Standard Charges
WCHS Website Charges Disclaimer
Pricing of medical expenses is dynamic and changes are made periodically. Actual cost to consumer is dependent on your healthcare coverage from Medicare, Medicaid, Insurance Coverage or other source. In addition you may receive separate bills for radiology or laboratory services for the service you receive. If you have any questions on your bill and/or coverage, please contact our business office at (307) 746-4491.
<p>Standard Charges Hospital Procedures
Service Area Px Code Procedure Description CPT(R)/HCPCS Code Fee Schedule Name Unit Price
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.113
HC/HH WCH SUPP PADDNG UNDRCST WEBRIL 3INX4YDS__2059
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.114
HC/HH WCH SUPP PADDNG UNDRCST WEBRIL 4X4__3175
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.115
HC/HH WCH SUPP PADDNG UNDRCST WEBRIL 6X4__3489
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.116
HC/HH WCH SUPP PATHODX DISPOSABLE S__R62070
WCH HB SUPPLY FEE SCHEDULE
138,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.117
HC/HH WCH SUPP PLASTER BANDAGE 2__7372
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.118
HC/HH WCH SUPP POROUS TAPE 1 INCH__5104
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.119
HC/HH WCH SUPP POROUS TAPE 2 INCH__5106
WCH HB SUPPLY FEE SCHEDULE
10,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.120
HC/HH WCH SUPP POROUS TAPE 3 INCH__5108
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.121
HC/HH WCH SUPP PUMP SET KANGAROO FLH__8884773600
WCH HB SUPPLY FEE SCHEDULE
16,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.122
HC/HH WCH SUPP QUICKVUE ONE-STEP HCG COMBO__00178
WCH HB SUPPLY FEE SCHEDULE
2,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.259.500
HC REF CRYOGLOBULIN S&P
82595
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.123
HC/HH WCH SUPP RAZOR NONSTERILE__KEND139083
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.124
HC/HH WCH SUPP RHINO ROCKET LARGE__11S-S0800-08AS
WCH HB SUPPLY FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.125
HC/HH WCH SUPP RHINO ROCKET MED__11S-S0500-08AS
WCH HB SUPPLY FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.126
HC/HH WCH SUPP RHINO ROCKET SMALL__11S-S0300-08AS
WCH HB SUPPLY FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.127
HC/HH WCH SUPP RIB BELT 6" FEMALE L__0814-1389
WCH HB SUPPLY FEE SCHEDULE
22,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.128
HC/HH WCH SUPP RIB BELT 6" FEMALE M__13780400
WCH HB SUPPLY FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.129
HC/HH WCH SUPP RIB BELT MALE SM__0814-1388
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.130
HC/HH WCH SUPP RIB BELT X LRG__89068
WCH HB SUPPLY FEE SCHEDULE
31,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.131
HC/HH WCH SUPP SAM SLING L__SL55662
WCH HB SUPPLY FEE SCHEDULE
72,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.132
HC/HH WCH SUPP SAM SLING M__SL556652
WCH HB SUPPLY FEE SCHEDULE
72,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.260.700
HC VIT B12 SERUM
82607
WCH HB LAB FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.133
HC/HH WCH SUPP SHOE/POST-OP/LARGE__18017
WCH HB SUPPLY FEE SCHEDULE
33,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.134
HC/HH WCH SUPP SHOE/POST-OP/MEDIUM__18015
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.135
HC/HH WCH SUPP SHOE/POST-OP/PEDIATR__117PEDB
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.136
HC/HH WCH SUPP SHOE/POST-OP/SMALL__18013
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.137
HC/HH WCH SUPP SHOE/POST-OP/X.LARGE__18018
WCH HB SUPPLY FEE SCHEDULE
36,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.138
HC/HH WCH SUPP SHOULDER IMMOB MED__8144503
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.139
HC/HH WCH SUPP SHOULDER IMMOB SM__8144502
WCH HB SUPPLY FEE SCHEDULE
25,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.140
HC/HH WCH SUPP SLING ARM ADULT SMALL__8140062
WCH HB SUPPLY FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.141
HC/HH WCH SUPP SLING ARM ADULT XL__8140065
WCH HB SUPPLY FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.142
HC/HH WCH SUPP SLING ARM PEDS XS__0814-0061
WCH HB SUPPLY FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.262.600
HC REF DHEA
82626
WCH HB LAB FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.143
HC/HH WCH SUPP SLING ARM UNIVERSAL ENVELOPE__0814-0015
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.144
HC/HH WCH SUPP SLING ARM W/FOAM LARGE__8141064
WCH HB SUPPLY FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.145
HC/HH WCH SUPP SLING ARM W/FOAM MED ADULT__08141063
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.146
HC/HH WCH SUPP SLIPPERS MEDIUM__80103
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.147
HC/HH WCH SUPP SM AIR WALKER__AW0400
WCH HB SUPPLY FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.148
HC/HH WCH SUPP SOL CLEANSER PERINEAL 8OZ__324509
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.149
HC/HH WCH SUPP SOL CLEANSER WOUND SHUR CLENS__121253
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.150
HC/HH WCH SUPP SPECIMEN TRAP__8884724500
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.151
HC/HH WCH SUPP SPIROMETER INCENTIVE__001902A
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.152
HC/HH WCH SUPP SPLINT CLAVICLE/SML__0814-1232
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.262.700
HC REF DHEA SULFATE
82627
WCH HB LAB FEE SCHEDULE
208,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.153
HC/HH WCH SUPP SPLINT COCKUP UNIV LT__1769-03
WCH HB SUPPLY FEE SCHEDULE
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.154
HC/HH WCH SUPP SPLINT COCKUP UNIV RT__1769-02
WCH HB SUPPLY FEE SCHEDULE
38,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.155
HC/HH WCH SUPP SPLINT ORTHO GLASS 3X35__OG-335PC
WCH HB SUPPLY FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.156
HC/HH WCH SUPP SPLINT ORTHO-GLASS 2X12__OG-2PC
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.157
HC/HH WCH SUPP SPLINT ORTHO-GLASS 4X30__OG-430PC
WCH HB SUPPLY FEE SCHEDULE
42,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.158
HC/HH WCH SUPP SPLINT ORTHO-GLASS 6X30__OG-6PC
WCH HB SUPPLY FEE SCHEDULE
86,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.159
HC/HH WCH SUPP SPRAY NO STING BARRIER__3346
WCH HB SUPPLY FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.160
HC/HH WCH SUPP STAX FINGER SPLINT #5.5__72246
WCH HB SUPPLY FEE SCHEDULE
15,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.161
HC/HH WCH SUPP STOCKINETTE BIAS 3IN__730
WCH HB SUPPLY FEE SCHEDULE
43,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.162
HC/HH WCH SUPP STOCKINETTE BIAS 4IN__740
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.265.200
HC REF VIT D1 25 DIHYDROXY W FRAC
82652
WCH HB LAB FEE SCHEDULE
292,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.163
HC/HH WCH SUPP STOCKINETTE BIAS 6IN__760
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.164
HC/HH WCH SUPP STOCKINETTE SYNTH 2__MS02
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.165
HC/HH WCH SUPP STOCKINETTE SYNTH 3__MS03
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.166
HC/HH WCH SUPP STOCKINETTE SYNTH 4__MS04
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.167
HC/HH WCH SUPP STRAP ARM PADDED L__0814-1314
WCH HB SUPPLY FEE SCHEDULE
50,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.168
HC/HH WCH SUPP STRAP ARM PADDED M__0814-1313
WCH HB SUPPLY FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.169
HC/HH WCH SUPP STRAP ARM PADDED S__8141312
WCH HB SUPPLY FEE SCHEDULE
15,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.170
HC/HH WCH SUPP STRAP ARM PADDED XL__0814-1315
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.171
HC/HH WCH SUPP STRAP MONTGOMERY__1583702
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.172
HC/HH WCH SUPP SUPPORT LUMBOSACRAL S__A818030
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.266.800
HC REF ERYTHROPOIETIN
82668
WCH HB LAB FEE SCHEDULE
225,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.173
HC/HH WCH SUPP SYRINGE ECC TIP 10CC__305482
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.174
HC/HH WCH SUPP TAPE CASTING 2" WHT__82002
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.175
HC/HH WCH SUPP TAPE CASTING 3" WHT__82003
WCH HB SUPPLY FEE SCHEDULE
23,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.176
HC/HH WCH SUPP TAPE CASTING 4" WHT__82004
WCH HB SUPPLY FEE SCHEDULE
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.177
HC/HH WCH SUPP TAPE CASTING 5" WHT__82005
WCH HB SUPPLY FEE SCHEDULE
17,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.178
HC/HH WCH SUPP TAPE CLOTH MEDIPORE 2X10__2962
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.179
HC/HH WCH SUPP TAPE PAPER MICROPORE .5INX10__1530-0
WCH HB SUPPLY FEE SCHEDULE
14,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.180
HC/HH WCH SUPP TAPE PAPER MICROPORE 2INX10__1530-2
WCH HB SUPPLY FEE SCHEDULE
14,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.181
HC/HH WCH SUPP TAPE PLASTIC TRANSPORE 1X10__1527-1
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.182
HC/HH WCH SUPP TAPE PLASTIC TRANSPORE 2X10__1527-2
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.267.000
HC ESTRADIOL
82670
WCH HB LAB FEE SCHEDULE
162,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.183
HC/HH WCH SUPP TEDS KNEE HI LG/REG__7203
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.184
HC/HH WCH SUPP TEDS KNEE HI MED/REG__7115
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.185
HC/HH WCH SUPP TEDS KNEE HI SM/REG__7071
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.186
HC/HH WCH SUPP TEDS THIGH HIGH LG/REG__3728LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.187
HC/HH WCH SUPP TEDS THIGH HIGH LG/SHORT__3634LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.188
HC/HH WCH SUPP TEDS THIGH HIGH LRG/LONG__3856LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.189
HC/HH WCH SUPP TEDS THIGH HIGH MED/LONG__3549LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.190
HC/HH WCH SUPP TEDS THIGH HIGH MED/REG__3416LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.191
HC/HH WCH SUPP TEDS THIGH HIGH MED/SHORT__3310LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.192
HC/HH WCH SUPP TEDS THIGH HIGH SM/LONG__3222LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.267.900
HC REF ASSAY OF ESTRONE
82679
WCH HB LAB FEE SCHEDULE
208,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.193
HC/HH WCH SUPP TEDS THIGH HIGH SM/REG__3130LF
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.194
HC/HH WCH SUPP TEDS THIGH HIGH SM/SHORT__3071LF
WCH HB SUPPLY FEE SCHEDULE
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.195
HC/HH WCH SUPP TENA PULL-UPS XLARGE__72412
WCH HB SUPPLY FEE SCHEDULE
17,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.196
HC/HH WCH SUPP TENA UNDERPAD 23X24 BLUE CHUX__354
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.204
HC/HH WCH SUPP TUBE CONNECTOR O2__1420
WCH HB SUPPLY FEE SCHEDULE
2,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.205
HC/HH WCH SUPP TUBIGRIP BANDAGE SZ D__1437
WCH HB SUPPLY FEE SCHEDULE
79,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.206
HC/HH WCH SUPP TUBIGRIP BANDAGE SZ E__1434
WCH HB SUPPLY FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.207
HC/HH WCH SUPP TUBING BAIR HUGGER FLUID__24110
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.208
HC/HH WCH SUPP TUBULAR BANDAGE SIZE__MTTG319
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.209
HC/HH WCH SUPP TUBULAR BANDAGE SZ 2__C15510220
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.032.003
HC REF ETHYLENE GLYCOL
82693
WCH HB LAB FEE SCHEDULE
167,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.210
HC/HH WCH SUPP TUBULAR DRESSING SZ 10__GL711
WCH HB SUPPLY FEE SCHEDULE
94,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.211
HC/HH WCH SUPP TUBULAR DRESSING SZ 1__GL701
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.212
HC/HH WCH SUPP TUBULAR DRESSING SZ 3__GL703
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.213
HC/HH WCH SUPP TUBULAR DRESSING SZ 4__GL704
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.214
HC/HH WCH SUPP UNIV EXTRI COLLAR AD__0814-9428
WCH HB SUPPLY FEE SCHEDULE
9,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.215
HC/HH WCH SUPP UNIV-EXTRI COLLAR PEDS__0814-9427
WCH HB SUPPLY FEE SCHEDULE
9,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.216
HC/HH WCH SUPP VALVE CLEARLINK LUER ACTIVATED__2N8399
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.217
HC/HH WCH SUPP VENTILATION CIRCUIT__L599-010
WCH HB SUPPLY FEE SCHEDULE
41,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.218
HC/HH WCH SUPP WARMER HEEL INFANT 4X4__11460-010T
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.219
HC/HH WCH SUPP WASHCLOTH PRE-MOISTENED__6599N
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.271.000
HC REF FECAL FAT QUANT
82710
WCH HB LAB FEE SCHEDULE
169,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.636.700
HC IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR
96367
WCH HB DEFAULT FEE SCHEDULE
175,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.220
HC/HH WCH SUPP WCHS MED/SUPPLY PICKUP
WCH HB SUPPLY FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.239
HC/HH WCH SUPP XLG AIR WALKER__AW1000BLK
WCH HB SUPPLY FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.240
HC/HH WCH SUPP XSM AIR WALKER__AW0200
WCH HB SUPPLY FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.241
HC/HH WCH SUPP YANKAUER SUCTION TIP__CFK82
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.715.000.001
HC/HH WCH SUPP GREEN CHUX__MSC282030LB
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.715.000.002
HC/HH WCH SUPP KNEE IMMOBILIZER 12__8142662
WCH HB SUPPLY FEE SCHEDULE
55,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.715.000.003
HC/HH WCH SUPP PATHODX STREP B GRP 60 TEST__R62031
WCH HB SUPPLY FEE SCHEDULE
73,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.001
HC/HH WCH SUPP SAFE-T-CENTESIS TRAY__PIG1260T
A4550
WCH HB SUPPLY FEE SCHEDULE
128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.002
HC/HH WCH SUPP SUTURE REMOVER KIT__723
A4649
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.003
HC/HH WCH SUPP GAUZE STERILE 4X4 TRAY (12PLY)__6939
A6402
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.272.800
HC FERRITIN
82728
WCH HB LAB FEE SCHEDULE
129,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.004
HC/HH WCH SUPP SPONGE STERILE 4X4 2PK__3033
A6402
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.005
HC/HH WCH SUPP BNDG CNFRM STRETCH ST 2X75__2231
A6442
WCH HB SUPPLY FEE SCHEDULE
3,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.006
HC/HH WCH SUPP CATH KIT CENTRAL VENOUS__M3720HKIC
C1751
WCH HB SUPPLY FEE SCHEDULE
130,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.007
HC/HH WCH SUPP 3M SURGICAL CLIPPER BLADE__9660
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.008
HC/HH WCH SUPP ADD A FOLEY TRAY__896300
WCH HB SUPPLY FEE SCHEDULE
89,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.009
HC/HH WCH SUPP ADHESIVE MASTISOL VIAL__0523-48
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.010
HC/HH WCH SUPP AIRWAY NASOPH 26FR__8888247023
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.011
HC/HH WCH SUPP AIRWAY NASOPH 28FR__8888247031
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.012
HC/HH WCH SUPP AIRWAY NASOPH 30FR__8888247049
WCH HB SUPPLY FEE SCHEDULE
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.013
HC/HH WCH SUPP AIRWAY NASOPH 32FR__8888247056
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.274.600
HC FOLATE SERUM
82746
WCH HB LAB FEE SCHEDULE
142,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.014
HC/HH WCH SUPP AIRWAY NASOPH 34FR__8888247064
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.015
HC/HH WCH SUPP ASPIRATOR MECONIUM__N0101
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.016
HC/HH WCH SUPP BAG URINE LEG DRAIN M__9645
WCH HB SUPPLY FEE SCHEDULE
49,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.017
HC/HH WCH SUPP BNDG CNFRM STRETCH ST 6X82__2238
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.018
HC/HH WCH SUPP BNDG COBAN 2 LAYER__2094
WCH HB SUPPLY FEE SCHEDULE
42,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.019
HC/HH WCH SUPP BNDG NON ADH 3X8__6115
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.020
HC/HH WCH SUPP BNDG PLASTER 3X3__7373
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.021
HC/HH WCH SUPP CATH FOLEY 14 FR 5CC__265714
WCH HB SUPPLY FEE SCHEDULE
39,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.022
HC/HH WCH SUPP CATH FOLEY 16FR 30CC__266716
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.023
HC/HH WCH SUPP CATH FOLEY 3WAY 30CC 22FR__0167V22S
WCH HB SUPPLY FEE SCHEDULE
14,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.278.400
HC REF CELIAC DIS SERLGY CASCADE IGA
82784
WCH HB LAB FEE SCHEDULE
96,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.024
HC/HH WCH SUPP CATH FOLEY SIL LX 5CC 12 FR__265712
WCH HB SUPPLY FEE SCHEDULE
20,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.025
HC/HH WCH SUPP CATH FOLEY SIL PED 10FR__165810
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.026
HC/HH WCH SUPP CATH FOLEY14 FR 30CC__266714
WCH HB SUPPLY FEE SCHEDULE
15,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.027
HC/HH WCH SUPP CATH FOLEY16 FR 5CC__265716
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.028
HC/HH WCH SUPP CATH FOLEY8 FR.3CC__165808
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.029
HC/HH WCH SUPP CATH SUCTION 10FR__31000
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.030
HC/HH WCH SUPP CATH SUCTION 14F STRAIGHT__31400
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.031
HC/HH WCH SUPP CATH-FOLEY 24FR 30CC__0166L 24
WCH HB SUPPLY FEE SCHEDULE
54,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.032
HC/HH WCH SUPP CATHETER DELEE 8FR MUCUS TRAP__8888257378
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.033
HC/HH WCH SUPP CATHETER THORACIC 12FR__8888570507
WCH HB SUPPLY FEE SCHEDULE
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.278.700
HC REF IGG SUBCLASSES EACH
82787
WCH HB LAB FEE SCHEDULE
260,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.034
HC/HH WCH SUPP CATHETER THORACIC 32FR__8888570556
WCH HB SUPPLY FEE SCHEDULE
35,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.035
HC/HH WCH SUPP CATHETER THORACIC 36FR__8888570564
WCH HB SUPPLY FEE SCHEDULE
35,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.036
HC/HH WCH SUPP CATHFOLEY-SUPRAPUBIC__DYND11782
WCH HB SUPPLY FEE SCHEDULE
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.037
HC/HH WCH SUPP COTTON BALLS UNSTERI__P159025
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.038
HC/HH WCH SUPP DRAIN PENROSE .25X12__20414-025
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.039
HC/HH WCH SUPP DRAIN PENROSE .5X12__20414-050
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.040
HC/HH WCH SUPP DRAIN PENROSE .75X12__20414-075
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.041
HC/HH WCH SUPP DRAPE SHEET 44X57 HALF__9358
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.042
HC/HH WCH SUPP DRESSING NON ADHESIVE 3X16__6114
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.043
HC/HH WCH SUPP DRSSING ADPTC ST NON-ADH 3X3__2012
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.280.300
HC BL GAS W O2 SAT CALCULATED LAB
82803
WCH HB LAB FEE SCHEDULE
202,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.044
HC/HH WCH SUPP DRSSING TEGADERM 2.38X2.75__1624W
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.045
HC/HH WCH SUPP DRSSING TEGADERM 4X4.75__1626W
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.046
HC/HH WCH SUPP DRSSNG COMBIDERM ACD 5X5__187725
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.047
HC/HH WCH SUPP DRSSNG COMBIDERM ACD 6X7__651027
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.048
HC/HH WCH SUPP DRSSNG COMBIDERM ACD 4X 4__651031
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.049
HC/HH WCH SUPP DRSSNG DUODERM 5.5 SQ__403327
WCH HB SUPPLY FEE SCHEDULE
25,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.050
HC/HH WCH SUPP DRSSNG TEGADERM FILM 4X4__90021
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.051
HC/HH WCH SUPP DRSSNG TELFA ST 3X4__2132
WCH HB SUPPLY FEE SCHEDULE
2,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.052
HC/HH WCH SUPP EZ-IO 25MM NEEDLE__9001
WCH HB SUPPLY FEE SCHEDULE
230,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.053
HC/HH WCH SUPP EZ-IO 45MM NEEDLE__9079
WCH HB SUPPLY FEE SCHEDULE
233,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.280.500
HC BL GAS W 02 SAT MEASURE RT
82805
WCH HB LAB FEE SCHEDULE
202,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.054
HC/HH WCH SUPP EZ-IO STABILIZER__9066
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.055
HC/HH WCH SUPP FOLEY CATH TRAY 16 F__899616
WCH HB SUPPLY FEE SCHEDULE
54,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.056
HC/HH WCH SUPP GAUZE PACKING IODOFORM 0.5IN__7832
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.057
HC/HH WCH SUPP GAUZE PACKING IODOFORM 1IN__7833
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.058
HC/HH WCH SUPP GAUZE PACKING PLAIN 0.5IN__7632
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.059
HC/HH WCH SUPP GAUZE PACKING PLAIN 1/4"__7631
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.060
HC/HH WCH SUPP GAUZE PACKING PLAIN 1IN__7633
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.061
HC/HH WCH SUPP GAUZE PACKING PLAIN 2IN__7634
WCH HB SUPPLY FEE SCHEDULE
36,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.062
HC/HH WCH SUPP GAUZE SPONGE STERILE 2X2__1806
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.063
HC/HH WCH SUPP GOWN SURG ST XL__9545
WCH HB SUPPLY FEE SCHEDULE
14,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.294.100
HC REF GASTRIN
82941
WCH HB LAB FEE SCHEDULE
138,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.064
HC/HH WCH SUPP GAUZE VASELINE 1X8
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.065
HC/HH WCH SUPP HUBER INF SET Y 19X1 12/BX__PMI191YS
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.066
HC/HH WCH SUPP INF SET HUBER 19X3/4__PMI193S
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.067
HC/HH WCH SUPP IODOFORM PACKING 1/4__7831AMD
WCH HB SUPPLY FEE SCHEDULE
20,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.068
HC/HH WCH SUPP IV CATHETER EXTENSION__2N8378
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.069
HC/HH WCH SUPP KING AIRWAY LT-D SIZE 3.0__KLTD203
WCH HB SUPPLY FEE SCHEDULE
106,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.070
HC/HH WCH SUPP NEEDLE BIOPSY 14GX6__2N2704X
WCH HB SUPPLY FEE SCHEDULE
53,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.071
HC/HH WCH SUPP NEEDLE BONE MARROW 15GX3__DIN1515X
WCH HB SUPPLY FEE SCHEDULE
43,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.072
HC/HH WCH SUPP NEEDLE SPINAL QUINCKE 22GX3.5__405181
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.073
HC/HH WCH SUPP NEEDLE SPINAL QUINCKE 26GX3.5__405164
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.294.500
HC GLUCOSE CSF OR BODY FLUID
82945
WCH HB LAB FEE SCHEDULE
128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.074
HC/HH WCH SUPP PAD ABDOMINAL 8X10__7198D
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.075
HC/HH WCH SUPP POOLE SUCTION INSTRU__0035040
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.076
HC/HH WCH SUPP POVIDONE-IODINE SWABSTICK__S41125
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.077
HC/HH WCH SUPP QUICKTRACH 4.0__120900040
WCH HB SUPPLY FEE SCHEDULE
317,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.078
HC/HH WCH SUPP RAZOR NST__139004
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.079
HC/HH WCH SUPP REMOVER STAPLE SKIN__ESPSX
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.080
HC/HH WCH SUPP SALEM SUMP TUBE/18FR__8888264986
WCH HB SUPPLY FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.081
HC/HH WCH SUPP SCALPEL PROTECTED BLADE #12__372612
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.082
HC/HH WCH SUPP SCALPEL PROTECTED BLADE #15__372615
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.083
HC/HH WCH SUPP SCALPEL PROTECTED DISP #10__372610
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.294.700
HC GLUCOSE
82947
WCH HB LAB FEE SCHEDULE
67,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.084
HC/HH WCH SUPP SCALPEL PROTECTED DISP #11__372611
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.085
HC/HH WCH SUPP SKIN STAPLER__ESPMW35
WCH HB SUPPLY FEE SCHEDULE
21,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.086
HC/HH WCH SUPP SOL IRRIGATION NS 0.9 1000ML__2F7124
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.087
HC/HH WCH SUPP SOL IRRIGATION NS 0.9 250ML__2F7122
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.088
HC/HH WCH SUPP SOL IRRIGATION WATER ST 250ML__2F7112
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.089
HC/HH WCH SUPP SOL SURG SCRUB PREVAIL__4VAIL
WCH HB SUPPLY FEE SCHEDULE
14,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.090
HC/HH WCH SUPP STAT PADZ__8900-4004
WCH HB SUPPLY FEE SCHEDULE
102,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.091
HC/HH WCH SUPP STOP COCK 3 WAY__2C6246
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.092
HC/HH WCH SUPP STYLET INTUBATING 14FR__85865
WCH HB SUPPLY FEE SCHEDULE
20,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.093
HC/HH WCH SUPP STYLET INTUBATING 6FR__85863
WCH HB SUPPLY FEE SCHEDULE
20,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.295.000
HC GLUCOSE TOLERANCE OB
82950
WCH HB LAB FEE SCHEDULE
50,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.636.800
HC IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS
96368
WCH HB DEFAULT FEE SCHEDULE
101,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.094
HC/HH WCH SUPP SUCTION CATH PEDS 8__30888
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.095
HC/HH WCH SUPP SUCTION TUBING__CFN510
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.096
HC/HH WCH SUPP SURGIFOAM__ET1972
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.097
HC/HH WCH SUPP SUTURE CHROMIC 4-0__G121H
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.098
HC/HH WCH SUPP SUTURE PROLENE 2-0__ET8423H
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.099
HC/HH WCH SUPP SUTURE PROLENE 3-0__ET8684G
WCH HB SUPPLY FEE SCHEDULE
17,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.100
HC/HH WCH SUPP SUTURE PROLENE 4-0__ET8683G
WCH HB SUPPLY FEE SCHEDULE
17,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.101
HC/HH WCH SUPP SUTURE PROLENE 5-0__ET8661G
WCH HB SUPPLY FEE SCHEDULE
17,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.102
HC/HH WCH SUPP SUTURE PROLENE 6-0__ET8680G
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.103
HC/HH WCH SUPP SYRINGE EAR/ULCER__4173
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.295.100
HC GTT 3 3HR GLUCOSE TOLERANCE
82951
WCH HB LAB FEE SCHEDULE
110,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.104
HC/HH WCH SUPP SYRINGE LUER LOK 10ML__309604
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.105
HC/HH WCH SUPP SYRINGE LUER LOK 20ML__309661
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.106
HC/HH WCH SUPP TAPE STERISTRIP .25X3__R1541
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.107
HC/HH WCH SUPP TAPE STERISTRIP .5X4__R1547
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.108
HC/HH WCH SUPP THORAC.CATH.24FR.16"__8888561050
WCH HB SUPPLY FEE SCHEDULE
59,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.109
HC/HH WCH SUPP TRACH TUBE CUFFED 3.5 MRPHY__5-10107
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.110
HC/HH WCH SUPP TRACH TUBE CUFFED 4.5 MRPHY__5-10109
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.111
HC/HH WCH SUPP TRACH TUBE CUFFED 7 MRPHY__5-10314
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.112
HC/HH WCH SUPP TRACH TUBE CUFFED 7.5__5-10315
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.113
HC/HH WCH SUPP TRACH TUBE CUFFED 8.0__5-10316
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.295.200
HC GLUC TOLERANCE ADDL >3 SPEC
82952
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.114
HC/HH WCH SUPP TRAY CATH IRRIGATION 70CC__750301
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.115
HC/HH WCH SUPP TRAY LUMBAR SAF-T-LP ADULT__4301CSP
WCH HB SUPPLY FEE SCHEDULE
57,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.116
HC/HH WCH SUPP TRAY LUMBAR SAFE-T-LP PEDS__4302CS
WCH HB SUPPLY FEE SCHEDULE
45,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.117
HC/HH WCH SUPP TUBE SALEM SUMP SENT 16FR 48__8888264960
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.118
HC/HH WCH SUPP TUBE TRACH HI LO 6.5 MRPHY TIP__86110
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.119
HC/HH WCH SUPP TUBE TRACH LO-PRO 3MM__86043
WCH HB SUPPLY FEE SCHEDULE
31,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.120
HC/HH WCH SUPP TUBE TRACH LO-PRO 4MM__86045
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.121
HC/HH WCH SUPP TUBE TRACH LO-PRO 5.5MM__86048
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.122
HC/HH WCH SUPP TUBE TRACH LO-PRO 5MM__86047
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.123
HC/HH WCH SUPP TUBE TRACH LO-PRO 6MM__86049
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.295.500
HC REF G 6 PD QN RC
82955
WCH HB LAB FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.124
HC/HH WCH SUPP TUBE TRACH LO-PRO 8.5MM__86054
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.125
HC/HH WCH SUPP TUBE TRACH LO-PRO 9MM__86055
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.126
HC/HH WCH SUPP TUBE TRACH UNCUFFED 2.5__86222
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.127
HC/HH WCH SUPP TUBE TRACH UNCUFFED 3.0__86223
WCH HB SUPPLY FEE SCHEDULE
10,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.128
HC/HH WCH SUPP TUBE TRACH UNCUFFED 3.5__86224
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.129
HC/HH WCH SUPP TUBE TRACH UNCUFFED 4.0__86464
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.130
HC/HH WCH SUPP TUBE TRACH UNCUFFED 5.0__86466
WCH HB SUPPLY FEE SCHEDULE
10,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.131
HC/HH WCH SUPP URINE DRAIN BAG 2000__154102
WCH HB SUPPLY FEE SCHEDULE
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.132
HC/HH WCH SUPP VICRYL 4-0__ETJ496G
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.725.000.133
HC/HH WCH SUPP WOUND CLOSURE TRAY__756
WCH HB SUPPLY FEE SCHEDULE
31,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.297.700
HC GAMMA GT (GTT)
82977
WCH HB LAB FEE SCHEDULE
39,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.745.000.001
HC/HH WCH SUPP KNEE IMMOBILIZER 14"__E200010
WCH HB SUPPLY FEE SCHEDULE
106,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.745.000.002
HC/HH WCH SUPP PADDING CAST ST 6IN__23626-560
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.505.000.001
HC/HH WCH SUPP NEEDLE ASPIRATION 16GA__8881245164
WCH HB SUPPLY FEE SCHEDULE
18,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.505.000.002
HC/HH WCH SUPP IV CATH 22GA__4252519-02
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.000.300
HC PT MAINTENANCE
WCH HB DEFAULT FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.009.900.002
HC WCH LEGAL BLOOD DRAW
99000
WCH HB DEFAULT FEE SCHEDULE
25,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.298.500
HC REF FRUCTOSAMINE
82985
WCH HB LAB FEE SCHEDULE
59,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.300.100
HC FSH
83001
WCH HB LAB FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.300.200
HC REF LUTEINZINE HORMONE (LH)
83002
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.300.300
HC REF GROWTH HORMONE
83003
WCH HB LAB FEE SCHEDULE
141,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.301.000
HC REF HAPTOGLOBIN
83010
WCH HB LAB FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.217.501
HC REF ARSENIC, 24 HOUR, URINE
82175
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.637.200
HC THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM
96372
WCH HB DEFAULT FEE SCHEDULE
64,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.302.000
HC REF HEMOGLOBIN ELECTROPHORESIS (HGB E)
83020
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.303.600
HC HEMOGLOBIN A1C
83036
WCH HB LAB FEE SCHEDULE
83,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.307.000
HC REF HEMOSIDERIN U
83070
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.309.000
HC ASSAY, HOMOCYSTINE
83090
WCH HB LAB FEE SCHEDULE
187,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.349.700
HC REF QUANT 5HIAA
83497
WCH HB LAB FEE SCHEDULE
153,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.349.800
HC REF 18 HYDROXYPROGESTERONE
83498
WCH HB LAB FEE SCHEDULE
210,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.351.600
HC GLIADIN AB OR IGG OR IGM
83516
WCH HB LAB FEE SCHEDULE
117,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.351.900
HC REF PARANEOPLASTIC (V-G) K+ CHNL
83519
WCH HB LAB FEE SCHEDULE
175,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.352.000
HC REF GLOMERULAR BASEMNT MEMBRANE AB
83520
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.352.500
HC REF INSULIN
83525
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.637.400
HC THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG
96374
WCH HB DEFAULT FEE SCHEDULE
200,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.354.000
HC IRON SERUM
83540
WCH HB LAB FEE SCHEDULE
51,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.355.000
HC IRON BIND SERUM
83550
WCH HB LAB FEE SCHEDULE
66,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.360.500
HC LACTIC ACID
83605
WCH HB LAB FEE SCHEDULE
116,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.361.500
HC LDH
83615
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.362.500
HC REF LDH ISOENZYMES S
83625
WCH HB LAB FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.365.500
HC HEAVY METAL LEAD WB
83655
WCH HB LAB FEE SCHEDULE
97,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.369.000
HC LIPASE
83690
WCH HB LAB FEE SCHEDULE
88,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.371.800
HC HDL HIGH DENS LIPOPROTEIN
83718
WCH HB LAB FEE SCHEDULE
74,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.372.100
HC DIRECT LDL CHOLESTEROL
83721
WCH HB LAB FEE SCHEDULE
77,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.373.500
HC MAGNESIUM
83735
WCH HB LAB FEE SCHEDULE
61,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.637.500
HC THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG
96375
WCH HB DEFAULT FEE SCHEDULE
142,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.383.500
HC REF METANEPRINES
83835
WCH HB LAB FEE SCHEDULE
234,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.387.400
HC MYOGLOBIN
83874
WCH HB LAB FEE SCHEDULE
137,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.388.000
HC BNP B-TYPE NATRIUETIC PEPTIDE
83880
WCH HB LAB FEE SCHEDULE
279,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.392.100
HC REF METHYLMALONIC ACID SERUM
83921
WCH HB LAB FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.393.000
HC OSMOLARITY SERUM
83930
WCH HB LAB FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.393.500
HC OSMOLARITY URINE
83935
WCH HB LAB FEE SCHEDULE
78,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.394.500
HC REF OXALATE URINE (SAT 24)
83945
WCH HB LAB FEE SCHEDULE
105,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.397.000
HC ASSAY, PARATHORMONE
83970
WCH HB LAB FEE SCHEDULE
286,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.398.600
HC PH-BODY FLUID (P-METRIC)
83986
WCH HB LAB FEE SCHEDULE
56,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.407.500
HC ALK PHOSPHOTASE
84075
WCH HB LAB FEE SCHEDULE
38,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.637.600
HC THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC
96376
WCH HB DEFAULT FEE SCHEDULE
126,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.408.000
HC REF ALK PHOSPHATASE ISOENZYME
84080
WCH HB LAB FEE SCHEDULE
135,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.410.000
HC PHOSPHORUS
84100
WCH HB LAB FEE SCHEDULE
45,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.410.500
HC PHOS URINE
84105
WCH HB LAB FEE SCHEDULE
50,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.411.000
HC ASSAY OF PORPHOBLINOGEN
84110
WCH HB LAB FEE SCHEDULE
91,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.413.200
HC POTASSIUM SERUM PLASMA WB
84132
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.413.300
HC POTASSIUM URINE
84133
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.413.400
HC PREALBUMIN
84134
WCH HB LAB FEE SCHEDULE
111,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.414.400
HC PROGESTERONE
84144
WCH HB LAB FEE SCHEDULE
196,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.414.600
HC PROLACTIN
84146
WCH HB LAB FEE SCHEDULE
157,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.300
HC PSA DIAGNOSTIC
84153
WCH HB DEFAULT FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.300
HC PSA DIAGNOSTIC
84153
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.009.900.100
HC HANDLING OR CONVEYANCE SPEC
99001
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.400
HC REF PROSTATE SPECIFIC ANTIGEN (PSA-FREE)
84154
WCH HB LAB FEE SCHEDULE
126,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.500
HC TOTAL PROTEIN SERUM PLASMA WB
84155
WCH HB LAB FEE SCHEDULE
111,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.600
HC PROTEIN-QUANT URINE
84156
WCH HB LAB FEE SCHEDULE
62,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.700
HC ASSAY, PROTEIN, OTHER SOURCE, TOTAL
84157
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.416.500
HC E-PHORESIS-PROTEIN
84165
WCH HB LAB FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.416.600
HC ELP-UA
84166
WCH HB LAB FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.420.700
HC REF VITAMIN B6 PLASMA
84207
WCH HB LAB FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.424.400
HC REF RENIN ACTIVITY
84244
WCH HB LAB FEE SCHEDULE
216,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.427.000
HC REF SEX HORMONE BINDING GLOBULIN
84270
WCH HB LAB FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.429.500
HC SODIUM SERUM PLASMA WB
84295
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.004.800
HC BMP W TOTAL CALCIUM PANEL
80048
WCH HB DEFAULT FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.004.800
HC BMP W TOTAL CALCIUM PANEL
80048
WCH HB LAB FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.430.000
HC SODIUM URINE
84300
WCH HB LAB FEE SCHEDULE
45,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.430.200
HC SODIUM OTHER SOURCE
84302
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.430.500
HC REF ASSAY OF SOMATOMEDIN
84305
WCH HB LAB FEE SCHEDULE
274,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.431.500
HC SPECIFIC GRAVITY EXCEPT URINE
84315
WCH HB LAB FEE SCHEDULE
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.440.300
HC TESTOSTERONE TOTAL
84403
WCH HB LAB FEE SCHEDULE
169,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.442.500
HC REF THIAMINE
84425
WCH HB LAB FEE SCHEDULE
192,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.443.200
HC REF THYROGLOBULIN TUMOR MARKER
84432
WCH HB LAB FEE SCHEDULE
173,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.443.600
HC ASSAY, TRUE THYROXINE
84436
WCH HB LAB FEE SCHEDULE
61,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.443.900
HC FREE T 4
84439
WCH HB LAB FEE SCHEDULE
106,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.444.300
HC TSH
84443
WCH HB DEFAULT FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.005.100
HC ELECTROLYTE PANEL
80051
WCH HB LAB FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.444.500
HC REF THYROID STIMULATING IMMUNE GLOBULINS
84445
WCH HB LAB FEE SCHEDULE
458,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.444.600
HC REF VITAMIN E (TODOPHEROL ALPHA)
84446
WCH HB LAB FEE SCHEDULE
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.445.000
HC SGOT AST
84450
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.446.000
HC SGPT ALT
84460
WCH HB LAB FEE SCHEDULE
2,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.446.600
HC REF TRANSFERRIN
84466
WCH HB LAB FEE SCHEDULE
143,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.447.800
HC VAP CHOLESTEROL TRIGLYCERIDES
84478
WCH HB DEFAULT FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.447.800
HC VAP CHOLESTEROL TRIGLYCERIDES
84478
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.448.000
HC REF T-3 TRIIODOTHYRONINE TOTAL
84480
WCH HB LAB FEE SCHEDULE
187,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.448.100
HC T3 TRIIODOTHYRONINE FREE
84481
WCH HB LAB FEE SCHEDULE
199,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.448.200
HC REF T3 TEIODOTHYRONINE REVERSE
84482
WCH HB LAB FEE SCHEDULE
188,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.448.400
HC TROPONIN I
84484
WCH HB LAB FEE SCHEDULE
97,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.005.300
HC CMP COMPREHENSIVE METABOLIC
80053
WCH HB LAB FEE SCHEDULE
142,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.110.000.100
HC ROOM PRIVATE W TELE
WCH HB DEFAULT FEE SCHEDULE
2.041,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.452.000
HC BUN
84520
WCH HB LAB FEE SCHEDULE
64,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.454.000
HC UREA N URINE
84540
WCH HB LAB FEE SCHEDULE
66,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.455.000
HC URIC ACID BLOOD
84550
WCH HB LAB FEE SCHEDULE
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.456.000
HC ASSAY OF URINE/URIC ACID
84560
WCH HB LAB FEE SCHEDULE
64,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.458.500
HC REF VANILLYMANDELIC AC
84585
WCH HB LAB FEE SCHEDULE
180,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.458.800
HC REF ARGININE VASOPRESSIN
84588
WCH HB LAB FEE SCHEDULE
334,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.459.000
HC REF VITAMIN A SERUM
84590
WCH HB LAB FEE SCHEDULE
180,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.463.000
HC ASSAY OF ZINC
84630
WCH HB LAB FEE SCHEDULE
152,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.468.100
HC REF C PEPTIDE
84681
WCH HB LAB FEE SCHEDULE
227,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.470.200
HC HCG QUANT PREG TEST
84702
WCH HB LAB FEE SCHEDULE
152,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.005.500
HC OB PANEL
80055
WCH HB LAB FEE SCHEDULE
299,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.470.300
HC HCG QUAL PREG TEST
84703
WCH HB LAB FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.499.900
HC REF OSMOLALITY STOOL
84999
WCH HB LAB FEE SCHEDULE
35,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.600.300
HC REF FOOD PANEL
86003
WCH HB LAB FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.603.800
HC ANTI NUCLEAR AB
86038
WCH HB LAB FEE SCHEDULE
116,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.603.900
HC FANA TITER
86039
WCH HB LAB FEE SCHEDULE
116,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.606.000
HC STREPZT
86060
WCH HB LAB FEE SCHEDULE
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.614.100
HC CRPQ C REATIVE PROTEIN
86141
WCH HB LAB FEE SCHEDULE
94,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.615.700
HC REF COLD AGGLUTININS TITER
86157
WCH HB LAB FEE SCHEDULE
146,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.616.000
HC COMPLEMENT 3 ANTIGEN
86160
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.616.200
HC REF CH 50 COMPLEMENT
86162
WCH HB LAB FEE SCHEDULE
225,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.006.100
HC LIPID PANEL CHOL TGL LDL HDL
80061
WCH HB LAB FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.620.000
HC REF CYCLIC CITRULLINATED PEPTIDE (CCP)
86200
WCH HB LAB FEE SCHEDULE
153,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.621.500
HC REF DEOXYRIBONUCLEASE ANTIBODY
86215
WCH HB LAB FEE SCHEDULE
157,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.622.500
HC REF DNA ANTIBODY, NATIVE/DOUBLE STRAND
86225
WCH HB LAB FEE SCHEDULE
156,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.623.500
HC REF EXTRACTABLE NUCLEAR AG EACH AB
86235
WCH HB LAB FEE SCHEDULE
138,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.625.500
HC REF CYTOPLASMIC NEUTROPHIL AB
86255
WCH HB LAB FEE SCHEDULE
128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.625.600
HC REF FLORESCENT ANTIBODY TITER; EACH
86256
WCH HB LAB FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.630.000
HC IMMUNOASSAY, TUMOR, CA 15-4
86300
WCH HB LAB FEE SCHEDULE
189,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.630.100
HC REF IMMUNOASSAY, TUMOR, CA 19-9
86301
WCH HB LAB FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.630.400
HC CANCER ANTIGEN 125
86304
WCH HB LAB FEE SCHEDULE
189,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.630.800
HC MONO HETEROPHILE SCR
86308
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.006.900
HC RENAL FUNCTION PANEL
80069
WCH HB LAB FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.631.600
HC REF CHROMOGRANIN A
86316
WCH HB LAB FEE SCHEDULE
239,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.633.400
HC REF IMMUNOFIXATION ELECTROPHORESIS
86334
WCH HB LAB FEE SCHEDULE
206,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.633.500
HC REF IMMUNOFIXATION, URINE
86335
WCH HB LAB FEE SCHEDULE
206,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.633.700
HC REF INSULIN ANTIBODIES
86337
WCH HB LAB FEE SCHEDULE
240,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.634.100
HC REF ISLET CELL ANTIBODY
86341
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.637.600
HC THYROID ANTIBODIES
86376
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.643.000
HC RA QUAL
86430
WCH HB LAB FEE SCHEDULE
63,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.643.100
HC RA QUAN
86431
WCH HB LAB FEE SCHEDULE
66,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.648.000
HC TB GOLD
86480
WCH HB LAB FEE SCHEDULE
210,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.659.200
HC RPR
86592
WCH HB LAB FEE SCHEDULE
47,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.007.400
HC HEPATITIS ACUTE PANEL
80074
WCH HB LAB FEE SCHEDULE
336,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.661.800
HC REF LYME CNS INEFECTION IGG WITH ANTIBODY INDEX REFLEX
86618
WCH HB LAB FEE SCHEDULE
162,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.662.200
HC REF BRUCELLA AB IGG OR IGM
86622
WCH HB LAB FEE SCHEDULE
98,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.663.100
HC CHLAMYDIA ANTIBODY
86631
WCH HB LAB FEE SCHEDULE
101,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.663.200
HC REF CHLAMYDIA IGG EACH SPECIES
86632
WCH HB LAB FEE SCHEDULE
128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.663.500
HC REF COCCIDIOIDES AB
86635
WCH HB LAB FEE SCHEDULE
146,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.663.800
HC REF Q FEVER AB IGG OR IGM
86638
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.664.400
HC REF CYTOMEGALOVIRUS (CMV)
86644
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.664.500
HC REF CMV (CYTOMEGALOVIRIS) IGM
86645
WCH HB LAB FEE SCHEDULE
167,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.665.800
HC REF ECHOVIRUS SEROTYPES EACH
86658
WCH HB LAB FEE SCHEDULE
318,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.666.400
HC REF EBSTEIN-BARR VIRUS:NUCLEAR ANTIGEN
86664
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.007.600
HC HEPATIC FUNCTION PANEL
80076
WCH HB LAB FEE SCHEDULE
105,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.667.700
HC HELIOBACTER PYLORI AB
86677
WCH HB LAB FEE SCHEDULE
168,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.669.500
HC REF HERPES SIMPLEX TYPE 1
86695
WCH HB LAB FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.669.600
HC HERPES SIMPLEX TYPE 3
86696
WCH HB LAB FEE SCHEDULE
143,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.300
HC HIV I & II
86703
WCH HB LAB FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.400
HC REF HBC TOTAL AB
86704
WCH HB LAB FEE SCHEDULE
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.500
HC HEPATITIS B CORE ANTI-BODY IGM
86705
WCH HB LAB FEE SCHEDULE
124,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.600
HC HBS AB
86706
WCH HB LAB FEE SCHEDULE
101,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.700
HC REF HEPATITIS BE ANTIBODY
86707
WCH HB LAB FEE SCHEDULE
112,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.800
HC REF HEP A ANTIBODY IGG
86708
WCH HB LAB FEE SCHEDULE
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.670.900
HC HAV IGM
86709
WCH HB LAB FEE SCHEDULE
116,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.015.600
HC CARBAMAZEPINE
80156
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.671.300
HC REF LEGIONELLA TITER
86713
WCH HB LAB FEE SCHEDULE
157,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.672.000
HC REF LEPTOSPIRA ANTIBODY
86720
WCH HB LAB FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.673.500
HC MUMPS
86735
WCH HB LAB FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.676.200
HC RUBELLA
86762
WCH HB LAB FEE SCHEDULE
78,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.676.500
HC RUBEOLA
86765
WCH HB LAB FEE SCHEDULE
156,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.677.700
HC REF TORCH PROFILE IGG TOXOPLASMA
86777
WCH HB LAB FEE SCHEDULE
124,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.678.700
HC VARICELLA ZOSTER AB IGM
86787
WCH HB LAB FEE SCHEDULE
134,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.678.800
HC WEST NILE VIRUS IGM
86788
WCH HB LAB FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.678.900
HC REF WEST NILE VIRUS IGG
86789
WCH HB LAB FEE SCHEDULE
141,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.679.000
HC REF DENGUE FEVER AB IGG OR IGM
86790
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.015.800
HC CYCLOSPORINE
80158
WCH HB LAB FEE SCHEDULE
127,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.680.000
HC REF THYROGLOBULIN AB SCRN
86800
WCH HB LAB FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.680.300
HC HCV AB
86803
WCH HB LAB FEE SCHEDULE
160,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.681.200
HC REF HLA B27 RL
86812
WCH HB LAB FEE SCHEDULE
228,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.500.700
HC BL COUNT W MANUAL DIFF WBC CT
85007
WCH HB LAB FEE SCHEDULE
39,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.501.400
HC HEMATOCRIT
85014
WCH HB LAB FEE SCHEDULE
35,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.501.800
HC HEMOGLOBIN
85018
WCH HB LAB FEE SCHEDULE
35,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.502.500
HC COMPLETE BL COUNT W DIFF AUTO
85025
WCH HB LAB FEE SCHEDULE
97,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.502.700
HC COMPLETE BL COUNT AUTOMATED
85027
WCH HB LAB FEE SCHEDULE
71,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.504.800
HC WBC WHITE BLOOD COUNT
85048
WCH HB LAB FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.504.900
HC PLATELET CT
85049
WCH HB LAB FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.016.200
HC DIGOXIN TOTAL
80162
WCH HB LAB FEE SCHEDULE
115,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.526.000
HC REF COAG FACTOR X ASSAY, P (MAYO)
85260
WCH HB LAB FEE SCHEDULE
223,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.530.000
HC REF ANTITHROMBIN III
85300
WCH HB LAB FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.530.300
HC REF PROTEIN C FUNCTIONAL
85303
WCH HB LAB FEE SCHEDULE
212,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.530.500
HC REF PROTEIN S TOTAL
85305
WCH HB LAB FEE SCHEDULE
216,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.530.600
HC REF PROTEIN S ACTIVITY PLASMA
85306
WCH HB LAB FEE SCHEDULE
223,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.530.700
HC REF ASSAY ACTIVIATED PROTEIN C
85307
WCH HB LAB FEE SCHEDULE
195,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.537.900
HC D DIMER
85379
WCH HB LAB FEE SCHEDULE
154,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.538.400
HC FIBRINOGEN
85384
WCH HB LAB FEE SCHEDULE
97,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.546.100
HC FETAL SCREEN
85461
WCH HB LAB FEE SCHEDULE
83,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.552.000
HC HEPARIN ANTI XA
85520
WCH HB LAB FEE SCHEDULE
158,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.016.400
HC VALPROIC ACID TOTAL
80164
WCH HB LAB FEE SCHEDULE
137,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.561.000
HC REF PROTHROMBIN TIME (PT),P (MAYO) PROCT PANEL
85610
WCH HB LAB FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.561.300
HC REF RUSSELL VIPER VENOM, DILUTED
85613
WCH HB LAB FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.565.200
HC WESTERGREN ESR
85652
WCH HB LAB FEE SCHEDULE
51,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.566.000
HC REF SICKLE CELL TEST
85660
WCH HB LAB FEE SCHEDULE
53,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.567.000
HC THROMBIN TIME, PLASMA
85670
WCH HB LAB FEE SCHEDULE
72,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.573.000
HC PTT
85730
WCH HB LAB FEE SCHEDULE
73,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.701.500
HC REF CYCLOSPORA SPECIES DETECT CONC
87015
WCH HB LAB FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.704.000
HC CULTURE BACT BLD AER ANAER
87040
WCH HB DEFAULT FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.704.000
HC CULTURE BACT BLD AER ANAER
87040
WCH HB LAB FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.704.500
HC FECAL CULTURE
87045
WCH HB DEFAULT FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.704.500
HC FECAL CULTURE
87045
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.704.600
HC CAMPYLOBACTER
87046
WCH HB LAB FEE SCHEDULE
77,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.016.800
HC REF ETHOSUXIMIDE
80168
WCH HB LAB FEE SCHEDULE
134,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.110.000.200
HC ROOM PRIVATE
WCH HB DEFAULT FEE SCHEDULE
1.588,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.707.500
HC CULTURE ANAEROBIC ANY SOURCE
87075
WCH HB LAB FEE SCHEDULE
124,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.707.600
HC ANAEROBE ID
87076
WCH HB LAB FEE SCHEDULE
87,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.707.700
HC BACTERIAL ID
87077
WCH HB DEFAULT FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.707.700
HC BACTERIAL ID
87077
WCH HB LAB FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.708.100
HC CULTURE SCREENING
87081
WCH HB LAB FEE SCHEDULE
121,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.708.800
HC URINE CULTURE
87088
WCH HB LAB FEE SCHEDULE
77,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.710.100
HC FNG DERMAT CULTURE FUNGI
87101
WCH HB LAB FEE SCHEDULE
72,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.710.200
HC FUNGAL CULTURE
87102
WCH HB LAB FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.711.600
HC REF ACID FAST CULTURE AFBX
87116
WCH HB LAB FEE SCHEDULE
93,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.714.700
HC SEROTYPE
87147
WCH HB LAB FEE SCHEDULE
51,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.716.900
HC MACRO WORM MACROSCOPIC PARASIT
87169
WCH HB LAB FEE SCHEDULE
51,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.017.000
HC GENTAMICIN
80170
WCH HB LAB FEE SCHEDULE
135,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.717.200
HC PINWORM PREP
87172
WCH HB LAB FEE SCHEDULE
51,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.717.700
HC REF OVA & PARASITE EXAMINATION
87177
WCH HB LAB FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.718.600
HC SUSCEPTABILITY AEROBIC MIC
87186
WCH HB LAB FEE SCHEDULE
99,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.720.500
HC DIRECT SMEAR ONLY
87205
WCH HB LAB FEE SCHEDULE
51,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.720.600
HC STAIN FLORESCENT ACID FAST
87206
WCH HB LAB FEE SCHEDULE
61,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.720.900
HC REF PARASITIC EXAMINATION SMEAR
87209
WCH HB LAB FEE SCHEDULE
197,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.721.000
HC WET MOUNT CERVICAL OR SKIN
87210
WCH HB LAB FEE SCHEDULE
45,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.725.200
HC VIRAL CULTURE
87252
WCH HB LAB FEE SCHEDULE
171,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.726.000
HC ADENOVIRUS DFA
87260
WCH HB LAB FEE SCHEDULE
79,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.727.500
HC INFLUENZA B DFA
87275
WCH HB LAB FEE SCHEDULE
79,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.017.100
HC REF DRUG SCREEN QUANTITATIVE GABOP
80171
WCH HB LAB FEE SCHEDULE
166,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.727.600
HC INFLUENZA A DFA
87276
WCH HB LAB FEE SCHEDULE
79,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.727.900
HC PARAINFLUENZA VIRUS ANY TYPE
87279
WCH HB LAB FEE SCHEDULE
79,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.728.000
HC RSV DFA
87280
WCH HB LAB FEE SCHEDULE
79,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.732.400
HC C DIFFICILE TOXIN
87324
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.733.800
HC REF STL FOR H PYLORI
87338
WCH HB LAB FEE SCHEDULE
204,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.734.000
HC REF HBS AG
87340
WCH HB LAB FEE SCHEDULE
63,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.738.500
HC REF HISTOPLASMA CAPSUL AG, EIA
87385
WCH HB LAB FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.742.000
HC RSV RESP SYNCTIAL VIRUS
87420
WCH HB LAB FEE SCHEDULE
103,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.742.500
HC ROTAVIR
87425
WCH HB LAB FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.744.900
HC STREP PNEUMO ANTIGEN URINE
87449
WCH HB LAB FEE SCHEDULE
74,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.017.500
HC LAMOTRIGINE LAMICTAL
80175
WCH HB LAB FEE SCHEDULE
86,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.748.600
HC C PNEUMONIAE BY PCR
87486
WCH HB LAB FEE SCHEDULE
91,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.749.100
HC REF CHLAMYDIA TRACHOMATIS-AMPLIFIED PROB
87491
WCH HB LAB FEE SCHEDULE
159,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.749.300
HC C DIFF AMPLIFIED PROBE
87493
WCH HB LAB FEE SCHEDULE
158,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.749.800
HC ENTEROVIRUS PCR CSF
87498
WCH HB LAB FEE SCHEDULE
368,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.750.700
HC GI PCR PANEL 12-25 TARGETS
87507
WCH HB LAB FEE SCHEDULE
1.058,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.751.700
HC REF HEPATITIS B, DNA, QUANT
87517
WCH HB LAB FEE SCHEDULE
240,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.752.200
HC REF HCV VIRAL LOAD
87522
WCH HB LAB FEE SCHEDULE
466,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.752.900
HC REF HSV BY RAPID PCR
87529
WCH HB LAB FEE SCHEDULE
178,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.753.600
HC REF HIV 1 RNA BY ULTRA SENS PCR Q
87536
WCH HB LAB FEE SCHEDULE
670,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.758.100
HC M PNEUMONIAE BY PCR
87581
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.017.800
HC LITHIUM
80178
WCH HB LAB FEE SCHEDULE
97,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.759.100
HC REF NEISSERIA GONORRHOEAE
87591
WCH HB LAB FEE SCHEDULE
161,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.763.300
HC RESP PANEL VIRUS BY PCR 12-25
87633
WCH HB LAB FEE SCHEDULE
681,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.779.800
HC B PERTUSSIS BY PCR
87798
WCH HB LAB FEE SCHEDULE
157,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.779.900
HC REF DETECT AGENT NOS, DNA, QUANT
87799
WCH HB LAB FEE SCHEDULE
193,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.780.400
HC INFLUENZA A&B WAIVED
87804
WCH HB LAB FEE SCHEDULE
77,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.788.000
HC STREP SCREEN GROUP A WAIVED
87880
WCH HB LAB FEE SCHEDULE
83,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.789.900
HC INFECT AGENT BY IA DIRECT OBS
87899
WCH HB LAB FEE SCHEDULE
77,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.790.200
HC REF HCV GENOTYPE
87902
WCH HB LAB FEE SCHEDULE
870,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.100.100
HC URINE AUTO WITH MICRO
81001
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.100.200
HC URINE DIP POC
81002
WCH HB LAB FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.018.300
HC REF OXCARBAZEPINE METABOLITE (MHC)
80183
WCH HB LAB FEE SCHEDULE
142,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.100.300
HC URINE AUTO WO MICRO WAIVED
81003
WCH HB DEFAULT FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.100.300
HC URINE AUTO WO MICRO WAIVED
81003
WCH HB LAB FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.101.500
HC URINE MICROSCOPIC ONLY
81015
WCH HB LAB FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.102.500
HC HCG URINE WAIVED
81025
WCH HB DEFAULT FEE SCHEDULE
76,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.102.500
HC HCG URINE WAIVED
81025
WCH HB LAB FEE SCHEDULE
76,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.109.900
HC DRUG SCREEN COLLECTION ONLY
81099
WCH HB LAB FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.118.818.400
HC FIRST MARKER
88184
WCH HB LAB FEE SCHEDULE
312,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.118.818.500
HC ADDITIONAL MARKER
88185
WCH HB LAB FEE SCHEDULE
236,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.010.000
HC RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
70100
WCH HB DEFAULT FEE SCHEDULE
130,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.011.000
HC RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS
70110
WCH HB DEFAULT FEE SCHEDULE
366,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.014.000
HC RADEX FACIAL BONES < 3 VIEWS
70140
WCH HB DEFAULT FEE SCHEDULE
173,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.015.000
HC RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS
70150
WCH HB DEFAULT FEE SCHEDULE
394,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.018.400
HC PHENOBARB
80184
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.016.000
HC RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS
70160
WCH HB DEFAULT FEE SCHEDULE
128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.020.000
HC RADEX ORBITS COMPLETE MINIMUM 4 VIEWS
70200
WCH HB DEFAULT FEE SCHEDULE
196,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.021.000
HC RADEX SINUSES PARANASAL <3 VIEWS
70210
WCH HB DEFAULT FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.022.000
HC RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS
70220
WCH HB DEFAULT FEE SCHEDULE
246,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.025.000
HC RADIOLOGIC EXAMINATION SKULL 4/> VIEWS
70250
WCH HB DEFAULT FEE SCHEDULE
173,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.026.000
HC RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
70260
WCH HB DEFAULT FEE SCHEDULE
246,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.033.000
HC RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT
70330
WCH HB DEFAULT FEE SCHEDULE
259,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.036.000
HC RADIOLOGIC EXAMINATION NECK SOFT TISSUE
70360
WCH HB DEFAULT FEE SCHEDULE
144,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.110.000
HC RADEX RIBS UNILATERAL 2 VIEWS
71100
WCH HB DEFAULT FEE SCHEDULE
172,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.110.100
HC RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS
71101
WCH HB DEFAULT FEE SCHEDULE
358,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.018.500
HC PHENYTOIN
80185
WCH HB LAB FEE SCHEDULE
110,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.111.000
HC RADEX RIBS BILATERAL 3 VIEWS
71110
WCH HB DEFAULT FEE SCHEDULE
226,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.111.100
HC RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS
71111
WCH HB DEFAULT FEE SCHEDULE
259,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.112.000
HC RADEX STERNUM MINIMUM 2 VIEWS
71120
WCH HB DEFAULT FEE SCHEDULE
177,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.113.000
HC RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS
71130
WCH HB DEFAULT FEE SCHEDULE
196,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.202.000
HC RADEX SPINE 1 VIEW SPECIFY LEVEL
72020
WCH HB DEFAULT FEE SCHEDULE
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.204.000
HC RADEX SPINE CERVICAL 2 OR 3 VIEWS
72040
WCH HB DEFAULT FEE SCHEDULE
315,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.205.000
HC RADEX SPINE CERVICAL 4 OR 5 VIEWS
72050
WCH HB DEFAULT FEE SCHEDULE
447,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.205.200
HC RADEX SPINE CERVICAL 6 OR MORE VIEWS
72052
WCH HB DEFAULT FEE SCHEDULE
625,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.207.000
HC RADEX SPINE THORACIC 2 VIEWS
72070
WCH HB DEFAULT FEE SCHEDULE
330,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.207.200
HC RADEX SPINE THORACIC 3 VIEWS
72072
WCH HB DEFAULT FEE SCHEDULE
403,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.018.600
HC REF PHENYTOIN DILANTIN FREE
80186
WCH HB LAB FEE SCHEDULE
117,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.208.000
HC RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS
72080
WCH HB DEFAULT FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.208.100
HC RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW
72081
WCH HB DEFAULT FEE SCHEDULE
205,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.208.200
HC RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW
72082
WCH HB DEFAULT FEE SCHEDULE
328,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.210.000
HC RADEX SPINE LUMBOSACRAL 2/3 VIEWS
72100
WCH HB DEFAULT FEE SCHEDULE
412,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.217.000
HC RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
72170
WCH HB DEFAULT FEE SCHEDULE
267,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.219.000
HC RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
72190
WCH HB DEFAULT FEE SCHEDULE
219,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.220.200
HC RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
72202
WCH HB DEFAULT FEE SCHEDULE
216,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.222.000
HC RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
72220
WCH HB DEFAULT FEE SCHEDULE
186,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.300.000
HC RADEX CLAVICLE COMPLETE
73000
WCH HB DEFAULT FEE SCHEDULE
263,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.301.000
HC RADEX SCAPULA COMPLETE
73010
WCH HB DEFAULT FEE SCHEDULE
349,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.018.800
HC REF ASSAY OF PRIMIDONE
80188
WCH HB LAB FEE SCHEDULE
137,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.302.000
HC RADEX SHOULDER 1 VIEW
73020
WCH HB DEFAULT FEE SCHEDULE
135,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.303.000
HC RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS
73030
WCH HB DEFAULT FEE SCHEDULE
340,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.305.000
HC RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ
73050
WCH HB DEFAULT FEE SCHEDULE
181,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.306.000
HC RADEX HUMERUS MINIMUM 2 VIEWS
73060
WCH HB DEFAULT FEE SCHEDULE
160,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.307.000
HC RADEX ELBOW 2 VIEWS
73070
WCH HB DEFAULT FEE SCHEDULE
134,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.308.000
HC RADEX ELBOW COMPLETE MINIMUM 3 VIEWS
73080
WCH HB DEFAULT FEE SCHEDULE
155,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.309.000
HC RADEX FOREARM 2 VIEWS
73090
WCH HB DEFAULT FEE SCHEDULE
137,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.309.200
HC RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS
73092
WCH HB DEFAULT FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.310.000
HC RADEX WRIST 2 VIEWS
73100
WCH HB DEFAULT FEE SCHEDULE
206,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.311.000
HC RADEX WRIST COMPLETE MINIMUM 3 VIEWS
73110
WCH HB DEFAULT FEE SCHEDULE
304,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.019.500
HC REF SIROLIMUS RAPAMUNE
80195
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.200.000.100
HC ROOM SEMI PRIVATE SWINGBED INTERMEDIATE
WCH HB DEFAULT FEE SCHEDULE
248,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.312.000
HC RADEX HAND 2 VIEWS
73120
WCH HB DEFAULT FEE SCHEDULE
126,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.313.000
HC RADEX HAND MINIMUM 3 VIEWS
73130
WCH HB DEFAULT FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.314.000
HC RADEX FINGR MINIMUM 2 VIEWS
73140
WCH HB DEFAULT FEE SCHEDULE
108,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.350.100
HC RADIOLOGIC EXAM, HIP W PELVIS WHEN PERFORMED, UNILATERAL, 1 VIEW
73501
WCH HB DEFAULT FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.350.200
HC RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
73502
WCH HB DEFAULT FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.355.200
HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
73552
WCH HB DEFAULT FEE SCHEDULE
310,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.356.000
HC RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
73560
WCH HB DEFAULT FEE SCHEDULE
305,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.356.200
HC RADIOLOGIC EXAMINATION KNEE 3 VIEWS
73562
WCH HB DEFAULT FEE SCHEDULE
368,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.356.400
HC RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
73564
WCH HB DEFAULT FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.356.500
HC RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
73565
WCH HB DEFAULT FEE SCHEDULE
202,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.019.700
HC REF TACROLIMUS FK506
80197
WCH HB LAB FEE SCHEDULE
152,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.359.000
HC RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
73590
WCH HB DEFAULT FEE SCHEDULE
280,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.359.200
HC RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS
73592
WCH HB DEFAULT FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.360.000
HC RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
73600
WCH HB DEFAULT FEE SCHEDULE
127,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.361.000
HC RADEX ANKLE COMPLETE MINIMUM 3 VIEWS
73610
WCH HB DEFAULT FEE SCHEDULE
295,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.362.000
HC RADIOLOGIC EXAMINATION FOOT 2 VIEWS
73620
WCH HB DEFAULT FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.363.000
HC RADEX FOOT COMPLETE MINIMUM 3 VIEWS
73630
WCH HB DEFAULT FEE SCHEDULE
316,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.365.000
HC RADEX CALCANEUS MINIMUM 2 VIEWS
73650
WCH HB DEFAULT FEE SCHEDULE
121,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.366.000
HC RADEX TOE MINIMUM 2 VIEWS
73660
WCH HB DEFAULT FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.402.200
HC RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH
74022
WCH HB DEFAULT FEE SCHEDULE
475,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.430.000
HC CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I
74300
WCH HB DEFAULT FEE SCHEDULE
326,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.019.800
HC THEOPHYLLINE
80198
WCH HB LAB FEE SCHEDULE
116,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.440.000
HC UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
74400
WCH HB DEFAULT FEE SCHEDULE
690,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.445.500
HC URETHROCYSTOGRAPHY VOIDING RS&I
74455
WCH HB DEFAULT FEE SCHEDULE
638,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.707.300
HC BONE LENGTH STUDIES
77073
WCH HB DEFAULT FEE SCHEDULE
202,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.707.400
HC RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED
77074
WCH HB DEFAULT FEE SCHEDULE
331,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.707.500
HC RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL
77075
WCH HB DEFAULT FEE SCHEDULE
332,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.707.600
HC RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT
77076
WCH HB DEFAULT FEE SCHEDULE
210,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.708.000
HC DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL
77080
WCH HB DEFAULT FEE SCHEDULE
505,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.417.858.000
HC PULMONARY PERFUSION IMAGING PARTICULATE
78580
WCH HB DEFAULT FEE SCHEDULE
1.125,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.507.638.000
HC CT LIMITED/LOCALIZED FOLLOW UP STUDY
76380
WCH HB DEFAULT FEE SCHEDULE
952,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.045.000
HC CT HEAD/BRAIN W/O CONTRAST MATERIAL
70450
WCH HB DEFAULT FEE SCHEDULE
2.048,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.020.000
HC TOBRAMYCIN
80200
WCH HB LAB FEE SCHEDULE
123,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.046.000
HC CT HEAD/BRAIN W/CONTRAST MATERIAL
70460
WCH HB DEFAULT FEE SCHEDULE
1.404,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.047.000
HC CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
70470
WCH HB DEFAULT FEE SCHEDULE
2.326,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.048.000
HC CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL
70480
WCH HB DEFAULT FEE SCHEDULE
1.389,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.048.100
HC CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL
70481
WCH HB DEFAULT FEE SCHEDULE
1.532,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.048.200
HC CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR
70482
WCH HB DEFAULT FEE SCHEDULE
1.834,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.048.600
HC CT MAXILLOFACIAL W/O CONTRAST MATERIAL
70486
WCH HB DEFAULT FEE SCHEDULE
1.759,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.048.700
HC CT MAXILLOFACIAL W/CONTRAST MATERIAL
70487
WCH HB DEFAULT FEE SCHEDULE
1.496,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.048.800
HC CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL
70488
WCH HB DEFAULT FEE SCHEDULE
1.806,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.049.000
HC CT SOFT TISSUE NECK W/O CONTRAST MATERIAL
70490
WCH HB DEFAULT FEE SCHEDULE
2.042,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.049.100
HC CT SOFT TISSUE NECK W/CONTRAST MATERIAL
70491
WCH HB DEFAULT FEE SCHEDULE
1.515,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.020.100
HC REF TOPIRAMATE
80201
WCH HB LAB FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.049.200
HC CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL
70492
WCH HB DEFAULT FEE SCHEDULE
1.824,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.049.600
HC CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST
70496
WCH HB DEFAULT FEE SCHEDULE
2.351,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.517.049.800
HC CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
70498
WCH HB DEFAULT FEE SCHEDULE
2.351,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.125.000
HC CT THORAX W/O CONTRAST MATERIAL
71250
WCH HB DEFAULT FEE SCHEDULE
2.326,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.126.000
HC CT THORAX W/CONTRAST MATERIAL
71260
WCH HB DEFAULT FEE SCHEDULE
2.467,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.127.000
HC CT THORAX W/O & W/CONTRAST MATERIAL
71270
WCH HB DEFAULT FEE SCHEDULE
2.607,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.127.500
HC CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST
71275
WCH HB DEFAULT FEE SCHEDULE
2.617,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.212.500
HC CT CERVICAL SPINE W/O CONTRAST MATERIAL
72125
WCH HB DEFAULT FEE SCHEDULE
2.183,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.212.700
HC CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
72127
WCH HB DEFAULT FEE SCHEDULE
2.183,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.212.800
HC CT THORACIC SPINE W/O CONTRAST MATERIAL
72128
WCH HB DEFAULT FEE SCHEDULE
2.183,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.020.200
HC VANCOMYCIN
80202
WCH HB LAB FEE SCHEDULE
110,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.213.100
HC CT LUMBAR SPINE W/O CONTRAST MATERIAL
72131
WCH HB DEFAULT FEE SCHEDULE
2.183,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.213.200
HC CT LUMBAR SPINE W/CONTRAST MATERIAL
72132
WCH HB DEFAULT FEE SCHEDULE
1.755,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.219.200
HC CT PELVIS W/O CONTRAST MATERIAL
72192
WCH HB DEFAULT FEE SCHEDULE
2.183,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.219.300
HC CT PELVIS W/CONTRAST MATERIAL
72193
WCH HB DEFAULT FEE SCHEDULE
2.326,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.219.400
HC CT PELVIS W/O & W/CONTRAST MATERIAL
72194
WCH HB DEFAULT FEE SCHEDULE
1.839,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.320.000
HC CT UPPER EXTREMITY W/O CONTRAST MATERIAL
73200
WCH HB DEFAULT FEE SCHEDULE
1.194,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.320.100
HC CT UPPER EXTREMITY W/CONTRAST MATERIAL
73201
WCH HB DEFAULT FEE SCHEDULE
1.343,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.320.600
HC CT ANGIOGRAPHY UPPER EXTREMITY
73206
WCH HB DEFAULT FEE SCHEDULE
2.244,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.370.000
HC CT LOWER EXTREMITY W/O CONTRAST MATERIAL
73700
WCH HB DEFAULT FEE SCHEDULE
1.900,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.370.100
HC CT LOWER EXTREMITY W/CONTRAST MATERIAL
73701
WCH HB DEFAULT FEE SCHEDULE
1.366,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.020.300
HC REF ZONISAMIDE
80203
WCH HB LAB FEE SCHEDULE
65,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.370.600
HC CT ANGIOGRAPHY LOWER EXTREMITY
73706
WCH HB DEFAULT FEE SCHEDULE
2.297,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.415.000
HC CT ABDOMEN W/O CONTRAST MATERIAL
74150
WCH HB DEFAULT FEE SCHEDULE
1.673,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.416.000
HC CT ABDOMEN W/CONTRAST MATERIAL
74160
WCH HB DEFAULT FEE SCHEDULE
2.037,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.417.000
HC CT ABDOMEN W/O & W/CONTRAST MATERIAL
74170
WCH HB DEFAULT FEE SCHEDULE
2.359,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.417.400
HC CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG
74174
WCH HB DEFAULT FEE SCHEDULE
3.421,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.417.500
HC CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST
74175
WCH HB DEFAULT FEE SCHEDULE
4.128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.417.600
HC CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL
74176
WCH HB DEFAULT FEE SCHEDULE
3.402,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.417.700
HC CT ABDOMEN & PELVIS W/CONTRAST MATERIAL
74177
WCH HB DEFAULT FEE SCHEDULE
4.083,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.417.800
HC CT ABDOMEN & PELVIS W/O CONTRST FOLLOWED BY W CONTRST 1/> BODY RE
74178
WCH HB DEFAULT FEE SCHEDULE
4.763,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.601.006.000
HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
10060
WCH HB DEFAULT FEE SCHEDULE
309,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.029.900
HC REF FLECAINIDE
80299
WCH HB DEFAULT FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.029.900
HC REF FLECAINIDE
80299
WCH HB LAB FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.601.200.100
HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<
12001
WCH HB DEFAULT FEE SCHEDULE
499,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.601.200.200
HC SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM
12002
WCH HB DEFAULT FEE SCHEDULE
604,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.601.201.100
HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
12011
WCH HB DEFAULT FEE SCHEDULE
604,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.601.205.100
HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<
12051
WCH HB DEFAULT FEE SCHEDULE
804,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.602.061.000
HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
20610
WCH HB DEFAULT FEE SCHEDULE
272,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.602.365.000
HC CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
23650
WCH HB DEFAULT FEE SCHEDULE
1.064,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.602.912.500
HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC
29125
WCH HB DEFAULT FEE SCHEDULE
232,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.602.940.500
HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE
29405
WCH HB DEFAULT FEE SCHEDULE
359,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.602.958.000
HC STRAPPING UNNA BOOT
29580
WCH HB DEFAULT FEE SCHEDULE
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.602.958.100
HC APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT
29581
WCH HB DEFAULT FEE SCHEDULE
253,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.032.000
HC ALCOHOL
80320
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.603.660.000
HC ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
36600
WCH HB DEFAULT FEE SCHEDULE
223,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.603.660.000
HC ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
36600
WCH HB LAB FEE SCHEDULE
223,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.603.668.000
HC PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
36680
WCH HB DEFAULT FEE SCHEDULE
592,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.605.170.100
HC INSERTION OF NON-INDWELLING BLADDER CATHETER
51701
WCH HB DEFAULT FEE SCHEDULE
399,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.605.170.200
HC INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER, SIMPLE
51702
WCH HB DEFAULT FEE SCHEDULE
469,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.605.170.500
HC CHANGE OF CYSTOSTOMY TUBE, SIMPLE
51705
WCH HB DEFAULT FEE SCHEDULE
507,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.759.700
HC DEBRIDEMENT OPEN WOUND 20 SQ CM/<
97597
WCH HB DEFAULT FEE SCHEDULE
223,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.900.901.600
HC RBC LEUKO REDUCED
P9016
WCH HB LAB FEE SCHEDULE
710,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.900.901.700
HC FRESH FROZEN PLASMA ONE DONOR, FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT
P9017
WCH HB LAB FEE SCHEDULE
216,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.900.905.900
HC FRESH FROZEN PLASMA BETWEEN 8-24 HRS OF COLLECTION, EACH UNIT
P9059
WCH HB LAB FEE SCHEDULE
216,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.913.643.000
HC TRANSFUSION, BLOOD OR BLOOD COMPONENTS
36430
WCH HB LAB FEE SCHEDULE
278,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.032.300
HC REF NICOTINE AND METABOLITES
80323
WCH HB LAB FEE SCHEDULE
193,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.653.600
HC US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM
76536
WCH HB DEFAULT FEE SCHEDULE
398,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.660.400
HC US CHEST REAL TIME W/IMAGE DOCUMENTATION
76604
WCH HB DEFAULT FEE SCHEDULE
388,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.670.000
HC US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
76700
WCH HB DEFAULT FEE SCHEDULE
751,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.670.500
HC US ABDOMINAL REAL TIME W/IMAGE LIMITED
76705
WCH HB DEFAULT FEE SCHEDULE
588,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.677.000
HC US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE
76770
WCH HB DEFAULT FEE SCHEDULE
707,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.677.500
HC US RETROPERITONEAL REAL TIME W/IMAGE LIMITED
76775
WCH HB DEFAULT FEE SCHEDULE
401,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.680.100
HC US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT
76801
WCH HB DEFAULT FEE SCHEDULE
549,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.680.500
HC US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION
76805
WCH HB DEFAULT FEE SCHEDULE
549,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.681.000
HC US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO
76810
WCH HB DEFAULT FEE SCHEDULE
312,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.681.500
HC US PREGNANT UTERUS LIMITED 1/> FETUSES
76815
WCH HB DEFAULT FEE SCHEDULE
401,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.032.900
HC SALICYLATES
80329
WCH HB LAB FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.200.000.200
HC ROOM SEMI PRIVATE SWINGBED SKILLED
WCH HB DEFAULT FEE SCHEDULE
2.041,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.681.600
HC US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS
76816
WCH HB DEFAULT FEE SCHEDULE
358,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.681.700
HC US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG
76817
WCH HB DEFAULT FEE SCHEDULE
466,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.681.900
HC FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING
76819
WCH HB DEFAULT FEE SCHEDULE
528,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.683.000
HC US TRANSVAGINAL
76830
WCH HB DEFAULT FEE SCHEDULE
613,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.685.600
HC US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE
76856
WCH HB DEFAULT FEE SCHEDULE
794,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.685.700
HC US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U
76857
WCH HB DEFAULT FEE SCHEDULE
394,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.687.000
HC US SCROTUM & CONTENTS
76870
WCH HB DEFAULT FEE SCHEDULE
602,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.688.200
HC US EXTREMITY NON-VASC REAL-TIME IMG LMTD
76882
WCH HB DEFAULT FEE SCHEDULE
165,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.694.200
HC US GUIDANCE NEEDLE PLACEMENT IMG S&I
76942
WCH HB DEFAULT FEE SCHEDULE
907,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.100.023.900
HC THERA PROC RESP FUNCTOR INCR STRENGTH OR ENDRUANCERESPIRATORY MUSCLES, 2 OR MORE INDIVIDUALS
G0239
WCH HB DEFAULT FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.034.600
HC REF BENZODIAZEPINE CONF URINE
80346
WCH HB LAB FEE SCHEDULE
268,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.400.200
HC VENTILATION ASSIST & MGMT INPATIENT 1ST DAY
94002
WCH HB DEFAULT FEE SCHEDULE
357,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.464.000
HC PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
94640
WCH HB DEFAULT FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.464.000
HC PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
94640
WCH HB LAB FEE SCHEDULE
147,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.466.000
HC CPAP VENTILATION CPAP INITIATION&MGMT
94660
WCH HB DEFAULT FEE SCHEDULE
211,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.466.400
HC DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP
94664
WCH HB DEFAULT FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.466.700
HC MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL
94667
WCH HB DEFAULT FEE SCHEDULE
166,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.109.466.800
HC MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ
94668
WCH HB DEFAULT FEE SCHEDULE
67,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.701.200
HC APPL MODALITY 1/> AREAS TRACTION MECHANICAL
97012
WCH HB DEFAULT FEE SCHEDULE
47,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.701.400
HC APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED
97014
WCH HB DEFAULT FEE SCHEDULE
43,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.701.800
HC APPL MODALITY 1/> AREAS PARAFFIN BATH
97018
WCH HB DEFAULT FEE SCHEDULE
47,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.702.600
HC APPLICATION MODALITY 1/> AREAS INFRARED
97026
WCH HB DEFAULT FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.037.700
HC REF DRUG SUBS NOT SPEC 7 MORE PM U
80377
WCH HB LAB FEE SCHEDULE
130,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.703.200
HC APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN
97032
WCH HB DEFAULT FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.703.300
HC APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN
97033
WCH HB DEFAULT FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.703.500
HC APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN
97035
WCH HB DEFAULT FEE SCHEDULE
63,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.714.000
HC MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES
97140
WCH HB DEFAULT FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.753.000
HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
97530
WCH HB DEFAULT FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.753.500
HC SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
97535
WCH HB DEFAULT FEE SCHEDULE
78,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.754.200
HC WHEELCHAIR MANAGEMENT, EACH 15 MINS
97542
WCH HB DEFAULT FEE SCHEDULE
48,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.776.000
HC ORTHOTIC MGMT&TRAINJ UXTR LXTR&/TRNK EA 15
97760
WCH HB DEFAULT FEE SCHEDULE
141,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.776.100
HC PROSTHETIC TRAINING UPPR&/LOWER EXTREM EA 15 M
97761
WCH HB DEFAULT FEE SCHEDULE
130,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.701.800
HC APPL MODALITY 1/> AREAS PARAFFIN BATH
97018
WCH HB DEFAULT FEE SCHEDULE
47,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.202.400
HC ACTH
82024
WCH HB LAB FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.703.200
HC APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN
97032
WCH HB DEFAULT FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.703.300
HC APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN
97033
WCH HB DEFAULT FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.703.500
HC APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN
97035
WCH HB DEFAULT FEE SCHEDULE
63,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.714.000
HC MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES
97140
WCH HB DEFAULT FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.753.000
HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
97530
WCH HB DEFAULT FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.753.200
HC DEVELOPMENT OF COGNITIVE SKILLS EACH 15 MINUTES
97532
WCH HB DEFAULT FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.753.500
HC SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
97535
WCH HB DEFAULT FEE SCHEDULE
78,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.754.200
HC WHEELCHAIR MANAGEMENT, EACH 15 MINS
97542
WCH HB DEFAULT FEE SCHEDULE
48,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.776.000
HC ORTHOTIC MGMT&TRAINJ UXTR LXTR&/TRNK EA 15
97760
WCH HB DEFAULT FEE SCHEDULE
141,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.776.100
HC PROSTHETIC TRAINING UPPR&/LOWER EXTREM EA 15 M
97761
WCH HB DEFAULT FEE SCHEDULE
130,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.204.000
HC ALBUMIN SERUM PLASMA WH BLOOD
82040
WCH HB LAB FEE SCHEDULE
36,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.339.715.000
HC THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
97150
WCH HB DEFAULT FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.409.250.700
HC TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND
92507
WCH HB DEFAULT FEE SCHEDULE
168,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.409.252.600
HC TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING
92526
WCH HB DEFAULT FEE SCHEDULE
233,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.409.260.900
HC THER SP-GENRATJ DEV PRGRMG&MODIFICAJ
92609
WCH HB DEFAULT FEE SCHEDULE
229,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.419.252.400
HC BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
92524
WCH HB DEFAULT FEE SCHEDULE
322,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.449.252.100
HC EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
92521
WCH HB DEFAULT FEE SCHEDULE
381,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.449.252.200
HC EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
92522
WCH HB DEFAULT FEE SCHEDULE
309,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.449.252.300
HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
92523
WCH HB DEFAULT FEE SCHEDULE
642,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.449.260.700
HC RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR
92607
WCH HB DEFAULT FEE SCHEDULE
443,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.449.261.000
HC EVAL ORAL&PHARYNGEAL SWLNG FUNCJ
92610
WCH HB DEFAULT FEE SCHEDULE
503,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.204.200
HC ALBUMIN BODY FLUID
82042
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.449.610.500
HC ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR
96105
WCH HB DEFAULT FEE SCHEDULE
254,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.509.928.100
HC EMERGENCY DEPARTMENT VISIT LEVEL 1 LIMITED/MINOR PROB
99281
WCH HB DEFAULT FEE SCHEDULE
269,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.509.928.200
HC EMERGENCY DEPARTMENT VISIT LEVEL 2 LOW/MODER SEVERITY
99282
WCH HB DEFAULT FEE SCHEDULE
363,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.509.928.300
HC EMERGENCY DEPARTMENT VISIT LEVEL 3 MODERATE SEVERITY
99283
WCH HB DEFAULT FEE SCHEDULE
546,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.509.928.400
HC EMERGENCY DEPARTMENT VISIT LEVEL 4 HIGH/URGENT SEVERITY
99284
WCH HB DEFAULT FEE SCHEDULE
815,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.509.928.500
HC EMERGENCY DEPT VISIT LEVEL 5 HIGH SEVERITY&THREAT FUNCJ
99285
WCH HB DEFAULT FEE SCHEDULE
1.215,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.509.929.100
HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
99291
WCH HB DEFAULT FEE SCHEDULE
1.588,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.609.401.000
HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ
94010
WCH HB DEFAULT FEE SCHEDULE
128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.609.462.000
HC PULMONARY STRESS TESTING SIMPLE
94620
WCH HB DEFAULT FEE SCHEDULE
545,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.609.476.200
HC NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR
94762
WCH HB DEFAULT FEE SCHEDULE
408,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.204.300
HC URINE MICROALBUMIN QUANTITATIV
82043
WCH HB LAB FEE SCHEDULE
93,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.809.295.000
HC CARDIOPULMONARY RESUSCITATION
92950
WCH HB DEFAULT FEE SCHEDULE
227,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.829.301.700
HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY
93017
WCH HB DEFAULT FEE SCHEDULE
454,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.839.330.600
HC ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
93306
WCH HB DEFAULT FEE SCHEDULE
989,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.839.330.800
HC ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD
93308
WCH HB DEFAULT FEE SCHEDULE
576,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.839.332.000
HC DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY
93320
WCH HB DEFAULT FEE SCHEDULE
506,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.839.332.100
HC DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD
93321
WCH HB DEFAULT FEE SCHEDULE
319,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.921.100
HC LEVEL 1 OFFICE OUTPATIENT ESTABLISHED VISIT 5 MINUTES
99211
WCH HB DEFAULT FEE SCHEDULE
93,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.921.200
HC LEVEL 2 OFFICE OUTPATIENT ESTABLISHED VISIT 10 MINUTES
99212
WCH HB DEFAULT FEE SCHEDULE
133,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.921.300
HC LEVEL 3 OFFICE OUTPATIENT ESTABLISHED VISIT 15 MINUTES
99213
WCH HB DEFAULT FEE SCHEDULE
171,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.921.400
HC LEVEL 4 OFFICE OUTPATIENT ESTABLISHED VISIT 25 MINUTES
99214
WCH HB DEFAULT FEE SCHEDULE
246,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.208.500
HC REF ALDOLASE
82085
WCH HB LAB FEE SCHEDULE
78,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.921.500
HC LEVEL 5 OFFICE OUTPATIENT ESTABLISHED VISIT 40 MINUTES
99215
WCH HB DEFAULT FEE SCHEDULE
394,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.155.000
HC MRI CHEST W/O CONTRAST MATERIAL
71550
WCH HB DEFAULT FEE SCHEDULE
3.317,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.155.200
HC MRI CHEST W/O & W/CONTRAST MATERIAL
71552
WCH HB DEFAULT FEE SCHEDULE
4.581,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.322.000
HC MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS
73220
WCH HB DEFAULT FEE SCHEDULE
3.024,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.322.100
HC MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL
73221
WCH HB DEFAULT FEE SCHEDULE
2.386,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.371.800
HC MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL
73718
WCH HB DEFAULT FEE SCHEDULE
2.407,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.372.000
HC MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR
73720
WCH HB DEFAULT FEE SCHEDULE
3.314,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.372.100
HC MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL
73721
WCH HB DEFAULT FEE SCHEDULE
2.666,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.372.300
HC MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL
73723
WCH HB DEFAULT FEE SCHEDULE
3.257,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.418.100
HC MRI ABDOMEN W/O CONTRAST MATERIAL
74181
WCH HB DEFAULT FEE SCHEDULE
3.346,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.208.800
HC REF ALDOSTERONE SERUM
82088
WCH HB LAB FEE SCHEDULE
265,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.418.200
HC MRI ABDOMEN W/CONTRAST MATERIAL
74182
WCH HB DEFAULT FEE SCHEDULE
3.021,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.107.418.300
HC MRI ABDOMEN W/O & W/CONTRAST MATERIAL
74183
WCH HB DEFAULT FEE SCHEDULE
3.609,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.117.055.100
HC MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL
70551
WCH HB DEFAULT FEE SCHEDULE
3.516,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.117.055.200
HC MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL
70552
WCH HB DEFAULT FEE SCHEDULE
3.816,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.117.055.300
HC MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL
70553
WCH HB DEFAULT FEE SCHEDULE
4.801,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.214.100
HC MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL
72141
WCH HB DEFAULT FEE SCHEDULE
3.176,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.214.200
HC MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL
72142
WCH HB DEFAULT FEE SCHEDULE
3.310,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.214.600
HC MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL
72146
WCH HB DEFAULT FEE SCHEDULE
2.908,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.214.700
HC MRI SPINAL CANAL THORACIC W/CONTRAST MATRL
72147
WCH HB DEFAULT FEE SCHEDULE
3.310,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.214.800
HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL
72148
WCH HB DEFAULT FEE SCHEDULE
3.176,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.210.300
HC REF ALPHA 1 ANTITRYPSIN
82103
WCH HB LAB FEE SCHEDULE
1.131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.214.900
HC MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL
72149
WCH HB DEFAULT FEE SCHEDULE
3.176,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.215.600
HC MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL
72156
WCH HB DEFAULT FEE SCHEDULE
3.807,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.215.700
HC MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL
72157
WCH HB DEFAULT FEE SCHEDULE
4.011,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.127.215.800
HC MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL
72158
WCH HB DEFAULT FEE SCHEDULE
3.944,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.147.219.500
HC MRI PELVIS W/O CONTRAST MATERIAL
72195
WCH HB DEFAULT FEE SCHEDULE
2.735,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.147.219.700
HC MRI PELVIS W/O & W/CONTRAST MATERIAL
72197
WCH HB DEFAULT FEE SCHEDULE
3.843,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.157.054.400
HC MRA HEAD W/O CONTRST MATERIAL
70544
WCH HB DEFAULT FEE SCHEDULE
3.015,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.157.054.700
HC MRA NECK W/O CONTRST MATERIAL
70547
WCH HB DEFAULT FEE SCHEDULE
2.968,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.157.054.800
HC MRA NECK W/CONTRAST MATERIAL
70548
WCH HB DEFAULT FEE SCHEDULE
3.393,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.157.054.900
HC MRA NECK W/O &W/CONTRAST MATERIAL
70549
WCH HB DEFAULT FEE SCHEDULE
4.254,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.210.400
HC REF A1AT PHENOTYPE
82104
WCH HB LAB FEE SCHEDULE
153,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.210.000.200
HC ROOM SEMI PRIVATE
WCH HB DEFAULT FEE SCHEDULE
2.041,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.167.372.500
HC MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL
73725
WCH HB DEFAULT FEE SCHEDULE
2.450,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.187.155.500
HC MRA CHEST W/O & W/CONTRAST MATERIAL
71555
WCH HB DEFAULT FEE SCHEDULE
3.272,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.187.219.800
HC MRA PELVIS W/WO CONTRAST MATERIAL
72198
WCH HB DEFAULT FEE SCHEDULE
2.753,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.187.418.500
HC MRA ABDOMEN W/WO CONTRAST MATERIAL
74185
WCH HB DEFAULT FEE SCHEDULE
2.729,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.205.902.500
HC FETAL NON-STRESS TEST
59025
WCH HB DEFAULT FEE SCHEDULE
234,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.309.300.500
HC ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R
93005
WCH HB DEFAULT FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.319.322.500
HC ECG MONIT/REPRT UP TO 48 HRS
93225
WCH HB DEFAULT FEE SCHEDULE
369,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.319.322.600
HC EXTERNAL ECG SCANNING ANALYSIS REPORT
93226
WCH HB DEFAULT FEE SCHEDULE
333,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.319.327.000
HC XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS
93270
WCH HB DEFAULT FEE SCHEDULE
200,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.620.000.100
HC SSO PER HOUR
G0378
WCH HB DEFAULT FEE SCHEDULE
386,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.210.500
HC REF ALPHA-FETOPROTEIN: SERUM
82105
WCH HB LAB FEE SCHEDULE
118,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.620.000.200
HC SSO INCREASED ACUITY PER HOUR
G0378
WCH HB DEFAULT FEE SCHEDULE
409,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.620.000.300
HC SSO CARVE OUT
G0378
WCH HB DEFAULT FEE SCHEDULE
386,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.620.000.400
HC SSO INCREASED ACUITY CARVE OUT
G0378
WCH HB DEFAULT FEE SCHEDULE
409,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.100
HC IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE
90471
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.200
HC IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE
90472
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.209.580.500
HC MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG
95805
WCH HB DEFAULT FEE SCHEDULE
2.854,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.209.581.000
HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
95810
WCH HB DEFAULT FEE SCHEDULE
3.194,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.209.581.100
HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND
95811
WCH HB DEFAULT FEE SCHEDULE
3.607,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.388.000
HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
93880
WCH HB DEFAULT FEE SCHEDULE
654,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.392.200
HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL
93922
WCH HB DEFAULT FEE SCHEDULE
469,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.213.500
HC REF AMINOLEVULINIC ACID ALA U
82135
WCH HB LAB FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.392.500
HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY
93925
WCH HB DEFAULT FEE SCHEDULE
1.029,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.392.600
HC DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY
93926
WCH HB DEFAULT FEE SCHEDULE
626,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.393.000
HC DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY
93930
WCH HB DEFAULT FEE SCHEDULE
899,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.393.100
HC DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY
93931
WCH HB DEFAULT FEE SCHEDULE
543,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.397.000
HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY
93970
WCH HB DEFAULT FEE SCHEDULE
1.205,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.397.100
HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY
93971
WCH HB DEFAULT FEE SCHEDULE
885,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.397.600
HC DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
93976
WCH HB DEFAULT FEE SCHEDULE
890,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.397.800
HC DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
93978
WCH HB DEFAULT FEE SCHEDULE
949,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.409.652.300
HC IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST
96523
WCH HB DEFAULT FEE SCHEDULE
129,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.409.919.500
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE
99195
WCH HB DEFAULT FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.409.919.500
HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE
99195
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.214.000
HC AMMONIA
82140
WCH HB LAB FEE SCHEDULE
91,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.429.896.000
HC EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT
98960
WCH HB DEFAULT FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.439.379.700
HC OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR
93797
WCH HB DEFAULT FEE SCHEDULE
227,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.439.379.800
HC OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING
93798
WCH HB DEFAULT FEE SCHEDULE
227,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.605.170.000
HC BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION
51700
WCH HB DEFAULT FEE SCHEDULE
197,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.352.200
HC RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
73522
WCH HB DEFAULT FEE SCHEDULE
214,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.108.124.000
HC REF PROTHROMBIN G20210A MUTATION,B
81240
WCH HB LAB FEE SCHEDULE
533,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.108.124.100
HC REF F5 GENE ANALYSIS, LEIDEN VARIANT
81241
WCH HB LAB FEE SCHEDULE
187,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.108.125.600
HC REF HFE GENE ANALYSIS COMMON VRNTS
81256
WCH HB LAB FEE SCHEDULE
265,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.108.127.000
HC REF JAK2 GENE ANAL P.VAL617PHE VRN
81270
WCH HB LAB FEE SCHEDULE
664,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.108.133.200
HC REF SERPINA1 A1AT DEF GENE ANALYSI
81332
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.215.000
HC AMYLASE SERUM
82150
WCH HB LAB FEE SCHEDULE
87,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.108.151.100
HC REF FETAL CONG ABN ASSAY 4 ANALYTE
81511
WCH HB LAB FEE SCHEDULE
279,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.614.600
HC GLYCOPROTEIN ANTIBODY
86146
WCH HB LAB FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.687.000
HC ANTIBODY ID
86870
WCH HB LAB FEE SCHEDULE
155,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.688.000
HC DIRECT COOMBS POLY
86880
WCH HB LAB FEE SCHEDULE
67,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.688.600
HC AB TITER INDIRECT
86886
WCH HB LAB FEE SCHEDULE
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.690.000
HC ABO TYPE SEROLOGIC-OB GROUP
86900
WCH HB LAB FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.690.200
HC ANTIGEN TEST DONOR BLD EA UNIT
86902
WCH HB LAB FEE SCHEDULE
273,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.690.500
HC CAGP
86905
WCH HB LAB FEE SCHEDULE
172,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.690.600
HC REF RBC ANTIGEN TYPING, RH
86906
WCH HB LAB FEE SCHEDULE
93,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.692.000
HC IMMEDIATE SPIN CROSSMATCH
86920
WCH HB LAB FEE SCHEDULE
127,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.215.700
HC REF ANDROSTENEDIONE S
82157
WCH HB LAB FEE SCHEDULE
164,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.692.200
HC X MATCH AHG
86922
WCH HB LAB FEE SCHEDULE
127,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.759.800
HC DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM
97598
WCH HB DEFAULT FEE SCHEDULE
281,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.760.200
HC RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS
97602
WCH HB DEFAULT FEE SCHEDULE
146,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.760.500
HC NEGATIVE PRESSURE WOUND THERAPY DME
97605
WCH HB DEFAULT FEE SCHEDULE
153,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.760.600
HC NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
97606
WCH HB DEFAULT FEE SCHEDULE
265,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.100.000.100
HC ROOM PRIVATE SWINGBED SKILLED
WCH HB DEFAULT FEE SCHEDULE
2.041,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.905.100
HC CELL COUNT MISC BDYFLUID W DIF
89051
WCH HB LAB FEE SCHEDULE
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.905.500
HC FECAL LEUKOCYTE ASSESSMENT
89055
WCH HB DEFAULT FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.905.500
HC FECAL LEUKOCYTE ASSESSMENT
89055
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.906.000
HC CRYSTAL STUDY TECHNICAL
89060
WCH HB LAB FEE SCHEDULE
73,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.707.000
HC CULTURE AEROBIC ANY SOURCE
87070
WCH HB DEFAULT FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.707.000
HC CULTURE AEROBIC ANY SOURCE
87070
WCH HB LAB FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.216.400
HC REF ANGIOTENSIN I-CONVERTING ENZYME CSF
82164
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.735.000
HC HEPATITIS BE AG, EIA
87350
WCH HB LAB FEE SCHEDULE
67,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.128.832.100
HC MUSCLE BIOPSY INTERP
88321
WCH HB LAB FEE SCHEDULE
436,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.237.563.500
HC CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
75635
WCH HB DEFAULT FEE SCHEDULE
3.155,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.219.711.000
HC THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
97110
WCH HB DEFAULT FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.219.711.200
HC THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
97112
WCH HB DEFAULT FEE SCHEDULE
88,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.219.711.300
HC THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS
97113
WCH HB DEFAULT FEE SCHEDULE
100,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.219.711.600
HC THER PX 1/> AREAS EA 15 MIN GAIT TRAINJ W/STAIR
97116
WCH HB DEFAULT FEE SCHEDULE
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.239.715.000
HC THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
97150
WCH HB DEFAULT FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.319.711.000
HC THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
97110
WCH HB DEFAULT FEE SCHEDULE
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.319.711.200
HC THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
97112
WCH HB DEFAULT FEE SCHEDULE
88,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.217.200
HC REF APOLIPOPROTEIN A1
82172
WCH HB LAB FEE SCHEDULE
87,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.319.711.300
HC THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS
97113
WCH HB DEFAULT FEE SCHEDULE
100,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.117.054.000
HC MRI ORBIT FACE &/NECK W/O CONTRAST
70540
WCH HB DEFAULT FEE SCHEDULE
3.435,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.117.054.300
HC MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL
70543
WCH HB DEFAULT FEE SCHEDULE
4.770,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.147.219.600
HC MRI PELVIS W/CONTRAST MATERIAL
72196
WCH HB DEFAULT FEE SCHEDULE
3.158,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.157.054.500
HC MRA HEAD W/CONTRAST MATERIAL
70545
WCH HB DEFAULT FEE SCHEDULE
3.351,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.157.054.600
HC MRA HEAD W/O & W/CONTRAST MATERIAL
70546
WCH HB DEFAULT FEE SCHEDULE
4.254,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.504.450.000
HC INTRODUCTION OF LONG GASTROINTESTINAL TUBE
44500
WCH HB DEFAULT FEE SCHEDULE
226,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.207.500
HC ASSAY OF BREATH ETHANOL
82075
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.267.700
HC REF QUAD SCRN ESTRIOL
82677
WCH HB LAB FEE SCHEDULE
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.301.800
HC QUANTITATIVE SCREEN, METALS
83018
WCH HB LAB FEE SCHEDULE
178,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.223.200
HC REF BETA 2 MICROGLOBULIN URINE
82232
WCH HB LAB FEE SCHEDULE
177,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.399.300
HC ASSAY FOR CALPROTECTIN FECAL
83993
WCH HB LAB FEE SCHEDULE
273,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.440.200
HC REF TESTOSTERONE, FREE FOR MAYO TOTAL AND FREE
84402
WCH HB LAB FEE SCHEDULE
210,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.614.000
HC C-RACTIVE PROTEIN QUANT
86140
WCH HB LAB FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.635.900
HC T CELLS TOTAL COUNT
86359
WCH HB LAB FEE SCHEDULE
189,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.554.900
HC MURAMIDASE
85549
WCH HB LAB FEE SCHEDULE
155,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.100.000
HC URINE DIP W MICRO08012012
81000
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.013.000
HC RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE
70130
WCH HB DEFAULT FEE SCHEDULE
236,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.019.000
HC RADEX OPTIC FORAMINA
70190
WCH HB DEFAULT FEE SCHEDULE
121,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.024.000
HC RADIOLOGIC EXAMINATION SELLA TURCICA
70240
WCH HB DEFAULT FEE SCHEDULE
124,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.032.800
HC RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT
70328
WCH HB DEFAULT FEE SCHEDULE
180,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.224.700
HC BILIRUBIN TOTAL
82247
WCH HB LAB FEE SCHEDULE
48,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.211.400
HC RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6
72114
WCH HB DEFAULT FEE SCHEDULE
307,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.707.200
HC BONE AGE STUDIES
77072
WCH HB DEFAULT FEE SCHEDULE
202,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.527.219.100
HC CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
72191
WCH HB DEFAULT FEE SCHEDULE
2.366,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.681.800
HC FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING
76818
WCH HB DEFAULT FEE SCHEDULE
544,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.027.688.100
HC US XTR NON-VASC COMPLETE
76881
WCH HB DEFAULT FEE SCHEDULE
577,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.609.476.000
HC NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER
94760
WCH HB DEFAULT FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.420.000
HC LUNG FUNCTION TEST (MBC/MVV)
94200
WCH HB DEFAULT FEE SCHEDULE
84,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.940.600
HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
99406
WCH HB DEFAULT FEE SCHEDULE
56,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
5.109.940.700
HC TOBACCO USE CESSATION INTENSIVE >10 MINUTES
99407
WCH HB DEFAULT FEE SCHEDULE
111,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.219.397.500
HC DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
93975
WCH HB DEFAULT FEE SCHEDULE
1.484,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.224.800
HC CONJUGATED BILIRUBIN
82248
WCH HB LAB FEE SCHEDULE
36,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.636.000
HC IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR
96360
WCH HB DEFAULT FEE SCHEDULE
293,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.831.200.200
HC PRO SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM
12002
WCH HB DEFAULT FEE SCHEDULE
604,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.831.201.100
HC PRO SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
12011
WCH HB DEFAULT FEE SCHEDULE
604,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.832.365.000
HC PRO CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
23650
WCH HB DEFAULT FEE SCHEDULE
1.457,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.832.560.000
HC PRO CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ
25600
WCH HB DEFAULT FEE SCHEDULE
1.182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.832.910.500
HC PRO APPLICATION LONG ARM SPLINT SHOULDER HAND
29105
WCH HB DEFAULT FEE SCHEDULE
270,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.832.958.100
HC PRO APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT
29581
WCH HB DEFAULT FEE SCHEDULE
253,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.833.150.000
HC PRO INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
31500
WCH HB DEFAULT FEE SCHEDULE
727,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.833.600.000
HC PRO INTRODUCTION NEEDLE/INTRACATHETER VEIN
36000
WCH HB DEFAULT FEE SCHEDULE
310,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.301.000
HC PRO ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY
93010
WCH HB DEFAULT FEE SCHEDULE
49,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.905.000
HC PRO SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
99050
WCH HB LAB FEE SCHEDULE
171,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.227.000
HC FECAL OCCULT BLOOD NONMEDICARE
82270
WCH HB LAB FEE SCHEDULE
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.003.641.500
HC COLLECTION VENOUS BLOOD VENIPUNCTURE
36415
WCH HB LAB FEE SCHEDULE
32,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.003.641.600
HC COLLECTION CAPILLARY BLOOD SPECIMEN
36416
WCH HB LAB FEE SCHEDULE
23,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
1.100.000.300
HC ROOM PRIVATE SWINGBED INTERMEDIATE
WCH HB DEFAULT FEE SCHEDULE
248,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.897.800
HC MOBILITY CURRENT STATUS
G8978
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.897.900
HC MOBILITY GOAL STATUS
G8979
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.000
HC MOBILITY D/C STATUS
G8980
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.100
HC BODY POS CURRENT STATUS
G8981
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.200
HC BODY POS GOAL STATUS
G8982
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.300
HC BODY POS D/C STATUS
G8983
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.400
HC CARRY CURRENT STATUS
G8984
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.227.200
HC OCCULT BLOOD FECES WAIVED
82272
WCH HB LAB FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.500
HC CARRY GOAL STATUS
G8985
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.600
HC CARRY D/C STATUS
G8986
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.700
HC SELF CARE CURRENT STATUS
G8987
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.800
HC SELF CARE GOAL STATUS
G8988
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.898.900
HC SELF CARE D/C STATUS
G8989
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.899.000
HC OTHER PT/OT CURRENT STATUS
G8990
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.899.100
HC OTHER PT/OT GOAL STATUS
G8991
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.899.200
HC OTHER PT/OT D/C STATUS
G8992
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.899.300
HC SUB PT/OT CURRENT STATUS
G8993
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.899.400
HC SUB PT/OT GOAL STATUS
G8994
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.227.400
HC FECAL OCC BL TEST IFOB DIAG
82274
WCH HB LAB FEE SCHEDULE
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.899.500
HC SUB PT/OT D/C STATUS
G8995
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.897.800
HC MOBILITY CURRENT STATUS
G8978
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.897.900
HC MOBILITY GOAL STATUS
G8979
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.000
HC MOBILITY D/C STATUS
G8980
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.100
HC BODY POS CURRENT STATUS
G8981
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.200
HC BODY POS GOAL STATUS
G8982
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.300
HC BODY POS D/C STATUS
G8983
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.400
HC CARRY CURRENT STATUS
G8984
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.500
HC CARRY GOAL STATUS
G8985
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.600
HC CARRY D/C STATUS
G8986
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.230.000
HC REF HEAVY METALS SCRN UR CADMIUM
82300
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.700
HC SELF CARE CURRENT STATUS
G8987
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.800
HC SELF CARE GOAL STATUS
G8988
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.898.900
HC SELF CARE D/C STATUS
G8989
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.899.000
HC OTHER PT/OT CURRENT STATUS
G8990
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.899.100
HC OTHER PT/OT GOAL STATUS
G8991
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.899.200
HC OTHER PT/OT D/C STATUS
G8992
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.899.300
HC SUB PT/OT CURRENT STATUS
G8993
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.899.400
HC SUB PT/OT GOAL STATUS
G8994
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.300.899.500
HC SUB PT/OT D/C STATUS
G8995
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.899.600
HC SWALLOW CURRENT STATUS
G8996
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.230.600
HC VIT D 25 HYDROXY W FRACTIONS
82306
WCH HB LAB FEE SCHEDULE
275,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.899.700
HC SWALLOW GOAL STATUS
G8997
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.899.800
HC SWALLOW D/C STATUS
G8998
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.899.900
HC MOTOR SPEECH CURRENT STATUS
G8999
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.915.800
HC MOTOR SPEECH D/C STATUS
G9158
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.915.900
HC LANG COMP CURRENT STATUS
G9159
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.000
HC LANG COMP GOAL STATUS
G9160
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.100
HC LANG COMP D/C STATUS
G9161
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.200
HC LANG EXPRESS CURRENT STATUS
G9162
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.300
HC LANG EXPRESS GOAL STATUS
G9163
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.400
HC LANG EXPRESS D/C STATUS
G9164
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.230.800
HC REF CALCITONIN
82308
WCH HB LAB FEE SCHEDULE
250,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.500
HC ATTEN CURRENT STATUS
G9165
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.600
HC ATTEN GOAL STATUS
G9166
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.700
HC ATTEN D/C STATUS
G9167
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.800
HC MEMORY CURRENT STATUS
G9168
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.916.900
HC MEMORY GOAL STATUS
G9169
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.917.000
HC MEMORY D/C STATUS
G9170
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.917.100
HC VOICE CURRENT STATUS
G9171
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.917.200
HC VOICE GOAL STATUS
G9172
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.917.300
HC VOICE D/C STATUS
G9173
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.917.500
HC SPEECH LANG GOAL STATUS
G9175
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.231.000
HC CALCIUM TOTAL SERUM
82310
WCH HB LAB FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.400.917.600
HC SPEECH LANG D/C STATUS
G9176
WCH HB DEFAULT FEE SCHEDULE
0,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.101
HC ADMINISTRATION OF INFLUENZA VIRUS VACCINE
90471
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.102
HC ADMINISTRATION OF PNEUMOCOCCAL VACCINE
90471
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.103
HC ADMINISTRATION OF HEPATITIS B VACCINE
90471
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.019.701
HC REF TACROLIMUS FK506
80197
WCH HB LAB FEE SCHEDULE
152,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.020.101
HC REF TOPIRAMATE
80201
WCH HB LAB FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.029.901
HC REF AMIODARONE P S
80299
WCH HB LAB FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.032.901
HC ACETAMINOPHEN
80329
WCH HB LAB FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.208.802
HC REF ALDOSTERONE SERUM
82088
WCH HB LAB FEE SCHEDULE
265,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.210.502
HC AFP TUMOR MARKER
82105
WCH HB LAB FEE SCHEDULE
118,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.233.000
HC CALCIUM IONIZED ASSAY
82330
WCH HB LAB FEE SCHEDULE
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.216.401
HC REF ANGIOTENSIN CONV ENZYME
82164
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.230.601
HC REF VIT D 25 HYDROXY W FRACTIONS
82306
WCH HB LAB FEE SCHEDULE
275,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.237.501
HC CARBOXYHEMOGLOBIN QUANT
82375
WCH HB LAB FEE SCHEDULE
111,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.300.201
HC LUTEINIZING HORMONE
83002
WCH HB LAB FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.351.605
HC REF MITOCHONDIRAL AB M2
83516
WCH HB LAB FEE SCHEDULE
117,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.351.609
HC REF TISSUE TRANSGLUTAMINASE AB IGG OR IGA
83516
WCH HB LAB FEE SCHEDULE
116,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.388.301
HC REF IMMUNOGLOBULIN LIGHT CH
83883
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.412.001
HC REF PORPHYRINS QN U
84120
WCH HB LAB FEE SCHEDULE
156,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.303
HC PSA SCREENING
84153
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.502
HC REF PROTEIN: TOTAL EXCEPT REFRACTOMETRY
84155
WCH HB LAB FEE SCHEDULE
111,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.234.000
HC REF 24 HR URINE CALCIUM
82340
WCH HB LAB FEE SCHEDULE
59,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.416.502
HC E-PHORESIS-PROTEIN
84165
WCH HB LAB FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.424.401
HC REF RENIN ACTIVITY
84244
WCH HB LAB FEE SCHEDULE
216,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.441.000
HC REF TESTOSTERONE BIOAVAILABLE FOR MAYO TOTAL, BIO, FREE
84410
WCH HB LAB FEE SCHEDULE
210,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.440.301
HC REF TESTOSTERONE TOTAL, FOR MAYO TOTAL AND FREE
84403
WCH HB LAB FEE SCHEDULE
169,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.442.501
HC REF THIAMINE
84425
WCH HB LAB FEE SCHEDULE
192,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.443.201
HC REF THYROGLOBULIN TUMOR MARKER
84432
WCH HB LAB FEE SCHEDULE
173,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.444.601
HC REF VITAMIN E
84446
WCH HB LAB FEE SCHEDULE
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.447.803
HC TRIGLYCERIDES
84478
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.614.703
HC REF PHOSPHOLIPID AB IGA
86147
WCH HB LAB FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.905.501
HC FECAL LEUKOCYTE ASSESS QUAL
89055
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.237.400
HC CARBON DIOXIDE BICARB
82374
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.636.100
HC IV INFUSION HYDRATION EACH ADDITIONAL HOUR
96361
WCH HB DEFAULT FEE SCHEDULE
98,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.614.701
HC REF PHOSPHOLIPID AB IGM
86147
WCH HB LAB FEE SCHEDULE
217,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.614.702
HC REF PHOSPHOLIPID AB IGG
86147
WCH HB LAB FEE SCHEDULE
217,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.621.501
HC REF DNASE ANTI DNASE B
86215
WCH HB LAB FEE SCHEDULE
157,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.623.502
HC EXTRACTABLE NUCLEAR AG EACH AB
86235
WCH HB LAB FEE SCHEDULE
138,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.625.503
HC REF ANTI SMOOTH MUSCLE AB
86255
WCH HB LAB FEE SCHEDULE
127,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.631.701
HC REF RABIES ANTIBODY ELISA
86317
WCH HB LAB FEE SCHEDULE
91,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.666.401
HC REF EPSTEIN BARR ANTI EBNA
86664
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.666.501
HC REF EBV AB BCA IGG OR IGM
86665
WCH HB LAB FEE SCHEDULE
169,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.669.401
HC REF HSV AB IGM S BY EIA
86694
WCH HB LAB FEE SCHEDULE
143,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.673.801
HC REF MYCOPLASMA PNEUMO IGG OR IGM
86738
WCH HB DEFAULT FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.673.801
HC REF MYCOPLASMA PNEUMO IGG OR IGM
86738
WCH HB LAB FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.237.800
HC CARCINOEMBRYONIC ANTIGEN
82378
WCH HB LAB FEE SCHEDULE
186,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.674.701
HC REF PARVOVIRUS B19 AB IGG OR IGM
86747
WCH HB LAB FEE SCHEDULE
154,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.675.701
HC REF TYPHUS ANTIBODY IGG OR IGM
86757
WCH HB LAB FEE SCHEDULE
131,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.678.801
HC REF WEST NILE VIRUS IGM
86788
WCH HB LAB FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.680.001
HC REF THYROGLOBULIN AB SCRN
86800
WCH HB LAB FEE SCHEDULE
140,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.561.005
HC PROTIME
85610
WCH HB DEFAULT FEE SCHEDULE
64,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.733.801
HC REF STL FOR H PYLORI
87338
WCH HB LAB FEE SCHEDULE
204,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.749.103
HC C TRACHOMATIS APMLIFIED PROBE
87491
WCH HB LAB FEE SCHEDULE
159,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.752.201
HC REF HCV VIRAL LOAD
87522
WCH HB LAB FEE SCHEDULE
466,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.759.102
HC N GONORRHOEAE AMPLIFIED PROBE
87591
WCH HB LAB FEE SCHEDULE
161,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.779.903
HC REF EPSTEIN BARR VIRUS DNA
87799
WCH HB LAB FEE SCHEDULE
193,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.238.400
HC ASSAY, THREE CATECHOLAMINES
82384
WCH HB LAB FEE SCHEDULE
250,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.100.301
HC URINE AUTO WO MICRO
81003
WCH HB LAB FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.688.501
HC AHG INDIRECT QUAL REAGENT RBC*2
86885
WCH HB LAB FEE SCHEDULE
88,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.690.001
HC ABO TYPE SEROLOGIC
86900
WCH HB LAB FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.098.690.101
HC RH BLOOD TYPING
86901
WCH HB LAB FEE SCHEDULE
52,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.030.700
HC REF HYPOGLYCEMIC AGENT SCRN
80307
WCH HB LAB FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.249.716.100
HC PT EVAL VISIT LOW COMPLEXITY
97161
WCH HB DEFAULT FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.249.716.200
HC PT EVAL VISIT MODERATE COMPLEX
97162
WCH HB DEFAULT FEE SCHEDULE
207,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.249.716.300
HC PT EVAL VISIT HIGH COMPLEXITY
97163
WCH HB DEFAULT FEE SCHEDULE
229,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.249.716.400
HC PT REEVAL
97164
WCH HB DEFAULT FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.349.716.500
HC OT EVAL LOW COMPLEXITY
97165
WCH HB DEFAULT FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.239.000
HC REF CERULOPLASMIN
82390
WCH HB LAB FEE SCHEDULE
117,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.349.716.600
HC OT EVAL MODERATE COMPLEXITY
97166
WCH HB DEFAULT FEE SCHEDULE
207,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.349.716.700
HC OT EVAL HIGH COMPLEXITY
97167
WCH HB DEFAULT FEE SCHEDULE
229,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.349.716.800
HC OT REEVAL
97168
WCH HB DEFAULT FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.921.700
HC PRO OBSERVATION CARE DISCHARGE MANAGEMENT
99217
WCH HB DEFAULT FEE SCHEDULE
232,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.921.900
HC PRO INITIAL OBSERVATION CARE/DAY 50 MINUTES
99219
WCH HB DEFAULT FEE SCHEDULE
399,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.922.000
HC PRO INITIAL OBSERVATION CARE/DAY 70 MINUTES
99220
WCH HB DEFAULT FEE SCHEDULE
493,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.922.500
HC PRO SBSQ OBSERVATION CARE/DAY 25 MINUTES
99225
WCH HB DEFAULT FEE SCHEDULE
184,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.923.600
HC PRO OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES
99236
WCH HB DEFAULT FEE SCHEDULE
2.128,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.928.100
HC PRO EMERGENCY DEPARTMENT VISIT LEVEL 1 LIMITED/MINOR PROB
99281
WCH HB DEFAULT FEE SCHEDULE
269,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.928.200
HC PRO EMERGENCY DEPARTMENT VISIT LEVEL 2 LOW/MODER SEVERITY
99282
WCH HB DEFAULT FEE SCHEDULE
363,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.239.700
HC REF PTH RELATED PEPTIDE
82397
WCH HB LAB FEE SCHEDULE
165,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.928.300
HC PRO EMERGENCY DEPARTMENT VISIT LEVEL 3 MODERATE SEVERITY
99283
WCH HB DEFAULT FEE SCHEDULE
546,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.928.400
HC PRO EMERGENCY DEPARTMENT VISIT LEVEL 4 HIGH/URGENT SEVERITY
99284
WCH HB DEFAULT FEE SCHEDULE
815,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.928.500
HC PRO EMERGENCY DEPT VISIT LEVEL 5 HIGH SEVERITY&THREAT FUNCJ
99285
WCH HB DEFAULT FEE SCHEDULE
1.215,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.929.200
HC PRO CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
99292
WCH HB DEFAULT FEE SCHEDULE
584,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.030.600
HC URINE DRUG SCREEN
80306
WCH HB LAB FEE SCHEDULE
214,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.008.666.300
HC REF EBV EA
86663
WCH HB LAB FEE SCHEDULE
151,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.019.400
HC REF QUINIDINE
80194
WCH HB LAB FEE SCHEDULE
126,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.217.500
HC REF HEAVY METAL SCREEN ARSENIC, 24 HOUR
82175
WCH HB LAB FEE SCHEDULE
132,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.309.003
HC REF HOMOCYSTEINE TOTAL SERUM
83090
WCH HB LAB FEE SCHEDULE
187,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.447.900
HC T3 UPTAKE
84479
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.243.500
HC CHLORIDE, SERUM
82435
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.685.000
HC ANTIBODY SCREEN
86850
WCH HB LAB FEE SCHEDULE
88,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.542.000
HC REF PLASMINOGEN ACTIVITY
85420
WCH HB LAB FEE SCHEDULE
155,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.708.600
HC REF URINE CULTURE QUANT CC
87086
WCH HB LAB FEE SCHEDULE
77,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.718.400
HC D TEST CLINDAMYCIN
87184
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.734.001
HC HEP B SURFACE AG
87340
WCH HB LAB FEE SCHEDULE
63,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.068.780.200
HC GRP B VAGINAL
87802
WCH HB LAB FEE SCHEDULE
83,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.102.501
HC HCG URINE
81025
WCH HB LAB FEE SCHEDULE
76,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.200.000.200
HC BHSS PER 15 MIN
WCH HB DEFAULT FEE SCHEDULE
394,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.414.500
HC PROCALCITONIN
84145
WCH HB LAB FEE SCHEDULE
224,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.620.002
HC CCP ANTIBODY
86200
WCH HB LAB FEE SCHEDULE
153,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.243.600
HC CHLORIDE URINE
82436
WCH HB LAB FEE SCHEDULE
44,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.209.711.600
HC PT GAIT TRAINING BIRTH TO 3
97116
WCH HB DEFAULT FEE SCHEDULE
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.840.039.000
HC TRAUMA RESP W ACTIVATION SPRH
G0390
WCH HB DEFAULT FEE SCHEDULE
1.305,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.929.100
HC PRO CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
99291
WCH HB DEFAULT FEE SCHEDULE
1.588,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.923.800
HC PRO HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<
99238
WCH HB DEFAULT FEE SCHEDULE
241,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.923.200
HC PRO SBSQ HOSPITAL CARE/DAY 25 MINUTES
99232
WCH HB DEFAULT FEE SCHEDULE
213,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.923.900
HC PRO HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN
99239
WCH HB DEFAULT FEE SCHEDULE
301,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.201
HC SUBSEQUENT ADMINISTRATION OF INFLUENZA VIRUS VACCINE
90472
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.202
HC SUBSEQUENT ADMINISTRATION OF PNEUMOCOCCAL VACCINE
90472
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
7.719.047.203
HC SUBSEQUENT ADMINISTRATION OF HEPATITIS B VACCINE
90472
WCH HB DEFAULT FEE SCHEDULE
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.058.536.600
HC REF SOLUBLE FIBRIN MONOMER- THROMBO PANEL
85366
WCH HB LAB FEE SCHEDULE
103,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.243.800
HC CHLORIDE CSF BODY FLUID URINE
82438
WCH HB LAB FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.254.217
HC REF PYRIDOXIC ACID
82542
WCH HB LAB FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.401.800
HC RADIOLOGIC EXAM ABDOMEN 1 VIEW
74018
WCH HB DEFAULT FEE SCHEDULE
255,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.207.401.900
HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS
74019
WCH HB DEFAULT FEE SCHEDULE
376,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.247.104.500
HC RADIOLOGIC EXAM CHEST SINGLE VIEW
71045
WCH HB DEFAULT FEE SCHEDULE
237,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.247.104.600
HC RADIOLOGIC EXAM CHEST 2 VIEWS
71046
WCH HB DEFAULT FEE SCHEDULE
305,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.247.104.700
HC RADIOLOGIC EXAM CHEST 3 VIEWS
71047
WCH HB DEFAULT FEE SCHEDULE
213,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.409.712.700
HC THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION
97127
WCH HB DEFAULT FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
4.309.712.700
HC THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION
97127
WCH HB DEFAULT FEE SCHEDULE
69,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
9.839.923.300
HC PRO SBSQ HOSPITAL CARE/DAY 35 MINUTES
99233
WCH HB DEFAULT FEE SCHEDULE
291,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.415.602
HC REF PROTEIN, TOTAL, URINE
84156
WCH HB LAB FEE SCHEDULE
62,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.246.500
HC CHOLESTEROL
82465
WCH HB LAB FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.416.602
HC REF PROTEIN ELECTRPHORSIS URINE
84166
WCH HB LAB FEE SCHEDULE
119,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.635.700
HC REF NATURAL KILLER CELLS FOR T-B LYMPHOCYTE PROFILE
86357
WCH HB LAB FEE SCHEDULE
228,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.635.500
HC REF B-CELLS TOTAL COUNT FOR T-B LYMPHOCYTE PROFILE
86355
WCH HB LAB FEE SCHEDULE
206,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.028.636.000
HC REF ABSOLUTE CD4/CD8 COUNT FOR CD4-CD3 PROFILE
86360
WCH HB LAB FEE SCHEDULE
239,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.009.900.001
HC WORKPLACE URINE DRUG SCREEN COLLECTION ONLY
99000
WCH HB LAB FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.030.602
HC WORKPLACE URINE NON-DOT DRUG SCREEN (WITH MRO)
80306
WCH HB LAB FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.030.603
HC WORKPLACE URINE DOT DRUG SCREEN (WITH MRO)
80306
WCH HB LAB FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.207.501
HC WORKPLACE BREATH ALCOHOL TEST (BAT)
82075
WCH HB LAB FEE SCHEDULE
58,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.001
HC/HH WCH SUPP MASK AEROSAL ADULT__001206
E0601
WCH HB SUPPLY FEE SCHEDULE
2,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.002
HC/HH WCH SUPP THUMB SPICA LG.LT__3070
L3807
WCH HB SUPPLY FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.250.700
HC REF CITRATE EXCRETION (SAT 24)
82507
WCH HB LAB FEE SCHEDULE
255,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.003
HC/HH WCH SUPP THUMB SPICA LG.RT__3170
L3807
WCH HB SUPPLY FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.004
HC/HH WCH SUPP THUMB SPICA MED RT__3150
L3807
WCH HB SUPPLY FEE SCHEDULE
109,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.005
HC/HH WCH SUPP ADULT ONE STEP PADS__8900021401
WCH HB SUPPLY FEE SCHEDULE
168,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.006
HC/HH WCH SUPP AIRWAY 90MM ADULT M__10-80090
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.007
HC/HH WCH SUPP AIRWAY/INFANT 40MM__8400-12#0
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.008
HC/HH WCH SUPP ALOE VESTA CLEANSING FOAM__325208
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.009
HC/HH WCH SUPP ANKLE BRACE W/STRAPS__B-212000002
WCH HB SUPPLY FEE SCHEDULE
76,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.010
HC/HH WCH SUPP ANKLE BRACE W/STRAPS__B-212000003
WCH HB SUPPLY FEE SCHEDULE
76,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.011
HC/HH WCH SUPP ANKLE BRACE W/STRAPS__B-212000004
WCH HB SUPPLY FEE SCHEDULE
76,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.012
HC/HH WCH SUPP ANKLE STIRRUP-LEFT__80100
WCH HB SUPPLY FEE SCHEDULE
82,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.252.300
HC REF NTX TELOPEPTIDE U
82523
WCH HB LAB FEE SCHEDULE
157,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.636.500
HC IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR
96365
WCH HB DEFAULT FEE SCHEDULE
293,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.013
HC/HH WCH SUPP ANKLE STIRRUP-RIGHT__80101
WCH HB SUPPLY FEE SCHEDULE
82,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.014
HC/HH WCH SUPP AQUACEL 4X4__177902
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.015
HC/HH WCH SUPP AQUACEL SILVER 4X4__403765
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.016
HC/HH WCH SUPP ARM SLING ADULT UNIVERSAL__8140015
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.017
HC/HH WCH SUPP ARM SLING ENVELOPE STYLE S__0814-0062
WCH HB SUPPLY FEE SCHEDULE
26,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.018
HC/HH WCH SUPP ATHLETIC SUPPORT L__202636
WCH HB SUPPLY FEE SCHEDULE
22,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.019
HC/HH WCH SUPP ATHLETIC SUPPORT M__202549
WCH HB SUPPLY FEE SCHEDULE
22,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.020
HC/HH WCH SUPP ATHLETIC SUPPORT-SMA__202460
WCH HB SUPPLY FEE SCHEDULE
31,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.021
HC/HH WCH SUPP BAG RESUSCITATION MAN ADULT__2K8005
WCH HB SUPPLY FEE SCHEDULE
84,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.022
HC/HH WCH SUPP BAG RESUSCITATION MAN INFANT__2K8038
WCH HB SUPPLY FEE SCHEDULE
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.078.252.500
HC REF COPPER URINE
82525
WCH HB LAB FEE SCHEDULE
117,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.023
HC/HH WCH SUPP BAG RESUSCITATION MAN PED__2K8008
WCH HB SUPPLY FEE SCHEDULE
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.024
HC/HH WCH SUPP BITE BLOCKS DISP__1140
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.025
HC/HH WCH SUPP BLANKET BAIR HUGGER UPPER BODY__52200
WCH HB SUPPLY FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.026
HC/HH WCH SUPP BLANKET BAIR HUGGER__11101
WCH HB SUPPLY FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.027
HC/HH WCH SUPP BNDG COBAN LF 2X5__2082
WCH HB SUPPLY FEE SCHEDULE
9,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.028
HC/HH WCH SUPP BNDG COBAN TAN 2X5__1582
WCH HB SUPPLY FEE SCHEDULE
9,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.029
HC/HH WCH SUPP BNDG COMPRESSION LF 4IN__23594-040
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.030
HC/HH WCH SUPP BNDG COMPRESSION LF 6IN__23594-060
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.031
HC/HH WCH SUPP BNDG ELASTIC NST 2IN__23593-02LF
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.032
HC/HH WCH SUPP BNDG ELASTIC NST 3IN__23593-03LF
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.253.000
HC CORTISOL, FREE, URINE
82530
WCH HB LAB FEE SCHEDULE
182,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.033
HC/HH WCH SUPP BNDG ELASTIC NST 4IN__23593-04LF
WCH HB SUPPLY FEE SCHEDULE
10,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.034
HC/HH WCH SUPP BNDG ELASTIC NST 6IN__23593-06LF
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.035
HC/HH WCH SUPP BNDG KERLIX 4IN__8074
WCH HB SUPPLY FEE SCHEDULE
68,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.036
HC/HH WCH SUPP BNDG PLASTER 4X5__7374
WCH HB SUPPLY FEE SCHEDULE
9,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.037
HC/HH WCH SUPP BNDG PLASTER 6X5__7376
WCH HB SUPPLY FEE SCHEDULE
12,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.038
HC/HH WCH SUPP BNDG ROLL NST 4IN__6021
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.039
HC/HH WCH SUPP BNDGE SETOPRESS 4IN__3505
WCH HB SUPPLY FEE SCHEDULE
41,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.040
HC/HH WCH SUPP BRACE CLAVICLE VELCRO STRAP XS__0814-1231
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.041
HC/HH WCH SUPP BRACE CLAVICLE XL__1179556
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.042
HC/HH WCH SUPP CANNISTER SUCTION ORTHO 1500CC__65651-515
WCH HB SUPPLY FEE SCHEDULE
13,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.253.300
HC CORTISOL SINGLE
82533
WCH HB LAB FEE SCHEDULE
156,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.043
HC/HH WCH SUPP CANNULA O2 NASAL PED__1101
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.044
HC/HH WCH SUPP CAP SHAMPOO__7909
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.045
HC/HH WCH SUPP CAST AIR WALKER L__AW0800
WCH HB SUPPLY FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.046
HC/HH WCH SUPP CAST AIR WALKER M__AW0600
WCH HB SUPPLY FEE SCHEDULE
148,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.047
HC/HH WCH SUPP CAST PADDING 2" COTT__1418
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.048
HC/HH WCH SUPP CATH FOLEY16FR 10CC__DYND11502
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.049
HC/HH WCH SUPP CATH TRAY URETHRAL__772416
WCH HB SUPPLY FEE SCHEDULE
14,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.050
HC/HH WCH SUPP CLOTH TAPE 1 INCH__7138C
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.051
HC/HH WCH SUPP CLOTH TAPE 2 INCH__7139C
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.052
HC/HH WCH SUPP COLLAR CERV LO UNIV 3"__08140380
WCH HB SUPPLY FEE SCHEDULE
30,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.254.200
HC REF CORTISOL URINE LC-MS/MS
82542
WCH HB LAB FEE SCHEDULE
145,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.053
HC/HH WCH SUPP COLLAR CERVICAL 3.5 L UNI__0814-0381
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.054
HC/HH WCH SUPP COLLAR CERVICAL 3.5 REG S__0814-9702
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.055
HC/HH WCH SUPP COLLAR CERVICAL RD LG 4.5X22__0814-9704
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.056
HC/HH WCH SUPP COLLECTION UNIT SPECIPAN__4014
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.057
HC/HH WCH SUPP COMPRESSION SLEEVE THIGH HI__KDL5345H
WCH HB SUPPLY FEE SCHEDULE
220,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.058
HC/HH WCH SUPP COTTON ROLL #1__2287
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.059
HC/HH WCH SUPP COVER PROBE ULTRASOUND__38-01
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.060
HC/HH WCH SUPP DETECTOR CO2 EASY CAP II__EASYCAP II 6
WCH HB SUPPLY FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.061
HC/HH WCH SUPP DRSSNG DUODERM EXTRA THIN SPOT__187932
WCH HB SUPPLY FEE SCHEDULE
3,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.062
HC/HH WCH SUPP DRSSNG NET SURGILAST #6__GL707
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.255.000
HC CPK TOTAL
82550
WCH HB LAB FEE SCHEDULE
153,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.063
HC/HH WCH SUPP DRSSNG NET SURGILAST #8__GL709
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.064
HC/HH WCH SUPP DRSSNG TEGADERM 6X8__1628
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.065
HC/HH WCH SUPP EYE PROTECTOR PAD MED__G 7013-1276
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.066
HC/HH WCH SUPP FETAL MONITOR BELT__40000008
WCH HB SUPPLY FEE SCHEDULE
25,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.067
HC/HH WCH SUPP FINGER COT-LRG 3"__71907
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.068
HC/HH WCH SUPP FINGER COT-MED 2.25"__71905
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.069
HC/HH WCH SUPP FINGER COT-SML 1.5"*__71903
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.070
HC/HH WCH SUPP FINGER COT-XSM 1"__71902
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.071
HC/HH WCH SUPP FINGER/THUMB SPLINT__510719
WCH HB SUPPLY FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.072
HC/HH WCH SUPP FINGERSPLINT/ABDUCTI__510718
WCH HB SUPPLY FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.255.300
HC MB FRACTION
82553
WCH HB LAB FEE SCHEDULE
75,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.073
HC/HH WCH SUPP FINGHER/THUMB SPLINT__510717
WCH HB SUPPLY FEE SCHEDULE
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.074
HC/HH WCH SUPP GEL ANKLE BRACE-LEFT__E8020L
WCH HB SUPPLY FEE SCHEDULE
86,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.075
HC/HH WCH SUPP GEL ANKLE BRACE-PONY__E200PR
WCH HB SUPPLY FEE SCHEDULE
47,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.076
HC/HH WCH SUPP GEL ANKLE BRACE-RIGH__E8020R
WCH HB SUPPLY FEE SCHEDULE
86,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.077
HC/HH WCH SUPP GOWN ISOLATION__NONTH150
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.078
HC/HH WCH SUPP HOLDER ENDOTRACH TUBE__PM 1110
WCH HB SUPPLY FEE SCHEDULE
15,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.079
HC/HH WCH SUPP IMMOBILIZER SHDLR L__08144504
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.080
HC/HH WCH SUPP IRRIGATION SYSTEM__0210-100-000
WCH HB SUPPLY FEE SCHEDULE
209,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.081
HC/HH WCH SUPP IV NS 0.9 VIAFLEX 1000ML__2B1324X
WCH HB SUPPLY FEE SCHEDULE
121,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.082
HC/HH WCH SUPP KIT COMBITUBE 37FR__5-18537
WCH HB SUPPLY FEE SCHEDULE
173,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.256.500
HC CREATININE SERUM
82565
WCH HB LAB FEE SCHEDULE
73,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.083
HC/HH WCH SUPP KNEE IMMOBILIZER 16"__200016
WCH HB SUPPLY FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.084
HC/HH WCH SUPP KNEE IMMOBILIZER 20IN__8142744
WCH HB SUPPLY FEE SCHEDULE
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.085
HC/HH WCH SUPP KNEE IMMOBILIZER 24"__200030
WCH HB SUPPLY FEE SCHEDULE
113,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.086
HC/HH WCH SUPP LIFEBAND__8700-0706-01
WCH HB SUPPLY FEE SCHEDULE
246,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.087
HC/HH WCH SUPP LOTION ALOE 4OZ__324804
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.088
HC/HH WCH SUPP LUBE GEL FOIL PACK 3__0281-0205-43
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.089
HC/HH WCH SUPP MAC 3 BLADE ADULT, DISPOSABLE__48033
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.090
HC/HH WCH SUPP MASK CPAP COMFORTFULL II LARGE__1004950
WCH HB SUPPLY FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.091
HC/HH WCH SUPP MASK CPAP COMFORTFULL II MED__1004872
WCH HB SUPPLY FEE SCHEDULE
235,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.092
HC/HH WCH SUPP MASK CPAP COMFORTFULL II SMALL__1004880
WCH HB SUPPLY FEE SCHEDULE
253,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.257.000
HC CREATININE BODY FLUID
82570
WCH HB LAB FEE SCHEDULE
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.093
HC/HH WCH SUPP MASK MULTI-VENT ADULT__1088
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.094
HC/HH WCH SUPP MASK OXYGEN PEDS NO VALVE__001267
WCH HB SUPPLY FEE SCHEDULE
6,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.095
HC/HH WCH SUPP MASK OXYGEN VAL PEDS__001268
WCH HB SUPPLY FEE SCHEDULE
5,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.096
HC/HH WCH SUPP MEPILEX BORDER 3X3__295200
WCH HB SUPPLY FEE SCHEDULE
17,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.097
HC/HH WCH SUPP MEPILEX AG 4X4__287100
WCH HB SUPPLY FEE SCHEDULE
37,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.098
HC/HH WCH SUPP MEPILEX WITH BORDER 4X4__295300
WCH HB SUPPLY FEE SCHEDULE
15,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.099
HC/HH WCH SUPP MEPILEX WITH SAFETAC__294199
WCH HB SUPPLY FEE SCHEDULE
11,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.100
HC/HH WCH SUPP MEPITEL SAFETAC 10X18CM SILICN__291099
WCH HB SUPPLY FEE SCHEDULE
42,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.101
HC/HH WCH SUPP MESH UNDERWEAR XL__MSC86400
WCH HB SUPPLY FEE SCHEDULE
25,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.102
HC/HH WCH SUPP MESH UNDERWEAR XXL__MSC86500
WCH HB SUPPLY FEE SCHEDULE
27,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.257.500
HC CREAT CLEARANCE
82575
WCH HB LAB FEE SCHEDULE
104,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.103
HC/HH WCH SUPP METER PEAK FLOW ACCESS FL RNG__HS710-012
WCH HB SUPPLY FEE SCHEDULE
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.104
HC/HH WCH SUPP MOISTURIZER MOUTH__6083
WCH HB SUPPLY FEE SCHEDULE
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.105
HC/HH WCH SUPP NASAL CANNULA__1600
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.106
HC/HH WCH SUPP NEBULIZER SIDESTREAM__002174
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.107
HC/HH WCH SUPP OINTMENT BARRIER SENSICARE 4OZ__325614
WCH HB SUPPLY FEE SCHEDULE
24,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.108
HC/HH WCH SUPP OINTMENT/ANTIFUNGAL__325102
WCH HB SUPPLY FEE SCHEDULE
19,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.109
HC/HH WCH SUPP PACKING FOR SETOPRESS__650948
WCH HB SUPPLY FEE SCHEDULE
28,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.110
HC/HH WCH SUPP PADDING CAST SYNTHETIC 2X4__CMW02
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.111
HC/HH WCH SUPP PADDING CAST SYNTHETIC 3X4__CMW03
WCH HB SUPPLY FEE SCHEDULE
4,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.705.000.112
HC/HH WCH SUPP PADDING CAST SYNTHETIC 4X4__CMW04
WCH HB SUPPLY FEE SCHEDULE
8,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
3.018.258.500
HC REF CRYOG CRYOFIBRENGOGEN
82585
WCH HB LAB FEE SCHEDULE
74,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.609.636.600
HC IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR
96366
WCH HB DEFAULT FEE SCHEDULE
121,00
Service Area Px Code Procedure Description CPT(R)/HCPCS Code Fee Schedule Name Unit Price
</p>
<p>Standard Charges Medication
Service Area Px Code Generic Name CPT(R)/HCPCS Code NDC Unit Price
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
insulin human U-100 NPH-regulr 70-30 mix 100 unit/mL subcutaneous susp
J1815
2.871.517
223,05
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
labetalol 5 mg/mL intravenous solution
409.226.720
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
lidocaine 1 %-epinephrine 1:100,000 injection solution
63.323.048.226
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
mepivacaine (PF) 15 mg/mL (1.5 %) injection solution
J0670
409.104.130
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
bupivacaine-epinephrine (PF) 0.5 %-1:200,000 injection solution
409.904.501
10,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
bupivacaine (PF) 0.5 % (5 mg/mL) injection solution
63.323.046.631
29,64
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
bupivacaine (PF) 0.5 % (5 mg/mL) injection solution
409.116.219
8,45
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
balanced salt solution non-surgical no.3 eye wash
65.053.001
109,80
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium borate-boric acid-sodium chloride-water eye wash soln
904.537.720
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
ceFAZolin 2 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback
J0690
264.310.511
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium chloride 0.9 % irrigation solution
264.220.100
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium chloride 0.9 % irrigation solution
338.004.802
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
vecuronium bromide 10 mg intravenous solution
67.457.043.810
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
vecuronium bromide 20 mg intravenous solution
67.457.047.520
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
water for injection, sterile injection solution
409.488.750
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
water for injection, sterile injection solution
409.488.723
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
zidovudine 100 mg capsule
65.862.010.701
7,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
lidocaine 2 % mucosal solution
50.383.077.504
7,62
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution
55.150.016.830
8,18
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
famotidine (PF) 20 mg/2 mL intravenous solution
S0028
63.323.073.916
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
vasopressin 20 unit/mL intravenous solution
42.023.016.401
501,74
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
norepinephrine bitartrate 1 mg/mL intravenous solution
703.115.303
108,12
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
lidocaine 2 % mucosal jelly in applicator
76.329.301.305
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
calcium chloride 100 mg/mL (10 %) intravenous syringe
409.163.110
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
mvi,adult no.4 with vit K 3300 unit-150 mcg/10 mL intravenous solution
54.643.786.201
121,38
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sugammadex 100 mg/mL intravenous solution
6.542.312
380,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
bacitracin zinc 500 unit/gram topical ointment
67.777.022.007
68,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium hypochlorite 0.25 % solution
39.328.006.325
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium nitroprusside 25 mg/mL intravenous solution
187.430.202
690,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium nitroprusside 25 mg/mL intravenous solution
67.457.083.902
600,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
cyclopentolate 1 % eye drops
17.478.010.002
47,28
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
cyclopentolate 1 % eye drops
24.208.073.501
48,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
etomidate 2 mg/mL intravenous solution
409.669.502
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
etomidate 2 mg/mL intravenous solution
55.150.022.220
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
diazePAM 5 mg/mL injection solution
J3360
409.321.312
182,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
ondansetron 4 mg disintegrating tablet
68.462.015.740
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
insulin glargine (U-100) 100 unit/mL subcutaneous solution
J1815
88.222.033
600,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
folic acid 5 mg/mL injection solution
63.323.018.410
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
flumazenil 0.1 mg/mL intravenous solution
63.323.042.405
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
diphenhydrAMINE 25 mg capsule,diphenhydrAMINE 25 mg tablet
904.555.159
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
calcium chloride 100 mg/mL (10 %) intravenous solution,calcium chloride 100 mg/mL (10 %) intravenous syringe
409.163.110
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
metoprolol tartrate 5 mg/5 mL intravenous solution,metoprolol tartrate 5 mg/5 mL intravenous syringe
143.987.325
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
morphine 4 mg/mL injection syringe,morphine 4 mg/mL intravenous cartridge,morphine 4 mg/mL intravenous solution,morphine 4 mg/mL injection solution,morphine 4 mg/mL intravenous syringe
J2270
641.612.525
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
9.999.999.021
15,59
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
9.999.999.027
14,94
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium chloride 0.9 % injection solution
63.323.018.620
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
ketamine 10 mg/mL injection solution
42.023.011.310
108,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
ketamine 50 mg/mL injection solution
143.950.801
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
lidocaine 10 mg/mL (1 %) injection solution
63.323.048.526
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
mannitol 20 % intravenous solution
338.035.703
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
nafcillin 2 gram solution for injection
S0032
63.323.032.820
173,35
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
phenylephrine 2.5 % eye drops
17.478.020.115
315,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
prochlorperazine maleate 5 mg tablet
378.510.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
promethazine 25 mg tablet
65.162.052.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium bicarbonate 8.4 % (1 mEq/mL) intravenous syringe
409.663.734
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium bicarbonate 8.4 % (1 mEq/mL) intravenous syringe
76.329.335.201
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium chloride 0.9 % injection syringe
63.807.010.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
sodium thiosulfate 12.5 gram/50 mL (250 mg/mL) intravenous solution
60.267.070.550
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
water for irrigation, sterile solution
338.000.402
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
water for irrigation, sterile solution
338.000.404
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
clindamycin 150 mg/mL injection solution
9.030.225
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
clindamycin 150 mg/mL injection solution
67.457.081.402
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
tuberculin PPD 5 tub. unit/0.1 mL intradermal injection solution
42.023.010.401
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
tuberculin PPD 5 tub. unit/0.1 mL intradermal injection solution
9.999.020.101
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
verapamil 2.5 mg/mL intravenous solution
409.114.401
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
verapamil 2.5 mg/mL intravenous solution
409.401.101
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
verapamil 2.5 mg/mL intravenous solution
409.114.402
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
aztreonam 1 gram solution for injection
S0073
63.323.040.120
164,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
cefTRIAXone 1 gram/50 mL in dextrose (iso-osmot) intravenous piggyback
J0696
264.315.311
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
cefTRIAXone 2 gram/50 mL in dextrose (iso-osm) intravenous piggyback
J0696
264.315.511
109,38
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
dilTIAZem 5 mg/mL intravenous solution
17.478.093.710
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
dilTIAZem 5 mg/mL intravenous solution
17.478.081.705
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
dilTIAZem 5 mg/mL intravenous solution
17.478.081.725
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
dilTIAZem 5 mg/mL intravenous solution
17.478.093.726
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
dronabinol 2.5 mg capsule
49.884.086.702
21,76
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
dronabinol 2.5 mg capsule
67.877.056.860
9,12
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.500.000.200
enalaprilat 1.25 mg/mL intravenous solution
143.978.610
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
fluconazole 200 mg/100 mL in sod. chloride (iso) intravenous piggyback
J1450
36.000.000.210
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
heparin (porcine) 1,000 unit/mL injection solution
J1644
25.021.040.067
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
heparin (porcine) 10,000 unit/mL injection solution
J1644
25.021.040.366
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
pneumococcal 13-val conj vaccine-dip crm (PF) 0.5 mL IM syringe
90670
5.197.105
554,76
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 10 mg/mL (1 %) injection solution
J2001
409.471.302
7,07
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 10 mg/mL (1 %) injection solution
J2001
63.323.049.257
15,66
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 20 mg/mL (2 %) injection solution
J2001
63.323.049.507
13,17
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 20 mg/mL (2 %) injection solution
J2001
409.206.610
11,32
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
measles,mumps,rubella vaccine live(PF)1,000-12,500TCID50/0.5 mL subcut
90707
6.468.100
291,16
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
denosumab 60 mg/mL subcutaneous syringe
J0897
55.513.071.001
2.367,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylergonovine 0.2 mg/mL (1 mL) injection solution
J2210
51.991.014.499
118,56
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
enoxaparin 30 mg/0.3 mL subcutaneous syringe
J1650
955.100.310
133,82
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
enoxaparin 40 mg/0.4 mL subcutaneous syringe
J1650
955.100.410
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
enoxaparin 40 mg/0.4 mL subcutaneous syringe
J1650
75.801.410
165,38
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
enoxaparin 60 mg/0.6 mL subcutaneous syringe
J1650
955.100.610
223,28
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
enoxaparin 60 mg/0.6 mL subcutaneous syringe
J1650
75.062.160
248,36
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
enoxaparin 100 mg/mL subcutaneous syringe
J1650
955.101.010
297,70
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ondansetron HCl (PF) 4 mg/2 mL injection solution
J2405
641.607.825
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ondansetron HCl (PF) 4 mg/2 mL injection solution
J2405
23.155.054.831
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ondansetron HCl 2 mg/mL intravenous solution
J2405
23.155.055.031
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
acetaminophen 1,000 mg/100 mL (10 mg/mL) intravenous solution
J0131
43.825.010.201
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
penicillin G benzathine 1,200,000 unit/2 mL intramuscular syringe
J0561
60.793.070.102
472,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
filgrastim 480 mcg/1.6 mL injection solution
J1442
55.513.054.601
1.153,06
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
levoFLOXacin 500 mg/100 mL in 5 % dextrose intravenous piggyback
J1956
25.021.013.267
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
levoFLOXacin 750 mg/150 mL in 5 % dextrose intravenous piggyback
J1956
25.021.013.268
250,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ciprofloxacin 400 mg/200 mL in 5 % dextrose intravenous piggyback
J0744
36.000.000.924
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
phytonadione (vitamin K1) 10 mg/mL injection solution
J3430
409.915.801
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ibandronate 3 mg/3 mL intravenous syringe
J1740
60.505.609.700
600,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
pneumococcal 23 polyvalent vaccine 25 mcg/0.5 mL injection solution
90732
6.494.301
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
potassium chloride 10 mEq/100mL in sterile water intravenous piggyback
J3480
338.070.948
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
propofol 10 mg/mL intravenous emulsion
J2704
25.021.060.850
87,60
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
terbutaline 1 mg/mL subcutaneous solution
J3105
143.974.610
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
dexamethasone sodium phosphate (PF) 10 mg/mL injection solution
J1100
63.323.050.601
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
digoxin 250 mcg/mL injection solution
J1160
641.141.035
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hydrocortisone sodium succinate 100 mg solution for injection
J1720
9.082.501
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ferric carboxymaltose 50 mg iron/mL intravenous solution
J1439
517.065.002
2.283,28
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
acetylcysteine 200 mg/mL (20 %) solution
J7608
63.323.069.030
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
EPINEPHrine 0.1 mg/mL injection syringe
J0171
409.492.120
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium bromide 0.02 % solution for inhalation
J7644
487.980.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium bromide 0.02 % solution for inhalation
J7644
487.980.160
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
heparin, porcine (PF) 100 unit/mL intravenous syringe
J1642
63.807.060.005
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
testosterone cypionate 200 mg/mL intramuscular oil
J1071
9.052.001
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular syringe
90747
58.160.082.152
250,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hepatitis B virus vaccine recomb (PF) 10 mcg/0.5 mL IM syringe
90740
58.160.082.052
133,80
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hepatitis B virus vaccine recomb (PF) 10 mcg/0.5 mL intramuscular susp
90744
58.160.082.011
133,80
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
rho(D) immune globulin 1,500 unit (300 mcg)/2 mL injection syringe
J2791
44.206.030.001
481,14
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf unit/0.5 mL IM syringe
90714
49.281.021.588
156,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf unit/0.5 mL IM susp
90714
49.281.021.510
156,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe
90715
49.281.040.015
209,96
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe
90715
49.281.040.020
209,96
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
dimethyl sulfoxide 50 % intravesical solution
J1212
67.457.017.750
1.307,67
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylPREDNISolone sod succ (PF) 125 mg/2 mL solution for injection
J2930
9.004.722
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylPREDNISolone sod succ (PF) 125 mg/2 mL solution for injection
J2930
9.004.704
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylPREDNISolone sod succ (PF) 500 mg/4 mL intravenous solution
J2930
9.000.302
195,25
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylPREDNISolone sod succ (PF) 1,000 mg/8 mL intravenous solution
J2930
9.001.820
250,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
filgrastim-sndz 300 mcg/0.5 mL injection syringe
Q5101
61.314.031.801
600,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
filgrastim-sndz 480 mcg/0.8 mL injection syringe
Q5101
61.314.031.210
1.009,65
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
pegfilgrastim 6 mg/0.6 mL subcutaneous syringe
J2505
55.513.019.001
9.969,70
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
chlorproMAZINE 25 mg/mL injection solution
J3230
641.139.835
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
darbepoetin alfa 25 mcg/0.42 mL in polysorbate injection syringe
J0882
55.513.005.704
580,50
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
leuprolide 7.5 mg intramuscular syringe kit
J9217
74.364.203
2.918,26
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
calcium gluconate 100 mg/mL (10 %) intravenous solution
J0610
63.323.036.001
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylnaltrexone 12 mg/0.6 mL subcutaneous syringe
J2212
65.649.055.107
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
midazolam (PF) 5 mg/mL injection solution
J2250
409.230.801
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hum prothrombin cplx (PCC) 4factor 500 unit (400-620 unit) IV solution
C9132
63.833.038.602
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hum prothrombin cplx(PCC)4fact 1,000 unit (800-1,240 unit) IV solution
C9132
63.833.038.702
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
morphine 8 mg/mL intravenous syringe
J2270
409.189.210
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
mepolizumab 100 mg subcutaneous solution
J2182
173.088.101
4.876,74
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ceFAZolin 1 gram solution for injection
J0690
44.567.070.725
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ceFAZolin 1 gram solution for injection
J0690
25.021.010.167
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 4 mg/mL (0.4 %) in 5 % dextrose intravenous solution
J2001
264.959.420
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
morphine (PF) 1 mg/mL injection solution
J2274
641.601.910
103,92
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefepime 1 gram solution for injection
J0692
25.021.012.166
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefepime 2 gram solution for injection
J0692
25.021.012.267
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ocrelizumab 30 mg/mL intravenous solution
J2350
50.242.015.001
24.375,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
meropenem 1 gram intravenous solution
J2185
63.323.050.825
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
flu vacc qs2018-19 (36 mos up)(PF)60 mcg (15 mcg x4)/0.5 mL IM syringe
6360000200
49.281.041.850
103,32
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
piperacillin-tazobactam 4.5 gram intravenous solution
J2543
63.323.032.056
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
piperacillin-tazobactam 4.5 gram intravenous solution
J2543
64.679.001.201
87,61
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
piperacillin-tazobactam 3.375 gram intravenous solution
J2543
63.323.030.036
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
piperacillin-tazobactam 3.375 gram intravenous solution
J2543
64.679.005.601
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
DOBUTamine 500 mg/250 mL (2,000 mcg/mL) in 5 % dextrose IV
J1250
409.234.732
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cyanocobalamin (vit B-12) 1,000 mcg/mL injection solution
J3420
63.323.004.401
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
leuprolide 22.5 mg (3 month) intramuscular syringe kit
J9217
74.334.603
7.441,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
azithromycin 500 mg intravenous solution
J0456
63.323.039.814
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
amphotericin B liposome 50 mg intravenous suspension
J0289
469.305.130
600,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
rabies vaccine, purified chicken embryo cell (PF) 2.5 unit IM susp
90675
58.160.096.412
775,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ketorolac 30 mg/mL (1 mL) injection solution
J1885
63.323.016.216
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
eptifibatide 0.75 mg/mL intravenous solution
J1327
70.121.100.301
690,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
dexamethasone 4 mg tablet
J8540
54.418.425
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
dexamethasone 10 mg/mL injection solution
J1100
641.036.721
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
dexamethasone 4 mg/mL injection solution
J1100
63.323.016.516
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
levalbuterol 1.25 mg/3 mL solution for nebulization
J7614
93.414.864
24,78
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
sodium ferric gluconate complex in sucrose 62.5 mg/5 mL intravenous
J2916
24.279.410
159,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization
J7613
487.950.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization
J7613
487.950.160
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization
J7613
4.879.050.160
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
diphenhydrAMINE 50 mg/mL injection solution
J1200
63.323.066.416
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
diphenhydrAMINE 50 mg/mL injection solution
J1200
63.323.066.401
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
pantoprazole 40 mg intravenous solution
C9113
8.400.101
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
morphine 10 mg/mL intravenous solution
J2270
641.612.725
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
tenecteplase 50 mg intravenous kit
J3101
50.242.012.001
5.979,11
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
budesonide 0.5 mg/2 mL suspension for nebulization
J7626
93.681.673
35,46
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
budesonide 0.5 mg/2 mL suspension for nebulization
J7626
781.751.614
35,46
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
iron sucrose 100 mg iron/5 mL intravenous solution
J1756
517.234.099
240,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
prednisoLONE sodium phosphate 15 mg/5 mL (3 mg/mL) oral solution
J7510
121.075.908
86,27
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
crotalidae polyval immune fab solution for injection
J0840
50.633.011.012
10.233,60
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
propranolol 1 mg/mL intravenous solution
J1800
143.987.201
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
alteplase 2 mg intra-catheter solution
J2997
50.242.004.164
459,18
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ertapenem 1 gram solution for injection
J1335
6.384.371
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ertapenem 1 gram solution for injection
J1335
42.023.022.110
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
pamidronate 30 mg/10 mL (3 mg/mL) intravenous solution
J2430
67.457.043.010
150,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
furosemide 10 mg/mL injection solution
J1940
63.323.028.026
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ziprasidone 20 mg/mL (final concentration) intramuscular solution
J3486
49.392.020
149,04
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
gentamicin 40 mg/mL injection solution
J1580
63.323.001.094
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
zoledronic acid 4 mg/5 mL intravenous solution
J3489
25.021.080.166
540,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
haloperidol lactate 5 mg/mL injection solution
J1630
63.323.047.401
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
heparin (porcine) 20,000 unit/500 mL (40 unit/mL) in dextrose 5 % IV
J1644
264.956.710
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
palonosetron 0.25 mg/5 mL intravenous solution
J2469
62.856.079.701
1.041,90
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hydrALAZINE 20 mg/mL injection solution
J0360
63.323.061.401
290,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hydrOXYzine HCl 50 mg/mL intramuscular solution
J3410
517.560.125
128,16
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cinacalcet 60 mg tablet
J0604
55.513.007.430
107,56
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
acetylcysteine 200 mg/mL (20 %) intravenous solution
J0132
55.150.025.930
112,50
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
adenosine 3 mg/mL intravenous solution
J0153
63.323.065.102
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
natalizumab 300 mg/15 mL intravenous solution
J2323
64.406.000.801
9.888,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
aminophylline 250 mg/10 mL intravenous solution
J0280
409.592.101
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
LORazepam 2 mg/mL injection solution,LORazepam 2 mg/mL injection syringe
J2060
409.198.530
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
LORazepam 2 mg/mL injection solution,LORazepam 2 mg/mL injection syringe
J2060
641.604.425
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hydrocortisone sod succinate (PF) 100 mg/2 mL solution for injection,hydrocortisone sodium succinate 100 mg solution for injection
J1720
9.082.501
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
fentaNYL (PF) 100 mcg/2 mL (50 mcg/mL) intravenous syringe,fentaNYL (PF) 50 mcg/mL injection solution
J3010
409.909.332
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
midazolam 1 mg/mL injection solution,midazolam (PF) 1 mg/mL injection solution
J2250
409.230.517
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
amiodarone 50 mg/mL intravenous solution,amiodarone 150 mg/3 mL intravenous syringe
J0282
143.987.501
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
amiodarone 50 mg/mL intravenous solution,amiodarone 150 mg/3 mL intravenous syringe
J0282
143.987.525
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefTRIAXone 1 gram solution for injection
J0696
409.733.201
105,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular susp,hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular syringe
90746
58.160.082.152
250,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
EPINEPHrine 1 mg/mL injection solution,EPINEPHrine HCL (PF) 1 mg/mL (1 mL) injection solution
J0171
42.023.015.925
89,76
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
HYDROmorphone 2 mg/mL injection solution,HYDROmorphone (PF) 2 mg/mL injection solution,HYDROmorphone 2 mg/mL injection syringe
J1170
409.336.511
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
J7613
9.999.999.003
15,34
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
J7512
9.999.999.026
15,85
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
J7510
9.999.999.025
16,48
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
diphth,pertussis(acel),tetanus 2.5 Lf unit-8 mcg-5 Lf/0.5mL IM syringe
90715
58.160.084.252
189,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
glucagon (human recombinant) 1 mg/mL solution for injection
J1610
597.026.010
514,80
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 40 mg/mL (4 %) injection solution
J2001
409.428.325
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 50 mg/5 mL (1 %) intravenous syringe
6360000200
409.913.705
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
lidocaine (PF) 100 mg/5 mL (2 %) intravenous syringe
J2001
409.132.305
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ampicillin 2 gram solution for injection
J0290
781.927.395
80,41
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
magnesium sulfate 4 mEq/mL (50 %) injection solution
J3475
63.323.006.426
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
magnesium sulfate 4 mEq/mL (50 %) injection solution
J3475
63.323.006.403
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylPREDNISolone 4 mg tablet
J7509
59.746.000.106
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
methylPREDNISolone acetate 80 mg/mL suspension for injection
J1040
9.347.501
110,04
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
metoclopramide 5 mg/mL injection solution
J2765
703.450.281
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
nalbuphine 10 mg/mL injection solution
J2300
409.146.401
175,65
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
naloxone 1 mg/mL injection syringe
J2310
76.329.346.901
165,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
orphenadrine citrate 30 mg/mL injection solution
J2360
17.478.053.802
95,16
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
oxytocin 10 unit/mL injection solution
J2590
42.023.011.625
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
phenylephrine 10 mg/mL injection solution
J2370
76.014.000.433
216,25
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
phenytoin sodium 50 mg/mL intravenous solution
J1165
641.255.545
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
potassium chloride 2 mEq/mL intravenous solution
J3480
409.665.305
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
predniSONE 1 mg tablet
J7512
603.533.521
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
predniSONE 10 mg tablet
J7512
143.973.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
predniSONE 20 mg tablet
J7512
54.001.825
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
predniSONE 5 mg tablet
J7512
54.472.825
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
prochlorperazine Edisylate 10 mg/2 mL (5 mg/mL) injection solution
J0780
23.155.052.341
111,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
promethazine 25 mg/mL injection solution
J2550
641.092.825
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
promethazine 50 mg/mL injection solution
J2550
641.149.631
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
protamine 10 mg/mL intravenous solution
J2720
63.323.022.930
184,25
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
atropine 0.1 mg/mL injection syringe
J0461
409.163.010
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
succinylcholine chloride 20 mg/mL injection solution
J0330
409.662.902
115,08
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
levETIRAcetam 500 mg/5 mL intravenous solution
J1953
143.967.310
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
levETIRAcetam 500 mg/5 mL intravenous solution
J1953
63.323.040.005
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
arformoterol 15 mcg/2 mL solution for nebulization
J7605
63.402.091.101
64,72
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
arformoterol 15 mcg/2 mL solution for nebulization
J7605
63.402.091.104
64,72
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
thiamine HCl (vitamin B1) 100 mg/mL injection solution
J3411
63.323.001.302
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
triamcinolone acetonide 40 mg/mL suspension for injection
J3301
70.121.116.801
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
zoledronic acid 5 mg/100 mL in mannitol 5 %-water intravenous piggybck
J3489
78.043.561
2.350,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
vancomycin 1,000 mg intravenous injection
J3370
63.323.028.426
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
vancomycin 1,000 mg intravenous injection
J3370
63.323.028.441
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
fosphenytoin 100 mg PE/2 mL injection solution
Q2009
70.121.138.105
90,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
alteplase 100 mg intravenous solution
J2997
50.242.008.525
14.080,58
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
alteplase 100 mg intravenous solution
J2997
50.242.008.527
14.080,58
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ampicillin-sulbactam 1.5 gram solution for injection
J0295
49.001.381
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ampicillin-sulbactam 3 gram solution for injection
J0295
67.457.034.903
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ketorolac 60 mg/2 mL intramuscular solution
J1885
63.323.016.202
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
azaTHIOprine 50 mg tablet
J7500
378.100.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
betamethasone acetate and sodium phos 6 mg/mL suspension for injection
J0702
517.072.001
247,20
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
romiPLOStim 250 mcg subcutaneous solution
J2796
55.513.022.101
3.428,46
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
romiPLOStim 500 mcg subcutaneous solution
J2796
55.513.022.201
6.135,13
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL nebulization soln
J7620
487.020.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL nebulization soln
J7620
69.097.017.353
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL nebulization soln
J7620
69.097.017.364
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL nebulization soln
J7620
76.204.060.060
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL nebulization soln
J7620
69.097.017.348
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefOXitin 1 gram intravenous solution
J0694
25.021.010.910
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefOXitin 1 gram intravenous solution
J0694
63.323.034.125
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefTAZidime 1 gram solution for injection
J0713
409.508.216
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefTAZidime 2 gram solution for injection
J0713
25.021.012.867
119,82
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
cefTRIAXone 2 gram solution for injection
J0696
409.733.503
156,25
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
imipenem-cilastatin 500 mg intravenous solution
J0743
63.323.032.294
80,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.360.000.200
EPINEPHrine 1 mg/mL injection solution
J0171
42.023.016.801
569,97
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
famotidine 20 mg tablet
172.572.860
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
finasteride 5 mg tablet
16.729.009.015
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
balsam peru-castor oil 87 mg-788 mg/gram topical ointment
58.980.078.021
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
flavoxATE 100 mg tablet
51.224.015.450
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluconazole 200 mg tablet
67.405.060.403
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fludrocortisone 0.1 mg tablet
115.703.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
diclofenac 1 % topical gel
65.162.083.366
176,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
FLUoxetine 10 mg capsule
50.111.064.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
FLUoxetine 20 mg capsule
50.111.064.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
Lactobacil rhamnosus GG 10 billion cell-inulin 200 mg sprinkle capsule
49.100.040.009
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
estradiol 10 mcg vaginal tablet
65.162.022.623
77,59
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glipiZIDE 5 mg tablet
781.145.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glycopyrrolate 1 mg tablet
23.155.060.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone 5 mg tablet
59.762.007.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydroxychloroquine 200 mg tablet
781.140.797
15,11
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydroxychloroquine 200 mg tablet
781.599.401
15,11
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin NPH isophane U-100 human 100 unit/mL subcutaneous suspension
2.831.501
446,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin U-100 regular human 100 unit/mL injection solution
2.821.517
223,05
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
iodoquinol-HC 1 %-1 % topical cream
58.980.081.110
13,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ketoconazole 2 % topical cream
51.672.129.802
5,86
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ketoconazole 2 % topical cream
51.672.129.803
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ketorolac 10 mg tablet
93.031.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
labetalol 100 mg tablet
185.001.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ammonium lactate 12 % lotion
45.802.052.526
62,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tamsulosin 0.4 mg capsule
781.207.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 88 mcg tablet
527.134.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 112 mcg tablet
781.518.592
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 175 mcg tablet
74.707.090
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lidocaine-prilocaine 2.5 %-2.5 % topical cream
115.146.845
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lidocaine-prilocaine 2.5 %-2.5 % topical cream
168.035.705
7,64
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methyl salicylate-menthol topical ointment
54.162.055.501
6,34
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 10 mg tablet
68.180.098.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 40 mg tablet
68.180.051.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 5 mg tablet
68.180.051.303
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 100 mcg-salmeterol 50 mcg/dose blistr powdr for inhalation
173.069.504
43,35
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 250 mcg-salmeterol 50 mcg/dose blistr powdr for inhalation
173.069.600
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 250 mcg-salmeterol 50 mcg/dose blistr powdr for inhalation
173.069.604
43,35
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 500 mcg-salmeterol 50 mcg/dose blistr powdr for inhalation
173.069.704
70,66
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
loratadine 10 mg tablet
45.802.065.078
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium oxide 400 mg (241.3 mg magnesium) tablet
904.660.961
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium oxide 400 mg (241.3 mg magnesium) tablet
63.739.035.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metFORMIN 500 mg tablet
23.155.010.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metOLazone 2.5 mg tablet
378.617.201
8,33
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metroNIDAZOLE 0.75 % vaginal gel
781.707.787
8,07
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
midodrine 5 mg tablet
245.021.211
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
neomycin 3.5 mg/g-polymyxin B 10,000 unit/g-dexameth 0.1 % eye oint
574.416.035
66,60
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
miSOPROStol 200 mcg tablet
43.386.016.106
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 10 mg-chlorpheniramine 8 mg/5 mL oral susp extend.rel 12hr
27.808.008.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dabigatran etexilate 75 mg capsule
597.035.556
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
mupirocin 2 % topical ointment
51.672.131.200
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
mupirocin 2 % topical ointment
45.802.011.222
35,99
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
NIFEdipine ER 60 mg tablet,extended release
591.319.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitrofurantoin monohydrate/macrocrystals 100 mg capsule
378.342.201
11,85
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitrofurantoin monohydrate/macrocrystals 100 mg capsule
185.012.201
11,86
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
omega-3 fatty acids-fish oil 300 mg-1,000 mg capsule
30.768.003.304
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
electrolytes-dextrose oral solution
70.074.080.365
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE 5 mg tablet
10.702.001.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
peg 3350-electrolytes 236 gram-22.74 gram-6.74 gram-5.86 gram solution
43.386.009.019
64,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
PARoxetine 20 mg tablet
60.505.008.302
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
PARoxetine 20 mg tablet
904.567.761
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
PARoxetine 30 mg tablet
378.700.393
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
linagliptin 5 mg tablet
597.014.030
54,86
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rivaroxaban 10 mg tablet
50.458.058.030
55,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcium polycarbophil 625 mg tablet
536.430.605
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oseltamivir 6 mg/mL oral suspension
4.082.205
33,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pravastatin 10 mg tablet
68.462.019.590
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pravastatin 20 mg tablet
68.462.019.690
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pravastatin 20 mg tablet
68.382.007.116
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pravastatin 40 mg tablet
60.505.017.009
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pravastatin 40 mg tablet
68.462.019.790
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pravastatin 40 mg tablet
42.291.066.890
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ferrous gluconate 324 mg (37.5 mg iron) tablet
904.213.761
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
primidone 50 mg tablet
603.537.121
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
prochlorperazine 25 mg rectal suppository
713.013.512
39,23
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
promethazine 12.5 mg rectal suppository
713.053.612
38,99
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
promethazine 25 mg rectal suppository
713.052.612
22,52
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
quinapril 20 mg tablet
69.097.084.205
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ramipril 1.25 mg capsule
54.010.625
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ramipril 2.5 mg capsule
65.862.047.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
raNITIdine 150 mg tablet
65.162.025.350
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rivaroxaban 15 mg tablet
50.458.057.830
37,25
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rivaroxaban 20 mg tablet
50.458.057.990
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acetaZOLAMIDE 250 mg tablet
23.155.028.801
10,66
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
racepinephrine 2.25 % solution for nebulization
487.590.102
6,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sertraline 100 mg tablet
68.180.035.302
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sertraline 50 mg tablet
68.180.035.202
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
simvastatin 10 mg tablet
16.729.000.415
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
simvastatin 20 mg tablet
68.180.047.902
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
simvastatin 40 mg tablet
16.729.000.615
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sodium phosphates 19 gram-7 gram/118 mL enema
132.020.140
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sotalol 80 mg tablet
60.505.008.000
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sucralfate 1 gram tablet
93.221.005
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium 64 mg (magnesium chloride) tablet,delayed release
68.585.000.575
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tamoxifen 20 mg tablet
378.027.493
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
timolol maleate 0.25 % eye drops
64.980.051.301
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tobramycin 0.3 %-dexamethasone 0.1 % eye drops,suspension
24.208.029.505
354,90
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sulfamethoxazole 800 mg-trimethoprim 160 mg tablet
53.746.027.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
vancomycin 125 mg capsule
68.180.016.611
23,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 1 mg tablet
93.171.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 1 mg tablet
56.016.975
9,53
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ipratropium 20 mcg-albuterol 100 mcg/actuation mist for inhalation
597.002.402
856,78
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
mirabegron ER 25 mg tablet,extended release 24 hr
469.260.190
47,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
zolpidem 5 mg tablet
378.530.501
10,70
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
morphine ER 30 mg tablet,extended release
42.858.080.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
diclofenac 50 mg-misoprostol 200 mcg tablet,immed.and delayed release
59.762.002.802
12,39
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
apixaban 2.5 mg tablet
3.089.321
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
morphine ER 15 mg tablet,extended release
42.858.080.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
morphine ER 60 mg tablet,extended release
42.858.080.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
morphine ER 100 mg tablet,extended release
42.858.080.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
apixaban 5 mg tablet
3.089.421
16,13
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
meclizine 12.5 mg tablet
536.101.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
memantine 14 mg capsule sprinkle,extended release 24hr
456.341.490
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
doxylamine 10 mg-pyridoxine (vit B6) 10 mg tablet,delayed release
55.494.010.010
54,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium hydroxide 400 mg/5 mL oral suspension
121.043.130
9,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
venlafaxine 100 mg tablet
57.664.039.688
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
venlafaxine 75 mg tablet
52.817.013.310
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
venlafaxine 37.5 mg tablet
57.664.039.388
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE ER 10 mg tablet,crush resistant,extended release 12 hr
59.011.041.010
16,98
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE ER 10 mg tablet,crush resistant,extended release 12 hr
59.011.041.020
17,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE ER 20 mg tablet,crush resistant,extended release 12 hr
59.011.042.010
15,84
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cholestyramine-aspartame 4 gram oral powder for susp in a packet
49.884.046.663
9,48
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluocinonide-emollient 0.05 % topical cream
93.026.330
11,87
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
activated charcoal-sorbitol 25 gram/120 mL oral suspension
574.012.074
53,28
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
activated charcoal 25 gram/120 mL oral suspension
574.012.104
53,28
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin aspart U-100 100 unit/mL subcutaneous pen
169.633.910
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin glargine (U-100) 100 unit/mL (3 mL) subcutaneous pen
88.221.905
323,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin glargine (U-100) 100 unit/mL (3 mL) subcutaneous pen
2.771.559
261,08
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin lispro (U-100) 100 unit/mL subcutaneous pen
2.879.959
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin detemir (U-100) 100 unit/mL (3 mL) subcutaneous pen
169.643.810
352,50
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin aspar prot-insulin aspart 100 unit/mL (70-30) subcutaneous pen
169.369.619
400,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
liraglutide 0.6 mg/0.1 mL (18 mg/3 mL) subcutaneous pen injector
169.406.013
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
estradiol 0.5 mg tablet
555.089.902
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sodium chloride-aloe vera nasal gel
225.052.547
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
aspirin-sod bicarb-citric acid 325 mg-1,916 mg-1,000 mg efferves tab
16.500.004.012
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
trolamine salicylate-aloe vera 10 % topical cream
41.167.005.703
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carbidopa ER 25 mg-levodopa 100 mg tablet,extended release
378.008.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
multivit-min-FA 100 mcg-lut 1.66 mg-zeaxanth 0.83 mg tablet,delay rel.
65.804.083
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
terbinafine HCl 250 mg tablet
51.991.052.633
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tiotropium bromide 2.5 mcg/actuation mist for inhalation
597.010.061
914,62
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
umeclidinium 62.5 mcg/actuation blister powder for inhalation
173.087.310
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
naloxegol 25 mg tablet
310.197.030
46,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
white petrolatum-mineral oil 83 %-15 % eye ointment
904.648.838
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
white petrolatum-mineral oil 83 %-15 % eye ointment
536.108.691
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
scopolamine 1 mg over 3 days transdermal patch
66.758.020.854
71,33
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pentosan polysulfate sodium 100 mg capsule
50.458.009.801
35,46
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
thyroid (pork) 30 mg tablet
456.045.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcium carbonate 500 mg calcium (1,250 mg) tablet
904.188.372
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
thiamine mononitrate (vitamin B1) 100 mg tablet
50.268.085.111
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
salt irrigation solution no.3 2.1 % nasal solution
51.817.060.223
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
verapamil ER (SR) 240 mg tablet,extended release
68.462.026.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 2.5 mg tablet
68.180.051.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
valACYclovir 1 gram tablet
378.427.693
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
valACYclovir 500 mg tablet
51.079.009.301
14,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
naproxen sodium 220 mg tablet
10.939.063.544
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
naproxen sodium 220 mg tablet
536.109.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
verapamil ER (SR) 120 mg tablet,extended release
51.079.089.401
8,92
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methyl salicylate 15 %-menthol 1 % topical cream
178.032.005
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
SUMAtriptan 100 mg tablet
55.111.029.309
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acidophilus 25 million cell-pectin, citrus 100 mg tablet
536.718.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carBAMazepine 100 mg chewable tablet
51.672.404.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carBAMazepine 200 mg tablet
13.668.026.801
5,91
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluconazole 150 mg tablet
57.237.000.511
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carbamide peroxide 6.5 % ear drops
904.322.035
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
potassium chloride ER 10 mEq capsule,extended release
53.746.054.205
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
potassium chloride ER 10 mEq capsule,extended release
66.758.020.505
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carisoprodol 350 mg tablet
64.980.017.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carisoprodol 350 mg tablet
603.258.221
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lamoTRIgine 25 mg tablet
51.672.413.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lamoTRIgine 100 mg tablet
51.672.413.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acetaminophen 300 mg-codeine 30 mg tablet
406.048.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acetaminophen 300 mg-codeine 30 mg tablet
93.015.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem ER 60 mg capsule,extended release 12 hr
378.606.001
11,73
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ketoconazole 2 % shampoo
10.147.075.004
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
terazosin 1 mg capsule
59.746.038.306
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
terazosin 2 mg capsule
59.746.038.406
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
terazosin 5 mg capsule
59.746.038.506
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
traMADol 50 mg tablet
63.739.067.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
traMADol 50 mg tablet
57.664.037.718
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metFORMIN 850 mg tablet
23.155.010.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tiZANidine 2 mg tablet
57.664.050.289
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tiZANidine 4 mg tablet
904.641.861
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
losartan 25 mg tablet
65.862.020.190
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
losartan 50 mg tablet
65.862.020.290
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fosfomycin tromethamine 3 gram oral packet
456.430.001
277,83
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
SUMAtriptan 50 mg tablet
55.111.029.236
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
diclofenac sodium 75 mg tablet,delayed release
61.442.010.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcitonin (salmon) 200 unit/actuation nasal spray
49.884.016.111
13,34
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carvedilol 6.25 mg tablet
68.382.009.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carvedilol 25 mg tablet
68.382.009.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carvedilol 25 mg tablet
68.462.016.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carvedilol 12.5 mg tablet
68.382.009.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
azithromycin 200 mg/5 mL oral suspension
93.202.623
104,64
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
azithromycin 200 mg/5 mL oral suspension
93.202.631
104,64
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
azithromycin 200 mg/5 mL oral suspension
70.710.145.802
84,24
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ipratropium bromide 0.03 % nasal spray
54.004.544
126,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
chlordiazePOXIDE 10 mg capsule
555.003.302
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
chlordiazePOXIDE 25 mg capsule
555.015.902
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
chlordiazePOXIDE 5 mg capsule
51.079.037.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glimepiride 1 mg tablet
16.729.000.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glimepiride 2 mg tablet
68.084.032.611
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glimepiride 4 mg tablet
16.729.000.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
buPROPion HCl 150 mg tablet,12 hr sustained-release(smoking deterrent)
591.354.360
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ferrous sulfate 220 mg (44 mg iron)/5 mL oral elixir
904.146.516
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ferrous sulfate 220 mg (44 mg iron)/5 mL oral elixir
50.383.077.816
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
chlorthalidone 25 mg tablet
51.079.005.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
PARoxetine 10 mg tablet
378.700.193
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
PARoxetine 40 mg tablet
378.700.493
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lidocaine 4 % topical patch
41.167.005.840
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lidocaine 4 % topical patch
46.581.083.006
54,96
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
theophylline ER 400 mg tablet,extended release 24 hr
42.858.070.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sodium polystyrene sulfonate 15 gram-sorbitol 20 gram/60 mL oral susp
46.287.000.660
36,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium 70 mg (magnesium chloride) tablet,delayed release
904.791.152
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
melatonin 3 mg tablet
904.518.252
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clindamycin HCl 150 mg capsule
63.304.069.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin lispro (U-100) 100 unit/mL subcutaneous solution
2.751.001
505,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
busPIRone 15 mg tablet
68.382.018.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
mirtazapine 30 mg tablet
93.720.756
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
mirtazapine 15 mg tablet
93.720.656
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cloNIDine HCl 0.1 mg tablet
29.300.013.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clotrimazole 1 % topical cream
904.782.231
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler
173.068.220
188,12
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler
173.068.224
85,70
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler
59.310.057.922
208,49
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
brimonidine 0.2 % eye drops
24.208.041.110
109,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
brimonidine 0.2 % eye drops
61.314.014.310
112,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
OLANZapine 5 mg tablet
43.598.016.430
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
OLANZapine 10 mg tablet
43.598.016.630
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
colchicine 0.6 mg tablet
64.764.011.907
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
peg-electrolyte solution 420 gram oral solution
52.268.040.001
112,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
bisoprolol 10 mg-hydrochlorothiazide 6.25 mg tablet
29.300.018.913
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gabapentin 400 mg capsule
67.877.022.405
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gabapentin 300 mg capsule
67.877.022.305
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gabapentin 100 mg capsule
67.877.022.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gabapentin 100 mg capsule
67.877.022.205
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
risperiDONE 1 mg tablet
50.458.059.260
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
buPROPion HCl SR 100 mg tablet,12 hr sustained-release
185.041.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
buPROPion HCl SR 150 mg tablet,12 hr sustained-release
185.041.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carvedilol 3.125 mg tablet
378.363.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carvedilol 3.125 mg tablet
68.462.016.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
latanoprost 0.005 % eye drops
61.314.054.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
donepezil 10 mg tablet
43.547.027.609
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levoFLOXacin 500 mg tablet
55.111.028.050
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydroCHLOROthiazide 12.5 mg capsule
29.300.013.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydroCHLOROthiazide 12.5 mg capsule
591.034.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atorvastatin 10 mg tablet
378.395.077
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atorvastatin 40 mg tablet
378.395.277
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atorvastatin 20 mg tablet
93.505.998
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 3 mg tablet
93.171.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 3 mg tablet
56.018.875
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcium carbonate 500 mg (1,250 mg)-vitamin D3 200 unit tablet
37.864.000.032
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
benzocaine 20 % gum/denture cream
41.167.005.302
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clindamycin 1 % lotion
168.020.360
8,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metroNIDAZOLE 0.75 % topical gel
115.147.446
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ofloxacin 0.3 % eye drops
64.980.051.505
205,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sertraline 25 mg tablet
68.180.035.109
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cyanocobalamin (vit B-12) 100 mcg tablet
536.354.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cyanocobalamin (vit B-12) 500 mcg tablet
96.295.012.778
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cyclobenzaprine 10 mg tablet
603.307.921
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
meloxicam 7.5 mg tablet
68.180.050.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
imiquimod 5 % topical cream packet
45.802.036.862
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
azithromycin 250 mg tablet
Q0144
50.111.078.751
11,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
azithromycin 250 mg tablet
Q0144
68.180.016.011
6,50
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
OLANZapine 2.5 mg tablet
55.111.016.330
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
citalopram 20 mg tablet
378.623.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pramipexole 0.125 mg tablet
68.462.033.090
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pramipexole 0.25 mg tablet
68.382.019.716
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dapsone 100 mg tablet
49.938.010.130
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 4 mg tablet
56.016.875
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 4 mg tablet
51.672.403.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
letrozole 2.5 mg tablet
51.991.075.933
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rOPINIRole 0.25 mg tablet
54.011.625
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rOPINIRole 0.5 mg tablet
43.547.026.910
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine 25 mg tablet
67.877.024.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine 200 mg tablet
67.877.024.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clopidogrel 75 mg tablet
16.729.021.816
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cefdinir 300 mg capsule
781.217.660
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
montelukast 10 mg tablet
54.025.922
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sulfamethoxazole 200 mg-trimethoprim 40 mg/5 mL oral suspension
65.862.049.647
412,31
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
losartan 100 mg tablet
65.862.020.390
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
losartan 100 mg tablet
43.547.036.209
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ursodiol 250 mg tablet
49.884.041.201
9,91
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tolterodine 2 mg tablet
93.001.806
6,28
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
camphor-menthol 0.5 %-0.5 % lotion
73.462.006.285
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
simvastatin 80 mg tablet
16.729.000.715
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lidocaine 5 % topical cream
496.089.230
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
citalopram 40 mg tablet
378.623.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
diazePAM 5 mg tablet
172.392.660
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dicloxacillin 250 mg capsule
93.312.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dicloxacillin 500 mg capsule
93.312.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dicyclomine 20 mg tablet
378.162.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
isosorbide mononitrate ER 60 mg tablet,extended release 24 hr
62.175.011.937
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
digoxin 125 mcg tablet
143.124.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
digoxin 250 mcg tablet
49.884.049.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxybutynin chloride ER 5 mg tablet,extended release 24 hr
378.660.501
10,79
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxybutynin chloride ER 10 mg tablet,extended release 24 hr
378.661.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cilostazol 50 mg tablet
60.505.252.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cilostazol 100 mg tablet
93.206.406
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
celecoxib 100 mg capsule
59.762.151.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
celecoxib 200 mg capsule
69.097.042.107
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
isosorbide mononitrate ER 30 mg tablet,extended release 24 hr
62.175.012.837
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 10 mg-hydrochlorothiazide 12.5 mg tablet
68.180.051.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem 120 mg tablet
93.032.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem 30 mg tablet
93.031.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem 60 mg tablet
51.079.074.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dextromethorphan-guaifenesin 30 mg-600 mg tablet extended release12 hr
63.824.005.640
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dimenhyDRINATE 50 mg tablet
904.205.159
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ciprofloxacin 500 mg tablet
143.992.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
diphenoxylate-atropine 2.5 mg-0.025 mg tablet
378.041.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
verapamil ER 120 mg 24 hr capsule,extended release
378.632.001
6,72
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 400 mg/5 mL oral suspension
143.988.701
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glucosamine-chondroitin 500 mg-400 mg tablet
43.292.056.003
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
polyethylene glycol 3350 17 gram oral powder packet
904.642.286
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fexofenadine 180 mg tablet
904.621.446
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
risperiDONE 0.25 mg tablet
68.382.011.214
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
risperiDONE 0.25 mg tablet
904.635.761
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
risperiDONE 0.5 mg tablet
50.458.059.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
risperiDONE 0.5 mg tablet
68.382.011.314
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pioglitazone 15 mg tablet
16.729.002.010
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pioglitazone 45 mg tablet
16.729.002.215
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gabapentin 600 mg tablet
68.462.012.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
doxepin 10 mg capsule
378.104.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pantoprazole 40 mg tablet,delayed release
65.862.056.090
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
doxycycline hyclate 100 mg capsule
143.314.250
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oseltamivir 75 mg capsule
4.080.085
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oseltamivir 75 mg capsule
70.710.101.002
18,85
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levETIRAcetam 500 mg tablet
31.722.053.712
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ciclopirox 8 % topical solution
51.672.530.200
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
theophylline ER 200 mg capsule,extended release 24 hr
52.244.020.010
13,72
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin 0.1 mg/hr transdermal 24 hour patch
378.910.216
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin 0.2 mg/hr transdermal 24 hour patch
68.382.030.930
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin 0.4 mg/hr transdermal 24 hour patch
904.549.646
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
felodipine ER 5 mg tablet,extended release 24 hr
13.668.013.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pseudoephedrine-guaifenesin ER 60 mg-600 mg tablet,extend release 12hr
63.824.005.718
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
divalproex 125 mg capsule,delayed release sprinkle
68.382.010.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
NIFEdipine ER 60 mg tablet,extended release 24 hr
68.682.010.910
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lansoprazole 15 mg capsule,delayed release
781.214.731
9,24
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lansoprazole 30 mg capsule,delayed release
378.803.093
9,24
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
omeprazole 20 mg capsule,delayed release
60.505.006.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
omeprazole 40 mg capsule,delayed release
781.223.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
omeprazole 40 mg capsule,delayed release
60.505.014.602
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
venlafaxine ER 37.5 mg capsule,extended release 24 hr
65.862.052.790
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
venlafaxine ER 75 mg capsule,extended release 24 hr
65.862.052.890
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fentaNYL 25 mcg/hr transdermal patch
60.505.700.600
21,11
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fentaNYL 50 mcg/hr transdermal patch
60.505.700.702
39,20
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fentaNYL 75 mcg/hr transdermal patch
60.505.700.802
49,49
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fentaNYL 100 mcg/hr transdermal patch
60.505.700.902
77,60
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carboxymethylcellulose sodium 1 % eye liquid gel drops
23.920.515
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
chlorhexidine gluconate 4 % topical liquid
32.551.093.835
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lidocaine 5 % topical patch
603.188.010
29,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
linezolid 600 mg tablet
59.762.130.701
38,52
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
salmeterol 50 mcg/dose blister powder for inhalation
173.052.000
31,73
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 10 mg-acetaminophen 325 mg tablet
43.386.035.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
insulin aspart U-100 100 unit/mL subcutaneous solution
169.750.111
665,53
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ergocalciferol (vitamin D2) 50,000 unit capsule
64.380.073.706
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
NIFEdipine ER 30 mg tablet,extended release 24 hr
68.682.010.810
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atorvastatin 80 mg tablet
93.505.798
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glyBURIDE 5 mg-metformin 500 mg tablet
65.862.008.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone 2.5 % topical cream with perineal applicator
64.980.032.430
9,71
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
erythromycin 5 mg/gram (0.5 %) eye ointment
24.208.091.055
60,80
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metFORMIN ER 500 mg tablet,extended release 24 hr
62.756.014.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
alendronate 70 mg tablet
69.097.022.416
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine 300 mg tablet
47.335.090.688
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem ER 120 mg capsule,24 hr,extended release
68.682.036.790
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem CD 120 mg capsule,extended release 24 hr
63.739.028.331
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem CD 180 mg capsule,extended release 24 hr
68.084.005.311
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem CD 240 mg capsule,extended release 24 hr
10.370.083.109
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem ER (XR/XT) 180 mg capsule,extended release 24 hr, controlled
378.528.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dilTIAZem ER (XR/XT) 240 mg capsule,extended release 24 hr, controlled
60.505.001.606
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clotrimazole-betamethasone 1 %-0.05 % topical cream
168.025.815
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tolterodine ER 2 mg capsule,extended release 24 hr
378.340.293
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tolterodine ER 4 mg capsule,extended release 24 hr
93.716.498
14,85
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sodium chloride 0.65 % nasal spray aerosol
904.386.575
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
esomeprazole magnesium 20 mg capsule,delayed release
186.502.054
33,46
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
esomeprazole magnesium 20 mg capsule,delayed release
93.645.098
23,62
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
esomeprazole magnesium 40 mg capsule,delayed release
186.504.054
19,32
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
esomeprazole magnesium 40 mg capsule,delayed release
93.645.198
23,19
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoprolol succinate ER 25 mg tablet,extended release 24 hr
62.037.083.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoprolol succinate ER 50 mg tablet,extended release 24 hr
62.037.083.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoprolol succinate ER 100 mg tablet,extended release 24 hr
68.084.067.311
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoprolol succinate ER 200 mg tablet,extended release 24 hr
49.884.082.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
citalopram 10 mg tablet
378.623.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ferrous gluconate 324 mg (38 mg iron) tablet
574.050.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ferrous sulfate 220 mg (44 mg iron)/5 mL oral solution
5.361.015.516
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ferrous sulfate 325 mg (65 mg iron) tablet
904.759.180
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
allopurinol 100 mg tablet
378.013.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
allopurinol 300 mg tablet
603.211.621
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
allopurinol 300 mg tablet
70.710.121.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
valsartan 80 mg tablet
43.547.036.809
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE-acetaminophen 10 mg-325 mg tablet
406.052.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluorometholone 0.1 % eye drops,suspension
60.758.088.005
248,68
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
folic acid 1 mg tablet
603.316.221
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
folic acid 1 mg tablet
11.534.016.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ALPRAZolam 0.25 mg tablet
67.253.090.010
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ALPRAZolam 0.25 mg tablet
51.079.078.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ALPRAZolam 0.5 mg tablet
67.253.090.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
risedronate 35 mg tablet
430.047.203
46,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
furosemide 10 mg/mL oral solution
54.329.446
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
furosemide 20 mg tablet
54.429.731
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
furosemide 40 mg tablet
378.021.610
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
furosemide 80 mg tablet
378.023.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 500 mg-potassium clavulanate 125 mg tablet
66.685.100.200
6,52
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 875 mg-potassium clavulanate 125 mg tablet
66.685.100.100
23,33
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 400 mg-potassium clavulanate 57 mg/5 mL oral suspension
65.862.053.401
58,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
escitalopram 10 mg tablet
93.585.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
escitalopram 20 mg tablet
93.585.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
valsartan 40 mg tablet
43.547.036.703
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gemfibrozil 600 mg tablet
69.097.082.103
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dutasteride 0.5 mg capsule
173.071.215
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ezetimibe 10 mg tablet
49.884.022.811
9,67
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
propylene glycol 1 %-glycerin 0.3 % eye drops
10.119.002.003
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
gentian violet 1 % topical solution
395.100.392
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ARIPiprazole 10 mg tablet
60.505.267.403
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 5 mg-acetaminophen 325 mg tablet
53.746.010.905
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 5 mg-acetaminophen 325 mg tablet
904.656.761
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
603.389.128
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
904.642.061
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
65.162.011.550
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
guaiFENesin 400 mg tablet
57.896.079.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
neomycin-polymyxin-hydrocort 3.5 mg/mL-10,000 unit/mL-1 % ear solution
24.208.063.110
293,65
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
neomycin-polymyxin-hydrocort 3.5 mg/mL-10,000 unit/mL-1 % ear solution
61.314.064.610
262,57
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glyBURIDE 5 mg tablet
23.155.005.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rosuvastatin 20 mg tablet
310.075.290
10,04
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cyclobenzaprine 5 mg tablet
591.325.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
coenzyme Q10 50 mg capsule
79.854.000.848
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
haloperidol 1 mg tablet
378.025.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
haloperidol 2 mg tablet
781.139.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
peg 400-propylene glycol 0.4 %-0.3 % eye drops
65.143.105
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
potassium chloride ER 20 mEq tablet,extended release(part/cryst)
781.572.010
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
potassium chloride ER 20 mEq tablet,extended release(part/cryst)
66.758.019.006
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
menthol 5 % topical patch
41.167.000.843
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amantadine HCl 100 mg capsule
832.201.200
7,46
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ARIPiprazole 5 mg tablet
13.668.021.730
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levETIRAcetam 100 mg/mL oral solution
16.714.035.801
167,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
rosuvastatin 5 mg tablet
781.540.092
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
buPROPion HCl XL 150 mg 24 hr tablet, extended release
10.370.010.103
6,03
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
phenylephrine 0.125 % nasal drops
56.184.012.105
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amiodarone 100 mg tablet
51.862.015.430
12,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amiodarone 100 mg tablet
51.862.024.030
12,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
memantine 10 mg tablet
29.300.017.216
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
alfuzosin ER 10 mg tablet,extended release 24 hr
60.505.285.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrALAZINE 25 mg tablet
23.155.000.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydroCHLOROthiazide 25 mg tablet
16.729.018.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone 1 % topical cream
45.802.043.803
9,70
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone 2.5 % topical cream
168.008.031
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone 10 mg tablet
68.084.046.911
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone 20 mg tablet
59.762.007.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrocortisone acetate 25 mg rectal suppository
713.050.312
26,56
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROmorphone 2 mg tablet
42.858.030.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
escitalopram 5 mg tablet
378.385.577
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoprolol tartrate 25 mg tablet
378.001.805
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glipiZIDE ER 5 mg tablet, extended release 24 hr
68.084.011.111
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glipiZIDE ER 10 mg tablet, extended release 24 hr
59.762.054.202
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
guaiFENesin ER 600 mg tablet, extended release 12 hr
63.824.000.840
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrOXYzine HCl 25 mg tablet
10.702.001.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
hydrOXYzine HCl 25 mg tablet
23.155.050.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
HYDROcodone 7.5 mg-acetaminophen 325 mg/15 mL oral solution
66.689.002.316
167,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
propranolol ER 60 mg capsule,24 hr,extended release
51.991.081.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lactulose 10 gram/15 mL oral solution
50.383.077.932
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tiotropium bromide 18 mcg capsule with inhalation device
597.007.575
63,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ibuprofen 400 mg tablet
67.877.031.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ibuprofen 600 mg tablet
55.111.068.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ibuprofen 800 mg tablet
53.746.046.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
vitamin B complex and vitamin C no.20-folic acid 1 mg capsule
69.543.026.010
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
aMILoride 5 mg tablet
574.029.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nystatin 100,000 unit/gram topical powder
832.046.530
6,57
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
DULoxetine 20 mg capsule,delayed release
57.237.001.760
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
DULoxetine 30 mg capsule,delayed release
57.237.001.830
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
DULoxetine 60 mg capsule,delayed release
57.237.001.930
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
DULoxetine 60 mg capsule,delayed release
57.237.001.999
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
solifenacin 5 mg tablet
51.248.015.003
48,49
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
darifenacin ER 7.5 mg tablet,extended release 24 hr
69.097.043.102
32,76
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
isosorbide dinitrate 10 mg tablet
143.177.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 110 mcg/actuation HFA aerosol inhaler
173.071.920
559,56
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 220 mcg/actuation HFA aerosol inhaler
173.072.020
869,15
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cholecalciferol (vitamin D3) 1,000 unit tablet,cholecalciferol (vitamin D3) 1,000 unit capsule
79.854.005.023
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cholecalciferol (vitamin D3) 5,000 unit capsule,cholecalciferol (vitamin D3) 5,000 unit tablet
904.598.660
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cholecalciferol (vitamin D3) 400 unit tablet,cholecalciferol (vitamin D3) 400 unit capsule
904.582.360
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
loperamide 2 mg capsule,loperamide 2 mg tablet
378.210.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
Lactobacillus rhamnosus GG 10 billion cell capsule,Lactobacillus rhamnosus GG 15 billion cell sprinkle capsule,Lactobacillus acidophilus 75 million cell-pectin 100 mg capsule
49.100.038.164
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.307.701
28,90
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.307.801
28,35
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.307.901
25,87
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.308.001
28,63
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dextromethorphan-guaifenesin 10 mg-100 mg/5 mL syrup,dextromethorphan-guaifenesin 10 mg-100 mg/5 mL oral liquid
31.873.612
20,72
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dextromethorphan-guaifenesin 10 mg-100 mg/5 mL syrup,dextromethorphan-guaifenesin 10 mg-100 mg/5 mL oral liquid
70.000.030.101
25,62
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dextromethorphan-guaifenesin 10 mg-100 mg/5 mL syrup,dextromethorphan-guaifenesin 10 mg-100 mg/5 mL oral liquid
96.295.013.210
25,62
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cocaine 4 % topical solution,cocaine 4 % nasal solution
527.172.874
156,18
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
morphine concentrate 20 mg/mL oral syringe (FOR ORAL USE ONLY),morphine concentrate 100 mg/5 mL (20 mg/mL) oral solution
406.800.330
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
polyethylene glycol 3350 17 gram oral powder packet,polyethylene glycol 3350 17 gram/dose oral powder
45.802.086.801
18,69
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
polyethylene glycol 3350 17 gram oral powder packet,polyethylene glycol 3350 17 gram/dose oral powder
45.802.086.802
29,51
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
polyethylene glycol 3350 17 gram oral powder packet,polyethylene glycol 3350 17 gram/dose oral powder
904.642.286
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
potassium chloride ER 10 mEq tablet,extended release,potassium chloride ER 10 mEq tablet,extended release(part/cryst)
66.758.016.005
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.308.401
20,25
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.000
21,19
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.007
43,05
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.001
15,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.014
17,15
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.023
15,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.002
35,17
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.004
14,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.005
14,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.308.301
17,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.308.101
14,31
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.006
20,13
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.008
36,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.009
14,54
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.010
14,59
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.013
19,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.011
14,29
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.015
14,01
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.016
14,19
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.019
29,13
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.022
59,31
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.024
14,96
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.029
19,99
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.031
14,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.030
14,20
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.012
28,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.017
30,40
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.018
265,45
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.308.501
15,45
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.308.201
28,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glycerin (adult) rectal suppository
132.007.912
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ibandronate 150 mg tablet
55.111.057.511
56,67
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fentaNYL 12 mcg/hr transdermal patch
60.505.701.000
64,96
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
mometasone 220 mcg (14 doses) breath activated powder inhaler
85.134.106
258,86
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pregabalin 25 mg capsule
71.101.268
29,73
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pregabalin 50 mg capsule
71.101.368
17,17
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pregabalin 75 mg capsule
71.101.468
11,45
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pregabalin 100 mg capsule
71.101.568
29,73
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
losartan 100 mg-hydrochlorothiazide 12.5 mg tablet
13.668.011.790
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
leucovorin calcium 5 mg tablet
54.449.613
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 25 mcg tablet
527.134.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 50 mcg tablet
378.180.377
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 75 mcg tablet
378.180.577
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 100 mcg tablet
378.180.977
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 125 mcg tablet
378.181.377
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levothyroxine 150 mcg tablet
378.181.577
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 250 mg capsule
781.202.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
liothyronine 25 mcg tablet
42.794.001.902
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 500 mg capsule
781.261.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 250 mg chewable tablet
93.226.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 20 mg tablet
378.207.510
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lisinopril 20 mg tablet
68.180.098.103
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 250 mg/5 mL oral suspension
781.604.146
16,63
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
loperamide 2 mg capsule
378.210.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
loperamide 2 mg capsule
96.295.013.094
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
LORazepam 2 mg/mL oral concentrate
54.353.244
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
LORazepam 0.5 mg tablet
69.315.090.405
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
LORazepam 1 mg tablet
69.315.090.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
LORazepam 1 mg tablet
904.600.861
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ampicillin 250 mg capsule
67.253.018.010
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium citrate oral solution
904.630.477
8,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
magnesium oxide 500 mg tablet
904.423.960
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
medroxyPROGESTERone 2.5 mg tablet
555.087.202
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
medroxyPROGESTERone 2.5 mg tablet
59.762.374.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
9.999.999.028
42,99
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
meperidine 50 mg tablet
54.459.525
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methocarbamol 750 mg tablet
31.722.053.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methotrexate sodium 2.5 mg tablet
68.382.077.501
10,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methotrexate sodium 2.5 mg tablet
54.855.025
14,08
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methyldopa 250 mg tablet
16.729.003.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
methylphenidate 10 mg tablet
31.722.017.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoclopramide 10 mg tablet
93.220.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoclopramide 5 mg tablet
93.220.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoprolol tartrate 50 mg tablet
378.003.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metroNIDAZOLE 500 mg tablet
29.300.022.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
miconazole nitrate 2 % topical cream
472.073.556
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
morphine 15 mg immediate release tablet
54.023.525
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
naproxen 250 mg tablet
65.162.018.810
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
naproxen 500 mg tablet
49.483.061.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
niacin 100 mg tablet
79.854.020.130
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
niacin 500 mg tablet
904.227.260
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin ER 2.5 mg capsule,extended release
904.064.360
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin ER 6.5 mg capsule,extended release
904.064.460
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin 0.4 mg sublingual tablet
71.041.813
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nitroglycerin 2 % transdermal ointment
281.032.608
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nortriptyline 25 mg capsule
51.672.400.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nystatin 100,000 unit/gram topical ointment
168.000.730
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nystatin 100,000 unit/mL oral suspension
68.094.059.959
6,38
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nystatin 100,000 unit/mL oral suspension
60.432.053.760
50,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxybutynin chloride 5 mg tablet
832.003.800
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxybutynin chloride 5 mg tablet
50.111.045.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE-acetaminophen 5 mg-325 mg tablet
53.746.020.305
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxyCODONE-acetaminophen 5 mg-325 mg tablet
68.308.040.547
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oxymetazoline 0.05 % nasal spray
904.571.135
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
penicillin V potassium 250 mg/5 mL oral solution
93.412.773
32,80
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
penicillin V potassium 250 mg tablet
16.714.023.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
phenazopyridine 200 mg tablet
75.826.011.510
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
PHENobarbital 20 mg/5 mL (4 mg/mL) oral elixir
16.571.033.016
279,78
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
phenobarb-hyoscy-atropine-scop 16.2 mg-0.1037 mg-0.0194 mg/5 mL elixir
59.212.042.204
817,79
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
phenobarb-hyoscy-atropine-scop 16.2 mg-0.1037 mg-0.0194 mg/5 mL elixir
75.826.012.804
613,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
phenytoin sodium extended 100 mg capsule
62.756.040.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
phenytoin sodium extended 100 mg capsule
904.618.761
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pilocarpine 1 % eye drops
61.314.020.315
275,99
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
prednisoLONE acetate 1 % eye drops,suspension
61.314.063.705
154,88
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ascorbic acid (vitamin C) 250 mg tablet
96.295.012.843
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ascorbic acid (vitamin C) 500 mg tablet
57.896.084.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
ascorbic acid (vitamin C) 500 mg tablet
904.052.360
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
propranolol 10 mg tablet
50.111.046.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
propranolol 40 mg tablet
115.166.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pseudoephedrine 30 mg tablet
904.505.324
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pyridoxine (vitamin B6) 100 mg tablet
96.295.011.912
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
pyridoxine (vitamin B6) 50 mg tablet
37.864.090.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine 50 mg tablet
54.022.925
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine 50 mg tablet
67.877.024.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 50 mcg/actuation nasal spray,suspension
54.327.099
295,12
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fluticasone 50 mcg/actuation nasal spray,suspension
60.505.082.901
88,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atenolol 100 mg tablet
93.075.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atenolol 25 mg tablet
93.078.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atenolol 25 mg tablet
93.078.710
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atenolol 50 mg tablet
93.075.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
silver sulfADIAZINE 1 % topical cream
67.877.012.405
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
silver sulfADIAZINE 1 % topical cream
61.570.013.140
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sodium chloride 0.9 % for nebulization
487.930.103
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sodium chloride 5 % eye ointment
17.478.062.235
37,72
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
atropine 1 % eye drops
17.478.021.502
108,16
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
spironolactone 25 mg tablet
63.739.054.410
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
spironolactone 25 mg tablet
53.746.051.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sulfamethoxazole 400 mg-trimethoprim 80 mg tablet
53.746.027.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
glycerin (child) rectal suppository
132.008.112
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
temazepam 15 mg capsule
378.401.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sitaGLIPtin 100 mg tablet
6.027.731
16,54
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
metoclopramide 5 mg/5 mL oral solution
121.057.616
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tetracaine 0.5 % eye drops
69.292.031.715
126,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
tetracaine 0.5 % eye drops
24.208.092.064
33,78
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
codeine 10 mg-guaifenesin 100 mg/5 mL oral liquid
121.077.504
42,95
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
thiamine HCl (vitamin B1) 100 mg tablet
37.864.090.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
thioridazine 25 mg tablet
378.061.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
thioridazine 50 mg tablet
378.061.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
traZODone 50 mg tablet
50.111.043.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.025 % topical cream
168.000.315
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.1 % topical cream
168.000.480
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.1 % topical cream
67.877.025.145
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.1 % topical cream
45.802.006.435
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.025 % topical ointment
45.802.005.435
34,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.1 % topical ointment
168.000.615
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
triamcinolone acetonide 0.1 % topical ointment
168.000.680
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
divalproex ER 500 mg tablet,extended release 24 hr
10.370.051.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
budesonide-formoterol HFA 80 mcg-4.5 mcg/actuation aerosol inhaler
186.037.220
658,38
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
budesonide-formoterol HFA 160 mcg-4.5 mcg/actuation aerosol inhaler
186.037.020
752,55
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine ER 200 mg tablet,extended release 24 hr
310.028.260
64,92
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
melatonin 1 mg tablet
536.111.411
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
verapamil 40 mg tablet
23.155.005.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
baclofen 10 mg tablet
172.409.680
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 2 mg tablet
93.171.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 2 mg tablet
56.017.075
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 2.5 mg tablet
93.171.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 2.5 mg tablet
56.017.675
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 5 mg tablet
93.172.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 5 mg tablet
56.017.275
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
warfarin 7.5 mg tablet
93.171.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oseltamivir 30 mg capsule
47.781.046.813
37,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oseltamivir 30 mg capsule
70.710.100.802
37,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
oseltamivir 30 mg capsule
68.180.067.511
37,44
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
zinc oxide 20 % topical ointment
168.006.231
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
zinc oxide 20 % topical ointment
536.570.098
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cholecalciferol (vitamin D3) 50,000 unit capsule
75.834.002.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
nebivolol 5 mg tablet
456.140.530
10,07
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acetaZOLAMIDE ER 500 mg capsule,extended release
68.382.026.101
14,32
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acetaZOLAMIDE ER 500 mg capsule,extended release
50.742.023.301
5,78
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
acyclovir 800 mg tablet
60.505.530.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amiodarone 200 mg tablet
51.672.402.504
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amLODIPine 10 mg tablet
67.877.019.990
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amLODIPine 2.5 mg tablet
69.097.083.605
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amLODIPine 5 mg tablet
378.520.977
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amLODIPine 5 mg tablet
69.097.012.705
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 125 mg-potassium clavulanate 31.25 mg/5 mL oral susp
43.598.001.251
960,31
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
amoxicillin 250 mg-potassium clavulanate 62.5 mg/5 mL oral suspension
43.598.020.453
408,83
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
difluprednate 0.05 % eye drops
65.924.007
405,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
bumetanide 1 mg tablet
185.012.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
bumetanide 2 mg tablet
185.013.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
busPIRone 5 mg tablet
378.114.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
butamben-tetracaine-benzocaine 2 %-2 %-14 % (200 mg/sec) topical spray
10.223.020.103
164,71
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcitriol 0.25 mcg capsule
23.155.011.803
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcium carbonate 200 mg calcium (500 mg) chewable tablet
37.864.000.150
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
captopril 25 mg tablet
143.117.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carbidopa 10 mg-levodopa 100 mg tablet
62.756.051.788
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carbidopa 10 mg-levodopa 100 mg tablet
378.007.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carbidopa 25 mg-levodopa 100 mg tablet
228.253.950
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
carbidopa 25 mg-levodopa 100 mg tablet
62.756.051.813
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cefprozil 250 mg/5 mL oral suspension
68.180.040.201
120,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cefprozil 250 mg tablet
68.180.040.301
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cefuroxime axetil 250 mg tablet
65.862.069.920
8,49
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cephalexin 250 mg capsule
93.314.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cephalexin 500 mg capsule
93.314.701
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cephalexin 250 mg/5 mL oral suspension
93.417.773
92,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
cetirizine 10 mg tablet
45.802.091.939
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
chlorhexidine gluconate 0.12 % mouthwash
116.200.116
24,04
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
QUEtiapine ER 150 mg tablet,extended release 24 hr
310.028.160
22,71
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clobetasol 0.05 % topical cream
51.672.125.802
19,18
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clonazePAM 0.5 mg tablet
16.729.013.600
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clonazePAM 0.5 mg tablet
16.729.013.616
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
clotrimazole 10 mg troche
54.414.622
9,14
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
collagenase clostridium histolyticum 250 unit/gram topical ointment
50.484.001.030
30,10
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lamoTRIgine 50 mg disintegrating tablet
49.884.048.511
17,57
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
lamoTRIgine 100 mg disintegrating tablet
49.884.048.611
9,37
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
fesoterodine ER 4 mg tablet,extended release 24 hr
69.024.230
42,11
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
dexlansoprazole 30 mg capsule,biphase delayed release
64.764.017.130
36,56
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
prasugrel 5 mg tablet
60.505.464.203
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
benzonatate 100 mg capsule
67.877.010.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
doxazosin 1 mg tablet
16.729.021.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
doxazosin 4 mg tablet
67.253.038.210
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
enalapril maleate 10 mg tablet
64.679.092.502
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
enalapril maleate 20 mg tablet
51.672.404.001
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
enalapril maleate 5 mg tablet
51.672.403.801
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
calcium citrate-vitamin D3 500 mg calcium-400 unit chewable tablet
178.027.730
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
levonorgestrel 1.5 mg tablet
62.756.071.860
40,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
sAXagliptin 5 mg tablet
310.610.530
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
estradiol 1 mg tablet
378.145.401
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
estradiol 0.01% (0.1 mg/gram) vaginal cream
378.877.035
46,71
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
conjugated estrogens 0.625 mg/gram vaginal cream
46.087.221
29,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.370.000.100
etodolac 400 mg tablet
185.067.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
6.350.000.100
epoetin alfa 20,000 unit/mL injection solution
Q4081
55.513.047.810
762,68
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 160 mg/5 mL oral liquid
904.198.516
13,11
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 325 mg tablet
57.896.010.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 500 mg tablet
37.864.000.104
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 500 mg tablet
904.198.340
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
ibuprofen 100 mg/5 mL oral suspension
66.689.000.901
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 120 mg rectal suppository
45.802.073.230
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 325 mg rectal suppository
713.016.412
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 650 mg rectal suppository
45.802.073.030
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
nicotine (polacrilex) 4 mg gum
96.295.011.276
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
bisacodyl 5 mg tablet,delayed release
904.792.760
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
bisacodyl 10 mg rectal suppository
904.505.812
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
psyllium husk (aspartame) 3.4 gram oral powder packet
37.000.002.410
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
sennosides 8.6 mg tablet
57.896.045.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
white petrolatum-mineral oil topical cream
72.140.000.021
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
diphenhydrAMINE 12.5 mg/5 mL oral liquid
50.580.053.504
20,17
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
vit A 1,000 unit-C 200 mg-E 60 unit-lutein 2 mg and minerals tablet
536.509.008
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
carboxymethylcellulose 0.5 %-glycerin 0.9 % (PF) eye drops,dropperette
23.341.630
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
multivitamin-iron 9 mg-folic acid 400 mcg-calcium and minerals tablet
904.549.213
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
acetaminophen 160 mg/5 mL (5 mL) oral suspension
121.178.105
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
peg 400-propylene glycol 0.4 %-0.3 % eye gel drops
65.045.407
38,16
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
diluent no.1 for live virus vaccines (sterile water)
6.430.900
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
benzocaine 20 % mucosal aerosol spray
283.067.902
114,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
sennosides 8.6 mg-docusate sodium 50 mg tablet
57.896.045.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
sennosides 8.6 mg-docusate sodium 50 mg tablet
536.408.601
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
cholecalciferol (vitamin D3) 400 unit tablet
904.582.360
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
docusate sodium 100 mg capsule
57.896.040.110
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
nicotine 7 mg/24 hr daily transdermal patch
48.985.000.155
8,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
nicotine 14 mg/24 hr daily transdermal patch
48.985.000.150
8,21
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
nicotine 21 mg/24 hr daily transdermal patch
536.110.888
7,92
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
carboxymethylcellulose sodium 0.5 % eye drops in a dropperette
904.632.946
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
polyvinyl alcohol 1.4 % eye drops
904.649.235
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
docusate sodium 50 mg/5 mL oral liquid
50.383.077.116
15,30
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aluminum-mag hydroxide-simethicone 200 mg-200 mg-20 mg/5 mL oral susp
121.176.130
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
ibuprofen 200 mg tablet
57.896.094.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
95.138.002.039
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
inhalational spacing device
456.315.467
121,35
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
white petrolatum 41 % topical ointment,white petrolatum 42 % topical ointment,white petrolatum topical ointment
168.005.316
79,83
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
amitriptyline 10 mg tablet
603.221.221
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
amitriptyline 25 mg tablet
16.729.017.201
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
mineral oil oral
54.162.019.016
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 81 mg chewable tablet
57.896.091.136
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 325 mg tablet
536.330.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 325 mg tablet,delayed release
57.896.092.101
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 300 mg rectal suppository
574.703.412
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
vitamins A and D-white petrolatum-lanolin topical ointment
168.003.501
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
99.999.999.999
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
menthol 0.44 %-zinc oxide 20.6 % topical ointment
46.876.000.040
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 81 mg tablet,delayed release
904.770.480
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 81 mg tablet,delayed release
69.618.001.710
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
aspirin 81 mg tablet,delayed release
69.618.004.610
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
benzocaine-menthol 15 mg-3.6 mg lozenges
904.625.549
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.590.000.100
omega 3-dha-epa-fish oil 300 mg-1,000 mg capsule
40.985.022.921
5,75
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
potassium chloride 20 mEq/L in 0.9 % sodium chloride intravenous
J3480
338.069.104
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 50 % in water (D50W) intravenous syringe
J3490
409.751.716
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous piggyback
J3490
338.055.311
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous piggyback
J3490
338.055.318
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
nitroglycerin 50 mg/250 mL (200 mcg/mL) in 5 % dextrose intravenous
J3490
338.104.902
115,50
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 10 % in water (D10W) intravenous solution
J3490
338.002.304
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 5 % in water (D5W) intravenous solution
J7060
338.001.702
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 5 % in water (D5W) intravenous solution
J7070
338.001.704
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 5 % in water (D5W) intravenous solution
J3490
338.001.718
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
hetastarch 6 % in 0.9 % sodium chloride intravenous solution
J3490
264.196.510
99,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous solution
J7050
338.004.902
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous solution
J7040
338.004.903
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous solution
J7030
338.004.904
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous solution
J3490
338.004.911
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous solution
J3490
338.004.918
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.9 % intravenous solution
J7030
338.004.904
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
lactated Ringers intravenous solution
J7120
338.011.704
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
metroNIDAZOLE 500 mg/100 mL-sodium chloride(iso) intravenous piggyback
J3490
338.954.124
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 0.45 % intravenous solution
J3490
338.004.304
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
sodium chloride 3 % intravenous injection solution
J3490
338.005.403
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
potassium chloride 20 mEq/L in D5-0.9 % sodium chloride intravenous
J3480
409.710.709
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
potassium chloride 20 mEq/L in dextrose 5 %-0.45 % sodium chloride IV
J3480
409.790.209
60,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 5 % and 0.2 % sodium chloride intravenous solution
J7042
338.007.704
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 5 % and 0.45 % sodium chloride intravenous solution
J7042
338.008.504
70,00
WESTON COUNTY HEALTH SERVICES SERVICE AREA
2.580.000.300
dextrose 5 % and 0.9 % sodium chloride intravenous solution
J7042
338.008.904
70,00
Service Area Px Code Generic Name CPT(R)/HCPCS Code NDC Unit Price
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