ST. JOSEPH'S HOSPITAL - BREESE - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hospital_Cdm_Chg , Self_Pay_Chg , Minimum_Negotiated_Chg , Maximum_Negotiated_Chg ," 6 DEGREES HEALTH, INC ", AETNA , AETNA HSHS , AETNA MEDICARE , AMISH COMMUNITY DISCOUNT , BC EXCHANGE , BC MEDICARE , BCBS OF ILLINOIS PPO , BLUE CROSS BLUE SHEILD OF ILLINOIS DUAL , BLUE CROSS BLUE SHIELD IL HMO , BLUE CROSS BLUE SHIELD IPA IL , BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV , BLUE CROSS SIHCA , CELTIC INSURANCE COMPANY , CIGNA , CLAIM DOC , CLEAR SPRING HEALTH MEDICARE ADV ," ESSENCE, L.L.P. ", FIRST HEALTH NETWORK , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE ," HEALTH ALLIANCE MEDICAL PLANS, INC. ", HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTHLINK , HEALTHLINK CASINO QUEEN , HEALTHLINK PPO , HEARTLAND HOSPICE , HOPETRUST , HUMANA , HUMANA MEDICARE , ILLINOIS BREAST AND CERVICAL CANCER PROGRAM , LIVE360 HSHS HEALTHY PLAN , LIVE360 MEDICARE COST PLAN , LIVE360 NON HSHS HEALTHY PLAN , MERIDIAN HMO MCD , MOLINA MEDICAID , MOLINA MEDICARE , MULTIPLAN , NAPHCARE , PHYSICIANS HEALTH ASSOCIATION OF IL BCBS HMO , PLAIN CHURCH MEDICAL GROUP , PROVIDER NETWORK OF AMERICA , SAE MEMORIAL HOSPICE , ST CLAIR COUNTY HOUSING AUTHORITY , UHC CATERPILLAR , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , WELLFIRST ST. JOSEPH'S HOSPITAL - BREESE,N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$43,572.74 ","$7,953.57 ","$197,261.65 ","$197,261.65 ","$39,336.51 ","$36,129.07 ","$77,326.57 ","$16,944.96 ","$60,517.70 ","$77,326.57 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$60,517.70 ","$33,284.74 ","$60,517.70 ","$77,326.57 ","$59,307.35 ","$45,388.28 ","$30,258.85 ","$30,258.85 ","$77,326.57 ","$30,258.85 ","$42,967.57 ","$42,967.57 ","$42,967.57 ", N/A ,"$60,517.70 ","$51,440.05 ","$59,307.35 ", N/A ,"$33,950.43 ","$77,326.57 ","$25,054.33 ","$8,748.93 ","$7,953.57 ","$77,326.57 ","$48,414.16 ","$60,517.70 ","$60,517.70 ","$16,944.96 ","$54,465.93 ","$77,326.57 ","$42,967.57 ","$60,517.70 ","$60,517.70 ","$77,326.57 ","$39,336.51 " ST. JOSEPH'S HOSPITAL - BREESE,N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$11,020.10 ","$2,385.37 ","$52,847.63 ","$52,847.63 ","$9,948.71 ","$9,137.50 ","$20,716.27 ","$4,285.60 ","$15,305.70 ","$20,716.27 ","$15,305.70 ","$14,999.59 ","$15,305.70 ","$15,305.70 ","$14,999.59 ","$15,305.70 ","$15,305.70 ","$8,418.14 ","$15,305.70 ","$20,716.27 ","$14,999.59 ","$11,479.28 ","$7,652.85 ","$7,652.85 ","$20,716.27 ","$7,652.85 ","$15,305.70 ","$15,305.70 ","$15,305.70 ", N/A ,"$15,305.70 ","$13,009.85 ","$14,999.59 ", N/A ,"$8,586.50 ","$20,716.27 ","$6,336.56 ","$2,623.91 ","$2,385.37 ","$20,716.27 ","$12,244.56 ","$15,305.70 ","$15,305.70 ","$4,285.60 ","$13,775.13 ","$20,716.27 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$20,716.27 ","$9,948.71 " ST. JOSEPH'S HOSPITAL - BREESE,N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$8,247.72 ","$2,385.37 ","$40,359.58 ","$40,359.58 ","$7,445.85 ","$6,838.73 ","$15,820.95 ","$3,207.44 ","$11,455.16 ","$15,820.95 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$11,455.16 ","$6,300.34 ","$11,455.16 ","$15,820.95 ","$11,226.06 ","$8,591.37 ","$5,727.58 ","$5,727.58 ","$15,820.95 ","$5,727.58 ","$11,455.16 ","$11,455.16 ","$11,455.16 ", N/A ,"$11,455.16 ","$9,736.89 ","$11,226.06 ", N/A ,"$6,426.34 ","$15,820.95 ","$4,742.44 ","$2,623.91 ","$2,385.37 ","$15,820.95 ","$9,164.13 ","$11,455.16 ","$11,455.16 ","$3,207.44 ","$10,309.64 ","$15,820.95 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$15,820.95 ","$7,445.85 " ST. JOSEPH'S HOSPITAL - BREESE,N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$17,060.09 ","$2,385.37 ","$77,513.10 ","$77,513.10 ","$15,401.47 ","$14,145.66 ","$30,385.14 ","$6,634.48 ","$23,694.57 ","$30,385.14 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$23,694.57 ","$13,032.01 ","$23,694.57 ","$30,385.14 ","$23,220.68 ","$17,770.93 ","$11,847.29 ","$11,847.29 ","$30,385.14 ","$11,847.29 ","$23,694.57 ","$23,694.57 ","$23,694.57 ", N/A ,"$23,694.57 ","$20,140.38 ","$23,220.68 ", N/A ,"$13,292.65 ","$30,385.14 ","$9,809.55 ","$2,623.91 ","$2,385.37 ","$30,385.14 ","$18,955.66 ","$23,694.57 ","$23,694.57 ","$6,634.48 ","$21,325.11 ","$30,385.14 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$30,385.14 ","$15,401.47 " ST. JOSEPH'S HOSPITAL - BREESE,N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$4,916.60 ","$1,912.01 ","$25,504.95 ","$25,504.95 ","$4,438.60 ","$4,076.68 ","$9,997.94 ","$1,912.01 ","$6,828.61 ","$9,997.94 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$6,828.61 ","$3,755.74 ","$6,828.61 ","$9,997.94 ","$6,692.04 ","$5,121.46 ","$3,414.31 ","$3,414.31 ","$9,997.94 ","$3,414.31 ","$6,828.61 ","$6,828.61 ","$6,828.61 ", N/A ,"$6,828.61 ","$5,804.32 ","$6,692.04 ", N/A ,"$3,830.85 ","$9,997.94 ","$2,827.04 ","$2,623.91 ","$2,385.37 ","$9,997.94 ","$5,462.89 ","$6,828.61 ","$6,828.61 ","$1,912.01 ","$6,145.75 ","$9,997.94 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$9,997.94 ","$4,438.60 " ST. JOSEPH'S HOSPITAL - BREESE,12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,$986.00 ,$709.92 ,$276.08 ,$986.00 , Inpatient Medicare +150% ,$640.90 ,$588.64 , Inpatient Medicare ,$276.08 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$542.30 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$739.50 ,$493.00 ,$493.00 , Inpatient Medicare ,$493.00 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$838.10 , Inpatient Medicare , N/A ,$553.15 , Inpatient Medicare ,$408.20 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$788.80 , Inpatient Medicare +90% ,"$10,260.00 ",$276.08 ,$887.40 , Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,$640.90 ST. JOSEPH'S HOSPITAL - BREESE,12000002,N/A,HC DAILY SERVICE SWING BED,120,1 ,$482.00 ,$347.04 ,$134.96 ,$482.00 , Inpatient Medicare +150% ,$313.30 ,$287.75 , Inpatient Medicare ,$134.96 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$265.10 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$361.50 ,$241.00 ,$241.00 , Inpatient Medicare ,$241.00 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$409.70 , Inpatient Medicare , N/A ,$270.40 , Inpatient Medicare ,$199.55 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$385.60 , Inpatient Medicare +90% ,"$10,260.00 ",$134.96 ,$433.80 , Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,$313.30 ST. JOSEPH'S HOSPITAL - BREESE,12000006,N/A,HC DAILY SERVICE W/TELEMETRY,120,1 ,"$2,404.00 ","$1,730.88 ",$673.12 ,"$2,404.00 ", Inpatient Medicare +150% ,"$1,562.60 ","$1,435.19 ", Inpatient Medicare ,$673.12 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,"$1,322.20 ", Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,803.00 ","$1,202.00 ","$1,202.00 ", Inpatient Medicare ,"$1,202.00 ","$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,"$2,043.40 ", Inpatient Medicare , N/A ,"$1,348.64 ", Inpatient Medicare ,$995.26 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,"$1,923.20 ", Inpatient Medicare +90% ,"$10,260.00 ",$673.12 ,"$2,163.60 ", Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,"$1,562.60 " ST. JOSEPH'S HOSPITAL - BREESE,12100001,N/A,HC DAILY SERVICE,121,1 ,$957.00 ,$689.04 ,$267.96 ,$957.00 , Inpatient Medicare +150% ,$622.05 ,$571.33 , Inpatient Medicare ,$267.96 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$526.35 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$717.75 ,$478.50 ,$478.50 , Inpatient Medicare ,$478.50 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$813.45 , Inpatient Medicare , N/A ,$536.88 , Inpatient Medicare ,$396.20 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$765.60 , Inpatient Medicare +90% ,"$10,260.00 ",$267.96 ,$861.30 , Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,$622.05 ST. JOSEPH'S HOSPITAL - BREESE,12200001,N/A,HC DAILY SERVICE OBSTETRICS,122,1 ,$986.00 ,$709.92 ,$276.08 ,$986.00 , Inpatient Medicare +150% ,$640.90 ,$588.64 , Inpatient Medicare ,$276.08 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$542.30 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$739.50 ,$493.00 ,$493.00 , Inpatient Medicare ,$493.00 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$838.10 , Inpatient Medicare , N/A ,$553.15 , Inpatient Medicare ,$408.20 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$788.80 , Inpatient Medicare +90% ,"$10,260.00 ",$276.08 ,$887.40 , Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,$640.90 ST. JOSEPH'S HOSPITAL - BREESE,12300001,N/A,HC DAILY PEDIATRIC,123,1 ,$986.00 ,$709.92 ,$276.08 ,$986.00 , Inpatient Medicare +150% ,$640.90 ,$588.64 , Inpatient Medicare ,$276.08 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$542.30 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$739.50 ,$493.00 ,$493.00 , Inpatient Medicare ,$493.00 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$838.10 , Inpatient Medicare , N/A ,$553.15 , Inpatient Medicare ,$408.20 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$788.80 , Inpatient Medicare +90% ,"$10,260.00 ",$276.08 ,$887.40 , Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,$640.90 ST. JOSEPH'S HOSPITAL - BREESE,12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,$957.00 ,$689.04 ,$267.96 ,$957.00 , Inpatient Medicare +150% ,$622.05 ,$571.33 , Inpatient Medicare ,$267.96 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$526.35 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$717.75 ,$478.50 ,$478.50 , Inpatient Medicare ,$478.50 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$813.45 , Inpatient Medicare , N/A ,$536.88 , Inpatient Medicare ,$396.20 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$765.60 , Inpatient Medicare +90% ,"$10,260.00 ",$267.96 ,$861.30 , Inpatient Medicare ,"$9,566.00 ","$1,053.00 ","$1,053.00 ", Inpatient Medicare ,$622.05 ST. JOSEPH'S HOSPITAL - BREESE,17000001,N/A,HC DAILY SERVICE NURSERY,170,1 ,$703.00 ,$506.16 ,$196.84 ,$703.00 , Inpatient Medicare +150% ,$456.95 ,$419.69 , Inpatient Medicare ,$196.84 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$386.65 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$527.25 ,$351.50 ,$351.50 , Inpatient Medicare ,$351.50 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$597.55 , Inpatient Medicare , N/A ,$394.38 , Inpatient Medicare ,$291.04 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$562.40 , Inpatient Medicare +90% ,"$10,260.00 ",$196.84 ,$632.70 , Inpatient Medicare ,"$9,566.00 ",$707.00 ,$707.00 , Inpatient Medicare ,$456.95 ST. JOSEPH'S HOSPITAL - BREESE,17100001,N/A,HC DAILY INFANT SERVICE LEV 1,171,1 ,$895.00 ,$644.40 ,$250.60 ,$895.00 , Inpatient Medicare +150% ,$581.75 ,$534.32 , Inpatient Medicare ,$250.60 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$492.25 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,$671.25 ,$447.50 ,$447.50 , Inpatient Medicare ,$447.50 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,$760.75 , Inpatient Medicare , N/A ,$502.10 , Inpatient Medicare ,$370.53 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,$716.00 , Inpatient Medicare +90% ,"$10,260.00 ",$250.60 ,$805.50 , Inpatient Medicare ,"$9,566.00 ",$707.00 ,$707.00 , Inpatient Medicare ,$581.75 ST. JOSEPH'S HOSPITAL - BREESE,17200002,N/A,HC DAILY INFANT SERVICE LEV 2,172,1 ,"$2,041.00 ","$1,469.52 ",$571.48 ,"$2,041.00 ", Inpatient Medicare +150% ,"$1,326.65 ","$1,218.48 ", Inpatient Medicare ,$571.48 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,"$1,122.55 ", Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,530.75 ","$1,020.50 ","$1,020.50 ", Inpatient Medicare ,"$1,020.50 ","$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,"$1,734.85 ", Inpatient Medicare , N/A ,"$1,145.00 ", Inpatient Medicare ,$844.97 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,"$1,632.80 ", Inpatient Medicare +90% ,"$10,260.00 ",$571.48 ,"$1,836.90 ", Inpatient Medicare ,"$9,566.00 ","$1,053.00 ","$1,053.00 ", Inpatient Medicare ,"$1,326.65 " ST. JOSEPH'S HOSPITAL - BREESE,20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$2,041.00 ","$1,469.52 ",$571.48 ,"$2,041.00 ", Inpatient Medicare +150% ,"$1,326.65 ","$1,218.48 ", Inpatient Medicare ,$571.48 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,"$1,122.55 ", Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,530.75 ","$1,020.50 ","$1,020.50 ", Inpatient Medicare ,"$1,020.50 ","$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,"$1,734.85 ", Inpatient Medicare , N/A ,"$1,145.00 ", Inpatient Medicare ,$844.97 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,"$1,632.80 ", Inpatient Medicare +90% ,"$10,260.00 ",$571.48 ,"$1,836.90 ", Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,"$1,326.65 " ST. JOSEPH'S HOSPITAL - BREESE,20600002,N/A,HC DAILY SERVICE IMCU,206,1 ,"$1,731.00 ","$1,246.32 ",$484.68 ,"$1,731.00 ", Inpatient Medicare +150% ,"$1,125.15 ","$1,033.41 ", Inpatient Medicare ,$484.68 ,"$11,400.00 ", Inpatient Medicare ,"$11,400.00 ", Inpatient Medicare ,"$10,260.00 ","$10,260.00 ", Inpatient Medicare ,"$10,260.00 ", Inpatient Medicare +102% ,$952.05 , Inpatient Medicare +150% , Inpatient Medicare , Inpatient Medicare +2% ,"$1,298.25 ",$865.50 ,$865.50 , Inpatient Medicare ,$865.50 ,"$9,566.00 ","$9,566.00 ","$9,566.00 ", N/A , Inpatient Medicare +150% ,"$1,471.35 ", Inpatient Medicare , N/A ,$971.09 , Inpatient Medicare ,$716.63 , Inpatient Medicaid +10% , Inpatient Medicaid , Inpatient Medicare ,"$1,384.80 ", Inpatient Medicare +90% ,"$10,260.00 ",$484.68 ,"$1,557.90 ", Inpatient Medicare ,"$9,566.00 ","$9,477.00 ","$9,477.00 ", Inpatient Medicare ,"$1,125.15 " ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ATROPINE 1 % SOLN 5 ML BOTTLE,250,1 ,$121.85 ,$87.73 ,$34.12 ,$121.85 , N/A ,$79.20 ,$72.74 , N/A ,$34.12 ,$80.66 , N/A ,$80.66 , N/A ,$72.62 ,$72.62 , N/A ,$72.62 , N/A ,$93.82 , N/A , N/A , N/A ,$91.39 ,$86.51 ,$86.51 , N/A ,$86.51 ,$103.57 ,$103.57 ,$103.57 , N/A , N/A ,$103.57 , N/A ,$121.85 ,$68.36 , N/A ,$50.45 , N/A , N/A , N/A ,$103.57 , N/A ,$72.62 ,$34.12 ,$109.67 , N/A ,$103.57 ,$102.96 ,$102.96 , N/A ,$79.20 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,AZTREONAM 1 G SOLR 1 EACH VIAL,250,1 ,$173.20 ,$124.70 ,$48.50 ,$173.20 , N/A ,$112.58 ,$103.40 , N/A ,$48.50 ,$114.66 , N/A ,$114.66 , N/A ,$103.23 ,$103.23 , N/A ,$103.23 , N/A ,$133.36 , N/A , N/A , N/A ,$129.90 ,$122.97 ,$122.97 , N/A ,$122.97 ,$147.22 ,$147.22 ,$147.22 , N/A , N/A ,$147.22 , N/A ,$173.20 ,$97.17 , N/A ,$71.70 , N/A , N/A , N/A ,$147.22 , N/A ,$103.23 ,$48.50 ,$155.88 , N/A ,$147.22 ,$146.35 ,$146.35 , N/A ,$112.58 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,AZTREONAM 2 G SOLR 1 EACH VIAL,250,1 ,$351.90 ,$253.37 ,$98.53 ,$351.90 , N/A ,$228.74 ,$210.08 , N/A ,$98.53 ,$232.96 , N/A ,$232.96 , N/A ,$209.73 ,$209.73 , N/A ,$209.73 , N/A ,$270.96 , N/A , N/A , N/A ,$263.93 ,$249.85 ,$249.85 , N/A ,$249.85 ,$299.12 ,$299.12 ,$299.12 , N/A , N/A ,$299.12 , N/A ,$351.90 ,$197.42 , N/A ,$145.69 , N/A , N/A , N/A ,$299.12 , N/A ,$209.73 ,$98.53 ,$316.71 , N/A ,$299.12 ,$297.36 ,$297.36 , N/A ,$228.74 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BALANCED SALTS SOLN 15 ML BOTTLE,250,1 ,$25.75 ,$18.54 ,$7.21 ,$25.75 , N/A ,$16.74 ,$15.37 , N/A ,$7.21 ,$17.05 , N/A ,$17.05 , N/A ,$15.35 ,$15.35 , N/A ,$15.35 , N/A ,$19.83 , N/A , N/A , N/A ,$19.31 ,$18.28 ,$18.28 , N/A ,$18.28 ,$21.89 ,$21.89 ,$21.89 , N/A , N/A ,$21.89 , N/A ,$25.75 ,$14.45 , N/A ,$10.66 , N/A , N/A , N/A ,$21.89 , N/A ,$15.35 ,$7.21 ,$23.18 , N/A ,$21.89 ,$21.76 ,$21.76 , N/A ,$16.74 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BALANCED SALTS SOLN 500 ML FLEX CONT,250,1 ,$71.00 ,$51.12 ,$19.88 ,$71.00 , N/A ,$46.15 ,$42.39 , N/A ,$19.88 ,$47.00 , N/A ,$47.00 , N/A ,$42.32 ,$42.32 , N/A ,$42.32 , N/A ,$54.67 , N/A , N/A , N/A ,$53.25 ,$50.41 ,$50.41 , N/A ,$50.41 ,$60.35 ,$60.35 ,$60.35 , N/A , N/A ,$60.35 , N/A ,$71.00 ,$39.83 , N/A ,$29.39 , N/A , N/A , N/A ,$60.35 , N/A ,$42.32 ,$19.88 ,$63.90 , N/A ,$60.35 ,$60.00 ,$60.00 , N/A ,$46.15 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BENZOCAINE-MENTHOL 20-0.5 % AERO 85 G CAN,250,1 ,$13.30 ,$9.58 ,$3.72 ,$13.30 , N/A ,$8.65 ,$7.94 , N/A ,$3.72 ,$8.80 , N/A ,$8.80 , N/A ,$7.93 ,$7.93 , N/A ,$7.93 , N/A ,$10.24 , N/A , N/A , N/A ,$9.98 ,$9.44 ,$9.44 , N/A ,$9.44 ,$11.31 ,$11.31 ,$11.31 , N/A , N/A ,$11.31 , N/A ,$13.30 ,$7.46 , N/A ,$5.51 , N/A , N/A , N/A ,$11.31 , N/A ,$7.93 ,$3.72 ,$11.97 , N/A ,$11.31 ,$11.24 ,$11.24 , N/A ,$8.65 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BERACTANT 25-0.9 MG/ML-% SUSP,250,1 ,"$1,008.70 ",$726.26 ,$282.44 ,"$1,008.70 ", N/A ,$655.66 ,$602.19 , N/A ,$282.44 ,$667.76 , N/A ,$667.76 , N/A ,$601.19 ,$601.19 , N/A ,$601.19 , N/A ,$776.70 , N/A , N/A , N/A ,$756.53 ,$716.18 ,$716.18 , N/A ,$716.18 ,$857.40 ,$857.40 ,$857.40 , N/A , N/A ,$857.40 , N/A ,"$1,008.70 ",$565.88 , N/A ,$417.60 , N/A , N/A , N/A ,$857.40 , N/A ,$601.19 ,$282.44 ,$907.83 , N/A ,$857.40 ,$852.35 ,$852.35 , N/A ,$655.66 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BRIMONIDINE 0.2 % SOLN 5 ML BOTTLE,250,1 ,$36.30 ,$26.14 ,$10.16 ,$36.30 , N/A ,$23.60 ,$21.67 , N/A ,$10.16 ,$24.03 , N/A ,$24.03 , N/A ,$21.63 ,$21.63 , N/A ,$21.63 , N/A ,$27.95 , N/A , N/A , N/A ,$27.23 ,$25.77 ,$25.77 , N/A ,$25.77 ,$30.86 ,$30.86 ,$30.86 , N/A , N/A ,$30.86 , N/A ,$36.30 ,$20.36 , N/A ,$15.03 , N/A , N/A , N/A ,$30.86 , N/A ,$21.63 ,$10.16 ,$32.67 , N/A ,$30.86 ,$30.67 ,$30.67 , N/A ,$23.60 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUDESONIDE 0.5 MG/2ML SUSP,250,1 ,$22.20 ,$15.98 ,$6.22 ,$22.20 , N/A ,$14.43 ,$13.25 , N/A ,$6.22 ,$14.70 , N/A ,$14.70 , N/A ,$13.23 ,$13.23 , N/A ,$13.23 , N/A ,$17.09 , N/A , N/A , N/A ,$16.65 ,$15.76 ,$15.76 , N/A ,$15.76 ,$18.87 ,$18.87 ,$18.87 , N/A , N/A ,$18.87 , N/A ,$22.20 ,$12.45 , N/A ,$9.19 , N/A , N/A , N/A ,$18.87 , N/A ,$13.23 ,$6.22 ,$19.98 , N/A ,$18.87 ,$18.76 ,$18.76 , N/A ,$14.43 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE-EPINEPHRINE (PF) 0.25% -1:200000 SOLN,250,1 ,$44.20 ,$31.82 ,$12.38 ,$44.20 , N/A ,$28.73 ,$26.39 , N/A ,$12.38 ,$29.26 , N/A ,$29.26 , N/A ,$26.34 ,$26.34 , N/A ,$26.34 , N/A ,$34.03 , N/A , N/A , N/A ,$33.15 ,$31.38 ,$31.38 , N/A ,$31.38 ,$37.57 ,$37.57 ,$37.57 , N/A , N/A ,$37.57 , N/A ,$44.20 ,$24.80 , N/A ,$18.30 , N/A , N/A , N/A ,$37.57 , N/A ,$26.34 ,$12.38 ,$39.78 , N/A ,$37.57 ,$37.35 ,$37.35 , N/A ,$28.73 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CAFFEINE-SODIUM BENZOATE 125-125 MG/ML SOLN 2 ML VIAL,250,1 ,$115.25 ,$82.98 ,$32.27 ,$115.25 , N/A ,$74.91 ,$68.80 , N/A ,$32.27 ,$76.30 , N/A ,$76.30 , N/A ,$68.69 ,$68.69 , N/A ,$68.69 , N/A ,$88.74 , N/A , N/A , N/A ,$86.44 ,$81.83 ,$81.83 , N/A ,$81.83 ,$97.96 ,$97.96 ,$97.96 , N/A , N/A ,$97.96 , N/A ,$115.25 ,$64.66 , N/A ,$47.71 , N/A , N/A , N/A ,$97.96 , N/A ,$68.69 ,$32.27 ,$103.73 , N/A ,$97.96 ,$97.39 ,$97.39 , N/A ,$74.91 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CALCIUM CHLORIDE 10 % SOLN,250,1 ,$56.05 ,$40.36 ,$15.69 ,$56.05 , N/A ,$36.43 ,$33.46 , N/A ,$15.69 ,$37.11 , N/A ,$37.11 , N/A ,$33.41 ,$33.41 , N/A ,$33.41 , N/A ,$43.16 , N/A , N/A , N/A ,$42.04 ,$39.80 ,$39.80 , N/A ,$39.80 ,$47.64 ,$47.64 ,$47.64 , N/A , N/A ,$47.64 , N/A ,$56.05 ,$31.44 , N/A ,$23.20 , N/A , N/A , N/A ,$47.64 , N/A ,$33.41 ,$15.69 ,$50.45 , N/A ,$47.64 ,$47.36 ,$47.36 , N/A ,$36.43 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CARBOPROST 250 MCG/ML SOLN,250,1 ,"$1,709.80 ","$1,231.06 ",$478.74 ,"$1,709.80 ", N/A ,"$1,111.37 ","$1,020.75 ", N/A ,$478.74 ,"$1,131.89 ", N/A ,"$1,131.89 ", N/A ,"$1,019.04 ","$1,019.04 ", N/A ,"$1,019.04 ", N/A ,"$1,316.55 ", N/A , N/A , N/A ,"$1,282.35 ","$1,213.96 ","$1,213.96 ", N/A ,"$1,213.96 ","$1,453.33 ","$1,453.33 ","$1,453.33 ", N/A , N/A ,"$1,453.33 ", N/A ,"$1,709.80 ",$959.20 , N/A ,$707.86 , N/A , N/A , N/A ,"$1,453.33 ", N/A ,"$1,019.04 ",$478.74 ,"$1,538.82 ", N/A ,"$1,453.33 ","$1,444.78 ","$1,444.78 ", N/A ,"$1,111.37 " ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CHARCOAL ACTIVATED LIQD 240 ML BOTTLE,250,1 ,$9.55 ,$6.88 ,$2.67 ,$9.55 , N/A ,$6.21 ,$5.70 , N/A ,$2.67 ,$6.32 , N/A ,$6.32 , N/A ,$5.69 ,$5.69 , N/A ,$5.69 , N/A ,$7.35 , N/A , N/A , N/A ,$7.16 ,$6.78 ,$6.78 , N/A ,$6.78 ,$8.12 ,$8.12 ,$8.12 , N/A , N/A ,$8.12 , N/A ,$9.55 ,$5.36 , N/A ,$3.95 , N/A , N/A , N/A ,$8.12 , N/A ,$5.69 ,$2.67 ,$8.60 , N/A ,$8.12 ,$8.07 ,$8.07 , N/A ,$6.21 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CHARCOAL ACTIVATED LIQD 240 ML TUBE,250,1 ,$47.55 ,$34.24 ,$13.31 ,$47.55 , N/A ,$30.91 ,$28.39 , N/A ,$13.31 ,$31.48 , N/A ,$31.48 , N/A ,$28.34 ,$28.34 , N/A ,$28.34 , N/A ,$36.61 , N/A , N/A , N/A ,$35.66 ,$33.76 ,$33.76 , N/A ,$33.76 ,$40.42 ,$40.42 ,$40.42 , N/A , N/A ,$40.42 , N/A ,$47.55 ,$26.68 , N/A ,$19.69 , N/A , N/A , N/A ,$40.42 , N/A ,$28.34 ,$13.31 ,$42.80 , N/A ,$40.42 ,$40.18 ,$40.18 , N/A ,$30.91 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE-EPINEPHRINE PF 0.5% -1:200000 SOLN,250,1 ,$47.55 ,$34.24 ,$13.31 ,$47.55 , N/A ,$30.91 ,$28.39 , N/A ,$13.31 ,$31.48 , N/A ,$31.48 , N/A ,$28.34 ,$28.34 , N/A ,$28.34 , N/A ,$36.61 , N/A , N/A , N/A ,$35.66 ,$33.76 ,$33.76 , N/A ,$33.76 ,$40.42 ,$40.42 ,$40.42 , N/A , N/A ,$40.42 , N/A ,$47.55 ,$26.68 , N/A ,$19.69 , N/A , N/A , N/A ,$40.42 , N/A ,$28.34 ,$13.31 ,$42.80 , N/A ,$40.42 ,$40.18 ,$40.18 , N/A ,$30.91 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CHLORHEXIDINE 0.12 % SOLN 118 ML BOTTLE,250,1 ,$6.40 ,$4.61 ,$1.79 ,$6.40 , N/A ,$4.16 ,$3.82 , N/A ,$1.79 ,$4.24 , N/A ,$4.24 , N/A ,$3.81 ,$3.81 , N/A ,$3.81 , N/A ,$4.93 , N/A , N/A , N/A ,$4.80 ,$4.54 ,$4.54 , N/A ,$4.54 ,$5.44 ,$5.44 ,$5.44 , N/A , N/A ,$5.44 , N/A ,$6.40 ,$3.59 , N/A ,$2.65 , N/A , N/A , N/A ,$5.44 , N/A ,$3.81 ,$1.79 ,$5.76 , N/A ,$5.44 ,$5.41 ,$5.41 , N/A ,$4.16 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CIPROFLOXACIN 0.3 % SOLN 5 ML BOTTLE,250,1 ,$94.65 ,$68.15 ,$26.50 ,$94.65 , N/A ,$61.52 ,$56.51 , N/A ,$26.50 ,$62.66 , N/A ,$62.66 , N/A ,$56.41 ,$56.41 , N/A ,$56.41 , N/A ,$72.88 , N/A , N/A , N/A ,$70.99 ,$67.20 ,$67.20 , N/A ,$67.20 ,$80.45 ,$80.45 ,$80.45 , N/A , N/A ,$80.45 , N/A ,$94.65 ,$53.10 , N/A ,$39.19 , N/A , N/A , N/A ,$80.45 , N/A ,$56.41 ,$26.50 ,$85.19 , N/A ,$80.45 ,$79.98 ,$79.98 , N/A ,$61.52 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CLINDAMYCIN 900 MG/6ML SOLN 6 ML VIAL,250,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 , N/A ,$14.30 ,$13.13 , N/A ,$6.16 ,$14.56 , N/A ,$14.56 , N/A ,$13.11 ,$13.11 , N/A ,$13.11 , N/A ,$16.94 , N/A , N/A , N/A ,$16.50 ,$15.62 ,$15.62 , N/A ,$15.62 ,$18.70 ,$18.70 ,$18.70 , N/A , N/A ,$18.70 , N/A ,$22.00 ,$12.34 , N/A ,$9.11 , N/A , N/A , N/A ,$18.70 , N/A ,$13.11 ,$6.16 ,$19.80 , N/A ,$18.70 ,$18.59 ,$18.59 , N/A ,$14.30 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,COLLAGENASE 250 UNIT/GM OINT 30 G TUBE,250,1 ,$658.20 ,$473.90 ,$184.30 ,$658.20 , N/A ,$427.83 ,$392.95 , N/A ,$184.30 ,$435.73 , N/A ,$435.73 , N/A ,$392.29 ,$392.29 , N/A ,$392.29 , N/A ,$506.81 , N/A , N/A , N/A ,$493.65 ,$467.32 ,$467.32 , N/A ,$467.32 ,$559.47 ,$559.47 ,$559.47 , N/A , N/A ,$559.47 , N/A ,$658.20 ,$369.25 , N/A ,$272.49 , N/A , N/A , N/A ,$559.47 , N/A ,$392.29 ,$184.30 ,$592.38 , N/A ,$559.47 ,$556.18 ,$556.18 , N/A ,$427.83 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CYCLOPENTOLATE 2 % SOLN 2 ML BOTTLE,250,1 ,$95.25 ,$68.58 ,$26.67 ,$95.25 , N/A ,$61.91 ,$56.86 , N/A ,$26.67 ,$63.06 , N/A ,$63.06 , N/A ,$56.77 ,$56.77 , N/A ,$56.77 , N/A ,$73.34 , N/A , N/A , N/A ,$71.44 ,$67.63 ,$67.63 , N/A ,$67.63 ,$80.96 ,$80.96 ,$80.96 , N/A , N/A ,$80.96 , N/A ,$95.25 ,$53.44 , N/A ,$39.43 , N/A , N/A , N/A ,$80.96 , N/A ,$56.77 ,$26.67 ,$85.73 , N/A ,$80.96 ,$80.49 ,$80.49 , N/A ,$61.91 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DEXMEDETOMIDINE 200 MCG/2ML SOLN,250,1 ,$25.95 ,$18.68 ,$7.27 ,$25.95 , N/A ,$16.87 ,$15.49 , N/A ,$7.27 ,$17.18 , N/A ,$17.18 , N/A ,$15.47 ,$15.47 , N/A ,$15.47 , N/A ,$19.98 , N/A , N/A , N/A ,$19.46 ,$18.42 ,$18.42 , N/A ,$18.42 ,$22.06 ,$22.06 ,$22.06 , N/A , N/A ,$22.06 , N/A ,$25.95 ,$14.56 , N/A ,$10.74 , N/A , N/A , N/A ,$22.06 , N/A ,$15.47 ,$7.27 ,$23.36 , N/A ,$22.06 ,$21.93 ,$21.93 , N/A ,$16.87 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DEXMEDETOMIDINE 200 MCG/2ML SOLN 2 ML VIAL,250,1 ,$26.03 ,$18.74 ,$7.29 ,$26.03 , N/A ,$16.92 ,$15.54 , N/A ,$7.29 ,$17.23 , N/A ,$17.23 , N/A ,$15.51 ,$15.51 , N/A ,$15.51 , N/A ,$20.04 , N/A , N/A , N/A ,$19.52 ,$18.48 ,$18.48 , N/A ,$18.48 ,$22.13 ,$22.13 ,$22.13 , N/A , N/A ,$22.13 , N/A ,$26.03 ,$14.60 , N/A ,$10.78 , N/A , N/A , N/A ,$22.13 , N/A ,$15.51 ,$7.29 ,$23.43 , N/A ,$22.13 ,$22.00 ,$22.00 , N/A ,$16.92 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DILTIAZEM 125 MG/25ML SOLN 25 ML VIAL,250,1 ,$43.70 ,$31.46 ,$12.24 ,$43.70 , N/A ,$28.41 ,$26.09 , N/A ,$12.24 ,$28.93 , N/A ,$28.93 , N/A ,$26.05 ,$26.05 , N/A ,$26.05 , N/A ,$33.65 , N/A , N/A , N/A ,$32.78 ,$31.03 ,$31.03 , N/A ,$31.03 ,$37.15 ,$37.15 ,$37.15 , N/A , N/A ,$37.15 , N/A ,$43.70 ,$24.52 , N/A ,$18.09 , N/A , N/A , N/A ,$37.15 , N/A ,$26.05 ,$12.24 ,$39.33 , N/A ,$37.15 ,$36.93 ,$36.93 , N/A ,$28.41 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,"DIPHENHYDRAMINE 12.5 MG/5ML 20 ML, MAGNESIUM-ALUMINUM-SIMETHICONE 400-400-40 MG/5ML 20 ML SUSPENSION",250,1 ,$7.20 ,$5.18 ,$2.02 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$6.08 ,$6.08 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DOXYCYCLINE HYCLATE 100 MG SOLR 1 EACH VIAL,250,1 ,$126.40 ,$91.01 ,$35.39 ,$126.40 , N/A ,$82.16 ,$75.46 , N/A ,$35.39 ,$83.68 , N/A ,$83.68 , N/A ,$75.33 ,$75.33 , N/A ,$75.33 , N/A ,$97.33 , N/A , N/A , N/A ,$94.80 ,$89.74 ,$89.74 , N/A ,$89.74 ,$107.44 ,$107.44 ,$107.44 , N/A , N/A ,$107.44 , N/A ,$126.40 ,$70.91 , N/A ,$52.33 , N/A , N/A , N/A ,$107.44 , N/A ,$75.33 ,$35.39 ,$113.76 , N/A ,$107.44 ,$106.81 ,$106.81 , N/A ,$82.16 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ENALAPRILAT 1.25 MG/ML INJ,250,1 ,$22.80 ,$16.42 ,$6.38 ,$22.80 , N/A ,$14.82 ,$13.61 , N/A ,$6.38 ,$15.09 , N/A ,$15.09 , N/A ,$13.59 ,$13.59 , N/A ,$13.59 , N/A ,$17.56 , N/A , N/A , N/A ,$17.10 ,$16.19 ,$16.19 , N/A ,$16.19 ,$19.38 ,$19.38 ,$19.38 , N/A , N/A ,$19.38 , N/A ,$22.80 ,$12.79 , N/A ,$9.44 , N/A , N/A , N/A ,$19.38 , N/A ,$13.59 ,$6.38 ,$20.52 , N/A ,$19.38 ,$19.27 ,$19.27 , N/A ,$14.82 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CLINDAMYCIN PHOSPHATE 300 MG/2ML SOLN,250,1 ,$22.80 ,$16.42 ,$6.38 ,$22.80 , N/A ,$14.82 ,$13.61 , N/A ,$6.38 ,$15.09 , N/A ,$15.09 , N/A ,$13.59 ,$13.59 , N/A ,$13.59 , N/A ,$17.56 , N/A , N/A , N/A ,$17.10 ,$16.19 ,$16.19 , N/A ,$16.19 ,$19.38 ,$19.38 ,$19.38 , N/A , N/A ,$19.38 , N/A ,$22.80 ,$12.79 , N/A ,$9.44 , N/A , N/A , N/A ,$19.38 , N/A ,$13.59 ,$6.38 ,$20.52 , N/A ,$19.38 ,$19.27 ,$19.27 , N/A ,$14.82 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ETOMIDATE 2 MG/ML SOLN,250,1 ,$44.40 ,$31.97 ,$12.43 ,$44.40 , N/A ,$28.86 ,$26.51 , N/A ,$12.43 ,$29.39 , N/A ,$29.39 , N/A ,$26.46 ,$26.46 , N/A ,$26.46 , N/A ,$34.19 , N/A , N/A , N/A ,$33.30 ,$31.52 ,$31.52 , N/A ,$31.52 ,$37.74 ,$37.74 ,$37.74 , N/A , N/A ,$37.74 , N/A ,$44.40 ,$24.91 , N/A ,$18.38 , N/A , N/A , N/A ,$37.74 , N/A ,$26.46 ,$12.43 ,$39.96 , N/A ,$37.74 ,$37.52 ,$37.52 , N/A ,$28.86 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FAT EMULSION 20 % EMUL,250,1 ,$226.00 ,$162.72 ,$63.28 ,$226.00 , N/A ,$146.90 ,$134.92 , N/A ,$63.28 ,$149.61 , N/A ,$149.61 , N/A ,$134.70 ,$134.70 , N/A ,$134.70 , N/A ,$174.02 , N/A , N/A , N/A ,$169.50 ,$160.46 ,$160.46 , N/A ,$160.46 ,$192.10 ,$192.10 ,$192.10 , N/A , N/A ,$192.10 , N/A ,$226.00 ,$126.79 , N/A ,$93.56 , N/A , N/A , N/A ,$192.10 , N/A ,$134.70 ,$63.28 ,$203.40 , N/A ,$192.10 ,$190.97 ,$190.97 , N/A ,$146.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FERRIC SUBSULFATE 259 MG/GM SOLN 8 G BOTTLE,250,1 ,$37.45 ,$26.96 ,$10.49 ,$37.45 , N/A ,$24.34 ,$22.36 , N/A ,$10.49 ,$24.79 , N/A ,$24.79 , N/A ,$22.32 ,$22.32 , N/A ,$22.32 , N/A ,$28.84 , N/A , N/A , N/A ,$28.09 ,$26.59 ,$26.59 , N/A ,$26.59 ,$31.83 ,$31.83 ,$31.83 , N/A , N/A ,$31.83 , N/A ,$37.45 ,$21.01 , N/A ,$15.50 , N/A , N/A , N/A ,$31.83 , N/A ,$22.32 ,$10.49 ,$33.71 , N/A ,$31.83 ,$31.65 ,$31.65 , N/A ,$24.34 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,GLYCOPYRROLATE 0.2 MG/ML SOLN,250,1 ,$65.00 ,$46.80 ,$18.20 ,$65.00 , N/A ,$42.25 ,$38.81 , N/A ,$18.20 ,$43.03 , N/A ,$43.03 , N/A ,$38.74 ,$38.74 , N/A ,$38.74 , N/A ,$50.05 , N/A , N/A , N/A ,$48.75 ,$46.15 ,$46.15 , N/A ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A , N/A ,$55.25 , N/A ,$65.00 ,$36.47 , N/A ,$26.91 , N/A , N/A , N/A ,$55.25 , N/A ,$38.74 ,$18.20 ,$58.50 , N/A ,$55.25 ,$54.93 ,$54.93 , N/A ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,INDIGOTINDISULFONATE 8 MG/ML SOLN,250,1 ,$904.40 ,$651.17 ,$253.23 ,$904.40 , N/A ,$587.86 ,$539.93 , N/A ,$253.23 ,$598.71 , N/A ,$598.71 , N/A ,$539.02 ,$539.02 , N/A ,$539.02 , N/A ,$696.39 , N/A , N/A , N/A ,$678.30 ,$642.12 ,$642.12 , N/A ,$642.12 ,$768.74 ,$768.74 ,$768.74 , N/A , N/A ,$768.74 , N/A ,$904.40 ,$507.37 , N/A ,$374.42 , N/A , N/A , N/A ,$768.74 , N/A ,$539.02 ,$253.23 ,$813.96 , N/A ,$768.74 ,$764.22 ,$764.22 , N/A ,$587.86 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,INDOCYANINE GREEN 25 MG SOLR,250,1 ,$96.85 ,$69.73 ,$27.12 ,$96.85 , N/A ,$62.95 ,$57.82 , N/A ,$27.12 ,$64.11 , N/A ,$64.11 , N/A ,$57.72 ,$57.72 , N/A ,$57.72 , N/A ,$74.57 , N/A , N/A , N/A ,$72.64 ,$68.76 ,$68.76 , N/A ,$68.76 ,$82.32 ,$82.32 ,$82.32 , N/A , N/A ,$82.32 , N/A ,$96.85 ,$54.33 , N/A ,$40.10 , N/A , N/A , N/A ,$82.32 , N/A ,$57.72 ,$27.12 ,$87.17 , N/A ,$82.32 ,$81.84 ,$81.84 , N/A ,$62.95 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,INSULIN REGULAR 100 UNITS/100 ML NS SOLN,250,1 ,$168.00 ,$120.96 ,$47.04 ,$168.00 , N/A ,$109.20 ,$100.30 , N/A ,$47.04 ,$111.22 , N/A ,$111.22 , N/A ,$100.13 ,$100.13 , N/A ,$100.13 , N/A ,$129.36 , N/A , N/A , N/A ,$126.00 ,$119.28 ,$119.28 , N/A ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A , N/A ,$142.80 , N/A ,$168.00 ,$94.25 , N/A ,$69.55 , N/A , N/A , N/A ,$142.80 , N/A ,$100.13 ,$47.04 ,$151.20 , N/A ,$142.80 ,$141.96 ,$141.96 , N/A ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,IPRATROPIUM 0.03 % SOLN 30 ML BOTTLE,250,1 ,$223.35 ,$160.81 ,$62.54 ,$223.35 , N/A ,$145.18 ,$133.34 , N/A ,$62.54 ,$147.86 , N/A ,$147.86 , N/A ,$133.12 ,$133.12 , N/A ,$133.12 , N/A ,$171.98 , N/A , N/A , N/A ,$167.51 ,$158.58 ,$158.58 , N/A ,$158.58 ,$189.85 ,$189.85 ,$189.85 , N/A , N/A ,$189.85 , N/A ,$223.35 ,$125.30 , N/A ,$92.47 , N/A , N/A , N/A ,$189.85 , N/A ,$133.12 ,$62.54 ,$201.02 , N/A ,$189.85 ,$188.73 ,$188.73 , N/A ,$145.18 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,KETAMINE 10 MG/ML SOLN,250,1 ,$45.75 ,$32.94 ,$12.81 ,$45.75 , N/A ,$29.74 ,$27.31 , N/A ,$12.81 ,$30.29 , N/A ,$30.29 , N/A ,$27.27 ,$27.27 , N/A ,$27.27 , N/A ,$35.23 , N/A , N/A , N/A ,$34.31 ,$32.48 ,$32.48 , N/A ,$32.48 ,$38.89 ,$38.89 ,$38.89 , N/A , N/A ,$38.89 , N/A ,$45.75 ,$25.67 , N/A ,$18.94 , N/A , N/A , N/A ,$38.89 , N/A ,$27.27 ,$12.81 ,$41.18 , N/A ,$38.89 ,$38.66 ,$38.66 , N/A ,$29.74 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LEVOTHYROXINE 100 MCG SOLR,250,1 ,$253.40 ,$182.45 ,$70.95 ,$253.40 , N/A ,$164.71 ,$151.28 , N/A ,$70.95 ,$167.75 , N/A ,$167.75 , N/A ,$151.03 ,$151.03 , N/A ,$151.03 , N/A ,$195.12 , N/A , N/A , N/A ,$190.05 ,$179.91 ,$179.91 , N/A ,$179.91 ,$215.39 ,$215.39 ,$215.39 , N/A , N/A ,$215.39 , N/A ,$253.40 ,$142.16 , N/A ,$104.91 , N/A , N/A , N/A ,$215.39 , N/A ,$151.03 ,$70.95 ,$228.06 , N/A ,$215.39 ,$214.12 ,$214.12 , N/A ,$164.71 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE (PF) 1 % SOLN,250,1 ,$49.20 ,$35.42 ,$13.78 ,$49.20 , N/A ,$31.98 ,$29.37 , N/A ,$13.78 ,$32.57 , N/A ,$32.57 , N/A ,$29.32 ,$29.32 , N/A ,$29.32 , N/A ,$37.88 , N/A , N/A , N/A ,$36.90 ,$34.93 ,$34.93 , N/A ,$34.93 ,$41.82 ,$41.82 ,$41.82 , N/A , N/A ,$41.82 , N/A ,$49.20 ,$27.60 , N/A ,$20.37 , N/A , N/A , N/A ,$41.82 , N/A ,$29.32 ,$13.78 ,$44.28 , N/A ,$41.82 ,$41.57 ,$41.57 , N/A ,$31.98 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE (PF) 2 % SOLN,250,1 ,$12.24 ,$8.81 ,$3.43 ,$12.24 , N/A ,$7.96 ,$7.31 , N/A ,$3.43 ,$8.10 , N/A ,$8.10 , N/A ,$7.30 ,$7.30 , N/A ,$7.30 , N/A ,$9.42 , N/A , N/A , N/A ,$9.18 ,$8.69 ,$8.69 , N/A ,$8.69 ,$10.40 ,$10.40 ,$10.40 , N/A , N/A ,$10.40 , N/A ,$12.24 ,$6.87 , N/A ,$5.07 , N/A , N/A , N/A ,$10.40 , N/A ,$7.30 ,$3.43 ,$11.02 , N/A ,$10.40 ,$10.34 ,$10.34 , N/A ,$7.96 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 0.5 % SOLN,250,1 ,$48.35 ,$34.81 ,$13.54 ,$48.35 , N/A ,$31.43 ,$28.87 , N/A ,$13.54 ,$32.01 , N/A ,$32.01 , N/A ,$28.82 ,$28.82 , N/A ,$28.82 , N/A ,$37.23 , N/A , N/A , N/A ,$36.26 ,$34.33 ,$34.33 , N/A ,$34.33 ,$41.10 ,$41.10 ,$41.10 , N/A , N/A ,$41.10 , N/A ,$48.35 ,$27.12 , N/A ,$20.02 , N/A , N/A , N/A ,$41.10 , N/A ,$28.82 ,$13.54 ,$43.52 , N/A ,$41.10 ,$40.86 ,$40.86 , N/A ,$31.43 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 1 % SOLN,250,1 ,$32.80 ,$23.62 ,$9.18 ,$32.80 , N/A ,$21.32 ,$19.58 , N/A ,$9.18 ,$21.71 , N/A ,$21.71 , N/A ,$19.55 ,$19.55 , N/A ,$19.55 , N/A ,$25.26 , N/A , N/A , N/A ,$24.60 ,$23.29 ,$23.29 , N/A ,$23.29 ,$27.88 ,$27.88 ,$27.88 , N/A , N/A ,$27.88 , N/A ,$32.80 ,$18.40 , N/A ,$13.58 , N/A , N/A , N/A ,$27.88 , N/A ,$19.55 ,$9.18 ,$29.52 , N/A ,$27.88 ,$27.72 ,$27.72 , N/A ,$21.32 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 2 % GEL 5 ML TUBE,250,1 ,$16.80 ,$12.10 ,$4.70 ,$16.80 , N/A ,$10.92 ,$10.03 , N/A ,$4.70 ,$11.12 , N/A ,$11.12 , N/A ,$10.01 ,$10.01 , N/A ,$10.01 , N/A ,$12.94 , N/A , N/A , N/A ,$12.60 ,$11.93 ,$11.93 , N/A ,$11.93 ,$14.28 ,$14.28 ,$14.28 , N/A , N/A ,$14.28 , N/A ,$16.80 ,$9.42 , N/A ,$6.96 , N/A , N/A , N/A ,$14.28 , N/A ,$10.01 ,$4.70 ,$15.12 , N/A ,$14.28 ,$14.20 ,$14.20 , N/A ,$10.92 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 2 % PRSY 10 ML SYRINGE,250,1 ,$15.40 ,$11.09 ,$4.31 ,$15.40 , N/A ,$10.01 ,$9.19 , N/A ,$4.31 ,$10.19 , N/A ,$10.19 , N/A ,$9.18 ,$9.18 , N/A ,$9.18 , N/A ,$11.86 , N/A , N/A , N/A ,$11.55 ,$10.93 ,$10.93 , N/A ,$10.93 ,$13.09 ,$13.09 ,$13.09 , N/A , N/A ,$13.09 , N/A ,$15.40 ,$8.64 , N/A ,$6.38 , N/A , N/A , N/A ,$13.09 , N/A ,$9.18 ,$4.31 ,$13.86 , N/A ,$13.09 ,$13.01 ,$13.01 , N/A ,$10.01 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 2 % PRSY 5 ML SYRINGE,250,1 ,$14.40 ,$10.37 ,$4.03 ,$14.40 , N/A ,$9.36 ,$8.60 , N/A ,$4.03 ,$9.53 , N/A ,$9.53 , N/A ,$8.58 ,$8.58 , N/A ,$8.58 , N/A ,$11.09 , N/A , N/A , N/A ,$10.80 ,$10.22 ,$10.22 , N/A ,$10.22 ,$12.24 ,$12.24 ,$12.24 , N/A , N/A ,$12.24 , N/A ,$14.40 ,$8.08 , N/A ,$5.96 , N/A , N/A , N/A ,$12.24 , N/A ,$8.58 ,$4.03 ,$12.96 , N/A ,$12.24 ,$12.17 ,$12.17 , N/A ,$9.36 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:200000 SOLN,250,1 ,$49.45 ,$35.60 ,$13.85 ,$49.45 , N/A ,$32.14 ,$29.52 , N/A ,$13.85 ,$32.74 , N/A ,$32.74 , N/A ,$29.47 ,$29.47 , N/A ,$29.47 , N/A ,$38.08 , N/A , N/A , N/A ,$37.09 ,$35.11 ,$35.11 , N/A ,$35.11 ,$42.03 ,$42.03 ,$42.03 , N/A , N/A ,$42.03 , N/A ,$49.45 ,$27.74 , N/A ,$20.47 , N/A , N/A , N/A ,$42.03 , N/A ,$29.47 ,$13.85 ,$44.51 , N/A ,$42.03 ,$41.79 ,$41.79 , N/A ,$32.14 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE-EPINEPHRINE 1.5 %-1:200000 SOLN,250,1 ,$23.70 ,$17.06 ,$6.64 ,$23.70 , N/A ,$15.41 ,$14.15 , N/A ,$6.64 ,$15.69 , N/A ,$15.69 , N/A ,$14.13 ,$14.13 , N/A ,$14.13 , N/A ,$18.25 , N/A , N/A , N/A ,$17.78 ,$16.83 ,$16.83 , N/A ,$16.83 ,$20.15 ,$20.15 ,$20.15 , N/A , N/A ,$20.15 , N/A ,$23.70 ,$13.30 , N/A ,$9.81 , N/A , N/A , N/A ,$20.15 , N/A ,$14.13 ,$6.64 ,$21.33 , N/A ,$20.15 ,$20.03 ,$20.03 , N/A ,$15.41 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE-EPINEPHRINE 2 %-1:200000 SOLN,250,1 ,$75.45 ,$54.32 ,$21.13 ,$75.45 , N/A ,$49.04 ,$45.04 , N/A ,$21.13 ,$49.95 , N/A ,$49.95 , N/A ,$44.97 ,$44.97 , N/A ,$44.97 , N/A ,$58.10 , N/A , N/A , N/A ,$56.59 ,$53.57 ,$53.57 , N/A ,$53.57 ,$64.13 ,$64.13 ,$64.13 , N/A , N/A ,$64.13 , N/A ,$75.45 ,$42.33 , N/A ,$31.24 , N/A , N/A , N/A ,$64.13 , N/A ,$44.97 ,$21.13 ,$67.91 , N/A ,$64.13 ,$63.76 ,$63.76 , N/A ,$49.04 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE-PRILOCAINE 2.5-2.5 % CREA 5 G TUBE,250,1 ,$19.85 ,$14.29 ,$5.56 ,$19.85 , N/A ,$12.90 ,$11.85 , N/A ,$5.56 ,$13.14 , N/A ,$13.14 , N/A ,$11.83 ,$11.83 , N/A ,$11.83 , N/A ,$15.28 , N/A , N/A , N/A ,$14.89 ,$14.09 ,$14.09 , N/A ,$14.09 ,$16.87 ,$16.87 ,$16.87 , N/A , N/A ,$16.87 , N/A ,$19.85 ,$11.14 , N/A ,$8.22 , N/A , N/A , N/A ,$16.87 , N/A ,$11.83 ,$5.56 ,$17.87 , N/A ,$16.87 ,$16.77 ,$16.77 , N/A ,$12.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,METRONIDAZOLE 500 MG/100ML SOLN,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 , N/A , N/A , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$76.90 ,$76.90 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,MANNITOL 20 % SOLN,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 , N/A , N/A , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$76.90 ,$76.90 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CLINDAMYCIN 600 MG/50ML SOLN,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 , N/A , N/A , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$76.90 ,$76.90 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,MOXIFLOXACIN 0.5 % SOLN 3 ML BOTTLE,250,1 ,$334.70 ,$240.98 ,$93.72 ,$334.70 , N/A ,$217.56 ,$199.82 , N/A ,$93.72 ,$221.57 , N/A ,$221.57 , N/A ,$199.48 ,$199.48 , N/A ,$199.48 , N/A ,$257.72 , N/A , N/A , N/A ,$251.03 ,$237.64 ,$237.64 , N/A ,$237.64 ,$284.50 ,$284.50 ,$284.50 , N/A , N/A ,$284.50 , N/A ,$334.70 ,$187.77 , N/A ,$138.57 , N/A , N/A , N/A ,$284.50 , N/A ,$199.48 ,$93.72 ,$301.23 , N/A ,$284.50 ,$282.82 ,$282.82 , N/A ,$217.56 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,MULTIVITAMIN (ADULT MVI) INJ 10 ML VIAL,250,1 ,$52.95 ,$38.12 ,$14.83 ,$52.95 , N/A ,$34.42 ,$31.61 , N/A ,$14.83 ,$35.05 , N/A ,$35.05 , N/A ,$31.56 ,$31.56 , N/A ,$31.56 , N/A ,$40.77 , N/A , N/A , N/A ,$39.71 ,$37.59 ,$37.59 , N/A ,$37.59 ,$45.01 ,$45.01 ,$45.01 , N/A , N/A ,$45.01 , N/A ,$52.95 ,$29.71 , N/A ,$21.92 , N/A , N/A , N/A ,$45.01 , N/A ,$31.56 ,$14.83 ,$47.66 , N/A ,$45.01 ,$44.74 ,$44.74 , N/A ,$34.42 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,NEOMYCIN-POLYMYXIN-DEXAMETHASONE 3.5-10000-0.1 OINT 3.5 G TUBE,250,1 ,$39.75 ,$28.62 ,$11.13 ,$39.75 , N/A ,$25.84 ,$23.73 , N/A ,$11.13 ,$26.31 , N/A ,$26.31 , N/A ,$23.69 ,$23.69 , N/A ,$23.69 , N/A ,$30.61 , N/A , N/A , N/A ,$29.81 ,$28.22 ,$28.22 , N/A ,$28.22 ,$33.79 ,$33.79 ,$33.79 , N/A , N/A ,$33.79 , N/A ,$39.75 ,$22.30 , N/A ,$16.46 , N/A , N/A , N/A ,$33.79 , N/A ,$23.69 ,$11.13 ,$35.78 , N/A ,$33.79 ,$33.59 ,$33.59 , N/A ,$25.84 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,NICARDIPINE HCL IN NACL 20-0.9 MG/200ML-% SOLN,250,1 ,$390.40 ,$281.09 ,$109.31 ,$390.40 , N/A ,$253.76 ,$233.07 , N/A ,$109.31 ,$258.44 , N/A ,$258.44 , N/A ,$232.68 ,$232.68 , N/A ,$232.68 , N/A ,$300.61 , N/A , N/A , N/A ,$292.80 ,$277.18 ,$277.18 , N/A ,$277.18 ,$331.84 ,$331.84 ,$331.84 , N/A , N/A ,$331.84 , N/A ,$390.40 ,$219.01 , N/A ,$161.63 , N/A , N/A , N/A ,$331.84 , N/A ,$232.68 ,$109.31 ,$351.36 , N/A ,$331.84 ,$329.89 ,$329.89 , N/A ,$253.76 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,NITROGLYCERIN 200-5 MCG/ML-% SOLN,250,1 ,$108.00 ,$77.76 ,$30.24 ,$108.00 , N/A ,$70.20 ,$64.48 , N/A ,$30.24 ,$71.50 , N/A ,$71.50 , N/A ,$64.37 ,$64.37 , N/A ,$64.37 , N/A ,$83.16 , N/A , N/A , N/A ,$81.00 ,$76.68 ,$76.68 , N/A ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A , N/A ,$91.80 , N/A ,$108.00 ,$60.59 , N/A ,$44.71 , N/A , N/A , N/A ,$91.80 , N/A ,$64.37 ,$30.24 ,$97.20 , N/A ,$91.80 ,$91.26 ,$91.26 , N/A ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,NOREPINEPHRINE 1 MG/ML SOLN 4 ML AMPULE,250,1 ,$39.95 ,$28.76 ,$11.19 ,$39.95 , N/A ,$25.97 ,$23.85 , N/A ,$11.19 ,$26.45 , N/A ,$26.45 , N/A ,$23.81 ,$23.81 , N/A ,$23.81 , N/A ,$30.76 , N/A , N/A , N/A ,$29.96 ,$28.36 ,$28.36 , N/A ,$28.36 ,$33.96 ,$33.96 ,$33.96 , N/A , N/A ,$33.96 , N/A ,$39.95 ,$22.41 , N/A ,$16.54 , N/A , N/A , N/A ,$33.96 , N/A ,$23.81 ,$11.19 ,$35.96 , N/A ,$33.96 ,$33.76 ,$33.76 , N/A ,$25.97 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,NOREPINEPHRINE 1 MG/ML SOLN 4 ML VIAL,250,1 ,$91.05 ,$65.56 ,$25.49 ,$91.05 , N/A ,$59.18 ,$54.36 , N/A ,$25.49 ,$60.28 , N/A ,$60.28 , N/A ,$54.27 ,$54.27 , N/A ,$54.27 , N/A ,$70.11 , N/A , N/A , N/A ,$68.29 ,$64.65 ,$64.65 , N/A ,$64.65 ,$77.39 ,$77.39 ,$77.39 , N/A , N/A ,$77.39 , N/A ,$91.05 ,$51.08 , N/A ,$37.69 , N/A , N/A , N/A ,$77.39 , N/A ,$54.27 ,$25.49 ,$81.95 , N/A ,$77.39 ,$76.94 ,$76.94 , N/A ,$59.18 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,OFLOXACIN 0.3 % SOLN 5 ML BOTTLE,250,1 ,$140.70 ,$101.30 ,$39.40 ,$140.70 , N/A ,$91.46 ,$84.00 , N/A ,$39.40 ,$93.14 , N/A ,$93.14 , N/A ,$83.86 ,$83.86 , N/A ,$83.86 , N/A ,$108.34 , N/A , N/A , N/A ,$105.53 ,$99.90 ,$99.90 , N/A ,$99.90 ,$119.60 ,$119.60 ,$119.60 , N/A , N/A ,$119.60 , N/A ,$140.70 ,$78.93 , N/A ,$58.25 , N/A , N/A , N/A ,$119.60 , N/A ,$83.86 ,$39.40 ,$126.63 , N/A ,$119.60 ,$118.89 ,$118.89 , N/A ,$91.46 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,OLANZAPINE 10 MG SOLR,250,1 ,$83.00 ,$59.76 ,$23.24 ,$83.00 , N/A ,$53.95 ,$49.55 , N/A ,$23.24 ,$54.95 , N/A ,$54.95 , N/A ,$49.47 ,$49.47 , N/A ,$49.47 , N/A ,$63.91 , N/A , N/A , N/A ,$62.25 ,$58.93 ,$58.93 , N/A ,$58.93 ,$70.55 ,$70.55 ,$70.55 , N/A , N/A ,$70.55 , N/A ,$83.00 ,$46.56 , N/A ,$34.36 , N/A , N/A , N/A ,$70.55 , N/A ,$49.47 ,$23.24 ,$74.70 , N/A ,$70.55 ,$70.14 ,$70.14 , N/A ,$53.95 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,OPHTHALMIC IRRIGATION SOLN 118 ML BOTTLE,250,1 ,$7.35 ,$5.29 ,$2.06 ,$7.35 , N/A ,$4.78 ,$4.39 , N/A ,$2.06 ,$4.87 , N/A ,$4.87 , N/A ,$4.38 ,$4.38 , N/A ,$4.38 , N/A ,$5.66 , N/A , N/A , N/A ,$5.51 ,$5.22 ,$5.22 , N/A ,$5.22 ,$6.25 ,$6.25 ,$6.25 , N/A , N/A ,$6.25 , N/A ,$7.35 ,$4.12 , N/A ,$3.04 , N/A , N/A , N/A ,$6.25 , N/A ,$4.38 ,$2.06 ,$6.62 , N/A ,$6.25 ,$6.21 ,$6.21 , N/A ,$4.78 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,PHENYLEPHRINE 2.5 % SOLN 2 ML BOTTLE,250,1 ,$81.30 ,$58.54 ,$22.76 ,$81.30 , N/A ,$52.85 ,$48.54 , N/A ,$22.76 ,$53.82 , N/A ,$53.82 , N/A ,$48.45 ,$48.45 , N/A ,$48.45 , N/A ,$62.60 , N/A , N/A , N/A ,$60.98 ,$57.72 ,$57.72 , N/A ,$57.72 ,$69.11 ,$69.11 ,$69.11 , N/A , N/A ,$69.11 , N/A ,$81.30 ,$45.61 , N/A ,$33.66 , N/A , N/A , N/A ,$69.11 , N/A ,$48.45 ,$22.76 ,$73.17 , N/A ,$69.11 ,$68.70 ,$68.70 , N/A ,$52.85 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,"POLYETHYLENE GLYCOL 236 G SOLR 4,000 ML BOTTLE",250,1 ,$56.00 ,$40.32 ,$15.68 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A ,$43.12 , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 , N/A , N/A , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 ,$47.32 ,$47.32 , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,POTASSIUM PHOSPHATE 45 MMOLE/15ML SOLN 15 ML VIAL,250,1 ,$47.35 ,$34.09 ,$13.26 ,$47.35 , N/A ,$30.78 ,$28.27 , N/A ,$13.26 ,$31.35 , N/A ,$31.35 , N/A ,$28.22 ,$28.22 , N/A ,$28.22 , N/A ,$36.46 , N/A , N/A , N/A ,$35.51 ,$33.62 ,$33.62 , N/A ,$33.62 ,$40.25 ,$40.25 ,$40.25 , N/A , N/A ,$40.25 , N/A ,$47.35 ,$26.56 , N/A ,$19.60 , N/A , N/A , N/A ,$40.25 , N/A ,$28.22 ,$13.26 ,$42.62 , N/A ,$40.25 ,$40.01 ,$40.01 , N/A ,$30.78 ST. JOSEPH'S HOSPITAL - BREESE,25000003,J0248,REMDESIVIR 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$24.96 ,$17.97 ,$5.40 ,$24.96 ,$13.78 ,$16.22 ,$14.90 ,$5.40 ,$6.99 ,$16.52 ,$5.40 ,$16.52 ,$5.40 ,$14.88 ,$14.88 ,$5.40 ,$14.88 ,$11.13 ,$19.22 ,$13.78 ,$5.40 ,$5.51 ,$18.72 ,$17.72 ,$17.72 ,$5.40 ,$17.72 ,$21.22 ,$21.22 ,$21.22 , N/A ,$13.78 ,$21.22 ,$5.40 ,$24.96 ,$14.00 ,$5.40 ,$10.33 ,$24.96 ,$24.96 ,$5.40 ,$21.22 ,$11.58 ,$14.88 ,$6.99 ,$22.46 ,$5.40 ,$21.22 ,$9.09 ,$9.09 ,$5.40 ,$16.22 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ROCURONIUM 100 MG/10ML SOLN,250,1 ,$19.60 ,$14.11 ,$5.49 ,$19.60 , N/A ,$12.74 ,$11.70 , N/A ,$5.49 ,$12.98 , N/A ,$12.98 , N/A ,$11.68 ,$11.68 , N/A ,$11.68 , N/A ,$15.09 , N/A , N/A , N/A ,$14.70 ,$13.92 ,$13.92 , N/A ,$13.92 ,$16.66 ,$16.66 ,$16.66 , N/A , N/A ,$16.66 , N/A ,$19.60 ,$11.00 , N/A ,$8.11 , N/A , N/A , N/A ,$16.66 , N/A ,$11.68 ,$5.49 ,$17.64 , N/A ,$16.66 ,$16.56 ,$16.56 , N/A ,$12.74 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ROCURONIUM 50 MG/5ML SOLN,250,1 ,$42.00 ,$30.24 ,$11.76 ,$42.00 , N/A ,$27.30 ,$25.07 , N/A ,$11.76 ,$27.80 , N/A ,$27.80 , N/A ,$25.03 ,$25.03 , N/A ,$25.03 , N/A ,$32.34 , N/A , N/A , N/A ,$31.50 ,$29.82 ,$29.82 , N/A ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A , N/A ,$35.70 , N/A ,$42.00 ,$23.56 , N/A ,$17.39 , N/A , N/A , N/A ,$35.70 , N/A ,$25.03 ,$11.76 ,$37.80 , N/A ,$35.70 ,$35.49 ,$35.49 , N/A ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SCOPOLAMINE 1 MG/3DAYS PT72,250,1 ,$51.15 ,$36.83 ,$14.32 ,$51.15 , N/A ,$33.25 ,$30.54 , N/A ,$14.32 ,$33.86 , N/A ,$33.86 , N/A ,$30.49 ,$30.49 , N/A ,$30.49 , N/A ,$39.39 , N/A , N/A , N/A ,$38.36 ,$36.32 ,$36.32 , N/A ,$36.32 ,$43.48 ,$43.48 ,$43.48 , N/A , N/A ,$43.48 , N/A ,$51.15 ,$28.70 , N/A ,$21.18 , N/A , N/A , N/A ,$43.48 , N/A ,$30.49 ,$14.32 ,$46.04 , N/A ,$43.48 ,$43.22 ,$43.22 , N/A ,$33.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM BICARBONATE 4.2 % SOLN,250,1 ,$26.55 ,$19.12 ,$7.43 ,$26.55 , N/A ,$17.26 ,$15.85 , N/A ,$7.43 ,$17.58 , N/A ,$17.58 , N/A ,$15.82 ,$15.82 , N/A ,$15.82 , N/A ,$20.44 , N/A , N/A , N/A ,$19.91 ,$18.85 ,$18.85 , N/A ,$18.85 ,$22.57 ,$22.57 ,$22.57 , N/A , N/A ,$22.57 , N/A ,$26.55 ,$14.89 , N/A ,$10.99 , N/A , N/A , N/A ,$22.57 , N/A ,$15.82 ,$7.43 ,$23.90 , N/A ,$22.57 ,$22.43 ,$22.43 , N/A ,$17.26 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM BICARBONATE 8.4 % SOLN 50 ML SYRINGE,250,1 ,$62.80 ,$45.22 ,$17.58 ,$62.80 , N/A ,$40.82 ,$37.49 , N/A ,$17.58 ,$41.57 , N/A ,$41.57 , N/A ,$37.43 ,$37.43 , N/A ,$37.43 , N/A ,$48.36 , N/A , N/A , N/A ,$47.10 ,$44.59 ,$44.59 , N/A ,$44.59 ,$53.38 ,$53.38 ,$53.38 , N/A , N/A ,$53.38 , N/A ,$62.80 ,$35.23 , N/A ,$26.00 , N/A , N/A , N/A ,$53.38 , N/A ,$37.43 ,$17.58 ,$56.52 , N/A ,$53.38 ,$53.07 ,$53.07 , N/A ,$40.82 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM BICARBONATE 8.4 % SOLN 50 ML VIAL,250,1 ,$46.80 ,$33.70 ,$13.10 ,$46.80 , N/A ,$30.42 ,$27.94 , N/A ,$13.10 ,$30.98 , N/A ,$30.98 , N/A ,$27.89 ,$27.89 , N/A ,$27.89 , N/A ,$36.04 , N/A , N/A , N/A ,$35.10 ,$33.23 ,$33.23 , N/A ,$33.23 ,$39.78 ,$39.78 ,$39.78 , N/A , N/A ,$39.78 , N/A ,$46.80 ,$26.25 , N/A ,$19.38 , N/A , N/A , N/A ,$39.78 , N/A ,$27.89 ,$13.10 ,$42.12 , N/A ,$39.78 ,$39.55 ,$39.55 , N/A ,$30.42 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DILTIAZEM 25 MG/5ML SOLN,250,1 ,$46.80 ,$33.70 ,$13.10 ,$46.80 , N/A ,$30.42 ,$27.94 , N/A ,$13.10 ,$30.98 , N/A ,$30.98 , N/A ,$27.89 ,$27.89 , N/A ,$27.89 , N/A ,$36.04 , N/A , N/A , N/A ,$35.10 ,$33.23 ,$33.23 , N/A ,$33.23 ,$39.78 ,$39.78 ,$39.78 , N/A , N/A ,$39.78 , N/A ,$46.80 ,$26.25 , N/A ,$19.38 , N/A , N/A , N/A ,$39.78 , N/A ,$27.89 ,$13.10 ,$42.12 , N/A ,$39.78 ,$39.55 ,$39.55 , N/A ,$30.42 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,"SODIUM CHLORIDE 0.45 % SOLN 1,000 ML FLEX CONT",250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DEXTROSE 10 % - SODIUM CHLORIDE 0.2 % 10-0.2 % SOLN 250 ML FLEX CONT,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DEXTROSE 10 % BOLUS,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,DEXTROSE 5 % LACTATED RINGERS BOLUS,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM CHLORIDE 0.45 % SOLN,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BARIUM SULFATE 700 MG TABS,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BARIUM SULFATE 98 % SUSR,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM CHLORIDE 0.9 % SOLN,250,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM CHLORIDE 10 % NEBU,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FLUORESCEIN 0.6 MG STRP,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FLUORESCEIN 1 MG STRP,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,IPRATROPIUM 0.02 % SOLN,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML SOLN,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 4 % PTCH,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE VISCOUS 2 % SOLN 100 ML BOTTLE,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE VISCOUS 2 % SOLN 15 ML CUP,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SILVER-POTASSIUM NITRATE 75-25 % MISC,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SIMETHICONE 40 MG/0.6ML SUSP,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SODIUM CHLORIDE 0.9 % NEBU,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ALBUTEROL (2.5 MG/3ML) 0.083% NEBU,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ALBUTEROL (5 MG/ML) 0.5% NEBU,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CHLORHEXIDINE 0.12 % SOLN 473 ML BOTTLE,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,PREDNISOLONE ACETATE 1 % SUSP,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,PREDNISOLONE ACETATE 1 % SUSP 5 ML BOTTLE,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,RACEPINEPHRINE 2.25 % 2.25 % NEBU,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,STERILE WATER SOLN 10 ML VIAL,250,1 ,$18.35 ,$13.21 ,$5.14 ,$18.35 , N/A ,$11.93 ,$10.96 , N/A ,$5.14 ,$12.15 , N/A ,$12.15 , N/A ,$10.94 ,$10.94 , N/A ,$10.94 , N/A ,$14.13 , N/A , N/A , N/A ,$13.76 ,$13.03 ,$13.03 , N/A ,$13.03 ,$15.60 ,$15.60 ,$15.60 , N/A , N/A ,$15.60 , N/A ,$18.35 ,$10.29 , N/A ,$7.60 , N/A , N/A , N/A ,$15.60 , N/A ,$10.94 ,$5.14 ,$16.52 , N/A ,$15.60 ,$15.51 ,$15.51 , N/A ,$11.93 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,STERILE WATER SOLN 20 ML VIAL,250,1 ,$23.95 ,$17.24 ,$6.71 ,$23.95 , N/A ,$15.57 ,$14.30 , N/A ,$6.71 ,$15.85 , N/A ,$15.85 , N/A ,$14.27 ,$14.27 , N/A ,$14.27 , N/A ,$18.44 , N/A , N/A , N/A ,$17.96 ,$17.00 ,$17.00 , N/A ,$17.00 ,$20.36 ,$20.36 ,$20.36 , N/A , N/A ,$20.36 , N/A ,$23.95 ,$13.44 , N/A ,$9.92 , N/A , N/A , N/A ,$20.36 , N/A ,$14.27 ,$6.71 ,$21.56 , N/A ,$20.36 ,$20.24 ,$20.24 , N/A ,$15.57 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,STERILE WATER SOLN 50 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,ESMOLOL 100 MG/10ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FAMOTIDINE (PF) 20 MG/2ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FAMOTIDINE 20 MG/2ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,FOLIC ACID 5 MG/ML SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,KETAMINE 50 MG/ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,KETAMINE 50 MG/ML SOLN 10 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LABETALOL 5 MG/ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE (PF) 1 % SOLN 2 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE (PF) 1 % SOLN 5 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 2 % SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE 2 % SOLN 20 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE-EPINEPHRINE 0.5 %-1:200000 SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:100000 SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,METOPROLOL TARTRATE 5 MG/5ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,"STERILE WATER SOLN 1,000 ML FLEX CONT",250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUMETANIDE 0.25 MG/ML SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN 30 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE (PF) 0.75 % SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE (PF) 0.75 % SOLN 30 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE 0.25 % SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,BUPIVACAINE 0.75% IN DEXTROSE 8.25% (INTRATHECAL) 0.75-8.25 % SOLN,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CLINDAMYCIN 600 MG/4ML SOLN 4 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,CLINDAMYCIN 900 MG/6ML SOLN 4 ML VIAL,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,STRONG IODINE SOLN,250,1 ,$21.90 ,$15.77 ,$6.13 ,$21.90 , N/A ,$14.24 ,$13.07 , N/A ,$6.13 ,$14.50 , N/A ,$14.50 , N/A ,$13.05 ,$13.05 , N/A ,$13.05 , N/A ,$16.86 , N/A , N/A , N/A ,$16.43 ,$15.55 ,$15.55 , N/A ,$15.55 ,$18.62 ,$18.62 ,$18.62 , N/A , N/A ,$18.62 , N/A ,$21.90 ,$12.29 , N/A ,$9.07 , N/A , N/A , N/A ,$18.62 , N/A ,$13.05 ,$6.13 ,$19.71 , N/A ,$18.62 ,$18.51 ,$18.51 , N/A ,$14.24 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SUGAMMADEX 200 MG/2ML SOLN,250,1 ,$554.05 ,$398.92 ,$155.13 ,$554.05 , N/A ,$360.13 ,$330.77 , N/A ,$155.13 ,$366.78 , N/A ,$366.78 , N/A ,$330.21 ,$330.21 , N/A ,$330.21 , N/A ,$426.62 , N/A , N/A , N/A ,$415.54 ,$393.38 ,$393.38 , N/A ,$393.38 ,$470.94 ,$470.94 ,$470.94 , N/A , N/A ,$470.94 , N/A ,$554.05 ,$310.82 , N/A ,$229.38 , N/A , N/A , N/A ,$470.94 , N/A ,$330.21 ,$155.13 ,$498.65 , N/A ,$470.94 ,$468.17 ,$468.17 , N/A ,$360.13 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,SUGAMMADEX 500 MG/5ML SOLN,250,1 ,"$1,014.75 ",$730.62 ,$284.13 ,"$1,014.75 ", N/A ,$659.59 ,$605.81 , N/A ,$284.13 ,$671.76 , N/A ,$671.76 , N/A ,$604.79 ,$604.79 , N/A ,$604.79 , N/A ,$781.36 , N/A , N/A , N/A ,$761.06 ,$720.47 ,$720.47 , N/A ,$720.47 ,$862.54 ,$862.54 ,$862.54 , N/A , N/A ,$862.54 , N/A ,"$1,014.75 ",$569.27 , N/A ,$420.11 , N/A , N/A , N/A ,$862.54 , N/A ,$604.79 ,$284.13 ,$913.28 , N/A ,$862.54 ,$857.46 ,$857.46 , N/A ,$659.59 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,TETRACAINE 0.5 % SOLN 4 ML PLAS CONT,250,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 , N/A ,$18.20 ,$16.72 , N/A ,$7.84 ,$18.54 , N/A ,$18.54 , N/A ,$16.69 ,$16.69 , N/A ,$16.69 , N/A ,$21.56 , N/A , N/A , N/A ,$21.00 ,$19.88 ,$19.88 , N/A ,$19.88 ,$23.80 ,$23.80 ,$23.80 , N/A , N/A ,$23.80 , N/A ,$28.00 ,$15.71 , N/A ,$11.59 , N/A , N/A , N/A ,$23.80 , N/A ,$16.69 ,$7.84 ,$25.20 , N/A ,$23.80 ,$23.66 ,$23.66 , N/A ,$18.20 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,"SODIUM CHLORIDE 0.9 % SOLN 2,000 ML BOTTLE",250,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 , N/A ,$18.20 ,$16.72 , N/A ,$7.84 ,$18.54 , N/A ,$18.54 , N/A ,$16.69 ,$16.69 , N/A ,$16.69 , N/A ,$21.56 , N/A , N/A , N/A ,$21.00 ,$19.88 ,$19.88 , N/A ,$19.88 ,$23.80 ,$23.80 ,$23.80 , N/A , N/A ,$23.80 , N/A ,$28.00 ,$15.71 , N/A ,$11.59 , N/A , N/A , N/A ,$23.80 , N/A ,$16.69 ,$7.84 ,$25.20 , N/A ,$23.80 ,$23.66 ,$23.66 , N/A ,$18.20 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,TETRACAINE 1 % SOLN,250,1 ,$145.83 ,$105.00 ,$40.83 ,$145.83 , N/A ,$94.79 ,$87.06 , N/A ,$40.83 ,$96.54 , N/A ,$96.54 , N/A ,$86.91 ,$86.91 , N/A ,$86.91 , N/A ,$112.29 , N/A , N/A , N/A ,$109.37 ,$103.54 ,$103.54 , N/A ,$103.54 ,$123.96 ,$123.96 ,$123.96 , N/A , N/A ,$123.96 , N/A ,$145.83 ,$81.81 , N/A ,$60.37 , N/A , N/A , N/A ,$123.96 , N/A ,$86.91 ,$40.83 ,$131.25 , N/A ,$123.96 ,$123.23 ,$123.23 , N/A ,$94.79 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,TPN-CLINIMIX 4.25/5 (STANDARD ELECTROLYTES),250,1 ,$996.15 ,$717.23 ,$278.92 ,$996.15 , N/A ,$647.50 ,$594.70 , N/A ,$278.92 ,$659.45 , N/A ,$659.45 , N/A ,$593.71 ,$593.71 , N/A ,$593.71 , N/A ,$767.04 , N/A , N/A , N/A ,$747.11 ,$707.27 ,$707.27 , N/A ,$707.27 ,$846.73 ,$846.73 ,$846.73 , N/A , N/A ,$846.73 , N/A ,$996.15 ,$558.84 , N/A ,$412.41 , N/A , N/A , N/A ,$846.73 , N/A ,$593.71 ,$278.92 ,$896.54 , N/A ,$846.73 ,$841.75 ,$841.75 , N/A ,$647.50 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,TRANEXAMIC ACID 1000 MG/10ML SOLN 10 ML VIAL,250,1 ,$240.00 ,$172.80 ,$67.20 ,$240.00 , N/A ,$156.00 ,$143.28 , N/A ,$67.20 ,$158.88 , N/A ,$158.88 , N/A ,$143.04 ,$143.04 , N/A ,$143.04 , N/A ,$184.80 , N/A , N/A , N/A ,$180.00 ,$170.40 ,$170.40 , N/A ,$170.40 ,$204.00 ,$204.00 ,$204.00 , N/A , N/A ,$204.00 , N/A ,$240.00 ,$134.64 , N/A ,$99.36 , N/A , N/A , N/A ,$204.00 , N/A ,$143.04 ,$67.20 ,$216.00 , N/A ,$204.00 ,$202.80 ,$202.80 , N/A ,$156.00 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,TROPICAMIDE 1 % SOLN 15 ML BOTTLE,250,1 ,$21.30 ,$15.34 ,$5.96 ,$21.30 , N/A ,$13.85 ,$12.72 , N/A ,$5.96 ,$14.10 , N/A ,$14.10 , N/A ,$12.69 ,$12.69 , N/A ,$12.69 , N/A ,$16.40 , N/A , N/A , N/A ,$15.98 ,$15.12 ,$15.12 , N/A ,$15.12 ,$18.11 ,$18.11 ,$18.11 , N/A , N/A ,$18.11 , N/A ,$21.30 ,$11.95 , N/A ,$8.82 , N/A , N/A , N/A ,$18.11 , N/A ,$12.69 ,$5.96 ,$19.17 , N/A ,$18.11 ,$18.00 ,$18.00 , N/A ,$13.85 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,TROPICAMIDE 1%-CYCLOPENTOLATE 1%-PHENYLEPHRINE 2.5%-KETOROLAC 0.5% 1-1-2.5-0.5 % SOSY,250,1 ,$12.00 ,$8.64 ,$3.36 ,$12.00 , N/A ,$7.80 ,$7.16 , N/A ,$3.36 ,$7.94 , N/A ,$7.94 , N/A ,$7.15 ,$7.15 , N/A ,$7.15 , N/A ,$9.24 , N/A , N/A , N/A ,$9.00 ,$8.52 ,$8.52 , N/A ,$8.52 ,$10.20 ,$10.20 ,$10.20 , N/A , N/A ,$10.20 , N/A ,$12.00 ,$6.73 , N/A ,$4.97 , N/A , N/A , N/A ,$10.20 , N/A ,$7.15 ,$3.36 ,$10.80 , N/A ,$10.20 ,$10.14 ,$10.14 , N/A ,$7.80 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,VALPROATE 100 MG/ML SOLN 5 ML VIAL,250,1 ,$32.18 ,$23.17 ,$9.01 ,$32.18 , N/A ,$20.92 ,$19.21 , N/A ,$9.01 ,$21.30 , N/A ,$21.30 , N/A ,$19.18 ,$19.18 , N/A ,$19.18 , N/A ,$24.78 , N/A , N/A , N/A ,$24.14 ,$22.85 ,$22.85 , N/A ,$22.85 ,$27.35 ,$27.35 ,$27.35 , N/A , N/A ,$27.35 , N/A ,$32.18 ,$18.05 , N/A ,$13.32 , N/A , N/A , N/A ,$27.35 , N/A ,$19.18 ,$9.01 ,$28.96 , N/A ,$27.35 ,$27.19 ,$27.19 , N/A ,$20.92 ST. JOSEPH'S HOSPITAL - BREESE,25000003,N/A,VECURONIUM 10 MG SOLR,250,1 ,$28.58 ,$20.58 ,$8.00 ,$28.58 , N/A ,$18.58 ,$17.06 , N/A ,$8.00 ,$18.92 , N/A ,$18.92 , N/A ,$17.03 ,$17.03 , N/A ,$17.03 , N/A ,$22.01 , N/A , N/A , N/A ,$21.44 ,$20.29 ,$20.29 , N/A ,$20.29 ,$24.29 ,$24.29 ,$24.29 , N/A , N/A ,$24.29 , N/A ,$28.58 ,$16.03 , N/A ,$11.83 , N/A , N/A , N/A ,$24.29 , N/A ,$17.03 ,$8.00 ,$25.72 , N/A ,$24.29 ,$24.15 ,$24.15 , N/A ,$18.58 ST. JOSEPH'S HOSPITAL - BREESE,25800000,N/A,DEXTROSE 10 % SOLN 250 ML FLEX CONT,258,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25800000,N/A,DEXTROSE 10 % SOLN,258,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,25800000,N/A,DEXTROSE 50 % SOLN 50 ML SYRINGE,258,1 ,$63.60 ,$45.79 ,$17.81 ,$63.60 , N/A ,$41.34 ,$37.97 , N/A ,$17.81 ,$42.10 , N/A ,$42.10 , N/A ,$37.91 ,$37.91 , N/A ,$37.91 , N/A ,$48.97 , N/A , N/A , N/A ,$47.70 ,$45.16 ,$45.16 , N/A ,$45.16 ,$54.06 ,$54.06 ,$54.06 , N/A , N/A ,$54.06 , N/A ,$63.60 ,$35.68 , N/A ,$26.33 , N/A , N/A , N/A ,$54.06 , N/A ,$37.91 ,$17.81 ,$57.24 , N/A ,$54.06 ,$53.74 ,$53.74 , N/A ,$41.34 ST. JOSEPH'S HOSPITAL - BREESE,25800000,N/A,TPN-CLINIMIX E 5/15 (STANDARD ELECTROLYTES),258,1 ,$996.15 ,$717.23 ,$278.92 ,$996.15 , N/A ,$647.50 ,$594.70 , N/A ,$278.92 ,$659.45 , N/A ,$659.45 , N/A ,$593.71 ,$593.71 , N/A ,$593.71 , N/A ,$767.04 , N/A , N/A , N/A ,$747.11 ,$707.27 ,$707.27 , N/A ,$707.27 ,$846.73 ,$846.73 ,$846.73 , N/A , N/A ,$846.73 , N/A ,$996.15 ,$558.84 , N/A ,$412.41 , N/A , N/A , N/A ,$846.73 , N/A ,$593.71 ,$278.92 ,$896.54 , N/A ,$846.73 ,$841.75 ,$841.75 , N/A ,$647.50 ST. JOSEPH'S HOSPITAL - BREESE,26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$382.00 ,$275.04 ,$106.96 ,$495.95 ,$495.95 ,$248.30 ,$228.05 ,$194.41 ,$106.96 ,$252.88 ,$194.41 ,$252.88 ,$194.41 ,$227.67 ,$227.67 ,$194.41 ,$227.67 ,$382.00 , N/A ,$495.94 ,$194.41 ,$198.29 ,$286.50 ,$271.22 ,$271.22 ,$194.41 ,$271.22 ,$324.70 ,$324.70 ,$324.70 , N/A ,$382.00 ,$324.70 ,$194.41 ,$382.00 ,$214.30 ,$194.41 ,$158.15 ,$231.63 ,$210.57 ,$194.41 ,$324.70 ,$416.59 ,$227.67 ,$106.96 ,$343.80 ,$194.41 ,$324.70 ,$322.79 ,$322.79 ,$194.41 ,$248.30 ST. JOSEPH'S HOSPITAL - BREESE,26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$63.00 ,$45.36 ,$17.64 ,$101.73 ,$101.73 ,$40.95 ,$37.61 ,$39.88 ,$17.64 ,$41.71 ,$39.88 ,$41.71 ,$39.88 ,$37.55 ,$37.55 ,$39.88 ,$37.55 ,$63.00 , N/A ,$101.72 ,$39.88 ,$40.67 ,$47.25 ,$44.73 ,$44.73 ,$39.88 ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A ,$63.00 ,$53.55 ,$39.88 ,$63.00 ,$35.34 ,$39.88 ,$26.08 ,$63.00 ,$63.00 ,$39.88 ,$53.55 ,$85.45 ,$37.55 ,$17.64 ,$56.70 ,$39.88 ,$53.55 ,$53.24 ,$53.24 ,$39.88 ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$634.00 ,$456.48 ,$177.52 ,$634.00 ,$495.95 ,$412.10 ,$378.50 ,$194.41 ,$177.52 ,$419.71 ,$194.41 ,$419.71 ,$194.41 ,$377.86 ,$377.86 ,$194.41 ,$377.86 ,$400.72 , N/A ,$495.94 ,$194.41 ,$198.29 ,$475.50 ,$450.14 ,$450.14 ,$194.41 ,$450.14 ,$538.90 ,$538.90 ,$538.90 , N/A ,$495.94 ,$538.90 ,$194.41 ,$634.00 ,$355.67 ,$194.41 ,$262.48 ,$231.63 ,$210.57 ,$194.41 ,$538.90 ,$416.59 ,$377.86 ,$177.52 ,$570.60 ,$194.41 ,$538.90 ,$535.73 ,$535.73 ,$194.41 ,$412.10 ST. JOSEPH'S HOSPITAL - BREESE,26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$99.00 ,$71.28 ,$27.72 ,$101.73 ,$101.73 ,$64.35 ,$59.10 ,$39.88 ,$27.72 ,$65.54 ,$39.88 ,$65.54 ,$39.88 ,$59.00 ,$59.00 ,$39.88 ,$59.00 ,$82.19 , N/A ,$101.72 ,$39.88 ,$40.67 ,$74.25 ,$70.29 ,$70.29 ,$39.88 ,$70.29 ,$84.15 ,$84.15 ,$84.15 , N/A ,$99.00 ,$84.15 ,$39.88 ,$99.00 ,$55.54 ,$39.88 ,$40.99 ,$99.00 ,$99.00 ,$39.88 ,$84.15 ,$85.45 ,$59.00 ,$27.72 ,$89.10 ,$39.88 ,$84.15 ,$83.66 ,$83.66 ,$39.88 ,$64.35 ST. JOSEPH'S HOSPITAL - BREESE,26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$136.00 ,$97.92 ,$38.08 ,$161.99 ,$161.98 ,$88.40 ,$81.19 ,$63.49 ,$38.08 ,$90.03 ,$63.49 ,$90.03 ,$63.49 ,$81.06 ,$81.06 ,$63.49 ,$81.06 ,$130.88 , N/A ,$161.99 ,$63.49 ,$64.77 ,$102.00 ,$96.56 ,$96.56 ,$63.49 ,$96.56 ,$115.60 ,$115.60 ,$115.60 , N/A ,$136.00 ,$115.60 ,$63.49 ,$136.00 ,$76.30 ,$63.49 ,$56.30 ,$136.00 ,$136.00 ,$63.49 ,$115.60 ,$136.07 ,$81.06 ,$38.08 ,$122.40 ,$63.49 ,$115.60 ,$114.92 ,$114.92 ,$63.49 ,$88.40 ST. JOSEPH'S HOSPITAL - BREESE,26000005,96368,HC INFUS CONCURRENT,260,1 ,$136.00 ,$97.92 ,$38.08 ,$136.00 , N/A ,$88.40 ,$81.19 , N/A ,$38.08 ,$90.03 , N/A ,$90.03 , N/A ,$81.06 ,$81.06 , N/A ,$81.06 , N/A , N/A , N/A , N/A , N/A ,$102.00 ,$96.56 ,$96.56 , N/A ,$96.56 ,$115.60 ,$115.60 ,$115.60 , N/A , N/A ,$115.60 , N/A ,$136.00 ,$76.30 , N/A ,$56.30 ,$136.00 ,$136.00 , N/A ,$115.60 , N/A ,$81.06 ,$38.08 ,$122.40 , N/A ,$115.60 ,$114.92 ,$114.92 , N/A ,$88.40 ST. JOSEPH'S HOSPITAL - BREESE,26000015,M0243,"HC INTRAVENOUS INFUSION, CASIRIVIMAB AND IMDEVIMAB ADMINISTRATION",260,1 ,"$1,070.00 ",$770.40 ,$210.57 ,"$1,081.58 ","$1,081.58 ",$695.50 ,$638.79 ,$423.98 ,$299.60 ,$708.34 ,$423.98 ,$708.34 ,$423.98 ,$637.72 ,$637.72 ,$423.98 ,$637.72 ,$873.92 ,$823.90 ,"$1,081.58 ",$423.98 ,$432.46 ,$802.50 ,$759.70 ,$759.70 ,$423.98 ,$759.70 ,$909.50 ,$909.50 ,$909.50 , N/A ,"$1,070.00 ",$909.50 ,$423.98 ,"$1,070.00 ",$600.27 ,$423.98 ,$442.98 ,$231.63 ,$210.57 ,$423.98 ,$909.50 ,$908.53 ,$637.72 ,$299.60 ,$963.00 ,$423.98 ,$909.50 ,$904.15 ,$904.15 ,$423.98 ,$695.50 ST. JOSEPH'S HOSPITAL - BREESE,26000016,M0245,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB ADMINISTRATION",260,1 ,"$1,072.00 ",$771.84 ,$210.57 ,"$1,081.58 ","$1,081.58 ",$696.80 ,$639.98 ,$423.98 ,$300.16 ,$709.66 ,$423.98 ,$709.66 ,$423.98 ,$638.91 ,$638.91 ,$423.98 ,$638.91 ,$873.92 ,$825.44 ,"$1,081.58 ",$423.98 ,$432.46 ,$804.00 ,$761.12 ,$761.12 ,$423.98 ,$761.12 ,$911.20 ,$911.20 ,$911.20 , N/A ,"$1,072.00 ",$911.20 ,$423.98 ,"$1,072.00 ",$601.39 ,$423.98 ,$443.81 ,$231.63 ,$210.57 ,$423.98 ,$911.20 ,$908.53 ,$638.91 ,$300.16 ,$964.80 ,$423.98 ,$911.20 ,$905.84 ,$905.84 ,$423.98 ,$696.80 ST. JOSEPH'S HOSPITAL - BREESE,26000017,M0247,"HC INTRAVENOUS INFUSION, SOTROVIMAB ADMINISTRATION",260,1 ,"$1,552.00 ","$1,117.44 ",$210.57 ,"$1,552.00 ","$1,081.58 ","$1,008.80 ",$926.54 ,$423.98 ,$434.56 ,"$1,027.42 ",$423.98 ,"$1,027.42 ",$423.98 ,$924.99 ,$924.99 ,$423.98 ,$924.99 ,$873.92 ,"$1,195.04 ","$1,081.58 ",$423.98 ,$432.46 ,"$1,164.00 ","$1,101.92 ","$1,101.92 ",$423.98 ,"$1,101.92 ","$1,319.20 ","$1,319.20 ","$1,319.20 ", N/A ,"$1,081.58 ","$1,319.20 ",$423.98 ,"$1,552.00 ",$870.67 ,$423.98 ,$642.53 ,$231.63 ,$210.57 ,$423.98 ,"$1,319.20 ",$908.53 ,$924.99 ,$434.56 ,"$1,396.80 ",$423.98 ,"$1,319.20 ","$1,311.44 ","$1,311.44 ",$423.98 ,"$1,008.80 " ST. JOSEPH'S HOSPITAL - BREESE,27000012,N/A,HC PAD BREAST NURSING,270,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 , N/A ,$15.60 ,$14.33 , N/A ,$6.72 ,$15.89 , N/A ,$15.89 , N/A ,$14.30 ,$14.30 , N/A ,$14.30 , N/A ,$18.48 , N/A , N/A , N/A ,$18.00 ,$17.04 ,$17.04 , N/A ,$17.04 ,$20.40 ,$20.40 ,$20.40 , N/A , N/A ,$20.40 , N/A ,$24.00 ,$13.46 , N/A ,$9.94 , N/A , N/A , N/A ,$20.40 , N/A ,$14.30 ,$6.72 ,$21.60 , N/A ,$20.40 ,$20.28 ,$20.28 , N/A ,$15.60 ST. JOSEPH'S HOSPITAL - BREESE,27000014,N/A,HC SET CYSTO IRRIGATION TUBING,270,1 ,$19.00 ,$13.68 ,$5.32 ,$19.00 , N/A ,$12.35 ,$11.34 , N/A ,$5.32 ,$12.58 , N/A ,$12.58 , N/A ,$11.32 ,$11.32 , N/A ,$11.32 , N/A ,$14.63 , N/A , N/A , N/A ,$14.25 ,$13.49 ,$13.49 , N/A ,$13.49 ,$16.15 ,$16.15 ,$16.15 , N/A , N/A ,$16.15 , N/A ,$19.00 ,$10.66 , N/A ,$7.87 , N/A , N/A , N/A ,$16.15 , N/A ,$11.32 ,$5.32 ,$17.10 , N/A ,$16.15 ,$16.06 ,$16.06 , N/A ,$12.35 ST. JOSEPH'S HOSPITAL - BREESE,27000020,N/A,HC WARMER BAIR HUGGER,270,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 , N/A ,$13.65 ,$12.54 , N/A ,$5.88 ,$13.90 , N/A ,$13.90 , N/A ,$12.52 ,$12.52 , N/A ,$12.52 , N/A ,$16.17 , N/A , N/A , N/A ,$15.75 ,$14.91 ,$14.91 , N/A ,$14.91 ,$17.85 ,$17.85 ,$17.85 , N/A , N/A ,$17.85 , N/A ,$21.00 ,$11.78 , N/A ,$8.69 , N/A , N/A , N/A ,$17.85 , N/A ,$12.52 ,$5.88 ,$18.90 , N/A ,$17.85 ,$17.75 ,$17.75 , N/A ,$13.65 ST. JOSEPH'S HOSPITAL - BREESE,27000021,N/A,HC TRAY ARTHROGRAM,270,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,27000023,N/A,HC TRAY EPIDURAL CONTINUOUS,270,1 ,$71.78 ,$51.68 ,$20.10 ,$71.78 , N/A ,$46.66 ,$42.85 , N/A ,$20.10 ,$47.52 , N/A ,$47.52 , N/A ,$42.78 ,$42.78 , N/A ,$42.78 , N/A ,$55.27 , N/A , N/A , N/A ,$53.84 ,$50.96 ,$50.96 , N/A ,$50.96 ,$61.01 ,$61.01 ,$61.01 , N/A , N/A ,$61.01 , N/A ,$71.78 ,$40.27 , N/A ,$29.72 , N/A , N/A , N/A ,$61.01 , N/A ,$42.78 ,$20.10 ,$64.60 , N/A ,$61.01 ,$60.65 ,$60.65 , N/A ,$46.66 ST. JOSEPH'S HOSPITAL - BREESE,27000055,N/A,HC MASK ANESTHESIA,270,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 , N/A ,$78.00 ,$71.64 , N/A ,$33.60 ,$79.44 , N/A ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A , N/A , N/A ,$90.00 ,$85.20 ,$85.20 , N/A ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A , N/A ,$102.00 , N/A ,$120.00 ,$67.32 , N/A ,$49.68 , N/A , N/A , N/A ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 , N/A ,$102.00 ,$101.40 ,$101.40 , N/A ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,27000073,N/A,HC DETECTOR CARBON DIOXIDE,270,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 , N/A ,$15.60 ,$14.33 , N/A ,$6.72 ,$15.89 , N/A ,$15.89 , N/A ,$14.30 ,$14.30 , N/A ,$14.30 , N/A ,$18.48 , N/A , N/A , N/A ,$18.00 ,$17.04 ,$17.04 , N/A ,$17.04 ,$20.40 ,$20.40 ,$20.40 , N/A , N/A ,$20.40 , N/A ,$24.00 ,$13.46 , N/A ,$9.94 , N/A , N/A , N/A ,$20.40 , N/A ,$14.30 ,$6.72 ,$21.60 , N/A ,$20.40 ,$20.28 ,$20.28 , N/A ,$15.60 ST. JOSEPH'S HOSPITAL - BREESE,27000093,N/A,HC MATTRESS WARMING,270,1 ,$87.00 ,$62.64 ,$24.36 ,$87.00 , N/A ,$56.55 ,$51.94 , N/A ,$24.36 ,$57.59 , N/A ,$57.59 , N/A ,$51.85 ,$51.85 , N/A ,$51.85 , N/A ,$66.99 , N/A , N/A , N/A ,$65.25 ,$61.77 ,$61.77 , N/A ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A , N/A ,$73.95 , N/A ,$87.00 ,$48.81 , N/A ,$36.02 , N/A , N/A , N/A ,$73.95 , N/A ,$51.85 ,$24.36 ,$78.30 , N/A ,$73.95 ,$73.52 ,$73.52 , N/A ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,27000123,N/A,HC CAUTERY BATTERY,270,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 , N/A ,$11.38 ,$10.45 , N/A ,$4.90 ,$11.59 , N/A ,$11.59 , N/A ,$10.43 ,$10.43 , N/A ,$10.43 , N/A ,$13.48 , N/A , N/A , N/A ,$13.13 ,$12.43 ,$12.43 , N/A ,$12.43 ,$14.88 ,$14.88 ,$14.88 , N/A , N/A ,$14.88 , N/A ,$17.50 ,$9.82 , N/A ,$7.25 , N/A , N/A , N/A ,$14.88 , N/A ,$10.43 ,$4.90 ,$15.75 , N/A ,$14.88 ,$14.79 ,$14.79 , N/A ,$11.38 ST. JOSEPH'S HOSPITAL - BREESE,27100021,N/A,HC CAST ARM SYNTHETIC,271,1 ,$26.00 ,$18.72 ,$7.28 ,$26.00 , N/A ,$16.90 ,$15.52 , N/A ,$7.28 ,$17.21 , N/A ,$17.21 , N/A ,$15.50 ,$15.50 , N/A ,$15.50 , N/A ,$20.02 , N/A , N/A , N/A ,$19.50 ,$18.46 ,$18.46 , N/A ,$18.46 ,$22.10 ,$22.10 ,$22.10 , N/A , N/A ,$22.10 , N/A ,$26.00 ,$14.59 , N/A ,$10.76 , N/A , N/A , N/A ,$22.10 , N/A ,$15.50 ,$7.28 ,$23.40 , N/A ,$22.10 ,$21.97 ,$21.97 , N/A ,$16.90 ST. JOSEPH'S HOSPITAL - BREESE,27100024,N/A,HC CAST LEG SYNTHETIC,271,1 ,$95.00 ,$68.40 ,$26.60 ,$95.00 , N/A ,$61.75 ,$56.72 , N/A ,$26.60 ,$62.89 , N/A ,$62.89 , N/A ,$56.62 ,$56.62 , N/A ,$56.62 , N/A ,$73.15 , N/A , N/A , N/A ,$71.25 ,$67.45 ,$67.45 , N/A ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A , N/A ,$80.75 , N/A ,$95.00 ,$53.30 , N/A ,$39.33 , N/A , N/A , N/A ,$80.75 , N/A ,$56.62 ,$26.60 ,$85.50 , N/A ,$80.75 ,$80.28 ,$80.28 , N/A ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,27100038,N/A,HC CPAP MASK,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27100096,N/A,HC NASAL PHANYNGEAL AIRWAY,271,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,27100106,N/A,HC OXYGEN DAILY,271,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27100114,N/A,HC PEAK FLOWMETER,271,1 ,$70.00 ,$50.40 ,$19.60 ,$70.00 , N/A ,$45.50 ,$41.79 , N/A ,$19.60 ,$46.34 , N/A ,$46.34 , N/A ,$41.72 ,$41.72 , N/A ,$41.72 , N/A ,$53.90 , N/A , N/A , N/A ,$52.50 ,$49.70 ,$49.70 , N/A ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A , N/A ,$59.50 , N/A ,$70.00 ,$39.27 , N/A ,$28.98 , N/A , N/A , N/A ,$59.50 , N/A ,$41.72 ,$19.60 ,$63.00 , N/A ,$59.50 ,$59.15 ,$59.15 , N/A ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,27100155,N/A,HC THERABAND PER FOOT,271,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$3.85 , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$4.23 ,$4.23 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,27100167,N/A,HC WARMING BLANKET DISPOSABLE,271,1 ,$59.00 ,$42.48 ,$16.52 ,$59.00 , N/A ,$38.35 ,$35.22 , N/A ,$16.52 ,$39.06 , N/A ,$39.06 , N/A ,$35.16 ,$35.16 , N/A ,$35.16 , N/A ,$45.43 , N/A , N/A , N/A ,$44.25 ,$41.89 ,$41.89 , N/A ,$41.89 ,$50.15 ,$50.15 ,$50.15 , N/A , N/A ,$50.15 , N/A ,$59.00 ,$33.10 , N/A ,$24.43 , N/A , N/A , N/A ,$50.15 , N/A ,$35.16 ,$16.52 ,$53.10 , N/A ,$50.15 ,$49.86 ,$49.86 , N/A ,$38.35 ST. JOSEPH'S HOSPITAL - BREESE,27100187,N/A,HC BAG DRAINAGE,271,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 , N/A ,$13.65 ,$12.54 , N/A ,$5.88 ,$13.90 , N/A ,$13.90 , N/A ,$12.52 ,$12.52 , N/A ,$12.52 , N/A ,$16.17 , N/A , N/A , N/A ,$15.75 ,$14.91 ,$14.91 , N/A ,$14.91 ,$17.85 ,$17.85 ,$17.85 , N/A , N/A ,$17.85 , N/A ,$21.00 ,$11.78 , N/A ,$8.69 , N/A , N/A , N/A ,$17.85 , N/A ,$12.52 ,$5.88 ,$18.90 , N/A ,$17.85 ,$17.75 ,$17.75 , N/A ,$13.65 ST. JOSEPH'S HOSPITAL - BREESE,27100188,N/A,HC SLING ARM,271,1 ,$105.00 ,$75.60 ,$29.40 ,$105.00 , N/A ,$68.25 ,$62.69 , N/A ,$29.40 ,$69.51 , N/A ,$69.51 , N/A ,$62.58 ,$62.58 , N/A ,$62.58 , N/A ,$80.85 , N/A , N/A , N/A ,$78.75 ,$74.55 ,$74.55 , N/A ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A , N/A ,$89.25 , N/A ,$105.00 ,$58.91 , N/A ,$43.47 , N/A , N/A , N/A ,$89.25 , N/A ,$62.58 ,$29.40 ,$94.50 , N/A ,$89.25 ,$88.73 ,$88.73 , N/A ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,27100197,N/A,HC ADHESIVE STOMAHESIVE,271,1 ,$70.00 ,$50.40 ,$19.60 ,$70.00 , N/A ,$45.50 ,$41.79 , N/A ,$19.60 ,$46.34 , N/A ,$46.34 , N/A ,$41.72 ,$41.72 , N/A ,$41.72 , N/A ,$53.90 , N/A , N/A , N/A ,$52.50 ,$49.70 ,$49.70 , N/A ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A , N/A ,$59.50 , N/A ,$70.00 ,$39.27 , N/A ,$28.98 , N/A , N/A , N/A ,$59.50 , N/A ,$41.72 ,$19.60 ,$63.00 , N/A ,$59.50 ,$59.15 ,$59.15 , N/A ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,27100201,N/A,HC CANNULA NASAL OXYGEN,271,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27100204,N/A,HC CIRCUIT BREATHING,271,1 ,$29.00 ,$20.88 ,$8.12 ,$29.00 , N/A ,$18.85 ,$17.31 , N/A ,$8.12 ,$19.20 , N/A ,$19.20 , N/A ,$17.28 ,$17.28 , N/A ,$17.28 , N/A ,$22.33 , N/A , N/A , N/A ,$21.75 ,$20.59 ,$20.59 , N/A ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A , N/A ,$24.65 , N/A ,$29.00 ,$16.27 , N/A ,$12.01 , N/A , N/A , N/A ,$24.65 , N/A ,$17.28 ,$8.12 ,$26.10 , N/A ,$24.65 ,$24.51 ,$24.51 , N/A ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,27100207,N/A,HC DRESSING BANDAGE ELASTIC,271,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27100209,N/A,HC ENEMA BAG,271,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 , N/A ,$14.30 ,$13.13 , N/A ,$6.16 ,$14.56 , N/A ,$14.56 , N/A ,$13.11 ,$13.11 , N/A ,$13.11 , N/A ,$16.94 , N/A , N/A , N/A ,$16.50 ,$15.62 ,$15.62 , N/A ,$15.62 ,$18.70 ,$18.70 ,$18.70 , N/A , N/A ,$18.70 , N/A ,$22.00 ,$12.34 , N/A ,$9.11 , N/A , N/A , N/A ,$18.70 , N/A ,$13.11 ,$6.16 ,$19.80 , N/A ,$18.70 ,$18.59 ,$18.59 , N/A ,$14.30 ST. JOSEPH'S HOSPITAL - BREESE,27100210,N/A,HC KIT CANISTER SUCTION,271,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 , N/A ,$13.65 ,$12.54 , N/A ,$5.88 ,$13.90 , N/A ,$13.90 , N/A ,$12.52 ,$12.52 , N/A ,$12.52 , N/A ,$16.17 , N/A , N/A , N/A ,$15.75 ,$14.91 ,$14.91 , N/A ,$14.91 ,$17.85 ,$17.85 ,$17.85 , N/A , N/A ,$17.85 , N/A ,$21.00 ,$11.78 , N/A ,$8.69 , N/A , N/A , N/A ,$17.85 , N/A ,$12.52 ,$5.88 ,$18.90 , N/A ,$17.85 ,$17.75 ,$17.75 , N/A ,$13.65 ST. JOSEPH'S HOSPITAL - BREESE,27100211,N/A,HC PAD DEFIBRILLATOR,271,1 ,$183.60 ,$132.19 ,$51.41 ,$183.60 , N/A ,$119.34 ,$109.61 , N/A ,$51.41 ,$121.54 , N/A ,$121.54 , N/A ,$109.43 ,$109.43 , N/A ,$109.43 , N/A ,$141.37 , N/A , N/A , N/A ,$137.70 ,$130.36 ,$130.36 , N/A ,$130.36 ,$156.06 ,$156.06 ,$156.06 , N/A , N/A ,$156.06 , N/A ,$183.60 ,$103.00 , N/A ,$76.01 , N/A , N/A , N/A ,$156.06 , N/A ,$109.43 ,$51.41 ,$165.24 , N/A ,$156.06 ,$155.14 ,$155.14 , N/A ,$119.34 ST. JOSEPH'S HOSPITAL - BREESE,27100215,N/A,HC RESTRAINT ANY TYPE,271,1 ,$36.60 ,$26.35 ,$10.25 ,$36.60 , N/A ,$23.79 ,$21.85 , N/A ,$10.25 ,$24.23 , N/A ,$24.23 , N/A ,$21.81 ,$21.81 , N/A ,$21.81 , N/A ,$28.18 , N/A , N/A , N/A ,$27.45 ,$25.99 ,$25.99 , N/A ,$25.99 ,$31.11 ,$31.11 ,$31.11 , N/A , N/A ,$31.11 , N/A ,$36.60 ,$20.53 , N/A ,$15.15 , N/A , N/A , N/A ,$31.11 , N/A ,$21.81 ,$10.25 ,$32.94 , N/A ,$31.11 ,$30.93 ,$30.93 , N/A ,$23.79 ST. JOSEPH'S HOSPITAL - BREESE,27100216,N/A,HC SET FLUID WARMER,271,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 , N/A ,$17.55 ,$16.12 , N/A ,$7.56 ,$17.87 , N/A ,$17.87 , N/A ,$16.09 ,$16.09 , N/A ,$16.09 , N/A ,$20.79 , N/A , N/A , N/A ,$20.25 ,$19.17 ,$19.17 , N/A ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A , N/A ,$22.95 , N/A ,$27.00 ,$15.15 , N/A ,$11.18 , N/A , N/A , N/A ,$22.95 , N/A ,$16.09 ,$7.56 ,$24.30 , N/A ,$22.95 ,$22.82 ,$22.82 , N/A ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,27100228,N/A,HC STOCK ANTIEMBOLISM THIGH,271,1 ,$48.00 ,$34.56 ,$13.44 ,$48.00 , N/A ,$31.20 ,$28.66 , N/A ,$13.44 ,$31.78 , N/A ,$31.78 , N/A ,$28.61 ,$28.61 , N/A ,$28.61 , N/A ,$36.96 , N/A , N/A , N/A ,$36.00 ,$34.08 ,$34.08 , N/A ,$34.08 ,$40.80 ,$40.80 ,$40.80 , N/A , N/A ,$40.80 , N/A ,$48.00 ,$26.93 , N/A ,$19.87 , N/A , N/A , N/A ,$40.80 , N/A ,$28.61 ,$13.44 ,$43.20 , N/A ,$40.80 ,$40.56 ,$40.56 , N/A ,$31.20 ST. JOSEPH'S HOSPITAL - BREESE,27100229,N/A,HC STRAINER URINE,271,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$3.85 , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$4.23 ,$4.23 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,27100240,N/A,HC CAUTERY GROUNDING PAD,271,1 ,$23.00 ,$16.56 ,$6.44 ,$23.00 , N/A ,$14.95 ,$13.73 , N/A ,$6.44 ,$15.23 , N/A ,$15.23 , N/A ,$13.71 ,$13.71 , N/A ,$13.71 , N/A ,$17.71 , N/A , N/A , N/A ,$17.25 ,$16.33 ,$16.33 , N/A ,$16.33 ,$19.55 ,$19.55 ,$19.55 , N/A , N/A ,$19.55 , N/A ,$23.00 ,$12.90 , N/A ,$9.52 , N/A , N/A , N/A ,$19.55 , N/A ,$13.71 ,$6.44 ,$20.70 , N/A ,$19.55 ,$19.44 ,$19.44 , N/A ,$14.95 ST. JOSEPH'S HOSPITAL - BREESE,27100255,N/A,HC ELECTRODE DEFIB FAST PATCH,271,1 ,$71.58 ,$51.54 ,$20.04 ,$71.58 , N/A ,$46.53 ,$42.73 , N/A ,$20.04 ,$47.39 , N/A ,$47.39 , N/A ,$42.66 ,$42.66 , N/A ,$42.66 , N/A ,$55.12 , N/A , N/A , N/A ,$53.69 ,$50.82 ,$50.82 , N/A ,$50.82 ,$60.84 ,$60.84 ,$60.84 , N/A , N/A ,$60.84 , N/A ,$71.58 ,$40.16 , N/A ,$29.63 , N/A , N/A , N/A ,$60.84 , N/A ,$42.66 ,$20.04 ,$64.42 , N/A ,$60.84 ,$60.49 ,$60.49 , N/A ,$46.53 ST. JOSEPH'S HOSPITAL - BREESE,27100256,N/A,HC ELECTRODE FETAL SCALP,271,1 ,$29.00 ,$20.88 ,$8.12 ,$29.00 , N/A ,$18.85 ,$17.31 , N/A ,$8.12 ,$19.20 , N/A ,$19.20 , N/A ,$17.28 ,$17.28 , N/A ,$17.28 , N/A ,$22.33 , N/A , N/A , N/A ,$21.75 ,$20.59 ,$20.59 , N/A ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A , N/A ,$24.65 , N/A ,$29.00 ,$16.27 , N/A ,$12.01 , N/A , N/A , N/A ,$24.65 , N/A ,$17.28 ,$8.12 ,$26.10 , N/A ,$24.65 ,$24.51 ,$24.51 , N/A ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,27100281,N/A,HC PACK HOT/ COLD LARGE,271,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 , N/A ,$16.25 ,$14.93 , N/A ,$7.00 ,$16.55 , N/A ,$16.55 , N/A ,$14.90 ,$14.90 , N/A ,$14.90 , N/A ,$19.25 , N/A , N/A , N/A ,$18.75 ,$17.75 ,$17.75 , N/A ,$17.75 ,$21.25 ,$21.25 ,$21.25 , N/A , N/A ,$21.25 , N/A ,$25.00 ,$14.03 , N/A ,$10.35 , N/A , N/A , N/A ,$21.25 , N/A ,$14.90 ,$7.00 ,$22.50 , N/A ,$21.25 ,$21.13 ,$21.13 , N/A ,$16.25 ST. JOSEPH'S HOSPITAL - BREESE,27100292,E0710,HC RESTRAINTS,271,1 ,$20.13 ,$14.49 ,$5.64 ,$20.13 , N/A ,$13.08 ,$12.02 , N/A ,$5.64 ,$13.33 , N/A ,$13.33 , N/A ,$12.00 ,$12.00 , N/A ,$12.00 , N/A ,$15.50 , N/A , N/A , N/A ,$15.10 ,$14.29 ,$14.29 , N/A ,$14.29 ,$17.11 ,$17.11 ,$17.11 , N/A , N/A ,$17.11 , N/A ,$20.13 ,$11.29 , N/A ,$8.33 , N/A , N/A , N/A ,$17.11 , N/A ,$12.00 ,$5.64 ,$18.12 , N/A ,$17.11 ,$17.01 ,$17.01 , N/A ,$13.08 ST. JOSEPH'S HOSPITAL - BREESE,27100324,N/A,HC DRESSING SELF ADHESIVE ROLL,271,1 ,$13.00 ,$9.36 ,$3.64 ,$13.00 , N/A ,$8.45 ,$7.76 , N/A ,$3.64 ,$8.61 , N/A ,$8.61 , N/A ,$7.75 ,$7.75 , N/A ,$7.75 , N/A ,$10.01 , N/A , N/A , N/A ,$9.75 ,$9.23 ,$9.23 , N/A ,$9.23 ,$11.05 ,$11.05 ,$11.05 , N/A , N/A ,$11.05 , N/A ,$13.00 ,$7.29 , N/A ,$5.38 , N/A , N/A , N/A ,$11.05 , N/A ,$7.75 ,$3.64 ,$11.70 , N/A ,$11.05 ,$10.99 ,$10.99 , N/A ,$8.45 ST. JOSEPH'S HOSPITAL - BREESE,27100325,N/A,HC SPACER MDI,271,1 ,$43.00 ,$30.96 ,$12.04 ,$43.00 , N/A ,$27.95 ,$25.67 , N/A ,$12.04 ,$28.47 , N/A ,$28.47 , N/A ,$25.63 ,$25.63 , N/A ,$25.63 , N/A ,$33.11 , N/A , N/A , N/A ,$32.25 ,$30.53 ,$30.53 , N/A ,$30.53 ,$36.55 ,$36.55 ,$36.55 , N/A , N/A ,$36.55 , N/A ,$43.00 ,$24.12 , N/A ,$17.80 , N/A , N/A , N/A ,$36.55 , N/A ,$25.63 ,$12.04 ,$38.70 , N/A ,$36.55 ,$36.34 ,$36.34 , N/A ,$27.95 ST. JOSEPH'S HOSPITAL - BREESE,27100338,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T1,271,1 ,$8.75 ,$6.30 ,$2.45 ,$8.75 , N/A ,$5.69 ,$5.22 , N/A ,$2.45 ,$5.79 , N/A ,$5.79 , N/A ,$5.22 ,$5.22 , N/A ,$5.22 , N/A ,$6.74 , N/A , N/A , N/A ,$6.56 ,$6.21 ,$6.21 , N/A ,$6.21 ,$7.44 ,$7.44 ,$7.44 , N/A , N/A ,$7.44 , N/A ,$8.75 ,$4.91 , N/A ,$3.62 , N/A , N/A , N/A ,$7.44 , N/A ,$5.22 ,$2.45 ,$7.88 , N/A ,$7.44 ,$7.39 ,$7.39 , N/A ,$5.69 ST. JOSEPH'S HOSPITAL - BREESE,27100339,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T2,271,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 , N/A ,$11.38 ,$10.45 , N/A ,$4.90 ,$11.59 , N/A ,$11.59 , N/A ,$10.43 ,$10.43 , N/A ,$10.43 , N/A ,$13.48 , N/A , N/A , N/A ,$13.13 ,$12.43 ,$12.43 , N/A ,$12.43 ,$14.88 ,$14.88 ,$14.88 , N/A , N/A ,$14.88 , N/A ,$17.50 ,$9.82 , N/A ,$7.25 , N/A , N/A , N/A ,$14.88 , N/A ,$10.43 ,$4.90 ,$15.75 , N/A ,$14.88 ,$14.79 ,$14.79 , N/A ,$11.38 ST. JOSEPH'S HOSPITAL - BREESE,27100340,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T3,271,1 ,$26.25 ,$18.90 ,$7.35 ,$26.25 , N/A ,$17.06 ,$15.67 , N/A ,$7.35 ,$17.38 , N/A ,$17.38 , N/A ,$15.65 ,$15.65 , N/A ,$15.65 , N/A ,$20.21 , N/A , N/A , N/A ,$19.69 ,$18.64 ,$18.64 , N/A ,$18.64 ,$22.31 ,$22.31 ,$22.31 , N/A , N/A ,$22.31 , N/A ,$26.25 ,$14.73 , N/A ,$10.87 , N/A , N/A , N/A ,$22.31 , N/A ,$15.65 ,$7.35 ,$23.63 , N/A ,$22.31 ,$22.18 ,$22.18 , N/A ,$17.06 ST. JOSEPH'S HOSPITAL - BREESE,27100341,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T4,271,1 ,$35.00 ,$25.20 ,$9.80 ,$35.00 , N/A ,$22.75 ,$20.90 , N/A ,$9.80 ,$23.17 , N/A ,$23.17 , N/A ,$20.86 ,$20.86 , N/A ,$20.86 , N/A ,$26.95 , N/A , N/A , N/A ,$26.25 ,$24.85 ,$24.85 , N/A ,$24.85 ,$29.75 ,$29.75 ,$29.75 , N/A , N/A ,$29.75 , N/A ,$35.00 ,$19.64 , N/A ,$14.49 , N/A , N/A , N/A ,$29.75 , N/A ,$20.86 ,$9.80 ,$31.50 , N/A ,$29.75 ,$29.58 ,$29.58 , N/A ,$22.75 ST. JOSEPH'S HOSPITAL - BREESE,27100342,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T5,271,1 ,$70.00 ,$50.40 ,$19.60 ,$70.00 , N/A ,$45.50 ,$41.79 , N/A ,$19.60 ,$46.34 , N/A ,$46.34 , N/A ,$41.72 ,$41.72 , N/A ,$41.72 , N/A ,$53.90 , N/A , N/A , N/A ,$52.50 ,$49.70 ,$49.70 , N/A ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A , N/A ,$59.50 , N/A ,$70.00 ,$39.27 , N/A ,$28.98 , N/A , N/A , N/A ,$59.50 , N/A ,$41.72 ,$19.60 ,$63.00 , N/A ,$59.50 ,$59.15 ,$59.15 , N/A ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,27100343,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T6,271,1 ,$105.00 ,$75.60 ,$29.40 ,$105.00 , N/A ,$68.25 ,$62.69 , N/A ,$29.40 ,$69.51 , N/A ,$69.51 , N/A ,$62.58 ,$62.58 , N/A ,$62.58 , N/A ,$80.85 , N/A , N/A , N/A ,$78.75 ,$74.55 ,$74.55 , N/A ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A , N/A ,$89.25 , N/A ,$105.00 ,$58.91 , N/A ,$43.47 , N/A , N/A , N/A ,$89.25 , N/A ,$62.58 ,$29.40 ,$94.50 , N/A ,$89.25 ,$88.73 ,$88.73 , N/A ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,27100344,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T7,271,1 ,$140.00 ,$100.80 ,$39.20 ,$140.00 , N/A ,$91.00 ,$83.58 , N/A ,$39.20 ,$92.68 , N/A ,$92.68 , N/A ,$83.44 ,$83.44 , N/A ,$83.44 , N/A ,$107.80 , N/A , N/A , N/A ,$105.00 ,$99.40 ,$99.40 , N/A ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A , N/A ,$119.00 , N/A ,$140.00 ,$78.54 , N/A ,$57.96 , N/A , N/A , N/A ,$119.00 , N/A ,$83.44 ,$39.20 ,$126.00 , N/A ,$119.00 ,$118.30 ,$118.30 , N/A ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,27100345,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T8,271,1 ,$175.00 ,$126.00 ,$49.00 ,$175.00 , N/A ,$113.75 ,$104.48 , N/A ,$49.00 ,$115.85 , N/A ,$115.85 , N/A ,$104.30 ,$104.30 , N/A ,$104.30 , N/A ,$134.75 , N/A , N/A , N/A ,$131.25 ,$124.25 ,$124.25 , N/A ,$124.25 ,$148.75 ,$148.75 ,$148.75 , N/A , N/A ,$148.75 , N/A ,$175.00 ,$98.18 , N/A ,$72.45 , N/A , N/A , N/A ,$148.75 , N/A ,$104.30 ,$49.00 ,$157.50 , N/A ,$148.75 ,$147.88 ,$147.88 , N/A ,$113.75 ST. JOSEPH'S HOSPITAL - BREESE,27100346,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T9,271,1 ,$210.00 ,$151.20 ,$58.80 ,$210.00 , N/A ,$136.50 ,$125.37 , N/A ,$58.80 ,$139.02 , N/A ,$139.02 , N/A ,$125.16 ,$125.16 , N/A ,$125.16 , N/A ,$161.70 , N/A , N/A , N/A ,$157.50 ,$149.10 ,$149.10 , N/A ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A , N/A ,$178.50 , N/A ,$210.00 ,$117.81 , N/A ,$86.94 , N/A , N/A , N/A ,$178.50 , N/A ,$125.16 ,$58.80 ,$189.00 , N/A ,$178.50 ,$177.45 ,$177.45 , N/A ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,27100347,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T10,271,1 ,$245.00 ,$176.40 ,$68.60 ,$245.00 , N/A ,$159.25 ,$146.27 , N/A ,$68.60 ,$162.19 , N/A ,$162.19 , N/A ,$146.02 ,$146.02 , N/A ,$146.02 , N/A ,$188.65 , N/A , N/A , N/A ,$183.75 ,$173.95 ,$173.95 , N/A ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A , N/A ,$208.25 , N/A ,$245.00 ,$137.45 , N/A ,$101.43 , N/A , N/A , N/A ,$208.25 , N/A ,$146.02 ,$68.60 ,$220.50 , N/A ,$208.25 ,$207.03 ,$207.03 , N/A ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,27100348,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T11,271,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 , N/A , N/A , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,27100349,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T12,271,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$130.41 , N/A , N/A , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 ,$266.18 ,$266.18 , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,27100350,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T13,271,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,27100351,V5050,HC HEARING AID MONAURAL IN EAR T1,271,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 , N/A , N/A , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,27100352,V5050,HC HEARING AID MONAURAL IN EAR T2,271,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$130.41 , N/A , N/A , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 ,$266.18 ,$266.18 , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,27100353,V5050,HC HEARING AID MONAURAL IN EAR T3,271,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,27100354,V5050,HC HEARING AID MONAURAL IN EAR T4,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100355,V5050,HC HEARING AID MONAURAL IN EAR T5,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100356,V5050,HC HEARING AID MONAURAL IN EAR T6,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100357,V5050,HC HEARING AID MONAURAL IN EAR T7,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100358,V5050,HC HEARING AID MONAURAL IN EAR T8,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100359,V5050,HC HEARING AID MONAURAL IN EAR T9,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100360,V5050,HC HEARING AID MONAURAL IN EAR T10,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100361,V5050,HC HEARING AID MONAURAL IN EAR T11,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100362,V5050,HC HEARING AID MONAURAL IN EAR T12,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100363,V5050,HC HEARING AID MONAURAL IN EAR T13,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100364,V5050,HC HEARING AID MONAURAL IN EAR T14,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100365,V5050,HC HEARING AID MONAURAL IN EAR T15,271,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100366,V5050,HC HEARING AID MONAURAL IN EAR T16,271,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100367,V5060,HC HEARING AID MONAURAL BEHIND EAR T1,271,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 , N/A , N/A , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,27100368,V5060,HC HEARING AID MONAURAL BEHIND EAR T2,271,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$130.41 , N/A , N/A , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 ,$266.18 ,$266.18 , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,27100369,V5060,HC HEARING AID MONAURAL BEHIND EAR T3,271,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,27100370,V5060,HC HEARING AID MONAURAL BEHIND EAR T4,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100371,V5060,HC HEARING AID MONAURAL BEHIND EAR T5,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100372,V5060,HC HEARING AID MONAURAL BEHIND EAR T6,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100373,V5060,HC HEARING AID MONAURAL BEHIND EAR T7,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100374,V5060,HC HEARING AID MONAURAL BEHIND EAR T8,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100375,V5060,HC HEARING AID MONAURAL BEHIND EAR T9,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100376,V5060,HC HEARING AID MONAURAL BEHIND EAR T10,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100377,V5060,HC HEARING AID MONAURAL BEHIND EAR T11,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100378,V5060,HC HEARING AID MONAURAL BEHIND EAR T12,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100379,V5060,HC HEARING AID MONAURAL BEHIND EAR T13,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100380,V5060,HC HEARING AID MONAURAL BEHIND EAR T14,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100381,V5060,HC HEARING AID MONAURAL BEHIND EAR T15,271,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100382,V5060,HC HEARING AID MONAURAL BEHIND EAR T16,271,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100383,V5130,HC HEARING AID BINAURAL IN EAR T1,470,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100384,V5130,HC HEARING AID BINAURAL IN EAR T2,470,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100385,V5130,HC HEARING AID BINAURAL IN EAR T3,470,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100386,V5130,HC HEARING AID BINAURAL IN EAR T4,470,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100387,V5130,HC HEARING AID BINAURAL IN EAR T5,470,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100388,V5130,HC HEARING AID BINAURAL IN EAR T6,470,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100389,V5130,HC HEARING AID BINAURAL IN EAR T7,470,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100390,V5130,HC HEARING AID BINAURAL IN EAR T8,470,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100391,V5130,HC HEARING AID BINAURAL IN EAR T9,470,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100392,V5130,HC HEARING AID BINAURAL IN EAR T10,470,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100393,V5130,HC HEARING AID BINAURAL IN EAR T11,470,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100394,V5130,HC HEARING AID BINAURAL IN EAR T12,470,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100395,V5130,HC HEARING AID BINAURAL IN EAR T13,470,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100396,V5130,HC HEARING AID BINAURAL IN EAR T14,470,1 ,"$4,900.00 ","$3,528.00 ","$1,372.00 ","$4,900.00 ", N/A ,"$3,185.00 ","$2,925.30 ", N/A ,"$1,372.00 ","$3,243.80 ", N/A ,"$3,243.80 ", N/A ,"$2,920.40 ","$2,920.40 ", N/A ,"$2,920.40 ", N/A ,"$3,773.00 ", N/A , N/A , N/A ,"$3,675.00 ","$3,479.00 ","$3,479.00 ", N/A ,"$3,479.00 ","$4,165.00 ","$4,165.00 ","$4,165.00 ", N/A , N/A ,"$4,165.00 ", N/A ,"$4,900.00 ","$2,748.90 ", N/A ,"$2,028.60 ", N/A , N/A , N/A ,"$4,165.00 ", N/A ,"$2,920.40 ","$1,372.00 ","$4,410.00 ", N/A ,"$4,165.00 ","$4,140.50 ","$4,140.50 ", N/A ,"$3,185.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100397,V5130,HC HEARING AID BINAURAL IN EAR T15,470,1 ,"$5,425.00 ","$3,906.00 ","$1,519.00 ","$5,425.00 ", N/A ,"$3,526.25 ","$3,238.73 ", N/A ,"$1,519.00 ","$3,591.35 ", N/A ,"$3,591.35 ", N/A ,"$3,233.30 ","$3,233.30 ", N/A ,"$3,233.30 ", N/A ,"$4,177.25 ", N/A , N/A , N/A ,"$4,068.75 ","$3,851.75 ","$3,851.75 ", N/A ,"$3,851.75 ","$4,611.25 ","$4,611.25 ","$4,611.25 ", N/A , N/A ,"$4,611.25 ", N/A ,"$5,425.00 ","$3,043.43 ", N/A ,"$2,245.95 ", N/A , N/A , N/A ,"$4,611.25 ", N/A ,"$3,233.30 ","$1,519.00 ","$4,882.50 ", N/A ,"$4,611.25 ","$4,584.13 ","$4,584.13 ", N/A ,"$3,526.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100398,V5130,HC HEARING AID BINAURAL IN EAR T16,470,1 ,"$5,950.00 ","$4,284.00 ","$1,666.00 ","$5,950.00 ", N/A ,"$3,867.50 ","$3,552.15 ", N/A ,"$1,666.00 ","$3,938.90 ", N/A ,"$3,938.90 ", N/A ,"$3,546.20 ","$3,546.20 ", N/A ,"$3,546.20 ", N/A ,"$4,581.50 ", N/A , N/A , N/A ,"$4,462.50 ","$4,224.50 ","$4,224.50 ", N/A ,"$4,224.50 ","$5,057.50 ","$5,057.50 ","$5,057.50 ", N/A , N/A ,"$5,057.50 ", N/A ,"$5,950.00 ","$3,337.95 ", N/A ,"$2,463.30 ", N/A , N/A , N/A ,"$5,057.50 ", N/A ,"$3,546.20 ","$1,666.00 ","$5,355.00 ", N/A ,"$5,057.50 ","$5,027.75 ","$5,027.75 ", N/A ,"$3,867.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100399,V5140,HC HEARING AID BINAURAL BEHIND EAR T1,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100400,V5140,HC HEARING AID BINAURAL BEHIND EAR T2,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100401,V5140,HC HEARING AID BINAURAL BEHIND EAR T3,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100402,V5140,HC HEARING AID BINAURAL BEHIND EAR T4,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100403,V5140,HC HEARING AID BINAURAL BEHIND EAR T5,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100404,V5140,HC HEARING AID BINAURAL BEHIND EAR T6,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100405,V5140,HC HEARING AID BINAURAL BEHIND EAR T7,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100406,V5140,HC HEARING AID BINAURAL BEHIND EAR T8,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100407,V5140,HC HEARING AID BINAURAL BEHIND EAR T9,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100408,V5140,HC HEARING AID BINAURAL BEHIND EAR T10,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100409,V5140,HC HEARING AID BINAURAL BEHIND EAR T11,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100410,V5140,HC HEARING AID BINAURAL BEHIND EAR T12,271,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100411,V5140,HC HEARING AID BINAURAL BEHIND EAR T13,271,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100412,V5140,HC HEARING AID BINAURAL BEHIND EAR T14,271,1 ,"$4,900.00 ","$3,528.00 ","$1,372.00 ","$4,900.00 ", N/A ,"$3,185.00 ","$2,925.30 ", N/A ,"$1,372.00 ","$3,243.80 ", N/A ,"$3,243.80 ", N/A ,"$2,920.40 ","$2,920.40 ", N/A ,"$2,920.40 ", N/A ,"$3,773.00 ", N/A , N/A , N/A ,"$3,675.00 ","$3,479.00 ","$3,479.00 ", N/A ,"$3,479.00 ","$4,165.00 ","$4,165.00 ","$4,165.00 ", N/A , N/A ,"$4,165.00 ", N/A ,"$4,900.00 ","$2,748.90 ", N/A ,"$2,028.60 ", N/A , N/A , N/A ,"$4,165.00 ", N/A ,"$2,920.40 ","$1,372.00 ","$4,410.00 ", N/A ,"$4,165.00 ","$4,140.50 ","$4,140.50 ", N/A ,"$3,185.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100413,V5140,HC HEARING AID BINAURAL BEHIND EAR T15,271,1 ,"$5,425.00 ","$3,906.00 ","$1,519.00 ","$5,425.00 ", N/A ,"$3,526.25 ","$3,238.73 ", N/A ,"$1,519.00 ","$3,591.35 ", N/A ,"$3,591.35 ", N/A ,"$3,233.30 ","$3,233.30 ", N/A ,"$3,233.30 ", N/A ,"$4,177.25 ", N/A , N/A , N/A ,"$4,068.75 ","$3,851.75 ","$3,851.75 ", N/A ,"$3,851.75 ","$4,611.25 ","$4,611.25 ","$4,611.25 ", N/A , N/A ,"$4,611.25 ", N/A ,"$5,425.00 ","$3,043.43 ", N/A ,"$2,245.95 ", N/A , N/A , N/A ,"$4,611.25 ", N/A ,"$3,233.30 ","$1,519.00 ","$4,882.50 ", N/A ,"$4,611.25 ","$4,584.13 ","$4,584.13 ", N/A ,"$3,526.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100414,V5140,HC HEARING AID BINAURAL BEHIND EAR T16,271,1 ,"$5,950.00 ","$4,284.00 ","$1,666.00 ","$5,950.00 ", N/A ,"$3,867.50 ","$3,552.15 ", N/A ,"$1,666.00 ","$3,938.90 ", N/A ,"$3,938.90 ", N/A ,"$3,546.20 ","$3,546.20 ", N/A ,"$3,546.20 ", N/A ,"$4,581.50 ", N/A , N/A , N/A ,"$4,462.50 ","$4,224.50 ","$4,224.50 ", N/A ,"$4,224.50 ","$5,057.50 ","$5,057.50 ","$5,057.50 ", N/A , N/A ,"$5,057.50 ", N/A ,"$5,950.00 ","$3,337.95 ", N/A ,"$2,463.30 ", N/A , N/A , N/A ,"$5,057.50 ", N/A ,"$3,546.20 ","$1,666.00 ","$5,355.00 ", N/A ,"$5,057.50 ","$5,027.75 ","$5,027.75 ", N/A ,"$3,867.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100415,V5171,HC HEARING AID CROS MONAURAL IN EAR T1,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100416,V5171,HC HEARING AID CROS MONAURAL IN EAR T2,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100417,V5171,HC HEARING AID CROS MONAURAL IN EAR T3,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100418,V5171,HC HEARING AID CROS MONAURAL IN EAR T4,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100419,V5171,HC HEARING AID CROS MONAURAL IN EAR T5,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100420,V5171,HC HEARING AID CROS MONAURAL IN EAR T6,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100421,V5171,HC HEARING AID CROS MONAURAL IN EAR T7,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100422,V5171,HC HEARING AID CROS MONAURAL IN EAR T8,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100423,V5171,HC HEARING AID CROS MONAURAL IN EAR T9,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100424,V5171,HC HEARING AID CROS MONAURAL IN EAR T10,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100425,V5171,HC HEARING AID CROS MONAURAL IN EAR T11,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100431,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T1,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100432,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T2,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100433,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T3,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100434,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T4,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100435,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T5,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100436,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T6,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100437,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T7,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100438,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T8,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100439,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T9,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100440,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T10,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100441,V5181,HC HEARING AID CROS MONAURAL BEHIND EAR T11,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100447,V5160,HC HEARING AID DISPENSING FEE BINAURAL,470,1 ,$495.00 ,$356.40 ,$138.60 ,$495.00 , N/A ,$321.75 ,$295.52 , N/A ,$138.60 ,$327.69 , N/A ,$327.69 , N/A ,$295.02 ,$295.02 , N/A ,$295.02 , N/A ,$381.15 , N/A , N/A , N/A ,$371.25 ,$351.45 ,$351.45 , N/A ,$351.45 ,$420.75 ,$420.75 ,$420.75 , N/A , N/A ,$420.75 , N/A ,$495.00 ,$277.70 , N/A ,$204.93 , N/A , N/A , N/A ,$420.75 , N/A ,$295.02 ,$138.60 ,$445.50 , N/A ,$420.75 ,$418.28 ,$418.28 , N/A ,$321.75 ST. JOSEPH'S HOSPITAL - BREESE,27100448,V5200,HC HEARING AID DISPENSING FEE CROS,271,1 ,$495.00 ,$356.40 ,$138.60 ,$495.00 , N/A ,$321.75 ,$295.52 , N/A ,$138.60 ,$327.69 , N/A ,$327.69 , N/A ,$295.02 ,$295.02 , N/A ,$295.02 , N/A ,$381.15 , N/A , N/A , N/A ,$371.25 ,$351.45 ,$351.45 , N/A ,$351.45 ,$420.75 ,$420.75 ,$420.75 , N/A , N/A ,$420.75 , N/A ,$495.00 ,$277.70 , N/A ,$204.93 , N/A , N/A , N/A ,$420.75 , N/A ,$295.02 ,$138.60 ,$445.50 , N/A ,$420.75 ,$418.28 ,$418.28 , N/A ,$321.75 ST. JOSEPH'S HOSPITAL - BREESE,27100449,V5240,HC HEARING AID DISPENSING FEE BICROS,271,1 ,$498.00 ,$358.56 ,$139.44 ,$498.00 , N/A ,$323.70 ,$297.31 , N/A ,$139.44 ,$329.68 , N/A ,$329.68 , N/A ,$296.81 ,$296.81 , N/A ,$296.81 , N/A ,$383.46 , N/A , N/A , N/A ,$373.50 ,$353.58 ,$353.58 , N/A ,$353.58 ,$423.30 ,$423.30 ,$423.30 , N/A , N/A ,$423.30 , N/A ,$498.00 ,$279.38 , N/A ,$206.17 , N/A , N/A , N/A ,$423.30 , N/A ,$296.81 ,$139.44 ,$448.20 , N/A ,$423.30 ,$420.81 ,$420.81 , N/A ,$323.70 ST. JOSEPH'S HOSPITAL - BREESE,27100450,V5241,HC HEARING AID DISPENSING FEE MONAURAL,271,1 ,$345.00 ,$248.40 ,$96.60 ,$345.00 , N/A ,$224.25 ,$205.97 , N/A ,$96.60 ,$228.39 , N/A ,$228.39 , N/A ,$205.62 ,$205.62 , N/A ,$205.62 , N/A ,$265.65 , N/A , N/A , N/A ,$258.75 ,$244.95 ,$244.95 , N/A ,$244.95 ,$293.25 ,$293.25 ,$293.25 , N/A , N/A ,$293.25 , N/A ,$345.00 ,$193.55 , N/A ,$142.83 , N/A , N/A , N/A ,$293.25 , N/A ,$205.62 ,$96.60 ,$310.50 , N/A ,$293.25 ,$291.53 ,$291.53 , N/A ,$224.25 ST. JOSEPH'S HOSPITAL - BREESE,27100451,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T1,271,1 ,$26.25 ,$18.90 ,$7.35 ,$26.25 , N/A ,$17.06 ,$15.67 , N/A ,$7.35 ,$17.38 , N/A ,$17.38 , N/A ,$15.65 ,$15.65 , N/A ,$15.65 , N/A ,$20.21 , N/A , N/A , N/A ,$19.69 ,$18.64 ,$18.64 , N/A ,$18.64 ,$22.31 ,$22.31 ,$22.31 , N/A , N/A ,$22.31 , N/A ,$26.25 ,$14.73 , N/A ,$10.87 , N/A , N/A , N/A ,$22.31 , N/A ,$15.65 ,$7.35 ,$23.63 , N/A ,$22.31 ,$22.18 ,$22.18 , N/A ,$17.06 ST. JOSEPH'S HOSPITAL - BREESE,27100452,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T2,271,1 ,$35.00 ,$25.20 ,$9.80 ,$35.00 , N/A ,$22.75 ,$20.90 , N/A ,$9.80 ,$23.17 , N/A ,$23.17 , N/A ,$20.86 ,$20.86 , N/A ,$20.86 , N/A ,$26.95 , N/A , N/A , N/A ,$26.25 ,$24.85 ,$24.85 , N/A ,$24.85 ,$29.75 ,$29.75 ,$29.75 , N/A , N/A ,$29.75 , N/A ,$35.00 ,$19.64 , N/A ,$14.49 , N/A , N/A , N/A ,$29.75 , N/A ,$20.86 ,$9.80 ,$31.50 , N/A ,$29.75 ,$29.58 ,$29.58 , N/A ,$22.75 ST. JOSEPH'S HOSPITAL - BREESE,27100453,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T3,271,1 ,$70.00 ,$50.40 ,$19.60 ,$70.00 , N/A ,$45.50 ,$41.79 , N/A ,$19.60 ,$46.34 , N/A ,$46.34 , N/A ,$41.72 ,$41.72 , N/A ,$41.72 , N/A ,$53.90 , N/A , N/A , N/A ,$52.50 ,$49.70 ,$49.70 , N/A ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A , N/A ,$59.50 , N/A ,$70.00 ,$39.27 , N/A ,$28.98 , N/A , N/A , N/A ,$59.50 , N/A ,$41.72 ,$19.60 ,$63.00 , N/A ,$59.50 ,$59.15 ,$59.15 , N/A ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,27100454,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T4,271,1 ,$105.00 ,$75.60 ,$29.40 ,$105.00 , N/A ,$68.25 ,$62.69 , N/A ,$29.40 ,$69.51 , N/A ,$69.51 , N/A ,$62.58 ,$62.58 , N/A ,$62.58 , N/A ,$80.85 , N/A , N/A , N/A ,$78.75 ,$74.55 ,$74.55 , N/A ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A , N/A ,$89.25 , N/A ,$105.00 ,$58.91 , N/A ,$43.47 , N/A , N/A , N/A ,$89.25 , N/A ,$62.58 ,$29.40 ,$94.50 , N/A ,$89.25 ,$88.73 ,$88.73 , N/A ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,27100455,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T5,271,1 ,$140.00 ,$100.80 ,$39.20 ,$140.00 , N/A ,$91.00 ,$83.58 , N/A ,$39.20 ,$92.68 , N/A ,$92.68 , N/A ,$83.44 ,$83.44 , N/A ,$83.44 , N/A ,$107.80 , N/A , N/A , N/A ,$105.00 ,$99.40 ,$99.40 , N/A ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A , N/A ,$119.00 , N/A ,$140.00 ,$78.54 , N/A ,$57.96 , N/A , N/A , N/A ,$119.00 , N/A ,$83.44 ,$39.20 ,$126.00 , N/A ,$119.00 ,$118.30 ,$118.30 , N/A ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,27100456,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T6,271,1 ,$175.00 ,$126.00 ,$49.00 ,$175.00 , N/A ,$113.75 ,$104.48 , N/A ,$49.00 ,$115.85 , N/A ,$115.85 , N/A ,$104.30 ,$104.30 , N/A ,$104.30 , N/A ,$134.75 , N/A , N/A , N/A ,$131.25 ,$124.25 ,$124.25 , N/A ,$124.25 ,$148.75 ,$148.75 ,$148.75 , N/A , N/A ,$148.75 , N/A ,$175.00 ,$98.18 , N/A ,$72.45 , N/A , N/A , N/A ,$148.75 , N/A ,$104.30 ,$49.00 ,$157.50 , N/A ,$148.75 ,$147.88 ,$147.88 , N/A ,$113.75 ST. JOSEPH'S HOSPITAL - BREESE,27100457,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T7,271,1 ,$210.00 ,$151.20 ,$58.80 ,$210.00 , N/A ,$136.50 ,$125.37 , N/A ,$58.80 ,$139.02 , N/A ,$139.02 , N/A ,$125.16 ,$125.16 , N/A ,$125.16 , N/A ,$161.70 , N/A , N/A , N/A ,$157.50 ,$149.10 ,$149.10 , N/A ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A , N/A ,$178.50 , N/A ,$210.00 ,$117.81 , N/A ,$86.94 , N/A , N/A , N/A ,$178.50 , N/A ,$125.16 ,$58.80 ,$189.00 , N/A ,$178.50 ,$177.45 ,$177.45 , N/A ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,27100461,V5266,HC HEARING AID BATTERY,271,1 ,$0.60 ,$0.43 ,$0.17 ,$0.60 , N/A ,$0.39 ,$0.36 , N/A ,$0.17 ,$0.40 , N/A ,$0.40 , N/A ,$0.36 ,$0.36 , N/A ,$0.36 , N/A ,$0.46 , N/A , N/A , N/A ,$0.45 ,$0.43 ,$0.43 , N/A ,$0.43 ,$0.51 ,$0.51 ,$0.51 , N/A , N/A ,$0.51 , N/A ,$0.60 ,$0.34 , N/A ,$0.25 , N/A , N/A , N/A ,$0.51 , N/A ,$0.36 ,$0.17 ,$0.54 , N/A ,$0.51 ,$0.51 ,$0.51 , N/A ,$0.39 ST. JOSEPH'S HOSPITAL - BREESE,27100462,V5266,HC HEARING AID BATTERY RECHARGEABLE,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27100463,V5275,HC EAR MOLD IMPRESSION,271,1 ,$40.00 ,$28.80 ,$11.20 ,$40.00 , N/A ,$26.00 ,$23.88 , N/A ,$11.20 ,$26.48 , N/A ,$26.48 , N/A ,$23.84 ,$23.84 , N/A ,$23.84 , N/A ,$30.80 , N/A , N/A , N/A ,$30.00 ,$28.40 ,$28.40 , N/A ,$28.40 ,$34.00 ,$34.00 ,$34.00 , N/A , N/A ,$34.00 , N/A ,$40.00 ,$22.44 , N/A ,$16.56 , N/A , N/A , N/A ,$34.00 , N/A ,$23.84 ,$11.20 ,$36.00 , N/A ,$34.00 ,$33.80 ,$33.80 , N/A ,$26.00 ST. JOSEPH'S HOSPITAL - BREESE,27100469,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T14,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100470,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T15,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100471,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T16,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100472,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T17,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100473,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T18,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100474,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T19,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100475,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T20,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100476,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T21,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100477,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T22,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100478,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T23,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100479,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T24,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100480,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T25,271,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100481,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T26,271,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100484,N/A,HC ROLL CAST FIBERGLASS,271,1 ,$43.00 ,$30.96 ,$12.04 ,$43.00 , N/A ,$27.95 ,$25.67 , N/A ,$12.04 ,$28.47 , N/A ,$28.47 , N/A ,$25.63 ,$25.63 , N/A ,$25.63 , N/A ,$33.11 , N/A , N/A , N/A ,$32.25 ,$30.53 ,$30.53 , N/A ,$30.53 ,$36.55 ,$36.55 ,$36.55 , N/A , N/A ,$36.55 , N/A ,$43.00 ,$24.12 , N/A ,$17.80 , N/A , N/A , N/A ,$36.55 , N/A ,$25.63 ,$12.04 ,$38.70 , N/A ,$36.55 ,$36.34 ,$36.34 , N/A ,$27.95 ST. JOSEPH'S HOSPITAL - BREESE,27100488,N/A,HC PAD HEATING,271,1 ,$17.00 ,$12.24 ,$4.76 ,$17.00 , N/A ,$11.05 ,$10.15 , N/A ,$4.76 ,$11.25 , N/A ,$11.25 , N/A ,$10.13 ,$10.13 , N/A ,$10.13 , N/A ,$13.09 , N/A , N/A , N/A ,$12.75 ,$12.07 ,$12.07 , N/A ,$12.07 ,$14.45 ,$14.45 ,$14.45 , N/A , N/A ,$14.45 , N/A ,$17.00 ,$9.54 , N/A ,$7.04 , N/A , N/A , N/A ,$14.45 , N/A ,$10.13 ,$4.76 ,$15.30 , N/A ,$14.45 ,$14.37 ,$14.37 , N/A ,$11.05 ST. JOSEPH'S HOSPITAL - BREESE,27100497,N/A,HC STRAP CATHETER,271,1 ,$13.00 ,$9.36 ,$3.64 ,$13.00 , N/A ,$8.45 ,$7.76 , N/A ,$3.64 ,$8.61 , N/A ,$8.61 , N/A ,$7.75 ,$7.75 , N/A ,$7.75 , N/A ,$10.01 , N/A , N/A , N/A ,$9.75 ,$9.23 ,$9.23 , N/A ,$9.23 ,$11.05 ,$11.05 ,$11.05 , N/A , N/A ,$11.05 , N/A ,$13.00 ,$7.29 , N/A ,$5.38 , N/A , N/A , N/A ,$11.05 , N/A ,$7.75 ,$3.64 ,$11.70 , N/A ,$11.05 ,$10.99 ,$10.99 , N/A ,$8.45 ST. JOSEPH'S HOSPITAL - BREESE,27100499,V5172,HC HEARING AID CROS MONAURAL IN CANAL T1,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100500,V5172,HC HEARING AID CROS MONAURAL IN CANAL T2,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100501,V5172,HC HEARING AID CROS MONAURAL IN CANAL T3,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100502,V5172,HC HEARING AID CROS MONAURAL IN CANAL T4,271,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27100503,V5172,HC HEARING AID CROS MONAURAL IN CANAL T5,271,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,27100504,V5172,HC HEARING AID CROS MONAURAL IN CANAL T6,271,1 ,"$1,400.00 ","$1,008.00 ",$392.00 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 , N/A , N/A , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,27100505,V5172,HC HEARING AID CROS MONAURAL IN CANAL T7,271,1 ,"$1,575.00 ","$1,134.00 ",$441.00 ,"$1,575.00 ", N/A ,"$1,023.75 ",$940.28 , N/A ,$441.00 ,"$1,042.65 ", N/A ,"$1,042.65 ", N/A ,$938.70 ,$938.70 , N/A ,$938.70 , N/A ,"$1,212.75 ", N/A , N/A , N/A ,"$1,181.25 ","$1,118.25 ","$1,118.25 ", N/A ,"$1,118.25 ","$1,338.75 ","$1,338.75 ","$1,338.75 ", N/A , N/A ,"$1,338.75 ", N/A ,"$1,575.00 ",$883.58 , N/A ,$652.05 , N/A , N/A , N/A ,"$1,338.75 ", N/A ,$938.70 ,$441.00 ,"$1,417.50 ", N/A ,"$1,338.75 ","$1,330.88 ","$1,330.88 ", N/A ,"$1,023.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100506,V5172,HC HEARING AID CROS MONAURAL IN CANAL T8,271,1 ,"$1,750.00 ","$1,260.00 ",$490.00 ,"$1,750.00 ", N/A ,"$1,137.50 ","$1,044.75 ", N/A ,$490.00 ,"$1,158.50 ", N/A ,"$1,158.50 ", N/A ,"$1,043.00 ","$1,043.00 ", N/A ,"$1,043.00 ", N/A ,"$1,347.50 ", N/A , N/A , N/A ,"$1,312.50 ","$1,242.50 ","$1,242.50 ", N/A ,"$1,242.50 ","$1,487.50 ","$1,487.50 ","$1,487.50 ", N/A , N/A ,"$1,487.50 ", N/A ,"$1,750.00 ",$981.75 , N/A ,$724.50 , N/A , N/A , N/A ,"$1,487.50 ", N/A ,"$1,043.00 ",$490.00 ,"$1,575.00 ", N/A ,"$1,487.50 ","$1,478.75 ","$1,478.75 ", N/A ,"$1,137.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100507,V5172,HC HEARING AID CROS MONAURAL IN CANAL T9,271,1 ,"$2,275.00 ","$1,638.00 ",$637.00 ,"$2,275.00 ", N/A ,"$1,478.75 ","$1,358.18 ", N/A ,$637.00 ,"$1,506.05 ", N/A ,"$1,506.05 ", N/A ,"$1,355.90 ","$1,355.90 ", N/A ,"$1,355.90 ", N/A ,"$1,751.75 ", N/A , N/A , N/A ,"$1,706.25 ","$1,615.25 ","$1,615.25 ", N/A ,"$1,615.25 ","$1,933.75 ","$1,933.75 ","$1,933.75 ", N/A , N/A ,"$1,933.75 ", N/A ,"$2,275.00 ","$1,276.28 ", N/A ,$941.85 , N/A , N/A , N/A ,"$1,933.75 ", N/A ,"$1,355.90 ",$637.00 ,"$2,047.50 ", N/A ,"$1,933.75 ","$1,922.38 ","$1,922.38 ", N/A ,"$1,478.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100508,V5172,HC HEARING AID CROS MONAURAL IN CANAL T10,271,1 ,"$2,800.00 ","$2,016.00 ",$784.00 ,"$2,800.00 ", N/A ,"$1,820.00 ","$1,671.60 ", N/A ,$784.00 ,"$1,853.60 ", N/A ,"$1,853.60 ", N/A ,"$1,668.80 ","$1,668.80 ", N/A ,"$1,668.80 ", N/A ,"$2,156.00 ", N/A , N/A , N/A ,"$2,100.00 ","$1,988.00 ","$1,988.00 ", N/A ,"$1,988.00 ","$2,380.00 ","$2,380.00 ","$2,380.00 ", N/A , N/A ,"$2,380.00 ", N/A ,"$2,800.00 ","$1,570.80 ", N/A ,"$1,159.20 ", N/A , N/A , N/A ,"$2,380.00 ", N/A ,"$1,668.80 ",$784.00 ,"$2,520.00 ", N/A ,"$2,380.00 ","$2,366.00 ","$2,366.00 ", N/A ,"$1,820.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100509,V5172,HC HEARING AID CROS MONAURAL IN CANAL T11,271,1 ,"$3,325.00 ","$2,394.00 ",$931.00 ,"$3,325.00 ", N/A ,"$2,161.25 ","$1,985.03 ", N/A ,$931.00 ,"$2,201.15 ", N/A ,"$2,201.15 ", N/A ,"$1,981.70 ","$1,981.70 ", N/A ,"$1,981.70 ", N/A ,"$2,560.25 ", N/A , N/A , N/A ,"$2,493.75 ","$2,360.75 ","$2,360.75 ", N/A ,"$2,360.75 ","$2,826.25 ","$2,826.25 ","$2,826.25 ", N/A , N/A ,"$2,826.25 ", N/A ,"$3,325.00 ","$1,865.33 ", N/A ,"$1,376.55 ", N/A , N/A , N/A ,"$2,826.25 ", N/A ,"$1,981.70 ",$931.00 ,"$2,992.50 ", N/A ,"$2,826.25 ","$2,809.63 ","$2,809.63 ", N/A ,"$2,161.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100515,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T8,271,1 ,$245.00 ,$176.40 ,$68.60 ,$245.00 , N/A ,$159.25 ,$146.27 , N/A ,$68.60 ,$162.19 , N/A ,$162.19 , N/A ,$146.02 ,$146.02 , N/A ,$146.02 , N/A ,$188.65 , N/A , N/A , N/A ,$183.75 ,$173.95 ,$173.95 , N/A ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A , N/A ,$208.25 , N/A ,$245.00 ,$137.45 , N/A ,$101.43 , N/A , N/A , N/A ,$208.25 , N/A ,$146.02 ,$68.60 ,$220.50 , N/A ,$208.25 ,$207.03 ,$207.03 , N/A ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,27100516,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T9,271,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 , N/A , N/A , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,27100517,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T10,271,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$130.41 , N/A , N/A , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 ,$266.18 ,$266.18 , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,27100518,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T11,271,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,27100519,N/A,HC SYSTEM MONITR NOVII PTCH,271,1 ,$116.85 ,$84.13 ,$32.72 ,$116.85 , N/A ,$75.95 ,$69.76 , N/A ,$32.72 ,$77.35 , N/A ,$77.35 , N/A ,$69.64 ,$69.64 , N/A ,$69.64 , N/A ,$89.97 , N/A , N/A , N/A ,$87.64 ,$82.96 ,$82.96 , N/A ,$82.96 ,$99.32 ,$99.32 ,$99.32 , N/A , N/A ,$99.32 , N/A ,$116.85 ,$65.55 , N/A ,$48.38 , N/A , N/A , N/A ,$99.32 , N/A ,$69.64 ,$32.72 ,$105.17 , N/A ,$99.32 ,$98.74 ,$98.74 , N/A ,$75.95 ST. JOSEPH'S HOSPITAL - BREESE,27100523,N/A,HC PORT BREATHING CIRCUIT,271,1 ,$51.00 ,$36.72 ,$14.28 ,$51.00 , N/A ,$33.15 ,$30.45 , N/A ,$14.28 ,$33.76 , N/A ,$33.76 , N/A ,$30.40 ,$30.40 , N/A ,$30.40 , N/A ,$39.27 , N/A , N/A , N/A ,$38.25 ,$36.21 ,$36.21 , N/A ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A , N/A ,$43.35 , N/A ,$51.00 ,$28.61 , N/A ,$21.11 , N/A , N/A , N/A ,$43.35 , N/A ,$30.40 ,$14.28 ,$45.90 , N/A ,$43.35 ,$43.10 ,$43.10 , N/A ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,27100524,V5140,HC HEARING AID BINAURAL BEHIND EAR T17,271,1 ,"$6,475.00 ","$4,662.00 ","$1,813.00 ","$6,475.00 ", N/A ,"$4,208.75 ","$3,865.58 ", N/A ,"$1,813.00 ","$4,286.45 ", N/A ,"$4,286.45 ", N/A ,"$3,859.10 ","$3,859.10 ", N/A ,"$3,859.10 ", N/A ,"$4,985.75 ", N/A , N/A , N/A ,"$4,856.25 ","$4,597.25 ","$4,597.25 ", N/A ,"$4,597.25 ","$5,503.75 ","$5,503.75 ","$5,503.75 ", N/A , N/A ,"$5,503.75 ", N/A ,"$6,475.00 ","$3,632.48 ", N/A ,"$2,680.65 ", N/A , N/A , N/A ,"$5,503.75 ", N/A ,"$3,859.10 ","$1,813.00 ","$5,827.50 ", N/A ,"$5,503.75 ","$5,471.38 ","$5,471.38 ", N/A ,"$4,208.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100525,V5140,HC HEARING AID BINAURAL BEHIND EAR T18,271,1 ,"$7,000.00 ","$5,040.00 ","$1,960.00 ","$7,000.00 ", N/A ,"$4,550.00 ","$4,179.00 ", N/A ,"$1,960.00 ","$4,634.00 ", N/A ,"$4,634.00 ", N/A ,"$4,172.00 ","$4,172.00 ", N/A ,"$4,172.00 ", N/A ,"$5,390.00 ", N/A , N/A , N/A ,"$5,250.00 ","$4,970.00 ","$4,970.00 ", N/A ,"$4,970.00 ","$5,950.00 ","$5,950.00 ","$5,950.00 ", N/A , N/A ,"$5,950.00 ", N/A ,"$7,000.00 ","$3,927.00 ", N/A ,"$2,898.00 ", N/A , N/A , N/A ,"$5,950.00 ", N/A ,"$4,172.00 ","$1,960.00 ","$6,300.00 ", N/A ,"$5,950.00 ","$5,915.00 ","$5,915.00 ", N/A ,"$4,550.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100526,V5140,HC HEARING AID BINAURAL BEHIND EAR T19,271,1 ,"$7,525.00 ","$5,418.00 ","$2,107.00 ","$7,525.00 ", N/A ,"$4,891.25 ","$4,492.43 ", N/A ,"$2,107.00 ","$4,981.55 ", N/A ,"$4,981.55 ", N/A ,"$4,484.90 ","$4,484.90 ", N/A ,"$4,484.90 ", N/A ,"$5,794.25 ", N/A , N/A , N/A ,"$5,643.75 ","$5,342.75 ","$5,342.75 ", N/A ,"$5,342.75 ","$6,396.25 ","$6,396.25 ","$6,396.25 ", N/A , N/A ,"$6,396.25 ", N/A ,"$7,525.00 ","$4,221.53 ", N/A ,"$3,115.35 ", N/A , N/A , N/A ,"$6,396.25 ", N/A ,"$4,484.90 ","$2,107.00 ","$6,772.50 ", N/A ,"$6,396.25 ","$6,358.63 ","$6,358.63 ", N/A ,"$4,891.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100527,V5140,HC HEARING AID BINAURAL BEHIND EAR T20,271,1 ,"$8,050.00 ","$5,796.00 ","$2,254.00 ","$8,050.00 ", N/A ,"$5,232.50 ","$4,805.85 ", N/A ,"$2,254.00 ","$5,329.10 ", N/A ,"$5,329.10 ", N/A ,"$4,797.80 ","$4,797.80 ", N/A ,"$4,797.80 ", N/A ,"$6,198.50 ", N/A , N/A , N/A ,"$6,037.50 ","$5,715.50 ","$5,715.50 ", N/A ,"$5,715.50 ","$6,842.50 ","$6,842.50 ","$6,842.50 ", N/A , N/A ,"$6,842.50 ", N/A ,"$8,050.00 ","$4,516.05 ", N/A ,"$3,332.70 ", N/A , N/A , N/A ,"$6,842.50 ", N/A ,"$4,797.80 ","$2,254.00 ","$7,245.00 ", N/A ,"$6,842.50 ","$6,802.25 ","$6,802.25 ", N/A ,"$5,232.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100529,V5060,HC HEARING AID MONAURAL BEHIND EAR T17,271,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100530,V5060,HC HEARING AID MONAURAL BEHIND EAR T18,271,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100531,V5060,HC HEARING AID MONAURAL BEHIND EAR T19,271,1 ,"$4,900.00 ","$3,528.00 ","$1,372.00 ","$4,900.00 ", N/A ,"$3,185.00 ","$2,925.30 ", N/A ,"$1,372.00 ","$3,243.80 ", N/A ,"$3,243.80 ", N/A ,"$2,920.40 ","$2,920.40 ", N/A ,"$2,920.40 ", N/A ,"$3,773.00 ", N/A , N/A , N/A ,"$3,675.00 ","$3,479.00 ","$3,479.00 ", N/A ,"$3,479.00 ","$4,165.00 ","$4,165.00 ","$4,165.00 ", N/A , N/A ,"$4,165.00 ", N/A ,"$4,900.00 ","$2,748.90 ", N/A ,"$2,028.60 ", N/A , N/A , N/A ,"$4,165.00 ", N/A ,"$2,920.40 ","$1,372.00 ","$4,410.00 ", N/A ,"$4,165.00 ","$4,140.50 ","$4,140.50 ", N/A ,"$3,185.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100532,V5060,HC HEARING AID MONAURAL BEHIND EAR T20,271,1 ,"$5,425.00 ","$3,906.00 ","$1,519.00 ","$5,425.00 ", N/A ,"$3,526.25 ","$3,238.73 ", N/A ,"$1,519.00 ","$3,591.35 ", N/A ,"$3,591.35 ", N/A ,"$3,233.30 ","$3,233.30 ", N/A ,"$3,233.30 ", N/A ,"$4,177.25 ", N/A , N/A , N/A ,"$4,068.75 ","$3,851.75 ","$3,851.75 ", N/A ,"$3,851.75 ","$4,611.25 ","$4,611.25 ","$4,611.25 ", N/A , N/A ,"$4,611.25 ", N/A ,"$5,425.00 ","$3,043.43 ", N/A ,"$2,245.95 ", N/A , N/A , N/A ,"$4,611.25 ", N/A ,"$3,233.30 ","$1,519.00 ","$4,882.50 ", N/A ,"$4,611.25 ","$4,584.13 ","$4,584.13 ", N/A ,"$3,526.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100533,V5060,HC HEARING AID MONAURAL BEHIND EAR T21,271,1 ,"$5,950.00 ","$4,284.00 ","$1,666.00 ","$5,950.00 ", N/A ,"$3,867.50 ","$3,552.15 ", N/A ,"$1,666.00 ","$3,938.90 ", N/A ,"$3,938.90 ", N/A ,"$3,546.20 ","$3,546.20 ", N/A ,"$3,546.20 ", N/A ,"$4,581.50 ", N/A , N/A , N/A ,"$4,462.50 ","$4,224.50 ","$4,224.50 ", N/A ,"$4,224.50 ","$5,057.50 ","$5,057.50 ","$5,057.50 ", N/A , N/A ,"$5,057.50 ", N/A ,"$5,950.00 ","$3,337.95 ", N/A ,"$2,463.30 ", N/A , N/A , N/A ,"$5,057.50 ", N/A ,"$3,546.20 ","$1,666.00 ","$5,355.00 ", N/A ,"$5,057.50 ","$5,027.75 ","$5,027.75 ", N/A ,"$3,867.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100534,V5060,HC HEARING AID MONAURAL BEHIND EAR T22,271,1 ,"$6,475.00 ","$4,662.00 ","$1,813.00 ","$6,475.00 ", N/A ,"$4,208.75 ","$3,865.58 ", N/A ,"$1,813.00 ","$4,286.45 ", N/A ,"$4,286.45 ", N/A ,"$3,859.10 ","$3,859.10 ", N/A ,"$3,859.10 ", N/A ,"$4,985.75 ", N/A , N/A , N/A ,"$4,856.25 ","$4,597.25 ","$4,597.25 ", N/A ,"$4,597.25 ","$5,503.75 ","$5,503.75 ","$5,503.75 ", N/A , N/A ,"$5,503.75 ", N/A ,"$6,475.00 ","$3,632.48 ", N/A ,"$2,680.65 ", N/A , N/A , N/A ,"$5,503.75 ", N/A ,"$3,859.10 ","$1,813.00 ","$5,827.50 ", N/A ,"$5,503.75 ","$5,471.38 ","$5,471.38 ", N/A ,"$4,208.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100556,N/A,HC ELECTRODE COMBO CONNECTOR CARDIOVERSION,271,1 ,$76.56 ,$55.12 ,$21.44 ,$76.56 , N/A ,$49.76 ,$45.71 , N/A ,$21.44 ,$50.68 , N/A ,$50.68 , N/A ,$45.63 ,$45.63 , N/A ,$45.63 , N/A ,$58.95 , N/A , N/A , N/A ,$57.42 ,$54.36 ,$54.36 , N/A ,$54.36 ,$65.08 ,$65.08 ,$65.08 , N/A , N/A ,$65.08 , N/A ,$76.56 ,$42.95 , N/A ,$31.70 , N/A , N/A , N/A ,$65.08 , N/A ,$45.63 ,$21.44 ,$68.90 , N/A ,$65.08 ,$64.69 ,$64.69 , N/A ,$49.76 ST. JOSEPH'S HOSPITAL - BREESE,27100557,N/A,HC MASK/HEADGEAR CPAP,271,1 ,$50.85 ,$36.61 ,$14.24 ,$50.85 , N/A ,$33.05 ,$30.36 , N/A ,$14.24 ,$33.66 , N/A ,$33.66 , N/A ,$30.31 ,$30.31 , N/A ,$30.31 , N/A ,$39.15 , N/A , N/A , N/A ,$38.14 ,$36.10 ,$36.10 , N/A ,$36.10 ,$43.22 ,$43.22 ,$43.22 , N/A , N/A ,$43.22 , N/A ,$50.85 ,$28.53 , N/A ,$21.05 , N/A , N/A , N/A ,$43.22 , N/A ,$30.31 ,$14.24 ,$45.77 , N/A ,$43.22 ,$42.97 ,$42.97 , N/A ,$33.05 ST. JOSEPH'S HOSPITAL - BREESE,27100559,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T12,271,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27100560,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T13,271,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,27100561,V5264,HC EAR MOLD/INSERT NON DISPOSABLE ANY TYPE T14,271,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,27100566,V5050,HC HEARING AID MONAURAL IN EAR T17,271,1 ,"$3,850.00 ","$2,772.00 ","$1,078.00 ","$3,850.00 ", N/A ,"$2,502.50 ","$2,298.45 ", N/A ,"$1,078.00 ","$2,548.70 ", N/A ,"$2,548.70 ", N/A ,"$2,294.60 ","$2,294.60 ", N/A ,"$2,294.60 ", N/A ,"$2,964.50 ", N/A , N/A , N/A ,"$2,887.50 ","$2,733.50 ","$2,733.50 ", N/A ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A , N/A ,"$3,272.50 ", N/A ,"$3,850.00 ","$2,159.85 ", N/A ,"$1,593.90 ", N/A , N/A , N/A ,"$3,272.50 ", N/A ,"$2,294.60 ","$1,078.00 ","$3,465.00 ", N/A ,"$3,272.50 ","$3,253.25 ","$3,253.25 ", N/A ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100567,V5050,HC HEARING AID MONAURAL IN EAR T18,271,1 ,"$4,375.00 ","$3,150.00 ","$1,225.00 ","$4,375.00 ", N/A ,"$2,843.75 ","$2,611.88 ", N/A ,"$1,225.00 ","$2,896.25 ", N/A ,"$2,896.25 ", N/A ,"$2,607.50 ","$2,607.50 ", N/A ,"$2,607.50 ", N/A ,"$3,368.75 ", N/A , N/A , N/A ,"$3,281.25 ","$3,106.25 ","$3,106.25 ", N/A ,"$3,106.25 ","$3,718.75 ","$3,718.75 ","$3,718.75 ", N/A , N/A ,"$3,718.75 ", N/A ,"$4,375.00 ","$2,454.38 ", N/A ,"$1,811.25 ", N/A , N/A , N/A ,"$3,718.75 ", N/A ,"$2,607.50 ","$1,225.00 ","$3,937.50 ", N/A ,"$3,718.75 ","$3,696.88 ","$3,696.88 ", N/A ,"$2,843.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100568,V5050,HC HEARING AID MONAURAL IN EAR T19,271,1 ,"$4,900.00 ","$3,528.00 ","$1,372.00 ","$4,900.00 ", N/A ,"$3,185.00 ","$2,925.30 ", N/A ,"$1,372.00 ","$3,243.80 ", N/A ,"$3,243.80 ", N/A ,"$2,920.40 ","$2,920.40 ", N/A ,"$2,920.40 ", N/A ,"$3,773.00 ", N/A , N/A , N/A ,"$3,675.00 ","$3,479.00 ","$3,479.00 ", N/A ,"$3,479.00 ","$4,165.00 ","$4,165.00 ","$4,165.00 ", N/A , N/A ,"$4,165.00 ", N/A ,"$4,900.00 ","$2,748.90 ", N/A ,"$2,028.60 ", N/A , N/A , N/A ,"$4,165.00 ", N/A ,"$2,920.40 ","$1,372.00 ","$4,410.00 ", N/A ,"$4,165.00 ","$4,140.50 ","$4,140.50 ", N/A ,"$3,185.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100569,V5050,HC HEARING AID MONAURAL IN EAR T20,271,1 ,"$5,425.00 ","$3,906.00 ","$1,519.00 ","$5,425.00 ", N/A ,"$3,526.25 ","$3,238.73 ", N/A ,"$1,519.00 ","$3,591.35 ", N/A ,"$3,591.35 ", N/A ,"$3,233.30 ","$3,233.30 ", N/A ,"$3,233.30 ", N/A ,"$4,177.25 ", N/A , N/A , N/A ,"$4,068.75 ","$3,851.75 ","$3,851.75 ", N/A ,"$3,851.75 ","$4,611.25 ","$4,611.25 ","$4,611.25 ", N/A , N/A ,"$4,611.25 ", N/A ,"$5,425.00 ","$3,043.43 ", N/A ,"$2,245.95 ", N/A , N/A , N/A ,"$4,611.25 ", N/A ,"$3,233.30 ","$1,519.00 ","$4,882.50 ", N/A ,"$4,611.25 ","$4,584.13 ","$4,584.13 ", N/A ,"$3,526.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100570,V5050,HC HEARING AID MONAURAL IN EAR T21,271,1 ,"$5,950.00 ","$4,284.00 ","$1,666.00 ","$5,950.00 ", N/A ,"$3,867.50 ","$3,552.15 ", N/A ,"$1,666.00 ","$3,938.90 ", N/A ,"$3,938.90 ", N/A ,"$3,546.20 ","$3,546.20 ", N/A ,"$3,546.20 ", N/A ,"$4,581.50 ", N/A , N/A , N/A ,"$4,462.50 ","$4,224.50 ","$4,224.50 ", N/A ,"$4,224.50 ","$5,057.50 ","$5,057.50 ","$5,057.50 ", N/A , N/A ,"$5,057.50 ", N/A ,"$5,950.00 ","$3,337.95 ", N/A ,"$2,463.30 ", N/A , N/A , N/A ,"$5,057.50 ", N/A ,"$3,546.20 ","$1,666.00 ","$5,355.00 ", N/A ,"$5,057.50 ","$5,027.75 ","$5,027.75 ", N/A ,"$3,867.50 " ST. JOSEPH'S HOSPITAL - BREESE,27100571,V5267,HC HEARING AID ACCESSORY/SUPPLY NOS T27,271,1 ,"$4,900.00 ","$3,528.00 ","$1,372.00 ","$4,900.00 ", N/A ,"$3,185.00 ","$2,925.30 ", N/A ,"$1,372.00 ","$3,243.80 ", N/A ,"$3,243.80 ", N/A ,"$2,920.40 ","$2,920.40 ", N/A ,"$2,920.40 ", N/A ,"$3,773.00 ", N/A , N/A , N/A ,"$3,675.00 ","$3,479.00 ","$3,479.00 ", N/A ,"$3,479.00 ","$4,165.00 ","$4,165.00 ","$4,165.00 ", N/A , N/A ,"$4,165.00 ", N/A ,"$4,900.00 ","$2,748.90 ", N/A ,"$2,028.60 ", N/A , N/A , N/A ,"$4,165.00 ", N/A ,"$2,920.40 ","$1,372.00 ","$4,410.00 ", N/A ,"$4,165.00 ","$4,140.50 ","$4,140.50 ", N/A ,"$3,185.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100572,V5130,HC HEARING AID BINAURAL IN EAR T17,271,1 ,"$6,475.00 ","$4,662.00 ","$1,813.00 ","$6,475.00 ", N/A ,"$4,208.75 ","$3,865.58 ", N/A ,"$1,813.00 ","$4,286.45 ", N/A ,"$4,286.45 ", N/A ,"$3,859.10 ","$3,859.10 ", N/A ,"$3,859.10 ", N/A ,"$4,985.75 ", N/A , N/A , N/A ,"$4,856.25 ","$4,597.25 ","$4,597.25 ", N/A ,"$4,597.25 ","$5,503.75 ","$5,503.75 ","$5,503.75 ", N/A , N/A ,"$5,503.75 ", N/A ,"$6,475.00 ","$3,632.48 ", N/A ,"$2,680.65 ", N/A , N/A , N/A ,"$5,503.75 ", N/A ,"$3,859.10 ","$1,813.00 ","$5,827.50 ", N/A ,"$5,503.75 ","$5,471.38 ","$5,471.38 ", N/A ,"$4,208.75 " ST. JOSEPH'S HOSPITAL - BREESE,27100573,V5130,HC HEARING AID BINAURAL IN EAR T18,271,1 ,"$7,000.00 ","$5,040.00 ","$1,960.00 ","$7,000.00 ", N/A ,"$4,550.00 ","$4,179.00 ", N/A ,"$1,960.00 ","$4,634.00 ", N/A ,"$4,634.00 ", N/A ,"$4,172.00 ","$4,172.00 ", N/A ,"$4,172.00 ", N/A ,"$5,390.00 ", N/A , N/A , N/A ,"$5,250.00 ","$4,970.00 ","$4,970.00 ", N/A ,"$4,970.00 ","$5,950.00 ","$5,950.00 ","$5,950.00 ", N/A , N/A ,"$5,950.00 ", N/A ,"$7,000.00 ","$3,927.00 ", N/A ,"$2,898.00 ", N/A , N/A , N/A ,"$5,950.00 ", N/A ,"$4,172.00 ","$1,960.00 ","$6,300.00 ", N/A ,"$5,950.00 ","$5,915.00 ","$5,915.00 ", N/A ,"$4,550.00 " ST. JOSEPH'S HOSPITAL - BREESE,27100574,V5130,HC HEARING AID BINAURAL IN EAR T19,271,1 ,"$7,525.00 ","$5,418.00 ","$2,107.00 ","$7,525.00 ", N/A ,"$4,891.25 ","$4,492.43 ", N/A ,"$2,107.00 ","$4,981.55 ", N/A ,"$4,981.55 ", N/A ,"$4,484.90 ","$4,484.90 ", N/A ,"$4,484.90 ", N/A ,"$5,794.25 ", N/A , N/A , N/A ,"$5,643.75 ","$5,342.75 ","$5,342.75 ", N/A ,"$5,342.75 ","$6,396.25 ","$6,396.25 ","$6,396.25 ", N/A , N/A ,"$6,396.25 ", N/A ,"$7,525.00 ","$4,221.53 ", N/A ,"$3,115.35 ", N/A , N/A , N/A ,"$6,396.25 ", N/A ,"$4,484.90 ","$2,107.00 ","$6,772.50 ", N/A ,"$6,396.25 ","$6,358.63 ","$6,358.63 ", N/A ,"$4,891.25 " ST. JOSEPH'S HOSPITAL - BREESE,27100575,V5130,HC HEARING AID BINAURAL IN EAR T20,271,1 ,"$8,050.00 ","$5,796.00 ","$2,254.00 ","$8,050.00 ", N/A ,"$5,232.50 ","$4,805.85 ", N/A ,"$2,254.00 ","$5,329.10 ", N/A ,"$5,329.10 ", N/A ,"$4,797.80 ","$4,797.80 ", N/A ,"$4,797.80 ", N/A ,"$6,198.50 ", N/A , N/A , N/A ,"$6,037.50 ","$5,715.50 ","$5,715.50 ", N/A ,"$5,715.50 ","$6,842.50 ","$6,842.50 ","$6,842.50 ", N/A , N/A ,"$6,842.50 ", N/A ,"$8,050.00 ","$4,516.05 ", N/A ,"$3,332.70 ", N/A , N/A , N/A ,"$6,842.50 ", N/A ,"$4,797.80 ","$2,254.00 ","$7,245.00 ", N/A ,"$6,842.50 ","$6,802.25 ","$6,802.25 ", N/A ,"$5,232.50 " ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,DEVICE POSITIONING STAR TRACTION SLEEVE,271,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,CASSETTE IRRIGATION ESSX HUMMER STERILE LATEX FREE DISPOSABLE,271,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SPLINT ORTHOGLASS 4 WIDE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,CUBE POLAR CARE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,TIP SURGILAV BONE CLEANING (210-10),271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,BAG PRESSURE INFUSION 3000CC,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,BLANKET WARMING 25 X 69,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,CHAMBER HUMIDIFIER 2 FLOAT AUTO FILL COMPRESSIBLE VOLUME MR SERIES NONSTERILE LATEX FREE DISPOSABLE,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,HOLDER TUBE ANCHORFAST FASTENER BARRIER PAD SECURITY CLAMP STABILIZER 5-10MM LATEX FREE ORAL ENDOTRACHEAL,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,MASK OXYGEN PVC ADULT ADAPTER 2 ENTRY PORT ELASTIC STRAP NOSE CLIP LATEX FREE POM ELITE 14X6.5MM CAPNOGRAPHY,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SOLN IRR 0.9 NACL 2000ML BAG,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SUPPORT ORTHOPEDIC UNIVERSAL RIGHT LEFT WRIST FOREARM 12IN,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SUPPORTER ADULT LARGE,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SUPPORTER ADULT MEDIUM,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SUPPORTER ADULT X-LARGE,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SUPPORTER MENS LARGE,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,TOURNIQUET 18X1IN FLAT PHLEBOTOMY DISPOSABLE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,BAG DRAINAGE 2000ML DOVER URINE NEEDLE ANTIREFLUX DEVICE PORT,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,INFUSOR PRESSURE 1000ML VITAL SIGNS NET,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,MASK CPAP LARGE FRAME HEADGEAR ADVANCE AIR DIFFUSER LOW PROFILE SIMPLUS ERGOFORM ROLLFIT,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,PILLOW ABDUCTION HIP MEDIUM DISPOSABLE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,POSITIONER LARGE BUMP ROUND TOP STERILE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,POSITIONING SURGICAL ASSISTANT HOLDER INSERT LEG FOAM BLUE DISPOSABLE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SOLUTION IRRIGATION UROMATIC VIAFLEX 1.5% GLYCINE PLASTIC CONTAINER PH 6 3000ML,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SPLINT NASAL 64X36MM MEDIUM ALUMINUM DENVER PAD SELF ADHESIVE UNDERSIDE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SPLINT ORTHOPEDIC UNIVERSAL 9IN RIGHT LEFT WRIST FOREARM,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SPLINT PLASTER XFAST 5 X 30,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,STOCKINETTE 3 X 25YD,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,STOCKINETTE 6 X 25YD,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,STOCKINETTE IMPERVIOUS LARGE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,STRAP DISPOSABLE HEAD AND CHIN STRAP (12),271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,VEST 5 XL FRONT ZIP ADJUSTABLE SHOULDER STRAP WITHOUT CUP POSTOPERATIVE JOBST LATEX FREE 42DD 44D 44DD 46C,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,KIT CIRCUIT EVAQUA 2 2 LIMB HEAT INFANT LATEX FREE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SLING LIFT GREEN HOYERPRO C850LB LARGE FULL BACK PAD LOOP CRADLE CALIBRE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SLING PATIENT XL DISPOSABLE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SPLINT NASAL 69X43MM LARGE AQUAPLAST DENVER SEPTUM VELCRO EXTERNAL KIT STERILE LATEX FREE DISPOSABLE WHITE 4000 SERIES,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SPLINT ORTHOGLASS 3 WIDE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,STRAP GUHL ANKLE DISTRACTOR,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,STRAP POSITIONING 30FTX1.5IN ALISTRAP REGULAR HOOK LOOP,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,VEST 2 FRONT ZIP ADJUSTABLE SHOULDER STRAP HOOK MACHINE WASHABLE POST SURGICAL JOBST VELCRO NYLON FABRIC LATEX FREE 35 1/8-39IN WHITE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,VEST 3 FRONT ZIP ADJUSTABLE SHOULDER STRAP HOOK MACHINE WASHABLE POST SURGICAL JOBST VELCRO NYLON FABRIC LATEX FREE 39 1/8-43IN WHITE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,VEST 4 FRONT ZIP ADJUSTABLE SHOULDER STRAP HOOK MACHINE WASHABLE POST SURGICAL JOBST VELCRO NYLON FABRIC LATEX FREE 43 1/8-47IN WHITE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,WRAP HEATING LARGE XL BACK,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,BAG PRESSURE INFUSION 1000CC,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,BAG URIMETER DRAINAGE,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,MASK ANESTHESIA CLEAR PLASTIC FOAM CUSHION RIGID EYE PROTECTOR BAT ADULT STERILE,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,PREP CHLORAPREP 26ML,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,SUNGLASSES PROTECTIVE POLYCARBONATE LENS POSTOPERATIVE SQUARE LITE LIGHTWEIGHT FRAME COMFORTABLE SOLAR SHIELD SMOKE,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,TAPE MEDIPORE 4,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,TAPE MEDIPORE 4 X 10YD,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27170000,N/A,TOURNIQUET SURGICAL ADULT LARGE RING FINGER TOE WARNING LABEL TOURNI-COT EXSANGUINATE DIGIT STERILE LATEX FREE GREEN,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27200189,N/A,HC 12 FR ESOPHAGEAL STEHOSCOPE,272,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 , N/A ,$18.20 ,$16.72 , N/A ,$7.84 ,$18.54 , N/A ,$18.54 , N/A ,$16.69 ,$16.69 , N/A ,$16.69 , N/A ,$21.56 , N/A , N/A , N/A ,$21.00 ,$19.88 ,$19.88 , N/A ,$19.88 ,$23.80 ,$23.80 ,$23.80 , N/A , N/A ,$23.80 , N/A ,$28.00 ,$15.71 , N/A ,$11.59 , N/A , N/A , N/A ,$23.80 , N/A ,$16.69 ,$7.84 ,$25.20 , N/A ,$23.80 ,$23.66 ,$23.66 , N/A ,$18.20 ST. JOSEPH'S HOSPITAL - BREESE,27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$79.00 ,$56.88 ,$22.12 ,$79.00 , N/A ,$51.35 ,$47.16 , N/A ,$22.12 ,$52.30 , N/A ,$52.30 , N/A ,$47.08 ,$47.08 , N/A ,$47.08 , N/A ,$60.83 , N/A , N/A , N/A ,$59.25 ,$56.09 ,$56.09 , N/A ,$56.09 ,$67.15 ,$67.15 ,$67.15 , N/A , N/A ,$67.15 , N/A ,$79.00 ,$44.32 , N/A ,$32.71 , N/A , N/A , N/A ,$67.15 , N/A ,$47.08 ,$22.12 ,$71.10 , N/A ,$67.15 ,$66.76 ,$66.76 , N/A ,$51.35 ST. JOSEPH'S HOSPITAL - BREESE,27200240,N/A,HC AMNIOTOMY HOOK,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27200331,N/A,HC BED SENSOR,272,1 ,$33.63 ,$24.21 ,$9.42 ,$33.63 , N/A ,$21.86 ,$20.08 , N/A ,$9.42 ,$22.26 , N/A ,$22.26 , N/A ,$20.04 ,$20.04 , N/A ,$20.04 , N/A ,$25.90 , N/A , N/A , N/A ,$25.22 ,$23.88 ,$23.88 , N/A ,$23.88 ,$28.59 ,$28.59 ,$28.59 , N/A , N/A ,$28.59 , N/A ,$33.63 ,$18.87 , N/A ,$13.92 , N/A , N/A , N/A ,$28.59 , N/A ,$20.04 ,$9.42 ,$30.27 , N/A ,$28.59 ,$28.42 ,$28.42 , N/A ,$21.86 ST. JOSEPH'S HOSPITAL - BREESE,27200338,N/A,HC BIOPSY DEVICE NEEDLE CORE,272,1 ,$139.00 ,$100.08 ,$38.92 ,$139.00 , N/A ,$90.35 ,$82.98 , N/A ,$38.92 ,$92.02 , N/A ,$92.02 , N/A ,$82.84 ,$82.84 , N/A ,$82.84 , N/A ,$107.03 , N/A , N/A , N/A ,$104.25 ,$98.69 ,$98.69 , N/A ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A , N/A ,$118.15 , N/A ,$139.00 ,$77.98 , N/A ,$57.55 , N/A , N/A , N/A ,$118.15 , N/A ,$82.84 ,$38.92 ,$125.10 , N/A ,$118.15 ,$117.46 ,$117.46 , N/A ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,27200571,N/A,HC BREAST PUMP KIT,272,1 ,$85.00 ,$61.20 ,$23.80 ,$85.00 , N/A ,$55.25 ,$50.75 , N/A ,$23.80 ,$56.27 , N/A ,$56.27 , N/A ,$50.66 ,$50.66 , N/A ,$50.66 , N/A ,$65.45 , N/A , N/A , N/A ,$63.75 ,$60.35 ,$60.35 , N/A ,$60.35 ,$72.25 ,$72.25 ,$72.25 , N/A , N/A ,$72.25 , N/A ,$85.00 ,$47.69 , N/A ,$35.19 , N/A , N/A , N/A ,$72.25 , N/A ,$50.66 ,$23.80 ,$76.50 , N/A ,$72.25 ,$71.83 ,$71.83 , N/A ,$55.25 ST. JOSEPH'S HOSPITAL - BREESE,27200712,N/A,HC CATHETER PLUG,272,1 ,$26.00 ,$18.72 ,$7.28 ,$26.00 , N/A ,$16.90 ,$15.52 , N/A ,$7.28 ,$17.21 , N/A ,$17.21 , N/A ,$15.50 ,$15.50 , N/A ,$15.50 , N/A ,$20.02 , N/A , N/A , N/A ,$19.50 ,$18.46 ,$18.46 , N/A ,$18.46 ,$22.10 ,$22.10 ,$22.10 , N/A , N/A ,$22.10 , N/A ,$26.00 ,$14.59 , N/A ,$10.76 , N/A , N/A , N/A ,$22.10 , N/A ,$15.50 ,$7.28 ,$23.40 , N/A ,$22.10 ,$21.97 ,$21.97 , N/A ,$16.90 ST. JOSEPH'S HOSPITAL - BREESE,27200747,N/A,HC CATH ARGYLE THORACIC,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27200828,N/A,HC CATH FOLEY TEMPERATURE PROBE 16FR,272,1 ,$108.00 ,$77.76 ,$30.24 ,$108.00 , N/A ,$70.20 ,$64.48 , N/A ,$30.24 ,$71.50 , N/A ,$71.50 , N/A ,$64.37 ,$64.37 , N/A ,$64.37 , N/A ,$83.16 , N/A , N/A , N/A ,$81.00 ,$76.68 ,$76.68 , N/A ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A , N/A ,$91.80 , N/A ,$108.00 ,$60.59 , N/A ,$44.71 , N/A , N/A , N/A ,$91.80 , N/A ,$64.37 ,$30.24 ,$97.20 , N/A ,$91.80 ,$91.26 ,$91.26 , N/A ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,27200832,N/A,HC CATH TRAY WITH FOLEY,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 , N/A ,$25.35 ,$23.28 , N/A ,$10.92 ,$25.82 , N/A ,$25.82 , N/A ,$23.24 ,$23.24 , N/A ,$23.24 , N/A ,$30.03 , N/A , N/A , N/A ,$29.25 ,$27.69 ,$27.69 , N/A ,$27.69 ,$33.15 ,$33.15 ,$33.15 , N/A , N/A ,$33.15 , N/A ,$39.00 ,$21.88 , N/A ,$16.15 , N/A , N/A , N/A ,$33.15 , N/A ,$23.24 ,$10.92 ,$35.10 , N/A ,$33.15 ,$32.96 ,$32.96 , N/A ,$25.35 ST. JOSEPH'S HOSPITAL - BREESE,27200849,N/A,HC CATHETER - FOLEY,272,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 , N/A ,$16.25 ,$14.93 , N/A ,$7.00 ,$16.55 , N/A ,$16.55 , N/A ,$14.90 ,$14.90 , N/A ,$14.90 , N/A ,$19.25 , N/A , N/A , N/A ,$18.75 ,$17.75 ,$17.75 , N/A ,$17.75 ,$21.25 ,$21.25 ,$21.25 , N/A , N/A ,$21.25 , N/A ,$25.00 ,$14.03 , N/A ,$10.35 , N/A , N/A , N/A ,$21.25 , N/A ,$14.90 ,$7.00 ,$22.50 , N/A ,$21.25 ,$21.13 ,$21.13 , N/A ,$16.25 ST. JOSEPH'S HOSPITAL - BREESE,27201077,N/A,HC DIS INCENTIVE SPIROMETER,272,1 ,$97.00 ,$69.84 ,$27.16 ,$97.00 , N/A ,$63.05 ,$57.91 , N/A ,$27.16 ,$64.21 , N/A ,$64.21 , N/A ,$57.81 ,$57.81 , N/A ,$57.81 , N/A ,$74.69 , N/A , N/A , N/A ,$72.75 ,$68.87 ,$68.87 , N/A ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A , N/A ,$82.45 , N/A ,$97.00 ,$54.42 , N/A ,$40.16 , N/A , N/A , N/A ,$82.45 , N/A ,$57.81 ,$27.16 ,$87.30 , N/A ,$82.45 ,$81.97 ,$81.97 , N/A ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,27201083,N/A,HC DISP. OXIMETER SENSOR,272,1 ,$47.00 ,$33.84 ,$13.16 ,$47.00 , N/A ,$30.55 ,$28.06 , N/A ,$13.16 ,$31.11 , N/A ,$31.11 , N/A ,$28.01 ,$28.01 , N/A ,$28.01 , N/A ,$36.19 , N/A , N/A , N/A ,$35.25 ,$33.37 ,$33.37 , N/A ,$33.37 ,$39.95 ,$39.95 ,$39.95 , N/A , N/A ,$39.95 , N/A ,$47.00 ,$26.37 , N/A ,$19.46 , N/A , N/A , N/A ,$39.95 , N/A ,$28.01 ,$13.16 ,$42.30 , N/A ,$39.95 ,$39.72 ,$39.72 , N/A ,$30.55 ST. JOSEPH'S HOSPITAL - BREESE,27201147,N/A,HC DRESSING ADAPTIC 3X8,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27201148,N/A,HC DRESSING AQUACELL W/HYDROFIBER,272,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27201165,N/A,HC MORGAN LENS,272,1 ,$115.20 ,$82.94 ,$32.26 ,$115.20 , N/A ,$74.88 ,$68.77 , N/A ,$32.26 ,$76.26 , N/A ,$76.26 , N/A ,$68.66 ,$68.66 , N/A ,$68.66 , N/A ,$88.70 , N/A , N/A , N/A ,$86.40 ,$81.79 ,$81.79 , N/A ,$81.79 ,$97.92 ,$97.92 ,$97.92 , N/A , N/A ,$97.92 , N/A ,$115.20 ,$64.63 , N/A ,$47.69 , N/A , N/A , N/A ,$97.92 , N/A ,$68.66 ,$32.26 ,$103.68 , N/A ,$97.92 ,$97.34 ,$97.34 , N/A ,$74.88 ST. JOSEPH'S HOSPITAL - BREESE,27201247,N/A,HC ENDOTRACH TUBE HOLDER,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 , N/A ,$17.55 ,$16.12 , N/A ,$7.56 ,$17.87 , N/A ,$17.87 , N/A ,$16.09 ,$16.09 , N/A ,$16.09 , N/A ,$20.79 , N/A , N/A , N/A ,$20.25 ,$19.17 ,$19.17 , N/A ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A , N/A ,$22.95 , N/A ,$27.00 ,$15.15 , N/A ,$11.18 , N/A , N/A , N/A ,$22.95 , N/A ,$16.09 ,$7.56 ,$24.30 , N/A ,$22.95 ,$22.82 ,$22.82 , N/A ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,27201248,N/A,HC ENDOTRACHEAL TUBE (DUAL LUMEN),272,1 ,$19.00 ,$13.68 ,$5.32 ,$19.00 , N/A ,$12.35 ,$11.34 , N/A ,$5.32 ,$12.58 , N/A ,$12.58 , N/A ,$11.32 ,$11.32 , N/A ,$11.32 , N/A ,$14.63 , N/A , N/A , N/A ,$14.25 ,$13.49 ,$13.49 , N/A ,$13.49 ,$16.15 ,$16.15 ,$16.15 , N/A , N/A ,$16.15 , N/A ,$19.00 ,$10.66 , N/A ,$7.87 , N/A , N/A , N/A ,$16.15 , N/A ,$11.32 ,$5.32 ,$17.10 , N/A ,$16.15 ,$16.06 ,$16.06 , N/A ,$12.35 ST. JOSEPH'S HOSPITAL - BREESE,27201250,N/A,HC EPIDURAL TRAY SNGL USE,272,1 ,$54.00 ,$38.88 ,$15.12 ,$54.00 , N/A ,$35.10 ,$32.24 , N/A ,$15.12 ,$35.75 , N/A ,$35.75 , N/A ,$32.18 ,$32.18 , N/A ,$32.18 , N/A ,$41.58 , N/A , N/A , N/A ,$40.50 ,$38.34 ,$38.34 , N/A ,$38.34 ,$45.90 ,$45.90 ,$45.90 , N/A , N/A ,$45.90 , N/A ,$54.00 ,$30.29 , N/A ,$22.36 , N/A , N/A , N/A ,$45.90 , N/A ,$32.18 ,$15.12 ,$48.60 , N/A ,$45.90 ,$45.63 ,$45.63 , N/A ,$35.10 ST. JOSEPH'S HOSPITAL - BREESE,27201279,N/A,HC FECAL MANAGEMENT KIT,272,1 ,$276.00 ,$198.72 ,$77.28 ,$276.00 , N/A ,$179.40 ,$164.77 , N/A ,$77.28 ,$182.71 , N/A ,$182.71 , N/A ,$164.50 ,$164.50 , N/A ,$164.50 , N/A ,$212.52 , N/A , N/A , N/A ,$207.00 ,$195.96 ,$195.96 , N/A ,$195.96 ,$234.60 ,$234.60 ,$234.60 , N/A , N/A ,$234.60 , N/A ,$276.00 ,$154.84 , N/A ,$114.26 , N/A , N/A , N/A ,$234.60 , N/A ,$164.50 ,$77.28 ,$248.40 , N/A ,$234.60 ,$233.22 ,$233.22 , N/A ,$179.40 ST. JOSEPH'S HOSPITAL - BREESE,27201282,N/A,HC FEEDING TUBE,272,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,27201302,N/A,HC FINE MARKING PEN,272,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27201362,N/A,HC GRID ACCU,272,1 ,$64.98 ,$46.79 ,$18.19 ,$64.98 , N/A ,$42.24 ,$38.79 , N/A ,$18.19 ,$43.02 , N/A ,$43.02 , N/A ,$38.73 ,$38.73 , N/A ,$38.73 , N/A ,$50.03 , N/A , N/A , N/A ,$48.74 ,$46.14 ,$46.14 , N/A ,$46.14 ,$55.23 ,$55.23 ,$55.23 , N/A , N/A ,$55.23 , N/A ,$64.98 ,$36.45 , N/A ,$26.90 , N/A , N/A , N/A ,$55.23 , N/A ,$38.73 ,$18.19 ,$58.48 , N/A ,$55.23 ,$54.91 ,$54.91 , N/A ,$42.24 ST. JOSEPH'S HOSPITAL - BREESE,27201521,N/A,HC KIT INTRODUCER,272,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 , N/A ,$10.40 ,$9.55 , N/A ,$4.48 ,$10.59 , N/A ,$10.59 , N/A ,$9.54 ,$9.54 , N/A ,$9.54 , N/A ,$12.32 , N/A , N/A , N/A ,$12.00 ,$11.36 ,$11.36 , N/A ,$11.36 ,$13.60 ,$13.60 ,$13.60 , N/A , N/A ,$13.60 , N/A ,$16.00 ,$8.98 , N/A ,$6.62 , N/A , N/A , N/A ,$13.60 , N/A ,$9.54 ,$4.48 ,$14.40 , N/A ,$13.60 ,$13.52 ,$13.52 , N/A ,$10.40 ST. JOSEPH'S HOSPITAL - BREESE,27201637,N/A,HC MAMMOTOME PROBE,272,1 ,$519.42 ,$373.98 ,$145.44 ,$519.42 , N/A ,$337.62 ,$310.09 , N/A ,$145.44 ,$343.86 , N/A ,$343.86 , N/A ,$309.57 ,$309.57 , N/A ,$309.57 , N/A ,$399.95 , N/A , N/A , N/A ,$389.57 ,$368.79 ,$368.79 , N/A ,$368.79 ,$441.51 ,$441.51 ,$441.51 , N/A , N/A ,$441.51 , N/A ,$519.42 ,$291.39 , N/A ,$215.04 , N/A , N/A , N/A ,$441.51 , N/A ,$309.57 ,$145.44 ,$467.48 , N/A ,$441.51 ,$438.91 ,$438.91 , N/A ,$337.62 ST. JOSEPH'S HOSPITAL - BREESE,27201738,N/A,HC NIPPLE SHIELD,272,1 ,$17.00 ,$12.24 ,$4.76 ,$17.00 , N/A ,$11.05 ,$10.15 , N/A ,$4.76 ,$11.25 , N/A ,$11.25 , N/A ,$10.13 ,$10.13 , N/A ,$10.13 , N/A ,$13.09 , N/A , N/A , N/A ,$12.75 ,$12.07 ,$12.07 , N/A ,$12.07 ,$14.45 ,$14.45 ,$14.45 , N/A , N/A ,$14.45 , N/A ,$17.00 ,$9.54 , N/A ,$7.04 , N/A , N/A , N/A ,$14.45 , N/A ,$10.13 ,$4.76 ,$15.30 , N/A ,$14.45 ,$14.37 ,$14.37 , N/A ,$11.05 ST. JOSEPH'S HOSPITAL - BREESE,27201894,N/A,HC PRESSURE CATHETER IUPC,272,1 ,$172.00 ,$123.84 ,$48.16 ,$172.00 , N/A ,$111.80 ,$102.68 , N/A ,$48.16 ,$113.86 , N/A ,$113.86 , N/A ,$102.51 ,$102.51 , N/A ,$102.51 , N/A ,$132.44 , N/A , N/A , N/A ,$129.00 ,$122.12 ,$122.12 , N/A ,$122.12 ,$146.20 ,$146.20 ,$146.20 , N/A , N/A ,$146.20 , N/A ,$172.00 ,$96.49 , N/A ,$71.21 , N/A , N/A , N/A ,$146.20 , N/A ,$102.51 ,$48.16 ,$154.80 , N/A ,$146.20 ,$145.34 ,$145.34 , N/A ,$111.80 ST. JOSEPH'S HOSPITAL - BREESE,27201896,N/A,HC PREVENA INCISION SYSTEM,272,1 ,"$1,560.00 ","$1,123.20 ",$436.80 ,"$1,560.00 ", N/A ,"$1,014.00 ",$931.32 , N/A ,$436.80 ,"$1,032.72 ", N/A ,"$1,032.72 ", N/A ,$929.76 ,$929.76 , N/A ,$929.76 , N/A ,"$1,201.20 ", N/A , N/A , N/A ,"$1,170.00 ","$1,107.60 ","$1,107.60 ", N/A ,"$1,107.60 ","$1,326.00 ","$1,326.00 ","$1,326.00 ", N/A , N/A ,"$1,326.00 ", N/A ,"$1,560.00 ",$875.16 , N/A ,$645.84 , N/A , N/A , N/A ,"$1,326.00 ", N/A ,$929.76 ,$436.80 ,"$1,404.00 ", N/A ,"$1,326.00 ","$1,318.20 ","$1,318.20 ", N/A ,"$1,014.00 " ST. JOSEPH'S HOSPITAL - BREESE,27201938,N/A,HC PULSE OXIMETER PROBE DISP,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 , N/A ,$25.35 ,$23.28 , N/A ,$10.92 ,$25.82 , N/A ,$25.82 , N/A ,$23.24 ,$23.24 , N/A ,$23.24 , N/A ,$30.03 , N/A , N/A , N/A ,$29.25 ,$27.69 ,$27.69 , N/A ,$27.69 ,$33.15 ,$33.15 ,$33.15 , N/A , N/A ,$33.15 , N/A ,$39.00 ,$21.88 , N/A ,$16.15 , N/A , N/A , N/A ,$33.15 , N/A ,$23.24 ,$10.92 ,$35.10 , N/A ,$33.15 ,$32.96 ,$32.96 , N/A ,$25.35 ST. JOSEPH'S HOSPITAL - BREESE,27202002,N/A,HC SCD SLEEVE KNEE,272,1 ,$110.00 ,$79.20 ,$30.80 ,$110.00 , N/A ,$71.50 ,$65.67 , N/A ,$30.80 ,$72.82 , N/A ,$72.82 , N/A ,$65.56 ,$65.56 , N/A ,$65.56 , N/A ,$84.70 , N/A , N/A , N/A ,$82.50 ,$78.10 ,$78.10 , N/A ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A , N/A ,$93.50 , N/A ,$110.00 ,$61.71 , N/A ,$45.54 , N/A , N/A , N/A ,$93.50 , N/A ,$65.56 ,$30.80 ,$99.00 , N/A ,$93.50 ,$92.95 ,$92.95 , N/A ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,27202120,N/A,HC STAPLER SKIN,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,27202600,N/A,HC SUTURE,272,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 , N/A ,$9.75 ,$8.96 , N/A ,$4.20 ,$9.93 , N/A ,$9.93 , N/A ,$8.94 ,$8.94 , N/A ,$8.94 , N/A ,$11.55 , N/A , N/A , N/A ,$11.25 ,$10.65 ,$10.65 , N/A ,$10.65 ,$12.75 ,$12.75 ,$12.75 , N/A , N/A ,$12.75 , N/A ,$15.00 ,$8.42 , N/A ,$6.21 , N/A , N/A , N/A ,$12.75 , N/A ,$8.94 ,$4.20 ,$13.50 , N/A ,$12.75 ,$12.68 ,$12.68 , N/A ,$9.75 ST. JOSEPH'S HOSPITAL - BREESE,27202634,N/A,HC SYRINGE ASEPTO,272,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,27202656,N/A,HC TAPE MEDIPORE 4 INCH,272,1 ,$19.00 ,$13.68 ,$5.32 ,$19.00 , N/A ,$12.35 ,$11.34 , N/A ,$5.32 ,$12.58 , N/A ,$12.58 , N/A ,$11.32 ,$11.32 , N/A ,$11.32 , N/A ,$14.63 , N/A , N/A , N/A ,$14.25 ,$13.49 ,$13.49 , N/A ,$13.49 ,$16.15 ,$16.15 ,$16.15 , N/A , N/A ,$16.15 , N/A ,$19.00 ,$10.66 , N/A ,$7.87 , N/A , N/A , N/A ,$16.15 , N/A ,$11.32 ,$5.32 ,$17.10 , N/A ,$16.15 ,$16.06 ,$16.06 , N/A ,$12.35 ST. JOSEPH'S HOSPITAL - BREESE,27202665,N/A,HC THORACENTESIS TRAY,272,1 ,$167.00 ,$120.24 ,$46.76 ,$167.00 , N/A ,$108.55 ,$99.70 , N/A ,$46.76 ,$110.55 , N/A ,$110.55 , N/A ,$99.53 ,$99.53 , N/A ,$99.53 , N/A ,$128.59 , N/A , N/A , N/A ,$125.25 ,$118.57 ,$118.57 , N/A ,$118.57 ,$141.95 ,$141.95 ,$141.95 , N/A , N/A ,$141.95 , N/A ,$167.00 ,$93.69 , N/A ,$69.14 , N/A , N/A , N/A ,$141.95 , N/A ,$99.53 ,$46.76 ,$150.30 , N/A ,$141.95 ,$141.12 ,$141.12 , N/A ,$108.55 ST. JOSEPH'S HOSPITAL - BREESE,27202743,N/A,HC TRAY CATH,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 , N/A ,$17.55 ,$16.12 , N/A ,$7.56 ,$17.87 , N/A ,$17.87 , N/A ,$16.09 ,$16.09 , N/A ,$16.09 , N/A ,$20.79 , N/A , N/A , N/A ,$20.25 ,$19.17 ,$19.17 , N/A ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A , N/A ,$22.95 , N/A ,$27.00 ,$15.15 , N/A ,$11.18 , N/A , N/A , N/A ,$22.95 , N/A ,$16.09 ,$7.56 ,$24.30 , N/A ,$22.95 ,$22.82 ,$22.82 , N/A ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,27202759,N/A,HC TRAY EPIDURAL CONTINUOUS,272,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 , N/A ,$13.65 ,$12.54 , N/A ,$5.88 ,$13.90 , N/A ,$13.90 , N/A ,$12.52 ,$12.52 , N/A ,$12.52 , N/A ,$16.17 , N/A , N/A , N/A ,$15.75 ,$14.91 ,$14.91 , N/A ,$14.91 ,$17.85 ,$17.85 ,$17.85 , N/A , N/A ,$17.85 , N/A ,$21.00 ,$11.78 , N/A ,$8.69 , N/A , N/A , N/A ,$17.85 , N/A ,$12.52 ,$5.88 ,$18.90 , N/A ,$17.85 ,$17.75 ,$17.75 , N/A ,$13.65 ST. JOSEPH'S HOSPITAL - BREESE,27202807,N/A,HC TRAY SPINAL,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 , N/A ,$25.35 ,$23.28 , N/A ,$10.92 ,$25.82 , N/A ,$25.82 , N/A ,$23.24 ,$23.24 , N/A ,$23.24 , N/A ,$30.03 , N/A , N/A , N/A ,$29.25 ,$27.69 ,$27.69 , N/A ,$27.69 ,$33.15 ,$33.15 ,$33.15 , N/A , N/A ,$33.15 , N/A ,$39.00 ,$21.88 , N/A ,$16.15 , N/A , N/A , N/A ,$33.15 , N/A ,$23.24 ,$10.92 ,$35.10 , N/A ,$33.15 ,$32.96 ,$32.96 , N/A ,$25.35 ST. JOSEPH'S HOSPITAL - BREESE,27202916,N/A,HC TUBING DISP CO2,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 , N/A ,$17.55 ,$16.12 , N/A ,$7.56 ,$17.87 , N/A ,$17.87 , N/A ,$16.09 ,$16.09 , N/A ,$16.09 , N/A ,$20.79 , N/A , N/A , N/A ,$20.25 ,$19.17 ,$19.17 , N/A ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A , N/A ,$22.95 , N/A ,$27.00 ,$15.15 , N/A ,$11.18 , N/A , N/A , N/A ,$22.95 , N/A ,$16.09 ,$7.56 ,$24.30 , N/A ,$22.95 ,$22.82 ,$22.82 , N/A ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,27203051,N/A,HC NASAL PACKING,272,1 ,$49.11 ,$35.36 ,$13.75 ,$49.11 , N/A ,$31.92 ,$29.32 , N/A ,$13.75 ,$32.51 , N/A ,$32.51 , N/A ,$29.27 ,$29.27 , N/A ,$29.27 , N/A ,$37.81 , N/A , N/A , N/A ,$36.83 ,$34.87 ,$34.87 , N/A ,$34.87 ,$41.74 ,$41.74 ,$41.74 , N/A , N/A ,$41.74 , N/A ,$49.11 ,$27.55 , N/A ,$20.33 , N/A , N/A , N/A ,$41.74 , N/A ,$29.27 ,$13.75 ,$44.20 , N/A ,$41.74 ,$41.50 ,$41.50 , N/A ,$31.92 ST. JOSEPH'S HOSPITAL - BREESE,27203100,N/A,HC SET QUICK PRESSURE MONITOR,272,1 ,$339.00 ,$244.08 ,$94.92 ,$339.00 , N/A ,$220.35 ,$202.38 , N/A ,$94.92 ,$224.42 , N/A ,$224.42 , N/A ,$202.04 ,$202.04 , N/A ,$202.04 , N/A ,$261.03 , N/A , N/A , N/A ,$254.25 ,$240.69 ,$240.69 , N/A ,$240.69 ,$288.15 ,$288.15 ,$288.15 , N/A , N/A ,$288.15 , N/A ,$339.00 ,$190.18 , N/A ,$140.35 , N/A , N/A , N/A ,$288.15 , N/A ,$202.04 ,$94.92 ,$305.10 , N/A ,$288.15 ,$286.46 ,$286.46 , N/A ,$220.35 ST. JOSEPH'S HOSPITAL - BREESE,27203239,N/A,HC PUTTY,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27203255,N/A,HC CPM PADS,272,1 ,$66.00 ,$47.52 ,$18.48 ,$66.00 , N/A ,$42.90 ,$39.40 , N/A ,$18.48 ,$43.69 , N/A ,$43.69 , N/A ,$39.34 ,$39.34 , N/A ,$39.34 , N/A ,$50.82 , N/A , N/A , N/A ,$49.50 ,$46.86 ,$46.86 , N/A ,$46.86 ,$56.10 ,$56.10 ,$56.10 , N/A , N/A ,$56.10 , N/A ,$66.00 ,$37.03 , N/A ,$27.32 , N/A , N/A , N/A ,$56.10 , N/A ,$39.34 ,$18.48 ,$59.40 , N/A ,$56.10 ,$55.77 ,$55.77 , N/A ,$42.90 ST. JOSEPH'S HOSPITAL - BREESE,27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$63.00 ,$45.36 ,$17.64 ,$63.00 , N/A ,$40.95 ,$37.61 , N/A ,$17.64 ,$41.71 , N/A ,$41.71 , N/A ,$37.55 ,$37.55 , N/A ,$37.55 , N/A ,$48.51 , N/A , N/A , N/A ,$47.25 ,$44.73 ,$44.73 , N/A ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A , N/A ,$53.55 , N/A ,$63.00 ,$35.34 , N/A ,$26.08 , N/A , N/A , N/A ,$53.55 , N/A ,$37.55 ,$17.64 ,$56.70 , N/A ,$53.55 ,$53.24 ,$53.24 , N/A ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,27203509,N/A,HC CATHETER FOLEY 3W,272,1 ,$46.00 ,$33.12 ,$12.88 ,$46.00 , N/A ,$29.90 ,$27.46 , N/A ,$12.88 ,$30.45 , N/A ,$30.45 , N/A ,$27.42 ,$27.42 , N/A ,$27.42 , N/A ,$35.42 , N/A , N/A , N/A ,$34.50 ,$32.66 ,$32.66 , N/A ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A , N/A ,$39.10 , N/A ,$46.00 ,$25.81 , N/A ,$19.04 , N/A , N/A , N/A ,$39.10 , N/A ,$27.42 ,$12.88 ,$41.40 , N/A ,$39.10 ,$38.87 ,$38.87 , N/A ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,27203511,N/A,HC BAG LEG URINARY,272,1 ,$14.00 ,$10.08 ,$3.92 ,$14.00 , N/A ,$9.10 ,$8.36 , N/A ,$3.92 ,$9.27 , N/A ,$9.27 , N/A ,$8.34 ,$8.34 , N/A ,$8.34 , N/A ,$10.78 , N/A , N/A , N/A ,$10.50 ,$9.94 ,$9.94 , N/A ,$9.94 ,$11.90 ,$11.90 ,$11.90 , N/A , N/A ,$11.90 , N/A ,$14.00 ,$7.85 , N/A ,$5.80 , N/A , N/A , N/A ,$11.90 , N/A ,$8.34 ,$3.92 ,$12.60 , N/A ,$11.90 ,$11.83 ,$11.83 , N/A ,$9.10 ST. JOSEPH'S HOSPITAL - BREESE,27203518,A6222,HC DRESSING VASELINE GAUZE,623,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A , N/A , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27203521,A6234,HC DRESSING DUODERM <16 SQ CM,272,1 ,$40.00 ,$28.80 ,$11.20 ,$40.00 , N/A ,$26.00 ,$23.88 , N/A ,$11.20 ,$26.48 , N/A ,$26.48 , N/A ,$23.84 ,$23.84 , N/A ,$23.84 , N/A , N/A , N/A , N/A , N/A ,$30.00 ,$28.40 ,$28.40 , N/A ,$28.40 ,$34.00 ,$34.00 ,$34.00 , N/A , N/A ,$34.00 , N/A ,$40.00 ,$22.44 , N/A ,$16.56 , N/A , N/A , N/A ,$34.00 , N/A ,$23.84 ,$11.20 ,$36.00 , N/A ,$34.00 ,$33.80 ,$33.80 , N/A ,$26.00 ST. JOSEPH'S HOSPITAL - BREESE,27203527,A6402,HC DRESSING GAUZE,623,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A , N/A , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$4.23 ,$4.23 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,27203531,C1751,HC CATHETER CV TRIPLE-LUMEN,272,1 ,$255.00 ,$183.60 ,$71.40 ,$255.00 , N/A ,$165.75 ,$152.24 , N/A ,$71.40 ,$168.81 , N/A ,$168.81 , N/A ,$151.98 ,$151.98 , N/A ,$151.98 , N/A , N/A , N/A , N/A , N/A ,$191.25 ,$181.05 ,$181.05 , N/A ,$181.05 ,$216.75 ,$216.75 ,$216.75 , N/A , N/A ,$216.75 , N/A ,$255.00 ,$143.06 , N/A ,$105.57 , N/A , N/A , N/A ,$216.75 , N/A ,$151.98 ,$71.40 ,$229.50 , N/A ,$216.75 ,$215.48 ,$215.48 , N/A ,$165.75 ST. JOSEPH'S HOSPITAL - BREESE,27203532,C1751,HC CATHETER CV DUAL-LUMEN,272,1 ,$645.00 ,$464.40 ,$180.60 ,$645.00 , N/A ,$419.25 ,$385.07 , N/A ,$180.60 ,$426.99 , N/A ,$426.99 , N/A ,$384.42 ,$384.42 , N/A ,$384.42 , N/A , N/A , N/A , N/A , N/A ,$483.75 ,$457.95 ,$457.95 , N/A ,$457.95 ,$548.25 ,$548.25 ,$548.25 , N/A , N/A ,$548.25 , N/A ,$645.00 ,$361.85 , N/A ,$267.03 , N/A , N/A , N/A ,$548.25 , N/A ,$384.42 ,$180.60 ,$580.50 , N/A ,$548.25 ,$545.03 ,$545.03 , N/A ,$419.25 ST. JOSEPH'S HOSPITAL - BREESE,27203533,C1751,HC CATHETER CV SINGLE-LUMEN,272,1 ,$397.00 ,$285.84 ,$111.16 ,$397.00 , N/A ,$258.05 ,$237.01 , N/A ,$111.16 ,$262.81 , N/A ,$262.81 , N/A ,$236.61 ,$236.61 , N/A ,$236.61 , N/A , N/A , N/A , N/A , N/A ,$297.75 ,$281.87 ,$281.87 , N/A ,$281.87 ,$337.45 ,$337.45 ,$337.45 , N/A , N/A ,$337.45 , N/A ,$397.00 ,$222.72 , N/A ,$164.36 , N/A , N/A , N/A ,$337.45 , N/A ,$236.61 ,$111.16 ,$357.30 , N/A ,$337.45 ,$335.47 ,$335.47 , N/A ,$258.05 ST. JOSEPH'S HOSPITAL - BREESE,27203535,N/A,HC TRAY LUMBAR PUNCTURE,272,1 ,$66.00 ,$47.52 ,$18.48 ,$66.00 , N/A ,$42.90 ,$39.40 , N/A ,$18.48 ,$43.69 , N/A ,$43.69 , N/A ,$39.34 ,$39.34 , N/A ,$39.34 , N/A ,$50.82 , N/A , N/A , N/A ,$49.50 ,$46.86 ,$46.86 , N/A ,$46.86 ,$56.10 ,$56.10 ,$56.10 , N/A , N/A ,$56.10 , N/A ,$66.00 ,$37.03 , N/A ,$27.32 , N/A , N/A , N/A ,$56.10 , N/A ,$39.34 ,$18.48 ,$59.40 , N/A ,$56.10 ,$55.77 ,$55.77 , N/A ,$42.90 ST. JOSEPH'S HOSPITAL - BREESE,27203537,N/A,HC CATHETER RADIAL ARTERY,272,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 , N/A ,$21.45 ,$19.70 , N/A ,$9.24 ,$21.85 , N/A ,$21.85 , N/A ,$19.67 ,$19.67 , N/A ,$19.67 , N/A ,$25.41 , N/A , N/A , N/A ,$24.75 ,$23.43 ,$23.43 , N/A ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A , N/A ,$28.05 , N/A ,$33.00 ,$18.51 , N/A ,$13.66 , N/A , N/A , N/A ,$28.05 , N/A ,$19.67 ,$9.24 ,$29.70 , N/A ,$28.05 ,$27.89 ,$27.89 , N/A ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,27203539,N/A,HC TRANSDUCER,272,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 , N/A ,$21.45 ,$19.70 , N/A ,$9.24 ,$21.85 , N/A ,$21.85 , N/A ,$19.67 ,$19.67 , N/A ,$19.67 , N/A ,$25.41 , N/A , N/A , N/A ,$24.75 ,$23.43 ,$23.43 , N/A ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A , N/A ,$28.05 , N/A ,$33.00 ,$18.51 , N/A ,$13.66 , N/A , N/A , N/A ,$28.05 , N/A ,$19.67 ,$9.24 ,$29.70 , N/A ,$28.05 ,$27.89 ,$27.89 , N/A ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,27203558,N/A,HC EXTRACTOR,272,1 ,$255.93 ,$184.27 ,$71.66 ,$255.93 , N/A ,$166.35 ,$152.79 , N/A ,$71.66 ,$169.43 , N/A ,$169.43 , N/A ,$152.53 ,$152.53 , N/A ,$152.53 , N/A ,$197.07 , N/A , N/A , N/A ,$191.95 ,$181.71 ,$181.71 , N/A ,$181.71 ,$217.54 ,$217.54 ,$217.54 , N/A , N/A ,$217.54 , N/A ,$255.93 ,$143.58 , N/A ,$105.96 , N/A , N/A , N/A ,$217.54 , N/A ,$152.53 ,$71.66 ,$230.34 , N/A ,$217.54 ,$216.26 ,$216.26 , N/A ,$166.35 ST. JOSEPH'S HOSPITAL - BREESE,27203560,N/A,HC CATHETER IV,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27203562,N/A,HC CATHETER SUCTION,272,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 , N/A ,$10.40 ,$9.55 , N/A ,$4.48 ,$10.59 , N/A ,$10.59 , N/A ,$9.54 ,$9.54 , N/A ,$9.54 , N/A ,$12.32 , N/A , N/A , N/A ,$12.00 ,$11.36 ,$11.36 , N/A ,$11.36 ,$13.60 ,$13.60 ,$13.60 , N/A , N/A ,$13.60 , N/A ,$16.00 ,$8.98 , N/A ,$6.62 , N/A , N/A , N/A ,$13.60 , N/A ,$9.54 ,$4.48 ,$14.40 , N/A ,$13.60 ,$13.52 ,$13.52 , N/A ,$10.40 ST. JOSEPH'S HOSPITAL - BREESE,27203564,N/A,HC CATHETER UMBILICAL ARTERY,272,1 ,$60.00 ,$43.20 ,$16.80 ,$60.00 , N/A ,$39.00 ,$35.82 , N/A ,$16.80 ,$39.72 , N/A ,$39.72 , N/A ,$35.76 ,$35.76 , N/A ,$35.76 , N/A ,$46.20 , N/A , N/A , N/A ,$45.00 ,$42.60 ,$42.60 , N/A ,$42.60 ,$51.00 ,$51.00 ,$51.00 , N/A , N/A ,$51.00 , N/A ,$60.00 ,$33.66 , N/A ,$24.84 , N/A , N/A , N/A ,$51.00 , N/A ,$35.76 ,$16.80 ,$54.00 , N/A ,$51.00 ,$50.70 ,$50.70 , N/A ,$39.00 ST. JOSEPH'S HOSPITAL - BREESE,27203572,N/A,HC DRESSING BIOPATCH,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,27203575,N/A,HC DRESSING TELFA,272,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,27203576,N/A,HC DRESSING V.A.C.,272,1 ,$123.00 ,$88.56 ,$34.44 ,$123.00 , N/A ,$79.95 ,$73.43 , N/A ,$34.44 ,$81.43 , N/A ,$81.43 , N/A ,$73.31 ,$73.31 , N/A ,$73.31 , N/A ,$94.71 , N/A , N/A , N/A ,$92.25 ,$87.33 ,$87.33 , N/A ,$87.33 ,$104.55 ,$104.55 ,$104.55 , N/A , N/A ,$104.55 , N/A ,$123.00 ,$69.00 , N/A ,$50.92 , N/A , N/A , N/A ,$104.55 , N/A ,$73.31 ,$34.44 ,$110.70 , N/A ,$104.55 ,$103.94 ,$103.94 , N/A ,$79.95 ST. JOSEPH'S HOSPITAL - BREESE,27203579,N/A,HC KIT CATHETER FEMALE/INFANT/CHILD,272,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 , N/A ,$13.65 ,$12.54 , N/A ,$5.88 ,$13.90 , N/A ,$13.90 , N/A ,$12.52 ,$12.52 , N/A ,$12.52 , N/A ,$16.17 , N/A , N/A , N/A ,$15.75 ,$14.91 ,$14.91 , N/A ,$14.91 ,$17.85 ,$17.85 ,$17.85 , N/A , N/A ,$17.85 , N/A ,$21.00 ,$11.78 , N/A ,$8.69 , N/A , N/A , N/A ,$17.85 , N/A ,$12.52 ,$5.88 ,$18.90 , N/A ,$17.85 ,$17.75 ,$17.75 , N/A ,$13.65 ST. JOSEPH'S HOSPITAL - BREESE,27203586,N/A,HC SALEM SUMP,272,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27203589,N/A,HC STYLET INTUBATING,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,27203590,N/A,HC SYRINGE PUMP SYRINGE,272,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,27203597,N/A,HC TUBING ANY,272,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27203614,N/A,HC NEEDLE LOCALIZATION,272,1 ,$83.34 ,$60.00 ,$23.34 ,$83.34 , N/A ,$54.17 ,$49.75 , N/A ,$23.34 ,$55.17 , N/A ,$55.17 , N/A ,$49.67 ,$49.67 , N/A ,$49.67 , N/A ,$64.17 , N/A , N/A , N/A ,$62.51 ,$59.17 ,$59.17 , N/A ,$59.17 ,$70.84 ,$70.84 ,$70.84 , N/A , N/A ,$70.84 , N/A ,$83.34 ,$46.75 , N/A ,$34.50 , N/A , N/A , N/A ,$70.84 , N/A ,$49.67 ,$23.34 ,$75.01 , N/A ,$70.84 ,$70.42 ,$70.42 , N/A ,$54.17 ST. JOSEPH'S HOSPITAL - BREESE,27203689,N/A,HC COVER PROBE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27203719,C1729,HC CATHETER CENTESIS ONE STEP,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 , N/A ,$25.35 ,$23.28 , N/A ,$10.92 ,$25.82 , N/A ,$25.82 , N/A ,$23.24 ,$23.24 , N/A ,$23.24 , N/A , N/A , N/A , N/A , N/A ,$29.25 ,$27.69 ,$27.69 , N/A ,$27.69 ,$33.15 ,$33.15 ,$33.15 , N/A , N/A ,$33.15 , N/A ,$39.00 ,$21.88 , N/A ,$16.15 , N/A , N/A , N/A ,$33.15 , N/A ,$23.24 ,$10.92 ,$35.10 , N/A ,$33.15 ,$32.96 ,$32.96 , N/A ,$25.35 ST. JOSEPH'S HOSPITAL - BREESE,27203844,N/A,HC TRAY CHEST TUBE,272,1 ,$84.00 ,$60.48 ,$23.52 ,$84.00 , N/A ,$54.60 ,$50.15 , N/A ,$23.52 ,$55.61 , N/A ,$55.61 , N/A ,$50.06 ,$50.06 , N/A ,$50.06 , N/A ,$64.68 , N/A , N/A , N/A ,$63.00 ,$59.64 ,$59.64 , N/A ,$59.64 ,$71.40 ,$71.40 ,$71.40 , N/A , N/A ,$71.40 , N/A ,$84.00 ,$47.12 , N/A ,$34.78 , N/A , N/A , N/A ,$71.40 , N/A ,$50.06 ,$23.52 ,$75.60 , N/A ,$71.40 ,$70.98 ,$70.98 , N/A ,$54.60 ST. JOSEPH'S HOSPITAL - BREESE,27203846,N/A,HC SYSTEM VACUUM ASSIST MUSHROOM CAP,272,1 ,$99.00 ,$71.28 ,$27.72 ,$99.00 , N/A ,$64.35 ,$59.10 , N/A ,$27.72 ,$65.54 , N/A ,$65.54 , N/A ,$59.00 ,$59.00 , N/A ,$59.00 , N/A ,$76.23 , N/A , N/A , N/A ,$74.25 ,$70.29 ,$70.29 , N/A ,$70.29 ,$84.15 ,$84.15 ,$84.15 , N/A , N/A ,$84.15 , N/A ,$99.00 ,$55.54 , N/A ,$40.99 , N/A , N/A , N/A ,$84.15 , N/A ,$59.00 ,$27.72 ,$89.10 , N/A ,$84.15 ,$83.66 ,$83.66 , N/A ,$64.35 ST. JOSEPH'S HOSPITAL - BREESE,27203847,N/A,HC NEEDLE INTRAOSSEOUS,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27203849,N/A,HC DRESSING WOUND PICO,272,1 ,$714.00 ,$514.08 ,$199.92 ,$714.00 , N/A ,$464.10 ,$426.26 , N/A ,$199.92 ,$472.67 , N/A ,$472.67 , N/A ,$425.54 ,$425.54 , N/A ,$425.54 , N/A ,$549.78 , N/A , N/A , N/A ,$535.50 ,$506.94 ,$506.94 , N/A ,$506.94 ,$606.90 ,$606.90 ,$606.90 , N/A , N/A ,$606.90 , N/A ,$714.00 ,$400.55 , N/A ,$295.60 , N/A , N/A , N/A ,$606.90 , N/A ,$425.54 ,$199.92 ,$642.60 , N/A ,$606.90 ,$603.33 ,$603.33 , N/A ,$464.10 ST. JOSEPH'S HOSPITAL - BREESE,27203871,N/A,HC NASAL RHINO ROCKET,272,1 ,$132.12 ,$95.13 ,$36.99 ,$132.12 , N/A ,$85.88 ,$78.88 , N/A ,$36.99 ,$87.46 , N/A ,$87.46 , N/A ,$78.74 ,$78.74 , N/A ,$78.74 , N/A ,$101.73 , N/A , N/A , N/A ,$99.09 ,$93.81 ,$93.81 , N/A ,$93.81 ,$112.30 ,$112.30 ,$112.30 , N/A , N/A ,$112.30 , N/A ,$132.12 ,$74.12 , N/A ,$54.70 , N/A , N/A , N/A ,$112.30 , N/A ,$78.74 ,$36.99 ,$118.91 , N/A ,$112.30 ,$111.64 ,$111.64 , N/A ,$85.88 ST. JOSEPH'S HOSPITAL - BREESE,27203875,N/A,HC SYSTEM DRESSING WOUND VAC THERAPY,272,1 ,"$1,521.00 ","$1,095.12 ",$425.88 ,"$1,521.00 ", N/A ,$988.65 ,$908.04 , N/A ,$425.88 ,"$1,006.90 ", N/A ,"$1,006.90 ", N/A ,$906.52 ,$906.52 , N/A ,$906.52 , N/A ,"$1,171.17 ", N/A , N/A , N/A ,"$1,140.75 ","$1,079.91 ","$1,079.91 ", N/A ,"$1,079.91 ","$1,292.85 ","$1,292.85 ","$1,292.85 ", N/A , N/A ,"$1,292.85 ", N/A ,"$1,521.00 ",$853.28 , N/A ,$629.69 , N/A , N/A , N/A ,"$1,292.85 ", N/A ,$906.52 ,$425.88 ,"$1,368.90 ", N/A ,"$1,292.85 ","$1,285.25 ","$1,285.25 ", N/A ,$988.65 ST. JOSEPH'S HOSPITAL - BREESE,27204583,N/A,HC LARYNGOSCOPE GLIDESCOPE,272,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 , N/A ,$78.00 ,$71.64 , N/A ,$33.60 ,$79.44 , N/A ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A , N/A , N/A ,$90.00 ,$85.20 ,$85.20 , N/A ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A , N/A ,$102.00 , N/A ,$120.00 ,$67.32 , N/A ,$49.68 , N/A , N/A , N/A ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 , N/A ,$102.00 ,$101.40 ,$101.40 , N/A ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,27204603,N/A,HC TRAY UMBILICAL CATH,272,1 ,$151.00 ,$108.72 ,$42.28 ,$151.00 , N/A ,$98.15 ,$90.15 , N/A ,$42.28 ,$99.96 , N/A ,$99.96 , N/A ,$90.00 ,$90.00 , N/A ,$90.00 , N/A ,$116.27 , N/A , N/A , N/A ,$113.25 ,$107.21 ,$107.21 , N/A ,$107.21 ,$128.35 ,$128.35 ,$128.35 , N/A , N/A ,$128.35 , N/A ,$151.00 ,$84.71 , N/A ,$62.51 , N/A , N/A , N/A ,$128.35 , N/A ,$90.00 ,$42.28 ,$135.90 , N/A ,$128.35 ,$127.60 ,$127.60 , N/A ,$98.15 ST. JOSEPH'S HOSPITAL - BREESE,27204607,N/A,HC TUBE NASOGASTRIC,272,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,27204622,N/A,HC MARKER BIOPSY SITE,272,1 ,$182.00 ,$131.04 ,$50.96 ,$182.00 , N/A ,$118.30 ,$108.65 , N/A ,$50.96 ,$120.48 , N/A ,$120.48 , N/A ,$108.47 ,$108.47 , N/A ,$108.47 , N/A ,$140.14 , N/A , N/A , N/A ,$136.50 ,$129.22 ,$129.22 , N/A ,$129.22 ,$154.70 ,$154.70 ,$154.70 , N/A , N/A ,$154.70 , N/A ,$182.00 ,$102.10 , N/A ,$75.35 , N/A , N/A , N/A ,$154.70 , N/A ,$108.47 ,$50.96 ,$163.80 , N/A ,$154.70 ,$153.79 ,$153.79 , N/A ,$118.30 ST. JOSEPH'S HOSPITAL - BREESE,27204623,N/A,HC NEEDLE GUIDE,272,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 , N/A ,$14.30 ,$13.13 , N/A ,$6.16 ,$14.56 , N/A ,$14.56 , N/A ,$13.11 ,$13.11 , N/A ,$13.11 , N/A ,$16.94 , N/A , N/A , N/A ,$16.50 ,$15.62 ,$15.62 , N/A ,$15.62 ,$18.70 ,$18.70 ,$18.70 , N/A , N/A ,$18.70 , N/A ,$22.00 ,$12.34 , N/A ,$9.11 , N/A , N/A , N/A ,$18.70 , N/A ,$13.11 ,$6.16 ,$19.80 , N/A ,$18.70 ,$18.59 ,$18.59 , N/A ,$14.30 ST. JOSEPH'S HOSPITAL - BREESE,27204624,N/A,HC DEVICE BIOPSY COAXIAL ADJUSTABLE,272,1 ,$170.22 ,$122.56 ,$47.66 ,$170.22 , N/A ,$110.64 ,$101.62 , N/A ,$47.66 ,$112.69 , N/A ,$112.69 , N/A ,$101.45 ,$101.45 , N/A ,$101.45 , N/A ,$131.07 , N/A , N/A , N/A ,$127.67 ,$120.86 ,$120.86 , N/A ,$120.86 ,$144.69 ,$144.69 ,$144.69 , N/A , N/A ,$144.69 , N/A ,$170.22 ,$95.49 , N/A ,$70.47 , N/A , N/A , N/A ,$144.69 , N/A ,$101.45 ,$47.66 ,$153.20 , N/A ,$144.69 ,$143.84 ,$143.84 , N/A ,$110.64 ST. JOSEPH'S HOSPITAL - BREESE,27204654,N/A,HC BAG RESUSCITATE INFANT,272,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 , N/A ,$21.45 ,$19.70 , N/A ,$9.24 ,$21.85 , N/A ,$21.85 , N/A ,$19.67 ,$19.67 , N/A ,$19.67 , N/A ,$25.41 , N/A , N/A , N/A ,$24.75 ,$23.43 ,$23.43 , N/A ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A , N/A ,$28.05 , N/A ,$33.00 ,$18.51 , N/A ,$13.66 , N/A , N/A , N/A ,$28.05 , N/A ,$19.67 ,$9.24 ,$29.70 , N/A ,$28.05 ,$27.89 ,$27.89 , N/A ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,27204656,N/A,HC BAG RESUSCITOR,272,1 ,$63.00 ,$45.36 ,$17.64 ,$63.00 , N/A ,$40.95 ,$37.61 , N/A ,$17.64 ,$41.71 , N/A ,$41.71 , N/A ,$37.55 ,$37.55 , N/A ,$37.55 , N/A ,$48.51 , N/A , N/A , N/A ,$47.25 ,$44.73 ,$44.73 , N/A ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A , N/A ,$53.55 , N/A ,$63.00 ,$35.34 , N/A ,$26.08 , N/A , N/A , N/A ,$53.55 , N/A ,$37.55 ,$17.64 ,$56.70 , N/A ,$53.55 ,$53.24 ,$53.24 , N/A ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,27204662,N/A,HC CATH IV ANGIOCATH S1,272,1 ,$36.45 ,$26.24 ,$10.21 ,$36.45 , N/A ,$23.69 ,$21.76 , N/A ,$10.21 ,$24.13 , N/A ,$24.13 , N/A ,$21.72 ,$21.72 , N/A ,$21.72 , N/A ,$28.07 , N/A , N/A , N/A ,$27.34 ,$25.88 ,$25.88 , N/A ,$25.88 ,$30.98 ,$30.98 ,$30.98 , N/A , N/A ,$30.98 , N/A ,$36.45 ,$20.45 , N/A ,$15.09 , N/A , N/A , N/A ,$30.98 , N/A ,$21.72 ,$10.21 ,$32.81 , N/A ,$30.98 ,$30.80 ,$30.80 , N/A ,$23.69 ST. JOSEPH'S HOSPITAL - BREESE,27204714,N/A,HC SUCTION YANKAUER,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27204755,N/A,HC DEVICE BREAST BIOPSY,272,1 ,$587.00 ,$422.64 ,$164.36 ,$587.00 , N/A ,$381.55 ,$350.44 , N/A ,$164.36 ,$388.59 , N/A ,$388.59 , N/A ,$349.85 ,$349.85 , N/A ,$349.85 , N/A ,$451.99 , N/A , N/A , N/A ,$440.25 ,$416.77 ,$416.77 , N/A ,$416.77 ,$498.95 ,$498.95 ,$498.95 , N/A , N/A ,$498.95 , N/A ,$587.00 ,$329.31 , N/A ,$243.02 , N/A , N/A , N/A ,$498.95 , N/A ,$349.85 ,$164.36 ,$528.30 , N/A ,$498.95 ,$496.02 ,$496.02 , N/A ,$381.55 ST. JOSEPH'S HOSPITAL - BREESE,27204760,N/A,HC BLANKET BAIR HUGGER,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 , N/A ,$25.35 ,$23.28 , N/A ,$10.92 ,$25.82 , N/A ,$25.82 , N/A ,$23.24 ,$23.24 , N/A ,$23.24 , N/A ,$30.03 , N/A , N/A , N/A ,$29.25 ,$27.69 ,$27.69 , N/A ,$27.69 ,$33.15 ,$33.15 ,$33.15 , N/A , N/A ,$33.15 , N/A ,$39.00 ,$21.88 , N/A ,$16.15 , N/A , N/A , N/A ,$33.15 , N/A ,$23.24 ,$10.92 ,$35.10 , N/A ,$33.15 ,$32.96 ,$32.96 , N/A ,$25.35 ST. JOSEPH'S HOSPITAL - BREESE,27204771,N/A,HC BLADE LARYNGOSCOPE,272,1 ,$36.00 ,$25.92 ,$10.08 ,$36.00 , N/A ,$23.40 ,$21.49 , N/A ,$10.08 ,$23.83 , N/A ,$23.83 , N/A ,$21.46 ,$21.46 , N/A ,$21.46 , N/A ,$27.72 , N/A , N/A , N/A ,$27.00 ,$25.56 ,$25.56 , N/A ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A , N/A ,$30.60 , N/A ,$36.00 ,$20.20 , N/A ,$14.90 , N/A , N/A , N/A ,$30.60 , N/A ,$21.46 ,$10.08 ,$32.40 , N/A ,$30.60 ,$30.42 ,$30.42 , N/A ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,27204772,N/A,HC BLADE LARYNGEAL,272,1 ,$171.60 ,$123.55 ,$48.05 ,$171.60 , N/A ,$111.54 ,$102.45 , N/A ,$48.05 ,$113.60 , N/A ,$113.60 , N/A ,$102.27 ,$102.27 , N/A ,$102.27 , N/A ,$132.13 , N/A , N/A , N/A ,$128.70 ,$121.84 ,$121.84 , N/A ,$121.84 ,$145.86 ,$145.86 ,$145.86 , N/A , N/A ,$145.86 , N/A ,$171.60 ,$96.27 , N/A ,$71.04 , N/A , N/A , N/A ,$145.86 , N/A ,$102.27 ,$48.05 ,$154.44 , N/A ,$145.86 ,$145.00 ,$145.00 , N/A ,$111.54 ST. JOSEPH'S HOSPITAL - BREESE,27204805,N/A,HC CHEST TUBE THAL-QUICK,272,1 ,$542.00 ,$390.24 ,$151.76 ,$542.00 , N/A ,$352.30 ,$323.57 , N/A ,$151.76 ,$358.80 , N/A ,$358.80 , N/A ,$323.03 ,$323.03 , N/A ,$323.03 , N/A ,$417.34 , N/A , N/A , N/A ,$406.50 ,$384.82 ,$384.82 , N/A ,$384.82 ,$460.70 ,$460.70 ,$460.70 , N/A , N/A ,$460.70 , N/A ,$542.00 ,$304.06 , N/A ,$224.39 , N/A , N/A , N/A ,$460.70 , N/A ,$323.03 ,$151.76 ,$487.80 , N/A ,$460.70 ,$457.99 ,$457.99 , N/A ,$352.30 ST. JOSEPH'S HOSPITAL - BREESE,27204821,N/A,HC CONNECTOR STRAIGHT,272,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$3.85 , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$4.23 ,$4.23 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,27204860,N/A,HC HEMOSTAT MATRIX,272,1 ,$952.41 ,$685.74 ,$266.67 ,$952.41 , N/A ,$619.07 ,$568.59 , N/A ,$266.67 ,$630.50 , N/A ,$630.50 , N/A ,$567.64 ,$567.64 , N/A ,$567.64 , N/A ,$733.36 , N/A , N/A , N/A ,$714.31 ,$676.21 ,$676.21 , N/A ,$676.21 ,$809.55 ,$809.55 ,$809.55 , N/A , N/A ,$809.55 , N/A ,$952.41 ,$534.30 , N/A ,$394.30 , N/A , N/A , N/A ,$809.55 , N/A ,$567.64 ,$266.67 ,$857.17 , N/A ,$809.55 ,$804.79 ,$804.79 , N/A ,$619.07 ST. JOSEPH'S HOSPITAL - BREESE,27204865,N/A,HC INTRODUCER/SHEATH,272,1 ,$42.00 ,$30.24 ,$11.76 ,$42.00 , N/A ,$27.30 ,$25.07 , N/A ,$11.76 ,$27.80 , N/A ,$27.80 , N/A ,$25.03 ,$25.03 , N/A ,$25.03 , N/A ,$32.34 , N/A , N/A , N/A ,$31.50 ,$29.82 ,$29.82 , N/A ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A , N/A ,$35.70 , N/A ,$42.00 ,$23.56 , N/A ,$17.39 , N/A , N/A , N/A ,$35.70 , N/A ,$25.03 ,$11.76 ,$37.80 , N/A ,$35.70 ,$35.49 ,$35.49 , N/A ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,27204869,N/A,HC IV ANGIOCATH,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,27204887,N/A,HC KIT CATHETER FEMALE,272,1 ,$19.20 ,$13.82 ,$5.38 ,$19.20 , N/A ,$12.48 ,$11.46 , N/A ,$5.38 ,$12.71 , N/A ,$12.71 , N/A ,$11.44 ,$11.44 , N/A ,$11.44 , N/A ,$14.78 , N/A , N/A , N/A ,$14.40 ,$13.63 ,$13.63 , N/A ,$13.63 ,$16.32 ,$16.32 ,$16.32 , N/A , N/A ,$16.32 , N/A ,$19.20 ,$10.77 , N/A ,$7.95 , N/A , N/A , N/A ,$16.32 , N/A ,$11.44 ,$5.38 ,$17.28 , N/A ,$16.32 ,$16.22 ,$16.22 , N/A ,$12.48 ST. JOSEPH'S HOSPITAL - BREESE,27204894,N/A,HC KIT CHEST TUBE INSERTION,272,1 ,$359.00 ,$258.48 ,$100.52 ,$359.00 , N/A ,$233.35 ,$214.32 , N/A ,$100.52 ,$237.66 , N/A ,$237.66 , N/A ,$213.96 ,$213.96 , N/A ,$213.96 , N/A ,$276.43 , N/A , N/A , N/A ,$269.25 ,$254.89 ,$254.89 , N/A ,$254.89 ,$305.15 ,$305.15 ,$305.15 , N/A , N/A ,$305.15 , N/A ,$359.00 ,$201.40 , N/A ,$148.63 , N/A , N/A , N/A ,$305.15 , N/A ,$213.96 ,$100.52 ,$323.10 , N/A ,$305.15 ,$303.36 ,$303.36 , N/A ,$233.35 ST. JOSEPH'S HOSPITAL - BREESE,27204936,N/A,HC NEEDLE NERVE BLOCK ECHOGENIC,272,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 , N/A ,$21.45 ,$19.70 , N/A ,$9.24 ,$21.85 , N/A ,$21.85 , N/A ,$19.67 ,$19.67 , N/A ,$19.67 , N/A ,$25.41 , N/A , N/A , N/A ,$24.75 ,$23.43 ,$23.43 , N/A ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A , N/A ,$28.05 , N/A ,$33.00 ,$18.51 , N/A ,$13.66 , N/A , N/A , N/A ,$28.05 , N/A ,$19.67 ,$9.24 ,$29.70 , N/A ,$28.05 ,$27.89 ,$27.89 , N/A ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,27204937,N/A,HC NEEDLE NERVE BLOCK STIMULATING,272,1 ,$36.00 ,$25.92 ,$10.08 ,$36.00 , N/A ,$23.40 ,$21.49 , N/A ,$10.08 ,$23.83 , N/A ,$23.83 , N/A ,$21.46 ,$21.46 , N/A ,$21.46 , N/A ,$27.72 , N/A , N/A , N/A ,$27.00 ,$25.56 ,$25.56 , N/A ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A , N/A ,$30.60 , N/A ,$36.00 ,$20.20 , N/A ,$14.90 , N/A , N/A , N/A ,$30.60 , N/A ,$21.46 ,$10.08 ,$32.40 , N/A ,$30.60 ,$30.42 ,$30.42 , N/A ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,27204941,N/A,HC NEEDLE EPIDURAL,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.21 ,$15.21 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,27204942,C1819,HC NEEDLE BIOPSY BREAST,272,1 ,$587.00 ,$422.64 ,$164.36 ,$587.00 , N/A ,$381.55 ,$350.44 , N/A ,$164.36 ,$388.59 , N/A ,$388.59 , N/A ,$349.85 ,$349.85 , N/A ,$349.85 , N/A ,$451.99 , N/A , N/A , N/A ,$440.25 ,$416.77 ,$416.77 , N/A ,$416.77 ,$498.95 ,$498.95 ,$498.95 , N/A , N/A ,$498.95 , N/A ,$587.00 ,$329.31 , N/A ,$243.02 , N/A , N/A , N/A ,$498.95 , N/A ,$349.85 ,$164.36 ,$528.30 , N/A ,$498.95 ,$496.02 ,$496.02 , N/A ,$381.55 ST. JOSEPH'S HOSPITAL - BREESE,27204944,N/A,HC NEEDLE SPINAL WHITACRE,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 , N/A ,$17.55 ,$16.12 , N/A ,$7.56 ,$17.87 , N/A ,$17.87 , N/A ,$16.09 ,$16.09 , N/A ,$16.09 , N/A ,$20.79 , N/A , N/A , N/A ,$20.25 ,$19.17 ,$19.17 , N/A ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A , N/A ,$22.95 , N/A ,$27.00 ,$15.15 , N/A ,$11.18 , N/A , N/A , N/A ,$22.95 , N/A ,$16.09 ,$7.56 ,$24.30 , N/A ,$22.95 ,$22.82 ,$22.82 , N/A ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,27204949,N/A,HC HOLDER ENDOTRACH NEOBAR,272,1 ,$21.78 ,$15.68 ,$6.10 ,$21.78 , N/A ,$14.16 ,$13.00 , N/A ,$6.10 ,$14.42 , N/A ,$14.42 , N/A ,$12.98 ,$12.98 , N/A ,$12.98 , N/A ,$16.77 , N/A , N/A , N/A ,$16.34 ,$15.46 ,$15.46 , N/A ,$15.46 ,$18.51 ,$18.51 ,$18.51 , N/A , N/A ,$18.51 , N/A ,$21.78 ,$12.22 , N/A ,$9.02 , N/A , N/A , N/A ,$18.51 , N/A ,$12.98 ,$6.10 ,$19.60 , N/A ,$18.51 ,$18.40 ,$18.40 , N/A ,$14.16 ST. JOSEPH'S HOSPITAL - BREESE,27204966,N/A,HC OSTOMY POUCH,272,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27204968,N/A,HC OSTOMY PASTE,272,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 , N/A ,$18.20 ,$16.72 , N/A ,$7.84 ,$18.54 , N/A ,$18.54 , N/A ,$16.69 ,$16.69 , N/A ,$16.69 , N/A ,$21.56 , N/A , N/A , N/A ,$21.00 ,$19.88 ,$19.88 , N/A ,$19.88 ,$23.80 ,$23.80 ,$23.80 , N/A , N/A ,$23.80 , N/A ,$28.00 ,$15.71 , N/A ,$11.59 , N/A , N/A , N/A ,$23.80 , N/A ,$16.69 ,$7.84 ,$25.20 , N/A ,$23.80 ,$23.66 ,$23.66 , N/A ,$18.20 ST. JOSEPH'S HOSPITAL - BREESE,27204988,N/A,HC BAG INFUSION PRESSURE,272,1 ,$60.00 ,$43.20 ,$16.80 ,$60.00 , N/A ,$39.00 ,$35.82 , N/A ,$16.80 ,$39.72 , N/A ,$39.72 , N/A ,$35.76 ,$35.76 , N/A ,$35.76 , N/A ,$46.20 , N/A , N/A , N/A ,$45.00 ,$42.60 ,$42.60 , N/A ,$42.60 ,$51.00 ,$51.00 ,$51.00 , N/A , N/A ,$51.00 , N/A ,$60.00 ,$33.66 , N/A ,$24.84 , N/A , N/A , N/A ,$51.00 , N/A ,$35.76 ,$16.80 ,$54.00 , N/A ,$51.00 ,$50.70 ,$50.70 , N/A ,$39.00 ST. JOSEPH'S HOSPITAL - BREESE,27204997,N/A,HC PROTECTOR HEEL ELBOW,272,1 ,$41.73 ,$30.05 ,$11.68 ,$41.73 , N/A ,$27.12 ,$24.91 , N/A ,$11.68 ,$27.63 , N/A ,$27.63 , N/A ,$24.87 ,$24.87 , N/A ,$24.87 , N/A ,$32.13 , N/A , N/A , N/A ,$31.30 ,$29.63 ,$29.63 , N/A ,$29.63 ,$35.47 ,$35.47 ,$35.47 , N/A , N/A ,$35.47 , N/A ,$41.73 ,$23.41 , N/A ,$17.28 , N/A , N/A , N/A ,$35.47 , N/A ,$24.87 ,$11.68 ,$37.56 , N/A ,$35.47 ,$35.26 ,$35.26 , N/A ,$27.12 ST. JOSEPH'S HOSPITAL - BREESE,27204999,N/A,HC SENSOR PULSE OX,272,1 ,$42.00 ,$30.24 ,$11.76 ,$42.00 , N/A ,$27.30 ,$25.07 , N/A ,$11.76 ,$27.80 , N/A ,$27.80 , N/A ,$25.03 ,$25.03 , N/A ,$25.03 , N/A ,$32.34 , N/A , N/A , N/A ,$31.50 ,$29.82 ,$29.82 , N/A ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A , N/A ,$35.70 , N/A ,$42.00 ,$23.56 , N/A ,$17.39 , N/A , N/A , N/A ,$35.70 , N/A ,$25.03 ,$11.76 ,$37.80 , N/A ,$35.70 ,$35.49 ,$35.49 , N/A ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,27205006,N/A,HC RETRACTOR ABDOMINAL T2,272,1 ,$285.00 ,$205.20 ,$79.80 ,$285.00 , N/A ,$185.25 ,$170.15 , N/A ,$79.80 ,$188.67 , N/A ,$188.67 , N/A ,$169.86 ,$169.86 , N/A ,$169.86 , N/A ,$219.45 , N/A , N/A , N/A ,$213.75 ,$202.35 ,$202.35 , N/A ,$202.35 ,$242.25 ,$242.25 ,$242.25 , N/A , N/A ,$242.25 , N/A ,$285.00 ,$159.89 , N/A ,$117.99 , N/A , N/A , N/A ,$242.25 , N/A ,$169.86 ,$79.80 ,$256.50 , N/A ,$242.25 ,$240.83 ,$240.83 , N/A ,$185.25 ST. JOSEPH'S HOSPITAL - BREESE,27205016,N/A,HC SET PRESSURE MONITOR,272,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,27205029,N/A,HC STATLOCK DEVICE FOLEY,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27205046,N/A,HC SYRINGE ATOMIZER MUCOSAL,272,1 ,$26.91 ,$19.38 ,$7.53 ,$26.91 , N/A ,$17.49 ,$16.07 , N/A ,$7.53 ,$17.81 , N/A ,$17.81 , N/A ,$16.04 ,$16.04 , N/A ,$16.04 , N/A ,$20.72 , N/A , N/A , N/A ,$20.18 ,$19.11 ,$19.11 , N/A ,$19.11 ,$22.87 ,$22.87 ,$22.87 , N/A , N/A ,$22.87 , N/A ,$26.91 ,$15.10 , N/A ,$11.14 , N/A , N/A , N/A ,$22.87 , N/A ,$16.04 ,$7.53 ,$24.22 , N/A ,$22.87 ,$22.74 ,$22.74 , N/A ,$17.49 ST. JOSEPH'S HOSPITAL - BREESE,27205060,N/A,HC TRAY PICC LINE,272,1 ,$508.40 ,$366.05 ,$142.35 ,$508.40 , N/A ,$330.46 ,$303.51 , N/A ,$142.35 ,$336.56 , N/A ,$336.56 , N/A ,$303.01 ,$303.01 , N/A ,$303.01 , N/A ,$391.47 , N/A , N/A , N/A ,$381.30 ,$360.96 ,$360.96 , N/A ,$360.96 ,$432.14 ,$432.14 ,$432.14 , N/A , N/A ,$432.14 , N/A ,$508.40 ,$285.21 , N/A ,$210.48 , N/A , N/A , N/A ,$432.14 , N/A ,$303.01 ,$142.35 ,$457.56 , N/A ,$432.14 ,$429.60 ,$429.60 , N/A ,$330.46 ST. JOSEPH'S HOSPITAL - BREESE,27205063,N/A,HC TRAY SUTURE REMOVAL,272,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 , N/A ,$4.55 ,$4.18 , N/A ,$1.96 ,$4.63 , N/A ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A , N/A , N/A ,$5.25 ,$4.97 ,$4.97 , N/A ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A , N/A ,$5.95 , N/A ,$7.00 ,$3.93 , N/A ,$2.90 , N/A , N/A , N/A ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 , N/A ,$5.95 ,$5.92 ,$5.92 , N/A ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,27205074,N/A,HC TUBE TRACH,272,1 ,$142.00 ,$102.24 ,$39.76 ,$142.00 , N/A ,$92.30 ,$84.77 , N/A ,$39.76 ,$94.00 , N/A ,$94.00 , N/A ,$84.63 ,$84.63 , N/A ,$84.63 , N/A ,$109.34 , N/A , N/A , N/A ,$106.50 ,$100.82 ,$100.82 , N/A ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A , N/A ,$120.70 , N/A ,$142.00 ,$79.66 , N/A ,$58.79 , N/A , N/A , N/A ,$120.70 , N/A ,$84.63 ,$39.76 ,$127.80 , N/A ,$120.70 ,$119.99 ,$119.99 , N/A ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,27205078,N/A,HC TUBE RECTAL,272,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,27205086,N/A,HC CANISTER WOUND VAC,272,1 ,$69.15 ,$49.79 ,$19.36 ,$69.15 , N/A ,$44.95 ,$41.28 , N/A ,$19.36 ,$45.78 , N/A ,$45.78 , N/A ,$41.21 ,$41.21 , N/A ,$41.21 , N/A ,$53.25 , N/A , N/A , N/A ,$51.86 ,$49.10 ,$49.10 , N/A ,$49.10 ,$58.78 ,$58.78 ,$58.78 , N/A , N/A ,$58.78 , N/A ,$69.15 ,$38.79 , N/A ,$28.63 , N/A , N/A , N/A ,$58.78 , N/A ,$41.21 ,$19.36 ,$62.24 , N/A ,$58.78 ,$58.43 ,$58.43 , N/A ,$44.95 ST. JOSEPH'S HOSPITAL - BREESE,27205088,N/A,HC KIT DRESSING WOUND VAC INSTILL CASSETTE/TUBE,272,1 ,$140.25 ,$100.98 ,$39.27 ,$140.25 , N/A ,$91.16 ,$83.73 , N/A ,$39.27 ,$92.85 , N/A ,$92.85 , N/A ,$83.59 ,$83.59 , N/A ,$83.59 , N/A ,$107.99 , N/A , N/A , N/A ,$105.19 ,$99.58 ,$99.58 , N/A ,$99.58 ,$119.21 ,$119.21 ,$119.21 , N/A , N/A ,$119.21 , N/A ,$140.25 ,$78.68 , N/A ,$58.06 , N/A , N/A , N/A ,$119.21 , N/A ,$83.59 ,$39.27 ,$126.23 , N/A ,$119.21 ,$118.51 ,$118.51 , N/A ,$91.16 ST. JOSEPH'S HOSPITAL - BREESE,27205091,N/A,HC KIT DRESSING WOUND VAC PREVENA PEEL N PLACE,272,1 ,"$1,158.30 ",$833.98 ,$324.32 ,"$1,158.30 ", N/A ,$752.90 ,$691.51 , N/A ,$324.32 ,$766.79 , N/A ,$766.79 , N/A ,$690.35 ,$690.35 , N/A ,$690.35 , N/A ,$891.89 , N/A , N/A , N/A ,$868.73 ,$822.39 ,$822.39 , N/A ,$822.39 ,$984.56 ,$984.56 ,$984.56 , N/A , N/A ,$984.56 , N/A ,"$1,158.30 ",$649.81 , N/A ,$479.54 , N/A , N/A , N/A ,$984.56 , N/A ,$690.35 ,$324.32 ,"$1,042.47 ", N/A ,$984.56 ,$978.76 ,$978.76 , N/A ,$752.90 ST. JOSEPH'S HOSPITAL - BREESE,27205148,C1751,HC KIT POWER PICC,272,1 ,$798.00 ,$574.56 ,$223.44 ,$798.00 , N/A ,$518.70 ,$476.41 , N/A ,$223.44 ,$528.28 , N/A ,$528.28 , N/A ,$475.61 ,$475.61 , N/A ,$475.61 , N/A , N/A , N/A , N/A , N/A ,$598.50 ,$566.58 ,$566.58 , N/A ,$566.58 ,$678.30 ,$678.30 ,$678.30 , N/A , N/A ,$678.30 , N/A ,$798.00 ,$447.68 , N/A ,$330.37 , N/A , N/A , N/A ,$678.30 , N/A ,$475.61 ,$223.44 ,$718.20 , N/A ,$678.30 ,$674.31 ,$674.31 , N/A ,$518.70 ST. JOSEPH'S HOSPITAL - BREESE,27205182,N/A,HC NEEDLE INTRAOSSEOUS/STABILIZER KIT,272,1 ,$79.00 ,$56.88 ,$22.12 ,$79.00 , N/A ,$51.35 ,$47.16 , N/A ,$22.12 ,$52.30 , N/A ,$52.30 , N/A ,$47.08 ,$47.08 , N/A ,$47.08 , N/A ,$60.83 , N/A , N/A , N/A ,$59.25 ,$56.09 ,$56.09 , N/A ,$56.09 ,$67.15 ,$67.15 ,$67.15 , N/A , N/A ,$67.15 , N/A ,$79.00 ,$44.32 , N/A ,$32.71 , N/A , N/A , N/A ,$67.15 , N/A ,$47.08 ,$22.12 ,$71.10 , N/A ,$67.15 ,$66.76 ,$66.76 , N/A ,$51.35 ST. JOSEPH'S HOSPITAL - BREESE,27205183,N/A,HC MASK AIRWAY DOUBLE ENTRY PORT,272,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,27205253,C1729,HC SYSTEM PLUERIX DRAIN W/CATHETER,272,1 ,"$1,452.00 ","$1,045.44 ",$406.56 ,"$1,452.00 ", N/A ,$943.80 ,$866.84 , N/A ,$406.56 ,$961.22 , N/A ,$961.22 , N/A ,$865.39 ,$865.39 , N/A ,$865.39 , N/A , N/A , N/A , N/A , N/A ,"$1,089.00 ","$1,030.92 ","$1,030.92 ", N/A ,"$1,030.92 ","$1,234.20 ","$1,234.20 ","$1,234.20 ", N/A , N/A ,"$1,234.20 ", N/A ,"$1,452.00 ",$814.57 , N/A ,$601.13 , N/A , N/A , N/A ,"$1,234.20 ", N/A ,$865.39 ,$406.56 ,"$1,306.80 ", N/A ,"$1,234.20 ","$1,226.94 ","$1,226.94 ", N/A ,$943.80 ST. JOSEPH'S HOSPITAL - BREESE,27205262,N/A,HC BRONCHOSCOPE,272,1 ,$810.00 ,$583.20 ,$226.80 ,$810.00 , N/A ,$526.50 ,$483.57 , N/A ,$226.80 ,$536.22 , N/A ,$536.22 , N/A ,$482.76 ,$482.76 , N/A ,$482.76 , N/A ,$623.70 , N/A , N/A , N/A ,$607.50 ,$575.10 ,$575.10 , N/A ,$575.10 ,$688.50 ,$688.50 ,$688.50 , N/A , N/A ,$688.50 , N/A ,$810.00 ,$454.41 , N/A ,$335.34 , N/A , N/A , N/A ,$688.50 , N/A ,$482.76 ,$226.80 ,$729.00 , N/A ,$688.50 ,$684.45 ,$684.45 , N/A ,$526.50 ST. JOSEPH'S HOSPITAL - BREESE,27205283,N/A,HC AIRWAY ORAL NASAL,272,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 , N/A ,$14.30 ,$13.13 , N/A ,$6.16 ,$14.56 , N/A ,$14.56 , N/A ,$13.11 ,$13.11 , N/A ,$13.11 , N/A ,$16.94 , N/A , N/A , N/A ,$16.50 ,$15.62 ,$15.62 , N/A ,$15.62 ,$18.70 ,$18.70 ,$18.70 , N/A , N/A ,$18.70 , N/A ,$22.00 ,$12.34 , N/A ,$9.11 , N/A , N/A , N/A ,$18.70 , N/A ,$13.11 ,$6.16 ,$19.80 , N/A ,$18.70 ,$18.59 ,$18.59 , N/A ,$14.30 ST. JOSEPH'S HOSPITAL - BREESE,27205298,N/A,HC CATHETER FOLEY COUDE,272,1 ,$44.00 ,$31.68 ,$12.32 ,$44.00 , N/A ,$28.60 ,$26.27 , N/A ,$12.32 ,$29.13 , N/A ,$29.13 , N/A ,$26.22 ,$26.22 , N/A ,$26.22 , N/A ,$33.88 , N/A , N/A , N/A ,$33.00 ,$31.24 ,$31.24 , N/A ,$31.24 ,$37.40 ,$37.40 ,$37.40 , N/A , N/A ,$37.40 , N/A ,$44.00 ,$24.68 , N/A ,$18.22 , N/A , N/A , N/A ,$37.40 , N/A ,$26.22 ,$12.32 ,$39.60 , N/A ,$37.40 ,$37.18 ,$37.18 , N/A ,$28.60 ST. JOSEPH'S HOSPITAL - BREESE,27205310,N/A,HC KIT ENEMA,272,1 ,$19.00 ,$13.68 ,$5.32 ,$19.00 , N/A ,$12.35 ,$11.34 , N/A ,$5.32 ,$12.58 , N/A ,$12.58 , N/A ,$11.32 ,$11.32 , N/A ,$11.32 , N/A ,$14.63 , N/A , N/A , N/A ,$14.25 ,$13.49 ,$13.49 , N/A ,$13.49 ,$16.15 ,$16.15 ,$16.15 , N/A , N/A ,$16.15 , N/A ,$19.00 ,$10.66 , N/A ,$7.87 , N/A , N/A , N/A ,$16.15 , N/A ,$11.32 ,$5.32 ,$17.10 , N/A ,$16.15 ,$16.06 ,$16.06 , N/A ,$12.35 ST. JOSEPH'S HOSPITAL - BREESE,27205319,C1819,HC NEEDLE KOPANS LOCAL,272,1 ,$442.44 ,$318.56 ,$123.88 ,$442.44 , N/A ,$287.59 ,$264.14 , N/A ,$123.88 ,$292.90 , N/A ,$292.90 , N/A ,$263.69 ,$263.69 , N/A ,$263.69 , N/A ,$340.68 , N/A , N/A , N/A ,$331.83 ,$314.13 ,$314.13 , N/A ,$314.13 ,$376.07 ,$376.07 ,$376.07 , N/A , N/A ,$376.07 , N/A ,$442.44 ,$248.21 , N/A ,$183.17 , N/A , N/A , N/A ,$376.07 , N/A ,$263.69 ,$123.88 ,$398.20 , N/A ,$376.07 ,$373.86 ,$373.86 , N/A ,$287.59 ST. JOSEPH'S HOSPITAL - BREESE,27205320,N/A,HC NEEDLE PORT-A-CATH,272,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$7.61 ,$7.61 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,27205324,N/A,HC PAD ABDOMNINAL,272,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$5.07 ,$5.07 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,27205326,N/A,HC SENSOR INFANT ADHESIVE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27205332,N/A,HC SYRINGE TOOMEY,272,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 , N/A ,$4.55 ,$4.18 , N/A ,$1.96 ,$4.63 , N/A ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A , N/A , N/A ,$5.25 ,$4.97 ,$4.97 , N/A ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A , N/A ,$5.95 , N/A ,$7.00 ,$3.93 , N/A ,$2.90 , N/A , N/A , N/A ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 , N/A ,$5.95 ,$5.92 ,$5.92 , N/A ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,27205338,N/A,HC CATHETER STRAIGHT,272,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 , N/A ,$4.55 ,$4.18 , N/A ,$1.96 ,$4.63 , N/A ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A , N/A , N/A ,$5.25 ,$4.97 ,$4.97 , N/A ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A , N/A ,$5.95 , N/A ,$7.00 ,$3.93 , N/A ,$2.90 , N/A , N/A , N/A ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 , N/A ,$5.95 ,$5.92 ,$5.92 , N/A ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,27205339,N/A,HC KIT DRESSING,272,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$3.85 , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$4.23 ,$4.23 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,27205345,N/A,HC DRESSING GAUZE STRETCH,272,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 , N/A ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 , N/A , N/A , N/A ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 ,$6.76 ,$6.76 , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,27205371,C1894,HC SHEATH INTRODUCER 8FR,272,1 ,$120.09 ,$86.46 ,$33.63 ,$120.09 , N/A ,$78.06 ,$71.69 , N/A ,$33.63 ,$79.50 , N/A ,$79.50 , N/A ,$71.57 ,$71.57 , N/A ,$71.57 , N/A , N/A , N/A , N/A , N/A ,$90.07 ,$85.26 ,$85.26 , N/A ,$85.26 ,$102.08 ,$102.08 ,$102.08 , N/A , N/A ,$102.08 , N/A ,$120.09 ,$67.37 , N/A ,$49.72 , N/A , N/A , N/A ,$102.08 , N/A ,$71.57 ,$33.63 ,$108.08 , N/A ,$102.08 ,$101.48 ,$101.48 , N/A ,$78.06 ST. JOSEPH'S HOSPITAL - BREESE,27205378,N/A,HC MARKER BIOPSY BREAST STEREOTATIC,272,1 ,$182.00 ,$131.04 ,$50.96 ,$182.00 , N/A ,$118.30 ,$108.65 , N/A ,$50.96 ,$120.48 , N/A ,$120.48 , N/A ,$108.47 ,$108.47 , N/A ,$108.47 , N/A ,$140.14 , N/A , N/A , N/A ,$136.50 ,$129.22 ,$129.22 , N/A ,$129.22 ,$154.70 ,$154.70 ,$154.70 , N/A , N/A ,$154.70 , N/A ,$182.00 ,$102.10 , N/A ,$75.35 , N/A , N/A , N/A ,$154.70 , N/A ,$108.47 ,$50.96 ,$163.80 , N/A ,$154.70 ,$153.79 ,$153.79 , N/A ,$118.30 ST. JOSEPH'S HOSPITAL - BREESE,27205386,N/A,HC HANDLE LARYNGEAL BLADE,272,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 , N/A ,$10.40 ,$9.55 , N/A ,$4.48 ,$10.59 , N/A ,$10.59 , N/A ,$9.54 ,$9.54 , N/A ,$9.54 , N/A ,$12.32 , N/A , N/A , N/A ,$12.00 ,$11.36 ,$11.36 , N/A ,$11.36 ,$13.60 ,$13.60 ,$13.60 , N/A , N/A ,$13.60 , N/A ,$16.00 ,$8.98 , N/A ,$6.62 , N/A , N/A , N/A ,$13.60 , N/A ,$9.54 ,$4.48 ,$14.40 , N/A ,$13.60 ,$13.52 ,$13.52 , N/A ,$10.40 ST. JOSEPH'S HOSPITAL - BREESE,27205388,N/A,HC BLADE LARYNGOSCOPE MACINTOSH,272,1 ,$51.00 ,$36.72 ,$14.28 ,$51.00 , N/A ,$33.15 ,$30.45 , N/A ,$14.28 ,$33.76 , N/A ,$33.76 , N/A ,$30.40 ,$30.40 , N/A ,$30.40 , N/A ,$39.27 , N/A , N/A , N/A ,$38.25 ,$36.21 ,$36.21 , N/A ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A , N/A ,$43.35 , N/A ,$51.00 ,$28.61 , N/A ,$21.11 , N/A , N/A , N/A ,$43.35 , N/A ,$30.40 ,$14.28 ,$45.90 , N/A ,$43.35 ,$43.10 ,$43.10 , N/A ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,27205400,N/A,HC SURGICEL HEMOSTAT 4X8,272,1 ,$166.00 ,$119.52 ,$46.48 ,$166.00 , N/A ,$107.90 ,$99.10 , N/A ,$46.48 ,$109.89 , N/A ,$109.89 , N/A ,$98.94 ,$98.94 , N/A ,$98.94 , N/A ,$127.82 , N/A , N/A , N/A ,$124.50 ,$117.86 ,$117.86 , N/A ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A , N/A ,$141.10 , N/A ,$166.00 ,$93.13 , N/A ,$68.72 , N/A , N/A , N/A ,$141.10 , N/A ,$98.94 ,$46.48 ,$149.40 , N/A ,$141.10 ,$140.27 ,$140.27 , N/A ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,27205423,N/A,HC CANISTER WOUND VAC 150ML,272,1 ,$60.84 ,$43.80 ,$17.04 ,$60.84 , N/A ,$39.55 ,$36.32 , N/A ,$17.04 ,$40.28 , N/A ,$40.28 , N/A ,$36.26 ,$36.26 , N/A ,$36.26 , N/A ,$46.85 , N/A , N/A , N/A ,$45.63 ,$43.20 ,$43.20 , N/A ,$43.20 ,$51.71 ,$51.71 ,$51.71 , N/A , N/A ,$51.71 , N/A ,$60.84 ,$34.13 , N/A ,$25.19 , N/A , N/A , N/A ,$51.71 , N/A ,$36.26 ,$17.04 ,$54.76 , N/A ,$51.71 ,$51.41 ,$51.41 , N/A ,$39.55 ST. JOSEPH'S HOSPITAL - BREESE,27205425,N/A,HC VAPOR CLEAR FILTER,272,1 ,$28.08 ,$20.22 ,$7.86 ,$28.08 , N/A ,$18.25 ,$16.76 , N/A ,$7.86 ,$18.59 , N/A ,$18.59 , N/A ,$16.74 ,$16.74 , N/A ,$16.74 , N/A ,$21.62 , N/A , N/A , N/A ,$21.06 ,$19.94 ,$19.94 , N/A ,$19.94 ,$23.87 ,$23.87 ,$23.87 , N/A , N/A ,$23.87 , N/A ,$28.08 ,$15.75 , N/A ,$11.63 , N/A , N/A , N/A ,$23.87 , N/A ,$16.74 ,$7.86 ,$25.27 , N/A ,$23.87 ,$23.73 ,$23.73 , N/A ,$18.25 ST. JOSEPH'S HOSPITAL - BREESE,27205428,N/A,HC INFANT SUCTION DEVICE,272,1 ,$15.15 ,$10.91 ,$4.24 ,$15.15 , N/A ,$9.85 ,$9.04 , N/A ,$4.24 ,$10.03 , N/A ,$10.03 , N/A ,$9.03 ,$9.03 , N/A ,$9.03 , N/A ,$11.67 , N/A , N/A , N/A ,$11.36 ,$10.76 ,$10.76 , N/A ,$10.76 ,$12.88 ,$12.88 ,$12.88 , N/A , N/A ,$12.88 , N/A ,$15.15 ,$8.50 , N/A ,$6.27 , N/A , N/A , N/A ,$12.88 , N/A ,$9.03 ,$4.24 ,$13.64 , N/A ,$12.88 ,$12.80 ,$12.80 , N/A ,$9.85 ST. JOSEPH'S HOSPITAL - BREESE,27205429,N/A,HC BLADE LARYNGOSCOPE LATEX FREE,272,1 ,$76.00 ,$54.72 ,$21.28 ,$76.00 , N/A ,$49.40 ,$45.37 , N/A ,$21.28 ,$50.31 , N/A ,$50.31 , N/A ,$45.30 ,$45.30 , N/A ,$45.30 , N/A ,$58.52 , N/A , N/A , N/A ,$57.00 ,$53.96 ,$53.96 , N/A ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A , N/A ,$64.60 , N/A ,$76.00 ,$42.64 , N/A ,$31.46 , N/A , N/A , N/A ,$64.60 , N/A ,$45.30 ,$21.28 ,$68.40 , N/A ,$64.60 ,$64.22 ,$64.22 , N/A ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,27205441,N/A,HC ENVIRONMENTAL TEST KIT,272,1 ,$145.50 ,$104.76 ,$40.74 ,$145.50 , N/A ,$94.58 ,$86.86 , N/A ,$40.74 ,$96.32 , N/A ,$96.32 , N/A ,$86.72 ,$86.72 , N/A ,$86.72 , N/A ,$112.04 , N/A , N/A , N/A ,$109.13 ,$103.31 ,$103.31 , N/A ,$103.31 ,$123.68 ,$123.68 ,$123.68 , N/A , N/A ,$123.68 , N/A ,$145.50 ,$81.63 , N/A ,$60.24 , N/A , N/A , N/A ,$123.68 , N/A ,$86.72 ,$40.74 ,$130.95 , N/A ,$123.68 ,$122.95 ,$122.95 , N/A ,$94.58 ST. JOSEPH'S HOSPITAL - BREESE,27205493,N/A,HC OXYGEN REPLACEMENT PROC MODULES,272,1 ,$42.00 ,$30.24 ,$11.76 ,$42.00 , N/A ,$27.30 ,$25.07 , N/A ,$11.76 ,$27.80 , N/A ,$27.80 , N/A ,$25.03 ,$25.03 , N/A ,$25.03 , N/A ,$32.34 , N/A , N/A , N/A ,$31.50 ,$29.82 ,$29.82 , N/A ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A , N/A ,$35.70 , N/A ,$42.00 ,$23.56 , N/A ,$17.39 , N/A , N/A , N/A ,$35.70 , N/A ,$25.03 ,$11.76 ,$37.80 , N/A ,$35.70 ,$35.49 ,$35.49 , N/A ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,27205494,N/A,HC REPLACEMENT PROC MODULES,272,1 ,$142.50 ,$102.60 ,$39.90 ,$142.50 , N/A ,$92.63 ,$85.07 , N/A ,$39.90 ,$94.34 , N/A ,$94.34 , N/A ,$84.93 ,$84.93 , N/A ,$84.93 , N/A ,$109.73 , N/A , N/A , N/A ,$106.88 ,$101.18 ,$101.18 , N/A ,$101.18 ,$121.13 ,$121.13 ,$121.13 , N/A , N/A ,$121.13 , N/A ,$142.50 ,$79.94 , N/A ,$59.00 , N/A , N/A , N/A ,$121.13 , N/A ,$84.93 ,$39.90 ,$128.25 , N/A ,$121.13 ,$120.41 ,$120.41 , N/A ,$92.63 ST. JOSEPH'S HOSPITAL - BREESE,27205516,N/A,HC VACCUM ASSISTED BREAST BIOPSY SYSTEM,272,1 ,$32.22 ,$23.20 ,$9.02 ,$32.22 , N/A ,$20.94 ,$19.24 , N/A ,$9.02 ,$21.33 , N/A ,$21.33 , N/A ,$19.20 ,$19.20 , N/A ,$19.20 , N/A ,$24.81 , N/A , N/A , N/A ,$24.17 ,$22.88 ,$22.88 , N/A ,$22.88 ,$27.39 ,$27.39 ,$27.39 , N/A , N/A ,$27.39 , N/A ,$32.22 ,$18.08 , N/A ,$13.34 , N/A , N/A , N/A ,$27.39 , N/A ,$19.20 ,$9.02 ,$29.00 , N/A ,$27.39 ,$27.23 ,$27.23 , N/A ,$20.94 ST. JOSEPH'S HOSPITAL - BREESE,27205517,N/A,HC SHAPEABLE HSG PROCEDURE TRAY,272,1 ,$132.87 ,$95.67 ,$37.20 ,$132.87 , N/A ,$86.37 ,$79.32 , N/A ,$37.20 ,$87.96 , N/A ,$87.96 , N/A ,$79.19 ,$79.19 , N/A ,$79.19 , N/A ,$102.31 , N/A , N/A , N/A ,$99.65 ,$94.34 ,$94.34 , N/A ,$94.34 ,$112.94 ,$112.94 ,$112.94 , N/A , N/A ,$112.94 , N/A ,$132.87 ,$74.54 , N/A ,$55.01 , N/A , N/A , N/A ,$112.94 , N/A ,$79.19 ,$37.20 ,$119.58 , N/A ,$112.94 ,$112.28 ,$112.28 , N/A ,$86.37 ST. JOSEPH'S HOSPITAL - BREESE,27205518,N/A,HC ARTHROGRAM TRAY,272,1 ,$435.00 ,$313.20 ,$121.80 ,$435.00 , N/A ,$282.75 ,$259.70 , N/A ,$121.80 ,$287.97 , N/A ,$287.97 , N/A ,$259.26 ,$259.26 , N/A ,$259.26 , N/A ,$334.95 , N/A , N/A , N/A ,$326.25 ,$308.85 ,$308.85 , N/A ,$308.85 ,$369.75 ,$369.75 ,$369.75 , N/A , N/A ,$369.75 , N/A ,$435.00 ,$244.04 , N/A ,$180.09 , N/A , N/A , N/A ,$369.75 , N/A ,$259.26 ,$121.80 ,$391.50 , N/A ,$369.75 ,$367.58 ,$367.58 , N/A ,$282.75 ST. JOSEPH'S HOSPITAL - BREESE,27205519,N/A,HC DUAL SYRINGE KIT,272,1 ,$32.73 ,$23.57 ,$9.16 ,$32.73 , N/A ,$21.27 ,$19.54 , N/A ,$9.16 ,$21.67 , N/A ,$21.67 , N/A ,$19.51 ,$19.51 , N/A ,$19.51 , N/A ,$25.20 , N/A , N/A , N/A ,$24.55 ,$23.24 ,$23.24 , N/A ,$23.24 ,$27.82 ,$27.82 ,$27.82 , N/A , N/A ,$27.82 , N/A ,$32.73 ,$18.36 , N/A ,$13.55 , N/A , N/A , N/A ,$27.82 , N/A ,$19.51 ,$9.16 ,$29.46 , N/A ,$27.82 ,$27.66 ,$27.66 , N/A ,$21.27 ST. JOSEPH'S HOSPITAL - BREESE,27206782,N/A,HC CATHETER FOLEY LUBRICATH HYDROGEL 2W,272,1 ,$30.21 ,$21.75 ,$8.46 ,$30.21 , N/A ,$19.64 ,$18.04 , N/A ,$8.46 ,$20.00 , N/A ,$20.00 , N/A ,$18.01 ,$18.01 , N/A ,$18.01 , N/A ,$23.26 , N/A , N/A , N/A ,$22.66 ,$21.45 ,$21.45 , N/A ,$21.45 ,$25.68 ,$25.68 ,$25.68 , N/A , N/A ,$25.68 , N/A ,$30.21 ,$16.95 , N/A ,$12.51 , N/A , N/A , N/A ,$25.68 , N/A ,$18.01 ,$8.46 ,$27.19 , N/A ,$25.68 ,$25.53 ,$25.53 , N/A ,$19.64 ST. JOSEPH'S HOSPITAL - BREESE,27206784,N/A,HC KIT CV CATH 7FR MULTILUM PRESSURE SPRIING GUIDEWIRE,272,1 ,$303.54 ,$218.55 ,$84.99 ,$303.54 , N/A ,$197.30 ,$181.21 , N/A ,$84.99 ,$200.94 , N/A ,$200.94 , N/A ,$180.91 ,$180.91 , N/A ,$180.91 , N/A ,$233.73 , N/A , N/A , N/A ,$227.66 ,$215.51 ,$215.51 , N/A ,$215.51 ,$258.01 ,$258.01 ,$258.01 , N/A , N/A ,$258.01 , N/A ,$303.54 ,$170.29 , N/A ,$125.67 , N/A , N/A , N/A ,$258.01 , N/A ,$180.91 ,$84.99 ,$273.19 , N/A ,$258.01 ,$256.49 ,$256.49 , N/A ,$197.30 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HEMOSPRAY ENDOSCOPIC HEMOSTAT 7FR,272,1 ,"$6,900.00 ","$4,968.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$4,485.00 ","$4,119.30 ", N/A ,"$1,932.00 ","$4,567.80 ", N/A ,"$4,567.80 ", N/A ,"$4,112.40 ","$4,112.40 ", N/A ,"$4,112.40 ", N/A ,"$5,313.00 ", N/A , N/A , N/A ,"$5,175.00 ","$4,899.00 ","$4,899.00 ", N/A ,"$4,899.00 ","$5,865.00 ","$5,865.00 ","$5,865.00 ", N/A , N/A ,"$5,865.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$2,856.60 ", N/A , N/A , N/A ,"$5,865.00 ", N/A ,"$4,112.40 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,865.00 ","$5,830.50 ","$5,830.50 ", N/A ,"$4,485.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT THINPREP PAP BROOM COLLECTION DEVICE CYTOLOGY 500 TEST,272,1 ,"$14,700.00 ","$10,584.00 ","$4,116.00 ","$14,700.00 ", N/A ,"$9,555.00 ","$8,775.90 ", N/A ,"$4,116.00 ","$9,731.40 ", N/A ,"$9,731.40 ", N/A ,"$8,761.20 ","$8,761.20 ", N/A ,"$8,761.20 ", N/A ,"$11,319.00 ", N/A , N/A , N/A ,"$11,025.00 ","$10,437.00 ","$10,437.00 ", N/A ,"$10,437.00 ","$12,495.00 ","$12,495.00 ","$12,495.00 ", N/A , N/A ,"$12,495.00 ", N/A ,"$14,700.00 ","$8,246.70 ", N/A ,"$6,085.80 ", N/A , N/A , N/A ,"$12,495.00 ", N/A ,"$8,761.20 ","$4,116.00 ","$13,230.00 ", N/A ,"$12,495.00 ","$12,421.50 ","$12,421.50 ", N/A ,"$9,555.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,LINE MONITOR SMART CAPNOLINE PLUS NASAL ORAL O2 TUBE INTERMEDIATE ADULT,272,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT UTERINE NOVASURE V5,272,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE NOVASURE,272,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,Needle HYPO 18G X 1 1/2,272,1 ,$0.60 ,$0.43 ,$0.17 ,$0.60 , N/A ,$0.39 ,$0.36 , N/A ,$0.17 ,$0.40 , N/A ,$0.40 , N/A ,$0.36 ,$0.36 , N/A ,$0.36 , N/A ,$0.46 , N/A , N/A , N/A ,$0.45 ,$0.43 ,$0.43 , N/A ,$0.43 ,$0.51 ,$0.51 ,$0.51 , N/A , N/A ,$0.51 , N/A ,$0.60 ,$0.34 , N/A ,$0.25 , N/A , N/A , N/A ,$0.51 , N/A ,$0.36 ,$0.17 ,$0.54 , N/A ,$0.51 ,$0.51 ,$0.51 , N/A ,$0.39 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PREVENA RESTOR INCISION MGMT SYS W/BELLA FORM DRESS 21X19CM,272,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT SECONDARY FIXATION ACL/PCL,272,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER ECHELON POWERED FLEX 60MM X 34MM,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SHEARS HARMONIC FOCUS 9MM CURVED,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BIT DRILL 2.4MM 2MM QUICK RELEASE CANNULATED,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE PIN ORTHO 3.2MM 230MM,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER GIA ENDO WHITE 30 2.5MM CARDINAL,272,1 ,"$8,700.00 ","$6,264.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$5,655.00 ","$5,193.90 ", N/A ,"$2,436.00 ","$5,759.40 ", N/A ,"$5,759.40 ", N/A ,"$5,185.20 ","$5,185.20 ", N/A ,"$5,185.20 ", N/A ,"$6,699.00 ", N/A , N/A , N/A ,"$6,525.00 ","$6,177.00 ","$6,177.00 ", N/A ,"$6,177.00 ","$7,395.00 ","$7,395.00 ","$7,395.00 ", N/A , N/A ,"$7,395.00 ", N/A ,"$8,700.00 ","$4,880.70 ", N/A ,"$3,601.80 ", N/A , N/A , N/A ,"$7,395.00 ", N/A ,"$5,185.20 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,395.00 ","$7,351.50 ","$7,351.50 ", N/A ,"$5,655.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER TA 90 4.8 TA9048S,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PORT GELPORT LAPAROSCOPIC SYSTEM 120MM INCISION,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PREVENA RESTOR INCISION MGMT SYS ARTHRO FORM DRESS 33X30CM,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET ENDOSCOPIC INSTRUMENT 220CM 8.5-11MM OTSC 6MM NITINOL STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ANCHOR SUTURE 2 2/0 BIOKNOTLESS PLUS ORTHOCORD ROTATOR CUFF ABSORBABLE BRAID ETHIBOND STERILE LATEX DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 16.1X4.5MM THK.4MM THK.63MM SAGITTAL,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY LIGASURE CRVD LARGE JAW OPEN SEALER,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT DRESSING 35CM PREVENA PLUS PEEL AND PLACE STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING PREVENA CUSTOMIZABLE SYSTEM KIT,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FILTER SMOKE EVACUATOR PLUMEGUARD,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GRASPER ENDOSCOPIC TWIN 220CM OTSC,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUCTION VACUUM CURETTE 10 MM CURVED,272,1 ,$10.59 ,$7.62 ,$2.97 ,$10.59 , N/A ,$6.88 ,$6.32 , N/A ,$2.97 ,$7.01 , N/A ,$7.01 , N/A ,$6.31 ,$6.31 , N/A ,$6.31 , N/A ,$8.15 , N/A , N/A , N/A ,$7.94 ,$7.52 ,$7.52 , N/A ,$7.52 ,$9.00 ,$9.00 ,$9.00 , N/A , N/A ,$9.00 , N/A ,$10.59 ,$5.94 , N/A ,$4.38 , N/A , N/A , N/A ,$9.00 , N/A ,$6.31 ,$2.97 ,$9.53 , N/A ,$9.00 ,$8.95 ,$8.95 , N/A ,$6.88 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUCTION YANKAUER SELECT-TROL TIP,272,1 ,$4.17 ,$3.00 ,$1.17 ,$4.17 , N/A ,$2.71 ,$2.49 , N/A ,$1.17 ,$2.76 , N/A ,$2.76 , N/A ,$2.49 ,$2.49 , N/A ,$2.49 , N/A ,$3.21 , N/A , N/A , N/A ,$3.13 ,$2.96 ,$2.96 , N/A ,$2.96 ,$3.54 ,$3.54 ,$3.54 , N/A , N/A ,$3.54 , N/A ,$4.17 ,$2.34 , N/A ,$1.73 , N/A , N/A , N/A ,$3.54 , N/A ,$2.49 ,$1.17 ,$3.75 , N/A ,$3.54 ,$3.52 ,$3.52 , N/A ,$2.71 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 10-0 CS160-6 12IN 2,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT PUSHLOCK 2.9 PERCUTANEOUS,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE SUTURE EXPRESS SEW IIII,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK CATARACT,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PRECISION POINT TRANSPERINEAL ACCESS SYSTEM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE BREAST BIOPSY 10GA MAMMOTOME ELITE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE BREAST BIOPSY MAMMOTOME ELITE L13.6 CM OD13 GA STERILE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET CABLE/SLEEVE 2MM DALL-MILES STAINLESS STEEL,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPONGE INTERCEED,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER ENDOSCOPIC CURVED 25MM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER INTERNAL 37CM XL CIRCULAR 2 ROW SEAL 5.2MMX1.5-2.2MM 25MM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER INTERNAL 37CMX5.5MM CURVE CIRCLE INTRALUMINAL LINEAR CUTTER ADJUSTABLE FLEXIBLE STERILE LATEX FREE DISPOSABLE ENDOPATH 20.4MM LUMEN 1-2.5MM 29MM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLR INT 5.5MM 1-2.5MM CRV CIRC INTRLUM ENDO,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ASSEMBLY SMARTRELEASE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP RESOLUTION 360 DEG 2.8MM X 235CM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING PICO 20 X 10CM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING PICO 30 X 10CM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING PICO 40 X 10CM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL ACUMED 2.0MM QUICK COUPLER SURGBIT,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT CANNULATED 2.9 X 70MM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE ROD ORTHOPEDIC 900MM 3MM BALL TIP,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDEWIRE STRYKER GAMMA 3 BALL TIP 3X1000MM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 3-0 VIOLET SH V-20 J316H,272,1 ,$3.66 ,$2.64 ,$1.02 ,$3.66 , N/A ,$2.38 ,$2.19 , N/A ,$1.02 ,$2.42 , N/A ,$2.42 , N/A ,$2.18 ,$2.18 , N/A ,$2.18 , N/A ,$2.82 , N/A , N/A , N/A ,$2.75 ,$2.60 ,$2.60 , N/A ,$2.60 ,$3.11 ,$3.11 ,$3.11 , N/A , N/A ,$3.11 , N/A ,$3.66 ,$2.05 , N/A ,$1.52 , N/A , N/A , N/A ,$3.11 , N/A ,$2.18 ,$1.02 ,$3.29 , N/A ,$3.11 ,$3.09 ,$3.09 , N/A ,$2.38 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM DRAINAGE PVC CHEST 1 COLLECTION CHAMBER 1 WAY VALVE DRY SEAL CONTROL NEEDLELESS CONNECTOR PLEUR-EVAC SAHARA C6L/MIN SMALL STATURE 2000CC STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT PINK PAD,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE OPHTHALMIC 2MM PERFORMANCE ANGLED CRESCENT BEVEL UP BLADE STERILE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACKING NASAL RAPID RHINO POSTERIOR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RASP SURGICAL .51X.26IN RECIPROCATE STRAIGHT CUT LARGE TEAR BONE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR ALEXIS L,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR ALEXIS WOUND LARGE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR OPHTHALMIC GRIESHABER IRIS CORNEA NYLON FLEXIBLE HOOK SMOOTH FINISH STERILE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR SCOTT RING,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR WOUND ALEXIS 11-17CM APPLIED MEDICAL,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRIEVER SUTURE HEWSON,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SHEATH ACCESS 11-13FR RADIOPAQUE 2 TAPER DILATOR TIP HUB NAVIGATOR URETERAL STAINLESS STEEL HYDROPHILIC 46CM LATEX FREE URETEROSCOPIC,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER TX90 4.8 TL90,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAYS LONE STAR RETRACTOR SHARP 5MM,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ANCHOR SUTURE XBRAID TT COBRAID UHMWPE 2MM STERILE LATEX FREE DISPOSABLE VIOLET,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,APPLICATOR ENDOSCOPIC 474MM BAXTER MALLEABLE TIP DEHP FREE S,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,APPLICATOR ENDOSCOPIC BAXTER L474 MM MALLEABLE TIP DEHP FREE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BALLOON RETRIEVAL 200CM 7-5FR 11.5MM DURAGLIDE .035IN BILIARY 3 LUMEN STONE REMOVAL STERILE LATEX DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BIT DRILL 152.4MM 3.5MM LONG STAINLESS STEEL TWIST STERILE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BIT DRILL 2.2MM DVR CROSSLOCK TRAY,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BIT DRILL 254MM 3.5MM RUSSELL-TAYLOR DELTA TIBIA TWIST STERILE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 4MM LONG BURR AGGRESSIVE PLUS ARTHROSCOPIC STERILE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BRUSH FEMORAL CANAL STERILE LATEX FREE DISPOSABLE SURGILAV PLUS,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER SPECIMEN RETRIEVAL 200CM 7-5FR 8.5MM DURAGLIDE .035IN BILIARY STONE 3 LUMEN ENDOSCOPIC STERILE LATEX DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP DURACLIP 2.8MM 235CM 16MM,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUTTING LOOP 24FR MONOPOLAR ANGLED,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE ENDOSCOPIC INFINITY SAMPLE RETROGRADE CHOLANGIOPANCREATOGRAPHY,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE ZIP 16CM SKIN CLOSURE STERILE LATEX FREE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE UHMWPE XBRAID TT 2MM TAPE VIOLET ROTATOR CUFF REPAIR NONABSORBABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM BONE CEMENT REVOLUTION BREAKAWAY NOZZLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT 2.5MM,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT ARTHREX 1.7MM,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT ARTHREX 2.5MM CALIBRATED,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT ARTHREX 2.5MM TRIM-IT,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE COAGULATING POINTED 27FR MONOPOLAR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE MONOPOLAR 24/26FR 3MM BALL COAG (YELLOW),272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,EXTRACTOR SURGICAL KATZ EXTRACTOR FOREIGN BODY REMOVER OTO-RHINO STERILE DISPOSABLE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FILTER ANESTHESIA VAPOR-CLEAN,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEP GRASPER RESCUE COMBO RAT ALLIGATOR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,IRRISEPT IRRIGATION,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM FIXATION CPR VIPER,272,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT NOVASURE HANDLE ABLATATION ENDOMETRIUM,272,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT THR PREP-IM HIP PLUG BRUSH SPONGE SUCTION LATEX FREE,272,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE MYOSURE REACH,272,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM FIXATION SPEEDBRIDGE JUMPSTART ACHILLES BIOCOMPOSITE STERILE,272,1 ,"$6,300.00 ","$4,536.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,095.00 ","$3,761.10 ", N/A ,"$1,764.00 ","$4,170.60 ", N/A ,"$4,170.60 ", N/A ,"$3,754.80 ","$3,754.80 ", N/A ,"$3,754.80 ", N/A ,"$4,851.00 ", N/A , N/A , N/A ,"$4,725.00 ","$4,473.00 ","$4,473.00 ", N/A ,"$4,473.00 ","$5,355.00 ","$5,355.00 ","$5,355.00 ", N/A , N/A ,"$5,355.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$2,608.20 ", N/A , N/A , N/A ,"$5,355.00 ", N/A ,"$3,754.80 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,355.00 ","$5,323.50 ","$5,323.50 ", N/A ,"$4,095.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM INTERNAL FIXATION 14X3.6MM 2.5MM 2.5MM LAPIPLASTY BIPLANAR PLATE LOW PROFILE LOCK SCREW MULTIPLANAR 12MM STERILE,272,1 ,"$11,700.00 ","$8,424.00 ","$3,276.00 ","$11,700.00 ", N/A ,"$7,605.00 ","$6,984.90 ", N/A ,"$3,276.00 ","$7,745.40 ", N/A ,"$7,745.40 ", N/A ,"$6,973.20 ","$6,973.20 ", N/A ,"$6,973.20 ", N/A ,"$9,009.00 ", N/A , N/A , N/A ,"$8,775.00 ","$8,307.00 ","$8,307.00 ", N/A ,"$8,307.00 ","$9,945.00 ","$9,945.00 ","$9,945.00 ", N/A , N/A ,"$9,945.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$4,843.80 ", N/A , N/A , N/A ,"$9,945.00 ", N/A ,"$6,973.20 ","$3,276.00 ","$10,530.00 ", N/A ,"$9,945.00 ","$9,886.50 ","$9,886.50 ", N/A ,"$7,605.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY HUMERAL COMPREHENSIVE REVERSE SHOULDER BIOMET,272,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$3,705.00 ","$3,402.90 ", N/A ,"$1,596.00 ","$3,773.40 ", N/A ,"$3,773.40 ", N/A ,"$3,397.20 ","$3,397.20 ", N/A ,"$3,397.20 ", N/A ,"$4,389.00 ", N/A , N/A , N/A ,"$4,275.00 ","$4,047.00 ","$4,047.00 ", N/A ,"$4,047.00 ","$4,845.00 ","$4,845.00 ","$4,845.00 ", N/A , N/A ,"$4,845.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$2,359.80 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$3,397.20 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,845.00 ","$4,816.50 ","$4,816.50 ", N/A ,"$3,705.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR DILATING TIP XCEL 12MM X 150MM,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT SAFETY PEG TUBE 20FR,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE SCORPION AR-13995N,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PASSER PERFECTPASSER MAGNUMWIRE CARTRIDGE SUTURE POLYESTER STERILE DISPOSABLE WHITE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE ELECTROSURGICAL APOLLORF 90D MULTIPORT,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE SERFAS 90S CRUISE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPHINCTEROTOME 200CM 4MM 5FR HUIBREGTSE 1 LUMEN NEEDLE KNIFE CUT WIRE GUIDEWIRE STERILE DISPOSABLE ENDOSCOPIC .035IN PURPLE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER PROXIMATE CUTTER 100 3.8,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BASKET STONE RETRIEVAL 90CM 12MM 1.9FR ZERO TIP URETERAL NITINOL 4 WIRE FLAT DISTAL SURFACE KNOT TIPLESS STERILE LATEX FREE DISPOSABLE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 4MM HUMMER IV ENT SERRATED IRRIGATED AGGRESSIVE ARTHROSCOPIC STERILE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 8CM 2.5MM ESSX AGGRESSIVE STERILE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER BIPOLAR 2.8MM 7FR 300CM,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP RESOLUTION 2.8MM 11MM,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE CARTRIDGE ARTHROCARE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT INSTRUMENT SHORT DRILL BIT DRILL GUIDE DISPOSABLE 2.9/12.5MM BIOCOMPOSITE PUSHLOCK,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT BIOMET 2.7MM PERIPHERAL SCREW,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT DEPUY 4.4MM,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT SYNTHES 2.8MM X 200MM,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,EXTRACTOR STONE 120CM 12MM 1.9FR URETERAL NITINOL TIPLESS,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 5MM SPACEMAKER PRO ROUND DISSECTION BALLOON BLUNT TIP LOW PROFILE OPTICAL LATEX FREE TOTAL EXTRAPERITONEAL HERNIA REPAIR,272,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRIEVER ROTH NET STANDARD,272,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY LIGASURE HANDPIECE BLUNT TIP 37CM,272,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT SYNTHES 3.2 CANNULATED 170MM,272,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR XCEL 11MMX100MM 6 BX DILATING TIP,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE ARTHROSCOPIC GRAFT 9MM ACL,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE SACHSE STRAIGHT COLD,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,LASSO MICRO SUTURE ARTHREX STRAIGHT,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR MALYUGIN RING SYSTEM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET NEEDLE 15MM 15GA EZ-IO WRIST BAND SHARP BLOCK EXTENSION STERILE LATEX FREE DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET NEEDLE 25MM 15GA EZ-IO STAINLESS STEEL WRISTBAND 5GM STERILE LATEX FREE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET NEEDLE 45MM 15GA EZ-IO EZ-CONNECT NEEDLE VISE STAINLESS STEEL WRISTBAND SHARP BLOCK 5GM INTRAOSSEOUS VASCULAR ACCESS SYSTEM STERILE LATEX FREE DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET STRYKER QUICK PRESSURE MONITOR,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE RELOAD 10 COUNT RELIATACK FIXATION,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE RELOAD ENDOCUT GREEN 60MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER INTERNAL 5.3MMX3.7MM TITANIUM LINEAR CUTTER MULTIFEED STERILE LATEX FREE DISPOSABLE ENDOPATH,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER RELOAD ECHELON 60MM BLUE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER RELOAD ECHELON 60MM GREEN,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO 25DEG TIGHT LEFT CURVE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO 25DEG TIGHT RIGHT CURVE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO 90' SMALL DIAMETER STRAIGHT,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AVITENE FLOUR,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BAG POLYMER 4IN ATTACH MEMORY WIRE CANNULA INSERT INDICATOR 120ML SPECIMEN STERILE DISPOSABLE 3IN 5MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BAG SPECIMEN RETRIEVAL 9.9IN 5.5IN ANCHOR TISSUE SYSTEM C1550ML 15MM INTRODUCER TROCAR,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER CHOLANGIOGRAM GOLD 23CM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO MICRO TFCC SMALL CURVE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO SD 45 DEG CURVED LT (AR-4068-45L),272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO SD 45 DEG CURVED RT (AR-4068-45R),272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY ARTHROGRAM SYRINGE 30CC,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY PROCEDURE 12-18FR BARD HEYMAN NATURAL RUBBER SYRINGE CATHETER LUBRICANT WATERPROOF UNDERPAD FILIFORM OLIVE TIP 10CC STERILE LATEX DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY SURGICAL 3.5IN ARGYLE TURKEL DISPOSABLE STERILE LATEX PNEUMOTHORAX 8FR,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX LASSO CRESCENT CAT NUM AR 4068C,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT INSTRUMENT ACL TRANSTIBIAL DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT DEPUY 3.8MM X 6IN,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT SYNTHES 2.0 QC 140MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL TWIST YELLOW 122MM 2.6MM AO SHAFT END 70MM VARIAX LOCK PLATE SYSTEM NONSTERILE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBE 20FR SILICONE RADIOPAQUE TRANSLUCENT NONBALLOON REPLACEMENT DEHP FREE GASTROSTOMY PONSKY WHITE STERILE LATEX FREE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE ARTHROSCOPIC GRAFT 10MM ACL,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RASP SURGICAL 11X5MM SMALL CROSS CUT TEAR STERILE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RELOAD ECHELON 45MM GREEN,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RELOAD ECHELON 45MM WHITE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR ALEXIS XL,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPHINCTEROTOME 170CM 20MM 4FR CLEVERCUT3V BILIARY PANCREAS 3 LUMEN MONOFILAMENT RADIOPAQUE GUIDEWIRE STERILE DISPOSABLE ENDOSCOPIC DIFFICULT CANNULATION .025IN SMALL PRECURVE TAPER,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER ECHELON 45 BLUE RELOAD,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER ECHELON 45 GREEN RELOAD,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER INTERNAL 4.8MM TITANIUM 0D 12MM THICK TISSUE LINEAR CUTTER DLU STERILE LATEX FREE MULTIFIRE ENDO HERNIA BLACK HERNIA FIXATION ENDOSCOPIC,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER PROXIMATE CUTTER 75 3.8,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER RELOAD 45MM GREY VASC,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER RELOAD 60MM GREY VASC,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER RELOAD ECHELON 45MM BLUE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER RELOAD ECHELON 60MM WHITE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ZIMMER PATELLA REAMER SZ 38,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ZIMMER PATELLA REAMER SZ 41,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ZIMMER PATELLA REAMER SZ 46,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BUR STRYKER ROUND 4.0MM,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CARTER-THOMPSON SUTURE PASSER GUIDE 5MM 10/12MM DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM BONE CEMENT 1 2 MIX,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM CLOSURE ZIPLINE 24,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 75MM 5MM ENDOPATH XCEL STABILITY SLEEVE DILATE TIP STERILE LATEX FREE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR XCEL 5MM X 100MM DILATING TIP THREADED BLADED,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT INSTRUMENT ACL TRANSTIBIAL HALL STYLE SAW BLADE DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING WOUND VAC VERAFLO CLEANSE CHOICE MEDIUM TUBULAR FLEXIBLE COMPLEX GEOMETRY MOISTURE RESISTANCE LATEX FREE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT 2.7MM CALIBRATED,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT 3.5 SOLID,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT QUICK RELEASE 2.8MM,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT RICHARDS 5/64 (1.9-2.0),272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR CPR-D PADZ 1 PIECE ADULT AED PLUS DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDEWIRE ENDOSCOPIC 250CM SAVARY-GILLIARD,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HEMADERM/EPISTAXIS KIT ENT,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING ARTHREX ARTHROSCOPY,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT PEG 20FR 13.8FR SILICONE PUSH,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT PEG 20FR SILICONE CLAMP FENESTRATE DRAPE PULL ENDOVIVE STANDARD UNIVERSAL 5ML STERILE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MALLET SURGICAL 38.1MM DELRIN REPLACEMENT HEAD NONSTERILE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK SURGICAL SHOULDER ARTHROSCOPY LATEX FREE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAGENT CYTOLOGY PRESERVCYT VIAL PRESERVATIVE SOLUTION PREFILL 20ML,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR ALEXIS WOUND MEDIUM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR ALEXIS WOUND SMALL,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SENSOR TISSUE OXIMETRY,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET TUBING BLUE INTEGRATE IRRIGATION FMS SOLO FMS DUO+,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPONGE SURGICEL 4 X 8,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE PROXIMATE CUTTER 7.5 - 3.8 RELOAD TCR75,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE RELOAD 75 PROXIMATE GREEN 4.5,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER PROXIMATE CUTTER 60 3.8 TLC55 GIA,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER TX 60 3.5 TX60B,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER TX 60 4.8,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STIMULATOR HANDHELD LOCATOR VARI-STIM III NERVE STANDARD SUBDERMIS,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ADHESIVE DERMABOND PRINEO SKIN CLOSURE STRIP,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ENDOSCOPIC END CUTTER STERILE YELLOW 3.5MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 3.5MM MENISCUS AGGRESSIVE STERILE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 4MM MENISCUS AGGRESSIVE STERILE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 5.5MM DYONICS PLATINUM FULL RADIUS,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 5MM MENISCUS AGGRESSIVE STERILE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER ELITE 4.5,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BOWL BONE CEMENT VACU-MIX 180GM FEMUR MIXING CARTRIDGE HIGH VACUUM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP APPLIER LOAD 19 MED LG 10MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE EXPRESSBRAID BLUE WHITE GRAFT MANIPULATION NONABSORBABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE EXPRESSBRAID WHITE NONABSORBABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE LAPRA-TY CLIP XC200,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE SUTURETAPE 40IN X 2 STRAND BLACK BLUE WHITE 1.3MM NONABSORBABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE TIGERLINK FIBERWIRE 2 26IN CLOSED LOOP BLACK WHITE NONABSORBABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TIP PHACO 45 DEGREE ALCON 0.9MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TIP SCISSOR CURVED METZENBAUM CARE FUSION,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY SUPRAPUBIC 14GA 18GA 11IN CATHETER PUNCTURE NEEDLE ADAPTER CLAMP ANESTHESIA BD BONNANO TEFLON STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY THORACENTESIS 5/8IN 8FR 25GA SAFE-T-CENTESIS PLUS DRAINAGE CATHETER 60ML STERILE LATEX FREE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT BREAST PUMP INITIATE BPA FREE SYMPHONY LACTINA 35ML STERILE LATEX FREE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT DRAINAGE VACUUM BOTTLE PLEURX 1000ML,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT INSERTION STENT V MARK 8.5FR STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING TOPIFOAM 7.75 X 11.5,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT RICHARDS 1/16 (1.6),272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT RICHARDS 1/4 (6.3),272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT RICHARDS 3/32 (2.4),272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT SYNTHES 2.5 QC 110MM GOLD,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR ONESTEP CODE-READY RESUSCITATION COMPLETE SPEED PACK CONNECTOR R SERIES,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE ENDOSCOPIC 3FR COAGULATE STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ENDO CLIP APPLIER LIGAMAX M/L 5MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FIBER LINK ARTHREX,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEPS GRASPING 3 PRONG RING DISTAL TIP 230CMX20MM POLYGRAB TRIPOD STERILE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GRASPER DIRECT DRIVE REPOSABLE 5MM X 38CM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE ROD ORTHOPEDIC 900MM 3.2MM STRAIGHT BALL TIP REAMER DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE ROD ORTHOPEDIC 900MM 3MM STRAIGHT STAINLESS STEEL INTRAMEDULLARY NAIL REAMER,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,INTRODUCER ENDOSCOPIC 10FR 6FR 205CM RADIOPAQUE OASIS TRACER METRO DIRECT STERILE DISPOSABLE PURPLE ACCEPTS .035IN GUIDEWIRE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING INSUFFLATION,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT PHENOL APPLICATION,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT SLEEVE MICRO SMOOTH ALCON 0.9,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE OPHTHALMIC 12.7X2.1X3.7MM LASEREDGE ANGLE CRESCENT FULL HANDLE BEVEL UP STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE OPHTHALMIC 2.4MM INTREPID ANGLE BEVEL STAB MICRO COAXIAL SLIT STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,LINE FILTER ORANGE 6.5FT MICROSTREAM ADVANCE .2UM STANDARD NASAL ORAL O2 FEMALE CONNECTOR NONINTUBATE KINK RESISTANT DEHP FREE ADULT SHORT TERM CAPNOGRAPHY DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,LINE MONITOR SMART CAPNOLINE PLUS NASAL ORAL INTERMEDIATE ADULT MICROSTREAM NONINTUBATE SHORT TERM STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MANIFOLD SUCTION INTELLICART CLOG FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MASK CPAP MEDIUM FRAME HEADGEAR ADVANCE AIR DIFFUSER LOW PROFILE SIMPLUS ERGOFORM ROLLFIT,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE NERVE STIMULATOR 4IN 20GA STIMUPLEX ULTRA 360 30D BEVEL INSULATE ECHOGENIC EXTENSION SET STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ORGANIZER INSTRUMENT CLEAR 86X76CM MIO 3 POUCH ADHERE 28X25CM STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK BASIC EXCISION,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK LAPAROSCOPY,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK T AND A,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACKING NASAL RHINO ROCKET 3X2X1CM SMALL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACKING NASAL RHINO ROCKET LARGE POST OP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACKING WOUND 15FTX2IN COTTON GAUZE VAGINAL WOVEN 4 PLY MESH LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PAD ALVARADO KNEE HOLDER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PAD NURSING COMFORTGEL BREAST HYDROGEL SOOTH HEALING COMFORT CONTOURED,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PAD POLAR CARE KNEE/SHOULDER PAD,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RASP SURGICAL 13CMX4MM FLAT POWERASP COOLCUT SMOOTH,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETAINER DRESSING 25YDX12.25IN 4 LARGE TUBULAR SURGILAST NYLON RUBBER ELASTIC NET LATEX ARM FOOT HAND LEG,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETAINER DRESSING 25YDX15IN 5 SMALL TUBULAR SURGILAST NYLON RUBBER ELASTIC NET LATEX HEAD THIGH SHOULDER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETAINER DRESSING 25YDX25.5IN 6 LARGE TUBULAR SURGILAST NYLON RUBBER ELASTIC MAXIMUM AIR FLOW STRETCH NET LATEX FREE HEAD THIGH SHOULDER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETAINER DRESSING 25YDX8IN 2 SMALL TUBULAR SURGILAST ELASTIC NET HAND ARM LEG FOOT,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRIEVER SUTURE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SENSOR ADULT NELLCOR LOSAT 18IN C50+ KG NASAL OXIMETER SPO2 ADHESIVE TEAR RESISTANT BANDAGE PVC STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SENSOR NELLCOR OXIMETER SPO2 ADHESIVE STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SLEEVE SCD CALF 23 LARGE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SNARE MEDIUM OVAL 240CMX20MM 2.4MM ROTATABLE STAR CATHETER MEDIUM STIFF ENDOSCOPIC POLYPECTOMY 2.8MM DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SNARE SMALL OVAL 13MM ROTATABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SNARE SPIRAL 230CM 2.8MM 20MM SNAREMASTER RIDGE WIRE ENDOSCOPIC POLYPECTOMY STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SNARE THIN CRESCENT 230CM 2MM 25MM SNAREMASTER PLIANT WIRE INTEGRATE HANDLE LOOP OPEN ENDOSCOPIC PCF CF POLYPECTOMY STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPLINT NASAL THIN LARGE REUTER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPONGE GELFOAM COMPRESSED 100,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUCTION DEVICE FLOOR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ADAPTER URETERAL CATHETER CONNECTOR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ADHESIVE DERMABOND,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ADHESIVE SKIN CLOSURE 2 OCTYL CYANOACRYLATE DERMABOND ADVANCED LIQUID APPLICATOR MICROBIAL BARRIER FLEXIBLE .7ML,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,APPLICATOR ARISTA AH FLEXITIP XL 38CM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BAG DRAINAGE FLEXIBLE DRAPE FLUID COLLECTOR STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ANGLED BEVEL UP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE CAST CUTTER 2.5IN ION NITRIDE NONSTERILE REUSABLE ROUND LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE LARYNGOSCOPE MACINTOSH 2,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE LARYNGOSCOPE MACINTOSH 3,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 18.5X5.5X.6MM MICROPOWER MICRO100 OSCILLATING FINE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 75X25MM THK1.27MM LARGE BONE SAGITTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 77.5X11.2MM THK.76MM THK1.17MM LARGE BONE RECIPROCATE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 84.5X21MM THK.89MM MEDIUM LONG STAINLESS STEEL SAGITTAL STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 96.3X18.5MM THK1.37MM SAGITTAL STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLANKET WARMING PEDIATRIC,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 44.5MM CARBIDE 3MM ROUND 6 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 44.5MM CARBIDE 5MM ROUND 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 44.5MM CARBIDE 7.9MM 4MM OVAL 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 48MM CARBIDE 8MM 4MM OVAL 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 54.5MM STAINLESS STEEL 11.1MM 2.1MM SHANNON 3 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 54.5MM STAINLESS STEEL 3.2MM ROUND 8 FLUTE DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR 65.5MM STAINLESS STEEL 6.9MM 1.5MM 2 FLUTE WIRE PASS DRILL DENTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SURGICAL 67MM 2.3MM MEDIUM CARBIDE SIDE CUTTING STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SURGICAL LINDEMANN SERRATE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANISTER 150ML PREVENA XL 150ML REPLACEMENT,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANISTER WOUND DRAINAGE PREVENA REPLACEMENT 45ML INCISION MANAGEMENT SYSTEM DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA ARTHREX PARTIAL THREADED,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA ARTHROSCOPIC 5.5MM 70MM PLASTIC UNIVERSAL SHOULDER SET 2 SEAL FENESTRATE STERILE LATEX FREE DISPOSABLE GRAY ORANGE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA ARTHROSCOPIC 5.5MM 70MM UNIVERSAL SHOULDER SET 2 SEAL BLUNT OBTURATOR STERILE LATEX FREE DISPOSABLE GRAY,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CARRIER DERMACERRIER 1.5 TO 1,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER IV 14GA 3.25IN DEHP-FR PERIPH ANGCATHETER FEP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER UMBILICAL 3.5FR 20/23GA 15IN 2 LUMEN LUER LOCK HUB RADIOPAQUE DEHP FREE CLEAR ARGYLE POLYURETHANE .21ML .16ML NEONATE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER URETERAL BARD-IC 16FR 2WY FOLEY 2 OPPOSE EYE SH OPEN TIP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER URETERAL BARD-IC 18FR 2WY FOLEY 2 OPPOSE EYE SH OPEN TIP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CONTAINER IV 1000ML STOPPER PVC FREE DEHP FREE GLASS LATEX FREE STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET 24X4.5IN,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET 4 X 34,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET BLUE 34X4IN 1 LINE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET CONTOUR 18X4.5IN,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET GRAY 15X4IN EXPRESSAIRE LONG 1 FILL LINE PEDIATRIC STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET GREEN 24X4IN ATS CYLINDER 2 PORT 2 BLADDER POSITIVE LOCK CONNECTOR SLEEVE STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET GREEN ATS 3K 4 X 24,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET RED 18X4IN EXPRESSAIRE STANDARD ARM 1 FILL LINE STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET YELLOW 24X4IN 1 LINE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CURETTE SMALL 8X6MM NO-SCRATCH WHITNEY CURETTE CEMENT SURGICAL PLASTIC STERILE DISPOSABLE BLUE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE CLOSURE V-LOC 180 2-0 GS-21 1/2 CIRCLE L6 IN L37 MM A,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE POSITIONING 13X10.5IN XL LEAD HAND IMMOBILIZER HAND ALUMINUM STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE SURGALLOY V-LOC 180 3-0 V-20 .5 CIRCLE 12IN TAPER POINT ABSORBABLE GREEN 26MM CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE SYNETURE V-LOC 2-0 GS-21 9IN ABSORBABLE BLUE CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE V-LOC 180 0 GS-21 6IN ABSORBABLE GREEN CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE V-LOC 180 0 GS-25 .5 CIRCLE TAPER POINT 30CM 2 ANGLE CUT ABSORBABLE BARB GREEN 48MM CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE V-LOC 180 2-0 GS-21 30CM ABSORBABLE GREEN 37MM CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE V-LOC 2-0 GS-21 18IN NONABSORBABLE BLUE CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE V-LOC 90 3-0 V-20 12IN ABSORBABLE VIOLET CLOSURE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRAIN BLAKE 10 FR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRAIN INCISION 19FR .25IN BARD SILICONE 4 FREE FLOW CHANNEL RADIOPAQUE TROCAR STERILE LATEX FREE 3/16IN .75 FLUTE ROUND DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRAIN JP 15FR 3/16,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING 5.75X5.25X1.25IN EZ-STABILIZER ADHESIVE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING AQUACEL AG 6X3.5 IN,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ETHIBOND 2 V- 37 30 MX69G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ETHIBOND 5 CCS 30 MB47G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ETHIBOND GREEN BR 5 30 V-40 MB46G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ETHILON 10-0 TG160-4 12 DA 7707G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE FIBERWIRE #2 AR-7200,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE MERSILENE 5MM / CTX,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE PDO MONODERM QUILL SRS 2-0 3/8 CIRCLE 30X30CM 2 ARM MONOFILAMENT BARB PRECISION REVERSE CUT 24MM ABSORBABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE PDO MONODERM QUILL SRS 2-0 3/8 CIRCLE DIAMOND 30X30CM 2 ARM MONOFILAMENT BARB 26MM ABSORBABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE PDO QUILL 0 .5 CIRCLE 24CM 2 ARM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE POLYDIOXANONE 2 24CM HALF CIRCLE HEAVY NEEDLE 36CM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE STEEL 7 CCS HRS-48 4 X 18 M655G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 8-0 TG 140-8/TG140-8 J547G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL MICROPOINT 8-0 TG140-6 DA 12IN,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VLOC 3-0 90 6 V-20,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VLOC O GS-21 18,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TIP ALCON I AND A INTREPID 0.3MM CONICAL ANGLED,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY BIOPSY T-LOK STANDARD BONE MARROW,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY LACERATION STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY SPINAL 2.5IN 22GA 25GA PORTEX LANCET NEEDLE 5/8IN 3ML PEDIATRIC LUMBAR PUNCTURE STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY SPINAL 3.5IN 20GA PORTEX PLASTIC PAPER LANCET NEEDLE SPONGE APPLICATOR FENESTRATE DRAPE 3ML ADULT LUMBAR PUNCTURE STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY SPINAL 3.5IN 25GA PENCAN 8.25% DEXTROSE 0.75% BUPIVACAINE BPA DEHP PENCIL POINT NEEDLE PREP SPONGE FENESTRATE DRAPE THIN WALL INTRODUCER STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY THORACENTESIS 7IN 5FR 14GA SHORT INTRODUCER NEEDLE CATHETER 2IN STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY THORACENTESIS/PARACENTESIS 8FR THORA-PARA POLYURETHANE CATHETER STERILE LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR BALLOON HASSAN 12X100MM BLUNT TIP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR FIOS ADVANCE 5X100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 100MM 11MM KII Z THREAD SLEEVE SHIELD BLADE STERILE LATEX FREE ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 100MM 12MM KII Z THREAD SLEEVE RETENTION DISC STERILE LATEX FREE OPTICAL ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 100MM 8MM KII Z THREAD SLEEVE RETENTION DISC STERILE LATEX FREE OPTICAL ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 150MM 12MM KII FIOS Z THREAD SLEEVE FIRST ENTRY STERILE LATEX FREE ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 150MM 12MM KII Z THREAD SLEEVE SHIELD BLADE STERILE LATEX FREE ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR LAPAROSCOPIC 150MM 5MM KII FIOS Z THREAD SLEEVE FIRST ENTRY STERILE LATEX FREE ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR XCEL 5MM X 100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR Z THREADED 12X100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR Z THREADED 5X100MM BLADED,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TROCAR Z THREADED 5X100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBE ENDOTRACHEAL 14MM 6.7MM 5MM NASAL ORAL CUFF MAGILL CURVE RADIOPAQUE DEPTH MARK MICROCUFF POLYURETHANE PEDIATRIC STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBE MIC GASTROSTOMY 20FR/20CC,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBE MIC GASTROSTOMY 24FR/20CC,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBE PEG REPLACMENT 22FR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING COLLECTION 6FT BERKELEY,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT IRRIGATION ENDOGATOR STERILE LATEX FREE REUSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING GLASSCOCK EAR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING STOCKINETTE TAN J AND J 4,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING WEBRIL 3 UNSTERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT 125MM 1.6MM TWST STER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT 125MM 2.4MM TWST STER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR RED 5.95X5.24IN EDGE SYSTEM RECTANGLE PRECONNECT CONDUCTIVE GEL LEADWIRE PAD 42IN ADULT LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE LEEP BALL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE TELESCOPING BOVIE PENCIL WITH SMOKE EVACUATION,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ENDOCLOSE SUTURING INSTRUMENT,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FLYTE HELMET COVER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEPS BIOPSY 240CM 2.8MM 3.2MM RADIAL JAW 4 JUMBO STERILE DISPOSABLE ORANGE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEPS BIOPSY SWING JAW FENESTRATE SMOOTH INSERT 230CM 2.8MM ENDOJAW STAINLESS STEEL STANDARD OVAL STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HANDLE LAPAROSCOPE BRITEPRO SOLO MACINTOSH 4 METAL BLADE FIBER OPTIC STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HANDLE LARYNGOSCOPE BRITEPRO SOLO MACINTOSH 3 METAL BLADE OVERMOULD SOFT GRIP BATTERY LIGHTSOURCE STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HANDLE LARYNGOSCOPE BRITEPRO SOLO MILLER 2 METAL BLADE FIBER OPTIC STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HANDPIECE 10FT INTERPULSE SURGILAV PLUS SET TUBE PULSED LAVAGE STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT ANESTHESIA EPIDURAL PERIFEX CUSTOM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING IRRIGATION CYSTO,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE MYRINGOTOMY SPEAR BLADE INTEGRAL HANDLE STERILE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KNIFE OPHTHALMIC 3MM A-OK SATINSLIT ANGLE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE INSULATED STIMUPLEX,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK HEAD AND NECK,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETAINER DRESSING 25YDX10 1/8IN 3 MEDIUM TUBULAR SURGILAST ELASTIC NET ARM FOOT HAND LEG,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETAINER DRESSING 25YDX6IN 1 TUBULAR SPANDEX RAYON ELASTIC NET STRETCH NEOPRENE FREE NO PRECUT LATEX FREE NONSTERILE WRIST,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SENSOR INFANT MASIMOSET LNCS FINGER OXIMETER SPO2 ADHESIVE CABLE REPLACEABLE TAPE NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SENSOR NEONATE MASIMOSET LNCS FINGER OXIMETER SPO2 ADHESIVE CABLE REPLACEABLE TAPE NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SENSOR PEDIATRIC LNCS 3FT L FINGER OXIMETER SPO2 ADHESIVE CABLE NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET BLOOD WARMING STANDARD FLOW HEAT EXCHANGER BUBBLE TRAP 39ML RANGER DISPOSABLE 9000ML/HOUR 30IN STERILE LATEX FREE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET SEAL MYOSURE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SLEEVE SCD CALF 17,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SNARE MINI OVAL 5.5CM 1.5CM 7FR SOFT ACUSNARE 1 PIECE BRAID SMOOTH ENDOSCOPIC POLYPECTOMY TEFLON NITINOL STAINLESS STEEL 240CM ESOPHAGEAL STERILE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SNARE THK.47MM STANDARD OVAL 2300MM 2.8MM 25MM SNAREMASTER BRAID WIRE INTEGRAL HANDLE SHORT LOOP ENDOSCOPIC CF GIF POLYPECTOMY STERILE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SOLUTION IRRIGATION ARTHROMATIC LACTATED RINGERS 3000ML PLASTIC CONTAINER LATEX FREE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ADHESIVE DERMABOND MINI,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY LARYNGEAL 4 C110-155LB ADULT MASK SEMIRIGID FLEXIBLE TUBE SOFT TIP LATEX FREE PVC DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 18.5X5.5X.4MM MICRO OSCILLATING FLAT STERILE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 18.5X7MM SAGITTAL STERILE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 25X9MM THK.38MM THK.43MM SMALL BONE OSCILLATE SAGITTAL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 31X10MM THK.4MM CUT EDGE ZIMMER STERILE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 31X9MM BRASSELER USA THK.38MM THK.43MM SAGITTAL OSCILLATE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA SLEEVE WITH BALLOON FIXATION,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY EPITOME BLADE ELECTRODE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP LARGE CHEVRON HEART INTERNAL WECK HEMOCLIP TITANIUM LIGATE TRIANGULATE CROSS SECTION WIRE CARTRIDGE BASE STERILE DISPOSABLE LATEX FREE ORANGE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,COAGULATOR SUCTION 6IN 10FR VALLEYLAB HANDSWITCH CORD THERMAL REDUCTION FLUID EVACUATION TUBE ENT STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,COVER PROBE 36X5.5IN TELESCOPICAL FOLD ELASTIC BAND GEL PACKET STERILE LATEX FREE CIV-FLEX,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DETECTOR CARBON DIOXIDE COLORIMETRIC LATEX FREE NELLCOR ENDOTRACHEAL TUBE PLACEMENT 22MM 13MM DISPOSABLE ADULT,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DETECTOR CARBON DIOXIDE COLORIMETRIC LATEX FREE NELLCOR ENDOTRACHEAL TUBE PLACEMENT 22MM 15MM 15MM 13MM DISPOSABLE ADULT,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRAIN BARD W/ TROCAR KIT CLSD WND SUCTION 3/16 15FR,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRAIN BARD W/ TROCAR LARGE HEMOVAC 1/4,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRAIN BARD W/ TROCAR ROUND 10FR,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING 5X4X.5IN FILLER PICO FOAM,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ETHIBOND 0 CT-1 CR CX21D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ETHIBOND 0 M07 18 GREEN CX41D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE NUROLON 0 MO-7 18 C541D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE PROLENE 5-0 SM-1 DA 12 7740G,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 0 8-18 C/R CT-2 J727D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 0 CT-1 CR 27 JJ41G,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 0 CT-1 CR J840D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 1 CT 18IN,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 2-0 CT-1/CR-8 J839D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 3-0 SH 18 C/R UNDYED J864D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRANSDUCER SINGLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY CATHETERIZATION COMPLETE CARE STATLOCK ADD-A-FOLEY SURESTEP DRAINAGE BAG STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY CATHETERIZATION STATLOCK SURESTEP 16FR FOLEY DRAINAGE BAG SILICONE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY CATHETERIZATION SURESTEP STATLOCK 14FR 2000ML FOLEY DRAINAGE BAG STABILIZATION DEVICE SILICONE STERILE LATEX FREE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY CATHETERIZATION SURESTEP STATLOCK 18FR 2L DRAINAGE BAG FOLEY SILICONE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY EPIDURAL 3.5IN 18GA 20GA PERIFIX TUOHY LIDOCAINE DEHP METAL PVC LOR CLOSED END CATHETER CONNECTOR 5ML LATEX FREE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBE NASOGASTRIC 90CM 6.5FR LARGE ENTERAL RADIOPAQUE DEHP FREE ORANGE POLYURETHANE NEONATE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING SMOKE EVACUATOR RAPIDVAC 10FT,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING GERMICIDAL 45X2CM AQUACEL AG MICRO CONTOUR RIBBON ANTIMICROBIAL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRSG WND 45X2CM AQCL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE ELECTROSURGICAL BALL 5MM STERILE STAINLESS STEEL EXTEND,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,UNIT ELECTROSURGICAL PROCEDURE SET GENESYS HTA PROCERVA,272,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,VAC PREVENA WOUND -SMALL,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE ELECTROSURGICAL 180MM 3.5MM SERFAS ENERGY 50-S XL NONBENDABLE SWEEP STERILE LATEX FREE DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAMER SURGICAL 10MM FLEXIBLE PRECISION DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAMER SURGICAL 4.5MM FLEXIBLE PRECISION DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SHEARS HARMONIC ACE SHEARS 36CM,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY LIGASURE HANDPIECE CURVED SMALL JAW,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CEMENT SCULPS,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE FIXATION VIOLET 5MM ABSORBATACK POLYESTER 30 TACK ABSORBABLE PISTOL GRIP HANDLE LAPAROSCOPIC HERNIA REPAIR STERILE DISPOSABLE,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TIP HARMONIC SCALPEL SHEARS 5MM 36CM,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING PREVENA INCISIONAL MANAGMENT,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT SYNTHES 2.0 QC 150MM,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEPS SPECIMEN RETRIEVAL 230CMX20MM 2.8MM 3 PRONG PROXIMAL FLUSH PORT PLASTIC TRIPOD NONSTERILE REUSABLE POLYPECTOMY,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HARMONIC 36CM,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,VALVE 9- FR Y UROSEAL ENDOSCOPIC ADJUSTABLE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT SHOULDER SUSPENSION,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MANIPULATOR 2 CUP LOCK SCREW HOLE INFLATE BALLOON HYSTERECTOMY ENDOSCOPIC VCARE SMALL 32MM CERVIX UTERUS STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MANIPULATOR UTERINE HUMI CURVE 2 LUMEN INJECTOR RIGID DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MARKER ENDOSCOPIC ENDOINK FLUID CAP SYRINGE GI TRACT 10ML STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MARKER ENDOSCOPIC PMT ENDOMARK DILUTE INDIA INK 10ML STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MARKER ENDOSPOT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE BIOPSY BARD MONOPTY 18GA X 20CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,Needle BIOPSY MAXCORE 18GA X 20CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,Needle ENDO INSUFFLATION 120MM (PN120),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,Needle ENDO INSUFFLATION 150MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE HYPO INTERJECT SCLEROTHERAPY 25GA,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE LOCALIZATION 7CM 20GA KOPANS SPRING HOOK WIRE REINFORCE STERILE BREAST LESION DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK ARTHROSCOPY KNEE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK ARTHROSCOPY SHOULDER,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK C-SECTION SJB,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK CYSTOSCOPY II BAG BOWL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK EXTREMITY SJB,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK LAPARATOMY,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK LAPARATOMY SJB,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACKING 5.5CM NASAL INFLATABLE UNILATERAL WITHOUT AIRWAY RAPID RHINO HYDROCOLLOID FABRIC,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACKING NASAL RAPID RHINO ANTERIOR,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PIN GUIDE SMITH AND NEPHEW IM HIP SCREW 3.2 X 353MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE ARTHROSCOPIC .75MM 1 PIECE ACTIVE ELECTRODE HANDCONTROL NONASPIRATE STERILE SYNERGYRF APOLLORF TISSUE DISPOSABLE 90D HOOK 2MM LATEX FREE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PROBE ELECTROSURGICAL APOLLORF 90D XL ASPIRATE ABLATOR,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RAPID RHINO 4.5 ANTERIOR EPISTAX,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RASP SURGICAL 11X5.5MM MICRO SMALL TEAR RECIPROCATE CROSS CUT SMALL BONE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RETRACTOR V-CARE VAG/CERV MED-STD,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RF PROBE VENOM ACTIVE TIP 100MM 20 GA,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET BLOOD WARMING HIGH FLOW,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET DILATOR SHEATH COAXIAL BOSTON SCIENTIFIC,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET INTERPULSE COAXIAL MULTIORIFICE TIP SUCTION TUBE HANDPIECE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET TUBING PNEUMOCLEAR HIGH FLOW SMOKE EVACUATION,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SETS ASEPTIC FLUID TRANSFER,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPLINT NAIL LARGE 22MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPLINT NASAL C-FLEX DOYLE BIVALVE SET,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPONGE SURGICEL 2 X 3,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE PROXIMATE CUTTER 60-3.8 RELOAD TCR55 GIA,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE PROXIMATE CUTTER 60-4.8 RELOAD XR60G,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE RELOAD GIA 60 4.1 GREEN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE TX60-3.5 RELOAD XR60B,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE TX90-4.8 RELOAD TR90,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER APPOSE ULC AUTO SUTURE SLIM BODY 35W,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUCTION TIP VIA GUARD,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE ARTHREX FIBERWIRE #2,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BIT DRILL 6.3MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE ARTHROSCOPY TOMCAT 4.0MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE DERMATOME 1.25-4.25IN STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE FULL RADIUS 2.9MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE INCISOR PLUS 4.5MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE LARYNGOSCOPE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE LARYNGOSCOPE MCGRATH,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 22.5MMX.38MM THIN RECIPROCATE STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 28.5X5.5X.4MM MICRO STAINLESS STEEL OSCILLATING FINE FLAT MICROCHOICE MICRO 100 E STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 35X10MM MICRO,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 90X18MM STRYKER PERFORMANCE SERIES THK1.37MM SAGITTAL HEAVY DUTY SYSTEM 6 STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 13CM 4MM COOLCUT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER 4.5MM TOMCAT ANGLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SHAVER EXCALIBER 13CM 4MM COOLCUT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE STRYKER DUAL CUT SAGITTAL 4 IN 1,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE STRYKER RECIPROCATING HEAVY SAW DUTY 277-96-325,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE STRYKER SAGITTAL 25MM X 1.37 X 90 (6125-137-90),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BUR STRYKER 12 FLUTED BARREL FORMULA 5.5 (0375-951-013),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR BRICK RED 5.5MM DYONICS ACROMIOBLASTER,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SHAVER 13CM 4MM COOLCUT 8 FLUTE OVAL STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SHAVER 13CM 4MM COOLCUT 8 FLUTE ROUND STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SHAVER 13CM 5.5MM COOLCUT 12 FLUTE OVAL STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SURGICAL 4MM ROUND 6 FLUTE F SERIES,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SURGICAL LILAC 4MM DYONICS NOTCHBLASTER STRAIGHT WIDE MOUTH REPROCESSED STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BURR SURGICAL WIRE PASS,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANISTER WOUND DRAINAGE INFOVAC GEL TUBE CLAMP CONNECTOR 500ML VAC ULTA,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA BUTTON 8MM 2CM PASSPORT BUTTON SILICONE CURVE HIP 1 PIECE MOLD 2 DAM 2 FLANGE LOW PROFILE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA CLEAR MITEK 7 X 75MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA PASSPORT BUTTON 4MM X 8CM (AR-6592-08-40),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA PASSPORT BUTTON 5CM X 8MM (AR-6592-08-50),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANNULA PASSPORT BUTTON 8 X 3,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CARTRIDGE FILTER CASTVAC REPLACEMENT LATEX FREE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CASSETTE WOUND DRAINAGE VAC VERALINK 38MM INSTILLATION TUBE SPIKEABLE CAP ADAPTER,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATCH ENDO POUCH,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER CHOLANGIOGRAM 19GA PRVW KUMAR CHOLANGIOCATHETER,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER ENDOSCOPIC 200CM 5.5FR CLASSIC METAL CANNULA TIP 2.8MM MINIMUM ACCESSORY CHANNEL STERILE REUSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER ENDOSCOPIC 200CM 5.5FR CLASSIC METAL CANNULA TIP ERCP 2.8MM MINIMUM ACCESSORY CHANNEL DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER ENDOSCOPIC 200CM 5.5FR HUIBREGTSE-KATON METAL BALL TIP ACCEPTS .035IN STANDARD GUIDEWIRE 2.8MM MINIMUM ACCESSORY CHANNEL STERILE REUSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER ENDOSCOPIC 200CM 5.5FR HUIBREGTSE-KATON METAL BALL TIP ERCP ACCEPTS .035IN GUIDEWIRE 2.8MM MINIMUM ACCESSORY CHANNEL DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER INTRAUTERINE PRESSURE SENSOR TIP EXTERNAL TRANSDUCER KOALA STERILE SMALL ROUND LATEX FREE URETHANE DISPOSABLE CLEAR,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER SUCTION 8FR 15IN CONTROL VALVE ATRAUMATIC TIP STANDARD CONNECTOR GENTLE-FLO STERILE TRANSPARENT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY ERASER WET-FIELD 23GA,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CEMENT MIXER STRYKER BOWL (MIXEVAC),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP LIGACLIP MCA MEDIUM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP LIGACLIP TITANIUM SMALL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET 4.5 X 44,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET BIER BLOCK DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUFF TOURNIQUET GREEN 44X4IN EXPRESSAIRE XLONG LEG 1 FILL LINE 1 BLADDER 1 PORT LUER LOCK ADHESIVE STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUTTER 13CM 5.5MM COOLCUT BONE CUTTER BONE CUTTING DISPOSABLE STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUTTER ARTHROSCOPIC BONE COOLCUT CURVE 13CM STERILE 4MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUTTER ARTHROSCOPIC BONE CURVE 4MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CUTTER ENDOSCOPIC AGGRESSIVE STRAIGHT STERILE DISPOSABLE 4MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE CPAP LARGE ADULT MRI COMPATIBLE HEAD STRAP SUPERNO2VA LATEX FREE NASAL PT HT 5FT 10IN-7FT 3IN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE CPAP MEDIUM ADULT MRI COMPATIBLE HEAD STRAP SUPERNO2VA LATEX FREE NASAL PT HT 4FT 7IN-6FT 9IN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE STRATAFIX MONOCRYL 45 CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE STRATAFIX PDS 24 INCH,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DISSECTOR ENDOSCOPIC 13CM 3.5MM COOLCUT STERILE ARTHROSCOPY,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE FIBERSTICK 2-0 FIBERWIRE 2-0,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE FIBERWIRE #5 AR-7211,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE GORTX CV-0 THX-26 36IN NONABSORB,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE MONOCRYL 4-0 KS 27IN UNDYED D9600,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE PDS ENDOLOOP 18 EZ10G,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE VICRYL 0 ENDOLOOP 18 EJ10G,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM CLEARIFY VISUALIZATION,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM DRUG DELIVERY ON-Q PAINBUSTER SILVERSOAKER DEHP CATHETER EXPANSION KIT 5IN STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM DRUG DELIVERY ON-Q PAINBUSTER SILVERSOAKER DEHP PUMP KIT CATHETER 2.5IN STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM FETAL MONITOR NOVII PATCH,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAP DORNOCH SPECIMEN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY BIOPSY JAMSHIDI ILLINOIS STANDARD BONE MARROW T HANDLE STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY SURGICAL CHEST TUBE INSERTION DISPOSABLE STERILE LATEX FREE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY THORACENTESIS/PARACENTESIS 5FR THORA-PARA DRAINAGE NONVALVE CATHETER 2 INDICATION STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY THORACENTESIS/PARACENTESIS ORANGE TINT 5FR CHLORAPREP FUTURA CATHETER APPLICATOR SCALPEL LUERLOCK SYRINGE 3ML 60ML 10ML LATEX FREE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING ARTHREX ARTHROSCOPY DUAL WAVE (AR-6430),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING ARTHROSCOPY PUMP GOFLO,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING STRYKER CROSSFLOW INFLOW CASSETTE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,V-CARE VAGINAL CERVICAL LARGE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING AQUACEL AG HYDROFIBER 3.5 X 14,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING AQUACEL AG HYDROFIBER 3.5 X11.8,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING AQUACEL AG HYRDOFIBER 3.5 X 10,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING VAC GRANUFOAM 10X7.5CM SMALL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING VAC GRANUFOAM BLACK 18X12.5CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING VAC GRANUFOAM LARGE 26X15CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT EBI LONG 3.5,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR ADULT CONDUCTIVE GEL RTS EDGE SYSTEM QUIK COMBO DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR ONESTEP CODE-READY RESUSCITATION COMPLETE SPEED PACK CONNECTOR PEDIATRIC R SERIES,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR PEDI-PADZ II PEDIATRIC AED PLUS DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE DEFIBRILLATOR PEDI-PADZ MULTIFUNCTION PAD LIQUID GEL PEDIATRIC ACLS,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEPS BIOPSY MULTIPLE SAMPLE 240CM 2.4MM MULTIBITE 2.8MM STERILE DISPOSABLE ORANGE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUARD PIN WHITE JURGAN PIN BALL 6 BALL .035IN K WIRE W SERIES STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE 8MM RING TUBE ALIGNMENT SURGICAL MEDULLARY,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE PIN 230MM X 2.4MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,IRRIGATOR LAPAROSCOPIC 33CM 5MM HYDRO-SURG PLUS NEZHAT-DORSEY SMOKEVAC SUCTION TUBE TRUMPET VALVE PROBE TIP HOLE STERILE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,IRRIGATOR SUCTION STRYKEFLOW 2,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT BREAST PUMP 2 SHIELD 2 DUET 2 MEMBRANE 2 VALVE PERSONALFIT HARMONY SYMPHONY 24MM 35ML STERILE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,WAND ARTHROCARE SHOULDER SUPER TURBO VAC,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT JEJUNOSTOMY 45CM 18FR SILICONE MIC SECUR-LOK LUER-SLIP RADIOPAQUE UNIVERSAL FEED PORT CONNECTOR INTERNAL RETENTION BALLOON TAPER DISTAL TIP 7-10ML STERILE LATEX FREE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT JEJUNOSTOMY 45CM 22FR SILICONE MIC SECUR-LOK LUER-SLIP RADIOPAQUE UNIVERSAL FEED PORT CONNECTOR INTERNAL RETENTION BALLOON TAPER DISTAL TIP 7-10ML STERILE LATEX FREE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,Needle SCLEROTHERAPY 25GA,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,OVERTUBES GUARDUS 8.6MM-10MM,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PAK VITRECTOMY ANTERIOR,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PASSER FIRSTPASS ST SELF CAPTURE PRELOAD ROUND PRECURVE NEEDLE DEEP BITE SUTURE NITINOL STERILE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PUMP PAIN ON-Q 400ML,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAMER LOW PROFILE ARTHREX 7.0MM,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAMER SURGICAL 10MM CANNULATED ACL LOW PROFILE STERILE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET DRAINAGE 29CM 14FR 19GA STAINLESS STEEL POLYURETHANE PVC 20 SIDEPORT 3 WAY STOPCOCK CATHETER THUMB SCALPEL WAYNE PIGTAIL CURVE 16.5CM STERILE DISPOSABLE PNEUMOTHORAX TROCAR PLACEMENT,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SPONGE ABSORBABLE 125X80X2.5MM DEHP FREE COMPRESS INDIVIDUAL WRAP GELFOAM 100,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BASKET DEVICE STONE RETRIEVAL 120CM 1.9FR 11MM DAKOTA OPENSURE NITINOL 3 ARM FLEXIBLE BASKET,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BIT DRILL 36.5CM 4.3MM CALIBRATE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAY DRAINAGE 41CM 16FR THAL-QUICK 4 SIDEPORT CATHETER CHEST TUBE NEEDLE STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING NASOPORE 4 CM STD,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL BIT ARTHREX 2.2MM STRGHT CANNULATED MINI COMPRESSION,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HANDPIECE MITEK VAPOR BIOMET,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT ARTHREX BIO TENODESIS INSTRUMENT DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,WAND ELECTROSURGICAL WEREWOLF FLOW 50 STERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAMER ARTHREX LOW PROFILE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,REAMER SURGICAL 8.5MM LOW PROFILE ACL RECONSTRUCTION STERILE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SHAFT SCREWDRIVER LUHR 2MM ASSEMBLY,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER CURVED CUTTER 3.0MM X 4.7MM CS40G,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER ECHELON POWERED FLEX 45MM X 34MM,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER INTERNAL 37CM XL CIRCULAR 2 ROW SEAL 5.2MMX1.5-2.2MM 29MM,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER INTERNAL 37CM XL CIRCULAR 2 ROW SEAL 5.2MMX1.5-2.2MM 33MM,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER LAPAROSCOPIC HERNIA PROTAC,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER PURSESTRING 65 020242,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BALLOON POSTPARTUM BAKRI 24FR,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW PRECISION FALCON OSCILLATING TIP CARTRIDGE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW PRECISION L90 MM FALCON CARTRIDGE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BRONCHOSCOPE FLEXIBLE 3.8MM 1.2MM,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BRONCHOSCOPE FLEXIBLE AMBU ASCOPE 4 AVIEW 85 D D6-50 MM REGU,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CATHETER CRICOTHYROTOMY SET PEEL OPEN CUFF RADIOPAQUE EMERGENCY AIRWAY ACCESS 9CM MELKER 7.2MM 5MM DISPOSABLE STERILE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DEVICE SUTURE PERFECT PASSER,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYRINGE INFLATION ALN 2 GAGE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT ENDOSCOPIC INSTRUMENT 1.35-1.6MM DRILL GUIDE GUIDEWIRE DISPOSABLE FIBERTAK DX SUTURE ANCHOR,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRILL SURGICAL FULL THICK CALIBRATE DEPTH MARK CANNULATED ACL 10MM STERILE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,WAND ESURG 3.75MM 3MM AMB SUPR MULTIVAC CBLTN 50D,272,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLE RELOAD RELIATACK ARTIC FIXATION,272,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SYSTEM FIXATION OPTIFIX 30 ABSORBABLE FASTENER ARTICULATE,272,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING SUCTION 30CM 8FR T SILICONE TRANSLUCENT STERILE LATEX FREE,272,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,WATER STERILE 2000ML STERILE UROMATIC LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,KIT PROCEDURE ENDO CARRY-ON DEFENDO DISPOSABLE VALVE CONNECTOR,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,MASK OXYGEN RESIN ADULT SOFT NONKINKING TUBE LUER LOCK CONNECTION BEVEL TIP LATEX FREE CAPNOXYGEN 8FT 8IN,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,NEEDLE OPHTHALMIC 1.5IN 25GA ATKINSON RETROBULBAR ANESTHESIA STERILE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,PACK PERI GYN,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,RESUSCITATOR MANUAL INFANT MASK O2 RESERVOIR BAG PRESSURE LIMIT VALVE LATEX FREE DISPOSABLE SPUR II,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET EPIDURAL 3.5IN 18GA 20GA PERIFIX TUOHY BPA NYLON PVC FREE DEHP FREE CLOSED TIP CATHETER NEEDLE STERILE LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET EXTENSION STRAIGHT 3.3ML 19IN INTRAVENOUS MALE LUER LOCK ADAPTER STANDARD BORE LUER ACTIVATE VALVE RETRACT COLLAR STERILE CLEARLINK CONTROL-A-FLO LATEX FREE DEHP,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SET EXTENSION Y .47ML 5.7IN INTRAVENOUS CATHETER DEHP FREE NEEDLE FREE IV CONNECTOR MICROBORE STERILE ONE-LINK LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER SKIN APPOSE ULC 35 REGULAR,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STAPLER SKIN PROXIMATE WIDE PXW35,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,STYLET INTUBATION SMALL GLIDERITE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 1 STRAIGHT INFANT LMA-UNIQUE CUFF SYRINGE 4ML DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 1.5 LMA UNIQUE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 2 LMA UNIQUE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 2.5 LMA UNIQUE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 3 STRAIGHT PEDIATRIC LMA-UNIQUE CUFF SYRINGE 20ML DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 4 STRAIGHT ADULT LMA-UNIQUE CUFF SYRINGE 30ML DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,AIRWAY ESOPHAGEAL 5 LMA UNIQUE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BAG RESUSITATION ADULT,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE OPHTH 5MM I KNIFE 15D STD,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 18.5X9MM THK.38MM THK.43MM SMALL BONE OSCILLATE SAGITTAL,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,BLADE SAW 25X9.5X.4MM MICRO SAGITTAL STERILE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CANISTER CARBON DIOXIDE 1KG CYLINDRICAL LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAST 3YDX4IN GYPSONA PLASTER GAUZE BANDAGE ORTHOPEDIC,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY BATTERY BOVIE 2200F HIGH TEMPERATURE FINE TIP STERILE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CAUTERY ERASER WET-FIELD 18GA,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,CLIP MEDIUM LARGE CHEVRON HEART INTERNAL WECK HEMOCLIP TITANIUM LIGATE TRIANGULATE CROSS SECTION WIRE CARTRIDGE BASE STERILE DISPOSABLE LATEX FREE GREEN,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING 4X4IN BACTERIOSTATIC HYDROFERA BLUE FOAM,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING AQUACEL AG 4X5IN,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,SUTURE SILK 3-0 SH-1 CR 18,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TIP PULSED LAVAGE SIPS MULTIPLE ORIFICE TIP COAXIAL STERILE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TRAP POLYP,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,TUBING COLLECTION SET D AND C,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,VALVE SUCTION BRONCHOSCOPE STERILE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING BIOPATCH 2.5CM X 4.0MM,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING GAUZE IODOFORM 2,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRESSING TUBE GAUZE #1 5/8,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,DRSG WND 5X4IN RECT,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,ELECTRODE ELECTROSURGICAL BLADE 2.75IN 3/32IN EDGE SAFETY SLEEVE STERILE .2IN DISPOSABLE INSULATE STANDARD SHAFT LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,FORCEPS BIOPSY ALLIGATOR 155CM 2.8MM ENDOJAW STAINLESS STEEL STERILE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUARD BALL JURGAN PIN .065-5/64 3/8 DIA,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUARD PIN COVERS .045,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,GUIDE PROBE 8GA REVOLVE MAMMOTOME BUTTON STEROTACTIC DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27270000,N/A,HANDLE LARYNGOSCOPE BRITEPRO SOLO ROUND METAL 3 SPRUNG BALL ADVANCE LED LIGHT BLADE MOLD SOFT GRIP STERILE LATEX DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271726,C1726,BALLOON CRE DILATION 12-15MM 7.5FR,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A , N/A , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27271726,C1726,CATHETER URINARY TRACT 5.8FR 24FR 75CM 8CM HIPRES KINK,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27271726,C1726,BALLOON CRE DILATION 15-18MM 7.5FR,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A , N/A , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27271726,C1726,DEVICE INFLATION CRE (SYRINGE),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271726,C1726,DILATOR AMPLATZ SET,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27271727,C1727,BALLOON DISSECTOR LAPAROSCOPIC SPACEMAKER PLUS BTT 65X3FT PNEUMOPERITONEUM BLUNT TIP ACCESS PORT SPRING GRIP LOCK COLLAR FOAM LATEX DISPOSABLE HERNIA REPAIR ROUND BLUE,272,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A , N/A , N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER URETHRAL BARDEX LUBRICATH 20FR 40CM STANDARD FOLEY 2 WAY DRAINAGE EYE MEDIUM OLIVE COUDE TIP NATURAL RUBBER HYDROGEL 5CC STERILE LATEX DISPOSABLE CARSON MODEL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER DRAIN 24FR 20IN ARG SENTL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER DRAIN CLR 20IN 32FR ARG S,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY 18FR 5CC 3-WAY,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY BARD 3-WAY 22FR 5ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY BARD 3-WAY 24FR 5ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY SILCONE BACTI GUARD 20 FR 3 WAY 30ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY SILCONE BACTI GUARD 22 FR 3 WAY 30ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER THORACIC 28FR X 20CM STR,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER URETERAL DOV 22FR 16IN FOLEY,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER URETERAL LBRSL 24FR SH RND,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER URETHRAL BARDEX LUBRICATH 18FR 40CM FOLEY 2 WAY DRAINAGE EYE MEDIUM OLIVE COUDE TIP RUBBER HYDROGEL HYDROPHILIC 5CC STERILE LATEX DISPOSABLE AMBER CARSON MODEL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER URETHRAL CURITY DOVER 16FR 16IN FOLEY 2 WAY LARGE SMOOTH DRAINAGE EYE RIBBED BALLOON ULTRAMER 30CC STERILE LATEX DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATH T-TUBE 8FR,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY SILICONE 10FR DOVER,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER URETHRAL 18FR FOLEY 3 WAY BALLOON 5ML LATEX,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,DRAIN INCISION 7FR SILICONE TROCAR MIDDLE PERFORATION ROUND,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER FOLEY 18FR 30CC 3 WAY,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,CATHETER TROCAR CHEST 10FR 9 W/TROCAR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,KIT CATHETER PLEURAL STARTER 4 BOTTLE PLEURX 1000ML,272,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27271729,C1729,KIT CATHETER PERITONEAL STARTER PLEURX 1000ML STERILE LATEX FREE DISPOSABLE,272,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A , N/A , N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27271751,C1751,CATHETER 5FR IV POWERPICC SHERLOCK 3CG 2 LUMEN MAXIMAL BARRIER POLYPROPYLENE LATEX FREE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27271751,C1751,KIT CATHETER 4FR 20CM BIOFLO ENDEXO 1 LUMEN MAXIMAL BARRIER 2 GUIDEWIRE MIDLINE NITINOL,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27271751,C1751,CATHETER CV DUAL LUMEN HICKMAN 10.0FR BARD,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27271751,C1751,KIT CATHETER 5FR 55CM POWERPICC PROVENA SOLO PLACEMENT STERILE LATEX FREE DISPOSABLE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A , N/A , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL WHISTLE TIP 6 FR,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL BARD 5FR 69CM LARGE OPEN TIP ADAPTER KINK RESISTANCE GRADUATED POLYURETHANE STERILE LATEX FREE DISPOSABLE ACCEPTS .038IN GUIDEWIRE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL BARD 5FR 70CM SPRL TIP ADAPT KINK RST,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL BARD 6FR 69CM LARGE OPEN TIP ADAPTER KINK RESISTANCE GRADUATED POLYURETHANE STERILE LATEX FREE DISPOSABLE ACCEPTS .038IN GUIDEWIRE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A , N/A , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETHRAL PUREWICK FREE FEMALE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER FOLEY 20 FR 5 CC 3-WAY,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL OPEN ENDED 5FR X 70CM BOSTON SCIENTIFIC,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETHRAL BARDEX LUBRICATH 16FR STANDARD FOLEY 2 WAY DRAINAGE EYE MEDIUM OLIVE COUDE TIP RUBBER HYDROGEL HYDROPHILIC 5CC STERILE LATEX DISPOSABLE AMBER CARSON MODEL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,MANIPULATOR RUMI UTERINE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL BARD TIGERTAIL 5FR 70CM OPEN TIP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETERAL POLLACK OPEN END 5FR ACCESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271758,C1758,CATHETER URETHRAL BARDEX LUBRICATH 20FR STANDARD OVOID FLUTE FOLEY 2 WAY 2 STAGGER EYE MEDIUM ROUND TIP NATURAL RUBBER HYDROGEL 75CC STERILE LATEX DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ENDOSCOPIC SOLO NITINOL STRAIGHT OD.035 IN HYBRID,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A , N/A , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ORTHOPEDIC PRECISION NITINOL FLEXIBLE,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A , N/A , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE STRYKER,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE URO 150CM .035IN BNTSN PTFE STRT TIP FIX,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE .035 X 4,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ARTHREX KIRSCHNER .062 (157MM/1.6IN) TROCAR TIP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE BENTSON STRAIGHT .035IN 150CM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ORTHOPEDIC 6IN .054IN STAINLESS STEEL TROCAR,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A , N/A , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,WIRE GUIDE .025/450CM,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE BALL NOSE DEPUY 3MM X 80CM,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ORTHO 3MM 98CM BEAD TIP,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,WIRE GUIDE SYNTHES 1.1 NON-THREADED 150MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ORTHOPEDIC .045IN 2 TROCAR TIP LASER MARK 3.5 MINI 4 STANDARD COMPRESSION FT SCREW DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE SENSOR .035 X 150CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE URO BLUE STRIP WHT STRIP 150CM .035IN ZBR,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ZIPWIRE BOSTON SCI.035IN X 150CM LF,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ZIPWIRE STRAIGHT .035 X 150CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,WIRE K STRYKER GAMMA 3 3.2X450MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27271769,C1769,GUIDEWIRE ORTHOPEDIC 460MM 3.2MM COCR THREAD TIP PHOENIX ANTEGRADE FEMORAL NAIL SYSTEM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A , N/A , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27271885,C1885,CATHETER TAUT CHOLANGIOGRAM 4.5FR,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271885,C1885,CATHETER TAUT CHOLANGIOGRAM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,INTRODUCER LEAD 10.5FR SPLITTABLE STERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A , N/A , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,INTRODUCER SHEATH 8FR 11CM MINI GUIDEWIRE AVANTI+ STAINLESS STEEL .038IN STANDARD LENGTH DISPOSABLE BLUE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,CATHETER TELEFLEX A-LINE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,INTRODUCER SHEATH 7FR 11CM MINI GUIDEWIRE AVANTI+ STAINLESS STEEL .038IN STANDARD LENGTH DISPOSABLE ORANGE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A , N/A , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,KIT INTRODUCER 10CM 8.5FR 18GA ARROW-FLEX .035IN PERCUTANEOUS POLYURETHANE SHEATH CATHETER GUIDEWIRE NEEDLE 6.35CM LATEX FREE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,KIT ARROW 8.5 PSI W/VLAVE SIDE PORT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A , N/A , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,SHEATH URETERAL ACCESS 12/14*46CM NAVIGATOR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,SHEATH SET URETERAL ACCESS 11F 13F,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,SHEATH URETERAL ACCESS 11/13*36CM NAVIGATOR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27271894,C1894,SHEATH URETERAL ACCESS 12/14*36CM NAVIGATOR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A , N/A , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27571785,C1785,PACEMAKER CARDIAC THK6MM 52X44MM VICTORY XL DR 2 CHAMBER RATE RESPONSIVE EXTEND LONGEVITY 11ML 23.5GM,275,1 ,"$11,700.00 ","$8,424.00 ","$3,276.00 ","$11,700.00 ", N/A ,"$7,605.00 ","$6,984.90 ", N/A ,"$3,276.00 ","$7,745.40 ", N/A ,"$7,745.40 ", N/A ,"$6,973.20 ","$6,973.20 ", N/A ,"$6,973.20 ", N/A ,"$9,009.00 ", N/A , N/A , N/A ,"$8,775.00 ","$8,307.00 ","$8,307.00 ", N/A ,"$8,307.00 ","$9,945.00 ","$9,945.00 ","$9,945.00 ", N/A , N/A ,"$9,945.00 ", N/A ,"$11,700.00 ","$6,563.70 ", N/A ,"$4,843.80 ", N/A , N/A , N/A ,"$9,945.00 ", N/A ,"$6,973.20 ","$3,276.00 ","$10,530.00 ", N/A ,"$9,945.00 ","$9,886.50 ","$9,886.50 ", N/A ,"$7,605.00 " ST. JOSEPH'S HOSPITAL - BREESE,27671780,C1780,IOL ALCON MN60AC,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27671780,C1780,IOL ALCON MTA4U0,276,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27672632,V2632,IOL ALCON SN60WF,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27672632,V2632,IOL ALCON AU00T0,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27672632,V2632,IOL TECNIS SIMPLICITY DCB00,276,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27800553,A4648,HC TISSUE MARKER IMPLANTABLE,278,1 ,$367.50 ,$264.60 ,$102.90 ,$367.50 , N/A ,$238.88 ,$219.40 , N/A ,$102.90 ,$243.29 , N/A ,$243.29 , N/A ,$219.03 ,$219.03 , N/A ,$219.03 , N/A ,$282.98 , N/A , N/A , N/A ,$275.63 ,$260.93 ,$260.93 , N/A ,$260.93 ,$312.38 ,$312.38 ,$312.38 , N/A , N/A ,$312.38 , N/A ,$367.50 ,$206.17 , N/A ,$152.15 , N/A , N/A , N/A ,$312.38 , N/A ,$219.03 ,$102.90 ,$330.75 , N/A ,$312.38 ,$310.54 ,$310.54 , N/A ,$238.88 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,ALLOGRAFT THERASKIN 1 X 1IN 6SQ CM MATRIX,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,BARRIER SEPRAFILM 5 X 6,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,GRAFT BONE CANCELLOUS CORTICAL 15ML FREEZE DRIED CHIPS,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,GRAFT SOFT TISSUE ANTERIOR TIBIALIS TENDON L260 MM OD8 MM FR,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,KIT BONE CEMENT MIXEVAC II BOWL HIGH VACUUM SPATULA STERILE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,GRAFT BONE CANCELLOUS 5ML FREEZE DRIED CHIPS 9.5X4MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SCREW INTERFERENCE BIOCOMPOSITE 20MM 7MM KNEE FASTTHREAD,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,CLIP RESOLUTION 2.8MM 360 235CM 11MM OPEN,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SLEEVE CENTERING 10MM 11MM MATRIX OPTI-FIX PLUS 8 FEMUR DISTAL POROUS PRIMARY,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,ALLOGRAFT THERASKIN 3 X 2IN CRYOPRESSURE MESH,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SLEEVE CENTERING 38.1MM 9MM 12.7MM IMHS CP HIP INTRAMEDULLARY SET SCREW,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SLEEVE CENTERING 60MM 15MM MATRIX 12 STRAIGHT FEMUR DISTAL POROUS PRIMARY,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,ALLOGRAFT THERASKIN 2 X 1IN 13SQ CM CRYOPRESSURE MESH,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SYSTEM BONE CEMENT COMPRESSOR CAP FEMUR DISPOSABLE,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,CABLE STAINLESS STEEL 2.0MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,GUIDEWIRE STRYKER BALL TIP STERILE 3.0 X 800MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SYSTEM BONE CEMENT HIVAC 7,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,AGENT HEMOSTATIC FLOSEAL MATRIX 5 ML,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,KIT HEMOSTATIC FLOSEAL MATRIX 13 CM 5 ML MALLEABLE APPLICATOR,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,SLEEVE CABLE 2.0MM STAINLESS STEEL,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TISSUE WRIGHT MEDICAL STANDARD CURE RESORB MINI BEAD 5ML,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,GRAFT BONE ALLOMATRIX PUTTY WRIGHT MEDICAL 5ML,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,KIT PREPARATION PREP-IM 1M HIP BONE TOTAL HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TRAY TIBIAL 75MM KNEE POROUS PRIMARY,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TRAY TIBIAL 71MM KNEE POROUS PRIMARY,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TUBE VENTILATION BLUE 1.27MM 1.5MM COLLAR BUTTON EAR SILICONE ELASTICITY SMOOTH MYRINGOTOMY,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,DEVICE V-LOC 0 GS-21 L9 IN VLOCN0346,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TUBE EAR BLUE 1.55MM 1.27MM 3MM SHEEHY 3MM BUTTON EAR FLUOROPLASTIC CLASSIC COLLAR,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TUBE EAR BLUE 12MM 1.14MM 9.8MM T TYMPANIC,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TUBE EAR REUTER FLUOROPLASTIC WIDE BOBBIN ID1 MM IDS,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TUBE GASTRO TUBE SZ 22 MIC,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27870000,N/A,TUBE MIC GASTROSTOMY 16FR/20CC,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT BONE TOBRAMYCIN SIMPLEX,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE 2 FULL THREAD BIO-CORKSCREW FIBERWIRE POLY L LACTIC ACID 14MM STERILE DISPOSABLE,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CABLE STRYKER D/M 1.6MM CABLE/SLEEVE SET,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CABLE/SLEEVE ORTHOPEDIC 2MM DALL-MILES HIP VITALLIUM SET,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW INTERFERENCE 70% PLDLA 30% BETA TRI-CALCIUM PHOSPHATE 25MM 9MM FULL THREAD TIBIA ACL COMPOSITCP 30 TOGGLELOC FIXATION DEVICE,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW INTERFERENCE BIOCOMPOSITE 20MM 8MM KNEE VENT FASTTHREAD,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW INTERFERENCE BIOMET 8 X 25MM,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT FULL DOSE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES TI QUARTER-TUBULAR WITH COLLAR 4 HOLES/31MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW NON-LOCKING HEXALOBE ACUMED 3.5 X 12MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 19MM COMPRESSION,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 28.5MM COMPRESSION,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 6MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 7MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 8MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 9MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 10MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 11MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 12MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 13MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.0 TI CORTEX SELF TAP 14MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.3 CORTEX SELF TAP 11MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CORTEX SELF TAP 13MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 9MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 10MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 11MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 12MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 13MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 14MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 16MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 18MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 22MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 TI CORTEX SELF TAP 24MM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WASHER 12.7MM 6.5MM ORTHOPEDIC,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE FIXATION .035IN 9IN KIRSCHNER STAINLESS STEEL 2 END DIAMOND POINT THREAD NONSTERILE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE FIXATION .045IN 9IN KIRSCHNER STAINLESS STEEL 2 END DIAMOND POINT THREAD NONSTERILE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE FIXATION .062IN 9IN KIRSCHNER STAINLESS STEEL 2 END DIAMOND POINT THREAD NONSTERILE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,K-WIRE 6 HALF BAY PT 1.6MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CABLE ORTHOPEDIC VITALLIUM 2MM HIP SLEEVE DALL-MILES,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,K-WIRE 0.062,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 4.5MM 30MM IMHS CORTICAL SELF TAPPING,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 10MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 12MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 14MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 16MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 18MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 22MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 24MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 CORTEX S/TAP 40MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 TI CORTEX S/TAP F/T 10MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 TI CORTEX S/TAP F/T 12MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 TI CORTEX S/TAP F/T 14MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 TI CORTEX S/TAP F/T 16MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 14,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 16,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 18,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS FULL THREAD 20,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 CANCELLOUS PT 10,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 TI CANC F/THRD 12MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 TI CANC F/THRD 14MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 TI CANC F/THRD 16MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 TI CANC F/THRD 18MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 4.0 TI CANC F/THRD 20MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WASHER SYNTHES TITANIUM 7MM,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,KIT ARTHREX BIOANCHOR SPEEDBRIDGE 5.5 SWIVELOCK,278,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$3,705.00 ","$3,402.90 ", N/A ,"$1,596.00 ","$3,773.40 ", N/A ,"$3,773.40 ", N/A ,"$3,397.20 ","$3,397.20 ", N/A ,"$3,397.20 ", N/A ,"$4,389.00 ", N/A , N/A , N/A ,"$4,275.00 ","$4,047.00 ","$4,047.00 ", N/A ,"$4,047.00 ","$4,845.00 ","$4,845.00 ","$4,845.00 ", N/A , N/A ,"$4,845.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$2,359.80 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$3,397.20 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,845.00 ","$4,816.50 ","$4,816.50 ", N/A ,"$3,705.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE SPEEDBRIDGE ARTHREX 4.75 X 19.1MM,278,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$3,705.00 ","$3,402.90 ", N/A ,"$1,596.00 ","$3,773.40 ", N/A ,"$3,773.40 ", N/A ,"$3,397.20 ","$3,397.20 ", N/A ,"$3,397.20 ", N/A ,"$4,389.00 ", N/A , N/A , N/A ,"$4,275.00 ","$4,047.00 ","$4,047.00 ", N/A ,"$4,047.00 ","$4,845.00 ","$4,845.00 ","$4,845.00 ", N/A , N/A ,"$4,845.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$2,359.80 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$3,397.20 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,845.00 ","$4,816.50 ","$4,816.50 ", N/A ,"$3,705.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,KIT INSTRUMENT 2MM 2X100MM BONE TAMP GUIDE SLEEVE RADIOLUCENCY SUPERIOR SHEAR STRENGTH TRIM-IT DRILL PIN KIRSCHNER DISPOSABLE STERILE,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,BONE SCREW ARTHREX QUICKFIX TITANIUM 2MMx12MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,IMPLANT ARTHREX ANCHOR CORKSCREW 5.0 X 15.5MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,KIT INSTRUMENT 1.5MM BONE TAMP GUIDE SLEEVE RADIOLUCENCY SUPERIOR SHEAR STRENGTH TRIM-IT DRILL PIN KIRSCHNER DISPOSABLE STERILE,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIO COMPOSITE 7MM X 23MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 5MM 34MM TITANIUM CORTICAL 2 LEAD THREAD SELF TAP TIP STERILE LIGHT GREEN PHOENIX RETROGRADE FEMORAL NAIL SYSTEM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CANNULATED SMITH AND NEPHEW 4.0 X 30MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CANNULATED SMITH AND NEPHEW 4.0 X 40MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CANNULATED SMITH AND NEPHEW 4.0 X 50MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CANNULATED SMITH AND NEPHEW 4.0 X 52MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW QUICKFIX ARTHREX 3MM X 13MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW QUICKFIX ARTHREX 3MM X 15MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SET IM HIP,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW STRYKER LOCKING 5MM X 35MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW STRYKER LOCKING 5MM X 40MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,TIGHTROPE ARTHRES BUTTON ACL 12 X 8MM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PEG FIXATION 2.3MM 16MM CORTICAL LOCK SMOOTH TITANIUM ACU-LOC NONSTERILE BRONZE,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 4.0 CANN CANCELLOUS 40MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CANNULATED HEADED ARTHREX 7 X 25MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW INTERFERENCE CANNULATED ARTHREX 8 X 20MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW INTERFERENCE SHEATHED ARTHREX 8 X 25MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW INTERFERENCE SHEATHED CANNULATED ARTHREX 7 X 20MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOCKING 2.4 X 10MM ARTHREX,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW MEDSOURCE SMOOTH 2.3 X 18MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW MEDSOURCE SMOOTH 2.3 X 20MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW MEDSOURCE THREADED 2.3 X 20MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW NON-LOCKING 2.4 X 10MM ARTHREX,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW OSTEOMED CAN LAG 2.0 X 10MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 12MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 14MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 16MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 18MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 20MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 24MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 38MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5 LOCKING STARDRIVE 48MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PIN FIXATION 240MM 3.5MM TIBIA TROCAR INTRAMEDULLARY NAIL DISPOSABLE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,HOLDER PLATE ARTHREX BB TAK,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 CORTICAL 20MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 CORTICAL 22MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 CORTICAL 24MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 4.5 CANN CORTEX BONE 34MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 4.5 CANN CORTEX BONE 44MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET LOW PROFILE 3.5MM X 16MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2.7MM 14MM RADIUS DISTAL VOLAR NONLOCK 3 LEAD TAPER NONSTERILE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2.7MM 5MM 6MM TITANIUM FULL THREAD RADIUS CORTEX DISTAL SELF TAP SMALL HEXAGONAL SPHERICAL NONSTERILE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2.7MM 5MM 8MM LCP TITANIUM FULL THREAD RADIUS CORTICAL DISTAL SELF TAP HEXAGONAL SPHERICAL NONSTERILE SMALL FRAGMENT SET,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CORTICAL LOW PROFILE DEPUY 3.5 X 18MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 34MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 36MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 38MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 40MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 42MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 44MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 46MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS AMBI HEXHEAD 48MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 6MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.5 TI CORTEX SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.0 TI CORTEX SELF TAP 11MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CORTEX SELF TAP 12MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CORTEX SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CORTEX SELF TAP 16MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CORTEX SELF TAP 18MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CORTEX SELF TAP 22MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 METAPHY SEAL SELF TAP 40MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 10MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 12MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 14MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 16MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 18MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 20MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 22MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 TI CORTEX S/TAP 24MM F/T,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SUTURE FIBERWIRE #2 TAPE 1.3 BRAIDED FLAT,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE FIXATION .035IN 9IN KIRSCHNER STAINLESS STEEL 2 END DIAMOND POINT NONSTERILE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE FIXATION .045IN 9IN KIRSCHNER STAINLESS STEEL 2 END DIAMOND POINT NONSTERILE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE FIXATION .062IN 12IN KIRSCHNER STAINLESS STEEL 2 END DIAMOND POINT NONSTERILE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PIN ORTHOPEDIC BB-TAK THREAD DISPOSABLE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,BONE SCREW ARTHREX LOW PROFILE HEXALOBE LOCK 3.5MMx16MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,BONE SCREW ARTHREX LOW PROFILE HEXALOBE LOCK 3.5MMx18MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT BONE LVC COPOLYMER,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES TI QUARTER-TUBULAR WITH COLLAR 5 HOLES/39MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES TI QUARTER-TUBULAR WITH COLLAR 6 HOLES/47MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 SELF TAP LOCKING 10MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 SELF TAP LOCKING 14MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 SELF TAP LOCKING 16MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 SELF TAP LOCKING 18MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOMET 3.5 SELF TAP LOCKING 20MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2.7MM 18MM RADIUS DISTAL VOLAR LOCK 3 LEAD TAPER NONSTERILE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2.7MM 20MM RADIUS DISTAL VOLAR LOCK 3 LEAD TAPER NONSTERILE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 3.5MM 12MM VARIAX TITANIUM T10 FULL THREAD FOOT ANKLE SELF TAP NONSTERILE YELLOW LOCK PLATE SYSTEM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 3.5MM 14MM VARIAX TITANIUM T10 FULL THREAD FOOT ANKLE SELF TAP NONSTERILE YELLOW LOCK PLATE SYSTEM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 6.5MM 35MM TITANIUM DOME HIP ACETABULAR CANCELLOUS SELF TAP LOW PROFILE STERILE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 6.5MM 50MM TITANIUM DOME HIP ACETABULAR CANCELLOUS SELF TAP LOW PROFILE STERILE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE DEPUY 5.5 X 45MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW CANCELLOUS DEPUY 4.8 X 46MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOCKING ARTHREX 3.5 X 24MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOW PROFILE BIOMET 6.5 X 25MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOW PROFILE SELF TAPPING BIOMET 6.5 X 30,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOW PROFILE SELF TAPPING BIOMET 6.5 X 40MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW NON-LOCKING STRYKER T10 3.5 X 32MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW NON-LOCKING STRYKER T10 3.5X22MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 6MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 7MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 8MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 9MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 10MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 11MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 12MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 13MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 14MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 16MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 1.3 TI CORTEX SELF TAP 18MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 15MM TITANIUM EXTEND BONE RIGHT NONSTERILE,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT BONE LVC 80/40 1 KIT,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW OSTEOMED CAN LAG 2.4 X 16MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 14MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 18MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 20MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 22MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 24MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 26MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 30MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 36MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 40MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.7 VA LOCKING S/TAP T8 50MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5MM VAR ANGLE LOCK SLF-TAP 26MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 3.5MM VAR ANGLE LOCK SLF-TAP 30MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI H EXTENDED / LEFT,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE OMEGA PEEK OD3.9 MM 1 ARM KNOTLESS,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,IMPLANT FIXATION SPEEDLOCK PEEK KNOTLESS RADIOLUCENT INDEPENDENT LOCK,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI TUB 8H,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE 6.5MM OMEGA KNOTLESS PEEK STERILE LATEX FREE,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOCKING HEXALOBE ACUMED 3.5 X 14MM,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI Y 3 HOLES HEAD/ 8 HOLES SHAFT/32MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR ARTHREX PUSHLOCK BIOCOMPOSITE 2.9 X 12.5MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE 2.9MM 2.3MM SHORT MEDIUM PUSHLOCK BIOCOMPOSITE 12.5MM STERILE,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE 4.75MM BIO-SWIVLOCK C CLOSE EYELT VENT,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE 5.5MM BIO-SWIVELOCK C CLOSED EYELET VENT 19.1MM STERILE DISPOSABLE,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE ARTHREX BIO SWIVELOCK 3.5X15.8MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE FLAT FIBERTAK FIBERWIRE ROTATOR CUFF TAPE BRAID 1.3MM BLACK BLUE WHITE,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PIN FIXATION 3.5IN 1/8IN FLUTE SQUARE KNEE STAINLESS STEEL HEADLESS STERILE,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BIOCOMPOSITE TENODESIS ARTHREX 5.5 X15MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 100MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 105MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 110MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 120MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 65MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 70MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 75MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 80MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 85MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 90MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 95MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS LAG 60MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE POLETHYLENE POROUS PE SYNTHES 50MM X50MM/0.8MM THICK,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 12H STRAIGHT 47MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI T 3 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI T 4 HOLES HEAD/ 8 HOLES SHAFT,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1/3 TUBULAR LCP W/COLLAR 6 HOLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT BONE BIOMET COBALT HV W/ GENTAMYCIN,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT BONE DJO SURGICAL COBALT GENTAMICIN 40GM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,CEMENT BONE REFOBACIN,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 10 HOLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 12 HOLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 7 HOLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES ONE-THIRD TUBULAR LCP W/COLLAR 8 HOLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2.7MM 20MM RADIUS DISTAL VOLAR 3 LEAD THREAD MULTIDIRECTIONAL TAPER NONSTERILE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOCKING STRYKER T10 3.5 X 14MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOCKING STRYKER T10 3.5 X 16MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LOCKING STRYKER T10 3.5 X 18MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW OSTEOMED CAN LAG 2.4 X 14MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI TUB 6H,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3 TI TUB 7H,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 2.7MM TI L 3 HOLES/34MM-OBLIQUE RIGHT,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,IMPLANT ARTHREX ANCHOR BIO-CORKSCREW 4.5MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES SM T OB TITANIUM 3.5MM 3H HEAD 4H SHAFT 63MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 2MM 12MM HPS TITANIUM HAND CANNULATED,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 6.5 CANN 100MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 6.5 CANN 105MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 6.5 CANN 85MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 6.5 CANN 90MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW RICHARDS 6.5 CANN 95MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW SYNTHES 2.4 CANN SELF TAP SHORT TH 10MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 1.3MM TI STRAIGHT 6 HOLES/23MM,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 2.7MM TI L 3 HOLES/34MM-OBLIQUE LEFT,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 2.7MM TI T 3 HOLES/32MM,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR MITEK QUICK GII #2,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE 1 FIBERTAK FIBERWIRE NEEDLE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE BIOKNOTLESS PLUS OROTHOCORD LOW PROFILE KNOTLESS REPAIR SUPERIOR SHIFT RENTENTION STERILE LATEX FREE BLUE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE MINI QUICKANCHOR SUTURE #2-0 ORTHOCORD,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,DEVICE FIXATION 5MM SECURESTRAP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,IMPLANT ANCHOR SUT 2 VERSLN OTHCRD 36IN LTXFR BLUE VIO,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,IMPLANT WRIGHT MEDICAL OSTEOSET BEAD KIT TISSUE 5CC,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL IMHS 135DEG SMITH AND NEPHEW 12 X 21,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL IMHS 135DEG SMITH AND NEPHEW 14 X 21,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL IMHS 135DEG SMITH AND NEPHEW 16 X 21,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 100MM TITAN ORTHO,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 105MM TITAN,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 110MM TITAN,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 95MM ORTHO LAG TLSC,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW GAMMA 3 STRYKER,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW LAG CHS SMITH AND NEPHEW 115MM,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 130D STANDARD BARREL 100MM STAINLESS STEEL 4 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 130D STANDARD BARREL 120MM STAINLESS STEEL 5 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 130D STANDARD BARREL 140MM STAINLESS STEEL 6 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 135D STANDARD BARREL 100MM STAINLESS STEEL 4 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 135D STANDARD BARREL 120MM STAINLESS STEEL 5 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 135D STANDARD BARREL 140MM STAINLESS STEEL 6 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 140D 4 HOLE CLASSIC CHS BONE HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 140D STANDARD BARREL 120MM STAINLESS STEEL 5 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 140D STANDARD BARREL 140MM STAINLESS STEEL 6 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 145D STANDARD BARREL 100MM STAINLESS STEEL 4 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 145D STANDARD BARREL 120MM STAINLESS STEEL 5 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 145D STANDARD BARREL 140MM STAINLESS STEEL 6 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 150D STANDARD BARREL 100MM STAINLESS STEEL 4 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 150D STANDARD BARREL 120MM STAINLESS STEEL 5 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 150D STANDARD BARREL 140MM STAINLESS STEEL 6 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 2.7 VA LATERAL DISTAL 4H RIGHT,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 2.7MM TI CONDYLAR 7 HOLES/57MM-LEFT,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 2.7MM TI CONDYLAR 7 HOLES/57MM-RIGHT,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 3.5 LCP RECON 8 HOLE,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,ANCHOR SUTURE ARTHREX DX FIBERTAK NEEDLE,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL IMHS 130DEG SMITH AND NEPHEW 12 X 21,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL IMHS 130DEG SMITH AND NEPHEW 14 X 21,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL IMHS 130DEG SMITH AND NEPHEW 16 X 21,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW FIXATION 5.5MM SPEEDSCREW PEEK KNOTLESS,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 3.5 LCP SUPERIOR ANT CLAVICLE W/EXT 4H 81MM LT,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 135D STANDARD BARREL 180MM STAINLESS STEEL 8 HOLE COMPRESSION CLASSIC CHS BONE 38.1MM HIP STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE 77X10X2MM TITANIUM 3 HOLE POLYAXIAL LOCK LOW PROFILE VARIAX BONE 16X1.3MM FIBULA LATERAL NONSTERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE MINI NARROW 41X22MM LOW PROFILE CROSSLOCK DVR BONE RADIUS RIGHT DISTAL VOLAR NONSTERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 3.5MM LCP SUPERIOR CLAVICLE PLATE 7H LT,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,DEVICE FIXATION ARTHREX BIOCOMPOSITE DISTAL BICEPS REPAIR,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,IMPLANT ARTHREX MINI SCORPION CPR,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,KIT LIGAMENT ARTIFICIAL BIOMET,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 3.5MM VA-LCP PROX TIBIA SM BEND 6H/117MM LT,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,PLATE SYNTHES 3.5MM VA-LCP PROX TIBIA SM BEND 8H/147MM LT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,NAIL BIOMET 11MM 22CM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SYSTEM INT FIX 14X3.9MM 2.7MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,948.00 ","$14,100.00 ", N/A ,"$9,165.00 ","$8,417.70 ", N/A ,"$3,948.00 ","$9,334.20 ", N/A ,"$9,334.20 ", N/A ,"$8,403.60 ","$8,403.60 ", N/A ,"$8,403.60 ", N/A ,"$10,857.00 ", N/A , N/A , N/A ,"$10,575.00 ","$10,011.00 ","$10,011.00 ", N/A ,"$10,011.00 ","$11,985.00 ","$11,985.00 ","$11,985.00 ", N/A , N/A ,"$11,985.00 ", N/A ,"$14,100.00 ","$7,910.10 ", N/A ,"$5,837.40 ", N/A , N/A , N/A ,"$11,985.00 ", N/A ,"$8,403.60 ","$3,948.00 ","$12,690.00 ", N/A ,"$11,985.00 ","$11,914.50 ","$11,914.50 ", N/A ,"$9,165.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,WIRE SYNTHES 1.6MM KIRSCHNER 150MM W/TROCAR POINT,278,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27871713,C1713,SCREW BONE 4.5MM 48MM IMHS HIP SELF TAP,278,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 , N/A , N/A , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,27871771,C1771,SLING ADVANTAGE FIT MID-URETHRAL TRANSVAGINAL,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD TM 67.5MM LEFT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET 75MM RIGHT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD 70MM LEFT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD CR 62.5MM RIGHT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD CR 65MM RIGHT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD CR 67.5 RIGHT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL BIOMET VANGUARD TM 65MM LEFT,278,1 ,"$7,500.00 ","$5,400.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$4,875.00 ","$4,477.50 ", N/A ,"$2,100.00 ","$4,965.00 ", N/A ,"$4,965.00 ", N/A ,"$4,470.00 ","$4,470.00 ", N/A ,"$4,470.00 ", N/A ,"$5,775.00 ", N/A , N/A , N/A ,"$5,625.00 ","$5,325.00 ","$5,325.00 ", N/A ,"$5,325.00 ","$6,375.00 ","$6,375.00 ","$6,375.00 ", N/A , N/A ,"$6,375.00 ", N/A ,"$7,500.00 ","$4,207.50 ", N/A ,"$3,105.00 ", N/A , N/A , N/A ,"$6,375.00 ", N/A ,"$4,470.00 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,375.00 ","$6,337.50 ","$6,337.50 ", N/A ,"$4,875.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 5 LEFT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL 6 KNEE RIGHT POSTERIOR STABILIZE CEMENT TRIATHLON STERILE LATEX FREE TOTAL KNEE ARTHROPLASTY,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 3 LEFT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT FEMORAL STRYKER POSTERIOR STABILIZED SZ 3 RIGHT,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,HEAD FEMORAL +3MM 28MM HIP MODULAR COCR M2A-TAPER BRONZE,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR HIP RIGHT HEAD,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,HEAD BIPOLAR CONVENE HIP FEMUR,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,HEAD FEMORAL HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +0MM 38-42MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +0MM 57-60MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +4MM 38-42MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +4MM 43-46MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +4MM 47-51MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +4MM 52-56MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +4MM 57-60MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +8MM 38-42MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +8MM 43-46MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +8MM 47-51MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +8MM 52-56MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR +8MM 57-60MM HIP,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR RINGLOC BIOMET SIZE 24,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PEG FIXATION KNEE FEMORAL MODULAR TRIATHLON,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT MODULAR HEAD BIOMET 28MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,COMPONENT MODULAR HEAD BIOMET 32MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,HEAD FEMORAL +9MM OFFSET 28MM HIP TYPE 1 SKIRT COCR G7,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 60MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL ACETABULAR 42MM HIP BIPOLAR COCR CONVENE UNIVERSAL,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL ACETABULAR 44MM HIP BIPOLAR COCR CONVENE UNIVERSAL,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL ACETABULAR 46MM HIP BIPOLAR COCR CONVENE UNIVERSAL,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL ACETABULAR 47MM HIP BIPOLAR COCR CONVENE UNIVERSAL,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL ACETABULAR 56MM HIP BIPOLAR COCR CONVENE UNIVERSAL,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL ACETABULAR 59MM HIP BIPOLAR COCR CONVENE UNIVERSAL,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 38MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 39MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 40MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 41MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 43MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 45MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 48MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 49MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 50MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 51MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 52MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 53MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 54MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 55MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 57MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,SHELL BIPOLAR 58MM CONVENE UNIVERSAL HIP ACETABULAR COCR,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,STEM FEMORAL 140MM MATRIX 10D 13 SLONG TAPER HIP,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,GLENOSPHERE COMPREHENSIVE BIOMET,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,LINER ACETABULAR BIOMET SIZE 23,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PLATE STRYKER TRI TS BASE SIZE 3,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PLATE STRYKER TRI TS BASE SIZE 4,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,STEM FEMORAL 6 LARGE HIP,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,BASE ZIMMER PLATE TIBIAL SIZE 3,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,INSERT STRYKER TIBIAL TRIATHLON PS X3 #3 11MM,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,INSERT TIBIAL 3 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,INSERT TIBIAL 4 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,INSERT TIBIAL 5 9MM KNEE X3 POSTERIOR STABILIZE BEARING TRIATHLON STERILE LATEX FREE,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 2,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 3,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PLATE STRYKER TIBAL BASE SIZE 5,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,STEM FINNED BIOMET W/ SCREW 40MM,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PATELLA STRYKER ASYMMETRIC 33 X 9MM,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PATELLA STRYKER ASYMMETRIC S 31 X 9MM,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,PATELLA STRYKER ASYMMETRIC S 36 X10MM,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871776,C1776,STEM FEMORAL 100MM MATRIX OPTI-FIX II 17D 14 LONG HIP,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,COMPOSIX KUGEL BARD EXTRA LARGE OVAL 7.7 X 9.7,278,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$3,705.00 ","$3,402.90 ", N/A ,"$1,596.00 ","$3,773.40 ", N/A ,"$3,773.40 ", N/A ,"$3,397.20 ","$3,397.20 ", N/A ,"$3,397.20 ", N/A ,"$4,389.00 ", N/A , N/A , N/A ,"$4,275.00 ","$4,047.00 ","$4,047.00 ", N/A ,"$4,047.00 ","$4,845.00 ","$4,845.00 ","$4,845.00 ", N/A , N/A ,"$4,845.00 ", N/A ,"$5,700.00 ","$3,197.70 ", N/A ,"$2,359.80 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$3,397.20 ","$1,596.00 ","$5,130.00 ", N/A ,"$4,845.00 ","$4,816.50 ","$4,816.50 ", N/A ,"$3,705.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH BARD PLUG XLARGE 0112780,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PARIETEX LIGHTWEIGHT 15X10CM,278,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 , N/A ,$13.00 ,$11.94 , N/A ,$5.60 ,$13.24 , N/A ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A , N/A , N/A ,$15.00 ,$14.20 ,$14.20 , N/A ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A , N/A ,$17.00 , N/A ,$20.00 ,$11.22 , N/A ,$8.28 , N/A , N/A , N/A ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 , N/A ,$17.00 ,$16.90 ,$16.90 , N/A ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PARTX MONO POLY LITE 6X11CM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH BARD MARLEX 3 X 6 0112680,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PARIETENE 20X20CM MACROPOROUS,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PP MACRO COVIDIEN 30CM X 30CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL 5.4X2.4IN HERNIA SOFT PRESHAPED KEYHOLE LARGE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PARIETEX 6.3X4IN RIGHT FLEXIBLE LATERAL SLIT ANATOMIC POLYESTER MACROPOROUS HYDROPHILIC LAPAROSCOPIC INGUINAL HERNIA REPAIR,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PARIETEX 6.3X4IN LEFT FLEXIBLE LATERAL SLIT ANATOMIC POLYESTER MACROPOROUS HYDROPHILIC LAPAROSCOPIC INGUINAL HERNIA REPAIR,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$186.30 , N/A , N/A , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 ,$380.25 ,$380.25 , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PARIETEX 6X4IN RIGHT HERNIA CUSTOM DESIGN FLEXIBLE ANATOMICAL LATERAL SLIT LIGHTWEIGHT POLYESTER,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH BARD 10 X 14 011266,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PARIETEX RIGID 15CM X 10CM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PARIETEX 6X4IN LEFT FLEXIBLE ANATOMIC LATERAL SLIT POLYESTER HERNIA,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PROLENE 6X3IN CUSTOMIZABLE KNIT NONABSORBABLE MONOFILAMENT STERILE POLYPROPYLENE FLAT RECTANGLE LATEX FREE HERNIA REPAIR,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH BARD MARLEX 6 X 6,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH MARLEX GROIN 4 X 1.8,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH MARLEX KEYHOLE 10CM X 4.5CM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROL 6X6IN CSTM KNIT,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SYMBOTEX 3.3 X 2.3MM 9CM,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PARIETENE 45X30CM MACROPOROUS,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SYMBOTEX COMPOSITE 12CM,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH 3DMAX LEFT MID XL 17X12CM INGUINAL,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH 3DMAX RIGHT MID XL 17X12CM INGUINAL,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PROGRIP 16X12CM SELF FIXATE MONOFILAMENT GRIP STERILE POLYACTIC ACID COLLAGEN POLYESTER LATEX FREE LAPAROSCOPIC INGUINAL REPAIR,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SYMBOTEX 15X10CM,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ", N/A ,$877.50 ,$805.95 , N/A ,$378.00 ,$893.70 , N/A ,$893.70 , N/A ,$804.60 ,$804.60 , N/A ,$804.60 , N/A ,"$1,039.50 ", N/A , N/A , N/A ,"$1,012.50 ",$958.50 ,$958.50 , N/A ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A , N/A ,"$1,147.50 ", N/A ,"$1,350.00 ",$757.35 , N/A ,$558.90 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$804.60 ,$378.00 ,"$1,215.00 ", N/A ,"$1,147.50 ","$1,140.75 ","$1,140.75 ", N/A ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALEX ST MEDIUM WITH STRAP 5950008,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,DNU MESH SURGICAL C-QUR V-PATCH 2.5IN FASCIA 2 EXTENDED STRAP BIORESORBABLE STABILITY RING STERILE MEDIUM,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL C-QUR V-PATCH 3.2X3.2IN 2 EXTEND STRAP STABILITY RING PROLITE OMEGA 3 FATTY ACID LARGE HERNIA,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALEX LARGE 0010303,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALEX MEDIUM 0010302,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,365.00 ","$1,253.70 ", N/A ,$588.00 ,"$1,390.20 ", N/A ,"$1,390.20 ", N/A ,"$1,251.60 ","$1,251.60 ", N/A ,"$1,251.60 ", N/A ,"$1,617.00 ", N/A , N/A , N/A ,"$1,575.00 ","$1,491.00 ","$1,491.00 ", N/A ,"$1,491.00 ","$1,785.00 ","$1,785.00 ","$1,785.00 ", N/A , N/A ,"$1,785.00 ", N/A ,"$2,100.00 ","$1,178.10 ", N/A ,$869.40 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,251.60 ",$588.00 ,"$1,890.00 ", N/A ,"$1,785.00 ","$1,774.50 ","$1,774.50 ", N/A ,"$1,365.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALIGHT ST ECHO 2 15CM CIRCLE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,535.00 ","$2,328.30 ", N/A ,"$1,092.00 ","$2,581.80 ", N/A ,"$2,581.80 ", N/A ,"$2,324.40 ","$2,324.40 ", N/A ,"$2,324.40 ", N/A ,"$3,003.00 ", N/A , N/A , N/A ,"$2,925.00 ","$2,769.00 ","$2,769.00 ", N/A ,"$2,769.00 ","$3,315.00 ","$3,315.00 ","$3,315.00 ", N/A , N/A ,"$3,315.00 ", N/A ,"$3,900.00 ","$2,187.90 ", N/A ,"$1,614.60 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,324.40 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,315.00 ","$3,295.50 ","$3,295.50 ", N/A ,"$2,535.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALIGHT ST ECHO 2 15X10CM ELLIPSE,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,COMPOSIX KUGEL BARD LARGE CIRCLE,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,COMPOSIX KUGEL BARD SMALL OVAL 8 X 12,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL VICRYL 12X12IN ABSORBABLE WOVEN FLAT HERNIA REPAIR,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SYMBOTEX 20X15CM,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALEX LARGE 5950009,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ", N/A ,"$1,755.00 ","$1,611.90 ", N/A ,$756.00 ,"$1,787.40 ", N/A ,"$1,787.40 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$2,079.00 ", N/A , N/A , N/A ,"$2,025.00 ","$1,917.00 ","$1,917.00 ", N/A ,"$1,917.00 ","$2,295.00 ","$2,295.00 ","$2,295.00 ", N/A , N/A ,"$2,295.00 ", N/A ,"$2,700.00 ","$1,514.70 ", N/A ,"$1,117.80 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,609.20 ",$756.00 ,"$2,430.00 ", N/A ,"$2,295.00 ","$2,281.50 ","$2,281.50 ", N/A ,"$1,755.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALIGHT ST ECHO 2 20X15CM ELLIPSE,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROCEED 30X20CM,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,315.00 ","$3,044.70 ", N/A ,"$1,428.00 ","$3,376.20 ", N/A ,"$3,376.20 ", N/A ,"$3,039.60 ","$3,039.60 ", N/A ,"$3,039.60 ", N/A ,"$3,927.00 ", N/A , N/A , N/A ,"$3,825.00 ","$3,621.00 ","$3,621.00 ", N/A ,"$3,621.00 ","$4,335.00 ","$4,335.00 ","$4,335.00 ", N/A , N/A ,"$4,335.00 ", N/A ,"$5,100.00 ","$2,861.10 ", N/A ,"$2,111.40 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$3,039.60 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,335.00 ","$4,309.50 ","$4,309.50 ", N/A ,"$3,315.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALIGHT ST ECHO 2 25X20CM ELLIPSE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$4,485.00 ","$4,119.30 ", N/A ,"$1,932.00 ","$4,567.80 ", N/A ,"$4,567.80 ", N/A ,"$4,112.40 ","$4,112.40 ", N/A ,"$4,112.40 ", N/A ,"$5,313.00 ", N/A , N/A , N/A ,"$5,175.00 ","$4,899.00 ","$4,899.00 ", N/A ,"$4,899.00 ","$5,865.00 ","$5,865.00 ","$5,865.00 ", N/A , N/A ,"$5,865.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$2,856.60 ", N/A , N/A , N/A ,"$5,865.00 ", N/A ,"$4,112.40 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,865.00 ","$5,830.50 ","$5,830.50 ", N/A ,"$4,485.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROCEED 14X10IN,278,1 ,"$6,900.00 ","$4,968.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$4,485.00 ","$4,119.30 ", N/A ,"$1,932.00 ","$4,567.80 ", N/A ,"$4,567.80 ", N/A ,"$4,112.40 ","$4,112.40 ", N/A ,"$4,112.40 ", N/A ,"$5,313.00 ", N/A , N/A , N/A ,"$5,175.00 ","$4,899.00 ","$4,899.00 ", N/A ,"$4,899.00 ","$5,865.00 ","$5,865.00 ","$5,865.00 ", N/A , N/A ,"$5,865.00 ", N/A ,"$6,900.00 ","$3,870.90 ", N/A ,"$2,856.60 ", N/A , N/A , N/A ,"$5,865.00 ", N/A ,"$4,112.40 ","$1,932.00 ","$6,210.00 ", N/A ,"$5,865.00 ","$5,830.50 ","$5,830.50 ", N/A ,"$4,485.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRIO ST 4.3 X 5.5 5950040,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL SYMBOTEX 25X15CM 2 SIDE COMPOSITE 3D BIOABSORBABLE FILM STERILE POLYESTER COLLAGEN GREEN WHITE LAPAROSCOPIC OPEN VENTRAL HERNIA REPAIR,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SYMBOTEX 25X20CM,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALIGHT ST ECHO 2 11CM CIRCLE,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRIO ST 5.4 X 7.0 5950050,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SYMBOTEX 30X20CM,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VICRYL KNITTED 6 X 6,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH 3DMAX LEFT MID LARGE 16X10CM INGUINAL,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH 3DMAX RIGHT MID LARGE 16X10CM INGUINAL,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROGRIP SELF FIXATING 15CM X 10CM LAP,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ", N/A ,$780.00 ,$716.40 , N/A ,$336.00 ,$794.40 , N/A ,$794.40 , N/A ,$715.20 ,$715.20 , N/A ,$715.20 , N/A ,$924.00 , N/A , N/A , N/A ,$900.00 ,$852.00 ,$852.00 , N/A ,$852.00 ,"$1,020.00 ","$1,020.00 ","$1,020.00 ", N/A , N/A ,"$1,020.00 ", N/A ,"$1,200.00 ",$673.20 , N/A ,$496.80 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$715.20 ,$336.00 ,"$1,080.00 ", N/A ,"$1,020.00 ","$1,014.00 ","$1,014.00 ", N/A ,$780.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,PATCH HERNIA KUGEL COMPOSIX CIRCLE 8 X 8CM SMALL,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROCEED 20X10CM,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROGRIP ANATOMICAL 10X15CM LEFT,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROGRIP ANATOMICAL 10X15CM RIGHT,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH VENTRALEX SMALL WITH STRAP 5950007,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ", N/A ,$975.00 ,$895.50 , N/A ,$420.00 ,$993.00 , N/A ,$993.00 , N/A ,$894.00 ,$894.00 , N/A ,$894.00 , N/A ,"$1,155.00 ", N/A , N/A , N/A ,"$1,125.00 ","$1,065.00 ","$1,065.00 ", N/A ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A , N/A ,"$1,275.00 ", N/A ,"$1,500.00 ",$841.50 , N/A ,$621.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$894.00 ,$420.00 ,"$1,350.00 ", N/A ,"$1,275.00 ","$1,267.50 ","$1,267.50 ", N/A ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,PLUG HERNIA LIGHT MESH XLARGE,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH 3DMAX LEFT MID MEDIUM 8CMX13CM INGUINAL,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH 3DMAX RIGHT MID MEDIUM 8CMX13CM INGUINAL,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH COMPOSIX 4X6 '0123460,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,PLUG LARGE MESH PERFIX 1.6 X 1.90,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH BARD PERFIX PLUG SM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH BARD PLUG MEDIUM 0112760,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,PLUG MEDIUM LIGHT MESH,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROL 3 15/16INX1.75,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH PROL 4 15/16INX2,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,MESH SURGICAL PERFIX LIGHT 1IN 1.4IN GROIN PLUG MONOFILAMENT STERILE POLYPROPYLENE SMALL HERNIA REPAIR,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871781,C1781,PLUG LARGE LIGHT MESH,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871788,C1788,POWERPORT AIRGUARD CHRONOFLEX TI 8FR,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 , N/A ,$585.00 ,$537.30 , N/A ,$252.00 ,$595.80 , N/A ,$595.80 , N/A ,$536.40 ,$536.40 , N/A ,$536.40 , N/A ,$693.00 , N/A , N/A , N/A ,$675.00 ,$639.00 ,$639.00 , N/A ,$639.00 ,$765.00 ,$765.00 ,$765.00 , N/A , N/A ,$765.00 , N/A ,$900.00 ,$504.90 , N/A ,$372.60 , N/A , N/A , N/A ,$765.00 , N/A ,$536.40 ,$252.00 ,$810.00 , N/A ,$765.00 ,$760.50 ,$760.50 , N/A ,$585.00 ST. JOSEPH'S HOSPITAL - BREESE,27871789,C1789,IMPLANT BREAST 620CC P6.9CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 14X13.2CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871789,C1789,IMPLANT BREAST 440CC P6.2CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 12.5X11.8CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871789,C1789,IMPLANT BREAST 495CC P5CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 13X12.2CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871789,C1789,IMPLANT BREAST 555CC P6.7CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 13.5X12.7CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871789,C1789,IMPLANT BREAST 390CC P6CM HIGH PROFILE MEDIUM HEIGHT STYLE CPG 323 GEL MEMORYSHAPE COHESIVE III SILTEX 12X11.3CM STERILE,278,1 ,"$4,500.00 ","$3,240.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$2,925.00 ","$2,686.50 ", N/A ,"$1,260.00 ","$2,979.00 ", N/A ,"$2,979.00 ", N/A ,"$2,682.00 ","$2,682.00 ", N/A ,"$2,682.00 ", N/A ,"$3,465.00 ", N/A , N/A , N/A ,"$3,375.00 ","$3,195.00 ","$3,195.00 ", N/A ,"$3,195.00 ","$3,825.00 ","$3,825.00 ","$3,825.00 ", N/A , N/A ,"$3,825.00 ", N/A ,"$4,500.00 ","$2,524.50 ", N/A ,"$1,863.00 ", N/A , N/A , N/A ,"$3,825.00 ", N/A ,"$2,682.00 ","$1,260.00 ","$4,050.00 ", N/A ,"$3,825.00 ","$3,802.50 ","$3,802.50 ", N/A ,"$2,925.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871874,C1874,STENT ENDOPROSTHESIS BILIARY 4CM 10MM 8.5FR NITINOL EPTFE FEP NONPOROUS GORE 200CM FULL COVER SELF EXPAND PULL LINE ULTRATHIN ENDOSCOPIC,278,1 ,"$6,300.00 ","$4,536.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,095.00 ","$3,761.10 ", N/A ,"$1,764.00 ","$4,170.60 ", N/A ,"$4,170.60 ", N/A ,"$3,754.80 ","$3,754.80 ", N/A ,"$3,754.80 ", N/A ,"$4,851.00 ", N/A , N/A , N/A ,"$4,725.00 ","$4,473.00 ","$4,473.00 ", N/A ,"$4,473.00 ","$5,355.00 ","$5,355.00 ","$5,355.00 ", N/A , N/A ,"$5,355.00 ", N/A ,"$6,300.00 ","$3,534.30 ", N/A ,"$2,608.20 ", N/A , N/A , N/A ,"$5,355.00 ", N/A ,"$3,754.80 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,355.00 ","$5,323.50 ","$5,323.50 ", N/A ,"$4,095.00 " ST. JOSEPH'S HOSPITAL - BREESE,27871876,C1876,STENT BILIARY 8.5FR 7CM NATURAL CURVE TAPER TIP POSITION SLEEVE PROXIMAL DISTAL FLAP COTTON-LEUNG POLYETHYLENE STERILE PURPLE ACCEPTS .035IN GUIDEWIRE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT BILIARY 10FR 9CM,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 , N/A ,$146.25 ,$134.33 , N/A ,$63.00 ,$148.95 , N/A ,$148.95 , N/A ,$134.10 ,$134.10 , N/A ,$134.10 , N/A ,$173.25 , N/A , N/A , N/A ,$168.75 ,$159.75 ,$159.75 , N/A ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A , N/A ,$191.25 , N/A ,$225.00 ,$126.23 , N/A ,$93.15 , N/A , N/A , N/A ,$191.25 , N/A ,$134.10 ,$63.00 ,$202.50 , N/A ,$191.25 ,$190.13 ,$190.13 , N/A ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT URETERAL 6FR 30CM .038IN,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A ,$288.75 , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$316.88 ,$316.88 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT URETERAL PIGTAIL 6FR 24CM CRV TAPER TIP,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT URETERAL 6FR 22CM PIGTAIL CURVED,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT URETERAL 6FR 26CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT URETERAL 6FR 28CM PIGTL CRV TAPER TIP BLDR MRK,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27872617,C2617,STENT URETERAL BOSTON SCI CONTOUR VL 4.8FR X 22-30CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,27872625,C2625,STENT PANCREATIC 7FR 3CM .035IN SMALL PIGTAIL FLEXIBLE FREEMAN FLEXI-STENT,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27872625,C2625,STENT PANCREATIC 4FR 2CM .025IN SMALL PIGTAIL STRAIGHT FLEXIBLE FREEMAN FLEXI-STENT,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,27878699,L8699,UROLIFT,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,145.00 ","$1,970.10 ", N/A ,$924.00 ,"$2,184.60 ", N/A ,"$2,184.60 ", N/A ,"$1,966.80 ","$1,966.80 ", N/A ,"$1,966.80 ", N/A ,"$2,541.00 ", N/A , N/A , N/A ,"$2,475.00 ","$2,343.00 ","$2,343.00 ", N/A ,"$2,343.00 ","$2,805.00 ","$2,805.00 ","$2,805.00 ", N/A , N/A ,"$2,805.00 ", N/A ,"$3,300.00 ","$1,851.30 ", N/A ,"$1,366.20 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,966.80 ",$924.00 ,"$2,970.00 ", N/A ,"$2,805.00 ","$2,788.50 ","$2,788.50 ", N/A ,"$2,145.00 " ST. JOSEPH'S HOSPITAL - BREESE,30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$56.00 ,$40.32 ,$12.56 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A , N/A , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 , N/A , N/A , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 ,$12.56 ,$12.56 , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30000010,36415,HC VENIPUNCTURE,300,1 ,$36.00 ,$25.92 ,$1.58 ,$36.00 ,$21.43 ,$23.40 ,$21.49 ,$8.40 ,$10.08 ,$23.83 ,$8.40 ,$23.83 ,$8.40 ,$21.46 ,$21.46 ,$8.40 ,$21.46 ,$17.31 , N/A ,$21.43 ,$8.40 ,$8.57 ,$27.00 , N/A , N/A ,$8.40 , N/A ,$30.60 ,$30.60 ,$30.60 , N/A ,$21.43 ,$30.60 ,$8.40 ,$3.00 ,$20.20 ,$8.40 ,$14.90 ,$1.74 ,$1.58 ,$8.40 ,$30.60 ,$18.00 ,$21.46 ,$10.08 ,$32.40 ,$8.40 ,$30.60 ,$12.00 ,$12.00 ,$8.40 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$397.00 ,$285.84 ,$32.62 ,$397.00 ,$278.78 ,$258.05 ,$237.01 ,$109.28 ,$111.16 ,$262.81 ,$109.28 ,$262.81 ,$109.28 ,$236.61 ,$236.61 ,$109.28 ,$236.61 ,$225.24 , N/A ,$278.76 ,$109.28 ,$111.47 ,$297.75 ,$281.87 ,$281.87 ,$109.28 ,$281.87 ,$337.45 ,$337.45 ,$337.45 , N/A ,$278.76 ,$337.45 ,$109.28 ,$397.00 ,$222.72 ,$109.28 ,$164.36 ,$35.88 ,$32.62 ,$109.28 ,$337.45 ,$234.16 ,$236.61 ,$111.16 ,$357.30 ,$109.28 ,$337.45 , N/A , N/A ,$109.28 ,$258.05 ST. JOSEPH'S HOSPITAL - BREESE,30000101,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$194.00 ,$139.68 ,$5.49 ,$194.00 ,$14.00 ,$126.10 ,$115.82 ,$5.49 ,$54.32 ,$128.43 ,$5.49 ,$128.43 ,$5.49 ,$115.62 ,$115.62 ,$5.49 ,$115.62 ,$11.31 ,$149.38 ,$14.00 ,$5.49 ,$5.60 ,$145.50 ,$137.74 ,$137.74 ,$5.49 ,$137.74 ,$164.90 ,$164.90 ,$164.90 , N/A ,$14.00 ,$164.90 ,$5.49 ,$194.00 ,$108.83 ,$5.49 ,$80.32 ,$23.84 ,$21.67 ,$5.49 ,$164.90 ,$11.76 ,$115.62 ,$54.32 ,$174.60 ,$5.49 ,$164.90 ,$22.40 ,$22.40 ,$5.49 ,$126.10 ST. JOSEPH'S HOSPITAL - BREESE,30000104,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$64.00 ,$46.08 ,$4.18 ,$64.00 ,$10.68 ,$41.60 ,$38.21 ,$4.18 ,$17.92 ,$42.37 ,$4.18 ,$42.37 ,$4.18 ,$38.14 ,$38.14 ,$4.18 ,$38.14 ,$8.63 ,$49.28 ,$10.68 ,$4.18 ,$4.27 ,$48.00 ,$45.44 ,$45.44 ,$4.18 ,$45.44 ,$54.40 ,$54.40 ,$54.40 , N/A ,$10.68 ,$54.40 ,$4.18 ,$64.00 ,$35.90 ,$4.18 ,$26.50 ,$5.18 ,$4.71 ,$4.18 ,$54.40 ,$8.97 ,$38.14 ,$17.92 ,$57.60 ,$4.18 ,$54.40 ,$17.08 ,$17.08 ,$4.18 ,$41.60 ST. JOSEPH'S HOSPITAL - BREESE,30000105,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$74.00 ,$53.28 ,$7.18 ,$74.00 ,$18.33 ,$48.10 ,$44.18 ,$7.18 ,$20.72 ,$48.99 ,$7.18 ,$48.99 ,$7.18 ,$44.10 ,$44.10 ,$7.18 ,$44.10 ,$14.81 ,$56.98 ,$18.33 ,$7.18 ,$7.33 ,$55.50 ,$52.54 ,$52.54 ,$7.18 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$18.33 ,$62.90 ,$7.18 ,$74.00 ,$41.51 ,$7.18 ,$30.64 ,$23.84 ,$21.67 ,$7.18 ,$62.90 ,$15.39 ,$44.10 ,$20.72 ,$66.60 ,$7.18 ,$62.90 ,$29.32 ,$29.32 ,$7.18 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30000112,89320,HC SEMEN ANALYSIS COMPLETE,300,1 ,$217.00 ,$156.24 ,$12.06 ,$217.00 ,$30.78 ,$141.05 ,$129.55 ,$12.06 ,$60.76 ,$143.65 ,$12.06 ,$143.65 ,$12.06 ,$129.33 ,$129.33 ,$12.06 ,$129.33 ,$24.87 ,$167.09 ,$30.78 ,$12.06 ,$12.31 ,$162.75 ,$154.07 ,$154.07 ,$12.06 ,$154.07 ,$184.45 ,$184.45 ,$184.45 , N/A ,$30.78 ,$184.45 ,$12.06 ,$217.00 ,$121.74 ,$12.06 ,$89.84 ,$23.84 ,$21.67 ,$12.06 ,$184.45 ,$25.85 ,$129.33 ,$60.76 ,$195.30 ,$12.06 ,$184.45 ,$49.24 ,$49.24 ,$12.06 ,$141.05 ST. JOSEPH'S HOSPITAL - BREESE,30000131,G0480,HC DRUG CONFIRMATION EA PROC 1-7 CLASSES-90,301,1 ,$220.00 ,$158.40 ,$20.42 ,$286.08 ,$286.08 ,$143.00 ,$131.34 ,$112.14 ,$61.60 ,$145.64 ,$112.14 ,$145.64 ,$112.14 ,$131.12 ,$131.12 ,$112.14 ,$131.12 ,$220.00 ,$169.40 ,$286.08 ,$112.14 ,$114.39 ,$165.00 ,$156.20 ,$156.20 ,$112.14 ,$156.20 ,$187.00 ,$187.00 ,$187.00 , N/A ,$220.00 ,$187.00 ,$112.14 ,$220.00 ,$123.42 ,$112.14 ,$91.08 ,$22.46 ,$20.42 ,$112.14 ,$187.00 ,$240.30 ,$131.12 ,$61.60 ,$198.00 ,$112.14 ,$187.00 ,$220.00 ,$220.00 ,$112.14 ,$143.00 ST. JOSEPH'S HOSPITAL - BREESE,30000213,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$168.00 ,$120.96 ,$32.62 ,$278.78 ,$278.78 ,$109.20 ,$100.30 ,$109.28 ,$47.04 ,$111.22 ,$109.28 ,$111.22 ,$109.28 ,$100.13 ,$100.13 ,$109.28 ,$100.13 ,$168.00 , N/A ,$278.76 ,$109.28 ,$111.47 ,$126.00 ,$119.28 ,$119.28 ,$109.28 ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A ,$168.00 ,$142.80 ,$109.28 ,$168.00 ,$94.25 ,$109.28 ,$69.55 ,$35.88 ,$32.62 ,$109.28 ,$142.80 ,$234.16 ,$100.13 ,$47.04 ,$151.20 ,$109.28 ,$142.80 , N/A , N/A ,$109.28 ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,30000230,99001,HC LAB HANDLING CHARGE SPECIMEN,300,1 ,$68.00 ,$48.96 ,$19.04 ,$68.00 , N/A ,$44.20 ,$40.60 , N/A ,$19.04 ,$45.02 , N/A ,$45.02 , N/A ,$40.53 ,$40.53 , N/A ,$40.53 , N/A ,$52.36 , N/A , N/A , N/A ,$51.00 ,$48.28 ,$48.28 , N/A ,$48.28 ,$57.80 ,$57.80 ,$57.80 , N/A , N/A ,$57.80 , N/A ,$68.00 ,$38.15 , N/A ,$28.15 , N/A , N/A , N/A ,$57.80 , N/A ,$40.53 ,$19.04 ,$61.20 , N/A ,$57.80 ,$26.52 ,$26.52 , N/A ,$44.20 ST. JOSEPH'S HOSPITAL - BREESE,30000252,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$68.00 ,$48.96 ,$11.81 ,$68.00 ,$30.13 ,$44.20 ,$40.60 ,$11.81 ,$19.04 ,$45.02 ,$11.81 ,$45.02 ,$11.81 ,$40.53 ,$40.53 ,$11.81 ,$40.53 ,$24.34 ,$52.36 ,$30.13 ,$11.81 ,$12.04 ,$51.00 ,$48.28 ,$48.28 ,$11.81 ,$48.28 ,$57.80 ,$57.80 ,$57.80 , N/A ,$30.13 ,$57.80 ,$11.81 ,$68.00 ,$38.15 ,$11.81 ,$28.15 ,$23.84 ,$21.67 ,$11.81 ,$57.80 ,$25.31 ,$40.53 ,$19.04 ,$61.20 ,$11.81 ,$57.80 ,$48.20 ,$48.20 ,$11.81 ,$44.20 ST. JOSEPH'S HOSPITAL - BREESE,30000260,36600,HC ARTERIAL PUNCTURE,300,1 ,$360.00 ,$259.20 ,$32.62 ,$360.00 ,$278.78 ,$234.00 ,$214.92 ,$109.28 ,$100.80 ,$238.32 ,$109.28 ,$238.32 ,$109.28 ,$214.56 ,$214.56 ,$109.28 ,$214.56 ,$225.24 ,$277.20 ,$278.76 ,$109.28 ,$111.47 ,$270.00 ,$255.60 ,$255.60 ,$109.28 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$278.76 ,$306.00 ,$109.28 ,$360.00 ,$201.96 ,$109.28 ,$149.04 ,$35.88 ,$32.62 ,$109.28 ,$306.00 ,$234.16 ,$214.56 ,$100.80 ,$324.00 ,$109.28 ,$306.00 , N/A , N/A ,$109.28 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,30000263,N/A,HC HEALTH FAIR PULMONARY SCREEN,300,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$3.85 , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$2.50 ,$2.50 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,30002012,36415,HC KIT DRAW AND PROCESSING,300,1 ,$36.00 ,$25.92 ,$1.58 ,$36.00 ,$21.43 ,$23.40 ,$21.49 ,$8.40 ,$10.08 ,$23.83 ,$8.40 ,$23.83 ,$8.40 ,$21.46 ,$21.46 ,$8.40 ,$21.46 ,$17.31 , N/A ,$21.43 ,$8.40 ,$8.57 ,$27.00 , N/A , N/A ,$8.40 , N/A ,$30.60 ,$30.60 ,$30.60 , N/A ,$21.43 ,$30.60 ,$8.40 ,$3.00 ,$20.20 ,$8.40 ,$14.90 ,$1.74 ,$1.58 ,$8.40 ,$30.60 ,$18.00 ,$21.46 ,$10.08 ,$32.40 ,$8.40 ,$30.60 ,$12.00 ,$12.00 ,$8.40 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30002013,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$333.51 ,$240.13 ,$32.62 ,$333.51 ,$278.78 ,$216.78 ,$199.11 ,$109.28 ,$93.38 ,$220.78 ,$109.28 ,$220.78 ,$109.28 ,$198.77 ,$198.77 ,$109.28 ,$198.77 ,$225.24 , N/A ,$278.76 ,$109.28 ,$111.47 ,$250.13 ,$236.79 ,$236.79 ,$109.28 ,$236.79 ,$283.48 ,$283.48 ,$283.48 , N/A ,$278.76 ,$283.48 ,$109.28 ,$333.51 ,$187.10 ,$109.28 ,$138.07 ,$35.88 ,$32.62 ,$109.28 ,$283.48 ,$234.16 ,$198.77 ,$93.38 ,$300.16 ,$109.28 ,$283.48 , N/A , N/A ,$109.28 ,$216.78 ST. JOSEPH'S HOSPITAL - BREESE,30002015,89050,HC BODY FLUID CELL COUNT,300,1 ,$124.00 ,$89.28 ,$4.63 ,$124.00 ,$11.80 ,$80.60 ,$74.03 ,$4.63 ,$34.72 ,$82.09 ,$4.63 ,$82.09 ,$4.63 ,$73.90 ,$73.90 ,$4.63 ,$73.90 ,$9.53 ,$95.48 ,$11.80 ,$4.63 ,$4.71 ,$93.00 ,$88.04 ,$88.04 ,$4.63 ,$88.04 ,$105.40 ,$105.40 ,$105.40 , N/A ,$11.80 ,$105.40 ,$4.63 ,$124.00 ,$69.56 ,$4.63 ,$51.34 ,$23.84 ,$21.67 ,$4.63 ,$105.40 ,$9.91 ,$73.90 ,$34.72 ,$111.60 ,$4.63 ,$105.40 ,$18.88 ,$18.88 ,$4.63 ,$80.60 ST. JOSEPH'S HOSPITAL - BREESE,30002016,89051,HC CELL CT BODY FLUID W/DIFF T2,300,1 ,$194.00 ,$139.68 ,$5.49 ,$194.00 ,$14.00 ,$126.10 ,$115.82 ,$5.49 ,$54.32 ,$128.43 ,$5.49 ,$128.43 ,$5.49 ,$115.62 ,$115.62 ,$5.49 ,$115.62 ,$11.31 ,$149.38 ,$14.00 ,$5.49 ,$5.60 ,$145.50 ,$137.74 ,$137.74 ,$5.49 ,$137.74 ,$164.90 ,$164.90 ,$164.90 , N/A ,$14.00 ,$164.90 ,$5.49 ,$194.00 ,$108.83 ,$5.49 ,$80.32 ,$23.84 ,$21.67 ,$5.49 ,$164.90 ,$11.76 ,$115.62 ,$54.32 ,$174.60 ,$5.49 ,$164.90 ,$22.40 ,$22.40 ,$5.49 ,$126.10 ST. JOSEPH'S HOSPITAL - BREESE,30002018,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$126.00 ,$90.72 ,$7.18 ,$126.00 ,$18.33 ,$81.90 ,$75.22 ,$7.18 ,$35.28 ,$83.41 ,$7.18 ,$83.41 ,$7.18 ,$75.10 ,$75.10 ,$7.18 ,$75.10 ,$14.81 ,$97.02 ,$18.33 ,$7.18 ,$7.33 ,$94.50 ,$89.46 ,$89.46 ,$7.18 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$18.33 ,$107.10 ,$7.18 ,$126.00 ,$70.69 ,$7.18 ,$52.16 ,$23.84 ,$21.67 ,$7.18 ,$107.10 ,$15.39 ,$75.10 ,$35.28 ,$113.40 ,$7.18 ,$107.10 ,$29.32 ,$29.32 ,$7.18 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30002023,G0483,HC TOX SCREEN CHAIN OF CUSTODY URINE,300,1 ,$94.00 ,$67.68 ,$20.42 ,$235.00 ,$235.00 ,$61.10 ,$56.12 ,$92.12 ,$26.32 ,$62.23 ,$92.12 ,$62.23 ,$92.12 ,$56.02 ,$56.02 ,$92.12 ,$56.02 ,$94.00 ,$72.38 ,$235.00 ,$92.12 ,$92.12 ,$70.50 ,$66.74 ,$66.74 ,$92.12 ,$66.74 ,$79.90 ,$79.90 ,$79.90 , N/A ,$94.00 ,$79.90 ,$92.12 ,$94.00 ,$52.73 ,$92.12 ,$38.92 ,$22.46 ,$20.42 ,$92.12 ,$79.90 ,$197.40 ,$56.02 ,$26.32 ,$84.60 ,$92.12 ,$79.90 ,$94.00 ,$94.00 ,$92.12 ,$61.10 ST. JOSEPH'S HOSPITAL - BREESE,30002031,36415,HC VENIPUNCTURE,300,1 ,$36.00 ,$25.92 ,$1.58 ,$36.00 ,$21.43 ,$23.40 ,$21.49 ,$8.40 ,$10.08 ,$23.83 ,$8.40 ,$23.83 ,$8.40 ,$21.46 ,$21.46 ,$8.40 ,$21.46 ,$17.31 , N/A ,$21.43 ,$8.40 ,$8.57 ,$27.00 , N/A , N/A ,$8.40 , N/A ,$30.60 ,$30.60 ,$30.60 , N/A ,$21.43 ,$30.60 ,$8.40 ,$3.00 ,$20.20 ,$8.40 ,$14.90 ,$1.74 ,$1.58 ,$8.40 ,$30.60 ,$18.00 ,$21.46 ,$10.08 ,$32.40 ,$8.40 ,$30.60 ,$12.00 ,$12.00 ,$8.40 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30002033,36416,HC CAPILLARY COLLECTION,300,1 ,$56.00 ,$40.32 ,$12.56 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A , N/A , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 , N/A , N/A , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 ,$12.56 ,$12.56 , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30002040,81352,HC TP53 GENE TRGT SEQUENCE ANALYSIS-90,300,1 ,"$1,863.00 ","$1,341.36 ",$87.62 ,"$1,863.00 ",$823.78 ,"$1,210.95 ","$1,112.21 ",$322.92 ,$521.64 ,"$1,233.31 ",$322.92 ,"$1,233.31 ",$322.92 ,"$1,110.35 ","$1,110.35 ",$322.92 ,"$1,110.35 ",$665.61 ,$500.00 ,$823.78 ,$322.92 ,$329.38 ,"$1,397.25 ","$1,322.73 ","$1,322.73 ",$322.92 ,"$1,322.73 ","$1,583.55 ","$1,583.55 ","$1,583.55 ", N/A ,$823.78 ,"$1,583.55 ",$322.92 ,"$1,863.00 ","$1,045.14 ",$322.92 ,$771.28 ,$96.38 ,$87.62 ,$322.92 ,"$1,583.55 ",$691.97 ,"$1,110.35 ",$521.64 ,"$1,676.70 ",$322.92 ,"$1,583.55 ","$1,318.04 ","$1,318.04 ",$322.92 ,"$1,210.95 " ST. JOSEPH'S HOSPITAL - BREESE,30002042,85027,HC HEALTH FAIR HEMOGRAM,300,1 ,$5.00 ,$3.60 ,$1.40 ,$12.50 ,$12.50 ,$3.25 ,$2.99 ,$4.90 ,$1.40 ,$3.31 ,$4.90 ,$3.31 ,$4.90 ,$2.98 ,$2.98 ,$4.90 ,$2.98 ,$5.00 ,$3.85 ,$12.50 ,$4.90 ,$4.90 ,$3.75 ,$3.55 ,$3.55 ,$4.90 ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A ,$5.00 ,$4.25 ,$4.90 ,$5.00 ,$2.81 ,$4.90 ,$2.07 ,$5.00 ,$4.71 ,$4.90 ,$4.25 ,$10.50 ,$2.98 ,$1.40 ,$4.50 ,$4.90 ,$4.25 ,$5.00 ,$5.00 ,$4.90 ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$415.00 ,$298.80 ,$6.92 ,$415.00 ,$26.40 ,$269.75 ,$247.76 ,$10.35 ,$116.20 ,$274.73 ,$10.35 ,$274.73 ,$10.35 ,$247.34 ,$247.34 ,$10.35 ,$247.34 ,$21.33 ,$319.55 ,$26.40 ,$10.35 ,$10.55 ,$311.25 ,$294.65 ,$294.65 ,$10.35 ,$294.65 ,$352.75 ,$352.75 ,$352.75 , N/A ,$26.40 ,$352.75 ,$10.35 ,$10.56 ,$232.82 ,$10.35 ,$171.81 ,$7.61 ,$6.92 ,$10.35 ,$352.75 ,$22.18 ,$247.34 ,$116.20 ,$373.50 ,$10.35 ,$352.75 ,$42.24 ,$42.24 ,$10.35 ,$269.75 ST. JOSEPH'S HOSPITAL - BREESE,30100121,80164,HC VALPROIC ACID,301,1 ,$169.00 ,$121.68 ,$8.71 ,$169.00 ,$33.85 ,$109.85 ,$100.89 ,$13.27 ,$47.32 ,$111.88 ,$13.27 ,$111.88 ,$13.27 ,$100.72 ,$100.72 ,$13.27 ,$100.72 ,$27.35 ,$130.13 ,$33.85 ,$13.27 ,$13.53 ,$126.75 ,$119.99 ,$119.99 ,$13.27 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$33.85 ,$143.65 ,$13.27 ,$169.00 ,$94.81 ,$13.27 ,$69.97 ,$9.58 ,$8.71 ,$13.27 ,$143.65 ,$28.43 ,$100.72 ,$47.32 ,$152.10 ,$13.27 ,$143.65 ,$54.16 ,$54.16 ,$13.27 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30100124,80170,HC GENTAMICIN,301,1 ,$125.00 ,$90.00 ,$8.71 ,$125.00 ,$40.95 ,$81.25 ,$74.63 ,$16.05 ,$35.00 ,$82.75 ,$16.05 ,$82.75 ,$16.05 ,$74.50 ,$74.50 ,$16.05 ,$74.50 ,$33.09 ,$96.25 ,$40.95 ,$16.05 ,$16.38 ,$93.75 ,$88.75 ,$88.75 ,$16.05 ,$88.75 ,$106.25 ,$106.25 ,$106.25 , N/A ,$40.95 ,$106.25 ,$16.05 ,$125.00 ,$70.13 ,$16.05 ,$51.75 ,$9.58 ,$8.71 ,$16.05 ,$106.25 ,$34.40 ,$74.50 ,$35.00 ,$112.50 ,$16.05 ,$106.25 ,$65.52 ,$65.52 ,$16.05 ,$81.25 ST. JOSEPH'S HOSPITAL - BREESE,30100139,80200,HC TOBRAMYCIN,301,1 ,$154.00 ,$110.88 ,$8.71 ,$154.00 ,$40.33 ,$100.10 ,$91.94 ,$15.81 ,$43.12 ,$101.95 ,$15.81 ,$101.95 ,$15.81 ,$91.78 ,$91.78 ,$15.81 ,$91.78 ,$32.58 ,$118.58 ,$40.33 ,$15.81 ,$16.12 ,$115.50 ,$109.34 ,$109.34 ,$15.81 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$40.33 ,$130.90 ,$15.81 ,$154.00 ,$86.39 ,$15.81 ,$63.76 ,$9.58 ,$8.71 ,$15.81 ,$130.90 ,$33.87 ,$91.78 ,$43.12 ,$138.60 ,$15.81 ,$130.90 ,$64.52 ,$64.52 ,$15.81 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30100157,82009,HC ACETONE SERUM,301,1 ,$61.00 ,$43.92 ,$3.37 ,$61.00 ,$11.30 ,$39.65 ,$36.42 ,$4.43 ,$17.08 ,$40.38 ,$4.43 ,$40.38 ,$4.43 ,$36.36 ,$36.36 ,$4.43 ,$36.36 ,$9.13 ,$46.97 ,$11.30 ,$4.43 ,$4.52 ,$45.75 ,$43.31 ,$43.31 ,$4.43 ,$43.31 ,$51.85 ,$51.85 ,$51.85 , N/A ,$11.30 ,$51.85 ,$4.43 ,$61.00 ,$34.22 ,$4.43 ,$25.25 ,$3.71 ,$3.37 ,$4.43 ,$51.85 ,$9.49 ,$36.36 ,$17.08 ,$54.90 ,$4.43 ,$51.85 ,$18.08 ,$18.08 ,$4.43 ,$39.65 ST. JOSEPH'S HOSPITAL - BREESE,30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$96.00 ,$69.12 ,$7.58 ,$96.00 ,$20.43 ,$62.40 ,$57.31 ,$8.01 ,$26.88 ,$63.55 ,$8.01 ,$63.55 ,$8.01 ,$57.22 ,$57.22 ,$8.01 ,$57.22 ,$16.50 ,$73.92 ,$20.43 ,$8.01 ,$8.16 ,$72.00 ,$68.16 ,$68.16 ,$8.01 ,$68.16 ,$81.60 ,$81.60 ,$81.60 , N/A ,$20.43 ,$81.60 ,$8.01 ,$96.00 ,$53.86 ,$8.01 ,$39.74 ,$8.34 ,$7.58 ,$8.01 ,$81.60 ,$17.16 ,$57.22 ,$26.88 ,$86.40 ,$8.01 ,$81.60 ,$32.68 ,$32.68 ,$8.01 ,$62.40 ST. JOSEPH'S HOSPITAL - BREESE,30100165,82040,HC ALBUMIN SERUM,301,1 ,$76.00 ,$54.72 ,$3.37 ,$76.00 ,$12.38 ,$49.40 ,$45.37 ,$4.85 ,$21.28 ,$50.31 ,$4.85 ,$50.31 ,$4.85 ,$45.30 ,$45.30 ,$4.85 ,$45.30 ,$10.00 ,$58.52 ,$12.38 ,$4.85 ,$4.95 ,$57.00 ,$53.96 ,$53.96 ,$4.85 ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A ,$12.38 ,$64.60 ,$4.85 ,$76.00 ,$42.64 ,$4.85 ,$31.46 ,$3.71 ,$3.37 ,$4.85 ,$64.60 ,$10.40 ,$45.30 ,$21.28 ,$68.40 ,$4.85 ,$64.60 ,$19.80 ,$19.80 ,$4.85 ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$119.00 ,$85.68 ,$2.71 ,$119.00 ,$14.45 ,$77.35 ,$71.04 ,$5.66 ,$33.32 ,$78.78 ,$5.66 ,$78.78 ,$5.66 ,$70.92 ,$70.92 ,$5.66 ,$70.92 ,$11.68 ,$91.63 ,$14.45 ,$5.66 ,$5.78 ,$89.25 ,$84.49 ,$84.49 ,$5.66 ,$84.49 ,$101.15 ,$101.15 ,$101.15 , N/A ,$14.45 ,$101.15 ,$5.66 ,$119.00 ,$66.76 ,$5.66 ,$49.27 ,$2.98 ,$2.71 ,$5.66 ,$101.15 ,$12.14 ,$70.92 ,$33.32 ,$107.10 ,$5.66 ,$101.15 ,$23.12 ,$23.12 ,$5.66 ,$77.35 ST. JOSEPH'S HOSPITAL - BREESE,30100186,82140,HC AMMONIA,301,1 ,$209.00 ,$150.48 ,$7.58 ,$209.00 ,$36.43 ,$135.85 ,$124.77 ,$14.28 ,$58.52 ,$138.36 ,$14.28 ,$138.36 ,$14.28 ,$124.56 ,$124.56 ,$14.28 ,$124.56 ,$29.43 ,$160.93 ,$36.43 ,$14.28 ,$14.56 ,$156.75 ,$148.39 ,$148.39 ,$14.28 ,$148.39 ,$177.65 ,$177.65 ,$177.65 , N/A ,$36.43 ,$177.65 ,$14.28 ,$209.00 ,$117.25 ,$14.28 ,$86.53 ,$8.34 ,$7.58 ,$14.28 ,$177.65 ,$30.60 ,$124.56 ,$58.52 ,$188.10 ,$14.28 ,$177.65 ,$58.28 ,$58.28 ,$14.28 ,$135.85 ST. JOSEPH'S HOSPITAL - BREESE,30100188,82150,HC AMYLASE,301,1 ,$126.00 ,$90.72 ,$6.35 ,$126.00 ,$16.20 ,$81.90 ,$75.22 ,$6.35 ,$35.28 ,$83.41 ,$6.35 ,$83.41 ,$6.35 ,$75.10 ,$75.10 ,$6.35 ,$75.10 ,$13.09 ,$97.02 ,$16.20 ,$6.35 ,$6.48 ,$94.50 ,$89.46 ,$89.46 ,$6.35 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$16.20 ,$107.10 ,$6.35 ,$126.00 ,$70.69 ,$6.35 ,$52.16 ,$8.34 ,$7.58 ,$6.35 ,$107.10 ,$13.61 ,$75.10 ,$35.28 ,$113.40 ,$6.35 ,$107.10 ,$25.92 ,$25.92 ,$6.35 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$12.55 ,$37.70 ,$34.63 ,$4.92 ,$16.24 ,$38.40 ,$4.92 ,$38.40 ,$4.92 ,$34.57 ,$34.57 ,$4.92 ,$34.57 ,$10.14 ,$44.66 ,$12.55 ,$4.92 ,$5.02 ,$43.50 ,$41.18 ,$41.18 ,$4.92 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$12.55 ,$49.30 ,$4.92 ,$58.00 ,$32.54 ,$4.92 ,$24.01 ,$3.71 ,$3.37 ,$4.92 ,$49.30 ,$10.54 ,$34.57 ,$16.24 ,$52.20 ,$4.92 ,$49.30 ,$20.08 ,$20.08 ,$4.92 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$81.00 ,$58.32 ,$3.37 ,$81.00 ,$12.55 ,$52.65 ,$48.36 ,$4.92 ,$22.68 ,$53.62 ,$4.92 ,$53.62 ,$4.92 ,$48.28 ,$48.28 ,$4.92 ,$48.28 ,$10.14 ,$62.37 ,$12.55 ,$4.92 ,$5.02 ,$60.75 ,$57.51 ,$57.51 ,$4.92 ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A ,$12.55 ,$68.85 ,$4.92 ,$81.00 ,$45.44 ,$4.92 ,$33.53 ,$3.71 ,$3.37 ,$4.92 ,$68.85 ,$10.54 ,$48.28 ,$22.68 ,$72.90 ,$4.92 ,$68.85 ,$20.08 ,$20.08 ,$4.92 ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,30100212,82306,HC VITAMIN D 25 OH,301,1 ,$97.00 ,$69.84 ,$20.42 ,$97.00 ,$74.00 ,$63.05 ,$57.91 ,$29.01 ,$27.16 ,$64.21 ,$29.01 ,$64.21 ,$29.01 ,$57.81 ,$57.81 ,$29.01 ,$57.81 ,$59.79 ,$74.69 ,$74.00 ,$29.01 ,$29.59 ,$72.75 ,$68.87 ,$68.87 ,$29.01 ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A ,$74.00 ,$82.45 ,$29.01 ,$97.00 ,$54.42 ,$29.01 ,$40.16 ,$22.46 ,$20.42 ,$29.01 ,$82.45 ,$62.16 ,$57.81 ,$27.16 ,$87.30 ,$29.01 ,$82.45 ,$97.00 ,$97.00 ,$29.01 ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,30100214,82310,HC CALCIUM,301,1 ,$82.00 ,$59.04 ,$3.37 ,$82.00 ,$12.90 ,$53.30 ,$48.95 ,$5.06 ,$22.96 ,$54.28 ,$5.06 ,$54.28 ,$5.06 ,$48.87 ,$48.87 ,$5.06 ,$48.87 ,$10.42 ,$63.14 ,$12.90 ,$5.06 ,$5.15 ,$61.50 ,$58.22 ,$58.22 ,$5.06 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$12.90 ,$69.70 ,$5.06 ,$82.00 ,$46.00 ,$5.06 ,$33.95 ,$3.71 ,$3.37 ,$5.06 ,$69.70 ,$10.84 ,$48.87 ,$22.96 ,$73.80 ,$5.06 ,$69.70 ,$20.64 ,$20.64 ,$5.06 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30100215,82330,HC CALCIUM IONIZED,301,1 ,$56.00 ,$40.32 ,$7.58 ,$56.00 ,$34.20 ,$36.40 ,$33.43 ,$13.41 ,$15.68 ,$37.07 ,$13.41 ,$37.07 ,$13.41 ,$33.38 ,$33.38 ,$13.41 ,$33.38 ,$27.63 ,$43.12 ,$34.20 ,$13.41 ,$13.67 ,$42.00 ,$39.76 ,$39.76 ,$13.41 ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A ,$34.20 ,$47.60 ,$13.41 ,$56.00 ,$31.42 ,$13.41 ,$23.18 ,$8.34 ,$7.58 ,$13.41 ,$47.60 ,$28.73 ,$33.38 ,$15.68 ,$50.40 ,$13.41 ,$47.60 ,$54.72 ,$54.72 ,$13.41 ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30100222,82374,HC BICARBONATE,301,1 ,$119.00 ,$85.68 ,$3.37 ,$119.00 ,$12.20 ,$77.35 ,$71.04 ,$4.78 ,$33.32 ,$78.78 ,$4.78 ,$78.78 ,$4.78 ,$70.92 ,$70.92 ,$4.78 ,$70.92 ,$9.86 ,$91.63 ,$12.20 ,$4.78 ,$4.88 ,$89.25 ,$84.49 ,$84.49 ,$4.78 ,$84.49 ,$101.15 ,$101.15 ,$101.15 , N/A ,$12.20 ,$101.15 ,$4.78 ,$119.00 ,$66.76 ,$4.78 ,$49.27 ,$3.71 ,$3.37 ,$4.78 ,$101.15 ,$10.25 ,$70.92 ,$33.32 ,$107.10 ,$4.78 ,$101.15 ,$19.52 ,$19.52 ,$4.78 ,$77.35 ST. JOSEPH'S HOSPITAL - BREESE,30100237,82435,HC CHLORIDE,301,1 ,$52.00 ,$37.44 ,$3.37 ,$52.00 ,$11.50 ,$33.80 ,$31.04 ,$4.51 ,$14.56 ,$34.42 ,$4.51 ,$34.42 ,$4.51 ,$30.99 ,$30.99 ,$4.51 ,$30.99 ,$9.29 ,$40.04 ,$11.50 ,$4.51 ,$4.60 ,$39.00 ,$36.92 ,$36.92 ,$4.51 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$11.50 ,$44.20 ,$4.51 ,$52.00 ,$29.17 ,$4.51 ,$21.53 ,$3.71 ,$3.37 ,$4.51 ,$44.20 ,$9.66 ,$30.99 ,$14.56 ,$46.80 ,$4.51 ,$44.20 ,$18.40 ,$18.40 ,$4.51 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30100238,82436,HC CHLORIDE URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$14.38 ,$60.45 ,$55.52 ,$5.63 ,$26.04 ,$61.57 ,$5.63 ,$61.57 ,$5.63 ,$55.43 ,$55.43 ,$5.63 ,$55.43 ,$11.62 ,$71.61 ,$14.38 ,$5.63 ,$5.75 ,$69.75 ,$66.03 ,$66.03 ,$5.63 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$14.38 ,$79.05 ,$5.63 ,$93.00 ,$52.17 ,$5.63 ,$38.50 ,$3.71 ,$3.37 ,$5.63 ,$79.05 ,$12.08 ,$55.43 ,$26.04 ,$83.70 ,$5.63 ,$79.05 ,$23.00 ,$23.00 ,$5.63 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30100241,82465,HC CHOLESTEROL,301,1 ,$88.00 ,$63.36 ,$3.37 ,$88.00 ,$10.88 ,$57.20 ,$52.54 ,$4.26 ,$24.64 ,$58.26 ,$4.26 ,$58.26 ,$4.26 ,$52.45 ,$52.45 ,$4.26 ,$52.45 ,$8.79 ,$67.76 ,$10.88 ,$4.26 ,$4.35 ,$66.00 ,$62.48 ,$62.48 ,$4.26 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$10.88 ,$74.80 ,$4.26 ,$88.00 ,$49.37 ,$4.26 ,$36.43 ,$3.71 ,$3.37 ,$4.26 ,$74.80 ,$9.14 ,$52.45 ,$24.64 ,$79.20 ,$4.26 ,$74.80 ,$17.40 ,$17.40 ,$4.26 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$126.00 ,$90.72 ,$3.37 ,$126.00 ,$16.28 ,$81.90 ,$75.22 ,$6.38 ,$35.28 ,$83.41 ,$6.38 ,$83.41 ,$6.38 ,$75.10 ,$75.10 ,$6.38 ,$75.10 ,$13.15 ,$97.02 ,$16.28 ,$6.38 ,$6.51 ,$94.50 ,$89.46 ,$89.46 ,$6.38 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$16.28 ,$107.10 ,$6.38 ,$126.00 ,$70.69 ,$6.38 ,$52.16 ,$3.71 ,$3.37 ,$6.38 ,$107.10 ,$13.67 ,$75.10 ,$35.28 ,$113.40 ,$6.38 ,$107.10 ,$26.04 ,$26.04 ,$6.38 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$174.00 ,$125.28 ,$7.58 ,$174.00 ,$28.88 ,$113.10 ,$103.88 ,$11.32 ,$48.72 ,$115.19 ,$11.32 ,$115.19 ,$11.32 ,$103.70 ,$103.70 ,$11.32 ,$103.70 ,$23.33 ,$133.98 ,$28.88 ,$11.32 ,$11.54 ,$130.50 ,$123.54 ,$123.54 ,$11.32 ,$123.54 ,$147.90 ,$147.90 ,$147.90 , N/A ,$28.88 ,$147.90 ,$11.32 ,$174.00 ,$97.61 ,$11.32 ,$72.04 ,$8.34 ,$7.58 ,$11.32 ,$147.90 ,$24.26 ,$103.70 ,$48.72 ,$156.60 ,$11.32 ,$147.90 ,$46.20 ,$46.20 ,$11.32 ,$113.10 ST. JOSEPH'S HOSPITAL - BREESE,30100262,82565,HC CREATININE,301,1 ,$72.00 ,$51.84 ,$3.37 ,$72.00 ,$12.80 ,$46.80 ,$42.98 ,$5.02 ,$20.16 ,$47.66 ,$5.02 ,$47.66 ,$5.02 ,$42.91 ,$42.91 ,$5.02 ,$42.91 ,$10.34 ,$55.44 ,$12.80 ,$5.02 ,$5.12 ,$54.00 ,$51.12 ,$51.12 ,$5.02 ,$51.12 ,$61.20 ,$61.20 ,$61.20 , N/A ,$12.80 ,$61.20 ,$5.02 ,$5.12 ,$40.39 ,$5.02 ,$29.81 ,$3.71 ,$3.37 ,$5.02 ,$61.20 ,$10.75 ,$42.91 ,$20.16 ,$64.80 ,$5.02 ,$61.20 ,$20.48 ,$20.48 ,$5.02 ,$46.80 ST. JOSEPH'S HOSPITAL - BREESE,30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$97.00 ,$69.84 ,$3.37 ,$97.00 ,$12.95 ,$63.05 ,$57.91 ,$5.08 ,$27.16 ,$64.21 ,$5.08 ,$64.21 ,$5.08 ,$57.81 ,$57.81 ,$5.08 ,$57.81 ,$10.46 ,$74.69 ,$12.95 ,$5.08 ,$5.17 ,$72.75 ,$68.87 ,$68.87 ,$5.08 ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A ,$12.95 ,$82.45 ,$5.08 ,$97.00 ,$54.42 ,$5.08 ,$40.16 ,$3.71 ,$3.37 ,$5.08 ,$82.45 ,$10.88 ,$57.81 ,$27.16 ,$87.30 ,$5.08 ,$82.45 ,$20.72 ,$20.72 ,$5.08 ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,30100266,82575,HC CREATININE CLEARANCE,301,1 ,$40.00 ,$28.80 ,$7.58 ,$40.00 ,$23.65 ,$26.00 ,$23.88 ,$9.27 ,$11.20 ,$26.48 ,$9.27 ,$26.48 ,$9.27 ,$23.84 ,$23.84 ,$9.27 ,$23.84 ,$19.11 ,$30.80 ,$23.65 ,$9.27 ,$9.46 ,$30.00 ,$28.40 ,$28.40 ,$9.27 ,$28.40 ,$34.00 ,$34.00 ,$34.00 , N/A ,$23.65 ,$34.00 ,$9.27 ,$40.00 ,$22.44 ,$9.27 ,$16.56 ,$8.34 ,$7.58 ,$9.27 ,$34.00 ,$19.87 ,$23.84 ,$11.20 ,$36.00 ,$9.27 ,$34.00 ,$37.84 ,$37.84 ,$9.27 ,$26.00 ST. JOSEPH'S HOSPITAL - BREESE,30100269,82607,HC VITAMIN B12,301,1 ,$214.00 ,$154.08 ,$10.21 ,$214.00 ,$37.70 ,$139.10 ,$127.76 ,$14.78 ,$59.92 ,$141.67 ,$14.78 ,$141.67 ,$14.78 ,$127.54 ,$127.54 ,$14.78 ,$127.54 ,$30.46 ,$164.78 ,$37.70 ,$14.78 ,$15.07 ,$160.50 ,$151.94 ,$151.94 ,$14.78 ,$151.94 ,$181.90 ,$181.90 ,$181.90 , N/A ,$37.70 ,$181.90 ,$14.78 ,$214.00 ,$120.05 ,$14.78 ,$88.60 ,$11.23 ,$10.21 ,$14.78 ,$181.90 ,$31.67 ,$127.54 ,$59.92 ,$192.60 ,$14.78 ,$181.90 ,$60.32 ,$60.32 ,$14.78 ,$139.10 ST. JOSEPH'S HOSPITAL - BREESE,30100290,82728,HC FERRITIN,301,1 ,$184.00 ,$132.48 ,$7.58 ,$184.00 ,$34.08 ,$119.60 ,$109.85 ,$13.36 ,$51.52 ,$121.81 ,$13.36 ,$121.81 ,$13.36 ,$109.66 ,$109.66 ,$13.36 ,$109.66 ,$27.53 ,$141.68 ,$34.08 ,$13.36 ,$13.62 ,$138.00 ,$130.64 ,$130.64 ,$13.36 ,$130.64 ,$156.40 ,$156.40 ,$156.40 , N/A ,$34.08 ,$156.40 ,$13.36 ,$184.00 ,$103.22 ,$13.36 ,$76.18 ,$8.34 ,$7.58 ,$13.36 ,$156.40 ,$28.62 ,$109.66 ,$51.52 ,$165.60 ,$13.36 ,$156.40 ,$54.52 ,$54.52 ,$13.36 ,$119.60 ST. JOSEPH'S HOSPITAL - BREESE,30100291,82731,HC FETAL FIBRONECTIN,301,1 ,$245.00 ,$176.40 ,$20.42 ,$245.00 ,$161.03 ,$159.25 ,$146.27 ,$63.12 ,$68.60 ,$162.19 ,$63.12 ,$162.19 ,$63.12 ,$146.02 ,$146.02 ,$63.12 ,$146.02 ,$130.11 ,$188.65 ,$161.03 ,$63.12 ,$64.39 ,$183.75 ,$173.95 ,$173.95 ,$63.12 ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A ,$161.03 ,$208.25 ,$63.12 ,$245.00 ,$137.45 ,$63.12 ,$101.43 ,$22.46 ,$20.42 ,$63.12 ,$208.25 ,$135.26 ,$146.02 ,$68.60 ,$220.50 ,$63.12 ,$208.25 ,$245.00 ,$245.00 ,$63.12 ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,30100292,82746,HC FOLIC ACID SERUM,301,1 ,$184.00 ,$132.48 ,$7.58 ,$184.00 ,$36.75 ,$119.60 ,$109.85 ,$14.41 ,$51.52 ,$121.81 ,$14.41 ,$121.81 ,$14.41 ,$109.66 ,$109.66 ,$14.41 ,$109.66 ,$29.69 ,$141.68 ,$36.75 ,$14.41 ,$14.69 ,$138.00 ,$130.64 ,$130.64 ,$14.41 ,$130.64 ,$156.40 ,$156.40 ,$156.40 , N/A ,$36.75 ,$156.40 ,$14.41 ,$184.00 ,$103.22 ,$14.41 ,$76.18 ,$8.34 ,$7.58 ,$14.41 ,$156.40 ,$30.87 ,$109.66 ,$51.52 ,$165.60 ,$14.41 ,$156.40 ,$58.80 ,$58.80 ,$14.41 ,$119.60 ST. JOSEPH'S HOSPITAL - BREESE,30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$86.00 ,$61.92 ,$3.37 ,$86.00 ,$9.83 ,$55.90 ,$51.34 ,$3.85 ,$24.08 ,$56.93 ,$3.85 ,$56.93 ,$3.85 ,$51.26 ,$51.26 ,$3.85 ,$51.26 ,$7.94 ,$66.22 ,$9.83 ,$3.85 ,$3.93 ,$64.50 ,$61.06 ,$61.06 ,$3.85 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$9.83 ,$73.10 ,$3.85 ,$86.00 ,$48.25 ,$3.85 ,$35.60 ,$3.71 ,$3.37 ,$3.85 ,$73.10 ,$8.25 ,$51.26 ,$24.08 ,$77.40 ,$3.85 ,$73.10 ,$15.72 ,$15.72 ,$3.85 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30100312,82947,HC GLUCOSE,301,1 ,$86.00 ,$61.92 ,$3.37 ,$86.00 ,$9.83 ,$55.90 ,$51.34 ,$3.85 ,$24.08 ,$56.93 ,$3.85 ,$56.93 ,$3.85 ,$51.26 ,$51.26 ,$3.85 ,$51.26 ,$7.94 ,$66.22 ,$9.83 ,$3.85 ,$3.93 ,$64.50 ,$61.06 ,$61.06 ,$3.85 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$9.83 ,$73.10 ,$3.85 ,$86.00 ,$48.25 ,$3.85 ,$35.60 ,$3.71 ,$3.37 ,$3.85 ,$73.10 ,$8.25 ,$51.26 ,$24.08 ,$77.40 ,$3.85 ,$73.10 ,$15.72 ,$15.72 ,$3.85 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30100313,82950,HC GLUCOSE SCREEN,301,1 ,$66.00 ,$47.52 ,$3.37 ,$66.00 ,$11.88 ,$42.90 ,$39.40 ,$4.65 ,$18.48 ,$43.69 ,$4.65 ,$43.69 ,$4.65 ,$39.34 ,$39.34 ,$4.65 ,$39.34 ,$9.60 ,$50.82 ,$11.88 ,$4.65 ,$4.75 ,$49.50 ,$46.86 ,$46.86 ,$4.65 ,$46.86 ,$56.10 ,$56.10 ,$56.10 , N/A ,$11.88 ,$56.10 ,$4.65 ,$66.00 ,$37.03 ,$4.65 ,$27.32 ,$3.71 ,$3.37 ,$4.65 ,$56.10 ,$9.98 ,$39.34 ,$18.48 ,$59.40 ,$4.65 ,$56.10 ,$19.00 ,$19.00 ,$4.65 ,$42.90 ST. JOSEPH'S HOSPITAL - BREESE,30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$121.00 ,$87.12 ,$7.58 ,$121.00 ,$32.18 ,$78.65 ,$72.24 ,$12.61 ,$33.88 ,$80.10 ,$12.61 ,$80.10 ,$12.61 ,$72.12 ,$72.12 ,$12.61 ,$72.12 ,$26.00 ,$93.17 ,$32.18 ,$12.61 ,$12.87 ,$90.75 ,$85.91 ,$85.91 ,$12.61 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$32.18 ,$102.85 ,$12.61 ,$121.00 ,$67.88 ,$12.61 ,$50.09 ,$8.34 ,$7.58 ,$12.61 ,$102.85 ,$27.03 ,$72.12 ,$33.88 ,$108.90 ,$12.61 ,$102.85 ,$51.48 ,$51.48 ,$12.61 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$38.00 ,$27.36 ,$3.84 ,$38.00 ,$9.80 ,$24.70 ,$22.69 ,$3.84 ,$10.64 ,$25.16 ,$3.84 ,$25.16 ,$3.84 ,$22.65 ,$22.65 ,$3.84 ,$22.65 ,$7.92 ,$29.26 ,$9.80 ,$3.84 ,$3.92 ,$28.50 ,$26.98 ,$26.98 ,$3.84 ,$26.98 ,$32.30 ,$32.30 ,$32.30 , N/A ,$9.80 ,$32.30 ,$3.84 ,$38.00 ,$21.32 ,$3.84 ,$15.73 ,$8.34 ,$7.58 ,$3.84 ,$32.30 ,$8.23 ,$22.65 ,$10.64 ,$34.20 ,$3.84 ,$32.30 ,$15.68 ,$15.68 ,$3.84 ,$24.70 ST. JOSEPH'S HOSPITAL - BREESE,30100393,83540,HC IRON TOTAL,301,1 ,$120.00 ,$86.40 ,$3.37 ,$120.00 ,$16.18 ,$78.00 ,$71.64 ,$6.34 ,$33.60 ,$79.44 ,$6.34 ,$79.44 ,$6.34 ,$71.52 ,$71.52 ,$6.34 ,$71.52 ,$13.07 ,$92.40 ,$16.18 ,$6.34 ,$6.47 ,$90.00 ,$85.20 ,$85.20 ,$6.34 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$16.18 ,$102.00 ,$6.34 ,$120.00 ,$67.32 ,$6.34 ,$49.68 ,$3.71 ,$3.37 ,$6.34 ,$102.00 ,$13.59 ,$71.52 ,$33.60 ,$108.00 ,$6.34 ,$102.00 ,$25.88 ,$25.88 ,$6.34 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$127.00 ,$91.44 ,$7.58 ,$127.00 ,$21.85 ,$82.55 ,$75.82 ,$8.57 ,$35.56 ,$84.07 ,$8.57 ,$84.07 ,$8.57 ,$75.69 ,$75.69 ,$8.57 ,$75.69 ,$17.65 ,$97.79 ,$21.85 ,$8.57 ,$8.73 ,$95.25 ,$90.17 ,$90.17 ,$8.57 ,$90.17 ,$107.95 ,$107.95 ,$107.95 , N/A ,$21.85 ,$107.95 ,$8.57 ,$127.00 ,$71.25 ,$8.57 ,$52.58 ,$8.34 ,$7.58 ,$8.57 ,$107.95 ,$18.35 ,$75.69 ,$35.56 ,$114.30 ,$8.57 ,$107.95 ,$34.96 ,$34.96 ,$8.57 ,$82.55 ST. JOSEPH'S HOSPITAL - BREESE,30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$158.00 ,$113.76 ,$7.58 ,$158.00 ,$28.93 ,$102.70 ,$94.33 ,$11.34 ,$44.24 ,$104.60 ,$11.34 ,$104.60 ,$11.34 ,$94.17 ,$94.17 ,$11.34 ,$94.17 ,$23.37 ,$121.66 ,$28.93 ,$11.34 ,$11.56 ,$118.50 ,$112.18 ,$112.18 ,$11.34 ,$112.18 ,$134.30 ,$134.30 ,$134.30 , N/A ,$28.93 ,$134.30 ,$11.34 ,$158.00 ,$88.64 ,$11.34 ,$65.41 ,$8.34 ,$7.58 ,$11.34 ,$134.30 ,$24.30 ,$94.17 ,$44.24 ,$142.20 ,$11.34 ,$134.30 ,$46.28 ,$46.28 ,$11.34 ,$102.70 ST. JOSEPH'S HOSPITAL - BREESE,30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$102.00 ,$73.44 ,$3.37 ,$102.00 ,$15.10 ,$66.30 ,$60.89 ,$5.92 ,$28.56 ,$67.52 ,$5.92 ,$67.52 ,$5.92 ,$60.79 ,$60.79 ,$5.92 ,$60.79 ,$12.20 ,$78.54 ,$15.10 ,$5.92 ,$6.04 ,$76.50 ,$72.42 ,$72.42 ,$5.92 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$15.10 ,$86.70 ,$5.92 ,$102.00 ,$57.22 ,$5.92 ,$42.23 ,$3.71 ,$3.37 ,$5.92 ,$86.70 ,$12.68 ,$60.79 ,$28.56 ,$91.80 ,$5.92 ,$86.70 ,$24.16 ,$24.16 ,$5.92 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30100409,83690,HC LIPASE,301,1 ,$119.00 ,$85.68 ,$3.37 ,$119.00 ,$17.23 ,$77.35 ,$71.04 ,$6.75 ,$33.32 ,$78.78 ,$6.75 ,$78.78 ,$6.75 ,$70.92 ,$70.92 ,$6.75 ,$70.92 ,$13.92 ,$91.63 ,$17.23 ,$6.75 ,$6.89 ,$89.25 ,$84.49 ,$84.49 ,$6.75 ,$84.49 ,$101.15 ,$101.15 ,$101.15 , N/A ,$17.23 ,$101.15 ,$6.75 ,$119.00 ,$66.76 ,$6.75 ,$49.27 ,$3.71 ,$3.37 ,$6.75 ,$101.15 ,$14.47 ,$70.92 ,$33.32 ,$107.10 ,$6.75 ,$101.15 ,$27.56 ,$27.56 ,$6.75 ,$77.35 ST. JOSEPH'S HOSPITAL - BREESE,30100415,83718,HC CHOLESTEROL HDL,301,1 ,$88.00 ,$63.36 ,$7.58 ,$88.00 ,$20.48 ,$57.20 ,$52.54 ,$8.03 ,$24.64 ,$58.26 ,$8.03 ,$58.26 ,$8.03 ,$52.45 ,$52.45 ,$8.03 ,$52.45 ,$16.54 ,$67.76 ,$20.48 ,$8.03 ,$8.18 ,$66.00 ,$62.48 ,$62.48 ,$8.03 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$20.48 ,$74.80 ,$8.03 ,$88.00 ,$49.37 ,$8.03 ,$36.43 ,$8.34 ,$7.58 ,$8.03 ,$74.80 ,$17.20 ,$52.45 ,$24.64 ,$79.20 ,$8.03 ,$74.80 ,$32.76 ,$32.76 ,$8.03 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,30100416,83721,HC CHOLESTEROL LDL,301,1 ,$124.00 ,$89.28 ,$7.58 ,$124.00 ,$26.25 ,$80.60 ,$74.03 ,$10.29 ,$34.72 ,$82.09 ,$10.29 ,$82.09 ,$10.29 ,$73.90 ,$73.90 ,$10.29 ,$73.90 ,$21.21 ,$95.48 ,$26.25 ,$10.29 ,$10.50 ,$93.00 ,$88.04 ,$88.04 ,$10.29 ,$88.04 ,$105.40 ,$105.40 ,$105.40 , N/A ,$26.25 ,$105.40 ,$10.29 ,$124.00 ,$69.56 ,$10.29 ,$51.34 ,$8.34 ,$7.58 ,$10.29 ,$105.40 ,$22.05 ,$73.90 ,$34.72 ,$111.60 ,$10.29 ,$105.40 ,$42.00 ,$42.00 ,$10.29 ,$80.60 ST. JOSEPH'S HOSPITAL - BREESE,30100417,83735,HC MAGNESIUM,301,1 ,$80.00 ,$57.60 ,$3.37 ,$80.00 ,$16.75 ,$52.00 ,$47.76 ,$6.57 ,$22.40 ,$52.96 ,$6.57 ,$52.96 ,$6.57 ,$47.68 ,$47.68 ,$6.57 ,$47.68 ,$13.53 ,$61.60 ,$16.75 ,$6.57 ,$6.69 ,$60.00 ,$56.80 ,$56.80 ,$6.57 ,$56.80 ,$68.00 ,$68.00 ,$68.00 , N/A ,$16.75 ,$68.00 ,$6.57 ,$80.00 ,$44.88 ,$6.57 ,$33.12 ,$3.71 ,$3.37 ,$6.57 ,$68.00 ,$14.07 ,$47.68 ,$22.40 ,$72.00 ,$6.57 ,$68.00 ,$26.80 ,$26.80 ,$6.57 ,$52.00 ST. JOSEPH'S HOSPITAL - BREESE,30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$270.00 ,$194.40 ,$20.42 ,$270.00 ,$98.15 ,$175.50 ,$161.19 ,$38.47 ,$75.60 ,$178.74 ,$38.47 ,$178.74 ,$38.47 ,$160.92 ,$160.92 ,$38.47 ,$160.92 ,$79.31 ,$207.90 ,$98.15 ,$38.47 ,$39.25 ,$202.50 ,$191.70 ,$191.70 ,$38.47 ,$191.70 ,$229.50 ,$229.50 ,$229.50 , N/A ,$98.15 ,$229.50 ,$38.47 ,$270.00 ,$151.47 ,$38.47 ,$111.78 ,$22.46 ,$20.42 ,$38.47 ,$229.50 ,$82.45 ,$160.92 ,$75.60 ,$243.00 ,$38.47 ,$229.50 ,$157.04 ,$157.04 ,$38.47 ,$175.50 ST. JOSEPH'S HOSPITAL - BREESE,30100672,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$102.00 ,$73.44 ,$17.75 ,$103.20 ,$103.20 ,$66.30 ,$60.89 ,$40.45 ,$28.56 ,$67.52 ,$40.45 ,$67.52 ,$40.45 ,$60.79 ,$60.79 ,$40.45 ,$60.79 ,$83.39 ,$78.54 ,$103.20 ,$40.45 ,$41.27 ,$76.50 ,$72.42 ,$72.42 ,$40.45 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$102.00 ,$86.70 ,$40.45 ,$102.00 ,$57.22 ,$40.45 ,$42.23 ,$19.53 ,$17.75 ,$40.45 ,$86.70 ,$86.69 ,$60.79 ,$28.56 ,$91.80 ,$40.45 ,$86.70 ,$102.00 ,$102.00 ,$40.45 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30100676,84030,HC NEWBORN SCREEN PKU,301,1 ,$157.00 ,$113.04 ,$3.37 ,$157.00 ,$13.75 ,$102.05 ,$93.73 ,$5.39 ,$43.96 ,$103.93 ,$5.39 ,$103.93 ,$5.39 ,$93.57 ,$93.57 ,$5.39 ,$93.57 ,$11.11 ,$120.89 ,$13.75 ,$5.39 ,$5.50 ,$117.75 ,$111.47 ,$111.47 ,$5.39 ,$111.47 ,$133.45 ,$133.45 ,$133.45 , N/A ,$13.75 ,$133.45 ,$5.39 ,$157.00 ,$88.08 ,$5.39 ,$65.00 ,$3.71 ,$3.37 ,$5.39 ,$133.45 ,$11.55 ,$93.57 ,$43.96 ,$141.30 ,$5.39 ,$133.45 ,$22.00 ,$22.00 ,$5.39 ,$102.05 ST. JOSEPH'S HOSPITAL - BREESE,30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$12.95 ,$37.70 ,$34.63 ,$5.08 ,$16.24 ,$38.40 ,$5.08 ,$38.40 ,$5.08 ,$34.57 ,$34.57 ,$5.08 ,$34.57 ,$10.46 ,$44.66 ,$12.95 ,$5.08 ,$5.17 ,$43.50 ,$41.18 ,$41.18 ,$5.08 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$12.95 ,$49.30 ,$5.08 ,$58.00 ,$32.54 ,$5.08 ,$24.01 ,$3.71 ,$3.37 ,$5.08 ,$49.30 ,$10.88 ,$34.57 ,$16.24 ,$52.20 ,$5.08 ,$49.30 ,$20.72 ,$20.72 ,$5.08 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30100684,84100,HC PHOSPHORUS,301,1 ,$98.00 ,$70.56 ,$3.37 ,$98.00 ,$11.85 ,$63.70 ,$58.51 ,$4.65 ,$27.44 ,$64.88 ,$4.65 ,$64.88 ,$4.65 ,$58.41 ,$58.41 ,$4.65 ,$58.41 ,$9.57 ,$75.46 ,$11.85 ,$4.65 ,$4.73 ,$73.50 ,$69.58 ,$69.58 ,$4.65 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$11.85 ,$83.30 ,$4.65 ,$98.00 ,$54.98 ,$4.65 ,$40.57 ,$3.71 ,$3.37 ,$4.65 ,$83.30 ,$9.95 ,$58.41 ,$27.44 ,$88.20 ,$4.65 ,$83.30 ,$18.96 ,$18.96 ,$4.65 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,30100691,84132,HC POTASSIUM,301,1 ,$82.00 ,$59.04 ,$3.37 ,$82.00 ,$11.90 ,$53.30 ,$48.95 ,$4.66 ,$22.96 ,$54.28 ,$4.66 ,$54.28 ,$4.66 ,$48.87 ,$48.87 ,$4.66 ,$48.87 ,$9.62 ,$63.14 ,$11.90 ,$4.66 ,$4.76 ,$61.50 ,$58.22 ,$58.22 ,$4.66 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$11.90 ,$69.70 ,$4.66 ,$82.00 ,$46.00 ,$4.66 ,$33.95 ,$3.71 ,$3.37 ,$4.66 ,$69.70 ,$10.00 ,$48.87 ,$22.96 ,$73.80 ,$4.66 ,$69.70 ,$19.04 ,$19.04 ,$4.66 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30100694,84133,HC POTASSIUM URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$11.83 ,$60.45 ,$55.52 ,$4.64 ,$26.04 ,$61.57 ,$4.64 ,$61.57 ,$4.64 ,$55.43 ,$55.43 ,$4.64 ,$55.43 ,$9.55 ,$71.61 ,$11.83 ,$4.64 ,$4.72 ,$69.75 ,$66.03 ,$66.03 ,$4.64 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$11.83 ,$79.05 ,$4.64 ,$93.00 ,$52.17 ,$4.64 ,$38.50 ,$3.71 ,$3.37 ,$4.64 ,$79.05 ,$9.93 ,$55.43 ,$26.04 ,$83.70 ,$4.64 ,$79.05 ,$18.92 ,$18.92 ,$4.64 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30100698,84153,HC PSA TOTAL,301,1 ,$176.00 ,$126.72 ,$7.58 ,$176.00 ,$45.98 ,$114.40 ,$105.07 ,$18.02 ,$49.28 ,$116.51 ,$18.02 ,$116.51 ,$18.02 ,$104.90 ,$104.90 ,$18.02 ,$104.90 ,$37.15 ,$135.52 ,$45.98 ,$18.02 ,$18.38 ,$132.00 ,$124.96 ,$124.96 ,$18.02 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$45.98 ,$149.60 ,$18.02 ,$176.00 ,$98.74 ,$18.02 ,$72.86 ,$8.34 ,$7.58 ,$18.02 ,$149.60 ,$38.62 ,$104.90 ,$49.28 ,$158.40 ,$18.02 ,$149.60 ,$73.56 ,$73.56 ,$18.02 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,30100700,84155,HC PROTEIN TOTAL,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$9.18 ,$37.70 ,$34.63 ,$3.60 ,$16.24 ,$38.40 ,$3.60 ,$38.40 ,$3.60 ,$34.57 ,$34.57 ,$3.60 ,$34.57 ,$7.41 ,$44.66 ,$9.18 ,$3.60 ,$3.67 ,$43.50 ,$41.18 ,$41.18 ,$3.60 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$9.18 ,$49.30 ,$3.60 ,$58.00 ,$32.54 ,$3.60 ,$24.01 ,$3.71 ,$3.37 ,$3.60 ,$49.30 ,$7.71 ,$34.57 ,$16.24 ,$52.20 ,$3.60 ,$49.30 ,$14.68 ,$14.68 ,$3.60 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$9.18 ,$60.45 ,$55.52 ,$3.60 ,$26.04 ,$61.57 ,$3.60 ,$61.57 ,$3.60 ,$55.43 ,$55.43 ,$3.60 ,$55.43 ,$7.41 ,$71.61 ,$9.18 ,$3.60 ,$3.67 ,$69.75 ,$66.03 ,$66.03 ,$3.60 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$9.18 ,$79.05 ,$3.60 ,$93.00 ,$52.17 ,$3.60 ,$38.50 ,$3.71 ,$3.37 ,$3.60 ,$79.05 ,$7.71 ,$55.43 ,$26.04 ,$83.70 ,$3.60 ,$79.05 ,$14.68 ,$14.68 ,$3.60 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$10.00 ,$60.45 ,$55.52 ,$3.92 ,$26.04 ,$61.57 ,$3.92 ,$61.57 ,$3.92 ,$55.43 ,$55.43 ,$3.92 ,$55.43 ,$8.08 ,$71.61 ,$10.00 ,$3.92 ,$4.00 ,$69.75 ,$66.03 ,$66.03 ,$3.92 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$10.00 ,$79.05 ,$3.92 ,$93.00 ,$52.17 ,$3.92 ,$38.50 ,$3.71 ,$3.37 ,$3.92 ,$79.05 ,$8.40 ,$55.43 ,$26.04 ,$83.70 ,$3.92 ,$79.05 ,$16.00 ,$16.00 ,$3.92 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30100721,84295,HC SODIUM,301,1 ,$82.00 ,$59.04 ,$3.37 ,$82.00 ,$12.03 ,$53.30 ,$48.95 ,$4.71 ,$22.96 ,$54.28 ,$4.71 ,$54.28 ,$4.71 ,$48.87 ,$48.87 ,$4.71 ,$48.87 ,$9.72 ,$63.14 ,$12.03 ,$4.71 ,$4.81 ,$61.50 ,$58.22 ,$58.22 ,$4.71 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$12.03 ,$69.70 ,$4.71 ,$82.00 ,$46.00 ,$4.71 ,$33.95 ,$3.71 ,$3.37 ,$4.71 ,$69.70 ,$10.10 ,$48.87 ,$22.96 ,$73.80 ,$4.71 ,$69.70 ,$19.24 ,$19.24 ,$4.71 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30100724,84300,HC SODIUM URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$12.65 ,$60.45 ,$55.52 ,$4.96 ,$26.04 ,$61.57 ,$4.96 ,$61.57 ,$4.96 ,$55.43 ,$55.43 ,$4.96 ,$55.43 ,$10.22 ,$71.61 ,$12.65 ,$4.96 ,$5.06 ,$69.75 ,$66.03 ,$66.03 ,$4.96 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$12.65 ,$79.05 ,$4.96 ,$93.00 ,$52.17 ,$4.96 ,$38.50 ,$3.71 ,$3.37 ,$4.96 ,$79.05 ,$10.63 ,$55.43 ,$26.04 ,$83.70 ,$4.96 ,$79.05 ,$20.24 ,$20.24 ,$4.96 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30100740,84439,HC T4 FREE,301,1 ,$102.00 ,$73.44 ,$8.84 ,$102.00 ,$22.55 ,$66.30 ,$60.89 ,$8.84 ,$28.56 ,$67.52 ,$8.84 ,$67.52 ,$8.84 ,$60.79 ,$60.79 ,$8.84 ,$60.79 ,$18.22 ,$78.54 ,$22.55 ,$8.84 ,$9.02 ,$76.50 ,$72.42 ,$72.42 ,$8.84 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$22.55 ,$86.70 ,$8.84 ,$102.00 ,$57.22 ,$8.84 ,$42.23 ,$11.23 ,$10.21 ,$8.84 ,$86.70 ,$18.94 ,$60.79 ,$28.56 ,$91.80 ,$8.84 ,$86.70 ,$36.08 ,$36.08 ,$8.84 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$123.00 ,$88.56 ,$10.21 ,$123.00 ,$42.00 ,$79.95 ,$73.43 ,$16.46 ,$34.44 ,$81.43 ,$16.46 ,$81.43 ,$16.46 ,$73.31 ,$73.31 ,$16.46 ,$73.31 ,$33.94 ,$94.71 ,$42.00 ,$16.46 ,$16.80 ,$92.25 ,$87.33 ,$87.33 ,$16.46 ,$87.33 ,$104.55 ,$104.55 ,$104.55 , N/A ,$42.00 ,$104.55 ,$16.46 ,$123.00 ,$69.00 ,$16.46 ,$50.92 ,$11.23 ,$10.21 ,$16.46 ,$104.55 ,$35.28 ,$73.31 ,$34.44 ,$110.70 ,$16.46 ,$104.55 ,$67.20 ,$67.20 ,$16.46 ,$79.95 ST. JOSEPH'S HOSPITAL - BREESE,30100746,84450,HC AST,301,1 ,$96.00 ,$69.12 ,$3.37 ,$96.00 ,$12.95 ,$62.40 ,$57.31 ,$5.08 ,$26.88 ,$63.55 ,$5.08 ,$63.55 ,$5.08 ,$57.22 ,$57.22 ,$5.08 ,$57.22 ,$10.46 ,$73.92 ,$12.95 ,$5.08 ,$5.17 ,$72.00 ,$68.16 ,$68.16 ,$5.08 ,$68.16 ,$81.60 ,$81.60 ,$81.60 , N/A ,$12.95 ,$81.60 ,$5.08 ,$96.00 ,$53.86 ,$5.08 ,$39.74 ,$3.71 ,$3.37 ,$5.08 ,$81.60 ,$10.88 ,$57.22 ,$26.88 ,$86.40 ,$5.08 ,$81.60 ,$20.72 ,$20.72 ,$5.08 ,$62.40 ST. JOSEPH'S HOSPITAL - BREESE,30100747,84460,HC ALT,301,1 ,$103.00 ,$74.16 ,$3.37 ,$103.00 ,$13.25 ,$66.95 ,$61.49 ,$5.19 ,$28.84 ,$68.19 ,$5.19 ,$68.19 ,$5.19 ,$61.39 ,$61.39 ,$5.19 ,$61.39 ,$10.71 ,$79.31 ,$13.25 ,$5.19 ,$5.30 ,$77.25 ,$73.13 ,$73.13 ,$5.19 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$13.25 ,$87.55 ,$5.19 ,$103.00 ,$57.78 ,$5.19 ,$42.64 ,$3.71 ,$3.37 ,$5.19 ,$87.55 ,$11.13 ,$61.39 ,$28.84 ,$92.70 ,$5.19 ,$87.55 ,$21.20 ,$21.20 ,$5.19 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,30100750,84478,HC TRIGLYCERIDES,301,1 ,$90.00 ,$64.80 ,$3.37 ,$90.00 ,$14.35 ,$58.50 ,$53.73 ,$5.63 ,$25.20 ,$59.58 ,$5.63 ,$59.58 ,$5.63 ,$53.64 ,$53.64 ,$5.63 ,$53.64 ,$11.59 ,$69.30 ,$14.35 ,$5.63 ,$5.73 ,$67.50 ,$63.90 ,$63.90 ,$5.63 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$14.35 ,$76.50 ,$5.63 ,$90.00 ,$50.49 ,$5.63 ,$37.26 ,$3.71 ,$3.37 ,$5.63 ,$76.50 ,$12.05 ,$53.64 ,$25.20 ,$81.00 ,$5.63 ,$76.50 ,$22.96 ,$22.96 ,$5.63 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30100755,84481,HC T3 FREE,301,1 ,$127.00 ,$91.44 ,$10.21 ,$127.00 ,$42.35 ,$82.55 ,$75.82 ,$16.60 ,$35.56 ,$84.07 ,$16.60 ,$84.07 ,$16.60 ,$75.69 ,$75.69 ,$16.60 ,$75.69 ,$34.22 ,$97.79 ,$42.35 ,$16.60 ,$16.93 ,$95.25 ,$90.17 ,$90.17 ,$16.60 ,$90.17 ,$107.95 ,$107.95 ,$107.95 , N/A ,$42.35 ,$107.95 ,$16.60 ,$127.00 ,$71.25 ,$16.60 ,$52.58 ,$11.23 ,$10.21 ,$16.60 ,$107.95 ,$35.57 ,$75.69 ,$35.56 ,$114.30 ,$16.60 ,$107.95 ,$67.76 ,$67.76 ,$16.60 ,$82.55 ST. JOSEPH'S HOSPITAL - BREESE,30100758,84484,HC TROPONIN QN,301,1 ,$212.00 ,$152.64 ,$7.58 ,$212.00 ,$31.18 ,$137.80 ,$126.56 ,$12.22 ,$59.36 ,$140.34 ,$12.22 ,$140.34 ,$12.22 ,$126.35 ,$126.35 ,$12.22 ,$126.35 ,$25.19 ,$163.24 ,$31.18 ,$12.22 ,$12.47 ,$159.00 ,$150.52 ,$150.52 ,$12.22 ,$150.52 ,$180.20 ,$180.20 ,$180.20 , N/A ,$31.18 ,$180.20 ,$12.22 ,$212.00 ,$118.93 ,$12.22 ,$87.77 ,$8.34 ,$7.58 ,$12.22 ,$180.20 ,$26.19 ,$126.35 ,$59.36 ,$190.80 ,$12.22 ,$180.20 ,$49.88 ,$49.88 ,$12.22 ,$137.80 ST. JOSEPH'S HOSPITAL - BREESE,30100761,84520,HC BUN,301,1 ,$65.00 ,$46.80 ,$3.37 ,$65.00 ,$9.88 ,$42.25 ,$38.81 ,$3.87 ,$18.20 ,$43.03 ,$3.87 ,$43.03 ,$3.87 ,$38.74 ,$38.74 ,$3.87 ,$38.74 ,$7.98 ,$50.05 ,$9.88 ,$3.87 ,$3.95 ,$48.75 ,$46.15 ,$46.15 ,$3.87 ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A ,$9.88 ,$55.25 ,$3.87 ,$3.95 ,$36.47 ,$3.87 ,$26.91 ,$3.71 ,$3.37 ,$3.87 ,$55.25 ,$8.30 ,$38.74 ,$18.20 ,$58.50 ,$3.87 ,$55.25 ,$15.80 ,$15.80 ,$3.87 ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,30100765,84550,HC URIC ACID,301,1 ,$100.00 ,$72.00 ,$3.37 ,$100.00 ,$11.30 ,$65.00 ,$59.70 ,$4.43 ,$28.00 ,$66.20 ,$4.43 ,$66.20 ,$4.43 ,$59.60 ,$59.60 ,$4.43 ,$59.60 ,$9.13 ,$77.00 ,$11.30 ,$4.43 ,$4.52 ,$75.00 ,$71.00 ,$71.00 ,$4.43 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$11.30 ,$85.00 ,$4.43 ,$100.00 ,$56.10 ,$4.43 ,$41.40 ,$3.71 ,$3.37 ,$4.43 ,$85.00 ,$9.49 ,$59.60 ,$28.00 ,$90.00 ,$4.43 ,$85.00 ,$18.08 ,$18.08 ,$4.43 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,30100802,84702,HC HCG QN,301,1 ,$193.00 ,$138.96 ,$10.21 ,$193.00 ,$37.63 ,$125.45 ,$115.22 ,$14.75 ,$54.04 ,$127.77 ,$14.75 ,$127.77 ,$14.75 ,$115.03 ,$115.03 ,$14.75 ,$115.03 ,$30.40 ,$148.61 ,$37.63 ,$14.75 ,$15.04 ,$144.75 ,$137.03 ,$137.03 ,$14.75 ,$137.03 ,$164.05 ,$164.05 ,$164.05 , N/A ,$37.63 ,$164.05 ,$14.75 ,$193.00 ,$108.27 ,$14.75 ,$79.90 ,$11.23 ,$10.21 ,$14.75 ,$164.05 ,$31.61 ,$115.03 ,$54.04 ,$173.70 ,$14.75 ,$164.05 ,$60.20 ,$60.20 ,$14.75 ,$125.45 ST. JOSEPH'S HOSPITAL - BREESE,30100808,84703,HC HCG QL,301,1 ,$102.00 ,$73.44 ,$7.37 ,$102.00 ,$18.80 ,$66.30 ,$60.89 ,$7.37 ,$28.56 ,$67.52 ,$7.37 ,$67.52 ,$7.37 ,$60.79 ,$60.79 ,$7.37 ,$60.79 ,$15.19 ,$78.54 ,$18.80 ,$7.37 ,$7.52 ,$76.50 ,$72.42 ,$72.42 ,$7.37 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$18.80 ,$86.70 ,$7.37 ,$102.00 ,$57.22 ,$7.37 ,$42.23 ,$8.34 ,$7.58 ,$7.37 ,$86.70 ,$15.79 ,$60.79 ,$28.56 ,$91.80 ,$7.37 ,$86.70 ,$30.08 ,$30.08 ,$7.37 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30100810,88720,HC BILICHECK TEST,301,1 ,$27.00 ,$19.44 ,$3.37 ,$27.00 ,$12.55 ,$17.55 ,$16.12 ,$4.92 ,$7.56 ,$17.87 ,$4.92 ,$17.87 ,$4.92 ,$16.09 ,$16.09 ,$4.92 ,$16.09 ,$10.14 ,$20.79 ,$12.55 ,$4.92 ,$5.02 ,$20.25 ,$19.17 ,$19.17 ,$4.92 ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A ,$12.55 ,$22.95 ,$4.92 ,$27.00 ,$15.15 ,$4.92 ,$11.18 ,$3.71 ,$3.37 ,$4.92 ,$22.95 ,$10.54 ,$16.09 ,$7.56 ,$24.30 ,$4.92 ,$22.95 ,$20.08 ,$20.08 ,$4.92 ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,30100838,83033,HC FETAL HGB QI,301,1 ,$72.00 ,$51.84 ,$7.58 ,$72.00 ,$20.00 ,$46.80 ,$42.98 ,$7.84 ,$20.16 ,$47.66 ,$7.84 ,$47.66 ,$7.84 ,$42.91 ,$42.91 ,$7.84 ,$42.91 ,$16.16 ,$55.44 ,$20.00 ,$7.84 ,$8.00 ,$54.00 ,$51.12 ,$51.12 ,$7.84 ,$51.12 ,$61.20 ,$61.20 ,$61.20 , N/A ,$20.00 ,$61.20 ,$7.84 ,$72.00 ,$40.39 ,$7.84 ,$29.81 ,$8.34 ,$7.58 ,$7.84 ,$61.20 ,$16.80 ,$42.91 ,$20.16 ,$64.80 ,$7.84 ,$61.20 ,$32.00 ,$32.00 ,$7.84 ,$46.80 ST. JOSEPH'S HOSPITAL - BREESE,30100845,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$42.00 ,$30.24 ,$1.71 ,$42.00 ,$12.60 ,$27.30 ,$25.07 ,$4.94 ,$11.76 ,$27.80 ,$4.94 ,$27.80 ,$4.94 ,$25.03 ,$25.03 ,$4.94 ,$25.03 ,$10.18 ,$32.34 ,$12.60 ,$4.94 ,$5.04 ,$31.50 ,$29.82 ,$29.82 ,$4.94 ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A ,$12.60 ,$35.70 ,$4.94 ,$42.00 ,$23.56 ,$4.94 ,$17.39 ,$1.88 ,$1.71 ,$4.94 ,$35.70 ,$10.58 ,$25.03 ,$11.76 ,$37.80 ,$4.94 ,$35.70 ,$20.16 ,$20.16 ,$4.94 ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,30100993,80055,HC PRENATAL PANEL,301,1 ,$376.00 ,$270.72 ,$6.92 ,$376.00 ,$119.53 ,$244.40 ,$224.47 ,$46.85 ,$105.28 ,$248.91 ,$46.85 ,$248.91 ,$46.85 ,$224.10 ,$224.10 ,$46.85 ,$224.10 ,$96.58 ,$289.52 ,$119.53 ,$46.85 ,$47.79 ,$282.00 ,$266.96 ,$266.96 ,$46.85 ,$266.96 ,$319.60 ,$319.60 ,$319.60 , N/A ,$119.53 ,$319.60 ,$46.85 ,$376.00 ,$210.94 ,$46.85 ,$155.66 ,$7.61 ,$6.92 ,$46.85 ,$319.60 ,$100.40 ,$224.10 ,$105.28 ,$338.40 ,$46.85 ,$319.60 ,$191.24 ,$191.24 ,$46.85 ,$244.40 ST. JOSEPH'S HOSPITAL - BREESE,30101011,83630,HC LACTOFERRIN FECAL QL,301,1 ,$59.00 ,$42.48 ,$7.58 ,$59.00 ,$49.25 ,$38.35 ,$35.22 ,$19.31 ,$16.52 ,$39.06 ,$19.31 ,$39.06 ,$19.31 ,$35.16 ,$35.16 ,$19.31 ,$35.16 ,$39.79 ,$45.43 ,$49.25 ,$19.31 ,$19.69 ,$44.25 ,$41.89 ,$41.89 ,$19.31 ,$41.89 ,$50.15 ,$50.15 ,$50.15 , N/A ,$49.25 ,$50.15 ,$19.31 ,$59.00 ,$33.10 ,$19.31 ,$24.43 ,$8.34 ,$7.58 ,$19.31 ,$50.15 ,$41.37 ,$35.16 ,$16.52 ,$53.10 ,$19.31 ,$50.15 ,$59.00 ,$59.00 ,$19.31 ,$38.35 ST. JOSEPH'S HOSPITAL - BREESE,30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$223.00 ,$160.56 ,$7.58 ,$223.00 ,$48.28 ,$144.95 ,$133.13 ,$18.92 ,$62.44 ,$147.63 ,$18.92 ,$147.63 ,$18.92 ,$132.91 ,$132.91 ,$18.92 ,$132.91 ,$39.01 ,$171.71 ,$48.28 ,$18.92 ,$19.31 ,$167.25 ,$158.33 ,$158.33 ,$18.92 ,$158.33 ,$189.55 ,$189.55 ,$189.55 , N/A ,$48.28 ,$189.55 ,$18.92 ,$223.00 ,$125.10 ,$18.92 ,$92.32 ,$8.34 ,$7.58 ,$18.92 ,$189.55 ,$40.55 ,$132.91 ,$62.44 ,$200.70 ,$18.92 ,$189.55 ,$77.24 ,$77.24 ,$18.92 ,$144.95 ST. JOSEPH'S HOSPITAL - BREESE,30101062,83516,HC IMMUNO QL/SQ MLT - 90,301,1 ,$29.00 ,$20.88 ,$6.79 ,$29.00 ,$28.83 ,$18.85 ,$17.31 ,$11.30 ,$8.12 ,$19.20 ,$11.30 ,$19.20 ,$11.30 ,$17.28 ,$17.28 ,$11.30 ,$17.28 ,$23.29 ,$22.33 ,$28.83 ,$11.30 ,$11.52 ,$21.75 ,$20.59 ,$20.59 ,$11.30 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$28.83 ,$24.65 ,$11.30 ,$29.00 ,$16.27 ,$11.30 ,$12.01 ,$7.47 ,$6.79 ,$11.30 ,$24.65 ,$24.21 ,$17.28 ,$8.12 ,$26.10 ,$11.30 ,$24.65 ,$29.00 ,$29.00 ,$11.30 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,30101063,83519,HC ACETYLCHOLINE RECEPTR AB TIER 1-90,301,1 ,$56.00 ,$40.32 ,$6.79 ,$56.00 ,$46.00 ,$36.40 ,$33.43 ,$18.03 ,$15.68 ,$37.07 ,$18.03 ,$37.07 ,$18.03 ,$33.38 ,$33.38 ,$18.03 ,$33.38 ,$37.17 ,$43.12 ,$46.00 ,$18.03 ,$18.39 ,$42.00 ,$39.76 ,$39.76 ,$18.03 ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A ,$46.00 ,$47.60 ,$18.03 ,$56.00 ,$31.42 ,$18.03 ,$23.18 ,$7.47 ,$6.79 ,$18.03 ,$47.60 ,$38.64 ,$33.38 ,$15.68 ,$50.40 ,$18.03 ,$47.60 ,$56.00 ,$56.00 ,$18.03 ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101065,83520,HC ANTI-NEURONAL CELL AB-90,301,1 ,$50.00 ,$36.00 ,$6.79 ,$50.00 ,$43.18 ,$32.50 ,$29.85 ,$16.92 ,$14.00 ,$33.10 ,$16.92 ,$33.10 ,$16.92 ,$29.80 ,$29.80 ,$16.92 ,$29.80 ,$34.89 ,$38.50 ,$43.18 ,$16.92 ,$17.27 ,$37.50 ,$35.50 ,$35.50 ,$16.92 ,$35.50 ,$42.50 ,$42.50 ,$42.50 , N/A ,$43.18 ,$42.50 ,$16.92 ,$50.00 ,$28.05 ,$16.92 ,$20.70 ,$7.47 ,$6.79 ,$16.92 ,$42.50 ,$36.27 ,$29.80 ,$14.00 ,$45.00 ,$16.92 ,$42.50 ,$50.00 ,$50.00 ,$16.92 ,$32.50 ST. JOSEPH'S HOSPITAL - BREESE,30101075,80048,HC BASIC METABOLIC PANEL,301,1 ,$352.00 ,$253.44 ,$6.92 ,$352.00 ,$21.15 ,$228.80 ,$210.14 ,$8.29 ,$98.56 ,$233.02 ,$8.29 ,$233.02 ,$8.29 ,$209.79 ,$209.79 ,$8.29 ,$209.79 ,$17.09 ,$271.04 ,$21.15 ,$8.29 ,$8.46 ,$264.00 ,$249.92 ,$249.92 ,$8.29 ,$249.92 ,$299.20 ,$299.20 ,$299.20 , N/A ,$21.15 ,$299.20 ,$8.29 ,$8.46 ,$197.47 ,$8.29 ,$145.73 ,$7.61 ,$6.92 ,$8.29 ,$299.20 ,$17.77 ,$209.79 ,$98.56 ,$316.80 ,$8.29 ,$299.20 ,$33.84 ,$33.84 ,$8.29 ,$228.80 ST. JOSEPH'S HOSPITAL - BREESE,30101078,80051,HC ELECTROLYTE PANEL,301,1 ,$259.00 ,$186.48 ,$6.87 ,$259.00 ,$17.53 ,$168.35 ,$154.62 ,$6.87 ,$72.52 ,$171.46 ,$6.87 ,$171.46 ,$6.87 ,$154.36 ,$154.36 ,$6.87 ,$154.36 ,$14.16 ,$199.43 ,$17.53 ,$6.87 ,$7.01 ,$194.25 ,$183.89 ,$183.89 ,$6.87 ,$183.89 ,$220.15 ,$220.15 ,$220.15 , N/A ,$17.53 ,$220.15 ,$6.87 ,$259.00 ,$145.30 ,$6.87 ,$107.23 ,$7.61 ,$6.92 ,$6.87 ,$220.15 ,$14.72 ,$154.36 ,$72.52 ,$233.10 ,$6.87 ,$220.15 ,$28.04 ,$28.04 ,$6.87 ,$168.35 ST. JOSEPH'S HOSPITAL - BREESE,30101080,80053,HC COMPREHENSIVE METABOLIC PANEL,301,1 ,$415.00 ,$298.80 ,$6.92 ,$415.00 ,$26.40 ,$269.75 ,$247.76 ,$10.35 ,$116.20 ,$274.73 ,$10.35 ,$274.73 ,$10.35 ,$247.34 ,$247.34 ,$10.35 ,$247.34 ,$21.33 ,$319.55 ,$26.40 ,$10.35 ,$10.55 ,$311.25 ,$294.65 ,$294.65 ,$10.35 ,$294.65 ,$352.75 ,$352.75 ,$352.75 , N/A ,$26.40 ,$352.75 ,$10.35 ,$10.56 ,$232.82 ,$10.35 ,$171.81 ,$7.61 ,$6.92 ,$10.35 ,$352.75 ,$22.18 ,$247.34 ,$116.20 ,$373.50 ,$10.35 ,$352.75 ,$42.24 ,$42.24 ,$10.35 ,$269.75 ST. JOSEPH'S HOSPITAL - BREESE,30101082,80061,HC LIPID PANEL,301,1 ,$316.00 ,$227.52 ,$6.92 ,$316.00 ,$33.48 ,$205.40 ,$188.65 ,$13.12 ,$88.48 ,$209.19 ,$13.12 ,$209.19 ,$13.12 ,$188.34 ,$188.34 ,$13.12 ,$188.34 ,$27.05 ,$243.32 ,$33.48 ,$13.12 ,$13.39 ,$237.00 ,$224.36 ,$224.36 ,$13.12 ,$224.36 ,$268.60 ,$268.60 ,$268.60 , N/A ,$33.48 ,$268.60 ,$13.12 ,$316.00 ,$177.28 ,$13.12 ,$130.82 ,$7.61 ,$6.92 ,$13.12 ,$268.60 ,$28.12 ,$188.34 ,$88.48 ,$284.40 ,$13.12 ,$268.60 ,$53.56 ,$53.56 ,$13.12 ,$205.40 ST. JOSEPH'S HOSPITAL - BREESE,30101083,80061,HC LIPID PANEL - 90,301,1 ,$42.82 ,$30.83 ,$6.92 ,$42.82 ,$33.48 ,$27.83 ,$25.56 ,$13.12 ,$11.99 ,$28.35 ,$13.12 ,$28.35 ,$13.12 ,$25.52 ,$25.52 ,$13.12 ,$25.52 ,$27.05 ,$32.97 ,$33.48 ,$13.12 ,$13.39 ,$32.12 ,$30.40 ,$30.40 ,$13.12 ,$30.40 ,$36.40 ,$36.40 ,$36.40 , N/A ,$33.48 ,$36.40 ,$13.12 ,$42.82 ,$24.02 ,$13.12 ,$17.73 ,$7.61 ,$6.92 ,$13.12 ,$36.40 ,$28.12 ,$25.52 ,$11.99 ,$38.54 ,$13.12 ,$36.40 ,$42.82 ,$42.82 ,$13.12 ,$27.83 ST. JOSEPH'S HOSPITAL - BREESE,30101084,80069,HC RENAL PANEL,301,1 ,$293.00 ,$210.96 ,$6.92 ,$293.00 ,$21.70 ,$190.45 ,$174.92 ,$8.51 ,$82.04 ,$193.97 ,$8.51 ,$193.97 ,$8.51 ,$174.63 ,$174.63 ,$8.51 ,$174.63 ,$17.53 ,$225.61 ,$21.70 ,$8.51 ,$8.67 ,$219.75 ,$208.03 ,$208.03 ,$8.51 ,$208.03 ,$249.05 ,$249.05 ,$249.05 , N/A ,$21.70 ,$249.05 ,$8.51 ,$293.00 ,$164.37 ,$8.51 ,$121.30 ,$7.61 ,$6.92 ,$8.51 ,$249.05 ,$18.23 ,$174.63 ,$82.04 ,$263.70 ,$8.51 ,$249.05 ,$34.72 ,$34.72 ,$8.51 ,$190.45 ST. JOSEPH'S HOSPITAL - BREESE,30101088,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$353.00 ,$254.16 ,$6.92 ,$353.00 ,$20.43 ,$229.45 ,$210.74 ,$8.01 ,$98.84 ,$233.69 ,$8.01 ,$233.69 ,$8.01 ,$210.39 ,$210.39 ,$8.01 ,$210.39 ,$16.50 ,$271.81 ,$20.43 ,$8.01 ,$8.16 ,$264.75 ,$250.63 ,$250.63 ,$8.01 ,$250.63 ,$300.05 ,$300.05 ,$300.05 , N/A ,$20.43 ,$300.05 ,$8.01 ,$353.00 ,$198.03 ,$8.01 ,$146.14 ,$7.61 ,$6.92 ,$8.01 ,$300.05 ,$17.16 ,$210.39 ,$98.84 ,$317.70 ,$8.01 ,$300.05 ,$32.68 ,$32.68 ,$8.01 ,$229.45 ST. JOSEPH'S HOSPITAL - BREESE,30101089,80150,HC AMIKACIN - 90,301,1 ,$67.00 ,$48.24 ,$8.71 ,$67.00 ,$37.70 ,$43.55 ,$40.00 ,$14.78 ,$18.76 ,$44.35 ,$14.78 ,$44.35 ,$14.78 ,$39.93 ,$39.93 ,$14.78 ,$39.93 ,$30.46 ,$51.59 ,$37.70 ,$14.78 ,$15.07 ,$50.25 ,$47.57 ,$47.57 ,$14.78 ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A ,$37.70 ,$56.95 ,$14.78 ,$67.00 ,$37.59 ,$14.78 ,$27.74 ,$9.58 ,$8.71 ,$14.78 ,$56.95 ,$31.67 ,$39.93 ,$18.76 ,$60.30 ,$14.78 ,$56.95 ,$60.32 ,$60.32 ,$14.78 ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,30101091,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$170.00 ,$122.40 ,$8.71 ,$170.00 ,$36.43 ,$110.50 ,$101.49 ,$14.28 ,$47.60 ,$112.54 ,$14.28 ,$112.54 ,$14.28 ,$101.32 ,$101.32 ,$14.28 ,$101.32 ,$29.43 ,$130.90 ,$36.43 ,$14.28 ,$14.56 ,$127.50 ,$120.70 ,$120.70 ,$14.28 ,$120.70 ,$144.50 ,$144.50 ,$144.50 , N/A ,$36.43 ,$144.50 ,$14.28 ,$170.00 ,$95.37 ,$14.28 ,$70.38 ,$9.58 ,$8.71 ,$14.28 ,$144.50 ,$30.60 ,$101.32 ,$47.60 ,$153.00 ,$14.28 ,$144.50 ,$58.28 ,$58.28 ,$14.28 ,$110.50 ST. JOSEPH'S HOSPITAL - BREESE,30101092,80156,HC CARBAMAZEPINE TOTAL - 90,301,1 ,$170.00 ,$122.40 ,$8.71 ,$170.00 ,$36.43 ,$110.50 ,$101.49 ,$14.28 ,$47.60 ,$112.54 ,$14.28 ,$112.54 ,$14.28 ,$101.32 ,$101.32 ,$14.28 ,$101.32 ,$29.43 ,$130.90 ,$36.43 ,$14.28 ,$14.56 ,$127.50 ,$120.70 ,$120.70 ,$14.28 ,$120.70 ,$144.50 ,$144.50 ,$144.50 , N/A ,$36.43 ,$144.50 ,$14.28 ,$170.00 ,$95.37 ,$14.28 ,$70.38 ,$9.58 ,$8.71 ,$14.28 ,$144.50 ,$30.60 ,$101.32 ,$47.60 ,$153.00 ,$14.28 ,$144.50 ,$58.28 ,$58.28 ,$14.28 ,$110.50 ST. JOSEPH'S HOSPITAL - BREESE,30101093,80157,HC CARBAMAZEPINE FREE - 90,301,1 ,$90.00 ,$64.80 ,$8.71 ,$90.00 ,$33.13 ,$58.50 ,$53.73 ,$12.98 ,$25.20 ,$59.58 ,$12.98 ,$59.58 ,$12.98 ,$53.64 ,$53.64 ,$12.98 ,$53.64 ,$26.77 ,$69.30 ,$33.13 ,$12.98 ,$13.25 ,$67.50 ,$63.90 ,$63.90 ,$12.98 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$33.13 ,$76.50 ,$12.98 ,$90.00 ,$50.49 ,$12.98 ,$37.26 ,$9.58 ,$8.71 ,$12.98 ,$76.50 ,$27.83 ,$53.64 ,$25.20 ,$81.00 ,$12.98 ,$76.50 ,$53.00 ,$53.00 ,$12.98 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$77.00 ,$55.44 ,$8.71 ,$77.00 ,$45.13 ,$50.05 ,$45.97 ,$17.69 ,$21.56 ,$50.97 ,$17.69 ,$50.97 ,$17.69 ,$45.89 ,$45.89 ,$17.69 ,$45.89 ,$36.46 ,$59.29 ,$45.13 ,$17.69 ,$18.04 ,$57.75 ,$54.67 ,$54.67 ,$17.69 ,$54.67 ,$65.45 ,$65.45 ,$65.45 , N/A ,$45.13 ,$65.45 ,$17.69 ,$77.00 ,$43.20 ,$17.69 ,$31.88 ,$9.58 ,$8.71 ,$17.69 ,$65.45 ,$37.91 ,$45.89 ,$21.56 ,$69.30 ,$17.69 ,$65.45 ,$72.20 ,$72.20 ,$17.69 ,$50.05 ST. JOSEPH'S HOSPITAL - BREESE,30101096,80162,HC DIGOXIN LEVELS,301,1 ,$143.00 ,$102.96 ,$8.71 ,$143.00 ,$33.20 ,$92.95 ,$85.37 ,$13.01 ,$40.04 ,$94.67 ,$13.01 ,$94.67 ,$13.01 ,$85.23 ,$85.23 ,$13.01 ,$85.23 ,$26.83 ,$110.11 ,$33.20 ,$13.01 ,$13.28 ,$107.25 ,$101.53 ,$101.53 ,$13.01 ,$101.53 ,$121.55 ,$121.55 ,$121.55 , N/A ,$33.20 ,$121.55 ,$13.01 ,$143.00 ,$80.22 ,$13.01 ,$59.20 ,$9.58 ,$8.71 ,$13.01 ,$121.55 ,$27.89 ,$85.23 ,$40.04 ,$128.70 ,$13.01 ,$121.55 ,$53.12 ,$53.12 ,$13.01 ,$92.95 ST. JOSEPH'S HOSPITAL - BREESE,30101099,80168,HC ETHOSUXIMIDE - 90,301,1 ,$58.00 ,$41.76 ,$8.71 ,$58.00 ,$40.85 ,$37.70 ,$34.63 ,$16.01 ,$16.24 ,$38.40 ,$16.01 ,$38.40 ,$16.01 ,$34.57 ,$34.57 ,$16.01 ,$34.57 ,$33.01 ,$44.66 ,$40.85 ,$16.01 ,$16.34 ,$43.50 ,$41.18 ,$41.18 ,$16.01 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$40.85 ,$49.30 ,$16.01 ,$58.00 ,$32.54 ,$16.01 ,$24.01 ,$9.58 ,$8.71 ,$16.01 ,$49.30 ,$34.31 ,$34.57 ,$16.24 ,$52.20 ,$16.01 ,$49.30 ,$58.00 ,$58.00 ,$16.01 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101100,80169,HC EVEROLIMUS - 90,301,1 ,$163.00 ,$117.36 ,$8.71 ,$163.00 ,$34.33 ,$105.95 ,$97.31 ,$13.46 ,$45.64 ,$107.91 ,$13.46 ,$107.91 ,$13.46 ,$97.15 ,$97.15 ,$13.46 ,$97.15 ,$27.73 ,$125.51 ,$34.33 ,$13.46 ,$13.72 ,$122.25 ,$115.73 ,$115.73 ,$13.46 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$34.33 ,$138.55 ,$13.46 ,$163.00 ,$91.44 ,$13.46 ,$67.48 ,$9.58 ,$8.71 ,$13.46 ,$138.55 ,$28.83 ,$97.15 ,$45.64 ,$146.70 ,$13.46 ,$138.55 ,$54.92 ,$54.92 ,$13.46 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,30101102,80171,HC GABAPENTIN PLASMA - 90,301,1 ,$160.00 ,$115.20 ,$8.71 ,$160.00 ,$54.18 ,$104.00 ,$95.52 ,$21.24 ,$44.80 ,$105.92 ,$21.24 ,$105.92 ,$21.24 ,$95.36 ,$95.36 ,$21.24 ,$95.36 ,$43.77 ,$123.20 ,$54.18 ,$21.24 ,$21.66 ,$120.00 ,$113.60 ,$113.60 ,$21.24 ,$113.60 ,$136.00 ,$136.00 ,$136.00 , N/A ,$54.18 ,$136.00 ,$21.24 ,$160.00 ,$89.76 ,$21.24 ,$66.24 ,$9.58 ,$8.71 ,$21.24 ,$136.00 ,$45.51 ,$95.36 ,$44.80 ,$144.00 ,$21.24 ,$136.00 ,$86.68 ,$86.68 ,$21.24 ,$104.00 ST. JOSEPH'S HOSPITAL - BREESE,30101104,80175,HC LAMOTRIGINE - 90,301,1 ,$163.00 ,$117.36 ,$8.71 ,$163.00 ,$33.13 ,$105.95 ,$97.31 ,$12.98 ,$45.64 ,$107.91 ,$12.98 ,$107.91 ,$12.98 ,$97.15 ,$97.15 ,$12.98 ,$97.15 ,$26.77 ,$125.51 ,$33.13 ,$12.98 ,$13.25 ,$122.25 ,$115.73 ,$115.73 ,$12.98 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$33.13 ,$138.55 ,$12.98 ,$163.00 ,$91.44 ,$12.98 ,$67.48 ,$9.58 ,$8.71 ,$12.98 ,$138.55 ,$27.83 ,$97.15 ,$45.64 ,$146.70 ,$12.98 ,$138.55 ,$53.00 ,$53.00 ,$12.98 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,30101106,80177,HC LEVETIRACETAM - 90,301,1 ,$163.00 ,$117.36 ,$8.71 ,$163.00 ,$33.13 ,$105.95 ,$97.31 ,$12.98 ,$45.64 ,$107.91 ,$12.98 ,$107.91 ,$12.98 ,$97.15 ,$97.15 ,$12.98 ,$97.15 ,$26.77 ,$125.51 ,$33.13 ,$12.98 ,$13.25 ,$122.25 ,$115.73 ,$115.73 ,$12.98 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$33.13 ,$138.55 ,$12.98 ,$163.00 ,$91.44 ,$12.98 ,$67.48 ,$9.58 ,$8.71 ,$12.98 ,$138.55 ,$27.83 ,$97.15 ,$45.64 ,$146.70 ,$12.98 ,$138.55 ,$53.00 ,$53.00 ,$12.98 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,30101107,80178,HC LITHIUM,301,1 ,$114.00 ,$82.08 ,$6.48 ,$114.00 ,$16.53 ,$74.10 ,$68.06 ,$6.48 ,$31.92 ,$75.47 ,$6.48 ,$75.47 ,$6.48 ,$67.94 ,$67.94 ,$6.48 ,$67.94 ,$13.35 ,$87.78 ,$16.53 ,$6.48 ,$6.61 ,$85.50 ,$80.94 ,$80.94 ,$6.48 ,$80.94 ,$96.90 ,$96.90 ,$96.90 , N/A ,$16.53 ,$96.90 ,$6.48 ,$114.00 ,$63.95 ,$6.48 ,$47.20 ,$9.58 ,$8.71 ,$6.48 ,$96.90 ,$13.88 ,$67.94 ,$31.92 ,$102.60 ,$6.48 ,$96.90 ,$26.44 ,$26.44 ,$6.48 ,$74.10 ST. JOSEPH'S HOSPITAL - BREESE,30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$57.00 ,$41.04 ,$8.71 ,$57.00 ,$33.13 ,$37.05 ,$34.03 ,$12.98 ,$15.96 ,$37.73 ,$12.98 ,$37.73 ,$12.98 ,$33.97 ,$33.97 ,$12.98 ,$33.97 ,$26.77 ,$43.89 ,$33.13 ,$12.98 ,$13.25 ,$42.75 ,$40.47 ,$40.47 ,$12.98 ,$40.47 ,$48.45 ,$48.45 ,$48.45 , N/A ,$33.13 ,$48.45 ,$12.98 ,$57.00 ,$31.98 ,$12.98 ,$23.60 ,$9.58 ,$8.71 ,$12.98 ,$48.45 ,$27.83 ,$33.97 ,$15.96 ,$51.30 ,$12.98 ,$48.45 ,$53.00 ,$53.00 ,$12.98 ,$37.05 ST. JOSEPH'S HOSPITAL - BREESE,30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$164.00 ,$118.08 ,$8.71 ,$164.00 ,$38.25 ,$106.60 ,$97.91 ,$14.99 ,$45.92 ,$108.57 ,$14.99 ,$108.57 ,$14.99 ,$97.74 ,$97.74 ,$14.99 ,$97.74 ,$30.91 ,$126.28 ,$38.25 ,$14.99 ,$15.30 ,$123.00 ,$116.44 ,$116.44 ,$14.99 ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A ,$38.25 ,$139.40 ,$14.99 ,$164.00 ,$92.00 ,$14.99 ,$67.90 ,$9.58 ,$8.71 ,$14.99 ,$139.40 ,$32.13 ,$97.74 ,$45.92 ,$147.60 ,$14.99 ,$139.40 ,$61.20 ,$61.20 ,$14.99 ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,30101111,80184,HC PHENOBARBITAL,301,1 ,$164.00 ,$118.08 ,$8.71 ,$164.00 ,$38.25 ,$106.60 ,$97.91 ,$14.99 ,$45.92 ,$108.57 ,$14.99 ,$108.57 ,$14.99 ,$97.74 ,$97.74 ,$14.99 ,$97.74 ,$30.91 ,$126.28 ,$38.25 ,$14.99 ,$15.30 ,$123.00 ,$116.44 ,$116.44 ,$14.99 ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A ,$38.25 ,$139.40 ,$14.99 ,$164.00 ,$92.00 ,$14.99 ,$67.90 ,$9.58 ,$8.71 ,$14.99 ,$139.40 ,$32.13 ,$97.74 ,$45.92 ,$147.60 ,$14.99 ,$139.40 ,$61.20 ,$61.20 ,$14.99 ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,30101112,80185,HC PHENYTOIN TOTAL,301,1 ,$156.00 ,$112.32 ,$8.71 ,$156.00 ,$33.13 ,$101.40 ,$93.13 ,$12.98 ,$43.68 ,$103.27 ,$12.98 ,$103.27 ,$12.98 ,$92.98 ,$92.98 ,$12.98 ,$92.98 ,$26.77 ,$120.12 ,$33.13 ,$12.98 ,$13.25 ,$117.00 ,$110.76 ,$110.76 ,$12.98 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$33.13 ,$132.60 ,$12.98 ,$156.00 ,$87.52 ,$12.98 ,$64.58 ,$9.58 ,$8.71 ,$12.98 ,$132.60 ,$27.83 ,$92.98 ,$43.68 ,$140.40 ,$12.98 ,$132.60 ,$53.00 ,$53.00 ,$12.98 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,30101114,80186,HC PHENYTOIN FREE - 90,301,1 ,$58.00 ,$41.76 ,$8.71 ,$58.00 ,$34.40 ,$37.70 ,$34.63 ,$13.48 ,$16.24 ,$38.40 ,$13.48 ,$38.40 ,$13.48 ,$34.57 ,$34.57 ,$13.48 ,$34.57 ,$27.80 ,$44.66 ,$34.40 ,$13.48 ,$13.76 ,$43.50 ,$41.18 ,$41.18 ,$13.48 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$34.40 ,$49.30 ,$13.48 ,$58.00 ,$32.54 ,$13.48 ,$24.01 ,$9.58 ,$8.71 ,$13.48 ,$49.30 ,$28.90 ,$34.57 ,$16.24 ,$52.20 ,$13.48 ,$49.30 ,$55.04 ,$55.04 ,$13.48 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101115,80188,HC PRIMIDONE - 90,301,1 ,$64.00 ,$46.08 ,$8.71 ,$64.00 ,$41.48 ,$41.60 ,$38.21 ,$16.26 ,$17.92 ,$42.37 ,$16.26 ,$42.37 ,$16.26 ,$38.14 ,$38.14 ,$16.26 ,$38.14 ,$33.51 ,$49.28 ,$41.48 ,$16.26 ,$16.58 ,$48.00 ,$45.44 ,$45.44 ,$16.26 ,$45.44 ,$54.40 ,$54.40 ,$54.40 , N/A ,$41.48 ,$54.40 ,$16.26 ,$64.00 ,$35.90 ,$16.26 ,$26.50 ,$9.58 ,$8.71 ,$16.26 ,$54.40 ,$34.84 ,$38.14 ,$17.92 ,$57.60 ,$16.26 ,$54.40 ,$64.00 ,$64.00 ,$16.26 ,$41.60 ST. JOSEPH'S HOSPITAL - BREESE,30101116,80192,HC PROCAINEAMIDE - 90,301,1 ,$59.00 ,$42.48 ,$8.71 ,$59.00 ,$41.88 ,$38.35 ,$35.22 ,$16.41 ,$16.52 ,$39.06 ,$16.41 ,$39.06 ,$16.41 ,$35.16 ,$35.16 ,$16.41 ,$35.16 ,$33.84 ,$45.43 ,$41.88 ,$16.41 ,$16.75 ,$44.25 ,$41.89 ,$41.89 ,$16.41 ,$41.89 ,$50.15 ,$50.15 ,$50.15 , N/A ,$41.88 ,$50.15 ,$16.41 ,$59.00 ,$33.10 ,$16.41 ,$24.43 ,$9.58 ,$8.71 ,$16.41 ,$50.15 ,$35.18 ,$35.16 ,$16.52 ,$53.10 ,$16.41 ,$50.15 ,$59.00 ,$59.00 ,$16.41 ,$38.35 ST. JOSEPH'S HOSPITAL - BREESE,30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$90.00 ,$64.80 ,$8.71 ,$90.00 ,$34.33 ,$58.50 ,$53.73 ,$13.46 ,$25.20 ,$59.58 ,$13.46 ,$59.58 ,$13.46 ,$53.64 ,$53.64 ,$13.46 ,$53.64 ,$27.73 ,$69.30 ,$34.33 ,$13.46 ,$13.72 ,$67.50 ,$63.90 ,$63.90 ,$13.46 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$34.33 ,$76.50 ,$13.46 ,$90.00 ,$50.49 ,$13.46 ,$37.26 ,$9.58 ,$8.71 ,$13.46 ,$76.50 ,$28.83 ,$53.64 ,$25.20 ,$81.00 ,$13.46 ,$76.50 ,$54.92 ,$54.92 ,$13.46 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30101119,80197,HC TACROLIMUS - 90,301,1 ,$110.00 ,$79.20 ,$8.71 ,$110.00 ,$34.33 ,$71.50 ,$65.67 ,$13.46 ,$30.80 ,$72.82 ,$13.46 ,$72.82 ,$13.46 ,$65.56 ,$65.56 ,$13.46 ,$65.56 ,$27.73 ,$84.70 ,$34.33 ,$13.46 ,$13.72 ,$82.50 ,$78.10 ,$78.10 ,$13.46 ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A ,$34.33 ,$93.50 ,$13.46 ,$110.00 ,$61.71 ,$13.46 ,$45.54 ,$9.58 ,$8.71 ,$13.46 ,$93.50 ,$28.83 ,$65.56 ,$30.80 ,$99.00 ,$13.46 ,$93.50 ,$54.92 ,$54.92 ,$13.46 ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,30101120,80198,HC THEOPHYLLINE,301,1 ,$155.00 ,$111.60 ,$8.71 ,$155.00 ,$35.35 ,$100.75 ,$92.54 ,$13.86 ,$43.40 ,$102.61 ,$13.86 ,$102.61 ,$13.86 ,$92.38 ,$92.38 ,$13.86 ,$92.38 ,$28.56 ,$119.35 ,$35.35 ,$13.86 ,$14.13 ,$116.25 ,$110.05 ,$110.05 ,$13.86 ,$110.05 ,$131.75 ,$131.75 ,$131.75 , N/A ,$35.35 ,$131.75 ,$13.86 ,$155.00 ,$86.96 ,$13.86 ,$64.17 ,$9.58 ,$8.71 ,$13.86 ,$131.75 ,$29.69 ,$92.38 ,$43.40 ,$139.50 ,$13.86 ,$131.75 ,$56.56 ,$56.56 ,$13.86 ,$100.75 ST. JOSEPH'S HOSPITAL - BREESE,30101124,80201,HC TOPIRAMATE - 90,301,1 ,$121.00 ,$87.12 ,$8.71 ,$121.00 ,$29.80 ,$78.65 ,$72.24 ,$11.68 ,$33.88 ,$80.10 ,$11.68 ,$80.10 ,$11.68 ,$72.12 ,$72.12 ,$11.68 ,$72.12 ,$24.08 ,$93.17 ,$29.80 ,$11.68 ,$11.92 ,$90.75 ,$85.91 ,$85.91 ,$11.68 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$29.80 ,$102.85 ,$11.68 ,$121.00 ,$67.88 ,$11.68 ,$50.09 ,$9.58 ,$8.71 ,$11.68 ,$102.85 ,$25.03 ,$72.12 ,$33.88 ,$108.90 ,$11.68 ,$102.85 ,$47.68 ,$47.68 ,$11.68 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30101125,80202,HC VANCOMYCIN,301,1 ,$169.00 ,$121.68 ,$8.71 ,$169.00 ,$33.85 ,$109.85 ,$100.89 ,$13.27 ,$47.32 ,$111.88 ,$13.27 ,$111.88 ,$13.27 ,$100.72 ,$100.72 ,$13.27 ,$100.72 ,$27.35 ,$130.13 ,$33.85 ,$13.27 ,$13.53 ,$126.75 ,$119.99 ,$119.99 ,$13.27 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$33.85 ,$143.65 ,$13.27 ,$169.00 ,$94.81 ,$13.27 ,$69.97 ,$9.58 ,$8.71 ,$13.27 ,$143.65 ,$28.43 ,$100.72 ,$47.32 ,$152.10 ,$13.27 ,$143.65 ,$54.16 ,$54.16 ,$13.27 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30101126,80203,HC ZONISAMIDE - 90,301,1 ,$141.00 ,$101.52 ,$8.71 ,$141.00 ,$33.13 ,$91.65 ,$84.18 ,$12.98 ,$39.48 ,$93.34 ,$12.98 ,$93.34 ,$12.98 ,$84.04 ,$84.04 ,$12.98 ,$84.04 ,$26.77 ,$108.57 ,$33.13 ,$12.98 ,$13.25 ,$105.75 ,$100.11 ,$100.11 ,$12.98 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$33.13 ,$119.85 ,$12.98 ,$141.00 ,$79.10 ,$12.98 ,$58.37 ,$9.58 ,$8.71 ,$12.98 ,$119.85 ,$27.83 ,$84.04 ,$39.48 ,$126.90 ,$12.98 ,$119.85 ,$53.00 ,$53.00 ,$12.98 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$156.00 ,$112.32 ,$8.71 ,$156.00 ,$46.60 ,$101.40 ,$93.13 ,$18.27 ,$43.68 ,$103.27 ,$18.27 ,$103.27 ,$18.27 ,$92.98 ,$92.98 ,$18.27 ,$92.98 ,$37.65 ,$120.12 ,$46.60 ,$18.27 ,$18.63 ,$117.00 ,$110.76 ,$110.76 ,$18.27 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$46.60 ,$132.60 ,$18.27 ,$156.00 ,$87.52 ,$18.27 ,$64.58 ,$9.58 ,$8.71 ,$18.27 ,$132.60 ,$39.14 ,$92.98 ,$43.68 ,$140.40 ,$18.27 ,$132.60 ,$74.56 ,$74.56 ,$18.27 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,30101133,80306,HC DRUG SCREEN PRESUMPTIVE INSTRMNT ASSIST DIR OPTICAL T2,301,1 ,$254.00 ,$182.88 ,$7.58 ,$254.00 ,$42.85 ,$165.10 ,$151.64 ,$16.80 ,$71.12 ,$168.15 ,$16.80 ,$168.15 ,$16.80 ,$151.38 ,$151.38 ,$16.80 ,$151.38 ,$34.62 ,$195.58 ,$42.85 ,$16.80 ,$17.13 ,$190.50 ,$180.34 ,$180.34 ,$16.80 ,$180.34 ,$215.90 ,$215.90 ,$215.90 , N/A ,$42.85 ,$215.90 ,$16.80 ,$254.00 ,$142.49 ,$16.80 ,$105.16 ,$8.34 ,$7.58 ,$16.80 ,$215.90 ,$35.99 ,$151.38 ,$71.12 ,$228.60 ,$16.80 ,$215.90 ,$68.56 ,$68.56 ,$16.80 ,$165.10 ST. JOSEPH'S HOSPITAL - BREESE,30101137,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4,301,1 ,$367.00 ,$264.24 ,$20.42 ,$367.00 ,$155.35 ,$238.55 ,$219.10 ,$60.90 ,$102.76 ,$242.95 ,$60.90 ,$242.95 ,$60.90 ,$218.73 ,$218.73 ,$60.90 ,$218.73 ,$125.52 ,$282.59 ,$155.35 ,$60.90 ,$62.11 ,$275.25 ,$260.57 ,$260.57 ,$60.90 ,$260.57 ,$311.95 ,$311.95 ,$311.95 , N/A ,$155.35 ,$311.95 ,$60.90 ,$367.00 ,$205.89 ,$60.90 ,$151.94 ,$22.46 ,$20.42 ,$60.90 ,$311.95 ,$130.49 ,$218.73 ,$102.76 ,$330.30 ,$60.90 ,$311.95 ,$248.56 ,$248.56 ,$60.90 ,$238.55 ST. JOSEPH'S HOSPITAL - BREESE,30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$33.00 ,$23.76 ,$9.24 ,$82.50 ,$82.50 ,$21.45 ,$19.70 ,$32.34 ,$9.24 ,$21.85 ,$32.34 ,$21.85 ,$32.34 ,$19.67 ,$19.67 ,$32.34 ,$19.67 ,$33.00 ,$25.41 ,$82.50 ,$32.34 ,$32.34 ,$24.75 ,$23.43 ,$23.43 ,$32.34 ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A ,$33.00 ,$28.05 ,$32.34 ,$33.00 ,$18.51 ,$32.34 ,$13.66 ,$22.46 ,$20.42 ,$32.34 ,$28.05 ,$69.30 ,$19.67 ,$9.24 ,$29.70 ,$32.34 ,$28.05 ,$33.00 ,$33.00 ,$32.34 ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,30101141,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2-90,301,1 ,$173.00 ,$124.56 ,$20.42 ,$173.00 ,$155.35 ,$112.45 ,$103.28 ,$60.90 ,$48.44 ,$114.53 ,$60.90 ,$114.53 ,$60.90 ,$103.11 ,$103.11 ,$60.90 ,$103.11 ,$125.52 ,$133.21 ,$155.35 ,$60.90 ,$62.11 ,$129.75 ,$122.83 ,$122.83 ,$60.90 ,$122.83 ,$147.05 ,$147.05 ,$147.05 , N/A ,$155.35 ,$147.05 ,$60.90 ,$173.00 ,$97.05 ,$60.90 ,$71.62 ,$22.46 ,$20.42 ,$60.90 ,$147.05 ,$130.49 ,$103.11 ,$48.44 ,$155.70 ,$60.90 ,$147.05 ,$173.00 ,$173.00 ,$60.90 ,$112.45 ST. JOSEPH'S HOSPITAL - BREESE,30101143,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4-90,301,1 ,$367.00 ,$264.24 ,$20.42 ,$367.00 ,$155.35 ,$238.55 ,$219.10 ,$60.90 ,$102.76 ,$242.95 ,$60.90 ,$242.95 ,$60.90 ,$218.73 ,$218.73 ,$60.90 ,$218.73 ,$125.52 ,$282.59 ,$155.35 ,$60.90 ,$62.11 ,$275.25 ,$260.57 ,$260.57 ,$60.90 ,$260.57 ,$311.95 ,$311.95 ,$311.95 , N/A ,$155.35 ,$311.95 ,$60.90 ,$367.00 ,$205.89 ,$60.90 ,$151.94 ,$22.46 ,$20.42 ,$60.90 ,$311.95 ,$130.49 ,$218.73 ,$102.76 ,$330.30 ,$60.90 ,$311.95 ,$248.56 ,$248.56 ,$60.90 ,$238.55 ST. JOSEPH'S HOSPITAL - BREESE,30101146,80323,HC NICOTINE - 90,301,1 ,$91.00 ,$65.52 ,$20.42 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 ,$22.46 ,$20.42 , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 , N/A , N/A , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,30101147,80323,HC NICOTINE URINE - 90,301,1 ,$50.00 ,$36.00 ,$14.00 ,$50.00 , N/A ,$32.50 ,$29.85 , N/A ,$14.00 ,$33.10 , N/A ,$33.10 , N/A ,$29.80 ,$29.80 , N/A ,$29.80 , N/A ,$38.50 , N/A , N/A , N/A ,$37.50 ,$35.50 ,$35.50 , N/A ,$35.50 ,$42.50 ,$42.50 ,$42.50 , N/A , N/A ,$42.50 , N/A ,$50.00 ,$28.05 , N/A ,$20.70 ,$22.46 ,$20.42 , N/A ,$42.50 , N/A ,$29.80 ,$14.00 ,$45.00 , N/A ,$42.50 , N/A , N/A , N/A ,$32.50 ST. JOSEPH'S HOSPITAL - BREESE,30101149,80342,HC ANTIPSYCHOTICS NOT 1-3 -90,301,1 ,$138.00 ,$99.36 ,$20.42 ,$138.00 , N/A ,$89.70 ,$82.39 , N/A ,$38.64 ,$91.36 , N/A ,$91.36 , N/A ,$82.25 ,$82.25 , N/A ,$82.25 , N/A ,$106.26 , N/A , N/A , N/A ,$103.50 ,$97.98 ,$97.98 , N/A ,$97.98 ,$117.30 ,$117.30 ,$117.30 , N/A , N/A ,$117.30 , N/A ,$138.00 ,$77.42 , N/A ,$57.13 ,$22.46 ,$20.42 , N/A ,$117.30 , N/A ,$82.25 ,$38.64 ,$124.20 , N/A ,$117.30 , N/A , N/A , N/A ,$89.70 ST. JOSEPH'S HOSPITAL - BREESE,30101150,80346,HC BENZODIAZEPINES 1-12 -90,301,1 ,$47.00 ,$33.84 ,$13.16 ,$47.00 , N/A ,$30.55 ,$28.06 , N/A ,$13.16 ,$31.11 , N/A ,$31.11 , N/A ,$28.01 ,$28.01 , N/A ,$28.01 , N/A ,$36.19 , N/A , N/A , N/A ,$35.25 ,$33.37 ,$33.37 , N/A ,$33.37 ,$39.95 ,$39.95 ,$39.95 , N/A , N/A ,$39.95 , N/A ,$47.00 ,$26.37 , N/A ,$19.46 ,$22.46 ,$20.42 , N/A ,$39.95 , N/A ,$28.01 ,$13.16 ,$42.30 , N/A ,$39.95 , N/A , N/A , N/A ,$30.55 ST. JOSEPH'S HOSPITAL - BREESE,30101151,80349,HC CANNABINOIDS NATURAL -90,301,1 ,$56.00 ,$40.32 ,$7.58 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A ,$43.12 , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 ,$8.34 ,$7.58 , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 , N/A , N/A , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101153,80359,HC METHYLENEDIOXYAMPHETAMINES MDA MDEA MDMA -90,301,1 ,$231.00 ,$166.32 ,$7.58 ,$231.00 , N/A ,$150.15 ,$137.91 , N/A ,$64.68 ,$152.92 , N/A ,$152.92 , N/A ,$137.68 ,$137.68 , N/A ,$137.68 , N/A ,$177.87 , N/A , N/A , N/A ,$173.25 ,$164.01 ,$164.01 , N/A ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A , N/A ,$196.35 , N/A ,$231.00 ,$129.59 , N/A ,$95.63 ,$8.34 ,$7.58 , N/A ,$196.35 , N/A ,$137.68 ,$64.68 ,$207.90 , N/A ,$196.35 , N/A , N/A , N/A ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,30101154,80361,HC OPIATES 1 OR MORE -90,301,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 , N/A ,$25.35 ,$23.28 , N/A ,$10.92 ,$25.82 , N/A ,$25.82 , N/A ,$23.24 ,$23.24 , N/A ,$23.24 , N/A ,$30.03 , N/A , N/A , N/A ,$29.25 ,$27.69 ,$27.69 , N/A ,$27.69 ,$33.15 ,$33.15 ,$33.15 , N/A , N/A ,$33.15 , N/A ,$39.00 ,$21.88 , N/A ,$16.15 ,$22.46 ,$20.42 , N/A ,$33.15 , N/A ,$23.24 ,$10.92 ,$35.10 , N/A ,$33.15 , N/A , N/A , N/A ,$25.35 ST. JOSEPH'S HOSPITAL - BREESE,30101158,82024,HC ACTH -90,301,1 ,$71.00 ,$51.12 ,$17.75 ,$96.55 ,$96.55 ,$46.15 ,$42.39 ,$37.85 ,$19.88 ,$47.00 ,$37.85 ,$47.00 ,$37.85 ,$42.32 ,$42.32 ,$37.85 ,$42.32 ,$71.00 ,$54.67 ,$96.55 ,$37.85 ,$38.60 ,$53.25 ,$50.41 ,$50.41 ,$37.85 ,$50.41 ,$60.35 ,$60.35 ,$60.35 , N/A ,$71.00 ,$60.35 ,$37.85 ,$71.00 ,$39.83 ,$37.85 ,$29.39 ,$19.53 ,$17.75 ,$37.85 ,$60.35 ,$81.10 ,$42.32 ,$19.88 ,$63.90 ,$37.85 ,$60.35 ,$71.00 ,$71.00 ,$37.85 ,$46.15 ST. JOSEPH'S HOSPITAL - BREESE,30101159,82040,HC ALBUMIN-90,301,1 ,$76.00 ,$54.72 ,$3.37 ,$76.00 ,$12.38 ,$49.40 ,$45.37 ,$4.85 ,$21.28 ,$50.31 ,$4.85 ,$50.31 ,$4.85 ,$45.30 ,$45.30 ,$4.85 ,$45.30 ,$10.00 ,$58.52 ,$12.38 ,$4.85 ,$4.95 ,$57.00 ,$53.96 ,$53.96 ,$4.85 ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A ,$12.38 ,$64.60 ,$4.85 ,$76.00 ,$42.64 ,$4.85 ,$31.46 ,$3.71 ,$3.37 ,$4.85 ,$64.60 ,$10.40 ,$45.30 ,$21.28 ,$68.40 ,$4.85 ,$64.60 ,$19.80 ,$19.80 ,$4.85 ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,30101160,82042,HC ALBUMIN OTHER SOURCE-90,301,1 ,$34.00 ,$24.48 ,$3.37 ,$34.00 ,$19.45 ,$22.10 ,$20.30 ,$7.62 ,$9.52 ,$22.51 ,$7.62 ,$22.51 ,$7.62 ,$20.26 ,$20.26 ,$7.62 ,$20.26 ,$15.72 ,$26.18 ,$19.45 ,$7.62 ,$7.78 ,$25.50 ,$24.14 ,$24.14 ,$7.62 ,$24.14 ,$28.90 ,$28.90 ,$28.90 , N/A ,$19.45 ,$28.90 ,$7.62 ,$34.00 ,$19.07 ,$7.62 ,$14.08 ,$3.71 ,$3.37 ,$7.62 ,$28.90 ,$16.34 ,$20.26 ,$9.52 ,$30.60 ,$7.62 ,$28.90 ,$31.12 ,$31.12 ,$7.62 ,$22.10 ST. JOSEPH'S HOSPITAL - BREESE,30101162,82085,HC ALDOLASE-90,301,1 ,$79.00 ,$56.88 ,$7.58 ,$79.00 ,$24.28 ,$51.35 ,$47.16 ,$9.52 ,$22.12 ,$52.30 ,$9.52 ,$52.30 ,$9.52 ,$47.08 ,$47.08 ,$9.52 ,$47.08 ,$19.61 ,$60.83 ,$24.28 ,$9.52 ,$9.70 ,$59.25 ,$56.09 ,$56.09 ,$9.52 ,$56.09 ,$67.15 ,$67.15 ,$67.15 , N/A ,$24.28 ,$67.15 ,$9.52 ,$79.00 ,$44.32 ,$9.52 ,$32.71 ,$8.34 ,$7.58 ,$9.52 ,$67.15 ,$20.39 ,$47.08 ,$22.12 ,$71.10 ,$9.52 ,$67.15 ,$38.84 ,$38.84 ,$9.52 ,$51.35 ST. JOSEPH'S HOSPITAL - BREESE,30101163,82088,HC ALDOSTERONE-90,301,1 ,$124.00 ,$89.28 ,$17.75 ,$124.00 ,$101.88 ,$80.60 ,$74.03 ,$39.93 ,$34.72 ,$82.09 ,$39.93 ,$82.09 ,$39.93 ,$73.90 ,$73.90 ,$39.93 ,$73.90 ,$82.32 ,$95.48 ,$101.88 ,$39.93 ,$40.74 ,$93.00 ,$88.04 ,$88.04 ,$39.93 ,$88.04 ,$105.40 ,$105.40 ,$105.40 , N/A ,$101.88 ,$105.40 ,$39.93 ,$124.00 ,$69.56 ,$39.93 ,$51.34 ,$19.53 ,$17.75 ,$39.93 ,$105.40 ,$85.58 ,$73.90 ,$34.72 ,$111.60 ,$39.93 ,$105.40 ,$124.00 ,$124.00 ,$39.93 ,$80.60 ST. JOSEPH'S HOSPITAL - BREESE,30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$92.00 ,$66.24 ,$7.58 ,$92.00 ,$33.60 ,$59.80 ,$54.92 ,$13.17 ,$25.76 ,$60.90 ,$13.17 ,$60.90 ,$13.17 ,$54.83 ,$54.83 ,$13.17 ,$54.83 ,$27.15 ,$70.84 ,$33.60 ,$13.17 ,$13.44 ,$69.00 ,$65.32 ,$65.32 ,$13.17 ,$65.32 ,$78.20 ,$78.20 ,$78.20 , N/A ,$33.60 ,$78.20 ,$13.17 ,$92.00 ,$51.61 ,$13.17 ,$38.09 ,$8.34 ,$7.58 ,$13.17 ,$78.20 ,$28.22 ,$54.83 ,$25.76 ,$82.80 ,$13.17 ,$78.20 ,$53.76 ,$53.76 ,$13.17 ,$59.80 ST. JOSEPH'S HOSPITAL - BREESE,30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$188.00 ,$135.36 ,$7.58 ,$188.00 ,$36.15 ,$122.20 ,$112.24 ,$14.17 ,$52.64 ,$124.46 ,$14.17 ,$124.46 ,$14.17 ,$112.05 ,$112.05 ,$14.17 ,$112.05 ,$29.21 ,$144.76 ,$36.15 ,$14.17 ,$14.45 ,$141.00 ,$133.48 ,$133.48 ,$14.17 ,$133.48 ,$159.80 ,$159.80 ,$159.80 , N/A ,$36.15 ,$159.80 ,$14.17 ,$188.00 ,$105.47 ,$14.17 ,$77.83 ,$8.34 ,$7.58 ,$14.17 ,$159.80 ,$30.37 ,$112.05 ,$52.64 ,$169.20 ,$14.17 ,$159.80 ,$57.84 ,$57.84 ,$14.17 ,$122.20 ST. JOSEPH'S HOSPITAL - BREESE,30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$96.00 ,$69.12 ,$7.58 ,$96.00 ,$41.93 ,$62.40 ,$57.31 ,$16.43 ,$26.88 ,$63.55 ,$16.43 ,$63.55 ,$16.43 ,$57.22 ,$57.22 ,$16.43 ,$57.22 ,$33.88 ,$73.92 ,$41.93 ,$16.43 ,$16.77 ,$72.00 ,$68.16 ,$68.16 ,$16.43 ,$68.16 ,$81.60 ,$81.60 ,$81.60 , N/A ,$41.93 ,$81.60 ,$16.43 ,$96.00 ,$53.86 ,$16.43 ,$39.74 ,$8.34 ,$7.58 ,$16.43 ,$81.60 ,$35.22 ,$57.22 ,$26.88 ,$86.40 ,$16.43 ,$81.60 ,$67.08 ,$67.08 ,$16.43 ,$62.40 ST. JOSEPH'S HOSPITAL - BREESE,30101167,82105,HC ALPHA FETOPROTEIN SERUM SINGLE-90,301,1 ,$16.00 ,$11.52 ,$4.48 ,$40.00 ,$40.00 ,$10.40 ,$9.55 ,$15.68 ,$4.48 ,$10.59 ,$15.68 ,$10.59 ,$15.68 ,$9.54 ,$9.54 ,$15.68 ,$9.54 ,$16.00 ,$12.32 ,$40.00 ,$15.68 ,$15.68 ,$12.00 ,$11.36 ,$11.36 ,$15.68 ,$11.36 ,$13.60 ,$13.60 ,$13.60 , N/A ,$16.00 ,$13.60 ,$15.68 ,$16.00 ,$8.98 ,$15.68 ,$6.62 ,$8.34 ,$7.58 ,$15.68 ,$13.60 ,$33.60 ,$9.54 ,$4.48 ,$14.40 ,$15.68 ,$13.60 ,$16.00 ,$16.00 ,$15.68 ,$10.40 ST. JOSEPH'S HOSPITAL - BREESE,30101169,82108,HC ALUMINUM-90,301,1 ,$18.00 ,$12.96 ,$5.04 ,$45.00 ,$45.00 ,$11.70 ,$10.75 ,$17.64 ,$5.04 ,$11.92 ,$17.64 ,$11.92 ,$17.64 ,$10.73 ,$10.73 ,$17.64 ,$10.73 ,$18.00 ,$13.86 ,$45.00 ,$17.64 ,$17.64 ,$13.50 ,$12.78 ,$12.78 ,$17.64 ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A ,$18.00 ,$15.30 ,$17.64 ,$18.00 ,$10.10 ,$17.64 ,$7.45 ,$10.18 ,$9.25 ,$17.64 ,$15.30 ,$37.80 ,$10.73 ,$5.04 ,$16.20 ,$17.64 ,$15.30 ,$18.00 ,$18.00 ,$17.64 ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$69.00 ,$49.68 ,$7.58 ,$69.00 ,$57.45 ,$44.85 ,$41.19 ,$22.52 ,$19.32 ,$45.68 ,$22.52 ,$45.68 ,$22.52 ,$41.12 ,$41.12 ,$22.52 ,$41.12 ,$46.42 ,$53.13 ,$57.45 ,$22.52 ,$22.97 ,$51.75 ,$48.99 ,$48.99 ,$22.52 ,$48.99 ,$58.65 ,$58.65 ,$58.65 , N/A ,$57.45 ,$58.65 ,$22.52 ,$69.00 ,$38.71 ,$22.52 ,$28.57 ,$8.34 ,$7.58 ,$22.52 ,$58.65 ,$48.26 ,$41.12 ,$19.32 ,$62.10 ,$22.52 ,$58.65 ,$69.00 ,$69.00 ,$22.52 ,$44.85 ST. JOSEPH'S HOSPITAL - BREESE,30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$360.00 ,$259.20 ,$7.58 ,$360.00 ,$42.18 ,$234.00 ,$214.92 ,$16.53 ,$100.80 ,$238.32 ,$16.53 ,$238.32 ,$16.53 ,$214.56 ,$214.56 ,$16.53 ,$214.56 ,$34.08 ,$277.20 ,$42.18 ,$16.53 ,$16.87 ,$270.00 ,$255.60 ,$255.60 ,$16.53 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$42.18 ,$306.00 ,$16.53 ,$360.00 ,$201.96 ,$16.53 ,$149.04 ,$8.34 ,$7.58 ,$16.53 ,$306.00 ,$35.43 ,$214.56 ,$100.80 ,$324.00 ,$16.53 ,$306.00 ,$67.48 ,$67.48 ,$16.53 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,30101176,82140,HC AMMONIA-90,301,1 ,$209.00 ,$150.48 ,$7.58 ,$209.00 ,$36.43 ,$135.85 ,$124.77 ,$14.28 ,$58.52 ,$138.36 ,$14.28 ,$138.36 ,$14.28 ,$124.56 ,$124.56 ,$14.28 ,$124.56 ,$29.43 ,$160.93 ,$36.43 ,$14.28 ,$14.56 ,$156.75 ,$148.39 ,$148.39 ,$14.28 ,$148.39 ,$177.65 ,$177.65 ,$177.65 , N/A ,$36.43 ,$177.65 ,$14.28 ,$209.00 ,$117.25 ,$14.28 ,$86.53 ,$8.34 ,$7.58 ,$14.28 ,$177.65 ,$30.60 ,$124.56 ,$58.52 ,$188.10 ,$14.28 ,$177.65 ,$58.28 ,$58.28 ,$14.28 ,$135.85 ST. JOSEPH'S HOSPITAL - BREESE,30101177,82150,HC AMYLASE-90,301,1 ,$126.00 ,$90.72 ,$6.35 ,$126.00 ,$16.20 ,$81.90 ,$75.22 ,$6.35 ,$35.28 ,$83.41 ,$6.35 ,$83.41 ,$6.35 ,$75.10 ,$75.10 ,$6.35 ,$75.10 ,$13.09 ,$97.02 ,$16.20 ,$6.35 ,$6.48 ,$94.50 ,$89.46 ,$89.46 ,$6.35 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$16.20 ,$107.10 ,$6.35 ,$126.00 ,$70.69 ,$6.35 ,$52.16 ,$8.34 ,$7.58 ,$6.35 ,$107.10 ,$13.61 ,$75.10 ,$35.28 ,$113.40 ,$6.35 ,$107.10 ,$25.92 ,$25.92 ,$6.35 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$110.00 ,$79.20 ,$17.75 ,$110.00 ,$73.20 ,$71.50 ,$65.67 ,$28.69 ,$30.80 ,$72.82 ,$28.69 ,$72.82 ,$28.69 ,$65.56 ,$65.56 ,$28.69 ,$65.56 ,$59.15 ,$84.70 ,$73.20 ,$28.69 ,$29.27 ,$82.50 ,$78.10 ,$78.10 ,$28.69 ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A ,$73.20 ,$93.50 ,$28.69 ,$110.00 ,$61.71 ,$28.69 ,$45.54 ,$19.53 ,$17.75 ,$28.69 ,$93.50 ,$61.49 ,$65.56 ,$30.80 ,$99.00 ,$28.69 ,$93.50 ,$110.00 ,$110.00 ,$28.69 ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$97.00 ,$69.84 ,$7.58 ,$97.00 ,$36.50 ,$63.05 ,$57.91 ,$14.31 ,$27.16 ,$64.21 ,$14.31 ,$64.21 ,$14.31 ,$57.81 ,$57.81 ,$14.31 ,$57.81 ,$29.49 ,$74.69 ,$36.50 ,$14.31 ,$14.59 ,$72.75 ,$68.87 ,$68.87 ,$14.31 ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A ,$36.50 ,$82.45 ,$14.31 ,$97.00 ,$54.42 ,$14.31 ,$40.16 ,$8.34 ,$7.58 ,$14.31 ,$82.45 ,$30.66 ,$57.81 ,$27.16 ,$87.30 ,$14.31 ,$82.45 ,$58.40 ,$58.40 ,$14.31 ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$52.73 ,$37.70 ,$34.63 ,$20.67 ,$16.24 ,$38.40 ,$20.67 ,$38.40 ,$20.67 ,$34.57 ,$34.57 ,$20.67 ,$34.57 ,$42.60 ,$44.66 ,$52.73 ,$20.67 ,$21.08 ,$43.50 ,$41.18 ,$41.18 ,$20.67 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$52.73 ,$49.30 ,$20.67 ,$58.00 ,$32.54 ,$20.67 ,$24.01 ,$8.34 ,$7.58 ,$20.67 ,$49.30 ,$44.29 ,$34.57 ,$16.24 ,$52.20 ,$20.67 ,$49.30 ,$58.00 ,$58.00 ,$20.67 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101181,82175,HC ARSENIC-90,301,1 ,$73.00 ,$52.56 ,$9.25 ,$73.00 ,$47.43 ,$47.45 ,$43.58 ,$18.59 ,$20.44 ,$48.33 ,$18.59 ,$48.33 ,$18.59 ,$43.51 ,$43.51 ,$18.59 ,$43.51 ,$38.32 ,$56.21 ,$47.43 ,$18.59 ,$18.96 ,$54.75 ,$51.83 ,$51.83 ,$18.59 ,$51.83 ,$62.05 ,$62.05 ,$62.05 , N/A ,$47.43 ,$62.05 ,$18.59 ,$73.00 ,$40.95 ,$18.59 ,$30.22 ,$10.18 ,$9.25 ,$18.59 ,$62.05 ,$39.84 ,$43.51 ,$20.44 ,$65.70 ,$18.59 ,$62.05 ,$73.00 ,$73.00 ,$18.59 ,$47.45 ST. JOSEPH'S HOSPITAL - BREESE,30101182,82180,HC VITAMIN C (ASCORBIC ACID)-90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$24.73 ,$37.70 ,$34.63 ,$9.69 ,$16.24 ,$38.40 ,$9.69 ,$38.40 ,$9.69 ,$34.57 ,$34.57 ,$9.69 ,$34.57 ,$19.98 ,$44.66 ,$24.73 ,$9.69 ,$9.89 ,$43.50 ,$41.18 ,$41.18 ,$9.69 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$24.73 ,$49.30 ,$9.69 ,$58.00 ,$32.54 ,$9.69 ,$24.01 ,$8.34 ,$7.58 ,$9.69 ,$49.30 ,$20.77 ,$34.57 ,$16.24 ,$52.20 ,$9.69 ,$49.30 ,$39.56 ,$39.56 ,$9.69 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$95.00 ,$68.40 ,$15.86 ,$95.00 ,$40.45 ,$61.75 ,$56.72 ,$15.86 ,$26.60 ,$62.89 ,$15.86 ,$62.89 ,$15.86 ,$56.62 ,$56.62 ,$15.86 ,$56.62 ,$32.68 ,$73.15 ,$40.45 ,$15.86 ,$16.17 ,$71.25 ,$67.45 ,$67.45 ,$15.86 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$40.45 ,$80.75 ,$15.86 ,$95.00 ,$53.30 ,$15.86 ,$39.33 ,$19.53 ,$17.75 ,$15.86 ,$80.75 ,$33.98 ,$56.62 ,$26.60 ,$85.50 ,$15.86 ,$80.75 ,$64.72 ,$64.72 ,$15.86 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,30101185,82239,HC BILE ACID TOTAL-90,301,1 ,$19.00 ,$13.68 ,$5.32 ,$42.80 ,$42.80 ,$12.35 ,$11.34 ,$16.78 ,$5.32 ,$12.58 ,$16.78 ,$12.58 ,$16.78 ,$11.32 ,$11.32 ,$16.78 ,$11.32 ,$19.00 ,$14.63 ,$42.80 ,$16.78 ,$17.11 ,$14.25 ,$13.49 ,$13.49 ,$16.78 ,$13.49 ,$16.15 ,$16.15 ,$16.15 , N/A ,$19.00 ,$16.15 ,$16.78 ,$19.00 ,$10.66 ,$16.78 ,$7.87 ,$8.34 ,$7.58 ,$16.78 ,$16.15 ,$35.95 ,$11.32 ,$5.32 ,$17.10 ,$16.78 ,$16.15 ,$19.00 ,$19.00 ,$16.78 ,$12.35 ST. JOSEPH'S HOSPITAL - BREESE,30101186,82247,HC BILIRUBIN TOTAL-90,301,1 ,$18.00 ,$12.96 ,$3.37 ,$18.00 ,$12.55 ,$11.70 ,$10.75 ,$4.92 ,$5.04 ,$11.92 ,$4.92 ,$11.92 ,$4.92 ,$10.73 ,$10.73 ,$4.92 ,$10.73 ,$10.14 ,$13.86 ,$12.55 ,$4.92 ,$5.02 ,$13.50 ,$12.78 ,$12.78 ,$4.92 ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A ,$12.55 ,$15.30 ,$4.92 ,$18.00 ,$10.10 ,$4.92 ,$7.45 ,$3.71 ,$3.37 ,$4.92 ,$15.30 ,$10.54 ,$10.73 ,$5.04 ,$16.20 ,$4.92 ,$15.30 ,$18.00 ,$18.00 ,$4.92 ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,30101191,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$47.00 ,$33.84 ,$3.37 ,$47.00 ,$13.30 ,$30.55 ,$28.06 ,$5.21 ,$13.16 ,$31.11 ,$5.21 ,$31.11 ,$5.21 ,$28.01 ,$28.01 ,$5.21 ,$28.01 ,$10.75 ,$36.19 ,$13.30 ,$5.21 ,$5.32 ,$35.25 ,$33.37 ,$33.37 ,$5.21 ,$33.37 ,$39.95 ,$39.95 ,$39.95 , N/A ,$13.30 ,$39.95 ,$5.21 ,$47.00 ,$26.37 ,$5.21 ,$19.46 ,$3.71 ,$3.37 ,$5.21 ,$39.95 ,$11.17 ,$28.01 ,$13.16 ,$42.30 ,$5.21 ,$39.95 ,$21.28 ,$21.28 ,$5.21 ,$30.55 ST. JOSEPH'S HOSPITAL - BREESE,30101196,82300,HC CADMIUM-90,301,1 ,$67.00 ,$48.24 ,$9.25 ,$67.00 ,$59.10 ,$43.55 ,$40.00 ,$23.17 ,$18.76 ,$44.35 ,$23.17 ,$44.35 ,$23.17 ,$39.93 ,$39.93 ,$23.17 ,$39.93 ,$47.75 ,$51.59 ,$59.10 ,$23.17 ,$23.63 ,$50.25 ,$47.57 ,$47.57 ,$23.17 ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A ,$59.10 ,$56.95 ,$23.17 ,$67.00 ,$37.59 ,$23.17 ,$27.74 ,$10.18 ,$9.25 ,$23.17 ,$56.95 ,$49.64 ,$39.93 ,$18.76 ,$60.30 ,$23.17 ,$56.95 ,$67.00 ,$67.00 ,$23.17 ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,30101197,82306,HC VITAMIN D 25 OH-90,301,1 ,$18.00 ,$12.96 ,$5.04 ,$45.00 ,$45.00 ,$11.70 ,$10.75 ,$17.64 ,$5.04 ,$11.92 ,$17.64 ,$11.92 ,$17.64 ,$10.73 ,$10.73 ,$17.64 ,$10.73 ,$18.00 ,$13.86 ,$45.00 ,$17.64 ,$17.64 ,$13.50 ,$12.78 ,$12.78 ,$17.64 ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A ,$18.00 ,$15.30 ,$17.64 ,$18.00 ,$10.10 ,$17.64 ,$7.45 ,$18.00 ,$18.00 ,$17.64 ,$15.30 ,$37.80 ,$10.73 ,$5.04 ,$16.20 ,$17.64 ,$15.30 ,$18.00 ,$18.00 ,$17.64 ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,30101199,82308,HC CALCITONIN-90,301,1 ,$79.00 ,$56.88 ,$17.75 ,$79.00 ,$66.98 ,$51.35 ,$47.16 ,$26.25 ,$22.12 ,$52.30 ,$26.25 ,$52.30 ,$26.25 ,$47.08 ,$47.08 ,$26.25 ,$47.08 ,$54.12 ,$60.83 ,$66.98 ,$26.25 ,$26.78 ,$59.25 ,$56.09 ,$56.09 ,$26.25 ,$56.09 ,$67.15 ,$67.15 ,$67.15 , N/A ,$66.98 ,$67.15 ,$26.25 ,$79.00 ,$44.32 ,$26.25 ,$32.71 ,$19.53 ,$17.75 ,$26.25 ,$67.15 ,$56.26 ,$47.08 ,$22.12 ,$71.10 ,$26.25 ,$67.15 ,$79.00 ,$79.00 ,$26.25 ,$51.35 ST. JOSEPH'S HOSPITAL - BREESE,30101200,82310,HC CALCIUM-90,301,1 ,$292.00 ,$210.24 ,$3.37 ,$292.00 ,$12.90 ,$189.80 ,$174.32 ,$5.06 ,$81.76 ,$193.30 ,$5.06 ,$193.30 ,$5.06 ,$174.03 ,$174.03 ,$5.06 ,$174.03 ,$10.42 ,$224.84 ,$12.90 ,$5.06 ,$5.15 ,$219.00 ,$207.32 ,$207.32 ,$5.06 ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A ,$12.90 ,$248.20 ,$5.06 ,$292.00 ,$163.81 ,$5.06 ,$120.89 ,$3.71 ,$3.37 ,$5.06 ,$248.20 ,$10.84 ,$174.03 ,$81.76 ,$262.80 ,$5.06 ,$248.20 ,$20.64 ,$20.64 ,$5.06 ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,30101203,82340,HC CALCIUM URINE QN TIMED-90,301,1 ,$154.00 ,$110.88 ,$5.91 ,$154.00 ,$15.08 ,$100.10 ,$91.94 ,$5.91 ,$43.12 ,$101.95 ,$5.91 ,$101.95 ,$5.91 ,$91.78 ,$91.78 ,$5.91 ,$91.78 ,$12.18 ,$118.58 ,$15.08 ,$5.91 ,$6.03 ,$115.50 ,$109.34 ,$109.34 ,$5.91 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$15.08 ,$130.90 ,$5.91 ,$154.00 ,$86.39 ,$5.91 ,$63.76 ,$8.34 ,$7.58 ,$5.91 ,$130.90 ,$12.66 ,$91.78 ,$43.12 ,$138.60 ,$5.91 ,$130.90 ,$24.12 ,$24.12 ,$5.91 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$82.00 ,$59.04 ,$7.58 ,$82.00 ,$32.25 ,$53.30 ,$48.95 ,$12.64 ,$22.96 ,$54.28 ,$12.64 ,$54.28 ,$12.64 ,$48.87 ,$48.87 ,$12.64 ,$48.87 ,$26.06 ,$63.14 ,$32.25 ,$12.64 ,$12.90 ,$61.50 ,$58.22 ,$58.22 ,$12.64 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$32.25 ,$69.70 ,$12.64 ,$82.00 ,$46.00 ,$12.64 ,$33.95 ,$8.34 ,$7.58 ,$12.64 ,$69.70 ,$27.09 ,$48.87 ,$22.96 ,$73.80 ,$12.64 ,$69.70 ,$51.60 ,$51.60 ,$12.64 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30101207,82373,HC CARBOHY DEFICIENT TRANSFER CONGENTIAL-90,301,1 ,$146.00 ,$105.12 ,$7.58 ,$146.00 ,$45.15 ,$94.90 ,$87.16 ,$17.70 ,$40.88 ,$96.65 ,$17.70 ,$96.65 ,$17.70 ,$87.02 ,$87.02 ,$17.70 ,$87.02 ,$36.48 ,$112.42 ,$45.15 ,$17.70 ,$18.05 ,$109.50 ,$103.66 ,$103.66 ,$17.70 ,$103.66 ,$124.10 ,$124.10 ,$124.10 , N/A ,$45.15 ,$124.10 ,$17.70 ,$146.00 ,$81.91 ,$17.70 ,$60.44 ,$8.34 ,$7.58 ,$17.70 ,$124.10 ,$37.93 ,$87.02 ,$40.88 ,$131.40 ,$17.70 ,$124.10 ,$72.24 ,$72.24 ,$17.70 ,$94.90 ST. JOSEPH'S HOSPITAL - BREESE,30101208,82378,HC CARBINOEMBRYONIC AG (CEA)-90,301,1 ,$88.00 ,$63.36 ,$7.58 ,$88.00 ,$47.40 ,$57.20 ,$52.54 ,$18.58 ,$24.64 ,$58.26 ,$18.58 ,$58.26 ,$18.58 ,$52.45 ,$52.45 ,$18.58 ,$52.45 ,$38.30 ,$67.76 ,$47.40 ,$18.58 ,$18.95 ,$66.00 ,$62.48 ,$62.48 ,$18.58 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$47.40 ,$74.80 ,$18.58 ,$88.00 ,$49.37 ,$18.58 ,$36.43 ,$8.34 ,$7.58 ,$18.58 ,$74.80 ,$39.82 ,$52.45 ,$24.64 ,$79.20 ,$18.58 ,$74.80 ,$75.84 ,$75.84 ,$18.58 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$217.00 ,$156.24 ,$7.58 ,$217.00 ,$42.18 ,$141.05 ,$129.55 ,$16.53 ,$60.76 ,$143.65 ,$16.53 ,$143.65 ,$16.53 ,$129.33 ,$129.33 ,$16.53 ,$129.33 ,$34.08 ,$167.09 ,$42.18 ,$16.53 ,$16.87 ,$162.75 ,$154.07 ,$154.07 ,$16.53 ,$154.07 ,$184.45 ,$184.45 ,$184.45 , N/A ,$42.18 ,$184.45 ,$16.53 ,$217.00 ,$121.74 ,$16.53 ,$89.84 ,$8.34 ,$7.58 ,$16.53 ,$184.45 ,$35.43 ,$129.33 ,$60.76 ,$195.30 ,$16.53 ,$184.45 ,$67.48 ,$67.48 ,$16.53 ,$141.05 ST. JOSEPH'S HOSPITAL - BREESE,30101210,82380,HC CAROTENE-90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$23.05 ,$37.70 ,$34.63 ,$9.04 ,$16.24 ,$38.40 ,$9.04 ,$38.40 ,$9.04 ,$34.57 ,$34.57 ,$9.04 ,$34.57 ,$18.62 ,$44.66 ,$23.05 ,$9.04 ,$9.21 ,$43.50 ,$41.18 ,$41.18 ,$9.04 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$23.05 ,$49.30 ,$9.04 ,$58.00 ,$32.54 ,$9.04 ,$24.01 ,$8.34 ,$7.58 ,$9.04 ,$49.30 ,$19.36 ,$34.57 ,$16.24 ,$52.20 ,$9.04 ,$49.30 ,$36.88 ,$36.88 ,$9.04 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$52.00 ,$37.44 ,$14.56 ,$63.13 ,$63.13 ,$33.80 ,$31.04 ,$24.74 ,$14.56 ,$34.42 ,$24.74 ,$34.42 ,$24.74 ,$30.99 ,$30.99 ,$24.74 ,$30.99 ,$51.01 ,$40.04 ,$63.13 ,$24.74 ,$25.24 ,$39.00 ,$36.92 ,$36.92 ,$24.74 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$52.00 ,$44.20 ,$24.74 ,$52.00 ,$29.17 ,$24.74 ,$21.53 ,$19.53 ,$17.75 ,$24.74 ,$44.20 ,$53.03 ,$30.99 ,$14.56 ,$46.80 ,$24.74 ,$44.20 ,$52.00 ,$52.00 ,$24.74 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30101212,82390,HC CERULOPLASMIN-90,301,1 ,$81.00 ,$58.32 ,$7.58 ,$81.00 ,$26.85 ,$52.65 ,$48.36 ,$10.53 ,$22.68 ,$53.62 ,$10.53 ,$53.62 ,$10.53 ,$48.28 ,$48.28 ,$10.53 ,$48.28 ,$21.69 ,$62.37 ,$26.85 ,$10.53 ,$10.73 ,$60.75 ,$57.51 ,$57.51 ,$10.53 ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A ,$26.85 ,$68.85 ,$10.53 ,$81.00 ,$45.44 ,$10.53 ,$33.53 ,$8.34 ,$7.58 ,$10.53 ,$68.85 ,$22.55 ,$48.28 ,$22.68 ,$72.90 ,$10.53 ,$68.85 ,$42.96 ,$42.96 ,$10.53 ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,30101213,82397,HC CHEMILUMINESCENT ASSAY-90,301,1 ,$154.00 ,$110.88 ,$7.58 ,$154.00 ,$35.30 ,$100.10 ,$91.94 ,$13.84 ,$43.12 ,$101.95 ,$13.84 ,$101.95 ,$13.84 ,$91.78 ,$91.78 ,$13.84 ,$91.78 ,$28.52 ,$118.58 ,$35.30 ,$13.84 ,$14.11 ,$115.50 ,$109.34 ,$109.34 ,$13.84 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$35.30 ,$130.90 ,$13.84 ,$154.00 ,$86.39 ,$13.84 ,$63.76 ,$8.34 ,$7.58 ,$13.84 ,$130.90 ,$29.65 ,$91.78 ,$43.12 ,$138.60 ,$13.84 ,$130.90 ,$56.48 ,$56.48 ,$13.84 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101215,82438,HC CHLORIDE OTHER SOURCE-90,301,1 ,$25.00 ,$18.00 ,$3.37 ,$25.00 ,$12.50 ,$16.25 ,$14.93 ,$4.90 ,$7.00 ,$16.55 ,$4.90 ,$16.55 ,$4.90 ,$14.90 ,$14.90 ,$4.90 ,$14.90 ,$10.10 ,$19.25 ,$12.50 ,$4.90 ,$5.00 ,$18.75 ,$17.75 ,$17.75 ,$4.90 ,$17.75 ,$21.25 ,$21.25 ,$21.25 , N/A ,$12.50 ,$21.25 ,$4.90 ,$25.00 ,$14.03 ,$4.90 ,$10.35 ,$3.71 ,$3.37 ,$4.90 ,$21.25 ,$10.50 ,$14.90 ,$7.00 ,$22.50 ,$4.90 ,$21.25 ,$20.00 ,$20.00 ,$4.90 ,$16.25 ST. JOSEPH'S HOSPITAL - BREESE,30101216,82480,HC CHOLINESTERASE PSEUDO-90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$19.68 ,$37.70 ,$34.63 ,$7.71 ,$16.24 ,$38.40 ,$7.71 ,$38.40 ,$7.71 ,$34.57 ,$34.57 ,$7.71 ,$34.57 ,$15.90 ,$44.66 ,$19.68 ,$7.71 ,$7.87 ,$43.50 ,$41.18 ,$41.18 ,$7.71 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$19.68 ,$49.30 ,$7.71 ,$58.00 ,$32.54 ,$7.71 ,$24.01 ,$8.34 ,$7.58 ,$7.71 ,$49.30 ,$16.53 ,$34.57 ,$16.24 ,$52.20 ,$7.71 ,$49.30 ,$31.48 ,$31.48 ,$7.71 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$100.00 ,$72.00 ,$9.25 ,$100.00 ,$50.70 ,$65.00 ,$59.70 ,$19.87 ,$28.00 ,$66.20 ,$19.87 ,$66.20 ,$19.87 ,$59.60 ,$59.60 ,$19.87 ,$59.60 ,$40.97 ,$77.00 ,$50.70 ,$19.87 ,$20.28 ,$75.00 ,$71.00 ,$71.00 ,$19.87 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$50.70 ,$85.00 ,$19.87 ,$100.00 ,$56.10 ,$19.87 ,$41.40 ,$10.18 ,$9.25 ,$19.87 ,$85.00 ,$42.59 ,$59.60 ,$28.00 ,$90.00 ,$19.87 ,$85.00 ,$81.12 ,$81.12 ,$19.87 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,30101219,82507,HC CITRATE-90,301,1 ,$65.00 ,$46.80 ,$7.58 ,$69.50 ,$69.50 ,$42.25 ,$38.81 ,$27.24 ,$18.20 ,$43.03 ,$27.24 ,$43.03 ,$27.24 ,$38.74 ,$38.74 ,$27.24 ,$38.74 ,$56.16 ,$50.05 ,$69.50 ,$27.24 ,$27.79 ,$48.75 ,$46.15 ,$46.15 ,$27.24 ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A ,$65.00 ,$55.25 ,$27.24 ,$65.00 ,$36.47 ,$27.24 ,$26.91 ,$8.34 ,$7.58 ,$27.24 ,$55.25 ,$58.38 ,$38.74 ,$18.20 ,$58.50 ,$27.24 ,$55.25 ,$65.00 ,$65.00 ,$27.24 ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$141.00 ,$101.52 ,$11.71 ,$141.00 ,$46.70 ,$91.65 ,$84.18 ,$18.31 ,$39.48 ,$93.34 ,$18.31 ,$93.34 ,$18.31 ,$84.04 ,$84.04 ,$18.31 ,$84.04 ,$37.73 ,$108.57 ,$46.70 ,$18.31 ,$18.67 ,$105.75 ,$100.11 ,$100.11 ,$18.31 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$46.70 ,$119.85 ,$18.31 ,$141.00 ,$79.10 ,$18.31 ,$58.37 ,$12.88 ,$11.71 ,$18.31 ,$119.85 ,$39.23 ,$84.04 ,$39.48 ,$126.90 ,$18.31 ,$119.85 ,$74.72 ,$74.72 ,$18.31 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,30101221,82525,HC COPPER-90,301,1 ,$69.00 ,$49.68 ,$9.25 ,$69.00 ,$31.03 ,$44.85 ,$41.19 ,$12.16 ,$19.32 ,$45.68 ,$12.16 ,$45.68 ,$12.16 ,$41.12 ,$41.12 ,$12.16 ,$41.12 ,$25.07 ,$53.13 ,$31.03 ,$12.16 ,$12.41 ,$51.75 ,$48.99 ,$48.99 ,$12.16 ,$48.99 ,$58.65 ,$58.65 ,$58.65 , N/A ,$31.03 ,$58.65 ,$12.16 ,$69.00 ,$38.71 ,$12.16 ,$28.57 ,$10.18 ,$9.25 ,$12.16 ,$58.65 ,$26.06 ,$41.12 ,$19.32 ,$62.10 ,$12.16 ,$58.65 ,$49.64 ,$49.64 ,$12.16 ,$44.85 ST. JOSEPH'S HOSPITAL - BREESE,30101222,82530,HC CORTISOL FREE-90,301,1 ,$122.00 ,$87.84 ,$7.58 ,$122.00 ,$41.78 ,$79.30 ,$72.83 ,$16.38 ,$34.16 ,$80.76 ,$16.38 ,$80.76 ,$16.38 ,$72.71 ,$72.71 ,$16.38 ,$72.71 ,$33.75 ,$93.94 ,$41.78 ,$16.38 ,$16.70 ,$91.50 ,$86.62 ,$86.62 ,$16.38 ,$86.62 ,$103.70 ,$103.70 ,$103.70 , N/A ,$41.78 ,$103.70 ,$16.38 ,$122.00 ,$68.44 ,$16.38 ,$50.51 ,$8.34 ,$7.58 ,$16.38 ,$103.70 ,$35.09 ,$72.71 ,$34.16 ,$109.80 ,$16.38 ,$103.70 ,$66.84 ,$66.84 ,$16.38 ,$79.30 ST. JOSEPH'S HOSPITAL - BREESE,30101223,82533,HC CORTISOL TOTAL-90,301,1 ,$20.00 ,$14.40 ,$5.60 ,$40.75 ,$40.75 ,$13.00 ,$11.94 ,$15.97 ,$5.60 ,$13.24 ,$15.97 ,$13.24 ,$15.97 ,$11.92 ,$11.92 ,$15.97 ,$11.92 ,$20.00 ,$15.40 ,$40.75 ,$15.97 ,$16.30 ,$15.00 ,$14.20 ,$14.20 ,$15.97 ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A ,$20.00 ,$17.00 ,$15.97 ,$20.00 ,$11.22 ,$15.97 ,$8.28 ,$19.53 ,$17.75 ,$15.97 ,$17.00 ,$34.23 ,$11.92 ,$5.60 ,$18.00 ,$15.97 ,$17.00 ,$20.00 ,$20.00 ,$15.97 ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$191.00 ,$137.52 ,$7.58 ,$191.00 ,$60.23 ,$124.15 ,$114.03 ,$23.61 ,$53.48 ,$126.44 ,$23.61 ,$126.44 ,$23.61 ,$113.84 ,$113.84 ,$23.61 ,$113.84 ,$48.66 ,$147.07 ,$60.23 ,$23.61 ,$24.08 ,$143.25 ,$135.61 ,$135.61 ,$23.61 ,$135.61 ,$162.35 ,$162.35 ,$162.35 , N/A ,$60.23 ,$162.35 ,$23.61 ,$191.00 ,$107.15 ,$23.61 ,$79.07 ,$8.34 ,$7.58 ,$23.61 ,$162.35 ,$50.59 ,$113.84 ,$53.48 ,$171.90 ,$23.61 ,$162.35 ,$96.36 ,$96.36 ,$23.61 ,$124.15 ST. JOSEPH'S HOSPITAL - BREESE,30101225,82550,HC CREATINE KINASE (CPK) TOTAL-90,301,1 ,$126.00 ,$90.72 ,$3.37 ,$126.00 ,$16.28 ,$81.90 ,$75.22 ,$6.38 ,$35.28 ,$83.41 ,$6.38 ,$83.41 ,$6.38 ,$75.10 ,$75.10 ,$6.38 ,$75.10 ,$13.15 ,$97.02 ,$16.28 ,$6.38 ,$6.51 ,$94.50 ,$89.46 ,$89.46 ,$6.38 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$16.28 ,$107.10 ,$6.38 ,$126.00 ,$70.69 ,$6.38 ,$52.16 ,$3.71 ,$3.37 ,$6.38 ,$107.10 ,$13.67 ,$75.10 ,$35.28 ,$113.40 ,$6.38 ,$107.10 ,$26.04 ,$26.04 ,$6.38 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$44.00 ,$31.68 ,$7.58 ,$44.00 ,$33.48 ,$28.60 ,$26.27 ,$13.12 ,$12.32 ,$29.13 ,$13.12 ,$29.13 ,$13.12 ,$26.22 ,$26.22 ,$13.12 ,$26.22 ,$27.05 ,$33.88 ,$33.48 ,$13.12 ,$13.39 ,$33.00 ,$31.24 ,$31.24 ,$13.12 ,$31.24 ,$37.40 ,$37.40 ,$37.40 , N/A ,$33.48 ,$37.40 ,$13.12 ,$44.00 ,$24.68 ,$13.12 ,$18.22 ,$8.34 ,$7.58 ,$13.12 ,$37.40 ,$28.12 ,$26.22 ,$12.32 ,$39.60 ,$13.12 ,$37.40 ,$44.00 ,$44.00 ,$13.12 ,$28.60 ST. JOSEPH'S HOSPITAL - BREESE,30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$27.00 ,$19.44 ,$3.37 ,$27.00 ,$12.95 ,$17.55 ,$16.12 ,$5.08 ,$7.56 ,$17.87 ,$5.08 ,$17.87 ,$5.08 ,$16.09 ,$16.09 ,$5.08 ,$16.09 ,$10.46 ,$20.79 ,$12.95 ,$5.08 ,$5.17 ,$20.25 ,$19.17 ,$19.17 ,$5.08 ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A ,$12.95 ,$22.95 ,$5.08 ,$27.00 ,$15.15 ,$5.08 ,$11.18 ,$3.71 ,$3.37 ,$5.08 ,$22.95 ,$10.88 ,$16.09 ,$7.56 ,$24.30 ,$5.08 ,$22.95 ,$20.72 ,$20.72 ,$5.08 ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$95.00 ,$68.40 ,$6.34 ,$95.00 ,$16.18 ,$61.75 ,$56.72 ,$6.34 ,$26.60 ,$62.89 ,$6.34 ,$62.89 ,$6.34 ,$56.62 ,$56.62 ,$6.34 ,$56.62 ,$13.07 ,$73.15 ,$16.18 ,$6.34 ,$6.47 ,$71.25 ,$67.45 ,$67.45 ,$6.34 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$16.18 ,$80.75 ,$6.34 ,$95.00 ,$53.30 ,$6.34 ,$39.33 ,$8.34 ,$7.58 ,$6.34 ,$80.75 ,$13.59 ,$56.62 ,$26.60 ,$85.50 ,$6.34 ,$80.75 ,$25.88 ,$25.88 ,$6.34 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,30101234,82600,HC CYANIDE-90,301,1 ,$71.00 ,$51.12 ,$9.25 ,$71.00 ,$48.50 ,$46.15 ,$42.39 ,$19.01 ,$19.88 ,$47.00 ,$19.01 ,$47.00 ,$19.01 ,$42.32 ,$42.32 ,$19.01 ,$42.32 ,$39.19 ,$54.67 ,$48.50 ,$19.01 ,$19.39 ,$53.25 ,$50.41 ,$50.41 ,$19.01 ,$50.41 ,$60.35 ,$60.35 ,$60.35 , N/A ,$48.50 ,$60.35 ,$19.01 ,$71.00 ,$39.83 ,$19.01 ,$29.39 ,$10.18 ,$9.25 ,$19.01 ,$60.35 ,$40.74 ,$42.32 ,$19.88 ,$63.90 ,$19.01 ,$60.35 ,$71.00 ,$71.00 ,$19.01 ,$46.15 ST. JOSEPH'S HOSPITAL - BREESE,30101236,82608,HC VITAMIN B-12 BINDING CAPACITY-90,301,1 ,$61.00 ,$43.92 ,$7.58 ,$61.00 ,$35.80 ,$39.65 ,$36.42 ,$14.03 ,$17.08 ,$40.38 ,$14.03 ,$40.38 ,$14.03 ,$36.36 ,$36.36 ,$14.03 ,$36.36 ,$28.93 ,$46.97 ,$35.80 ,$14.03 ,$14.32 ,$45.75 ,$43.31 ,$43.31 ,$14.03 ,$43.31 ,$51.85 ,$51.85 ,$51.85 , N/A ,$35.80 ,$51.85 ,$14.03 ,$61.00 ,$34.22 ,$14.03 ,$25.25 ,$8.34 ,$7.58 ,$14.03 ,$51.85 ,$30.07 ,$36.36 ,$17.08 ,$54.90 ,$14.03 ,$51.85 ,$57.28 ,$57.28 ,$14.03 ,$39.65 ST. JOSEPH'S HOSPITAL - BREESE,30101237,82626,HC DHEA-90,301,1 ,$65.00 ,$46.80 ,$7.58 ,$65.00 ,$63.18 ,$42.25 ,$38.81 ,$24.76 ,$18.20 ,$43.03 ,$24.76 ,$43.03 ,$24.76 ,$38.74 ,$38.74 ,$24.76 ,$38.74 ,$51.05 ,$50.05 ,$63.18 ,$24.76 ,$25.26 ,$48.75 ,$46.15 ,$46.15 ,$24.76 ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A ,$63.18 ,$55.25 ,$24.76 ,$65.00 ,$36.47 ,$24.76 ,$26.91 ,$8.34 ,$7.58 ,$24.76 ,$55.25 ,$53.07 ,$38.74 ,$18.20 ,$58.50 ,$24.76 ,$55.25 ,$65.00 ,$65.00 ,$24.76 ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,30101238,82627,HC DHEA SULFATE-90,301,1 ,$67.00 ,$48.24 ,$17.75 ,$67.00 ,$55.58 ,$43.55 ,$40.00 ,$21.79 ,$18.76 ,$44.35 ,$21.79 ,$44.35 ,$21.79 ,$39.93 ,$39.93 ,$21.79 ,$39.93 ,$44.90 ,$51.59 ,$55.58 ,$21.79 ,$22.22 ,$50.25 ,$47.57 ,$47.57 ,$21.79 ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A ,$55.58 ,$56.95 ,$21.79 ,$67.00 ,$37.59 ,$21.79 ,$27.74 ,$19.53 ,$17.75 ,$21.79 ,$56.95 ,$46.68 ,$39.93 ,$18.76 ,$60.30 ,$21.79 ,$56.95 ,$67.00 ,$67.00 ,$21.79 ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$100.00 ,$72.00 ,$20.42 ,$100.00 ,$96.25 ,$65.00 ,$59.70 ,$37.73 ,$28.00 ,$66.20 ,$37.73 ,$66.20 ,$37.73 ,$59.60 ,$59.60 ,$37.73 ,$59.60 ,$77.77 ,$77.00 ,$96.25 ,$37.73 ,$38.48 ,$75.00 ,$71.00 ,$71.00 ,$37.73 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$96.25 ,$85.00 ,$37.73 ,$100.00 ,$56.10 ,$37.73 ,$41.40 ,$22.46 ,$20.42 ,$37.73 ,$85.00 ,$80.85 ,$59.60 ,$28.00 ,$90.00 ,$37.73 ,$85.00 ,$100.00 ,$100.00 ,$37.73 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$323.00 ,$232.56 ,$7.58 ,$323.00 ,$28.83 ,$209.95 ,$192.83 ,$11.30 ,$90.44 ,$213.83 ,$11.30 ,$213.83 ,$11.30 ,$192.51 ,$192.51 ,$11.30 ,$192.51 ,$23.29 ,$248.71 ,$28.83 ,$11.30 ,$11.52 ,$242.25 ,$229.33 ,$229.33 ,$11.30 ,$229.33 ,$274.55 ,$274.55 ,$274.55 , N/A ,$28.83 ,$274.55 ,$11.30 ,$323.00 ,$181.20 ,$11.30 ,$133.72 ,$8.34 ,$7.58 ,$11.30 ,$274.55 ,$24.21 ,$192.51 ,$90.44 ,$290.70 ,$11.30 ,$274.55 ,$46.12 ,$46.12 ,$11.30 ,$209.95 ST. JOSEPH'S HOSPITAL - BREESE,30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$102.00 ,$73.44 ,$7.58 ,$102.00 ,$46.98 ,$66.30 ,$60.89 ,$18.41 ,$28.56 ,$67.52 ,$18.41 ,$67.52 ,$18.41 ,$60.79 ,$60.79 ,$18.41 ,$60.79 ,$37.96 ,$78.54 ,$46.98 ,$18.41 ,$18.79 ,$76.50 ,$72.42 ,$72.42 ,$18.41 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$46.98 ,$86.70 ,$18.41 ,$102.00 ,$57.22 ,$18.41 ,$42.23 ,$8.34 ,$7.58 ,$18.41 ,$86.70 ,$39.46 ,$60.79 ,$28.56 ,$91.80 ,$18.41 ,$86.70 ,$75.16 ,$75.16 ,$18.41 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30101246,82670,HC ESTRADIOL-90,301,1 ,$120.00 ,$86.40 ,$17.75 ,$120.00 ,$69.85 ,$78.00 ,$71.64 ,$27.38 ,$33.60 ,$79.44 ,$27.38 ,$79.44 ,$27.38 ,$71.52 ,$71.52 ,$27.38 ,$71.52 ,$56.44 ,$92.40 ,$69.85 ,$27.38 ,$27.93 ,$90.00 ,$85.20 ,$85.20 ,$27.38 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$69.85 ,$102.00 ,$27.38 ,$120.00 ,$67.32 ,$27.38 ,$49.68 ,$19.53 ,$17.75 ,$27.38 ,$102.00 ,$58.67 ,$71.52 ,$33.60 ,$108.00 ,$27.38 ,$102.00 ,$111.76 ,$111.76 ,$27.38 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,30101247,82670,HC ESTRADIOL FREE-90,301,1 ,$33.00 ,$23.76 ,$9.24 ,$69.85 ,$69.85 ,$21.45 ,$19.70 ,$27.38 ,$9.24 ,$21.85 ,$27.38 ,$21.85 ,$27.38 ,$19.67 ,$19.67 ,$27.38 ,$19.67 ,$33.00 ,$25.41 ,$69.85 ,$27.38 ,$27.93 ,$24.75 ,$23.43 ,$23.43 ,$27.38 ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A ,$33.00 ,$28.05 ,$27.38 ,$33.00 ,$18.51 ,$27.38 ,$13.66 ,$19.53 ,$17.75 ,$27.38 ,$28.05 ,$58.67 ,$19.67 ,$9.24 ,$29.70 ,$27.38 ,$28.05 ,$33.00 ,$33.00 ,$27.38 ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,30101248,82671,HC ESTROGEN FRACTIONATED-90,301,1 ,$184.00 ,$132.48 ,$17.75 ,$184.00 ,$80.75 ,$119.60 ,$109.85 ,$31.65 ,$51.52 ,$121.81 ,$31.65 ,$121.81 ,$31.65 ,$109.66 ,$109.66 ,$31.65 ,$109.66 ,$65.25 ,$141.68 ,$80.75 ,$31.65 ,$32.29 ,$138.00 ,$130.64 ,$130.64 ,$31.65 ,$130.64 ,$156.40 ,$156.40 ,$156.40 , N/A ,$80.75 ,$156.40 ,$31.65 ,$184.00 ,$103.22 ,$31.65 ,$76.18 ,$19.53 ,$17.75 ,$31.65 ,$156.40 ,$67.83 ,$109.66 ,$51.52 ,$165.60 ,$31.65 ,$156.40 ,$129.20 ,$129.20 ,$31.65 ,$119.60 ST. JOSEPH'S HOSPITAL - BREESE,30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$79.00 ,$56.88 ,$17.75 ,$79.00 ,$54.25 ,$51.35 ,$47.16 ,$21.27 ,$22.12 ,$52.30 ,$21.27 ,$52.30 ,$21.27 ,$47.08 ,$47.08 ,$21.27 ,$47.08 ,$43.83 ,$60.83 ,$54.25 ,$21.27 ,$21.69 ,$59.25 ,$56.09 ,$56.09 ,$21.27 ,$56.09 ,$67.15 ,$67.15 ,$67.15 , N/A ,$54.25 ,$67.15 ,$21.27 ,$79.00 ,$44.32 ,$21.27 ,$32.71 ,$19.53 ,$17.75 ,$21.27 ,$67.15 ,$45.57 ,$47.08 ,$22.12 ,$71.10 ,$21.27 ,$67.15 ,$79.00 ,$79.00 ,$21.27 ,$51.35 ST. JOSEPH'S HOSPITAL - BREESE,30101250,82677,HC ESTRIOL-90,301,1 ,$30.00 ,$21.60 ,$8.40 ,$60.45 ,$60.45 ,$19.50 ,$17.91 ,$23.70 ,$8.40 ,$19.86 ,$23.70 ,$19.86 ,$23.70 ,$17.88 ,$17.88 ,$23.70 ,$17.88 ,$30.00 ,$23.10 ,$60.45 ,$23.70 ,$24.17 ,$22.50 ,$21.30 ,$21.30 ,$23.70 ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A ,$30.00 ,$25.50 ,$23.70 ,$30.00 ,$16.83 ,$23.70 ,$12.42 ,$19.53 ,$17.75 ,$23.70 ,$25.50 ,$50.78 ,$17.88 ,$8.40 ,$27.00 ,$23.70 ,$25.50 ,$30.00 ,$30.00 ,$23.70 ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,30101251,82679,HC ESTRONE-90,301,1 ,$88.00 ,$63.36 ,$17.75 ,$88.00 ,$62.38 ,$57.20 ,$52.54 ,$24.45 ,$24.64 ,$58.26 ,$24.45 ,$58.26 ,$24.45 ,$52.45 ,$52.45 ,$24.45 ,$52.45 ,$50.40 ,$67.76 ,$62.38 ,$24.45 ,$24.94 ,$66.00 ,$62.48 ,$62.48 ,$24.45 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$62.38 ,$74.80 ,$24.45 ,$88.00 ,$49.37 ,$24.45 ,$36.43 ,$19.53 ,$17.75 ,$24.45 ,$74.80 ,$52.40 ,$52.45 ,$24.64 ,$79.20 ,$24.45 ,$74.80 ,$88.00 ,$88.00 ,$24.45 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,30101252,82693,HC ETHYLENE GLYCOL-90,301,1 ,$27.00 ,$19.44 ,$7.56 ,$37.25 ,$37.25 ,$17.55 ,$16.12 ,$14.60 ,$7.56 ,$17.87 ,$14.60 ,$17.87 ,$14.60 ,$16.09 ,$16.09 ,$14.60 ,$16.09 ,$27.00 ,$20.79 ,$37.25 ,$14.60 ,$14.90 ,$20.25 ,$19.17 ,$19.17 ,$14.60 ,$19.17 ,$22.95 ,$22.95 ,$22.95 , N/A ,$27.00 ,$22.95 ,$14.60 ,$27.00 ,$15.15 ,$14.60 ,$11.18 ,$10.18 ,$9.25 ,$14.60 ,$22.95 ,$31.29 ,$16.09 ,$7.56 ,$24.30 ,$14.60 ,$22.95 ,$27.00 ,$27.00 ,$14.60 ,$17.55 ST. JOSEPH'S HOSPITAL - BREESE,30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$74.00 ,$53.28 ,$3.37 ,$74.00 ,$12.75 ,$48.10 ,$44.18 ,$5.00 ,$20.72 ,$48.99 ,$5.00 ,$48.99 ,$5.00 ,$44.10 ,$44.10 ,$5.00 ,$44.10 ,$10.30 ,$56.98 ,$12.75 ,$5.00 ,$5.10 ,$55.50 ,$52.54 ,$52.54 ,$5.00 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$12.75 ,$62.90 ,$5.00 ,$74.00 ,$41.51 ,$5.00 ,$30.64 ,$3.71 ,$3.37 ,$5.00 ,$62.90 ,$10.71 ,$44.10 ,$20.72 ,$66.60 ,$5.00 ,$62.90 ,$20.40 ,$20.40 ,$5.00 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30101255,82726,HC FATTY ACIDS VERY LONG CHAIN-90,301,1 ,$649.00 ,$467.28 ,$7.58 ,$649.00 ,$49.38 ,$421.85 ,$387.45 ,$19.35 ,$181.72 ,$429.64 ,$19.35 ,$429.64 ,$19.35 ,$386.80 ,$386.80 ,$19.35 ,$386.80 ,$39.90 ,$499.73 ,$49.38 ,$19.35 ,$19.75 ,$486.75 ,$460.79 ,$460.79 ,$19.35 ,$460.79 ,$551.65 ,$551.65 ,$551.65 , N/A ,$49.38 ,$551.65 ,$19.35 ,$649.00 ,$364.09 ,$19.35 ,$268.69 ,$8.34 ,$7.58 ,$19.35 ,$551.65 ,$41.48 ,$386.80 ,$181.72 ,$584.10 ,$19.35 ,$551.65 ,$79.00 ,$79.00 ,$19.35 ,$421.85 ST. JOSEPH'S HOSPITAL - BREESE,30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$95.00 ,$68.40 ,$4.71 ,$95.00 ,$44.13 ,$61.75 ,$56.72 ,$17.30 ,$26.60 ,$62.89 ,$17.30 ,$62.89 ,$17.30 ,$56.62 ,$56.62 ,$17.30 ,$56.62 ,$35.65 ,$73.15 ,$44.13 ,$17.30 ,$17.64 ,$71.25 ,$67.45 ,$67.45 ,$17.30 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$44.13 ,$80.75 ,$17.30 ,$95.00 ,$53.30 ,$17.30 ,$39.33 ,$5.18 ,$4.71 ,$17.30 ,$80.75 ,$37.07 ,$56.62 ,$26.60 ,$85.50 ,$17.30 ,$80.75 ,$70.60 ,$70.60 ,$17.30 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$101.00 ,$72.72 ,$7.58 ,$101.00 ,$23.25 ,$65.65 ,$60.30 ,$9.11 ,$28.28 ,$66.86 ,$9.11 ,$66.86 ,$9.11 ,$60.20 ,$60.20 ,$9.11 ,$60.20 ,$18.79 ,$77.77 ,$23.25 ,$9.11 ,$9.30 ,$75.75 ,$71.71 ,$71.71 ,$9.11 ,$71.71 ,$85.85 ,$85.85 ,$85.85 , N/A ,$23.25 ,$85.85 ,$9.11 ,$101.00 ,$56.66 ,$9.11 ,$41.81 ,$8.34 ,$7.58 ,$9.11 ,$85.85 ,$19.53 ,$60.20 ,$28.28 ,$90.90 ,$9.11 ,$85.85 ,$37.20 ,$37.20 ,$9.11 ,$65.65 ST. JOSEPH'S HOSPITAL - BREESE,30101263,82785,HC GAMMAGLOBULIN IGE-90,301,1 ,$126.00 ,$90.72 ,$7.58 ,$126.00 ,$41.15 ,$81.90 ,$75.22 ,$16.13 ,$35.28 ,$83.41 ,$16.13 ,$83.41 ,$16.13 ,$75.10 ,$75.10 ,$16.13 ,$75.10 ,$33.25 ,$97.02 ,$41.15 ,$16.13 ,$16.45 ,$94.50 ,$89.46 ,$89.46 ,$16.13 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$41.15 ,$107.10 ,$16.13 ,$126.00 ,$70.69 ,$16.13 ,$52.16 ,$8.34 ,$7.58 ,$16.13 ,$107.10 ,$34.57 ,$75.10 ,$35.28 ,$113.40 ,$16.13 ,$107.10 ,$65.84 ,$65.84 ,$16.13 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$67.00 ,$48.24 ,$7.86 ,$67.00 ,$20.05 ,$43.55 ,$40.00 ,$7.86 ,$18.76 ,$44.35 ,$7.86 ,$44.35 ,$7.86 ,$39.93 ,$39.93 ,$7.86 ,$39.93 ,$16.20 ,$51.59 ,$20.05 ,$7.86 ,$8.02 ,$50.25 ,$47.57 ,$47.57 ,$7.86 ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A ,$20.05 ,$56.95 ,$7.86 ,$67.00 ,$37.59 ,$7.86 ,$27.74 ,$12.88 ,$11.71 ,$7.86 ,$56.95 ,$16.84 ,$39.93 ,$18.76 ,$60.30 ,$7.86 ,$56.95 ,$32.08 ,$32.08 ,$7.86 ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,30101268,82941,HC GASTRIN-90,301,1 ,$87.00 ,$62.64 ,$17.28 ,$87.00 ,$44.08 ,$56.55 ,$51.94 ,$17.28 ,$24.36 ,$57.59 ,$17.28 ,$57.59 ,$17.28 ,$51.85 ,$51.85 ,$17.28 ,$51.85 ,$35.61 ,$66.99 ,$44.08 ,$17.28 ,$17.62 ,$65.25 ,$61.77 ,$61.77 ,$17.28 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$44.08 ,$73.95 ,$17.28 ,$87.00 ,$48.81 ,$17.28 ,$36.02 ,$19.53 ,$17.75 ,$17.28 ,$73.95 ,$37.02 ,$51.85 ,$24.36 ,$78.30 ,$17.28 ,$73.95 ,$70.52 ,$70.52 ,$17.28 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$57.00 ,$41.04 ,$7.58 ,$57.00 ,$24.25 ,$37.05 ,$34.03 ,$9.51 ,$15.96 ,$37.73 ,$9.51 ,$37.73 ,$9.51 ,$33.97 ,$33.97 ,$9.51 ,$33.97 ,$19.59 ,$43.89 ,$24.25 ,$9.51 ,$9.69 ,$42.75 ,$40.47 ,$40.47 ,$9.51 ,$40.47 ,$48.45 ,$48.45 ,$48.45 , N/A ,$24.25 ,$48.45 ,$9.51 ,$57.00 ,$31.98 ,$9.51 ,$23.60 ,$8.34 ,$7.58 ,$9.51 ,$48.45 ,$20.37 ,$33.97 ,$15.96 ,$51.30 ,$9.51 ,$48.45 ,$38.80 ,$38.80 ,$9.51 ,$37.05 ST. JOSEPH'S HOSPITAL - BREESE,30101275,82977,HC GGT/GGTP-90,301,1 ,$90.00 ,$64.80 ,$3.37 ,$90.00 ,$18.00 ,$58.50 ,$53.73 ,$7.06 ,$25.20 ,$59.58 ,$7.06 ,$59.58 ,$7.06 ,$53.64 ,$53.64 ,$7.06 ,$53.64 ,$14.54 ,$69.30 ,$18.00 ,$7.06 ,$7.19 ,$67.50 ,$63.90 ,$63.90 ,$7.06 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$18.00 ,$76.50 ,$7.06 ,$90.00 ,$50.49 ,$7.06 ,$37.26 ,$3.71 ,$3.37 ,$7.06 ,$76.50 ,$15.12 ,$53.64 ,$25.20 ,$81.00 ,$7.06 ,$76.50 ,$28.80 ,$28.80 ,$7.06 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$9.00 ,$6.48 ,$2.52 ,$22.50 ,$22.50 ,$5.85 ,$5.37 ,$8.82 ,$2.52 ,$5.96 ,$8.82 ,$5.96 ,$8.82 ,$5.36 ,$5.36 ,$8.82 ,$5.36 ,$9.00 ,$6.93 ,$22.50 ,$8.82 ,$8.82 ,$6.75 ,$6.39 ,$6.39 ,$8.82 ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A ,$9.00 ,$7.65 ,$8.82 ,$9.00 ,$5.05 ,$8.82 ,$3.73 ,$8.34 ,$7.58 ,$8.82 ,$7.65 ,$18.90 ,$5.36 ,$2.52 ,$8.10 ,$8.82 ,$7.65 ,$9.00 ,$9.00 ,$8.82 ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$62.00 ,$44.64 ,$16.34 ,$62.00 ,$41.68 ,$40.30 ,$37.01 ,$16.34 ,$17.36 ,$41.04 ,$16.34 ,$41.04 ,$16.34 ,$36.95 ,$36.95 ,$16.34 ,$36.95 ,$33.67 ,$47.74 ,$41.68 ,$16.34 ,$16.66 ,$46.50 ,$44.02 ,$44.02 ,$16.34 ,$44.02 ,$52.70 ,$52.70 ,$52.70 , N/A ,$41.68 ,$52.70 ,$16.34 ,$62.00 ,$34.78 ,$16.34 ,$25.67 ,$19.53 ,$17.75 ,$16.34 ,$52.70 ,$35.01 ,$36.95 ,$17.36 ,$55.80 ,$16.34 ,$52.70 ,$62.00 ,$62.00 ,$16.34 ,$40.30 ST. JOSEPH'S HOSPITAL - BREESE,30101281,83010,HC HAPTOGLOBIN-90,301,1 ,$119.00 ,$85.68 ,$7.58 ,$119.00 ,$31.45 ,$77.35 ,$71.04 ,$12.33 ,$33.32 ,$78.78 ,$12.33 ,$78.78 ,$12.33 ,$70.92 ,$70.92 ,$12.33 ,$70.92 ,$25.41 ,$91.63 ,$31.45 ,$12.33 ,$12.57 ,$89.25 ,$84.49 ,$84.49 ,$12.33 ,$84.49 ,$101.15 ,$101.15 ,$101.15 , N/A ,$31.45 ,$101.15 ,$12.33 ,$119.00 ,$66.76 ,$12.33 ,$49.27 ,$8.34 ,$7.58 ,$12.33 ,$101.15 ,$26.42 ,$70.92 ,$33.32 ,$107.10 ,$12.33 ,$101.15 ,$50.32 ,$50.32 ,$12.33 ,$77.35 ST. JOSEPH'S HOSPITAL - BREESE,30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$284.00 ,$204.48 ,$20.42 ,$284.00 ,$168.40 ,$184.60 ,$169.55 ,$66.01 ,$79.52 ,$188.01 ,$66.01 ,$188.01 ,$66.01 ,$169.26 ,$169.26 ,$66.01 ,$169.26 ,$136.07 ,$218.68 ,$168.40 ,$66.01 ,$67.34 ,$213.00 ,$201.64 ,$201.64 ,$66.01 ,$201.64 ,$241.40 ,$241.40 ,$241.40 , N/A ,$168.40 ,$241.40 ,$66.01 ,$284.00 ,$159.32 ,$66.01 ,$117.58 ,$22.46 ,$20.42 ,$66.01 ,$241.40 ,$141.46 ,$169.26 ,$79.52 ,$255.60 ,$66.01 ,$241.40 ,$269.44 ,$269.44 ,$66.01 ,$184.60 ST. JOSEPH'S HOSPITAL - BREESE,30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$134.00 ,$96.48 ,$9.25 ,$134.00 ,$54.90 ,$87.10 ,$80.00 ,$21.52 ,$37.52 ,$88.71 ,$21.52 ,$88.71 ,$21.52 ,$79.86 ,$79.86 ,$21.52 ,$79.86 ,$44.36 ,$103.18 ,$54.90 ,$21.52 ,$21.95 ,$100.50 ,$95.14 ,$95.14 ,$21.52 ,$95.14 ,$113.90 ,$113.90 ,$113.90 , N/A ,$54.90 ,$113.90 ,$21.52 ,$134.00 ,$75.17 ,$21.52 ,$55.48 ,$10.18 ,$9.25 ,$21.52 ,$113.90 ,$46.12 ,$79.86 ,$37.52 ,$120.60 ,$21.52 ,$113.90 ,$87.84 ,$87.84 ,$21.52 ,$87.10 ST. JOSEPH'S HOSPITAL - BREESE,30101284,83020,HC HGB ELECTROPHORESIS-90,301,1 ,$63.00 ,$45.36 ,$7.58 ,$63.00 ,$32.18 ,$40.95 ,$37.61 ,$12.61 ,$17.64 ,$41.71 ,$12.61 ,$41.71 ,$12.61 ,$37.55 ,$37.55 ,$12.61 ,$37.55 ,$26.00 ,$48.51 ,$32.18 ,$12.61 ,$12.87 ,$47.25 ,$44.73 ,$44.73 ,$12.61 ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A ,$32.18 ,$53.55 ,$12.61 ,$63.00 ,$35.34 ,$12.61 ,$26.08 ,$8.34 ,$7.58 ,$12.61 ,$53.55 ,$27.03 ,$37.55 ,$17.64 ,$56.70 ,$12.61 ,$53.55 ,$51.48 ,$51.48 ,$12.61 ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,30101285,83021,HC HEMOGLOBIN FRACT QN-90,301,1 ,$63.00 ,$45.36 ,$7.17 ,$63.00 ,$45.15 ,$40.95 ,$37.61 ,$17.70 ,$17.64 ,$41.71 ,$17.70 ,$41.71 ,$17.70 ,$37.55 ,$37.55 ,$17.70 ,$37.55 ,$36.48 ,$48.51 ,$45.15 ,$17.70 ,$18.05 ,$47.25 ,$44.73 ,$44.73 ,$17.70 ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A ,$45.15 ,$53.55 ,$17.70 ,$63.00 ,$35.34 ,$17.70 ,$26.08 ,$7.89 ,$7.17 ,$17.70 ,$53.55 ,$37.93 ,$37.55 ,$17.64 ,$56.70 ,$17.70 ,$53.55 ,$63.00 ,$63.00 ,$17.70 ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,30101289,83051,HC HEMOGLOBIN PLASMA-90,301,1 ,$52.00 ,$37.44 ,$7.16 ,$52.00 ,$18.28 ,$33.80 ,$31.04 ,$7.16 ,$14.56 ,$34.42 ,$7.16 ,$34.42 ,$7.16 ,$30.99 ,$30.99 ,$7.16 ,$30.99 ,$14.77 ,$40.04 ,$18.28 ,$7.16 ,$7.31 ,$39.00 ,$36.92 ,$36.92 ,$7.16 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$18.28 ,$44.20 ,$7.16 ,$52.00 ,$29.17 ,$7.16 ,$21.53 ,$8.34 ,$7.58 ,$7.16 ,$44.20 ,$15.35 ,$30.99 ,$14.56 ,$46.80 ,$7.16 ,$44.20 ,$29.24 ,$29.24 ,$7.16 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30101292,83090,HC HOMOCYSTEINE-90,301,1 ,$107.00 ,$77.04 ,$17.56 ,$107.00 ,$44.80 ,$69.55 ,$63.88 ,$17.56 ,$29.96 ,$70.83 ,$17.56 ,$70.83 ,$17.56 ,$63.77 ,$63.77 ,$17.56 ,$63.77 ,$36.20 ,$82.39 ,$44.80 ,$17.56 ,$17.91 ,$80.25 ,$75.97 ,$75.97 ,$17.56 ,$75.97 ,$90.95 ,$90.95 ,$90.95 , N/A ,$44.80 ,$90.95 ,$17.56 ,$107.00 ,$60.03 ,$17.56 ,$44.30 ,$19.53 ,$17.75 ,$17.56 ,$90.95 ,$37.63 ,$63.77 ,$29.96 ,$96.30 ,$17.56 ,$90.95 ,$71.68 ,$71.68 ,$17.56 ,$69.55 ST. JOSEPH'S HOSPITAL - BREESE,30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$65.00 ,$46.80 ,$10.21 ,$65.00 ,$32.25 ,$42.25 ,$38.81 ,$12.64 ,$18.20 ,$43.03 ,$12.64 ,$43.03 ,$12.64 ,$38.74 ,$38.74 ,$12.64 ,$38.74 ,$26.06 ,$50.05 ,$32.25 ,$12.64 ,$12.90 ,$48.75 ,$46.15 ,$46.15 ,$12.64 ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A ,$32.25 ,$55.25 ,$12.64 ,$65.00 ,$36.47 ,$12.64 ,$26.91 ,$11.23 ,$10.21 ,$12.64 ,$55.25 ,$27.09 ,$38.74 ,$18.20 ,$58.50 ,$12.64 ,$55.25 ,$51.60 ,$51.60 ,$12.64 ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$121.00 ,$87.12 ,$17.75 ,$121.00 ,$67.93 ,$78.65 ,$72.24 ,$26.63 ,$33.88 ,$80.10 ,$26.63 ,$80.10 ,$26.63 ,$72.12 ,$72.12 ,$26.63 ,$72.12 ,$54.88 ,$93.17 ,$67.93 ,$26.63 ,$27.16 ,$90.75 ,$85.91 ,$85.91 ,$26.63 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$67.93 ,$102.85 ,$26.63 ,$121.00 ,$67.88 ,$26.63 ,$50.09 ,$19.53 ,$17.75 ,$26.63 ,$102.85 ,$57.06 ,$72.12 ,$33.88 ,$108.90 ,$26.63 ,$102.85 ,$108.68 ,$108.68 ,$26.63 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$121.00 ,$87.12 ,$6.79 ,$121.00 ,$28.83 ,$78.65 ,$72.24 ,$11.30 ,$33.88 ,$80.10 ,$11.30 ,$80.10 ,$11.30 ,$72.12 ,$72.12 ,$11.30 ,$72.12 ,$23.29 ,$93.17 ,$28.83 ,$11.30 ,$11.52 ,$90.75 ,$85.91 ,$85.91 ,$11.30 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$28.83 ,$102.85 ,$11.30 ,$121.00 ,$67.88 ,$11.30 ,$50.09 ,$7.47 ,$6.79 ,$11.30 ,$102.85 ,$24.21 ,$72.12 ,$33.88 ,$108.90 ,$11.30 ,$102.85 ,$46.12 ,$46.12 ,$11.30 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30101302,83519,HC QN RIA-90,301,1 ,$220.00 ,$158.40 ,$6.79 ,$220.00 ,$46.00 ,$143.00 ,$131.34 ,$18.03 ,$61.60 ,$145.64 ,$18.03 ,$145.64 ,$18.03 ,$131.12 ,$131.12 ,$18.03 ,$131.12 ,$37.17 ,$169.40 ,$46.00 ,$18.03 ,$18.39 ,$165.00 ,$156.20 ,$156.20 ,$18.03 ,$156.20 ,$187.00 ,$187.00 ,$187.00 , N/A ,$46.00 ,$187.00 ,$18.03 ,$220.00 ,$123.42 ,$18.03 ,$91.08 ,$7.47 ,$6.79 ,$18.03 ,$187.00 ,$38.64 ,$131.12 ,$61.60 ,$198.00 ,$18.03 ,$187.00 ,$73.60 ,$73.60 ,$18.03 ,$143.00 ST. JOSEPH'S HOSPITAL - BREESE,30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$169.00 ,$121.68 ,$6.79 ,$169.00 ,$43.18 ,$109.85 ,$100.89 ,$16.92 ,$47.32 ,$111.88 ,$16.92 ,$111.88 ,$16.92 ,$100.72 ,$100.72 ,$16.92 ,$100.72 ,$34.89 ,$130.13 ,$43.18 ,$16.92 ,$17.27 ,$126.75 ,$119.99 ,$119.99 ,$16.92 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$43.18 ,$143.65 ,$16.92 ,$169.00 ,$94.81 ,$16.92 ,$69.97 ,$7.47 ,$6.79 ,$16.92 ,$143.65 ,$36.27 ,$100.72 ,$47.32 ,$152.10 ,$16.92 ,$143.65 ,$69.08 ,$69.08 ,$16.92 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30101305,83520,HC IMMUNOASSAY QN OTHER MBL-90,301,1 ,$200.00 ,$144.00 ,$6.79 ,$200.00 ,$43.18 ,$130.00 ,$119.40 ,$16.92 ,$56.00 ,$132.40 ,$16.92 ,$132.40 ,$16.92 ,$119.20 ,$119.20 ,$16.92 ,$119.20 ,$34.89 ,$154.00 ,$43.18 ,$16.92 ,$17.27 ,$150.00 ,$142.00 ,$142.00 ,$16.92 ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A ,$43.18 ,$170.00 ,$16.92 ,$200.00 ,$112.20 ,$16.92 ,$82.80 ,$7.47 ,$6.79 ,$16.92 ,$170.00 ,$36.27 ,$119.20 ,$56.00 ,$180.00 ,$16.92 ,$170.00 ,$69.08 ,$69.08 ,$16.92 ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,30101306,83520,HC IMMUNOASSAY QN ENZYME-90,301,1 ,$369.00 ,$265.68 ,$6.79 ,$369.00 ,$43.18 ,$239.85 ,$220.29 ,$16.92 ,$103.32 ,$244.28 ,$16.92 ,$244.28 ,$16.92 ,$219.92 ,$219.92 ,$16.92 ,$219.92 ,$34.89 ,$284.13 ,$43.18 ,$16.92 ,$17.27 ,$276.75 ,$261.99 ,$261.99 ,$16.92 ,$261.99 ,$313.65 ,$313.65 ,$313.65 , N/A ,$43.18 ,$313.65 ,$16.92 ,$369.00 ,$207.01 ,$16.92 ,$152.77 ,$7.47 ,$6.79 ,$16.92 ,$313.65 ,$36.27 ,$219.92 ,$103.32 ,$332.10 ,$16.92 ,$313.65 ,$69.08 ,$69.08 ,$16.92 ,$239.85 ST. JOSEPH'S HOSPITAL - BREESE,30101307,83525,HC INSULIN TOTAL-90,301,1 ,$87.00 ,$62.64 ,$10.21 ,$87.00 ,$28.58 ,$56.55 ,$51.94 ,$11.20 ,$24.36 ,$57.59 ,$11.20 ,$57.59 ,$11.20 ,$51.85 ,$51.85 ,$11.20 ,$51.85 ,$23.09 ,$66.99 ,$28.58 ,$11.20 ,$11.43 ,$65.25 ,$61.77 ,$61.77 ,$11.20 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$28.58 ,$73.95 ,$11.20 ,$87.00 ,$48.81 ,$11.20 ,$36.02 ,$11.23 ,$10.21 ,$11.20 ,$73.95 ,$24.00 ,$51.85 ,$24.36 ,$78.30 ,$11.20 ,$73.95 ,$45.72 ,$45.72 ,$11.20 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30101308,83527,HC INSULIN FREE-90,301,1 ,$26.00 ,$18.72 ,$7.28 ,$32.38 ,$32.38 ,$16.90 ,$15.52 ,$12.69 ,$7.28 ,$17.21 ,$12.69 ,$17.21 ,$12.69 ,$15.50 ,$15.50 ,$12.69 ,$15.50 ,$26.00 ,$20.02 ,$32.38 ,$12.69 ,$12.95 ,$19.50 ,$18.46 ,$18.46 ,$12.69 ,$18.46 ,$22.10 ,$22.10 ,$22.10 , N/A ,$26.00 ,$22.10 ,$12.69 ,$26.00 ,$14.59 ,$12.69 ,$10.76 ,$19.53 ,$17.75 ,$12.69 ,$22.10 ,$27.20 ,$15.50 ,$7.28 ,$23.40 ,$12.69 ,$22.10 ,$26.00 ,$26.00 ,$12.69 ,$16.90 ST. JOSEPH'S HOSPITAL - BREESE,30101311,83605,HC LACTATE/LACTIC ACID-90,301,1 ,$24.00 ,$17.28 ,$6.72 ,$28.93 ,$28.93 ,$15.60 ,$14.33 ,$11.34 ,$6.72 ,$15.89 ,$11.34 ,$15.89 ,$11.34 ,$14.30 ,$14.30 ,$11.34 ,$14.30 ,$23.37 ,$18.48 ,$28.93 ,$11.34 ,$11.56 ,$18.00 ,$17.04 ,$17.04 ,$11.34 ,$17.04 ,$20.40 ,$20.40 ,$20.40 , N/A ,$24.00 ,$20.40 ,$11.34 ,$24.00 ,$13.46 ,$11.34 ,$9.94 ,$8.34 ,$7.58 ,$11.34 ,$20.40 ,$24.30 ,$14.30 ,$6.72 ,$21.60 ,$11.34 ,$20.40 ,$24.00 ,$24.00 ,$11.34 ,$15.60 ST. JOSEPH'S HOSPITAL - BREESE,30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$102.00 ,$73.44 ,$3.37 ,$102.00 ,$15.10 ,$66.30 ,$60.89 ,$5.92 ,$28.56 ,$67.52 ,$5.92 ,$67.52 ,$5.92 ,$60.79 ,$60.79 ,$5.92 ,$60.79 ,$12.20 ,$78.54 ,$15.10 ,$5.92 ,$6.04 ,$76.50 ,$72.42 ,$72.42 ,$5.92 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$15.10 ,$86.70 ,$5.92 ,$102.00 ,$57.22 ,$5.92 ,$42.23 ,$3.71 ,$3.37 ,$5.92 ,$86.70 ,$12.68 ,$60.79 ,$28.56 ,$91.80 ,$5.92 ,$86.70 ,$24.16 ,$24.16 ,$5.92 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30101313,83625,HC LDH ISOENZYMES-90,301,1 ,$42.00 ,$30.24 ,$7.58 ,$42.00 ,$31.98 ,$27.30 ,$25.07 ,$12.53 ,$11.76 ,$27.80 ,$12.53 ,$27.80 ,$12.53 ,$25.03 ,$25.03 ,$12.53 ,$25.03 ,$25.84 ,$32.34 ,$31.98 ,$12.53 ,$12.79 ,$31.50 ,$29.82 ,$29.82 ,$12.53 ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A ,$31.98 ,$35.70 ,$12.53 ,$42.00 ,$23.56 ,$12.53 ,$17.39 ,$8.34 ,$7.58 ,$12.53 ,$35.70 ,$26.86 ,$25.03 ,$11.76 ,$37.80 ,$12.53 ,$35.70 ,$42.00 ,$42.00 ,$12.53 ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,30101314,83630,HC LACTOGEN FECAL QL-90,301,1 ,$114.00 ,$82.08 ,$7.58 ,$114.00 ,$49.25 ,$74.10 ,$68.06 ,$19.31 ,$31.92 ,$75.47 ,$19.31 ,$75.47 ,$19.31 ,$67.94 ,$67.94 ,$19.31 ,$67.94 ,$39.79 ,$87.78 ,$49.25 ,$19.31 ,$19.69 ,$85.50 ,$80.94 ,$80.94 ,$19.31 ,$80.94 ,$96.90 ,$96.90 ,$96.90 , N/A ,$49.25 ,$96.90 ,$19.31 ,$114.00 ,$63.95 ,$19.31 ,$47.20 ,$8.34 ,$7.58 ,$19.31 ,$96.90 ,$41.37 ,$67.94 ,$31.92 ,$102.60 ,$19.31 ,$96.90 ,$78.80 ,$78.80 ,$19.31 ,$74.10 ST. JOSEPH'S HOSPITAL - BREESE,30101316,83655,HC LEAD-90,301,1 ,$67.00 ,$48.24 ,$9.25 ,$67.00 ,$30.28 ,$43.55 ,$40.00 ,$11.87 ,$18.76 ,$44.35 ,$11.87 ,$44.35 ,$11.87 ,$39.93 ,$39.93 ,$11.87 ,$39.93 ,$24.46 ,$51.59 ,$30.28 ,$11.87 ,$12.10 ,$50.25 ,$47.57 ,$47.57 ,$11.87 ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A ,$30.28 ,$56.95 ,$11.87 ,$67.00 ,$37.59 ,$11.87 ,$27.74 ,$10.18 ,$9.25 ,$11.87 ,$56.95 ,$25.43 ,$39.93 ,$18.76 ,$60.30 ,$11.87 ,$56.95 ,$48.44 ,$48.44 ,$11.87 ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,30101319,83695,HC LIPOPROTEIN-90,301,1 ,$74.00 ,$53.28 ,$7.58 ,$74.00 ,$35.80 ,$48.10 ,$44.18 ,$14.03 ,$20.72 ,$48.99 ,$14.03 ,$48.99 ,$14.03 ,$44.10 ,$44.10 ,$14.03 ,$44.10 ,$28.93 ,$56.98 ,$35.80 ,$14.03 ,$14.32 ,$55.50 ,$52.54 ,$52.54 ,$14.03 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$35.80 ,$62.90 ,$14.03 ,$74.00 ,$41.51 ,$14.03 ,$30.64 ,$8.34 ,$7.58 ,$14.03 ,$62.90 ,$30.07 ,$44.10 ,$20.72 ,$66.60 ,$14.03 ,$62.90 ,$57.28 ,$57.28 ,$14.03 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30101325,80335,HC ANTIDEPRESSANTS TRYCLIC 1-2 -90,301,1 ,$56.00 ,$40.32 ,$15.68 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A ,$43.12 , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 ,$22.46 ,$20.42 , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 , N/A , N/A , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101326,83735,HC MAGNESIUM-90,301,1 ,$80.00 ,$57.60 ,$3.37 ,$80.00 ,$16.75 ,$52.00 ,$47.76 ,$6.57 ,$22.40 ,$52.96 ,$6.57 ,$52.96 ,$6.57 ,$47.68 ,$47.68 ,$6.57 ,$47.68 ,$13.53 ,$61.60 ,$16.75 ,$6.57 ,$6.69 ,$60.00 ,$56.80 ,$56.80 ,$6.57 ,$56.80 ,$68.00 ,$68.00 ,$68.00 , N/A ,$16.75 ,$68.00 ,$6.57 ,$80.00 ,$44.88 ,$6.57 ,$33.12 ,$3.71 ,$3.37 ,$6.57 ,$68.00 ,$14.07 ,$47.68 ,$22.40 ,$72.00 ,$6.57 ,$68.00 ,$26.80 ,$26.80 ,$6.57 ,$52.00 ST. JOSEPH'S HOSPITAL - BREESE,30101327,83785,HC MANGANESE-90,301,1 ,$164.00 ,$118.08 ,$9.25 ,$164.00 ,$66.63 ,$106.60 ,$97.91 ,$26.12 ,$45.92 ,$108.57 ,$26.12 ,$108.57 ,$26.12 ,$97.74 ,$97.74 ,$26.12 ,$97.74 ,$53.83 ,$126.28 ,$66.63 ,$26.12 ,$26.64 ,$123.00 ,$116.44 ,$116.44 ,$26.12 ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A ,$66.63 ,$139.40 ,$26.12 ,$164.00 ,$92.00 ,$26.12 ,$67.90 ,$10.18 ,$9.25 ,$26.12 ,$139.40 ,$55.97 ,$97.74 ,$45.92 ,$147.60 ,$26.12 ,$139.40 ,$106.60 ,$106.60 ,$26.12 ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,30101328,83789,HC MASS SPEC QN EACH-90,301,1 ,$189.00 ,$136.08 ,$7.58 ,$189.00 ,$60.28 ,$122.85 ,$112.83 ,$23.63 ,$52.92 ,$125.12 ,$23.63 ,$125.12 ,$23.63 ,$112.64 ,$112.64 ,$23.63 ,$112.64 ,$48.70 ,$145.53 ,$60.28 ,$23.63 ,$24.10 ,$141.75 ,$134.19 ,$134.19 ,$23.63 ,$134.19 ,$160.65 ,$160.65 ,$160.65 , N/A ,$60.28 ,$160.65 ,$23.63 ,$189.00 ,$106.03 ,$23.63 ,$78.25 ,$8.34 ,$7.58 ,$23.63 ,$160.65 ,$50.63 ,$112.64 ,$52.92 ,$170.10 ,$23.63 ,$160.65 ,$96.44 ,$96.44 ,$23.63 ,$122.85 ST. JOSEPH'S HOSPITAL - BREESE,30101329,83825,HC MERCURY-90,301,1 ,$82.00 ,$59.04 ,$9.25 ,$82.00 ,$40.65 ,$53.30 ,$48.95 ,$15.93 ,$22.96 ,$54.28 ,$15.93 ,$54.28 ,$15.93 ,$48.87 ,$48.87 ,$15.93 ,$48.87 ,$32.85 ,$63.14 ,$40.65 ,$15.93 ,$16.26 ,$61.50 ,$58.22 ,$58.22 ,$15.93 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$40.65 ,$69.70 ,$15.93 ,$82.00 ,$46.00 ,$15.93 ,$33.95 ,$10.18 ,$9.25 ,$15.93 ,$69.70 ,$34.15 ,$48.87 ,$22.96 ,$73.80 ,$15.93 ,$69.70 ,$65.04 ,$65.04 ,$15.93 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30101330,83835,HC METANEPHRINES-90,301,1 ,$111.00 ,$79.92 ,$16.60 ,$111.00 ,$42.35 ,$72.15 ,$66.27 ,$16.60 ,$31.08 ,$73.48 ,$16.60 ,$73.48 ,$16.60 ,$66.16 ,$66.16 ,$16.60 ,$66.16 ,$34.22 ,$85.47 ,$42.35 ,$16.60 ,$16.93 ,$83.25 ,$78.81 ,$78.81 ,$16.60 ,$78.81 ,$94.35 ,$94.35 ,$94.35 , N/A ,$42.35 ,$94.35 ,$16.60 ,$111.00 ,$62.27 ,$16.60 ,$45.95 ,$19.53 ,$17.75 ,$16.60 ,$94.35 ,$35.57 ,$66.16 ,$31.08 ,$99.90 ,$16.60 ,$94.35 ,$67.76 ,$67.76 ,$16.60 ,$72.15 ST. JOSEPH'S HOSPITAL - BREESE,30101333,83873,HC MYELIN BASIC PROTEIN (CSF)-90,301,1 ,$66.00 ,$47.52 ,$7.58 ,$66.00 ,$43.00 ,$42.90 ,$39.40 ,$16.86 ,$18.48 ,$43.69 ,$16.86 ,$43.69 ,$16.86 ,$39.34 ,$39.34 ,$16.86 ,$39.34 ,$34.74 ,$50.82 ,$43.00 ,$16.86 ,$17.19 ,$49.50 ,$46.86 ,$46.86 ,$16.86 ,$46.86 ,$56.10 ,$56.10 ,$56.10 , N/A ,$43.00 ,$56.10 ,$16.86 ,$66.00 ,$37.03 ,$16.86 ,$27.32 ,$8.34 ,$7.58 ,$16.86 ,$56.10 ,$36.12 ,$39.34 ,$18.48 ,$59.40 ,$16.86 ,$56.10 ,$66.00 ,$66.00 ,$16.86 ,$42.90 ST. JOSEPH'S HOSPITAL - BREESE,30101334,83874,HC MYOGLOBIN-90,301,1 ,$114.00 ,$82.08 ,$7.58 ,$114.00 ,$32.30 ,$74.10 ,$68.06 ,$12.66 ,$31.92 ,$75.47 ,$12.66 ,$75.47 ,$12.66 ,$67.94 ,$67.94 ,$12.66 ,$67.94 ,$26.10 ,$87.78 ,$32.30 ,$12.66 ,$12.92 ,$85.50 ,$80.94 ,$80.94 ,$12.66 ,$80.94 ,$96.90 ,$96.90 ,$96.90 , N/A ,$32.30 ,$96.90 ,$12.66 ,$114.00 ,$63.95 ,$12.66 ,$47.20 ,$8.34 ,$7.58 ,$12.66 ,$96.90 ,$27.13 ,$67.94 ,$31.92 ,$102.60 ,$12.66 ,$96.90 ,$51.68 ,$51.68 ,$12.66 ,$74.10 ST. JOSEPH'S HOSPITAL - BREESE,30101336,83880,HC BNP NATRIURETIC PEPTIDE-90,301,1 ,$139.00 ,$100.08 ,$20.42 ,$139.00 ,$98.15 ,$90.35 ,$82.98 ,$38.47 ,$38.92 ,$92.02 ,$38.47 ,$92.02 ,$38.47 ,$82.84 ,$82.84 ,$38.47 ,$82.84 ,$79.31 ,$107.03 ,$98.15 ,$38.47 ,$39.25 ,$104.25 ,$98.69 ,$98.69 ,$38.47 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$98.15 ,$118.15 ,$38.47 ,$139.00 ,$77.98 ,$38.47 ,$57.55 ,$22.46 ,$20.42 ,$38.47 ,$118.15 ,$82.45 ,$82.84 ,$38.92 ,$125.10 ,$38.47 ,$118.15 ,$139.00 ,$139.00 ,$38.47 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$97.00 ,$69.84 ,$11.71 ,$97.00 ,$34.00 ,$63.05 ,$57.91 ,$13.33 ,$27.16 ,$64.21 ,$13.33 ,$64.21 ,$13.33 ,$57.81 ,$57.81 ,$13.33 ,$57.81 ,$27.47 ,$74.69 ,$34.00 ,$13.33 ,$13.59 ,$72.75 ,$68.87 ,$68.87 ,$13.33 ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A ,$34.00 ,$82.45 ,$13.33 ,$97.00 ,$54.42 ,$13.33 ,$40.16 ,$12.88 ,$11.71 ,$13.33 ,$82.45 ,$28.56 ,$57.81 ,$27.16 ,$87.30 ,$13.33 ,$82.45 ,$54.40 ,$54.40 ,$13.33 ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,30101338,83885,HC NICKEL-90,301,1 ,$166.00 ,$119.52 ,$9.25 ,$166.00 ,$61.28 ,$107.90 ,$99.10 ,$24.02 ,$46.48 ,$109.89 ,$24.02 ,$109.89 ,$24.02 ,$98.94 ,$98.94 ,$24.02 ,$98.94 ,$49.51 ,$127.82 ,$61.28 ,$24.02 ,$24.50 ,$124.50 ,$117.86 ,$117.86 ,$24.02 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$61.28 ,$141.10 ,$24.02 ,$166.00 ,$93.13 ,$24.02 ,$68.72 ,$10.18 ,$9.25 ,$24.02 ,$141.10 ,$51.47 ,$98.94 ,$46.48 ,$149.40 ,$24.02 ,$141.10 ,$98.04 ,$98.04 ,$24.02 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$117.00 ,$84.24 ,$7.58 ,$117.00 ,$27.88 ,$76.05 ,$69.85 ,$10.93 ,$32.76 ,$77.45 ,$10.93 ,$77.45 ,$10.93 ,$69.73 ,$69.73 ,$10.93 ,$69.73 ,$22.52 ,$90.09 ,$27.88 ,$10.93 ,$11.14 ,$87.75 ,$83.07 ,$83.07 ,$10.93 ,$83.07 ,$99.45 ,$99.45 ,$99.45 , N/A ,$27.88 ,$99.45 ,$10.93 ,$117.00 ,$65.64 ,$10.93 ,$48.44 ,$8.34 ,$7.58 ,$10.93 ,$99.45 ,$23.42 ,$69.73 ,$32.76 ,$105.30 ,$10.93 ,$99.45 ,$44.60 ,$44.60 ,$10.93 ,$76.05 ST. JOSEPH'S HOSPITAL - BREESE,30101340,83916,HC OLIGOCLONAL BANDS-90,301,1 ,$100.00 ,$72.00 ,$7.58 ,$100.00 ,$68.48 ,$65.00 ,$59.70 ,$26.84 ,$28.00 ,$66.20 ,$26.84 ,$66.20 ,$26.84 ,$59.60 ,$59.60 ,$26.84 ,$59.60 ,$55.33 ,$77.00 ,$68.48 ,$26.84 ,$27.38 ,$75.00 ,$71.00 ,$71.00 ,$26.84 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$68.48 ,$85.00 ,$26.84 ,$100.00 ,$56.10 ,$26.84 ,$41.40 ,$8.34 ,$7.58 ,$26.84 ,$85.00 ,$57.52 ,$59.60 ,$28.00 ,$90.00 ,$26.84 ,$85.00 ,$100.00 ,$100.00 ,$26.84 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,30101341,83918,HC ORGANIC ACIDS QN-90,301,1 ,$244.00 ,$175.68 ,$9.25 ,$244.00 ,$59.00 ,$158.60 ,$145.67 ,$23.13 ,$68.32 ,$161.53 ,$23.13 ,$161.53 ,$23.13 ,$145.42 ,$145.42 ,$23.13 ,$145.42 ,$47.67 ,$187.88 ,$59.00 ,$23.13 ,$23.59 ,$183.00 ,$173.24 ,$173.24 ,$23.13 ,$173.24 ,$207.40 ,$207.40 ,$207.40 , N/A ,$59.00 ,$207.40 ,$23.13 ,$244.00 ,$136.88 ,$23.13 ,$101.02 ,$10.18 ,$9.25 ,$23.13 ,$207.40 ,$49.56 ,$145.42 ,$68.32 ,$219.60 ,$23.13 ,$207.40 ,$94.40 ,$94.40 ,$23.13 ,$158.60 ST. JOSEPH'S HOSPITAL - BREESE,30101342,83919,HC ORGANIC ACIDS QL-90,301,1 ,$231.00 ,$166.32 ,$7.58 ,$231.00 ,$41.13 ,$150.15 ,$137.91 ,$16.12 ,$64.68 ,$152.92 ,$16.12 ,$152.92 ,$16.12 ,$137.68 ,$137.68 ,$16.12 ,$137.68 ,$33.23 ,$177.87 ,$41.13 ,$16.12 ,$16.44 ,$173.25 ,$164.01 ,$164.01 ,$16.12 ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A ,$41.13 ,$196.35 ,$16.12 ,$231.00 ,$129.59 ,$16.12 ,$95.63 ,$8.34 ,$7.58 ,$16.12 ,$196.35 ,$34.55 ,$137.68 ,$64.68 ,$207.90 ,$16.12 ,$196.35 ,$65.80 ,$65.80 ,$16.12 ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,30101344,83937,HC OSTEOCALCIN-90,301,1 ,$91.00 ,$65.52 ,$17.75 ,$91.00 ,$74.63 ,$59.15 ,$54.33 ,$29.25 ,$25.48 ,$60.24 ,$29.25 ,$60.24 ,$29.25 ,$54.24 ,$54.24 ,$29.25 ,$54.24 ,$60.30 ,$70.07 ,$74.63 ,$29.25 ,$29.84 ,$68.25 ,$64.61 ,$64.61 ,$29.25 ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A ,$74.63 ,$77.35 ,$29.25 ,$91.00 ,$51.05 ,$29.25 ,$37.67 ,$19.53 ,$17.75 ,$29.25 ,$77.35 ,$62.69 ,$54.24 ,$25.48 ,$81.90 ,$29.25 ,$77.35 ,$91.00 ,$91.00 ,$29.25 ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,30101345,83945,HC OXALATE-90,301,1 ,$74.00 ,$53.28 ,$7.58 ,$74.00 ,$36.13 ,$48.10 ,$44.18 ,$14.16 ,$20.72 ,$48.99 ,$14.16 ,$48.99 ,$14.16 ,$44.10 ,$44.10 ,$14.16 ,$44.10 ,$29.19 ,$56.98 ,$36.13 ,$14.16 ,$14.45 ,$55.50 ,$52.54 ,$52.54 ,$14.16 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$36.13 ,$62.90 ,$14.16 ,$74.00 ,$41.51 ,$14.16 ,$30.64 ,$8.34 ,$7.58 ,$14.16 ,$62.90 ,$30.35 ,$44.10 ,$20.72 ,$66.60 ,$14.16 ,$62.90 ,$57.80 ,$57.80 ,$14.16 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30101348,83986,HC PH BODY FLUID NOT BLOOD-90,301,1 ,$103.00 ,$74.16 ,$3.37 ,$103.00 ,$8.95 ,$66.95 ,$61.49 ,$3.51 ,$28.84 ,$68.19 ,$3.51 ,$68.19 ,$3.51 ,$61.39 ,$61.39 ,$3.51 ,$61.39 ,$7.23 ,$79.31 ,$8.95 ,$3.51 ,$3.58 ,$77.25 ,$73.13 ,$73.13 ,$3.51 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$8.95 ,$87.55 ,$3.51 ,$103.00 ,$57.78 ,$3.51 ,$42.64 ,$3.71 ,$3.37 ,$3.51 ,$87.55 ,$7.52 ,$61.39 ,$28.84 ,$92.70 ,$3.51 ,$87.55 ,$14.32 ,$14.32 ,$3.51 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,30101349,83992,HC PHENCYCLIDINE (PCP)-90,301,1 ,$44.00 ,$31.68 ,$9.25 ,$44.00 , N/A ,$28.60 ,$26.27 , N/A ,$12.32 ,$29.13 , N/A ,$29.13 , N/A ,$26.22 ,$26.22 , N/A ,$26.22 , N/A ,$33.88 , N/A , N/A , N/A ,$33.00 ,$31.24 ,$31.24 , N/A ,$31.24 ,$37.40 ,$37.40 ,$37.40 , N/A , N/A ,$37.40 , N/A ,$44.00 ,$24.68 , N/A ,$18.22 ,$10.18 ,$9.25 , N/A ,$37.40 , N/A ,$26.22 ,$12.32 ,$39.60 , N/A ,$37.40 ,$44.00 ,$44.00 , N/A ,$28.60 ST. JOSEPH'S HOSPITAL - BREESE,30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$231.00 ,$166.32 ,$7.58 ,$231.00 ,$49.08 ,$150.15 ,$137.91 ,$19.24 ,$64.68 ,$152.92 ,$19.24 ,$152.92 ,$19.24 ,$137.68 ,$137.68 ,$19.24 ,$137.68 ,$39.65 ,$177.87 ,$49.08 ,$19.24 ,$19.62 ,$173.25 ,$164.01 ,$164.01 ,$19.24 ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A ,$49.08 ,$196.35 ,$19.24 ,$231.00 ,$129.59 ,$19.24 ,$95.63 ,$8.34 ,$7.58 ,$19.24 ,$196.35 ,$41.22 ,$137.68 ,$64.68 ,$207.90 ,$19.24 ,$196.35 ,$78.52 ,$78.52 ,$19.24 ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$177.00 ,$127.44 ,$3.37 ,$177.00 ,$13.75 ,$115.05 ,$105.67 ,$5.39 ,$49.56 ,$117.17 ,$5.39 ,$117.17 ,$5.39 ,$105.49 ,$105.49 ,$5.39 ,$105.49 ,$11.11 ,$136.29 ,$13.75 ,$5.39 ,$5.50 ,$132.75 ,$125.67 ,$125.67 ,$5.39 ,$125.67 ,$150.45 ,$150.45 ,$150.45 , N/A ,$13.75 ,$150.45 ,$5.39 ,$177.00 ,$99.30 ,$5.39 ,$73.28 ,$3.71 ,$3.37 ,$5.39 ,$150.45 ,$11.55 ,$105.49 ,$49.56 ,$159.30 ,$5.39 ,$150.45 ,$22.00 ,$22.00 ,$5.39 ,$115.05 ST. JOSEPH'S HOSPITAL - BREESE,30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$24.15 ,$37.70 ,$34.63 ,$9.47 ,$16.24 ,$38.40 ,$9.47 ,$38.40 ,$9.47 ,$34.57 ,$34.57 ,$9.47 ,$34.57 ,$19.51 ,$44.66 ,$24.15 ,$9.47 ,$9.65 ,$43.50 ,$41.18 ,$41.18 ,$9.47 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$24.15 ,$49.30 ,$9.47 ,$58.00 ,$32.54 ,$9.47 ,$24.01 ,$8.34 ,$7.58 ,$9.47 ,$49.30 ,$20.29 ,$34.57 ,$16.24 ,$52.20 ,$9.47 ,$49.30 ,$38.64 ,$38.64 ,$9.47 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$12.95 ,$37.70 ,$34.63 ,$5.08 ,$16.24 ,$38.40 ,$5.08 ,$38.40 ,$5.08 ,$34.57 ,$34.57 ,$5.08 ,$34.57 ,$10.46 ,$44.66 ,$12.95 ,$5.08 ,$5.17 ,$43.50 ,$41.18 ,$41.18 ,$5.08 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$12.95 ,$49.30 ,$5.08 ,$58.00 ,$32.54 ,$5.08 ,$24.01 ,$3.71 ,$3.37 ,$5.08 ,$49.30 ,$10.88 ,$34.57 ,$16.24 ,$52.20 ,$5.08 ,$49.30 ,$20.72 ,$20.72 ,$5.08 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$74.00 ,$53.28 ,$7.58 ,$74.00 ,$36.95 ,$48.10 ,$44.18 ,$14.48 ,$20.72 ,$48.99 ,$14.48 ,$48.99 ,$14.48 ,$44.10 ,$44.10 ,$14.48 ,$44.10 ,$29.86 ,$56.98 ,$36.95 ,$14.48 ,$14.78 ,$55.50 ,$52.54 ,$52.54 ,$14.48 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$36.95 ,$62.90 ,$14.48 ,$74.00 ,$41.51 ,$14.48 ,$30.64 ,$8.34 ,$7.58 ,$14.48 ,$62.90 ,$31.04 ,$44.10 ,$20.72 ,$66.60 ,$14.48 ,$62.90 ,$59.12 ,$59.12 ,$14.48 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30101358,84105,HC PHOSPHORUS URINE-90,301,1 ,$154.00 ,$110.88 ,$3.37 ,$154.00 ,$14.45 ,$100.10 ,$91.94 ,$5.66 ,$43.12 ,$101.95 ,$5.66 ,$101.95 ,$5.66 ,$91.78 ,$91.78 ,$5.66 ,$91.78 ,$11.68 ,$118.58 ,$14.45 ,$5.66 ,$5.78 ,$115.50 ,$109.34 ,$109.34 ,$5.66 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$14.45 ,$130.90 ,$5.66 ,$154.00 ,$86.39 ,$5.66 ,$63.76 ,$3.71 ,$3.37 ,$5.66 ,$130.90 ,$12.14 ,$91.78 ,$43.12 ,$138.60 ,$5.66 ,$130.90 ,$23.12 ,$23.12 ,$5.66 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101359,84110,HC PORPHOBILINOGEN QN-90,301,1 ,$69.00 ,$49.68 ,$7.58 ,$69.00 ,$21.10 ,$44.85 ,$41.19 ,$8.27 ,$19.32 ,$45.68 ,$8.27 ,$45.68 ,$8.27 ,$41.12 ,$41.12 ,$8.27 ,$41.12 ,$17.05 ,$53.13 ,$21.10 ,$8.27 ,$8.44 ,$51.75 ,$48.99 ,$48.99 ,$8.27 ,$48.99 ,$58.65 ,$58.65 ,$58.65 , N/A ,$21.10 ,$58.65 ,$8.27 ,$69.00 ,$38.71 ,$8.27 ,$28.57 ,$8.34 ,$7.58 ,$8.27 ,$58.65 ,$17.72 ,$41.12 ,$19.32 ,$62.10 ,$8.27 ,$58.65 ,$33.76 ,$33.76 ,$8.27 ,$44.85 ST. JOSEPH'S HOSPITAL - BREESE,30101361,84120,HC PORPHYRINS QN FRACT-90,301,1 ,$72.00 ,$51.84 ,$7.58 ,$72.00 ,$36.78 ,$46.80 ,$42.98 ,$14.42 ,$20.16 ,$47.66 ,$14.42 ,$47.66 ,$14.42 ,$42.91 ,$42.91 ,$14.42 ,$42.91 ,$29.71 ,$55.44 ,$36.78 ,$14.42 ,$14.70 ,$54.00 ,$51.12 ,$51.12 ,$14.42 ,$51.12 ,$61.20 ,$61.20 ,$61.20 , N/A ,$36.78 ,$61.20 ,$14.42 ,$72.00 ,$40.39 ,$14.42 ,$29.81 ,$8.34 ,$7.58 ,$14.42 ,$61.20 ,$30.89 ,$42.91 ,$20.16 ,$64.80 ,$14.42 ,$61.20 ,$58.84 ,$58.84 ,$14.42 ,$46.80 ST. JOSEPH'S HOSPITAL - BREESE,30101364,84133,HC POTASSIUM URINE-90,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$11.83 ,$60.45 ,$55.52 ,$4.64 ,$26.04 ,$61.57 ,$4.64 ,$61.57 ,$4.64 ,$55.43 ,$55.43 ,$4.64 ,$55.43 ,$9.55 ,$71.61 ,$11.83 ,$4.64 ,$4.72 ,$69.75 ,$66.03 ,$66.03 ,$4.64 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$11.83 ,$79.05 ,$4.64 ,$93.00 ,$52.17 ,$4.64 ,$38.50 ,$3.71 ,$3.37 ,$4.64 ,$79.05 ,$9.93 ,$55.43 ,$26.04 ,$83.70 ,$4.64 ,$79.05 ,$18.92 ,$18.92 ,$4.64 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101365,84134,HC PREALBUMIN-90,301,1 ,$11.00 ,$7.92 ,$3.08 ,$27.50 ,$27.50 ,$7.15 ,$6.57 ,$10.78 ,$3.08 ,$7.28 ,$10.78 ,$7.28 ,$10.78 ,$6.56 ,$6.56 ,$10.78 ,$6.56 ,$11.00 ,$8.47 ,$27.50 ,$10.78 ,$10.78 ,$8.25 ,$7.81 ,$7.81 ,$10.78 ,$7.81 ,$9.35 ,$9.35 ,$9.35 , N/A ,$11.00 ,$9.35 ,$10.78 ,$11.00 ,$6.17 ,$10.78 ,$4.55 ,$8.34 ,$7.58 ,$10.78 ,$9.35 ,$23.10 ,$6.56 ,$3.08 ,$9.90 ,$10.78 ,$9.35 ,$11.00 ,$11.00 ,$10.78 ,$7.15 ST. JOSEPH'S HOSPITAL - BREESE,30101366,84140,HC PREGNENOLONE-90,301,1 ,$120.00 ,$86.40 ,$17.75 ,$120.00 ,$51.68 ,$78.00 ,$71.64 ,$20.26 ,$33.60 ,$79.44 ,$20.26 ,$79.44 ,$20.26 ,$71.52 ,$71.52 ,$20.26 ,$71.52 ,$41.75 ,$92.40 ,$51.68 ,$20.26 ,$20.66 ,$90.00 ,$85.20 ,$85.20 ,$20.26 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$51.68 ,$102.00 ,$20.26 ,$120.00 ,$67.32 ,$20.26 ,$49.68 ,$19.53 ,$17.75 ,$20.26 ,$102.00 ,$43.41 ,$71.52 ,$33.60 ,$108.00 ,$20.26 ,$102.00 ,$82.68 ,$82.68 ,$20.26 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,30101368,84144,HC PROGESTERONE-90,301,1 ,$154.00 ,$110.88 ,$10.21 ,$154.00 ,$52.15 ,$100.10 ,$91.94 ,$20.44 ,$43.12 ,$101.95 ,$20.44 ,$101.95 ,$20.44 ,$91.78 ,$91.78 ,$20.44 ,$91.78 ,$42.14 ,$118.58 ,$52.15 ,$20.44 ,$20.85 ,$115.50 ,$109.34 ,$109.34 ,$20.44 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$52.15 ,$130.90 ,$20.44 ,$154.00 ,$86.39 ,$20.44 ,$63.76 ,$11.23 ,$10.21 ,$20.44 ,$130.90 ,$43.81 ,$91.78 ,$43.12 ,$138.60 ,$20.44 ,$130.90 ,$83.44 ,$83.44 ,$20.44 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101370,84153,HC PSA TOTAL-90,301,1 ,$192.00 ,$138.24 ,$7.58 ,$192.00 ,$45.98 ,$124.80 ,$114.62 ,$18.02 ,$53.76 ,$127.10 ,$18.02 ,$127.10 ,$18.02 ,$114.43 ,$114.43 ,$18.02 ,$114.43 ,$37.15 ,$147.84 ,$45.98 ,$18.02 ,$18.38 ,$144.00 ,$136.32 ,$136.32 ,$18.02 ,$136.32 ,$163.20 ,$163.20 ,$163.20 , N/A ,$45.98 ,$163.20 ,$18.02 ,$192.00 ,$107.71 ,$18.02 ,$79.49 ,$8.34 ,$7.58 ,$18.02 ,$163.20 ,$38.62 ,$114.43 ,$53.76 ,$172.80 ,$18.02 ,$163.20 ,$73.56 ,$73.56 ,$18.02 ,$124.80 ST. JOSEPH'S HOSPITAL - BREESE,30101372,84155,HC PROTEIN TOTAL-90,301,1 ,$58.00 ,$41.76 ,$3.37 ,$58.00 ,$9.18 ,$37.70 ,$34.63 ,$3.60 ,$16.24 ,$38.40 ,$3.60 ,$38.40 ,$3.60 ,$34.57 ,$34.57 ,$3.60 ,$34.57 ,$7.41 ,$44.66 ,$9.18 ,$3.60 ,$3.67 ,$43.50 ,$41.18 ,$41.18 ,$3.60 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$9.18 ,$49.30 ,$3.60 ,$58.00 ,$32.54 ,$3.60 ,$24.01 ,$3.71 ,$3.37 ,$3.60 ,$49.30 ,$7.71 ,$34.57 ,$16.24 ,$52.20 ,$3.60 ,$49.30 ,$14.68 ,$14.68 ,$3.60 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101373,84156,HC PROTEIN TOTAL URINE-90,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$9.18 ,$60.45 ,$55.52 ,$3.60 ,$26.04 ,$61.57 ,$3.60 ,$61.57 ,$3.60 ,$55.43 ,$55.43 ,$3.60 ,$55.43 ,$7.41 ,$71.61 ,$9.18 ,$3.60 ,$3.67 ,$69.75 ,$66.03 ,$66.03 ,$3.60 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$9.18 ,$79.05 ,$3.60 ,$93.00 ,$52.17 ,$3.60 ,$38.50 ,$3.71 ,$3.37 ,$3.60 ,$79.05 ,$7.71 ,$55.43 ,$26.04 ,$83.70 ,$3.60 ,$79.05 ,$14.68 ,$14.68 ,$3.60 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101374,84157,HC PROTEIN TOTAL OTH SRC-90,301,1 ,$30.00 ,$21.60 ,$3.37 ,$30.00 ,$10.00 ,$19.50 ,$17.91 ,$3.92 ,$8.40 ,$19.86 ,$3.92 ,$19.86 ,$3.92 ,$17.88 ,$17.88 ,$3.92 ,$17.88 ,$8.08 ,$23.10 ,$10.00 ,$3.92 ,$4.00 ,$22.50 ,$21.30 ,$21.30 ,$3.92 ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A ,$10.00 ,$25.50 ,$3.92 ,$30.00 ,$16.83 ,$3.92 ,$12.42 ,$3.71 ,$3.37 ,$3.92 ,$25.50 ,$8.40 ,$17.88 ,$8.40 ,$27.00 ,$3.92 ,$25.50 ,$16.00 ,$16.00 ,$3.92 ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,30101375,84165,HC PROTEIN ELECTROPHORESIS-90,301,1 ,$62.00 ,$44.64 ,$7.58 ,$62.00 ,$26.85 ,$40.30 ,$37.01 ,$10.53 ,$17.36 ,$41.04 ,$10.53 ,$41.04 ,$10.53 ,$36.95 ,$36.95 ,$10.53 ,$36.95 ,$21.69 ,$47.74 ,$26.85 ,$10.53 ,$10.73 ,$46.50 ,$44.02 ,$44.02 ,$10.53 ,$44.02 ,$52.70 ,$52.70 ,$52.70 , N/A ,$26.85 ,$52.70 ,$10.53 ,$62.00 ,$34.78 ,$10.53 ,$25.67 ,$8.34 ,$7.58 ,$10.53 ,$52.70 ,$22.55 ,$36.95 ,$17.36 ,$55.80 ,$10.53 ,$52.70 ,$42.96 ,$42.96 ,$10.53 ,$40.30 ST. JOSEPH'S HOSPITAL - BREESE,30101377,84166,HC PROTEIN EP OTH FLUID-90,301,1 ,$115.00 ,$82.80 ,$7.58 ,$115.00 ,$44.58 ,$74.75 ,$68.66 ,$17.47 ,$32.20 ,$76.13 ,$17.47 ,$76.13 ,$17.47 ,$68.54 ,$68.54 ,$17.47 ,$68.54 ,$36.02 ,$88.55 ,$44.58 ,$17.47 ,$17.83 ,$86.25 ,$81.65 ,$81.65 ,$17.47 ,$81.65 ,$97.75 ,$97.75 ,$97.75 , N/A ,$44.58 ,$97.75 ,$17.47 ,$115.00 ,$64.52 ,$17.47 ,$47.61 ,$8.34 ,$7.58 ,$17.47 ,$97.75 ,$37.44 ,$68.54 ,$32.20 ,$103.50 ,$17.47 ,$97.75 ,$71.32 ,$71.32 ,$17.47 ,$74.75 ST. JOSEPH'S HOSPITAL - BREESE,30101379,84181,HC PROTEIN WESTERN BLOT-90,301,1 ,$134.00 ,$96.48 ,$6.79 ,$134.00 ,$42.58 ,$87.10 ,$80.00 ,$16.69 ,$37.52 ,$88.71 ,$16.69 ,$88.71 ,$16.69 ,$79.86 ,$79.86 ,$16.69 ,$79.86 ,$34.40 ,$103.18 ,$42.58 ,$16.69 ,$17.02 ,$100.50 ,$95.14 ,$95.14 ,$16.69 ,$95.14 ,$113.90 ,$113.90 ,$113.90 , N/A ,$42.58 ,$113.90 ,$16.69 ,$134.00 ,$75.17 ,$16.69 ,$55.48 ,$7.47 ,$6.79 ,$16.69 ,$113.90 ,$35.76 ,$79.86 ,$37.52 ,$120.60 ,$16.69 ,$113.90 ,$68.12 ,$68.12 ,$16.69 ,$87.10 ST. JOSEPH'S HOSPITAL - BREESE,30101380,84182,HC PROTEIN WEST BLOT BAND ID-90,301,1 ,$106.00 ,$76.32 ,$11.71 ,$106.00 ,$73.03 ,$68.90 ,$63.28 ,$28.63 ,$29.68 ,$70.17 ,$28.63 ,$70.17 ,$28.63 ,$63.18 ,$63.18 ,$28.63 ,$63.18 ,$59.00 ,$81.62 ,$73.03 ,$28.63 ,$29.19 ,$79.50 ,$75.26 ,$75.26 ,$28.63 ,$75.26 ,$90.10 ,$90.10 ,$90.10 , N/A ,$73.03 ,$90.10 ,$28.63 ,$106.00 ,$59.47 ,$28.63 ,$43.88 ,$12.88 ,$11.71 ,$28.63 ,$90.10 ,$61.34 ,$63.18 ,$29.68 ,$95.40 ,$28.63 ,$90.10 ,$106.00 ,$106.00 ,$28.63 ,$68.90 ST. JOSEPH'S HOSPITAL - BREESE,30101381,84202,HC PROTOPORPHYRIN-90,301,1 ,$69.00 ,$49.68 ,$7.58 ,$69.00 ,$35.88 ,$44.85 ,$41.19 ,$14.06 ,$19.32 ,$45.68 ,$14.06 ,$45.68 ,$14.06 ,$41.12 ,$41.12 ,$14.06 ,$41.12 ,$28.99 ,$53.13 ,$35.88 ,$14.06 ,$14.35 ,$51.75 ,$48.99 ,$48.99 ,$14.06 ,$48.99 ,$58.65 ,$58.65 ,$58.65 , N/A ,$35.88 ,$58.65 ,$14.06 ,$69.00 ,$38.71 ,$14.06 ,$28.57 ,$8.34 ,$7.58 ,$14.06 ,$58.65 ,$30.14 ,$41.12 ,$19.32 ,$62.10 ,$14.06 ,$58.65 ,$57.40 ,$57.40 ,$14.06 ,$44.85 ST. JOSEPH'S HOSPITAL - BREESE,30101382,84206,HC PROINSULIN-90,301,1 ,$100.00 ,$72.00 ,$17.75 ,$100.00 ,$66.73 ,$65.00 ,$59.70 ,$26.16 ,$28.00 ,$66.20 ,$26.16 ,$66.20 ,$26.16 ,$59.60 ,$59.60 ,$26.16 ,$59.60 ,$53.91 ,$77.00 ,$66.73 ,$26.16 ,$26.68 ,$75.00 ,$71.00 ,$71.00 ,$26.16 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$66.73 ,$85.00 ,$26.16 ,$100.00 ,$56.10 ,$26.16 ,$41.40 ,$19.53 ,$17.75 ,$26.16 ,$85.00 ,$56.05 ,$59.60 ,$28.00 ,$90.00 ,$26.16 ,$85.00 ,$100.00 ,$100.00 ,$26.16 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,30101383,84207,HC VITAMIN B6-90,301,1 ,$115.00 ,$82.80 ,$7.58 ,$115.00 ,$70.25 ,$74.75 ,$68.66 ,$27.54 ,$32.20 ,$76.13 ,$27.54 ,$76.13 ,$27.54 ,$68.54 ,$68.54 ,$27.54 ,$68.54 ,$56.76 ,$88.55 ,$70.25 ,$27.54 ,$28.09 ,$86.25 ,$81.65 ,$81.65 ,$27.54 ,$81.65 ,$97.75 ,$97.75 ,$97.75 , N/A ,$70.25 ,$97.75 ,$27.54 ,$115.00 ,$64.52 ,$27.54 ,$47.61 ,$8.34 ,$7.58 ,$27.54 ,$97.75 ,$59.01 ,$68.54 ,$32.20 ,$103.50 ,$27.54 ,$97.75 ,$112.40 ,$112.40 ,$27.54 ,$74.75 ST. JOSEPH'S HOSPITAL - BREESE,30101386,84238,HC RECEPTOR ASSAY NON ENDO-90,301,1 ,$292.00 ,$210.24 ,$20.42 ,$292.00 ,$91.43 ,$189.80 ,$174.32 ,$35.84 ,$81.76 ,$193.30 ,$35.84 ,$193.30 ,$35.84 ,$174.03 ,$174.03 ,$35.84 ,$174.03 ,$73.87 ,$224.84 ,$91.43 ,$35.84 ,$36.55 ,$219.00 ,$207.32 ,$207.32 ,$35.84 ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A ,$91.43 ,$248.20 ,$35.84 ,$292.00 ,$163.81 ,$35.84 ,$120.89 ,$22.46 ,$20.42 ,$35.84 ,$248.20 ,$76.80 ,$174.03 ,$81.76 ,$262.80 ,$35.84 ,$248.20 ,$146.28 ,$146.28 ,$35.84 ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,30101387,84244,HC RENIN-90,301,1 ,$97.00 ,$69.84 ,$17.75 ,$97.00 ,$54.98 ,$63.05 ,$57.91 ,$21.55 ,$27.16 ,$64.21 ,$21.55 ,$64.21 ,$21.55 ,$57.81 ,$57.81 ,$21.55 ,$57.81 ,$44.42 ,$74.69 ,$54.98 ,$21.55 ,$21.98 ,$72.75 ,$68.87 ,$68.87 ,$21.55 ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A ,$54.98 ,$82.45 ,$21.55 ,$97.00 ,$54.42 ,$21.55 ,$40.16 ,$19.53 ,$17.75 ,$21.55 ,$82.45 ,$46.18 ,$57.81 ,$27.16 ,$87.30 ,$21.55 ,$82.45 ,$87.96 ,$87.96 ,$21.55 ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,30101388,84255,HC SELENIUM-90,301,1 ,$150.00 ,$108.00 ,$7.58 ,$150.00 ,$63.83 ,$97.50 ,$89.55 ,$25.02 ,$42.00 ,$99.30 ,$25.02 ,$99.30 ,$25.02 ,$89.40 ,$89.40 ,$25.02 ,$89.40 ,$51.57 ,$115.50 ,$63.83 ,$25.02 ,$25.52 ,$112.50 ,$106.50 ,$106.50 ,$25.02 ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A ,$63.83 ,$127.50 ,$25.02 ,$150.00 ,$84.15 ,$25.02 ,$62.10 ,$8.34 ,$7.58 ,$25.02 ,$127.50 ,$53.61 ,$89.40 ,$42.00 ,$135.00 ,$25.02 ,$127.50 ,$102.12 ,$102.12 ,$25.02 ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,30101389,84252,HC VITAMIN B-2 (RIBOFLAVIN)-90,301,1 ,$87.00 ,$62.64 ,$7.58 ,$87.00 ,$50.60 ,$56.55 ,$51.94 ,$19.84 ,$24.36 ,$57.59 ,$19.84 ,$57.59 ,$19.84 ,$51.85 ,$51.85 ,$19.84 ,$51.85 ,$40.88 ,$66.99 ,$50.60 ,$19.84 ,$20.23 ,$65.25 ,$61.77 ,$61.77 ,$19.84 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$50.60 ,$73.95 ,$19.84 ,$87.00 ,$48.81 ,$19.84 ,$36.02 ,$8.34 ,$7.58 ,$19.84 ,$73.95 ,$42.50 ,$51.85 ,$24.36 ,$78.30 ,$19.84 ,$73.95 ,$80.96 ,$80.96 ,$19.84 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$111.00 ,$79.92 ,$7.58 ,$111.00 ,$54.33 ,$72.15 ,$66.27 ,$21.30 ,$31.08 ,$73.48 ,$21.30 ,$73.48 ,$21.30 ,$66.16 ,$66.16 ,$21.30 ,$66.16 ,$43.89 ,$85.47 ,$54.33 ,$21.30 ,$21.72 ,$83.25 ,$78.81 ,$78.81 ,$21.30 ,$78.81 ,$94.35 ,$94.35 ,$94.35 , N/A ,$54.33 ,$94.35 ,$21.30 ,$111.00 ,$62.27 ,$21.30 ,$45.95 ,$8.34 ,$7.58 ,$21.30 ,$94.35 ,$45.63 ,$66.16 ,$31.08 ,$99.90 ,$21.30 ,$94.35 ,$86.92 ,$86.92 ,$21.30 ,$72.15 ST. JOSEPH'S HOSPITAL - BREESE,30101392,84260,HC SEROTONIN-90,301,1 ,$72.00 ,$51.84 ,$17.75 ,$77.45 ,$77.45 ,$46.80 ,$42.98 ,$30.36 ,$20.16 ,$47.66 ,$30.36 ,$47.66 ,$30.36 ,$42.91 ,$42.91 ,$30.36 ,$42.91 ,$62.58 ,$55.44 ,$77.45 ,$30.36 ,$30.97 ,$54.00 ,$51.12 ,$51.12 ,$30.36 ,$51.12 ,$61.20 ,$61.20 ,$61.20 , N/A ,$72.00 ,$61.20 ,$30.36 ,$72.00 ,$40.39 ,$30.36 ,$29.81 ,$19.53 ,$17.75 ,$30.36 ,$61.20 ,$65.06 ,$42.91 ,$20.16 ,$64.80 ,$30.36 ,$61.20 ,$72.00 ,$72.00 ,$30.36 ,$46.80 ST. JOSEPH'S HOSPITAL - BREESE,30101394,84300,HC SODIUM URINE-90,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$12.65 ,$60.45 ,$55.52 ,$4.96 ,$26.04 ,$61.57 ,$4.96 ,$61.57 ,$4.96 ,$55.43 ,$55.43 ,$4.96 ,$55.43 ,$10.22 ,$71.61 ,$12.65 ,$4.96 ,$5.06 ,$69.75 ,$66.03 ,$66.03 ,$4.96 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$12.65 ,$79.05 ,$4.96 ,$93.00 ,$52.17 ,$4.96 ,$38.50 ,$3.71 ,$3.37 ,$4.96 ,$79.05 ,$10.63 ,$55.43 ,$26.04 ,$83.70 ,$4.96 ,$79.05 ,$20.24 ,$20.24 ,$4.96 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$16.00 ,$11.52 ,$3.37 ,$16.00 ,$12.15 ,$10.40 ,$9.55 ,$4.76 ,$4.48 ,$10.59 ,$4.76 ,$10.59 ,$4.76 ,$9.54 ,$9.54 ,$4.76 ,$9.54 ,$9.82 ,$12.32 ,$12.15 ,$4.76 ,$4.86 ,$12.00 ,$11.36 ,$11.36 ,$4.76 ,$11.36 ,$13.60 ,$13.60 ,$13.60 , N/A ,$12.15 ,$13.60 ,$4.76 ,$16.00 ,$8.98 ,$4.76 ,$6.62 ,$3.71 ,$3.37 ,$4.76 ,$13.60 ,$10.21 ,$9.54 ,$4.48 ,$14.40 ,$4.76 ,$13.60 ,$16.00 ,$16.00 ,$4.76 ,$10.40 ST. JOSEPH'S HOSPITAL - BREESE,30101396,84305,HC SOMATOMEDIN-90,301,1 ,$140.00 ,$100.80 ,$17.75 ,$140.00 ,$53.15 ,$91.00 ,$83.58 ,$20.83 ,$39.20 ,$92.68 ,$20.83 ,$92.68 ,$20.83 ,$83.44 ,$83.44 ,$20.83 ,$83.44 ,$42.95 ,$107.80 ,$53.15 ,$20.83 ,$21.26 ,$105.00 ,$99.40 ,$99.40 ,$20.83 ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A ,$53.15 ,$119.00 ,$20.83 ,$140.00 ,$78.54 ,$20.83 ,$57.96 ,$19.53 ,$17.75 ,$20.83 ,$119.00 ,$44.65 ,$83.44 ,$39.20 ,$126.00 ,$20.83 ,$119.00 ,$85.04 ,$85.04 ,$20.83 ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$78.00 ,$56.16 ,$7.58 ,$78.00 ,$20.25 ,$50.70 ,$46.57 ,$7.94 ,$21.84 ,$51.64 ,$7.94 ,$51.64 ,$7.94 ,$46.49 ,$46.49 ,$7.94 ,$46.49 ,$16.36 ,$60.06 ,$20.25 ,$7.94 ,$8.09 ,$58.50 ,$55.38 ,$55.38 ,$7.94 ,$55.38 ,$66.30 ,$66.30 ,$66.30 , N/A ,$20.25 ,$66.30 ,$7.94 ,$78.00 ,$43.76 ,$7.94 ,$32.29 ,$8.34 ,$7.58 ,$7.94 ,$66.30 ,$17.01 ,$46.49 ,$21.84 ,$70.20 ,$7.94 ,$66.30 ,$32.40 ,$32.40 ,$7.94 ,$50.70 ST. JOSEPH'S HOSPITAL - BREESE,30101402,84376,HC SUGARS SINGLE QL-90,301,1 ,$4.80 ,$3.46 ,$1.34 ,$12.00 ,$12.00 ,$3.12 ,$2.87 ,$4.70 ,$1.34 ,$3.18 ,$4.70 ,$3.18 ,$4.70 ,$2.86 ,$2.86 ,$4.70 ,$2.86 ,$4.80 ,$3.70 ,$12.00 ,$4.70 ,$4.70 ,$3.60 ,$3.41 ,$3.41 ,$4.70 ,$3.41 ,$4.08 ,$4.08 ,$4.08 , N/A ,$4.80 ,$4.08 ,$4.70 ,$4.80 ,$2.69 ,$4.70 ,$1.99 ,$3.71 ,$3.37 ,$4.70 ,$4.08 ,$10.08 ,$2.86 ,$1.34 ,$4.32 ,$4.70 ,$4.08 ,$4.80 ,$4.80 ,$4.70 ,$3.12 ST. JOSEPH'S HOSPITAL - BREESE,30101405,84392,HC SULFATE URINE-90,301,1 ,$154.00 ,$110.88 ,$2.71 ,$154.00 ,$13.73 ,$100.10 ,$91.94 ,$5.38 ,$43.12 ,$101.95 ,$5.38 ,$101.95 ,$5.38 ,$91.78 ,$91.78 ,$5.38 ,$91.78 ,$11.09 ,$118.58 ,$13.73 ,$5.38 ,$5.49 ,$115.50 ,$109.34 ,$109.34 ,$5.38 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$13.73 ,$130.90 ,$5.38 ,$154.00 ,$86.39 ,$5.38 ,$63.76 ,$2.98 ,$2.71 ,$5.38 ,$130.90 ,$11.53 ,$91.78 ,$43.12 ,$138.60 ,$5.38 ,$130.90 ,$21.96 ,$21.96 ,$5.38 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$58.00 ,$41.76 ,$16.24 ,$63.68 ,$63.68 ,$37.70 ,$34.63 ,$24.96 ,$16.24 ,$38.40 ,$24.96 ,$38.40 ,$24.96 ,$34.57 ,$34.57 ,$24.96 ,$34.57 ,$51.45 ,$44.66 ,$63.68 ,$24.96 ,$25.46 ,$43.50 ,$41.18 ,$41.18 ,$24.96 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$58.00 ,$49.30 ,$24.96 ,$58.00 ,$32.54 ,$24.96 ,$24.01 ,$19.53 ,$17.75 ,$24.96 ,$49.30 ,$53.49 ,$34.57 ,$16.24 ,$52.20 ,$24.96 ,$49.30 ,$58.00 ,$58.00 ,$24.96 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$173.00 ,$124.56 ,$17.75 ,$173.00 ,$64.53 ,$112.45 ,$103.28 ,$25.29 ,$48.44 ,$114.53 ,$25.29 ,$114.53 ,$25.29 ,$103.11 ,$103.11 ,$25.29 ,$103.11 ,$52.14 ,$133.21 ,$64.53 ,$25.29 ,$25.80 ,$129.75 ,$122.83 ,$122.83 ,$25.29 ,$122.83 ,$147.05 ,$147.05 ,$147.05 , N/A ,$64.53 ,$147.05 ,$25.29 ,$173.00 ,$97.05 ,$25.29 ,$71.62 ,$19.53 ,$17.75 ,$25.29 ,$147.05 ,$54.20 ,$103.11 ,$48.44 ,$155.70 ,$25.29 ,$147.05 ,$103.24 ,$103.24 ,$25.29 ,$112.45 ST. JOSEPH'S HOSPITAL - BREESE,30101408,84425,HC VITAMIN B1-90,301,1 ,$107.00 ,$77.04 ,$7.58 ,$107.00 ,$53.08 ,$69.55 ,$63.88 ,$20.81 ,$29.96 ,$70.83 ,$20.81 ,$70.83 ,$20.81 ,$63.77 ,$63.77 ,$20.81 ,$63.77 ,$42.88 ,$82.39 ,$53.08 ,$20.81 ,$21.22 ,$80.25 ,$75.97 ,$75.97 ,$20.81 ,$75.97 ,$90.95 ,$90.95 ,$90.95 , N/A ,$53.08 ,$90.95 ,$20.81 ,$107.00 ,$60.03 ,$20.81 ,$44.30 ,$8.34 ,$7.58 ,$20.81 ,$90.95 ,$44.58 ,$63.77 ,$29.96 ,$96.30 ,$20.81 ,$90.95 ,$84.92 ,$84.92 ,$20.81 ,$69.55 ST. JOSEPH'S HOSPITAL - BREESE,30101409,84430,HC THIOCYANATE-90,301,1 ,$22.00 ,$15.84 ,$6.16 ,$29.08 ,$29.08 ,$14.30 ,$13.13 ,$11.40 ,$6.16 ,$14.56 ,$11.40 ,$14.56 ,$11.40 ,$13.11 ,$13.11 ,$11.40 ,$13.11 ,$22.00 ,$16.94 ,$29.08 ,$11.40 ,$11.62 ,$16.50 ,$15.62 ,$15.62 ,$11.40 ,$15.62 ,$18.70 ,$18.70 ,$18.70 , N/A ,$22.00 ,$18.70 ,$11.40 ,$22.00 ,$12.34 ,$11.40 ,$9.11 ,$10.18 ,$9.25 ,$11.40 ,$18.70 ,$24.42 ,$13.11 ,$6.16 ,$19.80 ,$11.40 ,$18.70 ,$22.00 ,$22.00 ,$11.40 ,$14.30 ST. JOSEPH'S HOSPITAL - BREESE,30101410,84432,HC THYROGLOBULIN-90,301,1 ,$188.00 ,$135.36 ,$15.74 ,$188.00 ,$40.15 ,$122.20 ,$112.24 ,$15.74 ,$52.64 ,$124.46 ,$15.74 ,$124.46 ,$15.74 ,$112.05 ,$112.05 ,$15.74 ,$112.05 ,$32.44 ,$144.76 ,$40.15 ,$15.74 ,$16.05 ,$141.00 ,$133.48 ,$133.48 ,$15.74 ,$133.48 ,$159.80 ,$159.80 ,$159.80 , N/A ,$40.15 ,$159.80 ,$15.74 ,$188.00 ,$105.47 ,$15.74 ,$77.83 ,$19.53 ,$17.75 ,$15.74 ,$159.80 ,$33.73 ,$112.05 ,$52.64 ,$169.20 ,$15.74 ,$159.80 ,$64.24 ,$64.24 ,$15.74 ,$122.20 ST. JOSEPH'S HOSPITAL - BREESE,30101413,84439,HC T4 FREE-90,301,1 ,$23.00 ,$16.56 ,$6.44 ,$23.00 ,$22.55 ,$14.95 ,$13.73 ,$8.84 ,$6.44 ,$15.23 ,$8.84 ,$15.23 ,$8.84 ,$13.71 ,$13.71 ,$8.84 ,$13.71 ,$18.22 ,$17.71 ,$22.55 ,$8.84 ,$9.02 ,$17.25 ,$16.33 ,$16.33 ,$8.84 ,$16.33 ,$19.55 ,$19.55 ,$19.55 , N/A ,$22.55 ,$19.55 ,$8.84 ,$23.00 ,$12.90 ,$8.84 ,$9.52 ,$11.23 ,$10.21 ,$8.84 ,$19.55 ,$18.94 ,$13.71 ,$6.44 ,$20.70 ,$8.84 ,$19.55 ,$23.00 ,$23.00 ,$8.84 ,$14.95 ST. JOSEPH'S HOSPITAL - BREESE,30101415,84442,HC THYROXINE BIND GLOB-90,301,1 ,$61.00 ,$43.92 ,$10.21 ,$61.00 ,$36.95 ,$39.65 ,$36.42 ,$14.48 ,$17.08 ,$40.38 ,$14.48 ,$40.38 ,$14.48 ,$36.36 ,$36.36 ,$14.48 ,$36.36 ,$29.86 ,$46.97 ,$36.95 ,$14.48 ,$14.78 ,$45.75 ,$43.31 ,$43.31 ,$14.48 ,$43.31 ,$51.85 ,$51.85 ,$51.85 , N/A ,$36.95 ,$51.85 ,$14.48 ,$61.00 ,$34.22 ,$14.48 ,$25.25 ,$11.23 ,$10.21 ,$14.48 ,$51.85 ,$31.04 ,$36.36 ,$17.08 ,$54.90 ,$14.48 ,$51.85 ,$59.12 ,$59.12 ,$14.48 ,$39.65 ST. JOSEPH'S HOSPITAL - BREESE,30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$117.00 ,$84.24 ,$17.75 ,$127.15 ,$127.15 ,$76.05 ,$69.85 ,$49.84 ,$32.76 ,$77.45 ,$49.84 ,$77.45 ,$49.84 ,$69.73 ,$69.73 ,$49.84 ,$69.73 ,$102.74 ,$90.09 ,$127.15 ,$49.84 ,$50.84 ,$87.75 ,$83.07 ,$83.07 ,$49.84 ,$83.07 ,$99.45 ,$99.45 ,$99.45 , N/A ,$117.00 ,$99.45 ,$49.84 ,$117.00 ,$65.64 ,$49.84 ,$48.44 ,$19.53 ,$17.75 ,$49.84 ,$99.45 ,$106.81 ,$69.73 ,$32.76 ,$105.30 ,$49.84 ,$99.45 ,$117.00 ,$117.00 ,$49.84 ,$76.05 ST. JOSEPH'S HOSPITAL - BREESE,30101418,84446,HC VITAMIN E-90,301,1 ,$57.00 ,$41.04 ,$7.58 ,$57.00 ,$35.45 ,$37.05 ,$34.03 ,$13.90 ,$15.96 ,$37.73 ,$13.90 ,$37.73 ,$13.90 ,$33.97 ,$33.97 ,$13.90 ,$33.97 ,$28.64 ,$43.89 ,$35.45 ,$13.90 ,$14.17 ,$42.75 ,$40.47 ,$40.47 ,$13.90 ,$40.47 ,$48.45 ,$48.45 ,$48.45 , N/A ,$35.45 ,$48.45 ,$13.90 ,$57.00 ,$31.98 ,$13.90 ,$23.60 ,$8.34 ,$7.58 ,$13.90 ,$48.45 ,$29.78 ,$33.97 ,$15.96 ,$51.30 ,$13.90 ,$48.45 ,$56.72 ,$56.72 ,$13.90 ,$37.05 ST. JOSEPH'S HOSPITAL - BREESE,30101419,84460,HC ALT-90,301,1 ,$37.00 ,$26.64 ,$3.37 ,$37.00 ,$13.25 ,$24.05 ,$22.09 ,$5.19 ,$10.36 ,$24.49 ,$5.19 ,$24.49 ,$5.19 ,$22.05 ,$22.05 ,$5.19 ,$22.05 ,$10.71 ,$28.49 ,$13.25 ,$5.19 ,$5.30 ,$27.75 ,$26.27 ,$26.27 ,$5.19 ,$26.27 ,$31.45 ,$31.45 ,$31.45 , N/A ,$13.25 ,$31.45 ,$5.19 ,$37.00 ,$20.76 ,$5.19 ,$15.32 ,$3.71 ,$3.37 ,$5.19 ,$31.45 ,$11.13 ,$22.05 ,$10.36 ,$33.30 ,$5.19 ,$31.45 ,$21.20 ,$21.20 ,$5.19 ,$24.05 ST. JOSEPH'S HOSPITAL - BREESE,30101420,84466,HC TRANSFERRIN-90,301,1 ,$146.00 ,$105.12 ,$7.58 ,$146.00 ,$31.90 ,$94.90 ,$87.16 ,$12.50 ,$40.88 ,$96.65 ,$12.50 ,$96.65 ,$12.50 ,$87.02 ,$87.02 ,$12.50 ,$87.02 ,$25.78 ,$112.42 ,$31.90 ,$12.50 ,$12.76 ,$109.50 ,$103.66 ,$103.66 ,$12.50 ,$103.66 ,$124.10 ,$124.10 ,$124.10 , N/A ,$31.90 ,$124.10 ,$12.50 ,$146.00 ,$81.91 ,$12.50 ,$60.44 ,$8.34 ,$7.58 ,$12.50 ,$124.10 ,$26.80 ,$87.02 ,$40.88 ,$131.40 ,$12.50 ,$124.10 ,$51.04 ,$51.04 ,$12.50 ,$94.90 ST. JOSEPH'S HOSPITAL - BREESE,30101421,84478,HC TRIGLYCERIDES-90,301,1 ,$86.00 ,$61.92 ,$3.37 ,$86.00 ,$14.35 ,$55.90 ,$51.34 ,$5.63 ,$24.08 ,$56.93 ,$5.63 ,$56.93 ,$5.63 ,$51.26 ,$51.26 ,$5.63 ,$51.26 ,$11.59 ,$66.22 ,$14.35 ,$5.63 ,$5.73 ,$64.50 ,$61.06 ,$61.06 ,$5.63 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$14.35 ,$73.10 ,$5.63 ,$86.00 ,$48.25 ,$5.63 ,$35.60 ,$3.71 ,$3.37 ,$5.63 ,$73.10 ,$12.05 ,$51.26 ,$24.08 ,$77.40 ,$5.63 ,$73.10 ,$22.96 ,$22.96 ,$5.63 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30101422,84479,HC T3 UPTAKE-90,301,1 ,$73.00 ,$52.56 ,$6.34 ,$73.00 ,$16.18 ,$47.45 ,$43.58 ,$6.34 ,$20.44 ,$48.33 ,$6.34 ,$48.33 ,$6.34 ,$43.51 ,$43.51 ,$6.34 ,$43.51 ,$13.07 ,$56.21 ,$16.18 ,$6.34 ,$6.47 ,$54.75 ,$51.83 ,$51.83 ,$6.34 ,$51.83 ,$62.05 ,$62.05 ,$62.05 , N/A ,$16.18 ,$62.05 ,$6.34 ,$73.00 ,$40.95 ,$6.34 ,$30.22 ,$11.23 ,$10.21 ,$6.34 ,$62.05 ,$13.59 ,$43.51 ,$20.44 ,$65.70 ,$6.34 ,$62.05 ,$25.88 ,$25.88 ,$6.34 ,$47.45 ST. JOSEPH'S HOSPITAL - BREESE,30101423,84480,HC T3 TOTAL-90,301,1 ,$134.00 ,$96.48 ,$10.21 ,$134.00 ,$35.45 ,$87.10 ,$80.00 ,$13.90 ,$37.52 ,$88.71 ,$13.90 ,$88.71 ,$13.90 ,$79.86 ,$79.86 ,$13.90 ,$79.86 ,$28.64 ,$103.18 ,$35.45 ,$13.90 ,$14.17 ,$100.50 ,$95.14 ,$95.14 ,$13.90 ,$95.14 ,$113.90 ,$113.90 ,$113.90 , N/A ,$35.45 ,$113.90 ,$13.90 ,$134.00 ,$75.17 ,$13.90 ,$55.48 ,$11.23 ,$10.21 ,$13.90 ,$113.90 ,$29.78 ,$79.86 ,$37.52 ,$120.60 ,$13.90 ,$113.90 ,$56.72 ,$56.72 ,$13.90 ,$87.10 ST. JOSEPH'S HOSPITAL - BREESE,30101425,84482,HC T3 REVERSE-90,301,1 ,$82.00 ,$59.04 ,$10.21 ,$82.00 ,$39.40 ,$53.30 ,$48.95 ,$15.44 ,$22.96 ,$54.28 ,$15.44 ,$54.28 ,$15.44 ,$48.87 ,$48.87 ,$15.44 ,$48.87 ,$31.84 ,$63.14 ,$39.40 ,$15.44 ,$15.76 ,$61.50 ,$58.22 ,$58.22 ,$15.44 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$39.40 ,$69.70 ,$15.44 ,$82.00 ,$46.00 ,$15.44 ,$33.95 ,$11.23 ,$10.21 ,$15.44 ,$69.70 ,$33.10 ,$48.87 ,$22.96 ,$73.80 ,$15.44 ,$69.70 ,$63.04 ,$63.04 ,$15.44 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$52.00 ,$37.44 ,$3.37 ,$52.00 ,$12.70 ,$33.80 ,$31.04 ,$4.98 ,$14.56 ,$34.42 ,$4.98 ,$34.42 ,$4.98 ,$30.99 ,$30.99 ,$4.98 ,$30.99 ,$10.26 ,$40.04 ,$12.70 ,$4.98 ,$5.08 ,$39.00 ,$36.92 ,$36.92 ,$4.98 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$12.70 ,$44.20 ,$4.98 ,$52.00 ,$29.17 ,$4.98 ,$21.53 ,$3.71 ,$3.37 ,$4.98 ,$44.20 ,$10.67 ,$30.99 ,$14.56 ,$46.80 ,$4.98 ,$44.20 ,$20.32 ,$20.32 ,$4.98 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$98.00 ,$70.56 ,$15.19 ,$98.00 ,$38.75 ,$63.70 ,$58.51 ,$15.19 ,$27.44 ,$64.88 ,$15.19 ,$64.88 ,$15.19 ,$58.41 ,$58.41 ,$15.19 ,$58.41 ,$31.31 ,$75.46 ,$38.75 ,$15.19 ,$15.49 ,$73.50 ,$69.58 ,$69.58 ,$15.19 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$38.75 ,$83.30 ,$15.19 ,$98.00 ,$54.98 ,$15.19 ,$40.57 ,$19.53 ,$17.75 ,$15.19 ,$83.30 ,$32.55 ,$58.41 ,$27.44 ,$88.20 ,$15.19 ,$83.30 ,$62.00 ,$62.00 ,$15.19 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,30101436,84586,HC VASOACTIVE INTEST PEPTIDE-90,301,1 ,$158.00 ,$113.76 ,$17.75 ,$158.00 ,$88.33 ,$102.70 ,$94.33 ,$34.62 ,$44.24 ,$104.60 ,$34.62 ,$104.60 ,$34.62 ,$94.17 ,$94.17 ,$34.62 ,$94.17 ,$71.37 ,$121.66 ,$88.33 ,$34.62 ,$35.32 ,$118.50 ,$112.18 ,$112.18 ,$34.62 ,$112.18 ,$134.30 ,$134.30 ,$134.30 , N/A ,$88.33 ,$134.30 ,$34.62 ,$158.00 ,$88.64 ,$34.62 ,$65.41 ,$19.53 ,$17.75 ,$34.62 ,$134.30 ,$74.19 ,$94.17 ,$44.24 ,$142.20 ,$34.62 ,$134.30 ,$141.32 ,$141.32 ,$34.62 ,$102.70 ST. JOSEPH'S HOSPITAL - BREESE,30101437,84588,HC VASOPRESSIN (ADH)-90,301,1 ,$152.00 ,$109.44 ,$17.75 ,$152.00 ,$84.85 ,$98.80 ,$90.74 ,$33.26 ,$42.56 ,$100.62 ,$33.26 ,$100.62 ,$33.26 ,$90.59 ,$90.59 ,$33.26 ,$90.59 ,$68.56 ,$117.04 ,$84.85 ,$33.26 ,$33.93 ,$114.00 ,$107.92 ,$107.92 ,$33.26 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$84.85 ,$129.20 ,$33.26 ,$152.00 ,$85.27 ,$33.26 ,$62.93 ,$19.53 ,$17.75 ,$33.26 ,$129.20 ,$71.27 ,$90.59 ,$42.56 ,$136.80 ,$33.26 ,$129.20 ,$135.76 ,$135.76 ,$33.26 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,30101438,84590,HC VITAMIN A-90,301,1 ,$67.00 ,$48.24 ,$7.58 ,$67.00 ,$29.03 ,$43.55 ,$40.00 ,$11.38 ,$18.76 ,$44.35 ,$11.38 ,$44.35 ,$11.38 ,$39.93 ,$39.93 ,$11.38 ,$39.93 ,$23.45 ,$51.59 ,$29.03 ,$11.38 ,$11.60 ,$50.25 ,$47.57 ,$47.57 ,$11.38 ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A ,$29.03 ,$56.95 ,$11.38 ,$67.00 ,$37.59 ,$11.38 ,$27.74 ,$8.34 ,$7.58 ,$11.38 ,$56.95 ,$24.38 ,$39.93 ,$18.76 ,$60.30 ,$11.38 ,$56.95 ,$46.44 ,$46.44 ,$11.38 ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,30101439,84591,HC VITAMIN A OTHER-90,301,1 ,$123.00 ,$88.56 ,$8.71 ,$123.00 ,$42.65 ,$79.95 ,$73.43 ,$16.72 ,$34.44 ,$81.43 ,$16.72 ,$81.43 ,$16.72 ,$73.31 ,$73.31 ,$16.72 ,$73.31 ,$34.46 ,$94.71 ,$42.65 ,$16.72 ,$17.05 ,$92.25 ,$87.33 ,$87.33 ,$16.72 ,$87.33 ,$104.55 ,$104.55 ,$104.55 , N/A ,$42.65 ,$104.55 ,$16.72 ,$123.00 ,$69.00 ,$16.72 ,$50.92 ,$9.58 ,$8.71 ,$16.72 ,$104.55 ,$35.83 ,$73.31 ,$34.44 ,$110.70 ,$16.72 ,$104.55 ,$68.24 ,$68.24 ,$16.72 ,$79.95 ST. JOSEPH'S HOSPITAL - BREESE,30101440,84597,HC VITAMIN K-90,301,1 ,$107.00 ,$77.04 ,$7.58 ,$107.00 ,$34.30 ,$69.55 ,$63.88 ,$13.45 ,$29.96 ,$70.83 ,$13.45 ,$70.83 ,$13.45 ,$63.77 ,$63.77 ,$13.45 ,$63.77 ,$27.71 ,$82.39 ,$34.30 ,$13.45 ,$13.71 ,$80.25 ,$75.97 ,$75.97 ,$13.45 ,$75.97 ,$90.95 ,$90.95 ,$90.95 , N/A ,$34.30 ,$90.95 ,$13.45 ,$107.00 ,$60.03 ,$13.45 ,$44.30 ,$8.34 ,$7.58 ,$13.45 ,$90.95 ,$28.81 ,$63.77 ,$29.96 ,$96.30 ,$13.45 ,$90.95 ,$54.88 ,$54.88 ,$13.45 ,$69.55 ST. JOSEPH'S HOSPITAL - BREESE,30101441,84600,HC VOLATILES-90,301,1 ,$58.00 ,$41.76 ,$7.58 ,$58.00 ,$42.78 ,$37.70 ,$34.63 ,$16.77 ,$16.24 ,$38.40 ,$16.77 ,$38.40 ,$16.77 ,$34.57 ,$34.57 ,$16.77 ,$34.57 ,$34.56 ,$44.66 ,$42.78 ,$16.77 ,$17.10 ,$43.50 ,$41.18 ,$41.18 ,$16.77 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$42.78 ,$49.30 ,$16.77 ,$58.00 ,$32.54 ,$16.77 ,$24.01 ,$8.34 ,$7.58 ,$16.77 ,$49.30 ,$35.93 ,$34.57 ,$16.24 ,$52.20 ,$16.77 ,$49.30 ,$58.00 ,$58.00 ,$16.77 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30101442,84630,HC ZINC-90,301,1 ,$82.00 ,$59.04 ,$9.25 ,$82.00 ,$28.48 ,$53.30 ,$48.95 ,$11.16 ,$22.96 ,$54.28 ,$11.16 ,$54.28 ,$11.16 ,$48.87 ,$48.87 ,$11.16 ,$48.87 ,$23.01 ,$63.14 ,$28.48 ,$11.16 ,$11.39 ,$61.50 ,$58.22 ,$58.22 ,$11.16 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$28.48 ,$69.70 ,$11.16 ,$82.00 ,$46.00 ,$11.16 ,$33.95 ,$10.18 ,$9.25 ,$11.16 ,$69.70 ,$23.92 ,$48.87 ,$22.96 ,$73.80 ,$11.16 ,$69.70 ,$45.56 ,$45.56 ,$11.16 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30101443,84681,HC C PEPTIDE-90,301,1 ,$92.00 ,$66.24 ,$7.58 ,$92.00 ,$52.03 ,$59.80 ,$54.92 ,$20.39 ,$25.76 ,$60.90 ,$20.39 ,$60.90 ,$20.39 ,$54.83 ,$54.83 ,$20.39 ,$54.83 ,$42.04 ,$70.84 ,$52.03 ,$20.39 ,$20.81 ,$69.00 ,$65.32 ,$65.32 ,$20.39 ,$65.32 ,$78.20 ,$78.20 ,$78.20 , N/A ,$52.03 ,$78.20 ,$20.39 ,$92.00 ,$51.61 ,$20.39 ,$38.09 ,$8.34 ,$7.58 ,$20.39 ,$78.20 ,$43.70 ,$54.83 ,$25.76 ,$82.80 ,$20.39 ,$78.20 ,$83.24 ,$83.24 ,$20.39 ,$59.80 ST. JOSEPH'S HOSPITAL - BREESE,30101444,84702,HC HCG QN-90,301,1 ,$193.00 ,$138.96 ,$10.21 ,$193.00 ,$37.63 ,$125.45 ,$115.22 ,$14.75 ,$54.04 ,$127.77 ,$14.75 ,$127.77 ,$14.75 ,$115.03 ,$115.03 ,$14.75 ,$115.03 ,$30.40 ,$148.61 ,$37.63 ,$14.75 ,$15.04 ,$144.75 ,$137.03 ,$137.03 ,$14.75 ,$137.03 ,$164.05 ,$164.05 ,$164.05 , N/A ,$37.63 ,$164.05 ,$14.75 ,$193.00 ,$108.27 ,$14.75 ,$79.90 ,$11.23 ,$10.21 ,$14.75 ,$164.05 ,$31.61 ,$115.03 ,$54.04 ,$173.70 ,$14.75 ,$164.05 ,$60.20 ,$60.20 ,$14.75 ,$125.45 ST. JOSEPH'S HOSPITAL - BREESE,30101455,G0480,HC DRUG SCRN DEFNT 1-7 CLS T1-90,301,1 ,$60.00 ,$43.20 ,$16.80 ,$150.00 ,$150.00 ,$39.00 ,$35.82 ,$58.80 ,$16.80 ,$39.72 ,$58.80 ,$39.72 ,$58.80 ,$35.76 ,$35.76 ,$58.80 ,$35.76 ,$60.00 ,$46.20 ,$150.00 ,$58.80 ,$58.80 ,$45.00 ,$42.60 ,$42.60 ,$58.80 ,$42.60 ,$51.00 ,$51.00 ,$51.00 , N/A ,$60.00 ,$51.00 ,$58.80 ,$60.00 ,$33.66 ,$58.80 ,$24.84 ,$22.46 ,$20.42 ,$58.80 ,$51.00 ,$126.00 ,$35.76 ,$16.80 ,$54.00 ,$58.80 ,$51.00 ,$60.00 ,$60.00 ,$58.80 ,$39.00 ST. JOSEPH'S HOSPITAL - BREESE,30101456,G0480,HC DRUG SCRN DEFNT 1-7 CLS T2-90,301,1 ,$148.00 ,$106.56 ,$20.42 ,$286.08 ,$286.08 ,$96.20 ,$88.36 ,$112.14 ,$41.44 ,$97.98 ,$112.14 ,$97.98 ,$112.14 ,$88.21 ,$88.21 ,$112.14 ,$88.21 ,$148.00 ,$113.96 ,$286.08 ,$112.14 ,$114.39 ,$111.00 ,$105.08 ,$105.08 ,$112.14 ,$105.08 ,$125.80 ,$125.80 ,$125.80 , N/A ,$148.00 ,$125.80 ,$112.14 ,$148.00 ,$83.03 ,$112.14 ,$61.27 ,$22.46 ,$20.42 ,$112.14 ,$125.80 ,$240.30 ,$88.21 ,$41.44 ,$133.20 ,$112.14 ,$125.80 ,$148.00 ,$148.00 ,$112.14 ,$96.20 ST. JOSEPH'S HOSPITAL - BREESE,30101457,G0480,HC DRUG SCRN DEFNT 1-7 CLS T3-90,301,1 ,$237.00 ,$170.64 ,$20.42 ,$286.08 ,$286.08 ,$154.05 ,$141.49 ,$112.14 ,$66.36 ,$156.89 ,$112.14 ,$156.89 ,$112.14 ,$141.25 ,$141.25 ,$112.14 ,$141.25 ,$231.15 ,$182.49 ,$286.08 ,$112.14 ,$114.39 ,$177.75 ,$168.27 ,$168.27 ,$112.14 ,$168.27 ,$201.45 ,$201.45 ,$201.45 , N/A ,$237.00 ,$201.45 ,$112.14 ,$237.00 ,$132.96 ,$112.14 ,$98.12 ,$22.46 ,$20.42 ,$112.14 ,$201.45 ,$240.30 ,$141.25 ,$66.36 ,$213.30 ,$112.14 ,$201.45 ,$237.00 ,$237.00 ,$112.14 ,$154.05 ST. JOSEPH'S HOSPITAL - BREESE,30101463,G0483,HC DRUG SCRN DEFINT 22+ CLASS-90,301,1 ,$263.00 ,$189.36 ,$20.42 ,$617.30 ,$617.30 ,$170.95 ,$157.01 ,$241.98 ,$73.64 ,$174.11 ,$241.98 ,$174.11 ,$241.98 ,$156.75 ,$156.75 ,$241.98 ,$156.75 ,$263.00 ,$202.51 ,$617.30 ,$241.98 ,$246.82 ,$197.25 ,$186.73 ,$186.73 ,$241.98 ,$186.73 ,$223.55 ,$223.55 ,$223.55 , N/A ,$263.00 ,$223.55 ,$241.98 ,$263.00 ,$147.54 ,$241.98 ,$108.88 ,$22.46 ,$20.42 ,$241.98 ,$223.55 ,$518.53 ,$156.75 ,$73.64 ,$236.70 ,$241.98 ,$223.55 ,$263.00 ,$263.00 ,$241.98 ,$170.95 ST. JOSEPH'S HOSPITAL - BREESE,30101464,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$46.00 ,$33.12 ,$3.37 ,$46.00 ,$10.58 ,$29.90 ,$27.46 ,$4.15 ,$12.88 ,$30.45 ,$4.15 ,$30.45 ,$4.15 ,$27.42 ,$27.42 ,$4.15 ,$27.42 ,$8.54 ,$35.42 ,$10.58 ,$4.15 ,$4.22 ,$34.50 ,$32.66 ,$32.66 ,$4.15 ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A ,$10.58 ,$39.10 ,$4.15 ,$46.00 ,$25.81 ,$4.15 ,$19.04 ,$3.71 ,$3.37 ,$4.15 ,$39.10 ,$8.88 ,$27.42 ,$12.88 ,$41.40 ,$4.15 ,$39.10 ,$16.92 ,$16.92 ,$4.15 ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,30101465,83921,HC ORGANIC ACIDS QN SINGLE-90,301,1 ,$183.00 ,$131.76 ,$7.58 ,$183.00 ,$53.03 ,$118.95 ,$109.25 ,$20.79 ,$51.24 ,$121.15 ,$20.79 ,$121.15 ,$20.79 ,$109.07 ,$109.07 ,$20.79 ,$109.07 ,$42.84 ,$140.91 ,$53.03 ,$20.79 ,$21.20 ,$137.25 ,$129.93 ,$129.93 ,$20.79 ,$129.93 ,$155.55 ,$155.55 ,$155.55 , N/A ,$53.03 ,$155.55 ,$20.79 ,$183.00 ,$102.66 ,$20.79 ,$75.76 ,$8.34 ,$7.58 ,$20.79 ,$155.55 ,$44.54 ,$109.07 ,$51.24 ,$164.70 ,$20.79 ,$155.55 ,$84.84 ,$84.84 ,$20.79 ,$118.95 ST. JOSEPH'S HOSPITAL - BREESE,30101473,80339,HC ANTIEPILIPTICS NOS 1-3 -90,301,1 ,$81.00 ,$58.32 ,$20.42 ,$81.00 , N/A ,$52.65 ,$48.36 , N/A ,$22.68 ,$53.62 , N/A ,$53.62 , N/A ,$48.28 ,$48.28 , N/A ,$48.28 , N/A ,$62.37 , N/A , N/A , N/A ,$60.75 ,$57.51 ,$57.51 , N/A ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A , N/A ,$68.85 , N/A ,$81.00 ,$45.44 , N/A ,$33.53 ,$22.46 ,$20.42 , N/A ,$68.85 , N/A ,$48.28 ,$22.68 ,$72.90 , N/A ,$68.85 , N/A , N/A , N/A ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,30101476,82610,HC CYSTATIN C -90,301,1 ,$141.00 ,$101.52 ,$7.58 ,$141.00 ,$46.30 ,$91.65 ,$84.18 ,$18.15 ,$39.48 ,$93.34 ,$18.15 ,$93.34 ,$18.15 ,$84.04 ,$84.04 ,$18.15 ,$84.04 ,$37.41 ,$108.57 ,$46.30 ,$18.15 ,$18.51 ,$105.75 ,$100.11 ,$100.11 ,$18.15 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$46.30 ,$119.85 ,$18.15 ,$141.00 ,$79.10 ,$18.15 ,$58.37 ,$8.34 ,$7.58 ,$18.15 ,$119.85 ,$38.89 ,$84.04 ,$39.48 ,$126.90 ,$18.15 ,$119.85 ,$74.08 ,$74.08 ,$18.15 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,30101477,83519,HC QN RIA MUSK-90,301,1 ,"$1,920.00 ","$1,382.40 ",$6.79 ,"$1,920.00 ",$46.00 ,"$1,248.00 ","$1,146.24 ",$18.03 ,$537.60 ,"$1,271.04 ",$18.03 ,"$1,271.04 ",$18.03 ,"$1,144.32 ","$1,144.32 ",$18.03 ,"$1,144.32 ",$37.17 ,$500.00 ,$46.00 ,$18.03 ,$18.39 ,"$1,440.00 ","$1,363.20 ","$1,363.20 ",$18.03 ,"$1,363.20 ","$1,632.00 ","$1,632.00 ","$1,632.00 ", N/A ,$46.00 ,"$1,632.00 ",$18.03 ,"$1,920.00 ","$1,077.12 ",$18.03 ,$794.88 ,$7.47 ,$6.79 ,$18.03 ,"$1,632.00 ",$38.64 ,"$1,144.32 ",$537.60 ,"$1,728.00 ",$18.03 ,"$1,632.00 ",$73.60 ,$73.60 ,$18.03 ,"$1,248.00 " ST. JOSEPH'S HOSPITAL - BREESE,30101478,82800,HC BLOOD GAS PH,301,1 ,$217.00 ,$156.24 ,$7.58 ,$217.00 ,$27.50 ,$141.05 ,$129.55 ,$10.78 ,$60.76 ,$143.65 ,$10.78 ,$143.65 ,$10.78 ,$129.33 ,$129.33 ,$10.78 ,$129.33 ,$22.22 ,$167.09 ,$27.50 ,$10.78 ,$11.00 ,$162.75 ,$154.07 ,$154.07 ,$10.78 ,$154.07 ,$184.45 ,$184.45 ,$184.45 , N/A ,$27.50 ,$184.45 ,$10.78 ,$217.00 ,$121.74 ,$10.78 ,$89.84 ,$8.34 ,$7.58 ,$10.78 ,$184.45 ,$23.10 ,$129.33 ,$60.76 ,$195.30 ,$10.78 ,$184.45 ,$44.00 ,$44.00 ,$10.78 ,$141.05 ST. JOSEPH'S HOSPITAL - BREESE,30101479,82803,HC BLOOD GAS PH PO2 AND /OR PCO2,301,1 ,$223.00 ,$160.56 ,$7.58 ,$223.00 ,$65.18 ,$144.95 ,$133.13 ,$25.55 ,$62.44 ,$147.63 ,$25.55 ,$147.63 ,$25.55 ,$132.91 ,$132.91 ,$25.55 ,$132.91 ,$52.66 ,$171.71 ,$65.18 ,$25.55 ,$26.06 ,$167.25 ,$158.33 ,$158.33 ,$25.55 ,$158.33 ,$189.55 ,$189.55 ,$189.55 , N/A ,$65.18 ,$189.55 ,$25.55 ,$223.00 ,$125.10 ,$25.55 ,$92.32 ,$8.34 ,$7.58 ,$25.55 ,$189.55 ,$54.75 ,$132.91 ,$62.44 ,$200.70 ,$25.55 ,$189.55 ,$104.28 ,$104.28 ,$25.55 ,$144.95 ST. JOSEPH'S HOSPITAL - BREESE,30101480,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$431.00 ,$310.32 ,$7.58 ,$431.00 ,$196.93 ,$280.15 ,$257.31 ,$77.19 ,$120.68 ,$285.32 ,$77.19 ,$285.32 ,$77.19 ,$256.88 ,$256.88 ,$77.19 ,$256.88 ,$159.12 ,$331.87 ,$196.93 ,$77.19 ,$78.74 ,$323.25 ,$306.01 ,$306.01 ,$77.19 ,$306.01 ,$366.35 ,$366.35 ,$366.35 , N/A ,$196.93 ,$366.35 ,$77.19 ,$431.00 ,$241.79 ,$77.19 ,$178.43 ,$8.34 ,$7.58 ,$77.19 ,$366.35 ,$165.42 ,$256.88 ,$120.68 ,$387.90 ,$77.19 ,$366.35 ,$315.08 ,$315.08 ,$77.19 ,$280.15 ST. JOSEPH'S HOSPITAL - BREESE,30101486,82375,HC CARBON MONOXIDE QN,301,1 ,$223.00 ,$160.56 ,$7.58 ,$223.00 ,$30.80 ,$144.95 ,$133.13 ,$12.07 ,$62.44 ,$147.63 ,$12.07 ,$147.63 ,$12.07 ,$132.91 ,$132.91 ,$12.07 ,$132.91 ,$24.89 ,$171.71 ,$30.80 ,$12.07 ,$12.32 ,$167.25 ,$158.33 ,$158.33 ,$12.07 ,$158.33 ,$189.55 ,$189.55 ,$189.55 , N/A ,$30.80 ,$189.55 ,$12.07 ,$223.00 ,$125.10 ,$12.07 ,$92.32 ,$8.34 ,$7.58 ,$12.07 ,$189.55 ,$25.87 ,$132.91 ,$62.44 ,$200.70 ,$12.07 ,$189.55 ,$49.28 ,$49.28 ,$12.07 ,$144.95 ST. JOSEPH'S HOSPITAL - BREESE,30101497,80373,HC TRAMADOL-90,301,1 ,$56.00 ,$40.32 ,$7.58 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A ,$43.12 , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 ,$8.34 ,$7.58 , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 , N/A , N/A , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101509,82330,HC CALCIUM IONIZED STAT -90,301,1 ,$95.00 ,$68.40 ,$7.58 ,$95.00 ,$34.20 ,$61.75 ,$56.72 ,$13.41 ,$26.60 ,$62.89 ,$13.41 ,$62.89 ,$13.41 ,$56.62 ,$56.62 ,$13.41 ,$56.62 ,$27.63 ,$73.15 ,$34.20 ,$13.41 ,$13.67 ,$71.25 ,$67.45 ,$67.45 ,$13.41 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$34.20 ,$80.75 ,$13.41 ,$95.00 ,$53.30 ,$13.41 ,$39.33 ,$8.34 ,$7.58 ,$13.41 ,$80.75 ,$28.73 ,$56.62 ,$26.60 ,$85.50 ,$13.41 ,$80.75 ,$54.72 ,$54.72 ,$13.41 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,30101511,80345,HC BARBITURATE -90,301,1 ,$47.00 ,$33.84 ,$7.58 ,$47.00 , N/A ,$30.55 ,$28.06 , N/A ,$13.16 ,$31.11 , N/A ,$31.11 , N/A ,$28.01 ,$28.01 , N/A ,$28.01 , N/A ,$36.19 , N/A , N/A , N/A ,$35.25 ,$33.37 ,$33.37 , N/A ,$33.37 ,$39.95 ,$39.95 ,$39.95 , N/A , N/A ,$39.95 , N/A ,$47.00 ,$26.37 , N/A ,$19.46 ,$8.34 ,$7.58 , N/A ,$39.95 , N/A ,$28.01 ,$13.16 ,$42.30 , N/A ,$39.95 , N/A , N/A , N/A ,$30.55 ST. JOSEPH'S HOSPITAL - BREESE,30101512,80324,HC AMPHETAMINE 1-2 -90,301,1 ,$47.00 ,$33.84 ,$13.16 ,$47.00 , N/A ,$30.55 ,$28.06 , N/A ,$13.16 ,$31.11 , N/A ,$31.11 , N/A ,$28.01 ,$28.01 , N/A ,$28.01 , N/A ,$36.19 , N/A , N/A , N/A ,$35.25 ,$33.37 ,$33.37 , N/A ,$33.37 ,$39.95 ,$39.95 ,$39.95 , N/A , N/A ,$39.95 , N/A ,$47.00 ,$26.37 , N/A ,$19.46 ,$22.46 ,$20.42 , N/A ,$39.95 , N/A ,$28.01 ,$13.16 ,$42.30 , N/A ,$39.95 , N/A , N/A , N/A ,$30.55 ST. JOSEPH'S HOSPITAL - BREESE,30101516,80321,HC ALCOHOL BIOMARKERS 1-2 - 90,301,1 ,$208.00 ,$149.76 ,$20.42 ,$208.00 , N/A ,$135.20 ,$124.18 , N/A ,$58.24 ,$137.70 , N/A ,$137.70 , N/A ,$123.97 ,$123.97 , N/A ,$123.97 , N/A ,$160.16 , N/A , N/A , N/A ,$156.00 ,$147.68 ,$147.68 , N/A ,$147.68 ,$176.80 ,$176.80 ,$176.80 , N/A , N/A ,$176.80 , N/A ,$208.00 ,$116.69 , N/A ,$86.11 ,$22.46 ,$20.42 , N/A ,$176.80 , N/A ,$123.97 ,$58.24 ,$187.20 , N/A ,$176.80 , N/A , N/A , N/A ,$135.20 ST. JOSEPH'S HOSPITAL - BREESE,30101525,82465,HC CHOLESTEROL -90,301,1 ,$37.00 ,$26.64 ,$3.37 ,$37.00 ,$10.88 ,$24.05 ,$22.09 ,$4.26 ,$10.36 ,$24.49 ,$4.26 ,$24.49 ,$4.26 ,$22.05 ,$22.05 ,$4.26 ,$22.05 ,$8.79 ,$28.49 ,$10.88 ,$4.26 ,$4.35 ,$27.75 ,$26.27 ,$26.27 ,$4.26 ,$26.27 ,$31.45 ,$31.45 ,$31.45 , N/A ,$10.88 ,$31.45 ,$4.26 ,$37.00 ,$20.76 ,$4.26 ,$15.32 ,$3.71 ,$3.37 ,$4.26 ,$31.45 ,$9.14 ,$22.05 ,$10.36 ,$33.30 ,$4.26 ,$31.45 ,$17.40 ,$17.40 ,$4.26 ,$24.05 ST. JOSEPH'S HOSPITAL - BREESE,30101526,82947,HC GLUCOSE -90,301,1 ,$37.00 ,$26.64 ,$3.37 ,$37.00 ,$9.83 ,$24.05 ,$22.09 ,$3.85 ,$10.36 ,$24.49 ,$3.85 ,$24.49 ,$3.85 ,$22.05 ,$22.05 ,$3.85 ,$22.05 ,$7.94 ,$28.49 ,$9.83 ,$3.85 ,$3.93 ,$27.75 ,$26.27 ,$26.27 ,$3.85 ,$26.27 ,$31.45 ,$31.45 ,$31.45 , N/A ,$9.83 ,$31.45 ,$3.85 ,$37.00 ,$20.76 ,$3.85 ,$15.32 ,$3.71 ,$3.37 ,$3.85 ,$31.45 ,$8.25 ,$22.05 ,$10.36 ,$33.30 ,$3.85 ,$31.45 ,$15.72 ,$15.72 ,$3.85 ,$24.05 ST. JOSEPH'S HOSPITAL - BREESE,30101527,84450,HC AST -90,301,1 ,$37.00 ,$26.64 ,$3.37 ,$37.00 ,$12.95 ,$24.05 ,$22.09 ,$5.08 ,$10.36 ,$24.49 ,$5.08 ,$24.49 ,$5.08 ,$22.05 ,$22.05 ,$5.08 ,$22.05 ,$10.46 ,$28.49 ,$12.95 ,$5.08 ,$5.17 ,$27.75 ,$26.27 ,$26.27 ,$5.08 ,$26.27 ,$31.45 ,$31.45 ,$31.45 , N/A ,$12.95 ,$31.45 ,$5.08 ,$37.00 ,$20.76 ,$5.08 ,$15.32 ,$3.71 ,$3.37 ,$5.08 ,$31.45 ,$10.88 ,$22.05 ,$10.36 ,$33.30 ,$5.08 ,$31.45 ,$20.72 ,$20.72 ,$5.08 ,$24.05 ST. JOSEPH'S HOSPITAL - BREESE,30101529,82725,HC FATTY ACIDS NONESTERIFIED-90,301,1 ,$147.00 ,$105.84 ,$7.58 ,$147.00 ,$46.93 ,$95.55 ,$87.76 ,$18.39 ,$41.16 ,$97.31 ,$18.39 ,$97.31 ,$18.39 ,$87.61 ,$87.61 ,$18.39 ,$87.61 ,$37.92 ,$113.19 ,$46.93 ,$18.39 ,$18.77 ,$110.25 ,$104.37 ,$104.37 ,$18.39 ,$104.37 ,$124.95 ,$124.95 ,$124.95 , N/A ,$46.93 ,$124.95 ,$18.39 ,$147.00 ,$82.47 ,$18.39 ,$60.86 ,$8.34 ,$7.58 ,$18.39 ,$124.95 ,$39.42 ,$87.61 ,$41.16 ,$132.30 ,$18.39 ,$124.95 ,$75.08 ,$75.08 ,$18.39 ,$95.55 ST. JOSEPH'S HOSPITAL - BREESE,30101534,80377,HC PANEL HYPOGLYCEMIC QL-90,301,1 ,$200.00 ,$144.00 ,$20.42 ,$200.00 , N/A ,$130.00 ,$119.40 , N/A ,$56.00 ,$132.40 , N/A ,$132.40 , N/A ,$119.20 ,$119.20 , N/A ,$119.20 , N/A ,$154.00 , N/A , N/A , N/A ,$150.00 ,$142.00 ,$142.00 , N/A ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A , N/A ,$170.00 , N/A ,$200.00 ,$112.20 , N/A ,$82.80 ,$22.46 ,$20.42 , N/A ,$170.00 , N/A ,$119.20 ,$56.00 ,$180.00 , N/A ,$170.00 , N/A , N/A , N/A ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,30101538,83491,HC CORTICOSTEROIDS 17D -90,301,1 ,$65.00 ,$46.80 ,$17.54 ,$65.00 ,$44.75 ,$42.25 ,$38.81 ,$17.54 ,$18.20 ,$43.03 ,$17.54 ,$43.03 ,$17.54 ,$38.74 ,$38.74 ,$17.54 ,$38.74 ,$36.16 ,$50.05 ,$44.75 ,$17.54 ,$17.89 ,$48.75 ,$46.15 ,$46.15 ,$17.54 ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A ,$44.75 ,$55.25 ,$17.54 ,$65.00 ,$36.47 ,$17.54 ,$26.91 ,$19.53 ,$17.75 ,$17.54 ,$55.25 ,$37.59 ,$38.74 ,$18.20 ,$58.50 ,$17.54 ,$55.25 ,$65.00 ,$65.00 ,$17.54 ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,30101540,84163,HC PLASMA PROTEIN-A PREGNANCY ASSOCIATED-90,301,1 ,$164.00 ,$118.08 ,$7.58 ,$164.00 ,$37.63 ,$106.60 ,$97.91 ,$14.75 ,$45.92 ,$108.57 ,$14.75 ,$108.57 ,$14.75 ,$97.74 ,$97.74 ,$14.75 ,$97.74 ,$30.40 ,$126.28 ,$37.63 ,$14.75 ,$15.04 ,$123.00 ,$116.44 ,$116.44 ,$14.75 ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A ,$37.63 ,$139.40 ,$14.75 ,$164.00 ,$92.00 ,$14.75 ,$67.90 ,$8.34 ,$7.58 ,$14.75 ,$139.40 ,$31.61 ,$97.74 ,$45.92 ,$147.60 ,$14.75 ,$139.40 ,$60.20 ,$60.20 ,$14.75 ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,30101543,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$827.00 ,$595.44 ,$6.92 ,$827.00 ,$119.08 ,$537.55 ,$493.72 ,$46.68 ,$231.56 ,$547.47 ,$46.68 ,$547.47 ,$46.68 ,$492.89 ,$492.89 ,$46.68 ,$492.89 ,$96.21 ,$500.00 ,$119.08 ,$46.68 ,$47.61 ,$620.25 ,$587.17 ,$587.17 ,$46.68 ,$587.17 ,$702.95 ,$702.95 ,$702.95 , N/A ,$119.08 ,$702.95 ,$46.68 ,$827.00 ,$463.95 ,$46.68 ,$342.38 ,$7.61 ,$6.92 ,$46.68 ,$702.95 ,$100.02 ,$492.89 ,$231.56 ,$744.30 ,$46.68 ,$702.95 ,$190.52 ,$190.52 ,$46.68 ,$537.55 ST. JOSEPH'S HOSPITAL - BREESE,30101545,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$170.00 ,$122.40 ,$8.71 ,$170.00 ,$36.43 ,$110.50 ,$101.49 ,$14.28 ,$47.60 ,$112.54 ,$14.28 ,$112.54 ,$14.28 ,$101.32 ,$101.32 ,$14.28 ,$101.32 ,$29.43 ,$130.90 ,$36.43 ,$14.28 ,$14.56 ,$127.50 ,$120.70 ,$120.70 ,$14.28 ,$120.70 ,$144.50 ,$144.50 ,$144.50 , N/A ,$36.43 ,$144.50 ,$14.28 ,$170.00 ,$95.37 ,$14.28 ,$70.38 ,$9.58 ,$8.71 ,$14.28 ,$144.50 ,$30.60 ,$101.32 ,$47.60 ,$153.00 ,$14.28 ,$144.50 ,$58.28 ,$58.28 ,$14.28 ,$110.50 ST. JOSEPH'S HOSPITAL - BREESE,30101546,80164,HC VALPROCIC ACID,301,1 ,$169.00 ,$121.68 ,$8.71 ,$169.00 ,$33.85 ,$109.85 ,$100.89 ,$13.27 ,$47.32 ,$111.88 ,$13.27 ,$111.88 ,$13.27 ,$100.72 ,$100.72 ,$13.27 ,$100.72 ,$27.35 ,$130.13 ,$33.85 ,$13.27 ,$13.53 ,$126.75 ,$119.99 ,$119.99 ,$13.27 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$33.85 ,$143.65 ,$13.27 ,$169.00 ,$94.81 ,$13.27 ,$69.97 ,$9.58 ,$8.71 ,$13.27 ,$143.65 ,$28.43 ,$100.72 ,$47.32 ,$152.10 ,$13.27 ,$143.65 ,$54.16 ,$54.16 ,$13.27 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30101548,80178,HC LITHIUM,301,1 ,$114.00 ,$82.08 ,$6.48 ,$114.00 ,$16.53 ,$74.10 ,$68.06 ,$6.48 ,$31.92 ,$75.47 ,$6.48 ,$75.47 ,$6.48 ,$67.94 ,$67.94 ,$6.48 ,$67.94 ,$13.35 ,$87.78 ,$16.53 ,$6.48 ,$6.61 ,$85.50 ,$80.94 ,$80.94 ,$6.48 ,$80.94 ,$96.90 ,$96.90 ,$96.90 , N/A ,$16.53 ,$96.90 ,$6.48 ,$114.00 ,$63.95 ,$6.48 ,$47.20 ,$9.58 ,$8.71 ,$6.48 ,$96.90 ,$13.88 ,$67.94 ,$31.92 ,$102.60 ,$6.48 ,$96.90 ,$26.44 ,$26.44 ,$6.48 ,$74.10 ST. JOSEPH'S HOSPITAL - BREESE,30101549,80184,HC PHENOBARBITAL,301,1 ,$164.00 ,$118.08 ,$8.71 ,$164.00 ,$38.25 ,$106.60 ,$97.91 ,$14.99 ,$45.92 ,$108.57 ,$14.99 ,$108.57 ,$14.99 ,$97.74 ,$97.74 ,$14.99 ,$97.74 ,$30.91 ,$126.28 ,$38.25 ,$14.99 ,$15.30 ,$123.00 ,$116.44 ,$116.44 ,$14.99 ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A ,$38.25 ,$139.40 ,$14.99 ,$164.00 ,$92.00 ,$14.99 ,$67.90 ,$9.58 ,$8.71 ,$14.99 ,$139.40 ,$32.13 ,$97.74 ,$45.92 ,$147.60 ,$14.99 ,$139.40 ,$61.20 ,$61.20 ,$14.99 ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,30101551,80198,HC THEOPHYLLINE,301,1 ,$155.00 ,$111.60 ,$8.71 ,$155.00 ,$35.35 ,$100.75 ,$92.54 ,$13.86 ,$43.40 ,$102.61 ,$13.86 ,$102.61 ,$13.86 ,$92.38 ,$92.38 ,$13.86 ,$92.38 ,$28.56 ,$119.35 ,$35.35 ,$13.86 ,$14.13 ,$116.25 ,$110.05 ,$110.05 ,$13.86 ,$110.05 ,$131.75 ,$131.75 ,$131.75 , N/A ,$35.35 ,$131.75 ,$13.86 ,$155.00 ,$86.96 ,$13.86 ,$64.17 ,$9.58 ,$8.71 ,$13.86 ,$131.75 ,$29.69 ,$92.38 ,$43.40 ,$139.50 ,$13.86 ,$131.75 ,$56.56 ,$56.56 ,$13.86 ,$100.75 ST. JOSEPH'S HOSPITAL - BREESE,30101552,80200,HC TOBRAMYCIN,301,1 ,$154.00 ,$110.88 ,$8.71 ,$154.00 ,$40.33 ,$100.10 ,$91.94 ,$15.81 ,$43.12 ,$101.95 ,$15.81 ,$101.95 ,$15.81 ,$91.78 ,$91.78 ,$15.81 ,$91.78 ,$32.58 ,$118.58 ,$40.33 ,$15.81 ,$16.12 ,$115.50 ,$109.34 ,$109.34 ,$15.81 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$40.33 ,$130.90 ,$15.81 ,$154.00 ,$86.39 ,$15.81 ,$63.76 ,$9.58 ,$8.71 ,$15.81 ,$130.90 ,$33.87 ,$91.78 ,$43.12 ,$138.60 ,$15.81 ,$130.90 ,$64.52 ,$64.52 ,$15.81 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101555,81479,HC IDH GENE MUTATION ASSAY - 90,301,1 ,$727.00 ,$523.44 ,$26.92 ,$727.00 , N/A ,$472.55 ,$434.02 ,$218.10 ,$203.56 ,$481.27 , N/A ,$481.27 , N/A ,$433.29 ,$433.29 , N/A ,$433.29 ,$327.15 ,$500.00 ,$508.90 , N/A , N/A ,$545.25 ,$516.17 ,$516.17 , N/A ,$516.17 ,$617.95 ,$617.95 ,$617.95 , N/A , N/A ,$617.95 , N/A ,$727.00 ,$407.85 , N/A ,$300.98 ,$29.61 ,$26.92 , N/A ,$617.95 ,$436.20 ,$433.29 ,$203.56 ,$654.30 , N/A ,$617.95 , N/A , N/A , N/A ,$472.55 ST. JOSEPH'S HOSPITAL - BREESE,30101556,82042,HC ALBUMIN OTHER SOURCE,301,1 ,$35.00 ,$25.20 ,$3.37 ,$35.00 ,$19.45 ,$22.75 ,$20.90 ,$7.62 ,$9.80 ,$23.17 ,$7.62 ,$23.17 ,$7.62 ,$20.86 ,$20.86 ,$7.62 ,$20.86 ,$15.72 ,$26.95 ,$19.45 ,$7.62 ,$7.78 ,$26.25 ,$24.85 ,$24.85 ,$7.62 ,$24.85 ,$29.75 ,$29.75 ,$29.75 , N/A ,$19.45 ,$29.75 ,$7.62 ,$35.00 ,$19.64 ,$7.62 ,$14.49 ,$3.71 ,$3.37 ,$7.62 ,$29.75 ,$16.34 ,$20.86 ,$9.80 ,$31.50 ,$7.62 ,$29.75 ,$31.12 ,$31.12 ,$7.62 ,$22.75 ST. JOSEPH'S HOSPITAL - BREESE,30101558,82105,HC ALPHA FETOPROTEIN SERUM,301,1 ,$83.00 ,$59.76 ,$7.58 ,$83.00 ,$41.93 ,$53.95 ,$49.55 ,$16.43 ,$23.24 ,$54.95 ,$16.43 ,$54.95 ,$16.43 ,$49.47 ,$49.47 ,$16.43 ,$49.47 ,$33.88 ,$63.91 ,$41.93 ,$16.43 ,$16.77 ,$62.25 ,$58.93 ,$58.93 ,$16.43 ,$58.93 ,$70.55 ,$70.55 ,$70.55 , N/A ,$41.93 ,$70.55 ,$16.43 ,$83.00 ,$46.56 ,$16.43 ,$34.36 ,$8.34 ,$7.58 ,$16.43 ,$70.55 ,$35.22 ,$49.47 ,$23.24 ,$74.70 ,$16.43 ,$70.55 ,$67.08 ,$67.08 ,$16.43 ,$53.95 ST. JOSEPH'S HOSPITAL - BREESE,30101559,82150,HC AMYLASE,301,1 ,$110.00 ,$79.20 ,$6.35 ,$110.00 ,$16.20 ,$71.50 ,$65.67 ,$6.35 ,$30.80 ,$72.82 ,$6.35 ,$72.82 ,$6.35 ,$65.56 ,$65.56 ,$6.35 ,$65.56 ,$13.09 ,$84.70 ,$16.20 ,$6.35 ,$6.48 ,$82.50 ,$78.10 ,$78.10 ,$6.35 ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A ,$16.20 ,$93.50 ,$6.35 ,$110.00 ,$61.71 ,$6.35 ,$45.54 ,$8.34 ,$7.58 ,$6.35 ,$93.50 ,$13.61 ,$65.56 ,$30.80 ,$99.00 ,$6.35 ,$93.50 ,$25.92 ,$25.92 ,$6.35 ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,30101561,82247,HC BILIRUBIN TOTAL,301,1 ,$51.00 ,$36.72 ,$3.37 ,$51.00 ,$12.55 ,$33.15 ,$30.45 ,$4.92 ,$14.28 ,$33.76 ,$4.92 ,$33.76 ,$4.92 ,$30.40 ,$30.40 ,$4.92 ,$30.40 ,$10.14 ,$39.27 ,$12.55 ,$4.92 ,$5.02 ,$38.25 ,$36.21 ,$36.21 ,$4.92 ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A ,$12.55 ,$43.35 ,$4.92 ,$51.00 ,$28.61 ,$4.92 ,$21.11 ,$3.71 ,$3.37 ,$4.92 ,$43.35 ,$10.54 ,$30.40 ,$14.28 ,$45.90 ,$4.92 ,$43.35 ,$20.08 ,$20.08 ,$4.92 ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,30101562,82248,HC BILIRUBIN DIRECT T1,301,1 ,$70.00 ,$50.40 ,$3.37 ,$70.00 ,$12.55 ,$45.50 ,$41.79 ,$4.92 ,$19.60 ,$46.34 ,$4.92 ,$46.34 ,$4.92 ,$41.72 ,$41.72 ,$4.92 ,$41.72 ,$10.14 ,$53.90 ,$12.55 ,$4.92 ,$5.02 ,$52.50 ,$49.70 ,$49.70 ,$4.92 ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A ,$12.55 ,$59.50 ,$4.92 ,$70.00 ,$39.27 ,$4.92 ,$28.98 ,$3.71 ,$3.37 ,$4.92 ,$59.50 ,$10.54 ,$41.72 ,$19.60 ,$63.00 ,$4.92 ,$59.50 ,$20.08 ,$20.08 ,$4.92 ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,30101564,82306,HC VITAMIN D 25 OH,301,1 ,$97.00 ,$69.84 ,$20.42 ,$97.00 ,$74.00 ,$63.05 ,$57.91 ,$29.01 ,$27.16 ,$64.21 ,$29.01 ,$64.21 ,$29.01 ,$57.81 ,$57.81 ,$29.01 ,$57.81 ,$59.79 ,$74.69 ,$74.00 ,$29.01 ,$29.59 ,$72.75 ,$68.87 ,$68.87 ,$29.01 ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A ,$74.00 ,$82.45 ,$29.01 ,$97.00 ,$54.42 ,$29.01 ,$40.16 ,$22.46 ,$20.42 ,$29.01 ,$82.45 ,$62.16 ,$57.81 ,$27.16 ,$87.30 ,$29.01 ,$82.45 ,$97.00 ,$97.00 ,$29.01 ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,30101565,82310,HC CALCIUM,301,1 ,$71.00 ,$51.12 ,$3.37 ,$71.00 ,$12.90 ,$46.15 ,$42.39 ,$5.06 ,$19.88 ,$47.00 ,$5.06 ,$47.00 ,$5.06 ,$42.32 ,$42.32 ,$5.06 ,$42.32 ,$10.42 ,$54.67 ,$12.90 ,$5.06 ,$5.15 ,$53.25 ,$50.41 ,$50.41 ,$5.06 ,$50.41 ,$60.35 ,$60.35 ,$60.35 , N/A ,$12.90 ,$60.35 ,$5.06 ,$71.00 ,$39.83 ,$5.06 ,$29.39 ,$3.71 ,$3.37 ,$5.06 ,$60.35 ,$10.84 ,$42.32 ,$19.88 ,$63.90 ,$5.06 ,$60.35 ,$20.64 ,$20.64 ,$5.06 ,$46.15 ST. JOSEPH'S HOSPITAL - BREESE,30101566,82340,HC CALCIUM URINE QN TIMED,301,1 ,$154.00 ,$110.88 ,$5.91 ,$154.00 ,$15.08 ,$100.10 ,$91.94 ,$5.91 ,$43.12 ,$101.95 ,$5.91 ,$101.95 ,$5.91 ,$91.78 ,$91.78 ,$5.91 ,$91.78 ,$12.18 ,$118.58 ,$15.08 ,$5.91 ,$6.03 ,$115.50 ,$109.34 ,$109.34 ,$5.91 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$15.08 ,$130.90 ,$5.91 ,$154.00 ,$86.39 ,$5.91 ,$63.76 ,$8.34 ,$7.58 ,$5.91 ,$130.90 ,$12.66 ,$91.78 ,$43.12 ,$138.60 ,$5.91 ,$130.90 ,$24.12 ,$24.12 ,$5.91 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101568,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$77.00 ,$55.44 ,$7.58 ,$77.00 ,$47.40 ,$50.05 ,$45.97 ,$18.58 ,$21.56 ,$50.97 ,$18.58 ,$50.97 ,$18.58 ,$45.89 ,$45.89 ,$18.58 ,$45.89 ,$38.30 ,$59.29 ,$47.40 ,$18.58 ,$18.95 ,$57.75 ,$54.67 ,$54.67 ,$18.58 ,$54.67 ,$65.45 ,$65.45 ,$65.45 , N/A ,$47.40 ,$65.45 ,$18.58 ,$77.00 ,$43.20 ,$18.58 ,$31.88 ,$8.34 ,$7.58 ,$18.58 ,$65.45 ,$39.82 ,$45.89 ,$21.56 ,$69.30 ,$18.58 ,$65.45 ,$75.84 ,$75.84 ,$18.58 ,$50.05 ST. JOSEPH'S HOSPITAL - BREESE,30101569,82436,HC CHLORIDE URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$14.38 ,$60.45 ,$55.52 ,$5.63 ,$26.04 ,$61.57 ,$5.63 ,$61.57 ,$5.63 ,$55.43 ,$55.43 ,$5.63 ,$55.43 ,$11.62 ,$71.61 ,$14.38 ,$5.63 ,$5.75 ,$69.75 ,$66.03 ,$66.03 ,$5.63 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$14.38 ,$79.05 ,$5.63 ,$93.00 ,$52.17 ,$5.63 ,$38.50 ,$3.71 ,$3.37 ,$5.63 ,$79.05 ,$12.08 ,$55.43 ,$26.04 ,$83.70 ,$5.63 ,$79.05 ,$23.00 ,$23.00 ,$5.63 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101570,82465,HC CHOLESTEROL,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$10.88 ,$60.45 ,$55.52 ,$4.26 ,$26.04 ,$61.57 ,$4.26 ,$61.57 ,$4.26 ,$55.43 ,$55.43 ,$4.26 ,$55.43 ,$8.79 ,$71.61 ,$10.88 ,$4.26 ,$4.35 ,$69.75 ,$66.03 ,$66.03 ,$4.26 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$10.88 ,$79.05 ,$4.26 ,$93.00 ,$52.17 ,$4.26 ,$38.50 ,$3.71 ,$3.37 ,$4.26 ,$79.05 ,$9.14 ,$55.43 ,$26.04 ,$83.70 ,$4.26 ,$79.05 ,$17.40 ,$17.40 ,$4.26 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101571,82533,HC CORTISOL TOTAL,301,1 ,$92.00 ,$66.24 ,$15.97 ,$92.00 ,$40.75 ,$59.80 ,$54.92 ,$15.97 ,$25.76 ,$60.90 ,$15.97 ,$60.90 ,$15.97 ,$54.83 ,$54.83 ,$15.97 ,$54.83 ,$32.93 ,$70.84 ,$40.75 ,$15.97 ,$16.30 ,$69.00 ,$65.32 ,$65.32 ,$15.97 ,$65.32 ,$78.20 ,$78.20 ,$78.20 , N/A ,$40.75 ,$78.20 ,$15.97 ,$92.00 ,$51.61 ,$15.97 ,$38.09 ,$19.53 ,$17.75 ,$15.97 ,$78.20 ,$34.23 ,$54.83 ,$25.76 ,$82.80 ,$15.97 ,$78.20 ,$65.20 ,$65.20 ,$15.97 ,$59.80 ST. JOSEPH'S HOSPITAL - BREESE,30101572,82570,HC CREATININE OTH SOURCE,301,1 ,$85.00 ,$61.20 ,$3.37 ,$85.00 ,$12.95 ,$55.25 ,$50.75 ,$5.08 ,$23.80 ,$56.27 ,$5.08 ,$56.27 ,$5.08 ,$50.66 ,$50.66 ,$5.08 ,$50.66 ,$10.46 ,$65.45 ,$12.95 ,$5.08 ,$5.17 ,$63.75 ,$60.35 ,$60.35 ,$5.08 ,$60.35 ,$72.25 ,$72.25 ,$72.25 , N/A ,$12.95 ,$72.25 ,$5.08 ,$85.00 ,$47.69 ,$5.08 ,$35.19 ,$3.71 ,$3.37 ,$5.08 ,$72.25 ,$10.88 ,$50.66 ,$23.80 ,$76.50 ,$5.08 ,$72.25 ,$20.72 ,$20.72 ,$5.08 ,$55.25 ST. JOSEPH'S HOSPITAL - BREESE,30101573,82607,HC VITAMIN B12,301,1 ,$111.00 ,$79.92 ,$10.21 ,$111.00 ,$37.70 ,$72.15 ,$66.27 ,$14.78 ,$31.08 ,$73.48 ,$14.78 ,$73.48 ,$14.78 ,$66.16 ,$66.16 ,$14.78 ,$66.16 ,$30.46 ,$85.47 ,$37.70 ,$14.78 ,$15.07 ,$83.25 ,$78.81 ,$78.81 ,$14.78 ,$78.81 ,$94.35 ,$94.35 ,$94.35 , N/A ,$37.70 ,$94.35 ,$14.78 ,$111.00 ,$62.27 ,$14.78 ,$45.95 ,$11.23 ,$10.21 ,$14.78 ,$94.35 ,$31.67 ,$66.16 ,$31.08 ,$99.90 ,$14.78 ,$94.35 ,$60.32 ,$60.32 ,$14.78 ,$72.15 ST. JOSEPH'S HOSPITAL - BREESE,30101575,82728,HC FERRITIN,301,1 ,$127.00 ,$91.44 ,$7.58 ,$127.00 ,$34.08 ,$82.55 ,$75.82 ,$13.36 ,$35.56 ,$84.07 ,$13.36 ,$84.07 ,$13.36 ,$75.69 ,$75.69 ,$13.36 ,$75.69 ,$27.53 ,$97.79 ,$34.08 ,$13.36 ,$13.62 ,$95.25 ,$90.17 ,$90.17 ,$13.36 ,$90.17 ,$107.95 ,$107.95 ,$107.95 , N/A ,$34.08 ,$107.95 ,$13.36 ,$127.00 ,$71.25 ,$13.36 ,$52.58 ,$8.34 ,$7.58 ,$13.36 ,$107.95 ,$28.62 ,$75.69 ,$35.56 ,$114.30 ,$13.36 ,$107.95 ,$54.52 ,$54.52 ,$13.36 ,$82.55 ST. JOSEPH'S HOSPITAL - BREESE,30101576,82731,HC FETAL FIBRONECTIN,301,1 ,$433.00 ,$311.76 ,$20.42 ,$433.00 ,$161.03 ,$281.45 ,$258.50 ,$63.12 ,$121.24 ,$286.65 ,$63.12 ,$286.65 ,$63.12 ,$258.07 ,$258.07 ,$63.12 ,$258.07 ,$130.11 ,$333.41 ,$161.03 ,$63.12 ,$64.39 ,$324.75 ,$307.43 ,$307.43 ,$63.12 ,$307.43 ,$368.05 ,$368.05 ,$368.05 , N/A ,$161.03 ,$368.05 ,$63.12 ,$433.00 ,$242.91 ,$63.12 ,$179.26 ,$22.46 ,$20.42 ,$63.12 ,$368.05 ,$135.26 ,$258.07 ,$121.24 ,$389.70 ,$63.12 ,$368.05 ,$257.64 ,$257.64 ,$63.12 ,$281.45 ST. JOSEPH'S HOSPITAL - BREESE,30101577,82746,HC FOLIC ACID SERUM,301,1 ,$127.00 ,$91.44 ,$7.58 ,$127.00 ,$36.75 ,$82.55 ,$75.82 ,$14.41 ,$35.56 ,$84.07 ,$14.41 ,$84.07 ,$14.41 ,$75.69 ,$75.69 ,$14.41 ,$75.69 ,$29.69 ,$97.79 ,$36.75 ,$14.41 ,$14.69 ,$95.25 ,$90.17 ,$90.17 ,$14.41 ,$90.17 ,$107.95 ,$107.95 ,$107.95 , N/A ,$36.75 ,$107.95 ,$14.41 ,$127.00 ,$71.25 ,$14.41 ,$52.58 ,$8.34 ,$7.58 ,$14.41 ,$107.95 ,$30.87 ,$75.69 ,$35.56 ,$114.30 ,$14.41 ,$107.95 ,$58.80 ,$58.80 ,$14.41 ,$82.55 ST. JOSEPH'S HOSPITAL - BREESE,30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$200.00 ,$144.00 ,$7.58 ,$200.00 ,$41.15 ,$130.00 ,$119.40 ,$16.13 ,$56.00 ,$132.40 ,$16.13 ,$132.40 ,$16.13 ,$119.20 ,$119.20 ,$16.13 ,$119.20 ,$33.25 ,$154.00 ,$41.15 ,$16.13 ,$16.45 ,$150.00 ,$142.00 ,$142.00 ,$16.13 ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A ,$41.15 ,$170.00 ,$16.13 ,$200.00 ,$112.20 ,$16.13 ,$82.80 ,$8.34 ,$7.58 ,$16.13 ,$170.00 ,$34.57 ,$119.20 ,$56.00 ,$180.00 ,$16.13 ,$170.00 ,$65.84 ,$65.84 ,$16.13 ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,30101581,82945,HC GLUCOSE BODY FLUID,301,1 ,$75.00 ,$54.00 ,$3.37 ,$75.00 ,$9.83 ,$48.75 ,$44.78 ,$3.85 ,$21.00 ,$49.65 ,$3.85 ,$49.65 ,$3.85 ,$44.70 ,$44.70 ,$3.85 ,$44.70 ,$7.94 ,$57.75 ,$9.83 ,$3.85 ,$3.93 ,$56.25 ,$53.25 ,$53.25 ,$3.85 ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A ,$9.83 ,$63.75 ,$3.85 ,$75.00 ,$42.08 ,$3.85 ,$31.05 ,$3.71 ,$3.37 ,$3.85 ,$63.75 ,$8.25 ,$44.70 ,$21.00 ,$67.50 ,$3.85 ,$63.75 ,$15.72 ,$15.72 ,$3.85 ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,30101584,82977,HC GGT / GGTP,301,1 ,$115.00 ,$82.80 ,$3.37 ,$115.00 ,$18.00 ,$74.75 ,$68.66 ,$7.06 ,$32.20 ,$76.13 ,$7.06 ,$76.13 ,$7.06 ,$68.54 ,$68.54 ,$7.06 ,$68.54 ,$14.54 ,$88.55 ,$18.00 ,$7.06 ,$7.19 ,$86.25 ,$81.65 ,$81.65 ,$7.06 ,$81.65 ,$97.75 ,$97.75 ,$97.75 , N/A ,$18.00 ,$97.75 ,$7.06 ,$115.00 ,$64.52 ,$7.06 ,$47.61 ,$3.71 ,$3.37 ,$7.06 ,$97.75 ,$15.12 ,$68.54 ,$32.20 ,$103.50 ,$7.06 ,$97.75 ,$28.80 ,$28.80 ,$7.06 ,$74.75 ST. JOSEPH'S HOSPITAL - BREESE,30101585,83001,HC FSH,301,1 ,$139.00 ,$100.08 ,$17.75 ,$139.00 ,$46.45 ,$90.35 ,$82.98 ,$18.21 ,$38.92 ,$92.02 ,$18.21 ,$92.02 ,$18.21 ,$82.84 ,$82.84 ,$18.21 ,$82.84 ,$37.53 ,$107.03 ,$46.45 ,$18.21 ,$18.57 ,$104.25 ,$98.69 ,$98.69 ,$18.21 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$46.45 ,$118.15 ,$18.21 ,$139.00 ,$77.98 ,$18.21 ,$57.55 ,$19.53 ,$17.75 ,$18.21 ,$118.15 ,$39.02 ,$82.84 ,$38.92 ,$125.10 ,$18.21 ,$118.15 ,$74.32 ,$74.32 ,$18.21 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30101586,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$139.00 ,$100.08 ,$17.75 ,$139.00 ,$46.30 ,$90.35 ,$82.98 ,$18.15 ,$38.92 ,$92.02 ,$18.15 ,$92.02 ,$18.15 ,$82.84 ,$82.84 ,$18.15 ,$82.84 ,$37.41 ,$107.03 ,$46.30 ,$18.15 ,$18.51 ,$104.25 ,$98.69 ,$98.69 ,$18.15 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$46.30 ,$118.15 ,$18.15 ,$139.00 ,$77.98 ,$18.15 ,$57.55 ,$19.53 ,$17.75 ,$18.15 ,$118.15 ,$38.89 ,$82.84 ,$38.92 ,$125.10 ,$18.15 ,$118.15 ,$74.08 ,$74.08 ,$18.15 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30101587,83010,HC HAPTOGLOBIN,301,1 ,$82.00 ,$59.04 ,$7.58 ,$82.00 ,$31.45 ,$53.30 ,$48.95 ,$12.33 ,$22.96 ,$54.28 ,$12.33 ,$54.28 ,$12.33 ,$48.87 ,$48.87 ,$12.33 ,$48.87 ,$25.41 ,$63.14 ,$31.45 ,$12.33 ,$12.57 ,$61.50 ,$58.22 ,$58.22 ,$12.33 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$31.45 ,$69.70 ,$12.33 ,$82.00 ,$46.00 ,$12.33 ,$33.95 ,$8.34 ,$7.58 ,$12.33 ,$69.70 ,$26.42 ,$48.87 ,$22.96 ,$73.80 ,$12.33 ,$69.70 ,$50.32 ,$50.32 ,$12.33 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30101590,83036,HC GLYCOSYLATED HGB,301,1 ,$124.00 ,$89.28 ,$7.58 ,$124.00 ,$24.28 ,$80.60 ,$74.03 ,$9.52 ,$34.72 ,$82.09 ,$9.52 ,$82.09 ,$9.52 ,$73.90 ,$73.90 ,$9.52 ,$73.90 ,$19.61 ,$95.48 ,$24.28 ,$9.52 ,$9.70 ,$93.00 ,$88.04 ,$88.04 ,$9.52 ,$88.04 ,$105.40 ,$105.40 ,$105.40 , N/A ,$24.28 ,$105.40 ,$9.52 ,$124.00 ,$69.56 ,$9.52 ,$51.34 ,$8.34 ,$7.58 ,$9.52 ,$105.40 ,$20.39 ,$73.90 ,$34.72 ,$111.60 ,$9.52 ,$105.40 ,$38.84 ,$38.84 ,$9.52 ,$80.60 ST. JOSEPH'S HOSPITAL - BREESE,30101592,83540,HC IRON TOTAL,301,1 ,$105.00 ,$75.60 ,$3.37 ,$105.00 ,$16.18 ,$68.25 ,$62.69 ,$6.34 ,$29.40 ,$69.51 ,$6.34 ,$69.51 ,$6.34 ,$62.58 ,$62.58 ,$6.34 ,$62.58 ,$13.07 ,$80.85 ,$16.18 ,$6.34 ,$6.47 ,$78.75 ,$74.55 ,$74.55 ,$6.34 ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A ,$16.18 ,$89.25 ,$6.34 ,$105.00 ,$58.91 ,$6.34 ,$43.47 ,$3.71 ,$3.37 ,$6.34 ,$89.25 ,$13.59 ,$62.58 ,$29.40 ,$94.50 ,$6.34 ,$89.25 ,$25.88 ,$25.88 ,$6.34 ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,30101593,83550,HC IRON BINDING CAPACITY,301,1 ,$139.00 ,$100.08 ,$7.58 ,$139.00 ,$21.85 ,$90.35 ,$82.98 ,$8.57 ,$38.92 ,$92.02 ,$8.57 ,$92.02 ,$8.57 ,$82.84 ,$82.84 ,$8.57 ,$82.84 ,$17.65 ,$107.03 ,$21.85 ,$8.57 ,$8.73 ,$104.25 ,$98.69 ,$98.69 ,$8.57 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$21.85 ,$118.15 ,$8.57 ,$139.00 ,$77.98 ,$8.57 ,$57.55 ,$8.34 ,$7.58 ,$8.57 ,$118.15 ,$18.35 ,$82.84 ,$38.92 ,$125.10 ,$8.57 ,$118.15 ,$34.96 ,$34.96 ,$8.57 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30101594,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$89.00 ,$64.08 ,$3.37 ,$89.00 ,$15.10 ,$57.85 ,$53.13 ,$5.92 ,$24.92 ,$58.92 ,$5.92 ,$58.92 ,$5.92 ,$53.04 ,$53.04 ,$5.92 ,$53.04 ,$12.20 ,$68.53 ,$15.10 ,$5.92 ,$6.04 ,$66.75 ,$63.19 ,$63.19 ,$5.92 ,$63.19 ,$75.65 ,$75.65 ,$75.65 , N/A ,$15.10 ,$75.65 ,$5.92 ,$89.00 ,$49.93 ,$5.92 ,$36.85 ,$3.71 ,$3.37 ,$5.92 ,$75.65 ,$12.68 ,$53.04 ,$24.92 ,$80.10 ,$5.92 ,$75.65 ,$24.16 ,$24.16 ,$5.92 ,$57.85 ST. JOSEPH'S HOSPITAL - BREESE,30101595,83690,HC LIPASE,301,1 ,$103.00 ,$74.16 ,$3.37 ,$103.00 ,$17.23 ,$66.95 ,$61.49 ,$6.75 ,$28.84 ,$68.19 ,$6.75 ,$68.19 ,$6.75 ,$61.39 ,$61.39 ,$6.75 ,$61.39 ,$13.92 ,$79.31 ,$17.23 ,$6.75 ,$6.89 ,$77.25 ,$73.13 ,$73.13 ,$6.75 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$17.23 ,$87.55 ,$6.75 ,$103.00 ,$57.78 ,$6.75 ,$42.64 ,$3.71 ,$3.37 ,$6.75 ,$87.55 ,$14.47 ,$61.39 ,$28.84 ,$92.70 ,$6.75 ,$87.55 ,$27.56 ,$27.56 ,$6.75 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,30101598,83930,HC OSMOLALITY BLOOD,301,1 ,$56.00 ,$40.32 ,$3.37 ,$56.00 ,$16.53 ,$36.40 ,$33.43 ,$6.48 ,$15.68 ,$37.07 ,$6.48 ,$37.07 ,$6.48 ,$33.38 ,$33.38 ,$6.48 ,$33.38 ,$13.35 ,$43.12 ,$16.53 ,$6.48 ,$6.61 ,$42.00 ,$39.76 ,$39.76 ,$6.48 ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A ,$16.53 ,$47.60 ,$6.48 ,$56.00 ,$31.42 ,$6.48 ,$23.18 ,$3.71 ,$3.37 ,$6.48 ,$47.60 ,$13.88 ,$33.38 ,$15.68 ,$50.40 ,$6.48 ,$47.60 ,$26.44 ,$26.44 ,$6.48 ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101599,83935,HC OSMOLALITY URINE,301,1 ,$74.00 ,$53.28 ,$3.37 ,$74.00 ,$17.05 ,$48.10 ,$44.18 ,$6.68 ,$20.72 ,$48.99 ,$6.68 ,$48.99 ,$6.68 ,$44.10 ,$44.10 ,$6.68 ,$44.10 ,$13.78 ,$56.98 ,$17.05 ,$6.68 ,$6.82 ,$55.50 ,$52.54 ,$52.54 ,$6.68 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$17.05 ,$62.90 ,$6.68 ,$74.00 ,$41.51 ,$6.68 ,$30.64 ,$3.71 ,$3.37 ,$6.68 ,$62.90 ,$14.32 ,$44.10 ,$20.72 ,$66.60 ,$6.68 ,$62.90 ,$27.28 ,$27.28 ,$6.68 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30101600,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$93.00 ,$66.96 ,$17.75 ,$103.20 ,$103.20 ,$60.45 ,$55.52 ,$40.45 ,$26.04 ,$61.57 ,$40.45 ,$61.57 ,$40.45 ,$55.43 ,$55.43 ,$40.45 ,$55.43 ,$83.39 ,$71.61 ,$103.20 ,$40.45 ,$41.27 ,$69.75 ,$66.03 ,$66.03 ,$40.45 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$93.00 ,$79.05 ,$40.45 ,$93.00 ,$52.17 ,$40.45 ,$38.50 ,$19.53 ,$17.75 ,$40.45 ,$79.05 ,$86.69 ,$55.43 ,$26.04 ,$83.70 ,$40.45 ,$79.05 ,$93.00 ,$93.00 ,$40.45 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101601,84075,HC ALKALINE PHOSPHATASE,301,1 ,$51.00 ,$36.72 ,$3.37 ,$51.00 ,$12.95 ,$33.15 ,$30.45 ,$5.08 ,$14.28 ,$33.76 ,$5.08 ,$33.76 ,$5.08 ,$30.40 ,$30.40 ,$5.08 ,$30.40 ,$10.46 ,$39.27 ,$12.95 ,$5.08 ,$5.17 ,$38.25 ,$36.21 ,$36.21 ,$5.08 ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A ,$12.95 ,$43.35 ,$5.08 ,$51.00 ,$28.61 ,$5.08 ,$21.11 ,$3.71 ,$3.37 ,$5.08 ,$43.35 ,$10.88 ,$30.40 ,$14.28 ,$45.90 ,$5.08 ,$43.35 ,$20.72 ,$20.72 ,$5.08 ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,30101602,84105,HC PHOSPHORUS UR,301,1 ,$154.00 ,$110.88 ,$3.37 ,$154.00 ,$14.45 ,$100.10 ,$91.94 ,$5.66 ,$43.12 ,$101.95 ,$5.66 ,$101.95 ,$5.66 ,$91.78 ,$91.78 ,$5.66 ,$91.78 ,$11.68 ,$118.58 ,$14.45 ,$5.66 ,$5.78 ,$115.50 ,$109.34 ,$109.34 ,$5.66 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$14.45 ,$130.90 ,$5.66 ,$154.00 ,$86.39 ,$5.66 ,$63.76 ,$3.71 ,$3.37 ,$5.66 ,$130.90 ,$12.14 ,$91.78 ,$43.12 ,$138.60 ,$5.66 ,$130.90 ,$23.12 ,$23.12 ,$5.66 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101603,84112,HC EVAL C/V AMNIOTIC FLD QL EA,301,1 ,$215.00 ,$154.80 ,$20.42 ,$245.28 ,$245.28 ,$139.75 ,$128.36 ,$96.15 ,$60.20 ,$142.33 ,$96.15 ,$142.33 ,$96.15 ,$128.14 ,$128.14 ,$96.15 ,$128.14 ,$198.18 ,$165.55 ,$245.28 ,$96.15 ,$98.07 ,$161.25 ,$152.65 ,$152.65 ,$96.15 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$215.00 ,$182.75 ,$96.15 ,$215.00 ,$120.62 ,$96.15 ,$89.01 ,$22.46 ,$20.42 ,$96.15 ,$182.75 ,$206.03 ,$128.14 ,$60.20 ,$193.50 ,$96.15 ,$182.75 ,$215.00 ,$215.00 ,$96.15 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,30101604,84133,HC POTASSIUM UR,301,1 ,$81.00 ,$58.32 ,$3.37 ,$81.00 ,$11.83 ,$52.65 ,$48.36 ,$4.64 ,$22.68 ,$53.62 ,$4.64 ,$53.62 ,$4.64 ,$48.28 ,$48.28 ,$4.64 ,$48.28 ,$9.55 ,$62.37 ,$11.83 ,$4.64 ,$4.72 ,$60.75 ,$57.51 ,$57.51 ,$4.64 ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A ,$11.83 ,$68.85 ,$4.64 ,$81.00 ,$45.44 ,$4.64 ,$33.53 ,$3.71 ,$3.37 ,$4.64 ,$68.85 ,$9.93 ,$48.28 ,$22.68 ,$72.90 ,$4.64 ,$68.85 ,$18.92 ,$18.92 ,$4.64 ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,30101605,84134,HC PREALBUMIN,301,1 ,$154.00 ,$110.88 ,$7.58 ,$154.00 ,$36.48 ,$100.10 ,$91.94 ,$14.30 ,$43.12 ,$101.95 ,$14.30 ,$101.95 ,$14.30 ,$91.78 ,$91.78 ,$14.30 ,$91.78 ,$29.47 ,$118.58 ,$36.48 ,$14.30 ,$14.58 ,$115.50 ,$109.34 ,$109.34 ,$14.30 ,$109.34 ,$130.90 ,$130.90 ,$130.90 , N/A ,$36.48 ,$130.90 ,$14.30 ,$154.00 ,$86.39 ,$14.30 ,$63.76 ,$8.34 ,$7.58 ,$14.30 ,$130.90 ,$30.64 ,$91.78 ,$43.12 ,$138.60 ,$14.30 ,$130.90 ,$58.36 ,$58.36 ,$14.30 ,$100.10 ST. JOSEPH'S HOSPITAL - BREESE,30101607,84145,HC PROCALCITONIN (PCT),301,1 ,$88.00 ,$63.36 ,$17.75 ,$88.00 ,$68.05 ,$57.20 ,$52.54 ,$26.68 ,$24.64 ,$58.26 ,$26.68 ,$58.26 ,$26.68 ,$52.45 ,$52.45 ,$26.68 ,$52.45 ,$54.98 ,$67.76 ,$68.05 ,$26.68 ,$27.20 ,$66.00 ,$62.48 ,$62.48 ,$26.68 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$68.05 ,$74.80 ,$26.68 ,$88.00 ,$49.37 ,$26.68 ,$36.43 ,$19.53 ,$17.75 ,$26.68 ,$74.80 ,$57.16 ,$52.45 ,$24.64 ,$79.20 ,$26.68 ,$74.80 ,$88.00 ,$88.00 ,$26.68 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,30101608,84146,HC PROLACTIN,301,1 ,$87.00 ,$62.64 ,$17.75 ,$87.00 ,$48.45 ,$56.55 ,$51.94 ,$18.99 ,$24.36 ,$57.59 ,$18.99 ,$57.59 ,$18.99 ,$51.85 ,$51.85 ,$18.99 ,$51.85 ,$39.15 ,$66.99 ,$48.45 ,$18.99 ,$19.37 ,$65.25 ,$61.77 ,$61.77 ,$18.99 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$48.45 ,$73.95 ,$18.99 ,$87.00 ,$48.81 ,$18.99 ,$36.02 ,$19.53 ,$17.75 ,$18.99 ,$73.95 ,$40.70 ,$51.85 ,$24.36 ,$78.30 ,$18.99 ,$73.95 ,$77.52 ,$77.52 ,$18.99 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30101609,84153,HC PSA TOTAL,301,1 ,$192.00 ,$138.24 ,$7.58 ,$192.00 ,$45.98 ,$124.80 ,$114.62 ,$18.02 ,$53.76 ,$127.10 ,$18.02 ,$127.10 ,$18.02 ,$114.43 ,$114.43 ,$18.02 ,$114.43 ,$37.15 ,$147.84 ,$45.98 ,$18.02 ,$18.38 ,$144.00 ,$136.32 ,$136.32 ,$18.02 ,$136.32 ,$163.20 ,$163.20 ,$163.20 , N/A ,$45.98 ,$163.20 ,$18.02 ,$192.00 ,$107.71 ,$18.02 ,$79.49 ,$8.34 ,$7.58 ,$18.02 ,$163.20 ,$38.62 ,$114.43 ,$53.76 ,$172.80 ,$18.02 ,$163.20 ,$73.56 ,$73.56 ,$18.02 ,$124.80 ST. JOSEPH'S HOSPITAL - BREESE,30101610,84154,HC PSA FREE,301,1 ,$126.00 ,$90.72 ,$7.58 ,$126.00 ,$45.98 ,$81.90 ,$75.22 ,$18.02 ,$35.28 ,$83.41 ,$18.02 ,$83.41 ,$18.02 ,$75.10 ,$75.10 ,$18.02 ,$75.10 ,$37.15 ,$97.02 ,$45.98 ,$18.02 ,$18.38 ,$94.50 ,$89.46 ,$89.46 ,$18.02 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$45.98 ,$107.10 ,$18.02 ,$126.00 ,$70.69 ,$18.02 ,$52.16 ,$8.34 ,$7.58 ,$18.02 ,$107.10 ,$38.62 ,$75.10 ,$35.28 ,$113.40 ,$18.02 ,$107.10 ,$73.56 ,$73.56 ,$18.02 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30101613,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$81.00 ,$58.32 ,$3.37 ,$81.00 ,$10.00 ,$52.65 ,$48.36 ,$3.92 ,$22.68 ,$53.62 ,$3.92 ,$53.62 ,$3.92 ,$48.28 ,$48.28 ,$3.92 ,$48.28 ,$8.08 ,$62.37 ,$10.00 ,$3.92 ,$4.00 ,$60.75 ,$57.51 ,$57.51 ,$3.92 ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A ,$10.00 ,$68.85 ,$3.92 ,$81.00 ,$45.44 ,$3.92 ,$33.53 ,$3.71 ,$3.37 ,$3.92 ,$68.85 ,$8.40 ,$48.28 ,$22.68 ,$72.90 ,$3.92 ,$68.85 ,$16.00 ,$16.00 ,$3.92 ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,30101617,84300,HC SODIUM URINE,301,1 ,$93.00 ,$66.96 ,$3.37 ,$93.00 ,$12.65 ,$60.45 ,$55.52 ,$4.96 ,$26.04 ,$61.57 ,$4.96 ,$61.57 ,$4.96 ,$55.43 ,$55.43 ,$4.96 ,$55.43 ,$10.22 ,$71.61 ,$12.65 ,$4.96 ,$5.06 ,$69.75 ,$66.03 ,$66.03 ,$4.96 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$12.65 ,$79.05 ,$4.96 ,$93.00 ,$52.17 ,$4.96 ,$38.50 ,$3.71 ,$3.37 ,$4.96 ,$79.05 ,$10.63 ,$55.43 ,$26.04 ,$83.70 ,$4.96 ,$79.05 ,$20.24 ,$20.24 ,$4.96 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101618,84302,HC SODIUM OTHER FLUID,301,1 ,$14.00 ,$10.08 ,$3.37 ,$14.00 ,$12.15 ,$9.10 ,$8.36 ,$4.76 ,$3.92 ,$9.27 ,$4.76 ,$9.27 ,$4.76 ,$8.34 ,$8.34 ,$4.76 ,$8.34 ,$9.82 ,$10.78 ,$12.15 ,$4.76 ,$4.86 ,$10.50 ,$9.94 ,$9.94 ,$4.76 ,$9.94 ,$11.90 ,$11.90 ,$11.90 , N/A ,$12.15 ,$11.90 ,$4.76 ,$14.00 ,$7.85 ,$4.76 ,$5.80 ,$3.71 ,$3.37 ,$4.76 ,$11.90 ,$10.21 ,$8.34 ,$3.92 ,$12.60 ,$4.76 ,$11.90 ,$14.00 ,$14.00 ,$4.76 ,$9.10 ST. JOSEPH'S HOSPITAL - BREESE,30101620,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$98.00 ,$70.56 ,$6.73 ,$98.00 ,$17.18 ,$63.70 ,$58.51 ,$6.73 ,$27.44 ,$64.88 ,$6.73 ,$64.88 ,$6.73 ,$58.41 ,$58.41 ,$6.73 ,$58.41 ,$13.88 ,$75.46 ,$17.18 ,$6.73 ,$6.87 ,$73.50 ,$69.58 ,$69.58 ,$6.73 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$17.18 ,$83.30 ,$6.73 ,$98.00 ,$54.98 ,$6.73 ,$40.57 ,$11.23 ,$10.21 ,$6.73 ,$83.30 ,$14.43 ,$58.41 ,$27.44 ,$88.20 ,$6.73 ,$83.30 ,$27.48 ,$27.48 ,$6.73 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,30101621,84450,HC AST,301,1 ,$83.00 ,$59.76 ,$3.37 ,$83.00 ,$12.95 ,$53.95 ,$49.55 ,$5.08 ,$23.24 ,$54.95 ,$5.08 ,$54.95 ,$5.08 ,$49.47 ,$49.47 ,$5.08 ,$49.47 ,$10.46 ,$63.91 ,$12.95 ,$5.08 ,$5.17 ,$62.25 ,$58.93 ,$58.93 ,$5.08 ,$58.93 ,$70.55 ,$70.55 ,$70.55 , N/A ,$12.95 ,$70.55 ,$5.08 ,$83.00 ,$46.56 ,$5.08 ,$34.36 ,$3.71 ,$3.37 ,$5.08 ,$70.55 ,$10.88 ,$49.47 ,$23.24 ,$74.70 ,$5.08 ,$70.55 ,$20.72 ,$20.72 ,$5.08 ,$53.95 ST. JOSEPH'S HOSPITAL - BREESE,30101622,84466,HC TRANSFERRIN,301,1 ,$88.00 ,$63.36 ,$7.58 ,$88.00 ,$31.90 ,$57.20 ,$52.54 ,$12.50 ,$24.64 ,$58.26 ,$12.50 ,$58.26 ,$12.50 ,$52.45 ,$52.45 ,$12.50 ,$52.45 ,$25.78 ,$67.76 ,$31.90 ,$12.50 ,$12.76 ,$66.00 ,$62.48 ,$62.48 ,$12.50 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$31.90 ,$74.80 ,$12.50 ,$88.00 ,$49.37 ,$12.50 ,$36.43 ,$8.34 ,$7.58 ,$12.50 ,$74.80 ,$26.80 ,$52.45 ,$24.64 ,$79.20 ,$12.50 ,$74.80 ,$51.04 ,$51.04 ,$12.50 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,30101623,84478,HC TRIGLYCERIDES,301,1 ,$78.00 ,$56.16 ,$3.37 ,$78.00 ,$14.35 ,$50.70 ,$46.57 ,$5.63 ,$21.84 ,$51.64 ,$5.63 ,$51.64 ,$5.63 ,$46.49 ,$46.49 ,$5.63 ,$46.49 ,$11.59 ,$60.06 ,$14.35 ,$5.63 ,$5.73 ,$58.50 ,$55.38 ,$55.38 ,$5.63 ,$55.38 ,$66.30 ,$66.30 ,$66.30 , N/A ,$14.35 ,$66.30 ,$5.63 ,$78.00 ,$43.76 ,$5.63 ,$32.29 ,$3.71 ,$3.37 ,$5.63 ,$66.30 ,$12.05 ,$46.49 ,$21.84 ,$70.20 ,$5.63 ,$66.30 ,$22.96 ,$22.96 ,$5.63 ,$50.70 ST. JOSEPH'S HOSPITAL - BREESE,30101626,84520,HC BUN,301,1 ,$56.00 ,$40.32 ,$3.37 ,$56.00 ,$9.88 ,$36.40 ,$33.43 ,$3.87 ,$15.68 ,$37.07 ,$3.87 ,$37.07 ,$3.87 ,$33.38 ,$33.38 ,$3.87 ,$33.38 ,$7.98 ,$43.12 ,$9.88 ,$3.87 ,$3.95 ,$42.00 ,$39.76 ,$39.76 ,$3.87 ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A ,$9.88 ,$47.60 ,$3.87 ,$3.95 ,$31.42 ,$3.87 ,$23.18 ,$3.71 ,$3.37 ,$3.87 ,$47.60 ,$8.30 ,$33.38 ,$15.68 ,$50.40 ,$3.87 ,$47.60 ,$15.80 ,$15.80 ,$3.87 ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101627,84540,HC UREA URINE,301,1 ,$103.00 ,$74.16 ,$3.37 ,$103.00 ,$13.90 ,$66.95 ,$61.49 ,$5.45 ,$28.84 ,$68.19 ,$5.45 ,$68.19 ,$5.45 ,$61.39 ,$61.39 ,$5.45 ,$61.39 ,$11.23 ,$79.31 ,$13.90 ,$5.45 ,$5.56 ,$77.25 ,$73.13 ,$73.13 ,$5.45 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$13.90 ,$87.55 ,$5.45 ,$103.00 ,$57.78 ,$5.45 ,$42.64 ,$3.71 ,$3.37 ,$5.45 ,$87.55 ,$11.68 ,$61.39 ,$28.84 ,$92.70 ,$5.45 ,$87.55 ,$22.24 ,$22.24 ,$5.45 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,30101628,84560,HC URIC ACID OTH SRC,301,1 ,$52.00 ,$37.44 ,$3.37 ,$52.00 ,$12.70 ,$33.80 ,$31.04 ,$4.98 ,$14.56 ,$34.42 ,$4.98 ,$34.42 ,$4.98 ,$30.99 ,$30.99 ,$4.98 ,$30.99 ,$10.26 ,$40.04 ,$12.70 ,$4.98 ,$5.08 ,$39.00 ,$36.92 ,$36.92 ,$4.98 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$12.70 ,$44.20 ,$4.98 ,$52.00 ,$29.17 ,$4.98 ,$21.53 ,$3.71 ,$3.37 ,$4.98 ,$44.20 ,$10.67 ,$30.99 ,$14.56 ,$46.80 ,$4.98 ,$44.20 ,$20.32 ,$20.32 ,$4.98 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30101630,84702,HC HCG QN,301,1 ,$168.00 ,$120.96 ,$10.21 ,$168.00 ,$37.63 ,$109.20 ,$100.30 ,$14.75 ,$47.04 ,$111.22 ,$14.75 ,$111.22 ,$14.75 ,$100.13 ,$100.13 ,$14.75 ,$100.13 ,$30.40 ,$129.36 ,$37.63 ,$14.75 ,$15.04 ,$126.00 ,$119.28 ,$119.28 ,$14.75 ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A ,$37.63 ,$142.80 ,$14.75 ,$168.00 ,$94.25 ,$14.75 ,$69.55 ,$11.23 ,$10.21 ,$14.75 ,$142.80 ,$31.61 ,$100.13 ,$47.04 ,$151.20 ,$14.75 ,$142.80 ,$60.20 ,$60.20 ,$14.75 ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,30101633,83070,HC HEMOSIDERIN QL - 90,301,1 ,$46.00 ,$33.12 ,$4.65 ,$46.00 ,$11.88 ,$29.90 ,$27.46 ,$4.65 ,$12.88 ,$30.45 ,$4.65 ,$30.45 ,$4.65 ,$27.42 ,$27.42 ,$4.65 ,$27.42 ,$9.60 ,$35.42 ,$11.88 ,$4.65 ,$4.75 ,$34.50 ,$32.66 ,$32.66 ,$4.65 ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A ,$11.88 ,$39.10 ,$4.65 ,$46.00 ,$25.81 ,$4.65 ,$19.04 ,$8.34 ,$7.58 ,$4.65 ,$39.10 ,$9.98 ,$27.42 ,$12.88 ,$41.40 ,$4.65 ,$39.10 ,$19.00 ,$19.00 ,$4.65 ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,30101634,80348,HC BUPRENORPHINE -90,301,1 ,$82.00 ,$59.04 ,$7.58 ,$82.00 , N/A ,$53.30 ,$48.95 , N/A ,$22.96 ,$54.28 , N/A ,$54.28 , N/A ,$48.87 ,$48.87 , N/A ,$48.87 , N/A ,$63.14 , N/A , N/A , N/A ,$61.50 ,$58.22 ,$58.22 , N/A ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A , N/A ,$69.70 , N/A ,$82.00 ,$46.00 , N/A ,$33.95 ,$8.34 ,$7.58 , N/A ,$69.70 , N/A ,$48.87 ,$22.96 ,$73.80 , N/A ,$69.70 , N/A , N/A , N/A ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30101636,83735,HC MAGNESIUM,301,1 ,$80.00 ,$57.60 ,$3.37 ,$80.00 ,$16.75 ,$52.00 ,$47.76 ,$6.57 ,$22.40 ,$52.96 ,$6.57 ,$52.96 ,$6.57 ,$47.68 ,$47.68 ,$6.57 ,$47.68 ,$13.53 ,$61.60 ,$16.75 ,$6.57 ,$6.69 ,$60.00 ,$56.80 ,$56.80 ,$6.57 ,$56.80 ,$68.00 ,$68.00 ,$68.00 , N/A ,$16.75 ,$68.00 ,$6.57 ,$80.00 ,$44.88 ,$6.57 ,$33.12 ,$3.71 ,$3.37 ,$6.57 ,$68.00 ,$14.07 ,$47.68 ,$22.40 ,$72.00 ,$6.57 ,$68.00 ,$26.80 ,$26.80 ,$6.57 ,$52.00 ST. JOSEPH'S HOSPITAL - BREESE,30101638,84100,HC PHOSPHORUS,301,1 ,$98.00 ,$70.56 ,$3.37 ,$98.00 ,$11.85 ,$63.70 ,$58.51 ,$4.65 ,$27.44 ,$64.88 ,$4.65 ,$64.88 ,$4.65 ,$58.41 ,$58.41 ,$4.65 ,$58.41 ,$9.57 ,$75.46 ,$11.85 ,$4.65 ,$4.73 ,$73.50 ,$69.58 ,$69.58 ,$4.65 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$11.85 ,$83.30 ,$4.65 ,$98.00 ,$54.98 ,$4.65 ,$40.57 ,$3.71 ,$3.37 ,$4.65 ,$83.30 ,$9.95 ,$58.41 ,$27.44 ,$88.20 ,$4.65 ,$83.30 ,$18.96 ,$18.96 ,$4.65 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,30101642,84999,HC OSMOLALITY FECAL-90,301,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 , N/A ,$5.20 ,$4.78 ,$2.40 ,$2.24 ,$5.30 , N/A ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 ,$3.60 ,$6.16 ,$5.60 , N/A , N/A ,$6.00 ,$5.68 ,$5.68 , N/A ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A , N/A ,$6.80 , N/A ,$8.00 ,$4.49 , N/A ,$3.31 ,$8.00 ,$7.58 , N/A ,$6.80 ,$4.80 ,$4.77 ,$2.24 ,$7.20 , N/A ,$6.80 , N/A , N/A , N/A ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,30101643,81596,HC CHRONIC HEP C VIRUS ASSAYS-90,301,1 ,$612.00 ,$440.64 ,$26.92 ,$612.00 ,$180.48 ,$397.80 ,$365.36 ,$70.75 ,$171.36 ,$405.14 ,$70.75 ,$405.14 ,$70.75 ,$364.75 ,$364.75 ,$70.75 ,$364.75 ,$145.82 ,$471.24 ,$180.48 ,$70.75 ,$72.16 ,$459.00 ,$434.52 ,$434.52 ,$70.75 ,$434.52 ,$520.20 ,$520.20 ,$520.20 , N/A ,$180.48 ,$520.20 ,$70.75 ,$612.00 ,$343.33 ,$70.75 ,$253.37 ,$29.61 ,$26.92 ,$70.75 ,$520.20 ,$151.60 ,$364.75 ,$171.36 ,$550.80 ,$70.75 ,$520.20 ,$288.76 ,$288.76 ,$70.75 ,$397.80 ST. JOSEPH'S HOSPITAL - BREESE,30101648,83664,HC LAMELLAR BODY CT,301,1 ,$29.00 ,$20.88 ,$8.12 ,$48.30 ,$48.30 ,$18.85 ,$17.31 ,$18.93 ,$8.12 ,$19.20 ,$18.93 ,$19.20 ,$18.93 ,$17.28 ,$17.28 ,$18.93 ,$17.28 ,$29.00 ,$22.33 ,$48.30 ,$18.93 ,$19.32 ,$21.75 ,$20.59 ,$20.59 ,$18.93 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$29.00 ,$24.65 ,$18.93 ,$29.00 ,$16.27 ,$18.93 ,$12.01 ,$23.84 ,$21.67 ,$18.93 ,$24.65 ,$40.57 ,$17.28 ,$8.12 ,$26.10 ,$18.93 ,$24.65 ,$29.00 ,$29.00 ,$18.93 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,30101653,82642,HC DIHYDROTESTOSTERONE-90,301,1 ,$338.00 ,$243.36 ,$10.21 ,$338.00 ,$73.20 ,$219.70 ,$201.79 ,$28.69 ,$94.64 ,$223.76 ,$28.69 ,$223.76 ,$28.69 ,$201.45 ,$201.45 ,$28.69 ,$201.45 ,$59.15 ,$260.26 ,$73.20 ,$28.69 ,$29.27 ,$253.50 ,$239.98 ,$239.98 ,$28.69 ,$239.98 ,$287.30 ,$287.30 ,$287.30 , N/A ,$73.20 ,$287.30 ,$28.69 ,$338.00 ,$189.62 ,$28.69 ,$139.93 ,$11.23 ,$10.21 ,$28.69 ,$287.30 ,$61.49 ,$201.45 ,$94.64 ,$304.20 ,$28.69 ,$287.30 ,$117.12 ,$117.12 ,$28.69 ,$219.70 ST. JOSEPH'S HOSPITAL - BREESE,30101656,83036,HC HEALTH FAIR HEMOGLOBIN A1C,301,1 ,$10.00 ,$7.20 ,$2.80 ,$24.28 ,$24.28 ,$6.50 ,$5.97 ,$9.52 ,$2.80 ,$6.62 ,$9.52 ,$6.62 ,$9.52 ,$5.96 ,$5.96 ,$9.52 ,$5.96 ,$10.00 ,$7.70 ,$24.28 ,$9.52 ,$9.70 ,$7.50 ,$7.10 ,$7.10 ,$9.52 ,$7.10 ,$8.50 ,$8.50 ,$8.50 , N/A ,$10.00 ,$8.50 ,$9.52 ,$10.00 ,$5.61 ,$9.52 ,$4.14 ,$8.34 ,$7.58 ,$9.52 ,$8.50 ,$20.39 ,$5.96 ,$2.80 ,$9.00 ,$9.52 ,$8.50 ,$10.00 ,$10.00 ,$9.52 ,$6.50 ST. JOSEPH'S HOSPITAL - BREESE,30101657,N/A,HC HEALTH FAIR TOTAL PSA SCREEN,301,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 , N/A ,$9.75 ,$8.96 , N/A ,$4.20 ,$9.93 , N/A ,$9.93 , N/A ,$8.94 ,$8.94 , N/A ,$8.94 , N/A ,$11.55 , N/A , N/A , N/A ,$11.25 ,$10.65 ,$10.65 , N/A ,$10.65 ,$12.75 ,$12.75 ,$12.75 , N/A , N/A ,$12.75 , N/A ,$15.00 ,$8.42 , N/A ,$6.21 , N/A , N/A , N/A ,$12.75 , N/A ,$8.94 ,$4.20 ,$13.50 , N/A ,$12.75 ,$7.50 ,$7.50 , N/A ,$9.75 ST. JOSEPH'S HOSPITAL - BREESE,30101658,N/A,HC HEALTH FAIR VITAMIN D 25-OH,301,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 , N/A ,$9.75 ,$8.96 , N/A ,$4.20 ,$9.93 , N/A ,$9.93 , N/A ,$8.94 ,$8.94 , N/A ,$8.94 , N/A ,$11.55 , N/A , N/A , N/A ,$11.25 ,$10.65 ,$10.65 , N/A ,$10.65 ,$12.75 ,$12.75 ,$12.75 , N/A , N/A ,$12.75 , N/A ,$15.00 ,$8.42 , N/A ,$6.21 , N/A , N/A , N/A ,$12.75 , N/A ,$8.94 ,$4.20 ,$13.50 , N/A ,$12.75 ,$7.50 ,$7.50 , N/A ,$9.75 ST. JOSEPH'S HOSPITAL - BREESE,30101659,84443,HC HEALTH FAIR TSH,301,1 ,$15.00 ,$10.80 ,$4.20 ,$37.50 ,$37.50 ,$9.75 ,$8.96 ,$14.70 ,$4.20 ,$9.93 ,$14.70 ,$9.93 ,$14.70 ,$8.94 ,$8.94 ,$14.70 ,$8.94 ,$15.00 ,$11.55 ,$37.50 ,$14.70 ,$14.70 ,$11.25 ,$10.65 ,$10.65 ,$14.70 ,$10.65 ,$12.75 ,$12.75 ,$12.75 , N/A ,$15.00 ,$12.75 ,$14.70 ,$15.00 ,$8.42 ,$14.70 ,$6.21 ,$11.23 ,$10.21 ,$14.70 ,$12.75 ,$31.50 ,$8.94 ,$4.20 ,$13.50 ,$14.70 ,$12.75 ,$15.00 ,$15.00 ,$14.70 ,$9.75 ST. JOSEPH'S HOSPITAL - BREESE,30101660,N/A,HC HEALTH FAIR LAB PANEL,301,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$22.50 ,$22.50 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,30101661,80061,HC HEALTH FAIR LIPID W/CALC LDL,301,1 ,$15.00 ,$10.80 ,$4.20 ,$33.48 ,$33.48 ,$9.75 ,$8.96 ,$13.12 ,$4.20 ,$9.93 ,$13.12 ,$9.93 ,$13.12 ,$8.94 ,$8.94 ,$13.12 ,$8.94 ,$15.00 ,$11.55 ,$33.48 ,$13.12 ,$13.39 ,$11.25 ,$10.65 ,$10.65 ,$13.12 ,$10.65 ,$12.75 ,$12.75 ,$12.75 , N/A ,$15.00 ,$12.75 ,$13.12 ,$15.00 ,$8.42 ,$13.12 ,$6.21 ,$7.61 ,$6.92 ,$13.12 ,$12.75 ,$28.12 ,$8.94 ,$4.20 ,$13.50 ,$13.12 ,$12.75 ,$15.00 ,$15.00 ,$13.12 ,$9.75 ST. JOSEPH'S HOSPITAL - BREESE,30101662,N/A,HC HEALTH FAIR OCCULT BLOOD FECAL SCREEN,301,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 , N/A ,$9.75 ,$8.96 , N/A ,$4.20 ,$9.93 , N/A ,$9.93 , N/A ,$8.94 ,$8.94 , N/A ,$8.94 , N/A ,$11.55 , N/A , N/A , N/A ,$11.25 ,$10.65 ,$10.65 , N/A ,$10.65 ,$12.75 ,$12.75 ,$12.75 , N/A , N/A ,$12.75 , N/A ,$15.00 ,$8.42 , N/A ,$6.21 , N/A , N/A , N/A ,$12.75 , N/A ,$8.94 ,$4.20 ,$13.50 , N/A ,$12.75 ,$7.50 ,$7.50 , N/A ,$9.75 ST. JOSEPH'S HOSPITAL - BREESE,30101663,83631,HC LACTOFERRIN FECAL QN-90,301,1 ,$242.00 ,$174.24 ,$7.58 ,$242.00 ,$49.08 ,$157.30 ,$144.47 ,$19.24 ,$67.76 ,$160.20 ,$19.24 ,$160.20 ,$19.24 ,$144.23 ,$144.23 ,$19.24 ,$144.23 ,$39.65 ,$186.34 ,$49.08 ,$19.24 ,$19.62 ,$181.50 ,$171.82 ,$171.82 ,$19.24 ,$171.82 ,$205.70 ,$205.70 ,$205.70 , N/A ,$49.08 ,$205.70 ,$19.24 ,$242.00 ,$135.76 ,$19.24 ,$100.19 ,$8.34 ,$7.58 ,$19.24 ,$205.70 ,$41.22 ,$144.23 ,$67.76 ,$217.80 ,$19.24 ,$205.70 ,$78.52 ,$78.52 ,$19.24 ,$157.30 ST. JOSEPH'S HOSPITAL - BREESE,30101664,80307,HC DRUG SCREEN UMBILICAL CORD-90,301,1 ,$165.50 ,$119.16 ,$20.42 ,$165.50 ,$155.35 ,$107.58 ,$98.80 ,$60.90 ,$46.34 ,$109.56 ,$60.90 ,$109.56 ,$60.90 ,$98.64 ,$98.64 ,$60.90 ,$98.64 ,$125.52 ,$127.44 ,$155.35 ,$60.90 ,$62.11 ,$124.13 ,$117.51 ,$117.51 ,$60.90 ,$117.51 ,$140.68 ,$140.68 ,$140.68 , N/A ,$155.35 ,$140.68 ,$60.90 ,$165.50 ,$92.85 ,$60.90 ,$68.52 ,$22.46 ,$20.42 ,$60.90 ,$140.68 ,$130.49 ,$98.64 ,$46.34 ,$148.95 ,$60.90 ,$140.68 ,$165.50 ,$165.50 ,$60.90 ,$107.58 ST. JOSEPH'S HOSPITAL - BREESE,30101669,81500,HC ONCOLOGY OVARIAN BIOCHEMICAL ASSAY CA-125/HE4 -90,301,1 ,$833.08 ,$599.82 ,$26.92 ,$833.08 ,$651.25 ,$541.50 ,$497.35 ,$255.29 ,$233.26 ,$551.50 ,$255.29 ,$551.50 ,$255.29 ,$496.52 ,$496.52 ,$255.29 ,$496.52 ,$526.21 ,$500.00 ,$651.25 ,$255.29 ,$260.40 ,$624.81 ,$591.49 ,$591.49 ,$255.29 ,$591.49 ,$708.12 ,$708.12 ,$708.12 , N/A ,$651.25 ,$708.12 ,$255.29 ,$833.08 ,$467.36 ,$255.29 ,$344.90 ,$29.61 ,$26.92 ,$255.29 ,$708.12 ,$547.05 ,$496.52 ,$233.26 ,$749.77 ,$255.29 ,$708.12 ,$833.08 ,$833.08 ,$255.29 ,$541.50 ST. JOSEPH'S HOSPITAL - BREESE,30101674,82978,HC GLUTATHIONE-90,301,1 ,$93.00 ,$66.96 ,$7.58 ,$93.00 ,$38.63 ,$60.45 ,$55.52 ,$15.14 ,$26.04 ,$61.57 ,$15.14 ,$61.57 ,$15.14 ,$55.43 ,$55.43 ,$15.14 ,$55.43 ,$31.21 ,$71.61 ,$38.63 ,$15.14 ,$15.44 ,$69.75 ,$66.03 ,$66.03 ,$15.14 ,$66.03 ,$79.05 ,$79.05 ,$79.05 , N/A ,$38.63 ,$79.05 ,$15.14 ,$93.00 ,$52.17 ,$15.14 ,$38.50 ,$8.34 ,$7.58 ,$15.14 ,$79.05 ,$32.45 ,$55.43 ,$26.04 ,$83.70 ,$15.14 ,$79.05 ,$61.80 ,$61.80 ,$15.14 ,$60.45 ST. JOSEPH'S HOSPITAL - BREESE,30101678,83516,HC FLUOR AB SCR AQUAPORIN 4-90,301,1 ,$886.00 ,$637.92 ,$6.79 ,$886.00 ,$28.83 ,$575.90 ,$528.94 ,$11.30 ,$248.08 ,$586.53 ,$11.30 ,$586.53 ,$11.30 ,$528.06 ,$528.06 ,$11.30 ,$528.06 ,$23.29 ,$500.00 ,$28.83 ,$11.30 ,$11.52 ,$664.50 ,$629.06 ,$629.06 ,$11.30 ,$629.06 ,$753.10 ,$753.10 ,$753.10 , N/A ,$28.83 ,$753.10 ,$11.30 ,$886.00 ,$497.05 ,$11.30 ,$366.80 ,$7.47 ,$6.79 ,$11.30 ,$753.10 ,$24.21 ,$528.06 ,$248.08 ,$797.40 ,$11.30 ,$753.10 ,$46.12 ,$46.12 ,$11.30 ,$575.90 ST. JOSEPH'S HOSPITAL - BREESE,30101685,80235,HC LACOSAMIDE -90,301,1 ,$159.00 ,$114.48 ,$8.71 ,$159.00 ,$67.78 ,$103.35 ,$94.92 ,$26.57 ,$44.52 ,$105.26 ,$26.57 ,$105.26 ,$26.57 ,$94.76 ,$94.76 ,$26.57 ,$94.76 ,$54.76 ,$122.43 ,$67.78 ,$26.57 ,$27.10 ,$119.25 ,$112.89 ,$112.89 ,$26.57 ,$112.89 ,$135.15 ,$135.15 ,$135.15 , N/A ,$67.78 ,$135.15 ,$26.57 ,$159.00 ,$89.20 ,$26.57 ,$65.83 ,$9.58 ,$8.71 ,$26.57 ,$135.15 ,$56.93 ,$94.76 ,$44.52 ,$143.10 ,$26.57 ,$135.15 ,$108.44 ,$108.44 ,$26.57 ,$103.35 ST. JOSEPH'S HOSPITAL - BREESE,30101689,82565,HC CREATININE,301,1 ,$71.00 ,$51.12 ,$3.37 ,$71.00 ,$12.80 ,$46.15 ,$42.39 ,$5.02 ,$19.88 ,$47.00 ,$5.02 ,$47.00 ,$5.02 ,$42.32 ,$42.32 ,$5.02 ,$42.32 ,$10.34 ,$54.67 ,$12.80 ,$5.02 ,$5.12 ,$53.25 ,$50.41 ,$50.41 ,$5.02 ,$50.41 ,$60.35 ,$60.35 ,$60.35 , N/A ,$12.80 ,$60.35 ,$5.02 ,$5.12 ,$39.83 ,$5.02 ,$29.39 ,$3.71 ,$3.37 ,$5.02 ,$60.35 ,$10.75 ,$42.32 ,$19.88 ,$63.90 ,$5.02 ,$60.35 ,$20.48 ,$20.48 ,$5.02 ,$46.15 ST. JOSEPH'S HOSPITAL - BREESE,30101692,80366,HC DRUG SCREEN PREGABALIN-90,301,1 ,$220.00 ,$158.40 ,$7.58 ,$220.00 , N/A ,$143.00 ,$131.34 , N/A ,$61.60 ,$145.64 , N/A ,$145.64 , N/A ,$131.12 ,$131.12 , N/A ,$131.12 , N/A ,$169.40 , N/A , N/A , N/A ,$165.00 ,$156.20 ,$156.20 , N/A ,$156.20 ,$187.00 ,$187.00 ,$187.00 , N/A , N/A ,$187.00 , N/A ,$220.00 ,$123.42 , N/A ,$91.08 ,$8.34 ,$7.58 , N/A ,$187.00 , N/A ,$131.12 ,$61.60 ,$198.00 , N/A ,$187.00 , N/A , N/A , N/A ,$143.00 ST. JOSEPH'S HOSPITAL - BREESE,30101703,80299,HC HYPOGLYCEMIC PANEL-90,301,1 ,$452.00 ,$325.44 ,$8.71 ,$452.00 ,$46.60 ,$293.80 ,$269.84 ,$18.27 ,$126.56 ,$299.22 ,$18.27 ,$299.22 ,$18.27 ,$269.39 ,$269.39 ,$18.27 ,$269.39 ,$37.65 ,$348.04 ,$46.60 ,$18.27 ,$18.63 ,$339.00 ,$320.92 ,$320.92 ,$18.27 ,$320.92 ,$384.20 ,$384.20 ,$384.20 , N/A ,$46.60 ,$384.20 ,$18.27 ,$452.00 ,$253.57 ,$18.27 ,$187.13 ,$9.58 ,$8.71 ,$18.27 ,$384.20 ,$39.14 ,$269.39 ,$126.56 ,$406.80 ,$18.27 ,$384.20 ,$74.56 ,$74.56 ,$18.27 ,$293.80 ST. JOSEPH'S HOSPITAL - BREESE,30101705,80145,HC DRUG ASSAY ADALIMUMAB -90,301,1 ,$77.14 ,$55.54 ,$8.71 ,$96.43 ,$96.43 ,$50.14 ,$46.05 ,$37.80 ,$21.60 ,$51.07 ,$37.80 ,$51.07 ,$37.80 ,$45.98 ,$45.98 ,$37.80 ,$45.98 ,$77.14 ,$59.40 ,$96.43 ,$37.80 ,$38.55 ,$57.86 ,$54.77 ,$54.77 ,$37.80 ,$54.77 ,$65.57 ,$65.57 ,$65.57 , N/A ,$77.14 ,$65.57 ,$37.80 ,$77.14 ,$43.28 ,$37.80 ,$31.94 ,$9.58 ,$8.71 ,$37.80 ,$65.57 ,$81.00 ,$45.98 ,$21.60 ,$69.43 ,$37.80 ,$65.57 ,$77.14 ,$77.14 ,$37.80 ,$50.14 ST. JOSEPH'S HOSPITAL - BREESE,30101706,80230,HC DRUG ASSAY INFLIXIMAB-90,301,1 ,$396.00 ,$285.12 ,$8.71 ,$396.00 ,$96.43 ,$257.40 ,$236.41 ,$37.80 ,$110.88 ,$262.15 ,$37.80 ,$262.15 ,$37.80 ,$236.02 ,$236.02 ,$37.80 ,$236.02 ,$77.91 ,$304.92 ,$96.43 ,$37.80 ,$38.55 ,$297.00 ,$281.16 ,$281.16 ,$37.80 ,$281.16 ,$336.60 ,$336.60 ,$336.60 , N/A ,$96.43 ,$336.60 ,$37.80 ,$396.00 ,$222.16 ,$37.80 ,$163.94 ,$9.58 ,$8.71 ,$37.80 ,$336.60 ,$81.00 ,$236.02 ,$110.88 ,$356.40 ,$37.80 ,$336.60 ,$154.28 ,$154.28 ,$37.80 ,$257.40 ST. JOSEPH'S HOSPITAL - BREESE,30101714,80374,HC METHAMPHETAMINE- 90,301,1 ,$56.00 ,$40.32 ,$7.58 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A ,$43.12 , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 ,$8.34 ,$7.58 , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 , N/A , N/A , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30101716,80187,HC POSACONAZOLE -90,301,1 ,$305.94 ,$220.28 ,$8.71 ,$305.94 ,$67.78 ,$198.86 ,$182.65 ,$26.57 ,$85.66 ,$202.53 ,$26.57 ,$202.53 ,$26.57 ,$182.34 ,$182.34 ,$26.57 ,$182.34 ,$54.76 ,$235.57 ,$67.78 ,$26.57 ,$27.10 ,$229.46 ,$217.22 ,$217.22 ,$26.57 ,$217.22 ,$260.05 ,$260.05 ,$260.05 , N/A ,$67.78 ,$260.05 ,$26.57 ,$305.94 ,$171.63 ,$26.57 ,$126.66 ,$9.58 ,$8.71 ,$26.57 ,$260.05 ,$56.93 ,$182.34 ,$85.66 ,$275.35 ,$26.57 ,$260.05 ,$108.44 ,$108.44 ,$26.57 ,$198.86 ST. JOSEPH'S HOSPITAL - BREESE,30101722,82542,HC COL CHROMOTOGRAPHY QUAL/QUAN-90,301,1 ,$75.00 ,$54.00 ,$7.58 ,$75.00 ,$60.23 ,$48.75 ,$44.78 ,$23.61 ,$21.00 ,$49.65 ,$23.61 ,$49.65 ,$23.61 ,$44.70 ,$44.70 ,$23.61 ,$44.70 ,$48.66 ,$57.75 ,$60.23 ,$23.61 ,$24.08 ,$56.25 ,$53.25 ,$53.25 ,$23.61 ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A ,$60.23 ,$63.75 ,$23.61 ,$75.00 ,$42.08 ,$23.61 ,$31.05 ,$8.34 ,$7.58 ,$23.61 ,$63.75 ,$50.59 ,$44.70 ,$21.00 ,$67.50 ,$23.61 ,$63.75 ,$75.00 ,$75.00 ,$23.61 ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,30101735,84146,HC PROLACTIN-90,301,1 ,$212.00 ,$152.64 ,$17.75 ,$212.00 ,$48.45 ,$137.80 ,$126.56 ,$18.99 ,$59.36 ,$140.34 ,$18.99 ,$140.34 ,$18.99 ,$126.35 ,$126.35 ,$18.99 ,$126.35 ,$39.15 ,$163.24 ,$48.45 ,$18.99 ,$19.37 ,$159.00 ,$150.52 ,$150.52 ,$18.99 ,$150.52 ,$180.20 ,$180.20 ,$180.20 , N/A ,$48.45 ,$180.20 ,$18.99 ,$212.00 ,$118.93 ,$18.99 ,$87.77 ,$19.53 ,$17.75 ,$18.99 ,$180.20 ,$40.70 ,$126.35 ,$59.36 ,$190.80 ,$18.99 ,$180.20 ,$77.52 ,$77.52 ,$18.99 ,$137.80 ST. JOSEPH'S HOSPITAL - BREESE,30101750,80189,HC ITRACONAZOLE - 90,301,1 ,$128.00 ,$92.16 ,$8.71 ,$128.00 ,$67.78 ,$83.20 ,$76.42 ,$26.57 ,$35.84 ,$84.74 ,$26.57 ,$84.74 ,$26.57 ,$76.29 ,$76.29 ,$26.57 ,$76.29 ,$54.76 ,$98.56 ,$67.78 ,$26.57 ,$27.10 ,$96.00 ,$90.88 ,$90.88 ,$26.57 ,$90.88 ,$108.80 ,$108.80 ,$108.80 , N/A ,$67.78 ,$108.80 ,$26.57 ,$128.00 ,$71.81 ,$26.57 ,$52.99 ,$9.58 ,$8.71 ,$26.57 ,$108.80 ,$56.93 ,$76.29 ,$35.84 ,$115.20 ,$26.57 ,$108.80 ,$108.44 ,$108.44 ,$26.57 ,$83.20 ST. JOSEPH'S HOSPITAL - BREESE,30101752,83722,HC LIPOPROTEIN DIR MEAS SMALL DENSE LDL CHOLESTEROL-90,301,1 ,$38.00 ,$27.36 ,$10.64 ,$85.48 ,$85.48 ,$24.70 ,$22.69 ,$33.51 ,$10.64 ,$25.16 ,$33.51 ,$25.16 ,$33.51 ,$22.65 ,$22.65 ,$33.51 ,$22.65 ,$38.00 ,$29.26 ,$85.48 ,$33.51 ,$34.17 ,$28.50 ,$26.98 ,$26.98 ,$33.51 ,$26.98 ,$32.30 ,$32.30 ,$32.30 , N/A ,$38.00 ,$32.30 ,$33.51 ,$38.00 ,$21.32 ,$33.51 ,$15.73 ,$22.46 ,$20.42 ,$33.51 ,$32.30 ,$71.80 ,$22.65 ,$10.64 ,$34.20 ,$33.51 ,$32.30 ,$38.00 ,$38.00 ,$33.51 ,$24.70 ST. JOSEPH'S HOSPITAL - BREESE,30101755,82553,HC CREATINE MB FRACTION,301,1 ,$169.00 ,$121.68 ,$7.58 ,$169.00 ,$28.88 ,$109.85 ,$100.89 ,$11.32 ,$47.32 ,$111.88 ,$11.32 ,$111.88 ,$11.32 ,$100.72 ,$100.72 ,$11.32 ,$100.72 ,$23.33 ,$130.13 ,$28.88 ,$11.32 ,$11.54 ,$126.75 ,$119.99 ,$119.99 ,$11.32 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$28.88 ,$143.65 ,$11.32 ,$169.00 ,$94.81 ,$11.32 ,$69.97 ,$8.34 ,$7.58 ,$11.32 ,$143.65 ,$24.26 ,$100.72 ,$47.32 ,$152.10 ,$11.32 ,$143.65 ,$46.20 ,$46.20 ,$11.32 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30101762,82951,HC GLUCOSE TOLERANCE-90,301,1 ,$38.61 ,$27.80 ,$7.58 ,$38.61 ,$32.18 ,$25.10 ,$23.05 ,$12.61 ,$10.81 ,$25.56 ,$12.61 ,$25.56 ,$12.61 ,$23.01 ,$23.01 ,$12.61 ,$23.01 ,$26.00 ,$29.73 ,$32.18 ,$12.61 ,$12.87 ,$28.96 ,$27.41 ,$27.41 ,$12.61 ,$27.41 ,$32.82 ,$32.82 ,$32.82 , N/A ,$32.18 ,$32.82 ,$12.61 ,$38.61 ,$21.66 ,$12.61 ,$15.98 ,$8.34 ,$7.58 ,$12.61 ,$32.82 ,$27.03 ,$23.01 ,$10.81 ,$34.75 ,$12.61 ,$32.82 ,$38.61 ,$38.61 ,$12.61 ,$25.10 ST. JOSEPH'S HOSPITAL - BREESE,30101763,82952,HC GLUCOSE TOLERANCE ADDL SPEC-90,301,1 ,$11.76 ,$8.47 ,$3.29 ,$11.76 ,$9.80 ,$7.64 ,$7.02 ,$3.84 ,$3.29 ,$7.79 ,$3.84 ,$7.79 ,$3.84 ,$7.01 ,$7.01 ,$3.84 ,$7.01 ,$7.92 ,$9.06 ,$9.80 ,$3.84 ,$3.92 ,$8.82 ,$8.35 ,$8.35 ,$3.84 ,$8.35 ,$10.00 ,$10.00 ,$10.00 , N/A ,$9.80 ,$10.00 ,$3.84 ,$11.76 ,$6.60 ,$3.84 ,$4.87 ,$8.34 ,$7.58 ,$3.84 ,$10.00 ,$8.23 ,$7.01 ,$3.29 ,$10.58 ,$3.84 ,$10.00 ,$11.76 ,$11.76 ,$3.84 ,$7.64 ST. JOSEPH'S HOSPITAL - BREESE,30101770,83521,HC IMMUNOGLOBULIN LIGHT CHAINS- 90,301,1 ,$169.00 ,$121.68 ,$7.58 ,$169.00 ,$43.18 ,$109.85 ,$100.89 ,$16.92 ,$47.32 ,$111.88 ,$16.92 ,$111.88 ,$16.92 ,$100.72 ,$100.72 ,$16.92 ,$100.72 ,$34.89 ,$130.13 ,$43.18 ,$16.92 ,$17.27 ,$126.75 ,$119.99 ,$119.99 ,$16.92 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$43.18 ,$143.65 ,$16.92 ,$169.00 ,$94.81 ,$16.92 ,$69.97 ,$8.34 ,$7.58 ,$16.92 ,$143.65 ,$36.27 ,$100.72 ,$47.32 ,$152.10 ,$16.92 ,$143.65 ,$69.08 ,$69.08 ,$16.92 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30101771,82653,HC EL-1 FECAL QUANTITATIVE-90,301,1 ,$323.00 ,$232.56 ,$7.58 ,$323.00 ,$57.43 ,$209.95 ,$192.83 ,$22.51 ,$90.44 ,$213.83 ,$22.51 ,$213.83 ,$22.51 ,$192.51 ,$192.51 ,$22.51 ,$192.51 ,$46.40 ,$248.71 ,$57.43 ,$22.51 ,$22.96 ,$242.25 ,$229.33 ,$229.33 ,$22.51 ,$229.33 ,$274.55 ,$274.55 ,$274.55 , N/A ,$57.43 ,$274.55 ,$22.51 ,$323.00 ,$181.20 ,$22.51 ,$133.72 ,$8.34 ,$7.58 ,$22.51 ,$274.55 ,$48.24 ,$192.51 ,$90.44 ,$290.70 ,$22.51 ,$274.55 ,$91.88 ,$91.88 ,$22.51 ,$209.95 ST. JOSEPH'S HOSPITAL - BREESE,30101774,80053,HC HEALTH FAIR COMPREHENSIVE METABOLIC PANEL,301,1 ,$10.00 ,$7.20 ,$2.80 ,$25.00 ,$25.00 ,$6.50 ,$5.97 ,$9.80 ,$2.80 ,$6.62 ,$9.80 ,$6.62 ,$9.80 ,$5.96 ,$5.96 ,$9.80 ,$5.96 ,$10.00 ,$7.70 ,$25.00 ,$9.80 ,$9.80 ,$7.50 ,$7.10 ,$7.10 ,$9.80 ,$7.10 ,$8.50 ,$8.50 ,$8.50 , N/A ,$10.00 ,$8.50 ,$9.80 ,$10.00 ,$5.61 ,$9.80 ,$4.14 ,$7.61 ,$6.92 ,$9.80 ,$8.50 ,$21.00 ,$5.96 ,$2.80 ,$9.00 ,$9.80 ,$8.50 ,$10.00 ,$10.00 ,$9.80 ,$6.50 ST. JOSEPH'S HOSPITAL - BREESE,30101780,80361,HC DRUG SCREENING OPIATES 1 OR MORE-90,301,1 ,$44.00 ,$31.68 ,$12.32 ,$44.00 , N/A ,$28.60 ,$26.27 , N/A ,$12.32 ,$29.13 , N/A ,$29.13 , N/A ,$26.22 ,$26.22 , N/A ,$26.22 , N/A ,$33.88 , N/A , N/A , N/A ,$33.00 ,$31.24 ,$31.24 , N/A ,$31.24 ,$37.40 ,$37.40 ,$37.40 , N/A , N/A ,$37.40 , N/A ,$44.00 ,$24.68 , N/A ,$18.22 ,$22.46 ,$20.42 , N/A ,$37.40 , N/A ,$26.22 ,$12.32 ,$39.60 , N/A ,$37.40 , N/A , N/A , N/A ,$28.60 ST. JOSEPH'S HOSPITAL - BREESE,30101787,82784,HC ASSAY IGA/IGD/IGG/IGM EACH-90,301,1 ,$29.00 ,$20.88 ,$7.58 ,$29.00 ,$23.25 ,$18.85 ,$17.31 ,$9.11 ,$8.12 ,$19.20 ,$9.11 ,$19.20 ,$9.11 ,$17.28 ,$17.28 ,$9.11 ,$17.28 ,$18.79 ,$22.33 ,$23.25 ,$9.11 ,$9.30 ,$21.75 ,$20.59 ,$20.59 ,$9.11 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$23.25 ,$24.65 ,$9.11 ,$29.00 ,$16.27 ,$9.11 ,$12.01 ,$8.34 ,$7.58 ,$9.11 ,$24.65 ,$19.53 ,$17.28 ,$8.12 ,$26.10 ,$9.11 ,$24.65 ,$29.00 ,$29.00 ,$9.11 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,30101788,84146,HC ASSAY OF PROLACTIN-90,301,1 ,$14.40 ,$10.37 ,$4.03 ,$36.00 ,$36.00 ,$9.36 ,$8.60 ,$14.11 ,$4.03 ,$9.53 ,$14.11 ,$9.53 ,$14.11 ,$8.58 ,$8.58 ,$14.11 ,$8.58 ,$14.40 ,$11.09 ,$36.00 ,$14.11 ,$14.11 ,$10.80 ,$10.22 ,$10.22 ,$14.11 ,$10.22 ,$12.24 ,$12.24 ,$12.24 , N/A ,$14.40 ,$12.24 ,$14.11 ,$14.40 ,$8.08 ,$14.11 ,$5.96 ,$14.40 ,$14.40 ,$14.11 ,$12.24 ,$30.24 ,$8.58 ,$4.03 ,$12.96 ,$14.11 ,$12.24 ,$14.40 ,$14.40 ,$14.11 ,$9.36 ST. JOSEPH'S HOSPITAL - BREESE,30101805,83735,HC ASSAY OF MAGNESIUM-90,301,1 ,$17.66 ,$12.72 ,$3.37 ,$17.66 ,$16.75 ,$11.48 ,$10.54 ,$6.57 ,$4.94 ,$11.69 ,$6.57 ,$11.69 ,$6.57 ,$10.53 ,$10.53 ,$6.57 ,$10.53 ,$13.53 ,$13.60 ,$16.75 ,$6.57 ,$6.69 ,$13.25 ,$12.54 ,$12.54 ,$6.57 ,$12.54 ,$15.01 ,$15.01 ,$15.01 , N/A ,$16.75 ,$15.01 ,$6.57 ,$17.66 ,$9.91 ,$6.57 ,$7.31 ,$3.71 ,$3.37 ,$6.57 ,$15.01 ,$14.07 ,$10.53 ,$4.94 ,$15.89 ,$6.57 ,$15.01 ,$17.66 ,$17.66 ,$6.57 ,$11.48 ST. JOSEPH'S HOSPITAL - BREESE,30101809,82131,HC AMINO ACIDS SINGLE QUANT-90,301,1 ,$26.96 ,$19.41 ,$7.55 ,$57.45 ,$57.45 ,$17.52 ,$16.10 ,$22.52 ,$7.55 ,$17.85 ,$22.52 ,$17.85 ,$22.52 ,$16.07 ,$16.07 ,$22.52 ,$16.07 ,$26.96 ,$20.76 ,$57.45 ,$22.52 ,$22.97 ,$20.22 ,$19.14 ,$19.14 ,$22.52 ,$19.14 ,$22.92 ,$22.92 ,$22.92 , N/A ,$26.96 ,$22.92 ,$22.52 ,$26.96 ,$15.12 ,$22.52 ,$11.16 ,$8.34 ,$7.58 ,$22.52 ,$22.92 ,$48.26 ,$16.07 ,$7.55 ,$24.26 ,$22.52 ,$22.92 ,$26.96 ,$26.96 ,$22.52 ,$17.52 ST. JOSEPH'S HOSPITAL - BREESE,30101821,82542,HC BETA-AMYLOID AD-DETECT-90,301,1 ,$292.00 ,$210.24 ,$7.58 ,$292.00 ,$60.23 ,$189.80 ,$174.32 ,$23.61 ,$81.76 ,$193.30 ,$23.61 ,$193.30 ,$23.61 ,$174.03 ,$174.03 ,$23.61 ,$174.03 ,$48.66 ,$224.84 ,$60.23 ,$23.61 ,$24.08 ,$219.00 ,$207.32 ,$207.32 ,$23.61 ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A ,$60.23 ,$248.20 ,$23.61 ,$292.00 ,$163.81 ,$23.61 ,$120.89 ,$8.34 ,$7.58 ,$23.61 ,$248.20 ,$50.59 ,$174.03 ,$81.76 ,$262.80 ,$23.61 ,$248.20 ,$96.36 ,$96.36 ,$23.61 ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,30200121,86060,HC ASO,302,1 ,$211.00 ,$151.92 ,$6.79 ,$211.00 ,$18.25 ,$137.15 ,$125.97 ,$7.15 ,$59.08 ,$139.68 ,$7.15 ,$139.68 ,$7.15 ,$125.76 ,$125.76 ,$7.15 ,$125.76 ,$14.75 ,$162.47 ,$18.25 ,$7.15 ,$7.30 ,$158.25 ,$149.81 ,$149.81 ,$7.15 ,$149.81 ,$179.35 ,$179.35 ,$179.35 , N/A ,$18.25 ,$179.35 ,$7.15 ,$211.00 ,$118.37 ,$7.15 ,$87.35 ,$7.47 ,$6.79 ,$7.15 ,$179.35 ,$15.33 ,$125.76 ,$59.08 ,$189.90 ,$7.15 ,$179.35 ,$29.20 ,$29.20 ,$7.15 ,$137.15 ST. JOSEPH'S HOSPITAL - BREESE,30200123,86140,HC C-REACTIVE PROTEIN,302,1 ,$165.00 ,$118.80 ,$5.08 ,$165.00 ,$12.95 ,$107.25 ,$98.51 ,$5.08 ,$46.20 ,$109.23 ,$5.08 ,$109.23 ,$5.08 ,$98.34 ,$98.34 ,$5.08 ,$98.34 ,$10.46 ,$127.05 ,$12.95 ,$5.08 ,$5.17 ,$123.75 ,$117.15 ,$117.15 ,$5.08 ,$117.15 ,$140.25 ,$140.25 ,$140.25 , N/A ,$12.95 ,$140.25 ,$5.08 ,$165.00 ,$92.57 ,$5.08 ,$68.31 ,$7.47 ,$6.79 ,$5.08 ,$140.25 ,$10.88 ,$98.34 ,$46.20 ,$148.50 ,$5.08 ,$140.25 ,$20.72 ,$20.72 ,$5.08 ,$107.25 ST. JOSEPH'S HOSPITAL - BREESE,30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$212.00 ,$152.64 ,$5.08 ,$212.00 ,$12.95 ,$137.80 ,$126.56 ,$5.08 ,$59.36 ,$140.34 ,$5.08 ,$140.34 ,$5.08 ,$126.35 ,$126.35 ,$5.08 ,$126.35 ,$10.46 ,$163.24 ,$12.95 ,$5.08 ,$5.17 ,$159.00 ,$150.52 ,$150.52 ,$5.08 ,$150.52 ,$180.20 ,$180.20 ,$180.20 , N/A ,$12.95 ,$180.20 ,$5.08 ,$212.00 ,$118.93 ,$5.08 ,$87.77 ,$7.47 ,$6.79 ,$5.08 ,$180.20 ,$10.88 ,$126.35 ,$59.36 ,$190.80 ,$5.08 ,$180.20 ,$20.72 ,$20.72 ,$5.08 ,$137.80 ST. JOSEPH'S HOSPITAL - BREESE,30200197,86430,HC RHEUMATOID FACTOR,302,1 ,$165.00 ,$118.80 ,$6.02 ,$165.00 ,$15.35 ,$107.25 ,$98.51 ,$6.02 ,$46.20 ,$109.23 ,$6.02 ,$109.23 ,$6.02 ,$98.34 ,$98.34 ,$6.02 ,$98.34 ,$12.40 ,$127.05 ,$15.35 ,$6.02 ,$6.13 ,$123.75 ,$117.15 ,$117.15 ,$6.02 ,$117.15 ,$140.25 ,$140.25 ,$140.25 , N/A ,$15.35 ,$140.25 ,$6.02 ,$165.00 ,$92.57 ,$6.02 ,$68.31 ,$7.47 ,$6.79 ,$6.02 ,$140.25 ,$12.89 ,$98.34 ,$46.20 ,$148.50 ,$6.02 ,$140.25 ,$24.56 ,$24.56 ,$6.02 ,$107.25 ST. JOSEPH'S HOSPITAL - BREESE,30200200,86580,HC SKIN TEST TB INTRADERMAL,302,1 ,$64.00 ,$46.08 ,$6.79 ,$64.00 ,$59.93 ,$41.60 ,$38.21 ,$23.49 ,$17.92 ,$42.37 ,$23.49 ,$42.37 ,$23.49 ,$38.14 ,$38.14 ,$23.49 ,$38.14 ,$48.42 ,$49.28 ,$59.93 ,$23.49 ,$23.96 ,$48.00 ,$45.44 ,$45.44 ,$23.49 ,$45.44 ,$54.40 ,$54.40 ,$54.40 , N/A ,$59.93 ,$54.40 ,$23.49 ,$64.00 ,$35.90 ,$23.49 ,$26.50 ,$7.47 ,$6.79 ,$23.49 ,$54.40 ,$50.34 ,$38.14 ,$17.92 ,$57.60 ,$23.49 ,$54.40 ,$64.00 ,$64.00 ,$23.49 ,$41.60 ST. JOSEPH'S HOSPITAL - BREESE,30200270,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$169.00 ,$121.68 ,$6.79 ,$169.00 ,$34.28 ,$109.85 ,$100.89 ,$13.44 ,$47.32 ,$111.88 ,$13.44 ,$111.88 ,$13.44 ,$100.72 ,$100.72 ,$13.44 ,$100.72 ,$27.69 ,$130.13 ,$34.28 ,$13.44 ,$13.70 ,$126.75 ,$119.99 ,$119.99 ,$13.44 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$34.28 ,$143.65 ,$13.44 ,$169.00 ,$94.81 ,$13.44 ,$69.97 ,$7.47 ,$6.79 ,$13.44 ,$143.65 ,$28.79 ,$100.72 ,$47.32 ,$152.10 ,$13.44 ,$143.65 ,$54.84 ,$54.84 ,$13.44 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30200561,86870,HC RBC AB ID PANEL,302,1 ,$260.00 ,$187.20 ,$6.79 ,$778.15 ,$778.15 ,$169.00 ,$155.22 ,$305.03 ,$72.80 ,$172.12 ,$305.03 ,$172.12 ,$254.80 ,$154.96 ,$154.96 ,$254.80 ,$154.96 ,$260.00 ,$200.20 ,$778.14 ,$305.03 ,$254.80 ,$195.00 ,$184.60 ,$184.60 ,$305.03 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$254.80 ,$260.00 ,$145.86 ,$305.03 ,$107.64 ,$7.47 ,$6.79 ,$305.03 ,$221.00 ,$653.64 ,$154.96 ,$72.80 ,$234.00 ,$305.03 ,$221.00 ,$260.00 ,$260.00 ,$305.03 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,30200562,86880,HC COOMBS DIRECT,302,1 ,$108.00 ,$77.76 ,$6.79 ,$138.00 ,$138.00 ,$70.20 ,$64.48 ,$54.10 ,$30.24 ,$71.50 ,$54.10 ,$71.50 ,$54.10 ,$64.37 ,$64.37 ,$54.10 ,$64.37 ,$108.00 ,$83.16 ,$138.00 ,$54.10 ,$55.17 ,$81.00 ,$76.68 ,$76.68 ,$54.10 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$108.00 ,$91.80 ,$54.10 ,$108.00 ,$60.59 ,$54.10 ,$44.71 ,$7.47 ,$6.79 ,$54.10 ,$91.80 ,$115.92 ,$64.37 ,$30.24 ,$97.20 ,$54.10 ,$91.80 ,$21.56 ,$21.56 ,$54.10 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30200563,86885,HC INDIRECT COOMBS,302,1 ,$108.00 ,$77.76 ,$6.79 ,$377.53 ,$377.53 ,$70.20 ,$64.48 ,$147.99 ,$30.24 ,$71.50 ,$147.99 ,$71.50 ,$105.84 ,$64.37 ,$64.37 ,$105.84 ,$64.37 ,$108.00 ,$83.16 ,$377.53 ,$147.99 ,$105.84 ,$81.00 ,$76.68 ,$76.68 ,$147.99 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$108.00 ,$91.80 ,$105.84 ,$108.00 ,$60.59 ,$147.99 ,$44.71 ,$7.47 ,$6.79 ,$147.99 ,$91.80 ,$317.13 ,$64.37 ,$30.24 ,$97.20 ,$147.99 ,$91.80 ,$22.88 ,$22.88 ,$147.99 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30200564,86890,HC AUTOLOGOUS PROCESSING FEE,302,1 ,"$1,693.00 ","$1,218.96 ",$27.42 ,"$1,693.00 ",$377.53 ,"$1,100.45 ","$1,010.72 ",$147.99 ,$474.04 ,"$1,120.77 ",$147.99 ,"$1,120.77 ",$147.99 ,"$1,009.03 ","$1,009.03 ",$147.99 ,"$1,009.03 ",$305.05 ,$500.00 ,$377.53 ,$147.99 ,$150.95 ,"$1,269.75 ","$1,202.03 ","$1,202.03 ",$147.99 ,"$1,202.03 ","$1,439.05 ","$1,439.05 ","$1,439.05 ", N/A ,$377.53 ,"$1,439.05 ",$147.99 ,"$1,693.00 ",$949.77 ,$147.99 ,$700.90 ,$30.16 ,$27.42 ,$147.99 ,"$1,439.05 ",$317.13 ,"$1,009.03 ",$474.04 ,"$1,523.70 ",$147.99 ,"$1,439.05 ",$596.64 ,$596.64 ,$147.99 ,"$1,100.45 " ST. JOSEPH'S HOSPITAL - BREESE,30200565,86900,HC BLOOD TYPING ABO,302,1 ,$82.00 ,$59.04 ,$4.21 ,$278.78 ,$278.78 ,$53.30 ,$48.95 ,$109.28 ,$22.96 ,$54.28 ,$109.28 ,$54.28 ,$80.36 ,$48.87 ,$48.87 ,$80.36 ,$48.87 ,$82.00 ,$63.14 ,$278.76 ,$109.28 ,$80.36 ,$61.50 ,$58.22 ,$58.22 ,$109.28 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$82.00 ,$69.70 ,$80.36 ,$82.00 ,$46.00 ,$109.28 ,$33.95 ,$4.63 ,$4.21 ,$109.28 ,$69.70 ,$234.16 ,$48.87 ,$22.96 ,$73.80 ,$109.28 ,$69.70 ,$11.96 ,$11.96 ,$109.28 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30200566,86901,HC BLOOD TYPING RH,302,1 ,$77.00 ,$55.44 ,$4.21 ,$81.53 ,$81.53 ,$50.05 ,$45.97 ,$31.96 ,$21.56 ,$50.97 ,$31.96 ,$50.97 ,$31.96 ,$45.89 ,$45.89 ,$31.96 ,$45.89 ,$65.88 ,$59.29 ,$81.53 ,$31.96 ,$32.60 ,$57.75 ,$54.67 ,$54.67 ,$31.96 ,$54.67 ,$65.45 ,$65.45 ,$65.45 , N/A ,$77.00 ,$65.45 ,$31.96 ,$77.00 ,$43.20 ,$31.96 ,$31.88 ,$4.63 ,$4.21 ,$31.96 ,$65.45 ,$68.49 ,$45.89 ,$21.56 ,$69.30 ,$31.96 ,$65.45 ,$11.96 ,$11.96 ,$31.96 ,$50.05 ST. JOSEPH'S HOSPITAL - BREESE,30200567,86902,HC RBC AG SCR RGT SERUM,302,1 ,$126.00 ,$90.72 ,$4.21 ,$778.15 ,$778.15 ,$81.90 ,$75.22 ,$305.03 ,$35.28 ,$83.41 ,$305.03 ,$83.41 ,$123.48 ,$75.10 ,$75.10 ,$123.48 ,$75.10 ,$126.00 ,$97.02 ,$778.14 ,$305.03 ,$123.48 ,$94.50 ,$89.46 ,$89.46 ,$305.03 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$126.00 ,$107.10 ,$123.48 ,$126.00 ,$70.69 ,$305.03 ,$52.16 ,$4.63 ,$4.21 ,$305.03 ,$107.10 ,$653.64 ,$75.10 ,$35.28 ,$113.40 ,$305.03 ,$107.10 ,$25.40 ,$25.40 ,$305.03 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$164.00 ,$118.08 ,$4.21 ,$778.15 ,$778.15 ,$106.60 ,$97.91 ,$305.03 ,$45.92 ,$108.57 ,$305.03 ,$108.57 ,$160.72 ,$97.74 ,$97.74 ,$160.72 ,$97.74 ,$164.00 ,$126.28 ,$778.14 ,$305.03 ,$160.72 ,$123.00 ,$116.44 ,$116.44 ,$305.03 ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A ,$164.00 ,$139.40 ,$160.72 ,$164.00 ,$92.00 ,$305.03 ,$67.90 ,$4.63 ,$4.21 ,$305.03 ,$139.40 ,$653.64 ,$97.74 ,$45.92 ,$147.60 ,$305.03 ,$139.40 ,$15.32 ,$15.32 ,$305.03 ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$184.00 ,$132.48 ,$4.21 ,$377.53 ,$377.53 ,$119.60 ,$109.85 ,$147.99 ,$51.52 ,$121.81 ,$147.99 ,$121.81 ,$147.99 ,$109.66 ,$109.66 ,$147.99 ,$109.66 ,$184.00 ,$141.68 ,$377.53 ,$147.99 ,$150.95 ,$138.00 ,$130.64 ,$130.64 ,$147.99 ,$130.64 ,$156.40 ,$156.40 ,$156.40 , N/A ,$184.00 ,$156.40 ,$147.99 ,$184.00 ,$103.22 ,$147.99 ,$76.18 ,$4.63 ,$4.21 ,$147.99 ,$156.40 ,$317.13 ,$109.66 ,$51.52 ,$165.60 ,$147.99 ,$156.40 ,$184.00 ,$184.00 ,$147.99 ,$119.60 ST. JOSEPH'S HOSPITAL - BREESE,30200571,86922,HC CROSSMATCH AHG,302,1 ,$158.00 ,$113.76 ,$27.42 ,$377.53 ,$377.53 ,$102.70 ,$94.33 ,$147.99 ,$44.24 ,$104.60 ,$147.99 ,$104.60 ,$147.99 ,$94.17 ,$94.17 ,$147.99 ,$94.17 ,$158.00 ,$121.66 ,$377.53 ,$147.99 ,$150.95 ,$118.50 ,$112.18 ,$112.18 ,$147.99 ,$112.18 ,$134.30 ,$134.30 ,$134.30 , N/A ,$158.00 ,$134.30 ,$147.99 ,$158.00 ,$88.64 ,$147.99 ,$65.41 ,$30.16 ,$27.42 ,$147.99 ,$134.30 ,$317.13 ,$94.17 ,$44.24 ,$142.20 ,$147.99 ,$134.30 ,$158.00 ,$158.00 ,$147.99 ,$102.70 ST. JOSEPH'S HOSPITAL - BREESE,30200839,86003,HC ALLERGEN IGE QN EA - 90,302,1 ,$10.28 ,$7.40 ,$2.88 ,$13.05 ,$13.05 ,$6.68 ,$6.14 ,$5.12 ,$2.88 ,$6.81 ,$5.12 ,$6.81 ,$5.12 ,$6.13 ,$6.13 ,$5.12 ,$6.13 ,$10.28 ,$7.92 ,$13.05 ,$5.12 ,$5.21 ,$7.71 ,$7.30 ,$7.30 ,$5.12 ,$7.30 ,$8.74 ,$8.74 ,$8.74 , N/A ,$10.28 ,$8.74 ,$5.12 ,$10.28 ,$5.77 ,$5.12 ,$4.26 ,$7.47 ,$6.79 ,$5.12 ,$8.74 ,$10.96 ,$6.13 ,$2.88 ,$9.25 ,$5.12 ,$8.74 ,$10.28 ,$10.28 ,$5.12 ,$6.68 ST. JOSEPH'S HOSPITAL - BREESE,30200844,86001,HC RAST ALLERGEN IGG QN SQ EA-90,302,1 ,$77.00 ,$55.44 ,$6.79 ,$77.00 ,$19.55 ,$50.05 ,$45.97 ,$7.66 ,$21.56 ,$50.97 ,$7.66 ,$50.97 ,$7.66 ,$45.89 ,$45.89 ,$7.66 ,$45.89 ,$15.80 ,$59.29 ,$19.55 ,$7.66 ,$7.82 ,$57.75 ,$54.67 ,$54.67 ,$7.66 ,$54.67 ,$65.45 ,$65.45 ,$65.45 , N/A ,$19.55 ,$65.45 ,$7.66 ,$77.00 ,$43.20 ,$7.66 ,$31.88 ,$7.47 ,$6.79 ,$7.66 ,$65.45 ,$16.42 ,$45.89 ,$21.56 ,$69.30 ,$7.66 ,$65.45 ,$31.28 ,$31.28 ,$7.66 ,$50.05 ST. JOSEPH'S HOSPITAL - BREESE,30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$78.00 ,$56.16 ,$5.12 ,$78.00 ,$13.05 ,$50.70 ,$46.57 ,$5.12 ,$21.84 ,$51.64 ,$5.12 ,$51.64 ,$5.12 ,$46.49 ,$46.49 ,$5.12 ,$46.49 ,$10.54 ,$60.06 ,$13.05 ,$5.12 ,$5.21 ,$58.50 ,$55.38 ,$55.38 ,$5.12 ,$55.38 ,$66.30 ,$66.30 ,$66.30 , N/A ,$13.05 ,$66.30 ,$5.12 ,$78.00 ,$43.76 ,$5.12 ,$32.29 ,$7.47 ,$6.79 ,$5.12 ,$66.30 ,$10.96 ,$46.49 ,$21.84 ,$70.20 ,$5.12 ,$66.30 ,$20.88 ,$20.88 ,$5.12 ,$50.70 ST. JOSEPH'S HOSPITAL - BREESE,30200847,86021,HC LEUKO AB ID-90,302,1 ,$256.00 ,$184.32 ,$6.79 ,$256.00 ,$37.63 ,$166.40 ,$152.83 ,$14.75 ,$71.68 ,$169.47 ,$14.75 ,$169.47 ,$14.75 ,$152.58 ,$152.58 ,$14.75 ,$152.58 ,$30.40 ,$197.12 ,$37.63 ,$14.75 ,$15.04 ,$192.00 ,$181.76 ,$181.76 ,$14.75 ,$181.76 ,$217.60 ,$217.60 ,$217.60 , N/A ,$37.63 ,$217.60 ,$14.75 ,$256.00 ,$143.62 ,$14.75 ,$105.98 ,$7.47 ,$6.79 ,$14.75 ,$217.60 ,$31.61 ,$152.58 ,$71.68 ,$230.40 ,$14.75 ,$217.60 ,$60.20 ,$60.20 ,$14.75 ,$166.40 ST. JOSEPH'S HOSPITAL - BREESE,30200851,86022,HC PLATELET AB ID-90,302,1 ,$200.00 ,$144.00 ,$6.79 ,$200.00 ,$45.93 ,$130.00 ,$119.40 ,$18.00 ,$56.00 ,$132.40 ,$18.00 ,$132.40 ,$18.00 ,$119.20 ,$119.20 ,$18.00 ,$119.20 ,$37.11 ,$154.00 ,$45.93 ,$18.00 ,$18.37 ,$150.00 ,$142.00 ,$142.00 ,$18.00 ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A ,$45.93 ,$170.00 ,$18.00 ,$200.00 ,$112.20 ,$18.00 ,$82.80 ,$7.47 ,$6.79 ,$18.00 ,$170.00 ,$38.58 ,$119.20 ,$56.00 ,$180.00 ,$18.00 ,$170.00 ,$73.48 ,$73.48 ,$18.00 ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,30200857,86023,HC PLATELET ASSOC AB ID IGG-90,302,1 ,$145.00 ,$104.40 ,$6.79 ,$145.00 ,$31.15 ,$94.25 ,$86.57 ,$12.21 ,$40.60 ,$95.99 ,$12.21 ,$95.99 ,$12.21 ,$86.42 ,$86.42 ,$12.21 ,$86.42 ,$25.17 ,$111.65 ,$31.15 ,$12.21 ,$12.46 ,$108.75 ,$102.95 ,$102.95 ,$12.21 ,$102.95 ,$123.25 ,$123.25 ,$123.25 , N/A ,$31.15 ,$123.25 ,$12.21 ,$145.00 ,$81.35 ,$12.21 ,$60.03 ,$7.47 ,$6.79 ,$12.21 ,$123.25 ,$26.17 ,$86.42 ,$40.60 ,$130.50 ,$12.21 ,$123.25 ,$49.84 ,$49.84 ,$12.21 ,$94.25 ST. JOSEPH'S HOSPITAL - BREESE,30200858,86038,HC ANA SCREEN-90,302,1 ,$150.00 ,$108.00 ,$6.79 ,$150.00 ,$30.23 ,$97.50 ,$89.55 ,$11.85 ,$42.00 ,$99.30 ,$11.85 ,$99.30 ,$11.85 ,$89.40 ,$89.40 ,$11.85 ,$89.40 ,$24.42 ,$115.50 ,$30.23 ,$11.85 ,$12.08 ,$112.50 ,$106.50 ,$106.50 ,$11.85 ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A ,$30.23 ,$127.50 ,$11.85 ,$150.00 ,$84.15 ,$11.85 ,$62.10 ,$7.47 ,$6.79 ,$11.85 ,$127.50 ,$25.39 ,$89.40 ,$42.00 ,$135.00 ,$11.85 ,$127.50 ,$48.36 ,$48.36 ,$11.85 ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,30200859,86039,HC ANA TITER-90,302,1 ,$134.00 ,$96.48 ,$6.79 ,$134.00 ,$27.90 ,$87.10 ,$80.00 ,$10.94 ,$37.52 ,$88.71 ,$10.94 ,$88.71 ,$10.94 ,$79.86 ,$79.86 ,$10.94 ,$79.86 ,$22.54 ,$103.18 ,$27.90 ,$10.94 ,$11.15 ,$100.50 ,$95.14 ,$95.14 ,$10.94 ,$95.14 ,$113.90 ,$113.90 ,$113.90 , N/A ,$27.90 ,$113.90 ,$10.94 ,$134.00 ,$75.17 ,$10.94 ,$55.48 ,$7.47 ,$6.79 ,$10.94 ,$113.90 ,$23.44 ,$79.86 ,$37.52 ,$120.60 ,$10.94 ,$113.90 ,$44.64 ,$44.64 ,$10.94 ,$87.10 ST. JOSEPH'S HOSPITAL - BREESE,30200860,86060,HC ASO-90,302,1 ,$12.00 ,$8.64 ,$3.36 ,$18.25 ,$18.25 ,$7.80 ,$7.16 ,$7.15 ,$3.36 ,$7.94 ,$7.15 ,$7.94 ,$7.15 ,$7.15 ,$7.15 ,$7.15 ,$7.15 ,$12.00 ,$9.24 ,$18.25 ,$7.15 ,$7.30 ,$9.00 ,$8.52 ,$8.52 ,$7.15 ,$8.52 ,$10.20 ,$10.20 ,$10.20 , N/A ,$12.00 ,$10.20 ,$7.15 ,$12.00 ,$6.73 ,$7.15 ,$4.97 ,$7.47 ,$6.79 ,$7.15 ,$10.20 ,$15.33 ,$7.15 ,$3.36 ,$10.80 ,$7.15 ,$10.20 ,$12.00 ,$12.00 ,$7.15 ,$7.80 ST. JOSEPH'S HOSPITAL - BREESE,30200863,86141,HC C-REACTIVE PROTEIN (HS)-90,302,1 ,$202.00 ,$145.44 ,$6.79 ,$202.00 ,$32.38 ,$131.30 ,$120.59 ,$12.69 ,$56.56 ,$133.72 ,$12.69 ,$133.72 ,$12.69 ,$120.39 ,$120.39 ,$12.69 ,$120.39 ,$26.16 ,$155.54 ,$32.38 ,$12.69 ,$12.95 ,$151.50 ,$143.42 ,$143.42 ,$12.69 ,$143.42 ,$171.70 ,$171.70 ,$171.70 , N/A ,$32.38 ,$171.70 ,$12.69 ,$202.00 ,$113.32 ,$12.69 ,$83.63 ,$7.47 ,$6.79 ,$12.69 ,$171.70 ,$27.20 ,$120.39 ,$56.56 ,$181.80 ,$12.69 ,$171.70 ,$51.80 ,$51.80 ,$12.69 ,$131.30 ST. JOSEPH'S HOSPITAL - BREESE,30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$108.00 ,$77.76 ,$7.58 ,$108.00 ,$63.63 ,$70.20 ,$64.48 ,$24.94 ,$30.24 ,$71.50 ,$24.94 ,$71.50 ,$24.94 ,$64.37 ,$64.37 ,$24.94 ,$64.37 ,$51.41 ,$83.16 ,$63.63 ,$24.94 ,$25.44 ,$81.00 ,$76.68 ,$76.68 ,$24.94 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$63.63 ,$91.80 ,$24.94 ,$108.00 ,$60.59 ,$24.94 ,$44.71 ,$8.34 ,$7.58 ,$24.94 ,$91.80 ,$53.45 ,$64.37 ,$30.24 ,$97.20 ,$24.94 ,$91.80 ,$101.80 ,$101.80 ,$24.94 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$179.00 ,$128.88 ,$11.71 ,$179.00 ,$63.63 ,$116.35 ,$106.86 ,$24.94 ,$50.12 ,$118.50 ,$24.94 ,$118.50 ,$24.94 ,$106.68 ,$106.68 ,$24.94 ,$106.68 ,$51.41 ,$137.83 ,$63.63 ,$24.94 ,$25.44 ,$134.25 ,$127.09 ,$127.09 ,$24.94 ,$127.09 ,$152.15 ,$152.15 ,$152.15 , N/A ,$63.63 ,$152.15 ,$24.94 ,$179.00 ,$100.42 ,$24.94 ,$74.11 ,$12.88 ,$11.71 ,$24.94 ,$152.15 ,$53.45 ,$106.68 ,$50.12 ,$161.10 ,$24.94 ,$152.15 ,$101.80 ,$101.80 ,$24.94 ,$116.35 ST. JOSEPH'S HOSPITAL - BREESE,30200866,86148,HC ANTI-PHOSPHATIDYLSERINE AB-90,302,1 ,$69.00 ,$49.68 ,$7.58 ,$69.00 ,$40.18 ,$44.85 ,$41.19 ,$15.75 ,$19.32 ,$45.68 ,$15.75 ,$45.68 ,$15.75 ,$41.12 ,$41.12 ,$15.75 ,$41.12 ,$32.46 ,$53.13 ,$40.18 ,$15.75 ,$16.06 ,$51.75 ,$48.99 ,$48.99 ,$15.75 ,$48.99 ,$58.65 ,$58.65 ,$58.65 , N/A ,$40.18 ,$58.65 ,$15.75 ,$69.00 ,$38.71 ,$15.75 ,$28.57 ,$8.34 ,$7.58 ,$15.75 ,$58.65 ,$33.75 ,$41.12 ,$19.32 ,$62.10 ,$15.75 ,$58.65 ,$64.28 ,$64.28 ,$15.75 ,$44.85 ST. JOSEPH'S HOSPITAL - BREESE,30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$254.00 ,$182.88 ,$6.79 ,$254.00 ,$20.15 ,$165.10 ,$151.64 ,$7.90 ,$71.12 ,$168.15 ,$7.90 ,$168.15 ,$7.90 ,$151.38 ,$151.38 ,$7.90 ,$151.38 ,$16.28 ,$195.58 ,$20.15 ,$7.90 ,$8.06 ,$190.50 ,$180.34 ,$180.34 ,$7.90 ,$180.34 ,$215.90 ,$215.90 ,$215.90 , N/A ,$20.15 ,$215.90 ,$7.90 ,$254.00 ,$142.49 ,$7.90 ,$105.16 ,$7.47 ,$6.79 ,$7.90 ,$215.90 ,$16.93 ,$151.38 ,$71.12 ,$228.60 ,$7.90 ,$215.90 ,$32.24 ,$32.24 ,$7.90 ,$165.10 ST. JOSEPH'S HOSPITAL - BREESE,30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$186.00 ,$133.92 ,$6.79 ,$186.00 ,$30.00 ,$120.90 ,$111.04 ,$11.76 ,$52.08 ,$123.13 ,$11.76 ,$123.13 ,$11.76 ,$110.86 ,$110.86 ,$11.76 ,$110.86 ,$24.24 ,$143.22 ,$30.00 ,$11.76 ,$12.00 ,$139.50 ,$132.06 ,$132.06 ,$11.76 ,$132.06 ,$158.10 ,$158.10 ,$158.10 , N/A ,$30.00 ,$158.10 ,$11.76 ,$186.00 ,$104.35 ,$11.76 ,$77.00 ,$7.47 ,$6.79 ,$11.76 ,$158.10 ,$25.20 ,$110.86 ,$52.08 ,$167.40 ,$11.76 ,$158.10 ,$48.00 ,$48.00 ,$11.76 ,$120.90 ST. JOSEPH'S HOSPITAL - BREESE,30200870,86161,HC C1 ESTERASE INHIBITOR-90,302,1 ,$129.00 ,$92.88 ,$6.79 ,$129.00 ,$30.00 ,$83.85 ,$77.01 ,$11.76 ,$36.12 ,$85.40 ,$11.76 ,$85.40 ,$11.76 ,$76.88 ,$76.88 ,$11.76 ,$76.88 ,$24.24 ,$99.33 ,$30.00 ,$11.76 ,$12.00 ,$96.75 ,$91.59 ,$91.59 ,$11.76 ,$91.59 ,$109.65 ,$109.65 ,$109.65 , N/A ,$30.00 ,$109.65 ,$11.76 ,$129.00 ,$72.37 ,$11.76 ,$53.41 ,$7.47 ,$6.79 ,$11.76 ,$109.65 ,$25.20 ,$76.88 ,$36.12 ,$116.10 ,$11.76 ,$109.65 ,$48.00 ,$48.00 ,$11.76 ,$83.85 ST. JOSEPH'S HOSPITAL - BREESE,30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$183.00 ,$131.76 ,$6.79 ,$183.00 ,$50.80 ,$118.95 ,$109.25 ,$19.91 ,$51.24 ,$121.15 ,$19.91 ,$121.15 ,$19.91 ,$109.07 ,$109.07 ,$19.91 ,$109.07 ,$41.05 ,$140.91 ,$50.80 ,$19.91 ,$20.32 ,$137.25 ,$129.93 ,$129.93 ,$19.91 ,$129.93 ,$155.55 ,$155.55 ,$155.55 , N/A ,$50.80 ,$155.55 ,$19.91 ,$183.00 ,$102.66 ,$19.91 ,$75.76 ,$7.47 ,$6.79 ,$19.91 ,$155.55 ,$42.67 ,$109.07 ,$51.24 ,$164.70 ,$19.91 ,$155.55 ,$81.28 ,$81.28 ,$19.91 ,$118.95 ST. JOSEPH'S HOSPITAL - BREESE,30200873,86200,HC CCP AB-90,302,1 ,$248.00 ,$178.56 ,$6.79 ,$248.00 ,$32.38 ,$161.20 ,$148.06 ,$12.69 ,$69.44 ,$164.18 ,$12.69 ,$164.18 ,$12.69 ,$147.81 ,$147.81 ,$12.69 ,$147.81 ,$26.16 ,$190.96 ,$32.38 ,$12.69 ,$12.95 ,$186.00 ,$176.08 ,$176.08 ,$12.69 ,$176.08 ,$210.80 ,$210.80 ,$210.80 , N/A ,$32.38 ,$210.80 ,$12.69 ,$248.00 ,$139.13 ,$12.69 ,$102.67 ,$7.47 ,$6.79 ,$12.69 ,$210.80 ,$27.20 ,$147.81 ,$69.44 ,$223.20 ,$12.69 ,$210.80 ,$51.80 ,$51.80 ,$12.69 ,$161.20 ST. JOSEPH'S HOSPITAL - BREESE,30200874,86215,HC DEOXYRIBONUCLEASE AB-90,302,1 ,$160.00 ,$115.20 ,$6.79 ,$160.00 ,$33.13 ,$104.00 ,$95.52 ,$12.98 ,$44.80 ,$105.92 ,$12.98 ,$105.92 ,$12.98 ,$95.36 ,$95.36 ,$12.98 ,$95.36 ,$26.77 ,$123.20 ,$33.13 ,$12.98 ,$13.25 ,$120.00 ,$113.60 ,$113.60 ,$12.98 ,$113.60 ,$136.00 ,$136.00 ,$136.00 , N/A ,$33.13 ,$136.00 ,$12.98 ,$160.00 ,$89.76 ,$12.98 ,$66.24 ,$7.47 ,$6.79 ,$12.98 ,$136.00 ,$27.83 ,$95.36 ,$44.80 ,$144.00 ,$12.98 ,$136.00 ,$53.00 ,$53.00 ,$12.98 ,$104.00 ST. JOSEPH'S HOSPITAL - BREESE,30200875,86225,HC DNA DOUBLE STRAND AB-90,302,1 ,$166.00 ,$119.52 ,$6.79 ,$166.00 ,$34.35 ,$107.90 ,$99.10 ,$13.47 ,$46.48 ,$109.89 ,$13.47 ,$109.89 ,$13.47 ,$98.94 ,$98.94 ,$13.47 ,$98.94 ,$27.75 ,$127.82 ,$34.35 ,$13.47 ,$13.73 ,$124.50 ,$117.86 ,$117.86 ,$13.47 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$34.35 ,$141.10 ,$13.47 ,$166.00 ,$93.13 ,$13.47 ,$68.72 ,$7.47 ,$6.79 ,$13.47 ,$141.10 ,$28.85 ,$98.94 ,$46.48 ,$149.40 ,$13.47 ,$141.10 ,$54.96 ,$54.96 ,$13.47 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30200877,86235,HC ENA AB-90,302,1 ,$177.00 ,$127.44 ,$11.71 ,$177.00 ,$44.83 ,$115.05 ,$105.67 ,$17.57 ,$49.56 ,$117.17 ,$17.57 ,$117.17 ,$17.57 ,$105.49 ,$105.49 ,$17.57 ,$105.49 ,$36.22 ,$136.29 ,$44.83 ,$17.57 ,$17.92 ,$132.75 ,$125.67 ,$125.67 ,$17.57 ,$125.67 ,$150.45 ,$150.45 ,$150.45 , N/A ,$44.83 ,$150.45 ,$17.57 ,$177.00 ,$99.30 ,$17.57 ,$73.28 ,$12.88 ,$11.71 ,$17.57 ,$150.45 ,$37.65 ,$105.49 ,$49.56 ,$159.30 ,$17.57 ,$150.45 ,$71.72 ,$71.72 ,$17.57 ,$115.05 ST. JOSEPH'S HOSPITAL - BREESE,30200878,86255,HC FLUOR AB SCR-90,302,1 ,$211.00 ,$151.92 ,$11.71 ,$211.00 ,$30.13 ,$137.15 ,$125.97 ,$11.81 ,$59.08 ,$139.68 ,$11.81 ,$139.68 ,$11.81 ,$125.76 ,$125.76 ,$11.81 ,$125.76 ,$24.34 ,$162.47 ,$30.13 ,$11.81 ,$12.04 ,$158.25 ,$149.81 ,$149.81 ,$11.81 ,$149.81 ,$179.35 ,$179.35 ,$179.35 , N/A ,$30.13 ,$179.35 ,$11.81 ,$211.00 ,$118.37 ,$11.81 ,$87.35 ,$12.88 ,$11.71 ,$11.81 ,$179.35 ,$25.31 ,$125.76 ,$59.08 ,$189.90 ,$11.81 ,$179.35 ,$48.20 ,$48.20 ,$11.81 ,$137.15 ST. JOSEPH'S HOSPITAL - BREESE,30200879,86256,HC FLUOR AB TITER-90,302,1 ,$64.00 ,$46.08 ,$11.71 ,$64.00 ,$30.13 ,$41.60 ,$38.21 ,$11.81 ,$17.92 ,$42.37 ,$11.81 ,$42.37 ,$11.81 ,$38.14 ,$38.14 ,$11.81 ,$38.14 ,$24.34 ,$49.28 ,$30.13 ,$11.81 ,$12.04 ,$48.00 ,$45.44 ,$45.44 ,$11.81 ,$45.44 ,$54.40 ,$54.40 ,$54.40 , N/A ,$30.13 ,$54.40 ,$11.81 ,$64.00 ,$35.90 ,$11.81 ,$26.50 ,$12.88 ,$11.71 ,$11.81 ,$54.40 ,$25.31 ,$38.14 ,$17.92 ,$57.60 ,$11.81 ,$54.40 ,$48.20 ,$48.20 ,$11.81 ,$41.60 ST. JOSEPH'S HOSPITAL - BREESE,30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$205.00 ,$147.60 ,$18.00 ,$205.00 ,$52.03 ,$133.25 ,$122.39 ,$20.39 ,$57.40 ,$135.71 ,$20.39 ,$135.71 ,$20.39 ,$122.18 ,$122.18 ,$20.39 ,$122.18 ,$42.04 ,$157.85 ,$52.03 ,$20.39 ,$20.81 ,$153.75 ,$145.55 ,$145.55 ,$20.39 ,$145.55 ,$174.25 ,$174.25 ,$174.25 , N/A ,$52.03 ,$174.25 ,$20.39 ,$205.00 ,$115.01 ,$20.39 ,$84.87 ,$19.80 ,$18.00 ,$20.39 ,$174.25 ,$43.70 ,$122.18 ,$57.40 ,$184.50 ,$20.39 ,$174.25 ,$83.24 ,$83.24 ,$20.39 ,$133.25 ST. JOSEPH'S HOSPITAL - BREESE,30200881,86301,HC TUMOR AG CA 19-9 -90,302,1 ,$200.00 ,$144.00 ,$18.00 ,$200.00 ,$52.03 ,$130.00 ,$119.40 ,$20.39 ,$56.00 ,$132.40 ,$20.39 ,$132.40 ,$20.39 ,$119.20 ,$119.20 ,$20.39 ,$119.20 ,$42.04 ,$154.00 ,$52.03 ,$20.39 ,$20.81 ,$150.00 ,$142.00 ,$142.00 ,$20.39 ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A ,$52.03 ,$170.00 ,$20.39 ,$200.00 ,$112.20 ,$20.39 ,$82.80 ,$19.80 ,$18.00 ,$20.39 ,$170.00 ,$43.70 ,$119.20 ,$56.00 ,$180.00 ,$20.39 ,$170.00 ,$83.24 ,$83.24 ,$20.39 ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,30200882,86304,HC TUMOR AG CA 125 -90,302,1 ,$63.00 ,$45.36 ,$17.64 ,$63.00 ,$52.03 ,$40.95 ,$37.61 ,$20.39 ,$17.64 ,$41.71 ,$20.39 ,$41.71 ,$20.39 ,$37.55 ,$37.55 ,$20.39 ,$37.55 ,$42.04 ,$48.51 ,$52.03 ,$20.39 ,$20.81 ,$47.25 ,$44.73 ,$44.73 ,$20.39 ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A ,$52.03 ,$53.55 ,$20.39 ,$63.00 ,$35.34 ,$20.39 ,$26.08 ,$19.80 ,$18.00 ,$20.39 ,$53.55 ,$43.70 ,$37.55 ,$17.64 ,$56.70 ,$20.39 ,$53.55 ,$63.00 ,$63.00 ,$20.39 ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,30200883,86305,HC HE4 OVARIAN CANCER-90,302,1 ,$678.00 ,$488.16 ,$18.00 ,$678.00 ,$52.03 ,$440.70 ,$404.77 ,$20.39 ,$189.84 ,$448.84 ,$20.39 ,$448.84 ,$20.39 ,$404.09 ,$404.09 ,$20.39 ,$404.09 ,$42.04 ,$500.00 ,$52.03 ,$20.39 ,$20.81 ,$508.50 ,$481.38 ,$481.38 ,$20.39 ,$481.38 ,$576.30 ,$576.30 ,$576.30 , N/A ,$52.03 ,$576.30 ,$20.39 ,$678.00 ,$380.36 ,$20.39 ,$280.69 ,$19.80 ,$18.00 ,$20.39 ,$576.30 ,$43.70 ,$404.09 ,$189.84 ,$610.20 ,$20.39 ,$576.30 ,$83.24 ,$83.24 ,$20.39 ,$440.70 ST. JOSEPH'S HOSPITAL - BREESE,30200886,86632,HC CHLAMYDIA AB IGM-90,302,1 ,$185.00 ,$133.20 ,$5.42 ,$185.00 ,$31.70 ,$120.25 ,$110.45 ,$12.43 ,$51.80 ,$122.47 ,$12.43 ,$122.47 ,$12.43 ,$110.26 ,$110.26 ,$12.43 ,$110.26 ,$25.61 ,$142.45 ,$31.70 ,$12.43 ,$12.67 ,$138.75 ,$131.35 ,$131.35 ,$12.43 ,$131.35 ,$157.25 ,$157.25 ,$157.25 , N/A ,$31.70 ,$157.25 ,$12.43 ,$185.00 ,$103.79 ,$12.43 ,$76.59 ,$5.96 ,$5.42 ,$12.43 ,$157.25 ,$26.63 ,$110.26 ,$51.80 ,$166.50 ,$12.43 ,$157.25 ,$50.72 ,$50.72 ,$12.43 ,$120.25 ST. JOSEPH'S HOSPITAL - BREESE,30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$150.00 ,$108.00 ,$11.24 ,$150.00 ,$28.68 ,$97.50 ,$89.55 ,$11.24 ,$42.00 ,$99.30 ,$11.24 ,$99.30 ,$11.24 ,$89.40 ,$89.40 ,$11.24 ,$89.40 ,$23.17 ,$115.50 ,$28.68 ,$11.24 ,$11.47 ,$112.50 ,$106.50 ,$106.50 ,$11.24 ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A ,$28.68 ,$127.50 ,$11.24 ,$150.00 ,$84.15 ,$11.24 ,$62.10 ,$12.88 ,$11.71 ,$11.24 ,$127.50 ,$24.09 ,$89.40 ,$42.00 ,$135.00 ,$11.24 ,$127.50 ,$45.88 ,$45.88 ,$11.24 ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,30200889,86641,HC CRYPTOCOCCAL AB-90,302,1 ,$23.00 ,$16.56 ,$6.44 ,$36.03 ,$36.03 ,$14.95 ,$13.73 ,$14.12 ,$6.44 ,$15.23 ,$14.12 ,$15.23 ,$14.12 ,$13.71 ,$13.71 ,$14.12 ,$13.71 ,$23.00 ,$17.71 ,$36.03 ,$14.12 ,$14.41 ,$17.25 ,$16.33 ,$16.33 ,$14.12 ,$16.33 ,$19.55 ,$19.55 ,$19.55 , N/A ,$23.00 ,$19.55 ,$14.12 ,$23.00 ,$12.90 ,$14.12 ,$9.52 ,$12.88 ,$11.71 ,$14.12 ,$19.55 ,$30.26 ,$13.71 ,$6.44 ,$20.70 ,$14.12 ,$19.55 ,$23.00 ,$23.00 ,$14.12 ,$14.95 ST. JOSEPH'S HOSPITAL - BREESE,30200890,86644,HC CMV AB-90,302,1 ,$179.00 ,$128.88 ,$11.71 ,$179.00 ,$35.98 ,$116.35 ,$106.86 ,$14.10 ,$50.12 ,$118.50 ,$14.10 ,$118.50 ,$14.10 ,$106.68 ,$106.68 ,$14.10 ,$106.68 ,$29.07 ,$137.83 ,$35.98 ,$14.10 ,$14.39 ,$134.25 ,$127.09 ,$127.09 ,$14.10 ,$127.09 ,$152.15 ,$152.15 ,$152.15 , N/A ,$35.98 ,$152.15 ,$14.10 ,$179.00 ,$100.42 ,$14.10 ,$74.11 ,$12.88 ,$11.71 ,$14.10 ,$152.15 ,$30.22 ,$106.68 ,$50.12 ,$161.10 ,$14.10 ,$152.15 ,$57.56 ,$57.56 ,$14.10 ,$116.35 ST. JOSEPH'S HOSPITAL - BREESE,30200891,86645,HC CMV AB IGM-90,302,1 ,$126.00 ,$90.72 ,$11.71 ,$126.00 ,$42.13 ,$81.90 ,$75.22 ,$16.51 ,$35.28 ,$83.41 ,$16.51 ,$83.41 ,$16.51 ,$75.10 ,$75.10 ,$16.51 ,$75.10 ,$34.04 ,$97.02 ,$42.13 ,$16.51 ,$16.85 ,$94.50 ,$89.46 ,$89.46 ,$16.51 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$42.13 ,$107.10 ,$16.51 ,$126.00 ,$70.69 ,$16.51 ,$52.16 ,$12.88 ,$11.71 ,$16.51 ,$107.10 ,$35.39 ,$75.10 ,$35.28 ,$113.40 ,$16.51 ,$107.10 ,$67.40 ,$67.40 ,$16.51 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,30200892,86648,HC DIPTHERIA-90,302,1 ,$210.00 ,$151.20 ,$11.71 ,$210.00 ,$38.03 ,$136.50 ,$125.37 ,$14.91 ,$58.80 ,$139.02 ,$14.91 ,$139.02 ,$14.91 ,$125.16 ,$125.16 ,$14.91 ,$125.16 ,$30.72 ,$161.70 ,$38.03 ,$14.91 ,$15.20 ,$157.50 ,$149.10 ,$149.10 ,$14.91 ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A ,$38.03 ,$178.50 ,$14.91 ,$210.00 ,$117.81 ,$14.91 ,$86.94 ,$12.88 ,$11.71 ,$14.91 ,$178.50 ,$31.94 ,$125.16 ,$58.80 ,$189.00 ,$14.91 ,$178.50 ,$60.84 ,$60.84 ,$14.91 ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,30200897,86658,HC ENTEROVIRUS AB-90,302,1 ,$36.00 ,$25.92 ,$10.08 ,$36.00 ,$32.58 ,$23.40 ,$21.49 ,$12.77 ,$10.08 ,$23.83 ,$12.77 ,$23.83 ,$12.77 ,$21.46 ,$21.46 ,$12.77 ,$21.46 ,$26.32 ,$27.72 ,$32.58 ,$12.77 ,$13.02 ,$27.00 ,$25.56 ,$25.56 ,$12.77 ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A ,$32.58 ,$30.60 ,$12.77 ,$36.00 ,$20.20 ,$12.77 ,$14.90 ,$12.88 ,$11.71 ,$12.77 ,$30.60 ,$27.36 ,$21.46 ,$10.08 ,$32.40 ,$12.77 ,$30.60 ,$36.00 ,$36.00 ,$12.77 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30200898,86663,HC EBV EARLY AG-90,302,1 ,$108.00 ,$77.76 ,$11.71 ,$108.00 ,$32.80 ,$70.20 ,$64.48 ,$12.86 ,$30.24 ,$71.50 ,$12.86 ,$71.50 ,$12.86 ,$64.37 ,$64.37 ,$12.86 ,$64.37 ,$26.50 ,$83.16 ,$32.80 ,$12.86 ,$13.11 ,$81.00 ,$76.68 ,$76.68 ,$12.86 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$32.80 ,$91.80 ,$12.86 ,$108.00 ,$60.59 ,$12.86 ,$44.71 ,$12.88 ,$11.71 ,$12.86 ,$91.80 ,$27.55 ,$64.37 ,$30.24 ,$97.20 ,$12.86 ,$91.80 ,$52.48 ,$52.48 ,$12.86 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$73.00 ,$52.56 ,$11.71 ,$73.00 ,$38.23 ,$47.45 ,$43.58 ,$14.98 ,$20.44 ,$48.33 ,$14.98 ,$48.33 ,$14.98 ,$43.51 ,$43.51 ,$14.98 ,$43.51 ,$30.89 ,$56.21 ,$38.23 ,$14.98 ,$15.29 ,$54.75 ,$51.83 ,$51.83 ,$14.98 ,$51.83 ,$62.05 ,$62.05 ,$62.05 , N/A ,$38.23 ,$62.05 ,$14.98 ,$73.00 ,$40.95 ,$14.98 ,$30.22 ,$12.88 ,$11.71 ,$14.98 ,$62.05 ,$32.11 ,$43.51 ,$20.44 ,$65.70 ,$14.98 ,$62.05 ,$61.16 ,$61.16 ,$14.98 ,$47.45 ST. JOSEPH'S HOSPITAL - BREESE,30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$91.00 ,$65.52 ,$11.71 ,$91.00 ,$45.35 ,$59.15 ,$54.33 ,$17.78 ,$25.48 ,$60.24 ,$17.78 ,$60.24 ,$17.78 ,$54.24 ,$54.24 ,$17.78 ,$54.24 ,$36.64 ,$70.07 ,$45.35 ,$17.78 ,$18.13 ,$68.25 ,$64.61 ,$64.61 ,$17.78 ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A ,$45.35 ,$77.35 ,$17.78 ,$91.00 ,$51.05 ,$17.78 ,$37.67 ,$12.88 ,$11.71 ,$17.78 ,$77.35 ,$38.09 ,$54.24 ,$25.48 ,$81.90 ,$17.78 ,$77.35 ,$72.56 ,$72.56 ,$17.78 ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,30200901,86666,HC EHRLICHIA AB-90,302,1 ,$173.00 ,$124.56 ,$9.98 ,$173.00 ,$25.45 ,$112.45 ,$103.28 ,$9.98 ,$48.44 ,$114.53 ,$9.98 ,$114.53 ,$9.98 ,$103.11 ,$103.11 ,$9.98 ,$103.11 ,$20.56 ,$133.21 ,$25.45 ,$9.98 ,$10.17 ,$129.75 ,$122.83 ,$122.83 ,$9.98 ,$122.83 ,$147.05 ,$147.05 ,$147.05 , N/A ,$25.45 ,$147.05 ,$9.98 ,$173.00 ,$97.05 ,$9.98 ,$71.62 ,$12.88 ,$11.71 ,$9.98 ,$147.05 ,$21.38 ,$103.11 ,$48.44 ,$155.70 ,$9.98 ,$147.05 ,$40.72 ,$40.72 ,$9.98 ,$112.45 ST. JOSEPH'S HOSPITAL - BREESE,30200902,86668,HC FRANCISELLA AB-90,302,1 ,$211.00 ,$151.92 ,$11.71 ,$211.00 ,$35.40 ,$137.15 ,$125.97 ,$13.88 ,$59.08 ,$139.68 ,$13.88 ,$139.68 ,$13.88 ,$125.76 ,$125.76 ,$13.88 ,$125.76 ,$28.60 ,$162.47 ,$35.40 ,$13.88 ,$14.15 ,$158.25 ,$149.81 ,$149.81 ,$13.88 ,$149.81 ,$179.35 ,$179.35 ,$179.35 , N/A ,$35.40 ,$179.35 ,$13.88 ,$211.00 ,$118.37 ,$13.88 ,$87.35 ,$12.88 ,$11.71 ,$13.88 ,$179.35 ,$29.74 ,$125.76 ,$59.08 ,$189.90 ,$13.88 ,$179.35 ,$56.64 ,$56.64 ,$13.88 ,$137.15 ST. JOSEPH'S HOSPITAL - BREESE,30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$179.00 ,$128.88 ,$6.79 ,$179.00 ,$30.63 ,$116.35 ,$106.86 ,$12.00 ,$50.12 ,$118.50 ,$12.00 ,$118.50 ,$12.00 ,$106.68 ,$106.68 ,$12.00 ,$106.68 ,$24.75 ,$137.83 ,$30.63 ,$12.00 ,$12.25 ,$134.25 ,$127.09 ,$127.09 ,$12.00 ,$127.09 ,$152.15 ,$152.15 ,$152.15 , N/A ,$30.63 ,$152.15 ,$12.00 ,$179.00 ,$100.42 ,$12.00 ,$74.11 ,$7.47 ,$6.79 ,$12.00 ,$152.15 ,$25.73 ,$106.68 ,$50.12 ,$161.10 ,$12.00 ,$152.15 ,$49.00 ,$49.00 ,$12.00 ,$116.35 ST. JOSEPH'S HOSPITAL - BREESE,30200906,86682,HC HELMINTH ANTIBODY-90,302,1 ,$108.00 ,$77.76 ,$6.79 ,$108.00 ,$32.53 ,$70.20 ,$64.48 ,$12.75 ,$30.24 ,$71.50 ,$12.75 ,$71.50 ,$12.75 ,$64.37 ,$64.37 ,$12.75 ,$64.37 ,$26.28 ,$83.16 ,$32.53 ,$12.75 ,$13.00 ,$81.00 ,$76.68 ,$76.68 ,$12.75 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$32.53 ,$91.80 ,$12.75 ,$108.00 ,$60.59 ,$12.75 ,$44.71 ,$7.47 ,$6.79 ,$12.75 ,$91.80 ,$27.32 ,$64.37 ,$30.24 ,$97.20 ,$12.75 ,$91.80 ,$52.04 ,$52.04 ,$12.75 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30200907,86684,HC HAEMOPHILUS INFLUENZA AB-90,302,1 ,$210.00 ,$151.20 ,$6.79 ,$210.00 ,$39.60 ,$136.50 ,$125.37 ,$15.52 ,$58.80 ,$139.02 ,$15.52 ,$139.02 ,$15.52 ,$125.16 ,$125.16 ,$15.52 ,$125.16 ,$32.00 ,$161.70 ,$39.60 ,$15.52 ,$15.84 ,$157.50 ,$149.10 ,$149.10 ,$15.52 ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A ,$39.60 ,$178.50 ,$15.52 ,$210.00 ,$117.81 ,$15.52 ,$86.94 ,$7.47 ,$6.79 ,$15.52 ,$178.50 ,$33.26 ,$125.16 ,$58.80 ,$189.00 ,$15.52 ,$178.50 ,$63.36 ,$63.36 ,$15.52 ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,30200909,86689,HC HTLV OR HIV AB CONF-90,302,1 ,$142.00 ,$102.24 ,$11.71 ,$142.00 ,$48.38 ,$92.30 ,$84.77 ,$18.96 ,$39.76 ,$94.00 ,$18.96 ,$94.00 ,$18.96 ,$84.63 ,$84.63 ,$18.96 ,$84.63 ,$39.09 ,$109.34 ,$48.38 ,$18.96 ,$19.35 ,$106.50 ,$100.82 ,$100.82 ,$18.96 ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A ,$48.38 ,$120.70 ,$18.96 ,$142.00 ,$79.66 ,$18.96 ,$58.79 ,$12.88 ,$11.71 ,$18.96 ,$120.70 ,$40.64 ,$84.63 ,$39.76 ,$127.80 ,$18.96 ,$120.70 ,$77.40 ,$77.40 ,$18.96 ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,30200910,86692,HC HEPATITIS D AB-90,302,1 ,$26.00 ,$18.72 ,$6.79 ,$42.90 ,$42.90 ,$16.90 ,$15.52 ,$16.82 ,$7.28 ,$17.21 ,$16.82 ,$17.21 ,$16.82 ,$15.50 ,$15.50 ,$16.82 ,$15.50 ,$26.00 ,$20.02 ,$42.90 ,$16.82 ,$17.15 ,$19.50 ,$18.46 ,$18.46 ,$16.82 ,$18.46 ,$22.10 ,$22.10 ,$22.10 , N/A ,$26.00 ,$22.10 ,$16.82 ,$26.00 ,$14.59 ,$16.82 ,$10.76 ,$7.47 ,$6.79 ,$16.82 ,$22.10 ,$36.04 ,$15.50 ,$7.28 ,$23.40 ,$16.82 ,$22.10 ,$26.00 ,$26.00 ,$16.82 ,$16.90 ST. JOSEPH'S HOSPITAL - BREESE,30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$100.00 ,$72.00 ,$11.71 ,$100.00 ,$32.98 ,$65.00 ,$59.70 ,$12.93 ,$28.00 ,$66.20 ,$12.93 ,$66.20 ,$12.93 ,$59.60 ,$59.60 ,$12.93 ,$59.60 ,$26.64 ,$77.00 ,$32.98 ,$12.93 ,$13.18 ,$75.00 ,$71.00 ,$71.00 ,$12.93 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$32.98 ,$85.00 ,$12.93 ,$100.00 ,$56.10 ,$12.93 ,$41.40 ,$12.88 ,$11.71 ,$12.93 ,$85.00 ,$27.70 ,$59.60 ,$28.00 ,$90.00 ,$12.93 ,$85.00 ,$52.76 ,$52.76 ,$12.93 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$135.00 ,$97.20 ,$6.79 ,$135.00 ,$48.38 ,$87.75 ,$80.60 ,$18.96 ,$37.80 ,$89.37 ,$18.96 ,$89.37 ,$18.96 ,$80.46 ,$80.46 ,$18.96 ,$80.46 ,$39.09 ,$103.95 ,$48.38 ,$18.96 ,$19.35 ,$101.25 ,$95.85 ,$95.85 ,$18.96 ,$95.85 ,$114.75 ,$114.75 ,$114.75 , N/A ,$48.38 ,$114.75 ,$18.96 ,$135.00 ,$75.74 ,$18.96 ,$55.89 ,$7.47 ,$6.79 ,$18.96 ,$114.75 ,$40.64 ,$80.46 ,$37.80 ,$121.50 ,$18.96 ,$114.75 ,$77.40 ,$77.40 ,$18.96 ,$87.75 ST. JOSEPH'S HOSPITAL - BREESE,30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$142.00 ,$102.24 ,$11.71 ,$142.00 ,$34.48 ,$92.30 ,$84.77 ,$13.51 ,$39.76 ,$94.00 ,$13.51 ,$94.00 ,$13.51 ,$84.63 ,$84.63 ,$13.51 ,$84.63 ,$27.86 ,$109.34 ,$34.48 ,$13.51 ,$13.79 ,$106.50 ,$100.82 ,$100.82 ,$13.51 ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A ,$34.48 ,$120.70 ,$13.51 ,$142.00 ,$79.66 ,$13.51 ,$58.79 ,$12.88 ,$11.71 ,$13.51 ,$120.70 ,$28.96 ,$84.63 ,$39.76 ,$127.80 ,$13.51 ,$120.70 ,$55.16 ,$55.16 ,$13.51 ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,30200915,86701,HC HIV-1 AB-90,302,1 ,$57.00 ,$41.04 ,$6.79 ,$57.00 ,$22.23 ,$37.05 ,$34.03 ,$8.71 ,$15.96 ,$37.73 ,$8.71 ,$37.73 ,$8.71 ,$33.97 ,$33.97 ,$8.71 ,$33.97 ,$17.96 ,$43.89 ,$22.23 ,$8.71 ,$8.89 ,$42.75 ,$40.47 ,$40.47 ,$8.71 ,$40.47 ,$48.45 ,$48.45 ,$48.45 , N/A ,$22.23 ,$48.45 ,$8.71 ,$57.00 ,$31.98 ,$8.71 ,$23.60 ,$7.47 ,$6.79 ,$8.71 ,$48.45 ,$18.67 ,$33.97 ,$15.96 ,$51.30 ,$8.71 ,$48.45 ,$35.56 ,$35.56 ,$8.71 ,$37.05 ST. JOSEPH'S HOSPITAL - BREESE,30200918,86702,HC HIV-2 AB-90,302,1 ,$57.00 ,$41.04 ,$6.79 ,$57.00 ,$33.80 ,$37.05 ,$34.03 ,$13.25 ,$15.96 ,$37.73 ,$13.25 ,$37.73 ,$13.25 ,$33.97 ,$33.97 ,$13.25 ,$33.97 ,$27.31 ,$43.89 ,$33.80 ,$13.25 ,$13.51 ,$42.75 ,$40.47 ,$40.47 ,$13.25 ,$40.47 ,$48.45 ,$48.45 ,$48.45 , N/A ,$33.80 ,$48.45 ,$13.25 ,$57.00 ,$31.98 ,$13.25 ,$23.60 ,$7.47 ,$6.79 ,$13.25 ,$48.45 ,$28.39 ,$33.97 ,$15.96 ,$51.30 ,$13.25 ,$48.45 ,$54.08 ,$54.08 ,$13.25 ,$37.05 ST. JOSEPH'S HOSPITAL - BREESE,30200919,86704,HC HEP CORE AB-90,302,1 ,$106.00 ,$76.32 ,$6.79 ,$106.00 ,$30.13 ,$68.90 ,$63.28 ,$11.81 ,$29.68 ,$70.17 ,$11.81 ,$70.17 ,$11.81 ,$63.18 ,$63.18 ,$11.81 ,$63.18 ,$24.34 ,$81.62 ,$30.13 ,$11.81 ,$12.04 ,$79.50 ,$75.26 ,$75.26 ,$11.81 ,$75.26 ,$90.10 ,$90.10 ,$90.10 , N/A ,$30.13 ,$90.10 ,$11.81 ,$106.00 ,$59.47 ,$11.81 ,$43.88 ,$7.47 ,$6.79 ,$11.81 ,$90.10 ,$25.31 ,$63.18 ,$29.68 ,$95.40 ,$11.81 ,$90.10 ,$48.20 ,$48.20 ,$11.81 ,$68.90 ST. JOSEPH'S HOSPITAL - BREESE,30200923,86707,HC HEP B E AB-90,302,1 ,$90.00 ,$64.80 ,$6.79 ,$90.00 ,$28.93 ,$58.50 ,$53.73 ,$11.34 ,$25.20 ,$59.58 ,$11.34 ,$59.58 ,$11.34 ,$53.64 ,$53.64 ,$11.34 ,$53.64 ,$23.37 ,$69.30 ,$28.93 ,$11.34 ,$11.56 ,$67.50 ,$63.90 ,$63.90 ,$11.34 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$28.93 ,$76.50 ,$11.34 ,$90.00 ,$50.49 ,$11.34 ,$37.26 ,$7.47 ,$6.79 ,$11.34 ,$76.50 ,$24.30 ,$53.64 ,$25.20 ,$81.00 ,$11.34 ,$76.50 ,$46.28 ,$46.28 ,$11.34 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$235.00 ,$169.20 ,$6.79 ,$235.00 ,$30.98 ,$152.75 ,$140.30 ,$12.14 ,$65.80 ,$155.57 ,$12.14 ,$155.57 ,$12.14 ,$140.06 ,$140.06 ,$12.14 ,$140.06 ,$25.03 ,$180.95 ,$30.98 ,$12.14 ,$12.39 ,$176.25 ,$166.85 ,$166.85 ,$12.14 ,$166.85 ,$199.75 ,$199.75 ,$199.75 , N/A ,$30.98 ,$199.75 ,$12.14 ,$235.00 ,$131.84 ,$12.14 ,$97.29 ,$7.47 ,$6.79 ,$12.14 ,$199.75 ,$26.02 ,$140.06 ,$65.80 ,$211.50 ,$12.14 ,$199.75 ,$49.56 ,$49.56 ,$12.14 ,$152.75 ST. JOSEPH'S HOSPITAL - BREESE,30200926,86710,HC INFLUENZA AB-90,302,1 ,$166.00 ,$119.52 ,$6.79 ,$166.00 ,$33.88 ,$107.90 ,$99.10 ,$13.28 ,$46.48 ,$109.89 ,$13.28 ,$109.89 ,$13.28 ,$98.94 ,$98.94 ,$13.28 ,$98.94 ,$27.37 ,$127.82 ,$33.88 ,$13.28 ,$13.54 ,$124.50 ,$117.86 ,$117.86 ,$13.28 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$33.88 ,$141.10 ,$13.28 ,$166.00 ,$93.13 ,$13.28 ,$68.72 ,$7.47 ,$6.79 ,$13.28 ,$141.10 ,$28.46 ,$98.94 ,$46.48 ,$149.40 ,$13.28 ,$141.10 ,$54.20 ,$54.20 ,$13.28 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30200927,86713,HC LEGIONELLA AB-90,302,1 ,$99.00 ,$71.28 ,$11.71 ,$99.00 ,$38.25 ,$64.35 ,$59.10 ,$14.99 ,$27.72 ,$65.54 ,$14.99 ,$65.54 ,$14.99 ,$59.00 ,$59.00 ,$14.99 ,$59.00 ,$30.91 ,$76.23 ,$38.25 ,$14.99 ,$15.30 ,$74.25 ,$70.29 ,$70.29 ,$14.99 ,$70.29 ,$84.15 ,$84.15 ,$84.15 , N/A ,$38.25 ,$84.15 ,$14.99 ,$99.00 ,$55.54 ,$14.99 ,$40.99 ,$12.88 ,$11.71 ,$14.99 ,$84.15 ,$32.13 ,$59.00 ,$27.72 ,$89.10 ,$14.99 ,$84.15 ,$61.20 ,$61.20 ,$14.99 ,$64.35 ST. JOSEPH'S HOSPITAL - BREESE,30200931,86735,HC MUMPS AB-90,302,1 ,$145.00 ,$104.40 ,$6.79 ,$145.00 ,$32.63 ,$94.25 ,$86.57 ,$12.79 ,$40.60 ,$95.99 ,$12.79 ,$95.99 ,$12.79 ,$86.42 ,$86.42 ,$12.79 ,$86.42 ,$26.36 ,$111.65 ,$32.63 ,$12.79 ,$13.04 ,$108.75 ,$102.95 ,$102.95 ,$12.79 ,$102.95 ,$123.25 ,$123.25 ,$123.25 , N/A ,$32.63 ,$123.25 ,$12.79 ,$145.00 ,$81.35 ,$12.79 ,$60.03 ,$7.47 ,$6.79 ,$12.79 ,$123.25 ,$27.41 ,$86.42 ,$40.60 ,$130.50 ,$12.79 ,$123.25 ,$52.20 ,$52.20 ,$12.79 ,$94.25 ST. JOSEPH'S HOSPITAL - BREESE,30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$145.00 ,$104.40 ,$11.71 ,$145.00 ,$33.10 ,$94.25 ,$86.57 ,$12.98 ,$40.60 ,$95.99 ,$12.98 ,$95.99 ,$12.98 ,$86.42 ,$86.42 ,$12.98 ,$86.42 ,$26.74 ,$111.65 ,$33.10 ,$12.98 ,$13.23 ,$108.75 ,$102.95 ,$102.95 ,$12.98 ,$102.95 ,$123.25 ,$123.25 ,$123.25 , N/A ,$33.10 ,$123.25 ,$12.98 ,$145.00 ,$81.35 ,$12.98 ,$60.03 ,$12.88 ,$11.71 ,$12.98 ,$123.25 ,$27.80 ,$86.42 ,$40.60 ,$130.50 ,$12.98 ,$123.25 ,$52.96 ,$52.96 ,$12.98 ,$94.25 ST. JOSEPH'S HOSPITAL - BREESE,30200933,86738,HC MYCOPLASMA AB IFA-90,302,1 ,$15.30 ,$11.02 ,$4.28 ,$33.10 ,$33.10 ,$9.95 ,$9.13 ,$12.98 ,$4.28 ,$10.13 ,$12.98 ,$10.13 ,$12.98 ,$9.12 ,$9.12 ,$12.98 ,$9.12 ,$15.30 ,$11.78 ,$33.10 ,$12.98 ,$13.23 ,$11.48 ,$10.86 ,$10.86 ,$12.98 ,$10.86 ,$13.01 ,$13.01 ,$13.01 , N/A ,$15.30 ,$13.01 ,$12.98 ,$15.30 ,$8.58 ,$12.98 ,$6.33 ,$12.88 ,$11.71 ,$12.98 ,$13.01 ,$27.80 ,$9.12 ,$4.28 ,$13.77 ,$12.98 ,$13.01 ,$15.30 ,$15.30 ,$12.98 ,$9.95 ST. JOSEPH'S HOSPITAL - BREESE,30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$160.00 ,$115.20 ,$11.71 ,$160.00 ,$37.58 ,$104.00 ,$95.52 ,$14.73 ,$44.80 ,$105.92 ,$14.73 ,$105.92 ,$14.73 ,$95.36 ,$95.36 ,$14.73 ,$95.36 ,$30.36 ,$123.20 ,$37.58 ,$14.73 ,$15.02 ,$120.00 ,$113.60 ,$113.60 ,$14.73 ,$113.60 ,$136.00 ,$136.00 ,$136.00 , N/A ,$37.58 ,$136.00 ,$14.73 ,$160.00 ,$89.76 ,$14.73 ,$66.24 ,$12.88 ,$11.71 ,$14.73 ,$136.00 ,$31.56 ,$95.36 ,$44.80 ,$144.00 ,$14.73 ,$136.00 ,$60.12 ,$60.12 ,$14.73 ,$104.00 ST. JOSEPH'S HOSPITAL - BREESE,30200937,86753,HC PROTOZOA AB-90,302,1 ,$135.00 ,$97.20 ,$6.79 ,$135.00 ,$30.98 ,$87.75 ,$80.60 ,$12.14 ,$37.80 ,$89.37 ,$12.14 ,$89.37 ,$12.14 ,$80.46 ,$80.46 ,$12.14 ,$80.46 ,$25.03 ,$103.95 ,$30.98 ,$12.14 ,$12.39 ,$101.25 ,$95.85 ,$95.85 ,$12.14 ,$95.85 ,$114.75 ,$114.75 ,$114.75 , N/A ,$30.98 ,$114.75 ,$12.14 ,$135.00 ,$75.74 ,$12.14 ,$55.89 ,$7.47 ,$6.79 ,$12.14 ,$114.75 ,$26.02 ,$80.46 ,$37.80 ,$121.50 ,$12.14 ,$114.75 ,$49.56 ,$49.56 ,$12.14 ,$87.75 ST. JOSEPH'S HOSPITAL - BREESE,30200939,86757,HC RICKETTSIA AB-90,302,1 ,$68.00 ,$48.96 ,$11.71 ,$68.00 ,$48.38 ,$44.20 ,$40.60 ,$18.96 ,$19.04 ,$45.02 ,$18.96 ,$45.02 ,$18.96 ,$40.53 ,$40.53 ,$18.96 ,$40.53 ,$39.09 ,$52.36 ,$48.38 ,$18.96 ,$19.35 ,$51.00 ,$48.28 ,$48.28 ,$18.96 ,$48.28 ,$57.80 ,$57.80 ,$57.80 , N/A ,$48.38 ,$57.80 ,$18.96 ,$68.00 ,$38.15 ,$18.96 ,$28.15 ,$12.88 ,$11.71 ,$18.96 ,$57.80 ,$40.64 ,$40.53 ,$19.04 ,$61.20 ,$18.96 ,$57.80 ,$68.00 ,$68.00 ,$18.96 ,$44.20 ST. JOSEPH'S HOSPITAL - BREESE,30200941,86765,HC RUBEOLA AB-90,302,1 ,$140.00 ,$100.80 ,$6.79 ,$140.00 ,$32.20 ,$91.00 ,$83.58 ,$12.62 ,$39.20 ,$92.68 ,$12.62 ,$92.68 ,$12.62 ,$83.44 ,$83.44 ,$12.62 ,$83.44 ,$26.02 ,$107.80 ,$32.20 ,$12.62 ,$12.88 ,$105.00 ,$99.40 ,$99.40 ,$12.62 ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A ,$32.20 ,$119.00 ,$12.62 ,$140.00 ,$78.54 ,$12.62 ,$57.96 ,$7.47 ,$6.79 ,$12.62 ,$119.00 ,$27.05 ,$83.44 ,$39.20 ,$126.00 ,$12.62 ,$119.00 ,$51.52 ,$51.52 ,$12.62 ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,30200943,86774,HC TETANUS AB-90,302,1 ,$152.00 ,$109.44 ,$11.71 ,$152.00 ,$37.00 ,$98.80 ,$90.74 ,$14.50 ,$42.56 ,$100.62 ,$14.50 ,$100.62 ,$14.50 ,$90.59 ,$90.59 ,$14.50 ,$90.59 ,$29.90 ,$117.04 ,$37.00 ,$14.50 ,$14.80 ,$114.00 ,$107.92 ,$107.92 ,$14.50 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$37.00 ,$129.20 ,$14.50 ,$152.00 ,$85.27 ,$14.50 ,$62.93 ,$12.88 ,$11.71 ,$14.50 ,$129.20 ,$31.08 ,$90.59 ,$42.56 ,$136.80 ,$14.50 ,$129.20 ,$59.20 ,$59.20 ,$14.50 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,30200944,86777,HC TOXOPLASMA AB-90,302,1 ,$132.00 ,$95.04 ,$11.71 ,$132.00 ,$35.98 ,$85.80 ,$78.80 ,$14.10 ,$36.96 ,$87.38 ,$14.10 ,$87.38 ,$14.10 ,$78.67 ,$78.67 ,$14.10 ,$78.67 ,$29.07 ,$101.64 ,$35.98 ,$14.10 ,$14.39 ,$99.00 ,$93.72 ,$93.72 ,$14.10 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$35.98 ,$112.20 ,$14.10 ,$132.00 ,$74.05 ,$14.10 ,$54.65 ,$12.88 ,$11.71 ,$14.10 ,$112.20 ,$30.22 ,$78.67 ,$36.96 ,$118.80 ,$14.10 ,$112.20 ,$57.56 ,$57.56 ,$14.10 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$132.00 ,$95.04 ,$11.71 ,$132.00 ,$36.03 ,$85.80 ,$78.80 ,$14.12 ,$36.96 ,$87.38 ,$14.12 ,$87.38 ,$14.12 ,$78.67 ,$78.67 ,$14.12 ,$78.67 ,$29.11 ,$101.64 ,$36.03 ,$14.12 ,$14.41 ,$99.00 ,$93.72 ,$93.72 ,$14.12 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$36.03 ,$112.20 ,$14.12 ,$132.00 ,$74.05 ,$14.12 ,$54.65 ,$12.88 ,$11.71 ,$14.12 ,$112.20 ,$30.26 ,$78.67 ,$36.96 ,$118.80 ,$14.12 ,$112.20 ,$57.64 ,$57.64 ,$14.12 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$109.00 ,$78.48 ,$11.71 ,$109.00 ,$33.10 ,$70.85 ,$65.07 ,$12.98 ,$30.52 ,$72.16 ,$12.98 ,$72.16 ,$12.98 ,$64.96 ,$64.96 ,$12.98 ,$64.96 ,$26.74 ,$83.93 ,$33.10 ,$12.98 ,$13.23 ,$81.75 ,$77.39 ,$77.39 ,$12.98 ,$77.39 ,$92.65 ,$92.65 ,$92.65 , N/A ,$33.10 ,$92.65 ,$12.98 ,$109.00 ,$61.15 ,$12.98 ,$45.13 ,$12.88 ,$11.71 ,$12.98 ,$92.65 ,$27.80 ,$64.96 ,$30.52 ,$98.10 ,$12.98 ,$92.65 ,$52.96 ,$52.96 ,$12.98 ,$70.85 ST. JOSEPH'S HOSPITAL - BREESE,30200947,86784,HC TRICHANELLA AB-90,302,1 ,$87.00 ,$62.64 ,$11.71 ,$87.00 ,$31.40 ,$56.55 ,$51.94 ,$12.31 ,$24.36 ,$57.59 ,$12.31 ,$57.59 ,$12.31 ,$51.85 ,$51.85 ,$12.31 ,$51.85 ,$25.37 ,$66.99 ,$31.40 ,$12.31 ,$12.55 ,$65.25 ,$61.77 ,$61.77 ,$12.31 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$31.40 ,$73.95 ,$12.31 ,$87.00 ,$48.81 ,$12.31 ,$36.02 ,$12.88 ,$11.71 ,$12.31 ,$73.95 ,$26.38 ,$51.85 ,$24.36 ,$78.30 ,$12.31 ,$73.95 ,$50.24 ,$50.24 ,$12.31 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$168.00 ,$120.96 ,$6.79 ,$168.00 ,$32.20 ,$109.20 ,$100.30 ,$12.62 ,$47.04 ,$111.22 ,$12.62 ,$111.22 ,$12.62 ,$100.13 ,$100.13 ,$12.62 ,$100.13 ,$26.02 ,$129.36 ,$32.20 ,$12.62 ,$12.88 ,$126.00 ,$119.28 ,$119.28 ,$12.62 ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A ,$32.20 ,$142.80 ,$12.62 ,$168.00 ,$94.25 ,$12.62 ,$69.55 ,$7.47 ,$6.79 ,$12.62 ,$142.80 ,$27.05 ,$100.13 ,$47.04 ,$151.20 ,$12.62 ,$142.80 ,$51.52 ,$51.52 ,$12.62 ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,30200951,86790,HC VIRUS AB NOT SPECIFIED-90,302,1 ,$135.00 ,$97.20 ,$6.79 ,$135.00 ,$32.20 ,$87.75 ,$80.60 ,$12.62 ,$37.80 ,$89.37 ,$12.62 ,$89.37 ,$12.62 ,$80.46 ,$80.46 ,$12.62 ,$80.46 ,$26.02 ,$103.95 ,$32.20 ,$12.62 ,$12.88 ,$101.25 ,$95.85 ,$95.85 ,$12.62 ,$95.85 ,$114.75 ,$114.75 ,$114.75 , N/A ,$32.20 ,$114.75 ,$12.62 ,$135.00 ,$75.74 ,$12.62 ,$55.89 ,$7.47 ,$6.79 ,$12.62 ,$114.75 ,$27.05 ,$80.46 ,$37.80 ,$121.50 ,$12.62 ,$114.75 ,$51.52 ,$51.52 ,$12.62 ,$87.75 ST. JOSEPH'S HOSPITAL - BREESE,30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$173.00 ,$124.56 ,$15.59 ,$173.00 ,$39.78 ,$112.45 ,$103.28 ,$15.59 ,$48.44 ,$114.53 ,$15.59 ,$114.53 ,$15.59 ,$103.11 ,$103.11 ,$15.59 ,$103.11 ,$32.14 ,$133.21 ,$39.78 ,$15.59 ,$15.91 ,$129.75 ,$122.83 ,$122.83 ,$15.59 ,$122.83 ,$147.05 ,$147.05 ,$147.05 , N/A ,$39.78 ,$147.05 ,$15.59 ,$173.00 ,$97.05 ,$15.59 ,$71.62 ,$19.53 ,$17.75 ,$15.59 ,$147.05 ,$33.41 ,$103.11 ,$48.44 ,$155.70 ,$15.59 ,$147.05 ,$63.64 ,$63.64 ,$15.59 ,$112.45 ST. JOSEPH'S HOSPITAL - BREESE,30200954,86803,HC HEP C AB-90,302,1 ,$11.00 ,$7.92 ,$3.08 ,$27.50 ,$27.50 ,$7.15 ,$6.57 ,$10.78 ,$3.08 ,$7.28 ,$10.78 ,$7.28 ,$10.78 ,$6.56 ,$6.56 ,$10.78 ,$6.56 ,$11.00 ,$8.47 ,$27.50 ,$10.78 ,$10.78 ,$8.25 ,$7.81 ,$7.81 ,$10.78 ,$7.81 ,$9.35 ,$9.35 ,$9.35 , N/A ,$11.00 ,$9.35 ,$10.78 ,$11.00 ,$6.17 ,$10.78 ,$4.55 ,$11.00 ,$11.00 ,$10.78 ,$9.35 ,$23.10 ,$6.56 ,$3.08 ,$9.90 ,$10.78 ,$9.35 ,$11.00 ,$11.00 ,$10.78 ,$7.15 ST. JOSEPH'S HOSPITAL - BREESE,30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$217.00 ,$156.24 ,$25.29 ,$217.00 ,$64.53 ,$141.05 ,$129.55 ,$25.29 ,$60.76 ,$143.65 ,$25.29 ,$143.65 ,$25.29 ,$129.33 ,$129.33 ,$25.29 ,$129.33 ,$52.14 ,$167.09 ,$64.53 ,$25.29 ,$25.80 ,$162.75 ,$154.07 ,$154.07 ,$25.29 ,$154.07 ,$184.45 ,$184.45 ,$184.45 , N/A ,$64.53 ,$184.45 ,$25.29 ,$217.00 ,$121.74 ,$25.29 ,$89.84 ,$30.16 ,$27.42 ,$25.29 ,$184.45 ,$54.20 ,$129.33 ,$60.76 ,$195.30 ,$25.29 ,$184.45 ,$103.24 ,$103.24 ,$25.29 ,$141.05 ST. JOSEPH'S HOSPITAL - BREESE,30200966,86850,HC AB SCREEN-90,302,1 ,$116.00 ,$83.52 ,$6.79 ,$120.38 ,$120.38 ,$75.40 ,$69.25 ,$47.19 ,$32.48 ,$76.79 ,$47.19 ,$76.79 ,$47.19 ,$69.14 ,$69.14 ,$47.19 ,$69.14 ,$97.27 ,$89.32 ,$120.38 ,$47.19 ,$48.13 ,$87.00 ,$82.36 ,$82.36 ,$47.19 ,$82.36 ,$98.60 ,$98.60 ,$98.60 , N/A ,$116.00 ,$98.60 ,$47.19 ,$116.00 ,$65.08 ,$47.19 ,$48.02 ,$7.47 ,$6.79 ,$47.19 ,$98.60 ,$101.12 ,$69.14 ,$32.48 ,$104.40 ,$47.19 ,$98.60 ,$39.08 ,$39.08 ,$47.19 ,$75.40 ST. JOSEPH'S HOSPITAL - BREESE,30200970,86860,HC ELUTION-90,302,1 ,$281.00 ,$202.32 ,$6.79 ,$377.53 ,$377.53 ,$182.65 ,$167.76 ,$147.99 ,$78.68 ,$186.02 ,$147.99 ,$186.02 ,$147.99 ,$167.48 ,$167.48 ,$147.99 ,$167.48 ,$281.00 ,$216.37 ,$377.53 ,$147.99 ,$150.95 ,$210.75 ,$199.51 ,$199.51 ,$147.99 ,$199.51 ,$238.85 ,$238.85 ,$238.85 , N/A ,$281.00 ,$238.85 ,$147.99 ,$281.00 ,$157.64 ,$147.99 ,$116.33 ,$7.47 ,$6.79 ,$147.99 ,$238.85 ,$317.13 ,$167.48 ,$78.68 ,$252.90 ,$147.99 ,$238.85 ,$281.00 ,$281.00 ,$147.99 ,$182.65 ST. JOSEPH'S HOSPITAL - BREESE,30200974,86870,HC RBC AB ID PANEL-90,302,1 ,$230.00 ,$165.60 ,$6.79 ,$778.15 ,$778.15 ,$149.50 ,$137.31 ,$305.03 ,$64.40 ,$152.26 ,$305.03 ,$152.26 ,$225.40 ,$137.08 ,$137.08 ,$225.40 ,$137.08 ,$230.00 ,$177.10 ,$778.14 ,$305.03 ,$225.40 ,$172.50 ,$163.30 ,$163.30 ,$305.03 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$230.00 ,$195.50 ,$225.40 ,$230.00 ,$129.03 ,$305.03 ,$95.22 ,$7.47 ,$6.79 ,$305.03 ,$195.50 ,$653.64 ,$137.08 ,$64.40 ,$207.00 ,$305.03 ,$195.50 ,$230.00 ,$230.00 ,$305.03 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,30200976,86880,HC COOMBS DIRECT-90,302,1 ,$108.00 ,$77.76 ,$6.79 ,$138.00 ,$138.00 ,$70.20 ,$64.48 ,$54.10 ,$30.24 ,$71.50 ,$54.10 ,$71.50 ,$54.10 ,$64.37 ,$64.37 ,$54.10 ,$64.37 ,$108.00 ,$83.16 ,$138.00 ,$54.10 ,$55.17 ,$81.00 ,$76.68 ,$76.68 ,$54.10 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$108.00 ,$91.80 ,$54.10 ,$108.00 ,$60.59 ,$54.10 ,$44.71 ,$7.47 ,$6.79 ,$54.10 ,$91.80 ,$115.92 ,$64.37 ,$30.24 ,$97.20 ,$54.10 ,$91.80 ,$21.56 ,$21.56 ,$54.10 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30200978,86886,HC INDIRECT TITER-90,302,1 ,$256.00 ,$184.32 ,$6.79 ,$377.53 ,$377.53 ,$166.40 ,$152.83 ,$147.99 ,$71.68 ,$169.47 ,$147.99 ,$169.47 ,$147.99 ,$152.58 ,$152.58 ,$147.99 ,$152.58 ,$256.00 ,$197.12 ,$377.53 ,$147.99 ,$150.95 ,$192.00 ,$181.76 ,$181.76 ,$147.99 ,$181.76 ,$217.60 ,$217.60 ,$217.60 , N/A ,$256.00 ,$217.60 ,$147.99 ,$256.00 ,$143.62 ,$147.99 ,$105.98 ,$7.47 ,$6.79 ,$147.99 ,$217.60 ,$317.13 ,$152.58 ,$71.68 ,$230.40 ,$147.99 ,$217.60 ,$20.72 ,$20.72 ,$147.99 ,$166.40 ST. JOSEPH'S HOSPITAL - BREESE,30200981,86900,HC BLOOD TYPING ABO-90,302,1 ,$87.00 ,$62.64 ,$4.21 ,$278.78 ,$278.78 ,$56.55 ,$51.94 ,$109.28 ,$24.36 ,$57.59 ,$109.28 ,$57.59 ,$85.26 ,$51.85 ,$51.85 ,$85.26 ,$51.85 ,$87.00 ,$66.99 ,$278.76 ,$109.28 ,$85.26 ,$65.25 ,$61.77 ,$61.77 ,$109.28 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$87.00 ,$73.95 ,$85.26 ,$87.00 ,$48.81 ,$109.28 ,$36.02 ,$4.63 ,$4.21 ,$109.28 ,$73.95 ,$234.16 ,$51.85 ,$24.36 ,$78.30 ,$109.28 ,$73.95 ,$11.96 ,$11.96 ,$109.28 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30200983,86901,HC BLOOD TYPING RH-90,302,1 ,$87.00 ,$62.64 ,$4.21 ,$87.00 ,$81.53 ,$56.55 ,$51.94 ,$31.96 ,$24.36 ,$57.59 ,$31.96 ,$57.59 ,$31.96 ,$51.85 ,$51.85 ,$31.96 ,$51.85 ,$65.88 ,$66.99 ,$81.53 ,$31.96 ,$32.60 ,$65.25 ,$61.77 ,$61.77 ,$31.96 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$81.53 ,$73.95 ,$31.96 ,$87.00 ,$48.81 ,$31.96 ,$36.02 ,$4.63 ,$4.21 ,$31.96 ,$73.95 ,$68.49 ,$51.85 ,$24.36 ,$78.30 ,$31.96 ,$73.95 ,$11.96 ,$11.96 ,$31.96 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30200989,86902,HC RBC AG SCR RGT SERUM-90,302,1 ,$116.00 ,$83.52 ,$4.21 ,$778.15 ,$778.15 ,$75.40 ,$69.25 ,$305.03 ,$32.48 ,$76.79 ,$305.03 ,$76.79 ,$113.68 ,$69.14 ,$69.14 ,$113.68 ,$69.14 ,$116.00 ,$89.32 ,$778.14 ,$305.03 ,$113.68 ,$87.00 ,$82.36 ,$82.36 ,$305.03 ,$82.36 ,$98.60 ,$98.60 ,$98.60 , N/A ,$116.00 ,$98.60 ,$113.68 ,$116.00 ,$65.08 ,$305.03 ,$48.02 ,$4.63 ,$4.21 ,$305.03 ,$98.60 ,$653.64 ,$69.14 ,$32.48 ,$104.40 ,$305.03 ,$98.60 ,$25.40 ,$25.40 ,$305.03 ,$75.40 ST. JOSEPH'S HOSPITAL - BREESE,30200990,86904,HC RBC AG SCR PAT SERUM-90,302,1 ,$89.00 ,$64.08 ,$4.21 ,$89.00 ,$81.53 ,$57.85 ,$53.13 ,$31.96 ,$24.92 ,$58.92 ,$31.96 ,$58.92 ,$31.96 ,$53.04 ,$53.04 ,$31.96 ,$53.04 ,$65.88 ,$68.53 ,$81.53 ,$31.96 ,$32.60 ,$66.75 ,$63.19 ,$63.19 ,$31.96 ,$63.19 ,$75.65 ,$75.65 ,$75.65 , N/A ,$81.53 ,$75.65 ,$31.96 ,$89.00 ,$49.93 ,$31.96 ,$36.85 ,$4.63 ,$4.21 ,$31.96 ,$75.65 ,$68.49 ,$53.04 ,$24.92 ,$80.10 ,$31.96 ,$75.65 ,$65.36 ,$65.36 ,$31.96 ,$57.85 ST. JOSEPH'S HOSPITAL - BREESE,30200997,86905,HC RBC AG TYPING NON ABO/RH-90,302,1 ,$116.00 ,$83.52 ,$4.21 ,$778.15 ,$778.15 ,$75.40 ,$69.25 ,$305.03 ,$32.48 ,$76.79 ,$305.03 ,$76.79 ,$113.68 ,$69.14 ,$69.14 ,$113.68 ,$69.14 ,$116.00 ,$89.32 ,$778.14 ,$305.03 ,$113.68 ,$87.00 ,$82.36 ,$82.36 ,$305.03 ,$82.36 ,$98.60 ,$98.60 ,$98.60 , N/A ,$116.00 ,$98.60 ,$113.68 ,$116.00 ,$65.08 ,$305.03 ,$48.02 ,$4.63 ,$4.21 ,$305.03 ,$98.60 ,$653.64 ,$69.14 ,$32.48 ,$104.40 ,$305.03 ,$98.60 ,$15.32 ,$15.32 ,$305.03 ,$75.40 ST. JOSEPH'S HOSPITAL - BREESE,30200998,86906,HC RH PHENOTYPE COMPLETE-90,302,1 ,$132.00 ,$95.04 ,$4.21 ,$132.00 ,$81.53 ,$85.80 ,$78.80 ,$31.96 ,$36.96 ,$87.38 ,$31.96 ,$87.38 ,$31.96 ,$78.67 ,$78.67 ,$31.96 ,$78.67 ,$65.88 ,$101.64 ,$81.53 ,$31.96 ,$32.60 ,$99.00 ,$93.72 ,$93.72 ,$31.96 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$81.53 ,$112.20 ,$31.96 ,$132.00 ,$74.05 ,$31.96 ,$54.65 ,$4.63 ,$4.21 ,$31.96 ,$112.20 ,$68.49 ,$78.67 ,$36.96 ,$118.80 ,$31.96 ,$112.20 ,$31.00 ,$31.00 ,$31.96 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,30201003,86970,HC RBC PRETREAT CHEM-90,302,1 ,$236.00 ,$169.92 ,$27.42 ,$236.00 ,$81.53 ,$153.40 ,$140.89 ,$31.96 ,$66.08 ,$156.23 ,$31.96 ,$156.23 ,$31.96 ,$140.66 ,$140.66 ,$31.96 ,$140.66 ,$65.88 ,$181.72 ,$81.53 ,$31.96 ,$32.60 ,$177.00 ,$167.56 ,$167.56 ,$31.96 ,$167.56 ,$200.60 ,$200.60 ,$200.60 , N/A ,$81.53 ,$200.60 ,$31.96 ,$236.00 ,$132.40 ,$31.96 ,$97.70 ,$30.16 ,$27.42 ,$31.96 ,$200.60 ,$68.49 ,$140.66 ,$66.08 ,$212.40 ,$31.96 ,$200.60 ,$135.36 ,$135.36 ,$31.96 ,$153.40 ST. JOSEPH'S HOSPITAL - BREESE,30201005,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$116.00 ,$83.52 ,$27.42 ,$778.15 ,$778.15 ,$75.40 ,$69.25 ,$305.03 ,$32.48 ,$76.79 ,$305.03 ,$76.79 ,$113.68 ,$69.14 ,$69.14 ,$113.68 ,$69.14 ,$116.00 ,$89.32 ,$778.14 ,$305.03 ,$113.68 ,$87.00 ,$82.36 ,$82.36 ,$305.03 ,$82.36 ,$98.60 ,$98.60 ,$98.60 , N/A ,$116.00 ,$98.60 ,$113.68 ,$116.00 ,$65.08 ,$305.03 ,$48.02 ,$30.16 ,$27.42 ,$305.03 ,$98.60 ,$653.64 ,$69.14 ,$32.48 ,$104.40 ,$305.03 ,$98.60 ,$116.00 ,$116.00 ,$305.03 ,$75.40 ST. JOSEPH'S HOSPITAL - BREESE,30201007,86972,HC RBC PRETREAT DENSITY SEP-90,302,1 ,$132.00 ,$95.04 ,$27.42 ,$377.53 ,$377.53 ,$85.80 ,$78.80 ,$147.99 ,$36.96 ,$87.38 ,$147.99 ,$87.38 ,$129.36 ,$78.67 ,$78.67 ,$129.36 ,$78.67 ,$132.00 ,$101.64 ,$377.53 ,$147.99 ,$129.36 ,$99.00 ,$93.72 ,$93.72 ,$147.99 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$132.00 ,$112.20 ,$129.36 ,$132.00 ,$74.05 ,$147.99 ,$54.65 ,$30.16 ,$27.42 ,$147.99 ,$112.20 ,$317.13 ,$78.67 ,$36.96 ,$118.80 ,$147.99 ,$112.20 ,$132.00 ,$132.00 ,$147.99 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,30201009,86975,HC INCUBATION OF SERUM W/DRUG-90,302,1 ,$191.00 ,$137.52 ,$27.42 ,$906.50 ,$906.50 ,$124.15 ,$114.03 ,$355.35 ,$53.48 ,$126.44 ,$355.35 ,$126.44 ,$187.18 ,$113.84 ,$113.84 ,$187.18 ,$113.84 ,$191.00 ,$147.07 ,$906.49 ,$355.35 ,$187.18 ,$143.25 ,$135.61 ,$135.61 ,$355.35 ,$135.61 ,$162.35 ,$162.35 ,$162.35 , N/A ,$191.00 ,$162.35 ,$187.18 ,$191.00 ,$107.15 ,$355.35 ,$79.07 ,$30.16 ,$27.42 ,$355.35 ,$162.35 ,$761.45 ,$113.84 ,$53.48 ,$171.90 ,$355.35 ,$162.35 ,$191.00 ,$191.00 ,$355.35 ,$124.15 ST. JOSEPH'S HOSPITAL - BREESE,30201011,86976,HC RBC PRETREAT SERUM DIL-90,302,1 ,$44.00 ,$31.68 ,$12.32 ,$59.93 ,$59.93 ,$28.60 ,$26.27 ,$23.49 ,$12.32 ,$29.13 ,$23.49 ,$29.13 ,$23.49 ,$26.22 ,$26.22 ,$23.49 ,$26.22 ,$44.00 ,$33.88 ,$59.93 ,$23.49 ,$23.96 ,$33.00 ,$31.24 ,$31.24 ,$23.49 ,$31.24 ,$37.40 ,$37.40 ,$37.40 , N/A ,$44.00 ,$37.40 ,$23.49 ,$44.00 ,$24.68 ,$23.49 ,$18.22 ,$30.16 ,$27.42 ,$23.49 ,$37.40 ,$50.34 ,$26.22 ,$12.32 ,$39.60 ,$23.49 ,$37.40 ,$44.00 ,$44.00 ,$23.49 ,$28.60 ST. JOSEPH'S HOSPITAL - BREESE,30201016,86977,HC RBC PRETREAT NEUTRAL SERUM INHIBIT-90,302,1 ,$193.00 ,$138.96 ,$27.42 ,$377.53 ,$377.53 ,$125.45 ,$115.22 ,$147.99 ,$54.04 ,$127.77 ,$147.99 ,$127.77 ,$147.99 ,$115.03 ,$115.03 ,$147.99 ,$115.03 ,$193.00 ,$148.61 ,$377.53 ,$147.99 ,$150.95 ,$144.75 ,$137.03 ,$137.03 ,$147.99 ,$137.03 ,$164.05 ,$164.05 ,$164.05 , N/A ,$193.00 ,$164.05 ,$147.99 ,$193.00 ,$108.27 ,$147.99 ,$79.90 ,$30.16 ,$27.42 ,$147.99 ,$164.05 ,$317.13 ,$115.03 ,$54.04 ,$173.70 ,$147.99 ,$164.05 ,$193.00 ,$193.00 ,$147.99 ,$125.45 ST. JOSEPH'S HOSPITAL - BREESE,30201020,86978,HC RBC PRETREAT ABSOR-90,302,1 ,$222.00 ,$159.84 ,$4.21 ,$222.00 ,$81.53 ,$144.30 ,$132.53 ,$31.96 ,$62.16 ,$146.96 ,$31.96 ,$146.96 ,$31.96 ,$132.31 ,$132.31 ,$31.96 ,$132.31 ,$65.88 ,$170.94 ,$81.53 ,$31.96 ,$32.60 ,$166.50 ,$157.62 ,$157.62 ,$31.96 ,$157.62 ,$188.70 ,$188.70 ,$188.70 , N/A ,$81.53 ,$188.70 ,$31.96 ,$222.00 ,$124.54 ,$31.96 ,$91.91 ,$4.63 ,$4.21 ,$31.96 ,$188.70 ,$68.49 ,$132.31 ,$62.16 ,$199.80 ,$31.96 ,$188.70 ,$135.36 ,$135.36 ,$31.96 ,$144.30 ST. JOSEPH'S HOSPITAL - BREESE,30201022,87801,HC INFECT MLT ORG AMP-90,302,1 ,$190.00 ,$136.80 ,$5.42 ,$190.00 ,$175.50 ,$123.50 ,$113.43 ,$68.80 ,$53.20 ,$125.78 ,$68.80 ,$125.78 ,$68.80 ,$113.24 ,$113.24 ,$68.80 ,$113.24 ,$141.80 ,$146.30 ,$175.50 ,$68.80 ,$70.17 ,$142.50 ,$134.90 ,$134.90 ,$68.80 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$175.50 ,$161.50 ,$68.80 ,$190.00 ,$106.59 ,$68.80 ,$78.66 ,$5.96 ,$5.42 ,$68.80 ,$161.50 ,$147.42 ,$113.24 ,$53.20 ,$171.00 ,$68.80 ,$161.50 ,$190.00 ,$190.00 ,$68.80 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$371.00 ,$267.12 ,$7.58 ,$371.00 ,$52.03 ,$241.15 ,$221.49 ,$20.39 ,$103.88 ,$245.60 ,$20.39 ,$245.60 ,$20.39 ,$221.12 ,$221.12 ,$20.39 ,$221.12 ,$42.04 ,$285.67 ,$52.03 ,$20.39 ,$20.81 ,$278.25 ,$263.41 ,$263.41 ,$20.39 ,$263.41 ,$315.35 ,$315.35 ,$315.35 , N/A ,$52.03 ,$315.35 ,$20.39 ,$371.00 ,$208.13 ,$20.39 ,$153.59 ,$8.34 ,$7.58 ,$20.39 ,$315.35 ,$43.70 ,$221.12 ,$103.88 ,$333.90 ,$20.39 ,$315.35 ,$83.24 ,$83.24 ,$20.39 ,$241.15 ST. JOSEPH'S HOSPITAL - BREESE,30201026,86317,HC INFECTIOUS AB QN-90,302,1 ,$314.00 ,$226.08 ,$11.71 ,$314.00 ,$37.48 ,$204.10 ,$187.46 ,$14.69 ,$87.92 ,$207.87 ,$14.69 ,$207.87 ,$14.69 ,$187.14 ,$187.14 ,$14.69 ,$187.14 ,$30.28 ,$241.78 ,$37.48 ,$14.69 ,$14.98 ,$235.50 ,$222.94 ,$222.94 ,$14.69 ,$222.94 ,$266.90 ,$266.90 ,$266.90 , N/A ,$37.48 ,$266.90 ,$14.69 ,$314.00 ,$176.15 ,$14.69 ,$130.00 ,$12.88 ,$11.71 ,$14.69 ,$266.90 ,$31.48 ,$187.14 ,$87.92 ,$282.60 ,$14.69 ,$266.90 ,$59.96 ,$59.96 ,$14.69 ,$204.10 ST. JOSEPH'S HOSPITAL - BREESE,30201029,86331,HC IMMUNODIFF EL EA AG AB QL-90,302,1 ,$46.00 ,$33.12 ,$11.71 ,$46.00 ,$29.95 ,$29.90 ,$27.46 ,$11.74 ,$12.88 ,$30.45 ,$11.74 ,$30.45 ,$11.74 ,$27.42 ,$27.42 ,$11.74 ,$27.42 ,$24.20 ,$35.42 ,$29.95 ,$11.74 ,$11.98 ,$34.50 ,$32.66 ,$32.66 ,$11.74 ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A ,$29.95 ,$39.10 ,$11.74 ,$46.00 ,$25.81 ,$11.74 ,$19.04 ,$12.88 ,$11.71 ,$11.74 ,$39.10 ,$25.16 ,$27.42 ,$12.88 ,$41.40 ,$11.74 ,$39.10 ,$46.00 ,$46.00 ,$11.74 ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,30201030,86332,HC IMMUNE COMPLEX ASSAY-90,302,1 ,$60.00 ,$43.20 ,$11.71 ,$60.93 ,$60.93 ,$39.00 ,$35.82 ,$23.88 ,$16.80 ,$39.72 ,$23.88 ,$39.72 ,$23.88 ,$35.76 ,$35.76 ,$23.88 ,$35.76 ,$49.23 ,$46.20 ,$60.93 ,$23.88 ,$24.36 ,$45.00 ,$42.60 ,$42.60 ,$23.88 ,$42.60 ,$51.00 ,$51.00 ,$51.00 , N/A ,$60.00 ,$51.00 ,$23.88 ,$60.00 ,$33.66 ,$23.88 ,$24.84 ,$12.88 ,$11.71 ,$23.88 ,$51.00 ,$51.18 ,$35.76 ,$16.80 ,$54.00 ,$23.88 ,$51.00 ,$60.00 ,$60.00 ,$23.88 ,$39.00 ST. JOSEPH'S HOSPITAL - BREESE,30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$166.00 ,$119.52 ,$11.71 ,$166.00 ,$55.85 ,$107.90 ,$99.10 ,$21.89 ,$46.48 ,$109.89 ,$21.89 ,$109.89 ,$21.89 ,$98.94 ,$98.94 ,$21.89 ,$98.94 ,$45.13 ,$127.82 ,$55.85 ,$21.89 ,$22.33 ,$124.50 ,$117.86 ,$117.86 ,$21.89 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$55.85 ,$141.10 ,$21.89 ,$166.00 ,$93.13 ,$21.89 ,$68.72 ,$12.88 ,$11.71 ,$21.89 ,$141.10 ,$46.91 ,$98.94 ,$46.48 ,$149.40 ,$21.89 ,$141.10 ,$89.36 ,$89.36 ,$21.89 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30201032,86335,HC IMMUNOFIX ELECTRO OTH-90,302,1 ,$157.00 ,$113.04 ,$11.71 ,$157.00 ,$73.38 ,$102.05 ,$93.73 ,$28.76 ,$43.96 ,$103.93 ,$28.76 ,$103.93 ,$28.76 ,$93.57 ,$93.57 ,$28.76 ,$93.57 ,$59.29 ,$120.89 ,$73.38 ,$28.76 ,$29.34 ,$117.75 ,$111.47 ,$111.47 ,$28.76 ,$111.47 ,$133.45 ,$133.45 ,$133.45 , N/A ,$73.38 ,$133.45 ,$28.76 ,$157.00 ,$88.08 ,$28.76 ,$65.00 ,$12.88 ,$11.71 ,$28.76 ,$133.45 ,$61.64 ,$93.57 ,$43.96 ,$141.30 ,$28.76 ,$133.45 ,$117.40 ,$117.40 ,$28.76 ,$102.05 ST. JOSEPH'S HOSPITAL - BREESE,30201033,86336,HC INHIBIN A-90,302,1 ,$179.00 ,$128.88 ,$7.58 ,$179.00 ,$38.98 ,$116.35 ,$106.86 ,$15.28 ,$50.12 ,$118.50 ,$15.28 ,$118.50 ,$15.28 ,$106.68 ,$106.68 ,$15.28 ,$106.68 ,$31.49 ,$137.83 ,$38.98 ,$15.28 ,$15.58 ,$134.25 ,$127.09 ,$127.09 ,$15.28 ,$127.09 ,$152.15 ,$152.15 ,$152.15 , N/A ,$38.98 ,$152.15 ,$15.28 ,$179.00 ,$100.42 ,$15.28 ,$74.11 ,$8.34 ,$7.58 ,$15.28 ,$152.15 ,$32.74 ,$106.68 ,$50.12 ,$161.10 ,$15.28 ,$152.15 ,$62.36 ,$62.36 ,$15.28 ,$116.35 ST. JOSEPH'S HOSPITAL - BREESE,30201034,86337,HC INSULIN AB-90,302,1 ,$177.00 ,$127.44 ,$17.75 ,$177.00 ,$53.53 ,$115.05 ,$105.67 ,$20.98 ,$49.56 ,$117.17 ,$20.98 ,$117.17 ,$20.98 ,$105.49 ,$105.49 ,$20.98 ,$105.49 ,$43.25 ,$136.29 ,$53.53 ,$20.98 ,$21.40 ,$132.75 ,$125.67 ,$125.67 ,$20.98 ,$125.67 ,$150.45 ,$150.45 ,$150.45 , N/A ,$53.53 ,$150.45 ,$20.98 ,$177.00 ,$99.30 ,$20.98 ,$73.28 ,$19.53 ,$17.75 ,$20.98 ,$150.45 ,$44.96 ,$105.49 ,$49.56 ,$159.30 ,$20.98 ,$150.45 ,$85.64 ,$85.64 ,$20.98 ,$115.05 ST. JOSEPH'S HOSPITAL - BREESE,30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$111.00 ,$79.92 ,$14.78 ,$111.00 ,$37.70 ,$72.15 ,$66.27 ,$14.78 ,$31.08 ,$73.48 ,$14.78 ,$73.48 ,$14.78 ,$66.16 ,$66.16 ,$14.78 ,$66.16 ,$30.46 ,$85.47 ,$37.70 ,$14.78 ,$15.07 ,$83.25 ,$78.81 ,$78.81 ,$14.78 ,$78.81 ,$94.35 ,$94.35 ,$94.35 , N/A ,$37.70 ,$94.35 ,$14.78 ,$111.00 ,$62.27 ,$14.78 ,$45.95 ,$19.53 ,$17.75 ,$14.78 ,$94.35 ,$31.67 ,$66.16 ,$31.08 ,$99.90 ,$14.78 ,$94.35 ,$60.32 ,$60.32 ,$14.78 ,$72.15 ST. JOSEPH'S HOSPITAL - BREESE,30201036,86341,HC ISLET CELL AB-90,302,1 ,$245.00 ,$176.40 ,$11.71 ,$245.00 ,$58.93 ,$159.25 ,$146.27 ,$23.10 ,$68.60 ,$162.19 ,$23.10 ,$162.19 ,$23.10 ,$146.02 ,$146.02 ,$23.10 ,$146.02 ,$47.61 ,$188.65 ,$58.93 ,$23.10 ,$23.56 ,$183.75 ,$173.95 ,$173.95 ,$23.10 ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A ,$58.93 ,$208.25 ,$23.10 ,$245.00 ,$137.45 ,$23.10 ,$101.43 ,$12.88 ,$11.71 ,$23.10 ,$208.25 ,$49.50 ,$146.02 ,$68.60 ,$220.50 ,$23.10 ,$208.25 ,$94.28 ,$94.28 ,$23.10 ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,30201037,86343,HC LEUKOCYTE HISTAMINE RELEASE-90,302,1 ,$349.00 ,$251.28 ,$11.71 ,$349.00 ,$31.15 ,$226.85 ,$208.35 ,$12.21 ,$97.72 ,$231.04 ,$12.21 ,$231.04 ,$12.21 ,$208.00 ,$208.00 ,$12.21 ,$208.00 ,$25.17 ,$268.73 ,$31.15 ,$12.21 ,$12.46 ,$261.75 ,$247.79 ,$247.79 ,$12.21 ,$247.79 ,$296.65 ,$296.65 ,$296.65 , N/A ,$31.15 ,$296.65 ,$12.21 ,$349.00 ,$195.79 ,$12.21 ,$144.49 ,$12.88 ,$11.71 ,$12.21 ,$296.65 ,$26.17 ,$208.00 ,$97.72 ,$314.10 ,$12.21 ,$296.65 ,$49.84 ,$49.84 ,$12.21 ,$226.85 ST. JOSEPH'S HOSPITAL - BREESE,30201040,86355,HC B CELLS TOTAL COUNT-90,302,1 ,$236.00 ,$169.92 ,$11.71 ,$236.00 ,$94.33 ,$153.40 ,$140.89 ,$36.98 ,$66.08 ,$156.23 ,$36.98 ,$156.23 ,$36.98 ,$140.66 ,$140.66 ,$36.98 ,$140.66 ,$76.21 ,$181.72 ,$94.33 ,$36.98 ,$37.71 ,$177.00 ,$167.56 ,$167.56 ,$36.98 ,$167.56 ,$200.60 ,$200.60 ,$200.60 , N/A ,$94.33 ,$200.60 ,$36.98 ,$236.00 ,$132.40 ,$36.98 ,$97.70 ,$12.88 ,$11.71 ,$36.98 ,$200.60 ,$79.23 ,$140.66 ,$66.08 ,$212.40 ,$36.98 ,$200.60 ,$150.92 ,$150.92 ,$36.98 ,$153.40 ST. JOSEPH'S HOSPITAL - BREESE,30201042,86357,HC CD8 TOTAL COUNT-90,302,1 ,$231.00 ,$166.32 ,$11.71 ,$231.00 ,$94.33 ,$150.15 ,$137.91 ,$36.98 ,$64.68 ,$152.92 ,$36.98 ,$152.92 ,$36.98 ,$137.68 ,$137.68 ,$36.98 ,$137.68 ,$76.21 ,$177.87 ,$94.33 ,$36.98 ,$37.71 ,$173.25 ,$164.01 ,$164.01 ,$36.98 ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A ,$94.33 ,$196.35 ,$36.98 ,$231.00 ,$129.59 ,$36.98 ,$95.63 ,$12.88 ,$11.71 ,$36.98 ,$196.35 ,$79.23 ,$137.68 ,$64.68 ,$207.90 ,$36.98 ,$196.35 ,$150.92 ,$150.92 ,$36.98 ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,30201043,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$231.00 ,$166.32 ,$11.71 ,$231.00 ,$94.33 ,$150.15 ,$137.91 ,$36.98 ,$64.68 ,$152.92 ,$36.98 ,$152.92 ,$36.98 ,$137.68 ,$137.68 ,$36.98 ,$137.68 ,$76.21 ,$177.87 ,$94.33 ,$36.98 ,$37.71 ,$173.25 ,$164.01 ,$164.01 ,$36.98 ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A ,$94.33 ,$196.35 ,$36.98 ,$231.00 ,$129.59 ,$36.98 ,$95.63 ,$12.88 ,$11.71 ,$36.98 ,$196.35 ,$79.23 ,$137.68 ,$64.68 ,$207.90 ,$36.98 ,$196.35 ,$150.92 ,$150.92 ,$36.98 ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$243.00 ,$174.96 ,$11.71 ,$243.00 ,$117.45 ,$157.95 ,$145.07 ,$46.04 ,$68.04 ,$160.87 ,$46.04 ,$160.87 ,$46.04 ,$144.83 ,$144.83 ,$46.04 ,$144.83 ,$94.90 ,$187.11 ,$117.45 ,$46.04 ,$46.96 ,$182.25 ,$172.53 ,$172.53 ,$46.04 ,$172.53 ,$206.55 ,$206.55 ,$206.55 , N/A ,$117.45 ,$206.55 ,$46.04 ,$243.00 ,$136.32 ,$46.04 ,$100.60 ,$12.88 ,$11.71 ,$46.04 ,$206.55 ,$98.66 ,$144.83 ,$68.04 ,$218.70 ,$46.04 ,$206.55 ,$187.92 ,$187.92 ,$46.04 ,$157.95 ST. JOSEPH'S HOSPITAL - BREESE,30201046,86361,HC T CELLS CD4 COUNT-90,302,1 ,$27.28 ,$19.64 ,$7.64 ,$66.95 ,$66.95 ,$17.73 ,$16.29 ,$26.24 ,$7.64 ,$18.06 ,$26.24 ,$18.06 ,$26.24 ,$16.26 ,$16.26 ,$26.24 ,$16.26 ,$27.28 ,$21.01 ,$66.95 ,$26.24 ,$26.73 ,$20.46 ,$19.37 ,$19.37 ,$26.24 ,$19.37 ,$23.19 ,$23.19 ,$23.19 , N/A ,$27.28 ,$23.19 ,$26.24 ,$27.28 ,$15.30 ,$26.24 ,$11.29 ,$12.88 ,$11.71 ,$26.24 ,$23.19 ,$56.24 ,$16.26 ,$7.64 ,$24.55 ,$26.24 ,$23.19 ,$27.28 ,$27.28 ,$26.24 ,$17.73 ST. JOSEPH'S HOSPITAL - BREESE,30201047,86376,HC MICROSOMAL AB-90,302,1 ,$174.00 ,$125.28 ,$14.26 ,$174.00 ,$36.38 ,$113.10 ,$103.88 ,$14.26 ,$48.72 ,$115.19 ,$14.26 ,$115.19 ,$14.26 ,$103.70 ,$103.70 ,$14.26 ,$103.70 ,$29.39 ,$133.98 ,$36.38 ,$14.26 ,$14.54 ,$130.50 ,$123.54 ,$123.54 ,$14.26 ,$123.54 ,$147.90 ,$147.90 ,$147.90 , N/A ,$36.38 ,$147.90 ,$14.26 ,$174.00 ,$97.61 ,$14.26 ,$72.04 ,$19.53 ,$17.75 ,$14.26 ,$147.90 ,$30.56 ,$103.70 ,$48.72 ,$156.60 ,$14.26 ,$147.90 ,$58.20 ,$58.20 ,$14.26 ,$113.10 ST. JOSEPH'S HOSPITAL - BREESE,30201048,86382,HC NEUTRALIZATION TEST VIRAL-90,302,1 ,$248.00 ,$178.56 ,$11.71 ,$248.00 ,$42.28 ,$161.20 ,$148.06 ,$16.57 ,$69.44 ,$164.18 ,$16.57 ,$164.18 ,$16.57 ,$147.81 ,$147.81 ,$16.57 ,$147.81 ,$34.16 ,$190.96 ,$42.28 ,$16.57 ,$16.90 ,$186.00 ,$176.08 ,$176.08 ,$16.57 ,$176.08 ,$210.80 ,$210.80 ,$210.80 , N/A ,$42.28 ,$210.80 ,$16.57 ,$248.00 ,$139.13 ,$16.57 ,$102.67 ,$12.88 ,$11.71 ,$16.57 ,$210.80 ,$35.51 ,$147.81 ,$69.44 ,$223.20 ,$16.57 ,$210.80 ,$67.64 ,$67.64 ,$16.57 ,$161.20 ST. JOSEPH'S HOSPITAL - BREESE,30201049,86403,HC PARTICLE AGG SCREEN-90,302,1 ,$102.00 ,$73.44 ,$6.79 ,$102.00 ,$28.85 ,$66.30 ,$60.89 ,$11.31 ,$28.56 ,$67.52 ,$11.31 ,$67.52 ,$11.31 ,$60.79 ,$60.79 ,$11.31 ,$60.79 ,$23.31 ,$78.54 ,$28.85 ,$11.31 ,$11.53 ,$76.50 ,$72.42 ,$72.42 ,$11.31 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$28.85 ,$86.70 ,$11.31 ,$102.00 ,$57.22 ,$11.31 ,$42.23 ,$7.47 ,$6.79 ,$11.31 ,$86.70 ,$24.23 ,$60.79 ,$28.56 ,$91.80 ,$11.31 ,$86.70 ,$46.16 ,$46.16 ,$11.31 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$6.00 ,$4.32 ,$1.68 ,$14.18 ,$14.18 ,$3.90 ,$3.58 ,$5.56 ,$1.68 ,$3.97 ,$5.56 ,$3.97 ,$5.56 ,$3.58 ,$3.58 ,$5.56 ,$3.58 ,$6.00 ,$4.62 ,$14.18 ,$5.56 ,$5.66 ,$4.50 ,$4.26 ,$4.26 ,$5.56 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 ,$5.56 ,$6.00 ,$3.37 ,$5.56 ,$2.48 ,$6.00 ,$6.00 ,$5.56 ,$5.10 ,$11.91 ,$3.58 ,$1.68 ,$5.40 ,$5.56 ,$5.10 ,$6.00 ,$6.00 ,$5.56 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,30201053,86480,HC TB QUANTIFERON GOLD-90,302,1 ,$428.00 ,$308.16 ,$11.71 ,$428.00 ,$154.95 ,$278.20 ,$255.52 ,$60.74 ,$119.84 ,$283.34 ,$60.74 ,$283.34 ,$60.74 ,$255.09 ,$255.09 ,$60.74 ,$255.09 ,$125.20 ,$329.56 ,$154.95 ,$60.74 ,$61.96 ,$321.00 ,$303.88 ,$303.88 ,$60.74 ,$303.88 ,$363.80 ,$363.80 ,$363.80 , N/A ,$154.95 ,$363.80 ,$60.74 ,$428.00 ,$240.11 ,$60.74 ,$177.19 ,$12.88 ,$11.71 ,$60.74 ,$363.80 ,$130.16 ,$255.09 ,$119.84 ,$385.20 ,$60.74 ,$363.80 ,$247.92 ,$247.92 ,$60.74 ,$278.20 ST. JOSEPH'S HOSPITAL - BREESE,30201054,86592,HC SYPHILIS VDRL RPR QL-90,302,1 ,$161.00 ,$115.92 ,$4.18 ,$161.00 ,$10.68 ,$104.65 ,$96.12 ,$4.18 ,$45.08 ,$106.58 ,$4.18 ,$106.58 ,$4.18 ,$95.96 ,$95.96 ,$4.18 ,$95.96 ,$8.63 ,$123.97 ,$10.68 ,$4.18 ,$4.27 ,$120.75 ,$114.31 ,$114.31 ,$4.18 ,$114.31 ,$136.85 ,$136.85 ,$136.85 , N/A ,$10.68 ,$136.85 ,$4.18 ,$161.00 ,$90.32 ,$4.18 ,$66.65 ,$7.47 ,$6.79 ,$4.18 ,$136.85 ,$8.97 ,$95.96 ,$45.08 ,$144.90 ,$4.18 ,$136.85 ,$17.08 ,$17.08 ,$4.18 ,$104.65 ST. JOSEPH'S HOSPITAL - BREESE,30201055,86603,HC ADENOVIRUS AB-90,302,1 ,$111.00 ,$79.92 ,$11.71 ,$111.00 ,$32.18 ,$72.15 ,$66.27 ,$12.61 ,$31.08 ,$73.48 ,$12.61 ,$73.48 ,$12.61 ,$66.16 ,$66.16 ,$12.61 ,$66.16 ,$26.00 ,$85.47 ,$32.18 ,$12.61 ,$12.87 ,$83.25 ,$78.81 ,$78.81 ,$12.61 ,$78.81 ,$94.35 ,$94.35 ,$94.35 , N/A ,$32.18 ,$94.35 ,$12.61 ,$111.00 ,$62.27 ,$12.61 ,$45.95 ,$12.88 ,$11.71 ,$12.61 ,$94.35 ,$27.03 ,$66.16 ,$31.08 ,$99.90 ,$12.61 ,$94.35 ,$51.48 ,$51.48 ,$12.61 ,$72.15 ST. JOSEPH'S HOSPITAL - BREESE,30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$129.00 ,$92.88 ,$11.71 ,$129.00 ,$37.63 ,$83.85 ,$77.01 ,$14.75 ,$36.12 ,$85.40 ,$14.75 ,$85.40 ,$14.75 ,$76.88 ,$76.88 ,$14.75 ,$76.88 ,$30.40 ,$99.33 ,$37.63 ,$14.75 ,$15.04 ,$96.75 ,$91.59 ,$91.59 ,$14.75 ,$91.59 ,$109.65 ,$109.65 ,$109.65 , N/A ,$37.63 ,$109.65 ,$14.75 ,$129.00 ,$72.37 ,$14.75 ,$53.41 ,$12.88 ,$11.71 ,$14.75 ,$109.65 ,$31.61 ,$76.88 ,$36.12 ,$116.10 ,$14.75 ,$109.65 ,$60.20 ,$60.20 ,$14.75 ,$83.85 ST. JOSEPH'S HOSPITAL - BREESE,30201057,86609,HC BACTERIUM AB NOS-90,302,1 ,$103.00 ,$74.16 ,$12.62 ,$103.00 ,$32.20 ,$66.95 ,$61.49 ,$12.62 ,$28.84 ,$68.19 ,$12.62 ,$68.19 ,$12.62 ,$61.39 ,$61.39 ,$12.62 ,$61.39 ,$26.02 ,$79.31 ,$32.20 ,$12.62 ,$12.88 ,$77.25 ,$73.13 ,$73.13 ,$12.62 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$32.20 ,$87.55 ,$12.62 ,$103.00 ,$57.78 ,$12.62 ,$42.64 ,$19.80 ,$18.00 ,$12.62 ,$87.55 ,$27.05 ,$61.39 ,$28.84 ,$92.70 ,$12.62 ,$87.55 ,$51.52 ,$51.52 ,$12.62 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$87.00 ,$62.64 ,$9.98 ,$87.00 ,$25.45 ,$56.55 ,$51.94 ,$9.98 ,$24.36 ,$57.59 ,$9.98 ,$57.59 ,$9.98 ,$51.85 ,$51.85 ,$9.98 ,$51.85 ,$20.56 ,$66.99 ,$25.45 ,$9.98 ,$10.17 ,$65.25 ,$61.77 ,$61.77 ,$9.98 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$25.45 ,$73.95 ,$9.98 ,$87.00 ,$48.81 ,$9.98 ,$36.02 ,$12.88 ,$11.71 ,$9.98 ,$73.95 ,$21.38 ,$51.85 ,$24.36 ,$78.30 ,$9.98 ,$73.95 ,$40.72 ,$40.72 ,$9.98 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$82.00 ,$59.04 ,$11.71 ,$82.00 ,$32.25 ,$53.30 ,$48.95 ,$12.64 ,$22.96 ,$54.28 ,$12.64 ,$54.28 ,$12.64 ,$48.87 ,$48.87 ,$12.64 ,$48.87 ,$26.06 ,$63.14 ,$32.25 ,$12.64 ,$12.90 ,$61.50 ,$58.22 ,$58.22 ,$12.64 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$32.25 ,$69.70 ,$12.64 ,$82.00 ,$46.00 ,$12.64 ,$33.95 ,$12.88 ,$11.71 ,$12.64 ,$69.70 ,$27.09 ,$48.87 ,$22.96 ,$73.80 ,$12.64 ,$69.70 ,$51.60 ,$51.60 ,$12.64 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,30201061,86615,HC BORDETELLA AB-90,302,1 ,$123.00 ,$88.56 ,$11.71 ,$123.00 ,$32.98 ,$79.95 ,$73.43 ,$12.93 ,$34.44 ,$81.43 ,$12.93 ,$81.43 ,$12.93 ,$73.31 ,$73.31 ,$12.93 ,$73.31 ,$26.64 ,$94.71 ,$32.98 ,$12.93 ,$13.18 ,$92.25 ,$87.33 ,$87.33 ,$12.93 ,$87.33 ,$104.55 ,$104.55 ,$104.55 , N/A ,$32.98 ,$104.55 ,$12.93 ,$123.00 ,$69.00 ,$12.93 ,$50.92 ,$12.88 ,$11.71 ,$12.93 ,$104.55 ,$27.70 ,$73.31 ,$34.44 ,$110.70 ,$12.93 ,$104.55 ,$52.76 ,$52.76 ,$12.93 ,$79.95 ST. JOSEPH'S HOSPITAL - BREESE,30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$150.00 ,$108.00 ,$11.71 ,$150.00 ,$38.73 ,$97.50 ,$89.55 ,$15.18 ,$42.00 ,$99.30 ,$15.18 ,$99.30 ,$15.18 ,$89.40 ,$89.40 ,$15.18 ,$89.40 ,$31.29 ,$115.50 ,$38.73 ,$15.18 ,$15.48 ,$112.50 ,$106.50 ,$106.50 ,$15.18 ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A ,$38.73 ,$127.50 ,$15.18 ,$150.00 ,$84.15 ,$15.18 ,$62.10 ,$12.88 ,$11.71 ,$15.18 ,$127.50 ,$32.53 ,$89.40 ,$42.00 ,$135.00 ,$15.18 ,$127.50 ,$61.96 ,$61.96 ,$15.18 ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,30201063,86618,HC LYME AB-90,302,1 ,$168.00 ,$120.96 ,$11.71 ,$168.00 ,$42.58 ,$109.20 ,$100.30 ,$16.69 ,$47.04 ,$111.22 ,$16.69 ,$111.22 ,$16.69 ,$100.13 ,$100.13 ,$16.69 ,$100.13 ,$34.40 ,$129.36 ,$42.58 ,$16.69 ,$17.02 ,$126.00 ,$119.28 ,$119.28 ,$16.69 ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A ,$42.58 ,$142.80 ,$16.69 ,$168.00 ,$94.25 ,$16.69 ,$69.55 ,$12.88 ,$11.71 ,$16.69 ,$142.80 ,$35.76 ,$100.13 ,$47.04 ,$151.20 ,$16.69 ,$142.80 ,$68.12 ,$68.12 ,$16.69 ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,30201064,86619,HC BORRELIA AB-90,302,1 ,$166.00 ,$119.52 ,$11.71 ,$166.00 ,$33.45 ,$107.90 ,$99.10 ,$13.11 ,$46.48 ,$109.89 ,$13.11 ,$109.89 ,$13.11 ,$98.94 ,$98.94 ,$13.11 ,$98.94 ,$27.03 ,$127.82 ,$33.45 ,$13.11 ,$13.38 ,$124.50 ,$117.86 ,$117.86 ,$13.11 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$33.45 ,$141.10 ,$13.11 ,$166.00 ,$93.13 ,$13.11 ,$68.72 ,$12.88 ,$11.71 ,$13.11 ,$141.10 ,$28.10 ,$98.94 ,$46.48 ,$149.40 ,$13.11 ,$141.10 ,$53.52 ,$53.52 ,$13.11 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30201065,86622,HC BRUCELLA AB-90,302,1 ,$108.00 ,$77.76 ,$8.75 ,$108.00 ,$22.33 ,$70.20 ,$64.48 ,$8.75 ,$30.24 ,$71.50 ,$8.75 ,$71.50 ,$8.75 ,$64.37 ,$64.37 ,$8.75 ,$64.37 ,$18.04 ,$83.16 ,$22.33 ,$8.75 ,$8.93 ,$81.00 ,$76.68 ,$76.68 ,$8.75 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$22.33 ,$91.80 ,$8.75 ,$108.00 ,$60.59 ,$8.75 ,$44.71 ,$12.88 ,$11.71 ,$8.75 ,$91.80 ,$18.75 ,$64.37 ,$30.24 ,$97.20 ,$8.75 ,$91.80 ,$35.72 ,$35.72 ,$8.75 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30201067,86631,HC CHLAMYDIA AB-90,302,1 ,$117.00 ,$84.24 ,$5.42 ,$117.00 ,$29.55 ,$76.05 ,$69.85 ,$11.58 ,$32.76 ,$77.45 ,$11.58 ,$77.45 ,$11.58 ,$69.73 ,$69.73 ,$11.58 ,$69.73 ,$23.88 ,$90.09 ,$29.55 ,$11.58 ,$11.82 ,$87.75 ,$83.07 ,$83.07 ,$11.58 ,$83.07 ,$99.45 ,$99.45 ,$99.45 , N/A ,$29.55 ,$99.45 ,$11.58 ,$117.00 ,$65.64 ,$11.58 ,$48.44 ,$5.96 ,$5.42 ,$11.58 ,$99.45 ,$24.82 ,$69.73 ,$32.76 ,$105.30 ,$11.58 ,$99.45 ,$47.28 ,$47.28 ,$11.58 ,$76.05 ST. JOSEPH'S HOSPITAL - BREESE,30201079,86711,HC AB JOHN CUNNINGHAM VIRUS-90,302,1 ,"$3,129.00 ","$2,252.88 ",$6.79 ,"$3,129.00 ",$42.23 ,"$2,033.85 ","$1,868.01 ",$16.55 ,$876.12 ,"$2,071.40 ",$16.55 ,"$2,071.40 ",$16.55 ,"$1,864.88 ","$1,864.88 ",$16.55 ,"$1,864.88 ",$34.12 ,$500.00 ,$42.23 ,$16.55 ,$16.89 ,"$2,346.75 ","$2,221.59 ","$2,221.59 ",$16.55 ,"$2,221.59 ","$2,659.65 ","$2,659.65 ","$2,659.65 ", N/A ,$42.23 ,"$2,659.65 ",$16.55 ,"$3,129.00 ","$1,755.37 ",$16.55 ,"$1,295.41 ",$7.47 ,$6.79 ,$16.55 ,"$2,659.65 ",$35.47 ,"$1,864.88 ",$876.12 ,"$2,816.10 ",$16.55 ,"$2,659.65 ",$67.56 ,$67.56 ,$16.55 ,"$2,033.85 " ST. JOSEPH'S HOSPITAL - BREESE,30201088,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA-90,302,1 ,$11.00 ,$7.92 ,$3.08 ,$27.50 ,$27.50 ,$7.15 ,$6.57 ,$10.78 ,$3.08 ,$7.28 ,$10.78 ,$7.28 ,$10.78 ,$6.56 ,$6.56 ,$10.78 ,$6.56 ,$11.00 ,$8.47 ,$27.50 ,$10.78 ,$10.78 ,$8.25 ,$7.81 ,$7.81 ,$10.78 ,$7.81 ,$9.35 ,$9.35 ,$9.35 , N/A ,$11.00 ,$9.35 ,$10.78 ,$11.00 ,$6.17 ,$10.78 ,$4.55 ,$7.47 ,$6.79 ,$10.78 ,$9.35 ,$23.10 ,$6.56 ,$3.08 ,$9.90 ,$10.78 ,$9.35 ,$11.00 ,$11.00 ,$10.78 ,$7.15 ST. JOSEPH'S HOSPITAL - BREESE,30201092,86593,HC SYPHILIS VDRL RPR QN-90,302,1 ,$55.00 ,$39.60 ,$4.31 ,$55.00 ,$11.00 ,$35.75 ,$32.84 ,$4.31 ,$15.40 ,$36.41 ,$4.31 ,$36.41 ,$4.31 ,$32.78 ,$32.78 ,$4.31 ,$32.78 ,$8.89 ,$42.35 ,$11.00 ,$4.31 ,$4.40 ,$41.25 ,$39.05 ,$39.05 ,$4.31 ,$39.05 ,$46.75 ,$46.75 ,$46.75 , N/A ,$11.00 ,$46.75 ,$4.31 ,$55.00 ,$30.86 ,$4.31 ,$22.77 ,$7.47 ,$6.79 ,$4.31 ,$46.75 ,$9.24 ,$32.78 ,$15.40 ,$49.50 ,$4.31 ,$46.75 ,$17.60 ,$17.60 ,$4.31 ,$35.75 ST. JOSEPH'S HOSPITAL - BREESE,30201093,86003,HC ALLERGEN IGE QN EA,302,1 ,$120.00 ,$86.40 ,$5.12 ,$120.00 ,$13.05 ,$78.00 ,$71.64 ,$5.12 ,$33.60 ,$79.44 ,$5.12 ,$79.44 ,$5.12 ,$71.52 ,$71.52 ,$5.12 ,$71.52 ,$10.54 ,$92.40 ,$13.05 ,$5.12 ,$5.21 ,$90.00 ,$85.20 ,$85.20 ,$5.12 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$13.05 ,$102.00 ,$5.12 ,$120.00 ,$67.32 ,$5.12 ,$49.68 ,$7.47 ,$6.79 ,$5.12 ,$102.00 ,$10.96 ,$71.52 ,$33.60 ,$108.00 ,$5.12 ,$102.00 ,$20.88 ,$20.88 ,$5.12 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,30201096,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$202.00 ,$145.44 ,$6.79 ,$202.00 ,$32.38 ,$131.30 ,$120.59 ,$12.69 ,$56.56 ,$133.72 ,$12.69 ,$133.72 ,$12.69 ,$120.39 ,$120.39 ,$12.69 ,$120.39 ,$26.16 ,$155.54 ,$32.38 ,$12.69 ,$12.95 ,$151.50 ,$143.42 ,$143.42 ,$12.69 ,$143.42 ,$171.70 ,$171.70 ,$171.70 , N/A ,$32.38 ,$171.70 ,$12.69 ,$202.00 ,$113.32 ,$12.69 ,$83.63 ,$7.47 ,$6.79 ,$12.69 ,$171.70 ,$27.20 ,$120.39 ,$56.56 ,$181.80 ,$12.69 ,$171.70 ,$51.80 ,$51.80 ,$12.69 ,$131.30 ST. JOSEPH'S HOSPITAL - BREESE,30201107,86403,HC PARTICLE AGG SCREEN,302,1 ,$142.00 ,$102.24 ,$6.79 ,$142.00 ,$28.85 ,$92.30 ,$84.77 ,$11.31 ,$39.76 ,$94.00 ,$11.31 ,$94.00 ,$11.31 ,$84.63 ,$84.63 ,$11.31 ,$84.63 ,$23.31 ,$109.34 ,$28.85 ,$11.31 ,$11.53 ,$106.50 ,$100.82 ,$100.82 ,$11.31 ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A ,$28.85 ,$120.70 ,$11.31 ,$142.00 ,$79.66 ,$11.31 ,$58.79 ,$7.47 ,$6.79 ,$11.31 ,$120.70 ,$24.23 ,$84.63 ,$39.76 ,$127.80 ,$11.31 ,$120.70 ,$46.16 ,$46.16 ,$11.31 ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,30201108,86431,HC RHEUMATOID FACTOR QN,302,1 ,$98.00 ,$70.56 ,$5.56 ,$98.00 ,$14.18 ,$63.70 ,$58.51 ,$5.56 ,$27.44 ,$64.88 ,$5.56 ,$64.88 ,$5.56 ,$58.41 ,$58.41 ,$5.56 ,$58.41 ,$11.45 ,$75.46 ,$14.18 ,$5.56 ,$5.66 ,$73.50 ,$69.58 ,$69.58 ,$5.56 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$14.18 ,$83.30 ,$5.56 ,$98.00 ,$54.98 ,$5.56 ,$40.57 ,$7.47 ,$6.79 ,$5.56 ,$83.30 ,$11.91 ,$58.41 ,$27.44 ,$88.20 ,$5.56 ,$83.30 ,$22.68 ,$22.68 ,$5.56 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,30201109,86480,HC TB QUANTIFERON GOLD,302,1 ,$272.00 ,$195.84 ,$11.71 ,$272.00 ,$154.95 ,$176.80 ,$162.38 ,$60.74 ,$76.16 ,$180.06 ,$60.74 ,$180.06 ,$60.74 ,$162.11 ,$162.11 ,$60.74 ,$162.11 ,$125.20 ,$209.44 ,$154.95 ,$60.74 ,$61.96 ,$204.00 ,$193.12 ,$193.12 ,$60.74 ,$193.12 ,$231.20 ,$231.20 ,$231.20 , N/A ,$154.95 ,$231.20 ,$60.74 ,$272.00 ,$152.59 ,$60.74 ,$112.61 ,$12.88 ,$11.71 ,$60.74 ,$231.20 ,$130.16 ,$162.11 ,$76.16 ,$244.80 ,$60.74 ,$231.20 ,$247.92 ,$247.92 ,$60.74 ,$176.80 ST. JOSEPH'S HOSPITAL - BREESE,30201110,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$161.00 ,$115.92 ,$4.18 ,$161.00 ,$10.68 ,$104.65 ,$96.12 ,$4.18 ,$45.08 ,$106.58 ,$4.18 ,$106.58 ,$4.18 ,$95.96 ,$95.96 ,$4.18 ,$95.96 ,$8.63 ,$123.97 ,$10.68 ,$4.18 ,$4.27 ,$120.75 ,$114.31 ,$114.31 ,$4.18 ,$114.31 ,$136.85 ,$136.85 ,$136.85 , N/A ,$10.68 ,$136.85 ,$4.18 ,$161.00 ,$90.32 ,$4.18 ,$66.65 ,$7.47 ,$6.79 ,$4.18 ,$136.85 ,$8.97 ,$95.96 ,$45.08 ,$144.90 ,$4.18 ,$136.85 ,$17.08 ,$17.08 ,$4.18 ,$104.65 ST. JOSEPH'S HOSPITAL - BREESE,30201121,86704,HC HEP CORE AB,302,1 ,$220.00 ,$158.40 ,$6.79 ,$220.00 ,$30.13 ,$143.00 ,$131.34 ,$11.81 ,$61.60 ,$145.64 ,$11.81 ,$145.64 ,$11.81 ,$131.12 ,$131.12 ,$11.81 ,$131.12 ,$24.34 ,$169.40 ,$30.13 ,$11.81 ,$12.04 ,$165.00 ,$156.20 ,$156.20 ,$11.81 ,$156.20 ,$187.00 ,$187.00 ,$187.00 , N/A ,$30.13 ,$187.00 ,$11.81 ,$220.00 ,$123.42 ,$11.81 ,$91.08 ,$7.47 ,$6.79 ,$11.81 ,$187.00 ,$25.31 ,$131.12 ,$61.60 ,$198.00 ,$11.81 ,$187.00 ,$48.20 ,$48.20 ,$11.81 ,$143.00 ST. JOSEPH'S HOSPITAL - BREESE,30201122,86705,HC HEP B CORE IGM,302,1 ,$212.00 ,$152.64 ,$6.79 ,$212.00 ,$29.43 ,$137.80 ,$126.56 ,$11.53 ,$59.36 ,$140.34 ,$11.53 ,$140.34 ,$11.53 ,$126.35 ,$126.35 ,$11.53 ,$126.35 ,$23.78 ,$163.24 ,$29.43 ,$11.53 ,$11.77 ,$159.00 ,$150.52 ,$150.52 ,$11.53 ,$150.52 ,$180.20 ,$180.20 ,$180.20 , N/A ,$29.43 ,$180.20 ,$11.53 ,$212.00 ,$118.93 ,$11.53 ,$87.77 ,$7.47 ,$6.79 ,$11.53 ,$180.20 ,$24.72 ,$126.35 ,$59.36 ,$190.80 ,$11.53 ,$180.20 ,$47.08 ,$47.08 ,$11.53 ,$137.80 ST. JOSEPH'S HOSPITAL - BREESE,30201123,86706,HC HEP B SURFACE AB,302,1 ,$203.00 ,$146.16 ,$6.79 ,$203.00 ,$26.85 ,$131.95 ,$121.19 ,$10.53 ,$56.84 ,$134.39 ,$10.53 ,$134.39 ,$10.53 ,$120.99 ,$120.99 ,$10.53 ,$120.99 ,$21.69 ,$156.31 ,$26.85 ,$10.53 ,$10.73 ,$152.25 ,$144.13 ,$144.13 ,$10.53 ,$144.13 ,$172.55 ,$172.55 ,$172.55 , N/A ,$26.85 ,$172.55 ,$10.53 ,$203.00 ,$113.88 ,$10.53 ,$84.04 ,$7.47 ,$6.79 ,$10.53 ,$172.55 ,$22.55 ,$120.99 ,$56.84 ,$182.70 ,$10.53 ,$172.55 ,$42.96 ,$42.96 ,$10.53 ,$131.95 ST. JOSEPH'S HOSPITAL - BREESE,30201125,86709,HC HEP A AB (HAAB) IGM,302,1 ,$220.00 ,$158.40 ,$6.79 ,$220.00 ,$28.15 ,$143.00 ,$131.34 ,$11.03 ,$61.60 ,$145.64 ,$11.03 ,$145.64 ,$11.03 ,$131.12 ,$131.12 ,$11.03 ,$131.12 ,$22.75 ,$169.40 ,$28.15 ,$11.03 ,$11.26 ,$165.00 ,$156.20 ,$156.20 ,$11.03 ,$156.20 ,$187.00 ,$187.00 ,$187.00 , N/A ,$28.15 ,$187.00 ,$11.03 ,$220.00 ,$123.42 ,$11.03 ,$91.08 ,$7.47 ,$6.79 ,$11.03 ,$187.00 ,$23.65 ,$131.12 ,$61.60 ,$198.00 ,$11.03 ,$187.00 ,$45.04 ,$45.04 ,$11.03 ,$143.00 ST. JOSEPH'S HOSPITAL - BREESE,30201127,86762,HC RUBELLA AB,302,1 ,$95.00 ,$68.40 ,$6.79 ,$95.00 ,$35.98 ,$61.75 ,$56.72 ,$14.10 ,$26.60 ,$62.89 ,$14.10 ,$62.89 ,$14.10 ,$56.62 ,$56.62 ,$14.10 ,$56.62 ,$29.07 ,$73.15 ,$35.98 ,$14.10 ,$14.39 ,$71.25 ,$67.45 ,$67.45 ,$14.10 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$35.98 ,$80.75 ,$14.10 ,$95.00 ,$53.30 ,$14.10 ,$39.33 ,$7.47 ,$6.79 ,$14.10 ,$80.75 ,$30.22 ,$56.62 ,$26.60 ,$85.50 ,$14.10 ,$80.75 ,$57.56 ,$57.56 ,$14.10 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,30201132,86803,HC HEP C AB,302,1 ,$231.00 ,$166.32 ,$11.71 ,$231.00 ,$35.68 ,$150.15 ,$137.91 ,$13.98 ,$64.68 ,$152.92 ,$13.98 ,$152.92 ,$13.98 ,$137.68 ,$137.68 ,$13.98 ,$137.68 ,$28.83 ,$177.87 ,$35.68 ,$13.98 ,$14.27 ,$173.25 ,$164.01 ,$164.01 ,$13.98 ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A ,$35.68 ,$196.35 ,$13.98 ,$231.00 ,$129.59 ,$13.98 ,$95.63 ,$12.88 ,$11.71 ,$13.98 ,$196.35 ,$29.97 ,$137.68 ,$64.68 ,$207.90 ,$13.98 ,$196.35 ,$57.08 ,$57.08 ,$13.98 ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,30201133,86885,HC INDIRECT COOMBS-90,302,1 ,$108.00 ,$77.76 ,$6.79 ,$377.53 ,$377.53 ,$70.20 ,$64.48 ,$147.99 ,$30.24 ,$71.50 ,$147.99 ,$71.50 ,$105.84 ,$64.37 ,$64.37 ,$105.84 ,$64.37 ,$108.00 ,$83.16 ,$377.53 ,$147.99 ,$105.84 ,$81.00 ,$76.68 ,$76.68 ,$147.99 ,$76.68 ,$91.80 ,$91.80 ,$91.80 , N/A ,$108.00 ,$91.80 ,$105.84 ,$108.00 ,$60.59 ,$147.99 ,$44.71 ,$7.47 ,$6.79 ,$147.99 ,$91.80 ,$317.13 ,$64.37 ,$30.24 ,$97.20 ,$147.99 ,$91.80 ,$22.88 ,$22.88 ,$147.99 ,$70.20 ST. JOSEPH'S HOSPITAL - BREESE,30201135,86902,HC RBC AG SCR RGT SERUM T2-90,302,1 ,$204.00 ,$146.88 ,$4.21 ,$778.15 ,$778.15 ,$132.60 ,$121.79 ,$305.03 ,$57.12 ,$135.05 ,$305.03 ,$135.05 ,$199.92 ,$121.58 ,$121.58 ,$199.92 ,$121.58 ,$204.00 ,$157.08 ,$778.14 ,$305.03 ,$199.92 ,$153.00 ,$144.84 ,$144.84 ,$305.03 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$199.92 ,$204.00 ,$114.44 ,$305.03 ,$84.46 ,$4.63 ,$4.21 ,$305.03 ,$173.40 ,$653.64 ,$121.58 ,$57.12 ,$183.60 ,$305.03 ,$173.40 ,$25.40 ,$25.40 ,$305.03 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,30201136,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$262.00 ,$188.64 ,$4.21 ,$778.15 ,$778.15 ,$170.30 ,$156.41 ,$305.03 ,$73.36 ,$173.44 ,$305.03 ,$173.44 ,$256.76 ,$156.15 ,$156.15 ,$256.76 ,$156.15 ,$262.00 ,$201.74 ,$778.14 ,$305.03 ,$256.76 ,$196.50 ,$186.02 ,$186.02 ,$305.03 ,$186.02 ,$222.70 ,$222.70 ,$222.70 , N/A ,$262.00 ,$222.70 ,$256.76 ,$262.00 ,$146.98 ,$305.03 ,$108.47 ,$4.63 ,$4.21 ,$305.03 ,$222.70 ,$653.64 ,$156.15 ,$73.36 ,$235.80 ,$305.03 ,$222.70 ,$25.40 ,$25.40 ,$305.03 ,$170.30 ST. JOSEPH'S HOSPITAL - BREESE,30201137,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$323.00 ,$232.56 ,$4.21 ,$778.15 ,$778.15 ,$209.95 ,$192.83 ,$305.03 ,$90.44 ,$213.83 ,$305.03 ,$213.83 ,$305.03 ,$192.51 ,$192.51 ,$305.03 ,$192.51 ,$323.00 ,$248.71 ,$778.14 ,$305.03 ,$311.13 ,$242.25 ,$229.33 ,$229.33 ,$305.03 ,$229.33 ,$274.55 ,$274.55 ,$274.55 , N/A ,$323.00 ,$274.55 ,$305.03 ,$323.00 ,$181.20 ,$305.03 ,$133.72 ,$4.63 ,$4.21 ,$305.03 ,$274.55 ,$653.64 ,$192.51 ,$90.44 ,$290.70 ,$305.03 ,$274.55 ,$25.40 ,$25.40 ,$305.03 ,$209.95 ST. JOSEPH'S HOSPITAL - BREESE,30201139,86905,HC RBC AG TYPING NON ABO/RH T2-90,302,1 ,$204.00 ,$146.88 ,$4.21 ,$778.15 ,$778.15 ,$132.60 ,$121.79 ,$305.03 ,$57.12 ,$135.05 ,$305.03 ,$135.05 ,$199.92 ,$121.58 ,$121.58 ,$199.92 ,$121.58 ,$204.00 ,$157.08 ,$778.14 ,$305.03 ,$199.92 ,$153.00 ,$144.84 ,$144.84 ,$305.03 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$199.92 ,$204.00 ,$114.44 ,$305.03 ,$84.46 ,$4.63 ,$4.21 ,$305.03 ,$173.40 ,$653.64 ,$121.58 ,$57.12 ,$183.60 ,$305.03 ,$173.40 ,$15.32 ,$15.32 ,$305.03 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,30201140,86905,HC RBC AG TYPING NON ABO/RH T3-90,302,1 ,$262.00 ,$188.64 ,$4.21 ,$778.15 ,$778.15 ,$170.30 ,$156.41 ,$305.03 ,$73.36 ,$173.44 ,$305.03 ,$173.44 ,$256.76 ,$156.15 ,$156.15 ,$256.76 ,$156.15 ,$262.00 ,$201.74 ,$778.14 ,$305.03 ,$256.76 ,$196.50 ,$186.02 ,$186.02 ,$305.03 ,$186.02 ,$222.70 ,$222.70 ,$222.70 , N/A ,$262.00 ,$222.70 ,$256.76 ,$262.00 ,$146.98 ,$305.03 ,$108.47 ,$4.63 ,$4.21 ,$305.03 ,$222.70 ,$653.64 ,$156.15 ,$73.36 ,$235.80 ,$305.03 ,$222.70 ,$15.32 ,$15.32 ,$305.03 ,$170.30 ST. JOSEPH'S HOSPITAL - BREESE,30201141,86905,HC RBC AG TYPING NON ABO/RH T4-90,302,1 ,$323.00 ,$232.56 ,$4.21 ,$778.15 ,$778.15 ,$209.95 ,$192.83 ,$305.03 ,$90.44 ,$213.83 ,$305.03 ,$213.83 ,$305.03 ,$192.51 ,$192.51 ,$305.03 ,$192.51 ,$323.00 ,$248.71 ,$778.14 ,$305.03 ,$311.13 ,$242.25 ,$229.33 ,$229.33 ,$305.03 ,$229.33 ,$274.55 ,$274.55 ,$274.55 , N/A ,$323.00 ,$274.55 ,$305.03 ,$323.00 ,$181.20 ,$305.03 ,$133.72 ,$4.63 ,$4.21 ,$305.03 ,$274.55 ,$653.64 ,$192.51 ,$90.44 ,$290.70 ,$305.03 ,$274.55 ,$15.32 ,$15.32 ,$305.03 ,$209.95 ST. JOSEPH'S HOSPITAL - BREESE,30201148,83986,HC PH BODY FLUID,302,1 ,$90.00 ,$64.80 ,$3.37 ,$90.00 ,$8.95 ,$58.50 ,$53.73 ,$3.51 ,$25.20 ,$59.58 ,$3.51 ,$59.58 ,$3.51 ,$53.64 ,$53.64 ,$3.51 ,$53.64 ,$7.23 ,$69.30 ,$8.95 ,$3.51 ,$3.58 ,$67.50 ,$63.90 ,$63.90 ,$3.51 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$8.95 ,$76.50 ,$3.51 ,$90.00 ,$50.49 ,$3.51 ,$37.26 ,$3.71 ,$3.37 ,$3.51 ,$76.50 ,$7.52 ,$53.64 ,$25.20 ,$81.00 ,$3.51 ,$76.50 ,$14.32 ,$14.32 ,$3.51 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30201152,86255,HC FLUOR AB SCR AQUAPORIN-90,302,1 ,"$1,118.00 ",$804.96 ,$11.71 ,"$1,118.00 ",$30.13 ,$726.70 ,$667.45 ,$11.81 ,$313.04 ,$740.12 ,$11.81 ,$740.12 ,$11.81 ,$666.33 ,$666.33 ,$11.81 ,$666.33 ,$24.34 ,$500.00 ,$30.13 ,$11.81 ,$12.04 ,$838.50 ,$793.78 ,$793.78 ,$11.81 ,$793.78 ,$950.30 ,$950.30 ,$950.30 , N/A ,$30.13 ,$950.30 ,$11.81 ,"$1,118.00 ",$627.20 ,$11.81 ,$462.85 ,$12.88 ,$11.71 ,$11.81 ,$950.30 ,$25.31 ,$666.33 ,$313.04 ,"$1,006.20 ",$11.81 ,$950.30 ,$48.20 ,$48.20 ,$11.81 ,$726.70 ST. JOSEPH'S HOSPITAL - BREESE,30201157,86255,HC FLUOR AB SCR PARANEOPLASTIC-90,302,1 ,$14.00 ,$10.08 ,$3.92 ,$30.13 ,$30.13 ,$9.10 ,$8.36 ,$11.81 ,$3.92 ,$9.27 ,$11.81 ,$9.27 ,$11.81 ,$8.34 ,$8.34 ,$11.81 ,$8.34 ,$14.00 ,$10.78 ,$30.13 ,$11.81 ,$12.04 ,$10.50 ,$9.94 ,$9.94 ,$11.81 ,$9.94 ,$11.90 ,$11.90 ,$11.90 , N/A ,$14.00 ,$11.90 ,$11.81 ,$14.00 ,$7.85 ,$11.81 ,$5.80 ,$12.88 ,$11.71 ,$11.81 ,$11.90 ,$25.31 ,$8.34 ,$3.92 ,$12.60 ,$11.81 ,$11.90 ,$14.00 ,$14.00 ,$11.81 ,$9.10 ST. JOSEPH'S HOSPITAL - BREESE,30201170,86481,HC TB ANTIGEN RESPONSE GAMMA INTER T-CELL SUSP-90,302,1 ,$96.00 ,$69.12 ,$11.71 ,$240.00 ,$240.00 ,$62.40 ,$57.31 ,$94.08 ,$26.88 ,$63.55 ,$94.08 ,$63.55 ,$94.08 ,$57.22 ,$57.22 ,$94.08 ,$57.22 ,$96.00 ,$73.92 ,$240.00 ,$94.08 ,$94.08 ,$72.00 ,$68.16 ,$68.16 ,$94.08 ,$68.16 ,$81.60 ,$81.60 ,$81.60 , N/A ,$96.00 ,$81.60 ,$94.08 ,$96.00 ,$53.86 ,$94.08 ,$39.74 ,$12.88 ,$11.71 ,$94.08 ,$81.60 ,$201.60 ,$57.22 ,$26.88 ,$86.40 ,$94.08 ,$81.60 ,$96.00 ,$96.00 ,$94.08 ,$62.40 ST. JOSEPH'S HOSPITAL - BREESE,30201186,86628,HC ANTIBODY CANDIDA-90,302,1 ,$232.00 ,$167.04 ,$5.42 ,$232.00 ,$30.03 ,$150.80 ,$138.50 ,$11.77 ,$64.96 ,$153.58 ,$11.77 ,$153.58 ,$11.77 ,$138.27 ,$138.27 ,$11.77 ,$138.27 ,$24.26 ,$178.64 ,$30.03 ,$11.77 ,$12.00 ,$174.00 ,$164.72 ,$164.72 ,$11.77 ,$164.72 ,$197.20 ,$197.20 ,$197.20 , N/A ,$30.03 ,$197.20 ,$11.77 ,$232.00 ,$130.15 ,$11.77 ,$96.05 ,$5.96 ,$5.42 ,$11.77 ,$197.20 ,$25.22 ,$138.27 ,$64.96 ,$208.80 ,$11.77 ,$197.20 ,$48.04 ,$48.04 ,$11.77 ,$150.80 ST. JOSEPH'S HOSPITAL - BREESE,30201187,86308,HC HETEROPHILE SCR MONO-90,302,1 ,$12.00 ,$8.64 ,$3.36 ,$12.95 ,$12.95 ,$7.80 ,$7.16 ,$5.08 ,$3.36 ,$7.94 ,$5.08 ,$7.94 ,$5.08 ,$7.15 ,$7.15 ,$5.08 ,$7.15 ,$10.46 ,$9.24 ,$12.95 ,$5.08 ,$5.17 ,$9.00 ,$8.52 ,$8.52 ,$5.08 ,$8.52 ,$10.20 ,$10.20 ,$10.20 , N/A ,$12.00 ,$10.20 ,$5.08 ,$12.00 ,$6.73 ,$5.08 ,$4.97 ,$7.47 ,$6.79 ,$5.08 ,$10.20 ,$10.88 ,$7.15 ,$3.36 ,$10.80 ,$5.08 ,$10.20 ,$12.00 ,$12.00 ,$5.08 ,$7.80 ST. JOSEPH'S HOSPITAL - BREESE,30201188,81380,HC HLA I TYPING 1 LOCUS HR-90,302,1 ,$345.00 ,$248.40 ,$87.62 ,$443.13 ,$443.13 ,$224.25 ,$205.97 ,$173.70 ,$96.60 ,$228.39 ,$173.70 ,$228.39 ,$173.70 ,$205.62 ,$205.62 ,$173.70 ,$205.62 ,$345.00 ,$265.65 ,$443.13 ,$173.70 ,$177.18 ,$258.75 ,$244.95 ,$244.95 ,$173.70 ,$244.95 ,$293.25 ,$293.25 ,$293.25 , N/A ,$345.00 ,$293.25 ,$173.70 ,$345.00 ,$193.55 ,$173.70 ,$142.83 ,$96.38 ,$87.62 ,$173.70 ,$293.25 ,$372.23 ,$205.62 ,$96.60 ,$310.50 ,$173.70 ,$293.25 ,$345.00 ,$345.00 ,$173.70 ,$224.25 ST. JOSEPH'S HOSPITAL - BREESE,30201189,86015,HC ACTIN SMOOTH MUSC ANTIBODY- 90,302,1 ,$139.00 ,$100.08 ,$6.79 ,$139.00 ,$30.13 ,$90.35 ,$82.98 ,$11.81 ,$38.92 ,$92.02 ,$11.81 ,$92.02 ,$11.81 ,$82.84 ,$82.84 ,$11.81 ,$82.84 ,$24.34 ,$107.03 ,$30.13 ,$11.81 ,$12.04 ,$104.25 ,$98.69 ,$98.69 ,$11.81 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$30.13 ,$118.15 ,$11.81 ,$139.00 ,$77.98 ,$11.81 ,$57.55 ,$7.47 ,$6.79 ,$11.81 ,$118.15 ,$25.31 ,$82.84 ,$38.92 ,$125.10 ,$11.81 ,$118.15 ,$46.12 ,$46.12 ,$11.81 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30201190,86036,HC ANTINEUTROPHIL CYTO ANTB SCREEN- 90,302,1 ,$256.00 ,$184.32 ,$6.79 ,$256.00 ,$30.13 ,$166.40 ,$152.83 ,$11.81 ,$71.68 ,$169.47 ,$11.81 ,$169.47 ,$11.81 ,$152.58 ,$152.58 ,$11.81 ,$152.58 ,$24.34 ,$197.12 ,$30.13 ,$11.81 ,$12.04 ,$192.00 ,$181.76 ,$181.76 ,$11.81 ,$181.76 ,$217.60 ,$217.60 ,$217.60 , N/A ,$30.13 ,$217.60 ,$11.81 ,$256.00 ,$143.62 ,$11.81 ,$105.98 ,$7.47 ,$6.79 ,$11.81 ,$217.60 ,$25.31 ,$152.58 ,$71.68 ,$230.40 ,$11.81 ,$217.60 ,$48.20 ,$48.20 ,$11.81 ,$166.40 ST. JOSEPH'S HOSPITAL - BREESE,30201191,86037,HC ANTINEUTROPHIL CYTOPLASMIC ANTIBODY TITER- 90,302,1 ,$64.00 ,$46.08 ,$6.79 ,$64.00 ,$30.13 ,$41.60 ,$38.21 ,$11.81 ,$17.92 ,$42.37 ,$11.81 ,$42.37 ,$11.81 ,$38.14 ,$38.14 ,$11.81 ,$38.14 ,$24.34 ,$49.28 ,$30.13 ,$11.81 ,$12.04 ,$48.00 ,$45.44 ,$45.44 ,$11.81 ,$45.44 ,$54.40 ,$54.40 ,$54.40 , N/A ,$30.13 ,$54.40 ,$11.81 ,$64.00 ,$35.90 ,$11.81 ,$26.50 ,$7.47 ,$6.79 ,$11.81 ,$54.40 ,$25.31 ,$38.14 ,$17.92 ,$57.60 ,$11.81 ,$54.40 ,$48.20 ,$48.20 ,$11.81 ,$41.60 ST. JOSEPH'S HOSPITAL - BREESE,30201192,86364,HC TISS TRANSGLUTAMINASE EA IMMUNO- 90,302,1 ,$139.00 ,$100.08 ,$6.79 ,$139.00 ,$28.83 ,$90.35 ,$82.98 ,$11.30 ,$38.92 ,$92.02 ,$11.30 ,$92.02 ,$11.30 ,$82.84 ,$82.84 ,$11.30 ,$82.84 ,$23.29 ,$107.03 ,$28.83 ,$11.30 ,$11.52 ,$104.25 ,$98.69 ,$98.69 ,$11.30 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$28.83 ,$118.15 ,$11.30 ,$139.00 ,$77.98 ,$11.30 ,$57.55 ,$7.47 ,$6.79 ,$11.30 ,$118.15 ,$24.21 ,$82.84 ,$38.92 ,$125.10 ,$11.30 ,$118.15 ,$46.12 ,$46.12 ,$11.30 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30201193,86231,HC EMA EACH IG CLASS- 90,302,1 ,$211.00 ,$151.92 ,$6.79 ,$211.00 ,$30.23 ,$137.15 ,$125.97 ,$11.85 ,$59.08 ,$139.68 ,$11.85 ,$139.68 ,$11.85 ,$125.76 ,$125.76 ,$11.85 ,$125.76 ,$24.42 ,$162.47 ,$30.23 ,$11.85 ,$12.08 ,$158.25 ,$149.81 ,$149.81 ,$11.85 ,$149.81 ,$179.35 ,$179.35 ,$179.35 , N/A ,$30.23 ,$179.35 ,$11.85 ,$211.00 ,$118.37 ,$11.85 ,$87.35 ,$7.47 ,$6.79 ,$11.85 ,$179.35 ,$25.39 ,$125.76 ,$59.08 ,$189.90 ,$11.85 ,$179.35 ,$48.36 ,$48.36 ,$11.85 ,$137.15 ST. JOSEPH'S HOSPITAL - BREESE,30201194,86258,HC GLIADIN ANTIBODY EA- 90,302,1 ,$139.00 ,$100.08 ,$6.79 ,$139.00 ,$30.13 ,$90.35 ,$82.98 ,$11.81 ,$38.92 ,$92.02 ,$11.81 ,$92.02 ,$11.81 ,$82.84 ,$82.84 ,$11.81 ,$82.84 ,$24.34 ,$107.03 ,$30.13 ,$11.81 ,$12.04 ,$104.25 ,$98.69 ,$98.69 ,$11.81 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$30.13 ,$118.15 ,$11.81 ,$139.00 ,$77.98 ,$11.81 ,$57.55 ,$7.47 ,$6.79 ,$11.81 ,$118.15 ,$25.31 ,$82.84 ,$38.92 ,$125.10 ,$11.81 ,$118.15 ,$46.12 ,$46.12 ,$11.81 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30201195,86381,HC MITOCHONDRIAL ANTIBODY- 90,302,1 ,$211.00 ,$151.92 ,$6.79 ,$211.00 ,$63.63 ,$137.15 ,$125.97 ,$24.94 ,$59.08 ,$139.68 ,$24.94 ,$139.68 ,$24.94 ,$125.76 ,$125.76 ,$24.94 ,$125.76 ,$51.41 ,$162.47 ,$63.63 ,$24.94 ,$25.44 ,$158.25 ,$149.81 ,$149.81 ,$24.94 ,$149.81 ,$179.35 ,$179.35 ,$179.35 , N/A ,$63.63 ,$179.35 ,$24.94 ,$211.00 ,$118.37 ,$24.94 ,$87.35 ,$7.47 ,$6.79 ,$24.94 ,$179.35 ,$53.45 ,$125.76 ,$59.08 ,$189.90 ,$24.94 ,$179.35 ,$101.80 ,$101.80 ,$24.94 ,$137.15 ST. JOSEPH'S HOSPITAL - BREESE,30201201,86596,HC VOLTAGE GTG CALCIUM CHNL- 90,302,1 ,$55.20 ,$39.74 ,$6.79 ,$55.20 ,$30.13 ,$35.88 ,$32.95 ,$11.81 ,$15.46 ,$36.54 ,$11.81 ,$36.54 ,$11.81 ,$32.90 ,$32.90 ,$11.81 ,$32.90 ,$24.34 ,$42.50 ,$30.13 ,$11.81 ,$12.04 ,$41.40 ,$39.19 ,$39.19 ,$11.81 ,$39.19 ,$46.92 ,$46.92 ,$46.92 , N/A ,$30.13 ,$46.92 ,$11.81 ,$55.20 ,$30.97 ,$11.81 ,$22.85 ,$7.47 ,$6.79 ,$11.81 ,$46.92 ,$25.31 ,$32.90 ,$15.46 ,$49.68 ,$11.81 ,$46.92 ,$55.20 ,$55.20 ,$11.81 ,$35.88 ST. JOSEPH'S HOSPITAL - BREESE,30201202,86052,HC AQUAPORIN 4- 90,302,1 ,$36.15 ,$26.03 ,$6.79 ,$36.15 ,$30.13 ,$23.50 ,$21.58 ,$11.81 ,$10.12 ,$23.93 ,$11.81 ,$23.93 ,$11.81 ,$21.55 ,$21.55 ,$11.81 ,$21.55 ,$24.34 ,$27.84 ,$30.13 ,$11.81 ,$12.04 ,$27.11 ,$25.67 ,$25.67 ,$11.81 ,$25.67 ,$30.73 ,$30.73 ,$30.73 , N/A ,$30.13 ,$30.73 ,$11.81 ,$36.15 ,$20.28 ,$11.81 ,$14.97 ,$7.47 ,$6.79 ,$11.81 ,$30.73 ,$25.31 ,$21.55 ,$10.12 ,$32.54 ,$11.81 ,$30.73 ,$36.15 ,$36.15 ,$11.81 ,$23.50 ST. JOSEPH'S HOSPITAL - BREESE,30201204,86001,HC ALLERGEN SPECIFIC IGG-90,302,1 ,$25.44 ,$18.32 ,$6.79 ,$25.44 ,$19.55 ,$16.54 ,$15.19 ,$7.66 ,$7.12 ,$16.84 ,$7.66 ,$16.84 ,$7.66 ,$15.16 ,$15.16 ,$7.66 ,$15.16 ,$15.80 ,$19.59 ,$19.55 ,$7.66 ,$7.82 ,$19.08 ,$18.06 ,$18.06 ,$7.66 ,$18.06 ,$21.62 ,$21.62 ,$21.62 , N/A ,$19.55 ,$21.62 ,$7.66 ,$25.44 ,$14.27 ,$7.66 ,$10.53 ,$7.47 ,$6.79 ,$7.66 ,$21.62 ,$16.42 ,$15.16 ,$7.12 ,$22.90 ,$7.66 ,$21.62 ,$25.44 ,$25.44 ,$7.66 ,$16.54 ST. JOSEPH'S HOSPITAL - BREESE,30201211,86235,HC NUCLEAR ANTIGEN ANTIBODY-90,302,1 ,$91.96 ,$66.21 ,$11.71 ,$91.96 ,$44.83 ,$59.77 ,$54.90 ,$17.57 ,$25.75 ,$60.88 ,$17.57 ,$60.88 ,$17.57 ,$54.81 ,$54.81 ,$17.57 ,$54.81 ,$36.22 ,$70.81 ,$44.83 ,$17.57 ,$17.92 ,$68.97 ,$65.29 ,$65.29 ,$17.57 ,$65.29 ,$78.17 ,$78.17 ,$78.17 , N/A ,$44.83 ,$78.17 ,$17.57 ,$91.96 ,$51.59 ,$17.57 ,$38.07 ,$12.88 ,$11.71 ,$17.57 ,$78.17 ,$37.65 ,$54.81 ,$25.75 ,$82.76 ,$17.57 ,$78.17 ,$71.72 ,$71.72 ,$17.57 ,$59.77 ST. JOSEPH'S HOSPITAL - BREESE,30201217,86592,HC SYPHILIS TEST NON-TREP QUAL-90,302,1 ,$5.00 ,$3.60 ,$1.40 ,$10.68 ,$10.68 ,$3.25 ,$2.99 ,$4.18 ,$1.40 ,$3.31 ,$4.18 ,$3.31 ,$4.18 ,$2.98 ,$2.98 ,$4.18 ,$2.98 ,$5.00 ,$3.85 ,$10.68 ,$4.18 ,$4.27 ,$3.75 ,$3.55 ,$3.55 ,$4.18 ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A ,$5.00 ,$4.25 ,$4.18 ,$5.00 ,$2.81 ,$4.18 ,$2.07 ,$5.00 ,$5.00 ,$4.18 ,$4.25 ,$8.97 ,$2.98 ,$1.40 ,$4.50 ,$4.18 ,$4.25 ,$5.00 ,$5.00 ,$4.18 ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,30201231,86146,HC BET-2 GLYCOPROTEIN ANTIBODY-90,302,1 ,$20.00 ,$14.40 ,$5.60 ,$50.00 ,$50.00 ,$13.00 ,$11.94 ,$19.60 ,$5.60 ,$13.24 ,$19.60 ,$13.24 ,$19.60 ,$11.92 ,$11.92 ,$19.60 ,$11.92 ,$20.00 ,$15.40 ,$50.00 ,$19.60 ,$19.60 ,$15.00 ,$14.20 ,$14.20 ,$19.60 ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A ,$20.00 ,$17.00 ,$19.60 ,$20.00 ,$11.22 ,$19.60 ,$8.28 ,$8.34 ,$7.58 ,$19.60 ,$17.00 ,$42.00 ,$11.92 ,$5.60 ,$18.00 ,$19.60 ,$17.00 ,$20.00 ,$20.00 ,$19.60 ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,30201233,86317,HC IMMUNOASSAY INFECTIOUS AGENT-90,302,1 ,$11.66 ,$8.40 ,$3.26 ,$29.15 ,$29.15 ,$7.58 ,$6.96 ,$11.43 ,$3.26 ,$7.72 ,$11.43 ,$7.72 ,$11.43 ,$6.95 ,$6.95 ,$11.43 ,$6.95 ,$11.66 ,$8.98 ,$29.15 ,$11.43 ,$11.43 ,$8.75 ,$8.28 ,$8.28 ,$11.43 ,$8.28 ,$9.91 ,$9.91 ,$9.91 , N/A ,$11.66 ,$9.91 ,$11.43 ,$11.66 ,$6.54 ,$11.43 ,$4.83 ,$11.66 ,$11.66 ,$11.43 ,$9.91 ,$24.49 ,$6.95 ,$3.26 ,$10.49 ,$11.43 ,$9.91 ,$11.66 ,$11.66 ,$11.43 ,$7.58 ST. JOSEPH'S HOSPITAL - BREESE,30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$57.00 ,$41.04 ,$3.72 ,$57.00 ,$9.50 ,$37.05 ,$34.03 ,$3.72 ,$15.96 ,$37.73 ,$3.72 ,$37.73 ,$3.72 ,$33.97 ,$33.97 ,$3.72 ,$33.97 ,$7.68 ,$43.89 ,$9.50 ,$3.72 ,$3.80 ,$42.75 ,$40.47 ,$40.47 ,$3.72 ,$40.47 ,$48.45 ,$48.45 ,$48.45 , N/A ,$9.50 ,$48.45 ,$3.72 ,$57.00 ,$31.98 ,$3.72 ,$23.60 ,$5.18 ,$4.71 ,$3.72 ,$48.45 ,$7.98 ,$33.97 ,$15.96 ,$51.30 ,$3.72 ,$48.45 ,$15.20 ,$15.20 ,$3.72 ,$37.05 ST. JOSEPH'S HOSPITAL - BREESE,30500104,85014,HC HEMATOCRIT,305,1 ,$42.00 ,$30.24 ,$2.32 ,$42.00 ,$5.93 ,$27.30 ,$25.07 ,$2.32 ,$11.76 ,$27.80 ,$2.32 ,$27.80 ,$2.32 ,$25.03 ,$25.03 ,$2.32 ,$25.03 ,$4.79 ,$32.34 ,$5.93 ,$2.32 ,$2.37 ,$31.50 ,$29.82 ,$29.82 ,$2.32 ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A ,$5.93 ,$35.70 ,$2.32 ,$2.37 ,$23.56 ,$2.32 ,$17.39 ,$5.18 ,$4.71 ,$2.32 ,$35.70 ,$4.98 ,$25.03 ,$11.76 ,$37.80 ,$2.32 ,$35.70 ,$9.48 ,$9.48 ,$2.32 ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,30500106,85018,HC HGB,305,1 ,$42.00 ,$30.24 ,$2.32 ,$42.00 ,$5.93 ,$27.30 ,$25.07 ,$2.32 ,$11.76 ,$27.80 ,$2.32 ,$27.80 ,$2.32 ,$25.03 ,$25.03 ,$2.32 ,$25.03 ,$4.79 ,$32.34 ,$5.93 ,$2.32 ,$2.37 ,$31.50 ,$29.82 ,$29.82 ,$2.32 ,$29.82 ,$35.70 ,$35.70 ,$35.70 , N/A ,$5.93 ,$35.70 ,$2.32 ,$2.37 ,$23.56 ,$2.32 ,$17.39 ,$5.18 ,$4.71 ,$2.32 ,$35.70 ,$4.98 ,$25.03 ,$11.76 ,$37.80 ,$2.32 ,$35.70 ,$9.48 ,$9.48 ,$2.32 ,$27.30 ST. JOSEPH'S HOSPITAL - BREESE,30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$147.00 ,$105.84 ,$4.71 ,$147.00 ,$19.43 ,$95.55 ,$87.76 ,$7.61 ,$41.16 ,$97.31 ,$7.61 ,$97.31 ,$7.61 ,$87.61 ,$87.61 ,$7.61 ,$87.61 ,$15.70 ,$113.19 ,$19.43 ,$7.61 ,$7.77 ,$110.25 ,$104.37 ,$104.37 ,$7.61 ,$104.37 ,$124.95 ,$124.95 ,$124.95 , N/A ,$19.43 ,$124.95 ,$7.61 ,$7.77 ,$82.47 ,$7.61 ,$60.86 ,$5.18 ,$4.71 ,$7.61 ,$124.95 ,$16.32 ,$87.61 ,$41.16 ,$132.30 ,$7.61 ,$124.95 ,$31.08 ,$31.08 ,$7.61 ,$95.55 ST. JOSEPH'S HOSPITAL - BREESE,30500108,85027,HC CBC W/O DIFF,305,1 ,$139.00 ,$100.08 ,$4.71 ,$139.00 ,$16.18 ,$90.35 ,$82.98 ,$6.34 ,$38.92 ,$92.02 ,$6.34 ,$92.02 ,$6.34 ,$82.84 ,$82.84 ,$6.34 ,$82.84 ,$13.07 ,$107.03 ,$16.18 ,$6.34 ,$6.47 ,$104.25 ,$98.69 ,$98.69 ,$6.34 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$16.18 ,$118.15 ,$6.34 ,$6.47 ,$77.98 ,$6.34 ,$57.55 ,$5.18 ,$4.71 ,$6.34 ,$118.15 ,$13.59 ,$82.84 ,$38.92 ,$125.10 ,$6.34 ,$118.15 ,$25.88 ,$25.88 ,$6.34 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30500111,85045,HC RETIC COUNT AUTO,305,1 ,$71.00 ,$51.12 ,$3.91 ,$71.00 ,$9.98 ,$46.15 ,$42.39 ,$3.91 ,$19.88 ,$47.00 ,$3.91 ,$47.00 ,$3.91 ,$42.32 ,$42.32 ,$3.91 ,$42.32 ,$8.06 ,$54.67 ,$9.98 ,$3.91 ,$3.99 ,$53.25 ,$50.41 ,$50.41 ,$3.91 ,$50.41 ,$60.35 ,$60.35 ,$60.35 , N/A ,$9.98 ,$60.35 ,$3.91 ,$71.00 ,$39.83 ,$3.91 ,$29.39 ,$5.18 ,$4.71 ,$3.91 ,$60.35 ,$8.38 ,$42.32 ,$19.88 ,$63.90 ,$3.91 ,$60.35 ,$15.96 ,$15.96 ,$3.91 ,$46.15 ST. JOSEPH'S HOSPITAL - BREESE,30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$60.00 ,$43.20 ,$2.49 ,$60.00 ,$6.35 ,$39.00 ,$35.82 ,$2.49 ,$16.80 ,$39.72 ,$2.49 ,$39.72 ,$2.49 ,$35.76 ,$35.76 ,$2.49 ,$35.76 ,$5.13 ,$46.20 ,$6.35 ,$2.49 ,$2.54 ,$45.00 ,$42.60 ,$42.60 ,$2.49 ,$42.60 ,$51.00 ,$51.00 ,$51.00 , N/A ,$6.35 ,$51.00 ,$2.49 ,$60.00 ,$33.66 ,$2.49 ,$24.84 ,$5.18 ,$4.71 ,$2.49 ,$51.00 ,$5.33 ,$35.76 ,$16.80 ,$54.00 ,$2.49 ,$51.00 ,$10.16 ,$10.16 ,$2.49 ,$39.00 ST. JOSEPH'S HOSPITAL - BREESE,30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$75.00 ,$54.00 ,$4.39 ,$75.00 ,$11.20 ,$48.75 ,$44.78 ,$4.39 ,$21.00 ,$49.65 ,$4.39 ,$49.65 ,$4.39 ,$44.70 ,$44.70 ,$4.39 ,$44.70 ,$9.05 ,$57.75 ,$11.20 ,$4.39 ,$4.48 ,$56.25 ,$53.25 ,$53.25 ,$4.39 ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A ,$11.20 ,$63.75 ,$4.39 ,$75.00 ,$42.08 ,$4.39 ,$31.05 ,$5.18 ,$4.71 ,$4.39 ,$63.75 ,$9.41 ,$44.70 ,$21.00 ,$67.50 ,$4.39 ,$63.75 ,$17.92 ,$17.92 ,$4.39 ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,30500175,85379,HC D DIMER QN,305,1 ,$210.00 ,$151.20 ,$8.17 ,$210.00 ,$25.45 ,$136.50 ,$125.37 ,$9.98 ,$58.80 ,$139.02 ,$9.98 ,$139.02 ,$9.98 ,$125.16 ,$125.16 ,$9.98 ,$125.16 ,$20.56 ,$161.70 ,$25.45 ,$9.98 ,$10.17 ,$157.50 ,$149.10 ,$149.10 ,$9.98 ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A ,$25.45 ,$178.50 ,$9.98 ,$210.00 ,$117.81 ,$9.98 ,$86.94 ,$8.99 ,$8.17 ,$9.98 ,$178.50 ,$21.38 ,$125.16 ,$58.80 ,$189.00 ,$9.98 ,$178.50 ,$40.72 ,$40.72 ,$9.98 ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,30500176,85384,HC FIBRINOGEN,305,1 ,$29.00 ,$20.88 ,$2.75 ,$29.00 ,$24.30 ,$18.85 ,$17.31 ,$9.53 ,$8.12 ,$19.20 ,$9.53 ,$19.20 ,$9.53 ,$17.28 ,$17.28 ,$9.53 ,$17.28 ,$19.63 ,$22.33 ,$24.30 ,$9.53 ,$9.71 ,$21.75 ,$20.59 ,$20.59 ,$9.53 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$24.30 ,$24.65 ,$9.53 ,$29.00 ,$16.27 ,$9.53 ,$12.01 ,$3.03 ,$2.75 ,$9.53 ,$24.65 ,$20.41 ,$17.28 ,$8.12 ,$26.10 ,$9.53 ,$24.65 ,$29.00 ,$29.00 ,$9.53 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,30500179,85385,HC FIBRINOGEN AG,305,1 ,$142.00 ,$102.24 ,$2.75 ,$142.00 ,$36.15 ,$92.30 ,$84.77 ,$14.17 ,$39.76 ,$94.00 ,$14.17 ,$94.00 ,$14.17 ,$84.63 ,$84.63 ,$14.17 ,$84.63 ,$29.21 ,$109.34 ,$36.15 ,$14.17 ,$14.45 ,$106.50 ,$100.82 ,$100.82 ,$14.17 ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A ,$36.15 ,$120.70 ,$14.17 ,$142.00 ,$79.66 ,$14.17 ,$58.79 ,$3.03 ,$2.75 ,$14.17 ,$120.70 ,$30.37 ,$84.63 ,$39.76 ,$127.80 ,$14.17 ,$120.70 ,$57.84 ,$57.84 ,$14.17 ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,30500187,85520,HC HEPARIN ASSAY,305,1 ,$191.00 ,$137.52 ,$8.17 ,$191.00 ,$32.73 ,$124.15 ,$114.03 ,$12.83 ,$53.48 ,$126.44 ,$12.83 ,$126.44 ,$12.83 ,$113.84 ,$113.84 ,$12.83 ,$113.84 ,$26.44 ,$147.07 ,$32.73 ,$12.83 ,$13.08 ,$143.25 ,$135.61 ,$135.61 ,$12.83 ,$135.61 ,$162.35 ,$162.35 ,$162.35 , N/A ,$32.73 ,$162.35 ,$12.83 ,$191.00 ,$107.15 ,$12.83 ,$79.07 ,$8.99 ,$8.17 ,$12.83 ,$162.35 ,$27.49 ,$113.84 ,$53.48 ,$171.90 ,$12.83 ,$162.35 ,$52.36 ,$52.36 ,$12.83 ,$124.15 ST. JOSEPH'S HOSPITAL - BREESE,30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$74.00 ,$53.28 ,$2.75 ,$74.00 ,$10.73 ,$48.10 ,$44.18 ,$4.20 ,$20.72 ,$48.99 ,$4.20 ,$48.99 ,$4.20 ,$44.10 ,$44.10 ,$4.20 ,$44.10 ,$8.67 ,$56.98 ,$10.73 ,$4.20 ,$4.29 ,$55.50 ,$52.54 ,$52.54 ,$4.20 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$10.73 ,$62.90 ,$4.20 ,$74.00 ,$41.51 ,$4.20 ,$30.64 ,$3.03 ,$2.75 ,$4.20 ,$62.90 ,$9.01 ,$44.10 ,$20.72 ,$66.60 ,$4.20 ,$62.90 ,$17.16 ,$17.16 ,$4.20 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30500205,85652,HC SED RATE AUTO,305,1 ,$80.00 ,$57.60 ,$2.65 ,$80.00 ,$6.75 ,$52.00 ,$47.76 ,$2.65 ,$22.40 ,$52.96 ,$2.65 ,$52.96 ,$2.65 ,$47.68 ,$47.68 ,$2.65 ,$47.68 ,$5.45 ,$61.60 ,$6.75 ,$2.65 ,$2.69 ,$60.00 ,$56.80 ,$56.80 ,$2.65 ,$56.80 ,$68.00 ,$68.00 ,$68.00 , N/A ,$6.75 ,$68.00 ,$2.65 ,$80.00 ,$44.88 ,$2.65 ,$33.12 ,$5.18 ,$4.71 ,$2.65 ,$68.00 ,$5.67 ,$47.68 ,$22.40 ,$72.00 ,$2.65 ,$68.00 ,$10.80 ,$10.80 ,$2.65 ,$52.00 ST. JOSEPH'S HOSPITAL - BREESE,30500211,85730,HC PTT,305,1 ,$105.00 ,$75.60 ,$2.75 ,$105.00 ,$15.03 ,$68.25 ,$62.69 ,$5.89 ,$29.40 ,$69.51 ,$5.89 ,$69.51 ,$5.89 ,$62.58 ,$62.58 ,$5.89 ,$62.58 ,$12.14 ,$80.85 ,$15.03 ,$5.89 ,$6.01 ,$78.75 ,$74.55 ,$74.55 ,$5.89 ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A ,$15.03 ,$89.25 ,$5.89 ,$105.00 ,$58.91 ,$5.89 ,$43.47 ,$3.03 ,$2.75 ,$5.89 ,$89.25 ,$12.62 ,$62.58 ,$29.40 ,$94.50 ,$5.89 ,$89.25 ,$24.04 ,$24.04 ,$5.89 ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,30500217,85810,HC VISCOSITY,305,1 ,$58.00 ,$41.76 ,$7.17 ,$58.00 ,$29.18 ,$37.70 ,$34.63 ,$11.44 ,$16.24 ,$38.40 ,$11.44 ,$38.40 ,$11.44 ,$34.57 ,$34.57 ,$11.44 ,$34.57 ,$23.57 ,$44.66 ,$29.18 ,$11.44 ,$11.66 ,$43.50 ,$41.18 ,$41.18 ,$11.44 ,$41.18 ,$49.30 ,$49.30 ,$49.30 , N/A ,$29.18 ,$49.30 ,$11.44 ,$58.00 ,$32.54 ,$11.44 ,$24.01 ,$7.89 ,$7.17 ,$11.44 ,$49.30 ,$24.51 ,$34.57 ,$16.24 ,$52.20 ,$11.44 ,$49.30 ,$46.68 ,$46.68 ,$11.44 ,$37.70 ST. JOSEPH'S HOSPITAL - BREESE,30500234,85014,HC HEMATOCRIT-90,305,1 ,$38.00 ,$27.36 ,$2.32 ,$38.00 ,$5.93 ,$24.70 ,$22.69 ,$2.32 ,$10.64 ,$25.16 ,$2.32 ,$25.16 ,$2.32 ,$22.65 ,$22.65 ,$2.32 ,$22.65 ,$4.79 ,$29.26 ,$5.93 ,$2.32 ,$2.37 ,$28.50 ,$26.98 ,$26.98 ,$2.32 ,$26.98 ,$32.30 ,$32.30 ,$32.30 , N/A ,$5.93 ,$32.30 ,$2.32 ,$2.37 ,$21.32 ,$2.32 ,$15.73 ,$5.18 ,$4.71 ,$2.32 ,$32.30 ,$4.98 ,$22.65 ,$10.64 ,$34.20 ,$2.32 ,$32.30 ,$9.48 ,$9.48 ,$2.32 ,$24.70 ST. JOSEPH'S HOSPITAL - BREESE,30500238,85018,HC HGB-90,305,1 ,$38.00 ,$27.36 ,$2.32 ,$38.00 ,$5.93 ,$24.70 ,$22.69 ,$2.32 ,$10.64 ,$25.16 ,$2.32 ,$25.16 ,$2.32 ,$22.65 ,$22.65 ,$2.32 ,$22.65 ,$4.79 ,$29.26 ,$5.93 ,$2.32 ,$2.37 ,$28.50 ,$26.98 ,$26.98 ,$2.32 ,$26.98 ,$32.30 ,$32.30 ,$32.30 , N/A ,$5.93 ,$32.30 ,$2.32 ,$2.37 ,$21.32 ,$2.32 ,$15.73 ,$5.18 ,$4.71 ,$2.32 ,$32.30 ,$4.98 ,$22.65 ,$10.64 ,$34.20 ,$2.32 ,$32.30 ,$9.48 ,$9.48 ,$2.32 ,$24.70 ST. JOSEPH'S HOSPITAL - BREESE,30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$29.00 ,$20.88 ,$2.96 ,$29.00 ,$7.55 ,$18.85 ,$17.31 ,$2.96 ,$8.12 ,$19.20 ,$2.96 ,$19.20 ,$2.96 ,$17.28 ,$17.28 ,$2.96 ,$17.28 ,$6.10 ,$22.33 ,$7.55 ,$2.96 ,$3.02 ,$21.75 ,$20.59 ,$20.59 ,$2.96 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$7.55 ,$24.65 ,$2.96 ,$29.00 ,$16.27 ,$2.96 ,$12.01 ,$5.18 ,$4.71 ,$2.96 ,$24.65 ,$6.34 ,$17.28 ,$8.12 ,$26.10 ,$2.96 ,$24.65 ,$12.08 ,$12.08 ,$2.96 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,30500247,85097,HC BONE MARROW SMEAR INTERP,305,1 ,$73.00 ,$52.56 ,$20.44 ,"$1,864.28 ","$1,864.28 ",$47.45 ,$43.58 ,$730.80 ,$20.44 ,$48.33 ,$730.80 ,$48.33 ,$71.54 ,$43.51 ,$43.51 ,$71.54 ,$43.51 ,$73.00 ,$56.21 ,"$1,864.28 ",$730.80 ,$71.54 ,$54.75 ,$51.83 ,$51.83 ,$730.80 ,$51.83 ,$62.05 ,$62.05 ,$62.05 , N/A ,$73.00 ,$62.05 ,$71.54 ,$73.00 ,$40.95 ,$730.80 ,$30.22 ,$23.84 ,$21.67 ,$730.80 ,$62.05 ,"$1,566.00 ",$43.51 ,$20.44 ,$65.70 ,$730.80 ,$62.05 ,$73.00 ,$73.00 ,$730.80 ,$47.45 ST. JOSEPH'S HOSPITAL - BREESE,30500249,85210,HC FACTOR II PROTHROM SPEC-90,305,1 ,$151.00 ,$108.72 ,$2.75 ,$151.00 ,$32.45 ,$98.15 ,$90.15 ,$12.72 ,$42.28 ,$99.96 ,$12.72 ,$99.96 ,$12.72 ,$90.00 ,$90.00 ,$12.72 ,$90.00 ,$26.22 ,$116.27 ,$32.45 ,$12.72 ,$12.98 ,$113.25 ,$107.21 ,$107.21 ,$12.72 ,$107.21 ,$128.35 ,$128.35 ,$128.35 , N/A ,$32.45 ,$128.35 ,$12.72 ,$151.00 ,$84.71 ,$12.72 ,$62.51 ,$3.03 ,$2.75 ,$12.72 ,$128.35 ,$27.26 ,$90.00 ,$42.28 ,$135.90 ,$12.72 ,$128.35 ,$51.92 ,$51.92 ,$12.72 ,$98.15 ST. JOSEPH'S HOSPITAL - BREESE,30500250,85220,HC FACTOR V CLOTTING FACTOR-90,305,1 ,$151.00 ,$108.72 ,$8.17 ,$151.00 ,$44.13 ,$98.15 ,$90.15 ,$17.30 ,$42.28 ,$99.96 ,$17.30 ,$99.96 ,$17.30 ,$90.00 ,$90.00 ,$17.30 ,$90.00 ,$35.65 ,$116.27 ,$44.13 ,$17.30 ,$17.64 ,$113.25 ,$107.21 ,$107.21 ,$17.30 ,$107.21 ,$128.35 ,$128.35 ,$128.35 , N/A ,$44.13 ,$128.35 ,$17.30 ,$151.00 ,$84.71 ,$17.30 ,$62.51 ,$8.99 ,$8.17 ,$17.30 ,$128.35 ,$37.07 ,$90.00 ,$42.28 ,$135.90 ,$17.30 ,$128.35 ,$70.60 ,$70.60 ,$17.30 ,$98.15 ST. JOSEPH'S HOSPITAL - BREESE,30500251,85230,HC FACTOR VII PROCONVERTIN-90,305,1 ,$145.00 ,$104.40 ,$8.17 ,$145.00 ,$44.75 ,$94.25 ,$86.57 ,$17.54 ,$40.60 ,$95.99 ,$17.54 ,$95.99 ,$17.54 ,$86.42 ,$86.42 ,$17.54 ,$86.42 ,$36.16 ,$111.65 ,$44.75 ,$17.54 ,$17.89 ,$108.75 ,$102.95 ,$102.95 ,$17.54 ,$102.95 ,$123.25 ,$123.25 ,$123.25 , N/A ,$44.75 ,$123.25 ,$17.54 ,$145.00 ,$81.35 ,$17.54 ,$60.03 ,$8.99 ,$8.17 ,$17.54 ,$123.25 ,$37.59 ,$86.42 ,$40.60 ,$130.50 ,$17.54 ,$123.25 ,$71.60 ,$71.60 ,$17.54 ,$94.25 ST. JOSEPH'S HOSPITAL - BREESE,30500252,85240,HC FACTOR VIII AHG 1 STAGE-90,305,1 ,$167.00 ,$120.24 ,$8.17 ,$167.00 ,$44.75 ,$108.55 ,$99.70 ,$17.54 ,$46.76 ,$110.55 ,$17.54 ,$110.55 ,$17.54 ,$99.53 ,$99.53 ,$17.54 ,$99.53 ,$36.16 ,$128.59 ,$44.75 ,$17.54 ,$17.89 ,$125.25 ,$118.57 ,$118.57 ,$17.54 ,$118.57 ,$141.95 ,$141.95 ,$141.95 , N/A ,$44.75 ,$141.95 ,$17.54 ,$167.00 ,$93.69 ,$17.54 ,$69.14 ,$8.99 ,$8.17 ,$17.54 ,$141.95 ,$37.59 ,$99.53 ,$46.76 ,$150.30 ,$17.54 ,$141.95 ,$71.60 ,$71.60 ,$17.54 ,$108.55 ST. JOSEPH'S HOSPITAL - BREESE,30500253,85245,HC FACTOR VIII VW RISTOCTN-90,305,1 ,$81.00 ,$58.32 ,$8.17 ,$81.00 ,$57.35 ,$52.65 ,$48.36 ,$22.48 ,$22.68 ,$53.62 ,$22.48 ,$53.62 ,$22.48 ,$48.28 ,$48.28 ,$22.48 ,$48.28 ,$46.34 ,$62.37 ,$57.35 ,$22.48 ,$22.93 ,$60.75 ,$57.51 ,$57.51 ,$22.48 ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A ,$57.35 ,$68.85 ,$22.48 ,$81.00 ,$45.44 ,$22.48 ,$33.53 ,$8.99 ,$8.17 ,$22.48 ,$68.85 ,$48.17 ,$48.28 ,$22.68 ,$72.90 ,$22.48 ,$68.85 ,$81.00 ,$81.00 ,$22.48 ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,30500254,85246,HC FACTOR VIII VW ANTIGEN-90,305,1 ,$152.00 ,$109.44 ,$8.17 ,$152.00 ,$57.35 ,$98.80 ,$90.74 ,$22.48 ,$42.56 ,$100.62 ,$22.48 ,$100.62 ,$22.48 ,$90.59 ,$90.59 ,$22.48 ,$90.59 ,$46.34 ,$117.04 ,$57.35 ,$22.48 ,$22.93 ,$114.00 ,$107.92 ,$107.92 ,$22.48 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$57.35 ,$129.20 ,$22.48 ,$152.00 ,$85.27 ,$22.48 ,$62.93 ,$8.99 ,$8.17 ,$22.48 ,$129.20 ,$48.17 ,$90.59 ,$42.56 ,$136.80 ,$22.48 ,$129.20 ,$91.76 ,$91.76 ,$22.48 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,30500255,85247,HC FACTOR VIII VW MULTIM ANALY-90,305,1 ,$122.00 ,$87.84 ,$8.17 ,$122.00 ,$57.35 ,$79.30 ,$72.83 ,$22.48 ,$34.16 ,$80.76 ,$22.48 ,$80.76 ,$22.48 ,$72.71 ,$72.71 ,$22.48 ,$72.71 ,$46.34 ,$93.94 ,$57.35 ,$22.48 ,$22.93 ,$91.50 ,$86.62 ,$86.62 ,$22.48 ,$86.62 ,$103.70 ,$103.70 ,$103.70 , N/A ,$57.35 ,$103.70 ,$22.48 ,$122.00 ,$68.44 ,$22.48 ,$50.51 ,$8.99 ,$8.17 ,$22.48 ,$103.70 ,$48.17 ,$72.71 ,$34.16 ,$109.80 ,$22.48 ,$103.70 ,$91.76 ,$91.76 ,$22.48 ,$79.30 ST. JOSEPH'S HOSPITAL - BREESE,30500256,85250,HC FACTOR IX (PTC OR CHRISTMAS)-90,305,1 ,$133.00 ,$95.76 ,$8.17 ,$133.00 ,$47.60 ,$86.45 ,$79.40 ,$18.66 ,$37.24 ,$88.05 ,$18.66 ,$88.05 ,$18.66 ,$79.27 ,$79.27 ,$18.66 ,$79.27 ,$38.46 ,$102.41 ,$47.60 ,$18.66 ,$19.03 ,$99.75 ,$94.43 ,$94.43 ,$18.66 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$47.60 ,$113.05 ,$18.66 ,$133.00 ,$74.61 ,$18.66 ,$55.06 ,$8.99 ,$8.17 ,$18.66 ,$113.05 ,$39.98 ,$79.27 ,$37.24 ,$119.70 ,$18.66 ,$113.05 ,$76.16 ,$76.16 ,$18.66 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,30500257,85260,HC FACTOR X (STUART-POWER)-90,305,1 ,$151.00 ,$108.72 ,$8.17 ,$151.00 ,$44.75 ,$98.15 ,$90.15 ,$17.54 ,$42.28 ,$99.96 ,$17.54 ,$99.96 ,$17.54 ,$90.00 ,$90.00 ,$17.54 ,$90.00 ,$36.16 ,$116.27 ,$44.75 ,$17.54 ,$17.89 ,$113.25 ,$107.21 ,$107.21 ,$17.54 ,$107.21 ,$128.35 ,$128.35 ,$128.35 , N/A ,$44.75 ,$128.35 ,$17.54 ,$151.00 ,$84.71 ,$17.54 ,$62.51 ,$8.99 ,$8.17 ,$17.54 ,$128.35 ,$37.59 ,$90.00 ,$42.28 ,$135.90 ,$17.54 ,$128.35 ,$71.60 ,$71.60 ,$17.54 ,$98.15 ST. JOSEPH'S HOSPITAL - BREESE,30500258,85270,HC FACTOR XI (PTA)-90,305,1 ,$52.00 ,$37.44 ,$8.17 ,$52.00 ,$44.75 ,$33.80 ,$31.04 ,$17.54 ,$14.56 ,$34.42 ,$17.54 ,$34.42 ,$17.54 ,$30.99 ,$30.99 ,$17.54 ,$30.99 ,$36.16 ,$40.04 ,$44.75 ,$17.54 ,$17.89 ,$39.00 ,$36.92 ,$36.92 ,$17.54 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$44.75 ,$44.20 ,$17.54 ,$52.00 ,$29.17 ,$17.54 ,$21.53 ,$8.99 ,$8.17 ,$17.54 ,$44.20 ,$37.59 ,$30.99 ,$14.56 ,$46.80 ,$17.54 ,$44.20 ,$52.00 ,$52.00 ,$17.54 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30500259,85280,HC FACTOR XII HAGEMAN-90,305,1 ,$52.00 ,$37.44 ,$8.17 ,$52.00 ,$48.38 ,$33.80 ,$31.04 ,$18.96 ,$14.56 ,$34.42 ,$18.96 ,$34.42 ,$18.96 ,$30.99 ,$30.99 ,$18.96 ,$30.99 ,$39.09 ,$40.04 ,$48.38 ,$18.96 ,$19.35 ,$39.00 ,$36.92 ,$36.92 ,$18.96 ,$36.92 ,$44.20 ,$44.20 ,$44.20 , N/A ,$48.38 ,$44.20 ,$18.96 ,$52.00 ,$29.17 ,$18.96 ,$21.53 ,$8.99 ,$8.17 ,$18.96 ,$44.20 ,$40.64 ,$30.99 ,$14.56 ,$46.80 ,$18.96 ,$44.20 ,$52.00 ,$52.00 ,$18.96 ,$33.80 ST. JOSEPH'S HOSPITAL - BREESE,30500261,85300,HC ANTITHROMBIN III ACT-90,305,1 ,$177.00 ,$127.44 ,$8.17 ,$177.00 ,$29.63 ,$115.05 ,$105.67 ,$11.61 ,$49.56 ,$117.17 ,$11.61 ,$117.17 ,$11.61 ,$105.49 ,$105.49 ,$11.61 ,$105.49 ,$23.94 ,$136.29 ,$29.63 ,$11.61 ,$11.85 ,$132.75 ,$125.67 ,$125.67 ,$11.61 ,$125.67 ,$150.45 ,$150.45 ,$150.45 , N/A ,$29.63 ,$150.45 ,$11.61 ,$177.00 ,$99.30 ,$11.61 ,$73.28 ,$8.99 ,$8.17 ,$11.61 ,$150.45 ,$24.89 ,$105.49 ,$49.56 ,$159.30 ,$11.61 ,$150.45 ,$47.40 ,$47.40 ,$11.61 ,$115.05 ST. JOSEPH'S HOSPITAL - BREESE,30500262,85301,HC ANTITHROMBIN III AG-90,305,1 ,$53.00 ,$38.16 ,$8.17 ,$53.00 ,$27.03 ,$34.45 ,$31.64 ,$10.59 ,$14.84 ,$35.09 ,$10.59 ,$35.09 ,$10.59 ,$31.59 ,$31.59 ,$10.59 ,$31.59 ,$21.84 ,$40.81 ,$27.03 ,$10.59 ,$10.81 ,$39.75 ,$37.63 ,$37.63 ,$10.59 ,$37.63 ,$45.05 ,$45.05 ,$45.05 , N/A ,$27.03 ,$45.05 ,$10.59 ,$53.00 ,$29.73 ,$10.59 ,$21.94 ,$8.99 ,$8.17 ,$10.59 ,$45.05 ,$22.70 ,$31.59 ,$14.84 ,$47.70 ,$10.59 ,$45.05 ,$43.24 ,$43.24 ,$10.59 ,$34.45 ST. JOSEPH'S HOSPITAL - BREESE,30500263,85302,HC PROTEIN C AG-90,305,1 ,$130.00 ,$93.60 ,$8.17 ,$130.00 ,$30.03 ,$84.50 ,$77.61 ,$11.77 ,$36.40 ,$86.06 ,$11.77 ,$86.06 ,$11.77 ,$77.48 ,$77.48 ,$11.77 ,$77.48 ,$24.26 ,$100.10 ,$30.03 ,$11.77 ,$12.00 ,$97.50 ,$92.30 ,$92.30 ,$11.77 ,$92.30 ,$110.50 ,$110.50 ,$110.50 , N/A ,$30.03 ,$110.50 ,$11.77 ,$130.00 ,$72.93 ,$11.77 ,$53.82 ,$8.99 ,$8.17 ,$11.77 ,$110.50 ,$25.22 ,$77.48 ,$36.40 ,$117.00 ,$11.77 ,$110.50 ,$48.04 ,$48.04 ,$11.77 ,$84.50 ST. JOSEPH'S HOSPITAL - BREESE,30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$215.00 ,$154.80 ,$8.17 ,$215.00 ,$34.60 ,$139.75 ,$128.36 ,$13.56 ,$60.20 ,$142.33 ,$13.56 ,$142.33 ,$13.56 ,$128.14 ,$128.14 ,$13.56 ,$128.14 ,$27.96 ,$165.55 ,$34.60 ,$13.56 ,$13.84 ,$161.25 ,$152.65 ,$152.65 ,$13.56 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$34.60 ,$182.75 ,$13.56 ,$215.00 ,$120.62 ,$13.56 ,$89.01 ,$8.99 ,$8.17 ,$13.56 ,$182.75 ,$29.06 ,$128.14 ,$60.20 ,$193.50 ,$13.56 ,$182.75 ,$55.36 ,$55.36 ,$13.56 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$37.00 ,$26.64 ,$8.17 ,$37.00 ,$29.03 ,$24.05 ,$22.09 ,$11.38 ,$10.36 ,$24.49 ,$11.38 ,$24.49 ,$11.38 ,$22.05 ,$22.05 ,$11.38 ,$22.05 ,$23.45 ,$28.49 ,$29.03 ,$11.38 ,$11.60 ,$27.75 ,$26.27 ,$26.27 ,$11.38 ,$26.27 ,$31.45 ,$31.45 ,$31.45 , N/A ,$29.03 ,$31.45 ,$11.38 ,$37.00 ,$20.76 ,$11.38 ,$15.32 ,$8.99 ,$8.17 ,$11.38 ,$31.45 ,$24.38 ,$22.05 ,$10.36 ,$33.30 ,$11.38 ,$31.45 ,$37.00 ,$37.00 ,$11.38 ,$24.05 ST. JOSEPH'S HOSPITAL - BREESE,30500266,85306,HC PROTEIN S FREE-90,305,1 ,$201.00 ,$144.72 ,$8.17 ,$201.00 ,$38.30 ,$130.65 ,$120.00 ,$15.01 ,$56.28 ,$133.06 ,$15.01 ,$133.06 ,$15.01 ,$119.80 ,$119.80 ,$15.01 ,$119.80 ,$30.95 ,$154.77 ,$38.30 ,$15.01 ,$15.32 ,$150.75 ,$142.71 ,$142.71 ,$15.01 ,$142.71 ,$170.85 ,$170.85 ,$170.85 , N/A ,$38.30 ,$170.85 ,$15.01 ,$201.00 ,$112.76 ,$15.01 ,$83.21 ,$8.99 ,$8.17 ,$15.01 ,$170.85 ,$32.17 ,$119.80 ,$56.28 ,$180.90 ,$15.01 ,$170.85 ,$61.28 ,$61.28 ,$15.01 ,$130.65 ST. JOSEPH'S HOSPITAL - BREESE,30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$139.00 ,$100.08 ,$7.58 ,$139.00 ,$38.30 ,$90.35 ,$82.98 ,$15.01 ,$38.92 ,$92.02 ,$15.01 ,$92.02 ,$15.01 ,$82.84 ,$82.84 ,$15.01 ,$82.84 ,$30.95 ,$107.03 ,$38.30 ,$15.01 ,$15.32 ,$104.25 ,$98.69 ,$98.69 ,$15.01 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$38.30 ,$118.15 ,$15.01 ,$139.00 ,$77.98 ,$15.01 ,$57.55 ,$8.34 ,$7.58 ,$15.01 ,$118.15 ,$32.17 ,$82.84 ,$38.92 ,$125.10 ,$15.01 ,$118.15 ,$61.28 ,$61.28 ,$15.01 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30500277,85415,HC PLASMINGEN ACTIVATOR INHIB-90,305,1 ,$216.00 ,$155.52 ,$8.17 ,$216.00 ,$42.98 ,$140.40 ,$128.95 ,$16.85 ,$60.48 ,$142.99 ,$16.85 ,$142.99 ,$16.85 ,$128.74 ,$128.74 ,$16.85 ,$128.74 ,$34.72 ,$166.32 ,$42.98 ,$16.85 ,$17.18 ,$162.00 ,$153.36 ,$153.36 ,$16.85 ,$153.36 ,$183.60 ,$183.60 ,$183.60 , N/A ,$42.98 ,$183.60 ,$16.85 ,$216.00 ,$121.18 ,$16.85 ,$89.42 ,$8.99 ,$8.17 ,$16.85 ,$183.60 ,$36.10 ,$128.74 ,$60.48 ,$194.40 ,$16.85 ,$183.60 ,$68.76 ,$68.76 ,$16.85 ,$140.40 ST. JOSEPH'S HOSPITAL - BREESE,30500278,85420,HC PLASMINOGEN ACTIVITY-90,305,1 ,$90.00 ,$64.80 ,$6.40 ,$90.00 ,$16.33 ,$58.50 ,$53.73 ,$6.40 ,$25.20 ,$59.58 ,$6.40 ,$59.58 ,$6.40 ,$53.64 ,$53.64 ,$6.40 ,$53.64 ,$13.19 ,$69.30 ,$16.33 ,$6.40 ,$6.53 ,$67.50 ,$63.90 ,$63.90 ,$6.40 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$16.33 ,$76.50 ,$6.40 ,$90.00 ,$50.49 ,$6.40 ,$37.26 ,$8.99 ,$8.17 ,$6.40 ,$76.50 ,$13.71 ,$53.64 ,$25.20 ,$81.00 ,$6.40 ,$76.50 ,$26.12 ,$26.12 ,$6.40 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,30500287,85549,HC MURAMIDASE-90,305,1 ,$70.00 ,$50.40 ,$7.58 ,$70.00 ,$46.88 ,$45.50 ,$41.79 ,$18.37 ,$19.60 ,$46.34 ,$18.37 ,$46.34 ,$18.37 ,$41.72 ,$41.72 ,$18.37 ,$41.72 ,$37.88 ,$53.90 ,$46.88 ,$18.37 ,$18.75 ,$52.50 ,$49.70 ,$49.70 ,$18.37 ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A ,$46.88 ,$59.50 ,$18.37 ,$70.00 ,$39.27 ,$18.37 ,$28.98 ,$8.34 ,$7.58 ,$18.37 ,$59.50 ,$39.38 ,$41.72 ,$19.60 ,$63.00 ,$18.37 ,$59.50 ,$70.00 ,$70.00 ,$18.37 ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,30500289,85597,HC PLATELET NEUTRALIZATION-90,305,1 ,$40.00 ,$28.80 ,$8.17 ,$44.95 ,$44.95 ,$26.00 ,$23.88 ,$17.62 ,$11.20 ,$26.48 ,$17.62 ,$26.48 ,$17.62 ,$23.84 ,$23.84 ,$17.62 ,$23.84 ,$36.32 ,$30.80 ,$44.95 ,$17.62 ,$17.97 ,$30.00 ,$28.40 ,$28.40 ,$17.62 ,$28.40 ,$34.00 ,$34.00 ,$34.00 , N/A ,$40.00 ,$34.00 ,$17.62 ,$40.00 ,$22.44 ,$17.62 ,$16.56 ,$8.99 ,$8.17 ,$17.62 ,$34.00 ,$37.76 ,$23.84 ,$11.20 ,$36.00 ,$17.62 ,$34.00 ,$40.00 ,$40.00 ,$17.62 ,$26.00 ST. JOSEPH'S HOSPITAL - BREESE,30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$66.00 ,$47.52 ,$8.17 ,$66.00 ,$23.95 ,$42.90 ,$39.40 ,$9.39 ,$18.48 ,$43.69 ,$9.39 ,$43.69 ,$9.39 ,$39.34 ,$39.34 ,$9.39 ,$39.34 ,$19.35 ,$50.82 ,$23.95 ,$9.39 ,$9.57 ,$49.50 ,$46.86 ,$46.86 ,$9.39 ,$46.86 ,$56.10 ,$56.10 ,$56.10 , N/A ,$23.95 ,$56.10 ,$9.39 ,$66.00 ,$37.03 ,$9.39 ,$27.32 ,$8.99 ,$8.17 ,$9.39 ,$56.10 ,$20.12 ,$39.34 ,$18.48 ,$59.40 ,$9.39 ,$56.10 ,$38.32 ,$38.32 ,$9.39 ,$42.90 ST. JOSEPH'S HOSPITAL - BREESE,30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$54.00 ,$38.88 ,$2.75 ,$54.00 ,$14.43 ,$35.10 ,$32.24 ,$5.65 ,$15.12 ,$35.75 ,$5.65 ,$35.75 ,$5.65 ,$32.18 ,$32.18 ,$5.65 ,$32.18 ,$11.66 ,$41.58 ,$14.43 ,$5.65 ,$5.77 ,$40.50 ,$38.34 ,$38.34 ,$5.65 ,$38.34 ,$45.90 ,$45.90 ,$45.90 , N/A ,$14.43 ,$45.90 ,$5.65 ,$54.00 ,$30.29 ,$5.65 ,$22.36 ,$3.03 ,$2.75 ,$5.65 ,$45.90 ,$12.12 ,$32.18 ,$15.12 ,$48.60 ,$5.65 ,$45.90 ,$23.08 ,$23.08 ,$5.65 ,$35.10 ST. JOSEPH'S HOSPITAL - BREESE,30500305,85730,HC PTT-90,305,1 ,$105.00 ,$75.60 ,$2.75 ,$105.00 ,$15.03 ,$68.25 ,$62.69 ,$5.89 ,$29.40 ,$69.51 ,$5.89 ,$69.51 ,$5.89 ,$62.58 ,$62.58 ,$5.89 ,$62.58 ,$12.14 ,$80.85 ,$15.03 ,$5.89 ,$6.01 ,$78.75 ,$74.55 ,$74.55 ,$5.89 ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A ,$15.03 ,$89.25 ,$5.89 ,$105.00 ,$58.91 ,$5.89 ,$43.47 ,$3.03 ,$2.75 ,$5.89 ,$89.25 ,$12.62 ,$62.58 ,$29.40 ,$94.50 ,$5.89 ,$89.25 ,$24.04 ,$24.04 ,$5.89 ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,30500306,85730,HC PTT PROFILE-90,305,1 ,$18.03 ,$12.98 ,$2.75 ,$18.03 ,$15.03 ,$11.72 ,$10.76 ,$5.89 ,$5.05 ,$11.94 ,$5.89 ,$11.94 ,$5.89 ,$10.75 ,$10.75 ,$5.89 ,$10.75 ,$12.14 ,$13.88 ,$15.03 ,$5.89 ,$6.01 ,$13.52 ,$12.80 ,$12.80 ,$5.89 ,$12.80 ,$15.33 ,$15.33 ,$15.33 , N/A ,$15.03 ,$15.33 ,$5.89 ,$18.03 ,$10.11 ,$5.89 ,$7.46 ,$3.03 ,$2.75 ,$5.89 ,$15.33 ,$12.62 ,$10.75 ,$5.05 ,$16.23 ,$5.89 ,$15.33 ,$18.03 ,$18.03 ,$5.89 ,$11.72 ST. JOSEPH'S HOSPITAL - BREESE,30500310,85810,HC VISCOSITY-90,305,1 ,$51.00 ,$36.72 ,$7.17 ,$51.00 ,$29.18 ,$33.15 ,$30.45 ,$11.44 ,$14.28 ,$33.76 ,$11.44 ,$33.76 ,$11.44 ,$30.40 ,$30.40 ,$11.44 ,$30.40 ,$23.57 ,$39.27 ,$29.18 ,$11.44 ,$11.66 ,$38.25 ,$36.21 ,$36.21 ,$11.44 ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A ,$29.18 ,$43.35 ,$11.44 ,$51.00 ,$28.61 ,$11.44 ,$21.11 ,$7.89 ,$7.17 ,$11.44 ,$43.35 ,$24.51 ,$30.40 ,$14.28 ,$45.90 ,$11.44 ,$43.35 ,$46.68 ,$46.68 ,$11.44 ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,30500324,85009,HC BLOOD COUNT MAN DIFF WBC BUFFY COAT,305,1 ,$77.00 ,$55.44 ,$4.71 ,$77.00 ,$12.68 ,$50.05 ,$45.97 ,$4.97 ,$21.56 ,$50.97 ,$4.97 ,$50.97 ,$4.97 ,$45.89 ,$45.89 ,$4.97 ,$45.89 ,$10.24 ,$59.29 ,$12.68 ,$4.97 ,$5.07 ,$57.75 ,$54.67 ,$54.67 ,$4.97 ,$54.67 ,$65.45 ,$65.45 ,$65.45 , N/A ,$12.68 ,$65.45 ,$4.97 ,$77.00 ,$43.20 ,$4.97 ,$31.88 ,$5.18 ,$4.71 ,$4.97 ,$65.45 ,$10.65 ,$45.89 ,$21.56 ,$69.30 ,$4.97 ,$65.45 ,$20.28 ,$20.28 ,$4.97 ,$50.05 ST. JOSEPH'S HOSPITAL - BREESE,30500327,85041,HC BLOOD COUNT RBS AUTO,305,1 ,$29.00 ,$20.88 ,$2.96 ,$29.00 ,$7.55 ,$18.85 ,$17.31 ,$2.96 ,$8.12 ,$19.20 ,$2.96 ,$19.20 ,$2.96 ,$17.28 ,$17.28 ,$2.96 ,$17.28 ,$6.10 ,$22.33 ,$7.55 ,$2.96 ,$3.02 ,$21.75 ,$20.59 ,$20.59 ,$2.96 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$7.55 ,$24.65 ,$2.96 ,$29.00 ,$16.27 ,$2.96 ,$12.01 ,$5.18 ,$4.71 ,$2.96 ,$24.65 ,$6.34 ,$17.28 ,$8.12 ,$26.10 ,$2.96 ,$24.65 ,$12.08 ,$12.08 ,$2.96 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,30500341,85046,HC BLOOD COUNT RETICULOCYTES AUTO,305,1 ,$17.00 ,$12.24 ,$4.71 ,$17.00 ,$13.93 ,$11.05 ,$10.15 ,$5.46 ,$4.76 ,$11.25 ,$5.46 ,$11.25 ,$5.46 ,$10.13 ,$10.13 ,$5.46 ,$10.13 ,$11.25 ,$13.09 ,$13.93 ,$5.46 ,$5.57 ,$12.75 ,$12.07 ,$12.07 ,$5.46 ,$12.07 ,$14.45 ,$14.45 ,$14.45 , N/A ,$13.93 ,$14.45 ,$5.46 ,$17.00 ,$9.54 ,$5.46 ,$7.04 ,$5.18 ,$4.71 ,$5.46 ,$14.45 ,$11.70 ,$10.13 ,$4.76 ,$15.30 ,$5.46 ,$14.45 ,$17.00 ,$17.00 ,$5.46 ,$11.05 ST. JOSEPH'S HOSPITAL - BREESE,30500345,85610,HC PROTHROMBIN TIME (PT)-QW,305,1 ,$74.00 ,$53.28 ,$2.75 ,$74.00 ,$10.73 ,$48.10 ,$44.18 ,$4.20 ,$20.72 ,$48.99 ,$4.20 ,$48.99 ,$4.20 ,$44.10 ,$44.10 ,$4.20 ,$44.10 ,$8.67 ,$56.98 ,$10.73 ,$4.20 ,$4.29 ,$55.50 ,$52.54 ,$52.54 ,$4.20 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$10.73 ,$62.90 ,$4.20 ,$74.00 ,$41.51 ,$4.20 ,$30.64 ,$3.03 ,$2.75 ,$4.20 ,$62.90 ,$9.01 ,$44.10 ,$20.72 ,$66.60 ,$4.20 ,$62.90 ,$17.16 ,$17.16 ,$4.20 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30500831,85384,HC FIBRINOGEN,305,1 ,$158.00 ,$113.76 ,$2.75 ,$158.00 ,$24.30 ,$102.70 ,$94.33 ,$9.53 ,$44.24 ,$104.60 ,$9.53 ,$104.60 ,$9.53 ,$94.17 ,$94.17 ,$9.53 ,$94.17 ,$19.63 ,$121.66 ,$24.30 ,$9.53 ,$9.71 ,$118.50 ,$112.18 ,$112.18 ,$9.53 ,$112.18 ,$134.30 ,$134.30 ,$134.30 , N/A ,$24.30 ,$134.30 ,$9.53 ,$158.00 ,$88.64 ,$9.53 ,$65.41 ,$3.03 ,$2.75 ,$9.53 ,$134.30 ,$20.41 ,$94.17 ,$44.24 ,$142.20 ,$9.53 ,$134.30 ,$38.88 ,$38.88 ,$9.53 ,$102.70 ST. JOSEPH'S HOSPITAL - BREESE,30500832,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$242.00 ,$174.24 ,$7.17 ,$242.00 ,$19.33 ,$157.30 ,$144.47 ,$7.58 ,$67.76 ,$160.20 ,$7.58 ,$160.20 ,$7.58 ,$144.23 ,$144.23 ,$7.58 ,$144.23 ,$15.61 ,$186.34 ,$19.33 ,$7.58 ,$7.72 ,$181.50 ,$171.82 ,$171.82 ,$7.58 ,$171.82 ,$205.70 ,$205.70 ,$205.70 , N/A ,$19.33 ,$205.70 ,$7.58 ,$242.00 ,$135.76 ,$7.58 ,$100.19 ,$7.89 ,$7.17 ,$7.58 ,$205.70 ,$16.23 ,$144.23 ,$67.76 ,$217.80 ,$7.58 ,$205.70 ,$30.92 ,$30.92 ,$7.58 ,$157.30 ST. JOSEPH'S HOSPITAL - BREESE,30500833,85520,HC HEPARIN ASSAY,305,1 ,$166.00 ,$119.52 ,$8.17 ,$166.00 ,$32.73 ,$107.90 ,$99.10 ,$12.83 ,$46.48 ,$109.89 ,$12.83 ,$109.89 ,$12.83 ,$98.94 ,$98.94 ,$12.83 ,$98.94 ,$26.44 ,$127.82 ,$32.73 ,$12.83 ,$13.08 ,$124.50 ,$117.86 ,$117.86 ,$12.83 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$32.73 ,$141.10 ,$12.83 ,$166.00 ,$93.13 ,$12.83 ,$68.72 ,$8.99 ,$8.17 ,$12.83 ,$141.10 ,$27.49 ,$98.94 ,$46.48 ,$149.40 ,$12.83 ,$141.10 ,$52.36 ,$52.36 ,$12.83 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30500835,85576,HC PLATELET AGGREGATION EA-90,305,1 ,$87.00 ,$62.64 ,$8.17 ,$87.00 ,$62.28 ,$56.55 ,$51.94 ,$24.41 ,$24.36 ,$57.59 ,$24.41 ,$57.59 ,$24.41 ,$51.85 ,$51.85 ,$24.41 ,$51.85 ,$50.32 ,$66.99 ,$62.28 ,$24.41 ,$24.90 ,$65.25 ,$61.77 ,$61.77 ,$24.41 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$62.28 ,$73.95 ,$24.41 ,$87.00 ,$48.81 ,$24.41 ,$36.02 ,$8.99 ,$8.17 ,$24.41 ,$73.95 ,$52.31 ,$51.85 ,$24.36 ,$78.30 ,$24.41 ,$73.95 ,$87.00 ,$87.00 ,$24.41 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,30500836,85610,HC PROTHROMBIN TIME (PT),305,1 ,$74.00 ,$53.28 ,$2.75 ,$74.00 ,$10.73 ,$48.10 ,$44.18 ,$4.20 ,$20.72 ,$48.99 ,$4.20 ,$48.99 ,$4.20 ,$44.10 ,$44.10 ,$4.20 ,$44.10 ,$8.67 ,$56.98 ,$10.73 ,$4.20 ,$4.29 ,$55.50 ,$52.54 ,$52.54 ,$4.20 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$10.73 ,$62.90 ,$4.20 ,$74.00 ,$41.51 ,$4.20 ,$30.64 ,$3.03 ,$2.75 ,$4.20 ,$62.90 ,$9.01 ,$44.10 ,$20.72 ,$66.60 ,$4.20 ,$62.90 ,$17.16 ,$17.16 ,$4.20 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30500837,85610,HC PROTHROMBIN TIME (PT)-QW,305,1 ,$74.00 ,$53.28 ,$2.75 ,$74.00 ,$10.73 ,$48.10 ,$44.18 ,$4.20 ,$20.72 ,$48.99 ,$4.20 ,$48.99 ,$4.20 ,$44.10 ,$44.10 ,$4.20 ,$44.10 ,$8.67 ,$56.98 ,$10.73 ,$4.20 ,$4.29 ,$55.50 ,$52.54 ,$52.54 ,$4.20 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$10.73 ,$62.90 ,$4.20 ,$74.00 ,$41.51 ,$4.20 ,$30.64 ,$3.03 ,$2.75 ,$4.20 ,$62.90 ,$9.01 ,$44.10 ,$20.72 ,$66.60 ,$4.20 ,$62.90 ,$17.16 ,$17.16 ,$4.20 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30500838,85730,HC PARTIAL THROMBO TIME (PTT),305,1 ,$91.00 ,$65.52 ,$2.75 ,$91.00 ,$15.03 ,$59.15 ,$54.33 ,$5.89 ,$25.48 ,$60.24 ,$5.89 ,$60.24 ,$5.89 ,$54.24 ,$54.24 ,$5.89 ,$54.24 ,$12.14 ,$70.07 ,$15.03 ,$5.89 ,$6.01 ,$68.25 ,$64.61 ,$64.61 ,$5.89 ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A ,$15.03 ,$77.35 ,$5.89 ,$91.00 ,$51.05 ,$5.89 ,$37.67 ,$3.03 ,$2.75 ,$5.89 ,$77.35 ,$12.62 ,$54.24 ,$25.48 ,$81.90 ,$5.89 ,$77.35 ,$24.04 ,$24.04 ,$5.89 ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,30500842,85660,HC SICKLE CELL RBC,305,1 ,$56.00 ,$40.32 ,$4.71 ,$56.00 ,$13.78 ,$36.40 ,$33.43 ,$5.40 ,$15.68 ,$37.07 ,$5.40 ,$37.07 ,$5.40 ,$33.38 ,$33.38 ,$5.40 ,$33.38 ,$11.13 ,$43.12 ,$13.78 ,$5.40 ,$5.51 ,$42.00 ,$39.76 ,$39.76 ,$5.40 ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A ,$13.78 ,$47.60 ,$5.40 ,$56.00 ,$31.42 ,$5.40 ,$23.18 ,$5.18 ,$4.71 ,$5.40 ,$47.60 ,$11.57 ,$33.38 ,$15.68 ,$50.40 ,$5.40 ,$47.60 ,$22.04 ,$22.04 ,$5.40 ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,30500846,85610,HC PROTHROMBIN TIME (PT)-QW,305,1 ,$74.00 ,$53.28 ,$2.75 ,$74.00 ,$10.73 ,$48.10 ,$44.18 ,$4.20 ,$20.72 ,$48.99 ,$4.20 ,$48.99 ,$4.20 ,$44.10 ,$44.10 ,$4.20 ,$44.10 ,$8.67 ,$56.98 ,$10.73 ,$4.20 ,$4.29 ,$55.50 ,$52.54 ,$52.54 ,$4.20 ,$52.54 ,$62.90 ,$62.90 ,$62.90 , N/A ,$10.73 ,$62.90 ,$4.20 ,$74.00 ,$41.51 ,$4.20 ,$30.64 ,$3.03 ,$2.75 ,$4.20 ,$62.90 ,$9.01 ,$44.10 ,$20.72 ,$66.60 ,$4.20 ,$62.90 ,$17.16 ,$17.16 ,$4.20 ,$48.10 ST. JOSEPH'S HOSPITAL - BREESE,30530232,85049,HC PLATELET COUNT AUTO-90,305,1 ,$13.00 ,$9.36 ,$3.64 ,$13.00 ,$11.20 ,$8.45 ,$7.76 ,$4.39 ,$3.64 ,$8.61 ,$4.39 ,$8.61 ,$4.39 ,$7.75 ,$7.75 ,$4.39 ,$7.75 ,$9.05 ,$10.01 ,$11.20 ,$4.39 ,$4.48 ,$9.75 ,$9.23 ,$9.23 ,$4.39 ,$9.23 ,$11.05 ,$11.05 ,$11.05 , N/A ,$11.20 ,$11.05 ,$4.39 ,$13.00 ,$7.29 ,$4.39 ,$5.38 ,$5.18 ,$4.71 ,$4.39 ,$11.05 ,$9.41 ,$7.75 ,$3.64 ,$11.70 ,$4.39 ,$11.05 ,$13.00 ,$13.00 ,$4.39 ,$8.45 ST. JOSEPH'S HOSPITAL - BREESE,30600102,87040,HC BLOOD CULTURE,306,1 ,$362.00 ,$260.64 ,$10.11 ,$362.00 ,$25.80 ,$235.30 ,$216.11 ,$10.11 ,$101.36 ,$239.64 ,$10.11 ,$239.64 ,$10.11 ,$215.75 ,$215.75 ,$10.11 ,$215.75 ,$20.85 ,$278.74 ,$25.80 ,$10.11 ,$10.32 ,$271.50 ,$257.02 ,$257.02 ,$10.11 ,$257.02 ,$307.70 ,$307.70 ,$307.70 , N/A ,$25.80 ,$307.70 ,$10.11 ,$362.00 ,$203.08 ,$10.11 ,$149.87 ,$19.80 ,$18.00 ,$10.11 ,$307.70 ,$21.67 ,$215.75 ,$101.36 ,$325.80 ,$10.11 ,$307.70 ,$41.28 ,$41.28 ,$10.11 ,$235.30 ST. JOSEPH'S HOSPITAL - BREESE,30600109,87070,HC BODY FLUID CULTURE,306,1 ,$242.00 ,$174.24 ,$5.42 ,$242.00 ,$21.55 ,$157.30 ,$144.47 ,$8.45 ,$67.76 ,$160.20 ,$8.45 ,$160.20 ,$8.45 ,$144.23 ,$144.23 ,$8.45 ,$144.23 ,$17.41 ,$186.34 ,$21.55 ,$8.45 ,$8.61 ,$181.50 ,$171.82 ,$171.82 ,$8.45 ,$171.82 ,$205.70 ,$205.70 ,$205.70 , N/A ,$21.55 ,$205.70 ,$8.45 ,$242.00 ,$135.76 ,$8.45 ,$100.19 ,$5.96 ,$5.42 ,$8.45 ,$205.70 ,$18.10 ,$144.23 ,$67.76 ,$217.80 ,$8.45 ,$205.70 ,$34.48 ,$34.48 ,$8.45 ,$157.30 ST. JOSEPH'S HOSPITAL - BREESE,30600163,87172,HC PINWORM EXAM,306,1 ,$110.00 ,$79.20 ,$4.18 ,$110.00 ,$10.68 ,$71.50 ,$65.67 ,$4.18 ,$30.80 ,$72.82 ,$4.18 ,$72.82 ,$4.18 ,$65.56 ,$65.56 ,$4.18 ,$65.56 ,$8.63 ,$84.70 ,$10.68 ,$4.18 ,$4.27 ,$82.50 ,$78.10 ,$78.10 ,$4.18 ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A ,$10.68 ,$93.50 ,$4.18 ,$110.00 ,$61.71 ,$4.18 ,$45.54 ,$5.96 ,$5.42 ,$4.18 ,$93.50 ,$8.97 ,$65.56 ,$30.80 ,$99.00 ,$4.18 ,$93.50 ,$17.08 ,$17.08 ,$4.18 ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$130.00 ,$93.60 ,$4.18 ,$130.00 ,$10.68 ,$84.50 ,$77.61 ,$4.18 ,$36.40 ,$86.06 ,$4.18 ,$86.06 ,$4.18 ,$77.48 ,$77.48 ,$4.18 ,$77.48 ,$8.63 ,$100.10 ,$10.68 ,$4.18 ,$4.27 ,$97.50 ,$92.30 ,$92.30 ,$4.18 ,$92.30 ,$110.50 ,$110.50 ,$110.50 , N/A ,$10.68 ,$110.50 ,$4.18 ,$130.00 ,$72.93 ,$4.18 ,$53.82 ,$5.96 ,$5.42 ,$4.18 ,$110.50 ,$8.97 ,$77.48 ,$36.40 ,$117.00 ,$4.18 ,$110.50 ,$17.08 ,$17.08 ,$4.18 ,$84.50 ST. JOSEPH'S HOSPITAL - BREESE,30600183,87210,HC SMEAR WET MOUNT,306,1 ,$137.00 ,$98.64 ,$5.42 ,$137.00 ,$14.55 ,$89.05 ,$81.79 ,$5.70 ,$38.36 ,$90.69 ,$5.70 ,$90.69 ,$5.70 ,$81.65 ,$81.65 ,$5.70 ,$81.65 ,$11.76 ,$105.49 ,$14.55 ,$5.70 ,$5.82 ,$102.75 ,$97.27 ,$97.27 ,$5.70 ,$97.27 ,$116.45 ,$116.45 ,$116.45 , N/A ,$14.55 ,$116.45 ,$5.70 ,$137.00 ,$76.86 ,$5.70 ,$56.72 ,$5.96 ,$5.42 ,$5.70 ,$116.45 ,$12.22 ,$81.65 ,$38.36 ,$123.30 ,$5.70 ,$116.45 ,$23.28 ,$23.28 ,$5.70 ,$89.05 ST. JOSEPH'S HOSPITAL - BREESE,30600185,87220,HC TISSUE KOH PREP,306,1 ,$122.00 ,$87.84 ,$4.18 ,$122.00 ,$10.68 ,$79.30 ,$72.83 ,$4.18 ,$34.16 ,$80.76 ,$4.18 ,$80.76 ,$4.18 ,$72.71 ,$72.71 ,$4.18 ,$72.71 ,$8.63 ,$93.94 ,$10.68 ,$4.18 ,$4.27 ,$91.50 ,$86.62 ,$86.62 ,$4.18 ,$86.62 ,$103.70 ,$103.70 ,$103.70 , N/A ,$10.68 ,$103.70 ,$4.18 ,$122.00 ,$68.44 ,$4.18 ,$50.51 ,$5.96 ,$5.42 ,$4.18 ,$103.70 ,$8.97 ,$72.71 ,$34.16 ,$109.80 ,$4.18 ,$103.70 ,$17.08 ,$17.08 ,$4.18 ,$79.30 ST. JOSEPH'S HOSPITAL - BREESE,30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$36.00 ,$25.92 ,$6.79 ,$36.00 ,$29.95 ,$23.40 ,$21.49 ,$11.74 ,$10.08 ,$23.83 ,$11.74 ,$23.83 ,$11.74 ,$21.46 ,$21.46 ,$11.74 ,$21.46 ,$24.20 ,$27.72 ,$29.95 ,$11.74 ,$11.98 ,$27.00 ,$25.56 ,$25.56 ,$11.74 ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A ,$29.95 ,$30.60 ,$11.74 ,$36.00 ,$20.20 ,$11.74 ,$14.90 ,$7.47 ,$6.79 ,$11.74 ,$30.60 ,$25.16 ,$21.46 ,$10.08 ,$32.40 ,$11.74 ,$30.60 ,$36.00 ,$36.00 ,$11.74 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30600269,87807,HC QL RSV,306,1 ,$170.00 ,$122.40 ,$5.42 ,$170.00 ,$32.75 ,$110.50 ,$101.49 ,$12.84 ,$47.60 ,$112.54 ,$12.84 ,$112.54 ,$12.84 ,$101.32 ,$101.32 ,$12.84 ,$101.32 ,$26.46 ,$130.90 ,$32.75 ,$12.84 ,$13.09 ,$127.50 ,$120.70 ,$120.70 ,$12.84 ,$120.70 ,$144.50 ,$144.50 ,$144.50 , N/A ,$32.75 ,$144.50 ,$12.84 ,$170.00 ,$95.37 ,$12.84 ,$70.38 ,$5.96 ,$5.42 ,$12.84 ,$144.50 ,$27.51 ,$101.32 ,$47.60 ,$153.00 ,$12.84 ,$144.50 ,$52.40 ,$52.40 ,$12.84 ,$110.50 ST. JOSEPH'S HOSPITAL - BREESE,30600270,87880,HC OPTICAL STREP,306,1 ,$120.00 ,$86.40 ,$5.42 ,$120.00 ,$41.33 ,$78.00 ,$71.64 ,$16.20 ,$33.60 ,$79.44 ,$16.20 ,$79.44 ,$16.20 ,$71.52 ,$71.52 ,$16.20 ,$71.52 ,$33.39 ,$92.40 ,$41.33 ,$16.20 ,$16.52 ,$90.00 ,$85.20 ,$85.20 ,$16.20 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$41.33 ,$102.00 ,$16.20 ,$120.00 ,$67.32 ,$16.20 ,$49.68 ,$5.96 ,$5.42 ,$16.20 ,$102.00 ,$34.71 ,$71.52 ,$33.60 ,$108.00 ,$16.20 ,$102.00 ,$66.12 ,$66.12 ,$16.20 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,30600271,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$434.00 ,$312.48 ,$5.42 ,$434.00 ,$40.18 ,$282.10 ,$259.10 ,$15.75 ,$121.52 ,$287.31 ,$15.75 ,$287.31 ,$15.75 ,$258.66 ,$258.66 ,$15.75 ,$258.66 ,$32.46 ,$334.18 ,$40.18 ,$15.75 ,$16.06 ,$325.50 ,$308.14 ,$308.14 ,$15.75 ,$308.14 ,$368.90 ,$368.90 ,$368.90 , N/A ,$40.18 ,$368.90 ,$15.75 ,$434.00 ,$243.47 ,$15.75 ,$179.68 ,$5.96 ,$5.42 ,$15.75 ,$368.90 ,$33.75 ,$258.66 ,$121.52 ,$390.60 ,$15.75 ,$368.90 ,$64.28 ,$64.28 ,$15.75 ,$282.10 ST. JOSEPH'S HOSPITAL - BREESE,30600283,87804,HC QL INFLUENZA A/B,306,1 ,$221.00 ,$159.12 ,$5.42 ,$221.00 ,$41.38 ,$143.65 ,$131.94 ,$16.22 ,$61.88 ,$146.30 ,$16.22 ,$146.30 ,$16.22 ,$131.72 ,$131.72 ,$16.22 ,$131.72 ,$33.43 ,$170.17 ,$41.38 ,$16.22 ,$16.54 ,$165.75 ,$156.91 ,$156.91 ,$16.22 ,$156.91 ,$187.85 ,$187.85 ,$187.85 , N/A ,$41.38 ,$187.85 ,$16.22 ,$221.00 ,$123.98 ,$16.22 ,$91.49 ,$5.96 ,$5.42 ,$16.22 ,$187.85 ,$34.76 ,$131.72 ,$61.88 ,$198.90 ,$16.22 ,$187.85 ,$66.20 ,$66.20 ,$16.22 ,$143.65 ST. JOSEPH'S HOSPITAL - BREESE,30600318,87449,HC EIA QL MLT AG INF,306,1 ,$36.00 ,$25.92 ,$6.79 ,$36.00 ,$29.95 ,$23.40 ,$21.49 ,$11.74 ,$10.08 ,$23.83 ,$11.74 ,$23.83 ,$11.74 ,$21.46 ,$21.46 ,$11.74 ,$21.46 ,$24.20 ,$27.72 ,$29.95 ,$11.74 ,$11.98 ,$27.00 ,$25.56 ,$25.56 ,$11.74 ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A ,$29.95 ,$30.60 ,$11.74 ,$36.00 ,$20.20 ,$11.74 ,$14.90 ,$7.47 ,$6.79 ,$11.74 ,$30.60 ,$25.16 ,$21.46 ,$10.08 ,$32.40 ,$11.74 ,$30.60 ,$36.00 ,$36.00 ,$11.74 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30600353,87015,HC CONCENTRATION INFECTIOUS AGENT-90,306,1 ,$70.00 ,$50.40 ,$5.42 ,$70.00 ,$16.70 ,$45.50 ,$41.79 ,$6.55 ,$19.60 ,$46.34 ,$6.55 ,$46.34 ,$6.55 ,$41.72 ,$41.72 ,$6.55 ,$41.72 ,$13.49 ,$53.90 ,$16.70 ,$6.55 ,$6.67 ,$52.50 ,$49.70 ,$49.70 ,$6.55 ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A ,$16.70 ,$59.50 ,$6.55 ,$70.00 ,$39.27 ,$6.55 ,$28.98 ,$5.96 ,$5.42 ,$6.55 ,$59.50 ,$14.03 ,$41.72 ,$19.60 ,$63.00 ,$6.55 ,$59.50 ,$26.72 ,$26.72 ,$6.55 ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,30600359,87081,HC CULTURE SCR PRESUMP PATHOGENS-90,306,1 ,$187.00 ,$134.64 ,$5.42 ,$187.00 ,$16.58 ,$121.55 ,$111.64 ,$6.50 ,$52.36 ,$123.79 ,$6.50 ,$123.79 ,$6.50 ,$111.45 ,$111.45 ,$6.50 ,$111.45 ,$13.39 ,$143.99 ,$16.58 ,$6.50 ,$6.62 ,$140.25 ,$132.77 ,$132.77 ,$6.50 ,$132.77 ,$158.95 ,$158.95 ,$158.95 , N/A ,$16.58 ,$158.95 ,$6.50 ,$187.00 ,$104.91 ,$6.50 ,$77.42 ,$5.96 ,$5.42 ,$6.50 ,$158.95 ,$13.92 ,$111.45 ,$52.36 ,$168.30 ,$6.50 ,$158.95 ,$26.52 ,$26.52 ,$6.50 ,$121.55 ST. JOSEPH'S HOSPITAL - BREESE,30600361,87081,HC CULTURE SCR PRESUMP PATHOGENS T2,306,1 ,$187.00 ,$134.64 ,$5.42 ,$187.00 ,$16.58 ,$121.55 ,$111.64 ,$6.50 ,$52.36 ,$123.79 ,$6.50 ,$123.79 ,$6.50 ,$111.45 ,$111.45 ,$6.50 ,$111.45 ,$13.39 ,$143.99 ,$16.58 ,$6.50 ,$6.62 ,$140.25 ,$132.77 ,$132.77 ,$6.50 ,$132.77 ,$158.95 ,$158.95 ,$158.95 , N/A ,$16.58 ,$158.95 ,$6.50 ,$187.00 ,$104.91 ,$6.50 ,$77.42 ,$5.96 ,$5.42 ,$6.50 ,$158.95 ,$13.92 ,$111.45 ,$52.36 ,$168.30 ,$6.50 ,$158.95 ,$26.52 ,$26.52 ,$6.50 ,$121.55 ST. JOSEPH'S HOSPITAL - BREESE,30600363,87103,HC CULTURE FUNGUS BLOOD-90,306,1 ,$22.00 ,$15.84 ,$6.16 ,$51.15 ,$51.15 ,$14.30 ,$13.13 ,$20.05 ,$6.16 ,$14.56 ,$20.05 ,$14.56 ,$20.05 ,$13.11 ,$13.11 ,$20.05 ,$13.11 ,$22.00 ,$16.94 ,$51.15 ,$20.05 ,$20.45 ,$16.50 ,$15.62 ,$15.62 ,$20.05 ,$15.62 ,$18.70 ,$18.70 ,$18.70 , N/A ,$22.00 ,$18.70 ,$20.05 ,$22.00 ,$12.34 ,$20.05 ,$9.11 ,$19.80 ,$18.00 ,$20.05 ,$18.70 ,$42.97 ,$13.11 ,$6.16 ,$19.80 ,$20.05 ,$18.70 ,$22.00 ,$22.00 ,$20.05 ,$14.30 ST. JOSEPH'S HOSPITAL - BREESE,30600364,87106,HC CULTURE FUNGUS ID YEAST-90,306,1 ,$99.00 ,$71.28 ,$5.42 ,$99.00 ,$25.80 ,$64.35 ,$59.10 ,$10.11 ,$27.72 ,$65.54 ,$10.11 ,$65.54 ,$10.11 ,$59.00 ,$59.00 ,$10.11 ,$59.00 ,$20.85 ,$76.23 ,$25.80 ,$10.11 ,$10.32 ,$74.25 ,$70.29 ,$70.29 ,$10.11 ,$70.29 ,$84.15 ,$84.15 ,$84.15 , N/A ,$25.80 ,$84.15 ,$10.11 ,$99.00 ,$55.54 ,$10.11 ,$40.99 ,$5.96 ,$5.42 ,$10.11 ,$84.15 ,$21.67 ,$59.00 ,$27.72 ,$89.10 ,$10.11 ,$84.15 ,$41.28 ,$41.28 ,$10.11 ,$64.35 ST. JOSEPH'S HOSPITAL - BREESE,30600365,87107,HC CULTURE FUNGUS ID MOLD-90,306,1 ,$18.00 ,$12.96 ,$5.04 ,$25.80 ,$25.80 ,$11.70 ,$10.75 ,$10.11 ,$5.04 ,$11.92 ,$10.11 ,$11.92 ,$10.11 ,$10.73 ,$10.73 ,$10.11 ,$10.73 ,$18.00 ,$13.86 ,$25.80 ,$10.11 ,$10.32 ,$13.50 ,$12.78 ,$12.78 ,$10.11 ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A ,$18.00 ,$15.30 ,$10.11 ,$18.00 ,$10.10 ,$10.11 ,$7.45 ,$18.00 ,$18.00 ,$10.11 ,$15.30 ,$21.67 ,$10.73 ,$5.04 ,$16.20 ,$10.11 ,$15.30 ,$18.00 ,$18.00 ,$10.11 ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,30600366,87109,HC CULTURE MYCOPLASMA-90,306,1 ,$163.00 ,$117.36 ,$15.08 ,$163.00 ,$38.48 ,$105.95 ,$97.31 ,$15.08 ,$45.64 ,$107.91 ,$15.08 ,$107.91 ,$15.08 ,$97.15 ,$97.15 ,$15.08 ,$97.15 ,$31.09 ,$125.51 ,$38.48 ,$15.08 ,$15.39 ,$122.25 ,$115.73 ,$115.73 ,$15.08 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$38.48 ,$138.55 ,$15.08 ,$163.00 ,$91.44 ,$15.08 ,$67.48 ,$19.80 ,$18.00 ,$15.08 ,$138.55 ,$32.32 ,$97.15 ,$45.64 ,$146.70 ,$15.08 ,$138.55 ,$61.56 ,$61.56 ,$15.08 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,30600367,87110,HC CULTURE CHLAMYDIA-90,306,1 ,$148.00 ,$106.56 ,$5.42 ,$148.00 ,$49.00 ,$96.20 ,$88.36 ,$19.21 ,$41.44 ,$97.98 ,$19.21 ,$97.98 ,$19.21 ,$88.21 ,$88.21 ,$19.21 ,$88.21 ,$39.59 ,$113.96 ,$49.00 ,$19.21 ,$19.59 ,$111.00 ,$105.08 ,$105.08 ,$19.21 ,$105.08 ,$125.80 ,$125.80 ,$125.80 , N/A ,$49.00 ,$125.80 ,$19.21 ,$148.00 ,$83.03 ,$19.21 ,$61.27 ,$5.96 ,$5.42 ,$19.21 ,$125.80 ,$41.16 ,$88.21 ,$41.44 ,$133.20 ,$19.21 ,$125.80 ,$78.40 ,$78.40 ,$19.21 ,$96.20 ST. JOSEPH'S HOSPITAL - BREESE,30600368,87116,HC CULTURE AFB/TB/MYCOBACT-90,306,1 ,$110.00 ,$79.20 ,$10.58 ,$110.00 ,$27.00 ,$71.50 ,$65.67 ,$10.58 ,$30.80 ,$72.82 ,$10.58 ,$72.82 ,$10.58 ,$65.56 ,$65.56 ,$10.58 ,$65.56 ,$21.82 ,$84.70 ,$27.00 ,$10.58 ,$10.80 ,$82.50 ,$78.10 ,$78.10 ,$10.58 ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A ,$27.00 ,$93.50 ,$10.58 ,$110.00 ,$61.71 ,$10.58 ,$45.54 ,$19.80 ,$18.00 ,$10.58 ,$93.50 ,$22.68 ,$65.56 ,$30.80 ,$99.00 ,$10.58 ,$93.50 ,$43.20 ,$43.20 ,$10.58 ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,30600369,87118,HC CULTURE MYCOBACTERIA ID-90,306,1 ,$104.00 ,$74.88 ,$14.32 ,$104.00 ,$36.53 ,$67.60 ,$62.09 ,$14.32 ,$29.12 ,$68.85 ,$14.32 ,$68.85 ,$14.32 ,$61.98 ,$61.98 ,$14.32 ,$61.98 ,$29.51 ,$80.08 ,$36.53 ,$14.32 ,$14.60 ,$78.00 ,$73.84 ,$73.84 ,$14.32 ,$73.84 ,$88.40 ,$88.40 ,$88.40 , N/A ,$36.53 ,$88.40 ,$14.32 ,$104.00 ,$58.34 ,$14.32 ,$43.06 ,$19.80 ,$18.00 ,$14.32 ,$88.40 ,$30.68 ,$61.98 ,$29.12 ,$93.60 ,$14.32 ,$88.40 ,$58.44 ,$58.44 ,$14.32 ,$67.60 ST. JOSEPH'S HOSPITAL - BREESE,30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$53.00 ,$38.16 ,$5.46 ,$53.00 ,$13.93 ,$34.45 ,$31.64 ,$5.46 ,$14.84 ,$35.09 ,$5.46 ,$35.09 ,$5.46 ,$31.59 ,$31.59 ,$5.46 ,$31.59 ,$11.25 ,$40.81 ,$13.93 ,$5.46 ,$5.57 ,$39.75 ,$37.63 ,$37.63 ,$5.46 ,$37.63 ,$45.05 ,$45.05 ,$45.05 , N/A ,$13.93 ,$45.05 ,$5.46 ,$53.00 ,$29.73 ,$5.46 ,$21.94 ,$19.80 ,$18.00 ,$5.46 ,$45.05 ,$11.70 ,$31.59 ,$14.84 ,$47.70 ,$5.46 ,$45.05 ,$22.28 ,$22.28 ,$5.46 ,$34.45 ST. JOSEPH'S HOSPITAL - BREESE,30600375,87149,HC CULTURE TYPING ID NUCLEIC ACID-90,306,1 ,$115.00 ,$82.80 ,$5.42 ,$115.00 ,$50.13 ,$74.75 ,$68.66 ,$19.65 ,$32.20 ,$76.13 ,$19.65 ,$76.13 ,$19.65 ,$68.54 ,$68.54 ,$19.65 ,$68.54 ,$40.50 ,$88.55 ,$50.13 ,$19.65 ,$20.04 ,$86.25 ,$81.65 ,$81.65 ,$19.65 ,$81.65 ,$97.75 ,$97.75 ,$97.75 , N/A ,$50.13 ,$97.75 ,$19.65 ,$115.00 ,$64.52 ,$19.65 ,$47.61 ,$5.96 ,$5.42 ,$19.65 ,$97.75 ,$42.11 ,$68.54 ,$32.20 ,$103.50 ,$19.65 ,$97.75 ,$80.20 ,$80.20 ,$19.65 ,$74.75 ST. JOSEPH'S HOSPITAL - BREESE,30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$227.00 ,$163.44 ,$5.42 ,$227.00 ,$22.25 ,$147.55 ,$135.52 ,$8.72 ,$63.56 ,$150.27 ,$8.72 ,$150.27 ,$8.72 ,$135.29 ,$135.29 ,$8.72 ,$135.29 ,$17.98 ,$174.79 ,$22.25 ,$8.72 ,$8.90 ,$170.25 ,$161.17 ,$161.17 ,$8.72 ,$161.17 ,$192.95 ,$192.95 ,$192.95 , N/A ,$22.25 ,$192.95 ,$8.72 ,$227.00 ,$127.35 ,$8.72 ,$93.98 ,$5.96 ,$5.42 ,$8.72 ,$192.95 ,$18.69 ,$135.29 ,$63.56 ,$204.30 ,$8.72 ,$192.95 ,$35.60 ,$35.60 ,$8.72 ,$147.55 ST. JOSEPH'S HOSPITAL - BREESE,30600388,87186,HC SENSITIVITY MIC INIT PLATE-90,306,1 ,$322.00 ,$231.84 ,$5.42 ,$322.00 ,$21.63 ,$209.30 ,$192.23 ,$8.48 ,$90.16 ,$213.16 ,$8.48 ,$213.16 ,$8.48 ,$191.91 ,$191.91 ,$8.48 ,$191.91 ,$17.47 ,$247.94 ,$21.63 ,$8.48 ,$8.64 ,$241.50 ,$228.62 ,$228.62 ,$8.48 ,$228.62 ,$273.70 ,$273.70 ,$273.70 , N/A ,$21.63 ,$273.70 ,$8.48 ,$322.00 ,$180.64 ,$8.48 ,$133.31 ,$5.96 ,$5.42 ,$8.48 ,$273.70 ,$18.17 ,$191.91 ,$90.16 ,$289.80 ,$8.48 ,$273.70 ,$34.60 ,$34.60 ,$8.48 ,$209.30 ST. JOSEPH'S HOSPITAL - BREESE,30600395,87206,HC SMEAR ACID FAST/FLUOR-90,306,1 ,$112.00 ,$80.64 ,$5.28 ,$112.00 ,$13.48 ,$72.80 ,$66.86 ,$5.28 ,$31.36 ,$74.14 ,$5.28 ,$74.14 ,$5.28 ,$66.75 ,$66.75 ,$5.28 ,$66.75 ,$10.89 ,$86.24 ,$13.48 ,$5.28 ,$5.39 ,$84.00 ,$79.52 ,$79.52 ,$5.28 ,$79.52 ,$95.20 ,$95.20 ,$95.20 , N/A ,$13.48 ,$95.20 ,$5.28 ,$112.00 ,$62.83 ,$5.28 ,$46.37 ,$5.96 ,$5.42 ,$5.28 ,$95.20 ,$11.32 ,$66.75 ,$31.36 ,$100.80 ,$5.28 ,$95.20 ,$21.56 ,$21.56 ,$5.28 ,$72.80 ST. JOSEPH'S HOSPITAL - BREESE,30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$116.00 ,$83.52 ,$5.42 ,$116.00 ,$14.98 ,$75.40 ,$69.25 ,$5.87 ,$32.48 ,$76.79 ,$5.87 ,$76.79 ,$5.87 ,$69.14 ,$69.14 ,$5.87 ,$69.14 ,$12.10 ,$89.32 ,$14.98 ,$5.87 ,$5.99 ,$87.00 ,$82.36 ,$82.36 ,$5.87 ,$82.36 ,$98.60 ,$98.60 ,$98.60 , N/A ,$14.98 ,$98.60 ,$5.87 ,$116.00 ,$65.08 ,$5.87 ,$48.02 ,$5.96 ,$5.42 ,$5.87 ,$98.60 ,$12.58 ,$69.14 ,$32.48 ,$104.40 ,$5.87 ,$98.60 ,$23.96 ,$23.96 ,$5.87 ,$75.40 ST. JOSEPH'S HOSPITAL - BREESE,30600399,87209,HC OVA AND PARASITE W/STAIN-90,306,1 ,$145.00 ,$104.40 ,$17.62 ,$145.00 ,$44.95 ,$94.25 ,$86.57 ,$17.62 ,$40.60 ,$95.99 ,$17.62 ,$95.99 ,$17.62 ,$86.42 ,$86.42 ,$17.62 ,$86.42 ,$36.32 ,$111.65 ,$44.95 ,$17.62 ,$17.97 ,$108.75 ,$102.95 ,$102.95 ,$17.62 ,$102.95 ,$123.25 ,$123.25 ,$123.25 , N/A ,$44.95 ,$123.25 ,$17.62 ,$145.00 ,$81.35 ,$17.62 ,$60.03 ,$19.80 ,$18.00 ,$17.62 ,$123.25 ,$37.76 ,$86.42 ,$40.60 ,$130.50 ,$17.62 ,$123.25 ,$71.92 ,$71.92 ,$17.62 ,$94.25 ST. JOSEPH'S HOSPITAL - BREESE,30600402,87252,HC CULTURE VIRUS ID TISSUE-90,306,1 ,$187.00 ,$134.64 ,$18.00 ,$187.00 ,$65.18 ,$121.55 ,$111.64 ,$25.55 ,$52.36 ,$123.79 ,$25.55 ,$123.79 ,$25.55 ,$111.45 ,$111.45 ,$25.55 ,$111.45 ,$52.66 ,$143.99 ,$65.18 ,$25.55 ,$26.06 ,$140.25 ,$132.77 ,$132.77 ,$25.55 ,$132.77 ,$158.95 ,$158.95 ,$158.95 , N/A ,$65.18 ,$158.95 ,$25.55 ,$187.00 ,$104.91 ,$25.55 ,$77.42 ,$19.80 ,$18.00 ,$25.55 ,$158.95 ,$54.75 ,$111.45 ,$52.36 ,$168.30 ,$25.55 ,$158.95 ,$104.28 ,$104.28 ,$25.55 ,$121.55 ST. JOSEPH'S HOSPITAL - BREESE,30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$130.00 ,$93.60 ,$18.00 ,$130.00 ,$48.90 ,$84.50 ,$77.61 ,$19.17 ,$36.40 ,$86.06 ,$19.17 ,$86.06 ,$19.17 ,$77.48 ,$77.48 ,$19.17 ,$77.48 ,$39.51 ,$100.10 ,$48.90 ,$19.17 ,$19.55 ,$97.50 ,$92.30 ,$92.30 ,$19.17 ,$92.30 ,$110.50 ,$110.50 ,$110.50 , N/A ,$48.90 ,$110.50 ,$19.17 ,$130.00 ,$72.93 ,$19.17 ,$53.82 ,$19.80 ,$18.00 ,$19.17 ,$110.50 ,$41.08 ,$77.48 ,$36.40 ,$117.00 ,$19.17 ,$110.50 ,$78.24 ,$78.24 ,$19.17 ,$84.50 ST. JOSEPH'S HOSPITAL - BREESE,30600407,87260,HC IF ADENOVIRUS AG-90,306,1 ,$238.00 ,$171.36 ,$6.79 ,$238.00 ,$36.08 ,$154.70 ,$142.09 ,$14.14 ,$66.64 ,$157.56 ,$14.14 ,$157.56 ,$14.14 ,$141.85 ,$141.85 ,$14.14 ,$141.85 ,$29.15 ,$183.26 ,$36.08 ,$14.14 ,$14.43 ,$178.50 ,$168.98 ,$168.98 ,$14.14 ,$168.98 ,$202.30 ,$202.30 ,$202.30 , N/A ,$36.08 ,$202.30 ,$14.14 ,$238.00 ,$133.52 ,$14.14 ,$98.53 ,$7.47 ,$6.79 ,$14.14 ,$202.30 ,$30.30 ,$141.85 ,$66.64 ,$214.20 ,$14.14 ,$202.30 ,$57.72 ,$57.72 ,$14.14 ,$154.70 ST. JOSEPH'S HOSPITAL - BREESE,30600413,87290,HC IF VARICELLA ZOETER AG-90,306,1 ,$32.00 ,$23.04 ,$6.79 ,$33.55 ,$33.55 ,$20.80 ,$19.10 ,$13.15 ,$8.96 ,$21.18 ,$13.15 ,$21.18 ,$13.15 ,$19.07 ,$19.07 ,$13.15 ,$19.07 ,$27.11 ,$24.64 ,$33.55 ,$13.15 ,$13.42 ,$24.00 ,$22.72 ,$22.72 ,$13.15 ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A ,$32.00 ,$27.20 ,$13.15 ,$32.00 ,$17.95 ,$13.15 ,$13.25 ,$7.47 ,$6.79 ,$13.15 ,$27.20 ,$28.18 ,$19.07 ,$8.96 ,$28.80 ,$13.15 ,$27.20 ,$32.00 ,$32.00 ,$13.15 ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,30600414,87299,HC ANTIBODY DETECT IF NOS-90,306,1 ,$84.00 ,$60.48 ,$6.79 ,$84.00 ,$40.25 ,$54.60 ,$50.15 ,$15.78 ,$23.52 ,$55.61 ,$15.78 ,$55.61 ,$15.78 ,$50.06 ,$50.06 ,$15.78 ,$50.06 ,$32.52 ,$64.68 ,$40.25 ,$15.78 ,$16.09 ,$63.00 ,$59.64 ,$59.64 ,$15.78 ,$59.64 ,$71.40 ,$71.40 ,$71.40 , N/A ,$40.25 ,$71.40 ,$15.78 ,$84.00 ,$47.12 ,$15.78 ,$34.78 ,$7.47 ,$6.79 ,$15.78 ,$71.40 ,$33.81 ,$50.06 ,$23.52 ,$75.60 ,$15.78 ,$71.40 ,$64.40 ,$64.40 ,$15.78 ,$54.60 ST. JOSEPH'S HOSPITAL - BREESE,30600418,87328,HC EIA QL CRYPTOSPORIDIUM AG-90,306,1 ,$205.00 ,$147.60 ,$6.79 ,$205.00 ,$34.55 ,$133.25 ,$122.39 ,$13.54 ,$57.40 ,$135.71 ,$13.54 ,$135.71 ,$13.54 ,$122.18 ,$122.18 ,$13.54 ,$122.18 ,$27.92 ,$157.85 ,$34.55 ,$13.54 ,$13.82 ,$153.75 ,$145.55 ,$145.55 ,$13.54 ,$145.55 ,$174.25 ,$174.25 ,$174.25 , N/A ,$34.55 ,$174.25 ,$13.54 ,$205.00 ,$115.01 ,$13.54 ,$84.87 ,$7.47 ,$6.79 ,$13.54 ,$174.25 ,$29.02 ,$122.18 ,$57.40 ,$184.50 ,$13.54 ,$174.25 ,$55.28 ,$55.28 ,$13.54 ,$133.25 ST. JOSEPH'S HOSPITAL - BREESE,30600419,87338,HC EIA QL H PYLORI AG STOOL-90,306,1 ,$331.00 ,$238.32 ,$6.79 ,$331.00 ,$35.95 ,$215.15 ,$197.61 ,$14.09 ,$92.68 ,$219.12 ,$14.09 ,$219.12 ,$14.09 ,$197.28 ,$197.28 ,$14.09 ,$197.28 ,$29.05 ,$254.87 ,$35.95 ,$14.09 ,$14.38 ,$248.25 ,$235.01 ,$235.01 ,$14.09 ,$235.01 ,$281.35 ,$281.35 ,$281.35 , N/A ,$35.95 ,$281.35 ,$14.09 ,$331.00 ,$185.69 ,$14.09 ,$137.03 ,$7.47 ,$6.79 ,$14.09 ,$281.35 ,$30.20 ,$197.28 ,$92.68 ,$297.90 ,$14.09 ,$281.35 ,$57.52 ,$57.52 ,$14.09 ,$215.15 ST. JOSEPH'S HOSPITAL - BREESE,30600421,87340,HC EIA QL HEPATITIS B AG-90,306,1 ,$227.00 ,$163.44 ,$6.79 ,$227.00 ,$25.83 ,$147.55 ,$135.52 ,$10.12 ,$63.56 ,$150.27 ,$10.12 ,$150.27 ,$10.12 ,$135.29 ,$135.29 ,$10.12 ,$135.29 ,$20.87 ,$174.79 ,$25.83 ,$10.12 ,$10.33 ,$170.25 ,$161.17 ,$161.17 ,$10.12 ,$161.17 ,$192.95 ,$192.95 ,$192.95 , N/A ,$25.83 ,$192.95 ,$10.12 ,$227.00 ,$127.35 ,$10.12 ,$93.98 ,$7.47 ,$6.79 ,$10.12 ,$192.95 ,$21.69 ,$135.29 ,$63.56 ,$204.30 ,$10.12 ,$192.95 ,$41.32 ,$41.32 ,$10.12 ,$147.55 ST. JOSEPH'S HOSPITAL - BREESE,30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$139.00 ,$100.08 ,$6.79 ,$139.00 ,$28.83 ,$90.35 ,$82.98 ,$11.30 ,$38.92 ,$92.02 ,$11.30 ,$92.02 ,$11.30 ,$82.84 ,$82.84 ,$11.30 ,$82.84 ,$23.29 ,$107.03 ,$28.83 ,$11.30 ,$11.52 ,$104.25 ,$98.69 ,$98.69 ,$11.30 ,$98.69 ,$118.15 ,$118.15 ,$118.15 , N/A ,$28.83 ,$118.15 ,$11.30 ,$139.00 ,$77.98 ,$11.30 ,$57.55 ,$7.47 ,$6.79 ,$11.30 ,$118.15 ,$24.21 ,$82.84 ,$38.92 ,$125.10 ,$11.30 ,$118.15 ,$46.12 ,$46.12 ,$11.30 ,$90.35 ST. JOSEPH'S HOSPITAL - BREESE,30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$408.00 ,$293.76 ,$6.79 ,$408.00 ,$33.13 ,$265.20 ,$243.58 ,$12.98 ,$114.24 ,$270.10 ,$12.98 ,$270.10 ,$12.98 ,$243.17 ,$243.17 ,$12.98 ,$243.17 ,$26.77 ,$314.16 ,$33.13 ,$12.98 ,$13.25 ,$306.00 ,$289.68 ,$289.68 ,$12.98 ,$289.68 ,$346.80 ,$346.80 ,$346.80 , N/A ,$33.13 ,$346.80 ,$12.98 ,$408.00 ,$228.89 ,$12.98 ,$168.91 ,$7.47 ,$6.79 ,$12.98 ,$346.80 ,$27.83 ,$243.17 ,$114.24 ,$367.20 ,$12.98 ,$346.80 ,$53.00 ,$53.00 ,$12.98 ,$265.20 ST. JOSEPH'S HOSPITAL - BREESE,30600432,87449,HC EIA QL MLT AG INF-90,306,1 ,$412.00 ,$296.64 ,$6.79 ,$412.00 ,$29.95 ,$267.80 ,$245.96 ,$11.74 ,$115.36 ,$272.74 ,$11.74 ,$272.74 ,$11.74 ,$245.55 ,$245.55 ,$11.74 ,$245.55 ,$24.20 ,$317.24 ,$29.95 ,$11.74 ,$11.98 ,$309.00 ,$292.52 ,$292.52 ,$11.74 ,$292.52 ,$350.20 ,$350.20 ,$350.20 , N/A ,$29.95 ,$350.20 ,$11.74 ,$412.00 ,$231.13 ,$11.74 ,$170.57 ,$7.47 ,$6.79 ,$11.74 ,$350.20 ,$25.16 ,$245.55 ,$115.36 ,$370.80 ,$11.74 ,$350.20 ,$47.92 ,$47.92 ,$11.74 ,$267.80 ST. JOSEPH'S HOSPITAL - BREESE,30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$301.00 ,$216.72 ,$6.79 ,$301.00 ,$87.73 ,$195.65 ,$179.70 ,$34.39 ,$84.28 ,$199.26 ,$34.39 ,$199.26 ,$34.39 ,$179.40 ,$179.40 ,$34.39 ,$179.40 ,$70.88 ,$231.77 ,$87.73 ,$34.39 ,$35.07 ,$225.75 ,$213.71 ,$213.71 ,$34.39 ,$213.71 ,$255.85 ,$255.85 ,$255.85 , N/A ,$87.73 ,$255.85 ,$34.39 ,$301.00 ,$168.86 ,$34.39 ,$124.61 ,$7.47 ,$6.79 ,$34.39 ,$255.85 ,$73.69 ,$179.40 ,$84.28 ,$270.90 ,$34.39 ,$255.85 ,$140.36 ,$140.36 ,$34.39 ,$195.65 ST. JOSEPH'S HOSPITAL - BREESE,30600439,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$152.00 ,$109.44 ,$6.79 ,$152.00 ,$87.73 ,$98.80 ,$90.74 ,$34.39 ,$42.56 ,$100.62 ,$34.39 ,$100.62 ,$34.39 ,$90.59 ,$90.59 ,$34.39 ,$90.59 ,$70.88 ,$117.04 ,$87.73 ,$34.39 ,$35.07 ,$114.00 ,$107.92 ,$107.92 ,$34.39 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$87.73 ,$129.20 ,$34.39 ,$152.00 ,$85.27 ,$34.39 ,$62.93 ,$7.47 ,$6.79 ,$34.39 ,$129.20 ,$73.69 ,$90.59 ,$42.56 ,$136.80 ,$34.39 ,$129.20 ,$140.36 ,$140.36 ,$34.39 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,30600440,87493,HC CLOSTRIDUM DIFFICILE-90,306,1 ,$120.00 ,$86.40 ,$6.79 ,$120.00 ,$93.18 ,$78.00 ,$71.64 ,$36.52 ,$33.60 ,$79.44 ,$36.52 ,$79.44 ,$36.52 ,$71.52 ,$71.52 ,$36.52 ,$71.52 ,$75.29 ,$92.40 ,$93.18 ,$36.52 ,$37.26 ,$90.00 ,$85.20 ,$85.20 ,$36.52 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$93.18 ,$102.00 ,$36.52 ,$120.00 ,$67.32 ,$36.52 ,$49.68 ,$7.47 ,$6.79 ,$36.52 ,$102.00 ,$78.27 ,$71.52 ,$33.60 ,$108.00 ,$36.52 ,$102.00 ,$120.00 ,$120.00 ,$36.52 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,30600441,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$268.00 ,$192.96 ,$6.79 ,$268.00 ,$93.18 ,$174.20 ,$160.00 ,$36.52 ,$75.04 ,$177.42 ,$36.52 ,$177.42 ,$36.52 ,$159.73 ,$159.73 ,$36.52 ,$159.73 ,$75.29 ,$206.36 ,$93.18 ,$36.52 ,$37.26 ,$201.00 ,$190.28 ,$190.28 ,$36.52 ,$190.28 ,$227.80 ,$227.80 ,$227.80 , N/A ,$93.18 ,$227.80 ,$36.52 ,$268.00 ,$150.35 ,$36.52 ,$110.95 ,$7.47 ,$6.79 ,$36.52 ,$227.80 ,$78.27 ,$159.73 ,$75.04 ,$241.20 ,$36.52 ,$227.80 ,$149.08 ,$149.08 ,$36.52 ,$174.20 ST. JOSEPH'S HOSPITAL - BREESE,30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,$736.00 ,$529.92 ,$18.00 ,$736.00 ,$87.73 ,$478.40 ,$439.39 ,$34.39 ,$206.08 ,$487.23 ,$34.39 ,$487.23 ,$34.39 ,$438.66 ,$438.66 ,$34.39 ,$438.66 ,$70.88 ,$500.00 ,$87.73 ,$34.39 ,$35.07 ,$552.00 ,$522.56 ,$522.56 ,$34.39 ,$522.56 ,$625.60 ,$625.60 ,$625.60 , N/A ,$87.73 ,$625.60 ,$34.39 ,$736.00 ,$412.90 ,$34.39 ,$304.70 ,$19.80 ,$18.00 ,$34.39 ,$625.60 ,$73.69 ,$438.66 ,$206.08 ,$662.40 ,$34.39 ,$625.60 ,$140.36 ,$140.36 ,$34.39 ,$478.40 ST. JOSEPH'S HOSPITAL - BREESE,30600443,87497,HC CMV QN-90,306,1 ,$542.00 ,$390.24 ,$18.00 ,$542.00 ,$107.10 ,$352.30 ,$323.57 ,$41.98 ,$151.76 ,$358.80 ,$41.98 ,$358.80 ,$41.98 ,$323.03 ,$323.03 ,$41.98 ,$323.03 ,$86.54 ,$417.34 ,$107.10 ,$41.98 ,$42.83 ,$406.50 ,$384.82 ,$384.82 ,$41.98 ,$384.82 ,$460.70 ,$460.70 ,$460.70 , N/A ,$107.10 ,$460.70 ,$41.98 ,$542.00 ,$304.06 ,$41.98 ,$224.39 ,$19.80 ,$18.00 ,$41.98 ,$460.70 ,$89.96 ,$323.03 ,$151.76 ,$487.80 ,$41.98 ,$460.70 ,$171.36 ,$171.36 ,$41.98 ,$352.30 ST. JOSEPH'S HOSPITAL - BREESE,30600444,87498,HC ENTEROVIRUS AMP PROBE-90,306,1 ,$190.00 ,$136.80 ,$18.00 ,$190.00 ,$87.73 ,$123.50 ,$113.43 ,$34.39 ,$53.20 ,$125.78 ,$34.39 ,$125.78 ,$34.39 ,$113.24 ,$113.24 ,$34.39 ,$113.24 ,$70.88 ,$146.30 ,$87.73 ,$34.39 ,$35.07 ,$142.50 ,$134.90 ,$134.90 ,$34.39 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$87.73 ,$161.50 ,$34.39 ,$190.00 ,$106.59 ,$34.39 ,$78.66 ,$19.80 ,$18.00 ,$34.39 ,$161.50 ,$73.69 ,$113.24 ,$53.20 ,$171.00 ,$34.39 ,$161.50 ,$140.36 ,$140.36 ,$34.39 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,30600446,87502,HC INFLUENZA VIRUS MULTIPLE DNA/RNA-90,306,1 ,$572.00 ,$411.84 ,$11.71 ,$572.00 ,$239.50 ,$371.80 ,$341.48 ,$93.88 ,$160.16 ,$378.66 ,$93.88 ,$378.66 ,$93.88 ,$340.91 ,$340.91 ,$93.88 ,$340.91 ,$193.52 ,$440.44 ,$239.50 ,$93.88 ,$95.77 ,$429.00 ,$406.12 ,$406.12 ,$93.88 ,$406.12 ,$486.20 ,$486.20 ,$486.20 , N/A ,$239.50 ,$486.20 ,$93.88 ,$572.00 ,$320.89 ,$93.88 ,$236.81 ,$12.88 ,$11.71 ,$93.88 ,$486.20 ,$201.18 ,$340.91 ,$160.16 ,$514.80 ,$93.88 ,$486.20 ,$383.20 ,$383.20 ,$93.88 ,$371.80 ST. JOSEPH'S HOSPITAL - BREESE,30600448,87517,HC HEPATITIS B QN-90,306,1 ,$408.00 ,$293.76 ,$18.00 ,$408.00 ,$107.10 ,$265.20 ,$243.58 ,$41.98 ,$114.24 ,$270.10 ,$41.98 ,$270.10 ,$41.98 ,$243.17 ,$243.17 ,$41.98 ,$243.17 ,$86.54 ,$314.16 ,$107.10 ,$41.98 ,$42.83 ,$306.00 ,$289.68 ,$289.68 ,$41.98 ,$289.68 ,$346.80 ,$346.80 ,$346.80 , N/A ,$107.10 ,$346.80 ,$41.98 ,$408.00 ,$228.89 ,$41.98 ,$168.91 ,$19.80 ,$18.00 ,$41.98 ,$346.80 ,$89.96 ,$243.17 ,$114.24 ,$367.20 ,$41.98 ,$346.80 ,$171.36 ,$171.36 ,$41.98 ,$265.20 ST. JOSEPH'S HOSPITAL - BREESE,30600451,87522,HC HEPATITIS C QN-90,306,1 ,$729.00 ,$524.88 ,$18.00 ,$729.00 ,$107.10 ,$473.85 ,$435.21 ,$41.98 ,$204.12 ,$482.60 ,$41.98 ,$482.60 ,$41.98 ,$434.48 ,$434.48 ,$41.98 ,$434.48 ,$86.54 ,$500.00 ,$107.10 ,$41.98 ,$42.83 ,$546.75 ,$517.59 ,$517.59 ,$41.98 ,$517.59 ,$619.65 ,$619.65 ,$619.65 , N/A ,$107.10 ,$619.65 ,$41.98 ,$729.00 ,$408.97 ,$41.98 ,$301.81 ,$19.80 ,$18.00 ,$41.98 ,$619.65 ,$89.96 ,$434.48 ,$204.12 ,$656.10 ,$41.98 ,$619.65 ,$171.36 ,$171.36 ,$41.98 ,$473.85 ST. JOSEPH'S HOSPITAL - BREESE,30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$704.00 ,$506.88 ,$18.00 ,$704.00 ,$87.73 ,$457.60 ,$420.29 ,$34.39 ,$197.12 ,$466.05 ,$34.39 ,$466.05 ,$34.39 ,$419.58 ,$419.58 ,$34.39 ,$419.58 ,$70.88 ,$500.00 ,$87.73 ,$34.39 ,$35.07 ,$528.00 ,$499.84 ,$499.84 ,$34.39 ,$499.84 ,$598.40 ,$598.40 ,$598.40 , N/A ,$87.73 ,$598.40 ,$34.39 ,$704.00 ,$394.94 ,$34.39 ,$291.46 ,$19.80 ,$18.00 ,$34.39 ,$598.40 ,$73.69 ,$419.58 ,$197.12 ,$633.60 ,$34.39 ,$598.40 ,$140.36 ,$140.36 ,$34.39 ,$457.60 ST. JOSEPH'S HOSPITAL - BREESE,30600454,87530,HC HSV QUANT-90,306,1 ,$380.00 ,$273.60 ,$18.00 ,$380.00 ,$107.10 ,$247.00 ,$226.86 ,$41.98 ,$106.40 ,$251.56 ,$41.98 ,$251.56 ,$41.98 ,$226.48 ,$226.48 ,$41.98 ,$226.48 ,$86.54 ,$292.60 ,$107.10 ,$41.98 ,$42.83 ,$285.00 ,$269.80 ,$269.80 ,$41.98 ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A ,$107.10 ,$323.00 ,$41.98 ,$380.00 ,$213.18 ,$41.98 ,$157.32 ,$19.80 ,$18.00 ,$41.98 ,$323.00 ,$89.96 ,$226.48 ,$106.40 ,$342.00 ,$41.98 ,$323.00 ,$171.36 ,$171.36 ,$41.98 ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,30600456,87535,HC PROBE HIV-1 AMP-90,306,1 ,$330.00 ,$237.60 ,$18.00 ,$330.00 ,$87.73 ,$214.50 ,$197.01 ,$34.39 ,$92.40 ,$218.46 ,$34.39 ,$218.46 ,$34.39 ,$196.68 ,$196.68 ,$34.39 ,$196.68 ,$70.88 ,$254.10 ,$87.73 ,$34.39 ,$35.07 ,$247.50 ,$234.30 ,$234.30 ,$34.39 ,$234.30 ,$280.50 ,$280.50 ,$280.50 , N/A ,$87.73 ,$280.50 ,$34.39 ,$330.00 ,$185.13 ,$34.39 ,$136.62 ,$19.80 ,$18.00 ,$34.39 ,$280.50 ,$73.69 ,$196.68 ,$92.40 ,$297.00 ,$34.39 ,$280.50 ,$140.36 ,$140.36 ,$34.39 ,$214.50 ST. JOSEPH'S HOSPITAL - BREESE,30600458,87536,HC HIV-1 QN-90,306,1 ,$381.00 ,$274.32 ,$18.00 ,$381.00 ,$212.75 ,$247.65 ,$227.46 ,$83.40 ,$106.68 ,$252.22 ,$83.40 ,$252.22 ,$83.40 ,$227.08 ,$227.08 ,$83.40 ,$227.08 ,$171.90 ,$293.37 ,$212.75 ,$83.40 ,$85.06 ,$285.75 ,$270.51 ,$270.51 ,$83.40 ,$270.51 ,$323.85 ,$323.85 ,$323.85 , N/A ,$212.75 ,$323.85 ,$83.40 ,$381.00 ,$213.74 ,$83.40 ,$157.73 ,$19.80 ,$18.00 ,$83.40 ,$323.85 ,$178.71 ,$227.08 ,$106.68 ,$342.90 ,$83.40 ,$323.85 ,$340.40 ,$340.40 ,$83.40 ,$247.65 ST. JOSEPH'S HOSPITAL - BREESE,30600460,87591,HC NEISSERIA AMP-90,306,1 ,$251.00 ,$180.72 ,$18.00 ,$251.00 ,$87.73 ,$163.15 ,$149.85 ,$34.39 ,$70.28 ,$166.16 ,$34.39 ,$166.16 ,$34.39 ,$149.60 ,$149.60 ,$34.39 ,$149.60 ,$70.88 ,$193.27 ,$87.73 ,$34.39 ,$35.07 ,$188.25 ,$178.21 ,$178.21 ,$34.39 ,$178.21 ,$213.35 ,$213.35 ,$213.35 , N/A ,$87.73 ,$213.35 ,$34.39 ,$251.00 ,$140.81 ,$34.39 ,$103.91 ,$19.80 ,$18.00 ,$34.39 ,$213.35 ,$73.69 ,$149.60 ,$70.28 ,$225.90 ,$34.39 ,$213.35 ,$140.36 ,$140.36 ,$34.39 ,$163.15 ST. JOSEPH'S HOSPITAL - BREESE,30600462,87624,HC HPV AMP HIGH RISK ALL OTHERS-90,306,1 ,$284.00 ,$204.48 ,$18.00 ,$284.00 ,$87.73 ,$184.60 ,$169.55 ,$34.39 ,$79.52 ,$188.01 ,$34.39 ,$188.01 ,$34.39 ,$169.26 ,$169.26 ,$34.39 ,$169.26 ,$70.88 ,$218.68 ,$87.73 ,$34.39 ,$35.07 ,$213.00 ,$201.64 ,$201.64 ,$34.39 ,$201.64 ,$241.40 ,$241.40 ,$241.40 , N/A ,$87.73 ,$241.40 ,$34.39 ,$35.09 ,$159.32 ,$34.39 ,$117.58 ,$19.80 ,$18.00 ,$34.39 ,$241.40 ,$73.69 ,$169.26 ,$79.52 ,$255.60 ,$34.39 ,$241.40 ,$140.36 ,$140.36 ,$34.39 ,$184.60 ST. JOSEPH'S HOSPITAL - BREESE,30600463,87625,HC HPV GENOTYPE 16 18/45-90,306,1 ,$258.00 ,$185.76 ,$18.00 ,$258.00 ,$101.38 ,$167.70 ,$154.03 ,$39.74 ,$72.24 ,$170.80 ,$39.74 ,$170.80 ,$39.74 ,$153.77 ,$153.77 ,$39.74 ,$153.77 ,$81.91 ,$198.66 ,$101.38 ,$39.74 ,$40.53 ,$193.50 ,$183.18 ,$183.18 ,$39.74 ,$183.18 ,$219.30 ,$219.30 ,$219.30 , N/A ,$101.38 ,$219.30 ,$39.74 ,$40.55 ,$144.74 ,$39.74 ,$106.81 ,$19.80 ,$18.00 ,$39.74 ,$219.30 ,$85.16 ,$153.77 ,$72.24 ,$232.20 ,$39.74 ,$219.30 ,$162.20 ,$162.20 ,$39.74 ,$167.70 ST. JOSEPH'S HOSPITAL - BREESE,30600467,87651,HC INFECT AMP (GRP A STREP),306,1 ,$230.00 ,$165.60 ,$18.00 ,$230.00 ,$87.73 ,$149.50 ,$137.31 ,$34.39 ,$64.40 ,$152.26 ,$34.39 ,$152.26 ,$34.39 ,$137.08 ,$137.08 ,$34.39 ,$137.08 ,$70.88 ,$177.10 ,$87.73 ,$34.39 ,$35.07 ,$172.50 ,$163.30 ,$163.30 ,$34.39 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$87.73 ,$195.50 ,$34.39 ,$230.00 ,$129.03 ,$34.39 ,$95.22 ,$19.80 ,$18.00 ,$34.39 ,$195.50 ,$73.69 ,$137.08 ,$64.40 ,$207.00 ,$34.39 ,$195.50 ,$140.36 ,$140.36 ,$34.39 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,30600468,87653,HC INFECT AMP (GRP B STREP),306,1 ,$230.00 ,$165.60 ,$18.00 ,$230.00 ,$87.73 ,$149.50 ,$137.31 ,$34.39 ,$64.40 ,$152.26 ,$34.39 ,$152.26 ,$34.39 ,$137.08 ,$137.08 ,$34.39 ,$137.08 ,$70.88 ,$177.10 ,$87.73 ,$34.39 ,$35.07 ,$172.50 ,$163.30 ,$163.30 ,$34.39 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$87.73 ,$195.50 ,$34.39 ,$230.00 ,$129.03 ,$34.39 ,$95.22 ,$19.80 ,$18.00 ,$34.39 ,$195.50 ,$73.69 ,$137.08 ,$64.40 ,$207.00 ,$34.39 ,$195.50 ,$140.36 ,$140.36 ,$34.39 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,30600469,87661,HC TRICHOMONAS VAG AMP PROBE-90,306,1 ,$252.00 ,$181.44 ,$18.00 ,$252.00 ,$87.73 ,$163.80 ,$150.44 ,$34.39 ,$70.56 ,$166.82 ,$34.39 ,$166.82 ,$34.39 ,$150.19 ,$150.19 ,$34.39 ,$150.19 ,$70.88 ,$194.04 ,$87.73 ,$34.39 ,$35.07 ,$189.00 ,$178.92 ,$178.92 ,$34.39 ,$178.92 ,$214.20 ,$214.20 ,$214.20 , N/A ,$87.73 ,$214.20 ,$34.39 ,$252.00 ,$141.37 ,$34.39 ,$104.33 ,$19.80 ,$18.00 ,$34.39 ,$214.20 ,$73.69 ,$150.19 ,$70.56 ,$226.80 ,$34.39 ,$214.20 ,$140.36 ,$140.36 ,$34.39 ,$163.80 ST. JOSEPH'S HOSPITAL - BREESE,30600471,87798,HC INFECT AMP-90,306,1 ,$585.00 ,$421.20 ,$18.00 ,$585.00 ,$87.73 ,$380.25 ,$349.25 ,$34.39 ,$163.80 ,$387.27 ,$34.39 ,$387.27 ,$34.39 ,$348.66 ,$348.66 ,$34.39 ,$348.66 ,$70.88 ,$450.45 ,$87.73 ,$34.39 ,$35.07 ,$438.75 ,$415.35 ,$415.35 ,$34.39 ,$415.35 ,$497.25 ,$497.25 ,$497.25 , N/A ,$87.73 ,$497.25 ,$34.39 ,$585.00 ,$328.19 ,$34.39 ,$242.19 ,$19.80 ,$18.00 ,$34.39 ,$497.25 ,$73.69 ,$348.66 ,$163.80 ,$526.50 ,$34.39 ,$497.25 ,$140.36 ,$140.36 ,$34.39 ,$380.25 ST. JOSEPH'S HOSPITAL - BREESE,30600475,87798,HC PROBE VZV DNA QUAL RT PCR-90,306,1 ,$200.00 ,$144.00 ,$18.00 ,$200.00 ,$87.73 ,$130.00 ,$119.40 ,$34.39 ,$56.00 ,$132.40 ,$34.39 ,$132.40 ,$34.39 ,$119.20 ,$119.20 ,$34.39 ,$119.20 ,$70.88 ,$154.00 ,$87.73 ,$34.39 ,$35.07 ,$150.00 ,$142.00 ,$142.00 ,$34.39 ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A ,$87.73 ,$170.00 ,$34.39 ,$200.00 ,$112.20 ,$34.39 ,$82.80 ,$19.80 ,$18.00 ,$34.39 ,$170.00 ,$73.69 ,$119.20 ,$56.00 ,$180.00 ,$34.39 ,$170.00 ,$140.36 ,$140.36 ,$34.39 ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,30600478,87799,HC INFECT AGENT QN-90,306,1 ,$468.00 ,$336.96 ,$18.00 ,$468.00 ,$107.10 ,$304.20 ,$279.40 ,$41.98 ,$131.04 ,$309.82 ,$41.98 ,$309.82 ,$41.98 ,$278.93 ,$278.93 ,$41.98 ,$278.93 ,$86.54 ,$360.36 ,$107.10 ,$41.98 ,$42.83 ,$351.00 ,$332.28 ,$332.28 ,$41.98 ,$332.28 ,$397.80 ,$397.80 ,$397.80 , N/A ,$107.10 ,$397.80 ,$41.98 ,$468.00 ,$262.55 ,$41.98 ,$193.75 ,$19.80 ,$18.00 ,$41.98 ,$397.80 ,$89.96 ,$278.93 ,$131.04 ,$421.20 ,$41.98 ,$397.80 ,$171.36 ,$171.36 ,$41.98 ,$304.20 ST. JOSEPH'S HOSPITAL - BREESE,30600483,87902,HC GENTOYPE HEP C-90,306,1 ,$720.00 ,$518.40 ,$18.00 ,$720.00 ,$643.63 ,$468.00 ,$429.84 ,$252.30 ,$201.60 ,$476.64 ,$252.30 ,$476.64 ,$252.30 ,$429.12 ,$429.12 ,$252.30 ,$429.12 ,$520.05 ,$500.00 ,$643.63 ,$252.30 ,$257.35 ,$540.00 ,$511.20 ,$511.20 ,$252.30 ,$511.20 ,$612.00 ,$612.00 ,$612.00 , N/A ,$643.63 ,$612.00 ,$252.30 ,$720.00 ,$403.92 ,$252.30 ,$298.08 ,$19.80 ,$18.00 ,$252.30 ,$612.00 ,$540.65 ,$429.12 ,$201.60 ,$648.00 ,$252.30 ,$612.00 ,$720.00 ,$720.00 ,$252.30 ,$468.00 ST. JOSEPH'S HOSPITAL - BREESE,30600503,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB-90,306,1 ,$46.00 ,$33.12 ,$6.79 ,$60.20 ,$60.20 ,$29.90 ,$27.46 ,$23.60 ,$12.88 ,$30.45 ,$23.60 ,$30.45 ,$23.60 ,$27.42 ,$27.42 ,$23.60 ,$27.42 ,$46.00 ,$35.42 ,$60.20 ,$23.60 ,$24.07 ,$34.50 ,$32.66 ,$32.66 ,$23.60 ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A ,$46.00 ,$39.10 ,$23.60 ,$46.00 ,$25.81 ,$23.60 ,$19.04 ,$7.47 ,$6.79 ,$23.60 ,$39.10 ,$50.57 ,$27.42 ,$12.88 ,$41.40 ,$23.60 ,$39.10 ,$46.00 ,$46.00 ,$23.60 ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,30600505,87329,HC EIA QL GIARDIA AG-90,306,1 ,$101.00 ,$72.72 ,$6.79 ,$101.00 ,$29.95 ,$65.65 ,$60.30 ,$11.74 ,$28.28 ,$66.86 ,$11.74 ,$66.86 ,$11.74 ,$60.20 ,$60.20 ,$11.74 ,$60.20 ,$24.20 ,$77.77 ,$29.95 ,$11.74 ,$11.98 ,$75.75 ,$71.71 ,$71.71 ,$11.74 ,$71.71 ,$85.85 ,$85.85 ,$85.85 , N/A ,$29.95 ,$85.85 ,$11.74 ,$101.00 ,$56.66 ,$11.74 ,$41.81 ,$7.47 ,$6.79 ,$11.74 ,$85.85 ,$25.16 ,$60.20 ,$28.28 ,$90.90 ,$11.74 ,$85.85 ,$47.92 ,$47.92 ,$11.74 ,$65.65 ST. JOSEPH'S HOSPITAL - BREESE,30600516,87040,HC BACTERIA BLOOD CULTURE T1,306,1 ,$362.00 ,$260.64 ,$10.11 ,$362.00 ,$25.80 ,$235.30 ,$216.11 ,$10.11 ,$101.36 ,$239.64 ,$10.11 ,$239.64 ,$10.11 ,$215.75 ,$215.75 ,$10.11 ,$215.75 ,$20.85 ,$278.74 ,$25.80 ,$10.11 ,$10.32 ,$271.50 ,$257.02 ,$257.02 ,$10.11 ,$257.02 ,$307.70 ,$307.70 ,$307.70 , N/A ,$25.80 ,$307.70 ,$10.11 ,$362.00 ,$203.08 ,$10.11 ,$149.87 ,$19.80 ,$18.00 ,$10.11 ,$307.70 ,$21.67 ,$215.75 ,$101.36 ,$325.80 ,$10.11 ,$307.70 ,$41.28 ,$41.28 ,$10.11 ,$235.30 ST. JOSEPH'S HOSPITAL - BREESE,30600517,87045,HC STOOL CULTURE,306,1 ,$166.00 ,$119.52 ,$5.42 ,$166.00 ,$23.60 ,$107.90 ,$99.10 ,$9.25 ,$46.48 ,$109.89 ,$9.25 ,$109.89 ,$9.25 ,$98.94 ,$98.94 ,$9.25 ,$98.94 ,$19.07 ,$127.82 ,$23.60 ,$9.25 ,$9.44 ,$124.50 ,$117.86 ,$117.86 ,$9.25 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$23.60 ,$141.10 ,$9.25 ,$166.00 ,$93.13 ,$9.25 ,$68.72 ,$5.96 ,$5.42 ,$9.25 ,$141.10 ,$19.82 ,$98.94 ,$46.48 ,$149.40 ,$9.25 ,$141.10 ,$37.76 ,$37.76 ,$9.25 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30600518,87046,HC STOOL CULTURE OTH SRC,306,1 ,$130.00 ,$93.60 ,$5.42 ,$130.00 ,$23.60 ,$84.50 ,$77.61 ,$9.25 ,$36.40 ,$86.06 ,$9.25 ,$86.06 ,$9.25 ,$77.48 ,$77.48 ,$9.25 ,$77.48 ,$19.07 ,$100.10 ,$23.60 ,$9.25 ,$9.44 ,$97.50 ,$92.30 ,$92.30 ,$9.25 ,$92.30 ,$110.50 ,$110.50 ,$110.50 , N/A ,$23.60 ,$110.50 ,$9.25 ,$130.00 ,$72.93 ,$9.25 ,$53.82 ,$5.96 ,$5.42 ,$9.25 ,$110.50 ,$19.82 ,$77.48 ,$36.40 ,$117.00 ,$9.25 ,$110.50 ,$37.76 ,$37.76 ,$9.25 ,$84.50 ST. JOSEPH'S HOSPITAL - BREESE,30600519,87070,HC BODY FLUID CULTURE,306,1 ,$41.00 ,$29.52 ,$5.42 ,$41.00 ,$21.55 ,$26.65 ,$24.48 ,$8.45 ,$11.48 ,$27.14 ,$8.45 ,$27.14 ,$8.45 ,$24.44 ,$24.44 ,$8.45 ,$24.44 ,$17.41 ,$31.57 ,$21.55 ,$8.45 ,$8.61 ,$30.75 ,$29.11 ,$29.11 ,$8.45 ,$29.11 ,$34.85 ,$34.85 ,$34.85 , N/A ,$21.55 ,$34.85 ,$8.45 ,$41.00 ,$23.00 ,$8.45 ,$16.97 ,$5.96 ,$5.42 ,$8.45 ,$34.85 ,$18.10 ,$24.44 ,$11.48 ,$36.90 ,$8.45 ,$34.85 ,$34.48 ,$34.48 ,$8.45 ,$26.65 ST. JOSEPH'S HOSPITAL - BREESE,30600520,87071,HC CULTURE AEROBIC OTH QN,306,1 ,$218.00 ,$156.96 ,$5.42 ,$218.00 ,$24.73 ,$141.70 ,$130.15 ,$9.69 ,$61.04 ,$144.32 ,$9.69 ,$144.32 ,$9.69 ,$129.93 ,$129.93 ,$9.69 ,$129.93 ,$19.98 ,$167.86 ,$24.73 ,$9.69 ,$9.89 ,$163.50 ,$154.78 ,$154.78 ,$9.69 ,$154.78 ,$185.30 ,$185.30 ,$185.30 , N/A ,$24.73 ,$185.30 ,$9.69 ,$218.00 ,$122.30 ,$9.69 ,$90.25 ,$5.96 ,$5.42 ,$9.69 ,$185.30 ,$20.77 ,$129.93 ,$61.04 ,$196.20 ,$9.69 ,$185.30 ,$39.56 ,$39.56 ,$9.69 ,$141.70 ST. JOSEPH'S HOSPITAL - BREESE,30600521,87073,HC CULTURE ANAEROBIC OTHER SOURCE QN,306,1 ,$246.00 ,$177.12 ,$9.47 ,$246.00 ,$24.15 ,$159.90 ,$146.86 ,$9.47 ,$68.88 ,$162.85 ,$9.47 ,$162.85 ,$9.47 ,$146.62 ,$146.62 ,$9.47 ,$146.62 ,$19.51 ,$189.42 ,$24.15 ,$9.47 ,$9.65 ,$184.50 ,$174.66 ,$174.66 ,$9.47 ,$174.66 ,$209.10 ,$209.10 ,$209.10 , N/A ,$24.15 ,$209.10 ,$9.47 ,$246.00 ,$138.01 ,$9.47 ,$101.84 ,$19.80 ,$18.00 ,$9.47 ,$209.10 ,$20.29 ,$146.62 ,$68.88 ,$221.40 ,$9.47 ,$209.10 ,$38.64 ,$38.64 ,$9.47 ,$159.90 ST. JOSEPH'S HOSPITAL - BREESE,30600522,87075,HC CULTURE ANAEROBIC,306,1 ,$244.00 ,$175.68 ,$5.42 ,$244.00 ,$23.68 ,$158.60 ,$145.67 ,$9.28 ,$68.32 ,$161.53 ,$9.28 ,$161.53 ,$9.28 ,$145.42 ,$145.42 ,$9.28 ,$145.42 ,$19.13 ,$187.88 ,$23.68 ,$9.28 ,$9.47 ,$183.00 ,$173.24 ,$173.24 ,$9.28 ,$173.24 ,$207.40 ,$207.40 ,$207.40 , N/A ,$23.68 ,$207.40 ,$9.28 ,$244.00 ,$136.88 ,$9.28 ,$101.02 ,$5.96 ,$5.42 ,$9.28 ,$207.40 ,$19.89 ,$145.42 ,$68.32 ,$219.60 ,$9.28 ,$207.40 ,$37.88 ,$37.88 ,$9.28 ,$158.60 ST. JOSEPH'S HOSPITAL - BREESE,30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$192.00 ,$138.24 ,$5.42 ,$192.00 ,$20.20 ,$124.80 ,$114.62 ,$7.92 ,$53.76 ,$127.10 ,$7.92 ,$127.10 ,$7.92 ,$114.43 ,$114.43 ,$7.92 ,$114.43 ,$16.32 ,$147.84 ,$20.20 ,$7.92 ,$8.08 ,$144.00 ,$136.32 ,$136.32 ,$7.92 ,$136.32 ,$163.20 ,$163.20 ,$163.20 , N/A ,$20.20 ,$163.20 ,$7.92 ,$192.00 ,$107.71 ,$7.92 ,$79.49 ,$5.96 ,$5.42 ,$7.92 ,$163.20 ,$16.97 ,$114.43 ,$53.76 ,$172.80 ,$7.92 ,$163.20 ,$32.32 ,$32.32 ,$7.92 ,$124.80 ST. JOSEPH'S HOSPITAL - BREESE,30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$169.00 ,$121.68 ,$5.42 ,$169.00 ,$20.20 ,$109.85 ,$100.89 ,$7.92 ,$47.32 ,$111.88 ,$7.92 ,$111.88 ,$7.92 ,$100.72 ,$100.72 ,$7.92 ,$100.72 ,$16.32 ,$130.13 ,$20.20 ,$7.92 ,$8.08 ,$126.75 ,$119.99 ,$119.99 ,$7.92 ,$119.99 ,$143.65 ,$143.65 ,$143.65 , N/A ,$20.20 ,$143.65 ,$7.92 ,$169.00 ,$94.81 ,$7.92 ,$69.97 ,$5.96 ,$5.42 ,$7.92 ,$143.65 ,$16.97 ,$100.72 ,$47.32 ,$152.10 ,$7.92 ,$143.65 ,$32.32 ,$32.32 ,$7.92 ,$109.85 ST. JOSEPH'S HOSPITAL - BREESE,30600525,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$187.00 ,$134.64 ,$5.42 ,$187.00 ,$16.58 ,$121.55 ,$111.64 ,$6.50 ,$52.36 ,$123.79 ,$6.50 ,$123.79 ,$6.50 ,$111.45 ,$111.45 ,$6.50 ,$111.45 ,$13.39 ,$143.99 ,$16.58 ,$6.50 ,$6.62 ,$140.25 ,$132.77 ,$132.77 ,$6.50 ,$132.77 ,$158.95 ,$158.95 ,$158.95 , N/A ,$16.58 ,$158.95 ,$6.50 ,$187.00 ,$104.91 ,$6.50 ,$77.42 ,$5.96 ,$5.42 ,$6.50 ,$158.95 ,$13.92 ,$111.45 ,$52.36 ,$168.30 ,$6.50 ,$158.95 ,$26.52 ,$26.52 ,$6.50 ,$121.55 ST. JOSEPH'S HOSPITAL - BREESE,30600526,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$187.00 ,$134.64 ,$5.42 ,$187.00 ,$16.58 ,$121.55 ,$111.64 ,$6.50 ,$52.36 ,$123.79 ,$6.50 ,$123.79 ,$6.50 ,$111.45 ,$111.45 ,$6.50 ,$111.45 ,$13.39 ,$143.99 ,$16.58 ,$6.50 ,$6.62 ,$140.25 ,$132.77 ,$132.77 ,$6.50 ,$132.77 ,$158.95 ,$158.95 ,$158.95 , N/A ,$16.58 ,$158.95 ,$6.50 ,$187.00 ,$104.91 ,$6.50 ,$77.42 ,$5.96 ,$5.42 ,$6.50 ,$158.95 ,$13.92 ,$111.45 ,$52.36 ,$168.30 ,$6.50 ,$158.95 ,$26.52 ,$26.52 ,$6.50 ,$121.55 ST. JOSEPH'S HOSPITAL - BREESE,30600527,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$214.00 ,$154.08 ,$5.42 ,$214.00 ,$20.18 ,$139.10 ,$127.76 ,$7.91 ,$59.92 ,$141.67 ,$7.91 ,$141.67 ,$7.91 ,$127.54 ,$127.54 ,$7.91 ,$127.54 ,$16.30 ,$164.78 ,$20.18 ,$7.91 ,$8.07 ,$160.50 ,$151.94 ,$151.94 ,$7.91 ,$151.94 ,$181.90 ,$181.90 ,$181.90 , N/A ,$20.18 ,$181.90 ,$7.91 ,$214.00 ,$120.05 ,$7.91 ,$88.60 ,$5.96 ,$5.42 ,$7.91 ,$181.90 ,$16.95 ,$127.54 ,$59.92 ,$192.60 ,$7.91 ,$181.90 ,$32.28 ,$32.28 ,$7.91 ,$139.10 ST. JOSEPH'S HOSPITAL - BREESE,30600528,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$121.00 ,$87.12 ,$5.42 ,$121.00 ,$20.23 ,$78.65 ,$72.24 ,$7.93 ,$33.88 ,$80.10 ,$7.93 ,$80.10 ,$7.93 ,$72.12 ,$72.12 ,$7.93 ,$72.12 ,$16.34 ,$93.17 ,$20.23 ,$7.93 ,$8.08 ,$90.75 ,$85.91 ,$85.91 ,$7.93 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$20.23 ,$102.85 ,$7.93 ,$121.00 ,$67.88 ,$7.93 ,$50.09 ,$5.96 ,$5.42 ,$7.93 ,$102.85 ,$16.99 ,$72.12 ,$33.88 ,$108.90 ,$7.93 ,$102.85 ,$32.36 ,$32.36 ,$7.93 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30600529,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL -90,306,1 ,$83.00 ,$59.76 ,$5.42 ,$83.00 ,$19.28 ,$53.95 ,$49.55 ,$7.56 ,$23.24 ,$54.95 ,$7.56 ,$54.95 ,$7.56 ,$49.47 ,$49.47 ,$7.56 ,$49.47 ,$15.57 ,$63.91 ,$19.28 ,$7.56 ,$7.70 ,$62.25 ,$58.93 ,$58.93 ,$7.56 ,$58.93 ,$70.55 ,$70.55 ,$70.55 , N/A ,$19.28 ,$70.55 ,$7.56 ,$83.00 ,$46.56 ,$7.56 ,$34.36 ,$5.96 ,$5.42 ,$7.56 ,$70.55 ,$16.19 ,$49.47 ,$23.24 ,$74.70 ,$7.56 ,$70.55 ,$30.84 ,$30.84 ,$7.56 ,$53.95 ST. JOSEPH'S HOSPITAL - BREESE,30600531,87102,HC CULTURE FUNGUS OTHER,306,1 ,$258.00 ,$185.76 ,$5.42 ,$258.00 ,$21.03 ,$167.70 ,$154.03 ,$8.24 ,$72.24 ,$170.80 ,$8.24 ,$170.80 ,$8.24 ,$153.77 ,$153.77 ,$8.24 ,$153.77 ,$16.99 ,$198.66 ,$21.03 ,$8.24 ,$8.41 ,$193.50 ,$183.18 ,$183.18 ,$8.24 ,$183.18 ,$219.30 ,$219.30 ,$219.30 , N/A ,$21.03 ,$219.30 ,$8.24 ,$258.00 ,$144.74 ,$8.24 ,$106.81 ,$5.96 ,$5.42 ,$8.24 ,$219.30 ,$17.66 ,$153.77 ,$72.24 ,$232.20 ,$8.24 ,$219.30 ,$33.64 ,$33.64 ,$8.24 ,$167.70 ST. JOSEPH'S HOSPITAL - BREESE,30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$201.00 ,$144.72 ,$5.42 ,$201.00 ,$25.80 ,$130.65 ,$120.00 ,$10.11 ,$56.28 ,$133.06 ,$10.11 ,$133.06 ,$10.11 ,$119.80 ,$119.80 ,$10.11 ,$119.80 ,$20.85 ,$154.77 ,$25.80 ,$10.11 ,$10.32 ,$150.75 ,$142.71 ,$142.71 ,$10.11 ,$142.71 ,$170.85 ,$170.85 ,$170.85 , N/A ,$25.80 ,$170.85 ,$10.11 ,$201.00 ,$112.76 ,$10.11 ,$83.21 ,$5.96 ,$5.42 ,$10.11 ,$170.85 ,$21.67 ,$119.80 ,$56.28 ,$180.90 ,$10.11 ,$170.85 ,$41.28 ,$41.28 ,$10.11 ,$130.65 ST. JOSEPH'S HOSPITAL - BREESE,30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$215.00 ,$154.80 ,$5.08 ,$215.00 ,$12.95 ,$139.75 ,$128.36 ,$5.08 ,$60.20 ,$142.33 ,$5.08 ,$142.33 ,$5.08 ,$128.14 ,$128.14 ,$5.08 ,$128.14 ,$10.46 ,$165.55 ,$12.95 ,$5.08 ,$5.17 ,$161.25 ,$152.65 ,$152.65 ,$5.08 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$12.95 ,$182.75 ,$5.08 ,$215.00 ,$120.62 ,$5.08 ,$89.01 ,$5.96 ,$5.42 ,$5.08 ,$182.75 ,$10.88 ,$128.14 ,$60.20 ,$193.50 ,$5.08 ,$182.75 ,$20.72 ,$20.72 ,$5.08 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$94.00 ,$67.68 ,$5.42 ,$94.00 ,$50.13 ,$61.10 ,$56.12 ,$19.65 ,$26.32 ,$62.23 ,$19.65 ,$62.23 ,$19.65 ,$56.02 ,$56.02 ,$19.65 ,$56.02 ,$40.50 ,$72.38 ,$50.13 ,$19.65 ,$20.04 ,$70.50 ,$66.74 ,$66.74 ,$19.65 ,$66.74 ,$79.90 ,$79.90 ,$79.90 , N/A ,$50.13 ,$79.90 ,$19.65 ,$94.00 ,$52.73 ,$19.65 ,$38.92 ,$5.96 ,$5.42 ,$19.65 ,$79.90 ,$42.11 ,$56.02 ,$26.32 ,$84.60 ,$19.65 ,$79.90 ,$80.20 ,$80.20 ,$19.65 ,$61.10 ST. JOSEPH'S HOSPITAL - BREESE,30600541,87172,HC PINWORM EXAM,306,1 ,$80.00 ,$57.60 ,$4.18 ,$80.00 ,$10.68 ,$52.00 ,$47.76 ,$4.18 ,$22.40 ,$52.96 ,$4.18 ,$52.96 ,$4.18 ,$47.68 ,$47.68 ,$4.18 ,$47.68 ,$8.63 ,$61.60 ,$10.68 ,$4.18 ,$4.27 ,$60.00 ,$56.80 ,$56.80 ,$4.18 ,$56.80 ,$68.00 ,$68.00 ,$68.00 , N/A ,$10.68 ,$68.00 ,$4.18 ,$80.00 ,$44.88 ,$4.18 ,$33.12 ,$5.96 ,$5.42 ,$4.18 ,$68.00 ,$8.97 ,$47.68 ,$22.40 ,$72.00 ,$4.18 ,$68.00 ,$17.08 ,$17.08 ,$4.18 ,$52.00 ST. JOSEPH'S HOSPITAL - BREESE,30600542,87176,HC HOMOGENIZATION TISSUE,306,1 ,$92.00 ,$66.24 ,$5.42 ,$92.00 ,$14.70 ,$59.80 ,$54.92 ,$5.76 ,$25.76 ,$60.90 ,$5.76 ,$60.90 ,$5.76 ,$54.83 ,$54.83 ,$5.76 ,$54.83 ,$11.88 ,$70.84 ,$14.70 ,$5.76 ,$5.88 ,$69.00 ,$65.32 ,$65.32 ,$5.76 ,$65.32 ,$78.20 ,$78.20 ,$78.20 , N/A ,$14.70 ,$78.20 ,$5.76 ,$92.00 ,$51.61 ,$5.76 ,$38.09 ,$5.96 ,$5.42 ,$5.76 ,$78.20 ,$12.35 ,$54.83 ,$25.76 ,$82.80 ,$5.76 ,$78.20 ,$23.52 ,$23.52 ,$5.76 ,$59.80 ST. JOSEPH'S HOSPITAL - BREESE,30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$33.00 ,$23.76 ,$4.65 ,$33.00 ,$11.88 ,$21.45 ,$19.70 ,$4.65 ,$9.24 ,$21.85 ,$4.65 ,$21.85 ,$4.65 ,$19.67 ,$19.67 ,$4.65 ,$19.67 ,$9.60 ,$25.41 ,$11.88 ,$4.65 ,$4.75 ,$24.75 ,$23.43 ,$23.43 ,$4.65 ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A ,$11.88 ,$28.05 ,$4.65 ,$33.00 ,$18.51 ,$4.65 ,$13.66 ,$5.96 ,$5.42 ,$4.65 ,$28.05 ,$9.98 ,$19.67 ,$9.24 ,$29.70 ,$4.65 ,$28.05 ,$19.00 ,$19.00 ,$4.65 ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,30600545,87184,HC SENSITIVITY DISK KB,306,1 ,$117.00 ,$84.24 ,$5.42 ,$117.00 ,$18.70 ,$76.05 ,$69.85 ,$7.33 ,$32.76 ,$77.45 ,$7.33 ,$77.45 ,$7.33 ,$69.73 ,$69.73 ,$7.33 ,$69.73 ,$15.11 ,$90.09 ,$18.70 ,$7.33 ,$7.48 ,$87.75 ,$83.07 ,$83.07 ,$7.33 ,$83.07 ,$99.45 ,$99.45 ,$99.45 , N/A ,$18.70 ,$99.45 ,$7.33 ,$117.00 ,$65.64 ,$7.33 ,$48.44 ,$5.96 ,$5.42 ,$7.33 ,$99.45 ,$15.71 ,$69.73 ,$32.76 ,$105.30 ,$7.33 ,$99.45 ,$29.92 ,$29.92 ,$7.33 ,$76.05 ST. JOSEPH'S HOSPITAL - BREESE,30600546,87185,HC BETA LACTAMASE,306,1 ,$23.00 ,$16.56 ,$4.65 ,$23.00 ,$11.88 ,$14.95 ,$13.73 ,$4.65 ,$6.44 ,$15.23 ,$4.65 ,$15.23 ,$4.65 ,$13.71 ,$13.71 ,$4.65 ,$13.71 ,$9.60 ,$17.71 ,$11.88 ,$4.65 ,$4.75 ,$17.25 ,$16.33 ,$16.33 ,$4.65 ,$16.33 ,$19.55 ,$19.55 ,$19.55 , N/A ,$11.88 ,$19.55 ,$4.65 ,$23.00 ,$12.90 ,$4.65 ,$9.52 ,$5.96 ,$5.42 ,$4.65 ,$19.55 ,$9.98 ,$13.71 ,$6.44 ,$20.70 ,$4.65 ,$19.55 ,$19.00 ,$19.00 ,$4.65 ,$14.95 ST. JOSEPH'S HOSPITAL - BREESE,30600547,87186,HC SENSITIVITY MIC,306,1 ,$238.00 ,$171.36 ,$5.42 ,$238.00 ,$21.63 ,$154.70 ,$142.09 ,$8.48 ,$66.64 ,$157.56 ,$8.48 ,$157.56 ,$8.48 ,$141.85 ,$141.85 ,$8.48 ,$141.85 ,$17.47 ,$183.26 ,$21.63 ,$8.48 ,$8.64 ,$178.50 ,$168.98 ,$168.98 ,$8.48 ,$168.98 ,$202.30 ,$202.30 ,$202.30 , N/A ,$21.63 ,$202.30 ,$8.48 ,$238.00 ,$133.52 ,$8.48 ,$98.53 ,$5.96 ,$5.42 ,$8.48 ,$202.30 ,$18.17 ,$141.85 ,$66.64 ,$214.20 ,$8.48 ,$202.30 ,$34.60 ,$34.60 ,$8.48 ,$154.70 ST. JOSEPH'S HOSPITAL - BREESE,30600551,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$113.00 ,$81.36 ,$4.18 ,$113.00 ,$10.68 ,$73.45 ,$67.46 ,$4.18 ,$31.64 ,$74.81 ,$4.18 ,$74.81 ,$4.18 ,$67.35 ,$67.35 ,$4.18 ,$67.35 ,$8.63 ,$87.01 ,$10.68 ,$4.18 ,$4.27 ,$84.75 ,$80.23 ,$80.23 ,$4.18 ,$80.23 ,$96.05 ,$96.05 ,$96.05 , N/A ,$10.68 ,$96.05 ,$4.18 ,$113.00 ,$63.39 ,$4.18 ,$46.78 ,$5.96 ,$5.42 ,$4.18 ,$96.05 ,$8.97 ,$67.35 ,$31.64 ,$101.70 ,$4.18 ,$96.05 ,$17.08 ,$17.08 ,$4.18 ,$73.45 ST. JOSEPH'S HOSPITAL - BREESE,30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$98.00 ,$70.56 ,$5.28 ,$98.00 ,$13.48 ,$63.70 ,$58.51 ,$5.28 ,$27.44 ,$64.88 ,$5.28 ,$64.88 ,$5.28 ,$58.41 ,$58.41 ,$5.28 ,$58.41 ,$10.89 ,$75.46 ,$13.48 ,$5.28 ,$5.39 ,$73.50 ,$69.58 ,$69.58 ,$5.28 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$13.48 ,$83.30 ,$5.28 ,$98.00 ,$54.98 ,$5.28 ,$40.57 ,$5.96 ,$5.42 ,$5.28 ,$83.30 ,$11.32 ,$58.41 ,$27.44 ,$88.20 ,$5.28 ,$83.30 ,$21.56 ,$21.56 ,$5.28 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,30600555,87255,HC VIRUS ID NON-IMMUNOLOGIC OTHER THAN CYTOPATHIC-90,306,1 ,$181.00 ,$130.32 ,$18.00 ,$181.00 ,$84.65 ,$117.65 ,$108.06 ,$33.18 ,$50.68 ,$119.82 ,$33.18 ,$119.82 ,$33.18 ,$107.88 ,$107.88 ,$33.18 ,$107.88 ,$68.40 ,$139.37 ,$84.65 ,$33.18 ,$33.85 ,$135.75 ,$128.51 ,$128.51 ,$33.18 ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A ,$84.65 ,$153.85 ,$33.18 ,$181.00 ,$101.54 ,$33.18 ,$74.93 ,$19.80 ,$18.00 ,$33.18 ,$153.85 ,$71.11 ,$107.88 ,$50.68 ,$162.90 ,$33.18 ,$153.85 ,$135.44 ,$135.44 ,$33.18 ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,30600556,87327,HC EIA QL CRYPTOCOCCUS AG,306,1 ,$144.00 ,$103.68 ,$6.79 ,$144.00 ,$33.55 ,$93.60 ,$85.97 ,$13.15 ,$40.32 ,$95.33 ,$13.15 ,$95.33 ,$13.15 ,$85.82 ,$85.82 ,$13.15 ,$85.82 ,$27.11 ,$110.88 ,$33.55 ,$13.15 ,$13.42 ,$108.00 ,$102.24 ,$102.24 ,$13.15 ,$102.24 ,$122.40 ,$122.40 ,$122.40 , N/A ,$33.55 ,$122.40 ,$13.15 ,$144.00 ,$80.78 ,$13.15 ,$59.62 ,$7.47 ,$6.79 ,$13.15 ,$122.40 ,$28.18 ,$85.82 ,$40.32 ,$129.60 ,$13.15 ,$122.40 ,$53.68 ,$53.68 ,$13.15 ,$93.60 ST. JOSEPH'S HOSPITAL - BREESE,30600557,87329,HC EIA QL GIARDIA AG,306,1 ,$166.00 ,$119.52 ,$6.79 ,$166.00 ,$29.95 ,$107.90 ,$99.10 ,$11.74 ,$46.48 ,$109.89 ,$11.74 ,$109.89 ,$11.74 ,$98.94 ,$98.94 ,$11.74 ,$98.94 ,$24.20 ,$127.82 ,$29.95 ,$11.74 ,$11.98 ,$124.50 ,$117.86 ,$117.86 ,$11.74 ,$117.86 ,$141.10 ,$141.10 ,$141.10 , N/A ,$29.95 ,$141.10 ,$11.74 ,$166.00 ,$93.13 ,$11.74 ,$68.72 ,$7.47 ,$6.79 ,$11.74 ,$141.10 ,$25.16 ,$98.94 ,$46.48 ,$149.40 ,$11.74 ,$141.10 ,$47.92 ,$47.92 ,$11.74 ,$107.90 ST. JOSEPH'S HOSPITAL - BREESE,30600559,87340,HC EIA QL HEPATITIS B AG,306,1 ,$227.00 ,$163.44 ,$6.79 ,$227.00 ,$25.83 ,$147.55 ,$135.52 ,$10.12 ,$63.56 ,$150.27 ,$10.12 ,$150.27 ,$10.12 ,$135.29 ,$135.29 ,$10.12 ,$135.29 ,$20.87 ,$174.79 ,$25.83 ,$10.12 ,$10.33 ,$170.25 ,$161.17 ,$161.17 ,$10.12 ,$161.17 ,$192.95 ,$192.95 ,$192.95 , N/A ,$25.83 ,$192.95 ,$10.12 ,$227.00 ,$127.35 ,$10.12 ,$93.98 ,$7.47 ,$6.79 ,$10.12 ,$192.95 ,$21.69 ,$135.29 ,$63.56 ,$204.30 ,$10.12 ,$192.95 ,$41.32 ,$41.32 ,$10.12 ,$147.55 ST. JOSEPH'S HOSPITAL - BREESE,30600560,87341,HC EIA QL HEPATITIS B AG NEUT,306,1 ,$213.00 ,$153.36 ,$6.79 ,$213.00 ,$25.83 ,$138.45 ,$127.16 ,$10.12 ,$59.64 ,$141.01 ,$10.12 ,$141.01 ,$10.12 ,$126.95 ,$126.95 ,$10.12 ,$126.95 ,$20.87 ,$164.01 ,$25.83 ,$10.12 ,$10.33 ,$159.75 ,$151.23 ,$151.23 ,$10.12 ,$151.23 ,$181.05 ,$181.05 ,$181.05 , N/A ,$25.83 ,$181.05 ,$10.12 ,$213.00 ,$119.49 ,$10.12 ,$88.18 ,$7.47 ,$6.79 ,$10.12 ,$181.05 ,$21.69 ,$126.95 ,$59.64 ,$191.70 ,$10.12 ,$181.05 ,$41.32 ,$41.32 ,$10.12 ,$138.45 ST. JOSEPH'S HOSPITAL - BREESE,30600561,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB,306,1 ,$232.00 ,$167.04 ,$6.79 ,$232.00 ,$60.20 ,$150.80 ,$138.50 ,$23.60 ,$64.96 ,$153.58 ,$23.60 ,$153.58 ,$23.60 ,$138.27 ,$138.27 ,$23.60 ,$138.27 ,$48.64 ,$178.64 ,$60.20 ,$23.60 ,$24.07 ,$174.00 ,$164.72 ,$164.72 ,$23.60 ,$164.72 ,$197.20 ,$197.20 ,$197.20 , N/A ,$60.20 ,$197.20 ,$23.60 ,$232.00 ,$130.15 ,$23.60 ,$96.05 ,$7.47 ,$6.79 ,$23.60 ,$197.20 ,$50.57 ,$138.27 ,$64.96 ,$208.80 ,$23.60 ,$197.20 ,$96.32 ,$96.32 ,$23.60 ,$150.80 ST. JOSEPH'S HOSPITAL - BREESE,30600562,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$371.00 ,$267.12 ,$6.79 ,$371.00 ,$29.95 ,$241.15 ,$221.49 ,$11.74 ,$103.88 ,$245.60 ,$11.74 ,$245.60 ,$11.74 ,$221.12 ,$221.12 ,$11.74 ,$221.12 ,$24.20 ,$285.67 ,$29.95 ,$11.74 ,$11.98 ,$278.25 ,$263.41 ,$263.41 ,$11.74 ,$263.41 ,$315.35 ,$315.35 ,$315.35 , N/A ,$29.95 ,$315.35 ,$11.74 ,$371.00 ,$208.13 ,$11.74 ,$153.59 ,$7.47 ,$6.79 ,$11.74 ,$315.35 ,$25.16 ,$221.12 ,$103.88 ,$333.90 ,$11.74 ,$315.35 ,$47.92 ,$47.92 ,$11.74 ,$241.15 ST. JOSEPH'S HOSPITAL - BREESE,30600563,87427,HC SHIGELLA LIKE TOXIN AG,306,1 ,$175.00 ,$126.00 ,$6.79 ,$175.00 ,$29.95 ,$113.75 ,$104.48 ,$11.74 ,$49.00 ,$115.85 ,$11.74 ,$115.85 ,$11.74 ,$104.30 ,$104.30 ,$11.74 ,$104.30 ,$24.20 ,$134.75 ,$29.95 ,$11.74 ,$11.98 ,$131.25 ,$124.25 ,$124.25 ,$11.74 ,$124.25 ,$148.75 ,$148.75 ,$148.75 , N/A ,$29.95 ,$148.75 ,$11.74 ,$175.00 ,$98.18 ,$11.74 ,$72.45 ,$7.47 ,$6.79 ,$11.74 ,$148.75 ,$25.16 ,$104.30 ,$49.00 ,$157.50 ,$11.74 ,$148.75 ,$47.92 ,$47.92 ,$11.74 ,$113.75 ST. JOSEPH'S HOSPITAL - BREESE,30600567,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,$746.00 ,$537.12 ,$18.00 ,"$1,041.95 ","$1,041.95 ",$484.90 ,$445.36 ,$408.44 ,$208.88 ,$493.85 ,$408.44 ,$493.85 ,$408.44 ,$444.62 ,$444.62 ,$408.44 ,$444.62 ,$746.00 ,$500.00 ,"$1,041.95 ",$408.44 ,$416.62 ,$559.50 ,$529.66 ,$529.66 ,$408.44 ,$529.66 ,$634.10 ,$634.10 ,$634.10 , N/A ,$746.00 ,$634.10 ,$408.44 ,$746.00 ,$418.51 ,$408.44 ,$308.84 ,$19.80 ,$18.00 ,$408.44 ,$634.10 ,$875.24 ,$444.62 ,$208.88 ,$671.40 ,$408.44 ,$634.10 ,$746.00 ,$746.00 ,$408.44 ,$484.90 ST. JOSEPH'S HOSPITAL - BREESE,30600568,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$121.00 ,$87.12 ,$18.00 ,$121.00 ,$87.73 ,$78.65 ,$72.24 ,$34.39 ,$33.88 ,$80.10 ,$34.39 ,$80.10 ,$34.39 ,$72.12 ,$72.12 ,$34.39 ,$72.12 ,$70.88 ,$93.17 ,$87.73 ,$34.39 ,$35.07 ,$90.75 ,$85.91 ,$85.91 ,$34.39 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$87.73 ,$102.85 ,$34.39 ,$121.00 ,$67.88 ,$34.39 ,$50.09 ,$19.80 ,$18.00 ,$34.39 ,$102.85 ,$73.69 ,$72.12 ,$33.88 ,$108.90 ,$34.39 ,$102.85 ,$121.00 ,$121.00 ,$34.39 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30600570,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$152.00 ,$109.44 ,$6.79 ,$152.00 ,$87.73 ,$98.80 ,$90.74 ,$34.39 ,$42.56 ,$100.62 ,$34.39 ,$100.62 ,$34.39 ,$90.59 ,$90.59 ,$34.39 ,$90.59 ,$70.88 ,$117.04 ,$87.73 ,$34.39 ,$35.07 ,$114.00 ,$107.92 ,$107.92 ,$34.39 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$87.73 ,$129.20 ,$34.39 ,$152.00 ,$85.27 ,$34.39 ,$62.93 ,$7.47 ,$6.79 ,$34.39 ,$129.20 ,$73.69 ,$90.59 ,$42.56 ,$136.80 ,$34.39 ,$129.20 ,$140.36 ,$140.36 ,$34.39 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,30600571,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,$791.00 ,$569.52 ,$18.00 ,"$1,041.95 ","$1,041.95 ",$514.15 ,$472.23 ,$408.44 ,$221.48 ,$523.64 ,$408.44 ,$523.64 ,$408.44 ,$471.44 ,$471.44 ,$408.44 ,$471.44 ,$791.00 ,$500.00 ,"$1,041.95 ",$408.44 ,$416.62 ,$593.25 ,$561.61 ,$561.61 ,$408.44 ,$561.61 ,$672.35 ,$672.35 ,$672.35 , N/A ,$791.00 ,$672.35 ,$408.44 ,$791.00 ,$443.75 ,$408.44 ,$327.47 ,$19.80 ,$18.00 ,$408.44 ,$672.35 ,$875.24 ,$471.44 ,$221.48 ,$711.90 ,$408.44 ,$672.35 ,$791.00 ,$791.00 ,$408.44 ,$514.15 ST. JOSEPH'S HOSPITAL - BREESE,30600573,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$531.00 ,$382.32 ,$18.00 ,$531.00 ,$87.73 ,$345.15 ,$317.01 ,$34.39 ,$148.68 ,$351.52 ,$34.39 ,$351.52 ,$34.39 ,$316.48 ,$316.48 ,$34.39 ,$316.48 ,$70.88 ,$408.87 ,$87.73 ,$34.39 ,$35.07 ,$398.25 ,$377.01 ,$377.01 ,$34.39 ,$377.01 ,$451.35 ,$451.35 ,$451.35 , N/A ,$87.73 ,$451.35 ,$34.39 ,$531.00 ,$297.89 ,$34.39 ,$219.83 ,$19.80 ,$18.00 ,$34.39 ,$451.35 ,$73.69 ,$316.48 ,$148.68 ,$477.90 ,$34.39 ,$451.35 ,$140.36 ,$140.36 ,$34.39 ,$345.15 ST. JOSEPH'S HOSPITAL - BREESE,30600575,87591,HC NEISSERIA AMP,306,1 ,$152.00 ,$109.44 ,$18.00 ,$152.00 ,$87.73 ,$98.80 ,$90.74 ,$34.39 ,$42.56 ,$100.62 ,$34.39 ,$100.62 ,$34.39 ,$90.59 ,$90.59 ,$34.39 ,$90.59 ,$70.88 ,$117.04 ,$87.73 ,$34.39 ,$35.07 ,$114.00 ,$107.92 ,$107.92 ,$34.39 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$87.73 ,$129.20 ,$34.39 ,$152.00 ,$85.27 ,$34.39 ,$62.93 ,$19.80 ,$18.00 ,$34.39 ,$129.20 ,$73.69 ,$90.59 ,$42.56 ,$136.80 ,$34.39 ,$129.20 ,$140.36 ,$140.36 ,$34.39 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,30600577,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,"$1,438.00 ","$1,035.36 ",$18.00 ,"$1,438.00 ","$1,041.95 ",$934.70 ,$858.49 ,$408.44 ,$402.64 ,$951.96 ,$408.44 ,$951.96 ,$408.44 ,$857.05 ,$857.05 ,$408.44 ,$857.05 ,$841.90 ,$500.00 ,"$1,041.95 ",$408.44 ,$416.62 ,"$1,078.50 ","$1,020.98 ","$1,020.98 ",$408.44 ,"$1,020.98 ","$1,222.30 ","$1,222.30 ","$1,222.30 ", N/A ,"$1,041.95 ","$1,222.30 ",$408.44 ,"$1,438.00 ",$806.72 ,$408.44 ,$595.33 ,$19.80 ,$18.00 ,$408.44 ,"$1,222.30 ",$875.24 ,$857.05 ,$402.64 ,"$1,294.20 ",$408.44 ,"$1,222.30 ","$1,438.00 ","$1,438.00 ",$408.44 ,$934.70 ST. JOSEPH'S HOSPITAL - BREESE,30600579,87653,HC INFECT AMP (GRP B STREP),306,1 ,$78.00 ,$56.16 ,$18.00 ,$87.73 ,$87.73 ,$50.70 ,$46.57 ,$34.39 ,$21.84 ,$51.64 ,$34.39 ,$51.64 ,$34.39 ,$46.49 ,$46.49 ,$34.39 ,$46.49 ,$70.88 ,$60.06 ,$87.73 ,$34.39 ,$35.07 ,$58.50 ,$55.38 ,$55.38 ,$34.39 ,$55.38 ,$66.30 ,$66.30 ,$66.30 , N/A ,$78.00 ,$66.30 ,$34.39 ,$78.00 ,$43.76 ,$34.39 ,$32.29 ,$19.80 ,$18.00 ,$34.39 ,$66.30 ,$73.69 ,$46.49 ,$21.84 ,$70.20 ,$34.39 ,$66.30 ,$78.00 ,$78.00 ,$34.39 ,$50.70 ST. JOSEPH'S HOSPITAL - BREESE,30600581,87798,HC INFECT AMP,306,1 ,$508.00 ,$365.76 ,$18.00 ,$508.00 ,$87.73 ,$330.20 ,$303.28 ,$34.39 ,$142.24 ,$336.30 ,$34.39 ,$336.30 ,$34.39 ,$302.77 ,$302.77 ,$34.39 ,$302.77 ,$70.88 ,$391.16 ,$87.73 ,$34.39 ,$35.07 ,$381.00 ,$360.68 ,$360.68 ,$34.39 ,$360.68 ,$431.80 ,$431.80 ,$431.80 , N/A ,$87.73 ,$431.80 ,$34.39 ,$508.00 ,$284.99 ,$34.39 ,$210.31 ,$19.80 ,$18.00 ,$34.39 ,$431.80 ,$73.69 ,$302.77 ,$142.24 ,$457.20 ,$34.39 ,$431.80 ,$140.36 ,$140.36 ,$34.39 ,$330.20 ST. JOSEPH'S HOSPITAL - BREESE,30600583,87808,HC TRICHOMONAS VAGINITIS OPTICAL,306,1 ,$192.00 ,$138.24 ,$5.42 ,$192.00 ,$38.23 ,$124.80 ,$114.62 ,$14.98 ,$53.76 ,$127.10 ,$14.98 ,$127.10 ,$14.98 ,$114.43 ,$114.43 ,$14.98 ,$114.43 ,$30.89 ,$147.84 ,$38.23 ,$14.98 ,$15.29 ,$144.00 ,$136.32 ,$136.32 ,$14.98 ,$136.32 ,$163.20 ,$163.20 ,$163.20 , N/A ,$38.23 ,$163.20 ,$14.98 ,$192.00 ,$107.71 ,$14.98 ,$79.49 ,$5.96 ,$5.42 ,$14.98 ,$163.20 ,$32.11 ,$114.43 ,$53.76 ,$172.80 ,$14.98 ,$163.20 ,$61.16 ,$61.16 ,$14.98 ,$124.80 ST. JOSEPH'S HOSPITAL - BREESE,30600590,87328,HC EIA QL CRYPTOSPORIDIUM AG,306,1 ,$140.00 ,$100.80 ,$6.79 ,$140.00 ,$34.55 ,$91.00 ,$83.58 ,$13.54 ,$39.20 ,$92.68 ,$13.54 ,$92.68 ,$13.54 ,$83.44 ,$83.44 ,$13.54 ,$83.44 ,$27.92 ,$107.80 ,$34.55 ,$13.54 ,$13.82 ,$105.00 ,$99.40 ,$99.40 ,$13.54 ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A ,$34.55 ,$119.00 ,$13.54 ,$140.00 ,$78.54 ,$13.54 ,$57.96 ,$7.47 ,$6.79 ,$13.54 ,$119.00 ,$29.02 ,$83.44 ,$39.20 ,$126.00 ,$13.54 ,$119.00 ,$55.28 ,$55.28 ,$13.54 ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,30600592,87486,HC CHLAMYDIA PNEUM AMP PROBE-90,306,1 ,$270.00 ,$194.40 ,$18.00 ,$270.00 ,$87.73 ,$175.50 ,$161.19 ,$34.39 ,$75.60 ,$178.74 ,$34.39 ,$178.74 ,$34.39 ,$160.92 ,$160.92 ,$34.39 ,$160.92 ,$70.88 ,$207.90 ,$87.73 ,$34.39 ,$35.07 ,$202.50 ,$191.70 ,$191.70 ,$34.39 ,$191.70 ,$229.50 ,$229.50 ,$229.50 , N/A ,$87.73 ,$229.50 ,$34.39 ,$270.00 ,$151.47 ,$34.39 ,$111.78 ,$19.80 ,$18.00 ,$34.39 ,$229.50 ,$73.69 ,$160.92 ,$75.60 ,$243.00 ,$34.39 ,$229.50 ,$140.36 ,$140.36 ,$34.39 ,$175.50 ST. JOSEPH'S HOSPITAL - BREESE,30600593,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$434.00 ,$312.48 ,$5.42 ,$434.00 ,$40.18 ,$282.10 ,$259.10 ,$15.75 ,$121.52 ,$287.31 ,$15.75 ,$287.31 ,$15.75 ,$258.66 ,$258.66 ,$15.75 ,$258.66 ,$32.46 ,$334.18 ,$40.18 ,$15.75 ,$16.06 ,$325.50 ,$308.14 ,$308.14 ,$15.75 ,$308.14 ,$368.90 ,$368.90 ,$368.90 , N/A ,$40.18 ,$368.90 ,$15.75 ,$434.00 ,$243.47 ,$15.75 ,$179.68 ,$5.96 ,$5.42 ,$15.75 ,$368.90 ,$33.75 ,$258.66 ,$121.52 ,$390.60 ,$15.75 ,$368.90 ,$64.28 ,$64.28 ,$15.75 ,$282.10 ST. JOSEPH'S HOSPITAL - BREESE,30600607,87661,HC TRICHOMONAS VAG AMP PROBE,306,1 ,$33.00 ,$23.76 ,$9.24 ,$82.50 ,$82.50 ,$21.45 ,$19.70 ,$32.34 ,$9.24 ,$21.85 ,$32.34 ,$21.85 ,$32.34 ,$19.67 ,$19.67 ,$32.34 ,$19.67 ,$33.00 ,$25.41 ,$82.50 ,$32.34 ,$32.34 ,$24.75 ,$23.43 ,$23.43 ,$32.34 ,$23.43 ,$28.05 ,$28.05 ,$28.05 , N/A ,$33.00 ,$28.05 ,$32.34 ,$33.00 ,$18.51 ,$32.34 ,$13.66 ,$19.80 ,$18.00 ,$32.34 ,$28.05 ,$69.30 ,$19.67 ,$9.24 ,$29.70 ,$32.34 ,$28.05 ,$33.00 ,$33.00 ,$32.34 ,$21.45 ST. JOSEPH'S HOSPITAL - BREESE,30600610,87632,HC RESP VIRUS AMP 6-11 TARGETS-90,306,1 ,"$2,313.00 ","$1,665.36 ",$18.00 ,"$2,313.00 ",$545.15 ,"$1,503.45 ","$1,380.86 ",$213.70 ,$647.64 ,"$1,531.21 ",$213.70 ,"$1,531.21 ",$213.70 ,"$1,378.55 ","$1,378.55 ",$213.70 ,"$1,378.55 ",$440.48 ,$500.00 ,$545.15 ,$213.70 ,$217.97 ,"$1,734.75 ","$1,642.23 ","$1,642.23 ",$213.70 ,"$1,642.23 ","$1,966.05 ","$1,966.05 ","$1,966.05 ", N/A ,$545.15 ,"$1,966.05 ",$213.70 ,"$2,313.00 ","$1,297.59 ",$213.70 ,$957.58 ,$19.80 ,$18.00 ,$213.70 ,"$1,966.05 ",$457.93 ,"$1,378.55 ",$647.64 ,"$2,081.70 ",$213.70 ,"$1,966.05 ",$872.24 ,$872.24 ,$213.70 ,"$1,503.45 " ST. JOSEPH'S HOSPITAL - BREESE,30600611,87512,HC G VAGINALIS DNA SCREEN QN-90,306,1 ,$557.00 ,$401.04 ,$18.00 ,$557.00 ,$104.40 ,$362.05 ,$332.53 ,$40.92 ,$155.96 ,$368.73 ,$40.92 ,$368.73 ,$40.92 ,$331.97 ,$331.97 ,$40.92 ,$331.97 ,$84.36 ,$428.89 ,$104.40 ,$40.92 ,$41.75 ,$417.75 ,$395.47 ,$395.47 ,$40.92 ,$395.47 ,$473.45 ,$473.45 ,$473.45 , N/A ,$104.40 ,$473.45 ,$40.92 ,$557.00 ,$312.48 ,$40.92 ,$230.60 ,$19.80 ,$18.00 ,$40.92 ,$473.45 ,$87.70 ,$331.97 ,$155.96 ,$501.30 ,$40.92 ,$473.45 ,$167.04 ,$167.04 ,$40.92 ,$362.05 ST. JOSEPH'S HOSPITAL - BREESE,30600613,87205,HC URINE FOR EOSINOPHILS-90,306,1 ,$109.00 ,$78.48 ,$4.18 ,$109.00 ,$10.68 ,$70.85 ,$65.07 ,$4.18 ,$30.52 ,$72.16 ,$4.18 ,$72.16 ,$4.18 ,$64.96 ,$64.96 ,$4.18 ,$64.96 ,$8.63 ,$83.93 ,$10.68 ,$4.18 ,$4.27 ,$81.75 ,$77.39 ,$77.39 ,$4.18 ,$77.39 ,$92.65 ,$92.65 ,$92.65 , N/A ,$10.68 ,$92.65 ,$4.18 ,$109.00 ,$61.15 ,$4.18 ,$45.13 ,$5.96 ,$5.42 ,$4.18 ,$92.65 ,$8.97 ,$64.96 ,$30.52 ,$98.10 ,$4.18 ,$92.65 ,$17.08 ,$17.08 ,$4.18 ,$70.85 ST. JOSEPH'S HOSPITAL - BREESE,30600614,87220,HC TISSUE KOH PREP,306,1 ,$70.00 ,$50.40 ,$4.18 ,$70.00 ,$10.68 ,$45.50 ,$41.79 ,$4.18 ,$19.60 ,$46.34 ,$4.18 ,$46.34 ,$4.18 ,$41.72 ,$41.72 ,$4.18 ,$41.72 ,$8.63 ,$53.90 ,$10.68 ,$4.18 ,$4.27 ,$52.50 ,$49.70 ,$49.70 ,$4.18 ,$49.70 ,$59.50 ,$59.50 ,$59.50 , N/A ,$10.68 ,$59.50 ,$4.18 ,$70.00 ,$39.27 ,$4.18 ,$28.98 ,$5.96 ,$5.42 ,$4.18 ,$59.50 ,$8.97 ,$41.72 ,$19.60 ,$63.00 ,$4.18 ,$59.50 ,$17.08 ,$17.08 ,$4.18 ,$45.50 ST. JOSEPH'S HOSPITAL - BREESE,30600619,87481,HC CANDIDA SPECIES DNA/RNA AMP PROBE TECH-90,306,1 ,$253.00 ,$182.16 ,$6.79 ,$253.00 ,$87.73 ,$164.45 ,$151.04 ,$34.39 ,$70.84 ,$167.49 ,$34.39 ,$167.49 ,$34.39 ,$150.79 ,$150.79 ,$34.39 ,$150.79 ,$70.88 ,$194.81 ,$87.73 ,$34.39 ,$35.07 ,$189.75 ,$179.63 ,$179.63 ,$34.39 ,$179.63 ,$215.05 ,$215.05 ,$215.05 , N/A ,$87.73 ,$215.05 ,$34.39 ,$253.00 ,$141.93 ,$34.39 ,$104.74 ,$7.47 ,$6.79 ,$34.39 ,$215.05 ,$73.69 ,$150.79 ,$70.84 ,$227.70 ,$34.39 ,$215.05 ,$140.36 ,$140.36 ,$34.39 ,$164.45 ST. JOSEPH'S HOSPITAL - BREESE,30600623,87635,HC COVID-19 LAB TEST CDC-90,306,1 ,$458.00 ,$329.76 ,$18.00 ,$458.00 ,$128.28 ,$297.70 ,$273.43 ,$50.28 ,$128.24 ,$303.20 ,$50.28 ,$303.20 ,$50.28 ,$272.97 ,$272.97 ,$50.28 ,$272.97 ,$103.65 ,$352.66 ,$128.28 ,$50.28 ,$51.29 ,$343.50 ,$325.18 ,$325.18 ,$50.28 ,$325.18 ,$389.30 ,$389.30 ,$389.30 , N/A ,$128.28 ,$389.30 ,$50.28 ,$51.31 ,$256.94 ,$50.28 ,$189.61 ,$19.80 ,$18.00 ,$50.28 ,$389.30 ,$107.75 ,$272.97 ,$128.24 ,$412.20 ,$50.28 ,$389.30 ,$205.24 ,$205.24 ,$50.28 ,$297.70 ST. JOSEPH'S HOSPITAL - BREESE,30600630,87481,HC CANDIDA SPECIES DNA/RNA AMPLIFIED PROBE TECH,306,1 ,$212.00 ,$152.64 ,$6.79 ,$212.00 ,$87.73 ,$137.80 ,$126.56 ,$34.39 ,$59.36 ,$140.34 ,$34.39 ,$140.34 ,$34.39 ,$126.35 ,$126.35 ,$34.39 ,$126.35 ,$70.88 ,$163.24 ,$87.73 ,$34.39 ,$35.07 ,$159.00 ,$150.52 ,$150.52 ,$34.39 ,$150.52 ,$180.20 ,$180.20 ,$180.20 , N/A ,$87.73 ,$180.20 ,$34.39 ,$212.00 ,$118.93 ,$34.39 ,$87.77 ,$7.47 ,$6.79 ,$34.39 ,$180.20 ,$73.69 ,$126.35 ,$59.36 ,$190.80 ,$34.39 ,$180.20 ,$140.36 ,$140.36 ,$34.39 ,$137.80 ST. JOSEPH'S HOSPITAL - BREESE,30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$125.00 ,$90.00 ,$5.42 ,$125.00 ,$103.45 ,$81.25 ,$74.63 ,$40.55 ,$35.00 ,$82.75 ,$40.55 ,$82.75 ,$40.55 ,$74.50 ,$74.50 ,$40.55 ,$74.50 ,$83.59 ,$96.25 ,$103.45 ,$40.55 ,$41.37 ,$93.75 ,$88.75 ,$88.75 ,$40.55 ,$88.75 ,$106.25 ,$106.25 ,$106.25 , N/A ,$103.45 ,$106.25 ,$40.55 ,$125.00 ,$70.13 ,$40.55 ,$51.75 ,$5.96 ,$5.42 ,$40.55 ,$106.25 ,$86.90 ,$74.50 ,$35.00 ,$112.50 ,$40.55 ,$106.25 ,$125.00 ,$125.00 ,$40.55 ,$81.25 ST. JOSEPH'S HOSPITAL - BREESE,30600637,87635,HC COVID-19 LAB PCR TEST,306,1 ,$458.00 ,$329.76 ,$18.00 ,$458.00 ,$128.28 ,$297.70 ,$273.43 ,$50.28 ,$128.24 ,$303.20 ,$50.28 ,$303.20 ,$50.28 ,$272.97 ,$272.97 ,$50.28 ,$272.97 ,$103.65 ,$352.66 ,$128.28 ,$50.28 ,$51.29 ,$343.50 ,$325.18 ,$325.18 ,$50.28 ,$325.18 ,$389.30 ,$389.30 ,$389.30 , N/A ,$128.28 ,$389.30 ,$50.28 ,$51.31 ,$256.94 ,$50.28 ,$189.61 ,$19.80 ,$18.00 ,$50.28 ,$389.30 ,$107.75 ,$272.97 ,$128.24 ,$412.20 ,$50.28 ,$389.30 ,$205.24 ,$205.24 ,$50.28 ,$297.70 ST. JOSEPH'S HOSPITAL - BREESE,30600638,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION - 90,306,1 ,$86.00 ,$61.92 ,$18.00 ,$128.28 ,$128.28 ,$55.90 ,$51.34 ,$50.28 ,$24.08 ,$56.93 ,$50.28 ,$56.93 ,$50.28 ,$51.26 ,$51.26 ,$50.28 ,$51.26 ,$86.00 ,$66.22 ,$128.28 ,$50.28 ,$51.29 ,$64.50 ,$61.06 ,$61.06 ,$50.28 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$86.00 ,$73.10 ,$50.28 ,$51.31 ,$48.25 ,$50.28 ,$35.60 ,$19.80 ,$18.00 ,$50.28 ,$73.10 ,$107.75 ,$51.26 ,$24.08 ,$77.40 ,$50.28 ,$73.10 ,$86.00 ,$86.00 ,$50.28 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30600639,87150,HC ID NUCLEAR ACID PROBE - 90,306,1 ,$121.00 ,$87.12 ,$5.42 ,$121.00 ,$87.73 ,$78.65 ,$72.24 ,$34.39 ,$33.88 ,$80.10 ,$34.39 ,$80.10 ,$34.39 ,$72.12 ,$72.12 ,$34.39 ,$72.12 ,$70.88 ,$93.17 ,$87.73 ,$34.39 ,$35.07 ,$90.75 ,$85.91 ,$85.91 ,$34.39 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$87.73 ,$102.85 ,$34.39 ,$121.00 ,$67.88 ,$34.39 ,$50.09 ,$5.96 ,$5.42 ,$34.39 ,$102.85 ,$73.69 ,$72.12 ,$33.88 ,$108.90 ,$34.39 ,$102.85 ,$121.00 ,$121.00 ,$34.39 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,30600642,81513,HC APTIMA BV MAAA SPEC CD,306,1 ,$243.00 ,$174.96 ,$26.92 ,$356.58 ,$356.58 ,$157.95 ,$145.07 ,$139.78 ,$68.04 ,$160.87 ,$139.78 ,$160.87 ,$139.78 ,$144.83 ,$144.83 ,$139.78 ,$144.83 ,$243.00 ,$187.11 ,$356.58 ,$139.78 ,$142.57 ,$182.25 ,$172.53 ,$172.53 ,$139.78 ,$172.53 ,$206.55 ,$206.55 ,$206.55 , N/A ,$243.00 ,$206.55 ,$139.78 ,$243.00 ,$136.32 ,$139.78 ,$100.60 ,$29.61 ,$26.92 ,$139.78 ,$206.55 ,$299.52 ,$144.83 ,$68.04 ,$218.70 ,$139.78 ,$206.55 ,$243.00 ,$243.00 ,$139.78 ,$157.95 ST. JOSEPH'S HOSPITAL - BREESE,30600643,87425,HC EIA QL ROTAVIRUS AG- 90,306,1 ,$371.00 ,$267.12 ,$6.79 ,$371.00 ,$29.95 ,$241.15 ,$221.49 ,$11.74 ,$103.88 ,$245.60 ,$11.74 ,$245.60 ,$11.74 ,$221.12 ,$221.12 ,$11.74 ,$221.12 ,$24.20 ,$285.67 ,$29.95 ,$11.74 ,$11.98 ,$278.25 ,$263.41 ,$263.41 ,$11.74 ,$263.41 ,$315.35 ,$315.35 ,$315.35 , N/A ,$29.95 ,$315.35 ,$11.74 ,$371.00 ,$208.13 ,$11.74 ,$153.59 ,$7.47 ,$6.79 ,$11.74 ,$315.35 ,$25.16 ,$221.12 ,$103.88 ,$333.90 ,$11.74 ,$315.35 ,$47.92 ,$47.92 ,$11.74 ,$241.15 ST. JOSEPH'S HOSPITAL - BREESE,30600649,87449,HC NOS EACH ORGANISM AG IA-90,306,1 ,$23.96 ,$17.25 ,$6.71 ,$29.95 ,$29.95 ,$15.57 ,$14.30 ,$11.74 ,$6.71 ,$15.86 ,$11.74 ,$15.86 ,$11.74 ,$14.28 ,$14.28 ,$11.74 ,$14.28 ,$23.96 ,$18.45 ,$29.95 ,$11.74 ,$11.98 ,$17.97 ,$17.01 ,$17.01 ,$11.74 ,$17.01 ,$20.37 ,$20.37 ,$20.37 , N/A ,$23.96 ,$20.37 ,$11.74 ,$23.96 ,$13.44 ,$11.74 ,$9.92 ,$7.47 ,$6.79 ,$11.74 ,$20.37 ,$25.16 ,$14.28 ,$6.71 ,$21.56 ,$11.74 ,$20.37 ,$23.96 ,$23.96 ,$11.74 ,$15.57 ST. JOSEPH'S HOSPITAL - BREESE,30600652,87324,HC CLOSTRIDIUM AG IA-90,306,1 ,$23.96 ,$17.25 ,$6.71 ,$29.95 ,$29.95 ,$15.57 ,$14.30 ,$11.74 ,$6.71 ,$15.86 ,$11.74 ,$15.86 ,$11.74 ,$14.28 ,$14.28 ,$11.74 ,$14.28 ,$23.96 ,$18.45 ,$29.95 ,$11.74 ,$11.98 ,$17.97 ,$17.01 ,$17.01 ,$11.74 ,$17.01 ,$20.37 ,$20.37 ,$20.37 , N/A ,$23.96 ,$20.37 ,$11.74 ,$23.96 ,$13.44 ,$11.74 ,$9.92 ,$7.47 ,$6.79 ,$11.74 ,$20.37 ,$25.16 ,$14.28 ,$6.71 ,$21.56 ,$11.74 ,$20.37 ,$23.96 ,$23.96 ,$11.74 ,$15.57 ST. JOSEPH'S HOSPITAL - BREESE,30600655,87491,HC CHLAMYDIA TRACH DNA AMP PROBE-90,306,1 ,$35.09 ,$25.26 ,$6.79 ,$87.73 ,$87.73 ,$22.81 ,$20.95 ,$34.39 ,$9.83 ,$23.23 ,$34.39 ,$23.23 ,$34.39 ,$20.91 ,$20.91 ,$34.39 ,$20.91 ,$35.09 ,$27.02 ,$87.73 ,$34.39 ,$34.39 ,$26.32 ,$24.91 ,$24.91 ,$34.39 ,$24.91 ,$29.83 ,$29.83 ,$29.83 , N/A ,$35.09 ,$29.83 ,$34.39 ,$35.09 ,$19.69 ,$34.39 ,$14.53 ,$7.47 ,$6.79 ,$34.39 ,$29.83 ,$73.69 ,$20.91 ,$9.83 ,$31.58 ,$34.39 ,$29.83 ,$35.09 ,$35.09 ,$34.39 ,$22.81 ST. JOSEPH'S HOSPITAL - BREESE,30600656,87591,HC NEISSERIA GONORRHOEAE DNA AMP PROBE-90,306,1 ,$35.09 ,$25.26 ,$9.83 ,$87.73 ,$87.73 ,$22.81 ,$20.95 ,$34.39 ,$9.83 ,$23.23 ,$34.39 ,$23.23 ,$34.39 ,$20.91 ,$20.91 ,$34.39 ,$20.91 ,$35.09 ,$27.02 ,$87.73 ,$34.39 ,$34.39 ,$26.32 ,$24.91 ,$24.91 ,$34.39 ,$24.91 ,$29.83 ,$29.83 ,$29.83 , N/A ,$35.09 ,$29.83 ,$34.39 ,$35.09 ,$19.69 ,$34.39 ,$14.53 ,$19.80 ,$18.00 ,$34.39 ,$29.83 ,$73.69 ,$20.91 ,$9.83 ,$31.58 ,$34.39 ,$29.83 ,$35.09 ,$35.09 ,$34.39 ,$22.81 ST. JOSEPH'S HOSPITAL - BREESE,30600662,87593,HC INFECT AMP ORTHOPOXVIRUS/MONKEYPOX DNA-90,306,1 ,$113.00 ,$81.36 ,$18.00 ,$113.00 , N/A ,$73.45 ,$67.46 , N/A ,$31.64 ,$74.81 , N/A ,$74.81 , N/A ,$67.35 ,$67.35 , N/A ,$67.35 , N/A ,$87.01 , N/A , N/A , N/A ,$84.75 ,$80.23 ,$80.23 , N/A ,$80.23 ,$96.05 ,$96.05 ,$96.05 , N/A , N/A ,$96.05 , N/A ,$113.00 ,$63.39 , N/A ,$46.78 ,$19.80 ,$18.00 , N/A ,$96.05 , N/A ,$67.35 ,$31.64 ,$101.70 , N/A ,$96.05 ,$113.00 ,$113.00 , N/A ,$73.45 ST. JOSEPH'S HOSPITAL - BREESE,30682004,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$268.00 ,$192.96 ,$6.79 ,$268.00 ,$93.18 ,$174.20 ,$160.00 ,$36.52 ,$75.04 ,$177.42 ,$36.52 ,$177.42 ,$36.52 ,$159.73 ,$159.73 ,$36.52 ,$159.73 ,$75.29 ,$206.36 ,$93.18 ,$36.52 ,$37.26 ,$201.00 ,$190.28 ,$190.28 ,$36.52 ,$190.28 ,$227.80 ,$227.80 ,$227.80 , N/A ,$93.18 ,$227.80 ,$36.52 ,$268.00 ,$150.35 ,$36.52 ,$110.95 ,$7.47 ,$6.79 ,$36.52 ,$227.80 ,$78.27 ,$159.73 ,$75.04 ,$241.20 ,$36.52 ,$227.80 ,$149.08 ,$149.08 ,$36.52 ,$174.20 ST. JOSEPH'S HOSPITAL - BREESE,30682010,87635,HC COVID-19 LAB TEST NON-CDC-90,306,1 ,$458.00 ,$329.76 ,$18.00 ,$458.00 ,$128.28 ,$297.70 ,$273.43 ,$50.28 ,$128.24 ,$303.20 ,$50.28 ,$303.20 ,$50.28 ,$272.97 ,$272.97 ,$50.28 ,$272.97 ,$103.65 ,$352.66 ,$128.28 ,$50.28 ,$51.29 ,$343.50 ,$325.18 ,$325.18 ,$50.28 ,$325.18 ,$389.30 ,$389.30 ,$389.30 , N/A ,$128.28 ,$389.30 ,$50.28 ,$51.31 ,$256.94 ,$50.28 ,$189.61 ,$19.80 ,$18.00 ,$50.28 ,$389.30 ,$107.75 ,$272.97 ,$128.24 ,$412.20 ,$50.28 ,$389.30 ,$205.24 ,$205.24 ,$50.28 ,$297.70 ST. JOSEPH'S HOSPITAL - BREESE,30682012,87635,HC COVID-19 LAB TEST,306,1 ,$458.00 ,$329.76 ,$18.00 ,$458.00 ,$128.28 ,$297.70 ,$273.43 ,$50.28 ,$128.24 ,$303.20 ,$50.28 ,$303.20 ,$50.28 ,$272.97 ,$272.97 ,$50.28 ,$272.97 ,$103.65 ,$352.66 ,$128.28 ,$50.28 ,$51.29 ,$343.50 ,$325.18 ,$325.18 ,$50.28 ,$325.18 ,$389.30 ,$389.30 ,$389.30 , N/A ,$128.28 ,$389.30 ,$50.28 ,$51.31 ,$256.94 ,$50.28 ,$189.61 ,$19.80 ,$18.00 ,$50.28 ,$389.30 ,$107.75 ,$272.97 ,$128.24 ,$412.20 ,$50.28 ,$389.30 ,$205.24 ,$205.24 ,$50.28 ,$297.70 ST. JOSEPH'S HOSPITAL - BREESE,30682013,87635,HC COVID-19 LAB TEST,306,1 ,$398.00 ,$286.56 ,$18.00 ,$398.00 ,$128.28 ,$258.70 ,$237.61 ,$50.28 ,$111.44 ,$263.48 ,$50.28 ,$263.48 ,$50.28 ,$237.21 ,$237.21 ,$50.28 ,$237.21 ,$103.65 ,$306.46 ,$128.28 ,$50.28 ,$51.29 ,$298.50 ,$282.58 ,$282.58 ,$50.28 ,$282.58 ,$338.30 ,$338.30 ,$338.30 , N/A ,$128.28 ,$338.30 ,$50.28 ,$51.31 ,$223.28 ,$50.28 ,$164.77 ,$19.80 ,$18.00 ,$50.28 ,$338.30 ,$107.75 ,$237.21 ,$111.44 ,$358.20 ,$50.28 ,$338.30 ,$205.24 ,$205.24 ,$50.28 ,$258.70 ST. JOSEPH'S HOSPITAL - BREESE,30682015,86769,HC SARS-COV-2 COVID-19 ANTIBODY-90,306,1 ,$298.00 ,$214.56 ,$6.79 ,$298.00 ,$105.33 ,$193.70 ,$177.91 ,$41.29 ,$83.44 ,$197.28 ,$41.29 ,$197.28 ,$41.29 ,$177.61 ,$177.61 ,$41.29 ,$177.61 ,$85.10 ,$229.46 ,$105.33 ,$41.29 ,$42.11 ,$223.50 ,$211.58 ,$211.58 ,$41.29 ,$211.58 ,$253.30 ,$253.30 ,$253.30 , N/A ,$105.33 ,$253.30 ,$41.29 ,$298.00 ,$167.18 ,$41.29 ,$123.37 ,$7.47 ,$6.79 ,$41.29 ,$253.30 ,$88.47 ,$177.61 ,$83.44 ,$268.20 ,$41.29 ,$253.30 ,$168.52 ,$168.52 ,$41.29 ,$193.70 ST. JOSEPH'S HOSPITAL - BREESE,30682022,87102,HC CULTURE FUNGUS OTHER-90,306,1 ,$24.46 ,$17.61 ,$5.42 ,$24.46 ,$21.03 ,$15.90 ,$14.60 ,$8.24 ,$6.85 ,$16.19 ,$8.24 ,$16.19 ,$8.24 ,$14.58 ,$14.58 ,$8.24 ,$14.58 ,$16.99 ,$18.83 ,$21.03 ,$8.24 ,$8.41 ,$18.35 ,$17.37 ,$17.37 ,$8.24 ,$17.37 ,$20.79 ,$20.79 ,$20.79 , N/A ,$21.03 ,$20.79 ,$8.24 ,$24.46 ,$13.72 ,$8.24 ,$10.13 ,$5.96 ,$5.42 ,$8.24 ,$20.79 ,$17.66 ,$14.58 ,$6.85 ,$22.01 ,$8.24 ,$20.79 ,$24.46 ,$24.46 ,$8.24 ,$15.90 ST. JOSEPH'S HOSPITAL - BREESE,30682023,87426,HC SARS COVID ANTIGEN TEST,306,1 ,$86.00 ,$61.92 ,$5.42 ,$88.33 ,$88.33 ,$55.90 ,$51.34 ,$34.62 ,$24.08 ,$56.93 ,$34.62 ,$56.93 ,$34.62 ,$51.26 ,$51.26 ,$34.62 ,$51.26 ,$71.37 ,$66.22 ,$88.33 ,$34.62 ,$35.32 ,$64.50 ,$61.06 ,$61.06 ,$34.62 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$86.00 ,$73.10 ,$34.62 ,$37.79 ,$48.25 ,$34.62 ,$35.60 ,$5.96 ,$5.42 ,$34.62 ,$73.10 ,$74.19 ,$51.26 ,$24.08 ,$77.40 ,$34.62 ,$73.10 ,$86.00 ,$86.00 ,$34.62 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30682024,87635,HC SARS-COV-2 COVID-19 TEST,306,1 ,$86.00 ,$61.92 ,$18.00 ,$128.28 ,$128.28 ,$55.90 ,$51.34 ,$50.28 ,$24.08 ,$56.93 ,$50.28 ,$56.93 ,$50.28 ,$51.26 ,$51.26 ,$50.28 ,$51.26 ,$86.00 ,$66.22 ,$128.28 ,$50.28 ,$51.29 ,$64.50 ,$61.06 ,$61.06 ,$50.28 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$86.00 ,$73.10 ,$50.28 ,$51.31 ,$48.25 ,$50.28 ,$35.60 ,$19.80 ,$18.00 ,$50.28 ,$73.10 ,$107.75 ,$51.26 ,$24.08 ,$77.40 ,$50.28 ,$73.10 ,$86.00 ,$86.00 ,$50.28 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30682025,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION,306,1 ,$86.00 ,$61.92 ,$18.00 ,$128.28 ,$128.28 ,$55.90 ,$51.34 ,$50.28 ,$24.08 ,$56.93 ,$50.28 ,$56.93 ,$50.28 ,$51.26 ,$51.26 ,$50.28 ,$51.26 ,$86.00 ,$66.22 ,$128.28 ,$50.28 ,$51.29 ,$64.50 ,$61.06 ,$61.06 ,$50.28 ,$61.06 ,$73.10 ,$73.10 ,$73.10 , N/A ,$86.00 ,$73.10 ,$50.28 ,$51.31 ,$48.25 ,$50.28 ,$35.60 ,$19.80 ,$18.00 ,$50.28 ,$73.10 ,$107.75 ,$51.26 ,$24.08 ,$77.40 ,$50.28 ,$73.10 ,$86.00 ,$86.00 ,$50.28 ,$55.90 ST. JOSEPH'S HOSPITAL - BREESE,30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$142.00 ,$102.24 ,$2.71 ,$142.00 ,$7.93 ,$92.30 ,$84.77 ,$3.11 ,$39.76 ,$94.00 ,$3.11 ,$94.00 ,$3.11 ,$84.63 ,$84.63 ,$3.11 ,$84.63 ,$6.40 ,$109.34 ,$7.93 ,$3.11 ,$3.17 ,$106.50 ,$100.82 ,$100.82 ,$3.11 ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A ,$7.93 ,$120.70 ,$3.11 ,$3.17 ,$79.66 ,$3.11 ,$58.79 ,$2.98 ,$2.71 ,$3.11 ,$120.70 ,$6.66 ,$84.63 ,$39.76 ,$127.80 ,$3.11 ,$120.70 ,$12.68 ,$12.68 ,$3.11 ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$65.00 ,$46.80 ,$1.71 ,$65.00 ,$5.63 ,$42.25 ,$38.81 ,$2.20 ,$18.20 ,$43.03 ,$2.20 ,$43.03 ,$2.20 ,$38.74 ,$38.74 ,$2.20 ,$38.74 ,$4.55 ,$50.05 ,$5.63 ,$2.20 ,$2.25 ,$48.75 ,$46.15 ,$46.15 ,$2.20 ,$46.15 ,$55.25 ,$55.25 ,$55.25 , N/A ,$5.63 ,$55.25 ,$2.20 ,$65.00 ,$36.47 ,$2.20 ,$26.91 ,$1.88 ,$1.71 ,$2.20 ,$55.25 ,$4.73 ,$38.74 ,$18.20 ,$58.50 ,$2.20 ,$55.25 ,$9.00 ,$9.00 ,$2.20 ,$42.25 ST. JOSEPH'S HOSPITAL - BREESE,30700115,81015,HC URINALYSIS MICRO ONLY,307,1 ,$49.00 ,$35.28 ,$2.71 ,$49.00 ,$7.63 ,$31.85 ,$29.25 ,$2.99 ,$13.72 ,$32.44 ,$2.99 ,$32.44 ,$2.99 ,$29.20 ,$29.20 ,$2.99 ,$29.20 ,$6.16 ,$37.73 ,$7.63 ,$2.99 ,$3.05 ,$36.75 ,$34.79 ,$34.79 ,$2.99 ,$34.79 ,$41.65 ,$41.65 ,$41.65 , N/A ,$7.63 ,$41.65 ,$2.99 ,$49.00 ,$27.49 ,$2.99 ,$20.29 ,$2.98 ,$2.71 ,$2.99 ,$41.65 ,$6.41 ,$29.20 ,$13.72 ,$44.10 ,$2.99 ,$41.65 ,$12.20 ,$12.20 ,$2.99 ,$31.85 ST. JOSEPH'S HOSPITAL - BREESE,30700116,81025,HC URINE PREGNANCY TEST,307,1 ,$130.00 ,$93.60 ,$2.71 ,$130.00 ,$21.53 ,$84.50 ,$77.61 ,$8.44 ,$36.40 ,$86.06 ,$8.44 ,$86.06 ,$8.44 ,$77.48 ,$77.48 ,$8.44 ,$77.48 ,$17.39 ,$100.10 ,$21.53 ,$8.44 ,$8.60 ,$97.50 ,$92.30 ,$92.30 ,$8.44 ,$92.30 ,$110.50 ,$110.50 ,$110.50 , N/A ,$21.53 ,$110.50 ,$8.44 ,$8.61 ,$72.93 ,$8.44 ,$53.82 ,$2.98 ,$2.71 ,$8.44 ,$110.50 ,$18.08 ,$77.48 ,$36.40 ,$117.00 ,$8.44 ,$110.50 ,$34.44 ,$34.44 ,$8.44 ,$84.50 ST. JOSEPH'S HOSPITAL - BREESE,30700117,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$36.00 ,$25.92 ,$2.71 ,$36.00 ,$9.10 ,$23.40 ,$21.49 ,$3.57 ,$10.08 ,$23.83 ,$3.57 ,$23.83 ,$3.57 ,$21.46 ,$21.46 ,$3.57 ,$21.46 ,$7.35 ,$27.72 ,$9.10 ,$3.57 ,$3.64 ,$27.00 ,$25.56 ,$25.56 ,$3.57 ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A ,$9.10 ,$30.60 ,$3.57 ,$36.00 ,$20.20 ,$3.57 ,$14.90 ,$2.98 ,$2.71 ,$3.57 ,$30.60 ,$7.64 ,$21.46 ,$10.08 ,$32.40 ,$3.57 ,$30.60 ,$14.56 ,$14.56 ,$3.57 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,30700124,81003,HC URINALYSIS AUTO W/O MICRO -90,307,1 ,$4.27 ,$3.07 ,$1.20 ,$5.63 ,$5.63 ,$2.78 ,$2.55 ,$2.20 ,$1.20 ,$2.83 ,$2.20 ,$2.83 ,$2.20 ,$2.54 ,$2.54 ,$2.20 ,$2.54 ,$4.27 ,$3.29 ,$5.63 ,$2.20 ,$2.25 ,$3.20 ,$3.03 ,$3.03 ,$2.20 ,$3.03 ,$3.63 ,$3.63 ,$3.63 , N/A ,$4.27 ,$3.63 ,$2.20 ,$4.27 ,$2.40 ,$2.20 ,$1.77 ,$1.88 ,$1.71 ,$2.20 ,$3.63 ,$4.73 ,$2.54 ,$1.20 ,$3.84 ,$2.20 ,$3.63 ,$4.27 ,$4.27 ,$2.20 ,$2.78 ST. JOSEPH'S HOSPITAL - BREESE,31000128,81162,HC BRCA1 AND BRCA2 FULL SEQ/DUPE/DEL ANALYSIS -90,310,1 ,"$5,015.00 ","$3,610.80 ",$248.66 ,"$5,015.00 ","$4,562.20 ","$3,259.75 ","$2,993.96 ","$1,788.38 ","$1,404.20 ","$3,319.93 ","$1,788.38 ","$3,319.93 ","$1,788.38 ","$2,988.94 ","$2,988.94 ","$1,788.38 ","$2,988.94 ","$3,686.26 ",$500.00 ,"$4,562.20 ","$1,788.38 ","$1,824.15 ","$3,761.25 ","$3,560.65 ","$3,560.65 ","$1,788.38 ","$3,560.65 ","$4,262.75 ","$4,262.75 ","$4,262.75 ", N/A ,"$4,562.20 ","$4,262.75 ","$1,788.38 ","$5,015.00 ","$2,813.42 ","$1,788.38 ","$2,076.21 ",$273.53 ,$248.66 ,"$1,788.38 ","$4,262.75 ","$3,832.25 ","$2,988.94 ","$1,404.20 ","$4,513.50 ","$1,788.38 ","$4,262.75 ","$5,015.00 ","$5,015.00 ","$1,788.38 ","$3,259.75 " ST. JOSEPH'S HOSPITAL - BREESE,31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$347.00 ,$249.84 ,$87.62 ,$409.90 ,$409.90 ,$225.55 ,$207.16 ,$160.68 ,$97.16 ,$229.71 ,$160.68 ,$229.71 ,$160.68 ,$206.81 ,$206.81 ,$160.68 ,$206.81 ,$331.20 ,$267.19 ,$409.90 ,$160.68 ,$163.90 ,$260.25 ,$246.37 ,$246.37 ,$160.68 ,$246.37 ,$294.95 ,$294.95 ,$294.95 , N/A ,$347.00 ,$294.95 ,$160.68 ,$347.00 ,$194.67 ,$160.68 ,$143.66 ,$96.38 ,$87.62 ,$160.68 ,$294.95 ,$344.32 ,$206.81 ,$97.16 ,$312.30 ,$160.68 ,$294.95 ,$347.00 ,$347.00 ,$160.68 ,$225.55 ST. JOSEPH'S HOSPITAL - BREESE,31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$347.00 ,$249.84 ,$87.62 ,$362.10 ,$362.10 ,$225.55 ,$207.16 ,$141.94 ,$97.16 ,$229.71 ,$141.94 ,$229.71 ,$141.94 ,$206.81 ,$206.81 ,$141.94 ,$206.81 ,$292.58 ,$267.19 ,$362.10 ,$141.94 ,$144.79 ,$260.25 ,$246.37 ,$246.37 ,$141.94 ,$246.37 ,$294.95 ,$294.95 ,$294.95 , N/A ,$347.00 ,$294.95 ,$141.94 ,$347.00 ,$194.67 ,$141.94 ,$143.66 ,$96.38 ,$87.62 ,$141.94 ,$294.95 ,$304.16 ,$206.81 ,$97.16 ,$312.30 ,$141.94 ,$294.95 ,$347.00 ,$347.00 ,$141.94 ,$225.55 ST. JOSEPH'S HOSPITAL - BREESE,31000134,81210,HC BRAF GENE ANALYS V600E VAR-90,310,1 ,$494.00 ,$355.68 ,$87.62 ,$494.00 ,$438.50 ,$321.10 ,$294.92 ,$171.89 ,$138.32 ,$327.03 ,$171.89 ,$327.03 ,$171.89 ,$294.42 ,$294.42 ,$171.89 ,$294.42 ,$354.31 ,$380.38 ,$438.50 ,$171.89 ,$175.33 ,$370.50 ,$350.74 ,$350.74 ,$171.89 ,$350.74 ,$419.90 ,$419.90 ,$419.90 , N/A ,$438.50 ,$419.90 ,$171.89 ,$494.00 ,$277.13 ,$171.89 ,$204.52 ,$96.38 ,$87.62 ,$171.89 ,$419.90 ,$368.34 ,$294.42 ,$138.32 ,$444.60 ,$171.89 ,$419.90 ,$494.00 ,$494.00 ,$171.89 ,$321.10 ST. JOSEPH'S HOSPITAL - BREESE,31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,$391.00 ,$281.52 ,$26.92 ,$977.50 ,$977.50 ,$254.15 ,$233.43 ,$383.18 ,$109.48 ,$258.84 ,$383.18 ,$258.84 ,$383.18 ,$233.04 ,$233.04 ,$383.18 ,$233.04 ,$391.00 ,$301.07 ,$977.50 ,$383.18 ,$383.18 ,$293.25 ,$277.61 ,$277.61 ,$383.18 ,$277.61 ,$332.35 ,$332.35 ,$332.35 , N/A ,$391.00 ,$332.35 ,$383.18 ,$391.00 ,$219.35 ,$383.18 ,$161.87 ,$29.61 ,$26.92 ,$383.18 ,$332.35 ,$821.10 ,$233.04 ,$109.48 ,$351.90 ,$383.18 ,$332.35 ,$391.00 ,$391.00 ,$383.18 ,$254.15 ST. JOSEPH'S HOSPITAL - BREESE,31000139,81229,HC CYTOGENOMIC MICROARRY ASSAY-90,310,1 ,"$1,442.00 ","$1,038.24 ",$248.66 ,"$2,900.00 ","$2,900.00 ",$937.30 ,$860.87 ,"$1,136.80 ",$403.76 ,$954.60 ,"$1,136.80 ",$954.60 ,"$1,136.80 ",$859.43 ,$859.43 ,"$1,136.80 ",$859.43 ,"$1,442.00 ",$500.00 ,"$2,900.00 ","$1,136.80 ","$1,159.54 ","$1,081.50 ","$1,023.82 ","$1,023.82 ","$1,136.80 ","$1,023.82 ","$1,225.70 ","$1,225.70 ","$1,225.70 ", N/A ,"$1,442.00 ","$1,225.70 ","$1,136.80 ","$1,442.00 ",$808.96 ,"$1,136.80 ",$596.99 ,$273.53 ,$248.66 ,"$1,136.80 ","$1,225.70 ","$2,436.00 ",$859.43 ,$403.76 ,"$1,297.80 ","$1,136.80 ","$1,225.70 ","$1,442.00 ","$1,442.00 ","$1,136.80 ",$937.30 ST. JOSEPH'S HOSPITAL - BREESE,31000140,81225,HC CYP2C19 GENE ANYL COMMON VARIANTS-90,310,1 ,"$1,005.00 ",$723.60 ,$87.62 ,"$1,005.00 ",$728.40 ,$653.25 ,$599.99 ,$285.53 ,$281.40 ,$665.31 ,$285.53 ,$665.31 ,$285.53 ,$598.98 ,$598.98 ,$285.53 ,$598.98 ,$588.55 ,$500.00 ,$728.40 ,$285.53 ,$291.25 ,$753.75 ,$713.55 ,$713.55 ,$285.53 ,$713.55 ,$854.25 ,$854.25 ,$854.25 , N/A ,$728.40 ,$854.25 ,$285.53 ,"$1,005.00 ",$563.81 ,$285.53 ,$416.07 ,$96.38 ,$87.62 ,$285.53 ,$854.25 ,$611.86 ,$598.98 ,$281.40 ,$904.50 ,$285.53 ,$854.25 ,"$1,005.00 ","$1,005.00 ",$285.53 ,$653.25 ST. JOSEPH'S HOSPITAL - BREESE,31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$568.00 ,$408.96 ,$26.92 ,$568.00 ,$164.23 ,$369.20 ,$339.10 ,$64.38 ,$159.04 ,$376.02 ,$64.38 ,$376.02 ,$64.38 ,$338.53 ,$338.53 ,$64.38 ,$338.53 ,$132.69 ,$437.36 ,$164.23 ,$64.38 ,$65.66 ,$426.00 ,$403.28 ,$403.28 ,$64.38 ,$403.28 ,$482.80 ,$482.80 ,$482.80 , N/A ,$164.23 ,$482.80 ,$64.38 ,$568.00 ,$318.65 ,$64.38 ,$235.15 ,$29.61 ,$26.92 ,$64.38 ,$482.80 ,$137.95 ,$338.53 ,$159.04 ,$511.20 ,$64.38 ,$482.80 ,$262.76 ,$262.76 ,$64.38 ,$369.20 ST. JOSEPH'S HOSPITAL - BREESE,31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$194.00 ,$139.68 ,$26.92 ,$194.00 ,$183.43 ,$126.10 ,$115.82 ,$71.90 ,$54.32 ,$128.43 ,$71.90 ,$128.43 ,$71.90 ,$115.62 ,$115.62 ,$71.90 ,$115.62 ,$148.21 ,$149.38 ,$183.43 ,$71.90 ,$73.34 ,$145.50 ,$137.74 ,$137.74 ,$71.90 ,$137.74 ,$164.90 ,$164.90 ,$164.90 , N/A ,$183.43 ,$164.90 ,$71.90 ,$194.00 ,$108.83 ,$71.90 ,$80.32 ,$29.61 ,$26.92 ,$71.90 ,$164.90 ,$154.08 ,$115.62 ,$54.32 ,$174.60 ,$71.90 ,$164.90 ,$194.00 ,$194.00 ,$71.90 ,$126.10 ST. JOSEPH'S HOSPITAL - BREESE,31000146,81243,HC FMR1 GENE DETECTION -90,310,1 ,$499.00 ,$359.28 ,$26.92 ,$499.00 , N/A ,$324.35 ,$297.90 ,$149.70 ,$139.72 ,$330.34 , N/A ,$330.34 , N/A ,$297.40 ,$297.40 , N/A ,$297.40 ,$224.55 ,$384.23 ,$349.30 , N/A , N/A ,$374.25 ,$354.29 ,$354.29 , N/A ,$354.29 ,$424.15 ,$424.15 ,$424.15 , N/A , N/A ,$424.15 , N/A ,$499.00 ,$279.94 , N/A ,$206.59 ,$29.61 ,$26.92 , N/A ,$424.15 ,$299.40 ,$297.40 ,$139.72 ,$449.10 , N/A ,$424.15 ,$228.16 ,$228.16 , N/A ,$324.35 ST. JOSEPH'S HOSPITAL - BREESE,31000147,81244,HC FMR1 GENE CHARACTERIZATION - 90,310,1 ,$261.00 ,$187.92 ,$26.92 ,$261.00 ,$112.23 ,$169.65 ,$155.82 ,$43.99 ,$73.08 ,$172.78 ,$43.99 ,$172.78 ,$43.99 ,$155.56 ,$155.56 ,$43.99 ,$155.56 ,$90.68 ,$200.97 ,$112.23 ,$43.99 ,$44.87 ,$195.75 ,$185.31 ,$185.31 ,$43.99 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$112.23 ,$221.85 ,$43.99 ,$261.00 ,$146.42 ,$43.99 ,$108.05 ,$29.61 ,$26.92 ,$43.99 ,$221.85 ,$94.27 ,$155.56 ,$73.08 ,$234.90 ,$43.99 ,$221.85 ,$179.56 ,$179.56 ,$43.99 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,31000149,81256,HC HFE GENE ANALYSIS -90,310,1 ,$499.00 ,$359.28 ,$26.92 ,$499.00 ,$163.40 ,$324.35 ,$297.90 ,$64.05 ,$139.72 ,$330.34 ,$64.05 ,$330.34 ,$64.05 ,$297.40 ,$297.40 ,$64.05 ,$297.40 ,$132.03 ,$384.23 ,$163.40 ,$64.05 ,$65.34 ,$374.25 ,$354.29 ,$354.29 ,$64.05 ,$354.29 ,$424.15 ,$424.15 ,$424.15 , N/A ,$163.40 ,$424.15 ,$64.05 ,$499.00 ,$279.94 ,$64.05 ,$206.59 ,$29.61 ,$26.92 ,$64.05 ,$424.15 ,$137.26 ,$297.40 ,$139.72 ,$449.10 ,$64.05 ,$424.15 ,$261.44 ,$261.44 ,$64.05 ,$324.35 ST. JOSEPH'S HOSPITAL - BREESE,31000151,81261,HC IGH GENE ANALYSIS REARRANGEMENT AMP-90,310,1 ,"$1,413.00 ","$1,017.36 ",$87.62 ,"$1,413.00 ",$494.98 ,$918.45 ,$843.56 ,$194.03 ,$395.64 ,$935.41 ,$194.03 ,$935.41 ,$194.03 ,$842.15 ,$842.15 ,$194.03 ,$842.15 ,$399.94 ,$500.00 ,$494.98 ,$194.03 ,$197.91 ,"$1,059.75 ","$1,003.23 ","$1,003.23 ",$194.03 ,"$1,003.23 ","$1,201.05 ","$1,201.05 ","$1,201.05 ", N/A ,$494.98 ,"$1,201.05 ",$194.03 ,"$1,413.00 ",$792.69 ,$194.03 ,$584.98 ,$96.38 ,$87.62 ,$194.03 ,"$1,201.05 ",$415.78 ,$842.15 ,$395.64 ,"$1,271.70 ",$194.03 ,"$1,201.05 ",$791.96 ,$791.96 ,$194.03 ,$918.45 ST. JOSEPH'S HOSPITAL - BREESE,31000153,81264,HC IGK GENE REARRANGE ANALYSIS-90,310,1 ,"$1,402.00 ","$1,009.44 ",$87.62 ,"$1,402.00 ",$431.83 ,$911.30 ,$836.99 ,$169.28 ,$392.56 ,$928.12 ,$169.28 ,$928.12 ,$169.28 ,$835.59 ,$835.59 ,$169.28 ,$835.59 ,$348.91 ,$500.00 ,$431.83 ,$169.28 ,$172.66 ,"$1,051.50 ",$995.42 ,$995.42 ,$169.28 ,$995.42 ,"$1,191.70 ","$1,191.70 ","$1,191.70 ", N/A ,$431.83 ,"$1,191.70 ",$169.28 ,"$1,402.00 ",$786.52 ,$169.28 ,$580.43 ,$96.38 ,$87.62 ,$169.28 ,"$1,191.70 ",$362.73 ,$835.59 ,$392.56 ,"$1,261.80 ",$169.28 ,"$1,191.70 ",$690.92 ,$690.92 ,$169.28 ,$911.30 ST. JOSEPH'S HOSPITAL - BREESE,31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,$476.00 ,$342.72 ,$26.92 ,$476.00 ,$229.15 ,$309.40 ,$284.17 ,$89.83 ,$133.28 ,$315.11 ,$89.83 ,$315.11 ,$89.83 ,$283.70 ,$283.70 ,$89.83 ,$283.70 ,$185.15 ,$366.52 ,$229.15 ,$89.83 ,$91.62 ,$357.00 ,$337.96 ,$337.96 ,$89.83 ,$337.96 ,$404.60 ,$404.60 ,$404.60 , N/A ,$229.15 ,$404.60 ,$89.83 ,$476.00 ,$267.04 ,$89.83 ,$197.06 ,$29.61 ,$26.92 ,$89.83 ,$404.60 ,$192.49 ,$283.70 ,$133.28 ,$428.40 ,$89.83 ,$404.60 ,$366.64 ,$366.64 ,$89.83 ,$309.40 ST. JOSEPH'S HOSPITAL - BREESE,31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$438.00 ,$315.36 ,$26.92 ,$438.00 ,$163.35 ,$284.70 ,$261.49 ,$64.03 ,$122.64 ,$289.96 ,$64.03 ,$289.96 ,$64.03 ,$261.05 ,$261.05 ,$64.03 ,$261.05 ,$131.99 ,$337.26 ,$163.35 ,$64.03 ,$65.32 ,$328.50 ,$310.98 ,$310.98 ,$64.03 ,$310.98 ,$372.30 ,$372.30 ,$372.30 , N/A ,$163.35 ,$372.30 ,$64.03 ,$438.00 ,$245.72 ,$64.03 ,$181.33 ,$29.61 ,$26.92 ,$64.03 ,$372.30 ,$137.21 ,$261.05 ,$122.64 ,$394.20 ,$64.03 ,$372.30 ,$261.36 ,$261.36 ,$64.03 ,$284.70 ST. JOSEPH'S HOSPITAL - BREESE,31000163,81301,HC MICROSATELLITE INSTAB ANALYSIS-90,310,1 ,"$1,206.00 ",$868.32 ,$87.62 ,"$1,206.00 ",$871.40 ,$783.90 ,$719.98 ,$341.59 ,$337.68 ,$798.37 ,$341.59 ,$798.37 ,$341.59 ,$718.78 ,$718.78 ,$341.59 ,$718.78 ,$704.09 ,$500.00 ,$871.40 ,$341.59 ,$348.42 ,$904.50 ,$856.26 ,$856.26 ,$341.59 ,$856.26 ,"$1,025.10 ","$1,025.10 ","$1,025.10 ", N/A ,$871.40 ,"$1,025.10 ",$341.59 ,"$1,206.00 ",$676.57 ,$341.59 ,$499.28 ,$96.38 ,$87.62 ,$341.59 ,"$1,025.10 ",$731.98 ,$718.78 ,$337.68 ,"$1,085.40 ",$341.59 ,"$1,025.10 ","$1,206.00 ","$1,206.00 ",$341.59 ,$783.90 ST. JOSEPH'S HOSPITAL - BREESE,31000172,81340,HC TRB GENE ANALYSIS-90,310,1 ,"$1,385.00 ",$997.20 ,$87.62 ,"$1,385.00 ",$522.30 ,$900.25 ,$826.85 ,$204.74 ,$387.80 ,$916.87 ,$204.74 ,$916.87 ,$204.74 ,$825.46 ,$825.46 ,$204.74 ,$825.46 ,$422.02 ,$500.00 ,$522.30 ,$204.74 ,$208.84 ,"$1,038.75 ",$983.35 ,$983.35 ,$204.74 ,$983.35 ,"$1,177.25 ","$1,177.25 ","$1,177.25 ", N/A ,$522.30 ,"$1,177.25 ",$204.74 ,"$1,385.00 ",$776.99 ,$204.74 ,$573.39 ,$96.38 ,$87.62 ,$204.74 ,"$1,177.25 ",$438.73 ,$825.46 ,$387.80 ,"$1,246.50 ",$204.74 ,"$1,177.25 ",$835.68 ,$835.68 ,$204.74 ,$900.25 ST. JOSEPH'S HOSPITAL - BREESE,31000173,81342,HC TRB GENE ANALYSIS DIRECT PROBE-90,310,1 ,$742.00 ,$534.24 ,$87.62 ,$742.00 ,$503.75 ,$482.30 ,$442.97 ,$197.47 ,$207.76 ,$491.20 ,$197.47 ,$491.20 ,$197.47 ,$442.23 ,$442.23 ,$197.47 ,$442.23 ,$407.03 ,$500.00 ,$503.75 ,$197.47 ,$201.42 ,$556.50 ,$526.82 ,$526.82 ,$197.47 ,$526.82 ,$630.70 ,$630.70 ,$630.70 , N/A ,$503.75 ,$630.70 ,$197.47 ,$742.00 ,$416.26 ,$197.47 ,$307.19 ,$96.38 ,$87.62 ,$197.47 ,$630.70 ,$423.15 ,$442.23 ,$207.76 ,$667.80 ,$197.47 ,$630.70 ,$742.00 ,$742.00 ,$197.47 ,$482.30 ST. JOSEPH'S HOSPITAL - BREESE,31000174,81372,HC CLASS 1 TYPING COMPLETE LOW RESOLUTION-90,310,1 ,$871.00 ,$627.12 ,$87.62 ,"$1,008.98 ","$1,008.98 ",$566.15 ,$519.99 ,$395.52 ,$243.88 ,$576.60 ,$395.52 ,$576.60 ,$395.52 ,$519.12 ,$519.12 ,$395.52 ,$519.12 ,$815.25 ,$500.00 ,"$1,008.98 ",$395.52 ,$403.43 ,$653.25 ,$618.41 ,$618.41 ,$395.52 ,$618.41 ,$740.35 ,$740.35 ,$740.35 , N/A ,$871.00 ,$740.35 ,$395.52 ,$871.00 ,$488.63 ,$395.52 ,$360.59 ,$96.38 ,$87.62 ,$395.52 ,$740.35 ,$847.54 ,$519.12 ,$243.88 ,$783.90 ,$395.52 ,$740.35 ,$871.00 ,$871.00 ,$395.52 ,$566.15 ST. JOSEPH'S HOSPITAL - BREESE,31000178,81377,HC HLA CLASS 2 TYPE 1 AG EQV LR-90,310,1 ,"$1,037.00 ",$746.64 ,$26.92 ,"$1,037.00 ",$236.85 ,$674.05 ,$619.09 ,$92.85 ,$290.36 ,$686.49 ,$92.85 ,$686.49 ,$92.85 ,$618.05 ,$618.05 ,$92.85 ,$618.05 ,$191.37 ,$500.00 ,$236.85 ,$92.85 ,$94.70 ,$777.75 ,$736.27 ,$736.27 ,$92.85 ,$736.27 ,$881.45 ,$881.45 ,$881.45 , N/A ,$236.85 ,$881.45 ,$92.85 ,"$1,037.00 ",$581.76 ,$92.85 ,$429.32 ,$29.61 ,$26.92 ,$92.85 ,$881.45 ,$198.95 ,$618.05 ,$290.36 ,$933.30 ,$92.85 ,$881.45 ,$378.96 ,$378.96 ,$92.85 ,$674.05 ST. JOSEPH'S HOSPITAL - BREESE,31000179,81381,HC HLA 1 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,$586.00 ,$421.92 ,$26.92 ,$586.00 ,$424.75 ,$380.90 ,$349.84 ,$166.50 ,$164.08 ,$387.93 ,$166.50 ,$387.93 ,$166.50 ,$349.26 ,$349.26 ,$166.50 ,$349.26 ,$343.20 ,$451.22 ,$424.75 ,$166.50 ,$169.83 ,$439.50 ,$416.06 ,$416.06 ,$166.50 ,$416.06 ,$498.10 ,$498.10 ,$498.10 , N/A ,$424.75 ,$498.10 ,$166.50 ,$586.00 ,$328.75 ,$166.50 ,$242.60 ,$29.61 ,$26.92 ,$166.50 ,$498.10 ,$356.79 ,$349.26 ,$164.08 ,$527.40 ,$166.50 ,$498.10 ,$586.00 ,$586.00 ,$166.50 ,$380.90 ST. JOSEPH'S HOSPITAL - BREESE,31000180,81383,HC HLA 2 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,"$1,037.00 ",$746.64 ,$26.92 ,"$1,037.00 ",$272.83 ,$674.05 ,$619.09 ,$106.95 ,$290.36 ,$686.49 ,$106.95 ,$686.49 ,$106.95 ,$618.05 ,$618.05 ,$106.95 ,$618.05 ,$220.44 ,$500.00 ,$272.83 ,$106.95 ,$109.08 ,$777.75 ,$736.27 ,$736.27 ,$106.95 ,$736.27 ,$881.45 ,$881.45 ,$881.45 , N/A ,$272.83 ,$881.45 ,$106.95 ,"$1,037.00 ",$581.76 ,$106.95 ,$429.32 ,$29.61 ,$26.92 ,$106.95 ,$881.45 ,$229.17 ,$618.05 ,$290.36 ,$933.30 ,$106.95 ,$881.45 ,$436.52 ,$436.52 ,$106.95 ,$674.05 ST. JOSEPH'S HOSPITAL - BREESE,31000181,81400,HC MOLECULAR PATH PROC LEVEL 1-90,310,1 ,$568.00 ,$408.96 ,$26.92 ,$568.00 ,$159.90 ,$369.20 ,$339.10 ,$62.68 ,$159.04 ,$376.02 ,$62.68 ,$376.02 ,$62.68 ,$338.53 ,$338.53 ,$62.68 ,$338.53 ,$129.20 ,$437.36 ,$159.90 ,$62.68 ,$63.94 ,$426.00 ,$403.28 ,$403.28 ,$62.68 ,$403.28 ,$482.80 ,$482.80 ,$482.80 , N/A ,$159.90 ,$482.80 ,$62.68 ,$568.00 ,$318.65 ,$62.68 ,$235.15 ,$29.61 ,$26.92 ,$62.68 ,$482.80 ,$134.32 ,$338.53 ,$159.04 ,$511.20 ,$62.68 ,$482.80 ,$255.84 ,$255.84 ,$62.68 ,$369.20 ST. JOSEPH'S HOSPITAL - BREESE,31000183,81401,HC MOLECULAR PATH PROC LEVEL 2-90,310,1 ,$997.00 ,$717.84 ,$26.92 ,$997.00 , N/A ,$648.05 ,$595.21 ,$299.10 ,$279.16 ,$660.01 , N/A ,$660.01 , N/A ,$594.21 ,$594.21 , N/A ,$594.21 ,$448.65 ,$500.00 ,$697.90 , N/A , N/A ,$747.75 ,$707.87 ,$707.87 , N/A ,$707.87 ,$847.45 ,$847.45 ,$847.45 , N/A , N/A ,$847.45 , N/A ,$997.00 ,$559.32 , N/A ,$412.76 ,$29.61 ,$26.92 , N/A ,$847.45 ,$598.20 ,$594.21 ,$279.16 ,$897.30 , N/A ,$847.45 ,$548.00 ,$548.00 , N/A ,$648.05 ST. JOSEPH'S HOSPITAL - BREESE,31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,"$1,294.00 ",$931.68 ,$26.92 ,"$1,294.00 ", N/A ,$841.10 ,$772.52 ,$388.20 ,$362.32 ,$856.63 , N/A ,$856.63 , N/A ,$771.22 ,$771.22 , N/A ,$771.22 ,$582.30 ,$500.00 ,$905.80 , N/A , N/A ,$970.50 ,$918.74 ,$918.74 , N/A ,$918.74 ,"$1,099.90 ","$1,099.90 ","$1,099.90 ", N/A , N/A ,"$1,099.90 ", N/A ,"$1,294.00 ",$725.93 , N/A ,$535.72 ,$29.61 ,$26.92 , N/A ,"$1,099.90 ",$776.40 ,$771.22 ,$362.32 ,"$1,164.60 ", N/A ,"$1,099.90 ",$740.80 ,$740.80 , N/A ,$841.10 ST. JOSEPH'S HOSPITAL - BREESE,31000205,81219,HC CALR GENE ANALYSIS EXON 9-90,310,1 ,"$1,240.00 ",$892.80 ,$87.62 ,"$1,240.00 ",$304.08 ,$806.00 ,$740.28 ,$119.20 ,$347.20 ,$820.88 ,$119.20 ,$820.88 ,$119.20 ,$739.04 ,$739.04 ,$119.20 ,$739.04 ,$245.69 ,$500.00 ,$304.08 ,$119.20 ,$121.58 ,$930.00 ,$880.40 ,$880.40 ,$119.20 ,$880.40 ,"$1,054.00 ","$1,054.00 ","$1,054.00 ", N/A ,$304.08 ,"$1,054.00 ",$119.20 ,"$1,240.00 ",$695.64 ,$119.20 ,$513.36 ,$96.38 ,$87.62 ,$119.20 ,"$1,054.00 ",$255.42 ,$739.04 ,$347.20 ,"$1,116.00 ",$119.20 ,"$1,054.00 ",$486.52 ,$486.52 ,$119.20 ,$806.00 ST. JOSEPH'S HOSPITAL - BREESE,31000208,81402,HC MOLECULAR PATHOLOGY PROC LEVEL 3-90,310,1 ,$649.00 ,$467.28 ,$26.92 ,$649.00 , N/A ,$421.85 ,$387.45 ,$194.70 ,$181.72 ,$429.64 , N/A ,$429.64 , N/A ,$386.80 ,$386.80 , N/A ,$386.80 ,$292.05 ,$499.73 ,$454.30 , N/A , N/A ,$486.75 ,$460.79 ,$460.79 , N/A ,$460.79 ,$551.65 ,$551.65 ,$551.65 , N/A , N/A ,$551.65 , N/A ,$649.00 ,$364.09 , N/A ,$268.69 ,$29.61 ,$26.92 , N/A ,$551.65 ,$389.40 ,$386.80 ,$181.72 ,$584.10 , N/A ,$551.65 ,$601.32 ,$601.32 , N/A ,$421.85 ST. JOSEPH'S HOSPITAL - BREESE,31000209,81232,HC DPYD GENE ANALYSIS COMMON VARIANT-90,310,1 ,$603.00 ,$434.16 ,$87.62 ,$603.00 ,$437.03 ,$391.95 ,$359.99 ,$171.31 ,$168.84 ,$399.19 ,$171.31 ,$399.19 ,$171.31 ,$359.39 ,$359.39 ,$171.31 ,$359.39 ,$353.12 ,$464.31 ,$437.03 ,$171.31 ,$174.74 ,$452.25 ,$428.13 ,$428.13 ,$171.31 ,$428.13 ,$512.55 ,$512.55 ,$512.55 , N/A ,$437.03 ,$512.55 ,$171.31 ,$603.00 ,$338.28 ,$171.31 ,$249.64 ,$96.38 ,$87.62 ,$171.31 ,$512.55 ,$367.10 ,$359.39 ,$168.84 ,$542.70 ,$171.31 ,$512.55 ,$603.00 ,$603.00 ,$171.31 ,$391.95 ST. JOSEPH'S HOSPITAL - BREESE,31000214,88285,HC CHROMOSOME ADDL CELLS COUNTED EA STUDY-90,310,1 ,$76.00 ,$54.72 ,$21.28 ,$76.00 ,$67.28 ,$49.40 ,$45.37 ,$26.37 ,$21.28 ,$50.31 ,$26.37 ,$50.31 ,$26.37 ,$45.30 ,$45.30 ,$26.37 ,$45.30 ,$54.36 ,$58.52 ,$67.28 ,$26.37 ,$26.90 ,$57.00 ,$53.96 ,$53.96 ,$26.37 ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A ,$67.28 ,$64.60 ,$26.37 ,$76.00 ,$42.64 ,$26.37 ,$31.46 ,$29.61 ,$26.92 ,$26.37 ,$64.60 ,$56.51 ,$45.30 ,$21.28 ,$68.40 ,$26.37 ,$64.60 ,$76.00 ,$76.00 ,$26.37 ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,31000215,81364,HC HBB FULL GENE SEQUENCE-90,310,1 ,"$1,044.00 ",$751.68 ,$87.62 ,"$1,044.00 ",$811.45 ,$678.60 ,$623.27 ,$318.09 ,$292.32 ,$691.13 ,$318.09 ,$691.13 ,$318.09 ,$622.22 ,$622.22 ,$318.09 ,$622.22 ,$655.65 ,$500.00 ,$811.45 ,$318.09 ,$324.45 ,$783.00 ,$741.24 ,$741.24 ,$318.09 ,$741.24 ,$887.40 ,$887.40 ,$887.40 , N/A ,$811.45 ,$887.40 ,$318.09 ,"$1,044.00 ",$585.68 ,$318.09 ,$432.22 ,$96.38 ,$87.62 ,$318.09 ,$887.40 ,$681.62 ,$622.22 ,$292.32 ,$939.60 ,$318.09 ,$887.40 ,"$1,044.00 ","$1,044.00 ",$318.09 ,$678.60 ST. JOSEPH'S HOSPITAL - BREESE,31000224,81335,HC TPMT GENE ANALYSIS COMMON VARIANTS-90,310,1 ,$476.00 ,$342.72 ,$87.62 ,$476.00 ,$437.03 ,$309.40 ,$284.17 ,$171.31 ,$133.28 ,$315.11 ,$171.31 ,$315.11 ,$171.31 ,$283.70 ,$283.70 ,$171.31 ,$283.70 ,$353.12 ,$366.52 ,$437.03 ,$171.31 ,$174.74 ,$357.00 ,$337.96 ,$337.96 ,$171.31 ,$337.96 ,$404.60 ,$404.60 ,$404.60 , N/A ,$437.03 ,$404.60 ,$171.31 ,$476.00 ,$267.04 ,$171.31 ,$197.06 ,$96.38 ,$87.62 ,$171.31 ,$404.60 ,$367.10 ,$283.70 ,$133.28 ,$428.40 ,$171.31 ,$404.60 ,$476.00 ,$476.00 ,$171.31 ,$309.40 ST. JOSEPH'S HOSPITAL - BREESE,31000226,81450,HC TARGET GENOMIC SEQ ANALYSIS HEMATOLYMPHOID 5-50 GENES-90,310,1 ,"$6,877.00 ","$4,951.44 ",$87.62 ,"$6,877.00 ","$1,898.83 ","$4,470.05 ","$4,105.57 ",$744.34 ,"$1,925.56 ","$4,552.57 ",$744.34 ,"$4,552.57 ",$744.34 ,"$4,098.69 ","$4,098.69 ",$744.34 ,"$4,098.69 ","$1,534.25 ",$500.00 ,"$1,898.83 ",$744.34 ,$759.23 ,"$5,157.75 ","$4,882.67 ","$4,882.67 ",$744.34 ,"$4,882.67 ","$5,845.45 ","$5,845.45 ","$5,845.45 ", N/A ,"$1,898.83 ","$5,845.45 ",$744.34 ,"$6,877.00 ","$3,858.00 ",$744.34 ,"$2,847.08 ",$96.38 ,$87.62 ,$744.34 ,"$5,845.45 ","$1,595.01 ","$4,098.69 ","$1,925.56 ","$6,189.30 ",$744.34 ,"$5,845.45 ","$3,038.12 ","$3,038.12 ",$744.34 ,"$4,470.05 " ST. JOSEPH'S HOSPITAL - BREESE,31000228,81350,HC UGT1A1 GENE ANALYSIS COM VARIANTS-90,310,1 ,$807.00 ,$581.04 ,$26.92 ,$807.00 ,$585.00 ,$524.55 ,$481.78 ,$229.32 ,$225.96 ,$534.23 ,$229.32 ,$534.23 ,$229.32 ,$480.97 ,$480.97 ,$229.32 ,$480.97 ,$472.68 ,$500.00 ,$585.00 ,$229.32 ,$233.91 ,$605.25 ,$572.97 ,$572.97 ,$229.32 ,$572.97 ,$685.95 ,$685.95 ,$685.95 , N/A ,$585.00 ,$685.95 ,$229.32 ,$807.00 ,$452.73 ,$229.32 ,$334.10 ,$29.61 ,$26.92 ,$229.32 ,$685.95 ,$491.40 ,$480.97 ,$225.96 ,$726.30 ,$229.32 ,$685.95 ,$807.00 ,$807.00 ,$229.32 ,$524.55 ST. JOSEPH'S HOSPITAL - BREESE,31000248,81226,HC CYP2D6 GENE COM VARIANTS-90,310,1 ,"$1,556.00 ","$1,120.32 ",$248.66 ,"$1,556.00 ","$1,127.28 ","$1,011.40 ",$928.93 ,$441.89 ,$435.68 ,"$1,030.07 ",$441.89 ,"$1,030.07 ",$441.89 ,$927.38 ,$927.38 ,$441.89 ,$927.38 ,$910.84 ,$500.00 ,"$1,127.28 ",$441.89 ,$450.73 ,"$1,167.00 ","$1,104.76 ","$1,104.76 ",$441.89 ,"$1,104.76 ","$1,322.60 ","$1,322.60 ","$1,322.60 ", N/A ,"$1,127.28 ","$1,322.60 ",$441.89 ,"$1,556.00 ",$872.92 ,$441.89 ,$644.18 ,$273.53 ,$248.66 ,$441.89 ,"$1,322.60 ",$946.91 ,$927.38 ,$435.68 ,"$1,400.40 ",$441.89 ,"$1,322.60 ","$1,556.00 ","$1,556.00 ",$441.89 ,"$1,011.40 " ST. JOSEPH'S HOSPITAL - BREESE,31000261,81227,HC CYP2C9 GENE COM VARIANTS-90,310,1 ,$603.00 ,$434.16 ,$87.62 ,$603.00 ,$437.03 ,$391.95 ,$359.99 ,$171.31 ,$168.84 ,$399.19 ,$171.31 ,$399.19 ,$171.31 ,$359.39 ,$359.39 ,$171.31 ,$359.39 ,$353.12 ,$464.31 ,$437.03 ,$171.31 ,$174.74 ,$452.25 ,$428.13 ,$428.13 ,$171.31 ,$428.13 ,$512.55 ,$512.55 ,$512.55 , N/A ,$437.03 ,$512.55 ,$171.31 ,$603.00 ,$338.28 ,$171.31 ,$249.64 ,$96.38 ,$87.62 ,$171.31 ,$512.55 ,$367.10 ,$359.39 ,$168.84 ,$542.70 ,$171.31 ,$512.55 ,$603.00 ,$603.00 ,$171.31 ,$391.95 ST. JOSEPH'S HOSPITAL - BREESE,31000262,81230,HC CYP3A4 GENE COM VARIANTS-90,310,1 ,$603.00 ,$434.16 ,$26.92 ,$603.00 ,$437.03 ,$391.95 ,$359.99 ,$171.31 ,$168.84 ,$399.19 ,$171.31 ,$399.19 ,$171.31 ,$359.39 ,$359.39 ,$171.31 ,$359.39 ,$353.12 ,$464.31 ,$437.03 ,$171.31 ,$174.74 ,$452.25 ,$428.13 ,$428.13 ,$171.31 ,$428.13 ,$512.55 ,$512.55 ,$512.55 , N/A ,$437.03 ,$512.55 ,$171.31 ,$603.00 ,$338.28 ,$171.31 ,$249.64 ,$29.61 ,$26.92 ,$171.31 ,$512.55 ,$367.10 ,$359.39 ,$168.84 ,$542.70 ,$171.31 ,$512.55 ,$603.00 ,$603.00 ,$171.31 ,$391.95 ST. JOSEPH'S HOSPITAL - BREESE,31000263,81231,HC CYP3A5 GENE COM VARIANTS-90,310,1 ,$603.00 ,$434.16 ,$87.62 ,$603.00 ,$437.03 ,$391.95 ,$359.99 ,$171.31 ,$168.84 ,$399.19 ,$171.31 ,$399.19 ,$171.31 ,$359.39 ,$359.39 ,$171.31 ,$359.39 ,$353.12 ,$464.31 ,$437.03 ,$171.31 ,$174.74 ,$452.25 ,$428.13 ,$428.13 ,$171.31 ,$428.13 ,$512.55 ,$512.55 ,$512.55 , N/A ,$437.03 ,$512.55 ,$171.31 ,$603.00 ,$338.28 ,$171.31 ,$249.64 ,$96.38 ,$87.62 ,$171.31 ,$512.55 ,$367.10 ,$359.39 ,$168.84 ,$542.70 ,$171.31 ,$512.55 ,$603.00 ,$603.00 ,$171.31 ,$391.95 ST. JOSEPH'S HOSPITAL - BREESE,31000266,81355,HC VKORC1 GENE ANALYSIS COMMON VARIANTS-90,310,1 ,$304.00 ,$218.88 ,$26.92 ,$304.00 ,$220.50 ,$197.60 ,$181.49 ,$86.44 ,$85.12 ,$201.25 ,$86.44 ,$201.25 ,$86.44 ,$181.18 ,$181.18 ,$86.44 ,$181.18 ,$178.16 ,$234.08 ,$220.50 ,$86.44 ,$88.16 ,$228.00 ,$215.84 ,$215.84 ,$86.44 ,$215.84 ,$258.40 ,$258.40 ,$258.40 , N/A ,$220.50 ,$258.40 ,$86.44 ,$304.00 ,$170.54 ,$86.44 ,$125.86 ,$29.61 ,$26.92 ,$86.44 ,$258.40 ,$185.22 ,$181.18 ,$85.12 ,$273.60 ,$86.44 ,$258.40 ,$304.00 ,$304.00 ,$86.44 ,$197.60 ST. JOSEPH'S HOSPITAL - BREESE,31000267,81247,HC G6PD GENE ANALYSIS COMMON VARIANT-90,310,1 ,$603.00 ,$434.16 ,$87.62 ,$603.00 ,$437.03 ,$391.95 ,$359.99 ,$171.31 ,$168.84 ,$399.19 ,$171.31 ,$399.19 ,$171.31 ,$359.39 ,$359.39 ,$171.31 ,$359.39 ,$353.12 ,$464.31 ,$437.03 ,$171.31 ,$174.74 ,$452.25 ,$428.13 ,$428.13 ,$171.31 ,$428.13 ,$512.55 ,$512.55 ,$512.55 , N/A ,$437.03 ,$512.55 ,$171.31 ,$603.00 ,$338.28 ,$171.31 ,$249.64 ,$96.38 ,$87.62 ,$171.31 ,$512.55 ,$367.10 ,$359.39 ,$168.84 ,$542.70 ,$171.31 ,$512.55 ,$603.00 ,$603.00 ,$171.31 ,$391.95 ST. JOSEPH'S HOSPITAL - BREESE,31000268,81306,HC NUDT15 GENE COMMON VARIANTS-90,310,1 ,"$1,005.00 ",$723.60 ,$87.62 ,"$1,005.00 ",$728.40 ,$653.25 ,$599.99 ,$285.53 ,$281.40 ,$665.31 ,$285.53 ,$665.31 ,$285.53 ,$598.98 ,$598.98 ,$285.53 ,$598.98 ,$588.55 ,$500.00 ,$728.40 ,$285.53 ,$291.25 ,$753.75 ,$713.55 ,$713.55 ,$285.53 ,$713.55 ,$854.25 ,$854.25 ,$854.25 , N/A ,$728.40 ,$854.25 ,$285.53 ,"$1,005.00 ",$563.81 ,$285.53 ,$416.07 ,$96.38 ,$87.62 ,$285.53 ,$854.25 ,$611.86 ,$598.98 ,$281.40 ,$904.50 ,$285.53 ,$854.25 ,"$1,005.00 ","$1,005.00 ",$285.53 ,$653.25 ST. JOSEPH'S HOSPITAL - BREESE,31000269,81328,HC SLCO1B1 GENE COMMON VARIANTS-90,310,1 ,$603.00 ,$434.16 ,$87.62 ,$603.00 ,$437.03 ,$391.95 ,$359.99 ,$171.31 ,$168.84 ,$399.19 ,$171.31 ,$399.19 ,$171.31 ,$359.39 ,$359.39 ,$171.31 ,$359.39 ,$353.12 ,$464.31 ,$437.03 ,$171.31 ,$174.74 ,$452.25 ,$428.13 ,$428.13 ,$171.31 ,$428.13 ,$512.55 ,$512.55 ,$512.55 , N/A ,$437.03 ,$512.55 ,$171.31 ,$603.00 ,$338.28 ,$171.31 ,$249.64 ,$96.38 ,$87.62 ,$171.31 ,$512.55 ,$367.10 ,$359.39 ,$168.84 ,$542.70 ,$171.31 ,$512.55 ,$603.00 ,$603.00 ,$171.31 ,$391.95 ST. JOSEPH'S HOSPITAL - BREESE,31000270,81223,HC CYSTIC FIBROSIS FULL GENE ANALYSIS-90,310,1 ,"$3,008.00 ","$2,165.76 ",$26.92 ,"$3,008.00 ","$1,247.50 ","$1,955.20 ","$1,795.78 ",$489.02 ,$842.24 ,"$1,991.30 ",$489.02 ,"$1,991.30 ",$489.02 ,"$1,792.77 ","$1,792.77 ",$489.02 ,"$1,792.77 ","$1,007.98 ",$500.00 ,"$1,247.50 ",$489.02 ,$498.80 ,"$2,256.00 ","$2,135.68 ","$2,135.68 ",$489.02 ,"$2,135.68 ","$2,556.80 ","$2,556.80 ","$2,556.80 ", N/A ,"$1,247.50 ","$2,556.80 ",$489.02 ,"$3,008.00 ","$1,687.49 ",$489.02 ,"$1,245.31 ",$29.61 ,$26.92 ,$489.02 ,"$2,556.80 ","$1,047.90 ","$1,792.77 ",$842.24 ,"$2,707.20 ",$489.02 ,"$2,556.80 ","$1,996.00 ","$1,996.00 ",$489.02 ,"$1,955.20 " ST. JOSEPH'S HOSPITAL - BREESE,31000280,81403,HC MOLECULAR PATHOLOGY PROC LEVEL 4-90,310,1 ,$660.00 ,$475.20 ,$26.92 ,$660.00 , N/A ,$429.00 ,$394.02 ,$198.00 ,$184.80 ,$436.92 , N/A ,$436.92 , N/A ,$393.36 ,$393.36 , N/A ,$393.36 ,$297.00 ,$500.00 ,$462.00 , N/A , N/A ,$495.00 ,$468.60 ,$468.60 , N/A ,$468.60 ,$561.00 ,$561.00 ,$561.00 , N/A , N/A ,$561.00 , N/A ,$660.00 ,$370.26 , N/A ,$273.24 ,$29.61 ,$26.92 , N/A ,$561.00 ,$396.00 ,$393.36 ,$184.80 ,$594.00 , N/A ,$561.00 ,$660.00 ,$660.00 , N/A ,$429.00 ST. JOSEPH'S HOSPITAL - BREESE,31000284,81339,HC MPL GENE SEQ ANLY EXON- 90,310,1 ,$537.00 ,$386.64 ,$87.62 ,$537.00 ,$463.00 ,$349.05 ,$320.59 ,$181.50 ,$150.36 ,$355.49 ,$181.50 ,$355.49 ,$181.50 ,$320.05 ,$320.05 ,$181.50 ,$320.05 ,$374.10 ,$413.49 ,$463.00 ,$181.50 ,$185.12 ,$402.75 ,$381.27 ,$381.27 ,$181.50 ,$381.27 ,$456.45 ,$456.45 ,$456.45 , N/A ,$463.00 ,$456.45 ,$181.50 ,$537.00 ,$301.26 ,$181.50 ,$222.32 ,$96.38 ,$87.62 ,$181.50 ,$456.45 ,$388.92 ,$320.05 ,$150.36 ,$483.30 ,$181.50 ,$456.45 ,$537.00 ,$537.00 ,$181.50 ,$349.05 ST. JOSEPH'S HOSPITAL - BREESE,31000306,81288,HC MLH1 GENE ANALYSIS - 90,310,1 ,$641.00 ,$461.52 ,$26.92 ,$641.00 ,$480.80 ,$416.65 ,$382.68 ,$188.47 ,$179.48 ,$424.34 ,$188.47 ,$424.34 ,$188.47 ,$382.04 ,$382.04 ,$188.47 ,$382.04 ,$388.49 ,$493.57 ,$480.80 ,$188.47 ,$192.25 ,$480.75 ,$455.11 ,$455.11 ,$188.47 ,$455.11 ,$544.85 ,$544.85 ,$544.85 , N/A ,$480.80 ,$544.85 ,$188.47 ,$641.00 ,$359.60 ,$188.47 ,$265.37 ,$29.61 ,$26.92 ,$188.47 ,$544.85 ,$403.87 ,$382.04 ,$179.48 ,$576.90 ,$188.47 ,$544.85 ,$641.00 ,$641.00 ,$188.47 ,$416.65 ST. JOSEPH'S HOSPITAL - BREESE,31040111,81162,HC BRCA1 AND 2 GEN FULL SEQ DUP/DEL-90,310,1 ,$60.00 ,$43.20 ,$16.80 ,$150.00 ,$150.00 ,$39.00 ,$35.82 ,$58.80 ,$16.80 ,$39.72 ,$58.80 ,$39.72 ,$58.80 ,$35.76 ,$35.76 ,$58.80 ,$35.76 ,$60.00 ,$46.20 ,$150.00 ,$58.80 ,$58.80 ,$45.00 ,$42.60 ,$42.60 ,$58.80 ,$42.60 ,$51.00 ,$51.00 ,$51.00 , N/A ,$60.00 ,$51.00 ,$58.80 ,$60.00 ,$33.66 ,$58.80 ,$24.84 ,$60.00 ,$60.00 ,$58.80 ,$51.00 ,$126.00 ,$35.76 ,$16.80 ,$54.00 ,$58.80 ,$51.00 ,$60.00 ,$60.00 ,$58.80 ,$39.00 ST. JOSEPH'S HOSPITAL - BREESE,31040112,81279,HC JAK2 GENE TARGETED SEQ ALYS- 90,310,1 ,$542.00 ,$390.24 ,$87.62 ,$542.00 ,$463.00 ,$352.30 ,$323.57 ,$181.50 ,$151.76 ,$358.80 ,$181.50 ,$358.80 ,$181.50 ,$323.03 ,$323.03 ,$181.50 ,$323.03 ,$374.10 ,$417.34 ,$463.00 ,$181.50 ,$185.12 ,$406.50 ,$384.82 ,$384.82 ,$181.50 ,$384.82 ,$460.70 ,$460.70 ,$460.70 , N/A ,$463.00 ,$460.70 ,$181.50 ,$542.00 ,$304.06 ,$181.50 ,$224.39 ,$96.38 ,$87.62 ,$181.50 ,$460.70 ,$388.92 ,$323.03 ,$151.76 ,$487.80 ,$181.50 ,$460.70 ,$542.00 ,$542.00 ,$181.50 ,$352.30 ST. JOSEPH'S HOSPITAL - BREESE,31100101,88104,HC CYTOPATH FLD SMEAR,311,1 ,$133.00 ,$95.76 ,$21.67 ,$133.00 ,$81.53 ,$86.45 ,$79.40 ,$31.96 ,$37.24 ,$88.05 ,$31.96 ,$88.05 ,$31.96 ,$79.27 ,$79.27 ,$31.96 ,$79.27 ,$65.88 ,$102.41 ,$81.53 ,$31.96 ,$32.60 ,$99.75 ,$94.43 ,$94.43 ,$31.96 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$81.53 ,$113.05 ,$31.96 ,$133.00 ,$74.61 ,$31.96 ,$55.06 ,$23.84 ,$21.67 ,$31.96 ,$113.05 ,$68.49 ,$79.27 ,$37.24 ,$119.70 ,$31.96 ,$113.05 ,$133.00 ,$133.00 ,$31.96 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$142.00 ,$102.24 ,$23.83 ,$142.00 ,$120.38 ,$92.30 ,$84.77 ,$47.19 ,$39.76 ,$94.00 ,$47.19 ,$94.00 ,$47.19 ,$84.63 ,$84.63 ,$47.19 ,$84.63 ,$97.27 ,$109.34 ,$120.38 ,$47.19 ,$48.13 ,$106.50 ,$100.82 ,$100.82 ,$47.19 ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A ,$120.38 ,$120.70 ,$47.19 ,$142.00 ,$79.66 ,$47.19 ,$58.79 ,$26.21 ,$23.83 ,$47.19 ,$120.70 ,$101.12 ,$84.63 ,$39.76 ,$127.80 ,$47.19 ,$120.70 ,$142.00 ,$142.00 ,$47.19 ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,31100107,88142,HC THINPREP PAP,311,1 ,$174.00 ,$125.28 ,$15.71 ,$174.00 ,$50.65 ,$113.10 ,$103.88 ,$19.85 ,$48.72 ,$115.19 ,$19.85 ,$115.19 ,$19.85 ,$103.70 ,$103.70 ,$19.85 ,$103.70 ,$40.93 ,$133.98 ,$50.65 ,$19.85 ,$20.26 ,$130.50 ,$123.54 ,$123.54 ,$19.85 ,$123.54 ,$147.90 ,$147.90 ,$147.90 , N/A ,$50.65 ,$147.90 ,$19.85 ,$20.26 ,$97.61 ,$19.85 ,$72.04 ,$17.28 ,$15.71 ,$19.85 ,$147.90 ,$42.55 ,$103.70 ,$48.72 ,$156.60 ,$19.85 ,$147.90 ,$81.04 ,$81.04 ,$19.85 ,$113.10 ST. JOSEPH'S HOSPITAL - BREESE,31100110,88160,HC CYTOPATH SMEAR NON GYN,311,1 ,$114.00 ,$82.08 ,$21.67 ,$114.00 ,$59.93 ,$74.10 ,$68.06 ,$23.49 ,$31.92 ,$75.47 ,$23.49 ,$75.47 ,$23.49 ,$67.94 ,$67.94 ,$23.49 ,$67.94 ,$48.42 ,$87.78 ,$59.93 ,$23.49 ,$23.96 ,$85.50 ,$80.94 ,$80.94 ,$23.49 ,$80.94 ,$96.90 ,$96.90 ,$96.90 , N/A ,$59.93 ,$96.90 ,$23.49 ,$114.00 ,$63.95 ,$23.49 ,$47.20 ,$23.84 ,$21.67 ,$23.49 ,$96.90 ,$50.34 ,$67.94 ,$31.92 ,$102.60 ,$23.49 ,$96.90 ,$98.68 ,$98.68 ,$23.49 ,$74.10 ST. JOSEPH'S HOSPITAL - BREESE,31100113,88164,HC CYTOPATH SCR BETHESDA,311,1 ,$159.00 ,$114.48 ,$15.71 ,$159.00 ,$43.28 ,$103.35 ,$94.92 ,$16.96 ,$44.52 ,$105.26 ,$16.96 ,$105.26 ,$16.96 ,$94.76 ,$94.76 ,$16.96 ,$94.76 ,$34.97 ,$122.43 ,$43.28 ,$16.96 ,$17.31 ,$119.25 ,$112.89 ,$112.89 ,$16.96 ,$112.89 ,$135.15 ,$135.15 ,$135.15 , N/A ,$43.28 ,$135.15 ,$16.96 ,$17.31 ,$89.20 ,$16.96 ,$65.83 ,$17.28 ,$15.71 ,$16.96 ,$135.15 ,$36.35 ,$94.76 ,$44.52 ,$143.10 ,$16.96 ,$135.15 ,$60.60 ,$60.60 ,$16.96 ,$103.35 ST. JOSEPH'S HOSPITAL - BREESE,31100115,88173,HC FINE NEEDLE INTERP,311,1 ,$236.00 ,$169.92 ,$21.67 ,$236.00 ,$120.38 ,$153.40 ,$140.89 ,$47.19 ,$66.08 ,$156.23 ,$47.19 ,$156.23 ,$47.19 ,$140.66 ,$140.66 ,$47.19 ,$140.66 ,$97.27 ,$181.72 ,$120.38 ,$47.19 ,$48.13 ,$177.00 ,$167.56 ,$167.56 ,$47.19 ,$167.56 ,$200.60 ,$200.60 ,$200.60 , N/A ,$120.38 ,$200.60 ,$47.19 ,$98.55 ,$132.40 ,$47.19 ,$97.70 ,$23.84 ,$21.67 ,$47.19 ,$200.60 ,$101.12 ,$140.66 ,$66.08 ,$212.40 ,$47.19 ,$200.60 ,$199.04 ,$199.04 ,$47.19 ,$153.40 ST. JOSEPH'S HOSPITAL - BREESE,31100240,88161,HC CYTOPATH SMEAR OTHER SOURCE W/PREP,311,1 ,$151.00 ,$108.72 ,$21.67 ,$151.00 ,$59.93 ,$98.15 ,$90.15 ,$23.49 ,$42.28 ,$99.96 ,$23.49 ,$99.96 ,$23.49 ,$90.00 ,$90.00 ,$23.49 ,$90.00 ,$48.42 ,$116.27 ,$59.93 ,$23.49 ,$23.96 ,$113.25 ,$107.21 ,$107.21 ,$23.49 ,$107.21 ,$128.35 ,$128.35 ,$128.35 , N/A ,$59.93 ,$128.35 ,$23.49 ,$151.00 ,$84.71 ,$23.49 ,$62.51 ,$23.84 ,$21.67 ,$23.49 ,$128.35 ,$50.34 ,$90.00 ,$42.28 ,$135.90 ,$23.49 ,$128.35 ,$98.68 ,$98.68 ,$23.49 ,$98.15 ST. JOSEPH'S HOSPITAL - BREESE,31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$197.00 ,$141.84 ,$23.83 ,$778.15 ,$778.15 ,$128.05 ,$117.61 ,$305.03 ,$55.16 ,$130.41 ,$305.03 ,$130.41 ,$193.06 ,$117.41 ,$117.41 ,$193.06 ,$117.41 ,$197.00 ,$151.69 ,$778.14 ,$305.03 ,$193.06 ,$147.75 ,$139.87 ,$139.87 ,$305.03 ,$139.87 ,$167.45 ,$167.45 ,$167.45 , N/A ,$197.00 ,$167.45 ,$193.06 ,$197.00 ,$110.52 ,$305.03 ,$81.56 ,$26.21 ,$23.83 ,$305.03 ,$167.45 ,$653.64 ,$117.41 ,$55.16 ,$177.30 ,$305.03 ,$167.45 ,$197.00 ,$197.00 ,$305.03 ,$128.05 ST. JOSEPH'S HOSPITAL - BREESE,31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$740.00 ,$532.80 ,$23.83 ,$740.00 , N/A ,$481.00 ,$441.78 , N/A ,$207.20 ,$489.88 , N/A ,$489.88 , N/A ,$441.04 ,$441.04 , N/A ,$441.04 , N/A ,$500.00 , N/A , N/A , N/A ,$555.00 ,$525.40 ,$525.40 , N/A ,$525.40 ,$629.00 ,$629.00 ,$629.00 , N/A , N/A ,$629.00 , N/A ,$740.00 ,$415.14 , N/A ,$306.36 ,$26.21 ,$23.83 , N/A ,$629.00 , N/A ,$441.04 ,$207.20 ,$666.00 , N/A ,$629.00 ,$92.12 ,$92.12 , N/A ,$481.00 ST. JOSEPH'S HOSPITAL - BREESE,31100251,88230,HC TISSUE CULT NONNEO LYMPHOCYTE-90,311,1 ,$485.00 ,$349.20 ,$23.83 ,$485.00 ,$291.23 ,$315.25 ,$289.55 ,$114.16 ,$135.80 ,$321.07 ,$114.16 ,$321.07 ,$114.16 ,$289.06 ,$289.06 ,$114.16 ,$289.06 ,$235.31 ,$373.45 ,$291.23 ,$114.16 ,$116.44 ,$363.75 ,$344.35 ,$344.35 ,$114.16 ,$344.35 ,$412.25 ,$412.25 ,$412.25 , N/A ,$291.23 ,$412.25 ,$114.16 ,$485.00 ,$272.09 ,$114.16 ,$200.79 ,$26.21 ,$23.83 ,$114.16 ,$412.25 ,$244.63 ,$289.06 ,$135.80 ,$436.50 ,$114.16 ,$412.25 ,$465.96 ,$465.96 ,$114.16 ,$315.25 ST. JOSEPH'S HOSPITAL - BREESE,31100252,88233,HC TISSUE CULT SKIN/OTH SOLID-90,311,1 ,$851.00 ,$612.72 ,$23.83 ,$851.00 ,$351.83 ,$553.15 ,$508.05 ,$137.92 ,$238.28 ,$563.36 ,$137.92 ,$563.36 ,$137.92 ,$507.20 ,$507.20 ,$137.92 ,$507.20 ,$284.27 ,$500.00 ,$351.83 ,$137.92 ,$140.67 ,$638.25 ,$604.21 ,$604.21 ,$137.92 ,$604.21 ,$723.35 ,$723.35 ,$723.35 , N/A ,$351.83 ,$723.35 ,$137.92 ,$851.00 ,$477.41 ,$137.92 ,$352.31 ,$26.21 ,$23.83 ,$137.92 ,$723.35 ,$295.53 ,$507.20 ,$238.28 ,$765.90 ,$137.92 ,$723.35 ,$562.92 ,$562.92 ,$137.92 ,$553.15 ST. JOSEPH'S HOSPITAL - BREESE,31100255,88237,HC TISSUE CULT BONE/BLD-90,311,1 ,$851.00 ,$612.72 ,$23.83 ,$851.00 ,$359.38 ,$553.15 ,$508.05 ,$140.87 ,$238.28 ,$563.36 ,$140.87 ,$563.36 ,$140.87 ,$507.20 ,$507.20 ,$140.87 ,$507.20 ,$290.38 ,$500.00 ,$359.38 ,$140.87 ,$143.70 ,$638.25 ,$604.21 ,$604.21 ,$140.87 ,$604.21 ,$723.35 ,$723.35 ,$723.35 , N/A ,$359.38 ,$723.35 ,$140.87 ,$851.00 ,$477.41 ,$140.87 ,$352.31 ,$26.21 ,$23.83 ,$140.87 ,$723.35 ,$301.88 ,$507.20 ,$238.28 ,$765.90 ,$140.87 ,$723.35 ,$575.00 ,$575.00 ,$140.87 ,$553.15 ST. JOSEPH'S HOSPITAL - BREESE,31100257,88262,HC CHROM COUNT 15-20/2-90,311,1 ,$642.00 ,$462.24 ,$26.92 ,$642.00 ,$313.73 ,$417.30 ,$383.27 ,$122.98 ,$179.76 ,$425.00 ,$122.98 ,$425.00 ,$122.98 ,$382.63 ,$382.63 ,$122.98 ,$382.63 ,$253.49 ,$494.34 ,$313.73 ,$122.98 ,$125.44 ,$481.50 ,$455.82 ,$455.82 ,$122.98 ,$455.82 ,$545.70 ,$545.70 ,$545.70 , N/A ,$313.73 ,$545.70 ,$122.98 ,$642.00 ,$360.16 ,$122.98 ,$265.79 ,$29.61 ,$26.92 ,$122.98 ,$545.70 ,$263.53 ,$382.63 ,$179.76 ,$577.80 ,$122.98 ,$545.70 ,$501.96 ,$501.96 ,$122.98 ,$417.30 ST. JOSEPH'S HOSPITAL - BREESE,31100258,88264,HC CHROM ANLYS ANALYZE 20-90,311,1 ,$380.00 ,$273.60 ,$26.92 ,$380.00 ,$361.53 ,$247.00 ,$226.86 ,$141.72 ,$106.40 ,$251.56 ,$141.72 ,$251.56 ,$141.72 ,$226.48 ,$226.48 ,$141.72 ,$226.48 ,$292.11 ,$292.60 ,$361.53 ,$141.72 ,$144.55 ,$285.00 ,$269.80 ,$269.80 ,$141.72 ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A ,$361.53 ,$323.00 ,$141.72 ,$380.00 ,$213.18 ,$141.72 ,$157.32 ,$29.61 ,$26.92 ,$141.72 ,$323.00 ,$303.68 ,$226.48 ,$106.40 ,$342.00 ,$141.72 ,$323.00 ,$380.00 ,$380.00 ,$141.72 ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,31100261,88271,HC MCG DNA PROBE(FISH)-90,311,1 ,$168.00 ,$120.96 ,$20.99 ,$168.00 ,$53.55 ,$109.20 ,$100.30 ,$20.99 ,$47.04 ,$111.22 ,$20.99 ,$111.22 ,$20.99 ,$100.13 ,$100.13 ,$20.99 ,$100.13 ,$43.27 ,$129.36 ,$53.55 ,$20.99 ,$21.41 ,$126.00 ,$119.28 ,$119.28 ,$20.99 ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A ,$53.55 ,$142.80 ,$20.99 ,$168.00 ,$94.25 ,$20.99 ,$69.55 ,$29.61 ,$26.92 ,$20.99 ,$142.80 ,$44.98 ,$100.13 ,$47.04 ,$151.20 ,$20.99 ,$142.80 ,$85.68 ,$85.68 ,$20.99 ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,31100269,88275,HC MCG INTERPH INSITU 100 -90,311,1 ,$252.00 ,$181.44 ,$26.92 ,$252.00 ,$127.98 ,$163.80 ,$150.44 ,$50.17 ,$70.56 ,$166.82 ,$50.17 ,$166.82 ,$50.17 ,$150.19 ,$150.19 ,$50.17 ,$150.19 ,$103.40 ,$194.04 ,$127.98 ,$50.17 ,$51.17 ,$189.00 ,$178.92 ,$178.92 ,$50.17 ,$178.92 ,$214.20 ,$214.20 ,$214.20 , N/A ,$127.98 ,$214.20 ,$50.17 ,$252.00 ,$141.37 ,$50.17 ,$104.33 ,$29.61 ,$26.92 ,$50.17 ,$214.20 ,$107.50 ,$150.19 ,$70.56 ,$226.80 ,$50.17 ,$214.20 ,$204.76 ,$204.76 ,$50.17 ,$163.80 ST. JOSEPH'S HOSPITAL - BREESE,31100270,88275,HC MCG INTERPH INSITU FISH 100-90,311,1 ,$252.00 ,$181.44 ,$26.92 ,$252.00 ,$127.98 ,$163.80 ,$150.44 ,$50.17 ,$70.56 ,$166.82 ,$50.17 ,$166.82 ,$50.17 ,$150.19 ,$150.19 ,$50.17 ,$150.19 ,$103.40 ,$194.04 ,$127.98 ,$50.17 ,$51.17 ,$189.00 ,$178.92 ,$178.92 ,$50.17 ,$178.92 ,$214.20 ,$214.20 ,$214.20 , N/A ,$127.98 ,$214.20 ,$50.17 ,$252.00 ,$141.37 ,$50.17 ,$104.33 ,$29.61 ,$26.92 ,$50.17 ,$214.20 ,$107.50 ,$150.19 ,$70.56 ,$226.80 ,$50.17 ,$214.20 ,$204.76 ,$204.76 ,$50.17 ,$163.80 ST. JOSEPH'S HOSPITAL - BREESE,31100273,88280,HC CHROM ADDL KARYO-90,311,1 ,$104.00 ,$74.88 ,$26.92 ,$104.00 ,$83.68 ,$67.60 ,$62.09 ,$32.80 ,$29.12 ,$68.85 ,$32.80 ,$68.85 ,$32.80 ,$61.98 ,$61.98 ,$32.80 ,$61.98 ,$67.61 ,$80.08 ,$83.68 ,$32.80 ,$33.46 ,$78.00 ,$73.84 ,$73.84 ,$32.80 ,$73.84 ,$88.40 ,$88.40 ,$88.40 , N/A ,$83.68 ,$88.40 ,$32.80 ,$104.00 ,$58.34 ,$32.80 ,$43.06 ,$29.61 ,$26.92 ,$32.80 ,$88.40 ,$70.29 ,$61.98 ,$29.12 ,$93.60 ,$32.80 ,$88.40 ,$104.00 ,$104.00 ,$32.80 ,$67.60 ST. JOSEPH'S HOSPITAL - BREESE,31100274,88289,HC CHROM ADDL HIGH RES-90,311,1 ,$138.00 ,$99.36 ,$26.92 ,$138.00 ,$86.08 ,$89.70 ,$82.39 ,$33.74 ,$38.64 ,$91.36 ,$33.74 ,$91.36 ,$33.74 ,$82.25 ,$82.25 ,$33.74 ,$82.25 ,$69.55 ,$106.26 ,$86.08 ,$33.74 ,$34.42 ,$103.50 ,$97.98 ,$97.98 ,$33.74 ,$97.98 ,$117.30 ,$117.30 ,$117.30 , N/A ,$86.08 ,$117.30 ,$33.74 ,$138.00 ,$77.42 ,$33.74 ,$57.13 ,$29.61 ,$26.92 ,$33.74 ,$117.30 ,$72.30 ,$82.25 ,$38.64 ,$124.20 ,$33.74 ,$117.30 ,$137.72 ,$137.72 ,$33.74 ,$89.70 ST. JOSEPH'S HOSPITAL - BREESE,31100275,88291,HC INTERPRETATION-90,311,1 ,$69.00 ,$49.68 ,$19.32 ,$69.00 , N/A ,$44.85 ,$41.19 , N/A ,$19.32 ,$45.68 , N/A ,$45.68 , N/A ,$41.12 ,$41.12 , N/A ,$41.12 , N/A ,$53.13 , N/A , N/A , N/A ,$51.75 ,$48.99 ,$48.99 , N/A ,$48.99 ,$58.65 ,$58.65 ,$58.65 , N/A , N/A ,$58.65 , N/A ,$69.00 ,$38.71 , N/A ,$28.57 ,$29.61 ,$26.92 , N/A ,$58.65 , N/A ,$41.12 ,$19.32 ,$62.10 , N/A ,$58.65 ,$69.00 ,$69.00 , N/A ,$44.85 ST. JOSEPH'S HOSPITAL - BREESE,31100283,88120,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC-90,311,1 ,$422.00 ,$303.84 ,$23.83 ,$422.00 ,$377.53 ,$274.30 ,$251.93 ,$147.99 ,$118.16 ,$279.36 ,$147.99 ,$279.36 ,$147.99 ,$251.51 ,$251.51 ,$147.99 ,$251.51 ,$305.05 ,$324.94 ,$377.53 ,$147.99 ,$150.95 ,$316.50 ,$299.62 ,$299.62 ,$147.99 ,$299.62 ,$358.70 ,$358.70 ,$358.70 , N/A ,$377.53 ,$358.70 ,$147.99 ,$422.00 ,$236.74 ,$147.99 ,$174.71 ,$26.21 ,$23.83 ,$147.99 ,$358.70 ,$317.13 ,$251.51 ,$118.16 ,$379.80 ,$147.99 ,$358.70 ,$422.00 ,$422.00 ,$147.99 ,$274.30 ST. JOSEPH'S HOSPITAL - BREESE,31100310,88121,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC COMP ASSIST-90,311,1 ,$400.00 ,$288.00 ,$23.83 ,$400.00 ,$377.53 ,$260.00 ,$238.80 ,$147.99 ,$112.00 ,$264.80 ,$147.99 ,$264.80 ,$147.99 ,$238.40 ,$238.40 ,$147.99 ,$238.40 ,$305.05 ,$308.00 ,$377.53 ,$147.99 ,$150.95 ,$300.00 ,$284.00 ,$284.00 ,$147.99 ,$284.00 ,$340.00 ,$340.00 ,$340.00 , N/A ,$377.53 ,$340.00 ,$147.99 ,$400.00 ,$224.40 ,$147.99 ,$165.60 ,$26.21 ,$23.83 ,$147.99 ,$340.00 ,$317.13 ,$238.40 ,$112.00 ,$360.00 ,$147.99 ,$340.00 ,$400.00 ,$400.00 ,$147.99 ,$260.00 ST. JOSEPH'S HOSPITAL - BREESE,31100311,88182,HC FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS -90,311,1 ,$622.00 ,$447.84 ,$23.83 ,$622.00 ,$120.38 ,$404.30 ,$371.33 ,$47.19 ,$174.16 ,$411.76 ,$47.19 ,$411.76 ,$47.19 ,$370.71 ,$370.71 ,$47.19 ,$370.71 ,$97.27 ,$478.94 ,$120.38 ,$47.19 ,$48.13 ,$466.50 ,$441.62 ,$441.62 ,$47.19 ,$441.62 ,$528.70 ,$528.70 ,$528.70 , N/A ,$120.38 ,$528.70 ,$47.19 ,$622.00 ,$348.94 ,$47.19 ,$257.51 ,$26.21 ,$23.83 ,$47.19 ,$528.70 ,$101.12 ,$370.71 ,$174.16 ,$559.80 ,$47.19 ,$528.70 ,$199.04 ,$199.04 ,$47.19 ,$404.30 ST. JOSEPH'S HOSPITAL - BREESE,31100312,88189,HC FLOW CYTO INT >16 MARKERS-90,311,1 ,$662.00 ,$476.64 ,$21.67 ,$662.00 , N/A ,$430.30 ,$395.21 , N/A ,$185.36 ,$438.24 , N/A ,$438.24 , N/A ,$394.55 ,$394.55 , N/A ,$394.55 , N/A ,$500.00 , N/A , N/A , N/A ,$496.50 ,$470.02 ,$470.02 , N/A ,$470.02 ,$562.70 ,$562.70 ,$562.70 , N/A , N/A ,$562.70 , N/A ,$662.00 ,$371.38 , N/A ,$274.07 ,$23.84 ,$21.67 , N/A ,$562.70 , N/A ,$394.55 ,$185.36 ,$595.80 , N/A ,$562.70 ,$340.56 ,$340.56 , N/A ,$430.30 ST. JOSEPH'S HOSPITAL - BREESE,31100318,88185,HC FLOW CYTO EA ADD MARKER OVER 24 - 90,311,1 ,$200.00 ,$144.00 ,$23.83 ,$200.00 , N/A ,$130.00 ,$119.40 , N/A ,$56.00 ,$132.40 , N/A ,$132.40 , N/A ,$119.20 ,$119.20 , N/A ,$119.20 , N/A ,$154.00 , N/A , N/A , N/A ,$150.00 ,$142.00 ,$142.00 , N/A ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A , N/A ,$170.00 , N/A ,$200.00 ,$112.20 , N/A ,$82.80 ,$26.21 ,$23.83 , N/A ,$170.00 , N/A ,$119.20 ,$56.00 ,$180.00 , N/A ,$170.00 ,$92.12 ,$92.12 , N/A ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,31100320,88261,"HC CHROMOSOME ANALYSIS 5 CELLS, 1 KARYOTYPE-90",311,1 ,$380.00 ,$273.60 ,$26.92 ,$660.85 ,$660.85 ,$247.00 ,$226.86 ,$259.05 ,$106.40 ,$251.56 ,$259.05 ,$251.56 ,$259.05 ,$226.48 ,$226.48 ,$259.05 ,$226.48 ,$380.00 ,$292.60 ,$660.85 ,$259.05 ,$264.24 ,$285.00 ,$269.80 ,$269.80 ,$259.05 ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A ,$380.00 ,$323.00 ,$259.05 ,$380.00 ,$213.18 ,$259.05 ,$157.32 ,$29.61 ,$26.92 ,$259.05 ,$323.00 ,$555.11 ,$226.48 ,$106.40 ,$342.00 ,$259.05 ,$323.00 ,$380.00 ,$380.00 ,$259.05 ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,31200101,88300,HC GROSS ONLY LEVEL I,312,1 ,$156.00 ,$112.32 ,$21.67 ,$156.00 ,$59.93 ,$101.40 ,$93.13 ,$23.49 ,$43.68 ,$103.27 ,$23.49 ,$103.27 ,$23.49 ,$92.98 ,$92.98 ,$23.49 ,$92.98 ,$48.42 ,$120.12 ,$59.93 ,$23.49 ,$23.96 ,$117.00 ,$110.76 ,$110.76 ,$23.49 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$59.93 ,$132.60 ,$23.49 ,$156.00 ,$87.52 ,$23.49 ,$64.58 ,$23.84 ,$21.67 ,$23.49 ,$132.60 ,$50.34 ,$92.98 ,$43.68 ,$140.40 ,$23.49 ,$132.60 ,$98.68 ,$98.68 ,$23.49 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,31200102,88302,HC GROSS AND MICRO LEVEL II,312,1 ,$297.00 ,$213.84 ,$21.67 ,$297.00 ,$59.93 ,$193.05 ,$177.31 ,$23.49 ,$83.16 ,$196.61 ,$23.49 ,$196.61 ,$23.49 ,$177.01 ,$177.01 ,$23.49 ,$177.01 ,$48.42 ,$228.69 ,$59.93 ,$23.49 ,$23.96 ,$222.75 ,$210.87 ,$210.87 ,$23.49 ,$210.87 ,$252.45 ,$252.45 ,$252.45 , N/A ,$59.93 ,$252.45 ,$23.49 ,$297.00 ,$166.62 ,$23.49 ,$122.96 ,$23.84 ,$21.67 ,$23.49 ,$252.45 ,$50.34 ,$177.01 ,$83.16 ,$267.30 ,$23.49 ,$252.45 ,$98.68 ,$98.68 ,$23.49 ,$193.05 ST. JOSEPH'S HOSPITAL - BREESE,31200103,88304,HC GROSS AND MICRO LEVEL III,312,1 ,$369.00 ,$265.68 ,$21.67 ,$369.00 ,$120.38 ,$239.85 ,$220.29 ,$47.19 ,$103.32 ,$244.28 ,$47.19 ,$244.28 ,$47.19 ,$219.92 ,$219.92 ,$47.19 ,$219.92 ,$97.27 ,$284.13 ,$120.38 ,$47.19 ,$48.13 ,$276.75 ,$261.99 ,$261.99 ,$47.19 ,$261.99 ,$313.65 ,$313.65 ,$313.65 , N/A ,$120.38 ,$313.65 ,$47.19 ,$369.00 ,$207.01 ,$47.19 ,$152.77 ,$23.84 ,$21.67 ,$47.19 ,$313.65 ,$101.12 ,$219.92 ,$103.32 ,$332.10 ,$47.19 ,$313.65 ,$199.04 ,$199.04 ,$47.19 ,$239.85 ST. JOSEPH'S HOSPITAL - BREESE,31200108,88305,HC GROSS AND MICRO LEVEL IV,312,1 ,$468.00 ,$336.96 ,$21.67 ,$468.00 ,$120.38 ,$304.20 ,$279.40 ,$47.19 ,$131.04 ,$309.82 ,$47.19 ,$309.82 ,$47.19 ,$278.93 ,$278.93 ,$47.19 ,$278.93 ,$97.27 ,$360.36 ,$120.38 ,$47.19 ,$48.13 ,$351.00 ,$332.28 ,$332.28 ,$47.19 ,$332.28 ,$397.80 ,$397.80 ,$397.80 , N/A ,$120.38 ,$397.80 ,$47.19 ,$36.72 ,$262.55 ,$47.19 ,$193.75 ,$23.84 ,$21.67 ,$47.19 ,$397.80 ,$101.12 ,$278.93 ,$131.04 ,$421.20 ,$47.19 ,$397.80 ,$199.04 ,$199.04 ,$47.19 ,$304.20 ST. JOSEPH'S HOSPITAL - BREESE,31200110,88307,HC GROSS AND MICRO LEVEL V,312,1 ,$851.00 ,$612.72 ,$23.83 ,$851.00 ,$778.15 ,$553.15 ,$508.05 ,$305.03 ,$238.28 ,$563.36 ,$305.03 ,$563.36 ,$305.03 ,$507.20 ,$507.20 ,$305.03 ,$507.20 ,$628.74 ,$500.00 ,$778.14 ,$305.03 ,$311.13 ,$638.25 ,$604.21 ,$604.21 ,$305.03 ,$604.21 ,$723.35 ,$723.35 ,$723.35 , N/A ,$778.14 ,$723.35 ,$305.03 ,$220.02 ,$477.41 ,$305.03 ,$352.31 ,$26.21 ,$23.83 ,$305.03 ,$723.35 ,$653.64 ,$507.20 ,$238.28 ,$765.90 ,$305.03 ,$723.35 ,$851.00 ,$851.00 ,$305.03 ,$553.15 ST. JOSEPH'S HOSPITAL - BREESE,31200113,88309,HC GROSS AND MICRO LEVEL VI,312,1 ,"$1,050.00 ",$756.00 ,$23.83 ,"$1,864.28 ","$1,864.28 ",$682.50 ,$626.85 ,$730.80 ,$294.00 ,$695.10 ,$730.80 ,$695.10 ,$730.80 ,$625.80 ,$625.80 ,$730.80 ,$625.80 ,"$1,050.00 ",$500.00 ,"$1,864.28 ",$730.80 ,$745.42 ,$787.50 ,$745.50 ,$745.50 ,$730.80 ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A ,"$1,050.00 ",$892.50 ,$730.80 ,"$1,050.00 ",$589.05 ,$730.80 ,$434.70 ,$26.21 ,$23.83 ,$730.80 ,$892.50 ,"$1,566.00 ",$625.80 ,$294.00 ,$945.00 ,$730.80 ,$892.50 ,"$1,050.00 ","$1,050.00 ",$730.80 ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,31200116,88311,HC DECALCIFICATION,312,1 ,$63.00 ,$45.36 ,$17.64 ,$63.00 , N/A ,$40.95 ,$37.61 , N/A ,$17.64 ,$41.71 , N/A ,$41.71 , N/A ,$37.55 ,$37.55 , N/A ,$37.55 , N/A ,$48.51 , N/A , N/A , N/A ,$47.25 ,$44.73 ,$44.73 , N/A ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A , N/A ,$53.55 , N/A ,$63.00 ,$35.34 , N/A ,$26.08 ,$23.84 ,$21.67 , N/A ,$53.55 , N/A ,$37.55 ,$17.64 ,$56.70 , N/A ,$53.55 ,$34.88 ,$34.88 , N/A ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,31200123,88312,HC SPECIAL STAIN I,312,1 ,$163.00 ,$117.36 ,$21.67 ,$163.00 ,$120.38 ,$105.95 ,$97.31 ,$47.19 ,$45.64 ,$107.91 ,$47.19 ,$107.91 ,$47.19 ,$97.15 ,$97.15 ,$47.19 ,$97.15 ,$97.27 ,$125.51 ,$120.38 ,$47.19 ,$48.13 ,$122.25 ,$115.73 ,$115.73 ,$47.19 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$120.38 ,$138.55 ,$47.19 ,$163.00 ,$91.44 ,$47.19 ,$67.48 ,$23.84 ,$21.67 ,$47.19 ,$138.55 ,$101.12 ,$97.15 ,$45.64 ,$146.70 ,$47.19 ,$138.55 ,$163.00 ,$163.00 ,$47.19 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,31200125,88313,HC SPECIAL STAIN II,312,1 ,$282.00 ,$203.04 ,$21.67 ,$282.00 ,$81.53 ,$183.30 ,$168.35 ,$31.96 ,$78.96 ,$186.68 ,$31.96 ,$186.68 ,$31.96 ,$168.07 ,$168.07 ,$31.96 ,$168.07 ,$65.88 ,$217.14 ,$81.53 ,$31.96 ,$32.60 ,$211.50 ,$200.22 ,$200.22 ,$31.96 ,$200.22 ,$239.70 ,$239.70 ,$239.70 , N/A ,$81.53 ,$239.70 ,$31.96 ,$282.00 ,$158.20 ,$31.96 ,$116.75 ,$23.84 ,$21.67 ,$31.96 ,$239.70 ,$68.49 ,$168.07 ,$78.96 ,$253.80 ,$31.96 ,$239.70 ,$135.36 ,$135.36 ,$31.96 ,$183.30 ST. JOSEPH'S HOSPITAL - BREESE,31200159,88321,HC CONSULT REFERRED SLIDES,312,1 ,$98.00 ,$70.56 ,$21.67 ,$98.00 ,$81.53 ,$63.70 ,$58.51 ,$31.96 ,$27.44 ,$64.88 ,$31.96 ,$64.88 ,$31.96 ,$58.41 ,$58.41 ,$31.96 ,$58.41 ,$65.88 ,$75.46 ,$81.53 ,$31.96 ,$32.60 ,$73.50 ,$69.58 ,$69.58 ,$31.96 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$81.53 ,$83.30 ,$31.96 ,$98.00 ,$54.98 ,$31.96 ,$40.57 ,$23.84 ,$21.67 ,$31.96 ,$83.30 ,$68.49 ,$58.41 ,$27.44 ,$88.20 ,$31.96 ,$83.30 ,$98.00 ,$98.00 ,$31.96 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,31200171,88325,HC CONSULT PATH REV/REP,312,1 ,$98.00 ,$70.56 ,$21.67 ,$377.53 ,$377.53 ,$63.70 ,$58.51 ,$147.99 ,$27.44 ,$64.88 ,$147.99 ,$64.88 ,$96.04 ,$58.41 ,$58.41 ,$96.04 ,$58.41 ,$98.00 ,$75.46 ,$377.53 ,$147.99 ,$96.04 ,$73.50 ,$69.58 ,$69.58 ,$147.99 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$98.00 ,$83.30 ,$96.04 ,$98.00 ,$54.98 ,$147.99 ,$40.57 ,$23.84 ,$21.67 ,$147.99 ,$83.30 ,$317.13 ,$58.41 ,$27.44 ,$88.20 ,$147.99 ,$83.30 ,$98.00 ,$98.00 ,$147.99 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,31200172,88329,HC CONSULT PATH SURGERY,312,1 ,$87.00 ,$62.64 ,$21.67 ,$87.00 ,$81.53 ,$56.55 ,$51.94 ,$31.96 ,$24.36 ,$57.59 ,$31.96 ,$57.59 ,$31.96 ,$51.85 ,$51.85 ,$31.96 ,$51.85 ,$65.88 ,$66.99 ,$81.53 ,$31.96 ,$32.60 ,$65.25 ,$61.77 ,$61.77 ,$31.96 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$81.53 ,$73.95 ,$31.96 ,$87.00 ,$48.81 ,$31.96 ,$36.02 ,$23.84 ,$21.67 ,$31.96 ,$73.95 ,$68.49 ,$51.85 ,$24.36 ,$78.30 ,$31.96 ,$73.95 ,$87.00 ,$87.00 ,$31.96 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,31200173,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,$243.00 ,$174.96 ,$21.67 ,$377.53 ,$377.53 ,$157.95 ,$145.07 ,$147.99 ,$68.04 ,$160.87 ,$147.99 ,$160.87 ,$147.99 ,$144.83 ,$144.83 ,$147.99 ,$144.83 ,$243.00 ,$187.11 ,$377.53 ,$147.99 ,$150.95 ,$182.25 ,$172.53 ,$172.53 ,$147.99 ,$172.53 ,$206.55 ,$206.55 ,$206.55 , N/A ,$243.00 ,$206.55 ,$147.99 ,$43.37 ,$136.32 ,$147.99 ,$100.60 ,$23.84 ,$21.67 ,$147.99 ,$206.55 ,$317.13 ,$144.83 ,$68.04 ,$218.70 ,$147.99 ,$206.55 ,$243.00 ,$243.00 ,$147.99 ,$157.95 ST. JOSEPH'S HOSPITAL - BREESE,31200174,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$164.00 ,$118.08 ,$21.67 ,$164.00 , N/A ,$106.60 ,$97.91 , N/A ,$45.92 ,$108.57 , N/A ,$108.57 , N/A ,$97.74 ,$97.74 , N/A ,$97.74 , N/A ,$126.28 , N/A , N/A , N/A ,$123.00 ,$116.44 ,$116.44 , N/A ,$116.44 ,$139.40 ,$139.40 ,$139.40 , N/A , N/A ,$139.40 , N/A ,$26.21 ,$92.00 , N/A ,$67.90 ,$23.84 ,$21.67 , N/A ,$139.40 , N/A ,$97.74 ,$45.92 ,$147.60 , N/A ,$139.40 ,$96.32 ,$96.32 , N/A ,$106.60 ST. JOSEPH'S HOSPITAL - BREESE,31200193,88360,HC MORPHO ANLYS TUMOR MAN,312,1 ,$408.00 ,$293.76 ,$23.83 ,$408.00 ,$377.53 ,$265.20 ,$243.58 ,$147.99 ,$114.24 ,$270.10 ,$147.99 ,$270.10 ,$147.99 ,$243.17 ,$243.17 ,$147.99 ,$243.17 ,$305.05 ,$314.16 ,$377.53 ,$147.99 ,$150.95 ,$306.00 ,$289.68 ,$289.68 ,$147.99 ,$289.68 ,$346.80 ,$346.80 ,$346.80 , N/A ,$377.53 ,$346.80 ,$147.99 ,$81.17 ,$228.89 ,$147.99 ,$168.91 ,$26.21 ,$23.83 ,$147.99 ,$346.80 ,$317.13 ,$243.17 ,$114.24 ,$367.20 ,$147.99 ,$346.80 ,$408.00 ,$408.00 ,$147.99 ,$265.20 ST. JOSEPH'S HOSPITAL - BREESE,31200212,G0416,HC PROSTATE NEEDLE BX SAMPLING 1-20 SPEC,312,1 ,$842.00 ,$606.24 ,$23.83 ,$842.00 ,$778.15 ,$547.30 ,$502.67 ,$305.03 ,$235.76 ,$557.40 ,$305.03 ,$557.40 ,$305.03 ,$501.83 ,$501.83 ,$305.03 ,$501.83 ,$628.74 ,$500.00 ,$778.14 ,$305.03 ,$311.13 ,$631.50 ,$597.82 ,$597.82 ,$305.03 ,$597.82 ,$715.70 ,$715.70 ,$715.70 , N/A ,$778.14 ,$715.70 ,$305.03 ,$842.00 ,$472.36 ,$305.03 ,$348.59 ,$26.21 ,$23.83 ,$305.03 ,$715.70 ,$653.64 ,$501.83 ,$235.76 ,$757.80 ,$305.03 ,$715.70 ,$842.00 ,$842.00 ,$305.03 ,$547.30 ST. JOSEPH'S HOSPITAL - BREESE,31200220,88342,HC IMMUNOHISTOCHEM AB-INITIAL,312,1 ,$349.00 ,$251.28 ,$21.67 ,$377.53 ,$377.53 ,$226.85 ,$208.35 ,$147.99 ,$97.72 ,$231.04 ,$147.99 ,$231.04 ,$147.99 ,$208.00 ,$208.00 ,$147.99 ,$208.00 ,$305.05 ,$268.73 ,$377.53 ,$147.99 ,$150.95 ,$261.75 ,$247.79 ,$247.79 ,$147.99 ,$247.79 ,$296.65 ,$296.65 ,$296.65 , N/A ,$349.00 ,$296.65 ,$147.99 ,$69.27 ,$195.79 ,$147.99 ,$144.49 ,$23.84 ,$21.67 ,$147.99 ,$296.65 ,$317.13 ,$208.00 ,$97.72 ,$314.10 ,$147.99 ,$296.65 ,$349.00 ,$349.00 ,$147.99 ,$226.85 ST. JOSEPH'S HOSPITAL - BREESE,31200249,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$701.00 ,$504.72 ,$21.67 ,$778.15 ,$778.15 ,$455.65 ,$418.50 ,$305.03 ,$196.28 ,$464.06 ,$305.03 ,$464.06 ,$305.03 ,$417.80 ,$417.80 ,$305.03 ,$417.80 ,$628.74 ,$500.00 ,$778.14 ,$305.03 ,$311.13 ,$525.75 ,$497.71 ,$497.71 ,$305.03 ,$497.71 ,$595.85 ,$595.85 ,$595.85 , N/A ,$701.00 ,$595.85 ,$305.03 ,$701.00 ,$393.26 ,$305.03 ,$290.21 ,$23.84 ,$21.67 ,$305.03 ,$595.85 ,$653.64 ,$417.80 ,$196.28 ,$630.90 ,$305.03 ,$595.85 ,$701.00 ,$701.00 ,$305.03 ,$455.65 ST. JOSEPH'S HOSPITAL - BREESE,31200255,88312,HC SPECIAL STAIN I-90,312,1 ,$102.00 ,$73.44 ,$21.67 ,$120.38 ,$120.38 ,$66.30 ,$60.89 ,$47.19 ,$28.56 ,$67.52 ,$47.19 ,$67.52 ,$47.19 ,$60.79 ,$60.79 ,$47.19 ,$60.79 ,$97.27 ,$78.54 ,$120.38 ,$47.19 ,$48.13 ,$76.50 ,$72.42 ,$72.42 ,$47.19 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$102.00 ,$86.70 ,$47.19 ,$102.00 ,$57.22 ,$47.19 ,$42.23 ,$23.84 ,$21.67 ,$47.19 ,$86.70 ,$101.12 ,$60.79 ,$28.56 ,$91.80 ,$47.19 ,$86.70 ,$102.00 ,$102.00 ,$47.19 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,31200261,88321,HC CONSULT REFERRED SLIDES-90,312,1 ,$400.00 ,$288.00 ,$21.67 ,$400.00 ,$81.53 ,$260.00 ,$238.80 ,$31.96 ,$112.00 ,$264.80 ,$31.96 ,$264.80 ,$31.96 ,$238.40 ,$238.40 ,$31.96 ,$238.40 ,$65.88 ,$308.00 ,$81.53 ,$31.96 ,$32.60 ,$300.00 ,$284.00 ,$284.00 ,$31.96 ,$284.00 ,$340.00 ,$340.00 ,$340.00 , N/A ,$81.53 ,$340.00 ,$31.96 ,$400.00 ,$224.40 ,$31.96 ,$165.60 ,$23.84 ,$21.67 ,$31.96 ,$340.00 ,$68.49 ,$238.40 ,$112.00 ,$360.00 ,$31.96 ,$340.00 ,$135.36 ,$135.36 ,$31.96 ,$260.00 ST. JOSEPH'S HOSPITAL - BREESE,31200265,88341,HC IMMUNOHISOCHEM EA AD SGL STN-90,312,1 ,$100.00 ,$72.00 ,$21.67 ,$100.00 , N/A ,$65.00 ,$59.70 , N/A ,$28.00 ,$66.20 , N/A ,$66.20 , N/A ,$59.60 ,$59.60 , N/A ,$59.60 , N/A ,$77.00 , N/A , N/A , N/A ,$75.00 ,$71.00 ,$71.00 , N/A ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A , N/A ,$85.00 , N/A ,$61.26 ,$56.10 , N/A ,$41.40 ,$23.84 ,$21.67 , N/A ,$85.00 , N/A ,$59.60 ,$28.00 ,$90.00 , N/A ,$85.00 ,$100.00 ,$100.00 , N/A ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,31200266,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$334.00 ,$240.48 ,$21.67 ,$334.00 , N/A ,$217.10 ,$199.40 , N/A ,$93.52 ,$221.11 , N/A ,$221.11 , N/A ,$199.06 ,$199.06 , N/A ,$199.06 , N/A ,$257.18 , N/A , N/A , N/A ,$250.50 ,$237.14 ,$237.14 , N/A ,$237.14 ,$283.90 ,$283.90 ,$283.90 , N/A , N/A ,$283.90 , N/A ,$61.26 ,$187.37 , N/A ,$138.28 ,$23.84 ,$21.67 , N/A ,$283.90 , N/A ,$199.06 ,$93.52 ,$300.60 , N/A ,$283.90 ,$261.00 ,$261.00 , N/A ,$217.10 ST. JOSEPH'S HOSPITAL - BREESE,31200269,88342,HC IMMUNOHISOCHEMISTR EA AB INIT-90,312,1 ,$100.00 ,$72.00 ,$21.67 ,$377.53 ,$377.53 ,$65.00 ,$59.70 ,$147.99 ,$28.00 ,$66.20 ,$147.99 ,$66.20 ,$98.00 ,$59.60 ,$59.60 ,$98.00 ,$59.60 ,$100.00 ,$77.00 ,$377.53 ,$147.99 ,$98.00 ,$75.00 ,$71.00 ,$71.00 ,$147.99 ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A ,$100.00 ,$85.00 ,$98.00 ,$69.27 ,$56.10 ,$147.99 ,$41.40 ,$23.84 ,$21.67 ,$147.99 ,$85.00 ,$317.13 ,$59.60 ,$28.00 ,$90.00 ,$147.99 ,$85.00 ,$100.00 ,$100.00 ,$147.99 ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,31200275,88360,HC MORPHO ANLYS TUMOR MAN-90,312,1 ,$566.00 ,$407.52 ,$23.83 ,$566.00 ,$377.53 ,$367.90 ,$337.90 ,$147.99 ,$158.48 ,$374.69 ,$147.99 ,$374.69 ,$147.99 ,$337.34 ,$337.34 ,$147.99 ,$337.34 ,$305.05 ,$435.82 ,$377.53 ,$147.99 ,$150.95 ,$424.50 ,$401.86 ,$401.86 ,$147.99 ,$401.86 ,$481.10 ,$481.10 ,$481.10 , N/A ,$377.53 ,$481.10 ,$147.99 ,$81.17 ,$317.53 ,$147.99 ,$234.32 ,$26.21 ,$23.83 ,$147.99 ,$481.10 ,$317.13 ,$337.34 ,$158.48 ,$509.40 ,$147.99 ,$481.10 ,$566.00 ,$566.00 ,$147.99 ,$367.90 ST. JOSEPH'S HOSPITAL - BREESE,31200276,88361,HC MORPHO ANLYS COMP ASSIST-90,312,1 ,$398.00 ,$286.56 ,$23.83 ,$778.15 ,$778.15 ,$258.70 ,$237.61 ,$305.03 ,$111.44 ,$263.48 ,$305.03 ,$263.48 ,$305.03 ,$237.21 ,$237.21 ,$305.03 ,$237.21 ,$398.00 ,$306.46 ,$778.14 ,$305.03 ,$311.13 ,$298.50 ,$282.58 ,$282.58 ,$305.03 ,$282.58 ,$338.30 ,$338.30 ,$338.30 , N/A ,$398.00 ,$338.30 ,$305.03 ,$79.07 ,$223.28 ,$305.03 ,$164.77 ,$26.21 ,$23.83 ,$305.03 ,$338.30 ,$653.64 ,$237.21 ,$111.44 ,$358.20 ,$305.03 ,$338.30 ,$398.00 ,$398.00 ,$305.03 ,$258.70 ST. JOSEPH'S HOSPITAL - BREESE,31200278,88364,HC IN SITU HYBRID(FISH) EA ADL-90,312,1 ,$380.00 ,$273.60 ,$21.67 ,$380.00 , N/A ,$247.00 ,$226.86 , N/A ,$106.40 ,$251.56 , N/A ,$251.56 , N/A ,$226.48 ,$226.48 , N/A ,$226.48 , N/A ,$292.60 , N/A , N/A , N/A ,$285.00 ,$269.80 ,$269.80 , N/A ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A , N/A ,$323.00 , N/A ,$380.00 ,$213.18 , N/A ,$157.32 ,$23.84 ,$21.67 , N/A ,$323.00 , N/A ,$226.48 ,$106.40 ,$342.00 , N/A ,$323.00 ,$380.00 ,$380.00 , N/A ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,31200279,88365,HC IN SITU HYBRID (FISH)-90,312,1 ,$723.00 ,$520.56 ,$21.67 ,$723.00 ,$377.53 ,$469.95 ,$431.63 ,$147.99 ,$202.44 ,$478.63 ,$147.99 ,$478.63 ,$147.99 ,$430.91 ,$430.91 ,$147.99 ,$430.91 ,$305.05 ,$500.00 ,$377.53 ,$147.99 ,$150.95 ,$542.25 ,$513.33 ,$513.33 ,$147.99 ,$513.33 ,$614.55 ,$614.55 ,$614.55 , N/A ,$377.53 ,$614.55 ,$147.99 ,$723.00 ,$405.60 ,$147.99 ,$299.32 ,$23.84 ,$21.67 ,$147.99 ,$614.55 ,$317.13 ,$430.91 ,$202.44 ,$650.70 ,$147.99 ,$614.55 ,$596.64 ,$596.64 ,$147.99 ,$469.95 ST. JOSEPH'S HOSPITAL - BREESE,31200280,88367,HC FISH HER-2NEU-90,312,1 ,$480.00 ,$345.60 ,$23.83 ,$778.15 ,$778.15 ,$312.00 ,$286.56 ,$305.03 ,$134.40 ,$317.76 ,$305.03 ,$317.76 ,$305.03 ,$286.08 ,$286.08 ,$305.03 ,$286.08 ,$480.00 ,$369.60 ,$778.14 ,$305.03 ,$311.13 ,$360.00 ,$340.80 ,$340.80 ,$305.03 ,$340.80 ,$408.00 ,$408.00 ,$408.00 , N/A ,$480.00 ,$408.00 ,$305.03 ,$480.00 ,$269.28 ,$305.03 ,$198.72 ,$26.21 ,$23.83 ,$305.03 ,$408.00 ,$653.64 ,$286.08 ,$134.40 ,$432.00 ,$305.03 ,$408.00 ,$480.00 ,$480.00 ,$305.03 ,$312.00 ST. JOSEPH'S HOSPITAL - BREESE,31200282,88373,HC MORPH ANLY AUTO EA ADDL-90,312,1 ,$503.00 ,$362.16 ,$23.83 ,$503.00 , N/A ,$326.95 ,$300.29 , N/A ,$140.84 ,$332.99 , N/A ,$332.99 , N/A ,$299.79 ,$299.79 , N/A ,$299.79 , N/A ,$387.31 , N/A , N/A , N/A ,$377.25 ,$357.13 ,$357.13 , N/A ,$357.13 ,$427.55 ,$427.55 ,$427.55 , N/A , N/A ,$427.55 , N/A ,$503.00 ,$282.18 , N/A ,$208.24 ,$26.21 ,$23.83 , N/A ,$427.55 , N/A ,$299.79 ,$140.84 ,$452.70 , N/A ,$427.55 ,$188.44 ,$188.44 , N/A ,$326.95 ST. JOSEPH'S HOSPITAL - BREESE,31200283,88374,HC MORPH ANLY AUTO EA MULTIPLX-90,312,1 ,$503.00 ,$362.16 ,$23.83 ,$503.00 ,$377.53 ,$326.95 ,$300.29 ,$147.99 ,$140.84 ,$332.99 ,$147.99 ,$332.99 ,$147.99 ,$299.79 ,$299.79 ,$147.99 ,$299.79 ,$305.05 ,$387.31 ,$377.53 ,$147.99 ,$150.95 ,$377.25 ,$357.13 ,$357.13 ,$147.99 ,$357.13 ,$427.55 ,$427.55 ,$427.55 , N/A ,$377.53 ,$427.55 ,$147.99 ,$503.00 ,$282.18 ,$147.99 ,$208.24 ,$26.21 ,$23.83 ,$147.99 ,$427.55 ,$317.13 ,$299.79 ,$140.84 ,$452.70 ,$147.99 ,$427.55 ,$503.00 ,$503.00 ,$147.99 ,$326.95 ST. JOSEPH'S HOSPITAL - BREESE,31200284,88377,HC MORPH ANLZ INST HYB EA MTPL-90,312,1 ,$730.00 ,$525.60 ,$23.83 ,$730.00 ,$377.53 ,$474.50 ,$435.81 ,$147.99 ,$204.40 ,$483.26 ,$147.99 ,$483.26 ,$147.99 ,$435.08 ,$435.08 ,$147.99 ,$435.08 ,$305.05 ,$500.00 ,$377.53 ,$147.99 ,$150.95 ,$547.50 ,$518.30 ,$518.30 ,$147.99 ,$518.30 ,$620.50 ,$620.50 ,$620.50 , N/A ,$377.53 ,$620.50 ,$147.99 ,$730.00 ,$409.53 ,$147.99 ,$302.22 ,$26.21 ,$23.83 ,$147.99 ,$620.50 ,$317.13 ,$435.08 ,$204.40 ,$657.00 ,$147.99 ,$620.50 ,$596.64 ,$596.64 ,$147.99 ,$474.50 ST. JOSEPH'S HOSPITAL - BREESE,32000005,22512,HC VERTEBROPLASTY INJ PERC ADDL,320,1 ,"$10,085.00 ","$7,261.20 ",$800.00 ,"$10,085.00 ", N/A ,"$6,555.25 ","$6,020.75 ", N/A ,"$2,823.80 ","$6,676.27 ", N/A ,"$6,676.27 ", N/A ,"$6,010.66 ","$6,010.66 ", N/A ,"$6,010.66 ", N/A ,$800.00 , N/A , N/A , N/A ,"$7,563.75 ","$7,160.35 ","$7,160.35 ", N/A ,"$7,160.35 ","$8,572.25 ","$8,572.25 ","$8,572.25 ", N/A , N/A ,"$8,572.25 ", N/A ,"$10,085.00 ","$5,657.69 ", N/A ,"$4,175.19 ","$3,630.03 ","$3,300.03 ", N/A ,"$8,572.25 ", N/A ,"$6,010.66 ","$2,823.80 ","$9,076.50 ", N/A ,"$8,572.25 ","$8,521.83 ","$8,521.83 ", N/A ,"$6,555.25 " ST. JOSEPH'S HOSPITAL - BREESE,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$247.00 ,$177.84 ,$69.16 ,$247.00 , N/A ,$160.55 ,$147.46 , N/A ,$69.16 ,$163.51 , N/A ,$163.51 , N/A ,$147.21 ,$147.21 , N/A ,$147.21 , N/A ,$190.19 , N/A , N/A , N/A ,$185.25 ,$175.37 ,$175.37 , N/A ,$175.37 ,$209.95 ,$209.95 ,$209.95 , N/A , N/A ,$209.95 , N/A ,$247.00 ,$138.57 , N/A ,$102.26 , N/A , N/A , N/A ,$209.95 , N/A ,$147.21 ,$69.16 ,$222.30 , N/A ,$209.95 ,$208.72 ,$208.72 , N/A ,$160.55 ST. JOSEPH'S HOSPITAL - BREESE,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$371.00 ,$267.12 ,$103.88 ,$371.00 , N/A ,$241.15 ,$221.49 , N/A ,$103.88 ,$245.60 , N/A ,$245.60 , N/A ,$221.12 ,$221.12 , N/A ,$221.12 , N/A ,$285.67 , N/A , N/A , N/A ,$278.25 ,$263.41 ,$263.41 , N/A ,$263.41 ,$315.35 ,$315.35 ,$315.35 , N/A , N/A ,$315.35 , N/A ,$371.00 ,$208.13 , N/A ,$153.59 , N/A , N/A , N/A ,$315.35 , N/A ,$221.12 ,$103.88 ,$333.90 , N/A ,$315.35 ,$313.50 ,$313.50 , N/A ,$241.15 ST. JOSEPH'S HOSPITAL - BREESE,32000010,24220,HC ARTHROGRAM INJ ELBOW,320,1 ,$262.00 ,$188.64 ,$73.36 ,$262.00 , N/A ,$170.30 ,$156.41 , N/A ,$73.36 ,$173.44 , N/A ,$173.44 , N/A ,$156.15 ,$156.15 , N/A ,$156.15 , N/A ,$201.74 , N/A , N/A , N/A ,$196.50 ,$186.02 ,$186.02 , N/A ,$186.02 ,$222.70 ,$222.70 ,$222.70 , N/A , N/A ,$222.70 , N/A ,$262.00 ,$146.98 , N/A ,$108.47 , N/A , N/A , N/A ,$222.70 , N/A ,$156.15 ,$73.36 ,$235.80 , N/A ,$222.70 ,$221.39 ,$221.39 , N/A ,$170.30 ST. JOSEPH'S HOSPITAL - BREESE,32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$282.00 ,$203.04 ,$78.96 ,$282.00 , N/A ,$183.30 ,$168.35 , N/A ,$78.96 ,$186.68 , N/A ,$186.68 , N/A ,$168.07 ,$168.07 , N/A ,$168.07 , N/A ,$217.14 , N/A , N/A , N/A ,$211.50 ,$200.22 ,$200.22 , N/A ,$200.22 ,$239.70 ,$239.70 ,$239.70 , N/A , N/A ,$239.70 , N/A ,$282.00 ,$158.20 , N/A ,$116.75 ,$257.03 ,$233.66 , N/A ,$239.70 , N/A ,$168.07 ,$78.96 ,$253.80 , N/A ,$239.70 ,$238.29 ,$238.29 , N/A ,$183.30 ST. JOSEPH'S HOSPITAL - BREESE,32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$423.00 ,$304.56 ,$118.44 ,$423.00 , N/A ,$274.95 ,$252.53 , N/A ,$118.44 ,$280.03 , N/A ,$280.03 , N/A ,$252.11 ,$252.11 , N/A ,$252.11 , N/A ,$325.71 , N/A , N/A , N/A ,$317.25 ,$300.33 ,$300.33 , N/A ,$300.33 ,$359.55 ,$359.55 ,$359.55 , N/A , N/A ,$359.55 , N/A ,$423.00 ,$237.30 , N/A ,$175.12 ,$385.54 ,$350.49 , N/A ,$359.55 , N/A ,$252.11 ,$118.44 ,$380.70 , N/A ,$359.55 ,$357.44 ,$357.44 , N/A ,$274.95 ST. JOSEPH'S HOSPITAL - BREESE,32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$331.00 ,$238.32 ,$92.68 ,$331.00 , N/A ,$215.15 ,$197.61 , N/A ,$92.68 ,$219.12 , N/A ,$219.12 , N/A ,$197.28 ,$197.28 , N/A ,$197.28 , N/A ,$254.87 , N/A , N/A , N/A ,$248.25 ,$235.01 ,$235.01 , N/A ,$235.01 ,$281.35 ,$281.35 ,$281.35 , N/A , N/A ,$281.35 , N/A ,$331.00 ,$185.69 , N/A ,$137.03 ,$257.03 ,$233.66 , N/A ,$281.35 , N/A ,$197.28 ,$92.68 ,$297.90 , N/A ,$281.35 ,$279.70 ,$279.70 , N/A ,$215.15 ST. JOSEPH'S HOSPITAL - BREESE,32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$231.00 ,$166.32 ,$64.68 ,$231.00 , N/A ,$150.15 ,$137.91 , N/A ,$64.68 ,$152.92 , N/A ,$152.92 , N/A ,$137.68 ,$137.68 , N/A ,$137.68 , N/A ,$177.87 , N/A , N/A , N/A ,$173.25 ,$164.01 ,$164.01 , N/A ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A , N/A ,$196.35 , N/A ,$231.00 ,$129.59 , N/A ,$95.63 , N/A , N/A , N/A ,$196.35 , N/A ,$137.68 ,$64.68 ,$207.90 , N/A ,$196.35 ,$195.20 ,$195.20 , N/A ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,32000016,27648,HC ARTHROGRAM INJ ANKLE,320,1 ,$231.00 ,$166.32 ,$64.68 ,$231.00 , N/A ,$150.15 ,$137.91 , N/A ,$64.68 ,$152.92 , N/A ,$152.92 , N/A ,$137.68 ,$137.68 , N/A ,$137.68 , N/A ,$177.87 , N/A , N/A , N/A ,$173.25 ,$164.01 ,$164.01 , N/A ,$164.01 ,$196.35 ,$196.35 ,$196.35 , N/A , N/A ,$196.35 , N/A ,$231.00 ,$129.59 , N/A ,$95.63 ,$231.00 ,$231.00 , N/A ,$196.35 , N/A ,$137.68 ,$64.68 ,$207.90 , N/A ,$196.35 ,$195.20 ,$195.20 , N/A ,$150.15 ST. JOSEPH'S HOSPITAL - BREESE,32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$5,377.00 ","$3,871.44 ",$465.61 ,"$5,377.00 ","$3,572.10 ","$3,495.05 ","$3,210.07 ","$1,400.26 ","$1,505.56 ","$3,559.57 ","$1,400.26 ","$3,559.57 ","$1,400.26 ","$3,204.69 ","$3,204.69 ","$1,400.26 ","$3,204.69 ","$2,886.26 ",$800.00 ,"$3,572.10 ","$1,400.26 ","$1,428.27 ","$4,032.75 ","$3,817.67 ","$3,817.67 ","$1,400.26 ","$3,817.67 ","$4,570.45 ","$4,570.45 ","$4,570.45 ", N/A ,"$3,572.10 ","$4,570.45 ","$1,400.26 ","$5,377.00 ","$3,016.50 ","$1,400.26 ","$2,226.08 ",$512.17 ,$465.61 ,"$1,400.26 ","$4,570.45 ","$3,000.57 ","$3,204.69 ","$1,505.56 ","$4,839.30 ","$1,400.26 ","$4,570.45 ","$4,543.57 ","$4,543.57 ","$1,400.26 ","$3,495.05 " ST. JOSEPH'S HOSPITAL - BREESE,32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,361,1 ,$181.00 ,$130.32 ,$32.62 ,$181.00 , N/A ,$117.65 ,$108.06 , N/A ,$50.68 ,$119.82 , N/A ,$119.82 , N/A ,$107.88 ,$107.88 , N/A ,$107.88 , N/A , N/A , N/A , N/A , N/A ,$135.75 ,$128.51 ,$128.51 , N/A ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A , N/A ,$153.85 , N/A ,$181.00 ,$101.54 , N/A ,$74.93 ,$35.88 ,$32.62 , N/A ,$153.85 , N/A ,$107.88 ,$50.68 ,$162.90 , N/A ,$153.85 ,$152.95 ,$152.95 , N/A ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$532.00 ,$383.04 ,$148.96 ,$532.00 ,$495.95 ,$345.80 ,$317.60 ,$194.41 ,$148.96 ,$352.18 ,$194.41 ,$352.18 ,$194.41 ,$317.07 ,$317.07 ,$194.41 ,$317.07 ,$400.72 ,$409.64 ,$495.94 ,$194.41 ,$198.29 ,$399.00 ,$377.72 ,$377.72 ,$194.41 ,$377.72 ,$452.20 ,$452.20 ,$452.20 , N/A ,$495.94 ,$452.20 ,$194.41 ,$532.00 ,$298.45 ,$194.41 ,$220.25 ,$532.00 ,$532.00 ,$194.41 ,$452.20 ,$416.59 ,$317.07 ,$148.96 ,$478.80 ,$194.41 ,$452.20 ,$449.54 ,$449.54 ,$194.41 ,$345.80 ST. JOSEPH'S HOSPITAL - BREESE,32000060,49450,HC RPLC G/CEC/OTH TB UNDER FLUORO,320,1 ,"$2,793.00 ","$2,010.96 ",$405.28 ,"$2,793.00 ","$1,981.93 ","$1,815.45 ","$1,667.42 ",$776.91 ,$782.04 ,"$1,848.97 ",$776.91 ,"$1,848.97 ",$776.91 ,"$1,664.63 ","$1,664.63 ",$776.91 ,"$1,664.63 ","$1,601.40 ",$800.00 ,"$1,981.93 ",$776.91 ,$792.46 ,"$2,094.75 ","$1,983.03 ","$1,983.03 ",$776.91 ,"$1,983.03 ","$2,374.05 ","$2,374.05 ","$2,374.05 ", N/A ,"$1,981.93 ","$2,374.05 ",$776.91 ,"$2,793.00 ","$1,566.87 ",$776.91 ,"$1,156.30 ",$445.81 ,$405.28 ,$776.91 ,"$2,374.05 ","$1,664.82 ","$1,664.63 ",$782.04 ,"$2,513.70 ",$776.91 ,"$2,374.05 ","$2,360.09 ","$2,360.09 ",$776.91 ,"$1,815.45 " ST. JOSEPH'S HOSPITAL - BREESE,32000061,49451,HC RPLC DUODEN/JEJUN TB FLUORO,320,1 ,"$2,393.19 ","$1,723.10 ",$405.28 ,"$2,393.19 ","$1,981.93 ","$1,555.57 ","$1,428.73 ",$776.91 ,$670.09 ,"$1,584.29 ",$776.91 ,"$1,584.29 ",$776.91 ,"$1,426.34 ","$1,426.34 ",$776.91 ,"$1,426.34 ","$1,601.40 ",$800.00 ,"$1,981.93 ",$776.91 ,$792.46 ,"$1,794.89 ","$1,699.16 ","$1,699.16 ",$776.91 ,"$1,699.16 ","$2,034.21 ","$2,034.21 ","$2,034.21 ", N/A ,"$1,981.93 ","$2,034.21 ",$776.91 ,"$2,393.19 ","$1,342.58 ",$776.91 ,$990.78 ,$445.81 ,$405.28 ,$776.91 ,"$2,034.21 ","$1,664.82 ","$1,426.34 ",$670.09 ,"$2,153.87 ",$776.91 ,"$2,034.21 ","$2,022.25 ","$2,022.25 ",$776.91 ,"$1,555.57 " ST. JOSEPH'S HOSPITAL - BREESE,32000085,51600,HC INJ CYSTOGRAM,320,1 ,"$1,047.00 ",$753.84 ,$233.66 ,"$1,047.00 ", N/A ,$680.55 ,$625.06 , N/A ,$293.16 ,$693.11 , N/A ,$693.11 , N/A ,$624.01 ,$624.01 , N/A ,$624.01 , N/A ,$800.00 , N/A , N/A , N/A ,$785.25 ,$743.37 ,$743.37 , N/A ,$743.37 ,$889.95 ,$889.95 ,$889.95 , N/A , N/A ,$889.95 , N/A ,"$1,047.00 ",$587.37 , N/A ,$433.46 ,$257.03 ,$233.66 , N/A ,$889.95 , N/A ,$624.01 ,$293.16 ,$942.30 , N/A ,$889.95 ,$884.72 ,$884.72 , N/A ,$680.55 ST. JOSEPH'S HOSPITAL - BREESE,32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$296.00 ,$213.12 ,$82.88 ,$296.00 , N/A ,$192.40 ,$176.71 , N/A ,$82.88 ,$195.95 , N/A ,$195.95 , N/A ,$176.42 ,$176.42 , N/A ,$176.42 , N/A ,$227.92 , N/A , N/A , N/A ,$222.00 ,$210.16 ,$210.16 , N/A ,$210.16 ,$251.60 ,$251.60 ,$251.60 , N/A , N/A ,$251.60 , N/A ,$296.00 ,$166.06 , N/A ,$122.54 ,$257.03 ,$233.66 , N/A ,$251.60 , N/A ,$176.42 ,$82.88 ,$266.40 , N/A ,$251.60 ,$250.12 ,$250.12 , N/A ,$192.40 ST. JOSEPH'S HOSPITAL - BREESE,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$451.00 ,$324.72 ,$37.46 ,$451.00 ,$208.58 ,$293.15 ,$269.25 ,$81.76 ,$126.28 ,$298.56 ,$81.76 ,$298.56 ,$81.76 ,$268.80 ,$268.80 ,$81.76 ,$268.80 ,$168.54 ,$347.27 ,$208.59 ,$81.76 ,$83.40 ,$338.25 ,$320.21 ,$320.21 ,$81.76 ,$320.21 ,$383.35 ,$383.35 ,$383.35 , N/A ,$208.59 ,$383.35 ,$81.76 ,$451.00 ,$253.01 ,$81.76 ,$186.71 ,$41.21 ,$37.46 ,$81.76 ,$383.35 ,$175.21 ,$268.80 ,$126.28 ,$405.90 ,$81.76 ,$383.35 ,$381.10 ,$381.10 ,$81.76 ,$293.15 ST. JOSEPH'S HOSPITAL - BREESE,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$675.00 ,$486.00 ,$56.19 ,$675.00 ,$208.58 ,$438.75 ,$402.98 ,$81.76 ,$189.00 ,$446.85 ,$81.76 ,$446.85 ,$81.76 ,$402.30 ,$402.30 ,$81.76 ,$402.30 ,$168.54 ,$519.75 ,$208.59 ,$81.76 ,$83.40 ,$506.25 ,$479.25 ,$479.25 ,$81.76 ,$479.25 ,$573.75 ,$573.75 ,$573.75 , N/A ,$208.59 ,$573.75 ,$81.76 ,$675.00 ,$378.68 ,$81.76 ,$279.45 ,$61.81 ,$56.19 ,$81.76 ,$573.75 ,$175.21 ,$402.30 ,$189.00 ,$607.50 ,$81.76 ,$573.75 ,$570.38 ,$570.38 ,$81.76 ,$438.75 ST. JOSEPH'S HOSPITAL - BREESE,32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$643.00 ,$462.96 ,$37.46 ,$643.00 ,$256.60 ,$417.95 ,$383.87 ,$100.59 ,$180.04 ,$425.67 ,$100.59 ,$425.67 ,$100.59 ,$383.23 ,$383.23 ,$100.59 ,$383.23 ,$207.34 ,$495.11 ,$256.60 ,$100.59 ,$102.60 ,$482.25 ,$456.53 ,$456.53 ,$100.59 ,$456.53 ,$546.55 ,$546.55 ,$546.55 , N/A ,$256.60 ,$546.55 ,$100.59 ,$643.00 ,$360.72 ,$100.59 ,$266.20 ,$41.21 ,$37.46 ,$100.59 ,$546.55 ,$215.55 ,$383.23 ,$180.04 ,$578.70 ,$100.59 ,$546.55 ,$543.34 ,$543.34 ,$100.59 ,$417.95 ST. JOSEPH'S HOSPITAL - BREESE,32000101,70130,HC MASTOIDS MN 3VW PER SIDE,320,1 ,$691.00 ,$497.52 ,$37.46 ,$691.00 ,$256.60 ,$449.15 ,$412.53 ,$100.59 ,$193.48 ,$457.44 ,$100.59 ,$457.44 ,$100.59 ,$411.84 ,$411.84 ,$100.59 ,$411.84 ,$207.34 ,$532.07 ,$256.60 ,$100.59 ,$102.60 ,$518.25 ,$490.61 ,$490.61 ,$100.59 ,$490.61 ,$587.35 ,$587.35 ,$587.35 , N/A ,$256.60 ,$587.35 ,$100.59 ,$691.00 ,$387.65 ,$100.59 ,$286.07 ,$41.21 ,$37.46 ,$100.59 ,$587.35 ,$215.55 ,$411.84 ,$193.48 ,$621.90 ,$100.59 ,$587.35 ,$583.90 ,$583.90 ,$100.59 ,$449.15 ST. JOSEPH'S HOSPITAL - BREESE,32000101,70130,HC MASTOIDS MN 3VW PER SIDE,320,1 ,"$1,037.00 ",$746.64 ,$56.19 ,"$1,037.00 ",$256.60 ,$674.05 ,$619.09 ,$100.59 ,$290.36 ,$686.49 ,$100.59 ,$686.49 ,$100.59 ,$618.05 ,$618.05 ,$100.59 ,$618.05 ,$207.34 ,$798.49 ,$256.60 ,$100.59 ,$102.60 ,$777.75 ,$736.27 ,$736.27 ,$100.59 ,$736.27 ,$881.45 ,$881.45 ,$881.45 , N/A ,$256.60 ,$881.45 ,$100.59 ,"$1,037.00 ",$581.76 ,$100.59 ,$429.32 ,$61.81 ,$56.19 ,$100.59 ,$881.45 ,$215.55 ,$618.05 ,$290.36 ,$933.30 ,$100.59 ,$881.45 ,$876.27 ,$876.27 ,$100.59 ,$674.05 ST. JOSEPH'S HOSPITAL - BREESE,32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$727.00 ,$523.44 ,$37.46 ,$727.00 ,$256.60 ,$472.55 ,$434.02 ,$100.59 ,$203.56 ,$481.27 ,$100.59 ,$481.27 ,$100.59 ,$433.29 ,$433.29 ,$100.59 ,$433.29 ,$207.34 ,$559.79 ,$256.60 ,$100.59 ,$102.60 ,$545.25 ,$516.17 ,$516.17 ,$100.59 ,$516.17 ,$617.95 ,$617.95 ,$617.95 , N/A ,$256.60 ,$617.95 ,$100.59 ,$727.00 ,$407.85 ,$100.59 ,$300.98 ,$41.21 ,$37.46 ,$100.59 ,$617.95 ,$215.55 ,$433.29 ,$203.56 ,$654.30 ,$100.59 ,$617.95 ,$614.32 ,$614.32 ,$100.59 ,$472.55 ST. JOSEPH'S HOSPITAL - BREESE,32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$532.00 ,$383.04 ,$37.46 ,$532.00 ,$208.58 ,$345.80 ,$317.60 ,$81.76 ,$148.96 ,$352.18 ,$81.76 ,$352.18 ,$81.76 ,$317.07 ,$317.07 ,$81.76 ,$317.07 ,$168.54 ,$409.64 ,$208.59 ,$81.76 ,$83.40 ,$399.00 ,$377.72 ,$377.72 ,$81.76 ,$377.72 ,$452.20 ,$452.20 ,$452.20 , N/A ,$208.59 ,$452.20 ,$81.76 ,$532.00 ,$298.45 ,$81.76 ,$220.25 ,$41.21 ,$37.46 ,$81.76 ,$452.20 ,$175.21 ,$317.07 ,$148.96 ,$478.80 ,$81.76 ,$452.20 ,$449.54 ,$449.54 ,$81.76 ,$345.80 ST. JOSEPH'S HOSPITAL - BREESE,32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$588.00 ,$423.36 ,$37.46 ,$588.00 ,$256.60 ,$382.20 ,$351.04 ,$100.59 ,$164.64 ,$389.26 ,$100.59 ,$389.26 ,$100.59 ,$350.45 ,$350.45 ,$100.59 ,$350.45 ,$207.34 ,$452.76 ,$256.60 ,$100.59 ,$102.60 ,$441.00 ,$417.48 ,$417.48 ,$100.59 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$256.60 ,$499.80 ,$100.59 ,$588.00 ,$329.87 ,$100.59 ,$243.43 ,$41.21 ,$37.46 ,$100.59 ,$499.80 ,$215.55 ,$350.45 ,$164.64 ,$529.20 ,$100.59 ,$499.80 ,$496.86 ,$496.86 ,$100.59 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$770.00 ,$554.40 ,$37.46 ,$770.00 ,$208.58 ,$500.50 ,$459.69 ,$81.76 ,$215.60 ,$509.74 ,$81.76 ,$509.74 ,$81.76 ,$458.92 ,$458.92 ,$81.76 ,$458.92 ,$168.54 ,$592.90 ,$208.59 ,$81.76 ,$83.40 ,$577.50 ,$546.70 ,$546.70 ,$81.76 ,$546.70 ,$654.50 ,$654.50 ,$654.50 , N/A ,$208.59 ,$654.50 ,$81.76 ,$770.00 ,$431.97 ,$81.76 ,$318.78 ,$41.21 ,$37.46 ,$81.76 ,$654.50 ,$175.21 ,$458.92 ,$215.60 ,$693.00 ,$81.76 ,$654.50 ,$650.65 ,$650.65 ,$81.76 ,$500.50 ST. JOSEPH'S HOSPITAL - BREESE,32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$593.00 ,$426.96 ,$37.46 ,$593.00 ,$256.60 ,$385.45 ,$354.02 ,$100.59 ,$166.04 ,$392.57 ,$100.59 ,$392.57 ,$100.59 ,$353.43 ,$353.43 ,$100.59 ,$353.43 ,$207.34 ,$456.61 ,$256.60 ,$100.59 ,$102.60 ,$444.75 ,$421.03 ,$421.03 ,$100.59 ,$421.03 ,$504.05 ,$504.05 ,$504.05 , N/A ,$256.60 ,$504.05 ,$100.59 ,$593.00 ,$332.67 ,$100.59 ,$245.50 ,$41.21 ,$37.46 ,$100.59 ,$504.05 ,$215.55 ,$353.43 ,$166.04 ,$533.70 ,$100.59 ,$504.05 ,$501.09 ,$501.09 ,$100.59 ,$385.45 ST. JOSEPH'S HOSPITAL - BREESE,32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$872.00 ,$627.84 ,$37.46 ,$872.00 ,$256.60 ,$566.80 ,$520.58 ,$100.59 ,$244.16 ,$577.26 ,$100.59 ,$577.26 ,$100.59 ,$519.71 ,$519.71 ,$100.59 ,$519.71 ,$207.34 ,$671.44 ,$256.60 ,$100.59 ,$102.60 ,$654.00 ,$619.12 ,$619.12 ,$100.59 ,$619.12 ,$741.20 ,$741.20 ,$741.20 , N/A ,$256.60 ,$741.20 ,$100.59 ,$872.00 ,$489.19 ,$100.59 ,$361.01 ,$41.21 ,$37.46 ,$100.59 ,$741.20 ,$215.55 ,$519.71 ,$244.16 ,$784.80 ,$100.59 ,$741.20 ,$736.84 ,$736.84 ,$100.59 ,$566.80 ST. JOSEPH'S HOSPITAL - BREESE,32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$406.00 ,$292.32 ,$37.46 ,$406.00 ,$208.58 ,$263.90 ,$242.38 ,$81.76 ,$113.68 ,$268.77 ,$81.76 ,$268.77 ,$81.76 ,$241.98 ,$241.98 ,$81.76 ,$241.98 ,$168.54 ,$312.62 ,$208.59 ,$81.76 ,$83.40 ,$304.50 ,$288.26 ,$288.26 ,$81.76 ,$288.26 ,$345.10 ,$345.10 ,$345.10 , N/A ,$208.59 ,$345.10 ,$81.76 ,$406.00 ,$227.77 ,$81.76 ,$168.08 ,$41.21 ,$37.46 ,$81.76 ,$345.10 ,$175.21 ,$241.98 ,$113.68 ,$365.40 ,$81.76 ,$345.10 ,$343.07 ,$343.07 ,$81.76 ,$263.90 ST. JOSEPH'S HOSPITAL - BREESE,32000114,70336,HC MRI TMJ,320,1 ,"$3,263.00 ","$2,349.36 ",$157.37 ,"$3,263.00 ",$560.65 ,"$2,120.95 ","$1,948.01 ",$219.77 ,$913.64 ,"$2,160.11 ",$219.77 ,"$2,160.11 ",$219.77 ,"$1,944.75 ","$1,944.75 ",$219.77 ,"$1,944.75 ",$453.00 ,$800.00 ,$560.65 ,$219.77 ,$224.17 ,"$2,447.25 ","$2,316.73 ","$2,316.73 ",$219.77 ,"$2,316.73 ","$2,773.55 ","$2,773.55 ","$2,773.55 ", N/A ,$560.65 ,"$2,773.55 ",$219.77 ,"$3,263.00 ","$1,830.54 ",$219.77 ,"$1,350.88 ",$173.11 ,$157.37 ,$219.77 ,"$2,773.55 ",$470.94 ,"$1,944.75 ",$913.64 ,"$2,936.70 ",$219.77 ,"$2,773.55 ","$2,757.24 ","$2,757.24 ",$219.77 ,"$2,120.95 " ST. JOSEPH'S HOSPITAL - BREESE,32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$403.00 ,$290.16 ,$37.46 ,$403.00 ,$208.58 ,$261.95 ,$240.59 ,$81.76 ,$112.84 ,$266.79 ,$81.76 ,$266.79 ,$81.76 ,$240.19 ,$240.19 ,$81.76 ,$240.19 ,$168.54 ,$310.31 ,$208.59 ,$81.76 ,$83.40 ,$302.25 ,$286.13 ,$286.13 ,$81.76 ,$286.13 ,$342.55 ,$342.55 ,$342.55 , N/A ,$208.59 ,$342.55 ,$81.76 ,$403.00 ,$226.08 ,$81.76 ,$166.84 ,$41.21 ,$37.46 ,$81.76 ,$342.55 ,$175.21 ,$240.19 ,$112.84 ,$362.70 ,$81.76 ,$342.55 ,$340.54 ,$340.54 ,$81.76 ,$261.95 ST. JOSEPH'S HOSPITAL - BREESE,32000121,71045,HC XR CHEST 1V,320,1 ,$447.00 ,$321.84 ,$18.51 ,$447.00 ,$208.58 ,$290.55 ,$266.86 ,$81.76 ,$125.16 ,$295.91 ,$81.76 ,$295.91 ,$81.76 ,$266.41 ,$266.41 ,$81.76 ,$266.41 ,$168.54 ,$344.19 ,$208.59 ,$81.76 ,$83.40 ,$335.25 ,$317.37 ,$317.37 ,$81.76 ,$317.37 ,$379.95 ,$379.95 ,$379.95 , N/A ,$208.59 ,$379.95 ,$81.76 ,$18.51 ,$250.77 ,$81.76 ,$185.06 ,$41.21 ,$37.46 ,$81.76 ,$379.95 ,$175.21 ,$266.41 ,$125.16 ,$402.30 ,$81.76 ,$379.95 ,$377.72 ,$377.72 ,$81.76 ,$290.55 ST. JOSEPH'S HOSPITAL - BREESE,32000127,71046,HC XR CHEST 2V,320,1 ,$614.00 ,$442.08 ,$24.81 ,$614.00 ,$208.58 ,$399.10 ,$366.56 ,$81.76 ,$171.92 ,$406.47 ,$81.76 ,$406.47 ,$81.76 ,$365.94 ,$365.94 ,$81.76 ,$365.94 ,$168.54 ,$472.78 ,$208.59 ,$81.76 ,$83.40 ,$460.50 ,$435.94 ,$435.94 ,$81.76 ,$435.94 ,$521.90 ,$521.90 ,$521.90 , N/A ,$208.59 ,$521.90 ,$81.76 ,$24.81 ,$344.45 ,$81.76 ,$254.20 ,$41.21 ,$37.46 ,$81.76 ,$521.90 ,$175.21 ,$365.94 ,$171.92 ,$552.60 ,$81.76 ,$521.90 ,$518.83 ,$518.83 ,$81.76 ,$399.10 ST. JOSEPH'S HOSPITAL - BREESE,32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$681.00 ,$490.32 ,$37.46 ,$681.00 ,$208.58 ,$442.65 ,$406.56 ,$81.76 ,$190.68 ,$450.82 ,$81.76 ,$450.82 ,$81.76 ,$405.88 ,$405.88 ,$81.76 ,$405.88 ,$168.54 ,$524.37 ,$208.59 ,$81.76 ,$83.40 ,$510.75 ,$483.51 ,$483.51 ,$81.76 ,$483.51 ,$578.85 ,$578.85 ,$578.85 , N/A ,$208.59 ,$578.85 ,$81.76 ,$681.00 ,$382.04 ,$81.76 ,$281.93 ,$41.21 ,$37.46 ,$81.76 ,$578.85 ,$175.21 ,$405.88 ,$190.68 ,$612.90 ,$81.76 ,$578.85 ,$575.45 ,$575.45 ,$81.76 ,$442.65 ST. JOSEPH'S HOSPITAL - BREESE,32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$681.00 ,$490.32 ,$37.46 ,$681.00 ,$256.60 ,$442.65 ,$406.56 ,$100.59 ,$190.68 ,$450.82 ,$100.59 ,$450.82 ,$100.59 ,$405.88 ,$405.88 ,$100.59 ,$405.88 ,$207.34 ,$524.37 ,$256.60 ,$100.59 ,$102.60 ,$510.75 ,$483.51 ,$483.51 ,$100.59 ,$483.51 ,$578.85 ,$578.85 ,$578.85 , N/A ,$256.60 ,$578.85 ,$100.59 ,$681.00 ,$382.04 ,$100.59 ,$281.93 ,$41.21 ,$37.46 ,$100.59 ,$578.85 ,$215.55 ,$405.88 ,$190.68 ,$612.90 ,$100.59 ,$578.85 ,$575.45 ,$575.45 ,$100.59 ,$442.65 ST. JOSEPH'S HOSPITAL - BREESE,32000133,71048,HC XR CHEST 4+V,320,1 ,$681.00 ,$490.32 ,$37.46 ,$681.00 ,$256.60 ,$442.65 ,$406.56 ,$100.59 ,$190.68 ,$450.82 ,$100.59 ,$450.82 ,$100.59 ,$405.88 ,$405.88 ,$100.59 ,$405.88 ,$207.34 ,$524.37 ,$256.60 ,$100.59 ,$102.60 ,$510.75 ,$483.51 ,$483.51 ,$100.59 ,$483.51 ,$578.85 ,$578.85 ,$578.85 , N/A ,$256.60 ,$578.85 ,$100.59 ,$681.00 ,$382.04 ,$100.59 ,$281.93 ,$41.21 ,$37.46 ,$100.59 ,$578.85 ,$215.55 ,$405.88 ,$190.68 ,$612.90 ,$100.59 ,$578.85 ,$575.45 ,$575.45 ,$100.59 ,$442.65 ST. JOSEPH'S HOSPITAL - BREESE,32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$614.00 ,$442.08 ,$24.81 ,$614.00 ,$208.58 ,$399.10 ,$366.56 ,$81.76 ,$171.92 ,$406.47 ,$81.76 ,$406.47 ,$81.76 ,$365.94 ,$365.94 ,$81.76 ,$365.94 ,$168.54 ,$472.78 ,$208.59 ,$81.76 ,$83.40 ,$460.50 ,$435.94 ,$435.94 ,$81.76 ,$435.94 ,$521.90 ,$521.90 ,$521.90 , N/A ,$208.59 ,$521.90 ,$81.76 ,$24.81 ,$344.45 ,$81.76 ,$254.20 ,$41.21 ,$37.46 ,$81.76 ,$521.90 ,$175.21 ,$365.94 ,$171.92 ,$552.60 ,$81.76 ,$521.90 ,$518.83 ,$518.83 ,$81.76 ,$399.10 ST. JOSEPH'S HOSPITAL - BREESE,32000137,71100,HC XR RIBS 2V UNI,320,1 ,$532.00 ,$383.04 ,$37.46 ,$532.00 ,$208.58 ,$345.80 ,$317.60 ,$81.76 ,$148.96 ,$352.18 ,$81.76 ,$352.18 ,$81.76 ,$317.07 ,$317.07 ,$81.76 ,$317.07 ,$168.54 ,$409.64 ,$208.59 ,$81.76 ,$83.40 ,$399.00 ,$377.72 ,$377.72 ,$81.76 ,$377.72 ,$452.20 ,$452.20 ,$452.20 , N/A ,$208.59 ,$452.20 ,$81.76 ,$532.00 ,$298.45 ,$81.76 ,$220.25 ,$41.21 ,$37.46 ,$81.76 ,$452.20 ,$175.21 ,$317.07 ,$148.96 ,$478.80 ,$81.76 ,$452.20 ,$449.54 ,$449.54 ,$81.76 ,$345.80 ST. JOSEPH'S HOSPITAL - BREESE,32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$357.00 ,$257.04 ,$37.46 ,$357.00 ,$256.60 ,$232.05 ,$213.13 ,$100.59 ,$99.96 ,$236.33 ,$100.59 ,$236.33 ,$100.59 ,$212.77 ,$212.77 ,$100.59 ,$212.77 ,$207.34 ,$274.89 ,$256.60 ,$100.59 ,$102.60 ,$267.75 ,$253.47 ,$253.47 ,$100.59 ,$253.47 ,$303.45 ,$303.45 ,$303.45 , N/A ,$256.60 ,$303.45 ,$100.59 ,$357.00 ,$200.28 ,$100.59 ,$147.80 ,$41.21 ,$37.46 ,$100.59 ,$303.45 ,$215.55 ,$212.77 ,$99.96 ,$321.30 ,$100.59 ,$303.45 ,$301.67 ,$301.67 ,$100.59 ,$232.05 ST. JOSEPH'S HOSPITAL - BREESE,32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$822.00 ,$591.84 ,$37.46 ,$822.00 ,$256.60 ,$534.30 ,$490.73 ,$100.59 ,$230.16 ,$544.16 ,$100.59 ,$544.16 ,$100.59 ,$489.91 ,$489.91 ,$100.59 ,$489.91 ,$207.34 ,$632.94 ,$256.60 ,$100.59 ,$102.60 ,$616.50 ,$583.62 ,$583.62 ,$100.59 ,$583.62 ,$698.70 ,$698.70 ,$698.70 , N/A ,$256.60 ,$698.70 ,$100.59 ,$822.00 ,$461.14 ,$100.59 ,$340.31 ,$41.21 ,$37.46 ,$100.59 ,$698.70 ,$215.55 ,$489.91 ,$230.16 ,$739.80 ,$100.59 ,$698.70 ,$694.59 ,$694.59 ,$100.59 ,$534.30 ST. JOSEPH'S HOSPITAL - BREESE,32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$358.00 ,$257.76 ,$37.46 ,$358.00 ,$256.60 ,$232.70 ,$213.73 ,$100.59 ,$100.24 ,$237.00 ,$100.59 ,$237.00 ,$100.59 ,$213.37 ,$213.37 ,$100.59 ,$213.37 ,$207.34 ,$275.66 ,$256.60 ,$100.59 ,$102.60 ,$268.50 ,$254.18 ,$254.18 ,$100.59 ,$254.18 ,$304.30 ,$304.30 ,$304.30 , N/A ,$256.60 ,$304.30 ,$100.59 ,$358.00 ,$200.84 ,$100.59 ,$148.21 ,$41.21 ,$37.46 ,$100.59 ,$304.30 ,$215.55 ,$213.37 ,$100.24 ,$322.20 ,$100.59 ,$304.30 ,$302.51 ,$302.51 ,$100.59 ,$232.70 ST. JOSEPH'S HOSPITAL - BREESE,32000141,71120,HC XR STERNUM 2+V,320,1 ,$564.00 ,$406.08 ,$37.46 ,$564.00 ,$208.58 ,$366.60 ,$336.71 ,$81.76 ,$157.92 ,$373.37 ,$81.76 ,$373.37 ,$81.76 ,$336.14 ,$336.14 ,$81.76 ,$336.14 ,$168.54 ,$434.28 ,$208.59 ,$81.76 ,$83.40 ,$423.00 ,$400.44 ,$400.44 ,$81.76 ,$400.44 ,$479.40 ,$479.40 ,$479.40 , N/A ,$208.59 ,$479.40 ,$81.76 ,$564.00 ,$316.40 ,$81.76 ,$233.50 ,$41.21 ,$37.46 ,$81.76 ,$479.40 ,$175.21 ,$336.14 ,$157.92 ,$507.60 ,$81.76 ,$479.40 ,$476.58 ,$476.58 ,$81.76 ,$366.60 ST. JOSEPH'S HOSPITAL - BREESE,32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$338.00 ,$243.36 ,$37.46 ,$338.00 ,$208.58 ,$219.70 ,$201.79 ,$81.76 ,$94.64 ,$223.76 ,$81.76 ,$223.76 ,$81.76 ,$201.45 ,$201.45 ,$81.76 ,$201.45 ,$168.54 ,$260.26 ,$208.59 ,$81.76 ,$83.40 ,$253.50 ,$239.98 ,$239.98 ,$81.76 ,$239.98 ,$287.30 ,$287.30 ,$287.30 , N/A ,$208.59 ,$287.30 ,$81.76 ,$338.00 ,$189.62 ,$81.76 ,$139.93 ,$41.21 ,$37.46 ,$81.76 ,$287.30 ,$175.21 ,$201.45 ,$94.64 ,$304.20 ,$81.76 ,$287.30 ,$285.61 ,$285.61 ,$81.76 ,$219.70 ST. JOSEPH'S HOSPITAL - BREESE,32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$3,181.00 ","$2,290.32 ",$93.45 ,"$3,181.00 ",$256.60 ,"$2,067.65 ","$1,899.06 ",$100.59 ,$890.68 ,"$2,105.82 ",$100.59 ,"$2,105.82 ",$100.59 ,"$1,895.88 ","$1,895.88 ",$100.59 ,"$1,895.88 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$2,385.75 ","$2,258.51 ","$2,258.51 ",$100.59 ,"$2,258.51 ","$2,703.85 ","$2,703.85 ","$2,703.85 ", N/A ,$256.60 ,"$2,703.85 ",$100.59 ,"$3,181.00 ","$1,784.54 ",$100.59 ,"$1,316.93 ",$102.80 ,$93.45 ,$100.59 ,"$2,703.85 ",$215.55 ,"$1,895.88 ",$890.68 ,"$2,862.90 ",$100.59 ,"$2,703.85 ","$2,687.95 ","$2,687.95 ",$100.59 ,"$2,067.65 " ST. JOSEPH'S HOSPITAL - BREESE,32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$3,948.00 ","$2,842.56 ",$93.45 ,"$3,948.00 ",$432.98 ,"$2,566.20 ","$2,356.96 ",$169.73 ,"$1,105.44 ","$2,613.58 ",$169.73 ,"$2,613.58 ",$169.73 ,"$2,353.01 ","$2,353.01 ",$169.73 ,"$2,353.01 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,961.00 ","$2,803.08 ","$2,803.08 ",$169.73 ,"$2,803.08 ","$3,355.80 ","$3,355.80 ","$3,355.80 ", N/A ,$432.97 ,"$3,355.80 ",$169.73 ,"$3,948.00 ","$2,214.83 ",$169.73 ,"$1,634.47 ",$102.80 ,$93.45 ,$169.73 ,"$3,355.80 ",$363.69 ,"$2,353.01 ","$1,105.44 ","$3,553.20 ",$169.73 ,"$3,355.80 ","$3,336.06 ","$3,336.06 ",$169.73 ,"$2,566.20 " ST. JOSEPH'S HOSPITAL - BREESE,32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$4,213.00 ","$3,033.36 ",$93.45 ,"$4,213.00 ",$432.98 ,"$2,738.45 ","$2,515.16 ",$169.73 ,"$1,179.64 ","$2,789.01 ",$169.73 ,"$2,789.01 ",$169.73 ,"$2,510.95 ","$2,510.95 ",$169.73 ,"$2,510.95 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$3,159.75 ","$2,991.23 ","$2,991.23 ",$169.73 ,"$2,991.23 ","$3,581.05 ","$3,581.05 ","$3,581.05 ", N/A ,$432.97 ,"$3,581.05 ",$169.73 ,"$4,213.00 ","$2,363.49 ",$169.73 ,"$1,744.18 ",$102.80 ,$93.45 ,$169.73 ,"$3,581.05 ",$363.69 ,"$2,510.95 ","$1,179.64 ","$3,791.70 ",$169.73 ,"$3,581.05 ","$3,559.99 ","$3,559.99 ",$169.73 ,"$2,738.45 " ST. JOSEPH'S HOSPITAL - BREESE,32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$3,406.00 ","$2,452.32 ",$169.73 ,"$3,406.00 ",$432.98 ,"$2,213.90 ","$2,033.38 ",$169.73 ,$953.68 ,"$2,254.77 ",$169.73 ,"$2,254.77 ",$169.73 ,"$2,029.98 ","$2,029.98 ",$169.73 ,"$2,029.98 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,554.50 ","$2,418.26 ","$2,418.26 ",$169.73 ,"$2,418.26 ","$2,895.10 ","$2,895.10 ","$2,895.10 ", N/A ,$432.97 ,"$2,895.10 ",$169.73 ,"$3,406.00 ","$1,910.77 ",$169.73 ,"$1,410.08 ",$232.32 ,$211.20 ,$169.73 ,"$2,895.10 ",$363.69 ,"$2,029.98 ",$953.68 ,"$3,065.40 ",$169.73 ,"$2,895.10 ","$2,878.07 ","$2,878.07 ",$169.73 ,"$2,213.90 " ST. JOSEPH'S HOSPITAL - BREESE,32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$3,655.00 ","$2,631.60 ",$219.77 ,"$3,655.00 ",$560.65 ,"$2,375.75 ","$2,182.04 ",$219.77 ,"$1,023.40 ","$2,419.61 ",$219.77 ,"$2,419.61 ",$219.77 ,"$2,178.38 ","$2,178.38 ",$219.77 ,"$2,178.38 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,741.25 ","$2,595.05 ","$2,595.05 ",$219.77 ,"$2,595.05 ","$3,106.75 ","$3,106.75 ","$3,106.75 ", N/A ,$560.65 ,"$3,106.75 ",$219.77 ,"$3,655.00 ","$2,050.46 ",$219.77 ,"$1,513.17 ",$352.58 ,$320.53 ,$219.77 ,"$3,106.75 ",$470.94 ,"$2,178.38 ","$1,023.40 ","$3,289.50 ",$219.77 ,"$3,106.75 ","$3,088.48 ","$3,088.48 ",$219.77 ,"$2,375.75 " ST. JOSEPH'S HOSPITAL - BREESE,32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$4,203.00 ","$3,026.16 ",$320.53 ,"$4,203.00 ","$1,778.43 ","$2,731.95 ","$2,509.19 ",$697.14 ,"$1,176.84 ","$2,782.39 ",$697.14 ,"$2,782.39 ",$697.14 ,"$2,504.99 ","$2,504.99 ",$697.14 ,"$2,504.99 ","$1,436.97 ","$2,500.00 ","$1,778.43 ",$697.14 ,$711.09 ,"$3,152.25 ","$2,984.13 ","$2,984.13 ",$697.14 ,"$2,984.13 ","$3,572.55 ","$3,572.55 ","$3,572.55 ", N/A ,"$1,778.43 ","$3,572.55 ",$697.14 ,"$4,203.00 ","$2,357.88 ",$697.14 ,"$1,740.04 ",$352.58 ,$320.53 ,$697.14 ,"$3,572.55 ","$1,493.88 ","$2,504.99 ","$1,176.84 ","$3,782.70 ",$697.14 ,"$3,572.55 ","$3,551.54 ","$3,551.54 ",$697.14 ,"$2,731.95 " ST. JOSEPH'S HOSPITAL - BREESE,32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$529.00 ,$380.88 ,$37.46 ,$529.00 ,$208.58 ,$343.85 ,$315.81 ,$81.76 ,$148.12 ,$350.20 ,$81.76 ,$350.20 ,$81.76 ,$315.28 ,$315.28 ,$81.76 ,$315.28 ,$168.54 ,$407.33 ,$208.59 ,$81.76 ,$83.40 ,$396.75 ,$375.59 ,$375.59 ,$81.76 ,$375.59 ,$449.65 ,$449.65 ,$449.65 , N/A ,$208.59 ,$449.65 ,$81.76 ,$529.00 ,$296.77 ,$81.76 ,$219.01 ,$41.21 ,$37.46 ,$81.76 ,$449.65 ,$175.21 ,$315.28 ,$148.12 ,$476.10 ,$81.76 ,$449.65 ,$447.01 ,$447.01 ,$81.76 ,$343.85 ST. JOSEPH'S HOSPITAL - BREESE,32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$643.00 ,$462.96 ,$37.46 ,$643.00 ,$208.58 ,$417.95 ,$383.87 ,$81.76 ,$180.04 ,$425.67 ,$81.76 ,$425.67 ,$81.76 ,$383.23 ,$383.23 ,$81.76 ,$383.23 ,$168.54 ,$495.11 ,$208.59 ,$81.76 ,$83.40 ,$482.25 ,$456.53 ,$456.53 ,$81.76 ,$456.53 ,$546.55 ,$546.55 ,$546.55 , N/A ,$208.59 ,$546.55 ,$81.76 ,$643.00 ,$360.72 ,$81.76 ,$266.20 ,$41.21 ,$37.46 ,$81.76 ,$546.55 ,$175.21 ,$383.23 ,$180.04 ,$578.70 ,$81.76 ,$546.55 ,$543.34 ,$543.34 ,$81.76 ,$417.95 ST. JOSEPH'S HOSPITAL - BREESE,32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$804.00 ,$578.88 ,$37.46 ,$804.00 ,$256.60 ,$522.60 ,$479.99 ,$100.59 ,$225.12 ,$532.25 ,$100.59 ,$532.25 ,$100.59 ,$479.18 ,$479.18 ,$100.59 ,$479.18 ,$207.34 ,$619.08 ,$256.60 ,$100.59 ,$102.60 ,$603.00 ,$570.84 ,$570.84 ,$100.59 ,$570.84 ,$683.40 ,$683.40 ,$683.40 , N/A ,$256.60 ,$683.40 ,$100.59 ,$804.00 ,$451.04 ,$100.59 ,$332.86 ,$41.21 ,$37.46 ,$100.59 ,$683.40 ,$215.55 ,$479.18 ,$225.12 ,$723.60 ,$100.59 ,$683.40 ,$679.38 ,$679.38 ,$100.59 ,$522.60 ST. JOSEPH'S HOSPITAL - BREESE,32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,"$1,208.00 ",$869.76 ,$37.46 ,"$1,208.00 ",$256.60 ,$785.20 ,$721.18 ,$100.59 ,$338.24 ,$799.70 ,$100.59 ,$799.70 ,$100.59 ,$719.97 ,$719.97 ,$100.59 ,$719.97 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$906.00 ,$857.68 ,$857.68 ,$100.59 ,$857.68 ,"$1,026.80 ","$1,026.80 ","$1,026.80 ", N/A ,$256.60 ,"$1,026.80 ",$100.59 ,"$1,208.00 ",$677.69 ,$100.59 ,$500.11 ,$41.21 ,$37.46 ,$100.59 ,"$1,026.80 ",$215.55 ,$719.97 ,$338.24 ,"$1,087.20 ",$100.59 ,"$1,026.80 ","$1,020.76 ","$1,020.76 ",$100.59 ,$785.20 ST. JOSEPH'S HOSPITAL - BREESE,32000172,72070,HC XR T-SPINE 2V,320,1 ,$403.00 ,$290.16 ,$37.46 ,$403.00 ,$256.60 ,$261.95 ,$240.59 ,$100.59 ,$112.84 ,$266.79 ,$100.59 ,$266.79 ,$100.59 ,$240.19 ,$240.19 ,$100.59 ,$240.19 ,$207.34 ,$310.31 ,$256.60 ,$100.59 ,$102.60 ,$302.25 ,$286.13 ,$286.13 ,$100.59 ,$286.13 ,$342.55 ,$342.55 ,$342.55 , N/A ,$256.60 ,$342.55 ,$100.59 ,$403.00 ,$226.08 ,$100.59 ,$166.84 ,$41.21 ,$37.46 ,$100.59 ,$342.55 ,$215.55 ,$240.19 ,$112.84 ,$362.70 ,$100.59 ,$342.55 ,$340.54 ,$340.54 ,$100.59 ,$261.95 ST. JOSEPH'S HOSPITAL - BREESE,32000174,72072,HC XR T-SPINE 3V,320,1 ,$738.00 ,$531.36 ,$37.46 ,$738.00 ,$256.60 ,$479.70 ,$440.59 ,$100.59 ,$206.64 ,$488.56 ,$100.59 ,$488.56 ,$100.59 ,$439.85 ,$439.85 ,$100.59 ,$439.85 ,$207.34 ,$568.26 ,$256.60 ,$100.59 ,$102.60 ,$553.50 ,$523.98 ,$523.98 ,$100.59 ,$523.98 ,$627.30 ,$627.30 ,$627.30 , N/A ,$256.60 ,$627.30 ,$100.59 ,$738.00 ,$414.02 ,$100.59 ,$305.53 ,$41.21 ,$37.46 ,$100.59 ,$627.30 ,$215.55 ,$439.85 ,$206.64 ,$664.20 ,$100.59 ,$627.30 ,$623.61 ,$623.61 ,$100.59 ,$479.70 ST. JOSEPH'S HOSPITAL - BREESE,32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$784.00 ,$564.48 ,$37.46 ,$784.00 ,$256.60 ,$509.60 ,$468.05 ,$100.59 ,$219.52 ,$519.01 ,$100.59 ,$519.01 ,$100.59 ,$467.26 ,$467.26 ,$100.59 ,$467.26 ,$207.34 ,$603.68 ,$256.60 ,$100.59 ,$102.60 ,$588.00 ,$556.64 ,$556.64 ,$100.59 ,$556.64 ,$666.40 ,$666.40 ,$666.40 , N/A ,$256.60 ,$666.40 ,$100.59 ,$784.00 ,$439.82 ,$100.59 ,$324.58 ,$41.21 ,$37.46 ,$100.59 ,$666.40 ,$215.55 ,$467.26 ,$219.52 ,$705.60 ,$100.59 ,$666.40 ,$662.48 ,$662.48 ,$100.59 ,$509.60 ST. JOSEPH'S HOSPITAL - BREESE,32000181,72110,HC XR L-SPINE 4+V,320,1 ,"$1,053.00 ",$758.16 ,$37.46 ,"$1,053.00 ",$256.60 ,$684.45 ,$628.64 ,$100.59 ,$294.84 ,$697.09 ,$100.59 ,$697.09 ,$100.59 ,$627.59 ,$627.59 ,$100.59 ,$627.59 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$789.75 ,$747.63 ,$747.63 ,$100.59 ,$747.63 ,$895.05 ,$895.05 ,$895.05 , N/A ,$256.60 ,$895.05 ,$100.59 ,"$1,053.00 ",$590.73 ,$100.59 ,$435.94 ,$41.21 ,$37.46 ,$100.59 ,$895.05 ,$215.55 ,$627.59 ,$294.84 ,$947.70 ,$100.59 ,$895.05 ,$889.79 ,$889.79 ,$100.59 ,$684.45 ST. JOSEPH'S HOSPITAL - BREESE,32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$442.00 ,$318.24 ,$37.46 ,$442.00 ,$256.60 ,$287.30 ,$263.87 ,$100.59 ,$123.76 ,$292.60 ,$100.59 ,$292.60 ,$100.59 ,$263.43 ,$263.43 ,$100.59 ,$263.43 ,$207.34 ,$340.34 ,$256.60 ,$100.59 ,$102.60 ,$331.50 ,$313.82 ,$313.82 ,$100.59 ,$313.82 ,$375.70 ,$375.70 ,$375.70 , N/A ,$256.60 ,$375.70 ,$100.59 ,$442.00 ,$247.96 ,$100.59 ,$182.99 ,$41.21 ,$37.46 ,$100.59 ,$375.70 ,$215.55 ,$263.43 ,$123.76 ,$397.80 ,$100.59 ,$375.70 ,$373.49 ,$373.49 ,$100.59 ,$287.30 ST. JOSEPH'S HOSPITAL - BREESE,32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,"$1,258.00 ",$905.76 ,$37.46 ,"$1,258.00 ",$256.60 ,$817.70 ,$751.03 ,$100.59 ,$352.24 ,$832.80 ,$100.59 ,$832.80 ,$100.59 ,$749.77 ,$749.77 ,$100.59 ,$749.77 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$943.50 ,$893.18 ,$893.18 ,$100.59 ,$893.18 ,"$1,069.30 ","$1,069.30 ","$1,069.30 ", N/A ,$256.60 ,"$1,069.30 ",$100.59 ,"$1,258.00 ",$705.74 ,$100.59 ,$520.81 ,$41.21 ,$37.46 ,$100.59 ,"$1,069.30 ",$215.55 ,$749.77 ,$352.24 ,"$1,132.20 ",$100.59 ,"$1,069.30 ","$1,063.01 ","$1,063.01 ",$100.59 ,$817.70 ST. JOSEPH'S HOSPITAL - BREESE,32000186,72170,HC XR PELVIS 1-2V,320,1 ,$524.00 ,$377.28 ,$37.46 ,$524.00 ,$256.60 ,$340.60 ,$312.83 ,$100.59 ,$146.72 ,$346.89 ,$100.59 ,$346.89 ,$100.59 ,$312.30 ,$312.30 ,$100.59 ,$312.30 ,$207.34 ,$403.48 ,$256.60 ,$100.59 ,$102.60 ,$393.00 ,$372.04 ,$372.04 ,$100.59 ,$372.04 ,$445.40 ,$445.40 ,$445.40 , N/A ,$256.60 ,$445.40 ,$100.59 ,$524.00 ,$293.96 ,$100.59 ,$216.94 ,$41.21 ,$37.46 ,$100.59 ,$445.40 ,$215.55 ,$312.30 ,$146.72 ,$471.60 ,$100.59 ,$445.40 ,$442.78 ,$442.78 ,$100.59 ,$340.60 ST. JOSEPH'S HOSPITAL - BREESE,32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$321.99 ,$231.83 ,$37.46 ,$321.99 ,$256.60 ,$209.29 ,$192.23 ,$100.59 ,$90.16 ,$213.16 ,$100.59 ,$213.16 ,$100.59 ,$191.91 ,$191.91 ,$100.59 ,$191.91 ,$207.34 ,$247.93 ,$256.60 ,$100.59 ,$102.60 ,$241.49 ,$228.61 ,$228.61 ,$100.59 ,$228.61 ,$273.69 ,$273.69 ,$273.69 , N/A ,$256.60 ,$273.69 ,$100.59 ,$321.99 ,$180.64 ,$100.59 ,$133.30 ,$41.21 ,$37.46 ,$100.59 ,$273.69 ,$215.55 ,$191.91 ,$90.16 ,$289.79 ,$100.59 ,$273.69 ,$272.08 ,$272.08 ,$100.59 ,$209.29 ST. JOSEPH'S HOSPITAL - BREESE,32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$571.00 ,$411.12 ,$37.46 ,$571.00 ,$256.60 ,$371.15 ,$340.89 ,$100.59 ,$159.88 ,$378.00 ,$100.59 ,$378.00 ,$100.59 ,$340.32 ,$340.32 ,$100.59 ,$340.32 ,$207.34 ,$439.67 ,$256.60 ,$100.59 ,$102.60 ,$428.25 ,$405.41 ,$405.41 ,$100.59 ,$405.41 ,$485.35 ,$485.35 ,$485.35 , N/A ,$256.60 ,$485.35 ,$100.59 ,$571.00 ,$320.33 ,$100.59 ,$236.39 ,$41.21 ,$37.46 ,$100.59 ,$485.35 ,$215.55 ,$340.32 ,$159.88 ,$513.90 ,$100.59 ,$485.35 ,$482.50 ,$482.50 ,$100.59 ,$371.15 ST. JOSEPH'S HOSPITAL - BREESE,32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$564.00 ,$406.08 ,$37.46 ,$564.00 ,$208.58 ,$366.60 ,$336.71 ,$81.76 ,$157.92 ,$373.37 ,$81.76 ,$373.37 ,$81.76 ,$336.14 ,$336.14 ,$81.76 ,$336.14 ,$168.54 ,$434.28 ,$208.59 ,$81.76 ,$83.40 ,$423.00 ,$400.44 ,$400.44 ,$81.76 ,$400.44 ,$479.40 ,$479.40 ,$479.40 , N/A ,$208.59 ,$479.40 ,$81.76 ,$564.00 ,$316.40 ,$81.76 ,$233.50 ,$41.21 ,$37.46 ,$81.76 ,$479.40 ,$175.21 ,$336.14 ,$157.92 ,$507.60 ,$81.76 ,$479.40 ,$476.58 ,$476.58 ,$81.76 ,$366.60 ST. JOSEPH'S HOSPITAL - BREESE,32000201,73000,HC XRAY CLAVICLE,320,1 ,$428.00 ,$308.16 ,$37.46 ,$428.00 ,$208.58 ,$278.20 ,$255.52 ,$81.76 ,$119.84 ,$283.34 ,$81.76 ,$283.34 ,$81.76 ,$255.09 ,$255.09 ,$81.76 ,$255.09 ,$168.54 ,$329.56 ,$208.59 ,$81.76 ,$83.40 ,$321.00 ,$303.88 ,$303.88 ,$81.76 ,$303.88 ,$363.80 ,$363.80 ,$363.80 , N/A ,$208.59 ,$363.80 ,$81.76 ,$428.00 ,$240.11 ,$81.76 ,$177.19 ,$41.21 ,$37.46 ,$81.76 ,$363.80 ,$175.21 ,$255.09 ,$119.84 ,$385.20 ,$81.76 ,$363.80 ,$361.66 ,$361.66 ,$81.76 ,$278.20 ST. JOSEPH'S HOSPITAL - BREESE,32000204,73010,HC XRAY SCAPULA,320,1 ,$428.00 ,$308.16 ,$37.46 ,$428.00 ,$256.60 ,$278.20 ,$255.52 ,$100.59 ,$119.84 ,$283.34 ,$100.59 ,$283.34 ,$100.59 ,$255.09 ,$255.09 ,$100.59 ,$255.09 ,$207.34 ,$329.56 ,$256.60 ,$100.59 ,$102.60 ,$321.00 ,$303.88 ,$303.88 ,$100.59 ,$303.88 ,$363.80 ,$363.80 ,$363.80 , N/A ,$256.60 ,$363.80 ,$100.59 ,$428.00 ,$240.11 ,$100.59 ,$177.19 ,$41.21 ,$37.46 ,$100.59 ,$363.80 ,$215.55 ,$255.09 ,$119.84 ,$385.20 ,$100.59 ,$363.80 ,$361.66 ,$361.66 ,$100.59 ,$278.20 ST. JOSEPH'S HOSPITAL - BREESE,32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$417.00 ,$300.24 ,$37.46 ,$417.00 ,$208.58 ,$271.05 ,$248.95 ,$81.76 ,$116.76 ,$276.05 ,$81.76 ,$276.05 ,$81.76 ,$248.53 ,$248.53 ,$81.76 ,$248.53 ,$168.54 ,$321.09 ,$208.59 ,$81.76 ,$83.40 ,$312.75 ,$296.07 ,$296.07 ,$81.76 ,$296.07 ,$354.45 ,$354.45 ,$354.45 , N/A ,$208.59 ,$354.45 ,$81.76 ,$417.00 ,$233.94 ,$81.76 ,$172.64 ,$41.21 ,$37.46 ,$81.76 ,$354.45 ,$175.21 ,$248.53 ,$116.76 ,$375.30 ,$81.76 ,$354.45 ,$352.37 ,$352.37 ,$81.76 ,$271.05 ST. JOSEPH'S HOSPITAL - BREESE,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$588.00 ,$423.36 ,$37.46 ,$588.00 ,$208.58 ,$382.20 ,$351.04 ,$81.76 ,$164.64 ,$389.26 ,$81.76 ,$389.26 ,$81.76 ,$350.45 ,$350.45 ,$81.76 ,$350.45 ,$168.54 ,$452.76 ,$208.59 ,$81.76 ,$83.40 ,$441.00 ,$417.48 ,$417.48 ,$81.76 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$208.59 ,$499.80 ,$81.76 ,$588.00 ,$329.87 ,$81.76 ,$243.43 ,$41.21 ,$37.46 ,$81.76 ,$499.80 ,$175.21 ,$350.45 ,$164.64 ,$529.20 ,$81.76 ,$499.80 ,$496.86 ,$496.86 ,$81.76 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$1,705.00 ","$1,227.60 ",$213.45 ,"$1,705.00 ",$884.55 ,"$1,108.25 ","$1,017.89 ",$346.74 ,$477.40 ,"$1,128.71 ",$346.74 ,"$1,128.71 ",$346.74 ,"$1,016.18 ","$1,016.18 ",$346.74 ,"$1,016.18 ",$714.71 ,$800.00 ,$884.55 ,$346.74 ,$353.67 ,"$1,278.75 ","$1,210.55 ","$1,210.55 ",$346.74 ,"$1,210.55 ","$1,449.25 ","$1,449.25 ","$1,449.25 ", N/A ,$884.55 ,"$1,449.25 ",$346.74 ,"$1,705.00 ",$956.51 ,$346.74 ,$705.87 ,$234.80 ,$213.45 ,$346.74 ,"$1,449.25 ",$743.02 ,"$1,016.18 ",$477.40 ,"$1,534.50 ",$346.74 ,"$1,449.25 ","$1,440.73 ","$1,440.73 ",$346.74 ,"$1,108.25 " ST. JOSEPH'S HOSPITAL - BREESE,32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$372.00 ,$267.84 ,$37.46 ,$372.00 ,$208.58 ,$241.80 ,$222.08 ,$81.76 ,$104.16 ,$246.26 ,$81.76 ,$246.26 ,$81.76 ,$221.71 ,$221.71 ,$81.76 ,$221.71 ,$168.54 ,$286.44 ,$208.59 ,$81.76 ,$83.40 ,$279.00 ,$264.12 ,$264.12 ,$81.76 ,$264.12 ,$316.20 ,$316.20 ,$316.20 , N/A ,$208.59 ,$316.20 ,$81.76 ,$372.00 ,$208.69 ,$81.76 ,$154.01 ,$41.21 ,$37.46 ,$81.76 ,$316.20 ,$175.21 ,$221.71 ,$104.16 ,$334.80 ,$81.76 ,$316.20 ,$314.34 ,$314.34 ,$81.76 ,$241.80 ST. JOSEPH'S HOSPITAL - BREESE,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$517.00 ,$372.24 ,$37.46 ,$517.00 ,$208.58 ,$336.05 ,$308.65 ,$81.76 ,$144.76 ,$342.25 ,$81.76 ,$342.25 ,$81.76 ,$308.13 ,$308.13 ,$81.76 ,$308.13 ,$168.54 ,$398.09 ,$208.59 ,$81.76 ,$83.40 ,$387.75 ,$367.07 ,$367.07 ,$81.76 ,$367.07 ,$439.45 ,$439.45 ,$439.45 , N/A ,$208.59 ,$439.45 ,$81.76 ,$517.00 ,$290.04 ,$81.76 ,$214.04 ,$41.21 ,$37.46 ,$81.76 ,$439.45 ,$175.21 ,$308.13 ,$144.76 ,$465.30 ,$81.76 ,$439.45 ,$436.87 ,$436.87 ,$81.76 ,$336.05 ST. JOSEPH'S HOSPITAL - BREESE,32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$440.00 ,$316.80 ,$37.46 ,$440.00 ,$208.58 ,$286.00 ,$262.68 ,$81.76 ,$123.20 ,$291.28 ,$81.76 ,$291.28 ,$81.76 ,$262.24 ,$262.24 ,$81.76 ,$262.24 ,$168.54 ,$338.80 ,$208.59 ,$81.76 ,$83.40 ,$330.00 ,$312.40 ,$312.40 ,$81.76 ,$312.40 ,$374.00 ,$374.00 ,$374.00 , N/A ,$208.59 ,$374.00 ,$81.76 ,$440.00 ,$246.84 ,$81.76 ,$182.16 ,$41.21 ,$37.46 ,$81.76 ,$374.00 ,$175.21 ,$262.24 ,$123.20 ,$396.00 ,$81.76 ,$374.00 ,$371.80 ,$371.80 ,$81.76 ,$286.00 ST. JOSEPH'S HOSPITAL - BREESE,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$548.00 ,$394.56 ,$37.46 ,$548.00 ,$208.58 ,$356.20 ,$327.16 ,$81.76 ,$153.44 ,$362.78 ,$81.76 ,$362.78 ,$81.76 ,$326.61 ,$326.61 ,$81.76 ,$326.61 ,$168.54 ,$421.96 ,$208.59 ,$81.76 ,$83.40 ,$411.00 ,$389.08 ,$389.08 ,$81.76 ,$389.08 ,$465.80 ,$465.80 ,$465.80 , N/A ,$208.59 ,$465.80 ,$81.76 ,$548.00 ,$307.43 ,$81.76 ,$226.87 ,$41.21 ,$37.46 ,$81.76 ,$465.80 ,$175.21 ,$326.61 ,$153.44 ,$493.20 ,$81.76 ,$465.80 ,$463.06 ,$463.06 ,$81.76 ,$356.20 ST. JOSEPH'S HOSPITAL - BREESE,32000222,73085,HC XRAY ELBOW ARTHRO,320,1 ,"$1,429.00 ","$1,028.88 ",$213.45 ,"$1,429.00 ",$884.55 ,$928.85 ,$853.11 ,$346.74 ,$400.12 ,$946.00 ,$346.74 ,$946.00 ,$346.74 ,$851.68 ,$851.68 ,$346.74 ,$851.68 ,$714.71 ,$800.00 ,$884.55 ,$346.74 ,$353.67 ,"$1,071.75 ","$1,014.59 ","$1,014.59 ",$346.74 ,"$1,014.59 ","$1,214.65 ","$1,214.65 ","$1,214.65 ", N/A ,$884.55 ,"$1,214.65 ",$346.74 ,"$1,429.00 ",$801.67 ,$346.74 ,$591.61 ,$234.80 ,$213.45 ,$346.74 ,"$1,214.65 ",$743.02 ,$851.68 ,$400.12 ,"$1,286.10 ",$346.74 ,"$1,214.65 ","$1,207.51 ","$1,207.51 ",$346.74 ,$928.85 ST. JOSEPH'S HOSPITAL - BREESE,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$483.00 ,$347.76 ,$37.46 ,$483.00 ,$208.58 ,$313.95 ,$288.35 ,$81.76 ,$135.24 ,$319.75 ,$81.76 ,$319.75 ,$81.76 ,$287.87 ,$287.87 ,$81.76 ,$287.87 ,$168.54 ,$371.91 ,$208.59 ,$81.76 ,$83.40 ,$362.25 ,$342.93 ,$342.93 ,$81.76 ,$342.93 ,$410.55 ,$410.55 ,$410.55 , N/A ,$208.59 ,$410.55 ,$81.76 ,$483.00 ,$270.96 ,$81.76 ,$199.96 ,$41.21 ,$37.46 ,$81.76 ,$410.55 ,$175.21 ,$287.87 ,$135.24 ,$434.70 ,$81.76 ,$410.55 ,$408.14 ,$408.14 ,$81.76 ,$313.95 ST. JOSEPH'S HOSPITAL - BREESE,32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$456.00 ,$328.32 ,$37.46 ,$456.00 ,$256.60 ,$296.40 ,$272.23 ,$100.59 ,$127.68 ,$301.87 ,$100.59 ,$301.87 ,$100.59 ,$271.78 ,$271.78 ,$100.59 ,$271.78 ,$207.34 ,$351.12 ,$256.60 ,$100.59 ,$102.60 ,$342.00 ,$323.76 ,$323.76 ,$100.59 ,$323.76 ,$387.60 ,$387.60 ,$387.60 , N/A ,$256.60 ,$387.60 ,$100.59 ,$456.00 ,$255.82 ,$100.59 ,$188.78 ,$41.21 ,$37.46 ,$100.59 ,$387.60 ,$215.55 ,$271.78 ,$127.68 ,$410.40 ,$100.59 ,$387.60 ,$385.32 ,$385.32 ,$100.59 ,$296.40 ST. JOSEPH'S HOSPITAL - BREESE,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$428.00 ,$308.16 ,$37.46 ,$428.00 ,$208.58 ,$278.20 ,$255.52 ,$81.76 ,$119.84 ,$283.34 ,$81.76 ,$283.34 ,$81.76 ,$255.09 ,$255.09 ,$81.76 ,$255.09 ,$168.54 ,$329.56 ,$208.59 ,$81.76 ,$83.40 ,$321.00 ,$303.88 ,$303.88 ,$81.76 ,$303.88 ,$363.80 ,$363.80 ,$363.80 , N/A ,$208.59 ,$363.80 ,$81.76 ,$428.00 ,$240.11 ,$81.76 ,$177.19 ,$41.21 ,$37.46 ,$81.76 ,$363.80 ,$175.21 ,$255.09 ,$119.84 ,$385.20 ,$81.76 ,$363.80 ,$361.66 ,$361.66 ,$81.76 ,$278.20 ST. JOSEPH'S HOSPITAL - BREESE,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$528.00 ,$380.16 ,$37.46 ,$528.00 ,$208.58 ,$343.20 ,$315.22 ,$81.76 ,$147.84 ,$349.54 ,$81.76 ,$349.54 ,$81.76 ,$314.69 ,$314.69 ,$81.76 ,$314.69 ,$168.54 ,$406.56 ,$208.59 ,$81.76 ,$83.40 ,$396.00 ,$374.88 ,$374.88 ,$81.76 ,$374.88 ,$448.80 ,$448.80 ,$448.80 , N/A ,$208.59 ,$448.80 ,$81.76 ,$528.00 ,$296.21 ,$81.76 ,$218.59 ,$41.21 ,$37.46 ,$81.76 ,$448.80 ,$175.21 ,$314.69 ,$147.84 ,$475.20 ,$81.76 ,$448.80 ,$446.16 ,$446.16 ,$81.76 ,$343.20 ST. JOSEPH'S HOSPITAL - BREESE,32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,"$1,521.00 ","$1,095.12 ",$213.45 ,"$1,521.00 ",$884.55 ,$988.65 ,$908.04 ,$346.74 ,$425.88 ,"$1,006.90 ",$346.74 ,"$1,006.90 ",$346.74 ,$906.52 ,$906.52 ,$346.74 ,$906.52 ,$714.71 ,$800.00 ,$884.55 ,$346.74 ,$353.67 ,"$1,140.75 ","$1,079.91 ","$1,079.91 ",$346.74 ,"$1,079.91 ","$1,292.85 ","$1,292.85 ","$1,292.85 ", N/A ,$884.55 ,"$1,292.85 ",$346.74 ,"$1,521.00 ",$853.28 ,$346.74 ,$629.69 ,$234.80 ,$213.45 ,$346.74 ,"$1,292.85 ",$743.02 ,$906.52 ,$425.88 ,"$1,368.90 ",$346.74 ,"$1,292.85 ","$1,285.25 ","$1,285.25 ",$346.74 ,$988.65 ST. JOSEPH'S HOSPITAL - BREESE,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$494.00 ,$355.68 ,$37.46 ,$494.00 ,$256.60 ,$321.10 ,$294.92 ,$100.59 ,$138.32 ,$327.03 ,$100.59 ,$327.03 ,$100.59 ,$294.42 ,$294.42 ,$100.59 ,$294.42 ,$207.34 ,$380.38 ,$256.60 ,$100.59 ,$102.60 ,$370.50 ,$350.74 ,$350.74 ,$100.59 ,$350.74 ,$419.90 ,$419.90 ,$419.90 , N/A ,$256.60 ,$419.90 ,$100.59 ,$494.00 ,$277.13 ,$100.59 ,$204.52 ,$41.21 ,$37.46 ,$100.59 ,$419.90 ,$215.55 ,$294.42 ,$138.32 ,$444.60 ,$100.59 ,$419.90 ,$417.43 ,$417.43 ,$100.59 ,$321.10 ST. JOSEPH'S HOSPITAL - BREESE,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$509.00 ,$366.48 ,$37.46 ,$509.00 ,$208.58 ,$330.85 ,$303.87 ,$81.76 ,$142.52 ,$336.96 ,$81.76 ,$336.96 ,$81.76 ,$303.36 ,$303.36 ,$81.76 ,$303.36 ,$168.54 ,$391.93 ,$208.59 ,$81.76 ,$83.40 ,$381.75 ,$361.39 ,$361.39 ,$81.76 ,$361.39 ,$432.65 ,$432.65 ,$432.65 , N/A ,$208.59 ,$432.65 ,$81.76 ,$509.00 ,$285.55 ,$81.76 ,$210.73 ,$41.21 ,$37.46 ,$81.76 ,$432.65 ,$175.21 ,$303.36 ,$142.52 ,$458.10 ,$81.76 ,$432.65 ,$430.11 ,$430.11 ,$81.76 ,$330.85 ST. JOSEPH'S HOSPITAL - BREESE,32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$662.00 ,$476.64 ,$37.46 ,$662.00 ,$208.58 ,$430.30 ,$395.21 ,$81.76 ,$185.36 ,$438.24 ,$81.76 ,$438.24 ,$81.76 ,$394.55 ,$394.55 ,$81.76 ,$394.55 ,$168.54 ,$509.74 ,$208.59 ,$81.76 ,$83.40 ,$496.50 ,$470.02 ,$470.02 ,$81.76 ,$470.02 ,$562.70 ,$562.70 ,$562.70 , N/A ,$208.59 ,$562.70 ,$81.76 ,$662.00 ,$371.38 ,$81.76 ,$274.07 ,$41.21 ,$37.46 ,$81.76 ,$562.70 ,$175.21 ,$394.55 ,$185.36 ,$595.80 ,$81.76 ,$562.70 ,$559.39 ,$559.39 ,$81.76 ,$430.30 ST. JOSEPH'S HOSPITAL - BREESE,32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$992.00 ,$714.24 ,$56.19 ,$992.00 ,$208.58 ,$644.80 ,$592.22 ,$81.76 ,$277.76 ,$656.70 ,$81.76 ,$656.70 ,$81.76 ,$591.23 ,$591.23 ,$81.76 ,$591.23 ,$168.54 ,$763.84 ,$208.59 ,$81.76 ,$83.40 ,$744.00 ,$704.32 ,$704.32 ,$81.76 ,$704.32 ,$843.20 ,$843.20 ,$843.20 , N/A ,$208.59 ,$843.20 ,$81.76 ,$992.00 ,$556.51 ,$81.76 ,$410.69 ,$61.81 ,$56.19 ,$81.76 ,$843.20 ,$175.21 ,$591.23 ,$277.76 ,$892.80 ,$81.76 ,$843.20 ,$838.24 ,$838.24 ,$81.76 ,$644.80 ST. JOSEPH'S HOSPITAL - BREESE,32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,"$1,500.00 ","$1,080.00 ",$213.45 ,"$1,500.00 ",$884.55 ,$975.00 ,$895.50 ,$346.74 ,$420.00 ,$993.00 ,$346.74 ,$993.00 ,$346.74 ,$894.00 ,$894.00 ,$346.74 ,$894.00 ,$714.71 ,$800.00 ,$884.55 ,$346.74 ,$353.67 ,"$1,125.00 ","$1,065.00 ","$1,065.00 ",$346.74 ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A ,$884.55 ,"$1,275.00 ",$346.74 ,"$1,500.00 ",$841.50 ,$346.74 ,$621.00 ,$234.80 ,$213.45 ,$346.74 ,"$1,275.00 ",$743.02 ,$894.00 ,$420.00 ,"$1,350.00 ",$346.74 ,"$1,275.00 ","$1,267.50 ","$1,267.50 ",$346.74 ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$517.00 ,$372.24 ,$37.46 ,$517.00 ,$208.58 ,$336.05 ,$308.65 ,$81.76 ,$144.76 ,$342.25 ,$81.76 ,$342.25 ,$81.76 ,$308.13 ,$308.13 ,$81.76 ,$308.13 ,$168.54 ,$398.09 ,$208.59 ,$81.76 ,$83.40 ,$387.75 ,$367.07 ,$367.07 ,$81.76 ,$367.07 ,$439.45 ,$439.45 ,$439.45 , N/A ,$208.59 ,$439.45 ,$81.76 ,$517.00 ,$290.04 ,$81.76 ,$214.04 ,$41.21 ,$37.46 ,$81.76 ,$439.45 ,$175.21 ,$308.13 ,$144.76 ,$465.30 ,$81.76 ,$439.45 ,$436.87 ,$436.87 ,$81.76 ,$336.05 ST. JOSEPH'S HOSPITAL - BREESE,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$625.00 ,$450.00 ,$37.46 ,$625.00 ,$208.58 ,$406.25 ,$373.13 ,$81.76 ,$175.00 ,$413.75 ,$81.76 ,$413.75 ,$81.76 ,$372.50 ,$372.50 ,$81.76 ,$372.50 ,$168.54 ,$481.25 ,$208.59 ,$81.76 ,$83.40 ,$468.75 ,$443.75 ,$443.75 ,$81.76 ,$443.75 ,$531.25 ,$531.25 ,$531.25 , N/A ,$208.59 ,$531.25 ,$81.76 ,$625.00 ,$350.63 ,$81.76 ,$258.75 ,$41.21 ,$37.46 ,$81.76 ,$531.25 ,$175.21 ,$372.50 ,$175.00 ,$562.50 ,$81.76 ,$531.25 ,$528.13 ,$528.13 ,$81.76 ,$406.25 ST. JOSEPH'S HOSPITAL - BREESE,32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$647.00 ,$465.84 ,$37.46 ,$647.00 ,$256.60 ,$420.55 ,$386.26 ,$100.59 ,$181.16 ,$428.31 ,$100.59 ,$428.31 ,$100.59 ,$385.61 ,$385.61 ,$100.59 ,$385.61 ,$207.34 ,$498.19 ,$256.60 ,$100.59 ,$102.60 ,$485.25 ,$459.37 ,$459.37 ,$100.59 ,$459.37 ,$549.95 ,$549.95 ,$549.95 , N/A ,$256.60 ,$549.95 ,$100.59 ,$647.00 ,$362.97 ,$100.59 ,$267.86 ,$41.21 ,$37.46 ,$100.59 ,$549.95 ,$215.55 ,$385.61 ,$181.16 ,$582.30 ,$100.59 ,$549.95 ,$546.72 ,$546.72 ,$100.59 ,$420.55 ST. JOSEPH'S HOSPITAL - BREESE,32000267,73565,HC XR KNEE STAND,320,1 ,$884.00 ,$636.48 ,$37.46 ,$884.00 ,$208.58 ,$574.60 ,$527.75 ,$81.76 ,$247.52 ,$585.21 ,$81.76 ,$585.21 ,$81.76 ,$526.86 ,$526.86 ,$81.76 ,$526.86 ,$168.54 ,$680.68 ,$208.59 ,$81.76 ,$83.40 ,$663.00 ,$627.64 ,$627.64 ,$81.76 ,$627.64 ,$751.40 ,$751.40 ,$751.40 , N/A ,$208.59 ,$751.40 ,$81.76 ,$884.00 ,$495.92 ,$81.76 ,$365.98 ,$41.21 ,$37.46 ,$81.76 ,$751.40 ,$175.21 ,$526.86 ,$247.52 ,$795.60 ,$81.76 ,$751.40 ,$746.98 ,$746.98 ,$81.76 ,$574.60 ST. JOSEPH'S HOSPITAL - BREESE,32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,"$1,521.00 ","$1,095.12 ",$213.45 ,"$1,521.00 ",$884.55 ,$988.65 ,$908.04 ,$346.74 ,$425.88 ,"$1,006.90 ",$346.74 ,"$1,006.90 ",$346.74 ,$906.52 ,$906.52 ,$346.74 ,$906.52 ,$714.71 ,$800.00 ,$884.55 ,$346.74 ,$353.67 ,"$1,140.75 ","$1,079.91 ","$1,079.91 ",$346.74 ,"$1,079.91 ","$1,292.85 ","$1,292.85 ","$1,292.85 ", N/A ,$884.55 ,"$1,292.85 ",$346.74 ,"$1,521.00 ",$853.28 ,$346.74 ,$629.69 ,$234.80 ,$213.45 ,$346.74 ,"$1,292.85 ",$743.02 ,$906.52 ,$425.88 ,"$1,368.90 ",$346.74 ,"$1,292.85 ","$1,285.25 ","$1,285.25 ",$346.74 ,$988.65 ST. JOSEPH'S HOSPITAL - BREESE,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$558.00 ,$401.76 ,$37.46 ,$558.00 ,$208.58 ,$362.70 ,$333.13 ,$81.76 ,$156.24 ,$369.40 ,$81.76 ,$369.40 ,$81.76 ,$332.57 ,$332.57 ,$81.76 ,$332.57 ,$168.54 ,$429.66 ,$208.59 ,$81.76 ,$83.40 ,$418.50 ,$396.18 ,$396.18 ,$81.76 ,$396.18 ,$474.30 ,$474.30 ,$474.30 , N/A ,$208.59 ,$474.30 ,$81.76 ,$558.00 ,$313.04 ,$81.76 ,$231.01 ,$41.21 ,$37.46 ,$81.76 ,$474.30 ,$175.21 ,$332.57 ,$156.24 ,$502.20 ,$81.76 ,$474.30 ,$471.51 ,$471.51 ,$81.76 ,$362.70 ST. JOSEPH'S HOSPITAL - BREESE,32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$419.00 ,$301.68 ,$37.46 ,$419.00 ,$208.58 ,$272.35 ,$250.14 ,$81.76 ,$117.32 ,$277.38 ,$81.76 ,$277.38 ,$81.76 ,$249.72 ,$249.72 ,$81.76 ,$249.72 ,$168.54 ,$322.63 ,$208.59 ,$81.76 ,$83.40 ,$314.25 ,$297.49 ,$297.49 ,$81.76 ,$297.49 ,$356.15 ,$356.15 ,$356.15 , N/A ,$208.59 ,$356.15 ,$81.76 ,$419.00 ,$235.06 ,$81.76 ,$173.47 ,$41.21 ,$37.46 ,$81.76 ,$356.15 ,$175.21 ,$249.72 ,$117.32 ,$377.10 ,$81.76 ,$356.15 ,$354.06 ,$354.06 ,$81.76 ,$272.35 ST. JOSEPH'S HOSPITAL - BREESE,32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$440.00 ,$316.80 ,$37.46 ,$440.00 ,$208.58 ,$286.00 ,$262.68 ,$81.76 ,$123.20 ,$291.28 ,$81.76 ,$291.28 ,$81.76 ,$262.24 ,$262.24 ,$81.76 ,$262.24 ,$168.54 ,$338.80 ,$208.59 ,$81.76 ,$83.40 ,$330.00 ,$312.40 ,$312.40 ,$81.76 ,$312.40 ,$374.00 ,$374.00 ,$374.00 , N/A ,$208.59 ,$374.00 ,$81.76 ,$440.00 ,$246.84 ,$81.76 ,$182.16 ,$41.21 ,$37.46 ,$81.76 ,$374.00 ,$175.21 ,$262.24 ,$123.20 ,$396.00 ,$81.76 ,$374.00 ,$371.80 ,$371.80 ,$81.76 ,$286.00 ST. JOSEPH'S HOSPITAL - BREESE,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$588.00 ,$423.36 ,$37.46 ,$588.00 ,$208.58 ,$382.20 ,$351.04 ,$81.76 ,$164.64 ,$389.26 ,$81.76 ,$389.26 ,$81.76 ,$350.45 ,$350.45 ,$81.76 ,$350.45 ,$168.54 ,$452.76 ,$208.59 ,$81.76 ,$83.40 ,$441.00 ,$417.48 ,$417.48 ,$81.76 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$208.59 ,$499.80 ,$81.76 ,$588.00 ,$329.87 ,$81.76 ,$243.43 ,$41.21 ,$37.46 ,$81.76 ,$499.80 ,$175.21 ,$350.45 ,$164.64 ,$529.20 ,$81.76 ,$499.80 ,$496.86 ,$496.86 ,$81.76 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,32000278,73615,HC XRAY ARTHRO ANKLE,320,1 ,"$1,444.00 ","$1,039.68 ",$213.45 ,"$1,444.00 ",$884.55 ,$938.60 ,$862.07 ,$346.74 ,$404.32 ,$955.93 ,$346.74 ,$955.93 ,$346.74 ,$860.62 ,$860.62 ,$346.74 ,$860.62 ,$714.71 ,$800.00 ,$884.55 ,$346.74 ,$353.67 ,"$1,083.00 ","$1,025.24 ","$1,025.24 ",$346.74 ,"$1,025.24 ","$1,227.40 ","$1,227.40 ","$1,227.40 ", N/A ,$884.55 ,"$1,227.40 ",$346.74 ,"$1,444.00 ",$810.08 ,$346.74 ,$597.82 ,$234.80 ,$213.45 ,$346.74 ,"$1,227.40 ",$743.02 ,$860.62 ,$404.32 ,"$1,299.60 ",$346.74 ,"$1,227.40 ","$1,220.18 ","$1,220.18 ",$346.74 ,$938.60 ST. JOSEPH'S HOSPITAL - BREESE,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$440.00 ,$316.80 ,$37.46 ,$440.00 ,$208.58 ,$286.00 ,$262.68 ,$81.76 ,$123.20 ,$291.28 ,$81.76 ,$291.28 ,$81.76 ,$262.24 ,$262.24 ,$81.76 ,$262.24 ,$168.54 ,$338.80 ,$208.59 ,$81.76 ,$83.40 ,$330.00 ,$312.40 ,$312.40 ,$81.76 ,$312.40 ,$374.00 ,$374.00 ,$374.00 , N/A ,$208.59 ,$374.00 ,$81.76 ,$440.00 ,$246.84 ,$81.76 ,$182.16 ,$41.21 ,$37.46 ,$81.76 ,$374.00 ,$175.21 ,$262.24 ,$123.20 ,$396.00 ,$81.76 ,$374.00 ,$371.80 ,$371.80 ,$81.76 ,$286.00 ST. JOSEPH'S HOSPITAL - BREESE,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$558.00 ,$401.76 ,$37.46 ,$558.00 ,$208.58 ,$362.70 ,$333.13 ,$81.76 ,$156.24 ,$369.40 ,$81.76 ,$369.40 ,$81.76 ,$332.57 ,$332.57 ,$81.76 ,$332.57 ,$168.54 ,$429.66 ,$208.59 ,$81.76 ,$83.40 ,$418.50 ,$396.18 ,$396.18 ,$81.76 ,$396.18 ,$474.30 ,$474.30 ,$474.30 , N/A ,$208.59 ,$474.30 ,$81.76 ,$558.00 ,$313.04 ,$81.76 ,$231.01 ,$41.21 ,$37.46 ,$81.76 ,$474.30 ,$175.21 ,$332.57 ,$156.24 ,$502.20 ,$81.76 ,$474.30 ,$471.51 ,$471.51 ,$81.76 ,$362.70 ST. JOSEPH'S HOSPITAL - BREESE,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$428.00 ,$308.16 ,$37.46 ,$428.00 ,$208.58 ,$278.20 ,$255.52 ,$81.76 ,$119.84 ,$283.34 ,$81.76 ,$283.34 ,$81.76 ,$255.09 ,$255.09 ,$81.76 ,$255.09 ,$168.54 ,$329.56 ,$208.59 ,$81.76 ,$83.40 ,$321.00 ,$303.88 ,$303.88 ,$81.76 ,$303.88 ,$363.80 ,$363.80 ,$363.80 , N/A ,$208.59 ,$363.80 ,$81.76 ,$428.00 ,$240.11 ,$81.76 ,$177.19 ,$41.21 ,$37.46 ,$81.76 ,$363.80 ,$175.21 ,$255.09 ,$119.84 ,$385.20 ,$81.76 ,$363.80 ,$361.66 ,$361.66 ,$81.76 ,$278.20 ST. JOSEPH'S HOSPITAL - BREESE,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$367.00 ,$264.24 ,$37.46 ,$367.00 ,$208.58 ,$238.55 ,$219.10 ,$81.76 ,$102.76 ,$242.95 ,$81.76 ,$242.95 ,$81.76 ,$218.73 ,$218.73 ,$81.76 ,$218.73 ,$168.54 ,$282.59 ,$208.59 ,$81.76 ,$83.40 ,$275.25 ,$260.57 ,$260.57 ,$81.76 ,$260.57 ,$311.95 ,$311.95 ,$311.95 , N/A ,$208.59 ,$311.95 ,$81.76 ,$367.00 ,$205.89 ,$81.76 ,$151.94 ,$41.21 ,$37.46 ,$81.76 ,$311.95 ,$175.21 ,$218.73 ,$102.76 ,$330.30 ,$81.76 ,$311.95 ,$310.12 ,$310.12 ,$81.76 ,$238.55 ST. JOSEPH'S HOSPITAL - BREESE,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$554.00 ,$398.88 ,$56.19 ,$554.00 ,$208.58 ,$360.10 ,$330.74 ,$81.76 ,$155.12 ,$366.75 ,$81.76 ,$366.75 ,$81.76 ,$330.18 ,$330.18 ,$81.76 ,$330.18 ,$168.54 ,$426.58 ,$208.59 ,$81.76 ,$83.40 ,$415.50 ,$393.34 ,$393.34 ,$81.76 ,$393.34 ,$470.90 ,$470.90 ,$470.90 , N/A ,$208.59 ,$470.90 ,$81.76 ,$554.00 ,$310.79 ,$81.76 ,$229.36 ,$61.81 ,$56.19 ,$81.76 ,$470.90 ,$175.21 ,$330.18 ,$155.12 ,$498.60 ,$81.76 ,$470.90 ,$468.13 ,$468.13 ,$81.76 ,$360.10 ST. JOSEPH'S HOSPITAL - BREESE,32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$490.00 ,$352.80 ,$37.46 ,$490.00 ,$208.58 ,$318.50 ,$292.53 ,$81.76 ,$137.20 ,$324.38 ,$81.76 ,$324.38 ,$81.76 ,$292.04 ,$292.04 ,$81.76 ,$292.04 ,$168.54 ,$377.30 ,$208.59 ,$81.76 ,$83.40 ,$367.50 ,$347.90 ,$347.90 ,$81.76 ,$347.90 ,$416.50 ,$416.50 ,$416.50 , N/A ,$208.59 ,$416.50 ,$81.76 ,$490.00 ,$274.89 ,$81.76 ,$202.86 ,$41.21 ,$37.46 ,$81.76 ,$416.50 ,$175.21 ,$292.04 ,$137.20 ,$441.00 ,$81.76 ,$416.50 ,$414.05 ,$414.05 ,$81.76 ,$318.50 ST. JOSEPH'S HOSPITAL - BREESE,32000294,74019,HC XRAY ABDOMEN AP AND LAT (2 V OR 3 V),320,1 ,$713.00 ,$513.36 ,$37.46 ,$713.00 ,$256.60 ,$463.45 ,$425.66 ,$100.59 ,$199.64 ,$472.01 ,$100.59 ,$472.01 ,$100.59 ,$424.95 ,$424.95 ,$100.59 ,$424.95 ,$207.34 ,$549.01 ,$256.60 ,$100.59 ,$102.60 ,$534.75 ,$506.23 ,$506.23 ,$100.59 ,$506.23 ,$606.05 ,$606.05 ,$606.05 , N/A ,$256.60 ,$606.05 ,$100.59 ,$713.00 ,$399.99 ,$100.59 ,$295.18 ,$41.21 ,$37.46 ,$100.59 ,$606.05 ,$215.55 ,$424.95 ,$199.64 ,$641.70 ,$100.59 ,$606.05 ,$602.49 ,$602.49 ,$100.59 ,$463.45 ST. JOSEPH'S HOSPITAL - BREESE,32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,"$1,169.00 ",$841.68 ,$37.46 ,"$1,169.00 ",$256.60 ,$759.85 ,$697.89 ,$100.59 ,$327.32 ,$773.88 ,$100.59 ,$773.88 ,$100.59 ,$696.72 ,$696.72 ,$100.59 ,$696.72 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$876.75 ,$829.99 ,$829.99 ,$100.59 ,$829.99 ,$993.65 ,$993.65 ,$993.65 , N/A ,$256.60 ,$993.65 ,$100.59 ,"$1,169.00 ",$655.81 ,$100.59 ,$483.97 ,$41.21 ,$37.46 ,$100.59 ,$993.65 ,$215.55 ,$696.72 ,$327.32 ,"$1,052.10 ",$100.59 ,$993.65 ,$987.81 ,$987.81 ,$100.59 ,$759.85 ST. JOSEPH'S HOSPITAL - BREESE,32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$726.00 ,$522.72 ,$37.46 ,$726.00 ,$432.98 ,$471.90 ,$433.42 ,$169.73 ,$203.28 ,$480.61 ,$169.73 ,$480.61 ,$169.73 ,$432.70 ,$432.70 ,$169.73 ,$432.70 ,$349.84 ,$559.02 ,$432.97 ,$169.73 ,$173.12 ,$544.50 ,$515.46 ,$515.46 ,$169.73 ,$515.46 ,$617.10 ,$617.10 ,$617.10 , N/A ,$432.97 ,$617.10 ,$169.73 ,$726.00 ,$407.29 ,$169.73 ,$300.56 ,$41.21 ,$37.46 ,$169.73 ,$617.10 ,$363.69 ,$432.70 ,$203.28 ,$653.40 ,$169.73 ,$617.10 ,$613.47 ,$613.47 ,$169.73 ,$471.90 ST. JOSEPH'S HOSPITAL - BREESE,32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$804.00 ,$578.88 ,$82.37 ,$804.00 ,$432.98 ,$522.60 ,$479.99 ,$169.73 ,$225.12 ,$532.25 ,$169.73 ,$532.25 ,$169.73 ,$479.18 ,$479.18 ,$169.73 ,$479.18 ,$349.84 ,$619.08 ,$432.97 ,$169.73 ,$173.12 ,$603.00 ,$570.84 ,$570.84 ,$169.73 ,$570.84 ,$683.40 ,$683.40 ,$683.40 , N/A ,$432.97 ,$683.40 ,$169.73 ,$804.00 ,$451.04 ,$169.73 ,$332.86 ,$90.61 ,$82.37 ,$169.73 ,$683.40 ,$363.69 ,$479.18 ,$225.12 ,$723.60 ,$169.73 ,$683.40 ,$679.38 ,$679.38 ,$169.73 ,$522.60 ST. JOSEPH'S HOSPITAL - BREESE,32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,"$1,284.00 ",$924.48 ,$82.37 ,"$1,284.00 ",$432.98 ,$834.60 ,$766.55 ,$169.73 ,$359.52 ,$850.01 ,$169.73 ,$850.01 ,$169.73 ,$765.26 ,$765.26 ,$169.73 ,$765.26 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,$963.00 ,$911.64 ,$911.64 ,$169.73 ,$911.64 ,"$1,091.40 ","$1,091.40 ","$1,091.40 ", N/A ,$432.97 ,"$1,091.40 ",$169.73 ,"$1,284.00 ",$720.32 ,$169.73 ,$531.58 ,$90.61 ,$82.37 ,$169.73 ,"$1,091.40 ",$363.69 ,$765.26 ,$359.52 ,"$1,155.60 ",$169.73 ,"$1,091.40 ","$1,084.98 ","$1,084.98 ",$169.73 ,$834.60 ST. JOSEPH'S HOSPITAL - BREESE,32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,"$1,433.00 ","$1,031.76 ",$82.37 ,"$1,433.00 ",$432.98 ,$931.45 ,$855.50 ,$169.73 ,$401.24 ,$948.65 ,$169.73 ,$948.65 ,$169.73 ,$854.07 ,$854.07 ,$169.73 ,$854.07 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,074.75 ","$1,017.43 ","$1,017.43 ",$169.73 ,"$1,017.43 ","$1,218.05 ","$1,218.05 ","$1,218.05 ", N/A ,$432.97 ,"$1,218.05 ",$169.73 ,"$1,433.00 ",$803.91 ,$169.73 ,$593.26 ,$90.61 ,$82.37 ,$169.73 ,"$1,218.05 ",$363.69 ,$854.07 ,$401.24 ,"$1,289.70 ",$169.73 ,"$1,218.05 ","$1,210.89 ","$1,210.89 ",$169.73 ,$931.45 ST. JOSEPH'S HOSPITAL - BREESE,32000307,74246,HC XRAY ESOPHAGUS/UGI W AIR,320,1 ,"$1,433.00 ","$1,031.76 ",$82.37 ,"$1,433.00 ",$432.98 ,$931.45 ,$855.50 ,$169.73 ,$401.24 ,$948.65 ,$169.73 ,$948.65 ,$169.73 ,$854.07 ,$854.07 ,$169.73 ,$854.07 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,074.75 ","$1,017.43 ","$1,017.43 ",$169.73 ,"$1,017.43 ","$1,218.05 ","$1,218.05 ","$1,218.05 ", N/A ,$432.97 ,"$1,218.05 ",$169.73 ,"$1,433.00 ",$803.91 ,$169.73 ,$593.26 ,$90.61 ,$82.37 ,$169.73 ,"$1,218.05 ",$363.69 ,$854.07 ,$401.24 ,"$1,289.70 ",$169.73 ,"$1,218.05 ","$1,210.89 ","$1,210.89 ",$169.73 ,$931.45 ST. JOSEPH'S HOSPITAL - BREESE,32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$804.00 ,$578.88 ,$82.37 ,$804.00 ,$432.98 ,$522.60 ,$479.99 ,$169.73 ,$225.12 ,$532.25 ,$169.73 ,$532.25 ,$169.73 ,$479.18 ,$479.18 ,$169.73 ,$479.18 ,$349.84 ,$619.08 ,$432.97 ,$169.73 ,$173.12 ,$603.00 ,$570.84 ,$570.84 ,$169.73 ,$570.84 ,$683.40 ,$683.40 ,$683.40 , N/A ,$432.97 ,$683.40 ,$169.73 ,$804.00 ,$451.04 ,$169.73 ,$332.86 ,$90.61 ,$82.37 ,$169.73 ,$683.40 ,$363.69 ,$479.18 ,$225.12 ,$723.60 ,$169.73 ,$683.40 ,$679.38 ,$679.38 ,$169.73 ,$522.60 ST. JOSEPH'S HOSPITAL - BREESE,32000315,74270,HC XRAY COLON BARIUM,320,1 ,"$1,470.00 ","$1,058.40 ",$82.37 ,"$1,470.00 ",$432.98 ,$955.50 ,$877.59 ,$169.73 ,$411.60 ,$973.14 ,$169.73 ,$973.14 ,$169.73 ,$876.12 ,$876.12 ,$169.73 ,$876.12 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,102.50 ","$1,043.70 ","$1,043.70 ",$169.73 ,"$1,043.70 ","$1,249.50 ","$1,249.50 ","$1,249.50 ", N/A ,$432.97 ,"$1,249.50 ",$169.73 ,"$1,470.00 ",$824.67 ,$169.73 ,$608.58 ,$90.61 ,$82.37 ,$169.73 ,"$1,249.50 ",$363.69 ,$876.12 ,$411.60 ,"$1,323.00 ",$169.73 ,"$1,249.50 ","$1,242.15 ","$1,242.15 ",$169.73 ,$955.50 ST. JOSEPH'S HOSPITAL - BREESE,32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,"$1,470.00 ","$1,058.40 ",$82.37 ,"$1,470.00 ",$432.98 ,$955.50 ,$877.59 ,$169.73 ,$411.60 ,$973.14 ,$169.73 ,$973.14 ,$169.73 ,$876.12 ,$876.12 ,$169.73 ,$876.12 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,102.50 ","$1,043.70 ","$1,043.70 ",$169.73 ,"$1,043.70 ","$1,249.50 ","$1,249.50 ","$1,249.50 ", N/A ,$432.97 ,"$1,249.50 ",$169.73 ,"$1,470.00 ",$824.67 ,$169.73 ,$608.58 ,$90.61 ,$82.37 ,$169.73 ,"$1,249.50 ",$363.69 ,$876.12 ,$411.60 ,"$1,323.00 ",$169.73 ,"$1,249.50 ","$1,242.15 ","$1,242.15 ",$169.73 ,$955.50 ST. JOSEPH'S HOSPITAL - BREESE,32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,"$1,470.00 ","$1,058.40 ",$82.37 ,"$1,470.00 ",$432.98 ,$955.50 ,$877.59 ,$169.73 ,$411.60 ,$973.14 ,$169.73 ,$973.14 ,$169.73 ,$876.12 ,$876.12 ,$169.73 ,$876.12 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,102.50 ","$1,043.70 ","$1,043.70 ",$169.73 ,"$1,043.70 ","$1,249.50 ","$1,249.50 ","$1,249.50 ", N/A ,$432.97 ,"$1,249.50 ",$169.73 ,"$1,470.00 ",$824.67 ,$169.73 ,$608.58 ,$90.61 ,$82.37 ,$169.73 ,"$1,249.50 ",$363.69 ,$876.12 ,$411.60 ,"$1,323.00 ",$169.73 ,"$1,249.50 ","$1,242.15 ","$1,242.15 ",$169.73 ,$955.50 ST. JOSEPH'S HOSPITAL - BREESE,32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,"$1,661.00 ","$1,195.92 ",$82.37 ,"$1,661.00 ",$432.98 ,"$1,079.65 ",$991.62 ,$169.73 ,$465.08 ,"$1,099.58 ",$169.73 ,"$1,099.58 ",$169.73 ,$989.96 ,$989.96 ,$169.73 ,$989.96 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,245.75 ","$1,179.31 ","$1,179.31 ",$169.73 ,"$1,179.31 ","$1,411.85 ","$1,411.85 ","$1,411.85 ", N/A ,$432.97 ,"$1,411.85 ",$169.73 ,"$1,661.00 ",$931.82 ,$169.73 ,$687.65 ,$90.61 ,$82.37 ,$169.73 ,"$1,411.85 ",$363.69 ,$989.96 ,$465.08 ,"$1,494.90 ",$169.73 ,"$1,411.85 ","$1,403.55 ","$1,403.55 ",$169.73 ,"$1,079.65 " ST. JOSEPH'S HOSPITAL - BREESE,32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,$961.00 ,$691.92 ,$213.45 ,$961.00 , N/A ,$624.65 ,$573.72 , N/A ,$269.08 ,$636.18 , N/A ,$636.18 , N/A ,$572.76 ,$572.76 , N/A ,$572.76 , N/A ,$739.97 , N/A , N/A , N/A ,$720.75 ,$682.31 ,$682.31 , N/A ,$682.31 ,$816.85 ,$816.85 ,$816.85 , N/A , N/A ,$816.85 , N/A ,$961.00 ,$539.12 , N/A ,$397.85 ,$234.80 ,$213.45 , N/A ,$816.85 , N/A ,$572.76 ,$269.08 ,$864.90 , N/A ,$816.85 ,$812.05 ,$812.05 , N/A ,$624.65 ST. JOSEPH'S HOSPITAL - BREESE,32000324,74301,HC CHOLANGIOGRAPHY OPERATIVE ADDL,320,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 , N/A ,$208.65 ,$191.64 , N/A ,$89.88 ,$212.50 , N/A ,$212.50 , N/A ,$191.32 ,$191.32 , N/A ,$191.32 , N/A ,$247.17 , N/A , N/A , N/A ,$240.75 ,$227.91 ,$227.91 , N/A ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A , N/A ,$272.85 , N/A ,$321.00 ,$180.08 , N/A ,$132.89 ,$234.80 ,$213.45 , N/A ,$272.85 , N/A ,$191.32 ,$89.88 ,$288.90 , N/A ,$272.85 ,$271.25 ,$271.25 , N/A ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,32000325,47531,HC XRAY CHOLANGIOGRAM THRU CATH,320,1 ,"$1,502.00 ","$1,081.44 ",$82.37 ,"$8,503.65 ","$8,503.65 ",$976.30 ,$896.69 ,"$3,333.43 ",$420.56 ,$994.32 ,"$3,333.43 ",$994.32 ,"$1,471.96 ",$895.19 ,$895.19 ,"$1,471.96 ",$895.19 ,"$1,502.00 ",$800.00 ,"$8,503.64 ","$3,333.43 ","$1,471.96 ","$1,126.50 ","$1,066.42 ","$1,066.42 ","$3,333.43 ","$1,066.42 ","$1,276.70 ","$1,276.70 ","$1,276.70 ", N/A ,"$1,502.00 ","$1,276.70 ","$1,471.96 ","$1,502.00 ",$842.62 ,"$3,333.43 ",$621.83 ,$90.61 ,$82.37 ,"$3,333.43 ","$1,276.70 ","$7,143.06 ",$895.19 ,$420.56 ,"$1,351.80 ","$3,333.43 ","$1,276.70 ","$1,269.19 ","$1,269.19 ","$3,333.43 ",$976.30 ST. JOSEPH'S HOSPITAL - BREESE,32000335,74400,HC XRAY IVP W OR W/O TOMO,320,1 ,"$1,526.00 ","$1,098.72 ",$169.73 ,"$1,526.00 ",$432.98 ,$991.90 ,$911.02 ,$169.73 ,$427.28 ,"$1,010.21 ",$169.73 ,"$1,010.21 ",$169.73 ,$909.50 ,$909.50 ,$169.73 ,$909.50 ,$349.84 ,$800.00 ,$432.97 ,$169.73 ,$173.12 ,"$1,144.50 ","$1,083.46 ","$1,083.46 ",$169.73 ,"$1,083.46 ","$1,297.10 ","$1,297.10 ","$1,297.10 ", N/A ,$432.97 ,"$1,297.10 ",$169.73 ,"$1,526.00 ",$856.09 ,$169.73 ,$631.76 ,$257.03 ,$233.66 ,$169.73 ,"$1,297.10 ",$363.69 ,$909.50 ,$427.28 ,"$1,373.40 ",$169.73 ,"$1,297.10 ","$1,289.47 ","$1,289.47 ",$169.73 ,$991.90 ST. JOSEPH'S HOSPITAL - BREESE,32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,$960.00 ,$691.20 ,$213.45 ,$960.00 ,$884.55 ,$624.00 ,$573.12 ,$346.74 ,$268.80 ,$635.52 ,$346.74 ,$635.52 ,$346.74 ,$572.16 ,$572.16 ,$346.74 ,$572.16 ,$714.71 ,$739.20 ,$884.55 ,$346.74 ,$353.67 ,$720.00 ,$681.60 ,$681.60 ,$346.74 ,$681.60 ,$816.00 ,$816.00 ,$816.00 , N/A ,$884.55 ,$816.00 ,$346.74 ,$960.00 ,$538.56 ,$346.74 ,$397.44 ,$234.80 ,$213.45 ,$346.74 ,$816.00 ,$743.02 ,$572.16 ,$268.80 ,$864.00 ,$346.74 ,$816.00 ,$811.20 ,$811.20 ,$346.74 ,$624.00 ST. JOSEPH'S HOSPITAL - BREESE,32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,"$1,350.00 ",$972.00 ,$213.45 ,"$1,350.00 ",$560.65 ,$877.50 ,$805.95 ,$219.77 ,$378.00 ,$893.70 ,$219.77 ,$893.70 ,$219.77 ,$804.60 ,$804.60 ,$219.77 ,$804.60 ,$453.00 ,$800.00 ,$560.65 ,$219.77 ,$224.17 ,"$1,012.50 ",$958.50 ,$958.50 ,$219.77 ,$958.50 ,"$1,147.50 ","$1,147.50 ","$1,147.50 ", N/A ,$560.65 ,"$1,147.50 ",$219.77 ,"$1,350.00 ",$757.35 ,$219.77 ,$558.90 ,$234.80 ,$213.45 ,$219.77 ,"$1,147.50 ",$470.94 ,$804.60 ,$378.00 ,"$1,215.00 ",$219.77 ,"$1,147.50 ","$1,140.75 ","$1,140.75 ",$219.77 ,$877.50 ST. JOSEPH'S HOSPITAL - BREESE,32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,$910.00 ,$655.20 ,$213.45 ,$910.00 ,$560.65 ,$591.50 ,$543.27 ,$219.77 ,$254.80 ,$602.42 ,$219.77 ,$602.42 ,$219.77 ,$542.36 ,$542.36 ,$219.77 ,$542.36 ,$453.00 ,$700.70 ,$560.65 ,$219.77 ,$224.17 ,$682.50 ,$646.10 ,$646.10 ,$219.77 ,$646.10 ,$773.50 ,$773.50 ,$773.50 , N/A ,$560.65 ,$773.50 ,$219.77 ,$910.00 ,$510.51 ,$219.77 ,$376.74 ,$234.80 ,$213.45 ,$219.77 ,$773.50 ,$470.94 ,$542.36 ,$254.80 ,$819.00 ,$219.77 ,$773.50 ,$768.95 ,$768.95 ,$219.77 ,$591.50 ST. JOSEPH'S HOSPITAL - BREESE,32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,"$1,691.00 ","$1,217.52 ",$213.45 ,"$1,691.00 ", N/A ,"$1,099.15 ","$1,009.53 ", N/A ,$473.48 ,"$1,119.44 ", N/A ,"$1,119.44 ", N/A ,"$1,007.84 ","$1,007.84 ", N/A ,"$1,007.84 ", N/A ,$800.00 , N/A , N/A , N/A ,"$1,268.25 ","$1,200.61 ","$1,200.61 ", N/A ,"$1,200.61 ","$1,437.35 ","$1,437.35 ","$1,437.35 ", N/A , N/A ,"$1,437.35 ", N/A ,"$1,691.00 ",$948.65 , N/A ,$700.07 ,$234.80 ,$213.45 , N/A ,"$1,437.35 ", N/A ,"$1,007.84 ",$473.48 ,"$1,521.90 ", N/A ,"$1,437.35 ","$1,428.90 ","$1,428.90 ", N/A ,"$1,099.15 " ST. JOSEPH'S HOSPITAL - BREESE,32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$672.00 ,$483.84 ,$37.46 ,$672.00 ,$560.65 ,$436.80 ,$401.18 ,$219.77 ,$188.16 ,$444.86 ,$219.77 ,$444.86 ,$219.77 ,$400.51 ,$400.51 ,$219.77 ,$400.51 ,$453.00 ,$517.44 ,$560.65 ,$219.77 ,$224.17 ,$504.00 ,$477.12 ,$477.12 ,$219.77 ,$477.12 ,$571.20 ,$571.20 ,$571.20 , N/A ,$560.65 ,$571.20 ,$219.77 ,$672.00 ,$376.99 ,$219.77 ,$278.21 ,$41.21 ,$37.46 ,$219.77 ,$571.20 ,$470.94 ,$400.51 ,$188.16 ,$604.80 ,$219.77 ,$571.20 ,$567.84 ,$567.84 ,$219.77 ,$436.80 ST. JOSEPH'S HOSPITAL - BREESE,32000464,76010,HC BABYGRAM,320,1 ,$472.00 ,$339.84 ,$37.46 ,$472.00 ,$208.58 ,$306.80 ,$281.78 ,$81.76 ,$132.16 ,$312.46 ,$81.76 ,$312.46 ,$81.76 ,$281.31 ,$281.31 ,$81.76 ,$281.31 ,$168.54 ,$363.44 ,$208.59 ,$81.76 ,$83.40 ,$354.00 ,$335.12 ,$335.12 ,$81.76 ,$335.12 ,$401.20 ,$401.20 ,$401.20 , N/A ,$208.59 ,$401.20 ,$81.76 ,$472.00 ,$264.79 ,$81.76 ,$195.41 ,$41.21 ,$37.46 ,$81.76 ,$401.20 ,$175.21 ,$281.31 ,$132.16 ,$424.80 ,$81.76 ,$401.20 ,$398.84 ,$398.84 ,$81.76 ,$306.80 ST. JOSEPH'S HOSPITAL - BREESE,32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$486.00 ,$349.92 ,$28.66 ,"$1,207.95 ","$1,207.95 ",$315.90 ,$290.14 ,$473.52 ,$136.08 ,$321.73 ,$473.52 ,$321.73 ,$473.52 ,$289.66 ,$289.66 ,$473.52 ,$289.66 ,$486.00 ,$374.22 ,"$1,207.94 ",$473.52 ,$476.28 ,$364.50 ,$345.06 ,$345.06 ,$473.52 ,$345.06 ,$413.10 ,$413.10 ,$413.10 , N/A ,$486.00 ,$413.10 ,$473.52 ,$28.66 ,$272.65 ,$473.52 ,$201.20 ,$41.21 ,$37.46 ,$473.52 ,$413.10 ,"$1,014.67 ",$289.66 ,$136.08 ,$437.40 ,$473.52 ,$413.10 ,$410.67 ,$410.67 ,$473.52 ,$315.90 ST. JOSEPH'S HOSPITAL - BREESE,32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,"$1,284.00 ",$924.48 ,$213.45 ,"$1,284.00 ", N/A ,$834.60 ,$766.55 , N/A ,$359.52 ,$850.01 , N/A ,$850.01 , N/A ,$765.26 ,$765.26 , N/A ,$765.26 , N/A ,$800.00 , N/A , N/A , N/A ,$963.00 ,$911.64 ,$911.64 , N/A ,$911.64 ,"$1,091.40 ","$1,091.40 ","$1,091.40 ", N/A , N/A ,"$1,091.40 ", N/A ,"$1,284.00 ",$720.32 , N/A ,$531.58 ,$234.80 ,$213.45 , N/A ,"$1,091.40 ", N/A ,$765.26 ,$359.52 ,"$1,155.60 ", N/A ,"$1,091.40 ","$1,084.98 ","$1,084.98 ", N/A ,$834.60 ST. JOSEPH'S HOSPITAL - BREESE,32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$807.00 ,$581.04 ,$213.45 ,$807.00 , N/A ,$524.55 ,$481.78 , N/A ,$225.96 ,$534.23 , N/A ,$534.23 , N/A ,$480.97 ,$480.97 , N/A ,$480.97 , N/A ,$621.39 , N/A , N/A , N/A ,$605.25 ,$572.97 ,$572.97 , N/A ,$572.97 ,$685.95 ,$685.95 ,$685.95 , N/A , N/A ,$685.95 , N/A ,$807.00 ,$452.73 , N/A ,$334.10 ,$234.80 ,$213.45 , N/A ,$685.95 , N/A ,$480.97 ,$225.96 ,$726.30 , N/A ,$685.95 ,$681.92 ,$681.92 , N/A ,$524.55 ST. JOSEPH'S HOSPITAL - BREESE,32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$5,953.00 ","$4,286.16 ",$539.22 ,"$5,953.00 ","$3,600.20 ","$3,869.45 ","$3,553.94 ","$1,411.28 ","$1,666.84 ","$3,940.89 ","$1,411.28 ","$3,940.89 ","$1,411.28 ","$3,547.99 ","$3,547.99 ","$1,411.28 ","$3,547.99 ","$2,908.96 ",$800.00 ,"$3,600.19 ","$1,411.28 ","$1,439.50 ","$4,464.75 ","$4,226.63 ","$4,226.63 ","$1,411.28 ","$4,226.63 ","$5,060.05 ","$5,060.05 ","$5,060.05 ", N/A ,"$3,600.19 ","$5,060.05 ","$1,411.28 ",$539.22 ,"$3,339.63 ","$1,411.28 ","$2,464.54 ",$912.65 ,$829.68 ,"$1,411.28 ","$5,060.05 ","$3,024.16 ","$3,547.99 ","$1,666.84 ","$5,357.70 ","$1,411.28 ","$5,060.05 ","$5,030.29 ","$5,030.29 ","$1,411.28 ","$3,869.45 " ST. JOSEPH'S HOSPITAL - BREESE,32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$2,077.00 ","$1,495.44 ",$80.37 ,"$3,600.20 ","$3,600.20 ","$1,350.05 ","$1,239.97 ","$1,411.28 ",$581.56 ,"$1,374.97 ","$1,411.28 ","$1,374.97 ","$1,411.28 ","$1,237.89 ","$1,237.89 ","$1,411.28 ","$1,237.89 ","$2,077.00 ",$800.00 ,"$3,600.19 ","$1,411.28 ","$1,439.50 ","$1,557.75 ","$1,474.67 ","$1,474.67 ","$1,411.28 ","$1,474.67 ","$1,765.45 ","$1,765.45 ","$1,765.45 ", N/A ,"$2,077.00 ","$1,765.45 ","$1,411.28 ",$258.08 ,"$1,165.20 ","$1,411.28 ",$859.88 ,$88.41 ,$80.37 ,"$1,411.28 ","$1,765.45 ","$3,024.16 ","$1,237.89 ",$581.56 ,"$1,869.30 ","$1,411.28 ","$1,765.45 ","$1,755.07 ","$1,755.07 ","$1,411.28 ","$1,350.05 " ST. JOSEPH'S HOSPITAL - BREESE,32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$3,114.00 ","$2,242.08 ",$120.56 ,"$3,600.20 ","$3,600.20 ","$2,024.10 ","$1,859.06 ","$1,411.28 ",$871.92 ,"$2,061.47 ","$1,411.28 ","$2,061.47 ","$1,411.28 ","$1,855.94 ","$1,855.94 ","$1,411.28 ","$1,855.94 ","$2,908.96 ",$800.00 ,"$3,600.19 ","$1,411.28 ","$1,439.50 ","$2,335.50 ","$2,210.94 ","$2,210.94 ","$1,411.28 ","$2,210.94 ","$2,646.90 ","$2,646.90 ","$2,646.90 ", N/A ,"$3,114.00 ","$2,646.90 ","$1,411.28 ",$258.08 ,"$1,746.95 ","$1,411.28 ","$1,289.20 ",$132.62 ,$120.56 ,"$1,411.28 ","$2,646.90 ","$3,024.16 ","$1,855.94 ",$871.92 ,"$2,802.60 ","$1,411.28 ","$2,646.90 ","$2,631.33 ","$2,631.33 ","$1,411.28 ","$2,024.10 " ST. JOSEPH'S HOSPITAL - BREESE,32000490,77053,HC GALACTOGRAM SINGLE DUCT,320,1 ,$701.00 ,$504.72 ,$38.47 ,$701.00 ,$560.65 ,$455.65 ,$418.50 ,$219.77 ,$196.28 ,$464.06 ,$219.77 ,$464.06 ,$219.77 ,$417.80 ,$417.80 ,$219.77 ,$417.80 ,$453.00 ,$539.77 ,$560.65 ,$219.77 ,$224.17 ,$525.75 ,$497.71 ,$497.71 ,$219.77 ,$497.71 ,$595.85 ,$595.85 ,$595.85 , N/A ,$560.65 ,$595.85 ,$219.77 ,$38.47 ,$393.26 ,$219.77 ,$290.21 ,$234.80 ,$213.45 ,$219.77 ,$595.85 ,$470.94 ,$417.80 ,$196.28 ,$630.90 ,$219.77 ,$595.85 ,$592.35 ,$592.35 ,$219.77 ,$455.65 ST. JOSEPH'S HOSPITAL - BREESE,32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$831.00 ,$598.32 ,$37.46 ,$831.00 ,$256.60 ,$540.15 ,$496.11 ,$100.59 ,$232.68 ,$550.12 ,$100.59 ,$550.12 ,$100.59 ,$495.28 ,$495.28 ,$100.59 ,$495.28 ,$207.34 ,$639.87 ,$256.60 ,$100.59 ,$102.60 ,$623.25 ,$590.01 ,$590.01 ,$100.59 ,$590.01 ,$706.35 ,$706.35 ,$706.35 , N/A ,$256.60 ,$706.35 ,$100.59 ,$831.00 ,$466.19 ,$100.59 ,$344.03 ,$41.21 ,$37.46 ,$100.59 ,$706.35 ,$215.55 ,$495.28 ,$232.68 ,$747.90 ,$100.59 ,$706.35 ,$702.20 ,$702.20 ,$100.59 ,$540.15 ST. JOSEPH'S HOSPITAL - BREESE,32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,"$1,120.00 ",$806.40 ,$37.46 ,"$1,120.00 ",$256.60 ,$728.00 ,$668.64 ,$100.59 ,$313.60 ,$741.44 ,$100.59 ,$741.44 ,$100.59 ,$667.52 ,$667.52 ,$100.59 ,$667.52 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$840.00 ,$795.20 ,$795.20 ,$100.59 ,$795.20 ,$952.00 ,$952.00 ,$952.00 , N/A ,$256.60 ,$952.00 ,$100.59 ,"$1,120.00 ",$628.32 ,$100.59 ,$463.68 ,$41.21 ,$37.46 ,$100.59 ,$952.00 ,$215.55 ,$667.52 ,$313.60 ,"$1,008.00 ",$100.59 ,$952.00 ,$946.40 ,$946.40 ,$100.59 ,$728.00 ST. JOSEPH'S HOSPITAL - BREESE,32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$894.00 ,$643.68 ,$37.46 ,$894.00 ,$256.60 ,$581.10 ,$533.72 ,$100.59 ,$250.32 ,$591.83 ,$100.59 ,$591.83 ,$100.59 ,$532.82 ,$532.82 ,$100.59 ,$532.82 ,$207.34 ,$688.38 ,$256.60 ,$100.59 ,$102.60 ,$670.50 ,$634.74 ,$634.74 ,$100.59 ,$634.74 ,$759.90 ,$759.90 ,$759.90 , N/A ,$256.60 ,$759.90 ,$100.59 ,$894.00 ,$501.53 ,$100.59 ,$370.12 ,$41.21 ,$37.46 ,$100.59 ,$759.90 ,$215.55 ,$532.82 ,$250.32 ,$804.60 ,$100.59 ,$759.90 ,$755.43 ,$755.43 ,$100.59 ,$581.10 ST. JOSEPH'S HOSPITAL - BREESE,32000496,77080,HC BONE DENSITY DXA,320,1 ,$529.00 ,$380.88 ,$59.16 ,$529.00 ,$256.60 ,$343.85 ,$315.81 ,$100.59 ,$148.12 ,$350.20 ,$100.59 ,$350.20 ,$100.59 ,$315.28 ,$315.28 ,$100.59 ,$315.28 ,$207.34 ,$407.33 ,$256.60 ,$100.59 ,$102.60 ,$396.75 ,$375.59 ,$375.59 ,$100.59 ,$375.59 ,$449.65 ,$449.65 ,$449.65 , N/A ,$256.60 ,$449.65 ,$100.59 ,$529.00 ,$296.77 ,$100.59 ,$219.01 ,$65.08 ,$59.16 ,$100.59 ,$449.65 ,$215.55 ,$315.28 ,$148.12 ,$476.10 ,$100.59 ,$449.65 ,$447.01 ,$447.01 ,$100.59 ,$343.85 ST. JOSEPH'S HOSPITAL - BREESE,32000497,77081,HC BONE DENSITY PERIPHERAL,320,1 ,$442.00 ,$318.24 ,$59.16 ,$442.00 ,$208.58 ,$287.30 ,$263.87 ,$81.76 ,$123.76 ,$292.60 ,$81.76 ,$292.60 ,$81.76 ,$263.43 ,$263.43 ,$81.76 ,$263.43 ,$168.54 ,$340.34 ,$208.59 ,$81.76 ,$83.40 ,$331.50 ,$313.82 ,$313.82 ,$81.76 ,$313.82 ,$375.70 ,$375.70 ,$375.70 , N/A ,$208.59 ,$375.70 ,$81.76 ,$442.00 ,$247.96 ,$81.76 ,$182.99 ,$65.08 ,$59.16 ,$81.76 ,$375.70 ,$175.21 ,$263.43 ,$123.76 ,$397.80 ,$81.76 ,$375.70 ,$373.49 ,$373.49 ,$81.76 ,$287.30 ST. JOSEPH'S HOSPITAL - BREESE,32000498,77086,HC BONE DENSITY VERTEB FX ASSEMT,320,1 ,$330.00 ,$237.60 ,$59.16 ,$330.00 ,$208.58 ,$214.50 ,$197.01 ,$81.76 ,$92.40 ,$218.46 ,$81.76 ,$218.46 ,$81.76 ,$196.68 ,$196.68 ,$81.76 ,$196.68 ,$168.54 ,$254.10 ,$208.59 ,$81.76 ,$83.40 ,$247.50 ,$234.30 ,$234.30 ,$81.76 ,$234.30 ,$280.50 ,$280.50 ,$280.50 , N/A ,$208.59 ,$280.50 ,$81.76 ,$330.00 ,$185.13 ,$81.76 ,$136.62 ,$65.08 ,$59.16 ,$81.76 ,$280.50 ,$175.21 ,$196.68 ,$92.40 ,$297.00 ,$81.76 ,$280.50 ,$278.85 ,$278.85 ,$81.76 ,$214.50 ST. JOSEPH'S HOSPITAL - BREESE,32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$672.00 ,$483.84 ,$37.46 ,$672.00 ,$560.65 ,$436.80 ,$401.18 ,$219.77 ,$188.16 ,$444.86 ,$219.77 ,$444.86 ,$219.77 ,$400.51 ,$400.51 ,$219.77 ,$400.51 ,$453.00 ,$517.44 ,$560.65 ,$219.77 ,$224.17 ,$504.00 ,$477.12 ,$477.12 ,$219.77 ,$477.12 ,$571.20 ,$571.20 ,$571.20 , N/A ,$560.65 ,$571.20 ,$219.77 ,$672.00 ,$376.99 ,$219.77 ,$278.21 ,$41.21 ,$37.46 ,$219.77 ,$571.20 ,$470.94 ,$400.51 ,$188.16 ,$604.80 ,$219.77 ,$571.20 ,$567.84 ,$567.84 ,$219.77 ,$436.80 ST. JOSEPH'S HOSPITAL - BREESE,32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$862.00 ,$620.64 ,$217.87 ,$862.00 ,$652.78 ,$560.30 ,$514.61 ,$255.89 ,$241.36 ,$570.64 ,$255.89 ,$570.64 ,$255.89 ,$513.75 ,$513.75 ,$255.89 ,$513.75 ,$527.44 ,$663.74 ,$652.77 ,$255.89 ,$261.00 ,$646.50 ,$612.02 ,$612.02 ,$255.89 ,$612.02 ,$732.70 ,$732.70 ,$732.70 , N/A ,$652.77 ,$732.70 ,$255.89 ,$862.00 ,$483.58 ,$255.89 ,$356.87 ,$239.66 ,$217.87 ,$255.89 ,$732.70 ,$548.32 ,$513.75 ,$241.36 ,$775.80 ,$255.89 ,$732.70 ,$728.39 ,$728.39 ,$255.89 ,$560.30 ST. JOSEPH'S HOSPITAL - BREESE,32000509,77072,HC BONE AGE STUDIES,320,1 ,$528.00 ,$380.16 ,$37.46 ,$528.00 ,$256.60 ,$343.20 ,$315.22 ,$100.59 ,$147.84 ,$349.54 ,$100.59 ,$349.54 ,$100.59 ,$314.69 ,$314.69 ,$100.59 ,$314.69 ,$207.34 ,$406.56 ,$256.60 ,$100.59 ,$102.60 ,$396.00 ,$374.88 ,$374.88 ,$100.59 ,$374.88 ,$448.80 ,$448.80 ,$448.80 , N/A ,$256.60 ,$448.80 ,$100.59 ,$528.00 ,$296.21 ,$100.59 ,$218.59 ,$41.21 ,$37.46 ,$100.59 ,$448.80 ,$215.55 ,$314.69 ,$147.84 ,$475.20 ,$100.59 ,$448.80 ,$446.16 ,$446.16 ,$100.59 ,$343.20 ST. JOSEPH'S HOSPITAL - BREESE,32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,$837.00 ,$602.64 ,$234.36 ,"$1,388.90 ","$1,388.90 ",$544.05 ,$499.69 ,$544.45 ,$234.36 ,$554.09 ,$544.45 ,$554.09 ,$544.45 ,$498.85 ,$498.85 ,$544.45 ,$498.85 ,$837.00 ,$644.49 ,"$1,388.89 ",$544.45 ,$555.34 ,$627.75 ,$594.27 ,$594.27 ,$544.45 ,$594.27 ,$711.45 ,$711.45 ,$711.45 , N/A ,$837.00 ,$711.45 ,$544.45 ,$837.00 ,$469.56 ,$544.45 ,$346.52 ,$512.17 ,$465.61 ,$544.45 ,$711.45 ,"$1,166.67 ",$498.85 ,$234.36 ,$753.30 ,$544.45 ,$711.45 ,$707.27 ,$707.27 ,$544.45 ,$544.05 ST. JOSEPH'S HOSPITAL - BREESE,32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,$956.00 ,$688.32 ,$267.68 ,"$1,388.90 ","$1,388.90 ",$621.40 ,$570.73 ,$544.45 ,$267.68 ,$632.87 ,$544.45 ,$632.87 ,$544.45 ,$569.78 ,$569.78 ,$544.45 ,$569.78 ,$956.00 ,$736.12 ,"$1,388.89 ",$544.45 ,$555.34 ,$717.00 ,$678.76 ,$678.76 ,$544.45 ,$678.76 ,$812.60 ,$812.60 ,$812.60 , N/A ,$956.00 ,$812.60 ,$544.45 ,$956.00 ,$536.32 ,$544.45 ,$395.78 ,$512.17 ,$465.61 ,$544.45 ,$812.60 ,"$1,166.67 ",$569.78 ,$267.68 ,$860.40 ,$544.45 ,$812.60 ,$807.82 ,$807.82 ,$544.45 ,$621.40 ST. JOSEPH'S HOSPITAL - BREESE,32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$861.00 ,$619.92 ,$37.46 ,$861.00 ,$256.60 ,$559.65 ,$514.02 ,$100.59 ,$241.08 ,$569.98 ,$100.59 ,$569.98 ,$100.59 ,$513.16 ,$513.16 ,$100.59 ,$513.16 ,$207.34 ,$662.97 ,$256.60 ,$100.59 ,$102.60 ,$645.75 ,$611.31 ,$611.31 ,$100.59 ,$611.31 ,$731.85 ,$731.85 ,$731.85 , N/A ,$256.60 ,$731.85 ,$100.59 ,$861.00 ,$483.02 ,$100.59 ,$356.45 ,$41.21 ,$37.46 ,$100.59 ,$731.85 ,$215.55 ,$513.16 ,$241.08 ,$774.90 ,$100.59 ,$731.85 ,$727.55 ,$727.55 ,$100.59 ,$559.65 ST. JOSEPH'S HOSPITAL - BREESE,32000552,70100,HC XR MANDIBLE <3V,320,1 ,$257.00 ,$185.04 ,$37.46 ,$257.00 ,$208.58 ,$167.05 ,$153.43 ,$81.76 ,$71.96 ,$170.13 ,$81.76 ,$170.13 ,$81.76 ,$153.17 ,$153.17 ,$81.76 ,$153.17 ,$168.54 ,$197.89 ,$208.59 ,$81.76 ,$83.40 ,$192.75 ,$182.47 ,$182.47 ,$81.76 ,$182.47 ,$218.45 ,$218.45 ,$218.45 , N/A ,$208.59 ,$218.45 ,$81.76 ,$257.00 ,$144.18 ,$81.76 ,$106.40 ,$41.21 ,$37.46 ,$81.76 ,$218.45 ,$175.21 ,$153.17 ,$71.96 ,$231.30 ,$81.76 ,$218.45 ,$217.17 ,$217.17 ,$81.76 ,$167.05 ST. JOSEPH'S HOSPITAL - BREESE,32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$257.00 ,$185.04 ,$37.46 ,$257.00 ,$208.58 ,$167.05 ,$153.43 ,$81.76 ,$71.96 ,$170.13 ,$81.76 ,$170.13 ,$81.76 ,$153.17 ,$153.17 ,$81.76 ,$153.17 ,$168.54 ,$197.89 ,$208.59 ,$81.76 ,$83.40 ,$192.75 ,$182.47 ,$182.47 ,$81.76 ,$182.47 ,$218.45 ,$218.45 ,$218.45 , N/A ,$208.59 ,$218.45 ,$81.76 ,$257.00 ,$144.18 ,$81.76 ,$106.40 ,$41.21 ,$37.46 ,$81.76 ,$218.45 ,$175.21 ,$153.17 ,$71.96 ,$231.30 ,$81.76 ,$218.45 ,$217.17 ,$217.17 ,$81.76 ,$167.05 ST. JOSEPH'S HOSPITAL - BREESE,32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$269.00 ,$193.68 ,$37.46 ,$269.00 ,$208.58 ,$174.85 ,$160.59 ,$81.76 ,$75.32 ,$178.08 ,$81.76 ,$178.08 ,$81.76 ,$160.32 ,$160.32 ,$81.76 ,$160.32 ,$168.54 ,$207.13 ,$208.59 ,$81.76 ,$83.40 ,$201.75 ,$190.99 ,$190.99 ,$81.76 ,$190.99 ,$228.65 ,$228.65 ,$228.65 , N/A ,$208.59 ,$228.65 ,$81.76 ,$269.00 ,$150.91 ,$81.76 ,$111.37 ,$41.21 ,$37.46 ,$81.76 ,$228.65 ,$175.21 ,$160.32 ,$75.32 ,$242.10 ,$81.76 ,$228.65 ,$227.31 ,$227.31 ,$81.76 ,$174.85 ST. JOSEPH'S HOSPITAL - BREESE,32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$269.00 ,$193.68 ,$37.46 ,$269.00 ,$256.60 ,$174.85 ,$160.59 ,$100.59 ,$75.32 ,$178.08 ,$100.59 ,$178.08 ,$100.59 ,$160.32 ,$160.32 ,$100.59 ,$160.32 ,$207.34 ,$207.13 ,$256.60 ,$100.59 ,$102.60 ,$201.75 ,$190.99 ,$190.99 ,$100.59 ,$190.99 ,$228.65 ,$228.65 ,$228.65 , N/A ,$256.60 ,$228.65 ,$100.59 ,$269.00 ,$150.91 ,$100.59 ,$111.37 ,$41.21 ,$37.46 ,$100.59 ,$228.65 ,$215.55 ,$160.32 ,$75.32 ,$242.10 ,$100.59 ,$228.65 ,$227.31 ,$227.31 ,$100.59 ,$174.85 ST. JOSEPH'S HOSPITAL - BREESE,32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$269.00 ,$193.68 ,$37.46 ,$269.00 ,$208.58 ,$174.85 ,$160.59 ,$81.76 ,$75.32 ,$178.08 ,$81.76 ,$178.08 ,$81.76 ,$160.32 ,$160.32 ,$81.76 ,$160.32 ,$168.54 ,$207.13 ,$208.59 ,$81.76 ,$83.40 ,$201.75 ,$190.99 ,$190.99 ,$81.76 ,$190.99 ,$228.65 ,$228.65 ,$228.65 , N/A ,$208.59 ,$228.65 ,$81.76 ,$269.00 ,$150.91 ,$81.76 ,$111.37 ,$41.21 ,$37.46 ,$81.76 ,$228.65 ,$175.21 ,$160.32 ,$75.32 ,$242.10 ,$81.76 ,$228.65 ,$227.31 ,$227.31 ,$81.76 ,$174.85 ST. JOSEPH'S HOSPITAL - BREESE,32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$269.00 ,$193.68 ,$37.46 ,$269.00 ,$208.58 ,$174.85 ,$160.59 ,$81.76 ,$75.32 ,$178.08 ,$81.76 ,$178.08 ,$81.76 ,$160.32 ,$160.32 ,$81.76 ,$160.32 ,$168.54 ,$207.13 ,$208.59 ,$81.76 ,$83.40 ,$201.75 ,$190.99 ,$190.99 ,$81.76 ,$190.99 ,$228.65 ,$228.65 ,$228.65 , N/A ,$208.59 ,$228.65 ,$81.76 ,$269.00 ,$150.91 ,$81.76 ,$111.37 ,$41.21 ,$37.46 ,$81.76 ,$228.65 ,$175.21 ,$160.32 ,$75.32 ,$242.10 ,$81.76 ,$228.65 ,$227.31 ,$227.31 ,$81.76 ,$174.85 ST. JOSEPH'S HOSPITAL - BREESE,32000576,73503,HC XR HIP W/PELVIS UNI 4+VWS,320,1 ,$346.00 ,$249.12 ,$37.46 ,$346.00 ,$256.60 ,$224.90 ,$206.56 ,$100.59 ,$96.88 ,$229.05 ,$100.59 ,$229.05 ,$100.59 ,$206.22 ,$206.22 ,$100.59 ,$206.22 ,$207.34 ,$266.42 ,$256.60 ,$100.59 ,$102.60 ,$259.50 ,$245.66 ,$245.66 ,$100.59 ,$245.66 ,$294.10 ,$294.10 ,$294.10 , N/A ,$256.60 ,$294.10 ,$100.59 ,$346.00 ,$194.11 ,$100.59 ,$143.24 ,$41.21 ,$37.46 ,$100.59 ,$294.10 ,$215.55 ,$206.22 ,$96.88 ,$311.40 ,$100.59 ,$294.10 ,$292.37 ,$292.37 ,$100.59 ,$224.90 ST. JOSEPH'S HOSPITAL - BREESE,32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$364.00 ,$262.08 ,$37.46 ,$364.00 ,$256.60 ,$236.60 ,$217.31 ,$100.59 ,$101.92 ,$240.97 ,$100.59 ,$240.97 ,$100.59 ,$216.94 ,$216.94 ,$100.59 ,$216.94 ,$207.34 ,$280.28 ,$256.60 ,$100.59 ,$102.60 ,$273.00 ,$258.44 ,$258.44 ,$100.59 ,$258.44 ,$309.40 ,$309.40 ,$309.40 , N/A ,$256.60 ,$309.40 ,$100.59 ,$364.00 ,$204.20 ,$100.59 ,$150.70 ,$41.21 ,$37.46 ,$100.59 ,$309.40 ,$215.55 ,$216.94 ,$101.92 ,$327.60 ,$100.59 ,$309.40 ,$307.58 ,$307.58 ,$100.59 ,$236.60 ST. JOSEPH'S HOSPITAL - BREESE,32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$358.00 ,$257.76 ,$37.46 ,$358.00 ,$256.60 ,$232.70 ,$213.73 ,$100.59 ,$100.24 ,$237.00 ,$100.59 ,$237.00 ,$100.59 ,$213.37 ,$213.37 ,$100.59 ,$213.37 ,$207.34 ,$275.66 ,$256.60 ,$100.59 ,$102.60 ,$268.50 ,$254.18 ,$254.18 ,$100.59 ,$254.18 ,$304.30 ,$304.30 ,$304.30 , N/A ,$256.60 ,$304.30 ,$100.59 ,$358.00 ,$200.84 ,$100.59 ,$148.21 ,$41.21 ,$37.46 ,$100.59 ,$304.30 ,$215.55 ,$213.37 ,$100.24 ,$322.20 ,$100.59 ,$304.30 ,$302.51 ,$302.51 ,$100.59 ,$232.70 ST. JOSEPH'S HOSPITAL - BREESE,32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$351.00 ,$252.72 ,$37.46 ,$351.00 ,$256.60 ,$228.15 ,$209.55 ,$100.59 ,$98.28 ,$232.36 ,$100.59 ,$232.36 ,$100.59 ,$209.20 ,$209.20 ,$100.59 ,$209.20 ,$207.34 ,$270.27 ,$256.60 ,$100.59 ,$102.60 ,$263.25 ,$249.21 ,$249.21 ,$100.59 ,$249.21 ,$298.35 ,$298.35 ,$298.35 , N/A ,$256.60 ,$298.35 ,$100.59 ,$351.00 ,$196.91 ,$100.59 ,$145.31 ,$41.21 ,$37.46 ,$100.59 ,$298.35 ,$215.55 ,$209.20 ,$98.28 ,$315.90 ,$100.59 ,$298.35 ,$296.60 ,$296.60 ,$100.59 ,$228.15 ST. JOSEPH'S HOSPITAL - BREESE,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$193.00 ,$138.96 ,$37.46 ,$208.59 ,$208.58 ,$125.45 ,$115.22 ,$81.76 ,$54.04 ,$127.77 ,$81.76 ,$127.77 ,$81.76 ,$115.03 ,$115.03 ,$81.76 ,$115.03 ,$168.54 ,$148.61 ,$208.59 ,$81.76 ,$83.40 ,$144.75 ,$137.03 ,$137.03 ,$81.76 ,$137.03 ,$164.05 ,$164.05 ,$164.05 , N/A ,$193.00 ,$164.05 ,$81.76 ,$193.00 ,$108.27 ,$81.76 ,$79.90 ,$41.21 ,$37.46 ,$81.76 ,$164.05 ,$175.21 ,$115.03 ,$54.04 ,$173.70 ,$81.76 ,$164.05 ,$163.09 ,$163.09 ,$81.76 ,$125.45 ST. JOSEPH'S HOSPITAL - BREESE,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$293.00 ,$210.96 ,$56.19 ,$293.00 ,$208.58 ,$190.45 ,$174.92 ,$81.76 ,$82.04 ,$193.97 ,$81.76 ,$193.97 ,$81.76 ,$174.63 ,$174.63 ,$81.76 ,$174.63 ,$168.54 ,$225.61 ,$208.59 ,$81.76 ,$83.40 ,$219.75 ,$208.03 ,$208.03 ,$81.76 ,$208.03 ,$249.05 ,$249.05 ,$249.05 , N/A ,$208.59 ,$249.05 ,$81.76 ,$293.00 ,$164.37 ,$81.76 ,$121.30 ,$61.81 ,$56.19 ,$81.76 ,$249.05 ,$175.21 ,$174.63 ,$82.04 ,$263.70 ,$81.76 ,$249.05 ,$247.59 ,$247.59 ,$81.76 ,$190.45 ST. JOSEPH'S HOSPITAL - BREESE,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$269.00 ,$193.68 ,$37.46 ,$269.00 ,$208.58 ,$174.85 ,$160.59 ,$81.76 ,$75.32 ,$178.08 ,$81.76 ,$178.08 ,$81.76 ,$160.32 ,$160.32 ,$81.76 ,$160.32 ,$168.54 ,$207.13 ,$208.59 ,$81.76 ,$83.40 ,$201.75 ,$190.99 ,$190.99 ,$81.76 ,$190.99 ,$228.65 ,$228.65 ,$228.65 , N/A ,$208.59 ,$228.65 ,$81.76 ,$269.00 ,$150.91 ,$81.76 ,$111.37 ,$41.21 ,$37.46 ,$81.76 ,$228.65 ,$175.21 ,$160.32 ,$75.32 ,$242.10 ,$81.76 ,$228.65 ,$227.31 ,$227.31 ,$81.76 ,$174.85 ST. JOSEPH'S HOSPITAL - BREESE,32000583,72200,HC XR SACROILIC JOINT <3VIEWS,320,1 ,$302.00 ,$217.44 ,$37.46 ,$302.00 ,$256.60 ,$196.30 ,$180.29 ,$100.59 ,$84.56 ,$199.92 ,$100.59 ,$199.92 ,$100.59 ,$179.99 ,$179.99 ,$100.59 ,$179.99 ,$207.34 ,$232.54 ,$256.60 ,$100.59 ,$102.60 ,$226.50 ,$214.42 ,$214.42 ,$100.59 ,$214.42 ,$256.70 ,$256.70 ,$256.70 , N/A ,$256.60 ,$256.70 ,$100.59 ,$302.00 ,$169.42 ,$100.59 ,$125.03 ,$41.21 ,$37.46 ,$100.59 ,$256.70 ,$215.55 ,$179.99 ,$84.56 ,$271.80 ,$100.59 ,$256.70 ,$255.19 ,$255.19 ,$100.59 ,$196.30 ST. JOSEPH'S HOSPITAL - BREESE,32000589,74019,HC XR ABDOMEN 2V,320,1 ,$713.00 ,$513.36 ,$37.46 ,$713.00 ,$256.60 ,$463.45 ,$425.66 ,$100.59 ,$199.64 ,$472.01 ,$100.59 ,$472.01 ,$100.59 ,$424.95 ,$424.95 ,$100.59 ,$424.95 ,$207.34 ,$549.01 ,$256.60 ,$100.59 ,$102.60 ,$534.75 ,$506.23 ,$506.23 ,$100.59 ,$506.23 ,$606.05 ,$606.05 ,$606.05 , N/A ,$256.60 ,$606.05 ,$100.59 ,$713.00 ,$399.99 ,$100.59 ,$295.18 ,$41.21 ,$37.46 ,$100.59 ,$606.05 ,$215.55 ,$424.95 ,$199.64 ,$641.70 ,$100.59 ,$606.05 ,$602.49 ,$602.49 ,$100.59 ,$463.45 ST. JOSEPH'S HOSPITAL - BREESE,32000595,76000,HC FLUOROSCOPY >1HR,320,1 ,$672.00 ,$483.84 ,$37.46 ,$672.00 ,$560.65 ,$436.80 ,$401.18 ,$219.77 ,$188.16 ,$444.86 ,$219.77 ,$444.86 ,$219.77 ,$400.51 ,$400.51 ,$219.77 ,$400.51 ,$453.00 ,$517.44 ,$560.65 ,$219.77 ,$224.17 ,$504.00 ,$477.12 ,$477.12 ,$219.77 ,$477.12 ,$571.20 ,$571.20 ,$571.20 , N/A ,$560.65 ,$571.20 ,$219.77 ,$672.00 ,$376.99 ,$219.77 ,$278.21 ,$41.21 ,$37.46 ,$219.77 ,$571.20 ,$470.94 ,$400.51 ,$188.16 ,$604.80 ,$219.77 ,$571.20 ,$567.84 ,$567.84 ,$219.77 ,$436.80 ST. JOSEPH'S HOSPITAL - BREESE,32000610,N/A,HC HEALTH FAIR BONE DENSITY,320,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 , N/A ,$3.25 ,$2.99 , N/A ,$1.40 ,$3.31 , N/A ,$3.31 , N/A ,$2.98 ,$2.98 , N/A ,$2.98 , N/A ,$3.85 , N/A , N/A , N/A ,$3.75 ,$3.55 ,$3.55 , N/A ,$3.55 ,$4.25 ,$4.25 ,$4.25 , N/A , N/A ,$4.25 , N/A ,$5.00 ,$2.81 , N/A ,$2.07 , N/A , N/A , N/A ,$4.25 , N/A ,$2.98 ,$1.40 ,$4.50 , N/A ,$4.25 ,$4.23 ,$4.23 , N/A ,$3.25 ST. JOSEPH'S HOSPITAL - BREESE,32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,284.00 ",$924.48 ,$37.46 ,"$1,284.00 ", N/A ,$834.60 ,$766.55 , N/A ,$359.52 ,$850.01 , N/A ,$850.01 , N/A ,$765.26 ,$765.26 , N/A ,$765.26 , N/A ,$800.00 , N/A , N/A , N/A ,$963.00 ,$911.64 ,$911.64 , N/A ,$911.64 ,"$1,091.40 ","$1,091.40 ","$1,091.40 ", N/A , N/A ,"$1,091.40 ", N/A ,"$1,284.00 ",$720.32 , N/A ,$531.58 ,$41.21 ,$37.46 , N/A ,"$1,091.40 ", N/A ,$765.26 ,$359.52 ,"$1,155.60 ", N/A ,"$1,091.40 ","$1,084.98 ","$1,084.98 ", N/A ,$834.60 ST. JOSEPH'S HOSPITAL - BREESE,32000613,G1002,HC RAD AUC CDSM MEDCURRENT,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000614,G1003,HC RAD AUC CDSM MEDICALIS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000615,G1005,HC RAD AUC CDSM NATIONAL IMAGING ASSOCIATES,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000616,G1006,HC RAD AUC CDSM TEST APPROPRIATE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000617,G1007,HC RAD AUC CDSM AIM SPECIALTY HEALTH,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000618,G1008,HC RAD AUC CDSM CRANBERRY PEAK,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000619,G1009,HC RAD AUC CDSM SAGE HEALTH MGMT SOLUTIONS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000620,G1010,HC RAD AUC CDSM STANSON,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000621,G1011,HC RAD AUC CDSM QUALIFIED TOOL NOS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,32000623,G1001,HC RAD AUC CDSM EVICORE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$201.00 ,$144.72 ,$56.28 ,$201.00 ,$161.98 ,$130.65 ,$120.00 ,$63.49 ,$56.28 ,$133.06 ,$63.49 ,$133.06 ,$63.49 ,$119.80 ,$119.80 ,$63.49 ,$119.80 ,$130.88 ,$154.77 ,$161.99 ,$63.49 ,$64.77 ,$150.75 ,$142.71 ,$142.71 ,$63.49 ,$142.71 ,$170.85 ,$170.85 ,$170.85 , N/A ,$161.99 ,$170.85 ,$63.49 ,$201.00 ,$112.76 ,$63.49 ,$83.21 , N/A , N/A ,$63.49 ,$170.85 ,$136.07 ,$119.80 ,$56.28 ,$180.90 ,$63.49 ,$170.85 ,$169.85 ,$169.85 ,$63.49 ,$130.65 ST. JOSEPH'S HOSPITAL - BREESE,33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$531.00 ,$382.32 ,$148.68 ,$531.00 ,$495.95 ,$345.15 ,$317.01 ,$194.41 ,$148.68 ,$351.52 ,$194.41 ,$351.52 ,$194.41 ,$316.48 ,$316.48 ,$194.41 ,$316.48 ,$400.72 ,$408.87 ,$495.94 ,$194.41 ,$198.29 ,$398.25 ,$377.01 ,$377.01 ,$194.41 ,$377.01 ,$451.35 ,$451.35 ,$451.35 , N/A ,$495.94 ,$451.35 ,$194.41 ,$531.00 ,$297.89 ,$194.41 ,$219.83 , N/A , N/A ,$194.41 ,$451.35 ,$416.59 ,$316.48 ,$148.68 ,$477.90 ,$194.41 ,$451.35 ,$448.70 ,$448.70 ,$194.41 ,$345.15 ST. JOSEPH'S HOSPITAL - BREESE,33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$348.00 ,$250.56 ,$97.44 ,$798.58 ,$798.58 ,$226.20 ,$207.76 ,$313.04 ,$97.44 ,$230.38 ,$313.04 ,$230.38 ,$313.04 ,$207.41 ,$207.41 ,$313.04 ,$207.41 ,$348.00 ,$267.96 ,$798.57 ,$313.04 ,$319.30 ,$261.00 ,$247.08 ,$247.08 ,$313.04 ,$247.08 ,$295.80 ,$295.80 ,$295.80 , N/A ,$348.00 ,$295.80 ,$313.04 ,$348.00 ,$195.23 ,$313.04 ,$144.07 ,$231.63 ,$210.57 ,$313.04 ,$295.80 ,$670.80 ,$207.41 ,$97.44 ,$313.20 ,$313.04 ,$295.80 ,$294.06 ,$294.06 ,$313.04 ,$226.20 ST. JOSEPH'S HOSPITAL - BREESE,33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$126.00 ,$90.72 ,$35.28 ,$161.99 ,$161.98 ,$81.90 ,$75.22 ,$63.49 ,$35.28 ,$83.41 ,$63.49 ,$83.41 ,$63.49 ,$75.10 ,$75.10 ,$63.49 ,$75.10 ,$126.00 ,$97.02 ,$161.99 ,$63.49 ,$64.77 ,$94.50 ,$89.46 ,$89.46 ,$63.49 ,$89.46 ,$107.10 ,$107.10 ,$107.10 , N/A ,$126.00 ,$107.10 ,$63.49 ,$126.00 ,$70.69 ,$63.49 ,$52.16 ,$126.00 ,$126.00 ,$63.49 ,$107.10 ,$136.07 ,$75.10 ,$35.28 ,$113.40 ,$63.49 ,$107.10 ,$106.47 ,$106.47 ,$63.49 ,$81.90 ST. JOSEPH'S HOSPITAL - BREESE,33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$170.00 ,$122.40 ,$47.60 ,$170.00 ,$161.98 ,$110.50 ,$101.49 ,$63.49 ,$47.60 ,$112.54 ,$63.49 ,$112.54 ,$63.49 ,$101.32 ,$101.32 ,$63.49 ,$101.32 ,$130.88 ,$130.90 ,$161.99 ,$63.49 ,$64.77 ,$127.50 ,$120.70 ,$120.70 ,$63.49 ,$120.70 ,$144.50 ,$144.50 ,$144.50 , N/A ,$161.99 ,$144.50 ,$63.49 ,$170.00 ,$95.37 ,$63.49 ,$70.38 , N/A , N/A ,$63.49 ,$144.50 ,$136.07 ,$101.32 ,$47.60 ,$153.00 ,$63.49 ,$144.50 ,$143.65 ,$143.65 ,$63.49 ,$110.50 ST. JOSEPH'S HOSPITAL - BREESE,34000002,78012,HC THYROID UPTAKE SGL/MULT 78012,340,1 ,$965.00 ,$694.80 ,$270.20 ,$965.00 ,$933.18 ,$627.25 ,$576.11 ,$365.80 ,$270.20 ,$638.83 ,$365.80 ,$638.83 ,$365.80 ,$575.14 ,$575.14 ,$365.80 ,$575.14 ,$754.00 ,$743.05 ,$933.16 ,$365.80 ,$373.12 ,$723.75 ,$685.15 ,$685.15 ,$365.80 ,$685.15 ,$820.25 ,$820.25 ,$820.25 , N/A ,$933.16 ,$820.25 ,$365.80 ,$965.00 ,$541.37 ,$365.80 ,$399.51 ,$311.56 ,$283.24 ,$365.80 ,$820.25 ,$783.86 ,$575.14 ,$270.20 ,$868.50 ,$365.80 ,$820.25 ,$815.43 ,$815.43 ,$365.80 ,$627.25 ST. JOSEPH'S HOSPITAL - BREESE,34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,579.00 ","$1,136.88 ",$283.24 ,"$1,579.00 ",$933.18 ,"$1,026.35 ",$942.66 ,$365.80 ,$442.12 ,"$1,045.30 ",$365.80 ,"$1,045.30 ",$365.80 ,$941.08 ,$941.08 ,$365.80 ,$941.08 ,$754.00 ,"$1,215.83 ",$933.16 ,$365.80 ,$373.12 ,"$1,184.25 ","$1,121.09 ","$1,121.09 ",$365.80 ,"$1,121.09 ","$1,342.15 ","$1,342.15 ","$1,342.15 ", N/A ,$933.16 ,"$1,342.15 ",$365.80 ,"$1,579.00 ",$885.82 ,$365.80 ,$653.71 ,$311.56 ,$283.24 ,$365.80 ,"$1,342.15 ",$783.86 ,$941.08 ,$442.12 ,"$1,421.10 ",$365.80 ,"$1,342.15 ","$1,334.26 ","$1,334.26 ",$365.80 ,"$1,026.35 " ST. JOSEPH'S HOSPITAL - BREESE,34000006,78013,HC NM THYROID SCAN,340,1 ,$759.00 ,$546.48 ,$212.52 ,$933.18 ,$933.18 ,$493.35 ,$453.12 ,$365.80 ,$212.52 ,$502.46 ,$365.80 ,$502.46 ,$365.80 ,$452.36 ,$452.36 ,$365.80 ,$452.36 ,$754.00 ,$584.43 ,$933.16 ,$365.80 ,$373.12 ,$569.25 ,$538.89 ,$538.89 ,$365.80 ,$538.89 ,$645.15 ,$645.15 ,$645.15 , N/A ,$759.00 ,$645.15 ,$365.80 ,$759.00 ,$425.80 ,$365.80 ,$314.23 ,$311.56 ,$283.24 ,$365.80 ,$645.15 ,$783.86 ,$452.36 ,$212.52 ,$683.10 ,$365.80 ,$645.15 ,$641.36 ,$641.36 ,$365.80 ,$493.35 ST. JOSEPH'S HOSPITAL - BREESE,34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$2,096.00 ","$1,509.12 ",$252.78 ,"$2,096.00 ",$933.18 ,"$1,362.40 ","$1,251.31 ",$365.80 ,$586.88 ,"$1,387.55 ",$365.80 ,"$1,387.55 ",$365.80 ,"$1,249.22 ","$1,249.22 ",$365.80 ,"$1,249.22 ",$754.00 ,"$1,613.92 ",$933.16 ,$365.80 ,$373.12 ,"$1,572.00 ","$1,488.16 ","$1,488.16 ",$365.80 ,"$1,488.16 ","$1,781.60 ","$1,781.60 ","$1,781.60 ", N/A ,$933.16 ,"$1,781.60 ",$365.80 ,"$2,096.00 ","$1,175.86 ",$365.80 ,$867.74 ,$278.06 ,$252.78 ,$365.80 ,"$1,781.60 ",$783.86 ,"$1,249.22 ",$586.88 ,"$1,886.40 ",$365.80 ,"$1,781.60 ","$1,771.12 ","$1,771.12 ",$365.80 ,"$1,362.40 " ST. JOSEPH'S HOSPITAL - BREESE,34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$3,742.00 ","$2,694.24 ",$283.24 ,"$3,742.00 ","$1,211.23 ","$2,432.30 ","$2,233.97 ",$474.80 ,"$1,047.76 ","$2,477.20 ",$474.80 ,"$2,477.20 ",$474.80 ,"$2,230.23 ","$2,230.23 ",$474.80 ,"$2,230.23 ",$978.67 ,"$2,881.34 ","$1,211.23 ",$474.80 ,$484.30 ,"$2,806.50 ","$2,656.82 ","$2,656.82 ",$474.80 ,"$2,656.82 ","$3,180.70 ","$3,180.70 ","$3,180.70 ", N/A ,"$1,211.23 ","$3,180.70 ",$474.80 ,"$3,742.00 ","$2,099.26 ",$474.80 ,"$1,549.19 ",$311.56 ,$283.24 ,$474.80 ,"$3,180.70 ","$1,017.43 ","$2,230.23 ","$1,047.76 ","$3,367.80 ",$474.80 ,"$3,180.70 ","$3,161.99 ","$3,161.99 ",$474.80 ,"$2,432.30 " ST. JOSEPH'S HOSPITAL - BREESE,34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$1,679.00 ","$1,208.88 ",$252.78 ,"$1,679.00 ",$933.18 ,"$1,091.35 ","$1,002.36 ",$365.80 ,$470.12 ,"$1,111.50 ",$365.80 ,"$1,111.50 ",$365.80 ,"$1,000.68 ","$1,000.68 ",$365.80 ,"$1,000.68 ",$754.00 ,"$1,292.83 ",$933.16 ,$365.80 ,$373.12 ,"$1,259.25 ","$1,192.09 ","$1,192.09 ",$365.80 ,"$1,192.09 ","$1,427.15 ","$1,427.15 ","$1,427.15 ", N/A ,$933.16 ,"$1,427.15 ",$365.80 ,"$1,679.00 ",$941.92 ,$365.80 ,$695.11 ,$278.06 ,$252.78 ,$365.80 ,"$1,427.15 ",$783.86 ,"$1,000.68 ",$470.12 ,"$1,511.10 ",$365.80 ,"$1,427.15 ","$1,418.76 ","$1,418.76 ",$365.80 ,"$1,091.35 " ST. JOSEPH'S HOSPITAL - BREESE,34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$2,889.00 ","$2,080.08 ",$283.24 ,"$2,889.00 ",$933.18 ,"$1,877.85 ","$1,724.73 ",$365.80 ,$808.92 ,"$1,912.52 ",$365.80 ,"$1,912.52 ",$365.80 ,"$1,721.84 ","$1,721.84 ",$365.80 ,"$1,721.84 ",$754.00 ,"$2,224.53 ",$933.16 ,$365.80 ,$373.12 ,"$2,166.75 ","$2,051.19 ","$2,051.19 ",$365.80 ,"$2,051.19 ","$2,455.65 ","$2,455.65 ","$2,455.65 ", N/A ,$933.16 ,"$2,455.65 ",$365.80 ,"$2,889.00 ","$1,620.73 ",$365.80 ,"$1,196.05 ",$311.56 ,$283.24 ,$365.80 ,"$2,455.65 ",$783.86 ,"$1,721.84 ",$808.92 ,"$2,600.10 ",$365.80 ,"$2,455.65 ","$2,441.21 ","$2,441.21 ",$365.80 ,"$1,877.85 " ST. JOSEPH'S HOSPITAL - BREESE,34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$2,537.00 ","$1,826.64 ",$283.24 ,"$2,537.00 ",$933.18 ,"$1,649.05 ","$1,514.59 ",$365.80 ,$710.36 ,"$1,679.49 ",$365.80 ,"$1,679.49 ",$365.80 ,"$1,512.05 ","$1,512.05 ",$365.80 ,"$1,512.05 ",$754.00 ,"$1,953.49 ",$933.16 ,$365.80 ,$373.12 ,"$1,902.75 ","$1,801.27 ","$1,801.27 ",$365.80 ,"$1,801.27 ","$2,156.45 ","$2,156.45 ","$2,156.45 ", N/A ,$933.16 ,"$2,156.45 ",$365.80 ,"$2,537.00 ","$1,423.26 ",$365.80 ,"$1,050.32 ",$311.56 ,$283.24 ,$365.80 ,"$2,156.45 ",$783.86 ,"$1,512.05 ",$710.36 ,"$2,283.30 ",$365.80 ,"$2,156.45 ","$2,143.77 ","$2,143.77 ",$365.80 ,"$1,649.05 " ST. JOSEPH'S HOSPITAL - BREESE,34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,780.00 ","$1,281.60 ",$283.24 ,"$1,780.00 ",$933.18 ,"$1,157.00 ","$1,062.66 ",$365.80 ,$498.40 ,"$1,178.36 ",$365.80 ,"$1,178.36 ",$365.80 ,"$1,060.88 ","$1,060.88 ",$365.80 ,"$1,060.88 ",$754.00 ,"$1,370.60 ",$933.16 ,$365.80 ,$373.12 ,"$1,335.00 ","$1,263.80 ","$1,263.80 ",$365.80 ,"$1,263.80 ","$1,513.00 ","$1,513.00 ","$1,513.00 ", N/A ,$933.16 ,"$1,513.00 ",$365.80 ,"$1,780.00 ",$998.58 ,$365.80 ,$736.92 ,$311.56 ,$283.24 ,$365.80 ,"$1,513.00 ",$783.86 ,"$1,060.88 ",$498.40 ,"$1,602.00 ",$365.80 ,"$1,513.00 ","$1,504.10 ","$1,504.10 ",$365.80 ,"$1,157.00 " ST. JOSEPH'S HOSPITAL - BREESE,34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,811.00 ","$1,303.92 ",$252.78 ,"$1,811.00 ",$933.18 ,"$1,177.15 ","$1,081.17 ",$365.80 ,$507.08 ,"$1,198.88 ",$365.80 ,"$1,198.88 ",$365.80 ,"$1,079.36 ","$1,079.36 ",$365.80 ,"$1,079.36 ",$754.00 ,"$1,394.47 ",$933.16 ,$365.80 ,$373.12 ,"$1,358.25 ","$1,285.81 ","$1,285.81 ",$365.80 ,"$1,285.81 ","$1,539.35 ","$1,539.35 ","$1,539.35 ", N/A ,$933.16 ,"$1,539.35 ",$365.80 ,"$1,811.00 ","$1,015.97 ",$365.80 ,$749.75 ,$278.06 ,$252.78 ,$365.80 ,"$1,539.35 ",$783.86 ,"$1,079.36 ",$507.08 ,"$1,629.90 ",$365.80 ,"$1,539.35 ","$1,530.30 ","$1,530.30 ",$365.80 ,"$1,177.15 " ST. JOSEPH'S HOSPITAL - BREESE,34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,909.00 ","$1,374.48 ",$252.78 ,"$1,909.00 ",$933.18 ,"$1,240.85 ","$1,139.67 ",$365.80 ,$534.52 ,"$1,263.76 ",$365.80 ,"$1,263.76 ",$365.80 ,"$1,137.76 ","$1,137.76 ",$365.80 ,"$1,137.76 ",$754.00 ,"$1,469.93 ",$933.16 ,$365.80 ,$373.12 ,"$1,431.75 ","$1,355.39 ","$1,355.39 ",$365.80 ,"$1,355.39 ","$1,622.65 ","$1,622.65 ","$1,622.65 ", N/A ,$933.16 ,"$1,622.65 ",$365.80 ,"$1,909.00 ","$1,070.95 ",$365.80 ,$790.33 ,$278.06 ,$252.78 ,$365.80 ,"$1,622.65 ",$783.86 ,"$1,137.76 ",$534.52 ,"$1,718.10 ",$365.80 ,"$1,622.65 ","$1,613.11 ","$1,613.11 ",$365.80 ,"$1,240.85 " ST. JOSEPH'S HOSPITAL - BREESE,34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,238.00 ",$891.36 ,$252.78 ,"$1,238.00 ",$933.18 ,$804.70 ,$739.09 ,$365.80 ,$346.64 ,$819.56 ,$365.80 ,$819.56 ,$365.80 ,$737.85 ,$737.85 ,$365.80 ,$737.85 ,$754.00 ,$953.26 ,$933.16 ,$365.80 ,$373.12 ,$928.50 ,$878.98 ,$878.98 ,$365.80 ,$878.98 ,"$1,052.30 ","$1,052.30 ","$1,052.30 ", N/A ,$933.16 ,"$1,052.30 ",$365.80 ,"$1,238.00 ",$694.52 ,$365.80 ,$512.53 ,$278.06 ,$252.78 ,$365.80 ,"$1,052.30 ",$783.86 ,$737.85 ,$346.64 ,"$1,114.20 ",$365.80 ,"$1,052.30 ","$1,046.11 ","$1,046.11 ",$365.80 ,$804.70 ST. JOSEPH'S HOSPITAL - BREESE,34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$2,966.00 ","$2,135.52 ",$252.78 ,"$2,966.00 ",$933.18 ,"$1,927.90 ","$1,770.70 ",$365.80 ,$830.48 ,"$1,963.49 ",$365.80 ,"$1,963.49 ",$365.80 ,"$1,767.74 ","$1,767.74 ",$365.80 ,"$1,767.74 ",$754.00 ,"$2,283.82 ",$933.16 ,$365.80 ,$373.12 ,"$2,224.50 ","$2,105.86 ","$2,105.86 ",$365.80 ,"$2,105.86 ","$2,521.10 ","$2,521.10 ","$2,521.10 ", N/A ,$933.16 ,"$2,521.10 ",$365.80 ,"$2,966.00 ","$1,663.93 ",$365.80 ,"$1,227.92 ",$278.06 ,$252.78 ,$365.80 ,"$2,521.10 ",$783.86 ,"$1,767.74 ",$830.48 ,"$2,669.40 ",$365.80 ,"$2,521.10 ","$2,506.27 ","$2,506.27 ",$365.80 ,"$1,927.90 " ST. JOSEPH'S HOSPITAL - BREESE,34000032,78315,HC BONE SCAN FLOW WHOLE BODY STATICS,340,1 ,"$3,116.00 ","$2,243.52 ",$252.78 ,"$3,116.00 ",$933.18 ,"$2,025.40 ","$1,860.25 ",$365.80 ,$872.48 ,"$2,062.79 ",$365.80 ,"$2,062.79 ",$365.80 ,"$1,857.14 ","$1,857.14 ",$365.80 ,"$1,857.14 ",$754.00 ,"$2,399.32 ",$933.16 ,$365.80 ,$373.12 ,"$2,337.00 ","$2,212.36 ","$2,212.36 ",$365.80 ,"$2,212.36 ","$2,648.60 ","$2,648.60 ","$2,648.60 ", N/A ,$933.16 ,"$2,648.60 ",$365.80 ,"$3,116.00 ","$1,748.08 ",$365.80 ,"$1,290.02 ",$278.06 ,$252.78 ,$365.80 ,"$2,648.60 ",$783.86 ,"$1,857.14 ",$872.48 ,"$2,804.40 ",$365.80 ,"$2,648.60 ","$2,633.02 ","$2,633.02 ",$365.80 ,"$2,025.40 " ST. JOSEPH'S HOSPITAL - BREESE,34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$3,116.00 ","$2,243.52 ",$252.78 ,"$3,116.00 ",$933.18 ,"$2,025.40 ","$1,860.25 ",$365.80 ,$872.48 ,"$2,062.79 ",$365.80 ,"$2,062.79 ",$365.80 ,"$1,857.14 ","$1,857.14 ",$365.80 ,"$1,857.14 ",$754.00 ,"$2,399.32 ",$933.16 ,$365.80 ,$373.12 ,"$2,337.00 ","$2,212.36 ","$2,212.36 ",$365.80 ,"$2,212.36 ","$2,648.60 ","$2,648.60 ","$2,648.60 ", N/A ,$933.16 ,"$2,648.60 ",$365.80 ,"$3,116.00 ","$1,748.08 ",$365.80 ,"$1,290.02 ",$278.06 ,$252.78 ,$365.80 ,"$2,648.60 ",$783.86 ,"$1,857.14 ",$872.48 ,"$2,804.40 ",$365.80 ,"$2,648.60 ","$2,633.02 ","$2,633.02 ",$365.80 ,"$2,025.40 " ST. JOSEPH'S HOSPITAL - BREESE,34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$1,641.00 ","$1,181.52 ",$283.24 ,"$3,186.58 ","$3,186.58 ","$1,066.65 ",$979.68 ,"$1,249.14 ",$459.48 ,"$1,086.34 ","$1,249.14 ","$1,086.34 ","$1,249.14 ",$978.04 ,$978.04 ,"$1,249.14 ",$978.04 ,"$1,641.00 ","$1,263.57 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,230.75 ","$1,165.11 ","$1,165.11 ","$1,249.14 ","$1,165.11 ","$1,394.85 ","$1,394.85 ","$1,394.85 ", N/A ,"$1,641.00 ","$1,394.85 ","$1,249.14 ","$1,641.00 ",$920.60 ,"$1,249.14 ",$679.37 ,$311.56 ,$283.24 ,"$1,249.14 ","$1,394.85 ","$2,676.72 ",$978.04 ,$459.48 ,"$1,476.90 ","$1,249.14 ","$1,394.85 ","$1,386.65 ","$1,386.65 ","$1,249.14 ","$1,066.65 " ST. JOSEPH'S HOSPITAL - BREESE,34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$5,000.00 ","$3,600.00 ",$620.14 ,"$5,000.00 ","$3,186.58 ","$3,250.00 ","$2,985.00 ","$1,249.14 ","$1,400.00 ","$3,310.00 ","$1,249.14 ","$3,310.00 ","$1,249.14 ","$2,980.00 ","$2,980.00 ","$1,249.14 ","$2,980.00 ","$2,574.75 ","$3,850.00 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$3,750.00 ","$3,550.00 ","$3,550.00 ","$1,249.14 ","$3,550.00 ","$4,250.00 ","$4,250.00 ","$4,250.00 ", N/A ,"$3,186.58 ","$4,250.00 ","$1,249.14 ","$5,000.00 ","$2,805.00 ","$1,249.14 ","$2,070.00 ",$682.15 ,$620.14 ,"$1,249.14 ","$4,250.00 ","$2,676.72 ","$2,980.00 ","$1,400.00 ","$4,500.00 ","$1,249.14 ","$4,250.00 ","$4,225.00 ","$4,225.00 ","$1,249.14 ","$3,250.00 " ST. JOSEPH'S HOSPITAL - BREESE,34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,463.00 ","$1,773.36 ",$252.78 ,"$2,463.00 ",$933.18 ,"$1,600.95 ","$1,470.41 ",$365.80 ,$689.64 ,"$1,630.51 ",$365.80 ,"$1,630.51 ",$365.80 ,"$1,467.95 ","$1,467.95 ",$365.80 ,"$1,467.95 ",$754.00 ,"$1,896.51 ",$933.16 ,$365.80 ,$373.12 ,"$1,847.25 ","$1,748.73 ","$1,748.73 ",$365.80 ,"$1,748.73 ","$2,093.55 ","$2,093.55 ","$2,093.55 ", N/A ,$933.16 ,"$2,093.55 ",$365.80 ,"$2,463.00 ","$1,381.74 ",$365.80 ,"$1,019.68 ",$278.06 ,$252.78 ,$365.80 ,"$2,093.55 ",$783.86 ,"$1,467.95 ",$689.64 ,"$2,216.70 ",$365.80 ,"$2,093.55 ","$2,081.24 ","$2,081.24 ",$365.80 ,"$1,600.95 " ST. JOSEPH'S HOSPITAL - BREESE,34000047,78580,HC LUNG PERFUS,340,1 ,"$2,639.00 ","$1,900.08 ",$283.24 ,"$2,639.00 ",$933.18 ,"$1,715.35 ","$1,575.48 ",$365.80 ,$738.92 ,"$1,747.02 ",$365.80 ,"$1,747.02 ",$365.80 ,"$1,572.84 ","$1,572.84 ",$365.80 ,"$1,572.84 ",$754.00 ,"$2,032.03 ",$933.16 ,$365.80 ,$373.12 ,"$1,979.25 ","$1,873.69 ","$1,873.69 ",$365.80 ,"$1,873.69 ","$2,243.15 ","$2,243.15 ","$2,243.15 ", N/A ,$933.16 ,"$2,243.15 ",$365.80 ,"$2,639.00 ","$1,480.48 ",$365.80 ,"$1,092.55 ",$311.56 ,$283.24 ,$365.80 ,"$2,243.15 ",$783.86 ,"$1,572.84 ",$738.92 ,"$2,375.10 ",$365.80 ,"$2,243.15 ","$2,229.96 ","$2,229.96 ",$365.80 ,"$1,715.35 " ST. JOSEPH'S HOSPITAL - BREESE,34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$3,847.00 ","$2,769.84 ",$283.24 ,"$3,847.00 ","$1,211.23 ","$2,500.55 ","$2,296.66 ",$474.80 ,"$1,077.16 ","$2,546.71 ",$474.80 ,"$2,546.71 ",$474.80 ,"$2,292.81 ","$2,292.81 ",$474.80 ,"$2,292.81 ",$978.67 ,"$2,962.19 ","$1,211.23 ",$474.80 ,$484.30 ,"$2,885.25 ","$2,731.37 ","$2,731.37 ",$474.80 ,"$2,731.37 ","$3,269.95 ","$3,269.95 ","$3,269.95 ", N/A ,"$1,211.23 ","$3,269.95 ",$474.80 ,"$3,847.00 ","$2,158.17 ",$474.80 ,"$1,592.66 ",$311.56 ,$283.24 ,$474.80 ,"$3,269.95 ","$1,017.43 ","$2,292.81 ","$1,077.16 ","$3,462.30 ",$474.80 ,"$3,269.95 ","$3,250.72 ","$3,250.72 ",$474.80 ,"$2,500.55 " ST. JOSEPH'S HOSPITAL - BREESE,34000061,78701,HC KIDNEY SCAN W/FLOW,340,1 ,$705.00 ,$507.60 ,$197.40 ,$933.18 ,$933.18 ,$458.25 ,$420.89 ,$365.80 ,$197.40 ,$466.71 ,$365.80 ,$466.71 ,$365.80 ,$420.18 ,$420.18 ,$365.80 ,$420.18 ,$705.00 ,$542.85 ,$933.16 ,$365.80 ,$373.12 ,$528.75 ,$500.55 ,$500.55 ,$365.80 ,$500.55 ,$599.25 ,$599.25 ,$599.25 , N/A ,$705.00 ,$599.25 ,$365.80 ,$705.00 ,$395.51 ,$365.80 ,$291.87 ,$278.06 ,$252.78 ,$365.80 ,$599.25 ,$783.86 ,$420.18 ,$197.40 ,$634.50 ,$365.80 ,$599.25 ,$595.73 ,$595.73 ,$365.80 ,$458.25 ST. JOSEPH'S HOSPITAL - BREESE,34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$1,195.00 ",$860.40 ,$252.78 ,"$1,211.23 ","$1,211.23 ",$776.75 ,$713.42 ,$474.80 ,$334.60 ,$791.09 ,$474.80 ,$791.09 ,$474.80 ,$712.22 ,$712.22 ,$474.80 ,$712.22 ,$978.67 ,$920.15 ,"$1,211.23 ",$474.80 ,$484.30 ,$896.25 ,$848.45 ,$848.45 ,$474.80 ,$848.45 ,"$1,015.75 ","$1,015.75 ","$1,015.75 ", N/A ,"$1,195.00 ","$1,015.75 ",$474.80 ,"$1,195.00 ",$670.40 ,$474.80 ,$494.73 ,$278.06 ,$252.78 ,$474.80 ,"$1,015.75 ","$1,017.43 ",$712.22 ,$334.60 ,"$1,075.50 ",$474.80 ,"$1,015.75 ","$1,009.78 ","$1,009.78 ",$474.80 ,$776.75 ST. JOSEPH'S HOSPITAL - BREESE,34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$1,353.00 ",$974.16 ,$252.78 ,"$1,353.00 ","$1,211.23 ",$879.45 ,$807.74 ,$474.80 ,$378.84 ,$895.69 ,$474.80 ,$895.69 ,$474.80 ,$806.39 ,$806.39 ,$474.80 ,$806.39 ,$978.67 ,"$1,041.81 ","$1,211.23 ",$474.80 ,$484.30 ,"$1,014.75 ",$960.63 ,$960.63 ,$474.80 ,$960.63 ,"$1,150.05 ","$1,150.05 ","$1,150.05 ", N/A ,"$1,211.23 ","$1,150.05 ",$474.80 ,"$1,353.00 ",$759.03 ,$474.80 ,$560.14 ,$278.06 ,$252.78 ,$474.80 ,"$1,150.05 ","$1,017.43 ",$806.39 ,$378.84 ,"$1,217.70 ",$474.80 ,"$1,150.05 ","$1,143.29 ","$1,143.29 ",$474.80 ,$879.45 ST. JOSEPH'S HOSPITAL - BREESE,34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$1,517.00 ","$1,092.24 ",$252.78 ,"$1,517.00 ","$1,211.23 ",$986.05 ,$905.65 ,$474.80 ,$424.76 ,"$1,004.25 ",$474.80 ,"$1,004.25 ",$474.80 ,$904.13 ,$904.13 ,$474.80 ,$904.13 ,$978.67 ,"$1,168.09 ","$1,211.23 ",$474.80 ,$484.30 ,"$1,137.75 ","$1,077.07 ","$1,077.07 ",$474.80 ,"$1,077.07 ","$1,289.45 ","$1,289.45 ","$1,289.45 ", N/A ,"$1,211.23 ","$1,289.45 ",$474.80 ,"$1,517.00 ",$851.04 ,$474.80 ,$628.04 ,$278.06 ,$252.78 ,$474.80 ,"$1,289.45 ","$1,017.43 ",$904.13 ,$424.76 ,"$1,365.30 ",$474.80 ,"$1,289.45 ","$1,281.87 ","$1,281.87 ",$474.80 ,$986.05 ST. JOSEPH'S HOSPITAL - BREESE,34000068,78800,HC TUMOR LOCAL LIMITED,340,1 ,"$1,238.00 ",$891.36 ,$283.24 ,"$1,238.00 ",$933.18 ,$804.70 ,$739.09 ,$365.80 ,$346.64 ,$819.56 ,$365.80 ,$819.56 ,$365.80 ,$737.85 ,$737.85 ,$365.80 ,$737.85 ,$754.00 ,$953.26 ,$933.16 ,$365.80 ,$373.12 ,$928.50 ,$878.98 ,$878.98 ,$365.80 ,$878.98 ,"$1,052.30 ","$1,052.30 ","$1,052.30 ", N/A ,$933.16 ,"$1,052.30 ",$365.80 ,"$1,238.00 ",$694.52 ,$365.80 ,$512.53 ,$311.56 ,$283.24 ,$365.80 ,"$1,052.30 ",$783.86 ,$737.85 ,$346.64 ,"$1,114.20 ",$365.80 ,"$1,052.30 ","$1,046.11 ","$1,046.11 ",$365.80 ,$804.70 ST. JOSEPH'S HOSPITAL - BREESE,34000069,78801,HC TUMOR LOCAL MULTIPLE,340,1 ,"$1,238.00 ",$891.36 ,$283.24 ,"$1,238.00 ",$933.18 ,$804.70 ,$739.09 ,$365.80 ,$346.64 ,$819.56 ,$365.80 ,$819.56 ,$365.80 ,$737.85 ,$737.85 ,$365.80 ,$737.85 ,$754.00 ,$953.26 ,$933.16 ,$365.80 ,$373.12 ,$928.50 ,$878.98 ,$878.98 ,$365.80 ,$878.98 ,"$1,052.30 ","$1,052.30 ","$1,052.30 ", N/A ,$933.16 ,"$1,052.30 ",$365.80 ,"$1,238.00 ",$694.52 ,$365.80 ,$512.53 ,$311.56 ,$283.24 ,$365.80 ,"$1,052.30 ",$783.86 ,$737.85 ,$346.64 ,"$1,114.20 ",$365.80 ,"$1,052.30 ","$1,046.11 ","$1,046.11 ",$365.80 ,$804.70 ST. JOSEPH'S HOSPITAL - BREESE,34000070,78802,HC TUMOR IMAGE-WHOLE BODY-1 DAY,340,1 ,"$4,305.00 ","$3,099.60 ",$620.14 ,"$4,305.00 ","$3,186.58 ","$2,798.25 ","$2,570.09 ","$1,249.14 ","$1,205.40 ","$2,849.91 ","$1,249.14 ","$2,849.91 ","$1,249.14 ","$2,565.78 ","$2,565.78 ","$1,249.14 ","$2,565.78 ","$2,574.75 ","$3,314.85 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$3,228.75 ","$3,056.55 ","$3,056.55 ","$1,249.14 ","$3,056.55 ","$3,659.25 ","$3,659.25 ","$3,659.25 ", N/A ,"$3,186.58 ","$3,659.25 ","$1,249.14 ","$4,305.00 ","$2,415.11 ","$1,249.14 ","$1,782.27 ",$682.15 ,$620.14 ,"$1,249.14 ","$3,659.25 ","$2,676.72 ","$2,565.78 ","$1,205.40 ","$3,874.50 ","$1,249.14 ","$3,659.25 ","$3,637.73 ","$3,637.73 ","$1,249.14 ","$2,798.25 " ST. JOSEPH'S HOSPITAL - BREESE,34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$1,595.00 ","$1,148.40 ",$446.60 ,"$3,186.58 ","$3,186.58 ","$1,036.75 ",$952.22 ,"$1,249.14 ",$446.60 ,"$1,055.89 ","$1,249.14 ","$1,055.89 ","$1,249.14 ",$950.62 ,$950.62 ,"$1,249.14 ",$950.62 ,"$1,595.00 ","$1,228.15 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,196.25 ","$1,132.45 ","$1,132.45 ","$1,249.14 ","$1,132.45 ","$1,355.75 ","$1,355.75 ","$1,355.75 ", N/A ,"$1,595.00 ","$1,355.75 ","$1,249.14 ","$1,595.00 ",$894.80 ,"$1,249.14 ",$660.33 ,$682.15 ,$620.14 ,"$1,249.14 ","$1,355.75 ","$2,676.72 ",$950.62 ,$446.60 ,"$1,435.50 ","$1,249.14 ","$1,355.75 ","$1,347.78 ","$1,347.78 ","$1,249.14 ","$1,036.75 " ST. JOSEPH'S HOSPITAL - BREESE,34000072,78803,HC TUMOR IMAGING (SPECT) MIBG,340,1 ,"$1,595.00 ","$1,148.40 ",$446.60 ,"$3,186.58 ","$3,186.58 ","$1,036.75 ",$952.22 ,"$1,249.14 ",$446.60 ,"$1,055.89 ","$1,249.14 ","$1,055.89 ","$1,249.14 ",$950.62 ,$950.62 ,"$1,249.14 ",$950.62 ,"$1,595.00 ","$1,228.15 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,196.25 ","$1,132.45 ","$1,132.45 ","$1,249.14 ","$1,132.45 ","$1,355.75 ","$1,355.75 ","$1,355.75 ", N/A ,"$1,595.00 ","$1,355.75 ","$1,249.14 ","$1,595.00 ",$894.80 ,"$1,249.14 ",$660.33 ,$682.15 ,$620.14 ,"$1,249.14 ","$1,355.75 ","$2,676.72 ",$950.62 ,$446.60 ,"$1,435.50 ","$1,249.14 ","$1,355.75 ","$1,347.78 ","$1,347.78 ","$1,249.14 ","$1,036.75 " ST. JOSEPH'S HOSPITAL - BREESE,34000073,78803,HC TUMOR IMAGING (SPECT) GALLIUM,340,1 ,"$1,595.00 ","$1,148.40 ",$446.60 ,"$3,186.58 ","$3,186.58 ","$1,036.75 ",$952.22 ,"$1,249.14 ",$446.60 ,"$1,055.89 ","$1,249.14 ","$1,055.89 ","$1,249.14 ",$950.62 ,$950.62 ,"$1,249.14 ",$950.62 ,"$1,595.00 ","$1,228.15 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,196.25 ","$1,132.45 ","$1,132.45 ","$1,249.14 ","$1,132.45 ","$1,355.75 ","$1,355.75 ","$1,355.75 ", N/A ,"$1,595.00 ","$1,355.75 ","$1,249.14 ","$1,595.00 ",$894.80 ,"$1,249.14 ",$660.33 ,$682.15 ,$620.14 ,"$1,249.14 ","$1,355.75 ","$2,676.72 ",$950.62 ,$446.60 ,"$1,435.50 ","$1,249.14 ","$1,355.75 ","$1,347.78 ","$1,347.78 ","$1,249.14 ","$1,036.75 " ST. JOSEPH'S HOSPITAL - BREESE,34000074,78803,HC TUMOR IMAGING (SPECT) NON GATED,340,1 ,"$1,595.00 ","$1,148.40 ",$446.60 ,"$3,186.58 ","$3,186.58 ","$1,036.75 ",$952.22 ,"$1,249.14 ",$446.60 ,"$1,055.89 ","$1,249.14 ","$1,055.89 ","$1,249.14 ",$950.62 ,$950.62 ,"$1,249.14 ",$950.62 ,"$1,595.00 ","$1,228.15 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,196.25 ","$1,132.45 ","$1,132.45 ","$1,249.14 ","$1,132.45 ","$1,355.75 ","$1,355.75 ","$1,355.75 ", N/A ,"$1,595.00 ","$1,355.75 ","$1,249.14 ","$1,595.00 ",$894.80 ,"$1,249.14 ",$660.33 ,$682.15 ,$620.14 ,"$1,249.14 ","$1,355.75 ","$2,676.72 ",$950.62 ,$446.60 ,"$1,435.50 ","$1,249.14 ","$1,355.75 ","$1,347.78 ","$1,347.78 ","$1,249.14 ","$1,036.75 " ST. JOSEPH'S HOSPITAL - BREESE,34000075,78803,HC TUMOR IMAGING (SPECT) OCTREO,340,1 ,"$1,595.00 ","$1,148.40 ",$446.60 ,"$3,186.58 ","$3,186.58 ","$1,036.75 ",$952.22 ,"$1,249.14 ",$446.60 ,"$1,055.89 ","$1,249.14 ","$1,055.89 ","$1,249.14 ",$950.62 ,$950.62 ,"$1,249.14 ",$950.62 ,"$1,595.00 ","$1,228.15 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,196.25 ","$1,132.45 ","$1,132.45 ","$1,249.14 ","$1,132.45 ","$1,355.75 ","$1,355.75 ","$1,355.75 ", N/A ,"$1,595.00 ","$1,355.75 ","$1,249.14 ","$1,595.00 ",$894.80 ,"$1,249.14 ",$660.33 ,$682.15 ,$620.14 ,"$1,249.14 ","$1,355.75 ","$2,676.72 ",$950.62 ,$446.60 ,"$1,435.50 ","$1,249.14 ","$1,355.75 ","$1,347.78 ","$1,347.78 ","$1,249.14 ","$1,036.75 " ST. JOSEPH'S HOSPITAL - BREESE,34000076,78803,HC TUMOR IMAGING (SPECT) PARATHYROID,340,1 ,"$1,595.00 ","$1,148.40 ",$446.60 ,"$3,186.58 ","$3,186.58 ","$1,036.75 ",$952.22 ,"$1,249.14 ",$446.60 ,"$1,055.89 ","$1,249.14 ","$1,055.89 ","$1,249.14 ",$950.62 ,$950.62 ,"$1,249.14 ",$950.62 ,"$1,595.00 ","$1,228.15 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$1,196.25 ","$1,132.45 ","$1,132.45 ","$1,249.14 ","$1,132.45 ","$1,355.75 ","$1,355.75 ","$1,355.75 ", N/A ,"$1,595.00 ","$1,355.75 ","$1,249.14 ","$1,595.00 ",$894.80 ,"$1,249.14 ",$660.33 ,$682.15 ,$620.14 ,"$1,249.14 ","$1,355.75 ","$2,676.72 ",$950.62 ,$446.60 ,"$1,435.50 ","$1,249.14 ","$1,355.75 ","$1,347.78 ","$1,347.78 ","$1,249.14 ","$1,036.75 " ST. JOSEPH'S HOSPITAL - BREESE,34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,"$1,936.00 ","$1,393.92 ",$283.24 ,"$1,936.00 ",$933.18 ,"$1,258.40 ","$1,155.79 ",$365.80 ,$542.08 ,"$1,281.63 ",$365.80 ,"$1,281.63 ",$365.80 ,"$1,153.86 ","$1,153.86 ",$365.80 ,"$1,153.86 ",$754.00 ,"$1,490.72 ",$933.16 ,$365.80 ,$373.12 ,"$1,452.00 ","$1,374.56 ","$1,374.56 ",$365.80 ,"$1,374.56 ","$1,645.60 ","$1,645.60 ","$1,645.60 ", N/A ,$933.16 ,"$1,645.60 ",$365.80 ,"$1,936.00 ","$1,086.10 ",$365.80 ,$801.50 ,$311.56 ,$283.24 ,$365.80 ,"$1,645.60 ",$783.86 ,"$1,153.86 ",$542.08 ,"$1,742.40 ",$365.80 ,"$1,645.60 ","$1,635.92 ","$1,635.92 ",$365.80 ,"$1,258.40 " ST. JOSEPH'S HOSPITAL - BREESE,34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$3,071.00 ","$2,211.12 ",$283.24 ,"$3,071.00 ","$1,211.23 ","$1,996.15 ","$1,833.39 ",$474.80 ,$859.88 ,"$2,033.00 ",$474.80 ,"$2,033.00 ",$474.80 ,"$1,830.32 ","$1,830.32 ",$474.80 ,"$1,830.32 ",$978.67 ,"$2,364.67 ","$1,211.23 ",$474.80 ,$484.30 ,"$2,303.25 ","$2,180.41 ","$2,180.41 ",$474.80 ,"$2,180.41 ","$2,610.35 ","$2,610.35 ","$2,610.35 ", N/A ,"$1,211.23 ","$2,610.35 ",$474.80 ,"$3,071.00 ","$1,722.83 ",$474.80 ,"$1,271.39 ",$311.56 ,$283.24 ,$474.80 ,"$2,610.35 ","$1,017.43 ","$1,830.32 ",$859.88 ,"$2,763.90 ",$474.80 ,"$2,610.35 ","$2,595.00 ","$2,595.00 ",$474.80 ,"$1,996.15 " ST. JOSEPH'S HOSPITAL - BREESE,34100007,A9538,HC NM PYROPHOSPHATE 99M VIAL,343,1 ,$152.00 ,$109.44 ,$42.56 ,$152.00 , N/A ,$98.80 ,$90.74 , N/A ,$42.56 ,$100.62 , N/A ,$100.62 , N/A ,$90.59 ,$90.59 , N/A ,$90.59 , N/A , N/A , N/A , N/A , N/A ,$114.00 ,$107.92 ,$107.92 , N/A ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A , N/A ,$129.20 , N/A ,$152.00 ,$85.27 , N/A ,$62.93 , N/A , N/A , N/A ,$129.20 , N/A ,$90.59 ,$42.56 ,$136.80 , N/A ,$129.20 ,$79.40 ,$79.40 , N/A ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,34100032,78494,HC MUGA RESTING W/SPECT,341,1 ,"$2,312.00 ","$1,664.64 ",$365.80 ,"$2,312.00 ",$933.18 ,"$1,502.80 ","$1,380.26 ",$365.80 ,$647.36 ,"$1,530.54 ",$365.80 ,"$1,530.54 ",$365.80 ,"$1,377.95 ","$1,377.95 ",$365.80 ,"$1,377.95 ",$754.00 ,"$1,780.24 ",$933.16 ,$365.80 ,$373.12 ,"$1,734.00 ","$1,641.52 ","$1,641.52 ",$365.80 ,"$1,641.52 ","$1,965.20 ","$1,965.20 ","$1,965.20 ", N/A ,$933.16 ,"$1,965.20 ",$365.80 ,"$2,312.00 ","$1,297.03 ",$365.80 ,$957.17 ,$682.15 ,$620.14 ,$365.80 ,"$1,965.20 ",$783.86 ,"$1,377.95 ",$647.36 ,"$2,080.80 ",$365.80 ,"$1,965.20 ","$1,953.64 ","$1,953.64 ",$365.80 ,"$1,502.80 " ST. JOSEPH'S HOSPITAL - BREESE,34100033,78831,HC TUMOR LOCAL SPECT MULT AREA 1 DAY OR SGL AREA W/MULT DAYS,341,1 ,"$4,305.00 ","$3,099.60 ",$620.14 ,"$4,305.00 ","$3,186.58 ","$2,798.25 ","$2,570.09 ","$1,249.14 ","$1,205.40 ","$2,849.91 ","$1,249.14 ","$2,849.91 ","$1,249.14 ","$2,565.78 ","$2,565.78 ","$1,249.14 ","$2,565.78 ","$2,574.75 ","$3,314.85 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$3,228.75 ","$3,056.55 ","$3,056.55 ","$1,249.14 ","$3,056.55 ","$3,659.25 ","$3,659.25 ","$3,659.25 ", N/A ,"$3,186.58 ","$3,659.25 ","$1,249.14 ","$4,305.00 ","$2,415.11 ","$1,249.14 ","$1,782.27 ",$682.15 ,$620.14 ,"$1,249.14 ","$3,659.25 ","$2,676.72 ","$2,565.78 ","$1,205.40 ","$3,874.50 ","$1,249.14 ","$3,659.25 ","$3,637.73 ","$3,637.73 ","$1,249.14 ","$2,798.25 " ST. JOSEPH'S HOSPITAL - BREESE,34100034,78830,HC TUMOR IMAGING SPECT W/CT SGL AREA 1 DAY,341,1 ,"$4,305.00 ","$3,099.60 ",$620.14 ,"$4,305.00 ","$3,186.58 ","$2,798.25 ","$2,570.09 ","$1,249.14 ","$1,205.40 ","$2,849.91 ","$1,249.14 ","$2,849.91 ","$1,249.14 ","$2,565.78 ","$2,565.78 ","$1,249.14 ","$2,565.78 ","$2,574.75 ","$3,314.85 ","$3,186.58 ","$1,249.14 ","$1,274.12 ","$3,228.75 ","$3,056.55 ","$3,056.55 ","$1,249.14 ","$3,056.55 ","$3,659.25 ","$3,659.25 ","$3,659.25 ", N/A ,"$3,186.58 ","$3,659.25 ","$1,249.14 ","$4,305.00 ","$2,415.11 ","$1,249.14 ","$1,782.27 ",$682.15 ,$620.14 ,"$1,249.14 ","$3,659.25 ","$2,676.72 ","$2,565.78 ","$1,205.40 ","$3,874.50 ","$1,249.14 ","$3,659.25 ","$3,637.73 ","$3,637.73 ","$1,249.14 ","$2,798.25 " ST. JOSEPH'S HOSPITAL - BREESE,34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 , N/A ,$243.75 ,$223.88 , N/A ,$105.00 ,$248.25 , N/A ,$248.25 , N/A ,$223.50 ,$223.50 , N/A ,$223.50 , N/A , N/A , N/A , N/A , N/A ,$281.25 ,$266.25 ,$266.25 , N/A ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A , N/A ,$318.75 , N/A ,$375.00 ,$210.38 , N/A ,$155.25 , N/A , N/A , N/A ,$318.75 , N/A ,$223.50 ,$105.00 ,$337.50 , N/A ,$318.75 ,$375.00 ,$375.00 , N/A ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$570.00 ,$410.40 ,$33.54 ,$570.00 , N/A ,$370.50 ,$340.29 , N/A ,$159.60 ,$377.34 , N/A ,$377.34 , N/A ,$339.72 ,$339.72 , N/A ,$339.72 , N/A , N/A , N/A , N/A , N/A ,$427.50 ,$404.70 ,$404.70 , N/A ,$404.70 ,$484.50 ,$484.50 ,$484.50 , N/A , N/A ,$484.50 , N/A ,$570.00 ,$319.77 , N/A ,$235.98 , N/A , N/A , N/A ,$484.50 , N/A ,$339.72 ,$159.60 ,$513.00 , N/A ,$484.50 ,$33.54 ,$33.54 , N/A ,$370.50 ST. JOSEPH'S HOSPITAL - BREESE,34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$87.00 ,$62.64 ,$24.36 ,$87.00 , N/A ,$56.55 ,$51.94 , N/A ,$24.36 ,$57.59 , N/A ,$57.59 , N/A ,$51.85 ,$51.85 , N/A ,$51.85 , N/A , N/A , N/A , N/A , N/A ,$65.25 ,$61.77 ,$61.77 , N/A ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A , N/A ,$73.95 , N/A ,$87.00 ,$48.81 , N/A ,$36.02 , N/A , N/A , N/A ,$73.95 , N/A ,$51.85 ,$24.36 ,$78.30 , N/A ,$73.95 ,$87.00 ,$87.00 , N/A ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$100.00 ,$72.00 ,$8.38 ,$100.00 , N/A ,$65.00 ,$59.70 , N/A ,$28.00 ,$66.20 , N/A ,$66.20 , N/A ,$59.60 ,$59.60 , N/A ,$59.60 , N/A , N/A , N/A , N/A , N/A ,$75.00 ,$71.00 ,$71.00 , N/A ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A , N/A ,$85.00 , N/A ,$100.00 ,$56.10 , N/A ,$41.40 , N/A , N/A , N/A ,$85.00 , N/A ,$59.60 ,$28.00 ,$90.00 , N/A ,$85.00 ,$8.38 ,$8.38 , N/A ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$212.00 ,$152.64 ,$59.36 ,$212.00 , N/A ,$137.80 ,$126.56 , N/A ,$59.36 ,$140.34 , N/A ,$140.34 , N/A ,$126.35 ,$126.35 , N/A ,$126.35 , N/A , N/A , N/A , N/A , N/A ,$159.00 ,$150.52 ,$150.52 , N/A ,$150.52 ,$180.20 ,$180.20 ,$180.20 , N/A , N/A ,$180.20 , N/A ,$212.00 ,$118.93 , N/A ,$87.77 , N/A , N/A , N/A ,$180.20 , N/A ,$126.35 ,$59.36 ,$190.80 , N/A ,$180.20 ,$182.84 ,$182.84 , N/A ,$137.80 ST. JOSEPH'S HOSPITAL - BREESE,34300012,A9521,HC DIAGNUCLIDE CERETEC,343,1 ,"$2,742.00 ","$1,974.24 ",$767.76 ,"$2,742.00 ", N/A ,"$1,782.30 ","$1,636.97 ", N/A ,$767.76 ,"$1,815.20 ", N/A ,"$1,815.20 ", N/A ,"$1,634.23 ","$1,634.23 ", N/A ,"$1,634.23 ", N/A , N/A , N/A , N/A , N/A ,"$2,056.50 ","$1,946.82 ","$1,946.82 ", N/A ,"$1,946.82 ","$2,330.70 ","$2,330.70 ","$2,330.70 ", N/A , N/A ,"$2,330.70 ", N/A ,"$2,742.00 ","$1,538.26 ", N/A ,"$1,135.19 ", N/A , N/A , N/A ,"$2,330.70 ", N/A ,"$1,634.23 ",$767.76 ,"$2,467.80 ", N/A ,"$2,330.70 ","$2,535.14 ","$2,535.14 ", N/A ,"$1,782.30 " ST. JOSEPH'S HOSPITAL - BREESE,34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$161.00 ,$115.92 ,$45.08 ,$161.00 , N/A ,$104.65 ,$96.12 , N/A ,$45.08 ,$106.58 , N/A ,$106.58 , N/A ,$95.96 ,$95.96 , N/A ,$95.96 , N/A , N/A , N/A , N/A , N/A ,$120.75 ,$114.31 ,$114.31 , N/A ,$114.31 ,$136.85 ,$136.85 ,$136.85 , N/A , N/A ,$136.85 , N/A ,$161.00 ,$90.32 , N/A ,$66.65 , N/A , N/A , N/A ,$136.85 , N/A ,$95.96 ,$45.08 ,$144.90 , N/A ,$136.85 ,$161.00 ,$161.00 , N/A ,$104.65 ST. JOSEPH'S HOSPITAL - BREESE,34300017,A9539,HC DIAGNUCLIDE DTPA KIDNEY PER DOSE,343,1 ,$292.00 ,$210.24 ,$50.89 ,$292.00 , N/A ,$189.80 ,$174.32 , N/A ,$81.76 ,$193.30 , N/A ,$193.30 , N/A ,$174.03 ,$174.03 , N/A ,$174.03 , N/A , N/A , N/A , N/A , N/A ,$219.00 ,$207.32 ,$207.32 , N/A ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A , N/A ,$248.20 , N/A ,$292.00 ,$163.81 , N/A ,$120.89 , N/A , N/A , N/A ,$248.20 , N/A ,$174.03 ,$81.76 ,$262.80 , N/A ,$248.20 ,$50.89 ,$50.89 , N/A ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$125.00 ,$90.00 ,$35.00 ,$125.00 , N/A ,$81.25 ,$74.63 , N/A ,$35.00 ,$82.75 , N/A ,$82.75 , N/A ,$74.50 ,$74.50 , N/A ,$74.50 , N/A , N/A , N/A , N/A , N/A ,$93.75 ,$88.75 ,$88.75 , N/A ,$88.75 ,$106.25 ,$106.25 ,$106.25 , N/A , N/A ,$106.25 , N/A ,$125.00 ,$70.13 , N/A ,$51.75 , N/A , N/A , N/A ,$106.25 , N/A ,$74.50 ,$35.00 ,$112.50 , N/A ,$106.25 ,$54.80 ,$54.80 , N/A ,$81.25 ST. JOSEPH'S HOSPITAL - BREESE,34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$161.00 ,$115.92 ,$45.08 ,$161.00 , N/A ,$104.65 ,$96.12 , N/A ,$45.08 ,$106.58 , N/A ,$106.58 , N/A ,$95.96 ,$95.96 , N/A ,$95.96 , N/A , N/A , N/A , N/A , N/A ,$120.75 ,$114.31 ,$114.31 , N/A ,$114.31 ,$136.85 ,$136.85 ,$136.85 , N/A , N/A ,$136.85 , N/A ,$161.00 ,$90.32 , N/A ,$66.65 , N/A , N/A , N/A ,$136.85 , N/A ,$95.96 ,$45.08 ,$144.90 , N/A ,$136.85 ,$161.00 ,$161.00 , N/A ,$104.65 ST. JOSEPH'S HOSPITAL - BREESE,34300024,A9547,HC DIAGNUCLIDE IN OXINE .5 MCI,343,1 ,"$1,287.00 ",$926.64 ,$360.36 ,"$1,287.00 ", N/A ,$836.55 ,$768.34 , N/A ,$360.36 ,$851.99 , N/A ,$851.99 , N/A ,$767.05 ,$767.05 , N/A ,$767.05 , N/A , N/A , N/A , N/A , N/A ,$965.25 ,$913.77 ,$913.77 , N/A ,$913.77 ,"$1,093.95 ","$1,093.95 ","$1,093.95 ", N/A , N/A ,"$1,093.95 ", N/A ,"$1,287.00 ",$722.01 , N/A ,$532.82 , N/A , N/A , N/A ,"$1,093.95 ", N/A ,$767.05 ,$360.36 ,"$1,158.30 ", N/A ,"$1,093.95 ",$511.05 ,$511.05 , N/A ,$836.55 ST. JOSEPH'S HOSPITAL - BREESE,34300031,A9556,HC DIAGNUCLIDE GA67 PER MCI,343,1 ,$252.00 ,$181.44 ,$38.02 ,$252.00 , N/A ,$163.80 ,$150.44 , N/A ,$70.56 ,$166.82 , N/A ,$166.82 , N/A ,$150.19 ,$150.19 , N/A ,$150.19 , N/A , N/A , N/A , N/A , N/A ,$189.00 ,$178.92 ,$178.92 , N/A ,$178.92 ,$214.20 ,$214.20 ,$214.20 , N/A , N/A ,$214.20 , N/A ,$252.00 ,$141.37 , N/A ,$104.33 , N/A , N/A , N/A ,$214.20 , N/A ,$150.19 ,$70.56 ,$226.80 , N/A ,$214.20 ,$38.02 ,$38.02 , N/A ,$163.80 ST. JOSEPH'S HOSPITAL - BREESE,34300033,A9558,HC DIAGNUCLIDE XE133 10 MCI,343,1 ,$142.00 ,$102.24 ,$39.76 ,$142.00 , N/A ,$92.30 ,$84.77 , N/A ,$39.76 ,$94.00 , N/A ,$94.00 , N/A ,$84.63 ,$84.63 , N/A ,$84.63 , N/A , N/A , N/A , N/A , N/A ,$106.50 ,$100.82 ,$100.82 , N/A ,$100.82 ,$120.70 ,$120.70 ,$120.70 , N/A , N/A ,$120.70 , N/A ,$142.00 ,$79.66 , N/A ,$58.79 , N/A , N/A , N/A ,$120.70 , N/A ,$84.63 ,$39.76 ,$127.80 , N/A ,$120.70 ,$142.00 ,$142.00 , N/A ,$92.30 ST. JOSEPH'S HOSPITAL - BREESE,34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$372.00 ,$267.84 ,$104.16 ,$372.00 , N/A ,$241.80 ,$222.08 , N/A ,$104.16 ,$246.26 , N/A ,$246.26 , N/A ,$221.71 ,$221.71 , N/A ,$221.71 , N/A , N/A , N/A , N/A , N/A ,$279.00 ,$264.12 ,$264.12 , N/A ,$264.12 ,$316.20 ,$316.20 ,$316.20 , N/A , N/A ,$316.20 , N/A ,$372.00 ,$208.69 , N/A ,$154.01 , N/A , N/A , N/A ,$316.20 , N/A ,$221.71 ,$104.16 ,$334.80 , N/A ,$316.20 ,$172.21 ,$172.21 , N/A ,$241.80 ST. JOSEPH'S HOSPITAL - BREESE,34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,$740.00 ,$532.80 ,$207.20 ,$740.00 , N/A ,$481.00 ,$441.78 , N/A ,$207.20 ,$489.88 , N/A ,$489.88 , N/A ,$441.04 ,$441.04 , N/A ,$441.04 , N/A , N/A , N/A , N/A , N/A ,$555.00 ,$525.40 ,$525.40 , N/A ,$525.40 ,$629.00 ,$629.00 ,$629.00 , N/A , N/A ,$629.00 , N/A ,$740.00 ,$415.14 , N/A ,$306.36 , N/A , N/A , N/A ,$629.00 , N/A ,$441.04 ,$207.20 ,$666.00 , N/A ,$629.00 ,$740.00 ,$740.00 , N/A ,$481.00 ST. JOSEPH'S HOSPITAL - BREESE,34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$312.00 ,$224.64 ,$87.36 ,$312.00 , N/A ,$202.80 ,$186.26 , N/A ,$87.36 ,$206.54 , N/A ,$206.54 , N/A ,$185.95 ,$185.95 , N/A ,$185.95 , N/A ,$240.24 , N/A , N/A , N/A ,$234.00 ,$221.52 ,$221.52 , N/A ,$221.52 ,$265.20 ,$265.20 ,$265.20 , N/A , N/A ,$265.20 , N/A ,$312.00 ,$175.03 , N/A ,$129.17 ,$101.06 ,$91.87 , N/A ,$265.20 , N/A ,$185.95 ,$87.36 ,$280.80 , N/A ,$265.20 ,$203.10 ,$203.10 , N/A ,$202.80 ST. JOSEPH'S HOSPITAL - BREESE,34300057,A9569,HC TC99M EXAMETAZIME CERETEC DX PER DOSE,343,1 ,"$2,449.00 ","$1,763.28 ",$685.72 ,"$2,449.00 ", N/A ,"$1,591.85 ","$1,462.05 ", N/A ,$685.72 ,"$1,621.24 ", N/A ,"$1,621.24 ", N/A ,"$1,459.60 ","$1,459.60 ", N/A ,"$1,459.60 ", N/A , N/A , N/A , N/A , N/A ,"$1,836.75 ","$1,738.79 ","$1,738.79 ", N/A ,"$1,738.79 ","$2,081.65 ","$2,081.65 ","$2,081.65 ", N/A , N/A ,"$2,081.65 ", N/A ,"$2,449.00 ","$1,373.89 ", N/A ,"$1,013.89 ", N/A , N/A , N/A ,"$2,081.65 ", N/A ,"$1,459.60 ",$685.72 ,"$2,204.10 ", N/A ,"$2,081.65 ","$2,449.00 ","$2,449.00 ", N/A ,"$1,591.85 " ST. JOSEPH'S HOSPITAL - BREESE,34300060,A9520,HC DIAGNUCLIDE TC-99 TILMANOCEPT DIAG UP TO 0.5 MCI,343,1 ,$411.00 ,$295.92 ,$115.08 ,$411.00 , N/A ,$267.15 ,$245.37 , N/A ,$115.08 ,$272.08 , N/A ,$272.08 , N/A ,$244.96 ,$244.96 , N/A ,$244.96 , N/A , N/A , N/A , N/A , N/A ,$308.25 ,$291.81 ,$291.81 , N/A ,$291.81 ,$349.35 ,$349.35 ,$349.35 , N/A , N/A ,$349.35 , N/A ,$411.00 ,$230.57 , N/A ,$170.15 , N/A , N/A , N/A ,$349.35 , N/A ,$244.96 ,$115.08 ,$369.90 , N/A ,$349.35 , N/A , N/A , N/A ,$267.15 ST. JOSEPH'S HOSPITAL - BREESE,34300067,A9561,HC DIAGNUCLIDE TC-99 OXIDRONATE PER STUDY UP TO 30MCI,343,1 ,$97.00 ,$69.84 ,$27.16 ,$97.00 , N/A ,$63.05 ,$57.91 , N/A ,$27.16 ,$64.21 , N/A ,$64.21 , N/A ,$57.81 ,$57.81 , N/A ,$57.81 , N/A , N/A , N/A , N/A , N/A ,$72.75 ,$68.87 ,$68.87 , N/A ,$68.87 ,$82.45 ,$82.45 ,$82.45 , N/A , N/A ,$82.45 , N/A ,$97.00 ,$54.42 , N/A ,$40.16 , N/A , N/A , N/A ,$82.45 , N/A ,$57.81 ,$27.16 ,$87.30 , N/A ,$82.45 ,$82.19 ,$82.19 , N/A ,$63.05 ST. JOSEPH'S HOSPITAL - BREESE,34300072,A9595,"HC PIFLUFOLASTAT F-18, DIAGNOSTIC, 1 MILLICURIE",343,1 ,"$1,579.00 ","$1,136.88 ",$442.12 ,"$1,579.00 ","$1,450.88 ","$1,026.35 ",$942.66 ,$568.74 ,$442.12 ,"$1,045.30 ",$568.74 ,"$1,045.30 ",$568.74 ,$941.08 ,$941.08 ,$568.74 ,$941.08 ,"$1,172.31 ", N/A ,"$1,450.88 ",$568.74 ,$580.12 ,"$1,184.25 ","$1,121.09 ","$1,121.09 ",$568.74 ,"$1,121.09 ","$1,342.15 ","$1,342.15 ","$1,342.15 ", N/A ,"$1,450.88 ","$1,342.15 ",$568.74 ,"$1,579.00 ",$885.82 ,$568.74 ,$653.71 , N/A , N/A ,$568.74 ,"$1,342.15 ","$1,218.74 ",$941.08 ,$442.12 ,"$1,421.10 ",$568.74 ,"$1,342.15 ",$920.75 ,$920.75 ,$568.74 ,"$1,026.35 " ST. JOSEPH'S HOSPITAL - BREESE,35000006,21550,HC BX TISSUE NECK/THORAX,350,1 ,"$4,485.00 ","$3,229.20 ",$433.73 ,"$4,485.00 ","$3,600.20 ","$2,915.25 ","$2,677.55 ","$1,411.28 ","$1,255.80 ","$2,969.07 ","$1,411.28 ","$2,969.07 ","$1,411.28 ","$2,673.06 ","$2,673.06 ","$1,411.28 ","$2,673.06 ","$2,908.96 ",$800.00 ,"$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,363.75 ","$3,184.35 ","$3,184.35 ","$1,411.28 ","$3,184.35 ","$3,812.25 ","$3,812.25 ","$3,812.25 ", N/A ,"$3,600.19 ","$3,812.25 ","$1,411.28 ","$4,485.00 ","$2,516.09 ","$1,411.28 ","$1,856.79 ",$477.10 ,$433.73 ,"$1,411.28 ","$3,812.25 ","$3,024.16 ","$2,673.06 ","$1,255.80 ","$4,036.50 ","$1,411.28 ","$3,812.25 ","$3,789.83 ","$3,789.83 ","$1,411.28 ","$2,915.25 " ST. JOSEPH'S HOSPITAL - BREESE,35000028,60100,HC BX THYROID NEEDLE PERC,350,1 ,"$1,891.00 ","$1,361.52 ",$409.40 ,"$1,891.00 ","$1,558.08 ","$1,229.15 ","$1,128.93 ",$610.77 ,$529.48 ,"$1,251.84 ",$610.77 ,"$1,251.84 ",$610.77 ,"$1,127.04 ","$1,127.04 ",$610.77 ,"$1,127.04 ","$1,258.93 ",$800.00 ,"$1,558.08 ",$610.77 ,$622.99 ,"$1,418.25 ","$1,342.61 ","$1,342.61 ",$610.77 ,"$1,342.61 ","$1,607.35 ","$1,607.35 ","$1,607.35 ", N/A ,"$1,558.08 ","$1,607.35 ",$610.77 ,"$1,891.00 ","$1,060.85 ",$610.77 ,$782.87 ,$450.34 ,$409.40 ,$610.77 ,"$1,607.35 ","$1,308.79 ","$1,127.04 ",$529.48 ,"$1,701.90 ",$610.77 ,"$1,607.35 ","$1,597.90 ","$1,597.90 ",$610.77 ,"$1,229.15 " ST. JOSEPH'S HOSPITAL - BREESE,35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$2,159.00 ","$1,554.48 ",$100.59 ,"$2,159.00 ",$256.60 ,"$1,403.35 ","$1,288.92 ",$100.59 ,$604.52 ,"$1,429.26 ",$100.59 ,"$1,429.26 ",$100.59 ,"$1,286.76 ","$1,286.76 ",$100.59 ,"$1,286.76 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$1,619.25 ","$1,532.89 ","$1,532.89 ",$100.59 ,"$1,532.89 ","$1,835.15 ","$1,835.15 ","$1,835.15 ", N/A ,$256.60 ,"$1,835.15 ",$100.59 ,"$2,159.00 ","$1,211.20 ",$100.59 ,$893.83 ,$211.56 ,$192.33 ,$100.59 ,"$1,835.15 ",$215.55 ,"$1,286.76 ",$604.52 ,"$1,943.10 ",$100.59 ,"$1,835.15 ","$1,824.36 ","$1,824.36 ",$100.59 ,"$1,403.35 " ST. JOSEPH'S HOSPITAL - BREESE,35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$2,609.00 ","$1,878.48 ",$169.73 ,"$2,609.00 ",$432.98 ,"$1,695.85 ","$1,557.57 ",$169.73 ,$730.52 ,"$1,727.16 ",$169.73 ,"$1,727.16 ",$169.73 ,"$1,554.96 ","$1,554.96 ",$169.73 ,"$1,554.96 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,956.75 ","$1,852.39 ","$1,852.39 ",$169.73 ,"$1,852.39 ","$2,217.65 ","$2,217.65 ","$2,217.65 ", N/A ,$432.97 ,"$2,217.65 ",$169.73 ,"$2,609.00 ","$1,463.65 ",$169.73 ,"$1,080.13 ",$211.56 ,$192.33 ,$169.73 ,"$2,217.65 ",$363.69 ,"$1,554.96 ",$730.52 ,"$2,348.10 ",$169.73 ,"$2,217.65 ","$2,204.61 ","$2,204.61 ",$169.73 ,"$1,695.85 " ST. JOSEPH'S HOSPITAL - BREESE,35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$3,154.00 ","$2,270.88 ",$169.73 ,"$3,154.00 ",$432.98 ,"$2,050.10 ","$1,882.94 ",$169.73 ,$883.12 ,"$2,087.95 ",$169.73 ,"$2,087.95 ",$169.73 ,"$1,879.78 ","$1,879.78 ",$169.73 ,"$1,879.78 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,365.50 ","$2,239.34 ","$2,239.34 ",$169.73 ,"$2,239.34 ","$2,680.90 ","$2,680.90 ","$2,680.90 ", N/A ,$432.97 ,"$2,680.90 ",$169.73 ,"$3,154.00 ","$1,769.39 ",$169.73 ,"$1,305.76 ",$211.56 ,$192.33 ,$169.73 ,"$2,680.90 ",$363.69 ,"$1,879.78 ",$883.12 ,"$2,838.60 ",$169.73 ,"$2,680.90 ","$2,665.13 ","$2,665.13 ",$169.73 ,"$2,050.10 " ST. JOSEPH'S HOSPITAL - BREESE,35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$1,997.00 ","$1,437.84 ",$93.45 ,"$1,997.00 ",$256.60 ,"$1,298.05 ","$1,192.21 ",$100.59 ,$559.16 ,"$1,322.01 ",$100.59 ,"$1,322.01 ",$100.59 ,"$1,190.21 ","$1,190.21 ",$100.59 ,"$1,190.21 ",$207.34 ,"$1,997.00 ",$256.60 ,$100.59 ,$102.60 ,"$1,497.75 ","$1,417.87 ","$1,417.87 ",$100.59 ,"$1,417.87 ","$1,697.45 ","$1,697.45 ","$1,697.45 ", N/A ,$256.60 ,"$1,697.45 ",$100.59 ,"$1,997.00 ","$1,120.32 ",$100.59 ,$826.76 ,$102.80 ,$93.45 ,$100.59 ,"$1,697.45 ",$215.55 ,"$1,190.21 ",$559.16 ,"$1,797.30 ",$100.59 ,"$1,697.45 ","$1,687.47 ","$1,687.47 ",$100.59 ,"$1,298.05 " ST. JOSEPH'S HOSPITAL - BREESE,35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$2,243.00 ","$1,614.96 ",$93.45 ,"$2,243.00 ",$432.98 ,"$1,457.95 ","$1,339.07 ",$169.73 ,$628.04 ,"$1,484.87 ",$169.73 ,"$1,484.87 ",$169.73 ,"$1,336.83 ","$1,336.83 ",$169.73 ,"$1,336.83 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,682.25 ","$1,592.53 ","$1,592.53 ",$169.73 ,"$1,592.53 ","$1,906.55 ","$1,906.55 ","$1,906.55 ", N/A ,$432.97 ,"$1,906.55 ",$169.73 ,"$2,243.00 ","$1,258.32 ",$169.73 ,$928.60 ,$102.80 ,$93.45 ,$169.73 ,"$1,906.55 ",$363.69 ,"$1,336.83 ",$628.04 ,"$2,018.70 ",$169.73 ,"$1,906.55 ","$1,895.34 ","$1,895.34 ",$169.73 ,"$1,457.95 " ST. JOSEPH'S HOSPITAL - BREESE,35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$2,489.00 ","$1,792.08 ",$93.45 ,"$2,489.00 ",$432.98 ,"$1,617.85 ","$1,485.93 ",$169.73 ,$696.92 ,"$1,647.72 ",$169.73 ,"$1,647.72 ",$169.73 ,"$1,483.44 ","$1,483.44 ",$169.73 ,"$1,483.44 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,866.75 ","$1,767.19 ","$1,767.19 ",$169.73 ,"$1,767.19 ","$2,115.65 ","$2,115.65 ","$2,115.65 ", N/A ,$432.97 ,"$2,115.65 ",$169.73 ,"$2,489.00 ","$1,396.33 ",$169.73 ,"$1,030.45 ",$102.80 ,$93.45 ,$169.73 ,"$2,115.65 ",$363.69 ,"$1,483.44 ",$696.92 ,"$2,240.10 ",$169.73 ,"$2,115.65 ","$2,103.21 ","$2,103.21 ",$169.73 ,"$1,617.85 " ST. JOSEPH'S HOSPITAL - BREESE,35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$2,188.00 ","$1,575.36 ",$93.45 ,"$2,188.00 ",$256.60 ,"$1,422.20 ","$1,306.24 ",$100.59 ,$612.64 ,"$1,448.46 ",$100.59 ,"$1,448.46 ",$100.59 ,"$1,304.05 ","$1,304.05 ",$100.59 ,"$1,304.05 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$1,641.00 ","$1,553.48 ","$1,553.48 ",$100.59 ,"$1,553.48 ","$1,859.80 ","$1,859.80 ","$1,859.80 ", N/A ,$256.60 ,"$1,859.80 ",$100.59 ,"$2,188.00 ","$1,227.47 ",$100.59 ,$905.83 ,$102.80 ,$93.45 ,$100.59 ,"$1,859.80 ",$215.55 ,"$1,304.05 ",$612.64 ,"$1,969.20 ",$100.59 ,"$1,859.80 ","$1,848.86 ","$1,848.86 ",$100.59 ,"$1,422.20 " ST. JOSEPH'S HOSPITAL - BREESE,35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$2,434.00 ","$1,752.48 ",$93.45 ,"$2,434.00 ",$432.98 ,"$1,582.10 ","$1,453.10 ",$169.73 ,$681.52 ,"$1,611.31 ",$169.73 ,"$1,611.31 ",$169.73 ,"$1,450.66 ","$1,450.66 ",$169.73 ,"$1,450.66 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,825.50 ","$1,728.14 ","$1,728.14 ",$169.73 ,"$1,728.14 ","$2,068.90 ","$2,068.90 ","$2,068.90 ", N/A ,$432.97 ,"$2,068.90 ",$169.73 ,"$2,434.00 ","$1,365.47 ",$169.73 ,"$1,007.68 ",$102.80 ,$93.45 ,$169.73 ,"$2,068.90 ",$363.69 ,"$1,450.66 ",$681.52 ,"$2,190.60 ",$169.73 ,"$2,068.90 ","$2,056.73 ","$2,056.73 ",$169.73 ,"$1,582.10 " ST. JOSEPH'S HOSPITAL - BREESE,35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,680.00 ","$1,929.60 ",$93.45 ,"$2,680.00 ",$432.98 ,"$1,742.00 ","$1,599.96 ",$169.73 ,$750.40 ,"$1,774.16 ",$169.73 ,"$1,774.16 ",$169.73 ,"$1,597.28 ","$1,597.28 ",$169.73 ,"$1,597.28 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,010.00 ","$1,902.80 ","$1,902.80 ",$169.73 ,"$1,902.80 ","$2,278.00 ","$2,278.00 ","$2,278.00 ", N/A ,$432.97 ,"$2,278.00 ",$169.73 ,"$2,680.00 ","$1,503.48 ",$169.73 ,"$1,109.52 ",$102.80 ,$93.45 ,$169.73 ,"$2,278.00 ",$363.69 ,"$1,597.28 ",$750.40 ,"$2,412.00 ",$169.73 ,"$2,278.00 ","$2,264.60 ","$2,264.60 ",$169.73 ,"$1,742.00 " ST. JOSEPH'S HOSPITAL - BREESE,35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$2,075.00 ","$1,494.00 ",$93.45 ,"$2,075.00 ",$256.60 ,"$1,348.75 ","$1,238.78 ",$100.59 ,$581.00 ,"$1,373.65 ",$100.59 ,"$1,373.65 ",$100.59 ,"$1,236.70 ","$1,236.70 ",$100.59 ,"$1,236.70 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$1,556.25 ","$1,473.25 ","$1,473.25 ",$100.59 ,"$1,473.25 ","$1,763.75 ","$1,763.75 ","$1,763.75 ", N/A ,$256.60 ,"$1,763.75 ",$100.59 ,"$2,075.00 ","$1,164.08 ",$100.59 ,$859.05 ,$102.80 ,$93.45 ,$100.59 ,"$1,763.75 ",$215.55 ,"$1,236.70 ",$581.00 ,"$1,867.50 ",$100.59 ,"$1,763.75 ","$1,753.38 ","$1,753.38 ",$100.59 ,"$1,348.75 " ST. JOSEPH'S HOSPITAL - BREESE,35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$2,564.00 ","$1,846.08 ",$93.45 ,"$2,564.00 ",$432.98 ,"$1,666.60 ","$1,530.71 ",$169.73 ,$717.92 ,"$1,697.37 ",$169.73 ,"$1,697.37 ",$169.73 ,"$1,528.14 ","$1,528.14 ",$169.73 ,"$1,528.14 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,923.00 ","$1,820.44 ","$1,820.44 ",$169.73 ,"$1,820.44 ","$2,179.40 ","$2,179.40 ","$2,179.40 ", N/A ,$432.97 ,"$2,179.40 ",$169.73 ,"$2,564.00 ","$1,438.40 ",$169.73 ,"$1,061.50 ",$102.80 ,$93.45 ,$169.73 ,"$2,179.40 ",$363.69 ,"$1,528.14 ",$717.92 ,"$2,307.60 ",$169.73 ,"$2,179.40 ","$2,166.58 ","$2,166.58 ",$169.73 ,"$1,666.60 " ST. JOSEPH'S HOSPITAL - BREESE,35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$2,891.00 ","$2,081.52 ",$93.45 ,"$2,891.00 ",$432.98 ,"$1,879.15 ","$1,725.93 ",$169.73 ,$809.48 ,"$1,913.84 ",$169.73 ,"$1,913.84 ",$169.73 ,"$1,723.04 ","$1,723.04 ",$169.73 ,"$1,723.04 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,168.25 ","$2,052.61 ","$2,052.61 ",$169.73 ,"$2,052.61 ","$2,457.35 ","$2,457.35 ","$2,457.35 ", N/A ,$432.97 ,"$2,457.35 ",$169.73 ,"$2,891.00 ","$1,621.85 ",$169.73 ,"$1,196.87 ",$102.80 ,$93.45 ,$169.73 ,"$2,457.35 ",$363.69 ,"$1,723.04 ",$809.48 ,"$2,601.90 ",$169.73 ,"$2,457.35 ","$2,442.90 ","$2,442.90 ",$169.73 ,"$1,879.15 " ST. JOSEPH'S HOSPITAL - BREESE,35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$2,609.00 ","$1,878.48 ",$169.73 ,"$2,609.00 ",$432.98 ,"$1,695.85 ","$1,557.57 ",$169.73 ,$730.52 ,"$1,727.16 ",$169.73 ,"$1,727.16 ",$169.73 ,"$1,554.96 ","$1,554.96 ",$169.73 ,"$1,554.96 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,956.75 ","$1,852.39 ","$1,852.39 ",$169.73 ,"$1,852.39 ","$2,217.65 ","$2,217.65 ","$2,217.65 ", N/A ,$432.97 ,"$2,217.65 ",$169.73 ,"$2,609.00 ","$1,463.65 ",$169.73 ,"$1,080.13 ",$270.95 ,$246.32 ,$169.73 ,"$2,217.65 ",$363.69 ,"$1,554.96 ",$730.52 ,"$2,348.10 ",$169.73 ,"$2,217.65 ","$2,204.61 ","$2,204.61 ",$169.73 ,"$1,695.85 " ST. JOSEPH'S HOSPITAL - BREESE,35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$2,891.00 ","$2,081.52 ",$93.45 ,"$2,891.00 ",$432.98 ,"$1,879.15 ","$1,725.93 ",$169.73 ,$809.48 ,"$1,913.84 ",$169.73 ,"$1,913.84 ",$169.73 ,"$1,723.04 ","$1,723.04 ",$169.73 ,"$1,723.04 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,168.25 ","$2,052.61 ","$2,052.61 ",$169.73 ,"$2,052.61 ","$2,457.35 ","$2,457.35 ","$2,457.35 ", N/A ,$432.97 ,"$2,457.35 ",$169.73 ,"$2,891.00 ","$1,621.85 ",$169.73 ,"$1,196.87 ",$102.80 ,$93.45 ,$169.73 ,"$2,457.35 ",$363.69 ,"$1,723.04 ",$809.48 ,"$2,601.90 ",$169.73 ,"$2,457.35 ","$2,442.90 ","$2,442.90 ",$169.73 ,"$1,879.15 " ST. JOSEPH'S HOSPITAL - BREESE,35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,628.00 ","$2,612.16 ",$219.77 ,"$3,628.00 ",$560.65 ,"$2,358.20 ","$2,165.92 ",$219.77 ,"$1,015.84 ","$2,401.74 ",$219.77 ,"$2,401.74 ",$219.77 ,"$2,162.29 ","$2,162.29 ",$219.77 ,"$2,162.29 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,721.00 ","$2,575.88 ","$2,575.88 ",$219.77 ,"$2,575.88 ","$3,083.80 ","$3,083.80 ","$3,083.80 ", N/A ,$560.65 ,"$3,083.80 ",$219.77 ,"$3,628.00 ","$2,035.31 ",$219.77 ,"$1,501.99 ",$256.48 ,$233.16 ,$219.77 ,"$3,083.80 ",$470.94 ,"$2,162.29 ","$1,015.84 ","$3,265.20 ",$219.77 ,"$3,083.80 ","$3,065.66 ","$3,065.66 ",$219.77 ,"$2,358.20 " ST. JOSEPH'S HOSPITAL - BREESE,35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$3,642.00 ","$2,622.24 ",$100.59 ,"$3,642.00 ",$256.60 ,"$2,367.30 ","$2,174.27 ",$100.59 ,"$1,019.76 ","$2,411.00 ",$100.59 ,"$2,411.00 ",$100.59 ,"$2,170.63 ","$2,170.63 ",$100.59 ,"$2,170.63 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$2,731.50 ","$2,585.82 ","$2,585.82 ",$100.59 ,"$2,585.82 ","$3,095.70 ","$3,095.70 ","$3,095.70 ", N/A ,$256.60 ,"$3,095.70 ",$100.59 ,"$3,642.00 ","$2,043.16 ",$100.59 ,"$1,507.79 ",$116.69 ,$106.08 ,$100.59 ,"$3,095.70 ",$215.55 ,"$2,170.63 ","$1,019.76 ","$3,277.80 ",$100.59 ,"$3,095.70 ","$3,077.49 ","$3,077.49 ",$100.59 ,"$2,367.30 " ST. JOSEPH'S HOSPITAL - BREESE,35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$1,128.00 ",$812.16 ,$106.08 ,"$1,128.00 ",$884.55 ,$733.20 ,$673.42 ,$346.74 ,$315.84 ,$746.74 ,$346.74 ,$746.74 ,$346.74 ,$672.29 ,$672.29 ,$346.74 ,$672.29 ,$714.71 ,"$1,128.00 ",$884.55 ,$346.74 ,$353.67 ,$846.00 ,$800.88 ,$800.88 ,$346.74 ,$800.88 ,$958.80 ,$958.80 ,$958.80 , N/A ,$884.55 ,$958.80 ,$346.74 ,"$1,128.00 ",$632.81 ,$346.74 ,$466.99 ,$116.69 ,$106.08 ,$346.74 ,$958.80 ,$743.02 ,$672.29 ,$315.84 ,"$1,015.20 ",$346.74 ,$958.80 ,$953.16 ,$953.16 ,$346.74 ,$733.20 ST. JOSEPH'S HOSPITAL - BREESE,35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$3,638.00 ","$2,619.36 ",$100.59 ,"$3,638.00 ",$256.60 ,"$2,364.70 ","$2,171.89 ",$100.59 ,"$1,018.64 ","$2,408.36 ",$100.59 ,"$2,408.36 ",$100.59 ,"$2,168.25 ","$2,168.25 ",$100.59 ,"$2,168.25 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$2,728.50 ","$2,582.98 ","$2,582.98 ",$100.59 ,"$2,582.98 ","$3,092.30 ","$3,092.30 ","$3,092.30 ", N/A ,$256.60 ,"$3,092.30 ",$100.59 ,"$3,638.00 ","$2,040.92 ",$100.59 ,"$1,506.13 ",$116.69 ,$106.08 ,$100.59 ,"$3,092.30 ",$215.55 ,"$2,168.25 ","$1,018.64 ","$3,274.20 ",$100.59 ,"$3,092.30 ","$3,074.11 ","$3,074.11 ",$100.59 ,"$2,364.70 " ST. JOSEPH'S HOSPITAL - BREESE,35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$4,180.00 ","$3,009.60 ",$106.08 ,"$4,180.00 ",$432.98 ,"$2,717.00 ","$2,495.46 ",$169.73 ,"$1,170.40 ","$2,767.16 ",$169.73 ,"$2,767.16 ",$169.73 ,"$2,491.28 ","$2,491.28 ",$169.73 ,"$2,491.28 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$3,135.00 ","$2,967.80 ","$2,967.80 ",$169.73 ,"$2,967.80 ","$3,553.00 ","$3,553.00 ","$3,553.00 ", N/A ,$432.97 ,"$3,553.00 ",$169.73 ,"$4,180.00 ","$2,344.98 ",$169.73 ,"$1,730.52 ",$116.69 ,$106.08 ,$169.73 ,"$3,553.00 ",$363.69 ,"$2,491.28 ","$1,170.40 ","$3,762.00 ",$169.73 ,"$3,553.00 ","$3,532.10 ","$3,532.10 ",$169.73 ,"$2,717.00 " ST. JOSEPH'S HOSPITAL - BREESE,35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,"$4,545.00 ","$3,272.40 ",$106.08 ,"$4,545.00 ",$432.98 ,"$2,954.25 ","$2,713.37 ",$169.73 ,"$1,272.60 ","$3,008.79 ",$169.73 ,"$3,008.79 ",$169.73 ,"$2,708.82 ","$2,708.82 ",$169.73 ,"$2,708.82 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$3,408.75 ","$3,226.95 ","$3,226.95 ",$169.73 ,"$3,226.95 ","$3,863.25 ","$3,863.25 ","$3,863.25 ", N/A ,$432.97 ,"$3,863.25 ",$169.73 ,"$4,545.00 ","$2,549.75 ",$169.73 ,"$1,881.63 ",$116.69 ,$106.08 ,$169.73 ,"$3,863.25 ",$363.69 ,"$2,708.82 ","$1,272.60 ","$4,090.50 ",$169.73 ,"$3,863.25 ","$3,840.53 ","$3,840.53 ",$169.73 ,"$2,954.25 " ST. JOSEPH'S HOSPITAL - BREESE,35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$3,704.00 ","$2,666.88 ",$100.59 ,"$3,704.00 ",$256.60 ,"$2,407.60 ","$2,211.29 ",$100.59 ,"$1,037.12 ","$2,452.05 ",$100.59 ,"$2,452.05 ",$100.59 ,"$2,207.58 ","$2,207.58 ",$100.59 ,"$2,207.58 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$2,778.00 ","$2,629.84 ","$2,629.84 ",$100.59 ,"$2,629.84 ","$3,148.40 ","$3,148.40 ","$3,148.40 ", N/A ,$256.60 ,"$3,148.40 ",$100.59 ,"$3,704.00 ","$2,077.94 ",$100.59 ,"$1,533.46 ",$116.69 ,$106.08 ,$100.59 ,"$3,148.40 ",$215.55 ,"$2,207.58 ","$1,037.12 ","$3,333.60 ",$100.59 ,"$3,148.40 ","$3,129.88 ","$3,129.88 ",$100.59 ,"$2,407.60 " ST. JOSEPH'S HOSPITAL - BREESE,35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$4,180.00 ","$3,009.60 ",$106.08 ,"$4,180.00 ",$884.55 ,"$2,717.00 ","$2,495.46 ",$346.74 ,"$1,170.40 ","$2,767.16 ",$346.74 ,"$2,767.16 ",$346.74 ,"$2,491.28 ","$2,491.28 ",$346.74 ,"$2,491.28 ",$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,135.00 ","$2,967.80 ","$2,967.80 ",$346.74 ,"$2,967.80 ","$3,553.00 ","$3,553.00 ","$3,553.00 ", N/A ,$884.55 ,"$3,553.00 ",$346.74 ,"$4,180.00 ","$2,344.98 ",$346.74 ,"$1,730.52 ",$116.69 ,$106.08 ,$346.74 ,"$3,553.00 ",$743.02 ,"$2,491.28 ","$1,170.40 ","$3,762.00 ",$346.74 ,"$3,553.00 ","$3,532.10 ","$3,532.10 ",$346.74 ,"$2,717.00 " ST. JOSEPH'S HOSPITAL - BREESE,35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$4,346.00 ","$3,129.12 ",$106.08 ,"$4,346.00 ",$432.98 ,"$2,824.90 ","$2,594.56 ",$169.73 ,"$1,216.88 ","$2,877.05 ",$169.73 ,"$2,877.05 ",$169.73 ,"$2,590.22 ","$2,590.22 ",$169.73 ,"$2,590.22 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$3,259.50 ","$3,085.66 ","$3,085.66 ",$169.73 ,"$3,085.66 ","$3,694.10 ","$3,694.10 ","$3,694.10 ", N/A ,$432.97 ,"$3,694.10 ",$169.73 ,"$4,346.00 ","$2,438.11 ",$169.73 ,"$1,799.24 ",$116.69 ,$106.08 ,$169.73 ,"$3,694.10 ",$363.69 ,"$2,590.22 ","$1,216.88 ","$3,911.40 ",$169.73 ,"$3,694.10 ","$3,672.37 ","$3,672.37 ",$169.73 ,"$2,824.90 " ST. JOSEPH'S HOSPITAL - BREESE,35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$3,530.00 ","$2,541.60 ",$169.73 ,"$3,530.00 ",$432.98 ,"$2,294.50 ","$2,107.41 ",$169.73 ,$988.40 ,"$2,336.86 ",$169.73 ,"$2,336.86 ",$169.73 ,"$2,103.88 ","$2,103.88 ",$169.73 ,"$2,103.88 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,647.50 ","$2,506.30 ","$2,506.30 ",$169.73 ,"$2,506.30 ","$3,000.50 ","$3,000.50 ","$3,000.50 ", N/A ,$432.97 ,"$3,000.50 ",$169.73 ,"$3,530.00 ","$1,980.33 ",$169.73 ,"$1,461.42 ",$232.32 ,$211.20 ,$169.73 ,"$3,000.50 ",$363.69 ,"$2,103.88 ",$988.40 ,"$3,177.00 ",$169.73 ,"$3,000.50 ","$2,982.85 ","$2,982.85 ",$169.73 ,"$2,294.50 " ST. JOSEPH'S HOSPITAL - BREESE,35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$2,959.00 ","$2,130.48 ",$100.59 ,"$2,959.00 ",$256.60 ,"$1,923.35 ","$1,766.52 ",$100.59 ,$828.52 ,"$1,958.86 ",$100.59 ,"$1,958.86 ",$100.59 ,"$1,763.56 ","$1,763.56 ",$100.59 ,"$1,763.56 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$2,219.25 ","$2,100.89 ","$2,100.89 ",$100.59 ,"$2,100.89 ","$2,515.15 ","$2,515.15 ","$2,515.15 ", N/A ,$256.60 ,"$2,515.15 ",$100.59 ,"$2,959.00 ","$1,660.00 ",$100.59 ,"$1,225.03 ",$232.55 ,$211.41 ,$100.59 ,"$2,515.15 ",$215.55 ,"$1,763.56 ",$828.52 ,"$2,663.10 ",$100.59 ,"$2,515.15 ","$2,500.36 ","$2,500.36 ",$100.59 ,"$1,923.35 " ST. JOSEPH'S HOSPITAL - BREESE,35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$3,246.00 ","$2,337.12 ",$169.73 ,"$3,246.00 ",$432.98 ,"$2,109.90 ","$1,937.86 ",$169.73 ,$908.88 ,"$2,148.85 ",$169.73 ,"$2,148.85 ",$169.73 ,"$1,934.62 ","$1,934.62 ",$169.73 ,"$1,934.62 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,434.50 ","$2,304.66 ","$2,304.66 ",$169.73 ,"$2,304.66 ","$2,759.10 ","$2,759.10 ","$2,759.10 ", N/A ,$432.97 ,"$2,759.10 ",$169.73 ,"$3,246.00 ","$1,821.01 ",$169.73 ,"$1,343.84 ",$232.55 ,$211.41 ,$169.73 ,"$2,759.10 ",$363.69 ,"$1,934.62 ",$908.88 ,"$2,921.40 ",$169.73 ,"$2,759.10 ","$2,742.87 ","$2,742.87 ",$169.73 ,"$2,109.90 " ST. JOSEPH'S HOSPITAL - BREESE,35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$3,530.00 ","$2,541.60 ",$169.73 ,"$3,530.00 ",$432.98 ,"$2,294.50 ","$2,107.41 ",$169.73 ,$988.40 ,"$2,336.86 ",$169.73 ,"$2,336.86 ",$169.73 ,"$2,103.88 ","$2,103.88 ",$169.73 ,"$2,103.88 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,647.50 ","$2,506.30 ","$2,506.30 ",$169.73 ,"$2,506.30 ","$3,000.50 ","$3,000.50 ","$3,000.50 ", N/A ,$432.97 ,"$3,000.50 ",$169.73 ,"$3,530.00 ","$1,980.33 ",$169.73 ,"$1,461.42 ",$232.55 ,$211.41 ,$169.73 ,"$3,000.50 ",$363.69 ,"$2,103.88 ",$988.40 ,"$3,177.00 ",$169.73 ,"$3,000.50 ","$2,982.85 ","$2,982.85 ",$169.73 ,"$2,294.50 " ST. JOSEPH'S HOSPITAL - BREESE,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,504.00 ","$1,802.88 ",$93.45 ,"$2,504.00 ",$256.60 ,"$1,627.60 ","$1,494.89 ",$100.59 ,$701.12 ,"$1,657.65 ",$100.59 ,"$1,657.65 ",$100.59 ,"$1,492.38 ","$1,492.38 ",$100.59 ,"$1,492.38 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$1,878.00 ","$1,777.84 ","$1,777.84 ",$100.59 ,"$1,777.84 ","$2,128.40 ","$2,128.40 ","$2,128.40 ", N/A ,$256.60 ,"$2,128.40 ",$100.59 ,"$2,504.00 ","$1,404.74 ",$100.59 ,"$1,036.66 ",$102.80 ,$93.45 ,$100.59 ,"$2,128.40 ",$215.55 ,"$1,492.38 ",$701.12 ,"$2,253.60 ",$100.59 ,"$2,128.40 ","$2,115.88 ","$2,115.88 ",$100.59 ,"$1,627.60 " ST. JOSEPH'S HOSPITAL - BREESE,35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$2,633.00 ","$1,895.76 ",$93.45 ,"$2,633.00 ",$884.55 ,"$1,711.45 ","$1,571.90 ",$346.74 ,$737.24 ,"$1,743.05 ",$346.74 ,"$1,743.05 ",$346.74 ,"$1,569.27 ","$1,569.27 ",$346.74 ,"$1,569.27 ",$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,$353.67 ,"$1,974.75 ","$1,869.43 ","$1,869.43 ",$346.74 ,"$1,869.43 ","$2,238.05 ","$2,238.05 ","$2,238.05 ", N/A ,$884.55 ,"$2,238.05 ",$346.74 ,"$2,633.00 ","$1,477.11 ",$346.74 ,"$1,090.06 ",$102.80 ,$93.45 ,$346.74 ,"$2,238.05 ",$743.02 ,"$1,569.27 ",$737.24 ,"$2,369.70 ",$346.74 ,"$2,238.05 ","$2,224.89 ","$2,224.89 ",$346.74 ,"$1,711.45 " ST. JOSEPH'S HOSPITAL - BREESE,35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$3,183.00 ","$2,291.76 ",$93.45 ,"$3,183.00 ",$432.98 ,"$2,068.95 ","$1,900.25 ",$169.73 ,$891.24 ,"$2,107.15 ",$169.73 ,"$2,107.15 ",$169.73 ,"$1,897.07 ","$1,897.07 ",$169.73 ,"$1,897.07 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,387.25 ","$2,259.93 ","$2,259.93 ",$169.73 ,"$2,259.93 ","$2,705.55 ","$2,705.55 ","$2,705.55 ", N/A ,$432.97 ,"$2,705.55 ",$169.73 ,"$3,183.00 ","$1,785.66 ",$169.73 ,"$1,317.76 ",$102.80 ,$93.45 ,$169.73 ,"$2,705.55 ",$363.69 ,"$1,897.07 ",$891.24 ,"$2,864.70 ",$169.73 ,"$2,705.55 ","$2,689.64 ","$2,689.64 ",$169.73 ,"$2,068.95 " ST. JOSEPH'S HOSPITAL - BREESE,35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$3,183.00 ","$2,291.76 ",$169.73 ,"$3,183.00 ",$432.98 ,"$2,068.95 ","$1,900.25 ",$169.73 ,$891.24 ,"$2,107.15 ",$169.73 ,"$2,107.15 ",$169.73 ,"$1,897.07 ","$1,897.07 ",$169.73 ,"$1,897.07 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,387.25 ","$2,259.93 ","$2,259.93 ",$169.73 ,"$2,259.93 ","$2,705.55 ","$2,705.55 ","$2,705.55 ", N/A ,$432.97 ,"$2,705.55 ",$169.73 ,"$3,183.00 ","$1,785.66 ",$169.73 ,"$1,317.76 ",$232.32 ,$211.20 ,$169.73 ,"$2,705.55 ",$363.69 ,"$1,897.07 ",$891.24 ,"$2,864.70 ",$169.73 ,"$2,705.55 ","$2,689.64 ","$2,689.64 ",$169.73 ,"$2,068.95 " ST. JOSEPH'S HOSPITAL - BREESE,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,504.00 ","$1,802.88 ",$93.45 ,"$2,504.00 ",$256.60 ,"$1,627.60 ","$1,494.89 ",$100.59 ,$701.12 ,"$1,657.65 ",$100.59 ,"$1,657.65 ",$100.59 ,"$1,492.38 ","$1,492.38 ",$100.59 ,"$1,492.38 ",$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,$102.60 ,"$1,878.00 ","$1,777.84 ","$1,777.84 ",$100.59 ,"$1,777.84 ","$2,128.40 ","$2,128.40 ","$2,128.40 ", N/A ,$256.60 ,"$2,128.40 ",$100.59 ,"$2,504.00 ","$1,404.74 ",$100.59 ,"$1,036.66 ",$102.80 ,$93.45 ,$100.59 ,"$2,128.40 ",$215.55 ,"$1,492.38 ",$701.12 ,"$2,253.60 ",$100.59 ,"$2,128.40 ","$2,115.88 ","$2,115.88 ",$100.59 ,"$1,627.60 " ST. JOSEPH'S HOSPITAL - BREESE,35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,633.00 ","$1,895.76 ",$93.45 ,"$2,633.00 ",$432.98 ,"$1,711.45 ","$1,571.90 ",$169.73 ,$737.24 ,"$1,743.05 ",$169.73 ,"$1,743.05 ",$169.73 ,"$1,569.27 ","$1,569.27 ",$169.73 ,"$1,569.27 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$1,974.75 ","$1,869.43 ","$1,869.43 ",$169.73 ,"$1,869.43 ","$2,238.05 ","$2,238.05 ","$2,238.05 ", N/A ,$432.97 ,"$2,238.05 ",$169.73 ,"$2,633.00 ","$1,477.11 ",$169.73 ,"$1,090.06 ",$102.80 ,$93.45 ,$169.73 ,"$2,238.05 ",$363.69 ,"$1,569.27 ",$737.24 ,"$2,369.70 ",$169.73 ,"$2,238.05 ","$2,224.89 ","$2,224.89 ",$169.73 ,"$1,711.45 " ST. JOSEPH'S HOSPITAL - BREESE,35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$3,077.00 ","$2,215.44 ",$93.45 ,"$3,077.00 ",$432.98 ,"$2,000.05 ","$1,836.97 ",$169.73 ,$861.56 ,"$2,036.97 ",$169.73 ,"$2,036.97 ",$169.73 ,"$1,833.89 ","$1,833.89 ",$169.73 ,"$1,833.89 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,307.75 ","$2,184.67 ","$2,184.67 ",$169.73 ,"$2,184.67 ","$2,615.45 ","$2,615.45 ","$2,615.45 ", N/A ,$432.97 ,"$2,615.45 ",$169.73 ,"$3,077.00 ","$1,726.20 ",$169.73 ,"$1,273.88 ",$102.80 ,$93.45 ,$169.73 ,"$2,615.45 ",$363.69 ,"$1,833.89 ",$861.56 ,"$2,769.30 ",$169.73 ,"$2,615.45 ","$2,600.07 ","$2,600.07 ",$169.73 ,"$2,000.05 " ST. JOSEPH'S HOSPITAL - BREESE,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$3,146.00 ","$2,265.12 ",$169.73 ,"$3,146.00 ",$432.98 ,"$2,044.90 ","$1,878.16 ",$169.73 ,$880.88 ,"$2,082.65 ",$169.73 ,"$2,082.65 ",$169.73 ,"$1,875.02 ","$1,875.02 ",$169.73 ,"$1,875.02 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,359.50 ","$2,233.66 ","$2,233.66 ",$169.73 ,"$2,233.66 ","$2,674.10 ","$2,674.10 ","$2,674.10 ", N/A ,$432.97 ,"$2,674.10 ",$169.73 ,"$3,146.00 ","$1,764.91 ",$169.73 ,"$1,302.44 ",$232.32 ,$211.20 ,$169.73 ,"$2,674.10 ",$363.69 ,"$1,875.02 ",$880.88 ,"$2,831.40 ",$169.73 ,"$2,674.10 ","$2,658.37 ","$2,658.37 ",$169.73 ,"$2,044.90 " ST. JOSEPH'S HOSPITAL - BREESE,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$4,719.00 ","$3,397.68 ",$316.80 ,"$4,719.00 ","$1,042.35 ","$3,067.35 ","$2,817.24 ",$408.60 ,"$1,321.32 ","$3,123.98 ",$408.60 ,"$3,123.98 ",$408.60 ,"$2,812.52 ","$2,812.52 ",$408.60 ,"$2,812.52 ",$842.22 ,"$2,000.00 ","$1,042.35 ",$408.60 ,$416.77 ,"$3,539.25 ","$3,350.49 ","$3,350.49 ",$408.60 ,"$3,350.49 ","$4,011.15 ","$4,011.15 ","$4,011.15 ", N/A ,"$1,042.35 ","$4,011.15 ",$408.60 ,"$4,719.00 ","$2,647.36 ",$408.60 ,"$1,953.67 ",$348.48 ,$316.80 ,$408.60 ,"$4,011.15 ",$875.58 ,"$2,812.52 ","$1,321.32 ","$4,247.10 ",$408.60 ,"$4,011.15 ","$3,987.56 ","$3,987.56 ",$408.60 ,"$3,067.35 " ST. JOSEPH'S HOSPITAL - BREESE,35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$3,336.00 ","$2,401.92 ",$100.59 ,"$3,336.00 ",$256.60 ,"$2,168.40 ","$1,991.59 ",$100.59 ,$934.08 ,"$2,208.43 ",$100.59 ,"$2,208.43 ",$100.59 ,"$1,988.26 ","$1,988.26 ",$100.59 ,"$1,988.26 ",$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$2,502.00 ","$2,368.56 ","$2,368.56 ",$100.59 ,"$2,368.56 ","$2,835.60 ","$2,835.60 ","$2,835.60 ", N/A ,$256.60 ,"$2,835.60 ",$100.59 ,"$3,336.00 ","$1,871.50 ",$100.59 ,"$1,381.10 ",$232.55 ,$211.41 ,$100.59 ,"$2,835.60 ",$215.55 ,"$1,988.26 ",$934.08 ,"$3,002.40 ",$100.59 ,"$2,835.60 ","$2,818.92 ","$2,818.92 ",$100.59 ,"$2,168.40 " ST. JOSEPH'S HOSPITAL - BREESE,35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$3,771.00 ","$2,715.12 ",$169.73 ,"$3,771.00 ",$432.98 ,"$2,451.15 ","$2,251.29 ",$169.73 ,"$1,055.88 ","$2,496.40 ",$169.73 ,"$2,496.40 ",$169.73 ,"$2,247.52 ","$2,247.52 ",$169.73 ,"$2,247.52 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,828.25 ","$2,677.41 ","$2,677.41 ",$169.73 ,"$2,677.41 ","$3,205.35 ","$3,205.35 ","$3,205.35 ", N/A ,$432.97 ,"$3,205.35 ",$169.73 ,"$3,771.00 ","$2,115.53 ",$169.73 ,"$1,561.19 ",$232.55 ,$211.41 ,$169.73 ,"$3,205.35 ",$363.69 ,"$2,247.52 ","$1,055.88 ","$3,393.90 ",$169.73 ,"$3,205.35 ","$3,186.50 ","$3,186.50 ",$169.73 ,"$2,451.15 " ST. JOSEPH'S HOSPITAL - BREESE,35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$4,612.00 ","$3,320.64 ",$169.73 ,"$4,612.00 ",$432.98 ,"$2,997.80 ","$2,753.36 ",$169.73 ,"$1,291.36 ","$3,053.14 ",$169.73 ,"$3,053.14 ",$169.73 ,"$2,748.75 ","$2,748.75 ",$169.73 ,"$2,748.75 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$3,459.00 ","$3,274.52 ","$3,274.52 ",$169.73 ,"$3,274.52 ","$3,920.20 ","$3,920.20 ","$3,920.20 ", N/A ,$432.97 ,"$3,920.20 ",$169.73 ,"$4,612.00 ","$2,587.33 ",$169.73 ,"$1,909.37 ",$232.55 ,$211.41 ,$169.73 ,"$3,920.20 ",$363.69 ,"$2,748.75 ","$1,291.36 ","$4,150.80 ",$169.73 ,"$3,920.20 ","$3,897.14 ","$3,897.14 ",$169.73 ,"$2,997.80 " ST. JOSEPH'S HOSPITAL - BREESE,35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,329.00 ","$2,396.88 ",$169.73 ,"$3,329.00 ",$432.98 ,"$2,163.85 ","$1,987.41 ",$169.73 ,$932.12 ,"$2,203.80 ",$169.73 ,"$2,203.80 ",$169.73 ,"$1,984.08 ","$1,984.08 ",$169.73 ,"$1,984.08 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,496.75 ","$2,363.59 ","$2,363.59 ",$169.73 ,"$2,363.59 ","$2,829.65 ","$2,829.65 ","$2,829.65 ", N/A ,$432.97 ,"$2,829.65 ",$169.73 ,"$3,329.00 ","$1,867.57 ",$169.73 ,"$1,378.21 ",$232.32 ,$211.20 ,$169.73 ,"$2,829.65 ",$363.69 ,"$1,984.08 ",$932.12 ,"$2,996.10 ",$169.73 ,"$2,829.65 ","$2,813.01 ","$2,813.01 ",$169.73 ,"$2,163.85 " ST. JOSEPH'S HOSPITAL - BREESE,35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$5,180.00 ","$3,729.60 ",$211.41 ,"$5,180.00 ",$560.65 ,"$3,367.00 ","$3,092.46 ",$219.77 ,"$1,450.40 ","$3,429.16 ",$219.77 ,"$3,429.16 ",$219.77 ,"$3,087.28 ","$3,087.28 ",$219.77 ,"$3,087.28 ",$453.00 ,"$2,000.00 ",$560.65 ,$219.77 ,$224.17 ,"$3,885.00 ","$3,677.80 ","$3,677.80 ",$219.77 ,"$3,677.80 ","$4,403.00 ","$4,403.00 ","$4,403.00 ", N/A ,$560.65 ,"$4,403.00 ",$219.77 ,"$5,180.00 ","$2,905.98 ",$219.77 ,"$2,144.52 ",$232.55 ,$211.41 ,$219.77 ,"$4,403.00 ",$470.94 ,"$3,087.28 ","$1,450.40 ","$4,662.00 ",$219.77 ,"$4,403.00 ","$4,377.10 ","$4,377.10 ",$219.77 ,"$3,367.00 " ST. JOSEPH'S HOSPITAL - BREESE,35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$5,339.00 ","$3,844.08 ",$211.41 ,"$5,339.00 ",$884.55 ,"$3,470.35 ","$3,187.38 ",$346.74 ,"$1,494.92 ","$3,534.42 ",$346.74 ,"$3,534.42 ",$346.74 ,"$3,182.04 ","$3,182.04 ",$346.74 ,"$3,182.04 ",$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,$353.67 ,"$4,004.25 ","$3,790.69 ","$3,790.69 ",$346.74 ,"$3,790.69 ","$4,538.15 ","$4,538.15 ","$4,538.15 ", N/A ,$884.55 ,"$4,538.15 ",$346.74 ,"$5,339.00 ","$2,995.18 ",$346.74 ,"$2,210.35 ",$232.55 ,$211.41 ,$346.74 ,"$4,538.15 ",$743.02 ,"$3,182.04 ","$1,494.92 ","$4,805.10 ",$346.74 ,"$4,538.15 ","$4,511.46 ","$4,511.46 ",$346.74 ,"$3,470.35 " ST. JOSEPH'S HOSPITAL - BREESE,35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$6,406.00 ","$4,612.32 ",$211.41 ,"$6,406.00 ",$884.55 ,"$4,163.90 ","$3,824.38 ",$346.74 ,"$1,793.68 ","$4,240.77 ",$346.74 ,"$4,240.77 ",$346.74 ,"$3,817.98 ","$3,817.98 ",$346.74 ,"$3,817.98 ",$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,$353.67 ,"$4,804.50 ","$4,548.26 ","$4,548.26 ",$346.74 ,"$4,548.26 ","$5,445.10 ","$5,445.10 ","$5,445.10 ", N/A ,$884.55 ,"$5,445.10 ",$346.74 ,"$6,406.00 ","$3,593.77 ",$346.74 ,"$2,652.08 ",$232.55 ,$211.41 ,$346.74 ,"$5,445.10 ",$743.02 ,"$3,817.98 ","$1,793.68 ","$5,765.40 ",$346.74 ,"$5,445.10 ","$5,413.07 ","$5,413.07 ",$346.74 ,"$4,163.90 " ST. JOSEPH'S HOSPITAL - BREESE,35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$102.00 ,$73.44 ,$28.56 ,$208.59 ,$208.58 ,$66.30 ,$60.89 ,$81.76 ,$28.56 ,$67.52 ,$81.76 ,$67.52 ,$81.76 ,$60.79 ,$60.79 ,$81.76 ,$60.79 ,$102.00 ,$102.00 ,$208.59 ,$81.76 ,$83.40 ,$76.50 ,$72.42 ,$72.42 ,$81.76 ,$72.42 ,$86.70 ,$86.70 ,$86.70 , N/A ,$102.00 ,$86.70 ,$81.76 ,$102.00 ,$57.22 ,$81.76 ,$42.23 , N/A , N/A ,$81.76 ,$86.70 ,$175.21 ,$60.79 ,$28.56 ,$91.80 ,$81.76 ,$86.70 ,$86.19 ,$86.19 ,$81.76 ,$66.30 ST. JOSEPH'S HOSPITAL - BREESE,35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$3,039.00 ","$2,188.08 ",$169.73 ,"$3,039.00 ",$432.98 ,"$1,975.35 ","$1,814.28 ",$169.73 ,$850.92 ,"$2,011.82 ",$169.73 ,"$2,011.82 ",$169.73 ,"$1,811.24 ","$1,811.24 ",$169.73 ,"$1,811.24 ",$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,279.25 ","$2,157.69 ","$2,157.69 ",$169.73 ,"$2,157.69 ","$2,583.15 ","$2,583.15 ","$2,583.15 ", N/A ,$432.97 ,"$2,583.15 ",$169.73 ,"$3,039.00 ","$1,704.88 ",$169.73 ,"$1,258.15 ",$232.32 ,$211.20 ,$169.73 ,"$2,583.15 ",$363.69 ,"$1,811.24 ",$850.92 ,"$2,735.10 ",$169.73 ,"$2,583.15 ","$2,567.96 ","$2,567.96 ",$169.73 ,"$1,975.35 " ST. JOSEPH'S HOSPITAL - BREESE,35000101,76380,HC CT LMTD OR LOCALIZ FU STUDY,350,1 ,"$2,698.00 ","$1,942.56 ",$81.76 ,"$2,698.00 ",$208.58 ,"$1,753.70 ","$1,610.71 ",$81.76 ,$755.44 ,"$1,786.08 ",$81.76 ,"$1,786.08 ",$81.76 ,"$1,608.01 ","$1,608.01 ",$81.76 ,"$1,608.01 ",$168.54 ,"$2,000.00 ",$208.59 ,$81.76 ,$83.40 ,"$2,023.50 ","$1,915.58 ","$1,915.58 ",$81.76 ,"$1,915.58 ","$2,293.30 ","$2,293.30 ","$2,293.30 ", N/A ,$208.59 ,"$2,293.30 ",$81.76 ,"$2,698.00 ","$1,513.58 ",$81.76 ,"$1,116.97 ",$102.80 ,$93.45 ,$81.76 ,"$2,293.30 ",$175.21 ,"$1,608.01 ",$755.44 ,"$2,428.20 ",$81.76 ,"$2,293.30 ","$2,279.81 ","$2,279.81 ",$81.76 ,"$1,753.70 " ST. JOSEPH'S HOSPITAL - BREESE,35000120,74174,HC CT ANGIO ABD/PELV W AND WO CONTRAST,350,1 ,"$5,616.00 ","$4,043.52 ",$211.41 ,"$5,616.00 ",$884.55 ,"$3,650.40 ","$3,352.75 ",$346.74 ,"$1,572.48 ","$3,717.79 ",$346.74 ,"$3,717.79 ",$346.74 ,"$3,347.14 ","$3,347.14 ",$346.74 ,"$3,347.14 ",$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,$353.67 ,"$4,212.00 ","$3,987.36 ","$3,987.36 ",$346.74 ,"$3,987.36 ","$4,773.60 ","$4,773.60 ","$4,773.60 ", N/A ,$884.55 ,"$4,773.60 ",$346.74 ,"$5,616.00 ","$3,150.58 ",$346.74 ,"$2,325.02 ",$232.55 ,$211.41 ,$346.74 ,"$4,773.60 ",$743.02 ,"$3,347.14 ","$1,572.48 ","$5,054.40 ",$346.74 ,"$4,773.60 ","$4,745.52 ","$4,745.52 ",$346.74 ,"$3,650.40 " ST. JOSEPH'S HOSPITAL - BREESE,35000135,22513,HC VERTEBROPLASTY INJ PERC THOR KYPHOPLASTY,350,1 ,"$20,521.00 ","$14,775.12 ",$800.00 ,"$20,521.00 ","$15,880.73 ","$13,338.65 ","$12,251.04 ","$6,225.24 ","$5,745.88 ","$13,584.90 ","$6,225.24 ","$13,584.90 ","$6,225.24 ","$12,230.52 ","$12,230.52 ","$6,225.24 ","$12,230.52 ","$12,831.63 ",$800.00 ,"$15,880.73 ","$6,225.24 ","$6,349.75 ","$15,390.75 ","$14,569.91 ","$14,569.91 ","$6,225.24 ","$14,569.91 ","$17,442.85 ","$17,442.85 ","$17,442.85 ", N/A ,"$15,880.73 ","$17,442.85 ","$6,225.24 ","$20,521.00 ","$11,512.28 ","$6,225.24 ","$8,495.69 ","$9,216.35 ","$8,378.50 ","$6,225.24 ","$17,442.85 ","$13,339.82 ","$12,230.52 ","$5,745.88 ","$18,468.90 ","$6,225.24 ","$17,442.85 ","$17,340.25 ","$17,340.25 ","$6,225.24 ","$13,338.65 " ST. JOSEPH'S HOSPITAL - BREESE,35000136,22514,HC VERTEBROPLASTY INJ PERC LUMBAR KYPHOPLASTY,350,1 ,"$20,521.00 ","$14,775.12 ",$800.00 ,"$20,521.00 ","$15,880.73 ","$13,338.65 ","$12,251.04 ","$6,225.24 ","$5,745.88 ","$13,584.90 ","$6,225.24 ","$13,584.90 ","$6,225.24 ","$12,230.52 ","$12,230.52 ","$6,225.24 ","$12,230.52 ","$12,831.63 ",$800.00 ,"$15,880.73 ","$6,225.24 ","$6,349.75 ","$15,390.75 ","$14,569.91 ","$14,569.91 ","$6,225.24 ","$14,569.91 ","$17,442.85 ","$17,442.85 ","$17,442.85 ", N/A ,"$15,880.73 ","$17,442.85 ","$6,225.24 ","$20,521.00 ","$11,512.28 ","$6,225.24 ","$8,495.69 ","$9,216.35 ","$8,378.50 ","$6,225.24 ","$17,442.85 ","$13,339.82 ","$12,230.52 ","$5,745.88 ","$18,468.90 ","$6,225.24 ","$17,442.85 ","$17,340.25 ","$17,340.25 ","$6,225.24 ","$13,338.65 " ST. JOSEPH'S HOSPITAL - BREESE,35000137,22515,HC VERTEBROPLASTY INJ PERC EA ADDNT THOR OR LUMB KYPHO,350,1 ,"$16,806.00 ","$12,100.32 ",$800.00 ,"$16,806.00 ", N/A ,"$10,923.90 ","$10,033.18 ", N/A ,"$4,705.68 ","$11,125.57 ", N/A ,"$11,125.57 ", N/A ,"$10,016.38 ","$10,016.38 ", N/A ,"$10,016.38 ", N/A ,$800.00 , N/A , N/A , N/A ,"$12,604.50 ","$11,932.26 ","$11,932.26 ", N/A ,"$11,932.26 ","$14,285.10 ","$14,285.10 ","$14,285.10 ", N/A , N/A ,"$14,285.10 ", N/A ,"$16,806.00 ","$9,428.17 ", N/A ,"$6,957.68 ","$9,216.35 ","$8,378.50 ", N/A ,"$14,285.10 ", N/A ,"$10,016.38 ","$4,705.68 ","$15,125.40 ", N/A ,"$14,285.10 ","$14,201.07 ","$14,201.07 ", N/A ,"$10,923.90 " ST. JOSEPH'S HOSPITAL - BREESE,35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$237.00 ,$170.64 ,$66.36 ,$256.60 ,$256.60 ,$154.05 ,$141.49 ,$100.59 ,$66.36 ,$156.89 ,$100.59 ,$156.89 ,$100.59 ,$141.25 ,$141.25 ,$100.59 ,$141.25 ,$207.34 ,$237.00 ,$256.60 ,$100.59 ,$102.60 ,$177.75 ,$168.27 ,$168.27 ,$100.59 ,$168.27 ,$201.45 ,$201.45 ,$201.45 , N/A ,$237.00 ,$201.45 ,$100.59 ,$237.00 ,$132.96 ,$100.59 ,$98.12 ,$102.80 ,$93.45 ,$100.59 ,$201.45 ,$215.55 ,$141.25 ,$66.36 ,$213.30 ,$100.59 ,$201.45 ,$200.27 ,$200.27 ,$100.59 ,$154.05 ST. JOSEPH'S HOSPITAL - BREESE,36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$483.00 ,$347.76 ,$135.24 ,$483.00 ,$433.55 ,$313.95 ,$288.35 ,$169.95 ,$135.24 ,$319.75 ,$169.95 ,$319.75 ,$169.95 ,$287.87 ,$287.87 ,$169.95 ,$287.87 ,$350.30 ,$371.91 ,$433.55 ,$169.95 ,$173.35 ,$362.25 ,$342.93 ,$342.93 ,$169.95 ,$342.93 ,$410.55 ,$410.55 ,$410.55 , N/A ,$433.55 ,$410.55 ,$169.95 ,$483.00 ,$270.96 ,$169.95 ,$199.96 ,$222.46 ,$202.24 ,$169.95 ,$410.55 ,$364.18 ,$287.87 ,$135.24 ,$434.70 ,$169.95 ,$410.55 ,$408.14 ,$408.14 ,$169.95 ,$313.95 ST. JOSEPH'S HOSPITAL - BREESE,36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$938.00 ,$675.36 ,$202.24 ,$938.00 ,$895.68 ,$609.70 ,$559.99 ,$351.10 ,$262.64 ,$620.96 ,$351.10 ,$620.96 ,$351.10 ,$559.05 ,$559.05 ,$351.10 ,$559.05 ,$723.71 ,$722.26 ,$895.69 ,$351.10 ,$358.13 ,$703.50 ,$665.98 ,$665.98 ,$351.10 ,$665.98 ,$797.30 ,$797.30 ,$797.30 , N/A ,$895.69 ,$797.30 ,$351.10 ,$938.00 ,$526.22 ,$351.10 ,$388.33 ,$222.46 ,$202.24 ,$351.10 ,$797.30 ,$752.38 ,$559.05 ,$262.64 ,$844.20 ,$351.10 ,$797.30 ,$792.61 ,$792.61 ,$351.10 ,$609.70 ST. JOSEPH'S HOSPITAL - BREESE,36000078,19000,HC ASP CYST BREAST,360,1 ,$935.00 ,$673.20 ,$109.83 ,"$1,558.08 ","$1,558.08 ",$607.75 ,$558.20 ,$610.77 ,$261.80 ,$618.97 ,$610.77 ,$618.97 ,$610.77 ,$557.26 ,$557.26 ,$610.77 ,$557.26 ,$935.00 ,$719.95 ,"$1,558.08 ",$610.77 ,$622.99 ,$701.25 ,$663.85 ,$663.85 ,$610.77 ,$663.85 ,$794.75 ,$794.75 ,$794.75 , N/A ,$935.00 ,$794.75 ,$610.77 ,$109.83 ,$524.54 ,$610.77 ,$387.09 ,$450.34 ,$409.40 ,$610.77 ,$794.75 ,"$1,308.79 ",$557.26 ,$261.80 ,$841.50 ,$610.77 ,$794.75 ,$790.08 ,$790.08 ,$610.77 ,$607.75 ST. JOSEPH'S HOSPITAL - BREESE,36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$769.00 ,$553.68 ,$28.20 ,$769.00 , N/A ,$499.85 ,$459.09 , N/A ,$215.32 ,$509.08 , N/A ,$509.08 , N/A ,$458.32 ,$458.32 , N/A ,$458.32 , N/A ,$592.13 , N/A , N/A , N/A ,$576.75 ,$545.99 ,$545.99 , N/A ,$545.99 ,$653.65 ,$653.65 ,$653.65 , N/A , N/A ,$653.65 , N/A ,$28.20 ,$431.41 , N/A ,$318.37 ,$450.34 ,$409.40 , N/A ,$653.65 , N/A ,$458.32 ,$215.32 ,$692.10 , N/A ,$653.65 ,$649.81 ,$649.81 , N/A ,$499.85 ST. JOSEPH'S HOSPITAL - BREESE,36000080,19020,HC BREAST ABSCESS DRAINAGE,360,1 ,"$3,924.00 ","$2,825.28 ",$705.39 ,"$3,924.00 ","$3,600.20 ","$2,550.60 ","$2,342.63 ","$1,411.28 ","$1,098.72 ","$2,597.69 ","$1,411.28 ","$2,597.69 ","$1,411.28 ","$2,338.70 ","$2,338.70 ","$1,411.28 ","$2,338.70 ","$2,908.96 ","$3,021.48 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$2,943.00 ","$2,786.04 ","$2,786.04 ","$1,411.28 ","$2,786.04 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,600.19 ","$3,335.40 ","$1,411.28 ","$3,924.00 ","$2,201.36 ","$1,411.28 ","$1,624.54 ",$775.93 ,$705.39 ,"$1,411.28 ","$3,335.40 ","$3,024.16 ","$2,338.70 ","$1,098.72 ","$3,531.60 ","$1,411.28 ","$3,129.00 ","$3,315.78 ","$3,315.78 ","$1,411.28 ","$2,550.60 " ST. JOSEPH'S HOSPITAL - BREESE,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,$458.00 ,$329.76 ,$128.24 ,$458.00 , N/A ,$297.70 ,$273.43 , N/A ,$128.24 ,$303.20 , N/A ,$303.20 , N/A ,$272.97 ,$272.97 , N/A ,$272.97 , N/A ,$352.66 , N/A , N/A , N/A ,$343.50 ,$325.18 ,$325.18 , N/A ,$325.18 ,$389.30 ,$389.30 ,$389.30 , N/A , N/A ,$389.30 , N/A ,$458.00 ,$256.94 , N/A ,$189.61 , N/A , N/A , N/A ,$389.30 , N/A ,$272.97 ,$128.24 ,$412.20 , N/A ,$389.30 ,$387.01 ,$387.01 , N/A ,$297.70 ST. JOSEPH'S HOSPITAL - BREESE,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,$687.00 ,$494.64 ,$192.36 ,$687.00 , N/A ,$446.55 ,$410.14 , N/A ,$192.36 ,$454.79 , N/A ,$454.79 , N/A ,$409.45 ,$409.45 , N/A ,$409.45 , N/A ,$528.99 , N/A , N/A , N/A ,$515.25 ,$487.77 ,$487.77 , N/A ,$487.77 ,$583.95 ,$583.95 ,$583.95 , N/A , N/A ,$583.95 , N/A ,$687.00 ,$385.41 , N/A ,$284.42 , N/A , N/A , N/A ,$583.95 , N/A ,$409.45 ,$192.36 ,$618.30 , N/A ,$583.95 ,$580.52 ,$580.52 , N/A ,$446.55 ST. JOSEPH'S HOSPITAL - BREESE,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$4,581.00 ","$3,298.32 ",$538.44 ,"$4,581.00 ","$3,600.20 ","$2,977.65 ","$2,734.86 ","$1,411.28 ","$1,282.68 ","$3,032.62 ","$1,411.28 ","$3,032.62 ","$1,411.28 ","$2,730.28 ","$2,730.28 ","$1,411.28 ","$2,730.28 ","$2,908.96 ","$3,527.37 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,435.75 ","$3,252.51 ","$3,252.51 ","$1,411.28 ","$3,252.51 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,600.19 ","$3,893.85 ","$1,411.28 ",$538.44 ,"$2,569.94 ","$1,411.28 ","$1,896.53 ",$912.65 ,$829.68 ,"$1,411.28 ","$3,893.85 ","$3,024.16 ","$2,730.28 ","$1,282.68 ","$4,122.90 ","$1,411.28 ","$3,129.00 ","$3,870.95 ","$3,870.95 ","$1,411.28 ","$2,977.65 " ST. JOSEPH'S HOSPITAL - BREESE,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$6,871.00 ","$4,947.12 ",$538.44 ,"$6,871.00 ","$6,202.00 ","$4,466.15 ","$4,101.99 ","$2,431.18 ","$1,923.88 ","$4,548.60 ","$2,431.18 ","$4,548.60 ","$2,431.18 ","$4,095.12 ","$4,095.12 ","$2,431.18 ","$4,095.12 ","$5,011.21 ","$5,290.67 ","$6,202.00 ","$2,431.18 ","$2,479.80 ","$5,153.25 ","$4,878.41 ","$4,878.41 ","$2,431.18 ","$4,878.41 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$6,202.00 ","$5,840.35 ","$2,431.18 ",$538.44 ,"$3,854.63 ","$2,431.18 ","$2,844.59 ","$1,368.96 ","$1,244.51 ","$2,431.18 ","$5,840.35 ","$5,209.68 ","$4,095.12 ","$1,923.88 ","$6,183.90 ","$2,431.18 ","$3,129.00 ","$5,806.00 ","$5,806.00 ","$2,431.18 ","$4,466.15 " ST. JOSEPH'S HOSPITAL - BREESE,36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$2,077.00 ","$1,495.44 ",$80.37 ,"$2,077.00 ","$1,558.08 ","$1,350.05 ","$1,239.97 ",$610.77 ,$581.56 ,"$1,374.97 ",$610.77 ,"$1,374.97 ",$610.77 ,"$1,237.89 ","$1,237.89 ",$610.77 ,"$1,237.89 ","$1,258.93 ","$1,599.29 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,557.75 ","$1,474.67 ","$1,474.67 ",$610.77 ,"$1,474.67 ","$1,765.45 ","$1,765.45 ","$1,765.45 ", N/A ,"$1,558.08 ","$1,765.45 ",$610.77 ,$397.29 ,"$1,165.20 ",$610.77 ,$859.88 ,$88.41 ,$80.37 ,$610.77 ,"$1,765.45 ","$1,308.79 ","$1,237.89 ",$581.56 ,"$1,869.30 ",$610.77 ,"$1,765.45 ","$1,755.07 ","$1,755.07 ",$610.77 ,"$1,350.05 " ST. JOSEPH'S HOSPITAL - BREESE,36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$3,114.00 ","$2,242.08 ",$120.56 ,"$3,114.00 ","$1,558.08 ","$2,024.10 ","$1,859.06 ",$610.77 ,$871.92 ,"$2,061.47 ",$610.77 ,"$2,061.47 ",$610.77 ,"$1,855.94 ","$1,855.94 ",$610.77 ,"$1,855.94 ","$1,258.93 ","$2,397.78 ","$1,558.08 ",$610.77 ,$622.99 ,"$2,335.50 ","$2,210.94 ","$2,210.94 ",$610.77 ,"$2,210.94 ","$2,646.90 ","$2,646.90 ","$2,646.90 ", N/A ,"$1,558.08 ","$2,646.90 ",$610.77 ,$397.29 ,"$1,746.95 ",$610.77 ,"$1,289.20 ",$132.62 ,$120.56 ,$610.77 ,"$2,646.90 ","$1,308.79 ","$1,855.94 ",$871.92 ,"$2,802.60 ",$610.77 ,"$2,646.90 ","$2,631.33 ","$2,631.33 ",$610.77 ,"$2,024.10 " ST. JOSEPH'S HOSPITAL - BREESE,36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,"$4,607.00 ","$3,317.04 ",$409.40 ,"$4,607.00 ","$3,600.20 ","$2,994.55 ","$2,750.38 ","$1,411.28 ","$1,289.96 ","$3,049.83 ","$1,411.28 ","$3,049.83 ","$1,411.28 ","$2,745.77 ","$2,745.77 ","$1,411.28 ","$2,745.77 ","$2,908.96 ","$3,547.39 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,455.25 ","$3,270.97 ","$3,270.97 ","$1,411.28 ","$3,270.97 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,600.19 ","$3,915.95 ","$1,411.28 ","$4,607.00 ","$2,584.53 ","$1,411.28 ","$1,907.30 ",$450.34 ,$409.40 ,"$1,411.28 ","$3,915.95 ","$3,024.16 ","$2,745.77 ","$1,289.96 ","$4,146.30 ","$1,411.28 ","$3,129.00 ","$3,892.92 ","$3,892.92 ","$1,411.28 ","$2,994.55 " ST. JOSEPH'S HOSPITAL - BREESE,36000101,29085,HC CAST APPL; HAND AND FOREARM,360,1 ,$325.00 ,$234.00 ,$91.00 ,$349.95 ,$349.95 ,$211.25 ,$194.03 ,$137.18 ,$91.00 ,$215.15 ,$137.18 ,$215.15 ,$137.18 ,$193.70 ,$193.70 ,$137.18 ,$193.70 ,$282.76 ,$250.25 ,$349.95 ,$137.18 ,$139.92 ,$243.75 ,$230.75 ,$230.75 ,$137.18 ,$230.75 ,$276.25 ,$276.25 ,$276.25 , N/A ,$325.00 ,$276.25 ,$137.18 ,$325.00 ,$182.33 ,$137.18 ,$134.55 ,$240.70 ,$218.82 ,$137.18 ,$276.25 ,$293.96 ,$193.70 ,$91.00 ,$292.50 ,$137.18 ,$276.25 ,$274.63 ,$274.63 ,$137.18 ,$211.25 ST. JOSEPH'S HOSPITAL - BREESE,36000108,19082,HC BREAST LOC BX PERC STEREO ADDN LESION,360,1 ,"$2,377.00 ","$1,711.44 ",$416.24 ,"$2,377.00 ", N/A ,"$1,545.05 ","$1,419.07 ", N/A ,$665.56 ,"$1,573.57 ", N/A ,"$1,573.57 ", N/A ,"$1,416.69 ","$1,416.69 ", N/A ,"$1,416.69 ", N/A ,"$1,830.29 ", N/A , N/A , N/A ,"$1,782.75 ","$1,687.67 ","$1,687.67 ", N/A ,"$1,687.67 ","$2,020.45 ","$2,020.45 ","$2,020.45 ", N/A , N/A ,"$2,020.45 ", N/A ,$416.24 ,"$1,333.50 ", N/A ,$984.08 ,$912.65 ,$829.68 , N/A ,"$2,020.45 ", N/A ,"$1,416.69 ",$665.56 ,"$2,139.30 ", N/A ,"$2,020.45 ","$2,008.57 ","$2,008.57 ", N/A ,"$1,545.05 " ST. JOSEPH'S HOSPITAL - BREESE,36000108,19082,HC BREAST LOC BX PERC STEREO ADDN LESION,360,1 ,"$3,565.00 ","$2,566.80 ",$416.24 ,"$3,565.00 ", N/A ,"$2,317.25 ","$2,128.31 ", N/A ,$998.20 ,"$2,360.03 ", N/A ,"$2,360.03 ", N/A ,"$2,124.74 ","$2,124.74 ", N/A ,"$2,124.74 ", N/A ,"$2,745.05 ", N/A , N/A , N/A ,"$2,673.75 ","$2,531.15 ","$2,531.15 ", N/A ,"$2,531.15 ","$3,030.25 ","$3,030.25 ","$3,030.25 ", N/A , N/A ,"$3,030.25 ", N/A ,$416.24 ,"$1,999.97 ", N/A ,"$1,475.91 ",$912.65 ,$829.68 , N/A ,"$3,030.25 ", N/A ,"$2,124.74 ",$998.20 ,"$3,208.50 ", N/A ,"$3,030.25 ","$3,012.43 ","$3,012.43 ", N/A ,"$2,317.25 " ST. JOSEPH'S HOSPITAL - BREESE,36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,"$1,691.00 ","$1,217.52 ",$410.06 ,"$1,691.00 ", N/A ,"$1,099.15 ","$1,009.53 ", N/A ,$473.48 ,"$1,119.44 ", N/A ,"$1,119.44 ", N/A ,"$1,007.84 ","$1,007.84 ", N/A ,"$1,007.84 ", N/A ,"$1,302.07 ", N/A , N/A , N/A ,"$1,268.25 ","$1,200.61 ","$1,200.61 ", N/A ,"$1,200.61 ","$1,437.35 ","$1,437.35 ","$1,437.35 ", N/A , N/A ,"$1,437.35 ", N/A ,$410.06 ,$948.65 , N/A ,$700.07 ,$912.65 ,$829.68 , N/A ,"$1,437.35 ", N/A ,"$1,007.84 ",$473.48 ,"$1,521.90 ", N/A ,"$1,437.35 ","$1,428.90 ","$1,428.90 ", N/A ,"$1,099.15 " ST. JOSEPH'S HOSPITAL - BREESE,36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,"$2,537.00 ","$1,826.64 ",$410.06 ,"$2,537.00 ", N/A ,"$1,649.05 ","$1,514.59 ", N/A ,$710.36 ,"$1,679.49 ", N/A ,"$1,679.49 ", N/A ,"$1,512.05 ","$1,512.05 ", N/A ,"$1,512.05 ", N/A ,"$1,953.49 ", N/A , N/A , N/A ,"$1,902.75 ","$1,801.27 ","$1,801.27 ", N/A ,"$1,801.27 ","$2,156.45 ","$2,156.45 ","$2,156.45 ", N/A , N/A ,"$2,156.45 ", N/A ,$410.06 ,"$1,423.26 ", N/A ,"$1,050.32 ",$912.65 ,$829.68 , N/A ,"$2,156.45 ", N/A ,"$1,512.05 ",$710.36 ,"$2,283.30 ", N/A ,"$2,156.45 ","$2,143.77 ","$2,143.77 ", N/A ,"$1,649.05 " ST. JOSEPH'S HOSPITAL - BREESE,36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,$732.00 ,$527.04 ,$80.37 ,$732.00 , N/A ,$475.80 ,$437.00 , N/A ,$204.96 ,$484.58 , N/A ,$484.58 , N/A ,$436.27 ,$436.27 , N/A ,$436.27 , N/A ,$563.64 , N/A , N/A , N/A ,$549.00 ,$519.72 ,$519.72 , N/A ,$519.72 ,$622.20 ,$622.20 ,$622.20 , N/A , N/A ,$622.20 , N/A ,$182.91 ,$410.65 , N/A ,$303.05 ,$88.41 ,$80.37 , N/A ,$622.20 , N/A ,$436.27 ,$204.96 ,$658.80 , N/A ,$622.20 ,$618.54 ,$618.54 , N/A ,$475.80 ST. JOSEPH'S HOSPITAL - BREESE,36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,"$1,098.00 ",$790.56 ,$80.37 ,"$1,098.00 ", N/A ,$713.70 ,$655.51 , N/A ,$307.44 ,$726.88 , N/A ,$726.88 , N/A ,$654.41 ,$654.41 , N/A ,$654.41 , N/A ,$845.46 , N/A , N/A , N/A ,$823.50 ,$779.58 ,$779.58 , N/A ,$779.58 ,$933.30 ,$933.30 ,$933.30 , N/A , N/A ,$933.30 , N/A ,$182.91 ,$615.98 , N/A ,$454.57 ,$88.41 ,$80.37 , N/A ,$933.30 , N/A ,$654.41 ,$307.44 ,$988.20 , N/A ,$933.30 ,$927.81 ,$927.81 , N/A ,$713.70 ST. JOSEPH'S HOSPITAL - BREESE,36000116,19286,HC BREAST NDL LOC BX ULTRA ADDN LESION,360,1 ,$732.00 ,$527.04 ,$80.37 ,$732.00 , N/A ,$475.80 ,$437.00 , N/A ,$204.96 ,$484.58 , N/A ,$484.58 , N/A ,$436.27 ,$436.27 , N/A ,$436.27 , N/A ,$563.64 , N/A , N/A , N/A ,$549.00 ,$519.72 ,$519.72 , N/A ,$519.72 ,$622.20 ,$622.20 ,$622.20 , N/A , N/A ,$622.20 , N/A ,$325.15 ,$410.65 , N/A ,$303.05 ,$88.41 ,$80.37 , N/A ,$622.20 , N/A ,$436.27 ,$204.96 ,$658.80 , N/A ,$622.20 ,$618.54 ,$618.54 , N/A ,$475.80 ST. JOSEPH'S HOSPITAL - BREESE,36000116,19286,HC BREAST NDL LOC BX ULTRA ADDN LESION,360,1 ,"$1,098.00 ",$790.56 ,$80.37 ,"$1,098.00 ", N/A ,$713.70 ,$655.51 , N/A ,$307.44 ,$726.88 , N/A ,$726.88 , N/A ,$654.41 ,$654.41 , N/A ,$654.41 , N/A ,$845.46 , N/A , N/A , N/A ,$823.50 ,$779.58 ,$779.58 , N/A ,$779.58 ,$933.30 ,$933.30 ,$933.30 , N/A , N/A ,$933.30 , N/A ,$325.15 ,$615.98 , N/A ,$454.57 ,$88.41 ,$80.37 , N/A ,$933.30 , N/A ,$654.41 ,$307.44 ,$988.20 , N/A ,$933.30 ,$927.81 ,$927.81 , N/A ,$713.70 ST. JOSEPH'S HOSPITAL - BREESE,36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$2,502.00 ","$1,801.44 ",$700.56 ,"$7,152.06 ","$7,152.05 ","$1,626.30 ","$1,493.69 ","$2,803.60 ",$700.56 ,"$1,656.32 ","$2,803.60 ","$1,656.32 ","$2,451.96 ","$1,491.19 ","$1,491.19 ","$2,451.96 ","$1,491.19 ","$2,502.00 ","$1,926.54 ","$7,152.06 ","$2,803.60 ","$2,451.96 ","$1,876.50 ","$1,776.42 ","$1,776.42 ","$2,803.60 ","$1,776.42 ","$2,126.70 ","$2,126.70 ","$2,126.70 ", N/A ,"$2,502.00 ","$2,126.70 ","$2,451.96 ","$2,502.00 ","$1,403.62 ","$2,803.60 ","$1,035.83 ","$1,260.18 ","$1,145.62 ","$2,803.60 ","$2,126.70 ","$6,007.73 ","$1,491.19 ",$700.56 ,"$2,251.80 ","$2,803.60 ","$2,126.70 ","$2,114.19 ","$2,114.19 ","$2,803.60 ","$1,626.30 " ST. JOSEPH'S HOSPITAL - BREESE,36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$2,500.00 ","$1,800.00 ",$333.49 ,"$3,572.10 ","$3,572.10 ","$1,625.00 ","$1,492.50 ","$1,400.26 ",$700.00 ,"$1,655.00 ","$1,400.26 ","$1,655.00 ","$1,400.26 ","$1,490.00 ","$1,490.00 ","$1,400.26 ","$1,490.00 ","$2,500.00 ","$1,925.00 ","$3,572.10 ","$1,400.26 ","$1,428.27 ","$1,875.00 ","$1,775.00 ","$1,775.00 ","$1,400.26 ","$1,775.00 ","$2,125.00 ","$2,125.00 ","$2,125.00 ", N/A ,"$2,500.00 ","$2,125.00 ","$1,400.26 ","$2,500.00 ","$1,402.50 ","$1,400.26 ","$1,035.00 ",$366.84 ,$333.49 ,"$1,400.26 ","$2,125.00 ","$3,000.57 ","$1,490.00 ",$700.00 ,"$2,250.00 ","$1,400.26 ","$2,125.00 ","$2,112.50 ","$2,112.50 ","$1,400.26 ","$1,625.00 " ST. JOSEPH'S HOSPITAL - BREESE,36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,$263.00 ,$189.36 ,$73.64 ,"$1,388.90 ","$1,388.90 ",$170.95 ,$157.01 ,$544.45 ,$73.64 ,$174.11 ,$544.45 ,$174.11 ,$257.74 ,$156.75 ,$156.75 ,$257.74 ,$156.75 ,$263.00 ,$202.51 ,"$1,388.89 ",$544.45 ,$257.74 ,$197.25 ,$186.73 ,$186.73 ,$544.45 ,$186.73 ,$223.55 ,$223.55 ,$223.55 , N/A ,$263.00 ,$223.55 ,$257.74 ,$263.00 ,$147.54 ,$544.45 ,$108.88 ,$105.00 ,$95.45 ,$544.45 ,$223.55 ,"$1,166.67 ",$156.75 ,$73.64 ,$236.70 ,$544.45 ,$223.55 ,$222.24 ,$222.24 ,$544.45 ,$170.95 ST. JOSEPH'S HOSPITAL - BREESE,36000148,36620,HC CATH/CANN ARTERY PERC 36620,360,1 ,"$1,226.00 ",$882.72 ,$343.28 ,"$1,226.00 ", N/A ,$796.90 ,$731.92 , N/A ,$343.28 ,$811.61 , N/A ,$811.61 , N/A ,$730.70 ,$730.70 , N/A ,$730.70 , N/A ,$944.02 , N/A , N/A , N/A ,$919.50 ,$870.46 ,$870.46 , N/A ,$870.46 ,"$1,042.10 ","$1,042.10 ","$1,042.10 ", N/A , N/A ,"$1,042.10 ", N/A ,"$1,226.00 ",$687.79 , N/A ,$507.56 ,"$1,226.00 ","$1,226.00 ", N/A ,"$1,042.10 ", N/A ,$730.70 ,$343.28 ,"$1,103.40 ", N/A ,"$1,042.10 ","$1,035.97 ","$1,035.97 ", N/A ,$796.90 ST. JOSEPH'S HOSPITAL - BREESE,36000157,38220,HC ASP BONE MARROW ONLY,360,1 ,"$4,486.00 ","$3,229.92 ",$409.40 ,"$4,486.00 ","$3,600.20 ","$2,915.90 ","$2,678.14 ","$1,411.28 ","$1,256.08 ","$2,969.73 ","$1,411.28 ","$2,969.73 ","$1,411.28 ","$2,673.66 ","$2,673.66 ","$1,411.28 ","$2,673.66 ","$2,908.96 ","$3,454.22 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,364.50 ","$3,185.06 ","$3,185.06 ","$1,411.28 ","$3,185.06 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,600.19 ","$3,813.10 ","$1,411.28 ","$4,486.00 ","$2,516.65 ","$1,411.28 ","$1,857.20 ",$450.34 ,$409.40 ,"$1,411.28 ","$3,813.10 ","$3,024.16 ","$2,673.66 ","$1,256.08 ","$4,037.40 ","$1,411.28 ","$3,129.00 ","$3,790.67 ","$3,790.67 ","$1,411.28 ","$2,915.90 " ST. JOSEPH'S HOSPITAL - BREESE,36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$4,485.00 ","$3,229.20 ",$433.73 ,"$4,485.00 ","$3,600.20 ","$2,915.25 ","$2,677.55 ","$1,411.28 ","$1,255.80 ","$2,969.07 ","$1,411.28 ","$2,969.07 ","$1,411.28 ","$2,673.06 ","$2,673.06 ","$1,411.28 ","$2,673.06 ","$2,908.96 ","$3,453.45 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,363.75 ","$3,184.35 ","$3,184.35 ","$1,411.28 ","$3,184.35 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,600.19 ","$3,812.25 ","$1,411.28 ","$4,485.00 ","$2,516.09 ","$1,411.28 ","$1,856.79 ",$477.10 ,$433.73 ,"$1,411.28 ","$3,812.25 ","$3,024.16 ","$2,673.06 ","$1,255.80 ","$4,036.50 ","$1,411.28 ","$3,129.00 ","$3,789.83 ","$3,789.83 ","$1,411.28 ","$2,915.25 " ST. JOSEPH'S HOSPITAL - BREESE,36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,"$1,074.00 ",$773.28 ,$300.72 ,"$1,074.00 ",$933.18 ,$698.10 ,$641.18 ,$365.80 ,$300.72 ,$710.99 ,$365.80 ,$710.99 ,$365.80 ,$640.10 ,$640.10 ,$365.80 ,$640.10 ,$754.00 ,$826.98 ,$933.16 ,$365.80 ,$373.12 ,$805.50 ,$762.54 ,$762.54 ,$365.80 ,$762.54 ,$912.90 ,$912.90 ,$912.90 , N/A ,$933.16 ,$912.90 ,$365.80 ,"$1,074.00 ",$602.51 ,$365.80 ,$444.64 , N/A , N/A ,$365.80 ,$912.90 ,$783.86 ,$640.10 ,$300.72 ,$966.60 ,$365.80 ,$912.90 ,$907.53 ,$907.53 ,$365.80 ,$698.10 ST. JOSEPH'S HOSPITAL - BREESE,36000187,54150,HC CIRCUMCISION OP,360,1 ,"$5,871.00 ","$4,227.12 ","$1,008.88 ","$5,871.00 ","$4,453.30 ","$3,816.15 ","$3,504.99 ","$1,745.69 ","$1,643.88 ","$3,886.60 ","$1,745.69 ","$3,886.60 ","$1,745.69 ","$3,499.12 ","$3,499.12 ","$1,745.69 ","$3,499.12 ","$3,598.26 ","$4,520.67 ","$4,453.29 ","$1,745.69 ","$1,780.60 ","$4,403.25 ","$4,168.41 ","$4,168.41 ","$1,745.69 ","$4,168.41 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,453.29 ","$4,990.35 ","$1,745.69 ","$5,871.00 ","$3,293.63 ","$1,745.69 ","$2,430.59 ","$1,109.77 ","$1,008.88 ","$1,745.69 ","$4,990.35 ","$3,740.76 ","$3,499.12 ","$1,643.88 ","$5,283.90 ","$1,745.69 ","$3,129.00 ","$4,961.00 ","$4,961.00 ","$1,745.69 ","$3,816.15 " ST. JOSEPH'S HOSPITAL - BREESE,36000194,62270,HC LUMBAR PUNCTURE,360,1 ,$678.00 ,$488.16 ,$189.84 ,"$1,546.98 ","$1,546.98 ",$440.70 ,$404.77 ,$606.41 ,$189.84 ,$448.84 ,$606.41 ,$448.84 ,$606.41 ,$404.09 ,$404.09 ,$606.41 ,$404.09 ,$678.00 ,$522.06 ,"$1,546.96 ",$606.41 ,$618.54 ,$508.50 ,$481.38 ,$481.38 ,$606.41 ,$481.38 ,$576.30 ,$576.30 ,$576.30 , N/A ,$678.00 ,$576.30 ,$606.41 ,$678.00 ,$380.36 ,$606.41 ,$280.69 ,$382.51 ,$347.74 ,$606.41 ,$576.30 ,"$1,299.45 ",$404.09 ,$189.84 ,$610.20 ,$606.41 ,$576.30 ,$572.91 ,$572.91 ,$606.41 ,$440.70 ST. JOSEPH'S HOSPITAL - BREESE,36000223,36575,HC REPAIR CATH CV W/O PORT/PUMP,360,1 ,"$1,656.12 ","$1,192.41 ",$333.49 ,"$1,656.12 ","$1,388.90 ","$1,076.48 ",$988.70 ,$544.45 ,$463.71 ,"$1,096.35 ",$544.45 ,"$1,096.35 ",$544.45 ,$987.05 ,$987.05 ,$544.45 ,$987.05 ,"$1,122.22 ","$1,275.21 ","$1,388.89 ",$544.45 ,$555.34 ,"$1,242.09 ","$1,175.85 ","$1,175.85 ",$544.45 ,"$1,175.85 ","$1,407.70 ","$1,407.70 ","$1,407.70 ", N/A ,"$1,388.89 ","$1,407.70 ",$544.45 ,"$1,656.12 ",$929.08 ,$544.45 ,$685.63 ,$366.84 ,$333.49 ,$544.45 ,"$1,407.70 ","$1,166.67 ",$987.05 ,$463.71 ,"$1,490.51 ",$544.45 ,"$1,407.70 ","$1,399.42 ","$1,399.42 ",$544.45 ,"$1,076.48 " ST. JOSEPH'S HOSPITAL - BREESE,36000334,63650,HC IMPLANT NEUROELECTRODES,360,1 ,"$7,760.00 ","$5,587.20 ","$2,172.80 ","$15,854.85 ","$15,854.85 ","$5,044.00 ","$4,632.72 ","$6,215.10 ","$2,172.80 ","$5,137.12 ","$6,215.10 ","$5,137.12 ","$6,215.10 ","$4,624.96 ","$4,624.96 ","$6,215.10 ","$4,624.96 ","$7,760.00 ","$5,975.20 ","$15,854.85 ","$6,215.10 ","$6,339.40 ","$5,820.00 ","$5,509.60 ","$5,509.60 ","$6,215.10 ","$5,509.60 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$7,760.00 ","$6,596.00 ","$6,215.10 ","$7,760.00 ","$4,353.36 ","$6,215.10 ","$3,212.64 ","$3,630.03 ","$3,300.03 ","$6,215.10 ","$6,596.00 ","$13,318.08 ","$4,624.96 ","$2,172.80 ","$6,984.00 ","$6,215.10 ","$3,129.00 ","$6,557.20 ","$6,557.20 ","$6,215.10 ","$5,044.00 " ST. JOSEPH'S HOSPITAL - BREESE,36000397,27301,HC I AND D ABSC/BURSA THIGH/KNEE,360,1 ,"$7,645.00 ","$5,504.40 ",$705.39 ,"$7,645.00 ","$6,202.00 ","$4,969.25 ","$4,564.07 ","$2,431.18 ","$2,140.60 ","$5,060.99 ","$2,431.18 ","$5,060.99 ","$2,431.18 ","$4,556.42 ","$4,556.42 ","$2,431.18 ","$4,556.42 ","$5,011.21 ","$5,886.65 ","$6,202.00 ","$2,431.18 ","$2,479.80 ","$5,733.75 ","$5,427.95 ","$5,427.95 ","$2,431.18 ","$5,427.95 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$6,202.00 ","$6,498.25 ","$2,431.18 ","$7,645.00 ","$4,288.85 ","$2,431.18 ","$3,165.03 ",$775.93 ,$705.39 ,"$2,431.18 ","$6,498.25 ","$5,209.68 ","$4,556.42 ","$2,140.60 ","$6,880.50 ","$2,431.18 ","$3,129.00 ","$6,460.03 ","$6,460.03 ","$2,431.18 ","$4,969.25 " ST. JOSEPH'S HOSPITAL - BREESE,36000420,26735,HC TX FX OPEN SHAFT FINGER/THUMB W/INT FIX EACH,360,1 ,"$9,025.00 ","$6,498.00 ","$2,527.00 ","$9,025.00 ","$7,146.53 ","$5,866.25 ","$5,387.93 ","$2,801.44 ","$2,527.00 ","$5,974.55 ","$2,801.44 ","$5,974.55 ","$2,801.44 ","$5,378.90 ","$5,378.90 ","$2,801.44 ","$5,378.90 ","$5,774.38 ","$6,949.25 ","$7,146.51 ","$2,801.44 ","$2,857.46 ","$6,768.75 ","$6,407.75 ","$6,407.75 ","$2,801.44 ","$6,407.75 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$7,146.51 ","$7,671.25 ","$2,801.44 ","$9,025.00 ","$5,063.03 ","$2,801.44 ","$3,736.35 ","$3,318.38 ","$3,016.71 ","$2,801.44 ","$7,671.25 ","$6,003.07 ","$5,378.90 ","$2,527.00 ","$8,122.50 ","$2,801.44 ","$3,129.00 ","$7,626.13 ","$7,626.13 ","$2,801.44 ","$5,866.25 " ST. JOSEPH'S HOSPITAL - BREESE,36000719,41010,HC INCISION LINGUAL FRENUM,360,1 ,"$6,218.00 ","$4,476.96 ",$861.34 ,"$6,218.00 ","$3,332.73 ","$4,041.70 ","$3,712.15 ","$1,306.43 ","$1,741.04 ","$4,116.32 ","$1,306.43 ","$4,116.32 ","$1,306.43 ","$3,705.93 ","$3,705.93 ","$1,306.43 ","$3,705.93 ","$2,692.83 ","$4,787.86 ","$3,332.72 ","$1,306.43 ","$1,332.55 ","$4,663.50 ","$4,414.78 ","$4,414.78 ","$1,306.43 ","$4,414.78 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,332.72 ","$5,285.30 ","$1,306.43 ","$6,218.00 ","$3,488.30 ","$1,306.43 ","$2,574.25 ",$947.47 ,$861.34 ,"$1,306.43 ","$5,285.30 ","$2,799.48 ","$3,705.93 ","$1,741.04 ","$5,596.20 ","$1,306.43 ","$3,129.00 ","$5,254.21 ","$5,254.21 ","$1,306.43 ","$4,041.70 " ST. JOSEPH'S HOSPITAL - BREESE,36000755,41018,HC I AND D MASTICATOR SPACE,360,1 ,"$4,667.00 ","$3,360.24 ",$861.34 ,"$4,667.00 ","$3,332.73 ","$3,033.55 ","$2,786.20 ","$1,306.43 ","$1,306.76 ","$3,089.55 ","$1,306.43 ","$3,089.55 ","$1,306.43 ","$2,781.53 ","$2,781.53 ","$1,306.43 ","$2,781.53 ","$2,692.83 ","$3,593.59 ","$3,332.72 ","$1,306.43 ","$1,332.55 ","$3,500.25 ","$3,313.57 ","$3,313.57 ","$1,306.43 ","$3,313.57 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,332.72 ","$3,966.95 ","$1,306.43 ","$4,667.00 ","$2,618.19 ","$1,306.43 ","$1,932.14 ",$947.47 ,$861.34 ,"$1,306.43 ","$3,966.95 ","$2,799.48 ","$2,781.53 ","$1,306.76 ","$4,200.30 ","$1,306.43 ","$3,129.00 ","$3,943.62 ","$3,943.62 ","$1,306.43 ","$3,033.55 " ST. JOSEPH'S HOSPITAL - BREESE,36000758,43460,HC PRESSURE TREATMENT ESOPHAGUS,360,1 ,"$1,633.00 ","$1,175.76 ",$457.24 ,"$1,633.00 ", N/A ,"$1,061.45 ",$974.90 , N/A ,$457.24 ,"$1,081.05 ", N/A ,"$1,081.05 ", N/A ,$973.27 ,$973.27 , N/A ,$973.27 , N/A ,"$1,257.41 ", N/A , N/A , N/A ,"$1,224.75 ","$1,159.43 ","$1,159.43 ", N/A ,"$1,159.43 ","$1,388.05 ","$1,388.05 ","$1,388.05 ", N/A , N/A ,"$1,388.05 ", N/A ,"$1,633.00 ",$916.11 , N/A ,$676.06 , N/A , N/A , N/A ,"$1,388.05 ", N/A ,$973.27 ,$457.24 ,"$1,469.70 ", N/A ,"$1,388.05 ","$1,379.89 ","$1,379.89 ", N/A ,"$1,061.45 " ST. JOSEPH'S HOSPITAL - BREESE,36000761,54115,HC REMOVAL FOREIGN BODY DEEP PENILE TISSUE,360,1 ,"$7,761.00 ","$5,587.92 ","$1,610.14 ","$7,761.00 ","$6,202.00 ","$5,044.65 ","$4,633.32 ","$2,431.18 ","$2,173.08 ","$5,137.78 ","$2,431.18 ","$5,137.78 ","$2,431.18 ","$4,625.56 ","$4,625.56 ","$2,431.18 ","$4,625.56 ","$5,011.21 ","$5,975.97 ","$6,202.00 ","$2,431.18 ","$2,479.80 ","$5,820.75 ","$5,510.31 ","$5,510.31 ","$2,431.18 ","$5,510.31 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$6,202.00 ","$6,596.85 ","$2,431.18 ","$7,761.00 ","$4,353.92 ","$2,431.18 ","$3,213.05 ","$1,771.15 ","$1,610.14 ","$2,431.18 ","$6,596.85 ","$5,209.68 ","$4,625.56 ","$2,173.08 ","$6,984.90 ","$2,431.18 ","$3,129.00 ","$6,558.05 ","$6,558.05 ","$2,431.18 ","$5,044.65 " ST. JOSEPH'S HOSPITAL - BREESE,36000777,58180,HC PARTIAL HYSTERECTOMY,360,1 ,"$2,888.79 ","$2,079.93 ",$808.86 ,"$2,888.79 ", N/A ,"$1,877.71 ","$1,724.61 ", N/A ,$808.86 ,"$1,912.38 ", N/A ,"$1,912.38 ", N/A ,"$1,721.72 ","$1,721.72 ", N/A ,"$1,721.72 ", N/A ,"$2,224.37 ", N/A , N/A , N/A ,"$2,166.59 ","$2,051.04 ","$2,051.04 ", N/A ,"$2,051.04 ","$2,455.47 ","$2,455.47 ","$2,455.47 ", N/A , N/A ,"$2,455.47 ", N/A ,"$2,888.79 ","$1,620.61 ", N/A ,"$1,195.96 ", N/A , N/A , N/A ,"$2,455.47 ", N/A ,"$1,721.72 ",$808.86 ,"$2,599.91 ", N/A ,"$2,455.47 ","$2,441.03 ","$2,441.03 ", N/A ,"$1,877.71 " ST. JOSEPH'S HOSPITAL - BREESE,36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,$861.00 ,$619.92 ,$241.08 ,$861.00 , N/A ,$559.65 ,$514.02 , N/A ,$241.08 ,$569.98 , N/A ,$569.98 , N/A ,$513.16 ,$513.16 , N/A ,$513.16 , N/A ,$662.97 , N/A , N/A , N/A ,$645.75 ,$611.31 ,$611.31 , N/A ,$611.31 ,$731.85 ,$731.85 ,$731.85 , N/A , N/A ,$731.85 , N/A ,$861.00 ,$483.02 , N/A ,$356.45 , N/A , N/A , N/A ,$731.85 , N/A ,$513.16 ,$241.08 ,$774.90 , N/A ,$731.85 ,$727.55 ,$727.55 , N/A ,$559.65 ST. JOSEPH'S HOSPITAL - BREESE,36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,$981.00 ,$706.32 ,$274.68 ,$981.00 , N/A ,$637.65 ,$585.66 , N/A ,$274.68 ,$649.42 , N/A ,$649.42 , N/A ,$584.68 ,$584.68 , N/A ,$584.68 , N/A ,$755.37 , N/A , N/A , N/A ,$735.75 ,$696.51 ,$696.51 , N/A ,$696.51 ,$833.85 ,$833.85 ,$833.85 , N/A , N/A ,$833.85 , N/A ,$981.00 ,$550.34 , N/A ,$406.13 , N/A , N/A , N/A ,$833.85 , N/A ,$584.68 ,$274.68 ,$882.90 , N/A ,$833.85 ,$828.95 ,$828.95 , N/A ,$637.65 ST. JOSEPH'S HOSPITAL - BREESE,36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,143.00 ",$822.96 ,$320.04 ,"$1,143.00 ", N/A ,$742.95 ,$682.37 , N/A ,$320.04 ,$756.67 , N/A ,$756.67 , N/A ,$681.23 ,$681.23 , N/A ,$681.23 , N/A ,$880.11 , N/A , N/A , N/A ,$857.25 ,$811.53 ,$811.53 , N/A ,$811.53 ,$971.55 ,$971.55 ,$971.55 , N/A , N/A ,$971.55 , N/A ,"$1,143.00 ",$641.22 , N/A ,$473.20 , N/A , N/A , N/A ,$971.55 , N/A ,$681.23 ,$320.04 ,"$1,028.70 ", N/A ,$971.55 ,$965.84 ,$965.84 , N/A ,$742.95 ST. JOSEPH'S HOSPITAL - BREESE,36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,292.00 ",$930.24 ,$361.76 ,"$1,292.00 ", N/A ,$839.80 ,$771.32 , N/A ,$361.76 ,$855.30 , N/A ,$855.30 , N/A ,$770.03 ,$770.03 , N/A ,$770.03 , N/A ,$994.84 , N/A , N/A , N/A ,$969.00 ,$917.32 ,$917.32 , N/A ,$917.32 ,"$1,098.20 ","$1,098.20 ","$1,098.20 ", N/A , N/A ,"$1,098.20 ", N/A ,"$1,292.00 ",$724.81 , N/A ,$534.89 , N/A , N/A , N/A ,"$1,098.20 ", N/A ,$770.03 ,$361.76 ,"$1,162.80 ", N/A ,"$1,098.20 ","$1,091.74 ","$1,091.74 ", N/A ,$839.80 ST. JOSEPH'S HOSPITAL - BREESE,36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$1,440.00 ","$1,036.80 ",$403.20 ,"$1,440.00 ", N/A ,$936.00 ,$859.68 , N/A ,$403.20 ,$953.28 , N/A ,$953.28 , N/A ,$858.24 ,$858.24 , N/A ,$858.24 , N/A ,"$1,108.80 ", N/A , N/A , N/A ,"$1,080.00 ","$1,022.40 ","$1,022.40 ", N/A ,"$1,022.40 ","$1,224.00 ","$1,224.00 ","$1,224.00 ", N/A , N/A ,"$1,224.00 ", N/A ,"$1,440.00 ",$807.84 , N/A ,$596.16 , N/A , N/A , N/A ,"$1,224.00 ", N/A ,$858.24 ,$403.20 ,"$1,296.00 ", N/A ,"$1,224.00 ","$1,216.80 ","$1,216.80 ", N/A ,$936.00 ST. JOSEPH'S HOSPITAL - BREESE,36060025,N/A,HC OR LEVEL 1 INITIAL 30MIN,360,1 ,"$2,656.00 ","$1,912.32 ",$743.68 ,"$2,656.00 ", N/A ,"$1,726.40 ","$1,585.63 ", N/A ,$743.68 ,"$1,758.27 ", N/A ,"$1,758.27 ", N/A ,"$1,582.98 ","$1,582.98 ", N/A ,"$1,582.98 ", N/A ,"$2,045.12 ", N/A , N/A , N/A ,"$1,992.00 ","$1,885.76 ","$1,885.76 ", N/A ,"$1,885.76 ","$2,257.60 ","$2,257.60 ","$2,257.60 ", N/A , N/A ,"$2,257.60 ", N/A ,"$2,656.00 ","$1,490.02 ", N/A ,"$1,099.58 ", N/A , N/A , N/A ,"$2,257.60 ", N/A ,"$1,582.98 ",$743.68 ,"$2,390.40 ", N/A ,"$2,257.60 ","$2,244.32 ","$2,244.32 ", N/A ,"$1,726.40 " ST. JOSEPH'S HOSPITAL - BREESE,36060026,N/A,HC OR LEVEL 2 INITIAL 30MIN,360,1 ,"$4,573.00 ","$3,292.56 ","$1,280.44 ","$4,573.00 ", N/A ,"$2,972.45 ","$2,730.08 ", N/A ,"$1,280.44 ","$3,027.33 ", N/A ,"$3,027.33 ", N/A ,"$2,725.51 ","$2,725.51 ", N/A ,"$2,725.51 ", N/A ,"$3,521.21 ", N/A , N/A , N/A ,"$3,429.75 ","$3,246.83 ","$3,246.83 ", N/A ,"$3,246.83 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$3,887.05 ", N/A ,"$4,573.00 ","$2,565.45 ", N/A ,"$1,893.22 ", N/A , N/A , N/A ,"$3,887.05 ", N/A ,"$2,725.51 ","$1,280.44 ","$4,115.70 ", N/A ,"$3,129.00 ","$3,864.19 ","$3,864.19 ", N/A ,"$2,972.45 " ST. JOSEPH'S HOSPITAL - BREESE,36060027,N/A,HC OR LEVEL 3 INITIAL 30MIN,360,1 ,"$5,949.00 ","$4,283.28 ","$1,665.72 ","$5,949.00 ", N/A ,"$3,866.85 ","$3,551.55 ", N/A ,"$1,665.72 ","$3,938.24 ", N/A ,"$3,938.24 ", N/A ,"$3,545.60 ","$3,545.60 ", N/A ,"$3,545.60 ", N/A ,"$4,580.73 ", N/A , N/A , N/A ,"$4,461.75 ","$4,223.79 ","$4,223.79 ", N/A ,"$4,223.79 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$5,056.65 ", N/A ,"$5,949.00 ","$3,337.39 ", N/A ,"$2,462.89 ", N/A , N/A , N/A ,"$5,056.65 ", N/A ,"$3,545.60 ","$1,665.72 ","$5,354.10 ", N/A ,"$3,129.00 ","$5,026.91 ","$5,026.91 ", N/A ,"$3,866.85 " ST. JOSEPH'S HOSPITAL - BREESE,36060028,N/A,HC OR LEVEL 4 INITIAL 30MIN,360,1 ,"$6,224.00 ","$4,481.28 ","$1,742.72 ","$6,224.00 ", N/A ,"$4,045.60 ","$3,715.73 ", N/A ,"$1,742.72 ","$4,120.29 ", N/A ,"$4,120.29 ", N/A ,"$3,709.50 ","$3,709.50 ", N/A ,"$3,709.50 ", N/A ,"$4,792.48 ", N/A , N/A , N/A ,"$4,668.00 ","$4,419.04 ","$4,419.04 ", N/A ,"$4,419.04 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$5,290.40 ", N/A ,"$6,224.00 ","$3,491.66 ", N/A ,"$2,576.74 ", N/A , N/A , N/A ,"$5,290.40 ", N/A ,"$3,709.50 ","$1,742.72 ","$5,601.60 ", N/A ,"$3,129.00 ","$5,259.28 ","$5,259.28 ", N/A ,"$4,045.60 " ST. JOSEPH'S HOSPITAL - BREESE,36060029,N/A,HC OR LEVEL 5 INITIAL 30MIN,360,1 ,"$6,534.00 ","$4,704.48 ","$1,829.52 ","$6,534.00 ", N/A ,"$4,247.10 ","$3,900.80 ", N/A ,"$1,829.52 ","$4,325.51 ", N/A ,"$4,325.51 ", N/A ,"$3,894.26 ","$3,894.26 ", N/A ,"$3,894.26 ", N/A ,"$5,031.18 ", N/A , N/A , N/A ,"$4,900.50 ","$4,639.14 ","$4,639.14 ", N/A ,"$4,639.14 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$5,553.90 ", N/A ,"$6,534.00 ","$3,665.57 ", N/A ,"$2,705.08 ", N/A , N/A , N/A ,"$5,553.90 ", N/A ,"$3,894.26 ","$1,829.52 ","$5,880.60 ", N/A ,"$3,129.00 ","$5,521.23 ","$5,521.23 ", N/A ,"$4,247.10 " ST. JOSEPH'S HOSPITAL - BREESE,36080006,64400,HC NERVE BLOCK TRIGEMINAL,360,1 ,$808.00 ,$581.76 ,$226.24 ,$808.00 ,$652.78 ,$525.20 ,$482.38 ,$255.89 ,$226.24 ,$534.90 ,$255.89 ,$534.90 ,$255.89 ,$481.57 ,$481.57 ,$255.89 ,$481.57 ,$527.44 ,$622.16 ,$652.77 ,$255.89 ,$261.00 ,$606.00 ,$573.68 ,$573.68 ,$255.89 ,$573.68 ,$686.80 ,$686.80 ,$686.80 , N/A ,$652.77 ,$686.80 ,$255.89 ,$808.00 ,$453.29 ,$255.89 ,$334.51 ,$325.59 ,$295.99 ,$255.89 ,$686.80 ,$548.32 ,$481.57 ,$226.24 ,$727.20 ,$255.89 ,$686.80 ,$682.76 ,$682.76 ,$255.89 ,$525.20 ST. JOSEPH'S HOSPITAL - BREESE,36080008,64417,HC NERVE BLOCK AXILLARY NERVE,360,1 ,"$2,653.00 ","$1,910.16 ",$295.99 ,"$2,653.00 ","$2,045.95 ","$1,724.45 ","$1,583.84 ",$802.01 ,$742.84 ,"$1,756.29 ",$802.01 ,"$1,756.29 ",$802.01 ,"$1,581.19 ","$1,581.19 ",$802.01 ,"$1,581.19 ","$1,653.13 ","$2,042.81 ","$2,045.96 ",$802.01 ,$818.05 ,"$1,989.75 ","$1,883.63 ","$1,883.63 ",$802.01 ,"$1,883.63 ","$2,255.05 ","$2,255.05 ","$2,255.05 ", N/A ,"$2,045.96 ","$2,255.05 ",$802.01 ,"$2,653.00 ","$1,488.33 ",$802.01 ,"$1,098.34 ",$325.59 ,$295.99 ,$802.01 ,"$2,255.05 ","$1,718.60 ","$1,581.19 ",$742.84 ,"$2,387.70 ",$802.01 ,"$2,255.05 ","$2,241.79 ","$2,241.79 ",$802.01 ,"$1,724.45 " ST. JOSEPH'S HOSPITAL - BREESE,36100015,11010,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISSUE,361,1 ,"$1,892.00 ","$1,362.24 ",$529.76 ,"$1,892.00 ","$1,558.08 ","$1,229.80 ","$1,129.52 ",$610.77 ,$529.76 ,"$1,252.50 ",$610.77 ,"$1,252.50 ",$610.77 ,"$1,127.63 ","$1,127.63 ",$610.77 ,"$1,127.63 ","$1,258.93 ","$1,456.84 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,419.00 ","$1,343.32 ","$1,343.32 ",$610.77 ,"$1,343.32 ","$1,608.20 ","$1,608.20 ","$1,608.20 ", N/A ,"$1,558.08 ","$1,608.20 ",$610.77 ,"$1,892.00 ","$1,061.41 ",$610.77 ,$783.29 ,$954.22 ,$867.47 ,$610.77 ,"$1,608.20 ","$1,308.79 ","$1,127.63 ",$529.76 ,"$1,702.80 ",$610.77 ,"$1,608.20 ","$1,598.74 ","$1,598.74 ",$610.77 ,"$1,229.80 " ST. JOSEPH'S HOSPITAL - BREESE,36100026,36510,HC UMBILICAL CATHETER INSERTION NEWBORN,361,1 ,$853.00 ,$614.16 ,$238.84 ,$853.00 , N/A ,$554.45 ,$509.24 , N/A ,$238.84 ,$564.69 , N/A ,$564.69 , N/A ,$508.39 ,$508.39 , N/A ,$508.39 , N/A ,$656.81 , N/A , N/A , N/A ,$639.75 ,$605.63 ,$605.63 , N/A ,$605.63 ,$725.05 ,$725.05 ,$725.05 , N/A , N/A ,$725.05 , N/A ,$853.00 ,$478.53 , N/A ,$353.14 , N/A , N/A , N/A ,$725.05 , N/A ,$508.39 ,$238.84 ,$767.70 , N/A ,$725.05 ,$720.79 ,$720.79 , N/A ,$554.45 ST. JOSEPH'S HOSPITAL - BREESE,36100034,55876,HC PLACE DEVICE/MARKER PROSTATE,361,1 ,"$4,273.00 ","$3,076.56 ",$984.50 ,"$4,273.00 ","$3,218.75 ","$2,777.45 ","$2,550.98 ","$1,261.75 ","$1,196.44 ","$2,828.73 ","$1,261.75 ","$2,828.73 ","$1,261.75 ","$2,546.71 ","$2,546.71 ","$1,261.75 ","$2,546.71 ","$2,600.75 ","$3,290.21 ","$3,218.75 ","$1,261.75 ","$1,286.98 ","$3,204.75 ","$3,033.83 ","$3,033.83 ","$1,261.75 ","$3,033.83 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,218.75 ","$3,632.05 ","$1,261.75 ","$4,273.00 ","$2,397.15 ","$1,261.75 ","$1,769.02 ","$1,082.95 ",$984.50 ,"$1,261.75 ","$3,632.05 ","$2,703.75 ","$2,546.71 ","$1,196.44 ","$3,845.70 ","$1,261.75 ","$3,129.00 ","$3,610.69 ","$3,610.69 ","$1,261.75 ","$2,777.45 " ST. JOSEPH'S HOSPITAL - BREESE,36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,$969.00 ,$697.68 ,$271.32 ,$979.15 ,$979.15 ,$629.85 ,$578.49 ,$383.83 ,$271.32 ,$641.48 ,$383.83 ,$641.48 ,$383.83 ,$577.52 ,$577.52 ,$383.83 ,$577.52 ,$791.15 ,$746.13 ,$979.15 ,$383.83 ,$391.50 ,$726.75 ,$687.99 ,$687.99 ,$383.83 ,$687.99 ,$823.65 ,$823.65 ,$823.65 , N/A ,$969.00 ,$823.65 ,$383.83 ,$969.00 ,$543.61 ,$383.83 ,$401.17 ,$359.48 ,$326.80 ,$383.83 ,$823.65 ,$822.49 ,$577.52 ,$271.32 ,$872.10 ,$383.83 ,$823.65 ,$818.81 ,$818.81 ,$383.83 ,$629.85 ST. JOSEPH'S HOSPITAL - BREESE,36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,$646.00 ,$465.12 ,$180.88 ,$652.78 ,$652.78 ,$419.90 ,$385.66 ,$255.89 ,$180.88 ,$427.65 ,$255.89 ,$427.65 ,$255.89 ,$385.02 ,$385.02 ,$255.89 ,$385.02 ,$527.44 ,$497.42 ,$652.77 ,$255.89 ,$261.00 ,$484.50 ,$458.66 ,$458.66 ,$255.89 ,$458.66 ,$549.10 ,$549.10 ,$549.10 , N/A ,$646.00 ,$549.10 ,$255.89 ,$646.00 ,$362.41 ,$255.89 ,$267.44 ,$239.66 ,$217.87 ,$255.89 ,$549.10 ,$548.32 ,$385.02 ,$180.88 ,$581.40 ,$255.89 ,$549.10 ,$545.87 ,$545.87 ,$255.89 ,$419.90 ST. JOSEPH'S HOSPITAL - BREESE,36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,$646.00 ,$465.12 ,$180.88 ,$652.78 ,$652.78 ,$419.90 ,$385.66 ,$255.89 ,$180.88 ,$427.65 ,$255.89 ,$427.65 ,$255.89 ,$385.02 ,$385.02 ,$255.89 ,$385.02 ,$527.44 ,$497.42 ,$652.77 ,$255.89 ,$261.00 ,$484.50 ,$458.66 ,$458.66 ,$255.89 ,$458.66 ,$549.10 ,$549.10 ,$549.10 , N/A ,$646.00 ,$549.10 ,$255.89 ,$646.00 ,$362.41 ,$255.89 ,$267.44 ,$239.66 ,$217.87 ,$255.89 ,$549.10 ,$548.32 ,$385.02 ,$180.88 ,$581.40 ,$255.89 ,$549.10 ,$545.87 ,$545.87 ,$255.89 ,$419.90 ST. JOSEPH'S HOSPITAL - BREESE,36100093,N/A,HC CENTRAL LINE INSERTION,361,1 ,"$2,912.00 ","$2,096.64 ",$815.36 ,"$2,912.00 ", N/A ,"$1,892.80 ","$1,738.46 ", N/A ,$815.36 ,"$1,927.74 ", N/A ,"$1,927.74 ", N/A ,"$1,735.55 ","$1,735.55 ", N/A ,"$1,735.55 ", N/A ,"$2,242.24 ", N/A , N/A , N/A ,"$2,184.00 ","$2,067.52 ","$2,067.52 ", N/A ,"$2,067.52 ","$2,475.20 ","$2,475.20 ","$2,475.20 ", N/A , N/A ,"$2,475.20 ", N/A ,"$2,912.00 ","$1,633.63 ", N/A ,"$1,205.57 ", N/A , N/A , N/A ,"$2,475.20 ", N/A ,"$1,735.55 ",$815.36 ,"$2,620.80 ", N/A ,"$2,475.20 ","$2,460.64 ","$2,460.64 ", N/A ,"$1,892.80 " ST. JOSEPH'S HOSPITAL - BREESE,36100100,62320,HC INJ INTRLAMNR CERV/THOR W/O GUIDE,361,1 ,"$1,984.00 ","$1,428.48 ",$295.99 ,"$1,984.00 ","$1,546.98 ","$1,289.60 ","$1,184.45 ",$606.41 ,$555.52 ,"$1,313.41 ",$606.41 ,"$1,313.41 ",$606.41 ,"$1,182.46 ","$1,182.46 ",$606.41 ,"$1,182.46 ","$1,249.95 ","$1,527.68 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,488.00 ","$1,408.64 ","$1,408.64 ",$606.41 ,"$1,408.64 ","$1,686.40 ","$1,686.40 ","$1,686.40 ", N/A ,"$1,546.96 ","$1,686.40 ",$606.41 ,"$1,984.00 ","$1,113.02 ",$606.41 ,$821.38 ,$325.59 ,$295.99 ,$606.41 ,"$1,686.40 ","$1,299.45 ","$1,182.46 ",$555.52 ,"$1,785.60 ",$606.41 ,"$1,686.40 ","$1,676.48 ","$1,676.48 ",$606.41 ,"$1,289.60 " ST. JOSEPH'S HOSPITAL - BREESE,36100101,62321,HC INJ INTRLAMNR CERV/THOR W/GUIDE,361,1 ,"$2,061.00 ","$1,483.92 ",$295.99 ,"$2,061.00 ","$1,546.98 ","$1,339.65 ","$1,230.42 ",$606.41 ,$577.08 ,"$1,364.38 ",$606.41 ,"$1,364.38 ",$606.41 ,"$1,228.36 ","$1,228.36 ",$606.41 ,"$1,228.36 ","$1,249.95 ","$1,586.97 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,545.75 ","$1,463.31 ","$1,463.31 ",$606.41 ,"$1,463.31 ","$1,751.85 ","$1,751.85 ","$1,751.85 ", N/A ,"$1,546.96 ","$1,751.85 ",$606.41 ,"$2,061.00 ","$1,156.22 ",$606.41 ,$853.25 ,$325.59 ,$295.99 ,$606.41 ,"$1,751.85 ","$1,299.45 ","$1,228.36 ",$577.08 ,"$1,854.90 ",$606.41 ,"$1,751.85 ","$1,741.55 ","$1,741.55 ",$606.41 ,"$1,339.65 " ST. JOSEPH'S HOSPITAL - BREESE,36100103,62323,HC INJ INTRLAMNR LUM/SAC W/GUIDE,361,1 ,"$2,061.00 ","$1,483.92 ",$295.99 ,"$2,061.00 ","$1,546.98 ","$1,339.65 ","$1,230.42 ",$606.41 ,$577.08 ,"$1,364.38 ",$606.41 ,"$1,364.38 ",$606.41 ,"$1,228.36 ","$1,228.36 ",$606.41 ,"$1,228.36 ","$1,249.95 ","$1,586.97 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,545.75 ","$1,463.31 ","$1,463.31 ",$606.41 ,"$1,463.31 ","$1,751.85 ","$1,751.85 ","$1,751.85 ", N/A ,"$1,546.96 ","$1,751.85 ",$606.41 ,"$2,061.00 ","$1,156.22 ",$606.41 ,$853.25 ,$325.59 ,$295.99 ,$606.41 ,"$1,751.85 ","$1,299.45 ","$1,228.36 ",$577.08 ,"$1,854.90 ",$606.41 ,"$1,751.85 ","$1,741.55 ","$1,741.55 ",$606.41 ,"$1,339.65 " ST. JOSEPH'S HOSPITAL - BREESE,36100106,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$3,731.00 ","$2,686.32 ",$536.81 ,"$3,731.00 ","$2,045.95 ","$2,425.15 ","$2,227.41 ",$802.01 ,"$1,044.68 ","$2,469.92 ",$802.01 ,"$2,469.92 ",$802.01 ,"$2,223.68 ","$2,223.68 ",$802.01 ,"$2,223.68 ","$1,653.13 ","$2,872.87 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,798.25 ","$2,649.01 ","$2,649.01 ",$802.01 ,"$2,649.01 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$2,045.96 ","$3,171.35 ",$802.01 ,"$3,731.00 ","$2,093.09 ",$802.01 ,"$1,544.63 ",$590.49 ,$536.81 ,$802.01 ,"$3,171.35 ","$1,718.60 ","$2,223.68 ","$1,044.68 ","$3,357.90 ",$802.01 ,"$3,129.00 ","$3,152.70 ","$3,152.70 ",$802.01 ,"$2,425.15 " ST. JOSEPH'S HOSPITAL - BREESE,36100119,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-BIL,361,1 ,"$5,695.00 ","$4,100.40 ",$805.22 ,"$5,695.00 ", N/A ,"$3,701.75 ","$3,399.92 ", N/A ,"$1,594.60 ","$3,770.09 ", N/A ,"$3,770.09 ", N/A ,"$3,394.22 ","$3,394.22 ", N/A ,"$3,394.22 ", N/A ,"$4,385.15 ", N/A , N/A , N/A ,"$4,271.25 ","$4,043.45 ","$4,043.45 ", N/A ,"$4,043.45 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,840.75 ", N/A ,"$5,695.00 ","$3,194.90 ", N/A ,"$2,357.73 ",$885.74 ,$805.22 , N/A ,"$4,840.75 ", N/A ,"$3,394.22 ","$1,594.60 ","$5,125.50 ", N/A ,"$3,129.00 ","$4,812.28 ","$4,812.28 ", N/A ,"$3,701.75 " ST. JOSEPH'S HOSPITAL - BREESE,36100120,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-LT,361,1 ,"$3,797.00 ","$2,733.84 ",$536.81 ,"$3,797.00 ", N/A ,"$2,468.05 ","$2,266.81 ", N/A ,"$1,063.16 ","$2,513.61 ", N/A ,"$2,513.61 ", N/A ,"$2,263.01 ","$2,263.01 ", N/A ,"$2,263.01 ", N/A ,"$2,923.69 ", N/A , N/A , N/A ,"$2,847.75 ","$2,695.87 ","$2,695.87 ", N/A ,"$2,695.87 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$3,227.45 ", N/A ,"$3,797.00 ","$2,130.12 ", N/A ,"$1,571.96 ",$590.49 ,$536.81 , N/A ,"$3,227.45 ", N/A ,"$2,263.01 ","$1,063.16 ","$3,417.30 ", N/A ,"$3,129.00 ","$3,208.47 ","$3,208.47 ", N/A ,"$2,468.05 " ST. JOSEPH'S HOSPITAL - BREESE,36100121,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-RT,361,1 ,"$3,797.00 ","$2,733.84 ",$536.81 ,"$3,797.00 ", N/A ,"$2,468.05 ","$2,266.81 ", N/A ,"$1,063.16 ","$2,513.61 ", N/A ,"$2,513.61 ", N/A ,"$2,263.01 ","$2,263.01 ", N/A ,"$2,263.01 ", N/A ,"$2,923.69 ", N/A , N/A , N/A ,"$2,847.75 ","$2,695.87 ","$2,695.87 ", N/A ,"$2,695.87 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$3,227.45 ", N/A ,"$3,797.00 ","$2,130.12 ", N/A ,"$1,571.96 ",$590.49 ,$536.81 , N/A ,"$3,227.45 ", N/A ,"$2,263.01 ","$1,063.16 ","$3,417.30 ", N/A ,"$3,129.00 ","$3,208.47 ","$3,208.47 ", N/A ,"$2,468.05 " ST. JOSEPH'S HOSPITAL - BREESE,36100122,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-BIL,361,1 ,"$8,848.00 ","$6,370.56 ",$805.22 ,"$8,848.00 ","$4,315.58 ","$5,751.20 ","$5,282.26 ","$1,691.71 ","$2,477.44 ","$5,857.38 ","$1,691.71 ","$5,857.38 ","$1,691.71 ","$5,273.41 ","$5,273.41 ","$1,691.71 ","$5,273.41 ","$3,486.99 ","$6,812.96 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$6,636.00 ","$6,282.08 ","$6,282.08 ","$1,691.71 ","$6,282.08 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$7,520.80 ","$1,691.71 ","$8,848.00 ","$4,963.73 ","$1,691.71 ","$3,663.07 ",$885.74 ,$805.22 ,"$1,691.71 ","$7,520.80 ","$3,625.08 ","$5,273.41 ","$2,477.44 ","$7,963.20 ","$1,691.71 ","$3,129.00 ","$7,476.56 ","$7,476.56 ","$1,691.71 ","$5,751.20 " ST. JOSEPH'S HOSPITAL - BREESE,36100123,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-LT,361,1 ,"$5,898.00 ","$4,246.56 ",$536.81 ,"$5,898.00 ","$4,315.58 ","$3,833.70 ","$3,521.11 ","$1,691.71 ","$1,651.44 ","$3,904.48 ","$1,691.71 ","$3,904.48 ","$1,691.71 ","$3,515.21 ","$3,515.21 ","$1,691.71 ","$3,515.21 ","$3,486.99 ","$4,541.46 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$4,423.50 ","$4,187.58 ","$4,187.58 ","$1,691.71 ","$4,187.58 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$5,013.30 ","$1,691.71 ","$5,898.00 ","$3,308.78 ","$1,691.71 ","$2,441.77 ",$590.49 ,$536.81 ,"$1,691.71 ","$5,013.30 ","$3,625.08 ","$3,515.21 ","$1,651.44 ","$5,308.20 ","$1,691.71 ","$3,129.00 ","$4,983.81 ","$4,983.81 ","$1,691.71 ","$3,833.70 " ST. JOSEPH'S HOSPITAL - BREESE,36100124,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-RT,361,1 ,"$5,898.00 ","$4,246.56 ",$536.81 ,"$5,898.00 ","$4,315.58 ","$3,833.70 ","$3,521.11 ","$1,691.71 ","$1,651.44 ","$3,904.48 ","$1,691.71 ","$3,904.48 ","$1,691.71 ","$3,515.21 ","$3,515.21 ","$1,691.71 ","$3,515.21 ","$3,486.99 ","$4,541.46 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$4,423.50 ","$4,187.58 ","$4,187.58 ","$1,691.71 ","$4,187.58 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$5,013.30 ","$1,691.71 ","$5,898.00 ","$3,308.78 ","$1,691.71 ","$2,441.77 ",$590.49 ,$536.81 ,"$1,691.71 ","$5,013.30 ","$3,625.08 ","$3,515.21 ","$1,651.44 ","$5,308.20 ","$1,691.71 ","$3,129.00 ","$4,983.81 ","$4,983.81 ","$1,691.71 ","$3,833.70 " ST. JOSEPH'S HOSPITAL - BREESE,36100125,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-BIL,361,1 ,"$5,980.00 ","$4,305.60 ",$805.22 ,"$5,980.00 ", N/A ,"$3,887.00 ","$3,570.06 ", N/A ,"$1,674.40 ","$3,958.76 ", N/A ,"$3,958.76 ", N/A ,"$3,564.08 ","$3,564.08 ", N/A ,"$3,564.08 ", N/A ,"$4,604.60 ", N/A , N/A , N/A ,"$4,485.00 ","$4,245.80 ","$4,245.80 ", N/A ,"$4,245.80 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$5,083.00 ", N/A ,"$5,980.00 ","$3,354.78 ", N/A ,"$2,475.72 ",$885.74 ,$805.22 , N/A ,"$5,083.00 ", N/A ,"$3,564.08 ","$1,674.40 ","$5,382.00 ", N/A ,"$3,129.00 ","$5,053.10 ","$5,053.10 ", N/A ,"$3,887.00 " ST. JOSEPH'S HOSPITAL - BREESE,36100126,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-LT,361,1 ,"$3,986.00 ","$2,869.92 ",$536.81 ,"$3,986.00 ", N/A ,"$2,590.90 ","$2,379.64 ", N/A ,"$1,116.08 ","$2,638.73 ", N/A ,"$2,638.73 ", N/A ,"$2,375.66 ","$2,375.66 ", N/A ,"$2,375.66 ", N/A ,"$3,069.22 ", N/A , N/A , N/A ,"$2,989.50 ","$2,830.06 ","$2,830.06 ", N/A ,"$2,830.06 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$3,388.10 ", N/A ,"$3,986.00 ","$2,236.15 ", N/A ,"$1,650.20 ",$590.49 ,$536.81 , N/A ,"$3,388.10 ", N/A ,"$2,375.66 ","$1,116.08 ","$3,587.40 ", N/A ,"$3,129.00 ","$3,368.17 ","$3,368.17 ", N/A ,"$2,590.90 " ST. JOSEPH'S HOSPITAL - BREESE,36100127,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-RT,361,1 ,"$3,986.00 ","$2,869.92 ",$536.81 ,"$3,986.00 ", N/A ,"$2,590.90 ","$2,379.64 ", N/A ,"$1,116.08 ","$2,638.73 ", N/A ,"$2,638.73 ", N/A ,"$2,375.66 ","$2,375.66 ", N/A ,"$2,375.66 ", N/A ,"$3,069.22 ", N/A , N/A , N/A ,"$2,989.50 ","$2,830.06 ","$2,830.06 ", N/A ,"$2,830.06 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$3,388.10 ", N/A ,"$3,986.00 ","$2,236.15 ", N/A ,"$1,650.20 ",$590.49 ,$536.81 , N/A ,"$3,388.10 ", N/A ,"$2,375.66 ","$1,116.08 ","$3,587.40 ", N/A ,"$3,129.00 ","$3,368.17 ","$3,368.17 ", N/A ,"$2,590.90 " ST. JOSEPH'S HOSPITAL - BREESE,36100128,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-BIL,361,1 ,"$8,848.00 ","$6,370.56 ",$805.22 ,"$8,848.00 ","$4,315.58 ","$5,751.20 ","$5,282.26 ","$1,691.71 ","$2,477.44 ","$5,857.38 ","$1,691.71 ","$5,857.38 ","$1,691.71 ","$5,273.41 ","$5,273.41 ","$1,691.71 ","$5,273.41 ","$3,486.99 ","$6,812.96 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$6,636.00 ","$6,282.08 ","$6,282.08 ","$1,691.71 ","$6,282.08 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$7,520.80 ","$1,691.71 ","$8,848.00 ","$4,963.73 ","$1,691.71 ","$3,663.07 ",$885.74 ,$805.22 ,"$1,691.71 ","$7,520.80 ","$3,625.08 ","$5,273.41 ","$2,477.44 ","$7,963.20 ","$1,691.71 ","$3,129.00 ","$7,476.56 ","$7,476.56 ","$1,691.71 ","$5,751.20 " ST. JOSEPH'S HOSPITAL - BREESE,36100129,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-LT,361,1 ,"$5,898.00 ","$4,246.56 ",$536.81 ,"$5,898.00 ","$4,315.58 ","$3,833.70 ","$3,521.11 ","$1,691.71 ","$1,651.44 ","$3,904.48 ","$1,691.71 ","$3,904.48 ","$1,691.71 ","$3,515.21 ","$3,515.21 ","$1,691.71 ","$3,515.21 ","$3,486.99 ","$4,541.46 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$4,423.50 ","$4,187.58 ","$4,187.58 ","$1,691.71 ","$4,187.58 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$5,013.30 ","$1,691.71 ","$5,898.00 ","$3,308.78 ","$1,691.71 ","$2,441.77 ",$590.49 ,$536.81 ,"$1,691.71 ","$5,013.30 ","$3,625.08 ","$3,515.21 ","$1,651.44 ","$5,308.20 ","$1,691.71 ","$3,129.00 ","$4,983.81 ","$4,983.81 ","$1,691.71 ","$3,833.70 " ST. JOSEPH'S HOSPITAL - BREESE,36100130,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-RT,361,1 ,"$5,898.00 ","$4,246.56 ",$536.81 ,"$5,898.00 ","$4,315.58 ","$3,833.70 ","$3,521.11 ","$1,691.71 ","$1,651.44 ","$3,904.48 ","$1,691.71 ","$3,904.48 ","$1,691.71 ","$3,515.21 ","$3,515.21 ","$1,691.71 ","$3,515.21 ","$3,486.99 ","$4,541.46 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$4,423.50 ","$4,187.58 ","$4,187.58 ","$1,691.71 ","$4,187.58 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$5,013.30 ","$1,691.71 ","$5,898.00 ","$3,308.78 ","$1,691.71 ","$2,441.77 ",$590.49 ,$536.81 ,"$1,691.71 ","$5,013.30 ","$3,625.08 ","$3,515.21 ","$1,651.44 ","$5,308.20 ","$1,691.71 ","$3,129.00 ","$4,983.81 ","$4,983.81 ","$1,691.71 ","$3,833.70 " ST. JOSEPH'S HOSPITAL - BREESE,36100131,64640,HC DESTROY NERVE PERIPHERAL-BIL,361,1 ,"$4,016.00 ","$2,891.52 ",$805.22 ,"$4,016.00 ","$3,068.93 ","$2,610.40 ","$2,397.55 ","$1,203.02 ","$1,124.48 ","$2,658.59 ","$1,203.02 ","$2,658.59 ","$1,203.02 ","$2,393.54 ","$2,393.54 ","$1,203.02 ","$2,393.54 ","$2,479.70 ","$3,092.32 ","$3,068.93 ","$1,203.02 ","$1,227.09 ","$3,012.00 ","$2,851.36 ","$2,851.36 ","$1,203.02 ","$2,851.36 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,068.93 ","$3,413.60 ","$1,203.02 ","$4,016.00 ","$2,252.98 ","$1,203.02 ","$1,662.62 ",$885.74 ,$805.22 ,"$1,203.02 ","$3,413.60 ","$2,577.90 ","$2,393.54 ","$1,124.48 ","$3,614.40 ","$1,203.02 ","$3,129.00 ","$3,393.52 ","$3,393.52 ","$1,203.02 ","$2,610.40 " ST. JOSEPH'S HOSPITAL - BREESE,36100132,64640,HC DESTROY NERVE PERIPHERAL-LT,361,1 ,"$2,677.00 ","$1,927.44 ",$536.81 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ","$2,262.07 ","$2,262.07 ",$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,36100133,64640,HC DESTROY NERVE PERIPHERAL-RT,361,1 ,"$2,677.00 ","$1,927.44 ",$536.81 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ","$2,262.07 ","$2,262.07 ",$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,36100156,38222,HC BONE MARROW ASPIRATION (BX/ASP SAME SITE),361,1 ,"$4,486.00 ","$3,229.92 ",$409.40 ,"$6,202.00 ","$6,202.00 ","$2,915.90 ","$2,678.14 ","$2,431.18 ","$1,256.08 ","$2,969.73 ","$2,431.18 ","$2,969.73 ","$2,431.18 ","$2,673.66 ","$2,673.66 ","$2,431.18 ","$2,673.66 ","$4,486.00 ","$3,454.22 ","$6,202.00 ","$2,431.18 ","$2,479.80 ","$3,364.50 ","$3,185.06 ","$3,185.06 ","$2,431.18 ","$3,185.06 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,486.00 ","$3,813.10 ","$2,431.18 ","$4,486.00 ","$2,516.65 ","$2,431.18 ","$1,857.20 ",$450.34 ,$409.40 ,"$2,431.18 ","$3,813.10 ","$5,209.68 ","$2,673.66 ","$1,256.08 ","$4,037.40 ","$2,431.18 ","$3,129.00 ","$3,790.67 ","$3,790.67 ","$2,431.18 ","$2,915.90 " ST. JOSEPH'S HOSPITAL - BREESE,36100189,64415,HC INTRASCALENE BLOCK SINGLE,361,1 ,"$3,731.00 ","$2,686.32 ",$295.99 ,"$3,731.00 ","$2,045.95 ","$2,425.15 ","$2,227.41 ",$802.01 ,"$1,044.68 ","$2,469.92 ",$802.01 ,"$2,469.92 ",$802.01 ,"$2,223.68 ","$2,223.68 ",$802.01 ,"$2,223.68 ","$1,653.13 ","$2,872.87 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,798.25 ","$2,649.01 ","$2,649.01 ",$802.01 ,"$2,649.01 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$2,045.96 ","$3,171.35 ",$802.01 ,"$3,731.00 ","$2,093.09 ",$802.01 ,"$1,544.63 ",$325.59 ,$295.99 ,$802.01 ,"$3,171.35 ","$1,718.60 ","$2,223.68 ","$1,044.68 ","$3,357.90 ",$802.01 ,"$3,129.00 ","$3,152.70 ","$3,152.70 ",$802.01 ,"$2,425.15 " ST. JOSEPH'S HOSPITAL - BREESE,36100196,64447,HC FEMORAL NERVE BLOCK SINGLE,361,1 ,"$2,653.00 ","$1,910.16 ",$295.99 ,"$2,653.00 ","$1,546.98 ","$1,724.45 ","$1,583.84 ",$606.41 ,$742.84 ,"$1,756.29 ",$606.41 ,"$1,756.29 ",$606.41 ,"$1,581.19 ","$1,581.19 ",$606.41 ,"$1,581.19 ","$1,249.95 ","$2,042.81 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,989.75 ","$1,883.63 ","$1,883.63 ",$606.41 ,"$1,883.63 ","$2,255.05 ","$2,255.05 ","$2,255.05 ", N/A ,"$1,546.96 ","$2,255.05 ",$606.41 ,"$2,653.00 ","$1,488.33 ",$606.41 ,"$1,098.34 ",$325.59 ,$295.99 ,$606.41 ,"$2,255.05 ","$1,299.45 ","$1,581.19 ",$742.84 ,"$2,387.70 ",$606.41 ,"$2,255.05 ","$2,241.79 ","$2,241.79 ",$606.41 ,"$1,724.45 " ST. JOSEPH'S HOSPITAL - BREESE,36100197,64450,HC INJ ANES NERVE PERIPHERAL,361,1 ,"$2,067.00 ","$1,488.24 ",$295.99 ,"$2,067.00 ","$1,546.98 ","$1,343.55 ","$1,234.00 ",$606.41 ,$578.76 ,"$1,368.35 ",$606.41 ,"$1,368.35 ",$606.41 ,"$1,231.93 ","$1,231.93 ",$606.41 ,"$1,231.93 ","$1,249.95 ","$1,591.59 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,550.25 ","$1,467.57 ","$1,467.57 ",$606.41 ,"$1,467.57 ","$1,756.95 ","$1,756.95 ","$1,756.95 ", N/A ,"$1,546.96 ","$1,756.95 ",$606.41 ,"$2,067.00 ","$1,159.59 ",$606.41 ,$855.74 ,$325.59 ,$295.99 ,$606.41 ,"$1,756.95 ","$1,299.45 ","$1,231.93 ",$578.76 ,"$1,860.30 ",$606.41 ,"$1,756.95 ","$1,746.62 ","$1,746.62 ",$606.41 ,"$1,343.55 " ST. JOSEPH'S HOSPITAL - BREESE,36100198,64480,HC INJ TRANSF CERV/THORACIC ADDL-LT,361,1 ,"$2,842.00 ","$2,046.24 ",$536.81 ,"$2,842.00 ", N/A ,"$1,847.30 ","$1,696.67 ", N/A ,$795.76 ,"$1,881.40 ", N/A ,"$1,881.40 ", N/A ,"$1,693.83 ","$1,693.83 ", N/A ,"$1,693.83 ", N/A ,"$2,188.34 ", N/A , N/A , N/A ,"$2,131.50 ","$2,017.82 ","$2,017.82 ", N/A ,"$2,017.82 ","$2,415.70 ","$2,415.70 ","$2,415.70 ", N/A , N/A ,"$2,415.70 ", N/A ,"$2,842.00 ","$1,594.36 ", N/A ,"$1,176.59 ",$590.49 ,$536.81 , N/A ,"$2,415.70 ", N/A ,"$1,693.83 ",$795.76 ,"$2,557.80 ", N/A ,"$2,415.70 ","$2,401.49 ","$2,401.49 ", N/A ,"$1,847.30 " ST. JOSEPH'S HOSPITAL - BREESE,36100199,64480,HC INJ TRANSF CERV/THORACIC ADDL-RT,361,1 ,"$2,842.00 ","$2,046.24 ",$536.81 ,"$2,842.00 ", N/A ,"$1,847.30 ","$1,696.67 ", N/A ,$795.76 ,"$1,881.40 ", N/A ,"$1,881.40 ", N/A ,"$1,693.83 ","$1,693.83 ", N/A ,"$1,693.83 ", N/A ,"$2,188.34 ", N/A , N/A , N/A ,"$2,131.50 ","$2,017.82 ","$2,017.82 ", N/A ,"$2,017.82 ","$2,415.70 ","$2,415.70 ","$2,415.70 ", N/A , N/A ,"$2,415.70 ", N/A ,"$2,842.00 ","$1,594.36 ", N/A ,"$1,176.59 ",$590.49 ,$536.81 , N/A ,"$2,415.70 ", N/A ,"$1,693.83 ",$795.76 ,"$2,557.80 ", N/A ,"$2,415.70 ","$2,401.49 ","$2,401.49 ", N/A ,"$1,847.30 " ST. JOSEPH'S HOSPITAL - BREESE,36100200,64480,HC INJ TRANSF CERV/THORACIC ADDL,361,1 ,"$2,842.00 ","$2,046.24 ",$536.81 ,"$2,842.00 ", N/A ,"$1,847.30 ","$1,696.67 ", N/A ,$795.76 ,"$1,881.40 ", N/A ,"$1,881.40 ", N/A ,"$1,693.83 ","$1,693.83 ", N/A ,"$1,693.83 ", N/A ,"$2,188.34 ", N/A , N/A , N/A ,"$2,131.50 ","$2,017.82 ","$2,017.82 ", N/A ,"$2,017.82 ","$2,415.70 ","$2,415.70 ","$2,415.70 ", N/A , N/A ,"$2,415.70 ", N/A ,"$2,842.00 ","$1,594.36 ", N/A ,"$1,176.59 ",$590.49 ,$536.81 , N/A ,"$2,415.70 ", N/A ,"$1,693.83 ",$795.76 ,"$2,557.80 ", N/A ,"$2,415.70 ","$2,401.49 ","$2,401.49 ", N/A ,"$1,847.30 " ST. JOSEPH'S HOSPITAL - BREESE,36100235,11102,HC BIOPSY SKIN TANGENTIAL INIT LESN,361,1 ,$511.29 ,$368.13 ,$143.16 ,$511.29 ,$433.55 ,$332.34 ,$305.24 ,$169.95 ,$143.16 ,$338.47 ,$169.95 ,$338.47 ,$169.95 ,$304.73 ,$304.73 ,$169.95 ,$304.73 ,$350.30 ,$393.69 ,$433.55 ,$169.95 ,$173.35 ,$383.47 ,$363.02 ,$363.02 ,$169.95 ,$363.02 ,$434.60 ,$434.60 ,$434.60 , N/A ,$433.55 ,$434.60 ,$169.95 ,$511.29 ,$286.83 ,$169.95 ,$211.67 ,$477.10 ,$433.73 ,$169.95 ,$434.60 ,$364.18 ,$304.73 ,$143.16 ,$460.16 ,$169.95 ,$434.60 ,$432.04 ,$432.04 ,$169.95 ,$332.34 ST. JOSEPH'S HOSPITAL - BREESE,36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,$427.00 ,$307.44 ,$119.56 ,"$1,558.08 ","$1,558.08 ",$277.55 ,$254.92 ,$610.77 ,$119.56 ,$282.67 ,$610.77 ,$282.67 ,$418.46 ,$254.49 ,$254.49 ,$418.46 ,$254.49 ,$427.00 ,$328.79 ,"$1,558.08 ",$610.77 ,$418.46 ,$320.25 ,$303.17 ,$303.17 ,$610.77 ,$303.17 ,$362.95 ,$362.95 ,$362.95 , N/A ,$427.00 ,$362.95 ,$418.46 ,$146.54 ,$239.55 ,$610.77 ,$176.78 ,$427.00 ,$409.40 ,$610.77 ,$362.95 ,"$1,308.79 ",$254.49 ,$119.56 ,$384.30 ,$610.77 ,$362.95 ,$360.82 ,$360.82 ,$610.77 ,$277.55 ST. JOSEPH'S HOSPITAL - BREESE,36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,$427.00 ,$307.44 ,$61.94 ,$427.00 , N/A ,$277.55 ,$254.92 , N/A ,$119.56 ,$282.67 , N/A ,$282.67 , N/A ,$254.49 ,$254.49 , N/A ,$254.49 , N/A ,$328.79 , N/A , N/A , N/A ,$320.25 ,$303.17 ,$303.17 , N/A ,$303.17 ,$362.95 ,$362.95 ,$362.95 , N/A , N/A ,$362.95 , N/A ,$61.94 ,$239.55 , N/A ,$176.78 ,$427.00 ,$409.40 , N/A ,$362.95 , N/A ,$254.49 ,$119.56 ,$384.30 , N/A ,$362.95 ,$360.82 ,$360.82 , N/A ,$277.55 ST. JOSEPH'S HOSPITAL - BREESE,36100268,11004,HC DEBRIDEMENT GENITALIA AND PERINEUM,361,1 ,"$2,061.00 ","$1,483.92 ",$577.08 ,"$2,061.00 ", N/A ,"$1,339.65 ","$1,230.42 ", N/A ,$577.08 ,"$1,364.38 ", N/A ,"$1,364.38 ", N/A ,"$1,228.36 ","$1,228.36 ", N/A ,"$1,228.36 ", N/A ,"$1,586.97 ", N/A , N/A , N/A ,"$1,545.75 ","$1,463.31 ","$1,463.31 ", N/A ,"$1,463.31 ","$1,751.85 ","$1,751.85 ","$1,751.85 ", N/A , N/A ,"$1,751.85 ", N/A ,"$2,061.00 ","$1,156.22 ", N/A ,$853.25 ,$886.47 ,$805.88 , N/A ,"$1,751.85 ", N/A ,"$1,228.36 ",$577.08 ,"$1,854.90 ", N/A ,"$1,751.85 ","$1,741.55 ","$1,741.55 ", N/A ,"$1,339.65 " ST. JOSEPH'S HOSPITAL - BREESE,36100269,11005,HC DEBRIDEMENT NSTI ABDOMINAL WALL,361,1 ,"$2,875.00 ","$2,070.00 ",$805.00 ,"$2,875.00 ", N/A ,"$1,868.75 ","$1,716.38 ", N/A ,$805.00 ,"$1,903.25 ", N/A ,"$1,903.25 ", N/A ,"$1,713.50 ","$1,713.50 ", N/A ,"$1,713.50 ", N/A ,"$2,213.75 ", N/A , N/A , N/A ,"$2,156.25 ","$2,041.25 ","$2,041.25 ", N/A ,"$2,041.25 ","$2,443.75 ","$2,443.75 ","$2,443.75 ", N/A , N/A ,"$2,443.75 ", N/A ,"$2,875.00 ","$1,612.88 ", N/A ,"$1,190.25 ",$886.47 ,$805.88 , N/A ,"$2,443.75 ", N/A ,"$1,713.50 ",$805.00 ,"$2,587.50 ", N/A ,"$2,443.75 ","$2,429.38 ","$2,429.38 ", N/A ,"$1,868.75 " ST. JOSEPH'S HOSPITAL - BREESE,36100274,64624,HC DESTRUST NEUROLYTIC AGENT GENICULAR NERVE W/IMG GUID,361,1 ,"$5,668.00 ","$4,080.96 ",$536.81 ,"$5,668.00 ","$4,315.58 ","$3,684.20 ","$3,383.80 ","$1,691.71 ","$1,587.04 ","$3,752.22 ","$1,691.71 ","$3,752.22 ","$1,691.71 ","$3,378.13 ","$3,378.13 ","$1,691.71 ","$3,378.13 ","$3,486.99 ","$4,364.36 ","$4,315.58 ","$1,691.71 ","$1,725.54 ","$4,251.00 ","$4,024.28 ","$4,024.28 ","$1,691.71 ","$4,024.28 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$4,315.58 ","$4,817.80 ","$1,691.71 ","$5,668.00 ","$3,179.75 ","$1,691.71 ","$2,346.55 ",$590.49 ,$536.81 ,"$1,691.71 ","$4,817.80 ","$3,625.08 ","$3,378.13 ","$1,587.04 ","$5,101.20 ","$1,691.71 ","$3,129.00 ","$4,789.46 ","$4,789.46 ","$1,691.71 ","$3,684.20 " ST. JOSEPH'S HOSPITAL - BREESE,36100281,32408,HC CORE NDL BX LUNG/MEDIASTINUM PERQ W IMG,361,1 ,"$4,607.00 ","$3,317.04 ",$465.61 ,"$4,607.00 ","$3,600.20 ","$2,994.55 ","$2,750.38 ","$1,411.28 ","$1,289.96 ","$3,049.83 ","$1,411.28 ","$3,049.83 ","$1,411.28 ","$2,745.77 ","$2,745.77 ","$1,411.28 ","$2,745.77 ","$2,908.96 ","$3,547.39 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,455.25 ","$3,270.97 ","$3,270.97 ","$1,411.28 ","$3,270.97 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A ,"$3,600.19 ","$3,915.95 ","$1,411.28 ","$4,607.00 ","$2,584.53 ","$1,411.28 ","$1,907.30 ",$512.17 ,$465.61 ,"$1,411.28 ","$3,915.95 ","$3,024.16 ","$2,745.77 ","$1,289.96 ","$4,146.30 ","$1,411.28 ","$3,129.00 ","$3,892.92 ","$3,892.92 ","$1,411.28 ","$2,994.55 " ST. JOSEPH'S HOSPITAL - BREESE,36100284,53060,HC DRAIN OF SKENE GLAND ABS OR CYST,450,1 ,$274.00 ,$197.28 ,$76.72 ,"$4,453.30 ","$4,453.30 ",$178.10 ,$163.58 ,"$1,745.69 ",$76.72 ,$181.39 ,"$1,745.69 ",$181.39 ,$268.52 ,$163.30 ,$163.30 ,$268.52 ,$163.30 ,$274.00 ,$210.98 ,"$4,453.29 ","$1,745.69 ",$268.52 ,$205.50 ,$194.54 ,$194.54 ,"$1,745.69 ",$194.54 ,$232.90 ,$232.90 ,$232.90 , N/A ,$274.00 ,$232.90 ,$268.52 ,$274.00 ,$153.71 ,"$1,745.69 ",$113.44 , N/A , N/A ,"$1,745.69 ",$232.90 ,"$3,740.76 ",$163.30 ,$76.72 ,$246.60 ,"$1,745.69 ",$232.90 ,$274.00 ,$274.00 ,"$1,745.69 ",$178.10 ST. JOSEPH'S HOSPITAL - BREESE,37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$615.00 ,$442.80 ,$172.20 ,$615.00 ,$498.98 ,$399.75 ,$367.16 ,$195.60 ,$172.20 ,$407.13 ,$195.60 ,$407.13 ,$195.60 ,$366.54 ,$366.54 ,$195.60 ,$366.54 ,$403.17 ,$473.55 ,$498.97 ,$195.60 ,$199.51 ,$461.25 ,$436.65 ,$436.65 ,$195.60 ,$436.65 ,$522.75 ,$522.75 ,$522.75 , N/A ,$498.97 ,$522.75 ,$195.60 ,$615.00 ,$345.02 ,$195.60 ,$254.61 ,$500.07 ,$454.61 ,$195.60 ,$522.75 ,$419.13 ,$366.54 ,$172.20 ,$553.50 ,$195.60 ,$522.75 ,$519.68 ,$519.68 ,$195.60 ,$399.75 ST. JOSEPH'S HOSPITAL - BREESE,37000017,99153,HC MODERATE SEDATION SAME PHY EA ADDL 15MIN,370,1 ,$223.00 ,$160.56 ,$15.87 ,$223.00 , N/A ,$144.95 ,$133.13 , N/A ,$62.44 ,$147.63 , N/A ,$147.63 , N/A ,$132.91 ,$132.91 , N/A ,$132.91 , N/A ,$171.71 , N/A , N/A , N/A ,$167.25 ,$158.33 ,$158.33 , N/A ,$158.33 ,$189.55 ,$189.55 ,$189.55 , N/A , N/A ,$189.55 , N/A ,$223.00 ,$125.10 , N/A ,$92.32 ,$17.46 ,$15.87 , N/A ,$189.55 , N/A ,$132.91 ,$62.44 ,$200.70 , N/A ,$189.55 ,$188.44 ,$188.44 , N/A ,$144.95 ST. JOSEPH'S HOSPITAL - BREESE,37000020,99157,HC MODERATE SEDATION DIFF PHY EA ADDL 15MIN,370,1 ,$197.00 ,$141.84 ,$15.87 ,$197.00 , N/A ,$128.05 ,$117.61 , N/A ,$55.16 ,$130.41 , N/A ,$130.41 , N/A ,$117.41 ,$117.41 , N/A ,$117.41 , N/A ,$151.69 , N/A , N/A , N/A ,$147.75 ,$139.87 ,$139.87 , N/A ,$139.87 ,$167.45 ,$167.45 ,$167.45 , N/A , N/A ,$167.45 , N/A ,$197.00 ,$110.52 , N/A ,$81.56 ,$17.46 ,$15.87 , N/A ,$167.45 , N/A ,$117.41 ,$55.16 ,$177.30 , N/A ,$167.45 ,$166.47 ,$166.47 , N/A ,$128.05 ST. JOSEPH'S HOSPITAL - BREESE,37000061,N/A,HC ANESTHESIA GENERAL INITIAL 15MIN,370,1 ,$492.00 ,$354.24 ,$137.76 ,$492.00 , N/A ,$319.80 ,$293.72 , N/A ,$137.76 ,$325.70 , N/A ,$325.70 , N/A ,$293.23 ,$293.23 , N/A ,$293.23 , N/A ,$378.84 , N/A , N/A , N/A ,$369.00 ,$349.32 ,$349.32 , N/A ,$349.32 ,$418.20 ,$418.20 ,$418.20 , N/A , N/A ,$418.20 , N/A ,$492.00 ,$276.01 , N/A ,$203.69 , N/A , N/A , N/A ,$418.20 , N/A ,$293.23 ,$137.76 ,$442.80 , N/A ,$418.20 ,$415.74 ,$415.74 , N/A ,$319.80 ST. JOSEPH'S HOSPITAL - BREESE,37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$309.00 ,$222.48 ,$86.52 ,$309.00 , N/A ,$200.85 ,$184.47 , N/A ,$86.52 ,$204.56 , N/A ,$204.56 , N/A ,$184.16 ,$184.16 , N/A ,$184.16 , N/A ,$237.93 , N/A , N/A , N/A ,$231.75 ,$219.39 ,$219.39 , N/A ,$219.39 ,$262.65 ,$262.65 ,$262.65 , N/A , N/A ,$262.65 , N/A ,$309.00 ,$173.35 , N/A ,$127.93 , N/A , N/A , N/A ,$262.65 , N/A ,$184.16 ,$86.52 ,$278.10 , N/A ,$262.65 ,$261.11 ,$261.11 , N/A ,$200.85 ST. JOSEPH'S HOSPITAL - BREESE,37000063,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 15MIN,370,1 ,$516.00 ,$371.52 ,$144.48 ,$516.00 , N/A ,$335.40 ,$308.05 , N/A ,$144.48 ,$341.59 , N/A ,$341.59 , N/A ,$307.54 ,$307.54 , N/A ,$307.54 , N/A ,$397.32 , N/A , N/A , N/A ,$387.00 ,$366.36 ,$366.36 , N/A ,$366.36 ,$438.60 ,$438.60 ,$438.60 , N/A , N/A ,$438.60 , N/A ,$516.00 ,$289.48 , N/A ,$213.62 , N/A , N/A , N/A ,$438.60 , N/A ,$307.54 ,$144.48 ,$464.40 , N/A ,$438.60 ,$436.02 ,$436.02 , N/A ,$335.40 ST. JOSEPH'S HOSPITAL - BREESE,37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$295.00 ,$212.40 ,$82.60 ,$295.00 , N/A ,$191.75 ,$176.12 , N/A ,$82.60 ,$195.29 , N/A ,$195.29 , N/A ,$175.82 ,$175.82 , N/A ,$175.82 , N/A ,$227.15 , N/A , N/A , N/A ,$221.25 ,$209.45 ,$209.45 , N/A ,$209.45 ,$250.75 ,$250.75 ,$250.75 , N/A , N/A ,$250.75 , N/A ,$295.00 ,$165.50 , N/A ,$122.13 , N/A , N/A , N/A ,$250.75 , N/A ,$175.82 ,$82.60 ,$265.50 , N/A ,$250.75 ,$249.28 ,$249.28 , N/A ,$191.75 ST. JOSEPH'S HOSPITAL - BREESE,37000072,99151,HC MODERATE SEDATION SAME PHY <5YR 1ST 15MIN,370,1 ,$842.00 ,$606.24 ,$15.87 ,$842.00 , N/A ,$547.30 ,$502.67 , N/A ,$235.76 ,$557.40 , N/A ,$557.40 , N/A ,$501.83 ,$501.83 , N/A ,$501.83 , N/A ,$648.34 , N/A , N/A , N/A ,$631.50 ,$597.82 ,$597.82 , N/A ,$597.82 ,$715.70 ,$715.70 ,$715.70 , N/A , N/A ,$715.70 , N/A ,$842.00 ,$472.36 , N/A ,$348.59 ,$17.46 ,$15.87 , N/A ,$715.70 , N/A ,$501.83 ,$235.76 ,$757.80 , N/A ,$715.70 ,$711.49 ,$711.49 , N/A ,$547.30 ST. JOSEPH'S HOSPITAL - BREESE,37000073,99152,HC MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,$842.00 ,$606.24 ,$15.87 ,$842.00 , N/A ,$547.30 ,$502.67 , N/A ,$235.76 ,$557.40 , N/A ,$557.40 , N/A ,$501.83 ,$501.83 , N/A ,$501.83 , N/A ,$648.34 , N/A , N/A , N/A ,$631.50 ,$597.82 ,$597.82 , N/A ,$597.82 ,$715.70 ,$715.70 ,$715.70 , N/A , N/A ,$715.70 , N/A ,$842.00 ,$472.36 , N/A ,$348.59 ,$17.46 ,$15.87 , N/A ,$715.70 , N/A ,$501.83 ,$235.76 ,$757.80 , N/A ,$715.70 ,$711.49 ,$711.49 , N/A ,$547.30 ST. JOSEPH'S HOSPITAL - BREESE,37000074,99155,HC MODERATE SEDATION DIFF PHY <5YR 1ST 15MIN,370,1 ,$868.00 ,$624.96 ,$15.87 ,$868.00 , N/A ,$564.20 ,$518.20 , N/A ,$243.04 ,$574.62 , N/A ,$574.62 , N/A ,$517.33 ,$517.33 , N/A ,$517.33 , N/A ,$668.36 , N/A , N/A , N/A ,$651.00 ,$616.28 ,$616.28 , N/A ,$616.28 ,$737.80 ,$737.80 ,$737.80 , N/A , N/A ,$737.80 , N/A ,$868.00 ,$486.95 , N/A ,$359.35 ,$17.46 ,$15.87 , N/A ,$737.80 , N/A ,$517.33 ,$243.04 ,$781.20 , N/A ,$737.80 ,$733.46 ,$733.46 , N/A ,$564.20 ST. JOSEPH'S HOSPITAL - BREESE,37000075,99156,HC MODERATE SEDATION DIFF PHY >5YR 1ST 15MIN,370,1 ,$868.00 ,$624.96 ,$15.87 ,$868.00 , N/A ,$564.20 ,$518.20 , N/A ,$243.04 ,$574.62 , N/A ,$574.62 , N/A ,$517.33 ,$517.33 , N/A ,$517.33 , N/A ,$668.36 , N/A , N/A , N/A ,$651.00 ,$616.28 ,$616.28 , N/A ,$616.28 ,$737.80 ,$737.80 ,$737.80 , N/A , N/A ,$737.80 , N/A ,$200.00 ,$486.95 , N/A ,$359.35 ,$17.46 ,$15.87 , N/A ,$737.80 , N/A ,$517.33 ,$243.04 ,$781.20 , N/A ,$737.80 ,$733.46 ,$733.46 , N/A ,$564.20 ST. JOSEPH'S HOSPITAL - BREESE,37000076,N/A,HC MONITORED ANESTHESIA INITIAL 15 MINS,370,1 ,$491.00 ,$353.52 ,$137.48 ,$491.00 , N/A ,$319.15 ,$293.13 , N/A ,$137.48 ,$325.04 , N/A ,$325.04 , N/A ,$292.64 ,$292.64 , N/A ,$292.64 , N/A ,$378.07 , N/A , N/A , N/A ,$368.25 ,$348.61 ,$348.61 , N/A ,$348.61 ,$417.35 ,$417.35 ,$417.35 , N/A , N/A ,$417.35 , N/A ,$491.00 ,$275.45 , N/A ,$203.27 , N/A , N/A , N/A ,$417.35 , N/A ,$292.64 ,$137.48 ,$441.90 , N/A ,$417.35 ,$414.90 ,$414.90 , N/A ,$319.15 ST. JOSEPH'S HOSPITAL - BREESE,37000077,N/A,HC MONITORED ANESTHESIA ADDL 15 MINS,370,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 , N/A , N/A , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,37001000,1967,HC EPIDURAL/SPINAL FOR LABOR,370,1 ,$827.00 ,$595.44 ,$15.87 ,$827.00 , N/A ,$537.55 ,$493.72 , N/A ,$231.56 ,$547.47 , N/A ,$547.47 , N/A ,$492.89 ,$492.89 , N/A ,$492.89 , N/A ,$636.79 , N/A , N/A , N/A ,$620.25 ,$587.17 ,$587.17 , N/A ,$587.17 ,$702.95 ,$702.95 ,$702.95 , N/A , N/A ,$702.95 , N/A ,$827.00 ,$463.95 , N/A ,$342.38 ,$17.46 ,$15.87 , N/A ,$702.95 , N/A ,$492.89 ,$231.56 ,$744.30 , N/A ,$702.95 ,$698.82 ,$698.82 , N/A ,$537.55 ST. JOSEPH'S HOSPITAL - BREESE,37080000,64447,HC FEMORAL NERVE BLOCK SINGLE,360,1 ,"$2,653.00 ","$1,910.16 ",$295.99 ,"$2,653.00 ","$1,546.98 ","$1,724.45 ","$1,583.84 ",$606.41 ,$742.84 ,"$1,756.29 ",$606.41 ,"$1,756.29 ",$606.41 ,"$1,581.19 ","$1,581.19 ",$606.41 ,"$1,581.19 ","$1,249.95 ","$2,042.81 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,989.75 ","$1,883.63 ","$1,883.63 ",$606.41 ,"$1,883.63 ","$2,255.05 ","$2,255.05 ","$2,255.05 ", N/A ,"$1,546.96 ","$2,255.05 ",$606.41 ,"$2,653.00 ","$1,488.33 ",$606.41 ,"$1,098.34 ",$325.59 ,$295.99 ,$606.41 ,"$2,255.05 ","$1,299.45 ","$1,581.19 ",$742.84 ,"$2,387.70 ",$606.41 ,"$2,255.05 ","$2,241.79 ","$2,241.79 ",$606.41 ,"$1,724.45 " ST. JOSEPH'S HOSPITAL - BREESE,39000143,86945,HC BLOOD PRODUCT IRRADIATION,390,1 ,$98.00 ,$70.56 ,$4.21 ,$98.00 ,$81.53 ,$63.70 ,$58.51 ,$31.96 ,$27.44 ,$64.88 ,$31.96 ,$64.88 ,$31.96 ,$58.41 ,$58.41 ,$31.96 ,$58.41 ,$65.88 ,$75.46 ,$81.53 ,$31.96 ,$32.60 ,$73.50 ,$69.58 ,$69.58 ,$31.96 ,$69.58 ,$83.30 ,$83.30 ,$83.30 , N/A ,$81.53 ,$83.30 ,$31.96 ,$98.00 ,$54.98 ,$31.96 ,$40.57 ,$4.63 ,$4.21 ,$31.96 ,$83.30 ,$68.49 ,$58.41 ,$27.44 ,$88.20 ,$31.96 ,$83.30 ,$82.81 ,$82.81 ,$31.96 ,$63.70 ST. JOSEPH'S HOSPITAL - BREESE,39000148,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$214.00 ,$154.08 ,$59.92 ,$214.00 ,$213.68 ,$139.10 ,$127.76 ,$83.76 ,$59.92 ,$141.67 ,$83.76 ,$141.67 ,$83.76 ,$127.54 ,$127.54 ,$83.76 ,$127.54 ,$172.65 ,$164.78 ,$213.68 ,$83.76 ,$85.44 ,$160.50 ,$151.94 ,$151.94 ,$83.76 ,$151.94 ,$181.90 ,$181.90 ,$181.90 , N/A ,$213.68 ,$181.90 ,$83.76 ,$214.00 ,$120.05 ,$83.76 ,$88.60 ,$214.00 ,$214.00 ,$83.76 ,$181.90 ,$179.49 ,$127.54 ,$59.92 ,$192.60 ,$83.76 ,$181.90 ,$180.83 ,$180.83 ,$83.76 ,$139.10 ST. JOSEPH'S HOSPITAL - BREESE,39000151,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,"$1,312.00 ",$944.64 ,$128.27 ,"$1,312.00 ",$327.23 ,$852.80 ,$783.26 ,$128.27 ,$367.36 ,$868.54 ,$128.27 ,$868.54 ,$128.27 ,$781.95 ,$781.95 ,$128.27 ,$781.95 ,$264.40 ,"$1,010.24 ",$327.23 ,$128.27 ,$130.84 ,$984.00 ,$931.52 ,$931.52 ,$128.27 ,$931.52 ,"$1,115.20 ","$1,115.20 ","$1,115.20 ", N/A ,$327.23 ,"$1,115.20 ",$128.27 ,"$1,312.00 ",$736.03 ,$128.27 ,$543.17 ,$491.45 ,$446.77 ,$128.27 ,"$1,115.20 ",$274.87 ,$781.95 ,$367.36 ,"$1,180.80 ",$128.27 ,"$1,115.20 ","$1,108.64 ","$1,108.64 ",$128.27 ,$852.80 ST. JOSEPH'S HOSPITAL - BREESE,39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,"$1,197.00 ",$861.84 ,$262.99 ,"$1,197.00 ",$670.90 ,$778.05 ,$714.61 ,$262.99 ,$335.16 ,$792.41 ,$262.99 ,$792.41 ,$262.99 ,$713.41 ,$713.41 ,$262.99 ,$713.41 ,$542.09 ,$921.69 ,$670.90 ,$262.99 ,$268.26 ,$897.75 ,$849.87 ,$849.87 ,$262.99 ,$849.87 ,"$1,017.45 ","$1,017.45 ","$1,017.45 ", N/A ,$670.90 ,"$1,017.45 ",$262.99 ,"$1,197.00 ",$671.52 ,$262.99 ,$495.56 ,$491.45 ,$446.77 ,$262.99 ,"$1,017.45 ",$563.56 ,$713.41 ,$335.16 ,"$1,077.30 ",$262.99 ,"$1,017.45 ","$1,011.47 ","$1,011.47 ",$262.99 ,$778.05 ST. JOSEPH'S HOSPITAL - BREESE,39000162,P9012,HC CRYOPRECIPITATE EA UNIT T1,390,1 ,$215.00 ,$154.80 ,$60.20 ,$215.00 ,$185.98 ,$139.75 ,$128.36 ,$72.90 ,$60.20 ,$142.33 ,$72.90 ,$142.33 ,$72.90 ,$128.14 ,$128.14 ,$72.90 ,$128.14 ,$150.27 ,$165.55 ,$185.98 ,$72.90 ,$74.36 ,$161.25 ,$152.65 ,$152.65 ,$72.90 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$185.98 ,$182.75 ,$72.90 ,$215.00 ,$120.62 ,$72.90 ,$89.01 ,$215.00 ,$215.00 ,$72.90 ,$182.75 ,$156.22 ,$128.14 ,$60.20 ,$193.50 ,$72.90 ,$182.75 ,$181.68 ,$181.68 ,$72.90 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,$748.00 ,$538.56 ,$185.43 ,$748.00 ,$473.03 ,$486.20 ,$446.56 ,$185.43 ,$209.44 ,$495.18 ,$185.43 ,$495.18 ,$185.43 ,$445.81 ,$445.81 ,$185.43 ,$445.81 ,$382.20 ,$575.96 ,$473.03 ,$185.43 ,$189.13 ,$561.00 ,$531.08 ,$531.08 ,$185.43 ,$531.08 ,$635.80 ,$635.80 ,$635.80 , N/A ,$473.03 ,$635.80 ,$185.43 ,$748.00 ,$419.63 ,$185.43 ,$309.67 ,$491.45 ,$446.77 ,$185.43 ,$635.80 ,$397.34 ,$445.81 ,$209.44 ,$673.20 ,$185.43 ,$635.80 ,$632.06 ,$632.06 ,$185.43 ,$486.20 ST. JOSEPH'S HOSPITAL - BREESE,39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,"$1,444.00 ","$1,039.68 ",$404.32 ,"$1,444.00 ","$1,214.15 ",$938.60 ,$862.07 ,$475.95 ,$404.32 ,$955.93 ,$475.95 ,$955.93 ,$475.95 ,$860.62 ,$860.62 ,$475.95 ,$860.62 ,$981.03 ,"$1,111.88 ","$1,214.15 ",$475.95 ,$485.46 ,"$1,083.00 ","$1,025.24 ","$1,025.24 ",$475.95 ,"$1,025.24 ","$1,227.40 ","$1,227.40 ","$1,227.40 ", N/A ,"$1,214.15 ","$1,227.40 ",$475.95 ,"$1,444.00 ",$810.08 ,$475.95 ,$597.82 ,$491.45 ,$446.77 ,$475.95 ,"$1,227.40 ","$1,019.89 ",$860.62 ,$404.32 ,"$1,299.60 ",$475.95 ,"$1,227.40 ","$1,220.18 ","$1,220.18 ",$475.95 ,$938.60 ST. JOSEPH'S HOSPITAL - BREESE,39000179,P9037,HC PLATELETS PHER L/R IRR EA T1,390,1 ,"$1,317.00 ",$948.24 ,$368.76 ,"$1,595.48 ","$1,595.48 ",$856.05 ,$786.25 ,$625.43 ,$368.76 ,$871.85 ,$625.43 ,$871.85 ,$625.43 ,$784.93 ,$784.93 ,$625.43 ,$784.93 ,"$1,289.14 ","$1,014.09 ","$1,595.48 ",$625.43 ,$637.93 ,$987.75 ,$935.07 ,$935.07 ,$625.43 ,$935.07 ,"$1,119.45 ","$1,119.45 ","$1,119.45 ", N/A ,"$1,317.00 ","$1,119.45 ",$625.43 ,"$1,317.00 ",$738.84 ,$625.43 ,$545.24 ,$491.45 ,$446.77 ,$625.43 ,"$1,119.45 ","$1,340.20 ",$784.93 ,$368.76 ,"$1,185.30 ",$625.43 ,"$1,119.45 ","$1,112.87 ","$1,112.87 ",$625.43 ,$856.05 ST. JOSEPH'S HOSPITAL - BREESE,39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,$814.00 ,$586.08 ,$227.92 ,$814.00 ,$647.80 ,$529.10 ,$485.96 ,$253.94 ,$227.92 ,$538.87 ,$253.94 ,$538.87 ,$253.94 ,$485.14 ,$485.14 ,$253.94 ,$485.14 ,$523.42 ,$626.78 ,$647.80 ,$253.94 ,$259.01 ,$610.50 ,$577.94 ,$577.94 ,$253.94 ,$577.94 ,$691.90 ,$691.90 ,$691.90 , N/A ,$647.80 ,$691.90 ,$253.94 ,$814.00 ,$456.65 ,$253.94 ,$337.00 ,$491.45 ,$446.77 ,$253.94 ,$691.90 ,$544.15 ,$485.14 ,$227.92 ,$732.60 ,$253.94 ,$691.90 ,$687.83 ,$687.83 ,$253.94 ,$529.10 ST. JOSEPH'S HOSPITAL - BREESE,39000198,P9058,HC RBC LEUKORED CMV NEG IRRAD,390,1 ,$568.00 ,$408.96 ,$159.04 ,$627.48 ,$627.48 ,$369.20 ,$339.10 ,$245.97 ,$159.04 ,$376.02 ,$245.97 ,$376.02 ,$245.97 ,$338.53 ,$338.53 ,$245.97 ,$338.53 ,$507.00 ,$437.36 ,$627.48 ,$245.97 ,$250.89 ,$426.00 ,$403.28 ,$403.28 ,$245.97 ,$403.28 ,$482.80 ,$482.80 ,$482.80 , N/A ,$568.00 ,$482.80 ,$245.97 ,$568.00 ,$318.65 ,$245.97 ,$235.15 ,$491.45 ,$446.77 ,$245.97 ,$482.80 ,$527.08 ,$338.53 ,$159.04 ,$511.20 ,$245.97 ,$482.80 ,$479.96 ,$479.96 ,$245.97 ,$369.20 ST. JOSEPH'S HOSPITAL - BREESE,39000205,P9073,HC PLATELETS PHERESIS PATH REDUCED EA UN T1,390,1 ,"$1,309.00 ",$942.48 ,$366.52 ,"$1,444.73 ","$1,444.73 ",$850.85 ,$781.47 ,$566.33 ,$366.52 ,$866.56 ,$566.33 ,$866.56 ,$566.33 ,$780.16 ,$780.16 ,$566.33 ,$780.16 ,"$1,167.34 ","$1,007.93 ","$1,444.73 ",$566.33 ,$577.66 ,$981.75 ,$929.39 ,$929.39 ,$566.33 ,$929.39 ,"$1,112.65 ","$1,112.65 ","$1,112.65 ", N/A ,"$1,309.00 ","$1,112.65 ",$566.33 ,"$1,309.00 ",$734.35 ,$566.33 ,$541.93 ,$491.45 ,$446.77 ,$566.33 ,"$1,112.65 ","$1,213.57 ",$780.16 ,$366.52 ,"$1,178.10 ",$566.33 ,"$1,112.65 ","$1,106.11 ","$1,106.11 ",$566.33 ,$850.85 ST. JOSEPH'S HOSPITAL - BREESE,39000212,P9053,HC PLATELETS LEUKOCUTES RED CMV NEG IRR,390,1 ,"$1,373.00 ",$988.56 ,$384.44 ,"$1,373.00 ","$1,331.13 ",$892.45 ,$819.68 ,$521.80 ,$384.44 ,$908.93 ,$521.80 ,$908.93 ,$521.80 ,$818.31 ,$818.31 ,$521.80 ,$818.31 ,"$1,075.55 ","$1,057.21 ","$1,331.13 ",$521.80 ,$532.24 ,"$1,029.75 ",$974.83 ,$974.83 ,$521.80 ,$974.83 ,"$1,167.05 ","$1,167.05 ","$1,167.05 ", N/A ,"$1,331.13 ","$1,167.05 ",$521.80 ,"$1,373.00 ",$770.25 ,$521.80 ,$568.42 ,$491.45 ,$446.77 ,$521.80 ,"$1,167.05 ","$1,118.15 ",$818.31 ,$384.44 ,"$1,235.70 ",$521.80 ,"$1,167.05 ","$1,160.19 ","$1,160.19 ",$521.80 ,$892.45 ST. JOSEPH'S HOSPITAL - BREESE,39100001,36430,HC BLOOD PROD ADMIN,391,1 ,"$1,007.00 ",$725.04 ,$281.96 ,"$1,007.00 ",$978.95 ,$654.55 ,$601.18 ,$383.75 ,$281.96 ,$666.63 ,$383.75 ,$666.63 ,$383.75 ,$600.17 ,$600.17 ,$383.75 ,$600.17 ,$790.99 ,$775.39 ,$978.95 ,$383.75 ,$391.42 ,$755.25 ,$714.97 ,$714.97 ,$383.75 ,$714.97 ,$855.95 ,$855.95 ,$855.95 , N/A ,$978.95 ,$855.95 ,$383.75 ,"$1,007.00 ",$564.93 ,$383.75 ,$416.90 ,$491.45 ,$446.77 ,$383.75 ,$855.95 ,$822.32 ,$600.17 ,$281.96 ,$906.30 ,$383.75 ,$855.95 ,$850.92 ,$850.92 ,$383.75 ,$654.55 ST. JOSEPH'S HOSPITAL - BREESE,40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$514.00 ,$370.08 ,$46.50 ,$514.00 ,$263.83 ,$334.10 ,$306.86 ,$103.42 ,$143.92 ,$340.27 ,$103.42 ,$340.27 ,$103.42 ,$306.34 ,$306.34 ,$103.42 ,$306.34 ,$213.17 ,$395.78 ,$263.83 ,$103.42 ,$105.49 ,$385.50 ,$364.94 ,$364.94 ,$103.42 ,$364.94 ,$436.90 ,$436.90 ,$436.90 , N/A ,$263.83 ,$436.90 ,$103.42 ,$117.23 ,$288.35 ,$103.42 ,$212.80 ,$51.15 ,$46.50 ,$103.42 ,$436.90 ,$221.61 ,$306.34 ,$143.92 ,$462.60 ,$103.42 ,$436.90 ,$434.33 ,$434.33 ,$103.42 ,$334.10 ST. JOSEPH'S HOSPITAL - BREESE,40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$514.00 ,$370.08 ,$46.50 ,$514.00 ,$263.83 ,$334.10 ,$306.86 ,$103.42 ,$143.92 ,$340.27 ,$103.42 ,$340.27 ,$103.42 ,$306.34 ,$306.34 ,$103.42 ,$306.34 ,$213.17 ,$395.78 ,$263.83 ,$103.42 ,$105.49 ,$385.50 ,$364.94 ,$364.94 ,$103.42 ,$364.94 ,$436.90 ,$436.90 ,$436.90 , N/A ,$263.83 ,$436.90 ,$103.42 ,$117.23 ,$288.35 ,$103.42 ,$212.80 ,$51.15 ,$46.50 ,$103.42 ,$436.90 ,$221.61 ,$306.34 ,$143.92 ,$462.60 ,$103.42 ,$436.90 ,$434.33 ,$434.33 ,$103.42 ,$334.10 ST. JOSEPH'S HOSPITAL - BREESE,40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$514.00 ,$370.08 ,$46.50 ,$514.00 ,$263.83 ,$334.10 ,$306.86 ,$103.42 ,$143.92 ,$340.27 ,$103.42 ,$340.27 ,$103.42 ,$306.34 ,$306.34 ,$103.42 ,$306.34 ,$213.17 ,$395.78 ,$263.83 ,$103.42 ,$105.49 ,$385.50 ,$364.94 ,$364.94 ,$103.42 ,$364.94 ,$436.90 ,$436.90 ,$436.90 , N/A ,$263.83 ,$436.90 ,$103.42 ,$117.23 ,$288.35 ,$103.42 ,$212.80 ,$51.15 ,$46.50 ,$103.42 ,$436.90 ,$221.61 ,$306.34 ,$143.92 ,$462.60 ,$103.42 ,$436.90 ,$434.33 ,$434.33 ,$103.42 ,$334.10 ST. JOSEPH'S HOSPITAL - BREESE,40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$292.00 ,$210.24 ,$46.50 ,$292.00 ,$207.10 ,$189.80 ,$174.32 ,$81.18 ,$81.76 ,$193.30 ,$81.18 ,$193.30 ,$81.18 ,$174.03 ,$174.03 ,$81.18 ,$174.03 ,$167.34 ,$224.84 ,$207.10 ,$81.18 ,$82.81 ,$219.00 ,$207.32 ,$207.32 ,$81.18 ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A ,$207.10 ,$248.20 ,$81.18 ,$92.02 ,$163.81 ,$81.18 ,$120.89 ,$51.15 ,$46.50 ,$81.18 ,$248.20 ,$173.96 ,$174.03 ,$81.76 ,$262.80 ,$81.18 ,$248.20 ,$246.74 ,$246.74 ,$81.18 ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD ADDNT VIEW,401,1 ,$292.00 ,$210.24 ,$46.50 ,$292.00 ,$207.10 ,$189.80 ,$174.32 ,$81.18 ,$81.76 ,$193.30 ,$81.18 ,$193.30 ,$81.18 ,$174.03 ,$174.03 ,$81.18 ,$174.03 ,$167.34 ,$224.84 ,$207.10 ,$81.18 ,$82.81 ,$219.00 ,$207.32 ,$207.32 ,$81.18 ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A ,$207.10 ,$248.20 ,$81.18 ,$92.02 ,$163.81 ,$81.18 ,$120.89 ,$51.15 ,$46.50 ,$81.18 ,$248.20 ,$173.96 ,$174.03 ,$81.76 ,$262.80 ,$81.18 ,$248.20 ,$246.74 ,$246.74 ,$81.18 ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$292.00 ,$210.24 ,$46.50 ,$292.00 ,$207.10 ,$189.80 ,$174.32 ,$81.18 ,$81.76 ,$193.30 ,$81.18 ,$193.30 ,$81.18 ,$174.03 ,$174.03 ,$81.18 ,$174.03 ,$167.34 ,$224.84 ,$207.10 ,$81.18 ,$82.81 ,$219.00 ,$207.32 ,$207.32 ,$81.18 ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A ,$207.10 ,$248.20 ,$81.18 ,$92.02 ,$163.81 ,$81.18 ,$120.89 ,$51.15 ,$46.50 ,$81.18 ,$248.20 ,$173.96 ,$174.03 ,$81.76 ,$262.80 ,$81.18 ,$248.20 ,$246.74 ,$246.74 ,$81.18 ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$103.00 ,$74.16 ,$22.24 ,$103.00 ,$56.73 ,$66.95 ,$61.49 ,$22.24 ,$28.84 ,$68.19 ,$22.24 ,$68.19 ,$22.24 ,$61.39 ,$61.39 ,$22.24 ,$61.39 ,$45.83 ,$79.31 ,$56.73 ,$22.24 ,$22.68 ,$77.25 ,$73.13 ,$73.13 ,$22.24 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$56.73 ,$87.55 ,$22.24 ,$25.20 ,$57.78 ,$22.24 ,$42.64 ,$51.15 ,$46.50 ,$22.24 ,$87.55 ,$47.65 ,$61.39 ,$28.84 ,$92.70 ,$22.24 ,$87.55 ,$87.04 ,$87.04 ,$22.24 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,40200007,51798,HC US BLADDER SCAN,402,1 ,$204.00 ,$146.88 ,$54.10 ,$204.00 ,$138.00 ,$132.60 ,$121.79 ,$54.10 ,$57.12 ,$135.05 ,$54.10 ,$135.05 ,$54.10 ,$121.58 ,$121.58 ,$54.10 ,$121.58 ,$111.50 ,$157.08 ,$138.00 ,$54.10 ,$55.17 ,$153.00 ,$144.84 ,$144.84 ,$54.10 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$138.00 ,$173.40 ,$54.10 ,$204.00 ,$114.44 ,$54.10 ,$84.46 ,$88.41 ,$80.37 ,$54.10 ,$173.40 ,$115.92 ,$121.58 ,$57.12 ,$183.60 ,$54.10 ,$173.40 ,$172.38 ,$172.38 ,$54.10 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,40200010,59000,HC AMNIOCENTESIS DIAGNOSTIC,402,1 ,$669.00 ,$481.68 ,$187.32 ,"$1,688.93 ","$1,688.93 ",$434.85 ,$399.39 ,$662.06 ,$187.32 ,$442.88 ,$662.06 ,$442.88 ,$655.62 ,$398.72 ,$398.72 ,$655.62 ,$398.72 ,$669.00 ,$515.13 ,"$1,688.93 ",$662.06 ,$655.62 ,$501.75 ,$474.99 ,$474.99 ,$662.06 ,$474.99 ,$568.65 ,$568.65 ,$568.65 , N/A ,$669.00 ,$568.65 ,$655.62 ,$669.00 ,$375.31 ,$662.06 ,$276.97 , N/A , N/A ,$662.06 ,$568.65 ,"$1,418.70 ",$398.72 ,$187.32 ,$602.10 ,$662.06 ,$568.65 ,$565.31 ,$565.31 ,$662.06 ,$434.85 ST. JOSEPH'S HOSPITAL - BREESE,40200012,76506,HC US ENCEPHALOGRAM,402,1 ,$788.00 ,$567.36 ,$100.59 ,$788.00 ,$256.60 ,$512.20 ,$470.44 ,$100.59 ,$220.64 ,$521.66 ,$100.59 ,$521.66 ,$100.59 ,$469.65 ,$469.65 ,$100.59 ,$469.65 ,$207.34 ,$606.76 ,$256.60 ,$100.59 ,$102.60 ,$591.00 ,$559.48 ,$559.48 ,$100.59 ,$559.48 ,$669.80 ,$669.80 ,$669.80 , N/A ,$256.60 ,$669.80 ,$100.59 ,$788.00 ,$442.07 ,$100.59 ,$326.23 ,$112.61 ,$102.37 ,$100.59 ,$669.80 ,$215.55 ,$469.65 ,$220.64 ,$709.20 ,$100.59 ,$669.80 ,$665.86 ,$665.86 ,$100.59 ,$512.20 ST. JOSEPH'S HOSPITAL - BREESE,40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,"$1,261.00 ",$907.92 ,$100.59 ,"$1,261.00 ",$256.60 ,$819.65 ,$752.82 ,$100.59 ,$353.08 ,$834.78 ,$100.59 ,$834.78 ,$100.59 ,$751.56 ,$751.56 ,$100.59 ,$751.56 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$945.75 ,$895.31 ,$895.31 ,$100.59 ,$895.31 ,"$1,071.85 ","$1,071.85 ","$1,071.85 ", N/A ,$256.60 ,"$1,071.85 ",$100.59 ,"$1,261.00 ",$707.42 ,$100.59 ,$522.05 ,$112.61 ,$102.37 ,$100.59 ,"$1,071.85 ",$215.55 ,$751.56 ,$353.08 ,"$1,134.90 ",$100.59 ,"$1,071.85 ","$1,065.55 ","$1,065.55 ",$100.59 ,$819.65 ST. JOSEPH'S HOSPITAL - BREESE,40200014,76604,HC US CHEST,402,1 ,$709.00 ,$510.48 ,$100.59 ,$709.00 ,$256.60 ,$460.85 ,$423.27 ,$100.59 ,$198.52 ,$469.36 ,$100.59 ,$469.36 ,$100.59 ,$422.56 ,$422.56 ,$100.59 ,$422.56 ,$207.34 ,$545.93 ,$256.60 ,$100.59 ,$102.60 ,$531.75 ,$503.39 ,$503.39 ,$100.59 ,$503.39 ,$602.65 ,$602.65 ,$602.65 , N/A ,$256.60 ,$602.65 ,$100.59 ,$709.00 ,$397.75 ,$100.59 ,$293.53 ,$112.61 ,$102.37 ,$100.59 ,$602.65 ,$215.55 ,$422.56 ,$198.52 ,$638.10 ,$100.59 ,$602.65 ,$599.11 ,$599.11 ,$100.59 ,$460.85 ST. JOSEPH'S HOSPITAL - BREESE,40200015,76641,HC US BREAST COMPLETE,402,1 ,"$1,028.00 ",$740.16 ,$72.77 ,"$1,028.00 ",$256.60 ,$668.20 ,$613.72 ,$100.59 ,$287.84 ,$680.54 ,$100.59 ,$680.54 ,$100.59 ,$612.69 ,$612.69 ,$100.59 ,$612.69 ,$207.34 ,$791.56 ,$256.60 ,$100.59 ,$102.60 ,$771.00 ,$729.88 ,$729.88 ,$100.59 ,$729.88 ,$873.80 ,$873.80 ,$873.80 , N/A ,$256.60 ,$873.80 ,$100.59 ,$72.77 ,$576.71 ,$100.59 ,$425.59 ,$112.61 ,$102.37 ,$100.59 ,$873.80 ,$215.55 ,$612.69 ,$287.84 ,$925.20 ,$100.59 ,$873.80 ,$868.66 ,$868.66 ,$100.59 ,$668.20 ST. JOSEPH'S HOSPITAL - BREESE,40200015,76641,HC US BREAST COMPLETE,402,1 ,"$1,543.00 ","$1,110.96 ",$72.77 ,"$1,543.00 ",$256.60 ,"$1,002.95 ",$921.17 ,$100.59 ,$432.04 ,"$1,021.47 ",$100.59 ,"$1,021.47 ",$100.59 ,$919.63 ,$919.63 ,$100.59 ,$919.63 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,157.25 ","$1,095.53 ","$1,095.53 ",$100.59 ,"$1,095.53 ","$1,311.55 ","$1,311.55 ","$1,311.55 ", N/A ,$256.60 ,"$1,311.55 ",$100.59 ,$72.77 ,$865.62 ,$100.59 ,$638.80 ,$168.92 ,$153.56 ,$100.59 ,"$1,311.55 ",$215.55 ,$919.63 ,$432.04 ,"$1,388.70 ",$100.59 ,"$1,311.55 ","$1,303.84 ","$1,303.84 ",$100.59 ,"$1,002.95 " ST. JOSEPH'S HOSPITAL - BREESE,40200016,76642,HC US BREAST LIMITED,402,1 ,$515.00 ,$370.80 ,$55.97 ,$515.00 ,$208.58 ,$334.75 ,$307.46 ,$81.76 ,$144.20 ,$340.93 ,$81.76 ,$340.93 ,$81.76 ,$306.94 ,$306.94 ,$81.76 ,$306.94 ,$168.54 ,$396.55 ,$208.59 ,$81.76 ,$83.40 ,$386.25 ,$365.65 ,$365.65 ,$81.76 ,$365.65 ,$437.75 ,$437.75 ,$437.75 , N/A ,$208.59 ,$437.75 ,$81.76 ,$55.97 ,$288.92 ,$81.76 ,$213.21 ,$112.61 ,$102.37 ,$81.76 ,$437.75 ,$175.21 ,$306.94 ,$144.20 ,$463.50 ,$81.76 ,$437.75 ,$435.18 ,$435.18 ,$81.76 ,$334.75 ST. JOSEPH'S HOSPITAL - BREESE,40200016,76642,HC US BREAST LIMITED,402,1 ,$771.00 ,$555.12 ,$55.97 ,$771.00 ,$208.58 ,$501.15 ,$460.29 ,$81.76 ,$215.88 ,$510.40 ,$81.76 ,$510.40 ,$81.76 ,$459.52 ,$459.52 ,$81.76 ,$459.52 ,$168.54 ,$593.67 ,$208.59 ,$81.76 ,$83.40 ,$578.25 ,$547.41 ,$547.41 ,$81.76 ,$547.41 ,$655.35 ,$655.35 ,$655.35 , N/A ,$208.59 ,$655.35 ,$81.76 ,$55.97 ,$432.53 ,$81.76 ,$319.19 ,$168.92 ,$153.56 ,$81.76 ,$655.35 ,$175.21 ,$459.52 ,$215.88 ,$693.90 ,$81.76 ,$655.35 ,$651.50 ,$651.50 ,$81.76 ,$501.15 ST. JOSEPH'S HOSPITAL - BREESE,40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,673.00 ","$1,204.56 ",$100.59 ,"$1,673.00 ",$256.60 ,"$1,087.45 ",$998.78 ,$100.59 ,$468.44 ,"$1,107.53 ",$100.59 ,"$1,107.53 ",$100.59 ,$997.11 ,$997.11 ,$100.59 ,$997.11 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,254.75 ","$1,187.83 ","$1,187.83 ",$100.59 ,"$1,187.83 ","$1,422.05 ","$1,422.05 ","$1,422.05 ", N/A ,$256.60 ,"$1,422.05 ",$100.59 ,"$1,673.00 ",$938.55 ,$100.59 ,$692.62 ,$112.61 ,$102.37 ,$100.59 ,"$1,422.05 ",$215.55 ,$997.11 ,$468.44 ,"$1,505.70 ",$100.59 ,"$1,422.05 ","$1,413.69 ","$1,413.69 ",$100.59 ,"$1,087.45 " ST. JOSEPH'S HOSPITAL - BREESE,40200018,76705,HC US ABDOMEN LTD,402,1 ,"$1,394.00 ","$1,003.68 ",$100.59 ,"$1,394.00 ",$256.60 ,$906.10 ,$832.22 ,$100.59 ,$390.32 ,$922.83 ,$100.59 ,$922.83 ,$100.59 ,$830.82 ,$830.82 ,$100.59 ,$830.82 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,045.50 ",$989.74 ,$989.74 ,$100.59 ,$989.74 ,"$1,184.90 ","$1,184.90 ","$1,184.90 ", N/A ,$256.60 ,"$1,184.90 ",$100.59 ,"$1,394.00 ",$782.03 ,$100.59 ,$577.12 ,$112.61 ,$102.37 ,$100.59 ,"$1,184.90 ",$215.55 ,$830.82 ,$390.32 ,"$1,254.60 ",$100.59 ,"$1,184.90 ","$1,177.93 ","$1,177.93 ",$100.59 ,$906.10 ST. JOSEPH'S HOSPITAL - BREESE,40200019,76770,HC US RETROPERITIONEAL,402,1 ,"$1,153.00 ",$830.16 ,$100.59 ,"$1,153.00 ",$256.60 ,$749.45 ,$688.34 ,$100.59 ,$322.84 ,$763.29 ,$100.59 ,$763.29 ,$100.59 ,$687.19 ,$687.19 ,$100.59 ,$687.19 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$864.75 ,$818.63 ,$818.63 ,$100.59 ,$818.63 ,$980.05 ,$980.05 ,$980.05 , N/A ,$256.60 ,$980.05 ,$100.59 ,"$1,153.00 ",$646.83 ,$100.59 ,$477.34 ,$112.61 ,$102.37 ,$100.59 ,$980.05 ,$215.55 ,$687.19 ,$322.84 ,"$1,037.70 ",$100.59 ,$980.05 ,$974.29 ,$974.29 ,$100.59 ,$749.45 ST. JOSEPH'S HOSPITAL - BREESE,40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,"$1,045.00 ",$752.40 ,$100.59 ,"$1,045.00 ",$256.60 ,$679.25 ,$623.87 ,$100.59 ,$292.60 ,$691.79 ,$100.59 ,$691.79 ,$100.59 ,$622.82 ,$622.82 ,$100.59 ,$622.82 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$783.75 ,$741.95 ,$741.95 ,$100.59 ,$741.95 ,$888.25 ,$888.25 ,$888.25 , N/A ,$256.60 ,$888.25 ,$100.59 ,"$1,045.00 ",$586.25 ,$100.59 ,$432.63 ,$112.61 ,$102.37 ,$100.59 ,$888.25 ,$215.55 ,$622.82 ,$292.60 ,$940.50 ,$100.59 ,$888.25 ,$883.03 ,$883.03 ,$100.59 ,$679.25 ST. JOSEPH'S HOSPITAL - BREESE,40200022,76800,HC US SPINAL CANAL AND CONTENTS,402,1 ,$358.00 ,$257.76 ,$100.24 ,$358.00 ,$256.60 ,$232.70 ,$213.73 ,$100.59 ,$100.24 ,$237.00 ,$100.59 ,$237.00 ,$100.59 ,$213.37 ,$213.37 ,$100.59 ,$213.37 ,$207.34 ,$275.66 ,$256.60 ,$100.59 ,$102.60 ,$268.50 ,$254.18 ,$254.18 ,$100.59 ,$254.18 ,$304.30 ,$304.30 ,$304.30 , N/A ,$256.60 ,$304.30 ,$100.59 ,$358.00 ,$200.84 ,$100.59 ,$148.21 ,$112.61 ,$102.37 ,$100.59 ,$304.30 ,$215.55 ,$213.37 ,$100.24 ,$322.20 ,$100.59 ,$304.30 ,$302.51 ,$302.51 ,$100.59 ,$232.70 ST. JOSEPH'S HOSPITAL - BREESE,40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,"$1,245.00 ",$896.40 ,$100.59 ,"$1,245.00 ",$256.60 ,$809.25 ,$743.27 ,$100.59 ,$348.60 ,$824.19 ,$100.59 ,$824.19 ,$100.59 ,$742.02 ,$742.02 ,$100.59 ,$742.02 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$933.75 ,$883.95 ,$883.95 ,$100.59 ,$883.95 ,"$1,058.25 ","$1,058.25 ","$1,058.25 ", N/A ,$256.60 ,"$1,058.25 ",$100.59 ,"$1,245.00 ",$698.45 ,$100.59 ,$515.43 , N/A , N/A ,$100.59 ,"$1,058.25 ",$215.55 ,$742.02 ,$348.60 ,"$1,120.50 ",$100.59 ,"$1,058.25 ","$1,052.03 ","$1,052.03 ",$100.59 ,$809.25 ST. JOSEPH'S HOSPITAL - BREESE,40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$571.00 ,$411.12 ,$159.88 ,$571.00 , N/A ,$371.15 ,$340.89 , N/A ,$159.88 ,$378.00 , N/A ,$378.00 , N/A ,$340.32 ,$340.32 , N/A ,$340.32 , N/A ,$439.67 , N/A , N/A , N/A ,$428.25 ,$405.41 ,$405.41 , N/A ,$405.41 ,$485.35 ,$485.35 ,$485.35 , N/A , N/A ,$485.35 , N/A ,$571.00 ,$320.33 , N/A ,$236.39 , N/A , N/A , N/A ,$485.35 , N/A ,$340.32 ,$159.88 ,$513.90 , N/A ,$485.35 ,$482.50 ,$482.50 , N/A ,$371.15 ST. JOSEPH'S HOSPITAL - BREESE,40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,"$1,341.00 ",$965.52 ,$100.59 ,"$1,341.00 ",$256.60 ,$871.65 ,$800.58 ,$100.59 ,$375.48 ,$887.74 ,$100.59 ,$887.74 ,$100.59 ,$799.24 ,$799.24 ,$100.59 ,$799.24 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,005.75 ",$952.11 ,$952.11 ,$100.59 ,$952.11 ,"$1,139.85 ","$1,139.85 ","$1,139.85 ", N/A ,$256.60 ,"$1,139.85 ",$100.59 ,"$1,341.00 ",$752.30 ,$100.59 ,$555.17 , N/A , N/A ,$100.59 ,"$1,139.85 ",$215.55 ,$799.24 ,$375.48 ,"$1,206.90 ",$100.59 ,"$1,139.85 ","$1,133.15 ","$1,133.15 ",$100.59 ,$871.65 ST. JOSEPH'S HOSPITAL - BREESE,40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,"$1,140.00 ",$820.80 ,$319.20 ,"$1,140.00 ", N/A ,$741.00 ,$680.58 , N/A ,$319.20 ,$754.68 , N/A ,$754.68 , N/A ,$679.44 ,$679.44 , N/A ,$679.44 , N/A ,$800.00 , N/A , N/A , N/A ,$855.00 ,$809.40 ,$809.40 , N/A ,$809.40 ,$969.00 ,$969.00 ,$969.00 , N/A , N/A ,$969.00 , N/A ,"$1,140.00 ",$639.54 , N/A ,$471.96 , N/A , N/A , N/A ,$969.00 , N/A ,$679.44 ,$319.20 ,"$1,026.00 ", N/A ,$969.00 ,$963.30 ,$963.30 , N/A ,$741.00 ST. JOSEPH'S HOSPITAL - BREESE,40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,"$1,513.00 ","$1,089.36 ",$219.77 ,"$1,513.00 ",$560.65 ,$983.45 ,$903.26 ,$219.77 ,$423.64 ,"$1,001.61 ",$219.77 ,"$1,001.61 ",$219.77 ,$901.75 ,$901.75 ,$219.77 ,$901.75 ,$453.00 ,$800.00 ,$560.65 ,$219.77 ,$224.17 ,"$1,134.75 ","$1,074.23 ","$1,074.23 ",$219.77 ,"$1,074.23 ","$1,286.05 ","$1,286.05 ","$1,286.05 ", N/A ,$560.65 ,"$1,286.05 ",$219.77 ,"$1,513.00 ",$848.79 ,$219.77 ,$626.38 , N/A , N/A ,$219.77 ,"$1,286.05 ",$470.94 ,$901.75 ,$423.64 ,"$1,361.70 ",$219.77 ,"$1,286.05 ","$1,278.49 ","$1,278.49 ",$219.77 ,$983.45 ST. JOSEPH'S HOSPITAL - BREESE,40200029,76812,HC US PREGNANCY DETAILED ADDL,402,1 ,$696.00 ,$501.12 ,$194.88 ,$696.00 , N/A ,$452.40 ,$415.51 , N/A ,$194.88 ,$460.75 , N/A ,$460.75 , N/A ,$414.82 ,$414.82 , N/A ,$414.82 , N/A ,$535.92 , N/A , N/A , N/A ,$522.00 ,$494.16 ,$494.16 , N/A ,$494.16 ,$591.60 ,$591.60 ,$591.60 , N/A , N/A ,$591.60 , N/A ,$696.00 ,$390.46 , N/A ,$288.14 , N/A , N/A , N/A ,$591.60 , N/A ,$414.82 ,$194.88 ,$626.40 , N/A ,$591.60 ,$588.12 ,$588.12 , N/A ,$452.40 ST. JOSEPH'S HOSPITAL - BREESE,40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,"$1,173.00 ",$844.56 ,$100.59 ,"$1,173.00 ",$256.60 ,$762.45 ,$700.28 ,$100.59 ,$328.44 ,$776.53 ,$100.59 ,$776.53 ,$100.59 ,$699.11 ,$699.11 ,$100.59 ,$699.11 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$879.75 ,$832.83 ,$832.83 ,$100.59 ,$832.83 ,$997.05 ,$997.05 ,$997.05 , N/A ,$256.60 ,$997.05 ,$100.59 ,"$1,173.00 ",$658.05 ,$100.59 ,$485.62 , N/A , N/A ,$100.59 ,$997.05 ,$215.55 ,$699.11 ,$328.44 ,"$1,055.70 ",$100.59 ,$997.05 ,$991.19 ,$991.19 ,$100.59 ,$762.45 ST. JOSEPH'S HOSPITAL - BREESE,40200031,76815,HC US FETAL HEART BEAT,402,1 ,"$1,104.00 ",$794.88 ,$100.59 ,"$1,104.00 ",$256.60 ,$717.60 ,$659.09 ,$100.59 ,$309.12 ,$730.85 ,$100.59 ,$730.85 ,$100.59 ,$657.98 ,$657.98 ,$100.59 ,$657.98 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$828.00 ,$783.84 ,$783.84 ,$100.59 ,$783.84 ,$938.40 ,$938.40 ,$938.40 , N/A ,$256.60 ,$938.40 ,$100.59 ,"$1,104.00 ",$619.34 ,$100.59 ,$457.06 , N/A , N/A ,$100.59 ,$938.40 ,$215.55 ,$657.98 ,$309.12 ,$993.60 ,$100.59 ,$938.40 ,$932.88 ,$932.88 ,$100.59 ,$717.60 ST. JOSEPH'S HOSPITAL - BREESE,40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,"$1,128.00 ",$812.16 ,$100.59 ,"$1,128.00 ",$256.60 ,$733.20 ,$673.42 ,$100.59 ,$315.84 ,$746.74 ,$100.59 ,$746.74 ,$100.59 ,$672.29 ,$672.29 ,$100.59 ,$672.29 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$846.00 ,$800.88 ,$800.88 ,$100.59 ,$800.88 ,$958.80 ,$958.80 ,$958.80 , N/A ,$256.60 ,$958.80 ,$100.59 ,"$1,128.00 ",$632.81 ,$100.59 ,$466.99 , N/A , N/A ,$100.59 ,$958.80 ,$215.55 ,$672.29 ,$315.84 ,"$1,015.20 ",$100.59 ,$958.80 ,$953.16 ,$953.16 ,$100.59 ,$733.20 ST. JOSEPH'S HOSPITAL - BREESE,40200033,76818,HC US FETAL BIO PROFILE W/NST,402,1 ,"$1,901.00 ","$1,368.72 ",$100.59 ,"$1,901.00 ",$256.60 ,"$1,235.65 ","$1,134.90 ",$100.59 ,$532.28 ,"$1,258.46 ",$100.59 ,"$1,258.46 ",$100.59 ,"$1,133.00 ","$1,133.00 ",$100.59 ,"$1,133.00 ",$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,425.75 ","$1,349.71 ","$1,349.71 ",$100.59 ,"$1,349.71 ","$1,615.85 ","$1,615.85 ","$1,615.85 ", N/A ,$256.60 ,"$1,615.85 ",$100.59 ,"$1,901.00 ","$1,066.46 ",$100.59 ,$787.01 , N/A , N/A ,$100.59 ,"$1,615.85 ",$215.55 ,"$1,133.00 ",$532.28 ,"$1,710.90 ",$100.59 ,"$1,615.85 ","$1,606.35 ","$1,606.35 ",$100.59 ,"$1,235.65 " ST. JOSEPH'S HOSPITAL - BREESE,40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,"$1,457.00 ","$1,049.04 ",$100.59 ,"$1,457.00 ",$256.60 ,$947.05 ,$869.83 ,$100.59 ,$407.96 ,$964.53 ,$100.59 ,$964.53 ,$100.59 ,$868.37 ,$868.37 ,$100.59 ,$868.37 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,092.75 ","$1,034.47 ","$1,034.47 ",$100.59 ,"$1,034.47 ","$1,238.45 ","$1,238.45 ","$1,238.45 ", N/A ,$256.60 ,"$1,238.45 ",$100.59 ,"$1,457.00 ",$817.38 ,$100.59 ,$603.20 , N/A , N/A ,$100.59 ,"$1,238.45 ",$215.55 ,$868.37 ,$407.96 ,"$1,311.30 ",$100.59 ,"$1,238.45 ","$1,231.17 ","$1,231.17 ",$100.59 ,$947.05 ST. JOSEPH'S HOSPITAL - BREESE,40200035,76819,HC US FETAL BIO PROFILE W/O NST EA ADDN,402,1 ,$310.00 ,$223.20 ,$86.80 ,$310.00 ,$256.60 ,$201.50 ,$185.07 ,$100.59 ,$86.80 ,$205.22 ,$100.59 ,$205.22 ,$100.59 ,$184.76 ,$184.76 ,$100.59 ,$184.76 ,$207.34 ,$238.70 ,$256.60 ,$100.59 ,$102.60 ,$232.50 ,$220.10 ,$220.10 ,$100.59 ,$220.10 ,$263.50 ,$263.50 ,$263.50 , N/A ,$256.60 ,$263.50 ,$100.59 ,$310.00 ,$173.91 ,$100.59 ,$128.34 , N/A , N/A ,$100.59 ,$263.50 ,$215.55 ,$184.76 ,$86.80 ,$279.00 ,$100.59 ,$263.50 ,$261.95 ,$261.95 ,$100.59 ,$201.50 ST. JOSEPH'S HOSPITAL - BREESE,40200036,76820,HC US FETAL DOPLR VELO UMB,402,1 ,$592.00 ,$426.24 ,$100.59 ,$592.00 ,$256.60 ,$384.80 ,$353.42 ,$100.59 ,$165.76 ,$391.90 ,$100.59 ,$391.90 ,$100.59 ,$352.83 ,$352.83 ,$100.59 ,$352.83 ,$207.34 ,$455.84 ,$256.60 ,$100.59 ,$102.60 ,$444.00 ,$420.32 ,$420.32 ,$100.59 ,$420.32 ,$503.20 ,$503.20 ,$503.20 , N/A ,$256.60 ,$503.20 ,$100.59 ,$592.00 ,$332.11 ,$100.59 ,$245.09 , N/A , N/A ,$100.59 ,$503.20 ,$215.55 ,$352.83 ,$165.76 ,$532.80 ,$100.59 ,$503.20 ,$500.24 ,$500.24 ,$100.59 ,$384.80 ST. JOSEPH'S HOSPITAL - BREESE,40200037,76821,HC US FETL DOPLR VELOCIMERTY,402,1 ,$310.00 ,$223.20 ,$86.80 ,$310.00 ,$256.60 ,$201.50 ,$185.07 ,$100.59 ,$86.80 ,$205.22 ,$100.59 ,$205.22 ,$100.59 ,$184.76 ,$184.76 ,$100.59 ,$184.76 ,$207.34 ,$238.70 ,$256.60 ,$100.59 ,$102.60 ,$232.50 ,$220.10 ,$220.10 ,$100.59 ,$220.10 ,$263.50 ,$263.50 ,$263.50 , N/A ,$256.60 ,$263.50 ,$100.59 ,$310.00 ,$173.91 ,$100.59 ,$128.34 , N/A , N/A ,$100.59 ,$263.50 ,$215.55 ,$184.76 ,$86.80 ,$279.00 ,$100.59 ,$263.50 ,$261.95 ,$261.95 ,$100.59 ,$201.50 ST. JOSEPH'S HOSPITAL - BREESE,40200038,76830,HC US TRANSVAGINAL,402,1 ,$996.00 ,$717.12 ,$100.59 ,$996.00 ,$256.60 ,$647.40 ,$594.61 ,$100.59 ,$278.88 ,$659.35 ,$100.59 ,$659.35 ,$100.59 ,$593.62 ,$593.62 ,$100.59 ,$593.62 ,$207.34 ,$766.92 ,$256.60 ,$100.59 ,$102.60 ,$747.00 ,$707.16 ,$707.16 ,$100.59 ,$707.16 ,$846.60 ,$846.60 ,$846.60 , N/A ,$256.60 ,$846.60 ,$100.59 ,$996.00 ,$558.76 ,$100.59 ,$412.34 ,$112.61 ,$102.37 ,$100.59 ,$846.60 ,$215.55 ,$593.62 ,$278.88 ,$896.40 ,$100.59 ,$846.60 ,$841.62 ,$841.62 ,$100.59 ,$647.40 ST. JOSEPH'S HOSPITAL - BREESE,40200039,76831,HC US HYSTEROSONOGRAM,402,1 ,"$1,174.00 ",$845.28 ,$219.77 ,"$1,174.00 ",$560.65 ,$763.10 ,$700.88 ,$219.77 ,$328.72 ,$777.19 ,$219.77 ,$777.19 ,$219.77 ,$699.70 ,$699.70 ,$219.77 ,$699.70 ,$453.00 ,$800.00 ,$560.65 ,$219.77 ,$224.17 ,$880.50 ,$833.54 ,$833.54 ,$219.77 ,$833.54 ,$997.90 ,$997.90 ,$997.90 , N/A ,$560.65 ,$997.90 ,$219.77 ,"$1,174.00 ",$658.61 ,$219.77 ,$486.04 ,$257.03 ,$233.66 ,$219.77 ,$997.90 ,$470.94 ,$699.70 ,$328.72 ,"$1,056.60 ",$219.77 ,$997.90 ,$992.03 ,$992.03 ,$219.77 ,$763.10 ST. JOSEPH'S HOSPITAL - BREESE,40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,468.00 ","$1,056.96 ",$77.32 ,"$1,468.00 ",$256.60 ,$954.20 ,$876.40 ,$100.59 ,$411.04 ,$971.82 ,$100.59 ,$971.82 ,$100.59 ,$874.93 ,$874.93 ,$100.59 ,$874.93 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,"$1,101.00 ","$1,042.28 ","$1,042.28 ",$100.59 ,"$1,042.28 ","$1,247.80 ","$1,247.80 ","$1,247.80 ", N/A ,$256.60 ,"$1,247.80 ",$100.59 ,$77.32 ,$823.55 ,$100.59 ,$607.75 ,$112.61 ,$102.37 ,$100.59 ,"$1,247.80 ",$215.55 ,$874.93 ,$411.04 ,"$1,321.20 ",$100.59 ,"$1,247.80 ","$1,240.46 ","$1,240.46 ",$100.59 ,$954.20 ST. JOSEPH'S HOSPITAL - BREESE,40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$668.00 ,$480.96 ,$100.59 ,$668.00 ,$256.60 ,$434.20 ,$398.80 ,$100.59 ,$187.04 ,$442.22 ,$100.59 ,$442.22 ,$100.59 ,$398.13 ,$398.13 ,$100.59 ,$398.13 ,$207.34 ,$514.36 ,$256.60 ,$100.59 ,$102.60 ,$501.00 ,$474.28 ,$474.28 ,$100.59 ,$474.28 ,$567.80 ,$567.80 ,$567.80 , N/A ,$256.60 ,$567.80 ,$100.59 ,$668.00 ,$374.75 ,$100.59 ,$276.55 ,$112.61 ,$102.37 ,$100.59 ,$567.80 ,$215.55 ,$398.13 ,$187.04 ,$601.20 ,$100.59 ,$567.80 ,$564.46 ,$564.46 ,$100.59 ,$434.20 ST. JOSEPH'S HOSPITAL - BREESE,40200042,76870,HC US SCROTUM,402,1 ,"$1,173.00 ",$844.56 ,$100.59 ,"$1,173.00 ",$256.60 ,$762.45 ,$700.28 ,$100.59 ,$328.44 ,$776.53 ,$100.59 ,$776.53 ,$100.59 ,$699.11 ,$699.11 ,$100.59 ,$699.11 ,$207.34 ,$800.00 ,$256.60 ,$100.59 ,$102.60 ,$879.75 ,$832.83 ,$832.83 ,$100.59 ,$832.83 ,$997.05 ,$997.05 ,$997.05 , N/A ,$256.60 ,$997.05 ,$100.59 ,"$1,173.00 ",$658.05 ,$100.59 ,$485.62 ,$112.61 ,$102.37 ,$100.59 ,$997.05 ,$215.55 ,$699.11 ,$328.44 ,"$1,055.70 ",$100.59 ,$997.05 ,$991.19 ,$991.19 ,$100.59 ,$762.45 ST. JOSEPH'S HOSPITAL - BREESE,40200043,76872,HC ULTRA BX PROS,402,1 ,"$1,029.00 ",$740.88 ,$100.59 ,"$1,029.00 ",$256.60 ,$668.85 ,$614.31 ,$100.59 ,$288.12 ,$681.20 ,$100.59 ,$681.20 ,$100.59 ,$613.28 ,$613.28 ,$100.59 ,$613.28 ,$207.34 ,$792.33 ,$256.60 ,$100.59 ,$102.60 ,$771.75 ,$730.59 ,$730.59 ,$100.59 ,$730.59 ,$874.65 ,$874.65 ,$874.65 , N/A ,$256.60 ,$874.65 ,$100.59 ,"$1,029.00 ",$577.27 ,$100.59 ,$426.01 ,$112.61 ,$102.37 ,$100.59 ,$874.65 ,$215.55 ,$613.28 ,$288.12 ,$926.10 ,$100.59 ,$874.65 ,$869.51 ,$869.51 ,$100.59 ,$668.85 ST. JOSEPH'S HOSPITAL - BREESE,40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$862.00 ,$620.64 ,$100.59 ,$862.00 ,$256.60 ,$560.30 ,$514.61 ,$100.59 ,$241.36 ,$570.64 ,$100.59 ,$570.64 ,$100.59 ,$513.75 ,$513.75 ,$100.59 ,$513.75 ,$207.34 ,$663.74 ,$256.60 ,$100.59 ,$102.60 ,$646.50 ,$612.02 ,$612.02 ,$100.59 ,$612.02 ,$732.70 ,$732.70 ,$732.70 , N/A ,$256.60 ,$732.70 ,$100.59 ,$862.00 ,$483.58 ,$100.59 ,$356.87 ,$112.61 ,$102.37 ,$100.59 ,$732.70 ,$215.55 ,$513.75 ,$241.36 ,$775.80 ,$100.59 ,$732.70 ,$728.39 ,$728.39 ,$100.59 ,$560.30 ST. JOSEPH'S HOSPITAL - BREESE,40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$734.00 ,$528.48 ,$100.59 ,$734.00 ,$256.60 ,$477.10 ,$438.20 ,$100.59 ,$205.52 ,$485.91 ,$100.59 ,$485.91 ,$100.59 ,$437.46 ,$437.46 ,$100.59 ,$437.46 ,$207.34 ,$565.18 ,$256.60 ,$100.59 ,$102.60 ,$550.50 ,$521.14 ,$521.14 ,$100.59 ,$521.14 ,$623.90 ,$623.90 ,$623.90 , N/A ,$256.60 ,$623.90 ,$100.59 ,$734.00 ,$411.77 ,$100.59 ,$303.88 ,$112.61 ,$102.37 ,$100.59 ,$623.90 ,$215.55 ,$437.46 ,$205.52 ,$660.60 ,$100.59 ,$623.90 ,$620.23 ,$620.23 ,$100.59 ,$477.10 ST. JOSEPH'S HOSPITAL - BREESE,40200048,76885,HC US HIPS INFANT DYNAMIC,402,1 ,$567.00 ,$408.24 ,$81.76 ,$567.00 ,$208.58 ,$368.55 ,$338.50 ,$81.76 ,$158.76 ,$375.35 ,$81.76 ,$375.35 ,$81.76 ,$337.93 ,$337.93 ,$81.76 ,$337.93 ,$168.54 ,$436.59 ,$208.59 ,$81.76 ,$83.40 ,$425.25 ,$402.57 ,$402.57 ,$81.76 ,$402.57 ,$481.95 ,$481.95 ,$481.95 , N/A ,$208.59 ,$481.95 ,$81.76 ,$567.00 ,$318.09 ,$81.76 ,$234.74 , N/A , N/A ,$81.76 ,$481.95 ,$175.21 ,$337.93 ,$158.76 ,$510.30 ,$81.76 ,$481.95 ,$479.12 ,$479.12 ,$81.76 ,$368.55 ST. JOSEPH'S HOSPITAL - BREESE,40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$775.00 ,$558.00 ,$74.71 ,$775.00 , N/A ,$503.75 ,$462.68 , N/A ,$217.00 ,$513.05 , N/A ,$513.05 , N/A ,$461.90 ,$461.90 , N/A ,$461.90 , N/A ,$596.75 , N/A , N/A , N/A ,$581.25 ,$550.25 ,$550.25 , N/A ,$550.25 ,$658.75 ,$658.75 ,$658.75 , N/A , N/A ,$658.75 , N/A ,$775.00 ,$434.78 , N/A ,$320.85 ,$82.18 ,$74.71 , N/A ,$658.75 , N/A ,$461.90 ,$217.00 ,$697.50 , N/A ,$658.75 ,$654.88 ,$654.88 , N/A ,$503.75 ST. JOSEPH'S HOSPITAL - BREESE,40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,"$1,359.00 ",$978.48 ,$29.71 ,"$1,359.00 ", N/A ,$883.35 ,$811.32 , N/A ,$380.52 ,$899.66 , N/A ,$899.66 , N/A ,$809.96 ,$809.96 , N/A ,$809.96 , N/A ,$800.00 , N/A , N/A , N/A ,"$1,019.25 ",$964.89 ,$964.89 , N/A ,$964.89 ,"$1,155.15 ","$1,155.15 ","$1,155.15 ", N/A , N/A ,"$1,155.15 ", N/A ,$29.71 ,$762.40 , N/A ,$562.63 ,$82.18 ,$74.71 , N/A ,"$1,155.15 ", N/A ,$809.96 ,$380.52 ,"$1,223.10 ", N/A ,"$1,155.15 ","$1,148.36 ","$1,148.36 ", N/A ,$883.35 ST. JOSEPH'S HOSPITAL - BREESE,40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,$620.00 ,$446.40 ,$74.71 ,$620.00 , N/A ,$403.00 ,$370.14 , N/A ,$173.60 ,$410.44 , N/A ,$410.44 , N/A ,$369.52 ,$369.52 , N/A ,$369.52 , N/A ,$477.40 , N/A , N/A , N/A ,$465.00 ,$440.20 ,$440.20 , N/A ,$440.20 ,$527.00 ,$527.00 ,$527.00 , N/A , N/A ,$527.00 , N/A ,$620.00 ,$347.82 , N/A ,$256.68 ,$82.18 ,$74.71 , N/A ,$527.00 , N/A ,$369.52 ,$173.60 ,$558.00 , N/A ,$527.00 ,$523.90 ,$523.90 , N/A ,$403.00 ST. JOSEPH'S HOSPITAL - BREESE,40200062,76998,HC US INTRAOPERATIVE,402,1 ,$906.00 ,$652.32 ,$74.71 ,$906.00 , N/A ,$588.90 ,$540.88 , N/A ,$253.68 ,$599.77 , N/A ,$599.77 , N/A ,$539.98 ,$539.98 , N/A ,$539.98 , N/A ,$697.62 , N/A , N/A , N/A ,$679.50 ,$643.26 ,$643.26 , N/A ,$643.26 ,$770.10 ,$770.10 ,$770.10 , N/A , N/A ,$770.10 , N/A ,$906.00 ,$508.27 , N/A ,$375.08 ,$82.18 ,$74.71 , N/A ,$770.10 , N/A ,$539.98 ,$253.68 ,$815.40 , N/A ,$770.10 ,$765.57 ,$765.57 , N/A ,$588.90 ST. JOSEPH'S HOSPITAL - BREESE,40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,$735.00 ,$529.20 ,$102.37 ,$735.00 ,$560.65 ,$477.75 ,$438.80 ,$219.77 ,$205.80 ,$486.57 ,$219.77 ,$486.57 ,$219.77 ,$438.06 ,$438.06 ,$219.77 ,$438.06 ,$453.00 ,$565.95 ,$560.65 ,$219.77 ,$224.17 ,$551.25 ,$521.85 ,$521.85 ,$219.77 ,$521.85 ,$624.75 ,$624.75 ,$624.75 , N/A ,$560.65 ,$624.75 ,$219.77 ,$735.00 ,$412.34 ,$219.77 ,$304.29 ,$112.61 ,$102.37 ,$219.77 ,$624.75 ,$470.94 ,$438.06 ,$205.80 ,$661.50 ,$219.77 ,$624.75 ,$621.08 ,$621.08 ,$219.77 ,$477.75 ST. JOSEPH'S HOSPITAL - BREESE,40200068,93976,HC DUPLEX ABD/PEL/RETRO LTD,402,1 ,"$1,025.00 ",$738.00 ,$100.59 ,"$1,025.00 ",$256.60 ,$666.25 ,$611.93 ,$100.59 ,$287.00 ,$678.55 ,$100.59 ,$678.55 ,$100.59 ,$610.90 ,$610.90 ,$100.59 ,$610.90 ,$207.34 ,$789.25 ,$256.60 ,$100.59 ,$102.60 ,$768.75 ,$727.75 ,$727.75 ,$100.59 ,$727.75 ,$871.25 ,$871.25 ,$871.25 , N/A ,$256.60 ,$871.25 ,$100.59 ,"$1,025.00 ",$575.03 ,$100.59 ,$424.35 ,$112.61 ,$102.37 ,$100.59 ,$871.25 ,$215.55 ,$610.90 ,$287.00 ,$922.50 ,$100.59 ,$871.25 ,$866.13 ,$866.13 ,$100.59 ,$666.25 ST. JOSEPH'S HOSPITAL - BREESE,40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,025.00 ",$738.00 ,$100.59 ,"$1,025.00 ",$256.60 ,$666.25 ,$611.93 ,$100.59 ,$287.00 ,$678.55 ,$100.59 ,$678.55 ,$100.59 ,$610.90 ,$610.90 ,$100.59 ,$610.90 ,$207.34 ,$789.25 ,$256.60 ,$100.59 ,$102.60 ,$768.75 ,$727.75 ,$727.75 ,$100.59 ,$727.75 ,$871.25 ,$871.25 ,$871.25 , N/A ,$256.60 ,$871.25 ,$100.59 ,"$1,025.00 ",$575.03 ,$100.59 ,$424.35 ,$112.61 ,$102.37 ,$100.59 ,$871.25 ,$215.55 ,$610.90 ,$287.00 ,$922.50 ,$100.59 ,$871.25 ,$866.13 ,$866.13 ,$100.59 ,$666.25 ST. JOSEPH'S HOSPITAL - BREESE,40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,"$1,500.00 ","$1,080.00 ",$102.37 ,"$1,500.00 ",$560.65 ,$975.00 ,$895.50 ,$219.77 ,$420.00 ,$993.00 ,$219.77 ,$993.00 ,$219.77 ,$894.00 ,$894.00 ,$219.77 ,$894.00 ,$453.00 ,"$1,155.00 ",$560.65 ,$219.77 ,$224.17 ,"$1,125.00 ","$1,065.00 ","$1,065.00 ",$219.77 ,"$1,065.00 ","$1,275.00 ","$1,275.00 ","$1,275.00 ", N/A ,$560.65 ,"$1,275.00 ",$219.77 ,"$1,500.00 ",$841.50 ,$219.77 ,$621.00 ,$112.61 ,$102.37 ,$219.77 ,"$1,275.00 ",$470.94 ,$894.00 ,$420.00 ,"$1,350.00 ",$219.77 ,"$1,275.00 ","$1,267.50 ","$1,267.50 ",$219.77 ,$975.00 ST. JOSEPH'S HOSPITAL - BREESE,40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,$355.00 ,$255.60 ,$99.40 ,$355.00 ,$256.60 ,$230.75 ,$211.94 ,$100.59 ,$99.40 ,$235.01 ,$100.59 ,$235.01 ,$100.59 ,$211.58 ,$211.58 ,$100.59 ,$211.58 ,$207.34 ,$273.35 ,$256.60 ,$100.59 ,$102.60 ,$266.25 ,$252.05 ,$252.05 ,$100.59 ,$252.05 ,$301.75 ,$301.75 ,$301.75 , N/A ,$256.60 ,$301.75 ,$100.59 ,$355.00 ,$199.16 ,$100.59 ,$146.97 ,$112.61 ,$102.37 ,$100.59 ,$301.75 ,$215.55 ,$211.58 ,$99.40 ,$319.50 ,$100.59 ,$301.75 ,$299.98 ,$299.98 ,$100.59 ,$230.75 ST. JOSEPH'S HOSPITAL - BREESE,40200075,76706,HC US AORTA (SCREENING),402,1 ,$970.00 ,$698.40 ,$100.59 ,$970.00 ,$256.60 ,$630.50 ,$579.09 ,$100.59 ,$271.60 ,$642.14 ,$100.59 ,$642.14 ,$100.59 ,$578.12 ,$578.12 ,$100.59 ,$578.12 ,$207.34 ,$746.90 ,$256.60 ,$100.59 ,$102.60 ,$727.50 ,$688.70 ,$688.70 ,$100.59 ,$688.70 ,$824.50 ,$824.50 ,$824.50 , N/A ,$256.60 ,$824.50 ,$100.59 ,$970.00 ,$544.17 ,$100.59 ,$401.58 ,$112.61 ,$102.37 ,$100.59 ,$824.50 ,$215.55 ,$578.12 ,$271.60 ,$873.00 ,$100.59 ,$824.50 ,$819.65 ,$819.65 ,$100.59 ,$630.50 ST. JOSEPH'S HOSPITAL - BREESE,40200091,76886,HC US HIPS INFANT STATIC,402,1 ,$504.00 ,$362.88 ,$81.76 ,$504.00 ,$208.58 ,$327.60 ,$300.89 ,$81.76 ,$141.12 ,$333.65 ,$81.76 ,$333.65 ,$81.76 ,$300.38 ,$300.38 ,$81.76 ,$300.38 ,$168.54 ,$388.08 ,$208.59 ,$81.76 ,$83.40 ,$378.00 ,$357.84 ,$357.84 ,$81.76 ,$357.84 ,$428.40 ,$428.40 ,$428.40 , N/A ,$208.59 ,$428.40 ,$81.76 ,$504.00 ,$282.74 ,$81.76 ,$208.66 , N/A , N/A ,$81.76 ,$428.40 ,$175.21 ,$300.38 ,$141.12 ,$453.60 ,$81.76 ,$428.40 ,$425.88 ,$425.88 ,$81.76 ,$327.60 ST. JOSEPH'S HOSPITAL - BREESE,40200092,76813,HC US FETAL NUCHAL TRANSLUCENCY SNG,402,1 ,$742.00 ,$534.24 ,$66.25 ,$742.00 ,$256.60 ,$482.30 ,$442.97 ,$100.59 ,$207.76 ,$491.20 ,$100.59 ,$491.20 ,$100.59 ,$442.23 ,$442.23 ,$100.59 ,$442.23 ,$207.34 ,$571.34 ,$256.60 ,$100.59 ,$102.60 ,$556.50 ,$526.82 ,$526.82 ,$100.59 ,$526.82 ,$630.70 ,$630.70 ,$630.70 , N/A ,$256.60 ,$630.70 ,$100.59 ,$742.00 ,$416.26 ,$100.59 ,$307.19 ,$72.88 ,$66.25 ,$100.59 ,$630.70 ,$215.55 ,$442.23 ,$207.76 ,$667.80 ,$100.59 ,$630.70 ,$626.99 ,$626.99 ,$100.59 ,$482.30 ST. JOSEPH'S HOSPITAL - BREESE,40200093,76814,HC US FETAL NUCHAL TRANSLUCENCY ADDL,402,1 ,$336.00 ,$241.92 ,$66.25 ,$336.00 , N/A ,$218.40 ,$200.59 , N/A ,$94.08 ,$222.43 , N/A ,$222.43 , N/A ,$200.26 ,$200.26 , N/A ,$200.26 , N/A ,$258.72 , N/A , N/A , N/A ,$252.00 ,$238.56 ,$238.56 , N/A ,$238.56 ,$285.60 ,$285.60 ,$285.60 , N/A , N/A ,$285.60 , N/A ,$336.00 ,$188.50 , N/A ,$139.10 ,$72.88 ,$66.25 , N/A ,$285.60 , N/A ,$200.26 ,$94.08 ,$302.40 , N/A ,$285.60 ,$283.92 ,$283.92 , N/A ,$218.40 ST. JOSEPH'S HOSPITAL - BREESE,40200094,76818,HC US FETAL BIO PROFILE W/NST EA ADDN,402,1 ,$327.00 ,$235.44 ,$91.56 ,$327.00 ,$256.60 ,$212.55 ,$195.22 ,$100.59 ,$91.56 ,$216.47 ,$100.59 ,$216.47 ,$100.59 ,$194.89 ,$194.89 ,$100.59 ,$194.89 ,$207.34 ,$251.79 ,$256.60 ,$100.59 ,$102.60 ,$245.25 ,$232.17 ,$232.17 ,$100.59 ,$232.17 ,$277.95 ,$277.95 ,$277.95 , N/A ,$256.60 ,$277.95 ,$100.59 ,$327.00 ,$183.45 ,$100.59 ,$135.38 , N/A , N/A ,$100.59 ,$277.95 ,$215.55 ,$194.89 ,$91.56 ,$294.30 ,$100.59 ,$277.95 ,$276.32 ,$276.32 ,$100.59 ,$212.55 ST. JOSEPH'S HOSPITAL - BREESE,40200097,76816,HC US OB GROWTH FOLLOWUP EA ADDN,402,1 ,$310.00 ,$223.20 ,$86.80 ,$310.00 ,$256.60 ,$201.50 ,$185.07 ,$100.59 ,$86.80 ,$205.22 ,$100.59 ,$205.22 ,$100.59 ,$184.76 ,$184.76 ,$100.59 ,$184.76 ,$207.34 ,$238.70 ,$256.60 ,$100.59 ,$102.60 ,$232.50 ,$220.10 ,$220.10 ,$100.59 ,$220.10 ,$263.50 ,$263.50 ,$263.50 , N/A ,$256.60 ,$263.50 ,$100.59 ,$310.00 ,$173.91 ,$100.59 ,$128.34 , N/A , N/A ,$100.59 ,$263.50 ,$215.55 ,$184.76 ,$86.80 ,$279.00 ,$100.59 ,$263.50 ,$261.95 ,$261.95 ,$100.59 ,$201.50 ST. JOSEPH'S HOSPITAL - BREESE,40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$420.00 ,$302.40 ,$23.25 ,$420.00 ,$218.93 ,$273.00 ,$250.74 ,$85.82 ,$117.60 ,$278.04 ,$85.82 ,$278.04 ,$85.82 ,$250.32 ,$250.32 ,$85.82 ,$250.32 ,$176.89 ,$323.40 ,$218.93 ,$85.82 ,$87.53 ,$315.00 ,$298.20 ,$298.20 ,$85.82 ,$298.20 ,$357.00 ,$357.00 ,$357.00 , N/A ,$218.93 ,$357.00 ,$85.82 ,$97.27 ,$235.62 ,$85.82 ,$173.88 ,$25.58 ,$23.25 ,$85.82 ,$357.00 ,$183.90 ,$250.32 ,$117.60 ,$378.00 ,$85.82 ,$357.00 ,$354.90 ,$354.90 ,$85.82 ,$273.00 ST. JOSEPH'S HOSPITAL - BREESE,40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$420.00 ,$302.40 ,$23.25 ,$420.00 ,$218.93 ,$273.00 ,$250.74 ,$85.82 ,$117.60 ,$278.04 ,$85.82 ,$278.04 ,$85.82 ,$250.32 ,$250.32 ,$85.82 ,$250.32 ,$176.89 ,$323.40 ,$218.93 ,$85.82 ,$87.53 ,$315.00 ,$298.20 ,$298.20 ,$85.82 ,$298.20 ,$357.00 ,$357.00 ,$357.00 , N/A ,$218.93 ,$357.00 ,$85.82 ,$97.27 ,$235.62 ,$85.82 ,$173.88 ,$25.58 ,$23.25 ,$85.82 ,$357.00 ,$183.90 ,$250.32 ,$117.60 ,$378.00 ,$85.82 ,$357.00 ,$354.90 ,$354.90 ,$85.82 ,$273.00 ST. JOSEPH'S HOSPITAL - BREESE,40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$420.00 ,$302.40 ,$23.25 ,$420.00 ,$218.93 ,$273.00 ,$250.74 ,$85.82 ,$117.60 ,$278.04 ,$85.82 ,$278.04 ,$85.82 ,$250.32 ,$250.32 ,$85.82 ,$250.32 ,$176.89 ,$323.40 ,$218.93 ,$85.82 ,$87.53 ,$315.00 ,$298.20 ,$298.20 ,$85.82 ,$298.20 ,$357.00 ,$357.00 ,$357.00 , N/A ,$218.93 ,$357.00 ,$85.82 ,$97.27 ,$235.62 ,$85.82 ,$173.88 ,$25.58 ,$23.25 ,$85.82 ,$357.00 ,$183.90 ,$250.32 ,$117.60 ,$378.00 ,$85.82 ,$357.00 ,$354.90 ,$354.90 ,$85.82 ,$273.00 ST. JOSEPH'S HOSPITAL - BREESE,40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$420.00 ,$302.40 ,$23.25 ,$420.00 ,$218.93 ,$273.00 ,$250.74 ,$85.82 ,$117.60 ,$278.04 ,$85.82 ,$278.04 ,$85.82 ,$250.32 ,$250.32 ,$85.82 ,$250.32 ,$176.89 ,$323.40 ,$218.93 ,$85.82 ,$87.53 ,$315.00 ,$298.20 ,$298.20 ,$85.82 ,$298.20 ,$357.00 ,$357.00 ,$357.00 , N/A ,$218.93 ,$357.00 ,$85.82 ,$97.27 ,$235.62 ,$85.82 ,$173.88 ,$25.58 ,$23.25 ,$85.82 ,$357.00 ,$183.90 ,$250.32 ,$117.60 ,$378.00 ,$85.82 ,$357.00 ,$354.90 ,$354.90 ,$85.82 ,$273.00 ST. JOSEPH'S HOSPITAL - BREESE,40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$103.00 ,$74.16 ,$22.24 ,$103.00 ,$56.73 ,$66.95 ,$61.49 ,$22.24 ,$28.84 ,$68.19 ,$22.24 ,$68.19 ,$22.24 ,$61.39 ,$61.39 ,$22.24 ,$61.39 ,$45.83 ,$79.31 ,$56.73 ,$22.24 ,$22.68 ,$77.25 ,$73.13 ,$73.13 ,$22.24 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$56.73 ,$87.55 ,$22.24 ,$25.20 ,$57.78 ,$22.24 ,$42.64 ,$51.15 ,$46.50 ,$22.24 ,$87.55 ,$47.65 ,$61.39 ,$28.84 ,$92.70 ,$22.24 ,$87.55 ,$87.04 ,$87.04 ,$22.24 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,40300007,77063,HC SCREEN DIG BREAST TOMO BIL-52,403,1 ,$103.00 ,$74.16 ,$22.24 ,$103.00 ,$56.73 ,$66.95 ,$61.49 ,$22.24 ,$28.84 ,$68.19 ,$22.24 ,$68.19 ,$22.24 ,$61.39 ,$61.39 ,$22.24 ,$61.39 ,$45.83 ,$79.31 ,$56.73 ,$22.24 ,$22.68 ,$77.25 ,$73.13 ,$73.13 ,$22.24 ,$73.13 ,$87.55 ,$87.55 ,$87.55 , N/A ,$56.73 ,$87.55 ,$22.24 ,$25.20 ,$57.78 ,$22.24 ,$42.64 ,$25.58 ,$23.25 ,$22.24 ,$87.55 ,$47.65 ,$61.39 ,$28.84 ,$92.70 ,$22.24 ,$87.55 ,$87.04 ,$87.04 ,$22.24 ,$66.95 ST. JOSEPH'S HOSPITAL - BREESE,41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$625.74 ,$450.53 ,$140.66 ,$625.74 ,$498.98 ,$406.73 ,$373.57 ,$195.60 ,$175.21 ,$414.24 ,$195.60 ,$414.24 ,$195.60 ,$372.94 ,$372.94 ,$195.60 ,$372.94 ,$403.17 ,$481.82 ,$498.97 ,$195.60 ,$199.51 ,$469.31 ,$444.28 ,$444.28 ,$195.60 ,$444.28 ,$531.88 ,$531.88 ,$531.88 , N/A ,$498.97 ,$531.88 ,$195.60 ,$625.74 ,$351.04 ,$195.60 ,$259.06 ,$154.73 ,$140.66 ,$195.60 ,$531.88 ,$419.13 ,$372.94 ,$175.21 ,$563.17 ,$195.60 ,$531.88 ,$528.75 ,$528.75 ,$195.60 ,$406.73 ST. JOSEPH'S HOSPITAL - BREESE,41000004,N/A,HC COUGH ASSIST,410,1 ,$482.00 ,$347.04 ,$134.96 ,$482.00 , N/A ,$313.30 ,$287.75 , N/A ,$134.96 ,$319.08 , N/A ,$319.08 , N/A ,$287.27 ,$287.27 , N/A ,$287.27 , N/A ,$371.14 , N/A , N/A , N/A ,$361.50 ,$342.22 ,$342.22 , N/A ,$342.22 ,$409.70 ,$409.70 ,$409.70 , N/A , N/A ,$409.70 , N/A ,$482.00 ,$270.40 , N/A ,$199.55 , N/A , N/A , N/A ,$409.70 , N/A ,$287.27 ,$134.96 ,$433.80 , N/A ,$409.70 ,$407.29 ,$407.29 , N/A ,$313.30 ST. JOSEPH'S HOSPITAL - BREESE,41000005,92950,HC CPR,480,1 ,$849.00 ,$611.28 ,$237.72 ,$849.00 ,$672.38 ,$551.85 ,$506.85 ,$263.57 ,$237.72 ,$562.04 ,$263.57 ,$562.04 ,$263.57 ,$506.00 ,$506.00 ,$263.57 ,$506.00 ,$543.28 ,$653.73 ,$672.38 ,$263.57 ,$268.84 ,$636.75 ,$602.79 ,$602.79 ,$263.57 ,$602.79 ,$721.65 ,$721.65 ,$721.65 , N/A ,$672.38 ,$721.65 ,$263.57 ,$849.00 ,$476.29 ,$263.57 ,$351.49 ,$500.07 ,$454.61 ,$263.57 ,$721.65 ,$564.80 ,$506.00 ,$237.72 ,$764.10 ,$263.57 ,$721.65 ,$717.41 ,$717.41 ,$263.57 ,$551.85 ST. JOSEPH'S HOSPITAL - BREESE,41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,"$1,023.00 ",$736.56 ,$286.44 ,"$1,336.60 ","$1,336.60 ",$664.95 ,$610.73 ,$523.95 ,$286.44 ,$677.23 ,$523.95 ,$677.23 ,$523.95 ,$609.71 ,$609.71 ,$523.95 ,$609.71 ,"$1,023.00 ",$787.71 ,"$1,336.60 ",$523.95 ,$534.42 ,$767.25 ,$726.33 ,$726.33 ,$523.95 ,$726.33 ,$869.55 ,$869.55 ,$869.55 , N/A ,"$1,023.00 ",$869.55 ,$523.95 ,"$1,023.00 ",$573.90 ,$523.95 ,$423.52 ,$542.19 ,$492.90 ,$523.95 ,$869.55 ,"$1,122.75 ",$609.71 ,$286.44 ,$920.70 ,$523.95 ,$869.55 ,$864.44 ,$864.44 ,$523.95 ,$664.95 ST. JOSEPH'S HOSPITAL - BREESE,41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,"$1,023.00 ",$736.56 ,$286.44 ,"$1,336.60 ","$1,336.60 ",$664.95 ,$610.73 ,$523.95 ,$286.44 ,$677.23 ,$523.95 ,$677.23 ,$523.95 ,$609.71 ,$609.71 ,$523.95 ,$609.71 ,"$1,023.00 ",$787.71 ,"$1,336.60 ",$523.95 ,$534.42 ,$767.25 ,$726.33 ,$726.33 ,$523.95 ,$726.33 ,$869.55 ,$869.55 ,$869.55 , N/A ,"$1,023.00 ",$869.55 ,$523.95 ,"$1,023.00 ",$573.90 ,$523.95 ,$423.52 ,$542.19 ,$492.90 ,$523.95 ,$869.55 ,"$1,122.75 ",$609.71 ,$286.44 ,$920.70 ,$523.95 ,$869.55 ,$864.44 ,$864.44 ,$523.95 ,$664.95 ST. JOSEPH'S HOSPITAL - BREESE,41000016,94660,HC VENT NONINVAS NEO INTL DAY,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000018,94660,HC VENT NONINVAS PEDS INTL DAY,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,$865.00 ,$622.80 ,$242.20 ,"$1,336.60 ","$1,336.60 ",$562.25 ,$516.41 ,$523.95 ,$242.20 ,$572.63 ,$523.95 ,$572.63 ,$523.95 ,$515.54 ,$515.54 ,$523.95 ,$515.54 ,$865.00 ,$666.05 ,"$1,336.60 ",$523.95 ,$534.42 ,$648.75 ,$614.15 ,$614.15 ,$523.95 ,$614.15 ,$735.25 ,$735.25 ,$735.25 , N/A ,$865.00 ,$735.25 ,$523.95 ,$865.00 ,$485.27 ,$523.95 ,$358.11 ,$542.19 ,$492.90 ,$523.95 ,$735.25 ,"$1,122.75 ",$515.54 ,$242.20 ,$778.50 ,$523.95 ,$735.25 ,$730.93 ,$730.93 ,$523.95 ,$562.25 ST. JOSEPH'S HOSPITAL - BREESE,41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000033,94660,HC VENT NONINVAS PEDS SUBQ DAY,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000037,94640,HC INCENTIVE SPIROMETER TRT,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000044,94640,HC UPDRAFT W/INSTRUCT AND EVAL,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$322.00 ,$231.84 ,$50.33 ,$322.00 ,$278.78 ,$209.30 ,$192.23 ,$109.28 ,$90.16 ,$213.16 ,$109.28 ,$213.16 ,$109.28 ,$191.91 ,$191.91 ,$109.28 ,$191.91 ,$225.24 ,$247.94 ,$278.76 ,$109.28 ,$111.47 ,$241.50 ,$228.62 ,$228.62 ,$109.28 ,$228.62 ,$273.70 ,$273.70 ,$273.70 , N/A ,$278.76 ,$273.70 ,$109.28 ,$322.00 ,$180.64 ,$109.28 ,$133.31 ,$55.36 ,$50.33 ,$109.28 ,$273.70 ,$234.16 ,$191.91 ,$90.16 ,$289.80 ,$109.28 ,$273.70 ,$272.09 ,$272.09 ,$109.28 ,$209.30 ST. JOSEPH'S HOSPITAL - BREESE,41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$308.00 ,$221.76 ,$50.33 ,$308.00 , N/A ,$200.20 ,$183.88 , N/A ,$86.24 ,$203.90 , N/A ,$203.90 , N/A ,$183.57 ,$183.57 , N/A ,$183.57 , N/A ,$237.16 , N/A , N/A , N/A ,$231.00 ,$218.68 ,$218.68 , N/A ,$218.68 ,$261.80 ,$261.80 ,$261.80 , N/A , N/A ,$261.80 , N/A ,$308.00 ,$172.79 , N/A ,$127.51 ,$55.36 ,$50.33 , N/A ,$261.80 , N/A ,$183.57 ,$86.24 ,$277.20 , N/A ,$261.80 ,$260.26 ,$260.26 , N/A ,$200.20 ST. JOSEPH'S HOSPITAL - BREESE,41000052,94660,HC CPAP,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000053,94660,HC CPAP DAILY EST PT,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$45.00 ,$32.40 ,$12.60 ,$459.78 ,$459.78 ,$29.25 ,$26.87 ,$180.23 ,$12.60 ,$29.79 ,$180.23 ,$29.79 ,$44.10 ,$26.82 ,$26.82 ,$44.10 ,$26.82 ,$45.00 ,$34.65 ,$459.76 ,$180.23 ,$44.10 ,$33.75 ,$31.95 ,$31.95 ,$180.23 ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A ,$45.00 ,$38.25 ,$44.10 ,$45.00 ,$25.25 ,$180.23 ,$18.63 ,$26.72 ,$24.29 ,$180.23 ,$38.25 ,$386.20 ,$26.82 ,$12.60 ,$40.50 ,$180.23 ,$38.25 ,$38.03 ,$38.03 ,$180.23 ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$90.00 ,$64.80 ,$25.20 ,$278.78 ,$278.78 ,$58.50 ,$53.73 ,$109.28 ,$25.20 ,$59.58 ,$109.28 ,$59.58 ,$88.20 ,$53.64 ,$53.64 ,$88.20 ,$53.64 ,$90.00 ,$69.30 ,$278.76 ,$109.28 ,$88.20 ,$67.50 ,$63.90 ,$63.90 ,$109.28 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$90.00 ,$76.50 ,$88.20 ,$90.00 ,$50.49 ,$109.28 ,$37.26 ,$90.00 ,$90.00 ,$109.28 ,$76.50 ,$234.16 ,$53.64 ,$25.20 ,$81.00 ,$109.28 ,$76.50 ,$76.05 ,$76.05 ,$109.28 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$90.00 ,$64.80 ,$25.20 ,$278.78 ,$278.78 ,$58.50 ,$53.73 ,$109.28 ,$25.20 ,$59.58 ,$109.28 ,$59.58 ,$88.20 ,$53.64 ,$53.64 ,$88.20 ,$53.64 ,$90.00 ,$69.30 ,$278.76 ,$109.28 ,$88.20 ,$67.50 ,$63.90 ,$63.90 ,$109.28 ,$63.90 ,$76.50 ,$76.50 ,$76.50 , N/A ,$90.00 ,$76.50 ,$88.20 ,$90.00 ,$50.49 ,$109.28 ,$37.26 ,$90.00 ,$90.00 ,$109.28 ,$76.50 ,$234.16 ,$53.64 ,$25.20 ,$81.00 ,$109.28 ,$76.50 ,$76.05 ,$76.05 ,$109.28 ,$58.50 ST. JOSEPH'S HOSPITAL - BREESE,41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$76.00 ,$54.72 ,$21.28 ,$278.78 ,$278.78 ,$49.40 ,$45.37 ,$109.28 ,$21.28 ,$50.31 ,$109.28 ,$50.31 ,$74.48 ,$45.30 ,$45.30 ,$74.48 ,$45.30 ,$76.00 ,$58.52 ,$278.76 ,$109.28 ,$74.48 ,$57.00 ,$53.96 ,$53.96 ,$109.28 ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A ,$76.00 ,$64.60 ,$74.48 ,$76.00 ,$42.64 ,$109.28 ,$31.46 ,$76.00 ,$76.00 ,$109.28 ,$64.60 ,$234.16 ,$45.30 ,$21.28 ,$68.40 ,$109.28 ,$64.60 ,$64.22 ,$64.22 ,$109.28 ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$76.00 ,$54.72 ,$21.28 ,$278.78 ,$278.78 ,$49.40 ,$45.37 ,$109.28 ,$21.28 ,$50.31 ,$109.28 ,$50.31 ,$74.48 ,$45.30 ,$45.30 ,$74.48 ,$45.30 ,$76.00 ,$58.52 ,$278.76 ,$109.28 ,$74.48 ,$57.00 ,$53.96 ,$53.96 ,$109.28 ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A ,$76.00 ,$64.60 ,$74.48 ,$76.00 ,$42.64 ,$109.28 ,$31.46 ,$76.00 ,$76.00 ,$109.28 ,$64.60 ,$234.16 ,$45.30 ,$21.28 ,$68.40 ,$109.28 ,$64.60 ,$64.22 ,$64.22 ,$109.28 ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,41000068,G0237,HC RESP STRENGTH/ENDURANCE,410,1 ,$76.00 ,$54.72 ,$21.28 ,$76.00 ,$59.93 ,$49.40 ,$45.37 ,$23.49 ,$21.28 ,$50.31 ,$23.49 ,$50.31 ,$23.49 ,$45.30 ,$45.30 ,$23.49 ,$45.30 ,$48.42 ,$58.52 ,$59.93 ,$23.49 ,$23.96 ,$57.00 ,$53.96 ,$53.96 ,$23.49 ,$53.96 ,$64.60 ,$64.60 ,$64.60 , N/A ,$59.93 ,$64.60 ,$23.49 ,$76.00 ,$42.64 ,$23.49 ,$31.46 ,$76.00 ,$76.00 ,$23.49 ,$64.60 ,$50.34 ,$45.30 ,$21.28 ,$68.40 ,$23.49 ,$64.60 ,$64.22 ,$64.22 ,$23.49 ,$49.40 ST. JOSEPH'S HOSPITAL - BREESE,41000069,G0238,HC RESP THRP FUNCTION,410,1 ,$85.00 ,$61.20 ,$23.49 ,$85.00 ,$59.93 ,$55.25 ,$50.75 ,$23.49 ,$23.80 ,$56.27 ,$23.49 ,$56.27 ,$23.49 ,$50.66 ,$50.66 ,$23.49 ,$50.66 ,$48.42 ,$65.45 ,$59.93 ,$23.49 ,$23.96 ,$63.75 ,$60.35 ,$60.35 ,$23.49 ,$60.35 ,$72.25 ,$72.25 ,$72.25 , N/A ,$59.93 ,$72.25 ,$23.49 ,$85.00 ,$47.69 ,$23.49 ,$35.19 ,$85.00 ,$85.00 ,$23.49 ,$72.25 ,$50.34 ,$50.66 ,$23.80 ,$76.50 ,$23.49 ,$72.25 ,$71.83 ,$71.83 ,$23.49 ,$55.25 ST. JOSEPH'S HOSPITAL - BREESE,41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$110.00 ,$79.20 ,$1.58 ,$110.00 ,$81.53 ,$71.50 ,$65.67 ,$31.96 ,$30.80 ,$72.82 ,$31.96 ,$72.82 ,$31.96 ,$65.56 ,$65.56 ,$31.96 ,$65.56 ,$65.88 ,$84.70 ,$81.53 ,$31.96 ,$32.60 ,$82.50 ,$78.10 ,$78.10 ,$31.96 ,$78.10 ,$93.50 ,$93.50 ,$93.50 , N/A ,$81.53 ,$93.50 ,$31.96 ,$110.00 ,$61.71 ,$31.96 ,$45.54 ,$1.74 ,$1.58 ,$31.96 ,$93.50 ,$68.49 ,$65.56 ,$30.80 ,$99.00 ,$31.96 ,$93.50 ,$92.95 ,$92.95 ,$31.96 ,$71.50 ST. JOSEPH'S HOSPITAL - BREESE,41000073,94660,HC VENT NONINVAS NEON SUBQ DAY,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000077,94762,HC PULSE OX PER DAY,410,1 ,$602.00 ,$433.44 ,$50.33 ,$602.00 ,$349.15 ,$391.30 ,$359.39 ,$136.87 ,$168.56 ,$398.52 ,$136.87 ,$398.52 ,$136.87 ,$358.79 ,$358.79 ,$136.87 ,$358.79 ,$282.12 ,$463.54 ,$349.16 ,$136.87 ,$139.61 ,$451.50 ,$427.42 ,$427.42 ,$136.87 ,$427.42 ,$511.70 ,$511.70 ,$511.70 , N/A ,$349.16 ,$511.70 ,$136.87 ,$602.00 ,$337.72 ,$136.87 ,$249.23 ,$55.36 ,$50.33 ,$136.87 ,$511.70 ,$293.29 ,$358.79 ,$168.56 ,$541.80 ,$136.87 ,$511.70 ,$508.69 ,$508.69 ,$136.87 ,$391.30 ST. JOSEPH'S HOSPITAL - BREESE,41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$449.00 ,$323.28 ,$125.72 ,$459.78 ,$459.78 ,$291.85 ,$268.05 ,$180.23 ,$125.72 ,$297.24 ,$180.23 ,$297.24 ,$180.23 ,$267.60 ,$267.60 ,$180.23 ,$267.60 ,$371.49 ,$345.73 ,$459.76 ,$180.23 ,$183.83 ,$336.75 ,$318.79 ,$318.79 ,$180.23 ,$318.79 ,$381.65 ,$381.65 ,$381.65 , N/A ,$449.00 ,$381.65 ,$180.23 ,$449.00 ,$251.89 ,$180.23 ,$185.89 ,$449.00 ,$449.00 ,$180.23 ,$381.65 ,$386.20 ,$267.60 ,$125.72 ,$404.10 ,$180.23 ,$381.65 ,$379.41 ,$379.41 ,$180.23 ,$291.85 ST. JOSEPH'S HOSPITAL - BREESE,41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,41000092,94640,HC AEROSOL INHALATION SUBSQ,410,1 ,$141.00 ,$101.52 ,$39.48 ,$459.78 ,$459.78 ,$91.65 ,$84.18 ,$180.23 ,$39.48 ,$93.34 ,$180.23 ,$93.34 ,$138.18 ,$84.04 ,$84.04 ,$138.18 ,$84.04 ,$141.00 ,$108.57 ,$459.76 ,$180.23 ,$138.18 ,$105.75 ,$100.11 ,$100.11 ,$180.23 ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A ,$141.00 ,$119.85 ,$138.18 ,$141.00 ,$79.10 ,$180.23 ,$58.37 ,$141.00 ,$141.00 ,$180.23 ,$119.85 ,$386.20 ,$84.04 ,$39.48 ,$126.90 ,$180.23 ,$119.85 ,$119.15 ,$119.15 ,$180.23 ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,42000006,G0283,HC APPL NEUROSTIMULATOR TRANSCUT,420,1 ,$133.00 ,$95.76 ,$11.80 ,$133.00 ,$30.10 ,$86.45 ,$79.40 ,$11.80 ,$37.24 ,$88.05 ,$11.80 ,$88.05 ,$11.80 ,$79.27 ,$79.27 ,$11.80 ,$79.27 ,$24.32 ,$102.41 ,$30.10 ,$11.80 ,$12.03 ,$99.75 ,$94.43 ,$94.43 ,$11.80 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$30.10 ,$113.05 ,$11.80 ,$133.00 ,$74.61 ,$11.80 ,$55.06 ,$20.44 ,$18.58 ,$11.80 ,$113.05 ,$25.28 ,$79.27 ,$37.24 ,$119.70 ,$11.80 ,$113.05 ,$112.39 ,$112.39 ,$11.80 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$214.00 ,$154.08 ,$14.12 ,$214.00 ,$36.03 ,$139.10 ,$127.76 ,$14.12 ,$59.92 ,$141.67 ,$14.12 ,$141.67 ,$14.12 ,$127.54 ,$127.54 ,$14.12 ,$127.54 ,$29.11 ,$164.78 ,$36.03 ,$14.12 ,$14.41 ,$160.50 ,$151.94 ,$151.94 ,$14.12 ,$151.94 ,$181.90 ,$181.90 ,$181.90 , N/A ,$36.03 ,$181.90 ,$14.12 ,$214.00 ,$120.05 ,$14.12 ,$88.60 ,$214.00 ,$214.00 ,$14.12 ,$181.90 ,$30.26 ,$127.54 ,$59.92 ,$192.60 ,$14.12 ,$181.90 ,$180.83 ,$180.83 ,$14.12 ,$139.10 ST. JOSEPH'S HOSPITAL - BREESE,42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$297.00 ,$213.84 ,$19.09 ,$297.00 ,$48.70 ,$193.05 ,$177.31 ,$19.09 ,$83.16 ,$196.61 ,$19.09 ,$196.61 ,$19.09 ,$177.01 ,$177.01 ,$19.09 ,$177.01 ,$39.35 ,$228.69 ,$48.70 ,$19.09 ,$19.47 ,$222.75 ,$210.87 ,$210.87 ,$19.09 ,$210.87 ,$252.45 ,$252.45 ,$252.45 , N/A ,$48.70 ,$252.45 ,$19.09 ,$297.00 ,$166.62 ,$19.09 ,$122.96 ,$250.20 ,$227.45 ,$19.09 ,$252.45 ,$40.91 ,$177.01 ,$83.16 ,$267.30 ,$19.09 ,$252.45 ,$250.97 ,$250.97 ,$19.09 ,$193.05 ST. JOSEPH'S HOSPITAL - BREESE,42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$214.00 ,$154.08 ,$14.03 ,$214.00 ,$35.80 ,$139.10 ,$127.76 ,$14.03 ,$59.92 ,$141.67 ,$14.03 ,$141.67 ,$14.03 ,$127.54 ,$127.54 ,$14.03 ,$127.54 ,$28.93 ,$164.78 ,$35.80 ,$14.03 ,$14.32 ,$160.50 ,$151.94 ,$151.94 ,$14.03 ,$151.94 ,$181.90 ,$181.90 ,$181.90 , N/A ,$35.80 ,$181.90 ,$14.03 ,$214.00 ,$120.05 ,$14.03 ,$88.60 ,$214.00 ,$214.00 ,$14.03 ,$181.90 ,$30.07 ,$127.54 ,$59.92 ,$192.60 ,$14.03 ,$181.90 ,$180.83 ,$180.83 ,$14.03 ,$139.10 ST. JOSEPH'S HOSPITAL - BREESE,42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$172.00 ,$123.84 ,$28.49 ,$172.00 ,$72.68 ,$111.80 ,$102.68 ,$28.49 ,$48.16 ,$113.86 ,$28.49 ,$113.86 ,$28.49 ,$102.51 ,$102.51 ,$28.49 ,$102.51 ,$58.72 ,$132.44 ,$72.68 ,$28.49 ,$29.06 ,$129.00 ,$122.12 ,$122.12 ,$28.49 ,$122.12 ,$146.20 ,$146.20 ,$146.20 , N/A ,$72.68 ,$146.20 ,$28.49 ,$172.00 ,$96.49 ,$28.49 ,$71.21 ,$172.00 ,$172.00 ,$28.49 ,$146.20 ,$61.05 ,$102.51 ,$48.16 ,$154.80 ,$28.49 ,$146.20 ,$145.34 ,$145.34 ,$28.49 ,$111.80 ST. JOSEPH'S HOSPITAL - BREESE,42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$193.00 ,$138.96 ,$32.62 ,$193.00 ,$83.23 ,$125.45 ,$115.22 ,$32.62 ,$54.04 ,$127.77 ,$32.62 ,$127.77 ,$32.62 ,$115.03 ,$115.03 ,$32.62 ,$115.03 ,$67.25 ,$148.61 ,$83.23 ,$32.62 ,$33.28 ,$144.75 ,$137.03 ,$137.03 ,$32.62 ,$137.03 ,$164.05 ,$164.05 ,$164.05 , N/A ,$83.23 ,$164.05 ,$32.62 ,$193.00 ,$108.27 ,$32.62 ,$79.90 ,$193.00 ,$193.00 ,$32.62 ,$164.05 ,$69.91 ,$115.03 ,$54.04 ,$173.70 ,$32.62 ,$164.05 ,$163.09 ,$163.09 ,$32.62 ,$125.45 ST. JOSEPH'S HOSPITAL - BREESE,42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$174.00 ,$125.28 ,$28.49 ,$174.00 ,$72.68 ,$113.10 ,$103.88 ,$28.49 ,$48.72 ,$115.19 ,$28.49 ,$115.19 ,$28.49 ,$103.70 ,$103.70 ,$28.49 ,$103.70 ,$58.72 ,$133.98 ,$72.68 ,$28.49 ,$29.06 ,$130.50 ,$123.54 ,$123.54 ,$28.49 ,$123.54 ,$147.90 ,$147.90 ,$147.90 , N/A ,$72.68 ,$147.90 ,$28.49 ,$174.00 ,$97.61 ,$28.49 ,$72.04 ,$174.00 ,$174.00 ,$28.49 ,$147.90 ,$61.05 ,$103.70 ,$48.72 ,$156.60 ,$28.49 ,$147.90 ,$147.03 ,$147.03 ,$28.49 ,$113.10 ST. JOSEPH'S HOSPITAL - BREESE,42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$190.00 ,$136.80 ,$28.87 ,$190.00 ,$73.65 ,$123.50 ,$113.43 ,$28.87 ,$53.20 ,$125.78 ,$28.87 ,$125.78 ,$28.87 ,$113.24 ,$113.24 ,$28.87 ,$113.24 ,$59.51 ,$146.30 ,$73.65 ,$28.87 ,$29.45 ,$142.50 ,$134.90 ,$134.90 ,$28.87 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$73.65 ,$161.50 ,$28.87 ,$190.00 ,$106.59 ,$28.87 ,$78.66 ,$190.00 ,$190.00 ,$28.87 ,$161.50 ,$61.87 ,$113.24 ,$53.20 ,$171.00 ,$28.87 ,$161.50 ,$160.55 ,$160.55 ,$28.87 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$172.00 ,$123.84 ,$26.28 ,$172.00 ,$67.05 ,$111.80 ,$102.68 ,$26.28 ,$48.16 ,$113.86 ,$26.28 ,$113.86 ,$26.28 ,$102.51 ,$102.51 ,$26.28 ,$102.51 ,$54.18 ,$132.44 ,$67.05 ,$26.28 ,$26.81 ,$129.00 ,$122.12 ,$122.12 ,$26.28 ,$122.12 ,$146.20 ,$146.20 ,$146.20 , N/A ,$67.05 ,$146.20 ,$26.28 ,$172.00 ,$96.49 ,$26.28 ,$71.21 ,$172.00 ,$172.00 ,$26.28 ,$146.20 ,$56.32 ,$102.51 ,$48.16 ,$154.80 ,$26.28 ,$146.20 ,$145.34 ,$145.34 ,$26.28 ,$111.80 ST. JOSEPH'S HOSPITAL - BREESE,42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$158.00 ,$113.76 ,$35.56 ,$158.00 ,$90.73 ,$102.70 ,$94.33 ,$35.56 ,$44.24 ,$104.60 ,$35.56 ,$104.60 ,$35.56 ,$94.17 ,$94.17 ,$35.56 ,$94.17 ,$73.31 ,$121.66 ,$90.73 ,$35.56 ,$36.28 ,$118.50 ,$112.18 ,$112.18 ,$35.56 ,$112.18 ,$134.30 ,$134.30 ,$134.30 , N/A ,$90.73 ,$134.30 ,$35.56 ,$158.00 ,$88.64 ,$35.56 ,$65.41 ,$158.00 ,$158.00 ,$35.56 ,$134.30 ,$76.21 ,$94.17 ,$44.24 ,$142.20 ,$35.56 ,$134.30 ,$133.51 ,$133.51 ,$35.56 ,$102.70 ST. JOSEPH'S HOSPITAL - BREESE,42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$180.00 ,$129.60 ,$32.51 ,$180.00 ,$82.93 ,$117.00 ,$107.46 ,$32.51 ,$50.40 ,$119.16 ,$32.51 ,$119.16 ,$32.51 ,$107.28 ,$107.28 ,$32.51 ,$107.28 ,$67.00 ,$138.60 ,$82.93 ,$32.51 ,$33.15 ,$135.00 ,$127.80 ,$127.80 ,$32.51 ,$127.80 ,$153.00 ,$153.00 ,$153.00 , N/A ,$82.93 ,$153.00 ,$32.51 ,$180.00 ,$100.98 ,$32.51 ,$74.52 ,$180.00 ,$180.00 ,$32.51 ,$153.00 ,$69.66 ,$107.28 ,$50.40 ,$162.00 ,$32.51 ,$153.00 ,$152.10 ,$152.10 ,$32.51 ,$117.00 ST. JOSEPH'S HOSPITAL - BREESE,42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$183.00 ,$131.76 ,$40.03 ,$183.00 ,$102.13 ,$118.95 ,$109.25 ,$40.03 ,$51.24 ,$121.15 ,$40.03 ,$121.15 ,$40.03 ,$109.07 ,$109.07 ,$40.03 ,$109.07 ,$82.52 ,$140.91 ,$102.13 ,$40.03 ,$40.84 ,$137.25 ,$129.93 ,$129.93 ,$40.03 ,$129.93 ,$155.55 ,$155.55 ,$155.55 , N/A ,$102.13 ,$155.55 ,$40.03 ,$183.00 ,$102.66 ,$40.03 ,$75.76 ,$183.00 ,$183.00 ,$40.03 ,$155.55 ,$85.79 ,$109.07 ,$51.24 ,$164.70 ,$40.03 ,$155.55 ,$154.64 ,$154.64 ,$40.03 ,$118.95 ST. JOSEPH'S HOSPITAL - BREESE,42000160,97113,HC THERAPEUTIC ACT W/AQUA,420,1 ,$227.00 ,$163.44 ,$35.35 ,$227.00 ,$90.18 ,$147.55 ,$135.52 ,$35.35 ,$63.56 ,$150.27 ,$35.35 ,$150.27 ,$35.35 ,$135.29 ,$135.29 ,$35.35 ,$135.29 ,$72.86 ,$174.79 ,$90.18 ,$35.35 ,$36.05 ,$170.25 ,$161.17 ,$161.17 ,$35.35 ,$161.17 ,$192.95 ,$192.95 ,$192.95 , N/A ,$90.18 ,$192.95 ,$35.35 ,$227.00 ,$127.35 ,$35.35 ,$93.98 ,$227.00 ,$227.00 ,$35.35 ,$192.95 ,$75.75 ,$135.29 ,$63.56 ,$204.30 ,$35.35 ,$192.95 ,$191.82 ,$191.82 ,$35.35 ,$147.55 ST. JOSEPH'S HOSPITAL - BREESE,42000161,97024,HC DIATHERMY,420,1 ,$163.00 ,$117.36 ,$7.19 ,$163.00 ,$18.35 ,$105.95 ,$97.31 ,$7.19 ,$45.64 ,$107.91 ,$7.19 ,$107.91 ,$7.19 ,$97.15 ,$97.15 ,$7.19 ,$97.15 ,$14.83 ,$125.51 ,$18.35 ,$7.19 ,$7.34 ,$122.25 ,$115.73 ,$115.73 ,$7.19 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$18.35 ,$138.55 ,$7.19 ,$163.00 ,$91.44 ,$7.19 ,$67.48 ,$20.44 ,$18.58 ,$7.19 ,$138.55 ,$15.41 ,$97.15 ,$45.64 ,$146.70 ,$7.19 ,$138.55 ,$137.74 ,$137.74 ,$7.19 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,42000206,G0283,HC ELECT STIM (UNATTEND) OTHER 15MIN,420,1 ,$133.00 ,$95.76 ,$11.80 ,$133.00 ,$30.10 ,$86.45 ,$79.40 ,$11.80 ,$37.24 ,$88.05 ,$11.80 ,$88.05 ,$11.80 ,$79.27 ,$79.27 ,$11.80 ,$79.27 ,$24.32 ,$102.41 ,$30.10 ,$11.80 ,$12.03 ,$99.75 ,$94.43 ,$94.43 ,$11.80 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$30.10 ,$113.05 ,$11.80 ,$133.00 ,$74.61 ,$11.80 ,$55.06 ,$20.44 ,$18.58 ,$11.80 ,$113.05 ,$25.28 ,$79.27 ,$37.24 ,$119.70 ,$11.80 ,$113.05 ,$112.39 ,$112.39 ,$11.80 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,42000207,G0283,HC ELECT STIM (UNATTEND) OTHER 30MIN,420,1 ,$133.00 ,$95.76 ,$11.80 ,$133.00 ,$30.10 ,$86.45 ,$79.40 ,$11.80 ,$37.24 ,$88.05 ,$11.80 ,$88.05 ,$11.80 ,$79.27 ,$79.27 ,$11.80 ,$79.27 ,$24.32 ,$102.41 ,$30.10 ,$11.80 ,$12.03 ,$99.75 ,$94.43 ,$94.43 ,$11.80 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$30.10 ,$113.05 ,$11.80 ,$133.00 ,$74.61 ,$11.80 ,$55.06 ,$20.44 ,$18.58 ,$11.80 ,$113.05 ,$25.28 ,$79.27 ,$37.24 ,$119.70 ,$11.80 ,$113.05 ,$112.39 ,$112.39 ,$11.80 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,42000208,G0283,HC ELECT STIM (UNATTEND) OTHER 45MIN,420,1 ,$133.00 ,$95.76 ,$11.80 ,$133.00 ,$30.10 ,$86.45 ,$79.40 ,$11.80 ,$37.24 ,$88.05 ,$11.80 ,$88.05 ,$11.80 ,$79.27 ,$79.27 ,$11.80 ,$79.27 ,$24.32 ,$102.41 ,$30.10 ,$11.80 ,$12.03 ,$99.75 ,$94.43 ,$94.43 ,$11.80 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$30.10 ,$113.05 ,$11.80 ,$133.00 ,$74.61 ,$11.80 ,$55.06 ,$20.44 ,$18.58 ,$11.80 ,$113.05 ,$25.28 ,$79.27 ,$37.24 ,$119.70 ,$11.80 ,$113.05 ,$112.39 ,$112.39 ,$11.80 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,42000209,G0283,HC ELECT STIM (UNATTEND) OTHER 60MIN,420,1 ,$133.00 ,$95.76 ,$11.80 ,$133.00 ,$30.10 ,$86.45 ,$79.40 ,$11.80 ,$37.24 ,$88.05 ,$11.80 ,$88.05 ,$11.80 ,$79.27 ,$79.27 ,$11.80 ,$79.27 ,$24.32 ,$102.41 ,$30.10 ,$11.80 ,$12.03 ,$99.75 ,$94.43 ,$94.43 ,$11.80 ,$94.43 ,$113.05 ,$113.05 ,$113.05 , N/A ,$30.10 ,$113.05 ,$11.80 ,$133.00 ,$74.61 ,$11.80 ,$55.06 ,$20.44 ,$18.58 ,$11.80 ,$113.05 ,$25.28 ,$79.27 ,$37.24 ,$119.70 ,$11.80 ,$113.05 ,$112.39 ,$112.39 ,$11.80 ,$86.45 ST. JOSEPH'S HOSPITAL - BREESE,42000210,97016,HC APPLY VASOPNEUMATIC DEVICE 15MIN,420,1 ,$190.00 ,$136.80 ,$11.50 ,$190.00 ,$29.33 ,$123.50 ,$113.43 ,$11.50 ,$53.20 ,$125.78 ,$11.50 ,$125.78 ,$11.50 ,$113.24 ,$113.24 ,$11.50 ,$113.24 ,$23.69 ,$146.30 ,$29.33 ,$11.50 ,$11.72 ,$142.50 ,$134.90 ,$134.90 ,$11.50 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$29.33 ,$161.50 ,$11.50 ,$190.00 ,$106.59 ,$11.50 ,$78.66 ,$20.44 ,$18.58 ,$11.50 ,$161.50 ,$24.63 ,$113.24 ,$53.20 ,$171.00 ,$11.50 ,$161.50 ,$160.55 ,$160.55 ,$11.50 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,42000211,97016,HC APPLY VASOPNEUMATIC DEVICE 30MIN,420,1 ,$190.00 ,$136.80 ,$11.50 ,$190.00 ,$29.33 ,$123.50 ,$113.43 ,$11.50 ,$53.20 ,$125.78 ,$11.50 ,$125.78 ,$11.50 ,$113.24 ,$113.24 ,$11.50 ,$113.24 ,$23.69 ,$146.30 ,$29.33 ,$11.50 ,$11.72 ,$142.50 ,$134.90 ,$134.90 ,$11.50 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$29.33 ,$161.50 ,$11.50 ,$190.00 ,$106.59 ,$11.50 ,$78.66 ,$20.44 ,$18.58 ,$11.50 ,$161.50 ,$24.63 ,$113.24 ,$53.20 ,$171.00 ,$11.50 ,$161.50 ,$160.55 ,$160.55 ,$11.50 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,42000212,97016,HC APPLY VASOPNEUMATIC DEVICE 45MIN,420,1 ,$190.00 ,$136.80 ,$11.50 ,$190.00 ,$29.33 ,$123.50 ,$113.43 ,$11.50 ,$53.20 ,$125.78 ,$11.50 ,$125.78 ,$11.50 ,$113.24 ,$113.24 ,$11.50 ,$113.24 ,$23.69 ,$146.30 ,$29.33 ,$11.50 ,$11.72 ,$142.50 ,$134.90 ,$134.90 ,$11.50 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$29.33 ,$161.50 ,$11.50 ,$190.00 ,$106.59 ,$11.50 ,$78.66 ,$20.44 ,$18.58 ,$11.50 ,$161.50 ,$24.63 ,$113.24 ,$53.20 ,$171.00 ,$11.50 ,$161.50 ,$160.55 ,$160.55 ,$11.50 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,42000213,97016,HC APPLY VASOPNEUMATIC DEVICE 60MIN,420,1 ,$190.00 ,$136.80 ,$11.50 ,$190.00 ,$29.33 ,$123.50 ,$113.43 ,$11.50 ,$53.20 ,$125.78 ,$11.50 ,$125.78 ,$11.50 ,$113.24 ,$113.24 ,$11.50 ,$113.24 ,$23.69 ,$146.30 ,$29.33 ,$11.50 ,$11.72 ,$142.50 ,$134.90 ,$134.90 ,$11.50 ,$134.90 ,$161.50 ,$161.50 ,$161.50 , N/A ,$29.33 ,$161.50 ,$11.50 ,$190.00 ,$106.59 ,$11.50 ,$78.66 ,$20.44 ,$18.58 ,$11.50 ,$161.50 ,$24.63 ,$113.24 ,$53.20 ,$171.00 ,$11.50 ,$161.50 ,$160.55 ,$160.55 ,$11.50 ,$123.50 ST. JOSEPH'S HOSPITAL - BREESE,42000214,97012,HC TRACTION MECHANICAL APPL 15 MIN,420,1 ,$182.00 ,$131.04 ,$14.12 ,$182.00 ,$36.03 ,$118.30 ,$108.65 ,$14.12 ,$50.96 ,$120.48 ,$14.12 ,$120.48 ,$14.12 ,$108.47 ,$108.47 ,$14.12 ,$108.47 ,$29.11 ,$140.14 ,$36.03 ,$14.12 ,$14.41 ,$136.50 ,$129.22 ,$129.22 ,$14.12 ,$129.22 ,$154.70 ,$154.70 ,$154.70 , N/A ,$36.03 ,$154.70 ,$14.12 ,$182.00 ,$102.10 ,$14.12 ,$75.35 ,$20.44 ,$18.58 ,$14.12 ,$154.70 ,$30.26 ,$108.47 ,$50.96 ,$163.80 ,$14.12 ,$154.70 ,$153.79 ,$153.79 ,$14.12 ,$118.30 ST. JOSEPH'S HOSPITAL - BREESE,42000215,97012,HC TRACTION MECHANICAL APPL 30 MIN,420,1 ,$182.00 ,$131.04 ,$14.12 ,$182.00 ,$36.03 ,$118.30 ,$108.65 ,$14.12 ,$50.96 ,$120.48 ,$14.12 ,$120.48 ,$14.12 ,$108.47 ,$108.47 ,$14.12 ,$108.47 ,$29.11 ,$140.14 ,$36.03 ,$14.12 ,$14.41 ,$136.50 ,$129.22 ,$129.22 ,$14.12 ,$129.22 ,$154.70 ,$154.70 ,$154.70 , N/A ,$36.03 ,$154.70 ,$14.12 ,$182.00 ,$102.10 ,$14.12 ,$75.35 ,$20.44 ,$18.58 ,$14.12 ,$154.70 ,$30.26 ,$108.47 ,$50.96 ,$163.80 ,$14.12 ,$154.70 ,$153.79 ,$153.79 ,$14.12 ,$118.30 ST. JOSEPH'S HOSPITAL - BREESE,42000267,N/A,HC THERAPY ASSESSMENT - SELF PAY,420,1 ,$135.00 ,$97.20 ,$37.80 ,$135.00 , N/A ,$87.75 ,$80.60 , N/A ,$37.80 ,$89.37 , N/A ,$89.37 , N/A ,$80.46 ,$80.46 , N/A ,$80.46 , N/A ,$103.95 , N/A , N/A , N/A ,$101.25 ,$95.85 ,$95.85 , N/A ,$95.85 ,$114.75 ,$114.75 ,$114.75 , N/A , N/A ,$114.75 , N/A ,$135.00 ,$75.74 , N/A ,$55.89 , N/A , N/A , N/A ,$114.75 , N/A ,$80.46 ,$37.80 ,$121.50 , N/A ,$114.75 ,$114.08 ,$114.08 , N/A ,$87.75 ST. JOSEPH'S HOSPITAL - BREESE,42000268,N/A,HC THERAPY TREATMENT 30MIN - SELF PAY,420,1 ,$81.00 ,$58.32 ,$22.68 ,$81.00 , N/A ,$52.65 ,$48.36 , N/A ,$22.68 ,$53.62 , N/A ,$53.62 , N/A ,$48.28 ,$48.28 , N/A ,$48.28 , N/A ,$62.37 , N/A , N/A , N/A ,$60.75 ,$57.51 ,$57.51 , N/A ,$57.51 ,$68.85 ,$68.85 ,$68.85 , N/A , N/A ,$68.85 , N/A ,$81.00 ,$45.44 , N/A ,$33.53 , N/A , N/A , N/A ,$68.85 , N/A ,$48.28 ,$22.68 ,$72.90 , N/A ,$68.85 ,$68.45 ,$68.45 , N/A ,$52.65 ST. JOSEPH'S HOSPITAL - BREESE,42000269,N/A,HC THERAPY GROUP - SELF PAY,420,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,42000270,20560,HC NEEDLE INSERTION W/O INJ 1-2 MUSC SELF PAY,420,1 ,$34.00 ,$24.48 ,$9.52 ,$59.93 ,$59.93 ,$22.10 ,$20.30 ,$23.49 ,$9.52 ,$22.51 ,$23.49 ,$22.51 ,$23.49 ,$20.26 ,$20.26 ,$23.49 ,$20.26 ,$34.00 ,$26.18 ,$59.93 ,$23.49 ,$23.96 ,$25.50 ,$24.14 ,$24.14 ,$23.49 ,$24.14 ,$28.90 ,$28.90 ,$28.90 , N/A ,$34.00 ,$28.90 ,$23.49 ,$34.00 ,$19.07 ,$23.49 ,$14.08 ,$20.44 ,$18.58 ,$23.49 ,$28.90 ,$50.34 ,$20.26 ,$9.52 ,$30.60 ,$23.49 ,$28.90 ,$28.73 ,$28.73 ,$23.49 ,$22.10 ST. JOSEPH'S HOSPITAL - BREESE,42000271,20561,HC NEEDLE INSERTION W/O INJ 3+ MUSC SELF PAY,420,1 ,$46.00 ,$33.12 ,$12.88 ,$59.93 ,$59.93 ,$29.90 ,$27.46 ,$23.49 ,$12.88 ,$30.45 ,$23.49 ,$30.45 ,$23.49 ,$27.42 ,$27.42 ,$23.49 ,$27.42 ,$46.00 ,$35.42 ,$59.93 ,$23.49 ,$23.96 ,$34.50 ,$32.66 ,$32.66 ,$23.49 ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A ,$46.00 ,$39.10 ,$23.49 ,$46.00 ,$25.81 ,$23.49 ,$19.04 ,$20.44 ,$18.58 ,$23.49 ,$39.10 ,$50.34 ,$27.42 ,$12.88 ,$41.40 ,$23.49 ,$39.10 ,$38.87 ,$38.87 ,$23.49 ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400047,97161,HC PT EVAL LOW COMPLEXITY 75MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400048,97161,HC PT EVAL LOW COMPLEXITY 90MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400049,97161,HC PT EVAL LOW COMPLEXITY 105MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400050,97161,HC PT EVAL LOW COMPLEXITY 120MIN,424,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$250.20 ,$227.45 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400059,97162,HC PT EVAL MOD COMPLEXITY 75MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400060,97162,HC PT EVAL MOD COMPLEXITY 90MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400061,97162,HC PT EVAL MOD COMPLEXITY 105MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400062,97162,HC PT EVAL MOD COMPLEXITY 120MIN,424,1 ,$290.00 ,$208.80 ,$81.20 ,$290.00 ,$248.18 ,$188.50 ,$173.13 ,$97.28 ,$81.20 ,$191.98 ,$97.28 ,$191.98 ,$97.28 ,$172.84 ,$172.84 ,$97.28 ,$172.84 ,$200.53 ,$223.30 ,$248.18 ,$97.28 ,$99.23 ,$217.50 ,$205.90 ,$205.90 ,$97.28 ,$205.90 ,$246.50 ,$246.50 ,$246.50 , N/A ,$248.18 ,$246.50 ,$97.28 ,$290.00 ,$162.69 ,$97.28 ,$120.06 ,$250.20 ,$227.45 ,$97.28 ,$246.50 ,$208.47 ,$172.84 ,$81.20 ,$261.00 ,$97.28 ,$246.50 ,$245.05 ,$245.05 ,$97.28 ,$188.50 ST. JOSEPH'S HOSPITAL - BREESE,42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400070,97163,HC PT EVAL HIGH COMPLEXITY 60MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400071,97163,HC PT EVAL HIGH COMPLEXITY 75MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400072,97163,HC PT EVAL HIGH COMPLEXITY 90MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400073,97163,HC PT EVAL HIGH COMPLEXITY 105MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400074,97163,HC PT EVAL HIGH COMPLEXITY 120MIN,424,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$250.20 ,$227.45 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$172.25 ,$114.40 ,$105.07 ,$67.52 ,$49.28 ,$116.51 ,$67.52 ,$116.51 ,$67.52 ,$104.90 ,$104.90 ,$67.52 ,$104.90 ,$139.18 ,$135.52 ,$172.25 ,$67.52 ,$68.87 ,$132.00 ,$124.96 ,$124.96 ,$67.52 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$172.25 ,$149.60 ,$67.52 ,$176.00 ,$98.74 ,$67.52 ,$72.86 ,$176.00 ,$176.00 ,$67.52 ,$149.60 ,$144.69 ,$104.90 ,$49.28 ,$158.40 ,$67.52 ,$149.60 ,$148.72 ,$148.72 ,$67.52 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$172.25 ,$114.40 ,$105.07 ,$67.52 ,$49.28 ,$116.51 ,$67.52 ,$116.51 ,$67.52 ,$104.90 ,$104.90 ,$67.52 ,$104.90 ,$139.18 ,$135.52 ,$172.25 ,$67.52 ,$68.87 ,$132.00 ,$124.96 ,$124.96 ,$67.52 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$172.25 ,$149.60 ,$67.52 ,$176.00 ,$98.74 ,$67.52 ,$72.86 ,$176.00 ,$176.00 ,$67.52 ,$149.60 ,$144.69 ,$104.90 ,$49.28 ,$158.40 ,$67.52 ,$149.60 ,$148.72 ,$148.72 ,$67.52 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$172.25 ,$114.40 ,$105.07 ,$67.52 ,$49.28 ,$116.51 ,$67.52 ,$116.51 ,$67.52 ,$104.90 ,$104.90 ,$67.52 ,$104.90 ,$139.18 ,$135.52 ,$172.25 ,$67.52 ,$68.87 ,$132.00 ,$124.96 ,$124.96 ,$67.52 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$172.25 ,$149.60 ,$67.52 ,$176.00 ,$98.74 ,$67.52 ,$72.86 ,$176.00 ,$176.00 ,$67.52 ,$149.60 ,$144.69 ,$104.90 ,$49.28 ,$158.40 ,$67.52 ,$149.60 ,$148.72 ,$148.72 ,$67.52 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$172.25 ,$114.40 ,$105.07 ,$67.52 ,$49.28 ,$116.51 ,$67.52 ,$116.51 ,$67.52 ,$104.90 ,$104.90 ,$67.52 ,$104.90 ,$139.18 ,$135.52 ,$172.25 ,$67.52 ,$68.87 ,$132.00 ,$124.96 ,$124.96 ,$67.52 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$172.25 ,$149.60 ,$67.52 ,$176.00 ,$98.74 ,$67.52 ,$72.86 ,$176.00 ,$176.00 ,$67.52 ,$149.60 ,$144.69 ,$104.90 ,$49.28 ,$158.40 ,$67.52 ,$149.60 ,$148.72 ,$148.72 ,$67.52 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,43000015,97533,HC PERCEPTUAL ACTIVITY EA 15 MIN,430,1 ,$129.00 ,$92.88 ,$36.12 ,$153.23 ,$153.23 ,$83.85 ,$77.01 ,$60.06 ,$36.12 ,$85.40 ,$60.06 ,$85.40 ,$60.06 ,$76.88 ,$76.88 ,$60.06 ,$76.88 ,$123.81 ,$99.33 ,$153.23 ,$60.06 ,$61.27 ,$96.75 ,$91.59 ,$91.59 ,$60.06 ,$91.59 ,$109.65 ,$109.65 ,$109.65 , N/A ,$129.00 ,$109.65 ,$60.06 ,$129.00 ,$72.37 ,$60.06 ,$53.41 ,$129.00 ,$129.00 ,$60.06 ,$109.65 ,$128.71 ,$76.88 ,$36.12 ,$116.10 ,$60.06 ,$109.65 ,$109.01 ,$109.01 ,$60.06 ,$83.85 ST. JOSEPH'S HOSPITAL - BREESE,43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$118.00 ,$84.96 ,$31.58 ,$118.00 ,$80.55 ,$76.70 ,$70.45 ,$31.58 ,$33.04 ,$78.12 ,$31.58 ,$78.12 ,$31.58 ,$70.33 ,$70.33 ,$31.58 ,$70.33 ,$65.08 ,$90.86 ,$80.55 ,$31.58 ,$32.20 ,$88.50 ,$83.78 ,$83.78 ,$31.58 ,$83.78 ,$100.30 ,$100.30 ,$100.30 , N/A ,$80.55 ,$100.30 ,$31.58 ,$118.00 ,$66.20 ,$31.58 ,$48.85 ,$118.00 ,$118.00 ,$31.58 ,$100.30 ,$67.66 ,$70.33 ,$33.04 ,$106.20 ,$31.58 ,$100.30 ,$99.71 ,$99.71 ,$31.58 ,$76.70 ST. JOSEPH'S HOSPITAL - BREESE,43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$183.00 ,$131.76 ,$46.21 ,$183.00 ,$117.88 ,$118.95 ,$109.25 ,$46.21 ,$51.24 ,$121.15 ,$46.21 ,$121.15 ,$46.21 ,$109.07 ,$109.07 ,$46.21 ,$109.07 ,$95.24 ,$140.91 ,$117.88 ,$46.21 ,$47.13 ,$137.25 ,$129.93 ,$129.93 ,$46.21 ,$129.93 ,$155.55 ,$155.55 ,$155.55 , N/A ,$117.88 ,$155.55 ,$46.21 ,$183.00 ,$102.66 ,$46.21 ,$75.76 ,$183.00 ,$183.00 ,$46.21 ,$155.55 ,$99.02 ,$109.07 ,$51.24 ,$164.70 ,$46.21 ,$155.55 ,$154.64 ,$154.64 ,$46.21 ,$118.95 ST. JOSEPH'S HOSPITAL - BREESE,43000035,97545,HC WORK HARDENING/CONDITIONING FIRST 2 HRS,430,1 ,$520.00 ,$374.40 ,$145.60 ,$520.00 , N/A ,$338.00 ,$310.44 , N/A ,$145.60 ,$344.24 , N/A ,$344.24 , N/A ,$309.92 ,$309.92 , N/A ,$309.92 , N/A ,$400.40 , N/A , N/A , N/A ,$390.00 ,$369.20 ,$369.20 , N/A ,$369.20 ,$442.00 ,$442.00 ,$442.00 , N/A , N/A ,$442.00 , N/A ,$520.00 ,$291.72 , N/A ,$215.28 ,$250.20 ,$227.45 , N/A ,$442.00 , N/A ,$309.92 ,$145.60 ,$468.00 , N/A ,$442.00 ,$439.40 ,$439.40 , N/A ,$338.00 ST. JOSEPH'S HOSPITAL - BREESE,43000036,97546,HC WORK HARDENING/CONDITIONINS ADD 1 HOUR,430,1 ,$159.00 ,$114.48 ,$44.52 ,$159.00 , N/A ,$103.35 ,$94.92 , N/A ,$44.52 ,$105.26 , N/A ,$105.26 , N/A ,$94.76 ,$94.76 , N/A ,$94.76 , N/A ,$122.43 , N/A , N/A , N/A ,$119.25 ,$112.89 ,$112.89 , N/A ,$112.89 ,$135.15 ,$135.15 ,$135.15 , N/A , N/A ,$135.15 , N/A ,$159.00 ,$89.20 , N/A ,$65.83 ,$159.00 ,$159.00 , N/A ,$135.15 , N/A ,$94.76 ,$44.52 ,$143.10 , N/A ,$135.15 ,$134.36 ,$134.36 , N/A ,$103.35 ST. JOSEPH'S HOSPITAL - BREESE,43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$147.00 ,$105.84 ,$5.65 ,$147.00 ,$14.43 ,$95.55 ,$87.76 ,$5.65 ,$41.16 ,$97.31 ,$5.65 ,$97.31 ,$5.65 ,$87.61 ,$87.61 ,$5.65 ,$87.61 ,$11.66 ,$113.19 ,$14.43 ,$5.65 ,$5.77 ,$110.25 ,$104.37 ,$104.37 ,$5.65 ,$104.37 ,$124.95 ,$124.95 ,$124.95 , N/A ,$14.43 ,$124.95 ,$5.65 ,$147.00 ,$82.47 ,$5.65 ,$60.86 ,$20.44 ,$18.58 ,$5.65 ,$124.95 ,$12.12 ,$87.61 ,$41.16 ,$132.30 ,$5.65 ,$124.95 ,$124.22 ,$124.22 ,$5.65 ,$95.55 ST. JOSEPH'S HOSPITAL - BREESE,43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$147.00 ,$105.84 ,$5.65 ,$147.00 ,$14.43 ,$95.55 ,$87.76 ,$5.65 ,$41.16 ,$97.31 ,$5.65 ,$97.31 ,$5.65 ,$87.61 ,$87.61 ,$5.65 ,$87.61 ,$11.66 ,$113.19 ,$14.43 ,$5.65 ,$5.77 ,$110.25 ,$104.37 ,$104.37 ,$5.65 ,$104.37 ,$124.95 ,$124.95 ,$124.95 , N/A ,$14.43 ,$124.95 ,$5.65 ,$147.00 ,$82.47 ,$5.65 ,$60.86 ,$20.44 ,$18.58 ,$5.65 ,$124.95 ,$12.12 ,$87.61 ,$41.16 ,$132.30 ,$5.65 ,$124.95 ,$124.22 ,$124.22 ,$5.65 ,$95.55 ST. JOSEPH'S HOSPITAL - BREESE,43000049,95852,HC RANGE OF MOTION TESTING HAND,430,1 ,$40.00 ,$28.80 ,$11.20 ,$42.30 ,$42.30 ,$26.00 ,$23.88 ,$16.58 ,$11.20 ,$26.48 ,$16.58 ,$26.48 ,$16.58 ,$23.84 ,$23.84 ,$16.58 ,$23.84 ,$34.18 ,$30.80 ,$42.30 ,$16.58 ,$16.91 ,$30.00 ,$28.40 ,$28.40 ,$16.58 ,$28.40 ,$34.00 ,$34.00 ,$34.00 , N/A ,$40.00 ,$34.00 ,$16.58 ,$40.00 ,$22.44 ,$16.58 ,$16.56 , N/A , N/A ,$16.58 ,$34.00 ,$35.53 ,$23.84 ,$11.20 ,$36.00 ,$16.58 ,$34.00 ,$33.80 ,$33.80 ,$16.58 ,$26.00 ST. JOSEPH'S HOSPITAL - BREESE,43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$95.00 ,$68.40 ,$18.58 ,$95.00 ,$56.43 ,$61.75 ,$56.72 ,$22.12 ,$26.60 ,$62.89 ,$22.12 ,$62.89 ,$22.12 ,$56.62 ,$56.62 ,$22.12 ,$56.62 ,$45.59 ,$73.15 ,$56.43 ,$22.12 ,$22.56 ,$71.25 ,$67.45 ,$67.45 ,$22.12 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$56.43 ,$80.75 ,$22.12 ,$95.00 ,$53.30 ,$22.12 ,$39.33 ,$20.44 ,$18.58 ,$22.12 ,$80.75 ,$47.40 ,$56.62 ,$26.60 ,$85.50 ,$22.12 ,$80.75 ,$80.28 ,$80.28 ,$22.12 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$95.00 ,$68.40 ,$18.58 ,$95.00 ,$53.95 ,$61.75 ,$56.72 ,$21.15 ,$26.60 ,$62.89 ,$21.15 ,$62.89 ,$21.15 ,$56.62 ,$56.62 ,$21.15 ,$56.62 ,$43.59 ,$73.15 ,$53.95 ,$21.15 ,$21.57 ,$71.25 ,$67.45 ,$67.45 ,$21.15 ,$67.45 ,$80.75 ,$80.75 ,$80.75 , N/A ,$53.95 ,$80.75 ,$21.15 ,$95.00 ,$53.30 ,$21.15 ,$39.33 ,$20.44 ,$18.58 ,$21.15 ,$80.75 ,$45.32 ,$56.62 ,$26.60 ,$85.50 ,$21.15 ,$80.75 ,$80.28 ,$80.28 ,$21.15 ,$61.75 ST. JOSEPH'S HOSPITAL - BREESE,43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400038,97165,HC OT EVAL LOW COMPLEXITY 75MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400039,97165,HC OT EVAL LOW COMPLEXITY 90MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400040,97165,HC OT EVAL LOW COMPLEXITY 105MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400041,97165,HC OT EVAL LOW COMPLEXITY 120MIN,434,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 ,$248.18 ,$169.65 ,$155.82 ,$97.28 ,$73.08 ,$172.78 ,$97.28 ,$172.78 ,$97.28 ,$155.56 ,$155.56 ,$97.28 ,$155.56 ,$200.53 ,$200.97 ,$248.18 ,$97.28 ,$99.23 ,$195.75 ,$185.31 ,$185.31 ,$97.28 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$248.18 ,$221.85 ,$97.28 ,$261.00 ,$146.42 ,$97.28 ,$108.05 ,$261.00 ,$261.00 ,$97.28 ,$221.85 ,$208.47 ,$155.56 ,$73.08 ,$234.90 ,$97.28 ,$221.85 ,$220.55 ,$220.55 ,$97.28 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400050,97166,HC OT EVAL MOD COMPLEXITY 75MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400051,97166,HC OT EVAL MOD COMPLEXITY 90MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400052,97166,HC OT EVAL MOD COMPLEXITY 105MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400053,97166,HC OT EVAL MOD COMPLEXITY 120MIN,434,1 ,$321.00 ,$231.12 ,$89.88 ,$321.00 ,$248.18 ,$208.65 ,$191.64 ,$97.28 ,$89.88 ,$212.50 ,$97.28 ,$212.50 ,$97.28 ,$191.32 ,$191.32 ,$97.28 ,$191.32 ,$200.53 ,$247.17 ,$248.18 ,$97.28 ,$99.23 ,$240.75 ,$227.91 ,$227.91 ,$97.28 ,$227.91 ,$272.85 ,$272.85 ,$272.85 , N/A ,$248.18 ,$272.85 ,$97.28 ,$321.00 ,$180.08 ,$97.28 ,$132.89 ,$321.00 ,$321.00 ,$97.28 ,$272.85 ,$208.47 ,$191.32 ,$89.88 ,$288.90 ,$97.28 ,$272.85 ,$271.25 ,$271.25 ,$97.28 ,$208.65 ST. JOSEPH'S HOSPITAL - BREESE,43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400062,97167,HC OT EVAL HIGH COMPLEXITY 75MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400063,97167,HC OT EVAL HIGH COMPLEXITY 90MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400064,97167,HC OT EVAL HIGH COMPLEXITY 105MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400065,97167,HC OT EVAL HIGH COMPLEXITY 120MIN,434,1 ,$606.00 ,$436.32 ,$97.28 ,$606.00 ,$248.18 ,$393.90 ,$361.78 ,$97.28 ,$169.68 ,$401.17 ,$97.28 ,$401.17 ,$97.28 ,$361.18 ,$361.18 ,$97.28 ,$361.18 ,$200.53 ,$466.62 ,$248.18 ,$97.28 ,$99.23 ,$454.50 ,$430.26 ,$430.26 ,$97.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$248.18 ,$515.10 ,$97.28 ,$606.00 ,$339.97 ,$97.28 ,$250.88 ,$398.00 ,$361.82 ,$97.28 ,$515.10 ,$208.47 ,$361.18 ,$169.68 ,$545.40 ,$97.28 ,$515.10 ,$512.07 ,$512.07 ,$97.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$171.48 ,$114.40 ,$105.07 ,$67.22 ,$49.28 ,$116.51 ,$67.22 ,$116.51 ,$67.22 ,$104.90 ,$104.90 ,$67.22 ,$104.90 ,$138.55 ,$135.52 ,$171.48 ,$67.22 ,$68.56 ,$132.00 ,$124.96 ,$124.96 ,$67.22 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$171.48 ,$149.60 ,$67.22 ,$176.00 ,$98.74 ,$67.22 ,$72.86 ,$176.00 ,$176.00 ,$67.22 ,$149.60 ,$144.04 ,$104.90 ,$49.28 ,$158.40 ,$67.22 ,$149.60 ,$148.72 ,$148.72 ,$67.22 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$171.48 ,$114.40 ,$105.07 ,$67.22 ,$49.28 ,$116.51 ,$67.22 ,$116.51 ,$67.22 ,$104.90 ,$104.90 ,$67.22 ,$104.90 ,$138.55 ,$135.52 ,$171.48 ,$67.22 ,$68.56 ,$132.00 ,$124.96 ,$124.96 ,$67.22 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$171.48 ,$149.60 ,$67.22 ,$176.00 ,$98.74 ,$67.22 ,$72.86 ,$176.00 ,$176.00 ,$67.22 ,$149.60 ,$144.04 ,$104.90 ,$49.28 ,$158.40 ,$67.22 ,$149.60 ,$148.72 ,$148.72 ,$67.22 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$171.48 ,$114.40 ,$105.07 ,$67.22 ,$49.28 ,$116.51 ,$67.22 ,$116.51 ,$67.22 ,$104.90 ,$104.90 ,$67.22 ,$104.90 ,$138.55 ,$135.52 ,$171.48 ,$67.22 ,$68.56 ,$132.00 ,$124.96 ,$124.96 ,$67.22 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$171.48 ,$149.60 ,$67.22 ,$176.00 ,$98.74 ,$67.22 ,$72.86 ,$176.00 ,$176.00 ,$67.22 ,$149.60 ,$144.04 ,$104.90 ,$49.28 ,$158.40 ,$67.22 ,$149.60 ,$148.72 ,$148.72 ,$67.22 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$176.00 ,$126.72 ,$49.28 ,$176.00 ,$171.48 ,$114.40 ,$105.07 ,$67.22 ,$49.28 ,$116.51 ,$67.22 ,$116.51 ,$67.22 ,$104.90 ,$104.90 ,$67.22 ,$104.90 ,$138.55 ,$135.52 ,$171.48 ,$67.22 ,$68.56 ,$132.00 ,$124.96 ,$124.96 ,$67.22 ,$124.96 ,$149.60 ,$149.60 ,$149.60 , N/A ,$171.48 ,$149.60 ,$67.22 ,$176.00 ,$98.74 ,$67.22 ,$72.86 ,$176.00 ,$176.00 ,$67.22 ,$149.60 ,$144.04 ,$104.90 ,$49.28 ,$158.40 ,$67.22 ,$149.60 ,$148.72 ,$148.72 ,$67.22 ,$114.40 ST. JOSEPH'S HOSPITAL - BREESE,44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$132.00 ,$95.04 ,$36.96 ,$190.03 ,$190.03 ,$85.80 ,$78.80 ,$74.49 ,$36.96 ,$87.38 ,$74.49 ,$87.38 ,$74.49 ,$78.67 ,$78.67 ,$74.49 ,$78.67 ,$132.00 ,$101.64 ,$190.03 ,$74.49 ,$75.98 ,$99.00 ,$93.72 ,$93.72 ,$74.49 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$132.00 ,$112.20 ,$74.49 ,$132.00 ,$74.05 ,$74.49 ,$54.65 ,$132.00 ,$132.00 ,$74.49 ,$112.20 ,$159.62 ,$78.67 ,$36.96 ,$118.80 ,$74.49 ,$112.20 ,$111.54 ,$111.54 ,$74.49 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$132.00 ,$95.04 ,$36.96 ,$190.03 ,$190.03 ,$85.80 ,$78.80 ,$74.49 ,$36.96 ,$87.38 ,$74.49 ,$87.38 ,$74.49 ,$78.67 ,$78.67 ,$74.49 ,$78.67 ,$132.00 ,$101.64 ,$190.03 ,$74.49 ,$75.98 ,$99.00 ,$93.72 ,$93.72 ,$74.49 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$132.00 ,$112.20 ,$74.49 ,$132.00 ,$74.05 ,$74.49 ,$54.65 ,$132.00 ,$132.00 ,$74.49 ,$112.20 ,$159.62 ,$78.67 ,$36.96 ,$118.80 ,$74.49 ,$112.20 ,$111.54 ,$111.54 ,$74.49 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$132.00 ,$95.04 ,$36.96 ,$190.03 ,$190.03 ,$85.80 ,$78.80 ,$74.49 ,$36.96 ,$87.38 ,$74.49 ,$87.38 ,$74.49 ,$78.67 ,$78.67 ,$74.49 ,$78.67 ,$132.00 ,$101.64 ,$190.03 ,$74.49 ,$75.98 ,$99.00 ,$93.72 ,$93.72 ,$74.49 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$132.00 ,$112.20 ,$74.49 ,$132.00 ,$74.05 ,$74.49 ,$54.65 ,$132.00 ,$132.00 ,$74.49 ,$112.20 ,$159.62 ,$78.67 ,$36.96 ,$118.80 ,$74.49 ,$112.20 ,$111.54 ,$111.54 ,$74.49 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$132.00 ,$95.04 ,$36.96 ,$190.03 ,$190.03 ,$85.80 ,$78.80 ,$74.49 ,$36.96 ,$87.38 ,$74.49 ,$87.38 ,$74.49 ,$78.67 ,$78.67 ,$74.49 ,$78.67 ,$132.00 ,$101.64 ,$190.03 ,$74.49 ,$75.98 ,$99.00 ,$93.72 ,$93.72 ,$74.49 ,$93.72 ,$112.20 ,$112.20 ,$112.20 , N/A ,$132.00 ,$112.20 ,$74.49 ,$132.00 ,$74.05 ,$74.49 ,$54.65 ,$132.00 ,$132.00 ,$74.49 ,$112.20 ,$159.62 ,$78.67 ,$36.96 ,$118.80 ,$74.49 ,$112.20 ,$111.54 ,$111.54 ,$74.49 ,$85.80 ST. JOSEPH'S HOSPITAL - BREESE,44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$144.00 ,$103.68 ,$40.32 ,$209.98 ,$209.98 ,$93.60 ,$85.97 ,$82.31 ,$40.32 ,$95.33 ,$82.31 ,$95.33 ,$82.31 ,$85.82 ,$85.82 ,$82.31 ,$85.82 ,$144.00 ,$110.88 ,$209.98 ,$82.31 ,$83.96 ,$108.00 ,$102.24 ,$102.24 ,$82.31 ,$102.24 ,$122.40 ,$122.40 ,$122.40 , N/A ,$144.00 ,$122.40 ,$82.31 ,$144.00 ,$80.78 ,$82.31 ,$59.62 ,$144.00 ,$144.00 ,$82.31 ,$122.40 ,$176.38 ,$85.82 ,$40.32 ,$129.60 ,$82.31 ,$122.40 ,$121.68 ,$121.68 ,$82.31 ,$93.60 ST. JOSEPH'S HOSPITAL - BREESE,44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$144.00 ,$103.68 ,$40.32 ,$209.98 ,$209.98 ,$93.60 ,$85.97 ,$82.31 ,$40.32 ,$95.33 ,$82.31 ,$95.33 ,$82.31 ,$85.82 ,$85.82 ,$82.31 ,$85.82 ,$144.00 ,$110.88 ,$209.98 ,$82.31 ,$83.96 ,$108.00 ,$102.24 ,$102.24 ,$82.31 ,$102.24 ,$122.40 ,$122.40 ,$122.40 , N/A ,$144.00 ,$122.40 ,$82.31 ,$144.00 ,$80.78 ,$82.31 ,$59.62 ,$144.00 ,$144.00 ,$82.31 ,$122.40 ,$176.38 ,$85.82 ,$40.32 ,$129.60 ,$82.31 ,$122.40 ,$121.68 ,$121.68 ,$82.31 ,$93.60 ST. JOSEPH'S HOSPITAL - BREESE,44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$144.00 ,$103.68 ,$40.32 ,$209.98 ,$209.98 ,$93.60 ,$85.97 ,$82.31 ,$40.32 ,$95.33 ,$82.31 ,$95.33 ,$82.31 ,$85.82 ,$85.82 ,$82.31 ,$85.82 ,$144.00 ,$110.88 ,$209.98 ,$82.31 ,$83.96 ,$108.00 ,$102.24 ,$102.24 ,$82.31 ,$102.24 ,$122.40 ,$122.40 ,$122.40 , N/A ,$144.00 ,$122.40 ,$82.31 ,$144.00 ,$80.78 ,$82.31 ,$59.62 ,$144.00 ,$144.00 ,$82.31 ,$122.40 ,$176.38 ,$85.82 ,$40.32 ,$129.60 ,$82.31 ,$122.40 ,$121.68 ,$121.68 ,$82.31 ,$93.60 ST. JOSEPH'S HOSPITAL - BREESE,44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$144.00 ,$103.68 ,$40.32 ,$209.98 ,$209.98 ,$93.60 ,$85.97 ,$82.31 ,$40.32 ,$95.33 ,$82.31 ,$95.33 ,$82.31 ,$85.82 ,$85.82 ,$82.31 ,$85.82 ,$144.00 ,$110.88 ,$209.98 ,$82.31 ,$83.96 ,$108.00 ,$102.24 ,$102.24 ,$82.31 ,$102.24 ,$122.40 ,$122.40 ,$122.40 , N/A ,$144.00 ,$122.40 ,$82.31 ,$144.00 ,$80.78 ,$82.31 ,$59.62 ,$144.00 ,$144.00 ,$82.31 ,$122.40 ,$176.38 ,$85.82 ,$40.32 ,$129.60 ,$82.31 ,$122.40 ,$121.68 ,$121.68 ,$82.31 ,$93.60 ST. JOSEPH'S HOSPITAL - BREESE,44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$260.00 ,$209.73 ,$169.00 ,$155.22 ,$82.21 ,$72.80 ,$172.12 ,$82.21 ,$172.12 ,$82.21 ,$154.96 ,$154.96 ,$82.21 ,$154.96 ,$169.46 ,$200.20 ,$209.73 ,$82.21 ,$83.86 ,$195.00 ,$184.60 ,$184.60 ,$82.21 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$209.73 ,$221.00 ,$82.21 ,$260.00 ,$145.86 ,$82.21 ,$107.64 ,$184.93 ,$168.12 ,$82.21 ,$221.00 ,$176.17 ,$154.96 ,$72.80 ,$234.00 ,$82.21 ,$221.00 ,$219.70 ,$219.70 ,$82.21 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400018,92610,HC DYSPHAGIA EVALUATION 30MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$260.00 ,$209.73 ,$169.00 ,$155.22 ,$82.21 ,$72.80 ,$172.12 ,$82.21 ,$172.12 ,$82.21 ,$154.96 ,$154.96 ,$82.21 ,$154.96 ,$169.46 ,$200.20 ,$209.73 ,$82.21 ,$83.86 ,$195.00 ,$184.60 ,$184.60 ,$82.21 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$209.73 ,$221.00 ,$82.21 ,$260.00 ,$145.86 ,$82.21 ,$107.64 ,$184.93 ,$168.12 ,$82.21 ,$221.00 ,$176.17 ,$154.96 ,$72.80 ,$234.00 ,$82.21 ,$221.00 ,$219.70 ,$219.70 ,$82.21 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$260.00 ,$209.73 ,$169.00 ,$155.22 ,$82.21 ,$72.80 ,$172.12 ,$82.21 ,$172.12 ,$82.21 ,$154.96 ,$154.96 ,$82.21 ,$154.96 ,$169.46 ,$200.20 ,$209.73 ,$82.21 ,$83.86 ,$195.00 ,$184.60 ,$184.60 ,$82.21 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$209.73 ,$221.00 ,$82.21 ,$260.00 ,$145.86 ,$82.21 ,$107.64 ,$184.93 ,$168.12 ,$82.21 ,$221.00 ,$176.17 ,$154.96 ,$72.80 ,$234.00 ,$82.21 ,$221.00 ,$219.70 ,$219.70 ,$82.21 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$260.00 ,$209.73 ,$169.00 ,$155.22 ,$82.21 ,$72.80 ,$172.12 ,$82.21 ,$172.12 ,$82.21 ,$154.96 ,$154.96 ,$82.21 ,$154.96 ,$169.46 ,$200.20 ,$209.73 ,$82.21 ,$83.86 ,$195.00 ,$184.60 ,$184.60 ,$82.21 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$209.73 ,$221.00 ,$82.21 ,$260.00 ,$145.86 ,$82.21 ,$107.64 ,$184.93 ,$168.12 ,$82.21 ,$221.00 ,$176.17 ,$154.96 ,$72.80 ,$234.00 ,$82.21 ,$221.00 ,$219.70 ,$219.70 ,$82.21 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$489.00 ,$352.08 ,$37.46 ,$489.00 ,$228.40 ,$317.85 ,$291.93 ,$89.53 ,$136.92 ,$323.72 ,$89.53 ,$323.72 ,$89.53 ,$291.44 ,$291.44 ,$89.53 ,$291.44 ,$184.55 ,$376.53 ,$228.40 ,$89.53 ,$91.33 ,$366.75 ,$347.19 ,$347.19 ,$89.53 ,$347.19 ,$415.65 ,$415.65 ,$415.65 , N/A ,$228.40 ,$415.65 ,$89.53 ,$489.00 ,$274.33 ,$89.53 ,$202.45 ,$41.21 ,$37.46 ,$89.53 ,$415.65 ,$191.86 ,$291.44 ,$136.92 ,$440.10 ,$89.53 ,$415.65 ,$413.21 ,$413.21 ,$89.53 ,$317.85 ST. JOSEPH'S HOSPITAL - BREESE,44400040,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN,444,1 ,$256.00 ,$184.32 ,$71.68 ,$329.33 ,$329.33 ,$166.40 ,$152.83 ,$129.10 ,$71.68 ,$169.47 ,$129.10 ,$169.47 ,$129.10 ,$152.58 ,$152.58 ,$129.10 ,$152.58 ,$256.00 ,$197.12 ,$329.33 ,$129.10 ,$131.67 ,$192.00 ,$181.76 ,$181.76 ,$129.10 ,$181.76 ,$217.60 ,$217.60 ,$217.60 , N/A ,$256.00 ,$217.60 ,$129.10 ,$256.00 ,$143.62 ,$129.10 ,$105.98 ,$184.93 ,$168.12 ,$129.10 ,$217.60 ,$276.63 ,$152.58 ,$71.68 ,$230.40 ,$129.10 ,$217.60 ,$216.32 ,$216.32 ,$129.10 ,$166.40 ST. JOSEPH'S HOSPITAL - BREESE,44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$564.45 ,$564.45 ,$169.00 ,$155.22 ,$221.26 ,$72.80 ,$172.12 ,$221.26 ,$172.12 ,$221.26 ,$154.96 ,$154.96 ,$221.26 ,$154.96 ,$260.00 ,$200.20 ,$564.45 ,$221.26 ,$225.69 ,$195.00 ,$184.60 ,$184.60 ,$221.26 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$221.26 ,$260.00 ,$145.86 ,$221.26 ,$107.64 ,$184.93 ,$168.12 ,$221.26 ,$221.00 ,$474.14 ,$154.96 ,$72.80 ,$234.00 ,$221.26 ,$221.00 ,$219.70 ,$219.70 ,$221.26 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400043,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 15MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$273.73 ,$273.73 ,$169.00 ,$155.22 ,$107.30 ,$72.80 ,$172.12 ,$107.30 ,$172.12 ,$107.30 ,$154.96 ,$154.96 ,$107.30 ,$154.96 ,$221.17 ,$200.20 ,$273.73 ,$107.30 ,$109.45 ,$195.00 ,$184.60 ,$184.60 ,$107.30 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$107.30 ,$260.00 ,$145.86 ,$107.30 ,$107.64 ,$184.93 ,$168.12 ,$107.30 ,$221.00 ,$229.93 ,$154.96 ,$72.80 ,$234.00 ,$107.30 ,$221.00 ,$219.70 ,$219.70 ,$107.30 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$256.00 ,$184.32 ,$71.68 ,$329.33 ,$329.33 ,$166.40 ,$152.83 ,$129.10 ,$71.68 ,$169.47 ,$129.10 ,$169.47 ,$129.10 ,$152.58 ,$152.58 ,$129.10 ,$152.58 ,$256.00 ,$197.12 ,$329.33 ,$129.10 ,$131.67 ,$192.00 ,$181.76 ,$181.76 ,$129.10 ,$181.76 ,$217.60 ,$217.60 ,$217.60 , N/A ,$256.00 ,$217.60 ,$129.10 ,$256.00 ,$143.62 ,$129.10 ,$105.98 ,$184.93 ,$168.12 ,$129.10 ,$217.60 ,$276.63 ,$152.58 ,$71.68 ,$230.40 ,$129.10 ,$217.60 ,$216.32 ,$216.32 ,$129.10 ,$166.40 ST. JOSEPH'S HOSPITAL - BREESE,44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$256.00 ,$184.32 ,$71.68 ,$329.33 ,$329.33 ,$166.40 ,$152.83 ,$129.10 ,$71.68 ,$169.47 ,$129.10 ,$169.47 ,$129.10 ,$152.58 ,$152.58 ,$129.10 ,$152.58 ,$256.00 ,$197.12 ,$329.33 ,$129.10 ,$131.67 ,$192.00 ,$181.76 ,$181.76 ,$129.10 ,$181.76 ,$217.60 ,$217.60 ,$217.60 , N/A ,$256.00 ,$217.60 ,$129.10 ,$256.00 ,$143.62 ,$129.10 ,$105.98 ,$184.93 ,$168.12 ,$129.10 ,$217.60 ,$276.63 ,$152.58 ,$71.68 ,$230.40 ,$129.10 ,$217.60 ,$216.32 ,$216.32 ,$129.10 ,$166.40 ST. JOSEPH'S HOSPITAL - BREESE,44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$564.45 ,$564.45 ,$169.00 ,$155.22 ,$221.26 ,$72.80 ,$172.12 ,$221.26 ,$172.12 ,$221.26 ,$154.96 ,$154.96 ,$221.26 ,$154.96 ,$260.00 ,$200.20 ,$564.45 ,$221.26 ,$225.69 ,$195.00 ,$184.60 ,$184.60 ,$221.26 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$221.26 ,$260.00 ,$145.86 ,$221.26 ,$107.64 ,$184.93 ,$168.12 ,$221.26 ,$221.00 ,$474.14 ,$154.96 ,$72.80 ,$234.00 ,$221.26 ,$221.00 ,$219.70 ,$219.70 ,$221.26 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$564.45 ,$564.45 ,$169.00 ,$155.22 ,$221.26 ,$72.80 ,$172.12 ,$221.26 ,$172.12 ,$221.26 ,$154.96 ,$154.96 ,$221.26 ,$154.96 ,$260.00 ,$200.20 ,$564.45 ,$221.26 ,$225.69 ,$195.00 ,$184.60 ,$184.60 ,$221.26 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$221.26 ,$260.00 ,$145.86 ,$221.26 ,$107.64 ,$184.93 ,$168.12 ,$221.26 ,$221.00 ,$474.14 ,$154.96 ,$72.80 ,$234.00 ,$221.26 ,$221.00 ,$219.70 ,$219.70 ,$221.26 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$564.45 ,$564.45 ,$169.00 ,$155.22 ,$221.26 ,$72.80 ,$172.12 ,$221.26 ,$172.12 ,$221.26 ,$154.96 ,$154.96 ,$221.26 ,$154.96 ,$260.00 ,$200.20 ,$564.45 ,$221.26 ,$225.69 ,$195.00 ,$184.60 ,$184.60 ,$221.26 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$221.26 ,$260.00 ,$145.86 ,$221.26 ,$107.64 ,$184.93 ,$168.12 ,$221.26 ,$221.00 ,$474.14 ,$154.96 ,$72.80 ,$234.00 ,$221.26 ,$221.00 ,$219.70 ,$219.70 ,$221.26 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$273.73 ,$273.73 ,$169.00 ,$155.22 ,$107.30 ,$72.80 ,$172.12 ,$107.30 ,$172.12 ,$107.30 ,$154.96 ,$154.96 ,$107.30 ,$154.96 ,$221.17 ,$200.20 ,$273.73 ,$107.30 ,$109.45 ,$195.00 ,$184.60 ,$184.60 ,$107.30 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$107.30 ,$260.00 ,$145.86 ,$107.30 ,$107.64 ,$184.93 ,$168.12 ,$107.30 ,$221.00 ,$229.93 ,$154.96 ,$72.80 ,$234.00 ,$107.30 ,$221.00 ,$219.70 ,$219.70 ,$107.30 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$273.73 ,$273.73 ,$169.00 ,$155.22 ,$107.30 ,$72.80 ,$172.12 ,$107.30 ,$172.12 ,$107.30 ,$154.96 ,$154.96 ,$107.30 ,$154.96 ,$221.17 ,$200.20 ,$273.73 ,$107.30 ,$109.45 ,$195.00 ,$184.60 ,$184.60 ,$107.30 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$107.30 ,$260.00 ,$145.86 ,$107.30 ,$107.64 ,$184.93 ,$168.12 ,$107.30 ,$221.00 ,$229.93 ,$154.96 ,$72.80 ,$234.00 ,$107.30 ,$221.00 ,$219.70 ,$219.70 ,$107.30 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$260.00 ,$187.20 ,$72.80 ,$273.73 ,$273.73 ,$169.00 ,$155.22 ,$107.30 ,$72.80 ,$172.12 ,$107.30 ,$172.12 ,$107.30 ,$154.96 ,$154.96 ,$107.30 ,$154.96 ,$221.17 ,$200.20 ,$273.73 ,$107.30 ,$109.45 ,$195.00 ,$184.60 ,$184.60 ,$107.30 ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A ,$260.00 ,$221.00 ,$107.30 ,$260.00 ,$145.86 ,$107.30 ,$107.64 ,$184.93 ,$168.12 ,$107.30 ,$221.00 ,$229.93 ,$154.96 ,$72.80 ,$234.00 ,$107.30 ,$221.00 ,$219.70 ,$219.70 ,$107.30 ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$938.00 ,$675.36 ,$262.64 ,$938.00 ,$895.68 ,$609.70 ,$559.99 ,$351.10 ,$262.64 ,$620.96 ,$351.10 ,$620.96 ,$351.10 ,$559.05 ,$559.05 ,$351.10 ,$559.05 ,$723.71 ,$722.26 ,$895.69 ,$351.10 ,$358.13 ,$703.50 ,$665.98 ,$665.98 ,$351.10 ,$665.98 ,$797.30 ,$797.30 ,$797.30 , N/A ,$895.69 ,$797.30 ,$351.10 ,$938.00 ,$526.22 ,$351.10 ,$388.33 , N/A , N/A ,$351.10 ,$797.30 ,$752.38 ,$559.05 ,$262.64 ,$844.20 ,$351.10 ,$797.30 ,$342.00 ,$342.00 ,$351.10 ,$609.70 ST. JOSEPH'S HOSPITAL - BREESE,45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$938.00 ,$675.36 ,$262.64 ,"$1,558.08 ","$1,558.08 ",$609.70 ,$559.99 ,$610.77 ,$262.64 ,$620.96 ,$610.77 ,$620.96 ,$610.77 ,$559.05 ,$559.05 ,$610.77 ,$559.05 ,$938.00 ,$722.26 ,"$1,558.08 ",$610.77 ,$622.99 ,$703.50 ,$665.98 ,$665.98 ,$610.77 ,$665.98 ,$797.30 ,$797.30 ,$797.30 , N/A ,$938.00 ,$797.30 ,$610.77 ,$938.00 ,$526.22 ,$610.77 ,$388.33 , N/A , N/A ,$610.77 ,$797.30 ,"$1,308.79 ",$559.05 ,$262.64 ,$844.20 ,$610.77 ,$797.30 ,$342.00 ,$342.00 ,$610.77 ,$609.70 ST. JOSEPH'S HOSPITAL - BREESE,45000004,10081,HC I AND D CYST PILONIDAL CPLX,450,1 ,"$2,011.00 ","$1,447.92 ",$342.00 ,"$2,011.00 ","$1,558.08 ","$1,307.15 ","$1,200.57 ",$610.77 ,$563.08 ,"$1,331.28 ",$610.77 ,"$1,331.28 ",$610.77 ,"$1,198.56 ","$1,198.56 ",$610.77 ,"$1,198.56 ","$1,258.93 ","$1,548.47 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,508.25 ","$1,427.81 ","$1,427.81 ",$610.77 ,"$1,427.81 ","$1,709.35 ","$1,709.35 ","$1,709.35 ", N/A ,"$1,558.08 ","$1,709.35 ",$610.77 ,"$2,011.00 ","$1,128.17 ",$610.77 ,$832.55 , N/A , N/A ,$610.77 ,"$1,709.35 ","$1,308.79 ","$1,198.56 ",$563.08 ,"$1,809.90 ",$610.77 ,"$1,709.35 ",$342.00 ,$342.00 ,$610.77 ,"$1,307.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$927.00 ,$667.44 ,$259.56 ,$927.00 ,$895.68 ,$602.55 ,$553.42 ,$351.10 ,$259.56 ,$613.67 ,$351.10 ,$613.67 ,$351.10 ,$552.49 ,$552.49 ,$351.10 ,$552.49 ,$723.71 ,$713.79 ,$895.69 ,$351.10 ,$358.13 ,$695.25 ,$658.17 ,$658.17 ,$351.10 ,$658.17 ,$787.95 ,$787.95 ,$787.95 , N/A ,$895.69 ,$787.95 ,$351.10 ,$927.00 ,$520.05 ,$351.10 ,$383.78 , N/A , N/A ,$351.10 ,$787.95 ,$752.38 ,$552.49 ,$259.56 ,$834.30 ,$351.10 ,$787.95 ,$342.00 ,$342.00 ,$351.10 ,$602.55 ST. JOSEPH'S HOSPITAL - BREESE,45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$485.00 ,$349.20 ,$135.80 ,$485.00 ,$433.55 ,$315.25 ,$289.55 ,$169.95 ,$135.80 ,$321.07 ,$169.95 ,$321.07 ,$169.95 ,$289.06 ,$289.06 ,$169.95 ,$289.06 ,$350.30 ,$373.45 ,$433.55 ,$169.95 ,$173.35 ,$363.75 ,$344.35 ,$344.35 ,$169.95 ,$344.35 ,$412.25 ,$412.25 ,$412.25 , N/A ,$433.55 ,$412.25 ,$169.95 ,$485.00 ,$272.09 ,$169.95 ,$200.79 , N/A , N/A ,$169.95 ,$412.25 ,$364.18 ,$289.06 ,$135.80 ,$436.50 ,$169.95 ,$412.25 ,$342.00 ,$342.00 ,$169.95 ,$315.25 ST. JOSEPH'S HOSPITAL - BREESE,45000010,11732,HC AVULSION NAIL PL PT/CO EA ADDL FAC,450,1 ,$209.00 ,$150.48 ,$58.52 ,$209.00 , N/A ,$135.85 ,$124.77 , N/A ,$58.52 ,$138.36 , N/A ,$138.36 , N/A ,$124.56 ,$124.56 , N/A ,$124.56 , N/A ,$160.93 , N/A , N/A , N/A ,$156.75 ,$148.39 ,$148.39 , N/A ,$148.39 ,$177.65 ,$177.65 ,$177.65 , N/A , N/A ,$177.65 , N/A ,$209.00 ,$117.25 , N/A ,$86.53 , N/A , N/A , N/A ,$177.65 , N/A ,$124.56 ,$58.52 ,$188.10 , N/A ,$177.65 ,$209.00 ,$209.00 , N/A ,$135.85 ST. JOSEPH'S HOSPITAL - BREESE,45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$215.00 ,$154.80 ,$60.20 ,$278.78 ,$278.78 ,$139.75 ,$128.36 ,$109.28 ,$60.20 ,$142.33 ,$109.28 ,$142.33 ,$109.28 ,$128.14 ,$128.14 ,$109.28 ,$128.14 ,$215.00 ,$165.55 ,$278.76 ,$109.28 ,$111.47 ,$161.25 ,$152.65 ,$152.65 ,$109.28 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$215.00 ,$182.75 ,$109.28 ,$215.00 ,$120.62 ,$109.28 ,$89.01 , N/A , N/A ,$109.28 ,$182.75 ,$234.16 ,$128.14 ,$60.20 ,$193.50 ,$109.28 ,$182.75 ,$215.00 ,$215.00 ,$109.28 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,45000012,11760,HC REPAIR NAIL BED,450,1 ,"$1,656.00 ","$1,192.32 ",$342.00 ,"$1,656.00 ","$1,394.78 ","$1,076.40 ",$988.63 ,$546.75 ,$463.68 ,"$1,096.27 ",$546.75 ,"$1,096.27 ",$546.75 ,$986.98 ,$986.98 ,$546.75 ,$986.98 ,"$1,126.98 ","$1,275.12 ","$1,394.77 ",$546.75 ,$557.69 ,"$1,242.00 ","$1,175.76 ","$1,175.76 ",$546.75 ,"$1,175.76 ","$1,407.60 ","$1,407.60 ","$1,407.60 ", N/A ,"$1,394.77 ","$1,407.60 ",$546.75 ,"$1,656.00 ",$929.02 ,$546.75 ,$685.58 , N/A , N/A ,$546.75 ,"$1,407.60 ","$1,171.61 ",$986.98 ,$463.68 ,"$1,490.40 ",$546.75 ,"$1,407.60 ",$342.00 ,$342.00 ,$546.75 ,"$1,076.40 " ST. JOSEPH'S HOSPITAL - BREESE,45000013,11765,HC EXC WEDGE SKIN NAIL FOLD,450,1 ,$350.00 ,$252.00 ,$98.00 ,$895.69 ,$895.68 ,$227.50 ,$208.95 ,$351.10 ,$98.00 ,$231.70 ,$351.10 ,$231.70 ,$343.00 ,$208.60 ,$208.60 ,$343.00 ,$208.60 ,$350.00 ,$269.50 ,$895.69 ,$351.10 ,$343.00 ,$262.50 ,$248.50 ,$248.50 ,$351.10 ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A ,$350.00 ,$297.50 ,$343.00 ,$350.00 ,$196.35 ,$351.10 ,$144.90 , N/A , N/A ,$351.10 ,$297.50 ,$752.38 ,$208.60 ,$98.00 ,$315.00 ,$351.10 ,$297.50 ,$342.00 ,$342.00 ,$351.10 ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$352.00 ,$253.44 ,$98.56 ,$433.55 ,$433.55 ,$228.80 ,$210.14 ,$169.95 ,$98.56 ,$233.02 ,$169.95 ,$233.02 ,$169.95 ,$209.79 ,$209.79 ,$169.95 ,$209.79 ,$350.30 ,$271.04 ,$433.55 ,$169.95 ,$173.35 ,$264.00 ,$249.92 ,$249.92 ,$169.95 ,$249.92 ,$299.20 ,$299.20 ,$299.20 , N/A ,$352.00 ,$299.20 ,$169.95 ,$352.00 ,$197.47 ,$169.95 ,$145.73 , N/A , N/A ,$169.95 ,$299.20 ,$364.18 ,$209.79 ,$98.56 ,$316.80 ,$169.95 ,$299.20 ,$342.00 ,$342.00 ,$169.95 ,$228.80 ST. JOSEPH'S HOSPITAL - BREESE,45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$360.00 ,$259.20 ,$100.80 ,$433.55 ,$433.55 ,$234.00 ,$214.92 ,$169.95 ,$100.80 ,$238.32 ,$169.95 ,$238.32 ,$169.95 ,$214.56 ,$214.56 ,$169.95 ,$214.56 ,$350.30 ,$277.20 ,$433.55 ,$169.95 ,$173.35 ,$270.00 ,$255.60 ,$255.60 ,$169.95 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$360.00 ,$306.00 ,$169.95 ,$360.00 ,$201.96 ,$169.95 ,$149.04 , N/A , N/A ,$169.95 ,$306.00 ,$364.18 ,$214.56 ,$100.80 ,$324.00 ,$169.95 ,$306.00 ,$342.00 ,$342.00 ,$169.95 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$365.00 ,$262.80 ,$102.20 ,$433.55 ,$433.55 ,$237.25 ,$217.91 ,$169.95 ,$102.20 ,$241.63 ,$169.95 ,$241.63 ,$169.95 ,$217.54 ,$217.54 ,$169.95 ,$217.54 ,$350.30 ,$281.05 ,$433.55 ,$169.95 ,$173.35 ,$273.75 ,$259.15 ,$259.15 ,$169.95 ,$259.15 ,$310.25 ,$310.25 ,$310.25 , N/A ,$365.00 ,$310.25 ,$169.95 ,$365.00 ,$204.77 ,$169.95 ,$151.11 , N/A , N/A ,$169.95 ,$310.25 ,$364.18 ,$217.54 ,$102.20 ,$328.50 ,$169.95 ,$310.25 ,$342.00 ,$342.00 ,$169.95 ,$237.25 ST. JOSEPH'S HOSPITAL - BREESE,45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$373.00 ,$268.56 ,$104.44 ,$895.69 ,$895.68 ,$242.45 ,$222.68 ,$351.10 ,$104.44 ,$246.93 ,$351.10 ,$246.93 ,$351.10 ,$222.31 ,$222.31 ,$351.10 ,$222.31 ,$373.00 ,$287.21 ,$895.69 ,$351.10 ,$358.13 ,$279.75 ,$264.83 ,$264.83 ,$351.10 ,$264.83 ,$317.05 ,$317.05 ,$317.05 , N/A ,$373.00 ,$317.05 ,$351.10 ,$373.00 ,$209.25 ,$351.10 ,$154.42 , N/A , N/A ,$351.10 ,$317.05 ,$752.38 ,$222.31 ,$104.44 ,$335.70 ,$351.10 ,$317.05 ,$342.00 ,$342.00 ,$351.10 ,$242.45 ST. JOSEPH'S HOSPITAL - BREESE,45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$378.00 ,$272.16 ,$105.84 ,$895.69 ,$895.68 ,$245.70 ,$225.67 ,$351.10 ,$105.84 ,$250.24 ,$351.10 ,$250.24 ,$351.10 ,$225.29 ,$225.29 ,$351.10 ,$225.29 ,$378.00 ,$291.06 ,$895.69 ,$351.10 ,$358.13 ,$283.50 ,$268.38 ,$268.38 ,$351.10 ,$268.38 ,$321.30 ,$321.30 ,$321.30 , N/A ,$378.00 ,$321.30 ,$351.10 ,$378.00 ,$212.06 ,$351.10 ,$156.49 , N/A , N/A ,$351.10 ,$321.30 ,$752.38 ,$225.29 ,$105.84 ,$340.20 ,$351.10 ,$321.30 ,$342.00 ,$342.00 ,$351.10 ,$245.70 ST. JOSEPH'S HOSPITAL - BREESE,45000019,12007,HC SIMP S/N/AX/GN/TRK/EXT > 30CM,450,1 ,$385.00 ,$277.20 ,$107.80 ,$433.55 ,$433.55 ,$250.25 ,$229.85 ,$169.95 ,$107.80 ,$254.87 ,$169.95 ,$254.87 ,$169.95 ,$229.46 ,$229.46 ,$169.95 ,$229.46 ,$350.30 ,$296.45 ,$433.55 ,$169.95 ,$173.35 ,$288.75 ,$273.35 ,$273.35 ,$169.95 ,$273.35 ,$327.25 ,$327.25 ,$327.25 , N/A ,$385.00 ,$327.25 ,$169.95 ,$385.00 ,$215.99 ,$169.95 ,$159.39 , N/A , N/A ,$169.95 ,$327.25 ,$364.18 ,$229.46 ,$107.80 ,$346.50 ,$169.95 ,$327.25 ,$342.00 ,$342.00 ,$169.95 ,$250.25 ST. JOSEPH'S HOSPITAL - BREESE,45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$352.00 ,$253.44 ,$98.56 ,$433.55 ,$433.55 ,$228.80 ,$210.14 ,$169.95 ,$98.56 ,$233.02 ,$169.95 ,$233.02 ,$169.95 ,$209.79 ,$209.79 ,$169.95 ,$209.79 ,$350.30 ,$271.04 ,$433.55 ,$169.95 ,$173.35 ,$264.00 ,$249.92 ,$249.92 ,$169.95 ,$249.92 ,$299.20 ,$299.20 ,$299.20 , N/A ,$352.00 ,$299.20 ,$169.95 ,$352.00 ,$197.47 ,$169.95 ,$145.73 , N/A , N/A ,$169.95 ,$299.20 ,$364.18 ,$209.79 ,$98.56 ,$316.80 ,$169.95 ,$299.20 ,$342.00 ,$342.00 ,$169.95 ,$228.80 ST. JOSEPH'S HOSPITAL - BREESE,45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$360.00 ,$259.20 ,$100.80 ,$433.55 ,$433.55 ,$234.00 ,$214.92 ,$169.95 ,$100.80 ,$238.32 ,$169.95 ,$238.32 ,$169.95 ,$214.56 ,$214.56 ,$169.95 ,$214.56 ,$350.30 ,$277.20 ,$433.55 ,$169.95 ,$173.35 ,$270.00 ,$255.60 ,$255.60 ,$169.95 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$360.00 ,$306.00 ,$169.95 ,$360.00 ,$201.96 ,$169.95 ,$149.04 , N/A , N/A ,$169.95 ,$306.00 ,$364.18 ,$214.56 ,$100.80 ,$324.00 ,$169.95 ,$306.00 ,$342.00 ,$342.00 ,$169.95 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$365.00 ,$262.80 ,$102.20 ,$433.55 ,$433.55 ,$237.25 ,$217.91 ,$169.95 ,$102.20 ,$241.63 ,$169.95 ,$241.63 ,$169.95 ,$217.54 ,$217.54 ,$169.95 ,$217.54 ,$350.30 ,$281.05 ,$433.55 ,$169.95 ,$173.35 ,$273.75 ,$259.15 ,$259.15 ,$169.95 ,$259.15 ,$310.25 ,$310.25 ,$310.25 , N/A ,$365.00 ,$310.25 ,$169.95 ,$365.00 ,$204.77 ,$169.95 ,$151.11 , N/A , N/A ,$169.95 ,$310.25 ,$364.18 ,$217.54 ,$102.20 ,$328.50 ,$169.95 ,$310.25 ,$342.00 ,$342.00 ,$169.95 ,$237.25 ST. JOSEPH'S HOSPITAL - BREESE,45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$373.00 ,$268.56 ,$104.44 ,$433.55 ,$433.55 ,$242.45 ,$222.68 ,$169.95 ,$104.44 ,$246.93 ,$169.95 ,$246.93 ,$169.95 ,$222.31 ,$222.31 ,$169.95 ,$222.31 ,$350.30 ,$287.21 ,$433.55 ,$169.95 ,$173.35 ,$279.75 ,$264.83 ,$264.83 ,$169.95 ,$264.83 ,$317.05 ,$317.05 ,$317.05 , N/A ,$373.00 ,$317.05 ,$169.95 ,$373.00 ,$209.25 ,$169.95 ,$154.42 , N/A , N/A ,$169.95 ,$317.05 ,$364.18 ,$222.31 ,$104.44 ,$335.70 ,$169.95 ,$317.05 ,$342.00 ,$342.00 ,$169.95 ,$242.45 ST. JOSEPH'S HOSPITAL - BREESE,45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$378.00 ,$272.16 ,$105.84 ,$895.69 ,$895.68 ,$245.70 ,$225.67 ,$351.10 ,$105.84 ,$250.24 ,$351.10 ,$250.24 ,$351.10 ,$225.29 ,$225.29 ,$351.10 ,$225.29 ,$378.00 ,$291.06 ,$895.69 ,$351.10 ,$358.13 ,$283.50 ,$268.38 ,$268.38 ,$351.10 ,$268.38 ,$321.30 ,$321.30 ,$321.30 , N/A ,$378.00 ,$321.30 ,$351.10 ,$378.00 ,$212.06 ,$351.10 ,$156.49 , N/A , N/A ,$351.10 ,$321.30 ,$752.38 ,$225.29 ,$105.84 ,$340.20 ,$351.10 ,$321.30 ,$342.00 ,$342.00 ,$351.10 ,$245.70 ST. JOSEPH'S HOSPITAL - BREESE,45000025,12017,HC SIMP F/E/E/N/L/MM 20.1-30.0CM,450,1 ,$385.00 ,$277.20 ,$107.80 ,$895.69 ,$895.68 ,$250.25 ,$229.85 ,$351.10 ,$107.80 ,$254.87 ,$351.10 ,$254.87 ,$351.10 ,$229.46 ,$229.46 ,$351.10 ,$229.46 ,$385.00 ,$296.45 ,$895.69 ,$351.10 ,$358.13 ,$288.75 ,$273.35 ,$273.35 ,$351.10 ,$273.35 ,$327.25 ,$327.25 ,$327.25 , N/A ,$385.00 ,$327.25 ,$351.10 ,$385.00 ,$215.99 ,$351.10 ,$159.39 , N/A , N/A ,$351.10 ,$327.25 ,$752.38 ,$229.46 ,$107.80 ,$346.50 ,$351.10 ,$327.25 ,$342.00 ,$342.00 ,$351.10 ,$250.25 ST. JOSEPH'S HOSPITAL - BREESE,45000026,12018,HC SIMP F/E/E/N/L/MM OVER 30CM,450,1 ,$391.00 ,$281.52 ,$109.48 ,$433.55 ,$433.55 ,$254.15 ,$233.43 ,$169.95 ,$109.48 ,$258.84 ,$169.95 ,$258.84 ,$169.95 ,$233.04 ,$233.04 ,$169.95 ,$233.04 ,$350.30 ,$301.07 ,$433.55 ,$169.95 ,$173.35 ,$293.25 ,$277.61 ,$277.61 ,$169.95 ,$277.61 ,$332.35 ,$332.35 ,$332.35 , N/A ,$391.00 ,$332.35 ,$169.95 ,$391.00 ,$219.35 ,$169.95 ,$161.87 , N/A , N/A ,$169.95 ,$332.35 ,$364.18 ,$233.04 ,$109.48 ,$351.90 ,$169.95 ,$332.35 ,$342.00 ,$342.00 ,$169.95 ,$254.15 ST. JOSEPH'S HOSPITAL - BREESE,45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,$440.00 ,$316.80 ,$123.20 ,$895.69 ,$895.68 ,$286.00 ,$262.68 ,$351.10 ,$123.20 ,$291.28 ,$351.10 ,$291.28 ,$351.10 ,$262.24 ,$262.24 ,$351.10 ,$262.24 ,$440.00 ,$338.80 ,$895.69 ,$351.10 ,$358.13 ,$330.00 ,$312.40 ,$312.40 ,$351.10 ,$312.40 ,$374.00 ,$374.00 ,$374.00 , N/A ,$440.00 ,$374.00 ,$351.10 ,$440.00 ,$246.84 ,$351.10 ,$182.16 , N/A , N/A ,$351.10 ,$374.00 ,$752.38 ,$262.24 ,$123.20 ,$396.00 ,$351.10 ,$374.00 ,$342.00 ,$342.00 ,$351.10 ,$286.00 ST. JOSEPH'S HOSPITAL - BREESE,45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$446.00 ,$321.12 ,$124.88 ,$895.69 ,$895.68 ,$289.90 ,$266.26 ,$351.10 ,$124.88 ,$295.25 ,$351.10 ,$295.25 ,$351.10 ,$265.82 ,$265.82 ,$351.10 ,$265.82 ,$446.00 ,$343.42 ,$895.69 ,$351.10 ,$358.13 ,$334.50 ,$316.66 ,$316.66 ,$351.10 ,$316.66 ,$379.10 ,$379.10 ,$379.10 , N/A ,$446.00 ,$379.10 ,$351.10 ,$446.00 ,$250.21 ,$351.10 ,$184.64 , N/A , N/A ,$351.10 ,$379.10 ,$752.38 ,$265.82 ,$124.88 ,$401.40 ,$351.10 ,$379.10 ,$342.00 ,$342.00 ,$351.10 ,$289.90 ST. JOSEPH'S HOSPITAL - BREESE,45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$453.00 ,$326.16 ,$126.84 ,$895.69 ,$895.68 ,$294.45 ,$270.44 ,$351.10 ,$126.84 ,$299.89 ,$351.10 ,$299.89 ,$351.10 ,$269.99 ,$269.99 ,$351.10 ,$269.99 ,$453.00 ,$348.81 ,$895.69 ,$351.10 ,$358.13 ,$339.75 ,$321.63 ,$321.63 ,$351.10 ,$321.63 ,$385.05 ,$385.05 ,$385.05 , N/A ,$453.00 ,$385.05 ,$351.10 ,$453.00 ,$254.13 ,$351.10 ,$187.54 , N/A , N/A ,$351.10 ,$385.05 ,$752.38 ,$269.99 ,$126.84 ,$407.70 ,$351.10 ,$385.05 ,$342.00 ,$342.00 ,$351.10 ,$294.45 ST. JOSEPH'S HOSPITAL - BREESE,45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,$459.00 ,$330.48 ,$128.52 ,$895.69 ,$895.68 ,$298.35 ,$274.02 ,$351.10 ,$128.52 ,$303.86 ,$351.10 ,$303.86 ,$351.10 ,$273.56 ,$273.56 ,$351.10 ,$273.56 ,$459.00 ,$353.43 ,$895.69 ,$351.10 ,$358.13 ,$344.25 ,$325.89 ,$325.89 ,$351.10 ,$325.89 ,$390.15 ,$390.15 ,$390.15 , N/A ,$459.00 ,$390.15 ,$351.10 ,$459.00 ,$257.50 ,$351.10 ,$190.03 , N/A , N/A ,$351.10 ,$390.15 ,$752.38 ,$273.56 ,$128.52 ,$413.10 ,$351.10 ,$390.15 ,$342.00 ,$342.00 ,$351.10 ,$298.35 ST. JOSEPH'S HOSPITAL - BREESE,45000033,12036,HC INTRM S/A/T/EXT 20.1-30.0CM,450,1 ,$466.00 ,$335.52 ,$130.48 ,"$1,394.78 ","$1,394.78 ",$302.90 ,$278.20 ,$546.75 ,$130.48 ,$308.49 ,$546.75 ,$308.49 ,$456.68 ,$277.74 ,$277.74 ,$456.68 ,$277.74 ,$466.00 ,$358.82 ,"$1,394.77 ",$546.75 ,$456.68 ,$349.50 ,$330.86 ,$330.86 ,$546.75 ,$330.86 ,$396.10 ,$396.10 ,$396.10 , N/A ,$466.00 ,$396.10 ,$456.68 ,$466.00 ,$261.43 ,$546.75 ,$192.92 , N/A , N/A ,$546.75 ,$396.10 ,"$1,171.61 ",$277.74 ,$130.48 ,$419.40 ,$546.75 ,$396.10 ,$342.00 ,$342.00 ,$546.75 ,$302.90 ST. JOSEPH'S HOSPITAL - BREESE,45000034,12037,HC INTRM S/A/T/EXT OVER 30CM,450,1 ,$473.00 ,$340.56 ,$132.44 ,"$4,143.53 ","$4,143.53 ",$307.45 ,$282.38 ,"$1,624.26 ",$132.44 ,$313.13 ,"$1,624.26 ",$313.13 ,$463.54 ,$281.91 ,$281.91 ,$463.54 ,$281.91 ,$473.00 ,$364.21 ,"$4,143.53 ","$1,624.26 ",$463.54 ,$354.75 ,$335.83 ,$335.83 ,"$1,624.26 ",$335.83 ,$402.05 ,$402.05 ,$402.05 , N/A ,$473.00 ,$402.05 ,$463.54 ,$473.00 ,$265.35 ,"$1,624.26 ",$195.82 , N/A , N/A ,"$1,624.26 ",$402.05 ,"$3,480.57 ",$281.91 ,$132.44 ,$425.70 ,"$1,624.26 ",$402.05 ,$342.00 ,$342.00 ,"$1,624.26 ",$307.45 ST. JOSEPH'S HOSPITAL - BREESE,45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$440.00 ,$316.80 ,$123.20 ,$895.69 ,$895.68 ,$286.00 ,$262.68 ,$351.10 ,$123.20 ,$291.28 ,$351.10 ,$291.28 ,$351.10 ,$262.24 ,$262.24 ,$351.10 ,$262.24 ,$440.00 ,$338.80 ,$895.69 ,$351.10 ,$358.13 ,$330.00 ,$312.40 ,$312.40 ,$351.10 ,$312.40 ,$374.00 ,$374.00 ,$374.00 , N/A ,$440.00 ,$374.00 ,$351.10 ,$440.00 ,$246.84 ,$351.10 ,$182.16 , N/A , N/A ,$351.10 ,$374.00 ,$752.38 ,$262.24 ,$123.20 ,$396.00 ,$351.10 ,$374.00 ,$342.00 ,$342.00 ,$351.10 ,$286.00 ST. JOSEPH'S HOSPITAL - BREESE,45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$446.00 ,$321.12 ,$124.88 ,$895.69 ,$895.68 ,$289.90 ,$266.26 ,$351.10 ,$124.88 ,$295.25 ,$351.10 ,$295.25 ,$351.10 ,$265.82 ,$265.82 ,$351.10 ,$265.82 ,$446.00 ,$343.42 ,$895.69 ,$351.10 ,$358.13 ,$334.50 ,$316.66 ,$316.66 ,$351.10 ,$316.66 ,$379.10 ,$379.10 ,$379.10 , N/A ,$446.00 ,$379.10 ,$351.10 ,$446.00 ,$250.21 ,$351.10 ,$184.64 , N/A , N/A ,$351.10 ,$379.10 ,$752.38 ,$265.82 ,$124.88 ,$401.40 ,$351.10 ,$379.10 ,$342.00 ,$342.00 ,$351.10 ,$289.90 ST. JOSEPH'S HOSPITAL - BREESE,45000037,12044,HC INTRM N/H/F/GEN 7.6-12.5CM,450,1 ,$453.00 ,$326.16 ,$126.84 ,"$1,394.78 ","$1,394.78 ",$294.45 ,$270.44 ,$546.75 ,$126.84 ,$299.89 ,$546.75 ,$299.89 ,$443.94 ,$269.99 ,$269.99 ,$443.94 ,$269.99 ,$453.00 ,$348.81 ,"$1,394.77 ",$546.75 ,$443.94 ,$339.75 ,$321.63 ,$321.63 ,$546.75 ,$321.63 ,$385.05 ,$385.05 ,$385.05 , N/A ,$453.00 ,$385.05 ,$443.94 ,$453.00 ,$254.13 ,$546.75 ,$187.54 , N/A , N/A ,$546.75 ,$385.05 ,"$1,171.61 ",$269.99 ,$126.84 ,$407.70 ,$546.75 ,$385.05 ,$342.00 ,$342.00 ,$546.75 ,$294.45 ST. JOSEPH'S HOSPITAL - BREESE,45000038,12045,HC INTRM N/H/F/GEN 12.6-20.0CM,450,1 ,$459.00 ,$330.48 ,$128.52 ,"$1,394.78 ","$1,394.78 ",$298.35 ,$274.02 ,$546.75 ,$128.52 ,$303.86 ,$546.75 ,$303.86 ,$449.82 ,$273.56 ,$273.56 ,$449.82 ,$273.56 ,$459.00 ,$353.43 ,"$1,394.77 ",$546.75 ,$449.82 ,$344.25 ,$325.89 ,$325.89 ,$546.75 ,$325.89 ,$390.15 ,$390.15 ,$390.15 , N/A ,$459.00 ,$390.15 ,$449.82 ,$459.00 ,$257.50 ,$546.75 ,$190.03 , N/A , N/A ,$546.75 ,$390.15 ,"$1,171.61 ",$273.56 ,$128.52 ,$413.10 ,$546.75 ,$390.15 ,$342.00 ,$342.00 ,$546.75 ,$298.35 ST. JOSEPH'S HOSPITAL - BREESE,45000039,12046,HC INTRM N/H/F/GEN 20.1-30CM,450,1 ,$466.00 ,$335.52 ,$130.48 ,"$1,394.78 ","$1,394.78 ",$302.90 ,$278.20 ,$546.75 ,$130.48 ,$308.49 ,$546.75 ,$308.49 ,$456.68 ,$277.74 ,$277.74 ,$456.68 ,$277.74 ,$466.00 ,$358.82 ,"$1,394.77 ",$546.75 ,$456.68 ,$349.50 ,$330.86 ,$330.86 ,$546.75 ,$330.86 ,$396.10 ,$396.10 ,$396.10 , N/A ,$466.00 ,$396.10 ,$456.68 ,$466.00 ,$261.43 ,$546.75 ,$192.92 , N/A , N/A ,$546.75 ,$396.10 ,"$1,171.61 ",$277.74 ,$130.48 ,$419.40 ,$546.75 ,$396.10 ,$342.00 ,$342.00 ,$546.75 ,$302.90 ST. JOSEPH'S HOSPITAL - BREESE,45000040,12047,HC INTRM N/H/F/GEN OVER 30CM,450,1 ,$473.00 ,$340.56 ,$132.44 ,"$4,143.53 ","$4,143.53 ",$307.45 ,$282.38 ,"$1,624.26 ",$132.44 ,$313.13 ,"$1,624.26 ",$313.13 ,$463.54 ,$281.91 ,$281.91 ,$463.54 ,$281.91 ,$473.00 ,$364.21 ,"$4,143.53 ","$1,624.26 ",$463.54 ,$354.75 ,$335.83 ,$335.83 ,"$1,624.26 ",$335.83 ,$402.05 ,$402.05 ,$402.05 , N/A ,$473.00 ,$402.05 ,$463.54 ,$473.00 ,$265.35 ,"$1,624.26 ",$195.82 , N/A , N/A ,"$1,624.26 ",$402.05 ,"$3,480.57 ",$281.91 ,$132.44 ,$425.70 ,"$1,624.26 ",$402.05 ,$342.00 ,$342.00 ,"$1,624.26 ",$307.45 ST. JOSEPH'S HOSPITAL - BREESE,45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$483.00 ,$347.76 ,$135.24 ,$895.69 ,$895.68 ,$313.95 ,$288.35 ,$351.10 ,$135.24 ,$319.75 ,$351.10 ,$319.75 ,$351.10 ,$287.87 ,$287.87 ,$351.10 ,$287.87 ,$483.00 ,$371.91 ,$895.69 ,$351.10 ,$358.13 ,$362.25 ,$342.93 ,$342.93 ,$351.10 ,$342.93 ,$410.55 ,$410.55 ,$410.55 , N/A ,$483.00 ,$410.55 ,$351.10 ,$483.00 ,$270.96 ,$351.10 ,$199.96 , N/A , N/A ,$351.10 ,$410.55 ,$752.38 ,$287.87 ,$135.24 ,$434.70 ,$351.10 ,$410.55 ,$342.00 ,$342.00 ,$351.10 ,$313.95 ST. JOSEPH'S HOSPITAL - BREESE,45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$486.00 ,$349.92 ,$136.08 ,$895.69 ,$895.68 ,$315.90 ,$290.14 ,$351.10 ,$136.08 ,$321.73 ,$351.10 ,$321.73 ,$351.10 ,$289.66 ,$289.66 ,$351.10 ,$289.66 ,$486.00 ,$374.22 ,$895.69 ,$351.10 ,$358.13 ,$364.50 ,$345.06 ,$345.06 ,$351.10 ,$345.06 ,$413.10 ,$413.10 ,$413.10 , N/A ,$486.00 ,$413.10 ,$351.10 ,$486.00 ,$272.65 ,$351.10 ,$201.20 , N/A , N/A ,$351.10 ,$413.10 ,$752.38 ,$289.66 ,$136.08 ,$437.40 ,$351.10 ,$413.10 ,$342.00 ,$342.00 ,$351.10 ,$315.90 ST. JOSEPH'S HOSPITAL - BREESE,45000043,12053,HC INTRM F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$511.00 ,$367.92 ,$143.08 ,$895.69 ,$895.68 ,$332.15 ,$305.07 ,$351.10 ,$143.08 ,$338.28 ,$351.10 ,$338.28 ,$351.10 ,$304.56 ,$304.56 ,$351.10 ,$304.56 ,$511.00 ,$393.47 ,$895.69 ,$351.10 ,$358.13 ,$383.25 ,$362.81 ,$362.81 ,$351.10 ,$362.81 ,$434.35 ,$434.35 ,$434.35 , N/A ,$511.00 ,$434.35 ,$351.10 ,$511.00 ,$286.67 ,$351.10 ,$211.55 , N/A , N/A ,$351.10 ,$434.35 ,$752.38 ,$304.56 ,$143.08 ,$459.90 ,$351.10 ,$434.35 ,$342.00 ,$342.00 ,$351.10 ,$332.15 ST. JOSEPH'S HOSPITAL - BREESE,45000044,12054,HC INTRM F/E/E/N/L/MM 7.6-12.5CM,450,1 ,$536.00 ,$385.92 ,$150.08 ,$895.69 ,$895.68 ,$348.40 ,$319.99 ,$351.10 ,$150.08 ,$354.83 ,$351.10 ,$354.83 ,$351.10 ,$319.46 ,$319.46 ,$351.10 ,$319.46 ,$536.00 ,$412.72 ,$895.69 ,$351.10 ,$358.13 ,$402.00 ,$380.56 ,$380.56 ,$351.10 ,$380.56 ,$455.60 ,$455.60 ,$455.60 , N/A ,$536.00 ,$455.60 ,$351.10 ,$536.00 ,$300.70 ,$351.10 ,$221.90 , N/A , N/A ,$351.10 ,$455.60 ,$752.38 ,$319.46 ,$150.08 ,$482.40 ,$351.10 ,$455.60 ,$342.00 ,$342.00 ,$351.10 ,$348.40 ST. JOSEPH'S HOSPITAL - BREESE,45000045,12055,HC INTRM F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$562.00 ,$404.64 ,$157.36 ,$895.69 ,$895.68 ,$365.30 ,$335.51 ,$351.10 ,$157.36 ,$372.04 ,$351.10 ,$372.04 ,$351.10 ,$334.95 ,$334.95 ,$351.10 ,$334.95 ,$562.00 ,$432.74 ,$895.69 ,$351.10 ,$358.13 ,$421.50 ,$399.02 ,$399.02 ,$351.10 ,$399.02 ,$477.70 ,$477.70 ,$477.70 , N/A ,$562.00 ,$477.70 ,$351.10 ,$562.00 ,$315.28 ,$351.10 ,$232.67 , N/A , N/A ,$351.10 ,$477.70 ,$752.38 ,$334.95 ,$157.36 ,$505.80 ,$351.10 ,$477.70 ,$342.00 ,$342.00 ,$351.10 ,$365.30 ST. JOSEPH'S HOSPITAL - BREESE,45000046,12056,HC INTRM F/E/E/N/L/MM 20.1-30.0CM,450,1 ,$590.00 ,$424.80 ,$165.20 ,$895.69 ,$895.68 ,$383.50 ,$352.23 ,$351.10 ,$165.20 ,$390.58 ,$351.10 ,$390.58 ,$351.10 ,$351.64 ,$351.64 ,$351.10 ,$351.64 ,$590.00 ,$454.30 ,$895.69 ,$351.10 ,$358.13 ,$442.50 ,$418.90 ,$418.90 ,$351.10 ,$418.90 ,$501.50 ,$501.50 ,$501.50 , N/A ,$590.00 ,$501.50 ,$351.10 ,$590.00 ,$330.99 ,$351.10 ,$244.26 , N/A , N/A ,$351.10 ,$501.50 ,$752.38 ,$351.64 ,$165.20 ,$531.00 ,$351.10 ,$501.50 ,$342.00 ,$342.00 ,$351.10 ,$383.50 ST. JOSEPH'S HOSPITAL - BREESE,45000047,12057,HC INTRM F/E/E/N/L/MM OVER 30.0CM,450,1 ,$619.00 ,$445.68 ,$173.32 ,$895.69 ,$895.68 ,$402.35 ,$369.54 ,$351.10 ,$173.32 ,$409.78 ,$351.10 ,$409.78 ,$351.10 ,$368.92 ,$368.92 ,$351.10 ,$368.92 ,$619.00 ,$476.63 ,$895.69 ,$351.10 ,$358.13 ,$464.25 ,$439.49 ,$439.49 ,$351.10 ,$439.49 ,$526.15 ,$526.15 ,$526.15 , N/A ,$619.00 ,$526.15 ,$351.10 ,$619.00 ,$347.26 ,$351.10 ,$256.27 , N/A , N/A ,$351.10 ,$526.15 ,$752.38 ,$368.92 ,$173.32 ,$557.10 ,$351.10 ,$526.15 ,$342.00 ,$342.00 ,$351.10 ,$402.35 ST. JOSEPH'S HOSPITAL - BREESE,45000048,13100,HC CMPLX TRUNK 1.1-2.5 CM,450,1 ,$536.00 ,$385.92 ,$150.08 ,"$1,394.78 ","$1,394.78 ",$348.40 ,$319.99 ,$546.75 ,$150.08 ,$354.83 ,$546.75 ,$354.83 ,$525.28 ,$319.46 ,$319.46 ,$525.28 ,$319.46 ,$536.00 ,$412.72 ,"$1,394.77 ",$546.75 ,$525.28 ,$402.00 ,$380.56 ,$380.56 ,$546.75 ,$380.56 ,$455.60 ,$455.60 ,$455.60 , N/A ,$536.00 ,$455.60 ,$525.28 ,$536.00 ,$300.70 ,$546.75 ,$221.90 , N/A , N/A ,$546.75 ,$455.60 ,"$1,171.61 ",$319.46 ,$150.08 ,$482.40 ,$546.75 ,$455.60 ,$342.00 ,$342.00 ,$546.75 ,$348.40 ST. JOSEPH'S HOSPITAL - BREESE,45000049,13101,HC CMPLX TRUNK 2.6-7.5 CM,450,1 ,$588.00 ,$423.36 ,$164.64 ,"$1,394.78 ","$1,394.78 ",$382.20 ,$351.04 ,$546.75 ,$164.64 ,$389.26 ,$546.75 ,$389.26 ,$546.75 ,$350.45 ,$350.45 ,$546.75 ,$350.45 ,$588.00 ,$452.76 ,"$1,394.77 ",$546.75 ,$557.69 ,$441.00 ,$417.48 ,$417.48 ,$546.75 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$588.00 ,$499.80 ,$546.75 ,$588.00 ,$329.87 ,$546.75 ,$243.43 , N/A , N/A ,$546.75 ,$499.80 ,"$1,171.61 ",$350.45 ,$164.64 ,$529.20 ,$546.75 ,$499.80 ,$342.00 ,$342.00 ,$546.75 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,45000050,13102,HC CMPLX TRUNK EA ADDL 5 CM OR LESS,450,1 ,$536.00 ,$385.92 ,$150.08 ,$536.00 , N/A ,$348.40 ,$319.99 , N/A ,$150.08 ,$354.83 , N/A ,$354.83 , N/A ,$319.46 ,$319.46 , N/A ,$319.46 , N/A ,$412.72 , N/A , N/A , N/A ,$402.00 ,$380.56 ,$380.56 , N/A ,$380.56 ,$455.60 ,$455.60 ,$455.60 , N/A , N/A ,$455.60 , N/A ,$536.00 ,$300.70 , N/A ,$221.90 , N/A , N/A , N/A ,$455.60 , N/A ,$319.46 ,$150.08 ,$482.40 , N/A ,$455.60 ,$342.00 ,$342.00 , N/A ,$348.40 ST. JOSEPH'S HOSPITAL - BREESE,45000051,13120,HC CMPLX S/A/L 1.1-2.5 CM,450,1 ,$443.00 ,$318.96 ,$124.04 ,"$1,394.78 ","$1,394.78 ",$287.95 ,$264.47 ,$546.75 ,$124.04 ,$293.27 ,$546.75 ,$293.27 ,$434.14 ,$264.03 ,$264.03 ,$434.14 ,$264.03 ,$443.00 ,$341.11 ,"$1,394.77 ",$546.75 ,$434.14 ,$332.25 ,$314.53 ,$314.53 ,$546.75 ,$314.53 ,$376.55 ,$376.55 ,$376.55 , N/A ,$443.00 ,$376.55 ,$434.14 ,$443.00 ,$248.52 ,$546.75 ,$183.40 , N/A , N/A ,$546.75 ,$376.55 ,"$1,171.61 ",$264.03 ,$124.04 ,$398.70 ,$546.75 ,$376.55 ,$342.00 ,$342.00 ,$546.75 ,$287.95 ST. JOSEPH'S HOSPITAL - BREESE,45000052,13121,HC CMPLX S/A/L 2.6-7.5 CM,450,1 ,$486.00 ,$349.92 ,$136.08 ,"$1,394.78 ","$1,394.78 ",$315.90 ,$290.14 ,$546.75 ,$136.08 ,$321.73 ,$546.75 ,$321.73 ,$476.28 ,$289.66 ,$289.66 ,$476.28 ,$289.66 ,$486.00 ,$374.22 ,"$1,394.77 ",$546.75 ,$476.28 ,$364.50 ,$345.06 ,$345.06 ,$546.75 ,$345.06 ,$413.10 ,$413.10 ,$413.10 , N/A ,$486.00 ,$413.10 ,$476.28 ,$486.00 ,$272.65 ,$546.75 ,$201.20 , N/A , N/A ,$546.75 ,$413.10 ,"$1,171.61 ",$289.66 ,$136.08 ,$437.40 ,$546.75 ,$413.10 ,$342.00 ,$342.00 ,$546.75 ,$315.90 ST. JOSEPH'S HOSPITAL - BREESE,45000053,13122,HC CMPLX S/A/L EA ADDL 5 CM OR LESS,450,1 ,$443.00 ,$318.96 ,$124.04 ,$443.00 , N/A ,$287.95 ,$264.47 , N/A ,$124.04 ,$293.27 , N/A ,$293.27 , N/A ,$264.03 ,$264.03 , N/A ,$264.03 , N/A ,$341.11 , N/A , N/A , N/A ,$332.25 ,$314.53 ,$314.53 , N/A ,$314.53 ,$376.55 ,$376.55 ,$376.55 , N/A , N/A ,$376.55 , N/A ,$443.00 ,$248.52 , N/A ,$183.40 , N/A , N/A , N/A ,$376.55 , N/A ,$264.03 ,$124.04 ,$398.70 , N/A ,$376.55 ,$342.00 ,$342.00 , N/A ,$287.95 ST. JOSEPH'S HOSPITAL - BREESE,45000054,13131,HC CMPLX F/C/C/M/N/A/G/H/F 1.1-2.5 CM,450,1 ,$585.00 ,$421.20 ,$163.80 ,$895.69 ,$895.68 ,$380.25 ,$349.25 ,$351.10 ,$163.80 ,$387.27 ,$351.10 ,$387.27 ,$351.10 ,$348.66 ,$348.66 ,$351.10 ,$348.66 ,$585.00 ,$450.45 ,$895.69 ,$351.10 ,$358.13 ,$438.75 ,$415.35 ,$415.35 ,$351.10 ,$415.35 ,$497.25 ,$497.25 ,$497.25 , N/A ,$585.00 ,$497.25 ,$351.10 ,$585.00 ,$328.19 ,$351.10 ,$242.19 , N/A , N/A ,$351.10 ,$497.25 ,$752.38 ,$348.66 ,$163.80 ,$526.50 ,$351.10 ,$497.25 ,$342.00 ,$342.00 ,$351.10 ,$380.25 ST. JOSEPH'S HOSPITAL - BREESE,45000055,13132,HC CMPLX F/C/C/M/N/A/G/H/F 2.6-7.5 CM,450,1 ,$644.00 ,$463.68 ,$180.32 ,"$1,394.78 ","$1,394.78 ",$418.60 ,$384.47 ,$546.75 ,$180.32 ,$426.33 ,$546.75 ,$426.33 ,$546.75 ,$383.82 ,$383.82 ,$546.75 ,$383.82 ,$644.00 ,$495.88 ,"$1,394.77 ",$546.75 ,$557.69 ,$483.00 ,$457.24 ,$457.24 ,$546.75 ,$457.24 ,$547.40 ,$547.40 ,$547.40 , N/A ,$644.00 ,$547.40 ,$546.75 ,$644.00 ,$361.28 ,$546.75 ,$266.62 , N/A , N/A ,$546.75 ,$547.40 ,"$1,171.61 ",$383.82 ,$180.32 ,$579.60 ,$546.75 ,$547.40 ,$342.00 ,$342.00 ,$546.75 ,$418.60 ST. JOSEPH'S HOSPITAL - BREESE,45000056,13133,HC CMPLX F/C/C/M/N/A/G/H/F EA ADDL 5 CM OR LESS,450,1 ,$536.00 ,$385.92 ,$150.08 ,$536.00 , N/A ,$348.40 ,$319.99 , N/A ,$150.08 ,$354.83 , N/A ,$354.83 , N/A ,$319.46 ,$319.46 , N/A ,$319.46 , N/A ,$412.72 , N/A , N/A , N/A ,$402.00 ,$380.56 ,$380.56 , N/A ,$380.56 ,$455.60 ,$455.60 ,$455.60 , N/A , N/A ,$455.60 , N/A ,$536.00 ,$300.70 , N/A ,$221.90 , N/A , N/A , N/A ,$455.60 , N/A ,$319.46 ,$150.08 ,$482.40 , N/A ,$455.60 ,$342.00 ,$342.00 , N/A ,$348.40 ST. JOSEPH'S HOSPITAL - BREESE,45000058,13151,HC CMPLX E/N/E/L 1.1-2.5 CM,450,1 ,$588.00 ,$423.36 ,$164.64 ,"$1,394.78 ","$1,394.78 ",$382.20 ,$351.04 ,$546.75 ,$164.64 ,$389.26 ,$546.75 ,$389.26 ,$546.75 ,$350.45 ,$350.45 ,$546.75 ,$350.45 ,$588.00 ,$452.76 ,"$1,394.77 ",$546.75 ,$557.69 ,$441.00 ,$417.48 ,$417.48 ,$546.75 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$588.00 ,$499.80 ,$546.75 ,$588.00 ,$329.87 ,$546.75 ,$243.43 , N/A , N/A ,$546.75 ,$499.80 ,"$1,171.61 ",$350.45 ,$164.64 ,$529.20 ,$546.75 ,$499.80 ,$342.00 ,$342.00 ,$546.75 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,$588.00 ,$423.36 ,$164.64 ,"$1,394.78 ","$1,394.78 ",$382.20 ,$351.04 ,$546.75 ,$164.64 ,$389.26 ,$546.75 ,$389.26 ,$546.75 ,$350.45 ,$350.45 ,$546.75 ,$350.45 ,$588.00 ,$452.76 ,"$1,394.77 ",$546.75 ,$557.69 ,$441.00 ,$417.48 ,$417.48 ,$546.75 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$588.00 ,$499.80 ,$546.75 ,$588.00 ,$329.87 ,$546.75 ,$243.43 , N/A , N/A ,$546.75 ,$499.80 ,"$1,171.61 ",$350.45 ,$164.64 ,$529.20 ,$546.75 ,$499.80 ,$342.00 ,$342.00 ,$546.75 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,45000060,13153,HC CMPLX E/N/E/L EA ADDL 5 CM OR LESS,450,1 ,$536.00 ,$385.92 ,$150.08 ,$536.00 , N/A ,$348.40 ,$319.99 , N/A ,$150.08 ,$354.83 , N/A ,$354.83 , N/A ,$319.46 ,$319.46 , N/A ,$319.46 , N/A ,$412.72 , N/A , N/A , N/A ,$402.00 ,$380.56 ,$380.56 , N/A ,$380.56 ,$455.60 ,$455.60 ,$455.60 , N/A , N/A ,$455.60 , N/A ,$536.00 ,$300.70 , N/A ,$221.90 , N/A , N/A , N/A ,$455.60 , N/A ,$319.46 ,$150.08 ,$482.40 , N/A ,$455.60 ,$342.00 ,$342.00 , N/A ,$348.40 ST. JOSEPH'S HOSPITAL - BREESE,45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$444.00 ,$319.68 ,$124.32 ,$444.00 ,$433.55 ,$288.60 ,$265.07 ,$169.95 ,$124.32 ,$293.93 ,$169.95 ,$293.93 ,$169.95 ,$264.62 ,$264.62 ,$169.95 ,$264.62 ,$350.30 ,$341.88 ,$433.55 ,$169.95 ,$173.35 ,$333.00 ,$315.24 ,$315.24 ,$169.95 ,$315.24 ,$377.40 ,$377.40 ,$377.40 , N/A ,$433.55 ,$377.40 ,$169.95 ,$444.00 ,$249.08 ,$169.95 ,$183.82 , N/A , N/A ,$169.95 ,$377.40 ,$364.18 ,$264.62 ,$124.32 ,$399.60 ,$169.95 ,$377.40 ,$342.00 ,$342.00 ,$169.95 ,$288.60 ST. JOSEPH'S HOSPITAL - BREESE,45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$444.00 ,$319.68 ,$124.32 ,$444.00 ,$433.55 ,$288.60 ,$265.07 ,$169.95 ,$124.32 ,$293.93 ,$169.95 ,$293.93 ,$169.95 ,$264.62 ,$264.62 ,$169.95 ,$264.62 ,$350.30 ,$341.88 ,$433.55 ,$169.95 ,$173.35 ,$333.00 ,$315.24 ,$315.24 ,$169.95 ,$315.24 ,$377.40 ,$377.40 ,$377.40 , N/A ,$433.55 ,$377.40 ,$169.95 ,$444.00 ,$249.08 ,$169.95 ,$183.82 , N/A , N/A ,$169.95 ,$377.40 ,$364.18 ,$264.62 ,$124.32 ,$399.60 ,$169.95 ,$377.40 ,$342.00 ,$342.00 ,$169.95 ,$288.60 ST. JOSEPH'S HOSPITAL - BREESE,45000063,16025,HC DRESS/DEB BURN 5-10% TOTAL MED,450,1 ,$467.00 ,$336.24 ,$130.76 ,$467.00 ,$433.55 ,$303.55 ,$278.80 ,$169.95 ,$130.76 ,$309.15 ,$169.95 ,$309.15 ,$169.95 ,$278.33 ,$278.33 ,$169.95 ,$278.33 ,$350.30 ,$359.59 ,$433.55 ,$169.95 ,$173.35 ,$350.25 ,$331.57 ,$331.57 ,$169.95 ,$331.57 ,$396.95 ,$396.95 ,$396.95 , N/A ,$433.55 ,$396.95 ,$169.95 ,$467.00 ,$261.99 ,$169.95 ,$193.34 , N/A , N/A ,$169.95 ,$396.95 ,$364.18 ,$278.33 ,$130.76 ,$420.30 ,$169.95 ,$396.95 ,$342.00 ,$342.00 ,$169.95 ,$303.55 ST. JOSEPH'S HOSPITAL - BREESE,45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,$491.00 ,$353.52 ,$137.48 ,$895.69 ,$895.68 ,$319.15 ,$293.13 ,$351.10 ,$137.48 ,$325.04 ,$351.10 ,$325.04 ,$351.10 ,$292.64 ,$292.64 ,$351.10 ,$292.64 ,$491.00 ,$378.07 ,$895.69 ,$351.10 ,$358.13 ,$368.25 ,$348.61 ,$348.61 ,$351.10 ,$348.61 ,$417.35 ,$417.35 ,$417.35 , N/A ,$491.00 ,$417.35 ,$351.10 ,$491.00 ,$275.45 ,$351.10 ,$203.27 , N/A , N/A ,$351.10 ,$417.35 ,$752.38 ,$292.64 ,$137.48 ,$441.90 ,$351.10 ,$417.35 ,$342.00 ,$342.00 ,$351.10 ,$319.15 ST. JOSEPH'S HOSPITAL - BREESE,45000067,17250,HC CAUT CHEM TISSUE GRANULATION,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$433.55 ,$374.40 ,$343.87 ,$169.95 ,$161.28 ,$381.31 ,$169.95 ,$381.31 ,$169.95 ,$343.30 ,$343.30 ,$169.95 ,$343.30 ,$350.30 ,$443.52 ,$433.55 ,$169.95 ,$173.35 ,$432.00 ,$408.96 ,$408.96 ,$169.95 ,$408.96 ,$489.60 ,$489.60 ,$489.60 , N/A ,$433.55 ,$489.60 ,$169.95 ,$576.00 ,$323.14 ,$169.95 ,$238.46 , N/A , N/A ,$169.95 ,$489.60 ,$364.18 ,$343.30 ,$161.28 ,$518.40 ,$169.95 ,$489.60 ,$342.00 ,$342.00 ,$169.95 ,$374.40 ST. JOSEPH'S HOSPITAL - BREESE,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,$391.00 ,$281.52 ,$109.48 ,$652.78 ,$652.78 ,$254.15 ,$233.43 ,$255.89 ,$109.48 ,$258.84 ,$255.89 ,$258.84 ,$255.89 ,$233.04 ,$233.04 ,$255.89 ,$233.04 ,$391.00 ,$301.07 ,$652.77 ,$255.89 ,$261.00 ,$293.25 ,$277.61 ,$277.61 ,$255.89 ,$277.61 ,$332.35 ,$332.35 ,$332.35 , N/A ,$391.00 ,$332.35 ,$255.89 ,$391.00 ,$219.35 ,$255.89 ,$161.87 , N/A , N/A ,$255.89 ,$332.35 ,$548.32 ,$233.04 ,$109.48 ,$351.90 ,$255.89 ,$332.35 ,$342.00 ,$342.00 ,$255.89 ,$254.15 ST. JOSEPH'S HOSPITAL - BREESE,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,$588.00 ,$423.36 ,$164.64 ,$979.15 ,$979.15 ,$382.20 ,$351.04 ,$383.83 ,$164.64 ,$389.26 ,$383.83 ,$389.26 ,$383.83 ,$350.45 ,$350.45 ,$383.83 ,$350.45 ,$588.00 ,$452.76 ,$979.15 ,$383.83 ,$391.50 ,$441.00 ,$417.48 ,$417.48 ,$383.83 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$588.00 ,$499.80 ,$383.83 ,$588.00 ,$329.87 ,$383.83 ,$243.43 , N/A , N/A ,$383.83 ,$499.80 ,$822.49 ,$350.45 ,$164.64 ,$529.20 ,$383.83 ,$499.80 ,$342.00 ,$342.00 ,$383.83 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$453.00 ,$326.16 ,$126.84 ,$652.78 ,$652.78 ,$294.45 ,$270.44 ,$255.89 ,$126.84 ,$299.89 ,$255.89 ,$299.89 ,$255.89 ,$269.99 ,$269.99 ,$255.89 ,$269.99 ,$453.00 ,$348.81 ,$652.77 ,$255.89 ,$261.00 ,$339.75 ,$321.63 ,$321.63 ,$255.89 ,$321.63 ,$385.05 ,$385.05 ,$385.05 , N/A ,$453.00 ,$385.05 ,$255.89 ,$453.00 ,$254.13 ,$255.89 ,$187.54 , N/A , N/A ,$255.89 ,$385.05 ,$548.32 ,$269.99 ,$126.84 ,$407.70 ,$255.89 ,$385.05 ,$342.00 ,$342.00 ,$255.89 ,$294.45 ST. JOSEPH'S HOSPITAL - BREESE,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$680.00 ,$489.60 ,$190.40 ,$979.15 ,$979.15 ,$442.00 ,$405.96 ,$383.83 ,$190.40 ,$450.16 ,$383.83 ,$450.16 ,$383.83 ,$405.28 ,$405.28 ,$383.83 ,$405.28 ,$680.00 ,$523.60 ,$979.15 ,$383.83 ,$391.50 ,$510.00 ,$482.80 ,$482.80 ,$383.83 ,$482.80 ,$578.00 ,$578.00 ,$578.00 , N/A ,$680.00 ,$578.00 ,$383.83 ,$680.00 ,$381.48 ,$383.83 ,$281.52 , N/A , N/A ,$383.83 ,$578.00 ,$822.49 ,$405.28 ,$190.40 ,$612.00 ,$383.83 ,$578.00 ,$342.00 ,$342.00 ,$383.83 ,$442.00 ST. JOSEPH'S HOSPITAL - BREESE,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$646.00 ,$465.12 ,$180.88 ,$652.78 ,$652.78 ,$419.90 ,$385.66 ,$255.89 ,$180.88 ,$427.65 ,$255.89 ,$427.65 ,$255.89 ,$385.02 ,$385.02 ,$255.89 ,$385.02 ,$527.44 ,$497.42 ,$652.77 ,$255.89 ,$261.00 ,$484.50 ,$458.66 ,$458.66 ,$255.89 ,$458.66 ,$549.10 ,$549.10 ,$549.10 , N/A ,$646.00 ,$549.10 ,$255.89 ,$646.00 ,$362.41 ,$255.89 ,$267.44 , N/A , N/A ,$255.89 ,$549.10 ,$548.32 ,$385.02 ,$180.88 ,$581.40 ,$255.89 ,$549.10 ,$342.00 ,$342.00 ,$255.89 ,$419.90 ST. JOSEPH'S HOSPITAL - BREESE,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$969.00 ,$697.68 ,$271.32 ,$979.15 ,$979.15 ,$629.85 ,$578.49 ,$383.83 ,$271.32 ,$641.48 ,$383.83 ,$641.48 ,$383.83 ,$577.52 ,$577.52 ,$383.83 ,$577.52 ,$791.15 ,$746.13 ,$979.15 ,$383.83 ,$391.50 ,$726.75 ,$687.99 ,$687.99 ,$383.83 ,$687.99 ,$823.65 ,$823.65 ,$823.65 , N/A ,$969.00 ,$823.65 ,$383.83 ,$969.00 ,$543.61 ,$383.83 ,$401.17 , N/A , N/A ,$383.83 ,$823.65 ,$822.49 ,$577.52 ,$271.32 ,$872.10 ,$383.83 ,$823.65 ,$342.00 ,$342.00 ,$383.83 ,$629.85 ST. JOSEPH'S HOSPITAL - BREESE,45000073,20950,HC MONT INTST FLD PRS COMP SYNDR,450,1 ,$239.00 ,$172.08 ,$66.92 ,"$1,558.08 ","$1,558.08 ",$155.35 ,$142.68 ,$610.77 ,$66.92 ,$158.22 ,$610.77 ,$158.22 ,$234.22 ,$142.44 ,$142.44 ,$234.22 ,$142.44 ,$239.00 ,$184.03 ,"$1,558.08 ",$610.77 ,$234.22 ,$179.25 ,$169.69 ,$169.69 ,$610.77 ,$169.69 ,$203.15 ,$203.15 ,$203.15 , N/A ,$239.00 ,$203.15 ,$234.22 ,$239.00 ,$134.08 ,$610.77 ,$98.95 , N/A , N/A ,$610.77 ,$203.15 ,"$1,308.79 ",$142.44 ,$66.92 ,$215.10 ,$610.77 ,$203.15 ,$239.00 ,$239.00 ,$610.77 ,$155.35 ST. JOSEPH'S HOSPITAL - BREESE,45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$380.00 ,$273.60 ,$106.40 ,$497.00 ,$497.00 ,$247.00 ,$226.86 ,$194.82 ,$106.40 ,$251.56 ,$194.82 ,$251.56 ,$194.82 ,$226.48 ,$226.48 ,$194.82 ,$226.48 ,$380.00 ,$292.60 ,$497.00 ,$194.82 ,$198.72 ,$285.00 ,$269.80 ,$269.80 ,$194.82 ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A ,$380.00 ,$323.00 ,$194.82 ,$380.00 ,$213.18 ,$194.82 ,$157.32 , N/A , N/A ,$194.82 ,$323.00 ,$417.48 ,$226.48 ,$106.40 ,$342.00 ,$194.82 ,$323.00 ,$342.00 ,$342.00 ,$194.82 ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,45000075,23655,HC TX DISL SHLDR W/MAN/ANES CLS,450,1 ,"$1,492.00 ","$1,074.24 ",$342.00 ,"$3,444.08 ","$3,444.08 ",$969.80 ,$890.72 ,"$1,350.08 ",$417.76 ,$987.70 ,"$1,350.08 ",$987.70 ,"$1,350.08 ",$889.23 ,$889.23 ,"$1,350.08 ",$889.23 ,"$1,492.00 ","$1,148.84 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$1,119.00 ","$1,059.32 ","$1,059.32 ","$1,350.08 ","$1,059.32 ","$1,268.20 ","$1,268.20 ","$1,268.20 ", N/A ,"$1,492.00 ","$1,268.20 ","$1,350.08 ","$1,492.00 ",$837.01 ,"$1,350.08 ",$617.69 , N/A , N/A ,"$1,350.08 ","$1,268.20 ","$2,893.02 ",$889.23 ,$417.76 ,"$1,342.80 ","$1,350.08 ","$1,268.20 ",$342.00 ,$342.00 ,"$1,350.08 ",$969.80 ST. JOSEPH'S HOSPITAL - BREESE,45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$565.00 ,$406.80 ,$158.20 ,$565.00 ,$497.00 ,$367.25 ,$337.31 ,$194.82 ,$158.20 ,$374.03 ,$194.82 ,$374.03 ,$194.82 ,$336.74 ,$336.74 ,$194.82 ,$336.74 ,$401.58 ,$435.05 ,$497.00 ,$194.82 ,$198.72 ,$423.75 ,$401.15 ,$401.15 ,$194.82 ,$401.15 ,$480.25 ,$480.25 ,$480.25 , N/A ,$497.00 ,$480.25 ,$194.82 ,$565.00 ,$316.97 ,$194.82 ,$233.91 , N/A , N/A ,$194.82 ,$480.25 ,$417.48 ,$336.74 ,$158.20 ,$508.50 ,$194.82 ,$480.25 ,$342.00 ,$342.00 ,$194.82 ,$367.25 ST. JOSEPH'S HOSPITAL - BREESE,45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$848.00 ,$610.56 ,$237.44 ,$848.00 ,$745.50 ,$551.20 ,$506.26 ,$292.24 ,$237.44 ,$561.38 ,$292.24 ,$561.38 ,$292.24 ,$505.41 ,$505.41 ,$292.24 ,$505.41 ,$602.36 ,$652.96 ,$745.50 ,$292.24 ,$298.08 ,$636.00 ,$602.08 ,$602.08 ,$292.24 ,$602.08 ,$720.80 ,$720.80 ,$720.80 , N/A ,$745.50 ,$720.80 ,$292.24 ,$848.00 ,$475.73 ,$292.24 ,$351.07 , N/A , N/A ,$292.24 ,$720.80 ,$626.22 ,$505.41 ,$237.44 ,$763.20 ,$292.24 ,$720.80 ,$342.00 ,$342.00 ,$292.24 ,$551.20 ST. JOSEPH'S HOSPITAL - BREESE,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$317.00 ,$228.24 ,$88.76 ,$497.00 ,$497.00 ,$206.05 ,$189.25 ,$194.82 ,$88.76 ,$209.85 ,$194.82 ,$209.85 ,$194.82 ,$188.93 ,$188.93 ,$194.82 ,$188.93 ,$317.00 ,$244.09 ,$497.00 ,$194.82 ,$198.72 ,$237.75 ,$225.07 ,$225.07 ,$194.82 ,$225.07 ,$269.45 ,$269.45 ,$269.45 , N/A ,$317.00 ,$269.45 ,$194.82 ,$317.00 ,$177.84 ,$194.82 ,$131.24 , N/A , N/A ,$194.82 ,$269.45 ,$417.48 ,$188.93 ,$88.76 ,$285.30 ,$194.82 ,$269.45 ,$317.00 ,$317.00 ,$194.82 ,$206.05 ST. JOSEPH'S HOSPITAL - BREESE,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$476.00 ,$342.72 ,$133.28 ,$745.50 ,$745.50 ,$309.40 ,$284.17 ,$292.24 ,$133.28 ,$315.11 ,$292.24 ,$315.11 ,$292.24 ,$283.70 ,$283.70 ,$292.24 ,$283.70 ,$476.00 ,$366.52 ,$745.50 ,$292.24 ,$298.08 ,$357.00 ,$337.96 ,$337.96 ,$292.24 ,$337.96 ,$404.60 ,$404.60 ,$404.60 , N/A ,$476.00 ,$404.60 ,$292.24 ,$476.00 ,$267.04 ,$292.24 ,$197.06 , N/A , N/A ,$292.24 ,$404.60 ,$626.22 ,$283.70 ,$133.28 ,$428.40 ,$292.24 ,$404.60 ,$342.00 ,$342.00 ,$292.24 ,$309.40 ST. JOSEPH'S HOSPITAL - BREESE,45000081,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP,450,1 ,"$4,506.00 ","$3,244.32 ",$342.00 ,"$4,506.00 ","$3,444.08 ","$2,928.90 ","$2,690.08 ","$1,350.08 ","$1,261.68 ","$2,982.97 ","$1,350.08 ","$2,982.97 ","$1,350.08 ","$2,685.58 ","$2,685.58 ","$1,350.08 ","$2,685.58 ","$2,782.81 ","$3,469.62 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,379.50 ","$3,199.26 ","$3,199.26 ","$1,350.08 ","$3,199.26 ","$3,830.10 ","$3,830.10 ","$3,830.10 ", N/A ,"$3,444.07 ","$3,830.10 ","$1,350.08 ","$4,506.00 ","$2,527.87 ","$1,350.08 ","$1,865.48 ", N/A , N/A ,"$1,350.08 ","$3,830.10 ","$2,893.02 ","$2,685.58 ","$1,261.68 ","$4,055.40 ","$1,350.08 ","$3,830.10 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,928.90 " ST. JOSEPH'S HOSPITAL - BREESE,45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,$636.00 ,$457.92 ,$178.08 ,"$3,444.08 ","$3,444.08 ",$413.40 ,$379.69 ,"$1,350.08 ",$178.08 ,$421.03 ,"$1,350.08 ",$421.03 ,$623.28 ,$379.06 ,$379.06 ,$623.28 ,$379.06 ,$636.00 ,$489.72 ,"$3,444.07 ","$1,350.08 ",$623.28 ,$477.00 ,$451.56 ,$451.56 ,"$1,350.08 ",$451.56 ,$540.60 ,$540.60 ,$540.60 , N/A ,$636.00 ,$540.60 ,$623.28 ,$636.00 ,$356.80 ,"$1,350.08 ",$263.30 , N/A , N/A ,"$1,350.08 ",$540.60 ,"$2,893.02 ",$379.06 ,$178.08 ,$572.40 ,"$1,350.08 ",$540.60 ,$342.00 ,$342.00 ,"$1,350.08 ",$413.40 ST. JOSEPH'S HOSPITAL - BREESE,45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,$953.00 ,$686.16 ,$266.84 ,"$3,444.08 ","$3,444.08 ",$619.45 ,$568.94 ,"$1,350.08 ",$266.84 ,$630.89 ,"$1,350.08 ",$630.89 ,$933.94 ,$567.99 ,$567.99 ,$933.94 ,$567.99 ,$953.00 ,$733.81 ,"$3,444.07 ","$1,350.08 ",$933.94 ,$714.75 ,$676.63 ,$676.63 ,"$1,350.08 ",$676.63 ,$810.05 ,$810.05 ,$810.05 , N/A ,$953.00 ,$810.05 ,$933.94 ,$953.00 ,$534.63 ,"$1,350.08 ",$394.54 , N/A , N/A ,"$1,350.08 ",$810.05 ,"$2,893.02 ",$567.99 ,$266.84 ,$857.70 ,"$1,350.08 ",$810.05 ,$342.00 ,$342.00 ,"$1,350.08 ",$619.45 ST. JOSEPH'S HOSPITAL - BREESE,45000083,26010,HC DRAIN ABSC FINGER SIMPLE,450,1 ,$531.12 ,$382.41 ,$148.71 ,$531.12 ,$433.55 ,$345.23 ,$317.08 ,$169.95 ,$148.71 ,$351.60 ,$169.95 ,$351.60 ,$169.95 ,$316.55 ,$316.55 ,$169.95 ,$316.55 ,$350.30 ,$408.96 ,$433.55 ,$169.95 ,$173.35 ,$398.34 ,$377.10 ,$377.10 ,$169.95 ,$377.10 ,$451.45 ,$451.45 ,$451.45 , N/A ,$433.55 ,$451.45 ,$169.95 ,$531.12 ,$297.96 ,$169.95 ,$219.88 , N/A , N/A ,$169.95 ,$451.45 ,$364.18 ,$316.55 ,$148.71 ,$478.01 ,$169.95 ,$451.45 ,$342.00 ,$342.00 ,$169.95 ,$345.23 ST. JOSEPH'S HOSPITAL - BREESE,45000084,26011,HC DRAIN ABSC FINGER COMPLCD,450,1 ,"$4,607.00 ","$3,317.04 ",$342.00 ,"$4,607.00 ","$3,600.20 ","$2,994.55 ","$2,750.38 ","$1,411.28 ","$1,289.96 ","$3,049.83 ","$1,411.28 ","$3,049.83 ","$1,411.28 ","$2,745.77 ","$2,745.77 ","$1,411.28 ","$2,745.77 ","$2,908.96 ","$3,547.39 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,455.25 ","$3,270.97 ","$3,270.97 ","$1,411.28 ","$3,270.97 ","$3,915.95 ","$3,915.95 ","$3,915.95 ", N/A ,"$3,600.19 ","$3,915.95 ","$1,411.28 ","$4,607.00 ","$2,584.53 ","$1,411.28 ","$1,907.30 ", N/A , N/A ,"$1,411.28 ","$3,915.95 ","$3,024.16 ","$2,745.77 ","$1,289.96 ","$4,146.30 ","$1,411.28 ","$3,915.95 ",$342.00 ,$342.00 ,"$1,411.28 ","$2,994.55 " ST. JOSEPH'S HOSPITAL - BREESE,45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,$975.00 ,$702.00 ,$194.82 ,$975.00 ,$497.00 ,$633.75 ,$582.08 ,$194.82 ,$273.00 ,$645.45 ,$194.82 ,$645.45 ,$194.82 ,$581.10 ,$581.10 ,$194.82 ,$581.10 ,$401.58 ,$750.75 ,$497.00 ,$194.82 ,$198.72 ,$731.25 ,$692.25 ,$692.25 ,$194.82 ,$692.25 ,$828.75 ,$828.75 ,$828.75 , N/A ,$497.00 ,$828.75 ,$194.82 ,$975.00 ,$546.98 ,$194.82 ,$403.65 , N/A , N/A ,$194.82 ,$828.75 ,$417.48 ,$581.10 ,$273.00 ,$877.50 ,$194.82 ,$828.75 ,$342.00 ,$342.00 ,$194.82 ,$633.75 ST. JOSEPH'S HOSPITAL - BREESE,45000088,26742,HC TX FX (M-P)(I-P) JT W/MAN,450,1 ,"$4,506.00 ","$3,244.32 ",$342.00 ,"$4,506.00 ","$3,444.08 ","$2,928.90 ","$2,690.08 ","$1,350.08 ","$1,261.68 ","$2,982.97 ","$1,350.08 ","$2,982.97 ","$1,350.08 ","$2,685.58 ","$2,685.58 ","$1,350.08 ","$2,685.58 ","$2,782.81 ","$3,469.62 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,379.50 ","$3,199.26 ","$3,199.26 ","$1,350.08 ","$3,199.26 ","$3,830.10 ","$3,830.10 ","$3,830.10 ", N/A ,"$3,444.07 ","$3,830.10 ","$1,350.08 ","$4,506.00 ","$2,527.87 ","$1,350.08 ","$1,865.48 ", N/A , N/A ,"$1,350.08 ","$3,830.10 ","$2,893.02 ","$2,685.58 ","$1,261.68 ","$4,055.40 ","$1,350.08 ","$3,830.10 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,928.90 " ST. JOSEPH'S HOSPITAL - BREESE,45000089,26755,HC TX FX PHALANX DIST W/MAN CLS,450,1 ,$975.00 ,$702.00 ,$194.82 ,$975.00 ,$497.00 ,$633.75 ,$582.08 ,$194.82 ,$273.00 ,$645.45 ,$194.82 ,$645.45 ,$194.82 ,$581.10 ,$581.10 ,$194.82 ,$581.10 ,$401.58 ,$750.75 ,$497.00 ,$194.82 ,$198.72 ,$731.25 ,$692.25 ,$692.25 ,$194.82 ,$692.25 ,$828.75 ,$828.75 ,$828.75 , N/A ,$497.00 ,$828.75 ,$194.82 ,$975.00 ,$546.98 ,$194.82 ,$403.65 , N/A , N/A ,$194.82 ,$828.75 ,$417.48 ,$581.10 ,$273.00 ,$877.50 ,$194.82 ,$828.75 ,$342.00 ,$342.00 ,$194.82 ,$633.75 ST. JOSEPH'S HOSPITAL - BREESE,45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$746.00 ,$537.12 ,$194.82 ,$746.00 ,$497.00 ,$484.90 ,$445.36 ,$194.82 ,$208.88 ,$493.85 ,$194.82 ,$493.85 ,$194.82 ,$444.62 ,$444.62 ,$194.82 ,$444.62 ,$401.58 ,$574.42 ,$497.00 ,$194.82 ,$198.72 ,$559.50 ,$529.66 ,$529.66 ,$194.82 ,$529.66 ,$634.10 ,$634.10 ,$634.10 , N/A ,$497.00 ,$634.10 ,$194.82 ,$746.00 ,$418.51 ,$194.82 ,$308.84 , N/A , N/A ,$194.82 ,$634.10 ,$417.48 ,$444.62 ,$208.88 ,$671.40 ,$194.82 ,$634.10 ,$342.00 ,$342.00 ,$194.82 ,$484.90 ST. JOSEPH'S HOSPITAL - BREESE,45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,"$9,025.00 ","$6,498.00 ",$342.00 ,"$9,025.00 ","$7,146.53 ","$5,866.25 ","$5,387.93 ","$2,801.44 ","$2,527.00 ","$5,974.55 ","$2,801.44 ","$5,974.55 ","$2,801.44 ","$5,378.90 ","$5,378.90 ","$2,801.44 ","$5,378.90 ","$5,774.38 ","$6,949.25 ","$7,146.51 ","$2,801.44 ","$2,857.46 ","$6,768.75 ","$6,407.75 ","$6,407.75 ","$2,801.44 ","$6,407.75 ","$7,671.25 ","$7,671.25 ","$7,671.25 ", N/A ,"$7,146.51 ","$7,671.25 ","$2,801.44 ","$9,025.00 ","$5,063.03 ","$2,801.44 ","$3,736.35 ", N/A , N/A ,"$2,801.44 ","$7,671.25 ","$6,003.07 ","$5,378.90 ","$2,527.00 ","$8,122.50 ","$2,801.44 ","$7,671.25 ",$342.00 ,$342.00 ,"$2,801.44 ","$5,866.25 " ST. JOSEPH'S HOSPITAL - BREESE,45000092,27250,HC TX DISCL HIP CLOSED W/O ANES,450,1 ,$708.00 ,$509.76 ,$194.82 ,$708.00 ,$497.00 ,$460.20 ,$422.68 ,$194.82 ,$198.24 ,$468.70 ,$194.82 ,$468.70 ,$194.82 ,$421.97 ,$421.97 ,$194.82 ,$421.97 ,$401.58 ,$545.16 ,$497.00 ,$194.82 ,$198.72 ,$531.00 ,$502.68 ,$502.68 ,$194.82 ,$502.68 ,$601.80 ,$601.80 ,$601.80 , N/A ,$497.00 ,$601.80 ,$194.82 ,$708.00 ,$397.19 ,$194.82 ,$293.11 , N/A , N/A ,$194.82 ,$601.80 ,$417.48 ,$421.97 ,$198.24 ,$637.20 ,$194.82 ,$601.80 ,$342.00 ,$342.00 ,$194.82 ,$460.20 ST. JOSEPH'S HOSPITAL - BREESE,45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,"$1,082.00 ",$779.04 ,$194.82 ,"$1,082.00 ",$497.00 ,$703.30 ,$645.95 ,$194.82 ,$302.96 ,$716.28 ,$194.82 ,$716.28 ,$194.82 ,$644.87 ,$644.87 ,$194.82 ,$644.87 ,$401.58 ,$833.14 ,$497.00 ,$194.82 ,$198.72 ,$811.50 ,$768.22 ,$768.22 ,$194.82 ,$768.22 ,$919.70 ,$919.70 ,$919.70 , N/A ,$497.00 ,$919.70 ,$194.82 ,"$1,082.00 ",$607.00 ,$194.82 ,$447.95 , N/A , N/A ,$194.82 ,$919.70 ,$417.48 ,$644.87 ,$302.96 ,$973.80 ,$194.82 ,$919.70 ,$342.00 ,$342.00 ,$194.82 ,$703.30 ST. JOSEPH'S HOSPITAL - BREESE,45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$409.00 ,$294.48 ,$114.52 ,$497.00 ,$497.00 ,$265.85 ,$244.17 ,$194.82 ,$114.52 ,$270.76 ,$194.82 ,$270.76 ,$194.82 ,$243.76 ,$243.76 ,$194.82 ,$243.76 ,$401.58 ,$314.93 ,$497.00 ,$194.82 ,$198.72 ,$306.75 ,$290.39 ,$290.39 ,$194.82 ,$290.39 ,$347.65 ,$347.65 ,$347.65 , N/A ,$409.00 ,$347.65 ,$194.82 ,$409.00 ,$229.45 ,$194.82 ,$169.33 , N/A , N/A ,$194.82 ,$347.65 ,$417.48 ,$243.76 ,$114.52 ,$368.10 ,$194.82 ,$347.65 ,$342.00 ,$342.00 ,$194.82 ,$265.85 ST. JOSEPH'S HOSPITAL - BREESE,45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$616.00 ,$443.52 ,$172.48 ,$745.50 ,$745.50 ,$400.40 ,$367.75 ,$292.24 ,$172.48 ,$407.79 ,$292.24 ,$407.79 ,$292.24 ,$367.14 ,$367.14 ,$292.24 ,$367.14 ,$602.36 ,$474.32 ,$745.50 ,$292.24 ,$298.08 ,$462.00 ,$437.36 ,$437.36 ,$292.24 ,$437.36 ,$523.60 ,$523.60 ,$523.60 , N/A ,$616.00 ,$523.60 ,$292.24 ,$616.00 ,$345.58 ,$292.24 ,$255.02 , N/A , N/A ,$292.24 ,$523.60 ,$626.22 ,$367.14 ,$172.48 ,$554.40 ,$292.24 ,$523.60 ,$342.00 ,$342.00 ,$292.24 ,$400.40 ST. JOSEPH'S HOSPITAL - BREESE,45000098,29065,HC APPL CAST ARM LONG,450,1 ,$854.00 ,$614.88 ,$225.79 ,$854.00 ,$576.00 ,$555.10 ,$509.84 ,$225.79 ,$239.12 ,$565.35 ,$225.79 ,$565.35 ,$225.79 ,$508.98 ,$508.98 ,$225.79 ,$508.98 ,$465.40 ,$657.58 ,$575.99 ,$225.79 ,$230.30 ,$640.50 ,$606.34 ,$606.34 ,$225.79 ,$606.34 ,$725.90 ,$725.90 ,$725.90 , N/A ,$575.99 ,$725.90 ,$225.79 ,$854.00 ,$479.09 ,$225.79 ,$353.56 , N/A , N/A ,$225.79 ,$725.90 ,$483.83 ,$508.98 ,$239.12 ,$768.60 ,$225.79 ,$725.90 ,$342.00 ,$342.00 ,$225.79 ,$555.10 ST. JOSEPH'S HOSPITAL - BREESE,45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$854.00 ,$614.88 ,$225.79 ,$854.00 ,$576.00 ,$555.10 ,$509.84 ,$225.79 ,$239.12 ,$565.35 ,$225.79 ,$565.35 ,$225.79 ,$508.98 ,$508.98 ,$225.79 ,$508.98 ,$465.40 ,$657.58 ,$575.99 ,$225.79 ,$230.30 ,$640.50 ,$606.34 ,$606.34 ,$225.79 ,$606.34 ,$725.90 ,$725.90 ,$725.90 , N/A ,$575.99 ,$725.90 ,$225.79 ,$854.00 ,$479.09 ,$225.79 ,$353.56 , N/A , N/A ,$225.79 ,$725.90 ,$483.83 ,$508.98 ,$239.12 ,$768.60 ,$225.79 ,$725.90 ,$342.00 ,$342.00 ,$225.79 ,$555.10 ST. JOSEPH'S HOSPITAL - BREESE,45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$491.00 ,$353.52 ,$137.18 ,$491.00 ,$349.95 ,$319.15 ,$293.13 ,$137.18 ,$137.48 ,$325.04 ,$137.18 ,$325.04 ,$137.18 ,$292.64 ,$292.64 ,$137.18 ,$292.64 ,$282.76 ,$378.07 ,$349.95 ,$137.18 ,$139.92 ,$368.25 ,$348.61 ,$348.61 ,$137.18 ,$348.61 ,$417.35 ,$417.35 ,$417.35 , N/A ,$349.95 ,$417.35 ,$137.18 ,$491.00 ,$275.45 ,$137.18 ,$203.27 , N/A , N/A ,$137.18 ,$417.35 ,$293.96 ,$292.64 ,$137.48 ,$441.90 ,$137.18 ,$417.35 ,$342.00 ,$342.00 ,$137.18 ,$319.15 ST. JOSEPH'S HOSPITAL - BREESE,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$376.00 ,$270.72 ,$105.28 ,$376.00 ,$278.78 ,$244.40 ,$224.47 ,$109.28 ,$105.28 ,$248.91 ,$109.28 ,$248.91 ,$109.28 ,$224.10 ,$224.10 ,$109.28 ,$224.10 ,$225.24 ,$289.52 ,$278.76 ,$109.28 ,$111.47 ,$282.00 ,$266.96 ,$266.96 ,$109.28 ,$266.96 ,$319.60 ,$319.60 ,$319.60 , N/A ,$278.76 ,$319.60 ,$109.28 ,$376.00 ,$210.94 ,$109.28 ,$155.66 , N/A , N/A ,$109.28 ,$319.60 ,$234.16 ,$224.10 ,$105.28 ,$338.40 ,$109.28 ,$319.60 ,$342.00 ,$342.00 ,$109.28 ,$244.40 ST. JOSEPH'S HOSPITAL - BREESE,45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$217.00 ,$156.24 ,$60.76 ,$278.78 ,$278.78 ,$141.05 ,$129.55 ,$109.28 ,$60.76 ,$143.65 ,$109.28 ,$143.65 ,$109.28 ,$129.33 ,$129.33 ,$109.28 ,$129.33 ,$217.00 ,$167.09 ,$278.76 ,$109.28 ,$111.47 ,$162.75 ,$154.07 ,$154.07 ,$109.28 ,$154.07 ,$184.45 ,$184.45 ,$184.45 , N/A ,$217.00 ,$184.45 ,$109.28 ,$217.00 ,$121.74 ,$109.28 ,$89.84 , N/A , N/A ,$109.28 ,$184.45 ,$234.16 ,$129.33 ,$60.76 ,$195.30 ,$109.28 ,$184.45 ,$217.00 ,$217.00 ,$109.28 ,$141.05 ST. JOSEPH'S HOSPITAL - BREESE,45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$230.00 ,$165.60 ,$64.40 ,$278.78 ,$278.78 ,$149.50 ,$137.31 ,$109.28 ,$64.40 ,$152.26 ,$109.28 ,$152.26 ,$109.28 ,$137.08 ,$137.08 ,$109.28 ,$137.08 ,$225.24 ,$177.10 ,$278.76 ,$109.28 ,$111.47 ,$172.50 ,$163.30 ,$163.30 ,$109.28 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$230.00 ,$195.50 ,$109.28 ,$230.00 ,$129.03 ,$109.28 ,$95.22 , N/A , N/A ,$109.28 ,$195.50 ,$234.16 ,$137.08 ,$64.40 ,$207.00 ,$109.28 ,$195.50 ,$230.00 ,$230.00 ,$109.28 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,45000105,29240,HC STRAPPING SHLDR,450,1 ,$230.00 ,$165.60 ,$64.40 ,$278.78 ,$278.78 ,$149.50 ,$137.31 ,$109.28 ,$64.40 ,$152.26 ,$109.28 ,$152.26 ,$109.28 ,$137.08 ,$137.08 ,$109.28 ,$137.08 ,$225.24 ,$177.10 ,$278.76 ,$109.28 ,$111.47 ,$172.50 ,$163.30 ,$163.30 ,$109.28 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$230.00 ,$195.50 ,$109.28 ,$230.00 ,$129.03 ,$109.28 ,$95.22 , N/A , N/A ,$109.28 ,$195.50 ,$234.16 ,$137.08 ,$64.40 ,$207.00 ,$109.28 ,$195.50 ,$230.00 ,$230.00 ,$109.28 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$854.00 ,$614.88 ,$225.79 ,$854.00 ,$576.00 ,$555.10 ,$509.84 ,$225.79 ,$239.12 ,$565.35 ,$225.79 ,$565.35 ,$225.79 ,$508.98 ,$508.98 ,$225.79 ,$508.98 ,$465.40 ,$657.58 ,$575.99 ,$225.79 ,$230.30 ,$640.50 ,$606.34 ,$606.34 ,$225.79 ,$606.34 ,$725.90 ,$725.90 ,$725.90 , N/A ,$575.99 ,$725.90 ,$225.79 ,$854.00 ,$479.09 ,$225.79 ,$353.56 , N/A , N/A ,$225.79 ,$725.90 ,$483.83 ,$508.98 ,$239.12 ,$768.60 ,$225.79 ,$725.90 ,$342.00 ,$342.00 ,$225.79 ,$555.10 ST. JOSEPH'S HOSPITAL - BREESE,45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$491.00 ,$353.52 ,$137.18 ,$491.00 ,$349.95 ,$319.15 ,$293.13 ,$137.18 ,$137.48 ,$325.04 ,$137.18 ,$325.04 ,$137.18 ,$292.64 ,$292.64 ,$137.18 ,$292.64 ,$282.76 ,$378.07 ,$349.95 ,$137.18 ,$139.92 ,$368.25 ,$348.61 ,$348.61 ,$137.18 ,$348.61 ,$417.35 ,$417.35 ,$417.35 , N/A ,$349.95 ,$417.35 ,$137.18 ,$491.00 ,$275.45 ,$137.18 ,$203.27 , N/A , N/A ,$137.18 ,$417.35 ,$293.96 ,$292.64 ,$137.48 ,$441.90 ,$137.18 ,$417.35 ,$342.00 ,$342.00 ,$137.18 ,$319.15 ST. JOSEPH'S HOSPITAL - BREESE,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$491.00 ,$353.52 ,$137.18 ,$491.00 ,$349.95 ,$319.15 ,$293.13 ,$137.18 ,$137.48 ,$325.04 ,$137.18 ,$325.04 ,$137.18 ,$292.64 ,$292.64 ,$137.18 ,$292.64 ,$282.76 ,$378.07 ,$349.95 ,$137.18 ,$139.92 ,$368.25 ,$348.61 ,$348.61 ,$137.18 ,$348.61 ,$417.35 ,$417.35 ,$417.35 , N/A ,$349.95 ,$417.35 ,$137.18 ,$491.00 ,$275.45 ,$137.18 ,$203.27 , N/A , N/A ,$137.18 ,$417.35 ,$293.96 ,$292.64 ,$137.48 ,$441.90 ,$137.18 ,$417.35 ,$342.00 ,$342.00 ,$137.18 ,$319.15 ST. JOSEPH'S HOSPITAL - BREESE,45000110,30300,HC REM FB INTRANASAL,450,1 ,$376.00 ,$270.72 ,$105.28 ,$376.00 ,$278.78 ,$244.40 ,$224.47 ,$109.28 ,$105.28 ,$248.91 ,$109.28 ,$248.91 ,$109.28 ,$224.10 ,$224.10 ,$109.28 ,$224.10 ,$225.24 ,$289.52 ,$278.76 ,$109.28 ,$111.47 ,$282.00 ,$266.96 ,$266.96 ,$109.28 ,$266.96 ,$319.60 ,$319.60 ,$319.60 , N/A ,$278.76 ,$319.60 ,$109.28 ,$376.00 ,$210.94 ,$109.28 ,$155.66 , N/A , N/A ,$109.28 ,$319.60 ,$234.16 ,$224.10 ,$105.28 ,$338.40 ,$109.28 ,$319.60 ,$342.00 ,$342.00 ,$109.28 ,$244.40 ST. JOSEPH'S HOSPITAL - BREESE,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$376.00 ,$270.72 ,$105.28 ,$376.00 ,$278.78 ,$244.40 ,$224.47 ,$109.28 ,$105.28 ,$248.91 ,$109.28 ,$248.91 ,$109.28 ,$224.10 ,$224.10 ,$109.28 ,$224.10 ,$225.24 ,$289.52 ,$278.76 ,$109.28 ,$111.47 ,$282.00 ,$266.96 ,$266.96 ,$109.28 ,$266.96 ,$319.60 ,$319.60 ,$319.60 , N/A ,$278.76 ,$319.60 ,$109.28 ,$376.00 ,$210.94 ,$109.28 ,$155.66 , N/A , N/A ,$109.28 ,$319.60 ,$234.16 ,$224.10 ,$105.28 ,$338.40 ,$109.28 ,$319.60 ,$342.00 ,$342.00 ,$109.28 ,$244.40 ST. JOSEPH'S HOSPITAL - BREESE,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$564.00 ,$406.08 ,$109.28 ,$564.00 ,$278.78 ,$366.60 ,$336.71 ,$109.28 ,$157.92 ,$373.37 ,$109.28 ,$373.37 ,$109.28 ,$336.14 ,$336.14 ,$109.28 ,$336.14 ,$225.24 ,$434.28 ,$278.76 ,$109.28 ,$111.47 ,$423.00 ,$400.44 ,$400.44 ,$109.28 ,$400.44 ,$479.40 ,$479.40 ,$479.40 , N/A ,$278.76 ,$479.40 ,$109.28 ,$564.00 ,$316.40 ,$109.28 ,$233.50 , N/A , N/A ,$109.28 ,$479.40 ,$234.16 ,$336.14 ,$157.92 ,$507.60 ,$109.28 ,$479.40 ,$342.00 ,$342.00 ,$109.28 ,$366.60 ST. JOSEPH'S HOSPITAL - BREESE,45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$473.00 ,$340.56 ,$109.28 ,$473.00 ,$278.78 ,$307.45 ,$282.38 ,$109.28 ,$132.44 ,$313.13 ,$109.28 ,$313.13 ,$109.28 ,$281.91 ,$281.91 ,$109.28 ,$281.91 ,$225.24 ,$364.21 ,$278.76 ,$109.28 ,$111.47 ,$354.75 ,$335.83 ,$335.83 ,$109.28 ,$335.83 ,$402.05 ,$402.05 ,$402.05 , N/A ,$278.76 ,$402.05 ,$109.28 ,$473.00 ,$265.35 ,$109.28 ,$195.82 , N/A , N/A ,$109.28 ,$402.05 ,$234.16 ,$281.91 ,$132.44 ,$425.70 ,$109.28 ,$402.05 ,$342.00 ,$342.00 ,$109.28 ,$307.45 ST. JOSEPH'S HOSPITAL - BREESE,45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$531.00 ,$382.32 ,$109.28 ,$531.00 ,$278.78 ,$345.15 ,$317.01 ,$109.28 ,$148.68 ,$351.52 ,$109.28 ,$351.52 ,$109.28 ,$316.48 ,$316.48 ,$109.28 ,$316.48 ,$225.24 ,$408.87 ,$278.76 ,$109.28 ,$111.47 ,$398.25 ,$377.01 ,$377.01 ,$109.28 ,$377.01 ,$451.35 ,$451.35 ,$451.35 , N/A ,$278.76 ,$451.35 ,$109.28 ,$531.00 ,$297.89 ,$109.28 ,$219.83 , N/A , N/A ,$109.28 ,$451.35 ,$234.16 ,$316.48 ,$148.68 ,$477.90 ,$109.28 ,$451.35 ,$342.00 ,$342.00 ,$109.28 ,$345.15 ST. JOSEPH'S HOSPITAL - BREESE,45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$932.00 ,$671.04 ,$260.96 ,$932.00 ,$906.50 ,$605.80 ,$556.40 ,$355.35 ,$260.96 ,$616.98 ,$355.35 ,$616.98 ,$355.35 ,$555.47 ,$555.47 ,$355.35 ,$555.47 ,$732.44 ,$717.64 ,$906.49 ,$355.35 ,$362.45 ,$699.00 ,$661.72 ,$661.72 ,$355.35 ,$661.72 ,$792.20 ,$792.20 ,$792.20 , N/A ,$906.49 ,$792.20 ,$355.35 ,$932.00 ,$522.85 ,$355.35 ,$385.85 , N/A , N/A ,$355.35 ,$792.20 ,$761.45 ,$555.47 ,$260.96 ,$838.80 ,$355.35 ,$792.20 ,$342.00 ,$342.00 ,$355.35 ,$605.80 ST. JOSEPH'S HOSPITAL - BREESE,45000136,40800,HC DRAINAGE MOUTH LESION,450,1 ,"$2,011.00 ","$1,447.92 ",$342.00 ,"$2,011.00 ","$1,558.08 ","$1,307.15 ","$1,200.57 ",$610.77 ,$563.08 ,"$1,331.28 ",$610.77 ,"$1,331.28 ",$610.77 ,"$1,198.56 ","$1,198.56 ",$610.77 ,"$1,198.56 ","$1,258.93 ","$1,548.47 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,508.25 ","$1,427.81 ","$1,427.81 ",$610.77 ,"$1,427.81 ","$1,709.35 ","$1,709.35 ","$1,709.35 ", N/A ,"$1,558.08 ","$1,709.35 ",$610.77 ,"$2,011.00 ","$1,128.17 ",$610.77 ,$832.55 , N/A , N/A ,$610.77 ,"$1,709.35 ","$1,308.79 ","$1,198.56 ",$563.08 ,"$1,809.90 ",$610.77 ,"$1,709.35 ",$342.00 ,$342.00 ,$610.77 ,"$1,307.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000137,40830,HC LAC REPAIR VESTIBULE MOUTH 2.5 CM OR LESS,450,1 ,$672.00 ,$483.84 ,$188.16 ,$672.00 ,$498.98 ,$436.80 ,$401.18 ,$195.60 ,$188.16 ,$444.86 ,$195.60 ,$444.86 ,$195.60 ,$400.51 ,$400.51 ,$195.60 ,$400.51 ,$403.17 ,$517.44 ,$498.97 ,$195.60 ,$199.51 ,$504.00 ,$477.12 ,$477.12 ,$195.60 ,$477.12 ,$571.20 ,$571.20 ,$571.20 , N/A ,$498.97 ,$571.20 ,$195.60 ,$672.00 ,$376.99 ,$195.60 ,$278.21 , N/A , N/A ,$195.60 ,$571.20 ,$419.13 ,$400.51 ,$188.16 ,$604.80 ,$195.60 ,$571.20 ,$342.00 ,$342.00 ,$195.60 ,$436.80 ST. JOSEPH'S HOSPITAL - BREESE,45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$325.00 ,$234.00 ,$91.00 ,$906.50 ,$906.50 ,$211.25 ,$194.03 ,$355.35 ,$91.00 ,$215.15 ,$355.35 ,$215.15 ,$318.50 ,$193.70 ,$193.70 ,$318.50 ,$193.70 ,$325.00 ,$250.25 ,$906.49 ,$355.35 ,$318.50 ,$243.75 ,$230.75 ,$230.75 ,$355.35 ,$230.75 ,$276.25 ,$276.25 ,$276.25 , N/A ,$325.00 ,$276.25 ,$318.50 ,$325.00 ,$182.33 ,$355.35 ,$134.55 , N/A , N/A ,$355.35 ,$276.25 ,$761.45 ,$193.70 ,$91.00 ,$292.50 ,$355.35 ,$276.25 ,$325.00 ,$325.00 ,$355.35 ,$211.25 ST. JOSEPH'S HOSPITAL - BREESE,45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$367.00 ,$264.24 ,$102.76 ,$367.00 ,$278.78 ,$238.55 ,$219.10 ,$109.28 ,$102.76 ,$242.95 ,$109.28 ,$242.95 ,$109.28 ,$218.73 ,$218.73 ,$109.28 ,$218.73 ,$225.24 ,$282.59 ,$278.76 ,$109.28 ,$111.47 ,$275.25 ,$260.57 ,$260.57 ,$109.28 ,$260.57 ,$311.95 ,$311.95 ,$311.95 , N/A ,$278.76 ,$311.95 ,$109.28 ,$367.00 ,$205.89 ,$109.28 ,$151.94 , N/A , N/A ,$109.28 ,$311.95 ,$234.16 ,$218.73 ,$102.76 ,$330.30 ,$109.28 ,$311.95 ,$342.00 ,$342.00 ,$109.28 ,$238.55 ST. JOSEPH'S HOSPITAL - BREESE,45000146,46040,HC INCISION RECTAL ABSCESS,450,1 ,"$3,311.00 ","$2,383.92 ",$342.00 ,"$3,311.00 ","$2,599.90 ","$2,152.15 ","$1,976.67 ","$1,019.16 ",$927.08 ,"$2,191.88 ","$1,019.16 ","$2,191.88 ","$1,019.16 ","$1,973.36 ","$1,973.36 ","$1,019.16 ","$1,973.36 ","$2,100.72 ","$2,549.47 ","$2,599.90 ","$1,019.16 ","$1,039.54 ","$2,483.25 ","$2,350.81 ","$2,350.81 ","$1,019.16 ","$2,350.81 ","$2,814.35 ","$2,814.35 ","$2,814.35 ", N/A ,"$2,599.90 ","$2,814.35 ","$1,019.16 ","$3,311.00 ","$1,857.47 ","$1,019.16 ","$1,370.75 ", N/A , N/A ,"$1,019.16 ","$2,814.35 ","$2,183.92 ","$1,973.36 ",$927.08 ,"$2,979.90 ","$1,019.16 ","$2,814.35 ",$342.00 ,$342.00 ,"$1,019.16 ","$2,152.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,"$2,432.00 ","$1,751.04 ",$342.00 ,"$2,432.00 ","$1,995.20 ","$1,580.80 ","$1,451.90 ",$782.12 ,$680.96 ,"$1,609.98 ",$782.12 ,"$1,609.98 ",$782.12 ,"$1,449.47 ","$1,449.47 ",$782.12 ,"$1,449.47 ","$1,612.12 ","$1,872.64 ","$1,995.20 ",$782.12 ,$797.76 ,"$1,824.00 ","$1,726.72 ","$1,726.72 ",$782.12 ,"$1,726.72 ","$2,067.20 ","$2,067.20 ","$2,067.20 ", N/A ,"$1,995.20 ","$2,067.20 ",$782.12 ,"$2,432.00 ","$1,364.35 ",$782.12 ,"$1,006.85 ", N/A , N/A ,$782.12 ,"$2,067.20 ","$1,675.97 ","$1,449.47 ",$680.96 ,"$2,188.80 ",$782.12 ,"$2,067.20 ",$342.00 ,$342.00 ,$782.12 ,"$1,580.80 " ST. JOSEPH'S HOSPITAL - BREESE,45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,$918.00 ,$660.96 ,$202.22 ,$918.00 ,$515.88 ,$596.70 ,$548.05 ,$202.22 ,$257.04 ,$607.72 ,$202.22 ,$607.72 ,$202.22 ,$547.13 ,$547.13 ,$202.22 ,$547.13 ,$416.82 ,$706.86 ,$515.87 ,$202.22 ,$206.27 ,$688.50 ,$651.78 ,$651.78 ,$202.22 ,$651.78 ,$780.30 ,$780.30 ,$780.30 , N/A ,$515.87 ,$780.30 ,$202.22 ,$918.00 ,$515.00 ,$202.22 ,$380.05 , N/A , N/A ,$202.22 ,$780.30 ,$433.33 ,$547.13 ,$257.04 ,$826.20 ,$202.22 ,$780.30 ,$342.00 ,$342.00 ,$202.22 ,$596.70 ST. JOSEPH'S HOSPITAL - BREESE,45000149,46320,HC EXCISION THROMBOSED HEMORRHOID; EXTERNAL,450,1 ,"$6,422.00 ","$4,623.84 ",$342.00 ,"$6,422.00 ","$2,599.90 ","$4,174.30 ","$3,833.93 ","$1,019.16 ","$1,798.16 ","$4,251.36 ","$1,019.16 ","$4,251.36 ","$1,019.16 ","$3,827.51 ","$3,827.51 ","$1,019.16 ","$3,827.51 ","$2,100.72 ","$4,944.94 ","$2,599.90 ","$1,019.16 ","$1,039.54 ","$4,816.50 ","$4,559.62 ","$4,559.62 ","$1,019.16 ","$4,559.62 ","$5,458.70 ","$5,458.70 ","$5,458.70 ", N/A ,"$2,599.90 ","$5,458.70 ","$1,019.16 ","$6,422.00 ","$3,602.74 ","$1,019.16 ","$2,658.71 ", N/A , N/A ,"$1,019.16 ","$5,458.70 ","$2,183.92 ","$3,827.51 ","$1,798.16 ","$5,779.80 ","$1,019.16 ","$5,458.70 ",$342.00 ,$342.00 ,"$1,019.16 ","$4,174.30 " ST. JOSEPH'S HOSPITAL - BREESE,45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$494.00 ,$355.68 ,$138.32 ,$515.88 ,$515.88 ,$321.10 ,$294.92 ,$202.22 ,$138.32 ,$327.03 ,$202.22 ,$327.03 ,$202.22 ,$294.42 ,$294.42 ,$202.22 ,$294.42 ,$416.82 ,$380.38 ,$515.87 ,$202.22 ,$206.27 ,$370.50 ,$350.74 ,$350.74 ,$202.22 ,$350.74 ,$419.90 ,$419.90 ,$419.90 , N/A ,$494.00 ,$419.90 ,$202.22 ,$494.00 ,$277.13 ,$202.22 ,$204.52 , N/A , N/A ,$202.22 ,$419.90 ,$433.33 ,$294.42 ,$138.32 ,$444.60 ,$202.22 ,$419.90 ,$342.00 ,$342.00 ,$202.22 ,$321.10 ST. JOSEPH'S HOSPITAL - BREESE,45000157,51705,HC CHG TUBE CYSTOSTOMY SMP,450,1 ,$872.00 ,$627.84 ,$202.22 ,$872.00 ,$515.88 ,$566.80 ,$520.58 ,$202.22 ,$244.16 ,$577.26 ,$202.22 ,$577.26 ,$202.22 ,$519.71 ,$519.71 ,$202.22 ,$519.71 ,$416.82 ,$671.44 ,$515.87 ,$202.22 ,$206.27 ,$654.00 ,$619.12 ,$619.12 ,$202.22 ,$619.12 ,$741.20 ,$741.20 ,$741.20 , N/A ,$515.87 ,$741.20 ,$202.22 ,$872.00 ,$489.19 ,$202.22 ,$361.01 , N/A , N/A ,$202.22 ,$741.20 ,$433.33 ,$519.71 ,$244.16 ,$784.80 ,$202.22 ,$741.20 ,$342.00 ,$342.00 ,$202.22 ,$566.80 ST. JOSEPH'S HOSPITAL - BREESE,45000159,54220,HC IRRIG CORPORA CAVNOSA,450,1 ,$756.00 ,$544.32 ,$202.22 ,$756.00 ,$515.88 ,$491.40 ,$451.33 ,$202.22 ,$211.68 ,$500.47 ,$202.22 ,$500.47 ,$202.22 ,$450.58 ,$450.58 ,$202.22 ,$450.58 ,$416.82 ,$582.12 ,$515.87 ,$202.22 ,$206.27 ,$567.00 ,$536.76 ,$536.76 ,$202.22 ,$536.76 ,$642.60 ,$642.60 ,$642.60 , N/A ,$515.87 ,$642.60 ,$202.22 ,$756.00 ,$424.12 ,$202.22 ,$312.98 , N/A , N/A ,$202.22 ,$642.60 ,$433.33 ,$450.58 ,$211.68 ,$680.40 ,$202.22 ,$642.60 ,$342.00 ,$342.00 ,$202.22 ,$491.40 ST. JOSEPH'S HOSPITAL - BREESE,45000161,54700,HC I AND D EPIDIDYMIS TESTIS OR SCROTAL SPACE,450,1 ,"$5,841.00 ","$4,205.52 ",$342.00 ,"$5,841.00 ","$4,453.30 ","$3,796.65 ","$3,487.08 ","$1,745.69 ","$1,635.48 ","$3,866.74 ","$1,745.69 ","$3,866.74 ","$1,745.69 ","$3,481.24 ","$3,481.24 ","$1,745.69 ","$3,481.24 ","$3,598.26 ","$4,497.57 ","$4,453.29 ","$1,745.69 ","$1,780.60 ","$4,380.75 ","$4,147.11 ","$4,147.11 ","$1,745.69 ","$4,147.11 ","$4,964.85 ","$4,964.85 ","$4,964.85 ", N/A ,"$4,453.29 ","$4,964.85 ","$1,745.69 ","$5,841.00 ","$3,276.80 ","$1,745.69 ","$2,418.17 ", N/A , N/A ,"$1,745.69 ","$4,964.85 ","$3,740.76 ","$3,481.24 ","$1,635.48 ","$5,256.90 ","$1,745.69 ","$4,964.85 ",$342.00 ,$342.00 ,"$1,745.69 ","$3,796.65 " ST. JOSEPH'S HOSPITAL - BREESE,45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$168.00 ,$120.96 ,$47.04 ,$700.95 ,$700.95 ,$109.20 ,$100.30 ,$274.77 ,$47.04 ,$111.22 ,$274.77 ,$111.22 ,$164.64 ,$100.13 ,$100.13 ,$164.64 ,$100.13 ,$168.00 ,$129.36 ,$700.95 ,$274.77 ,$164.64 ,$126.00 ,$119.28 ,$119.28 ,$274.77 ,$119.28 ,$142.80 ,$142.80 ,$142.80 , N/A ,$168.00 ,$142.80 ,$164.64 ,$168.00 ,$94.25 ,$274.77 ,$69.55 , N/A , N/A ,$274.77 ,$142.80 ,$588.80 ,$100.13 ,$47.04 ,$151.20 ,$274.77 ,$142.80 ,$168.00 ,$168.00 ,$274.77 ,$109.20 ST. JOSEPH'S HOSPITAL - BREESE,45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$452.00 ,$325.44 ,$126.56 ,$452.00 ,$427.68 ,$293.80 ,$269.84 ,$167.65 ,$126.56 ,$299.22 ,$167.65 ,$299.22 ,$167.65 ,$269.39 ,$269.39 ,$167.65 ,$269.39 ,$345.55 ,$348.04 ,$427.66 ,$167.65 ,$171.00 ,$339.00 ,$320.92 ,$320.92 ,$167.65 ,$320.92 ,$384.20 ,$384.20 ,$384.20 , N/A ,$427.66 ,$384.20 ,$167.65 ,$452.00 ,$253.57 ,$167.65 ,$187.13 , N/A , N/A ,$167.65 ,$384.20 ,$359.24 ,$269.39 ,$126.56 ,$406.80 ,$167.65 ,$384.20 ,$342.00 ,$342.00 ,$167.65 ,$293.80 ST. JOSEPH'S HOSPITAL - BREESE,45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$391.00 ,$281.52 ,$109.48 ,$652.78 ,$652.78 ,$254.15 ,$233.43 ,$255.89 ,$109.48 ,$258.84 ,$255.89 ,$258.84 ,$255.89 ,$233.04 ,$233.04 ,$255.89 ,$233.04 ,$391.00 ,$301.07 ,$652.77 ,$255.89 ,$261.00 ,$293.25 ,$277.61 ,$277.61 ,$255.89 ,$277.61 ,$332.35 ,$332.35 ,$332.35 , N/A ,$391.00 ,$332.35 ,$255.89 ,$391.00 ,$219.35 ,$255.89 ,$161.87 , N/A , N/A ,$255.89 ,$332.35 ,$548.32 ,$233.04 ,$109.48 ,$351.90 ,$255.89 ,$332.35 ,$342.00 ,$342.00 ,$255.89 ,$254.15 ST. JOSEPH'S HOSPITAL - BREESE,45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$2,067.00 ","$1,488.24 ",$342.00 ,"$2,067.00 ","$1,546.98 ","$1,343.55 ","$1,234.00 ",$606.41 ,$578.76 ,"$1,368.35 ",$606.41 ,"$1,368.35 ",$606.41 ,"$1,231.93 ","$1,231.93 ",$606.41 ,"$1,231.93 ","$1,249.95 ","$1,591.59 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,550.25 ","$1,467.57 ","$1,467.57 ",$606.41 ,"$1,467.57 ","$1,756.95 ","$1,756.95 ","$1,756.95 ", N/A ,"$1,546.96 ","$1,756.95 ",$606.41 ,"$2,067.00 ","$1,159.59 ",$606.41 ,$855.74 , N/A , N/A ,$606.41 ,"$1,756.95 ","$1,299.45 ","$1,231.93 ",$578.76 ,"$1,860.30 ",$606.41 ,"$1,756.95 ",$342.00 ,$342.00 ,$606.41 ,"$1,343.55 " ST. JOSEPH'S HOSPITAL - BREESE,45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$435.00 ,$313.20 ,$109.28 ,$435.00 ,$278.78 ,$282.75 ,$259.70 ,$109.28 ,$121.80 ,$287.97 ,$109.28 ,$287.97 ,$109.28 ,$259.26 ,$259.26 ,$109.28 ,$259.26 ,$225.24 ,$334.95 ,$278.76 ,$109.28 ,$111.47 ,$326.25 ,$308.85 ,$308.85 ,$109.28 ,$308.85 ,$369.75 ,$369.75 ,$369.75 , N/A ,$278.76 ,$369.75 ,$109.28 ,$435.00 ,$244.04 ,$109.28 ,$180.09 , N/A , N/A ,$109.28 ,$369.75 ,$234.16 ,$259.26 ,$121.80 ,$391.50 ,$109.28 ,$369.75 ,$342.00 ,$342.00 ,$109.28 ,$282.75 ST. JOSEPH'S HOSPITAL - BREESE,45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,$435.00 ,$313.20 ,$121.80 ,$906.50 ,$906.50 ,$282.75 ,$259.70 ,$355.35 ,$121.80 ,$287.97 ,$355.35 ,$287.97 ,$355.35 ,$259.26 ,$259.26 ,$355.35 ,$259.26 ,$435.00 ,$334.95 ,$906.49 ,$355.35 ,$362.45 ,$326.25 ,$308.85 ,$308.85 ,$355.35 ,$308.85 ,$369.75 ,$369.75 ,$369.75 , N/A ,$435.00 ,$369.75 ,$355.35 ,$435.00 ,$244.04 ,$355.35 ,$180.09 , N/A , N/A ,$355.35 ,$369.75 ,$761.45 ,$259.26 ,$121.80 ,$391.50 ,$355.35 ,$369.75 ,$342.00 ,$342.00 ,$355.35 ,$282.75 ST. JOSEPH'S HOSPITAL - BREESE,45000177,67700,HC I AND D ABSCESS EYELID,450,1 ,$497.00 ,$357.84 ,$139.16 ,$635.53 ,$635.53 ,$323.05 ,$296.71 ,$249.13 ,$139.16 ,$329.01 ,$249.13 ,$329.01 ,$249.13 ,$296.21 ,$296.21 ,$249.13 ,$296.21 ,$497.00 ,$382.69 ,$635.53 ,$249.13 ,$254.11 ,$372.75 ,$352.87 ,$352.87 ,$249.13 ,$352.87 ,$422.45 ,$422.45 ,$422.45 , N/A ,$497.00 ,$422.45 ,$249.13 ,$497.00 ,$278.82 ,$249.13 ,$205.76 , N/A , N/A ,$249.13 ,$422.45 ,$533.84 ,$296.21 ,$139.16 ,$447.30 ,$249.13 ,$422.45 ,$342.00 ,$342.00 ,$249.13 ,$323.05 ST. JOSEPH'S HOSPITAL - BREESE,45000177,67700,HC I AND D ABSCESS EYELID,450,1 ,$744.00 ,$535.68 ,$208.32 ,$953.30 ,$953.30 ,$483.60 ,$444.17 ,$373.69 ,$208.32 ,$492.53 ,$373.69 ,$492.53 ,$373.69 ,$443.42 ,$443.42 ,$373.69 ,$443.42 ,$744.00 ,$572.88 ,$953.29 ,$373.69 ,$381.16 ,$558.00 ,$528.24 ,$528.24 ,$373.69 ,$528.24 ,$632.40 ,$632.40 ,$632.40 , N/A ,$744.00 ,$632.40 ,$373.69 ,$744.00 ,$417.38 ,$373.69 ,$308.02 , N/A , N/A ,$373.69 ,$632.40 ,$800.77 ,$443.42 ,$208.32 ,$669.60 ,$373.69 ,$632.40 ,$342.00 ,$342.00 ,$373.69 ,$483.60 ST. JOSEPH'S HOSPITAL - BREESE,45000178,67938,HC REMOVE EMBEDDED FB EYELID,450,1 ,"$1,242.00 ",$894.24 ,$249.13 ,"$1,242.00 ",$635.53 ,$807.30 ,$741.47 ,$249.13 ,$347.76 ,$822.20 ,$249.13 ,$822.20 ,$249.13 ,$740.23 ,$740.23 ,$249.13 ,$740.23 ,$513.51 ,$956.34 ,$635.53 ,$249.13 ,$254.11 ,$931.50 ,$881.82 ,$881.82 ,$249.13 ,$881.82 ,"$1,055.70 ","$1,055.70 ","$1,055.70 ", N/A ,$635.53 ,"$1,055.70 ",$249.13 ,"$1,242.00 ",$696.76 ,$249.13 ,$514.19 , N/A , N/A ,$249.13 ,"$1,055.70 ",$533.84 ,$740.23 ,$347.76 ,"$1,117.80 ",$249.13 ,"$1,055.70 ",$342.00 ,$342.00 ,$249.13 ,$807.30 ST. JOSEPH'S HOSPITAL - BREESE,45000179,69000,HC DRAIN ABSC/HEMA EAR EXT SMP,450,1 ,"$2,011.00 ","$1,447.92 ",$342.00 ,"$2,011.00 ","$1,558.08 ","$1,307.15 ","$1,200.57 ",$610.77 ,$563.08 ,"$1,331.28 ",$610.77 ,"$1,331.28 ",$610.77 ,"$1,198.56 ","$1,198.56 ",$610.77 ,"$1,198.56 ","$1,258.93 ","$1,548.47 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,508.25 ","$1,427.81 ","$1,427.81 ",$610.77 ,"$1,427.81 ","$1,709.35 ","$1,709.35 ","$1,709.35 ", N/A ,"$1,558.08 ","$1,709.35 ",$610.77 ,"$2,011.00 ","$1,128.17 ",$610.77 ,$832.55 , N/A , N/A ,$610.77 ,"$1,709.35 ","$1,308.79 ","$1,198.56 ",$563.08 ,"$1,809.90 ",$610.77 ,"$1,709.35 ",$342.00 ,$342.00 ,$610.77 ,"$1,307.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000181,69200,HC FB REMOVAL EAR,450,1 ,$248.00 ,$178.56 ,$69.44 ,$278.78 ,$278.78 ,$161.20 ,$148.06 ,$109.28 ,$69.44 ,$164.18 ,$109.28 ,$164.18 ,$109.28 ,$147.81 ,$147.81 ,$109.28 ,$147.81 ,$225.24 ,$190.96 ,$278.76 ,$109.28 ,$111.47 ,$186.00 ,$176.08 ,$176.08 ,$109.28 ,$176.08 ,$210.80 ,$210.80 ,$210.80 , N/A ,$248.00 ,$210.80 ,$109.28 ,$248.00 ,$139.13 ,$109.28 ,$102.67 , N/A , N/A ,$109.28 ,$210.80 ,$234.16 ,$147.81 ,$69.44 ,$223.20 ,$109.28 ,$210.80 ,$248.00 ,$248.00 ,$109.28 ,$161.20 ST. JOSEPH'S HOSPITAL - BREESE,45000181,69200,HC FB REMOVAL EAR,450,1 ,$373.00 ,$268.56 ,$104.44 ,$373.00 ,$278.78 ,$242.45 ,$222.68 ,$109.28 ,$104.44 ,$246.93 ,$109.28 ,$246.93 ,$109.28 ,$222.31 ,$222.31 ,$109.28 ,$222.31 ,$225.24 ,$287.21 ,$278.76 ,$109.28 ,$111.47 ,$279.75 ,$264.83 ,$264.83 ,$109.28 ,$264.83 ,$317.05 ,$317.05 ,$317.05 , N/A ,$278.76 ,$317.05 ,$109.28 ,$373.00 ,$209.25 ,$109.28 ,$154.42 , N/A , N/A ,$109.28 ,$317.05 ,$234.16 ,$222.31 ,$104.44 ,$335.70 ,$109.28 ,$317.05 ,$342.00 ,$342.00 ,$109.28 ,$242.45 ST. JOSEPH'S HOSPITAL - BREESE,45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$255.00 ,$183.60 ,$54.10 ,$255.00 ,$138.00 ,$165.75 ,$152.24 ,$54.10 ,$71.40 ,$168.81 ,$54.10 ,$168.81 ,$54.10 ,$151.98 ,$151.98 ,$54.10 ,$151.98 ,$111.50 ,$196.35 ,$138.00 ,$54.10 ,$55.17 ,$191.25 ,$181.05 ,$181.05 ,$54.10 ,$181.05 ,$216.75 ,$216.75 ,$216.75 , N/A ,$138.00 ,$216.75 ,$54.10 ,$255.00 ,$143.06 ,$54.10 ,$105.57 , N/A , N/A ,$54.10 ,$216.75 ,$115.92 ,$151.98 ,$71.40 ,$229.50 ,$54.10 ,$216.75 ,$255.00 ,$255.00 ,$54.10 ,$165.75 ST. JOSEPH'S HOSPITAL - BREESE,45000188,99281,HC ER LEVEL 1,450,1 ,$422.00 ,$303.84 ,$70.67 ,$422.00 ,$180.28 ,$274.30 ,$251.93 ,$70.67 ,$118.16 ,$279.36 ,$70.67 ,$279.36 ,$70.67 ,$251.51 ,$251.51 ,$70.67 ,$251.51 ,$145.67 ,$324.94 ,$180.28 ,$70.67 ,$72.08 ,$316.50 ,$299.62 ,$299.62 ,$70.67 ,$299.62 ,$358.70 ,$358.70 ,$358.70 , N/A ,$180.28 ,$358.70 ,$70.67 ,$422.00 ,$236.74 ,$70.67 ,$174.71 , N/A , N/A ,$70.67 ,$358.70 ,$151.43 ,$251.51 ,$118.16 ,$379.80 ,$70.67 ,$358.70 ,$342.00 ,$342.00 ,$70.67 ,$274.30 ST. JOSEPH'S HOSPITAL - BREESE,45000189,99282,HC ER LEVEL 2,450,1 ,$629.00 ,$452.88 ,$131.47 ,$629.00 ,$335.38 ,$408.85 ,$375.51 ,$131.47 ,$176.12 ,$416.40 ,$131.47 ,$416.40 ,$131.47 ,$374.88 ,$374.88 ,$131.47 ,$374.88 ,$270.98 ,$484.33 ,$335.37 ,$131.47 ,$134.09 ,$471.75 ,$446.59 ,$446.59 ,$131.47 ,$446.59 ,$534.65 ,$534.65 ,$534.65 , N/A ,$335.37 ,$534.65 ,$131.47 ,$629.00 ,$352.87 ,$131.47 ,$260.41 , N/A , N/A ,$131.47 ,$534.65 ,$281.71 ,$374.88 ,$176.12 ,$566.10 ,$131.47 ,$534.65 ,$584.00 ,$584.00 ,$131.47 ,$408.85 ST. JOSEPH'S HOSPITAL - BREESE,45000190,99283,HC ER LEVEL 3,450,1 ,$922.00 ,$663.84 ,$230.60 ,$922.00 ,$588.28 ,$599.30 ,$550.43 ,$230.60 ,$258.16 ,$610.36 ,$230.60 ,$610.36 ,$230.60 ,$549.51 ,$549.51 ,$230.60 ,$549.51 ,$475.33 ,$709.94 ,$588.28 ,$230.60 ,$235.22 ,$691.50 ,$654.62 ,$654.62 ,$230.60 ,$654.62 ,$783.70 ,$783.70 ,$783.70 , N/A ,$588.28 ,$783.70 ,$230.60 ,$922.00 ,$517.24 ,$230.60 ,$381.71 , N/A , N/A ,$230.60 ,$783.70 ,$494.16 ,$549.51 ,$258.16 ,$829.80 ,$230.60 ,$783.70 ,$922.00 ,$922.00 ,$230.60 ,$599.30 ST. JOSEPH'S HOSPITAL - BREESE,45000191,99284,HC ER LEVEL 4,450,1 ,"$1,410.00 ","$1,015.20 ",$94.62 ,"$1,410.00 ",$916.20 ,$916.50 ,$841.77 ,$359.15 ,$394.80 ,$933.42 ,$359.15 ,$933.42 ,$359.15 ,$840.36 ,$840.36 ,$359.15 ,$840.36 ,$740.28 ,"$1,085.70 ",$916.19 ,$359.15 ,$366.32 ,"$1,057.50 ","$1,001.10 ","$1,001.10 ",$359.15 ,"$1,001.10 ","$1,198.50 ","$1,198.50 ","$1,198.50 ", N/A ,$916.19 ,"$1,198.50 ",$359.15 ,"$1,410.00 ",$791.01 ,$359.15 ,$583.74 ,$104.08 ,$94.62 ,$359.15 ,"$1,198.50 ",$769.60 ,$840.36 ,$394.80 ,"$1,269.00 ",$359.15 ,"$1,198.50 ","$1,410.00 ","$1,410.00 ",$359.15 ,$916.50 ST. JOSEPH'S HOSPITAL - BREESE,45000192,99285,HC ER LEVEL 5,450,1 ,"$2,034.00 ","$1,464.48 ",$94.62 ,"$2,034.00 ","$1,315.93 ","$1,322.10 ","$1,214.30 ",$515.84 ,$569.52 ,"$1,346.51 ",$515.84 ,"$1,346.51 ",$515.84 ,"$1,212.26 ","$1,212.26 ",$515.84 ,"$1,212.26 ","$1,063.27 ","$1,566.18 ","$1,315.93 ",$515.84 ,$526.16 ,"$1,525.50 ","$1,444.14 ","$1,444.14 ",$515.84 ,"$1,444.14 ","$1,728.90 ","$1,728.90 ","$1,728.90 ", N/A ,"$1,315.93 ","$1,728.90 ",$515.84 ,"$2,034.00 ","$1,141.07 ",$515.84 ,$842.08 ,$104.08 ,$94.62 ,$515.84 ,"$1,728.90 ","$1,105.38 ","$1,212.26 ",$569.52 ,"$1,830.60 ",$515.84 ,"$1,728.90 ","$2,034.00 ","$2,034.00 ",$515.84 ,"$1,322.10 " ST. JOSEPH'S HOSPITAL - BREESE,45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$2,586.00 ","$1,861.92 ",$94.62 ,"$2,586.00 ","$1,843.18 ","$1,680.90 ","$1,543.84 ",$722.52 ,$724.08 ,"$1,711.93 ",$722.52 ,"$1,711.93 ",$722.52 ,"$1,541.26 ","$1,541.26 ",$722.52 ,"$1,541.26 ","$1,489.29 ","$1,991.22 ","$1,843.18 ",$722.52 ,$736.98 ,"$1,939.50 ","$1,836.06 ","$1,836.06 ",$722.52 ,"$1,836.06 ","$2,198.10 ","$2,198.10 ","$2,198.10 ", N/A ,"$1,843.18 ","$2,198.10 ",$722.52 ,"$2,586.00 ","$1,450.75 ",$722.52 ,"$1,070.60 ",$104.08 ,$94.62 ,$722.52 ,"$2,198.10 ","$1,548.27 ","$1,541.26 ",$724.08 ,"$2,327.40 ",$722.52 ,"$2,198.10 ","$2,586.00 ","$2,586.00 ",$722.52 ,"$1,680.90 " ST. JOSEPH'S HOSPITAL - BREESE,45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,"$1,057.00 ",$761.04 ,$295.96 ,"$1,057.00 ", N/A ,$687.05 ,$631.03 , N/A ,$295.96 ,$699.73 , N/A ,$699.73 , N/A ,$629.97 ,$629.97 , N/A ,$629.97 , N/A ,$813.89 , N/A , N/A , N/A ,$792.75 ,$750.47 ,$750.47 , N/A ,$750.47 ,$898.45 ,$898.45 ,$898.45 , N/A , N/A ,$898.45 , N/A ,"$1,057.00 ",$592.98 , N/A ,$437.60 , N/A , N/A , N/A ,$898.45 , N/A ,$629.97 ,$295.96 ,$951.30 , N/A ,$898.45 ,$342.00 ,$342.00 , N/A ,$687.05 ST. JOSEPH'S HOSPITAL - BREESE,45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,"$4,469.00 ","$3,217.68 ",$342.00 ,"$4,469.00 ","$3,444.08 ","$2,904.85 ","$2,667.99 ","$1,350.08 ","$1,251.32 ","$2,958.48 ","$1,350.08 ","$2,958.48 ","$1,350.08 ","$2,663.52 ","$2,663.52 ","$1,350.08 ","$2,663.52 ","$2,782.81 ","$3,441.13 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,351.75 ","$3,172.99 ","$3,172.99 ","$1,350.08 ","$3,172.99 ","$3,798.65 ","$3,798.65 ","$3,798.65 ", N/A ,"$3,444.07 ","$3,798.65 ","$1,350.08 ","$4,469.00 ","$2,507.11 ","$1,350.08 ","$1,850.17 ", N/A , N/A ,"$1,350.08 ","$3,798.65 ","$2,893.02 ","$2,663.52 ","$1,251.32 ","$4,022.10 ","$1,350.08 ","$3,798.65 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,904.85 " ST. JOSEPH'S HOSPITAL - BREESE,45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$975.00 ,$702.00 ,$194.82 ,$975.00 ,$497.00 ,$633.75 ,$582.08 ,$194.82 ,$273.00 ,$645.45 ,$194.82 ,$645.45 ,$194.82 ,$581.10 ,$581.10 ,$194.82 ,$581.10 ,$401.58 ,$750.75 ,$497.00 ,$194.82 ,$198.72 ,$731.25 ,$692.25 ,$692.25 ,$194.82 ,$692.25 ,$828.75 ,$828.75 ,$828.75 , N/A ,$497.00 ,$828.75 ,$194.82 ,$975.00 ,$546.98 ,$194.82 ,$403.65 , N/A , N/A ,$194.82 ,$828.75 ,$417.48 ,$581.10 ,$273.00 ,$877.50 ,$194.82 ,$828.75 ,$342.00 ,$342.00 ,$194.82 ,$633.75 ST. JOSEPH'S HOSPITAL - BREESE,45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$485.00 ,$349.20 ,$135.80 ,$497.00 ,$497.00 ,$315.25 ,$289.55 ,$194.82 ,$135.80 ,$321.07 ,$194.82 ,$321.07 ,$194.82 ,$289.06 ,$289.06 ,$194.82 ,$289.06 ,$401.58 ,$373.45 ,$497.00 ,$194.82 ,$198.72 ,$363.75 ,$344.35 ,$344.35 ,$194.82 ,$344.35 ,$412.25 ,$412.25 ,$412.25 , N/A ,$485.00 ,$412.25 ,$194.82 ,$485.00 ,$272.09 ,$194.82 ,$200.79 , N/A , N/A ,$194.82 ,$412.25 ,$417.48 ,$289.06 ,$135.80 ,$436.50 ,$194.82 ,$412.25 ,$342.00 ,$342.00 ,$194.82 ,$315.25 ST. JOSEPH'S HOSPITAL - BREESE,45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$729.00 ,$524.88 ,$204.12 ,$745.50 ,$745.50 ,$473.85 ,$435.21 ,$292.24 ,$204.12 ,$482.60 ,$292.24 ,$482.60 ,$292.24 ,$434.48 ,$434.48 ,$292.24 ,$434.48 ,$602.36 ,$561.33 ,$745.50 ,$292.24 ,$298.08 ,$546.75 ,$517.59 ,$517.59 ,$292.24 ,$517.59 ,$619.65 ,$619.65 ,$619.65 , N/A ,$729.00 ,$619.65 ,$292.24 ,$729.00 ,$408.97 ,$292.24 ,$301.81 , N/A , N/A ,$292.24 ,$619.65 ,$626.22 ,$434.48 ,$204.12 ,$656.10 ,$292.24 ,$619.65 ,$342.00 ,$342.00 ,$292.24 ,$473.85 ST. JOSEPH'S HOSPITAL - BREESE,45000200,35206,HC RPR VESSEL EXTREM UPR,450,1 ,"$6,250.00 ","$4,500.00 ",$342.00 ,"$7,152.06 ","$7,152.05 ","$4,062.50 ","$3,731.25 ","$2,803.60 ","$1,750.00 ","$4,137.50 ","$2,803.60 ","$4,137.50 ","$2,803.60 ","$3,725.00 ","$3,725.00 ","$2,803.60 ","$3,725.00 ","$5,778.86 ","$4,812.50 ","$7,152.06 ","$2,803.60 ","$2,859.68 ","$4,687.50 ","$4,437.50 ","$4,437.50 ","$2,803.60 ","$4,437.50 ","$5,312.50 ","$5,312.50 ","$5,312.50 ", N/A ,"$6,250.00 ","$5,312.50 ","$2,803.60 ","$6,250.00 ","$3,506.25 ","$2,803.60 ","$2,587.50 ", N/A , N/A ,"$2,803.60 ","$5,312.50 ","$6,007.73 ","$3,725.00 ","$1,750.00 ","$5,625.00 ","$2,803.60 ","$5,312.50 ",$342.00 ,$342.00 ,"$2,803.60 ","$4,062.50 " ST. JOSEPH'S HOSPITAL - BREESE,45000203,27840,HC TX DISL ANKLE W/O ANES CLS,450,1 ,$519.00 ,$373.68 ,$145.32 ,$519.00 ,$497.00 ,$337.35 ,$309.84 ,$194.82 ,$145.32 ,$343.58 ,$194.82 ,$343.58 ,$194.82 ,$309.32 ,$309.32 ,$194.82 ,$309.32 ,$401.58 ,$399.63 ,$497.00 ,$194.82 ,$198.72 ,$389.25 ,$368.49 ,$368.49 ,$194.82 ,$368.49 ,$441.15 ,$441.15 ,$441.15 , N/A ,$497.00 ,$441.15 ,$194.82 ,$519.00 ,$291.16 ,$194.82 ,$214.87 , N/A , N/A ,$194.82 ,$441.15 ,$417.48 ,$309.32 ,$145.32 ,$467.10 ,$194.82 ,$441.15 ,$342.00 ,$342.00 ,$194.82 ,$337.35 ST. JOSEPH'S HOSPITAL - BREESE,45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,"$4,169.00 ","$3,001.68 ",$342.00 ,"$4,169.00 ","$3,600.20 ","$2,709.85 ","$2,488.89 ","$1,411.28 ","$1,167.32 ","$2,759.88 ","$1,411.28 ","$2,759.88 ","$1,411.28 ","$2,484.72 ","$2,484.72 ","$1,411.28 ","$2,484.72 ","$2,908.96 ","$3,210.13 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$3,126.75 ","$2,959.99 ","$2,959.99 ","$1,411.28 ","$2,959.99 ","$3,543.65 ","$3,543.65 ","$3,543.65 ", N/A ,"$3,600.19 ","$3,543.65 ","$1,411.28 ","$4,169.00 ","$2,338.81 ","$1,411.28 ","$1,725.97 ", N/A , N/A ,"$1,411.28 ","$3,543.65 ","$3,024.16 ","$2,484.72 ","$1,167.32 ","$3,752.10 ","$1,411.28 ","$3,543.65 ",$342.00 ,$342.00 ,"$1,411.28 ","$2,709.85 " ST. JOSEPH'S HOSPITAL - BREESE,45000207,49084,HC PERITONEAL LAVAGE,450,1 ,$311.00 ,$223.92 ,$87.08 ,"$1,981.93 ","$1,981.93 ",$202.15 ,$185.67 ,$776.91 ,$87.08 ,$205.88 ,$776.91 ,$205.88 ,$304.78 ,$185.36 ,$185.36 ,$304.78 ,$185.36 ,$311.00 ,$239.47 ,"$1,981.93 ",$776.91 ,$304.78 ,$233.25 ,$220.81 ,$220.81 ,$776.91 ,$220.81 ,$264.35 ,$264.35 ,$264.35 , N/A ,$311.00 ,$264.35 ,$304.78 ,$311.00 ,$174.47 ,$776.91 ,$128.75 , N/A , N/A ,$776.91 ,$264.35 ,"$1,664.82 ",$185.36 ,$87.08 ,$279.90 ,$776.91 ,$264.35 ,$311.00 ,$311.00 ,$776.91 ,$202.15 ST. JOSEPH'S HOSPITAL - BREESE,45000212,25690,HC CLSD WRIST DISLOC,450,1 ,"$4,559.00 ","$3,282.48 ",$342.00 ,"$4,559.00 ","$3,444.08 ","$2,963.35 ","$2,721.72 ","$1,350.08 ","$1,276.52 ","$3,018.06 ","$1,350.08 ","$3,018.06 ","$1,350.08 ","$2,717.16 ","$2,717.16 ","$1,350.08 ","$2,717.16 ","$2,782.81 ","$3,510.43 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,419.25 ","$3,236.89 ","$3,236.89 ","$1,350.08 ","$3,236.89 ","$3,875.15 ","$3,875.15 ","$3,875.15 ", N/A ,"$3,444.07 ","$3,875.15 ","$1,350.08 ","$4,559.00 ","$2,557.60 ","$1,350.08 ","$1,887.43 ", N/A , N/A ,"$1,350.08 ","$3,875.15 ","$2,893.02 ","$2,717.16 ","$1,276.52 ","$4,103.10 ","$1,350.08 ","$3,875.15 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,963.35 " ST. JOSEPH'S HOSPITAL - BREESE,45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,$841.00 ,$605.52 ,$235.48 ,$841.00 ,$798.58 ,$546.65 ,$502.08 ,$313.04 ,$235.48 ,$556.74 ,$313.04 ,$556.74 ,$313.04 ,$501.24 ,$501.24 ,$313.04 ,$501.24 ,$645.25 ,$647.57 ,$798.57 ,$313.04 ,$319.30 ,$630.75 ,$597.11 ,$597.11 ,$313.04 ,$597.11 ,$714.85 ,$714.85 ,$714.85 , N/A ,$798.57 ,$714.85 ,$313.04 ,$841.00 ,$471.80 ,$313.04 ,$348.17 , N/A , N/A ,$313.04 ,$714.85 ,$670.80 ,$501.24 ,$235.48 ,$756.90 ,$313.04 ,$714.85 ,$342.00 ,$342.00 ,$313.04 ,$546.65 ST. JOSEPH'S HOSPITAL - BREESE,45000215,27786,HC DIST FIB FX W/O MANIP,450,1 ,$412.00 ,$296.64 ,$115.36 ,$497.00 ,$497.00 ,$267.80 ,$245.96 ,$194.82 ,$115.36 ,$272.74 ,$194.82 ,$272.74 ,$194.82 ,$245.55 ,$245.55 ,$194.82 ,$245.55 ,$401.58 ,$317.24 ,$497.00 ,$194.82 ,$198.72 ,$309.00 ,$292.52 ,$292.52 ,$194.82 ,$292.52 ,$350.20 ,$350.20 ,$350.20 , N/A ,$412.00 ,$350.20 ,$194.82 ,$412.00 ,$231.13 ,$194.82 ,$170.57 , N/A , N/A ,$194.82 ,$350.20 ,$417.48 ,$245.55 ,$115.36 ,$370.80 ,$194.82 ,$350.20 ,$342.00 ,$342.00 ,$194.82 ,$267.80 ST. JOSEPH'S HOSPITAL - BREESE,45000215,27786,HC DIST FIB FX W/O MANIP,450,1 ,$618.00 ,$444.96 ,$173.04 ,$745.50 ,$745.50 ,$401.70 ,$368.95 ,$292.24 ,$173.04 ,$409.12 ,$292.24 ,$409.12 ,$292.24 ,$368.33 ,$368.33 ,$292.24 ,$368.33 ,$602.36 ,$475.86 ,$745.50 ,$292.24 ,$298.08 ,$463.50 ,$438.78 ,$438.78 ,$292.24 ,$438.78 ,$525.30 ,$525.30 ,$525.30 , N/A ,$618.00 ,$525.30 ,$292.24 ,$618.00 ,$346.70 ,$292.24 ,$255.85 , N/A , N/A ,$292.24 ,$525.30 ,$626.22 ,$368.33 ,$173.04 ,$556.20 ,$292.24 ,$525.30 ,$342.00 ,$342.00 ,$292.24 ,$401.70 ST. JOSEPH'S HOSPITAL - BREESE,45000216,41899,HC DENTOALVEOLAR STRUCT PROC,450,1 ,$771.00 ,$555.12 ,$195.60 ,$771.00 ,$498.98 ,$501.15 ,$460.29 ,$195.60 ,$215.88 ,$510.40 ,$195.60 ,$510.40 ,$195.60 ,$459.52 ,$459.52 ,$195.60 ,$459.52 ,$403.17 ,$593.67 ,$498.97 ,$195.60 ,$199.51 ,$578.25 ,$547.41 ,$547.41 ,$195.60 ,$547.41 ,$655.35 ,$655.35 ,$655.35 , N/A ,$498.97 ,$655.35 ,$195.60 ,$771.00 ,$432.53 ,$195.60 ,$319.19 , N/A , N/A ,$195.60 ,$655.35 ,$419.13 ,$459.52 ,$215.88 ,$693.90 ,$195.60 ,$655.35 ,$342.00 ,$342.00 ,$195.60 ,$501.15 ST. JOSEPH'S HOSPITAL - BREESE,45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,"$4,652.00 ","$3,349.44 ",$342.00 ,"$4,652.00 ","$3,444.08 ","$3,023.80 ","$2,777.24 ","$1,350.08 ","$1,302.56 ","$3,079.62 ","$1,350.08 ","$3,079.62 ","$1,350.08 ","$2,772.59 ","$2,772.59 ","$1,350.08 ","$2,772.59 ","$2,782.81 ","$3,582.04 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,489.00 ","$3,302.92 ","$3,302.92 ","$1,350.08 ","$3,302.92 ","$3,954.20 ","$3,954.20 ","$3,954.20 ", N/A ,"$3,444.07 ","$3,954.20 ","$1,350.08 ","$4,652.00 ","$2,609.77 ","$1,350.08 ","$1,925.93 ", N/A , N/A ,"$1,350.08 ","$3,954.20 ","$2,893.02 ","$2,772.59 ","$1,302.56 ","$4,186.80 ","$1,350.08 ","$3,954.20 ",$342.00 ,$342.00 ,"$1,350.08 ","$3,023.80 " ST. JOSEPH'S HOSPITAL - BREESE,45000221,10121,HC RM FB SUBQ W/INC COMPL,450,1 ,"$5,812.00 ","$4,184.64 ",$342.00 ,"$5,812.00 ","$3,600.20 ","$3,777.80 ","$3,469.76 ","$1,411.28 ","$1,627.36 ","$3,847.54 ","$1,411.28 ","$3,847.54 ","$1,411.28 ","$3,463.95 ","$3,463.95 ","$1,411.28 ","$3,463.95 ","$2,908.96 ","$4,475.24 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$4,359.00 ","$4,126.52 ","$4,126.52 ","$1,411.28 ","$4,126.52 ","$4,940.20 ","$4,940.20 ","$4,940.20 ", N/A ,"$3,600.19 ","$4,940.20 ","$1,411.28 ","$5,812.00 ","$3,260.53 ","$1,411.28 ","$2,406.17 ", N/A , N/A ,"$1,411.28 ","$4,940.20 ","$3,024.16 ","$3,463.95 ","$1,627.36 ","$5,230.80 ","$1,411.28 ","$4,940.20 ",$342.00 ,$342.00 ,"$1,411.28 ","$3,777.80 " ST. JOSEPH'S HOSPITAL - BREESE,45000227,25600,HC CLSD DIS.RADIUS W/O MANIP,450,1 ,$675.00 ,$486.00 ,$189.00 ,$675.00 ,$497.00 ,$438.75 ,$402.98 ,$194.82 ,$189.00 ,$446.85 ,$194.82 ,$446.85 ,$194.82 ,$402.30 ,$402.30 ,$194.82 ,$402.30 ,$401.58 ,$519.75 ,$497.00 ,$194.82 ,$198.72 ,$506.25 ,$479.25 ,$479.25 ,$194.82 ,$479.25 ,$573.75 ,$573.75 ,$573.75 , N/A ,$497.00 ,$573.75 ,$194.82 ,$675.00 ,$378.68 ,$194.82 ,$279.45 , N/A , N/A ,$194.82 ,$573.75 ,$417.48 ,$402.30 ,$189.00 ,$607.50 ,$194.82 ,$573.75 ,$342.00 ,$342.00 ,$194.82 ,$438.75 ST. JOSEPH'S HOSPITAL - BREESE,45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$975.00 ,$702.00 ,$194.82 ,$975.00 ,$497.00 ,$633.75 ,$582.08 ,$194.82 ,$273.00 ,$645.45 ,$194.82 ,$645.45 ,$194.82 ,$581.10 ,$581.10 ,$194.82 ,$581.10 ,$401.58 ,$750.75 ,$497.00 ,$194.82 ,$198.72 ,$731.25 ,$692.25 ,$692.25 ,$194.82 ,$692.25 ,$828.75 ,$828.75 ,$828.75 , N/A ,$497.00 ,$828.75 ,$194.82 ,$975.00 ,$546.98 ,$194.82 ,$403.65 , N/A , N/A ,$194.82 ,$828.75 ,$417.48 ,$581.10 ,$273.00 ,$877.50 ,$194.82 ,$828.75 ,$342.00 ,$342.00 ,$194.82 ,$633.75 ST. JOSEPH'S HOSPITAL - BREESE,45000231,25505,HC RADIUS FX W MANIP,450,1 ,"$4,235.00 ","$3,049.20 ",$342.00 ,"$4,235.00 ","$3,444.08 ","$2,752.75 ","$2,528.30 ","$1,350.08 ","$1,185.80 ","$2,803.57 ","$1,350.08 ","$2,803.57 ","$1,350.08 ","$2,524.06 ","$2,524.06 ","$1,350.08 ","$2,524.06 ","$2,782.81 ","$3,260.95 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,176.25 ","$3,006.85 ","$3,006.85 ","$1,350.08 ","$3,006.85 ","$3,599.75 ","$3,599.75 ","$3,599.75 ", N/A ,"$3,444.07 ","$3,599.75 ","$1,350.08 ","$4,235.00 ","$2,375.84 ","$1,350.08 ","$1,753.29 ", N/A , N/A ,"$1,350.08 ","$3,599.75 ","$2,893.02 ","$2,524.06 ","$1,185.80 ","$3,811.50 ","$1,350.08 ","$3,599.75 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,752.75 " ST. JOSEPH'S HOSPITAL - BREESE,45000235,28470,HC CLSD METATARSAL W/O MANIP,450,1 ,$381.00 ,$274.32 ,$106.68 ,$497.00 ,$497.00 ,$247.65 ,$227.46 ,$194.82 ,$106.68 ,$252.22 ,$194.82 ,$252.22 ,$194.82 ,$227.08 ,$227.08 ,$194.82 ,$227.08 ,$381.00 ,$293.37 ,$497.00 ,$194.82 ,$198.72 ,$285.75 ,$270.51 ,$270.51 ,$194.82 ,$270.51 ,$323.85 ,$323.85 ,$323.85 , N/A ,$381.00 ,$323.85 ,$194.82 ,$381.00 ,$213.74 ,$194.82 ,$157.73 , N/A , N/A ,$194.82 ,$323.85 ,$417.48 ,$227.08 ,$106.68 ,$342.90 ,$194.82 ,$323.85 ,$342.00 ,$342.00 ,$194.82 ,$247.65 ST. JOSEPH'S HOSPITAL - BREESE,45000238,26670,HC HAND DISL W/MANIP W/O ANES,450,1 ,$610.00 ,$439.20 ,$170.80 ,$610.00 ,$497.00 ,$396.50 ,$364.17 ,$194.82 ,$170.80 ,$403.82 ,$194.82 ,$403.82 ,$194.82 ,$363.56 ,$363.56 ,$194.82 ,$363.56 ,$401.58 ,$469.70 ,$497.00 ,$194.82 ,$198.72 ,$457.50 ,$433.10 ,$433.10 ,$194.82 ,$433.10 ,$518.50 ,$518.50 ,$518.50 , N/A ,$497.00 ,$518.50 ,$194.82 ,$610.00 ,$342.21 ,$194.82 ,$252.54 , N/A , N/A ,$194.82 ,$518.50 ,$417.48 ,$363.56 ,$170.80 ,$549.00 ,$194.82 ,$518.50 ,$342.00 ,$342.00 ,$194.82 ,$396.50 ST. JOSEPH'S HOSPITAL - BREESE,45000246,24505,HC HUMERAL CLOSED RED FX,450,1 ,$738.00 ,$531.36 ,$206.64 ,"$3,444.08 ","$3,444.08 ",$479.70 ,$440.59 ,"$1,350.08 ",$206.64 ,$488.56 ,"$1,350.08 ",$488.56 ,$723.24 ,$439.85 ,$439.85 ,$723.24 ,$439.85 ,$738.00 ,$568.26 ,"$3,444.07 ","$1,350.08 ",$723.24 ,$553.50 ,$523.98 ,$523.98 ,"$1,350.08 ",$523.98 ,$627.30 ,$627.30 ,$627.30 , N/A ,$738.00 ,$627.30 ,$723.24 ,$738.00 ,$414.02 ,"$1,350.08 ",$305.53 , N/A , N/A ,"$1,350.08 ",$627.30 ,"$2,893.02 ",$439.85 ,$206.64 ,$664.20 ,"$1,350.08 ",$627.30 ,$342.00 ,$342.00 ,"$1,350.08 ",$479.70 ST. JOSEPH'S HOSPITAL - BREESE,45000248,28475,HC CLSD METATARSAL W/MANIP,450,1 ,$399.00 ,$287.28 ,$111.72 ,$497.00 ,$497.00 ,$259.35 ,$238.20 ,$194.82 ,$111.72 ,$264.14 ,$194.82 ,$264.14 ,$194.82 ,$237.80 ,$237.80 ,$194.82 ,$237.80 ,$399.00 ,$307.23 ,$497.00 ,$194.82 ,$198.72 ,$299.25 ,$283.29 ,$283.29 ,$194.82 ,$283.29 ,$339.15 ,$339.15 ,$339.15 , N/A ,$399.00 ,$339.15 ,$194.82 ,$399.00 ,$223.84 ,$194.82 ,$165.19 , N/A , N/A ,$194.82 ,$339.15 ,$417.48 ,$237.80 ,$111.72 ,$359.10 ,$194.82 ,$339.15 ,$342.00 ,$342.00 ,$194.82 ,$259.35 ST. JOSEPH'S HOSPITAL - BREESE,45000249,28515,HC TOE FX W/MANIP,450,1 ,$735.00 ,$529.20 ,$194.82 ,$735.00 ,$497.00 ,$477.75 ,$438.80 ,$194.82 ,$205.80 ,$486.57 ,$194.82 ,$486.57 ,$194.82 ,$438.06 ,$438.06 ,$194.82 ,$438.06 ,$401.58 ,$565.95 ,$497.00 ,$194.82 ,$198.72 ,$551.25 ,$521.85 ,$521.85 ,$194.82 ,$521.85 ,$624.75 ,$624.75 ,$624.75 , N/A ,$497.00 ,$624.75 ,$194.82 ,$735.00 ,$412.34 ,$194.82 ,$304.29 , N/A , N/A ,$194.82 ,$624.75 ,$417.48 ,$438.06 ,$205.80 ,$661.50 ,$194.82 ,$624.75 ,$342.00 ,$342.00 ,$194.82 ,$477.75 ST. JOSEPH'S HOSPITAL - BREESE,45000258,29345,HC LONG LEG CAST,450,1 ,$854.00 ,$614.88 ,$225.79 ,$854.00 ,$576.00 ,$555.10 ,$509.84 ,$225.79 ,$239.12 ,$565.35 ,$225.79 ,$565.35 ,$225.79 ,$508.98 ,$508.98 ,$225.79 ,$508.98 ,$465.40 ,$657.58 ,$575.99 ,$225.79 ,$230.30 ,$640.50 ,$606.34 ,$606.34 ,$225.79 ,$606.34 ,$725.90 ,$725.90 ,$725.90 , N/A ,$575.99 ,$725.90 ,$225.79 ,$854.00 ,$479.09 ,$225.79 ,$353.56 , N/A , N/A ,$225.79 ,$725.90 ,$483.83 ,$508.98 ,$239.12 ,$768.60 ,$225.79 ,$725.90 ,$342.00 ,$342.00 ,$225.79 ,$555.10 ST. JOSEPH'S HOSPITAL - BREESE,45000259,28630,HC FOOT DISCL W/O ANES,450,1 ,$735.00 ,$529.20 ,$194.82 ,$735.00 ,$497.00 ,$477.75 ,$438.80 ,$194.82 ,$205.80 ,$486.57 ,$194.82 ,$486.57 ,$194.82 ,$438.06 ,$438.06 ,$194.82 ,$438.06 ,$401.58 ,$565.95 ,$497.00 ,$194.82 ,$198.72 ,$551.25 ,$521.85 ,$521.85 ,$194.82 ,$521.85 ,$624.75 ,$624.75 ,$624.75 , N/A ,$497.00 ,$624.75 ,$194.82 ,$735.00 ,$412.34 ,$194.82 ,$304.29 , N/A , N/A ,$194.82 ,$624.75 ,$417.48 ,$438.06 ,$205.80 ,$661.50 ,$194.82 ,$624.75 ,$342.00 ,$342.00 ,$194.82 ,$477.75 ST. JOSEPH'S HOSPITAL - BREESE,45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,$855.00 ,$615.60 ,$239.40 ,$855.00 ,$652.78 ,$555.75 ,$510.44 ,$255.89 ,$239.40 ,$566.01 ,$255.89 ,$566.01 ,$255.89 ,$509.58 ,$509.58 ,$255.89 ,$509.58 ,$527.44 ,$658.35 ,$652.77 ,$255.89 ,$261.00 ,$641.25 ,$607.05 ,$607.05 ,$255.89 ,$607.05 ,$726.75 ,$726.75 ,$726.75 , N/A ,$652.77 ,$726.75 ,$255.89 ,$855.00 ,$479.66 ,$255.89 ,$353.97 , N/A , N/A ,$255.89 ,$726.75 ,$548.32 ,$509.58 ,$239.40 ,$769.50 ,$255.89 ,$726.75 ,$342.00 ,$342.00 ,$255.89 ,$555.75 ST. JOSEPH'S HOSPITAL - BREESE,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$179.00 ,$128.88 ,$50.12 ,$179.00 ,$138.00 ,$116.35 ,$106.86 ,$54.10 ,$50.12 ,$118.50 ,$54.10 ,$118.50 ,$54.10 ,$106.68 ,$106.68 ,$54.10 ,$106.68 ,$111.50 ,$137.83 ,$138.00 ,$54.10 ,$55.17 ,$134.25 ,$127.09 ,$127.09 ,$54.10 ,$127.09 ,$152.15 ,$152.15 ,$152.15 , N/A ,$138.00 ,$152.15 ,$54.10 ,$179.00 ,$100.42 ,$54.10 ,$74.11 , N/A , N/A ,$54.10 ,$152.15 ,$115.92 ,$106.68 ,$50.12 ,$161.10 ,$54.10 ,$152.15 ,$179.00 ,$179.00 ,$54.10 ,$116.35 ST. JOSEPH'S HOSPITAL - BREESE,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$269.00 ,$193.68 ,$54.10 ,$269.00 ,$138.00 ,$174.85 ,$160.59 ,$54.10 ,$75.32 ,$178.08 ,$54.10 ,$178.08 ,$54.10 ,$160.32 ,$160.32 ,$54.10 ,$160.32 ,$111.50 ,$207.13 ,$138.00 ,$54.10 ,$55.17 ,$201.75 ,$190.99 ,$190.99 ,$54.10 ,$190.99 ,$228.65 ,$228.65 ,$228.65 , N/A ,$138.00 ,$228.65 ,$54.10 ,$269.00 ,$150.91 ,$54.10 ,$111.37 , N/A , N/A ,$54.10 ,$228.65 ,$115.92 ,$160.32 ,$75.32 ,$242.10 ,$54.10 ,$228.65 ,$269.00 ,$269.00 ,$54.10 ,$174.85 ST. JOSEPH'S HOSPITAL - BREESE,45000293,11440,HC EXCISION LESION BENIGN FACE/EAR<0.5CM,450,1 ,"$1,891.00 ","$1,361.52 ",$342.00 ,"$1,891.00 ","$1,558.08 ","$1,229.15 ","$1,128.93 ",$610.77 ,$529.48 ,"$1,251.84 ",$610.77 ,"$1,251.84 ",$610.77 ,"$1,127.04 ","$1,127.04 ",$610.77 ,"$1,127.04 ","$1,258.93 ","$1,456.07 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,418.25 ","$1,342.61 ","$1,342.61 ",$610.77 ,"$1,342.61 ","$1,607.35 ","$1,607.35 ","$1,607.35 ", N/A ,"$1,558.08 ","$1,607.35 ",$610.77 ,"$1,891.00 ","$1,060.85 ",$610.77 ,$782.87 , N/A , N/A ,$610.77 ,"$1,607.35 ","$1,308.79 ","$1,127.04 ",$529.48 ,"$1,701.90 ",$610.77 ,"$1,607.35 ",$342.00 ,$342.00 ,$610.77 ,"$1,229.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000301,24200,HC REMOVE FOREIGN BODY UPPER ARM/ELBOW SUBQ,450,1 ,"$1,975.00 ","$1,422.00 ",$342.00 ,"$3,600.20 ","$3,600.20 ","$1,283.75 ","$1,179.08 ","$1,411.28 ",$553.00 ,"$1,307.45 ","$1,411.28 ","$1,307.45 ","$1,411.28 ","$1,177.10 ","$1,177.10 ","$1,411.28 ","$1,177.10 ","$1,975.00 ","$1,520.75 ","$3,600.19 ","$1,411.28 ","$1,439.50 ","$1,481.25 ","$1,402.25 ","$1,402.25 ","$1,411.28 ","$1,402.25 ","$1,678.75 ","$1,678.75 ","$1,678.75 ", N/A ,"$1,975.00 ","$1,678.75 ","$1,411.28 ","$1,975.00 ","$1,107.98 ","$1,411.28 ",$817.65 , N/A , N/A ,"$1,411.28 ","$1,678.75 ","$3,024.16 ","$1,177.10 ",$553.00 ,"$1,777.50 ","$1,411.28 ","$1,678.75 ",$342.00 ,$342.00 ,"$1,411.28 ","$1,283.75 " ST. JOSEPH'S HOSPITAL - BREESE,45000302,24565,HC CLOSED TX HUMERUS EPICONDYLR FX W/MANIP,450,1 ,$480.00 ,$345.60 ,$134.40 ,"$3,444.08 ","$3,444.08 ",$312.00 ,$286.56 ,"$1,350.08 ",$134.40 ,$317.76 ,"$1,350.08 ",$317.76 ,$470.40 ,$286.08 ,$286.08 ,$470.40 ,$286.08 ,$480.00 ,$369.60 ,"$3,444.07 ","$1,350.08 ",$470.40 ,$360.00 ,$340.80 ,$340.80 ,"$1,350.08 ",$340.80 ,$408.00 ,$408.00 ,$408.00 , N/A ,$480.00 ,$408.00 ,$470.40 ,$480.00 ,$269.28 ,"$1,350.08 ",$198.72 , N/A , N/A ,"$1,350.08 ",$408.00 ,"$2,893.02 ",$286.08 ,$134.40 ,$432.00 ,"$1,350.08 ",$408.00 ,$342.00 ,$342.00 ,"$1,350.08 ",$312.00 ST. JOSEPH'S HOSPITAL - BREESE,45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,$711.00 ,$511.92 ,$194.82 ,$711.00 ,$497.00 ,$462.15 ,$424.47 ,$194.82 ,$199.08 ,$470.68 ,$194.82 ,$470.68 ,$194.82 ,$423.76 ,$423.76 ,$194.82 ,$423.76 ,$401.58 ,$547.47 ,$497.00 ,$194.82 ,$198.72 ,$533.25 ,$504.81 ,$504.81 ,$194.82 ,$504.81 ,$604.35 ,$604.35 ,$604.35 , N/A ,$497.00 ,$604.35 ,$194.82 ,$711.00 ,$398.87 ,$194.82 ,$294.35 , N/A , N/A ,$194.82 ,$604.35 ,$417.48 ,$423.76 ,$199.08 ,$639.90 ,$194.82 ,$604.35 ,$342.00 ,$342.00 ,$194.82 ,$462.15 ST. JOSEPH'S HOSPITAL - BREESE,45000310,31505,HC LARYNGOSCOPY INDIRECT,450,1 ,$493.00 ,$354.96 ,$138.04 ,$493.00 ,$429.15 ,$320.45 ,$294.32 ,$168.23 ,$138.04 ,$326.37 ,$168.23 ,$326.37 ,$168.23 ,$293.83 ,$293.83 ,$168.23 ,$293.83 ,$346.75 ,$379.61 ,$429.15 ,$168.23 ,$171.59 ,$369.75 ,$350.03 ,$350.03 ,$168.23 ,$350.03 ,$419.05 ,$419.05 ,$419.05 , N/A ,$429.15 ,$419.05 ,$168.23 ,$493.00 ,$276.57 ,$168.23 ,$204.10 , N/A , N/A ,$168.23 ,$419.05 ,$360.49 ,$293.83 ,$138.04 ,$443.70 ,$168.23 ,$419.05 ,$342.00 ,$342.00 ,$168.23 ,$320.45 ST. JOSEPH'S HOSPITAL - BREESE,45000325,24655,HC CLOSED TX FX RADIAL HEAD/NECK W/MANIP,450,1 ,"$4,506.00 ","$3,244.32 ",$342.00 ,"$4,506.00 ","$3,444.08 ","$2,928.90 ","$2,690.08 ","$1,350.08 ","$1,261.68 ","$2,982.97 ","$1,350.08 ","$2,982.97 ","$1,350.08 ","$2,685.58 ","$2,685.58 ","$1,350.08 ","$2,685.58 ","$2,782.81 ","$3,469.62 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,379.50 ","$3,199.26 ","$3,199.26 ","$1,350.08 ","$3,199.26 ","$3,830.10 ","$3,830.10 ","$3,830.10 ", N/A ,"$3,444.07 ","$3,830.10 ","$1,350.08 ","$4,506.00 ","$2,527.87 ","$1,350.08 ","$1,865.48 ", N/A , N/A ,"$1,350.08 ","$3,830.10 ","$2,893.02 ","$2,685.58 ","$1,261.68 ","$4,055.40 ","$1,350.08 ","$3,830.10 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,928.90 " ST. JOSEPH'S HOSPITAL - BREESE,45000327,26765,HC TX FX OPEN FINGER/THUMB W/INT FIX EACH,450,1 ,"$5,980.00 ","$4,305.60 ",$342.00 ,"$7,146.53 ","$7,146.53 ","$3,887.00 ","$3,570.06 ","$2,801.44 ","$1,674.40 ","$3,958.76 ","$2,801.44 ","$3,958.76 ","$2,801.44 ","$3,564.08 ","$3,564.08 ","$2,801.44 ","$3,564.08 ","$5,774.38 ","$4,604.60 ","$7,146.51 ","$2,801.44 ","$2,857.46 ","$4,485.00 ","$4,245.80 ","$4,245.80 ","$2,801.44 ","$4,245.80 ","$5,083.00 ","$5,083.00 ","$5,083.00 ", N/A ,"$5,980.00 ","$5,083.00 ","$2,801.44 ","$5,980.00 ","$3,354.78 ","$2,801.44 ","$2,475.72 ", N/A , N/A ,"$2,801.44 ","$5,083.00 ","$6,003.07 ","$3,564.08 ","$1,674.40 ","$5,382.00 ","$2,801.44 ","$5,083.00 ",$342.00 ,$342.00 ,"$2,801.44 ","$3,887.00 " ST. JOSEPH'S HOSPITAL - BREESE,45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,$975.00 ,$702.00 ,$194.82 ,$975.00 ,$497.00 ,$633.75 ,$582.08 ,$194.82 ,$273.00 ,$645.45 ,$194.82 ,$645.45 ,$194.82 ,$581.10 ,$581.10 ,$194.82 ,$581.10 ,$401.58 ,$750.75 ,$497.00 ,$194.82 ,$198.72 ,$731.25 ,$692.25 ,$692.25 ,$194.82 ,$692.25 ,$828.75 ,$828.75 ,$828.75 , N/A ,$497.00 ,$828.75 ,$194.82 ,$975.00 ,$546.98 ,$194.82 ,$403.65 , N/A , N/A ,$194.82 ,$828.75 ,$417.48 ,$581.10 ,$273.00 ,$877.50 ,$194.82 ,$828.75 ,$342.00 ,$342.00 ,$194.82 ,$633.75 ST. JOSEPH'S HOSPITAL - BREESE,45000329,27752,HC CLSD TX FX TIBIAL SHAFT W/MANIP,450,1 ,"$4,676.00 ","$3,366.72 ",$342.00 ,"$4,676.00 ","$3,444.08 ","$3,039.40 ","$2,791.57 ","$1,350.08 ","$1,309.28 ","$3,095.51 ","$1,350.08 ","$3,095.51 ","$1,350.08 ","$2,786.90 ","$2,786.90 ","$1,350.08 ","$2,786.90 ","$2,782.81 ","$3,600.52 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,507.00 ","$3,319.96 ","$3,319.96 ","$1,350.08 ","$3,319.96 ","$3,974.60 ","$3,974.60 ","$3,974.60 ", N/A ,"$3,444.07 ","$3,974.60 ","$1,350.08 ","$4,676.00 ","$2,623.24 ","$1,350.08 ","$1,935.86 ", N/A , N/A ,"$1,350.08 ","$3,974.60 ","$2,893.02 ","$2,786.90 ","$1,309.28 ","$4,208.40 ","$1,350.08 ","$3,974.60 ",$342.00 ,$342.00 ,"$1,350.08 ","$3,039.40 " ST. JOSEPH'S HOSPITAL - BREESE,45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,$668.00 ,$480.96 ,$187.04 ,$668.00 ,$497.00 ,$434.20 ,$398.80 ,$194.82 ,$187.04 ,$442.22 ,$194.82 ,$442.22 ,$194.82 ,$398.13 ,$398.13 ,$194.82 ,$398.13 ,$401.58 ,$514.36 ,$497.00 ,$194.82 ,$198.72 ,$501.00 ,$474.28 ,$474.28 ,$194.82 ,$474.28 ,$567.80 ,$567.80 ,$567.80 , N/A ,$497.00 ,$567.80 ,$194.82 ,$668.00 ,$374.75 ,$194.82 ,$276.55 , N/A , N/A ,$194.82 ,$567.80 ,$417.48 ,$398.13 ,$187.04 ,$601.20 ,$194.82 ,$567.80 ,$342.00 ,$342.00 ,$194.82 ,$434.20 ST. JOSEPH'S HOSPITAL - BREESE,45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,"$1,003.00 ",$722.16 ,$280.84 ,"$1,003.00 ",$745.50 ,$651.95 ,$598.79 ,$292.24 ,$280.84 ,$663.99 ,$292.24 ,$663.99 ,$292.24 ,$597.79 ,$597.79 ,$292.24 ,$597.79 ,$602.36 ,$772.31 ,$745.50 ,$292.24 ,$298.08 ,$752.25 ,$712.13 ,$712.13 ,$292.24 ,$712.13 ,$852.55 ,$852.55 ,$852.55 , N/A ,$745.50 ,$852.55 ,$292.24 ,"$1,003.00 ",$562.68 ,$292.24 ,$415.24 , N/A , N/A ,$292.24 ,$852.55 ,$626.22 ,$597.79 ,$280.84 ,$902.70 ,$292.24 ,$852.55 ,$342.00 ,$342.00 ,$292.24 ,$651.95 ST. JOSEPH'S HOSPITAL - BREESE,45000335,29530,HC STRAPPING KNEE,450,1 ,$230.00 ,$165.60 ,$64.40 ,$278.78 ,$278.78 ,$149.50 ,$137.31 ,$109.28 ,$64.40 ,$152.26 ,$109.28 ,$152.26 ,$109.28 ,$137.08 ,$137.08 ,$109.28 ,$137.08 ,$225.24 ,$177.10 ,$278.76 ,$109.28 ,$111.47 ,$172.50 ,$163.30 ,$163.30 ,$109.28 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$230.00 ,$195.50 ,$109.28 ,$230.00 ,$129.03 ,$109.28 ,$95.22 , N/A , N/A ,$109.28 ,$195.50 ,$234.16 ,$137.08 ,$64.40 ,$207.00 ,$109.28 ,$195.50 ,$230.00 ,$230.00 ,$109.28 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,45000346,23625,HC CLOSED TX GR TUBER HUM FX W/MANIP,450,1 ,"$4,560.00 ","$3,283.20 ",$342.00 ,"$4,560.00 ","$3,444.08 ","$2,964.00 ","$2,722.32 ","$1,350.08 ","$1,276.80 ","$3,018.72 ","$1,350.08 ","$3,018.72 ","$1,350.08 ","$2,717.76 ","$2,717.76 ","$1,350.08 ","$2,717.76 ","$2,782.81 ","$3,511.20 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,420.00 ","$3,237.60 ","$3,237.60 ","$1,350.08 ","$3,237.60 ","$3,876.00 ","$3,876.00 ","$3,876.00 ", N/A ,"$3,444.07 ","$3,876.00 ","$1,350.08 ","$4,560.00 ","$2,558.16 ","$1,350.08 ","$1,887.84 ", N/A , N/A ,"$1,350.08 ","$3,876.00 ","$2,893.02 ","$2,717.76 ","$1,276.80 ","$4,104.00 ","$1,350.08 ","$3,876.00 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,964.00 " ST. JOSEPH'S HOSPITAL - BREESE,45000431,32551,HC TUBE THORACOSTOMY-LT,450,1 ,"$5,377.00 ","$3,871.44 ",$342.00 ,"$5,377.00 ","$3,572.10 ","$3,495.05 ","$3,210.07 ","$1,400.26 ","$1,505.56 ","$3,559.57 ","$1,400.26 ","$3,559.57 ","$1,400.26 ","$3,204.69 ","$3,204.69 ","$1,400.26 ","$3,204.69 ","$2,886.26 ","$4,140.29 ","$3,572.10 ","$1,400.26 ","$1,428.27 ","$4,032.75 ","$3,817.67 ","$3,817.67 ","$1,400.26 ","$3,817.67 ","$4,570.45 ","$4,570.45 ","$4,570.45 ", N/A ,"$3,572.10 ","$4,570.45 ","$1,400.26 ","$5,377.00 ","$3,016.50 ","$1,400.26 ","$2,226.08 ", N/A , N/A ,"$1,400.26 ","$4,570.45 ","$3,000.57 ","$3,204.69 ","$1,505.56 ","$4,839.30 ","$1,400.26 ","$4,570.45 ",$342.00 ,$342.00 ,"$1,400.26 ","$3,495.05 " ST. JOSEPH'S HOSPITAL - BREESE,45000432,32551,HC TUBE THORACOSTOMY-RT,450,1 ,"$5,377.00 ","$3,871.44 ",$342.00 ,"$5,377.00 ","$3,572.10 ","$3,495.05 ","$3,210.07 ","$1,400.26 ","$1,505.56 ","$3,559.57 ","$1,400.26 ","$3,559.57 ","$1,400.26 ","$3,204.69 ","$3,204.69 ","$1,400.26 ","$3,204.69 ","$2,886.26 ","$4,140.29 ","$3,572.10 ","$1,400.26 ","$1,428.27 ","$4,032.75 ","$3,817.67 ","$3,817.67 ","$1,400.26 ","$3,817.67 ","$4,570.45 ","$4,570.45 ","$4,570.45 ", N/A ,"$3,572.10 ","$4,570.45 ","$1,400.26 ","$5,377.00 ","$3,016.50 ","$1,400.26 ","$2,226.08 ", N/A , N/A ,"$1,400.26 ","$4,570.45 ","$3,000.57 ","$3,204.69 ","$1,505.56 ","$4,839.30 ","$1,400.26 ","$4,570.45 ",$342.00 ,$342.00 ,"$1,400.26 ","$3,495.05 " ST. JOSEPH'S HOSPITAL - BREESE,45000439,64450,HC INJ ANES OTHER THAN PERIPHERAL-LT,450,1 ,"$2,067.00 ","$1,488.24 ",$342.00 ,"$2,067.00 ","$1,546.98 ","$1,343.55 ","$1,234.00 ",$606.41 ,$578.76 ,"$1,368.35 ",$606.41 ,"$1,368.35 ",$606.41 ,"$1,231.93 ","$1,231.93 ",$606.41 ,"$1,231.93 ","$1,249.95 ","$1,591.59 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,550.25 ","$1,467.57 ","$1,467.57 ",$606.41 ,"$1,467.57 ","$1,756.95 ","$1,756.95 ","$1,756.95 ", N/A ,"$1,546.96 ","$1,756.95 ",$606.41 ,"$2,067.00 ","$1,159.59 ",$606.41 ,$855.74 , N/A , N/A ,$606.41 ,"$1,756.95 ","$1,299.45 ","$1,231.93 ",$578.76 ,"$1,860.30 ",$606.41 ,"$1,756.95 ",$342.00 ,$342.00 ,$606.41 ,"$1,343.55 " ST. JOSEPH'S HOSPITAL - BREESE,45000440,64450,HC INJ ANES OTHER THAN PERIPHERAL-RT,450,1 ,"$2,067.00 ","$1,488.24 ",$342.00 ,"$2,067.00 ","$1,546.98 ","$1,343.55 ","$1,234.00 ",$606.41 ,$578.76 ,"$1,368.35 ",$606.41 ,"$1,368.35 ",$606.41 ,"$1,231.93 ","$1,231.93 ",$606.41 ,"$1,231.93 ","$1,249.95 ","$1,591.59 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,550.25 ","$1,467.57 ","$1,467.57 ",$606.41 ,"$1,467.57 ","$1,756.95 ","$1,756.95 ","$1,756.95 ", N/A ,"$1,546.96 ","$1,756.95 ",$606.41 ,"$2,067.00 ","$1,159.59 ",$606.41 ,$855.74 , N/A , N/A ,$606.41 ,"$1,756.95 ","$1,299.45 ","$1,231.93 ",$578.76 ,"$1,860.30 ",$606.41 ,"$1,756.95 ",$342.00 ,$342.00 ,$606.41 ,"$1,343.55 " ST. JOSEPH'S HOSPITAL - BREESE,45000451,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-LT,450,1 ,"$2,011.00 ","$1,447.92 ",$342.00 ,"$2,011.00 ","$1,558.08 ","$1,307.15 ","$1,200.57 ",$610.77 ,$563.08 ,"$1,331.28 ",$610.77 ,"$1,331.28 ",$610.77 ,"$1,198.56 ","$1,198.56 ",$610.77 ,"$1,198.56 ","$1,258.93 ","$1,548.47 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,508.25 ","$1,427.81 ","$1,427.81 ",$610.77 ,"$1,427.81 ","$1,709.35 ","$1,709.35 ","$1,709.35 ", N/A ,"$1,558.08 ","$1,709.35 ",$610.77 ,"$2,011.00 ","$1,128.17 ",$610.77 ,$832.55 , N/A , N/A ,$610.77 ,"$1,709.35 ","$1,308.79 ","$1,198.56 ",$563.08 ,"$1,809.90 ",$610.77 ,"$1,709.35 ",$342.00 ,$342.00 ,$610.77 ,"$1,307.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000452,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-RT,450,1 ,"$2,011.00 ","$1,447.92 ",$342.00 ,"$2,011.00 ","$1,558.08 ","$1,307.15 ","$1,200.57 ",$610.77 ,$563.08 ,"$1,331.28 ",$610.77 ,"$1,331.28 ",$610.77 ,"$1,198.56 ","$1,198.56 ",$610.77 ,"$1,198.56 ","$1,258.93 ","$1,548.47 ","$1,558.08 ",$610.77 ,$622.99 ,"$1,508.25 ","$1,427.81 ","$1,427.81 ",$610.77 ,"$1,427.81 ","$1,709.35 ","$1,709.35 ","$1,709.35 ", N/A ,"$1,558.08 ","$1,709.35 ",$610.77 ,"$2,011.00 ","$1,128.17 ",$610.77 ,$832.55 , N/A , N/A ,$610.77 ,"$1,709.35 ","$1,308.79 ","$1,198.56 ",$563.08 ,"$1,809.90 ",$610.77 ,"$1,709.35 ",$342.00 ,$342.00 ,$610.77 ,"$1,307.15 " ST. JOSEPH'S HOSPITAL - BREESE,45000467,27842,HC CLOSED TX ANKLE DISLOC W/ANESTH W/W/O FIXATION,450,1 ,"$1,474.00 ","$1,061.28 ",$342.00 ,"$3,444.08 ","$3,444.08 ",$958.10 ,$879.98 ,"$1,350.08 ",$412.72 ,$975.79 ,"$1,350.08 ",$975.79 ,"$1,350.08 ",$878.50 ,$878.50 ,"$1,350.08 ",$878.50 ,"$1,474.00 ","$1,134.98 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$1,105.50 ","$1,046.54 ","$1,046.54 ","$1,350.08 ","$1,046.54 ","$1,252.90 ","$1,252.90 ","$1,252.90 ", N/A ,"$1,474.00 ","$1,252.90 ","$1,350.08 ","$1,474.00 ",$826.91 ,"$1,350.08 ",$610.24 , N/A , N/A ,"$1,350.08 ","$1,252.90 ","$2,893.02 ",$878.50 ,$412.72 ,"$1,326.60 ","$1,350.08 ","$1,252.90 ",$342.00 ,$342.00 ,"$1,350.08 ",$958.10 ST. JOSEPH'S HOSPITAL - BREESE,45000493,36600,HC ARTERIAL PUNCTURE,450,1 ,$360.00 ,$259.20 ,$100.80 ,$360.00 ,$278.78 ,$234.00 ,$214.92 ,$109.28 ,$100.80 ,$238.32 ,$109.28 ,$238.32 ,$109.28 ,$214.56 ,$214.56 ,$109.28 ,$214.56 ,$225.24 ,$277.20 ,$278.76 ,$109.28 ,$111.47 ,$270.00 ,$255.60 ,$255.60 ,$109.28 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$278.76 ,$306.00 ,$109.28 ,$360.00 ,$201.96 ,$109.28 ,$149.04 , N/A , N/A ,$109.28 ,$306.00 ,$234.16 ,$214.56 ,$100.80 ,$324.00 ,$109.28 ,$306.00 ,$342.00 ,$342.00 ,$109.28 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,45000497,27086,HC REMOVE FB PELVIS/HIP SUBQ TISSUE,450,1 ,"$5,812.00 ","$4,184.64 ",$342.00 ,"$6,202.00 ","$6,202.00 ","$3,777.80 ","$3,469.76 ","$2,431.18 ","$1,627.36 ","$3,847.54 ","$2,431.18 ","$3,847.54 ","$2,431.18 ","$3,463.95 ","$3,463.95 ","$2,431.18 ","$3,463.95 ","$5,011.21 ","$4,475.24 ","$6,202.00 ","$2,431.18 ","$2,479.80 ","$4,359.00 ","$4,126.52 ","$4,126.52 ","$2,431.18 ","$4,126.52 ","$4,940.20 ","$4,940.20 ","$4,940.20 ", N/A ,"$5,812.00 ","$4,940.20 ","$2,431.18 ","$5,812.00 ","$3,260.53 ","$2,431.18 ","$2,406.17 ", N/A , N/A ,"$2,431.18 ","$4,940.20 ","$5,209.68 ","$3,463.95 ","$1,627.36 ","$5,230.80 ","$2,431.18 ","$4,940.20 ",$342.00 ,$342.00 ,"$2,431.18 ","$3,777.80 " ST. JOSEPH'S HOSPITAL - BREESE,45000500,57200,HC REPAIR SUTURE VAGINA COLPORRHAPHY,450,1 ,"$7,759.89 ","$5,587.12 ",$342.00 ,"$7,759.89 ","$6,788.25 ","$5,043.93 ","$4,632.65 ","$2,660.99 ","$2,172.77 ","$5,137.05 ","$2,660.99 ","$5,137.05 ","$2,660.99 ","$4,624.89 ","$4,624.89 ","$2,660.99 ","$4,624.89 ","$5,484.91 ","$5,975.12 ","$6,788.26 ","$2,660.99 ","$2,714.22 ","$5,819.92 ","$5,509.52 ","$5,509.52 ","$2,660.99 ","$5,509.52 ","$6,595.91 ","$6,595.91 ","$6,595.91 ", N/A ,"$6,788.26 ","$6,595.91 ","$2,660.99 ","$7,759.89 ","$4,353.30 ","$2,660.99 ","$3,212.59 ", N/A , N/A ,"$2,660.99 ","$6,595.91 ","$5,702.14 ","$4,624.89 ","$2,172.77 ","$6,983.90 ","$2,660.99 ","$6,595.91 ",$342.00 ,$342.00 ,"$2,660.99 ","$5,043.93 " ST. JOSEPH'S HOSPITAL - BREESE,45000515,32551,HC TUBE THORACOSTOMY-BIL,450,1 ,"$8,066.00 ","$5,807.52 ",$342.00 ,"$8,066.00 ","$7,152.05 ","$5,242.90 ","$4,815.40 ","$2,803.60 ","$2,258.48 ","$5,339.69 ","$2,803.60 ","$5,339.69 ","$2,803.60 ","$4,807.34 ","$4,807.34 ","$2,803.60 ","$4,807.34 ","$5,778.86 ","$6,210.82 ","$7,152.06 ","$2,803.60 ","$2,859.68 ","$6,049.50 ","$5,726.86 ","$5,726.86 ","$2,803.60 ","$5,726.86 ","$6,856.10 ","$6,856.10 ","$6,856.10 ", N/A ,"$7,152.06 ","$6,856.10 ","$2,803.60 ","$8,066.00 ","$4,525.03 ","$2,803.60 ","$3,339.32 ", N/A , N/A ,"$2,803.60 ","$6,856.10 ","$6,007.73 ","$4,807.34 ","$2,258.48 ","$7,259.40 ","$2,803.60 ","$6,856.10 ",$342.00 ,$342.00 ,"$2,803.60 ","$5,242.90 " ST. JOSEPH'S HOSPITAL - BREESE,45000516,26775,HC TX DISLOC I-P JOINT W/ANES/MAN,450,1 ,$854.00 ,$614.88 ,$225.79 ,$854.00 ,$576.00 ,$555.10 ,$509.84 ,$225.79 ,$239.12 ,$565.35 ,$225.79 ,$565.35 ,$225.79 ,$508.98 ,$508.98 ,$225.79 ,$508.98 ,$465.40 ,$657.58 ,$575.99 ,$225.79 ,$230.30 ,$640.50 ,$606.34 ,$606.34 ,$225.79 ,$606.34 ,$725.90 ,$725.90 ,$725.90 , N/A ,$575.99 ,$725.90 ,$225.79 ,$854.00 ,$479.09 ,$225.79 ,$353.56 , N/A , N/A ,$225.79 ,$725.90 ,$483.83 ,$508.98 ,$239.12 ,$768.60 ,$225.79 ,$725.90 ,$342.00 ,$342.00 ,$225.79 ,$555.10 ST. JOSEPH'S HOSPITAL - BREESE,45000518,27200,HC TX FX COCCYGEAL CLOSED,450,1 ,$708.00 ,$509.76 ,$194.82 ,$708.00 ,$497.00 ,$460.20 ,$422.68 ,$194.82 ,$198.24 ,$468.70 ,$194.82 ,$468.70 ,$194.82 ,$421.97 ,$421.97 ,$194.82 ,$421.97 ,$401.58 ,$545.16 ,$497.00 ,$194.82 ,$198.72 ,$531.00 ,$502.68 ,$502.68 ,$194.82 ,$502.68 ,$601.80 ,$601.80 ,$601.80 , N/A ,$497.00 ,$601.80 ,$194.82 ,$708.00 ,$397.19 ,$194.82 ,$293.11 , N/A , N/A ,$194.82 ,$601.80 ,$417.48 ,$421.97 ,$198.24 ,$637.20 ,$194.82 ,$601.80 ,$342.00 ,$342.00 ,$194.82 ,$460.20 ST. JOSEPH'S HOSPITAL - BREESE,45000548,29425,HC APPLY SHORT LEG CAST WALKING,450,1 ,$854.00 ,$614.88 ,$225.79 ,$854.00 ,$576.00 ,$555.10 ,$509.84 ,$225.79 ,$239.12 ,$565.35 ,$225.79 ,$565.35 ,$225.79 ,$508.98 ,$508.98 ,$225.79 ,$508.98 ,$465.40 ,$657.58 ,$575.99 ,$225.79 ,$230.30 ,$640.50 ,$606.34 ,$606.34 ,$225.79 ,$606.34 ,$725.90 ,$725.90 ,$725.90 , N/A ,$575.99 ,$725.90 ,$225.79 ,$854.00 ,$479.09 ,$225.79 ,$353.56 , N/A , N/A ,$225.79 ,$725.90 ,$483.83 ,$508.98 ,$239.12 ,$768.60 ,$225.79 ,$725.90 ,$342.00 ,$342.00 ,$225.79 ,$555.10 ST. JOSEPH'S HOSPITAL - BREESE,45001165,45915,HC REMOVE IMPACTED FECAL/FB W/ANES,450,1 ,"$3,578.00 ","$2,576.16 ",$342.00 ,"$3,578.00 ","$2,599.90 ","$2,325.70 ","$2,136.07 ","$1,019.16 ","$1,001.84 ","$2,368.64 ","$1,019.16 ","$2,368.64 ","$1,019.16 ","$2,132.49 ","$2,132.49 ","$1,019.16 ","$2,132.49 ","$2,100.72 ","$2,755.06 ","$2,599.90 ","$1,019.16 ","$1,039.54 ","$2,683.50 ","$2,540.38 ","$2,540.38 ","$1,019.16 ","$2,540.38 ","$3,041.30 ","$3,041.30 ","$3,041.30 ", N/A ,"$2,599.90 ","$3,041.30 ","$1,019.16 ","$3,578.00 ","$2,007.26 ","$1,019.16 ","$1,481.29 ", N/A , N/A ,"$1,019.16 ","$3,041.30 ","$2,183.92 ","$2,132.49 ","$1,001.84 ","$3,220.20 ","$1,019.16 ","$3,041.30 ",$342.00 ,$342.00 ,"$1,019.16 ","$2,325.70 " ST. JOSEPH'S HOSPITAL - BREESE,45001168,52281,HC CYSTOURETHROSCOPY W/CALIBRATION/DILATION,450,1 ,"$5,106.00 ","$3,676.32 ",$342.00 ,"$5,106.00 ","$4,453.30 ","$3,318.90 ","$3,048.28 ","$1,745.69 ","$1,429.68 ","$3,380.17 ","$1,745.69 ","$3,380.17 ","$1,745.69 ","$3,043.18 ","$3,043.18 ","$1,745.69 ","$3,043.18 ","$3,598.26 ","$3,931.62 ","$4,453.29 ","$1,745.69 ","$1,780.60 ","$3,829.50 ","$3,625.26 ","$3,625.26 ","$1,745.69 ","$3,625.26 ","$4,340.10 ","$4,340.10 ","$4,340.10 ", N/A ,"$4,453.29 ","$4,340.10 ","$1,745.69 ","$5,106.00 ","$2,864.47 ","$1,745.69 ","$2,113.88 ", N/A , N/A ,"$1,745.69 ","$4,340.10 ","$3,740.76 ","$3,043.18 ","$1,429.68 ","$4,595.40 ","$1,745.69 ","$4,340.10 ",$342.00 ,$342.00 ,"$1,745.69 ","$3,318.90 " ST. JOSEPH'S HOSPITAL - BREESE,45001169,54235,HC INJ PENILE W/RX AGENT,450,1 ,$872.00 ,$627.84 ,$202.22 ,$872.00 ,$515.88 ,$566.80 ,$520.58 ,$202.22 ,$244.16 ,$577.26 ,$202.22 ,$577.26 ,$202.22 ,$519.71 ,$519.71 ,$202.22 ,$519.71 ,$416.82 ,$671.44 ,$515.87 ,$202.22 ,$206.27 ,$654.00 ,$619.12 ,$619.12 ,$202.22 ,$619.12 ,$741.20 ,$741.20 ,$741.20 , N/A ,$515.87 ,$741.20 ,$202.22 ,$872.00 ,$489.19 ,$202.22 ,$361.01 , N/A , N/A ,$202.22 ,$741.20 ,$433.33 ,$519.71 ,$244.16 ,$784.80 ,$202.22 ,$741.20 ,$342.00 ,$342.00 ,$202.22 ,$566.80 ST. JOSEPH'S HOSPITAL - BREESE,45001272,23665,HC TX FX DISLOC SHOULDER HUMERW/MANIP,450,1 ,"$4,559.00 ","$3,282.48 ",$342.00 ,"$4,559.00 ","$3,444.08 ","$2,963.35 ","$2,721.72 ","$1,350.08 ","$1,276.52 ","$3,018.06 ","$1,350.08 ","$3,018.06 ","$1,350.08 ","$2,717.16 ","$2,717.16 ","$1,350.08 ","$2,717.16 ","$2,782.81 ","$3,510.43 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,419.25 ","$3,236.89 ","$3,236.89 ","$1,350.08 ","$3,236.89 ","$3,875.15 ","$3,875.15 ","$3,875.15 ", N/A ,"$3,444.07 ","$3,875.15 ","$1,350.08 ","$4,559.00 ","$2,557.60 ","$1,350.08 ","$1,887.43 ", N/A , N/A ,"$1,350.08 ","$3,875.15 ","$2,893.02 ","$2,717.16 ","$1,276.52 ","$4,103.10 ","$1,350.08 ","$3,875.15 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,963.35 " ST. JOSEPH'S HOSPITAL - BREESE,45001273,23675,HC TX FX DISLOC SHOULDER W/PROX HUM W/MANIP,450,1 ,"$4,469.00 ","$3,217.68 ",$342.00 ,"$4,469.00 ","$3,444.08 ","$2,904.85 ","$2,667.99 ","$1,350.08 ","$1,251.32 ","$2,958.48 ","$1,350.08 ","$2,958.48 ","$1,350.08 ","$2,663.52 ","$2,663.52 ","$1,350.08 ","$2,663.52 ","$2,782.81 ","$3,441.13 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,351.75 ","$3,172.99 ","$3,172.99 ","$1,350.08 ","$3,172.99 ","$3,798.65 ","$3,798.65 ","$3,798.65 ", N/A ,"$3,444.07 ","$3,798.65 ","$1,350.08 ","$4,469.00 ","$2,507.11 ","$1,350.08 ","$1,850.17 ", N/A , N/A ,"$1,350.08 ","$3,798.65 ","$2,893.02 ","$2,663.52 ","$1,251.32 ","$4,022.10 ","$1,350.08 ","$3,798.65 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,904.85 " ST. JOSEPH'S HOSPITAL - BREESE,45001277,24577,HC TX FX HUMERUS CONDYLAR W/MANIP CLOSED,450,1 ,"$4,560.00 ","$3,283.20 ",$342.00 ,"$4,560.00 ","$3,444.08 ","$2,964.00 ","$2,722.32 ","$1,350.08 ","$1,276.80 ","$3,018.72 ","$1,350.08 ","$3,018.72 ","$1,350.08 ","$2,717.76 ","$2,717.76 ","$1,350.08 ","$2,717.76 ","$2,782.81 ","$3,511.20 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,420.00 ","$3,237.60 ","$3,237.60 ","$1,350.08 ","$3,237.60 ","$3,876.00 ","$3,876.00 ","$3,876.00 ", N/A ,"$3,444.07 ","$3,876.00 ","$1,350.08 ","$4,560.00 ","$2,558.16 ","$1,350.08 ","$1,887.84 ", N/A , N/A ,"$1,350.08 ","$3,876.00 ","$2,893.02 ","$2,717.76 ","$1,276.80 ","$4,104.00 ","$1,350.08 ","$3,876.00 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,964.00 " ST. JOSEPH'S HOSPITAL - BREESE,45001278,24675,HC TX FX CLOSED ULNA PROXIMAL W/MANIP,450,1 ,"$4,506.00 ","$3,244.32 ",$342.00 ,"$4,506.00 ","$3,444.08 ","$2,928.90 ","$2,690.08 ","$1,350.08 ","$1,261.68 ","$2,982.97 ","$1,350.08 ","$2,982.97 ","$1,350.08 ","$2,685.58 ","$2,685.58 ","$1,350.08 ","$2,685.58 ","$2,782.81 ","$3,469.62 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,379.50 ","$3,199.26 ","$3,199.26 ","$1,350.08 ","$3,199.26 ","$3,830.10 ","$3,830.10 ","$3,830.10 ", N/A ,"$3,444.07 ","$3,830.10 ","$1,350.08 ","$4,506.00 ","$2,527.87 ","$1,350.08 ","$1,865.48 ", N/A , N/A ,"$1,350.08 ","$3,830.10 ","$2,893.02 ","$2,685.58 ","$1,261.68 ","$4,055.40 ","$1,350.08 ","$3,830.10 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,928.90 " ST. JOSEPH'S HOSPITAL - BREESE,45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,"$4,895.00 ","$3,524.40 ",$342.00 ,"$4,895.00 ","$3,444.08 ","$3,181.75 ","$2,922.32 ","$1,350.08 ","$1,370.60 ","$3,240.49 ","$1,350.08 ","$3,240.49 ","$1,350.08 ","$2,917.42 ","$2,917.42 ","$1,350.08 ","$2,917.42 ","$2,782.81 ","$3,769.15 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,671.25 ","$3,475.45 ","$3,475.45 ","$1,350.08 ","$3,475.45 ","$4,160.75 ","$4,160.75 ","$4,160.75 ", N/A ,"$3,444.07 ","$4,160.75 ","$1,350.08 ","$4,895.00 ","$2,746.10 ","$1,350.08 ","$2,026.53 ", N/A , N/A ,"$1,350.08 ","$4,160.75 ","$2,893.02 ","$2,917.42 ","$1,370.60 ","$4,405.50 ","$1,350.08 ","$4,160.75 ",$342.00 ,$342.00 ,"$1,350.08 ","$3,181.75 " ST. JOSEPH'S HOSPITAL - BREESE,45001291,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION,450,1 ,"$4,649.00 ","$3,347.28 ",$342.00 ,"$4,649.00 ","$3,444.08 ","$3,021.85 ","$2,775.45 ","$1,350.08 ","$1,301.72 ","$3,077.64 ","$1,350.08 ","$3,077.64 ","$1,350.08 ","$2,770.80 ","$2,770.80 ","$1,350.08 ","$2,770.80 ","$2,782.81 ","$3,579.73 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,486.75 ","$3,300.79 ","$3,300.79 ","$1,350.08 ","$3,300.79 ","$3,951.65 ","$3,951.65 ","$3,951.65 ", N/A ,"$3,444.07 ","$3,951.65 ","$1,350.08 ","$4,649.00 ","$2,608.09 ","$1,350.08 ","$1,924.69 ", N/A , N/A ,"$1,350.08 ","$3,951.65 ","$2,893.02 ","$2,770.80 ","$1,301.72 ","$4,184.10 ","$1,350.08 ","$3,951.65 ",$342.00 ,$342.00 ,"$1,350.08 ","$3,021.85 " ST. JOSEPH'S HOSPITAL - BREESE,45001296,27762,HC TX FX CLOSED MEDIAL MALLEOLUS W/MANIP,450,1 ,"$4,559.00 ","$3,282.48 ",$342.00 ,"$4,559.00 ","$3,444.08 ","$2,963.35 ","$2,721.72 ","$1,350.08 ","$1,276.52 ","$3,018.06 ","$1,350.08 ","$3,018.06 ","$1,350.08 ","$2,717.16 ","$2,717.16 ","$1,350.08 ","$2,717.16 ","$2,782.81 ","$3,510.43 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,419.25 ","$3,236.89 ","$3,236.89 ","$1,350.08 ","$3,236.89 ","$3,875.15 ","$3,875.15 ","$3,875.15 ", N/A ,"$3,444.07 ","$3,875.15 ","$1,350.08 ","$4,559.00 ","$2,557.60 ","$1,350.08 ","$1,887.43 ", N/A , N/A ,"$1,350.08 ","$3,875.15 ","$2,893.02 ","$2,717.16 ","$1,276.52 ","$4,103.10 ","$1,350.08 ","$3,875.15 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,963.35 " ST. JOSEPH'S HOSPITAL - BREESE,45001298,27816,HC TX FX CLOSED TRIMALLEOLAR ANKLE W/O MANIP,450,1 ,$675.00 ,$486.00 ,$189.00 ,$675.00 ,$497.00 ,$438.75 ,$402.98 ,$194.82 ,$189.00 ,$446.85 ,$194.82 ,$446.85 ,$194.82 ,$402.30 ,$402.30 ,$194.82 ,$402.30 ,$401.58 ,$519.75 ,$497.00 ,$194.82 ,$198.72 ,$506.25 ,$479.25 ,$479.25 ,$194.82 ,$479.25 ,$573.75 ,$573.75 ,$573.75 , N/A ,$497.00 ,$573.75 ,$194.82 ,$675.00 ,$378.68 ,$194.82 ,$279.45 , N/A , N/A ,$194.82 ,$573.75 ,$417.48 ,$402.30 ,$189.00 ,$607.50 ,$194.82 ,$573.75 ,$342.00 ,$342.00 ,$194.82 ,$438.75 ST. JOSEPH'S HOSPITAL - BREESE,45001305,28435,HC TX FX CLOSED TALUS W/MANIP,450,1 ,"$4,119.54 ","$2,966.07 ",$342.00 ,"$4,119.54 ","$3,444.08 ","$2,677.70 ","$2,459.37 ","$1,350.08 ","$1,153.47 ","$2,727.14 ","$1,350.08 ","$2,727.14 ","$1,350.08 ","$2,455.25 ","$2,455.25 ","$1,350.08 ","$2,455.25 ","$2,782.81 ","$3,172.05 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,089.66 ","$2,924.87 ","$2,924.87 ","$1,350.08 ","$2,924.87 ","$3,501.61 ","$3,501.61 ","$3,501.61 ", N/A ,"$3,444.07 ","$3,501.61 ","$1,350.08 ","$4,119.54 ","$2,311.06 ","$1,350.08 ","$1,705.49 ", N/A , N/A ,"$1,350.08 ","$3,501.61 ","$2,893.02 ","$2,455.25 ","$1,153.47 ","$3,707.59 ","$1,350.08 ","$3,501.61 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,677.70 " ST. JOSEPH'S HOSPITAL - BREESE,45001317,67935,HC REPAIR EYELID WOUND FULL THICKNESS,450,1 ,"$7,337.00 ","$5,282.64 ",$342.00 ,"$7,337.00 ","$5,075.93 ","$4,769.05 ","$4,380.19 ","$1,989.76 ","$2,054.36 ","$4,857.09 ","$1,989.76 ","$4,857.09 ","$1,989.76 ","$4,372.85 ","$4,372.85 ","$1,989.76 ","$4,372.85 ","$4,101.35 ","$5,649.49 ","$5,075.93 ","$1,989.76 ","$2,029.56 ","$5,502.75 ","$5,209.27 ","$5,209.27 ","$1,989.76 ","$5,209.27 ","$6,236.45 ","$6,236.45 ","$6,236.45 ", N/A ,"$5,075.93 ","$6,236.45 ","$1,989.76 ","$7,337.00 ","$4,116.06 ","$1,989.76 ","$3,037.52 ", N/A , N/A ,"$1,989.76 ","$6,236.45 ","$4,263.78 ","$4,372.85 ","$2,054.36 ","$6,603.30 ","$1,989.76 ","$6,236.45 ",$342.00 ,$342.00 ,"$1,989.76 ","$4,769.05 " ST. JOSEPH'S HOSPITAL - BREESE,45001329,41005,HC I AND D INTRAORAL LESION,450,1 ,$445.00 ,$320.40 ,$124.60 ,$498.98 ,$498.98 ,$289.25 ,$265.67 ,$195.60 ,$124.60 ,$294.59 ,$195.60 ,$294.59 ,$195.60 ,$265.22 ,$265.22 ,$195.60 ,$265.22 ,$403.17 ,$342.65 ,$498.97 ,$195.60 ,$199.51 ,$333.75 ,$315.95 ,$315.95 ,$195.60 ,$315.95 ,$378.25 ,$378.25 ,$378.25 , N/A ,$445.00 ,$378.25 ,$195.60 ,$445.00 ,$249.65 ,$195.60 ,$184.23 , N/A , N/A ,$195.60 ,$378.25 ,$419.13 ,$265.22 ,$124.60 ,$400.50 ,$195.60 ,$378.25 ,$342.00 ,$342.00 ,$195.60 ,$289.25 ST. JOSEPH'S HOSPITAL - BREESE,45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$756.00 ,$544.32 ,$202.22 ,$756.00 ,$515.88 ,$491.40 ,$451.33 ,$202.22 ,$211.68 ,$500.47 ,$202.22 ,$500.47 ,$202.22 ,$450.58 ,$450.58 ,$202.22 ,$450.58 ,$416.82 ,$582.12 ,$515.87 ,$202.22 ,$206.27 ,$567.00 ,$536.76 ,$536.76 ,$202.22 ,$536.76 ,$642.60 ,$642.60 ,$642.60 , N/A ,$515.87 ,$642.60 ,$202.22 ,$756.00 ,$424.12 ,$202.22 ,$312.98 , N/A , N/A ,$202.22 ,$642.60 ,$433.33 ,$450.58 ,$211.68 ,$680.40 ,$202.22 ,$642.60 ,$342.00 ,$342.00 ,$202.22 ,$491.40 ST. JOSEPH'S HOSPITAL - BREESE,45001332,43763,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT,450,1 ,$756.00 ,$544.32 ,$202.22 ,$756.00 ,$515.88 ,$491.40 ,$451.33 ,$202.22 ,$211.68 ,$500.47 ,$202.22 ,$500.47 ,$202.22 ,$450.58 ,$450.58 ,$202.22 ,$450.58 ,$416.82 ,$582.12 ,$515.87 ,$202.22 ,$206.27 ,$567.00 ,$536.76 ,$536.76 ,$202.22 ,$536.76 ,$642.60 ,$642.60 ,$642.60 , N/A ,$515.87 ,$642.60 ,$202.22 ,$756.00 ,$424.12 ,$202.22 ,$312.98 , N/A , N/A ,$202.22 ,$642.60 ,$433.33 ,$450.58 ,$211.68 ,$680.40 ,$202.22 ,$642.60 ,$342.00 ,$342.00 ,$202.22 ,$491.40 ST. JOSEPH'S HOSPITAL - BREESE,45001341,42720,HC I AND D ABSCESS PHARYNGEAL INTRAORAL APPROACH,450,1 ,"$9,037.00 ","$6,506.64 ",$342.00 ,"$9,037.00 ","$6,830.50 ","$5,874.05 ","$5,395.09 ","$2,677.56 ","$2,530.36 ","$5,982.49 ","$2,677.56 ","$5,982.49 ","$2,677.56 ","$5,386.05 ","$5,386.05 ","$2,677.56 ","$5,386.05 ","$5,519.04 ","$6,958.49 ","$6,830.49 ","$2,677.56 ","$2,731.10 ","$6,777.75 ","$6,416.27 ","$6,416.27 ","$2,677.56 ","$6,416.27 ","$7,681.45 ","$7,681.45 ","$7,681.45 ", N/A ,"$6,830.49 ","$7,681.45 ","$2,677.56 ","$9,037.00 ","$5,069.76 ","$2,677.56 ","$3,741.32 ", N/A , N/A ,"$2,677.56 ","$7,681.45 ","$5,737.61 ","$5,386.05 ","$2,530.36 ","$8,133.30 ","$2,677.56 ","$7,681.45 ",$342.00 ,$342.00 ,"$2,677.56 ","$5,874.05 " ST. JOSEPH'S HOSPITAL - BREESE,45001347,27503,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,450,1 ,"$4,649.00 ","$3,347.28 ",$342.00 ,"$4,649.00 ","$3,444.08 ","$3,021.85 ","$2,775.45 ","$1,350.08 ","$1,301.72 ","$3,077.64 ","$1,350.08 ","$3,077.64 ","$1,350.08 ","$2,770.80 ","$2,770.80 ","$1,350.08 ","$2,770.80 ","$2,782.81 ","$3,579.73 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,486.75 ","$3,300.79 ","$3,300.79 ","$1,350.08 ","$3,300.79 ","$3,951.65 ","$3,951.65 ","$3,951.65 ", N/A ,"$3,444.07 ","$3,951.65 ","$1,350.08 ","$4,649.00 ","$2,608.09 ","$1,350.08 ","$1,924.69 ", N/A , N/A ,"$1,350.08 ","$3,951.65 ","$2,893.02 ","$2,770.80 ","$1,301.72 ","$4,184.10 ","$1,350.08 ","$3,951.65 ",$342.00 ,$342.00 ,"$1,350.08 ","$3,021.85 " ST. JOSEPH'S HOSPITAL - BREESE,45001350,P9612,HC STRAIGHT CATH FOR URINE SPECIMEN,450,1 ,$215.00 ,$154.80 ,$8.40 ,$215.00 ,$21.43 ,$139.75 ,$128.36 ,$8.40 ,$60.20 ,$142.33 ,$8.40 ,$142.33 ,$8.40 ,$128.14 ,$128.14 ,$8.40 ,$128.14 ,$17.31 ,$165.55 ,$21.43 ,$8.40 ,$8.57 ,$161.25 ,$152.65 ,$152.65 ,$8.40 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$21.43 ,$182.75 ,$8.40 ,$215.00 ,$120.62 ,$8.40 ,$89.01 , N/A , N/A ,$8.40 ,$182.75 ,$18.00 ,$128.14 ,$60.20 ,$193.50 ,$8.40 ,$182.75 ,$215.00 ,$215.00 ,$8.40 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,45001352,26545,HC RECONSTRUCT FINGER JOINT,450,1 ,"$9,024.00 ","$6,497.28 ",$342.00 ,"$9,024.00 ","$7,146.53 ","$5,865.60 ","$5,387.33 ","$2,801.44 ","$2,526.72 ","$5,973.89 ","$2,801.44 ","$5,973.89 ","$2,801.44 ","$5,378.30 ","$5,378.30 ","$2,801.44 ","$5,378.30 ","$5,774.38 ","$6,948.48 ","$7,146.51 ","$2,801.44 ","$2,857.46 ","$6,768.00 ","$6,407.04 ","$6,407.04 ","$2,801.44 ","$6,407.04 ","$7,670.40 ","$7,670.40 ","$7,670.40 ", N/A ,"$7,146.51 ","$7,670.40 ","$2,801.44 ","$9,024.00 ","$5,062.46 ","$2,801.44 ","$3,735.94 ", N/A , N/A ,"$2,801.44 ","$7,670.40 ","$6,003.07 ","$5,378.30 ","$2,526.72 ","$8,121.60 ","$2,801.44 ","$7,670.40 ",$342.00 ,$342.00 ,"$2,801.44 ","$5,865.60 " ST. JOSEPH'S HOSPITAL - BREESE,45001355,25660,HC CLTX RDCRPL/INTERCARPL DISLC 1 >BONES W MAN,450,1 ,$675.00 ,$486.00 ,$189.00 ,$675.00 ,$497.00 ,$438.75 ,$402.98 ,$194.82 ,$189.00 ,$446.85 ,$194.82 ,$446.85 ,$194.82 ,$402.30 ,$402.30 ,$194.82 ,$402.30 ,$401.58 ,$519.75 ,$497.00 ,$194.82 ,$198.72 ,$506.25 ,$479.25 ,$479.25 ,$194.82 ,$479.25 ,$573.75 ,$573.75 ,$573.75 , N/A ,$497.00 ,$573.75 ,$194.82 ,$675.00 ,$378.68 ,$194.82 ,$279.45 , N/A , N/A ,$194.82 ,$573.75 ,$417.48 ,$402.30 ,$189.00 ,$607.50 ,$194.82 ,$573.75 ,$342.00 ,$342.00 ,$194.82 ,$438.75 ST. JOSEPH'S HOSPITAL - BREESE,45001360,31577,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),450,1 ,"$1,072.00 ",$771.84 ,$300.16 ,"$1,072.00 ",$905.45 ,$696.80 ,$639.98 ,$354.94 ,$300.16 ,$709.66 ,$354.94 ,$709.66 ,$354.94 ,$638.91 ,$638.91 ,$354.94 ,$638.91 ,$731.61 ,$825.44 ,$905.46 ,$354.94 ,$362.04 ,$804.00 ,$761.12 ,$761.12 ,$354.94 ,$761.12 ,$911.20 ,$911.20 ,$911.20 , N/A ,$905.46 ,$911.20 ,$354.94 ,"$1,072.00 ",$601.39 ,$354.94 ,$443.81 , N/A , N/A ,$354.94 ,$911.20 ,$760.58 ,$638.91 ,$300.16 ,$964.80 ,$354.94 ,$911.20 ,$342.00 ,$342.00 ,$354.94 ,$696.80 ST. JOSEPH'S HOSPITAL - BREESE,45001367,15853,HC REMOVAL SUTURES OR STAPLES NOT REQ ANESTH,450,1 ,$1.00 ,$0.72 ,$0.28 ,$1.00 , N/A ,$0.65 ,$0.60 , N/A ,$0.28 ,$0.66 , N/A ,$0.66 , N/A ,$0.60 ,$0.60 , N/A ,$0.60 , N/A ,$0.77 , N/A , N/A , N/A ,$0.75 ,$0.71 ,$0.71 , N/A ,$0.71 ,$0.85 ,$0.85 ,$0.85 , N/A , N/A ,$0.85 , N/A ,$1.00 ,$0.56 , N/A ,$0.41 , N/A , N/A , N/A ,$0.85 , N/A ,$0.60 ,$0.28 ,$0.90 , N/A ,$0.85 ,$1.00 ,$1.00 , N/A ,$0.65 ST. JOSEPH'S HOSPITAL - BREESE,45001368,15854,HC REMOVAL SUTURES AND STAPLES NOT REQ ANESTH,450,1 ,$1.00 ,$0.72 ,$0.28 ,$1.00 , N/A ,$0.65 ,$0.60 , N/A ,$0.28 ,$0.66 , N/A ,$0.66 , N/A ,$0.60 ,$0.60 , N/A ,$0.60 , N/A ,$0.77 , N/A , N/A , N/A ,$0.75 ,$0.71 ,$0.71 , N/A ,$0.71 ,$0.85 ,$0.85 ,$0.85 , N/A , N/A ,$0.85 , N/A ,$1.00 ,$0.56 , N/A ,$0.41 , N/A , N/A , N/A ,$0.85 , N/A ,$0.60 ,$0.28 ,$0.90 , N/A ,$0.85 ,$1.00 ,$1.00 , N/A ,$0.65 ST. JOSEPH'S HOSPITAL - BREESE,45080003,59409,HC DELIVERY VAGINAL,450,1 ,"$3,105.00 ","$2,235.60 ",$342.00 ,"$6,788.26 ","$6,788.25 ","$2,018.25 ","$1,853.69 ","$2,660.99 ",$869.40 ,"$2,055.51 ","$2,660.99 ","$2,055.51 ","$2,660.99 ","$1,850.58 ","$1,850.58 ","$2,660.99 ","$1,850.58 ","$3,105.00 ","$2,390.85 ","$6,788.26 ","$2,660.99 ","$2,714.22 ","$2,328.75 ","$2,204.55 ","$2,204.55 ","$2,660.99 ","$2,204.55 ","$2,639.25 ","$2,639.25 ","$2,639.25 ", N/A ,"$3,105.00 ","$2,639.25 ","$2,660.99 ","$3,105.00 ","$1,741.91 ","$2,660.99 ","$1,285.47 ", N/A , N/A ,"$2,660.99 ","$2,639.25 ","$5,702.14 ","$1,850.58 ",$869.40 ,"$2,794.50 ","$2,660.99 ","$2,639.25 ",$342.00 ,$342.00 ,"$2,660.99 ","$2,018.25 " ST. JOSEPH'S HOSPITAL - BREESE,45080004,23605,HC CLOSED RX PROX HUMERUS FX MANIP,450,1 ,"$4,267.53 ","$3,072.62 ",$342.00 ,"$4,267.53 ","$3,444.08 ","$2,773.89 ","$2,547.72 ","$1,350.08 ","$1,194.91 ","$2,825.10 ","$1,350.08 ","$2,825.10 ","$1,350.08 ","$2,543.45 ","$2,543.45 ","$1,350.08 ","$2,543.45 ","$2,782.81 ","$3,286.00 ","$3,444.07 ","$1,350.08 ","$1,377.08 ","$3,200.65 ","$3,029.95 ","$3,029.95 ","$1,350.08 ","$3,029.95 ","$3,627.40 ","$3,627.40 ","$3,627.40 ", N/A ,"$3,444.07 ","$3,627.40 ","$1,350.08 ","$4,267.53 ","$2,394.08 ","$1,350.08 ","$1,766.76 ", N/A , N/A ,"$1,350.08 ","$3,627.40 ","$2,893.02 ","$2,543.45 ","$1,194.91 ","$3,840.78 ","$1,350.08 ","$3,627.40 ",$342.00 ,$342.00 ,"$1,350.08 ","$2,773.89 " ST. JOSEPH'S HOSPITAL - BREESE,46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$326.00 ,$234.72 ,$50.33 ,$349.16 ,$349.15 ,$211.90 ,$194.62 ,$136.87 ,$91.28 ,$215.81 ,$136.87 ,$215.81 ,$136.87 ,$194.30 ,$194.30 ,$136.87 ,$194.30 ,$282.12 ,$251.02 ,$349.16 ,$136.87 ,$139.61 ,$244.50 ,$231.46 ,$231.46 ,$136.87 ,$231.46 ,$277.10 ,$277.10 ,$277.10 , N/A ,$326.00 ,$277.10 ,$136.87 ,$326.00 ,$182.89 ,$136.87 ,$134.96 ,$55.36 ,$50.33 ,$136.87 ,$277.10 ,$293.29 ,$194.30 ,$91.28 ,$293.40 ,$136.87 ,$277.10 ,$275.47 ,$275.47 ,$136.87 ,$211.90 ST. JOSEPH'S HOSPITAL - BREESE,46000004,94060,HC SPIROMETRY/PFT PRE AND POST,460,1 ,$702.00 ,$505.44 ,$50.33 ,$702.00 ,$672.38 ,$456.30 ,$419.09 ,$263.57 ,$196.56 ,$464.72 ,$263.57 ,$464.72 ,$263.57 ,$418.39 ,$418.39 ,$263.57 ,$418.39 ,$543.28 ,$540.54 ,$672.38 ,$263.57 ,$268.84 ,$526.50 ,$498.42 ,$498.42 ,$263.57 ,$498.42 ,$596.70 ,$596.70 ,$596.70 , N/A ,$672.38 ,$596.70 ,$263.57 ,$702.00 ,$393.82 ,$263.57 ,$290.63 ,$55.36 ,$50.33 ,$263.57 ,$596.70 ,$564.80 ,$418.39 ,$196.56 ,$631.80 ,$263.57 ,$596.70 ,$593.19 ,$593.19 ,$263.57 ,$456.30 ST. JOSEPH'S HOSPITAL - BREESE,46000006,94070,HC SPIROMETRY/PFT CPLX,460,1 ,$553.00 ,$398.16 ,$153.79 ,$672.38 ,$672.38 ,$359.45 ,$330.14 ,$263.57 ,$154.84 ,$366.09 ,$263.57 ,$366.09 ,$263.57 ,$329.59 ,$329.59 ,$263.57 ,$329.59 ,$543.28 ,$425.81 ,$672.38 ,$263.57 ,$268.84 ,$414.75 ,$392.63 ,$392.63 ,$263.57 ,$392.63 ,$470.05 ,$470.05 ,$470.05 , N/A ,$553.00 ,$470.05 ,$263.57 ,$553.00 ,$310.23 ,$263.57 ,$228.94 ,$169.17 ,$153.79 ,$263.57 ,$470.05 ,$564.80 ,$329.59 ,$154.84 ,$497.70 ,$263.57 ,$470.05 ,$467.29 ,$467.29 ,$263.57 ,$359.45 ST. JOSEPH'S HOSPITAL - BREESE,46000007,94150,HC VITAL CAPACITY TOTAL,460,1 ,$85.00 ,$61.20 ,$23.80 ,$349.16 ,$349.15 ,$55.25 ,$50.75 ,$136.87 ,$23.80 ,$56.27 ,$136.87 ,$56.27 ,$83.30 ,$50.66 ,$50.66 ,$83.30 ,$50.66 ,$85.00 ,$65.45 ,$349.16 ,$136.87 ,$83.30 ,$63.75 ,$60.35 ,$60.35 ,$136.87 ,$60.35 ,$72.25 ,$72.25 ,$72.25 , N/A ,$85.00 ,$72.25 ,$83.30 ,$85.00 ,$47.69 ,$136.87 ,$35.19 ,$55.36 ,$50.33 ,$136.87 ,$72.25 ,$293.29 ,$50.66 ,$23.80 ,$76.50 ,$136.87 ,$72.25 ,$71.83 ,$71.83 ,$136.87 ,$55.25 ST. JOSEPH'S HOSPITAL - BREESE,46000012,94728,HC AIRFLOW RESISTANCE,460,1 ,$328.00 ,$236.16 ,$50.33 ,$672.38 ,$672.38 ,$213.20 ,$195.82 ,$263.57 ,$91.84 ,$217.14 ,$263.57 ,$217.14 ,$263.57 ,$195.49 ,$195.49 ,$263.57 ,$195.49 ,$328.00 ,$252.56 ,$672.38 ,$263.57 ,$268.84 ,$246.00 ,$232.88 ,$232.88 ,$263.57 ,$232.88 ,$278.80 ,$278.80 ,$278.80 , N/A ,$328.00 ,$278.80 ,$263.57 ,$328.00 ,$184.01 ,$263.57 ,$135.79 ,$55.36 ,$50.33 ,$263.57 ,$278.80 ,$564.80 ,$195.49 ,$91.84 ,$295.20 ,$263.57 ,$278.80 ,$277.16 ,$277.16 ,$263.57 ,$213.20 ST. JOSEPH'S HOSPITAL - BREESE,46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$821.00 ,$591.12 ,$50.33 ,$821.00 ,$672.38 ,$533.65 ,$490.14 ,$263.57 ,$229.88 ,$543.50 ,$263.57 ,$543.50 ,$263.57 ,$489.32 ,$489.32 ,$263.57 ,$489.32 ,$543.28 ,$632.17 ,$672.38 ,$263.57 ,$268.84 ,$615.75 ,$582.91 ,$582.91 ,$263.57 ,$582.91 ,$697.85 ,$697.85 ,$697.85 , N/A ,$672.38 ,$697.85 ,$263.57 ,$821.00 ,$460.58 ,$263.57 ,$339.89 ,$55.36 ,$50.33 ,$263.57 ,$697.85 ,$564.80 ,$489.32 ,$229.88 ,$738.90 ,$263.57 ,$697.85 ,$693.75 ,$693.75 ,$263.57 ,$533.65 ST. JOSEPH'S HOSPITAL - BREESE,46000014,94618,HC WALK TEST 6 MIN,460,1 ,$323.00 ,$232.56 ,$90.44 ,$323.00 ,$278.78 ,$209.95 ,$192.83 ,$109.28 ,$90.44 ,$213.83 ,$109.28 ,$213.83 ,$109.28 ,$192.51 ,$192.51 ,$109.28 ,$192.51 ,$225.24 ,$248.71 ,$278.76 ,$109.28 ,$111.47 ,$242.25 ,$229.33 ,$229.33 ,$109.28 ,$229.33 ,$274.55 ,$274.55 ,$274.55 , N/A ,$278.76 ,$274.55 ,$109.28 ,$323.00 ,$181.20 ,$109.28 ,$133.72 ,$169.17 ,$153.79 ,$109.28 ,$274.55 ,$234.16 ,$192.51 ,$90.44 ,$290.70 ,$109.28 ,$274.55 ,$272.94 ,$272.94 ,$109.28 ,$209.95 ST. JOSEPH'S HOSPITAL - BREESE,46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$363.00 ,$261.36 ,$50.33 ,$363.00 , N/A ,$235.95 ,$216.71 , N/A ,$101.64 ,$240.31 , N/A ,$240.31 , N/A ,$216.35 ,$216.35 , N/A ,$216.35 , N/A ,$279.51 , N/A , N/A , N/A ,$272.25 ,$257.73 ,$257.73 , N/A ,$257.73 ,$308.55 ,$308.55 ,$308.55 , N/A , N/A ,$308.55 , N/A ,$363.00 ,$203.64 , N/A ,$150.28 ,$55.36 ,$50.33 , N/A ,$308.55 , N/A ,$216.35 ,$101.64 ,$326.70 , N/A ,$308.55 ,$306.74 ,$306.74 , N/A ,$235.95 ST. JOSEPH'S HOSPITAL - BREESE,46000021,94760,HC PULSE OX SINGLE,460,1 ,$83.00 ,$59.76 ,$23.24 ,$83.00 , N/A ,$53.95 ,$49.55 , N/A ,$23.24 ,$54.95 , N/A ,$54.95 , N/A ,$49.47 ,$49.47 , N/A ,$49.47 , N/A ,$63.91 , N/A , N/A , N/A ,$62.25 ,$58.93 ,$58.93 , N/A ,$58.93 ,$70.55 ,$70.55 ,$70.55 , N/A , N/A ,$70.55 , N/A ,$83.00 ,$46.56 , N/A ,$34.36 , N/A , N/A , N/A ,$70.55 , N/A ,$49.47 ,$23.24 ,$74.70 , N/A ,$70.55 ,$70.14 ,$70.14 , N/A ,$53.95 ST. JOSEPH'S HOSPITAL - BREESE,46000022,94200,HC MAXIMAL VOL VENTILATION,942,1 ,$177.00 ,$127.44 ,$49.56 ,$177.00 ,$138.00 ,$115.05 ,$105.67 ,$54.10 ,$49.56 ,$117.17 ,$54.10 ,$117.17 ,$54.10 ,$105.49 ,$105.49 ,$54.10 ,$105.49 ,$111.50 ,$136.29 ,$138.00 ,$54.10 ,$55.17 ,$132.75 ,$125.67 ,$125.67 ,$54.10 ,$125.67 ,$150.45 ,$150.45 ,$150.45 , N/A ,$138.00 ,$150.45 ,$54.10 ,$177.00 ,$99.30 ,$54.10 ,$73.28 , N/A , N/A ,$54.10 ,$150.45 ,$115.92 ,$105.49 ,$49.56 ,$159.30 ,$54.10 ,$150.45 ,$149.57 ,$149.57 ,$54.10 ,$115.05 ST. JOSEPH'S HOSPITAL - BREESE,47000001,92587,HC DISTORTION EVOKED POTENT LTD,470,1 ,$277.00 ,$199.44 ,$77.56 ,$672.38 ,$672.38 ,$180.05 ,$165.37 ,$263.57 ,$77.56 ,$183.37 ,$263.57 ,$183.37 ,$263.57 ,$165.09 ,$165.09 ,$263.57 ,$165.09 ,$277.00 ,$213.29 ,$672.38 ,$263.57 ,$268.84 ,$207.75 ,$196.67 ,$196.67 ,$263.57 ,$196.67 ,$235.45 ,$235.45 ,$235.45 , N/A ,$277.00 ,$235.45 ,$263.57 ,$277.00 ,$155.40 ,$263.57 ,$114.68 ,$161.47 ,$146.79 ,$263.57 ,$235.45 ,$564.80 ,$165.09 ,$77.56 ,$249.30 ,$263.57 ,$235.45 ,$234.07 ,$234.07 ,$263.57 ,$180.05 ST. JOSEPH'S HOSPITAL - BREESE,47000003,92586,HC NEWBORN HEARING SCREENING,470,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 , N/A ,$78.00 ,$71.64 , N/A ,$33.60 ,$79.44 , N/A ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A , N/A , N/A ,$90.00 ,$85.20 ,$85.20 , N/A ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A , N/A ,$102.00 , N/A ,$120.00 ,$67.32 , N/A ,$49.68 , N/A , N/A , N/A ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 , N/A ,$102.00 ,$101.40 ,$101.40 , N/A ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,47000015,V5014,HC REPAIR HEARING AID T1,470,1 ,$105.00 ,$75.60 ,$29.40 ,$105.00 , N/A ,$68.25 ,$62.69 , N/A ,$29.40 ,$69.51 , N/A ,$69.51 , N/A ,$62.58 ,$62.58 , N/A ,$62.58 , N/A ,$80.85 , N/A , N/A , N/A ,$78.75 ,$74.55 ,$74.55 , N/A ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A , N/A ,$89.25 , N/A ,$105.00 ,$58.91 , N/A ,$43.47 ,$102.20 ,$92.91 , N/A ,$89.25 , N/A ,$62.58 ,$29.40 ,$94.50 , N/A ,$89.25 ,$88.73 ,$88.73 , N/A ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,47000016,V5014,HC REPAIR HEARING AID T2,470,1 ,$140.00 ,$100.80 ,$39.20 ,$140.00 , N/A ,$91.00 ,$83.58 , N/A ,$39.20 ,$92.68 , N/A ,$92.68 , N/A ,$83.44 ,$83.44 , N/A ,$83.44 , N/A ,$107.80 , N/A , N/A , N/A ,$105.00 ,$99.40 ,$99.40 , N/A ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A , N/A ,$119.00 , N/A ,$140.00 ,$78.54 , N/A ,$57.96 ,$102.20 ,$92.91 , N/A ,$119.00 , N/A ,$83.44 ,$39.20 ,$126.00 , N/A ,$119.00 ,$118.30 ,$118.30 , N/A ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,47000017,V5014,HC REPAIR HEARING AID T3,470,1 ,$175.00 ,$126.00 ,$49.00 ,$175.00 , N/A ,$113.75 ,$104.48 , N/A ,$49.00 ,$115.85 , N/A ,$115.85 , N/A ,$104.30 ,$104.30 , N/A ,$104.30 , N/A ,$134.75 , N/A , N/A , N/A ,$131.25 ,$124.25 ,$124.25 , N/A ,$124.25 ,$148.75 ,$148.75 ,$148.75 , N/A , N/A ,$148.75 , N/A ,$175.00 ,$98.18 , N/A ,$72.45 ,$102.20 ,$92.91 , N/A ,$148.75 , N/A ,$104.30 ,$49.00 ,$157.50 , N/A ,$148.75 ,$147.88 ,$147.88 , N/A ,$113.75 ST. JOSEPH'S HOSPITAL - BREESE,47000018,V5014,HC REPAIR HEARING AID T4,470,1 ,$210.00 ,$151.20 ,$58.80 ,$210.00 , N/A ,$136.50 ,$125.37 , N/A ,$58.80 ,$139.02 , N/A ,$139.02 , N/A ,$125.16 ,$125.16 , N/A ,$125.16 , N/A ,$161.70 , N/A , N/A , N/A ,$157.50 ,$149.10 ,$149.10 , N/A ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A , N/A ,$178.50 , N/A ,$210.00 ,$117.81 , N/A ,$86.94 ,$102.20 ,$92.91 , N/A ,$178.50 , N/A ,$125.16 ,$58.80 ,$189.00 , N/A ,$178.50 ,$177.45 ,$177.45 , N/A ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,47000019,V5014,HC REPAIR HEARING AID T5,470,1 ,$245.00 ,$176.40 ,$68.60 ,$245.00 , N/A ,$159.25 ,$146.27 , N/A ,$68.60 ,$162.19 , N/A ,$162.19 , N/A ,$146.02 ,$146.02 , N/A ,$146.02 , N/A ,$188.65 , N/A , N/A , N/A ,$183.75 ,$173.95 ,$173.95 , N/A ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A , N/A ,$208.25 , N/A ,$245.00 ,$137.45 , N/A ,$101.43 ,$102.20 ,$92.91 , N/A ,$208.25 , N/A ,$146.02 ,$68.60 ,$220.50 , N/A ,$208.25 ,$207.03 ,$207.03 , N/A ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,47000020,V5014,HC REPAIR HEARING AID T6,470,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 ,$102.20 ,$92.91 , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,47000021,V5014,HC REPAIR HEARING AID T7,470,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$130.41 ,$102.20 ,$92.91 , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 ,$266.18 ,$266.18 , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,47000022,V5014,HC REPAIR HEARING AID T8,470,1 ,$350.00 ,$252.00 ,$92.91 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 ,$102.20 ,$92.91 , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,47000023,V5014,HC REPAIR HEARING AID T9,470,1 ,$525.00 ,$378.00 ,$92.91 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 ,$102.20 ,$92.91 , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,47000024,V5014,HC REPAIR HEARING AID T10,470,1 ,$700.00 ,$504.00 ,$92.91 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 ,$102.20 ,$92.91 , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,47000025,V5014,HC REPAIR HEARING AID T11,470,1 ,$875.00 ,$630.00 ,$92.91 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 ,$102.20 ,$92.91 , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,47000026,V5014,HC REPAIR HEARING AID T12,470,1 ,"$1,050.00 ",$756.00 ,$92.91 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 ,$102.20 ,$92.91 , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,47000027,V5014,HC REPAIR HEARING AID T13,470,1 ,"$1,225.00 ",$882.00 ,$92.91 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 ,$102.20 ,$92.91 , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,47000028,V5010,HC HEARING AID ASSESSMENT,470,1 ,$214.00 ,$154.08 ,$59.92 ,$214.00 , N/A ,$139.10 ,$127.76 , N/A ,$59.92 ,$141.67 , N/A ,$141.67 , N/A ,$127.54 ,$127.54 , N/A ,$127.54 , N/A ,$164.78 , N/A , N/A , N/A ,$160.50 ,$151.94 ,$151.94 , N/A ,$151.94 ,$181.90 ,$181.90 ,$181.90 , N/A , N/A ,$181.90 , N/A ,$214.00 ,$120.05 , N/A ,$88.60 ,$102.20 ,$92.91 , N/A ,$181.90 , N/A ,$127.54 ,$59.92 ,$192.60 , N/A ,$181.90 ,$180.83 ,$180.83 , N/A ,$139.10 ST. JOSEPH'S HOSPITAL - BREESE,47000029,V5011,HC HEARING AID FITTING/CHECK,470,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 , N/A ,$19.50 ,$17.91 , N/A ,$8.40 ,$19.86 , N/A ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A , N/A , N/A ,$22.50 ,$21.30 ,$21.30 , N/A ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A , N/A ,$25.50 , N/A ,$30.00 ,$16.83 , N/A ,$12.42 ,$30.00 ,$30.00 , N/A ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 , N/A ,$25.50 ,$25.35 ,$25.35 , N/A ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,47000030,V5020,HC CONFORMITY EVAL,470,1 ,$83.00 ,$59.76 ,$23.24 ,$83.00 , N/A ,$53.95 ,$49.55 , N/A ,$23.24 ,$54.95 , N/A ,$54.95 , N/A ,$49.47 ,$49.47 , N/A ,$49.47 , N/A ,$63.91 , N/A , N/A , N/A ,$62.25 ,$58.93 ,$58.93 , N/A ,$58.93 ,$70.55 ,$70.55 ,$70.55 , N/A , N/A ,$70.55 , N/A ,$83.00 ,$46.56 , N/A ,$34.36 ,$83.00 ,$83.00 , N/A ,$70.55 , N/A ,$49.47 ,$23.24 ,$74.70 , N/A ,$70.55 ,$70.14 ,$70.14 , N/A ,$53.95 ST. JOSEPH'S HOSPITAL - BREESE,47000031,V5299,HC WARRANTY/DEDUCTIBLE TIER 1,470,1 ,$105.00 ,$75.60 ,$29.40 ,$105.00 , N/A ,$68.25 ,$62.69 , N/A ,$29.40 ,$69.51 , N/A ,$69.51 , N/A ,$62.58 ,$62.58 , N/A ,$62.58 , N/A ,$80.85 , N/A , N/A , N/A ,$78.75 ,$74.55 ,$74.55 , N/A ,$74.55 ,$89.25 ,$89.25 ,$89.25 , N/A , N/A ,$89.25 , N/A ,$105.00 ,$58.91 , N/A ,$43.47 , N/A , N/A , N/A ,$89.25 , N/A ,$62.58 ,$29.40 ,$94.50 , N/A ,$89.25 ,$88.73 ,$88.73 , N/A ,$68.25 ST. JOSEPH'S HOSPITAL - BREESE,47000032,V5299,HC WARRANTY/DEDUCTIBLE TIER 2,470,1 ,$140.00 ,$100.80 ,$39.20 ,$140.00 , N/A ,$91.00 ,$83.58 , N/A ,$39.20 ,$92.68 , N/A ,$92.68 , N/A ,$83.44 ,$83.44 , N/A ,$83.44 , N/A ,$107.80 , N/A , N/A , N/A ,$105.00 ,$99.40 ,$99.40 , N/A ,$99.40 ,$119.00 ,$119.00 ,$119.00 , N/A , N/A ,$119.00 , N/A ,$140.00 ,$78.54 , N/A ,$57.96 , N/A , N/A , N/A ,$119.00 , N/A ,$83.44 ,$39.20 ,$126.00 , N/A ,$119.00 ,$118.30 ,$118.30 , N/A ,$91.00 ST. JOSEPH'S HOSPITAL - BREESE,47000033,V5299,HC WARRANTY/DEDUCTIBLE TIER 3,470,1 ,$175.00 ,$126.00 ,$49.00 ,$175.00 , N/A ,$113.75 ,$104.48 , N/A ,$49.00 ,$115.85 , N/A ,$115.85 , N/A ,$104.30 ,$104.30 , N/A ,$104.30 , N/A ,$134.75 , N/A , N/A , N/A ,$131.25 ,$124.25 ,$124.25 , N/A ,$124.25 ,$148.75 ,$148.75 ,$148.75 , N/A , N/A ,$148.75 , N/A ,$175.00 ,$98.18 , N/A ,$72.45 , N/A , N/A , N/A ,$148.75 , N/A ,$104.30 ,$49.00 ,$157.50 , N/A ,$148.75 ,$147.88 ,$147.88 , N/A ,$113.75 ST. JOSEPH'S HOSPITAL - BREESE,47000034,V5299,HC WARRANTY/DEDUCTIBLE TIER 4,470,1 ,$210.00 ,$151.20 ,$58.80 ,$210.00 , N/A ,$136.50 ,$125.37 , N/A ,$58.80 ,$139.02 , N/A ,$139.02 , N/A ,$125.16 ,$125.16 , N/A ,$125.16 , N/A ,$161.70 , N/A , N/A , N/A ,$157.50 ,$149.10 ,$149.10 , N/A ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A , N/A ,$178.50 , N/A ,$210.00 ,$117.81 , N/A ,$86.94 , N/A , N/A , N/A ,$178.50 , N/A ,$125.16 ,$58.80 ,$189.00 , N/A ,$178.50 ,$177.45 ,$177.45 , N/A ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,47000035,V5299,HC WARRANTY/DEDUCTIBLE TIER 5,470,1 ,$245.00 ,$176.40 ,$68.60 ,$245.00 , N/A ,$159.25 ,$146.27 , N/A ,$68.60 ,$162.19 , N/A ,$162.19 , N/A ,$146.02 ,$146.02 , N/A ,$146.02 , N/A ,$188.65 , N/A , N/A , N/A ,$183.75 ,$173.95 ,$173.95 , N/A ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A , N/A ,$208.25 , N/A ,$245.00 ,$137.45 , N/A ,$101.43 , N/A , N/A , N/A ,$208.25 , N/A ,$146.02 ,$68.60 ,$220.50 , N/A ,$208.25 ,$207.03 ,$207.03 , N/A ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,47000036,V5299,HC HEARING AID FLEX SOFTWARE UPGRADE 500-600,470,1 ,$292.00 ,$210.24 ,$81.76 ,$292.00 , N/A ,$189.80 ,$174.32 , N/A ,$81.76 ,$193.30 , N/A ,$193.30 , N/A ,$174.03 ,$174.03 , N/A ,$174.03 , N/A ,$224.84 , N/A , N/A , N/A ,$219.00 ,$207.32 ,$207.32 , N/A ,$207.32 ,$248.20 ,$248.20 ,$248.20 , N/A , N/A ,$248.20 , N/A ,$292.00 ,$163.81 , N/A ,$120.89 , N/A , N/A , N/A ,$248.20 , N/A ,$174.03 ,$81.76 ,$262.80 , N/A ,$248.20 ,$246.74 ,$246.74 , N/A ,$189.80 ST. JOSEPH'S HOSPITAL - BREESE,47000037,V5299,HC HEARING AID FLEX SOFTWARE UPGRADE 600-700,470,1 ,$341.00 ,$245.52 ,$95.48 ,$341.00 , N/A ,$221.65 ,$203.58 , N/A ,$95.48 ,$225.74 , N/A ,$225.74 , N/A ,$203.24 ,$203.24 , N/A ,$203.24 , N/A ,$262.57 , N/A , N/A , N/A ,$255.75 ,$242.11 ,$242.11 , N/A ,$242.11 ,$289.85 ,$289.85 ,$289.85 , N/A , N/A ,$289.85 , N/A ,$341.00 ,$191.30 , N/A ,$141.17 , N/A , N/A , N/A ,$289.85 , N/A ,$203.24 ,$95.48 ,$306.90 , N/A ,$289.85 ,$288.15 ,$288.15 , N/A ,$221.65 ST. JOSEPH'S HOSPITAL - BREESE,47000038,V5299,HC HEARING AID FLEX SOFTWARE UPGRADE 700-800,470,1 ,$385.00 ,$277.20 ,$107.80 ,$385.00 , N/A ,$250.25 ,$229.85 , N/A ,$107.80 ,$254.87 , N/A ,$254.87 , N/A ,$229.46 ,$229.46 , N/A ,$229.46 , N/A ,$296.45 , N/A , N/A , N/A ,$288.75 ,$273.35 ,$273.35 , N/A ,$273.35 ,$327.25 ,$327.25 ,$327.25 , N/A , N/A ,$327.25 , N/A ,$385.00 ,$215.99 , N/A ,$159.39 , N/A , N/A , N/A ,$327.25 , N/A ,$229.46 ,$107.80 ,$346.50 , N/A ,$327.25 ,$325.33 ,$325.33 , N/A ,$250.25 ST. JOSEPH'S HOSPITAL - BREESE,47000039,V5299,HC HEARING AID FLEX SOFTWARE UPGRADE 800-PRO,470,1 ,$770.00 ,$554.40 ,$215.60 ,$770.00 , N/A ,$500.50 ,$459.69 , N/A ,$215.60 ,$509.74 , N/A ,$509.74 , N/A ,$458.92 ,$458.92 , N/A ,$458.92 , N/A ,$592.90 , N/A , N/A , N/A ,$577.50 ,$546.70 ,$546.70 , N/A ,$546.70 ,$654.50 ,$654.50 ,$654.50 , N/A , N/A ,$654.50 , N/A ,$770.00 ,$431.97 , N/A ,$318.78 , N/A , N/A , N/A ,$654.50 , N/A ,$458.92 ,$215.60 ,$693.00 , N/A ,$654.50 ,$650.65 ,$650.65 , N/A ,$500.50 ST. JOSEPH'S HOSPITAL - BREESE,47000040,V5299,HC WARRANTY/DEDUCTIBLE TIER 6,470,1 ,$280.00 ,$201.60 ,$78.40 ,$280.00 , N/A ,$182.00 ,$167.16 , N/A ,$78.40 ,$185.36 , N/A ,$185.36 , N/A ,$166.88 ,$166.88 , N/A ,$166.88 , N/A ,$215.60 , N/A , N/A , N/A ,$210.00 ,$198.80 ,$198.80 , N/A ,$198.80 ,$238.00 ,$238.00 ,$238.00 , N/A , N/A ,$238.00 , N/A ,$280.00 ,$157.08 , N/A ,$115.92 , N/A , N/A , N/A ,$238.00 , N/A ,$166.88 ,$78.40 ,$252.00 , N/A ,$238.00 ,$236.60 ,$236.60 , N/A ,$182.00 ST. JOSEPH'S HOSPITAL - BREESE,47000041,V5299,HC WARRANTY/DEDUCTIBLE TIER 7,470,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$130.41 , N/A , N/A , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 ,$266.18 ,$266.18 , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,47000042,V5299,HC WARRANTY/DEDUCTIBLE TIER 8,470,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,47000043,V5299,HC WARRANTY/DEDUCTIBLE TIER 9,470,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 , N/A ,$341.25 ,$313.43 , N/A ,$147.00 ,$347.55 , N/A ,$347.55 , N/A ,$312.90 ,$312.90 , N/A ,$312.90 , N/A ,$404.25 , N/A , N/A , N/A ,$393.75 ,$372.75 ,$372.75 , N/A ,$372.75 ,$446.25 ,$446.25 ,$446.25 , N/A , N/A ,$446.25 , N/A ,$525.00 ,$294.53 , N/A ,$217.35 , N/A , N/A , N/A ,$446.25 , N/A ,$312.90 ,$147.00 ,$472.50 , N/A ,$446.25 ,$443.63 ,$443.63 , N/A ,$341.25 ST. JOSEPH'S HOSPITAL - BREESE,47000044,V5299,HC WARRANTY/DEDUCTIBLE TIER 10,470,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,47000045,N/A,HC AMPLIFON LOSS AND DAMAGE DED - STARKEY (2017 AND EARLIER),470,1 ,$185.00 ,$133.20 ,$51.80 ,$185.00 , N/A ,$120.25 ,$110.45 , N/A ,$51.80 ,$122.47 , N/A ,$122.47 , N/A ,$110.26 ,$110.26 , N/A ,$110.26 , N/A ,$142.45 , N/A , N/A , N/A ,$138.75 ,$131.35 ,$131.35 , N/A ,$131.35 ,$157.25 ,$157.25 ,$157.25 , N/A , N/A ,$157.25 , N/A ,$185.00 ,$103.79 , N/A ,$76.59 , N/A , N/A , N/A ,$157.25 , N/A ,$110.26 ,$51.80 ,$166.50 , N/A ,$157.25 ,$156.33 ,$156.33 , N/A ,$120.25 ST. JOSEPH'S HOSPITAL - BREESE,47000046,N/A,HC AMPLIFON LOSS AND DAMAGE DED - SIGNIA TIER 1,470,1 ,$210.00 ,$151.20 ,$58.80 ,$210.00 , N/A ,$136.50 ,$125.37 , N/A ,$58.80 ,$139.02 , N/A ,$139.02 , N/A ,$125.16 ,$125.16 , N/A ,$125.16 , N/A ,$161.70 , N/A , N/A , N/A ,$157.50 ,$149.10 ,$149.10 , N/A ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A , N/A ,$178.50 , N/A ,$210.00 ,$117.81 , N/A ,$86.94 , N/A , N/A , N/A ,$178.50 , N/A ,$125.16 ,$58.80 ,$189.00 , N/A ,$178.50 ,$177.45 ,$177.45 , N/A ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,47000047,N/A,HC AMPLIFON LOSS AND DAMAGE DED - PHONAK,470,1 ,$245.00 ,$176.40 ,$68.60 ,$245.00 , N/A ,$159.25 ,$146.27 , N/A ,$68.60 ,$162.19 , N/A ,$162.19 , N/A ,$146.02 ,$146.02 , N/A ,$146.02 , N/A ,$188.65 , N/A , N/A , N/A ,$183.75 ,$173.95 ,$173.95 , N/A ,$173.95 ,$208.25 ,$208.25 ,$208.25 , N/A , N/A ,$208.25 , N/A ,$245.00 ,$137.45 , N/A ,$101.43 , N/A , N/A , N/A ,$208.25 , N/A ,$146.02 ,$68.60 ,$220.50 , N/A ,$208.25 ,$207.03 ,$207.03 , N/A ,$159.25 ST. JOSEPH'S HOSPITAL - BREESE,47000048,N/A,HC AMPLIFON LOSS AND DAMAGE DED - UNITRON,470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000049,N/A,HC AMPLIFON LOSS AND DAMAGE DED - WIDEX,470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000050,N/A,HC AMPLIFON LOSS AND DAMAGE DED - SIGNIA TIER 2,470,1 ,$260.00 ,$187.20 ,$72.80 ,$260.00 , N/A ,$169.00 ,$155.22 , N/A ,$72.80 ,$172.12 , N/A ,$172.12 , N/A ,$154.96 ,$154.96 , N/A ,$154.96 , N/A ,$200.20 , N/A , N/A , N/A ,$195.00 ,$184.60 ,$184.60 , N/A ,$184.60 ,$221.00 ,$221.00 ,$221.00 , N/A , N/A ,$221.00 , N/A ,$260.00 ,$145.86 , N/A ,$107.64 , N/A , N/A , N/A ,$221.00 , N/A ,$154.96 ,$72.80 ,$234.00 , N/A ,$221.00 ,$219.70 ,$219.70 , N/A ,$169.00 ST. JOSEPH'S HOSPITAL - BREESE,47000051,N/A,HC AMPLIFON LOSS AND DAMAGE DED - STARKEY (2018 AND LATER),470,1 ,$270.00 ,$194.40 ,$75.60 ,$270.00 , N/A ,$175.50 ,$161.19 , N/A ,$75.60 ,$178.74 , N/A ,$178.74 , N/A ,$160.92 ,$160.92 , N/A ,$160.92 , N/A ,$207.90 , N/A , N/A , N/A ,$202.50 ,$191.70 ,$191.70 , N/A ,$191.70 ,$229.50 ,$229.50 ,$229.50 , N/A , N/A ,$229.50 , N/A ,$270.00 ,$151.47 , N/A ,$111.78 , N/A , N/A , N/A ,$229.50 , N/A ,$160.92 ,$75.60 ,$243.00 , N/A ,$229.50 ,$228.15 ,$228.15 , N/A ,$175.50 ST. JOSEPH'S HOSPITAL - BREESE,47000052,N/A,HC AMPLIFON LOSS AND DAMAGE DED - OTICON,470,1 ,$275.00 ,$198.00 ,$77.00 ,$275.00 , N/A ,$178.75 ,$164.18 , N/A ,$77.00 ,$182.05 , N/A ,$182.05 , N/A ,$163.90 ,$163.90 , N/A ,$163.90 , N/A ,$211.75 , N/A , N/A , N/A ,$206.25 ,$195.25 ,$195.25 , N/A ,$195.25 ,$233.75 ,$233.75 ,$233.75 , N/A , N/A ,$233.75 , N/A ,$275.00 ,$154.28 , N/A ,$113.85 , N/A , N/A , N/A ,$233.75 , N/A ,$163.90 ,$77.00 ,$247.50 , N/A ,$233.75 ,$232.38 ,$232.38 , N/A ,$178.75 ST. JOSEPH'S HOSPITAL - BREESE,47000053,N/A,HC AMPLIFON LOSS AND DAMAGE DED - RESOUND,470,1 ,$285.00 ,$205.20 ,$79.80 ,$285.00 , N/A ,$185.25 ,$170.15 , N/A ,$79.80 ,$188.67 , N/A ,$188.67 , N/A ,$169.86 ,$169.86 , N/A ,$169.86 , N/A ,$219.45 , N/A , N/A , N/A ,$213.75 ,$202.35 ,$202.35 , N/A ,$202.35 ,$242.25 ,$242.25 ,$242.25 , N/A , N/A ,$242.25 , N/A ,$285.00 ,$159.89 , N/A ,$117.99 , N/A , N/A , N/A ,$242.25 , N/A ,$169.86 ,$79.80 ,$256.50 , N/A ,$242.25 ,$240.83 ,$240.83 , N/A ,$185.25 ST. JOSEPH'S HOSPITAL - BREESE,47000055,N/A,HC AMPLIFON LOSS AND DAMAGE DED - REXTON,470,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,47000056,N/A,HC AMPLIFON LOSS AND DAMAGE DED - SIGNIA TIER 3,470,1 ,$320.00 ,$230.40 ,$89.60 ,$320.00 , N/A ,$208.00 ,$191.04 , N/A ,$89.60 ,$211.84 , N/A ,$211.84 , N/A ,$190.72 ,$190.72 , N/A ,$190.72 , N/A ,$246.40 , N/A , N/A , N/A ,$240.00 ,$227.20 ,$227.20 , N/A ,$227.20 ,$272.00 ,$272.00 ,$272.00 , N/A , N/A ,$272.00 , N/A ,$320.00 ,$179.52 , N/A ,$132.48 , N/A , N/A , N/A ,$272.00 , N/A ,$190.72 ,$89.60 ,$288.00 , N/A ,$272.00 ,$270.40 ,$270.40 , N/A ,$208.00 ST. JOSEPH'S HOSPITAL - BREESE,47000057,N/A,HC AMPLIFON HEARING AIDS - BASIC,470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000058,N/A,HC AMPLIFON HEARING AIDS - WC BASIC,470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000059,N/A,HC AMPLIFON HEARING AIDS - PLUS,470,1 ,$275.00 ,$198.00 ,$77.00 ,$275.00 , N/A ,$178.75 ,$164.18 , N/A ,$77.00 ,$182.05 , N/A ,$182.05 , N/A ,$163.90 ,$163.90 , N/A ,$163.90 , N/A ,$211.75 , N/A , N/A , N/A ,$206.25 ,$195.25 ,$195.25 , N/A ,$195.25 ,$233.75 ,$233.75 ,$233.75 , N/A , N/A ,$233.75 , N/A ,$275.00 ,$154.28 , N/A ,$113.85 , N/A , N/A , N/A ,$233.75 , N/A ,$163.90 ,$77.00 ,$247.50 , N/A ,$233.75 ,$232.38 ,$232.38 , N/A ,$178.75 ST. JOSEPH'S HOSPITAL - BREESE,47000060,N/A,HC AMPLIFON HEARING AIDS - WC CROS,470,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,47000061,N/A,HC AMPLIFON HEARING AIDS - CROS,470,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,47000062,N/A,HC AMPLIFON HEARING AIDS - WC PLUS,470,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,47000063,N/A,HC AMPLIFON HEARING AIDS - ADVANTAGE,470,1 ,$400.00 ,$288.00 ,$112.00 ,$400.00 , N/A ,$260.00 ,$238.80 , N/A ,$112.00 ,$264.80 , N/A ,$264.80 , N/A ,$238.40 ,$238.40 , N/A ,$238.40 , N/A ,$308.00 , N/A , N/A , N/A ,$300.00 ,$284.00 ,$284.00 , N/A ,$284.00 ,$340.00 ,$340.00 ,$340.00 , N/A , N/A ,$340.00 , N/A ,$400.00 ,$224.40 , N/A ,$165.60 , N/A , N/A , N/A ,$340.00 , N/A ,$238.40 ,$112.00 ,$360.00 , N/A ,$340.00 ,$338.00 ,$338.00 , N/A ,$260.00 ST. JOSEPH'S HOSPITAL - BREESE,47000064,N/A,HC AMPLIFON HEARING AIDS - PREMIER,470,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 , N/A ,$487.50 ,$447.75 , N/A ,$210.00 ,$496.50 , N/A ,$496.50 , N/A ,$447.00 ,$447.00 , N/A ,$447.00 , N/A ,$577.50 , N/A , N/A , N/A ,$562.50 ,$532.50 ,$532.50 , N/A ,$532.50 ,$637.50 ,$637.50 ,$637.50 , N/A , N/A ,$637.50 , N/A ,$750.00 ,$420.75 , N/A ,$310.50 , N/A , N/A , N/A ,$637.50 , N/A ,$447.00 ,$210.00 ,$675.00 , N/A ,$637.50 ,$633.75 ,$633.75 , N/A ,$487.50 ST. JOSEPH'S HOSPITAL - BREESE,47000065,N/A,HC AMPLIFON HEARING AIDS - SIGNATURE,470,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,47000066,N/A,HC AMPLIFON HEARING AIDS - WC PREMIER,470,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,47000067,N/A,HC AMPLIFON HEARING AIDS - WC SIGNATURE,470,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,47000068,N/A,HC AMPLIFON HEARING AIDS - WC ADVANTAGE,470,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,47000069,N/A,HC UHC RETURN SERVICE FEE LEVEL 2,470,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,47000070,N/A,HC UHC LOSS AND DAMAGE 3 YR WARRANTY,470,1 ,$400.00 ,$288.00 ,$112.00 ,$400.00 , N/A ,$260.00 ,$238.80 , N/A ,$112.00 ,$264.80 , N/A ,$264.80 , N/A ,$238.40 ,$238.40 , N/A ,$238.40 , N/A ,$308.00 , N/A , N/A , N/A ,$300.00 ,$284.00 ,$284.00 , N/A ,$284.00 ,$340.00 ,$340.00 ,$340.00 , N/A , N/A ,$340.00 , N/A ,$400.00 ,$224.40 , N/A ,$165.60 , N/A , N/A , N/A ,$340.00 , N/A ,$238.40 ,$112.00 ,$360.00 , N/A ,$340.00 ,$338.00 ,$338.00 , N/A ,$260.00 ST. JOSEPH'S HOSPITAL - BREESE,47000071,N/A,HC UHC RETURN SERVICE FEE LEVEL 1,470,1 ,$200.00 ,$144.00 ,$56.00 ,$200.00 , N/A ,$130.00 ,$119.40 , N/A ,$56.00 ,$132.40 , N/A ,$132.40 , N/A ,$119.20 ,$119.20 , N/A ,$119.20 , N/A ,$154.00 , N/A , N/A , N/A ,$150.00 ,$142.00 ,$142.00 , N/A ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A , N/A ,$170.00 , N/A ,$200.00 ,$112.20 , N/A ,$82.80 , N/A , N/A , N/A ,$170.00 , N/A ,$119.20 ,$56.00 ,$180.00 , N/A ,$170.00 ,$169.00 ,$169.00 , N/A ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,47000072,N/A,HC UHC EARMOLD,470,1 ,$10.00 ,$7.20 ,$2.80 ,$10.00 , N/A ,$6.50 ,$5.97 , N/A ,$2.80 ,$6.62 , N/A ,$6.62 , N/A ,$5.96 ,$5.96 , N/A ,$5.96 , N/A ,$7.70 , N/A , N/A , N/A ,$7.50 ,$7.10 ,$7.10 , N/A ,$7.10 ,$8.50 ,$8.50 ,$8.50 , N/A , N/A ,$8.50 , N/A ,$10.00 ,$5.61 , N/A ,$4.14 , N/A , N/A , N/A ,$8.50 , N/A ,$5.96 ,$2.80 ,$9.00 , N/A ,$8.50 ,$8.45 ,$8.45 , N/A ,$6.50 ST. JOSEPH'S HOSPITAL - BREESE,47000073,N/A,HC UHC PRO FEE - FM RECEIVERS,470,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 , N/A ,$48.75 ,$44.78 , N/A ,$21.00 ,$49.65 , N/A ,$49.65 , N/A ,$44.70 ,$44.70 , N/A ,$44.70 , N/A ,$57.75 , N/A , N/A , N/A ,$56.25 ,$53.25 ,$53.25 , N/A ,$53.25 ,$63.75 ,$63.75 ,$63.75 , N/A , N/A ,$63.75 , N/A ,$75.00 ,$42.08 , N/A ,$31.05 , N/A , N/A , N/A ,$63.75 , N/A ,$44.70 ,$21.00 ,$67.50 , N/A ,$63.75 ,$63.38 ,$63.38 , N/A ,$48.75 ST. JOSEPH'S HOSPITAL - BREESE,47000074,N/A,HC UHC FM TRANSMITTER DEVICE,470,1 ,$100.00 ,$72.00 ,$28.00 ,$100.00 , N/A ,$65.00 ,$59.70 , N/A ,$28.00 ,$66.20 , N/A ,$66.20 , N/A ,$59.60 ,$59.60 , N/A ,$59.60 , N/A ,$77.00 , N/A , N/A , N/A ,$75.00 ,$71.00 ,$71.00 , N/A ,$71.00 ,$85.00 ,$85.00 ,$85.00 , N/A , N/A ,$85.00 , N/A ,$100.00 ,$56.10 , N/A ,$41.40 , N/A , N/A , N/A ,$85.00 , N/A ,$59.60 ,$28.00 ,$90.00 , N/A ,$85.00 ,$84.50 ,$84.50 , N/A ,$65.00 ST. JOSEPH'S HOSPITAL - BREESE,47000075,N/A,HC UHCPRO FEE - RETURN/CREDIT W/O REORDER,470,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,47000076,N/A,HC UHC CROS - EAR TRANSMITTER DEVICE,470,1 ,$200.00 ,$144.00 ,$56.00 ,$200.00 , N/A ,$130.00 ,$119.40 , N/A ,$56.00 ,$132.40 , N/A ,$132.40 , N/A ,$119.20 ,$119.20 , N/A ,$119.20 , N/A ,$154.00 , N/A , N/A , N/A ,$150.00 ,$142.00 ,$142.00 , N/A ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A , N/A ,$170.00 , N/A ,$200.00 ,$112.20 , N/A ,$82.80 , N/A , N/A , N/A ,$170.00 , N/A ,$119.20 ,$56.00 ,$180.00 , N/A ,$170.00 ,$169.00 ,$169.00 , N/A ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,47000077,N/A,HC UHC LOSS AND DAMAGE FEE,470,1 ,$200.00 ,$144.00 ,$56.00 ,$200.00 , N/A ,$130.00 ,$119.40 , N/A ,$56.00 ,$132.40 , N/A ,$132.40 , N/A ,$119.20 ,$119.20 , N/A ,$119.20 , N/A ,$154.00 , N/A , N/A , N/A ,$150.00 ,$142.00 ,$142.00 , N/A ,$142.00 ,$170.00 ,$170.00 ,$170.00 , N/A , N/A ,$170.00 , N/A ,$200.00 ,$112.20 , N/A ,$82.80 , N/A , N/A , N/A ,$170.00 , N/A ,$119.20 ,$56.00 ,$180.00 , N/A ,$170.00 ,$169.00 ,$169.00 , N/A ,$130.00 ST. JOSEPH'S HOSPITAL - BREESE,47000078,N/A,HC UHC PRO FEE - ENTRY,470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000079,N/A,HC UHC HEARING AID FITTING/FOLLOW-UP TIER 1,470,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 , N/A ,$195.00 ,$179.10 , N/A ,$84.00 ,$198.60 , N/A ,$198.60 , N/A ,$178.80 ,$178.80 , N/A ,$178.80 , N/A ,$231.00 , N/A , N/A , N/A ,$225.00 ,$213.00 ,$213.00 , N/A ,$213.00 ,$255.00 ,$255.00 ,$255.00 , N/A , N/A ,$255.00 , N/A ,$300.00 ,$168.30 , N/A ,$124.20 , N/A , N/A , N/A ,$255.00 , N/A ,$178.80 ,$84.00 ,$270.00 , N/A ,$255.00 ,$253.50 ,$253.50 , N/A ,$195.00 ST. JOSEPH'S HOSPITAL - BREESE,47000080,N/A,HC UHC HEARING AID FITTING/FOLLOW-UP TIER 2,470,1 ,$400.00 ,$288.00 ,$112.00 ,$400.00 , N/A ,$260.00 ,$238.80 , N/A ,$112.00 ,$264.80 , N/A ,$264.80 , N/A ,$238.40 ,$238.40 , N/A ,$238.40 , N/A ,$308.00 , N/A , N/A , N/A ,$300.00 ,$284.00 ,$284.00 , N/A ,$284.00 ,$340.00 ,$340.00 ,$340.00 , N/A , N/A ,$340.00 , N/A ,$400.00 ,$224.40 , N/A ,$165.60 , N/A , N/A , N/A ,$340.00 , N/A ,$238.40 ,$112.00 ,$360.00 , N/A ,$340.00 ,$338.00 ,$338.00 , N/A ,$260.00 ST. JOSEPH'S HOSPITAL - BREESE,47000081,N/A,HC UHC HEARING AID FITTING/FOLLOW-UP TIER 3,470,1 ,$400.00 ,$288.00 ,$112.00 ,$400.00 , N/A ,$260.00 ,$238.80 , N/A ,$112.00 ,$264.80 , N/A ,$264.80 , N/A ,$238.40 ,$238.40 , N/A ,$238.40 , N/A ,$308.00 , N/A , N/A , N/A ,$300.00 ,$284.00 ,$284.00 , N/A ,$284.00 ,$340.00 ,$340.00 ,$340.00 , N/A , N/A ,$340.00 , N/A ,$400.00 ,$224.40 , N/A ,$165.60 , N/A , N/A , N/A ,$340.00 , N/A ,$238.40 ,$112.00 ,$360.00 , N/A ,$340.00 ,$338.00 ,$338.00 , N/A ,$260.00 ST. JOSEPH'S HOSPITAL - BREESE,47000082,N/A,HC UHC HEARING AID FITTING/FOLLOW-UP TIER 4,470,1 ,$500.00 ,$360.00 ,$140.00 ,$500.00 , N/A ,$325.00 ,$298.50 , N/A ,$140.00 ,$331.00 , N/A ,$331.00 , N/A ,$298.00 ,$298.00 , N/A ,$298.00 , N/A ,$385.00 , N/A , N/A , N/A ,$375.00 ,$355.00 ,$355.00 , N/A ,$355.00 ,$425.00 ,$425.00 ,$425.00 , N/A , N/A ,$425.00 , N/A ,$500.00 ,$280.50 , N/A ,$207.00 , N/A , N/A , N/A ,$425.00 , N/A ,$298.00 ,$140.00 ,$450.00 , N/A ,$425.00 ,$422.50 ,$422.50 , N/A ,$325.00 ST. JOSEPH'S HOSPITAL - BREESE,47000083,N/A,HC UHC HEARING AID FITTING/FOLLOW-UP TIER 5,470,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,47000084,N/A,HC UHC LYRIC (PER YEAR),470,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 , N/A ,$390.00 ,$358.20 , N/A ,$168.00 ,$397.20 , N/A ,$397.20 , N/A ,$357.60 ,$357.60 , N/A ,$357.60 , N/A ,$462.00 , N/A , N/A , N/A ,$450.00 ,$426.00 ,$426.00 , N/A ,$426.00 ,$510.00 ,$510.00 ,$510.00 , N/A , N/A ,$510.00 , N/A ,$600.00 ,$336.60 , N/A ,$248.40 , N/A , N/A , N/A ,$510.00 , N/A ,$357.60 ,$168.00 ,$540.00 , N/A ,$510.00 ,$507.00 ,$507.00 , N/A ,$390.00 ST. JOSEPH'S HOSPITAL - BREESE,47000085,N/A,HC UHC HEARING AID FITTING/FOLLOW-UP TIER 6,470,1 ,$700.00 ,$504.00 ,$196.00 ,$700.00 , N/A ,$455.00 ,$417.90 , N/A ,$196.00 ,$463.40 , N/A ,$463.40 , N/A ,$417.20 ,$417.20 , N/A ,$417.20 , N/A ,$539.00 , N/A , N/A , N/A ,$525.00 ,$497.00 ,$497.00 , N/A ,$497.00 ,$595.00 ,$595.00 ,$595.00 , N/A , N/A ,$595.00 , N/A ,$700.00 ,$392.70 , N/A ,$289.80 , N/A , N/A , N/A ,$595.00 , N/A ,$417.20 ,$196.00 ,$630.00 , N/A ,$595.00 ,$591.50 ,$591.50 , N/A ,$455.00 ST. JOSEPH'S HOSPITAL - BREESE,47000086,N/A,HC UHC AUDIENT PROGRAM - ENTRY (MONAURAL AND BINAURAL),470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000087,N/A,HC UHC AUDIENT PROGRAM - ALL OTHERS (BINAURAL),470,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$144.90 , N/A , N/A , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 ,$295.75 ,$295.75 , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,47000088,N/A,HC UHC AUDIENT PROGRAM - ALL OTHERS (MONAURAL),470,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 , N/A ,$162.50 ,$149.25 , N/A ,$70.00 ,$165.50 , N/A ,$165.50 , N/A ,$149.00 ,$149.00 , N/A ,$149.00 , N/A ,$192.50 , N/A , N/A , N/A ,$187.50 ,$177.50 ,$177.50 , N/A ,$177.50 ,$212.50 ,$212.50 ,$212.50 , N/A , N/A ,$212.50 , N/A ,$250.00 ,$140.25 , N/A ,$103.50 , N/A , N/A , N/A ,$212.50 , N/A ,$149.00 ,$70.00 ,$225.00 , N/A ,$212.50 ,$211.25 ,$211.25 , N/A ,$162.50 ST. JOSEPH'S HOSPITAL - BREESE,47000089,N/A,HC UHC HEARING TEST AND EVALUATION,470,1 ,$40.00 ,$28.80 ,$11.20 ,$40.00 , N/A ,$26.00 ,$23.88 , N/A ,$11.20 ,$26.48 , N/A ,$26.48 , N/A ,$23.84 ,$23.84 , N/A ,$23.84 , N/A ,$30.80 , N/A , N/A , N/A ,$30.00 ,$28.40 ,$28.40 , N/A ,$28.40 ,$34.00 ,$34.00 ,$34.00 , N/A , N/A ,$34.00 , N/A ,$40.00 ,$22.44 , N/A ,$16.56 , N/A , N/A , N/A ,$34.00 , N/A ,$23.84 ,$11.20 ,$36.00 , N/A ,$34.00 ,$33.80 ,$33.80 , N/A ,$26.00 ST. JOSEPH'S HOSPITAL - BREESE,47000094,V5014,HC REPAIR HEARING AID T14,470,1 ,"$1,400.00 ","$1,008.00 ",$92.91 ,"$1,400.00 ", N/A ,$910.00 ,$835.80 , N/A ,$392.00 ,$926.80 , N/A ,$926.80 , N/A ,$834.40 ,$834.40 , N/A ,$834.40 , N/A ,"$1,078.00 ", N/A , N/A , N/A ,"$1,050.00 ",$994.00 ,$994.00 , N/A ,$994.00 ,"$1,190.00 ","$1,190.00 ","$1,190.00 ", N/A , N/A ,"$1,190.00 ", N/A ,"$1,400.00 ",$785.40 , N/A ,$579.60 ,$102.20 ,$92.91 , N/A ,"$1,190.00 ", N/A ,$834.40 ,$392.00 ,"$1,260.00 ", N/A ,"$1,190.00 ","$1,183.00 ","$1,183.00 ", N/A ,$910.00 ST. JOSEPH'S HOSPITAL - BREESE,47000095,V5299,HC WARRANTY/DEDUCTIBLE T11,470,1 ,$875.00 ,$630.00 ,$245.00 ,$875.00 , N/A ,$568.75 ,$522.38 , N/A ,$245.00 ,$579.25 , N/A ,$579.25 , N/A ,$521.50 ,$521.50 , N/A ,$521.50 , N/A ,$673.75 , N/A , N/A , N/A ,$656.25 ,$621.25 ,$621.25 , N/A ,$621.25 ,$743.75 ,$743.75 ,$743.75 , N/A , N/A ,$743.75 , N/A ,$875.00 ,$490.88 , N/A ,$362.25 , N/A , N/A , N/A ,$743.75 , N/A ,$521.50 ,$245.00 ,$787.50 , N/A ,$743.75 ,$739.38 ,$739.38 , N/A ,$568.75 ST. JOSEPH'S HOSPITAL - BREESE,47000096,V5299,HC WARRANTY/DEDUCTIBLE T12,470,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ", N/A ,$682.50 ,$626.85 , N/A ,$294.00 ,$695.10 , N/A ,$695.10 , N/A ,$625.80 ,$625.80 , N/A ,$625.80 , N/A ,$808.50 , N/A , N/A , N/A ,$787.50 ,$745.50 ,$745.50 , N/A ,$745.50 ,$892.50 ,$892.50 ,$892.50 , N/A , N/A ,$892.50 , N/A ,"$1,050.00 ",$589.05 , N/A ,$434.70 , N/A , N/A , N/A ,$892.50 , N/A ,$625.80 ,$294.00 ,$945.00 , N/A ,$892.50 ,$887.25 ,$887.25 , N/A ,$682.50 ST. JOSEPH'S HOSPITAL - BREESE,47000097,V5299,HC WARRANTY/DEDUCTIBLE T13,470,1 ,"$1,225.00 ",$882.00 ,$343.00 ,"$1,225.00 ", N/A ,$796.25 ,$731.33 , N/A ,$343.00 ,$810.95 , N/A ,$810.95 , N/A ,$730.10 ,$730.10 , N/A ,$730.10 , N/A ,$943.25 , N/A , N/A , N/A ,$918.75 ,$869.75 ,$869.75 , N/A ,$869.75 ,"$1,041.25 ","$1,041.25 ","$1,041.25 ", N/A , N/A ,"$1,041.25 ", N/A ,"$1,225.00 ",$687.23 , N/A ,$507.15 , N/A , N/A , N/A ,"$1,041.25 ", N/A ,$730.10 ,$343.00 ,"$1,102.50 ", N/A ,"$1,041.25 ","$1,035.13 ","$1,035.13 ", N/A ,$796.25 ST. JOSEPH'S HOSPITAL - BREESE,47100001,92550,HC AUD TYMPAN/REFLEX THRESHOLD MEASURE,471,1 ,$134.00 ,$96.48 ,$37.52 ,$349.16 ,$349.15 ,$87.10 ,$80.00 ,$136.87 ,$37.52 ,$88.71 ,$136.87 ,$88.71 ,$131.32 ,$79.86 ,$79.86 ,$131.32 ,$79.86 ,$134.00 ,$103.18 ,$349.16 ,$136.87 ,$131.32 ,$100.50 ,$95.14 ,$95.14 ,$136.87 ,$95.14 ,$113.90 ,$113.90 ,$113.90 , N/A ,$134.00 ,$113.90 ,$131.32 ,$134.00 ,$75.17 ,$136.87 ,$55.48 ,$134.00 ,$134.00 ,$136.87 ,$113.90 ,$293.29 ,$79.86 ,$37.52 ,$120.60 ,$136.87 ,$113.90 ,$113.23 ,$113.23 ,$136.87 ,$87.10 ST. JOSEPH'S HOSPITAL - BREESE,47100003,92567,HC TYMPANOMETRY IMPED TEST,471,1 ,$156.00 ,$112.32 ,$31.96 ,$156.00 ,$81.53 ,$101.40 ,$93.13 ,$31.96 ,$43.68 ,$103.27 ,$31.96 ,$103.27 ,$31.96 ,$92.98 ,$92.98 ,$31.96 ,$92.98 ,$65.88 ,$120.12 ,$81.53 ,$31.96 ,$32.60 ,$117.00 ,$110.76 ,$110.76 ,$31.96 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$81.53 ,$132.60 ,$31.96 ,$156.00 ,$87.52 ,$31.96 ,$64.58 ,$102.20 ,$92.91 ,$31.96 ,$132.60 ,$68.49 ,$92.98 ,$43.68 ,$140.40 ,$31.96 ,$132.60 ,$131.82 ,$131.82 ,$31.96 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,47100006,92557,HC AUD COMPREHENSIVE AUDIO,471,1 ,$375.00 ,$270.00 ,$92.91 ,$375.00 ,$349.15 ,$243.75 ,$223.88 ,$136.87 ,$105.00 ,$248.25 ,$136.87 ,$248.25 ,$136.87 ,$223.50 ,$223.50 ,$136.87 ,$223.50 ,$282.12 ,$288.75 ,$349.16 ,$136.87 ,$139.61 ,$281.25 ,$266.25 ,$266.25 ,$136.87 ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A ,$349.16 ,$318.75 ,$136.87 ,$375.00 ,$210.38 ,$136.87 ,$155.25 ,$102.20 ,$92.91 ,$136.87 ,$318.75 ,$293.29 ,$223.50 ,$105.00 ,$337.50 ,$136.87 ,$318.75 ,$316.88 ,$316.88 ,$136.87 ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,47100007,92582,HC AUD CONDITION PLAY AUDIOMETRY,471,1 ,$185.00 ,$133.20 ,$51.80 ,$349.16 ,$349.15 ,$120.25 ,$110.45 ,$136.87 ,$51.80 ,$122.47 ,$136.87 ,$122.47 ,$136.87 ,$110.26 ,$110.26 ,$136.87 ,$110.26 ,$185.00 ,$142.45 ,$349.16 ,$136.87 ,$139.61 ,$138.75 ,$131.35 ,$131.35 ,$136.87 ,$131.35 ,$157.25 ,$157.25 ,$157.25 , N/A ,$185.00 ,$157.25 ,$136.87 ,$185.00 ,$103.79 ,$136.87 ,$76.59 ,$88.41 ,$80.37 ,$136.87 ,$157.25 ,$293.29 ,$110.26 ,$51.80 ,$166.50 ,$136.87 ,$157.25 ,$156.33 ,$156.33 ,$136.87 ,$120.25 ST. JOSEPH'S HOSPITAL - BREESE,47100008,92588,HC AUD EVOKED OTOACOUS EMISSIONS COMP EVAL,471,1 ,$120.00 ,$86.40 ,$33.60 ,$672.38 ,$672.38 ,$78.00 ,$71.64 ,$263.57 ,$33.60 ,$79.44 ,$263.57 ,$79.44 ,$117.60 ,$71.52 ,$71.52 ,$117.60 ,$71.52 ,$120.00 ,$92.40 ,$672.38 ,$263.57 ,$117.60 ,$90.00 ,$85.20 ,$85.20 ,$263.57 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 ,$117.60 ,$120.00 ,$67.32 ,$263.57 ,$49.68 ,$120.00 ,$120.00 ,$263.57 ,$102.00 ,$564.80 ,$71.52 ,$33.60 ,$108.00 ,$263.57 ,$102.00 ,$101.40 ,$101.40 ,$263.57 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,47100009,92558,HC AUD EVOKED OTOACOUS EMISSIONS SCREENING,471,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 , N/A ,$78.00 ,$71.64 , N/A ,$33.60 ,$79.44 , N/A ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A , N/A , N/A ,$90.00 ,$85.20 ,$85.20 , N/A ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A , N/A ,$102.00 , N/A ,$120.00 ,$67.32 , N/A ,$49.68 ,$102.20 ,$92.91 , N/A ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 , N/A ,$102.00 ,$101.40 ,$101.40 , N/A ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,47100011,92553,HC AUD PURE TONE AIR AND BONE,471,1 ,$305.00 ,$219.60 ,$85.40 ,$349.16 ,$349.15 ,$198.25 ,$182.09 ,$136.87 ,$85.40 ,$201.91 ,$136.87 ,$201.91 ,$136.87 ,$181.78 ,$181.78 ,$136.87 ,$181.78 ,$282.12 ,$234.85 ,$349.16 ,$136.87 ,$139.61 ,$228.75 ,$216.55 ,$216.55 ,$136.87 ,$216.55 ,$259.25 ,$259.25 ,$259.25 , N/A ,$305.00 ,$259.25 ,$136.87 ,$305.00 ,$171.11 ,$136.87 ,$126.27 ,$102.20 ,$92.91 ,$136.87 ,$259.25 ,$293.29 ,$181.78 ,$85.40 ,$274.50 ,$136.87 ,$259.25 ,$257.73 ,$257.73 ,$136.87 ,$198.25 ST. JOSEPH'S HOSPITAL - BREESE,47100012,92553,HC AUD PURE TONE AIR AND BONE -52,471,1 ,$305.00 ,$219.60 ,$46.46 ,$305.00 ,$174.58 ,$198.25 ,$182.09 ,$68.43 ,$85.40 ,$201.91 ,$68.43 ,$201.91 ,$68.43 ,$181.78 ,$181.78 ,$68.43 ,$181.78 ,$141.06 ,$234.85 ,$174.58 ,$68.43 ,$69.81 ,$228.75 ,$216.55 ,$216.55 ,$68.43 ,$216.55 ,$259.25 ,$259.25 ,$259.25 , N/A ,$174.58 ,$259.25 ,$68.43 ,$305.00 ,$171.11 ,$68.43 ,$126.27 ,$51.11 ,$46.46 ,$68.43 ,$259.25 ,$146.65 ,$181.78 ,$85.40 ,$274.50 ,$68.43 ,$259.25 ,$257.73 ,$257.73 ,$68.43 ,$198.25 ST. JOSEPH'S HOSPITAL - BREESE,47100013,92552,HC AUD PURE TONE AIR ONLY,471,1 ,$88.00 ,$63.36 ,$24.64 ,$278.78 ,$278.78 ,$57.20 ,$52.54 ,$109.28 ,$24.64 ,$58.26 ,$109.28 ,$58.26 ,$86.24 ,$52.45 ,$52.45 ,$86.24 ,$52.45 ,$88.00 ,$67.76 ,$278.76 ,$109.28 ,$86.24 ,$66.00 ,$62.48 ,$62.48 ,$109.28 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$88.00 ,$74.80 ,$86.24 ,$88.00 ,$49.37 ,$109.28 ,$36.43 ,$88.00 ,$88.00 ,$109.28 ,$74.80 ,$234.16 ,$52.45 ,$24.64 ,$79.20 ,$109.28 ,$74.80 ,$74.36 ,$74.36 ,$109.28 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,47100014,92583,HC AUD SELECT PICTURE AUDIOMETRY,471,1 ,$119.00 ,$85.68 ,$33.32 ,$138.00 ,$138.00 ,$77.35 ,$71.04 ,$54.10 ,$33.32 ,$78.78 ,$54.10 ,$78.78 ,$54.10 ,$70.92 ,$70.92 ,$54.10 ,$70.92 ,$111.50 ,$91.63 ,$138.00 ,$54.10 ,$55.17 ,$89.25 ,$84.49 ,$84.49 ,$54.10 ,$84.49 ,$101.15 ,$101.15 ,$101.15 , N/A ,$119.00 ,$101.15 ,$54.10 ,$119.00 ,$66.76 ,$54.10 ,$49.27 ,$88.41 ,$80.37 ,$54.10 ,$101.15 ,$115.92 ,$70.92 ,$33.32 ,$107.10 ,$54.10 ,$101.15 ,$100.56 ,$100.56 ,$54.10 ,$77.35 ST. JOSEPH'S HOSPITAL - BREESE,47100015,92555,HC AUD SPEECH THRESHOLD,471,1 ,$87.00 ,$62.64 ,$24.36 ,$87.00 ,$81.53 ,$56.55 ,$51.94 ,$31.96 ,$24.36 ,$57.59 ,$31.96 ,$57.59 ,$31.96 ,$51.85 ,$51.85 ,$31.96 ,$51.85 ,$65.88 ,$66.99 ,$81.53 ,$31.96 ,$32.60 ,$65.25 ,$61.77 ,$61.77 ,$31.96 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$81.53 ,$73.95 ,$31.96 ,$87.00 ,$48.81 ,$31.96 ,$36.02 ,$87.00 ,$87.00 ,$31.96 ,$73.95 ,$68.49 ,$51.85 ,$24.36 ,$78.30 ,$31.96 ,$73.95 ,$73.52 ,$73.52 ,$31.96 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,47100016,92556,HC AUD SPEECH THRESHOLD W/SPEECH RECOGNITION,471,1 ,$156.00 ,$112.32 ,$43.68 ,$156.00 ,$138.00 ,$101.40 ,$93.13 ,$54.10 ,$43.68 ,$103.27 ,$54.10 ,$103.27 ,$54.10 ,$92.98 ,$92.98 ,$54.10 ,$92.98 ,$111.50 ,$120.12 ,$138.00 ,$54.10 ,$55.17 ,$117.00 ,$110.76 ,$110.76 ,$54.10 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$138.00 ,$132.60 ,$54.10 ,$156.00 ,$87.52 ,$54.10 ,$64.58 ,$102.20 ,$92.91 ,$54.10 ,$132.60 ,$115.92 ,$92.98 ,$43.68 ,$140.40 ,$54.10 ,$132.60 ,$131.82 ,$131.82 ,$54.10 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,47100017,92579,HC AUD VISUAL REINFORCEMENT AUDIOMETRY,471,1 ,$204.00 ,$146.88 ,$57.12 ,$349.16 ,$349.15 ,$132.60 ,$121.79 ,$136.87 ,$57.12 ,$135.05 ,$136.87 ,$135.05 ,$136.87 ,$121.58 ,$121.58 ,$136.87 ,$121.58 ,$204.00 ,$157.08 ,$349.16 ,$136.87 ,$139.61 ,$153.00 ,$144.84 ,$144.84 ,$136.87 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$136.87 ,$204.00 ,$114.44 ,$136.87 ,$84.46 ,$102.20 ,$92.91 ,$136.87 ,$173.40 ,$293.29 ,$121.58 ,$57.12 ,$183.60 ,$136.87 ,$173.40 ,$172.38 ,$172.38 ,$136.87 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,47100019,92537,HC CALORIC VESTIBULAR TEST W/REC BILAT BITHERMAL,471,1 ,$561.00 ,$403.92 ,$136.87 ,$561.00 ,$349.15 ,$364.65 ,$334.92 ,$136.87 ,$157.08 ,$371.38 ,$136.87 ,$371.38 ,$136.87 ,$334.36 ,$334.36 ,$136.87 ,$334.36 ,$282.12 ,$431.97 ,$349.16 ,$136.87 ,$139.61 ,$420.75 ,$398.31 ,$398.31 ,$136.87 ,$398.31 ,$476.85 ,$476.85 ,$476.85 , N/A ,$349.16 ,$476.85 ,$136.87 ,$561.00 ,$314.72 ,$136.87 ,$232.25 ,$161.47 ,$146.79 ,$136.87 ,$476.85 ,$293.29 ,$334.36 ,$157.08 ,$504.90 ,$136.87 ,$476.85 ,$474.05 ,$474.05 ,$136.87 ,$364.65 ST. JOSEPH'S HOSPITAL - BREESE,47100020,92538,HC CALORIC VESTIBULAR TEST W/REC BILAT MONOTHERMAL,471,1 ,$561.00 ,$403.92 ,$136.87 ,$561.00 ,$349.15 ,$364.65 ,$334.92 ,$136.87 ,$157.08 ,$371.38 ,$136.87 ,$371.38 ,$136.87 ,$334.36 ,$334.36 ,$136.87 ,$334.36 ,$282.12 ,$431.97 ,$349.16 ,$136.87 ,$139.61 ,$420.75 ,$398.31 ,$398.31 ,$136.87 ,$398.31 ,$476.85 ,$476.85 ,$476.85 , N/A ,$349.16 ,$476.85 ,$136.87 ,$561.00 ,$314.72 ,$136.87 ,$232.25 ,$161.47 ,$146.79 ,$136.87 ,$476.85 ,$293.29 ,$334.36 ,$157.08 ,$504.90 ,$136.87 ,$476.85 ,$474.05 ,$474.05 ,$136.87 ,$364.65 ST. JOSEPH'S HOSPITAL - BREESE,47100021,92540,HC BASIC VESTIBULAR EVAL,471,1 ,$828.00 ,$596.16 ,$136.87 ,$828.00 ,$349.15 ,$538.20 ,$494.32 ,$136.87 ,$231.84 ,$548.14 ,$136.87 ,$548.14 ,$136.87 ,$493.49 ,$493.49 ,$136.87 ,$493.49 ,$282.12 ,$500.00 ,$349.16 ,$136.87 ,$139.61 ,$621.00 ,$587.88 ,$587.88 ,$136.87 ,$587.88 ,$703.80 ,$703.80 ,$703.80 , N/A ,$349.16 ,$703.80 ,$136.87 ,$828.00 ,$464.51 ,$136.87 ,$342.79 ,$161.47 ,$146.79 ,$136.87 ,$703.80 ,$293.29 ,$493.49 ,$231.84 ,$745.20 ,$136.87 ,$703.80 ,$699.66 ,$699.66 ,$136.87 ,$538.20 ST. JOSEPH'S HOSPITAL - BREESE,47100023,92542,HC POSITIONAL NYSTAGMUS TEST W/RECORDING,471,1 ,$311.00 ,$223.92 ,$80.37 ,$311.00 ,$278.78 ,$202.15 ,$185.67 ,$109.28 ,$87.08 ,$205.88 ,$109.28 ,$205.88 ,$109.28 ,$185.36 ,$185.36 ,$109.28 ,$185.36 ,$225.24 ,$239.47 ,$278.76 ,$109.28 ,$111.47 ,$233.25 ,$220.81 ,$220.81 ,$109.28 ,$220.81 ,$264.35 ,$264.35 ,$264.35 , N/A ,$278.76 ,$264.35 ,$109.28 ,$311.00 ,$174.47 ,$109.28 ,$128.75 ,$88.41 ,$80.37 ,$109.28 ,$264.35 ,$234.16 ,$185.36 ,$87.08 ,$279.90 ,$109.28 ,$264.35 ,$262.80 ,$262.80 ,$109.28 ,$202.15 ST. JOSEPH'S HOSPITAL - BREESE,47100038,92592,HC HEARING AID CHECK MONAURAL,471,1 ,$68.00 ,$48.96 ,$19.04 ,$68.00 , N/A ,$44.20 ,$40.60 , N/A ,$19.04 ,$45.02 , N/A ,$45.02 , N/A ,$40.53 ,$40.53 , N/A ,$40.53 , N/A ,$52.36 , N/A , N/A , N/A ,$51.00 ,$48.28 ,$48.28 , N/A ,$48.28 ,$57.80 ,$57.80 ,$57.80 , N/A , N/A ,$57.80 , N/A ,$68.00 ,$38.15 , N/A ,$28.15 ,$68.00 ,$68.00 , N/A ,$57.80 , N/A ,$40.53 ,$19.04 ,$61.20 , N/A ,$57.80 ,$57.46 ,$57.46 , N/A ,$44.20 ST. JOSEPH'S HOSPITAL - BREESE,47100039,92591,HC HEARING AID EXAM BINAURAL,471,1 ,$211.00 ,$151.92 ,$59.08 ,$211.00 , N/A ,$137.15 ,$125.97 , N/A ,$59.08 ,$139.68 , N/A ,$139.68 , N/A ,$125.76 ,$125.76 , N/A ,$125.76 , N/A ,$162.47 , N/A , N/A , N/A ,$158.25 ,$149.81 ,$149.81 , N/A ,$149.81 ,$179.35 ,$179.35 ,$179.35 , N/A , N/A ,$179.35 , N/A ,$211.00 ,$118.37 , N/A ,$87.35 ,$102.20 ,$92.91 , N/A ,$179.35 , N/A ,$125.76 ,$59.08 ,$189.90 , N/A ,$179.35 ,$178.30 ,$178.30 , N/A ,$137.15 ST. JOSEPH'S HOSPITAL - BREESE,47100040,92590,HC HEARING AID EXAM MONAURAL,471,1 ,$206.00 ,$148.32 ,$57.68 ,$206.00 , N/A ,$133.90 ,$122.98 , N/A ,$57.68 ,$136.37 , N/A ,$136.37 , N/A ,$122.78 ,$122.78 , N/A ,$122.78 , N/A ,$158.62 , N/A , N/A , N/A ,$154.50 ,$146.26 ,$146.26 , N/A ,$146.26 ,$175.10 ,$175.10 ,$175.10 , N/A , N/A ,$175.10 , N/A ,$206.00 ,$115.57 , N/A ,$85.28 ,$102.20 ,$92.91 , N/A ,$175.10 , N/A ,$122.78 ,$57.68 ,$185.40 , N/A ,$175.10 ,$174.07 ,$174.07 , N/A ,$133.90 ST. JOSEPH'S HOSPITAL - BREESE,47100041,92555,HC AUD SPEECH THRESHOLD -52,471,1 ,$87.00 ,$62.64 ,$15.98 ,$87.00 ,$40.78 ,$56.55 ,$51.94 ,$15.98 ,$24.36 ,$57.59 ,$15.98 ,$57.59 ,$15.98 ,$51.85 ,$51.85 ,$15.98 ,$51.85 ,$32.94 ,$66.99 ,$40.77 ,$15.98 ,$16.30 ,$65.25 ,$61.77 ,$61.77 ,$15.98 ,$61.77 ,$73.95 ,$73.95 ,$73.95 , N/A ,$40.77 ,$73.95 ,$15.98 ,$87.00 ,$48.81 ,$15.98 ,$36.02 ,$51.11 ,$46.46 ,$15.98 ,$73.95 ,$34.24 ,$51.85 ,$24.36 ,$78.30 ,$15.98 ,$73.95 ,$73.52 ,$73.52 ,$15.98 ,$56.55 ST. JOSEPH'S HOSPITAL - BREESE,47100042,92567,HC TYMPANOMETRY IMPED TEST -52,471,1 ,$156.00 ,$112.32 ,$15.98 ,$156.00 ,$40.78 ,$101.40 ,$93.13 ,$15.98 ,$43.68 ,$103.27 ,$15.98 ,$103.27 ,$15.98 ,$92.98 ,$92.98 ,$15.98 ,$92.98 ,$32.94 ,$120.12 ,$40.77 ,$15.98 ,$16.30 ,$117.00 ,$110.76 ,$110.76 ,$15.98 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$40.77 ,$132.60 ,$15.98 ,$156.00 ,$87.52 ,$15.98 ,$64.58 ,$51.11 ,$46.46 ,$15.98 ,$132.60 ,$34.24 ,$92.98 ,$43.68 ,$140.40 ,$15.98 ,$132.60 ,$131.82 ,$131.82 ,$15.98 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,47100043,92552,HC AUD PURE TONE AIR ONLY -52,471,1 ,$88.00 ,$63.36 ,$24.64 ,$139.38 ,$139.38 ,$57.20 ,$52.54 ,$54.63 ,$24.64 ,$58.26 ,$54.63 ,$58.26 ,$54.63 ,$52.45 ,$52.45 ,$54.63 ,$52.45 ,$88.00 ,$67.76 ,$139.38 ,$54.63 ,$55.73 ,$66.00 ,$62.48 ,$62.48 ,$54.63 ,$62.48 ,$74.80 ,$74.80 ,$74.80 , N/A ,$88.00 ,$74.80 ,$54.63 ,$88.00 ,$49.37 ,$54.63 ,$36.43 ,$51.11 ,$46.46 ,$54.63 ,$74.80 ,$117.08 ,$52.45 ,$24.64 ,$79.20 ,$54.63 ,$74.80 ,$74.36 ,$74.36 ,$54.63 ,$57.20 ST. JOSEPH'S HOSPITAL - BREESE,47100044,92556,HC AUD SPEECH THRESHOLD W/SPEECH RECOGNITION -52,471,1 ,$156.00 ,$112.32 ,$27.05 ,$156.00 ,$69.00 ,$101.40 ,$93.13 ,$27.05 ,$43.68 ,$103.27 ,$27.05 ,$103.27 ,$27.05 ,$92.98 ,$92.98 ,$27.05 ,$92.98 ,$55.75 ,$120.12 ,$69.00 ,$27.05 ,$27.59 ,$117.00 ,$110.76 ,$110.76 ,$27.05 ,$110.76 ,$132.60 ,$132.60 ,$132.60 , N/A ,$69.00 ,$132.60 ,$27.05 ,$156.00 ,$87.52 ,$27.05 ,$64.58 ,$51.11 ,$46.46 ,$27.05 ,$132.60 ,$57.96 ,$92.98 ,$43.68 ,$140.40 ,$27.05 ,$132.60 ,$131.82 ,$131.82 ,$27.05 ,$101.40 ST. JOSEPH'S HOSPITAL - BREESE,47100046,92540,HC BASIC VESTIBULAR EVAL -52,471,1 ,$828.00 ,$596.16 ,$68.43 ,$828.00 ,$174.58 ,$538.20 ,$494.32 ,$68.43 ,$231.84 ,$548.14 ,$68.43 ,$548.14 ,$68.43 ,$493.49 ,$493.49 ,$68.43 ,$493.49 ,$141.06 ,$500.00 ,$174.58 ,$68.43 ,$69.81 ,$621.00 ,$587.88 ,$587.88 ,$68.43 ,$587.88 ,$703.80 ,$703.80 ,$703.80 , N/A ,$174.58 ,$703.80 ,$68.43 ,$828.00 ,$464.51 ,$68.43 ,$342.79 ,$80.73 ,$73.39 ,$68.43 ,$703.80 ,$146.65 ,$493.49 ,$231.84 ,$745.20 ,$68.43 ,$703.80 ,$699.66 ,$699.66 ,$68.43 ,$538.20 ST. JOSEPH'S HOSPITAL - BREESE,47100047,V5008,HC HEARING SCREENING,471,1 ,$82.00 ,$59.04 ,$22.96 ,$82.00 , N/A ,$53.30 ,$48.95 , N/A ,$22.96 ,$54.28 , N/A ,$54.28 , N/A ,$48.87 ,$48.87 , N/A ,$48.87 , N/A ,$63.14 , N/A , N/A , N/A ,$61.50 ,$58.22 ,$58.22 , N/A ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A , N/A ,$69.70 , N/A ,$82.00 ,$46.00 , N/A ,$33.95 ,$82.00 ,$82.00 , N/A ,$69.70 , N/A ,$48.87 ,$22.96 ,$73.80 , N/A ,$69.70 ,$69.29 ,$69.29 , N/A ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,47100048,92587,HC DISTORTION AUDITORY EVOKED POTENT LTD-52,471,1 ,$277.00 ,$199.44 ,$73.39 ,$336.20 ,$336.20 ,$180.05 ,$165.37 ,$131.79 ,$77.56 ,$183.37 ,$131.79 ,$183.37 ,$131.79 ,$165.09 ,$165.09 ,$131.79 ,$165.09 ,$271.64 ,$213.29 ,$336.19 ,$131.79 ,$134.43 ,$207.75 ,$196.67 ,$196.67 ,$131.79 ,$196.67 ,$235.45 ,$235.45 ,$235.45 , N/A ,$277.00 ,$235.45 ,$131.79 ,$277.00 ,$155.40 ,$131.79 ,$114.68 ,$80.73 ,$73.39 ,$131.79 ,$235.45 ,$282.40 ,$165.09 ,$77.56 ,$249.30 ,$131.79 ,$235.45 ,$234.07 ,$234.07 ,$131.79 ,$180.05 ST. JOSEPH'S HOSPITAL - BREESE,47100049,92588,HC AUD EVOKED OTOACOUS EMISSIONS COMP EVAL-52,471,1 ,$120.00 ,$86.40 ,$33.60 ,$336.20 ,$336.20 ,$78.00 ,$71.64 ,$131.79 ,$33.60 ,$79.44 ,$131.79 ,$79.44 ,$117.60 ,$71.52 ,$71.52 ,$117.60 ,$71.52 ,$120.00 ,$92.40 ,$336.19 ,$131.79 ,$117.60 ,$90.00 ,$85.20 ,$85.20 ,$131.79 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 ,$117.60 ,$120.00 ,$67.32 ,$131.79 ,$49.68 ,$80.73 ,$73.39 ,$131.79 ,$102.00 ,$282.40 ,$71.52 ,$33.60 ,$108.00 ,$131.79 ,$102.00 ,$101.40 ,$101.40 ,$131.79 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,47100050,92557,HC AUD COMPREHENSIVE AUDIO-52,471,1 ,$375.00 ,$270.00 ,$46.46 ,$375.00 ,$174.58 ,$243.75 ,$223.88 ,$68.43 ,$105.00 ,$248.25 ,$68.43 ,$248.25 ,$68.43 ,$223.50 ,$223.50 ,$68.43 ,$223.50 ,$141.06 ,$288.75 ,$174.58 ,$68.43 ,$69.81 ,$281.25 ,$266.25 ,$266.25 ,$68.43 ,$266.25 ,$318.75 ,$318.75 ,$318.75 , N/A ,$174.58 ,$318.75 ,$68.43 ,$375.00 ,$210.38 ,$68.43 ,$155.25 ,$51.11 ,$46.46 ,$68.43 ,$318.75 ,$146.65 ,$223.50 ,$105.00 ,$337.50 ,$68.43 ,$318.75 ,$316.88 ,$316.88 ,$68.43 ,$243.75 ST. JOSEPH'S HOSPITAL - BREESE,47100051,92570,HC AUD ACOUSTIC REFLEX DECAY-52,471,1 ,$46.00 ,$33.12 ,$12.88 ,$174.58 ,$174.58 ,$29.90 ,$27.46 ,$68.43 ,$12.88 ,$30.45 ,$68.43 ,$30.45 ,$45.08 ,$27.42 ,$27.42 ,$45.08 ,$27.42 ,$46.00 ,$35.42 ,$174.58 ,$68.43 ,$45.08 ,$34.50 ,$32.66 ,$32.66 ,$68.43 ,$32.66 ,$39.10 ,$39.10 ,$39.10 , N/A ,$46.00 ,$39.10 ,$45.08 ,$46.00 ,$25.81 ,$68.43 ,$19.04 ,$44.21 ,$40.19 ,$68.43 ,$39.10 ,$146.65 ,$27.42 ,$12.88 ,$41.40 ,$68.43 ,$39.10 ,$38.87 ,$38.87 ,$68.43 ,$29.90 ST. JOSEPH'S HOSPITAL - BREESE,48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$1,128.00 ",$812.16 ,$315.84 ,"$1,412.04 ","$1,412.03 ",$733.20 ,$673.42 ,$553.51 ,$315.84 ,$746.74 ,$553.51 ,$746.74 ,$553.51 ,$672.29 ,$672.29 ,$553.51 ,$672.29 ,"$1,128.00 ",$868.56 ,"$1,412.04 ",$553.51 ,$564.59 ,$846.00 ,$800.88 ,$800.88 ,$553.51 ,$800.88 ,$958.80 ,$958.80 ,$958.80 , N/A ,"$1,128.00 ",$958.80 ,$553.51 ,"$1,128.00 ",$632.81 ,$553.51 ,$466.99 ,$451.08 ,$410.07 ,$553.51 ,$958.80 ,"$1,186.11 ",$672.29 ,$315.84 ,"$1,015.20 ",$553.51 ,$958.80 ,$953.16 ,$953.16 ,$553.51 ,$733.20 ST. JOSEPH'S HOSPITAL - BREESE,48000024,93668,HC PAD REHAB PER SESSION,480,1 ,$158.00 ,$113.76 ,$44.24 ,$158.00 ,$138.00 ,$102.70 ,$94.33 ,$54.10 ,$44.24 ,$104.60 ,$54.10 ,$104.60 ,$54.10 ,$94.17 ,$94.17 ,$54.10 ,$94.17 ,$111.50 ,$121.66 ,$138.00 ,$54.10 ,$55.17 ,$118.50 ,$112.18 ,$112.18 ,$54.10 ,$112.18 ,$134.30 ,$134.30 ,$134.30 , N/A ,$138.00 ,$134.30 ,$54.10 ,$158.00 ,$88.64 ,$54.10 ,$65.41 ,$158.00 ,$158.00 ,$54.10 ,$134.30 ,$115.92 ,$94.17 ,$44.24 ,$142.20 ,$54.10 ,$134.30 ,$133.51 ,$133.51 ,$54.10 ,$102.70 ST. JOSEPH'S HOSPITAL - BREESE,48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,611.00 ","$1,159.92 ",$205.45 ,"$1,611.00 ",$672.38 ,"$1,047.15 ",$961.77 ,$263.57 ,$451.08 ,"$1,066.48 ",$263.57 ,"$1,066.48 ",$263.57 ,$960.16 ,$960.16 ,$263.57 ,$960.16 ,$543.28 ,"$1,240.47 ",$672.38 ,$263.57 ,$268.84 ,"$1,208.25 ","$1,143.81 ","$1,143.81 ",$263.57 ,"$1,143.81 ","$1,369.35 ","$1,369.35 ","$1,369.35 ", N/A ,$672.38 ,"$1,369.35 ",$263.57 ,"$1,611.00 ",$903.77 ,$263.57 ,$666.95 ,$226.00 ,$205.45 ,$263.57 ,"$1,369.35 ",$564.80 ,$960.16 ,$451.08 ,"$1,449.90 ",$263.57 ,"$1,369.35 ","$1,361.30 ","$1,361.30 ",$263.57 ,"$1,047.15 " ST. JOSEPH'S HOSPITAL - BREESE,48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$1,717.00 ","$1,236.24 ",$326.53 ,"$1,717.00 ","$1,207.95 ","$1,116.05 ","$1,025.05 ",$473.52 ,$480.76 ,"$1,136.65 ",$473.52 ,"$1,136.65 ",$473.52 ,"$1,023.33 ","$1,023.33 ",$473.52 ,"$1,023.33 ",$976.02 ,"$1,322.09 ","$1,207.94 ",$473.52 ,$482.98 ,"$1,287.75 ","$1,219.07 ","$1,219.07 ",$473.52 ,"$1,219.07 ","$1,459.45 ","$1,459.45 ","$1,459.45 ", N/A ,"$1,207.94 ","$1,459.45 ",$473.52 ,"$1,717.00 ",$963.24 ,$473.52 ,$710.84 ,$359.18 ,$326.53 ,$473.52 ,"$1,459.45 ","$1,014.67 ","$1,023.33 ",$480.76 ,"$1,545.30 ",$473.52 ,"$1,459.45 ","$1,450.87 ","$1,450.87 ",$473.52 ,"$1,116.05 " ST. JOSEPH'S HOSPITAL - BREESE,48300001,93307,HC ECHOCARDIOGRAM 2D W/O DOP,483,1 ,$624.00 ,$449.28 ,$174.72 ,$624.00 ,$560.65 ,$405.60 ,$372.53 ,$219.77 ,$174.72 ,$413.09 ,$219.77 ,$413.09 ,$219.77 ,$371.90 ,$371.90 ,$219.77 ,$371.90 ,$453.00 ,$480.48 ,$560.65 ,$219.77 ,$224.17 ,$468.00 ,$443.04 ,$443.04 ,$219.77 ,$443.04 ,$530.40 ,$530.40 ,$530.40 , N/A ,$560.65 ,$530.40 ,$219.77 ,$624.00 ,$350.06 ,$219.77 ,$258.34 ,$359.18 ,$326.53 ,$219.77 ,$530.40 ,$470.94 ,$371.90 ,$174.72 ,$561.60 ,$219.77 ,$530.40 ,$527.28 ,$527.28 ,$219.77 ,$405.60 ST. JOSEPH'S HOSPITAL - BREESE,48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$466.00 ,$335.52 ,$130.48 ,$560.65 ,$560.65 ,$302.90 ,$278.20 ,$219.77 ,$130.48 ,$308.49 ,$219.77 ,$308.49 ,$219.77 ,$277.74 ,$277.74 ,$219.77 ,$277.74 ,$453.00 ,$358.82 ,$560.65 ,$219.77 ,$224.17 ,$349.50 ,$330.86 ,$330.86 ,$219.77 ,$330.86 ,$396.10 ,$396.10 ,$396.10 , N/A ,$466.00 ,$396.10 ,$219.77 ,$466.00 ,$261.43 ,$219.77 ,$192.92 ,$359.18 ,$326.53 ,$219.77 ,$396.10 ,$470.94 ,$277.74 ,$130.48 ,$419.40 ,$219.77 ,$396.10 ,$393.77 ,$393.77 ,$219.77 ,$302.90 ST. JOSEPH'S HOSPITAL - BREESE,48300005,93320,HC ECHO DOPPLER,483,1 ,$456.00 ,$328.32 ,$127.68 ,$456.00 , N/A ,$296.40 ,$272.23 , N/A ,$127.68 ,$301.87 , N/A ,$301.87 , N/A ,$271.78 ,$271.78 , N/A ,$271.78 , N/A ,$351.12 , N/A , N/A , N/A ,$342.00 ,$323.76 ,$323.76 , N/A ,$323.76 ,$387.60 ,$387.60 ,$387.60 , N/A , N/A ,$387.60 , N/A ,$456.00 ,$255.82 , N/A ,$188.78 ,$359.18 ,$326.53 , N/A ,$387.60 , N/A ,$271.78 ,$127.68 ,$410.40 , N/A ,$387.60 ,$385.32 ,$385.32 , N/A ,$296.40 ST. JOSEPH'S HOSPITAL - BREESE,48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$271.00 ,$195.12 ,$75.88 ,$271.00 , N/A ,$176.15 ,$161.79 , N/A ,$75.88 ,$179.40 , N/A ,$179.40 , N/A ,$161.52 ,$161.52 , N/A ,$161.52 , N/A ,$208.67 , N/A , N/A , N/A ,$203.25 ,$192.41 ,$192.41 , N/A ,$192.41 ,$230.35 ,$230.35 ,$230.35 , N/A , N/A ,$230.35 , N/A ,$271.00 ,$152.03 , N/A ,$112.19 ,$271.00 ,$271.00 , N/A ,$230.35 , N/A ,$161.52 ,$75.88 ,$243.90 , N/A ,$230.35 ,$229.00 ,$229.00 , N/A ,$176.15 ST. JOSEPH'S HOSPITAL - BREESE,48300007,93350,HC ECHO REST AND STRESS W/PF,483,1 ,"$2,020.00 ","$1,454.40 ",$326.53 ,"$2,020.00 ","$1,207.95 ","$1,313.00 ","$1,205.94 ",$473.52 ,$565.60 ,"$1,337.24 ",$473.52 ,"$1,337.24 ",$473.52 ,"$1,203.92 ","$1,203.92 ",$473.52 ,"$1,203.92 ",$976.02 ,"$1,555.40 ","$1,207.94 ",$473.52 ,$482.98 ,"$1,515.00 ","$1,434.20 ","$1,434.20 ",$473.52 ,"$1,434.20 ","$1,717.00 ","$1,717.00 ","$1,717.00 ", N/A ,"$1,207.94 ","$1,717.00 ",$473.52 ,"$2,020.00 ","$1,133.22 ",$473.52 ,$836.28 ,$359.18 ,$326.53 ,$473.52 ,"$1,717.00 ","$1,014.67 ","$1,203.92 ",$565.60 ,"$1,818.00 ",$473.52 ,"$1,717.00 ","$1,706.90 ","$1,706.90 ",$473.52 ,"$1,313.00 " ST. JOSEPH'S HOSPITAL - BREESE,48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$261.00 ,$187.92 ,$73.08 ,$261.00 , N/A ,$169.65 ,$155.82 , N/A ,$73.08 ,$172.78 , N/A ,$172.78 , N/A ,$155.56 ,$155.56 , N/A ,$155.56 , N/A ,$200.97 , N/A , N/A , N/A ,$195.75 ,$185.31 ,$185.31 , N/A ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A , N/A ,$221.85 , N/A ,$261.00 ,$146.42 , N/A ,$108.05 ,$261.00 ,$261.00 , N/A ,$221.85 , N/A ,$155.56 ,$73.08 ,$234.90 , N/A ,$221.85 ,$220.55 ,$220.55 , N/A ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,48300016,C8924,HC ECHO TTE W/W/O CONT AND W/CONT LIMIT,483,1 ,"$1,130.00 ",$813.60 ,$316.40 ,"$1,130.00 ",$884.55 ,$734.50 ,$674.61 ,$346.74 ,$316.40 ,$748.06 ,$346.74 ,$748.06 ,$346.74 ,$673.48 ,$673.48 ,$346.74 ,$673.48 ,$714.71 ,$870.10 ,$884.55 ,$346.74 ,$353.67 ,$847.50 ,$802.30 ,$802.30 ,$346.74 ,$802.30 ,$960.50 ,$960.50 ,$960.50 , N/A ,$884.55 ,$960.50 ,$346.74 ,"$1,130.00 ",$633.93 ,$346.74 ,$467.82 ,$359.18 ,$326.53 ,$346.74 ,$960.50 ,$743.02 ,$673.48 ,$316.40 ,"$1,017.00 ",$346.74 ,$960.50 ,$954.85 ,$954.85 ,$346.74 ,$734.50 ST. JOSEPH'S HOSPITAL - BREESE,48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$2,028.00 ","$1,460.16 ",$326.53 ,"$2,028.00 ","$1,778.43 ","$1,318.20 ","$1,210.72 ",$697.14 ,$567.84 ,"$1,342.54 ",$697.14 ,"$1,342.54 ",$697.14 ,"$1,208.69 ","$1,208.69 ",$697.14 ,"$1,208.69 ","$1,436.97 ","$1,561.56 ","$1,778.43 ",$697.14 ,$711.09 ,"$1,521.00 ","$1,439.88 ","$1,439.88 ",$697.14 ,"$1,439.88 ","$1,723.80 ","$1,723.80 ","$1,723.80 ", N/A ,"$1,778.43 ","$1,723.80 ",$697.14 ,"$2,028.00 ","$1,137.71 ",$697.14 ,$839.59 ,$359.18 ,$326.53 ,$697.14 ,"$1,723.80 ","$1,493.88 ","$1,208.69 ",$567.84 ,"$1,825.20 ",$697.14 ,"$1,723.80 ","$1,713.66 ","$1,713.66 ",$697.14 ,"$1,318.20 " ST. JOSEPH'S HOSPITAL - BREESE,48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT AND W/CONT,483,1 ,"$2,170.00 ","$1,562.40 ",$326.53 ,"$2,170.00 ","$1,778.43 ","$1,410.50 ","$1,295.49 ",$697.14 ,$607.60 ,"$1,436.54 ",$697.14 ,"$1,436.54 ",$697.14 ,"$1,293.32 ","$1,293.32 ",$697.14 ,"$1,293.32 ","$1,436.97 ","$1,670.90 ","$1,778.43 ",$697.14 ,$711.09 ,"$1,627.50 ","$1,540.70 ","$1,540.70 ",$697.14 ,"$1,540.70 ","$1,844.50 ","$1,844.50 ","$1,844.50 ", N/A ,"$1,778.43 ","$1,844.50 ",$697.14 ,"$2,170.00 ","$1,217.37 ",$697.14 ,$898.38 ,$359.18 ,$326.53 ,$697.14 ,"$1,844.50 ","$1,493.88 ","$1,293.32 ",$607.60 ,"$1,953.00 ",$697.14 ,"$1,844.50 ","$1,833.65 ","$1,833.65 ",$697.14 ,"$1,410.50 " ST. JOSEPH'S HOSPITAL - BREESE,48300020,C8930,HC ECHO TTE 2D REST/STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$2,028.00 ","$1,460.16 ",$326.53 ,"$2,028.00 ","$1,778.43 ","$1,318.20 ","$1,210.72 ",$697.14 ,$567.84 ,"$1,342.54 ",$697.14 ,"$1,342.54 ",$697.14 ,"$1,208.69 ","$1,208.69 ",$697.14 ,"$1,208.69 ","$1,436.97 ","$1,561.56 ","$1,778.43 ",$697.14 ,$711.09 ,"$1,521.00 ","$1,439.88 ","$1,439.88 ",$697.14 ,"$1,439.88 ","$1,723.80 ","$1,723.80 ","$1,723.80 ", N/A ,"$1,778.43 ","$1,723.80 ",$697.14 ,"$2,028.00 ","$1,137.71 ",$697.14 ,$839.59 ,$359.18 ,$326.53 ,$697.14 ,"$1,723.80 ","$1,493.88 ","$1,208.69 ",$567.84 ,"$1,825.20 ",$697.14 ,"$1,723.80 ","$1,713.66 ","$1,713.66 ",$697.14 ,"$1,318.20 " ST. JOSEPH'S HOSPITAL - BREESE,51000002,95117,HC ALLERGY SHOTS 2 OR MORE,510,1 ,$82.00 ,$59.04 ,$16.54 ,$101.73 ,$101.73 ,$53.30 ,$48.95 ,$39.88 ,$22.96 ,$54.28 ,$39.88 ,$54.28 ,$39.88 ,$48.87 ,$48.87 ,$39.88 ,$48.87 ,$82.00 ,$63.14 ,$101.72 ,$39.88 ,$40.67 ,$61.50 ,$58.22 ,$58.22 ,$39.88 ,$58.22 ,$69.70 ,$69.70 ,$69.70 , N/A ,$82.00 ,$69.70 ,$39.88 ,$82.00 ,$46.00 ,$39.88 ,$33.95 ,$18.19 ,$16.54 ,$39.88 ,$69.70 ,$85.45 ,$48.87 ,$22.96 ,$73.80 ,$39.88 ,$69.70 ,$82.00 ,$82.00 ,$39.88 ,$53.30 ST. JOSEPH'S HOSPITAL - BREESE,51000005,11042,HC DEBR SKIN/SUBQ TISS INIT 20CM FAC,510,1 ,$927.00 ,$667.44 ,$132.00 ,$927.00 ,$895.68 ,$602.55 ,$553.42 ,$351.10 ,$259.56 ,$613.67 ,$351.10 ,$613.67 ,$351.10 ,$552.49 ,$552.49 ,$351.10 ,$552.49 ,$723.71 ,$713.79 ,$895.69 ,$351.10 ,$358.13 ,$695.25 ,$658.17 ,$658.17 ,$351.10 ,$658.17 ,$787.95 ,$787.95 ,$787.95 , N/A ,$895.69 ,$787.95 ,$351.10 ,$927.00 ,$520.05 ,$351.10 ,$383.78 ,$227.01 ,$206.37 ,$351.10 ,$787.95 ,$752.38 ,$552.49 ,$259.56 ,$834.30 ,$351.10 ,$787.95 ,$132.00 ,$132.00 ,$351.10 ,$602.55 ST. JOSEPH'S HOSPITAL - BREESE,51000014,11056,HC PARING LESN BENIGN 2-4 FAC,510,1 ,$588.00 ,$423.36 ,$132.00 ,$588.00 ,$433.55 ,$382.20 ,$351.04 ,$169.95 ,$164.64 ,$389.26 ,$169.95 ,$389.26 ,$169.95 ,$350.45 ,$350.45 ,$169.95 ,$350.45 ,$350.30 ,$452.76 ,$433.55 ,$169.95 ,$173.35 ,$441.00 ,$417.48 ,$417.48 ,$169.95 ,$417.48 ,$499.80 ,$499.80 ,$499.80 , N/A ,$433.55 ,$499.80 ,$169.95 ,$588.00 ,$329.87 ,$169.95 ,$243.43 ,$227.01 ,$206.37 ,$169.95 ,$499.80 ,$364.18 ,$350.45 ,$164.64 ,$529.20 ,$169.95 ,$499.80 ,$132.00 ,$132.00 ,$169.95 ,$382.20 ST. JOSEPH'S HOSPITAL - BREESE,51000023,11720,HC DEBR NAIL(S) UP TO 5,510,1 ,$230.00 ,$165.60 ,$54.10 ,$230.00 ,$138.00 ,$149.50 ,$137.31 ,$54.10 ,$64.40 ,$152.26 ,$54.10 ,$152.26 ,$54.10 ,$137.08 ,$137.08 ,$54.10 ,$137.08 ,$111.50 ,$177.10 ,$138.00 ,$54.10 ,$55.17 ,$172.50 ,$163.30 ,$163.30 ,$54.10 ,$163.30 ,$195.50 ,$195.50 ,$195.50 , N/A ,$138.00 ,$195.50 ,$54.10 ,$230.00 ,$129.03 ,$54.10 ,$95.22 ,$60.73 ,$55.21 ,$54.10 ,$195.50 ,$115.92 ,$137.08 ,$64.40 ,$207.00 ,$54.10 ,$195.50 ,$132.00 ,$132.00 ,$54.10 ,$149.50 ST. JOSEPH'S HOSPITAL - BREESE,51000024,11721,HC DEBR NAIL(S) 6 OR MORE,510,1 ,$376.00 ,$270.72 ,$54.10 ,$376.00 ,$138.00 ,$244.40 ,$224.47 ,$54.10 ,$105.28 ,$248.91 ,$54.10 ,$248.91 ,$54.10 ,$224.10 ,$224.10 ,$54.10 ,$224.10 ,$111.50 ,$289.52 ,$138.00 ,$54.10 ,$55.17 ,$282.00 ,$266.96 ,$266.96 ,$54.10 ,$266.96 ,$319.60 ,$319.60 ,$319.60 , N/A ,$138.00 ,$319.60 ,$54.10 ,$376.00 ,$210.94 ,$54.10 ,$155.66 ,$60.73 ,$55.21 ,$54.10 ,$319.60 ,$115.92 ,$224.10 ,$105.28 ,$338.40 ,$54.10 ,$319.60 ,$132.00 ,$132.00 ,$54.10 ,$244.40 ST. JOSEPH'S HOSPITAL - BREESE,51000025,11750,HC REMOVE NAIL BED FACIL,510,1 ,$973.00 ,$700.56 ,$132.00 ,$973.00 ,$895.68 ,$632.45 ,$580.88 ,$351.10 ,$272.44 ,$644.13 ,$351.10 ,$644.13 ,$351.10 ,$579.91 ,$579.91 ,$351.10 ,$579.91 ,$723.71 ,$749.21 ,$895.69 ,$351.10 ,$358.13 ,$729.75 ,$690.83 ,$690.83 ,$351.10 ,$690.83 ,$827.05 ,$827.05 ,$827.05 , N/A ,$895.69 ,$827.05 ,$351.10 ,$973.00 ,$545.85 ,$351.10 ,$402.82 ,$477.10 ,$433.73 ,$351.10 ,$827.05 ,$752.38 ,$579.91 ,$272.44 ,$875.70 ,$351.10 ,$827.05 ,$132.00 ,$132.00 ,$351.10 ,$632.45 ST. JOSEPH'S HOSPITAL - BREESE,51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$380.00 ,$273.60 ,$80.37 ,$798.58 ,$798.58 ,$247.00 ,$226.86 ,$313.04 ,$106.40 ,$251.56 ,$313.04 ,$251.56 ,$313.04 ,$226.48 ,$226.48 ,$313.04 ,$226.48 ,$380.00 ,$292.60 ,$798.57 ,$313.04 ,$319.30 ,$285.00 ,$269.80 ,$269.80 ,$313.04 ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A ,$380.00 ,$323.00 ,$313.04 ,$380.00 ,$213.18 ,$313.04 ,$157.32 ,$88.41 ,$80.37 ,$313.04 ,$323.00 ,$670.80 ,$226.48 ,$106.40 ,$342.00 ,$313.04 ,$323.00 ,$132.00 ,$132.00 ,$313.04 ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,51000053,29580,HC APPLY UNNA BOOT,510,1 ,$491.00 ,$353.52 ,$132.00 ,$491.00 ,$349.95 ,$319.15 ,$293.13 ,$137.18 ,$137.48 ,$325.04 ,$137.18 ,$325.04 ,$137.18 ,$292.64 ,$292.64 ,$137.18 ,$292.64 ,$282.76 ,$378.07 ,$349.95 ,$137.18 ,$139.92 ,$368.25 ,$348.61 ,$348.61 ,$137.18 ,$348.61 ,$417.35 ,$417.35 ,$417.35 , N/A ,$349.95 ,$417.35 ,$137.18 ,$491.00 ,$275.45 ,$137.18 ,$203.27 ,$186.58 ,$169.62 ,$137.18 ,$417.35 ,$293.96 ,$292.64 ,$137.48 ,$441.90 ,$137.18 ,$417.35 ,$132.00 ,$132.00 ,$137.18 ,$319.15 ST. JOSEPH'S HOSPITAL - BREESE,51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$63.00 ,$45.36 ,$17.64 ,$161.99 ,$161.98 ,$40.95 ,$37.61 ,$63.49 ,$17.64 ,$41.71 ,$63.49 ,$41.71 ,$61.74 ,$37.55 ,$37.55 ,$61.74 ,$37.55 ,$63.00 , N/A ,$161.99 ,$63.49 ,$61.74 ,$47.25 ,$44.73 ,$44.73 ,$63.49 ,$44.73 ,$53.55 ,$53.55 ,$53.55 , N/A ,$63.00 ,$53.55 ,$61.74 ,$63.00 ,$35.34 ,$63.49 ,$26.08 , N/A , N/A ,$63.49 ,$53.55 ,$136.07 ,$37.55 ,$17.64 ,$56.70 ,$63.49 ,$53.55 ,$53.24 ,$53.24 ,$63.49 ,$40.95 ST. JOSEPH'S HOSPITAL - BREESE,51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$179.00 ,$128.88 ,$50.12 ,$495.95 ,$495.95 ,$116.35 ,$106.86 ,$194.41 ,$50.12 ,$118.50 ,$194.41 ,$118.50 ,$175.42 ,$106.68 ,$106.68 ,$175.42 ,$106.68 ,$179.00 , N/A ,$495.94 ,$194.41 ,$175.42 ,$134.25 ,$127.09 ,$127.09 ,$194.41 ,$127.09 ,$152.15 ,$152.15 ,$152.15 , N/A ,$179.00 ,$152.15 ,$175.42 ,$179.00 ,$100.42 ,$194.41 ,$74.11 , N/A , N/A ,$194.41 ,$152.15 ,$416.59 ,$106.68 ,$50.12 ,$161.10 ,$194.41 ,$152.15 ,$151.26 ,$151.26 ,$194.41 ,$116.35 ST. JOSEPH'S HOSPITAL - BREESE,51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$99.00 ,$71.28 ,$27.72 ,$101.73 ,$101.73 ,$64.35 ,$59.10 ,$39.88 ,$27.72 ,$65.54 ,$39.88 ,$65.54 ,$39.88 ,$59.00 ,$59.00 ,$39.88 ,$59.00 ,$82.19 , N/A ,$101.72 ,$39.88 ,$40.67 ,$74.25 ,$70.29 ,$70.29 ,$39.88 ,$70.29 ,$84.15 ,$84.15 ,$84.15 , N/A ,$99.00 ,$84.15 ,$39.88 ,$99.00 ,$55.54 ,$39.88 ,$40.99 , N/A , N/A ,$39.88 ,$84.15 ,$85.45 ,$59.00 ,$27.72 ,$89.10 ,$39.88 ,$84.15 ,$83.66 ,$83.66 ,$39.88 ,$64.35 ST. JOSEPH'S HOSPITAL - BREESE,51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$99.00 ,$71.28 ,$27.72 ,$99.00 , N/A ,$64.35 ,$59.10 , N/A ,$27.72 ,$65.54 , N/A ,$65.54 , N/A ,$59.00 ,$59.00 , N/A ,$59.00 , N/A , N/A , N/A , N/A , N/A ,$74.25 ,$70.29 ,$70.29 , N/A ,$70.29 ,$84.15 ,$84.15 ,$84.15 , N/A , N/A ,$84.15 , N/A ,$99.00 ,$55.54 , N/A ,$40.99 , N/A , N/A , N/A ,$84.15 , N/A ,$59.00 ,$27.72 ,$89.10 , N/A ,$84.15 ,$83.66 ,$83.66 , N/A ,$64.35 ST. JOSEPH'S HOSPITAL - BREESE,51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$152.00 ,$109.44 ,$42.56 ,$152.00 ,$138.00 ,$98.80 ,$90.74 ,$54.10 ,$42.56 ,$100.62 ,$54.10 ,$100.62 ,$54.10 ,$90.59 ,$90.59 ,$54.10 ,$90.59 ,$111.50 , N/A ,$138.00 ,$54.10 ,$55.17 ,$114.00 ,$107.92 ,$107.92 ,$54.10 ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A ,$138.00 ,$129.20 ,$54.10 ,$152.00 ,$85.27 ,$54.10 ,$62.93 ,$88.41 ,$80.37 ,$54.10 ,$129.20 ,$115.92 ,$90.59 ,$42.56 ,$136.80 ,$54.10 ,$129.20 ,$132.00 ,$132.00 ,$54.10 ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$144.00 ,$103.68 ,$40.32 ,$144.00 , N/A ,$93.60 ,$85.97 , N/A ,$40.32 ,$95.33 , N/A ,$95.33 , N/A ,$85.82 ,$85.82 , N/A ,$85.82 , N/A ,$110.88 , N/A , N/A , N/A ,$108.00 ,$102.24 ,$102.24 , N/A ,$102.24 ,$122.40 ,$122.40 ,$122.40 , N/A , N/A ,$122.40 , N/A ,$76.98 ,$80.78 , N/A ,$59.62 ,$104.08 ,$94.62 , N/A ,$122.40 , N/A ,$85.82 ,$40.32 ,$129.60 , N/A ,$122.40 ,$132.00 ,$132.00 , N/A ,$93.60 ST. JOSEPH'S HOSPITAL - BREESE,51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$337.00 ,$242.64 ,$94.36 ,$337.00 , N/A ,$219.05 ,$201.19 , N/A ,$94.36 ,$223.09 , N/A ,$223.09 , N/A ,$200.85 ,$200.85 , N/A ,$200.85 , N/A ,$259.49 , N/A , N/A , N/A ,$252.75 ,$239.27 ,$239.27 , N/A ,$239.27 ,$286.45 ,$286.45 ,$286.45 , N/A , N/A ,$286.45 , N/A ,$120.52 ,$189.06 , N/A ,$139.52 ,$104.08 ,$94.62 , N/A ,$286.45 , N/A ,$200.85 ,$94.36 ,$303.30 , N/A ,$286.45 ,$132.00 ,$132.00 , N/A ,$219.05 ST. JOSEPH'S HOSPITAL - BREESE,51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$210.00 ,$151.20 ,$58.80 ,$210.00 , N/A ,$136.50 ,$125.37 , N/A ,$58.80 ,$139.02 , N/A ,$139.02 , N/A ,$125.16 ,$125.16 , N/A ,$125.16 , N/A ,$161.70 , N/A , N/A , N/A ,$157.50 ,$149.10 ,$149.10 , N/A ,$149.10 ,$178.50 ,$178.50 ,$178.50 , N/A , N/A ,$178.50 , N/A ,$177.92 ,$117.81 , N/A ,$86.94 ,$104.08 ,$94.62 , N/A ,$178.50 , N/A ,$125.16 ,$58.80 ,$189.00 , N/A ,$178.50 ,$132.00 ,$132.00 , N/A ,$136.50 ST. JOSEPH'S HOSPITAL - BREESE,51000113,99205,HC CLINIC VISIT COMPREH NEW,510,1 ,$541.00 ,$389.52 ,$94.62 ,$541.00 , N/A ,$351.65 ,$322.98 , N/A ,$151.48 ,$358.14 , N/A ,$358.14 , N/A ,$322.44 ,$322.44 , N/A ,$322.44 , N/A ,$416.57 , N/A , N/A , N/A ,$405.75 ,$384.11 ,$384.11 , N/A ,$384.11 ,$459.85 ,$459.85 ,$459.85 , N/A , N/A ,$459.85 , N/A ,$234.97 ,$303.50 , N/A ,$223.97 ,$104.08 ,$94.62 , N/A ,$459.85 , N/A ,$322.44 ,$151.48 ,$486.90 , N/A ,$459.85 ,$132.00 ,$132.00 , N/A ,$351.65 ST. JOSEPH'S HOSPITAL - BREESE,51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$188.00 ,$135.36 ,$52.64 ,$188.00 , N/A ,$122.20 ,$112.24 , N/A ,$52.64 ,$124.46 , N/A ,$124.46 , N/A ,$112.05 ,$112.05 , N/A ,$112.05 , N/A ,$144.76 , N/A , N/A , N/A ,$141.00 ,$133.48 ,$133.48 , N/A ,$133.48 ,$159.80 ,$159.80 ,$159.80 , N/A , N/A ,$159.80 , N/A ,$188.00 ,$105.47 , N/A ,$77.83 ,$104.08 ,$94.62 , N/A ,$159.80 , N/A ,$112.05 ,$52.64 ,$169.20 , N/A ,$159.80 ,$132.00 ,$132.00 , N/A ,$122.20 ST. JOSEPH'S HOSPITAL - BREESE,51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$213.00 ,$153.36 ,$59.64 ,$213.00 , N/A ,$138.45 ,$127.16 , N/A ,$59.64 ,$141.01 , N/A ,$141.01 , N/A ,$126.95 ,$126.95 , N/A ,$126.95 , N/A ,$164.01 , N/A , N/A , N/A ,$159.75 ,$151.23 ,$151.23 , N/A ,$151.23 ,$181.05 ,$181.05 ,$181.05 , N/A , N/A ,$181.05 , N/A ,$60.09 ,$119.49 , N/A ,$88.18 ,$104.08 ,$94.62 , N/A ,$181.05 , N/A ,$126.95 ,$59.64 ,$191.70 , N/A ,$181.05 ,$132.00 ,$132.00 , N/A ,$138.45 ST. JOSEPH'S HOSPITAL - BREESE,51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$239.00 ,$172.08 ,$66.92 ,$239.00 , N/A ,$155.35 ,$142.68 , N/A ,$66.92 ,$158.22 , N/A ,$158.22 , N/A ,$142.44 ,$142.44 , N/A ,$142.44 , N/A ,$184.03 , N/A , N/A , N/A ,$179.25 ,$169.69 ,$169.69 , N/A ,$169.69 ,$203.15 ,$203.15 ,$203.15 , N/A , N/A ,$203.15 , N/A ,$95.85 ,$134.08 , N/A ,$98.95 ,$104.08 ,$94.62 , N/A ,$203.15 , N/A ,$142.44 ,$66.92 ,$215.10 , N/A ,$203.15 ,$132.00 ,$132.00 , N/A ,$155.35 ST. JOSEPH'S HOSPITAL - BREESE,51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$304.00 ,$218.88 ,$85.12 ,$304.00 , N/A ,$197.60 ,$181.49 , N/A ,$85.12 ,$201.25 , N/A ,$201.25 , N/A ,$181.18 ,$181.18 , N/A ,$181.18 , N/A ,$234.08 , N/A , N/A , N/A ,$228.00 ,$215.84 ,$215.84 , N/A ,$215.84 ,$258.40 ,$258.40 ,$258.40 , N/A , N/A ,$258.40 , N/A ,$304.00 ,$170.54 , N/A ,$125.86 ,$104.08 ,$94.62 , N/A ,$258.40 , N/A ,$181.18 ,$85.12 ,$273.60 , N/A ,$258.40 ,$132.00 ,$132.00 , N/A ,$197.60 ST. JOSEPH'S HOSPITAL - BREESE,51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$380.00 ,$273.60 ,$94.62 ,$380.00 , N/A ,$247.00 ,$226.86 , N/A ,$106.40 ,$251.56 , N/A ,$251.56 , N/A ,$226.48 ,$226.48 , N/A ,$226.48 , N/A ,$292.60 , N/A , N/A , N/A ,$285.00 ,$269.80 ,$269.80 , N/A ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A , N/A ,$323.00 , N/A ,$380.00 ,$213.18 , N/A ,$157.32 ,$104.08 ,$94.62 , N/A ,$323.00 , N/A ,$226.48 ,$106.40 ,$342.00 , N/A ,$323.00 ,$132.00 ,$132.00 , N/A ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$215.00 ,$154.80 ,$8.40 ,$215.00 ,$21.43 ,$139.75 ,$128.36 ,$8.40 ,$60.20 ,$142.33 ,$8.40 ,$142.33 ,$8.40 ,$128.14 ,$128.14 ,$8.40 ,$128.14 ,$17.31 ,$165.55 ,$21.43 ,$8.40 ,$8.57 ,$161.25 ,$152.65 ,$152.65 ,$8.40 ,$152.65 ,$182.75 ,$182.75 ,$182.75 , N/A ,$21.43 ,$182.75 ,$8.40 ,$215.00 ,$120.62 ,$8.40 ,$89.01 , N/A , N/A ,$8.40 ,$182.75 ,$18.00 ,$128.14 ,$60.20 ,$193.50 ,$8.40 ,$182.75 ,$12.00 ,$12.00 ,$8.40 ,$139.75 ST. JOSEPH'S HOSPITAL - BREESE,51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$225.00 ,$162.00 ,$63.00 ,$278.78 ,$278.78 ,$146.25 ,$134.33 ,$109.28 ,$63.00 ,$148.95 ,$109.28 ,$148.95 ,$109.28 ,$134.10 ,$134.10 ,$109.28 ,$134.10 ,$225.00 ,$173.25 ,$278.76 ,$109.28 ,$111.47 ,$168.75 ,$159.75 ,$159.75 ,$109.28 ,$159.75 ,$191.25 ,$191.25 ,$191.25 , N/A ,$225.00 ,$191.25 ,$109.28 ,$225.00 ,$126.23 ,$109.28 ,$93.15 ,$88.41 ,$80.37 ,$109.28 ,$191.25 ,$234.16 ,$134.10 ,$63.00 ,$202.50 ,$109.28 ,$191.25 ,$132.00 ,$132.00 ,$109.28 ,$146.25 ST. JOSEPH'S HOSPITAL - BREESE,51000172,51702,HC CATH BLADDER SMP,510,1 ,$246.00 ,$177.12 ,$68.88 ,$278.78 ,$278.78 ,$159.90 ,$146.86 ,$109.28 ,$68.88 ,$162.85 ,$109.28 ,$162.85 ,$109.28 ,$146.62 ,$146.62 ,$109.28 ,$146.62 ,$225.24 ,$189.42 ,$278.76 ,$109.28 ,$111.47 ,$184.50 ,$174.66 ,$174.66 ,$109.28 ,$174.66 ,$209.10 ,$209.10 ,$209.10 , N/A ,$246.00 ,$209.10 ,$109.28 ,$246.00 ,$138.01 ,$109.28 ,$101.84 ,$88.41 ,$80.37 ,$109.28 ,$209.10 ,$234.16 ,$146.62 ,$68.88 ,$221.40 ,$109.28 ,$209.10 ,$132.00 ,$132.00 ,$109.28 ,$159.90 ST. JOSEPH'S HOSPITAL - BREESE,51000173,51703,HC CATH BLADDER CPLX,510,1 ,$457.00 ,$329.04 ,$80.37 ,$457.00 ,$349.15 ,$297.05 ,$272.83 ,$136.87 ,$127.96 ,$302.53 ,$136.87 ,$302.53 ,$136.87 ,$272.37 ,$272.37 ,$136.87 ,$272.37 ,$282.12 ,$351.89 ,$349.16 ,$136.87 ,$139.61 ,$342.75 ,$324.47 ,$324.47 ,$136.87 ,$324.47 ,$388.45 ,$388.45 ,$388.45 , N/A ,$349.16 ,$388.45 ,$136.87 ,$457.00 ,$256.38 ,$136.87 ,$189.20 ,$88.41 ,$80.37 ,$136.87 ,$388.45 ,$293.29 ,$272.37 ,$127.96 ,$411.30 ,$136.87 ,$388.45 ,$132.00 ,$132.00 ,$136.87 ,$297.05 ST. JOSEPH'S HOSPITAL - BREESE,51000175,94780,HC CARSEAT ANALYSIS FIRST 60MIN,510,1 ,$177.00 ,$127.44 ,$31.96 ,$177.00 ,$81.53 ,$115.05 ,$105.67 ,$31.96 ,$49.56 ,$117.17 ,$31.96 ,$117.17 ,$31.96 ,$105.49 ,$105.49 ,$31.96 ,$105.49 ,$65.88 ,$136.29 ,$81.53 ,$31.96 ,$32.60 ,$132.75 ,$125.67 ,$125.67 ,$31.96 ,$125.67 ,$150.45 ,$150.45 ,$150.45 , N/A ,$81.53 ,$150.45 ,$31.96 ,$177.00 ,$99.30 ,$31.96 ,$73.28 ,$55.36 ,$50.33 ,$31.96 ,$150.45 ,$68.49 ,$105.49 ,$49.56 ,$159.30 ,$31.96 ,$150.45 ,$132.00 ,$132.00 ,$31.96 ,$115.05 ST. JOSEPH'S HOSPITAL - BREESE,51000207,52000,HC CYSTOURETHROSCOPY,510,1 ,"$1,637.00 ","$1,178.64 ",$132.00 ,"$1,637.00 ","$1,501.35 ","$1,064.05 ",$977.29 ,$588.53 ,$458.36 ,"$1,083.69 ",$588.53 ,"$1,083.69 ",$588.53 ,$975.65 ,$975.65 ,$588.53 ,$975.65 ,"$1,213.09 ","$1,260.49 ","$1,501.35 ",$588.53 ,$600.30 ,"$1,227.75 ","$1,162.27 ","$1,162.27 ",$588.53 ,"$1,162.27 ","$1,391.45 ","$1,391.45 ","$1,391.45 ", N/A ,"$1,501.35 ","$1,391.45 ",$588.53 ,"$1,637.00 ",$918.36 ,$588.53 ,$677.72 ,$803.61 ,$730.55 ,$588.53 ,"$1,391.45 ","$1,261.13 ",$975.65 ,$458.36 ,"$1,473.30 ",$588.53 ,"$1,391.45 ",$132.00 ,$132.00 ,$588.53 ,"$1,064.05 " ST. JOSEPH'S HOSPITAL - BREESE,51000320,94781,HC CARSEAT ANALYSIS EA ADDN 30MIN,510,1 ,$104.00 ,$74.88 ,$29.12 ,$104.00 , N/A ,$67.60 ,$62.09 , N/A ,$29.12 ,$68.85 , N/A ,$68.85 , N/A ,$61.98 ,$61.98 , N/A ,$61.98 , N/A ,$80.08 , N/A , N/A , N/A ,$78.00 ,$73.84 ,$73.84 , N/A ,$73.84 ,$88.40 ,$88.40 ,$88.40 , N/A , N/A ,$88.40 , N/A ,$104.00 ,$58.34 , N/A ,$43.06 ,$55.36 ,$50.33 , N/A ,$88.40 , N/A ,$61.98 ,$29.12 ,$93.60 , N/A ,$88.40 ,$104.00 ,$104.00 , N/A ,$67.60 ST. JOSEPH'S HOSPITAL - BREESE,51000481,98925,HC OSTEOPATHIC MAN 1-2 REGIONS,510,1 ,$78.90 ,$56.81 ,$22.09 ,$78.90 ,$59.98 ,$51.29 ,$47.10 ,$23.51 ,$22.09 ,$52.23 ,$23.51 ,$52.23 ,$23.51 ,$47.02 ,$47.02 ,$23.51 ,$47.02 ,$48.46 ,$60.75 ,$59.97 ,$23.51 ,$23.98 ,$59.18 ,$56.02 ,$56.02 ,$23.51 ,$56.02 ,$67.07 ,$67.07 ,$67.07 , N/A ,$59.97 ,$67.07 ,$23.51 ,$78.90 ,$44.26 ,$23.51 ,$32.66 ,$34.33 ,$31.21 ,$23.51 ,$67.07 ,$50.38 ,$47.02 ,$22.09 ,$71.01 ,$23.51 ,$67.07 ,$78.90 ,$78.90 ,$23.51 ,$51.29 ST. JOSEPH'S HOSPITAL - BREESE,51001010,99215,HC CLINIC VISIT - MEMORY INITIAL,510,1 ,$380.00 ,$273.60 ,$94.62 ,$380.00 , N/A ,$247.00 ,$226.86 , N/A ,$106.40 ,$251.56 , N/A ,$251.56 , N/A ,$226.48 ,$226.48 , N/A ,$226.48 , N/A ,$292.60 , N/A , N/A , N/A ,$285.00 ,$269.80 ,$269.80 , N/A ,$269.80 ,$323.00 ,$323.00 ,$323.00 , N/A , N/A ,$323.00 , N/A ,$380.00 ,$213.18 , N/A ,$157.32 ,$104.08 ,$94.62 , N/A ,$323.00 , N/A ,$226.48 ,$106.40 ,$342.00 , N/A ,$323.00 ,$132.00 ,$132.00 , N/A ,$247.00 ST. JOSEPH'S HOSPITAL - BREESE,51001012,95115,HC ALLERGY SHOTS ONE INJECTION,510,1 ,$54.00 ,$38.88 ,$15.12 ,$101.73 ,$101.73 ,$35.10 ,$32.24 ,$39.88 ,$15.12 ,$35.75 ,$39.88 ,$35.75 ,$39.88 ,$32.18 ,$32.18 ,$39.88 ,$32.18 ,$54.00 ,$41.58 ,$101.72 ,$39.88 ,$40.67 ,$40.50 ,$38.34 ,$38.34 ,$39.88 ,$38.34 ,$45.90 ,$45.90 ,$45.90 , N/A ,$54.00 ,$45.90 ,$39.88 ,$54.00 ,$30.29 ,$39.88 ,$22.36 ,$18.19 ,$16.54 ,$39.88 ,$45.90 ,$85.45 ,$32.18 ,$15.12 ,$48.60 ,$39.88 ,$45.90 ,$54.00 ,$54.00 ,$39.88 ,$35.10 ST. JOSEPH'S HOSPITAL - BREESE,51070001,98960,HC EDUCATION SELF MGNT NON PHY HLTCARE PROF,510,1 ,$91.00 ,$65.52 ,$24.29 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 ,$26.72 ,$24.29 , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$91.00 ,$91.00 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$5,450.00 ","$3,924.00 ",$233.16 ,"$5,450.00 ",$884.55 ,"$3,542.50 ","$3,253.65 ",$346.74 ,"$1,526.00 ","$3,607.90 ",$346.74 ,"$3,607.90 ",$346.74 ,"$3,248.20 ","$3,248.20 ",$346.74 ,"$3,248.20 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$4,087.50 ","$3,869.50 ","$3,869.50 ",$346.74 ,"$3,869.50 ","$4,632.50 ","$4,632.50 ","$4,632.50 ", N/A ,$884.55 ,"$4,632.50 ",$346.74 ,"$5,450.00 ","$3,057.45 ",$346.74 ,"$2,256.30 ",$256.48 ,$233.16 ,$346.74 ,"$4,632.50 ",$743.02 ,"$3,248.20 ","$1,526.00 ","$4,905.00 ",$346.74 ,"$4,632.50 ","$4,605.25 ","$4,605.25 ",$346.74 ,"$3,542.50 " ST. JOSEPH'S HOSPITAL - BREESE,61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$3,721.00 ","$2,679.12 ",$219.77 ,"$3,721.00 ",$560.65 ,"$2,418.65 ","$2,221.44 ",$219.77 ,"$1,041.88 ","$2,463.30 ",$219.77 ,"$2,463.30 ",$219.77 ,"$2,217.72 ","$2,217.72 ",$219.77 ,"$2,217.72 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,790.75 ","$2,641.91 ","$2,641.91 ",$219.77 ,"$2,641.91 ","$3,162.85 ","$3,162.85 ","$3,162.85 ", N/A ,$560.65 ,"$3,162.85 ",$219.77 ,"$3,721.00 ","$2,087.48 ",$219.77 ,"$1,540.49 ",$314.00 ,$285.45 ,$219.77 ,"$3,162.85 ",$470.94 ,"$2,217.72 ","$1,041.88 ","$3,348.90 ",$219.77 ,"$3,162.85 ","$3,144.25 ","$3,144.25 ",$219.77 ,"$2,418.65 " ST. JOSEPH'S HOSPITAL - BREESE,61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$3,909.00 ","$2,814.48 ",$285.45 ,"$3,909.00 ",$884.55 ,"$2,540.85 ","$2,333.67 ",$346.74 ,"$1,094.52 ","$2,587.76 ",$346.74 ,"$2,587.76 ",$346.74 ,"$2,329.76 ","$2,329.76 ",$346.74 ,"$2,329.76 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$2,931.75 ","$2,775.39 ","$2,775.39 ",$346.74 ,"$2,775.39 ","$3,322.65 ","$3,322.65 ","$3,322.65 ", N/A ,$884.55 ,"$3,322.65 ",$346.74 ,"$3,909.00 ","$2,192.95 ",$346.74 ,"$1,618.33 ",$314.00 ,$285.45 ,$346.74 ,"$3,322.65 ",$743.02 ,"$2,329.76 ","$1,094.52 ","$3,518.10 ",$346.74 ,"$3,322.65 ","$3,303.11 ","$3,303.11 ",$346.74 ,"$2,540.85 " ST. JOSEPH'S HOSPITAL - BREESE,61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$3,850.00 ","$2,772.00 ",$285.45 ,"$3,850.00 ",$884.55 ,"$2,502.50 ","$2,298.45 ",$346.74 ,"$1,078.00 ","$2,548.70 ",$346.74 ,"$2,548.70 ",$346.74 ,"$2,294.60 ","$2,294.60 ",$346.74 ,"$2,294.60 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$2,887.50 ","$2,733.50 ","$2,733.50 ",$346.74 ,"$2,733.50 ","$3,272.50 ","$3,272.50 ","$3,272.50 ", N/A ,$884.55 ,"$3,272.50 ",$346.74 ,"$3,850.00 ","$2,159.85 ",$346.74 ,"$1,593.90 ",$314.00 ,$285.45 ,$346.74 ,"$3,272.50 ",$743.02 ,"$2,294.60 ","$1,078.00 ","$3,465.00 ",$346.74 ,"$3,272.50 ","$3,253.25 ","$3,253.25 ",$346.74 ,"$2,502.50 " ST. JOSEPH'S HOSPITAL - BREESE,61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$3,906.00 ","$2,812.32 ",$219.77 ,"$3,906.00 ",$560.65 ,"$2,538.90 ","$2,331.88 ",$219.77 ,"$1,093.68 ","$2,585.77 ",$219.77 ,"$2,585.77 ",$219.77 ,"$2,327.98 ","$2,327.98 ",$219.77 ,"$2,327.98 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,929.50 ","$2,773.26 ","$2,773.26 ",$219.77 ,"$2,773.26 ","$3,320.10 ","$3,320.10 ","$3,320.10 ", N/A ,$560.65 ,"$3,320.10 ",$219.77 ,"$3,906.00 ","$2,191.27 ",$219.77 ,"$1,617.08 ",$314.00 ,$285.45 ,$219.77 ,"$3,320.10 ",$470.94 ,"$2,327.98 ","$1,093.68 ","$3,515.40 ",$219.77 ,"$3,320.10 ","$3,300.57 ","$3,300.57 ",$219.77 ,"$2,538.90 " ST. JOSEPH'S HOSPITAL - BREESE,61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$4,169.00 ","$3,001.68 ",$285.45 ,"$4,169.00 ",$884.55 ,"$2,709.85 ","$2,488.89 ",$346.74 ,"$1,167.32 ","$2,759.88 ",$346.74 ,"$2,759.88 ",$346.74 ,"$2,484.72 ","$2,484.72 ",$346.74 ,"$2,484.72 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,126.75 ","$2,959.99 ","$2,959.99 ",$346.74 ,"$2,959.99 ","$3,543.65 ","$3,543.65 ","$3,543.65 ", N/A ,$884.55 ,"$3,543.65 ",$346.74 ,"$4,169.00 ","$2,338.81 ",$346.74 ,"$1,725.97 ",$314.00 ,$285.45 ,$346.74 ,"$3,543.65 ",$743.02 ,"$2,484.72 ","$1,167.32 ","$3,752.10 ",$346.74 ,"$3,543.65 ","$3,522.81 ","$3,522.81 ",$346.74 ,"$2,709.85 " ST. JOSEPH'S HOSPITAL - BREESE,61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$4,433.00 ","$3,191.76 ",$285.45 ,"$4,433.00 ",$884.55 ,"$2,881.45 ","$2,646.50 ",$346.74 ,"$1,241.24 ","$2,934.65 ",$346.74 ,"$2,934.65 ",$346.74 ,"$2,642.07 ","$2,642.07 ",$346.74 ,"$2,642.07 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,324.75 ","$3,147.43 ","$3,147.43 ",$346.74 ,"$3,147.43 ","$3,768.05 ","$3,768.05 ","$3,768.05 ", N/A ,$884.55 ,"$3,768.05 ",$346.74 ,"$4,433.00 ","$2,486.91 ",$346.74 ,"$1,835.26 ",$314.00 ,$285.45 ,$346.74 ,"$3,768.05 ",$743.02 ,"$2,642.07 ","$1,241.24 ","$3,989.70 ",$346.74 ,"$3,768.05 ","$3,745.89 ","$3,745.89 ",$346.74 ,"$2,881.45 " ST. JOSEPH'S HOSPITAL - BREESE,61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$4,001.00 ","$2,880.72 ",$219.77 ,"$4,001.00 ",$560.65 ,"$2,600.65 ","$2,388.60 ",$219.77 ,"$1,120.28 ","$2,648.66 ",$219.77 ,"$2,648.66 ",$219.77 ,"$2,384.60 ","$2,384.60 ",$219.77 ,"$2,384.60 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$3,000.75 ","$2,840.71 ","$2,840.71 ",$219.77 ,"$2,840.71 ","$3,400.85 ","$3,400.85 ","$3,400.85 ", N/A ,$560.65 ,"$3,400.85 ",$219.77 ,"$4,001.00 ","$2,244.56 ",$219.77 ,"$1,656.41 ",$287.36 ,$261.24 ,$219.77 ,"$3,400.85 ",$470.94 ,"$2,384.60 ","$1,120.28 ","$3,600.90 ",$219.77 ,"$3,400.85 ","$3,380.85 ","$3,380.85 ",$219.77 ,"$2,600.65 " ST. JOSEPH'S HOSPITAL - BREESE,61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$4,654.00 ","$3,350.88 ",$261.24 ,"$4,654.00 ",$884.55 ,"$3,025.10 ","$2,778.44 ",$346.74 ,"$1,303.12 ","$3,080.95 ",$346.74 ,"$3,080.95 ",$346.74 ,"$2,773.78 ","$2,773.78 ",$346.74 ,"$2,773.78 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,490.50 ","$3,304.34 ","$3,304.34 ",$346.74 ,"$3,304.34 ","$3,955.90 ","$3,955.90 ","$3,955.90 ", N/A ,$884.55 ,"$3,955.90 ",$346.74 ,"$4,654.00 ","$2,610.89 ",$346.74 ,"$1,926.76 ",$287.36 ,$261.24 ,$346.74 ,"$3,955.90 ",$743.02 ,"$2,773.78 ","$1,303.12 ","$4,188.60 ",$346.74 ,"$3,955.90 ","$3,932.63 ","$3,932.63 ",$346.74 ,"$3,025.10 " ST. JOSEPH'S HOSPITAL - BREESE,61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$5,324.00 ","$3,833.28 ",$261.24 ,"$5,324.00 ",$884.55 ,"$3,460.60 ","$3,178.43 ",$346.74 ,"$1,490.72 ","$3,524.49 ",$346.74 ,"$3,524.49 ",$346.74 ,"$3,173.10 ","$3,173.10 ",$346.74 ,"$3,173.10 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,993.00 ","$3,780.04 ","$3,780.04 ",$346.74 ,"$3,780.04 ","$4,525.40 ","$4,525.40 ","$4,525.40 ", N/A ,$884.55 ,"$4,525.40 ",$346.74 ,"$5,324.00 ","$2,986.76 ",$346.74 ,"$2,204.14 ",$287.36 ,$261.24 ,$346.74 ,"$4,525.40 ",$743.02 ,"$3,173.10 ","$1,490.72 ","$4,791.60 ",$346.74 ,"$4,525.40 ","$4,498.78 ","$4,498.78 ",$346.74 ,"$3,460.60 " ST. JOSEPH'S HOSPITAL - BREESE,61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$3,911.00 ","$2,815.92 ",$188.41 ,"$3,911.00 ",$560.65 ,"$2,542.15 ","$2,334.87 ",$219.77 ,"$1,095.08 ","$2,589.08 ",$219.77 ,"$2,589.08 ",$219.77 ,"$2,330.96 ","$2,330.96 ",$219.77 ,"$2,330.96 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,933.25 ","$2,776.81 ","$2,776.81 ",$219.77 ,"$2,776.81 ","$3,324.35 ","$3,324.35 ","$3,324.35 ", N/A ,$560.65 ,"$3,324.35 ",$219.77 ,"$3,911.00 ","$2,194.07 ",$219.77 ,"$1,619.15 ",$207.25 ,$188.41 ,$219.77 ,"$3,324.35 ",$470.94 ,"$2,330.96 ","$1,095.08 ","$3,519.90 ",$219.77 ,"$3,324.35 ","$3,304.80 ","$3,304.80 ",$219.77 ,"$2,542.15 " ST. JOSEPH'S HOSPITAL - BREESE,61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$4,662.00 ","$3,356.64 ",$188.41 ,"$4,662.00 ",$884.55 ,"$3,030.30 ","$2,783.21 ",$346.74 ,"$1,305.36 ","$3,086.24 ",$346.74 ,"$3,086.24 ",$346.74 ,"$2,778.55 ","$2,778.55 ",$346.74 ,"$2,778.55 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,496.50 ","$3,310.02 ","$3,310.02 ",$346.74 ,"$3,310.02 ","$3,962.70 ","$3,962.70 ","$3,962.70 ", N/A ,$884.55 ,"$3,962.70 ",$346.74 ,"$4,662.00 ","$2,615.38 ",$346.74 ,"$1,930.07 ",$207.25 ,$188.41 ,$346.74 ,"$3,962.70 ",$743.02 ,"$2,778.55 ","$1,305.36 ","$4,195.80 ",$346.74 ,"$3,962.70 ","$3,939.39 ","$3,939.39 ",$346.74 ,"$3,030.30 " ST. JOSEPH'S HOSPITAL - BREESE,61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$3,868.00 ","$2,784.96 ",$188.41 ,"$3,868.00 ",$560.65 ,"$2,514.20 ","$2,309.20 ",$219.77 ,"$1,083.04 ","$2,560.62 ",$219.77 ,"$2,560.62 ",$219.77 ,"$2,305.33 ","$2,305.33 ",$219.77 ,"$2,305.33 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,901.00 ","$2,746.28 ","$2,746.28 ",$219.77 ,"$2,746.28 ","$3,287.80 ","$3,287.80 ","$3,287.80 ", N/A ,$560.65 ,"$3,287.80 ",$219.77 ,"$3,868.00 ","$2,169.95 ",$219.77 ,"$1,601.35 ",$207.25 ,$188.41 ,$219.77 ,"$3,287.80 ",$470.94 ,"$2,305.33 ","$1,083.04 ","$3,481.20 ",$219.77 ,"$3,287.80 ","$3,268.46 ","$3,268.46 ",$219.77 ,"$2,514.20 " ST. JOSEPH'S HOSPITAL - BREESE,61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$4,359.00 ","$3,138.48 ",$188.41 ,"$4,359.00 ",$884.55 ,"$2,833.35 ","$2,602.32 ",$346.74 ,"$1,220.52 ","$2,885.66 ",$346.74 ,"$2,885.66 ",$346.74 ,"$2,597.96 ","$2,597.96 ",$346.74 ,"$2,597.96 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,269.25 ","$3,094.89 ","$3,094.89 ",$346.74 ,"$3,094.89 ","$3,705.15 ","$3,705.15 ","$3,705.15 ", N/A ,$884.55 ,"$3,705.15 ",$346.74 ,"$4,359.00 ","$2,445.40 ",$346.74 ,"$1,804.63 ",$207.25 ,$188.41 ,$346.74 ,"$3,705.15 ",$743.02 ,"$2,597.96 ","$1,220.52 ","$3,923.10 ",$346.74 ,"$3,705.15 ","$3,683.36 ","$3,683.36 ",$346.74 ,"$2,833.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$3,897.00 ","$2,805.84 ",$188.41 ,"$3,897.00 ",$560.65 ,"$2,533.05 ","$2,326.51 ",$219.77 ,"$1,091.16 ","$2,579.81 ",$219.77 ,"$2,579.81 ",$219.77 ,"$2,322.61 ","$2,322.61 ",$219.77 ,"$2,322.61 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,922.75 ","$2,766.87 ","$2,766.87 ",$219.77 ,"$2,766.87 ","$3,312.45 ","$3,312.45 ","$3,312.45 ", N/A ,$560.65 ,"$3,312.45 ",$219.77 ,"$3,897.00 ","$2,186.22 ",$219.77 ,"$1,613.36 ",$207.25 ,$188.41 ,$219.77 ,"$3,312.45 ",$470.94 ,"$2,322.61 ","$1,091.16 ","$3,507.30 ",$219.77 ,"$3,312.45 ","$3,292.97 ","$3,292.97 ",$219.77 ,"$2,533.05 " ST. JOSEPH'S HOSPITAL - BREESE,61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$4,390.00 ","$3,160.80 ",$188.41 ,"$4,390.00 ",$884.55 ,"$2,853.50 ","$2,620.83 ",$346.74 ,"$1,229.20 ","$2,906.18 ",$346.74 ,"$2,906.18 ",$346.74 ,"$2,616.44 ","$2,616.44 ",$346.74 ,"$2,616.44 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,292.50 ","$3,116.90 ","$3,116.90 ",$346.74 ,"$3,116.90 ","$3,731.50 ","$3,731.50 ","$3,731.50 ", N/A ,$884.55 ,"$3,731.50 ",$346.74 ,"$4,390.00 ","$2,462.79 ",$346.74 ,"$1,817.46 ",$207.25 ,$188.41 ,$346.74 ,"$3,731.50 ",$743.02 ,"$2,616.44 ","$1,229.20 ","$3,951.00 ",$346.74 ,"$3,731.50 ","$3,709.55 ","$3,709.55 ",$346.74 ,"$2,853.50 " ST. JOSEPH'S HOSPITAL - BREESE,61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$5,230.00 ","$3,765.60 ",$188.41 ,"$5,230.00 ",$884.55 ,"$3,399.50 ","$3,122.31 ",$346.74 ,"$1,464.40 ","$3,462.26 ",$346.74 ,"$3,462.26 ",$346.74 ,"$3,117.08 ","$3,117.08 ",$346.74 ,"$3,117.08 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,922.50 ","$3,713.30 ","$3,713.30 ",$346.74 ,"$3,713.30 ","$4,445.50 ","$4,445.50 ","$4,445.50 ", N/A ,$884.55 ,"$4,445.50 ",$346.74 ,"$5,230.00 ","$2,934.03 ",$346.74 ,"$2,165.22 ",$207.25 ,$188.41 ,$346.74 ,"$4,445.50 ",$743.02 ,"$3,117.08 ","$1,464.40 ","$4,707.00 ",$346.74 ,"$4,445.50 ","$4,419.35 ","$4,419.35 ",$346.74 ,"$3,399.50 " ST. JOSEPH'S HOSPITAL - BREESE,61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$5,340.00 ","$3,844.80 ",$188.41 ,"$5,340.00 ",$884.55 ,"$3,471.00 ","$3,187.98 ",$346.74 ,"$1,495.20 ","$3,535.08 ",$346.74 ,"$3,535.08 ",$346.74 ,"$3,182.64 ","$3,182.64 ",$346.74 ,"$3,182.64 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$4,005.00 ","$3,791.40 ","$3,791.40 ",$346.74 ,"$3,791.40 ","$4,539.00 ","$4,539.00 ","$4,539.00 ", N/A ,$884.55 ,"$4,539.00 ",$346.74 ,"$5,340.00 ","$2,995.74 ",$346.74 ,"$2,210.76 ",$207.25 ,$188.41 ,$346.74 ,"$4,539.00 ",$743.02 ,"$3,182.64 ","$1,495.20 ","$4,806.00 ",$346.74 ,"$4,539.00 ","$4,512.30 ","$4,512.30 ",$346.74 ,"$3,471.00 " ST. JOSEPH'S HOSPITAL - BREESE,61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$5,294.00 ","$3,811.68 ",$188.41 ,"$5,294.00 ",$884.55 ,"$3,441.10 ","$3,160.52 ",$346.74 ,"$1,482.32 ","$3,504.63 ",$346.74 ,"$3,504.63 ",$346.74 ,"$3,155.22 ","$3,155.22 ",$346.74 ,"$3,155.22 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,970.50 ","$3,758.74 ","$3,758.74 ",$346.74 ,"$3,758.74 ","$4,499.90 ","$4,499.90 ","$4,499.90 ", N/A ,$884.55 ,"$4,499.90 ",$346.74 ,"$5,294.00 ","$2,969.93 ",$346.74 ,"$2,191.72 ",$207.25 ,$188.41 ,$346.74 ,"$4,499.90 ",$743.02 ,"$3,155.22 ","$1,482.32 ","$4,764.60 ",$346.74 ,"$4,499.90 ","$4,473.43 ","$4,473.43 ",$346.74 ,"$3,441.10 " ST. JOSEPH'S HOSPITAL - BREESE,61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$3,672.00 ","$2,643.84 ",$219.77 ,"$3,672.00 ",$560.65 ,"$2,386.80 ","$2,192.18 ",$219.77 ,"$1,028.16 ","$2,430.86 ",$219.77 ,"$2,430.86 ",$219.77 ,"$2,188.51 ","$2,188.51 ",$219.77 ,"$2,188.51 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,754.00 ","$2,607.12 ","$2,607.12 ",$219.77 ,"$2,607.12 ","$3,121.20 ","$3,121.20 ","$3,121.20 ", N/A ,$560.65 ,"$3,121.20 ",$219.77 ,"$3,672.00 ","$2,059.99 ",$219.77 ,"$1,520.21 ",$256.48 ,$233.16 ,$219.77 ,"$3,121.20 ",$470.94 ,"$2,188.51 ","$1,028.16 ","$3,304.80 ",$219.77 ,"$3,121.20 ","$3,102.84 ","$3,102.84 ",$219.77 ,"$2,386.80 " ST. JOSEPH'S HOSPITAL - BREESE,61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$4,287.00 ","$3,086.64 ",$233.16 ,"$4,287.00 ",$884.55 ,"$2,786.55 ","$2,559.34 ",$346.74 ,"$1,200.36 ","$2,837.99 ",$346.74 ,"$2,837.99 ",$346.74 ,"$2,555.05 ","$2,555.05 ",$346.74 ,"$2,555.05 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,215.25 ","$3,043.77 ","$3,043.77 ",$346.74 ,"$3,043.77 ","$3,643.95 ","$3,643.95 ","$3,643.95 ", N/A ,$884.55 ,"$3,643.95 ",$346.74 ,"$4,287.00 ","$2,405.01 ",$346.74 ,"$1,774.82 ",$256.48 ,$233.16 ,$346.74 ,"$3,643.95 ",$743.02 ,"$2,555.05 ","$1,200.36 ","$3,858.30 ",$346.74 ,"$3,643.95 ","$3,622.52 ","$3,622.52 ",$346.74 ,"$2,786.55 " ST. JOSEPH'S HOSPITAL - BREESE,61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$5,045.00 ","$3,632.40 ",$233.16 ,"$5,045.00 ",$884.55 ,"$3,279.25 ","$3,011.87 ",$346.74 ,"$1,412.60 ","$3,339.79 ",$346.74 ,"$3,339.79 ",$346.74 ,"$3,006.82 ","$3,006.82 ",$346.74 ,"$3,006.82 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,783.75 ","$3,581.95 ","$3,581.95 ",$346.74 ,"$3,581.95 ","$4,288.25 ","$4,288.25 ","$4,288.25 ", N/A ,$884.55 ,"$4,288.25 ",$346.74 ,"$5,045.00 ","$2,830.25 ",$346.74 ,"$2,088.63 ",$256.48 ,$233.16 ,$346.74 ,"$4,288.25 ",$743.02 ,"$3,006.82 ","$1,412.60 ","$4,540.50 ",$346.74 ,"$4,288.25 ","$4,263.03 ","$4,263.03 ",$346.74 ,"$3,279.25 " ST. JOSEPH'S HOSPITAL - BREESE,61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$3,984.00 ","$2,868.48 ",$219.77 ,"$3,984.00 ",$560.65 ,"$2,589.60 ","$2,378.45 ",$219.77 ,"$1,115.52 ","$2,637.41 ",$219.77 ,"$2,637.41 ",$219.77 ,"$2,374.46 ","$2,374.46 ",$219.77 ,"$2,374.46 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,988.00 ","$2,828.64 ","$2,828.64 ",$219.77 ,"$2,828.64 ","$3,386.40 ","$3,386.40 ","$3,386.40 ", N/A ,$560.65 ,"$3,386.40 ",$219.77 ,"$3,984.00 ","$2,235.02 ",$219.77 ,"$1,649.38 ",$256.48 ,$233.16 ,$219.77 ,"$3,386.40 ",$470.94 ,"$2,374.46 ","$1,115.52 ","$3,585.60 ",$219.77 ,"$3,386.40 ","$3,366.48 ","$3,366.48 ",$219.77 ,"$2,589.60 " ST. JOSEPH'S HOSPITAL - BREESE,61000025,73219,HC MRI UPPR EXT NONJOINT W/CONTRAST,610,1 ,"$4,366.00 ","$3,143.52 ",$233.16 ,"$4,366.00 ",$884.55 ,"$2,837.90 ","$2,606.50 ",$346.74 ,"$1,222.48 ","$2,890.29 ",$346.74 ,"$2,890.29 ",$346.74 ,"$2,602.14 ","$2,602.14 ",$346.74 ,"$2,602.14 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,274.50 ","$3,099.86 ","$3,099.86 ",$346.74 ,"$3,099.86 ","$3,711.10 ","$3,711.10 ","$3,711.10 ", N/A ,$884.55 ,"$3,711.10 ",$346.74 ,"$4,366.00 ","$2,449.33 ",$346.74 ,"$1,807.52 ",$256.48 ,$233.16 ,$346.74 ,"$3,711.10 ",$743.02 ,"$2,602.14 ","$1,222.48 ","$3,929.40 ",$346.74 ,"$3,711.10 ","$3,689.27 ","$3,689.27 ",$346.74 ,"$2,837.90 " ST. JOSEPH'S HOSPITAL - BREESE,61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$5,099.00 ","$3,671.28 ",$233.16 ,"$5,099.00 ",$884.55 ,"$3,314.35 ","$3,044.10 ",$346.74 ,"$1,427.72 ","$3,375.54 ",$346.74 ,"$3,375.54 ",$346.74 ,"$3,039.00 ","$3,039.00 ",$346.74 ,"$3,039.00 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,824.25 ","$3,620.29 ","$3,620.29 ",$346.74 ,"$3,620.29 ","$4,334.15 ","$4,334.15 ","$4,334.15 ", N/A ,$884.55 ,"$4,334.15 ",$346.74 ,"$5,099.00 ","$2,860.54 ",$346.74 ,"$2,110.99 ",$256.48 ,$233.16 ,$346.74 ,"$4,334.15 ",$743.02 ,"$3,039.00 ","$1,427.72 ","$4,589.10 ",$346.74 ,"$4,334.15 ","$4,308.66 ","$4,308.66 ",$346.74 ,"$3,314.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,984.00 ","$2,868.48 ",$157.37 ,"$3,984.00 ",$560.65 ,"$2,589.60 ","$2,378.45 ",$219.77 ,"$1,115.52 ","$2,637.41 ",$219.77 ,"$2,637.41 ",$219.77 ,"$2,374.46 ","$2,374.46 ",$219.77 ,"$2,374.46 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,988.00 ","$2,828.64 ","$2,828.64 ",$219.77 ,"$2,828.64 ","$3,386.40 ","$3,386.40 ","$3,386.40 ", N/A ,$560.65 ,"$3,386.40 ",$219.77 ,"$3,984.00 ","$2,235.02 ",$219.77 ,"$1,649.38 ",$173.11 ,$157.37 ,$219.77 ,"$3,386.40 ",$470.94 ,"$2,374.46 ","$1,115.52 ","$3,585.60 ",$219.77 ,"$3,386.40 ","$3,366.48 ","$3,366.48 ",$219.77 ,"$2,589.60 " ST. JOSEPH'S HOSPITAL - BREESE,61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,477.00 ","$3,223.44 ",$157.37 ,"$4,477.00 ","$1,778.43 ","$2,910.05 ","$2,672.77 ",$697.14 ,"$1,253.56 ","$2,963.77 ",$697.14 ,"$2,963.77 ",$697.14 ,"$2,668.29 ","$2,668.29 ",$697.14 ,"$2,668.29 ","$1,436.97 ","$2,500.00 ","$1,778.43 ",$697.14 ,$711.09 ,"$3,357.75 ","$3,178.67 ","$3,178.67 ",$697.14 ,"$3,178.67 ","$3,805.45 ","$3,805.45 ","$3,805.45 ", N/A ,"$1,778.43 ","$3,805.45 ",$697.14 ,"$4,477.00 ","$2,511.60 ",$697.14 ,"$1,853.48 ",$173.11 ,$157.37 ,$697.14 ,"$3,805.45 ","$1,493.88 ","$2,668.29 ","$1,253.56 ","$4,029.30 ",$697.14 ,"$3,805.45 ","$3,783.07 ","$3,783.07 ",$697.14 ,"$2,910.05 " ST. JOSEPH'S HOSPITAL - BREESE,61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$5,099.00 ","$3,671.28 ",$157.37 ,"$5,099.00 ",$884.55 ,"$3,314.35 ","$3,044.10 ",$346.74 ,"$1,427.72 ","$3,375.54 ",$346.74 ,"$3,375.54 ",$346.74 ,"$3,039.00 ","$3,039.00 ",$346.74 ,"$3,039.00 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,824.25 ","$3,620.29 ","$3,620.29 ",$346.74 ,"$3,620.29 ","$4,334.15 ","$4,334.15 ","$4,334.15 ", N/A ,$884.55 ,"$4,334.15 ",$346.74 ,"$5,099.00 ","$2,860.54 ",$346.74 ,"$2,110.99 ",$173.11 ,$157.37 ,$346.74 ,"$4,334.15 ",$743.02 ,"$3,039.00 ","$1,427.72 ","$4,589.10 ",$346.74 ,"$4,334.15 ","$4,308.66 ","$4,308.66 ",$346.74 ,"$3,314.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$3,984.00 ","$2,868.48 ",$219.77 ,"$3,984.00 ",$560.65 ,"$2,589.60 ","$2,378.45 ",$219.77 ,"$1,115.52 ","$2,637.41 ",$219.77 ,"$2,637.41 ",$219.77 ,"$2,374.46 ","$2,374.46 ",$219.77 ,"$2,374.46 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,988.00 ","$2,828.64 ","$2,828.64 ",$219.77 ,"$2,828.64 ","$3,386.40 ","$3,386.40 ","$3,386.40 ", N/A ,$560.65 ,"$3,386.40 ",$219.77 ,"$3,984.00 ","$2,235.02 ",$219.77 ,"$1,649.38 ",$256.48 ,$233.16 ,$219.77 ,"$3,386.40 ",$470.94 ,"$2,374.46 ","$1,115.52 ","$3,585.60 ",$219.77 ,"$3,386.40 ","$3,366.48 ","$3,366.48 ",$219.77 ,"$2,589.60 " ST. JOSEPH'S HOSPITAL - BREESE,61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$4,353.00 ","$3,134.16 ",$233.16 ,"$4,353.00 ",$884.55 ,"$2,829.45 ","$2,598.74 ",$346.74 ,"$1,218.84 ","$2,881.69 ",$346.74 ,"$2,881.69 ",$346.74 ,"$2,594.39 ","$2,594.39 ",$346.74 ,"$2,594.39 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,264.75 ","$3,090.63 ","$3,090.63 ",$346.74 ,"$3,090.63 ","$3,700.05 ","$3,700.05 ","$3,700.05 ", N/A ,$884.55 ,"$3,700.05 ",$346.74 ,"$4,353.00 ","$2,442.03 ",$346.74 ,"$1,802.14 ",$256.48 ,$233.16 ,$346.74 ,"$3,700.05 ",$743.02 ,"$2,594.39 ","$1,218.84 ","$3,917.70 ",$346.74 ,"$3,700.05 ","$3,678.29 ","$3,678.29 ",$346.74 ,"$2,829.45 " ST. JOSEPH'S HOSPITAL - BREESE,61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$5,099.00 ","$3,671.28 ",$233.16 ,"$5,099.00 ",$884.55 ,"$3,314.35 ","$3,044.10 ",$346.74 ,"$1,427.72 ","$3,375.54 ",$346.74 ,"$3,375.54 ",$346.74 ,"$3,039.00 ","$3,039.00 ",$346.74 ,"$3,039.00 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,824.25 ","$3,620.29 ","$3,620.29 ",$346.74 ,"$3,620.29 ","$4,334.15 ","$4,334.15 ","$4,334.15 ", N/A ,$884.55 ,"$4,334.15 ",$346.74 ,"$5,099.00 ","$2,860.54 ",$346.74 ,"$2,110.99 ",$256.48 ,$233.16 ,$346.74 ,"$4,334.15 ",$743.02 ,"$3,039.00 ","$1,427.72 ","$4,589.10 ",$346.74 ,"$4,334.15 ","$4,308.66 ","$4,308.66 ",$346.74 ,"$3,314.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$3,984.00 ","$2,868.48 ",$157.37 ,"$3,984.00 ",$560.65 ,"$2,589.60 ","$2,378.45 ",$219.77 ,"$1,115.52 ","$2,637.41 ",$219.77 ,"$2,637.41 ",$219.77 ,"$2,374.46 ","$2,374.46 ",$219.77 ,"$2,374.46 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,988.00 ","$2,828.64 ","$2,828.64 ",$219.77 ,"$2,828.64 ","$3,386.40 ","$3,386.40 ","$3,386.40 ", N/A ,$560.65 ,"$3,386.40 ",$219.77 ,"$3,984.00 ","$2,235.02 ",$219.77 ,"$1,649.38 ",$173.11 ,$157.37 ,$219.77 ,"$3,386.40 ",$470.94 ,"$2,374.46 ","$1,115.52 ","$3,585.60 ",$219.77 ,"$3,386.40 ","$3,366.48 ","$3,366.48 ",$219.77 ,"$2,589.60 " ST. JOSEPH'S HOSPITAL - BREESE,61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$4,353.00 ","$3,134.16 ",$157.37 ,"$4,353.00 ","$1,778.43 ","$2,829.45 ","$2,598.74 ",$697.14 ,"$1,218.84 ","$2,881.69 ",$697.14 ,"$2,881.69 ",$697.14 ,"$2,594.39 ","$2,594.39 ",$697.14 ,"$2,594.39 ","$1,436.97 ","$2,500.00 ","$1,778.43 ",$697.14 ,$711.09 ,"$3,264.75 ","$3,090.63 ","$3,090.63 ",$697.14 ,"$3,090.63 ","$3,700.05 ","$3,700.05 ","$3,700.05 ", N/A ,"$1,778.43 ","$3,700.05 ",$697.14 ,"$4,353.00 ","$2,442.03 ",$697.14 ,"$1,802.14 ",$173.11 ,$157.37 ,$697.14 ,"$3,700.05 ","$1,493.88 ","$2,594.39 ","$1,218.84 ","$3,917.70 ",$697.14 ,"$3,700.05 ","$3,678.29 ","$3,678.29 ",$697.14 ,"$2,829.45 " ST. JOSEPH'S HOSPITAL - BREESE,61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$5,099.00 ","$3,671.28 ",$157.37 ,"$5,099.00 ",$884.55 ,"$3,314.35 ","$3,044.10 ",$346.74 ,"$1,427.72 ","$3,375.54 ",$346.74 ,"$3,375.54 ",$346.74 ,"$3,039.00 ","$3,039.00 ",$346.74 ,"$3,039.00 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,824.25 ","$3,620.29 ","$3,620.29 ",$346.74 ,"$3,620.29 ","$4,334.15 ","$4,334.15 ","$4,334.15 ", N/A ,$884.55 ,"$4,334.15 ",$346.74 ,"$5,099.00 ","$2,860.54 ",$346.74 ,"$2,110.99 ",$173.11 ,$157.37 ,$346.74 ,"$4,334.15 ",$743.02 ,"$3,039.00 ","$1,427.72 ","$4,589.10 ",$346.74 ,"$4,334.15 ","$4,308.66 ","$4,308.66 ",$346.74 ,"$3,314.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$3,907.00 ","$2,813.04 ",$219.77 ,"$3,907.00 ",$560.65 ,"$2,539.55 ","$2,332.48 ",$219.77 ,"$1,093.96 ","$2,586.43 ",$219.77 ,"$2,586.43 ",$219.77 ,"$2,328.57 ","$2,328.57 ",$219.77 ,"$2,328.57 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,930.25 ","$2,773.97 ","$2,773.97 ",$219.77 ,"$2,773.97 ","$3,320.95 ","$3,320.95 ","$3,320.95 ", N/A ,$560.65 ,"$3,320.95 ",$219.77 ,"$3,907.00 ","$2,191.83 ",$219.77 ,"$1,617.50 ",$307.40 ,$279.45 ,$219.77 ,"$3,320.95 ",$470.94 ,"$2,328.57 ","$1,093.96 ","$3,516.30 ",$219.77 ,"$3,320.95 ","$3,301.42 ","$3,301.42 ",$219.77 ,"$2,539.55 " ST. JOSEPH'S HOSPITAL - BREESE,61000039,74182,HC MRI ABDOMEN W/CON,610,1 ,"$4,398.00 ","$3,166.56 ",$279.45 ,"$4,398.00 ",$884.55 ,"$2,858.70 ","$2,625.61 ",$346.74 ,"$1,231.44 ","$2,911.48 ",$346.74 ,"$2,911.48 ",$346.74 ,"$2,621.21 ","$2,621.21 ",$346.74 ,"$2,621.21 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,298.50 ","$3,122.58 ","$3,122.58 ",$346.74 ,"$3,122.58 ","$3,738.30 ","$3,738.30 ","$3,738.30 ", N/A ,$884.55 ,"$3,738.30 ",$346.74 ,"$4,398.00 ","$2,467.28 ",$346.74 ,"$1,820.77 ",$307.40 ,$279.45 ,$346.74 ,"$3,738.30 ",$743.02 ,"$2,621.21 ","$1,231.44 ","$3,958.20 ",$346.74 ,"$3,738.30 ","$3,716.31 ","$3,716.31 ",$346.74 ,"$2,858.70 " ST. JOSEPH'S HOSPITAL - BREESE,61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$5,059.00 ","$3,642.48 ",$279.45 ,"$5,059.00 ",$884.55 ,"$3,288.35 ","$3,020.22 ",$346.74 ,"$1,416.52 ","$3,349.06 ",$346.74 ,"$3,349.06 ",$346.74 ,"$3,015.16 ","$3,015.16 ",$346.74 ,"$3,015.16 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,794.25 ","$3,591.89 ","$3,591.89 ",$346.74 ,"$3,591.89 ","$4,300.15 ","$4,300.15 ","$4,300.15 ", N/A ,$884.55 ,"$4,300.15 ",$346.74 ,"$5,059.00 ","$2,838.10 ",$346.74 ,"$2,094.43 ",$307.40 ,$279.45 ,$346.74 ,"$4,300.15 ",$743.02 ,"$3,015.16 ","$1,416.52 ","$4,553.10 ",$346.74 ,"$4,300.15 ","$4,274.86 ","$4,274.86 ",$346.74 ,"$3,288.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000050,C8937,HC MRI BREAST CAD,610,1 ,$160.00 ,$115.20 ,$44.80 ,$160.00 , N/A ,$104.00 ,$95.52 , N/A ,$44.80 ,$105.92 , N/A ,$105.92 , N/A ,$95.36 ,$95.36 , N/A ,$95.36 , N/A ,$123.20 , N/A , N/A , N/A ,$120.00 ,$113.60 ,$113.60 , N/A ,$113.60 ,$136.00 ,$136.00 ,$136.00 , N/A , N/A ,$136.00 , N/A ,$160.00 ,$89.76 , N/A ,$66.24 , N/A , N/A , N/A ,$136.00 , N/A ,$95.36 ,$44.80 ,$144.00 , N/A ,$136.00 ,$135.20 ,$135.20 , N/A ,$104.00 ST. JOSEPH'S HOSPITAL - BREESE,61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$3,892.00 ","$2,802.24 ",$301.49 ,"$3,892.00 ",$884.55 ,"$2,529.80 ","$2,323.52 ",$346.74 ,"$1,089.76 ","$2,576.50 ",$346.74 ,"$2,576.50 ",$346.74 ,"$2,319.63 ","$2,319.63 ",$346.74 ,"$2,319.63 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$2,919.00 ","$2,763.32 ","$2,763.32 ",$346.74 ,"$2,763.32 ","$3,308.20 ","$3,308.20 ","$3,308.20 ", N/A ,$884.55 ,"$3,308.20 ",$346.74 ,"$3,892.00 ","$2,183.41 ",$346.74 ,"$1,611.29 ",$331.64 ,$301.49 ,$346.74 ,"$3,308.20 ",$743.02 ,"$2,319.63 ","$1,089.76 ","$3,502.80 ",$346.74 ,"$3,308.20 ","$3,288.74 ","$3,288.74 ",$346.74 ,"$2,529.80 " ST. JOSEPH'S HOSPITAL - BREESE,61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,"$3,655.00 ","$2,631.60 ",$219.77 ,"$3,655.00 ",$560.65 ,"$2,375.75 ","$2,182.04 ",$219.77 ,"$1,023.40 ","$2,419.61 ",$219.77 ,"$2,419.61 ",$219.77 ,"$2,178.38 ","$2,178.38 ",$219.77 ,"$2,178.38 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,741.25 ","$2,595.05 ","$2,595.05 ",$219.77 ,"$2,595.05 ","$3,106.75 ","$3,106.75 ","$3,106.75 ", N/A ,$560.65 ,"$3,106.75 ",$219.77 ,"$3,655.00 ","$2,050.46 ",$219.77 ,"$1,513.17 ",$331.64 ,$301.49 ,$219.77 ,"$3,106.75 ",$470.94 ,"$2,178.38 ","$1,023.40 ","$3,289.50 ",$219.77 ,"$3,106.75 ","$3,088.48 ","$3,088.48 ",$219.77 ,"$2,375.75 " ST. JOSEPH'S HOSPITAL - BREESE,61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$4,128.00 ","$2,972.16 ",$301.49 ,"$4,128.00 ",$884.55 ,"$2,683.20 ","$2,464.42 ",$346.74 ,"$1,155.84 ","$2,732.74 ",$346.74 ,"$2,732.74 ",$346.74 ,"$2,460.29 ","$2,460.29 ",$346.74 ,"$2,460.29 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,096.00 ","$2,930.88 ","$2,930.88 ",$346.74 ,"$2,930.88 ","$3,508.80 ","$3,508.80 ","$3,508.80 ", N/A ,$884.55 ,"$3,508.80 ",$346.74 ,"$4,128.00 ","$2,315.81 ",$346.74 ,"$1,708.99 ",$331.64 ,$301.49 ,$346.74 ,"$3,508.80 ",$743.02 ,"$2,460.29 ","$1,155.84 ","$3,715.20 ",$346.74 ,"$3,508.80 ","$3,488.16 ","$3,488.16 ",$346.74 ,"$2,683.20 " ST. JOSEPH'S HOSPITAL - BREESE,61000054,C8903,HC MRI BREAST UNI W/CONTRAST,610,1 ,"$3,263.00 ","$2,349.36 ",$169.73 ,"$3,263.00 ",$432.98 ,"$2,120.95 ","$1,948.01 ",$169.73 ,$913.64 ,"$2,160.11 ",$169.73 ,"$2,160.11 ",$169.73 ,"$1,944.75 ","$1,944.75 ",$169.73 ,"$1,944.75 ",$349.84 ,"$2,500.00 ",$432.97 ,$169.73 ,$173.12 ,"$2,447.25 ","$2,316.73 ","$2,316.73 ",$169.73 ,"$2,316.73 ","$2,773.55 ","$2,773.55 ","$2,773.55 ", N/A ,$432.97 ,"$2,773.55 ",$169.73 ,"$3,263.00 ","$1,830.54 ",$169.73 ,"$1,350.88 ",$256.48 ,$233.16 ,$169.73 ,"$2,773.55 ",$363.69 ,"$1,944.75 ",$913.64 ,"$2,936.70 ",$169.73 ,"$2,773.55 ","$2,757.24 ","$2,757.24 ",$169.73 ,"$2,120.95 " ST. JOSEPH'S HOSPITAL - BREESE,61000059,C8908,HC MRI BREAST BI W AND W/O CON,610,1 ,"$4,679.00 ","$3,368.88 ",$233.16 ,"$4,679.00 ",$884.55 ,"$3,041.35 ","$2,793.36 ",$346.74 ,"$1,310.12 ","$3,097.50 ",$346.74 ,"$3,097.50 ",$346.74 ,"$2,788.68 ","$2,788.68 ",$346.74 ,"$2,788.68 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,509.25 ","$3,322.09 ","$3,322.09 ",$346.74 ,"$3,322.09 ","$3,977.15 ","$3,977.15 ","$3,977.15 ", N/A ,$884.55 ,"$3,977.15 ",$346.74 ,"$4,679.00 ","$2,624.92 ",$346.74 ,"$1,937.11 ",$256.48 ,$233.16 ,$346.74 ,"$3,977.15 ",$743.02 ,"$2,788.68 ","$1,310.12 ","$4,211.10 ",$346.74 ,"$3,977.15 ","$3,953.76 ","$3,953.76 ",$346.74 ,"$3,041.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000060,C8909,HC MRA CHEST W/CONTRAST,610,1 ,"$4,026.00 ","$2,898.72 ",$265.20 ,"$4,026.00 ",$884.55 ,"$2,616.90 ","$2,403.52 ",$346.74 ,"$1,127.28 ","$2,665.21 ",$346.74 ,"$2,665.21 ",$346.74 ,"$2,399.50 ","$2,399.50 ",$346.74 ,"$2,399.50 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,019.50 ","$2,858.46 ","$2,858.46 ",$346.74 ,"$2,858.46 ","$3,422.10 ","$3,422.10 ","$3,422.10 ", N/A ,$884.55 ,"$3,422.10 ",$346.74 ,"$4,026.00 ","$2,258.59 ",$346.74 ,"$1,666.76 ",$291.72 ,$265.20 ,$346.74 ,"$3,422.10 ",$743.02 ,"$2,399.50 ","$1,127.28 ","$3,623.40 ",$346.74 ,"$3,422.10 ","$3,401.97 ","$3,401.97 ",$346.74 ,"$2,616.90 " ST. JOSEPH'S HOSPITAL - BREESE,61000061,C8910,HC MRA CHEST W/O CONTRAST,610,1 ,"$3,655.00 ","$2,631.60 ",$219.77 ,"$3,655.00 ",$560.65 ,"$2,375.75 ","$2,182.04 ",$219.77 ,"$1,023.40 ","$2,419.61 ",$219.77 ,"$2,419.61 ",$219.77 ,"$2,178.38 ","$2,178.38 ",$219.77 ,"$2,178.38 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,741.25 ","$2,595.05 ","$2,595.05 ",$219.77 ,"$2,595.05 ","$3,106.75 ","$3,106.75 ","$3,106.75 ", N/A ,$560.65 ,"$3,106.75 ",$219.77 ,"$3,655.00 ","$2,050.46 ",$219.77 ,"$1,513.17 ",$291.72 ,$265.20 ,$219.77 ,"$3,106.75 ",$470.94 ,"$2,178.38 ","$1,023.40 ","$3,289.50 ",$219.77 ,"$3,106.75 ","$3,088.48 ","$3,088.48 ",$219.77 ,"$2,375.75 " ST. JOSEPH'S HOSPITAL - BREESE,61000062,C8911,HC MRA CHEST W AND W/O CONTRAST,610,1 ,"$4,456.00 ","$3,208.32 ",$265.20 ,"$4,456.00 ",$884.55 ,"$2,896.40 ","$2,660.23 ",$346.74 ,"$1,247.68 ","$2,949.87 ",$346.74 ,"$2,949.87 ",$346.74 ,"$2,655.78 ","$2,655.78 ",$346.74 ,"$2,655.78 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,342.00 ","$3,163.76 ","$3,163.76 ",$346.74 ,"$3,163.76 ","$3,787.60 ","$3,787.60 ","$3,787.60 ", N/A ,$884.55 ,"$3,787.60 ",$346.74 ,"$4,456.00 ","$2,499.82 ",$346.74 ,"$1,844.78 ",$291.72 ,$265.20 ,$346.74 ,"$3,787.60 ",$743.02 ,"$2,655.78 ","$1,247.68 ","$4,010.40 ",$346.74 ,"$3,787.60 ","$3,765.32 ","$3,765.32 ",$346.74 ,"$2,896.40 " ST. JOSEPH'S HOSPITAL - BREESE,61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$3,655.00 ","$2,631.60 ",$219.77 ,"$3,655.00 ",$560.65 ,"$2,375.75 ","$2,182.04 ",$219.77 ,"$1,023.40 ","$2,419.61 ",$219.77 ,"$2,419.61 ",$219.77 ,"$2,178.38 ","$2,178.38 ",$219.77 ,"$2,178.38 ",$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,$224.17 ,"$2,741.25 ","$2,595.05 ","$2,595.05 ",$219.77 ,"$2,595.05 ","$3,106.75 ","$3,106.75 ","$3,106.75 ", N/A ,$560.65 ,"$3,106.75 ",$219.77 ,"$3,655.00 ","$2,050.46 ",$219.77 ,"$1,513.17 ",$331.64 ,$301.49 ,$219.77 ,"$3,106.75 ",$470.94 ,"$2,178.38 ","$1,023.40 ","$3,289.50 ",$219.77 ,"$3,106.75 ","$3,088.48 ","$3,088.48 ",$219.77 ,"$2,375.75 " ST. JOSEPH'S HOSPITAL - BREESE,61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$4,148.00 ","$2,986.56 ",$301.49 ,"$4,148.00 ",$884.55 ,"$2,696.20 ","$2,476.36 ",$346.74 ,"$1,161.44 ","$2,745.98 ",$346.74 ,"$2,745.98 ",$346.74 ,"$2,472.21 ","$2,472.21 ",$346.74 ,"$2,472.21 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,111.00 ","$2,945.08 ","$2,945.08 ",$346.74 ,"$2,945.08 ","$3,525.80 ","$3,525.80 ","$3,525.80 ", N/A ,$884.55 ,"$3,525.80 ",$346.74 ,"$4,148.00 ","$2,327.03 ",$346.74 ,"$1,717.27 ",$331.64 ,$301.49 ,$346.74 ,"$3,525.80 ",$743.02 ,"$2,472.21 ","$1,161.44 ","$3,733.20 ",$346.74 ,"$3,525.80 ","$3,505.06 ","$3,505.06 ",$346.74 ,"$2,696.20 " ST. JOSEPH'S HOSPITAL - BREESE,61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$4,679.00 ","$3,368.88 ",$301.49 ,"$4,679.00 ",$884.55 ,"$3,041.35 ","$2,793.36 ",$346.74 ,"$1,310.12 ","$3,097.50 ",$346.74 ,"$3,097.50 ",$346.74 ,"$2,788.68 ","$2,788.68 ",$346.74 ,"$2,788.68 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,509.25 ","$3,322.09 ","$3,322.09 ",$346.74 ,"$3,322.09 ","$3,977.15 ","$3,977.15 ","$3,977.15 ", N/A ,$884.55 ,"$3,977.15 ",$346.74 ,"$4,679.00 ","$2,624.92 ",$346.74 ,"$1,937.11 ",$331.64 ,$301.49 ,$346.74 ,"$3,977.15 ",$743.02 ,"$2,788.68 ","$1,310.12 ","$4,211.10 ",$346.74 ,"$3,977.15 ","$3,953.76 ","$3,953.76 ",$346.74 ,"$3,041.35 " ST. JOSEPH'S HOSPITAL - BREESE,61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$5,324.00 ","$3,833.28 ",$261.24 ,"$5,324.00 ",$884.55 ,"$3,460.60 ","$3,178.43 ",$346.74 ,"$1,490.72 ","$3,524.49 ",$346.74 ,"$3,524.49 ",$346.74 ,"$3,173.10 ","$3,173.10 ",$346.74 ,"$3,173.10 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,993.00 ","$3,780.04 ","$3,780.04 ",$346.74 ,"$3,780.04 ","$4,525.40 ","$4,525.40 ","$4,525.40 ", N/A ,$884.55 ,"$4,525.40 ",$346.74 ,"$5,324.00 ","$2,986.76 ",$346.74 ,"$2,204.14 ",$287.36 ,$261.24 ,$346.74 ,"$4,525.40 ",$743.02 ,"$3,173.10 ","$1,490.72 ","$4,791.60 ",$346.74 ,"$4,525.40 ","$4,498.78 ","$4,498.78 ",$346.74 ,"$3,460.60 " ST. JOSEPH'S HOSPITAL - BREESE,61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$4,259.00 ","$3,066.48 ",$233.16 ,"$4,259.00 ",$884.55 ,"$2,768.35 ","$2,542.62 ",$346.74 ,"$1,192.52 ","$2,819.46 ",$346.74 ,"$2,819.46 ",$346.74 ,"$2,538.36 ","$2,538.36 ",$346.74 ,"$2,538.36 ",$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,$353.67 ,"$3,194.25 ","$3,023.89 ","$3,023.89 ",$346.74 ,"$3,023.89 ","$3,620.15 ","$3,620.15 ","$3,620.15 ", N/A ,$884.55 ,"$3,620.15 ",$346.74 ,"$4,259.00 ","$2,389.30 ",$346.74 ,"$1,763.23 ",$256.48 ,$233.16 ,$346.74 ,"$3,620.15 ",$743.02 ,"$2,538.36 ","$1,192.52 ","$3,833.10 ",$346.74 ,"$3,620.15 ","$3,598.86 ","$3,598.86 ",$346.74 ,"$2,768.35 " ST. JOSEPH'S HOSPITAL - BREESE,63600002,N/A,N/A,636,1 ,$47.20 ,$33.98 ,$13.22 ,$47.20 , N/A ,$30.68 ,$28.18 , N/A ,$13.22 ,$31.25 , N/A ,$31.25 , N/A ,$28.13 ,$28.13 , N/A ,$28.13 , N/A ,$36.34 , N/A , N/A , N/A ,$35.40 ,$33.51 ,$33.51 , N/A ,$33.51 ,$40.12 ,$40.12 ,$40.12 , N/A , N/A ,$40.12 , N/A ,$47.20 ,$26.48 , N/A ,$19.54 , N/A , N/A , N/A ,$40.12 , N/A ,$28.13 ,$13.22 ,$42.48 , N/A ,$40.12 ,$23.60 ,$23.60 , N/A ,$30.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,0.9 % NACL WITH KCL 40 MEQ 40-0.9 MEQ/L-% SOLN per2 mEq,636,1 ,$2.60 ,$1.87 ,$0.23 ,$2.60 , N/A ,$1.69 ,$1.55 , N/A ,$0.73 ,$1.72 , N/A ,$1.72 , N/A ,$1.55 ,$1.55 , N/A ,$1.55 , N/A ,$2.00 , N/A , N/A , N/A ,$1.95 ,$1.85 ,$1.85 , N/A ,$1.85 ,$2.21 ,$2.21 ,$2.21 , N/A , N/A ,$2.21 , N/A ,$2.60 ,$1.46 , N/A ,$1.08 , N/A , N/A , N/A ,$2.21 , N/A ,$1.55 ,$0.73 ,$2.34 , N/A ,$2.21 ,$0.23 ,$0.23 , N/A ,$1.69 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0131,ACETAMINOPHEN 10 MG/ML SOLN per10 mg,636,1 ,$1.78 ,$1.28 ,$0.17 ,$1.78 , N/A ,$1.16 ,$1.06 , N/A ,$0.50 ,$1.18 , N/A ,$1.18 , N/A ,$1.06 ,$1.06 , N/A ,$1.06 , N/A ,$1.37 , N/A , N/A , N/A ,$1.34 ,$1.26 ,$1.26 , N/A ,$1.26 ,$1.51 ,$1.51 ,$1.51 , N/A , N/A ,$1.51 , N/A ,$1.78 ,$1.00 , N/A ,$0.74 , N/A , N/A , N/A ,$1.51 , N/A ,$1.06 ,$0.50 ,$1.60 , N/A ,$1.51 ,$0.17 ,$0.17 , N/A ,$1.16 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0132,ACETYLCYSTEINE 200 MG/ML SOLN 30 ML VIAL per100 mg,636,1 ,$23.02 ,$16.57 ,$1.63 ,$23.02 , N/A ,$14.96 ,$13.74 , N/A ,$6.45 ,$15.24 , N/A ,$15.24 , N/A ,$13.72 ,$13.72 , N/A ,$13.72 , N/A ,$17.73 , N/A , N/A , N/A ,$17.27 ,$16.34 ,$16.34 , N/A ,$16.34 ,$19.57 ,$19.57 ,$19.57 , N/A , N/A ,$19.57 , N/A ,$23.02 ,$12.91 , N/A ,$9.53 , N/A , N/A , N/A ,$19.57 , N/A ,$13.72 ,$6.45 ,$20.72 , N/A ,$19.57 ,$1.63 ,$1.63 , N/A ,$14.96 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0133,ACYCLOVIR 50 MG/ML SOLN 10 ML VIAL per5 mg,636,1 ,$0.64 ,$0.46 ,$0.08 ,$0.64 , N/A ,$0.42 ,$0.38 , N/A ,$0.18 ,$0.42 , N/A ,$0.42 , N/A ,$0.38 ,$0.38 , N/A ,$0.38 , N/A ,$0.49 , N/A , N/A , N/A ,$0.48 ,$0.45 ,$0.45 , N/A ,$0.45 ,$0.54 ,$0.54 ,$0.54 , N/A , N/A ,$0.54 , N/A ,$0.64 ,$0.36 , N/A ,$0.27 , N/A , N/A , N/A ,$0.54 , N/A ,$0.38 ,$0.18 ,$0.58 , N/A ,$0.54 ,$0.08 ,$0.08 , N/A ,$0.42 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0153,ADENOSINE 6 MG/2ML SOLN per1 mg,636,1 ,$8.77 ,$6.31 ,$0.86 ,$8.77 , N/A ,$5.70 ,$5.24 , N/A ,$2.46 ,$5.81 , N/A ,$5.81 , N/A ,$5.23 ,$5.23 , N/A ,$5.23 , N/A ,$6.75 , N/A , N/A , N/A ,$6.58 ,$6.23 ,$6.23 , N/A ,$6.23 ,$7.45 ,$7.45 ,$7.45 , N/A , N/A ,$7.45 , N/A ,$8.77 ,$4.92 , N/A ,$3.63 , N/A , N/A , N/A ,$7.45 , N/A ,$5.23 ,$2.46 ,$7.89 , N/A ,$7.45 ,$0.86 ,$0.86 , N/A ,$5.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,P9047,ALBUMIN HUMAN 25 % SOLN per50 mL,636,1 ,$432.00 ,$311.04 ,$52.02 ,$432.00 ,$132.70 ,$280.80 ,$257.90 ,$52.02 ,$120.96 ,$285.98 ,$52.02 ,$285.98 ,$52.02 ,$257.47 ,$257.47 ,$52.02 ,$257.47 ,$107.22 ,$332.64 ,$132.69 ,$52.02 ,$53.06 ,$324.00 ,$306.72 ,$306.72 ,$52.02 ,$306.72 ,$367.20 ,$367.20 ,$367.20 , N/A ,$132.69 ,$367.20 ,$52.02 ,$432.00 ,$242.35 ,$52.02 ,$178.85 ,$432.00 ,$432.00 ,$52.02 ,$367.20 ,$111.46 ,$257.47 ,$120.96 ,$388.80 ,$52.02 ,$367.20 ,$87.07 ,$87.07 ,$52.02 ,$280.80 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0270,ALPROSTADIL 500 MCG/ML SOLN 1 ML AMPULE per1.25 mcg,636,1 ,$1.58 ,$1.14 ,$0.44 ,$1.58 , N/A ,$1.03 ,$0.94 , N/A ,$0.44 ,$1.05 , N/A ,$1.05 , N/A ,$0.94 ,$0.94 , N/A ,$0.94 , N/A ,$1.22 , N/A , N/A , N/A ,$1.19 ,$1.12 ,$1.12 , N/A ,$1.12 ,$1.34 ,$1.34 ,$1.34 , N/A , N/A ,$1.34 , N/A ,$1.58 ,$0.89 , N/A ,$0.65 , N/A , N/A , N/A ,$1.34 , N/A ,$0.94 ,$0.44 ,$1.42 , N/A ,$1.34 ,$0.59 ,$0.59 , N/A ,$1.03 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0270,ALPROSTADIL 500 MCG/ML SOLN 1 ML VIAL per1.25 mcg,636,1 ,$1.30 ,$0.94 ,$0.36 ,$1.30 , N/A ,$0.85 ,$0.78 , N/A ,$0.36 ,$0.86 , N/A ,$0.86 , N/A ,$0.77 ,$0.77 , N/A ,$0.77 , N/A ,$1.00 , N/A , N/A , N/A ,$0.98 ,$0.92 ,$0.92 , N/A ,$0.92 ,$1.11 ,$1.11 ,$1.11 , N/A , N/A ,$1.11 , N/A ,$1.30 ,$0.73 , N/A ,$0.54 , N/A , N/A , N/A ,$1.11 , N/A ,$0.77 ,$0.36 ,$1.17 , N/A ,$1.11 ,$0.59 ,$0.59 , N/A ,$0.85 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2997,ALTEPLASE 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$404.31 ,$291.10 ,$53.96 ,$404.31 ,$218.93 ,$262.80 ,$241.37 ,$85.82 ,$113.21 ,$267.65 ,$85.82 ,$267.65 ,$85.82 ,$240.97 ,$240.97 ,$85.82 ,$240.97 ,$176.88 ,$311.32 ,$218.91 ,$85.82 ,$87.53 ,$303.23 ,$287.06 ,$287.06 ,$85.82 ,$287.06 ,$343.66 ,$343.66 ,$343.66 , N/A ,$218.91 ,$343.66 ,$85.82 ,$404.31 ,$226.82 ,$85.82 ,$167.38 ,$59.36 ,$53.96 ,$85.82 ,$343.66 ,$183.89 ,$240.97 ,$113.21 ,$363.88 ,$85.82 ,$343.66 ,$145.25 ,$145.25 ,$85.82 ,$262.80 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2997,ALTEPLASE 100 MG SOLR per1 mg,636,1 ,$422.42 ,$304.14 ,$53.96 ,$422.42 ,$218.93 ,$274.57 ,$252.18 ,$85.82 ,$118.28 ,$279.64 ,$85.82 ,$279.64 ,$85.82 ,$251.76 ,$251.76 ,$85.82 ,$251.76 ,$176.88 ,$325.26 ,$218.91 ,$85.82 ,$87.53 ,$316.82 ,$299.92 ,$299.92 ,$85.82 ,$299.92 ,$359.06 ,$359.06 ,$359.06 , N/A ,$218.91 ,$359.06 ,$85.82 ,$422.42 ,$236.98 ,$85.82 ,$174.88 ,$59.36 ,$53.96 ,$85.82 ,$359.06 ,$183.89 ,$251.76 ,$118.28 ,$380.18 ,$85.82 ,$359.06 ,$145.25 ,$145.25 ,$85.82 ,$274.57 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2997,ALTEPLASE 2 MG SOLR per1 mg,636,1 ,$385.70 ,$277.70 ,$53.96 ,$385.70 ,$218.93 ,$250.71 ,$230.26 ,$85.82 ,$108.00 ,$255.33 ,$85.82 ,$255.33 ,$85.82 ,$229.88 ,$229.88 ,$85.82 ,$229.88 ,$176.88 ,$296.99 ,$218.91 ,$85.82 ,$87.53 ,$289.28 ,$273.85 ,$273.85 ,$85.82 ,$273.85 ,$327.85 ,$327.85 ,$327.85 , N/A ,$218.91 ,$327.85 ,$85.82 ,$385.70 ,$216.38 ,$85.82 ,$159.68 ,$59.36 ,$53.96 ,$85.82 ,$327.85 ,$183.89 ,$229.88 ,$108.00 ,$347.13 ,$85.82 ,$327.85 ,$145.25 ,$145.25 ,$85.82 ,$250.71 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0282,AMIODARONE 150 MG/3ML SOLN 3 ML VIAL per30 mg,636,1 ,$3.60 ,$2.59 ,$1.01 ,$3.60 , N/A ,$2.34 ,$2.15 , N/A ,$1.01 ,$2.38 , N/A ,$2.38 , N/A ,$2.15 ,$2.15 , N/A ,$2.15 , N/A ,$2.77 , N/A , N/A , N/A ,$2.70 ,$2.56 ,$2.56 , N/A ,$2.56 ,$3.06 ,$3.06 ,$3.06 , N/A , N/A ,$3.06 , N/A ,$3.60 ,$2.02 , N/A ,$1.49 , N/A , N/A , N/A ,$3.06 , N/A ,$2.15 ,$1.01 ,$3.24 , N/A ,$3.06 ,$1.35 ,$1.35 , N/A ,$2.34 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0282,AMIODARONE 360-4.14 MG/200ML-% SOLN per30 mg,636,1 ,$18.47 ,$13.30 ,$1.35 ,$18.47 , N/A ,$12.01 ,$11.03 , N/A ,$5.17 ,$12.23 , N/A ,$12.23 , N/A ,$11.01 ,$11.01 , N/A ,$11.01 , N/A ,$14.22 , N/A , N/A , N/A ,$13.85 ,$13.11 ,$13.11 , N/A ,$13.11 ,$15.70 ,$15.70 ,$15.70 , N/A , N/A ,$15.70 , N/A ,$18.47 ,$10.36 , N/A ,$7.65 , N/A , N/A , N/A ,$15.70 , N/A ,$11.01 ,$5.17 ,$16.62 , N/A ,$15.70 ,$1.35 ,$1.35 , N/A ,$12.01 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0290,AMPICILLIN 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$15.93 ,$11.47 ,$1.20 ,$15.93 , N/A ,$10.35 ,$9.51 , N/A ,$4.46 ,$10.55 , N/A ,$10.55 , N/A ,$9.49 ,$9.49 , N/A ,$9.49 , N/A ,$12.27 , N/A , N/A , N/A ,$11.95 ,$11.31 ,$11.31 , N/A ,$11.31 ,$13.54 ,$13.54 ,$13.54 , N/A , N/A ,$13.54 , N/A ,$15.93 ,$8.94 , N/A ,$6.60 , N/A , N/A , N/A ,$13.54 , N/A ,$9.49 ,$4.46 ,$14.34 , N/A ,$13.54 ,$1.20 ,$1.20 , N/A ,$10.35 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0290,AMPICILLIN 250 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$26.15 ,$18.83 ,$1.20 ,$26.15 , N/A ,$17.00 ,$15.61 , N/A ,$7.32 ,$17.31 , N/A ,$17.31 , N/A ,$15.59 ,$15.59 , N/A ,$15.59 , N/A ,$20.14 , N/A , N/A , N/A ,$19.61 ,$18.57 ,$18.57 , N/A ,$18.57 ,$22.23 ,$22.23 ,$22.23 , N/A , N/A ,$22.23 , N/A ,$26.15 ,$14.67 , N/A ,$10.83 , N/A , N/A , N/A ,$22.23 , N/A ,$15.59 ,$7.32 ,$23.54 , N/A ,$22.23 ,$1.20 ,$1.20 , N/A ,$17.00 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0290,AMPICILLIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$18.00 ,$12.96 ,$1.20 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.20 ,$1.20 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0290,AMPICILLIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$18.00 ,$12.96 ,$1.20 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.20 ,$1.20 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0295,AMPICILLIN-SULBACTAM 1.5 (1-0.5) G SOLR 1 EACH VIAL per1.5 g,636,1 ,$37.15 ,$26.75 ,$3.76 ,$37.15 , N/A ,$24.15 ,$22.18 , N/A ,$10.40 ,$24.59 , N/A ,$24.59 , N/A ,$22.14 ,$22.14 , N/A ,$22.14 , N/A ,$28.61 , N/A , N/A , N/A ,$27.86 ,$26.38 ,$26.38 , N/A ,$26.38 ,$31.58 ,$31.58 ,$31.58 , N/A , N/A ,$31.58 , N/A ,$37.15 ,$20.84 , N/A ,$15.38 , N/A , N/A , N/A ,$31.58 , N/A ,$22.14 ,$10.40 ,$33.44 , N/A ,$31.58 ,$3.76 ,$3.76 , N/A ,$24.15 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0295,AMPICILLIN-SULBACTAM 3 (2-1) G SOLR 1 EACH VIAL per1.5 g,636,1 ,$38.30 ,$27.58 ,$3.76 ,$38.30 , N/A ,$24.90 ,$22.87 , N/A ,$10.72 ,$25.35 , N/A ,$25.35 , N/A ,$22.83 ,$22.83 , N/A ,$22.83 , N/A ,$29.49 , N/A , N/A , N/A ,$28.73 ,$27.19 ,$27.19 , N/A ,$27.19 ,$32.56 ,$32.56 ,$32.56 , N/A , N/A ,$32.56 , N/A ,$38.30 ,$21.49 , N/A ,$15.86 , N/A , N/A , N/A ,$32.56 , N/A ,$22.83 ,$10.72 ,$34.47 , N/A ,$32.56 ,$3.76 ,$3.76 , N/A ,$24.90 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0461,ATROPINE 0.4 MG/ML SOLN per0.01 mg,636,1 ,$0.96 ,$0.69 ,$0.10 ,$0.96 , N/A ,$0.62 ,$0.57 , N/A ,$0.27 ,$0.64 , N/A ,$0.64 , N/A ,$0.57 ,$0.57 , N/A ,$0.57 , N/A ,$0.74 , N/A , N/A , N/A ,$0.72 ,$0.68 ,$0.68 , N/A ,$0.68 ,$0.82 ,$0.82 ,$0.82 , N/A , N/A ,$0.82 , N/A ,$0.96 ,$0.54 , N/A ,$0.40 , N/A , N/A , N/A ,$0.82 , N/A ,$0.57 ,$0.27 ,$0.86 , N/A ,$0.82 ,$0.10 ,$0.10 , N/A ,$0.62 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0461,ATROPINE 1 MG/10ML SOSY per0.01 mg,636,1 ,$0.50 ,$0.36 ,$0.10 ,$0.50 , N/A ,$0.33 ,$0.30 , N/A ,$0.14 ,$0.33 , N/A ,$0.33 , N/A ,$0.30 ,$0.30 , N/A ,$0.30 , N/A ,$0.39 , N/A , N/A , N/A ,$0.38 ,$0.36 ,$0.36 , N/A ,$0.36 ,$0.43 ,$0.43 ,$0.43 , N/A , N/A ,$0.43 , N/A ,$0.50 ,$0.28 , N/A ,$0.21 , N/A , N/A , N/A ,$0.43 , N/A ,$0.30 ,$0.14 ,$0.45 , N/A ,$0.43 ,$0.10 ,$0.10 , N/A ,$0.33 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7500,AZATHIOPRINE 50 MG TABS per50 mg,636,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 , N/A ,$3.90 ,$3.58 , N/A ,$1.68 ,$3.97 , N/A ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A , N/A , N/A ,$4.50 ,$4.26 ,$4.26 , N/A ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A , N/A ,$5.10 , N/A ,$6.00 ,$3.37 , N/A ,$2.48 , N/A , N/A , N/A ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 , N/A ,$5.10 ,$6.00 ,$6.00 , N/A ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0456,AZITHROMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$69.20 ,$49.82 ,$4.24 ,$69.20 , N/A ,$44.98 ,$41.31 , N/A ,$19.38 ,$45.81 , N/A ,$45.81 , N/A ,$41.24 ,$41.24 , N/A ,$41.24 , N/A ,$53.28 , N/A , N/A , N/A ,$51.90 ,$49.13 ,$49.13 , N/A ,$49.13 ,$58.82 ,$58.82 ,$58.82 , N/A , N/A ,$58.82 , N/A ,$69.20 ,$38.82 , N/A ,$28.65 , N/A , N/A , N/A ,$58.82 , N/A ,$41.24 ,$19.38 ,$62.28 , N/A ,$58.82 ,$4.24 ,$4.24 , N/A ,$44.98 ST. JOSEPH'S HOSPITAL - BREESE,63600002,C9399,BARICITINIB 2 MG TABS per2 mg,636,1 ,$190.30 ,$137.02 ,$53.28 ,$190.30 , N/A ,$123.70 ,$113.61 ,$57.09 ,$53.28 ,$125.98 , N/A ,$125.98 , N/A ,$113.42 ,$113.42 , N/A ,$113.42 ,$85.64 ,$146.53 ,$133.21 , N/A , N/A ,$142.73 ,$135.11 ,$135.11 , N/A ,$135.11 ,$161.76 ,$161.76 ,$161.76 , N/A , N/A ,$161.76 , N/A ,$190.30 ,$106.76 , N/A ,$78.78 , N/A , N/A , N/A ,$161.76 ,$114.18 ,$113.42 ,$53.28 ,$171.27 , N/A ,$161.76 , N/A , N/A , N/A ,$123.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0702,BETAMETHASONE ACET/SODIUM PHOSPHATE 6 (3-3) MG/ML SUSP per6 mg,636,1 ,$50.33 ,$36.24 ,$11.45 ,$50.33 , N/A ,$32.71 ,$30.05 , N/A ,$14.09 ,$33.32 , N/A ,$33.32 , N/A ,$30.00 ,$30.00 , N/A ,$30.00 , N/A ,$38.75 , N/A , N/A , N/A ,$37.75 ,$35.73 ,$35.73 , N/A ,$35.73 ,$42.78 ,$42.78 ,$42.78 , N/A , N/A ,$42.78 , N/A ,$50.33 ,$28.24 , N/A ,$20.84 , N/A , N/A , N/A ,$42.78 , N/A ,$30.00 ,$14.09 ,$45.30 , N/A ,$42.78 ,$11.45 ,$11.45 , N/A ,$32.71 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0595,BUTORPHANOL 1 MG/ML SOLN per1 mg,636,1 ,$24.35 ,$17.53 ,$5.84 ,$24.35 , N/A ,$15.83 ,$14.54 , N/A ,$6.82 ,$16.12 , N/A ,$16.12 , N/A ,$14.51 ,$14.51 , N/A ,$14.51 , N/A ,$18.75 , N/A , N/A , N/A ,$18.26 ,$17.29 ,$17.29 , N/A ,$17.29 ,$20.70 ,$20.70 ,$20.70 , N/A , N/A ,$20.70 , N/A ,$24.35 ,$13.66 , N/A ,$10.08 , N/A , N/A , N/A ,$20.70 , N/A ,$14.51 ,$6.82 ,$21.92 , N/A ,$20.70 ,$5.84 ,$5.84 , N/A ,$15.83 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0610,CALCIUM GLUCONATE 10 % SOLN 10 ML VIAL per10 mL,636,1 ,$48.10 ,$34.63 ,$8.53 ,$48.10 , N/A ,$31.27 ,$28.72 , N/A ,$13.47 ,$31.84 , N/A ,$31.84 , N/A ,$28.67 ,$28.67 , N/A ,$28.67 , N/A ,$37.04 , N/A , N/A , N/A ,$36.08 ,$34.15 ,$34.15 , N/A ,$34.15 ,$40.89 ,$40.89 ,$40.89 , N/A , N/A ,$40.89 , N/A ,$48.10 ,$26.98 , N/A ,$19.91 , N/A , N/A , N/A ,$40.89 , N/A ,$28.67 ,$13.47 ,$43.29 , N/A ,$40.89 ,$8.53 ,$8.53 , N/A ,$31.27 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0690,CEFAZOLIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$5.23 ,$3.77 ,$1.20 ,$5.23 , N/A ,$3.40 ,$3.12 , N/A ,$1.46 ,$3.46 , N/A ,$3.46 , N/A ,$3.12 ,$3.12 , N/A ,$3.12 , N/A ,$4.03 , N/A , N/A , N/A ,$3.92 ,$3.71 ,$3.71 , N/A ,$3.71 ,$4.45 ,$4.45 ,$4.45 , N/A , N/A ,$4.45 , N/A ,$5.23 ,$2.93 , N/A ,$2.17 , N/A , N/A , N/A ,$4.45 , N/A ,$3.12 ,$1.46 ,$4.71 , N/A ,$4.45 ,$1.20 ,$1.20 , N/A ,$3.40 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0692,CEFEPIME 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$13.70 ,$9.86 ,$2.13 ,$13.70 , N/A ,$8.91 ,$8.18 , N/A ,$3.84 ,$9.07 , N/A ,$9.07 , N/A ,$8.17 ,$8.17 , N/A ,$8.17 , N/A ,$10.55 , N/A , N/A , N/A ,$10.28 ,$9.73 ,$9.73 , N/A ,$9.73 ,$11.65 ,$11.65 ,$11.65 , N/A , N/A ,$11.65 , N/A ,$13.70 ,$7.69 , N/A ,$5.67 , N/A , N/A , N/A ,$11.65 , N/A ,$8.17 ,$3.84 ,$12.33 , N/A ,$11.65 ,$2.13 ,$2.13 , N/A ,$8.91 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0692,CEFEPIME 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$11.76 ,$8.47 ,$2.13 ,$11.76 , N/A ,$7.64 ,$7.02 , N/A ,$3.29 ,$7.79 , N/A ,$7.79 , N/A ,$7.01 ,$7.01 , N/A ,$7.01 , N/A ,$9.06 , N/A , N/A , N/A ,$8.82 ,$8.35 ,$8.35 , N/A ,$8.35 ,$10.00 ,$10.00 ,$10.00 , N/A , N/A ,$10.00 , N/A ,$11.76 ,$6.60 , N/A ,$4.87 , N/A , N/A , N/A ,$10.00 , N/A ,$7.01 ,$3.29 ,$10.58 , N/A ,$10.00 ,$2.13 ,$2.13 , N/A ,$7.64 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0694,CEFOXITIN 1 G SOLR 1 EACH VIAL per1 g,636,1 ,$30.63 ,$22.05 ,$8.04 ,$30.63 , N/A ,$19.91 ,$18.29 , N/A ,$8.58 ,$20.28 , N/A ,$20.28 , N/A ,$18.26 ,$18.26 , N/A ,$18.26 , N/A ,$23.59 , N/A , N/A , N/A ,$22.97 ,$21.75 ,$21.75 , N/A ,$21.75 ,$26.04 ,$26.04 ,$26.04 , N/A , N/A ,$26.04 , N/A ,$30.63 ,$17.18 , N/A ,$12.68 , N/A , N/A , N/A ,$26.04 , N/A ,$18.26 ,$8.58 ,$27.57 , N/A ,$26.04 ,$8.04 ,$8.04 , N/A ,$19.91 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0712,CEFTAROLINE 600 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$17.79 ,$12.81 ,$3.69 ,$17.79 ,$9.43 ,$11.56 ,$10.62 ,$3.69 ,$4.98 ,$11.78 ,$3.69 ,$11.78 ,$3.69 ,$10.60 ,$10.60 ,$3.69 ,$10.60 ,$7.61 ,$13.70 ,$9.41 ,$3.69 ,$3.76 ,$13.34 ,$12.63 ,$12.63 ,$3.69 ,$12.63 ,$15.12 ,$15.12 ,$15.12 , N/A ,$9.41 ,$15.12 ,$3.69 ,$17.79 ,$9.98 ,$3.69 ,$7.37 ,$17.79 ,$17.79 ,$3.69 ,$15.12 ,$7.91 ,$10.60 ,$4.98 ,$16.01 ,$3.69 ,$15.12 ,$6.24 ,$6.24 ,$3.69 ,$11.56 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0713,CEFTAZIDIME 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$10.80 ,$7.78 ,$3.02 ,$10.80 , N/A ,$7.02 ,$6.45 , N/A ,$3.02 ,$7.15 , N/A ,$7.15 , N/A ,$6.44 ,$6.44 , N/A ,$6.44 , N/A ,$8.32 , N/A , N/A , N/A ,$8.10 ,$7.67 ,$7.67 , N/A ,$7.67 ,$9.18 ,$9.18 ,$9.18 , N/A , N/A ,$9.18 , N/A ,$10.80 ,$6.06 , N/A ,$4.47 , N/A , N/A , N/A ,$9.18 , N/A ,$6.44 ,$3.02 ,$9.72 , N/A ,$9.18 ,$3.27 ,$3.27 , N/A ,$7.02 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0696,CEFTRIAXONE 1 G SOLR 1 EACH VIAL per250 mg,636,1 ,$45.95 ,$33.08 ,$0.87 ,$45.95 , N/A ,$29.87 ,$27.43 , N/A ,$12.87 ,$30.42 , N/A ,$30.42 , N/A ,$27.39 ,$27.39 , N/A ,$27.39 , N/A ,$35.38 , N/A , N/A , N/A ,$34.46 ,$32.62 ,$32.62 , N/A ,$32.62 ,$39.06 ,$39.06 ,$39.06 , N/A , N/A ,$39.06 , N/A ,$45.95 ,$25.78 , N/A ,$19.02 , N/A , N/A , N/A ,$39.06 , N/A ,$27.39 ,$12.87 ,$41.36 , N/A ,$39.06 ,$0.87 ,$0.87 , N/A ,$29.87 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0696,CEFTRIAXONE 2 G SOLR 1 EACH VIAL per250 mg,636,1 ,$2.25 ,$1.62 ,$0.63 ,$2.25 , N/A ,$1.46 ,$1.34 , N/A ,$0.63 ,$1.49 , N/A ,$1.49 , N/A ,$1.34 ,$1.34 , N/A ,$1.34 , N/A ,$1.73 , N/A , N/A , N/A ,$1.69 ,$1.60 ,$1.60 , N/A ,$1.60 ,$1.91 ,$1.91 ,$1.91 , N/A , N/A ,$1.91 , N/A ,$2.25 ,$1.26 , N/A ,$0.93 , N/A , N/A , N/A ,$1.91 , N/A ,$1.34 ,$0.63 ,$2.03 , N/A ,$1.91 ,$0.87 ,$0.87 , N/A ,$1.46 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0696,CEFTRIAXONE 250 MG SOLR 1 EACH VIAL per250 mg,636,1 ,$48.50 ,$34.92 ,$0.87 ,$48.50 , N/A ,$31.53 ,$28.95 , N/A ,$13.58 ,$32.11 , N/A ,$32.11 , N/A ,$28.91 ,$28.91 , N/A ,$28.91 , N/A ,$37.35 , N/A , N/A , N/A ,$36.38 ,$34.44 ,$34.44 , N/A ,$34.44 ,$41.23 ,$41.23 ,$41.23 , N/A , N/A ,$41.23 , N/A ,$48.50 ,$27.21 , N/A ,$20.08 , N/A , N/A , N/A ,$41.23 , N/A ,$28.91 ,$13.58 ,$43.65 , N/A ,$41.23 ,$0.87 ,$0.87 , N/A ,$31.53 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0696,CEFTRIAXONE 500 MG SOLR 1 EACH VIAL per250 mg,636,1 ,$56.00 ,$40.32 ,$0.87 ,$56.00 , N/A ,$36.40 ,$33.43 , N/A ,$15.68 ,$37.07 , N/A ,$37.07 , N/A ,$33.38 ,$33.38 , N/A ,$33.38 , N/A ,$43.12 , N/A , N/A , N/A ,$42.00 ,$39.76 ,$39.76 , N/A ,$39.76 ,$47.60 ,$47.60 ,$47.60 , N/A , N/A ,$47.60 , N/A ,$56.00 ,$31.42 , N/A ,$23.18 , N/A , N/A , N/A ,$47.60 , N/A ,$33.38 ,$15.68 ,$50.40 , N/A ,$47.60 ,$0.87 ,$0.87 , N/A ,$36.40 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1410,CONJUGATED ESTROGENS 25 MG SOLR per25 mg,636,1 ,"$1,570.65 ","$1,130.87 ",$117.37 ,"$1,570.65 ",$889.45 ,"$1,020.92 ",$937.68 ,$348.66 ,$439.78 ,"$1,039.77 ",$348.66 ,"$1,039.77 ",$348.66 ,$936.11 ,$936.11 ,$348.66 ,$936.11 ,$718.68 ,"$1,209.40 ",$889.45 ,$348.66 ,$355.64 ,"$1,177.99 ","$1,115.16 ","$1,115.16 ",$348.66 ,"$1,115.16 ","$1,335.05 ","$1,335.05 ","$1,335.05 ", N/A ,$889.45 ,"$1,335.05 ",$348.66 ,"$1,570.65 ",$881.13 ,$348.66 ,$650.25 ,$129.11 ,$117.37 ,$348.66 ,"$1,335.05 ",$747.14 ,$936.11 ,$439.78 ,"$1,413.59 ",$348.66 ,"$1,335.05 ",$586.61 ,$586.61 ,$348.66 ,"$1,020.92 " ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0834,COSYNTROPIN 0.25 MG SOLR 1 EACH VIAL per0.25 mg,636,1 ,$511.60 ,$368.35 ,$40.29 ,$511.60 , N/A ,$332.54 ,$305.43 , N/A ,$143.25 ,$338.68 , N/A ,$338.68 , N/A ,$304.91 ,$304.91 , N/A ,$304.91 , N/A ,$393.93 , N/A , N/A , N/A ,$383.70 ,$363.24 ,$363.24 , N/A ,$363.24 ,$434.86 ,$434.86 ,$434.86 , N/A , N/A ,$434.86 , N/A ,$511.60 ,$287.01 , N/A ,$211.80 ,$59.36 ,$53.96 , N/A ,$434.86 , N/A ,$304.91 ,$143.25 ,$460.44 , N/A ,$434.86 ,$40.29 ,$40.29 , N/A ,$332.54 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3420,CYANOCOBALAMIN 1000 MCG/ML SOLN per1000 mcg,636,1 ,$18.00 ,$12.96 ,$3.38 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$3.38 ,$3.38 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0878,DAPTOMYCIN 500 MG SOLR per1 mg,636,1 ,$0.29 ,$0.21 ,$0.08 ,$0.29 , N/A ,$0.19 ,$0.17 , N/A ,$0.08 ,$0.19 , N/A ,$0.19 , N/A ,$0.17 ,$0.17 , N/A ,$0.17 , N/A ,$0.22 , N/A , N/A , N/A ,$0.22 ,$0.21 ,$0.21 , N/A ,$0.21 ,$0.25 ,$0.25 ,$0.25 , N/A , N/A ,$0.25 , N/A ,$0.29 ,$0.16 , N/A ,$0.12 ,$0.29 ,$0.29 , N/A ,$0.25 , N/A ,$0.17 ,$0.08 ,$0.26 , N/A ,$0.25 ,$0.08 ,$0.08 , N/A ,$0.19 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2597,DESMOPRESSIN 4 MCG/ML SOLN per1 mcg,636,1 ,$97.38 ,$70.11 ,$6.94 ,$97.38 ,$17.70 ,$63.30 ,$58.14 ,$6.94 ,$27.27 ,$64.47 ,$6.94 ,$64.47 ,$6.94 ,$58.04 ,$58.04 ,$6.94 ,$58.04 ,$14.29 ,$74.98 ,$17.69 ,$6.94 ,$7.08 ,$73.04 ,$69.14 ,$69.14 ,$6.94 ,$69.14 ,$82.77 ,$82.77 ,$82.77 , N/A ,$17.69 ,$82.77 ,$6.94 ,$97.38 ,$54.63 ,$6.94 ,$40.32 ,$59.36 ,$53.96 ,$6.94 ,$82.77 ,$14.86 ,$58.04 ,$27.27 ,$87.64 ,$6.94 ,$82.77 ,$12.09 ,$12.09 ,$6.94 ,$63.30 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J8540,DEXAMETHASONE 0.5 MG TABS per0.25 mg,636,1 ,$0.75 ,$0.54 ,$0.18 ,$0.75 , N/A ,$0.49 ,$0.45 , N/A ,$0.21 ,$0.50 , N/A ,$0.50 , N/A ,$0.45 ,$0.45 , N/A ,$0.45 , N/A ,$0.58 , N/A , N/A , N/A ,$0.56 ,$0.53 ,$0.53 , N/A ,$0.53 ,$0.64 ,$0.64 ,$0.64 , N/A , N/A ,$0.64 , N/A ,$0.75 ,$0.42 , N/A ,$0.31 , N/A , N/A , N/A ,$0.64 , N/A ,$0.45 ,$0.21 ,$0.68 , N/A ,$0.64 ,$0.18 ,$0.18 , N/A ,$0.49 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J8540,DEXAMETHASONE 10 MG/ML SOLN per0.25 mg,636,1 ,$0.40 ,$0.29 ,$0.11 ,$0.40 , N/A ,$0.26 ,$0.24 , N/A ,$0.11 ,$0.26 , N/A ,$0.26 , N/A ,$0.24 ,$0.24 , N/A ,$0.24 , N/A ,$0.31 , N/A , N/A , N/A ,$0.30 ,$0.28 ,$0.28 , N/A ,$0.28 ,$0.34 ,$0.34 ,$0.34 , N/A , N/A ,$0.34 , N/A ,$0.40 ,$0.22 , N/A ,$0.17 , N/A , N/A , N/A ,$0.34 , N/A ,$0.24 ,$0.11 ,$0.36 , N/A ,$0.34 ,$0.18 ,$0.18 , N/A ,$0.26 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J8540,DEXAMETHASONE 4 MG TABS per0.25 mg,636,1 ,$0.38 ,$0.27 ,$0.11 ,$0.38 , N/A ,$0.25 ,$0.23 , N/A ,$0.11 ,$0.25 , N/A ,$0.25 , N/A ,$0.23 ,$0.23 , N/A ,$0.23 , N/A ,$0.29 , N/A , N/A , N/A ,$0.29 ,$0.27 ,$0.27 , N/A ,$0.27 ,$0.32 ,$0.32 ,$0.32 , N/A , N/A ,$0.32 , N/A ,$0.38 ,$0.21 , N/A ,$0.16 , N/A , N/A , N/A ,$0.32 , N/A ,$0.23 ,$0.11 ,$0.34 , N/A ,$0.32 ,$0.18 ,$0.18 , N/A ,$0.25 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1100,DEXAMETHASONE 4 MG/ML SOLN per1 mg,636,1 ,$4.50 ,$3.24 ,$0.21 ,$4.50 , N/A ,$2.93 ,$2.69 , N/A ,$1.26 ,$2.98 , N/A ,$2.98 , N/A ,$2.68 ,$2.68 , N/A ,$2.68 , N/A ,$3.47 , N/A , N/A , N/A ,$3.38 ,$3.20 ,$3.20 , N/A ,$3.20 ,$3.83 ,$3.83 ,$3.83 , N/A , N/A ,$3.83 , N/A ,$4.50 ,$2.52 , N/A ,$1.86 , N/A , N/A , N/A ,$3.83 , N/A ,$2.68 ,$1.26 ,$4.05 , N/A ,$3.83 ,$0.21 ,$0.21 , N/A ,$2.93 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1100,DEXAMETHASONE PF 10 MG/ML SOLN per1 mg,636,1 ,$3.29 ,$2.37 ,$0.21 ,$3.29 , N/A ,$2.14 ,$1.96 , N/A ,$0.92 ,$2.18 , N/A ,$2.18 , N/A ,$1.96 ,$1.96 , N/A ,$1.96 , N/A ,$2.53 , N/A , N/A , N/A ,$2.47 ,$2.34 ,$2.34 , N/A ,$2.34 ,$2.80 ,$2.80 ,$2.80 , N/A , N/A ,$2.80 , N/A ,$3.29 ,$1.85 , N/A ,$1.36 , N/A , N/A , N/A ,$2.80 , N/A ,$1.96 ,$0.92 ,$2.96 , N/A ,$2.80 ,$0.21 ,$0.21 , N/A ,$2.14 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,DEXTROSE 5 % AND 0.45 % NACL WITH KCL 20 MEQ 20-5-0.45 MEQ/L-%-% SOLN per2 mEq,636,1 ,$4.50 ,$3.24 ,$0.23 ,$4.50 , N/A ,$2.93 ,$2.69 , N/A ,$1.26 ,$2.98 , N/A ,$2.98 , N/A ,$2.68 ,$2.68 , N/A ,$2.68 , N/A ,$3.47 , N/A , N/A , N/A ,$3.38 ,$3.20 ,$3.20 , N/A ,$3.20 ,$3.83 ,$3.83 ,$3.83 , N/A , N/A ,$3.83 , N/A ,$4.50 ,$2.52 , N/A ,$1.86 , N/A , N/A , N/A ,$3.83 , N/A ,$2.68 ,$1.26 ,$4.05 , N/A ,$3.83 ,$0.23 ,$0.23 , N/A ,$2.93 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,0.45 % NACL WITH KCL 20 MEQ 20-0.45 MEQ/L-% SOLN per2 mEq,636,1 ,$4.50 ,$3.24 ,$0.23 ,$4.50 , N/A ,$2.93 ,$2.69 , N/A ,$1.26 ,$2.98 , N/A ,$2.98 , N/A ,$2.68 ,$2.68 , N/A ,$2.68 , N/A ,$3.47 , N/A , N/A , N/A ,$3.38 ,$3.20 ,$3.20 , N/A ,$3.20 ,$3.83 ,$3.83 ,$3.83 , N/A , N/A ,$3.83 , N/A ,$4.50 ,$2.52 , N/A ,$1.86 , N/A , N/A , N/A ,$3.83 , N/A ,$2.68 ,$1.26 ,$4.05 , N/A ,$3.83 ,$0.23 ,$0.23 , N/A ,$2.93 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,DEXTROSE 5 % AND 0.45 % NACL WITH KCL 40 MEQ 40-5-0.45 MEQ/L-%-% SOLN per2 mEq,636,1 ,$2.40 ,$1.73 ,$0.23 ,$2.40 , N/A ,$1.56 ,$1.43 , N/A ,$0.67 ,$1.59 , N/A ,$1.59 , N/A ,$1.43 ,$1.43 , N/A ,$1.43 , N/A ,$1.85 , N/A , N/A , N/A ,$1.80 ,$1.70 ,$1.70 , N/A ,$1.70 ,$2.04 ,$2.04 ,$2.04 , N/A , N/A ,$2.04 , N/A ,$2.40 ,$1.35 , N/A ,$0.99 , N/A , N/A , N/A ,$2.04 , N/A ,$1.43 ,$0.67 ,$2.16 , N/A ,$2.04 ,$0.23 ,$0.23 , N/A ,$1.56 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,DEXTROSE 5 % AND 0.9 % NACL WITH KCL 20 MEQ 20-5-0.9 MEQ/L-%-% SOLN per2 mEq,636,1 ,$4.80 ,$3.46 ,$0.23 ,$4.80 , N/A ,$3.12 ,$2.87 , N/A ,$1.34 ,$3.18 , N/A ,$3.18 , N/A ,$2.86 ,$2.86 , N/A ,$2.86 , N/A ,$3.70 , N/A , N/A , N/A ,$3.60 ,$3.41 ,$3.41 , N/A ,$3.41 ,$4.08 ,$4.08 ,$4.08 , N/A , N/A ,$4.08 , N/A ,$4.80 ,$2.69 , N/A ,$1.99 , N/A , N/A , N/A ,$4.08 , N/A ,$2.86 ,$1.34 ,$4.32 , N/A ,$4.08 ,$0.23 ,$0.23 , N/A ,$3.12 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,0.9 % NACL WITH KCL 20 MEQ 20-0.9 MEQ/L-% SOLN per2 mEq,636,1 ,$4.80 ,$3.46 ,$0.23 ,$4.80 , N/A ,$3.12 ,$2.87 , N/A ,$1.34 ,$3.18 , N/A ,$3.18 , N/A ,$2.86 ,$2.86 , N/A ,$2.86 , N/A ,$3.70 , N/A , N/A , N/A ,$3.60 ,$3.41 ,$3.41 , N/A ,$3.41 ,$4.08 ,$4.08 ,$4.08 , N/A , N/A ,$4.08 , N/A ,$4.80 ,$2.69 , N/A ,$1.99 , N/A , N/A , N/A ,$4.08 , N/A ,$2.86 ,$1.34 ,$4.32 , N/A ,$4.08 ,$0.23 ,$0.23 , N/A ,$3.12 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7042,DEXTROSE 5 %-SODIUM CHLORIDE 0.9 % 5-0.9 % SOLN per500 mL,636,1 ,$22.50 ,$16.20 ,$1.75 ,$22.50 , N/A ,$14.63 ,$13.43 , N/A ,$6.30 ,$14.90 , N/A ,$14.90 , N/A ,$13.41 ,$13.41 , N/A ,$13.41 , N/A ,$17.33 , N/A , N/A , N/A ,$16.88 ,$15.98 ,$15.98 , N/A ,$15.98 ,$19.13 ,$19.13 ,$19.13 , N/A , N/A ,$19.13 , N/A ,$22.50 ,$12.62 , N/A ,$9.32 , N/A , N/A , N/A ,$19.13 , N/A ,$13.41 ,$6.30 ,$20.25 , N/A ,$19.13 ,$1.75 ,$1.75 , N/A ,$14.63 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7121,"DEXTROSE 5% LACTATED RINGERS 5 % SOLN 1,000 ML FLEX CONT per1000 mL",636,1 ,$45.00 ,$32.40 ,$9.11 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$9.11 ,$9.11 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3360,DIAZEPAM 5 MG/ML SOLN per5 mg,636,1 ,$66.80 ,$48.10 ,$14.11 ,$66.80 , N/A ,$43.42 ,$39.88 , N/A ,$18.70 ,$44.22 , N/A ,$44.22 , N/A ,$39.81 ,$39.81 , N/A ,$39.81 , N/A ,$51.44 , N/A , N/A , N/A ,$50.10 ,$47.43 ,$47.43 , N/A ,$47.43 ,$56.78 ,$56.78 ,$56.78 , N/A , N/A ,$56.78 , N/A ,$66.80 ,$37.47 , N/A ,$27.66 , N/A , N/A , N/A ,$56.78 , N/A ,$39.81 ,$18.70 ,$60.12 , N/A ,$56.78 ,$14.11 ,$14.11 , N/A ,$43.42 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0500,DICYCLOMINE 10 MG/ML SOLN per20 mg,636,1 ,$403.20 ,$290.30 ,$39.91 ,$403.20 , N/A ,$262.08 ,$240.71 , N/A ,$112.90 ,$266.92 , N/A ,$266.92 , N/A ,$240.31 ,$240.31 , N/A ,$240.31 , N/A ,$310.46 , N/A , N/A , N/A ,$302.40 ,$286.27 ,$286.27 , N/A ,$286.27 ,$342.72 ,$342.72 ,$342.72 , N/A , N/A ,$342.72 , N/A ,$403.20 ,$226.20 , N/A ,$166.92 , N/A , N/A , N/A ,$342.72 , N/A ,$240.31 ,$112.90 ,$362.88 , N/A ,$342.72 ,$39.91 ,$39.91 , N/A ,$262.08 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1160,DIGOXIN 0.25 MG/ML SOLN per0.5 mg,636,1 ,$29.95 ,$21.56 ,$8.39 ,$29.95 , N/A ,$19.47 ,$17.88 , N/A ,$8.39 ,$19.83 , N/A ,$19.83 , N/A ,$17.85 ,$17.85 , N/A ,$17.85 , N/A ,$23.06 , N/A , N/A , N/A ,$22.46 ,$21.26 ,$21.26 , N/A ,$21.26 ,$25.46 ,$25.46 ,$25.46 , N/A , N/A ,$25.46 , N/A ,$29.95 ,$16.80 , N/A ,$12.40 , N/A , N/A , N/A ,$25.46 , N/A ,$17.85 ,$8.39 ,$26.96 , N/A ,$25.46 ,$13.40 ,$13.40 , N/A ,$19.47 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1110,DIHYDROERGOTAMINE 1 MG/ML SOLN 1 ML AMPULE per1 mg,636,1 ,$717.60 ,$516.67 ,$94.58 ,$717.60 , N/A ,$466.44 ,$428.41 , N/A ,$200.93 ,$475.05 , N/A ,$475.05 , N/A ,$427.69 ,$427.69 , N/A ,$427.69 , N/A ,$552.55 , N/A , N/A , N/A ,$538.20 ,$509.50 ,$509.50 , N/A ,$509.50 ,$609.96 ,$609.96 ,$609.96 , N/A , N/A ,$609.96 , N/A ,$717.60 ,$402.57 , N/A ,$297.09 , N/A , N/A , N/A ,$609.96 , N/A ,$427.69 ,$200.93 ,$645.84 , N/A ,$609.96 ,$94.58 ,$94.58 , N/A ,$466.44 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1200,DIPHENHYDRAMINE 50 MG/ML SOLN per50 mg,636,1 ,$18.00 ,$12.96 ,$1.91 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.91 ,$1.91 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1265,DOPAMINE 1.6-5 MG/ML-% SOLN per40 mg,636,1 ,$9.10 ,$6.55 ,$1.02 ,$9.10 , N/A ,$5.92 ,$5.43 , N/A ,$2.55 ,$6.02 , N/A ,$6.02 , N/A ,$5.42 ,$5.42 , N/A ,$5.42 , N/A ,$7.01 , N/A , N/A , N/A ,$6.83 ,$6.46 ,$6.46 , N/A ,$6.46 ,$7.74 ,$7.74 ,$7.74 , N/A , N/A ,$7.74 , N/A ,$9.10 ,$5.11 , N/A ,$3.77 , N/A , N/A , N/A ,$7.74 , N/A ,$5.42 ,$2.55 ,$8.19 , N/A ,$7.74 ,$1.02 ,$1.02 , N/A ,$5.92 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1790,DROPERIDOL 2.5 MG/ML SOLN per5 mg,636,1 ,$20.70 ,$14.90 ,$5.80 ,$20.70 , N/A ,$13.46 ,$12.36 , N/A ,$5.80 ,$13.70 , N/A ,$13.70 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$15.94 , N/A , N/A , N/A ,$15.53 ,$14.70 ,$14.70 , N/A ,$14.70 ,$17.60 ,$17.60 ,$17.60 , N/A , N/A ,$17.60 , N/A ,$20.70 ,$11.61 , N/A ,$8.57 , N/A , N/A , N/A ,$17.60 , N/A ,$12.34 ,$5.80 ,$18.63 , N/A ,$17.60 ,$17.04 ,$17.04 , N/A ,$13.46 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 150 MG/ML SOSY per10 mg,636,1 ,$6.94 ,$5.00 ,$1.34 ,$6.94 , N/A ,$4.51 ,$4.14 , N/A ,$1.94 ,$4.59 , N/A ,$4.59 , N/A ,$4.14 ,$4.14 , N/A ,$4.14 , N/A ,$5.34 , N/A , N/A , N/A ,$5.21 ,$4.93 ,$4.93 , N/A ,$4.93 ,$5.90 ,$5.90 ,$5.90 , N/A , N/A ,$5.90 , N/A ,$6.94 ,$3.89 , N/A ,$2.87 , N/A , N/A , N/A ,$5.90 , N/A ,$4.14 ,$1.94 ,$6.25 , N/A ,$5.90 ,$1.34 ,$1.34 , N/A ,$4.51 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 30 MG/0.3ML SOLN per10 mg,636,1 ,$9.57 ,$6.89 ,$1.34 ,$9.57 , N/A ,$6.22 ,$5.71 , N/A ,$2.68 ,$6.34 , N/A ,$6.34 , N/A ,$5.70 ,$5.70 , N/A ,$5.70 , N/A ,$7.37 , N/A , N/A , N/A ,$7.18 ,$6.79 ,$6.79 , N/A ,$6.79 ,$8.13 ,$8.13 ,$8.13 , N/A , N/A ,$8.13 , N/A ,$9.57 ,$5.37 , N/A ,$3.96 , N/A , N/A , N/A ,$8.13 , N/A ,$5.70 ,$2.68 ,$8.61 , N/A ,$8.13 ,$1.34 ,$1.34 , N/A ,$6.22 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 60 MG/0.6ML SOLN per10 mg,636,1 ,$9.55 ,$6.88 ,$1.34 ,$9.55 , N/A ,$6.21 ,$5.70 , N/A ,$2.67 ,$6.32 , N/A ,$6.32 , N/A ,$5.69 ,$5.69 , N/A ,$5.69 , N/A ,$7.35 , N/A , N/A , N/A ,$7.16 ,$6.78 ,$6.78 , N/A ,$6.78 ,$8.12 ,$8.12 ,$8.12 , N/A , N/A ,$8.12 , N/A ,$9.55 ,$5.36 , N/A ,$3.95 , N/A , N/A , N/A ,$8.12 , N/A ,$5.69 ,$2.67 ,$8.60 , N/A ,$8.12 ,$1.34 ,$1.34 , N/A ,$6.21 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 80 MG/0.8ML SOLN per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 100 MG/ML SOSY 1 ML SYRINGE per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 120 MG/0.8ML SOSY per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 30 MG/0.3ML SOSY per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 40 MG/0.4ML SOLN per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 40 MG/0.4ML SOSY per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1650,ENOXAPARIN 60 MG/0.6ML SOSY 0.6 ML SYRINGE per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 , N/A ,$4.68 ,$4.30 , N/A ,$2.02 ,$4.77 , N/A ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A , N/A , N/A ,$5.40 ,$5.11 ,$5.11 , N/A ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A , N/A ,$6.12 , N/A ,$7.20 ,$4.04 , N/A ,$2.98 , N/A , N/A , N/A ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 , N/A ,$6.12 ,$1.34 ,$1.34 , N/A ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3490,EPHEDRINE 50 MG/ML SOLN per50 mg,636,1 ,$55.80 ,$40.18 ,$15.62 ,$55.80 , N/A ,$36.27 ,$33.31 , N/A ,$15.62 ,$36.94 , N/A ,$36.94 , N/A ,$33.26 ,$33.26 , N/A ,$33.26 , N/A ,$42.97 , N/A , N/A , N/A ,$41.85 ,$39.62 ,$39.62 , N/A ,$39.62 ,$47.43 ,$47.43 ,$47.43 , N/A , N/A ,$47.43 , N/A ,$55.80 ,$31.30 , N/A ,$23.10 , N/A , N/A , N/A ,$47.43 , N/A ,$33.26 ,$15.62 ,$50.22 , N/A ,$47.43 , N/A , N/A , N/A ,$36.27 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0171,EPINEPHRINE 1 MG/10ML SOSY per0.1 mg,636,1 ,$4.73 ,$3.41 ,$1.19 ,$4.73 , N/A ,$3.07 ,$2.82 , N/A ,$1.32 ,$3.13 , N/A ,$3.13 , N/A ,$2.82 ,$2.82 , N/A ,$2.82 , N/A ,$3.64 , N/A , N/A , N/A ,$3.55 ,$3.36 ,$3.36 , N/A ,$3.36 ,$4.02 ,$4.02 ,$4.02 , N/A , N/A ,$4.02 , N/A ,$4.73 ,$2.65 , N/A ,$1.96 , N/A , N/A , N/A ,$4.02 , N/A ,$2.82 ,$1.32 ,$4.26 , N/A ,$4.02 ,$1.19 ,$1.19 , N/A ,$3.07 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0171,EPINEPHRINE PF 1 MG/ML SOLN 1 ML AMPULE per0.1 mg,636,1 ,$7.00 ,$5.04 ,$1.19 ,$7.00 , N/A ,$4.55 ,$4.18 , N/A ,$1.96 ,$4.63 , N/A ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A , N/A , N/A ,$5.25 ,$4.97 ,$4.97 , N/A ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A , N/A ,$5.95 , N/A ,$7.00 ,$3.93 , N/A ,$2.90 , N/A , N/A , N/A ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 , N/A ,$5.95 ,$1.19 ,$1.19 , N/A ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1335,ERTAPENEM 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$308.80 ,$222.34 ,$25.36 ,$308.80 , N/A ,$200.72 ,$184.35 , N/A ,$86.46 ,$204.43 , N/A ,$204.43 , N/A ,$184.04 ,$184.04 , N/A ,$184.04 , N/A ,$237.78 , N/A , N/A , N/A ,$231.60 ,$219.25 ,$219.25 , N/A ,$219.25 ,$262.48 ,$262.48 ,$262.48 , N/A , N/A ,$262.48 , N/A ,$308.80 ,$173.24 , N/A ,$127.84 , N/A , N/A , N/A ,$262.48 , N/A ,$184.04 ,$86.46 ,$277.92 , N/A ,$262.48 ,$25.36 ,$25.36 , N/A ,$200.72 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3010,FENTANYL 500 MCG/10ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.52 ,$1.52 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3010,FENTANYL 100 MCG/2ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.52 ,$1.52 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3010,FENTANYL 250 MCG/5ML SOLN 5 ML VIAL per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.52 ,$1.52 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3010,FENTANYL 250 MCG/5ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.52 ,$1.52 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3010,FENTANYL 50 MCG/ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.52 ,$1.52 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1450,FLUCONAZOLE 200-0.9 MG/100ML-% SOLN per200 mg,636,1 ,$91.00 ,$65.52 ,$3.84 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 , N/A , N/A , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$3.84 ,$3.84 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1450,FLUCONAZOLE 400-0.9 MG/200ML-% SOLN per200 mg,636,1 ,$45.50 ,$32.76 ,$3.84 ,$45.50 , N/A ,$29.58 ,$27.16 , N/A ,$12.74 ,$30.12 , N/A ,$30.12 , N/A ,$27.12 ,$27.12 , N/A ,$27.12 , N/A ,$35.04 , N/A , N/A , N/A ,$34.13 ,$32.31 ,$32.31 , N/A ,$32.31 ,$38.68 ,$38.68 ,$38.68 , N/A , N/A ,$38.68 , N/A ,$45.50 ,$25.53 , N/A ,$18.84 , N/A , N/A , N/A ,$38.68 , N/A ,$27.12 ,$12.74 ,$40.95 , N/A ,$38.68 ,$3.84 ,$3.84 , N/A ,$29.58 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1652,FONDAPARINUX 7.5 MG/0.6ML SOLN per0.5 mg,636,1 ,$34.30 ,$24.70 ,$1.65 ,$34.30 , N/A ,$22.30 ,$20.48 , N/A ,$9.60 ,$22.71 , N/A ,$22.71 , N/A ,$20.44 ,$20.44 , N/A ,$20.44 , N/A ,$26.41 , N/A , N/A , N/A ,$25.73 ,$24.35 ,$24.35 , N/A ,$24.35 ,$29.16 ,$29.16 ,$29.16 , N/A , N/A ,$29.16 , N/A ,$34.30 ,$19.24 , N/A ,$14.20 , N/A , N/A , N/A ,$29.16 , N/A ,$20.44 ,$9.60 ,$30.87 , N/A ,$29.16 ,$1.65 ,$1.65 , N/A ,$22.30 ST. JOSEPH'S HOSPITAL - BREESE,63600002,Q2009,FOSPHENYTOIN 100 MG PE/2ML SOLN 2 ML VIAL per50 mg PE,636,1 ,$36.00 ,$25.92 ,$10.08 ,$36.00 , N/A ,$23.40 ,$21.49 , N/A ,$10.08 ,$23.83 , N/A ,$23.83 , N/A ,$21.46 ,$21.46 , N/A ,$21.46 , N/A ,$27.72 , N/A , N/A , N/A ,$27.00 ,$25.56 ,$25.56 , N/A ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A , N/A ,$30.60 , N/A ,$36.00 ,$20.20 , N/A ,$14.90 , N/A , N/A , N/A ,$30.60 , N/A ,$21.46 ,$10.08 ,$32.40 , N/A ,$30.60 ,$13.56 ,$13.56 , N/A ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1940,FUROSEMIDE 10 MG/ML SOLN 10 ML VIAL per20 mg,636,1 ,$3.60 ,$2.59 ,$1.01 ,$3.60 , N/A ,$2.34 ,$2.15 , N/A ,$1.01 ,$2.38 , N/A ,$2.38 , N/A ,$2.15 ,$2.15 , N/A ,$2.15 , N/A ,$2.77 , N/A , N/A , N/A ,$2.70 ,$2.56 ,$2.56 , N/A ,$2.56 ,$3.06 ,$3.06 ,$3.06 , N/A , N/A ,$3.06 , N/A ,$3.60 ,$2.02 , N/A ,$1.49 , N/A , N/A , N/A ,$3.06 , N/A ,$2.15 ,$1.01 ,$3.24 , N/A ,$3.06 ,$1.09 ,$1.09 , N/A ,$2.34 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1940,FUROSEMIDE 10 MG/ML SOLN per20 mg,636,1 ,$18.00 ,$12.96 ,$1.09 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.09 ,$1.09 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1580,GENTAMICIN 2-0.9 MG/ML-% SOLN per80 mg,636,1 ,$91.00 ,$65.52 ,$4.60 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 , N/A , N/A , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$4.60 ,$4.60 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1580,GENTAMICIN 40 MG/ML SOLN 2 ML VIAL per80 mg,636,1 ,$16.31 ,$11.74 ,$4.57 ,$16.31 , N/A ,$10.60 ,$9.74 , N/A ,$4.57 ,$10.80 , N/A ,$10.80 , N/A ,$9.72 ,$9.72 , N/A ,$9.72 , N/A ,$12.56 , N/A , N/A , N/A ,$12.23 ,$11.58 ,$11.58 , N/A ,$11.58 ,$13.86 ,$13.86 ,$13.86 , N/A , N/A ,$13.86 , N/A ,$16.31 ,$9.15 , N/A ,$6.75 , N/A , N/A , N/A ,$13.86 , N/A ,$9.72 ,$4.57 ,$14.68 , N/A ,$13.86 ,$4.60 ,$4.60 , N/A ,$10.60 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1610,GLUCAGON 1 MG SOLR per1 mg,636,1 ,$823.70 ,$593.06 ,$53.96 ,$823.70 ,$475.65 ,$535.41 ,$491.75 ,$186.45 ,$230.64 ,$545.29 ,$186.45 ,$545.29 ,$186.45 ,$490.93 ,$490.93 ,$186.45 ,$490.93 ,$384.32 ,$634.25 ,$475.65 ,$186.45 ,$190.18 ,$617.78 ,$584.83 ,$584.83 ,$186.45 ,$584.83 ,$700.15 ,$700.15 ,$700.15 , N/A ,$475.65 ,$700.15 ,$186.45 ,$823.70 ,$462.10 ,$186.45 ,$341.01 ,$59.36 ,$53.96 ,$186.45 ,$700.15 ,$399.54 ,$490.93 ,$230.64 ,$741.33 ,$186.45 ,$700.15 ,$286.74 ,$286.74 ,$186.45 ,$535.41 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1630,HALOPERIDOL LACTATE 5 MG/ML SOLN per5 mg,636,1 ,$18.00 ,$12.96 ,$1.42 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.42 ,$1.42 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN 2 ML VIAL per1000 Units,636,1 ,$32.99 ,$23.75 ,$0.21 ,$32.99 , N/A ,$21.44 ,$19.70 , N/A ,$9.24 ,$21.84 , N/A ,$21.84 , N/A ,$19.66 ,$19.66 , N/A ,$19.66 , N/A ,$25.40 , N/A , N/A , N/A ,$24.74 ,$23.42 ,$23.42 , N/A ,$23.42 ,$28.04 ,$28.04 ,$28.04 , N/A , N/A ,$28.04 , N/A ,$32.99 ,$18.51 , N/A ,$13.66 , N/A , N/A , N/A ,$28.04 , N/A ,$19.66 ,$9.24 ,$29.69 , N/A ,$28.04 ,$0.21 ,$0.21 , N/A ,$21.44 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN 30 ML VIAL per1000 Units,636,1 ,$1.24 ,$0.89 ,$0.21 ,$1.24 , N/A ,$0.81 ,$0.74 , N/A ,$0.35 ,$0.82 , N/A ,$0.82 , N/A ,$0.74 ,$0.74 , N/A ,$0.74 , N/A ,$0.95 , N/A , N/A , N/A ,$0.93 ,$0.88 ,$0.88 , N/A ,$0.88 ,$1.05 ,$1.05 ,$1.05 , N/A , N/A ,$1.05 , N/A ,$1.24 ,$0.70 , N/A ,$0.51 , N/A , N/A , N/A ,$1.05 , N/A ,$0.74 ,$0.35 ,$1.12 , N/A ,$1.05 ,$0.21 ,$0.21 , N/A ,$0.81 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1644,HEPARIN (PORCINE) 25000-0.45 UT/250ML-% SOLN per1000 Units,636,1 ,$3.64 ,$2.62 ,$0.21 ,$3.64 , N/A ,$2.37 ,$2.17 , N/A ,$1.02 ,$2.41 , N/A ,$2.41 , N/A ,$2.17 ,$2.17 , N/A ,$2.17 , N/A ,$2.80 , N/A , N/A , N/A ,$2.73 ,$2.58 ,$2.58 , N/A ,$2.58 ,$3.09 ,$3.09 ,$3.09 , N/A , N/A ,$3.09 , N/A ,$3.64 ,$2.04 , N/A ,$1.51 , N/A , N/A , N/A ,$3.09 , N/A ,$2.17 ,$1.02 ,$3.28 , N/A ,$3.09 ,$0.21 ,$0.21 , N/A ,$2.37 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1644,HEPARIN (PORCINE) 5000 UNIT/ML SOLN per1000 Units,636,1 ,$4.50 ,$3.24 ,$0.21 ,$4.50 , N/A ,$2.93 ,$2.69 , N/A ,$1.26 ,$2.98 , N/A ,$2.98 , N/A ,$2.68 ,$2.68 , N/A ,$2.68 , N/A ,$3.47 , N/A , N/A , N/A ,$3.38 ,$3.20 ,$3.20 , N/A ,$3.20 ,$3.83 ,$3.83 ,$3.83 , N/A , N/A ,$3.83 , N/A ,$4.50 ,$2.52 , N/A ,$1.86 , N/A , N/A , N/A ,$3.83 , N/A ,$2.68 ,$1.26 ,$4.05 , N/A ,$3.83 ,$0.21 ,$0.21 , N/A ,$2.93 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1642,HEPARIN FLUSH 100 UNIT/ML SOLN per10 Units,636,1 ,$0.15 ,$0.11 ,$0.03 ,$0.15 , N/A ,$0.10 ,$0.09 , N/A ,$0.04 ,$0.10 , N/A ,$0.10 , N/A ,$0.09 ,$0.09 , N/A ,$0.09 , N/A , N/A , N/A , N/A , N/A ,$0.11 ,$0.11 ,$0.11 , N/A ,$0.11 ,$0.13 ,$0.13 ,$0.13 , N/A , N/A ,$0.13 , N/A ,$0.15 ,$0.08 , N/A ,$0.06 , N/A , N/A , N/A ,$0.13 , N/A ,$0.09 ,$0.04 ,$0.14 , N/A ,$0.13 ,$0.03 ,$0.03 , N/A ,$0.10 ST. JOSEPH'S HOSPITAL - BREESE,63600002,90744,HEPATITIS B VACCINE 10 MCG/0.5ML SUSY per1 mL,636,1 ,$125.85 ,$90.61 ,$14.79 ,$125.85 ,$47.20 ,$81.80 ,$75.13 ,$18.50 ,$35.24 ,$83.31 ,$18.50 ,$83.31 ,$18.50 ,$75.01 ,$75.01 ,$18.50 ,$75.01 ,$38.13 ,$96.90 ,$47.19 ,$18.50 ,$18.87 ,$94.39 ,$89.35 ,$89.35 ,$18.50 ,$89.35 ,$106.97 ,$106.97 ,$106.97 , N/A ,$47.19 ,$106.97 ,$18.50 ,$125.85 ,$70.60 ,$18.50 ,$52.10 ,$16.27 ,$14.79 ,$18.50 ,$106.97 ,$39.64 ,$75.01 ,$35.24 ,$113.27 ,$18.50 ,$106.97 ,$49.34 ,$49.34 ,$18.50 ,$81.80 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0360,HYDRALAZINE 20 MG/ML SOLN per20 mg,636,1 ,$34.40 ,$24.77 ,$9.63 ,$34.40 , N/A ,$22.36 ,$20.54 , N/A ,$9.63 ,$22.77 , N/A ,$22.77 , N/A ,$20.50 ,$20.50 , N/A ,$20.50 , N/A ,$26.49 , N/A , N/A , N/A ,$25.80 ,$24.42 ,$24.42 , N/A ,$24.42 ,$29.24 ,$29.24 ,$29.24 , N/A , N/A ,$29.24 , N/A ,$34.40 ,$19.30 , N/A ,$14.24 , N/A , N/A , N/A ,$29.24 , N/A ,$20.50 ,$9.63 ,$30.96 , N/A ,$29.24 ,$11.15 ,$11.15 , N/A ,$22.36 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLR per100 mg,636,1 ,$44.45 ,$32.00 ,$12.45 ,$44.45 , N/A ,$28.89 ,$26.54 , N/A ,$12.45 ,$29.43 , N/A ,$29.43 , N/A ,$26.49 ,$26.49 , N/A ,$26.49 , N/A ,$34.23 , N/A , N/A , N/A ,$33.34 ,$31.56 ,$31.56 , N/A ,$31.56 ,$37.78 ,$37.78 ,$37.78 , N/A , N/A ,$37.78 , N/A ,$44.45 ,$24.94 , N/A ,$18.40 , N/A , N/A , N/A ,$37.78 , N/A ,$26.49 ,$12.45 ,$40.01 , N/A ,$37.78 ,$29.50 ,$29.50 , N/A ,$28.89 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1170,HYDROMORPHONE 1 MG/ML SOLN per4 mg,636,1 ,$19.95 ,$14.36 ,$5.59 ,$19.95 , N/A ,$12.97 ,$11.91 , N/A ,$5.59 ,$13.21 , N/A ,$13.21 , N/A ,$11.89 ,$11.89 , N/A ,$11.89 , N/A ,$15.36 , N/A , N/A , N/A ,$14.96 ,$14.16 ,$14.16 , N/A ,$14.16 ,$16.96 ,$16.96 ,$16.96 , N/A , N/A ,$16.96 , N/A ,$19.95 ,$11.19 , N/A ,$8.26 , N/A , N/A , N/A ,$16.96 , N/A ,$11.89 ,$5.59 ,$17.96 , N/A ,$16.96 ,$6.96 ,$6.96 , N/A ,$12.97 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1170,HYDROMORPHONE HCL PF 50 MG/5ML SOLN per4 mg,636,1 ,$2.59 ,$1.86 ,$0.73 ,$2.59 , N/A ,$1.68 ,$1.55 , N/A ,$0.73 ,$1.71 , N/A ,$1.71 , N/A ,$1.54 ,$1.54 , N/A ,$1.54 , N/A ,$1.99 , N/A , N/A , N/A ,$1.94 ,$1.84 ,$1.84 , N/A ,$1.84 ,$2.20 ,$2.20 ,$2.20 , N/A , N/A ,$2.20 , N/A ,$2.59 ,$1.45 , N/A ,$1.07 , N/A , N/A , N/A ,$2.20 , N/A ,$1.54 ,$0.73 ,$2.33 , N/A ,$2.20 ,$2.59 ,$2.59 , N/A ,$1.68 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3410,HYDROXYZINE 50 MG/ML SOLN per25 mg,636,1 ,$61.50 ,$44.28 ,$17.22 ,$61.50 , N/A ,$39.98 ,$36.72 , N/A ,$17.22 ,$40.71 , N/A ,$40.71 , N/A ,$36.65 ,$36.65 , N/A ,$36.65 , N/A ,$47.36 , N/A , N/A , N/A ,$46.13 ,$43.67 ,$43.67 , N/A ,$43.67 ,$52.28 ,$52.28 ,$52.28 , N/A , N/A ,$52.28 , N/A ,$61.50 ,$34.50 , N/A ,$25.46 , N/A , N/A , N/A ,$52.28 , N/A ,$36.65 ,$17.22 ,$55.35 , N/A ,$52.28 ,$17.62 ,$17.62 , N/A ,$39.98 ST. JOSEPH'S HOSPITAL - BREESE,63600002,90686,INFLUENZA VIRUS VACCINE (QUAD) 0.5 ML SUSY per0.5 mL,636,1 ,$92.45 ,$66.56 ,$13.59 ,$92.45 ,$34.68 ,$60.09 ,$55.19 ,$13.59 ,$25.89 ,$61.20 ,$13.59 ,$61.20 ,$13.59 ,$55.10 ,$55.10 ,$13.59 ,$55.10 ,$28.01 ,$71.19 ,$34.67 ,$13.59 ,$13.86 ,$69.34 ,$65.64 ,$65.64 ,$13.59 ,$65.64 ,$78.58 ,$78.58 ,$78.58 , N/A ,$34.67 ,$78.58 ,$13.59 ,$92.45 ,$51.86 ,$13.59 ,$38.27 ,$16.27 ,$14.79 ,$13.59 ,$78.58 ,$29.12 ,$55.10 ,$25.89 ,$83.21 ,$13.59 ,$78.58 ,$35.51 ,$35.51 ,$13.59 ,$60.09 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1756,IRON SUCROSE 20 MG/ML SOLN per1 mg,636,1 ,$2.77 ,$1.99 ,$0.36 ,$2.77 , N/A ,$1.80 ,$1.65 , N/A ,$0.78 ,$1.83 , N/A ,$1.83 , N/A ,$1.65 ,$1.65 , N/A ,$1.65 , N/A ,$2.13 , N/A , N/A , N/A ,$2.08 ,$1.97 ,$1.97 , N/A ,$1.97 ,$2.35 ,$2.35 ,$2.35 , N/A , N/A ,$2.35 , N/A ,$2.77 ,$1.55 , N/A ,$1.15 ,$2.77 ,$2.77 , N/A ,$2.35 , N/A ,$1.65 ,$0.78 ,$2.49 , N/A ,$2.35 ,$0.36 ,$0.36 , N/A ,$1.80 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1756,IRON SUCROSE 20 MG/ML SOLN 5 ML VIAL per1 mg,636,1 ,$2.77 ,$1.99 ,$0.36 ,$2.77 , N/A ,$1.80 ,$1.65 , N/A ,$0.78 ,$1.83 , N/A ,$1.83 , N/A ,$1.65 ,$1.65 , N/A ,$1.65 , N/A ,$2.13 , N/A , N/A , N/A ,$2.08 ,$1.97 ,$1.97 , N/A ,$1.97 ,$2.35 ,$2.35 ,$2.35 , N/A , N/A ,$2.35 , N/A ,$2.77 ,$1.55 , N/A ,$1.15 ,$2.77 ,$2.77 , N/A ,$2.35 , N/A ,$1.65 ,$0.78 ,$2.49 , N/A ,$2.35 ,$0.36 ,$0.36 , N/A ,$1.80 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1885,KETOROLAC 30 MG/ML SOLN 1 ML VIAL per15 mg,636,1 ,$12.00 ,$8.64 ,$0.97 ,$12.00 , N/A ,$7.80 ,$7.16 , N/A ,$3.36 ,$7.94 , N/A ,$7.94 , N/A ,$7.15 ,$7.15 , N/A ,$7.15 , N/A ,$9.24 , N/A , N/A , N/A ,$9.00 ,$8.52 ,$8.52 , N/A ,$8.52 ,$10.20 ,$10.20 ,$10.20 , N/A , N/A ,$10.20 , N/A ,$12.00 ,$6.73 , N/A ,$4.97 , N/A , N/A , N/A ,$10.20 , N/A ,$7.15 ,$3.36 ,$10.80 , N/A ,$10.20 ,$0.97 ,$0.97 , N/A ,$7.80 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1885,KETOROLAC 30 MG/ML SOLN per15 mg,636,1 ,$18.00 ,$12.96 ,$0.97 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$0.97 ,$0.97 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1885,KETOROLAC 60 MG/2ML SOLN per15 mg,636,1 ,$15.23 ,$10.97 ,$0.97 ,$15.23 , N/A ,$9.90 ,$9.09 , N/A ,$4.26 ,$10.08 , N/A ,$10.08 , N/A ,$9.08 ,$9.08 , N/A ,$9.08 , N/A ,$11.73 , N/A , N/A , N/A ,$11.42 ,$10.81 ,$10.81 , N/A ,$10.81 ,$12.95 ,$12.95 ,$12.95 , N/A , N/A ,$12.95 , N/A ,$15.23 ,$8.54 , N/A ,$6.31 , N/A , N/A , N/A ,$12.95 , N/A ,$9.08 ,$4.26 ,$13.71 , N/A ,$12.95 ,$0.97 ,$0.97 , N/A ,$9.90 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7120,LACTATED RINGERS SOLN per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.13 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$4.13 ,$4.13 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1953,LEVETIRACETAM 500 MG/5ML SOLN 5 ML VIAL per10 mg,636,1 ,$1.20 ,$0.86 ,$0.15 ,$1.20 , N/A ,$0.78 ,$0.72 , N/A ,$0.34 ,$0.79 , N/A ,$0.79 , N/A ,$0.72 ,$0.72 , N/A ,$0.72 , N/A ,$0.92 , N/A , N/A , N/A ,$0.90 ,$0.85 ,$0.85 , N/A ,$0.85 ,$1.02 ,$1.02 ,$1.02 , N/A , N/A ,$1.02 , N/A ,$1.20 ,$0.67 , N/A ,$0.50 , N/A , N/A , N/A ,$1.02 , N/A ,$0.72 ,$0.34 ,$1.08 , N/A ,$1.02 ,$0.15 ,$0.15 , N/A ,$0.78 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1956,LEVOFLOXACIN 250 MG/50ML SOLN per250 mg,636,1 ,$91.00 ,$65.52 ,$1.60 ,$91.00 , N/A ,$59.15 ,$54.33 , N/A ,$25.48 ,$60.24 , N/A ,$60.24 , N/A ,$54.24 ,$54.24 , N/A ,$54.24 , N/A ,$70.07 , N/A , N/A , N/A ,$68.25 ,$64.61 ,$64.61 , N/A ,$64.61 ,$77.35 ,$77.35 ,$77.35 , N/A , N/A ,$77.35 , N/A ,$91.00 ,$51.05 , N/A ,$37.67 , N/A , N/A , N/A ,$77.35 , N/A ,$54.24 ,$25.48 ,$81.90 , N/A ,$77.35 ,$1.60 ,$1.60 , N/A ,$59.15 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1956,LEVOFLOXACIN 500 MG/100ML SOLN per250 mg,636,1 ,$45.50 ,$32.76 ,$1.60 ,$45.50 , N/A ,$29.58 ,$27.16 , N/A ,$12.74 ,$30.12 , N/A ,$30.12 , N/A ,$27.12 ,$27.12 , N/A ,$27.12 , N/A ,$35.04 , N/A , N/A , N/A ,$34.13 ,$32.31 ,$32.31 , N/A ,$32.31 ,$38.68 ,$38.68 ,$38.68 , N/A , N/A ,$38.68 , N/A ,$45.50 ,$25.53 , N/A ,$18.84 , N/A , N/A , N/A ,$38.68 , N/A ,$27.12 ,$12.74 ,$40.95 , N/A ,$38.68 ,$1.60 ,$1.60 , N/A ,$29.58 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1956,LEVOFLOXACIN 750 MG/150ML SOLN per250 mg,636,1 ,$30.33 ,$21.84 ,$1.60 ,$30.33 , N/A ,$19.71 ,$18.11 , N/A ,$8.49 ,$20.08 , N/A ,$20.08 , N/A ,$18.08 ,$18.08 , N/A ,$18.08 , N/A ,$23.35 , N/A , N/A , N/A ,$22.75 ,$21.53 ,$21.53 , N/A ,$21.53 ,$25.78 ,$25.78 ,$25.78 , N/A , N/A ,$25.78 , N/A ,$30.33 ,$17.02 , N/A ,$12.56 , N/A , N/A , N/A ,$25.78 , N/A ,$18.08 ,$8.49 ,$27.30 , N/A ,$25.78 ,$1.60 ,$1.60 , N/A ,$19.71 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2020,LINEZOLID 600 MG/300ML SOLN per200 mg,636,1 ,$146.80 ,$105.70 ,$5.33 ,$146.80 , N/A ,$95.42 ,$87.64 , N/A ,$41.10 ,$97.18 , N/A ,$97.18 , N/A ,$87.49 ,$87.49 , N/A ,$87.49 , N/A ,$113.04 , N/A , N/A , N/A ,$110.10 ,$104.23 ,$104.23 , N/A ,$104.23 ,$124.78 ,$124.78 ,$124.78 , N/A , N/A ,$124.78 , N/A ,$146.80 ,$82.35 , N/A ,$60.78 ,$59.36 ,$53.96 , N/A ,$124.78 , N/A ,$87.49 ,$41.10 ,$132.12 , N/A ,$124.78 ,$5.33 ,$5.33 , N/A ,$95.42 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2060,LORAZEPAM 2 MG/ML SOLN per2 mg,636,1 ,$18.00 ,$12.96 ,$1.50 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.50 ,$1.50 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3475,MAGNESIUM SULFATE 2 GM/50ML SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.09 ,$22.75 , N/A ,$14.79 ,$13.58 , N/A ,$6.37 ,$15.06 , N/A ,$15.06 , N/A ,$13.56 ,$13.56 , N/A ,$13.56 , N/A ,$17.52 , N/A , N/A , N/A ,$17.06 ,$16.15 ,$16.15 , N/A ,$16.15 ,$19.34 ,$19.34 ,$19.34 , N/A , N/A ,$19.34 , N/A ,$22.75 ,$12.76 , N/A ,$9.42 , N/A , N/A , N/A ,$19.34 , N/A ,$13.56 ,$6.37 ,$20.48 , N/A ,$19.34 ,$1.09 ,$1.09 , N/A ,$14.79 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3475,MAGNESIUM SULFATE 20 GM/500ML SOLN per500 mg,636,1 ,$2.28 ,$1.64 ,$0.64 ,$2.28 , N/A ,$1.48 ,$1.36 , N/A ,$0.64 ,$1.51 , N/A ,$1.51 , N/A ,$1.36 ,$1.36 , N/A ,$1.36 , N/A ,$1.76 , N/A , N/A , N/A ,$1.71 ,$1.62 ,$1.62 , N/A ,$1.62 ,$1.94 ,$1.94 ,$1.94 , N/A , N/A ,$1.94 , N/A ,$2.28 ,$1.28 , N/A ,$0.94 , N/A , N/A , N/A ,$1.94 , N/A ,$1.36 ,$0.64 ,$2.05 , N/A ,$1.94 ,$1.09 ,$1.09 , N/A ,$1.48 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3475,MAGNESIUM SULFATE 4 GM/50ML SOLN per500 mg,636,1 ,$11.38 ,$8.19 ,$1.09 ,$11.38 , N/A ,$7.40 ,$6.79 , N/A ,$3.19 ,$7.53 , N/A ,$7.53 , N/A ,$6.78 ,$6.78 , N/A ,$6.78 , N/A ,$8.76 , N/A , N/A , N/A ,$8.54 ,$8.08 ,$8.08 , N/A ,$8.08 ,$9.67 ,$9.67 ,$9.67 , N/A , N/A ,$9.67 , N/A ,$11.38 ,$6.38 , N/A ,$4.71 , N/A , N/A , N/A ,$9.67 , N/A ,$6.78 ,$3.19 ,$10.24 , N/A ,$9.67 ,$1.09 ,$1.09 , N/A ,$7.40 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3475,MAGNESIUM SULFATE 50 % SOLN 2 ML VIAL per500 mg,636,1 ,$4.50 ,$3.24 ,$1.09 ,$4.50 , N/A ,$2.93 ,$2.69 , N/A ,$1.26 ,$2.98 , N/A ,$2.98 , N/A ,$2.68 ,$2.68 , N/A ,$2.68 , N/A ,$3.47 , N/A , N/A , N/A ,$3.38 ,$3.20 ,$3.20 , N/A ,$3.20 ,$3.83 ,$3.83 ,$3.83 , N/A , N/A ,$3.83 , N/A ,$4.50 ,$2.52 , N/A ,$1.86 , N/A , N/A , N/A ,$3.83 , N/A ,$2.68 ,$1.26 ,$4.05 , N/A ,$3.83 ,$1.09 ,$1.09 , N/A ,$2.93 ST. JOSEPH'S HOSPITAL - BREESE,63600002,90707,"MEASLES, MUMPS AND RUBELLA VACCINE SOLR per0.5 mL",636,1 ,$429.60 ,$309.31 ,$14.79 ,$429.60 , N/A ,$279.24 ,$256.47 , N/A ,$120.29 ,$284.40 , N/A ,$284.40 , N/A ,$256.04 ,$256.04 , N/A ,$256.04 , N/A ,$330.79 , N/A , N/A , N/A ,$322.20 ,$305.02 ,$305.02 , N/A ,$305.02 ,$365.16 ,$365.16 ,$365.16 , N/A , N/A ,$365.16 , N/A ,$429.60 ,$241.01 , N/A ,$177.85 ,$16.27 ,$14.79 , N/A ,$365.16 , N/A ,$256.04 ,$120.29 ,$386.64 , N/A ,$365.16 ,$174.67 ,$174.67 , N/A ,$279.24 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2175,MEPERIDINE 100 MG/ML SOLN 1 ML VIAL per100 mg,636,1 ,$13.92 ,$10.02 ,$3.90 ,$13.92 , N/A ,$9.05 ,$8.31 , N/A ,$3.90 ,$9.22 , N/A ,$9.22 , N/A ,$8.30 ,$8.30 , N/A ,$8.30 , N/A ,$10.72 , N/A , N/A , N/A ,$10.44 ,$9.88 ,$9.88 , N/A ,$9.88 ,$11.83 ,$11.83 ,$11.83 , N/A , N/A ,$11.83 , N/A ,$13.92 ,$7.81 , N/A ,$5.76 , N/A , N/A , N/A ,$11.83 , N/A ,$8.30 ,$3.90 ,$12.53 , N/A ,$11.83 ,$13.92 ,$13.92 , N/A ,$9.05 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2175,MEPERIDINE 50 MG/ML SOLN per100 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.82 ,$15.82 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2175,MEPERIDINE 25 MG/ML SOLN per100 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$15.82 ,$15.82 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2185,MEROPENEM 1 G SOLR 1 EACH VIAL per100 mg,636,1 ,$14.40 ,$10.37 ,$1.02 ,$14.40 , N/A ,$9.36 ,$8.60 , N/A ,$4.03 ,$9.53 , N/A ,$9.53 , N/A ,$8.58 ,$8.58 , N/A ,$8.58 , N/A ,$11.09 , N/A , N/A , N/A ,$10.80 ,$10.22 ,$10.22 , N/A ,$10.22 ,$12.24 ,$12.24 ,$12.24 , N/A , N/A ,$12.24 , N/A ,$14.40 ,$8.08 , N/A ,$5.96 , N/A , N/A , N/A ,$12.24 , N/A ,$8.58 ,$4.03 ,$12.96 , N/A ,$12.24 ,$1.02 ,$1.02 , N/A ,$9.36 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J8610,METHOTREXATE 2.5 MG TABS per2.5 mg,636,1 ,$12.50 ,$9.00 ,$0.38 ,$12.50 , N/A ,$8.13 ,$7.46 , N/A ,$3.50 ,$8.28 , N/A ,$8.28 , N/A ,$7.45 ,$7.45 , N/A ,$7.45 , N/A ,$9.63 , N/A , N/A , N/A ,$9.38 ,$8.88 ,$8.88 , N/A ,$8.88 ,$10.63 ,$10.63 ,$10.63 , N/A , N/A ,$10.63 , N/A ,$12.50 ,$7.01 , N/A ,$5.18 , N/A , N/A , N/A ,$10.63 , N/A ,$7.45 ,$3.50 ,$11.25 , N/A ,$10.63 ,$0.38 ,$0.38 , N/A ,$8.13 ST. JOSEPH'S HOSPITAL - BREESE,63600002,C9399,METHYLENE BLUE 50 MG/10ML SOLN per1 mL,636,1 ,$125.01 ,$90.01 ,$35.00 ,$125.01 , N/A ,$81.26 ,$74.63 ,$37.50 ,$35.00 ,$82.76 , N/A ,$82.76 , N/A ,$74.51 ,$74.51 , N/A ,$74.51 ,$56.25 ,$96.26 ,$87.51 , N/A , N/A ,$93.76 ,$88.76 ,$88.76 , N/A ,$88.76 ,$106.26 ,$106.26 ,$106.26 , N/A , N/A ,$106.26 , N/A ,$125.01 ,$70.13 , N/A ,$51.75 , N/A , N/A , N/A ,$106.26 ,$75.01 ,$74.51 ,$35.00 ,$112.51 , N/A ,$106.26 , N/A , N/A , N/A ,$81.26 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2210,METHYLERGONOVINE 0.2 MG/ML SOLN per0.2 mg,636,1 ,$94.85 ,$68.29 ,$26.56 ,$94.85 , N/A ,$61.65 ,$56.63 , N/A ,$26.56 ,$62.79 , N/A ,$62.79 , N/A ,$56.53 ,$56.53 , N/A ,$56.53 , N/A ,$73.03 , N/A , N/A , N/A ,$71.14 ,$67.34 ,$67.34 , N/A ,$67.34 ,$80.62 ,$80.62 ,$80.62 , N/A , N/A ,$80.62 , N/A ,$94.85 ,$53.21 , N/A ,$39.27 , N/A , N/A , N/A ,$80.62 , N/A ,$56.53 ,$26.56 ,$85.37 , N/A ,$80.62 ,$33.31 ,$33.31 , N/A ,$61.65 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7509,METHYLPREDNISOLONE 4 MG TABS per4 mg,636,1 ,$3.30 ,$2.38 ,$0.41 ,$3.30 , N/A ,$2.15 ,$1.97 , N/A ,$0.92 ,$2.18 , N/A ,$2.18 , N/A ,$1.97 ,$1.97 , N/A ,$1.97 , N/A ,$2.54 , N/A , N/A , N/A ,$2.48 ,$2.34 ,$2.34 , N/A ,$2.34 ,$2.81 ,$2.81 ,$2.81 , N/A , N/A ,$2.81 , N/A ,$3.30 ,$1.85 , N/A ,$1.37 , N/A , N/A , N/A ,$2.81 , N/A ,$1.97 ,$0.92 ,$2.97 , N/A ,$2.81 ,$0.41 ,$0.41 , N/A ,$2.15 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1030,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSP per40 mg,636,1 ,$51.00 ,$36.72 ,$13.30 ,$51.00 , N/A ,$33.15 ,$30.45 , N/A ,$14.28 ,$33.76 , N/A ,$33.76 , N/A ,$30.40 ,$30.40 , N/A ,$30.40 , N/A ,$39.27 , N/A , N/A , N/A ,$38.25 ,$36.21 ,$36.21 , N/A ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A , N/A ,$43.35 , N/A ,$51.00 ,$28.61 , N/A ,$21.11 , N/A , N/A , N/A ,$43.35 , N/A ,$30.40 ,$14.28 ,$45.90 , N/A ,$43.35 ,$13.30 ,$13.30 , N/A ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG SOLR 1 EACH VIAL per125 mg,636,1 ,$38.65 ,$27.83 ,$9.82 ,$38.65 , N/A ,$25.12 ,$23.07 , N/A ,$10.82 ,$25.59 , N/A ,$25.59 , N/A ,$23.04 ,$23.04 , N/A ,$23.04 , N/A ,$29.76 , N/A , N/A , N/A ,$28.99 ,$27.44 ,$27.44 , N/A ,$27.44 ,$32.85 ,$32.85 ,$32.85 , N/A , N/A ,$32.85 , N/A ,$38.65 ,$21.68 , N/A ,$16.00 , N/A , N/A , N/A ,$32.85 , N/A ,$23.04 ,$10.82 ,$34.79 , N/A ,$32.85 ,$9.82 ,$9.82 , N/A ,$25.12 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLR per125 mg,636,1 ,$46.80 ,$33.70 ,$9.82 ,$46.80 , N/A ,$30.42 ,$27.94 , N/A ,$13.10 ,$30.98 , N/A ,$30.98 , N/A ,$27.89 ,$27.89 , N/A ,$27.89 , N/A ,$36.04 , N/A , N/A , N/A ,$35.10 ,$33.23 ,$33.23 , N/A ,$33.23 ,$39.78 ,$39.78 ,$39.78 , N/A , N/A ,$39.78 , N/A ,$46.80 ,$26.25 , N/A ,$19.38 , N/A , N/A , N/A ,$39.78 , N/A ,$27.89 ,$13.10 ,$42.12 , N/A ,$39.78 ,$9.82 ,$9.82 , N/A ,$30.42 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2920,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLR per40 mg,636,1 ,$29.05 ,$20.92 ,$6.73 ,$29.05 , N/A ,$18.88 ,$17.34 , N/A ,$8.13 ,$19.23 , N/A ,$19.23 , N/A ,$17.31 ,$17.31 , N/A ,$17.31 , N/A ,$22.37 , N/A , N/A , N/A ,$21.79 ,$20.63 ,$20.63 , N/A ,$20.63 ,$24.69 ,$24.69 ,$24.69 , N/A , N/A ,$24.69 , N/A ,$29.05 ,$16.30 , N/A ,$12.03 , N/A , N/A , N/A ,$24.69 , N/A ,$17.31 ,$8.13 ,$26.15 , N/A ,$24.69 ,$6.73 ,$6.73 , N/A ,$18.88 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG SOLR 1 EACH VIAL per125 mg,636,1 ,$53.14 ,$38.26 ,$9.82 ,$53.14 , N/A ,$34.54 ,$31.72 , N/A ,$14.88 ,$35.18 , N/A ,$35.18 , N/A ,$31.67 ,$31.67 , N/A ,$31.67 , N/A ,$40.92 , N/A , N/A , N/A ,$39.86 ,$37.73 ,$37.73 , N/A ,$37.73 ,$45.17 ,$45.17 ,$45.17 , N/A , N/A ,$45.17 , N/A ,$53.14 ,$29.81 , N/A ,$22.00 , N/A , N/A , N/A ,$45.17 , N/A ,$31.67 ,$14.88 ,$47.83 , N/A ,$45.17 ,$9.82 ,$9.82 , N/A ,$34.54 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2765,METOCLOPRAMIDE 5 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$1.82 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$1.82 ,$1.82 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2250,MIDAZOLAM 2 MG/2ML SOLN per1 mg,636,1 ,$9.00 ,$6.48 ,$0.26 ,$9.00 , N/A ,$5.85 ,$5.37 , N/A ,$2.52 ,$5.96 , N/A ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A , N/A , N/A ,$6.75 ,$6.39 ,$6.39 , N/A ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A , N/A ,$7.65 , N/A ,$9.00 ,$5.05 , N/A ,$3.73 , N/A , N/A , N/A ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 , N/A ,$7.65 ,$0.26 ,$0.26 , N/A ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2250,MIDAZOLAM 50 MG/10ML SOLN 10 ML VIAL per1 mg,636,1 ,$0.66 ,$0.48 ,$0.18 ,$0.66 , N/A ,$0.43 ,$0.39 , N/A ,$0.18 ,$0.44 , N/A ,$0.44 , N/A ,$0.39 ,$0.39 , N/A ,$0.39 , N/A ,$0.51 , N/A , N/A , N/A ,$0.50 ,$0.47 ,$0.47 , N/A ,$0.47 ,$0.56 ,$0.56 ,$0.56 , N/A , N/A ,$0.56 , N/A ,$0.66 ,$0.37 , N/A ,$0.27 , N/A , N/A , N/A ,$0.56 , N/A ,$0.39 ,$0.18 ,$0.59 , N/A ,$0.56 ,$0.26 ,$0.26 , N/A ,$0.43 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2270,MORPHINE 1 MG/ML SOLN per10 mg,636,1 ,$30.33 ,$21.84 ,$4.06 ,$30.33 , N/A ,$19.71 ,$18.11 , N/A ,$8.49 ,$20.08 , N/A ,$20.08 , N/A ,$18.08 ,$18.08 , N/A ,$18.08 , N/A ,$23.35 , N/A , N/A , N/A ,$22.75 ,$21.53 ,$21.53 , N/A ,$21.53 ,$25.78 ,$25.78 ,$25.78 , N/A , N/A ,$25.78 , N/A ,$30.33 ,$17.02 , N/A ,$12.56 , N/A , N/A , N/A ,$25.78 , N/A ,$18.08 ,$8.49 ,$27.30 , N/A ,$25.78 ,$4.06 ,$4.06 , N/A ,$19.71 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2270,MORPHINE 10 MG/ML SOLN 1 ML VIAL per10 mg,636,1 ,$12.24 ,$8.81 ,$3.43 ,$12.24 , N/A ,$7.96 ,$7.31 , N/A ,$3.43 ,$8.10 , N/A ,$8.10 , N/A ,$7.30 ,$7.30 , N/A ,$7.30 , N/A ,$9.42 , N/A , N/A , N/A ,$9.18 ,$8.69 ,$8.69 , N/A ,$8.69 ,$10.40 ,$10.40 ,$10.40 , N/A , N/A ,$10.40 , N/A ,$12.24 ,$6.87 , N/A ,$5.07 , N/A , N/A , N/A ,$10.40 , N/A ,$7.30 ,$3.43 ,$11.02 , N/A ,$10.40 ,$4.06 ,$4.06 , N/A ,$7.96 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2270,MORPHINE 4 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$4.06 ,$4.06 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2270,MORPHINE (PF) 1 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$4.06 ,$4.06 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2270,MORPHINE 2 MG/ML SOLN 1 ML VIAL per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$4.06 ,$4.06 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2270,MORPHINE 2 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$4.06 ,$4.06 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2300,NALBUPHINE SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.59 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$4.59 ,$4.59 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2310,NALOXONE 0.4 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$17.00 ,$17.00 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2310,NALOXONE 0.4 MG/ML SOLN per1 mg,636,1 ,$94.90 ,$68.33 ,$17.00 ,$94.90 , N/A ,$61.69 ,$56.66 , N/A ,$26.57 ,$62.82 , N/A ,$62.82 , N/A ,$56.56 ,$56.56 , N/A ,$56.56 , N/A ,$73.07 , N/A , N/A , N/A ,$71.18 ,$67.38 ,$67.38 , N/A ,$67.38 ,$80.67 ,$80.67 ,$80.67 , N/A , N/A ,$80.67 , N/A ,$94.90 ,$53.24 , N/A ,$39.29 , N/A , N/A , N/A ,$80.67 , N/A ,$56.56 ,$26.57 ,$85.41 , N/A ,$80.67 ,$17.00 ,$17.00 , N/A ,$61.69 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2310,NALOXONE 2 MG/2ML SOSY per1 mg,636,1 ,$31.70 ,$22.82 ,$8.88 ,$31.70 , N/A ,$20.61 ,$18.92 , N/A ,$8.88 ,$20.99 , N/A ,$20.99 , N/A ,$18.89 ,$18.89 , N/A ,$18.89 , N/A ,$24.41 , N/A , N/A , N/A ,$23.78 ,$22.51 ,$22.51 , N/A ,$22.51 ,$26.95 ,$26.95 ,$26.95 , N/A , N/A ,$26.95 , N/A ,$31.70 ,$17.78 , N/A ,$13.12 , N/A , N/A , N/A ,$26.95 , N/A ,$18.89 ,$8.88 ,$28.53 , N/A ,$26.95 ,$17.00 ,$17.00 , N/A ,$20.61 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2710,NEOSTIGMINE 10 MG/10ML SOLN per0.5 mg,636,1 ,$4.33 ,$3.12 ,$1.21 ,$4.33 , N/A ,$2.81 ,$2.59 , N/A ,$1.21 ,$2.87 , N/A ,$2.87 , N/A ,$2.58 ,$2.58 , N/A ,$2.58 , N/A ,$3.33 , N/A , N/A , N/A ,$3.25 ,$3.07 ,$3.07 , N/A ,$3.07 ,$3.68 ,$3.68 ,$3.68 , N/A , N/A ,$3.68 , N/A ,$4.33 ,$2.43 , N/A ,$1.79 , N/A , N/A , N/A ,$3.68 , N/A ,$2.58 ,$1.21 ,$3.90 , N/A ,$3.68 ,$3.15 ,$3.15 , N/A ,$2.81 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2354,OCTREOTIDE 100 MCG/ML SOLN 1 ML VIAL per25 mcg,636,1 ,$11.93 ,$8.59 ,$2.34 ,$11.93 , N/A ,$7.75 ,$7.12 , N/A ,$3.34 ,$7.90 , N/A ,$7.90 , N/A ,$7.11 ,$7.11 , N/A ,$7.11 , N/A ,$9.19 , N/A , N/A , N/A ,$8.95 ,$8.47 ,$8.47 , N/A ,$8.47 ,$10.14 ,$10.14 ,$10.14 , N/A , N/A ,$10.14 , N/A ,$11.93 ,$6.69 , N/A ,$4.94 , N/A , N/A , N/A ,$10.14 , N/A ,$7.11 ,$3.34 ,$10.74 , N/A ,$10.14 ,$2.34 ,$2.34 , N/A ,$7.75 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2354,OCTREOTIDE 100 MCG/ML SOLN per25 mcg,636,1 ,$32.23 ,$23.21 ,$2.34 ,$32.23 , N/A ,$20.95 ,$19.24 , N/A ,$9.02 ,$21.34 , N/A ,$21.34 , N/A ,$19.21 ,$19.21 , N/A ,$19.21 , N/A ,$24.82 , N/A , N/A , N/A ,$24.17 ,$22.88 ,$22.88 , N/A ,$22.88 ,$27.40 ,$27.40 ,$27.40 , N/A , N/A ,$27.40 , N/A ,$32.23 ,$18.08 , N/A ,$13.34 , N/A , N/A , N/A ,$27.40 , N/A ,$19.21 ,$9.02 ,$29.01 , N/A ,$27.40 ,$2.34 ,$2.34 , N/A ,$20.95 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0585,ONABOTULINUMTOXINA 100 UNITS SOLR per1 Units,636,1 ,$29.86 ,$21.50 ,$6.19 ,$29.86 ,$15.80 ,$19.41 ,$17.83 ,$6.19 ,$8.36 ,$19.77 ,$6.19 ,$19.77 ,$6.19 ,$17.80 ,$17.80 ,$6.19 ,$17.80 ,$12.76 ,$22.99 ,$15.80 ,$6.19 ,$6.31 ,$22.40 ,$21.20 ,$21.20 ,$6.19 ,$21.20 ,$25.38 ,$25.38 ,$25.38 , N/A ,$15.80 ,$25.38 ,$6.19 ,$29.86 ,$16.75 ,$6.19 ,$12.36 ,$29.86 ,$29.86 ,$6.19 ,$25.38 ,$13.27 ,$17.80 ,$8.36 ,$26.87 ,$6.19 ,$25.38 ,$10.43 ,$10.43 ,$6.19 ,$19.41 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2405,ONDANSETRON 4 MG/2ML SOLN per1 mg,636,1 ,$4.50 ,$3.24 ,$0.15 ,$4.50 , N/A ,$2.93 ,$2.69 , N/A ,$1.26 ,$2.98 , N/A ,$2.98 , N/A ,$2.68 ,$2.68 , N/A ,$2.68 , N/A ,$3.47 , N/A , N/A , N/A ,$3.38 ,$3.20 ,$3.20 , N/A ,$3.20 ,$3.83 ,$3.83 ,$3.83 , N/A , N/A ,$3.83 , N/A ,$4.50 ,$2.52 , N/A ,$1.86 , N/A , N/A , N/A ,$3.83 , N/A ,$2.68 ,$1.26 ,$4.05 , N/A ,$3.83 ,$0.15 ,$0.15 , N/A ,$2.93 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2360,ORPHENADRINE 30 MG/ML SOLN per60 mg,636,1 ,$37.45 ,$26.96 ,$7.08 ,$37.45 , N/A ,$24.34 ,$22.36 , N/A ,$10.49 ,$24.79 , N/A ,$24.79 , N/A ,$22.32 ,$22.32 , N/A ,$22.32 , N/A ,$28.84 , N/A , N/A , N/A ,$28.09 ,$26.59 ,$26.59 , N/A ,$26.59 ,$31.83 ,$31.83 ,$31.83 , N/A , N/A ,$31.83 , N/A ,$37.45 ,$21.01 , N/A ,$15.50 , N/A , N/A , N/A ,$31.83 , N/A ,$22.32 ,$10.49 ,$33.71 , N/A ,$31.83 ,$7.08 ,$7.08 , N/A ,$24.34 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2590,OXYTOCIN 10 UNIT/ML SOLN per10 Units,636,1 ,$18.00 ,$12.96 ,$3.12 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$3.12 ,$3.12 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,C9113,PANTOPRAZOLE 40 MG SOLR 1 EACH VIAL per1 vial,636,1 ,$340.00 ,$244.80 ,$95.20 ,$340.00 , N/A ,$221.00 ,$202.98 , N/A ,$95.20 ,$225.08 , N/A ,$225.08 , N/A ,$202.64 ,$202.64 , N/A ,$202.64 , N/A ,$261.80 , N/A , N/A , N/A ,$255.00 ,$241.40 ,$241.40 , N/A ,$241.40 ,$289.00 ,$289.00 ,$289.00 , N/A , N/A ,$289.00 , N/A ,$340.00 ,$190.74 , N/A ,$140.76 , N/A , N/A , N/A ,$289.00 , N/A ,$202.64 ,$95.20 ,$306.00 , N/A ,$289.00 , N/A , N/A , N/A ,$221.00 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0561,PENICILLIN G BENZATHINE 1200000 UNIT/2ML SUSY per100000 Units,636,1 ,$83.33 ,$60.00 ,$18.22 ,$83.33 ,$46.48 ,$54.16 ,$49.75 ,$18.22 ,$23.33 ,$55.16 ,$18.22 ,$55.16 ,$18.22 ,$49.66 ,$49.66 ,$18.22 ,$49.66 ,$37.55 ,$64.16 ,$46.48 ,$18.22 ,$18.58 ,$62.50 ,$59.16 ,$59.16 ,$18.22 ,$59.16 ,$70.83 ,$70.83 ,$70.83 , N/A ,$46.48 ,$70.83 ,$18.22 ,$83.33 ,$46.75 ,$18.22 ,$34.50 , N/A , N/A ,$18.22 ,$70.83 ,$39.04 ,$49.66 ,$23.33 ,$75.00 ,$18.22 ,$70.83 ,$29.88 ,$29.88 ,$18.22 ,$54.16 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0561,PENICILLIN G BENZATHINE 600000 UNIT/ML SUSY per100000 Units,636,1 ,$96.23 ,$69.29 ,$18.22 ,$96.23 ,$46.48 ,$62.55 ,$57.45 ,$18.22 ,$26.94 ,$63.70 ,$18.22 ,$63.70 ,$18.22 ,$57.35 ,$57.35 ,$18.22 ,$57.35 ,$37.55 ,$74.10 ,$46.48 ,$18.22 ,$18.58 ,$72.17 ,$68.32 ,$68.32 ,$18.22 ,$68.32 ,$81.80 ,$81.80 ,$81.80 , N/A ,$46.48 ,$81.80 ,$18.22 ,$96.23 ,$53.99 ,$18.22 ,$39.84 , N/A , N/A ,$18.22 ,$81.80 ,$39.04 ,$57.35 ,$26.94 ,$86.61 ,$18.22 ,$81.80 ,$29.88 ,$29.88 ,$18.22 ,$62.55 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2540,PENICILLIN G POTASSIUM 20000000 UNITS SOLR per600000 Units,636,1 ,$18.20 ,$13.10 ,$1.29 ,$18.20 , N/A ,$11.83 ,$10.87 , N/A ,$5.10 ,$12.05 , N/A ,$12.05 , N/A ,$10.85 ,$10.85 , N/A ,$10.85 , N/A ,$14.01 , N/A , N/A , N/A ,$13.65 ,$12.92 ,$12.92 , N/A ,$12.92 ,$15.47 ,$15.47 ,$15.47 , N/A , N/A ,$15.47 , N/A ,$18.20 ,$10.21 , N/A ,$7.53 , N/A , N/A , N/A ,$15.47 , N/A ,$10.85 ,$5.10 ,$16.38 , N/A ,$15.47 ,$1.29 ,$1.29 , N/A ,$11.83 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2540,PENICILLIN G POTASSIUM 5000000 UNITS SOLR 1 EACH VIAL per600000 Units,636,1 ,$10.11 ,$7.28 ,$1.29 ,$10.11 , N/A ,$6.57 ,$6.04 , N/A ,$2.83 ,$6.69 , N/A ,$6.69 , N/A ,$6.03 ,$6.03 , N/A ,$6.03 , N/A ,$7.78 , N/A , N/A , N/A ,$7.58 ,$7.18 ,$7.18 , N/A ,$7.18 ,$8.59 ,$8.59 ,$8.59 , N/A , N/A ,$8.59 , N/A ,$10.11 ,$5.67 , N/A ,$4.19 , N/A , N/A , N/A ,$8.59 , N/A ,$6.03 ,$2.83 ,$9.10 , N/A ,$8.59 ,$1.29 ,$1.29 , N/A ,$6.57 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2560,PHENOBARBITAL 65 MG/ML SOLN 1 ML VIAL per120 mg,636,1 ,$187.94 ,$135.32 ,$38.25 ,$187.94 ,$97.58 ,$122.16 ,$112.20 ,$38.25 ,$52.62 ,$124.42 ,$38.25 ,$124.42 ,$38.25 ,$112.01 ,$112.01 ,$38.25 ,$112.01 ,$78.85 ,$144.71 ,$97.58 ,$38.25 ,$39.01 ,$140.96 ,$133.44 ,$133.44 ,$38.25 ,$133.44 ,$159.75 ,$159.75 ,$159.75 , N/A ,$97.58 ,$159.75 ,$38.25 ,$187.94 ,$105.43 ,$38.25 ,$77.81 , N/A , N/A ,$38.25 ,$159.75 ,$81.97 ,$112.01 ,$52.62 ,$169.15 ,$38.25 ,$159.75 ,$75.67 ,$75.67 ,$38.25 ,$122.16 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2760,PHENTOLAMINE 5 MG SOLR per5 mg,636,1 ,"$2,351.80 ","$1,693.30 ",$443.37 ,"$2,351.80 ","$1,131.05 ","$1,528.67 ","$1,404.02 ",$443.37 ,$658.50 ,"$1,556.89 ",$443.37 ,"$1,556.89 ",$443.37 ,"$1,401.67 ","$1,401.67 ",$443.37 ,"$1,401.67 ",$913.88 ,"$1,810.89 ","$1,131.04 ",$443.37 ,$452.24 ,"$1,763.85 ","$1,669.78 ","$1,669.78 ",$443.37 ,"$1,669.78 ","$1,999.03 ","$1,999.03 ","$1,999.03 ", N/A ,"$1,131.04 ","$1,999.03 ",$443.37 ,"$2,351.80 ","$1,319.36 ",$443.37 ,$973.65 , N/A , N/A ,$443.37 ,"$1,999.03 ",$950.08 ,"$1,401.67 ",$658.50 ,"$2,116.62 ",$443.37 ,"$1,999.03 ",$743.09 ,$743.09 ,$443.37 ,"$1,528.67 " ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2370,PHENYLEPHRINE SOLN per1 mL,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$6.80 ,$6.80 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2370,PHENYLEPHRINE 10 MG/ML SOLN 1 ML VIAL per1 mL,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$6.80 ,$6.80 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1165,PHENYTOIN 50 MG/ML SOLN 5 ML VIAL per50 mg,636,1 ,$3.60 ,$2.59 ,$0.92 ,$3.60 , N/A ,$2.34 ,$2.15 , N/A ,$1.01 ,$2.38 , N/A ,$2.38 , N/A ,$2.15 ,$2.15 , N/A ,$2.15 , N/A ,$2.77 , N/A , N/A , N/A ,$2.70 ,$2.56 ,$2.56 , N/A ,$2.56 ,$3.06 ,$3.06 ,$3.06 , N/A , N/A ,$3.06 , N/A ,$3.60 ,$2.02 , N/A ,$1.49 , N/A , N/A , N/A ,$3.06 , N/A ,$2.15 ,$1.01 ,$3.24 , N/A ,$3.06 ,$0.92 ,$0.92 , N/A ,$2.34 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1165,PHENYTOIN 50 MG/ML SOLN 2 ML VIAL per50 mg,636,1 ,$3.60 ,$2.59 ,$0.92 ,$3.60 , N/A ,$2.34 ,$2.15 , N/A ,$1.01 ,$2.38 , N/A ,$2.38 , N/A ,$2.15 ,$2.15 , N/A ,$2.15 , N/A ,$2.77 , N/A , N/A , N/A ,$2.70 ,$2.56 ,$2.56 , N/A ,$2.56 ,$3.06 ,$3.06 ,$3.06 , N/A , N/A ,$3.06 , N/A ,$3.60 ,$2.02 , N/A ,$1.49 , N/A , N/A , N/A ,$3.06 , N/A ,$2.15 ,$1.01 ,$3.24 , N/A ,$3.06 ,$0.92 ,$0.92 , N/A ,$2.34 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3430,PHYTONADIONE (ADULT) 10 MG/ML SOLN 1 ML AMPULE per1 mg,636,1 ,$23.51 ,$16.93 ,$5.26 ,$23.51 , N/A ,$15.28 ,$14.04 , N/A ,$6.58 ,$15.56 , N/A ,$15.56 , N/A ,$14.01 ,$14.01 , N/A ,$14.01 , N/A ,$18.10 , N/A , N/A , N/A ,$17.63 ,$16.69 ,$16.69 , N/A ,$16.69 ,$19.98 ,$19.98 ,$19.98 , N/A , N/A ,$19.98 , N/A ,$23.51 ,$13.19 , N/A ,$9.73 , N/A , N/A , N/A ,$19.98 , N/A ,$14.01 ,$6.58 ,$21.16 , N/A ,$19.98 ,$5.26 ,$5.26 , N/A ,$15.28 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3430,PHYTONADIONE (PEDS) 1 MG/0.5ML SOLN per1 mg,636,1 ,$22.80 ,$16.42 ,$5.26 ,$22.80 , N/A ,$14.82 ,$13.61 , N/A ,$6.38 ,$15.09 , N/A ,$15.09 , N/A ,$13.59 ,$13.59 , N/A ,$13.59 , N/A ,$17.56 , N/A , N/A , N/A ,$17.10 ,$16.19 ,$16.19 , N/A ,$16.19 ,$19.38 ,$19.38 ,$19.38 , N/A , N/A ,$19.38 , N/A ,$22.80 ,$12.79 , N/A ,$9.44 , N/A , N/A , N/A ,$19.38 , N/A ,$13.59 ,$6.38 ,$20.52 , N/A ,$19.38 ,$5.26 ,$5.26 , N/A ,$14.82 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2543,PIPERACILLIN-TAZOBACTAM 3.375 (3-0.375) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$29.02 ,$20.89 ,$2.51 ,$29.02 , N/A ,$18.86 ,$17.32 , N/A ,$8.13 ,$19.21 , N/A ,$19.21 , N/A ,$17.30 ,$17.30 , N/A ,$17.30 , N/A ,$22.35 , N/A , N/A , N/A ,$21.77 ,$20.60 ,$20.60 , N/A ,$20.60 ,$24.67 ,$24.67 ,$24.67 , N/A , N/A ,$24.67 , N/A ,$29.02 ,$16.28 , N/A ,$12.01 , N/A , N/A , N/A ,$24.67 , N/A ,$17.30 ,$8.13 ,$26.12 , N/A ,$24.67 ,$2.51 ,$2.51 , N/A ,$18.86 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2543,PIPERACILLIN-TAZOBACTAM 4.5 (4-0.5) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$27.55 ,$19.84 ,$2.51 ,$27.55 , N/A ,$17.91 ,$16.45 , N/A ,$7.71 ,$18.24 , N/A ,$18.24 , N/A ,$16.42 ,$16.42 , N/A ,$16.42 , N/A ,$21.21 , N/A , N/A , N/A ,$20.66 ,$19.56 ,$19.56 , N/A ,$19.56 ,$23.42 ,$23.42 ,$23.42 , N/A , N/A ,$23.42 , N/A ,$27.55 ,$15.46 , N/A ,$11.41 , N/A , N/A , N/A ,$23.42 , N/A ,$16.42 ,$7.71 ,$24.80 , N/A ,$23.42 ,$2.51 ,$2.51 , N/A ,$17.91 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML SOLN per2 mEq,636,1 ,$18.20 ,$13.10 ,$0.23 ,$18.20 , N/A ,$11.83 ,$10.87 , N/A ,$5.10 ,$12.05 , N/A ,$12.05 , N/A ,$10.85 ,$10.85 , N/A ,$10.85 , N/A ,$14.01 , N/A , N/A , N/A ,$13.65 ,$12.92 ,$12.92 , N/A ,$12.92 ,$15.47 ,$15.47 ,$15.47 , N/A , N/A ,$15.47 , N/A ,$18.20 ,$10.21 , N/A ,$7.53 , N/A , N/A , N/A ,$15.47 , N/A ,$10.85 ,$5.10 ,$16.38 , N/A ,$15.47 ,$0.23 ,$0.23 , N/A ,$11.83 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7510,PREDNISOLONE 15 MG/5ML SOLN per5 mg,636,1 ,$1.50 ,$1.08 ,$0.38 ,$1.50 , N/A ,$0.98 ,$0.90 , N/A ,$0.42 ,$0.99 , N/A ,$0.99 , N/A ,$0.89 ,$0.89 , N/A ,$0.89 , N/A ,$1.16 , N/A , N/A , N/A ,$1.13 ,$1.07 ,$1.07 , N/A ,$1.07 ,$1.28 ,$1.28 ,$1.28 , N/A , N/A ,$1.28 , N/A ,$1.50 ,$0.84 , N/A ,$0.62 , N/A , N/A , N/A ,$1.28 , N/A ,$0.89 ,$0.42 ,$1.35 , N/A ,$1.28 ,$0.38 ,$0.38 , N/A ,$0.98 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7512,PREDNISONE 10 MG TABS per1 mg,636,1 ,$0.60 ,$0.43 ,$0.03 ,$0.60 , N/A ,$0.39 ,$0.36 , N/A ,$0.17 ,$0.40 , N/A ,$0.40 , N/A ,$0.36 ,$0.36 , N/A ,$0.36 , N/A ,$0.46 , N/A , N/A , N/A ,$0.45 ,$0.43 ,$0.43 , N/A ,$0.43 ,$0.51 ,$0.51 ,$0.51 , N/A , N/A ,$0.51 , N/A ,$0.60 ,$0.34 , N/A ,$0.25 , N/A , N/A , N/A ,$0.51 , N/A ,$0.36 ,$0.17 ,$0.54 , N/A ,$0.51 ,$0.03 ,$0.03 , N/A ,$0.39 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7512,PREDNISONE 20 MG TABS per1 mg,636,1 ,$0.15 ,$0.11 ,$0.03 ,$0.15 , N/A ,$0.10 ,$0.09 , N/A ,$0.04 ,$0.10 , N/A ,$0.10 , N/A ,$0.09 ,$0.09 , N/A ,$0.09 , N/A ,$0.12 , N/A , N/A , N/A ,$0.11 ,$0.11 ,$0.11 , N/A ,$0.11 ,$0.13 ,$0.13 ,$0.13 , N/A , N/A ,$0.13 , N/A ,$0.15 ,$0.08 , N/A ,$0.06 , N/A , N/A , N/A ,$0.13 , N/A ,$0.09 ,$0.04 ,$0.14 , N/A ,$0.13 ,$0.03 ,$0.03 , N/A ,$0.10 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7512,PREDNISONE 5 MG TABS per1 mg,636,1 ,$1.20 ,$0.86 ,$0.03 ,$1.20 , N/A ,$0.78 ,$0.72 , N/A ,$0.34 ,$0.79 , N/A ,$0.79 , N/A ,$0.72 ,$0.72 , N/A ,$0.72 , N/A ,$0.92 , N/A , N/A , N/A ,$0.90 ,$0.85 ,$0.85 , N/A ,$0.85 ,$1.02 ,$1.02 ,$1.02 , N/A , N/A ,$1.02 , N/A ,$1.20 ,$0.67 , N/A ,$0.50 , N/A , N/A , N/A ,$1.02 , N/A ,$0.72 ,$0.34 ,$1.08 , N/A ,$1.02 ,$0.03 ,$0.03 , N/A ,$0.78 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2690,PROCAINAMIDE 500 MG/ML SOLN 2 ML VIAL per1 g,636,1 ,"$1,440.00 ","$1,036.80 ",$157.48 ,"$1,440.00 ", N/A ,$936.00 ,$859.68 , N/A ,$403.20 ,$953.28 , N/A ,$953.28 , N/A ,$858.24 ,$858.24 , N/A ,$858.24 , N/A ,"$1,108.80 ", N/A , N/A , N/A ,"$1,080.00 ","$1,022.40 ","$1,022.40 ", N/A ,"$1,022.40 ","$1,224.00 ","$1,224.00 ","$1,224.00 ", N/A , N/A ,"$1,224.00 ", N/A ,"$1,440.00 ",$807.84 , N/A ,$596.16 , N/A , N/A , N/A ,"$1,224.00 ", N/A ,$858.24 ,$403.20 ,"$1,296.00 ", N/A ,"$1,224.00 ",$157.48 ,$157.48 , N/A ,$936.00 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0780,PROCHLORPERAZINE 10 MG/2ML SOLN per10 mg,636,1 ,$34.80 ,$25.06 ,$4.87 ,$34.80 , N/A ,$22.62 ,$20.78 , N/A ,$9.74 ,$23.04 , N/A ,$23.04 , N/A ,$20.74 ,$20.74 , N/A ,$20.74 , N/A ,$26.80 , N/A , N/A , N/A ,$26.10 ,$24.71 ,$24.71 , N/A ,$24.71 ,$29.58 ,$29.58 ,$29.58 , N/A , N/A ,$29.58 , N/A ,$34.80 ,$19.52 , N/A ,$14.41 , N/A , N/A , N/A ,$29.58 , N/A ,$20.74 ,$9.74 ,$31.32 , N/A ,$29.58 ,$4.87 ,$4.87 , N/A ,$22.62 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2550,PROMETHAZINE 25 MG/ML SOLN 1 ML VIAL per50 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$5.31 ,$5.31 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2704,PROPOFOL 1000 MG/100ML EMUL per10 mg,636,1 ,$22.75 ,$16.38 ,$0.23 ,$22.75 , N/A ,$14.79 ,$13.58 , N/A ,$6.37 ,$15.06 , N/A ,$15.06 , N/A ,$13.56 ,$13.56 , N/A ,$13.56 , N/A ,$17.52 , N/A , N/A , N/A ,$17.06 ,$16.15 ,$16.15 , N/A ,$16.15 ,$19.34 ,$19.34 ,$19.34 , N/A , N/A ,$19.34 , N/A ,$22.75 ,$12.76 , N/A ,$9.42 , N/A , N/A , N/A ,$19.34 , N/A ,$13.56 ,$6.37 ,$20.48 , N/A ,$19.34 ,$0.23 ,$0.23 , N/A ,$14.79 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2704,PROPOFOL 200 MG/20ML EMUL per10 mg,636,1 ,$4.55 ,$3.28 ,$0.23 ,$4.55 , N/A ,$2.96 ,$2.72 , N/A ,$1.27 ,$3.01 , N/A ,$3.01 , N/A ,$2.71 ,$2.71 , N/A ,$2.71 , N/A ,$3.50 , N/A , N/A , N/A ,$3.41 ,$3.23 ,$3.23 , N/A ,$3.23 ,$3.87 ,$3.87 ,$3.87 , N/A , N/A ,$3.87 , N/A ,$4.55 ,$2.55 , N/A ,$1.88 , N/A , N/A , N/A ,$3.87 , N/A ,$2.71 ,$1.27 ,$4.10 , N/A ,$3.87 ,$0.23 ,$0.23 , N/A ,$2.96 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2720,PROTAMINE 10 MG/ML SOLN 25 ML VIAL per10 mg,636,1 ,$7.75 ,$5.58 ,$1.68 ,$7.75 , N/A ,$5.04 ,$4.63 , N/A ,$2.17 ,$5.13 , N/A ,$5.13 , N/A ,$4.62 ,$4.62 , N/A ,$4.62 , N/A ,$5.97 , N/A , N/A , N/A ,$5.81 ,$5.50 ,$5.50 , N/A ,$5.50 ,$6.59 ,$6.59 ,$6.59 , N/A , N/A ,$6.59 , N/A ,$7.75 ,$4.35 , N/A ,$3.21 , N/A , N/A , N/A ,$6.59 , N/A ,$4.62 ,$2.17 ,$6.98 , N/A ,$6.59 ,$1.68 ,$1.68 , N/A ,$5.04 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7168,PROTHROMBIN COMPLEX CONCENTRATE (HUMAN) 1000 UNITS KIT per1 Int'l Units,636,1 ,$13.64 ,$9.82 ,$2.14 ,$13.64 ,$5.45 ,$8.87 ,$8.14 ,$2.14 ,$3.82 ,$9.03 ,$2.14 ,$9.03 ,$2.14 ,$8.13 ,$8.13 ,$2.14 ,$8.13 ,$4.41 ,$10.50 ,$5.46 ,$2.14 ,$2.19 ,$10.23 ,$9.68 ,$9.68 ,$2.14 ,$9.68 ,$11.59 ,$11.59 ,$11.59 , N/A ,$5.46 ,$11.59 ,$2.14 ,$13.64 ,$7.65 ,$2.14 ,$5.65 ,$13.64 ,$13.64 ,$2.14 ,$11.59 ,$4.59 ,$8.13 ,$3.82 ,$12.28 ,$2.14 ,$11.59 ,$3.45 ,$3.45 ,$2.14 ,$8.87 ST. JOSEPH'S HOSPITAL - BREESE,63600002,90376,RABIES IMMUNE GLOBULIN 300 UNIT/2ML SOLN per1 mL,636,1 ,"$1,994.99 ","$1,436.39 ",$154.62 ,"$1,994.99 ",$741.85 ,"$1,296.74 ","$1,191.01 ",$290.81 ,$558.60 ,"$1,320.68 ",$290.81 ,"$1,320.68 ",$290.81 ,"$1,189.01 ","$1,189.01 ",$290.81 ,"$1,189.01 ",$599.42 ,"$1,536.14 ",$741.86 ,$290.81 ,$296.63 ,"$1,496.24 ","$1,416.44 ","$1,416.44 ",$290.81 ,"$1,416.44 ","$1,695.74 ","$1,695.74 ","$1,695.74 ", N/A ,$741.86 ,"$1,695.74 ",$290.81 ,"$1,994.99 ","$1,119.19 ",$290.81 ,$825.93 ,$170.08 ,$154.62 ,$290.81 ,"$1,695.74 ",$623.16 ,"$1,189.01 ",$558.60 ,"$1,795.49 ",$290.81 ,"$1,695.74 ",$529.42 ,$529.42 ,$290.81 ,"$1,296.74 " ST. JOSEPH'S HOSPITAL - BREESE,63600002,90675,RABIES VACCINE SUSR per1 mL,636,1 ,"$1,819.40 ","$1,309.97 ",$62.29 ,"$1,819.40 ",$855.55 ,"$1,182.61 ","$1,086.18 ",$335.38 ,$509.43 ,"$1,204.44 ",$335.38 ,"$1,204.44 ",$335.38 ,"$1,084.36 ","$1,084.36 ",$335.38 ,"$1,084.36 ",$691.29 ,"$1,400.94 ",$855.56 ,$335.38 ,$342.09 ,"$1,364.55 ","$1,291.77 ","$1,291.77 ",$335.38 ,"$1,291.77 ","$1,546.49 ","$1,546.49 ","$1,546.49 ", N/A ,$855.56 ,"$1,546.49 ",$335.38 ,"$1,819.40 ","$1,020.68 ",$335.38 ,$753.23 ,$68.52 ,$62.29 ,$335.38 ,"$1,546.49 ",$718.67 ,"$1,084.36 ",$509.43 ,"$1,637.46 ",$335.38 ,"$1,546.49 ",$586.11 ,$586.11 ,$335.38 ,"$1,182.61 " ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2785,REGADENOSON 0.4 MG/5ML SOLN per0.1 mg,636,1 ,$300.30 ,$216.22 ,$84.08 ,$300.30 , N/A ,$195.20 ,$179.28 , N/A ,$84.08 ,$198.80 , N/A ,$198.80 , N/A ,$178.98 ,$178.98 , N/A ,$178.98 , N/A ,$231.23 , N/A , N/A , N/A ,$225.23 ,$213.21 ,$213.21 , N/A ,$213.21 ,$255.26 ,$255.26 ,$255.26 , N/A , N/A ,$255.26 , N/A ,$300.30 ,$168.47 , N/A ,$124.32 , N/A , N/A , N/A ,$255.26 , N/A ,$178.98 ,$84.08 ,$270.27 , N/A ,$255.26 ,$100.90 ,$100.90 , N/A ,$195.20 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2791,RHO D IMMUNE GLOBULIN 1500 UNIT/2ML SOSY per100 Units,636,1 ,$51.32 ,$36.95 ,$8.22 ,$51.32 , N/A ,$33.36 ,$30.64 , N/A ,$14.37 ,$33.97 , N/A ,$33.97 , N/A ,$30.59 ,$30.59 , N/A ,$30.59 , N/A ,$39.52 , N/A , N/A , N/A ,$38.49 ,$36.44 ,$36.44 , N/A ,$36.44 ,$43.62 ,$43.62 ,$43.62 , N/A , N/A ,$43.62 , N/A ,$51.32 ,$28.79 , N/A ,$21.25 ,$51.32 ,$51.32 , N/A ,$43.62 , N/A ,$30.59 ,$14.37 ,$46.19 , N/A ,$43.62 ,$8.22 ,$8.22 , N/A ,$33.36 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2795,ROPIVACAINE 1 % 10 MG/ML SOLN 10 ML VIAL per1 mg,636,1 ,$0.55 ,$0.40 ,$0.12 ,$0.55 , N/A ,$0.36 ,$0.33 , N/A ,$0.15 ,$0.36 , N/A ,$0.36 , N/A ,$0.33 ,$0.33 , N/A ,$0.33 , N/A ,$0.42 , N/A , N/A , N/A ,$0.41 ,$0.39 ,$0.39 , N/A ,$0.39 ,$0.47 ,$0.47 ,$0.47 , N/A , N/A ,$0.47 , N/A ,$0.55 ,$0.31 , N/A ,$0.23 , N/A , N/A , N/A ,$0.47 , N/A ,$0.33 ,$0.15 ,$0.50 , N/A ,$0.47 ,$0.12 ,$0.12 , N/A ,$0.36 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2795,ROPIVACAINE 5 MG/ML SOLN 20 ML VIAL per1 mg,636,1 ,$0.70 ,$0.50 ,$0.12 ,$0.70 , N/A ,$0.46 ,$0.42 , N/A ,$0.20 ,$0.46 , N/A ,$0.46 , N/A ,$0.42 ,$0.42 , N/A ,$0.42 , N/A ,$0.54 , N/A , N/A , N/A ,$0.53 ,$0.50 ,$0.50 , N/A ,$0.50 ,$0.60 ,$0.60 ,$0.60 , N/A , N/A ,$0.60 , N/A ,$0.70 ,$0.39 , N/A ,$0.29 , N/A , N/A , N/A ,$0.60 , N/A ,$0.42 ,$0.20 ,$0.63 , N/A ,$0.60 ,$0.12 ,$0.12 , N/A ,$0.46 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J2795,ROPIVACAINE 5 MG/ML SOLN per1 mg,636,1 ,$1.01 ,$0.73 ,$0.12 ,$1.01 , N/A ,$0.66 ,$0.60 , N/A ,$0.28 ,$0.67 , N/A ,$0.67 , N/A ,$0.60 ,$0.60 , N/A ,$0.60 , N/A ,$0.78 , N/A , N/A , N/A ,$0.76 ,$0.72 ,$0.72 , N/A ,$0.72 ,$0.86 ,$0.86 ,$0.86 , N/A , N/A ,$0.86 , N/A ,$1.01 ,$0.57 , N/A ,$0.42 , N/A , N/A , N/A ,$0.86 , N/A ,$0.60 ,$0.28 ,$0.91 , N/A ,$0.86 ,$0.12 ,$0.12 , N/A ,$0.66 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7030,SODIUM CHLORIDE 0.9% SOLN per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.36 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$4.36 ,$4.36 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7030,SODIUM CHLORIDE 0.9 % SOLN 10 ML VIAL per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.36 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$4.36 ,$4.36 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J7030,SODIUM CHLORIDE 0.9 % SOLN 20 ML VIAL per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.36 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$4.36 ,$4.36 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J0330,SUCCINYLCHOLINE 20 MG/ML SOLN per20 mg,636,1 ,$9.30 ,$6.70 ,$2.60 ,$9.30 , N/A ,$6.05 ,$5.55 , N/A ,$2.60 ,$6.16 , N/A ,$6.16 , N/A ,$5.54 ,$5.54 , N/A ,$5.54 , N/A ,$7.16 , N/A , N/A , N/A ,$6.98 ,$6.60 ,$6.60 , N/A ,$6.60 ,$7.91 ,$7.91 ,$7.91 , N/A , N/A ,$7.91 , N/A ,$9.30 ,$5.22 , N/A ,$3.85 , N/A , N/A , N/A ,$7.91 , N/A ,$5.54 ,$2.60 ,$8.37 , N/A ,$7.91 ,$3.12 ,$3.12 , N/A ,$6.05 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3030,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SOLN per6 mg,636,1 ,$340.00 ,$244.80 ,$95.20 ,$340.00 , N/A ,$221.00 ,$202.98 , N/A ,$95.20 ,$225.08 , N/A ,$225.08 , N/A ,$202.64 ,$202.64 , N/A ,$202.64 , N/A ,$261.80 , N/A , N/A , N/A ,$255.00 ,$241.40 ,$241.40 , N/A ,$241.40 ,$289.00 ,$289.00 ,$289.00 , N/A , N/A ,$289.00 , N/A ,$340.00 ,$190.74 , N/A ,$140.76 , N/A , N/A , N/A ,$289.00 , N/A ,$202.64 ,$95.20 ,$306.00 , N/A ,$289.00 ,$272.88 ,$272.88 , N/A ,$221.00 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1447,TBO-FILGRASTIM 300 MCG/0.5ML SOSY per1 mcg,636,1 ,$4.00 ,$2.88 ,$0.38 ,$4.00 ,$0.98 ,$2.60 ,$2.39 ,$0.38 ,$1.12 ,$2.65 ,$0.38 ,$2.65 ,$0.38 ,$2.38 ,$2.38 ,$0.38 ,$2.38 ,$0.78 ,$3.08 ,$0.97 ,$0.38 ,$0.38 ,$3.00 ,$2.84 ,$2.84 ,$0.38 ,$2.84 ,$3.40 ,$3.40 ,$3.40 , N/A ,$0.97 ,$3.40 ,$0.38 ,$4.00 ,$2.24 ,$0.38 ,$1.66 ,$4.00 ,$4.00 ,$0.38 ,$3.40 ,$0.81 ,$2.38 ,$1.12 ,$3.60 ,$0.38 ,$3.40 ,$0.68 ,$0.68 ,$0.38 ,$2.60 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J1447,TBO-FILGRASTIM 480 MCG/0.8ML SOSY per1 mcg,636,1 ,$4.77 ,$3.43 ,$0.38 ,$4.77 ,$0.98 ,$3.10 ,$2.85 ,$0.38 ,$1.34 ,$3.16 ,$0.38 ,$3.16 ,$0.38 ,$2.84 ,$2.84 ,$0.38 ,$2.84 ,$0.78 ,$3.67 ,$0.97 ,$0.38 ,$0.38 ,$3.58 ,$3.39 ,$3.39 ,$0.38 ,$3.39 ,$4.05 ,$4.05 ,$4.05 , N/A ,$0.97 ,$4.05 ,$0.38 ,$4.77 ,$2.68 ,$0.38 ,$1.97 ,$4.77 ,$4.77 ,$0.38 ,$4.05 ,$0.81 ,$2.84 ,$1.34 ,$4.29 ,$0.38 ,$4.05 ,$0.68 ,$0.68 ,$0.38 ,$3.10 ST. JOSEPH'S HOSPITAL - BREESE,63600002,90715,TDAP 5-2-15.5 LF-MCG/0.5 SUSP per0.5 mL,636,1 ,$240.55 ,$173.20 ,$14.79 ,$240.55 , N/A ,$156.36 ,$143.61 , N/A ,$67.35 ,$159.24 , N/A ,$159.24 , N/A ,$143.37 ,$143.37 , N/A ,$143.37 , N/A ,$185.22 , N/A , N/A , N/A ,$180.41 ,$170.79 ,$170.79 , N/A ,$170.79 ,$204.47 ,$204.47 ,$204.47 , N/A , N/A ,$204.47 , N/A ,$240.55 ,$134.95 , N/A ,$99.59 ,$16.27 ,$14.79 , N/A ,$204.47 , N/A ,$143.37 ,$67.35 ,$216.50 , N/A ,$204.47 ,$61.88 ,$61.88 , N/A ,$156.36 ST. JOSEPH'S HOSPITAL - BREESE,63600002,90715,TDAP 5-2.5-18.5 LF-MCG/0.5 SUSY per0.5 mL,636,1 ,$213.25 ,$153.54 ,$14.79 ,$213.25 , N/A ,$138.61 ,$127.31 , N/A ,$59.71 ,$141.17 , N/A ,$141.17 , N/A ,$127.10 ,$127.10 , N/A ,$127.10 , N/A ,$164.20 , N/A , N/A , N/A ,$159.94 ,$151.41 ,$151.41 , N/A ,$151.41 ,$181.26 ,$181.26 ,$181.26 , N/A , N/A ,$181.26 , N/A ,$213.25 ,$119.63 , N/A ,$88.29 ,$16.27 ,$14.79 , N/A ,$181.26 , N/A ,$127.10 ,$59.71 ,$191.93 , N/A ,$181.26 ,$61.88 ,$61.88 , N/A ,$138.61 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3101,TENECTEPLASE 50 MG KIT per1 mg,636,1 ,$665.08 ,$478.86 ,$140.82 ,$665.08 ,$359.23 ,$432.30 ,$397.05 ,$140.82 ,$186.22 ,$440.28 ,$140.82 ,$440.28 ,$140.82 ,$396.39 ,$396.39 ,$140.82 ,$396.39 ,$290.26 ,$512.11 ,$359.23 ,$140.82 ,$143.64 ,$498.81 ,$472.21 ,$472.21 ,$140.82 ,$472.21 ,$565.32 ,$565.32 ,$565.32 , N/A ,$359.23 ,$565.32 ,$140.82 ,$665.08 ,$373.11 ,$140.82 ,$275.34 ,$665.08 ,$665.08 ,$140.82 ,$565.32 ,$301.75 ,$396.39 ,$186.22 ,$598.57 ,$140.82 ,$565.32 ,$237.02 ,$237.02 ,$140.82 ,$432.30 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3105,TERBUTALINE 1 MG/ML SOLN per1 mg,636,1 ,$18.00 ,$12.96 ,$2.18 ,$18.00 , N/A ,$11.70 ,$10.75 , N/A ,$5.04 ,$11.92 , N/A ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A , N/A , N/A ,$13.50 ,$12.78 ,$12.78 , N/A ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A , N/A ,$15.30 , N/A ,$18.00 ,$10.10 , N/A ,$7.45 , N/A , N/A , N/A ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 , N/A ,$15.30 ,$2.18 ,$2.18 , N/A ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3411,THIAMINE 100 MG/ML SOLN 2 ML VIAL per100 mg,636,1 ,$23.90 ,$17.21 ,$4.62 ,$23.90 , N/A ,$15.54 ,$14.27 , N/A ,$6.69 ,$15.82 , N/A ,$15.82 , N/A ,$14.24 ,$14.24 , N/A ,$14.24 , N/A ,$18.40 , N/A , N/A , N/A ,$17.93 ,$16.97 ,$16.97 , N/A ,$16.97 ,$20.32 ,$20.32 ,$20.32 , N/A , N/A ,$20.32 , N/A ,$23.90 ,$13.41 , N/A ,$9.89 , N/A , N/A , N/A ,$20.32 , N/A ,$14.24 ,$6.69 ,$21.51 , N/A ,$20.32 ,$4.62 ,$4.62 , N/A ,$15.54 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSP per10 mg,636,1 ,$11.23 ,$8.09 ,$1.75 ,$11.23 , N/A ,$7.30 ,$6.70 , N/A ,$3.14 ,$7.43 , N/A ,$7.43 , N/A ,$6.69 ,$6.69 , N/A ,$6.69 , N/A ,$8.65 , N/A , N/A , N/A ,$8.42 ,$7.97 ,$7.97 , N/A ,$7.97 ,$9.55 ,$9.55 ,$9.55 , N/A , N/A ,$9.55 , N/A ,$11.23 ,$6.30 , N/A ,$4.65 , N/A , N/A , N/A ,$9.55 , N/A ,$6.69 ,$3.14 ,$10.11 , N/A ,$9.55 ,$1.75 ,$1.75 , N/A ,$7.30 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3370,VANCOMYCIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$38.50 ,$27.72 ,$4.72 ,$38.50 , N/A ,$25.03 ,$22.98 , N/A ,$10.78 ,$25.49 , N/A ,$25.49 , N/A ,$22.95 ,$22.95 , N/A ,$22.95 , N/A ,$29.65 , N/A , N/A , N/A ,$28.88 ,$27.34 ,$27.34 , N/A ,$27.34 ,$32.73 ,$32.73 ,$32.73 , N/A , N/A ,$32.73 , N/A ,$38.50 ,$21.60 , N/A ,$15.94 , N/A , N/A , N/A ,$32.73 , N/A ,$22.95 ,$10.78 ,$34.65 , N/A ,$32.73 ,$4.72 ,$4.72 , N/A ,$25.03 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3370,VANCOMYCIN 10 G SOLR 1 EACH VIAL per500 mg,636,1 ,$51.36 ,$36.98 ,$4.72 ,$51.36 , N/A ,$33.38 ,$30.66 , N/A ,$14.38 ,$34.00 , N/A ,$34.00 , N/A ,$30.61 ,$30.61 , N/A ,$30.61 , N/A ,$39.55 , N/A , N/A , N/A ,$38.52 ,$36.47 ,$36.47 , N/A ,$36.47 ,$43.66 ,$43.66 ,$43.66 , N/A , N/A ,$43.66 , N/A ,$51.36 ,$28.81 , N/A ,$21.26 , N/A , N/A , N/A ,$43.66 , N/A ,$30.61 ,$14.38 ,$46.22 , N/A ,$43.66 ,$4.72 ,$4.72 , N/A ,$33.38 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3370,VANCOMYCIN 5 G SOLR 1 EACH VIAL per500 mg,636,1 ,$35.58 ,$25.62 ,$4.72 ,$35.58 , N/A ,$23.13 ,$21.24 , N/A ,$9.96 ,$23.55 , N/A ,$23.55 , N/A ,$21.21 ,$21.21 , N/A ,$21.21 , N/A ,$27.40 , N/A , N/A , N/A ,$26.69 ,$25.26 ,$25.26 , N/A ,$25.26 ,$30.24 ,$30.24 ,$30.24 , N/A , N/A ,$30.24 , N/A ,$35.58 ,$19.96 , N/A ,$14.73 , N/A , N/A , N/A ,$30.24 , N/A ,$21.21 ,$9.96 ,$32.02 , N/A ,$30.24 ,$4.72 ,$4.72 , N/A ,$23.13 ST. JOSEPH'S HOSPITAL - BREESE,63600002,J3370,VANCOMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$38.60 ,$27.79 ,$4.72 ,$38.60 , N/A ,$25.09 ,$23.04 , N/A ,$10.81 ,$25.55 , N/A ,$25.55 , N/A ,$23.01 ,$23.01 , N/A ,$23.01 , N/A ,$29.72 , N/A , N/A , N/A ,$28.95 ,$27.41 ,$27.41 , N/A ,$27.41 ,$32.81 ,$32.81 ,$32.81 , N/A , N/A ,$32.81 , N/A ,$38.60 ,$21.65 , N/A ,$15.98 , N/A , N/A , N/A ,$32.81 , N/A ,$23.01 ,$10.81 ,$34.74 , N/A ,$32.81 ,$4.72 ,$4.72 , N/A ,$25.09 ST. JOSEPH'S HOSPITAL - BREESE,63600002,C9399,VASOPRESSIN 20 UNIT/ML SOLN 1 ML VIAL per1 mL,636,1 ,"$1,019.45 ",$734.00 ,$285.45 ,"$1,019.45 ", N/A ,$662.64 ,$608.61 ,$305.84 ,$285.45 ,$674.88 , N/A ,$674.88 , N/A ,$607.59 ,$607.59 , N/A ,$607.59 ,$458.75 ,$784.98 ,$713.62 , N/A , N/A ,$764.59 ,$723.81 ,$723.81 , N/A ,$723.81 ,$866.53 ,$866.53 ,$866.53 , N/A , N/A ,$866.53 , N/A ,"$1,019.45 ",$571.91 , N/A ,$422.05 , N/A , N/A , N/A ,$866.53 ,$611.67 ,$607.59 ,$285.45 ,$917.51 , N/A ,$866.53 , N/A , N/A , N/A ,$662.64 ST. JOSEPH'S HOSPITAL - BREESE,63600012,Q9963,DIATRIZOATE MEGLUMINE AND SODIUM 66-10 % SOLN per1 mL,636,1 ,$2.17 ,$1.56 ,$0.35 ,$2.17 , N/A ,$1.41 ,$1.30 , N/A ,$0.61 ,$1.44 , N/A ,$1.44 , N/A ,$1.29 ,$1.29 , N/A ,$1.29 , N/A , N/A , N/A , N/A , N/A ,$1.63 ,$1.54 ,$1.54 , N/A ,$1.54 ,$1.84 ,$1.84 ,$1.84 , N/A , N/A ,$1.84 , N/A ,$2.17 ,$1.22 , N/A ,$0.90 , N/A , N/A , N/A ,$1.84 , N/A ,$1.29 ,$0.61 ,$1.95 , N/A ,$1.84 ,$0.35 ,$0.35 , N/A ,$1.41 ST. JOSEPH'S HOSPITAL - BREESE,63600012,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML SOLN per1 mL,636,1 ,$22.13 ,$15.93 ,$3.04 ,$22.13 , N/A ,$14.38 ,$13.21 , N/A ,$6.20 ,$14.65 , N/A ,$14.65 , N/A ,$13.19 ,$13.19 , N/A ,$13.19 , N/A , N/A , N/A , N/A , N/A ,$16.60 ,$15.71 ,$15.71 , N/A ,$15.71 ,$18.81 ,$18.81 ,$18.81 , N/A , N/A ,$18.81 , N/A ,$22.13 ,$12.41 , N/A ,$9.16 , N/A , N/A , N/A ,$18.81 , N/A ,$13.19 ,$6.20 ,$19.92 , N/A ,$18.81 ,$3.04 ,$3.04 , N/A ,$14.38 ST. JOSEPH'S HOSPITAL - BREESE,63600012,A9575,GADOTERATE MEGLUMINE 5 MMOL/10ML SOLN per0.1 mL,636,1 ,$1.23 ,$0.89 ,$0.23 ,$1.23 , N/A ,$0.80 ,$0.73 , N/A ,$0.34 ,$0.81 , N/A ,$0.81 , N/A ,$0.73 ,$0.73 , N/A ,$0.73 , N/A , N/A , N/A , N/A , N/A ,$0.92 ,$0.87 ,$0.87 , N/A ,$0.87 ,$1.05 ,$1.05 ,$1.05 , N/A , N/A ,$1.05 , N/A ,$1.23 ,$0.69 , N/A ,$0.51 , N/A , N/A , N/A ,$1.05 , N/A ,$0.73 ,$0.34 ,$1.11 , N/A ,$1.05 ,$0.23 ,$0.23 , N/A ,$0.80 ST. JOSEPH'S HOSPITAL - BREESE,63600012,A9575,GADOTERATE MEGLUMINE 7.5 MMOL/15ML SOLN per0.1 mL,636,1 ,$1.05 ,$0.76 ,$0.23 ,$1.05 , N/A ,$0.68 ,$0.63 , N/A ,$0.29 ,$0.70 , N/A ,$0.70 , N/A ,$0.63 ,$0.63 , N/A ,$0.63 , N/A , N/A , N/A , N/A , N/A ,$0.79 ,$0.75 ,$0.75 , N/A ,$0.75 ,$0.89 ,$0.89 ,$0.89 , N/A , N/A ,$0.89 , N/A ,$1.05 ,$0.59 , N/A ,$0.43 , N/A , N/A , N/A ,$0.89 , N/A ,$0.63 ,$0.29 ,$0.95 , N/A ,$0.89 ,$0.23 ,$0.23 , N/A ,$0.68 ST. JOSEPH'S HOSPITAL - BREESE,63600012,A9575,GADOTERATE MEGLUMINE 10 MMOL/20ML SOLN per0.1 mL,636,1 ,$1.05 ,$0.76 ,$0.23 ,$1.05 , N/A ,$0.68 ,$0.63 , N/A ,$0.29 ,$0.70 , N/A ,$0.70 , N/A ,$0.63 ,$0.63 , N/A ,$0.63 , N/A , N/A , N/A , N/A , N/A ,$0.79 ,$0.75 ,$0.75 , N/A ,$0.75 ,$0.89 ,$0.89 ,$0.89 , N/A , N/A ,$0.89 , N/A ,$1.05 ,$0.59 , N/A ,$0.43 , N/A , N/A , N/A ,$0.89 , N/A ,$0.63 ,$0.29 ,$0.95 , N/A ,$0.89 ,$0.23 ,$0.23 , N/A ,$0.68 ST. JOSEPH'S HOSPITAL - BREESE,63600012,Q9967,IOPAMIDOL 61 % SOLN per1 mL,636,1 ,$2.75 ,$1.98 ,$0.28 ,$2.75 , N/A ,$1.79 ,$1.64 , N/A ,$0.77 ,$1.82 , N/A ,$1.82 , N/A ,$1.64 ,$1.64 , N/A ,$1.64 , N/A , N/A , N/A , N/A , N/A ,$2.06 ,$1.95 ,$1.95 , N/A ,$1.95 ,$2.34 ,$2.34 ,$2.34 , N/A , N/A ,$2.34 , N/A ,$2.75 ,$1.54 , N/A ,$1.14 , N/A , N/A , N/A ,$2.34 , N/A ,$1.64 ,$0.77 ,$2.48 , N/A ,$2.34 ,$0.28 ,$0.28 , N/A ,$1.79 ST. JOSEPH'S HOSPITAL - BREESE,63600012,Q9967,IOPAMIDOL 76 % SOLN per1 mL,636,1 ,$3.22 ,$2.32 ,$0.28 ,$3.22 , N/A ,$2.09 ,$1.92 , N/A ,$0.90 ,$2.13 , N/A ,$2.13 , N/A ,$1.92 ,$1.92 , N/A ,$1.92 , N/A , N/A , N/A , N/A , N/A ,$2.42 ,$2.29 ,$2.29 , N/A ,$2.29 ,$2.74 ,$2.74 ,$2.74 , N/A , N/A ,$2.74 , N/A ,$3.22 ,$1.81 , N/A ,$1.33 , N/A , N/A , N/A ,$2.74 , N/A ,$1.92 ,$0.90 ,$2.90 , N/A ,$2.74 ,$0.28 ,$0.28 , N/A ,$2.09 ST. JOSEPH'S HOSPITAL - BREESE,63600012,Q9957,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML SUSP per1 mL,636,1 ,$376.06 ,$270.76 ,$75.54 ,$376.06 , N/A ,$244.44 ,$224.51 , N/A ,$105.30 ,$248.95 , N/A ,$248.95 , N/A ,$224.13 ,$224.13 , N/A ,$224.13 , N/A , N/A , N/A , N/A , N/A ,$282.05 ,$267.00 ,$267.00 , N/A ,$267.00 ,$319.65 ,$319.65 ,$319.65 , N/A , N/A ,$319.65 , N/A ,$376.06 ,$210.97 , N/A ,$155.69 , N/A , N/A , N/A ,$319.65 , N/A ,$224.13 ,$105.30 ,$338.45 , N/A ,$319.65 ,$75.54 ,$75.54 , N/A ,$244.44 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ALOGLIPTIN 12.5 MG TABS,637,1 ,$15.60 ,$11.23 ,$4.37 ,$39.00 ,$39.00 ,$10.14 ,$9.31 ,$15.29 ,$4.37 ,$10.33 ,$15.29 ,$10.33 , N/A ,$9.30 ,$9.30 , N/A ,$9.30 , N/A ,$12.01 , N/A ,$15.29 , N/A ,$11.70 ,$11.08 ,$11.08 ,$15.29 ,$11.08 ,$13.26 ,$13.26 ,$13.26 , N/A ,$15.60 ,$13.26 , N/A ,$15.60 ,$8.75 ,$15.29 ,$6.46 , N/A , N/A ,$15.29 ,$13.26 , N/A ,$9.30 ,$4.37 ,$14.04 ,$15.29 ,$13.26 ,$13.18 ,$13.18 ,$15.29 ,$10.14 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMLODIPINE 10 MG TABS,637,1 ,$9.05 ,$6.52 ,$2.53 ,$22.63 ,$22.63 ,$5.88 ,$5.40 ,$8.87 ,$2.53 ,$5.99 ,$8.87 ,$5.99 , N/A ,$5.39 ,$5.39 , N/A ,$5.39 , N/A ,$6.97 , N/A ,$8.87 , N/A ,$6.79 ,$6.43 ,$6.43 ,$8.87 ,$6.43 ,$7.69 ,$7.69 ,$7.69 , N/A ,$9.05 ,$7.69 , N/A ,$9.05 ,$5.08 ,$8.87 ,$3.75 , N/A , N/A ,$8.87 ,$7.69 , N/A ,$5.39 ,$2.53 ,$8.15 ,$8.87 ,$7.69 ,$7.65 ,$7.65 ,$8.87 ,$5.88 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN-CLAVULANATE 200-28.5 MG/5ML SUSR,637,1 ,$7.40 ,$5.33 ,$2.07 ,$18.50 ,$18.50 ,$4.81 ,$4.42 ,$7.25 ,$2.07 ,$4.90 ,$7.25 ,$4.90 , N/A ,$4.41 ,$4.41 , N/A ,$4.41 , N/A ,$5.70 , N/A ,$7.25 , N/A ,$5.55 ,$5.25 ,$5.25 ,$7.25 ,$5.25 ,$6.29 ,$6.29 ,$6.29 , N/A ,$7.40 ,$6.29 , N/A ,$7.40 ,$4.15 ,$7.25 ,$3.06 , N/A , N/A ,$7.25 ,$6.29 , N/A ,$4.41 ,$2.07 ,$6.66 ,$7.25 ,$6.29 ,$6.25 ,$6.25 ,$7.25 ,$4.81 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN-CLAVULANATE 600-42.9 MG/5ML SUSR,637,1 ,$10.10 ,$7.27 ,$2.83 ,$25.25 ,$25.25 ,$6.57 ,$6.03 ,$9.90 ,$2.83 ,$6.69 ,$9.90 ,$6.69 , N/A ,$6.02 ,$6.02 , N/A ,$6.02 , N/A ,$7.78 , N/A ,$9.90 , N/A ,$7.58 ,$7.17 ,$7.17 ,$9.90 ,$7.17 ,$8.59 ,$8.59 ,$8.59 , N/A ,$10.10 ,$8.59 , N/A ,$10.10 ,$5.67 ,$9.90 ,$4.18 , N/A , N/A ,$9.90 ,$8.59 , N/A ,$6.02 ,$2.83 ,$9.09 ,$9.90 ,$8.59 ,$8.53 ,$8.53 ,$9.90 ,$6.57 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,APIXABAN 5 MG TABS,637,1 ,$21.20 ,$15.26 ,$5.94 ,$53.00 ,$53.00 ,$13.78 ,$12.66 ,$20.78 ,$5.94 ,$14.03 ,$20.78 ,$14.03 , N/A ,$12.64 ,$12.64 , N/A ,$12.64 , N/A ,$16.32 , N/A ,$20.78 , N/A ,$15.90 ,$15.05 ,$15.05 ,$20.78 ,$15.05 ,$18.02 ,$18.02 ,$18.02 , N/A ,$21.20 ,$18.02 , N/A ,$21.20 ,$11.89 ,$20.78 ,$8.78 , N/A , N/A ,$20.78 ,$18.02 , N/A ,$12.64 ,$5.94 ,$19.08 ,$20.78 ,$18.02 ,$17.91 ,$17.91 ,$20.78 ,$13.78 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,APIXABAN 2.5 MG TABS,637,1 ,$21.20 ,$15.26 ,$5.94 ,$53.00 ,$53.00 ,$13.78 ,$12.66 ,$20.78 ,$5.94 ,$14.03 ,$20.78 ,$14.03 , N/A ,$12.64 ,$12.64 , N/A ,$12.64 , N/A ,$16.32 , N/A ,$20.78 , N/A ,$15.90 ,$15.05 ,$15.05 ,$20.78 ,$15.05 ,$18.02 ,$18.02 ,$18.02 , N/A ,$21.20 ,$18.02 , N/A ,$21.20 ,$11.89 ,$20.78 ,$8.78 , N/A , N/A ,$20.78 ,$18.02 , N/A ,$12.64 ,$5.94 ,$19.08 ,$20.78 ,$18.02 ,$17.91 ,$17.91 ,$20.78 ,$13.78 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ARIPIPRAZOLE 5 MG TABS,637,1 ,$64.00 ,$46.08 ,$17.92 ,$160.00 ,$160.00 ,$41.60 ,$38.21 ,$62.72 ,$17.92 ,$42.37 ,$62.72 ,$42.37 , N/A ,$38.14 ,$38.14 , N/A ,$38.14 , N/A ,$49.28 , N/A ,$62.72 , N/A ,$48.00 ,$45.44 ,$45.44 ,$62.72 ,$45.44 ,$54.40 ,$54.40 ,$54.40 , N/A ,$64.00 ,$54.40 , N/A ,$64.00 ,$35.90 ,$62.72 ,$26.50 , N/A , N/A ,$62.72 ,$54.40 , N/A ,$38.14 ,$17.92 ,$57.60 ,$62.72 ,$54.40 ,$54.08 ,$54.08 ,$62.72 ,$41.60 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ARTIFICIAL TEARS 83-15 % OINT 3.5 G TUBE,637,1 ,$23.45 ,$16.88 ,$6.57 ,$58.63 ,$58.63 ,$15.24 ,$14.00 ,$22.98 ,$6.57 ,$15.52 ,$22.98 ,$15.52 , N/A ,$13.98 ,$13.98 , N/A ,$13.98 , N/A ,$18.06 , N/A ,$22.98 , N/A ,$17.59 ,$16.65 ,$16.65 ,$22.98 ,$16.65 ,$19.93 ,$19.93 ,$19.93 , N/A ,$23.45 ,$19.93 , N/A ,$23.45 ,$13.16 ,$22.98 ,$9.71 , N/A , N/A ,$22.98 ,$19.93 , N/A ,$13.98 ,$6.57 ,$21.11 ,$22.98 ,$19.93 ,$19.82 ,$19.82 ,$22.98 ,$15.24 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AZITHROMYCIN 250 MG TABS,637,1 ,$15.58 ,$11.22 ,$4.36 ,$38.95 ,$38.95 ,$10.13 ,$9.30 ,$15.27 ,$4.36 ,$10.31 ,$15.27 ,$10.31 , N/A ,$9.29 ,$9.29 , N/A ,$9.29 , N/A ,$12.00 , N/A ,$15.27 , N/A ,$11.69 ,$11.06 ,$11.06 ,$15.27 ,$11.06 ,$13.24 ,$13.24 ,$13.24 , N/A ,$15.58 ,$13.24 , N/A ,$15.58 ,$8.74 ,$15.27 ,$6.45 , N/A , N/A ,$15.27 ,$13.24 , N/A ,$9.29 ,$4.36 ,$14.02 ,$15.27 ,$13.24 ,$13.17 ,$13.17 ,$15.27 ,$10.13 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BICALUTAMIDE 50 MG TABS,637,1 ,$36.75 ,$26.46 ,$10.29 ,$91.88 ,$91.88 ,$23.89 ,$21.94 ,$36.01 ,$10.29 ,$24.33 ,$36.01 ,$24.33 , N/A ,$21.90 ,$21.90 , N/A ,$21.90 , N/A ,$28.30 , N/A ,$36.01 , N/A ,$27.56 ,$26.09 ,$26.09 ,$36.01 ,$26.09 ,$31.24 ,$31.24 ,$31.24 , N/A ,$36.75 ,$31.24 , N/A ,$36.75 ,$20.62 ,$36.01 ,$15.21 , N/A , N/A ,$36.01 ,$31.24 , N/A ,$21.90 ,$10.29 ,$33.08 ,$36.01 ,$31.24 ,$31.05 ,$31.05 ,$36.01 ,$23.89 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BRINZOLAMIDE 1 % SUSP 10 ML BOTTLE,637,1 ,$823.80 ,$593.14 ,$230.66 ,"$2,059.50 ","$2,059.50 ",$535.47 ,$491.81 ,$807.32 ,$230.66 ,$545.36 ,$807.32 ,$545.36 , N/A ,$490.98 ,$490.98 , N/A ,$490.98 , N/A ,$634.33 , N/A ,$807.32 , N/A ,$617.85 ,$584.90 ,$584.90 ,$807.32 ,$584.90 ,$700.23 ,$700.23 ,$700.23 , N/A ,$823.80 ,$700.23 , N/A ,$823.80 ,$462.15 ,$807.32 ,$341.05 , N/A , N/A ,$807.32 ,$700.23 , N/A ,$490.98 ,$230.66 ,$741.42 ,$807.32 ,$700.23 ,$696.11 ,$696.11 ,$807.32 ,$535.47 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CALCITONIN 200 UNIT/ACT SOLN 3.7 ML BOTTLE,637,1 ,$237.10 ,$170.71 ,$66.39 ,$592.75 ,$592.75 ,$154.12 ,$141.55 ,$232.36 ,$66.39 ,$156.96 ,$232.36 ,$156.96 , N/A ,$141.31 ,$141.31 , N/A ,$141.31 , N/A ,$182.57 , N/A ,$232.36 , N/A ,$177.83 ,$168.34 ,$168.34 ,$232.36 ,$168.34 ,$201.54 ,$201.54 ,$201.54 , N/A ,$237.10 ,$201.54 , N/A ,$237.10 ,$133.01 ,$232.36 ,$98.16 , N/A , N/A ,$232.36 ,$201.54 , N/A ,$141.31 ,$66.39 ,$213.39 ,$232.36 ,$201.54 ,$200.35 ,$200.35 ,$232.36 ,$154.12 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARBAMIDE PEROXIDE 6.5 % SOLN 15 ML BOTTLE,637,1 ,$14.60 ,$10.51 ,$4.09 ,$36.50 ,$36.50 ,$9.49 ,$8.72 ,$14.31 ,$4.09 ,$9.67 ,$14.31 ,$9.67 , N/A ,$8.70 ,$8.70 , N/A ,$8.70 , N/A ,$11.24 , N/A ,$14.31 , N/A ,$10.95 ,$10.37 ,$10.37 ,$14.31 ,$10.37 ,$12.41 ,$12.41 ,$12.41 , N/A ,$14.60 ,$12.41 , N/A ,$14.60 ,$8.19 ,$14.31 ,$6.04 , N/A , N/A ,$14.31 ,$12.41 , N/A ,$8.70 ,$4.09 ,$13.14 ,$14.31 ,$12.41 ,$12.34 ,$12.34 ,$14.31 ,$9.49 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CEFDINIR 125 MG/5ML SUSR,637,1 ,$22.75 ,$16.38 ,$6.37 ,$56.88 ,$56.88 ,$14.79 ,$13.58 ,$22.29 ,$6.37 ,$15.06 ,$22.29 ,$15.06 , N/A ,$13.56 ,$13.56 , N/A ,$13.56 , N/A ,$17.52 , N/A ,$22.29 , N/A ,$17.06 ,$16.15 ,$16.15 ,$22.29 ,$16.15 ,$19.34 ,$19.34 ,$19.34 , N/A ,$22.75 ,$19.34 , N/A ,$22.75 ,$12.76 ,$22.29 ,$9.42 , N/A , N/A ,$22.29 ,$19.34 , N/A ,$13.56 ,$6.37 ,$20.48 ,$22.29 ,$19.34 ,$19.22 ,$19.22 ,$22.29 ,$14.79 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CEFDINIR 300 MG CAPS,637,1 ,$10.25 ,$7.38 ,$2.87 ,$25.63 ,$25.63 ,$6.66 ,$6.12 ,$10.04 ,$2.87 ,$6.79 ,$10.04 ,$6.79 , N/A ,$6.11 ,$6.11 , N/A ,$6.11 , N/A ,$7.89 , N/A ,$10.04 , N/A ,$7.69 ,$7.28 ,$7.28 ,$10.04 ,$7.28 ,$8.71 ,$8.71 ,$8.71 , N/A ,$10.25 ,$8.71 , N/A ,$10.25 ,$5.75 ,$10.04 ,$4.24 , N/A , N/A ,$10.04 ,$8.71 , N/A ,$6.11 ,$2.87 ,$9.23 ,$10.04 ,$8.71 ,$8.66 ,$8.66 ,$10.04 ,$6.66 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CHOLESTYRAMINE LIGHT 4 G PACK,637,1 ,$6.75 ,$4.86 ,$1.89 ,$16.88 ,$16.88 ,$4.39 ,$4.03 ,$6.61 ,$1.89 ,$4.47 ,$6.61 ,$4.47 , N/A ,$4.02 ,$4.02 , N/A ,$4.02 , N/A ,$5.20 , N/A ,$6.61 , N/A ,$5.06 ,$4.79 ,$4.79 ,$6.61 ,$4.79 ,$5.74 ,$5.74 ,$5.74 , N/A ,$6.75 ,$5.74 , N/A ,$6.75 ,$3.79 ,$6.61 ,$2.79 , N/A , N/A ,$6.61 ,$5.74 , N/A ,$4.02 ,$1.89 ,$6.08 ,$6.61 ,$5.74 ,$5.70 ,$5.70 ,$6.61 ,$4.39 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CHOLESTYRAMINE 4 G PACK,637,1 ,$6.75 ,$4.86 ,$1.89 ,$16.88 ,$16.88 ,$4.39 ,$4.03 ,$6.61 ,$1.89 ,$4.47 ,$6.61 ,$4.47 , N/A ,$4.02 ,$4.02 , N/A ,$4.02 , N/A ,$5.20 , N/A ,$6.61 , N/A ,$5.06 ,$4.79 ,$4.79 ,$6.61 ,$4.79 ,$5.74 ,$5.74 ,$5.74 , N/A ,$6.75 ,$5.74 , N/A ,$6.75 ,$3.79 ,$6.61 ,$2.79 , N/A , N/A ,$6.61 ,$5.74 , N/A ,$4.02 ,$1.89 ,$6.08 ,$6.61 ,$5.74 ,$5.70 ,$5.70 ,$6.61 ,$4.39 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CITRIC ACID-SODIUM CITRATE 500-334 MG/5ML SOLN,637,1 ,$10.20 ,$7.34 ,$2.86 ,$25.50 ,$25.50 ,$6.63 ,$6.09 ,$10.00 ,$2.86 ,$6.75 ,$10.00 ,$6.75 , N/A ,$6.08 ,$6.08 , N/A ,$6.08 , N/A ,$7.85 , N/A ,$10.00 , N/A ,$7.65 ,$7.24 ,$7.24 ,$10.00 ,$7.24 ,$8.67 ,$8.67 ,$8.67 , N/A ,$10.20 ,$8.67 , N/A ,$10.20 ,$5.72 ,$10.00 ,$4.22 , N/A , N/A ,$10.00 ,$8.67 , N/A ,$6.08 ,$2.86 ,$9.18 ,$10.00 ,$8.67 ,$8.62 ,$8.62 ,$10.00 ,$6.63 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLARITHROMYCIN 500 MG TABS,637,1 ,$12.30 ,$8.86 ,$3.44 ,$30.75 ,$30.75 ,$8.00 ,$7.34 ,$12.05 ,$3.44 ,$8.14 ,$12.05 ,$8.14 , N/A ,$7.33 ,$7.33 , N/A ,$7.33 , N/A ,$9.47 , N/A ,$12.05 , N/A ,$9.23 ,$8.73 ,$8.73 ,$12.05 ,$8.73 ,$10.46 ,$10.46 ,$10.46 , N/A ,$12.30 ,$10.46 , N/A ,$12.30 ,$6.90 ,$12.05 ,$5.09 , N/A , N/A ,$12.05 ,$10.46 , N/A ,$7.33 ,$3.44 ,$11.07 ,$12.05 ,$10.46 ,$10.39 ,$10.39 ,$12.05 ,$8.00 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLOBETASOL 0.05 % CREA 30 G TUBE,637,1 ,$272.55 ,$196.24 ,$76.31 ,$681.38 ,$681.38 ,$177.16 ,$162.71 ,$267.10 ,$76.31 ,$180.43 ,$267.10 ,$180.43 , N/A ,$162.44 ,$162.44 , N/A ,$162.44 , N/A ,$209.86 , N/A ,$267.10 , N/A ,$204.41 ,$193.51 ,$193.51 ,$267.10 ,$193.51 ,$231.67 ,$231.67 ,$231.67 , N/A ,$272.55 ,$231.67 , N/A ,$272.55 ,$152.90 ,$267.10 ,$112.84 , N/A , N/A ,$267.10 ,$231.67 , N/A ,$162.44 ,$76.31 ,$245.30 ,$267.10 ,$231.67 ,$230.30 ,$230.30 ,$267.10 ,$177.16 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLOBETASOL 0.05 % OINT 15 G TUBE,637,1 ,$310.90 ,$223.85 ,$87.05 ,$777.25 ,$777.25 ,$202.09 ,$185.61 ,$304.68 ,$87.05 ,$205.82 ,$304.68 ,$205.82 , N/A ,$185.30 ,$185.30 , N/A ,$185.30 , N/A ,$239.39 , N/A ,$304.68 , N/A ,$233.18 ,$220.74 ,$220.74 ,$304.68 ,$220.74 ,$264.27 ,$264.27 ,$264.27 , N/A ,$310.90 ,$264.27 , N/A ,$310.90 ,$174.41 ,$304.68 ,$128.71 , N/A , N/A ,$304.68 ,$264.27 , N/A ,$185.30 ,$87.05 ,$279.81 ,$304.68 ,$264.27 ,$262.71 ,$262.71 ,$304.68 ,$202.09 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLOPIDOGREL 75 MG TABS,637,1 ,$13.65 ,$9.83 ,$3.82 ,$34.13 ,$34.13 ,$8.87 ,$8.15 ,$13.38 ,$3.82 ,$9.04 ,$13.38 ,$9.04 , N/A ,$8.14 ,$8.14 , N/A ,$8.14 , N/A ,$10.51 , N/A ,$13.38 , N/A ,$10.24 ,$9.69 ,$9.69 ,$13.38 ,$9.69 ,$11.60 ,$11.60 ,$11.60 , N/A ,$13.65 ,$11.60 , N/A ,$13.65 ,$7.66 ,$13.38 ,$5.65 , N/A , N/A ,$13.38 ,$11.60 , N/A ,$8.14 ,$3.82 ,$12.29 ,$13.38 ,$11.60 ,$11.53 ,$11.53 ,$13.38 ,$8.87 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % CREA 15 G TUBE,637,1 ,$112.45 ,$80.96 ,$31.49 ,$281.13 ,$281.13 ,$73.09 ,$67.13 ,$110.20 ,$31.49 ,$74.44 ,$110.20 ,$74.44 , N/A ,$67.02 ,$67.02 , N/A ,$67.02 , N/A ,$86.59 , N/A ,$110.20 , N/A ,$84.34 ,$79.84 ,$79.84 ,$110.20 ,$79.84 ,$95.58 ,$95.58 ,$95.58 , N/A ,$112.45 ,$95.58 , N/A ,$112.45 ,$63.08 ,$110.20 ,$46.55 , N/A , N/A ,$110.20 ,$95.58 , N/A ,$67.02 ,$31.49 ,$101.21 ,$110.20 ,$95.58 ,$95.02 ,$95.02 ,$110.20 ,$73.09 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,COLCHICINE 0.6 MG TABS,637,1 ,$22.30 ,$16.06 ,$6.24 ,$55.75 ,$55.75 ,$14.50 ,$13.31 ,$21.85 ,$6.24 ,$14.76 ,$21.85 ,$14.76 , N/A ,$13.29 ,$13.29 , N/A ,$13.29 , N/A ,$17.17 , N/A ,$21.85 , N/A ,$16.73 ,$15.83 ,$15.83 ,$21.85 ,$15.83 ,$18.96 ,$18.96 ,$18.96 , N/A ,$22.30 ,$18.96 , N/A ,$22.30 ,$12.51 ,$21.85 ,$9.23 , N/A , N/A ,$21.85 ,$18.96 , N/A ,$13.29 ,$6.24 ,$20.07 ,$21.85 ,$18.96 ,$18.84 ,$18.84 ,$21.85 ,$14.50 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DABIGATRAN 75 MG CAPS,637,1 ,$19.85 ,$14.29 ,$5.56 ,$49.63 ,$49.63 ,$12.90 ,$11.85 ,$19.45 ,$5.56 ,$13.14 ,$19.45 ,$13.14 , N/A ,$11.83 ,$11.83 , N/A ,$11.83 , N/A ,$15.28 , N/A ,$19.45 , N/A ,$14.89 ,$14.09 ,$14.09 ,$19.45 ,$14.09 ,$16.87 ,$16.87 ,$16.87 , N/A ,$19.85 ,$16.87 , N/A ,$19.85 ,$11.14 ,$19.45 ,$8.22 , N/A , N/A ,$19.45 ,$16.87 , N/A ,$11.83 ,$5.56 ,$17.87 ,$19.45 ,$16.87 ,$16.77 ,$16.77 ,$19.45 ,$12.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DEXTROSE 40 % GEL 37.5 G TUBE,637,1 ,$7.90 ,$5.69 ,$2.21 ,$19.75 ,$19.75 ,$5.14 ,$4.72 ,$7.74 ,$2.21 ,$5.23 ,$7.74 ,$5.23 , N/A ,$4.71 ,$4.71 , N/A ,$4.71 , N/A ,$6.08 , N/A ,$7.74 , N/A ,$5.93 ,$5.61 ,$5.61 ,$7.74 ,$5.61 ,$6.72 ,$6.72 ,$6.72 , N/A ,$7.90 ,$6.72 , N/A ,$7.90 ,$4.43 ,$7.74 ,$3.27 , N/A , N/A ,$7.74 ,$6.72 , N/A ,$4.71 ,$2.21 ,$7.11 ,$7.74 ,$6.72 ,$6.68 ,$6.68 ,$7.74 ,$5.14 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIPHENHYDRAMINE 12.5 MG/5ML ELIX,637,1 ,$7.20 ,$5.18 ,$2.02 ,$18.00 ,$18.00 ,$4.68 ,$4.30 ,$7.06 ,$2.02 ,$4.77 ,$7.06 ,$4.77 , N/A ,$4.29 ,$4.29 , N/A ,$4.29 , N/A ,$5.54 , N/A ,$7.06 , N/A ,$5.40 ,$5.11 ,$5.11 ,$7.06 ,$5.11 ,$6.12 ,$6.12 ,$6.12 , N/A ,$7.20 ,$6.12 , N/A ,$7.20 ,$4.04 ,$7.06 ,$2.98 , N/A , N/A ,$7.06 ,$6.12 , N/A ,$4.29 ,$2.02 ,$6.48 ,$7.06 ,$6.12 ,$6.08 ,$6.08 ,$7.06 ,$4.68 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DORZOLAMIDE 2 % SOLN 10 ML BOTTLE,637,1 ,$133.60 ,$96.19 ,$37.41 ,$334.00 ,$334.00 ,$86.84 ,$79.76 ,$130.93 ,$37.41 ,$88.44 ,$130.93 ,$88.44 , N/A ,$79.63 ,$79.63 , N/A ,$79.63 , N/A ,$102.87 , N/A ,$130.93 , N/A ,$100.20 ,$94.86 ,$94.86 ,$130.93 ,$94.86 ,$113.56 ,$113.56 ,$113.56 , N/A ,$133.60 ,$113.56 , N/A ,$133.60 ,$74.95 ,$130.93 ,$55.31 , N/A , N/A ,$130.93 ,$113.56 , N/A ,$79.63 ,$37.41 ,$120.24 ,$130.93 ,$113.56 ,$112.89 ,$112.89 ,$130.93 ,$86.84 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML SOLN 10 ML BOTTLE,637,1 ,$245.20 ,$176.54 ,$68.66 ,$613.00 ,$613.00 ,$159.38 ,$146.38 ,$240.30 ,$68.66 ,$162.32 ,$240.30 ,$162.32 , N/A ,$146.14 ,$146.14 , N/A ,$146.14 , N/A ,$188.80 , N/A ,$240.30 , N/A ,$183.90 ,$174.09 ,$174.09 ,$240.30 ,$174.09 ,$208.42 ,$208.42 ,$208.42 , N/A ,$245.20 ,$208.42 , N/A ,$245.20 ,$137.56 ,$240.30 ,$101.51 , N/A , N/A ,$240.30 ,$208.42 , N/A ,$146.14 ,$68.66 ,$220.68 ,$240.30 ,$208.42 ,$207.19 ,$207.19 ,$240.30 ,$159.38 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DOXYCYCLINE HYCLATE 100 MG TABS,637,1 ,$11.20 ,$8.06 ,$3.14 ,$28.00 ,$28.00 ,$7.28 ,$6.69 ,$10.98 ,$3.14 ,$7.41 ,$10.98 ,$7.41 , N/A ,$6.68 ,$6.68 , N/A ,$6.68 , N/A ,$8.62 , N/A ,$10.98 , N/A ,$8.40 ,$7.95 ,$7.95 ,$10.98 ,$7.95 ,$9.52 ,$9.52 ,$9.52 , N/A ,$11.20 ,$9.52 , N/A ,$11.20 ,$6.28 ,$10.98 ,$4.64 , N/A , N/A ,$10.98 ,$9.52 , N/A ,$6.68 ,$3.14 ,$10.08 ,$10.98 ,$9.52 ,$9.46 ,$9.46 ,$10.98 ,$7.28 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DULOXETINE 20 MG CPEP,637,1 ,$16.35 ,$11.77 ,$4.58 ,$40.88 ,$40.88 ,$10.63 ,$9.76 ,$16.02 ,$4.58 ,$10.82 ,$16.02 ,$10.82 , N/A ,$9.74 ,$9.74 , N/A ,$9.74 , N/A ,$12.59 , N/A ,$16.02 , N/A ,$12.26 ,$11.61 ,$11.61 ,$16.02 ,$11.61 ,$13.90 ,$13.90 ,$13.90 , N/A ,$16.35 ,$13.90 , N/A ,$16.35 ,$9.17 ,$16.02 ,$6.77 , N/A , N/A ,$16.02 ,$13.90 , N/A ,$9.74 ,$4.58 ,$14.72 ,$16.02 ,$13.90 ,$13.82 ,$13.82 ,$16.02 ,$10.63 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DULOXETINE 30 MG CPEP,637,1 ,$15.70 ,$11.30 ,$4.40 ,$39.25 ,$39.25 ,$10.21 ,$9.37 ,$15.39 ,$4.40 ,$10.39 ,$15.39 ,$10.39 , N/A ,$9.36 ,$9.36 , N/A ,$9.36 , N/A ,$12.09 , N/A ,$15.39 , N/A ,$11.78 ,$11.15 ,$11.15 ,$15.39 ,$11.15 ,$13.35 ,$13.35 ,$13.35 , N/A ,$15.70 ,$13.35 , N/A ,$15.70 ,$8.81 ,$15.39 ,$6.50 , N/A , N/A ,$15.39 ,$13.35 , N/A ,$9.36 ,$4.40 ,$14.13 ,$15.39 ,$13.35 ,$13.27 ,$13.27 ,$15.39 ,$10.21 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DULOXETINE 60 MG CPEP,637,1 ,$15.40 ,$11.09 ,$4.31 ,$38.50 ,$38.50 ,$10.01 ,$9.19 ,$15.09 ,$4.31 ,$10.19 ,$15.09 ,$10.19 , N/A ,$9.18 ,$9.18 , N/A ,$9.18 , N/A ,$11.86 , N/A ,$15.09 , N/A ,$11.55 ,$10.93 ,$10.93 ,$15.09 ,$10.93 ,$13.09 ,$13.09 ,$13.09 , N/A ,$15.40 ,$13.09 , N/A ,$15.40 ,$8.64 ,$15.09 ,$6.38 , N/A , N/A ,$15.09 ,$13.09 , N/A ,$9.18 ,$4.31 ,$13.86 ,$15.09 ,$13.09 ,$13.01 ,$13.01 ,$15.09 ,$10.01 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,EMOLLIENT OINT 85 G TUBE,637,1 ,$18.90 ,$13.61 ,$5.29 ,$47.25 ,$47.25 ,$12.29 ,$11.28 ,$18.52 ,$5.29 ,$12.51 ,$18.52 ,$12.51 , N/A ,$11.26 ,$11.26 , N/A ,$11.26 , N/A ,$14.55 , N/A ,$18.52 , N/A ,$14.18 ,$13.42 ,$13.42 ,$18.52 ,$13.42 ,$16.07 ,$16.07 ,$16.07 , N/A ,$18.90 ,$16.07 , N/A ,$18.90 ,$10.60 ,$18.52 ,$7.82 , N/A , N/A ,$18.52 ,$16.07 , N/A ,$11.26 ,$5.29 ,$17.01 ,$18.52 ,$16.07 ,$15.97 ,$15.97 ,$18.52 ,$12.29 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,EMPAGLIFLOZIN 10 MG TABS,637,1 ,$45.65 ,$32.87 ,$12.78 ,$114.13 ,$114.13 ,$29.67 ,$27.25 ,$44.74 ,$12.78 ,$30.22 ,$44.74 ,$30.22 , N/A ,$27.21 ,$27.21 , N/A ,$27.21 , N/A ,$35.15 , N/A ,$44.74 , N/A ,$34.24 ,$32.41 ,$32.41 ,$44.74 ,$32.41 ,$38.80 ,$38.80 ,$38.80 , N/A ,$45.65 ,$38.80 , N/A ,$45.65 ,$25.61 ,$44.74 ,$18.90 , N/A , N/A ,$44.74 ,$38.80 , N/A ,$27.21 ,$12.78 ,$41.09 ,$44.74 ,$38.80 ,$38.57 ,$38.57 ,$44.74 ,$29.67 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,EPLERENONE 25 MG TABS,637,1 ,$8.70 ,$6.26 ,$2.44 ,$21.75 ,$21.75 ,$5.66 ,$5.19 ,$8.53 ,$2.44 ,$5.76 ,$8.53 ,$5.76 , N/A ,$5.19 ,$5.19 , N/A ,$5.19 , N/A ,$6.70 , N/A ,$8.53 , N/A ,$6.53 ,$6.18 ,$6.18 ,$8.53 ,$6.18 ,$7.40 ,$7.40 ,$7.40 , N/A ,$8.70 ,$7.40 , N/A ,$8.70 ,$4.88 ,$8.53 ,$3.60 , N/A , N/A ,$8.53 ,$7.40 , N/A ,$5.19 ,$2.44 ,$7.83 ,$8.53 ,$7.40 ,$7.35 ,$7.35 ,$8.53 ,$5.66 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIPHENHYDRAMINE-ZINC 2-0.1 % CREA 28 G TUBE,637,1 ,$8.70 ,$6.26 ,$2.44 ,$21.75 ,$21.75 ,$5.66 ,$5.19 ,$8.53 ,$2.44 ,$5.76 ,$8.53 ,$5.76 , N/A ,$5.19 ,$5.19 , N/A ,$5.19 , N/A ,$6.70 , N/A ,$8.53 , N/A ,$6.53 ,$6.18 ,$6.18 ,$8.53 ,$6.18 ,$7.40 ,$7.40 ,$7.40 , N/A ,$8.70 ,$7.40 , N/A ,$8.70 ,$4.88 ,$8.53 ,$3.60 , N/A , N/A ,$8.53 ,$7.40 , N/A ,$5.19 ,$2.44 ,$7.83 ,$8.53 ,$7.40 ,$7.35 ,$7.35 ,$8.53 ,$5.66 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ERYTHROMYCIN 5 MG/GM OINT 1 G TUBE,637,1 ,$24.85 ,$17.89 ,$6.96 ,$62.13 ,$62.13 ,$16.15 ,$14.84 ,$24.35 ,$6.96 ,$16.45 ,$24.35 ,$16.45 , N/A ,$14.81 ,$14.81 , N/A ,$14.81 , N/A ,$19.13 , N/A ,$24.35 , N/A ,$18.64 ,$17.64 ,$17.64 ,$24.35 ,$17.64 ,$21.12 ,$21.12 ,$21.12 , N/A ,$24.85 ,$21.12 , N/A ,$24.85 ,$13.94 ,$24.35 ,$10.29 , N/A , N/A ,$24.35 ,$21.12 , N/A ,$14.81 ,$6.96 ,$22.37 ,$24.35 ,$21.12 ,$21.00 ,$21.00 ,$24.35 ,$16.15 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ERYTHROMYCIN 5 MG/GM OINT 3.5 G TUBE,637,1 ,$37.35 ,$26.89 ,$10.46 ,$93.38 ,$93.38 ,$24.28 ,$22.30 ,$36.60 ,$10.46 ,$24.73 ,$36.60 ,$24.73 , N/A ,$22.26 ,$22.26 , N/A ,$22.26 , N/A ,$28.76 , N/A ,$36.60 , N/A ,$28.01 ,$26.52 ,$26.52 ,$36.60 ,$26.52 ,$31.75 ,$31.75 ,$31.75 , N/A ,$37.35 ,$31.75 , N/A ,$37.35 ,$20.95 ,$36.60 ,$15.46 , N/A , N/A ,$36.60 ,$31.75 , N/A ,$22.26 ,$10.46 ,$33.62 ,$36.60 ,$31.75 ,$31.56 ,$31.56 ,$36.60 ,$24.28 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,EZETIMIBE 10 MG TABS,637,1 ,$20.60 ,$14.83 ,$5.77 ,$51.50 ,$51.50 ,$13.39 ,$12.30 ,$20.19 ,$5.77 ,$13.64 ,$20.19 ,$13.64 , N/A ,$12.28 ,$12.28 , N/A ,$12.28 , N/A ,$15.86 , N/A ,$20.19 , N/A ,$15.45 ,$14.63 ,$14.63 ,$20.19 ,$14.63 ,$17.51 ,$17.51 ,$17.51 , N/A ,$20.60 ,$17.51 , N/A ,$20.60 ,$11.56 ,$20.19 ,$8.53 , N/A , N/A ,$20.19 ,$17.51 , N/A ,$12.28 ,$5.77 ,$18.54 ,$20.19 ,$17.51 ,$17.41 ,$17.41 ,$20.19 ,$13.39 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FENOFIBRATE 145 MG TABS,637,1 ,$10.30 ,$7.42 ,$2.88 ,$25.75 ,$25.75 ,$6.70 ,$6.15 ,$10.09 ,$2.88 ,$6.82 ,$10.09 ,$6.82 , N/A ,$6.14 ,$6.14 , N/A ,$6.14 , N/A ,$7.93 , N/A ,$10.09 , N/A ,$7.73 ,$7.31 ,$7.31 ,$10.09 ,$7.31 ,$8.76 ,$8.76 ,$8.76 , N/A ,$10.30 ,$8.76 , N/A ,$10.30 ,$5.78 ,$10.09 ,$4.26 , N/A , N/A ,$10.09 ,$8.76 , N/A ,$6.14 ,$2.88 ,$9.27 ,$10.09 ,$8.76 ,$8.70 ,$8.70 ,$10.09 ,$6.70 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FENTANYL 12 MCG/HR PT72,637,1 ,$40.60 ,$29.23 ,$11.37 ,$101.50 ,$101.50 ,$26.39 ,$24.24 ,$39.79 ,$11.37 ,$26.88 ,$39.79 ,$26.88 , N/A ,$24.20 ,$24.20 , N/A ,$24.20 , N/A ,$31.26 , N/A ,$39.79 , N/A ,$30.45 ,$28.83 ,$28.83 ,$39.79 ,$28.83 ,$34.51 ,$34.51 ,$34.51 , N/A ,$40.60 ,$34.51 , N/A ,$40.60 ,$22.78 ,$39.79 ,$16.81 , N/A , N/A ,$39.79 ,$34.51 , N/A ,$24.20 ,$11.37 ,$36.54 ,$39.79 ,$34.51 ,$34.31 ,$34.31 ,$39.79 ,$26.39 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FENTANYL 25 MCG/HR PT72,637,1 ,$28.85 ,$20.77 ,$8.08 ,$72.13 ,$72.13 ,$18.75 ,$17.22 ,$28.27 ,$8.08 ,$19.10 ,$28.27 ,$19.10 , N/A ,$17.19 ,$17.19 , N/A ,$17.19 , N/A ,$22.21 , N/A ,$28.27 , N/A ,$21.64 ,$20.48 ,$20.48 ,$28.27 ,$20.48 ,$24.52 ,$24.52 ,$24.52 , N/A ,$28.85 ,$24.52 , N/A ,$28.85 ,$16.18 ,$28.27 ,$11.94 , N/A , N/A ,$28.27 ,$24.52 , N/A ,$17.19 ,$8.08 ,$25.97 ,$28.27 ,$24.52 ,$24.38 ,$24.38 ,$28.27 ,$18.75 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FENTANYL 50 MCG/HR PT72,637,1 ,$52.75 ,$37.98 ,$14.77 ,$131.88 ,$131.88 ,$34.29 ,$31.49 ,$51.69 ,$14.77 ,$34.92 ,$51.69 ,$34.92 , N/A ,$31.44 ,$31.44 , N/A ,$31.44 , N/A ,$40.62 , N/A ,$51.69 , N/A ,$39.56 ,$37.45 ,$37.45 ,$51.69 ,$37.45 ,$44.84 ,$44.84 ,$44.84 , N/A ,$52.75 ,$44.84 , N/A ,$52.75 ,$29.59 ,$51.69 ,$21.84 , N/A , N/A ,$51.69 ,$44.84 , N/A ,$31.44 ,$14.77 ,$47.48 ,$51.69 ,$44.84 ,$44.57 ,$44.57 ,$51.69 ,$34.29 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FERROUS SULFATE 300 (60 FE) MG/5ML SYRP,637,1 ,$8.15 ,$5.87 ,$2.28 ,$20.38 ,$20.38 ,$5.30 ,$4.87 ,$7.99 ,$2.28 ,$5.40 ,$7.99 ,$5.40 , N/A ,$4.86 ,$4.86 , N/A ,$4.86 , N/A ,$6.28 , N/A ,$7.99 , N/A ,$6.11 ,$5.79 ,$5.79 ,$7.99 ,$5.79 ,$6.93 ,$6.93 ,$6.93 , N/A ,$8.15 ,$6.93 , N/A ,$8.15 ,$4.57 ,$7.99 ,$3.37 , N/A , N/A ,$7.99 ,$6.93 , N/A ,$4.86 ,$2.28 ,$7.34 ,$7.99 ,$6.93 ,$6.89 ,$6.89 ,$7.99 ,$5.30 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FIDAXOMICIN 200 MG TABS,637,1 ,$537.05 ,$386.68 ,$150.37 ,"$1,342.63 ","$1,342.63 ",$349.08 ,$320.62 ,$526.31 ,$150.37 ,$355.53 ,$526.31 ,$355.53 , N/A ,$320.08 ,$320.08 , N/A ,$320.08 , N/A ,$413.53 , N/A ,$526.31 , N/A ,$402.79 ,$381.31 ,$381.31 ,$526.31 ,$381.31 ,$456.49 ,$456.49 ,$456.49 , N/A ,$537.05 ,$456.49 , N/A ,$537.05 ,$301.29 ,$526.31 ,$222.34 , N/A , N/A ,$526.31 ,$456.49 , N/A ,$320.08 ,$150.37 ,$483.35 ,$526.31 ,$456.49 ,$453.81 ,$453.81 ,$526.31 ,$349.08 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FINASTERIDE 5 MG TABS,637,1 ,$6.30 ,$4.54 ,$1.76 ,$15.75 ,$15.75 ,$4.10 ,$3.76 ,$6.17 ,$1.76 ,$4.17 ,$6.17 ,$4.17 , N/A ,$3.75 ,$3.75 , N/A ,$3.75 , N/A ,$4.85 , N/A ,$6.17 , N/A ,$4.73 ,$4.47 ,$4.47 ,$6.17 ,$4.47 ,$5.36 ,$5.36 ,$5.36 , N/A ,$6.30 ,$5.36 , N/A ,$6.30 ,$3.53 ,$6.17 ,$2.61 , N/A , N/A ,$6.17 ,$5.36 , N/A ,$3.75 ,$1.76 ,$5.67 ,$6.17 ,$5.36 ,$5.32 ,$5.32 ,$6.17 ,$4.10 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLECAINIDE 100 MG TABS,637,1 ,$11.95 ,$8.60 ,$3.35 ,$29.88 ,$29.88 ,$7.77 ,$7.13 ,$11.71 ,$3.35 ,$7.91 ,$11.71 ,$7.91 , N/A ,$7.12 ,$7.12 , N/A ,$7.12 , N/A ,$9.20 , N/A ,$11.71 , N/A ,$8.96 ,$8.48 ,$8.48 ,$11.71 ,$8.48 ,$10.16 ,$10.16 ,$10.16 , N/A ,$11.95 ,$10.16 , N/A ,$11.95 ,$6.70 ,$11.71 ,$4.95 , N/A , N/A ,$11.71 ,$10.16 , N/A ,$7.12 ,$3.35 ,$10.76 ,$11.71 ,$10.16 ,$10.10 ,$10.10 ,$11.71 ,$7.77 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUCONAZOLE 100 MG TABS,637,1 ,$19.06 ,$13.72 ,$5.34 ,$47.65 ,$47.65 ,$12.39 ,$11.38 ,$18.68 ,$5.34 ,$12.62 ,$18.68 ,$12.62 , N/A ,$11.36 ,$11.36 , N/A ,$11.36 , N/A ,$14.68 , N/A ,$18.68 , N/A ,$14.30 ,$13.53 ,$13.53 ,$18.68 ,$13.53 ,$16.20 ,$16.20 ,$16.20 , N/A ,$19.06 ,$16.20 , N/A ,$19.06 ,$10.69 ,$18.68 ,$7.89 , N/A , N/A ,$18.68 ,$16.20 , N/A ,$11.36 ,$5.34 ,$17.15 ,$18.68 ,$16.20 ,$16.11 ,$16.11 ,$18.68 ,$12.39 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUCONAZOLE 150 MG TABS,637,1 ,$28.05 ,$20.20 ,$7.85 ,$70.13 ,$70.13 ,$18.23 ,$16.75 ,$27.49 ,$7.85 ,$18.57 ,$27.49 ,$18.57 , N/A ,$16.72 ,$16.72 , N/A ,$16.72 , N/A ,$21.60 , N/A ,$27.49 , N/A ,$21.04 ,$19.92 ,$19.92 ,$27.49 ,$19.92 ,$23.84 ,$23.84 ,$23.84 , N/A ,$28.05 ,$23.84 , N/A ,$28.05 ,$15.74 ,$27.49 ,$11.61 , N/A , N/A ,$27.49 ,$23.84 , N/A ,$16.72 ,$7.85 ,$25.25 ,$27.49 ,$23.84 ,$23.70 ,$23.70 ,$27.49 ,$18.23 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUTICASONE PROPIONATE 220 MCG/ACT AERO,637,1 ,$8.55 ,$6.16 ,$2.39 ,$21.38 ,$21.38 ,$5.56 ,$5.10 ,$8.38 ,$2.39 ,$5.66 ,$8.38 ,$5.66 , N/A ,$5.10 ,$5.10 , N/A ,$5.10 , N/A ,$6.58 , N/A ,$8.38 , N/A ,$6.41 ,$6.07 ,$6.07 ,$8.38 ,$6.07 ,$7.27 ,$7.27 ,$7.27 , N/A ,$8.55 ,$7.27 , N/A ,$8.55 ,$4.80 ,$8.38 ,$3.54 , N/A , N/A ,$8.38 ,$7.27 , N/A ,$5.10 ,$2.39 ,$7.70 ,$8.38 ,$7.27 ,$7.22 ,$7.22 ,$8.38 ,$5.56 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUTICASONE PROPIONATE 50 MCG/ACT SUSP 16 G BOTTLE,637,1 ,$170.55 ,$122.80 ,$47.75 ,$426.38 ,$426.38 ,$110.86 ,$101.82 ,$167.14 ,$47.75 ,$112.90 ,$167.14 ,$112.90 , N/A ,$101.65 ,$101.65 , N/A ,$101.65 , N/A ,$131.32 , N/A ,$167.14 , N/A ,$127.91 ,$121.09 ,$121.09 ,$167.14 ,$121.09 ,$144.97 ,$144.97 ,$144.97 , N/A ,$170.55 ,$144.97 , N/A ,$170.55 ,$95.68 ,$167.14 ,$70.61 , N/A , N/A ,$167.14 ,$144.97 , N/A ,$101.65 ,$47.75 ,$153.50 ,$167.14 ,$144.97 ,$144.11 ,$144.11 ,$167.14 ,$110.86 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUTICASONE-SALMETEROL 230-21 MCG/ACT AERO,637,1 ,$28.50 ,$20.52 ,$7.98 ,$71.25 ,$71.25 ,$18.53 ,$17.01 ,$27.93 ,$7.98 ,$18.87 ,$27.93 ,$18.87 , N/A ,$16.99 ,$16.99 , N/A ,$16.99 , N/A ,$21.95 , N/A ,$27.93 , N/A ,$21.38 ,$20.24 ,$20.24 ,$27.93 ,$20.24 ,$24.23 ,$24.23 ,$24.23 , N/A ,$28.50 ,$24.23 , N/A ,$28.50 ,$15.99 ,$27.93 ,$11.80 , N/A , N/A ,$27.93 ,$24.23 , N/A ,$16.99 ,$7.98 ,$25.65 ,$27.93 ,$24.23 ,$24.08 ,$24.08 ,$27.93 ,$18.53 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCERIN CREAM CREA 113 G JAR,637,1 ,$17.20 ,$12.38 ,$4.82 ,$43.00 ,$43.00 ,$11.18 ,$10.27 ,$16.86 ,$4.82 ,$11.39 ,$16.86 ,$11.39 , N/A ,$10.25 ,$10.25 , N/A ,$10.25 , N/A ,$13.24 , N/A ,$16.86 , N/A ,$12.90 ,$12.21 ,$12.21 ,$16.86 ,$12.21 ,$14.62 ,$14.62 ,$14.62 , N/A ,$17.20 ,$14.62 , N/A ,$17.20 ,$9.65 ,$16.86 ,$7.12 , N/A , N/A ,$16.86 ,$14.62 , N/A ,$10.25 ,$4.82 ,$15.48 ,$16.86 ,$14.62 ,$14.53 ,$14.53 ,$16.86 ,$11.18 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLOTRIMAZOLE 1 % CREA 28.4 G TUBE,637,1 ,$17.20 ,$12.38 ,$4.82 ,$43.00 ,$43.00 ,$11.18 ,$10.27 ,$16.86 ,$4.82 ,$11.39 ,$16.86 ,$11.39 , N/A ,$10.25 ,$10.25 , N/A ,$10.25 , N/A ,$13.24 , N/A ,$16.86 , N/A ,$12.90 ,$12.21 ,$12.21 ,$16.86 ,$12.21 ,$14.62 ,$14.62 ,$14.62 , N/A ,$17.20 ,$14.62 , N/A ,$17.20 ,$9.65 ,$16.86 ,$7.12 , N/A , N/A ,$16.86 ,$14.62 , N/A ,$10.25 ,$4.82 ,$15.48 ,$16.86 ,$14.62 ,$14.53 ,$14.53 ,$16.86 ,$11.18 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCORTISONE 1 % OINT 28 G TUBE,637,1 ,$8.05 ,$5.80 ,$2.25 ,$20.13 ,$20.13 ,$5.23 ,$4.81 ,$7.89 ,$2.25 ,$5.33 ,$7.89 ,$5.33 , N/A ,$4.80 ,$4.80 , N/A ,$4.80 , N/A ,$6.20 , N/A ,$7.89 , N/A ,$6.04 ,$5.72 ,$5.72 ,$7.89 ,$5.72 ,$6.84 ,$6.84 ,$6.84 , N/A ,$8.05 ,$6.84 , N/A ,$8.05 ,$4.52 ,$7.89 ,$3.33 , N/A , N/A ,$7.89 ,$6.84 , N/A ,$4.80 ,$2.25 ,$7.25 ,$7.89 ,$6.84 ,$6.80 ,$6.80 ,$7.89 ,$5.23 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCORTISONE 1 % CREA 28 G TUBE,637,1 ,$8.05 ,$5.80 ,$2.25 ,$20.13 ,$20.13 ,$5.23 ,$4.81 ,$7.89 ,$2.25 ,$5.33 ,$7.89 ,$5.33 , N/A ,$4.80 ,$4.80 , N/A ,$4.80 , N/A ,$6.20 , N/A ,$7.89 , N/A ,$6.04 ,$5.72 ,$5.72 ,$7.89 ,$5.72 ,$6.84 ,$6.84 ,$6.84 , N/A ,$8.05 ,$6.84 , N/A ,$8.05 ,$4.52 ,$7.89 ,$3.33 , N/A , N/A ,$7.89 ,$6.84 , N/A ,$4.80 ,$2.25 ,$7.25 ,$7.89 ,$6.84 ,$6.80 ,$6.80 ,$7.89 ,$5.23 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCORTISONE 2.5 % CREA 28 G TUBE,637,1 ,$21.65 ,$15.59 ,$6.06 ,$54.13 ,$54.13 ,$14.07 ,$12.93 ,$21.22 ,$6.06 ,$14.33 ,$21.22 ,$14.33 , N/A ,$12.90 ,$12.90 , N/A ,$12.90 , N/A ,$16.67 , N/A ,$21.22 , N/A ,$16.24 ,$15.37 ,$15.37 ,$21.22 ,$15.37 ,$18.40 ,$18.40 ,$18.40 , N/A ,$21.65 ,$18.40 , N/A ,$21.65 ,$12.15 ,$21.22 ,$8.96 , N/A , N/A ,$21.22 ,$18.40 , N/A ,$12.90 ,$6.06 ,$19.49 ,$21.22 ,$18.40 ,$18.29 ,$18.29 ,$21.22 ,$14.07 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUTICASONE-SALMETEROL 115-21 MCG/ACT AERO,637,1 ,$21.65 ,$15.59 ,$6.06 ,$54.13 ,$54.13 ,$14.07 ,$12.93 ,$21.22 ,$6.06 ,$14.33 ,$21.22 ,$14.33 , N/A ,$12.90 ,$12.90 , N/A ,$12.90 , N/A ,$16.67 , N/A ,$21.22 , N/A ,$16.24 ,$15.37 ,$15.37 ,$21.22 ,$15.37 ,$18.40 ,$18.40 ,$18.40 , N/A ,$21.65 ,$18.40 , N/A ,$21.65 ,$12.15 ,$21.22 ,$8.96 , N/A , N/A ,$21.22 ,$18.40 , N/A ,$12.90 ,$6.06 ,$19.49 ,$21.22 ,$18.40 ,$18.29 ,$18.29 ,$21.22 ,$14.07 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCORTISONE 2.5 % CREA 30 G TUBE,637,1 ,$22.05 ,$15.88 ,$6.17 ,$55.13 ,$55.13 ,$14.33 ,$13.16 ,$21.61 ,$6.17 ,$14.60 ,$21.61 ,$14.60 , N/A ,$13.14 ,$13.14 , N/A ,$13.14 , N/A ,$16.98 , N/A ,$21.61 , N/A ,$16.54 ,$15.66 ,$15.66 ,$21.61 ,$15.66 ,$18.74 ,$18.74 ,$18.74 , N/A ,$22.05 ,$18.74 , N/A ,$22.05 ,$12.37 ,$21.61 ,$9.13 , N/A , N/A ,$21.61 ,$18.74 , N/A ,$13.14 ,$6.17 ,$19.85 ,$21.61 ,$18.74 ,$18.63 ,$18.63 ,$21.61 ,$14.33 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLOTRIMAZOLE 1 % CREA 30 G TUBE,637,1 ,$22.05 ,$15.88 ,$6.17 ,$55.13 ,$55.13 ,$14.33 ,$13.16 ,$21.61 ,$6.17 ,$14.60 ,$21.61 ,$14.60 , N/A ,$13.14 ,$13.14 , N/A ,$13.14 , N/A ,$16.98 , N/A ,$21.61 , N/A ,$16.54 ,$15.66 ,$15.66 ,$21.61 ,$15.66 ,$18.74 ,$18.74 ,$18.74 , N/A ,$22.05 ,$18.74 , N/A ,$22.05 ,$12.37 ,$21.61 ,$9.13 , N/A , N/A ,$21.61 ,$18.74 , N/A ,$13.14 ,$6.17 ,$19.85 ,$21.61 ,$18.74 ,$18.63 ,$18.63 ,$21.61 ,$14.33 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCORTISONE 25 MG SUPP,637,1 ,$45.30 ,$32.62 ,$12.68 ,$113.25 ,$113.25 ,$29.45 ,$27.04 ,$44.39 ,$12.68 ,$29.99 ,$44.39 ,$29.99 , N/A ,$27.00 ,$27.00 , N/A ,$27.00 , N/A ,$34.88 , N/A ,$44.39 , N/A ,$33.98 ,$32.16 ,$32.16 ,$44.39 ,$32.16 ,$38.51 ,$38.51 ,$38.51 , N/A ,$45.30 ,$38.51 , N/A ,$45.30 ,$25.41 ,$44.39 ,$18.75 , N/A , N/A ,$44.39 ,$38.51 , N/A ,$27.00 ,$12.68 ,$40.77 ,$44.39 ,$38.51 ,$38.28 ,$38.28 ,$44.39 ,$29.45 ST. JOSEPH'S HOSPITAL - BREESE,63700001,J1815,INSULIN GLARGINE 100 UNIT/ML SOLN per5 Units,637,1 ,$6.81 ,$4.90 ,$1.91 ,$17.03 ,$17.03 ,$4.43 ,$4.07 ,$6.67 ,$1.91 ,$4.51 ,$6.67 ,$4.51 , N/A ,$4.06 ,$4.06 , N/A ,$4.06 , N/A ,$5.24 , N/A ,$6.67 , N/A ,$5.11 ,$4.84 ,$4.84 ,$6.67 ,$4.84 ,$5.79 ,$5.79 ,$5.79 , N/A ,$6.81 ,$5.79 , N/A ,$6.81 ,$3.82 ,$6.67 ,$2.82 , N/A , N/A ,$6.67 ,$5.79 , N/A ,$4.06 ,$1.91 ,$6.13 ,$6.67 ,$5.79 ,$5.75 ,$5.75 ,$6.67 ,$4.43 ST. JOSEPH'S HOSPITAL - BREESE,63700001,J1815,INSULIN LISPRO 100 UNIT/ML SOLN per5 Units,637,1 ,$18.00 ,$12.96 ,$5.04 ,$45.00 ,$45.00 ,$11.70 ,$10.75 ,$17.64 ,$5.04 ,$11.92 ,$17.64 ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A ,$17.64 , N/A ,$13.50 ,$12.78 ,$12.78 ,$17.64 ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A ,$18.00 ,$15.30 , N/A ,$18.00 ,$10.10 ,$17.64 ,$7.45 , N/A , N/A ,$17.64 ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 ,$17.64 ,$15.30 ,$15.21 ,$15.21 ,$17.64 ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63700001,J1815,INSULIN NPH 100 UNIT/ML SUSP per5 Units,637,1 ,$9.00 ,$6.48 ,$2.52 ,$22.50 ,$22.50 ,$5.85 ,$5.37 ,$8.82 ,$2.52 ,$5.96 ,$8.82 ,$5.96 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$6.93 , N/A ,$8.82 , N/A ,$6.75 ,$6.39 ,$6.39 ,$8.82 ,$6.39 ,$7.65 ,$7.65 ,$7.65 , N/A ,$9.00 ,$7.65 , N/A ,$9.00 ,$5.05 ,$8.82 ,$3.73 , N/A , N/A ,$8.82 ,$7.65 , N/A ,$5.36 ,$2.52 ,$8.10 ,$8.82 ,$7.65 ,$7.61 ,$7.61 ,$8.82 ,$5.85 ST. JOSEPH'S HOSPITAL - BREESE,63700001,J1815,INSULIN NPH-INSULIN REGULAR (70-30) 100 UNIT/ML SUSP per5 Units,637,1 ,$3.60 ,$2.59 ,$1.01 ,$9.00 ,$9.00 ,$2.34 ,$2.15 ,$3.53 ,$1.01 ,$2.38 ,$3.53 ,$2.38 , N/A ,$2.15 ,$2.15 , N/A ,$2.15 , N/A ,$2.77 , N/A ,$3.53 , N/A ,$2.70 ,$2.56 ,$2.56 ,$3.53 ,$2.56 ,$3.06 ,$3.06 ,$3.06 , N/A ,$3.60 ,$3.06 , N/A ,$3.60 ,$2.02 ,$3.53 ,$1.49 , N/A , N/A ,$3.53 ,$3.06 , N/A ,$2.15 ,$1.01 ,$3.24 ,$3.53 ,$3.06 ,$3.04 ,$3.04 ,$3.53 ,$2.34 ST. JOSEPH'S HOSPITAL - BREESE,63700001,J1815,INSULIN REGULAR 100 UNIT/ML SOLN per5 Units,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,KETOCONAZOLE 2 % CREA 15 G TUBE,637,1 ,$61.80 ,$44.50 ,$17.30 ,$154.50 ,$154.50 ,$40.17 ,$36.89 ,$60.56 ,$17.30 ,$40.91 ,$60.56 ,$40.91 , N/A ,$36.83 ,$36.83 , N/A ,$36.83 , N/A ,$47.59 , N/A ,$60.56 , N/A ,$46.35 ,$43.88 ,$43.88 ,$60.56 ,$43.88 ,$52.53 ,$52.53 ,$52.53 , N/A ,$61.80 ,$52.53 , N/A ,$61.80 ,$34.67 ,$60.56 ,$25.59 , N/A , N/A ,$60.56 ,$52.53 , N/A ,$36.83 ,$17.30 ,$55.62 ,$60.56 ,$52.53 ,$52.22 ,$52.22 ,$60.56 ,$40.17 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,KETOROLAC 0.5 % SOLN 5 ML BOTTLE,637,1 ,$213.75 ,$153.90 ,$59.85 ,$534.38 ,$534.38 ,$138.94 ,$127.61 ,$209.47 ,$59.85 ,$141.50 ,$209.47 ,$141.50 , N/A ,$127.40 ,$127.40 , N/A ,$127.40 , N/A ,$164.59 , N/A ,$209.47 , N/A ,$160.31 ,$151.76 ,$151.76 ,$209.47 ,$151.76 ,$181.69 ,$181.69 ,$181.69 , N/A ,$213.75 ,$181.69 , N/A ,$213.75 ,$119.91 ,$209.47 ,$88.49 , N/A , N/A ,$209.47 ,$181.69 , N/A ,$127.40 ,$59.85 ,$192.38 ,$209.47 ,$181.69 ,$180.62 ,$180.62 ,$209.47 ,$138.94 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,KETOTIFEN 0.025 % SOLN 5 ML BOTTLE,637,1 ,$24.40 ,$17.57 ,$6.83 ,$61.00 ,$61.00 ,$15.86 ,$14.57 ,$23.91 ,$6.83 ,$16.15 ,$23.91 ,$16.15 , N/A ,$14.54 ,$14.54 , N/A ,$14.54 , N/A ,$18.79 , N/A ,$23.91 , N/A ,$18.30 ,$17.32 ,$17.32 ,$23.91 ,$17.32 ,$20.74 ,$20.74 ,$20.74 , N/A ,$24.40 ,$20.74 , N/A ,$24.40 ,$13.69 ,$23.91 ,$10.10 , N/A , N/A ,$23.91 ,$20.74 , N/A ,$14.54 ,$6.83 ,$21.96 ,$23.91 ,$20.74 ,$20.62 ,$20.62 ,$23.91 ,$15.86 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LANOLIN CREA 7 G TUBE,637,1 ,$20.00 ,$14.40 ,$5.60 ,$50.00 ,$50.00 ,$13.00 ,$11.94 ,$19.60 ,$5.60 ,$13.24 ,$19.60 ,$13.24 , N/A ,$11.92 ,$11.92 , N/A ,$11.92 , N/A ,$15.40 , N/A ,$19.60 , N/A ,$15.00 ,$14.20 ,$14.20 ,$19.60 ,$14.20 ,$17.00 ,$17.00 ,$17.00 , N/A ,$20.00 ,$17.00 , N/A ,$20.00 ,$11.22 ,$19.60 ,$8.28 , N/A , N/A ,$19.60 ,$17.00 , N/A ,$11.92 ,$5.60 ,$18.00 ,$19.60 ,$17.00 ,$16.90 ,$16.90 ,$19.60 ,$13.00 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LATANOPROST 0.005 % SOLN 2.5 ML BOTTLE,637,1 ,$190.55 ,$137.20 ,$53.35 ,$476.38 ,$476.38 ,$123.86 ,$113.76 ,$186.74 ,$53.35 ,$126.14 ,$186.74 ,$126.14 , N/A ,$113.57 ,$113.57 , N/A ,$113.57 , N/A ,$146.72 , N/A ,$186.74 , N/A ,$142.91 ,$135.29 ,$135.29 ,$186.74 ,$135.29 ,$161.97 ,$161.97 ,$161.97 , N/A ,$190.55 ,$161.97 , N/A ,$190.55 ,$106.90 ,$186.74 ,$78.89 , N/A , N/A ,$186.74 ,$161.97 , N/A ,$113.57 ,$53.35 ,$171.50 ,$186.74 ,$161.97 ,$161.01 ,$161.01 ,$186.74 ,$123.86 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEFLUNOMIDE 10 MG TABS,637,1 ,$32.85 ,$23.65 ,$9.20 ,$82.13 ,$82.13 ,$21.35 ,$19.61 ,$32.19 ,$9.20 ,$21.75 ,$32.19 ,$21.75 , N/A ,$19.58 ,$19.58 , N/A ,$19.58 , N/A ,$25.29 , N/A ,$32.19 , N/A ,$24.64 ,$23.32 ,$23.32 ,$32.19 ,$23.32 ,$27.92 ,$27.92 ,$27.92 , N/A ,$32.85 ,$27.92 , N/A ,$32.85 ,$18.43 ,$32.19 ,$13.60 , N/A , N/A ,$32.19 ,$27.92 , N/A ,$19.58 ,$9.20 ,$29.57 ,$32.19 ,$27.92 ,$27.76 ,$27.76 ,$32.19 ,$21.35 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LETROZOLE 2.5 MG TABS,637,1 ,$36.15 ,$26.03 ,$10.12 ,$90.38 ,$90.38 ,$23.50 ,$21.58 ,$35.43 ,$10.12 ,$23.93 ,$35.43 ,$23.93 , N/A ,$21.55 ,$21.55 , N/A ,$21.55 , N/A ,$27.84 , N/A ,$35.43 , N/A ,$27.11 ,$25.67 ,$25.67 ,$35.43 ,$25.67 ,$30.73 ,$30.73 ,$30.73 , N/A ,$36.15 ,$30.73 , N/A ,$36.15 ,$20.28 ,$35.43 ,$14.97 , N/A , N/A ,$35.43 ,$30.73 , N/A ,$21.55 ,$10.12 ,$32.54 ,$35.43 ,$30.73 ,$30.55 ,$30.55 ,$35.43 ,$23.50 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVALBUTEROL 45 MCG/ACT AERO 15 G INHALER,637,1 ,$147.40 ,$106.13 ,$41.27 ,$368.50 ,$368.50 ,$95.81 ,$88.00 ,$144.45 ,$41.27 ,$97.58 ,$144.45 ,$97.58 , N/A ,$87.85 ,$87.85 , N/A ,$87.85 , N/A ,$113.50 , N/A ,$144.45 , N/A ,$110.55 ,$104.65 ,$104.65 ,$144.45 ,$104.65 ,$125.29 ,$125.29 ,$125.29 , N/A ,$147.40 ,$125.29 , N/A ,$147.40 ,$82.69 ,$144.45 ,$61.02 , N/A , N/A ,$144.45 ,$125.29 , N/A ,$87.85 ,$41.27 ,$132.66 ,$144.45 ,$125.29 ,$124.55 ,$124.55 ,$144.45 ,$95.81 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVETIRACETAM 100 MG/ML SOLN,637,1 ,$13.95 ,$10.04 ,$3.91 ,$34.88 ,$34.88 ,$9.07 ,$8.33 ,$13.67 ,$3.91 ,$9.23 ,$13.67 ,$9.23 , N/A ,$8.31 ,$8.31 , N/A ,$8.31 , N/A ,$10.74 , N/A ,$13.67 , N/A ,$10.46 ,$9.90 ,$9.90 ,$13.67 ,$9.90 ,$11.86 ,$11.86 ,$11.86 , N/A ,$13.95 ,$11.86 , N/A ,$13.95 ,$7.83 ,$13.67 ,$5.78 , N/A , N/A ,$13.67 ,$11.86 , N/A ,$8.31 ,$3.91 ,$12.56 ,$13.67 ,$11.86 ,$11.79 ,$11.79 ,$13.67 ,$9.07 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOFLOXACIN 500 MG TABS,637,1 ,$33.65 ,$24.23 ,$9.42 ,$84.13 ,$84.13 ,$21.87 ,$20.09 ,$32.98 ,$9.42 ,$22.28 ,$32.98 ,$22.28 , N/A ,$20.06 ,$20.06 , N/A ,$20.06 , N/A ,$25.91 , N/A ,$32.98 , N/A ,$25.24 ,$23.89 ,$23.89 ,$32.98 ,$23.89 ,$28.60 ,$28.60 ,$28.60 , N/A ,$33.65 ,$28.60 , N/A ,$33.65 ,$18.88 ,$32.98 ,$13.93 , N/A , N/A ,$32.98 ,$28.60 , N/A ,$20.06 ,$9.42 ,$30.29 ,$32.98 ,$28.60 ,$28.43 ,$28.43 ,$32.98 ,$21.87 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOFLOXACIN 750 MG TABS,637,1 ,$72.20 ,$51.98 ,$20.22 ,$180.50 ,$180.50 ,$46.93 ,$43.10 ,$70.76 ,$20.22 ,$47.80 ,$70.76 ,$47.80 , N/A ,$43.03 ,$43.03 , N/A ,$43.03 , N/A ,$55.59 , N/A ,$70.76 , N/A ,$54.15 ,$51.26 ,$51.26 ,$70.76 ,$51.26 ,$61.37 ,$61.37 ,$61.37 , N/A ,$72.20 ,$61.37 , N/A ,$72.20 ,$40.50 ,$70.76 ,$29.89 , N/A , N/A ,$70.76 ,$61.37 , N/A ,$43.03 ,$20.22 ,$64.98 ,$70.76 ,$61.37 ,$61.01 ,$61.01 ,$70.76 ,$46.93 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LINEZOLID 600 MG TABS,637,1 ,$367.35 ,$264.49 ,$102.86 ,$918.38 ,$918.38 ,$238.78 ,$219.31 ,$360.00 ,$102.86 ,$243.19 ,$360.00 ,$243.19 , N/A ,$218.94 ,$218.94 , N/A ,$218.94 , N/A ,$282.86 , N/A ,$360.00 , N/A ,$275.51 ,$260.82 ,$260.82 ,$360.00 ,$260.82 ,$312.25 ,$312.25 ,$312.25 , N/A ,$367.35 ,$312.25 , N/A ,$367.35 ,$206.08 ,$360.00 ,$152.08 , N/A , N/A ,$360.00 ,$312.25 , N/A ,$218.94 ,$102.86 ,$330.62 ,$360.00 ,$312.25 ,$310.41 ,$310.41 ,$360.00 ,$238.78 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MEGESTROL 40 MG/ML SUSP,637,1 ,$8.50 ,$6.12 ,$2.38 ,$21.25 ,$21.25 ,$5.53 ,$5.07 ,$8.33 ,$2.38 ,$5.63 ,$8.33 ,$5.63 , N/A ,$5.07 ,$5.07 , N/A ,$5.07 , N/A ,$6.55 , N/A ,$8.33 , N/A ,$6.38 ,$6.04 ,$6.04 ,$8.33 ,$6.04 ,$7.23 ,$7.23 ,$7.23 , N/A ,$8.50 ,$7.23 , N/A ,$8.50 ,$4.77 ,$8.33 ,$3.52 , N/A , N/A ,$8.33 ,$7.23 , N/A ,$5.07 ,$2.38 ,$7.65 ,$8.33 ,$7.23 ,$7.18 ,$7.18 ,$8.33 ,$5.53 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MELOXICAM 7.5 MG TABS,637,1 ,$6.35 ,$4.57 ,$1.78 ,$15.88 ,$15.88 ,$4.13 ,$3.79 ,$6.22 ,$1.78 ,$4.20 ,$6.22 ,$4.20 , N/A ,$3.78 ,$3.78 , N/A ,$3.78 , N/A ,$4.89 , N/A ,$6.22 , N/A ,$4.76 ,$4.51 ,$4.51 ,$6.22 ,$4.51 ,$5.40 ,$5.40 ,$5.40 , N/A ,$6.35 ,$5.40 , N/A ,$6.35 ,$3.56 ,$6.22 ,$2.63 , N/A , N/A ,$6.22 ,$5.40 , N/A ,$3.78 ,$1.78 ,$5.72 ,$6.22 ,$5.40 ,$5.37 ,$5.37 ,$6.22 ,$4.13 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MENTHOL-METHYL SALICYLATE 10-15 % CREA 85 G TUBE,637,1 ,$7.00 ,$5.04 ,$1.96 ,$17.50 ,$17.50 ,$4.55 ,$4.18 ,$6.86 ,$1.96 ,$4.63 ,$6.86 ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A ,$6.86 , N/A ,$5.25 ,$4.97 ,$4.97 ,$6.86 ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A ,$7.00 ,$5.95 , N/A ,$7.00 ,$3.93 ,$6.86 ,$2.90 , N/A , N/A ,$6.86 ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 ,$6.86 ,$5.95 ,$5.92 ,$5.92 ,$6.86 ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMANTADINE 100 MG CAPS,637,1 ,$7.00 ,$5.04 ,$1.96 ,$17.50 ,$17.50 ,$4.55 ,$4.18 ,$6.86 ,$1.96 ,$4.63 ,$6.86 ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A ,$6.86 , N/A ,$5.25 ,$4.97 ,$4.97 ,$6.86 ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A ,$7.00 ,$5.95 , N/A ,$7.00 ,$3.93 ,$6.86 ,$2.90 , N/A , N/A ,$6.86 ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 ,$6.86 ,$5.95 ,$5.92 ,$5.92 ,$6.86 ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMLODIPINE 5 MG TABS,637,1 ,$7.00 ,$5.04 ,$1.96 ,$17.50 ,$17.50 ,$4.55 ,$4.18 ,$6.86 ,$1.96 ,$4.63 ,$6.86 ,$4.63 , N/A ,$4.17 ,$4.17 , N/A ,$4.17 , N/A ,$5.39 , N/A ,$6.86 , N/A ,$5.25 ,$4.97 ,$4.97 ,$6.86 ,$4.97 ,$5.95 ,$5.95 ,$5.95 , N/A ,$7.00 ,$5.95 , N/A ,$7.00 ,$3.93 ,$6.86 ,$2.90 , N/A , N/A ,$6.86 ,$5.95 , N/A ,$4.17 ,$1.96 ,$6.30 ,$6.86 ,$5.95 ,$5.92 ,$5.92 ,$6.86 ,$4.55 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MESALAMINE ER 0.375 G CP24,637,1 ,$9.20 ,$6.62 ,$2.58 ,$23.00 ,$23.00 ,$5.98 ,$5.49 ,$9.02 ,$2.58 ,$6.09 ,$9.02 ,$6.09 , N/A ,$5.48 ,$5.48 , N/A ,$5.48 , N/A ,$7.08 , N/A ,$9.02 , N/A ,$6.90 ,$6.53 ,$6.53 ,$9.02 ,$6.53 ,$7.82 ,$7.82 ,$7.82 , N/A ,$9.20 ,$7.82 , N/A ,$9.20 ,$5.16 ,$9.02 ,$3.81 , N/A , N/A ,$9.02 ,$7.82 , N/A ,$5.48 ,$2.58 ,$8.28 ,$9.02 ,$7.82 ,$7.77 ,$7.77 ,$9.02 ,$5.98 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METAXALONE 800 MG TABS,637,1 ,$11.80 ,$8.50 ,$3.30 ,$29.50 ,$29.50 ,$7.67 ,$7.04 ,$11.56 ,$3.30 ,$7.81 ,$11.56 ,$7.81 , N/A ,$7.03 ,$7.03 , N/A ,$7.03 , N/A ,$9.09 , N/A ,$11.56 , N/A ,$8.85 ,$8.38 ,$8.38 ,$11.56 ,$8.38 ,$10.03 ,$10.03 ,$10.03 , N/A ,$11.80 ,$10.03 , N/A ,$11.80 ,$6.62 ,$11.56 ,$4.89 , N/A , N/A ,$11.56 ,$10.03 , N/A ,$7.03 ,$3.30 ,$10.62 ,$11.56 ,$10.03 ,$9.97 ,$9.97 ,$11.56 ,$7.67 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIBUCAINE 1 % OINT 28 G TUBE,637,1 ,$11.80 ,$8.50 ,$3.30 ,$29.50 ,$29.50 ,$7.67 ,$7.04 ,$11.56 ,$3.30 ,$7.81 ,$11.56 ,$7.81 , N/A ,$7.03 ,$7.03 , N/A ,$7.03 , N/A ,$9.09 , N/A ,$11.56 , N/A ,$8.85 ,$8.38 ,$8.38 ,$11.56 ,$8.38 ,$10.03 ,$10.03 ,$10.03 , N/A ,$11.80 ,$10.03 , N/A ,$11.80 ,$6.62 ,$11.56 ,$4.89 , N/A , N/A ,$11.56 ,$10.03 , N/A ,$7.03 ,$3.30 ,$10.62 ,$11.56 ,$10.03 ,$9.97 ,$9.97 ,$11.56 ,$7.67 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METHYLERGONOVINE 0.2 MG TABS,637,1 ,$134.50 ,$96.84 ,$37.66 ,$336.25 ,$336.25 ,$87.43 ,$80.30 ,$131.81 ,$37.66 ,$89.04 ,$131.81 ,$89.04 , N/A ,$80.16 ,$80.16 , N/A ,$80.16 , N/A ,$103.57 , N/A ,$131.81 , N/A ,$100.88 ,$95.50 ,$95.50 ,$131.81 ,$95.50 ,$114.33 ,$114.33 ,$114.33 , N/A ,$134.50 ,$114.33 , N/A ,$134.50 ,$75.45 ,$131.81 ,$55.68 , N/A , N/A ,$131.81 ,$114.33 , N/A ,$80.16 ,$37.66 ,$121.05 ,$131.81 ,$114.33 ,$113.65 ,$113.65 ,$131.81 ,$87.43 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOLAZONE 5 MG TABS,637,1 ,$8.25 ,$5.94 ,$2.31 ,$20.63 ,$20.63 ,$5.36 ,$4.93 ,$8.08 ,$2.31 ,$5.46 ,$8.08 ,$5.46 , N/A ,$4.92 ,$4.92 , N/A ,$4.92 , N/A ,$6.35 , N/A ,$8.08 , N/A ,$6.19 ,$5.86 ,$5.86 ,$8.08 ,$5.86 ,$7.01 ,$7.01 ,$7.01 , N/A ,$8.25 ,$7.01 , N/A ,$8.25 ,$4.63 ,$8.08 ,$3.42 , N/A , N/A ,$8.08 ,$7.01 , N/A ,$4.92 ,$2.31 ,$7.43 ,$8.08 ,$7.01 ,$6.97 ,$6.97 ,$8.08 ,$5.36 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MIDAZOLAM 2 MG/ML SYRP,637,1 ,$14.70 ,$10.58 ,$4.12 ,$36.75 ,$36.75 ,$9.56 ,$8.78 ,$14.41 ,$4.12 ,$9.73 ,$14.41 ,$9.73 , N/A ,$8.76 ,$8.76 , N/A ,$8.76 , N/A ,$11.32 , N/A ,$14.41 , N/A ,$11.03 ,$10.44 ,$10.44 ,$14.41 ,$10.44 ,$12.50 ,$12.50 ,$12.50 , N/A ,$14.70 ,$12.50 , N/A ,$14.70 ,$8.25 ,$14.41 ,$6.09 , N/A , N/A ,$14.41 ,$12.50 , N/A ,$8.76 ,$4.12 ,$13.23 ,$14.41 ,$12.50 ,$12.42 ,$12.42 ,$14.41 ,$9.56 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MIDODRINE 5 MG TABS,637,1 ,$8.33 ,$6.00 ,$2.33 ,$20.83 ,$20.83 ,$5.41 ,$4.97 ,$8.16 ,$2.33 ,$5.51 ,$8.16 ,$5.51 , N/A ,$4.96 ,$4.96 , N/A ,$4.96 , N/A ,$6.41 , N/A ,$8.16 , N/A ,$6.25 ,$5.91 ,$5.91 ,$8.16 ,$5.91 ,$7.08 ,$7.08 ,$7.08 , N/A ,$8.33 ,$7.08 , N/A ,$8.33 ,$4.67 ,$8.16 ,$3.45 , N/A , N/A ,$8.16 ,$7.08 , N/A ,$4.96 ,$2.33 ,$7.50 ,$8.16 ,$7.08 ,$7.04 ,$7.04 ,$8.16 ,$5.41 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MONTELUKAST 10 MG TABS,637,1 ,$11.05 ,$7.96 ,$3.09 ,$27.63 ,$27.63 ,$7.18 ,$6.60 ,$10.83 ,$3.09 ,$7.32 ,$10.83 ,$7.32 , N/A ,$6.59 ,$6.59 , N/A ,$6.59 , N/A ,$8.51 , N/A ,$10.83 , N/A ,$8.29 ,$7.85 ,$7.85 ,$10.83 ,$7.85 ,$9.39 ,$9.39 ,$9.39 , N/A ,$11.05 ,$9.39 , N/A ,$11.05 ,$6.20 ,$10.83 ,$4.57 , N/A , N/A ,$10.83 ,$9.39 , N/A ,$6.59 ,$3.09 ,$9.95 ,$10.83 ,$9.39 ,$9.34 ,$9.34 ,$10.83 ,$7.18 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MUPIROCIN 2 % OINT 22 G TUBE,637,1 ,$85.50 ,$61.56 ,$23.94 ,$213.75 ,$213.75 ,$55.58 ,$51.04 ,$83.79 ,$23.94 ,$56.60 ,$83.79 ,$56.60 , N/A ,$50.96 ,$50.96 , N/A ,$50.96 , N/A ,$65.84 , N/A ,$83.79 , N/A ,$64.13 ,$60.71 ,$60.71 ,$83.79 ,$60.71 ,$72.68 ,$72.68 ,$72.68 , N/A ,$85.50 ,$72.68 , N/A ,$85.50 ,$47.97 ,$83.79 ,$35.40 , N/A , N/A ,$83.79 ,$72.68 , N/A ,$50.96 ,$23.94 ,$76.95 ,$83.79 ,$72.68 ,$72.25 ,$72.25 ,$83.79 ,$55.58 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NEBIVOLOL 5 MG TABS,637,1 ,$13.55 ,$9.76 ,$3.79 ,$33.88 ,$33.88 ,$8.81 ,$8.09 ,$13.28 ,$3.79 ,$8.97 ,$13.28 ,$8.97 , N/A ,$8.08 ,$8.08 , N/A ,$8.08 , N/A ,$10.43 , N/A ,$13.28 , N/A ,$10.16 ,$9.62 ,$9.62 ,$13.28 ,$9.62 ,$11.52 ,$11.52 ,$11.52 , N/A ,$13.55 ,$11.52 , N/A ,$13.55 ,$7.60 ,$13.28 ,$5.61 , N/A , N/A ,$13.28 ,$11.52 , N/A ,$8.08 ,$3.79 ,$12.20 ,$13.28 ,$11.52 ,$11.45 ,$11.45 ,$13.28 ,$8.81 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 5-400-5000 OINT 28.4 G TUBE,637,1 ,$14.00 ,$10.08 ,$3.92 ,$35.00 ,$35.00 ,$9.10 ,$8.36 ,$13.72 ,$3.92 ,$9.27 ,$13.72 ,$9.27 , N/A ,$8.34 ,$8.34 , N/A ,$8.34 , N/A ,$10.78 , N/A ,$13.72 , N/A ,$10.50 ,$9.94 ,$9.94 ,$13.72 ,$9.94 ,$11.90 ,$11.90 ,$11.90 , N/A ,$14.00 ,$11.90 , N/A ,$14.00 ,$7.85 ,$13.72 ,$5.80 , N/A , N/A ,$13.72 ,$11.90 , N/A ,$8.34 ,$3.92 ,$12.60 ,$13.72 ,$11.90 ,$11.83 ,$11.83 ,$13.72 ,$9.10 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NEOMYCIN-POLYMYXIN-HYDROCORTISONE 3.5-10000-1 SUSP 10 ML BOTTLE,637,1 ,$209.80 ,$151.06 ,$58.74 ,$524.50 ,$524.50 ,$136.37 ,$125.25 ,$205.60 ,$58.74 ,$138.89 ,$205.60 ,$138.89 , N/A ,$125.04 ,$125.04 , N/A ,$125.04 , N/A ,$161.55 , N/A ,$205.60 , N/A ,$157.35 ,$148.96 ,$148.96 ,$205.60 ,$148.96 ,$178.33 ,$178.33 ,$178.33 , N/A ,$209.80 ,$178.33 , N/A ,$209.80 ,$117.70 ,$205.60 ,$86.86 , N/A , N/A ,$205.60 ,$178.33 , N/A ,$125.04 ,$58.74 ,$188.82 ,$205.60 ,$178.33 ,$177.28 ,$177.28 ,$205.60 ,$136.37 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITAZOXANIDE 500 MG TABS,637,1 ,$330.45 ,$237.92 ,$92.53 ,$826.13 ,$826.13 ,$214.79 ,$197.28 ,$323.84 ,$92.53 ,$218.76 ,$323.84 ,$218.76 , N/A ,$196.95 ,$196.95 , N/A ,$196.95 , N/A ,$254.45 , N/A ,$323.84 , N/A ,$247.84 ,$234.62 ,$234.62 ,$323.84 ,$234.62 ,$280.88 ,$280.88 ,$280.88 , N/A ,$330.45 ,$280.88 , N/A ,$330.45 ,$185.38 ,$323.84 ,$136.81 , N/A , N/A ,$323.84 ,$280.88 , N/A ,$196.95 ,$92.53 ,$297.41 ,$323.84 ,$280.88 ,$279.23 ,$279.23 ,$323.84 ,$214.79 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITROFURANTOIN (MACROCRYSTAL-MONOHYDRATE) 100 MG CAPS,637,1 ,$7.10 ,$5.11 ,$1.99 ,$17.75 ,$17.75 ,$4.62 ,$4.24 ,$6.96 ,$1.99 ,$4.70 ,$6.96 ,$4.70 , N/A ,$4.23 ,$4.23 , N/A ,$4.23 , N/A ,$5.47 , N/A ,$6.96 , N/A ,$5.33 ,$5.04 ,$5.04 ,$6.96 ,$5.04 ,$6.04 ,$6.04 ,$6.04 , N/A ,$7.10 ,$6.04 , N/A ,$7.10 ,$3.98 ,$6.96 ,$2.94 , N/A , N/A ,$6.96 ,$6.04 , N/A ,$4.23 ,$1.99 ,$6.39 ,$6.96 ,$6.04 ,$6.00 ,$6.00 ,$6.96 ,$4.62 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NYSTATIN 100000 UNIT/GM CREA 15 G TUBE,637,1 ,$35.05 ,$25.24 ,$9.81 ,$87.63 ,$87.63 ,$22.78 ,$20.92 ,$34.35 ,$9.81 ,$23.20 ,$34.35 ,$23.20 , N/A ,$20.89 ,$20.89 , N/A ,$20.89 , N/A ,$26.99 , N/A ,$34.35 , N/A ,$26.29 ,$24.89 ,$24.89 ,$34.35 ,$24.89 ,$29.79 ,$29.79 ,$29.79 , N/A ,$35.05 ,$29.79 , N/A ,$35.05 ,$19.66 ,$34.35 ,$14.51 , N/A , N/A ,$34.35 ,$29.79 , N/A ,$20.89 ,$9.81 ,$31.55 ,$34.35 ,$29.79 ,$29.62 ,$29.62 ,$34.35 ,$22.78 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NYSTATIN 100000 UNIT/GM POWD 15 G BOTTLE,637,1 ,$54.95 ,$39.56 ,$15.39 ,$137.38 ,$137.38 ,$35.72 ,$32.81 ,$53.85 ,$15.39 ,$36.38 ,$53.85 ,$36.38 , N/A ,$32.75 ,$32.75 , N/A ,$32.75 , N/A ,$42.31 , N/A ,$53.85 , N/A ,$41.21 ,$39.01 ,$39.01 ,$53.85 ,$39.01 ,$46.71 ,$46.71 ,$46.71 , N/A ,$54.95 ,$46.71 , N/A ,$54.95 ,$30.83 ,$53.85 ,$22.75 , N/A , N/A ,$53.85 ,$46.71 , N/A ,$32.75 ,$15.39 ,$49.46 ,$53.85 ,$46.71 ,$46.43 ,$46.43 ,$53.85 ,$35.72 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NYSTATIN-TRIAMCINOLONE 100000-0.1 UNIT/GM-% CREA 15 G TUBE,637,1 ,$223.90 ,$161.21 ,$62.69 ,$559.75 ,$559.75 ,$145.54 ,$133.67 ,$219.42 ,$62.69 ,$148.22 ,$219.42 ,$148.22 , N/A ,$133.44 ,$133.44 , N/A ,$133.44 , N/A ,$172.40 , N/A ,$219.42 , N/A ,$167.93 ,$158.97 ,$158.97 ,$219.42 ,$158.97 ,$190.32 ,$190.32 ,$190.32 , N/A ,$223.90 ,$190.32 , N/A ,$223.90 ,$125.61 ,$219.42 ,$92.69 , N/A , N/A ,$219.42 ,$190.32 , N/A ,$133.44 ,$62.69 ,$201.51 ,$219.42 ,$190.32 ,$189.20 ,$189.20 ,$219.42 ,$145.54 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OLANZAPINE 5 MG TABS,637,1 ,$26.45 ,$19.04 ,$7.41 ,$66.13 ,$66.13 ,$17.19 ,$15.79 ,$25.92 ,$7.41 ,$17.51 ,$25.92 ,$17.51 , N/A ,$15.76 ,$15.76 , N/A ,$15.76 , N/A ,$20.37 , N/A ,$25.92 , N/A ,$19.84 ,$18.78 ,$18.78 ,$25.92 ,$18.78 ,$22.48 ,$22.48 ,$22.48 , N/A ,$26.45 ,$22.48 , N/A ,$26.45 ,$14.84 ,$25.92 ,$10.95 , N/A , N/A ,$25.92 ,$22.48 , N/A ,$15.76 ,$7.41 ,$23.81 ,$25.92 ,$22.48 ,$22.35 ,$22.35 ,$25.92 ,$17.19 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OLANZAPINE 5 MG TBDP,637,1 ,$28.55 ,$20.56 ,$7.99 ,$71.38 ,$71.38 ,$18.56 ,$17.04 ,$27.98 ,$7.99 ,$18.90 ,$27.98 ,$18.90 , N/A ,$17.02 ,$17.02 , N/A ,$17.02 , N/A ,$21.98 , N/A ,$27.98 , N/A ,$21.41 ,$20.27 ,$20.27 ,$27.98 ,$20.27 ,$24.27 ,$24.27 ,$24.27 , N/A ,$28.55 ,$24.27 , N/A ,$28.55 ,$16.02 ,$27.98 ,$11.82 , N/A , N/A ,$27.98 ,$24.27 , N/A ,$17.02 ,$7.99 ,$25.70 ,$27.98 ,$24.27 ,$24.12 ,$24.12 ,$27.98 ,$18.56 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ONDANSETRON 4 MG TBDP,637,1 ,$46.25 ,$33.30 ,$12.95 ,$115.63 ,$115.63 ,$30.06 ,$27.61 ,$45.32 ,$12.95 ,$30.62 ,$45.32 ,$30.62 , N/A ,$27.57 ,$27.57 , N/A ,$27.57 , N/A ,$35.61 , N/A ,$45.32 , N/A ,$34.69 ,$32.84 ,$32.84 ,$45.32 ,$32.84 ,$39.31 ,$39.31 ,$39.31 , N/A ,$46.25 ,$39.31 , N/A ,$46.25 ,$25.95 ,$45.32 ,$19.15 , N/A , N/A ,$45.32 ,$39.31 , N/A ,$27.57 ,$12.95 ,$41.63 ,$45.32 ,$39.31 ,$39.08 ,$39.08 ,$45.32 ,$30.06 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ONDANSETRON 4 MG/5ML SOLN,637,1 ,$47.80 ,$34.42 ,$13.38 ,$119.50 ,$119.50 ,$31.07 ,$28.54 ,$46.84 ,$13.38 ,$31.64 ,$46.84 ,$31.64 , N/A ,$28.49 ,$28.49 , N/A ,$28.49 , N/A ,$36.81 , N/A ,$46.84 , N/A ,$35.85 ,$33.94 ,$33.94 ,$46.84 ,$33.94 ,$40.63 ,$40.63 ,$40.63 , N/A ,$47.80 ,$40.63 , N/A ,$47.80 ,$26.82 ,$46.84 ,$19.79 , N/A , N/A ,$46.84 ,$40.63 , N/A ,$28.49 ,$13.38 ,$43.02 ,$46.84 ,$40.63 ,$40.39 ,$40.39 ,$46.84 ,$31.07 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OSELTAMIVIR 30 MG CAPS,637,1 ,$28.40 ,$20.45 ,$7.95 ,$71.00 ,$71.00 ,$18.46 ,$16.95 ,$27.83 ,$7.95 ,$18.80 ,$27.83 ,$18.80 , N/A ,$16.93 ,$16.93 , N/A ,$16.93 , N/A ,$21.87 , N/A ,$27.83 , N/A ,$21.30 ,$20.16 ,$20.16 ,$27.83 ,$20.16 ,$24.14 ,$24.14 ,$24.14 , N/A ,$28.40 ,$24.14 , N/A ,$28.40 ,$15.93 ,$27.83 ,$11.76 , N/A , N/A ,$27.83 ,$24.14 , N/A ,$16.93 ,$7.95 ,$25.56 ,$27.83 ,$24.14 ,$24.00 ,$24.00 ,$27.83 ,$18.46 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OSELTAMIVIR 75 MG CAPS,637,1 ,$36.50 ,$26.28 ,$10.22 ,$91.25 ,$91.25 ,$23.73 ,$21.79 ,$35.77 ,$10.22 ,$24.16 ,$35.77 ,$24.16 , N/A ,$21.75 ,$21.75 , N/A ,$21.75 , N/A ,$28.11 , N/A ,$35.77 , N/A ,$27.38 ,$25.92 ,$25.92 ,$35.77 ,$25.92 ,$31.03 ,$31.03 ,$31.03 , N/A ,$36.50 ,$31.03 , N/A ,$36.50 ,$20.48 ,$35.77 ,$15.11 , N/A , N/A ,$35.77 ,$31.03 , N/A ,$21.75 ,$10.22 ,$32.85 ,$35.77 ,$31.03 ,$30.84 ,$30.84 ,$35.77 ,$23.73 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE 5 MG/5ML SOLN,637,1 ,$17.25 ,$12.42 ,$4.83 ,$43.13 ,$43.13 ,$11.21 ,$10.30 ,$16.90 ,$4.83 ,$11.42 ,$16.90 ,$11.42 , N/A ,$10.28 ,$10.28 , N/A ,$10.28 , N/A ,$13.28 , N/A ,$16.90 , N/A ,$12.94 ,$12.25 ,$12.25 ,$16.90 ,$12.25 ,$14.66 ,$14.66 ,$14.66 , N/A ,$17.25 ,$14.66 , N/A ,$17.25 ,$9.68 ,$16.90 ,$7.14 , N/A , N/A ,$16.90 ,$14.66 , N/A ,$10.28 ,$4.83 ,$15.53 ,$16.90 ,$14.66 ,$14.58 ,$14.58 ,$16.90 ,$11.21 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE ER 10 MG T12A,637,1 ,$11.50 ,$8.28 ,$3.22 ,$28.75 ,$28.75 ,$7.48 ,$6.87 ,$11.27 ,$3.22 ,$7.61 ,$11.27 ,$7.61 , N/A ,$6.85 ,$6.85 , N/A ,$6.85 , N/A ,$8.86 , N/A ,$11.27 , N/A ,$8.63 ,$8.17 ,$8.17 ,$11.27 ,$8.17 ,$9.78 ,$9.78 ,$9.78 , N/A ,$11.50 ,$9.78 , N/A ,$11.50 ,$6.45 ,$11.27 ,$4.76 , N/A , N/A ,$11.27 ,$9.78 , N/A ,$6.85 ,$3.22 ,$10.35 ,$11.27 ,$9.78 ,$9.72 ,$9.72 ,$11.27 ,$7.48 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NIACIN CR 500 MG TBCR,637,1 ,$11.50 ,$8.28 ,$3.22 ,$28.75 ,$28.75 ,$7.48 ,$6.87 ,$11.27 ,$3.22 ,$7.61 ,$11.27 ,$7.61 , N/A ,$6.85 ,$6.85 , N/A ,$6.85 , N/A ,$8.86 , N/A ,$11.27 , N/A ,$8.63 ,$8.17 ,$8.17 ,$11.27 ,$8.17 ,$9.78 ,$9.78 ,$9.78 , N/A ,$11.50 ,$9.78 , N/A ,$11.50 ,$6.45 ,$11.27 ,$4.76 , N/A , N/A ,$11.27 ,$9.78 , N/A ,$6.85 ,$3.22 ,$10.35 ,$11.27 ,$9.78 ,$9.72 ,$9.72 ,$11.27 ,$7.48 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE ER 20 MG T12A,637,1 ,$21.40 ,$15.41 ,$5.99 ,$53.50 ,$53.50 ,$13.91 ,$12.78 ,$20.97 ,$5.99 ,$14.17 ,$20.97 ,$14.17 , N/A ,$12.75 ,$12.75 , N/A ,$12.75 , N/A ,$16.48 , N/A ,$20.97 , N/A ,$16.05 ,$15.19 ,$15.19 ,$20.97 ,$15.19 ,$18.19 ,$18.19 ,$18.19 , N/A ,$21.40 ,$18.19 , N/A ,$21.40 ,$12.01 ,$20.97 ,$8.86 , N/A , N/A ,$20.97 ,$18.19 , N/A ,$12.75 ,$5.99 ,$19.26 ,$20.97 ,$18.19 ,$18.08 ,$18.08 ,$20.97 ,$13.91 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 15 ML BOTTLE,637,1 ,$10.55 ,$7.60 ,$2.95 ,$26.38 ,$26.38 ,$6.86 ,$6.30 ,$10.34 ,$2.95 ,$6.98 ,$10.34 ,$6.98 , N/A ,$6.29 ,$6.29 , N/A ,$6.29 , N/A ,$8.12 , N/A ,$10.34 , N/A ,$7.91 ,$7.49 ,$7.49 ,$10.34 ,$7.49 ,$8.97 ,$8.97 ,$8.97 , N/A ,$10.55 ,$8.97 , N/A ,$10.55 ,$5.92 ,$10.34 ,$4.37 , N/A , N/A ,$10.34 ,$8.97 , N/A ,$6.29 ,$2.95 ,$9.50 ,$10.34 ,$8.97 ,$8.91 ,$8.91 ,$10.34 ,$6.86 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PANCRELIPASE (LIP-PROT-AMYL) 10000-32000 UNITS CPEP,637,1 ,$9.15 ,$6.59 ,$2.56 ,$22.88 ,$22.88 ,$5.95 ,$5.46 ,$8.97 ,$2.56 ,$6.06 ,$8.97 ,$6.06 , N/A ,$5.45 ,$5.45 , N/A ,$5.45 , N/A ,$7.05 , N/A ,$8.97 , N/A ,$6.86 ,$6.50 ,$6.50 ,$8.97 ,$6.50 ,$7.78 ,$7.78 ,$7.78 , N/A ,$9.15 ,$7.78 , N/A ,$9.15 ,$5.13 ,$8.97 ,$3.79 , N/A , N/A ,$8.97 ,$7.78 , N/A ,$5.45 ,$2.56 ,$8.24 ,$8.97 ,$7.78 ,$7.73 ,$7.73 ,$8.97 ,$5.95 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PANCRELIPASE (LIP-PROT-AMYL) 10500-35500 UNITS CPEP,637,1 ,$7.25 ,$5.22 ,$2.03 ,$18.13 ,$18.13 ,$4.71 ,$4.33 ,$7.09 ,$2.03 ,$4.80 ,$7.09 ,$4.80 , N/A ,$4.32 ,$4.32 , N/A ,$4.32 , N/A ,$5.58 , N/A ,$7.09 , N/A ,$5.44 ,$5.15 ,$5.15 ,$7.09 ,$5.15 ,$6.16 ,$6.16 ,$6.16 , N/A ,$7.25 ,$6.16 , N/A ,$7.25 ,$4.07 ,$7.09 ,$3.00 , N/A , N/A ,$7.09 ,$6.16 , N/A ,$4.32 ,$2.03 ,$6.53 ,$7.09 ,$6.16 ,$6.13 ,$6.13 ,$7.09 ,$4.71 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PANTOPRAZOLE EC 40 MG TBEC,637,1 ,$8.10 ,$5.83 ,$2.27 ,$20.25 ,$20.25 ,$5.27 ,$4.84 ,$7.94 ,$2.27 ,$5.36 ,$7.94 ,$5.36 , N/A ,$4.83 ,$4.83 , N/A ,$4.83 , N/A ,$6.24 , N/A ,$7.94 , N/A ,$6.08 ,$5.75 ,$5.75 ,$7.94 ,$5.75 ,$6.89 ,$6.89 ,$6.89 , N/A ,$8.10 ,$6.89 , N/A ,$8.10 ,$4.54 ,$7.94 ,$3.35 , N/A , N/A ,$7.94 ,$6.89 , N/A ,$4.83 ,$2.27 ,$7.29 ,$7.94 ,$6.89 ,$6.84 ,$6.84 ,$7.94 ,$5.27 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PHENOL 1.4 % LIQD 177 ML SPRAY BOTTLE,637,1 ,$6.05 ,$4.36 ,$1.69 ,$15.13 ,$15.13 ,$3.93 ,$3.61 ,$5.93 ,$1.69 ,$4.01 ,$5.93 ,$4.01 , N/A ,$3.61 ,$3.61 , N/A ,$3.61 , N/A ,$4.66 , N/A ,$5.93 , N/A ,$4.54 ,$4.30 ,$4.30 ,$5.93 ,$4.30 ,$5.14 ,$5.14 ,$5.14 , N/A ,$6.05 ,$5.14 , N/A ,$6.05 ,$3.39 ,$5.93 ,$2.50 , N/A , N/A ,$5.93 ,$5.14 , N/A ,$3.61 ,$1.69 ,$5.45 ,$5.93 ,$5.14 ,$5.11 ,$5.11 ,$5.93 ,$3.93 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PHENYLEPHRINE 1 % SOLN 15 ML BOTTLE,637,1 ,$8.80 ,$6.34 ,$2.46 ,$22.00 ,$22.00 ,$5.72 ,$5.25 ,$8.62 ,$2.46 ,$5.83 ,$8.62 ,$5.83 , N/A ,$5.24 ,$5.24 , N/A ,$5.24 , N/A ,$6.78 , N/A ,$8.62 , N/A ,$6.60 ,$6.25 ,$6.25 ,$8.62 ,$6.25 ,$7.48 ,$7.48 ,$7.48 , N/A ,$8.80 ,$7.48 , N/A ,$8.80 ,$4.94 ,$8.62 ,$3.64 , N/A , N/A ,$8.62 ,$7.48 , N/A ,$5.24 ,$2.46 ,$7.92 ,$8.62 ,$7.48 ,$7.44 ,$7.44 ,$8.62 ,$5.72 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROXYCHLOROQUINE 200 MG TABS,637,1 ,$8.80 ,$6.34 ,$2.46 ,$22.00 ,$22.00 ,$5.72 ,$5.25 ,$8.62 ,$2.46 ,$5.83 ,$8.62 ,$5.83 , N/A ,$5.24 ,$5.24 , N/A ,$5.24 , N/A ,$6.78 , N/A ,$8.62 , N/A ,$6.60 ,$6.25 ,$6.25 ,$8.62 ,$6.25 ,$7.48 ,$7.48 ,$7.48 , N/A ,$8.80 ,$7.48 , N/A ,$8.80 ,$4.94 ,$8.62 ,$3.64 , N/A , N/A ,$8.62 ,$7.48 , N/A ,$5.24 ,$2.46 ,$7.92 ,$8.62 ,$7.48 ,$7.44 ,$7.44 ,$8.62 ,$5.72 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ESCITALOPRAM 10 MG TABS,637,1 ,$8.80 ,$6.34 ,$2.46 ,$22.00 ,$22.00 ,$5.72 ,$5.25 ,$8.62 ,$2.46 ,$5.83 ,$8.62 ,$5.83 , N/A ,$5.24 ,$5.24 , N/A ,$5.24 , N/A ,$6.78 , N/A ,$8.62 , N/A ,$6.60 ,$6.25 ,$6.25 ,$8.62 ,$6.25 ,$7.48 ,$7.48 ,$7.48 , N/A ,$8.80 ,$7.48 , N/A ,$8.80 ,$4.94 ,$8.62 ,$3.64 , N/A , N/A ,$8.62 ,$7.48 , N/A ,$5.24 ,$2.46 ,$7.92 ,$8.62 ,$7.48 ,$7.44 ,$7.44 ,$8.62 ,$5.72 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POLYETHYLENE GLYCOL 17 GM/SCOOP POWD,637,1 ,$18.60 ,$13.39 ,$5.21 ,$46.50 ,$46.50 ,$12.09 ,$11.10 ,$18.23 ,$5.21 ,$12.31 ,$18.23 ,$12.31 , N/A ,$11.09 ,$11.09 , N/A ,$11.09 , N/A ,$14.32 , N/A ,$18.23 , N/A ,$13.95 ,$13.21 ,$13.21 ,$18.23 ,$13.21 ,$15.81 ,$15.81 ,$15.81 , N/A ,$18.60 ,$15.81 , N/A ,$18.60 ,$10.43 ,$18.23 ,$7.70 , N/A , N/A ,$18.23 ,$15.81 , N/A ,$11.09 ,$5.21 ,$16.74 ,$18.23 ,$15.81 ,$15.72 ,$15.72 ,$18.23 ,$12.09 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POLYETHYLENE GLYCOL PACK,637,1 ,$6.20 ,$4.46 ,$1.74 ,$15.50 ,$15.50 ,$4.03 ,$3.70 ,$6.08 ,$1.74 ,$4.10 ,$6.08 ,$4.10 , N/A ,$3.70 ,$3.70 , N/A ,$3.70 , N/A ,$4.77 , N/A ,$6.08 , N/A ,$4.65 ,$4.40 ,$4.40 ,$6.08 ,$4.40 ,$5.27 ,$5.27 ,$5.27 , N/A ,$6.20 ,$5.27 , N/A ,$6.20 ,$3.48 ,$6.08 ,$2.57 , N/A , N/A ,$6.08 ,$5.27 , N/A ,$3.70 ,$1.74 ,$5.58 ,$6.08 ,$5.27 ,$5.24 ,$5.24 ,$6.08 ,$4.03 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POLYVINYL ALCOHOL 1.4 % SOLN 15 ML BOTTLE,637,1 ,$14.85 ,$10.69 ,$4.16 ,$37.13 ,$37.13 ,$9.65 ,$8.87 ,$14.55 ,$4.16 ,$9.83 ,$14.55 ,$9.83 , N/A ,$8.85 ,$8.85 , N/A ,$8.85 , N/A ,$11.43 , N/A ,$14.55 , N/A ,$11.14 ,$10.54 ,$10.54 ,$14.55 ,$10.54 ,$12.62 ,$12.62 ,$12.62 , N/A ,$14.85 ,$12.62 , N/A ,$14.85 ,$8.33 ,$14.55 ,$6.15 , N/A , N/A ,$14.55 ,$12.62 , N/A ,$8.85 ,$4.16 ,$13.37 ,$14.55 ,$12.62 ,$12.55 ,$12.55 ,$14.55 ,$9.65 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRAVASTATIN 20 MG TABS,637,1 ,$6.55 ,$4.72 ,$1.83 ,$16.38 ,$16.38 ,$4.26 ,$3.91 ,$6.42 ,$1.83 ,$4.34 ,$6.42 ,$4.34 , N/A ,$3.90 ,$3.90 , N/A ,$3.90 , N/A ,$5.04 , N/A ,$6.42 , N/A ,$4.91 ,$4.65 ,$4.65 ,$6.42 ,$4.65 ,$5.57 ,$5.57 ,$5.57 , N/A ,$6.55 ,$5.57 , N/A ,$6.55 ,$3.67 ,$6.42 ,$2.71 , N/A , N/A ,$6.42 ,$5.57 , N/A ,$3.90 ,$1.83 ,$5.90 ,$6.42 ,$5.57 ,$5.53 ,$5.53 ,$6.42 ,$4.26 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRAVASTATIN 40 MG TABS,637,1 ,$9.55 ,$6.88 ,$2.67 ,$23.88 ,$23.88 ,$6.21 ,$5.70 ,$9.36 ,$2.67 ,$6.32 ,$9.36 ,$6.32 , N/A ,$5.69 ,$5.69 , N/A ,$5.69 , N/A ,$7.35 , N/A ,$9.36 , N/A ,$7.16 ,$6.78 ,$6.78 ,$9.36 ,$6.78 ,$8.12 ,$8.12 ,$8.12 , N/A ,$9.55 ,$8.12 , N/A ,$9.55 ,$5.36 ,$9.36 ,$3.95 , N/A , N/A ,$9.36 ,$8.12 , N/A ,$5.69 ,$2.67 ,$8.60 ,$9.36 ,$8.12 ,$8.07 ,$8.07 ,$9.36 ,$6.21 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LAMOTRIGINE 100 MG TABS,637,1 ,$9.55 ,$6.88 ,$2.67 ,$23.88 ,$23.88 ,$6.21 ,$5.70 ,$9.36 ,$2.67 ,$6.32 ,$9.36 ,$6.32 , N/A ,$5.69 ,$5.69 , N/A ,$5.69 , N/A ,$7.35 , N/A ,$9.36 , N/A ,$7.16 ,$6.78 ,$6.78 ,$9.36 ,$6.78 ,$8.12 ,$8.12 ,$8.12 , N/A ,$9.55 ,$8.12 , N/A ,$9.55 ,$5.36 ,$9.36 ,$3.95 , N/A , N/A ,$9.36 ,$8.12 , N/A ,$5.69 ,$2.67 ,$8.60 ,$9.36 ,$8.12 ,$8.07 ,$8.07 ,$9.36 ,$6.21 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PROMETHAZINE 25 MG SUPP,637,1 ,$35.45 ,$25.52 ,$9.93 ,$88.63 ,$88.63 ,$23.04 ,$21.16 ,$34.74 ,$9.93 ,$23.47 ,$34.74 ,$23.47 , N/A ,$21.13 ,$21.13 , N/A ,$21.13 , N/A ,$27.30 , N/A ,$34.74 , N/A ,$26.59 ,$25.17 ,$25.17 ,$34.74 ,$25.17 ,$30.13 ,$30.13 ,$30.13 , N/A ,$35.45 ,$30.13 , N/A ,$35.45 ,$19.89 ,$34.74 ,$14.68 , N/A , N/A ,$34.74 ,$30.13 , N/A ,$21.13 ,$9.93 ,$31.91 ,$34.74 ,$30.13 ,$29.96 ,$29.96 ,$34.74 ,$23.04 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,QUETIAPINE 100 MG TABS,637,1 ,$13.00 ,$9.36 ,$3.64 ,$32.50 ,$32.50 ,$8.45 ,$7.76 ,$12.74 ,$3.64 ,$8.61 ,$12.74 ,$8.61 , N/A ,$7.75 ,$7.75 , N/A ,$7.75 , N/A ,$10.01 , N/A ,$12.74 , N/A ,$9.75 ,$9.23 ,$9.23 ,$12.74 ,$9.23 ,$11.05 ,$11.05 ,$11.05 , N/A ,$13.00 ,$11.05 , N/A ,$13.00 ,$7.29 ,$12.74 ,$5.38 , N/A , N/A ,$12.74 ,$11.05 , N/A ,$7.75 ,$3.64 ,$11.70 ,$12.74 ,$11.05 ,$10.99 ,$10.99 ,$12.74 ,$8.45 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,QUETIAPINE 25 MG TABS,637,1 ,$7.60 ,$5.47 ,$2.13 ,$19.00 ,$19.00 ,$4.94 ,$4.54 ,$7.45 ,$2.13 ,$5.03 ,$7.45 ,$5.03 , N/A ,$4.53 ,$4.53 , N/A ,$4.53 , N/A ,$5.85 , N/A ,$7.45 , N/A ,$5.70 ,$5.40 ,$5.40 ,$7.45 ,$5.40 ,$6.46 ,$6.46 ,$6.46 , N/A ,$7.60 ,$6.46 , N/A ,$7.60 ,$4.26 ,$7.45 ,$3.15 , N/A , N/A ,$7.45 ,$6.46 , N/A ,$4.53 ,$2.13 ,$6.84 ,$7.45 ,$6.46 ,$6.42 ,$6.42 ,$7.45 ,$4.94 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PANTOPRAZOLE EC 20 MG TBEC,637,1 ,$7.60 ,$5.47 ,$2.13 ,$19.00 ,$19.00 ,$4.94 ,$4.54 ,$7.45 ,$2.13 ,$5.03 ,$7.45 ,$5.03 , N/A ,$4.53 ,$4.53 , N/A ,$4.53 , N/A ,$5.85 , N/A ,$7.45 , N/A ,$5.70 ,$5.40 ,$5.40 ,$7.45 ,$5.40 ,$6.46 ,$6.46 ,$6.46 , N/A ,$7.60 ,$6.46 , N/A ,$7.60 ,$4.26 ,$7.45 ,$3.15 , N/A , N/A ,$7.45 ,$6.46 , N/A ,$4.53 ,$2.13 ,$6.84 ,$7.45 ,$6.46 ,$6.42 ,$6.42 ,$7.45 ,$4.94 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PHENYLEPHRINE 0.5 % SOLN 15 ML BOTTLE,637,1 ,$7.60 ,$5.47 ,$2.13 ,$19.00 ,$19.00 ,$4.94 ,$4.54 ,$7.45 ,$2.13 ,$5.03 ,$7.45 ,$5.03 , N/A ,$4.53 ,$4.53 , N/A ,$4.53 , N/A ,$5.85 , N/A ,$7.45 , N/A ,$5.70 ,$5.40 ,$5.40 ,$7.45 ,$5.40 ,$6.46 ,$6.46 ,$6.46 , N/A ,$7.60 ,$6.46 , N/A ,$7.60 ,$4.26 ,$7.45 ,$3.15 , N/A , N/A ,$7.45 ,$6.46 , N/A ,$4.53 ,$2.13 ,$6.84 ,$7.45 ,$6.46 ,$6.42 ,$6.42 ,$7.45 ,$4.94 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MAGNESIUM-ALUMINUM-SIMETHICONE 400-400-40 MG/5ML SUSP 30 ML CUP,637,1 ,$7.60 ,$5.47 ,$2.13 ,$19.00 ,$19.00 ,$4.94 ,$4.54 ,$7.45 ,$2.13 ,$5.03 ,$7.45 ,$5.03 , N/A ,$4.53 ,$4.53 , N/A ,$4.53 , N/A ,$5.85 , N/A ,$7.45 , N/A ,$5.70 ,$5.40 ,$5.40 ,$7.45 ,$5.40 ,$6.46 ,$6.46 ,$6.46 , N/A ,$7.60 ,$6.46 , N/A ,$7.60 ,$4.26 ,$7.45 ,$3.15 , N/A , N/A ,$7.45 ,$6.46 , N/A ,$4.53 ,$2.13 ,$6.84 ,$7.45 ,$6.46 ,$6.42 ,$6.42 ,$7.45 ,$4.94 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN-CLAVULANATE 500-125 MG TABS,637,1 ,$7.60 ,$5.47 ,$2.13 ,$19.00 ,$19.00 ,$4.94 ,$4.54 ,$7.45 ,$2.13 ,$5.03 ,$7.45 ,$5.03 , N/A ,$4.53 ,$4.53 , N/A ,$4.53 , N/A ,$5.85 , N/A ,$7.45 , N/A ,$5.70 ,$5.40 ,$5.40 ,$7.45 ,$5.40 ,$6.46 ,$6.46 ,$6.46 , N/A ,$7.60 ,$6.46 , N/A ,$7.60 ,$4.26 ,$7.45 ,$3.15 , N/A , N/A ,$7.45 ,$6.46 , N/A ,$4.53 ,$2.13 ,$6.84 ,$7.45 ,$6.46 ,$6.42 ,$6.42 ,$7.45 ,$4.94 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,REPAGLINIDE 1 MG TABS,637,1 ,$7.15 ,$5.15 ,$2.00 ,$17.88 ,$17.88 ,$4.65 ,$4.27 ,$7.01 ,$2.00 ,$4.73 ,$7.01 ,$4.73 , N/A ,$4.26 ,$4.26 , N/A ,$4.26 , N/A ,$5.51 , N/A ,$7.01 , N/A ,$5.36 ,$5.08 ,$5.08 ,$7.01 ,$5.08 ,$6.08 ,$6.08 ,$6.08 , N/A ,$7.15 ,$6.08 , N/A ,$7.15 ,$4.01 ,$7.01 ,$2.96 , N/A , N/A ,$7.01 ,$6.08 , N/A ,$4.26 ,$2.00 ,$6.44 ,$7.01 ,$6.08 ,$6.04 ,$6.04 ,$7.01 ,$4.65 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE-ACETAMINOPHEN 10-325 MG TABS,637,1 ,$7.15 ,$5.15 ,$2.00 ,$17.88 ,$17.88 ,$4.65 ,$4.27 ,$7.01 ,$2.00 ,$4.73 ,$7.01 ,$4.73 , N/A ,$4.26 ,$4.26 , N/A ,$4.26 , N/A ,$5.51 , N/A ,$7.01 , N/A ,$5.36 ,$5.08 ,$5.08 ,$7.01 ,$5.08 ,$6.08 ,$6.08 ,$6.08 , N/A ,$7.15 ,$6.08 , N/A ,$7.15 ,$4.01 ,$7.01 ,$2.96 , N/A , N/A ,$7.01 ,$6.08 , N/A ,$4.26 ,$2.00 ,$6.44 ,$7.01 ,$6.08 ,$6.04 ,$6.04 ,$7.01 ,$4.65 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RIFABUTIN 150 MG CAPS,637,1 ,$35.00 ,$25.20 ,$9.80 ,$87.50 ,$87.50 ,$22.75 ,$20.90 ,$34.30 ,$9.80 ,$23.17 ,$34.30 ,$23.17 , N/A ,$20.86 ,$20.86 , N/A ,$20.86 , N/A ,$26.95 , N/A ,$34.30 , N/A ,$26.25 ,$24.85 ,$24.85 ,$34.30 ,$24.85 ,$29.75 ,$29.75 ,$29.75 , N/A ,$35.00 ,$29.75 , N/A ,$35.00 ,$19.64 ,$34.30 ,$14.49 , N/A , N/A ,$34.30 ,$29.75 , N/A ,$20.86 ,$9.80 ,$31.50 ,$34.30 ,$29.75 ,$29.58 ,$29.58 ,$34.30 ,$22.75 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RIFAXIMIN 550 MG TABS,637,1 ,$119.05 ,$85.72 ,$33.33 ,$297.63 ,$297.63 ,$77.38 ,$71.07 ,$116.67 ,$33.33 ,$78.81 ,$116.67 ,$78.81 , N/A ,$70.95 ,$70.95 , N/A ,$70.95 , N/A ,$91.67 , N/A ,$116.67 , N/A ,$89.29 ,$84.53 ,$84.53 ,$116.67 ,$84.53 ,$101.19 ,$101.19 ,$101.19 , N/A ,$119.05 ,$101.19 , N/A ,$119.05 ,$66.79 ,$116.67 ,$49.29 , N/A , N/A ,$116.67 ,$101.19 , N/A ,$70.95 ,$33.33 ,$107.15 ,$116.67 ,$101.19 ,$100.60 ,$100.60 ,$116.67 ,$77.38 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RISPERIDONE 0.25 MG TABS,637,1 ,$7.80 ,$5.62 ,$2.18 ,$19.50 ,$19.50 ,$5.07 ,$4.66 ,$7.64 ,$2.18 ,$5.16 ,$7.64 ,$5.16 , N/A ,$4.65 ,$4.65 , N/A ,$4.65 , N/A ,$6.01 , N/A ,$7.64 , N/A ,$5.85 ,$5.54 ,$5.54 ,$7.64 ,$5.54 ,$6.63 ,$6.63 ,$6.63 , N/A ,$7.80 ,$6.63 , N/A ,$7.80 ,$4.38 ,$7.64 ,$3.23 , N/A , N/A ,$7.64 ,$6.63 , N/A ,$4.65 ,$2.18 ,$7.02 ,$7.64 ,$6.63 ,$6.59 ,$6.59 ,$7.64 ,$5.07 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RISPERIDONE 1 MG TABS,637,1 ,$9.08 ,$6.54 ,$2.54 ,$22.70 ,$22.70 ,$5.90 ,$5.42 ,$8.90 ,$2.54 ,$6.01 ,$8.90 ,$6.01 , N/A ,$5.41 ,$5.41 , N/A ,$5.41 , N/A ,$6.99 , N/A ,$8.90 , N/A ,$6.81 ,$6.45 ,$6.45 ,$8.90 ,$6.45 ,$7.72 ,$7.72 ,$7.72 , N/A ,$9.08 ,$7.72 , N/A ,$9.08 ,$5.09 ,$8.90 ,$3.76 , N/A , N/A ,$8.90 ,$7.72 , N/A ,$5.41 ,$2.54 ,$8.17 ,$8.90 ,$7.72 ,$7.67 ,$7.67 ,$8.90 ,$5.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RIVAROXABAN 15 MG TABS,637,1 ,$41.35 ,$29.77 ,$11.58 ,$103.38 ,$103.38 ,$26.88 ,$24.69 ,$40.52 ,$11.58 ,$27.37 ,$40.52 ,$27.37 , N/A ,$24.64 ,$24.64 , N/A ,$24.64 , N/A ,$31.84 , N/A ,$40.52 , N/A ,$31.01 ,$29.36 ,$29.36 ,$40.52 ,$29.36 ,$35.15 ,$35.15 ,$35.15 , N/A ,$41.35 ,$35.15 , N/A ,$41.35 ,$23.20 ,$40.52 ,$17.12 , N/A , N/A ,$40.52 ,$35.15 , N/A ,$24.64 ,$11.58 ,$37.22 ,$40.52 ,$35.15 ,$34.94 ,$34.94 ,$40.52 ,$26.88 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RIVAROXABAN 10 MG TABS,637,1 ,$41.35 ,$29.77 ,$11.58 ,$103.38 ,$103.38 ,$26.88 ,$24.69 ,$40.52 ,$11.58 ,$27.37 ,$40.52 ,$27.37 , N/A ,$24.64 ,$24.64 , N/A ,$24.64 , N/A ,$31.84 , N/A ,$40.52 , N/A ,$31.01 ,$29.36 ,$29.36 ,$40.52 ,$29.36 ,$35.15 ,$35.15 ,$35.15 , N/A ,$41.35 ,$35.15 , N/A ,$41.35 ,$23.20 ,$40.52 ,$17.12 , N/A , N/A ,$40.52 ,$35.15 , N/A ,$24.64 ,$11.58 ,$37.22 ,$40.52 ,$35.15 ,$34.94 ,$34.94 ,$40.52 ,$26.88 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RIVASTIGMINE 3 MG CAPS,637,1 ,$8.08 ,$5.82 ,$2.26 ,$20.20 ,$20.20 ,$5.25 ,$4.82 ,$7.92 ,$2.26 ,$5.35 ,$7.92 ,$5.35 , N/A ,$4.82 ,$4.82 , N/A ,$4.82 , N/A ,$6.22 , N/A ,$7.92 , N/A ,$6.06 ,$5.74 ,$5.74 ,$7.92 ,$5.74 ,$6.87 ,$6.87 ,$6.87 , N/A ,$8.08 ,$6.87 , N/A ,$8.08 ,$4.53 ,$7.92 ,$3.35 , N/A , N/A ,$7.92 ,$6.87 , N/A ,$4.82 ,$2.26 ,$7.27 ,$7.92 ,$6.87 ,$6.83 ,$6.83 ,$7.92 ,$5.25 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ROFLUMILAST 500 MCG TABS,637,1 ,$33.50 ,$24.12 ,$9.38 ,$83.75 ,$83.75 ,$21.78 ,$20.00 ,$32.83 ,$9.38 ,$22.18 ,$32.83 ,$22.18 , N/A ,$19.97 ,$19.97 , N/A ,$19.97 , N/A ,$25.80 , N/A ,$32.83 , N/A ,$25.13 ,$23.79 ,$23.79 ,$32.83 ,$23.79 ,$28.48 ,$28.48 ,$28.48 , N/A ,$33.50 ,$28.48 , N/A ,$33.50 ,$18.79 ,$32.83 ,$13.87 , N/A , N/A ,$32.83 ,$28.48 , N/A ,$19.97 ,$9.38 ,$30.15 ,$32.83 ,$28.48 ,$28.31 ,$28.31 ,$32.83 ,$21.78 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SACUBITRIL-VALSARTAN 24-26 MG TABS,637,1 ,$25.45 ,$18.32 ,$7.13 ,$63.63 ,$63.63 ,$16.54 ,$15.19 ,$24.94 ,$7.13 ,$16.85 ,$24.94 ,$16.85 , N/A ,$15.17 ,$15.17 , N/A ,$15.17 , N/A ,$19.60 , N/A ,$24.94 , N/A ,$19.09 ,$18.07 ,$18.07 ,$24.94 ,$18.07 ,$21.63 ,$21.63 ,$21.63 , N/A ,$25.45 ,$21.63 , N/A ,$25.45 ,$14.28 ,$24.94 ,$10.54 , N/A , N/A ,$24.94 ,$21.63 , N/A ,$15.17 ,$7.13 ,$22.91 ,$24.94 ,$21.63 ,$21.51 ,$21.51 ,$24.94 ,$16.54 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SILVER SULFADIAZINE 1 % CREA 25 G TUBE,637,1 ,$18.00 ,$12.96 ,$5.04 ,$45.00 ,$45.00 ,$11.70 ,$10.75 ,$17.64 ,$5.04 ,$11.92 ,$17.64 ,$11.92 , N/A ,$10.73 ,$10.73 , N/A ,$10.73 , N/A ,$13.86 , N/A ,$17.64 , N/A ,$13.50 ,$12.78 ,$12.78 ,$17.64 ,$12.78 ,$15.30 ,$15.30 ,$15.30 , N/A ,$18.00 ,$15.30 , N/A ,$18.00 ,$10.10 ,$17.64 ,$7.45 , N/A , N/A ,$17.64 ,$15.30 , N/A ,$10.73 ,$5.04 ,$16.20 ,$17.64 ,$15.30 ,$15.21 ,$15.21 ,$17.64 ,$11.70 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SODIUM POLYSTYRENE 15 GM/60ML SUSP,637,1 ,$50.30 ,$36.22 ,$14.08 ,$125.75 ,$125.75 ,$32.70 ,$30.03 ,$49.29 ,$14.08 ,$33.30 ,$49.29 ,$33.30 , N/A ,$29.98 ,$29.98 , N/A ,$29.98 , N/A ,$38.73 , N/A ,$49.29 , N/A ,$37.73 ,$35.71 ,$35.71 ,$49.29 ,$35.71 ,$42.76 ,$42.76 ,$42.76 , N/A ,$50.30 ,$42.76 , N/A ,$50.30 ,$28.22 ,$49.29 ,$20.82 , N/A , N/A ,$49.29 ,$42.76 , N/A ,$29.98 ,$14.08 ,$45.27 ,$49.29 ,$42.76 ,$42.50 ,$42.50 ,$49.29 ,$32.70 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SODIUM ZIRCONIUM CYCLOSILICATE 10 G PACK,637,1 ,$58.40 ,$42.05 ,$16.35 ,$146.00 ,$146.00 ,$37.96 ,$34.86 ,$57.23 ,$16.35 ,$38.66 ,$57.23 ,$38.66 , N/A ,$34.81 ,$34.81 , N/A ,$34.81 , N/A ,$44.97 , N/A ,$57.23 , N/A ,$43.80 ,$41.46 ,$41.46 ,$57.23 ,$41.46 ,$49.64 ,$49.64 ,$49.64 , N/A ,$58.40 ,$49.64 , N/A ,$58.40 ,$32.76 ,$57.23 ,$24.18 , N/A , N/A ,$57.23 ,$49.64 , N/A ,$34.81 ,$16.35 ,$52.56 ,$57.23 ,$49.64 ,$49.35 ,$49.35 ,$57.23 ,$37.96 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SOLIFENACIN 5 MG TABS,637,1 ,$26.23 ,$18.89 ,$7.34 ,$65.58 ,$65.58 ,$17.05 ,$15.66 ,$25.71 ,$7.34 ,$17.36 ,$25.71 ,$17.36 , N/A ,$15.63 ,$15.63 , N/A ,$15.63 , N/A ,$20.20 , N/A ,$25.71 , N/A ,$19.67 ,$18.62 ,$18.62 ,$25.71 ,$18.62 ,$22.30 ,$22.30 ,$22.30 , N/A ,$26.23 ,$22.30 , N/A ,$26.23 ,$14.72 ,$25.71 ,$10.86 , N/A , N/A ,$25.71 ,$22.30 , N/A ,$15.63 ,$7.34 ,$23.61 ,$25.71 ,$22.30 ,$22.16 ,$22.16 ,$25.71 ,$17.05 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SOTALOL 120 MG TABS,637,1 ,$6.85 ,$4.93 ,$1.92 ,$17.13 ,$17.13 ,$4.45 ,$4.09 ,$6.71 ,$1.92 ,$4.53 ,$6.71 ,$4.53 , N/A ,$4.08 ,$4.08 , N/A ,$4.08 , N/A ,$5.27 , N/A ,$6.71 , N/A ,$5.14 ,$4.86 ,$4.86 ,$6.71 ,$4.86 ,$5.82 ,$5.82 ,$5.82 , N/A ,$6.85 ,$5.82 , N/A ,$6.85 ,$3.84 ,$6.71 ,$2.84 , N/A , N/A ,$6.71 ,$5.82 , N/A ,$4.08 ,$1.92 ,$6.17 ,$6.71 ,$5.82 ,$5.79 ,$5.79 ,$6.71 ,$4.45 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SUMATRIPTAN 25 MG TABS,637,1 ,$54.13 ,$38.97 ,$15.16 ,$135.33 ,$135.33 ,$35.18 ,$32.32 ,$53.05 ,$15.16 ,$35.83 ,$53.05 ,$35.83 , N/A ,$32.26 ,$32.26 , N/A ,$32.26 , N/A ,$41.68 , N/A ,$53.05 , N/A ,$40.60 ,$38.43 ,$38.43 ,$53.05 ,$38.43 ,$46.01 ,$46.01 ,$46.01 , N/A ,$54.13 ,$46.01 , N/A ,$54.13 ,$30.37 ,$53.05 ,$22.41 , N/A , N/A ,$53.05 ,$46.01 , N/A ,$32.26 ,$15.16 ,$48.72 ,$53.05 ,$46.01 ,$45.74 ,$45.74 ,$53.05 ,$35.18 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TAMSULOSIN 0.4 MG CAPS,637,1 ,$8.45 ,$6.08 ,$2.37 ,$21.13 ,$21.13 ,$5.49 ,$5.04 ,$8.28 ,$2.37 ,$5.59 ,$8.28 ,$5.59 , N/A ,$5.04 ,$5.04 , N/A ,$5.04 , N/A ,$6.51 , N/A ,$8.28 , N/A ,$6.34 ,$6.00 ,$6.00 ,$8.28 ,$6.00 ,$7.18 ,$7.18 ,$7.18 , N/A ,$8.45 ,$7.18 , N/A ,$8.45 ,$4.74 ,$8.28 ,$3.50 , N/A , N/A ,$8.28 ,$7.18 , N/A ,$5.04 ,$2.37 ,$7.61 ,$8.28 ,$7.18 ,$7.14 ,$7.14 ,$8.28 ,$5.49 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TICAGRELOR 90 MG TABS,637,1 ,$17.05 ,$12.28 ,$4.77 ,$42.63 ,$42.63 ,$11.08 ,$10.18 ,$16.71 ,$4.77 ,$11.29 ,$16.71 ,$11.29 , N/A ,$10.16 ,$10.16 , N/A ,$10.16 , N/A ,$13.13 , N/A ,$16.71 , N/A ,$12.79 ,$12.11 ,$12.11 ,$16.71 ,$12.11 ,$14.49 ,$14.49 ,$14.49 , N/A ,$17.05 ,$14.49 , N/A ,$17.05 ,$9.57 ,$16.71 ,$7.06 , N/A , N/A ,$16.71 ,$14.49 , N/A ,$10.16 ,$4.77 ,$15.35 ,$16.71 ,$14.49 ,$14.41 ,$14.41 ,$16.71 ,$11.08 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TIMOLOL 0.25 % SOLN 5 ML BOTTLE,637,1 ,$30.00 ,$21.60 ,$8.40 ,$75.00 ,$75.00 ,$19.50 ,$17.91 ,$29.40 ,$8.40 ,$19.86 ,$29.40 ,$19.86 , N/A ,$17.88 ,$17.88 , N/A ,$17.88 , N/A ,$23.10 , N/A ,$29.40 , N/A ,$22.50 ,$21.30 ,$21.30 ,$29.40 ,$21.30 ,$25.50 ,$25.50 ,$25.50 , N/A ,$30.00 ,$25.50 , N/A ,$30.00 ,$16.83 ,$29.40 ,$12.42 , N/A , N/A ,$29.40 ,$25.50 , N/A ,$17.88 ,$8.40 ,$27.00 ,$29.40 ,$25.50 ,$25.35 ,$25.35 ,$29.40 ,$19.50 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TIMOLOL 0.5 % SOLN 2.5 ML BOTTLE,637,1 ,$7.05 ,$5.08 ,$1.97 ,$17.63 ,$17.63 ,$4.58 ,$4.21 ,$6.91 ,$1.97 ,$4.67 ,$6.91 ,$4.67 , N/A ,$4.20 ,$4.20 , N/A ,$4.20 , N/A ,$5.43 , N/A ,$6.91 , N/A ,$5.29 ,$5.01 ,$5.01 ,$6.91 ,$5.01 ,$5.99 ,$5.99 ,$5.99 , N/A ,$7.05 ,$5.99 , N/A ,$7.05 ,$3.96 ,$6.91 ,$2.92 , N/A , N/A ,$6.91 ,$5.99 , N/A ,$4.20 ,$1.97 ,$6.35 ,$6.91 ,$5.99 ,$5.96 ,$5.96 ,$6.91 ,$4.58 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TIMOLOL 0.5 % SOLN 5 ML BOTTLE,637,1 ,$34.00 ,$24.48 ,$9.52 ,$85.00 ,$85.00 ,$22.10 ,$20.30 ,$33.32 ,$9.52 ,$22.51 ,$33.32 ,$22.51 , N/A ,$20.26 ,$20.26 , N/A ,$20.26 , N/A ,$26.18 , N/A ,$33.32 , N/A ,$25.50 ,$24.14 ,$24.14 ,$33.32 ,$24.14 ,$28.90 ,$28.90 ,$28.90 , N/A ,$34.00 ,$28.90 , N/A ,$34.00 ,$19.07 ,$33.32 ,$14.08 , N/A , N/A ,$33.32 ,$28.90 , N/A ,$20.26 ,$9.52 ,$30.60 ,$33.32 ,$28.90 ,$28.73 ,$28.73 ,$33.32 ,$22.10 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TIOTROPIUM 2.5 MCG/ACT AERS 4 G INHALER,637,1 ,$36.00 ,$25.92 ,$10.08 ,$90.00 ,$90.00 ,$23.40 ,$21.49 ,$35.28 ,$10.08 ,$23.83 ,$35.28 ,$23.83 , N/A ,$21.46 ,$21.46 , N/A ,$21.46 , N/A ,$27.72 , N/A ,$35.28 , N/A ,$27.00 ,$25.56 ,$25.56 ,$35.28 ,$25.56 ,$30.60 ,$30.60 ,$30.60 , N/A ,$36.00 ,$30.60 , N/A ,$36.00 ,$20.20 ,$35.28 ,$14.90 , N/A , N/A ,$35.28 ,$30.60 , N/A ,$21.46 ,$10.08 ,$32.40 ,$35.28 ,$30.60 ,$30.42 ,$30.42 ,$35.28 ,$23.40 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TOBRAMYCIN 0.3 % SOLN 5 ML BOTTLE,637,1 ,$68.00 ,$48.96 ,$19.04 ,$170.00 ,$170.00 ,$44.20 ,$40.60 ,$66.64 ,$19.04 ,$45.02 ,$66.64 ,$45.02 , N/A ,$40.53 ,$40.53 , N/A ,$40.53 , N/A ,$52.36 , N/A ,$66.64 , N/A ,$51.00 ,$48.28 ,$48.28 ,$66.64 ,$48.28 ,$57.80 ,$57.80 ,$57.80 , N/A ,$68.00 ,$57.80 , N/A ,$68.00 ,$38.15 ,$66.64 ,$28.15 , N/A , N/A ,$66.64 ,$57.80 , N/A ,$40.53 ,$19.04 ,$61.20 ,$66.64 ,$57.80 ,$57.46 ,$57.46 ,$66.64 ,$44.20 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % SUSP 2.5 ML BOTTLE,637,1 ,$121.40 ,$87.41 ,$33.99 ,$303.50 ,$303.50 ,$78.91 ,$72.48 ,$118.97 ,$33.99 ,$80.37 ,$118.97 ,$80.37 , N/A ,$72.35 ,$72.35 , N/A ,$72.35 , N/A ,$93.48 , N/A ,$118.97 , N/A ,$91.05 ,$86.19 ,$86.19 ,$118.97 ,$86.19 ,$103.19 ,$103.19 ,$103.19 , N/A ,$121.40 ,$103.19 , N/A ,$121.40 ,$68.11 ,$118.97 ,$50.26 , N/A , N/A ,$118.97 ,$103.19 , N/A ,$72.35 ,$33.99 ,$109.26 ,$118.97 ,$103.19 ,$102.58 ,$102.58 ,$118.97 ,$78.91 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRANEXAMIC ACID 100 MG/ML SOLN,637,1 ,$49.90 ,$35.93 ,$13.97 ,$124.75 ,$124.75 ,$32.44 ,$29.79 ,$48.90 ,$13.97 ,$33.03 ,$48.90 ,$33.03 , N/A ,$29.74 ,$29.74 , N/A ,$29.74 , N/A ,$38.42 , N/A ,$48.90 , N/A ,$37.43 ,$35.43 ,$35.43 ,$48.90 ,$35.43 ,$42.42 ,$42.42 ,$42.42 , N/A ,$49.90 ,$42.42 , N/A ,$49.90 ,$27.99 ,$48.90 ,$20.66 , N/A , N/A ,$48.90 ,$42.42 , N/A ,$29.74 ,$13.97 ,$44.91 ,$48.90 ,$42.42 ,$42.17 ,$42.17 ,$48.90 ,$32.44 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRANEXAMIC ACID 1000 MG/10ML SOLN,637,1 ,$120.00 ,$86.40 ,$33.60 ,$300.00 ,$300.00 ,$78.00 ,$71.64 ,$117.60 ,$33.60 ,$79.44 ,$117.60 ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A ,$117.60 , N/A ,$90.00 ,$85.20 ,$85.20 ,$117.60 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 , N/A ,$120.00 ,$67.32 ,$117.60 ,$49.68 , N/A , N/A ,$117.60 ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 ,$117.60 ,$102.00 ,$101.40 ,$101.40 ,$117.60 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRANEXAMIC ACID 1000 MG/ML SOLN,637,1 ,$73.10 ,$52.63 ,$20.47 ,$182.75 ,$182.75 ,$47.52 ,$43.64 ,$71.64 ,$20.47 ,$48.39 ,$71.64 ,$48.39 , N/A ,$43.57 ,$43.57 , N/A ,$43.57 , N/A ,$56.29 , N/A ,$71.64 , N/A ,$54.83 ,$51.90 ,$51.90 ,$71.64 ,$51.90 ,$62.14 ,$62.14 ,$62.14 , N/A ,$73.10 ,$62.14 , N/A ,$73.10 ,$41.01 ,$71.64 ,$30.26 , N/A , N/A ,$71.64 ,$62.14 , N/A ,$43.57 ,$20.47 ,$65.79 ,$71.64 ,$62.14 ,$61.77 ,$61.77 ,$71.64 ,$47.52 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRIAMCINOLONE 0.1 % CREA 80 G TUBE,637,1 ,$25.15 ,$18.11 ,$7.04 ,$62.88 ,$62.88 ,$16.35 ,$15.01 ,$24.65 ,$7.04 ,$16.65 ,$24.65 ,$16.65 , N/A ,$14.99 ,$14.99 , N/A ,$14.99 , N/A ,$19.37 , N/A ,$24.65 , N/A ,$18.86 ,$17.86 ,$17.86 ,$24.65 ,$17.86 ,$21.38 ,$21.38 ,$21.38 , N/A ,$25.15 ,$21.38 , N/A ,$25.15 ,$14.11 ,$24.65 ,$10.41 , N/A , N/A ,$24.65 ,$21.38 , N/A ,$14.99 ,$7.04 ,$22.64 ,$24.65 ,$21.38 ,$21.25 ,$21.25 ,$24.65 ,$16.35 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,URSODIOL 300 MG CAPS,637,1 ,$14.75 ,$10.62 ,$4.13 ,$36.88 ,$36.88 ,$9.59 ,$8.81 ,$14.45 ,$4.13 ,$9.76 ,$14.45 ,$9.76 , N/A ,$8.79 ,$8.79 , N/A ,$8.79 , N/A ,$11.36 , N/A ,$14.45 , N/A ,$11.06 ,$10.47 ,$10.47 ,$14.45 ,$10.47 ,$12.54 ,$12.54 ,$12.54 , N/A ,$14.75 ,$12.54 , N/A ,$14.75 ,$8.27 ,$14.45 ,$6.11 , N/A , N/A ,$14.45 ,$12.54 , N/A ,$8.79 ,$4.13 ,$13.28 ,$14.45 ,$12.54 ,$12.46 ,$12.46 ,$14.45 ,$9.59 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VALACYCLOVIR 1 G TABS,637,1 ,$12.40 ,$8.93 ,$3.47 ,$31.00 ,$31.00 ,$8.06 ,$7.40 ,$12.15 ,$3.47 ,$8.21 ,$12.15 ,$8.21 , N/A ,$7.39 ,$7.39 , N/A ,$7.39 , N/A ,$9.55 , N/A ,$12.15 , N/A ,$9.30 ,$8.80 ,$8.80 ,$12.15 ,$8.80 ,$10.54 ,$10.54 ,$10.54 , N/A ,$12.40 ,$10.54 , N/A ,$12.40 ,$6.96 ,$12.15 ,$5.13 , N/A , N/A ,$12.15 ,$10.54 , N/A ,$7.39 ,$3.47 ,$11.16 ,$12.15 ,$10.54 ,$10.48 ,$10.48 ,$12.15 ,$8.06 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MOISTURIZING SOLN 59 ML BOTTLE,637,1 ,$12.40 ,$8.93 ,$3.47 ,$31.00 ,$31.00 ,$8.06 ,$7.40 ,$12.15 ,$3.47 ,$8.21 ,$12.15 ,$8.21 , N/A ,$7.39 ,$7.39 , N/A ,$7.39 , N/A ,$9.55 , N/A ,$12.15 , N/A ,$9.30 ,$8.80 ,$8.80 ,$12.15 ,$8.80 ,$10.54 ,$10.54 ,$10.54 , N/A ,$12.40 ,$10.54 , N/A ,$12.40 ,$6.96 ,$12.15 ,$5.13 , N/A , N/A ,$12.15 ,$10.54 , N/A ,$7.39 ,$3.47 ,$11.16 ,$12.15 ,$10.54 ,$10.48 ,$10.48 ,$12.15 ,$8.06 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TOPIRAMATE 100 MG TABS,637,1 ,$12.40 ,$8.93 ,$3.47 ,$31.00 ,$31.00 ,$8.06 ,$7.40 ,$12.15 ,$3.47 ,$8.21 ,$12.15 ,$8.21 , N/A ,$7.39 ,$7.39 , N/A ,$7.39 , N/A ,$9.55 , N/A ,$12.15 , N/A ,$9.30 ,$8.80 ,$8.80 ,$12.15 ,$8.80 ,$10.54 ,$10.54 ,$10.54 , N/A ,$12.40 ,$10.54 , N/A ,$12.40 ,$6.96 ,$12.15 ,$5.13 , N/A , N/A ,$12.15 ,$10.54 , N/A ,$7.39 ,$3.47 ,$11.16 ,$12.15 ,$10.54 ,$10.48 ,$10.48 ,$12.15 ,$8.06 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VANCOMYCIN 125 MG CAPS,637,1 ,$62.65 ,$45.11 ,$17.54 ,$156.63 ,$156.63 ,$40.72 ,$37.40 ,$61.40 ,$17.54 ,$41.47 ,$61.40 ,$41.47 , N/A ,$37.34 ,$37.34 , N/A ,$37.34 , N/A ,$48.24 , N/A ,$61.40 , N/A ,$46.99 ,$44.48 ,$44.48 ,$61.40 ,$44.48 ,$53.25 ,$53.25 ,$53.25 , N/A ,$62.65 ,$53.25 , N/A ,$62.65 ,$35.15 ,$61.40 ,$25.94 , N/A , N/A ,$61.40 ,$53.25 , N/A ,$37.34 ,$17.54 ,$56.39 ,$61.40 ,$53.25 ,$52.94 ,$52.94 ,$61.40 ,$40.72 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VENLAFAXINE XR 37.5 MG CP24,637,1 ,$7.50 ,$5.40 ,$2.10 ,$18.75 ,$18.75 ,$4.88 ,$4.48 ,$7.35 ,$2.10 ,$4.97 ,$7.35 ,$4.97 , N/A ,$4.47 ,$4.47 , N/A ,$4.47 , N/A ,$5.78 , N/A ,$7.35 , N/A ,$5.63 ,$5.33 ,$5.33 ,$7.35 ,$5.33 ,$6.38 ,$6.38 ,$6.38 , N/A ,$7.50 ,$6.38 , N/A ,$7.50 ,$4.21 ,$7.35 ,$3.11 , N/A , N/A ,$7.35 ,$6.38 , N/A ,$4.47 ,$2.10 ,$6.75 ,$7.35 ,$6.38 ,$6.34 ,$6.34 ,$7.35 ,$4.88 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACYCLOVIR 400 MG TABS,637,1 ,$7.50 ,$5.40 ,$2.10 ,$18.75 ,$18.75 ,$4.88 ,$4.48 ,$7.35 ,$2.10 ,$4.97 ,$7.35 ,$4.97 , N/A ,$4.47 ,$4.47 , N/A ,$4.47 , N/A ,$5.78 , N/A ,$7.35 , N/A ,$5.63 ,$5.33 ,$5.33 ,$7.35 ,$5.33 ,$6.38 ,$6.38 ,$6.38 , N/A ,$7.50 ,$6.38 , N/A ,$7.50 ,$4.21 ,$7.35 ,$3.11 , N/A , N/A ,$7.35 ,$6.38 , N/A ,$4.47 ,$2.10 ,$6.75 ,$7.35 ,$6.38 ,$6.34 ,$6.34 ,$7.35 ,$4.88 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VENLAFAXINE XR 75 MG CP24,637,1 ,$8.40 ,$6.05 ,$2.35 ,$21.00 ,$21.00 ,$5.46 ,$5.01 ,$8.23 ,$2.35 ,$5.56 ,$8.23 ,$5.56 , N/A ,$5.01 ,$5.01 , N/A ,$5.01 , N/A ,$6.47 , N/A ,$8.23 , N/A ,$6.30 ,$5.96 ,$5.96 ,$8.23 ,$5.96 ,$7.14 ,$7.14 ,$7.14 , N/A ,$8.40 ,$7.14 , N/A ,$8.40 ,$4.71 ,$8.23 ,$3.48 , N/A , N/A ,$8.23 ,$7.14 , N/A ,$5.01 ,$2.35 ,$7.56 ,$8.23 ,$7.14 ,$7.10 ,$7.10 ,$8.23 ,$5.46 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN A AND D OINT 113 G TUBE,637,1 ,$7.95 ,$5.72 ,$2.23 ,$19.88 ,$19.88 ,$5.17 ,$4.75 ,$7.79 ,$2.23 ,$5.26 ,$7.79 ,$5.26 , N/A ,$4.74 ,$4.74 , N/A ,$4.74 , N/A ,$6.12 , N/A ,$7.79 , N/A ,$5.96 ,$5.64 ,$5.64 ,$7.79 ,$5.64 ,$6.76 ,$6.76 ,$6.76 , N/A ,$7.95 ,$6.76 , N/A ,$7.95 ,$4.46 ,$7.79 ,$3.29 , N/A , N/A ,$7.79 ,$6.76 , N/A ,$4.74 ,$2.23 ,$7.16 ,$7.79 ,$6.76 ,$6.72 ,$6.72 ,$7.79 ,$5.17 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DILTIAZEM SR 60 MG CP12,637,1 ,$7.95 ,$5.72 ,$2.23 ,$19.88 ,$19.88 ,$5.17 ,$4.75 ,$7.79 ,$2.23 ,$5.26 ,$7.79 ,$5.26 , N/A ,$4.74 ,$4.74 , N/A ,$4.74 , N/A ,$6.12 , N/A ,$7.79 , N/A ,$5.96 ,$5.64 ,$5.64 ,$7.79 ,$5.64 ,$6.76 ,$6.76 ,$6.76 , N/A ,$7.95 ,$6.76 , N/A ,$7.95 ,$4.46 ,$7.79 ,$3.29 , N/A , N/A ,$7.79 ,$6.76 , N/A ,$4.74 ,$2.23 ,$7.16 ,$7.79 ,$6.76 ,$6.72 ,$6.72 ,$7.79 ,$5.17 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ZINC OXIDE 13 % CREA 57 G TUBE,637,1 ,$8.00 ,$5.76 ,$2.24 ,$20.00 ,$20.00 ,$5.20 ,$4.78 ,$7.84 ,$2.24 ,$5.30 ,$7.84 ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A ,$7.84 , N/A ,$6.00 ,$5.68 ,$5.68 ,$7.84 ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A ,$8.00 ,$6.80 , N/A ,$8.00 ,$4.49 ,$7.84 ,$3.31 , N/A , N/A ,$7.84 ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 ,$7.84 ,$6.80 ,$6.76 ,$6.76 ,$7.84 ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLUCOSE 15 GM/32ML GEL,637,1 ,$8.00 ,$5.76 ,$2.24 ,$20.00 ,$20.00 ,$5.20 ,$4.78 ,$7.84 ,$2.24 ,$5.30 ,$7.84 ,$5.30 , N/A ,$4.77 ,$4.77 , N/A ,$4.77 , N/A ,$6.16 , N/A ,$7.84 , N/A ,$6.00 ,$5.68 ,$5.68 ,$7.84 ,$5.68 ,$6.80 ,$6.80 ,$6.80 , N/A ,$8.00 ,$6.80 , N/A ,$8.00 ,$4.49 ,$7.84 ,$3.31 , N/A , N/A ,$7.84 ,$6.80 , N/A ,$4.77 ,$2.24 ,$7.20 ,$7.84 ,$6.80 ,$6.76 ,$6.76 ,$7.84 ,$5.20 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ZINC OXIDE 20 % OINT 28.4 G TUBE,637,1 ,$13.15 ,$9.47 ,$3.68 ,$32.88 ,$32.88 ,$8.55 ,$7.85 ,$12.89 ,$3.68 ,$8.71 ,$12.89 ,$8.71 , N/A ,$7.84 ,$7.84 , N/A ,$7.84 , N/A ,$10.13 , N/A ,$12.89 , N/A ,$9.86 ,$9.34 ,$9.34 ,$12.89 ,$9.34 ,$11.18 ,$11.18 ,$11.18 , N/A ,$13.15 ,$11.18 , N/A ,$13.15 ,$7.38 ,$12.89 ,$5.44 , N/A , N/A ,$12.89 ,$11.18 , N/A ,$7.84 ,$3.68 ,$11.84 ,$12.89 ,$11.18 ,$11.11 ,$11.11 ,$12.89 ,$8.55 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ZONISAMIDE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PAROXETINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PAROXETINE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PEDIATRIC MULTIVITAMIN SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PENICILLIN VK 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PENTOXIFYLLINE CR 400 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PHENAZOPYRIDINE 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PHENOL 1.4 % LIQD 177 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PHENYTOIN ER 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POTASSIUM AND SODIUM PHOSPHATES 280-160-250 MG PACK,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POTASSIUM BICARBONATE-CITRIC ACID 10 MEQ TBEF,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POTASSIUM BICARBONATE-CITRIC ACID 20 MEQ TBEF,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POTASSIUM CHLORIDE CR 10 MEQ TBCR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,POTASSIUM PHOSPHATE MONOBASIC 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRAMIPEXOLE 0.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRAZOSIN 1 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PREGABALIN 50 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PREGABALIN 75 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRENATAL 28-0.8 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRIMIDONE 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PRIMIDONE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PROCHLORPERAZINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PROMETHAZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PROPAFENONE 150 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PROPRANOLOL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PSEUDOEPHEDRINE 60 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PSYLLIUM 58.12 % PACK,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,PYRIDOSTIGMINE 60 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,RANOLAZINE ER 500 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ROPINIROLE 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ROPINIROLE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SALINE ENEMA ADULT 7-19 GM/118ML ENEM,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SENNA 8.6 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SENNA-DOCUSATE 8.6-50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SERTRALINE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SIMETHICONE 80 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SODIUM BICARBONATE 650 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SODIUM CHLORIDE 0.65 % SOLN 44 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SODIUM CHLORIDE 1 GM TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SOTALOL 80 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SPIRONOLACTONE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SUCRALFATE 1 G TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SUCROSE 24 % SUSP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FERROUS FUMARATE-VITAMIN C CR 65-25 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FERROUS SULFATE (65 MG ELEMENTAL) 325 (65 FE) MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FISH OIL 1000 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUDROCORTISONE 0.1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUOXETINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUOXETINE 20 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUTICASONE 110 MCG/ACT AERO,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FLUTICASONE PROPIONATE 44 MCG/ACT AERO,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FOLIC ACID 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FUROSEMIDE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FUROSEMIDE 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GABAPENTIN 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GABAPENTIN 300 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GABAPENTIN 400 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GEMFIBROZIL 600 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLIMEPIRIDE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLIPIZIDE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLIPIZIDE XL 2.5 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLYBURIDE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLYBURIDE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GLYCERIN (PEDS/INFANT) 1.2 G SUPP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GUAIFENESIN 100 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GUAIFENESIN ER 600 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GUAIFENESIN-CODEINE 100-10 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,GUAIFENESIN-DEXTROMETHORPHAN 100-10 MG/5ML SYRP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HALOPERIDOL 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDRALAZINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDRALAZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCHLOROTHIAZIDE 12.5 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCHLOROTHIAZIDE 12.5 MG CAPS 100 EACH BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCHLOROTHIAZIDE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 10-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROMORPHONE 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROXYUREA 500 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYDROXYZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYOSCYAMINE 0.125 MG SUBL,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,HYOSCYAMINE ER 0.375 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,IBUPROFEN 100 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,IBUPROFEN 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,IBUPROFEN 400 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,IBUPROFEN 600 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,IBUPROFEN 800 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,INDAPAMIDE 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,INDOMETHACIN 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ISOSORBIDE DINITRATE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ISOSORBIDE MONONITRATE ER 30 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ISOSORBIDE MONONITRATE ER 60 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,KETOROLAC 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LABETALOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LABETALOL 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LACTULOSE 10 GM/15ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LAMOTRIGINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVETIRACETAM 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVETIRACETAM 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 100 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 112 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 125 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 25 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 50 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 75 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LEVOTHYROXINE 88 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LISINOPRIL 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LISINOPRIL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LISINOPRIL 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LITHIUM 300 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LOPERAMIDE 2 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LORAZEPAM 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LORAZEPAM 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LOSARTAN 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,LOSARTAN 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MAGNESIUM CITRATE 1.745 GM/30ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MAGNESIUM HYDROXIDE 400 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MAGNESIUM OXIDE 400 (240 MG) MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MAGNESIUM OXIDE 400 (241.3 MG) MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MECLIZINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MEDROXYPROGESTERONE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MEGESTROL 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MELATONIN 3 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MEMANTINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MEMANTINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METFORMIN 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METHADONE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METHIMAZOLE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METHOCARBAMOL 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOCLOPRAMIDE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOPROLOL SUCCINATE ER 100 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOPROLOL SUCCINATE ER 25 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOPROLOL SUCCINATE ER 50 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOPROLOL TARTRATE 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOPROLOL TARTRATE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METOPROLOL TARTRATE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,METRONIDAZOLE 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MINOCYCLINE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MIRTAZAPINE 15 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MISOPROSTOL 100 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MISOPROSTOL 200 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MOISTURIZING SOLN 44.3 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MORPHINE 15 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MORPHINE CR 15 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MORPHINE SULFATE 100 MG/5ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,MULTI VITAMIN/MINERALS TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NAPROXEN 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 3.5-400-5000 OINT,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NICOTINE 14 MG/24HR PT24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NICOTINE 21 MG/24HR PT24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NICOTINE 7 MG/24HR PT24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NIFEDIPINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NIFEDIPINE XL 30 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITROGLYCERIN 0.1 MG/HR PT24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITROGLYCERIN 0.4 MG SUBL,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITROGLYCERIN 0.4 MG/HR PT24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITROGLYCERIN 0.4 MG/SPRAY SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NITROGLYCERIN 2 % OINT,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NORTRIPTYLINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NORTRIPTYLINE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,NYSTATIN 100000 UNIT/ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OSELTAMIVIR 6 MG/ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXCARBAZEPINE 300 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE IMMEDIATE RELEASE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE IMMEDIATE RELEASE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE-ACETAMINOPHEN 5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 15 ML SPRAY BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 30 ML BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 30 ML SPRAY BOTTLE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,OYSTER SHELL CALCIUM 500 MG (ELEMENTAL) 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,SULFASALAZINE 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TEMAZEPAM 15 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TERAZOSIN 1 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TERAZOSIN 5 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,THYROID 60 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TIZANIDINE 4 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TOPIRAMATE 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TOPIRAMATE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TORSEMIDE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRAMADOL 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRAZODONE 150 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRAZODONE 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VERAPAMIL 180 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VERAPAMIL 80 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN B-1 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN B-12 1000 MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN B-6 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN C 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN D2 (ERGOCALCIFEROL) 50000 UNITS CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN D3 (CHOLECALCIFEROL) 1000 UNIT TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,VITAMIN E 180 MG (400 UNIT) CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,WARFARIN 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,WARFARIN 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,WARFARIN 2.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,WARFARIN 3 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,WARFARIN 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,WHITE PETROLATUM OINT 28.4 G TUBE,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ZINC SULFATE 220 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ZOLPIDEM 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN 120 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN 325 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN 325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN 325 MG/10.15ML SOLN,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN 650 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAMINOPHEN-CODEINE 300-30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACETAZOLAMIDE 250 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ACIDOPHILUS CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT AERS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ALLOPURINOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ALLOPURINOL 300 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ALPRAZOLAM 0.25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ALPRAZOLAM 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMIODARONE 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMITRIPTYLINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMITRIPTYLINE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN 125 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN 250 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN 250 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AMOXICILLIN-CLAVULANATE 400-57 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ASPIRIN 300 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ASPIRIN 325 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ASPIRIN 81 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ASPIRIN EC 325 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ASPIRIN EC 81 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ATENOLOL 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ATENOLOL 50 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ATORVASTATIN 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ATORVASTATIN 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ATORVASTATIN 40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,AZITHROMYCIN 200 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,B COMPLEX CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,B COMPLEX-C-FOLIC ACID 0.8 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BACITRACIN 500 UNIT/GM OINT,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BACLOFEN 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BENZOCAINE-MENTHOL 15-3.6 MG LOZG,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BENZONATATE 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BENZTROPINE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BETHANECHOL 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BISACODYL 10 MG SUPP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BISACODYL EC 5 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BISMUTH SUBSALICYLATE 262 MG/15ML SUSP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUDESONIDE EC 3 MG CPEP,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUMETANIDE 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUPROPION 75 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUPROPION SR 100 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUPROPION SR 150 MG TB12,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUSPIRONE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50-325-40 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CALCITRIOL 0.25 MCG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CALCIUM CARBONATE 500 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CALCIUM CARBONATE-VITAMIN D 500-5 MG-MCG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CAPTOPRIL 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARBAMAZEPINE 100 MG CHEW,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARBAMAZEPINE 200 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARBIDOPA-LEVODOPA 10-100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARBIDOPA-LEVODOPA 25-100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARBIDOPA-LEVODOPA CR 50-200 MG TBCR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARVEDILOL 12.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CARVEDILOL 3.125 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CEPHALEXIN 250 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CEPHALEXIN 250 MG/5ML SUSR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CEPHALEXIN 500 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CETIRIZINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CHLORDIAZEPOXIDE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CHLORTHALIDONE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CILOSTAZOL 100 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CITALOPRAM 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CITALOPRAM 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLINDAMYCIN 150 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLINDAMYCIN 75 MG/5ML SOLR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLONAZEPAM 0.5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLONIDINE 0.1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CLORAZEPATE 3.75 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,CYCLOBENZAPRINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIAZEPAM 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIAZEPAM 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DICLOFENAC EC 75 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DICYCLOMINE 10 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIGOXIN 0.125 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DILTIAZEM 30 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DILTIAZEM CD 120 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DILTIAZEM CD 180 MG CP24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIPHENHYDRAMINE 12.5 MG/5ML LIQD,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIPHENHYDRAMINE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIVALPROEX DR SPRINKLE 125 MG CSDR,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIVALPROEX EC 250 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIVALPROEX EC 500 MG TBEC,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DIVALPROEX ER 250 MG TB24,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DOCUSATE 100 MG/10ML LIQD,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DOCUSATE SODIUM 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DONEPEZIL 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DONEPEZIL 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DOXAZOSIN 2 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,DOXEPIN 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,ESTRADIOL 1 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FAMOTIDINE 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,63700001,N/A,FENOFIBRATE 48 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$15.00 ,$15.00 ,$3.90 ,$3.58 ,$5.88 ,$1.68 ,$3.97 ,$5.88 ,$3.97 , N/A ,$3.58 ,$3.58 , N/A ,$3.58 , N/A ,$4.62 , N/A ,$5.88 , N/A ,$4.50 ,$4.26 ,$4.26 ,$5.88 ,$4.26 ,$5.10 ,$5.10 ,$5.10 , N/A ,$6.00 ,$5.10 , N/A ,$6.00 ,$3.37 ,$5.88 ,$2.48 , N/A , N/A ,$5.88 ,$5.10 , N/A ,$3.58 ,$1.68 ,$5.40 ,$5.88 ,$5.10 ,$5.07 ,$5.07 ,$5.88 ,$3.90 ST. JOSEPH'S HOSPITAL - BREESE,71000221,N/A,HC C-SECTION RECOVERY 30 MIN,710,1 ,"$1,486.00 ","$1,069.92 ",$416.08 ,"$1,486.00 ", N/A ,$965.90 ,$887.14 , N/A ,$416.08 ,$983.73 , N/A ,$983.73 , N/A ,$885.66 ,$885.66 , N/A ,$885.66 , N/A ,"$1,144.22 ", N/A , N/A , N/A ,"$1,114.50 ","$1,055.06 ","$1,055.06 ", N/A ,"$1,055.06 ","$1,263.10 ","$1,263.10 ","$1,263.10 ", N/A , N/A ,"$1,263.10 ", N/A ,"$1,486.00 ",$833.65 , N/A ,$615.20 , N/A , N/A , N/A ,"$1,263.10 ", N/A ,$885.66 ,$416.08 ,"$1,337.40 ", N/A ,"$1,263.10 ","$1,255.67 ","$1,255.67 ", N/A ,$965.90 ST. JOSEPH'S HOSPITAL - BREESE,71000230,N/A,HC PHASE II RECOVERY 15 MIN,710,1 ,$180.00 ,$129.60 ,$50.40 ,$180.00 , N/A ,$117.00 ,$107.46 , N/A ,$50.40 ,$119.16 , N/A ,$119.16 , N/A ,$107.28 ,$107.28 , N/A ,$107.28 , N/A ,$138.60 , N/A , N/A , N/A ,$135.00 ,$127.80 ,$127.80 , N/A ,$127.80 ,$153.00 ,$153.00 ,$153.00 , N/A , N/A ,$153.00 , N/A ,$180.00 ,$100.98 , N/A ,$74.52 , N/A , N/A , N/A ,$153.00 , N/A ,$107.28 ,$50.40 ,$162.00 , N/A ,$153.00 ,$152.10 ,$152.10 , N/A ,$117.00 ST. JOSEPH'S HOSPITAL - BREESE,71000231,N/A,HC RECOVERY <75 MIN,710,1 ,$967.00 ,$696.24 ,$270.76 ,$967.00 , N/A ,$628.55 ,$577.30 , N/A ,$270.76 ,$640.15 , N/A ,$640.15 , N/A ,$576.33 ,$576.33 , N/A ,$576.33 , N/A ,$744.59 , N/A , N/A , N/A ,$725.25 ,$686.57 ,$686.57 , N/A ,$686.57 ,$821.95 ,$821.95 ,$821.95 , N/A , N/A ,$821.95 , N/A ,$967.00 ,$542.49 , N/A ,$400.34 , N/A , N/A , N/A ,$821.95 , N/A ,$576.33 ,$270.76 ,$870.30 , N/A ,$821.95 ,$817.12 ,$817.12 , N/A ,$628.55 ST. JOSEPH'S HOSPITAL - BREESE,71000232,N/A,HC RECOVERY >75 MIN,710,1 ,$189.00 ,$136.08 ,$52.92 ,$189.00 , N/A ,$122.85 ,$112.83 , N/A ,$52.92 ,$125.12 , N/A ,$125.12 , N/A ,$112.64 ,$112.64 , N/A ,$112.64 , N/A ,$145.53 , N/A , N/A , N/A ,$141.75 ,$134.19 ,$134.19 , N/A ,$134.19 ,$160.65 ,$160.65 ,$160.65 , N/A , N/A ,$160.65 , N/A ,$189.00 ,$106.03 , N/A ,$78.25 , N/A , N/A , N/A ,$160.65 , N/A ,$112.64 ,$52.92 ,$170.10 , N/A ,$160.65 ,$159.71 ,$159.71 , N/A ,$122.85 ST. JOSEPH'S HOSPITAL - BREESE,71000233,N/A,HC PHASE I RECOVERY 30 MIN,710,1 ,"$1,381.00 ",$994.32 ,$386.68 ,"$1,381.00 ", N/A ,$897.65 ,$824.46 , N/A ,$386.68 ,$914.22 , N/A ,$914.22 , N/A ,$823.08 ,$823.08 , N/A ,$823.08 , N/A ,"$1,063.37 ", N/A , N/A , N/A ,"$1,035.75 ",$980.51 ,$980.51 , N/A ,$980.51 ,"$1,173.85 ","$1,173.85 ","$1,173.85 ", N/A , N/A ,"$1,173.85 ", N/A ,"$1,381.00 ",$774.74 , N/A ,$571.73 , N/A , N/A , N/A ,"$1,173.85 ", N/A ,$823.08 ,$386.68 ,"$1,242.90 ", N/A ,"$1,173.85 ","$1,166.95 ","$1,166.95 ", N/A ,$897.65 ST. JOSEPH'S HOSPITAL - BREESE,71000234,N/A,HC PHASE I RECOVERY 15 MIN,710,1 ,$267.00 ,$192.24 ,$74.76 ,$267.00 , N/A ,$173.55 ,$159.40 , N/A ,$74.76 ,$176.75 , N/A ,$176.75 , N/A ,$159.13 ,$159.13 , N/A ,$159.13 , N/A ,$205.59 , N/A , N/A , N/A ,$200.25 ,$189.57 ,$189.57 , N/A ,$189.57 ,$226.95 ,$226.95 ,$226.95 , N/A , N/A ,$226.95 , N/A ,$267.00 ,$149.79 , N/A ,$110.54 , N/A , N/A , N/A ,$226.95 , N/A ,$159.13 ,$74.76 ,$240.30 , N/A ,$226.95 ,$225.62 ,$225.62 , N/A ,$173.55 ST. JOSEPH'S HOSPITAL - BREESE,71000252,N/A,HC RECOVERY EXTENDED INIT HR,710,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 , N/A ,$29.25 ,$26.87 , N/A ,$12.60 ,$29.79 , N/A ,$29.79 , N/A ,$26.82 ,$26.82 , N/A ,$26.82 , N/A ,$34.65 , N/A , N/A , N/A ,$33.75 ,$31.95 ,$31.95 , N/A ,$31.95 ,$38.25 ,$38.25 ,$38.25 , N/A , N/A ,$38.25 , N/A ,$45.00 ,$25.25 , N/A ,$18.63 , N/A , N/A , N/A ,$38.25 , N/A ,$26.82 ,$12.60 ,$40.50 , N/A ,$38.25 ,$38.03 ,$38.03 , N/A ,$29.25 ST. JOSEPH'S HOSPITAL - BREESE,71000253,N/A,HC RECOVERY EXTENDED ADDL HR,710,1 ,$41.00 ,$29.52 ,$11.48 ,$41.00 , N/A ,$26.65 ,$24.48 , N/A ,$11.48 ,$27.14 , N/A ,$27.14 , N/A ,$24.44 ,$24.44 , N/A ,$24.44 , N/A ,$31.57 , N/A , N/A , N/A ,$30.75 ,$29.11 ,$29.11 , N/A ,$29.11 ,$34.85 ,$34.85 ,$34.85 , N/A , N/A ,$34.85 , N/A ,$41.00 ,$23.00 , N/A ,$16.97 , N/A , N/A , N/A ,$34.85 , N/A ,$24.44 ,$11.48 ,$36.90 , N/A ,$34.85 ,$34.65 ,$34.65 , N/A ,$26.65 ST. JOSEPH'S HOSPITAL - BREESE,71000256,N/A,HC C-SECTION RECOVERY ADDL 15MIN,710,1 ,$283.00 ,$203.76 ,$79.24 ,$283.00 , N/A ,$183.95 ,$168.95 , N/A ,$79.24 ,$187.35 , N/A ,$187.35 , N/A ,$168.67 ,$168.67 , N/A ,$168.67 , N/A ,$217.91 , N/A , N/A , N/A ,$212.25 ,$200.93 ,$200.93 , N/A ,$200.93 ,$240.55 ,$240.55 ,$240.55 , N/A , N/A ,$240.55 , N/A ,$283.00 ,$158.76 , N/A ,$117.16 , N/A , N/A , N/A ,$240.55 , N/A ,$168.67 ,$79.24 ,$254.70 , N/A ,$240.55 ,$239.14 ,$239.14 , N/A ,$183.95 ST. JOSEPH'S HOSPITAL - BREESE,72000008,59412,HC EXTERNAL CEPHALIC VERSION,720,1 ,$839.00 ,$604.08 ,$234.92 ,"$6,788.26 ","$6,788.25 ",$545.35 ,$500.88 ,"$2,660.99 ",$234.92 ,$555.42 ,"$2,660.99 ",$555.42 ,$822.22 ,$500.04 ,$500.04 ,$822.22 ,$500.04 ,$839.00 ,$646.03 ,"$6,788.26 ","$2,660.99 ",$822.22 ,$629.25 ,$595.69 ,$595.69 ,"$2,660.99 ",$595.69 ,$713.15 ,$713.15 ,$713.15 , N/A ,$839.00 ,$713.15 ,$822.22 ,$839.00 ,$470.68 ,"$2,660.99 ",$347.35 , N/A , N/A ,"$2,660.99 ",$713.15 ,"$5,702.14 ",$500.04 ,$234.92 ,$755.10 ,"$2,660.99 ",$713.15 ,$708.96 ,$708.96 ,"$2,660.99 ",$545.35 ST. JOSEPH'S HOSPITAL - BREESE,72000013,N/A,HC DELIVERY COMPLICATED,720,1 ,"$3,724.00 ","$2,681.28 ","$1,042.72 ","$3,724.00 ", N/A ,"$2,420.60 ","$2,223.23 ", N/A ,"$1,042.72 ","$2,465.29 ", N/A ,"$2,465.29 ", N/A ,"$2,219.50 ","$2,219.50 ", N/A ,"$2,219.50 ", N/A ,"$2,867.48 ", N/A , N/A , N/A ,"$2,793.00 ","$2,644.04 ","$2,644.04 ", N/A ,"$2,644.04 ","$3,165.40 ","$3,165.40 ","$3,165.40 ", N/A , N/A ,"$3,165.40 ", N/A ,"$3,724.00 ","$2,089.16 ", N/A ,"$1,541.74 ", N/A , N/A , N/A ,"$3,165.40 ", N/A ,"$2,219.50 ","$1,042.72 ","$3,351.60 ", N/A ,"$3,165.40 ","$3,146.78 ","$3,146.78 ", N/A ,"$2,420.60 " ST. JOSEPH'S HOSPITAL - BREESE,72100005,N/A,HC LABOR PER HR,721,1 ,$141.00 ,$101.52 ,$39.48 ,$141.00 , N/A ,$91.65 ,$84.18 , N/A ,$39.48 ,$93.34 , N/A ,$93.34 , N/A ,$84.04 ,$84.04 , N/A ,$84.04 , N/A ,$108.57 , N/A , N/A , N/A ,$105.75 ,$100.11 ,$100.11 , N/A ,$100.11 ,$119.85 ,$119.85 ,$119.85 , N/A , N/A ,$119.85 , N/A ,$141.00 ,$79.10 , N/A ,$58.37 , N/A , N/A , N/A ,$119.85 , N/A ,$84.04 ,$39.48 ,$126.90 , N/A ,$119.85 ,$119.15 ,$119.15 , N/A ,$91.65 ST. JOSEPH'S HOSPITAL - BREESE,72200009,N/A,HC DELIVERY,722,1 ,"$3,353.00 ","$2,414.16 ",$938.84 ,"$3,353.00 ", N/A ,"$2,179.45 ","$2,001.74 ", N/A ,$938.84 ,"$2,219.69 ", N/A ,"$2,219.69 ", N/A ,"$1,998.39 ","$1,998.39 ", N/A ,"$1,998.39 ", N/A ,"$2,581.81 ", N/A , N/A , N/A ,"$2,514.75 ","$2,380.63 ","$2,380.63 ", N/A ,"$2,380.63 ","$2,850.05 ","$2,850.05 ","$2,850.05 ", N/A , N/A ,"$2,850.05 ", N/A ,"$3,353.00 ","$1,881.03 ", N/A ,"$1,388.14 ", N/A , N/A , N/A ,"$2,850.05 ", N/A ,"$1,998.39 ",$938.84 ,"$3,017.70 ", N/A ,"$2,850.05 ","$2,833.29 ","$2,833.29 ", N/A ,"$2,179.45 " ST. JOSEPH'S HOSPITAL - BREESE,72200014,N/A,HC C-SECTION,722,1 ,"$8,723.00 ","$6,280.56 ","$2,442.44 ","$8,723.00 ", N/A ,"$5,669.95 ","$5,207.63 ", N/A ,"$2,442.44 ","$5,774.63 ", N/A ,"$5,774.63 ", N/A ,"$5,198.91 ","$5,198.91 ", N/A ,"$5,198.91 ", N/A ,"$6,716.71 ", N/A , N/A , N/A ,"$6,542.25 ","$6,193.33 ","$6,193.33 ", N/A ,"$6,193.33 ","$7,414.55 ","$7,414.55 ","$7,414.55 ", N/A , N/A ,"$7,414.55 ", N/A ,"$8,723.00 ","$4,893.60 ", N/A ,"$3,611.32 ", N/A , N/A , N/A ,"$7,414.55 ", N/A ,"$5,198.91 ","$2,442.44 ","$7,850.70 ", N/A ,"$7,414.55 ","$7,370.94 ","$7,370.94 ", N/A ,"$5,669.95 " ST. JOSEPH'S HOSPITAL - BREESE,72200015,N/A,HC C-SECTION COMPLICATED,722,1 ,"$9,482.00 ","$6,827.04 ","$2,654.96 ","$9,482.00 ", N/A ,"$6,163.30 ","$5,660.75 ", N/A ,"$2,654.96 ","$6,277.08 ", N/A ,"$6,277.08 ", N/A ,"$5,651.27 ","$5,651.27 ", N/A ,"$5,651.27 ", N/A ,"$7,301.14 ", N/A , N/A , N/A ,"$7,111.50 ","$6,732.22 ","$6,732.22 ", N/A ,"$6,732.22 ","$8,059.70 ","$8,059.70 ","$8,059.70 ", N/A , N/A ,"$8,059.70 ", N/A ,"$9,482.00 ","$5,319.40 ", N/A ,"$3,925.55 ", N/A , N/A , N/A ,"$8,059.70 ", N/A ,"$5,651.27 ","$2,654.96 ","$8,533.80 ", N/A ,"$8,059.70 ","$8,012.29 ","$8,012.29 ", N/A ,"$6,163.30 " ST. JOSEPH'S HOSPITAL - BREESE,72300002,54160,HC CIRCUMCISION,723,1 ,$537.00 ,$386.64 ,$150.36 ,"$1,501.35 ","$1,501.35 ",$349.05 ,$320.59 ,$588.53 ,$150.36 ,$355.49 ,$588.53 ,$355.49 ,$526.26 ,$320.05 ,$320.05 ,$526.26 ,$320.05 ,$537.00 ,$413.49 ,"$1,501.35 ",$588.53 ,$526.26 ,$402.75 ,$381.27 ,$381.27 ,$588.53 ,$381.27 ,$456.45 ,$456.45 ,$456.45 , N/A ,$537.00 ,$456.45 ,$526.26 ,$537.00 ,$301.26 ,$588.53 ,$222.32 , N/A , N/A ,$588.53 ,$456.45 ,"$1,261.13 ",$320.05 ,$150.36 ,$483.30 ,$588.53 ,$456.45 ,$453.77 ,$453.77 ,$588.53 ,$349.05 ST. JOSEPH'S HOSPITAL - BREESE,73000002,93005,HC EKG,730,1 ,$407.00 ,$293.04 ,$17.33 ,$407.00 ,$138.00 ,$264.55 ,$242.98 ,$54.10 ,$113.96 ,$269.43 ,$54.10 ,$269.43 ,$54.10 ,$242.57 ,$242.57 ,$54.10 ,$242.57 ,$111.50 ,$313.39 ,$138.00 ,$54.10 ,$55.17 ,$305.25 ,$288.97 ,$288.97 ,$54.10 ,$288.97 ,$345.95 ,$345.95 ,$345.95 , N/A ,$138.00 ,$345.95 ,$54.10 ,$407.00 ,$228.33 ,$54.10 ,$168.50 ,$19.06 ,$17.33 ,$54.10 ,$345.95 ,$115.92 ,$242.57 ,$113.96 ,$366.30 ,$54.10 ,$345.95 ,$343.92 ,$343.92 ,$54.10 ,$264.55 ST. JOSEPH'S HOSPITAL - BREESE,73000003,93041,HC EKG RHYTHM STRIP TRACING,730,1 ,$314.00 ,$226.08 ,$17.33 ,$314.00 ,$138.00 ,$204.10 ,$187.46 ,$54.10 ,$87.92 ,$207.87 ,$54.10 ,$207.87 ,$54.10 ,$187.14 ,$187.14 ,$54.10 ,$187.14 ,$111.50 ,$241.78 ,$138.00 ,$54.10 ,$55.17 ,$235.50 ,$222.94 ,$222.94 ,$54.10 ,$222.94 ,$266.90 ,$266.90 ,$266.90 , N/A ,$138.00 ,$266.90 ,$54.10 ,$314.00 ,$176.15 ,$54.10 ,$130.00 ,$19.06 ,$17.33 ,$54.10 ,$266.90 ,$115.92 ,$187.14 ,$87.92 ,$282.60 ,$54.10 ,$266.90 ,$265.33 ,$265.33 ,$54.10 ,$204.10 ST. JOSEPH'S HOSPITAL - BREESE,73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,$871.00 ,$627.12 ,$46.50 ,$871.00 ,$278.78 ,$566.15 ,$519.99 ,$109.28 ,$243.88 ,$576.60 ,$109.28 ,$576.60 ,$109.28 ,$519.12 ,$519.12 ,$109.28 ,$519.12 ,$225.24 ,$670.67 ,$278.76 ,$109.28 ,$111.47 ,$653.25 ,$618.41 ,$618.41 ,$109.28 ,$618.41 ,$740.35 ,$740.35 ,$740.35 , N/A ,$278.76 ,$740.35 ,$109.28 ,$871.00 ,$488.63 ,$109.28 ,$360.59 ,$51.15 ,$46.50 ,$109.28 ,$740.35 ,$234.16 ,$519.12 ,$243.88 ,$783.90 ,$109.28 ,$740.35 ,$736.00 ,$736.00 ,$109.28 ,$566.15 ST. JOSEPH'S HOSPITAL - BREESE,73100002,93226,HC HOLTER SCAN AND REPORT 48 HR,731,1 ,$809.00 ,$582.48 ,$46.50 ,$809.00 ,$278.78 ,$525.85 ,$482.97 ,$109.28 ,$226.52 ,$535.56 ,$109.28 ,$535.56 ,$109.28 ,$482.16 ,$482.16 ,$109.28 ,$482.16 ,$225.24 ,$622.93 ,$278.76 ,$109.28 ,$111.47 ,$606.75 ,$574.39 ,$574.39 ,$109.28 ,$574.39 ,$687.65 ,$687.65 ,$687.65 , N/A ,$278.76 ,$687.65 ,$109.28 ,$809.00 ,$453.85 ,$109.28 ,$334.93 ,$51.15 ,$46.50 ,$109.28 ,$687.65 ,$234.16 ,$482.16 ,$226.52 ,$728.10 ,$109.28 ,$687.65 ,$683.61 ,$683.61 ,$109.28 ,$525.85 ST. JOSEPH'S HOSPITAL - BREESE,73100004,93270,HC CARDIAC EVENT RECORDER,731,1 ,$659.00 ,$474.48 ,$32.94 ,$659.00 ,$84.03 ,$428.35 ,$393.42 ,$32.94 ,$184.52 ,$436.26 ,$32.94 ,$436.26 ,$32.94 ,$392.76 ,$392.76 ,$32.94 ,$392.76 ,$67.90 ,$507.43 ,$84.03 ,$32.94 ,$33.59 ,$494.25 ,$467.89 ,$467.89 ,$32.94 ,$467.89 ,$560.15 ,$560.15 ,$560.15 , N/A ,$84.03 ,$560.15 ,$32.94 ,$659.00 ,$369.70 ,$32.94 ,$272.83 ,$51.15 ,$46.50 ,$32.94 ,$560.15 ,$70.58 ,$392.76 ,$184.52 ,$593.10 ,$32.94 ,$560.15 ,$556.86 ,$556.86 ,$32.94 ,$428.35 ST. JOSEPH'S HOSPITAL - BREESE,73100005,93271,HC CARDIAC EVENT MONITOR,731,1 ,$777.00 ,$559.44 ,$93.93 ,$777.00 ,$239.63 ,$505.05 ,$463.87 ,$93.93 ,$217.56 ,$514.37 ,$93.93 ,$514.37 ,$93.93 ,$463.09 ,$463.09 ,$93.93 ,$463.09 ,$193.62 ,$598.29 ,$239.63 ,$93.93 ,$95.81 ,$582.75 ,$551.67 ,$551.67 ,$93.93 ,$551.67 ,$660.45 ,$660.45 ,$660.45 , N/A ,$239.63 ,$660.45 ,$93.93 ,$777.00 ,$435.90 ,$93.93 ,$321.68 ,$105.00 ,$95.45 ,$93.93 ,$660.45 ,$201.29 ,$463.09 ,$217.56 ,$699.30 ,$93.93 ,$660.45 ,$656.57 ,$656.57 ,$93.93 ,$505.05 ST. JOSEPH'S HOSPITAL - BREESE,74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,"$1,409.00 ","$1,014.48 ",$136.87 ,"$1,409.00 ",$349.15 ,$915.85 ,$841.17 ,$136.87 ,$394.52 ,$932.76 ,$136.87 ,$932.76 ,$136.87 ,$839.76 ,$839.76 ,$136.87 ,$839.76 ,$282.12 ,"$1,084.93 ",$349.16 ,$136.87 ,$139.61 ,"$1,056.75 ","$1,000.39 ","$1,000.39 ",$136.87 ,"$1,000.39 ","$1,197.65 ","$1,197.65 ","$1,197.65 ", N/A ,$349.16 ,"$1,197.65 ",$136.87 ,"$1,409.00 ",$790.45 ,$136.87 ,$583.33 ,$568.08 ,$516.44 ,$136.87 ,"$1,197.65 ",$293.29 ,$839.76 ,$394.52 ,"$1,268.10 ",$136.87 ,"$1,197.65 ",$895.00 ,$895.00 ,$136.87 ,$915.85 ST. JOSEPH'S HOSPITAL - BREESE,74000006,95810,HC SLEEP STUDY,740,1 ,"$6,028.00 ","$4,340.16 ",$516.44 ,"$6,028.00 ","$2,243.30 ","$3,918.20 ","$3,598.72 ",$879.37 ,"$1,687.84 ","$3,990.54 ",$879.37 ,"$3,990.54 ",$879.37 ,"$3,592.69 ","$3,592.69 ",$879.37 ,"$3,592.69 ","$1,812.59 ","$4,641.56 ","$2,243.31 ",$879.37 ,$896.96 ,"$4,521.00 ","$4,279.88 ","$4,279.88 ",$879.37 ,"$4,279.88 ","$5,123.80 ","$5,123.80 ","$5,123.80 ", N/A ,"$2,243.31 ","$5,123.80 ",$879.37 ,"$6,028.00 ","$3,381.71 ",$879.37 ,"$2,495.59 ",$568.08 ,$516.44 ,$879.37 ,"$5,123.80 ","$1,884.38 ","$3,592.69 ","$1,687.84 ","$5,425.20 ",$879.37 ,"$5,123.80 ","$3,422.00 ","$3,422.00 ",$879.37 ,"$3,918.20 " ST. JOSEPH'S HOSPITAL - BREESE,74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$6,821.00 ","$4,911.12 ",$516.44 ,"$6,821.00 ","$2,243.30 ","$4,433.65 ","$4,072.14 ",$879.37 ,"$1,909.88 ","$4,515.50 ",$879.37 ,"$4,515.50 ",$879.37 ,"$4,065.32 ","$4,065.32 ",$879.37 ,"$4,065.32 ","$1,812.59 ","$5,252.17 ","$2,243.31 ",$879.37 ,$896.96 ,"$5,115.75 ","$4,842.91 ","$4,842.91 ",$879.37 ,"$4,842.91 ","$5,797.85 ","$5,797.85 ","$5,797.85 ", N/A ,"$2,243.31 ","$5,797.85 ",$879.37 ,"$6,821.00 ","$3,826.58 ",$879.37 ,"$2,823.89 ",$568.08 ,$516.44 ,$879.37 ,"$5,797.85 ","$1,884.38 ","$4,065.32 ","$1,909.88 ","$6,138.90 ",$879.37 ,"$5,797.85 ","$3,422.00 ","$3,422.00 ",$879.37 ,"$4,433.65 " ST. JOSEPH'S HOSPITAL - BREESE,75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$1,262.00 ",$908.64 ,$353.36 ,"$1,981.93 ","$1,981.93 ",$820.30 ,$753.41 ,$776.91 ,$353.36 ,$835.44 ,$776.91 ,$835.44 ,$776.91 ,$752.15 ,$752.15 ,$776.91 ,$752.15 ,"$1,262.00 ",$971.74 ,"$1,981.93 ",$776.91 ,$792.46 ,$946.50 ,$896.02 ,$896.02 ,$776.91 ,$896.02 ,"$1,072.70 ","$1,072.70 ","$1,072.70 ", N/A ,"$1,262.00 ","$1,072.70 ",$776.91 ,"$1,262.00 ",$707.98 ,$776.91 ,$522.47 ,$512.17 ,$465.61 ,$776.91 ,"$1,072.70 ","$1,664.82 ",$752.15 ,$353.36 ,"$1,135.80 ",$776.91 ,"$1,072.70 ","$1,066.39 ","$1,066.39 ",$776.91 ,$820.30 ST. JOSEPH'S HOSPITAL - BREESE,75000510,49082,HC PARACENTESIS W/O IMAGING,750,1 ,$679.00 ,$488.88 ,$190.12 ,"$1,981.93 ","$1,981.93 ",$441.35 ,$405.36 ,$776.91 ,$190.12 ,$449.50 ,$776.91 ,$449.50 ,$665.42 ,$404.68 ,$404.68 ,$665.42 ,$404.68 ,$679.00 ,$522.83 ,"$1,981.93 ",$776.91 ,$665.42 ,$509.25 ,$482.09 ,$482.09 ,$776.91 ,$482.09 ,$577.15 ,$577.15 ,$577.15 , N/A ,$679.00 ,$577.15 ,$665.42 ,$679.00 ,$380.92 ,$776.91 ,$281.11 ,$512.17 ,$465.61 ,$776.91 ,$577.15 ,"$1,664.82 ",$404.68 ,$190.12 ,$611.10 ,$776.91 ,$577.15 ,$573.76 ,$573.76 ,$776.91 ,$441.35 ST. JOSEPH'S HOSPITAL - BREESE,75001071,N/A,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$5,246.00 ","$3,777.12 ","$1,468.88 ","$5,246.00 ", N/A ,"$3,409.90 ","$3,131.86 ", N/A ,"$1,468.88 ","$3,472.85 ", N/A ,"$3,472.85 ", N/A ,"$3,126.62 ","$3,126.62 ", N/A ,"$3,126.62 ", N/A ,"$4,039.42 ", N/A , N/A , N/A ,"$3,934.50 ","$3,724.66 ","$3,724.66 ", N/A ,"$3,724.66 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,459.10 ", N/A ,"$5,246.00 ","$2,943.01 ", N/A ,"$2,171.84 ", N/A , N/A , N/A ,"$4,459.10 ", N/A ,"$3,126.62 ","$1,468.88 ","$4,721.40 ", N/A ,"$3,129.00 ","$4,432.87 ","$4,432.87 ", N/A ,"$3,409.90 " ST. JOSEPH'S HOSPITAL - BREESE,75001072,N/A,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$3,242.00 ","$2,334.24 ",$907.76 ,"$3,242.00 ", N/A ,"$2,107.30 ","$1,935.47 ", N/A ,$907.76 ,"$2,146.20 ", N/A ,"$2,146.20 ", N/A ,"$1,932.23 ","$1,932.23 ", N/A ,"$1,932.23 ", N/A ,"$2,496.34 ", N/A , N/A , N/A ,"$2,431.50 ","$2,301.82 ","$2,301.82 ", N/A ,"$2,301.82 ","$2,755.70 ","$2,755.70 ","$2,755.70 ", N/A , N/A ,"$2,755.70 ", N/A ,"$3,242.00 ","$1,818.76 ", N/A ,"$1,342.19 ", N/A , N/A , N/A ,"$2,755.70 ", N/A ,"$1,932.23 ",$907.76 ,"$2,917.80 ", N/A ,"$2,755.70 ","$2,739.49 ","$2,739.49 ", N/A ,"$2,107.30 " ST. JOSEPH'S HOSPITAL - BREESE,75001073,N/A,HC EGD W/SUBMUCOSAL INJ - 43236,750,1 ,"$2,750.00 ","$1,980.00 ",$770.00 ,"$2,750.00 ", N/A ,"$1,787.50 ","$1,641.75 ", N/A ,$770.00 ,"$1,820.50 ", N/A ,"$1,820.50 ", N/A ,"$1,639.00 ","$1,639.00 ", N/A ,"$1,639.00 ", N/A ,"$2,117.50 ", N/A , N/A , N/A ,"$2,062.50 ","$1,952.50 ","$1,952.50 ", N/A ,"$1,952.50 ","$2,337.50 ","$2,337.50 ","$2,337.50 ", N/A , N/A ,"$2,337.50 ", N/A ,"$2,750.00 ","$1,542.75 ", N/A ,"$1,138.50 ", N/A , N/A , N/A ,"$2,337.50 ", N/A ,"$1,639.00 ",$770.00 ,"$2,475.00 ", N/A ,"$2,337.50 ","$2,323.75 ","$2,323.75 ", N/A ,"$1,787.50 " ST. JOSEPH'S HOSPITAL - BREESE,75001076,N/A,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001081,N/A,HC EGD W/DILAT STRICTURE - 43245,750,1 ,"$5,166.00 ","$3,719.52 ","$1,446.48 ","$5,166.00 ", N/A ,"$3,357.90 ","$3,084.10 ", N/A ,"$1,446.48 ","$3,419.89 ", N/A ,"$3,419.89 ", N/A ,"$3,078.94 ","$3,078.94 ", N/A ,"$3,078.94 ", N/A ,"$3,977.82 ", N/A , N/A , N/A ,"$3,874.50 ","$3,667.86 ","$3,667.86 ", N/A ,"$3,667.86 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,391.10 ", N/A ,"$5,166.00 ","$2,898.13 ", N/A ,"$2,138.72 ", N/A , N/A , N/A ,"$4,391.10 ", N/A ,"$3,078.94 ","$1,446.48 ","$4,649.40 ", N/A ,"$3,129.00 ","$4,365.27 ","$4,365.27 ", N/A ,"$3,357.90 " ST. JOSEPH'S HOSPITAL - BREESE,75001082,N/A,HC EGD W/PLACEMENT G-TUBE - 43246,750,1 ,"$5,246.00 ","$3,777.12 ","$1,468.88 ","$5,246.00 ", N/A ,"$3,409.90 ","$3,131.86 ", N/A ,"$1,468.88 ","$3,472.85 ", N/A ,"$3,472.85 ", N/A ,"$3,126.62 ","$3,126.62 ", N/A ,"$3,126.62 ", N/A ,"$4,039.42 ", N/A , N/A , N/A ,"$3,934.50 ","$3,724.66 ","$3,724.66 ", N/A ,"$3,724.66 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,459.10 ", N/A ,"$5,246.00 ","$2,943.01 ", N/A ,"$2,171.84 ", N/A , N/A , N/A ,"$4,459.10 ", N/A ,"$3,126.62 ","$1,468.88 ","$4,721.40 ", N/A ,"$3,129.00 ","$4,432.87 ","$4,432.87 ", N/A ,"$3,409.90 " ST. JOSEPH'S HOSPITAL - BREESE,75001083,N/A,HC EGD W/FB REMOVAL - 43247,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001084,N/A,HC EGD W/INSERT GUIDEWIRE - 43248,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001085,N/A,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001086,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$5,502.00 ","$3,961.44 ","$1,540.56 ","$5,502.00 ", N/A ,"$3,576.30 ","$3,284.69 ", N/A ,"$1,540.56 ","$3,642.32 ", N/A ,"$3,642.32 ", N/A ,"$3,279.19 ","$3,279.19 ", N/A ,"$3,279.19 ", N/A ,"$4,236.54 ", N/A , N/A , N/A ,"$4,126.50 ","$3,906.42 ","$3,906.42 ", N/A ,"$3,906.42 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,676.70 ", N/A ,"$5,502.00 ","$3,086.62 ", N/A ,"$2,277.83 ", N/A , N/A , N/A ,"$4,676.70 ", N/A ,"$3,279.19 ","$1,540.56 ","$4,951.80 ", N/A ,"$3,129.00 ","$4,649.19 ","$4,649.19 ", N/A ,"$3,576.30 " ST. JOSEPH'S HOSPITAL - BREESE,75001087,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$5,502.00 ","$3,961.44 ","$1,540.56 ","$5,502.00 ", N/A ,"$3,576.30 ","$3,284.69 ", N/A ,"$1,540.56 ","$3,642.32 ", N/A ,"$3,642.32 ", N/A ,"$3,279.19 ","$3,279.19 ", N/A ,"$3,279.19 ", N/A ,"$4,236.54 ", N/A , N/A , N/A ,"$4,126.50 ","$3,906.42 ","$3,906.42 ", N/A ,"$3,906.42 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,676.70 ", N/A ,"$5,502.00 ","$3,086.62 ", N/A ,"$2,277.83 ", N/A , N/A , N/A ,"$4,676.70 ", N/A ,"$3,279.19 ","$1,540.56 ","$4,951.80 ", N/A ,"$3,129.00 ","$4,649.19 ","$4,649.19 ", N/A ,"$3,576.30 " ST. JOSEPH'S HOSPITAL - BREESE,75001090,N/A,HC EGD W/CONTROL BLEEDING - 43255,750,1 ,"$5,404.00 ","$3,890.88 ","$1,513.12 ","$5,404.00 ", N/A ,"$3,512.60 ","$3,226.19 ", N/A ,"$1,513.12 ","$3,577.45 ", N/A ,"$3,577.45 ", N/A ,"$3,220.78 ","$3,220.78 ", N/A ,"$3,220.78 ", N/A ,"$4,161.08 ", N/A , N/A , N/A ,"$4,053.00 ","$3,836.84 ","$3,836.84 ", N/A ,"$3,836.84 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,593.40 ", N/A ,"$5,404.00 ","$3,031.64 ", N/A ,"$2,237.26 ", N/A , N/A , N/A ,"$4,593.40 ", N/A ,"$3,220.78 ","$1,513.12 ","$4,863.60 ", N/A ,"$3,129.00 ","$4,566.38 ","$4,566.38 ", N/A ,"$3,512.60 " ST. JOSEPH'S HOSPITAL - BREESE,75001096,N/A,HC ERCP W/SPHINCTEROTOMY - 43262,750,1 ,"$9,474.00 ","$6,821.28 ","$2,652.72 ","$9,474.00 ", N/A ,"$6,158.10 ","$5,655.98 ", N/A ,"$2,652.72 ","$6,271.79 ", N/A ,"$6,271.79 ", N/A ,"$5,646.50 ","$5,646.50 ", N/A ,"$5,646.50 ", N/A ,"$7,294.98 ", N/A , N/A , N/A ,"$7,105.50 ","$6,726.54 ","$6,726.54 ", N/A ,"$6,726.54 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$8,052.90 ", N/A ,"$9,474.00 ","$5,314.91 ", N/A ,"$3,922.24 ", N/A , N/A , N/A ,"$8,052.90 ", N/A ,"$5,646.50 ","$2,652.72 ","$8,526.60 ", N/A ,"$3,129.00 ","$8,005.53 ","$8,005.53 ", N/A ,"$6,158.10 " ST. JOSEPH'S HOSPITAL - BREESE,75001097,N/A,HC ERCP W/SPHINCTER PRESSURE MEASUREMENT - 43263,750,1 ,"$5,697.00 ","$4,101.84 ","$1,595.16 ","$5,697.00 ", N/A ,"$3,703.05 ","$3,401.11 ", N/A ,"$1,595.16 ","$3,771.41 ", N/A ,"$3,771.41 ", N/A ,"$3,395.41 ","$3,395.41 ", N/A ,"$3,395.41 ", N/A ,"$4,386.69 ", N/A , N/A , N/A ,"$4,272.75 ","$4,044.87 ","$4,044.87 ", N/A ,"$4,044.87 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,842.45 ", N/A ,"$5,697.00 ","$3,196.02 ", N/A ,"$2,358.56 ", N/A , N/A , N/A ,"$4,842.45 ", N/A ,"$3,395.41 ","$1,595.16 ","$5,127.30 ", N/A ,"$3,129.00 ","$4,813.97 ","$4,813.97 ", N/A ,"$3,703.05 " ST. JOSEPH'S HOSPITAL - BREESE,75001098,N/A,HC ERCP W/STONE REMOVAL DUCT - 43264,750,1 ,"$10,289.00 ","$7,408.08 ","$2,880.92 ","$10,289.00 ", N/A ,"$6,687.85 ","$6,142.53 ", N/A ,"$2,880.92 ","$6,811.32 ", N/A ,"$6,811.32 ", N/A ,"$6,132.24 ","$6,132.24 ", N/A ,"$6,132.24 ", N/A ,"$7,922.53 ", N/A , N/A , N/A ,"$7,716.75 ","$7,305.19 ","$7,305.19 ", N/A ,"$7,305.19 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$8,745.65 ", N/A ,"$10,289.00 ","$5,772.13 ", N/A ,"$4,259.65 ", N/A , N/A , N/A ,"$8,745.65 ", N/A ,"$6,132.24 ","$2,880.92 ","$9,260.10 ", N/A ,"$3,129.00 ","$8,694.21 ","$8,694.21 ", N/A ,"$6,687.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001099,N/A,HC ERCP W/LITHOTRIPSY - 43265,750,1 ,"$16,378.00 ","$11,792.16 ","$4,585.84 ","$16,378.00 ", N/A ,"$10,645.70 ","$9,777.67 ", N/A ,"$4,585.84 ","$10,842.24 ", N/A ,"$10,842.24 ", N/A ,"$9,761.29 ","$9,761.29 ", N/A ,"$9,761.29 ", N/A ,"$12,611.06 ", N/A , N/A , N/A ,"$12,283.50 ","$11,628.38 ","$11,628.38 ", N/A ,"$11,628.38 ","$13,921.30 ","$13,921.30 ","$13,921.30 ", N/A , N/A ,"$13,921.30 ", N/A ,"$16,378.00 ","$9,188.06 ", N/A ,"$6,780.49 ", N/A , N/A , N/A ,"$13,921.30 ", N/A ,"$9,761.29 ","$4,585.84 ","$14,740.20 ", N/A ,"$13,921.30 ","$13,839.41 ","$13,839.41 ", N/A ,"$10,645.70 " ST. JOSEPH'S HOSPITAL - BREESE,75001100,N/A,HC ERCP W/STENT PLACEMENT DUCT - 43274,750,1 ,"$16,378.00 ","$11,792.16 ","$4,585.84 ","$16,378.00 ", N/A ,"$10,645.70 ","$9,777.67 ", N/A ,"$4,585.84 ","$10,842.24 ", N/A ,"$10,842.24 ", N/A ,"$9,761.29 ","$9,761.29 ", N/A ,"$9,761.29 ", N/A ,"$12,611.06 ", N/A , N/A , N/A ,"$12,283.50 ","$11,628.38 ","$11,628.38 ", N/A ,"$11,628.38 ","$13,921.30 ","$13,921.30 ","$13,921.30 ", N/A , N/A ,"$13,921.30 ", N/A ,"$16,378.00 ","$9,188.06 ", N/A ,"$6,780.49 ", N/A , N/A , N/A ,"$13,921.30 ", N/A ,"$9,761.29 ","$4,585.84 ","$14,740.20 ", N/A ,"$13,921.30 ","$13,839.41 ","$13,839.41 ", N/A ,"$10,645.70 " ST. JOSEPH'S HOSPITAL - BREESE,75001101,N/A,HC ERCP W/FB OR STENT REMOVAL DUCT - 43275,750,1 ,"$10,289.00 ","$7,408.08 ","$2,880.92 ","$10,289.00 ", N/A ,"$6,687.85 ","$6,142.53 ", N/A ,"$2,880.92 ","$6,811.32 ", N/A ,"$6,811.32 ", N/A ,"$6,132.24 ","$6,132.24 ", N/A ,"$6,132.24 ", N/A ,"$7,922.53 ", N/A , N/A , N/A ,"$7,716.75 ","$7,305.19 ","$7,305.19 ", N/A ,"$7,305.19 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$8,745.65 ", N/A ,"$10,289.00 ","$5,772.13 ", N/A ,"$4,259.65 ", N/A , N/A , N/A ,"$8,745.65 ", N/A ,"$6,132.24 ","$2,880.92 ","$9,260.10 ", N/A ,"$3,129.00 ","$8,694.21 ","$8,694.21 ", N/A ,"$6,687.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001102,N/A,HC ERCP W/REM/EXCHG STENT W/DILAT AND WIRE EA - 43276,750,1 ,"$16,378.00 ","$11,792.16 ","$4,585.84 ","$16,378.00 ", N/A ,"$10,645.70 ","$9,777.67 ", N/A ,"$4,585.84 ","$10,842.24 ", N/A ,"$10,842.24 ", N/A ,"$9,761.29 ","$9,761.29 ", N/A ,"$9,761.29 ", N/A ,"$12,611.06 ", N/A , N/A , N/A ,"$12,283.50 ","$11,628.38 ","$11,628.38 ", N/A ,"$11,628.38 ","$13,921.30 ","$13,921.30 ","$13,921.30 ", N/A , N/A ,"$13,921.30 ", N/A ,"$16,378.00 ","$9,188.06 ", N/A ,"$6,780.49 ", N/A , N/A , N/A ,"$13,921.30 ", N/A ,"$9,761.29 ","$4,585.84 ","$14,740.20 ", N/A ,"$13,921.30 ","$13,839.41 ","$13,839.41 ", N/A ,"$10,645.70 " ST. JOSEPH'S HOSPITAL - BREESE,75001103,N/A,HC ERCP W/BALL DILAT DUCT/AMPULLA EA -43277,750,1 ,"$10,289.00 ","$7,408.08 ","$2,880.92 ","$10,289.00 ", N/A ,"$6,687.85 ","$6,142.53 ", N/A ,"$2,880.92 ","$6,811.32 ", N/A ,"$6,811.32 ", N/A ,"$6,132.24 ","$6,132.24 ", N/A ,"$6,132.24 ", N/A ,"$7,922.53 ", N/A , N/A , N/A ,"$7,716.75 ","$7,305.19 ","$7,305.19 ", N/A ,"$7,305.19 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$8,745.65 ", N/A ,"$10,289.00 ","$5,772.13 ", N/A ,"$4,259.65 ", N/A , N/A , N/A ,"$8,745.65 ", N/A ,"$6,132.24 ","$2,880.92 ","$9,260.10 ", N/A ,"$3,129.00 ","$8,694.21 ","$8,694.21 ", N/A ,"$6,687.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001106,N/A,HC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS - 43450,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001109,N/A,HC GASTROSTOMY TUBE PLACE OPEN - 43832,750,1 ,"$3,270.00 ","$2,354.40 ",$915.60 ,"$3,270.00 ", N/A ,"$2,125.50 ","$1,952.19 ", N/A ,$915.60 ,"$2,164.74 ", N/A ,"$2,164.74 ", N/A ,"$1,948.92 ","$1,948.92 ", N/A ,"$1,948.92 ", N/A ,"$2,517.90 ", N/A , N/A , N/A ,"$2,452.50 ","$2,321.70 ","$2,321.70 ", N/A ,"$2,321.70 ","$2,779.50 ","$2,779.50 ","$2,779.50 ", N/A , N/A ,"$2,779.50 ", N/A ,"$3,270.00 ","$1,834.47 ", N/A ,"$1,353.78 ", N/A , N/A , N/A ,"$2,779.50 ", N/A ,"$1,948.92 ",$915.60 ,"$2,943.00 ", N/A ,"$2,779.50 ","$2,763.15 ","$2,763.15 ", N/A ,"$2,125.50 " ST. JOSEPH'S HOSPITAL - BREESE,75001125,N/A,HC COLONOSCOPY STOMA DX W/BRUSH/WASH - 44388,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001126,N/A,HC COLONOSCOPY STOMA W/BX SGL/MULT - 44389,750,1 ,"$3,369.00 ","$2,425.68 ",$943.32 ,"$3,369.00 ", N/A ,"$2,189.85 ","$2,011.29 ", N/A ,$943.32 ,"$2,230.28 ", N/A ,"$2,230.28 ", N/A ,"$2,007.92 ","$2,007.92 ", N/A ,"$2,007.92 ", N/A ,"$2,594.13 ", N/A , N/A , N/A ,"$2,526.75 ","$2,391.99 ","$2,391.99 ", N/A ,"$2,391.99 ","$2,863.65 ","$2,863.65 ","$2,863.65 ", N/A , N/A ,"$2,863.65 ", N/A ,"$3,369.00 ","$1,890.01 ", N/A ,"$1,394.77 ", N/A , N/A , N/A ,"$2,863.65 ", N/A ,"$2,007.92 ",$943.32 ,"$3,032.10 ", N/A ,"$2,863.65 ","$2,846.81 ","$2,846.81 ", N/A ,"$2,189.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001128,N/A,HC COLONOSCOPY STOMA W/CONTROL BLEEDING - 44391,750,1 ,"$3,514.00 ","$2,530.08 ",$983.92 ,"$3,514.00 ", N/A ,"$2,284.10 ","$2,097.86 ", N/A ,$983.92 ,"$2,326.27 ", N/A ,"$2,326.27 ", N/A ,"$2,094.34 ","$2,094.34 ", N/A ,"$2,094.34 ", N/A ,"$2,705.78 ", N/A , N/A , N/A ,"$2,635.50 ","$2,494.94 ","$2,494.94 ", N/A ,"$2,494.94 ","$2,986.90 ","$2,986.90 ","$2,986.90 ", N/A , N/A ,"$2,986.90 ", N/A ,"$3,514.00 ","$1,971.35 ", N/A ,"$1,454.80 ", N/A , N/A , N/A ,"$2,986.90 ", N/A ,"$2,094.34 ",$983.92 ,"$3,162.60 ", N/A ,"$2,986.90 ","$2,969.33 ","$2,969.33 ", N/A ,"$2,284.10 " ST. JOSEPH'S HOSPITAL - BREESE,75001129,N/A,HC COLONOSCOPY STOMA W/REM TUMOR HOT BX - 44392,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001139,N/A,HC PROCTOSIGMOIDOSCOPY RIGID DX W/W/O SPECIMEN - 45300,750,1 ,"$2,673.00 ","$1,924.56 ",$748.44 ,"$2,673.00 ", N/A ,"$1,737.45 ","$1,595.78 ", N/A ,$748.44 ,"$1,769.53 ", N/A ,"$1,769.53 ", N/A ,"$1,593.11 ","$1,593.11 ", N/A ,"$1,593.11 ", N/A ,"$2,058.21 ", N/A , N/A , N/A ,"$2,004.75 ","$1,897.83 ","$1,897.83 ", N/A ,"$1,897.83 ","$2,272.05 ","$2,272.05 ","$2,272.05 ", N/A , N/A ,"$2,272.05 ", N/A ,"$2,673.00 ","$1,499.55 ", N/A ,"$1,106.62 ", N/A , N/A , N/A ,"$2,272.05 ", N/A ,"$1,593.11 ",$748.44 ,"$2,405.70 ", N/A ,"$2,272.05 ","$2,258.69 ","$2,258.69 ", N/A ,"$1,737.45 " ST. JOSEPH'S HOSPITAL - BREESE,75001142,N/A,HC SIGMOIDOSCOPY DX W/BRUSH/WASH - 45330,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001143,N/A,HC SIGMOIDOSCOPY W/BIOPSY SGL/MULT -45331,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001144,N/A,HC SIGMOIDOSCOPY W/FB REMOVAL -45332,750,1 ,"$3,189.00 ","$2,296.08 ",$892.92 ,"$3,189.00 ", N/A ,"$2,072.85 ","$1,903.83 ", N/A ,$892.92 ,"$2,111.12 ", N/A ,"$2,111.12 ", N/A ,"$1,900.64 ","$1,900.64 ", N/A ,"$1,900.64 ", N/A ,"$2,455.53 ", N/A , N/A , N/A ,"$2,391.75 ","$2,264.19 ","$2,264.19 ", N/A ,"$2,264.19 ","$2,710.65 ","$2,710.65 ","$2,710.65 ", N/A , N/A ,"$2,710.65 ", N/A ,"$3,189.00 ","$1,789.03 ", N/A ,"$1,320.25 ", N/A , N/A , N/A ,"$2,710.65 ", N/A ,"$1,900.64 ",$892.92 ,"$2,870.10 ", N/A ,"$2,710.65 ","$2,694.71 ","$2,694.71 ", N/A ,"$2,072.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001145,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY -45333,750,1 ,"$2,441.00 ","$1,757.52 ",$683.48 ,"$2,441.00 ", N/A ,"$1,586.65 ","$1,457.28 ", N/A ,$683.48 ,"$1,615.94 ", N/A ,"$1,615.94 ", N/A ,"$1,454.84 ","$1,454.84 ", N/A ,"$1,454.84 ", N/A ,"$1,879.57 ", N/A , N/A , N/A ,"$1,830.75 ","$1,733.11 ","$1,733.11 ", N/A ,"$1,733.11 ","$2,074.85 ","$2,074.85 ","$2,074.85 ", N/A , N/A ,"$2,074.85 ", N/A ,"$2,441.00 ","$1,369.40 ", N/A ,"$1,010.57 ", N/A , N/A , N/A ,"$2,074.85 ", N/A ,"$1,454.84 ",$683.48 ,"$2,196.90 ", N/A ,"$2,074.85 ","$2,062.65 ","$2,062.65 ", N/A ,"$1,586.65 " ST. JOSEPH'S HOSPITAL - BREESE,75001146,N/A,HC SIGMOIDOSCOPY W/CONTROL BLEEDING - 45334,750,1 ,"$3,360.00 ","$2,419.20 ",$940.80 ,"$3,360.00 ", N/A ,"$2,184.00 ","$2,005.92 ", N/A ,$940.80 ,"$2,224.32 ", N/A ,"$2,224.32 ", N/A ,"$2,002.56 ","$2,002.56 ", N/A ,"$2,002.56 ", N/A ,"$2,587.20 ", N/A , N/A , N/A ,"$2,520.00 ","$2,385.60 ","$2,385.60 ", N/A ,"$2,385.60 ","$2,856.00 ","$2,856.00 ","$2,856.00 ", N/A , N/A ,"$2,856.00 ", N/A ,"$3,360.00 ","$1,884.96 ", N/A ,"$1,391.04 ", N/A , N/A , N/A ,"$2,856.00 ", N/A ,"$2,002.56 ",$940.80 ,"$3,024.00 ", N/A ,"$2,856.00 ","$2,839.20 ","$2,839.20 ", N/A ,"$2,184.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001147,N/A,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJ - 45335,750,1 ,"$2,548.00 ","$1,834.56 ",$713.44 ,"$2,548.00 ", N/A ,"$1,656.20 ","$1,521.16 ", N/A ,$713.44 ,"$1,686.78 ", N/A ,"$1,686.78 ", N/A ,"$1,518.61 ","$1,518.61 ", N/A ,"$1,518.61 ", N/A ,"$1,961.96 ", N/A , N/A , N/A ,"$1,911.00 ","$1,809.08 ","$1,809.08 ", N/A ,"$1,809.08 ","$2,165.80 ","$2,165.80 ","$2,165.80 ", N/A , N/A ,"$2,165.80 ", N/A ,"$2,548.00 ","$1,429.43 ", N/A ,"$1,054.87 ", N/A , N/A , N/A ,"$2,165.80 ", N/A ,"$1,518.61 ",$713.44 ,"$2,293.20 ", N/A ,"$2,165.80 ","$2,153.06 ","$2,153.06 ", N/A ,"$1,656.20 " ST. JOSEPH'S HOSPITAL - BREESE,75001148,N/A,HC SIGMOIDOSCOPY W/DECOMPRESSION -45337,750,1 ,"$2,347.11 ","$1,689.92 ",$657.19 ,"$2,347.11 ", N/A ,"$1,525.62 ","$1,401.22 ", N/A ,$657.19 ,"$1,553.79 ", N/A ,"$1,553.79 ", N/A ,"$1,398.88 ","$1,398.88 ", N/A ,"$1,398.88 ", N/A ,"$1,807.27 ", N/A , N/A , N/A ,"$1,760.33 ","$1,666.45 ","$1,666.45 ", N/A ,"$1,666.45 ","$1,995.04 ","$1,995.04 ","$1,995.04 ", N/A , N/A ,"$1,995.04 ", N/A ,"$2,347.11 ","$1,316.73 ", N/A ,$971.70 , N/A , N/A , N/A ,"$1,995.04 ", N/A ,"$1,398.88 ",$657.19 ,"$2,112.40 ", N/A ,"$1,995.04 ","$1,983.31 ","$1,983.31 ", N/A ,"$1,525.62 " ST. JOSEPH'S HOSPITAL - BREESE,75001149,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45338,750,1 ,"$3,358.00 ","$2,417.76 ",$940.24 ,"$3,358.00 ", N/A ,"$2,182.70 ","$2,004.73 ", N/A ,$940.24 ,"$2,223.00 ", N/A ,"$2,223.00 ", N/A ,"$2,001.37 ","$2,001.37 ", N/A ,"$2,001.37 ", N/A ,"$2,585.66 ", N/A , N/A , N/A ,"$2,518.50 ","$2,384.18 ","$2,384.18 ", N/A ,"$2,384.18 ","$2,854.30 ","$2,854.30 ","$2,854.30 ", N/A , N/A ,"$2,854.30 ", N/A ,"$3,358.00 ","$1,883.84 ", N/A ,"$1,390.21 ", N/A , N/A , N/A ,"$2,854.30 ", N/A ,"$2,001.37 ",$940.24 ,"$3,022.20 ", N/A ,"$2,854.30 ","$2,837.51 ","$2,837.51 ", N/A ,"$2,182.70 " ST. JOSEPH'S HOSPITAL - BREESE,75001155,N/A,HC SIGMOIDOSCOPY W/ENDO MUCOSAL RESECTION - 45349,750,1 ,"$7,839.00 ","$5,644.08 ","$2,194.92 ","$7,839.00 ", N/A ,"$5,095.35 ","$4,679.88 ", N/A ,"$2,194.92 ","$5,189.42 ", N/A ,"$5,189.42 ", N/A ,"$4,672.04 ","$4,672.04 ", N/A ,"$4,672.04 ", N/A ,"$6,036.03 ", N/A , N/A , N/A ,"$5,879.25 ","$5,565.69 ","$5,565.69 ", N/A ,"$5,565.69 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$6,663.15 ", N/A ,"$7,839.00 ","$4,397.68 ", N/A ,"$3,245.35 ", N/A , N/A , N/A ,"$6,663.15 ", N/A ,"$4,672.04 ","$2,194.92 ","$7,055.10 ", N/A ,"$3,129.00 ","$6,623.96 ","$6,623.96 ", N/A ,"$5,095.35 " ST. JOSEPH'S HOSPITAL - BREESE,75001156,N/A,HC SIGMOIDOSCOPY W/BAND LIGATION - 45350,750,1 ,"$3,568.00 ","$2,568.96 ",$999.04 ,"$3,568.00 ", N/A ,"$2,319.20 ","$2,130.10 ", N/A ,$999.04 ,"$2,362.02 ", N/A ,"$2,362.02 ", N/A ,"$2,126.53 ","$2,126.53 ", N/A ,"$2,126.53 ", N/A ,"$2,747.36 ", N/A , N/A , N/A ,"$2,676.00 ","$2,533.28 ","$2,533.28 ", N/A ,"$2,533.28 ","$3,032.80 ","$3,032.80 ","$3,032.80 ", N/A , N/A ,"$3,032.80 ", N/A ,"$3,568.00 ","$2,001.65 ", N/A ,"$1,477.15 ", N/A , N/A , N/A ,"$3,032.80 ", N/A ,"$2,126.53 ",$999.04 ,"$3,211.20 ", N/A ,"$3,032.80 ","$3,014.96 ","$3,014.96 ", N/A ,"$2,319.20 " ST. JOSEPH'S HOSPITAL - BREESE,75001157,N/A,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$3,242.00 ","$2,334.24 ",$907.76 ,"$3,242.00 ", N/A ,"$2,107.30 ","$1,935.47 ", N/A ,$907.76 ,"$2,146.20 ", N/A ,"$2,146.20 ", N/A ,"$1,932.23 ","$1,932.23 ", N/A ,"$1,932.23 ", N/A ,"$2,496.34 ", N/A , N/A , N/A ,"$2,431.50 ","$2,301.82 ","$2,301.82 ", N/A ,"$2,301.82 ","$2,755.70 ","$2,755.70 ","$2,755.70 ", N/A , N/A ,"$2,755.70 ", N/A ,"$3,242.00 ","$1,818.76 ", N/A ,"$1,342.19 ", N/A , N/A , N/A ,"$2,755.70 ", N/A ,"$1,932.23 ",$907.76 ,"$2,917.80 ", N/A ,"$2,755.70 ","$2,739.49 ","$2,739.49 ", N/A ,"$2,107.30 " ST. JOSEPH'S HOSPITAL - BREESE,75001159,N/A,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001160,N/A,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001161,N/A,HC COLONOSCOPY W/CONTROL BLEEDING - 45382,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001162,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001163,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001164,N/A,HC COLONOSCOPY W/BALLOON DILATION - 45386,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001165,N/A,HC COLONOSCOPY W/ABLATION TUMOR - 45388,750,1 ,"$3,358.00 ","$2,417.76 ",$940.24 ,"$3,358.00 ", N/A ,"$2,182.70 ","$2,004.73 ", N/A ,$940.24 ,"$2,223.00 ", N/A ,"$2,223.00 ", N/A ,"$2,001.37 ","$2,001.37 ", N/A ,"$2,001.37 ", N/A ,"$2,585.66 ", N/A , N/A , N/A ,"$2,518.50 ","$2,384.18 ","$2,384.18 ", N/A ,"$2,384.18 ","$2,854.30 ","$2,854.30 ","$2,854.30 ", N/A , N/A ,"$2,854.30 ", N/A ,"$3,358.00 ","$1,883.84 ", N/A ,"$1,390.21 ", N/A , N/A , N/A ,"$2,854.30 ", N/A ,"$2,001.37 ",$940.24 ,"$3,022.20 ", N/A ,"$2,854.30 ","$2,837.51 ","$2,837.51 ", N/A ,"$2,182.70 " ST. JOSEPH'S HOSPITAL - BREESE,75001167,N/A,HC COLONOSCOPY W/MUCOSAL RESECTION - 45390,750,1 ,"$7,839.00 ","$5,644.08 ","$2,194.92 ","$7,839.00 ", N/A ,"$5,095.35 ","$4,679.88 ", N/A ,"$2,194.92 ","$5,189.42 ", N/A ,"$5,189.42 ", N/A ,"$4,672.04 ","$4,672.04 ", N/A ,"$4,672.04 ", N/A ,"$6,036.03 ", N/A , N/A , N/A ,"$5,879.25 ","$5,565.69 ","$5,565.69 ", N/A ,"$5,565.69 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$6,663.15 ", N/A ,"$7,839.00 ","$4,397.68 ", N/A ,"$3,245.35 ", N/A , N/A , N/A ,"$6,663.15 ", N/A ,"$4,672.04 ","$2,194.92 ","$7,055.10 ", N/A ,"$3,129.00 ","$6,623.96 ","$6,623.96 ", N/A ,"$5,095.35 " ST. JOSEPH'S HOSPITAL - BREESE,75001171,N/A,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$3,600.00 ","$2,592.00 ","$1,008.00 ","$3,600.00 ", N/A ,"$2,340.00 ","$2,149.20 ", N/A ,"$1,008.00 ","$2,383.20 ", N/A ,"$2,383.20 ", N/A ,"$2,145.60 ","$2,145.60 ", N/A ,"$2,145.60 ", N/A ,"$2,772.00 ", N/A , N/A , N/A ,"$2,700.00 ","$2,556.00 ","$2,556.00 ", N/A ,"$2,556.00 ","$3,060.00 ","$3,060.00 ","$3,060.00 ", N/A , N/A ,"$3,060.00 ", N/A ,"$3,600.00 ","$2,019.60 ", N/A ,"$1,490.40 ", N/A , N/A , N/A ,"$3,060.00 ", N/A ,"$2,145.60 ","$1,008.00 ","$3,240.00 ", N/A ,"$3,060.00 ","$3,042.00 ","$3,042.00 ", N/A ,"$2,340.00 " ST. JOSEPH'S HOSPITAL - BREESE,75001173,N/A,HC HERMORRHOIDECTOMY INTERNAL W/LIGATION - 46221,750,1 ,"$2,309.00 ","$1,662.48 ",$646.52 ,"$2,309.00 ", N/A ,"$1,500.85 ","$1,378.47 ", N/A ,$646.52 ,"$1,528.56 ", N/A ,"$1,528.56 ", N/A ,"$1,376.16 ","$1,376.16 ", N/A ,"$1,376.16 ", N/A ,"$1,777.93 ", N/A , N/A , N/A ,"$1,731.75 ","$1,639.39 ","$1,639.39 ", N/A ,"$1,639.39 ","$1,962.65 ","$1,962.65 ","$1,962.65 ", N/A , N/A ,"$1,962.65 ", N/A ,"$2,309.00 ","$1,295.35 ", N/A ,$955.93 , N/A , N/A , N/A ,"$1,962.65 ", N/A ,"$1,376.16 ",$646.52 ,"$2,078.10 ", N/A ,"$1,962.65 ","$1,951.11 ","$1,951.11 ", N/A ,"$1,500.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001174,N/A,HC ANOSCOPY DX W/SPECIMEN -46600,750,1 ,"$2,371.00 ","$1,707.12 ",$663.88 ,"$2,371.00 ", N/A ,"$1,541.15 ","$1,415.49 ", N/A ,$663.88 ,"$1,569.60 ", N/A ,"$1,569.60 ", N/A ,"$1,413.12 ","$1,413.12 ", N/A ,"$1,413.12 ", N/A ,"$1,825.67 ", N/A , N/A , N/A ,"$1,778.25 ","$1,683.41 ","$1,683.41 ", N/A ,"$1,683.41 ","$2,015.35 ","$2,015.35 ","$2,015.35 ", N/A , N/A ,"$2,015.35 ", N/A ,"$2,371.00 ","$1,330.13 ", N/A ,$981.59 , N/A , N/A , N/A ,"$2,015.35 ", N/A ,"$1,413.12 ",$663.88 ,"$2,133.90 ", N/A ,"$2,015.35 ","$2,003.50 ","$2,003.50 ", N/A ,"$1,541.15 " ST. JOSEPH'S HOSPITAL - BREESE,75001176,N/A,HC ANOSCOPY W/BIOPSY SGL/MULT - 46606,750,1 ,"$3,189.00 ","$2,296.08 ",$892.92 ,"$3,189.00 ", N/A ,"$2,072.85 ","$1,903.83 ", N/A ,$892.92 ,"$2,111.12 ", N/A ,"$2,111.12 ", N/A ,"$1,900.64 ","$1,900.64 ", N/A ,"$1,900.64 ", N/A ,"$2,455.53 ", N/A , N/A , N/A ,"$2,391.75 ","$2,264.19 ","$2,264.19 ", N/A ,"$2,264.19 ","$2,710.65 ","$2,710.65 ","$2,710.65 ", N/A , N/A ,"$2,710.65 ", N/A ,"$3,189.00 ","$1,789.03 ", N/A ,"$1,320.25 ", N/A , N/A , N/A ,"$2,710.65 ", N/A ,"$1,900.64 ",$892.92 ,"$2,870.10 ", N/A ,"$2,710.65 ","$2,694.71 ","$2,694.71 ", N/A ,"$2,072.85 " ST. JOSEPH'S HOSPITAL - BREESE,75001177,N/A,HC ANOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 46610,750,1 ,"$7,839.00 ","$5,644.08 ","$2,194.92 ","$7,839.00 ", N/A ,"$5,095.35 ","$4,679.88 ", N/A ,"$2,194.92 ","$5,189.42 ", N/A ,"$5,189.42 ", N/A ,"$4,672.04 ","$4,672.04 ", N/A ,"$4,672.04 ", N/A ,"$6,036.03 ", N/A , N/A , N/A ,"$5,879.25 ","$5,565.69 ","$5,565.69 ", N/A ,"$5,565.69 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$6,663.15 ", N/A ,"$7,839.00 ","$4,397.68 ", N/A ,"$3,245.35 ", N/A , N/A , N/A ,"$6,663.15 ", N/A ,"$4,672.04 ","$2,194.92 ","$7,055.10 ", N/A ,"$3,129.00 ","$6,623.96 ","$6,623.96 ", N/A ,"$5,095.35 " ST. JOSEPH'S HOSPITAL - BREESE,75001178,N/A,HC EXCISION ANAL LESIONS SIMPLE - 46922,750,1 ,"$5,246.00 ","$3,777.12 ","$1,468.88 ","$5,246.00 ", N/A ,"$3,409.90 ","$3,131.86 ", N/A ,"$1,468.88 ","$3,472.85 ", N/A ,"$3,472.85 ", N/A ,"$3,126.62 ","$3,126.62 ", N/A ,"$3,126.62 ", N/A ,"$4,039.42 ", N/A , N/A , N/A ,"$3,934.50 ","$3,724.66 ","$3,724.66 ", N/A ,"$3,724.66 ","$3,129.00 ","$3,129.00 ","$3,129.00 ", N/A , N/A ,"$4,459.10 ", N/A ,"$5,246.00 ","$2,943.01 ", N/A ,"$2,171.84 ", N/A , N/A , N/A ,"$4,459.10 ", N/A ,"$3,126.62 ","$1,468.88 ","$4,721.40 ", N/A ,"$3,129.00 ","$4,432.87 ","$4,432.87 ", N/A ,"$3,409.90 " ST. JOSEPH'S HOSPITAL - BREESE,75001179,N/A,HC LAP CHOLECYSTECTOMY W/CHOLANG - 47563,750,1 ,"$16,252.00 ","$11,701.44 ","$4,550.56 ","$16,252.00 ", N/A ,"$10,563.80 ","$9,702.44 ", N/A ,"$4,550.56 ","$10,758.82 ", N/A ,"$10,758.82 ", N/A ,"$9,686.19 ","$9,686.19 ", N/A ,"$9,686.19 ", N/A ,"$12,514.04 ", N/A , N/A , N/A ,"$12,189.00 ","$11,538.92 ","$11,538.92 ", N/A ,"$11,538.92 ","$13,814.20 ","$13,814.20 ","$13,814.20 ", N/A , N/A ,"$13,814.20 ", N/A ,"$16,252.00 ","$9,117.37 ", N/A ,"$6,728.33 ", N/A , N/A , N/A ,"$13,814.20 ", N/A ,"$9,686.19 ","$4,550.56 ","$14,626.80 ", N/A ,"$13,814.20 ","$13,732.94 ","$13,732.94 ", N/A ,"$10,563.80 " ST. JOSEPH'S HOSPITAL - BREESE,75001202,N/A,HC REPLACE GASTRO TUBE PERC - 43762,750,1 ,$843.00 ,$606.96 ,$236.04 ,$843.00 , N/A ,$547.95 ,$503.27 , N/A ,$236.04 ,$558.07 , N/A ,$558.07 , N/A ,$502.43 ,$502.43 , N/A ,$502.43 , N/A ,$649.11 , N/A , N/A , N/A ,$632.25 ,$598.53 ,$598.53 , N/A ,$598.53 ,$716.55 ,$716.55 ,$716.55 , N/A , N/A ,$716.55 , N/A ,$843.00 ,$472.92 , N/A ,$349.00 , N/A , N/A , N/A ,$716.55 , N/A ,$502.43 ,$236.04 ,$758.70 , N/A ,$716.55 ,$712.34 ,$712.34 , N/A ,$547.95 ST. JOSEPH'S HOSPITAL - BREESE,75001203,N/A,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT - 43763,750,1 ,$843.00 ,$606.96 ,$236.04 ,$843.00 , N/A ,$547.95 ,$503.27 , N/A ,$236.04 ,$558.07 , N/A ,$558.07 , N/A ,$502.43 ,$502.43 , N/A ,$502.43 , N/A ,$649.11 , N/A , N/A , N/A ,$632.25 ,$598.53 ,$598.53 , N/A ,$598.53 ,$716.55 ,$716.55 ,$716.55 , N/A , N/A ,$716.55 , N/A ,$843.00 ,$472.92 , N/A ,$349.00 , N/A , N/A , N/A ,$716.55 , N/A ,$502.43 ,$236.04 ,$758.70 , N/A ,$716.55 ,$712.34 ,$712.34 , N/A ,$547.95 ST. JOSEPH'S HOSPITAL - BREESE,75001204,N/A,HC REMOVE G TUBE W/ANESTHESIA - 43999,750,1 ,"$2,773.00 ","$1,996.56 ",$776.44 ,"$2,773.00 ", N/A ,"$1,802.45 ","$1,655.48 ", N/A ,$776.44 ,"$1,835.73 ", N/A ,"$1,835.73 ", N/A ,"$1,652.71 ","$1,652.71 ", N/A ,"$1,652.71 ", N/A ,"$2,135.21 ", N/A , N/A , N/A ,"$2,079.75 ","$1,968.83 ","$1,968.83 ", N/A ,"$1,968.83 ","$2,357.05 ","$2,357.05 ","$2,357.05 ", N/A , N/A ,"$2,357.05 ", N/A ,"$2,773.00 ","$1,555.65 ", N/A ,"$1,148.02 ", N/A , N/A , N/A ,"$2,357.05 ", N/A ,"$1,652.71 ",$776.44 ,"$2,495.70 ", N/A ,"$2,357.05 ","$2,343.19 ","$2,343.19 ", N/A ,"$1,802.45 " ST. JOSEPH'S HOSPITAL - BREESE,75001212,N/A,HC CHEMODENERVATION INTERNAL ANAL SPHINCTER - 46505,750,1 ,"$3,514.00 ","$2,530.08 ",$983.92 ,"$3,514.00 ", N/A ,"$2,284.10 ","$2,097.86 ", N/A ,$983.92 ,"$2,326.27 ", N/A ,"$2,326.27 ", N/A ,"$2,094.34 ","$2,094.34 ", N/A ,"$2,094.34 ", N/A ,"$2,705.78 ", N/A , N/A , N/A ,"$2,635.50 ","$2,494.94 ","$2,494.94 ", N/A ,"$2,494.94 ","$2,986.90 ","$2,986.90 ","$2,986.90 ", N/A , N/A ,"$2,986.90 ", N/A ,"$3,514.00 ","$1,971.35 ", N/A ,"$1,454.80 ", N/A , N/A , N/A ,"$2,986.90 ", N/A ,"$2,094.34 ",$983.92 ,"$3,162.60 ", N/A ,"$2,986.90 ","$2,969.33 ","$2,969.33 ", N/A ,"$2,284.10 " ST. JOSEPH'S HOSPITAL - BREESE,75001216,46220,HC ANAL EXT TAG/PAPILLA,750,1 ,"$3,396.00 ","$2,445.12 ",$441.48 ,"$3,396.00 ","$2,599.90 ","$2,207.40 ","$2,027.41 ","$1,019.16 ",$950.88 ,"$2,248.15 ","$1,019.16 ","$2,248.15 ","$1,019.16 ","$2,024.02 ","$2,024.02 ","$1,019.16 ","$2,024.02 ","$2,100.72 ","$2,614.92 ","$2,599.90 ","$1,019.16 ","$1,039.54 ","$2,547.00 ","$2,411.16 ","$2,411.16 ","$1,019.16 ","$2,411.16 ","$2,886.60 ","$2,886.60 ","$2,886.60 ", N/A ,"$2,599.90 ","$2,886.60 ","$1,019.16 ","$3,396.00 ","$1,905.16 ","$1,019.16 ","$1,405.94 ",$485.63 ,$441.48 ,"$1,019.16 ","$2,886.60 ","$2,183.92 ","$2,024.02 ",$950.88 ,"$3,056.40 ","$1,019.16 ","$2,886.60 ","$2,869.62 ","$2,869.62 ","$1,019.16 ","$2,207.40 " ST. JOSEPH'S HOSPITAL - BREESE,75001223,N/A,HC SMALL BOWEL ENDOSCOPY- 44378,750,1 ,"$2,066.00 ","$1,487.52 ",$578.48 ,"$2,066.00 ", N/A ,"$1,342.90 ","$1,233.40 ", N/A ,$578.48 ,"$1,367.69 ", N/A ,"$1,367.69 ", N/A ,"$1,231.34 ","$1,231.34 ", N/A ,"$1,231.34 ", N/A ,"$1,590.82 ", N/A , N/A , N/A ,"$1,549.50 ","$1,466.86 ","$1,466.86 ", N/A ,"$1,466.86 ","$1,756.10 ","$1,756.10 ","$1,756.10 ", N/A , N/A ,"$1,756.10 ", N/A ,"$2,066.00 ","$1,159.03 ", N/A ,$855.32 , N/A , N/A , N/A ,"$1,756.10 ", N/A ,"$1,231.34 ",$578.48 ,"$1,859.40 ", N/A ,"$1,756.10 ","$1,745.77 ","$1,745.77 ", N/A ,"$1,342.90 " ST. JOSEPH'S HOSPITAL - BREESE,76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$1,119.00 ",$805.68 ,$313.32 ,"$1,546.98 ","$1,546.98 ",$727.35 ,$668.04 ,$606.41 ,$313.32 ,$740.78 ,$606.41 ,$740.78 ,$606.41 ,$666.92 ,$666.92 ,$606.41 ,$666.92 ,"$1,119.00 ",$861.63 ,"$1,546.96 ",$606.41 ,$618.54 ,$839.25 ,$794.49 ,$794.49 ,$606.41 ,$794.49 ,$951.15 ,$951.15 ,$951.15 , N/A ,"$1,119.00 ",$951.15 ,$606.41 ,"$1,119.00 ",$627.76 ,$606.41 ,$463.27 ,$590.49 ,$536.81 ,$606.41 ,$951.15 ,"$1,299.45 ",$666.92 ,$313.32 ,"$1,007.10 ",$606.41 ,$951.15 ,$945.56 ,$945.56 ,$606.41 ,$727.35 ST. JOSEPH'S HOSPITAL - BREESE,76100006,64447,HC INJ ANES NERVE FEMORAL SINGLE-BI,761,1 ,"$3,979.00 ","$2,864.88 ",$253.00 ,"$3,979.00 ","$2,320.45 ","$2,586.35 ","$2,375.46 ",$909.62 ,"$1,114.12 ","$2,634.10 ",$909.62 ,"$2,634.10 ",$909.62 ,"$2,371.48 ","$2,371.48 ",$909.62 ,"$2,371.48 ","$1,874.92 ","$3,063.83 ","$2,320.45 ",$909.62 ,$927.81 ,"$2,984.25 ","$2,825.09 ","$2,825.09 ",$909.62 ,"$2,825.09 ","$3,382.15 ","$3,382.15 ","$3,382.15 ", N/A ,"$2,320.45 ","$3,382.15 ",$909.62 ,"$3,979.00 ","$2,232.22 ",$909.62 ,"$1,647.31 ",$488.38 ,$443.98 ,$909.62 ,"$3,382.15 ","$1,949.17 ","$2,371.48 ","$1,114.12 ","$3,581.10 ",$909.62 ,"$3,382.15 ",$253.00 ,$253.00 ,$909.62 ,"$2,586.35 " ST. JOSEPH'S HOSPITAL - BREESE,76100007,64447,HC INJ ANES NERVE FEMORAL SINGLE-LT,761,1 ,"$2,653.00 ","$1,910.16 ",$253.00 ,"$2,653.00 ","$1,546.98 ","$1,724.45 ","$1,583.84 ",$606.41 ,$742.84 ,"$1,756.29 ",$606.41 ,"$1,756.29 ",$606.41 ,"$1,581.19 ","$1,581.19 ",$606.41 ,"$1,581.19 ","$1,249.95 ","$2,042.81 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,989.75 ","$1,883.63 ","$1,883.63 ",$606.41 ,"$1,883.63 ","$2,255.05 ","$2,255.05 ","$2,255.05 ", N/A ,"$1,546.96 ","$2,255.05 ",$606.41 ,"$2,653.00 ","$1,488.33 ",$606.41 ,"$1,098.34 ",$325.59 ,$295.99 ,$606.41 ,"$2,255.05 ","$1,299.45 ","$1,581.19 ",$742.84 ,"$2,387.70 ",$606.41 ,"$2,255.05 ",$253.00 ,$253.00 ,$606.41 ,"$1,724.45 " ST. JOSEPH'S HOSPITAL - BREESE,76100008,64447,HC INJ ANES NERVE FEMORAL SINGLE-RT,761,1 ,"$2,653.00 ","$1,910.16 ",$253.00 ,"$2,653.00 ","$1,546.98 ","$1,724.45 ","$1,583.84 ",$606.41 ,$742.84 ,"$1,756.29 ",$606.41 ,"$1,756.29 ",$606.41 ,"$1,581.19 ","$1,581.19 ",$606.41 ,"$1,581.19 ","$1,249.95 ","$2,042.81 ","$1,546.96 ",$606.41 ,$618.54 ,"$1,989.75 ","$1,883.63 ","$1,883.63 ",$606.41 ,"$1,883.63 ","$2,255.05 ","$2,255.05 ","$2,255.05 ", N/A ,"$1,546.96 ","$2,255.05 ",$606.41 ,"$2,653.00 ","$1,488.33 ",$606.41 ,"$1,098.34 ",$325.59 ,$295.99 ,$606.41 ,"$2,255.05 ","$1,299.45 ","$1,581.19 ",$742.84 ,"$2,387.70 ",$606.41 ,"$2,255.05 ",$253.00 ,$253.00 ,$606.41 ,"$1,724.45 " ST. JOSEPH'S HOSPITAL - BREESE,76100021,64484,HC INJ EPID LUMBAR/SACRAL ADDL,761,1 ,"$2,751.00 ","$1,980.72 ",$253.00 ,"$2,751.00 ", N/A ,"$1,788.15 ","$1,642.35 ", N/A ,$770.28 ,"$1,821.16 ", N/A ,"$1,821.16 ", N/A ,"$1,639.60 ","$1,639.60 ", N/A ,"$1,639.60 ", N/A ,"$2,118.27 ", N/A , N/A , N/A ,"$2,063.25 ","$1,953.21 ","$1,953.21 ", N/A ,"$1,953.21 ","$2,338.35 ","$2,338.35 ","$2,338.35 ", N/A , N/A ,"$2,338.35 ", N/A ,"$2,751.00 ","$1,543.31 ", N/A ,"$1,138.91 ",$590.49 ,$536.81 , N/A ,"$2,338.35 ", N/A ,"$1,639.60 ",$770.28 ,"$2,475.90 ", N/A ,"$2,338.35 ",$253.00 ,$253.00 , N/A ,"$1,788.15 " ST. JOSEPH'S HOSPITAL - BREESE,76100024,64483,HC INJ EPID LUMBAR/SACRAL SGL-BI,761,1 ,"$4,016.00 ","$2,891.52 ",$253.00 ,"$4,016.00 ","$3,068.93 ","$2,610.40 ","$2,397.55 ","$1,203.02 ","$1,124.48 ","$2,658.59 ","$1,203.02 ","$2,658.59 ","$1,203.02 ","$2,393.54 ","$2,393.54 ","$1,203.02 ","$2,393.54 ","$2,479.70 ","$3,092.32 ","$3,068.93 ","$1,203.02 ","$1,227.09 ","$3,012.00 ","$2,851.36 ","$2,851.36 ","$1,203.02 ","$2,851.36 ","$3,413.60 ","$3,413.60 ","$3,413.60 ", N/A ,"$3,068.93 ","$3,413.60 ","$1,203.02 ","$4,016.00 ","$2,252.98 ","$1,203.02 ","$1,662.62 ",$885.74 ,$805.22 ,"$1,203.02 ","$3,413.60 ","$2,577.90 ","$2,393.54 ","$1,124.48 ","$3,614.40 ","$1,203.02 ","$3,413.60 ",$253.00 ,$253.00 ,"$1,203.02 ","$2,610.40 " ST. JOSEPH'S HOSPITAL - BREESE,76100025,64483,HC INJ EPID LUMBAR/SACRAL SGL-LT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100026,64483,HC INJ EPID LUMBAR/SACRAL SGL-RT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100027,64479,HC INJ EPIDURAL CREV/THOR SGL-BI,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$3,068.93 ","$3,068.93 ","$1,740.05 ","$1,598.17 ","$1,203.02 ",$749.56 ,"$1,772.17 ","$1,203.02 ","$1,772.17 ","$1,203.02 ","$1,595.49 ","$1,595.49 ","$1,203.02 ","$1,595.49 ","$2,479.70 ","$2,061.29 ","$3,068.93 ","$1,203.02 ","$1,227.09 ","$2,007.75 ","$1,900.67 ","$1,900.67 ","$1,203.02 ","$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,677.00 ","$2,275.45 ","$1,203.02 ","$2,677.00 ","$1,501.80 ","$1,203.02 ","$1,108.28 ",$885.74 ,$805.22 ,"$1,203.02 ","$2,275.45 ","$2,577.90 ","$1,595.49 ",$749.56 ,"$2,409.30 ","$1,203.02 ","$2,275.45 ",$253.00 ,$253.00 ,"$1,203.02 ","$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100028,64479,HC INJ EPIDURAL CREV/THOR SGL-LT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100029,64479,HC INJ EPIDURAL CREV/THOR SGL-RT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100032,64490,HC INJ PARAVERT F JNT C/T 1 LV-RT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100033,64491,HC INJ PARAVERT F JNT C/T 2 LV,761,1 ,"$2,341.00 ","$1,685.52 ",$253.00 ,"$2,341.00 ", N/A ,"$1,521.65 ","$1,397.58 ", N/A ,$655.48 ,"$1,549.74 ", N/A ,"$1,549.74 ", N/A ,"$1,395.24 ","$1,395.24 ", N/A ,"$1,395.24 ", N/A ,"$1,802.57 ", N/A , N/A , N/A ,"$1,755.75 ","$1,662.11 ","$1,662.11 ", N/A ,"$1,662.11 ","$1,989.85 ","$1,989.85 ","$1,989.85 ", N/A , N/A ,"$1,989.85 ", N/A ,"$2,341.00 ","$1,313.30 ", N/A ,$969.17 ,$590.49 ,$536.81 , N/A ,"$1,989.85 ", N/A ,"$1,395.24 ",$655.48 ,"$2,106.90 ", N/A ,"$1,989.85 ",$253.00 ,$253.00 , N/A ,"$1,521.65 " ST. JOSEPH'S HOSPITAL - BREESE,76100034,64491,HC INJ PARAVERT F JNT C/T 2 LV-LT,761,1 ,"$2,341.00 ","$1,685.52 ",$253.00 ,"$2,341.00 ", N/A ,"$1,521.65 ","$1,397.58 ", N/A ,$655.48 ,"$1,549.74 ", N/A ,"$1,549.74 ", N/A ,"$1,395.24 ","$1,395.24 ", N/A ,"$1,395.24 ", N/A ,"$1,802.57 ", N/A , N/A , N/A ,"$1,755.75 ","$1,662.11 ","$1,662.11 ", N/A ,"$1,662.11 ","$1,989.85 ","$1,989.85 ","$1,989.85 ", N/A , N/A ,"$1,989.85 ", N/A ,"$2,341.00 ","$1,313.30 ", N/A ,$969.17 ,$590.49 ,$536.81 , N/A ,"$1,989.85 ", N/A ,"$1,395.24 ",$655.48 ,"$2,106.90 ", N/A ,"$1,989.85 ",$253.00 ,$253.00 , N/A ,"$1,521.65 " ST. JOSEPH'S HOSPITAL - BREESE,76100035,64491,HC INJ PARAVERT F JNT C/T 2 LV-RT,761,1 ,"$2,341.00 ","$1,685.52 ",$253.00 ,"$2,341.00 ", N/A ,"$1,521.65 ","$1,397.58 ", N/A ,$655.48 ,"$1,549.74 ", N/A ,"$1,549.74 ", N/A ,"$1,395.24 ","$1,395.24 ", N/A ,"$1,395.24 ", N/A ,"$1,802.57 ", N/A , N/A , N/A ,"$1,755.75 ","$1,662.11 ","$1,662.11 ", N/A ,"$1,662.11 ","$1,989.85 ","$1,989.85 ","$1,989.85 ", N/A , N/A ,"$1,989.85 ", N/A ,"$2,341.00 ","$1,313.30 ", N/A ,$969.17 ,$590.49 ,$536.81 , N/A ,"$1,989.85 ", N/A ,"$1,395.24 ",$655.48 ,"$2,106.90 ", N/A ,"$1,989.85 ",$253.00 ,$253.00 , N/A ,"$1,521.65 " ST. JOSEPH'S HOSPITAL - BREESE,76100036,64492,HC INJ PARAVERT F JNT C/T 3 LV,761,1 ,"$2,317.00 ","$1,668.24 ",$253.00 ,"$2,317.00 ", N/A ,"$1,506.05 ","$1,383.25 ", N/A ,$648.76 ,"$1,533.85 ", N/A ,"$1,533.85 ", N/A ,"$1,380.93 ","$1,380.93 ", N/A ,"$1,380.93 ", N/A ,"$1,784.09 ", N/A , N/A , N/A ,"$1,737.75 ","$1,645.07 ","$1,645.07 ", N/A ,"$1,645.07 ","$1,969.45 ","$1,969.45 ","$1,969.45 ", N/A , N/A ,"$1,969.45 ", N/A ,"$2,317.00 ","$1,299.84 ", N/A ,$959.24 ,$590.49 ,$536.81 , N/A ,"$1,969.45 ", N/A ,"$1,380.93 ",$648.76 ,"$2,085.30 ", N/A ,"$1,969.45 ",$253.00 ,$253.00 , N/A ,"$1,506.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100037,64492,HC INJ PARAVERT F JNT C/T 3 LV-LT,761,1 ,"$2,317.00 ","$1,668.24 ",$253.00 ,"$2,317.00 ", N/A ,"$1,506.05 ","$1,383.25 ", N/A ,$648.76 ,"$1,533.85 ", N/A ,"$1,533.85 ", N/A ,"$1,380.93 ","$1,380.93 ", N/A ,"$1,380.93 ", N/A ,"$1,784.09 ", N/A , N/A , N/A ,"$1,737.75 ","$1,645.07 ","$1,645.07 ", N/A ,"$1,645.07 ","$1,969.45 ","$1,969.45 ","$1,969.45 ", N/A , N/A ,"$1,969.45 ", N/A ,"$2,317.00 ","$1,299.84 ", N/A ,$959.24 ,$590.49 ,$536.81 , N/A ,"$1,969.45 ", N/A ,"$1,380.93 ",$648.76 ,"$2,085.30 ", N/A ,"$1,969.45 ",$253.00 ,$253.00 , N/A ,"$1,506.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100038,64492,HC INJ PARAVERT F JNT C/T 3 LV-RT,761,1 ,"$2,317.00 ","$1,668.24 ",$253.00 ,"$2,317.00 ", N/A ,"$1,506.05 ","$1,383.25 ", N/A ,$648.76 ,"$1,533.85 ", N/A ,"$1,533.85 ", N/A ,"$1,380.93 ","$1,380.93 ", N/A ,"$1,380.93 ", N/A ,"$1,784.09 ", N/A , N/A , N/A ,"$1,737.75 ","$1,645.07 ","$1,645.07 ", N/A ,"$1,645.07 ","$1,969.45 ","$1,969.45 ","$1,969.45 ", N/A , N/A ,"$1,969.45 ", N/A ,"$2,317.00 ","$1,299.84 ", N/A ,$959.24 ,$590.49 ,$536.81 , N/A ,"$1,969.45 ", N/A ,"$1,380.93 ",$648.76 ,"$2,085.30 ", N/A ,"$1,969.45 ",$253.00 ,$253.00 , N/A ,"$1,506.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100039,64493,HC INJ PARAVERT F JNT L/S 1 LV-BI,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$3,068.93 ","$3,068.93 ","$1,740.05 ","$1,598.17 ","$1,203.02 ",$749.56 ,"$1,772.17 ","$1,203.02 ","$1,772.17 ","$1,203.02 ","$1,595.49 ","$1,595.49 ","$1,203.02 ","$1,595.49 ","$2,479.70 ","$2,061.29 ","$3,068.93 ","$1,203.02 ","$1,227.09 ","$2,007.75 ","$1,900.67 ","$1,900.67 ","$1,203.02 ","$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,677.00 ","$2,275.45 ","$1,203.02 ","$2,677.00 ","$1,501.80 ","$1,203.02 ","$1,108.28 ",$885.74 ,$805.22 ,"$1,203.02 ","$2,275.45 ","$2,577.90 ","$1,595.49 ",$749.56 ,"$2,409.30 ","$1,203.02 ","$2,275.45 ",$253.00 ,$253.00 ,"$1,203.02 ","$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100040,64493,HC INJ PARAVERT F JNT L/S 1 LV-LT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100041,64493,HC INJ PARAVERT F JNT L/S 1 LV-RT,761,1 ,"$2,677.00 ","$1,927.44 ",$253.00 ,"$2,677.00 ","$2,045.95 ","$1,740.05 ","$1,598.17 ",$802.01 ,$749.56 ,"$1,772.17 ",$802.01 ,"$1,772.17 ",$802.01 ,"$1,595.49 ","$1,595.49 ",$802.01 ,"$1,595.49 ","$1,653.13 ","$2,061.29 ","$2,045.96 ",$802.01 ,$818.05 ,"$2,007.75 ","$1,900.67 ","$1,900.67 ",$802.01 ,"$1,900.67 ","$2,275.45 ","$2,275.45 ","$2,275.45 ", N/A ,"$2,045.96 ","$2,275.45 ",$802.01 ,"$2,677.00 ","$1,501.80 ",$802.01 ,"$1,108.28 ",$590.49 ,$536.81 ,$802.01 ,"$2,275.45 ","$1,718.60 ","$1,595.49 ",$749.56 ,"$2,409.30 ",$802.01 ,"$2,275.45 ",$253.00 ,$253.00 ,$802.01 ,"$1,740.05 " ST. JOSEPH'S HOSPITAL - BREESE,76100042,64494,HC INJ PARAVERT F JNT L/S 2 LV,761,1 ,"$2,318.00 ","$1,668.96 ",$253.00 ,"$2,318.00 ", N/A ,"$1,506.70 ","$1,383.85 ", N/A ,$649.04 ,"$1,534.52 ", N/A ,"$1,534.52 ", N/A ,"$1,381.53 ","$1,381.53 ", N/A ,"$1,381.53 ", N/A ,"$1,784.86 ", N/A , N/A , N/A ,"$1,738.50 ","$1,645.78 ","$1,645.78 ", N/A ,"$1,645.78 ","$1,970.30 ","$1,970.30 ","$1,970.30 ", N/A , N/A ,"$1,970.30 ", N/A ,"$2,318.00 ","$1,300.40 ", N/A ,$959.65 ,$590.49 ,$536.81 , N/A ,"$1,970.30 ", N/A ,"$1,381.53 ",$649.04 ,"$2,086.20 ", N/A ,"$1,970.30 ",$253.00 ,$253.00 , N/A ,"$1,506.70 " ST. JOSEPH'S HOSPITAL - BREESE,76100043,64494,HC INJ PARAVERT F JNT L/S 2 LV-LT,761,1 ,"$2,318.00 ","$1,668.96 ",$253.00 ,"$2,318.00 ", N/A ,"$1,506.70 ","$1,383.85 ", N/A ,$649.04 ,"$1,534.52 ", N/A ,"$1,534.52 ", N/A ,"$1,381.53 ","$1,381.53 ", N/A ,"$1,381.53 ", N/A ,"$1,784.86 ", N/A , N/A , N/A ,"$1,738.50 ","$1,645.78 ","$1,645.78 ", N/A ,"$1,645.78 ","$1,970.30 ","$1,970.30 ","$1,970.30 ", N/A , N/A ,"$1,970.30 ", N/A ,"$2,318.00 ","$1,300.40 ", N/A ,$959.65 ,$590.49 ,$536.81 , N/A ,"$1,970.30 ", N/A ,"$1,381.53 ",$649.04 ,"$2,086.20 ", N/A ,"$1,970.30 ",$253.00 ,$253.00 , N/A ,"$1,506.70 " ST. JOSEPH'S HOSPITAL - BREESE,76100044,64494,HC INJ PARAVERT F JNT L/S 2 LV-RT,761,1 ,"$2,318.00 ","$1,668.96 ",$253.00 ,"$2,318.00 ", N/A ,"$1,506.70 ","$1,383.85 ", N/A ,$649.04 ,"$1,534.52 ", N/A ,"$1,534.52 ", N/A ,"$1,381.53 ","$1,381.53 ", N/A ,"$1,381.53 ", N/A ,"$1,784.86 ", N/A , N/A , N/A ,"$1,738.50 ","$1,645.78 ","$1,645.78 ", N/A ,"$1,645.78 ","$1,970.30 ","$1,970.30 ","$1,970.30 ", N/A , N/A ,"$1,970.30 ", N/A ,"$2,318.00 ","$1,300.40 ", N/A ,$959.65 ,$590.49 ,$536.81 , N/A ,"$1,970.30 ", N/A ,"$1,381.53 ",$649.04 ,"$2,086.20 ", N/A ,"$1,970.30 ",$253.00 ,$253.00 , N/A ,"$1,506.70 " ST. JOSEPH'S HOSPITAL - BREESE,76100045,64495,HC INJ PARAVRT F JNT L/S 3+ LV,761,1 ,"$2,160.00 ","$1,555.20 ",$253.00 ,"$2,160.00 ", N/A ,"$1,404.00 ","$1,289.52 ", N/A ,$604.80 ,"$1,429.92 ", N/A ,"$1,429.92 ", N/A ,"$1,287.36 ","$1,287.36 ", N/A ,"$1,287.36 ", N/A ,"$1,663.20 ", N/A , N/A , N/A ,"$1,620.00 ","$1,533.60 ","$1,533.60 ", N/A ,"$1,533.60 ","$1,836.00 ","$1,836.00 ","$1,836.00 ", N/A , N/A ,"$1,836.00 ", N/A ,"$2,160.00 ","$1,211.76 ", N/A ,$894.24 ,$590.49 ,$536.81 , N/A ,"$1,836.00 ", N/A ,"$1,287.36 ",$604.80 ,"$1,944.00 ", N/A ,"$1,836.00 ",$253.00 ,$253.00 , N/A ,"$1,404.00 " ST. JOSEPH'S HOSPITAL - BREESE,76100046,64495,HC INJ PARAVRT F JNT L/S 3+ LV-LT,761,1 ,"$2,160.00 ","$1,555.20 ",$253.00 ,"$2,160.00 ", N/A ,"$1,404.00 ","$1,289.52 ", N/A ,$604.80 ,"$1,429.92 ", N/A ,"$1,429.92 ", N/A ,"$1,287.36 ","$1,287.36 ", N/A ,"$1,287.36 ", N/A ,"$1,663.20 ", N/A , N/A , N/A ,"$1,620.00 ","$1,533.60 ","$1,533.60 ", N/A ,"$1,533.60 ","$1,836.00 ","$1,836.00 ","$1,836.00 ", N/A , N/A ,"$1,836.00 ", N/A ,"$2,160.00 ","$1,211.76 ", N/A ,$894.24 ,$590.49 ,$536.81 , N/A ,"$1,836.00 ", N/A ,"$1,287.36 ",$604.80 ,"$1,944.00 ", N/A ,"$1,836.00 ",$253.00 ,$253.00 , N/A ,"$1,404.00 " ST. JOSEPH'S HOSPITAL - BREESE,76100047,64495,HC INJ PARAVRT F JNT L/S 3+ LV-RT,761,1 ,"$2,160.00 ","$1,555.20 ",$253.00 ,"$2,160.00 ", N/A ,"$1,404.00 ","$1,289.52 ", N/A ,$604.80 ,"$1,429.92 ", N/A ,"$1,429.92 ", N/A ,"$1,287.36 ","$1,287.36 ", N/A ,"$1,287.36 ", N/A ,"$1,663.20 ", N/A , N/A , N/A ,"$1,620.00 ","$1,533.60 ","$1,533.60 ", N/A ,"$1,533.60 ","$1,836.00 ","$1,836.00 ","$1,836.00 ", N/A , N/A ,"$1,836.00 ", N/A ,"$2,160.00 ","$1,211.76 ", N/A ,$894.24 ,$590.49 ,$536.81 , N/A ,"$1,836.00 ", N/A ,"$1,287.36 ",$604.80 ,"$1,944.00 ", N/A ,"$1,836.00 ",$253.00 ,$253.00 , N/A ,"$1,404.00 " ST. JOSEPH'S HOSPITAL - BREESE,76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 , N/A ,$97.50 ,$89.55 , N/A ,$42.00 ,$99.30 , N/A ,$99.30 , N/A ,$89.40 ,$89.40 , N/A ,$89.40 , N/A ,$115.50 , N/A , N/A , N/A ,$112.50 ,$106.50 ,$106.50 , N/A ,$106.50 ,$127.50 ,$127.50 ,$127.50 , N/A , N/A ,$127.50 , N/A ,$150.00 ,$84.15 , N/A ,$62.10 , N/A , N/A , N/A ,$127.50 , N/A ,$89.40 ,$42.00 ,$135.00 , N/A ,$127.50 ,$126.75 ,$126.75 , N/A ,$97.50 ST. JOSEPH'S HOSPITAL - BREESE,76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$67.00 ,$48.24 ,$18.76 ,$67.00 , N/A ,$43.55 ,$40.00 , N/A ,$18.76 ,$44.35 , N/A ,$44.35 , N/A ,$39.93 ,$39.93 , N/A ,$39.93 , N/A ,$51.59 , N/A , N/A , N/A ,$50.25 ,$47.57 ,$47.57 , N/A ,$47.57 ,$56.95 ,$56.95 ,$56.95 , N/A , N/A ,$56.95 , N/A ,$67.00 ,$37.59 , N/A ,$27.74 , N/A , N/A , N/A ,$56.95 , N/A ,$39.93 ,$18.76 ,$60.30 , N/A ,$56.95 ,$56.62 ,$56.62 , N/A ,$43.55 ST. JOSEPH'S HOSPITAL - BREESE,77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$59.00 ,$42.48 ,$16.52 ,$161.99 ,$161.98 ,$38.35 ,$35.22 ,$63.49 ,$16.52 ,$39.06 ,$63.49 ,$39.06 ,$57.82 ,$35.16 ,$35.16 ,$57.82 ,$35.16 ,$59.00 ,$45.43 ,$161.99 ,$63.49 ,$57.82 ,$44.25 ,$41.89 ,$41.89 ,$63.49 ,$41.89 ,$50.15 ,$50.15 ,$50.15 , N/A ,$59.00 ,$50.15 ,$57.82 ,$59.00 ,$33.10 ,$63.49 ,$24.43 , N/A , N/A ,$63.49 ,$50.15 ,$136.07 ,$35.16 ,$16.52 ,$53.10 ,$63.49 ,$50.15 ,$49.86 ,$49.86 ,$63.49 ,$38.35 ST. JOSEPH'S HOSPITAL - BREESE,77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$79.00 ,$56.88 ,$22.12 ,$79.00 , N/A ,$51.35 ,$47.16 , N/A ,$22.12 ,$52.30 , N/A ,$52.30 , N/A ,$47.08 ,$47.08 , N/A ,$47.08 , N/A ,$60.83 , N/A , N/A , N/A ,$59.25 ,$56.09 ,$56.09 , N/A ,$56.09 ,$67.15 ,$67.15 ,$67.15 , N/A , N/A ,$67.15 , N/A ,$79.00 ,$44.32 , N/A ,$32.71 , N/A , N/A , N/A ,$67.15 , N/A ,$47.08 ,$22.12 ,$71.10 , N/A ,$67.15 ,$66.76 ,$66.76 , N/A ,$51.35 ST. JOSEPH'S HOSPITAL - BREESE,77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$55.00 ,$39.60 ,$15.40 ,$101.73 ,$101.73 ,$35.75 ,$32.84 ,$39.88 ,$15.40 ,$36.41 ,$39.88 ,$36.41 ,$39.88 ,$32.78 ,$32.78 ,$39.88 ,$32.78 ,$55.00 ,$42.35 ,$101.72 ,$39.88 ,$40.67 ,$41.25 ,$39.05 ,$39.05 ,$39.88 ,$39.05 ,$46.75 ,$46.75 ,$46.75 , N/A ,$55.00 ,$46.75 ,$39.88 ,$55.00 ,$30.86 ,$39.88 ,$22.77 , N/A , N/A ,$39.88 ,$46.75 ,$85.45 ,$32.78 ,$15.40 ,$49.50 ,$39.88 ,$46.75 ,$46.48 ,$46.48 ,$39.88 ,$35.75 ST. JOSEPH'S HOSPITAL - BREESE,77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$55.00 ,$39.60 ,$15.40 ,$101.73 ,$101.73 ,$35.75 ,$32.84 ,$39.88 ,$15.40 ,$36.41 ,$39.88 ,$36.41 ,$39.88 ,$32.78 ,$32.78 ,$39.88 ,$32.78 ,$55.00 ,$42.35 ,$101.72 ,$39.88 ,$40.67 ,$41.25 ,$39.05 ,$39.05 ,$39.88 ,$39.05 ,$46.75 ,$46.75 ,$46.75 , N/A ,$55.00 ,$46.75 ,$39.88 ,$55.00 ,$30.86 ,$39.88 ,$22.77 , N/A , N/A ,$39.88 ,$46.75 ,$85.45 ,$32.78 ,$15.40 ,$49.50 ,$39.88 ,$46.75 ,$46.48 ,$46.48 ,$39.88 ,$35.75 ST. JOSEPH'S HOSPITAL - BREESE,77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$55.00 ,$39.60 ,$15.40 ,$101.73 ,$101.73 ,$35.75 ,$32.84 ,$39.88 ,$15.40 ,$36.41 ,$39.88 ,$36.41 ,$39.88 ,$32.78 ,$32.78 ,$39.88 ,$32.78 ,$55.00 ,$42.35 ,$101.72 ,$39.88 ,$40.67 ,$41.25 ,$39.05 ,$39.05 ,$39.88 ,$39.05 ,$46.75 ,$46.75 ,$46.75 , N/A ,$55.00 ,$46.75 ,$39.88 ,$55.00 ,$30.86 ,$39.88 ,$22.77 , N/A , N/A ,$39.88 ,$46.75 ,$85.45 ,$32.78 ,$15.40 ,$49.50 ,$39.88 ,$46.75 ,$46.48 ,$46.48 ,$39.88 ,$35.75 ST. JOSEPH'S HOSPITAL - BREESE,77100008,N/A,HC HEALTH FAIR INFLUENZA VACCINE,771,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 , N/A ,$16.25 ,$14.93 , N/A ,$7.00 ,$16.55 , N/A ,$16.55 , N/A ,$14.90 ,$14.90 , N/A ,$14.90 , N/A ,$19.25 , N/A , N/A , N/A ,$18.75 ,$17.75 ,$17.75 , N/A ,$17.75 ,$21.25 ,$21.25 ,$21.25 , N/A , N/A ,$21.25 , N/A ,$25.00 ,$14.03 , N/A ,$10.35 , N/A , N/A , N/A ,$21.25 , N/A ,$14.90 ,$7.00 ,$22.50 , N/A ,$21.25 ,$21.13 ,$21.13 , N/A ,$16.25 ST. JOSEPH'S HOSPITAL - BREESE,77100009,0001A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100010,0002A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100011,0011A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100012,0012A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5M SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100013,0021A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 , N/A ,$78.00 ,$71.64 , N/A ,$33.60 ,$79.44 , N/A ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A , N/A , N/A ,$90.00 ,$85.20 ,$85.20 , N/A ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A , N/A ,$102.00 , N/A ,$120.00 ,$67.32 , N/A ,$49.68 , N/A , N/A , N/A ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 , N/A ,$102.00 ,$101.40 ,$101.40 , N/A ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100014,0022A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 , N/A ,$78.00 ,$71.64 , N/A ,$33.60 ,$79.44 , N/A ,$79.44 , N/A ,$71.52 ,$71.52 , N/A ,$71.52 , N/A ,$92.40 , N/A , N/A , N/A ,$90.00 ,$85.20 ,$85.20 , N/A ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A , N/A ,$102.00 , N/A ,$120.00 ,$67.32 , N/A ,$49.68 , N/A , N/A , N/A ,$102.00 , N/A ,$71.52 ,$33.60 ,$108.00 , N/A ,$102.00 ,$101.40 ,$101.40 , N/A ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100015,0031A,HC ADMINISTRATION SARS-COV-2 VACCINE AD26 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100016,0041A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100017,0042A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML SECOND DOSE,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100018,0003A,HC ADM SARSCOV2 30MCG/0.3ML 3RD - PFIZER,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100019,0013A,HC ADM SARSCOV2 100MCG/0.5ML 3RD - MODERNA,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100020,0051A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, FIRST DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100021,0052A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, SECOND DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100022,0053A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, THIRD DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100023,0004A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, DILUENT RECONSTITUTED, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100024,0054A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100025,0064A,"HC ADMIN SARS-COV-2 VACCINE 50MCG/0.25ML, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100026,0071A,"HC ADMIN SARS-COV-2 VACCINE 10MCG/0.2ML, TRIS-SUCROSE, FIRST DOSE (CHILD 5-11)",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100027,0072A,"HC ADMIN SARS-COV-2 VACCINE 10MCG/0.2ML, TRIS-SUCROSE, SECOND DOSE (CHILD 5-11)",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100028,0034A,"HC ADMIN SARS-COV-2 VACCINE JOHNSON AND JOHNSON, BOOSTER DOSE",771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100031,M0222,HC INTRAVENOUS INJECTION BEBTELOVIMAB ADMINISTRATION,260,1 ,$120.00 ,$86.40 ,$33.60 ,$841.50 ,$841.50 ,$78.00 ,$71.64 ,$329.87 ,$33.60 ,$79.44 ,$329.87 ,$79.44 ,$117.60 ,$71.52 ,$71.52 ,$117.60 ,$71.52 ,$120.00 ,$92.40 ,$841.50 ,$329.87 ,$117.60 ,$90.00 ,$85.20 ,$85.20 ,$329.87 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 ,$117.60 ,$120.00 ,$67.32 ,$329.87 ,$49.68 , N/A , N/A ,$329.87 ,$102.00 ,$706.86 ,$71.52 ,$33.60 ,$108.00 ,$329.87 ,$102.00 ,$101.40 ,$101.40 ,$329.87 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100036,0134A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT 50MCG/0.5ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100037,0144A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT 25MCG/0.25ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100038,0124A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT TRI-SUCROSE 30MCG/0.3ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,77100039,0154A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT TRI-SUCROSE 10MCG/0.2ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$99.68 ,$78.00 ,$71.64 ,$39.07 ,$33.60 ,$79.44 ,$39.07 ,$79.44 ,$39.07 ,$71.52 ,$71.52 ,$39.07 ,$71.52 ,$80.54 ,$92.40 ,$99.68 ,$39.07 ,$39.86 ,$90.00 ,$85.20 ,$85.20 ,$39.07 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$99.68 ,$102.00 ,$39.07 ,$120.00 ,$67.32 ,$39.07 ,$49.68 , N/A , N/A ,$39.07 ,$102.00 ,$83.73 ,$71.52 ,$33.60 ,$108.00 ,$39.07 ,$102.00 ,$101.40 ,$101.40 ,$39.07 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$113.00 ,$81.36 ,$9.83 ,$113.00 ,$71.60 ,$73.45 ,$67.46 ,$28.07 ,$31.64 ,$74.81 ,$28.07 ,$74.81 ,$28.07 ,$67.35 ,$67.35 ,$28.07 ,$67.35 ,$57.85 ,$87.01 ,$71.60 ,$28.07 ,$28.63 ,$84.75 ,$80.23 ,$80.23 ,$28.07 ,$80.23 ,$96.05 ,$96.05 ,$96.05 , N/A ,$71.60 ,$96.05 ,$28.07 ,$113.00 ,$63.39 ,$28.07 ,$46.78 ,$10.81 ,$9.83 ,$28.07 ,$96.05 ,$60.14 ,$67.35 ,$31.64 ,$101.70 ,$28.07 ,$96.05 ,$95.49 ,$95.49 ,$28.07 ,$73.45 ST. JOSEPH'S HOSPITAL - BREESE,78000024,90832,PC THERAPY INDIVIDUAL PSYCH 30 MIN - 95,780,1 ,$120.00 ,$86.40 ,$33.60 ,$349.80 ,$349.80 ,$78.00 ,$71.64 ,$137.12 ,$33.60 ,$79.44 ,$137.12 ,$79.44 ,$117.60 ,$71.52 ,$71.52 ,$117.60 ,$71.52 ,$120.00 ,$92.40 ,$349.80 ,$137.12 ,$117.60 ,$90.00 ,$85.20 ,$85.20 ,$137.12 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 ,$117.60 ,$120.00 ,$67.32 ,$137.12 ,$49.68 , N/A , N/A ,$137.12 ,$102.00 ,$293.84 ,$71.52 ,$33.60 ,$108.00 ,$137.12 ,$102.00 ,$101.40 ,$101.40 ,$137.12 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,78000026,90834,PC THERAPY INDIVIDUAL PSYCH 45 MIN - 95,961,1 ,$181.00 ,$130.32 ,$50.68 ,$349.80 ,$349.80 ,$117.65 ,$108.06 ,$137.12 ,$50.68 ,$119.82 ,$137.12 ,$119.82 ,$137.12 ,$107.88 ,$107.88 ,$137.12 ,$107.88 ,$181.00 ,$139.37 ,$349.80 ,$137.12 ,$139.87 ,$135.75 ,$128.51 ,$128.51 ,$137.12 ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A ,$181.00 ,$153.85 ,$137.12 ,$181.00 ,$101.54 ,$137.12 ,$126.09 ,$109.77 ,$99.79 ,$137.12 ,$153.85 ,$293.84 ,$107.88 ,$50.68 ,$162.90 ,$137.12 ,$153.85 , N/A , N/A ,$137.12 ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,78000028,90837,PC THERAPY INDIVIDUAL PSYCH 60 MIN - 95,961,1 ,$204.00 ,$146.88 ,$57.12 ,$349.80 ,$349.80 ,$132.60 ,$121.79 ,$137.12 ,$57.12 ,$135.05 ,$137.12 ,$135.05 ,$137.12 ,$121.58 ,$121.58 ,$137.12 ,$121.58 ,$204.00 ,$157.08 ,$349.80 ,$137.12 ,$139.87 ,$153.00 ,$144.84 ,$144.84 ,$137.12 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$137.12 ,$204.00 ,$114.44 ,$137.12 ,$188.50 ,$109.77 ,$99.79 ,$137.12 ,$173.40 ,$293.84 ,$121.58 ,$57.12 ,$183.60 ,$137.12 ,$173.40 , N/A , N/A ,$137.12 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,78000098,99221,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 1 LOW 40MIN - 95,960,1 ,$312.00 ,$224.64 ,$87.36 ,$312.00 , N/A ,$202.80 ,$186.26 , N/A ,$87.36 ,$206.54 , N/A ,$206.54 , N/A ,$185.95 ,$185.95 , N/A ,$185.95 , N/A ,$240.24 , N/A , N/A , N/A ,$234.00 ,$221.52 ,$221.52 , N/A ,$221.52 ,$265.20 ,$265.20 ,$265.20 , N/A , N/A ,$265.20 , N/A ,$312.00 ,$175.03 , N/A ,$141.83 , N/A , N/A , N/A ,$265.20 , N/A ,$185.95 ,$87.36 ,$280.80 , N/A ,$265.20 , N/A , N/A , N/A ,$202.80 ST. JOSEPH'S HOSPITAL - BREESE,78000099,99222,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 2 MODERATE 55 MIN -95,960,1 ,$415.00 ,$298.80 ,$116.20 ,$415.00 , N/A ,$269.75 ,$247.76 , N/A ,$116.20 ,$274.73 , N/A ,$274.73 , N/A ,$247.34 ,$247.34 , N/A ,$247.34 , N/A ,$319.55 , N/A , N/A , N/A ,$311.25 ,$294.65 ,$294.65 , N/A ,$294.65 ,$352.75 ,$352.75 ,$352.75 , N/A , N/A ,$352.75 , N/A ,$415.00 ,$232.82 , N/A ,$191.13 , N/A , N/A , N/A ,$352.75 , N/A ,$247.34 ,$116.20 ,$373.50 , N/A ,$352.75 , N/A , N/A , N/A ,$269.75 ST. JOSEPH'S HOSPITAL - BREESE,78000100,99223,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 3 HIGH 75 MIN -95,960,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 , N/A ,$393.25 ,$361.19 , N/A ,$169.40 ,$400.51 , N/A ,$400.51 , N/A ,$360.58 ,$360.58 , N/A ,$360.58 , N/A ,$465.85 , N/A , N/A , N/A ,$453.75 ,$429.55 ,$429.55 , N/A ,$429.55 ,$514.25 ,$514.25 ,$514.25 , N/A , N/A ,$514.25 , N/A ,$605.00 ,$339.41 , N/A ,$280.08 , N/A , N/A , N/A ,$514.25 , N/A ,$360.58 ,$169.40 ,$544.50 , N/A ,$514.25 , N/A , N/A , N/A ,$393.25 ST. JOSEPH'S HOSPITAL - BREESE,78000104,99231,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 1 LOW 25 MIN - 95,960,1 ,$117.00 ,$84.24 ,$32.76 ,$117.00 , N/A ,$76.05 ,$69.85 , N/A ,$32.76 ,$77.45 , N/A ,$77.45 , N/A ,$69.73 ,$69.73 , N/A ,$69.73 , N/A ,$90.09 , N/A , N/A , N/A ,$87.75 ,$83.07 ,$83.07 , N/A ,$83.07 ,$99.45 ,$99.45 ,$99.45 , N/A , N/A ,$99.45 , N/A ,$117.00 ,$65.64 , N/A ,$54.56 , N/A , N/A , N/A ,$99.45 , N/A ,$69.73 ,$32.76 ,$105.30 , N/A ,$99.45 , N/A , N/A , N/A ,$76.05 ST. JOSEPH'S HOSPITAL - BREESE,78000105,99232,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 2 MODERATE 35 MIN - 95,960,1 ,$216.00 ,$155.52 ,$60.48 ,$216.00 , N/A ,$140.40 ,$128.95 , N/A ,$60.48 ,$142.99 , N/A ,$142.99 , N/A ,$128.74 ,$128.74 , N/A ,$128.74 , N/A ,$166.32 , N/A , N/A , N/A ,$162.00 ,$153.36 ,$153.36 , N/A ,$153.36 ,$183.60 ,$183.60 ,$183.60 , N/A , N/A ,$183.60 , N/A ,$216.00 ,$121.18 , N/A ,$99.97 , N/A , N/A , N/A ,$183.60 , N/A ,$128.74 ,$60.48 ,$194.40 , N/A ,$183.60 , N/A , N/A , N/A ,$140.40 ST. JOSEPH'S HOSPITAL - BREESE,78000106,99233,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 3 HIGH 50 MIN - 95,960,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 , N/A ,$204.75 ,$188.06 , N/A ,$88.20 ,$208.53 , N/A ,$208.53 , N/A ,$187.74 ,$187.74 , N/A ,$187.74 , N/A ,$242.55 , N/A , N/A , N/A ,$236.25 ,$223.65 ,$223.65 , N/A ,$223.65 ,$267.75 ,$267.75 ,$267.75 , N/A , N/A ,$267.75 , N/A ,$315.00 ,$176.72 , N/A ,$144.07 , N/A , N/A , N/A ,$267.75 , N/A ,$187.74 ,$88.20 ,$283.50 , N/A ,$267.75 , N/A , N/A , N/A ,$204.75 ST. JOSEPH'S HOSPITAL - BREESE,78000107,99234,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE LOW 45 MIN- 95,960,1 ,$323.00 ,$232.56 ,$90.44 ,$323.00 , N/A ,$209.95 ,$192.83 , N/A ,$90.44 ,$213.83 , N/A ,$213.83 , N/A ,$192.51 ,$192.51 , N/A ,$192.51 , N/A ,$248.71 , N/A , N/A , N/A ,$242.25 ,$229.33 ,$229.33 , N/A ,$229.33 ,$274.55 ,$274.55 ,$274.55 , N/A , N/A ,$274.55 , N/A ,$323.00 ,$181.20 , N/A ,$185.32 ,$104.08 ,$94.62 , N/A ,$274.55 , N/A ,$192.51 ,$90.44 ,$290.70 , N/A ,$274.55 , N/A , N/A , N/A ,$209.95 ST. JOSEPH'S HOSPITAL - BREESE,78000108,99235,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE MODERATE 70 MIN-95,960,1 ,$505.00 ,$363.60 ,$94.62 ,$505.00 , N/A ,$328.25 ,$301.49 , N/A ,$141.40 ,$334.31 , N/A ,$334.31 , N/A ,$300.98 ,$300.98 , N/A ,$300.98 , N/A ,$388.85 , N/A , N/A , N/A ,$378.75 ,$358.55 ,$358.55 , N/A ,$358.55 ,$429.25 ,$429.25 ,$429.25 , N/A , N/A ,$429.25 , N/A ,$505.00 ,$283.31 , N/A ,$233.98 ,$104.08 ,$94.62 , N/A ,$429.25 , N/A ,$300.98 ,$141.40 ,$454.50 , N/A ,$429.25 , N/A , N/A , N/A ,$328.25 ST. JOSEPH'S HOSPITAL - BREESE,78000109,99236,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE HIGH 85 MIN-95,960,1 ,$565.00 ,$406.80 ,$94.62 ,$565.00 , N/A ,$367.25 ,$337.31 , N/A ,$158.20 ,$374.03 , N/A ,$374.03 , N/A ,$336.74 ,$336.74 , N/A ,$336.74 , N/A ,$435.05 , N/A , N/A , N/A ,$423.75 ,$401.15 ,$401.15 , N/A ,$401.15 ,$480.25 ,$480.25 ,$480.25 , N/A , N/A ,$480.25 , N/A ,$565.00 ,$316.97 , N/A ,$301.36 ,$104.08 ,$94.62 , N/A ,$480.25 , N/A ,$336.74 ,$158.20 ,$508.50 , N/A ,$480.25 , N/A , N/A , N/A ,$367.25 ST. JOSEPH'S HOSPITAL - BREESE,78000110,99238,PC TELEHEALTH HOSP INP/OBS DISCHARGE DAY <31MIN- 95,960,1 ,$218.00 ,$156.96 ,$61.04 ,$218.00 , N/A ,$141.70 ,$130.15 , N/A ,$61.04 ,$144.32 , N/A ,$144.32 , N/A ,$129.93 ,$129.93 , N/A ,$129.93 , N/A ,$167.86 , N/A , N/A , N/A ,$163.50 ,$154.78 ,$154.78 , N/A ,$154.78 ,$185.30 ,$185.30 ,$185.30 , N/A , N/A ,$185.30 , N/A ,$218.00 ,$122.30 , N/A ,$100.42 , N/A , N/A , N/A ,$185.30 , N/A ,$129.93 ,$61.04 ,$196.20 , N/A ,$185.30 , N/A , N/A , N/A ,$141.70 ST. JOSEPH'S HOSPITAL - BREESE,78000111,99239,PC TELEHEALTH HOSP INP/OBS DISCHARGE DAY >30MIN- 95,960,1 ,$265.00 ,$190.80 ,$74.20 ,$265.00 , N/A ,$172.25 ,$158.21 , N/A ,$74.20 ,$175.43 , N/A ,$175.43 , N/A ,$157.94 ,$157.94 , N/A ,$157.94 , N/A ,$204.05 , N/A , N/A , N/A ,$198.75 ,$188.15 ,$188.15 , N/A ,$188.15 ,$225.25 ,$225.25 ,$225.25 , N/A , N/A ,$225.25 , N/A ,$265.00 ,$148.67 , N/A ,$147.15 , N/A , N/A , N/A ,$225.25 , N/A ,$157.94 ,$74.20 ,$238.50 , N/A ,$225.25 , N/A , N/A , N/A ,$172.25 ST. JOSEPH'S HOSPITAL - BREESE,78000176,G0425,PC TELEHEALTH ED/IP CONSULT 30 MIN - 95,960,1 ,$350.00 ,$252.00 ,$94.62 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$198.87 ,$104.08 ,$94.62 , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 , N/A , N/A , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,78000177,G0426,PC TELEHEALTH ED/IP CONSULT 50 MIN - 95,960,1 ,$450.00 ,$324.00 ,$94.62 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$269.77 ,$104.08 ,$94.62 , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 , N/A , N/A , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,78000178,G0427,PC TELEHEALTH ED/IP CONSULT 70 MIN - 95,960,1 ,$550.00 ,$396.00 ,$94.62 ,$550.00 , N/A ,$357.50 ,$328.35 , N/A ,$154.00 ,$364.10 , N/A ,$364.10 , N/A ,$327.80 ,$327.80 , N/A ,$327.80 , N/A ,$423.50 , N/A , N/A , N/A ,$412.50 ,$390.50 ,$390.50 , N/A ,$390.50 ,$467.50 ,$467.50 ,$467.50 , N/A , N/A ,$467.50 , N/A ,$550.00 ,$308.55 , N/A ,$400.27 ,$104.08 ,$94.62 , N/A ,$467.50 , N/A ,$327.80 ,$154.00 ,$495.00 , N/A ,$467.50 , N/A , N/A , N/A ,$357.50 ST. JOSEPH'S HOSPITAL - BREESE,78000191,G0508,PC TELEHEALTH CRITICAL CARE CONSULT 60 MIN - 95,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$422.50 ,$388.05 , N/A ,$182.00 ,$430.30 , N/A ,$430.30 , N/A ,$387.40 ,$387.40 , N/A ,$387.40 , N/A ,$500.50 , N/A , N/A , N/A ,$487.50 ,$461.50 ,$461.50 , N/A ,$461.50 ,$552.50 ,$552.50 ,$552.50 , N/A , N/A ,$552.50 , N/A ,$650.00 ,$364.65 , N/A ,$419.54 ,$104.08 ,$94.62 , N/A ,$552.50 , N/A ,$387.40 ,$182.00 ,$585.00 , N/A ,$552.50 , N/A , N/A , N/A ,$422.50 ST. JOSEPH'S HOSPITAL - BREESE,78000192,G0509,PC TELEHEALTH CRITICAL CARE CONSULT 50 MIN - 95,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$422.50 ,$388.05 , N/A ,$182.00 ,$430.30 , N/A ,$430.30 , N/A ,$387.40 ,$387.40 , N/A ,$387.40 , N/A ,$500.50 , N/A , N/A , N/A ,$487.50 ,$461.50 ,$461.50 , N/A ,$461.50 ,$552.50 ,$552.50 ,$552.50 , N/A , N/A ,$552.50 , N/A ,$650.00 ,$364.65 , N/A ,$388.37 ,$104.08 ,$94.62 , N/A ,$552.50 , N/A ,$387.40 ,$182.00 ,$585.00 , N/A ,$552.50 , N/A , N/A , N/A ,$422.50 ST. JOSEPH'S HOSPITAL - BREESE,78000221,90832,HC THERAPY INDIVIDUAL PSYCH 30 MIN-95,780,1 ,$120.00 ,$86.40 ,$33.60 ,$349.80 ,$349.80 ,$78.00 ,$71.64 ,$137.12 ,$33.60 ,$79.44 ,$137.12 ,$79.44 ,$117.60 ,$71.52 ,$71.52 ,$117.60 ,$71.52 ,$120.00 ,$92.40 ,$349.80 ,$137.12 ,$117.60 ,$90.00 ,$85.20 ,$85.20 ,$137.12 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 ,$117.60 ,$120.00 ,$67.32 ,$137.12 ,$49.68 , N/A , N/A ,$137.12 ,$102.00 ,$293.84 ,$71.52 ,$33.60 ,$108.00 ,$137.12 ,$102.00 ,$101.40 ,$101.40 ,$137.12 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,78000222,90834,HC THERAPY INDIVIDUAL PSYCH 45 MIN-95,780,1 ,$181.00 ,$130.32 ,$50.68 ,$349.80 ,$349.80 ,$117.65 ,$108.06 ,$137.12 ,$50.68 ,$119.82 ,$137.12 ,$119.82 ,$137.12 ,$107.88 ,$107.88 ,$137.12 ,$107.88 ,$181.00 ,$139.37 ,$349.80 ,$137.12 ,$139.87 ,$135.75 ,$128.51 ,$128.51 ,$137.12 ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A ,$181.00 ,$153.85 ,$137.12 ,$181.00 ,$101.54 ,$137.12 ,$74.93 , N/A , N/A ,$137.12 ,$153.85 ,$293.84 ,$107.88 ,$50.68 ,$162.90 ,$137.12 ,$153.85 ,$152.95 ,$152.95 ,$137.12 ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,78000223,90837,HC THERAPY INDIVIDUAL PSYCH 60 MIN-95,780,1 ,$204.00 ,$146.88 ,$57.12 ,$349.80 ,$349.80 ,$132.60 ,$121.79 ,$137.12 ,$57.12 ,$135.05 ,$137.12 ,$135.05 ,$137.12 ,$121.58 ,$121.58 ,$137.12 ,$121.58 ,$204.00 ,$157.08 ,$349.80 ,$137.12 ,$139.87 ,$153.00 ,$144.84 ,$144.84 ,$137.12 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$137.12 ,$204.00 ,$114.44 ,$137.12 ,$84.46 , N/A , N/A ,$137.12 ,$173.40 ,$293.84 ,$121.58 ,$57.12 ,$183.60 ,$137.12 ,$173.40 ,$172.38 ,$172.38 ,$137.12 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,78000224,G0425,PC TELEHEALTH STROKE ED/IP CONSULT 30 MIN - G0,960,1 ,$350.00 ,$252.00 ,$94.62 ,$350.00 , N/A ,$227.50 ,$208.95 , N/A ,$98.00 ,$231.70 , N/A ,$231.70 , N/A ,$208.60 ,$208.60 , N/A ,$208.60 , N/A ,$269.50 , N/A , N/A , N/A ,$262.50 ,$248.50 ,$248.50 , N/A ,$248.50 ,$297.50 ,$297.50 ,$297.50 , N/A , N/A ,$297.50 , N/A ,$350.00 ,$196.35 , N/A ,$198.87 ,$104.08 ,$94.62 , N/A ,$297.50 , N/A ,$208.60 ,$98.00 ,$315.00 , N/A ,$297.50 , N/A , N/A , N/A ,$227.50 ST. JOSEPH'S HOSPITAL - BREESE,78000225,G0426,PC TELEHEALTH STROKE ED/IP CONSULT 50 MIN - G0,960,1 ,$450.00 ,$324.00 ,$94.62 ,$450.00 , N/A ,$292.50 ,$268.65 , N/A ,$126.00 ,$297.90 , N/A ,$297.90 , N/A ,$268.20 ,$268.20 , N/A ,$268.20 , N/A ,$346.50 , N/A , N/A , N/A ,$337.50 ,$319.50 ,$319.50 , N/A ,$319.50 ,$382.50 ,$382.50 ,$382.50 , N/A , N/A ,$382.50 , N/A ,$450.00 ,$252.45 , N/A ,$269.77 ,$104.08 ,$94.62 , N/A ,$382.50 , N/A ,$268.20 ,$126.00 ,$405.00 , N/A ,$382.50 , N/A , N/A , N/A ,$292.50 ST. JOSEPH'S HOSPITAL - BREESE,78000226,G0427,PC TELEHEALTH STROKE ED/IP CONSULT 70 MIN - G0,960,1 ,$550.00 ,$396.00 ,$94.62 ,$550.00 , N/A ,$357.50 ,$328.35 , N/A ,$154.00 ,$364.10 , N/A ,$364.10 , N/A ,$327.80 ,$327.80 , N/A ,$327.80 , N/A ,$423.50 , N/A , N/A , N/A ,$412.50 ,$390.50 ,$390.50 , N/A ,$390.50 ,$467.50 ,$467.50 ,$467.50 , N/A , N/A ,$467.50 , N/A ,$550.00 ,$308.55 , N/A ,$400.27 ,$104.08 ,$94.62 , N/A ,$467.50 , N/A ,$327.80 ,$154.00 ,$495.00 , N/A ,$467.50 , N/A , N/A , N/A ,$357.50 ST. JOSEPH'S HOSPITAL - BREESE,78000227,G0508,PC TELEHEALTH STROKE CRITICAL CARE CONSULT 60 MIN - G0,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$422.50 ,$388.05 , N/A ,$182.00 ,$430.30 , N/A ,$430.30 , N/A ,$387.40 ,$387.40 , N/A ,$387.40 , N/A ,$500.50 , N/A , N/A , N/A ,$487.50 ,$461.50 ,$461.50 , N/A ,$461.50 ,$552.50 ,$552.50 ,$552.50 , N/A , N/A ,$552.50 , N/A ,$650.00 ,$364.65 , N/A ,$419.54 ,$104.08 ,$94.62 , N/A ,$552.50 , N/A ,$387.40 ,$182.00 ,$585.00 , N/A ,$552.50 , N/A , N/A , N/A ,$422.50 ST. JOSEPH'S HOSPITAL - BREESE,78000228,G0509,PC TELEHEALTH STROKE CRITICAL CARE CONSULT 50 MIN -G0,960,1 ,$650.00 ,$468.00 ,$94.62 ,$650.00 , N/A ,$422.50 ,$388.05 , N/A ,$182.00 ,$430.30 , N/A ,$430.30 , N/A ,$387.40 ,$387.40 , N/A ,$387.40 , N/A ,$500.50 , N/A , N/A , N/A ,$487.50 ,$461.50 ,$461.50 , N/A ,$461.50 ,$552.50 ,$552.50 ,$552.50 , N/A , N/A ,$552.50 , N/A ,$650.00 ,$364.65 , N/A ,$388.37 ,$104.08 ,$94.62 , N/A ,$552.50 , N/A ,$387.40 ,$182.00 ,$585.00 , N/A ,$552.50 , N/A , N/A , N/A ,$422.50 ST. JOSEPH'S HOSPITAL - BREESE,91400004,90832,HC THERAPY INDIVIDUAL PSYCH 30MIN,914,1 ,$120.00 ,$86.40 ,$33.60 ,$349.80 ,$349.80 ,$78.00 ,$71.64 ,$137.12 ,$33.60 ,$79.44 ,$137.12 ,$79.44 ,$117.60 ,$71.52 ,$71.52 ,$117.60 ,$71.52 ,$120.00 ,$92.40 ,$349.80 ,$137.12 ,$117.60 ,$90.00 ,$85.20 ,$85.20 ,$137.12 ,$85.20 ,$102.00 ,$102.00 ,$102.00 , N/A ,$120.00 ,$102.00 ,$117.60 ,$120.00 ,$67.32 ,$137.12 ,$49.68 ,$109.58 ,$99.62 ,$137.12 ,$102.00 ,$293.84 ,$71.52 ,$33.60 ,$108.00 ,$137.12 ,$102.00 , N/A , N/A ,$137.12 ,$78.00 ST. JOSEPH'S HOSPITAL - BREESE,91400007,90834,HC THERAPY INDIVIDUAL PSYCH 45MIN,914,1 ,$181.00 ,$130.32 ,$50.68 ,$349.80 ,$349.80 ,$117.65 ,$108.06 ,$137.12 ,$50.68 ,$119.82 ,$137.12 ,$119.82 ,$137.12 ,$107.88 ,$107.88 ,$137.12 ,$107.88 ,$181.00 ,$139.37 ,$349.80 ,$137.12 ,$139.87 ,$135.75 ,$128.51 ,$128.51 ,$137.12 ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A ,$181.00 ,$153.85 ,$137.12 ,$181.00 ,$101.54 ,$137.12 ,$74.93 ,$109.77 ,$99.79 ,$137.12 ,$153.85 ,$293.84 ,$107.88 ,$50.68 ,$162.90 ,$137.12 ,$153.85 , N/A , N/A ,$137.12 ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,91400012,90837,HC THERAPY INDIVIDUAL PSYCH 60MIN,914,1 ,$204.00 ,$146.88 ,$57.12 ,$349.80 ,$349.80 ,$132.60 ,$121.79 ,$137.12 ,$57.12 ,$135.05 ,$137.12 ,$135.05 ,$137.12 ,$121.58 ,$121.58 ,$137.12 ,$121.58 ,$204.00 ,$157.08 ,$349.80 ,$137.12 ,$139.87 ,$153.00 ,$144.84 ,$144.84 ,$137.12 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$137.12 ,$204.00 ,$114.44 ,$137.12 ,$84.46 ,$109.77 ,$99.79 ,$137.12 ,$173.40 ,$293.84 ,$121.58 ,$57.12 ,$183.60 ,$137.12 ,$173.40 , N/A , N/A ,$137.12 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,91600005,90846,HC THERAPY FAMILY PSYCH W/O PATIENT 50 MIN,916,1 ,$204.00 ,$146.88 ,$57.12 ,$349.80 ,$349.80 ,$132.60 ,$121.79 ,$137.12 ,$57.12 ,$135.05 ,$137.12 ,$135.05 ,$137.12 ,$121.58 ,$121.58 ,$137.12 ,$121.58 ,$204.00 ,$157.08 ,$349.80 ,$137.12 ,$139.87 ,$153.00 ,$144.84 ,$144.84 ,$137.12 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$137.12 ,$204.00 ,$114.44 ,$137.12 ,$84.46 ,$115.72 ,$105.20 ,$137.12 ,$173.40 ,$293.84 ,$121.58 ,$57.12 ,$183.60 ,$137.12 ,$173.40 , N/A , N/A ,$137.12 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,91600006,90847,HC THERAPY FAMILY PSYCH W/PATIENT 50 MIN,916,1 ,$181.00 ,$130.32 ,$50.68 ,$349.80 ,$349.80 ,$117.65 ,$108.06 ,$137.12 ,$50.68 ,$119.82 ,$137.12 ,$119.82 ,$137.12 ,$107.88 ,$107.88 ,$137.12 ,$107.88 ,$181.00 ,$139.37 ,$349.80 ,$137.12 ,$139.87 ,$135.75 ,$128.51 ,$128.51 ,$137.12 ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A ,$181.00 ,$153.85 ,$137.12 ,$181.00 ,$101.54 ,$137.12 ,$74.93 ,$115.72 ,$105.20 ,$137.12 ,$153.85 ,$293.84 ,$107.88 ,$50.68 ,$162.90 ,$137.12 ,$153.85 , N/A , N/A ,$137.12 ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,91600007,90853,HC THERAPY GROUP PSYCH,916,1 ,$181.00 ,$130.32 ,$50.68 ,$182.10 ,$182.10 ,$117.65 ,$108.06 ,$71.38 ,$50.68 ,$119.82 ,$71.38 ,$119.82 ,$71.38 ,$107.88 ,$107.88 ,$71.38 ,$107.88 ,$147.14 ,$139.37 ,$182.10 ,$71.38 ,$72.81 ,$135.75 ,$128.51 ,$128.51 ,$71.38 ,$128.51 ,$153.85 ,$153.85 ,$153.85 , N/A ,$181.00 ,$153.85 ,$71.38 ,$181.00 ,$101.54 ,$71.38 ,$74.93 ,$155.64 ,$141.49 ,$71.38 ,$153.85 ,$152.97 ,$107.88 ,$50.68 ,$162.90 ,$71.38 ,$153.85 , N/A , N/A ,$71.38 ,$117.65 ST. JOSEPH'S HOSPITAL - BREESE,91800006,96116,HC NEUROPSYCH STATUS EXAM MD/QHCP INIT HOUR,918,1 ,$399.00 ,$287.28 ,$111.72 ,$643.96 ,$643.95 ,$259.35 ,$238.20 ,$252.43 ,$111.72 ,$264.14 ,$252.43 ,$264.14 ,$252.43 ,$237.80 ,$237.80 ,$252.43 ,$237.80 ,$399.00 ,$307.23 ,$643.96 ,$252.43 ,$257.48 ,$299.25 ,$283.29 ,$283.29 ,$252.43 ,$283.29 ,$339.15 ,$339.15 ,$339.15 , N/A ,$399.00 ,$339.15 ,$252.43 ,$399.00 ,$223.84 ,$252.43 ,$165.19 ,$399.00 ,$399.00 ,$252.43 ,$339.15 ,$540.92 ,$237.80 ,$111.72 ,$359.10 ,$252.43 ,$339.15 ,$337.16 ,$337.16 ,$252.43 ,$259.35 ST. JOSEPH'S HOSPITAL - BREESE,91800007,96121,HC NEUROPSYCH STATUS EXAM MD/QHCP ADDL HOUR,918,1 ,$399.00 ,$287.28 ,$111.72 ,$399.00 , N/A ,$259.35 ,$238.20 , N/A ,$111.72 ,$264.14 , N/A ,$264.14 , N/A ,$237.80 ,$237.80 , N/A ,$237.80 , N/A ,$307.23 , N/A , N/A , N/A ,$299.25 ,$283.29 ,$283.29 , N/A ,$283.29 ,$339.15 ,$339.15 ,$339.15 , N/A , N/A ,$339.15 , N/A ,$399.00 ,$223.84 , N/A ,$165.19 ,$399.00 ,$399.00 , N/A ,$339.15 , N/A ,$237.80 ,$111.72 ,$359.10 , N/A ,$339.15 ,$337.16 ,$337.16 , N/A ,$259.35 ST. JOSEPH'S HOSPITAL - BREESE,92000001,59020,HC TEST STRESS FETAL,920,1 ,$430.00 ,$309.60 ,$120.40 ,$430.00 ,$427.68 ,$279.50 ,$256.71 ,$167.65 ,$120.40 ,$284.66 ,$167.65 ,$284.66 ,$167.65 ,$256.28 ,$256.28 ,$167.65 ,$256.28 ,$345.55 ,$331.10 ,$427.66 ,$167.65 ,$171.00 ,$322.50 ,$305.30 ,$305.30 ,$167.65 ,$305.30 ,$365.50 ,$365.50 ,$365.50 , N/A ,$427.66 ,$365.50 ,$167.65 ,$430.00 ,$241.23 ,$167.65 ,$178.02 , N/A , N/A ,$167.65 ,$365.50 ,$359.24 ,$256.28 ,$120.40 ,$387.00 ,$167.65 ,$365.50 ,$363.35 ,$363.35 ,$167.65 ,$279.50 ST. JOSEPH'S HOSPITAL - BREESE,92000002,59025,HC TEST NON STRESS FETAL,920,1 ,$566.00 ,$407.52 ,$158.48 ,$566.00 ,$427.68 ,$367.90 ,$337.90 ,$167.65 ,$158.48 ,$374.69 ,$167.65 ,$374.69 ,$167.65 ,$337.34 ,$337.34 ,$167.65 ,$337.34 ,$345.55 ,$435.82 ,$427.66 ,$167.65 ,$171.00 ,$424.50 ,$401.86 ,$401.86 ,$167.65 ,$401.86 ,$481.10 ,$481.10 ,$481.10 , N/A ,$427.66 ,$481.10 ,$167.65 ,$566.00 ,$317.53 ,$167.65 ,$234.32 , N/A , N/A ,$167.65 ,$481.10 ,$359.24 ,$337.34 ,$158.48 ,$509.40 ,$167.65 ,$481.10 ,$478.27 ,$478.27 ,$167.65 ,$367.90 ST. JOSEPH'S HOSPITAL - BREESE,92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,397.00 ","$1,005.84 ",$102.37 ,"$1,397.00 ",$560.65 ,$908.05 ,$834.01 ,$219.77 ,$391.16 ,$924.81 ,$219.77 ,$924.81 ,$219.77 ,$832.61 ,$832.61 ,$219.77 ,$832.61 ,$453.00 ,"$1,075.69 ",$560.65 ,$219.77 ,$224.17 ,"$1,047.75 ",$991.87 ,$991.87 ,$219.77 ,$991.87 ,"$1,187.45 ","$1,187.45 ","$1,187.45 ", N/A ,$560.65 ,"$1,187.45 ",$219.77 ,"$1,397.00 ",$783.72 ,$219.77 ,$578.36 ,$112.61 ,$102.37 ,$219.77 ,"$1,187.45 ",$470.94 ,$832.61 ,$391.16 ,"$1,257.30 ",$219.77 ,"$1,187.45 ","$1,180.47 ","$1,180.47 ",$219.77 ,$908.05 ST. JOSEPH'S HOSPITAL - BREESE,92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$606.00 ,$436.32 ,$95.45 ,$606.00 ,$278.78 ,$393.90 ,$361.78 ,$109.28 ,$169.68 ,$401.17 ,$109.28 ,$401.17 ,$109.28 ,$361.18 ,$361.18 ,$109.28 ,$361.18 ,$225.24 ,$466.62 ,$278.76 ,$109.28 ,$111.47 ,$454.50 ,$430.26 ,$430.26 ,$109.28 ,$430.26 ,$515.10 ,$515.10 ,$515.10 , N/A ,$278.76 ,$515.10 ,$109.28 ,$606.00 ,$339.97 ,$109.28 ,$250.88 ,$105.00 ,$95.45 ,$109.28 ,$515.10 ,$234.16 ,$361.18 ,$169.68 ,$545.40 ,$109.28 ,$515.10 ,$512.07 ,$512.07 ,$109.28 ,$393.90 ST. JOSEPH'S HOSPITAL - BREESE,92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,"$1,560.00 ","$1,123.20 ",$95.45 ,"$1,560.00 ",$349.15 ,"$1,014.00 ",$931.32 ,$136.87 ,$436.80 ,"$1,032.72 ",$136.87 ,"$1,032.72 ",$136.87 ,$929.76 ,$929.76 ,$136.87 ,$929.76 ,$282.12 ,"$1,201.20 ",$349.16 ,$136.87 ,$139.61 ,"$1,170.00 ","$1,107.60 ","$1,107.60 ",$136.87 ,"$1,107.60 ","$1,326.00 ","$1,326.00 ","$1,326.00 ", N/A ,$349.16 ,"$1,326.00 ",$136.87 ,"$1,560.00 ",$875.16 ,$136.87 ,$645.84 ,$105.00 ,$95.45 ,$136.87 ,"$1,326.00 ",$293.29 ,$929.76 ,$436.80 ,"$1,404.00 ",$136.87 ,"$1,326.00 ","$1,318.20 ","$1,318.20 ",$136.87 ,"$1,014.00 " ST. JOSEPH'S HOSPITAL - BREESE,92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,"$1,096.00 ",$789.12 ,$95.45 ,"$1,096.00 ",$672.38 ,$712.40 ,$654.31 ,$263.57 ,$306.88 ,$725.55 ,$263.57 ,$725.55 ,$263.57 ,$653.22 ,$653.22 ,$263.57 ,$653.22 ,$543.28 ,$843.92 ,$672.38 ,$263.57 ,$268.84 ,$822.00 ,$778.16 ,$778.16 ,$263.57 ,$778.16 ,$931.60 ,$931.60 ,$931.60 , N/A ,$672.38 ,$931.60 ,$263.57 ,"$1,096.00 ",$614.86 ,$263.57 ,$453.74 ,$105.00 ,$95.45 ,$263.57 ,$931.60 ,$564.80 ,$653.22 ,$306.88 ,$986.40 ,$263.57 ,$931.60 ,$926.12 ,$926.12 ,$263.57 ,$712.40 ST. JOSEPH'S HOSPITAL - BREESE,92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$2,526.00 ","$1,818.72 ",$134.74 ,"$2,526.00 ",$560.65 ,"$1,641.90 ","$1,508.02 ",$219.77 ,$707.28 ,"$1,672.21 ",$219.77 ,"$1,672.21 ",$219.77 ,"$1,505.50 ","$1,505.50 ",$219.77 ,"$1,505.50 ",$453.00 ,"$1,945.02 ",$560.65 ,$219.77 ,$224.17 ,"$1,894.50 ","$1,793.46 ","$1,793.46 ",$219.77 ,"$1,793.46 ","$2,147.10 ","$2,147.10 ","$2,147.10 ", N/A ,$560.65 ,"$2,147.10 ",$219.77 ,"$2,526.00 ","$1,417.09 ",$219.77 ,"$1,045.76 ",$148.21 ,$134.74 ,$219.77 ,"$2,147.10 ",$470.94 ,"$1,505.50 ",$707.28 ,"$2,273.40 ",$219.77 ,"$2,147.10 ","$2,134.47 ","$2,134.47 ",$219.77 ,"$1,641.90 " ST. JOSEPH'S HOSPITAL - BREESE,92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,"$1,834.00 ","$1,320.48 ",$100.59 ,"$1,834.00 ",$256.60 ,"$1,192.10 ","$1,094.90 ",$100.59 ,$513.52 ,"$1,214.11 ",$100.59 ,"$1,214.11 ",$100.59 ,"$1,093.06 ","$1,093.06 ",$100.59 ,"$1,093.06 ",$207.34 ,"$1,412.18 ",$256.60 ,$100.59 ,$102.60 ,"$1,375.50 ","$1,302.14 ","$1,302.14 ",$100.59 ,"$1,302.14 ","$1,558.90 ","$1,558.90 ","$1,558.90 ", N/A ,$256.60 ,"$1,558.90 ",$100.59 ,"$1,834.00 ","$1,028.87 ",$100.59 ,$759.28 ,$148.21 ,$134.74 ,$100.59 ,"$1,558.90 ",$215.55 ,"$1,093.06 ",$513.52 ,"$1,650.60 ",$100.59 ,"$1,558.90 ","$1,549.73 ","$1,549.73 ",$100.59 ,"$1,192.10 " ST. JOSEPH'S HOSPITAL - BREESE,92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$2,861.00 ","$2,059.92 ",$102.37 ,"$2,861.00 ",$560.65 ,"$1,859.65 ","$1,708.02 ",$219.77 ,$801.08 ,"$1,893.98 ",$219.77 ,"$1,893.98 ",$219.77 ,"$1,705.16 ","$1,705.16 ",$219.77 ,"$1,705.16 ",$453.00 ,"$2,202.97 ",$560.65 ,$219.77 ,$224.17 ,"$2,145.75 ","$2,031.31 ","$2,031.31 ",$219.77 ,"$2,031.31 ","$2,431.85 ","$2,431.85 ","$2,431.85 ", N/A ,$560.65 ,"$2,431.85 ",$219.77 ,"$2,861.00 ","$1,605.02 ",$219.77 ,"$1,184.45 ",$112.61 ,$102.37 ,$219.77 ,"$2,431.85 ",$470.94 ,"$1,705.16 ",$801.08 ,"$2,574.90 ",$219.77 ,"$2,431.85 ","$2,417.55 ","$2,417.55 ",$219.77 ,"$1,859.65 " ST. JOSEPH'S HOSPITAL - BREESE,92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,"$1,486.00 ","$1,069.92 ",$100.59 ,"$1,486.00 ",$256.60 ,$965.90 ,$887.14 ,$100.59 ,$416.08 ,$983.73 ,$100.59 ,$983.73 ,$100.59 ,$885.66 ,$885.66 ,$100.59 ,$885.66 ,$207.34 ,"$1,144.22 ",$256.60 ,$100.59 ,$102.60 ,"$1,114.50 ","$1,055.06 ","$1,055.06 ",$100.59 ,"$1,055.06 ","$1,263.10 ","$1,263.10 ","$1,263.10 ", N/A ,$256.60 ,"$1,263.10 ",$100.59 ,"$1,486.00 ",$833.65 ,$100.59 ,$615.20 ,$112.61 ,$102.37 ,$100.59 ,"$1,263.10 ",$215.55 ,$885.66 ,$416.08 ,"$1,337.40 ",$100.59 ,"$1,263.10 ","$1,255.67 ","$1,255.67 ",$100.59 ,$965.90 ST. JOSEPH'S HOSPITAL - BREESE,92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$2,526.00 ","$1,818.72 ",$134.74 ,"$2,526.00 ",$560.65 ,"$1,641.90 ","$1,508.02 ",$219.77 ,$707.28 ,"$1,672.21 ",$219.77 ,"$1,672.21 ",$219.77 ,"$1,505.50 ","$1,505.50 ",$219.77 ,"$1,505.50 ",$453.00 ,"$1,945.02 ",$560.65 ,$219.77 ,$224.17 ,"$1,894.50 ","$1,793.46 ","$1,793.46 ",$219.77 ,"$1,793.46 ","$2,147.10 ","$2,147.10 ","$2,147.10 ", N/A ,$560.65 ,"$2,147.10 ",$219.77 ,"$2,526.00 ","$1,417.09 ",$219.77 ,"$1,045.76 ",$148.21 ,$134.74 ,$219.77 ,"$2,147.10 ",$470.94 ,"$1,505.50 ",$707.28 ,"$2,273.40 ",$219.77 ,"$2,147.10 ","$2,134.47 ","$2,134.47 ",$219.77 ,"$1,641.90 " ST. JOSEPH'S HOSPITAL - BREESE,92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,"$1,527.00 ","$1,099.44 ",$100.59 ,"$1,527.00 ",$256.60 ,$992.55 ,$911.62 ,$100.59 ,$427.56 ,"$1,010.87 ",$100.59 ,"$1,010.87 ",$100.59 ,$910.09 ,$910.09 ,$100.59 ,$910.09 ,$207.34 ,"$1,175.79 ",$256.60 ,$100.59 ,$102.60 ,"$1,145.25 ","$1,084.17 ","$1,084.17 ",$100.59 ,"$1,084.17 ","$1,297.95 ","$1,297.95 ","$1,297.95 ", N/A ,$256.60 ,"$1,297.95 ",$100.59 ,"$1,527.00 ",$856.65 ,$100.59 ,$632.18 ,$148.21 ,$134.74 ,$100.59 ,"$1,297.95 ",$215.55 ,$910.09 ,$427.56 ,"$1,374.30 ",$100.59 ,"$1,297.95 ","$1,290.32 ","$1,290.32 ",$100.59 ,$992.55 ST. JOSEPH'S HOSPITAL - BREESE,92100049,93923,HC RESTING ARTERIAL EXTREMITY COMP -52,921,1 ,"$1,560.00 ","$1,123.20 ",$47.73 ,"$1,560.00 ",$174.58 ,"$1,014.00 ",$931.32 ,$68.43 ,$436.80 ,"$1,032.72 ",$68.43 ,"$1,032.72 ",$68.43 ,$929.76 ,$929.76 ,$68.43 ,$929.76 ,$141.06 ,"$1,201.20 ",$174.58 ,$68.43 ,$69.81 ,"$1,170.00 ","$1,107.60 ","$1,107.60 ",$68.43 ,"$1,107.60 ","$1,326.00 ","$1,326.00 ","$1,326.00 ", N/A ,$174.58 ,"$1,326.00 ",$68.43 ,"$1,560.00 ",$875.16 ,$68.43 ,$645.84 ,$52.50 ,$47.73 ,$68.43 ,"$1,326.00 ",$146.65 ,$929.76 ,$436.80 ,"$1,404.00 ",$68.43 ,"$1,326.00 ","$1,318.20 ","$1,318.20 ",$68.43 ,"$1,014.00 " ST. JOSEPH'S HOSPITAL - BREESE,94000110,99195,HC THERAPEUTIC PHLEBOTOMY,940,1 ,$182.00 ,$131.04 ,$50.96 ,$278.78 ,$278.78 ,$118.30 ,$108.65 ,$109.28 ,$50.96 ,$120.48 ,$109.28 ,$120.48 ,$109.28 ,$108.47 ,$108.47 ,$109.28 ,$108.47 ,$182.00 ,$140.14 ,$278.76 ,$109.28 ,$111.47 ,$136.50 ,$129.22 ,$129.22 ,$109.28 ,$129.22 ,$154.70 ,$154.70 ,$154.70 , N/A ,$182.00 ,$154.70 ,$109.28 ,$182.00 ,$102.10 ,$109.28 ,$75.35 ,$65.58 ,$59.62 ,$109.28 ,$154.70 ,$234.16 ,$108.47 ,$50.96 ,$163.80 ,$109.28 ,$154.70 ,$153.79 ,$153.79 ,$109.28 ,$118.30 ST. JOSEPH'S HOSPITAL - BREESE,94000114,20560,HC NEEDLE INSERTION W/O INJECTION 1-2 MUSCLES,940,1 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$59.93 ,$0.01 ,$0.01 ,$23.49 , N/A ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$23.49 , N/A ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$50.34 ,$0.01 , N/A ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,94000115,20561,HC NEEDLE INSERTION W/O INJECTION 3+ MUSCLES,940,1 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$59.93 ,$0.01 ,$0.01 ,$23.49 , N/A ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$59.93 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$23.49 , N/A ,$0.01 ,$0.01 ,$23.49 ,$0.01 ,$50.34 ,$0.01 , N/A ,$0.01 ,$23.49 ,$0.01 ,$0.01 ,$0.01 ,$23.49 ,$0.01 ST. JOSEPH'S HOSPITAL - BREESE,94000118,N/A,HC CASH-BASED THERAPIES GENERIC PACKAGE #1,940,1 ,$432.00 ,$311.04 ,$120.96 ,$432.00 , N/A ,$280.80 ,$257.90 , N/A ,$120.96 ,$285.98 , N/A ,$285.98 , N/A ,$257.47 ,$257.47 , N/A ,$257.47 , N/A ,$332.64 , N/A , N/A , N/A ,$324.00 ,$306.72 ,$306.72 , N/A ,$306.72 ,$367.20 ,$367.20 ,$367.20 , N/A , N/A ,$367.20 , N/A ,$432.00 ,$242.35 , N/A ,$178.85 , N/A , N/A , N/A ,$367.20 , N/A ,$257.47 ,$120.96 ,$388.80 , N/A ,$367.20 ,$365.04 ,$365.04 , N/A ,$280.80 ST. JOSEPH'S HOSPITAL - BREESE,94000119,N/A,HC CASH-BASED THERAPIES GENERIC PACKAGE #2,940,1 ,$756.00 ,$544.32 ,$211.68 ,$756.00 , N/A ,$491.40 ,$451.33 , N/A ,$211.68 ,$500.47 , N/A ,$500.47 , N/A ,$450.58 ,$450.58 , N/A ,$450.58 , N/A ,$582.12 , N/A , N/A , N/A ,$567.00 ,$536.76 ,$536.76 , N/A ,$536.76 ,$642.60 ,$642.60 ,$642.60 , N/A , N/A ,$642.60 , N/A ,$756.00 ,$424.12 , N/A ,$312.98 , N/A , N/A , N/A ,$642.60 , N/A ,$450.58 ,$211.68 ,$680.40 , N/A ,$642.60 ,$638.82 ,$638.82 , N/A ,$491.40 ST. JOSEPH'S HOSPITAL - BREESE,94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$29.00 ,$20.88 ,$8.12 ,$89.70 ,$72.50 ,$18.85 ,$17.31 ,$35.16 ,$8.12 ,$19.20 ,$35.16 ,$19.20 ,$28.42 ,$17.28 ,$17.28 ,$28.42 ,$17.28 ,$29.00 ,$22.33 ,$89.70 ,$35.16 ,$28.42 ,$21.75 ,$20.59 ,$20.59 ,$35.16 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$29.00 ,$24.65 ,$28.42 ,$29.00 ,$16.27 ,$35.16 ,$12.01 , N/A , N/A ,$35.16 ,$24.65 ,$75.35 ,$17.28 ,$8.12 ,$26.10 ,$35.16 ,$24.65 ,$24.51 ,$24.51 ,$35.16 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,94200006,97803,HC NUTRITION THRPY RE-EVAL 15 MIN,942,1 ,$29.00 ,$20.88 ,$8.12 ,$78.20 ,$66.48 ,$18.85 ,$17.31 ,$30.65 ,$8.12 ,$19.20 ,$30.65 ,$19.20 ,$26.06 ,$17.28 ,$17.28 ,$26.06 ,$17.28 ,$29.00 ,$22.33 ,$78.20 ,$30.65 ,$28.42 ,$21.75 ,$20.59 ,$20.59 ,$30.65 ,$20.59 ,$24.65 ,$24.65 ,$24.65 , N/A ,$26.59 ,$24.65 ,$26.06 ,$29.00 ,$16.27 ,$30.65 ,$12.01 , N/A , N/A ,$30.65 ,$24.65 ,$65.69 ,$17.28 ,$8.12 ,$26.10 ,$30.65 ,$24.65 ,$24.51 ,$24.51 ,$30.65 ,$18.85 ST. JOSEPH'S HOSPITAL - BREESE,94200007,97804,HC MNT GROUP INIT 30 MIN,942,1 ,$61.00 ,$43.92 ,$13.85 ,$61.00 ,$35.33 ,$39.65 ,$36.42 ,$16.29 ,$17.08 ,$40.38 ,$16.29 ,$40.38 ,$13.85 ,$36.36 ,$36.36 ,$13.85 ,$36.36 ,$33.57 ,$46.97 ,$41.55 ,$16.29 ,$16.61 ,$45.75 ,$43.31 ,$43.31 ,$16.29 ,$43.31 ,$51.85 ,$51.85 ,$51.85 , N/A ,$14.13 ,$51.85 ,$13.85 ,$61.00 ,$34.22 ,$16.29 ,$25.25 , N/A , N/A ,$16.29 ,$51.85 ,$34.90 ,$36.36 ,$17.08 ,$54.90 ,$16.29 ,$51.85 ,$51.55 ,$51.55 ,$16.29 ,$39.65 ST. JOSEPH'S HOSPITAL - BREESE,94200011,G0108,HC DIABETES SELF MGT ED 30 MIN,942,1 ,$89.00 ,$64.08 ,$24.92 ,$135.65 ,$135.65 ,$57.85 ,$53.13 ,$53.17 ,$24.92 ,$58.92 ,$53.17 ,$58.92 ,$53.17 ,$53.04 ,$53.04 ,$53.17 ,$53.04 ,$89.00 ,$68.53 ,$135.65 ,$53.17 ,$54.24 ,$66.75 ,$63.19 ,$63.19 ,$53.17 ,$63.19 ,$75.65 ,$75.65 ,$75.65 , N/A ,$89.00 ,$75.65 ,$53.17 ,$89.00 ,$49.93 ,$53.17 ,$36.85 , N/A , N/A ,$53.17 ,$75.65 ,$113.95 ,$53.04 ,$24.92 ,$80.10 ,$53.17 ,$75.65 ,$75.21 ,$75.21 ,$53.17 ,$57.85 ST. JOSEPH'S HOSPITAL - BREESE,94200013,G0109,HC DIABETES SELF MGT GROUP 30MIN,942,1 ,$121.00 ,$87.12 ,$15.05 ,$121.00 ,$38.40 ,$78.65 ,$72.24 ,$15.05 ,$33.88 ,$80.10 ,$15.05 ,$80.10 ,$15.05 ,$72.12 ,$72.12 ,$15.05 ,$72.12 ,$31.03 ,$93.17 ,$38.40 ,$15.05 ,$15.36 ,$90.75 ,$85.91 ,$85.91 ,$15.05 ,$85.91 ,$102.85 ,$102.85 ,$102.85 , N/A ,$38.40 ,$102.85 ,$15.05 ,$121.00 ,$67.88 ,$15.05 ,$50.09 , N/A , N/A ,$15.05 ,$102.85 ,$32.26 ,$72.12 ,$33.88 ,$108.90 ,$15.05 ,$102.85 ,$102.25 ,$102.25 ,$15.05 ,$78.65 ST. JOSEPH'S HOSPITAL - BREESE,94300004,93797,HC CARDIAC REHAB W/O EKG SESSION,943,1 ,$188.00 ,$135.36 ,$52.64 ,$288.28 ,$288.28 ,$122.20 ,$112.24 ,$113.00 ,$52.64 ,$124.46 ,$113.00 ,$124.46 ,$113.00 ,$112.05 ,$112.05 ,$113.00 ,$112.05 ,$188.00 ,$144.76 ,$288.27 ,$113.00 ,$115.26 ,$141.00 ,$133.48 ,$133.48 ,$113.00 ,$133.48 ,$159.80 ,$159.80 ,$159.80 , N/A ,$188.00 ,$159.80 ,$113.00 ,$188.00 ,$105.47 ,$113.00 ,$77.83 , N/A , N/A ,$113.00 ,$159.80 ,$242.15 ,$112.05 ,$52.64 ,$169.20 ,$113.00 ,$159.80 ,$158.86 ,$158.86 ,$113.00 ,$122.20 ST. JOSEPH'S HOSPITAL - BREESE,94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$163.00 ,$117.36 ,$45.64 ,$288.28 ,$288.28 ,$105.95 ,$97.31 ,$113.00 ,$45.64 ,$107.91 ,$113.00 ,$107.91 ,$113.00 ,$97.15 ,$97.15 ,$113.00 ,$97.15 ,$163.00 ,$125.51 ,$288.27 ,$113.00 ,$115.26 ,$122.25 ,$115.73 ,$115.73 ,$113.00 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$163.00 ,$138.55 ,$113.00 ,$163.00 ,$91.44 ,$113.00 ,$67.48 , N/A , N/A ,$113.00 ,$138.55 ,$242.15 ,$97.15 ,$45.64 ,$146.70 ,$113.00 ,$138.55 ,$137.74 ,$137.74 ,$113.00 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,94300014,93798,HC CARD REHAB W/EKG SESS (PH2)-KX,943,1 ,$163.00 ,$117.36 ,$45.64 ,$288.28 ,$288.28 ,$105.95 ,$97.31 ,$113.00 ,$45.64 ,$107.91 ,$113.00 ,$107.91 ,$113.00 ,$97.15 ,$97.15 ,$113.00 ,$97.15 ,$163.00 ,$125.51 ,$288.27 ,$113.00 ,$115.26 ,$122.25 ,$115.73 ,$115.73 ,$113.00 ,$115.73 ,$138.55 ,$138.55 ,$138.55 , N/A ,$163.00 ,$138.55 ,$113.00 ,$163.00 ,$91.44 ,$113.00 ,$67.48 , N/A , N/A ,$113.00 ,$138.55 ,$242.15 ,$97.15 ,$45.64 ,$146.70 ,$113.00 ,$138.55 ,$137.74 ,$137.74 ,$113.00 ,$105.95 ST. JOSEPH'S HOSPITAL - BREESE,94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 , N/A ,$20.80 ,$19.10 , N/A ,$8.96 ,$21.18 , N/A ,$21.18 , N/A ,$19.07 ,$19.07 , N/A ,$19.07 , N/A ,$24.64 , N/A , N/A , N/A ,$24.00 ,$22.72 ,$22.72 , N/A ,$22.72 ,$27.20 ,$27.20 ,$27.20 , N/A , N/A ,$27.20 , N/A ,$32.00 ,$17.95 , N/A ,$13.25 , N/A , N/A , N/A ,$27.20 , N/A ,$19.07 ,$8.96 ,$28.80 , N/A ,$27.20 ,$27.04 ,$27.04 , N/A ,$20.80 ST. JOSEPH'S HOSPITAL - BREESE,94300022,N/A,HC CARDIAC REHAB 4 EXERCISE MONTHLY,943,1 ,$94.00 ,$67.68 ,$26.32 ,$94.00 , N/A ,$61.10 ,$56.12 , N/A ,$26.32 ,$62.23 , N/A ,$62.23 , N/A ,$56.02 ,$56.02 , N/A ,$56.02 , N/A ,$72.38 , N/A , N/A , N/A ,$70.50 ,$66.74 ,$66.74 , N/A ,$66.74 ,$79.90 ,$79.90 ,$79.90 , N/A , N/A ,$79.90 , N/A ,$94.00 ,$52.73 , N/A ,$38.92 , N/A , N/A , N/A ,$79.90 , N/A ,$56.02 ,$26.32 ,$84.60 , N/A ,$79.90 ,$79.43 ,$79.43 , N/A ,$61.10 ST. JOSEPH'S HOSPITAL - BREESE,94300030,G0422,HC INTENSIVE CARDIAC REHAB W/EXERCISE PER HOUR,943,1 ,$360.00 ,$259.20 ,$100.80 ,$360.00 ,$288.28 ,$234.00 ,$214.92 ,$113.00 ,$100.80 ,$238.32 ,$113.00 ,$238.32 ,$113.00 ,$214.56 ,$214.56 ,$113.00 ,$214.56 ,$232.92 ,$277.20 ,$288.27 ,$113.00 ,$115.26 ,$270.00 ,$255.60 ,$255.60 ,$113.00 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$288.27 ,$306.00 ,$113.00 ,$360.00 ,$201.96 ,$113.00 ,$149.04 , N/A , N/A ,$113.00 ,$306.00 ,$242.15 ,$214.56 ,$100.80 ,$324.00 ,$113.00 ,$306.00 ,$304.20 ,$304.20 ,$113.00 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,94300031,G0423,HC INTENSIVE CARDIAC REHAB W/O EXERCISE PER HOUR,943,1 ,$360.00 ,$259.20 ,$100.80 ,$360.00 ,$288.28 ,$234.00 ,$214.92 ,$113.00 ,$100.80 ,$238.32 ,$113.00 ,$238.32 ,$113.00 ,$214.56 ,$214.56 ,$113.00 ,$214.56 ,$232.92 ,$277.20 ,$288.27 ,$113.00 ,$115.26 ,$270.00 ,$255.60 ,$255.60 ,$113.00 ,$255.60 ,$306.00 ,$306.00 ,$306.00 , N/A ,$288.27 ,$306.00 ,$113.00 ,$360.00 ,$201.96 ,$113.00 ,$149.04 , N/A , N/A ,$113.00 ,$306.00 ,$242.15 ,$214.56 ,$100.80 ,$324.00 ,$113.00 ,$306.00 ,$304.20 ,$304.20 ,$113.00 ,$234.00 ST. JOSEPH'S HOSPITAL - BREESE,94800001,94625,HC PHY/QHP OP PULM RHB W/O MNTR,948,1 ,$165.00 ,$118.80 ,$46.20 ,$165.00 ,$138.00 ,$107.25 ,$98.51 ,$54.10 ,$46.20 ,$109.23 ,$54.10 ,$109.23 ,$54.10 ,$98.34 ,$98.34 ,$54.10 ,$98.34 ,$111.50 ,$127.05 ,$138.00 ,$54.10 ,$55.17 ,$123.75 ,$117.15 ,$117.15 ,$54.10 ,$117.15 ,$140.25 ,$140.25 ,$140.25 , N/A ,$138.00 ,$140.25 ,$54.10 ,$165.00 ,$92.57 ,$54.10 ,$68.31 , N/A , N/A ,$54.10 ,$140.25 ,$115.92 ,$98.34 ,$46.20 ,$148.50 ,$54.10 ,$140.25 ,$139.43 ,$139.43 ,$54.10 ,$107.25 ST. JOSEPH'S HOSPITAL - BREESE,94800002,94626,HC PHY/QHP OP PULM RHB W/MNTR,948,1 ,$165.00 ,$118.80 ,$46.20 ,$165.00 ,$138.00 ,$107.25 ,$98.51 ,$54.10 ,$46.20 ,$109.23 ,$54.10 ,$109.23 ,$54.10 ,$98.34 ,$98.34 ,$54.10 ,$98.34 ,$111.50 ,$127.05 ,$138.00 ,$54.10 ,$55.17 ,$123.75 ,$117.15 ,$117.15 ,$54.10 ,$117.15 ,$140.25 ,$140.25 ,$140.25 , N/A ,$138.00 ,$140.25 ,$54.10 ,$165.00 ,$92.57 ,$54.10 ,$68.31 , N/A , N/A ,$54.10 ,$140.25 ,$115.92 ,$98.34 ,$46.20 ,$148.50 ,$54.10 ,$140.25 ,$139.43 ,$139.43 ,$54.10 ,$107.25 ST. JOSEPH'S HOSPITAL - BREESE,97500073,43239,PC EGD W/BIOPSY SGL/MULT,975,1 ,$456.00 ,$328.32 ,$127.68 ,"$1,981.93 ","$1,981.93 ",$296.40 ,$272.23 ,$776.91 ,$127.68 ,$301.87 ,$776.91 ,$301.87 ,$446.88 ,$271.78 ,$271.78 ,$446.88 ,$271.78 ,$456.00 ,$351.12 ,"$1,981.93 ",$776.91 ,$446.88 ,$342.00 ,$323.76 ,$323.76 ,$776.91 ,$323.76 ,$387.60 ,$387.60 ,$387.60 , N/A ,$456.00 ,$387.60 ,$446.88 ,$456.00 ,$255.82 ,$776.91 ,$261.63 ,$456.00 ,$456.00 ,$776.91 ,$387.60 ,"$1,664.82 ",$271.78 ,$127.68 ,$410.40 ,$776.91 ,$387.60 , N/A , N/A ,$776.91 ,$296.40 ST. JOSEPH'S HOSPITAL - BREESE,97500074,45380,PC COLONOSCOPY W/BIOPSY SGL/MULT,975,1 ,$666.00 ,$479.52 ,$186.48 ,"$2,599.90 ","$2,599.90 ",$432.90 ,$397.60 ,"$1,019.16 ",$186.48 ,$440.89 ,"$1,019.16 ",$440.89 ,$652.68 ,$396.94 ,$396.94 ,$652.68 ,$396.94 ,$666.00 ,$512.82 ,"$2,599.90 ","$1,019.16 ",$652.68 ,$499.50 ,$472.86 ,$472.86 ,"$1,019.16 ",$472.86 ,$566.10 ,$566.10 ,$566.10 , N/A ,$666.00 ,$566.10 ,$652.68 ,$666.00 ,$373.63 ,"$1,019.16 ",$380.24 ,$502.45 ,$456.77 ,"$1,019.16 ",$566.10 ,"$2,183.92 ",$396.94 ,$186.48 ,$599.40 ,"$1,019.16 ",$566.10 , N/A , N/A ,"$1,019.16 ",$432.90 ST. JOSEPH'S HOSPITAL - BREESE,97500075,43450,PC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS,975,1 ,$261.00 ,$187.92 ,$73.08 ,"$1,981.93 ","$1,981.93 ",$169.65 ,$155.82 ,$776.91 ,$73.08 ,$172.78 ,$776.91 ,$172.78 ,$255.78 ,$155.56 ,$155.56 ,$255.78 ,$155.56 ,$261.00 ,$200.97 ,"$1,981.93 ",$776.91 ,$255.78 ,$195.75 ,$185.31 ,$185.31 ,$776.91 ,$185.31 ,$221.85 ,$221.85 ,$221.85 , N/A ,$261.00 ,$221.85 ,$255.78 ,$261.00 ,$146.42 ,$776.91 ,$147.86 ,$261.00 ,$261.00 ,$776.91 ,$221.85 ,"$1,664.82 ",$155.56 ,$73.08 ,$234.90 ,$776.91 ,$221.85 , N/A , N/A ,$776.91 ,$169.65 ST. JOSEPH'S HOSPITAL - BREESE,97500076,45378,PC COLONSCOPY DX W/SPECIMEN BRUSH/WASH,975,1 ,$205.00 ,$147.60 ,$57.40 ,"$1,995.20 ","$1,995.20 ",$133.25 ,$122.39 ,$782.12 ,$57.40 ,$135.71 ,$782.12 ,$135.71 ,$200.90 ,$122.18 ,$122.18 ,$200.90 ,$122.18 ,$205.00 ,$157.85 ,"$1,995.20 ",$782.12 ,$200.90 ,$153.75 ,$145.55 ,$145.55 ,$782.12 ,$145.55 ,$174.25 ,$174.25 ,$174.25 , N/A ,$205.00 ,$174.25 ,$200.90 ,$205.00 ,$115.01 ,$782.12 ,$205.00 ,$205.00 ,$205.00 ,$782.12 ,$174.25 ,"$1,675.97 ",$122.18 ,$57.40 ,$184.50 ,$782.12 ,$174.25 , N/A , N/A ,$782.12 ,$133.25 ST. JOSEPH'S HOSPITAL - BREESE,97500077,45385,PC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH,975,1 ,$843.00 ,$606.96 ,$236.04 ,"$2,599.90 ","$2,599.90 ",$547.95 ,$503.27 ,"$1,019.16 ",$236.04 ,$558.07 ,"$1,019.16 ",$558.07 ,$826.14 ,$502.43 ,$502.43 ,$826.14 ,$502.43 ,$843.00 ,$649.11 ,"$2,599.90 ","$1,019.16 ",$826.14 ,$632.25 ,$598.53 ,$598.53 ,"$1,019.16 ",$598.53 ,$716.55 ,$716.55 ,$716.55 , N/A ,$843.00 ,$716.55 ,$826.14 ,$843.00 ,$472.92 ,"$1,019.16 ",$482.96 ,$618.18 ,$561.98 ,"$1,019.16 ",$716.55 ,"$2,183.92 ",$502.43 ,$236.04 ,$758.70 ,"$1,019.16 ",$716.55 , N/A , N/A ,"$1,019.16 ",$547.95 ST. JOSEPH'S HOSPITAL - BREESE,97500078,G0105,PC COLONSCOPY CANCER SCREENING HIGH RISK,975,1 ,$204.00 ,$146.88 ,$57.12 ,"$1,995.20 ","$1,995.20 ",$132.60 ,$121.79 ,$782.12 ,$57.12 ,$135.05 ,$782.12 ,$135.05 ,$199.92 ,$121.58 ,$121.58 ,$199.92 ,$121.58 ,$204.00 ,$157.08 ,"$1,995.20 ",$782.12 ,$199.92 ,$153.00 ,$144.84 ,$144.84 ,$782.12 ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A ,$204.00 ,$173.40 ,$199.92 ,$204.00 ,$114.44 ,$782.12 ,$204.00 ,$204.00 ,$204.00 ,$782.12 ,$173.40 ,"$1,675.97 ",$121.58 ,$57.12 ,$183.60 ,$782.12 ,$173.40 , N/A , N/A ,$782.12 ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,97500079,G0121,PC COLONSCOPY CANCER SCREENING NOT HIGH RISK,975,1 ,$183.00 ,$131.76 ,$51.24 ,"$1,995.20 ","$1,995.20 ",$118.95 ,$109.25 ,$782.12 ,$51.24 ,$121.15 ,$782.12 ,$121.15 ,$179.34 ,$109.07 ,$109.07 ,$179.34 ,$109.07 ,$183.00 ,$140.91 ,"$1,995.20 ",$782.12 ,$179.34 ,$137.25 ,$129.93 ,$129.93 ,$782.12 ,$129.93 ,$155.55 ,$155.55 ,$155.55 , N/A ,$183.00 ,$155.55 ,$179.34 ,$183.00 ,$102.66 ,$782.12 ,$183.00 ,$183.00 ,$183.00 ,$782.12 ,$155.55 ,"$1,675.97 ",$109.07 ,$51.24 ,$164.70 ,$782.12 ,$155.55 , N/A , N/A ,$782.12 ,$118.95 ST. JOSEPH'S HOSPITAL - BREESE,97500080,43249,PC EGD W/BALLOON DILAT <30MM,975,1 ,$504.00 ,$362.88 ,$141.12 ,"$4,181.30 ","$4,181.30 ",$327.60 ,$300.89 ,"$1,639.07 ",$141.12 ,$333.65 ,"$1,639.07 ",$333.65 ,$493.92 ,$300.38 ,$300.38 ,$493.92 ,$300.38 ,$504.00 ,$388.08 ,"$4,181.30 ","$1,639.07 ",$493.92 ,$378.00 ,$357.84 ,$357.84 ,"$1,639.07 ",$357.84 ,$428.40 ,$428.40 ,$428.40 , N/A ,$504.00 ,$428.40 ,$493.92 ,$504.00 ,$282.74 ,"$1,639.07 ",$289.95 ,$504.00 ,$504.00 ,"$1,639.07 ",$428.40 ,"$3,512.29 ",$300.38 ,$141.12 ,$453.60 ,"$1,639.07 ",$428.40 , N/A , N/A ,"$1,639.07 ",$327.60 ST. JOSEPH'S HOSPITAL - BREESE,97500081,43235,PC EGD W/BRUSH/WASH,975,1 ,$468.00 ,$336.96 ,$131.04 ,"$1,981.93 ","$1,981.93 ",$304.20 ,$279.40 ,$776.91 ,$131.04 ,$309.82 ,$776.91 ,$309.82 ,$458.64 ,$278.93 ,$278.93 ,$458.64 ,$278.93 ,$468.00 ,$360.36 ,"$1,981.93 ",$776.91 ,$458.64 ,$351.00 ,$332.28 ,$332.28 ,$776.91 ,$332.28 ,$397.80 ,$397.80 ,$397.80 , N/A ,$468.00 ,$397.80 ,$458.64 ,$468.00 ,$262.55 ,$776.91 ,$232.17 ,$468.00 ,$468.00 ,$776.91 ,$397.80 ,"$1,664.82 ",$278.93 ,$131.04 ,$421.20 ,$776.91 ,$397.80 , N/A , N/A ,$776.91 ,$304.20 ST. JOSEPH'S HOSPITAL - BREESE,97500082,43251,PC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH,975,1 ,$651.00 ,$468.72 ,$182.28 ,"$4,181.30 ","$4,181.30 ",$423.15 ,$388.65 ,"$1,639.07 ",$182.28 ,$430.96 ,"$1,639.07 ",$430.96 ,$637.98 ,$388.00 ,$388.00 ,$637.98 ,$388.00 ,$651.00 ,$501.27 ,"$4,181.30 ","$1,639.07 ",$637.98 ,$488.25 ,$462.21 ,$462.21 ,"$1,639.07 ",$462.21 ,$553.35 ,$553.35 ,$553.35 , N/A ,$651.00 ,$553.35 ,$637.98 ,$651.00 ,$365.21 ,"$1,639.07 ",$371.63 ,$651.00 ,$651.00 ,"$1,639.07 ",$553.35 ,"$3,512.29 ",$388.00 ,$182.28 ,$585.90 ,"$1,639.07 ",$553.35 , N/A , N/A ,"$1,639.07 ",$423.15 ST. JOSEPH'S HOSPITAL - BREESE,97500083,43250,PC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY,975,1 ,$570.00 ,$410.40 ,$159.60 ,"$4,181.30 ","$4,181.30 ",$370.50 ,$340.29 ,"$1,639.07 ",$159.60 ,$377.34 ,"$1,639.07 ",$377.34 ,$558.60 ,$339.72 ,$339.72 ,$558.60 ,$339.72 ,$570.00 ,$438.90 ,"$4,181.30 ","$1,639.07 ",$558.60 ,$427.50 ,$404.70 ,$404.70 ,"$1,639.07 ",$404.70 ,$484.50 ,$484.50 ,$484.50 , N/A ,$570.00 ,$484.50 ,$558.60 ,$570.00 ,$319.77 ,"$1,639.07 ",$325.72 ,$570.00 ,$570.00 ,"$1,639.07 ",$484.50 ,"$3,512.29 ",$339.72 ,$159.60 ,$513.00 ,"$1,639.07 ",$484.50 , N/A , N/A ,"$1,639.07 ",$370.50 ST. JOSEPH'S HOSPITAL - BREESE,97500084,45386,PC COLONOSCOPY W/BALLOON DILATION,975,1 ,$702.00 ,$505.44 ,$196.56 ,"$2,599.90 ","$2,599.90 ",$456.30 ,$419.09 ,"$1,019.16 ",$196.56 ,$464.72 ,"$1,019.16 ",$464.72 ,$687.96 ,$418.39 ,$418.39 ,$687.96 ,$418.39 ,$702.00 ,$540.54 ,"$2,599.90 ","$1,019.16 ",$687.96 ,$526.50 ,$498.42 ,$498.42 ,"$1,019.16 ",$498.42 ,$596.70 ,$596.70 ,$596.70 , N/A ,$702.00 ,$596.70 ,$687.96 ,$702.00 ,$393.82 ,"$1,019.16 ",$401.47 ,$618.18 ,$561.98 ,"$1,019.16 ",$596.70 ,"$2,183.92 ",$418.39 ,$196.56 ,$631.80 ,"$1,019.16 ",$596.70 , N/A , N/A ,"$1,019.16 ",$456.30 ST. JOSEPH'S HOSPITAL - BREESE,97500085,45381,PC COLONSCOPY W/SUBMUCOSAL INJ,975,1 ,$666.00 ,$479.52 ,$186.48 ,"$2,599.90 ","$2,599.90 ",$432.90 ,$397.60 ,"$1,019.16 ",$186.48 ,$440.89 ,"$1,019.16 ",$440.89 ,$652.68 ,$396.94 ,$396.94 ,$652.68 ,$396.94 ,$666.00 ,$512.82 ,"$2,599.90 ","$1,019.16 ",$652.68 ,$499.50 ,$472.86 ,$472.86 ,"$1,019.16 ",$472.86 ,$566.10 ,$566.10 ,$566.10 , N/A ,$666.00 ,$566.10 ,$652.68 ,$666.00 ,$373.63 ,"$1,019.16 ",$380.24 ,$618.18 ,$561.98 ,"$1,019.16 ",$566.10 ,"$2,183.92 ",$396.94 ,$186.48 ,$599.40 ,"$1,019.16 ",$566.10 , N/A , N/A ,"$1,019.16 ",$432.90 ST. JOSEPH'S HOSPITAL - BREESE,97500086,45382,PC COLONSCOPY W/CONTROL BLEEDING,975,1 ,$858.00 ,$617.76 ,$240.24 ,"$2,599.90 ","$2,599.90 ",$557.70 ,$512.23 ,"$1,019.16 ",$240.24 ,$568.00 ,"$1,019.16 ",$568.00 ,$840.84 ,$511.37 ,$511.37 ,$840.84 ,$511.37 ,$858.00 ,$660.66 ,"$2,599.90 ","$1,019.16 ",$840.84 ,$643.50 ,$609.18 ,$609.18 ,"$1,019.16 ",$609.18 ,$729.30 ,$729.30 ,$729.30 , N/A ,$858.00 ,$729.30 ,$840.84 ,$858.00 ,$481.34 ,"$1,019.16 ",$491.20 ,$618.18 ,$561.98 ,"$1,019.16 ",$729.30 ,"$2,183.92 ",$511.37 ,$240.24 ,$772.20 ,"$1,019.16 ",$729.30 , N/A , N/A ,"$1,019.16 ",$557.70 ST. JOSEPH'S HOSPITAL - BREESE,97500087,43233,PC EGD W/BALLOON DILAT >30MM,975,1 ,$762.00 ,$548.64 ,$213.36 ,"$4,181.30 ","$4,181.30 ",$495.30 ,$454.91 ,"$1,639.07 ",$213.36 ,$504.44 ,"$1,639.07 ",$504.44 ,$746.76 ,$454.15 ,$454.15 ,$746.76 ,$454.15 ,$762.00 ,$586.74 ,"$4,181.30 ","$1,639.07 ",$746.76 ,$571.50 ,$541.02 ,$541.02 ,"$1,639.07 ",$541.02 ,$647.70 ,$647.70 ,$647.70 , N/A ,$762.00 ,$647.70 ,$746.76 ,$762.00 ,$427.48 ,"$1,639.07 ",$436.62 ,$762.00 ,$727.10 ,"$1,639.07 ",$647.70 ,"$3,512.29 ",$454.15 ,$213.36 ,$685.80 ,"$1,639.07 ",$647.70 , N/A , N/A ,"$1,639.07 ",$495.30 ST. JOSEPH'S HOSPITAL - BREESE,97500088,45398,PC COLONOSCOPY W/BAND LIGATION,975,1 ,"$1,296.00 ",$933.12 ,$362.88 ,"$2,599.90 ","$2,599.90 ",$842.40 ,$773.71 ,"$1,019.16 ",$362.88 ,$857.95 ,"$1,019.16 ",$857.95 ,"$1,019.16 ",$772.42 ,$772.42 ,"$1,019.16 ",$772.42 ,"$1,296.00 ",$997.92 ,"$2,599.90 ","$1,019.16 ","$1,039.54 ",$972.00 ,$920.16 ,$920.16 ,"$1,019.16 ",$920.16 ,"$1,101.60 ","$1,101.60 ","$1,101.60 ", N/A ,"$1,296.00 ","$1,101.60 ","$1,019.16 ","$1,296.00 ",$727.06 ,"$1,019.16 ",$451.07 ,$618.18 ,$561.98 ,"$1,019.16 ","$1,101.60 ","$2,183.92 ",$772.42 ,$362.88 ,"$1,166.40 ","$1,019.16 ","$1,101.60 ", N/A , N/A ,"$1,019.16 ",$842.40 ST. JOSEPH'S HOSPITAL - BREESE,97500089,43247,PC EGD W/FB REMOVAL,975,1 ,$718.00 ,$516.96 ,$201.04 ,"$1,981.93 ","$1,981.93 ",$466.70 ,$428.65 ,$776.91 ,$201.04 ,$475.32 ,$776.91 ,$475.32 ,$703.64 ,$427.93 ,$427.93 ,$703.64 ,$427.93 ,$718.00 ,$552.86 ,"$1,981.93 ",$776.91 ,$703.64 ,$538.50 ,$509.78 ,$509.78 ,$776.91 ,$509.78 ,$610.30 ,$610.30 ,$610.30 , N/A ,$718.00 ,$610.30 ,$703.64 ,$718.00 ,$402.80 ,$776.91 ,$335.74 ,$718.00 ,$718.00 ,$776.91 ,$610.30 ,"$1,664.82 ",$427.93 ,$201.04 ,$646.20 ,$776.91 ,$610.30 , N/A , N/A ,$776.91 ,$466.70 ST. JOSEPH'S HOSPITAL - BREESE,97500090,43236,PC EGD W/SUBMUCOSAL INJ,975,1 ,"$1,253.00 ",$902.16 ,$261.44 ,"$1,981.93 ","$1,981.93 ",$814.45 ,$748.04 ,$776.91 ,$350.84 ,$829.49 ,$776.91 ,$829.49 ,$776.91 ,$746.79 ,$746.79 ,$776.91 ,$746.79 ,"$1,253.00 ",$964.81 ,"$1,981.93 ",$776.91 ,$792.46 ,$939.75 ,$889.63 ,$889.63 ,$776.91 ,$889.63 ,"$1,065.05 ","$1,065.05 ","$1,065.05 ", N/A ,"$1,253.00 ","$1,065.05 ",$776.91 ,"$1,253.00 ",$702.93 ,$776.91 ,$261.44 ,$799.81 ,$727.10 ,$776.91 ,"$1,065.05 ","$1,664.82 ",$746.79 ,$350.84 ,"$1,127.70 ",$776.91 ,"$1,065.05 ", N/A , N/A ,$776.91 ,$814.45 ST. JOSEPH'S HOSPITAL - BREESE,97500091,43248,PC EGD W/DILAT ESOPH GD WIRE,975,1 ,$480.00 ,$345.60 ,$134.40 ,"$1,981.93 ","$1,981.93 ",$312.00 ,$286.56 ,$776.91 ,$134.40 ,$317.76 ,$776.91 ,$317.76 ,$470.40 ,$286.08 ,$286.08 ,$470.40 ,$286.08 ,$480.00 ,$369.60 ,"$1,981.93 ",$776.91 ,$470.40 ,$360.00 ,$340.80 ,$340.80 ,$776.91 ,$340.80 ,$408.00 ,$408.00 ,$408.00 , N/A ,$480.00 ,$408.00 ,$470.40 ,$480.00 ,$269.28 ,$776.91 ,$313.41 ,$480.00 ,$480.00 ,$776.91 ,$408.00 ,"$1,664.82 ",$286.08 ,$134.40 ,$432.00 ,$776.91 ,$408.00 , N/A , N/A ,$776.91 ,$312.00 ST. JOSEPH'S HOSPITAL - BREESE,97500092,43220,PC ESOPHAGOSC W/BALLOON,975,1 ,$387.00 ,$278.64 ,$108.36 ,"$4,181.30 ","$4,181.30 ",$251.55 ,$231.04 ,"$1,639.07 ",$108.36 ,$256.19 ,"$1,639.07 ",$256.19 ,$379.26 ,$230.65 ,$230.65 ,$379.26 ,$230.65 ,$387.00 ,$297.99 ,"$4,181.30 ","$1,639.07 ",$379.26 ,$290.25 ,$274.77 ,$274.77 ,"$1,639.07 ",$274.77 ,$328.95 ,$328.95 ,$328.95 , N/A ,$387.00 ,$328.95 ,$379.26 ,$387.00 ,$217.11 ,"$1,639.07 ",$223.14 ,$387.00 ,$387.00 ,"$1,639.07 ",$328.95 ,"$3,512.29 ",$230.65 ,$108.36 ,$348.30 ,"$1,639.07 ",$328.95 , N/A , N/A ,"$1,639.07 ",$251.55 ST. JOSEPH'S HOSPITAL - BREESE,97500093,43264,PC ERCP W/REMOVE CALCULUS,975,1 ,"$1,843.00 ","$1,326.96 ",$516.04 ,"$7,828.43 ","$7,828.43 ","$1,197.95 ","$1,100.27 ","$3,068.74 ",$516.04 ,"$1,220.07 ","$3,068.74 ","$1,220.07 ","$1,806.14 ","$1,098.43 ","$1,098.43 ","$1,806.14 ","$1,098.43 ","$1,843.00 ","$1,419.11 ","$7,828.43 ","$3,068.74 ","$1,806.14 ","$1,382.25 ","$1,308.53 ","$1,308.53 ","$3,068.74 ","$1,308.53 ","$1,566.55 ","$1,566.55 ","$1,566.55 ", N/A ,"$1,843.00 ","$1,566.55 ","$1,806.14 ","$1,843.00 ","$1,033.92 ","$3,068.74 ",$688.74 ,"$1,691.32 ","$1,537.56 ","$3,068.74 ","$1,566.55 ","$6,575.88 ","$1,098.43 ",$516.04 ,"$1,658.70 ","$3,068.74 ","$1,566.55 ", N/A , N/A ,"$3,068.74 ","$1,197.95 " ST. JOSEPH'S HOSPITAL - BREESE,97500094,43275,PC ERCP W/REM FB STENT DUCT,975,1 ,"$1,455.00 ","$1,047.60 ",$407.40 ,"$7,828.43 ","$7,828.43 ",$945.75 ,$868.64 ,"$3,068.74 ",$407.40 ,$963.21 ,"$3,068.74 ",$963.21 ,"$1,425.90 ",$867.18 ,$867.18 ,"$1,425.90 ",$867.18 ,"$1,455.00 ","$1,120.35 ","$7,828.43 ","$3,068.74 ","$1,425.90 ","$1,091.25 ","$1,033.05 ","$1,033.05 ","$3,068.74 ","$1,033.05 ","$1,236.75 ","$1,236.75 ","$1,236.75 ", N/A ,"$1,455.00 ","$1,236.75 ","$1,425.90 ","$1,455.00 ",$816.26 ,"$3,068.74 ",$713.49 ,"$1,455.00 ","$1,455.00 ","$3,068.74 ","$1,236.75 ","$6,575.88 ",$867.18 ,$407.40 ,"$1,309.50 ","$3,068.74 ","$1,236.75 ", N/A , N/A ,"$3,068.74 ",$945.75 ST. JOSEPH'S HOSPITAL - BREESE,97500095,45384,PC COLONOSCOPY FLEX W/REM FORCEP,975,1 ,$708.42 ,$510.06 ,$198.36 ,"$2,599.90 ","$2,599.90 ",$460.47 ,$422.93 ,"$1,019.16 ",$198.36 ,$468.97 ,"$1,019.16 ",$468.97 ,$694.25 ,$422.22 ,$422.22 ,$694.25 ,$422.22 ,$708.42 ,$545.48 ,"$2,599.90 ","$1,019.16 ",$694.25 ,$531.32 ,$502.98 ,$502.98 ,"$1,019.16 ",$502.98 ,$602.16 ,$602.16 ,$602.16 , N/A ,$708.42 ,$602.16 ,$694.25 ,$708.42 ,$397.42 ,"$1,019.16 ",$435.22 ,$618.18 ,$561.98 ,"$1,019.16 ",$602.16 ,"$2,183.92 ",$422.22 ,$198.36 ,$637.58 ,"$1,019.16 ",$602.16 , N/A , N/A ,"$1,019.16 ",$460.47 ST. JOSEPH'S HOSPITAL - BREESE,97500096,43274,PC ERCP W/STENT PLACEMENT DUCT,975,1 ,"$1,764.00 ","$1,270.08 ",$493.92 ,"$12,582.18 ","$12,582.18 ","$1,146.60 ","$1,053.11 ","$4,932.21 ",$493.92 ,"$1,167.77 ","$4,932.21 ","$1,167.77 ","$1,728.72 ","$1,051.34 ","$1,051.34 ","$1,728.72 ","$1,051.34 ","$1,764.00 ","$1,358.28 ","$12,582.18 ","$4,932.21 ","$1,728.72 ","$1,323.00 ","$1,252.44 ","$1,252.44 ","$4,932.21 ","$1,252.44 ","$1,499.40 ","$1,499.40 ","$1,499.40 ", N/A ,"$1,764.00 ","$1,499.40 ","$1,728.72 ","$1,764.00 ",$989.60 ,"$4,932.21 ",$878.01 ,"$1,691.32 ","$1,537.56 ","$4,932.21 ","$1,499.40 ","$10,569.03 ","$1,051.34 ",$493.92 ,"$1,587.60 ","$4,932.21 ","$1,499.40 ", N/A , N/A ,"$4,932.21 ","$1,146.60 " ST. JOSEPH'S HOSPITAL - BREESE,97500097,43276,PC ERCP W/REM/EXCHG STENT W/DILAT AND WIRE EA,975,1 ,"$1,835.00 ","$1,321.20 ",$513.80 ,"$12,582.18 ","$12,582.18 ","$1,192.75 ","$1,095.50 ","$4,932.21 ",$513.80 ,"$1,214.77 ","$4,932.21 ","$1,214.77 ","$1,798.30 ","$1,093.66 ","$1,093.66 ","$1,798.30 ","$1,093.66 ","$1,835.00 ","$1,412.95 ","$12,582.18 ","$4,932.21 ","$1,798.30 ","$1,376.25 ","$1,302.85 ","$1,302.85 ","$4,932.21 ","$1,302.85 ","$1,559.75 ","$1,559.75 ","$1,559.75 ", N/A ,"$1,835.00 ","$1,559.75 ","$1,798.30 ","$1,835.00 ","$1,029.44 ","$4,932.21 ",$913.29 ,"$1,691.32 ","$1,537.56 ","$4,932.21 ","$1,559.75 ","$10,569.03 ","$1,093.66 ",$513.80 ,"$1,651.50 ","$4,932.21 ","$1,559.75 ", N/A , N/A ,"$4,932.21 ","$1,192.75 " ST. JOSEPH'S HOSPITAL - BREESE,97500098,43275,PC ERCP W/FB OR STENT REMOVAL DUCT,975,1 ,"$1,455.00 ","$1,047.60 ",$407.40 ,"$7,828.43 ","$7,828.43 ",$945.75 ,$868.64 ,"$3,068.74 ",$407.40 ,$963.21 ,"$3,068.74 ",$963.21 ,"$1,425.90 ",$867.18 ,$867.18 ,"$1,425.90 ",$867.18 ,"$1,455.00 ","$1,120.35 ","$7,828.43 ","$3,068.74 ","$1,425.90 ","$1,091.25 ","$1,033.05 ","$1,033.05 ","$3,068.74 ","$1,033.05 ","$1,236.75 ","$1,236.75 ","$1,236.75 ", N/A ,"$1,455.00 ","$1,236.75 ","$1,425.90 ","$1,455.00 ",$816.26 ,"$3,068.74 ",$713.49 ,"$1,455.00 ","$1,455.00 ","$3,068.74 ","$1,236.75 ","$6,575.88 ",$867.18 ,$407.40 ,"$1,309.50 ","$3,068.74 ","$1,236.75 ", N/A , N/A ,"$3,068.74 ",$945.75 ST. JOSEPH'S HOSPITAL - BREESE,97500099,43265,PC ERCP W/LITHOTRIPSY,975,1 ,"$1,933.00 ","$1,391.76 ",$541.24 ,"$12,582.18 ","$12,582.18 ","$1,256.45 ","$1,154.00 ","$4,932.21 ",$541.24 ,"$1,279.65 ","$4,932.21 ","$1,279.65 ","$1,894.34 ","$1,152.07 ","$1,152.07 ","$1,894.34 ","$1,152.07 ","$1,933.00 ","$1,488.41 ","$12,582.18 ","$4,932.21 ","$1,894.34 ","$1,449.75 ","$1,372.43 ","$1,372.43 ","$4,932.21 ","$1,372.43 ","$1,643.05 ","$1,643.05 ","$1,643.05 ", N/A ,"$1,933.00 ","$1,643.05 ","$1,894.34 ","$1,933.00 ","$1,084.41 ","$4,932.21 ",$822.04 ,"$1,691.32 ","$1,537.56 ","$4,932.21 ","$1,643.05 ","$10,569.03 ","$1,152.07 ",$541.24 ,"$1,739.70 ","$4,932.21 ","$1,643.05 ", N/A , N/A ,"$4,932.21 ","$1,256.45 " ST. JOSEPH'S HOSPITAL - BREESE,97500100,43263,PC ERCP W/SPHINCTER PRESSURE MEASUREMENT,975,1 ,"$1,414.00 ","$1,018.08 ",$395.92 ,"$7,828.43 ","$7,828.43 ",$919.10 ,$844.16 ,"$3,068.74 ",$395.92 ,$936.07 ,"$3,068.74 ",$936.07 ,"$1,385.72 ",$842.74 ,$842.74 ,"$1,385.72 ",$842.74 ,"$1,414.00 ","$1,088.78 ","$7,828.43 ","$3,068.74 ","$1,385.72 ","$1,060.50 ","$1,003.94 ","$1,003.94 ","$3,068.74 ","$1,003.94 ","$1,201.90 ","$1,201.90 ","$1,201.90 ", N/A ,"$1,414.00 ","$1,201.90 ","$1,385.72 ","$1,414.00 ",$793.25 ,"$3,068.74 ",$676.25 ,"$1,414.00 ","$1,414.00 ","$3,068.74 ","$1,201.90 ","$6,575.88 ",$842.74 ,$395.92 ,"$1,272.60 ","$3,068.74 ","$1,201.90 ", N/A , N/A ,"$3,068.74 ",$919.10 ST. JOSEPH'S HOSPITAL - BREESE,97500101,43277,PC ERCP W/BALL DILAT DUCT/AMPULLA EA,975,1 ,"$1,463.00 ","$1,053.36 ",$409.64 ,"$7,828.43 ","$7,828.43 ",$950.95 ,$873.41 ,"$3,068.74 ",$409.64 ,$968.51 ,"$3,068.74 ",$968.51 ,"$1,433.74 ",$871.95 ,$871.95 ,"$1,433.74 ",$871.95 ,"$1,463.00 ","$1,126.51 ","$7,828.43 ","$3,068.74 ","$1,433.74 ","$1,097.25 ","$1,038.73 ","$1,038.73 ","$3,068.74 ","$1,038.73 ","$1,243.55 ","$1,243.55 ","$1,243.55 ", N/A ,"$1,463.00 ","$1,243.55 ","$1,433.74 ","$1,463.00 ",$820.74 ,"$3,068.74 ",$717.37 ,"$1,463.00 ","$1,463.00 ","$3,068.74 ","$1,243.55 ","$6,575.88 ",$871.95 ,$409.64 ,"$1,316.70 ","$3,068.74 ","$1,243.55 ", N/A , N/A ,"$3,068.74 ",$950.95 ST. JOSEPH'S HOSPITAL - BREESE,97500102,43245,PC EGD DILATE STRICTURE,975,1 ,$544.14 ,$391.78 ,$152.36 ,"$4,181.30 ","$4,181.30 ",$353.69 ,$324.85 ,"$1,639.07 ",$152.36 ,$360.22 ,"$1,639.07 ",$360.22 ,$533.26 ,$324.31 ,$324.31 ,$533.26 ,$324.31 ,$544.14 ,$418.99 ,"$4,181.30 ","$1,639.07 ",$533.26 ,$408.11 ,$386.34 ,$386.34 ,"$1,639.07 ",$386.34 ,$462.52 ,$462.52 ,$462.52 , N/A ,$544.14 ,$462.52 ,$533.26 ,$544.14 ,$305.26 ,"$1,639.07 ",$334.30 ,$544.14 ,$544.14 ,"$1,639.07 ",$462.52 ,"$3,512.29 ",$324.31 ,$152.36 ,$489.73 ,"$1,639.07 ",$462.52 , N/A , N/A ,"$1,639.07 ",$353.69 ST. JOSEPH'S HOSPITAL - BREESE,97500103,45390,PC COLONOSCOPY W/RESECTION,975,1 ,"$1,037.40 ",$746.93 ,$290.47 ,"$6,168.91 ","$6,168.90 ",$674.31 ,$619.33 ,"$2,418.21 ",$290.47 ,$686.76 ,"$2,418.21 ",$686.76 ,"$1,016.65 ",$618.29 ,$618.29 ,"$1,016.65 ",$618.29 ,"$1,037.40 ",$798.80 ,"$6,168.91 ","$2,418.21 ","$1,016.65 ",$778.05 ,$736.55 ,$736.55 ,"$2,418.21 ",$736.55 ,$881.79 ,$881.79 ,$881.79 , N/A ,"$1,037.40 ",$881.79 ,"$1,016.65 ","$1,037.40 ",$581.98 ,"$2,418.21 ",$629.69 ,$618.18 ,$561.98 ,"$2,418.21 ",$881.79 ,"$5,181.89 ",$618.29 ,$290.47 ,$933.66 ,"$2,418.21 ",$881.79 , N/A , N/A ,"$2,418.21 ",$674.31 ST. JOSEPH'S HOSPITAL - BREESE,98180092,20600,PC DRAIN/INJECT SMALL JOINT/BURSA,981,1 ,$117.24 ,$84.41 ,$32.83 ,$652.78 ,$652.78 ,$76.21 ,$69.99 ,$255.89 ,$32.83 ,$77.61 ,$255.89 ,$77.61 ,$114.90 ,$69.88 ,$69.88 ,$114.90 ,$69.88 ,$117.24 ,$90.27 ,$652.77 ,$255.89 ,$114.90 ,$87.93 ,$83.24 ,$83.24 ,$255.89 ,$83.24 ,$99.65 ,$99.65 ,$99.65 , N/A ,$117.24 ,$99.65 ,$114.90 ,$117.24 ,$65.77 ,$255.89 ,$68.72 ,$117.24 ,$117.24 ,$255.89 ,$99.65 ,$548.32 ,$69.88 ,$32.83 ,$105.52 ,$255.89 ,$99.65 , N/A , N/A ,$255.89 ,$76.21 ST. JOSEPH'S HOSPITAL - BREESE,98180093,20605,PC DRAIN/INJECT MEDIUM JOINT/BURSA,981,1 ,$121.41 ,$87.42 ,$33.99 ,$652.78 ,$652.78 ,$78.92 ,$72.48 ,$255.89 ,$33.99 ,$80.37 ,$255.89 ,$80.37 ,$118.98 ,$72.36 ,$72.36 ,$118.98 ,$72.36 ,$121.41 ,$93.49 ,$652.77 ,$255.89 ,$118.98 ,$91.06 ,$86.20 ,$86.20 ,$255.89 ,$86.20 ,$103.20 ,$103.20 ,$103.20 , N/A ,$121.41 ,$103.20 ,$118.98 ,$121.41 ,$68.11 ,$255.89 ,$71.27 ,$121.41 ,$121.41 ,$255.89 ,$103.20 ,$548.32 ,$72.36 ,$33.99 ,$109.27 ,$255.89 ,$103.20 , N/A , N/A ,$255.89 ,$78.92 ST. JOSEPH'S HOSPITAL - BREESE,98180094,20610,PC DRAIN/INJECT LARGE JOINT/BURSA,981,1 ,$149.01 ,$107.29 ,$41.72 ,$652.78 ,$652.78 ,$96.86 ,$88.96 ,$255.89 ,$41.72 ,$98.64 ,$255.89 ,$98.64 ,$146.03 ,$88.81 ,$88.81 ,$146.03 ,$88.81 ,$149.01 ,$114.74 ,$652.77 ,$255.89 ,$146.03 ,$111.76 ,$105.80 ,$105.80 ,$255.89 ,$105.80 ,$126.66 ,$126.66 ,$126.66 , N/A ,$149.01 ,$126.66 ,$146.03 ,$149.01 ,$83.59 ,$255.89 ,$87.06 ,$149.01 ,$149.01 ,$255.89 ,$126.66 ,$548.32 ,$88.81 ,$41.72 ,$134.11 ,$255.89 ,$126.66 , N/A , N/A ,$255.89 ,$96.86 ST. JOSEPH'S HOSPITAL - BREESE,98180506,20550,PC INJ SINGLE TENDON/LIGAMENT,981,1 ,$126.90 ,$91.37 ,$35.53 ,$652.78 ,$652.78 ,$82.49 ,$75.76 ,$255.89 ,$35.53 ,$84.01 ,$255.89 ,$84.01 ,$124.36 ,$75.63 ,$75.63 ,$124.36 ,$75.63 ,$126.90 ,$97.71 ,$652.77 ,$255.89 ,$124.36 ,$95.18 ,$90.10 ,$90.10 ,$255.89 ,$90.10 ,$107.87 ,$107.87 ,$107.87 , N/A ,$126.90 ,$107.87 ,$124.36 ,$126.90 ,$71.19 ,$255.89 ,$74.70 ,$126.90 ,$126.90 ,$255.89 ,$107.87 ,$548.32 ,$75.63 ,$35.53 ,$114.21 ,$255.89 ,$107.87 , N/A , N/A ,$255.89 ,$82.49 ST. JOSEPH'S HOSPITAL - BREESE,98180507,20552,PC INJ TRIGGER PT 1-2 MUSCLE,981,1 ,$124.35 ,$89.53 ,$34.82 ,$652.78 ,$652.78 ,$80.83 ,$74.24 ,$255.89 ,$34.82 ,$82.32 ,$255.89 ,$82.32 ,$121.86 ,$74.11 ,$74.11 ,$121.86 ,$74.11 ,$124.35 ,$95.75 ,$652.77 ,$255.89 ,$121.86 ,$93.26 ,$88.29 ,$88.29 ,$255.89 ,$88.29 ,$105.70 ,$105.70 ,$105.70 , N/A ,$124.35 ,$105.70 ,$121.86 ,$124.35 ,$69.76 ,$255.89 ,$72.98 ,$124.35 ,$124.35 ,$255.89 ,$105.70 ,$548.32 ,$74.11 ,$34.82 ,$111.92 ,$255.89 ,$105.70 , N/A , N/A ,$255.89 ,$80.83 ST. JOSEPH'S HOSPITAL - BREESE,98180508,20553,PC INJ TRIGGER PT 3+ MUSCLE,981,1 ,$139.11 ,$100.16 ,$38.95 ,$652.78 ,$652.78 ,$90.42 ,$83.05 ,$255.89 ,$38.95 ,$92.09 ,$255.89 ,$92.09 ,$136.33 ,$82.91 ,$82.91 ,$136.33 ,$82.91 ,$139.11 ,$107.11 ,$652.77 ,$255.89 ,$136.33 ,$104.33 ,$98.77 ,$98.77 ,$255.89 ,$98.77 ,$118.24 ,$118.24 ,$118.24 , N/A ,$139.11 ,$118.24 ,$136.33 ,$139.11 ,$78.04 ,$255.89 ,$82.01 ,$139.11 ,$139.11 ,$255.89 ,$118.24 ,$548.32 ,$82.91 ,$38.95 ,$125.20 ,$255.89 ,$118.24 , N/A , N/A ,$255.89 ,$90.42 ST. JOSEPH'S HOSPITAL - BREESE,98180552,45330,PC SIGMOIDOSCOPY FLEXIBLE DIAG,981,1 ,$174.00 ,$125.28 ,$48.72 ,"$1,995.20 ","$1,995.20 ",$113.10 ,$103.88 ,$782.12 ,$48.72 ,$115.19 ,$782.12 ,$115.19 ,$170.52 ,$103.70 ,$103.70 ,$170.52 ,$103.70 ,$174.00 ,$133.98 ,"$1,995.20 ",$782.12 ,$170.52 ,$130.50 ,$123.54 ,$123.54 ,$782.12 ,$123.54 ,$147.90 ,$147.90 ,$147.90 , N/A ,$174.00 ,$147.90 ,$170.52 ,$174.00 ,$97.61 ,$782.12 ,$104.82 ,$174.00 ,$174.00 ,$782.12 ,$147.90 ,"$1,675.97 ",$103.70 ,$48.72 ,$156.60 ,$782.12 ,$147.90 , N/A , N/A ,$782.12 ,$113.10 ST. JOSEPH'S HOSPITAL - BREESE,98180592,64405,PC INJ ANES NERVE OCCIPITAL,981,1 ,$180.90 ,$130.25 ,$50.65 ,$652.78 ,$652.78 ,$117.59 ,$108.00 ,$255.89 ,$50.65 ,$119.76 ,$255.89 ,$119.76 ,$177.28 ,$107.82 ,$107.82 ,$177.28 ,$107.82 ,$180.90 ,$139.29 ,$652.77 ,$255.89 ,$177.28 ,$135.68 ,$128.44 ,$128.44 ,$255.89 ,$128.44 ,$153.77 ,$153.77 ,$153.77 , N/A ,$180.90 ,$153.77 ,$177.28 ,$180.90 ,$101.48 ,$255.89 ,$103.58 ,$180.90 ,$180.90 ,$255.89 ,$153.77 ,$548.32 ,$107.82 ,$50.65 ,$162.81 ,$255.89 ,$153.77 , N/A , N/A ,$255.89 ,$117.59 ST. JOSEPH'S HOSPITAL - BREESE,98180621,20600,PC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-LT,981,1 ,$117.24 ,$84.41 ,$32.83 ,$652.78 ,$652.78 ,$76.21 ,$69.99 ,$255.89 ,$32.83 ,$77.61 ,$255.89 ,$77.61 ,$114.90 ,$69.88 ,$69.88 ,$114.90 ,$69.88 ,$117.24 ,$90.27 ,$652.77 ,$255.89 ,$114.90 ,$87.93 ,$83.24 ,$83.24 ,$255.89 ,$83.24 ,$99.65 ,$99.65 ,$99.65 , N/A ,$117.24 ,$99.65 ,$114.90 ,$117.24 ,$65.77 ,$255.89 ,$68.72 ,$117.24 ,$117.24 ,$255.89 ,$99.65 ,$548.32 ,$69.88 ,$32.83 ,$105.52 ,$255.89 ,$99.65 , N/A , N/A ,$255.89 ,$76.21 ST. JOSEPH'S HOSPITAL - BREESE,98180622,20600,PC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-RT,981,1 ,$117.24 ,$84.41 ,$32.83 ,$652.78 ,$652.78 ,$76.21 ,$69.99 ,$255.89 ,$32.83 ,$77.61 ,$255.89 ,$77.61 ,$114.90 ,$69.88 ,$69.88 ,$114.90 ,$69.88 ,$117.24 ,$90.27 ,$652.77 ,$255.89 ,$114.90 ,$87.93 ,$83.24 ,$83.24 ,$255.89 ,$83.24 ,$99.65 ,$99.65 ,$99.65 , N/A ,$117.24 ,$99.65 ,$114.90 ,$117.24 ,$65.77 ,$255.89 ,$68.72 ,$117.24 ,$117.24 ,$255.89 ,$99.65 ,$548.32 ,$69.88 ,$32.83 ,$105.52 ,$255.89 ,$99.65 , N/A , N/A ,$255.89 ,$76.21 ST. JOSEPH'S HOSPITAL - BREESE,98180623,20605,PC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,981,1 ,$121.41 ,$87.42 ,$33.99 ,$652.78 ,$652.78 ,$78.92 ,$72.48 ,$255.89 ,$33.99 ,$80.37 ,$255.89 ,$80.37 ,$118.98 ,$72.36 ,$72.36 ,$118.98 ,$72.36 ,$121.41 ,$93.49 ,$652.77 ,$255.89 ,$118.98 ,$91.06 ,$86.20 ,$86.20 ,$255.89 ,$86.20 ,$103.20 ,$103.20 ,$103.20 , N/A ,$121.41 ,$103.20 ,$118.98 ,$121.41 ,$68.11 ,$255.89 ,$71.27 ,$121.41 ,$121.41 ,$255.89 ,$103.20 ,$548.32 ,$72.36 ,$33.99 ,$109.27 ,$255.89 ,$103.20 , N/A , N/A ,$255.89 ,$78.92 ST. JOSEPH'S HOSPITAL - BREESE,98180624,20605,PC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,981,1 ,$121.41 ,$87.42 ,$33.99 ,$652.78 ,$652.78 ,$78.92 ,$72.48 ,$255.89 ,$33.99 ,$80.37 ,$255.89 ,$80.37 ,$118.98 ,$72.36 ,$72.36 ,$118.98 ,$72.36 ,$121.41 ,$93.49 ,$652.77 ,$255.89 ,$118.98 ,$91.06 ,$86.20 ,$86.20 ,$255.89 ,$86.20 ,$103.20 ,$103.20 ,$103.20 , N/A ,$121.41 ,$103.20 ,$118.98 ,$121.41 ,$68.11 ,$255.89 ,$71.27 ,$121.41 ,$121.41 ,$255.89 ,$103.20 ,$548.32 ,$72.36 ,$33.99 ,$109.27 ,$255.89 ,$103.20 , N/A , N/A ,$255.89 ,$78.92 ST. JOSEPH'S HOSPITAL - BREESE,98180625,20610,PC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,981,1 ,$149.01 ,$107.29 ,$41.72 ,$652.78 ,$652.78 ,$96.86 ,$88.96 ,$255.89 ,$41.72 ,$98.64 ,$255.89 ,$98.64 ,$146.03 ,$88.81 ,$88.81 ,$146.03 ,$88.81 ,$149.01 ,$114.74 ,$652.77 ,$255.89 ,$146.03 ,$111.76 ,$105.80 ,$105.80 ,$255.89 ,$105.80 ,$126.66 ,$126.66 ,$126.66 , N/A ,$149.01 ,$126.66 ,$146.03 ,$149.01 ,$83.59 ,$255.89 ,$87.06 ,$149.01 ,$149.01 ,$255.89 ,$126.66 ,$548.32 ,$88.81 ,$41.72 ,$134.11 ,$255.89 ,$126.66 , N/A , N/A ,$255.89 ,$96.86 ST. JOSEPH'S HOSPITAL - BREESE,98180626,20610,PC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,981,1 ,$149.01 ,$107.29 ,$41.72 ,$652.78 ,$652.78 ,$96.86 ,$88.96 ,$255.89 ,$41.72 ,$98.64 ,$255.89 ,$98.64 ,$146.03 ,$88.81 ,$88.81 ,$146.03 ,$88.81 ,$149.01 ,$114.74 ,$652.77 ,$255.89 ,$146.03 ,$111.76 ,$105.80 ,$105.80 ,$255.89 ,$105.80 ,$126.66 ,$126.66 ,$126.66 , N/A ,$149.01 ,$126.66 ,$146.03 ,$149.01 ,$83.59 ,$255.89 ,$87.06 ,$149.01 ,$149.01 ,$255.89 ,$126.66 ,$548.32 ,$88.81 ,$41.72 ,$134.11 ,$255.89 ,$126.66 , N/A , N/A ,$255.89 ,$96.86 ST. JOSEPH'S HOSPITAL - BREESE,98180665,64450,PC INJ ANES OTHER THAN PERIPHERAL-LT,981,1 ,$137.07 ,$98.69 ,$38.38 ,"$1,546.98 ","$1,546.98 ",$89.10 ,$81.83 ,$606.41 ,$38.38 ,$90.74 ,$606.41 ,$90.74 ,$134.33 ,$81.69 ,$81.69 ,$134.33 ,$81.69 ,$137.07 ,$105.54 ,"$1,546.96 ",$606.41 ,$134.33 ,$102.80 ,$97.32 ,$97.32 ,$606.41 ,$97.32 ,$116.51 ,$116.51 ,$116.51 , N/A ,$137.07 ,$116.51 ,$134.33 ,$137.07 ,$76.90 ,$606.41 ,$80.80 ,$137.07 ,$137.07 ,$606.41 ,$116.51 ,"$1,299.45 ",$81.69 ,$38.38 ,$123.36 ,$606.41 ,$116.51 , N/A , N/A ,$606.41 ,$89.10 ST. JOSEPH'S HOSPITAL - BREESE,98180666,64450,PC INJ ANES OTHER THAN PERIPHERAL-RT,981,1 ,$137.07 ,$98.69 ,$38.38 ,"$1,546.98 ","$1,546.98 ",$89.10 ,$81.83 ,$606.41 ,$38.38 ,$90.74 ,$606.41 ,$90.74 ,$134.33 ,$81.69 ,$81.69 ,$134.33 ,$81.69 ,$137.07 ,$105.54 ,"$1,546.96 ",$606.41 ,$134.33 ,$102.80 ,$97.32 ,$97.32 ,$606.41 ,$97.32 ,$116.51 ,$116.51 ,$116.51 , N/A ,$137.07 ,$116.51 ,$134.33 ,$137.07 ,$76.90 ,$606.41 ,$80.80 ,$137.07 ,$137.07 ,$606.41 ,$116.51 ,"$1,299.45 ",$81.69 ,$38.38 ,$123.36 ,$606.41 ,$116.51 , N/A , N/A ,$606.41 ,$89.10 ST. JOSEPH'S HOSPITAL - BREESE,98180871,62323,PC INJ INTRLAMNR LUM/SAC W/GUIDE,981,1 ,$316.59 ,$227.94 ,$88.65 ,"$1,546.98 ","$1,546.98 ",$205.78 ,$189.00 ,$606.41 ,$88.65 ,$209.58 ,$606.41 ,$209.58 ,$310.26 ,$188.69 ,$188.69 ,$310.26 ,$188.69 ,$316.59 ,$243.77 ,"$1,546.96 ",$606.41 ,$310.26 ,$237.44 ,$224.78 ,$224.78 ,$606.41 ,$224.78 ,$269.10 ,$269.10 ,$269.10 , N/A ,$316.59 ,$269.10 ,$310.26 ,$316.59 ,$177.61 ,$606.41 ,$187.64 ,$316.59 ,$295.99 ,$606.41 ,$269.10 ,"$1,299.45 ",$188.69 ,$88.65 ,$284.93 ,$606.41 ,$269.10 , N/A , N/A ,$606.41 ,$205.78 ST. JOSEPH'S HOSPITAL - BREESE,98180975,20551,PC INJECTION SINGLE TENDON ORIGIN/INSERTION,981,1 ,$138.12 ,$99.45 ,$38.67 ,$652.78 ,$652.78 ,$89.78 ,$82.46 ,$255.89 ,$38.67 ,$91.44 ,$255.89 ,$91.44 ,$135.36 ,$82.32 ,$82.32 ,$135.36 ,$82.32 ,$138.12 ,$106.35 ,$652.77 ,$255.89 ,$135.36 ,$103.59 ,$98.07 ,$98.07 ,$255.89 ,$98.07 ,$117.40 ,$117.40 ,$117.40 , N/A ,$138.12 ,$117.40 ,$135.36 ,$138.12 ,$77.49 ,$255.89 ,$75.92 ,$138.12 ,$138.12 ,$255.89 ,$117.40 ,$548.32 ,$82.32 ,$38.67 ,$124.31 ,$255.89 ,$117.40 , N/A , N/A ,$255.89 ,$89.78 ST. JOSEPH'S HOSPITAL - BREESE,98180976,20606,PC ARTHROCENTESIS ASPIR AND /INJ INTERM JT/BURS W/US,981,1 ,$169.71 ,$122.19 ,$47.52 ,"$1,546.98 ","$1,546.98 ",$110.31 ,$101.32 ,$606.41 ,$47.52 ,$112.35 ,$606.41 ,$112.35 ,$166.32 ,$101.15 ,$101.15 ,$166.32 ,$101.15 ,$169.71 ,$130.68 ,"$1,546.96 ",$606.41 ,$166.32 ,$127.28 ,$120.49 ,$120.49 ,$606.41 ,$120.49 ,$144.25 ,$144.25 ,$144.25 , N/A ,$169.71 ,$144.25 ,$166.32 ,$169.71 ,$95.21 ,$606.41 ,$100.23 ,$169.71 ,$169.71 ,$606.41 ,$144.25 ,"$1,299.45 ",$101.15 ,$47.52 ,$152.74 ,$606.41 ,$144.25 , N/A , N/A ,$606.41 ,$110.31 ST. JOSEPH'S HOSPITAL - BREESE,98180977,20611,PC ARTHROCENTESIS ASPIR AND /INJ MAJOR JT/BURSA W/US,981,1 ,$193.35 ,$139.21 ,$54.14 ,$652.78 ,$652.78 ,$125.68 ,$115.43 ,$255.89 ,$54.14 ,$128.00 ,$255.89 ,$128.00 ,$189.48 ,$115.24 ,$115.24 ,$189.48 ,$115.24 ,$193.35 ,$148.88 ,$652.77 ,$255.89 ,$189.48 ,$145.01 ,$137.28 ,$137.28 ,$255.89 ,$137.28 ,$164.35 ,$164.35 ,$164.35 , N/A ,$193.35 ,$164.35 ,$189.48 ,$193.35 ,$108.47 ,$255.89 ,$113.95 ,$193.35 ,$193.35 ,$255.89 ,$164.35 ,$548.32 ,$115.24 ,$54.14 ,$174.02 ,$255.89 ,$164.35 , N/A , N/A ,$255.89 ,$125.68 ST. JOSEPH'S HOSPITAL - BREESE,98200002,99202,PC CLINIC VISIT LIMITED NEW PRO,982,1 ,$158.46 ,$114.09 ,$44.37 ,$158.46 , N/A ,$103.00 ,$94.60 , N/A ,$44.37 ,$104.90 , N/A ,$104.90 , N/A ,$94.44 ,$94.44 , N/A ,$94.44 , N/A ,$122.01 , N/A , N/A , N/A ,$118.85 ,$112.51 ,$112.51 , N/A ,$112.51 ,$134.69 ,$134.69 ,$134.69 , N/A , N/A ,$134.69 , N/A ,$76.98 ,$88.90 , N/A ,$70.27 ,$104.08 ,$94.62 , N/A ,$134.69 , N/A ,$94.44 ,$44.37 ,$142.61 , N/A ,$134.69 , N/A , N/A , N/A ,$103.00 ST. JOSEPH'S HOSPITAL - BREESE,98200003,99203,PC CLINIC VISIT INTERM NEW PRO,982,1 ,$236.91 ,$170.58 ,$66.33 ,$236.91 , N/A ,$153.99 ,$141.44 , N/A ,$66.33 ,$156.83 , N/A ,$156.83 , N/A ,$141.20 ,$141.20 , N/A ,$141.20 , N/A ,$182.42 , N/A , N/A , N/A ,$177.68 ,$168.21 ,$168.21 , N/A ,$168.21 ,$201.37 ,$201.37 ,$201.37 , N/A , N/A ,$201.37 , N/A ,$120.52 ,$132.91 , N/A ,$105.21 ,$104.08 ,$94.62 , N/A ,$201.37 , N/A ,$141.20 ,$66.33 ,$213.22 , N/A ,$201.37 , N/A , N/A , N/A ,$153.99 ST. JOSEPH'S HOSPITAL - BREESE,98200004,99204,PC CLINIC VISIT COMPLEX NEW PRO,982,1 ,$405.00 ,$291.60 ,$94.62 ,$405.00 , N/A ,$263.25 ,$241.79 , N/A ,$113.40 ,$268.11 , N/A ,$268.11 , N/A ,$241.38 ,$241.38 , N/A ,$241.38 , N/A ,$311.85 , N/A , N/A , N/A ,$303.75 ,$287.55 ,$287.55 , N/A ,$287.55 ,$344.25 ,$344.25 ,$344.25 , N/A , N/A ,$344.25 , N/A ,$177.92 ,$227.21 , N/A ,$179.90 ,$104.08 ,$94.62 , N/A ,$344.25 , N/A ,$241.38 ,$113.40 ,$364.50 , N/A ,$344.25 , N/A , N/A , N/A ,$263.25 ST. JOSEPH'S HOSPITAL - BREESE,98200005,99205,PC CLINIC VISIT COMPREH NEW PRO,982,1 ,$528.30 ,$380.38 ,$94.62 ,$528.30 , N/A ,$343.40 ,$315.40 , N/A ,$147.92 ,$349.73 , N/A ,$349.73 , N/A ,$314.87 ,$314.87 , N/A ,$314.87 , N/A ,$406.79 , N/A , N/A , N/A ,$396.23 ,$375.09 ,$375.09 , N/A ,$375.09 ,$449.06 ,$449.06 ,$449.06 , N/A , N/A ,$449.06 , N/A ,$234.97 ,$296.38 , N/A ,$234.84 ,$104.08 ,$94.62 , N/A ,$449.06 , N/A ,$314.87 ,$147.92 ,$475.47 , N/A ,$449.06 , N/A , N/A , N/A ,$343.40 ST. JOSEPH'S HOSPITAL - BREESE,98200006,99211,PC CLINIC VISIT BRIEF EST PRO,982,1 ,$28.35 ,$20.41 ,$7.94 ,$28.35 , N/A ,$18.43 ,$16.93 , N/A ,$7.94 ,$18.77 , N/A ,$18.77 , N/A ,$16.90 ,$16.90 , N/A ,$16.90 , N/A ,$21.83 , N/A , N/A , N/A ,$21.26 ,$20.13 ,$20.13 , N/A ,$20.13 ,$24.10 ,$24.10 ,$24.10 , N/A , N/A ,$24.10 , N/A ,$28.35 ,$15.90 , N/A ,$12.73 ,$28.35 ,$28.35 , N/A ,$24.10 , N/A ,$16.90 ,$7.94 ,$25.52 , N/A ,$24.10 , N/A , N/A , N/A ,$18.43 ST. JOSEPH'S HOSPITAL - BREESE,98200007,99212,PC CLINIC VISIT LIMIT EST PRO,982,1 ,$81.27 ,$58.51 ,$22.76 ,$81.27 , N/A ,$52.83 ,$48.52 , N/A ,$22.76 ,$53.80 , N/A ,$53.80 , N/A ,$48.44 ,$48.44 , N/A ,$48.44 , N/A ,$62.58 , N/A , N/A , N/A ,$60.95 ,$57.70 ,$57.70 , N/A ,$57.70 ,$69.08 ,$69.08 ,$69.08 , N/A , N/A ,$69.08 , N/A ,$60.09 ,$45.59 , N/A ,$35.95 ,$81.27 ,$81.27 , N/A ,$69.08 , N/A ,$48.44 ,$22.76 ,$73.14 , N/A ,$69.08 , N/A , N/A , N/A ,$52.83 ST. JOSEPH'S HOSPITAL - BREESE,98200008,99213,PC CLINIC VISIT INTERM EST PRO,982,1 ,$157.17 ,$113.16 ,$44.01 ,$157.17 , N/A ,$102.16 ,$93.83 , N/A ,$44.01 ,$104.05 , N/A ,$104.05 , N/A ,$93.67 ,$93.67 , N/A ,$93.67 , N/A ,$121.02 , N/A , N/A , N/A ,$117.88 ,$111.59 ,$111.59 , N/A ,$111.59 ,$133.59 ,$133.59 ,$133.59 , N/A , N/A ,$133.59 , N/A ,$95.85 ,$88.17 , N/A ,$71.20 ,$104.08 ,$94.62 , N/A ,$133.59 , N/A ,$93.67 ,$44.01 ,$141.45 , N/A ,$133.59 , N/A , N/A , N/A ,$102.16 ST. JOSEPH'S HOSPITAL - BREESE,98200009,99214,PC CLINIC VISIT COMPLX EST PRO,982,1 ,$244.83 ,$176.28 ,$68.55 ,$244.83 , N/A ,$159.14 ,$146.16 , N/A ,$68.55 ,$162.08 , N/A ,$162.08 , N/A ,$145.92 ,$145.92 , N/A ,$145.92 , N/A ,$188.52 , N/A , N/A , N/A ,$183.62 ,$173.83 ,$173.83 , N/A ,$173.83 ,$208.11 ,$208.11 ,$208.11 , N/A , N/A ,$208.11 , N/A ,$244.83 ,$137.35 , N/A ,$109.36 ,$104.08 ,$94.62 , N/A ,$208.11 , N/A ,$145.92 ,$68.55 ,$220.35 , N/A ,$208.11 , N/A , N/A , N/A ,$159.14 ST. JOSEPH'S HOSPITAL - BREESE,98200010,99215,PC CLINIC VISIT COMPRH EST PRO,982,1 ,$345.33 ,$248.64 ,$94.62 ,$345.33 , N/A ,$224.46 ,$206.16 , N/A ,$96.69 ,$228.61 , N/A ,$228.61 , N/A ,$205.82 ,$205.82 , N/A ,$205.82 , N/A ,$265.90 , N/A , N/A , N/A ,$259.00 ,$245.18 ,$245.18 , N/A ,$245.18 ,$293.53 ,$293.53 ,$293.53 , N/A , N/A ,$293.53 , N/A ,$345.33 ,$193.73 , N/A ,$154.37 ,$104.08 ,$94.62 , N/A ,$293.53 , N/A ,$205.82 ,$96.69 ,$310.80 , N/A ,$293.53 , N/A , N/A , N/A ,$224.46 ST. JOSEPH'S HOSPITAL - BREESE,98200028,22512,PC VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,982,1 ,$675.18 ,$486.13 ,$189.05 ,$675.18 , N/A ,$438.87 ,$403.08 , N/A ,$189.05 ,$446.97 , N/A ,$446.97 , N/A ,$402.41 ,$402.41 , N/A ,$402.41 , N/A ,$519.89 , N/A , N/A , N/A ,$506.39 ,$479.38 ,$479.38 , N/A ,$479.38 ,$573.90 ,$573.90 ,$573.90 , N/A , N/A ,$573.90 , N/A ,$675.18 ,$378.78 , N/A ,$395.47 ,$675.18 ,$675.18 , N/A ,$573.90 , N/A ,$402.41 ,$189.05 ,$607.66 , N/A ,$573.90 , N/A , N/A , N/A ,$438.87 ST. JOSEPH'S HOSPITAL - BREESE,98200029,22513,PC VERTEBROPLASTY INJ PERC THOR KYPHOPLASTY,982,1 ,"$1,683.99 ","$1,212.47 ",$471.52 ,"$15,880.73 ","$15,880.73 ","$1,094.59 ","$1,005.34 ","$6,225.24 ",$471.52 ,"$1,114.80 ","$6,225.24 ","$1,114.80 ","$1,650.31 ","$1,003.66 ","$1,003.66 ","$1,650.31 ","$1,003.66 ","$1,683.99 ","$1,296.67 ","$15,880.73 ","$6,225.24 ","$1,650.31 ","$1,262.99 ","$1,195.63 ","$1,195.63 ","$6,225.24 ","$1,195.63 ","$1,431.39 ","$1,431.39 ","$1,431.39 ", N/A ,"$1,683.99 ","$1,431.39 ","$1,650.31 ","$1,683.99 ",$944.72 ,"$6,225.24 ",$979.28 ,"$1,683.99 ","$1,683.99 ","$6,225.24 ","$1,431.39 ","$13,339.82 ","$1,003.66 ",$471.52 ,"$1,515.59 ","$6,225.24 ","$1,431.39 ", N/A , N/A ,"$6,225.24 ","$1,094.59 " ST. JOSEPH'S HOSPITAL - BREESE,98200030,22514,PC VERTEBROPLASTY INJ PERC LUMBAR KYPHOPLASTY,982,1 ,"$1,569.96 ","$1,130.37 ",$439.59 ,"$15,880.73 ","$15,880.73 ","$1,020.47 ",$937.27 ,"$6,225.24 ",$439.59 ,"$1,039.31 ","$6,225.24 ","$1,039.31 ","$1,538.56 ",$935.70 ,$935.70 ,"$1,538.56 ",$935.70 ,"$1,569.96 ","$1,208.87 ","$15,880.73 ","$6,225.24 ","$1,538.56 ","$1,177.47 ","$1,114.67 ","$1,114.67 ","$6,225.24 ","$1,114.67 ","$1,334.47 ","$1,334.47 ","$1,334.47 ", N/A ,"$1,569.96 ","$1,334.47 ","$1,538.56 ","$1,569.96 ",$880.75 ,"$6,225.24 ",$912.81 ,"$1,569.96 ","$1,569.96 ","$6,225.24 ","$1,334.47 ","$13,339.82 ",$935.70 ,$439.59 ,"$1,412.96 ","$6,225.24 ","$1,334.47 ", N/A , N/A ,"$6,225.24 ","$1,020.47 " ST. JOSEPH'S HOSPITAL - BREESE,98200031,22515,PC VERTEBROPLASTY INJ PERC EA ADDNT THOR OR LUMB KYPHO,982,1 ,$735.03 ,$529.22 ,$205.81 ,$735.03 , N/A ,$477.77 ,$438.81 , N/A ,$205.81 ,$486.59 , N/A ,$486.59 , N/A ,$438.08 ,$438.08 , N/A ,$438.08 , N/A ,$565.97 , N/A , N/A , N/A ,$551.27 ,$521.87 ,$521.87 , N/A ,$521.87 ,$624.78 ,$624.78 ,$624.78 , N/A , N/A ,$624.78 , N/A ,$735.03 ,$412.35 , N/A ,$425.19 ,$735.03 ,$735.03 , N/A ,$624.78 , N/A ,$438.08 ,$205.81 ,$661.53 , N/A ,$624.78 , N/A , N/A , N/A ,$477.77 ST. JOSEPH'S HOSPITAL - BREESE,98200032,63650,PC IMPLANT NEUROELECTRODES,982,1 ,"$1,320.09 ",$950.46 ,$369.63 ,"$15,854.85 ","$15,854.85 ",$858.06 ,$788.09 ,"$6,215.10 ",$369.63 ,$873.90 ,"$6,215.10 ",$873.90 ,"$1,293.69 ",$786.77 ,$786.77 ,"$1,293.69 ",$786.77 ,"$1,320.09 ","$1,016.47 ","$15,854.85 ","$6,215.10 ","$1,293.69 ",$990.07 ,$937.26 ,$937.26 ,"$6,215.10 ",$937.26 ,"$1,122.08 ","$1,122.08 ","$1,122.08 ", N/A ,"$1,320.09 ","$1,122.08 ","$1,293.69 ","$1,320.09 ",$740.57 ,"$6,215.10 ",$781.04 ,"$1,320.09 ","$1,320.09 ","$6,215.10 ","$1,122.08 ","$13,318.08 ",$786.77 ,$369.63 ,"$1,188.08 ","$6,215.10 ","$1,122.08 ", N/A , N/A ,"$6,215.10 ",$858.06 ST. JOSEPH'S HOSPITAL - BREESE,98200033,64479,PC INJ EPIDURAL CREV/THOR SGL-BI,982,1 ,$415.35 ,$299.05 ,$116.30 ,"$2,045.96 ","$2,045.95 ",$269.98 ,$247.96 ,$802.01 ,$116.30 ,$274.96 ,$802.01 ,$274.96 ,$407.04 ,$247.55 ,$247.55 ,$407.04 ,$247.55 ,$415.35 ,$319.82 ,"$2,045.96 ",$802.01 ,$407.04 ,$311.51 ,$294.90 ,$294.90 ,$802.01 ,$294.90 ,$353.05 ,$353.05 ,$353.05 , N/A ,$415.35 ,$353.05 ,$407.04 ,$415.35 ,$233.01 ,$802.01 ,$246.56 ,$415.35 ,$415.35 ,$802.01 ,$353.05 ,"$1,718.60 ",$247.55 ,$116.30 ,$373.82 ,$802.01 ,$353.05 , N/A , N/A ,$802.01 ,$269.98 ST. JOSEPH'S HOSPITAL - BREESE,98200034,64479,PC INJ EPIDURAL CREV/THOR SGL-LT,982,1 ,$415.35 ,$299.05 ,$116.30 ,"$2,045.96 ","$2,045.95 ",$269.98 ,$247.96 ,$802.01 ,$116.30 ,$274.96 ,$802.01 ,$274.96 ,$407.04 ,$247.55 ,$247.55 ,$407.04 ,$247.55 ,$415.35 ,$319.82 ,"$2,045.96 ",$802.01 ,$407.04 ,$311.51 ,$294.90 ,$294.90 ,$802.01 ,$294.90 ,$353.05 ,$353.05 ,$353.05 , N/A ,$415.35 ,$353.05 ,$407.04 ,$415.35 ,$233.01 ,$802.01 ,$246.56 ,$415.35 ,$415.35 ,$802.01 ,$353.05 ,"$1,718.60 ",$247.55 ,$116.30 ,$373.82 ,$802.01 ,$353.05 , N/A , N/A ,$802.01 ,$269.98 ST. JOSEPH'S HOSPITAL - BREESE,98200035,64479,PC INJ EPIDURAL CREV/THOR SGL-RT,982,1 ,$415.35 ,$299.05 ,$116.30 ,"$2,045.96 ","$2,045.95 ",$269.98 ,$247.96 ,$802.01 ,$116.30 ,$274.96 ,$802.01 ,$274.96 ,$407.04 ,$247.55 ,$247.55 ,$407.04 ,$247.55 ,$415.35 ,$319.82 ,"$2,045.96 ",$802.01 ,$407.04 ,$311.51 ,$294.90 ,$294.90 ,$802.01 ,$294.90 ,$353.05 ,$353.05 ,$353.05 , N/A ,$415.35 ,$353.05 ,$407.04 ,$415.35 ,$233.01 ,$802.01 ,$246.56 ,$415.35 ,$415.35 ,$802.01 ,$353.05 ,"$1,718.60 ",$247.55 ,$116.30 ,$373.82 ,$802.01 ,$353.05 , N/A , N/A ,$802.01 ,$269.98 ST. JOSEPH'S HOSPITAL - BREESE,98200036,64480,PC INJ TRANSF CERV/THORACIC ADDL-LT,982,1 ,$200.22 ,$144.16 ,$56.06 ,$200.22 , N/A ,$130.14 ,$119.53 , N/A ,$56.06 ,$132.55 , N/A ,$132.55 , N/A ,$119.33 ,$119.33 , N/A ,$119.33 , N/A ,$154.17 , N/A , N/A , N/A ,$150.17 ,$142.16 ,$142.16 , N/A ,$142.16 ,$170.19 ,$170.19 ,$170.19 , N/A , N/A ,$170.19 , N/A ,$200.22 ,$112.32 , N/A ,$118.59 ,$200.22 ,$200.22 , N/A ,$170.19 , N/A ,$119.33 ,$56.06 ,$180.20 , N/A ,$170.19 , N/A , N/A , N/A ,$130.14 ST. JOSEPH'S HOSPITAL - BREESE,98200037,64480,PC INJ TRANSF CERV/THORACIC ADDL-RT,982,1 ,$200.22 ,$144.16 ,$56.06 ,$200.22 , N/A ,$130.14 ,$119.53 , N/A ,$56.06 ,$132.55 , N/A ,$132.55 , N/A ,$119.33 ,$119.33 , N/A ,$119.33 , N/A ,$154.17 , N/A , N/A , N/A ,$150.17 ,$142.16 ,$142.16 , N/A ,$142.16 ,$170.19 ,$170.19 ,$170.19 , N/A , N/A ,$170.19 , N/A ,$200.22 ,$112.32 , N/A ,$118.59 ,$200.22 ,$200.22 , N/A ,$170.19 , N/A ,$119.33 ,$56.06 ,$180.20 , N/A ,$170.19 , N/A , N/A , N/A ,$130.14 ST. JOSEPH'S HOSPITAL - BREESE,98200038,64483,PC INJ EPID LUMBAR/SACRAL SGL-BI,982,1 ,$352.74 ,$253.97 ,$98.77 ,"$2,045.96 ","$2,045.95 ",$229.28 ,$210.59 ,$802.01 ,$98.77 ,$233.51 ,$802.01 ,$233.51 ,$345.69 ,$210.23 ,$210.23 ,$345.69 ,$210.23 ,$352.74 ,$271.61 ,"$2,045.96 ",$802.01 ,$345.69 ,$264.56 ,$250.45 ,$250.45 ,$802.01 ,$250.45 ,$299.83 ,$299.83 ,$299.83 , N/A ,$352.74 ,$299.83 ,$345.69 ,$352.74 ,$197.89 ,$802.01 ,$209.52 ,$352.74 ,$352.74 ,$802.01 ,$299.83 ,"$1,718.60 ",$210.23 ,$98.77 ,$317.47 ,$802.01 ,$299.83 , N/A , N/A ,$802.01 ,$229.28 ST. JOSEPH'S HOSPITAL - BREESE,98200039,64483,PC INJ EPID LUMBAR/SACRAL SGL-LT,982,1 ,$352.74 ,$253.97 ,$98.77 ,"$2,045.96 ","$2,045.95 ",$229.28 ,$210.59 ,$802.01 ,$98.77 ,$233.51 ,$802.01 ,$233.51 ,$345.69 ,$210.23 ,$210.23 ,$345.69 ,$210.23 ,$352.74 ,$271.61 ,"$2,045.96 ",$802.01 ,$345.69 ,$264.56 ,$250.45 ,$250.45 ,$802.01 ,$250.45 ,$299.83 ,$299.83 ,$299.83 , N/A ,$352.74 ,$299.83 ,$345.69 ,$352.74 ,$197.89 ,$802.01 ,$209.52 ,$352.74 ,$352.74 ,$802.01 ,$299.83 ,"$1,718.60 ",$210.23 ,$98.77 ,$317.47 ,$802.01 ,$299.83 , N/A , N/A ,$802.01 ,$229.28 ST. JOSEPH'S HOSPITAL - BREESE,98200040,64483,PC INJ EPID LUMBAR/SACRAL SGL-RT,982,1 ,$352.74 ,$253.97 ,$98.77 ,"$2,045.96 ","$2,045.95 ",$229.28 ,$210.59 ,$802.01 ,$98.77 ,$233.51 ,$802.01 ,$233.51 ,$345.69 ,$210.23 ,$210.23 ,$345.69 ,$210.23 ,$352.74 ,$271.61 ,"$2,045.96 ",$802.01 ,$345.69 ,$264.56 ,$250.45 ,$250.45 ,$802.01 ,$250.45 ,$299.83 ,$299.83 ,$299.83 , N/A ,$352.74 ,$299.83 ,$345.69 ,$352.74 ,$197.89 ,$802.01 ,$209.52 ,$352.74 ,$352.74 ,$802.01 ,$299.83 ,"$1,718.60 ",$210.23 ,$98.77 ,$317.47 ,$802.01 ,$299.83 , N/A , N/A ,$802.01 ,$229.28 ST. JOSEPH'S HOSPITAL - BREESE,98200041,64484,PC INJ EPID LUMBAR/SACRAL ADDL-LT,982,1 ,$165.99 ,$119.51 ,$46.48 ,$165.99 , N/A ,$107.89 ,$99.10 , N/A ,$46.48 ,$109.89 , N/A ,$109.89 , N/A ,$98.93 ,$98.93 , N/A ,$98.93 , N/A ,$127.81 , N/A , N/A , N/A ,$124.49 ,$117.85 ,$117.85 , N/A ,$117.85 ,$141.09 ,$141.09 ,$141.09 , N/A , N/A ,$141.09 , N/A ,$165.99 ,$93.12 , N/A ,$98.64 ,$165.99 ,$165.99 , N/A ,$141.09 , N/A ,$98.93 ,$46.48 ,$149.39 , N/A ,$141.09 , N/A , N/A , N/A ,$107.89 ST. JOSEPH'S HOSPITAL - BREESE,98200042,64484,PC INJ EPID LUMBAR/SACRAL ADDL-RT,982,1 ,$165.99 ,$119.51 ,$46.48 ,$165.99 , N/A ,$107.89 ,$99.10 , N/A ,$46.48 ,$109.89 , N/A ,$109.89 , N/A ,$98.93 ,$98.93 , N/A ,$98.93 , N/A ,$127.81 , N/A , N/A , N/A ,$124.49 ,$117.85 ,$117.85 , N/A ,$117.85 ,$141.09 ,$141.09 ,$141.09 , N/A , N/A ,$141.09 , N/A ,$165.99 ,$93.12 , N/A ,$98.64 ,$165.99 ,$165.99 , N/A ,$141.09 , N/A ,$98.93 ,$46.48 ,$149.39 , N/A ,$141.09 , N/A , N/A , N/A ,$107.89 ST. JOSEPH'S HOSPITAL - BREESE,98200043,64490,PC INJ PARAVERT F JNT C/T 1 LV-BI,982,1 ,$335.01 ,$241.21 ,$93.80 ,"$2,045.96 ","$2,045.95 ",$217.76 ,$200.00 ,$802.01 ,$93.80 ,$221.78 ,$802.01 ,$221.78 ,$328.31 ,$199.67 ,$199.67 ,$328.31 ,$199.67 ,$335.01 ,$257.96 ,"$2,045.96 ",$802.01 ,$328.31 ,$251.26 ,$237.86 ,$237.86 ,$802.01 ,$237.86 ,$284.76 ,$284.76 ,$284.76 , N/A ,$335.01 ,$284.76 ,$328.31 ,$335.01 ,$187.94 ,$802.01 ,$198.71 ,$335.01 ,$335.01 ,$802.01 ,$284.76 ,"$1,718.60 ",$199.67 ,$93.80 ,$301.51 ,$802.01 ,$284.76 , N/A , N/A ,$802.01 ,$217.76 ST. JOSEPH'S HOSPITAL - BREESE,98200044,64490,PC INJ PARAVERT F JNT C/T 1 LV-RT,982,1 ,$335.01 ,$241.21 ,$93.80 ,"$2,045.96 ","$2,045.95 ",$217.76 ,$200.00 ,$802.01 ,$93.80 ,$221.78 ,$802.01 ,$221.78 ,$328.31 ,$199.67 ,$199.67 ,$328.31 ,$199.67 ,$335.01 ,$257.96 ,"$2,045.96 ",$802.01 ,$328.31 ,$251.26 ,$237.86 ,$237.86 ,$802.01 ,$237.86 ,$284.76 ,$284.76 ,$284.76 , N/A ,$335.01 ,$284.76 ,$328.31 ,$335.01 ,$187.94 ,$802.01 ,$198.71 ,$335.01 ,$335.01 ,$802.01 ,$284.76 ,"$1,718.60 ",$199.67 ,$93.80 ,$301.51 ,$802.01 ,$284.76 , N/A , N/A ,$802.01 ,$217.76 ST. JOSEPH'S HOSPITAL - BREESE,98200045,64490,PC INJ PARAVERT F JNT C/T 1 LV-LT,982,1 ,$335.01 ,$241.21 ,$93.80 ,"$2,045.96 ","$2,045.95 ",$217.76 ,$200.00 ,$802.01 ,$93.80 ,$221.78 ,$802.01 ,$221.78 ,$328.31 ,$199.67 ,$199.67 ,$328.31 ,$199.67 ,$335.01 ,$257.96 ,"$2,045.96 ",$802.01 ,$328.31 ,$251.26 ,$237.86 ,$237.86 ,$802.01 ,$237.86 ,$284.76 ,$284.76 ,$284.76 , N/A ,$335.01 ,$284.76 ,$328.31 ,$335.01 ,$187.94 ,$802.01 ,$198.71 ,$335.01 ,$335.01 ,$802.01 ,$284.76 ,"$1,718.60 ",$199.67 ,$93.80 ,$301.51 ,$802.01 ,$284.76 , N/A , N/A ,$802.01 ,$217.76 ST. JOSEPH'S HOSPITAL - BREESE,98200046,64491,PC INJ PARAVERT F JNT C/T 2 LV-LT,982,1 ,$192.00 ,$138.24 ,$53.76 ,$192.00 , N/A ,$124.80 ,$114.62 , N/A ,$53.76 ,$127.10 , N/A ,$127.10 , N/A ,$114.43 ,$114.43 , N/A ,$114.43 , N/A ,$147.84 , N/A , N/A , N/A ,$144.00 ,$136.32 ,$136.32 , N/A ,$136.32 ,$163.20 ,$163.20 ,$163.20 , N/A , N/A ,$163.20 , N/A ,$192.00 ,$107.71 , N/A ,$113.92 ,$192.00 ,$192.00 , N/A ,$163.20 , N/A ,$114.43 ,$53.76 ,$172.80 , N/A ,$163.20 , N/A , N/A , N/A ,$124.80 ST. JOSEPH'S HOSPITAL - BREESE,98200047,64491,PC INJ PARAVERT F JNT C/T 2 LV-RT,982,1 ,$192.00 ,$138.24 ,$53.76 ,$192.00 , N/A ,$124.80 ,$114.62 , N/A ,$53.76 ,$127.10 , N/A ,$127.10 , N/A ,$114.43 ,$114.43 , N/A ,$114.43 , N/A ,$147.84 , N/A , N/A , N/A ,$144.00 ,$136.32 ,$136.32 , N/A ,$136.32 ,$163.20 ,$163.20 ,$163.20 , N/A , N/A ,$163.20 , N/A ,$192.00 ,$107.71 , N/A ,$113.92 ,$192.00 ,$192.00 , N/A ,$163.20 , N/A ,$114.43 ,$53.76 ,$172.80 , N/A ,$163.20 , N/A , N/A , N/A ,$124.80 ST. JOSEPH'S HOSPITAL - BREESE,98200048,64492,PC INJ PARAVERT F JNT C/T 3 LV-LT,982,1 ,$194.04 ,$139.71 ,$54.33 ,$194.04 , N/A ,$126.13 ,$115.84 , N/A ,$54.33 ,$128.45 , N/A ,$128.45 , N/A ,$115.65 ,$115.65 , N/A ,$115.65 , N/A ,$149.41 , N/A , N/A , N/A ,$145.53 ,$137.77 ,$137.77 , N/A ,$137.77 ,$164.93 ,$164.93 ,$164.93 , N/A , N/A ,$164.93 , N/A ,$194.04 ,$108.86 , N/A ,$115.14 ,$194.04 ,$194.04 , N/A ,$164.93 , N/A ,$115.65 ,$54.33 ,$174.64 , N/A ,$164.93 , N/A , N/A , N/A ,$126.13 ST. JOSEPH'S HOSPITAL - BREESE,98200049,64492,PC INJ PARAVERT F JNT C/T 3 LV-RT,982,1 ,$194.04 ,$139.71 ,$54.33 ,$194.04 , N/A ,$126.13 ,$115.84 , N/A ,$54.33 ,$128.45 , N/A ,$128.45 , N/A ,$115.65 ,$115.65 , N/A ,$115.65 , N/A ,$149.41 , N/A , N/A , N/A ,$145.53 ,$137.77 ,$137.77 , N/A ,$137.77 ,$164.93 ,$164.93 ,$164.93 , N/A , N/A ,$164.93 , N/A ,$194.04 ,$108.86 , N/A ,$115.14 ,$194.04 ,$194.04 , N/A ,$164.93 , N/A ,$115.65 ,$54.33 ,$174.64 , N/A ,$164.93 , N/A , N/A , N/A ,$126.13 ST. JOSEPH'S HOSPITAL - BREESE,98200050,64493,PC INJ PARAVERT F JNT L/S 1 LV-BI,982,1 ,$282.24 ,$203.21 ,$79.03 ,"$2,045.96 ","$2,045.95 ",$183.46 ,$168.50 ,$802.01 ,$79.03 ,$186.84 ,$802.01 ,$186.84 ,$276.60 ,$168.22 ,$168.22 ,$276.60 ,$168.22 ,$282.24 ,$217.32 ,"$2,045.96 ",$802.01 ,$276.60 ,$211.68 ,$200.39 ,$200.39 ,$802.01 ,$200.39 ,$239.90 ,$239.90 ,$239.90 , N/A ,$282.24 ,$239.90 ,$276.60 ,$282.24 ,$158.34 ,$802.01 ,$168.09 ,$282.24 ,$282.24 ,$802.01 ,$239.90 ,"$1,718.60 ",$168.22 ,$79.03 ,$254.02 ,$802.01 ,$239.90 , N/A , N/A ,$802.01 ,$183.46 ST. JOSEPH'S HOSPITAL - BREESE,98200051,64493,PC INJ PARAVERT F JNT L/S 1 LV-LT,982,1 ,$282.24 ,$203.21 ,$79.03 ,"$2,045.96 ","$2,045.95 ",$183.46 ,$168.50 ,$802.01 ,$79.03 ,$186.84 ,$802.01 ,$186.84 ,$276.60 ,$168.22 ,$168.22 ,$276.60 ,$168.22 ,$282.24 ,$217.32 ,"$2,045.96 ",$802.01 ,$276.60 ,$211.68 ,$200.39 ,$200.39 ,$802.01 ,$200.39 ,$239.90 ,$239.90 ,$239.90 , N/A ,$282.24 ,$239.90 ,$276.60 ,$282.24 ,$158.34 ,$802.01 ,$168.09 ,$282.24 ,$282.24 ,$802.01 ,$239.90 ,"$1,718.60 ",$168.22 ,$79.03 ,$254.02 ,$802.01 ,$239.90 , N/A , N/A ,$802.01 ,$183.46 ST. JOSEPH'S HOSPITAL - BREESE,98200052,64493,PC INJ PARAVERT F JNT L/S 1 LV-RT,982,1 ,$282.24 ,$203.21 ,$79.03 ,"$2,045.96 ","$2,045.95 ",$183.46 ,$168.50 ,$802.01 ,$79.03 ,$186.84 ,$802.01 ,$186.84 ,$276.60 ,$168.22 ,$168.22 ,$276.60 ,$168.22 ,$282.24 ,$217.32 ,"$2,045.96 ",$802.01 ,$276.60 ,$211.68 ,$200.39 ,$200.39 ,$802.01 ,$200.39 ,$239.90 ,$239.90 ,$239.90 , N/A ,$282.24 ,$239.90 ,$276.60 ,$282.24 ,$158.34 ,$802.01 ,$168.09 ,$282.24 ,$282.24 ,$802.01 ,$239.90 ,"$1,718.60 ",$168.22 ,$79.03 ,$254.02 ,$802.01 ,$239.90 , N/A , N/A ,$802.01 ,$183.46 ST. JOSEPH'S HOSPITAL - BREESE,98200053,64494,PC INJ PARAVERT F JNT L/S 2 LV-LT,982,1 ,$164.97 ,$118.78 ,$46.19 ,$164.97 , N/A ,$107.23 ,$98.49 , N/A ,$46.19 ,$109.21 , N/A ,$109.21 , N/A ,$98.32 ,$98.32 , N/A ,$98.32 , N/A ,$127.03 , N/A , N/A , N/A ,$123.73 ,$117.13 ,$117.13 , N/A ,$117.13 ,$140.22 ,$140.22 ,$140.22 , N/A , N/A ,$140.22 , N/A ,$164.97 ,$92.55 , N/A ,$98.03 ,$164.97 ,$164.97 , N/A ,$140.22 , N/A ,$98.32 ,$46.19 ,$148.47 , N/A ,$140.22 , N/A , N/A , N/A ,$107.23 ST. JOSEPH'S HOSPITAL - BREESE,98200054,64494,PC INJ PARAVERT F JNT L/S 2 LV-RT,982,1 ,$164.97 ,$118.78 ,$46.19 ,$164.97 , N/A ,$107.23 ,$98.49 , N/A ,$46.19 ,$109.21 , N/A ,$109.21 , N/A ,$98.32 ,$98.32 , N/A ,$98.32 , N/A ,$127.03 , N/A , N/A , N/A ,$123.73 ,$117.13 ,$117.13 , N/A ,$117.13 ,$140.22 ,$140.22 ,$140.22 , N/A , N/A ,$140.22 , N/A ,$164.97 ,$92.55 , N/A ,$98.03 ,$164.97 ,$164.97 , N/A ,$140.22 , N/A ,$98.32 ,$46.19 ,$148.47 , N/A ,$140.22 , N/A , N/A , N/A ,$107.23 ST. JOSEPH'S HOSPITAL - BREESE,98200055,64495,PC INJ PARAVRT F JNT L/S 3+ LV-LT,982,1 ,$167.00 ,$120.24 ,$46.76 ,$167.00 , N/A ,$108.55 ,$99.70 , N/A ,$46.76 ,$110.55 , N/A ,$110.55 , N/A ,$99.53 ,$99.53 , N/A ,$99.53 , N/A ,$128.59 , N/A , N/A , N/A ,$125.25 ,$118.57 ,$118.57 , N/A ,$118.57 ,$141.95 ,$141.95 ,$141.95 , N/A , N/A ,$141.95 , N/A ,$167.00 ,$93.69 , N/A ,$99.25 ,$167.00 ,$167.00 , N/A ,$141.95 , N/A ,$99.53 ,$46.76 ,$150.30 , N/A ,$141.95 , N/A , N/A , N/A ,$108.55 ST. JOSEPH'S HOSPITAL - BREESE,98200056,64495,PC INJ PARAVRT F JNT L/S 3+ LV-RT,982,1 ,$167.00 ,$120.24 ,$46.76 ,$167.00 , N/A ,$108.55 ,$99.70 , N/A ,$46.76 ,$110.55 , N/A ,$110.55 , N/A ,$99.53 ,$99.53 , N/A ,$99.53 , N/A ,$128.59 , N/A , N/A , N/A ,$125.25 ,$118.57 ,$118.57 , N/A ,$118.57 ,$141.95 ,$141.95 ,$141.95 , N/A , N/A ,$141.95 , N/A ,$167.00 ,$93.69 , N/A ,$99.25 ,$167.00 ,$167.00 , N/A ,$141.95 , N/A ,$99.53 ,$46.76 ,$150.30 , N/A ,$141.95 , N/A , N/A , N/A ,$108.55 ST. JOSEPH'S HOSPITAL - BREESE,98200057,64633,PC DESTROY NERVE CERVICAL/THORACIC SGL-BIL,982,1 ,$710.64 ,$511.66 ,$198.98 ,"$4,315.58 ","$4,315.58 ",$461.92 ,$424.25 ,"$1,691.71 ",$198.98 ,$470.44 ,"$1,691.71 ",$470.44 ,$696.43 ,$423.54 ,$423.54 ,$696.43 ,$423.54 ,$710.64 ,$547.19 ,"$4,315.58 ","$1,691.71 ",$696.43 ,$532.98 ,$504.55 ,$504.55 ,"$1,691.71 ",$504.55 ,$604.04 ,$604.04 ,$604.04 , N/A ,$710.64 ,$604.04 ,$696.43 ,$710.64 ,$398.67 ,"$1,691.71 ",$421.88 ,$590.49 ,$536.81 ,"$1,691.71 ",$604.04 ,"$3,625.08 ",$423.54 ,$198.98 ,$639.58 ,"$1,691.71 ",$604.04 , N/A , N/A ,"$1,691.71 ",$461.92 ST. JOSEPH'S HOSPITAL - BREESE,98200058,64633,PC DESTROY NERVE CERVICAL/THORACIC SGL-LT,982,1 ,$710.64 ,$511.66 ,$198.98 ,"$4,315.58 ","$4,315.58 ",$461.92 ,$424.25 ,"$1,691.71 ",$198.98 ,$470.44 ,"$1,691.71 ",$470.44 ,$696.43 ,$423.54 ,$423.54 ,$696.43 ,$423.54 ,$710.64 ,$547.19 ,"$4,315.58 ","$1,691.71 ",$696.43 ,$532.98 ,$504.55 ,$504.55 ,"$1,691.71 ",$504.55 ,$604.04 ,$604.04 ,$604.04 , N/A ,$710.64 ,$604.04 ,$696.43 ,$710.64 ,$398.67 ,"$1,691.71 ",$421.88 ,$590.49 ,$536.81 ,"$1,691.71 ",$604.04 ,"$3,625.08 ",$423.54 ,$198.98 ,$639.58 ,"$1,691.71 ",$604.04 , N/A , N/A ,"$1,691.71 ",$461.92 ST. JOSEPH'S HOSPITAL - BREESE,98200059,64633,PC DESTROY NERVE CERVICAL/THORACIC SGL-RT,982,1 ,$710.64 ,$511.66 ,$198.98 ,"$4,315.58 ","$4,315.58 ",$461.92 ,$424.25 ,"$1,691.71 ",$198.98 ,$470.44 ,"$1,691.71 ",$470.44 ,$696.43 ,$423.54 ,$423.54 ,$696.43 ,$423.54 ,$710.64 ,$547.19 ,"$4,315.58 ","$1,691.71 ",$696.43 ,$532.98 ,$504.55 ,$504.55 ,"$1,691.71 ",$504.55 ,$604.04 ,$604.04 ,$604.04 , N/A ,$710.64 ,$604.04 ,$696.43 ,$710.64 ,$398.67 ,"$1,691.71 ",$421.88 ,$590.49 ,$536.81 ,"$1,691.71 ",$604.04 ,"$3,625.08 ",$423.54 ,$198.98 ,$639.58 ,"$1,691.71 ",$604.04 , N/A , N/A ,"$1,691.71 ",$461.92 ST. JOSEPH'S HOSPITAL - BREESE,98200060,64634,PC DESTROY NERVE CERVICAL/THORACIC EA ADDL-BIL,982,1 ,$217.17 ,$156.36 ,$60.81 ,$217.17 , N/A ,$141.16 ,$129.65 , N/A ,$60.81 ,$143.77 , N/A ,$143.77 , N/A ,$129.43 ,$129.43 , N/A ,$129.43 , N/A ,$167.22 , N/A , N/A , N/A ,$162.88 ,$154.19 ,$154.19 , N/A ,$154.19 ,$184.59 ,$184.59 ,$184.59 , N/A , N/A ,$184.59 , N/A ,$217.17 ,$121.83 , N/A ,$129.01 ,$217.17 ,$217.17 , N/A ,$184.59 , N/A ,$129.43 ,$60.81 ,$195.45 , N/A ,$184.59 , N/A , N/A , N/A ,$141.16 ST. JOSEPH'S HOSPITAL - BREESE,98200061,64634,PC DESTROY NERVE CERVICAL/THORACIC EA ADDL-LT,982,1 ,$217.17 ,$156.36 ,$60.81 ,$217.17 , N/A ,$141.16 ,$129.65 , N/A ,$60.81 ,$143.77 , N/A ,$143.77 , N/A ,$129.43 ,$129.43 , N/A ,$129.43 , N/A ,$167.22 , N/A , N/A , N/A ,$162.88 ,$154.19 ,$154.19 , N/A ,$154.19 ,$184.59 ,$184.59 ,$184.59 , N/A , N/A ,$184.59 , N/A ,$217.17 ,$121.83 , N/A ,$129.01 ,$217.17 ,$217.17 , N/A ,$184.59 , N/A ,$129.43 ,$60.81 ,$195.45 , N/A ,$184.59 , N/A , N/A , N/A ,$141.16 ST. JOSEPH'S HOSPITAL - BREESE,98200062,64634,PC DESTROY NERVE CERVICAL/THORACIC EA ADDL-RT,982,1 ,$217.17 ,$156.36 ,$60.81 ,$217.17 , N/A ,$141.16 ,$129.65 , N/A ,$60.81 ,$143.77 , N/A ,$143.77 , N/A ,$129.43 ,$129.43 , N/A ,$129.43 , N/A ,$167.22 , N/A , N/A , N/A ,$162.88 ,$154.19 ,$154.19 , N/A ,$154.19 ,$184.59 ,$184.59 ,$184.59 , N/A , N/A ,$184.59 , N/A ,$217.17 ,$121.83 , N/A ,$129.01 ,$217.17 ,$217.17 , N/A ,$184.59 , N/A ,$129.43 ,$60.81 ,$195.45 , N/A ,$184.59 , N/A , N/A , N/A ,$141.16 ST. JOSEPH'S HOSPITAL - BREESE,98200063,64635,PC DESTROY NERVE LUMBAR/SACRAL SGL-BIL,982,1 ,$699.45 ,$503.60 ,$195.85 ,"$4,315.58 ","$4,315.58 ",$454.64 ,$417.57 ,"$1,691.71 ",$195.85 ,$463.04 ,"$1,691.71 ",$463.04 ,$685.46 ,$416.87 ,$416.87 ,$685.46 ,$416.87 ,$699.45 ,$538.58 ,"$4,315.58 ","$1,691.71 ",$685.46 ,$524.59 ,$496.61 ,$496.61 ,"$1,691.71 ",$496.61 ,$594.53 ,$594.53 ,$594.53 , N/A ,$699.45 ,$594.53 ,$685.46 ,$699.45 ,$392.39 ,"$1,691.71 ",$415.69 ,$590.49 ,$536.81 ,"$1,691.71 ",$594.53 ,"$3,625.08 ",$416.87 ,$195.85 ,$629.51 ,"$1,691.71 ",$594.53 , N/A , N/A ,"$1,691.71 ",$454.64 ST. JOSEPH'S HOSPITAL - BREESE,98200064,64635,PC DESTROY NERVE LUMBAR/SACRAL SGL-LT,982,1 ,$699.45 ,$503.60 ,$195.85 ,"$4,315.58 ","$4,315.58 ",$454.64 ,$417.57 ,"$1,691.71 ",$195.85 ,$463.04 ,"$1,691.71 ",$463.04 ,$685.46 ,$416.87 ,$416.87 ,$685.46 ,$416.87 ,$699.45 ,$538.58 ,"$4,315.58 ","$1,691.71 ",$685.46 ,$524.59 ,$496.61 ,$496.61 ,"$1,691.71 ",$496.61 ,$594.53 ,$594.53 ,$594.53 , N/A ,$699.45 ,$594.53 ,$685.46 ,$699.45 ,$392.39 ,"$1,691.71 ",$415.69 ,$590.49 ,$536.81 ,"$1,691.71 ",$594.53 ,"$3,625.08 ",$416.87 ,$195.85 ,$629.51 ,"$1,691.71 ",$594.53 , N/A , N/A ,"$1,691.71 ",$454.64 ST. JOSEPH'S HOSPITAL - BREESE,98200065,64635,PC DESTROY NERVE LUMBAR/SACRAL SGL-RT,982,1 ,$699.45 ,$503.60 ,$195.85 ,"$4,315.58 ","$4,315.58 ",$454.64 ,$417.57 ,"$1,691.71 ",$195.85 ,$463.04 ,"$1,691.71 ",$463.04 ,$685.46 ,$416.87 ,$416.87 ,$685.46 ,$416.87 ,$699.45 ,$538.58 ,"$4,315.58 ","$1,691.71 ",$685.46 ,$524.59 ,$496.61 ,$496.61 ,"$1,691.71 ",$496.61 ,$594.53 ,$594.53 ,$594.53 , N/A ,$699.45 ,$594.53 ,$685.46 ,$699.45 ,$392.39 ,"$1,691.71 ",$415.69 ,$590.49 ,$536.81 ,"$1,691.71 ",$594.53 ,"$3,625.08 ",$416.87 ,$195.85 ,$629.51 ,"$1,691.71 ",$594.53 , N/A , N/A ,"$1,691.71 ",$454.64 ST. JOSEPH'S HOSPITAL - BREESE,98200066,64636,PC DESTROY NERVE LUMBAR/SACRAL EA ADDL-BIL,982,1 ,$190.98 ,$137.51 ,$53.47 ,$190.98 , N/A ,$124.14 ,$114.02 , N/A ,$53.47 ,$126.43 , N/A ,$126.43 , N/A ,$113.82 ,$113.82 , N/A ,$113.82 , N/A ,$147.05 , N/A , N/A , N/A ,$143.24 ,$135.60 ,$135.60 , N/A ,$135.60 ,$162.33 ,$162.33 ,$162.33 , N/A , N/A ,$162.33 , N/A ,$190.98 ,$107.14 , N/A ,$113.31 ,$190.98 ,$190.98 , N/A ,$162.33 , N/A ,$113.82 ,$53.47 ,$171.88 , N/A ,$162.33 , N/A , N/A , N/A ,$124.14 ST. JOSEPH'S HOSPITAL - BREESE,98200067,64636,PC DESTROY NERVE LUMBAR/SACRAL EA ADDL-LT,982,1 ,$190.98 ,$137.51 ,$53.47 ,$190.98 , N/A ,$124.14 ,$114.02 , N/A ,$53.47 ,$126.43 , N/A ,$126.43 , N/A ,$113.82 ,$113.82 , N/A ,$113.82 , N/A ,$147.05 , N/A , N/A , N/A ,$143.24 ,$135.60 ,$135.60 , N/A ,$135.60 ,$162.33 ,$162.33 ,$162.33 , N/A , N/A ,$162.33 , N/A ,$190.98 ,$107.14 , N/A ,$113.31 ,$190.98 ,$190.98 , N/A ,$162.33 , N/A ,$113.82 ,$53.47 ,$171.88 , N/A ,$162.33 , N/A , N/A , N/A ,$124.14 ST. JOSEPH'S HOSPITAL - BREESE,98200068,64636,PC DESTROY NERVE LUMBAR/SACRAL EA ADDL-RT,982,1 ,$190.98 ,$137.51 ,$53.47 ,$190.98 , N/A ,$124.14 ,$114.02 , N/A ,$53.47 ,$126.43 , N/A ,$126.43 , N/A ,$113.82 ,$113.82 , N/A ,$113.82 , N/A ,$147.05 , N/A , N/A , N/A ,$143.24 ,$135.60 ,$135.60 , N/A ,$135.60 ,$162.33 ,$162.33 ,$162.33 , N/A , N/A ,$162.33 , N/A ,$190.98 ,$107.14 , N/A ,$113.31 ,$190.98 ,$190.98 , N/A ,$162.33 , N/A ,$113.82 ,$53.47 ,$171.88 , N/A ,$162.33 , N/A , N/A , N/A ,$124.14 ST. JOSEPH'S HOSPITAL - BREESE,98200069,64640,PC DESTROY NERVE PERIPHERAL-BIL,982,1 ,$370.50 ,$266.76 ,$103.74 ,"$2,045.96 ","$2,045.95 ",$240.83 ,$221.19 ,$802.01 ,$103.74 ,$245.27 ,$802.01 ,$245.27 ,$363.09 ,$220.82 ,$220.82 ,$363.09 ,$220.82 ,$370.50 ,$285.29 ,"$2,045.96 ",$802.01 ,$363.09 ,$277.88 ,$263.06 ,$263.06 ,$802.01 ,$263.06 ,$314.93 ,$314.93 ,$314.93 , N/A ,$370.50 ,$314.93 ,$363.09 ,$370.50 ,$207.85 ,$802.01 ,$220.32 ,$370.50 ,$370.50 ,$802.01 ,$314.93 ,"$1,718.60 ",$220.82 ,$103.74 ,$333.45 ,$802.01 ,$314.93 , N/A , N/A ,$802.01 ,$240.83 ST. JOSEPH'S HOSPITAL - BREESE,98200070,64640,PC DESTROY NERVE PERIPHERAL-LT,982,1 ,$370.50 ,$266.76 ,$103.74 ,"$2,045.96 ","$2,045.95 ",$240.83 ,$221.19 ,$802.01 ,$103.74 ,$245.27 ,$802.01 ,$245.27 ,$363.09 ,$220.82 ,$220.82 ,$363.09 ,$220.82 ,$370.50 ,$285.29 ,"$2,045.96 ",$802.01 ,$363.09 ,$277.88 ,$263.06 ,$263.06 ,$802.01 ,$263.06 ,$314.93 ,$314.93 ,$314.93 , N/A ,$370.50 ,$314.93 ,$363.09 ,$370.50 ,$207.85 ,$802.01 ,$220.32 ,$370.50 ,$370.50 ,$802.01 ,$314.93 ,"$1,718.60 ",$220.82 ,$103.74 ,$333.45 ,$802.01 ,$314.93 , N/A , N/A ,$802.01 ,$240.83 ST. JOSEPH'S HOSPITAL - BREESE,98200071,64640,PC DESTROY NERVE PERIPHERAL-RT,982,1 ,$370.50 ,$266.76 ,$103.74 ,"$2,045.96 ","$2,045.95 ",$240.83 ,$221.19 ,$802.01 ,$103.74 ,$245.27 ,$802.01 ,$245.27 ,$363.09 ,$220.82 ,$220.82 ,$363.09 ,$220.82 ,$370.50 ,$285.29 ,"$2,045.96 ",$802.01 ,$363.09 ,$277.88 ,$263.06 ,$263.06 ,$802.01 ,$263.06 ,$314.93 ,$314.93 ,$314.93 , N/A ,$370.50 ,$314.93 ,$363.09 ,$370.50 ,$207.85 ,$802.01 ,$220.32 ,$370.50 ,$370.50 ,$802.01 ,$314.93 ,"$1,718.60 ",$220.82 ,$103.74 ,$333.45 ,$802.01 ,$314.93 , N/A , N/A ,$802.01 ,$240.83 ST. JOSEPH'S HOSPITAL - BREESE,98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$51.00 ,$36.72 ,$14.28 ,$51.00 , N/A ,$33.15 ,$30.45 , N/A ,$14.28 ,$33.76 , N/A ,$33.76 , N/A ,$30.40 ,$30.40 , N/A ,$30.40 , N/A ,$39.27 , N/A , N/A , N/A ,$38.25 ,$36.21 ,$36.21 , N/A ,$36.21 ,$43.35 ,$43.35 ,$43.35 , N/A , N/A ,$43.35 , N/A ,$51.00 ,$28.61 , N/A ,$16.94 ,$19.06 ,$17.33 , N/A ,$43.35 , N/A ,$30.40 ,$14.28 ,$45.90 , N/A ,$43.35 , N/A , N/A , N/A ,$33.15 ST. JOSEPH'S HOSPITAL - BREESE,98500015,45334,PC SIGMOIDOSCOPY W/CONTROL BLEEDING,985,1 ,$350.19 ,$252.14 ,$98.05 ,"$2,599.90 ","$2,599.90 ",$227.62 ,$209.06 ,"$1,019.16 ",$98.05 ,$231.83 ,"$1,019.16 ",$231.83 ,$343.19 ,$208.71 ,$208.71 ,$343.19 ,$208.71 ,$350.19 ,$269.65 ,"$2,599.90 ","$1,019.16 ",$343.19 ,$262.64 ,$248.63 ,$248.63 ,"$1,019.16 ",$248.63 ,$297.66 ,$297.66 ,$297.66 , N/A ,$350.19 ,$297.66 ,$343.19 ,$350.19 ,$196.46 ,"$1,019.16 ",$221.36 ,$350.19 ,$350.19 ,"$1,019.16 ",$297.66 ,"$2,183.92 ",$208.71 ,$98.05 ,$315.17 ,"$1,019.16 ",$297.66 , N/A , N/A ,"$1,019.16 ",$227.62 ST. JOSEPH'S HOSPITAL - BREESE,98880001,99252,PC INP/OBSERV CONSULT NEW/ESTAB SF MED DEC PT LEVEL 2 - 35 MIN,988,1 ,$152.00 ,$109.44 ,$42.56 ,$152.00 , N/A ,$98.80 ,$90.74 , N/A ,$42.56 ,$100.62 , N/A ,$100.62 , N/A ,$90.59 ,$90.59 , N/A ,$90.59 , N/A ,$117.04 , N/A , N/A , N/A ,$114.00 ,$107.92 ,$107.92 , N/A ,$107.92 ,$129.20 ,$129.20 ,$129.20 , N/A , N/A ,$129.20 , N/A ,$152.00 ,$85.27 , N/A ,$104.81 , N/A , N/A , N/A ,$129.20 , N/A ,$90.59 ,$42.56 ,$136.80 , N/A ,$129.20 , N/A , N/A , N/A ,$98.80 ST. JOSEPH'S HOSPITAL - BREESE,98880002,99253,PC INP/OBSERV CONSULT NEW/ESTAB LOW MED DEC PT LEVEL 3 - 45 MIN,988,1 ,$204.00 ,$146.88 ,$57.12 ,$204.00 , N/A ,$132.60 ,$121.79 , N/A ,$57.12 ,$135.05 , N/A ,$135.05 , N/A ,$121.58 ,$121.58 , N/A ,$121.58 , N/A ,$157.08 , N/A , N/A , N/A ,$153.00 ,$144.84 ,$144.84 , N/A ,$144.84 ,$173.40 ,$173.40 ,$173.40 , N/A , N/A ,$173.40 , N/A ,$204.00 ,$114.44 , N/A ,$161.83 , N/A , N/A , N/A ,$173.40 , N/A ,$121.58 ,$57.12 ,$183.60 , N/A ,$173.40 , N/A , N/A , N/A ,$132.60 ST. JOSEPH'S HOSPITAL - BREESE,98880003,99254,PC INP/OBSERV CONSULT NEW/ESTAB MOD MED DEC PT LEVEL 4 - 60 MIN,988,1 ,$298.00 ,$214.56 ,$83.44 ,$298.00 , N/A ,$193.70 ,$177.91 , N/A ,$83.44 ,$197.28 , N/A ,$197.28 , N/A ,$177.61 ,$177.61 , N/A ,$177.61 , N/A ,$229.46 , N/A , N/A , N/A ,$223.50 ,$211.58 ,$211.58 , N/A ,$211.58 ,$253.30 ,$253.30 ,$253.30 , N/A , N/A ,$253.30 , N/A ,$298.00 ,$167.18 , N/A ,$235.66 , N/A , N/A , N/A ,$253.30 , N/A ,$177.61 ,$83.44 ,$268.20 , N/A ,$253.30 , N/A , N/A , N/A ,$193.70 ST. JOSEPH'S HOSPITAL - BREESE,98880004,99255,PC INP/OBSERV CONSULT NEW/ESTAB HIGH MED DEC PT LEVEL 5 - 80 MIN,988,1 ,$345.00 ,$248.40 ,$96.60 ,$345.00 , N/A ,$224.25 ,$205.97 , N/A ,$96.60 ,$228.39 , N/A ,$228.39 , N/A ,$205.62 ,$205.62 , N/A ,$205.62 , N/A ,$265.65 , N/A , N/A , N/A ,$258.75 ,$244.95 ,$244.95 , N/A ,$244.95 ,$293.25 ,$293.25 ,$293.25 , N/A , N/A ,$293.25 , N/A ,$345.00 ,$193.55 , N/A ,$283.50 , N/A , N/A , N/A ,$293.25 , N/A ,$205.62 ,$96.60 ,$310.50 , N/A ,$293.25 , N/A , N/A , N/A ,$224.25