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.
Last Updated January 27, 2022
Px Code Procedure Description Default Rev Code CPT(R)/HCPCS Code Default Mod Fee Schedule Name Unit Price
1,100,000,300.00
ROOM PRIVATE SWINGBED INTERMEDIATE
ROOM & BOARD-PRIVATE (ONE BED)-GENERAL [0110]
WCH HB DEFAULT FEE SCHEDULE
268.28
1,200,000,200.00
ROOM SEMI PRIVATE SWINGBED SKILLED
ROOM & BOARD-SEMIPRIVATE (TWO-BEDS)-GENERAL [0120]
WCH HB DEFAULT FEE SCHEDULE
1,667.00
1,210,000,100.00
ROOM SEMI PRIVATE W TELE
ROOM & BOARD-SEMIPRIVATE (TWO-BEDS)-MEDICAL/SURGICAL/GYN [0121]
WCH HB DEFAULT FEE SCHEDULE
3,214.00
1,210,000,200.00
ROOM SEMI PRIVATE
ROOM & BOARD-SEMIPRIVATE (TWO-BEDS)-MEDICAL/SURGICAL/GYN [0121]
WCH HB DEFAULT FEE SCHEDULE
2,714.00
1,500,000,100.00
ROOM WARD 5 OR MORE PER ROOM
ROOM & BOARD-WARD (FIVE OR MORE-BEDS)-GENERAL [0150]
WCH HB DEFAULT FEE SCHEDULE
1,000.00
2,020,000,100.00
ROOM ICU MEDICAL
INTENSIVE CARE-MEDICAL [0202]
WCH HB DEFAULT FEE SCHEDULE
3,775.00
2,600,023,900.00
IV INFUSION, BAMLANIVIMAB-XXXX, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING
IV THERAPY-GENERAL [0260]
M0239
WCH HB DEFAULT FEE SCHEDULE
370.00
2,609,636,000.00
IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR
IV THERAPY-GENERAL [0260]
96360
WCH HB DEFAULT FEE SCHEDULE
370.00
2,609,636,100.00
IV INFUSION HYDRATION EACH ADDITIONAL HOUR
IV THERAPY-GENERAL [0260]
96361
WCH HB DEFAULT FEE SCHEDULE
124.00
2,609,636,500.00
IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR
IV THERAPY-GENERAL [0260]
96365
WCH HB DEFAULT FEE SCHEDULE
370.00
2,609,636,600.00
IV INFUSION THERAPY PROPHYLAXIS/DX EA ADDL HOUR
IV THERAPY-GENERAL [0260]
96366
WCH HB DEFAULT FEE SCHEDULE
152.00
2,609,636,700.00
IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR
IV THERAPY-GENERAL [0260]
96367
WCH HB DEFAULT FEE SCHEDULE
221.00
2,609,636,800.00
IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS
IV THERAPY-GENERAL [0260]
96368
WCH HB DEFAULT FEE SCHEDULE
127.00
2,609,637,200.00
THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM
IV THERAPY-GENERAL [0260]
96372
WCH HB DEFAULT FEE SCHEDULE
80.00
2,609,637,400.00
THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG
IV THERAPY-GENERAL [0260]
96374
WCH HB DEFAULT FEE SCHEDULE
252.00
2,609,637,500.00
THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG
IV THERAPY-GENERAL [0260]
96375
WCH HB DEFAULT FEE SCHEDULE
179.00
2,609,637,600.00
THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC
IV THERAPY-GENERAL [0260]
96376
WCH HB DEFAULT FEE SCHEDULE
158.00
2,705,000,001.00
Hc/hh Wch Supp Mask Aerosal Adult__001206
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
E0601
WCH HB SUPPLY FEE SCHEDULE
2.00
2,705,000,002.00
Hc/hh Wch Supp Thumb Spica Lg.lt__3070
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
L3807
WCH HB SUPPLY FEE SCHEDULE
104.00
2,705,000,003.00
Hc/hh Wch Supp Thumb Spica Lg.rt__3170
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
L3807
WCH HB SUPPLY FEE SCHEDULE
104.00
2,705,000,004.00
Hc/hh Wch Supp Thumb Spica Med Rt__3150
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
L3807
WCH HB SUPPLY FEE SCHEDULE
109.00
2,705,000,005.00
Hc/hh Wch Supp Adult One Step Pads__8900021401
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
168.00
2,705,000,006.00
Hc/hh Wch Supp Airway 90mm Adult M__10-80090
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,007.00
Hc/hh Wch Supp Airway/infant 40mm__8400-12#0
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,008.00
Hc/hh Wch Supp Aloe Vesta Cleansing Foam__325208
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,705,000,009.00
Hc/hh Wch Supp Ankle Brace W/straps__b-212000002
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
76.00
2,705,000,010.00
Hc/hh Wch Supp Ankle Brace W/straps__b-212000003
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
76.00
2,705,000,011.00
Hc/hh Wch Supp Ankle Brace W/straps__b-212000004
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
76.00
2,705,000,012.00
Hc/hh Wch Supp Ankle Stirrup-left__80100
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
82.00
2,705,000,013.00
Hc/hh Wch Supp Ankle Stirrup-right__80101
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
82.00
2,705,000,014.00
Hc/hh Wch Supp Aquacel 4x4__177902
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,705,000,015.00
Hc/hh Wch Supp Aquacel Silver 4x4__403765
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,705,000,016.00
Hc/hh Wch Supp Arm Sling Adult Universal__8140015
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,017.00
Hc/hh Wch Supp Arm Sling Envelope Style S__0814-0062
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
26.00
2,705,000,018.00
Hc/hh Wch Supp Athletic Support L__202636
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
22.00
2,705,000,019.00
Hc/hh Wch Supp Athletic Support M__202549
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
22.00
2,705,000,020.00
Hc/hh Wch Supp Athletic Support-sma__202460
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
31.00
2,705,000,021.00
Hc/hh Wch Supp Bag Resuscitation Man Adult__2k8005
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
84.00
2,705,000,022.00
Hc/hh Wch Supp Bag Resuscitation Man Infant__2k8038
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
80.00
2,705,000,023.00
Hc/hh Wch Supp Bag Resuscitation Man Ped__2k8008
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
80.00
2,705,000,024.00
Hc/hh Wch Supp Bite Blocks Disp__1140
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,705,000,025.00
Hc/hh Wch Supp Blanket Bair Hugger Upper Body__52200
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
145.00
2,705,000,026.00
Hc/hh Wch Supp Blanket Bair Hugger__11101
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
145.00
2,705,000,027.00
Hc/hh Wch Supp Bndg Coban Lf 2x5__2082
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
9.00
2,705,000,028.00
Hc/hh Wch Supp Bndg Coban Tan 2x5__1582
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
9.00
2,705,000,029.00
Hc/hh Wch Supp Bndg Compression Lf 4in__23594-040
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,705,000,030.00
Hc/hh Wch Supp Bndg Compression Lf 6in__23594-060
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,705,000,031.00
Hc/hh Wch Supp Bndg Elastic Nst 2in__23593-02lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,032.00
Hc/hh Wch Supp Bndg Elastic Nst 3in__23593-03lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,033.00
Hc/hh Wch Supp Bndg Elastic Nst 4in__23593-04lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
10.00
2,705,000,034.00
Hc/hh Wch Supp Bndg Elastic Nst 6in__23593-06lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,035.00
Hc/hh Wch Supp Bndg Kerlix 4in__8074
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
68.00
2,705,000,036.00
Hc/hh Wch Supp Bndg Plaster 4x5__7374
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
9.00
2,705,000,037.00
Hc/hh Wch Supp Bndg Plaster 6x5__7376
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,705,000,038.00
Hc/hh Wch Supp Bndg Roll Nst 4in__6021
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,039.00
Hc/hh Wch Supp Bndge Setopress 4in__3505
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
41.00
2,705,000,040.00
Hc/hh Wch Supp Brace Clavicle Velcro Strap Xs__0814-1231
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,041.00
Hc/hh Wch Supp Brace Clavicle Xl__1179556
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,705,000,042.00
Hc/hh Wch Supp Cannister Suction Ortho 1500cc__65651-515
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,705,000,043.00
Hc/hh Wch Supp Cannula O2 Nasal Ped__1101
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,044.00
Hc/hh Wch Supp Cap Shampoo__7909
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,045.00
Hc/hh Wch Supp Cast Air Walker L__aw0800
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
148.00
2,705,000,046.00
Hc/hh Wch Supp Cast Air Walker M__aw0600
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
148.00
2,705,000,047.00
Hc/hh Wch Supp Cast Padding 2″ Cott__1418
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,048.00
Hc/hh Wch Supp Cath Foley16fr 10cc__dynd11502
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,705,000,049.00
Hc/hh Wch Supp Cath Tray Urethral__772416
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
14.00
2,705,000,050.00
Hc/hh Wch Supp Cloth Tape 1 Inch__7138c
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,051.00
Hc/hh Wch Supp Cloth Tape 2 Inch__7139c
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,705,000,052.00
Hc/hh Wch Supp Collar Cerv Lo Univ 3″__08140380
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,705,000,053.00
Hc/hh Wch Supp Collar Cervical 3.5 L Uni__0814-0381
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,054.00
Hc/hh Wch Supp Collar Cervical 3.5 Reg S__0814-9702
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,055.00
Hc/hh Wch Supp Collar Cervical Rd Lg 4.5x22__0814-9704
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,056.00
Hc/hh Wch Supp Collection Unit Specipan__4014
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,057.00
Hc/hh Wch Supp Compression Sleeve Thigh Hi__kdl5345h
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
220.00
2,705,000,058.00
Hc/hh Wch Supp Cotton Roll #1__2287
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,705,000,059.00
Hc/hh Wch Supp Cover Probe Ultrasound__38-01
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,060.00
Hc/hh Wch Supp Detector Co2 Easy Cap Ii__easycap Ii 6
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
40.00
2,705,000,061.00
Hc/hh Wch Supp Drssng Duoderm Extra Thin Spot__187932
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
3.00
2,705,000,062.00
Hc/hh Wch Supp Drssng Net Surgilast #6__gl707
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,063.00
Hc/hh Wch Supp Drssng Net Surgilast #8__gl709
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,705,000,064.00
Hc/hh Wch Supp Drssng Tegaderm 6x8__1628
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,065.00
Hc/hh Wch Supp Eye Protector Pad Med__g 7013-1276
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,066.00
Hc/hh Wch Supp Fetal Monitor Belt__40000008
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
25.00
2,705,000,067.00
Hc/hh Wch Supp Finger Cot-lrg 3″__71907
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,705,000,068.00
Hc/hh Wch Supp Finger Cot-med 2.25″__71905
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,705,000,069.00
Hc/hh Wch Supp Finger Cot-sml 1.5″*__71903
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,070.00
Hc/hh Wch Supp Finger Cot-xsm 1″__71902
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,071.00
Hc/hh Wch Supp Finger/thumb Splint__510719
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
40.00
2,705,000,072.00
Hc/hh Wch Supp Fingersplint/abducti__510718
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
40.00
2,705,000,073.00
Hc/hh Wch Supp Fingher/thumb Splint__510717
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
40.00
2,705,000,074.00
Hc/hh Wch Supp Gel Ankle Brace-left__e8020l
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
86.00
2,705,000,075.00
Hc/hh Wch Supp Gel Ankle Brace-pony__e200pr
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
47.00
2,705,000,076.00
Hc/hh Wch Supp Gel Ankle Brace-righ__e8020r
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
86.00
2,705,000,077.00
Hc/hh Wch Supp Gown Isolation__nonth150
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,705,000,078.00
Hc/hh Wch Supp Holder Endotrach Tube__pm 1110
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
15.00
2,705,000,079.00
Hc/hh Wch Supp Immobilizer Shdlr L__08144504
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,080.00
Hc/hh Wch Supp Irrigation System__0210-100-000
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
209.00
2,705,000,081.00
Hc/hh Wch Supp Iv Ns 0.9 Viaflex 1000ml__2b1324x
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
121.00
2,705,000,082.00
Hc/hh Wch Supp Kit Combitube 37fr__5-18537
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
173.00
2,705,000,083.00
Hc/hh Wch Supp Knee Immobilizer 16″__200016
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
113.00
2,705,000,084.00
Hc/hh Wch Supp Knee Immobilizer 20in__8142744
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
114.00
2,705,000,085.00
Hc/hh Wch Supp Knee Immobilizer 24″__200030
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
113.00
2,705,000,086.00
Hc/hh Wch Supp Lifeband__8700-0706-01
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
246.00
2,705,000,087.00
Hc/hh Wch Supp Lotion Aloe 4oz__324804
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,088.00
Hc/hh Wch Supp Lube Gel Foil Pack 3__0281-0205-43
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,089.00
Hc/hh Wch Supp Mac 3 Blade Adult, Disposable__48033
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,705,000,090.00
Hc/hh Wch Supp Mask Cpap Comfortfull Ii Large__1004950
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
235.00
2,705,000,091.00
Hc/hh Wch Supp Mask Cpap Comfortfull Ii Med__1004872
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
235.00
2,705,000,092.00
Hc/hh Wch Supp Mask Cpap Comfortfull Ii Small__1004880
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
253.00
2,705,000,093.00
Hc/hh Wch Supp Mask Multi-vent Adult__1088
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,094.00
Hc/hh Wch Supp Mask Oxygen Peds No Valve__001267
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,705,000,095.00
Hc/hh Wch Supp Mask Oxygen Val Peds__001268
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,096.00
Hc/hh Wch Supp Mepilex Border 3x3__295200
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
17.00
2,705,000,097.00
Hc/hh Wch Supp Mepilex Ag 4x4__287100
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,098.00
Hc/hh Wch Supp Mepilex With Border 4x4__295300
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
15.00
2,705,000,099.00
Hc/hh Wch Supp Mepilex With Safetac__294199
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,100.00
Hc/hh Wch Supp Mepitel Safetac 10x18cm Silicn__291099
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
42.00
2,705,000,101.00
Hc/hh Wch Supp Mesh Underwear Xl__msc86400
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
25.00
2,705,000,102.00
Hc/hh Wch Supp Mesh Underwear Xxl__msc86500
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,103.00
Hc/hh Wch Supp Meter Peak Flow Access Fl Rng__hs710-012
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
46.00
2,705,000,104.00
Hc/hh Wch Supp Moisturizer Mouth__6083
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,105.00
Hc/hh Wch Supp Nasal Cannula__1600
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,106.00
Hc/hh Wch Supp Nebulizer Sidestream__002174
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,705,000,107.00
Hc/hh Wch Supp Ointment Barrier Sensicare 4oz__325614
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,705,000,108.00
Hc/hh Wch Supp Ointment/antifungal__325102
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,705,000,109.00
Hc/hh Wch Supp Packing For Setopress__650948
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,705,000,110.00
Hc/hh Wch Supp Padding Cast Synthetic 2x4__cmw02
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,111.00
Hc/hh Wch Supp Padding Cast Synthetic 3x4__cmw03
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,112.00
Hc/hh Wch Supp Padding Cast Synthetic 4x4__cmw04
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,705,000,113.00
Hc/hh Wch Supp Paddng Undrcst Webril 3inx4yds__2059
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,114.00
Hc/hh Wch Supp Paddng Undrcst Webril 4x4__3175
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,115.00
Hc/hh Wch Supp Paddng Undrcst Webril 6x4__3489
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,705,000,116.00
Hc/hh Wch Supp Pathodx Disposable S__r62070
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
138.00
2,705,000,117.00
Hc/hh Wch Supp Plaster Bandage 2__7372
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,118.00
Hc/hh Wch Supp Porous Tape 1 Inch__5104
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,119.00
Hc/hh Wch Supp Porous Tape 2 Inch__5106
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
10.00
2,705,000,120.00
Hc/hh Wch Supp Porous Tape 3 Inch__5108
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,705,000,121.00
Hc/hh Wch Supp Pump Set Kangaroo Flh__8884773600
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
16.00
2,705,000,122.00
Hc/hh Wch Supp Quickvue One-step Hcg Combo__00178
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
2.00
2,705,000,123.00
Hc/hh Wch Supp Razor Nonsterile__kend139083
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,124.00
Hc/hh Wch Supp Rhino Rocket Large__11s-s0800-08as
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
46.00
2,705,000,125.00
Hc/hh Wch Supp Rhino Rocket Med__11s-s0500-08as
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
40.00
2,705,000,126.00
Hc/hh Wch Supp Rhino Rocket Small__11s-s0300-08as
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
40.00
2,705,000,127.00
Hc/hh Wch Supp Rib Belt 6″ Female L__0814-1389
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
22.00
2,705,000,128.00
Hc/hh Wch Supp Rib Belt 6″ Female M__13780400
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
44.00
2,705,000,129.00
Hc/hh Wch Supp Rib Belt Male Sm__0814-1388
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,705,000,130.00
Hc/hh Wch Supp Rib Belt X Lrg__89068
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
31.00
2,705,000,131.00
Hc/hh Wch Supp Sam Sling L__sl55662
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
72.00
2,705,000,132.00
Hc/hh Wch Supp Sam Sling M__sl556652
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
100.00
2,705,000,133.00
Hc/hh Wch Supp Shoe/post-op/large__18017
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
33.00
2,705,000,134.00
Hc/hh Wch Supp Shoe/post-op/medium__18015
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,705,000,135.00
Hc/hh Wch Supp Shoe/post-op/pediatr__117pedb
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,705,000,136.00
Hc/hh Wch Supp Shoe/post-op/small__18013
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,705,000,137.00
Hc/hh Wch Supp Shoe/post-op/x.large__18018
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
36.00
2,705,000,138.00
Hc/hh Wch Supp Shoulder Immob Med__8144503
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,139.00
Hc/hh Wch Supp Shoulder Immob Sm__8144502
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
25.00
2,705,000,140.00
Hc/hh Wch Supp Sling Arm Adult Small__8140062
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
26.00
2,705,000,141.00
Hc/hh Wch Supp Sling Arm Adult Xl__8140065
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
26.00
2,705,000,142.00
Hc/hh Wch Supp Sling Arm Peds Xs__0814-0061
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
26.00
2,705,000,143.00
Hc/hh Wch Supp Sling Arm Universal Envelope__0814-0015
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,705,000,144.00
Hc/hh Wch Supp Sling Arm W/foam Large__8141064
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
26.00
2,705,000,145.00
Hc/hh Wch Supp Sling Arm W/foam Med Adult__08141063
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,705,000,146.00
Hc/hh Wch Supp Slippers Medium__80103
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,147.00
Hc/hh Wch Supp Sm Air Walker__aw0400
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
148.00
2,705,000,148.00
Hc/hh Wch Supp Sol Cleanser Perineal 8oz__324509
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,149.00
Hc/hh Wch Supp Sol Cleanser Wound Shur Clens__121253
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,705,000,150.00
Hc/hh Wch Supp Specimen Trap__8884724500
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,151.00
Hc/hh Wch Supp Spirometer Incentive__001902a
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,705,000,152.00
Hc/hh Wch Supp Splint Clavicle/sml__0814-1232
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,705,000,153.00
Hc/hh Wch Supp Splint Cockup Univ Lt__1769-03
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
34.00
2,705,000,154.00
Hc/hh Wch Supp Splint Cockup Univ Rt__1769-02
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
38.00
2,705,000,155.00
Hc/hh Wch Supp Splint Ortho Glass 3x35__og-335pc
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
46.00
2,705,000,156.00
Hc/hh Wch Supp Splint Ortho-glass 2x12__og-2pc
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,705,000,157.00
Hc/hh Wch Supp Splint Ortho-glass 4x30__og-430pc
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
42.00
2,705,000,158.00
Hc/hh Wch Supp Splint Ortho-glass 6x30__og-6pc
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
86.00
2,705,000,159.00
Hc/hh Wch Supp Spray No Sting Barrier__3346
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
52.00
2,705,000,160.00
Hc/hh Wch Supp Stax Finger Splint #5.5__72246
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
15.00
2,705,000,161.00
Hc/hh Wch Supp Stockinette Bias 3in__730
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
43.00
2,705,000,162.00
Hc/hh Wch Supp Stockinette Bias 4in__740
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,163.00
Hc/hh Wch Supp Stockinette Bias 6in__760
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,164.00
Hc/hh Wch Supp Stockinette Synth 2__ms02
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,165.00
Hc/hh Wch Supp Stockinette Synth 3__ms03
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,166.00
Hc/hh Wch Supp Stockinette Synth 4__ms04
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,167.00
Hc/hh Wch Supp Strap Arm Padded L__0814-1314
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
50.00
2,705,000,168.00
Hc/hh Wch Supp Strap Arm Padded M__0814-1313
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
46.00
2,705,000,169.00
Hc/hh Wch Supp Strap Arm Padded S__8141312
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
15.00
2,705,000,170.00
Hc/hh Wch Supp Strap Arm Padded Xl__0814-1315
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,705,000,171.00
Hc/hh Wch Supp Strap Montgomery__1583702
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,172.00
Hc/hh Wch Supp Support Lumbosacral S__a818030
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,173.00
Hc/hh Wch Supp Syringe Ecc Tip 10cc__305482
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,174.00
Hc/hh Wch Supp Tape Casting 2″ Wht__82002
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,175.00
Hc/hh Wch Supp Tape Casting 3″ Wht__82003
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
23.00
2,705,000,176.00
Hc/hh Wch Supp Tape Casting 4″ Wht__82004
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
29.00
2,705,000,177.00
Hc/hh Wch Supp Tape Casting 5″ Wht__82005
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
17.00
2,705,000,178.00
Hc/hh Wch Supp Tape Cloth Medipore 2x10__2962
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,705,000,179.00
Hc/hh Wch Supp Tape Paper Micropore .5inx10__1530-0
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
14.00
2,705,000,180.00
Hc/hh Wch Supp Tape Paper Micropore 2inx10__1530-2
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
14.00
2,705,000,181.00
Hc/hh Wch Supp Tape Plastic Transpore 1x10__1527-1
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,705,000,182.00
Hc/hh Wch Supp Tape Plastic Transpore 2x10__1527-2
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,705,000,183.00
Hc/hh Wch Supp Teds Knee Hi Lg/reg__7203
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,705,000,184.00
Hc/hh Wch Supp Teds Knee Hi Med/reg__7115
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,705,000,185.00
Hc/hh Wch Supp Teds Knee Hi Sm/reg__7071
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,705,000,186.00
Hc/hh Wch Supp Teds Thigh High Lg/reg__3728lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,187.00
Hc/hh Wch Supp Teds Thigh High Lg/short__3634lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,188.00
Hc/hh Wch Supp Teds Thigh High Lrg/long__3856lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,189.00
Hc/hh Wch Supp Teds Thigh High Med/long__3549lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,190.00
Hc/hh Wch Supp Teds Thigh High Med/reg__3416lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,191.00
Hc/hh Wch Supp Teds Thigh High Med/short__3310lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,192.00
Hc/hh Wch Supp Teds Thigh High Sm/long__3222lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,193.00
Hc/hh Wch Supp Teds Thigh High Sm/reg__3130lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,705,000,194.00
Hc/hh Wch Supp Teds Thigh High Sm/short__3071lf
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
34.00
2,705,000,195.00
Hc/hh Wch Supp Tena Pull-ups Xlarge__72412
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
17.00
2,705,000,196.00
Hc/hh Wch Supp Tena Underpad 23×24 Blue Chux__354
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,705,000,204.00
Hc/hh Wch Supp Tube Connector O2__1420
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
2.00
2,705,000,205.00
Hc/hh Wch Supp Tubigrip Bandage Sz D__1437
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
79.00
2,705,000,206.00
Hc/hh Wch Supp Tubigrip Bandage Sz E__1434
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
90.00
2,705,000,207.00
Hc/hh Wch Supp Tubing Bair Hugger Fluid__24110
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,705,000,208.00
Hc/hh Wch Supp Tubular Bandage Size__mttg319
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,209.00
Hc/hh Wch Supp Tubular Bandage Sz 2__c15510220
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,210.00
Hc/hh Wch Supp Tubular Dressing Sz 10__gl711
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
94.00
2,705,000,211.00
Hc/hh Wch Supp Tubular Dressing Sz 1__gl701
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,212.00
Hc/hh Wch Supp Tubular Dressing Sz 3__gl703
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,213.00
Hc/hh Wch Supp Tubular Dressing Sz 4__gl704
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,214.00
Hc/hh Wch Supp Univ Extri Collar Ad__0814-9428
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
9.00
2,705,000,215.00
Hc/hh Wch Supp Univ-extri Collar Peds__0814-9427
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
9.00
2,705,000,216.00
Hc/hh Wch Supp Valve Clearlink Luer Activated__2n8399
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,705,000,217.00
Hc/hh Wch Supp Ventilation Circuit__l599-010
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
41.00
2,705,000,218.00
Hc/hh Wch Supp Warmer Heel Infant 4x4__11460-010t
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,705,000,219.00
Hc/hh Wch Supp Washcloth Pre-moistened__6599n
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,705,000,220.00
Hc/hh Wch Supp Wchs Med/supply Pickup
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
26.00
2,705,000,239.00
Hc/hh Wch Supp Xlg Air Walker__aw1000blk
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
148.00
2,705,000,240.00
Hc/hh Wch Supp Xsm Air Walker__aw0200
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
148.00
2,705,000,241.00
Hc/hh Wch Supp Yankauer Suction Tip__cfk82
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,705,000,242.00
Hc/hh Wch Supp Coban 2 Layer Lite
MEDICAL/SURGICAL SUPPLIES AND DEVICES-GENERAL [0270]
A6442
WCH HB SUPPLY FEE SCHEDULE
42.00
2,715,000,001.00
Hc/hh Wch Supp Green Chux__msc282030lb
MEDICAL/SURGICAL SUPPLIES AND DEVICES-NONSTERILE SUPPLY [0271]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,715,000,002.00
Hc/hh Wch Supp Knee Immobilizer 12__8142662
MEDICAL/SURGICAL SUPPLIES AND DEVICES-NONSTERILE SUPPLY [0271]
WCH HB SUPPLY FEE SCHEDULE
55.00
2,715,000,003.00
Hc/hh Wch Supp Pathodx Strep B Grp 60 Test__r62031
MEDICAL/SURGICAL SUPPLIES AND DEVICES-NONSTERILE SUPPLY [0271]
WCH HB SUPPLY FEE SCHEDULE
73.00
2,725,000,001.00
Hc/hh Wch Supp Safe-t-centesis Tray__pig1260t
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
A4550
WCH HB SUPPLY FEE SCHEDULE
128.00
2,725,000,002.00
Hc/hh Wch Supp Suture Remover Kit__723
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
A4649
WCH HB SUPPLY FEE SCHEDULE
6.00
2,725,000,003.00
Hc/hh Wch Supp Gauze Sterile 4×4 Tray (12ply)__6939
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
A6402
WCH HB SUPPLY FEE SCHEDULE
6.00
2,725,000,004.00
Hc/hh Wch Supp Sponge Sterile 4×4 2pk__3033
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
A6402
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,005.00
Hc/hh Wch Supp Bndg Cnfrm Stretch St 2x75__2231
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
A6442
WCH HB SUPPLY FEE SCHEDULE
3.00
2,725,000,006.00
Hc/hh Wch Supp Cath Kit Central Venous__m3720hkic
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
C1751
WCH HB SUPPLY FEE SCHEDULE
130.00
2,725,000,007.00
Hc/hh Wch Supp 3m Surgical Clipper Blade__9660
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,725,000,008.00
Hc/hh Wch Supp Add A Foley Tray__896300
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
89.00
2,725,000,009.00
Hc/hh Wch Supp Adhesive Mastisol Vial__0523-48
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,725,000,010.00
Hc/hh Wch Supp Airway Nasoph 26fr__8888247023
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,725,000,011.00
Hc/hh Wch Supp Airway Nasoph 28fr__8888247031
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,725,000,012.00
Hc/hh Wch Supp Airway Nasoph 30fr__8888247049
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
29.00
2,725,000,013.00
Hc/hh Wch Supp Airway Nasoph 32fr__8888247056
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,725,000,014.00
Hc/hh Wch Supp Airway Nasoph 34fr__8888247064
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
27.00
2,725,000,015.00
Hc/hh Wch Supp Aspirator Meconium__n0101
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,725,000,016.00
Hc/hh Wch Supp Bag Urine Leg Drain M__9645
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
49.00
2,725,000,017.00
Hc/hh Wch Supp Bndg Cnfrm Stretch St 6x82__2238
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,018.00
Hc/hh Wch Supp Bndg Coban 2 Layer__2094
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
42.00
2,725,000,019.00
Hc/hh Wch Supp Bndg Non Adh 3x8__6115
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,725,000,020.00
Hc/hh Wch Supp Bndg Plaster 3x3__7373
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,021.00
Hc/hh Wch Supp Cath Foley 14 Fr 5cc__265714
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
39.00
2,725,000,022.00
Hc/hh Wch Supp Cath Foley 16fr 30cc__266716
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,725,000,023.00
Hc/hh Wch Supp Cath Foley 3way 30cc 22fr__0167v22s
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
14.00
2,725,000,024.00
Hc/hh Wch Supp Cath Foley Sil Lx 5cc 12 Fr__265712
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
20.00
2,725,000,025.00
Hc/hh Wch Supp Cath Foley Sil Ped 10fr__165810
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,725,000,026.00
Hc/hh Wch Supp Cath Foley14 Fr 30cc__266714
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
15.00
2,725,000,027.00
Hc/hh Wch Supp Cath Foley16 Fr 5cc__265716
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,028.00
Hc/hh Wch Supp Cath Foley8 Fr.3cc__165808
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,725,000,029.00
Hc/hh Wch Supp Cath Suction 10fr__31000
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,725,000,030.00
Hc/hh Wch Supp Cath Suction 14f Straight__31400
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,031.00
Hc/hh Wch Supp Cath-foley 24fr 30cc__0166l 24
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
54.00
2,725,000,032.00
Hc/hh Wch Supp Catheter Delee 8fr Mucus Trap__8888257378
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,033.00
Hc/hh Wch Supp Catheter Thoracic 12fr__8888570507
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
34.00
2,725,000,034.00
Hc/hh Wch Supp Catheter Thoracic 32fr__8888570556
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
35.00
2,725,000,035.00
Hc/hh Wch Supp Catheter Thoracic 36fr__8888570564
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
35.00
2,725,000,036.00
Hc/hh Wch Supp Cathfoley-suprapubic__dynd11782
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
34.00
2,725,000,037.00
Hc/hh Wch Supp Cotton Balls Unsteri__p159025
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,038.00
Hc/hh Wch Supp Drain Penrose .25x12__20414-025
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,039.00
Hc/hh Wch Supp Drain Penrose .5x12__20414-050
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,040.00
Hc/hh Wch Supp Drain Penrose .75x12__20414-075
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,041.00
Hc/hh Wch Supp Drape Sheet 44×57 Half__9358
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,042.00
Hc/hh Wch Supp Dressing Non Adhesive 3x16__6114
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,725,000,043.00
Hc/hh Wch Supp Drssing Adptc St Non-adh 3x3__2012
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,044.00
Hc/hh Wch Supp Drssing Tegaderm 2.38×2.75__1624w
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,045.00
Hc/hh Wch Supp Drssing Tegaderm 4×4.75__1626w
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,725,000,046.00
Hc/hh Wch Supp Drssng Combiderm Acd 5x5__187725
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,725,000,047.00
Hc/hh Wch Supp Drssng Combiderm Acd 6x7__651027
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,725,000,048.00
Hc/hh Wch Supp Drssng Combiderm Acd 4x 4__651031
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,725,000,049.00
Hc/hh Wch Supp Drssng Duoderm 5.5 Sq__403327
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
25.00
2,725,000,050.00
Hc/hh Wch Supp Drssng Tegaderm Film 4x4__90021
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,051.00
Hc/hh Wch Supp Drssng Telfa St 3x4__2132
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
2.00
2,725,000,052.00
Hc/hh Wch Supp Ez-io 25mm Needle__9001
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
230.00
2,725,000,053.00
Hc/hh Wch Supp Ez-io 45mm Needle__9079
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
233.00
2,725,000,054.00
Hc/hh Wch Supp Ez-io Stabilizer__9066
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,725,000,055.00
Hc/hh Wch Supp Foley Cath Tray 16 F__899616
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
54.00
2,725,000,056.00
Hc/hh Wch Supp Gauze Packing Iodoform 0.5in__7832
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,725,000,057.00
Hc/hh Wch Supp Gauze Packing Iodoform 1in__7833
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
24.00
2,725,000,058.00
Hc/hh Wch Supp Gauze Packing Plain 0.5in__7632
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
19.00
2,725,000,059.00
Hc/hh Wch Supp Gauze Packing Plain 1/4″__7631
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,725,000,060.00
Hc/hh Wch Supp Gauze Packing Plain 1in__7633
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,725,000,061.00
Hc/hh Wch Supp Gauze Packing Plain 2in__7634
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
36.00
2,725,000,062.00
Hc/hh Wch Supp Gauze Sponge Sterile 2x2__1806
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,063.00
Hc/hh Wch Supp Gown Surg St Xl__9545
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
14.00
2,725,000,064.00
Hc/hh Wch Supp Gauze Vaseline 1×8
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,065.00
Hc/hh Wch Supp Huber Inf Set Y 19×1 12/bx__pmi191ys
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,725,000,066.00
Hc/hh Wch Supp Inf Set Huber 19×3/4__pmi193s
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
18.00
2,725,000,067.00
Hc/hh Wch Supp Iodoform Packing 1/4__7831amd
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
20.00
2,725,000,068.00
Hc/hh Wch Supp Iv Catheter Extension__2n8378
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,069.00
Hc/hh Wch Supp King Airway Lt-d Size 3.0__kltd203
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
106.00
2,725,000,070.00
Hc/hh Wch Supp Needle Biopsy 14gx6__2n2704x
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
53.00
2,725,000,071.00
Hc/hh Wch Supp Needle Bone Marrow 15gx3__din1515x
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
43.00
2,725,000,072.00
Hc/hh Wch Supp Needle Spinal Quincke 22gx3.5__405181
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,073.00
Hc/hh Wch Supp Needle Spinal Quincke 26gx3.5__405164
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,725,000,074.00
Hc/hh Wch Supp Pad Abdominal 8x10__7198d
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,075.00
Hc/hh Wch Supp Poole Suction Instru__0035040
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,725,000,076.00
Hc/hh Wch Supp Povidone-iodine Swabstick__s41125
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,077.00
Hc/hh Wch Supp Quicktrach 4.0__120900040
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
317.00
2,725,000,078.00
Hc/hh Wch Supp Razor Nst__139004
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,079.00
Hc/hh Wch Supp Remover Staple Skin__espsx
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,725,000,080.00
Hc/hh Wch Supp Salem Sump Tube/18fr__8888264986
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
75.00
2,725,000,081.00
Hc/hh Wch Supp Scalpel Protected Blade #12__372612
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,082.00
Hc/hh Wch Supp Scalpel Protected Blade #15__372615
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,083.00
Hc/hh Wch Supp Scalpel Protected Disp #10__372610
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,084.00
Hc/hh Wch Supp Scalpel Protected Disp #11__372611
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,085.00
Hc/hh Wch Supp Skin Stapler__espmw35
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
21.00
2,725,000,086.00
Hc/hh Wch Supp Sol Irrigation Ns 0.9 1000ml__2f7124
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,725,000,087.00
Hc/hh Wch Supp Sol Irrigation Ns 0.9 250ml__2f7122
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,088.00
Hc/hh Wch Supp Sol Irrigation Water St 250ml__2f7112
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,725,000,089.00
Hc/hh Wch Supp Sol Surg Scrub Prevail__4vail
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
14.00
2,725,000,090.00
Hc/hh Wch Supp Stat Padz__8900-4004
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
102.00
2,725,000,091.00
Hc/hh Wch Supp Stop Cock 3 Way__2c6246
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,092.00
Hc/hh Wch Supp Stylet Intubating 14fr__85865
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
20.00
2,725,000,093.00
Hc/hh Wch Supp Stylet Intubating 6fr__85863
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
20.00
2,725,000,094.00
Hc/hh Wch Supp Suction Cath Peds 8__30888
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,095.00
Hc/hh Wch Supp Suction Tubing__cfn510
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
11.00
2,725,000,096.00
Hc/hh Wch Supp Surgifoam__et1972
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,725,000,097.00
Hc/hh Wch Supp Suture Chromic 4-0__g121h
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,098.00
Hc/hh Wch Supp Suture Prolene 2-0__et8423h
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
6.00
2,725,000,099.00
Hc/hh Wch Supp Suture Prolene 3-0__et8684g
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
17.00
2,725,000,100.00
Hc/hh Wch Supp Suture Prolene 4-0__et8683g
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
17.00
2,725,000,101.00
Hc/hh Wch Supp Suture Prolene 5-0__et8661g
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
17.00
2,725,000,102.00
Hc/hh Wch Supp Suture Prolene 6-0__et8680g
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
37.00
2,725,000,103.00
Hc/hh Wch Supp Syringe Ear/ulcer__4173
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,104.00
Hc/hh Wch Supp Syringe Luer Lok 10ml__309604
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,105.00
Hc/hh Wch Supp Syringe Luer Lok 20ml__309661
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
4.00
2,725,000,106.00
Hc/hh Wch Supp Tape Steristrip .25x3__r1541
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
5.00
2,725,000,107.00
Hc/hh Wch Supp Tape Steristrip .5x4__r1547
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,108.00
Hc/hh Wch Supp Thorac.cath.24fr.16″__8888561050
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
59.00
2,725,000,109.00
Hc/hh Wch Supp Trach Tube Cuffed 3.5 Mrphy__5-10107
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,110.00
Hc/hh Wch Supp Trach Tube Cuffed 4.5 Mrphy__5-10109
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,111.00
Hc/hh Wch Supp Trach Tube Cuffed 7 Mrphy__5-10314
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,112.00
Hc/hh Wch Supp Trach Tube Cuffed 7.5__5-10315
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
30.00
2,725,000,113.00
Hc/hh Wch Supp Trach Tube Cuffed 8.0__5-10316
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,114.00
Hc/hh Wch Supp Tray Cath Irrigation 70cc__750301
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
7.00
2,725,000,115.00
Hc/hh Wch Supp Tray Lumbar Saf-t-lp Adult__4301csp
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
57.00
2,725,000,116.00
Hc/hh Wch Supp Tray Lumbar Safe-t-lp Peds__4302cs
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
45.00
2,725,000,117.00
Hc/hh Wch Supp Tube Salem Sump Sent 16fr 48__8888264960
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
13.00
2,725,000,118.00
Hc/hh Wch Supp Tube Trach Hi Lo 6.5 Mrphy Tip__86110
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,119.00
Hc/hh Wch Supp Tube Trach Lo-pro 3mm__86043
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
31.00
2,725,000,120.00
Hc/hh Wch Supp Tube Trach Lo-pro 4mm__86045
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,121.00
Hc/hh Wch Supp Tube Trach Lo-pro 5.5mm__86048
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,122.00
Hc/hh Wch Supp Tube Trach Lo-pro 5mm__86047
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,123.00
Hc/hh Wch Supp Tube Trach Lo-pro 6mm__86049
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,124.00
Hc/hh Wch Supp Tube Trach Lo-pro 8.5mm__86054
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,125.00
Hc/hh Wch Supp Tube Trach Lo-pro 9mm__86055
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
28.00
2,725,000,126.00
Hc/hh Wch Supp Tube Trach Uncuffed 2.5__86222
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
8.00
2,725,000,127.00
Hc/hh Wch Supp Tube Trach Uncuffed 3.0__86223
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
10.00
2,725,000,128.00
Hc/hh Wch Supp Tube Trach Uncuffed 3.5__86224
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,129.00
Hc/hh Wch Supp Tube Trach Uncuffed 4.0__86464
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,130.00
Hc/hh Wch Supp Tube Trach Uncuffed 5.0__86466
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
10.00
2,725,000,131.00
Hc/hh Wch Supp Urine Drain Bag 2000__154102
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
29.00
2,725,000,132.00
Hc/hh Wch Supp Vicryl 4-0__etj496g
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
12.00
2,725,000,133.00
Hc/hh Wch Supp Wound Closure Tray__756
MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERILE SUPPLY [0272]
WCH HB SUPPLY FEE SCHEDULE
31.00
2,745,000,001.00
Hc/hh Wch Supp Knee Immobilizer 14″__e200010
MEDICAL/SURGICAL SUPPLIES AND DEVICES-PROSTHETIC/ORTHOTIC DEVICES [0274]
WCH HB SUPPLY FEE SCHEDULE
106.00
2,745,000,002.00
Hc/hh Wch Supp Padding Cast St 6in__23626-560
MEDICAL/SURGICAL SUPPLIES AND DEVICES-PROSTHETIC/ORTHOTIC DEVICES [0274]
WCH HB SUPPLY FEE SCHEDULE
18.00
3,000,029,000.00
REF FOCUSED PHARMACOGENOMICS PANEL
LABORATORY-GENERAL [0300]
0029U
WCH HB PB LAB FEE SCHEDULE
448.00
3,000,980,300.00
HOSPITAL OUTPATIENT CLINIC VISIT SPECIMEN COLLECTION FOR SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 SARS-COV-2 CORONAVIRUS DISEASE COVID-19, ANY SPECIMEN SOURCE)
LABORATORY-GENERAL [0300]
C9803
WCH HB DEFAULT FEE SCHEDULE
50.00
3,003,044,000.00
MOST RECENT HEMOGLOBIN A1C LEVEL < 7.0%
LABORATORY-GENERAL [0300]
3044F
WCH HB PB LAB FEE SCHEDULE
0.01
3,003,045,000.00
HC MOST RECENT HEMOGLOBIN A1C LEVEL 7.0-9.0%
LABORATORY-GENERAL [0300]
3045F
WCH HB PB LAB FEE SCHEDULE
0.01
3,003,046,000.00
MOST RECENT HEMOGLOBIN A1C LEVEL > 9.0%
LABORATORY-GENERAL [0300]
3046F
WCH HB PB LAB FEE SCHEDULE
0.01
3,003,641,500.00
COLLECTION VENOUS BLOOD VENIPUNCTURE
LABORATORY-GENERAL [0300]
36415
WCH HB PB LAB FEE SCHEDULE
37.00
3,003,641,600.00
COLLECTION CAPILLARY BLOOD SPECIMEN
LABORATORY-GENERAL [0300]
36416
WCH HB PB LAB FEE SCHEDULE
26.00
3,008,666,300.00
REF EBV EA
LABORATORY-GENERAL [0300]
86663
WCH HB PB LAB FEE SCHEDULE
175.00
3,009,900,000.00
HANDLING OF SPECIMEN
LABORATORY-GENERAL [0300]
99000
WCH HB PB LAB FEE SCHEDULE
66.00
3,009,900,001.00
WORKPLACE URINE DRUG SCREEN COLLECTION ONLY
LABORATORY-GENERAL [0300]
99000
WCH HB PB LAB FEE SCHEDULE
40.00
3,009,900,002.00
LEGAL BLOOD DRAW
LABORATORY-GENERAL [0300]
99000
WCH HB DEFAULT FEE SCHEDULE
25.00
3,009,900,100.00
HANDLING OR CONVEYANCE SPEC
LABORATORY-GENERAL [0300]
99001
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,004,800.00
BMP W TOTAL CALCIUM PANEL
LABORATORY-CHEMISTRY [0301]
80048
WCH HB DEFAULT FEE SCHEDULE
138.00
3,018,004,800.00
BMP W TOTAL CALCIUM PANEL
LABORATORY-CHEMISTRY [0301]
80048
WCH HB PB LAB FEE SCHEDULE
138.00
3,018,005,100.00
ELECTROLYTE PANEL
LABORATORY-CHEMISTRY [0301]
80051
WCH HB PB LAB FEE SCHEDULE
87.00
3,018,005,300.00
CMP COMPREHENSIVE METABOLIC
LABORATORY-CHEMISTRY [0301]
80053
WCH HB PB LAB FEE SCHEDULE
164.00
3,018,005,300.00
CMP COMPREHENSIVE METABOLIC
LABORATORY-CHEMISTRY [0301]
80053
WCH WELLNESS WEDNESDAY FSC
9.00
3,018,005,500.00
OB PANEL
LABORATORY-CHEMISTRY [0301]
80055
WCH HB PB LAB FEE SCHEDULE
345.00
3,018,006,100.00
LIPID PANEL CHOL TGL LDL HDL
LABORATORY-CHEMISTRY [0301]
80061
WCH HB PB LAB FEE SCHEDULE
138.00
3,018,006,100.00
LIPID PANEL CHOL TGL LDL HDL
LABORATORY-CHEMISTRY [0301]
80061
WCH WELLNESS WEDNESDAY FSC
20.00
3,018,006,900.00
RENAL FUNCTION PANEL
LABORATORY-CHEMISTRY [0301]
80069
WCH HB PB LAB FEE SCHEDULE
131.00
3,018,007,400.00
HEPATITIS ACUTE PANEL
LABORATORY-CHEMISTRY [0301]
80074
WCH HB PB LAB FEE SCHEDULE
388.00
3,018,007,600.00
HEPATIC FUNCTION PANEL
LABORATORY-CHEMISTRY [0301]
80076
WCH HB PB LAB FEE SCHEDULE
121.00
3,018,014,300.00
DRUG ASSAY ACETAMINOPHEN
LABORATORY-CHEMISTRY [0301]
80143
WCH HB PB LAB FEE SCHEDULE
212.00
3,018,015,600.00
CARBAMAZEPINE
LABORATORY-CHEMISTRY [0301]
80156
WCH HB PB LAB FEE SCHEDULE
132.00
3,018,015,800.00
CYCLOSPORINE
LABORATORY-CHEMISTRY [0301]
80158
WCH HB PB LAB FEE SCHEDULE
146.00
3,018,016,200.00
DIGOXIN TOTAL
LABORATORY-CHEMISTRY [0301]
80162
WCH HB PB LAB FEE SCHEDULE
133.00
3,018,016,400.00
VALPROIC ACID TOTAL
LABORATORY-CHEMISTRY [0301]
80164
WCH HB PB LAB FEE SCHEDULE
158.00
3,018,016,800.00
REF ETHOSUXIMIDE
LABORATORY-CHEMISTRY [0301]
80168
WCH HB PB LAB FEE SCHEDULE
155.00
3,018,017,000.00
GENTAMICIN
LABORATORY-CHEMISTRY [0301]
80170
WCH HB PB LAB FEE SCHEDULE
156.00
3,018,017,100.00
REF DRUG SCREEN QUANTITATIVE GABOP
LABORATORY-CHEMISTRY [0301]
80171
WCH HB PB LAB FEE SCHEDULE
191.00
3,018,017,500.00
LAMOTRIGINE LAMICTAL
LABORATORY-CHEMISTRY [0301]
80175
WCH HB PB LAB FEE SCHEDULE
160.00
3,018,017,700.00
LEVETIRACETAM KEPPRA
LABORATORY-CHEMISTRY [0301]
80177
WCH HB PB LAB FEE SCHEDULE
171.00
3,018,017,800.00
LITHIUM
LABORATORY-CHEMISTRY [0301]
80178
WCH HB PB LAB FEE SCHEDULE
112.00
3,018,017,900.00
DRUG ASSAY SALICYLATE
LABORATORY-CHEMISTRY [0301]
80179
WCH HB PB LAB FEE SCHEDULE
212.00
3,018,018,300.00
REF OXCARBAZEPINE METABOLITE (MHC)
LABORATORY-CHEMISTRY [0301]
80183
WCH HB PB LAB FEE SCHEDULE
164.00
3,018,018,301.00
REF OXCARBAZEPINE METABOLITE MHC
LABORATORY-CHEMISTRY [0301]
80183
WCH HB PB LAB FEE SCHEDULE
148.00
3,018,018,400.00
PHENOBARB
LABORATORY-CHEMISTRY [0301]
80184
WCH HB PB LAB FEE SCHEDULE
79.00
3,018,018,500.00
PHENYTOIN
LABORATORY-CHEMISTRY [0301]
80185
WCH HB PB LAB FEE SCHEDULE
128.00
3,018,018,501.00
REF PHENYTOIN TOTAL
LABORATORY-CHEMISTRY [0301]
80185
WCH HB PB LAB FEE SCHEDULE
117.00
3,018,018,600.00
REF PHENYTOIN DILANTIN FREE
LABORATORY-CHEMISTRY [0301]
80186
WCH HB PB LAB FEE SCHEDULE
135.00
3,018,018,601.00
REF PHENYTOIN FREE
LABORATORY-CHEMISTRY [0301]
80186
WCH HB PB LAB FEE SCHEDULE
130.00
3,018,018,800.00
REF ASSAY OF PRIMIDONE
LABORATORY-CHEMISTRY [0301]
80188
WCH HB PB LAB FEE SCHEDULE
158.00
3,018,019,400.00
REF QUINIDINE
LABORATORY-CHEMISTRY [0301]
80194
WCH HB PB LAB FEE SCHEDULE
145.00
3,018,019,500.00
REF SIROLIMUS RAPAMUNE
LABORATORY-CHEMISTRY [0301]
80195
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,019,700.00
Hc Ref Tacrolimus Fk506
LABORATORY-CHEMISTRY [0301]
80197
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,019,701.00
REF TACROLIMUS FK506
LABORATORY-CHEMISTRY [0301]
80197
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,019,800.00
THEOPHYLLINE
LABORATORY-CHEMISTRY [0301]
80198
WCH HB PB LAB FEE SCHEDULE
134.00
3,018,020,000.00
TOBRAMYCIN
LABORATORY-CHEMISTRY [0301]
80200
WCH HB PB LAB FEE SCHEDULE
142.00
3,018,020,100.00
Hc Ref Topiramate
LABORATORY-CHEMISTRY [0301]
80201
WCH HB PB LAB FEE SCHEDULE
120.00
3,018,020,101.00
REF TOPIRAMATE
LABORATORY-CHEMISTRY [0301]
80201
WCH HB PB LAB FEE SCHEDULE
120.00
3,018,020,200.00
VANCOMYCIN
LABORATORY-CHEMISTRY [0301]
80202
WCH HB PB LAB FEE SCHEDULE
128.00
3,018,020,300.00
REF ZONISAMIDE
LABORATORY-CHEMISTRY [0301]
80203
WCH HB PB LAB FEE SCHEDULE
75.00
3,018,023,500.00
REF LACOSAMIDE(MAYO)
LABORATORY-CHEMISTRY [0301]
80235
WCH HB PB LAB FEE SCHEDULE
162.00
3,018,029,900.00
REF FLECAINIDE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB DEFAULT FEE SCHEDULE
167.00
3,018,029,900.00
REF FLECAINIDE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,901.00
REF AMIODARONE P S
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,902.00
REF CARBAMAZEPINE 10 11 EPOXIDE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,903.00
REF MEXILETINE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,904.00
REF WARFARIN COUMADIN
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,905.00
REF FLECAINIDE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,906.00
REF INFLIXIMAB
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,907.00
REF METHOTREXATE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,911.00
REF FELBAMATE LEVEL
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,925.00
REF ADALIMUMAB AND AB
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,926.00
REF LACOSAMIDE
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,029,927.00
REF ADALIMUMAB QUANTITATION WITH REFLEX TO ANTIBODY
LABORATORY-CHEMISTRY [0301]
80299
WCH HB PB LAB FEE SCHEDULE
462.00
3,018,030,600.00
URINE DRUG SCREEN
LABORATORY-CHEMISTRY [0301]
80306
WCH HB PB LAB FEE SCHEDULE
248.00
3,018,030,700.00
REF HYPOGLYCEMIC AGENT SCRN
LABORATORY-CHEMISTRY [0301]
80307
WCH HB PB LAB FEE SCHEDULE
212.00
3,018,030,707.00
REF BUPRENORPHINE SCREEN AND CONFIRMATION, URINE
LABORATORY-CHEMISTRY [0301]
80307
WCH HB PB LAB FEE SCHEDULE
445.00
3,018,032,000.00
ALCOHOL
LABORATORY-CHEMISTRY [0301]
80320
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,032,003.00
REF ETHYLENE GLYCOL
LABORATORY-CHEMISTRY [0301]
82693
WCH HB PB LAB FEE SCHEDULE
193.00
3,018,032,300.00
REF NICOTINE AND METABOLITES
LABORATORY-CHEMISTRY [0301]
80323
WCH HB PB LAB FEE SCHEDULE
223.00
3,018,032,900.00
SALICYLATES
LABORATORY-CHEMISTRY [0301]
80329
WCH HB PB LAB FEE SCHEDULE
212.00
3,018,032,901.00
ACETAMINOPHEN
LABORATORY-CHEMISTRY [0301]
80329
WCH HB PB LAB FEE SCHEDULE
212.00
3,018,033,800.00
REF ANTIDPRESSNT NOT SPEC PM URINE
LABORATORY-CHEMISTRY [0301]
80338
WCH HB PB LAB FEE SCHEDULE
110.00
3,018,034,600.00
REF BENZODIAZEPINE CONF URINE
LABORATORY-CHEMISTRY [0301]
80346
WCH HB PB LAB FEE SCHEDULE
309.00
3,018,034,900.00
REF CANNABINOIDS NATURAL CONF
LABORATORY-CHEMISTRY [0301]
80349
WCH HB PB LAB FEE SCHEDULE
168.00
3,018,035,600.00
REF HEROINE METABOLITE CONF
LABORATORY-CHEMISTRY [0301]
80356
WCH HB PB LAB FEE SCHEDULE
112.00
3,018,036,100.00
REF OPIATES 1 OR MORE
LABORATORY-CHEMISTRY [0301]
80361
WCH HB PB LAB FEE SCHEDULE
144.00
3,018,036,500.00
REF OXYCODONE CONF
LABORATORY-CHEMISTRY [0301]
80365
WCH HB PB LAB FEE SCHEDULE
83.00
3,018,037,501.00
REF DIGITOXIN SERUM PLASMA
LABORATORY-CHEMISTRY [0301]
80375
WCH HB PB LAB FEE SCHEDULE
167.00
3,018,037,700.00
REF DRUG SUBS NOT SPEC 7 MORE PM U
LABORATORY-CHEMISTRY [0301]
80377
WCH HB PB LAB FEE SCHEDULE
151.00
3,018,201,000.00
KETONE
LABORATORY-CHEMISTRY [0301]
82010
WCH HB PB LAB FEE SCHEDULE
110.00
3,018,202,400.00
ACTH
LABORATORY-CHEMISTRY [0301]
82024
WCH HB PB LAB FEE SCHEDULE
272.00
3,018,202,401.00
REF ACTH
LABORATORY-CHEMISTRY [0301]
82024
WCH HB PB LAB FEE SCHEDULE
272.00
3,018,204,000.00
ALBUMIN SERUM PLASMA WH BLOOD
LABORATORY-CHEMISTRY [0301]
82040
WCH HB PB LAB FEE SCHEDULE
42.00
3,018,204,200.00
ALBUMIN BODY FLUID
LABORATORY-CHEMISTRY [0301]
82042
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,204,300.00
URINE MICROALBUMIN QUANTITATIV
LABORATORY-CHEMISTRY [0301]
82043
WCH HB PB LAB FEE SCHEDULE
108.00
3,018,204,400.00
MICROALBUMIN QUAL
LABORATORY-CHEMISTRY [0301]
82044
WCH HB PB LAB FEE SCHEDULE
35.00
3,018,207,500.00
ASSAY OF BREATH ETHANOL
LABORATORY-CHEMISTRY [0301]
82075
WCH HB PB LAB FEE SCHEDULE
67.00
3,018,207,700.00
ASSAY OF ALCOHOL (ETHANOL) SPEC XCP UR&BREATH IA
LABORATORY-CHEMISTRY [0301]
82077
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,208,500.00
REF ALDOLASE
LABORATORY-CHEMISTRY [0301]
82085
WCH HB PB LAB FEE SCHEDULE
90.00
3,018,208,501.00
REF ALDOLASE
LABORATORY-CHEMISTRY [0301]
82085
WCH HB PB LAB FEE SCHEDULE
84.00
3,018,208,800.00
HC REF ALDOSTERONE SERUM
LABORATORY-CHEMISTRY [0301]
82088
WCH HB PB LAB FEE SCHEDULE
306.00
3,018,208,801.00
REF ALDOSTERONE URINE
LABORATORY-CHEMISTRY [0301]
82088
WCH HB PB LAB FEE SCHEDULE
200.00
3,018,208,802.00
REF ALDOSTERONE SERUM
LABORATORY-CHEMISTRY [0301]
82088
WCH HB PB LAB FEE SCHEDULE
306.00
3,018,210,300.00
REF ALPHA 1 ANTITRYPSIN
LABORATORY-CHEMISTRY [0301]
82103
WCH HB PB LAB FEE SCHEDULE
1,307.00
3,018,210,400.00
REF A1AT PHENOTYPE
LABORATORY-CHEMISTRY [0301]
82104
WCH HB PB LAB FEE SCHEDULE
177.00
3,018,210,500.00
REF ALPHA-FETOPROTEIN: SERUM
LABORATORY-CHEMISTRY [0301]
82105
WCH HB PB LAB FEE SCHEDULE
136.00
3,018,210,502.00
AFP TUMOR MARKER
LABORATORY-CHEMISTRY [0301]
82105
WCH HB PB LAB FEE SCHEDULE
136.00
3,018,213,500.00
REF AMINOLEVULINIC ACID ALA U
LABORATORY-CHEMISTRY [0301]
82135
WCH HB PB LAB FEE SCHEDULE
132.00
3,018,214,000.00
AMMONIA
LABORATORY-CHEMISTRY [0301]
82140
WCH HB PB LAB FEE SCHEDULE
106.00
3,018,215,000.00
AMYLASE SERUM
LABORATORY-CHEMISTRY [0301]
82150
WCH HB PB LAB FEE SCHEDULE
100.00
3,018,215,700.00
REF ANDROSTENEDIONE S
LABORATORY-CHEMISTRY [0301]
82157
WCH HB PB LAB FEE SCHEDULE
189.00
3,018,216,400.00
REF ANGIOTENSIN I-CONVERTING ENZYME CSF
LABORATORY-CHEMISTRY [0301]
82164
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,216,401.00
REF ANGIOTENSIN CONV ENZYME
LABORATORY-CHEMISTRY [0301]
82164
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,217,200.00
REF APOLIPOPROTEIN A1
LABORATORY-CHEMISTRY [0301]
82172
WCH HB PB LAB FEE SCHEDULE
100.00
3,018,217,204.00
REF APOLIPOPROTEIN B FOR APOAB
LABORATORY-CHEMISTRY [0301]
82172
WCH HB PB LAB FEE SCHEDULE
84.00
3,018,217,500.00
REF HEAVY METAL SCREEN ARSENIC, 24 HOUR
LABORATORY-CHEMISTRY [0301]
82175
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,217,501.00
REF ARSENIC, 24 HOUR, URINE
LABORATORY-CHEMISTRY [0301]
82175
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,218,000.00
REF VITAMIN C
LABORATORY-CHEMISTRY [0301]
82180
WCH HB PB LAB FEE SCHEDULE
276.00
3,018,223,200.00
REF BETA 2 MICROGLOBULIN URINE
LABORATORY-CHEMISTRY [0301]
82232
WCH HB PB LAB FEE SCHEDULE
205.00
3,018,223,201.00
REF BETA 2 MICROGLOBULIN, SERUM
LABORATORY-CHEMISTRY [0301]
82232
WCH HB PB LAB FEE SCHEDULE
163.00
3,018,224,700.00
BILIRUBIN TOTAL
LABORATORY-CHEMISTRY [0301]
82247
WCH HB PB LAB FEE SCHEDULE
55.00
3,018,224,800.00
CONJUGATED BILIRUBIN
LABORATORY-CHEMISTRY [0301]
82248
WCH HB PB LAB FEE SCHEDULE
42.00
3,018,226,100.00
REF BIOTINIDASE DEFICIENCY SCREEN
LABORATORY-CHEMISTRY [0301]
82261
WCH HB PB LAB FEE SCHEDULE
29.00
3,018,227,000.00
FECAL OCCULT BLOOD NONMEDICARE
LABORATORY-CHEMISTRY [0301]
82270
WCH HB PB LAB FEE SCHEDULE
33.00
3,018,227,200.00
OCCULT BLOOD FECES WAIVED
LABORATORY-CHEMISTRY [0301]
82272
WCH HB PB LAB FEE SCHEDULE
58.00
3,018,227,400.00
FECAL OCC BL TEST IFOB DIAG
LABORATORY-CHEMISTRY [0301]
82274
WCH HB PB LAB FEE SCHEDULE
107.00
3,018,227,401.00
FECAL OCCULT BL TEST IFOB SCRN
LABORATORY-CHEMISTRY [0301]
82274
WCH HB PB LAB FEE SCHEDULE
110.00
3,018,230,000.00
REF HEAVY METALS SCRN UR CADMIUM
LABORATORY-CHEMISTRY [0301]
82300
WCH HB PB LAB FEE SCHEDULE
175.00
3,018,230,001.00
REF HEAVY METALS SCRN UR CADMIUM
LABORATORY-CHEMISTRY [0301]
82300
WCH HB PB LAB FEE SCHEDULE
130.00
3,018,230,600.00
VIT D 25 HYDROXY W FRACTIONS
LABORATORY-CHEMISTRY [0301]
82306
WCH HB PB LAB FEE SCHEDULE
318.00
3,018,230,600.00
VIT D 25 HYDROXY W FRACTIONS
LABORATORY-CHEMISTRY [0301]
82306
WCH WELLNESS WEDNESDAY FSC
40.00
3,018,230,601.00
REF VIT D 25 HYDROXY W FRACTIONS
LABORATORY-CHEMISTRY [0301]
82306
WCH HB PB LAB FEE SCHEDULE
318.00
3,018,230,800.00
REF CALCITONIN
LABORATORY-CHEMISTRY [0301]
82308
WCH HB PB LAB FEE SCHEDULE
289.00
3,018,231,000.00
CALCIUM TOTAL SERUM
LABORATORY-CHEMISTRY [0301]
82310
WCH HB PB LAB FEE SCHEDULE
61.00
3,018,233,000.00
CALCIUM IONIZED ASSAY
LABORATORY-CHEMISTRY [0301]
82330
WCH HB PB LAB FEE SCHEDULE
139.00
3,018,233,001.00
REF CALCUIM IONIZED SERUM
LABORATORY-CHEMISTRY [0301]
82330
WCH HB PB LAB FEE SCHEDULE
139.00
3,018,234,000.00
REF 24 HR URINE CALCIUM
LABORATORY-CHEMISTRY [0301]
82340
WCH HB PB LAB FEE SCHEDULE
68.00
3,018,236,501.00
REF CALCULUS QUAL ANAL INFRD SPECT
LABORATORY-CHEMISTRY [0301]
82365
WCH HB PB LAB FEE SCHEDULE
127.00
3,018,237,400.00
CARBON DIOXIDE BICARB
LABORATORY-CHEMISTRY [0301]
82374
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,237,501.00
CARBOXYHEMOGLOBIN QUANT
LABORATORY-CHEMISTRY [0301]
82375
WCH HB PB LAB FEE SCHEDULE
129.00
3,018,237,800.00
CARCINOEMBRYONIC ANTIGEN
LABORATORY-CHEMISTRY [0301]
82378
WCH HB PB LAB FEE SCHEDULE
215.00
3,018,237,900.00
REF CARNITINE P S
LABORATORY-CHEMISTRY [0301]
82379
WCH HB PB LAB FEE SCHEDULE
94.00
3,018,238,400.00
ASSAY, THREE CATECHOLAMINES
LABORATORY-CHEMISTRY [0301]
82384
WCH HB PB LAB FEE SCHEDULE
289.00
3,018,238,402.00
REF CATECHOLAMINE FRACT FREE URINE
LABORATORY-CHEMISTRY [0301]
82384
WCH HB PB LAB FEE SCHEDULE
297.00
3,018,239,000.00
REF CERULOPLASMIN
LABORATORY-CHEMISTRY [0301]
82390
WCH HB PB LAB FEE SCHEDULE
135.00
3,018,239,700.00
REF PTH RELATED PEPTIDE
LABORATORY-CHEMISTRY [0301]
82397
WCH HB PB LAB FEE SCHEDULE
190.00
3,018,239,702.00
REF INFLIXIMAB AB
LABORATORY-CHEMISTRY [0301]
82397
WCH HB PB LAB FEE SCHEDULE
152.00
3,018,243,500.00
CHLORIDE, SERUM
LABORATORY-CHEMISTRY [0301]
82435
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,243,600.00
CHLORIDE URINE
LABORATORY-CHEMISTRY [0301]
82436
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,243,800.00
CHLORIDE CSF BODY FLUID URINE
LABORATORY-CHEMISTRY [0301]
82438
WCH HB PB LAB FEE SCHEDULE
79.00
3,018,246,500.00
CHOLESTEROL
LABORATORY-CHEMISTRY [0301]
82465
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,249,500.00
REF CHROMIUM
LABORATORY-CHEMISTRY [0301]
82495
WCH HB PB LAB FEE SCHEDULE
244.00
3,018,250,700.00
REF CITRATE EXCRETION (SAT 24)
LABORATORY-CHEMISTRY [0301]
82507
WCH HB PB LAB FEE SCHEDULE
295.00
3,018,250,701.00
REF CITRATE EXCRETION
LABORATORY-CHEMISTRY [0301]
82507
WCH HB PB LAB FEE SCHEDULE
303.00
3,018,252,300.00
REF NTX TELOPEPTIDE U
LABORATORY-CHEMISTRY [0301]
82523
WCH HB PB LAB FEE SCHEDULE
182.00
3,018,252,301.00
REF NTX TELOPEPTIDE U
LABORATORY-CHEMISTRY [0301]
82523
WCH HB PB LAB FEE SCHEDULE
182.00
3,018,252,302.00
REF NTX SERUM
LABORATORY-CHEMISTRY [0301]
82523
WCH HB PB LAB FEE SCHEDULE
229.00
3,018,252,500.00
REF COPPER URINE
LABORATORY-CHEMISTRY [0301]
82525
WCH HB PB LAB FEE SCHEDULE
135.00
3,018,252,501.00
REF COPPER SERUM
LABORATORY-CHEMISTRY [0301]
82525
WCH HB PB LAB FEE SCHEDULE
135.00
3,018,253,000.00
CORTISOL, FREE, URINE
LABORATORY-CHEMISTRY [0301]
82530
WCH HB PB LAB FEE SCHEDULE
210.00
3,018,253,002.00
REF CORTISOL FREE URINE
LABORATORY-CHEMISTRY [0301]
82530
WCH HB PB LAB FEE SCHEDULE
210.00
3,018,253,005.00
REF CORTISOL, FREE
LABORATORY-CHEMISTRY [0301]
82530
WCH HB PB LAB FEE SCHEDULE
195.60
3,018,253,300.00
CORTISOL SINGLE
LABORATORY-CHEMISTRY [0301]
82533
WCH HB PB LAB FEE SCHEDULE
180.00
3,018,253,301.00
REF CORTISOL SALIVA
LABORATORY-CHEMISTRY [0301]
82533
WCH HB PB LAB FEE SCHEDULE
162.00
3,018,254,200.00
REF CORTISOL URINE LC-MS/MS
LABORATORY-CHEMISTRY [0301]
82542
WCH HB PB LAB FEE SCHEDULE
167.00
3,018,254,217.00
REF PYRIDOXIC ACID
LABORATORY-CHEMISTRY [0301]
82542
WCH HB PB LAB FEE SCHEDULE
167.00
3,018,255,000.00
CPK TOTAL
LABORATORY-CHEMISTRY [0301]
82550
WCH HB PB LAB FEE SCHEDULE
177.00
3,018,255,300.00
MB FRACTION
LABORATORY-CHEMISTRY [0301]
82553
WCH HB PB LAB FEE SCHEDULE
87.00
3,018,256,500.00
CREATININE SERUM
LABORATORY-CHEMISTRY [0301]
82565
WCH HB PB LAB FEE SCHEDULE
85.00
3,018,257,000.00
CREATININE BODY FLUID
LABORATORY-CHEMISTRY [0301]
82570
WCH HB PB LAB FEE SCHEDULE
92.00
3,018,257,001.00
REF CREATININE OTHER SOURCE
LABORATORY-CHEMISTRY [0301]
82570
WCH HB PB LAB FEE SCHEDULE
92.00
3,018,257,003.00
REF CREATINE (RPTU) URINE
LABORATORY-CHEMISTRY [0301]
82570
WCH HB PB LAB FEE SCHEDULE
70.00
3,018,257,500.00
CREAT CLEARANCE
LABORATORY-CHEMISTRY [0301]
82575
WCH HB PB LAB FEE SCHEDULE
120.00
3,018,258,500.00
REF CRYOG CRYOFIBRENGOGEN
LABORATORY-CHEMISTRY [0301]
82585
WCH HB PB LAB FEE SCHEDULE
86.00
3,018,259,500.00
REF CRYO PANEL, SERUM AND PLASMA(MAYO)
LABORATORY-CHEMISTRY [0301]
82595
WCH HB PB LAB FEE SCHEDULE
79.00
3,018,260,700.00
VIT B12 SERUM
LABORATORY-CHEMISTRY [0301]
82607
WCH HB PB LAB FEE SCHEDULE
162.00
3,018,260,700.00
VIT B12 SERUM
LABORATORY-CHEMISTRY [0301]
82607
WCH WELLNESS WEDNESDAY FSC
25.00
3,018,262,600.00
REF DHEA
LABORATORY-CHEMISTRY [0301]
82626
WCH HB PB LAB FEE SCHEDULE
272.00
3,018,262,601.00
REF DHEA
LABORATORY-CHEMISTRY [0301]
82626
WCH HB PB LAB FEE SCHEDULE
255.60
3,018,262,700.00
REF DHEA SULFATE
LABORATORY-CHEMISTRY [0301]
82627
WCH HB PB LAB FEE SCHEDULE
240.00
3,018,265,200.00
REF VIT D1 25 DIHYDROXY W FRAC
LABORATORY-CHEMISTRY [0301]
82652
WCH HB PB LAB FEE SCHEDULE
338.00
3,018,265,201.00
REF VIT D1 25 DIHYDROXY W FRAC
LABORATORY-CHEMISTRY [0301]
82652
WCH HB PB LAB FEE SCHEDULE
338.00
3,018,265,601.00
REF PANCREATIC ELASTASE FECAL
LABORATORY-CHEMISTRY [0301]
82656
WCH HB PB LAB FEE SCHEDULE
340.00
3,018,265,701.00
REF TPMT ACTIVITY, RBC
LABORATORY-CHEMISTRY [0301]
82657
WCH HB PB LAB FEE SCHEDULE
453.00
3,018,266,800.00
REF ERYTHROPOIETIN
LABORATORY-CHEMISTRY [0301]
82668
WCH HB PB LAB FEE SCHEDULE
260.00
3,018,267,000.00
ESTRADIOL
LABORATORY-CHEMISTRY [0301]
82670
WCH HB PB LAB FEE SCHEDULE
187.00
3,018,267,100.00
REF ESTROGENS, FRACTIONATED
LABORATORY-CHEMISTRY [0301]
82671
WCH HB PB LAB FEE SCHEDULE
258.60
3,018,267,700.00
REF QUAD SCRN ESTRIOL
LABORATORY-CHEMISTRY [0301]
82677
WCH HB PB LAB FEE SCHEDULE
174.00
3,018,267,900.00
REF ASSAY OF ESTRONE
LABORATORY-CHEMISTRY [0301]
82679
WCH HB PB LAB FEE SCHEDULE
240.00
3,018,271,000.00
REF FECAL FAT QUANT
LABORATORY-CHEMISTRY [0301]
82710
WCH HB PB LAB FEE SCHEDULE
195.00
3,018,272,800.00
FERRITIN
LABORATORY-CHEMISTRY [0301]
82728
WCH HB PB LAB FEE SCHEDULE
149.00
3,018,272,800.00
FERRITIN
LABORATORY-CHEMISTRY [0301]
82728
WCH WELLNESS WEDNESDAY FSC
8.50
3,018,272,801.00
REF FERRITIN SERUM
LABORATORY-CHEMISTRY [0301]
82728
WCH HB PB LAB FEE SCHEDULE
285.60
3,018,274,600.00
FOLATE SERUM
LABORATORY-CHEMISTRY [0301]
82746
WCH HB PB LAB FEE SCHEDULE
164.00
3,018,277,600.00
REF GALACTOSEMIA SCREEN
LABORATORY-CHEMISTRY [0301]
82776
WCH HB PB LAB FEE SCHEDULE
29.00
3,018,278,400.00
REF CELIAC DIS SERLGY CASCADE IGA
LABORATORY-CHEMISTRY [0301]
82784
WCH HB PB LAB FEE SCHEDULE
111.00
3,018,278,402.00
REF GAMMAGLOB IMMUNGLOB IGG TOTAL
LABORATORY-CHEMISTRY [0301]
82784
WCH HB PB LAB FEE SCHEDULE
73.20
3,018,278,404.00
REF CELIAC DIS SERLGY CASCADE IGA
LABORATORY-CHEMISTRY [0301]
82784
WCH HB PB LAB FEE SCHEDULE
111.00
3,018,278,406.00
GAMMAGLOB IMMUNOGLOBULIN EACH
LABORATORY-CHEMISTRY [0301]
82784
WCH HB PB LAB FEE SCHEDULE
111.00
3,018,278,500.00
REF IMMUGLOBULIN E
LABORATORY-CHEMISTRY [0301]
82785
WCH HB PB LAB FEE SCHEDULE
112.00
3,018,278,700.00
REF IGG SUBCLASSES EACH
LABORATORY-CHEMISTRY [0301]
82787
WCH HB PB LAB FEE SCHEDULE
300.00
3,018,280,300.00
BL GAS W O2 SAT CALCULATED LAB
LABORATORY-CHEMISTRY [0301]
82803
WCH HB PB LAB FEE SCHEDULE
233.00
3,018,280,500.00
BL GAS W 02 SAT MEASURE RT
LABORATORY-CHEMISTRY [0301]
82805
WCH HB PB LAB FEE SCHEDULE
233.00
3,018,294,100.00
REF GASTRIN
LABORATORY-CHEMISTRY [0301]
82941
WCH HB PB LAB FEE SCHEDULE
160.00
3,018,294,500.00
GLUCOSE CSF OR BODY FLUID
LABORATORY-CHEMISTRY [0301]
82945
WCH HB PB LAB FEE SCHEDULE
147.00
3,018,294,700.00
GLUCOSE
LABORATORY-CHEMISTRY [0301]
82947
WCH HB PB LAB FEE SCHEDULE
77.00
3,018,295,000.00
GLUCOSE TOLERANCE OB
LABORATORY-CHEMISTRY [0301]
82950
WCH HB PB LAB FEE SCHEDULE
58.00
3,018,295,100.00
GTT 3 3HR GLUCOSE TOLERANCE
LABORATORY-CHEMISTRY [0301]
82951
WCH HB PB LAB FEE SCHEDULE
128.00
3,018,295,200.00
GLUC TOLERANCE ADDL >3 SPEC
LABORATORY-CHEMISTRY [0301]
82952
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,295,500.00
REF G 6 PD QN RC
LABORATORY-CHEMISTRY [0301]
82955
WCH HB PB LAB FEE SCHEDULE
131.00
3,018,297,700.00
GAMMA GT (GTT)
LABORATORY-CHEMISTRY [0301]
82977
WCH HB PB LAB FEE SCHEDULE
102.50
3,018,298,500.00
REF FRUCTOSAMINE
LABORATORY-CHEMISTRY [0301]
82985
WCH HB PB LAB FEE SCHEDULE
68.00
3,018,300,100.00
FSH
LABORATORY-CHEMISTRY [0301]
83001
WCH HB PB LAB FEE SCHEDULE
166.00
3,018,300,200.00
REF LUTEINZINE HORMONE (LH)
LABORATORY-CHEMISTRY [0301]
83002
WCH HB PB LAB FEE SCHEDULE
171.00
3,018,300,201.00
LUTEINIZING HORMONE
LABORATORY-CHEMISTRY [0301]
83002
WCH HB PB LAB FEE SCHEDULE
171.00
3,018,300,300.00
REF GROWTH HORMONE
LABORATORY-CHEMISTRY [0301]
83003
WCH HB PB LAB FEE SCHEDULE
163.00
3,018,301,000.00
REF HAPTOGLOBIN
LABORATORY-CHEMISTRY [0301]
83010
WCH HB PB LAB FEE SCHEDULE
131.00
3,018,301,002.00
Hc Haptoglobin
LABORATORY-CHEMISTRY [0301]
83010
WCH HB PB LAB FEE SCHEDULE
110.00
3,018,301,800.00
QUANTITATIVE SCREEN, METALS
LABORATORY-CHEMISTRY [0301]
83018
WCH HB PB LAB FEE SCHEDULE
206.00
3,018,302,000.00
REF HEMOGLOBIN ELECTROPHORESIS (HGB E)
LABORATORY-CHEMISTRY [0301]
83020
WCH HB PB LAB FEE SCHEDULE
132.00
3,018,302,001.00
REF HEMOGLOBIN ELP B
LABORATORY-CHEMISTRY [0301]
83020
WCH HB PB LAB FEE SCHEDULE
750.00
3,018,302,002.00
REF HEMOGLOBIN ELP B – THALASSEMIA & HEMO EVAL
LABORATORY-CHEMISTRY [0301]
83020
WCH HB PB LAB FEE SCHEDULE
750.00
3,018,302,101.00
REF HEMOGLOBIN A2 & F
LABORATORY-CHEMISTRY [0301]
83021
WCH HB PB LAB FEE SCHEDULE
173.00
3,018,302,102.00
REF HEMOGLOBIN A2 & F – THALASSEMIA & HEMO EVAL
LABORATORY-CHEMISTRY [0301]
83021
WCH HB PB LAB FEE SCHEDULE
379.20
3,018,303,600.00
HEMOGLOBIN A1C
LABORATORY-CHEMISTRY [0301]
83036
WCH HB PB LAB FEE SCHEDULE
96.00
3,018,303,600.00
HEMOGLOBIN A1C
LABORATORY-CHEMISTRY [0301]
83036
WCH WELLNESS WEDNESDAY FSC
25.00
3,018,307,000.00
REF HEMOSIDERIN U
LABORATORY-CHEMISTRY [0301]
83070
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,309,000.00
HC ASSAY, HOMOCYSTINE
LABORATORY-CHEMISTRY [0301]
83090
WCH HB PB LAB FEE SCHEDULE
216.00
3,018,309,003.00
REF HOMOCYSTEINE TOTAL SERUM
LABORATORY-CHEMISTRY [0301]
83090
WCH HB PB LAB FEE SCHEDULE
216.00
3,018,349,700.00
REF QUANT 5HIAA
LABORATORY-CHEMISTRY [0301]
83497
WCH HB PB LAB FEE SCHEDULE
177.00
3,018,349,800.00
REF 18 HYDROXYPROGESTERONE
LABORATORY-CHEMISTRY [0301]
83498
WCH HB PB LAB FEE SCHEDULE
243.00
3,018,349,801.00
REF 17 HYDROXYPROGESTERONE
LABORATORY-CHEMISTRY [0301]
83498
WCH HB PB LAB FEE SCHEDULE
243.00
3,018,349,802.00
REF CAH
LABORATORY-CHEMISTRY [0301]
83498
WCH HB PB LAB FEE SCHEDULE
243.00
3,018,351,600.00
REF GLIADIN AB OR IGG OR IGM
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
135.00
3,018,351,601.00
REF CYSTIC FIBROSIS
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
139.00
3,018,351,602.00
REF PR3
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
134.00
3,018,351,603.00
REF MPO
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
134.00
3,018,351,604.00
REF GLIADIN DEAMINATED IGG OR IGA
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
163.00
3,018,351,605.00
REF MITOCHONDIRAL AB M2
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
135.00
3,018,351,607.00
REF PARIETAL CELL AB IGG
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
150.00
3,018,351,609.00
REF TISSUE TRANSGLUTAMINASE AB IGG OR IGA
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
134.00
3,018,351,617.00
REF ANTI GLOMERULAR BASEMENT MEMBR(MAYO)
LABORATORY-CHEMISTRY [0301]
83516
WCH HB PB LAB FEE SCHEDULE
150.00
3,018,351,900.00
REF PARANEOPLASTIC (V-G) K+ CHNL
LABORATORY-CHEMISTRY [0301]
83519
WCH HB PB LAB FEE SCHEDULE
202.00
3,018,351,904.00
REF ACH RECEPTOR MUSCLE BINDING
LABORATORY-CHEMISTRY [0301]
83519
WCH HB PB LAB FEE SCHEDULE
167.00
3,018,351,909.00
REF PARANEOPLASTIC ACH GANGLIONIC
LABORATORY-CHEMISTRY [0301]
83519
WCH HB PB LAB FEE SCHEDULE
317.00
3,018,351,914.00
REF MUSK AUTOANITBODY
LABORATORY-CHEMISTRY [0301]
83519
WCH HB PB LAB FEE SCHEDULE
858.00
3,018,352,000.00
REF GLOMERULAR BASEMNT MEMBRANE AB
LABORATORY-CHEMISTRY [0301]
83520
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,352,003.00
REF IBD SACCHAROMYCES IGG OR IGA
LABORATORY-CHEMISTRY [0301]
83520
WCH HB PB LAB FEE SCHEDULE
152.00
3,018,352,009.00
REF TRYPTASE
LABORATORY-CHEMISTRY [0301]
83520
WCH HB PB LAB FEE SCHEDULE
167.00
3,018,352,010.00
REF ANTIMULLERIAN HORMONE SERUM
LABORATORY-CHEMISTRY [0301]
83520
WCH HB PB LAB FEE SCHEDULE
178.00
3,018,352,011.00
REF THYROTROPIN RECEPTOR AB
LABORATORY-CHEMISTRY [0301]
83520
WCH HB PB LAB FEE SCHEDULE
167.00
3,018,352,013.00
PARANEOPLASTIC STRIATIONAL AB
LABORATORY-CHEMISTRY [0301]
83520
WCH HB PB LAB FEE SCHEDULE
152.00
3,018,352,500.00
REF INSULIN
LABORATORY-CHEMISTRY [0301]
83525
WCH HB PB LAB FEE SCHEDULE
171.00
3,018,354,000.00
IRON SERUM
LABORATORY-CHEMISTRY [0301]
83540
WCH HB PB LAB FEE SCHEDULE
59.00
3,018,354,000.00
IRON SERUM
LABORATORY-CHEMISTRY [0301]
83540
WCH WELLNESS WEDNESDAY FSC
7.00
3,018,355,000.00
IRON BIND SERUM
LABORATORY-CHEMISTRY [0301]
83550
WCH HB PB LAB FEE SCHEDULE
76.00
3,018,355,000.00
IRON BIND SERUM
LABORATORY-CHEMISTRY [0301]
83550
WCH WELLNESS WEDNESDAY FSC
7.00
3,018,360,500.00
LACTIC ACID
LABORATORY-CHEMISTRY [0301]
83605
WCH HB PB LAB FEE SCHEDULE
134.00
3,018,361,500.00
LDH
LABORATORY-CHEMISTRY [0301]
83615
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,361,501.00
REF LDH TOTAL
LABORATORY-CHEMISTRY [0301]
83615
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,362,500.00
HC REF LDH ISOENZYMES S
LABORATORY-CHEMISTRY [0301]
83625
WCH HB PB LAB FEE SCHEDULE
166.00
3,018,362,501.00
REF LDH ISOENZYMES S
LABORATORY-CHEMISTRY [0301]
83625
WCH HB PB LAB FEE SCHEDULE
129.00
3,018,365,500.00
HEAVY METAL LEAD WB
LABORATORY-CHEMISTRY [0301]
83655
WCH HB PB LAB FEE SCHEDULE
112.00
3,018,365,502.00
REF HEAVY METALS SCRN UR LEAD
LABORATORY-CHEMISTRY [0301]
83655
WCH HB PB LAB FEE SCHEDULE
109.00
3,018,369,000.00
LIPASE
LABORATORY-CHEMISTRY [0301]
83690
WCH HB PB LAB FEE SCHEDULE
101.00
3,018,369,500.00
REF LIPOPROTEIN A SERUM
LABORATORY-CHEMISTRY [0301]
83695
WCH HB PB LAB FEE SCHEDULE
200.00
3,018,370,001.00
REF LP(A) CHOLESTEROL SERUM
LABORATORY-CHEMISTRY [0301]
83700
WCH HB PB LAB FEE SCHEDULE
212.40
3,018,371,800.00
HDL HIGH DENS LIPOPROTEIN
LABORATORY-CHEMISTRY [0301]
83718
WCH HB PB LAB FEE SCHEDULE
86.00
3,018,372,100.00
DIRECT LDL CHOLESTEROL
LABORATORY-CHEMISTRY [0301]
83721
WCH HB PB LAB FEE SCHEDULE
89.00
3,018,373,500.00
MAGNESIUM
LABORATORY-CHEMISTRY [0301]
83735
WCH HB PB LAB FEE SCHEDULE
70.00
3,018,378,901.00
REF AMINO ACID ACYLCARNITINE SCRN
LABORATORY-CHEMISTRY [0301]
83789
WCH HB PB LAB FEE SCHEDULE
143.00
3,018,382,500.00
REF MERCURY, 24 HOUR, URINE
LABORATORY-CHEMISTRY [0301]
83825
WCH HB PB LAB FEE SCHEDULE
179.00
3,018,383,500.00
REF METANEPRINES
LABORATORY-CHEMISTRY [0301]
83835
WCH HB PB LAB FEE SCHEDULE
271.00
3,018,383,501.00
REF METANEPHRINES
LABORATORY-CHEMISTRY [0301]
83835
WCH HB PB LAB FEE SCHEDULE
292.00
3,018,383,502.00
REF METANEPHRINES FRACTION 24 HR
LABORATORY-CHEMISTRY [0301]
83835
WCH HB PB LAB FEE SCHEDULE
271.00
3,018,387,400.00
MYOGLOBIN
LABORATORY-CHEMISTRY [0301]
83874
WCH HB PB LAB FEE SCHEDULE
158.00
3,018,388,000.00
BNP B-TYPE NATRIUETIC PEPTIDE
LABORATORY-CHEMISTRY [0301]
83880
WCH HB PB LAB FEE SCHEDULE
322.00
3,018,388,301.00
REF IMMUNOGLOBULIN LIGHT CH
LABORATORY-CHEMISTRY [0301]
83883
WCH HB PB LAB FEE SCHEDULE
153.00
3,018,388,302.00
REF IGG TOTAL LIGHT CHAINS U
LABORATORY-CHEMISTRY [0301]
83883
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,392,100.00
REF METHYLMALONIC ACID SERUM
LABORATORY-CHEMISTRY [0301]
83921
WCH HB PB LAB FEE SCHEDULE
166.00
3,018,393,000.00
OSMOLARITY SERUM
LABORATORY-CHEMISTRY [0301]
83930
WCH HB PB LAB FEE SCHEDULE
69.00
3,018,393,500.00
OSMOLARITY URINE
LABORATORY-CHEMISTRY [0301]
83935
WCH HB PB LAB FEE SCHEDULE
90.00
3,018,394,500.00
REF OXALATE URINE (SAT 24)
LABORATORY-CHEMISTRY [0301]
83945
WCH HB PB LAB FEE SCHEDULE
121.00
3,018,394,501.00
REF OXALATE URINE
LABORATORY-CHEMISTRY [0301]
83945
WCH HB PB LAB FEE SCHEDULE
125.00
3,018,397,000.00
ASSAY, PARATHORMONE
LABORATORY-CHEMISTRY [0301]
83970
WCH HB PB LAB FEE SCHEDULE
330.00
3,018,398,600.00
PH-BODY FLUID (P-METRIC)
LABORATORY-CHEMISTRY [0301]
83986
WCH HB PB LAB FEE SCHEDULE
65.00
3,018,399,300.00
ASSAY FOR CALPROTECTIN FECAL
LABORATORY-CHEMISTRY [0301]
83993
WCH HB PB LAB FEE SCHEDULE
316.00
3,018,399,301.00
REF CALPROTECTIN, F
LABORATORY-CHEMISTRY [0301]
83993
WCH HB PB LAB FEE SCHEDULE
250.00
3,018,403,000.00
REF PHENYLALANINE, P (MAYO)
LABORATORY-CHEMISTRY [0301]
84030
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,407,500.00
ALK PHOSPHOTASE
LABORATORY-CHEMISTRY [0301]
84075
WCH HB PB LAB FEE SCHEDULE
44.00
3,018,407,501.00
REF ALK PTASE TOTAL
LABORATORY-CHEMISTRY [0301]
84075
WCH HB PB LAB FEE SCHEDULE
50.00
3,018,408,000.00
REF ALK PHOSPHATASE ISOENZYME
LABORATORY-CHEMISTRY [0301]
84080
WCH HB PB LAB FEE SCHEDULE
156.00
3,018,410,000.00
PHOSPHORUS
LABORATORY-CHEMISTRY [0301]
84100
WCH HB PB LAB FEE SCHEDULE
52.00
3,018,410,000.00
PHOSPHORUS
LABORATORY-CHEMISTRY [0301]
84100
WCH WELLNESS WEDNESDAY FSC
7.00
3,018,410,500.00
PHOS URINE
LABORATORY-CHEMISTRY [0301]
84105
WCH HB PB LAB FEE SCHEDULE
58.00
3,018,411,000.00
ASSAY OF PORPHOBLINOGEN
LABORATORY-CHEMISTRY [0301]
84110
WCH HB PB LAB FEE SCHEDULE
106.00
3,018,412,001.00
REF PORPHYRINS QN U
LABORATORY-CHEMISTRY [0301]
84120
WCH HB PB LAB FEE SCHEDULE
180.00
3,018,413,200.00
POTASSIUM SERUM PLASMA WB
LABORATORY-CHEMISTRY [0301]
84132
WCH HB PB LAB FEE SCHEDULE
79.00
3,018,413,300.00
POTASSIUM URINE
LABORATORY-CHEMISTRY [0301]
84133
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,413,400.00
PREALBUMIN
LABORATORY-CHEMISTRY [0301]
84134
WCH HB PB LAB FEE SCHEDULE
129.00
3,018,414,000.00
REF PREGNENOLONE
LABORATORY-CHEMISTRY [0301]
84140
WCH HB PB LAB FEE SCHEDULE
155.00
3,018,414,400.00
PROGESTERONE
LABORATORY-CHEMISTRY [0301]
84144
WCH HB PB LAB FEE SCHEDULE
227.00
3,018,414,500.00
PROCALCITONIN
LABORATORY-CHEMISTRY [0301]
84145
WCH HB PB LAB FEE SCHEDULE
259.00
3,018,414,600.00
PROLACTIN
LABORATORY-CHEMISTRY [0301]
84146
WCH HB PB LAB FEE SCHEDULE
182.00
3,018,415,300.00
PSA DIAGNOSTIC
LABORATORY-CHEMISTRY [0301]
84153
WCH HB DEFAULT FEE SCHEDULE
175.00
3,018,415,300.00
PSA DIAGNOSTIC
LABORATORY-CHEMISTRY [0301]
84153
WCH HB PB LAB FEE SCHEDULE
175.00
3,018,415,301.00
REF PSA TOTAL
LABORATORY-CHEMISTRY [0301]
84153
WCH HB PB LAB FEE SCHEDULE
175.00
3,018,415,303.00
PSA SCREENING
LABORATORY-CHEMISTRY [0301]
84153
WCH HB PB LAB FEE SCHEDULE
175.00
3,018,415,303.00
PSA SCREENING
LABORATORY-CHEMISTRY [0301]
84153
WCH WELLNESS WEDNESDAY FSC
27.50
3,018,415,400.00
REF PROSTATE SPECIFIC ANTIGEN (PSA-FREE)
LABORATORY-CHEMISTRY [0301]
84154
WCH HB PB LAB FEE SCHEDULE
145.00
3,018,415,401.00
REF PSA FREE
LABORATORY-CHEMISTRY [0301]
84154
WCH HB PB LAB FEE SCHEDULE
145.00
3,018,415,500.00
TOTAL PROTEIN SERUM PLASMA WB
LABORATORY-CHEMISTRY [0301]
84155
WCH HB PB LAB FEE SCHEDULE
129.00
3,018,415,501.00
REF MONOCLONAL PROTEIN STUDY TP
LABORATORY-CHEMISTRY [0301]
84155
WCH HB PB LAB FEE SCHEDULE
27.20
3,018,415,502.00
REF PROTEIN STUDY, SERUM TP MAYO
LABORATORY-CHEMISTRY [0301]
84155
WCH HB PB LAB FEE SCHEDULE
129.00
3,018,415,600.00
PROTEIN-QUANT URINE
LABORATORY-CHEMISTRY [0301]
84156
WCH HB PB LAB FEE SCHEDULE
72.00
3,018,415,601.00
REF PROTEIN, TOTAL, URINE MONOCLONAL
LABORATORY-CHEMISTRY [0301]
84156
WCH HB PB LAB FEE SCHEDULE
50.00
3,018,415,602.00
REF PROTEIN, TOTAL, URINE
LABORATORY-CHEMISTRY [0301]
84156
WCH HB PB LAB FEE SCHEDULE
72.00
3,018,415,603.00
REF PROTEIN (RPTU) URINE
LABORATORY-CHEMISTRY [0301]
84156
WCH HB PB LAB FEE SCHEDULE
54.00
3,018,415,700.00
ASSAY, PROTEIN, OTHER SOURCE, TOTAL
LABORATORY-CHEMISTRY [0301]
84157
WCH HB PB LAB FEE SCHEDULE
79.00
3,018,416,500.00
E-PHORESIS-PROTEIN
LABORATORY-CHEMISTRY [0301]
84165
WCH HB PB LAB FEE SCHEDULE
131.00
3,018,416,501.00
REF MONOCLONAL PROTEIN STUDY ELP
LABORATORY-CHEMISTRY [0301]
84165
WCH HB PB LAB FEE SCHEDULE
84.00
3,018,416,502.00
REF PROTEIN STUDY, SERUM ELP MAYO
LABORATORY-CHEMISTRY [0301]
84165
WCH HB PB LAB FEE SCHEDULE
131.00
3,018,416,600.00
ELP-UA
LABORATORY-CHEMISTRY [0301]
84166
WCH HB PB LAB FEE SCHEDULE
138.00
3,018,416,601.00
REF PROTEIN ELECTRPHORSIS URINE MONOCLONAL
LABORATORY-CHEMISTRY [0301]
84166
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,416,602.00
REF PROTEIN ELECTRPHORSIS URINE
LABORATORY-CHEMISTRY [0301]
84166
WCH HB PB LAB FEE SCHEDULE
138.00
3,018,420,700.00
REF VITAMIN B6 PLASMA
LABORATORY-CHEMISTRY [0301]
84207
WCH HB PB LAB FEE SCHEDULE
272.00
3,018,424,400.00
REF RENIN ACTIVITY
LABORATORY-CHEMISTRY [0301]
84244
WCH HB PB LAB FEE SCHEDULE
250.00
3,018,424,401.00
REF RENIN ACTIVITY
LABORATORY-CHEMISTRY [0301]
84244
WCH HB PB LAB FEE SCHEDULE
250.00
3,018,425,500.00
REF SELENIUM
LABORATORY-CHEMISTRY [0301]
84255
WCH HB PB LAB FEE SCHEDULE
177.00
3,018,427,000.00
REF SEX HORMONE BINDING GLOBULIN
LABORATORY-CHEMISTRY [0301]
84270
WCH HB PB LAB FEE SCHEDULE
210.00
3,018,429,500.00
SODIUM SERUM PLASMA WB
LABORATORY-CHEMISTRY [0301]
84295
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,430,000.00
SODIUM URINE
LABORATORY-CHEMISTRY [0301]
84300
WCH HB PB LAB FEE SCHEDULE
52.00
3,018,430,200.00
SODIUM OTHER SOURCE
LABORATORY-CHEMISTRY [0301]
84302
WCH HB PB LAB FEE SCHEDULE
53.00
3,018,430,500.00
REF ASSAY OF SOMATOMEDIN
LABORATORY-CHEMISTRY [0301]
84305
WCH HB PB LAB FEE SCHEDULE
317.00
3,018,431,500.00
SPECIFIC GRAVITY EXCEPT URINE
LABORATORY-CHEMISTRY [0301]
84315
WCH HB PB LAB FEE SCHEDULE
33.00
3,018,440,200.00
REF TESTOSTERONE, FREE FOR MAYO TOTAL AND FREE
LABORATORY-CHEMISTRY [0301]
84402
WCH HB PB LAB FEE SCHEDULE
243.00
3,018,440,202.00
REF TESTOSTERONE FREE FOR MAYO TOTAL, BIO, FREE
LABORATORY-CHEMISTRY [0301]
84402
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,440,300.00
TESTOSTERONE TOTAL
LABORATORY-CHEMISTRY [0301]
84403
WCH HB PB LAB FEE SCHEDULE
195.00
3,018,440,301.00
REF TESTOSTERONE TOTAL, FOR MAYO TOTAL AND FREE
LABORATORY-CHEMISTRY [0301]
84403
WCH HB PB LAB FEE SCHEDULE
195.00
3,018,440,302.00
REF TESTOSTERONE, TOTAL FOR MAYO TOTAL, BIO, AND FREE
LABORATORY-CHEMISTRY [0301]
84403
WCH HB PB LAB FEE SCHEDULE
187.58
3,018,441,000.00
REF TESTOSTERONE BIOAVAILABLE FOR MAYO TOTAL, BIO, FREE
LABORATORY-CHEMISTRY [0301]
84410
WCH HB PB LAB FEE SCHEDULE
243.00
3,018,442,500.00
REF THIAMINE
LABORATORY-CHEMISTRY [0301]
84425
WCH HB PB LAB FEE SCHEDULE
222.00
3,018,442,501.00
REF THIAMINE
LABORATORY-CHEMISTRY [0301]
84425
WCH HB PB LAB FEE SCHEDULE
222.00
3,018,443,200.00
REF THYROGLOBULIN TUMOR MARKER
LABORATORY-CHEMISTRY [0301]
84432
WCH HB PB LAB FEE SCHEDULE
200.00
3,018,443,201.00
REF THYROGLOBULIN TUMOR MARKER
LABORATORY-CHEMISTRY [0301]
84432
WCH HB PB LAB FEE SCHEDULE
200.00
3,018,443,600.00
ASSAY, TRUE THYROXINE
LABORATORY-CHEMISTRY [0301]
84436
WCH HB PB LAB FEE SCHEDULE
70.00
3,018,443,900.00
FREE T 4
LABORATORY-CHEMISTRY [0301]
84439
WCH HB PB LAB FEE SCHEDULE
122.00
3,018,443,900.00
FREE T 4
LABORATORY-CHEMISTRY [0301]
84439
WCH WELLNESS WEDNESDAY FSC
30.00
3,018,444,300.00
TSH
LABORATORY-CHEMISTRY [0301]
84443
WCH HB DEFAULT FEE SCHEDULE
175.00
3,018,444,300.00
TSH
LABORATORY-CHEMISTRY [0301]
84443
WCH WELLNESS WEDNESDAY FSC
17.50
3,018,444,301.00
REF TSH
LABORATORY-CHEMISTRY [0301]
84443
WCH HB PB LAB FEE SCHEDULE
180.00
3,018,444,500.00
REF THYROID STIMULATING IMMUNE GLOBULINS
LABORATORY-CHEMISTRY [0301]
84445
WCH HB PB LAB FEE SCHEDULE
529.00
3,018,444,501.00
REF THYROID STIMULATING IMMUNOGLOB
LABORATORY-CHEMISTRY [0301]
84445
WCH HB PB LAB FEE SCHEDULE
529.00
3,018,444,600.00
REF VITAMIN E (TODOPHEROL ALPHA)
LABORATORY-CHEMISTRY [0301]
84446
WCH HB PB LAB FEE SCHEDULE
139.00
3,018,444,601.00
REF VITAMIN E
LABORATORY-CHEMISTRY [0301]
84446
WCH HB PB LAB FEE SCHEDULE
139.00
3,018,445,000.00
SGOT AST
LABORATORY-CHEMISTRY [0301]
84450
WCH HB PB LAB FEE SCHEDULE
67.00
3,018,446,000.00
SGPT ALT
LABORATORY-CHEMISTRY [0301]
84460
WCH HB PB LAB FEE SCHEDULE
2.00
3,018,446,600.00
REF TRANSFERRIN
LABORATORY-CHEMISTRY [0301]
84466
WCH HB PB LAB FEE SCHEDULE
165.00
3,018,446,601.00
REF TRANSFERRIN
LABORATORY-CHEMISTRY [0301]
84466
WCH HB PB LAB FEE SCHEDULE
155.00
3,018,447,800.00
VAP CHOLESTEROL TRIGLYCERIDES
LABORATORY-CHEMISTRY [0301]
84478
WCH HB DEFAULT FEE SCHEDULE
51.00
3,018,447,800.00
VAP CHOLESTEROL TRIGLYCERIDES
LABORATORY-CHEMISTRY [0301]
84478
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,447,803.00
TRIGLYCERIDES
LABORATORY-CHEMISTRY [0301]
84478
WCH HB PB LAB FEE SCHEDULE
51.00
3,018,447,900.00
T3 UPTAKE
LABORATORY-CHEMISTRY [0301]
84479
WCH HB PB LAB FEE SCHEDULE
79.00
3,018,448,000.00
REF T-3 TRIIODOTHYRONINE TOTAL
LABORATORY-CHEMISTRY [0301]
84480
WCH HB PB LAB FEE SCHEDULE
216.00
3,018,448,001.00
REF T-3 TRIIODOTHYRONINE TOTAL
LABORATORY-CHEMISTRY [0301]
84480
WCH HB PB LAB FEE SCHEDULE
216.00
3,018,448,100.00
T3 TRIIODOTHYRONINE FREE
LABORATORY-CHEMISTRY [0301]
84481
WCH HB PB LAB FEE SCHEDULE
230.00
3,018,448,200.00
REF T3 TEIODOTHYRONINE REVERSE
LABORATORY-CHEMISTRY [0301]
84482
WCH HB PB LAB FEE SCHEDULE
217.00
3,018,448,201.00
REF T3 TRIIODOTHYRONINE REVERSE
LABORATORY-CHEMISTRY [0301]
84482
WCH HB PB LAB FEE SCHEDULE
303.00
3,018,448,400.00
TROPONIN I
LABORATORY-CHEMISTRY [0301]
84484
WCH HB PB LAB FEE SCHEDULE
112.00
3,018,451,000.00
REF TYROSINE, P (MAYO)
LABORATORY-CHEMISTRY [0301]
84510
WCH HB PB LAB FEE SCHEDULE
182.00
3,018,452,000.00
BUN
LABORATORY-CHEMISTRY [0301]
84520
WCH HB PB LAB FEE SCHEDULE
74.00
3,018,454,000.00
UREA N URINE
LABORATORY-CHEMISTRY [0301]
84540
WCH HB PB LAB FEE SCHEDULE
76.00
3,018,455,000.00
URIC ACID BLOOD
LABORATORY-CHEMISTRY [0301]
84550
WCH HB PB LAB FEE SCHEDULE
81.00
3,018,455,000.00
URIC ACID BLOOD
LABORATORY-CHEMISTRY [0301]
84550
WCH WELLNESS WEDNESDAY FSC
9.00
3,018,456,000.00
ASSAY OF URINE/URIC ACID
LABORATORY-CHEMISTRY [0301]
84560
WCH HB PB LAB FEE SCHEDULE
74.00
3,018,458,500.00
REF VANILLYMANDELIC AC
LABORATORY-CHEMISTRY [0301]
84585
WCH HB PB LAB FEE SCHEDULE
208.00
3,018,458,800.00
REF ARGININE VASOPRESSIN
LABORATORY-CHEMISTRY [0301]
84588
WCH HB PB LAB FEE SCHEDULE
386.00
3,018,459,000.00
REF VITAMIN A SERUM
LABORATORY-CHEMISTRY [0301]
84590
WCH HB PB LAB FEE SCHEDULE
208.00
3,018,459,701.00
REF VITAMIN K1
LABORATORY-CHEMISTRY [0301]
84597
WCH HB PB LAB FEE SCHEDULE
255.00
3,018,463,000.00
HC ASSAY OF ZINC
LABORATORY-CHEMISTRY [0301]
84630
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,463,001.00
REF ZINC SERUM
LABORATORY-CHEMISTRY [0301]
84630
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,468,100.00
REF C PEPTIDE
LABORATORY-CHEMISTRY [0301]
84681
WCH HB PB LAB FEE SCHEDULE
262.00
3,018,468,101.00
REF C PEPTIDE
LABORATORY-CHEMISTRY [0301]
84681
WCH HB PB LAB FEE SCHEDULE
207.00
3,018,470,200.00
HCG QUANT PREG TEST
LABORATORY-CHEMISTRY [0301]
84702
WCH HB PB LAB FEE SCHEDULE
176.00
3,018,470,201.00
REF BHCG CSF
LABORATORY-CHEMISTRY [0301]
84702
WCH HB PB LAB FEE SCHEDULE
143.00
3,018,470,300.00
HCG QUAL PREG TEST
LABORATORY-CHEMISTRY [0301]
84703
WCH HB PB LAB FEE SCHEDULE
107.00
3,018,499,900.00
REF OSMOLALITY STOOL
LABORATORY-CHEMISTRY [0301]
84999
WCH HB PB LAB FEE SCHEDULE
41.00
3,018,614,703.00
REF PHOSPHOLIPID AB IGA
LABORATORY-IMMUNOLOGY [0302]
86147
WCH HB PB LAB FEE SCHEDULE
272.00
3,018,763,400.00
RSV, MOLECULAR DETECTION
LABORATORY-CHEMISTRY [0301]
87634
WCH HB PB LAB FEE SCHEDULE
151.00
3,018,905,100.00
CELL COUNT MISC BDYFLUID W DIF
LABORATORY-CHEMISTRY [0301]
89051
WCH HB PB LAB FEE SCHEDULE
81.00
3,018,905,500.00
FECAL LEUKOCYTE ASSESSMENT
LABORATORY-GENERAL [0300]
89055
WCH HB DEFAULT FEE SCHEDULE
67.00
3,018,905,500.00
FECAL LEUKOCYTE ASSESSMENT
LABORATORY-GENERAL [0300]
89055
WCH HB PB LAB FEE SCHEDULE
67.00
3,018,905,501.00
FECAL LEUKOCYTE ASSESS QUAL
LABORATORY-GENERAL [0300]
89055
WCH HB PB LAB FEE SCHEDULE
67.00
3,018,906,000.00
CRYSTAL STUDY TECHNICAL
LABORATORY-CHEMISTRY [0301]
89060
WCH HB PB LAB FEE SCHEDULE
85.00
3,018,912,500.00
FAT STAIN FECES URINE RESP
LABORATORY-GENERAL [0300]
89125
WCH HB PB LAB FEE SCHEDULE
81.00
3,018,932,100.00
SEMEN ANALYSIS, PRESENCE AND OR MOTI
LABORATORY-CHEMISTRY [0301]
89321
WCH HB PB LAB FEE SCHEDULE
89.00
3,028,600,300.00
REF FOOD PANEL
LABORATORY-IMMUNOLOGY [0302]
86003
WCH HB PB LAB FEE SCHEDULE
43.00
3,028,600,301.00
REF ALLERGEN SPECIFIC IGE
LABORATORY-IMMUNOLOGY [0302]
86003
WCH HB PB LAB FEE SCHEDULE
43.00
3,028,603,800.00
ANTI NUCLEAR AB
LABORATORY-IMMUNOLOGY [0302]
86038
WCH HB PB LAB FEE SCHEDULE
134.00
3,028,603,900.00
FANA TITER
LABORATORY-IMMUNOLOGY [0302]
86039
WCH HB PB LAB FEE SCHEDULE
134.00
3,028,606,000.00
STREPZT
LABORATORY-IMMUNOLOGY [0302]
86060
WCH HB PB LAB FEE SCHEDULE
92.00
3,028,606,300.00
ANTISTREPTOLYSIN O SCREEN
LABORATORY-IMMUNOLOGY [0302]
86063
WCH HB PB LAB FEE SCHEDULE
87.00
3,028,614,000.00
C-RACTIVE PROTEIN QUANT
LABORATORY-IMMUNOLOGY [0302]
86140
WCH HB PB LAB FEE SCHEDULE
87.00
3,028,614,000.00
C-RACTIVE PROTEIN QUANT
LABORATORY-IMMUNOLOGY [0302]
86140
WCH WELLNESS WEDNESDAY FSC
22.50
3,028,614,100.00
CRPQ C REATIVE PROTEIN
LABORATORY-IMMUNOLOGY [0302]
86141
WCH HB PB LAB FEE SCHEDULE
109.00
3,028,614,100.00
CRPQ C REATIVE PROTEIN
LABORATORY-IMMUNOLOGY [0302]
86141
WCH WELLNESS WEDNESDAY FSC
22.50
3,028,614,600.00
GLYCOPROTEIN ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86146
WCH HB PB LAB FEE SCHEDULE
272.00
3,028,614,701.00
REF PHOSPHOLIPID AB IGM
LABORATORY-IMMUNOLOGY [0302]
86147
WCH HB PB LAB FEE SCHEDULE
251.00
3,028,614,702.00
REF PHOSPHOLIPID AB IGG
LABORATORY-IMMUNOLOGY [0302]
86147
WCH HB PB LAB FEE SCHEDULE
251.00
3,028,615,700.00
REF COLD AGGLUTININS TITER
LABORATORY-IMMUNOLOGY [0302]
86157
WCH HB PB LAB FEE SCHEDULE
168.00
3,028,616,000.00
COMPLEMENT 3 ANTIGEN
LABORATORY-IMMUNOLOGY [0302]
86160
WCH HB PB LAB FEE SCHEDULE
171.00
3,028,616,004.00
COMPLEMENT 4 ANTIGEN
LABORATORY-IMMUNOLOGY [0302]
86160
WCH HB PB LAB FEE SCHEDULE
168.00
3,028,616,101.00
REF C1Q COMPLEMENT FUNCTIONAL
LABORATORY-IMMUNOLOGY [0302]
86161
WCH HB PB LAB FEE SCHEDULE
168.00
3,028,616,200.00
REF CH 50 COMPLEMENT
LABORATORY-IMMUNOLOGY [0302]
86162
WCH HB PB LAB FEE SCHEDULE
260.00
3,028,620,000.00
REF CYCLIC CITRULLINATED PEPTIDE (CCP)
LABORATORY-IMMUNOLOGY [0302]
86200
WCH HB PB LAB FEE SCHEDULE
177.00
3,028,620,002.00
CCP ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86200
WCH HB PB LAB FEE SCHEDULE
177.00
3,028,621,500.00
REF DEOXYRIBONUCLEASE ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86215
WCH HB PB LAB FEE SCHEDULE
182.00
3,028,621,501.00
REF DNASE ANTI DNASE B
LABORATORY-IMMUNOLOGY [0302]
86215
WCH HB PB LAB FEE SCHEDULE
182.00
3,028,622,500.00
REF DNA ANTIBODY, NATIVE/DOUBLE STRAND
LABORATORY-IMMUNOLOGY [0302]
86225
WCH HB PB LAB FEE SCHEDULE
180.00
3,028,623,500.00
REF EXTRACTABLE NUCLEAR AG EACH AB
LABORATORY-IMMUNOLOGY [0302]
86235
WCH HB PB LAB FEE SCHEDULE
160.00
3,028,623,502.00
EXTRACTABLE NUCLEAR AG EACH AB
LABORATORY-IMMUNOLOGY [0302]
86235
WCH HB PB LAB FEE SCHEDULE
160.00
3,028,625,500.00
REF CYTOPLASMIC NEUTROPHIL AB
LABORATORY-IMMUNOLOGY [0302]
86255
WCH HB PB LAB FEE SCHEDULE
147.00
3,028,625,502.00
REF INFLAMMATORY BOWEL DIS PANEL
LABORATORY-IMMUNOLOGY [0302]
86255
WCH HB PB LAB FEE SCHEDULE
130.00
3,028,625,503.00
REF ANTI SMOOTH MUSCLE AB
LABORATORY-IMMUNOLOGY [0302]
86255
WCH HB PB LAB FEE SCHEDULE
146.00
3,028,625,512.00
REF PARANEOPLASTIC ANTI-NEURONAL NUCLEAR, TYPE 1
LABORATORY-IMMUNOLOGY [0302]
86255
WCH HB PB LAB FEE SCHEDULE
516.00
3,028,625,600.00
REF FLORESCENT ANTIBODY TITER; EACH
LABORATORY-IMMUNOLOGY [0302]
86256
WCH HB PB LAB FEE SCHEDULE
138.00
3,028,630,000.00
IMMUNOASSAY, TUMOR, CA 15-4
LABORATORY-IMMUNOLOGY [0302]
86300
WCH HB PB LAB FEE SCHEDULE
218.00
3,028,630,001.00
REF CA 27.29
LABORATORY-IMMUNOLOGY [0302]
86300
WCH HB PB LAB FEE SCHEDULE
218.00
3,028,630,002.00
REF CANCER ANTIGEN 15-3
LABORATORY-IMMUNOLOGY [0302]
86300
WCH HB PB LAB FEE SCHEDULE
218.00
3,028,630,100.00
REF IMMUNOASSAY, TUMOR, CA 19-9
LABORATORY-IMMUNOLOGY [0302]
86301
WCH HB PB LAB FEE SCHEDULE
210.00
3,028,630,400.00
CANCER ANTIGEN 125
LABORATORY-IMMUNOLOGY [0302]
86304
WCH HB PB LAB FEE SCHEDULE
218.00
3,028,630,800.00
MONO HETEROPHILE SCR
LABORATORY-IMMUNOLOGY [0302]
86308
WCH HB PB LAB FEE SCHEDULE
79.00
3,028,631,600.00
REF CHROMOGRANIN A
LABORATORY-IMMUNOLOGY [0302]
86316
WCH HB PB LAB FEE SCHEDULE
276.00
3,028,631,701.00
REF RABIES ANTIBODY ELISA
LABORATORY-IMMUNOLOGY [0302]
86317
WCH HB PB LAB FEE SCHEDULE
106.00
3,028,631,702.00
REF S PNEUMONIAE IGG EA SEROTYPE
LABORATORY-IMMUNOLOGY [0302]
86317
WCH HB PB LAB FEE SCHEDULE
49.00
3,028,633,400.00
REF IMMUNOFIXATION ELECTROPHORESIS
LABORATORY-IMMUNOLOGY [0302]
86334
WCH HB PB LAB FEE SCHEDULE
238.00
3,028,633,401.00
REF MONOCLONAL PROTEIN STUDY IF
LABORATORY-IMMUNOLOGY [0302]
86334
WCH HB PB LAB FEE SCHEDULE
214.00
3,028,633,404.00
REF IMMUNOFIXATION SERUM ONLY MAYO
LABORATORY-IMMUNOLOGY [0302]
86334
WCH HB PB LAB FEE SCHEDULE
235.00
3,028,633,500.00
REF IMMUNOFIXATION, URINE
LABORATORY-IMMUNOLOGY [0302]
86335
WCH HB PB LAB FEE SCHEDULE
238.00
3,028,633,503.00
REF IMMUNOFIXATION, URINE MONOCLONAL
LABORATORY-IMMUNOLOGY [0302]
86335
WCH HB PB LAB FEE SCHEDULE
286.00
3,028,633,700.00
REF INSULIN ANTIBODIES
LABORATORY-IMMUNOLOGY [0302]
86337
WCH HB PB LAB FEE SCHEDULE
277.00
3,028,634,000.00
REF INTRINSIC FACTOR BLOCKING AB
LABORATORY-IMMUNOLOGY [0302]
86340
WCH HB PB LAB FEE SCHEDULE
162.00
3,028,634,100.00
REF ISLET CELL ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86341
WCH HB PB LAB FEE SCHEDULE
132.00
3,028,634,102.00
REF GAD65 AB ASSAY
LABORATORY-IMMUNOLOGY [0302]
86341
WCH HB PB LAB FEE SCHEDULE
215.00
3,028,635,500.00
REF B-CELLS TOTAL COUNT FOR T-B LYMPHOCYTE PROFILE
LABORATORY-IMMUNOLOGY [0302]
86355
WCH HB PB LAB FEE SCHEDULE
238.00
3,028,635,700.00
REF NATURAL KILLER CELLS FOR T-B LYMPHOCYTE PROFILE
LABORATORY-IMMUNOLOGY [0302]
86357
WCH HB PB LAB FEE SCHEDULE
263.00
3,028,635,900.00
T CELLS TOTAL COUNT
LABORATORY-IMMUNOLOGY [0302]
86359
WCH HB PB LAB FEE SCHEDULE
218.00
3,028,635,901.00
REF T CELLS TOTAL COUNT FOR CD4-CD3 PROFILE
LABORATORY-IMMUNOLOGY [0302]
86359
WCH HB PB LAB FEE SCHEDULE
188.00
3,028,636,000.00
REF ABSOLUTE CD4/CD8 COUNT FOR CD4-CD3 PROFILE
LABORATORY-IMMUNOLOGY [0302]
86360
WCH HB PB LAB FEE SCHEDULE
276.00
3,028,637,600.00
THYROID ANTIBODIES
LABORATORY-IMMUNOLOGY [0302]
86376
WCH HB PB LAB FEE SCHEDULE
153.00
3,028,637,601.00
REF LIVER KIDNEY MICROSOMAL ANTIBO
LABORATORY-IMMUNOLOGY [0302]
86376
WCH HB PB LAB FEE SCHEDULE
165.60
3,028,643,000.00
RA QUAL
LABORATORY-IMMUNOLOGY [0302]
86430
WCH HB PB LAB FEE SCHEDULE
73.00
3,028,643,100.00
RA QUAN
LABORATORY-IMMUNOLOGY [0302]
86431
WCH HB PB LAB FEE SCHEDULE
76.00
3,028,648,000.00
TB GOLD
LABORATORY-IMMUNOLOGY [0302]
86480
WCH HB PB LAB FEE SCHEDULE
243.00
3,028,648,100.00
TB GOLD
LABORATORY-IMMUNOLOGY [0302]
86481
WCH HB PB LAB FEE SCHEDULE
139.00
3,028,659,200.00
RPR
LABORATORY-IMMUNOLOGY [0302]
86592
WCH HB PB LAB FEE SCHEDULE
54.00
3,028,661,800.00
REF LYME CNS INEFECTION IGG WITH ANTIBODY INDEX REFLEX
LABORATORY-IMMUNOLOGY [0302]
86618
WCH HB PB LAB FEE SCHEDULE
187.00
3,028,661,801.00
REF LYME DISEASE SEROLOGY
LABORATORY-IMMUNOLOGY [0302]
86618
WCH HB PB LAB FEE SCHEDULE
187.00
3,028,662,200.00
REF BRUCELLA AB IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86622
WCH HB PB LAB FEE SCHEDULE
113.00
3,028,663,100.00
CHLAMYDIA ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86631
WCH HB PB LAB FEE SCHEDULE
117.00
3,028,663,200.00
REF CHLAMYDIA IGG EACH SPECIES
LABORATORY-IMMUNOLOGY [0302]
86632
WCH HB PB LAB FEE SCHEDULE
147.00
3,028,663,500.00
REF COCCIDIOIDES AB SCREEN WITH REFLEX
LABORATORY-IMMUNOLOGY [0302]
86635
WCH HB PB LAB FEE SCHEDULE
168.00
3,028,663,501.00
REF COCCIDIODES IGG IGM CF OR ID
LABORATORY-IMMUNOLOGY [0302]
86635
WCH HB PB LAB FEE SCHEDULE
90.00
3,028,663,800.00
REF Q FEVER AB IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86638
WCH HB PB LAB FEE SCHEDULE
171.00
3,028,664,400.00
REF CYTOMEGALOVIRUS (CMV)
LABORATORY-IMMUNOLOGY [0302]
86644
WCH HB PB LAB FEE SCHEDULE
175.00
3,028,664,404.00
REF CYTOMEGALOVIRUS QUAL
LABORATORY-IMMUNOLOGY [0302]
86644
WCH HB PB LAB FEE SCHEDULE
129.40
3,028,664,500.00
REF CMV (CYTOMEGALOVIRIS) IGM
LABORATORY-IMMUNOLOGY [0302]
86645
WCH HB PB LAB FEE SCHEDULE
193.00
3,028,664,501.00
REF CYTOMEGALOVIRUS AB IGM
LABORATORY-IMMUNOLOGY [0302]
86645
WCH HB PB LAB FEE SCHEDULE
139.00
3,028,665,800.00
REF ECHOVIRUS SEROTYPES EACH
LABORATORY-IMMUNOLOGY [0302]
86658
WCH HB PB LAB FEE SCHEDULE
367.00
3,028,666,400.00
HC REF EBSTEIN-BARR VIRUS:NUCLEAR ANTIGEN
LABORATORY-IMMUNOLOGY [0302]
86664
WCH HB PB LAB FEE SCHEDULE
175.00
3,028,666,401.00
REF EPSTEIN BARR ANTI EBNA
LABORATORY-IMMUNOLOGY [0302]
86664
WCH HB PB LAB FEE SCHEDULE
175.00
3,028,666,501.00
REF EBV AB BCA IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86665
WCH HB PB LAB FEE SCHEDULE
195.00
3,028,666,800.00
REF F. TULARENSIS AB, IGM/IGG ELISA, S(MAYO)
LABORATORY-IMMUNOLOGY [0302]
86668
WCH HB PB LAB FEE SCHEDULE
100.80
3,028,667,700.00
HELIOBACTER PYLORI AB
LABORATORY-IMMUNOLOGY [0302]
86677
WCH HB PB LAB FEE SCHEDULE
194.00
3,028,669,401.00
REF HSV AB IGM S BY EIA
LABORATORY-IMMUNOLOGY [0302]
86694
WCH HB PB LAB FEE SCHEDULE
165.00
3,028,669,500.00
REF HERPES SIMPLEX TYPE 1
LABORATORY-IMMUNOLOGY [0302]
86695
WCH HB PB LAB FEE SCHEDULE
166.00
3,028,669,504.00
HSV TYPE 1 AB IGG
LABORATORY-IMMUNOLOGY [0302]
86695
WCH HB PB LAB FEE SCHEDULE
116.00
3,028,669,600.00
HERPES SIMPLEX TYPE 3
LABORATORY-IMMUNOLOGY [0302]
86696
WCH HB PB LAB FEE SCHEDULE
165.00
3,028,669,604.00
HSV TYPE 2 AB IGG
LABORATORY-IMMUNOLOGY [0302]
86696
WCH HB PB LAB FEE SCHEDULE
149.00
3,028,670,100.00
REF HIV 1 ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86701
WCH HB PB LAB FEE SCHEDULE
143.00
3,028,670,104.00
HIV1 AB
LABORATORY-IMMUNOLOGY [0302]
86701
WCH HB PB LAB FEE SCHEDULE
123.80
3,028,670,200.00
REF HIV 2 ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86702
WCH HB PB LAB FEE SCHEDULE
174.00
3,028,670,202.00
HIV2 AB
LABORATORY-IMMUNOLOGY [0302]
86702
WCH HB PB LAB FEE SCHEDULE
188.30
3,028,670,300.00
HIV I & II
LABORATORY-IMMUNOLOGY [0302]
86703
WCH HB PB LAB FEE SCHEDULE
152.00
3,028,670,400.00
REF HBC TOTAL AB
LABORATORY-IMMUNOLOGY [0302]
86704
WCH HB PB LAB FEE SCHEDULE
139.00
3,028,670,500.00
HEPATITIS B CORE ANTI-BODY IGM
LABORATORY-IMMUNOLOGY [0302]
86705
WCH HB PB LAB FEE SCHEDULE
143.00
3,028,670,600.00
HBS AB
LABORATORY-IMMUNOLOGY [0302]
86706
WCH HB PB LAB FEE SCHEDULE
117.00
3,028,670,601.00
REF HEP B SURFACE ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86706
WCH HB PB LAB FEE SCHEDULE
117.00
3,028,670,700.00
REF HEPATITIS BE ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86707
WCH HB PB LAB FEE SCHEDULE
130.00
3,028,670,800.00
REF HEP A ANTIBODY IGG
LABORATORY-IMMUNOLOGY [0302]
86708
WCH HB PB LAB FEE SCHEDULE
139.00
3,028,670,900.00
HAV IGM
LABORATORY-IMMUNOLOGY [0302]
86709
WCH HB PB LAB FEE SCHEDULE
134.00
3,028,671,300.00
REF LEGIONELLA TITER
LABORATORY-IMMUNOLOGY [0302]
86713
WCH HB PB LAB FEE SCHEDULE
182.00
3,028,672,000.00
REF LEPTOSPIRA ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86720
WCH HB PB LAB FEE SCHEDULE
152.00
3,028,673,500.00
MUMPS
LABORATORY-IMMUNOLOGY [0302]
86735
WCH HB PB LAB FEE SCHEDULE
152.00
3,028,673,500.00
MUMPS
LABORATORY-IMMUNOLOGY [0302]
86735
WCH WELLNESS WEDNESDAY FSC
16.50
3,028,673,801.00
REF MYCOPLASMA PNEUMO IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86738
WCH HB DEFAULT FEE SCHEDULE
152.00
3,028,673,801.00
REF MYCOPLASMA PNEUMO IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86738
WCH HB PB LAB FEE SCHEDULE
152.00
3,028,674,701.00
REF PARVOVIRUS B19 AB IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86747
WCH HB PB LAB FEE SCHEDULE
178.00
3,028,675,701.00
REF TYPHUS ANTIBODY IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86757
WCH HB PB LAB FEE SCHEDULE
152.00
3,028,676,200.00
RUBELLA
LABORATORY-IMMUNOLOGY [0302]
86762
WCH HB PB LAB FEE SCHEDULE
90.00
3,028,676,200.00
RUBELLA
LABORATORY-IMMUNOLOGY [0302]
86762
WCH WELLNESS WEDNESDAY FSC
17.00
3,028,676,500.00
RUBEOLA
LABORATORY-IMMUNOLOGY [0302]
86765
WCH HB PB LAB FEE SCHEDULE
180.00
3,028,676,501.00
REF RUBEOLA MEASLES AB IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86765
WCH WELLNESS WEDNESDAY FSC
16.50
3,028,676,900.00
REF SARS CORONAVIRUS 2 IGG AB, S (MAYO)
LABORATORY-IMMUNOLOGY [0302]
86769
WCH HB PB LAB FEE SCHEDULE
100.00
3,028,676,901.00
ANTIBODY: SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SAR-COV-2) COVID-19
LABORATORY-IMMUNOLOGY [0302]
86769
WCH HB PB LAB FEE SCHEDULE
100.00
3,028,677,700.00
REF TORCH PROFILE IGG TOXOPLASMA
LABORATORY-IMMUNOLOGY [0302]
86777
WCH HB PB LAB FEE SCHEDULE
143.00
3,028,677,701.00
REF TOXOPLASMOSIS AB IGG
LABORATORY-IMMUNOLOGY [0302]
86777
WCH HB PB LAB FEE SCHEDULE
143.00
3,028,677,801.00
REF TOXOPLASMOSIS IGM ANTIBODY
LABORATORY-IMMUNOLOGY [0302]
86778
WCH HB PB LAB FEE SCHEDULE
154.00
3,028,678,000.00
SYPHILIS T PALLIDUM AB
LABORATORY-IMMUNOLOGY [0302]
86780
WCH HB PB LAB FEE SCHEDULE
101.00
3,028,678,700.00
VARICELLA ZOSTER AB IGM
LABORATORY-IMMUNOLOGY [0302]
86787
WCH HB PB LAB FEE SCHEDULE
155.00
3,028,678,704.00
Hc Wch Varicella Zoster Igg
LABORATORY-IMMUNOLOGY [0302]
86787
WCH HB PB LAB FEE SCHEDULE
58.00
3,028,678,800.00
WEST NILE VIRUS IGM
LABORATORY-IMMUNOLOGY [0302]
86788
WCH HB PB LAB FEE SCHEDULE
162.00
3,028,678,801.00
REF WEST NILE VIRUS IGM
LABORATORY-IMMUNOLOGY [0302]
86788
WCH HB PB LAB FEE SCHEDULE
162.00
3,028,678,900.00
REF WEST NILE VIRUS IGG
LABORATORY-IMMUNOLOGY [0302]
86789
WCH HB PB LAB FEE SCHEDULE
163.00
3,028,679,000.00
REF DENGUE FEVER AB IGG OR IGM
LABORATORY-IMMUNOLOGY [0302]
86790
WCH HB PB LAB FEE SCHEDULE
171.00
3,028,679,003.00
REF HANTAVIRUS AB IGG
LABORATORY-IMMUNOLOGY [0302]
86790
WCH HB PB LAB FEE SCHEDULE
180.00
3,028,679,005.00
REF HUMAN T-CELL LYMPHOTROPIC VIRUS TYPES I AND II (HTLV-II) ANTIBODY SCREEN WITH CONFIRM
LABORATORY-IMMUNOLOGY [0302]
86790
WCH HB PB LAB FEE SCHEDULE
226.80
3,028,680,000.00
REF THYROGLOBULIN AB SCRN
LABORATORY-IMMUNOLOGY [0302]
86800
WCH HB PB LAB FEE SCHEDULE
162.00
3,028,680,001.00
REF THYROGLOBULIN AB SCRN
LABORATORY-IMMUNOLOGY [0302]
86800
WCH HB PB LAB FEE SCHEDULE
162.00
3,028,680,002.00
THYROGLOBULIN ANTIBODY SCRN
LABORATORY-IMMUNOLOGY [0302]
86800
WCH HB PB LAB FEE SCHEDULE
134.00
3,028,680,300.00
HCV AB
LABORATORY-IMMUNOLOGY [0302]
86803
WCH HB PB LAB FEE SCHEDULE
185.00
3,028,680,300.00
HCV AB
LABORATORY-IMMUNOLOGY [0302]
86803
WCH WELLNESS WEDNESDAY FSC
40.00
3,028,681,200.00
REF HLA B27 RL
LABORATORY-IMMUNOLOGY [0302]
86812
WCH HB PB LAB FEE SCHEDULE
209.00
3,058,500,400.00
AUTOMATED DIFFERENTIAL WBC CNT
LABORATORY-HEMATOLOGY [0305]
85004
WCH HB PB LAB FEE SCHEDULE
25.00
3,058,500,700.00
BL COUNT W MANUAL DIFF WBC CT
LABORATORY-HEMATOLOGY [0305]
85007
WCH HB PB LAB FEE SCHEDULE
45.00
3,058,501,400.00
HEMATOCRIT
LABORATORY-HEMATOLOGY [0305]
85014
WCH HB PB LAB FEE SCHEDULE
41.00
3,058,501,800.00
HEMOGLOBIN
LABORATORY-HEMATOLOGY [0305]
85018
WCH HB PB LAB FEE SCHEDULE
41.00
3,058,502,500.00
COMPLETE BL COUNT W DIFF AUTO
LABORATORY-HEMATOLOGY [0305]
85025
WCH HB PB LAB FEE SCHEDULE
112.00
3,058,502,500.00
COMPLETE BL COUNT W DIFF AUTO
LABORATORY-HEMATOLOGY [0305]
85025
WCH WELLNESS WEDNESDAY FSC
20.00
3,058,502,700.00
COMPLETE BL COUNT AUTOMATED
LABORATORY-HEMATOLOGY [0305]
85027
WCH HB PB LAB FEE SCHEDULE
83.00
3,058,504,500.00
RETICULOCYTE COUNT
LABORATORY-HEMATOLOGY [0305]
85045
WCH HB PB LAB FEE SCHEDULE
55.00
3,058,504,800.00
WBC WHITE BLOOD COUNT
LABORATORY-HEMATOLOGY [0305]
85048
WCH HB PB LAB FEE SCHEDULE
43.00
3,058,504,900.00
PLATELET CT
LABORATORY-HEMATOLOGY [0305]
85049
WCH HB PB LAB FEE SCHEDULE
43.00
3,058,524,000.00
REF CLOTTING: FACTOR VIII (AHG) ONE STAG
LABORATORY-HEMATOLOGY [0305]
85240
WCH HB PB LAB FEE SCHEDULE
240.00
3,058,526,000.00
REF COAG FACTOR X ASSAY, P (MAYO)
LABORATORY-HEMATOLOGY [0305]
85260
WCH HB PB LAB FEE SCHEDULE
257.00
3,058,530,000.00
REF ANTITHROMBIN III
LABORATORY-HEMATOLOGY [0305]
85300
WCH HB PB LAB FEE SCHEDULE
210.00
3,058,530,001.00
REF ANTITHROMBIN III ACTIVITY
LABORATORY-HEMATOLOGY [0305]
85300
WCH HB PB LAB FEE SCHEDULE
274.00
3,058,530,002.00
REF THROMBO AT ACTIVITY
LABORATORY-HEMATOLOGY [0305]
85300
WCH HB PB LAB FEE SCHEDULE
273.00
3,058,530,300.00
REF PROTEIN C FUNCTIONAL
LABORATORY-HEMATOLOGY [0305]
85303
WCH HB PB LAB FEE SCHEDULE
245.00
3,058,530,301.00
REF PROTEIN C FUNCTIONAL
LABORATORY-HEMATOLOGY [0305]
85303
WCH HB PB LAB FEE SCHEDULE
257.00
3,058,530,302.00
REF PROTEIN C ACTIVITY,P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85303
WCH HB PB LAB FEE SCHEDULE
257.00
3,058,530,304.00
REF PROTEIN C ACTIVITY,P (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85303
WCH HB PB LAB FEE SCHEDULE
235.00
3,058,530,500.00
REF PROTEIN S TOTAL
LABORATORY-HEMATOLOGY [0305]
85305
WCH HB PB LAB FEE SCHEDULE
250.00
3,058,530,600.00
REF PROTEIN S ACTIVITY PLASMA
LABORATORY-HEMATOLOGY [0305]
85306
WCH HB PB LAB FEE SCHEDULE
257.00
3,058,530,601.00
REF PROTEIN S ACTIVITY, P (MAYO)
LABORATORY-HEMATOLOGY [0305]
85306
WCH HB PB LAB FEE SCHEDULE
283.00
3,058,530,603.00
REF PROTEIN S AG, FREE, P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85306
WCH HB PB LAB FEE SCHEDULE
284.00
3,058,530,605.00
REF PROTEIN S AG, FREE, P (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85306
WCH HB PB LAB FEE SCHEDULE
259.00
3,058,530,700.00
REF ASSAY ACTIVIATED PROTEIN C
LABORATORY-HEMATOLOGY [0305]
85307
WCH HB PB LAB FEE SCHEDULE
226.00
3,058,530,702.00
REFACTIVATED PROTEIN RESISTANCE V, P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85307
WCH HB PB LAB FEE SCHEDULE
187.00
3,058,530,703.00
REF ACTIVATED PROTEIN RESISTANCE V, P (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85307
WCH HB PB LAB FEE SCHEDULE
174.00
3,058,536,600.00
REF SOLUBLE FIBRIN MONOMER- THROMBO PANEL
LABORATORY-HEMATOLOGY [0305]
85366
WCH HB PB LAB FEE SCHEDULE
119.00
3,058,536,602.00
REF SOLUBLE FIBRIN MONOMER (MAYO)
LABORATORY-HEMATOLOGY [0305]
85366
WCH HB PB LAB FEE SCHEDULE
312.00
3,058,537,900.00
D DIMER
LABORATORY-HEMATOLOGY [0305]
85379
WCH HB PB LAB FEE SCHEDULE
178.00
3,058,537,902.00
REF D-DIMER,P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85379
WCH HB PB LAB FEE SCHEDULE
162.00
3,058,537,904.00
REF D-DIMER, P-APROL
LABORATORY-HEMATOLOGY [0305]
85379
WCH HB PB LAB FEE SCHEDULE
147.00
3,058,538,400.00
FIBRINOGEN
LABORATORY-HEMATOLOGY [0305]
85384
WCH HB PB LAB FEE SCHEDULE
112.00
3,058,538,402.00
REF FIBRINOGEN,P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85384
WCH HB PB LAB FEE SCHEDULE
102.00
3,058,538,404.00
REF FIBRINOGEN,P (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85384
WCH HB PB LAB FEE SCHEDULE
94.00
3,058,539,001.00
REF FIBRINOLYSINS,OR COAGULOPATHY SCREEN,INTERP AND REPORT (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85390
WCH HB PB LAB FEE SCHEDULE
116.00
3,058,539,002.00
REF SPECIAL COAGULATION INTERPRETATION (MAYO) LUPPR PANEL
LABORATORY-HEMATOLOGY [0305]
85390
WCH HB PB LAB FEE SCHEDULE
235.00
3,058,539,005.00
REF FIBRINOLYSINS,OR COAGULOPATHY SCREEN,INTERP AND REPORT (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85390
WCH HB PB LAB FEE SCHEDULE
104.00
3,058,539,701.00
REF VON WILLEBRAND FACTOR ACTIVITY,P (MAYO) VWPR PANEL
LABORATORY-HEMATOLOGY [0305]
85397
WCH HB PB LAB FEE SCHEDULE
352.00
3,058,541,500.00
REF PLASMINOGEN ACTIVATOR INH1 ACT
LABORATORY-HEMATOLOGY [0305]
85415
WCH HB PB LAB FEE SCHEDULE
637.00
3,058,542,000.00
REF PLASMINOGEN ACTIVITY
LABORATORY-HEMATOLOGY [0305]
85420
WCH HB PB LAB FEE SCHEDULE
179.00
3,058,546,100.00
FETAL SCREEN
LABORATORY-HEMATOLOGY [0305]
85461
WCH HB PB LAB FEE SCHEDULE
96.00
3,058,552,000.00
HEPARIN ANTI XA
LABORATORY-HEMATOLOGY [0305]
85520
WCH HB PB LAB FEE SCHEDULE
183.00
3,058,554,900.00
MURAMIDASE
LABORATORY-HEMATOLOGY [0305]
85549
WCH HB PB LAB FEE SCHEDULE
179.00
3,058,557,601.00
PLAT FUNC
LABORATORY-HEMATOLOGY [0305]
85576
WCH HB PB LAB FEE SCHEDULE
144.00
3,058,561,000.00
REF PROTHROMBIN TIME (PT),P (MAYO) PROCT PANEL
LABORATORY-HEMATOLOGY [0305]
85610
WCH HB PB LAB FEE SCHEDULE
69.00
3,058,561,001.00
REF PROTHROMBIN TIME (PT),P (MAYO) LUPPR PANEL
LABORATORY-HEMATOLOGY [0305]
85610
WCH HB PB LAB FEE SCHEDULE
74.00
3,058,561,003.00
REF PROTHROMBIN TIME (PT),P MAYO THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85610
WCH HB PB LAB FEE SCHEDULE
46.00
3,058,561,005.00
PROTIME
LABORATORY-HEMATOLOGY [0305]
85610
WCH HB DEFAULT FEE SCHEDULE
74.00
3,058,561,007.00
REF PROTHROMBIN TIME (PT), P-APROL
LABORATORY-HEMATOLOGY [0305]
85610
WCH HB PB LAB FEE SCHEDULE
48.00
3,058,561,008.00
REF PROTHROMBIN TIME (PT),P MAYO AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85610
WCH HB PB LAB FEE SCHEDULE
45.00
3,058,561,300.00
REF RUSSELL VIPER VENOM, DILUTED
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
162.00
3,058,561,301.00
REF DILUTE RUSSELLS VIPER VENOM TIME, P (MAYO) LUPPR PANEL
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
178.00
3,058,561,302.00
REF DILUTE RUSSELLS VIPER VENOM TIME, P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
143.00
3,058,561,305.00
REF DRVVT MIX
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
154.00
3,058,561,306.00
REF DRVVT CONFIRMATION
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
161.00
3,058,561,309.00
REF DILUTE RUSSELLS VIPER VENOM TIME, P (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
130.00
3,058,561,310.00
REF DILUTE RUSSELLS VIPER VENOM TIME, P (MAYO) ALUPP PANEL
LABORATORY-HEMATOLOGY [0305]
85613
WCH HB PB LAB FEE SCHEDULE
162.00
3,058,565,200.00
WESTERGREN ESR
LABORATORY-HEMATOLOGY [0305]
85652
WCH HB PB LAB FEE SCHEDULE
59.00
3,058,566,000.00
REF SICKLE CELL TEST
LABORATORY-HEMATOLOGY [0305]
85660
WCH HB PB LAB FEE SCHEDULE
62.00
3,058,567,000.00
THROMBIN TIME, PLASMA
LABORATORY-HEMATOLOGY [0305]
85670
WCH HB PB LAB FEE SCHEDULE
84.00
3,058,567,001.00
REF THROMBIN TIME BOVINE
LABORATORY-HEMATOLOGY [0305]
85670
WCH HB PB LAB FEE SCHEDULE
79.00
3,058,567,003.00
REF THROMBIN TIME, PLASMA (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85670
WCH HB PB LAB FEE SCHEDULE
97.00
3,058,567,005.00
REF THROMBIN TIME, PLASMA (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85670
WCH HB PB LAB FEE SCHEDULE
88.00
3,058,573,000.00
PTT
LABORATORY-HEMATOLOGY [0305]
85730
WCH HB PB LAB FEE SCHEDULE
85.00
3,058,573,001.00
REF ACTIVATED PARTIAL THROMBOPLA TIME, P (MAYO) LUPPR PANEL
LABORATORY-HEMATOLOGY [0305]
85730
WCH HB PB LAB FEE SCHEDULE
119.00
3,058,573,003.00
REF ACTIVATED PARTIAL THROMBOPLA TIME, P (MAYO) THRMP PANEL
LABORATORY-HEMATOLOGY [0305]
85730
WCH HB PB LAB FEE SCHEDULE
61.00
3,058,573,006.00
REF ACTIVATED PARTIAL THROMBOPLA TIME, P (MAYO) AATHR PANEL
LABORATORY-HEMATOLOGY [0305]
85730
WCH HB PB LAB FEE SCHEDULE
63.00
3,058,573,007.00
REF ACTIVATED PARTIAL THROMBOPLA TIME, P (MAYO) ALUPP PANEL
LABORATORY-HEMATOLOGY [0305]
85730
WCH HB PB LAB FEE SCHEDULE
102.00
3,058,614,601.00
REF BETA 2 GP1 IGG IGM OR IGA
LABORATORY-IMMUNOLOGY [0302]
86146
WCH HB PB LAB FEE SCHEDULE
134.00
3,060,000,100.00
REF NOVEL CORONAVIRUS REAL TIME RT-PCR DIAGNOSTIC TEST PANEL
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
U0001
WCH HB PB LAB FEE SCHEDULE
0.01
3,068,701,500.00
REF CYCLOSPORA SPECIES DETECT CONC
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87015
WCH HB PB LAB FEE SCHEDULE
69.00
3,068,704,000.00
CULTURE BACT BLD AER ANAER
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87040
WCH HB DEFAULT FEE SCHEDULE
210.00
3,068,704,000.00
CULTURE BACT BLD AER ANAER
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87040
WCH HB PB LAB FEE SCHEDULE
210.00
3,068,704,500.00
FECAL CULTURE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87045
WCH HB DEFAULT FEE SCHEDULE
132.00
3,068,704,500.00
FECAL CULTURE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87045
WCH HB PB LAB FEE SCHEDULE
132.00
3,068,704,501.00
REF ENTERIC PATHOGEN STOOL CULTURE (NOT BY PCR) (STOOL WITH ISOLATION)
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87045
WCH HB PB LAB FEE SCHEDULE
88.00
3,068,704,600.00
CAMPYLOBACTER
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87046
WCH HB PB LAB FEE SCHEDULE
89.00
3,068,704,602.00
REF ENTERIC PATHOGEN STOOL CULTURE (NOT BY PCR) (STOOL ADDITIONAL PATHOGENS)
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87046
WCH HB PB LAB FEE SCHEDULE
88.00
3,068,707,000.00
CULTURE AEROBIC ANY SOURCE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87070
WCH HB DEFAULT FEE SCHEDULE
107.00
3,068,707,000.00
CULTURE AEROBIC ANY SOURCE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87070
WCH HB PB LAB FEE SCHEDULE
107.00
3,068,707,500.00
CULTURE ANAEROBIC ANY SOURCE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87075
WCH HB PB LAB FEE SCHEDULE
143.00
3,068,707,600.00
ANAEROBE ID
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87076
WCH HB PB LAB FEE SCHEDULE
100.00
3,068,707,700.00
BACTERIAL ID
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87077
WCH HB DEFAULT FEE SCHEDULE
105.00
3,068,707,700.00
BACTERIAL ID
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87077
WCH HB PB LAB FEE SCHEDULE
105.00
3,068,707,701.00
REF ORGANISM REFER FOR ID AEROBIC
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87077
WCH HB PB LAB FEE SCHEDULE
278.00
3,068,708,100.00
CULTURE SCREENING
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87081
WCH HB PB LAB FEE SCHEDULE
140.00
3,068,708,600.00
REF URINE CULTURE QUANT CC
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87086
WCH HB PB LAB FEE SCHEDULE
89.00
3,068,708,800.00
URINE CULTURE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87088
WCH HB PB LAB FEE SCHEDULE
89.00
3,068,710,100.00
FNG DERMAT CULTURE FUNGI
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87101
WCH HB PB LAB FEE SCHEDULE
84.00
3,068,710,200.00
FUNGAL CULTURE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87102
WCH HB PB LAB FEE SCHEDULE
87.00
3,068,710,600.00
YEAST ID
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87106
WCH HB PB LAB FEE SCHEDULE
90.00
3,068,711,600.00
REF ACID FAST CULTURE AFBX
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87116
WCH HB PB LAB FEE SCHEDULE
108.00
3,068,714,700.00
SEROTYPE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87147
WCH HB PB LAB FEE SCHEDULE
59.00
3,068,716,900.00
MACRO WORM MACROSCOPIC PARASIT
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87169
WCH HB PB LAB FEE SCHEDULE
59.00
3,068,717,200.00
PINWORM PREP
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87172
WCH HB PB LAB FEE SCHEDULE
59.00
3,068,717,700.00
REF OVA & PARASITE EXAMINATION
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87177
WCH HB PB LAB FEE SCHEDULE
107.00
3,068,718,400.00
D TEST CLINDAMYCIN
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87184
WCH HB PB LAB FEE SCHEDULE
79.00
3,068,718,600.00
SUSCEPTABILITY AEROBIC MIC
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87186
WCH HB PB LAB FEE SCHEDULE
114.00
3,068,718,603.00
REF AEROBIC SUSCEPTIBILITY PER ORG
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87186
WCH HB PB LAB FEE SCHEDULE
118.00
3,068,720,500.00
DIRECT SMEAR ONLY
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87205
WCH HB PB LAB FEE SCHEDULE
59.00
3,068,720,600.00
STAIN FLORESCENT ACID FAST
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87206
WCH HB PB LAB FEE SCHEDULE
70.00
3,068,720,900.00
REF PARASITIC EXAMINATION SMEAR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87209
WCH HB PB LAB FEE SCHEDULE
228.00
3,068,721,000.00
WET MOUNT CERVICAL OR SKIN
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87210
WCH HB PB LAB FEE SCHEDULE
52.00
3,068,722,000.00
KOH FUNGAL WET MOUNT
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87220
WCH HB PB LAB FEE SCHEDULE
44.00
3,068,725,200.00
VIRAL CULTURE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87252
WCH HB PB LAB FEE SCHEDULE
198.00
3,068,726,000.00
ADENOVIRUS DFA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87260
WCH HB PB LAB FEE SCHEDULE
91.00
3,068,727,500.00
INFLUENZA B DFA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87275
WCH HB PB LAB FEE SCHEDULE
91.00
3,068,727,600.00
INFLUENZA A DFA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87276
WCH HB PB LAB FEE SCHEDULE
91.00
3,068,727,900.00
PARAINFLUENZA VIRUS ANY TYPE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87279
WCH HB PB LAB FEE SCHEDULE
91.00
3,068,728,000.00
RSV DFA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87280
WCH HB PB LAB FEE SCHEDULE
91.00
3,068,730,501.00
REF ASPERGILLUS GALACTOMANNAN AG
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87305
WCH HB PB LAB FEE SCHEDULE
229.00
3,068,732,400.00
C DIFFICILE TOXIN
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87324
WCH HB PB LAB FEE SCHEDULE
132.00
3,068,732,401.00
C DIFFICILE TOXIN A/B
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87324
WCH HB PB LAB FEE SCHEDULE
146.00
3,068,732,800.00
CRYPTOSPORIDIUM CRSP EIA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87328
WCH HB PB LAB FEE SCHEDULE
70.00
3,068,732,900.00
GIARDIA EIA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87329
WCH HB PB LAB FEE SCHEDULE
144.00
3,068,733,800.00
REF STL FOR H PYLORI
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87338
WCH HB PB LAB FEE SCHEDULE
235.00
3,068,733,801.00
REF STL FOR H PYLORI
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87338
WCH HB PB LAB FEE SCHEDULE
235.00
3,068,734,000.00
REF HBS AG
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87340
WCH HB PB LAB FEE SCHEDULE
73.00
3,068,734,001.00
HEP B SURFACE AG
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87340
WCH HB PB LAB FEE SCHEDULE
73.00
3,068,735,000.00
HEPATITIS BE AG, EIA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87350
WCH HB PB LAB FEE SCHEDULE
77.00
3,068,738,500.00
REF HISTOPLASMA CAPSUL AG, EIA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87385
WCH HB PB LAB FEE SCHEDULE
166.00
3,068,738,900.00
HIV 1 AND 2 AG & AB SCREEN
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87389
WCH HB PB LAB FEE SCHEDULE
209.00
3,068,739,000.00
HIV-1 P24 ANTIGEN
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87390
WCH HB PB LAB FEE SCHEDULE
212.00
3,068,742,000.00
RSV RESP SYNCTIAL VIRUS
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87420
WCH HB PB LAB FEE SCHEDULE
119.00
3,068,742,500.00
ROTAVIR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87425
WCH HB PB LAB FEE SCHEDULE
152.00
3,068,742,600.00
RAPID DETECTION OF SARS-COV-2
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87426
WCH HB PB LAB FEE SCHEDULE
0.01
3,068,744,900.00
STREP PNEUMO ANTIGEN URINE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87449
WCH HB PB LAB FEE SCHEDULE
86.00
3,068,744,904.00
LEGIONELLA ANTIGEN URINE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87449
WCH HB PB LAB FEE SCHEDULE
113.00
3,068,748,600.00
C PNEUMONIAE BY PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87486
WCH HB PB LAB FEE SCHEDULE
106.00
3,068,749,100.00
REF CHLAMYDIA TRACHOMATIS-AMPLIFIED PROB
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87491
WCH HB PB LAB FEE SCHEDULE
184.00
3,068,749,103.00
C TRACHOMATIS APMLIFIED PROBE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87491
WCH HB PB LAB FEE SCHEDULE
184.00
3,068,749,300.00
C DIFF AMPLIFIED PROBE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87493
WCH HB PB LAB FEE SCHEDULE
183.00
3,068,749,700.00
REF CYTOMEG, DNA, QUANT
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87497
WCH HB PB LAB FEE SCHEDULE
473.00
3,068,749,701.00
REF CMV DNA QUAN BY RAPID PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87497
WCH HB PB LAB FEE SCHEDULE
487.00
3,068,749,800.00
ENTEROVIRUS PCR CSF
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87498
WCH HB PB LAB FEE SCHEDULE
425.00
3,068,750,200.00
INFLUENZA A/B, MOLECULAR DETECTION
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87502
WCH HB PB LAB FEE SCHEDULE
280.00
3,068,750,700.00
GI PCR PANEL 12-25 TARGETS
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87507
WCH HB PB LAB FEE SCHEDULE
1,222.00
3,068,751,700.00
REF HEPATITIS B, DNA, QUANT
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87517
WCH HB PB LAB FEE SCHEDULE
277.00
3,068,752,200.00
REF HCV VIRAL LOAD
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87522
WCH HB PB LAB FEE SCHEDULE
538.00
3,068,752,201.00
REF HCV VIRAL LOAD
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87522
WCH HB PB LAB FEE SCHEDULE
538.00
3,068,752,900.00
HC REF HSV BY RAPID PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87529
WCH HB PB LAB FEE SCHEDULE
206.00
3,068,753,600.00
REF HIV 1 RNA BY ULTRA SENS PCR Q
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87536
WCH HB PB LAB FEE SCHEDULE
774.00
3,068,753,601.00
REF HIV 1 RNA BY ULTRA SENS PCR Q
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87536
WCH HB PB LAB FEE SCHEDULE
543.00
3,068,758,100.00
M PNEUMONIAE BY PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87581
WCH HB PB LAB FEE SCHEDULE
132.00
3,068,759,100.00
REF NEISSERIA GONORRHOEAE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87591
WCH HB PB LAB FEE SCHEDULE
186.00
3,068,759,102.00
N GONORRHOEAE AMPLIFIED PROBE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87591
WCH HB PB LAB FEE SCHEDULE
186.00
3,068,763,300.00
RESP PANEL VIRUS BY PCR 12-25
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87633
WCH HB PB LAB FEE SCHEDULE
787.00
3,068,763,500.00
REF CORONAVIRUS WITH COV-2 RNA, QUALITATIVE REAL-TIME RT-PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87635
WCH HB PB LAB FEE SCHEDULE
185.00
3,068,763,501.00
COVID-19 PCR, HIGH THROUGHPUT TECHNOLOGIES
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87635
WCH HB PB LAB FEE SCHEDULE
185.00
3,068,763,502.00
COVID-19 PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87635
WCH HB PB LAB FEE SCHEDULE
185.00
3,068,764,100.00
MRSA PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87641
WCH HB PB LAB FEE SCHEDULE
150.00
3,068,779,800.00
B PERTUSSIS BY PCR
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87798
WCH HB PB LAB FEE SCHEDULE
344.00
3,068,779,900.00
REF DETECT AGENT NOS, DNA, QUANT
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87799
WCH HB PB LAB FEE SCHEDULE
223.00
3,068,779,903.00
REF EPSTEIN BARR VIRUS DNA
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87799
WCH HB PB LAB FEE SCHEDULE
223.00
3,068,780,200.00
GRP B VAGINAL
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87802
WCH HB PB LAB FEE SCHEDULE
96.00
3,068,780,400.00
INFLUENZA A&B WAIVED
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87804
WCH HB PB LAB FEE SCHEDULE
89.00
3,068,788,000.00
STREP SCREEN GROUP A WAIVED
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87880
WCH HB PB LAB FEE SCHEDULE
96.00
3,068,789,900.00
INFECT AGENT BY IA DIRECT OBS
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87899
WCH HB PB LAB FEE SCHEDULE
89.00
3,068,790,100.00
REF HIV 1 GENOTYPIC DRUG RESIST
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87901
WCH HB PB LAB FEE SCHEDULE
931.00
3,068,790,200.00
REF HCV GENOTYPE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87902
WCH HB PB LAB FEE SCHEDULE
1,005.00
3,068,790,201.00
REF HCV GENOTYPE
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87902
WCH HB PB LAB FEE SCHEDULE
770.00
3,078,030,602.00
WORKPLACE URINE NON-DOT DRUG SCREEN (WITH MRO)
LABORATORY-UROLOGY [0307]
80306
WCH HB PB LAB FEE SCHEDULE
40.00
3,078,030,603.00
WORKPLACE URINE DOT DRUG SCREEN (WITH MRO)
LABORATORY-UROLOGY [0307]
80306
WCH HB PB LAB FEE SCHEDULE
40.00
3,078,100,000.00
URINE DIP W MICRO08012012
LABORATORY-UROLOGY [0307]
81000
WCH HB PB LAB FEE SCHEDULE
67.00
3,078,100,100.00
URINE AUTO WITH MICRO
LABORATORY-UROLOGY [0307]
81001
WCH HB PB LAB FEE SCHEDULE
67.00
3,078,100,200.00
URINE DIP POC
LABORATORY-UROLOGY [0307]
81002
WCH HB PB LAB FEE SCHEDULE
30.00
3,078,100,300.00
URINE AUTO WO MICRO WAIVED
LABORATORY-UROLOGY [0307]
81003
WCH HB DEFAULT FEE SCHEDULE
30.00
3,078,100,300.00
URINE AUTO WO MICRO WAIVED
LABORATORY-UROLOGY [0307]
81003
WCH HB PB LAB FEE SCHEDULE
30.00
3,078,100,301.00
URINE AUTO WO MICRO
LABORATORY-UROLOGY [0307]
81003
WCH HB PB LAB FEE SCHEDULE
30.00
3,078,101,500.00
URINE MICROSCOPIC ONLY
LABORATORY-UROLOGY [0307]
81015
WCH HB PB LAB FEE SCHEDULE
30.00
3,078,102,500.00
HCG URINE WAIVED
LABORATORY-UROLOGY [0307]
81025
WCH HB DEFAULT FEE SCHEDULE
88.00
3,078,102,500.00
HCG URINE WAIVED
LABORATORY-UROLOGY [0307]
81025
WCH HB PB LAB FEE SCHEDULE
88.00
3,078,102,501.00
HCG URINE
LABORATORY-UROLOGY [0307]
81025
WCH HB PB LAB FEE SCHEDULE
88.00
3,078,109,900.00
DRUG SCREEN COLLECTION ONLY
LABORATORY-UROLOGY [0307]
81099
WCH HB PB LAB FEE SCHEDULE
46.00
3,078,207,501.00
WORKPLACE BREATH ALCOHOL TEST (BAT)
LABORATORY-UROLOGY [0307]
82075
WCH HB PB LAB FEE SCHEDULE
58.00
3,098,687,000.00
ANTIBODY ID
LABORATORY-OTHER LABORATORY [0309]
86870
WCH HB PB LAB FEE SCHEDULE
179.00
3,098,688,000.00
DIRECT COOMBS POLY
LABORATORY-OTHER LABORATORY [0309]
86880
WCH HB PB LAB FEE SCHEDULE
77.00
3,098,688,002.00
DIRECT COOMBS GAMMA
LABORATORY-OTHER LABORATORY [0309]
86880
WCH HB PB LAB FEE SCHEDULE
48.00
3,098,688,501.00
AHG INDIRECT QUAL REAGENT RBC*2
LABORATORY-OTHER LABORATORY [0309]
86885
WCH HB PB LAB FEE SCHEDULE
101.00
3,098,688,600.00
AB TITER INDIRECT
LABORATORY-OTHER LABORATORY [0309]
86886
WCH HB PB LAB FEE SCHEDULE
174.00
3,098,690,000.00
ABO TYPE SEROLOGIC-OB GROUP
LABORATORY-OTHER LABORATORY [0309]
86900
WCH HB PB LAB FEE SCHEDULE
61.00
3,098,690,001.00
ABO TYPE SEROLOGIC
LABORATORY-OTHER LABORATORY [0309]
86900
WCH HB PB LAB FEE SCHEDULE
61.00
3,098,690,001.00
ABO TYPE SEROLOGIC
LABORATORY-OTHER LABORATORY [0309]
86900
WCH WELLNESS WEDNESDAY FSC
12.50
3,098,690,101.00
RH BLOOD TYPING
LABORATORY-OTHER LABORATORY [0309]
86901
WCH HB PB LAB FEE SCHEDULE
61.00
3,098,690,101.00
RH BLOOD TYPING
LABORATORY-OTHER LABORATORY [0309]
86901
WCH WELLNESS WEDNESDAY FSC
12.50
3,098,690,200.00
ANTIGEN TEST DONOR BLD EA UNIT
LABORATORY-OTHER LABORATORY [0309]
86902
WCH HB PB LAB FEE SCHEDULE
316.00
3,098,690,500.00
CAGP
LABORATORY-OTHER LABORATORY [0309]
86905
WCH HB PB LAB FEE SCHEDULE
199.00
3,098,690,600.00
REF REF RBC ANTIGEN TYPING, RH
LABORATORY-OTHER LABORATORY [0309]
86906
WCH HB PB LAB FEE SCHEDULE
108.00
3,098,692,000.00
IMMEDIATE SPIN CROSSMATCH
LABORATORY-OTHER LABORATORY [0309]
86920
WCH HB PB LAB FEE SCHEDULE
146.00
3,098,692,200.00
X MATCH AHG
LABORATORY-OTHER LABORATORY [0309]
86922
WCH HB PB LAB FEE SCHEDULE
146.00
3,098,715,001.00
ID BY NUCLEIC ACID EA ORG PROB
LABORATORY-BACTERIOLOGY AND MICROBIOLOGY [0306]
87150
WCH HB PB LAB FEE SCHEDULE
180.00
3,100,027,000.00
REF JAK2 EXON 12 AND OTHER NON-V617F MUTATION DETECTION, BLOOD
LABORATORY PATHOLOGY-GENERAL [0310]
0027U
WCH HB PB LAB FEE SCHEDULE
508.00
3,100,034,000.00
REF TPMT AND NUDT15 GENOTYPE
LABORATORY PATHOLOGY-GENERAL [0310]
0034U
WCH HB PB LAB FEE SCHEDULE
593.00
3,108,116,200.00
REF BRCA1/BRCA2 FULL GENE ANALYSIS
LABORATORY PATHOLOGY-GENERAL [0310]
81162
WCH HB PB LAB FEE SCHEDULE
4,444.00
3,108,120,601.00
REF BCR ABL1 MAJOR BRKPT QUAL QUAN
LABORATORY PATHOLOGY-GENERAL [0310]
81206
WCH HB PB LAB FEE SCHEDULE
1,650.00
3,108,121,900.00
REF MPN, CALR GENE MUTATION
LABORATORY PATHOLOGY-GENERAL [0310]
81219
WCH HB PB LAB FEE SCHEDULE
729.00
3,108,124,000.00
REF PROTHROMBIN G20210A MUTATION,B
LABORATORY PATHOLOGY-GENERAL [0310]
81240
WCH HB PB LAB FEE SCHEDULE
616.00
3,108,124,001.00
REF PROTHROMBIN G20210A MUTATION,B THRMP PANEL
LABORATORY PATHOLOGY-GENERAL [0310]
81240
WCH HB PB LAB FEE SCHEDULE
321.00
3,108,124,002.00
REF PROTHROMBIN G20210A MUTATION,B AATHR PANEL
LABORATORY PATHOLOGY-GENERAL [0310]
81240
WCH HB PB LAB FEE SCHEDULE
292.00
3,108,124,100.00
REF F5 GENE ANALYSIS, LEIDEN VARIANT
LABORATORY PATHOLOGY-GENERAL [0310]
81241
WCH HB PB LAB FEE SCHEDULE
216.00
3,108,124,101.00
REF FACTOR V LEIDEN (R506Q) MUTATION, B (MAYO)
LABORATORY PATHOLOGY-GENERAL [0310]
81241
WCH HB PB LAB FEE SCHEDULE
378.00
3,108,125,600.00
REF HFE GENE ANALYSIS COMMON VRNTS
LABORATORY PATHOLOGY-GENERAL [0310]
81256
WCH HB PB LAB FEE SCHEDULE
535.00
3,108,127,000.00
REF JAK2 GENE ANAL P.VAL617PHE VRN
LABORATORY PATHOLOGY-GENERAL [0310]
81270
WCH HB PB LAB FEE SCHEDULE
767.00
3,108,133,200.00
REF SERPINA1 A1AT DEF GENE ANALYSI
LABORATORY PATHOLOGY-GENERAL [0310]
81332
WCH HB PB LAB FEE SCHEDULE
79.00
3,108,137,501.00
REF HLA DR-DQ DISASSOC TYPING LOWRES(MAYO)
LABORATORY PATHOLOGY-GENERAL [0310]
81376
WCH HB PB LAB FEE SCHEDULE
436.00
3,108,137,601.00
REF CDCOMP HLA-DQ TYPING
LABORATORY PATHOLOGY-GENERAL [0310]
81376
WCH HB PB LAB FEE SCHEDULE
436.00
3,108,137,602.00
REF CELIAC DISEASE GLUTEN-FREE CASCADE
LABORATORY PATHOLOGY-GENERAL [0310]
81376
WCH HB PB LAB FEE SCHEDULE
436.00
3,108,140,100.00
TPMT GENOTYPE
LABORATORY PATHOLOGY-GENERAL [0310]
81401
WCH HB PB LAB FEE SCHEDULE
700.00
3,108,140,300.00
REF MOLECULAR PATH PROC LEVEL 4
LABORATORY PATHOLOGY-GENERAL [0310]
81403
WCH HB PB LAB FEE SCHEDULE
1,012.00
3,108,147,900.00
REF SEVERE COMBINE IMMUNODEF
LABORATORY PATHOLOGY-GENERAL [0310]
81479
WCH HB PB LAB FEE SCHEDULE
682.00
3,108,151,100.00
HC REF FETAL CONG ABN ASSAY 4 ANALYTE
LABORATORY PATHOLOGY-GENERAL [0310]
81511
WCH HB PB LAB FEE SCHEDULE
322.00
3,108,159,600.00
FIBROTEST-ACTITEST, S(MAYO)
LABORATORY PATHOLOGY-GENERAL [0310]
81596
WCH HB PB LAB FEE SCHEDULE
427.20
3,118,818,400.00
FIRST MARKER
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88184
WCH HB PB LAB FEE SCHEDULE
361.00
3,118,818,404.00
REF LEUKEMIA/LYMPHOMA IMMUNOPHENOTYPING BY FLOW CYTOMETRY 1ST
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88184
WCH HB PB LAB FEE SCHEDULE
361.00
3,118,818,500.00
ADDITIONAL MARKER
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88185
WCH HB PB LAB FEE SCHEDULE
273.00
3,118,818,502.00
REF LEUKEMIA/LYMPHOMA IMMUNOPHENOTYPING BY FLOW CYTOMETRY ADD ON
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88185
WCH HB PB LAB FEE SCHEDULE
158.00
3,118,818,900.00
REF FLOWCYTOMETRY/READ, 16 & > MARKERS
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88189
WCH HB PB LAB FEE SCHEDULE
437.00
3,118,823,002.00
REF CHROMOSOME ANALYSIS, CONGENITAL DISORDERS, BLOOD
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88230
WCH HB PB LAB FEE SCHEDULE
482.00
3,118,823,702.00
REF CHROMOSOMES, HEMATOLOGIC BLOOD
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88237
WCH HB PB LAB FEE SCHEDULE
659.00
3,118,826,200.00
REF CHROMOSOMES CONGENITAL BLOOD
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88262
WCH HB PB LAB FEE SCHEDULE
673.00
3,118,827,102.00
REF CLL FISH
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88271
WCH HB PB LAB FEE SCHEDULE
127.00
3,118,829,105.00
REF CHROMHEM INTERP & REPORT
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88291
WCH HB PB LAB FEE SCHEDULE
179.00
3,118,829,106.00
REF CLL FISH INTERP & REPORT
LABORATORY PATHOLOGY-CYTOLOGY [0311]
88291
WCH HB PB LAB FEE SCHEDULE
171.00
3,128,832,100.00
CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE
LABORATORY PATHOLOGY-HISTOLOGY [0312]
88321
WCH HB PB LAB FEE SCHEDULE
504.00
3,207,010,000.00
RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70100
WCH HB DEFAULT FEE SCHEDULE
151.00
3,207,011,000.00
RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70110
WCH HB DEFAULT FEE SCHEDULE
422.00
3,207,013,000.00
RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70130
WCH HB DEFAULT FEE SCHEDULE
273.00
3,207,014,000.00
RADEX FACIAL BONES < 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70140
WCH HB DEFAULT FEE SCHEDULE
200.00
3,207,015,000.00
RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70150
WCH HB DEFAULT FEE SCHEDULE
455.00
3,207,016,000.00
RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70160
WCH HB DEFAULT FEE SCHEDULE
147.00
3,207,019,000.00
RADEX OPTIC FORAMINA
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70190
WCH HB DEFAULT FEE SCHEDULE
140.00
3,207,020,000.00
RADEX ORBITS COMPLETE MINIMUM 4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70200
WCH HB DEFAULT FEE SCHEDULE
227.00
3,207,021,000.00
RADEX SINUSES PARANASAL <3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70210
WCH HB DEFAULT FEE SCHEDULE
166.00
3,207,022,000.00
RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70220
WCH HB DEFAULT FEE SCHEDULE
284.00
3,207,024,000.00
RADIOLOGIC EXAMINATION SELLA TURCICA
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70240
WCH HB DEFAULT FEE SCHEDULE
143.00
3,207,025,000.00
RADIOLOGIC EXAMINATION SKULL <4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70250
WCH HB DEFAULT FEE SCHEDULE
200.00
3,207,026,000.00
RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70260
WCH HB DEFAULT FEE SCHEDULE
284.00
3,207,032,800.00
RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70328
WCH HB DEFAULT FEE SCHEDULE
208.00
3,207,033,000.00
RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70330
WCH HB DEFAULT FEE SCHEDULE
299.00
3,207,036,000.00
RADIOLOGIC EXAMINATION NECK SOFT TISSUE
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
70360
WCH HB DEFAULT FEE SCHEDULE
166.00
3,207,110,000.00
RADEX RIBS UNILATERAL 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
71100
WCH HB DEFAULT FEE SCHEDULE
199.00
3,207,110,100.00
RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
71101
WCH HB DEFAULT FEE SCHEDULE
414.00
3,207,111,000.00
RADEX RIBS BILATERAL 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
71110
WCH HB DEFAULT FEE SCHEDULE
261.00
3,207,111,100.00
RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
71111
WCH HB DEFAULT FEE SCHEDULE
299.00
3,207,112,000.00
RADEX STERNUM MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
71120
WCH HB DEFAULT FEE SCHEDULE
205.00
3,207,113,000.00
RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
71130
WCH HB DEFAULT FEE SCHEDULE
227.00
3,207,202,000.00
RADEX SPINE 1 VIEW SPECIFY LEVEL
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72020
WCH HB DEFAULT FEE SCHEDULE
139.00
3,207,204,000.00
RADEX SPINE CERVICAL 2 OR 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72040
WCH HB DEFAULT FEE SCHEDULE
364.00
3,207,205,000.00
RADEX SPINE CERVICAL 4 OR 5 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72050
WCH HB DEFAULT FEE SCHEDULE
516.00
3,207,205,200.00
RADEX SPINE CERVICAL 6 OR MORE VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72052
WCH HB DEFAULT FEE SCHEDULE
722.00
3,207,207,000.00
RADEX SPINE THORACIC 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72070
WCH HB DEFAULT FEE SCHEDULE
382.00
3,207,207,200.00
RADEX SPINE THORACIC 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72072
WCH HB DEFAULT FEE SCHEDULE
465.00
3,207,208,000.00
RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72080
WCH HB DEFAULT FEE SCHEDULE
212.00
3,207,208,100.00
RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72081
WCH HB DEFAULT FEE SCHEDULE
237.00
3,207,208,200.00
RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72082
WCH HB DEFAULT FEE SCHEDULE
378.00
3,207,210,000.00
RADEX SPINE LUMBOSACRAL 2/3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72100
WCH HB DEFAULT FEE SCHEDULE
476.00
3,207,211,000.00
RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72110
WCH HB DEFAULT FEE SCHEDULE
518.00
3,207,211,400.00
RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72114
WCH HB DEFAULT FEE SCHEDULE
354.00
3,207,212,000.00
RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72120
WCH HB DEFAULT FEE SCHEDULE
260.00
3,207,217,000.00
RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72170
WCH HB DEFAULT FEE SCHEDULE
308.00
3,207,219,000.00
RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72190
WCH HB DEFAULT FEE SCHEDULE
253.00
3,207,220,000.00
RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72200
WCH HB DEFAULT FEE SCHEDULE
135.00
3,207,220,200.00
RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72202
WCH HB DEFAULT FEE SCHEDULE
250.00
3,207,222,000.00
RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
72220
WCH HB DEFAULT FEE SCHEDULE
215.00
3,207,300,000.00
RADEX CLAVICLE COMPLETE
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73000
WCH HB DEFAULT FEE SCHEDULE
304.00
3,207,301,000.00
RADEX SCAPULA COMPLETE
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73010
WCH HB DEFAULT FEE SCHEDULE
403.00
3,207,302,000.00
RADEX SHOULDER 1 VIEW
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73020
WCH HB DEFAULT FEE SCHEDULE
156.00
3,207,303,000.00
RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73030
WCH HB DEFAULT FEE SCHEDULE
393.00
3,207,305,000.00
RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73050
WCH HB DEFAULT FEE SCHEDULE
209.00
3,207,306,000.00
RADEX HUMERUS MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73060
WCH HB DEFAULT FEE SCHEDULE
185.00
3,207,307,000.00
RADEX ELBOW 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73070
WCH HB DEFAULT FEE SCHEDULE
155.00
3,207,308,000.00
RADEX ELBOW COMPLETE MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73080
WCH HB DEFAULT FEE SCHEDULE
179.00
3,207,309,000.00
RADEX FOREARM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73090
WCH HB DEFAULT FEE SCHEDULE
158.00
3,207,309,200.00
RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73092
WCH HB DEFAULT FEE SCHEDULE
152.00
3,207,310,000.00
RADEX WRIST 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73100
WCH HB DEFAULT FEE SCHEDULE
238.00
3,207,311,000.00
RADEX WRIST COMPLETE MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73110
WCH HB DEFAULT FEE SCHEDULE
351.00
3,207,312,000.00
RADEX HAND 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73120
WCH HB DEFAULT FEE SCHEDULE
145.00
3,207,313,000.00
RADEX HAND MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73130
WCH HB DEFAULT FEE SCHEDULE
167.00
3,207,314,000.00
RADEX FINGR MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73140
WCH HB DEFAULT FEE SCHEDULE
124.00
3,207,350,100.00
RADIOLOGIC EXAM, HIP W PELVIS WHEN PERFORMED, UNILATERAL, 1 VIEW
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73501
WCH HB DEFAULT FEE SCHEDULE
153.00
3,207,350,200.00
RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73502
WCH HB DEFAULT FEE SCHEDULE
210.00
3,207,352,100.00
RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73521
WCH HB DEFAULT FEE SCHEDULE
210.00
3,207,352,200.00
RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73522
WCH HB DEFAULT FEE SCHEDULE
248.00
3,207,355,100.00
RADIOLOGIC EXAMINATION FEMUR 1 VIEW
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73551
WCH HB DEFAULT FEE SCHEDULE
170.00
3,207,355,200.00
RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73552
WCH HB DEFAULT FEE SCHEDULE
359.00
3,207,356,000.00
RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73560
WCH HB DEFAULT FEE SCHEDULE
352.00
3,207,356,200.00
RADIOLOGIC EXAMINATION KNEE 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73562
WCH HB DEFAULT FEE SCHEDULE
425.00
3,207,356,400.00
RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73564
WCH HB DEFAULT FEE SCHEDULE
210.00
3,207,356,500.00
RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73565
WCH HB DEFAULT FEE SCHEDULE
233.00
3,207,359,000.00
RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73590
WCH HB DEFAULT FEE SCHEDULE
323.00
3,207,359,200.00
RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73592
WCH HB DEFAULT FEE SCHEDULE
162.00
3,207,360,000.00
RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73600
WCH HB DEFAULT FEE SCHEDULE
146.00
3,207,361,000.00
RADEX ANKLE COMPLETE MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73610
WCH HB DEFAULT FEE SCHEDULE
341.00
3,207,362,000.00
RADIOLOGIC EXAMINATION FOOT 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73620
WCH HB DEFAULT FEE SCHEDULE
152.00
3,207,363,000.00
RADEX FOOT COMPLETE MINIMUM 3 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73630
WCH HB DEFAULT FEE SCHEDULE
365.00
3,207,365,000.00
RADEX CALCANEUS MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73650
WCH HB DEFAULT FEE SCHEDULE
140.00
3,207,366,000.00
RADEX TOE MINIMUM 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
73660
WCH HB DEFAULT FEE SCHEDULE
132.00
3,207,401,800.00
RADIOLOGIC EXAM ABDOMEN 1 VIEW
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
74018
WCH HB DEFAULT FEE SCHEDULE
295.00
3,207,401,900.00
RADIOLOGIC EXAM ABDOMEN 2 VIEWS
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
74019
WCH HB DEFAULT FEE SCHEDULE
435.00
3,207,402,200.00
RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
74022
WCH HB DEFAULT FEE SCHEDULE
549.00
3,207,430,000.00
CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
74300
WCH HB DEFAULT FEE SCHEDULE
376.00
3,207,440,000.00
UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
74400
WCH HB DEFAULT FEE SCHEDULE
798.00
3,207,445,500.00
URETHROCYSTOGRAPHY VOIDING RS&I
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
74455
WCH HB DEFAULT FEE SCHEDULE
737.00
3,207,601,000.00
RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
76010
WCH HB DEFAULT FEE SCHEDULE
139.00
3,207,707,200.00
BONE AGE STUDIES
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
77072
WCH HB DEFAULT FEE SCHEDULE
233.00
3,207,707,300.00
BONE LENGTH STUDIES
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
77073
WCH HB DEFAULT FEE SCHEDULE
233.00
3,207,707,400.00
RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
77074
WCH HB DEFAULT FEE SCHEDULE
383.00
3,207,707,500.00
RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
77075
WCH HB DEFAULT FEE SCHEDULE
384.00
3,207,707,600.00
RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
77076
WCH HB DEFAULT FEE SCHEDULE
243.00
3,207,708,000.00
DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL
RADIOLOGY-DIAGNOSTIC-GENERAL [0320]
77080
WCH HB DEFAULT FEE SCHEDULE
583.00
3,247,104,500.00
RADIOLOGIC EXAM CHEST SINGLE VIEW
RADIOLOGY-DIAGNOSTIC-CHEST X-RAY [0324]
71045
WCH HB DEFAULT FEE SCHEDULE
274.00
3,247,104,600.00
RADIOLOGIC EXAM CHEST 2 VIEWS
RADIOLOGY-DIAGNOSTIC-CHEST X-RAY [0324]
71046
WCH HB DEFAULT FEE SCHEDULE
352.00
3,247,104,700.00
RADIOLOGIC EXAM CHEST 3 VIEWS
RADIOLOGY-DIAGNOSTIC-CHEST X-RAY [0324]
71047
WCH HB DEFAULT FEE SCHEDULE
246.00
3,319,640,200.00
CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO
RADIOLOGY-THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION-CHEMOTHERAPY ADMINISTRATION-INJECTED [0331]
96402
WCH HB DEFAULT FEE SCHEDULE
149.00
3,359,641,300.00
CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG
RADIOLOGY-THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION-CHEMOTHERAPY ADMINISTRATION-IV [0335]
96413
WCH HB DEFAULT FEE SCHEDULE
619.00
3,359,641,500.00
CHEMOTHERAPY ADMN IV INFUSION TQ EA HR
RADIOLOGY-THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION-CHEMOTHERAPY ADMINISTRATION-IV [0335]
96415
WCH HB DEFAULT FEE SCHEDULE
166.00
3,417,858,000.00
PULMONARY PERFUSION IMAGING PARTICULATE
NUCLEAR MEDICINE-DIAGNOSTIC [0341]
78580
WCH HB DEFAULT FEE SCHEDULE
1,299.00
3,507,563,500.00
CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
CT SCAN-GENERAL [0350]
75635
WCH HB DEFAULT FEE SCHEDULE
3,644.00
3,507,638,000.00
CT LIMITED/LOCALIZED FOLLOW UP STUDY
CT SCAN-GENERAL [0350]
76380
WCH HB DEFAULT FEE SCHEDULE
660.00
3,517,045,000.00
CT HEAD/BRAIN W/O CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70450
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,517,046,000.00
CT HEAD/BRAIN W/CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70460
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,517,047,000.00
CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70470
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,517,048,000.00
CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL
CT SCAN-HEAD SCAN [0351]
70480
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,517,048,100.00
CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL
CT SCAN-HEAD SCAN [0351]
70481
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,517,048,200.00
CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR
CT SCAN-HEAD SCAN [0351]
70482
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,517,048,600.00
CT MAXILLOFACIAL W/O CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70486
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,517,048,700.00
CT MAXILLOFACIAL W/CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70487
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,517,048,800.00
CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70488
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,517,049,000.00
CT SOFT TISSUE NECK W/O CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70490
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,517,049,100.00
CT SOFT TISSUE NECK W/CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70491
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,517,049,200.00
CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL
CT SCAN-HEAD SCAN [0351]
70492
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,517,049,600.00
CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST
CT SCAN-HEAD SCAN [0351]
70496
WCH HB DEFAULT FEE SCHEDULE
2,585.00
3,517,049,800.00
CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
CT SCAN-HEAD SCAN [0351]
70498
WCH HB DEFAULT FEE SCHEDULE
2,585.00
3,520,029,700.00
LOW DOSE CT SCAN (LDCT) FOR LUNG CANCER SCREENING
CT SCAN-BODY SCAN [0352]
G0297
WCH HB DEFAULT FEE SCHEDULE
327.00
3,527,125,000.00
DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST
CT SCAN-BODY SCAN [0352]
71250
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,126,000.00
DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST
CT SCAN-BODY SCAN [0352]
71260
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,527,127,000.00
DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+
CT SCAN-BODY SCAN [0352]
71270
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,527,127,100.00
COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-
CT SCAN-BODY SCAN [0352]
71271
WCH HB DEFAULT FEE SCHEDULE
327.00
3,527,127,500.00
CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST
CT SCAN-BODY SCAN [0352]
71275
WCH HB DEFAULT FEE SCHEDULE
2,365.00
3,527,212,500.00
CT CERVICAL SPINE W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72125
WCH HB DEFAULT FEE SCHEDULE
2,090.00
3,527,212,600.00
CT CERVICAL SPINE W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72126
WCH HB DEFAULT FEE SCHEDULE
1,293.00
3,527,212,700.00
CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72127
WCH HB DEFAULT FEE SCHEDULE
2,090.00
3,527,212,800.00
CT THORACIC SPINE W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72128
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,212,900.00
CT THORACIC SPINE W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72129
WCH HB DEFAULT FEE SCHEDULE
139.00
3,527,213,100.00
CT LUMBAR SPINE W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72131
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,213,200.00
CT LUMBAR SPINE W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72132
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,527,219,100.00
CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
CT SCAN-BODY SCAN [0352]
72191
WCH HB DEFAULT FEE SCHEDULE
2,365.00
3,527,219,200.00
CT PELVIS W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72192
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,219,300.00
CT PELVIS W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72193
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,527,219,400.00
CT PELVIS W/O & W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
72194
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,527,320,000.00
CT UPPER EXTREMITY W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
73200
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,320,100.00
CT UPPER EXTREMITY W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
73201
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,527,320,600.00
CT ANGIOGRAPHY UPPER EXTREMITY
CT SCAN-BODY SCAN [0352]
73206
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,527,370,000.00
CT LOWER EXTREMITY W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
73700
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,370,100.00
CT LOWER EXTREMITY W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
73701
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,527,370,600.00
CT ANGIOGRAPHY LOWER EXTREMITY
CT SCAN-BODY SCAN [0352]
73706
WCH HB DEFAULT FEE SCHEDULE
2,365.00
3,527,415,000.00
CT ABDOMEN W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
74150
WCH HB DEFAULT FEE SCHEDULE
1,375.00
3,527,416,000.00
CT ABDOMEN W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
74160
WCH HB DEFAULT FEE SCHEDULE
1,925.00
3,527,417,000.00
CT ABDOMEN W/O & W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
74170
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,527,417,400.00
CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG
CT SCAN-BODY SCAN [0352]
74174
WCH HB DEFAULT FEE SCHEDULE
3,795.00
3,527,417,500.00
CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST
CT SCAN-BODY SCAN [0352]
74175
WCH HB DEFAULT FEE SCHEDULE
2,365.00
3,527,417,600.00
CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
74176
WCH HB DEFAULT FEE SCHEDULE
2,728.00
3,527,417,700.00
CT ABDOMEN & PELVIS W/CONTRAST MATERIAL
CT SCAN-BODY SCAN [0352]
74177
WCH HB DEFAULT FEE SCHEDULE
3,960.00
3,527,417,800.00
CT ABDOMEN & PELVIS W/O CONTRST FOLLOWED BY W CONTRST 1/> BODY RE
CT SCAN-BODY SCAN [0352]
74178
WCH HB DEFAULT FEE SCHEDULE
4,235.00
3,601,006,000.00
INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
OPERATING ROOM SERVICES-GENERAL [0360]
10060
WCH HB DEFAULT FEE SCHEDULE
389.00
3,601,008,000.00
INCISION & DRAINAGE PILONIDAL CYST SIMPLE
OPERATING ROOM SERVICES-GENERAL [0360]
10080
WCH HB DEFAULT FEE SCHEDULE
686.00
3,601,012,000.00
INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
OPERATING ROOM SERVICES-GENERAL [0360]
10120
WCH HB DEFAULT FEE SCHEDULE
504.00
3,601,174,000.00
EVACUATION SUBUNGUAL HEMATOMA
OPERATING ROOM SERVICES-GENERAL [0360]
11740
WCH HB DEFAULT FEE SCHEDULE
180.00
3,601,200,100.00
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<
OPERATING ROOM SERVICES-GENERAL [0360]
12001
WCH HB DEFAULT FEE SCHEDULE
629.00
3,601,200,200.00
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM
OPERATING ROOM SERVICES-GENERAL [0360]
12002
WCH HB DEFAULT FEE SCHEDULE
761.00
3,601,200,400.00
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM
OPERATING ROOM SERVICES-GENERAL [0360]
12004
WCH HB DEFAULT FEE SCHEDULE
943.00
3,601,200,700.00
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM
OPERATING ROOM SERVICES-GENERAL [0360]
12007
WCH HB DEFAULT FEE SCHEDULE
1,196.00
3,601,201,100.00
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
OPERATING ROOM SERVICES-GENERAL [0360]
12011
WCH HB DEFAULT FEE SCHEDULE
761.00
3,601,201,300.00
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM
OPERATING ROOM SERVICES-GENERAL [0360]
12013
WCH HB DEFAULT FEE SCHEDULE
762.00
3,601,203,100.00
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
OPERATING ROOM SERVICES-GENERAL [0360]
12031
WCH HB DEFAULT FEE SCHEDULE
562.00
3,601,203,200.00
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
OPERATING ROOM SERVICES-GENERAL [0360]
12032
WCH HB DEFAULT FEE SCHEDULE
923.00
3,601,203,400.00
REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
OPERATING ROOM SERVICES-GENERAL [0360]
12034
WCH HB DEFAULT FEE SCHEDULE
894.00
3,601,203,500.00
REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
OPERATING ROOM SERVICES-GENERAL [0360]
12035
WCH HB DEFAULT FEE SCHEDULE
1,542.00
3,601,204,200.00
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM
OPERATING ROOM SERVICES-GENERAL [0360]
12042
WCH HB DEFAULT FEE SCHEDULE
1,014.00
3,601,205,100.00
REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<
OPERATING ROOM SERVICES-GENERAL [0360]
12051
WCH HB DEFAULT FEE SCHEDULE
1,013.00
3,602,056,000.00
NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
OPERATING ROOM SERVICES-GENERAL [0360]
20560
WCH HB DEFAULT FEE SCHEDULE
46.00
3,602,056,100.00
NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
OPERATING ROOM SERVICES-GENERAL [0360]
20561
WCH HB DEFAULT FEE SCHEDULE
56.00
3,602,060,500.00
ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
OPERATING ROOM SERVICES-GENERAL [0360]
20605
WCH HB DEFAULT FEE SCHEDULE
288.00
3,602,061,000.00
ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
OPERATING ROOM SERVICES-GENERAL [0360]
20610
WCH HB DEFAULT FEE SCHEDULE
343.00
3,602,148,000.00
CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ
OPERATING ROOM SERVICES-GENERAL [0360]
21480
WCH HB DEFAULT FEE SCHEDULE
535.00
3,602,365,000.00
CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
OPERATING ROOM SERVICES-GENERAL [0360]
23650
WCH HB DEFAULT FEE SCHEDULE
1,340.00
3,602,556,500.00
CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ
OPERATING ROOM SERVICES-GENERAL [0360]
25565
WCH HB DEFAULT FEE SCHEDULE
2,603.00
3,602,560,500.00
CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF
OPERATING ROOM SERVICES-GENERAL [0360]
25605
WCH HB DEFAULT FEE SCHEDULE
2,744.00
3,602,674,200.00
CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ
OPERATING ROOM SERVICES-GENERAL [0360]
26742
WCH HB DEFAULT FEE SCHEDULE
1,796.00
3,602,677,000.00
CLTX IPHAL JT DISLC W/MANJ W/O ANES
OPERATING ROOM SERVICES-GENERAL [0360]
26770
WCH HB DEFAULT FEE SCHEDULE
1,178.00
3,602,755,000.00
CLOSED TX KNEE DISLOCATION W/O ANESTHESIA
OPERATING ROOM SERVICES-GENERAL [0360]
27550
WCH HB DEFAULT FEE SCHEDULE
2,200.00
3,602,784,000.00
CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA
OPERATING ROOM SERVICES-GENERAL [0360]
27840
WCH HB DEFAULT FEE SCHEDULE
1,684.00
3,602,910,500.00
APPLICATION LONG ARM SPLINT SHOULDER HAND
OPERATING ROOM SERVICES-GENERAL [0360]
29105
WCH HB DEFAULT FEE SCHEDULE
418.00
3,602,912,500.00
APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC
OPERATING ROOM SERVICES-GENERAL [0360]
29125
WCH HB DEFAULT FEE SCHEDULE
293.00
3,602,940,500.00
APPLICATION SHORT LEG CAST BELOW KNEE-TOE
OPERATING ROOM SERVICES-GENERAL [0360]
29405
WCH HB DEFAULT FEE SCHEDULE
452.00
3,602,950,500.00
APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES
OPERATING ROOM SERVICES-GENERAL [0360]
29505
WCH HB DEFAULT FEE SCHEDULE
406.00
3,602,951,500.00
APPLICATION SHORT LEG SPLINT CALF FOOT
OPERATING ROOM SERVICES-GENERAL [0360]
29515
WCH HB DEFAULT FEE SCHEDULE
238.00
3,602,958,000.00
STRAPPING UNNA BOOT
OPERATING ROOM SERVICES-GENERAL [0360]
29580
WCH HB DEFAULT FEE SCHEDULE
190.00
3,602,958,100.00
APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT
OPERATING ROOM SERVICES-GENERAL [0360]
29581
WCH HB DEFAULT FEE SCHEDULE
319.00
3,603,090,100.00
CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
OPERATING ROOM SERVICES-GENERAL [0360]
30901
WCH HB DEFAULT FEE SCHEDULE
408.00
3,603,255,100.00
TUBE THORACOSTOMY INCLUDES WATER SEAL
OPERATING ROOM SERVICES-GENERAL [0360]
32551
WCH HB DEFAULT FEE SCHEDULE
1,075.00
3,603,659,200.00
COLLECT BLOOD FROM CATHETER VENOUS NOS
OPERATING ROOM SERVICES-GENERAL [0360]
36592
WCH HB DEFAULT FEE SCHEDULE
120.00
3,603,660,000.00
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
OPERATING ROOM SERVICES-GENERAL [0360]
36600
WCH HB DEFAULT FEE SCHEDULE
281.00
3,603,660,000.00
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
OPERATING ROOM SERVICES-GENERAL [0360]
36600
WCH HB PB LAB FEE SCHEDULE
257.00
3,603,668,000.00
PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
OPERATING ROOM SERVICES-GENERAL [0360]
36680
WCH HB DEFAULT FEE SCHEDULE
746.00
3,604,908,200.00
ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE
OPERATING ROOM SERVICES-GENERAL [0360]
49082
WCH HB DEFAULT FEE SCHEDULE
769.00
3,604,908,300.00
ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE
OPERATING ROOM SERVICES-GENERAL [0360]
49083
WCH HB DEFAULT FEE SCHEDULE
700.00
3,605,170,000.00
BLDR IRRIGATION SMPL LAVAGE &/INSTLJ
OPERATING ROOM SERVICES-GENERAL [0360]
51700
WCH HB DEFAULT FEE SCHEDULE
248.00
3,605,170,100.00
INSJ NON-NDWELLG BLADDER CATHETER
OPERATING ROOM SERVICES-GENERAL [0360]
51701
WCH HB DEFAULT FEE SCHEDULE
503.00
3,605,170,200.00
INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE
OPERATING ROOM SERVICES-GENERAL [0360]
51702
WCH HB DEFAULT FEE SCHEDULE
590.00
3,605,170,500.00
CHANGE CYSTOSTOMY TUBE SIMPLE
OPERATING ROOM SERVICES-GENERAL [0360]
51705
WCH HB DEFAULT FEE SCHEDULE
638.00
3,605,642,000.00
I&D BARTHOLIN’S GLAND ABSCESS
OPERATING ROOM SERVICES-GENERAL [0360]
56420
WCH HB DEFAULT FEE SCHEDULE
548.00
3,606,445,000.00
INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH
OPERATING ROOM SERVICES-GENERAL [0360]
64450
WCH HB DEFAULT FEE SCHEDULE
460.00
3,606,520,500.00
REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
OPERATING ROOM SERVICES-GENERAL [0360]
65205
WCH HB DEFAULT FEE SCHEDULE
214.00
3,606,522,000.00
RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP
OPERATING ROOM SERVICES-GENERAL [0360]
65220
WCH HB DEFAULT FEE SCHEDULE
360.00
3,606,920,000.00
RMVL FB XTRNL AUDITORY CANAL W/O ANES
OPERATING ROOM SERVICES-GENERAL [0360]
69200
WCH HB DEFAULT FEE SCHEDULE
462.00
3,709,915,200.00
MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS
ANESTHESIA-GENERAL [0370]
99152
WCH HB DEFAULT FEE SCHEDULE
163.00
3,900,901,600.00
RBC LEUKO REDUCED
ADMINISTRATION, PROCESSING AND STORAGE FOR BLOOD AND BLOOD COMPONENTS-GENERAL [0390]
P9016
WCH HB PB LAB FEE SCHEDULE
821.00
3,900,901,700.00
FRESH FROZEN PLASMA ONE DONOR
ADMINISTRATION, PROCESSING AND STORAGE FOR BLOOD AND BLOOD COMPONENTS-GENERAL [0390]
P9017
WCH HB PB LAB FEE SCHEDULE
250.00
3,900,905,900.00
FRESH FROZEN PLASMA 24 HRS
ADMINISTRATION, PROCESSING AND STORAGE FOR BLOOD AND BLOOD COMPONENTS-GENERAL [0390]
P9059
WCH HB PB LAB FEE SCHEDULE
250.00
3,908,685,000.00
ANTIBODY SCREEN
ADMINISTRATION, PROCESSING AND STORAGE FOR BLOOD AND BLOOD COMPONENTS-GENERAL [0390]
86850
WCH HB PB LAB FEE SCHEDULE
101.00
3,913,643,000.00
TRANSFUSION, BLOOD OR BLOOD COMPONENTS
ADMINISTRATION, PROCESSING AND STORAGE FOR BLOOD AND BLOOD COMPONENTS-ADMINISTRATION (E.G., TRANSFUS [0391]
36430
WCH HB PB LAB FEE SCHEDULE
321.00
4,027,653,600.00
US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76536
WCH HB DEFAULT FEE SCHEDULE
460.00
4,027,660,400.00
US CHEST REAL TIME W/IMAGE DOCUMENTATION
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76604
WCH HB DEFAULT FEE SCHEDULE
448.00
4,027,670,000.00
US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76700
WCH HB DEFAULT FEE SCHEDULE
868.00
4,027,670,500.00
US ABDOMINAL REAL TIME W/IMAGE LIMITED
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76705
WCH HB DEFAULT FEE SCHEDULE
679.00
4,027,670,600.00
US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76706
WCH HB DEFAULT FEE SCHEDULE
347.00
4,027,677,000.00
US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76770
WCH HB DEFAULT FEE SCHEDULE
816.00
4,027,677,500.00
US RETROPERITONEAL REAL TIME W/IMAGE LIMITED
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76775
WCH HB DEFAULT FEE SCHEDULE
463.00
4,027,680,100.00
US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76801
WCH HB DEFAULT FEE SCHEDULE
634.00
4,027,680,500.00
US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76805
WCH HB DEFAULT FEE SCHEDULE
634.00
4,027,681,000.00
US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76810
WCH HB DEFAULT FEE SCHEDULE
361.00
4,027,681,500.00
US PREGNANT UTERUS LIMITED 1/> FETUSES
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76815
WCH HB DEFAULT FEE SCHEDULE
463.00
4,027,681,600.00
US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76816
WCH HB DEFAULT FEE SCHEDULE
414.00
4,027,681,700.00
US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76817
WCH HB DEFAULT FEE SCHEDULE
538.00
4,027,681,800.00
FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76818
WCH HB DEFAULT FEE SCHEDULE
628.00
4,027,681,900.00
FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76819
WCH HB DEFAULT FEE SCHEDULE
609.00
4,027,683,000.00
US TRANSVAGINAL
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76830
WCH HB DEFAULT FEE SCHEDULE
708.00
4,027,685,600.00
US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76856
WCH HB DEFAULT FEE SCHEDULE
917.00
4,027,685,700.00
US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76857
WCH HB DEFAULT FEE SCHEDULE
455.00
4,027,687,000.00
US SCROTUM & CONTENTS
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76870
WCH HB DEFAULT FEE SCHEDULE
695.00
4,027,688,100.00
US XTR NON-VASC COMPLETE
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76881
WCH HB DEFAULT FEE SCHEDULE
667.00
4,027,688,200.00
US EXTREMITY NON-VASC REAL-TIME IMG LMTD
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76882
WCH HB DEFAULT FEE SCHEDULE
190.00
4,027,694,200.00
US GUIDANCE NEEDLE PLACEMENT IMG S&I
OTHER IMAGING SERVICES-ULTRASOUND [0402]
76942
WCH HB DEFAULT FEE SCHEDULE
1,047.00
4,037,706,300.00
SCREENING DIGITAL BREAST TOMOSYNTHESIS BI
OTHER IMAGING SERVICES-SCREENING MAMMOGRAPHY [0403]
77063
WCH HB DEFAULT FEE SCHEDULE
200.00
4,037,706,700.00
SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD
OTHER IMAGING SERVICES-SCREENING MAMMOGRAPHY [0403]
77067
WCH HB DEFAULT FEE SCHEDULE
546.00
4,100,023,900.00
OTHER RESP PROC TO IMPROVE FUNCTION OR STRENGTH, GROUP
RESPIRATORY SERVICES-GENERAL [0410]
G0239
WCH HB DEFAULT FEE SCHEDULE
30.00
4,103,150,000.00
INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
RESPIRATORY SERVICES-GENERAL [0410]
31500
WCH HB DEFAULT FEE SCHEDULE
916.00
4,109,400,200.00
VENTILATION ASSIST & MGMT INPATIENT 1ST DAY
RESPIRATORY SERVICES-GENERAL [0410]
94002
WCH HB DEFAULT FEE SCHEDULE
450.00
4,109,464,000.00
PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
RESPIRATORY SERVICES-GENERAL [0410]
94640
WCH HB DEFAULT FEE SCHEDULE
186.00
4,109,464,000.00
PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
RESPIRATORY SERVICES-GENERAL [0410]
94640
WCH HB PB LAB FEE SCHEDULE
154.00
4,109,466,000.00
CPAP VENTILATION CPAP INITIATION&MGMT
RESPIRATORY SERVICES-GENERAL [0410]
94660
WCH HB DEFAULT FEE SCHEDULE
266.00
4,109,466,400.00
DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP
RESPIRATORY SERVICES-GENERAL [0410]
94664
WCH HB DEFAULT FEE SCHEDULE
150.00
4,109,466,700.00
MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL
RESPIRATORY SERVICES-GENERAL [0410]
94667
WCH HB DEFAULT FEE SCHEDULE
209.00
4,109,466,800.00
MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ
RESPIRATORY SERVICES-GENERAL [0410]
94668
WCH HB DEFAULT FEE SCHEDULE
84.00
4,200,000,200.00
BHSS PER 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
WCH HB DEFAULT FEE SCHEDULE
455.00
4,200,000,300.00
Hc Wch Pt Maintenance
PHYSICAL THERAPY-GENERAL [0420]
WCH HB DEFAULT FEE SCHEDULE
7.00
4,200,897,800.00
HC MOBILITY CURRENT STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8978
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,897,900.00
HC MOBILITY GOAL STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8979
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,000.00
HC MOBILITY D/C STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8980
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,100.00
HC BODY POS CURRENT STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8981
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,200.00
HC BODY POS GOAL STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8982
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,300.00
HC BODY POS D/C STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8983
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,400.00
HC CARRY CURRENT STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8984
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,500.00
HC CARRY GOAL STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8985
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,600.00
HC CARRY D/C STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8986
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,700.00
HC SELF CARE CURRENT STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8987
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,800.00
HC SELF CARE GOAL STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8988
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,898,900.00
HC SELF CARE D/C STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8989
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,899,000.00
HC OTHER PT/OT CURRENT STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8990
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,899,100.00
HC OTHER PT/OT GOAL STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8991
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,899,200.00
HC OTHER PT/OT D/C STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8992
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,899,300.00
HC SUB PT/OT CURRENT STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8993
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,899,400.00
HC SUB PT/OT GOAL STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8994
WCH HB DEFAULT FEE SCHEDULE
0.01
4,200,899,500.00
HC SUB PT/OT D/C STATUS
PHYSICAL THERAPY-GENERAL [0420]
G8995
WCH HB DEFAULT FEE SCHEDULE
0.01
4,209,701,200.00
APPL MODALITY 1/> AREAS TRACTION MECHANICAL
PHYSICAL THERAPY-GENERAL [0420]
97012
WCH HB DEFAULT FEE SCHEDULE
54.00
4,209,701,400.00
APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED
PHYSICAL THERAPY-GENERAL [0420]
97014
WCH HB DEFAULT FEE SCHEDULE
50.00
4,209,701,800.00
APPL MODALITY 1/> AREAS PARAFFIN BATH
PHYSICAL THERAPY-GENERAL [0420]
97018
WCH HB DEFAULT FEE SCHEDULE
54.00
4,209,702,600.00
APPLICATION MODALITY 1/> AREAS INFRARED
PHYSICAL THERAPY-GENERAL [0420]
97026
WCH HB DEFAULT FEE SCHEDULE
51.00
4,209,703,200.00
APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
97032
WCH HB DEFAULT FEE SCHEDULE
61.00
4,209,703,300.00
APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
97033
WCH HB DEFAULT FEE SCHEDULE
87.00
4,209,703,500.00
APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
97035
WCH HB DEFAULT FEE SCHEDULE
73.00
4,209,711,600.00
PT GAIT TRAINING BIRTH TO 3
PHYSICAL THERAPY-GENERAL [0420]
97116
WCH HB DEFAULT FEE SCHEDULE
92.00
4,209,712,400.00
THER PX 1/> AREAS EACH 15 MINUTES MASSAGE
PHYSICAL THERAPY-GENERAL [0420]
97124
WCH HB DEFAULT FEE SCHEDULE
54.00
4,209,714,000.00
MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES
PHYSICAL THERAPY-GENERAL [0420]
97140
WCH HB DEFAULT FEE SCHEDULE
107.00
4,209,753,000.00
THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
97530
WCH HB DEFAULT FEE SCHEDULE
87.00
4,209,753,500.00
SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
PHYSICAL THERAPY-GENERAL [0420]
97535
WCH HB DEFAULT FEE SCHEDULE
90.00
4,209,754,200.00
WHEELCHAIR MGMT EA 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
97542
WCH HB DEFAULT FEE SCHEDULE
55.00
4,209,775,000.00
PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN
PHYSICAL THERAPY-GENERAL [0420]
97750
WCH HB DEFAULT FEE SCHEDULE
89.00
4,209,776,000.00
ORTHOTIC MGMT&TRAINJ UXTR LXTR&/TRNK EA 15
PHYSICAL THERAPY-GENERAL [0420]
97760
WCH HB DEFAULT FEE SCHEDULE
163.00
4,209,776,100.00
PROSTHETIC TRAINING UPPR&/LOWER EXTREM EA 15 M
PHYSICAL THERAPY-GENERAL [0420]
97761
WCH HB DEFAULT FEE SCHEDULE
151.00
4,219,599,200.00
CANALITH REPOSITIONING PROCEDURE
PHYSICAL THERAPY-VISIT CHARGE [0421]
95992
WCH HB DEFAULT FEE SCHEDULE
122.00
4,219,711,000.00
THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
PHYSICAL THERAPY-VISIT CHARGE [0421]
97110
WCH HB DEFAULT FEE SCHEDULE
105.00
4,219,711,200.00
THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
PHYSICAL THERAPY-VISIT CHARGE [0421]
97112
WCH HB DEFAULT FEE SCHEDULE
101.00
4,219,711,300.00
THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS
PHYSICAL THERAPY-VISIT CHARGE [0421]
97113
WCH HB DEFAULT FEE SCHEDULE
116.00
4,219,711,600.00
THER PX 1/> AREAS EA 15 MIN GAIT TRAINJ W/STAIR
PHYSICAL THERAPY-VISIT CHARGE [0421]
97116
WCH HB DEFAULT FEE SCHEDULE
92.00
4,239,715,000.00
THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
PHYSICAL THERAPY-GROUP RATE [0423]
97150
WCH HB DEFAULT FEE SCHEDULE
105.00
4,249,716,100.00
PT EVAL VISIT LOW COMPLEXITY
PHYSICAL THERAPY-EVALUATION OR REEVALUATION [0424]
97161
WCH HB DEFAULT FEE SCHEDULE
212.00
4,249,716,200.00
PT EVAL VISIT MODERATE COMPLEX
PHYSICAL THERAPY-EVALUATION OR REEVALUATION [0424]
97162
WCH HB DEFAULT FEE SCHEDULE
239.00
4,249,716,300.00
PT EVAL VISIT HIGH COMPLEXITY
PHYSICAL THERAPY-EVALUATION OR REEVALUATION [0424]
97163
WCH HB DEFAULT FEE SCHEDULE
264.00
4,249,716,400.00
PT REEVAL
PHYSICAL THERAPY-EVALUATION OR REEVALUATION [0424]
97164
WCH HB DEFAULT FEE SCHEDULE
120.00
4,300,897,800.00
HC MOBILITY CURRENT STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8978
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,897,900.00
HC MOBILITY GOAL STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8979
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,000.00
HC MOBILITY D/C STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8980
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,100.00
HC BODY POS CURRENT STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8981
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,200.00
HC BODY POS GOAL STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8982
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,300.00
HC BODY POS D/C STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8983
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,400.00
HC CARRY CURRENT STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8984
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,500.00
HC CARRY GOAL STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8985
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,600.00
HC CARRY D/C STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8986
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,700.00
HC SELF CARE CURRENT STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8987
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,800.00
HC SELF CARE GOAL STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8988
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,898,900.00
HC SELF CARE D/C STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8989
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,899,000.00
HC OTHER PT/OT CURRENT STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8990
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,899,100.00
HC OTHER PT/OT GOAL STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8991
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,899,200.00
HC OTHER PT/OT D/C STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8992
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,899,300.00
HC SUB PT/OT CURRENT STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8993
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,899,400.00
HC SUB PT/OT GOAL STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8994
WCH HB DEFAULT FEE SCHEDULE
0.01
4,300,899,500.00
HC SUB PT/OT D/C STATUS
OCCUPATIONAL THERAPY-GENERAL [0430]
G8995
WCH HB DEFAULT FEE SCHEDULE
0.01
4,309,701,400.00
APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED
OCCUPATIONAL THERAPY-GENERAL [0430]
97014
WCH HB DEFAULT FEE SCHEDULE
46.00
4,309,701,800.00
APPL MODALITY 1/> AREAS PARAFFIN BATH
OCCUPATIONAL THERAPY-GENERAL [0430]
97018
WCH HB DEFAULT FEE SCHEDULE
54.00
4,309,703,200.00
APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97032
WCH HB DEFAULT FEE SCHEDULE
61.00
4,309,703,300.00
APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97033
WCH HB DEFAULT FEE SCHEDULE
87.00
4,309,703,500.00
APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97035
WCH HB DEFAULT FEE SCHEDULE
73.00
4,309,712,700.00
HC THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION
OCCUPATIONAL THERAPY-GENERAL [0430]
97127
WCH HB DEFAULT FEE SCHEDULE
79.00
4,309,712,900.00
THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES
OCCUPATIONAL THERAPY-GENERAL [0430]
97129
WCH HB DEFAULT FEE SCHEDULE
115.00
4,309,714,000.00
MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES
OCCUPATIONAL THERAPY-GENERAL [0430]
97140
WCH HB DEFAULT FEE SCHEDULE
107.00
4,309,753,000.00
THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97530
WCH HB DEFAULT FEE SCHEDULE
87.00
4,309,753,200.00
DEVELOPMENT OF COGNITIVE SKILLS EACH 15 MINUTES
OCCUPATIONAL THERAPY-GENERAL [0430]
97532
WCH HB DEFAULT FEE SCHEDULE
79.00
4,309,753,300.00
SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES
OCCUPATIONAL THERAPY-GENERAL [0430]
97533
WCH HB DEFAULT FEE SCHEDULE
87.00
4,309,753,500.00
SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
OCCUPATIONAL THERAPY-GENERAL [0430]
97535
WCH HB DEFAULT FEE SCHEDULE
90.00
4,309,754,200.00
WHEELCHAIR MGMT EA 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97542
WCH HB DEFAULT FEE SCHEDULE
55.00
4,309,775,000.00
PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97750
WCH HB DEFAULT FEE SCHEDULE
89.00
4,309,776,000.00
ORTHOTIC MGMT&TRAINJ UXTR LXTR&/TRNK EA 15
OCCUPATIONAL THERAPY-GENERAL [0430]
97760
WCH HB DEFAULT FEE SCHEDULE
163.00
4,309,776,100.00
PROSTHETIC TRAINING UPPR&/LOWER EXTREM EA 15 M
OCCUPATIONAL THERAPY-GENERAL [0430]
97761
WCH HB DEFAULT FEE SCHEDULE
151.00
4,309,776,300.00
ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN
OCCUPATIONAL THERAPY-GENERAL [0430]
97763
WCH HB DEFAULT FEE SCHEDULE
138.00
4,319,711,000.00
THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
OCCUPATIONAL THERAPY-VISIT CHARGE [0431]
97110
WCH HB DEFAULT FEE SCHEDULE
105.00
4,319,711,200.00
THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
OCCUPATIONAL THERAPY-VISIT CHARGE [0431]
97112
WCH HB DEFAULT FEE SCHEDULE
101.00
4,319,711,300.00
THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS
OCCUPATIONAL THERAPY-VISIT CHARGE [0431]
97113
WCH HB DEFAULT FEE SCHEDULE
116.00
4,339,715,000.00
THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
OCCUPATIONAL THERAPY-GROUP RATE [0433]
97150
WCH HB DEFAULT FEE SCHEDULE
105.00
4,349,716,500.00
OT EVAL LOW COMPLEXITY
OCCUPATIONAL THERAPY-EVALUATION OR REEVALUATION [0434]
97165
WCH HB DEFAULT FEE SCHEDULE
212.00
4,349,716,600.00
OT EVAL MODERATE COMPLEXITY
OCCUPATIONAL THERAPY-EVALUATION OR REEVALUATION [0434]
97166
WCH HB DEFAULT FEE SCHEDULE
239.00
4,349,716,700.00
OT EVAL HIGH COMPLEXITY
OCCUPATIONAL THERAPY-EVALUATION OR REEVALUATION [0434]
97167
WCH HB DEFAULT FEE SCHEDULE
264.00
4,349,716,800.00
OT REEVAL
OCCUPATIONAL THERAPY-EVALUATION OR REEVALUATION [0434]
97168
WCH HB DEFAULT FEE SCHEDULE
120.00
4,400,899,600.00
HC SWALLOW CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G8996
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,899,700.00
HC SWALLOW GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G8997
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,899,800.00
HC SWALLOW D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G8998
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,899,900.00
HC MOTOR SPEECH CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G8999
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,915,800.00
HC MOTOR SPEECH D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9158
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,915,900.00
HC LANG COMP CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9159
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,000.00
HC LANG COMP GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9160
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,100.00
HC LANG COMP D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9161
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,200.00
HC LANG EXPRESS CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9162
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,300.00
HC LANG EXPRESS GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9163
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,400.00
HC LANG EXPRESS D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9164
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,500.00
HC ATTEN CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9165
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,600.00
HC ATTEN GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9166
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,700.00
HC ATTEN D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9167
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,800.00
HC MEMORY CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9168
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,916,900.00
HC MEMORY GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9169
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,917,000.00
HC MEMORY D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9170
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,917,100.00
HC VOICE CURRENT STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9171
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,917,200.00
HC VOICE GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9172
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,917,300.00
HC VOICE D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9173
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,917,500.00
SPEECH LANG GOAL STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9175
WCH HB DEFAULT FEE SCHEDULE
0.01
4,400,917,600.00
SPEECH LANG D/C STATUS
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
G9176
WCH HB DEFAULT FEE SCHEDULE
0.01
4,409,250,700.00
TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
92507
WCH HB DEFAULT FEE SCHEDULE
194.00
4,409,252,600.00
TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
92526
WCH HB DEFAULT FEE SCHEDULE
270.00
4,409,260,900.00
THER SP-GENRATJ DEV PRGRMG&MODIFICAJ
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
92609
WCH HB DEFAULT FEE SCHEDULE
264.00
4,409,712,700.00
HC THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION
SPEECH THERAPY-LANGUAGE PATHOLOGY-GENERAL [0440]
97127
WCH HB DEFAULT FEE SCHEDULE
79.00
4,419,252,400.00
BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
SPEECH THERAPY-LANGUAGE PATHOLOGY-VISIT CHARGE [0441]
92524
WCH HB DEFAULT FEE SCHEDULE
372.00
4,449,252,100.00
EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
92521
WCH HB DEFAULT FEE SCHEDULE
440.00
4,449,252,200.00
EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
92522
WCH HB DEFAULT FEE SCHEDULE
356.00
4,449,252,300.00
EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
92523
WCH HB DEFAULT FEE SCHEDULE
741.00
4,449,260,700.00
RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
92607
WCH HB DEFAULT FEE SCHEDULE
512.00
4,449,261,000.00
EVAL ORAL&PHARYNGEAL SWLNG FUNCJ
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
92610
WCH HB DEFAULT FEE SCHEDULE
581.00
4,449,610,500.00
ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
96105
WCH HB DEFAULT FEE SCHEDULE
294.00
4,449,612,500.00
STANDARDIZED COGNITIVE PERFORMANCE TESTING
SPEECH THERAPY-LANGUAGE PATHOLOGY-EVALUATION OR REEVALUATION [0444]
96125
WCH HB DEFAULT FEE SCHEDULE
416.00
4,505,000,001.00
Hc/hh Wch Supp Needle Aspiration 16ga__8881245164
EMERGENCY ROOM-GENERAL [0450]
WCH HB SUPPLY FEE SCHEDULE
18.00
4,505,000,002.00
Hc/hh Wch Supp Iv Cath 22ga__4252519-02
EMERGENCY ROOM-GENERAL [0450]
WCH HB SUPPLY FEE SCHEDULE
11.00
4,509,928,100.00
EMERGENCY DEPARTMENT VISIT LEVEL 1 LIMITED/MINOR PROB
EMERGENCY ROOM-GENERAL [0450]
99281
WCH HB DEFAULT FEE SCHEDULE
338.00
4,509,928,200.00
EMERGENCY DEPARTMENT VISIT LEVEL 2 LOW/MODER SEVERITY
EMERGENCY ROOM-GENERAL [0450]
99282
WCH HB DEFAULT FEE SCHEDULE
457.00
4,509,928,300.00
EMERGENCY DEPARTMENT VISIT LEVEL 3 MODERATE SEVERITY
EMERGENCY ROOM-GENERAL [0450]
99283
WCH HB DEFAULT FEE SCHEDULE
688.00
4,509,928,400.00
EMERGENCY DEPARTMENT VISIT LEVEL 4 HIGH/URGENT SEVERITY
EMERGENCY ROOM-GENERAL [0450]
99284
WCH HB DEFAULT FEE SCHEDULE
1,027.00
4,509,928,500.00
EMERGENCY DEPT VISIT LEVEL 5 HIGH SEVERITY&THREAT FUNCJ
EMERGENCY ROOM-GENERAL [0450]
99285
WCH HB DEFAULT FEE SCHEDULE
1,531.00
4,509,929,100.00
CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
EMERGENCY ROOM-GENERAL [0450]
99291
WCH HB DEFAULT FEE SCHEDULE
2,000.00
4,609,401,000.00
SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ
PULMONARY FUNCTION-GENERAL [0460]
94010
WCH HB DEFAULT FEE SCHEDULE
134.00
4,609,476,000.00
NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER
PULMONARY FUNCTION-GENERAL [0460]
94760
WCH HB DEFAULT FEE SCHEDULE
55.00
4,609,476,200.00
NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR
PULMONARY FUNCTION-GENERAL [0460]
94762
WCH HB DEFAULT FEE SCHEDULE
428.00
4,809,295,000.00
CARDIOPULMONARY RESUSCITATION
CARDIOLOGY-GENERAL [0480]
92950
WCH HB DEFAULT FEE SCHEDULE
286.00
4,809,295,001.00
CARDIOPULMONARY RESUSCITATION 1-10 MINUTES
CARDIOLOGY-GENERAL [0480]
92950
WCH HB DEFAULT FEE SCHEDULE
1,535.00
4,829,301,700.00
CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY
CARDIOLOGY-STRESS TEST [0482]
93017
WCH HB DEFAULT FEE SCHEDULE
477.00
4,839,330,600.00
ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
CARDIOLOGY-ECHOCARDIOLOGY [0483]
93306
WCH HB DEFAULT FEE SCHEDULE
2,478.00
4,839,330,800.00
ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD
CARDIOLOGY-ECHOCARDIOLOGY [0483]
93308
WCH HB DEFAULT FEE SCHEDULE
666.00
4,839,332,000.00
DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY
CARDIOLOGY-ECHOCARDIOLOGY [0483]
93320
WCH HB DEFAULT FEE SCHEDULE
584.00
4,839,332,100.00
DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD
CARDIOLOGY-ECHOCARDIOLOGY [0483]
93321
WCH HB DEFAULT FEE SCHEDULE
369.00
4,839,332,500.00
DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY MAPPING
CARDIOLOGY-ECHOCARDIOLOGY [0483]
93325
WCH HB DEFAULT FEE SCHEDULE
649.00
5,109,420,000.00
LUNG FUNCTION TEST (MBC/MVV)
CLINIC-GENERAL CLASSIFICATION [0510]
94200
WCH HB DEFAULT FEE SCHEDULE
88.00
5,109,759,700.00
DEBRIDEMENT OPEN WOUND 20 SQ CM/<
OPERATING ROOM SERVICES-GENERAL [0360]
97597
WCH HB DEFAULT FEE SCHEDULE
234.00
5,109,759,800.00
DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM
OPERATING ROOM SERVICES-GENERAL [0360]
97598
WCH HB DEFAULT FEE SCHEDULE
295.00
5,109,760,200.00
RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS
OPERATING ROOM SERVICES-GENERAL [0360]
97602
WCH HB DEFAULT FEE SCHEDULE
153.00
5,109,760,500.00
NEGATIVE PRESSURE WOUND THERAPY DME
OPERATING ROOM SERVICES-GENERAL [0360]
97605
WCH HB DEFAULT FEE SCHEDULE
161.00
5,109,760,600.00
NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
OPERATING ROOM SERVICES-GENERAL [0360]
97606
WCH HB DEFAULT FEE SCHEDULE
278.00
5,109,920,100.00
LEVEL 1 OFFICE OUTPATIENT NEW 10 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99201
WCH HB DEFAULT FEE SCHEDULE
104.00
5,109,920,200.00
LEVEL 2 OFFICE OUTPATIENT NEW 20 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99202
WCH HB DEFAULT FEE SCHEDULE
182.00
5,109,921,100.00
OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP
CLINIC-GENERAL CLASSIFICATION [0510]
99211
WCH HB DEFAULT FEE SCHEDULE
98.00
5,109,921,200.00
LEVEL 2 OFFICE OUTPATIENT ESTABLISHED VISIT 10 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99212
WCH HB DEFAULT FEE SCHEDULE
140.00
5,109,921,300.00
LEVEL 3 OFFICE OUTPATIENT ESTABLISHED VISIT 15 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99213
WCH HB DEFAULT FEE SCHEDULE
180.00
5,109,921,400.00
LEVEL 4 OFFICE OUTPATIENT ESTABLISHED VISIT 25 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99214
WCH HB DEFAULT FEE SCHEDULE
258.00
5,109,921,500.00
LEVEL 5 OFFICE OUTPATIENT ESTABLISHED VISIT 40 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99215
WCH HB DEFAULT FEE SCHEDULE
414.00
5,109,940,600.00
TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99406
WCH HB DEFAULT FEE SCHEDULE
59.00
5,109,940,700.00
TOBACCO USE CESSATION INTENSIVE >10 MINUTES
CLINIC-GENERAL CLASSIFICATION [0510]
99407
WCH HB DEFAULT FEE SCHEDULE
117.00
6,107,155,000.00
MRI CHEST W/O CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
71550
WCH HB DEFAULT FEE SCHEDULE
2,519.00
6,107,155,200.00
MRI CHEST W/O & W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
71552
WCH HB DEFAULT FEE SCHEDULE
3,850.00
6,107,322,000.00
MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
73220
WCH HB DEFAULT FEE SCHEDULE
3,465.00
6,107,322,100.00
MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
73221
WCH HB DEFAULT FEE SCHEDULE
2,200.00
6,107,371,800.00
MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
73718
WCH HB DEFAULT FEE SCHEDULE
2,255.00
6,107,372,000.00
MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
73720
WCH HB DEFAULT FEE SCHEDULE
3,465.00
6,107,372,100.00
MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
73721
WCH HB DEFAULT FEE SCHEDULE
2,200.00
6,107,372,300.00
MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
73723
WCH HB DEFAULT FEE SCHEDULE
3,300.00
6,107,418,100.00
MRI ABDOMEN W/O CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
74181
WCH HB DEFAULT FEE SCHEDULE
2,200.00
6,107,418,200.00
MRI ABDOMEN W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
74182
WCH HB DEFAULT FEE SCHEDULE
2,750.00
6,107,418,300.00
MRI ABDOMEN W/O & W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-GENERAL [0610]
74183
WCH HB DEFAULT FEE SCHEDULE
3,520.00
6,117,054,000.00
MRI ORBIT FACE &/NECK W/O CONTRAST
MAGNETIC RESONANCE TECHNOLOGY-MRI-BRAIN/BRAIN STEM [0611]
70540
WCH HB DEFAULT FEE SCHEDULE
2,310.00
6,117,054,300.00
MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-BRAIN/BRAIN STEM [0611]
70543
WCH HB DEFAULT FEE SCHEDULE
3,410.00
6,117,055,100.00
MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-BRAIN/BRAIN STEM [0611]
70551
WCH HB DEFAULT FEE SCHEDULE
2,310.00
6,117,055,200.00
MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-BRAIN/BRAIN STEM [0611]
70552
WCH HB DEFAULT FEE SCHEDULE
2,310.00
6,117,055,300.00
MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-BRAIN/BRAIN STEM [0611]
70553
WCH HB DEFAULT FEE SCHEDULE
3,300.00
6,127,214,100.00
MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72141
WCH HB DEFAULT FEE SCHEDULE
2,200.00
6,127,214,200.00
MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72142
WCH HB DEFAULT FEE SCHEDULE
2,750.00
6,127,214,600.00
MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72146
WCH HB DEFAULT FEE SCHEDULE
2,200.00
6,127,214,700.00
MRI SPINAL CANAL THORACIC W/CONTRAST MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72147
WCH HB DEFAULT FEE SCHEDULE
2,750.00
6,127,214,800.00
MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72148
WCH HB DEFAULT FEE SCHEDULE
2,200.00
6,127,214,900.00
MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72149
WCH HB DEFAULT FEE SCHEDULE
2,530.00
6,127,215,600.00
MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72156
WCH HB DEFAULT FEE SCHEDULE
3,300.00
6,127,215,700.00
MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72157
WCH HB DEFAULT FEE SCHEDULE
3,190.00
6,127,215,800.00
MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL
MAGNETIC RESONANCE TECHNOLOGY-MRI-SPINAL CORD/SPINE [0612]
72158
WCH HB DEFAULT FEE SCHEDULE
3,300.00
6,147,219,500.00
MRI PELVIS W/O CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-OTHER [0614]
72195
WCH HB DEFAULT FEE SCHEDULE
2,310.00
6,147,219,600.00
MRI PELVIS W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-OTHER [0614]
72196
WCH HB DEFAULT FEE SCHEDULE
2,750.00
6,147,219,700.00
MRI PELVIS W/O & W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRI-OTHER [0614]
72197
WCH HB DEFAULT FEE SCHEDULE
3,520.00
6,157,054,400.00
MRA HEAD W/O CONTRST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-HEAD AND NECK [0615]
70544
WCH HB DEFAULT FEE SCHEDULE
2,530.00
6,157,054,500.00
MRA HEAD W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-HEAD AND NECK [0615]
70545
WCH HB DEFAULT FEE SCHEDULE
3,630.00
6,157,054,600.00
MRA HEAD W/O & W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-HEAD AND NECK [0615]
70546
WCH HB DEFAULT FEE SCHEDULE
3,630.00
6,157,054,700.00
MRA NECK W/O CONTRST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-HEAD AND NECK [0615]
70547
WCH HB DEFAULT FEE SCHEDULE
2,530.00
6,157,054,800.00
MRA NECK W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-HEAD AND NECK [0615]
70548
WCH HB DEFAULT FEE SCHEDULE
2,530.00
6,157,054,900.00
MRA NECK W/O &W/CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-HEAD AND NECK [0615]
70549
WCH HB DEFAULT FEE SCHEDULE
3,630.00
6,167,372,500.00
MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-LOWER EXTREMITIES [0616]
73725
WCH HB DEFAULT FEE SCHEDULE
2,640.00
6,187,155,500.00
MRA CHEST W/ CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-OTHER [0618]
71555
WCH HB DEFAULT FEE SCHEDULE
3,300.00
6,187,219,800.00
MRA PELVIS W/ CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-OTHER [0618]
72198
WCH HB DEFAULT FEE SCHEDULE
3,190.00
6,187,418,500.00
MRA ABDOMEN W CONTRAST MATERIAL
MAGNETIC RESONANCE TECHNOLOGY-MRA-OTHER [0618]
74185
WCH HB DEFAULT FEE SCHEDULE
3,190.00
6,840,039,000.00
TRAUMA RESP W ACTIVATION SPRH
TRAUMA RESPONSE-LEVEL IV [0684]
G0390
WCH HB DEFAULT FEE SCHEDULE
1,644.00
7,205,902,500.00
FETAL NONSTRESS TEST
LABOR ROOM/DELIVERY-GENERAL [0720]
59025
WCH HB DEFAULT FEE SCHEDULE
295.00
7,309,300,500.00
ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R
EKG/ECG (ELECTROCARDIOGRAM)-GENERAL [0730]
93005
WCH HB DEFAULT FEE SCHEDULE
131.00
7,319,322,500.00
ECG MONIT/REPRT UP TO 48 HRS
EKG/ECG (ELECTROCARDIOGRAM)-HOLTER MONITOR [0731]
93225
WCH HB DEFAULT FEE SCHEDULE
387.00
7,319,322,600.00
EXTERNAL ECG SCANNING ANALYSIS REPORT
EKG/ECG (ELECTROCARDIOGRAM)-HOLTER MONITOR [0731]
93226
WCH HB DEFAULT FEE SCHEDULE
350.00
7,319,327,000.00
XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS
EKG/ECG (ELECTROCARDIOGRAM)-HOLTER MONITOR [0731]
93270
WCH HB DEFAULT FEE SCHEDULE
210.00
7,504,450,000.00
INTRODUCTION OF LONG GASTROINTESTINAL TUBE
GASTROINTESTINAL (GI) SERVICES-GENERAL [0750]
44500
WCH HB DEFAULT FEE SCHEDULE
237.00
7,620,000,100.00
SSO PER HOUR
SPECIALTY SERVICES-OBSERVATION HOURS [0762]
G0378
WCH HB DEFAULT FEE SCHEDULE
113.10
7,620,000,200.00
SSO INCREASED ACUITY PER HOUR
SPECIALTY SERVICES-OBSERVATION HOURS [0762]
G0378
WCH HB DEFAULT FEE SCHEDULE
133.92
7,620,000,300.00
SSO CARVE OUT
SPECIALTY SERVICES-OBSERVATION HOURS [0762]
G0378
WCH HB DEFAULT FEE SCHEDULE
113.10
7,620,000,400.00
SSO INCREASED ACUITY CARVE OUT
SPECIALTY SERVICES-OBSERVATION HOURS [0762]
G0378
WCH HB DEFAULT FEE SCHEDULE
133.92
7,620,000,500.00
SSO DIRECT ADMIT
SPECIALTY SERVICES-OBSERVATION HOURS [0762]
G0379
WCH HB DEFAULT FEE SCHEDULE
420.00
7,719,047,100.00
IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90471
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,101.00
ADMINISTRATION OF INFLUENZA VIRUS VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90471
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,102.00
ADMINISTRATION OF PNEUMOCOCCAL VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90471
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,103.00
ADMINISTRATION OF HEPATITIS B VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90471
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,200.00
IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90472
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,201.00
SUBSEQUENT ADMINISTRATION OF INFLUENZA VIRUS VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90472
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,202.00
SUBSEQUENT ADMINISTRATION OF PNEUMOCOCCAL VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90472
WCH HB DEFAULT FEE SCHEDULE
63.00
7,719,047,203.00
SUBSEQUENT ADMINISTRATION OF HEPATITIS B VACCINE
PREVENTIVE CARE SERVICES-VACCINE ADMINISTRATION [0771]
90472
WCH HB DEFAULT FEE SCHEDULE
63.00
9,209,580,500.00
MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG
OTHER DIAGNOSTIC SERVICES-GENERAL [0920]
95805
WCH HB DEFAULT FEE SCHEDULE
2,997.00
9,209,581,000.00
POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
OTHER DIAGNOSTIC SERVICES-GENERAL [0920]
95810
WCH HB DEFAULT FEE SCHEDULE
3,354.00
9,209,581,100.00
POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND
OTHER DIAGNOSTIC SERVICES-GENERAL [0920]
95811
WCH HB DEFAULT FEE SCHEDULE
3,787.00
9,219,388,000.00
DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93880
WCH HB DEFAULT FEE SCHEDULE
1,404.00
9,219,388,200.00
DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93882
WCH HB DEFAULT FEE SCHEDULE
450.00
9,219,392,200.00
NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93922
WCH HB DEFAULT FEE SCHEDULE
300.00
9,219,392,500.00
DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93925
WCH HB DEFAULT FEE SCHEDULE
1,188.00
9,219,392,600.00
DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93926
WCH HB DEFAULT FEE SCHEDULE
723.00
9,219,393,000.00
DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93930
WCH HB DEFAULT FEE SCHEDULE
1,038.00
9,219,393,100.00
DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93931
WCH HB DEFAULT FEE SCHEDULE
627.00
9,219,397,000.00
DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93970
WCH HB DEFAULT FEE SCHEDULE
1,392.00
9,219,397,100.00
DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93971
WCH HB DEFAULT FEE SCHEDULE
1,022.00
9,219,397,500.00
DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93975
WCH HB DEFAULT FEE SCHEDULE
1,714.00
9,219,397,600.00
DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93976
WCH HB DEFAULT FEE SCHEDULE
1,029.00
9,219,397,800.00
DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
OTHER DIAGNOSTIC SERVICES-PERIPHERAL VASCULAR LAB [0921]
93978
WCH HB DEFAULT FEE SCHEDULE
1,096.00
9,409,652,300.00
IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST
OTHER THERAPEUTIC SERVICES (SEE ALSO 095X, AN EXTENSION OF 094X)-GENERAL [0940]
96523
WCH HB DEFAULT FEE SCHEDULE
135.00
9,409,919,500.00
PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE
OTHER THERAPEUTIC SERVICES (SEE ALSO 095X, AN EXTENSION OF 094X)-GENERAL [0940]
99195
WCH HB PB LAB FEE SCHEDULE
171.00
9,429,896,000.00
EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT
OTHER THERAPEUTIC SERVICES (SEE ALSO 095X, AN EXTENSION OF 094X)-EDUCATION/TRAINING [0942]
98960
WCH HB DEFAULT FEE SCHEDULE
97.00
9,430,000,100.00
Hc Wch Cardiac Wellness Maintenance
OTHER THERAPEUTIC SERVICES (SEE ALSO 095X, AN EXTENSION OF 094X)-CARDIAC REHABILITATION [0943]
WCH HB DEFAULT FEE SCHEDULE
7.00
9,439,379,700.00
OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR
OTHER THERAPEUTIC SERVICES (SEE ALSO 095X, AN EXTENSION OF 094X)-CARDIAC REHABILITATION [0943]
93797
WCH HB DEFAULT FEE SCHEDULE
238.00
9,439,379,800.00
OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING
OTHER THERAPEUTIC SERVICES (SEE ALSO 095X, AN EXTENSION OF 094X)-CARDIAC REHABILITATION [0943]
93798
WCH HB DEFAULT FEE SCHEDULE
238.00
9,831,200,100.00
PRO SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12001
WCH HB DEFAULT FEE SCHEDULE
629.00
9,831,200,200.00
PRO SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12002
WCH HB DEFAULT FEE SCHEDULE
761.00
9,831,200,400.00
PRO SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12004
WCH HB DEFAULT FEE SCHEDULE
857.00
9,831,201,100.00
PRO SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12011
WCH HB DEFAULT FEE SCHEDULE
761.00
9,831,201,500.00
PRO SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12015
WCH HB DEFAULT FEE SCHEDULE
923.00
9,831,203,100.00
PRO REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12031
WCH HB DEFAULT FEE SCHEDULE
562.00
9,831,203,200.00
PRO REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12032
WCH HB DEFAULT FEE SCHEDULE
824.00
9,831,204,200.00
PRO REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
12042
WCH HB DEFAULT FEE SCHEDULE
741.00
9,831,312,100.00
PRO REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
13121
WCH HB DEFAULT FEE SCHEDULE
1,906.00
9,832,060,000.00
PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
20600
WCH HB DEFAULT FEE SCHEDULE
165.00
9,832,061,000.00
PRO ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
20610
WCH HB DEFAULT FEE SCHEDULE
255.00
9,832,365,000.00
PRO CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
23650
WCH HB DEFAULT FEE SCHEDULE
1,836.00
9,832,556,500.00
PRO CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
25565
WCH HB DEFAULT FEE SCHEDULE
2,603.00
9,832,560,000.00
PRO CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
25600
WCH HB DEFAULT FEE SCHEDULE
1,489.00
9,832,677,000.00
PRO CLTX IPHAL JT DISLC W/MANJ W/O ANES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
26770
WCH HB DEFAULT FEE SCHEDULE
1,521.00
9,832,910,500.00
PRO APPLICATION LONG ARM SPLINT SHOULDER HAND
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
29105
WCH HB DEFAULT FEE SCHEDULE
341.00
9,832,912,500.00
PRO APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
29125
WCH HB DEFAULT FEE SCHEDULE
293.00
9,832,958,100.00
PRO APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
29581
WCH HB DEFAULT FEE SCHEDULE
319.00
9,833,090,100.00
PRO CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
30901
WCH HB DEFAULT FEE SCHEDULE
408.00
9,833,150,000.00
PRO INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
31500
WCH HB DEFAULT FEE SCHEDULE
916.00
9,833,255,100.00
PRO TUBE THORACOSTOMY INCLUDES WATER SEAL
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
32551
WCH HB DEFAULT FEE SCHEDULE
1,075.00
9,833,600,000.00
PRO INTRODUCTION NEEDLE/INTRACATHETER VEIN
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
36000
WCH HB DEFAULT FEE SCHEDULE
391.00
9,834,908,200.00
PRO ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
49082
WCH HB DEFAULT FEE SCHEDULE
650.00
9,836,920,000.00
PRO RMVL FB XTRNL AUDITORY CANAL W/O ANES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
69200
WCH HB DEFAULT FEE SCHEDULE
462.00
9,839,296,000.00
PRO CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
92960
WCH HB DEFAULT FEE SCHEDULE
840.00
9,839,301,000.00
PRO ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
93010
WCH HB DEFAULT FEE SCHEDULE
51.00
9,839,322,500.00
PRO ECG MONIT/REPRT UP TO 48 HRS
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
93225
WCH HB DEFAULT FEE SCHEDULE
387.00
9,839,332,500.00
PRO DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY MAPPING
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
93325
WCH HB DEFAULT FEE SCHEDULE
590.00
9,839,905,000.00
PRO SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99050
WCH HB PB LAB FEE SCHEDULE
180.00
9,839,921,700.00
PRO OBSERVATION CARE DISCHARGE MANAGEMENT
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99217
WCH HB DEFAULT FEE SCHEDULE
244.00
9,839,921,800.00
PRO INITIAL OBSERVATION CARE/DAY 30 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99218
WCH HB DEFAULT FEE SCHEDULE
303.00
9,839,921,900.00
PRO INITIAL OBSERVATION CARE/DAY 50 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99219
WCH HB DEFAULT FEE SCHEDULE
419.00
9,839,922,000.00
PRO INITIAL OBSERVATION CARE/DAY 70 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99220
WCH HB DEFAULT FEE SCHEDULE
518.00
9,839,922,500.00
PRO SBSQ OBSERVATION CARE/DAY 25 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99225
WCH HB DEFAULT FEE SCHEDULE
193.00
9,839,923,200.00
PRO SBSQ HOSPITAL CARE/DAY 25 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99232
WCH HB DEFAULT FEE SCHEDULE
224.00
9,839,923,300.00
PRO SBSQ HOSPITAL CARE/DAY 35 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99233
WCH HB DEFAULT FEE SCHEDULE
306.00
9,839,923,400.00
PRO OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99234
WCH HB DEFAULT FEE SCHEDULE
421.00
9,839,923,600.00
PRO OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99236
WCH HB DEFAULT FEE SCHEDULE
2,234.00
9,839,923,800.00
PRO HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99238
WCH HB DEFAULT FEE SCHEDULE
253.00
9,839,923,900.00
PRO HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99239
WCH HB DEFAULT FEE SCHEDULE
316.00
9,839,928,100.00
PRO EMERGENCY DEPARTMENT VISIT LEVEL 1 LIMITED/MINOR PROB
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99281
WCH HB DEFAULT FEE SCHEDULE
338.00
9,839,928,200.00
PRO EMERGENCY DEPARTMENT VISIT LEVEL 2 LOW/MODER SEVERITY
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99282
WCH HB DEFAULT FEE SCHEDULE
457.00
9,839,928,300.00
PRO EMERGENCY DEPARTMENT VISIT LEVEL 3 MODERATE SEVERITY
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99283
WCH HB DEFAULT FEE SCHEDULE
688.00
9,839,928,400.00
PRO EMERGENCY DEPARTMENT VISIT LEVEL 4 HIGH/URGENT SEVERITY
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99284
WCH HB DEFAULT FEE SCHEDULE
1,027.00
9,839,928,500.00
PRO EMERGENCY DEPT VISIT LEVEL 5 HIGH SEVERITY&THREAT FUNCJ
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99285
WCH HB DEFAULT FEE SCHEDULE
1,531.00
9,839,929,100.00
PRO CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99291
WCH HB DEFAULT FEE SCHEDULE
2,000.00
9,839,929,200.00
PRO CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
PROFESSIONAL FEES (EXTENSION OF 096X AND 097X)-CLINIC [0983]
99292
WCH HB DEFAULT FEE SCHEDULE
736.00
Px Code Generic Name CPT(R)/HCPCS Code NDC Unit Price Override Bill Code Override Price
2,500,000,200.00
lidocaine 1 %-epinephrine 1:100,000 injection solution
63,323,048,226.00
7.52
2,500,000,200.00
bupivacaine-epinephrine (PF) 0.5 %-1:200,000 injection solution
409,904,501.00
8.00
2,500,000,200.00
bupivacaine (PF) 0.5 % (5 mg/mL) injection solution
63,323,046,631.00
29.41
2,500,000,200.00
bupivacaine (PF) 0.5 % (5 mg/mL) injection solution
409,116,219.00
7.45
2,500,000,200.00
balanced salt solution non-surgical no.3 eye wash
65,053,001.00
107.34
2,500,000,200.00
sodium chloride 0.9 % irrigation solution
264,220,100.00
61.30
2,500,000,200.00
sodium chloride 0.9 % irrigation solution
338,004,802.00
84.00
2,500,000,200.00
tranexamic acid 1,000 mg/10 mL (100 mg/mL) intravenous solution
23,155,052,431.00
58.84
2,500,000,200.00
water for injection, sterile injection solution
409,488,750.00
60.65
2,500,000,200.00
water for injection, sterile injection solution
409,488,723.00
59.60
2,500,000,200.00
zidovudine 100 mg capsule
65,862,010,701.00
7.14
2,500,000,200.00
lidocaine HCL 2 % mucosal solution
50,383,077,515.00
6.52
2,500,000,200.00
lidocaine HCL 2 % mucosal solution
50,383,077,504.00
7.27
2,500,000,200.00
bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution
55,150,016,710.00
7.70
2,500,000,200.00
bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution
55,150,016,830.00
7.75
2,500,000,200.00
dexmedeTOMIDine 100 mcg/mL intravenous solution
J1555
44,567,060,104.00
395.23
2,500,000,200.00
dextrose 50 % in water (D50W) intravenous syringe
409,751,716.00
73.70
2,500,000,200.00
dextrose 50 % in water (D50W) intravenous syringe
76,329,330,101.00
83.25
2,500,000,200.00
niCARdipine 25 mg/10 mL intravenous solution
143,968,910.00
148.02
2,500,000,200.00
norepinephrine bitartrate 1 mg/mL intravenous solution
409,337,504.00
108.73
2,500,000,200.00
norepinephrine bitartrate 1 mg/mL intravenous solution
703,115,303.00
106.52
2,500,000,200.00
norepinephrine bitartrate 1 mg/mL intravenous solution
70,121,157,607.00
106.52
2,500,000,200.00
lidocaine 2 % mucosal jelly in applicator
76,329,301,305.00
61.51
2,500,000,200.00
mvi,adult no.4 with vit K 3300 unit-150 mcg/10 mL intravenous solution
54,643,786,201.00
81.03
2,500,000,200.00
sodium hypochlorite 0.25 % solution
39,328,006,325.00
5.65
2,500,000,200.00
sarilumab 200 mg/1.14 mL subcutaneous syringe
24,591,001.00
4,278.46
2,500,000,200.00
mvi,adult no.4,vit K,comp(vial 1 of 2) 3,300 unit-150 mcg/5 mL IV soln
54,643,786,208.00
70.02
2,500,000,200.00
mvi, adult no.4, vit K (vial 2 of 2) 600 mcg-60 mcg-5 mcg/5 mL IV soln
54,643,786,209.00
70.02
2,500,000,200.00
sodium nitroprusside 25 mg/mL intravenous solution
187,430,202.00
775.00
2,500,000,200.00
sodium nitroprusside 25 mg/mL intravenous solution
67,457,083,902.00
392.00
2,500,000,200.00
benzocaine 20 % mucosal aerosol spray
283,067,902.00
111.86
2,500,000,200.00
cinacalcet 60 mg tablet
55,513,007,430.00
109.39
J0604
2,500,000,200.00
diphenhydrAMINE 25 mg capsule,diphenhydrAMINE 25 mg tablet
904,555,159.00
5.64
2,500,000,200.00
cocaine 4 % topical solution,cocaine 4 % nasal solution
527,196,174.00
195.13
2,500,000,200.00
9,999,999,021.00
15.59
2,500,000,200.00
9,999,999,027.00
14.94
2,500,000,200.00
sodium chloride 0.9 % injection solution
63,323,018,620.00
59.76
2,500,000,200.00
ketamine 10 mg/mL injection solution
42,023,011,310.00
108.28
2,500,000,200.00
ketamine 10 mg/mL injection solution
67,457,018,100.00
107.80
2,500,000,200.00
ketamine 50 mg/mL injection solution
143,950,801.00
70.33
2,500,000,200.00
lidocaine HCL 10 mg/mL (1 %) injection solution
63,323,048,526.00
7.22
2,500,000,200.00
nafcillin 2 gram solution for injection
S0032
63,323,032,820.00
171.67
2,500,000,200.00
phenylephrine 2.5 % eye drops
17,478,020,115.00
321.50
2,500,000,200.00
prochlorperazine maleate 5 mg tablet
378,510,501.00
5.94
2,500,000,200.00
promethazine 25 mg tablet
65,162,052,110.00
5.67
2,500,000,200.00
sodium bicarbonate 8.4 % (1 mEq/mL) intravenous syringe
409,663,734.00
80.85
2,500,000,200.00
sodium bicarbonate 8.4 % (1 mEq/mL) intravenous syringe
76,329,335,201.00
83.50
2,500,000,200.00
sodium chloride 0.9 % (flush) injection syringe
63,807,010,001.00
5.70
2,500,000,200.00
sodium thiosulfate 12.5 gram/50 mL (250 mg/mL) intravenous solution
60,267,070,550.00
369.00
2,500,000,200.00
water for irrigation, sterile solution
338,000,402.00
72.00
2,500,000,200.00
water for irrigation, sterile solution
338,000,404.00
59.80
2,500,000,200.00
verapamiL 2.5 mg/mL intravenous solution
409,114,401.00
59.72
2,500,000,200.00
verapamiL 2.5 mg/mL intravenous solution
409,401,101.00
68.67
2,500,000,200.00
verapamiL 2.5 mg/mL intravenous solution
409,114,402.00
72.84
2,500,000,200.00
rocuronium 10 mg/mL intravenous solution
409,955,810.00
71.59
2,500,000,200.00
dronabinoL 2.5 mg capsule
49,884,086,702.00
23.41
2,500,000,200.00
dronabinoL 2.5 mg capsule
67,877,056,860.00
7.31
6,360,000,200.00
heparin (porcine) 10,000 unit/mL injection solution
J1644
25,021,040,366.00
60.13
6,360,000,200.00
heparin (porcine) 10,000 unit/mL injection solution
J1644
67,457,060,202.00
69.10
6,360,000,200.00
heparin (porcine) 10,000 unit/mL injection solution
J1644
71,288,040,402.00
61.55
6,360,000,200.00
heparin (porcine) 5,000 unit/mL injection solution
J1644
71,288,040,301.00
60.20
6,360,000,200.00
labetaloL 5 mg/mL intravenous solution
J3490
17,478,042,020.00
147.50
6,360,000,200.00
labetaloL 5 mg/mL intravenous solution
J3490
409,226,754.00
72.30
6,360,000,200.00
labetaloL 5 mg/mL intravenous solution
J3490
409,226,720.00
61.86
6,360,000,200.00
pneumococcal 13-val conj vaccine-dip crm (PF) 0.5 mL IM syringe
90670
5,197,105.00
617.74
6,360,000,200.00
lidocaine (PF) 10 mg/mL (1 %) injection solution
J2001
409,471,302.00
7.16
6,360,000,200.00
lidocaine (PF) 10 mg/mL (1 %) injection solution
J2001
63,323,049,257.00
15.39
6,360,000,200.00
lidocaine (PF) 20 mg/mL (2 %) injection solution
J2001
63,323,049,507.00
15.12
6,360,000,200.00
lidocaine (PF) 20 mg/mL (2 %) injection solution
J2001
409,206,610.00
8.08
6,360,000,200.00
measles,mumps,rubella vaccine live(PF)1,000-12,500TCID50/0.5 mL subcut
90707
6,468,100.00
347.06
6,360,000,200.00
mepivacaine (PF) 15 mg/mL (1.5 %) injection solution
J0670
409,104,130.00
70.08
6,360,000,200.00
denosumab 60 mg/mL subcutaneous syringe
J0897
55,513,071,001.00
2,579.24
6,360,000,200.00
methylergonovine 0.2 mg/mL (1 mL) injection solution
J2210
51,991,014,499.00
108.26
6,360,000,200.00
enoxaparin 30 mg/0.3 mL subcutaneous syringe
J1650
955,100,310.00
70.91
6,360,000,200.00
enoxaparin 40 mg/0.4 mL subcutaneous syringe
J1650
955,100,410.00
73.04
6,360,000,200.00
enoxaparin 40 mg/0.4 mL subcutaneous syringe
J1650
75,801,410.00
73.04
6,360,000,200.00
enoxaparin 60 mg/0.6 mL subcutaneous syringe
J1650
955,100,610.00
82.82
6,360,000,200.00
enoxaparin 60 mg/0.6 mL subcutaneous syringe
J1650
75,062,160.00
231.67
6,360,000,200.00
enoxaparin 100 mg/mL subcutaneous syringe
J1650
955,101,010.00
109.87
6,360,000,200.00
diazePAM 5 mg/mL injection syringe
J3360
409,127,332.00
150.04
6,360,000,200.00
ondansetron HCl (PF) 4 mg/2 mL injection solution
J2405
641,607,825.00
60.80
6,360,000,200.00
ondansetron HCl (PF) 4 mg/2 mL injection solution
J2405
23,155,054,842.00
60.80
6,360,000,200.00
ondansetron HCl (PF) 4 mg/2 mL injection solution
J2405
23,155,054,831.00
60.80
6,360,000,200.00
ondansetron HCL 2 mg/mL intravenous solution
J2405
23,155,055,031.00
58.55
6,360,000,200.00
immune glob G 20 gram/200 mL(10%)-gly-IgA ave 46 mcg/mL injection soln
J1561
13,533,080,025.00
5,052.40
6,360,000,200.00
acetaminophen 1,000 mg/100 mL (10 mg/mL) intravenous solution
J0131
43,825,010,201.00
229.40
6,360,000,200.00
penicillin G benzathine 1,200,000 unit/2 mL intramuscular syringe
J0561
60,793,070,102.00
522.16
6,360,000,200.00
filgrastim 480 mcg/1.6 mL injection solution
J1442
55,513,054,601.00
1,151.33
6,360,000,200.00
levoFLOXacin 500 mg/100 mL in 5 % dextrose intravenous piggyback
J1956
25,021,013,267.00
70.50
6,360,000,200.00
levoFLOXacin 750 mg/150 mL in 5 % dextrose intravenous piggyback
J1956
25,021,013,268.00
250.05
6,360,000,200.00
ciprofloxacin 400 mg/200 mL in 5 % dextrose intravenous piggyback
J0744
36,000,000,924.00
61.90
6,360,000,200.00
phytonadione (vitamin K1) 10 mg/mL injection solution
J3430
409,915,801.00
74.20
6,360,000,200.00
phytonadione (vitamin K1) 10 mg/mL injection solution
J3430
43,598,040,511.00
73.05
6,360,000,200.00
phytonadione (vitamin K1) 10 mg/mL injection solution
J3430
43,598,040,516.00
73.05
6,360,000,200.00
ibandronate 3 mg/3 mL intravenous syringe
J1740
60,505,609,700.00
640.00
6,360,000,200.00
pneumococcal 23 polyvalent vaccine 25 mcg/0.5 mL injection solution
90732
6,494,301.00
379.08
6,360,000,200.00
potassium chloride 10 mEq/100mL in sterile water intravenous piggyback
J3480
338,070,948.00
61.90
6,360,000,200.00
propofoL 10 mg/mL intravenous emulsion
J2704
25,021,060,850.00
84.60
6,360,000,200.00
propofoL 10 mg/mL intravenous emulsion
J2704
409,469,954.00
109.90
6,360,000,200.00
propofoL 10 mg/mL intravenous emulsion
J2704
43,598,054,910.00
150.50
6,360,000,200.00
ceFAZolin 2 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback
J0690
264,310,511.00
82.77
6,360,000,200.00
terbutaline 1 mg/mL subcutaneous solution
J3105
143,974,610.00
68.50
6,360,000,200.00
vecuronium bromide 10 mg intravenous solution
J3490
67,457,043,810.00
80.63
6,360,000,200.00
vecuronium bromide 10 mg intravenous solution
J3490
55,150,023,501.00
68.90
6,360,000,200.00
vecuronium bromide 20 mg intravenous solution
J3490
67,457,047,520.00
80.00
6,360,000,200.00
digoxin 250 mcg/mL (0.25 mg/mL) injection solution
J1160
641,141,035.00
70.00
6,360,000,200.00
hydrocortisone sodium succinate 100 mg solution for injection
J1720
9,082,501.00
81.41
6,360,000,200.00
golimumab 12.5 mg/mL intravenous solution
J1602
57,894,035,001.00
4,449.19
6,360,000,200.00
ferric carboxymaltose 50 mg iron/mL intravenous solution
J1439
517,065,001.00
2,434.08
6,360,000,200.00
ferric carboxymaltose 50 mg iron/mL intravenous solution
J1439
517,065,002.00
2,267.97
6,360,000,200.00
acetylcysteine 200 mg/mL (20 %) solution
J7608
63,323,069,030.00
6.30
6,360,000,200.00
adenosine 3 mg/mL intravenous syringe
J0153
25,021,030,167.00
104.50
6,360,000,200.00
pneumococcal 23 polyvalent vaccine 25 mcg/0.5 mL injection syringe
90732
6,483,701.00
364.11
6,360,000,200.00
famotidine (PF) 20 mg/2 mL intravenous solution
J3490
63,323,073,916.00
59.03
S0028
6,360,000,200.00
EPINEPHrine 0.1 mg/mL injection syringe
J0171
409,492,120.00
69.74
6,360,000,200.00
heparin, porcine (PF) 100 unit/mL intravenous syringe
J1642
63,807,060,005.00
59.30
6,360,000,200.00
heparin, porcine (PF) 100 unit/mL intravenous syringe
J1642
64,253,033,335.00
58.88
6,360,000,200.00
vedolizumab 300 mg intravenous solution
J3380
64,764,030,020.00
11,026.63
6,360,000,200.00
testosterone cypionate 200 mg/mL intramuscular oil
J1071
9,052,001.00
69.50
6,360,000,200.00
hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular syringe
90747
58,160,082,152.00
253.11
6,360,000,200.00
hepatitis B virus vaccine recomb (PF) 10 mcg/0.5 mL IM syringe
90740
58,160,082,052.00
147.10
6,360,000,200.00
immune glob G 40 gram/400 mL(10%)-gly-IgA ave 46 mcg/mL injection soln
J1561
13,533,080,040.00
8,954.80
6,360,000,200.00
vasopressin 20 unit/mL intravenous solution
J3490
42,023,016,401.00
612.38
6,360,000,200.00
rho(D) immune globulin 1,500 unit (300 mcg)/2 mL injection syringe
J2791
44,206,030,001.00
510.38
6,360,000,200.00
tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf unit/0.5 mL IM syringe
90714
49,281,021,588.00
173.42
6,360,000,200.00
tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf unit/0.5 mL IM susp
90714
49,281,021,510.00
173.42
6,360,000,200.00
diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe
90715
49,281,040,015.00
201.99
6,360,000,200.00
diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe
90715
49,281,040,020.00
230.23
6,360,000,200.00
diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe
90715
49,281,040,089.00
230.23
6,360,000,200.00
dimethyl sulfoxide 50 % intravesical solution
J1212
67,457,017,750.00
1,518.60
6,360,000,200.00
methylPREDNISolone sod succ (PF) 125 mg/2 mL solution for injection
J2930
9,004,722.00
74.24
6,360,000,200.00
methylPREDNISolone sod succ (PF) 125 mg/2 mL solution for injection
J2930
9,004,704.00
80.17
6,360,000,200.00
methylPREDNISolone sod succ (PF) 500 mg/4 mL intravenous solution
J2930
9,000,302.00
201.00
6,360,000,200.00
methylPREDNISolone sod succ (PF) 1,000 mg/8 mL intravenous solution
J2930
9,001,820.00
251.64
6,360,000,200.00
filgrastim-sndz 300 mcg/0.5 mL injection syringe
Q5101
61,314,031,801.00
674.36
6,360,000,200.00
filgrastim-sndz 480 mcg/0.8 mL injection syringe
Q5101
61,314,032,601.00
1,088.98
6,360,000,200.00
pegfilgrastim 6 mg/0.6 mL subcutaneous syringe
J2505
55,513,019,001.00
10,167.99
6,360,000,200.00
chlorproMAZINE 25 mg/mL injection solution
J3230
641,139,835.00
170.10
6,360,000,200.00
filgrastim 300 mcg/0.5 mL injection syringe
J1442
55,513,092,491.00
808.70
6,360,000,200.00
darbepoetin alfa 25 mcg/0.42 mL in polysorbate injection syringe
J0882
55,513,005,704.00
543.50
J0882
6,360,000,200.00
calcium chloride 100 mg/mL (10 %) intravenous syringe
J3490
409,163,110.00
71.62
6,360,000,200.00
leuprolide 7.5 mg intramuscular syringe kit
J9217
74,364,203.00
4,217.45
6,360,000,200.00
zoledronic acid 4 mg/100 mL in mannitoL 5 %-water intravenous piggybck
J3489
70,860,021,051.00
229.50
6,360,000,200.00
calcium gluconate 100 mg/mL (10 %) intravenous solution
J0610
63,323,036,001.00
69.51
6,360,000,200.00
hum prothrombin cplx (PCC) 4factor 500 unit (400-620 unit) IV solution
J7168
63,833,038,602.00
4,150.00
6,360,000,200.00
hum prothrombin cplx(PCC)4fact 1,000 unit (800-1,240 unit) IV solution
J7168
63,833,038,702.00
4,150.00
6,360,000,200.00
morphine 8 mg/mL intravenous syringe
J2270
409,189,210.00
60.52
6,360,000,200.00
sugammadex 100 mg/mL intravenous solution
J3490
6,542,312.00
371.94
6,360,000,200.00
mepolizumab 100 mg subcutaneous solution
J2182
173,088,101.00
5,616.99
6,360,000,200.00
ceFAZolin 1 gram solution for injection
J0690
44,567,070,725.00
59.95
6,360,000,200.00
ceFAZolin 1 gram solution for injection
J0690
25,021,010,167.00
59.22
6,360,000,200.00
ceFAZolin 1 gram solution for injection
J0690
60,505,614,205.00
59.73
6,360,000,200.00
epoetin alfa 20,000 unit/mL injection solution
Q4081
55,513,047,810.00
806.60
J0885
6,360,000,200.00
DOPamine 800 mg/250 mL (3,200 mcg/mL) in 5 % dextrose intravenous soln
J1265
338,100,902.00
106.75
6,360,000,200.00
lidocaine (PF) 4 mg/mL (0.4 %) in 5 % dextrose intravenous solution
J2001
264,959,420.00
70.25
6,360,000,200.00
heparin (porcine) 25,000 unit/500 mL (50 unit/mL) in dextrose 5 % IV
J1644
264,957,710.00
85.00
6,360,000,200.00
heparin (porcine) 25,000 unit/500 mL (50 unit/mL) in dextrose 5 % IV
J1644
63,323,052,201.00
73.50
6,360,000,200.00
morphine (PF) 1 mg/mL injection solution
J2274
641,601,910.00
151.46
6,360,000,200.00
cefepime 1 gram solution for injection
J0692
25,021,012,166.00
61.44
6,360,000,200.00
cefepime 2 gram solution for injection
J0692
25,021,012,267.00
70.20
6,360,000,200.00
ocrelizumab 30 mg/mL intravenous solution
J2350
50,242,015,001.00
25,155.41
6,360,000,200.00
varicella-zoster glycoE vacc-AS01B adj(PF) 50 mcg/0.5 mL IM susp, kit
90750
58,160,082,311.00
512.01
6,360,000,200.00
tenecteplase 50 mg intravenous solution
J3101
50,242,012,047.00
10,248.71
6,360,000,200.00
meropenem 1 gram intravenous solution
J2185
63,323,050,825.00
81.00
6,360,000,200.00
antivenin Crotalidae (equine) solution for injection
J0841
66,621,079,002.00
2,445.00
6,360,000,200.00
vancomycin 1 gram/200 mL in water for injection(PEG,NADA) IV piggyback
J3370
70,594,004,201.00
104.50
6,360,000,200.00
pegfilgrastim-cbqv 6 mg/0.6 mL subcutaneous syringe
Q5111
70,114,010,101.00
6,625.00
6,360,000,200.00
romosozumab-aqqg 210 mg/2.34 mL(105 mg/1.17 mL x2)subcutaneous syringe
J3111
55,513,088,002.00
4,382.68
6,360,000,200.00
vancomycin 2 gram/400 mL in water for injection(PEG,NADA) IV piggyback
J3370
70,594,004,401.00
150.50
6,360,000,200.00
vancomycin 2 gram/400 mL in water for injection(PEG,NADA) IV piggyback
J3370
70,594,004,402.00
150.50
6,360,000,200.00
pegfilgrastim-bmez 6 mg/0.6 mL subcutaneous syringe
Q5120
61,314,086,601.00
6,375.53
6,360,000,200.00
remdesivir 100 mg intravenous powder for solution
C9399
61,958,290,101.00
2,265.00
6,360,000,200.00
remdesivir 100 mg intravenous powder for solution
C9399
61,958,290,102.00
2,265.00
6,360,000,200.00
bamlanivimab 700 mg/20 mL (35 mg/mL) intravenous soln (1 of 2) (EUA)
Q0239
2,791,001.00
0.01
6,360,000,200.00
piperacillin-tazobactam 4.5 gram intravenous solution
J2543
63,323,032,056.00
72.10
6,360,000,200.00
piperacillin-tazobactam 4.5 gram intravenous solution
J2543
64,679,001,201.00
84.60
6,360,000,200.00
piperacillin-tazobactam 3.375 gram intravenous solution
J2543
63,323,030,036.00
70.20
6,360,000,200.00
piperacillin-tazobactam 3.375 gram intravenous solution
J2543
64,679,005,601.00
81.53
6,360,000,200.00
piperacillin-tazobactam 3.375 gram intravenous solution
J2543
63,323,098,353.00
61.30
6,360,000,200.00
DOBUTamine 500 mg/250 mL (2,000 mcg/mL) in 5 % dextrose IV
J1250
409,234,732.00
82.50
6,360,000,200.00
sotrovimab 500 mg/8 mL (62.5 mg/mL) intravenous solution (EUA)
Q0247
173,090,186.00
0.01
6,360,000,200.00
flu vaccine qs 2021-22(6mos up)(PF) 60 mcg(15 mcgx4)/0.5 mL IM syringe
90686
19,515,081,852.00
105.88
6,360,000,200.00
casirivimab 60 mg-imdevimab 60 mg/mL intravenous solution (EUA)
6360000200
61,755,003,900.00
0.01
6,360,000,200.00
cyanocobalamin (vit B-12) 1,000 mcg/mL injection solution
J3420
63,323,004,400.00
58.99
6,360,000,200.00
cyanocobalamin (vit B-12) 1,000 mcg/mL injection solution
J3420
63,323,004,401.00
58.99
6,360,000,200.00
etomidate 2 mg/mL intravenous solution
J3490
409,669,502.00
70.92
6,360,000,200.00
etomidate 2 mg/mL intravenous solution
J3490
55,150,022,220.00
70.86
6,360,000,200.00
leuprolide 22.5 mg (3 month) intramuscular syringe kit
J9217
74,334,603.00
9,052.34
6,360,000,200.00
azithromycin 500 mg intravenous solution
J0456
63,323,039,814.00
71.70
6,360,000,200.00
amphotericin B liposome 50 mg intravenous suspension
J0289
469,305,130.00
667.29
6,360,000,200.00
rabies vaccine, purified chicken embryo cell (PF) 2.5 unit IM susp
90675
58,160,096,412.00
835.99
6,360,000,200.00
ketorolac 30 mg/mL (1 mL) injection solution
J1885
63,323,016,216.00
59.23
6,360,000,200.00
ketorolac 30 mg/mL (1 mL) injection solution
J1885
72,611,072,201.00
59.42
6,360,000,200.00
eptifibatide 0.75 mg/mL intravenous solution
J1327
70,121,100,301.00
775.00
6,360,000,200.00
eptifibatide 0.75 mg/mL intravenous solution
J1327
85,113,601.00
1,194.10
6,360,000,200.00
dexAMETHasone 4 mg tablet
J8540
54,418,425.00
5.74
6,360,000,200.00
dexAMETHasone sodium phosphate 10 mg/mL injection solution
J1100
641,036,721.00
59.73
6,360,000,200.00
dexAMETHasone sodium phosphate 4 mg/mL injection solution
J1100
63,323,016,516.00
59.16
6,360,000,200.00
inFLIXimab 100 mg intravenous solution
J1745
57,894,003,001.00
2,392.82
6,360,000,200.00
diazePAM 5 mg/mL injection solution
J3360
409,321,312.00
200.11
6,360,000,200.00
dicyclomine 10 mg/mL intramuscular solution
J0500
31,722,096,332.00
106.00
6,360,000,200.00
dicyclomine 10 mg/mL intramuscular solution
J0500
31,722,096,331.00
106.00
6,360,000,200.00
heparin (porcine) 25,000 unit/250 mL (100 unit/mL) in dextrose 5 % IV
J1644
409,779,352.00
74.00
6,360,000,200.00
heparin (porcine) 25,000 unit/250 mL (100 unit/mL) in dextrose 5 % IV
J1644
63,323,052,374.00
72.75
6,360,000,200.00
sodium ferric gluconate complex in sucrose 62.5 mg/5 mL intravenous
J2916
24,279,410.00
154.30
6,360,000,200.00
diphenhydrAMINE 50 mg/mL injection solution
J1200
63,323,066,416.00
59.12
6,360,000,200.00
diphenhydrAMINE 50 mg/mL injection solution
J1200
63,323,066,401.00
61.05
6,360,000,200.00
pantoprazole 40 mg intravenous solution
C9113
8,400,101.00
69.53
6,360,000,200.00
pantoprazole 40 mg intravenous solution
C9113
55,150,020,200.00
69.50
6,360,000,200.00
pantoprazole 40 mg intravenous solution
C9113
781,323,294.00
69.40
6,360,000,200.00
droperidoL 2.5 mg/mL injection solution
J1790
517,970,201.00
60.35
6,360,000,200.00
morphine 10 mg/mL intravenous solution
J2270
641,612,725.00
60.62
6,360,000,200.00
EPINEPHrine 1 mg/mL (1 mL) injection solution
J0171
42,023,015,925.00
84.96
6,360,000,200.00
iron sucrose 100 mg iron/5 mL intravenous solution
J1756
517,234,099.00
247.00
6,360,000,200.00
prednisoLONE sodium phosphate 15 mg/5 mL (3 mg/mL) oral solution
J7510
121,075,908.00
139.82
6,360,000,200.00
propranoloL 1 mg/mL intravenous solution
J1800
143,987,201.00
72.50
6,360,000,200.00
alteplase 2 mg intra-catheter solution
J2997
50,242,004,164.00
503.06
6,360,000,200.00
ertapenem 1 gram solution for injection
J1335
6,384,371.00
390.66
6,360,000,200.00
ertapenem 1 gram solution for injection
J1335
42,023,022,110.00
379.07
6,360,000,200.00
folic acid 5 mg/mL injection solution
J3490
63,323,018,410.00
59.28
6,360,000,200.00
pamidronate 30 mg/10 mL (3 mg/mL) intravenous solution
J2430
67,457,043,010.00
149.50
6,360,000,200.00
furosemide 10 mg/mL injection solution
J1940
63,323,028,026.00
58.80
6,360,000,200.00
ziprasidone 20 mg/mL (final concentration) intramuscular solution
J3486
49,392,020.00
149.83
6,360,000,200.00
leuprolide 22.5 mg (3 month) subcutaneous syringe
J9217
62,935,022,305.00
2,580.07
6,360,000,200.00
gentamicin 40 mg/mL injection solution
J1580
63,323,001,094.00
59.14
6,360,000,200.00
zoledronic acid 4 mg/5 mL intravenous solution
J3489
25,021,080,166.00
530.00
6,360,000,200.00
haloperidol lactate 5 mg/mL injection solution
J1630
143,950,101.00
58.94
6,360,000,200.00
haloperidol lactate 5 mg/mL injection solution
J1630
143,950,125.00
58.94
6,360,000,200.00
haloperidol lactate 5 mg/mL injection solution
J1630
63,323,047,401.00
60.70
6,360,000,200.00
palonosetron 0.25 mg/5 mL intravenous solution
J2469
62,856,079,701.00
600.00
6,360,000,200.00
hydrALAZINE 20 mg/mL injection solution
J0360
63,323,061,401.00
334.60
6,360,000,200.00
DAPTOmycin 500 mg intravenous solution
J0878
67,919,001,202.00
1,095.49
6,360,000,200.00
hydrOXYzine HCL 50 mg/mL intramuscular solution
J3410
517,560,125.00
145.95
6,360,000,200.00
acetylcysteine 200 mg/mL (20 %) intravenous solution
J0132
55,150,025,930.00
107.25
6,360,000,200.00
acetylcysteine 200 mg/mL (20 %) intravenous solution
J0132
63,323,096,321.00
107.30
6,360,000,200.00
adenosine 3 mg/mL intravenous solution
J0153
63,323,065,102.00
80.95
6,360,000,200.00
flumazeniL 0.1 mg/mL intravenous solution
J3490
63,323,042,405.00
71.28
6,360,000,200.00
natalizumab 300 mg/15 mL intravenous solution
J2323
64,406,000,801.00
11,213.99
6,360,000,200.00
aminophylline 250 mg/10 mL intravenous solution
J0280
409,592,101.00
82.50
6,360,000,200.00
LORazepam 2 mg/mL injection solution,LORazepam 2 mg/mL injection syringe
J2060
409,198,530.00
61.24
6,360,000,200.00
LORazepam 2 mg/mL injection solution,LORazepam 2 mg/mL injection syringe
J2060
641,604,425.00
59.48
6,360,000,200.00
hydrocortisone sod succinate (PF) 100 mg/2 mL solution for injection,hydrocortisone sodium succinate 100 mg solution for injection
J1720
9,082,501.00
81.41
6,360,000,200.00
fentaNYL (PF) 100 mcg/2 mL (50 mcg/mL) intravenous syringe,fentaNYL (PF) 50 mcg/mL injection solution
J3010
409,909,332.00
59.76
6,360,000,200.00
fentaNYL (PF) 100 mcg/2 mL (50 mcg/mL) intravenous syringe,fentaNYL (PF) 50 mcg/mL injection solution
J3010
409,909,425.00
60.19
6,360,000,200.00
midazolam 1 mg/mL injection solution,midazolam (PF) 1 mg/mL injection solution
J2250
409,230,517.00
59.27
6,360,000,200.00
calcium chloride 100 mg/mL (10 %) intravenous solution,calcium chloride 100 mg/mL (10 %) intravenous syringe
J3490
409,163,110.00
60.08
6,360,000,200.00
amiodarone 50 mg/mL intravenous solution,amiodarone 150 mg/3 mL intravenous syringe
J0282
63,323,061,609.00
68.88
6,360,000,200.00
amiodarone 50 mg/mL intravenous solution,amiodarone 150 mg/3 mL intravenous syringe
J0282
143,987,501.00
60.30
6,360,000,200.00
amiodarone 50 mg/mL intravenous solution,amiodarone 150 mg/3 mL intravenous syringe
J0282
143,987,525.00
60.30
6,360,000,200.00
cefTRIAXone 1 gram solution for injection
J0696
409,733,201.00
106.00
6,360,000,200.00
metoprolol tartrate 5 mg/5 mL intravenous solution,metoprolol tartrate 5 mg/5 mL intravenous syringe
J3490
143,987,325.00
61.00
6,360,000,200.00
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
641,612,525.00
60.57
6,360,000,200.00
hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular susp,hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular syringe
90746
58,160,082,152.00
253.11
6,360,000,200.00
HYDROmorphone 2 mg/mL injection solution,HYDROmorphone (PF) 2 mg/mL injection solution,HYDROmorphone 2 mg/mL injection syringe
J1170
409,336,511.00
59.87
6,360,000,200.00
midazolam (PF) 5 mg/mL injection solution,midazolam 5 mg/mL injection solution
J2250
409,230,801.00
59.35
6,360,000,200.00
J7512
9,999,999,026.00
15.85
6,360,000,200.00
J7510
9,999,999,025.00
16.48
6,360,000,200.00
diphth,pertussis(acel),tetanus 2.5 Lf unit-8 mcg-5 Lf/0.5mL IM syringe
90715
58,160,084,252.00
201.31
6,360,000,200.00
glucagon 1 mg/mL solution for injection
J1610
597,026,010.00
521.60
6,360,000,200.00
lidocaine (PF) 40 mg/mL (4 %) injection solution
J2001
409,428,325.00
68.85
6,360,000,200.00
lidocaine (PF) 50 mg/5 mL (1 %) intravenous syringe
6360000200
409,913,705.00
71.49
6,360,000,200.00
lidocaine (PF) 100 mg/5 mL (2 %) intravenous syringe
J2001
409,132,305.00
61.69
6,360,000,200.00
ampicillin 2 gram solution for injection
J0290
781,927,395.00
83.40
6,360,000,200.00
magnesium sulfate 4 mEq/mL (50 %) injection solution
J3475
63,323,006,403.00
60.03
6,360,000,200.00
mannitoL 20 % intravenous solution
J2150
338,035,703.00
61.99
6,360,000,200.00
methylPREDNISolone 4 mg tablet
J7509
59,746,000,106.00
5.78
6,360,000,200.00
methylPREDNISolone acetate 80 mg/mL suspension for injection
J1040
9,347,501.00
106.93
6,360,000,200.00
metoclopramide 5 mg/mL injection solution
J2765
23,155,024,041.00
59.40
6,360,000,200.00
metoclopramide 5 mg/mL injection solution
J2765
703,450,281.00
58.75
6,360,000,200.00
nalbuphine 10 mg/mL injection solution
J2300
409,146,301.00
61.94
6,360,000,200.00
nalbuphine 10 mg/mL injection solution
J2300
409,146,401.00
172.31
6,360,000,200.00
naloxone 1 mg/mL injection syringe
J2310
76,329,346,901.00
170.00
6,360,000,200.00
orphenadrine citrate 30 mg/mL injection solution
J2360
17,478,053,802.00
85.86
6,360,000,200.00
orphenadrine citrate 30 mg/mL injection solution
J2360
641,618,201.00
85.60
6,360,000,200.00
orphenadrine citrate 30 mg/mL injection solution
J2360
641,618,210.00
85.60
6,360,000,200.00
oxytocin 10 unit/mL injection solution
J2590
42,023,011,625.00
59.38
6,360,000,200.00
phenylephrine 10 mg/mL injection solution
J2370
641,614,225.00
68.50
6,360,000,200.00
phenylephrine 10 mg/mL injection solution
J2370
76,014,000,433.00
203.25
6,360,000,200.00
phenytoin sodium 50 mg/mL intravenous solution
J1165
641,255,545.00
60.30
6,360,000,200.00
potassium chloride 2 mEq/mL intravenous solution
J3480
409,665,305.00
69.04
6,360,000,200.00
predniSONE 1 mg tablet
J7512
603,533,521.00
5.82
6,360,000,200.00
predniSONE 10 mg tablet
J7512
143,973,901.00
5.64
6,360,000,200.00
predniSONE 20 mg tablet
J7512
54,001,825.00
5.63
6,360,000,200.00
predniSONE 5 mg tablet
J7512
54,472,825.00
5.66
6,360,000,200.00
prochlorperazine Edisylate 10 mg/2 mL (5 mg/mL) injection solution
J0780
23,155,052,341.00
69.13
6,360,000,200.00
promethazine 25 mg/mL injection solution
J2550
641,092,825.00
60.15
6,360,000,200.00
promethazine 50 mg/mL injection solution
J2550
641,149,631.00
60.89
6,360,000,200.00
protamine 10 mg/mL intravenous solution
J2720
63,323,022,930.00
173.85
6,360,000,200.00
atropine 0.1 mg/mL injection syringe
J0461
409,163,010.00
70.30
6,360,000,200.00
succinylcholine chloride 20 mg/mL injection solution
J0330
409,662,902.00
107.68
6,360,000,200.00
succinylcholine chloride 20 mg/mL injection solution
J0330
70,710,137,702.00
107.68
6,360,000,200.00
levETIRAcetam 500 mg/5 mL intravenous solution
J1953
63,323,040,005.00
72.39
6,360,000,200.00
thiamine HCl (vitamin B1) 100 mg/mL injection solution
J3411
63,323,001,302.00
60.79
6,360,000,200.00
triamcinolone acetonide 40 mg/mL suspension for injection
J3301
70,121,116,801.00
73.17
6,360,000,200.00
triamcinolone acetonide 40 mg/mL suspension for injection
J3301
70,121,165,701.00
73.00
6,360,000,200.00
zoledronic acid 5 mg/100 mL in mannitoL 5 %-water intravenous piggybck
J3489
78,043,561.00
2,308.80
6,360,000,200.00
zoledronic acid 5 mg/100 mL in mannitoL 5 %-water intravenous piggybck
J3489
55,111,068,852.00
775.00
6,360,000,200.00
zoledronic acid 5 mg/100 mL in mannitoL 5 %-water intravenous piggybck
J3489
70,860,080,282.00
370.80
6,360,000,200.00
clindamycin 150 mg/mL injection solution
J3490
25,021,011,502.00
70.44
S0077
6,360,000,200.00
clindamycin 150 mg/mL injection solution
J3490
9,030,225.00
69.42
S0077
6,360,000,200.00
clindamycin 150 mg/mL injection solution
J3490
9,090,125.00
61.12
S0077
6,360,000,200.00
clindamycin 150 mg/mL injection solution
J3490
67,457,081,402.00
68.73
S0077
6,360,000,200.00
clindamycin 150 mg/mL injection solution
J3490
72,611,063,425.00
69.42
S0077
6,360,000,200.00
vancomycin 1,000 mg intravenous injection
J3370
67,457,034,001.00
71.44
6,360,000,200.00
vancomycin 1,000 mg intravenous injection
J3370
63,323,028,426.00
71.44
6,360,000,200.00
vancomycin 1,000 mg intravenous injection
J3370
63,323,028,441.00
68.80
6,360,000,200.00
fosphenytoin 100 mg PE/2 mL injection solution
Q2009
67,457,051,625.00
85.00
6,360,000,200.00
fosphenytoin 100 mg PE/2 mL injection solution
Q2009
70,121,138,105.00
85.00
6,360,000,200.00
albumin, human 25 % intravenous solution
P9047
68,982,064,301.00
249.40
6,360,000,200.00
albumin, human 25 % intravenous solution
P9047
76,125,079,210.00
358.00
6,360,000,200.00
albumin, human 25 % intravenous solution
P9047
76,125,079,211.00
358.00
6,360,000,200.00
alteplase 100 mg intravenous solution
J2997
50,242,008,525.00
14,050.36
6,360,000,200.00
alteplase 100 mg intravenous solution
J2997
50,242,008,527.00
14,050.36
6,360,000,200.00
ampicillin-sulbactam 1.5 gram solution for injection
J0295
49,001,381.00
72.14
6,360,000,200.00
ampicillin-sulbactam 3 gram solution for injection
J0295
67,457,034,903.00
62.26
6,360,000,200.00
ampicillin-sulbactam 3 gram solution for injection
J0295
67,457,034,910.00
62.26
6,360,000,200.00
ampicillin-sulbactam 3 gram solution for injection
J0295
71,288,000,630.00
72.67
6,360,000,200.00
ketorolac 60 mg/2 mL intramuscular solution
J1885
63,323,016,202.00
70.75
6,360,000,200.00
azaTHIOprine 50 mg tablet
J7500
378,100,501.00
5.85
6,360,000,200.00
aztreonam 1 gram solution for injection
J3490
63,323,040,120.00
173.08
S0073
6,360,000,200.00
betamethasone acetate and sodium phos 6 mg/mL suspension for injection
J0702
517,072,001.00
234.41
6,360,000,200.00
bumetanide 0.25 mg/mL injection solution
J3490
641,600,810.00
61.05
S0171
6,360,000,200.00
romiPLOStim 250 mcg subcutaneous solution
J2796
55,513,022,101.00
4,514.68
6,360,000,200.00
romiPLOStim 500 mcg subcutaneous solution
J2796
55,513,022,201.00
6,579.36
6,360,000,200.00
cefOXitin 1 gram intravenous solution
J0694
25,021,010,910.00
81.23
6,360,000,200.00
cefOXitin 1 gram intravenous solution
J0694
63,323,034,125.00
81.23
6,360,000,200.00
cefTAZidime 1 gram solution for injection
J0713
409,508,216.00
68.72
6,360,000,200.00
cefTAZidime 1 gram solution for injection
J0713
25,021,012,720.00
69.70
6,360,000,200.00
cefTAZidime 2 gram solution for injection
J0713
25,021,012,867.00
108.47
6,360,000,200.00
cefTRIAXone 2 gram solution for injection
J0696
409,733,503.00
153.75
6,360,000,200.00
cefTRIAXone 1 gram/50 mL in dextrose (iso-osmot) intravenous piggyback
J0696
264,315,311.00
105.53
6,360,000,200.00
cefTRIAXone 2 gram/50 mL in dextrose (iso-osm) intravenous piggyback
J0696
264,315,511.00
146.84
6,360,000,200.00
imipenem-cilastatin 500 mg intravenous solution
J0743
63,323,032,294.00
82.50
6,360,000,200.00
dilTIAZem 5 mg/mL intravenous solution
J3490
17,478,093,710.00
61.22
6,360,000,200.00
dilTIAZem 5 mg/mL intravenous solution
J3490
17,478,081,705.00
61.11
6,360,000,200.00
dilTIAZem 5 mg/mL intravenous solution
J3490
17,478,081,725.00
80.93
6,360,000,200.00
dilTIAZem 5 mg/mL intravenous solution
J3490
17,478,093,726.00
80.00
6,360,000,200.00
EPINEPHrine 1 mg/mL injection solution
J0171
42,023,016,801.00
650.56
6,360,000,200.00
enalaprilat 1.25 mg/mL intravenous solution
J3490
143,978,610.00
73.13
6,360,000,200.00
epoetin alfa 10,000 unit/mL injection solution
Q4081
59,676,031,001.00
667.25
J0885
6,360,000,200.00
epoetin alfa 4,000 unit/mL injection solution
Q4081
55,513,014,801.00
328.32
J0885
6,360,000,200.00
epoetin alfa 4,000 unit/mL injection solution
Q4081
55,513,014,810.00
328.32
J0885
6,370,000,100.00
famotidine 20 mg tablet
172,572,860.00
5.69
6,370,000,100.00
finasteride 5 mg tablet
16,729,009,015.00
5.80
6,370,000,100.00
finasteride 5 mg tablet
50,268,031,415.00
6.79
6,370,000,100.00
flavoxATE 100 mg tablet
51,224,015,450.00
6.42
6,370,000,100.00
fluconazole 200 mg tablet
67,405,060,403.00
5.95
6,370,000,100.00
fludrocortisone 0.1 mg tablet
115,703,301.00
5.92
6,370,000,100.00
diclofenac 1 % topical gel
65,162,083,366.00
190.40
6,370,000,100.00
diclofenac 1 % topical gel
76,282,066,339.00
15.50
6,370,000,100.00
FLUoxetine 10 mg capsule
50,111,064,701.00
5.68
6,370,000,100.00
FLUoxetine 20 mg capsule
50,111,064,801.00
5.65
6,370,000,100.00
Lactobacil rhamnosus GG 10 billion cell-inulin 200 mg sprinkle capsule
49,100,040,009.00
6.10
6,370,000,100.00
estradioL 10 mcg vaginal tablet
65,162,022,623.00
67.40
6,370,000,100.00
glipiZIDE 5 mg tablet
781,145,201.00
5.66
6,370,000,100.00
glycopyrrolate 1 mg tablet
23,155,060,601.00
5.74
6,370,000,100.00
hydrocortisone 5 mg tablet
59,762,007,301.00
5.79
6,370,000,100.00
hydrOXYchloroQUINE 200 mg tablet
781,599,401.00
6.47
6,370,000,100.00
insulin NPH isophane U-100 human 100 unit/mL subcutaneous suspension
2,831,501.00
410.70
6,370,000,100.00
insulin human U-100 NPH-regulr 70-30 mix 100 unit/mL subcutaneous susp
2,871,517.00
204.61
6,370,000,100.00
insulin U-100 regular human 100 unit/mL injection solution
2,821,517.00
204.61
6,370,000,100.00
hydrocortisone 1 %-iodoquinoL 1 % topical cream
58,980,081,110.00
15.02
6,370,000,100.00
ketoconazole 2 % topical cream
51,672,129,802.00
6.89
6,370,000,100.00
ketoconazole 2 % topical cream
51,672,129,803.00
6.57
6,370,000,100.00
ketorolac 10 mg tablet
93,031,401.00
6.70
6,370,000,100.00
labetaloL 100 mg tablet
185,001,001.00
6.03
6,370,000,100.00
labetaloL 100 mg tablet
68,382,079,801.00
5.91
6,370,000,100.00
ammonium lactate 12 % lotion
45,802,052,526.00
54.60
6,370,000,100.00
tamsulosin 0.4 mg capsule
781,207,601.00
6.12
6,370,000,100.00
tamsulosin 0.4 mg capsule
65,862,059,801.00
5.75
6,370,000,100.00
levothyroxine 88 mcg tablet
527,134,401.00
5.75
6,370,000,100.00
levothyroxine 112 mcg tablet
781,518,592.00
5.74
6,370,000,100.00
levothyroxine 175 mcg tablet
74,707,090.00
5.81
6,370,000,100.00
lidocaine-prilocaine 2.5 %-2.5 % topical cream
168,035,705.00
7.27
6,370,000,100.00
methyl salicylate-menthol topical ointment
54,162,055,501.00
6.99
6,370,000,100.00
lisinopriL 10 mg tablet
68,180,098,001.00
5.63
6,370,000,100.00
lisinopriL 40 mg tablet
68,180,051,701.00
5.63
6,370,000,100.00
lisinopriL 5 mg tablet
68,180,051,303.00
5.64
6,370,000,100.00
fluticasone 100 mcg-salmeteroL 50 mcg/dose blistr powdr for inhalation
173,069,504.00
46.44
6,370,000,100.00
fluticasone 250 mcg-salmeteroL 50 mcg/dose blistr powdr for inhalation
173,069,600.00
28.57
6,370,000,100.00
fluticasone 250 mcg-salmeteroL 50 mcg/dose blistr powdr for inhalation
173,069,604.00
46.44
6,370,000,100.00
fluticasone 500 mcg-salmeteroL 50 mcg/dose blistr powdr for inhalation
173,069,704.00
65.66
6,370,000,100.00
bethanechol chloride 50 mg tablet
51,293,064,801.00
5.70
6,370,000,100.00
loratadine 10 mg tablet
45,802,065,078.00
5.77
6,370,000,100.00
magnesium oxide 400 mg (241.3 mg magnesium) tablet
904,660,961.00
5.69
6,370,000,100.00
magnesium oxide 400 mg (241.3 mg magnesium) tablet
63,739,035,401.00
5.69
6,370,000,100.00
metFORMIN 500 mg tablet
23,155,010,201.00
5.66
6,370,000,100.00
methIMAzole 5 mg tablet
23,155,007,001.00
5.77
6,370,000,100.00
metOLazone 2.5 mg tablet
378,617,201.00
7.42
6,370,000,100.00
metroNIDAZOLE 0.75 % vaginal gel
781,707,787.00
7.37
6,370,000,100.00
midodrine 5 mg tablet
245,021,211.00
5.99
6,370,000,100.00
midodrine 5 mg tablet
60,505,132,101.00
5.99
6,370,000,100.00
neomycin 3.5 mg/g-polymyxin B 10,000 unit/g-dexameth 0.1 % eye oint
574,416,035.00
51.63
6,370,000,100.00
miSOPROStoL 200 mcg tablet
43,386,016,106.00
5.74
6,370,000,100.00
HYDROcodone 10 mg-chlorpheniramine 8 mg/5 mL oral susp extend.rel 12hr
27,808,008,601.00
6.85
6,370,000,100.00
HYDROcodone 10 mg-chlorpheniramine 8 mg/5 mL oral susp extend.rel 12hr
99,999,015,501.00
6.88
6,370,000,100.00
dabigatran etexilate 75 mg capsule
597,035,556.00
33.45
6,370,000,100.00
mupirocin 2 % topical ointment
51,672,131,200.00
6.53
6,370,000,100.00
mupirocin 2 % topical ointment
45,802,011,222.00
37.40
6,370,000,100.00
nitrofurantoin monohydrate/macrocrystals 100 mg capsule
378,342,201.00
8.18
6,370,000,100.00
nitrofurantoin monohydrate/macrocrystals 100 mg capsule
185,012,201.00
7.18
6,370,000,100.00
omega-3 fatty acids-fish oil 300 mg-1,000 mg capsule
30,768,003,304.00
5.66
6,370,000,100.00
electrolytes-dextrose oral solution
70,074,080,365.00
6.22
6,370,000,100.00
oxyCODONE 5 mg tablet
10,702,001,801.00
5.71
6,370,000,100.00
oxyCODONE 5 mg tablet
42,858,000,101.00
5.69
6,370,000,100.00
oxyCODONE 5 mg tablet
42,806,000,501.00
5.80
6,370,000,100.00
peg 3350-electrolytes 236 gram-22.74 gram-6.74 gram-5.86 gram solution
43,386,009,019.00
64.00
6,370,000,100.00
PARoxetine 20 mg tablet
60,505,008,302.00
5.69
6,370,000,100.00
PARoxetine 20 mg tablet
904,567,761.00
5.75
6,370,000,100.00
PARoxetine 30 mg tablet
378,700,393.00
5.68
6,370,000,100.00
linaGLIPtin 5 mg tablet
597,014,030.00
64.18
6,370,000,100.00
rivaroxaban 10 mg tablet
50,458,058,030.00
64.42
6,370,000,100.00
calcium polycarbophiL 625 mg tablet
536,430,605.00
5.67
6,370,000,100.00
oseltamivir 6 mg/mL oral suspension
4,082,205.00
33.94
6,370,000,100.00
pravastatin 10 mg tablet
68,462,019,590.00
5.98
6,370,000,100.00
pravastatin 20 mg tablet
68,462,019,690.00
5.80
6,370,000,100.00
pravastatin 20 mg tablet
68,382,007,116.00
5.87
6,370,000,100.00
pravastatin 40 mg tablet
60,505,017,009.00
5.72
6,370,000,100.00
pravastatin 40 mg tablet
68,462,019,790.00
5.75
6,370,000,100.00
pravastatin 40 mg tablet
42,291,066,890.00
5.63
6,370,000,100.00
ferrous gluconate 324 mg (37.5 mg iron) tablet
904,213,761.00
5.65
6,370,000,100.00
primidone 50 mg tablet
10,135,054,001.00
5.72
6,370,000,100.00
prochlorperazine 25 mg rectal suppository
713,013,512.00
37.11
6,370,000,100.00
promethazine 12.5 mg rectal suppository
713,053,612.00
38.15
6,370,000,100.00
promethazine 25 mg rectal suppository
713,052,612.00
23.57
6,370,000,100.00
quinapriL 20 mg tablet
69,097,084,205.00
5.66
6,370,000,100.00
ramipriL 1.25 mg capsule
16,729,015,201.00
5.81
6,370,000,100.00
ramipriL 10 mg capsule
65,862,047,701.00
5.65
6,370,000,100.00
ramipriL 2.5 mg capsule
65,862,047,501.00
5.72
6,370,000,100.00
rivaroxaban 15 mg tablet
50,458,057,830.00
46.54
6,370,000,100.00
rivaroxaban 20 mg tablet
50,458,057,990.00
33.71
6,370,000,100.00
acetaZOLAMIDE 250 mg tablet
23,155,028,801.00
5.97
6,370,000,100.00
racepinephrine 2.25 % solution for nebulization
487,278,401.00
6.45
6,370,000,100.00
sertraline 100 mg tablet
68,180,035,302.00
5.67
6,370,000,100.00
sertraline 50 mg tablet
68,180,035,202.00
5.71
6,370,000,100.00
simvastatin 10 mg tablet
16,729,000,415.00
5.66
6,370,000,100.00
simvastatin 20 mg tablet
68,180,047,902.00
5.64
6,370,000,100.00
simvastatin 40 mg tablet
16,729,000,615.00
5.63
6,370,000,100.00
sodium phosphates 19 gram-7 gram/118 mL enema
132,020,140.00
6.55
6,370,000,100.00
sotaloL 80 mg tablet
60,505,008,000.00
5.90
6,370,000,100.00
spironolactone 50 mg tablet
60,687,047,601.00
5.85
6,370,000,100.00
sucralfate 1 gram tablet
93,221,005.00
5.86
6,370,000,100.00
magnesium 64 mg (magnesium chloride) tablet,delayed release
68,585,000,575.00
5.70
6,370,000,100.00
tamoxifen 20 mg tablet
378,027,493.00
6.00
6,370,000,100.00
timoloL maleate 0.25 % eye drops
64,980,051,301.00
52.96
6,370,000,100.00
timoloL maleate 0.5 % eye drops
61,314,022,705.00
38.05
6,370,000,100.00
tobramycin 0.3 %-dexamethasone 0.1 % eye drops,suspension
24,208,029,505.00
332.90
6,370,000,100.00
sulfamethoxazole 800 mg-trimethoprim 160 mg tablet
53,746,027,201.00
5.82
6,370,000,100.00
sulfamethoxazole 800 mg-trimethoprim 160 mg tablet
65,862,042,001.00
5.68
6,370,000,100.00
vancomycin 125 mg capsule
68,180,016,613.00
23.70
6,370,000,100.00
vancomycin 125 mg capsule
68,180,016,611.00
23.70
6,370,000,100.00
warfarin 1 mg tablet
832,121,101.00
5.99
6,370,000,100.00
warfarin 1 mg tablet
93,171,201.00
5.84
6,370,000,100.00
warfarin 1 mg tablet
56,016,975.00
7.68
6,370,000,100.00
ipratropium 20 mcg-albuteroL 100 mcg/actuation mist for inhalation
597,002,402.00
1,078.51
6,370,000,100.00
mirabegron ER 25 mg tablet,extended release 24 hr
469,260,190.00
52.91
6,370,000,100.00
zolpidem 5 mg tablet
378,530,501.00
7.94
6,370,000,100.00
morphine ER 30 mg tablet,extended release
42,858,080,201.00
5.93
6,370,000,100.00
morphine ER 30 mg tablet,extended release
904,655,861.00
6.25
6,370,000,100.00
diclofenac 50 mg-misoprostoL 200 mcg tablet,immed.and delayed release
59,762,002,802.00
14.68
6,370,000,100.00
apixaban 2.5 mg tablet
3,089,321.00
33.82
6,370,000,100.00
tofacitinib 5 mg tablet
69,100,101.00
313.68
6,370,000,100.00
morphine ER 15 mg tablet,extended release
42,858,080,101.00
5.94
6,370,000,100.00
morphine ER 15 mg tablet,extended release
228,427,011.00
6.29
6,370,000,100.00
morphine ER 15 mg tablet,extended release
904,655,761.00
6.76
6,370,000,100.00
morphine ER 60 mg tablet,extended release
42,858,080,301.00
5.91
6,370,000,100.00
morphine ER 100 mg tablet,extended release
42,858,080,401.00
5.88
6,370,000,100.00
apixaban 5 mg tablet
3,089,421.00
19.06
6,370,000,100.00
memantine 14 mg capsule sprinkle,extended release 24hr
456,341,490.00
33.25
6,370,000,100.00
doxylamine 10 mg-pyridoxine (vit B6) 10 mg tablet,delayed release
55,494,010,010.00
46.48
6,370,000,100.00
canagliflozin 100 mg tablet
50,458,014,030.00
66.11
6,370,000,100.00
magnesium hydroxide 400 mg/5 mL oral suspension
121,043,130.00
7.57
6,370,000,100.00
venlafaxine 100 mg tablet
57,664,039,688.00
5.72
6,370,000,100.00
venlafaxine 75 mg tablet
52,817,013,310.00
5.67
6,370,000,100.00
venlafaxine 37.5 mg tablet
57,664,039,388.00
5.84
6,370,000,100.00
oxyCODONE ER 10 mg tablet,crush resistant,extended release 12 hr
59,011,041,010.00
19.34
6,370,000,100.00
oxyCODONE ER 10 mg tablet,crush resistant,extended release 12 hr
59,011,041,020.00
19.46
6,370,000,100.00
oxyCODONE ER 20 mg tablet,crush resistant,extended release 12 hr
59,011,042,010.00
19.04
6,370,000,100.00
cholestyramine-aspartame 4 gram oral powder for susp in a packet
49,884,046,663.00
7.67
6,370,000,100.00
fluocinonide-emollient 0.05 % topical cream
93,026,330.00
8.19
6,370,000,100.00
activated charcoal-sorbitoL 25 gram/120 mL oral suspension
574,012,074.00
52.32
6,370,000,100.00
activated charcoaL 50 gram/240 mL oral suspension
574,052,176.00
37.88
6,370,000,100.00
activated charcoaL 25 gram/120 mL oral suspension
574,012,104.00
52.32
6,370,000,100.00
insulin aspart (U-100) 100 unit/mL (3 mL) subcutaneous pen
169,633,910.00
125.00
6,370,000,100.00
insulin glargine (U-100) 100 unit/mL (3 mL) subcutaneous pen
88,221,905.00
125.00
6,370,000,100.00
insulin glargine (U-100) 100 unit/mL (3 mL) subcutaneous pen
2,771,559.00
125.00
6,370,000,100.00
insulin lispro (U-100) 100 unit/mL subcutaneous pen
2,879,959.00
125.00
6,370,000,100.00
insulin detemir (U-100) 100 unit/mL (3 mL) subcutaneous pen
169,643,810.00
125.00
6,370,000,100.00
insulin aspar prot-insulin aspart 100 unit/mL (70-30) subcutaneous pen
169,369,619.00
125.00
6,370,000,100.00
liraglutide 0.6 mg/0.1 mL (18 mg/3 mL) subcutaneous pen injector
169,406,013.00
81.29
6,370,000,100.00
estradioL 0.5 mg tablet
555,089,902.00
5.89
6,370,000,100.00
sodium chloride-aloe vera nasal gel
225,052,547.00
5.80
6,370,000,100.00
aspirin-sod bicarb-citric acid 325 mg-1,916 mg-1,000 mg efferves tab
16,500,004,012.00
5.73
6,370,000,100.00
ipratropium bromide 0.02 % solution for inhalation
487,980,101.00
5.83
6,370,000,100.00
ipratropium bromide 0.02 % solution for inhalation
487,980,160.00
5.81
6,370,000,100.00
trolamine salicylate-aloe vera 10 % topical cream
41,167,005,703.00
5.67
6,370,000,100.00
carbidopa ER 25 mg-levodopa 100 mg tablet,extended release
378,008,801.00
6.31
6,370,000,100.00
Lactobac no.2-Bifidobac no.1-S. thermo 112.5 billion cell capsule
69,355,041,203.00
6.29
6,370,000,100.00
terbinafine HCL 250 mg tablet
51,991,052,633.00
5.69
6,370,000,100.00
tiotropium bromide 2.5 mcg/actuation mist for inhalation
597,010,061.00
1,113.00
6,370,000,100.00
tiotropium bromide 2.5 mcg/actuation mist for inhalation
597,010,031.00
625.57
6,370,000,100.00
tiotropium bromide 2.5 mcg/actuation mist for inhalation
597,010,051.00
306.50
6,370,000,100.00
umeclidinium 62.5 mcg/actuation blister powder for inhalation
173,087,310.00
6.01
6,370,000,100.00
naloxegoL 25 mg tablet
310,197,030.00
47.45
6,370,000,100.00
white petrolatum-mineral oiL 83 %-15 % eye ointment
904,648,838.00
6.80
6,370,000,100.00
white petrolatum-mineral oiL 83 %-15 % eye ointment
536,108,691.00
6.41
6,370,000,100.00
scopolamine 1 mg over 3 days transdermal patch
66,758,020,854.00
66.73
6,370,000,100.00
pentosan polysulfate sodium 100 mg capsule
50,458,009,801.00
37.98
6,370,000,100.00
thyroid (pork) 30 mg tablet
456,045,801.00
6.04
6,370,000,100.00
thyroid (pork) 180 mg tablet
456,046,201.00
6.89
6,370,000,100.00
tiotropium 2.5 mcg-olodateroL 2.5 mcg/actuation mist for inhalation
597,015,570.00
306.50
6,370,000,100.00
sacubitriL 24 mg-valsartan 26 mg tablet
78,065,920.00
38.12
6,370,000,100.00
sacubitriL 97 mg-valsartan 103 mg tablet
78,069,620.00
38.12
6,370,000,100.00
calcium carbonate 500 mg calcium (1,250 mg) tablet
904,188,372.00
5.63
6,370,000,100.00
thiamine mononitrate (vitamin B1) 100 mg tablet
50,268,085,111.00
5.81
6,370,000,100.00
verapamiL ER (SR) 240 mg tablet,extended release
68,462,026,001.00
5.78
6,370,000,100.00
lisinopriL 2.5 mg tablet
68,180,051,201.00
5.65
6,370,000,100.00
lactulose 10 gram/15 mL (15 mL) oral solution
121,457,715.00
6.21
6,370,000,100.00
methylnaltrexone 12 mg/0.6 mL subcutaneous syringe
65,649,055,107.00
396.52
6,370,000,100.00
valACYclovir 1 gram tablet
378,427,693.00
6.27
6,370,000,100.00
valACYclovir 500 mg tablet
51,079,009,301.00
15.05
6,370,000,100.00
naproxen sodium 220 mg tablet
10,939,063,544.00
5.70
6,370,000,100.00
naproxen sodium 220 mg tablet
536,109,401.00
5.68
6,370,000,100.00
phenobarb-hyoscyamn-atropine-scop 16.2 mg-0.1037 mg/5 mL (5 mL) elixir
66,689,006,301.00
137.80
6,370,000,100.00
verapamiL ER (SR) 120 mg tablet,extended release
51,079,089,401.00
7.55
6,370,000,100.00
acetaminophen 120 mg-codeine 12 mg/5 mL (5 mL) oral solution
50,383,007,906.00
6.86
6,370,000,100.00
honey 100 % topical paste
9,958,003,361.00
53.43
6,370,000,100.00
honey 100 % topical paste
9,958,003,360.00
53.43
6,370,000,100.00
methyl salicylate 15 %-menthol 1 % topical cream
178,032,005.00
5.65
6,370,000,100.00
SUMAtriptan 100 mg tablet
55,111,029,309.00
6.06
6,370,000,100.00
patiromer calcium sorbitex 8.4 gram oral powder packet
53,436,008,401.00
113.91
6,370,000,100.00
acidophilus 25 million cell-pectin, citrus 100 mg tablet
536,718,001.00
5.65
6,370,000,100.00
carBAMazepine 100 mg chewable tablet
51,672,404,101.00
6.02
6,370,000,100.00
carBAMazepine 200 mg tablet
13,668,026,801.00
6.90
6,370,000,100.00
fluconazole 150 mg tablet
57,237,000,511.00
6.09
6,370,000,100.00
potassium chloride ER 10 mEq capsule,extended release
53,746,054,205.00
5.87
6,370,000,100.00
bacitracin zinc 500 unit/gram topical ointment
472,110,556.00
23.66
6,370,000,100.00
bacitracin zinc 500 unit/gram topical ointment
67,777,022,007.00
65.00
6,370,000,100.00
carisoprodoL 350 mg tablet
64,980,017,401.00
5.72
6,370,000,100.00
carisoprodoL 350 mg tablet
603,258,221.00
5.72
6,370,000,100.00
lamoTRIgine 25 mg tablet
51,672,413,001.00
5.68
6,370,000,100.00
lamoTRIgine 100 mg tablet
51,672,413,101.00
5.64
6,370,000,100.00
acetaminophen 300 mg-codeine 30 mg tablet
406,048,401.00
5.77
6,370,000,100.00
acetaminophen 300 mg-codeine 30 mg tablet
93,015,001.00
5.80
6,370,000,100.00
dilTIAZem ER 60 mg capsule,extended release 12 hr
378,606,001.00
8.16
6,370,000,100.00
terazosin 1 mg capsule
59,746,038,306.00
5.80
6,370,000,100.00
terazosin 2 mg capsule
59,746,038,406.00
5.71
6,370,000,100.00
terazosin 5 mg capsule
59,746,038,506.00
5.66
6,370,000,100.00
traMADoL 50 mg tablet
63,739,067,110.00
5.66
6,370,000,100.00
traMADoL 50 mg tablet
57,664,037,718.00
5.64
6,370,000,100.00
metFORMIN 850 mg tablet
23,155,010,301.00
5.66
6,370,000,100.00
tiZANidine 2 mg tablet
57,664,050,289.00
5.73
6,370,000,100.00
tiZANidine 4 mg tablet
904,641,861.00
5.88
6,370,000,100.00
losartan 25 mg tablet
65,862,020,190.00
5.70
6,370,000,100.00
losartan 50 mg tablet
65,862,020,290.00
5.67
6,370,000,100.00
fosfomycin tromethamine 3 gram oral packet
456,430,001.00
322.77
6,370,000,100.00
SUMAtriptan 50 mg tablet
55,111,029,236.00
6.51
6,370,000,100.00
diclofenac sodium 75 mg tablet,delayed release
61,442,010,301.00
5.71
6,370,000,100.00
calcitonin (salmon) 200 unit/actuation nasal spray
49,884,016,111.00
14.89
6,370,000,100.00
carvediloL 6.25 mg tablet
68,382,009,301.00
5.65
6,370,000,100.00
carvediloL 25 mg tablet
68,382,009,501.00
5.63
6,370,000,100.00
carvediloL 25 mg tablet
68,462,016,501.00
5.63
6,370,000,100.00
carvediloL 12.5 mg tablet
68,382,009,401.00
5.63
6,370,000,100.00
azithromycin 200 mg/5 mL oral suspension
93,202,623.00
108.66
6,370,000,100.00
azithromycin 200 mg/5 mL oral suspension
93,202,631.00
108.66
6,370,000,100.00
azithromycin 200 mg/5 mL oral suspension
42,806,014,932.00
52.01
6,370,000,100.00
azithromycin 200 mg/5 mL oral suspension
70,710,145,802.00
82.56
6,370,000,100.00
ipratropium bromide 21 mcg (0.03 %) nasal spray
54,004,544.00
118.50
6,370,000,100.00
chlordiazePOXIDE 10 mg capsule
555,003,302.00
5.69
6,370,000,100.00
chlordiazePOXIDE 25 mg capsule
555,015,902.00
5.65
6,370,000,100.00
chlordiazePOXIDE 5 mg capsule
51,079,037,401.00
6.26
6,370,000,100.00
glimepiride 1 mg tablet
16,729,000,101.00
5.80
6,370,000,100.00
glimepiride 2 mg tablet
68,084,032,611.00
6.16
6,370,000,100.00
glimepiride 4 mg tablet
16,729,000,301.00
5.76
6,370,000,100.00
ferrous sulfate 220 mg (44 mg iron)/5 mL oral elixir
904,146,516.00
5.65
6,370,000,100.00
ferrous sulfate 220 mg (44 mg iron)/5 mL oral elixir
50,383,077,816.00
5.70
6,370,000,100.00
chlorthalidone 25 mg tablet
57,664,064,888.00
5.74
6,370,000,100.00
chlorthalidone 25 mg tablet
60,687,031,725.00
6.58
6,370,000,100.00
chlorthalidone 25 mg tablet
51,079,005,801.00
6.58
6,370,000,100.00
PARoxetine 10 mg tablet
378,700,193.00
5.73
6,370,000,100.00
PARoxetine 40 mg tablet
378,700,493.00
5.67
6,370,000,100.00
lidocaine 4 % topical patch
41,167,005,840.00
6.96
6,370,000,100.00
lidocaine 4 % topical patch
45,611,000,938.00
6.95
6,370,000,100.00
lidocaine 4 % topical patch
46,581,083,006.00
6.79
6,370,000,100.00
lidocaine 4 % topical patch
70,000,055,701.00
7.29
6,370,000,100.00
theophylline ER 400 mg tablet,extended release 24 hr
42,858,070,101.00
6.66
6,370,000,100.00
sodium polystyrene sulfonate 15 gram-sorbitoL 20 gram/60 mL oral susp
46,287,000,660.00
67.14
6,370,000,100.00
magnesium 70 mg (magnesium chloride) tablet,delayed release
904,791,152.00
5.70
6,370,000,100.00
melatonin 3 mg tablet
904,518,252.00
5.65
6,370,000,100.00
clindamycin HCL 150 mg capsule
63,304,069,201.00
5.69
6,370,000,100.00
insulin lispro (U-100) 100 unit/mL subcutaneous solution
2,751,001.00
518.48
6,370,000,100.00
insulin lispro (U-100) 100 unit/mL subcutaneous solution
2,751,017.00
344.41
6,370,000,100.00
melatonin 5 mg tablet
30,768,015,745.00
5.67
6,370,000,100.00
melatonin 5 mg tablet
96,295,012,828.00
5.70
6,370,000,100.00
pimavanserin 34 mg capsule
63,090,034,030.00
572.67
6,370,000,100.00
busPIRone 15 mg tablet
68,382,018,201.00
5.65
6,370,000,100.00
mirtazapine 30 mg tablet
93,720,756.00
5.71
6,370,000,100.00
mirtazapine 15 mg tablet
93,720,656.00
5.77
6,370,000,100.00
balsam peru-castor oiL topical ointment
58,980,078,021.00
6.15
6,370,000,100.00
cloNIDine HCL 0.1 mg tablet
228,212,710.00
5.66
6,370,000,100.00
cloNIDine HCL 0.1 mg tablet
29,300,013,501.00
5.67
6,370,000,100.00
revefenacin 175 mcg/3 mL solution for nebulization
J7677
49,502,080,632.00
138.64
6,370,000,100.00
clotrimazole 1 % topical cream
904,782,231.00
5.68
6,370,000,100.00
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler
173,068,220.00
195.37
6,370,000,100.00
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler
173,068,224.00
83.56
6,370,000,100.00
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler
59,310,057,922.00
250.83
6,370,000,100.00
brimonidine 0.2 % eye drops
24,208,041,110.00
109.75
6,370,000,100.00
brimonidine 0.2 % eye drops
61,314,014,310.00
47.60
6,370,000,100.00
OLANZapine 5 mg tablet
43,598,016,430.00
5.85
6,370,000,100.00
OLANZapine 10 mg tablet
43,598,016,630.00
5.79
6,370,000,100.00
colchicine 0.6 mg tablet
64,764,011,907.00
29.19
6,370,000,100.00
peg-electrolyte solution 420 gram oral solution
52,268,040,001.00
110.50
6,370,000,100.00
bisoprolol 10 mg-hydrochlorothiazide 6.25 mg tablet
29,300,018,913.00
6.23
6,370,000,100.00
torsemide 20 mg tablet
31,722,053,101.00
5.73
6,370,000,100.00
gabapentin 400 mg capsule
67,877,022,405.00
5.64
6,370,000,100.00
gabapentin 300 mg capsule
67,877,022,305.00
5.64
6,370,000,100.00
gabapentin 100 mg capsule
67,877,022,201.00
5.66
6,370,000,100.00
gabapentin 100 mg capsule
67,877,022,205.00
5.66
6,370,000,100.00
buPROPion HCL SR 100 mg tablet,12 hr sustained-release
185,041,001.00
6.07
6,370,000,100.00
buPROPion HCL SR 150 mg tablet,12 hr sustained-release
185,041,501.00
5.92
6,370,000,100.00
carvediloL 3.125 mg tablet
378,363,101.00
5.70
6,370,000,100.00
carvediloL 3.125 mg tablet
68,462,016,201.00
5.68
6,370,000,100.00
latanoprost 0.005 % eye drops
61,314,054,701.00
5.83
6,370,000,100.00
donepeziL 10 mg tablet
43,547,027,609.00
5.70
6,370,000,100.00
levoFLOXacin 500 mg tablet
55,111,028,050.00
5.81
6,370,000,100.00
topiramate 25 mg tablet
68,382,013,814.00
5.69
6,370,000,100.00
hydroCHLOROthiazide 12.5 mg capsule
29,300,013,001.00
5.72
6,370,000,100.00
hydroCHLOROthiazide 12.5 mg capsule
591,034,701.00
5.70
6,370,000,100.00
atorvastatin 10 mg tablet
378,395,077.00
5.83
6,370,000,100.00
atorvastatin 40 mg tablet
378,395,277.00
5.70
6,370,000,100.00
atorvastatin 20 mg tablet
93,505,998.00
5.71
6,370,000,100.00
warfarin 3 mg tablet
93,171,501.00
5.70
6,370,000,100.00
warfarin 3 mg tablet
56,018,875.00
6.36
6,370,000,100.00
calcium carbonate 500 mg-vitamin D3 5 mcg (200 unit) tablet
37,864,000,032.00
5.64
6,370,000,100.00
clindamycin 1 % lotion
168,020,360.00
7.54
6,370,000,100.00
metroNIDAZOLE 0.75 % topical gel
115,147,446.00
34.00
6,370,000,100.00
ofloxacin 0.3 % eye drops
64,980,051,505.00
54.00
6,370,000,100.00
ofloxacin 0.3 % eye drops
60,505,056,001.00
114.80
6,370,000,100.00
sertraline 25 mg tablet
68,180,035,109.00
5.80
6,370,000,100.00
cyanocobalamin (vit B-12) 100 mcg tablet
536,354,201.00
5.63
6,370,000,100.00
cyanocobalamin (vit B-12) 500 mcg tablet
904,320,713.00
5.62
6,370,000,100.00
cyanocobalamin (vit B-12) 500 mcg tablet
96,295,012,778.00
5.63
6,370,000,100.00
cyclobenzaprine 10 mg tablet
591,565,801.00
5.66
6,370,000,100.00
cyclopentolate 1 % eye drops
17,478,010,002.00
47.42
6,370,000,100.00
cyclopentolate 1 % eye drops
24,208,073,501.00
47.70
6,370,000,100.00
imiquimod 5 % topical cream packet
45,802,036,862.00
7.70
6,370,000,100.00
azithromycin 250 mg tablet
50,111,078,751.00
8.12
6,370,000,100.00
azithromycin 250 mg tablet
68,180,016,011.00
7.03
6,370,000,100.00
azithromycin 250 mg tablet
781,808,931.00
7.79
6,370,000,100.00
OLANZapine 2.5 mg tablet
55,111,016,330.00
5.82
6,370,000,100.00
citalopram 20 mg tablet
378,623,201.00
5.66
6,370,000,100.00
pramipexole 0.125 mg tablet
68,462,033,090.00
5.73
6,370,000,100.00
pramipexole 0.25 mg tablet
68,382,019,710.00
5.70
6,370,000,100.00
dapsone 100 mg tablet
49,938,010,130.00
6.32
6,370,000,100.00
warfarin 4 mg tablet
56,016,875.00
6.18
6,370,000,100.00
warfarin 4 mg tablet
51,672,403,101.00
5.70
6,370,000,100.00
letrozole 2.5 mg tablet
51,991,075,933.00
5.92
6,370,000,100.00
rOPINIRole 0.25 mg tablet
378,552,501.00
6.12
6,370,000,100.00
rOPINIRole 1 mg tablet
43,547,027,010.00
5.75
6,370,000,100.00
rOPINIRole 0.5 mg tablet
43,547,026,910.00
5.87
6,370,000,100.00
QUEtiapine 25 mg tablet
67,877,024,201.00
5.66
6,370,000,100.00
QUEtiapine 200 mg tablet
67,877,024,601.00
5.68
6,370,000,100.00
clopidogreL 75 mg tablet
16,729,021,816.00
5.71
6,370,000,100.00
ofloxacin 0.3 % ear drops
60,505,036,301.00
245.00
6,370,000,100.00
cefdinir 300 mg capsule
781,217,660.00
6.45
6,370,000,100.00
montelukast 10 mg tablet
54,025,922.00
5.83
6,370,000,100.00
sulfamethoxazole 200 mg-trimethoprim 40 mg/5 mL oral suspension
65,862,049,647.00
143.04
6,370,000,100.00
losartan 100 mg tablet
65,862,020,390.00
5.66
6,370,000,100.00
losartan 100 mg tablet
43,547,036,209.00
5.68
6,370,000,100.00
ursodioL 250 mg tablet
49,884,041,201.00
7.77
6,370,000,100.00
tolterodine 2 mg tablet
93,001,806.00
6.98
6,370,000,100.00
camphor-menthoL 0.5 %-0.5 % lotion
316,022,975.00
5.65
6,370,000,100.00
simvastatin 80 mg tablet
16,729,000,715.00
5.63
6,370,000,100.00
lidocaine 5 % topical cream
496,089,230.00
6.39
6,370,000,100.00
citalopram 40 mg tablet
378,623,301.00
5.65
6,370,000,100.00
cranberry extract 425 mg capsule
43,292,055,812.00
5.65
6,370,000,100.00
diazePAM 5 mg tablet
172,392,660.00
5.64
6,370,000,100.00
dicloxacillin 250 mg capsule
93,312,301.00
6.25
6,370,000,100.00
dicloxacillin 500 mg capsule
93,312,501.00
6.25
6,370,000,100.00
dicyclomine 20 mg tablet
378,162,001.00
5.72
6,370,000,100.00
isosorbide mononitrate ER 60 mg tablet,extended release 24 hr
62,175,011,937.00
5.73
6,370,000,100.00
digoxin 125 mcg (0.125 mg) tablet
143,124,001.00
6.81
6,370,000,100.00
oxybutynin chloride ER 5 mg tablet,extended release 24 hr
378,660,501.00
7.96
6,370,000,100.00
oxybutynin chloride ER 10 mg tablet,extended release 24 hr
378,661,001.00
6.79
6,370,000,100.00
cilostazoL 50 mg tablet
60,505,252,101.00
5.99
6,370,000,100.00
cilostazoL 100 mg tablet
93,206,406.00
5.80
6,370,000,100.00
celecoxib 100 mg capsule
59,762,151,601.00
6.22
6,370,000,100.00
celecoxib 200 mg capsule
69,097,042,107.00
5.77
6,370,000,100.00
isosorbide mononitrate ER 30 mg tablet,extended release 24 hr
62,175,012,837.00
5.83
6,370,000,100.00
coenzyme Q10 100 mg capsule
96,295,011,765.00
5.90
6,370,000,100.00
coenzyme Q10 100 mg capsule
40,985,027,413.00
5.75
6,370,000,100.00
modafiniL 200 mg tablet
60,505,252,703.00
6.25
6,370,000,100.00
lisinopril 10 mg-hydrochlorothiazide 12.5 mg tablet
68,180,051,801.00
5.72
6,370,000,100.00
dilTIAZem 120 mg tablet
93,032,101.00
5.73
6,370,000,100.00
dilTIAZem 30 mg tablet
93,031,801.00
5.77
6,370,000,100.00
dilTIAZem 60 mg tablet
51,079,074,601.00
5.75
6,370,000,100.00
dextromethorphan-guaifenesin 30 mg-600 mg tablet extended release12 hr
63,824,005,640.00
6.09
6,370,000,100.00
dimenhyDRINATE 50 mg tablet
904,205,159.00
5.63
6,370,000,100.00
levalbuteroL 1.25 mg/3 mL solution for nebulization
93,414,864.00
24.06
6,370,000,100.00
levalbuteroL 1.25 mg/3 mL solution for nebulization
76,204,090,001.00
7.22
6,370,000,100.00
albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization
487,950,101.00
6.42
6,370,000,100.00
albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization
487,950,160.00
5.78
6,370,000,100.00
ciprofloxacin 500 mg tablet
143,992,801.00
5.66
6,370,000,100.00
diphenoxylate-atropine 2.5 mg-0.025 mg tablet
378,041,501.00
6.32
6,370,000,100.00
verapamiL ER 120 mg 24 hr capsule,extended release
378,632,001.00
7.08
6,370,000,100.00
amoxicillin 400 mg/5 mL oral suspension
143,988,701.00
28.50
6,370,000,100.00
glucosamine-chondroitin 500 mg-400 mg tablet
43,292,056,003.00
5.73
6,370,000,100.00
polyethylene glycol 3350 17 gram oral powder packet
904,642,286.00
7.01
6,370,000,100.00
risperiDONE 0.25 mg tablet
68,382,011,214.00
5.73
6,370,000,100.00
risperiDONE 0.25 mg tablet
904,635,761.00
5.79
6,370,000,100.00
risperiDONE 0.5 mg tablet
68,382,011,314.00
5.68
6,370,000,100.00
pioglitazone 15 mg tablet
16,729,002,010.00
5.75
6,370,000,100.00
pioglitazone 15 mg tablet
33,342,005,410.00
5.75
6,370,000,100.00
pioglitazone 45 mg tablet
16,729,002,215.00
5.68
6,370,000,100.00
gabapentin 600 mg tablet
68,462,012,601.00
5.82
6,370,000,100.00
doxepin 10 mg capsule
378,104,901.00
6.09
6,370,000,100.00
pantoprazole 40 mg tablet,delayed release
65,862,056,090.00
5.76
6,370,000,100.00
doxycycline hyclate 100 mg capsule
143,314,250.00
6.22
6,370,000,100.00
oseltamivir 75 mg capsule
4,080,085.00
28.08
6,370,000,100.00
oseltamivir 75 mg capsule
70,710,101,002.00
15.20
6,370,000,100.00
levETIRAcetam 500 mg tablet
31,722,053,712.00
5.78
6,370,000,100.00
ciclopirox 8 % topical solution
51,672,530,200.00
34.00
6,370,000,100.00
theophylline ER 200 mg capsule,extended release 24 hr
52,244,020,010.00
18.84
6,370,000,100.00
nitroglycerin 0.1 mg/hr transdermal 24 hour patch
378,910,216.00
6.23
6,370,000,100.00
nitroglycerin 0.2 mg/hr transdermal 24 hour patch
68,382,030,930.00
6.33
6,370,000,100.00
nitroglycerin 0.4 mg/hr transdermal 24 hour patch
904,549,646.00
6.13
6,370,000,100.00
felodipine ER 5 mg tablet,extended release 24 hr
13,668,013,301.00
5.81
6,370,000,100.00
pseudoephedrine-guaifenesin ER 60 mg-600 mg tablet,extend release 12hr
63,824,005,718.00
6.25
6,370,000,100.00
divalproex 125 mg capsule,delayed release sprinkle
68,382,010,601.00
6.18
6,370,000,100.00
NIFEdipine ER 60 mg tablet,extended release 24 hr
68,682,010,910.00
6.55
6,370,000,100.00
lansoprazole 15 mg capsule,delayed release
781,214,731.00
7.62
6,370,000,100.00
lansoprazole 30 mg capsule,delayed release
378,803,093.00
6.62
6,370,000,100.00
omeprazole 20 mg capsule,delayed release
60,505,006,501.00
5.79
6,370,000,100.00
omeprazole 40 mg capsule,delayed release
781,223,401.00
5.65
6,370,000,100.00
omeprazole 40 mg capsule,delayed release
60,505,014,602.00
5.76
6,370,000,100.00
ondansetron 4 mg disintegrating tablet
68,462,015,740.00
6.08
6,370,000,100.00
venlafaxine ER 37.5 mg capsule,extended release 24 hr
65,862,052,790.00
5.89
6,370,000,100.00
venlafaxine ER 75 mg capsule,extended release 24 hr
65,862,052,890.00
5.95
6,370,000,100.00
fentaNYL 25 mcg/hr transdermal patch
60,505,700,600.00
19.47
6,370,000,100.00
fentaNYL 50 mcg/hr transdermal patch
60,505,700,702.00
38.20
6,370,000,100.00
fentaNYL 50 mcg/hr transdermal patch
47,781,042,647.00
51.67
6,370,000,100.00
fentaNYL 75 mcg/hr transdermal patch
60,505,700,802.00
47.97
6,370,000,100.00
fentaNYL 100 mcg/hr transdermal patch
60,505,700,902.00
67.40
6,370,000,100.00
chlorhexidine gluconate 4 % topical liquid
32,551,093,835.00
5.65
6,370,000,100.00
lidocaine 5 % topical patch
591,352,511.00
15.00
6,370,000,100.00
lidocaine 5 % topical patch
603,188,010.00
29.49
6,370,000,100.00
linezolid 600 mg tablet
59,762,130,701.00
29.22
6,370,000,100.00
pentamidine 300 mg solution for inhalation
13,925,052,201.00
584.50
6,370,000,100.00
salmeteroL 50 mcg/dose blister powder for inhalation
173,052,000.00
37.07
6,370,000,100.00
insulin glargine (U-100) 100 unit/mL subcutaneous solution
88,222,033.00
683.56
6,370,000,100.00
HYDROcodone 10 mg-acetaminophen 325 mg tablet
43,386,035,801.00
5.85
6,370,000,100.00
HYDROcodone 10 mg-acetaminophen 325 mg tablet
60,687,041,801.00
6.22
6,370,000,100.00
insulin aspart U-100 100 unit/mL subcutaneous solution
169,750,111.00
151.44
6,370,000,100.00
calcium citrate 315 mg-vitamin D3 5 mcg (200 unit) tablet
80,681,004,500.00
5.68
6,370,000,100.00
ergocalciferol (vitamin D2) 1,250 mcg (50,000 unit) capsule
64,380,073,706.00
5.98
6,370,000,100.00
NIFEdipine ER 30 mg tablet,extended release 24 hr
68,682,010,810.00
6.69
6,370,000,100.00
atorvastatin 80 mg tablet
93,505,798.00
5.64
6,370,000,100.00
glyBURIDE 5 mg-metformin 500 mg tablet
65,862,008,201.00
5.71
6,370,000,100.00
budesonide 0.5 mg/2 mL suspension for nebulization
93,681,673.00
37.26
6,370,000,100.00
budesonide 0.5 mg/2 mL suspension for nebulization
781,751,614.00
14.98
6,370,000,100.00
budesonide 0.5 mg/2 mL suspension for nebulization
487,970,101.00
37.70
6,370,000,100.00
hydrocortisone 2.5 % topical cream with perineal applicator
64,980,032,430.00
6.28
6,370,000,100.00
erythromycin 5 mg/gram (0.5 %) eye ointment
24,208,091,055.00
54.20
6,370,000,100.00
metFORMIN ER 500 mg tablet,extended release 24 hr
62,756,014,201.00
5.71
6,370,000,100.00
alendronate 70 mg tablet
69,097,022,416.00
5.68
6,370,000,100.00
QUEtiapine 300 mg tablet
47,335,090,688.00
5.88
6,370,000,100.00
dilTIAZem ER 120 mg capsule,24 hr,extended release
68,682,036,790.00
6.24
6,370,000,100.00
clotrimazole-betamethasone 1 %-0.05 % topical cream
168,025,815.00
6.74
6,370,000,100.00
tolterodine ER 2 mg capsule,extended release 24 hr
378,340,293.00
28.42
6,370,000,100.00
tolterodine ER 4 mg capsule,extended release 24 hr
93,716,498.00
15.21
6,370,000,100.00
sodium chloride 0.65 % nasal spray aerosol
904,386,575.00
5.64
6,370,000,100.00
esomeprazole magnesium 20 mg capsule,delayed release
186,502,054.00
37.58
6,370,000,100.00
esomeprazole magnesium 20 mg capsule,delayed release
93,645,098.00
6.13
6,370,000,100.00
esomeprazole magnesium 40 mg capsule,delayed release
186,504,054.00
19.49
6,370,000,100.00
esomeprazole magnesium 40 mg capsule,delayed release
93,645,198.00
23.72
6,370,000,100.00
metoprolol succinate ER 25 mg tablet,extended release 24 hr
62,037,083,001.00
5.99
6,370,000,100.00
metoprolol succinate ER 50 mg tablet,extended release 24 hr
62,037,083,101.00
5.99
6,370,000,100.00
metoprolol succinate ER 100 mg tablet,extended release 24 hr
68,084,067,311.00
5.97
6,370,000,100.00
valGANciclovir 450 mg tablet
16,714,076,501.00
52.97
6,370,000,100.00
citalopram 10 mg tablet
378,623,101.00
5.69
6,370,000,100.00
ferrous gluconate 324 mg (38 mg iron) tablet
574,050,801.00
5.67
6,370,000,100.00
ferrous sulfate 220 mg (44 mg iron)/5 mL oral solution
5,361,015,516.00
5.67
6,370,000,100.00
ferrous sulfate 325 mg (65 mg iron) tablet
904,759,180.00
5.63
6,370,000,100.00
allopurinoL 100 mg tablet
378,013,701.00
5.90
6,370,000,100.00
allopurinoL 300 mg tablet
603,211,621.00
6.22
6,370,000,100.00
allopurinoL 300 mg tablet
70,710,121,001.00
5.83
6,370,000,100.00
valsartan 80 mg tablet
43,547,036,809.00
5.79
6,370,000,100.00
oxyCODONE-acetaminophen 10 mg-325 mg tablet
406,052,301.00
6.11
6,370,000,100.00
fluorometholone 0.1 % eye drops,suspension
60,758,088,005.00
251.05
6,370,000,100.00
folic acid 1 mg tablet
11,534,016,501.00
5.64
6,370,000,100.00
ALPRAZolam 0.25 mg tablet
67,253,090,010.00
5.64
6,370,000,100.00
ALPRAZolam 0.25 mg tablet
51,079,078,801.00
5.66
6,370,000,100.00
ALPRAZolam 0.5 mg tablet
67,253,090,110.00
5.63
6,370,000,100.00
risedronate 35 mg tablet
430,047,203.00
47.78
6,370,000,100.00
furosemide 10 mg/mL oral solution
54,329,446.00
28.72
6,370,000,100.00
furosemide 20 mg tablet
54,429,731.00
5.64
6,370,000,100.00
furosemide 40 mg tablet
378,021,610.00
5.63
6,370,000,100.00
furosemide 80 mg tablet
378,023,201.00
5.63
6,370,000,100.00
amoxicillin 500 mg-potassium clavulanate 125 mg tablet
66,685,100,200.00
7.03
6,370,000,100.00
amoxicillin 875 mg-potassium clavulanate 125 mg tablet
66,685,100,100.00
23.75
6,370,000,100.00
amoxicillin 400 mg-potassium clavulanate 57 mg/5 mL oral suspension
65,862,053,401.00
53.60
6,370,000,100.00
escitalopram 10 mg tablet
93,585,101.00
5.73
6,370,000,100.00
escitalopram 20 mg tablet
93,585,201.00
5.68
6,370,000,100.00
valsartan 40 mg tablet
43,547,036,703.00
5.89
6,370,000,100.00
gemfibroziL 600 mg tablet
69,097,082,103.00
5.71
6,370,000,100.00
dutasteride 0.5 mg capsule
173,071,215.00
29.60
6,370,000,100.00
ezetimibe 10 mg tablet
49,884,022,811.00
7.71
6,370,000,100.00
gentian violet 1 % topical solution
395,100,392.00
5.68
6,370,000,100.00
ARIPiprazole 10 mg tablet
60,505,267,403.00
5.92
6,370,000,100.00
HYDROcodone 5 mg-acetaminophen 325 mg tablet
53,746,010,905.00
5.80
6,370,000,100.00
HYDROcodone 5 mg-acetaminophen 325 mg tablet
904,656,761.00
5.96
6,370,000,100.00
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
603,389,128.00
6.04
6,370,000,100.00
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
13,107,002,005.00
6.04
6,370,000,100.00
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
904,642,061.00
6.00
6,370,000,100.00
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
50,268,040,015.00
5.97
6,370,000,100.00
HYDROcodone 7.5 mg-acetaminophen 325 mg tablet
65,162,011,550.00
5.74
6,370,000,100.00
guaiFENesin 400 mg tablet
57,896,079,401.00
5.63
6,370,000,100.00
neomycin-polymyxin-hydrocort 3.5 mg/mL-10,000 unit/mL-1 % ear solution
24,208,063,110.00
315.40
6,370,000,100.00
neomycin-polymyxin-hydrocort 3.5 mg/mL-10,000 unit/mL-1 % ear solution
61,314,064,610.00
315.40
6,370,000,100.00
glyBURIDE 5 mg tablet
23,155,005,801.00
5.70
6,370,000,100.00
rosuvastatin 20 mg tablet
310,075,290.00
7.92
6,370,000,100.00
rosuvastatin 40 mg tablet
65,862,029,630.00
5.64
6,370,000,100.00
cyclobenzaprine 5 mg tablet
591,325,601.00
5.79
6,370,000,100.00
coenzyme Q10 50 mg capsule
79,854,000,848.00
5.88
6,370,000,100.00
metFORMIN ER 750 mg tablet,extended release 24 hr
70,010,049,201.00
5.67
6,370,000,100.00
metFORMIN ER 750 mg tablet,extended release 24 hr
67,877,041,401.00
5.67
6,370,000,100.00
haloperidoL 1 mg tablet
378,025,701.00
5.99
6,370,000,100.00
haloperidoL 2 mg tablet
781,139,301.00
5.87
6,370,000,100.00
potassium chloride ER 20 mEq tablet,extended release(part/cryst)
781,572,010.00
5.87
6,370,000,100.00
potassium chloride ER 20 mEq tablet,extended release(part/cryst)
66,758,019,006.00
5.89
6,370,000,100.00
menthol 5 % topical patch
41,167,000,843.00
6.60
6,370,000,100.00
amantadine HCL 100 mg capsule
42,543,049,301.00
6.43
6,370,000,100.00
ARIPiprazole 5 mg tablet
13,668,021,730.00
6.21
6,370,000,100.00
ciprofloxacin 0.3 %-dexamethasone 0.1 % ear drops,suspension
43,598,032,675.00
615.00
6,370,000,100.00
levETIRAcetam 100 mg/mL oral solution
16,714,035,801.00
147.77
6,370,000,100.00
rosuvastatin 5 mg tablet
781,540,092.00
5.90
6,370,000,100.00
buPROPion HCL XL 150 mg 24 hr tablet, extended release
10,370,010,103.00
6.45
6,370,000,100.00
buPROPion HCL XL 150 mg 24 hr tablet, extended release
68,180,031,906.00
5.80
6,370,000,100.00
phenylephrine 0.125 % nasal drops
56,184,012,105.00
5.63
6,370,000,100.00
amiodarone 100 mg tablet
51,862,024,030.00
14.79
6,370,000,100.00
memantine 10 mg tablet
29,300,017,216.00
5.75
6,370,000,100.00
alfuzosin ER 10 mg tablet,extended release 24 hr
60,505,285,001.00
5.97
6,370,000,100.00
hydrALAZINE 25 mg tablet
23,155,000,201.00
5.64
6,370,000,100.00
hydrALAZINE 50 mg tablet
23,155,000,301.00
5.64
6,370,000,100.00
hydroCHLOROthiazide 25 mg tablet
16,729,018,301.00
5.64
6,370,000,100.00
hydrocortisone 1 % topical cream
45,802,043,803.00
7.72
6,370,000,100.00
hydrocortisone 2.5 % topical cream
168,008,031.00
15.30
6,370,000,100.00
hydrocortisone 2.5 % topical cream
45,802,000,403.00
18.71
6,370,000,100.00
hydrocortisone 10 mg tablet
68,084,046,911.00
6.35
6,370,000,100.00
hydrocortisone 20 mg tablet
59,762,007,501.00
5.75
6,370,000,100.00
hydrocortisone acetate 25 mg rectal suppository
713,050,312.00
27.75
6,370,000,100.00
HYDROmorphone 2 mg tablet
42,858,030,101.00
5.67
6,370,000,100.00
escitalopram 5 mg tablet
378,385,577.00
5.80
6,370,000,100.00
metoprolol tartrate 25 mg tablet
378,001,805.00
5.64
6,370,000,100.00
glipiZIDE ER 5 mg tablet, extended release 24 hr
68,084,011,111.00
5.92
6,370,000,100.00
glipiZIDE ER 10 mg tablet, extended release 24 hr
59,762,054,202.00
5.70
6,370,000,100.00
guaiFENesin ER 600 mg tablet, extended release 12 hr
536,116,361.00
6.10
6,370,000,100.00
guaiFENesin ER 600 mg tablet, extended release 12 hr
904,671,839.00
6.51
6,370,000,100.00
guaiFENesin ER 600 mg tablet, extended release 12 hr
63,824,000,840.00
6.05
6,370,000,100.00
hydrOXYzine HCL 25 mg tablet
10,702,001,101.00
5.66
6,370,000,100.00
hydrOXYzine HCL 25 mg tablet
23,155,050,101.00
5.64
6,370,000,100.00
HYDROcodone 7.5 mg-acetaminophen 325 mg/15 mL oral solution
66,689,002,316.00
147.77
6,370,000,100.00
propranoloL ER 60 mg capsule,24 hr,extended release
51,991,081,701.00
6.71
6,370,000,100.00
lactulose 10 gram/15 mL oral solution
50,383,077,932.00
5.98
6,370,000,100.00
tiotropium bromide 18 mcg capsule with inhalation device
597,007,575.00
66.93
6,370,000,100.00
ibuprofen 400 mg tablet
67,877,031,901.00
5.65
6,370,000,100.00
ibuprofen 600 mg tablet
55,111,068,301.00
5.66
6,370,000,100.00
ibuprofen 800 mg tablet
53,746,046,601.00
5.66
6,370,000,100.00
indomethacin 25 mg capsule
68,462,040,601.00
5.82
6,370,000,100.00
aMILoride 5 mg tablet
574,029,201.00
5.84
6,370,000,100.00
DULoxetine 20 mg capsule,delayed release
57,237,001,760.00
5.92
6,370,000,100.00
DULoxetine 30 mg capsule,delayed release
57,237,001,830.00
5.84
6,370,000,100.00
DULoxetine 60 mg capsule,delayed release
57,237,001,930.00
5.73
6,370,000,100.00
DULoxetine 60 mg capsule,delayed release
57,237,001,999.00
5.72
6,370,000,100.00
mesalamine 1,000 mg rectal suppository
64,980,028,203.00
19.07
6,370,000,100.00
solifenacin 5 mg tablet
51,248,015,003.00
51.85
6,370,000,100.00
darifenacin ER 7.5 mg tablet,extended release 24 hr
69,097,043,102.00
15.28
6,370,000,100.00
isosorbide dinitrate 10 mg tablet
143,177,101.00
5.91
6,370,000,100.00
fluticasone propionate 110 mcg/actuation HFA aerosol inhaler
173,071,920.00
705.85
6,370,000,100.00
fluticasone propionate 220 mcg/actuation HFA aerosol inhaler
173,072,020.00
1,047.94
6,370,000,100.00
cholecalciferol (vitamin D3) 1,000 unit tablet,cholecalciferol (vitamin D3) 1,000 unit capsule
79,854,005,023.00
5.63
6,370,000,100.00
cholecalciferol (vitamin D3) 5,000 unit capsule,cholecalciferol (vitamin D3) 5,000 unit tablet
904,598,660.00
5.62
6,370,000,100.00
cholecalciferol (vitamin D3) 400 unit tablet,cholecalciferol (vitamin D3) 400 unit capsule
904,582,360.00
5.63
6,370,000,100.00
loperamide 2 mg capsule,loperamide 2 mg tablet
378,210,001.00
5.99
6,370,000,100.00
Lactobacillus rhamnosus GG 10 billion cell capsule,Lactobacillus rhamnosus GG 15 billion cell sprinkle capsule
49,100,038,164.00
6.13
6,370,000,100.00
9,999,307,701.00
28.90
6,370,000,100.00
9,999,307,801.00
28.35
6,370,000,100.00
9,999,307,901.00
25.87
6,370,000,100.00
9,999,308,001.00
70.22
6,370,000,100.00
9,999,312,901.00
13.93
6,370,000,100.00
9,999,313,001.00
385.41
6,370,000,100.00
9,999,313,601.00
16.48
6,370,000,100.00
9,999,313,701.00
39.91
6,370,000,100.00
dextromethorphan-guaifenesin 10 mg-100 mg/5 mL syrup,dextromethorphan-guaifenesin 10 mg-100 mg/5 mL oral liquid
70,000,030,101.00
24.25
6,370,000,100.00
dextromethorphan-guaifenesin 10 mg-100 mg/5 mL syrup,dextromethorphan-guaifenesin 10 mg-100 mg/5 mL oral liquid
96,295,013,210.00
24.25
6,370,000,100.00
morphine concentrate 20 mg/mL oral syringe (FOR ORAL USE ONLY),morphine concentrate 100 mg/5 mL (20 mg/mL) oral solution,morphine concentrate 10 mg/0.5 mL oral syringe (FOR ORAL USE ONLY)
406,800,330.00
5.90
6,370,000,100.00
dilTIAZem CD 120 mg capsule,extended release 24 hr,dilTIAZEM ER (XR/XT) 120 mg capsule, extended release 24 hr, controlled
68,382,059,516.00
6.11
6,370,000,100.00
dilTIAZem CD 240 mg capsule,extended release 24 hr,dilTIAZem ER (XR/XT) 240 mg capsule, extended release 24 hr, controlled
10,370,083,109.00
6.28
6,370,000,100.00
9,999,701,000.00
14.82
6,370,000,100.00
51,552,153,601.00
325.50
6,370,000,100.00
potassium chloride ER 10 mEq tablet,extended release,potassium chloride ER 10 mEq tablet,extended release(part/cryst)
66,758,016,005.00
6.07
6,370,000,100.00
9,999,308,401.00
20.25
6,370,000,100.00
9,999,999,000.00
21.19
6,370,000,100.00
9,999,999,007.00
43.05
6,370,000,100.00
9,999,999,001.00
15.55
6,370,000,100.00
9,999,999,014.00
17.15
6,370,000,100.00
9,999,999,002.00
35.17
6,370,000,100.00
9,999,999,003.00
15.34
6,370,000,100.00
9,999,999,004.00
14.44
6,370,000,100.00
9,999,999,005.00
14.95
6,370,000,100.00
9,999,308,301.00
17.21
6,370,000,100.00
9,999,308,101.00
14.31
6,370,000,100.00
9,999,999,006.00
20.13
6,370,000,100.00
9,999,999,008.00
36.75
6,370,000,100.00
9,999,999,009.00
14.54
6,370,000,100.00
9,999,999,010.00
14.59
6,370,000,100.00
9,999,999,013.00
19.21
6,370,000,100.00
9,999,999,011.00
14.29
6,370,000,100.00
9,999,999,015.00
14.01
6,370,000,100.00
9,999,999,016.00
14.19
6,370,000,100.00
9,999,999,019.00
29.13
6,370,000,100.00
9,999,999,020.00
26.80
6,370,000,100.00
9,999,999,022.00
59.31
6,370,000,100.00
9,999,999,024.00
14.96
6,370,000,100.00
9,999,999,029.00
19.99
6,370,000,100.00
9,999,999,031.00
14.55
6,370,000,100.00
9,999,999,030.00
14.20
6,370,000,100.00
9,999,999,012.00
28.95
6,370,000,100.00
9,999,999,017.00
30.40
6,370,000,100.00
9,999,999,018.00
265.45
6,370,000,100.00
9,999,308,501.00
15.45
6,370,000,100.00
9,999,308,201.00
28.75
6,370,000,100.00
glycerin (adult) rectal suppository
132,007,912.00
5.71
6,370,000,100.00
ibandronate 150 mg tablet
55,111,057,511.00
53.17
6,370,000,100.00
fentaNYL 12 mcg/hr transdermal patch
60,505,701,000.00
64.24
6,370,000,100.00
mometasone 220 mcg/actuation(14 doses) breath activated powder inhaler
85,134,106.00
253.96
6,370,000,100.00
pregabalin 25 mg capsule
71,101,268.00
34.09
6,370,000,100.00
pregabalin 50 mg capsule
71,101,368.00
19.19
6,370,000,100.00
pregabalin 75 mg capsule
71,101,468.00
14.86
6,370,000,100.00
pregabalin 100 mg capsule
71,101,568.00
34.09
6,370,000,100.00
pregabalin 300 mg capsule
67,877,046,990.00
5.68
6,370,000,100.00
losartan 100 mg-hydrochlorothiazide 12.5 mg tablet
13,668,011,790.00
5.91
6,370,000,100.00
leucovorin calcium 5 mg tablet
54,449,613.00
6.74
6,370,000,100.00
levothyroxine 25 mcg tablet
527,134,110.00
5.98
6,370,000,100.00
levothyroxine 50 mcg tablet
378,180,377.00
5.83
6,370,000,100.00
levothyroxine 50 mcg tablet
68,180,096,609.00
5.69
6,370,000,100.00
levothyroxine 75 mcg tablet
378,180,577.00
5.77
6,370,000,100.00
levothyroxine 100 mcg tablet
378,180,977.00
5.74
6,370,000,100.00
levothyroxine 125 mcg tablet
378,181,377.00
5.73
6,370,000,100.00
levothyroxine 150 mcg tablet
378,181,577.00
5.71
6,370,000,100.00
amoxicillin 250 mg capsule
781,202,001.00
5.74
6,370,000,100.00
liothyronine 25 mcg tablet
42,794,001,902.00
5.79
6,370,000,100.00
amoxicillin 500 mg capsule
781,261,301.00
5.71
6,370,000,100.00
amoxicillin 250 mg chewable tablet
93,226,801.00
5.77
6,370,000,100.00
lisinopriL 20 mg tablet
378,207,510.00
5.62
6,370,000,100.00
lisinopriL 20 mg tablet
68,180,098,103.00
5.63
6,370,000,100.00
amoxicillin 250 mg/5 mL oral suspension
781,604,146.00
15.60
6,370,000,100.00
amoxicillin 250 mg/5 mL oral suspension
143,988,901.00
15.00
6,370,000,100.00
amoxicillin 250 mg/5 mL oral suspension
143,988,915.00
23.35
6,370,000,100.00
loperamide 2 mg capsule
378,210,001.00
5.99
6,370,000,100.00
loperamide 2 mg capsule
96,295,013,094.00
6.06
6,370,000,100.00
LORazepam 2 mg/mL oral concentrate
54,353,244.00
114.06
6,370,000,100.00
LORazepam 0.5 mg tablet
69,315,090,405.00
5.70
6,370,000,100.00
LORazepam 0.5 mg tablet
904,600,761.00
5.69
6,370,000,100.00
LORazepam 1 mg tablet
69,315,090,501.00
5.66
6,370,000,100.00
LORazepam 1 mg tablet
904,600,861.00
5.66
6,370,000,100.00
magnesium citrate oral solution
904,630,477.00
7.40
6,370,000,100.00
magnesium oxide 500 mg tablet
904,423,960.00
5.64
6,370,000,100.00
medroxyPROGESTERone 2.5 mg tablet
555,087,202.00
5.76
6,370,000,100.00
megestroL 40 mg tablet
904,357,161.00
5.74
6,370,000,100.00
9,999,999,028.00
42.99
6,370,000,100.00
methocarbamoL 500 mg tablet
76,385,012,301.00
5.70
6,370,000,100.00
methocarbamoL 750 mg tablet
31,722,053,401.00
5.72
6,370,000,100.00
methotrexate sodium 2.5 mg tablet
68,382,077,501.00
6.18
6,370,000,100.00
methotrexate sodium 2.5 mg tablet
54,855,025.00
15.05
6,370,000,100.00
methyldopa 250 mg tablet
16,729,003,001.00
5.74
6,370,000,100.00
methylphenidate 10 mg tablet
31,722,017,401.00
5.76
6,370,000,100.00
methylphenidate 5 mg tablet
16,729,047,801.00
5.72
6,370,000,100.00
metoclopramide 10 mg tablet
93,220,301.00
5.66
6,370,000,100.00
metoclopramide 5 mg tablet
93,220,401.00
5.69
6,370,000,100.00
metoprolol tartrate 50 mg tablet
378,003,201.00
5.63
6,370,000,100.00
metroNIDAZOLE 500 mg tablet
29,300,022,701.00
5.88
6,370,000,100.00
miconazole nitrate 2 % topical cream
472,073,556.00
5.71
6,370,000,100.00
morphine 15 mg immediate release tablet
54,023,525.00
6.05
6,370,000,100.00
naproxen 250 mg tablet
68,462,018,801.00
5.71
6,370,000,100.00
naproxen 250 mg tablet
68,462,018,805.00
5.71
6,370,000,100.00
naproxen 250 mg tablet
65,162,018,810.00
5.69
6,370,000,100.00
naproxen 500 mg tablet
49,483,061,801.00
5.66
6,370,000,100.00
niacin 100 mg tablet
79,854,020,130.00
5.65
6,370,000,100.00
niacin 500 mg tablet
904,227,260.00
5.63
6,370,000,100.00
nitroglycerin ER 2.5 mg capsule,extended release
904,064,360.00
5.92
6,370,000,100.00
nitroglycerin ER 6.5 mg capsule,extended release
904,064,460.00
5.75
6,370,000,100.00
nitroglycerin 0.4 mg sublingual tablet
71,041,813.00
6.99
6,370,000,100.00
nitroglycerin 2 % transdermal ointment
281,032,608.00
6.72
6,370,000,100.00
nortriptyline 25 mg capsule
51,672,400,205.00
5.68
6,370,000,100.00
nortriptyline 25 mg capsule
51,672,400,201.00
5.73
6,370,000,100.00
nystatin 100,000 unit/gram topical ointment
168,000,730.00
6.32
6,370,000,100.00
nystatin 100,000 unit/mL oral suspension
68,094,059,959.00
7.00
6,370,000,100.00
nystatin 100,000 unit/mL oral suspension
60,432,053,760.00
51.72
6,370,000,100.00
oxybutynin chloride 5 mg tablet
832,003,800.00
5.68
6,370,000,100.00
oxybutynin chloride 5 mg tablet
50,111,045,601.00
5.84
6,370,000,100.00
oxyCODONE-acetaminophen 5 mg-325 mg tablet
53,746,020,305.00
5.80
6,370,000,100.00
oxyCODONE-acetaminophen 5 mg-325 mg tablet
68,308,040,547.00
6.01
6,370,000,100.00
oxymetazoline 0.05 % nasal spray
904,571,135.00
5.63
6,370,000,100.00
penicillin V potassium 250 mg/5 mL oral solution
93,412,773.00
33.70
6,370,000,100.00
penicillin V potassium 250 mg tablet
16,714,023,401.00
5.82
6,370,000,100.00
phenazopyridine 200 mg tablet
75,826,011,510.00
6.36
6,370,000,100.00
PHENobarbitaL 20 mg/5 mL (4 mg/mL) oral elixir
16,571,033,016.00
311.44
6,370,000,100.00
phenobarb-hyoscy-atropine-scop 16.2 mg-0.1037 mg-0.0194 mg/5 mL elixir
59,212,042,204.00
1,046.96
6,370,000,100.00
phenobarb-hyoscy-atropine-scop 16.2 mg-0.1037 mg-0.0194 mg/5 mL elixir
75,826,012,804.00
706.76
6,370,000,100.00
phenytoin sodium extended 100 mg capsule
904,618,761.00
5.80
6,370,000,100.00
pilocarpine 1 % eye drops
61,314,020,315.00
310.36
6,370,000,100.00
prednisoLONE acetate 1 % eye drops,suspension
61,314,063,705.00
144.25
6,370,000,100.00
ascorbic acid (vitamin C) 250 mg tablet
96,295,012,843.00
5.66
6,370,000,100.00
ascorbic acid (vitamin C) 500 mg tablet
57,896,084,101.00
5.63
6,370,000,100.00
ascorbic acid (vitamin C) 500 mg tablet
904,052,360.00
5.63
6,370,000,100.00
propranoloL 10 mg tablet
115,165,901.00
5.78
6,370,000,100.00
propranoloL 40 mg tablet
115,166,101.00
5.68
6,370,000,100.00
pseudoephedrine 30 mg tablet
904,505,324.00
5.66
6,370,000,100.00
pyridoxine (vitamin B6) 100 mg tablet
96,295,012,780.00
5.64
6,370,000,100.00
pyridoxine (vitamin B6) 50 mg tablet
37,864,090,901.00
5.63
6,370,000,100.00
QUEtiapine 50 mg tablet
54,022,925.00
5.83
6,370,000,100.00
QUEtiapine 50 mg tablet
67,877,024,901.00
5.65
6,370,000,100.00
fluticasone propionate 50 mcg/actuation nasal spray,suspension
60,505,082,901.00
66.00
6,370,000,100.00
atenoloL 100 mg tablet
93,075,301.00
5.63
6,370,000,100.00
atenoloL 25 mg tablet
93,078,701.00
5.64
6,370,000,100.00
atenoloL 25 mg tablet
93,078,710.00
5.64
6,370,000,100.00
atenoloL 50 mg tablet
93,075,201.00
5.63
6,370,000,100.00
silver sulfADIAZINE 1 % topical cream
67,877,012,405.00
5.87
6,370,000,100.00
silver sulfADIAZINE 1 % topical cream
61,570,013,140.00
5.77
6,370,000,100.00
sodium bicarbonate 650 mg tablet
223,172,101.00
5.65
6,370,000,100.00
sodium chloride 0.9 % for nebulization
487,930,103.00
5.72
6,370,000,100.00
sodium chloride 5 % eye ointment
17,478,062,235.00
38.87
6,370,000,100.00
atropine 1 % eye drops
17,478,021,502.00
138.29
6,370,000,100.00
atropine 1 % eye drops
17,478,021,505.00
191.32
6,370,000,100.00
atropine 1 % eye drops
17,478,021,515.00
572.05
6,370,000,100.00
spironolactone 25 mg tablet
63,739,054,410.00
5.85
6,370,000,100.00
spironolactone 25 mg tablet
53,746,051,101.00
5.75
6,370,000,100.00
sulfamethoxazole 400 mg-trimethoprim 80 mg tablet
53,746,027,101.00
5.81
6,370,000,100.00
potassium chloride 20 mEq/15 mL oral liquid
603,154,258.00
624.94
6,370,000,100.00
potassium chloride 20 mEq/15 mL oral liquid
904,706,186.00
29.01
6,370,000,100.00
glycerin (child) rectal suppository
132,008,112.00
5.72
6,370,000,100.00
temazepam 15 mg capsule
378,401,001.00
5.67
6,370,000,100.00
arformoteroL 15 mcg/2 mL solution for nebulization
63,402,091,101.00
66.76
6,370,000,100.00
arformoteroL 15 mcg/2 mL solution for nebulization
63,402,091,104.00
66.76
6,370,000,100.00
SITagliptin 100 mg tablet
6,027,731.00
19.04
6,370,000,100.00
metoclopramide 5 mg/5 mL oral solution
121,057,616.00
111.83
6,370,000,100.00
tetracaine 0.5 % eye drops
69,292,031,715.00
118.50
6,370,000,100.00
tetracaine 0.5 % eye drops
24,208,092,064.00
33.95
6,370,000,100.00
codeine 10 mg-guaifenesin 100 mg/5 mL oral liquid
121,077,504.00
46.34
6,370,000,100.00
thioridazine 25 mg tablet
378,061,401.00
5.89
6,370,000,100.00
thioridazine 50 mg tablet
378,061,601.00
6.04
6,370,000,100.00
traZODone 50 mg tablet
50,111,043,301.00
5.65
6,370,000,100.00
triamcinolone acetonide 0.025 % topical cream
168,000,315.00
34.00
6,370,000,100.00
triamcinolone acetonide 0.1 % topical cream
168,000,480.00
5.71
6,370,000,100.00
triamcinolone acetonide 0.1 % topical cream
67,877,025,145.00
5.67
6,370,000,100.00
triamcinolone acetonide 0.1 % topical cream
45,802,006,435.00
5.84
6,370,000,100.00
triamcinolone acetonide 0.025 % topical ointment
45,802,005,435.00
34.00
6,370,000,100.00
triamcinolone acetonide 0.1 % topical ointment
168,000,615.00
5.93
6,370,000,100.00
triamcinolone acetonide 0.1 % topical ointment
168,000,680.00
5.77
6,370,000,100.00
divalproex ER 500 mg tablet,extended release 24 hr
10,370,051,110.00
6.04
6,370,000,100.00
budesonide-formoteroL HFA 80 mcg-4.5 mcg/actuation aerosol inhaler
186,037,220.00
960.15
6,370,000,100.00
budesonide-formoteroL HFA 160 mcg-4.5 mcg/actuation aerosol inhaler
186,037,020.00
1,006.66
6,370,000,100.00
QUEtiapine ER 200 mg tablet,extended release 24 hr
310,028,260.00
64.23
6,370,000,100.00
melatonin 1 mg tablet
536,111,411.00
5.64
6,370,000,100.00
verapamiL 40 mg tablet
23,155,005,901.00
5.78
6,370,000,100.00
baclofen 10 mg tablet
172,409,680.00
5.77
6,370,000,100.00
warfarin 2 mg tablet
93,171,301.00
5.73
6,370,000,100.00
warfarin 2 mg tablet
56,017,075.00
6.70
6,370,000,100.00
warfarin 2.5 mg tablet
93,171,401.00
5.71
6,370,000,100.00
warfarin 2.5 mg tablet
56,017,675.00
6.51
6,370,000,100.00
warfarin 5 mg tablet
93,172,101.00
5.67
6,370,000,100.00
warfarin 5 mg tablet
56,017,275.00
6.08
6,370,000,100.00
potassium bicarbonate-citric acid 20 mEq effervescent tablet
51,801,001,230.00
6.09
6,370,000,100.00
oseltamivir 30 mg capsule
47,781,046,813.00
37.76
6,370,000,100.00
oseltamivir 30 mg capsule
70,710,100,802.00
29.40
6,370,000,100.00
oseltamivir 30 mg capsule
68,180,067,511.00
18.90
6,370,000,100.00
zinc oxide 20 % topical ointment
168,006,231.00
5.71
6,370,000,100.00
zinc oxide 20 % topical ointment
536,570,098.00
5.64
6,370,000,100.00
cholecalciferol (vitamin D3) 1,250 mcg (50,000 unit) capsule
75,834,002,001.00
5.77
6,370,000,100.00
nebivoloL 5 mg tablet
456,140,530.00
14.63
6,370,000,100.00
acetaZOLAMIDE ER 500 mg capsule,extended release
68,382,026,101.00
15.10
6,370,000,100.00
acetaZOLAMIDE ER 500 mg capsule,extended release
50,742,023,301.00
6.12
6,370,000,100.00
acyclovir 800 mg tablet
60,505,530,701.00
5.92
6,370,000,100.00
amiodarone 200 mg tablet
51,672,402,504.00
5.87
6,370,000,100.00
amLODIPine 10 mg tablet
67,877,019,990.00
5.63
6,370,000,100.00
amLODIPine 2.5 mg tablet
69,097,083,605.00
5.66
6,370,000,100.00
amLODIPine 5 mg tablet
69,097,012,705.00
5.65
6,370,000,100.00
amoxicillin 125 mg-potassium clavulanate 31.25 mg/5 mL oral susp
43,598,001,251.00
1,052.53
6,370,000,100.00
amoxicillin 250 mg-potassium clavulanate 62.5 mg/5 mL oral suspension
43,598,020,453.00
617.75
6,370,000,100.00
difluprednate 0.05 % eye drops
65,924,007.00
647.62
6,370,000,100.00
bumetanide 1 mg tablet
185,012,901.00
5.85
6,370,000,100.00
bumetanide 2 mg tablet
185,013,001.00
5.83
6,370,000,100.00
buPROPion HCL 75 mg tablet
60,505,015,801.00
5.98
6,370,000,100.00
busPIRone 5 mg tablet
378,114,001.00
5.70
6,370,000,100.00
butamben-tetracaine-benzocaine 2 %-2 %-14 % (200 mg/sec) topical spray
10,223,020,103.00
350.50
6,370,000,100.00
calcium carbonate 200 mg calcium (500 mg) chewable tablet
37,864,000,150.00
5.63
6,370,000,100.00
calcium carbonate 200 mg calcium (500 mg) chewable tablet
66,553,000,401.00
5.66
6,370,000,100.00
ipratropium 0.5 mg-albuteroL 3 mg (2.5 mg base)/3 mL nebulization soln
487,020,101.00
6.12
6,370,000,100.00
ipratropium 0.5 mg-albuteroL 3 mg (2.5 mg base)/3 mL nebulization soln
69,097,017,353.00
5.92
6,370,000,100.00
ipratropium 0.5 mg-albuteroL 3 mg (2.5 mg base)/3 mL nebulization soln
69,097,017,364.00
5.92
6,370,000,100.00
ipratropium 0.5 mg-albuteroL 3 mg (2.5 mg base)/3 mL nebulization soln
76,204,060,060.00
6.02
6,370,000,100.00
ipratropium 0.5 mg-albuteroL 3 mg (2.5 mg base)/3 mL nebulization soln
69,097,017,348.00
5.92
6,370,000,100.00
captopriL 25 mg tablet
143,117,201.00
5.89
6,370,000,100.00
carbidopa 10 mg-levodopa 100 mg tablet
62,756,051,788.00
5.75
6,370,000,100.00
carbidopa 10 mg-levodopa 100 mg tablet
378,007,801.00
5.75
6,370,000,100.00
carbidopa 25 mg-levodopa 100 mg tablet
228,253,950.00
5.74
6,370,000,100.00
carbidopa 25 mg-levodopa 100 mg tablet
62,756,051,813.00
5.76
6,370,000,100.00
cefproziL 250 mg/5 mL oral suspension
68,180,040,201.00
111.80
6,370,000,100.00
cefproziL 250 mg tablet
68,180,040,301.00
6.42
6,370,000,100.00
cefuroxime axetil 250 mg tablet
65,862,069,920.00
6.05
6,370,000,100.00
cephalexin 250 mg capsule
93,314,501.00
5.75
6,370,000,100.00
cephalexin 500 mg capsule
93,314,701.00
5.73
6,370,000,100.00
cephalexin 250 mg/5 mL oral suspension
93,417,773.00
105.50
6,370,000,100.00
cetirizine 10 mg tablet
45,802,091,939.00
5.75
6,370,000,100.00
chlorhexidine gluconate 0.12 % mouthwash
116,200,116.00
14.84
6,370,000,100.00
chlorhexidine gluconate 0.12 % mouthwash
48,878,062,003.00
6.01
6,370,000,100.00
QUEtiapine ER 150 mg tablet,extended release 24 hr
310,028,160.00
23.62
6,370,000,100.00
clobetasoL 0.05 % topical cream
51,672,125,802.00
19.05
6,370,000,100.00
clonazePAM 0.5 mg tablet
16,729,013,600.00
5.64
6,370,000,100.00
clonazePAM 0.5 mg tablet
16,729,013,616.00
5.64
6,370,000,100.00
clotrimazole 10 mg troche
54,414,622.00
7.60
6,370,000,100.00
collagenase clostridium histolyticum 250 unit/gram topical ointment
50,484,001,030.00
37.11
6,370,000,100.00
lamoTRIgine 50 mg disintegrating tablet
49,884,048,511.00
18.70
6,370,000,100.00
lamoTRIgine 100 mg disintegrating tablet
49,884,048,611.00
7.65
6,370,000,100.00
lacosamide 200 mg tablet
131,248,035.00
33.74
6,370,000,100.00
fesoterodine ER 4 mg tablet,extended release 24 hr
69,024,230.00
47.55
6,370,000,100.00
dexlansoprazole 30 mg capsule,biphase delayed release
64,764,017,130.00
38.68
6,370,000,100.00
tolvaptan 15 mg tablet
59,148,002,050.00
1,155.20
6,370,000,100.00
acetaminophen 500 mg capsule