ST. ANTHONY'S MEMORIAL HOSPITAL - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hopsital_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 , CHOICE CARE , CIGNA , CLAIM DOC , CLEAR SPRING HEALTH MEDICARE ADV , CONSOCIATE GROUP ," ESSENCE, L.L.P. ", FIRST HEALTH NETWORK , HEALTH ALLIANCE KINGERY , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE ," HEALTH ALLIANCE MEDICAL PLANS, INC. ", HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTH PARTNERS MEDICARE , HEALTHLINK , HEALTHLINK CASINO QUEEN , HEALTHLINK PPO , HFN , 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 , UHC CATERPILLAR , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , WELLFIRST 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$39,336.51 ","$3,420.26 ","$150,552.52 ","$60,517.70 ","$45,085.69 ","$39,639.09 ","$59,307.35 ","$16,944.96 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$140,164.38 ","$54,465.93 ","$45,388.28 ","$60,517.70 ","$59,900.42 ","$51,440.05 ","$59,307.35 ","$45,388.28 ","$45,388.28 ","$51,440.05 ","$51,440.05 ","$59,307.35 ","$51,440.05 ","$59,307.35 ","$44,783.10 ","$44,783.10 ","$44,783.10 ","$54,465.93 ","$60,517.70 ","$54,465.93 ","$59,307.35 ", N/A ,"$39,639.09 ","$59,307.35 ","$25,175.36 ","$3,583.13 ","$3,420.26 ","$59,307.35 ","$54,465.93 ","$150,552.52 ","$60,517.70 ","$16,944.96 ","$54,465.93 ","$59,307.35 ","$54,465.93 ","$54,465.93 ","$59,307.35 ","$39,336.51 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$9,948.71 ","$2,504.64 ","$38,075.64 ","$15,305.70 ","$11,402.75 ","$10,025.23 ","$15,305.70 ","$4,285.60 ","$8,292.30 ","$15,305.70 ","$8,292.30 ","$15,305.70 ","$8,292.30 ","$8,292.30 ","$15,305.70 ","$8,292.30 ","$36,171.86 ","$13,775.13 ","$11,479.28 ","$15,305.70 ","$15,458.76 ","$13,009.85 ","$15,305.70 ","$11,479.28 ","$11,479.28 ","$13,009.85 ","$13,009.85 ","$15,305.70 ","$13,009.85 ","$15,305.70 ","$11,326.22 ","$11,326.22 ","$11,326.22 ","$13,775.13 ","$15,305.70 ","$13,775.13 ","$15,305.70 ", N/A ,"$10,025.23 ","$15,305.70 ","$6,367.17 ","$2,623.91 ","$2,504.64 ","$15,305.70 ","$13,775.13 ","$38,075.64 ","$8,292.30 ","$4,285.60 ","$13,775.13 ","$15,305.70 ","$13,775.13 ","$13,775.13 ","$15,305.70 ","$9,948.71 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$7,445.85 ","$2,504.64 ","$28,497.50 ","$11,455.16 ","$8,534.09 ","$7,503.13 ","$11,455.16 ","$3,207.44 ","$8,292.30 ","$11,455.16 ","$8,292.30 ","$11,455.16 ","$8,292.30 ","$8,292.30 ","$11,455.16 ","$8,292.30 ","$27,072.63 ","$10,309.64 ","$8,591.37 ","$11,455.16 ","$11,569.71 ","$9,736.89 ","$11,455.16 ","$8,591.37 ","$8,591.37 ","$9,736.89 ","$9,736.89 ","$11,455.16 ","$9,736.89 ","$11,455.16 ","$8,476.82 ","$8,476.82 ","$8,476.82 ","$10,309.64 ","$11,455.16 ","$10,309.64 ","$11,455.16 ", N/A ,"$7,503.13 ","$11,455.16 ","$4,765.35 ","$2,623.91 ","$2,504.64 ","$11,455.16 ","$10,309.64 ","$28,497.50 ","$8,292.30 ","$3,207.44 ","$10,309.64 ","$11,455.16 ","$10,309.64 ","$10,309.64 ","$11,455.16 ","$7,445.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$15,401.47 ","$2,504.64 ","$58,946.02 ","$23,694.57 ","$17,652.45 ","$15,519.94 ","$23,220.68 ","$6,634.48 ","$12,438.45 ","$23,220.68 ","$12,438.45 ","$23,220.68 ","$12,438.45 ","$12,438.45 ","$23,220.68 ","$12,438.45 ","$54,878.75 ","$21,325.11 ","$17,770.93 ","$23,694.57 ","$23,452.89 ","$20,140.38 ","$23,220.68 ","$17,770.93 ","$17,770.93 ","$20,140.38 ","$20,140.38 ","$23,220.68 ","$20,140.38 ","$23,220.68 ","$17,533.98 ","$17,533.98 ","$17,533.98 ","$21,325.11 ","$23,694.57 ","$21,325.11 ","$23,220.68 ", N/A ,"$15,519.94 ","$23,220.68 ","$9,856.94 ","$2,623.91 ","$2,504.64 ","$23,220.68 ","$21,325.11 ","$58,946.02 ","$12,438.45 ","$6,634.48 ","$21,325.11 ","$23,220.68 ","$21,325.11 ","$21,325.11 ","$23,220.68 ","$15,401.47 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$4,438.60 ","$1,912.01 ","$16,987.84 ","$6,828.61 ","$5,087.31 ","$4,472.74 ","$6,828.61 ","$1,912.01 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$16,138.45 ","$6,145.75 ","$5,121.46 ","$6,828.61 ","$6,896.90 ","$5,804.32 ","$6,828.61 ","$5,121.46 ","$5,121.46 ","$5,804.32 ","$5,804.32 ","$6,828.61 ","$5,804.32 ","$6,828.61 ","$6,722.00 ","$6,722.00 ","$6,722.00 ","$6,145.75 ","$6,828.61 ","$6,145.75 ","$6,828.61 ", N/A ,"$4,472.74 ","$6,828.61 ","$2,840.70 ","$2,623.91 ","$2,504.64 ","$6,828.61 ","$6,145.75 ","$16,987.84 ","$6,828.61 ","$1,912.01 ","$6,145.75 ","$6,828.61 ","$6,145.75 ","$6,145.75 ","$6,828.61 ","$4,438.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,$951.00 ,$618.15 ,$266.28 ,$951.00 , Inpatient Medicare +150% ,$708.50 ,$622.91 , Inpatient Medicare +150% ,$266.28 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,$855.90 ,$713.25 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$808.35 , Inpatient Medicare ,$713.25 ,$713.25 ,$808.35 ,$808.35 , Inpatient Medicare ,$808.35 , Inpatient Medicare ,$703.74 ,$703.74 ,$703.74 ,$855.90 , Inpatient Medicare +150% ,$855.90 , Inpatient Medicare , N/A ,$622.91 , Inpatient Medicare ,$395.62 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$855.90 , Inpatient Medicare +100% ,"$4,146.15 ",$266.28 ,$855.90 , Inpatient Medicare ,$855.90 ,$855.90 , Inpatient Medicare ,$618.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),12000006,N/A,HC DAILY SERVICE W/TELEMETRY,120,1 ,"$1,340.00 ",$871.00 ,$375.20 ,"$1,340.00 ", Inpatient Medicare +150% ,$998.30 ,$877.70 , Inpatient Medicare +150% ,$375.20 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,"$1,206.00 ","$1,005.00 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,139.00 ", Inpatient Medicare ,"$1,005.00 ","$1,005.00 ","$1,139.00 ","$1,139.00 ", Inpatient Medicare ,"$1,139.00 ", Inpatient Medicare ,$991.60 ,$991.60 ,$991.60 ,"$1,206.00 ", Inpatient Medicare +150% ,"$1,206.00 ", Inpatient Medicare , N/A ,$877.70 , Inpatient Medicare ,$557.44 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,206.00 ", Inpatient Medicare +100% ,"$4,146.15 ",$375.20 ,"$1,206.00 ", Inpatient Medicare ,"$1,206.00 ","$1,206.00 ", Inpatient Medicare ,$871.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),12200001,N/A,HC DAILY SERVICE OBSTETRICS,122,1 ,$951.00 ,$618.15 ,$266.28 ,$951.00 , Inpatient Medicare +150% ,$708.50 ,$622.91 , Inpatient Medicare +150% ,$266.28 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,$855.90 ,$713.25 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$808.35 , Inpatient Medicare ,$713.25 ,$713.25 ,$808.35 ,$808.35 , Inpatient Medicare ,$808.35 , Inpatient Medicare ,$703.74 ,$703.74 ,$703.74 ,$855.90 , Inpatient Medicare +150% ,$855.90 , Inpatient Medicare , N/A ,$622.91 , Inpatient Medicare ,$395.62 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$855.90 , Inpatient Medicare +100% ,"$4,146.15 ",$266.28 ,$855.90 , Inpatient Medicare ,$855.90 ,$855.90 , Inpatient Medicare ,$618.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,$923.00 ,$599.95 ,$258.44 ,$923.00 , Inpatient Medicare +150% ,$687.64 ,$604.57 , Inpatient Medicare +150% ,$258.44 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,$830.70 ,$692.25 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$784.55 , Inpatient Medicare ,$692.25 ,$692.25 ,$784.55 ,$784.55 , Inpatient Medicare ,$784.55 , Inpatient Medicare ,$683.02 ,$683.02 ,$683.02 ,$830.70 , Inpatient Medicare +150% ,$830.70 , Inpatient Medicare , N/A ,$604.57 , Inpatient Medicare ,$383.97 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$830.70 , Inpatient Medicare +100% ,"$4,146.15 ",$258.44 ,$830.70 , Inpatient Medicare ,$830.70 ,$830.70 , Inpatient Medicare ,$599.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),17100001,N/A,HC DAILY INFANT SERVICE LEV 1,171,1 ,$814.00 ,$529.10 ,$227.92 ,$814.00 , Inpatient Medicare +150% ,$606.43 ,$533.17 , Inpatient Medicare +150% ,$227.92 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,$732.60 ,$610.50 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$691.90 , Inpatient Medicare ,$610.50 ,$610.50 ,$691.90 ,$691.90 , Inpatient Medicare ,$691.90 , Inpatient Medicare ,$602.36 ,$602.36 ,$602.36 ,$732.60 , Inpatient Medicare +150% ,$732.60 , Inpatient Medicare , N/A ,$533.17 , Inpatient Medicare ,$338.62 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$732.60 , Inpatient Medicare +100% ,"$4,146.15 ",$227.92 ,$732.60 , Inpatient Medicare ,$732.60 ,$732.60 , Inpatient Medicare ,$529.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),17200002,N/A,HC DAILY INFANT SERVICE LEV 2,172,1 ,"$1,351.00 ",$878.15 ,$378.28 ,"$1,351.00 ", Inpatient Medicare +150% ,"$1,006.50 ",$884.91 , Inpatient Medicare +150% ,$378.28 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,"$1,215.90 ","$1,013.25 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,148.35 ", Inpatient Medicare ,"$1,013.25 ","$1,013.25 ","$1,148.35 ","$1,148.35 ", Inpatient Medicare ,"$1,148.35 ", Inpatient Medicare ,$999.74 ,$999.74 ,$999.74 ,"$1,215.90 ", Inpatient Medicare +150% ,"$1,215.90 ", Inpatient Medicare , N/A ,$884.91 , Inpatient Medicare ,$562.02 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,215.90 ", Inpatient Medicare +100% ,"$4,146.15 ",$378.28 ,"$1,215.90 ", Inpatient Medicare ,"$1,215.90 ","$1,215.90 ", Inpatient Medicare ,$878.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$1,962.00 ","$1,275.30 ",$549.36 ,"$1,962.00 ", Inpatient Medicare +150% ,"$1,461.69 ","$1,285.11 ", Inpatient Medicare +150% ,$549.36 ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare ,"$4,146.15 ","$4,146.15 ", Inpatient Medicare ,"$4,146.15 ", Inpatient Medicare +90% ,"$1,765.80 ","$1,471.50 ", Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,667.70 ", Inpatient Medicare ,"$1,471.50 ","$1,471.50 ","$1,667.70 ","$1,667.70 ", Inpatient Medicare ,"$1,667.70 ", Inpatient Medicare ,"$1,451.88 ","$1,451.88 ","$1,451.88 ","$1,765.80 ", Inpatient Medicare +150% ,"$1,765.80 ", Inpatient Medicare , N/A ,"$1,285.11 ", Inpatient Medicare ,$816.19 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,765.80 ", Inpatient Medicare +100% ,"$4,146.15 ",$549.36 ,"$1,765.80 ", Inpatient Medicare ,"$1,765.80 ","$1,765.80 ", Inpatient Medicare ,"$1,275.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$547.00 ,$355.55 ,$153.16 ,$547.00 ,$518.53 ,$407.52 ,$358.29 ,$216.00 ,$153.16 ,$276.24 ,$216.00 ,$337.50 ,$216.00 ,$337.50 ,$337.50 ,$216.00 ,$337.50 ,$410.40 ,$492.30 ,$410.25 ,$518.53 ,$216.00 ,$481.36 ,$216.00 ,$410.25 ,$410.25 ,$464.95 ,$464.95 ,$216.00 ,$464.95 ,$216.00 ,$426.66 ,$426.66 ,$426.66 ,$492.30 ,$518.53 ,$492.30 ,$216.00 ,$547.00 ,$358.29 ,$216.00 ,$227.55 ,$227.81 ,$217.46 ,$226.09 ,$492.30 ,$468.11 ,$337.50 ,$153.16 ,$492.30 ,$216.00 ,$492.30 ,$492.30 ,$216.00 ,$355.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$196.00 ,$127.40 ,$42.25 ,$196.00 ,$101.43 ,$146.02 ,$128.38 ,$42.25 ,$54.88 ,$98.98 ,$42.25 ,$120.93 ,$42.25 ,$120.93 ,$120.93 ,$42.25 ,$120.93 ,$80.28 ,$176.40 ,$147.00 ,$101.43 ,$42.25 ,$172.48 ,$42.25 ,$147.00 ,$147.00 ,$166.60 ,$166.60 ,$42.25 ,$166.60 ,$42.25 ,$152.88 ,$152.88 ,$152.88 ,$176.40 ,$101.43 ,$176.40 ,$42.25 ,$196.00 ,$128.38 ,$42.25 ,$81.54 ,$196.00 ,$196.00 ,$44.23 ,$176.40 ,$91.57 ,$120.93 ,$54.88 ,$176.40 ,$42.25 ,$176.40 ,$176.40 ,$42.25 ,$127.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$619.00 ,$402.35 ,$173.32 ,$619.00 ,$518.53 ,$461.16 ,$405.45 ,$216.00 ,$173.32 ,$312.60 ,$216.00 ,$381.92 ,$216.00 ,$381.92 ,$381.92 ,$216.00 ,$381.92 ,$410.40 ,$557.10 ,$464.25 ,$518.53 ,$216.00 ,$544.72 ,$216.00 ,$464.25 ,$464.25 ,$526.15 ,$526.15 ,$216.00 ,$526.15 ,$216.00 ,$482.82 ,$482.82 ,$482.82 ,$557.10 ,$518.53 ,$557.10 ,$216.00 ,$619.00 ,$405.45 ,$216.00 ,$257.50 ,$227.81 ,$217.46 ,$226.09 ,$557.10 ,$468.11 ,$381.92 ,$173.32 ,$557.10 ,$216.00 ,$557.10 ,$557.10 ,$216.00 ,$402.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$129.00 ,$83.85 ,$36.12 ,$129.00 ,$101.43 ,$96.11 ,$84.50 ,$42.25 ,$36.12 ,$65.15 ,$42.25 ,$79.59 ,$42.25 ,$79.59 ,$79.59 ,$42.25 ,$79.59 ,$80.28 ,$116.10 ,$96.75 ,$101.43 ,$42.25 ,$113.52 ,$42.25 ,$96.75 ,$96.75 ,$109.65 ,$109.65 ,$42.25 ,$109.65 ,$42.25 ,$100.62 ,$100.62 ,$100.62 ,$116.10 ,$101.43 ,$116.10 ,$42.25 ,$129.00 ,$84.50 ,$42.25 ,$53.66 ,$129.00 ,$129.00 ,$44.23 ,$116.10 ,$91.57 ,$79.59 ,$36.12 ,$116.10 ,$42.25 ,$116.10 ,$116.10 ,$42.25 ,$83.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$91.00 ,$59.15 ,$25.48 ,$141.87 ,$91.00 ,$67.80 ,$59.61 ,$65.46 ,$25.48 ,$45.96 ,$65.46 ,$56.15 ,$65.46 ,$56.15 ,$56.15 ,$65.46 ,$56.15 ,$124.37 ,$81.90 ,$68.25 ,$91.00 ,$65.46 ,$80.08 ,$65.46 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$65.46 ,$77.35 ,$65.46 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$91.00 ,$81.90 ,$65.46 ,$91.00 ,$59.61 ,$65.46 ,$37.86 ,$91.00 ,$91.00 ,$68.52 ,$81.90 ,$141.87 ,$56.15 ,$25.48 ,$81.90 ,$65.46 ,$81.90 ,$81.90 ,$65.46 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000005,96368,HC INFUS CONCURRENT,260,1 ,$137.00 ,$89.05 ,$38.36 ,$137.00 , N/A ,$102.07 ,$89.74 , N/A ,$38.36 ,$69.19 , N/A ,$84.53 , N/A ,$84.53 ,$84.53 , N/A ,$84.53 , N/A ,$123.30 ,$102.75 , N/A , N/A ,$120.56 , N/A ,$102.75 ,$102.75 ,$116.45 ,$116.45 , N/A ,$116.45 , N/A ,$106.86 ,$106.86 ,$106.86 ,$123.30 , N/A ,$123.30 , N/A ,$137.00 ,$89.74 , N/A ,$56.99 ,$137.00 ,$137.00 , N/A ,$123.30 , N/A ,$84.53 ,$38.36 ,$123.30 , N/A ,$123.30 ,$123.30 , N/A ,$89.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000006,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$547.00 ,$355.55 ,$153.16 ,$547.00 ,$518.53 ,$407.52 ,$358.29 ,$216.00 ,$153.16 ,$276.24 ,$216.00 ,$337.50 ,$216.00 ,$337.50 ,$337.50 ,$216.00 ,$337.50 ,$410.40 ,$492.30 ,$410.25 ,$518.53 ,$216.00 ,$481.36 ,$216.00 ,$410.25 ,$410.25 ,$464.95 ,$464.95 ,$216.00 ,$464.95 ,$216.00 ,$426.66 ,$426.66 ,$426.66 ,$492.30 ,$518.53 ,$492.30 ,$216.00 ,$547.00 ,$358.29 ,$216.00 ,$227.55 ,$227.81 ,$217.46 ,$226.09 ,$492.30 ,$468.11 ,$337.50 ,$153.16 ,$492.30 ,$216.00 ,$492.30 ,$492.30 ,$216.00 ,$355.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000014,M0239,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB",260,1 ,$929.00 ,$603.85 ,$260.12 ,$929.00 , N/A ,$692.11 ,$608.50 , N/A ,$260.12 ,$469.15 , N/A ,$573.19 , N/A ,$573.19 ,$573.19 , N/A ,$573.19 , N/A ,$836.10 ,$309.60 , N/A , N/A ,$817.52 , N/A ,$696.75 ,$696.75 ,$789.65 ,$789.65 , N/A ,$789.65 , N/A ,$724.62 ,$724.62 ,$724.62 ,$836.10 , N/A ,$836.10 , N/A ,$929.00 ,$608.50 , N/A ,$386.46 , N/A , N/A , N/A ,$836.10 , N/A ,$573.19 ,$260.12 ,$836.10 , N/A ,$836.10 ,$836.10 , N/A ,$603.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000015,M0243,"HC INTRAVENOUS INFUSION, CASIRIVIMAB AND IMDEVIMAB ADMINISTRATION",260,1 ,$930.00 ,$604.50 ,$217.46 ,"$1,009.35 ",$930.00 ,$692.85 ,$609.15 ,$465.75 ,$260.40 ,$469.65 ,$465.75 ,$573.81 ,$465.75 ,$573.81 ,$573.81 ,$465.75 ,$573.81 ,$884.93 ,$837.00 ,$450.00 ,$930.00 ,$465.75 ,$818.40 ,$465.75 ,$697.50 ,$697.50 ,$790.50 ,$790.50 ,$465.75 ,$790.50 ,$465.75 ,$725.40 ,$725.40 ,$725.40 ,$837.00 ,$930.00 ,$837.00 ,$465.75 ,$930.00 ,$609.15 ,$465.75 ,$386.88 ,$227.81 ,$217.46 ,$487.50 ,$837.00 ,"$1,009.35 ",$573.81 ,$260.40 ,$837.00 ,$465.75 ,$837.00 ,$837.00 ,$465.75 ,$604.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000016,M0245,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB ADMINISTRATION",260,1 ,$932.25 ,$605.96 ,$217.46 ,"$1,009.35 ",$932.25 ,$694.53 ,$610.62 ,$465.75 ,$261.03 ,$470.79 ,$465.75 ,$575.20 ,$465.75 ,$575.20 ,$575.20 ,$465.75 ,$575.20 ,$884.93 ,$839.03 ,$450.00 ,$932.25 ,$465.75 ,$820.38 ,$465.75 ,$699.19 ,$699.19 ,$792.41 ,$792.41 ,$465.75 ,$792.41 ,$465.75 ,$727.16 ,$727.16 ,$727.16 ,$839.03 ,$932.25 ,$839.03 ,$465.75 ,$932.25 ,$610.62 ,$465.75 ,$387.82 ,$227.81 ,$217.46 ,$487.50 ,$839.03 ,"$1,009.35 ",$575.20 ,$261.03 ,$839.03 ,$465.75 ,$839.03 ,$839.03 ,$465.75 ,$605.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),26000017,M0247,"HC INTRAVENOUS INFUSION, SOTROVIMAB ADMINISTRATION",260,1 ,"$1,350.00 ",$877.50 ,$217.46 ,"$1,350.00 ","$1,118.07 ","$1,005.75 ",$884.25 ,$465.75 ,$378.00 ,$681.75 ,$465.75 ,$832.95 ,$465.75 ,$832.95 ,$832.95 ,$465.75 ,$832.95 ,$884.93 ,"$1,215.00 ","$1,012.50 ","$1,118.07 ",$465.75 ,"$1,188.00 ",$465.75 ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ",$465.75 ,"$1,147.50 ",$465.75 ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ","$1,118.07 ","$1,215.00 ",$465.75 ,"$1,350.00 ",$884.25 ,$465.75 ,$561.60 ,$227.81 ,$217.46 ,$487.50 ,"$1,215.00 ","$1,009.35 ",$832.95 ,$378.00 ,"$1,215.00 ",$465.75 ,"$1,215.00 ","$1,215.00 ",$465.75 ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000013,N/A,HC PUMP BREAST,270,1 ,$411.21 ,$267.29 ,$115.14 ,$411.21 , N/A ,$306.35 ,$269.34 , N/A ,$115.14 ,$207.66 , N/A ,$253.72 , N/A ,$253.72 ,$253.72 , N/A ,$253.72 , N/A ,$370.09 ,$308.41 , N/A , N/A ,$361.86 , N/A ,$308.41 ,$308.41 ,$349.53 ,$349.53 , N/A ,$349.53 , N/A ,$320.74 ,$320.74 ,$320.74 ,$370.09 , N/A ,$370.09 , N/A ,$411.21 ,$269.34 , N/A ,$171.06 , N/A , N/A , N/A ,$370.09 , N/A ,$253.72 ,$115.14 ,$370.09 , N/A ,$370.09 ,$370.09 , N/A ,$267.29 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000014,N/A,HC SET CYSTO IRRIGATION TUBING,270,1 ,$23.82 ,$15.48 ,$6.67 ,$23.82 , N/A ,$17.75 ,$15.60 , N/A ,$6.67 ,$12.03 , N/A ,$14.70 , N/A ,$14.70 ,$14.70 , N/A ,$14.70 , N/A ,$21.44 ,$17.87 , N/A , N/A ,$20.96 , N/A ,$17.87 ,$17.87 ,$20.25 ,$20.25 , N/A ,$20.25 , N/A ,$18.58 ,$18.58 ,$18.58 ,$21.44 , N/A ,$21.44 , N/A ,$23.82 ,$15.60 , N/A ,$9.91 , N/A , N/A , N/A ,$21.44 , N/A ,$14.70 ,$6.67 ,$21.44 , N/A ,$21.44 ,$21.44 , N/A ,$15.48 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000015,N/A,HC SET IV EXTENSION,270,1 ,$8.95 ,$5.82 ,$2.51 ,$8.95 , N/A ,$6.67 ,$5.86 , N/A ,$2.51 ,$4.52 , N/A ,$5.52 , N/A ,$5.52 ,$5.52 , N/A ,$5.52 , N/A ,$8.06 ,$6.71 , N/A , N/A ,$7.88 , N/A ,$6.71 ,$6.71 ,$7.61 ,$7.61 , N/A ,$7.61 , N/A ,$6.98 ,$6.98 ,$6.98 ,$8.06 , N/A ,$8.06 , N/A ,$8.95 ,$5.86 , N/A ,$3.72 , N/A , N/A , N/A ,$8.06 , N/A ,$5.52 ,$2.51 ,$8.06 , N/A ,$8.06 ,$8.06 , N/A ,$5.82 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000017,N/A,HC SYSTEM DRAINAGE,270,1 ,$73.62 ,$47.85 ,$20.61 ,$73.62 , N/A ,$54.85 ,$48.22 , N/A ,$20.61 ,$37.18 , N/A ,$45.42 , N/A ,$45.42 ,$45.42 , N/A ,$45.42 , N/A ,$66.26 ,$55.22 , N/A , N/A ,$64.79 , N/A ,$55.22 ,$55.22 ,$62.58 ,$62.58 , N/A ,$62.58 , N/A ,$57.42 ,$57.42 ,$57.42 ,$66.26 , N/A ,$66.26 , N/A ,$73.62 ,$48.22 , N/A ,$30.63 , N/A , N/A , N/A ,$66.26 , N/A ,$45.42 ,$20.61 ,$66.26 , N/A ,$66.26 ,$66.26 , N/A ,$47.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000021,N/A,HC TRAY ARTHROGRAM,270,1 ,$102.21 ,$66.44 ,$28.62 ,$102.21 , N/A ,$76.15 ,$66.95 , N/A ,$28.62 ,$51.62 , N/A ,$63.06 , N/A ,$63.06 ,$63.06 , N/A ,$63.06 , N/A ,$91.99 ,$76.66 , N/A , N/A ,$89.94 , N/A ,$76.66 ,$76.66 ,$86.88 ,$86.88 , N/A ,$86.88 , N/A ,$79.72 ,$79.72 ,$79.72 ,$91.99 , N/A ,$91.99 , N/A ,$102.21 ,$66.95 , N/A ,$42.52 , N/A , N/A , N/A ,$91.99 , N/A ,$63.06 ,$28.62 ,$91.99 , N/A ,$91.99 ,$91.99 , N/A ,$66.44 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000022,N/A,HC TRAY BIOPSY,270,1 ,$35.85 ,$23.30 ,$10.04 ,$35.85 , N/A ,$26.71 ,$23.48 , N/A ,$10.04 ,$18.10 , N/A ,$22.12 , N/A ,$22.12 ,$22.12 , N/A ,$22.12 , N/A ,$32.27 ,$26.89 , N/A , N/A ,$31.55 , N/A ,$26.89 ,$26.89 ,$30.47 ,$30.47 , N/A ,$30.47 , N/A ,$27.96 ,$27.96 ,$27.96 ,$32.27 , N/A ,$32.27 , N/A ,$35.85 ,$23.48 , N/A ,$14.91 , N/A , N/A , N/A ,$32.27 , N/A ,$22.12 ,$10.04 ,$32.27 , N/A ,$32.27 ,$32.27 , N/A ,$23.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000024,N/A,HC TRAY SPINAL ANESTHESIA,272,1 ,$204.76 ,$133.09 ,$57.33 ,$204.76 , N/A ,$152.55 ,$134.12 , N/A ,$57.33 ,$103.40 , N/A ,$126.34 , N/A ,$126.34 ,$126.34 , N/A ,$126.34 , N/A ,$184.28 ,$153.57 , N/A , N/A ,$180.19 , N/A ,$153.57 ,$153.57 ,$174.05 ,$174.05 , N/A ,$174.05 , N/A ,$159.71 ,$159.71 ,$159.71 ,$184.28 , N/A ,$184.28 , N/A ,$204.76 ,$134.12 , N/A ,$85.18 , N/A , N/A , N/A ,$184.28 , N/A ,$126.34 ,$57.33 ,$184.28 , N/A ,$184.28 ,$184.28 , N/A ,$133.09 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000047,N/A,HC PAD CARDIAC MONITOR,270,1 ,$54.88 ,$35.67 ,$15.37 ,$54.88 , N/A ,$40.89 ,$35.95 , N/A ,$15.37 ,$27.71 , N/A ,$33.86 , N/A ,$33.86 ,$33.86 , N/A ,$33.86 , N/A ,$49.39 ,$41.16 , N/A , N/A ,$48.29 , N/A ,$41.16 ,$41.16 ,$46.65 ,$46.65 , N/A ,$46.65 , N/A ,$42.81 ,$42.81 ,$42.81 ,$49.39 , N/A ,$49.39 , N/A ,$54.88 ,$35.95 , N/A ,$22.83 , N/A , N/A , N/A ,$49.39 , N/A ,$33.86 ,$15.37 ,$49.39 , N/A ,$49.39 ,$49.39 , N/A ,$35.67 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000073,N/A,HC DETECTOR CARBON DIOXIDE,270,1 ,$94.94 ,$61.71 ,$26.58 ,$94.94 , N/A ,$70.73 ,$62.19 , N/A ,$26.58 ,$47.94 , N/A ,$58.58 , N/A ,$58.58 ,$58.58 , N/A ,$58.58 , N/A ,$85.45 ,$71.21 , N/A , N/A ,$83.55 , N/A ,$71.21 ,$71.21 ,$80.70 ,$80.70 , N/A ,$80.70 , N/A ,$74.05 ,$74.05 ,$74.05 ,$85.45 , N/A ,$85.45 , N/A ,$94.94 ,$62.19 , N/A ,$39.50 , N/A , N/A , N/A ,$85.45 , N/A ,$58.58 ,$26.58 ,$85.45 , N/A ,$85.45 ,$85.45 , N/A ,$61.71 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000077,N/A,HC TUBING CONNECTING,270,1 ,$32.66 ,$21.23 ,$9.14 ,$32.66 , N/A ,$24.33 ,$21.39 , N/A ,$9.14 ,$16.49 , N/A ,$20.15 , N/A ,$20.15 ,$20.15 , N/A ,$20.15 , N/A ,$29.39 ,$24.50 , N/A , N/A ,$28.74 , N/A ,$24.50 ,$24.50 ,$27.76 ,$27.76 , N/A ,$27.76 , N/A ,$25.47 ,$25.47 ,$25.47 ,$29.39 , N/A ,$29.39 , N/A ,$32.66 ,$21.39 , N/A ,$13.59 , N/A , N/A , N/A ,$29.39 , N/A ,$20.15 ,$9.14 ,$29.39 , N/A ,$29.39 ,$29.39 , N/A ,$21.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000093,N/A,HC MATTRESS WARMING,270,1 ,$193.21 ,$125.59 ,$54.10 ,$193.21 , N/A ,$143.94 ,$126.55 , N/A ,$54.10 ,$97.57 , N/A ,$119.21 , N/A ,$119.21 ,$119.21 , N/A ,$119.21 , N/A ,$173.89 ,$144.91 , N/A , N/A ,$170.02 , N/A ,$144.91 ,$144.91 ,$164.23 ,$164.23 , N/A ,$164.23 , N/A ,$150.70 ,$150.70 ,$150.70 ,$173.89 , N/A ,$173.89 , N/A ,$193.21 ,$126.55 , N/A ,$80.38 , N/A , N/A , N/A ,$173.89 , N/A ,$119.21 ,$54.10 ,$173.89 , N/A ,$173.89 ,$173.89 , N/A ,$125.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000104,N/A,HC POLAR CARE CUBE,270,1 ,$180.63 ,$117.41 ,$50.58 ,$180.63 , N/A ,$134.57 ,$118.31 , N/A ,$50.58 ,$91.22 , N/A ,$111.45 , N/A ,$111.45 ,$111.45 , N/A ,$111.45 , N/A ,$162.57 ,$135.47 , N/A , N/A ,$158.95 , N/A ,$135.47 ,$135.47 ,$153.54 ,$153.54 , N/A ,$153.54 , N/A ,$140.89 ,$140.89 ,$140.89 ,$162.57 , N/A ,$162.57 , N/A ,$180.63 ,$118.31 , N/A ,$75.14 , N/A , N/A , N/A ,$162.57 , N/A ,$111.45 ,$50.58 ,$162.57 , N/A ,$162.57 ,$162.57 , N/A ,$117.41 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000105,N/A,HC COLD PACK HALF SIZE,270,1 ,$18.82 ,$12.23 ,$5.27 ,$18.82 , N/A ,$14.02 ,$12.33 , N/A ,$5.27 ,$9.50 , N/A ,$11.61 , N/A ,$11.61 ,$11.61 , N/A ,$11.61 , N/A ,$16.94 ,$14.12 , N/A , N/A ,$16.56 , N/A ,$14.12 ,$14.12 ,$16.00 ,$16.00 , N/A ,$16.00 , N/A ,$14.68 ,$14.68 ,$14.68 ,$16.94 , N/A ,$16.94 , N/A ,$18.82 ,$12.33 , N/A ,$7.83 , N/A , N/A , N/A ,$16.94 , N/A ,$11.61 ,$5.27 ,$16.94 , N/A ,$16.94 ,$16.94 , N/A ,$12.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000110,N/A,HC BASIC MATERNITY KIT,270,1 ,$41.79 ,$27.16 ,$11.70 ,$41.79 , N/A ,$31.13 ,$27.37 , N/A ,$11.70 ,$21.10 , N/A ,$25.78 , N/A ,$25.78 ,$25.78 , N/A ,$25.78 , N/A ,$37.61 ,$31.34 , N/A , N/A ,$36.78 , N/A ,$31.34 ,$31.34 ,$35.52 ,$35.52 , N/A ,$35.52 , N/A ,$32.60 ,$32.60 ,$32.60 ,$37.61 , N/A ,$37.61 , N/A ,$41.79 ,$27.37 , N/A ,$17.38 , N/A , N/A , N/A ,$37.61 , N/A ,$25.78 ,$11.70 ,$37.61 , N/A ,$37.61 ,$37.61 , N/A ,$27.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000116,N/A,HC MATERNITY SURGERY KIT,270,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000117,N/A,HC NEWBORN SURGERY KIT,270,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000118,N/A,HC EPIDURAL TRAY PAINBLOCK,270,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000119,N/A,HC BIOPSY SURGERY TRAY,270,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000124,N/A,HC DISPOSABLE LENS CUFF,270,1 ,$16.50 ,$10.73 ,$4.62 ,$16.50 , N/A ,$12.29 ,$10.81 , N/A ,$4.62 ,$8.33 , N/A ,$10.18 , N/A ,$10.18 ,$10.18 , N/A ,$10.18 , N/A ,$14.85 ,$12.38 , N/A , N/A ,$14.52 , N/A ,$12.38 ,$12.38 ,$14.03 ,$14.03 , N/A ,$14.03 , N/A ,$12.87 ,$12.87 ,$12.87 ,$14.85 , N/A ,$14.85 , N/A ,$16.50 ,$10.81 , N/A ,$6.86 , N/A , N/A , N/A ,$14.85 , N/A ,$10.18 ,$4.62 ,$14.85 , N/A ,$14.85 ,$14.85 , N/A ,$10.73 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27000131,N/A,HC PRECUT SAFETY SPLINT FIBERGLASS,270,1 ,$29.16 ,$18.95 ,$8.16 ,$29.16 , N/A ,$21.72 ,$19.10 , N/A ,$8.16 ,$14.73 , N/A ,$17.99 , N/A ,$17.99 ,$17.99 , N/A ,$17.99 , N/A ,$26.24 ,$21.87 , N/A , N/A ,$25.66 , N/A ,$21.87 ,$21.87 ,$24.79 ,$24.79 , N/A ,$24.79 , N/A ,$22.74 ,$22.74 ,$22.74 ,$26.24 , N/A ,$26.24 , N/A ,$29.16 ,$19.10 , N/A ,$12.13 , N/A , N/A , N/A ,$26.24 , N/A ,$17.99 ,$8.16 ,$26.24 , N/A ,$26.24 ,$26.24 , N/A ,$18.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100005,N/A,HC AIR SHIELDS WARMER,271,1 ,$38.47 ,$25.01 ,$10.77 ,$38.47 , N/A ,$28.66 ,$25.20 , N/A ,$10.77 ,$19.43 , N/A ,$23.74 , N/A ,$23.74 ,$23.74 , N/A ,$23.74 , N/A ,$34.62 ,$28.85 , N/A , N/A ,$33.85 , N/A ,$28.85 ,$28.85 ,$32.70 ,$32.70 , N/A ,$32.70 , N/A ,$30.01 ,$30.01 ,$30.01 ,$34.62 , N/A ,$34.62 , N/A ,$38.47 ,$25.20 , N/A ,$16.00 , N/A , N/A , N/A ,$34.62 , N/A ,$23.74 ,$10.77 ,$34.62 , N/A ,$34.62 ,$34.62 , N/A ,$25.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100080,N/A,HC LARYNGEAL MASK AIRWAY,272,1 ,$145.09 ,$94.31 ,$40.63 ,$145.09 , N/A ,$108.09 ,$95.03 , N/A ,$40.63 ,$73.27 , N/A ,$89.52 , N/A ,$89.52 ,$89.52 , N/A ,$89.52 , N/A ,$130.58 ,$108.82 , N/A , N/A ,$127.68 , N/A ,$108.82 ,$108.82 ,$123.33 ,$123.33 , N/A ,$123.33 , N/A ,$113.17 ,$113.17 ,$113.17 ,$130.58 , N/A ,$130.58 , N/A ,$145.09 ,$95.03 , N/A ,$60.36 , N/A , N/A , N/A ,$130.58 , N/A ,$89.52 ,$40.63 ,$130.58 , N/A ,$130.58 ,$130.58 , N/A ,$94.31 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100107,N/A,HC OXYGEN HOURLY,271,1 ,$17.04 ,$11.08 ,$4.77 ,$17.04 , N/A ,$12.69 ,$11.16 , N/A ,$4.77 ,$8.61 , N/A ,$10.51 , N/A ,$10.51 ,$10.51 , N/A ,$10.51 , N/A ,$15.34 ,$12.78 , N/A , N/A ,$15.00 , N/A ,$12.78 ,$12.78 ,$14.48 ,$14.48 , N/A ,$14.48 , N/A ,$13.29 ,$13.29 ,$13.29 ,$15.34 , N/A ,$15.34 , N/A ,$17.04 ,$11.16 , N/A ,$7.09 , N/A , N/A , N/A ,$15.34 , N/A ,$10.51 ,$4.77 ,$15.34 , N/A ,$15.34 ,$15.34 , N/A ,$11.08 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100114,N/A,HC PEAK FLOWMETER,271,1 ,$61.77 ,$40.15 ,$17.30 ,$61.77 , N/A ,$46.02 ,$40.46 , N/A ,$17.30 ,$31.19 , N/A ,$38.11 , N/A ,$38.11 ,$38.11 , N/A ,$38.11 , N/A ,$55.59 ,$46.33 , N/A , N/A ,$54.36 , N/A ,$46.33 ,$46.33 ,$52.50 ,$52.50 , N/A ,$52.50 , N/A ,$48.18 ,$48.18 ,$48.18 ,$55.59 , N/A ,$55.59 , N/A ,$61.77 ,$40.46 , N/A ,$25.70 , N/A , N/A , N/A ,$55.59 , N/A ,$38.11 ,$17.30 ,$55.59 , N/A ,$55.59 ,$55.59 , N/A ,$40.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100155,N/A,HC THERABAND PER FOOT,271,1 ,$8.68 ,$5.64 ,$2.43 ,$8.68 , N/A ,$6.47 ,$5.69 , N/A ,$2.43 ,$4.38 , N/A ,$5.36 , N/A ,$5.36 ,$5.36 , N/A ,$5.36 , N/A ,$7.81 ,$6.51 , N/A , N/A ,$7.64 , N/A ,$6.51 ,$6.51 ,$7.38 ,$7.38 , N/A ,$7.38 , N/A ,$6.77 ,$6.77 ,$6.77 ,$7.81 , N/A ,$7.81 , N/A ,$8.68 ,$5.69 , N/A ,$3.61 , N/A , N/A , N/A ,$7.81 , N/A ,$5.36 ,$2.43 ,$7.81 , N/A ,$7.81 ,$7.81 , N/A ,$5.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100188,N/A,HC SLING ARM,271,1 ,$37.33 ,$24.26 ,$10.45 ,$37.33 , N/A ,$27.81 ,$24.45 , N/A ,$10.45 ,$18.85 , N/A ,$23.03 , N/A ,$23.03 ,$23.03 , N/A ,$23.03 , N/A ,$33.60 ,$28.00 , N/A , N/A ,$32.85 , N/A ,$28.00 ,$28.00 ,$31.73 ,$31.73 , N/A ,$31.73 , N/A ,$29.12 ,$29.12 ,$29.12 ,$33.60 , N/A ,$33.60 , N/A ,$37.33 ,$24.45 , N/A ,$15.53 , N/A , N/A , N/A ,$33.60 , N/A ,$23.03 ,$10.45 ,$33.60 , N/A ,$33.60 ,$33.60 , N/A ,$24.26 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100189,E0190,HC PILLOW ABDUCTION HIP,271,1 ,$182.92 ,$118.90 ,$51.22 ,$182.92 , N/A ,$136.28 ,$119.81 , N/A ,$51.22 ,$92.37 , N/A ,$112.86 , N/A ,$112.86 ,$112.86 , N/A ,$112.86 , N/A ,$164.63 ,$137.19 , N/A , N/A ,$160.97 , N/A ,$137.19 ,$137.19 ,$155.48 ,$155.48 , N/A ,$155.48 , N/A ,$142.68 ,$142.68 ,$142.68 ,$164.63 , N/A ,$164.63 , N/A ,$182.92 ,$119.81 , N/A ,$76.09 , N/A , N/A , N/A ,$164.63 , N/A ,$112.86 ,$51.22 ,$164.63 , N/A ,$164.63 ,$164.63 , N/A ,$118.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100196,N/A,HC SENSOR BIS,271,1 ,$163.28 ,$106.13 ,$45.72 ,$163.28 , N/A ,$121.64 ,$106.95 , N/A ,$45.72 ,$82.46 , N/A ,$100.74 , N/A ,$100.74 ,$100.74 , N/A ,$100.74 , N/A ,$146.95 ,$122.46 , N/A , N/A ,$143.69 , N/A ,$122.46 ,$122.46 ,$138.79 ,$138.79 , N/A ,$138.79 , N/A ,$127.36 ,$127.36 ,$127.36 ,$146.95 , N/A ,$146.95 , N/A ,$163.28 ,$106.95 , N/A ,$67.92 , N/A , N/A , N/A ,$146.95 , N/A ,$100.74 ,$45.72 ,$146.95 , N/A ,$146.95 ,$146.95 , N/A ,$106.13 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100201,N/A,HC CANNULA NASAL OXYGEN,271,1 ,$22.00 ,$14.30 ,$6.16 ,$22.00 , N/A ,$16.39 ,$14.41 , N/A ,$6.16 ,$11.11 , N/A ,$13.57 , N/A ,$13.57 ,$13.57 , N/A ,$13.57 , N/A ,$19.80 ,$16.50 , N/A , N/A ,$19.36 , N/A ,$16.50 ,$16.50 ,$18.70 ,$18.70 , N/A ,$18.70 , N/A ,$17.16 ,$17.16 ,$17.16 ,$19.80 , N/A ,$19.80 , N/A ,$22.00 ,$14.41 , N/A ,$9.15 , N/A , N/A , N/A ,$19.80 , N/A ,$13.57 ,$6.16 ,$19.80 , N/A ,$19.80 ,$19.80 , N/A ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100204,N/A,HC CIRCUIT BREATHING,271,1 ,$58.83 ,$38.24 ,$16.47 ,$58.83 , N/A ,$43.83 ,$38.53 , N/A ,$16.47 ,$29.71 , N/A ,$36.30 , N/A ,$36.30 ,$36.30 , N/A ,$36.30 , N/A ,$52.95 ,$44.12 , N/A , N/A ,$51.77 , N/A ,$44.12 ,$44.12 ,$50.01 ,$50.01 , N/A ,$50.01 , N/A ,$45.89 ,$45.89 ,$45.89 ,$52.95 , N/A ,$52.95 , N/A ,$58.83 ,$38.53 , N/A ,$24.47 , N/A , N/A , N/A ,$52.95 , N/A ,$36.30 ,$16.47 ,$52.95 , N/A ,$52.95 ,$52.95 , N/A ,$38.24 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100206,N/A,HC CUSHION CHAIR,271,1 ,$28.00 ,$18.20 ,$7.84 ,$28.00 , N/A ,$20.86 ,$18.34 , N/A ,$7.84 ,$14.14 , N/A ,$17.28 , N/A ,$17.28 ,$17.28 , N/A ,$17.28 , N/A ,$25.20 ,$21.00 , N/A , N/A ,$24.64 , N/A ,$21.00 ,$21.00 ,$23.80 ,$23.80 , N/A ,$23.80 , N/A ,$21.84 ,$21.84 ,$21.84 ,$25.20 , N/A ,$25.20 , N/A ,$28.00 ,$18.34 , N/A ,$11.65 , N/A , N/A , N/A ,$25.20 , N/A ,$17.28 ,$7.84 ,$25.20 , N/A ,$25.20 ,$25.20 , N/A ,$18.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100209,N/A,HC ENEMA BAG,271,1 ,$9.52 ,$6.19 ,$2.67 ,$9.52 , N/A ,$7.09 ,$6.24 , N/A ,$2.67 ,$4.81 , N/A ,$5.87 , N/A ,$5.87 ,$5.87 , N/A ,$5.87 , N/A ,$8.57 ,$7.14 , N/A , N/A ,$8.38 , N/A ,$7.14 ,$7.14 ,$8.09 ,$8.09 , N/A ,$8.09 , N/A ,$7.43 ,$7.43 ,$7.43 ,$8.57 , N/A ,$8.57 , N/A ,$9.52 ,$6.24 , N/A ,$3.96 , N/A , N/A , N/A ,$8.57 , N/A ,$5.87 ,$2.67 ,$8.57 , N/A ,$8.57 ,$8.57 , N/A ,$6.19 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100210,N/A,HC KIT CANISTER SUCTION,271,1 ,$10.70 ,$6.96 ,$3.00 ,$10.70 , N/A ,$7.97 ,$7.01 , N/A ,$3.00 ,$5.40 , N/A ,$6.60 , N/A ,$6.60 ,$6.60 , N/A ,$6.60 , N/A ,$9.63 ,$8.03 , N/A , N/A ,$9.42 , N/A ,$8.03 ,$8.03 ,$9.10 ,$9.10 , N/A ,$9.10 , N/A ,$8.35 ,$8.35 ,$8.35 ,$9.63 , N/A ,$9.63 , N/A ,$10.70 ,$7.01 , N/A ,$4.45 , N/A , N/A , N/A ,$9.63 , N/A ,$6.60 ,$3.00 ,$9.63 , N/A ,$9.63 ,$9.63 , N/A ,$6.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100211,N/A,HC PAD DEFIBRILLATOR,271,1 ,$222.76 ,$144.79 ,$62.37 ,$222.76 , N/A ,$165.96 ,$145.91 , N/A ,$62.37 ,$112.49 , N/A ,$137.44 , N/A ,$137.44 ,$137.44 , N/A ,$137.44 , N/A ,$200.48 ,$167.07 , N/A , N/A ,$196.03 , N/A ,$167.07 ,$167.07 ,$189.35 ,$189.35 , N/A ,$189.35 , N/A ,$173.75 ,$173.75 ,$173.75 ,$200.48 , N/A ,$200.48 , N/A ,$222.76 ,$145.91 , N/A ,$92.67 , N/A , N/A , N/A ,$200.48 , N/A ,$137.44 ,$62.37 ,$200.48 , N/A ,$200.48 ,$200.48 , N/A ,$144.79 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100216,N/A,HC SET FLUID WARMER,271,1 ,$103.00 ,$66.95 ,$28.84 ,$103.00 , N/A ,$76.74 ,$67.47 , N/A ,$28.84 ,$52.02 , N/A ,$63.55 , N/A ,$63.55 ,$63.55 , N/A ,$63.55 , N/A ,$92.70 ,$77.25 , N/A , N/A ,$90.64 , N/A ,$77.25 ,$77.25 ,$87.55 ,$87.55 , N/A ,$87.55 , N/A ,$80.34 ,$80.34 ,$80.34 ,$92.70 , N/A ,$92.70 , N/A ,$103.00 ,$67.47 , N/A ,$42.85 , N/A , N/A , N/A ,$92.70 , N/A ,$63.55 ,$28.84 ,$92.70 , N/A ,$92.70 ,$92.70 , N/A ,$66.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100218,N/A,HC SET IV BLOOD ADMINISTRATION,271,1 ,$27.00 ,$17.55 ,$7.56 ,$27.00 , N/A ,$20.12 ,$17.69 , N/A ,$7.56 ,$13.64 , N/A ,$16.66 , N/A ,$16.66 ,$16.66 , N/A ,$16.66 , N/A ,$24.30 ,$20.25 , N/A , N/A ,$23.76 , N/A ,$20.25 ,$20.25 ,$22.95 ,$22.95 , N/A ,$22.95 , N/A ,$21.06 ,$21.06 ,$21.06 ,$24.30 , N/A ,$24.30 , N/A ,$27.00 ,$17.69 , N/A ,$11.23 , N/A , N/A , N/A ,$24.30 , N/A ,$16.66 ,$7.56 ,$24.30 , N/A ,$24.30 ,$24.30 , N/A ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100235,N/A,HC MASK OXYGEN,271,1 ,$33.01 ,$21.46 ,$9.24 ,$33.01 , N/A ,$24.59 ,$21.62 , N/A ,$9.24 ,$16.67 , N/A ,$20.37 , N/A ,$20.37 ,$20.37 , N/A ,$20.37 , N/A ,$29.71 ,$24.76 , N/A , N/A ,$29.05 , N/A ,$24.76 ,$24.76 ,$28.06 ,$28.06 , N/A ,$28.06 , N/A ,$25.75 ,$25.75 ,$25.75 ,$29.71 , N/A ,$29.71 , N/A ,$33.01 ,$21.62 , N/A ,$13.73 , N/A , N/A , N/A ,$29.71 , N/A ,$20.37 ,$9.24 ,$29.71 , N/A ,$29.71 ,$29.71 , N/A ,$21.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100252,N/A,HC SITZ BATH,271,1 ,$35.95 ,$23.37 ,$10.07 ,$35.95 , N/A ,$26.78 ,$23.55 , N/A ,$10.07 ,$18.15 , N/A ,$22.18 , N/A ,$22.18 ,$22.18 , N/A ,$22.18 , N/A ,$32.36 ,$26.96 , N/A , N/A ,$31.64 , N/A ,$26.96 ,$26.96 ,$30.56 ,$30.56 , N/A ,$30.56 , N/A ,$28.04 ,$28.04 ,$28.04 ,$32.36 , N/A ,$32.36 , N/A ,$35.95 ,$23.55 , N/A ,$14.96 , N/A , N/A , N/A ,$32.36 , N/A ,$22.18 ,$10.07 ,$32.36 , N/A ,$32.36 ,$32.36 , N/A ,$23.37 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100256,N/A,HC ELECTRODE FETAL SCALP,271,1 ,$18.63 ,$12.11 ,$5.22 ,$18.63 , N/A ,$13.88 ,$12.20 , N/A ,$5.22 ,$9.41 , N/A ,$11.49 , N/A ,$11.49 ,$11.49 , N/A ,$11.49 , N/A ,$16.77 ,$13.97 , N/A , N/A ,$16.39 , N/A ,$13.97 ,$13.97 ,$15.84 ,$15.84 , N/A ,$15.84 , N/A ,$14.53 ,$14.53 ,$14.53 ,$16.77 , N/A ,$16.77 , N/A ,$18.63 ,$12.20 , N/A ,$7.75 , N/A , N/A , N/A ,$16.77 , N/A ,$11.49 ,$5.22 ,$16.77 , N/A ,$16.77 ,$16.77 , N/A ,$12.11 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100258,N/A,HC KIT RT OXYGEN SUPPLY,271,1 ,$98.28 ,$63.88 ,$27.52 ,$98.28 , N/A ,$73.22 ,$64.37 , N/A ,$27.52 ,$49.63 , N/A ,$60.64 , N/A ,$60.64 ,$60.64 , N/A ,$60.64 , N/A ,$88.45 ,$73.71 , N/A , N/A ,$86.49 , N/A ,$73.71 ,$73.71 ,$83.54 ,$83.54 , N/A ,$83.54 , N/A ,$76.66 ,$76.66 ,$76.66 ,$88.45 , N/A ,$88.45 , N/A ,$98.28 ,$64.37 , N/A ,$40.88 , N/A , N/A , N/A ,$88.45 , N/A ,$60.64 ,$27.52 ,$88.45 , N/A ,$88.45 ,$88.45 , N/A ,$63.88 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100259,N/A,HC LINER SUCTION CANISTER,271,1 ,$15.80 ,$10.27 ,$4.42 ,$15.80 , N/A ,$11.77 ,$10.35 , N/A ,$4.42 ,$7.98 , N/A ,$9.75 , N/A ,$9.75 ,$9.75 , N/A ,$9.75 , N/A ,$14.22 ,$11.85 , N/A , N/A ,$13.90 , N/A ,$11.85 ,$11.85 ,$13.43 ,$13.43 , N/A ,$13.43 , N/A ,$12.32 ,$12.32 ,$12.32 ,$14.22 , N/A ,$14.22 , N/A ,$15.80 ,$10.35 , N/A ,$6.57 , N/A , N/A , N/A ,$14.22 , N/A ,$9.75 ,$4.42 ,$14.22 , N/A ,$14.22 ,$14.22 , N/A ,$10.27 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100267,N/A,HC SLEEVE SCD FOOT,271,1 ,$36.00 ,$23.40 ,$10.08 ,$36.00 , N/A ,$26.82 ,$23.58 , N/A ,$10.08 ,$18.18 , N/A ,$22.21 , N/A ,$22.21 ,$22.21 , N/A ,$22.21 , N/A ,$32.40 ,$27.00 , N/A , N/A ,$31.68 , N/A ,$27.00 ,$27.00 ,$30.60 ,$30.60 , N/A ,$30.60 , N/A ,$28.08 ,$28.08 ,$28.08 ,$32.40 , N/A ,$32.40 , N/A ,$36.00 ,$23.58 , N/A ,$14.98 , N/A , N/A , N/A ,$32.40 , N/A ,$22.21 ,$10.08 ,$32.40 , N/A ,$32.40 ,$32.40 , N/A ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100269,N/A,HC SUSPENSORY/SUPPORT SCROTAL,271,1 ,$70.74 ,$45.98 ,$19.81 ,$70.74 , N/A ,$52.70 ,$46.33 , N/A ,$19.81 ,$35.72 , N/A ,$43.65 , N/A ,$43.65 ,$43.65 , N/A ,$43.65 , N/A ,$63.67 ,$53.06 , N/A , N/A ,$62.25 , N/A ,$53.06 ,$53.06 ,$60.13 ,$60.13 , N/A ,$60.13 , N/A ,$55.18 ,$55.18 ,$55.18 ,$63.67 , N/A ,$63.67 , N/A ,$70.74 ,$46.33 , N/A ,$29.43 , N/A , N/A , N/A ,$63.67 , N/A ,$43.65 ,$19.81 ,$63.67 , N/A ,$63.67 ,$63.67 , N/A ,$45.98 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100277,N/A,HC BAG WASTE,271,1 ,$59.96 ,$38.97 ,$16.79 ,$59.96 , N/A ,$44.67 ,$39.27 , N/A ,$16.79 ,$30.28 , N/A ,$37.00 , N/A ,$37.00 ,$37.00 , N/A ,$37.00 , N/A ,$53.96 ,$44.97 , N/A , N/A ,$52.76 , N/A ,$44.97 ,$44.97 ,$50.97 ,$50.97 , N/A ,$50.97 , N/A ,$46.77 ,$46.77 ,$46.77 ,$53.96 , N/A ,$53.96 , N/A ,$59.96 ,$39.27 , N/A ,$24.94 , N/A , N/A , N/A ,$53.96 , N/A ,$37.00 ,$16.79 ,$53.96 , N/A ,$53.96 ,$53.96 , N/A ,$38.97 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100282,N/A,HC PACK HOT/ COLD SMALL,271,1 ,$11.03 ,$7.17 ,$3.09 ,$11.03 , N/A ,$8.22 ,$7.22 , N/A ,$3.09 ,$5.57 , N/A ,$6.81 , N/A ,$6.81 ,$6.81 , N/A ,$6.81 , N/A ,$9.93 ,$8.27 , N/A , N/A ,$9.71 , N/A ,$8.27 ,$8.27 ,$9.38 ,$9.38 , N/A ,$9.38 , N/A ,$8.60 ,$8.60 ,$8.60 ,$9.93 , N/A ,$9.93 , N/A ,$11.03 ,$7.22 , N/A ,$4.59 , N/A , N/A , N/A ,$9.93 , N/A ,$6.81 ,$3.09 ,$9.93 , N/A ,$9.93 ,$9.93 , N/A ,$7.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100325,N/A,HC SPACER MDI,271,1 ,$38.20 ,$24.83 ,$10.70 ,$38.20 , N/A ,$28.46 ,$25.02 , N/A ,$10.70 ,$19.29 , N/A ,$23.57 , N/A ,$23.57 ,$23.57 , N/A ,$23.57 , N/A ,$34.38 ,$28.65 , N/A , N/A ,$33.62 , N/A ,$28.65 ,$28.65 ,$32.47 ,$32.47 , N/A ,$32.47 , N/A ,$29.80 ,$29.80 ,$29.80 ,$34.38 , N/A ,$34.38 , N/A ,$38.20 ,$25.02 , N/A ,$15.89 , N/A , N/A , N/A ,$34.38 , N/A ,$23.57 ,$10.70 ,$34.38 , N/A ,$34.38 ,$34.38 , N/A ,$24.83 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100482,N/A,HC SHEET PATIENT TRANSFER,271,1 ,$10.95 ,$7.12 ,$3.07 ,$10.95 , N/A ,$8.16 ,$7.17 , N/A ,$3.07 ,$5.53 , N/A ,$6.76 , N/A ,$6.76 ,$6.76 , N/A ,$6.76 , N/A ,$9.86 ,$8.21 , N/A , N/A ,$9.64 , N/A ,$8.21 ,$8.21 ,$9.31 ,$9.31 , N/A ,$9.31 , N/A ,$8.54 ,$8.54 ,$8.54 ,$9.86 , N/A ,$9.86 , N/A ,$10.95 ,$7.17 , N/A ,$4.56 , N/A , N/A , N/A ,$9.86 , N/A ,$6.76 ,$3.07 ,$9.86 , N/A ,$9.86 ,$9.86 , N/A ,$7.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100483,N/A,HC BOTTLE HUMIDITY,271,1 ,$16.48 ,$10.71 ,$4.61 ,$16.48 , N/A ,$12.28 ,$10.79 , N/A ,$4.61 ,$8.32 , N/A ,$10.17 , N/A ,$10.17 ,$10.17 , N/A ,$10.17 , N/A ,$14.83 ,$12.36 , N/A , N/A ,$14.50 , N/A ,$12.36 ,$12.36 ,$14.01 ,$14.01 , N/A ,$14.01 , N/A ,$12.85 ,$12.85 ,$12.85 ,$14.83 , N/A ,$14.83 , N/A ,$16.48 ,$10.79 , N/A ,$6.86 , N/A , N/A , N/A ,$14.83 , N/A ,$10.17 ,$4.61 ,$14.83 , N/A ,$14.83 ,$14.83 , N/A ,$10.71 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100487,N/A,HC MASK VENTILATION,271,1 ,$9.62 ,$6.25 ,$2.69 ,$9.62 , N/A ,$7.17 ,$6.30 , N/A ,$2.69 ,$4.86 , N/A ,$5.94 , N/A ,$5.94 ,$5.94 , N/A ,$5.94 , N/A ,$8.66 ,$7.22 , N/A , N/A ,$8.47 , N/A ,$7.22 ,$7.22 ,$8.18 ,$8.18 , N/A ,$8.18 , N/A ,$7.50 ,$7.50 ,$7.50 ,$8.66 , N/A ,$8.66 , N/A ,$9.62 ,$6.30 , N/A ,$4.00 , N/A , N/A , N/A ,$8.66 , N/A ,$5.94 ,$2.69 ,$8.66 , N/A ,$8.66 ,$8.66 , N/A ,$6.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100489,N/A,HC MASK RESPIRATOR,271,1 ,$169.85 ,$110.40 ,$47.56 ,$169.85 , N/A ,$126.54 ,$111.25 , N/A ,$47.56 ,$85.77 , N/A ,$104.80 , N/A ,$104.80 ,$104.80 , N/A ,$104.80 , N/A ,$152.87 ,$127.39 , N/A , N/A ,$149.47 , N/A ,$127.39 ,$127.39 ,$144.37 ,$144.37 , N/A ,$144.37 , N/A ,$132.48 ,$132.48 ,$132.48 ,$152.87 , N/A ,$152.87 , N/A ,$169.85 ,$111.25 , N/A ,$70.66 , N/A , N/A , N/A ,$152.87 , N/A ,$104.80 ,$47.56 ,$152.87 , N/A ,$152.87 ,$152.87 , N/A ,$110.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100490,N/A,HC PAD KNEE ELASTIC,271,1 ,$531.81 ,$345.68 ,$148.91 ,$531.81 , N/A ,$396.20 ,$348.34 , N/A ,$148.91 ,$268.56 , N/A ,$328.13 , N/A ,$328.13 ,$328.13 , N/A ,$328.13 , N/A ,$478.63 ,$398.86 , N/A , N/A ,$467.99 , N/A ,$398.86 ,$398.86 ,$452.04 ,$452.04 , N/A ,$452.04 , N/A ,$414.81 ,$414.81 ,$414.81 ,$478.63 , N/A ,$478.63 , N/A ,$531.81 ,$348.34 , N/A ,$221.23 , N/A , N/A , N/A ,$478.63 , N/A ,$328.13 ,$148.91 ,$478.63 , N/A ,$478.63 ,$478.63 , N/A ,$345.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100492,N/A,HC PULLEY OVERDOOR,271,1 ,$20.12 ,$13.08 ,$5.63 ,$20.12 , N/A ,$14.99 ,$13.18 , N/A ,$5.63 ,$10.16 , N/A ,$12.41 , N/A ,$12.41 ,$12.41 , N/A ,$12.41 , N/A ,$18.11 ,$15.09 , N/A , N/A ,$17.71 , N/A ,$15.09 ,$15.09 ,$17.10 ,$17.10 , N/A ,$17.10 , N/A ,$15.69 ,$15.69 ,$15.69 ,$18.11 , N/A ,$18.11 , N/A ,$20.12 ,$13.18 , N/A ,$8.37 , N/A , N/A , N/A ,$18.11 , N/A ,$12.41 ,$5.63 ,$18.11 , N/A ,$18.11 ,$18.11 , N/A ,$13.08 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100493,N/A,HC PAD SENSOR,271,1 ,$75.45 ,$49.04 ,$21.13 ,$75.45 , N/A ,$56.21 ,$49.42 , N/A ,$21.13 ,$38.10 , N/A ,$46.55 , N/A ,$46.55 ,$46.55 , N/A ,$46.55 , N/A ,$67.91 ,$56.59 , N/A , N/A ,$66.40 , N/A ,$56.59 ,$56.59 ,$64.13 ,$64.13 , N/A ,$64.13 , N/A ,$58.85 ,$58.85 ,$58.85 ,$67.91 , N/A ,$67.91 , N/A ,$75.45 ,$49.42 , N/A ,$31.39 , N/A , N/A , N/A ,$67.91 , N/A ,$46.55 ,$21.13 ,$67.91 , N/A ,$67.91 ,$67.91 , N/A ,$49.04 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100519,N/A,HC SYSTEM MONITR NOVII PTCH,271,1 ,$116.85 ,$75.95 ,$32.72 ,$116.85 , N/A ,$87.05 ,$76.54 , N/A ,$32.72 ,$59.01 , N/A ,$72.10 , N/A ,$72.10 ,$72.10 , N/A ,$72.10 , N/A ,$105.17 ,$87.64 , N/A , N/A ,$102.83 , N/A ,$87.64 ,$87.64 ,$99.32 ,$99.32 , N/A ,$99.32 , N/A ,$91.14 ,$91.14 ,$91.14 ,$105.17 , N/A ,$105.17 , N/A ,$116.85 ,$76.54 , N/A ,$48.61 , N/A , N/A , N/A ,$105.17 , N/A ,$72.10 ,$32.72 ,$105.17 , N/A ,$105.17 ,$105.17 , N/A ,$75.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100520,N/A,HC DISPOSABLE EXPIRATORY VALVE,271,1 ,$45.63 ,$29.66 ,$12.78 ,$45.63 , N/A ,$33.99 ,$29.89 , N/A ,$12.78 ,$23.04 , N/A ,$28.15 , N/A ,$28.15 ,$28.15 , N/A ,$28.15 , N/A ,$41.07 ,$34.22 , N/A , N/A ,$40.15 , N/A ,$34.22 ,$34.22 ,$38.79 ,$38.79 , N/A ,$38.79 , N/A ,$35.59 ,$35.59 ,$35.59 ,$41.07 , N/A ,$41.07 , N/A ,$45.63 ,$29.89 , N/A ,$18.98 , N/A , N/A , N/A ,$41.07 , N/A ,$28.15 ,$12.78 ,$41.07 , N/A ,$41.07 ,$41.07 , N/A ,$29.66 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100521,N/A,HC FLOW SENSOR,271,1 ,$62.16 ,$40.40 ,$17.40 ,$62.16 , N/A ,$46.31 ,$40.71 , N/A ,$17.40 ,$31.39 , N/A ,$38.35 , N/A ,$38.35 ,$38.35 , N/A ,$38.35 , N/A ,$55.94 ,$46.62 , N/A , N/A ,$54.70 , N/A ,$46.62 ,$46.62 ,$52.84 ,$52.84 , N/A ,$52.84 , N/A ,$48.48 ,$48.48 ,$48.48 ,$55.94 , N/A ,$55.94 , N/A ,$62.16 ,$40.71 , N/A ,$25.86 , N/A , N/A , N/A ,$55.94 , N/A ,$38.35 ,$17.40 ,$55.94 , N/A ,$55.94 ,$55.94 , N/A ,$40.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27100522,N/A,HC ENDOGATOR PVC TUBE CO2 CONNECTOR,272,1 ,$56.40 ,$36.66 ,$15.79 ,$56.40 , N/A ,$42.02 ,$36.94 , N/A ,$15.79 ,$28.48 , N/A ,$34.80 , N/A ,$34.80 ,$34.80 , N/A ,$34.80 , N/A ,$50.76 ,$42.30 , N/A , N/A ,$49.63 , N/A ,$42.30 ,$42.30 ,$47.94 ,$47.94 , N/A ,$47.94 , N/A ,$43.99 ,$43.99 ,$43.99 ,$50.76 , N/A ,$50.76 , N/A ,$56.40 ,$36.94 , N/A ,$23.46 , N/A , N/A , N/A ,$50.76 , N/A ,$34.80 ,$15.79 ,$50.76 , N/A ,$50.76 ,$50.76 , N/A ,$36.66 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200002,A7041,HC PLEURAL DRAINAGE SYSTEM,272,1 ,$36.00 ,$23.40 ,$10.08 ,$36.00 , N/A ,$26.82 ,$23.58 , N/A ,$10.08 ,$18.18 , N/A ,$22.21 , N/A ,$22.21 ,$22.21 , N/A ,$22.21 , N/A ,$32.40 ,$27.00 , N/A , N/A ,$31.68 , N/A ,$27.00 ,$27.00 ,$30.60 ,$30.60 , N/A ,$30.60 , N/A ,$28.08 ,$28.08 ,$28.08 ,$32.40 , N/A ,$32.40 , N/A ,$36.00 ,$23.58 , N/A ,$14.98 , N/A , N/A , N/A ,$32.40 , N/A ,$22.21 ,$10.08 ,$32.40 , N/A ,$32.40 ,$32.40 , N/A ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200029,C1726,HC DILATOR BALLOON,272,1 ,$16.29 ,$10.59 ,$4.56 ,$16.29 , N/A ,$12.14 ,$10.67 , N/A ,$4.56 ,$8.23 , N/A ,$10.05 , N/A ,$10.05 ,$10.05 , N/A ,$10.05 , N/A ,$14.66 ,$12.22 , N/A , N/A ,$14.34 , N/A ,$12.22 ,$12.22 ,$13.85 ,$13.85 , N/A ,$13.85 , N/A ,$12.71 ,$12.71 ,$12.71 ,$14.66 , N/A ,$14.66 , N/A ,$16.29 ,$10.67 , N/A ,$6.78 , N/A , N/A , N/A ,$14.66 , N/A ,$10.05 ,$4.56 ,$14.66 , N/A ,$14.66 ,$14.66 , N/A ,$10.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200054,C1751,HC KIT CATHETER,272,1 ,$329.46 ,$214.15 ,$92.25 ,$329.46 , N/A ,$245.45 ,$215.80 , N/A ,$92.25 ,$166.38 , N/A ,$203.28 , N/A ,$203.28 ,$203.28 , N/A ,$203.28 , N/A ,$296.51 ,$247.10 , N/A , N/A ,$289.92 , N/A ,$247.10 ,$247.10 ,$280.04 ,$280.04 , N/A ,$280.04 , N/A ,$256.98 ,$256.98 ,$256.98 ,$296.51 , N/A ,$296.51 , N/A ,$329.46 ,$215.80 , N/A ,$137.06 , N/A , N/A , N/A ,$296.51 , N/A ,$203.28 ,$92.25 ,$296.51 , N/A ,$296.51 ,$296.51 , N/A ,$214.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200075,C1758,HC CATHETER URETERAL,272,1 ,$139.01 ,$90.36 ,$38.92 ,$139.01 , N/A ,$103.56 ,$91.05 , N/A ,$38.92 ,$70.20 , N/A ,$85.77 , N/A ,$85.77 ,$85.77 , N/A ,$85.77 , N/A ,$125.11 ,$104.26 , N/A , N/A ,$122.33 , N/A ,$104.26 ,$104.26 ,$118.16 ,$118.16 , N/A ,$118.16 , N/A ,$108.43 ,$108.43 ,$108.43 ,$125.11 , N/A ,$125.11 , N/A ,$139.01 ,$91.05 , N/A ,$57.83 , N/A , N/A , N/A ,$125.11 , N/A ,$85.77 ,$38.92 ,$125.11 , N/A ,$125.11 ,$125.11 , N/A ,$90.36 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200078,C1765,HC INTERCEED ADHESION BARRIER,278,1 ,"$2,162.26 ","$1,405.47 ",$605.43 ,"$2,162.26 ", N/A ,"$1,610.88 ","$1,416.28 ", N/A ,$605.43 ,"$1,091.94 ", N/A ,"$1,334.11 ", N/A ,"$1,334.11 ","$1,334.11 ", N/A ,"$1,334.11 ", N/A ,"$1,946.03 ","$1,621.70 ", N/A , N/A ,"$1,902.79 ", N/A ,"$1,621.70 ","$1,621.70 ","$1,837.92 ","$1,837.92 ", N/A ,"$1,837.92 ", N/A ,"$1,686.56 ","$1,686.56 ","$1,686.56 ","$1,946.03 ", N/A ,"$1,946.03 ", N/A ,"$2,162.26 ","$1,416.28 ", N/A ,$899.50 , N/A , N/A , N/A ,"$1,946.03 ", N/A ,"$1,334.11 ",$605.43 ,"$1,946.03 ", N/A ,"$1,946.03 ","$1,946.03 ", N/A ,"$1,405.47 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200100,C1769,HC GUIDEWIRE - STIFF,272,1 ,$111.75 ,$72.64 ,$31.29 ,$111.75 , N/A ,$83.25 ,$73.20 , N/A ,$31.29 ,$56.43 , N/A ,$68.95 , N/A ,$68.95 ,$68.95 , N/A ,$68.95 , N/A ,$100.58 ,$83.81 , N/A , N/A ,$98.34 , N/A ,$83.81 ,$83.81 ,$94.99 ,$94.99 , N/A ,$94.99 , N/A ,$87.17 ,$87.17 ,$87.17 ,$100.58 , N/A ,$100.58 , N/A ,$111.75 ,$73.20 , N/A ,$46.49 , N/A , N/A , N/A ,$100.58 , N/A ,$68.95 ,$31.29 ,$100.58 , N/A ,$100.58 ,$100.58 , N/A ,$72.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200189,N/A,HC 12 FR ESOPHAGEAL STEHOSCOPE,272,1 ,$28.00 ,$18.20 ,$7.84 ,$28.00 , N/A ,$20.86 ,$18.34 , N/A ,$7.84 ,$14.14 , N/A ,$17.28 , N/A ,$17.28 ,$17.28 , N/A ,$17.28 , N/A ,$25.20 ,$21.00 , N/A , N/A ,$24.64 , N/A ,$21.00 ,$21.00 ,$23.80 ,$23.80 , N/A ,$23.80 , N/A ,$21.84 ,$21.84 ,$21.84 ,$25.20 , N/A ,$25.20 , N/A ,$28.00 ,$18.34 , N/A ,$11.65 , N/A , N/A , N/A ,$25.20 , N/A ,$17.28 ,$7.84 ,$25.20 , N/A ,$25.20 ,$25.20 , N/A ,$18.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200196,N/A,HC 5FR CATH,272,1 ,$37.35 ,$24.28 ,$10.46 ,$37.35 , N/A ,$27.83 ,$24.46 , N/A ,$10.46 ,$18.86 , N/A ,$23.05 , N/A ,$23.05 ,$23.05 , N/A ,$23.05 , N/A ,$33.62 ,$28.01 , N/A , N/A ,$32.87 , N/A ,$28.01 ,$28.01 ,$31.75 ,$31.75 , N/A ,$31.75 , N/A ,$29.13 ,$29.13 ,$29.13 ,$33.62 , N/A ,$33.62 , N/A ,$37.35 ,$24.46 , N/A ,$15.54 , N/A , N/A , N/A ,$33.62 , N/A ,$23.05 ,$10.46 ,$33.62 , N/A ,$33.62 ,$33.62 , N/A ,$24.28 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200200,N/A,HC ABDOMINAL BINDERS,272,1 ,$105.50 ,$68.58 ,$29.54 ,$105.50 , N/A ,$78.60 ,$69.10 , N/A ,$29.54 ,$53.28 , N/A ,$65.09 , N/A ,$65.09 ,$65.09 , N/A ,$65.09 , N/A ,$94.95 ,$79.13 , N/A , N/A ,$92.84 , N/A ,$79.13 ,$79.13 ,$89.68 ,$89.68 , N/A ,$89.68 , N/A ,$82.29 ,$82.29 ,$82.29 ,$94.95 , N/A ,$94.95 , N/A ,$105.50 ,$69.10 , N/A ,$43.89 , N/A , N/A , N/A ,$94.95 , N/A ,$65.09 ,$29.54 ,$94.95 , N/A ,$94.95 ,$94.95 , N/A ,$68.58 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$59.30 ,$38.55 ,$16.60 ,$59.30 , N/A ,$44.18 ,$38.84 , N/A ,$16.60 ,$29.95 , N/A ,$36.59 , N/A ,$36.59 ,$36.59 , N/A ,$36.59 , N/A ,$53.37 ,$44.48 , N/A , N/A ,$52.18 , N/A ,$44.48 ,$44.48 ,$50.41 ,$50.41 , N/A ,$50.41 , N/A ,$46.25 ,$46.25 ,$46.25 ,$53.37 , N/A ,$53.37 , N/A ,$59.30 ,$38.84 , N/A ,$24.67 , N/A , N/A , N/A ,$53.37 , N/A ,$36.59 ,$16.60 ,$53.37 , N/A ,$53.37 ,$53.37 , N/A ,$38.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200231,N/A,HC AEROCHAMBER,272,1 ,$47.62 ,$30.95 ,$13.33 ,$47.62 , N/A ,$35.48 ,$31.19 , N/A ,$13.33 ,$24.05 , N/A ,$29.38 , N/A ,$29.38 ,$29.38 , N/A ,$29.38 , N/A ,$42.86 ,$35.72 , N/A , N/A ,$41.91 , N/A ,$35.72 ,$35.72 ,$40.48 ,$40.48 , N/A ,$40.48 , N/A ,$37.14 ,$37.14 ,$37.14 ,$42.86 , N/A ,$42.86 , N/A ,$47.62 ,$31.19 , N/A ,$19.81 , N/A , N/A , N/A ,$42.86 , N/A ,$29.38 ,$13.33 ,$42.86 , N/A ,$42.86 ,$42.86 , N/A ,$30.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200261,N/A,HC ARMBOARD IV,272,1 ,$30.39 ,$19.75 ,$8.51 ,$30.39 , N/A ,$22.64 ,$19.91 , N/A ,$8.51 ,$15.35 , N/A ,$18.75 , N/A ,$18.75 ,$18.75 , N/A ,$18.75 , N/A ,$27.35 ,$22.79 , N/A , N/A ,$26.74 , N/A ,$22.79 ,$22.79 ,$25.83 ,$25.83 , N/A ,$25.83 , N/A ,$23.70 ,$23.70 ,$23.70 ,$27.35 , N/A ,$27.35 , N/A ,$30.39 ,$19.91 , N/A ,$12.64 , N/A , N/A , N/A ,$27.35 , N/A ,$18.75 ,$8.51 ,$27.35 , N/A ,$27.35 ,$27.35 , N/A ,$19.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200283,N/A,HC ATRIUM CHEST DRAINAGE,272,1 ,$475.09 ,$308.81 ,$133.03 ,$475.09 , N/A ,$353.94 ,$311.18 , N/A ,$133.03 ,$239.92 , N/A ,$293.13 , N/A ,$293.13 ,$293.13 , N/A ,$293.13 , N/A ,$427.58 ,$356.32 , N/A , N/A ,$418.08 , N/A ,$356.32 ,$356.32 ,$403.83 ,$403.83 , N/A ,$403.83 , N/A ,$370.57 ,$370.57 ,$370.57 ,$427.58 , N/A ,$427.58 , N/A ,$475.09 ,$311.18 , N/A ,$197.64 , N/A , N/A , N/A ,$427.58 , N/A ,$293.13 ,$133.03 ,$427.58 , N/A ,$427.58 ,$427.58 , N/A ,$308.81 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200297,N/A,HC BAG RESUSCITATION DISP,272,1 ,$16.00 ,$10.40 ,$4.48 ,$16.00 , N/A ,$11.92 ,$10.48 , N/A ,$4.48 ,$8.08 , N/A ,$9.87 , N/A ,$9.87 ,$9.87 , N/A ,$9.87 , N/A ,$14.40 ,$12.00 , N/A , N/A ,$14.08 , N/A ,$12.00 ,$12.00 ,$13.60 ,$13.60 , N/A ,$13.60 , N/A ,$12.48 ,$12.48 ,$12.48 ,$14.40 , N/A ,$14.40 , N/A ,$16.00 ,$10.48 , N/A ,$6.66 , N/A , N/A , N/A ,$14.40 , N/A ,$9.87 ,$4.48 ,$14.40 , N/A ,$14.40 ,$14.40 , N/A ,$10.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200338,N/A,HC BIOPSY DEVICE NEEDLE CORE,272,1 ,$147.00 ,$95.55 ,$41.16 ,$147.00 , N/A ,$109.52 ,$96.29 , N/A ,$41.16 ,$74.24 , N/A ,$90.70 , N/A ,$90.70 ,$90.70 , N/A ,$90.70 , N/A ,$132.30 ,$110.25 , N/A , N/A ,$129.36 , N/A ,$110.25 ,$110.25 ,$124.95 ,$124.95 , N/A ,$124.95 , N/A ,$114.66 ,$114.66 ,$114.66 ,$132.30 , N/A ,$132.30 , N/A ,$147.00 ,$96.29 , N/A ,$61.15 , N/A , N/A , N/A ,$132.30 , N/A ,$90.70 ,$41.16 ,$132.30 , N/A ,$132.30 ,$132.30 , N/A ,$95.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200351,N/A,HC BIOPSY GUIDE,272,1 ,$13.79 ,$8.96 ,$3.86 ,$13.79 , N/A ,$10.27 ,$9.03 , N/A ,$3.86 ,$6.96 , N/A ,$8.51 , N/A ,$8.51 ,$8.51 , N/A ,$8.51 , N/A ,$12.41 ,$10.34 , N/A , N/A ,$12.14 , N/A ,$10.34 ,$10.34 ,$11.72 ,$11.72 , N/A ,$11.72 , N/A ,$10.76 ,$10.76 ,$10.76 ,$12.41 , N/A ,$12.41 , N/A ,$13.79 ,$9.03 , N/A ,$5.74 , N/A , N/A , N/A ,$12.41 , N/A ,$8.51 ,$3.86 ,$12.41 , N/A ,$12.41 ,$12.41 , N/A ,$8.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200357,N/A,HC BIS MONITOR STRIP,272,1 ,$163.28 ,$106.13 ,$45.72 ,$163.28 , N/A ,$121.64 ,$106.95 , N/A ,$45.72 ,$82.46 , N/A ,$100.74 , N/A ,$100.74 ,$100.74 , N/A ,$100.74 , N/A ,$146.95 ,$122.46 , N/A , N/A ,$143.69 , N/A ,$122.46 ,$122.46 ,$138.79 ,$138.79 , N/A ,$138.79 , N/A ,$127.36 ,$127.36 ,$127.36 ,$146.95 , N/A ,$146.95 , N/A ,$163.28 ,$106.95 , N/A ,$67.92 , N/A , N/A , N/A ,$146.95 , N/A ,$100.74 ,$45.72 ,$146.95 , N/A ,$146.95 ,$146.95 , N/A ,$106.13 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200480,N/A,HC BLADE PATELLA REAMER,272,1 ,$509.82 ,$331.38 ,$142.75 ,$509.82 , N/A ,$379.82 ,$333.93 , N/A ,$142.75 ,$257.46 , N/A ,$314.56 , N/A ,$314.56 ,$314.56 , N/A ,$314.56 , N/A ,$458.84 ,$382.37 , N/A , N/A ,$448.64 , N/A ,$382.37 ,$382.37 ,$433.35 ,$433.35 , N/A ,$433.35 , N/A ,$397.66 ,$397.66 ,$397.66 ,$458.84 , N/A ,$458.84 , N/A ,$509.82 ,$333.93 , N/A ,$212.09 , N/A , N/A , N/A ,$458.84 , N/A ,$314.56 ,$142.75 ,$458.84 , N/A ,$458.84 ,$458.84 , N/A ,$331.38 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200543,N/A,HC BLOOD FILTER,272,1 ,$67.65 ,$43.97 ,$18.94 ,$67.65 , N/A ,$50.40 ,$44.31 , N/A ,$18.94 ,$34.16 , N/A ,$41.74 , N/A ,$41.74 ,$41.74 , N/A ,$41.74 , N/A ,$60.89 ,$50.74 , N/A , N/A ,$59.53 , N/A ,$50.74 ,$50.74 ,$57.50 ,$57.50 , N/A ,$57.50 , N/A ,$52.77 ,$52.77 ,$52.77 ,$60.89 , N/A ,$60.89 , N/A ,$67.65 ,$44.31 , N/A ,$28.14 , N/A , N/A , N/A ,$60.89 , N/A ,$41.74 ,$18.94 ,$60.89 , N/A ,$60.89 ,$60.89 , N/A ,$43.97 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200551,N/A,HC BONE CEMENT KIT,272,1 ,$162.42 ,$105.57 ,$45.48 ,$162.42 , N/A ,$121.00 ,$106.39 , N/A ,$45.48 ,$82.02 , N/A ,$100.21 , N/A ,$100.21 ,$100.21 , N/A ,$100.21 , N/A ,$146.18 ,$121.82 , N/A , N/A ,$142.93 , N/A ,$121.82 ,$121.82 ,$138.06 ,$138.06 , N/A ,$138.06 , N/A ,$126.69 ,$126.69 ,$126.69 ,$146.18 , N/A ,$146.18 , N/A ,$162.42 ,$106.39 , N/A ,$67.57 , N/A , N/A , N/A ,$146.18 , N/A ,$100.21 ,$45.48 ,$146.18 , N/A ,$146.18 ,$146.18 , N/A ,$105.57 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200571,N/A,HC BREAST PUMP KIT,272,1 ,$162.35 ,$105.53 ,$45.46 ,$162.35 , N/A ,$120.95 ,$106.34 , N/A ,$45.46 ,$81.99 , N/A ,$100.17 , N/A ,$100.17 ,$100.17 , N/A ,$100.17 , N/A ,$146.12 ,$121.76 , N/A , N/A ,$142.87 , N/A ,$121.76 ,$121.76 ,$138.00 ,$138.00 , N/A ,$138.00 , N/A ,$126.63 ,$126.63 ,$126.63 ,$146.12 , N/A ,$146.12 , N/A ,$162.35 ,$106.34 , N/A ,$67.54 , N/A , N/A , N/A ,$146.12 , N/A ,$100.17 ,$45.46 ,$146.12 , N/A ,$146.12 ,$146.12 , N/A ,$105.53 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200747,N/A,HC CATH ARGYLE THORACIC,272,1 ,$57.02 ,$37.06 ,$15.97 ,$57.02 , N/A ,$42.48 ,$37.35 , N/A ,$15.97 ,$28.80 , N/A ,$35.18 , N/A ,$35.18 ,$35.18 , N/A ,$35.18 , N/A ,$51.32 ,$42.77 , N/A , N/A ,$50.18 , N/A ,$42.77 ,$42.77 ,$48.47 ,$48.47 , N/A ,$48.47 , N/A ,$44.48 ,$44.48 ,$44.48 ,$51.32 , N/A ,$51.32 , N/A ,$57.02 ,$37.35 , N/A ,$23.72 , N/A , N/A , N/A ,$51.32 , N/A ,$35.18 ,$15.97 ,$51.32 , N/A ,$51.32 ,$51.32 , N/A ,$37.06 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200819,N/A,HC CATH RED RUBBER,272,1 ,$157.46 ,$102.35 ,$44.09 ,$157.46 , N/A ,$117.31 ,$103.14 , N/A ,$44.09 ,$79.52 , N/A ,$97.15 , N/A ,$97.15 ,$97.15 , N/A ,$97.15 , N/A ,$141.71 ,$118.10 , N/A , N/A ,$138.56 , N/A ,$118.10 ,$118.10 ,$133.84 ,$133.84 , N/A ,$133.84 , N/A ,$122.82 ,$122.82 ,$122.82 ,$141.71 , N/A ,$141.71 , N/A ,$157.46 ,$103.14 , N/A ,$65.50 , N/A , N/A , N/A ,$141.71 , N/A ,$97.15 ,$44.09 ,$141.71 , N/A ,$141.71 ,$141.71 , N/A ,$102.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200832,N/A,HC CATH TRAY WITH FOLEY,272,1 ,$100.87 ,$65.57 ,$28.24 ,$100.87 , N/A ,$75.15 ,$66.07 , N/A ,$28.24 ,$50.94 , N/A ,$62.24 , N/A ,$62.24 ,$62.24 , N/A ,$62.24 , N/A ,$90.78 ,$75.65 , N/A , N/A ,$88.77 , N/A ,$75.65 ,$75.65 ,$85.74 ,$85.74 , N/A ,$85.74 , N/A ,$78.68 ,$78.68 ,$78.68 ,$90.78 , N/A ,$90.78 , N/A ,$100.87 ,$66.07 , N/A ,$41.96 , N/A , N/A , N/A ,$90.78 , N/A ,$62.24 ,$28.24 ,$90.78 , N/A ,$90.78 ,$90.78 , N/A ,$65.57 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200848,N/A,HC CATHETER - ARTERIAL SET,272,1 ,$79.91 ,$51.94 ,$22.37 ,$79.91 , N/A ,$59.53 ,$52.34 , N/A ,$22.37 ,$40.35 , N/A ,$49.30 , N/A ,$49.30 ,$49.30 , N/A ,$49.30 , N/A ,$71.92 ,$59.93 , N/A , N/A ,$70.32 , N/A ,$59.93 ,$59.93 ,$67.92 ,$67.92 , N/A ,$67.92 , N/A ,$62.33 ,$62.33 ,$62.33 ,$71.92 , N/A ,$71.92 , N/A ,$79.91 ,$52.34 , N/A ,$33.24 , N/A , N/A , N/A ,$71.92 , N/A ,$49.30 ,$22.37 ,$71.92 , N/A ,$71.92 ,$71.92 , N/A ,$51.94 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200849,N/A,HC CATHETER - FOLEY,272,1 ,$29.00 ,$18.85 ,$8.12 ,$29.00 , N/A ,$21.61 ,$19.00 , N/A ,$8.12 ,$14.65 , N/A ,$17.89 , N/A ,$17.89 ,$17.89 , N/A ,$17.89 , N/A ,$26.10 ,$21.75 , N/A , N/A ,$25.52 , N/A ,$21.75 ,$21.75 ,$24.65 ,$24.65 , N/A ,$24.65 , N/A ,$22.62 ,$22.62 ,$22.62 ,$26.10 , N/A ,$26.10 , N/A ,$29.00 ,$19.00 , N/A ,$12.06 , N/A , N/A , N/A ,$26.10 , N/A ,$17.89 ,$8.12 ,$26.10 , N/A ,$26.10 ,$26.10 , N/A ,$18.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200906,N/A,HC CHIBA NEEDLE,272,1 ,$12.57 ,$8.17 ,$3.52 ,$12.57 , N/A ,$9.36 ,$8.23 , N/A ,$3.52 ,$6.35 , N/A ,$7.76 , N/A ,$7.76 ,$7.76 , N/A ,$7.76 , N/A ,$11.31 ,$9.43 , N/A , N/A ,$11.06 , N/A ,$9.43 ,$9.43 ,$10.68 ,$10.68 , N/A ,$10.68 , N/A ,$9.80 ,$9.80 ,$9.80 ,$11.31 , N/A ,$11.31 , N/A ,$12.57 ,$8.23 , N/A ,$5.23 , N/A , N/A , N/A ,$11.31 , N/A ,$7.76 ,$3.52 ,$11.31 , N/A ,$11.31 ,$11.31 , N/A ,$8.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200907,N/A,HC CHLORAPREP,272,1 ,$16.41 ,$10.67 ,$4.59 ,$16.41 , N/A ,$12.23 ,$10.75 , N/A ,$4.59 ,$8.29 , N/A ,$10.13 , N/A ,$10.13 ,$10.13 , N/A ,$10.13 , N/A ,$14.77 ,$12.31 , N/A , N/A ,$14.44 , N/A ,$12.31 ,$12.31 ,$13.95 ,$13.95 , N/A ,$13.95 , N/A ,$12.80 ,$12.80 ,$12.80 ,$14.77 , N/A ,$14.77 , N/A ,$16.41 ,$10.75 , N/A ,$6.83 , N/A , N/A , N/A ,$14.77 , N/A ,$10.13 ,$4.59 ,$14.77 , N/A ,$14.77 ,$14.77 , N/A ,$10.67 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27200942,N/A,HC COAXIAL GUIDING NEEDLE,272,1 ,$191.67 ,$124.59 ,$53.67 ,$191.67 , N/A ,$142.79 ,$125.54 , N/A ,$53.67 ,$96.79 , N/A ,$118.26 , N/A ,$118.26 ,$118.26 , N/A ,$118.26 , N/A ,$172.50 ,$143.75 , N/A , N/A ,$168.67 , N/A ,$143.75 ,$143.75 ,$162.92 ,$162.92 , N/A ,$162.92 , N/A ,$149.50 ,$149.50 ,$149.50 ,$172.50 , N/A ,$172.50 , N/A ,$191.67 ,$125.54 , N/A ,$79.73 , N/A , N/A , N/A ,$172.50 , N/A ,$118.26 ,$53.67 ,$172.50 , N/A ,$172.50 ,$172.50 , N/A ,$124.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201009,N/A,HC CRICOTHYROTOMY CATH SET,272,1 ,"$1,576.91 ","$1,024.99 ",$441.53 ,"$1,576.91 ", N/A ,"$1,174.80 ","$1,032.88 ", N/A ,$441.53 ,$796.34 , N/A ,$972.95 , N/A ,$972.95 ,$972.95 , N/A ,$972.95 , N/A ,"$1,419.22 ","$1,182.68 ", N/A , N/A ,"$1,387.68 ", N/A ,"$1,182.68 ","$1,182.68 ","$1,340.37 ","$1,340.37 ", N/A ,"$1,340.37 ", N/A ,"$1,229.99 ","$1,229.99 ","$1,229.99 ","$1,419.22 ", N/A ,"$1,419.22 ", N/A ,"$1,576.91 ","$1,032.88 ", N/A ,$655.99 , N/A , N/A , N/A ,"$1,419.22 ", N/A ,$972.95 ,$441.53 ,"$1,419.22 ", N/A ,"$1,419.22 ","$1,419.22 ", N/A ,"$1,024.99 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201012,N/A,HC BONOPTY BX SET,272,1 ,$95.09 ,$61.81 ,$26.63 ,$95.09 , N/A ,$70.84 ,$62.28 , N/A ,$26.63 ,$48.02 , N/A ,$58.67 , N/A ,$58.67 ,$58.67 , N/A ,$58.67 , N/A ,$85.58 ,$71.32 , N/A , N/A ,$83.68 , N/A ,$71.32 ,$71.32 ,$80.83 ,$80.83 , N/A ,$80.83 , N/A ,$74.17 ,$74.17 ,$74.17 ,$85.58 , N/A ,$85.58 , N/A ,$95.09 ,$62.28 , N/A ,$39.56 , N/A , N/A , N/A ,$85.58 , N/A ,$58.67 ,$26.63 ,$85.58 , N/A ,$85.58 ,$85.58 , N/A ,$61.81 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201013,N/A,HC BONOPTY ED DRILL,272,1 ,$33.08 ,$21.50 ,$9.26 ,$33.08 , N/A ,$24.64 ,$21.67 , N/A ,$9.26 ,$16.71 , N/A ,$20.41 , N/A ,$20.41 ,$20.41 , N/A ,$20.41 , N/A ,$29.77 ,$24.81 , N/A , N/A ,$29.11 , N/A ,$24.81 ,$24.81 ,$28.12 ,$28.12 , N/A ,$28.12 , N/A ,$25.80 ,$25.80 ,$25.80 ,$29.77 , N/A ,$29.77 , N/A ,$33.08 ,$21.67 , N/A ,$13.76 , N/A , N/A , N/A ,$29.77 , N/A ,$20.41 ,$9.26 ,$29.77 , N/A ,$29.77 ,$29.77 , N/A ,$21.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201014,N/A,HC BONOPTY PENETRATION SET,272,1 ,$413.44 ,$268.74 ,$115.76 ,$413.44 , N/A ,$308.01 ,$270.80 , N/A ,$115.76 ,$208.79 , N/A ,$255.09 , N/A ,$255.09 ,$255.09 , N/A ,$255.09 , N/A ,$372.10 ,$310.08 , N/A , N/A ,$363.83 , N/A ,$310.08 ,$310.08 ,$351.42 ,$351.42 , N/A ,$351.42 , N/A ,$322.48 ,$322.48 ,$322.48 ,$372.10 , N/A ,$372.10 , N/A ,$413.44 ,$270.80 , N/A ,$171.99 , N/A , N/A , N/A ,$372.10 , N/A ,$255.09 ,$115.76 ,$372.10 , N/A ,$372.10 ,$372.10 , N/A ,$268.74 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201042,N/A,HC DERMABOND,272,1 ,$32.66 ,$21.23 ,$9.14 ,$32.66 , N/A ,$24.33 ,$21.39 , N/A ,$9.14 ,$16.49 , N/A ,$20.15 , N/A ,$20.15 ,$20.15 , N/A ,$20.15 , N/A ,$29.39 ,$24.50 , N/A , N/A ,$28.74 , N/A ,$24.50 ,$24.50 ,$27.76 ,$27.76 , N/A ,$27.76 , N/A ,$25.47 ,$25.47 ,$25.47 ,$29.39 , N/A ,$29.39 , N/A ,$32.66 ,$21.39 , N/A ,$13.59 , N/A , N/A , N/A ,$29.39 , N/A ,$20.15 ,$9.14 ,$29.39 , N/A ,$29.39 ,$29.39 , N/A ,$21.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201071,N/A,HC DILATOR BARD,272,1 ,$21.88 ,$14.22 ,$6.13 ,$21.88 , N/A ,$16.30 ,$14.33 , N/A ,$6.13 ,$11.05 , N/A ,$13.50 , N/A ,$13.50 ,$13.50 , N/A ,$13.50 , N/A ,$19.69 ,$16.41 , N/A , N/A ,$19.25 , N/A ,$16.41 ,$16.41 ,$18.60 ,$18.60 , N/A ,$18.60 , N/A ,$17.07 ,$17.07 ,$17.07 ,$19.69 , N/A ,$19.69 , N/A ,$21.88 ,$14.33 , N/A ,$9.10 , N/A , N/A , N/A ,$19.69 , N/A ,$13.50 ,$6.13 ,$19.69 , N/A ,$19.69 ,$19.69 , N/A ,$14.22 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201077,N/A,HC DIS INCENTIVE SPIROMETER,272,1 ,$61.47 ,$39.96 ,$17.21 ,$61.47 , N/A ,$45.80 ,$40.26 , N/A ,$17.21 ,$31.04 , N/A ,$37.93 , N/A ,$37.93 ,$37.93 , N/A ,$37.93 , N/A ,$55.32 ,$46.10 , N/A , N/A ,$54.09 , N/A ,$46.10 ,$46.10 ,$52.25 ,$52.25 , N/A ,$52.25 , N/A ,$47.95 ,$47.95 ,$47.95 ,$55.32 , N/A ,$55.32 , N/A ,$61.47 ,$40.26 , N/A ,$25.57 , N/A , N/A , N/A ,$55.32 , N/A ,$37.93 ,$17.21 ,$55.32 , N/A ,$55.32 ,$55.32 , N/A ,$39.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201083,N/A,HC DISP. OXIMETER SENSOR,272,1 ,$129.41 ,$84.12 ,$36.23 ,$129.41 , N/A ,$96.41 ,$84.76 , N/A ,$36.23 ,$65.35 , N/A ,$79.85 , N/A ,$79.85 ,$79.85 , N/A ,$79.85 , N/A ,$116.47 ,$97.06 , N/A , N/A ,$113.88 , N/A ,$97.06 ,$97.06 ,$110.00 ,$110.00 , N/A ,$110.00 , N/A ,$100.94 ,$100.94 ,$100.94 ,$116.47 , N/A ,$116.47 , N/A ,$129.41 ,$84.76 , N/A ,$53.83 , N/A , N/A , N/A ,$116.47 , N/A ,$79.85 ,$36.23 ,$116.47 , N/A ,$116.47 ,$116.47 , N/A ,$84.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201138,N/A,HC WOUND VAC DRAPE,272,1 ,$15.59 ,$10.13 ,$4.37 ,$15.59 , N/A ,$11.61 ,$10.21 , N/A ,$4.37 ,$7.87 , N/A ,$9.62 , N/A ,$9.62 ,$9.62 , N/A ,$9.62 , N/A ,$14.03 ,$11.69 , N/A , N/A ,$13.72 , N/A ,$11.69 ,$11.69 ,$13.25 ,$13.25 , N/A ,$13.25 , N/A ,$12.16 ,$12.16 ,$12.16 ,$14.03 , N/A ,$14.03 , N/A ,$15.59 ,$10.21 , N/A ,$6.49 , N/A , N/A , N/A ,$14.03 , N/A ,$9.62 ,$4.37 ,$14.03 , N/A ,$14.03 ,$14.03 , N/A ,$10.13 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201165,N/A,HC MORGAN LENS,272,1 ,$247.54 ,$160.90 ,$69.31 ,$247.54 , N/A ,$184.42 ,$162.14 , N/A ,$69.31 ,$125.01 , N/A ,$152.73 , N/A ,$152.73 ,$152.73 , N/A ,$152.73 , N/A ,$222.79 ,$185.66 , N/A , N/A ,$217.84 , N/A ,$185.66 ,$185.66 ,$210.41 ,$210.41 , N/A ,$210.41 , N/A ,$193.08 ,$193.08 ,$193.08 ,$222.79 , N/A ,$222.79 , N/A ,$247.54 ,$162.14 , N/A ,$102.98 , N/A , N/A , N/A ,$222.79 , N/A ,$152.73 ,$69.31 ,$222.79 , N/A ,$222.79 ,$222.79 , N/A ,$160.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201252,N/A,HC EPIDURAL TRAY,272,1 ,$156.20 ,$101.53 ,$43.74 ,$156.20 , N/A ,$116.37 ,$102.31 , N/A ,$43.74 ,$78.88 , N/A ,$96.38 , N/A ,$96.38 ,$96.38 , N/A ,$96.38 , N/A ,$140.58 ,$117.15 , N/A , N/A ,$137.46 , N/A ,$117.15 ,$117.15 ,$132.77 ,$132.77 , N/A ,$132.77 , N/A ,$121.84 ,$121.84 ,$121.84 ,$140.58 , N/A ,$140.58 , N/A ,$156.20 ,$102.31 , N/A ,$64.98 , N/A , N/A , N/A ,$140.58 , N/A ,$96.38 ,$43.74 ,$140.58 , N/A ,$140.58 ,$140.58 , N/A ,$101.53 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201279,N/A,HC FECAL MANAGEMENT KIT,272,1 ,$246.00 ,$159.90 ,$68.88 ,$246.00 , N/A ,$183.27 ,$161.13 , N/A ,$68.88 ,$124.23 , N/A ,$151.78 , N/A ,$151.78 ,$151.78 , N/A ,$151.78 , N/A ,$221.40 ,$184.50 , N/A , N/A ,$216.48 , N/A ,$184.50 ,$184.50 ,$209.10 ,$209.10 , N/A ,$209.10 , N/A ,$191.88 ,$191.88 ,$191.88 ,$221.40 , N/A ,$221.40 , N/A ,$246.00 ,$161.13 , N/A ,$102.34 , N/A , N/A , N/A ,$221.40 , N/A ,$151.78 ,$68.88 ,$221.40 , N/A ,$221.40 ,$221.40 , N/A ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201332,N/A,HC GASTRIC LAVAGE KIT,272,1 ,"$1,882.87 ","$1,223.87 ",$527.20 ,"$1,882.87 ", N/A ,"$1,402.74 ","$1,233.28 ", N/A ,$527.20 ,$950.85 , N/A ,"$1,161.73 ", N/A ,"$1,161.73 ","$1,161.73 ", N/A ,"$1,161.73 ", N/A ,"$1,694.58 ","$1,412.15 ", N/A , N/A ,"$1,656.93 ", N/A ,"$1,412.15 ","$1,412.15 ","$1,600.44 ","$1,600.44 ", N/A ,"$1,600.44 ", N/A ,"$1,468.64 ","$1,468.64 ","$1,468.64 ","$1,694.58 ", N/A ,"$1,694.58 ", N/A ,"$1,882.87 ","$1,233.28 ", N/A ,$783.27 , N/A , N/A , N/A ,"$1,694.58 ", N/A ,"$1,161.73 ",$527.20 ,"$1,694.58 ", N/A ,"$1,694.58 ","$1,694.58 ", N/A ,"$1,223.87 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201339,N/A,HC GELFILM,272,1 ,$16.80 ,$10.92 ,$4.70 ,$16.80 , N/A ,$12.52 ,$11.00 , N/A ,$4.70 ,$8.48 , N/A ,$10.37 , N/A ,$10.37 ,$10.37 , N/A ,$10.37 , N/A ,$15.12 ,$12.60 , N/A , N/A ,$14.78 , N/A ,$12.60 ,$12.60 ,$14.28 ,$14.28 , N/A ,$14.28 , N/A ,$13.10 ,$13.10 ,$13.10 ,$15.12 , N/A ,$15.12 , N/A ,$16.80 ,$11.00 , N/A ,$6.99 , N/A , N/A , N/A ,$15.12 , N/A ,$10.37 ,$4.70 ,$15.12 , N/A ,$15.12 ,$15.12 , N/A ,$10.92 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201391,N/A,HC HEEL PROTECTOR EA,272,1 ,$57.96 ,$37.67 ,$16.23 ,$57.96 , N/A ,$43.18 ,$37.96 , N/A ,$16.23 ,$29.27 , N/A ,$35.76 , N/A ,$35.76 ,$35.76 , N/A ,$35.76 , N/A ,$52.16 ,$43.47 , N/A , N/A ,$51.00 , N/A ,$43.47 ,$43.47 ,$49.27 ,$49.27 , N/A ,$49.27 , N/A ,$45.21 ,$45.21 ,$45.21 ,$52.16 , N/A ,$52.16 , N/A ,$57.96 ,$37.96 , N/A ,$24.11 , N/A , N/A , N/A ,$52.16 , N/A ,$35.76 ,$16.23 ,$52.16 , N/A ,$52.16 ,$52.16 , N/A ,$37.67 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201404,N/A,HC HEMOVAC MINI EVACAT ONLY,272,1 ,$22.53 ,$14.64 ,$6.31 ,$22.53 , N/A ,$16.78 ,$14.76 , N/A ,$6.31 ,$11.38 , N/A ,$13.90 , N/A ,$13.90 ,$13.90 , N/A ,$13.90 , N/A ,$20.28 ,$16.90 , N/A , N/A ,$19.83 , N/A ,$16.90 ,$16.90 ,$19.15 ,$19.15 , N/A ,$19.15 , N/A ,$17.57 ,$17.57 ,$17.57 ,$20.28 , N/A ,$20.28 , N/A ,$22.53 ,$14.76 , N/A ,$9.37 , N/A , N/A , N/A ,$20.28 , N/A ,$13.90 ,$6.31 ,$20.28 , N/A ,$20.28 ,$20.28 , N/A ,$14.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201419,N/A,HC HUBER NEEDLE,272,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201450,N/A,HC INTRODUCER KIT,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201521,N/A,HC KIT INTRODUCER,272,1 ,$25.83 ,$16.79 ,$7.23 ,$25.83 , N/A ,$19.24 ,$16.92 , N/A ,$7.23 ,$13.04 , N/A ,$15.94 , N/A ,$15.94 ,$15.94 , N/A ,$15.94 , N/A ,$23.25 ,$19.37 , N/A , N/A ,$22.73 , N/A ,$19.37 ,$19.37 ,$21.96 ,$21.96 , N/A ,$21.96 , N/A ,$20.15 ,$20.15 ,$20.15 ,$23.25 , N/A ,$23.25 , N/A ,$25.83 ,$16.92 , N/A ,$10.75 , N/A , N/A , N/A ,$23.25 , N/A ,$15.94 ,$7.23 ,$23.25 , N/A ,$23.25 ,$23.25 , N/A ,$16.79 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201637,N/A,HC MAMMOTOME PROBE,272,1 ,$534.56 ,$347.46 ,$149.68 ,$534.56 , N/A ,$398.25 ,$350.14 , N/A ,$149.68 ,$269.95 , N/A ,$329.82 , N/A ,$329.82 ,$329.82 , N/A ,$329.82 , N/A ,$481.10 ,$400.92 , N/A , N/A ,$470.41 , N/A ,$400.92 ,$400.92 ,$454.38 ,$454.38 , N/A ,$454.38 , N/A ,$416.96 ,$416.96 ,$416.96 ,$481.10 , N/A ,$481.10 , N/A ,$534.56 ,$350.14 , N/A ,$222.38 , N/A , N/A , N/A ,$481.10 , N/A ,$329.82 ,$149.68 ,$481.10 , N/A ,$481.10 ,$481.10 , N/A ,$347.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201647,N/A,HC METER URINE,272,1 ,$61.03 ,$39.67 ,$17.09 ,$61.03 , N/A ,$45.47 ,$39.97 , N/A ,$17.09 ,$30.82 , N/A ,$37.66 , N/A ,$37.66 ,$37.66 , N/A ,$37.66 , N/A ,$54.93 ,$45.77 , N/A , N/A ,$53.71 , N/A ,$45.77 ,$45.77 ,$51.88 ,$51.88 , N/A ,$51.88 , N/A ,$47.60 ,$47.60 ,$47.60 ,$54.93 , N/A ,$54.93 , N/A ,$61.03 ,$39.97 , N/A ,$25.39 , N/A , N/A , N/A ,$54.93 , N/A ,$37.66 ,$17.09 ,$54.93 , N/A ,$54.93 ,$54.93 , N/A ,$39.67 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201737,N/A,HC NIPPLE ENHANCER,272,1 ,$12.31 ,$8.00 ,$3.45 ,$12.31 , N/A ,$9.17 ,$8.06 , N/A ,$3.45 ,$6.22 , N/A ,$7.60 , N/A ,$7.60 ,$7.60 , N/A ,$7.60 , N/A ,$11.08 ,$9.23 , N/A , N/A ,$10.83 , N/A ,$9.23 ,$9.23 ,$10.46 ,$10.46 , N/A ,$10.46 , N/A ,$9.60 ,$9.60 ,$9.60 ,$11.08 , N/A ,$11.08 , N/A ,$12.31 ,$8.06 , N/A ,$5.12 , N/A , N/A , N/A ,$11.08 , N/A ,$7.60 ,$3.45 ,$11.08 , N/A ,$11.08 ,$11.08 , N/A ,$8.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201867,N/A,HC PLEURX DRAINAGE KIT,272,1 ,$78.75 ,$51.19 ,$22.05 ,$78.75 , N/A ,$58.67 ,$51.58 , N/A ,$22.05 ,$39.77 , N/A ,$48.59 , N/A ,$48.59 ,$48.59 , N/A ,$48.59 , N/A ,$70.88 ,$59.06 , N/A , N/A ,$69.30 , N/A ,$59.06 ,$59.06 ,$66.94 ,$66.94 , N/A ,$66.94 , N/A ,$61.43 ,$61.43 ,$61.43 ,$70.88 , N/A ,$70.88 , N/A ,$78.75 ,$51.58 , N/A ,$32.76 , N/A , N/A , N/A ,$70.88 , N/A ,$48.59 ,$22.05 ,$70.88 , N/A ,$70.88 ,$70.88 , N/A ,$51.19 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201868,N/A,HC PLEURX DRAINAGE LINE SET,272,1 ,$32.66 ,$21.23 ,$9.14 ,$32.66 , N/A ,$24.33 ,$21.39 , N/A ,$9.14 ,$16.49 , N/A ,$20.15 , N/A ,$20.15 ,$20.15 , N/A ,$20.15 , N/A ,$29.39 ,$24.50 , N/A , N/A ,$28.74 , N/A ,$24.50 ,$24.50 ,$27.76 ,$27.76 , N/A ,$27.76 , N/A ,$25.47 ,$25.47 ,$25.47 ,$29.39 , N/A ,$29.39 , N/A ,$32.66 ,$21.39 , N/A ,$13.59 , N/A , N/A , N/A ,$29.39 , N/A ,$20.15 ,$9.14 ,$29.39 , N/A ,$29.39 ,$29.39 , N/A ,$21.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201869,N/A,HC PLEURX REPLACEMENT CAP,272,1 ,$11.03 ,$7.17 ,$3.09 ,$11.03 , N/A ,$8.22 ,$7.22 , N/A ,$3.09 ,$5.57 , N/A ,$6.81 , N/A ,$6.81 ,$6.81 , N/A ,$6.81 , N/A ,$9.93 ,$8.27 , N/A , N/A ,$9.71 , N/A ,$8.27 ,$8.27 ,$9.38 ,$9.38 , N/A ,$9.38 , N/A ,$8.60 ,$8.60 ,$8.60 ,$9.93 , N/A ,$9.93 , N/A ,$11.03 ,$7.22 , N/A ,$4.59 , N/A , N/A , N/A ,$9.93 , N/A ,$6.81 ,$3.09 ,$9.93 , N/A ,$9.93 ,$9.93 , N/A ,$7.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201890,N/A,HC PREP CHLORAPREP 26ML,272,1 ,$53.06 ,$34.49 ,$14.86 ,$53.06 , N/A ,$39.53 ,$34.75 , N/A ,$14.86 ,$26.80 , N/A ,$32.74 , N/A ,$32.74 ,$32.74 , N/A ,$32.74 , N/A ,$47.75 ,$39.80 , N/A , N/A ,$46.69 , N/A ,$39.80 ,$39.80 ,$45.10 ,$45.10 , N/A ,$45.10 , N/A ,$41.39 ,$41.39 ,$41.39 ,$47.75 , N/A ,$47.75 , N/A ,$53.06 ,$34.75 , N/A ,$22.07 , N/A , N/A , N/A ,$47.75 , N/A ,$32.74 ,$14.86 ,$47.75 , N/A ,$47.75 ,$47.75 , N/A ,$34.49 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201896,N/A,HC PREVENA INCISION SYSTEM,272,1 ,"$1,560.00 ","$1,014.00 ",$436.80 ,"$1,560.00 ", N/A ,"$1,162.20 ","$1,021.80 ", N/A ,$436.80 ,$787.80 , N/A ,$962.52 , N/A ,$962.52 ,$962.52 , N/A ,$962.52 , N/A ,"$1,404.00 ","$1,170.00 ", N/A , N/A ,"$1,372.80 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,326.00 ","$1,326.00 ", N/A ,"$1,326.00 ", N/A ,"$1,216.80 ","$1,216.80 ","$1,216.80 ","$1,404.00 ", N/A ,"$1,404.00 ", N/A ,"$1,560.00 ","$1,021.80 ", N/A ,$648.96 , N/A , N/A , N/A ,"$1,404.00 ", N/A ,$962.52 ,$436.80 ,"$1,404.00 ", N/A ,"$1,404.00 ","$1,404.00 ", N/A ,"$1,014.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27201938,N/A,HC PULSE OXIMETER PROBE DISP,272,1 ,$24.87 ,$16.17 ,$6.96 ,$24.87 , N/A ,$18.53 ,$16.29 , N/A ,$6.96 ,$12.56 , N/A ,$15.34 , N/A ,$15.34 ,$15.34 , N/A ,$15.34 , N/A ,$22.38 ,$18.65 , N/A , N/A ,$21.89 , N/A ,$18.65 ,$18.65 ,$21.14 ,$21.14 , N/A ,$21.14 , N/A ,$19.40 ,$19.40 ,$19.40 ,$22.38 , N/A ,$22.38 , N/A ,$24.87 ,$16.29 , N/A ,$10.35 , N/A , N/A , N/A ,$22.38 , N/A ,$15.34 ,$6.96 ,$22.38 , N/A ,$22.38 ,$22.38 , N/A ,$16.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202002,N/A,HC SCD SLEEVE KNEE,272,1 ,$42.00 ,$27.30 ,$11.76 ,$42.00 , N/A ,$31.29 ,$27.51 , N/A ,$11.76 ,$21.21 , N/A ,$25.91 , N/A ,$25.91 ,$25.91 , N/A ,$25.91 , N/A ,$37.80 ,$31.50 , N/A , N/A ,$36.96 , N/A ,$31.50 ,$31.50 ,$35.70 ,$35.70 , N/A ,$35.70 , N/A ,$32.76 ,$32.76 ,$32.76 ,$37.80 , N/A ,$37.80 , N/A ,$42.00 ,$27.51 , N/A ,$17.47 , N/A , N/A , N/A ,$37.80 , N/A ,$25.91 ,$11.76 ,$37.80 , N/A ,$37.80 ,$37.80 , N/A ,$27.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202013,N/A,HC SEALANT FLOSEAL MATRIX,272,1 ,$384.33 ,$249.81 ,$107.61 ,$384.33 , N/A ,$286.33 ,$251.74 , N/A ,$107.61 ,$194.09 , N/A ,$237.13 , N/A ,$237.13 ,$237.13 , N/A ,$237.13 , N/A ,$345.90 ,$288.25 , N/A , N/A ,$338.21 , N/A ,$288.25 ,$288.25 ,$326.68 ,$326.68 , N/A ,$326.68 , N/A ,$299.78 ,$299.78 ,$299.78 ,$345.90 , N/A ,$345.90 , N/A ,$384.33 ,$251.74 , N/A ,$159.88 , N/A , N/A , N/A ,$345.90 , N/A ,$237.13 ,$107.61 ,$345.90 , N/A ,$345.90 ,$345.90 , N/A ,$249.81 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202018,N/A,HC SENSOR ADULT ADHESIVE,272,1 ,$457.97 ,$297.68 ,$128.23 ,$457.97 , N/A ,$341.19 ,$299.97 , N/A ,$128.23 ,$231.27 , N/A ,$282.57 , N/A ,$282.57 ,$282.57 , N/A ,$282.57 , N/A ,$412.17 ,$343.48 , N/A , N/A ,$403.01 , N/A ,$343.48 ,$343.48 ,$389.27 ,$389.27 , N/A ,$389.27 , N/A ,$357.22 ,$357.22 ,$357.22 ,$412.17 , N/A ,$412.17 , N/A ,$457.97 ,$299.97 , N/A ,$190.52 , N/A , N/A , N/A ,$412.17 , N/A ,$282.57 ,$128.23 ,$412.17 , N/A ,$412.17 ,$412.17 , N/A ,$297.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202120,N/A,HC STAPLER SKIN,272,1 ,$18.00 ,$11.70 ,$5.04 ,$18.00 , N/A ,$13.41 ,$11.79 , N/A ,$5.04 ,$9.09 , N/A ,$11.11 , N/A ,$11.11 ,$11.11 , N/A ,$11.11 , N/A ,$16.20 ,$13.50 , N/A , N/A ,$15.84 , N/A ,$13.50 ,$13.50 ,$15.30 ,$15.30 , N/A ,$15.30 , N/A ,$14.04 ,$14.04 ,$14.04 ,$16.20 , N/A ,$16.20 , N/A ,$18.00 ,$11.79 , N/A ,$7.49 , N/A , N/A , N/A ,$16.20 , N/A ,$11.11 ,$5.04 ,$16.20 , N/A ,$16.20 ,$16.20 , N/A ,$11.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202600,N/A,HC SUTURE,272,1 ,$27.37 ,$17.79 ,$7.66 ,$27.37 , N/A ,$20.39 ,$17.93 , N/A ,$7.66 ,$13.82 , N/A ,$16.89 , N/A ,$16.89 ,$16.89 , N/A ,$16.89 , N/A ,$24.63 ,$20.53 , N/A , N/A ,$24.09 , N/A ,$20.53 ,$20.53 ,$23.26 ,$23.26 , N/A ,$23.26 , N/A ,$21.35 ,$21.35 ,$21.35 ,$24.63 , N/A ,$24.63 , N/A ,$27.37 ,$17.93 , N/A ,$11.39 , N/A , N/A , N/A ,$24.63 , N/A ,$16.89 ,$7.66 ,$24.63 , N/A ,$24.63 ,$24.63 , N/A ,$17.79 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202665,N/A,HC THORACENTESIS TRAY,272,1 ,$249.75 ,$162.34 ,$69.93 ,$249.75 , N/A ,$186.06 ,$163.59 , N/A ,$69.93 ,$126.12 , N/A ,$154.10 , N/A ,$154.10 ,$154.10 , N/A ,$154.10 , N/A ,$224.78 ,$187.31 , N/A , N/A ,$219.78 , N/A ,$187.31 ,$187.31 ,$212.29 ,$212.29 , N/A ,$212.29 , N/A ,$194.81 ,$194.81 ,$194.81 ,$224.78 , N/A ,$224.78 , N/A ,$249.75 ,$163.59 , N/A ,$103.90 , N/A , N/A , N/A ,$224.78 , N/A ,$154.10 ,$69.93 ,$224.78 , N/A ,$224.78 ,$224.78 , N/A ,$162.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202729,N/A,HC TRANSDUCER COVER,272,1 ,$16.21 ,$10.54 ,$4.54 ,$16.21 , N/A ,$12.08 ,$10.62 , N/A ,$4.54 ,$8.19 , N/A ,$10.00 , N/A ,$10.00 ,$10.00 , N/A ,$10.00 , N/A ,$14.59 ,$12.16 , N/A , N/A ,$14.26 , N/A ,$12.16 ,$12.16 ,$13.78 ,$13.78 , N/A ,$13.78 , N/A ,$12.64 ,$12.64 ,$12.64 ,$14.59 , N/A ,$14.59 , N/A ,$16.21 ,$10.62 , N/A ,$6.74 , N/A , N/A , N/A ,$14.59 , N/A ,$10.00 ,$4.54 ,$14.59 , N/A ,$14.59 ,$14.59 , N/A ,$10.54 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202743,N/A,HC TRAY CATH,272,1 ,$96.43 ,$62.68 ,$27.00 ,$96.43 , N/A ,$71.84 ,$63.16 , N/A ,$27.00 ,$48.70 , N/A ,$59.50 , N/A ,$59.50 ,$59.50 , N/A ,$59.50 , N/A ,$86.79 ,$72.32 , N/A , N/A ,$84.86 , N/A ,$72.32 ,$72.32 ,$81.97 ,$81.97 , N/A ,$81.97 , N/A ,$75.22 ,$75.22 ,$75.22 ,$86.79 , N/A ,$86.79 , N/A ,$96.43 ,$63.16 , N/A ,$40.11 , N/A , N/A , N/A ,$86.79 , N/A ,$59.50 ,$27.00 ,$86.79 , N/A ,$86.79 ,$86.79 , N/A ,$62.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202786,N/A,HC TRAY PERI-CERV BLOCK,272,1 ,$66.14 ,$42.99 ,$18.52 ,$66.14 , N/A ,$49.27 ,$43.32 , N/A ,$18.52 ,$33.40 , N/A ,$40.81 , N/A ,$40.81 ,$40.81 , N/A ,$40.81 , N/A ,$59.53 ,$49.61 , N/A , N/A ,$58.20 , N/A ,$49.61 ,$49.61 ,$56.22 ,$56.22 , N/A ,$56.22 , N/A ,$51.59 ,$51.59 ,$51.59 ,$59.53 , N/A ,$59.53 , N/A ,$66.14 ,$43.32 , N/A ,$27.51 , N/A , N/A , N/A ,$59.53 , N/A ,$40.81 ,$18.52 ,$59.53 , N/A ,$59.53 ,$59.53 , N/A ,$42.99 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202807,N/A,HC TRAY SPINAL,272,1 ,$141.67 ,$92.09 ,$39.67 ,$141.67 , N/A ,$105.54 ,$92.79 , N/A ,$39.67 ,$71.54 , N/A ,$87.41 , N/A ,$87.41 ,$87.41 , N/A ,$87.41 , N/A ,$127.50 ,$106.25 , N/A , N/A ,$124.67 , N/A ,$106.25 ,$106.25 ,$120.42 ,$120.42 , N/A ,$120.42 , N/A ,$110.50 ,$110.50 ,$110.50 ,$127.50 , N/A ,$127.50 , N/A ,$141.67 ,$92.79 , N/A ,$58.93 , N/A , N/A , N/A ,$127.50 , N/A ,$87.41 ,$39.67 ,$127.50 , N/A ,$127.50 ,$127.50 , N/A ,$92.09 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202901,N/A,HC TUBES TRACH,278,1 ,$72.81 ,$47.33 ,$20.39 ,$72.81 , N/A ,$54.24 ,$47.69 , N/A ,$20.39 ,$36.77 , N/A ,$44.92 , N/A ,$44.92 ,$44.92 , N/A ,$44.92 , N/A ,$65.53 ,$54.61 , N/A , N/A ,$64.07 , N/A ,$54.61 ,$54.61 ,$61.89 ,$61.89 , N/A ,$61.89 , N/A ,$56.79 ,$56.79 ,$56.79 ,$65.53 , N/A ,$65.53 , N/A ,$72.81 ,$47.69 , N/A ,$30.29 , N/A , N/A , N/A ,$65.53 , N/A ,$44.92 ,$20.39 ,$65.53 , N/A ,$65.53 ,$65.53 , N/A ,$47.33 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27202915,N/A,HC TUBING CYSTO,272,1 ,$604.69 ,$393.05 ,$169.31 ,$604.69 , N/A ,$450.49 ,$396.07 , N/A ,$169.31 ,$305.37 , N/A ,$373.09 , N/A ,$373.09 ,$373.09 , N/A ,$373.09 , N/A ,$544.22 ,$453.52 , N/A , N/A ,$532.13 , N/A ,$453.52 ,$453.52 ,$513.99 ,$513.99 , N/A ,$513.99 , N/A ,$471.66 ,$471.66 ,$471.66 ,$544.22 , N/A ,$544.22 , N/A ,$604.69 ,$396.07 , N/A ,$251.55 , N/A , N/A , N/A ,$544.22 , N/A ,$373.09 ,$169.31 ,$544.22 , N/A ,$544.22 ,$544.22 , N/A ,$393.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203051,N/A,HC NASAL PACKING,272,1 ,$37.65 ,$24.47 ,$10.54 ,$37.65 , N/A ,$28.05 ,$24.66 , N/A ,$10.54 ,$19.01 , N/A ,$23.23 , N/A ,$23.23 ,$23.23 , N/A ,$23.23 , N/A ,$33.89 ,$28.24 , N/A , N/A ,$33.13 , N/A ,$28.24 ,$28.24 ,$32.00 ,$32.00 , N/A ,$32.00 , N/A ,$29.37 ,$29.37 ,$29.37 ,$33.89 , N/A ,$33.89 , N/A ,$37.65 ,$24.66 , N/A ,$15.66 , N/A , N/A , N/A ,$33.89 , N/A ,$23.23 ,$10.54 ,$33.89 , N/A ,$33.89 ,$33.89 , N/A ,$24.47 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203239,N/A,HC PUTTY,272,1 ,$13.52 ,$8.79 ,$3.79 ,$13.52 , N/A ,$10.07 ,$8.86 , N/A ,$3.79 ,$6.83 , N/A ,$8.34 , N/A ,$8.34 ,$8.34 , N/A ,$8.34 , N/A ,$12.17 ,$10.14 , N/A , N/A ,$11.90 , N/A ,$10.14 ,$10.14 ,$11.49 ,$11.49 , N/A ,$11.49 , N/A ,$10.55 ,$10.55 ,$10.55 ,$12.17 , N/A ,$12.17 , N/A ,$13.52 ,$8.86 , N/A ,$5.62 , N/A , N/A , N/A ,$12.17 , N/A ,$8.34 ,$3.79 ,$12.17 , N/A ,$12.17 ,$12.17 , N/A ,$8.79 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203246,N/A,HC ERGONOMIC HAND EXERCISER,272,1 ,$34.09 ,$22.16 ,$9.55 ,$34.09 , N/A ,$25.40 ,$22.33 , N/A ,$9.55 ,$17.22 , N/A ,$21.03 , N/A ,$21.03 ,$21.03 , N/A ,$21.03 , N/A ,$30.68 ,$25.57 , N/A , N/A ,$30.00 , N/A ,$25.57 ,$25.57 ,$28.98 ,$28.98 , N/A ,$28.98 , N/A ,$26.59 ,$26.59 ,$26.59 ,$30.68 , N/A ,$30.68 , N/A ,$34.09 ,$22.33 , N/A ,$14.18 , N/A , N/A , N/A ,$30.68 , N/A ,$21.03 ,$9.55 ,$30.68 , N/A ,$30.68 ,$30.68 , N/A ,$22.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203255,N/A,HC CPM PADS,272,1 ,$158.11 ,$102.77 ,$44.27 ,$158.11 , N/A ,$117.79 ,$103.56 , N/A ,$44.27 ,$79.85 , N/A ,$97.55 , N/A ,$97.55 ,$97.55 , N/A ,$97.55 , N/A ,$142.30 ,$118.58 , N/A , N/A ,$139.14 , N/A ,$118.58 ,$118.58 ,$134.39 ,$134.39 , N/A ,$134.39 , N/A ,$123.33 ,$123.33 ,$123.33 ,$142.30 , N/A ,$142.30 , N/A ,$158.11 ,$103.56 , N/A ,$65.77 , N/A , N/A , N/A ,$142.30 , N/A ,$97.55 ,$44.27 ,$142.30 , N/A ,$142.30 ,$142.30 , N/A ,$102.77 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203271,N/A,HC WOUND VAC VERALINK CASSETTE,272,1 ,$140.25 ,$91.16 ,$39.27 ,$140.25 , N/A ,$104.49 ,$91.86 , N/A ,$39.27 ,$70.83 , N/A ,$86.53 , N/A ,$86.53 ,$86.53 , N/A ,$86.53 , N/A ,$126.23 ,$105.19 , N/A , N/A ,$123.42 , N/A ,$105.19 ,$105.19 ,$119.21 ,$119.21 , N/A ,$119.21 , N/A ,$109.40 ,$109.40 ,$109.40 ,$126.23 , N/A ,$126.23 , N/A ,$140.25 ,$91.86 , N/A ,$58.34 , N/A , N/A , N/A ,$126.23 , N/A ,$86.53 ,$39.27 ,$126.23 , N/A ,$126.23 ,$126.23 , N/A ,$91.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$63.00 ,$40.95 ,$17.64 ,$63.00 , N/A ,$46.94 ,$41.27 , N/A ,$17.64 ,$31.82 , N/A ,$38.87 , N/A ,$38.87 ,$38.87 , N/A ,$38.87 , N/A ,$56.70 ,$47.25 , N/A , N/A ,$55.44 , N/A ,$47.25 ,$47.25 ,$53.55 ,$53.55 , N/A ,$53.55 , N/A ,$49.14 ,$49.14 ,$49.14 ,$56.70 , N/A ,$56.70 , N/A ,$63.00 ,$41.27 , N/A ,$26.21 , N/A , N/A , N/A ,$56.70 , N/A ,$38.87 ,$17.64 ,$56.70 , N/A ,$56.70 ,$56.70 , N/A ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203509,N/A,HC CATHETER FOLEY 3W,272,1 ,$46.81 ,$30.43 ,$13.11 ,$46.81 , N/A ,$34.87 ,$30.66 , N/A ,$13.11 ,$23.64 , N/A ,$28.88 , N/A ,$28.88 ,$28.88 , N/A ,$28.88 , N/A ,$42.13 ,$35.11 , N/A , N/A ,$41.19 , N/A ,$35.11 ,$35.11 ,$39.79 ,$39.79 , N/A ,$39.79 , N/A ,$36.51 ,$36.51 ,$36.51 ,$42.13 , N/A ,$42.13 , N/A ,$46.81 ,$30.66 , N/A ,$19.47 , N/A , N/A , N/A ,$42.13 , N/A ,$28.88 ,$13.11 ,$42.13 , N/A ,$42.13 ,$42.13 , N/A ,$30.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203512,A6196,HC DRESSING ALGINATE <16,623,1 ,$16.23 ,$10.55 ,$4.54 ,$16.23 , N/A ,$12.09 ,$10.63 , N/A ,$4.54 ,$8.20 , N/A ,$10.01 , N/A ,$10.01 ,$10.01 , N/A ,$10.01 , N/A ,$14.61 ,$12.17 , N/A , N/A ,$14.28 , N/A ,$12.17 ,$12.17 ,$13.80 ,$13.80 , N/A ,$13.80 , N/A ,$12.66 ,$12.66 ,$12.66 ,$14.61 , N/A ,$14.61 , N/A ,$16.23 ,$10.63 , N/A ,$6.75 , N/A , N/A , N/A ,$14.61 , N/A ,$10.01 ,$4.54 ,$14.61 , N/A ,$14.61 ,$14.61 , N/A ,$10.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203524,A6258,HC DRESSING TRANSPARENT  >16  AND  <48 SQ CM TIER 1,623,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203525,A6258,HC DRESSING TRANSPARENT  >16  AND  <48 SQ CM TIER 2,623,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203531,C1751,HC CATHETER CV TRIPLE-LUMEN,272,1 ,"$1,352.31 ",$879.00 ,$378.65 ,"$1,352.31 ", N/A ,"$1,007.47 ",$885.76 , N/A ,$378.65 ,$682.92 , N/A ,$834.38 , N/A ,$834.38 ,$834.38 , N/A ,$834.38 , N/A ,"$1,217.08 ","$1,014.23 ", N/A , N/A ,"$1,190.03 ", N/A ,"$1,014.23 ","$1,014.23 ","$1,149.46 ","$1,149.46 ", N/A ,"$1,149.46 ", N/A ,"$1,054.80 ","$1,054.80 ","$1,054.80 ","$1,217.08 ", N/A ,"$1,217.08 ", N/A ,"$1,352.31 ",$885.76 , N/A ,$562.56 , N/A , N/A , N/A ,"$1,217.08 ", N/A ,$834.38 ,$378.65 ,"$1,217.08 ", N/A ,"$1,217.08 ","$1,217.08 ", N/A ,$879.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203533,C1751,HC CATHETER CV SINGLE-LUMEN,272,1 ,$345.03 ,$224.27 ,$96.61 ,$345.03 , N/A ,$257.05 ,$225.99 , N/A ,$96.61 ,$174.24 , N/A ,$212.88 , N/A ,$212.88 ,$212.88 , N/A ,$212.88 , N/A ,$310.53 ,$258.77 , N/A , N/A ,$303.63 , N/A ,$258.77 ,$258.77 ,$293.28 ,$293.28 , N/A ,$293.28 , N/A ,$269.12 ,$269.12 ,$269.12 ,$310.53 , N/A ,$310.53 , N/A ,$345.03 ,$225.99 , N/A ,$143.53 , N/A , N/A , N/A ,$310.53 , N/A ,$212.88 ,$96.61 ,$310.53 , N/A ,$310.53 ,$310.53 , N/A ,$224.27 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203535,N/A,HC TRAY LUMBAR PUNCTURE,272,1 ,$160.63 ,$104.41 ,$44.98 ,$160.63 , N/A ,$119.67 ,$105.21 , N/A ,$44.98 ,$81.12 , N/A ,$99.11 , N/A ,$99.11 ,$99.11 , N/A ,$99.11 , N/A ,$144.57 ,$120.47 , N/A , N/A ,$141.35 , N/A ,$120.47 ,$120.47 ,$136.54 ,$136.54 , N/A ,$136.54 , N/A ,$125.29 ,$125.29 ,$125.29 ,$144.57 , N/A ,$144.57 , N/A ,$160.63 ,$105.21 , N/A ,$66.82 , N/A , N/A , N/A ,$144.57 , N/A ,$99.11 ,$44.98 ,$144.57 , N/A ,$144.57 ,$144.57 , N/A ,$104.41 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203544,N/A,HC CATHETER FEMORAL ARTERY,272,1 ,$119.13 ,$77.43 ,$33.36 ,$119.13 , N/A ,$88.75 ,$78.03 , N/A ,$33.36 ,$60.16 , N/A ,$73.50 , N/A ,$73.50 ,$73.50 , N/A ,$73.50 , N/A ,$107.22 ,$89.35 , N/A , N/A ,$104.83 , N/A ,$89.35 ,$89.35 ,$101.26 ,$101.26 , N/A ,$101.26 , N/A ,$92.92 ,$92.92 ,$92.92 ,$107.22 , N/A ,$107.22 , N/A ,$119.13 ,$78.03 , N/A ,$49.56 , N/A , N/A , N/A ,$107.22 , N/A ,$73.50 ,$33.36 ,$107.22 , N/A ,$107.22 ,$107.22 , N/A ,$77.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203554,N/A,HC KIT ICP PRESSURE MONITOR,272,1 ,$68.76 ,$44.69 ,$19.25 ,$68.76 , N/A ,$51.23 ,$45.04 , N/A ,$19.25 ,$34.72 , N/A ,$42.42 , N/A ,$42.42 ,$42.42 , N/A ,$42.42 , N/A ,$61.88 ,$51.57 , N/A , N/A ,$60.51 , N/A ,$51.57 ,$51.57 ,$58.45 ,$58.45 , N/A ,$58.45 , N/A ,$53.63 ,$53.63 ,$53.63 ,$61.88 , N/A ,$61.88 , N/A ,$68.76 ,$45.04 , N/A ,$28.60 , N/A , N/A , N/A ,$61.88 , N/A ,$42.42 ,$19.25 ,$61.88 , N/A ,$61.88 ,$61.88 , N/A ,$44.69 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203557,N/A,HC CATHETER INTRAUTERINE,272,1 ,$158.69 ,$103.15 ,$44.43 ,$158.69 , N/A ,$118.22 ,$103.94 , N/A ,$44.43 ,$80.14 , N/A ,$97.91 , N/A ,$97.91 ,$97.91 , N/A ,$97.91 , N/A ,$142.82 ,$119.02 , N/A , N/A ,$139.65 , N/A ,$119.02 ,$119.02 ,$134.89 ,$134.89 , N/A ,$134.89 , N/A ,$123.78 ,$123.78 ,$123.78 ,$142.82 , N/A ,$142.82 , N/A ,$158.69 ,$103.94 , N/A ,$66.02 , N/A , N/A , N/A ,$142.82 , N/A ,$97.91 ,$44.43 ,$142.82 , N/A ,$142.82 ,$142.82 , N/A ,$103.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203562,N/A,HC CATHETER SUCTION,272,1 ,$6.23 ,$4.05 ,$1.74 ,$6.23 , N/A ,$4.64 ,$4.08 , N/A ,$1.74 ,$3.15 , N/A ,$3.84 , N/A ,$3.84 ,$3.84 , N/A ,$3.84 , N/A ,$5.61 ,$4.67 , N/A , N/A ,$5.48 , N/A ,$4.67 ,$4.67 ,$5.30 ,$5.30 , N/A ,$5.30 , N/A ,$4.86 ,$4.86 ,$4.86 ,$5.61 , N/A ,$5.61 , N/A ,$6.23 ,$4.08 , N/A ,$2.59 , N/A , N/A , N/A ,$5.61 , N/A ,$3.84 ,$1.74 ,$5.61 , N/A ,$5.61 ,$5.61 , N/A ,$4.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203563,N/A,HC CATHETER TROCAR,272,1 ,$143.61 ,$93.35 ,$40.21 ,$143.61 , N/A ,$106.99 ,$94.06 , N/A ,$40.21 ,$72.52 , N/A ,$88.61 , N/A ,$88.61 ,$88.61 , N/A ,$88.61 , N/A ,$129.25 ,$107.71 , N/A , N/A ,$126.38 , N/A ,$107.71 ,$107.71 ,$122.07 ,$122.07 , N/A ,$122.07 , N/A ,$112.02 ,$112.02 ,$112.02 ,$129.25 , N/A ,$129.25 , N/A ,$143.61 ,$94.06 , N/A ,$59.74 , N/A , N/A , N/A ,$129.25 , N/A ,$88.61 ,$40.21 ,$129.25 , N/A ,$129.25 ,$129.25 , N/A ,$93.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203564,N/A,HC CATHETER UMBILICAL ARTERY,272,1 ,$88.21 ,$57.34 ,$24.70 ,$88.21 , N/A ,$65.72 ,$57.78 , N/A ,$24.70 ,$44.55 , N/A ,$54.43 , N/A ,$54.43 ,$54.43 , N/A ,$54.43 , N/A ,$79.39 ,$66.16 , N/A , N/A ,$77.62 , N/A ,$66.16 ,$66.16 ,$74.98 ,$74.98 , N/A ,$74.98 , N/A ,$68.80 ,$68.80 ,$68.80 ,$79.39 , N/A ,$79.39 , N/A ,$88.21 ,$57.78 , N/A ,$36.70 , N/A , N/A , N/A ,$79.39 , N/A ,$54.43 ,$24.70 ,$79.39 , N/A ,$79.39 ,$79.39 , N/A ,$57.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203573,A6237,HC DRESSING COMBIDERM <16 SQ CM,623,1 ,$94.75 ,$61.59 ,$26.53 ,$94.75 , N/A ,$70.59 ,$62.06 , N/A ,$26.53 ,$47.85 , N/A ,$58.46 , N/A ,$58.46 ,$58.46 , N/A ,$58.46 , N/A ,$85.28 ,$71.06 , N/A , N/A ,$83.38 , N/A ,$71.06 ,$71.06 ,$80.54 ,$80.54 , N/A ,$80.54 , N/A ,$73.91 ,$73.91 ,$73.91 ,$85.28 , N/A ,$85.28 , N/A ,$94.75 ,$62.06 , N/A ,$39.42 , N/A , N/A , N/A ,$85.28 , N/A ,$58.46 ,$26.53 ,$85.28 , N/A ,$85.28 ,$85.28 , N/A ,$61.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203576,N/A,HC DRESSING V.A.C.,272,1 ,$477.13 ,$310.13 ,$133.60 ,$477.13 , N/A ,$355.46 ,$312.52 , N/A ,$133.60 ,$240.95 , N/A ,$294.39 , N/A ,$294.39 ,$294.39 , N/A ,$294.39 , N/A ,$429.42 ,$357.85 , N/A , N/A ,$419.87 , N/A ,$357.85 ,$357.85 ,$405.56 ,$405.56 , N/A ,$405.56 , N/A ,$372.16 ,$372.16 ,$372.16 ,$429.42 , N/A ,$429.42 , N/A ,$477.13 ,$312.52 , N/A ,$198.49 , N/A , N/A , N/A ,$429.42 , N/A ,$294.39 ,$133.60 ,$429.42 , N/A ,$429.42 ,$429.42 , N/A ,$310.13 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203597,N/A,HC TUBING ANY,272,1 ,$179.50 ,$116.68 ,$50.26 ,$179.50 , N/A ,$133.73 ,$117.57 , N/A ,$50.26 ,$90.65 , N/A ,$110.75 , N/A ,$110.75 ,$110.75 , N/A ,$110.75 , N/A ,$161.55 ,$134.63 , N/A , N/A ,$157.96 , N/A ,$134.63 ,$134.63 ,$152.58 ,$152.58 , N/A ,$152.58 , N/A ,$140.01 ,$140.01 ,$140.01 ,$161.55 , N/A ,$161.55 , N/A ,$179.50 ,$117.57 , N/A ,$74.67 , N/A , N/A , N/A ,$161.55 , N/A ,$110.75 ,$50.26 ,$161.55 , N/A ,$161.55 ,$161.55 , N/A ,$116.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203601,N/A,HC BLOCK BITE TEETH GUARD,272,1 ,$97.00 ,$63.05 ,$27.16 ,$97.00 , N/A ,$72.27 ,$63.54 , N/A ,$27.16 ,$48.99 , N/A ,$59.85 , N/A ,$59.85 ,$59.85 , N/A ,$59.85 , N/A ,$87.30 ,$72.75 , N/A , N/A ,$85.36 , N/A ,$72.75 ,$72.75 ,$82.45 ,$82.45 , N/A ,$82.45 , N/A ,$75.66 ,$75.66 ,$75.66 ,$87.30 , N/A ,$87.30 , N/A ,$97.00 ,$63.54 , N/A ,$40.35 , N/A , N/A , N/A ,$87.30 , N/A ,$59.85 ,$27.16 ,$87.30 , N/A ,$87.30 ,$87.30 , N/A ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203636,N/A,HC TRAY MYELOGRAM,272,1 ,$96.85 ,$62.95 ,$27.12 ,$96.85 , N/A ,$72.15 ,$63.44 , N/A ,$27.12 ,$48.91 , N/A ,$59.76 , N/A ,$59.76 ,$59.76 , N/A ,$59.76 , N/A ,$87.17 ,$72.64 , N/A , N/A ,$85.23 , N/A ,$72.64 ,$72.64 ,$82.32 ,$82.32 , N/A ,$82.32 , N/A ,$75.54 ,$75.54 ,$75.54 ,$87.17 , N/A ,$87.17 , N/A ,$96.85 ,$63.44 , N/A ,$40.29 , N/A , N/A , N/A ,$87.17 , N/A ,$59.76 ,$27.12 ,$87.17 , N/A ,$87.17 ,$87.17 , N/A ,$62.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203641,N/A,HC NEEDLE BIOPSY,272,1 ,$162.42 ,$105.57 ,$45.48 ,$162.42 , N/A ,$121.00 ,$106.39 , N/A ,$45.48 ,$82.02 , N/A ,$100.21 , N/A ,$100.21 ,$100.21 , N/A ,$100.21 , N/A ,$146.18 ,$121.82 , N/A , N/A ,$142.93 , N/A ,$121.82 ,$121.82 ,$138.06 ,$138.06 , N/A ,$138.06 , N/A ,$126.69 ,$126.69 ,$126.69 ,$146.18 , N/A ,$146.18 , N/A ,$162.42 ,$106.39 , N/A ,$67.57 , N/A , N/A , N/A ,$146.18 , N/A ,$100.21 ,$45.48 ,$146.18 , N/A ,$146.18 ,$146.18 , N/A ,$105.57 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203654,N/A,HC CATHETER SWAN GANZ,272,1 ,$309.06 ,$200.89 ,$86.54 ,$309.06 , N/A ,$230.25 ,$202.43 , N/A ,$86.54 ,$156.08 , N/A ,$190.69 , N/A ,$190.69 ,$190.69 , N/A ,$190.69 , N/A ,$278.15 ,$231.80 , N/A , N/A ,$271.97 , N/A ,$231.80 ,$231.80 ,$262.70 ,$262.70 , N/A ,$262.70 , N/A ,$241.07 ,$241.07 ,$241.07 ,$278.15 , N/A ,$278.15 , N/A ,$309.06 ,$202.43 , N/A ,$128.57 , N/A , N/A , N/A ,$278.15 , N/A ,$190.69 ,$86.54 ,$278.15 , N/A ,$278.15 ,$278.15 , N/A ,$200.89 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203657,C1769,HC GUIDEWIRE,272,1 ,$243.29 ,$158.14 ,$68.12 ,$243.29 , N/A ,$181.25 ,$159.36 , N/A ,$68.12 ,$122.86 , N/A ,$150.11 , N/A ,$150.11 ,$150.11 , N/A ,$150.11 , N/A ,$218.96 ,$182.47 , N/A , N/A ,$214.10 , N/A ,$182.47 ,$182.47 ,$206.80 ,$206.80 , N/A ,$206.80 , N/A ,$189.77 ,$189.77 ,$189.77 ,$218.96 , N/A ,$218.96 , N/A ,$243.29 ,$159.36 , N/A ,$101.21 , N/A , N/A , N/A ,$218.96 , N/A ,$150.11 ,$68.12 ,$218.96 , N/A ,$218.96 ,$218.96 , N/A ,$158.14 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203658,C1769,HC GUIDEWIRE GLIDEWIRE,272,1 ,$672.14 ,$436.89 ,$188.20 ,$672.14 , N/A ,$500.74 ,$440.25 , N/A ,$188.20 ,$339.43 , N/A ,$414.71 , N/A ,$414.71 ,$414.71 , N/A ,$414.71 , N/A ,$604.93 ,$504.11 , N/A , N/A ,$591.48 , N/A ,$504.11 ,$504.11 ,$571.32 ,$571.32 , N/A ,$571.32 , N/A ,$524.27 ,$524.27 ,$524.27 ,$604.93 , N/A ,$604.93 , N/A ,$672.14 ,$440.25 , N/A ,$279.61 , N/A , N/A , N/A ,$604.93 , N/A ,$414.71 ,$188.20 ,$604.93 , N/A ,$604.93 ,$604.93 , N/A ,$436.89 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203689,N/A,HC COVER PROBE,272,1 ,$22.04 ,$14.33 ,$6.17 ,$22.04 , N/A ,$16.42 ,$14.44 , N/A ,$6.17 ,$11.13 , N/A ,$13.60 , N/A ,$13.60 ,$13.60 , N/A ,$13.60 , N/A ,$19.84 ,$16.53 , N/A , N/A ,$19.40 , N/A ,$16.53 ,$16.53 ,$18.73 ,$18.73 , N/A ,$18.73 , N/A ,$17.19 ,$17.19 ,$17.19 ,$19.84 , N/A ,$19.84 , N/A ,$22.04 ,$14.44 , N/A ,$9.17 , N/A , N/A , N/A ,$19.84 , N/A ,$13.60 ,$6.17 ,$19.84 , N/A ,$19.84 ,$19.84 , N/A ,$14.33 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203691,N/A,HC TUBE GASTROSTOMY,272,1 ,$33.08 ,$21.50 ,$9.26 ,$33.08 , N/A ,$24.64 ,$21.67 , N/A ,$9.26 ,$16.71 , N/A ,$20.41 , N/A ,$20.41 ,$20.41 , N/A ,$20.41 , N/A ,$29.77 ,$24.81 , N/A , N/A ,$29.11 , N/A ,$24.81 ,$24.81 ,$28.12 ,$28.12 , N/A ,$28.12 , N/A ,$25.80 ,$25.80 ,$25.80 ,$29.77 , N/A ,$29.77 , N/A ,$33.08 ,$21.67 , N/A ,$13.76 , N/A , N/A , N/A ,$29.77 , N/A ,$20.41 ,$9.26 ,$29.77 , N/A ,$29.77 ,$29.77 , N/A ,$21.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203703,C1751,HC CATHETER PICC,272,1 ,$556.00 ,$361.40 ,$155.68 ,$556.00 , N/A ,$414.22 ,$364.18 , N/A ,$155.68 ,$280.78 , N/A ,$343.05 , N/A ,$343.05 ,$343.05 , N/A ,$343.05 , N/A ,$500.40 ,$417.00 , N/A , N/A ,$489.28 , N/A ,$417.00 ,$417.00 ,$472.60 ,$472.60 , N/A ,$472.60 , N/A ,$433.68 ,$433.68 ,$433.68 ,$500.40 , N/A ,$500.40 , N/A ,$556.00 ,$364.18 , N/A ,$231.30 , N/A , N/A , N/A ,$500.40 , N/A ,$343.05 ,$155.68 ,$500.40 , N/A ,$500.40 ,$500.40 , N/A ,$361.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203719,C1729,HC CATHETER CENTESIS ONE STEP,272,1 ,$51.71 ,$33.61 ,$14.48 ,$51.71 , N/A ,$38.52 ,$33.87 , N/A ,$14.48 ,$26.11 , N/A ,$31.91 , N/A ,$31.91 ,$31.91 , N/A ,$31.91 , N/A ,$46.54 ,$38.78 , N/A , N/A ,$45.50 , N/A ,$38.78 ,$38.78 ,$43.95 ,$43.95 , N/A ,$43.95 , N/A ,$40.33 ,$40.33 ,$40.33 ,$46.54 , N/A ,$46.54 , N/A ,$51.71 ,$33.87 , N/A ,$21.51 , N/A , N/A , N/A ,$46.54 , N/A ,$31.91 ,$14.48 ,$46.54 , N/A ,$46.54 ,$46.54 , N/A ,$33.61 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203720,N/A,HC MARKER BREAST CORE MARK,272,1 ,$167.28 ,$108.73 ,$46.84 ,$167.28 , N/A ,$124.62 ,$109.57 , N/A ,$46.84 ,$84.48 , N/A ,$103.21 , N/A ,$103.21 ,$103.21 , N/A ,$103.21 , N/A ,$150.55 ,$125.46 , N/A , N/A ,$147.21 , N/A ,$125.46 ,$125.46 ,$142.19 ,$142.19 , N/A ,$142.19 , N/A ,$130.48 ,$130.48 ,$130.48 ,$150.55 , N/A ,$150.55 , N/A ,$167.28 ,$109.57 , N/A ,$69.59 , N/A , N/A , N/A ,$150.55 , N/A ,$103.21 ,$46.84 ,$150.55 , N/A ,$150.55 ,$150.55 , N/A ,$108.73 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203766,N/A,HC CATHETER SELECT,272,1 ,$267.79 ,$174.06 ,$74.98 ,$267.79 , N/A ,$199.50 ,$175.40 , N/A ,$74.98 ,$135.23 , N/A ,$165.23 , N/A ,$165.23 ,$165.23 , N/A ,$165.23 , N/A ,$241.01 ,$200.84 , N/A , N/A ,$235.66 , N/A ,$200.84 ,$200.84 ,$227.62 ,$227.62 , N/A ,$227.62 , N/A ,$208.88 ,$208.88 ,$208.88 ,$241.01 , N/A ,$241.01 , N/A ,$267.79 ,$175.40 , N/A ,$111.40 , N/A , N/A , N/A ,$241.01 , N/A ,$165.23 ,$74.98 ,$241.01 , N/A ,$241.01 ,$241.01 , N/A ,$174.06 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203827,C1894,HC INTRODUCER/SHEATH/CATH,272,1 ,$45.00 ,$29.25 ,$12.60 ,$45.00 , N/A ,$33.53 ,$29.48 , N/A ,$12.60 ,$22.73 , N/A ,$27.77 , N/A ,$27.77 ,$27.77 , N/A ,$27.77 , N/A ,$40.50 ,$33.75 , N/A , N/A ,$39.60 , N/A ,$33.75 ,$33.75 ,$38.25 ,$38.25 , N/A ,$38.25 , N/A ,$35.10 ,$35.10 ,$35.10 ,$40.50 , N/A ,$40.50 , N/A ,$45.00 ,$29.48 , N/A ,$18.72 , N/A , N/A , N/A ,$40.50 , N/A ,$27.77 ,$12.60 ,$40.50 , N/A ,$40.50 ,$40.50 , N/A ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203846,N/A,HC SYSTEM VACUUM ASSIST MUSHROOM CAP,272,1 ,$90.93 ,$59.10 ,$25.46 ,$90.93 , N/A ,$67.74 ,$59.56 , N/A ,$25.46 ,$45.92 , N/A ,$56.10 , N/A ,$56.10 ,$56.10 , N/A ,$56.10 , N/A ,$81.84 ,$68.20 , N/A , N/A ,$80.02 , N/A ,$68.20 ,$68.20 ,$77.29 ,$77.29 , N/A ,$77.29 , N/A ,$70.93 ,$70.93 ,$70.93 ,$81.84 , N/A ,$81.84 , N/A ,$90.93 ,$59.56 , N/A ,$37.83 , N/A , N/A , N/A ,$81.84 , N/A ,$56.10 ,$25.46 ,$81.84 , N/A ,$81.84 ,$81.84 , N/A ,$59.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203847,N/A,HC NEEDLE INTRAOSSEOUS,272,1 ,$369.08 ,$239.90 ,$103.34 ,$369.08 , N/A ,$274.96 ,$241.75 , N/A ,$103.34 ,$186.39 , N/A ,$227.72 , N/A ,$227.72 ,$227.72 , N/A ,$227.72 , N/A ,$332.17 ,$276.81 , N/A , N/A ,$324.79 , N/A ,$276.81 ,$276.81 ,$313.72 ,$313.72 , N/A ,$313.72 , N/A ,$287.88 ,$287.88 ,$287.88 ,$332.17 , N/A ,$332.17 , N/A ,$369.08 ,$241.75 , N/A ,$153.54 , N/A , N/A , N/A ,$332.17 , N/A ,$227.72 ,$103.34 ,$332.17 , N/A ,$332.17 ,$332.17 , N/A ,$239.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203848,N/A,HC PACK GYNE,272,1 ,$117.34 ,$76.27 ,$32.86 ,$117.34 , N/A ,$87.42 ,$76.86 , N/A ,$32.86 ,$59.26 , N/A ,$72.40 , N/A ,$72.40 ,$72.40 , N/A ,$72.40 , N/A ,$105.61 ,$88.01 , N/A , N/A ,$103.26 , N/A ,$88.01 ,$88.01 ,$99.74 ,$99.74 , N/A ,$99.74 , N/A ,$91.53 ,$91.53 ,$91.53 ,$105.61 , N/A ,$105.61 , N/A ,$117.34 ,$76.86 , N/A ,$48.81 , N/A , N/A , N/A ,$105.61 , N/A ,$72.40 ,$32.86 ,$105.61 , N/A ,$105.61 ,$105.61 , N/A ,$76.27 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203858,N/A,HC DRESSING WOUND SILVER ANTIMICROBIAL,272,1 ,$136.59 ,$88.78 ,$38.25 ,$136.59 , N/A ,$101.76 ,$89.47 , N/A ,$38.25 ,$68.98 , N/A ,$84.28 , N/A ,$84.28 ,$84.28 , N/A ,$84.28 , N/A ,$122.93 ,$102.44 , N/A , N/A ,$120.20 , N/A ,$102.44 ,$102.44 ,$116.10 ,$116.10 , N/A ,$116.10 , N/A ,$106.54 ,$106.54 ,$106.54 ,$122.93 , N/A ,$122.93 , N/A ,$136.59 ,$89.47 , N/A ,$56.82 , N/A , N/A , N/A ,$122.93 , N/A ,$84.28 ,$38.25 ,$122.93 , N/A ,$122.93 ,$122.93 , N/A ,$88.78 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203860,N/A,HC KIT DRESSING WOUND VAC GRANUFOAM SILVER,272,1 ,$293.25 ,$190.61 ,$82.11 ,$293.25 , N/A ,$218.47 ,$192.08 , N/A ,$82.11 ,$148.09 , N/A ,$180.94 , N/A ,$180.94 ,$180.94 , N/A ,$180.94 , N/A ,$263.93 ,$219.94 , N/A , N/A ,$258.06 , N/A ,$219.94 ,$219.94 ,$249.26 ,$249.26 , N/A ,$249.26 , N/A ,$228.74 ,$228.74 ,$228.74 ,$263.93 , N/A ,$263.93 , N/A ,$293.25 ,$192.08 , N/A ,$121.99 , N/A , N/A , N/A ,$263.93 , N/A ,$180.94 ,$82.11 ,$263.93 , N/A ,$263.93 ,$263.93 , N/A ,$190.61 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203871,N/A,HC NASAL RHINO ROCKET,272,1 ,$53.32 ,$34.66 ,$14.93 ,$53.32 , N/A ,$39.72 ,$34.92 , N/A ,$14.93 ,$26.93 , N/A ,$32.90 , N/A ,$32.90 ,$32.90 , N/A ,$32.90 , N/A ,$47.99 ,$39.99 , N/A , N/A ,$46.92 , N/A ,$39.99 ,$39.99 ,$45.32 ,$45.32 , N/A ,$45.32 , N/A ,$41.59 ,$41.59 ,$41.59 ,$47.99 , N/A ,$47.99 , N/A ,$53.32 ,$34.92 , N/A ,$22.18 , N/A , N/A , N/A ,$47.99 , N/A ,$32.90 ,$14.93 ,$47.99 , N/A ,$47.99 ,$47.99 , N/A ,$34.66 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203873,N/A,HC BAG RESUSCITATION PEDI,272,1 ,$119.19 ,$77.47 ,$33.37 ,$119.19 , N/A ,$88.80 ,$78.07 , N/A ,$33.37 ,$60.19 , N/A ,$73.54 , N/A ,$73.54 ,$73.54 , N/A ,$73.54 , N/A ,$107.27 ,$89.39 , N/A , N/A ,$104.89 , N/A ,$89.39 ,$89.39 ,$101.31 ,$101.31 , N/A ,$101.31 , N/A ,$92.97 ,$92.97 ,$92.97 ,$107.27 , N/A ,$107.27 , N/A ,$119.19 ,$78.07 , N/A ,$49.58 , N/A , N/A , N/A ,$107.27 , N/A ,$73.54 ,$33.37 ,$107.27 , N/A ,$107.27 ,$107.27 , N/A ,$77.47 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203874,N/A,HC KIT DRESSING WOUND VAC GRANUFOAM  LARGE,272,1 ,$660.00 ,$429.00 ,$184.80 ,$660.00 , N/A ,$491.70 ,$432.30 , N/A ,$184.80 ,$333.30 , N/A ,$407.22 , N/A ,$407.22 ,$407.22 , N/A ,$407.22 , N/A ,$594.00 ,$495.00 , N/A , N/A ,$580.80 , N/A ,$495.00 ,$495.00 ,$561.00 ,$561.00 , N/A ,$561.00 , N/A ,$514.80 ,$514.80 ,$514.80 ,$594.00 , N/A ,$594.00 , N/A ,$660.00 ,$432.30 , N/A ,$274.56 , N/A , N/A , N/A ,$594.00 , N/A ,$407.22 ,$184.80 ,$594.00 , N/A ,$594.00 ,$594.00 , N/A ,$429.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203875,N/A,HC SYSTEM DRESSING WOUND VAC THERAPY,272,1 ,"$1,521.00 ",$988.65 ,$425.88 ,"$1,521.00 ", N/A ,"$1,133.15 ",$996.26 , N/A ,$425.88 ,$768.11 , N/A ,$938.46 , N/A ,$938.46 ,$938.46 , N/A ,$938.46 , N/A ,"$1,368.90 ","$1,140.75 ", N/A , N/A ,"$1,338.48 ", N/A ,"$1,140.75 ","$1,140.75 ","$1,292.85 ","$1,292.85 ", N/A ,"$1,292.85 ", N/A ,"$1,186.38 ","$1,186.38 ","$1,186.38 ","$1,368.90 ", N/A ,"$1,368.90 ", N/A ,"$1,521.00 ",$996.26 , N/A ,$632.74 , N/A , N/A , N/A ,"$1,368.90 ", N/A ,$938.46 ,$425.88 ,"$1,368.90 ", N/A ,"$1,368.90 ","$1,368.90 ", N/A ,$988.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203885,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203886,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203887,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203888,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203889,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203890,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203891,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203892,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203893,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203894,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203895,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203896,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203897,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T22,272,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203898,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T23,272,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203899,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T24,272,1 ,"$5,700.00 ","$3,705.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$4,246.50 ","$3,733.50 ", N/A ,"$1,596.00 ","$2,878.50 ", N/A ,"$3,516.90 ", N/A ,"$3,516.90 ","$3,516.90 ", N/A ,"$3,516.90 ", N/A ,"$5,130.00 ","$4,275.00 ", N/A , N/A ,"$5,016.00 ", N/A ,"$4,275.00 ","$4,275.00 ","$4,845.00 ","$4,845.00 ", N/A ,"$4,845.00 ", N/A ,"$4,446.00 ","$4,446.00 ","$4,446.00 ","$5,130.00 ", N/A ,"$5,130.00 ", N/A ,"$5,700.00 ","$3,733.50 ", N/A ,"$2,371.20 ", N/A , N/A , N/A ,"$5,130.00 ", N/A ,"$3,516.90 ","$1,596.00 ","$5,130.00 ", N/A ,"$5,130.00 ","$5,130.00 ", N/A ,"$3,705.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203900,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T25,272,1 ,"$6,300.00 ","$4,095.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,693.50 ","$4,126.50 ", N/A ,"$1,764.00 ","$3,181.50 ", N/A ,"$3,887.10 ", N/A ,"$3,887.10 ","$3,887.10 ", N/A ,"$3,887.10 ", N/A ,"$5,670.00 ","$4,725.00 ", N/A , N/A ,"$5,544.00 ", N/A ,"$4,725.00 ","$4,725.00 ","$5,355.00 ","$5,355.00 ", N/A ,"$5,355.00 ", N/A ,"$4,914.00 ","$4,914.00 ","$4,914.00 ","$5,670.00 ", N/A ,"$5,670.00 ", N/A ,"$6,300.00 ","$4,126.50 ", N/A ,"$2,620.80 ", N/A , N/A , N/A ,"$5,670.00 ", N/A ,"$3,887.10 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,670.00 ","$5,670.00 ", N/A ,"$4,095.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203901,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T26,272,1 ,"$6,900.00 ","$4,485.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$5,140.50 ","$4,519.50 ", N/A ,"$1,932.00 ","$3,484.50 ", N/A ,"$4,257.30 ", N/A ,"$4,257.30 ","$4,257.30 ", N/A ,"$4,257.30 ", N/A ,"$6,210.00 ","$5,175.00 ", N/A , N/A ,"$6,072.00 ", N/A ,"$5,175.00 ","$5,175.00 ","$5,865.00 ","$5,865.00 ", N/A ,"$5,865.00 ", N/A ,"$5,382.00 ","$5,382.00 ","$5,382.00 ","$6,210.00 ", N/A ,"$6,210.00 ", N/A ,"$6,900.00 ","$4,519.50 ", N/A ,"$2,870.40 ", N/A , N/A , N/A ,"$6,210.00 ", N/A ,"$4,257.30 ","$1,932.00 ","$6,210.00 ", N/A ,"$6,210.00 ","$6,210.00 ", N/A ,"$4,485.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203902,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T27,272,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203903,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T28,272,1 ,"$8,100.00 ","$5,265.00 ","$2,268.00 ","$8,100.00 ", N/A ,"$6,034.50 ","$5,305.50 ", N/A ,"$2,268.00 ","$4,090.50 ", N/A ,"$4,997.70 ", N/A ,"$4,997.70 ","$4,997.70 ", N/A ,"$4,997.70 ", N/A ,"$7,290.00 ","$6,075.00 ", N/A , N/A ,"$7,128.00 ", N/A ,"$6,075.00 ","$6,075.00 ","$6,885.00 ","$6,885.00 ", N/A ,"$6,885.00 ", N/A ,"$6,318.00 ","$6,318.00 ","$6,318.00 ","$7,290.00 ", N/A ,"$7,290.00 ", N/A ,"$8,100.00 ","$5,305.50 ", N/A ,"$3,369.60 ", N/A , N/A , N/A ,"$7,290.00 ", N/A ,"$4,997.70 ","$2,268.00 ","$7,290.00 ", N/A ,"$7,290.00 ","$7,290.00 ", N/A ,"$5,265.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203904,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T29,272,1 ,"$8,700.00 ","$5,655.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$6,481.50 ","$5,698.50 ", N/A ,"$2,436.00 ","$4,393.50 ", N/A ,"$5,367.90 ", N/A ,"$5,367.90 ","$5,367.90 ", N/A ,"$5,367.90 ", N/A ,"$7,830.00 ","$6,525.00 ", N/A , N/A ,"$7,656.00 ", N/A ,"$6,525.00 ","$6,525.00 ","$7,395.00 ","$7,395.00 ", N/A ,"$7,395.00 ", N/A ,"$6,786.00 ","$6,786.00 ","$6,786.00 ","$7,830.00 ", N/A ,"$7,830.00 ", N/A ,"$8,700.00 ","$5,698.50 ", N/A ,"$3,619.20 ", N/A , N/A , N/A ,"$7,830.00 ", N/A ,"$5,367.90 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,830.00 ","$7,830.00 ", N/A ,"$5,655.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203905,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T30,272,1 ,"$9,300.00 ","$6,045.00 ","$2,604.00 ","$9,300.00 ", N/A ,"$6,928.50 ","$6,091.50 ", N/A ,"$2,604.00 ","$4,696.50 ", N/A ,"$5,738.10 ", N/A ,"$5,738.10 ","$5,738.10 ", N/A ,"$5,738.10 ", N/A ,"$8,370.00 ","$6,975.00 ", N/A , N/A ,"$8,184.00 ", N/A ,"$6,975.00 ","$6,975.00 ","$7,905.00 ","$7,905.00 ", N/A ,"$7,905.00 ", N/A ,"$7,254.00 ","$7,254.00 ","$7,254.00 ","$8,370.00 ", N/A ,"$8,370.00 ", N/A ,"$9,300.00 ","$6,091.50 ", N/A ,"$3,868.80 ", N/A , N/A , N/A ,"$8,370.00 ", N/A ,"$5,738.10 ","$2,604.00 ","$8,370.00 ", N/A ,"$8,370.00 ","$8,370.00 ", N/A ,"$6,045.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203906,C1714,HC CATHETER ATHERECTOMY TRANSLUMINAL DIRECTIONAL T31,272,1 ,"$9,900.00 ","$6,435.00 ","$2,772.00 ","$9,900.00 ", N/A ,"$7,375.50 ","$6,484.50 ", N/A ,"$2,772.00 ","$4,999.50 ", N/A ,"$6,108.30 ", N/A ,"$6,108.30 ","$6,108.30 ", N/A ,"$6,108.30 ", N/A ,"$8,910.00 ","$7,425.00 ", N/A , N/A ,"$8,712.00 ", N/A ,"$7,425.00 ","$7,425.00 ","$8,415.00 ","$8,415.00 ", N/A ,"$8,415.00 ", N/A ,"$7,722.00 ","$7,722.00 ","$7,722.00 ","$8,910.00 ", N/A ,"$8,910.00 ", N/A ,"$9,900.00 ","$6,484.50 ", N/A ,"$4,118.40 ", N/A , N/A , N/A ,"$8,910.00 ", N/A ,"$6,108.30 ","$2,772.00 ","$8,910.00 ", N/A ,"$8,910.00 ","$8,910.00 ", N/A ,"$6,435.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203922,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203923,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203924,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203925,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203926,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203927,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203928,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203929,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203930,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203931,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203932,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T22,272,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203933,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T23,272,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203934,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T24,272,1 ,"$5,700.00 ","$3,705.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$4,246.50 ","$3,733.50 ", N/A ,"$1,596.00 ","$2,878.50 ", N/A ,"$3,516.90 ", N/A ,"$3,516.90 ","$3,516.90 ", N/A ,"$3,516.90 ", N/A ,"$5,130.00 ","$4,275.00 ", N/A , N/A ,"$5,016.00 ", N/A ,"$4,275.00 ","$4,275.00 ","$4,845.00 ","$4,845.00 ", N/A ,"$4,845.00 ", N/A ,"$4,446.00 ","$4,446.00 ","$4,446.00 ","$5,130.00 ", N/A ,"$5,130.00 ", N/A ,"$5,700.00 ","$3,733.50 ", N/A ,"$2,371.20 ", N/A , N/A , N/A ,"$5,130.00 ", N/A ,"$3,516.90 ","$1,596.00 ","$5,130.00 ", N/A ,"$5,130.00 ","$5,130.00 ", N/A ,"$3,705.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203935,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T25,272,1 ,"$6,300.00 ","$4,095.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,693.50 ","$4,126.50 ", N/A ,"$1,764.00 ","$3,181.50 ", N/A ,"$3,887.10 ", N/A ,"$3,887.10 ","$3,887.10 ", N/A ,"$3,887.10 ", N/A ,"$5,670.00 ","$4,725.00 ", N/A , N/A ,"$5,544.00 ", N/A ,"$4,725.00 ","$4,725.00 ","$5,355.00 ","$5,355.00 ", N/A ,"$5,355.00 ", N/A ,"$4,914.00 ","$4,914.00 ","$4,914.00 ","$5,670.00 ", N/A ,"$5,670.00 ", N/A ,"$6,300.00 ","$4,126.50 ", N/A ,"$2,620.80 ", N/A , N/A , N/A ,"$5,670.00 ", N/A ,"$3,887.10 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,670.00 ","$5,670.00 ", N/A ,"$4,095.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203936,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T26,272,1 ,"$6,900.00 ","$4,485.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$5,140.50 ","$4,519.50 ", N/A ,"$1,932.00 ","$3,484.50 ", N/A ,"$4,257.30 ", N/A ,"$4,257.30 ","$4,257.30 ", N/A ,"$4,257.30 ", N/A ,"$6,210.00 ","$5,175.00 ", N/A , N/A ,"$6,072.00 ", N/A ,"$5,175.00 ","$5,175.00 ","$5,865.00 ","$5,865.00 ", N/A ,"$5,865.00 ", N/A ,"$5,382.00 ","$5,382.00 ","$5,382.00 ","$6,210.00 ", N/A ,"$6,210.00 ", N/A ,"$6,900.00 ","$4,519.50 ", N/A ,"$2,870.40 ", N/A , N/A , N/A ,"$6,210.00 ", N/A ,"$4,257.30 ","$1,932.00 ","$6,210.00 ", N/A ,"$6,210.00 ","$6,210.00 ", N/A ,"$4,485.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203937,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T27,272,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203938,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T28,272,1 ,"$8,100.00 ","$5,265.00 ","$2,268.00 ","$8,100.00 ", N/A ,"$6,034.50 ","$5,305.50 ", N/A ,"$2,268.00 ","$4,090.50 ", N/A ,"$4,997.70 ", N/A ,"$4,997.70 ","$4,997.70 ", N/A ,"$4,997.70 ", N/A ,"$7,290.00 ","$6,075.00 ", N/A , N/A ,"$7,128.00 ", N/A ,"$6,075.00 ","$6,075.00 ","$6,885.00 ","$6,885.00 ", N/A ,"$6,885.00 ", N/A ,"$6,318.00 ","$6,318.00 ","$6,318.00 ","$7,290.00 ", N/A ,"$7,290.00 ", N/A ,"$8,100.00 ","$5,305.50 ", N/A ,"$3,369.60 ", N/A , N/A , N/A ,"$7,290.00 ", N/A ,"$4,997.70 ","$2,268.00 ","$7,290.00 ", N/A ,"$7,290.00 ","$7,290.00 ", N/A ,"$5,265.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203939,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T29,272,1 ,"$8,700.00 ","$5,655.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$6,481.50 ","$5,698.50 ", N/A ,"$2,436.00 ","$4,393.50 ", N/A ,"$5,367.90 ", N/A ,"$5,367.90 ","$5,367.90 ", N/A ,"$5,367.90 ", N/A ,"$7,830.00 ","$6,525.00 ", N/A , N/A ,"$7,656.00 ", N/A ,"$6,525.00 ","$6,525.00 ","$7,395.00 ","$7,395.00 ", N/A ,"$7,395.00 ", N/A ,"$6,786.00 ","$6,786.00 ","$6,786.00 ","$7,830.00 ", N/A ,"$7,830.00 ", N/A ,"$8,700.00 ","$5,698.50 ", N/A ,"$3,619.20 ", N/A , N/A , N/A ,"$7,830.00 ", N/A ,"$5,367.90 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,830.00 ","$7,830.00 ", N/A ,"$5,655.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203940,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T30,272,1 ,"$9,300.00 ","$6,045.00 ","$2,604.00 ","$9,300.00 ", N/A ,"$6,928.50 ","$6,091.50 ", N/A ,"$2,604.00 ","$4,696.50 ", N/A ,"$5,738.10 ", N/A ,"$5,738.10 ","$5,738.10 ", N/A ,"$5,738.10 ", N/A ,"$8,370.00 ","$6,975.00 ", N/A , N/A ,"$8,184.00 ", N/A ,"$6,975.00 ","$6,975.00 ","$7,905.00 ","$7,905.00 ", N/A ,"$7,905.00 ", N/A ,"$7,254.00 ","$7,254.00 ","$7,254.00 ","$8,370.00 ", N/A ,"$8,370.00 ", N/A ,"$9,300.00 ","$6,091.50 ", N/A ,"$3,868.80 ", N/A , N/A , N/A ,"$8,370.00 ", N/A ,"$5,738.10 ","$2,604.00 ","$8,370.00 ", N/A ,"$8,370.00 ","$8,370.00 ", N/A ,"$6,045.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203941,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T31,272,1 ,"$9,900.00 ","$6,435.00 ","$2,772.00 ","$9,900.00 ", N/A ,"$7,375.50 ","$6,484.50 ", N/A ,"$2,772.00 ","$4,999.50 ", N/A ,"$6,108.30 ", N/A ,"$6,108.30 ","$6,108.30 ", N/A ,"$6,108.30 ", N/A ,"$8,910.00 ","$7,425.00 ", N/A , N/A ,"$8,712.00 ", N/A ,"$7,425.00 ","$7,425.00 ","$8,415.00 ","$8,415.00 ", N/A ,"$8,415.00 ", N/A ,"$7,722.00 ","$7,722.00 ","$7,722.00 ","$8,910.00 ", N/A ,"$8,910.00 ", N/A ,"$9,900.00 ","$6,484.50 ", N/A ,"$4,118.40 ", N/A , N/A , N/A ,"$8,910.00 ", N/A ,"$6,108.30 ","$2,772.00 ","$8,910.00 ", N/A ,"$8,910.00 ","$8,910.00 ", N/A ,"$6,435.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203942,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T32,272,1 ,"$10,500.00 ","$6,825.00 ","$2,940.00 ","$10,500.00 ", N/A ,"$7,822.50 ","$6,877.50 ", N/A ,"$2,940.00 ","$5,302.50 ", N/A ,"$6,478.50 ", N/A ,"$6,478.50 ","$6,478.50 ", N/A ,"$6,478.50 ", N/A ,"$9,450.00 ","$7,875.00 ", N/A , N/A ,"$9,240.00 ", N/A ,"$7,875.00 ","$7,875.00 ","$8,925.00 ","$8,925.00 ", N/A ,"$8,925.00 ", N/A ,"$8,190.00 ","$8,190.00 ","$8,190.00 ","$9,450.00 ", N/A ,"$9,450.00 ", N/A ,"$10,500.00 ","$6,877.50 ", N/A ,"$4,368.00 ", N/A , N/A , N/A ,"$9,450.00 ", N/A ,"$6,478.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$9,450.00 ","$9,450.00 ", N/A ,"$6,825.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203943,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T1,272,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203944,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T2,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203945,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203946,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203947,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203948,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203949,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203950,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203951,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203952,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203953,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203954,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203955,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203956,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203957,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203961,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27203962,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204058,C1733,HC CATHETER EP DIAG/ABLATION OTHR COOL TIP T12,272,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204066,C1733,HC CATHETER EP DIAG/ABLATION OTHR COOL TIP T20,272,1 ,"$3,150.00 ","$2,047.50 ",$882.00 ,"$3,150.00 ", N/A ,"$2,346.75 ","$2,063.25 ", N/A ,$882.00 ,"$1,590.75 ", N/A ,"$1,943.55 ", N/A ,"$1,943.55 ","$1,943.55 ", N/A ,"$1,943.55 ", N/A ,"$2,835.00 ","$2,362.50 ", N/A , N/A ,"$2,772.00 ", N/A ,"$2,362.50 ","$2,362.50 ","$2,677.50 ","$2,677.50 ", N/A ,"$2,677.50 ", N/A ,"$2,457.00 ","$2,457.00 ","$2,457.00 ","$2,835.00 ", N/A ,"$2,835.00 ", N/A ,"$3,150.00 ","$2,063.25 ", N/A ,"$1,310.40 ", N/A , N/A , N/A ,"$2,835.00 ", N/A ,"$1,943.55 ",$882.00 ,"$2,835.00 ", N/A ,"$2,835.00 ","$2,835.00 ", N/A ,"$2,047.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204073,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T1,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204078,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T6,272,1 ,$705.00 ,$458.25 ,$197.40 ,$705.00 , N/A ,$525.23 ,$461.78 , N/A ,$197.40 ,$356.03 , N/A ,$434.99 , N/A ,$434.99 ,$434.99 , N/A ,$434.99 , N/A ,$634.50 ,$528.75 , N/A , N/A ,$620.40 , N/A ,$528.75 ,$528.75 ,$599.25 ,$599.25 , N/A ,$599.25 , N/A ,$549.90 ,$549.90 ,$549.90 ,$634.50 , N/A ,$634.50 , N/A ,$705.00 ,$461.78 , N/A ,$293.28 , N/A , N/A , N/A ,$634.50 , N/A ,$434.99 ,$197.40 ,$634.50 , N/A ,$634.50 ,$634.50 , N/A ,$458.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204090,C1753,HC CATHETER US IMAGING/IVUS T5,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204091,C1753,HC CATHETER US IMAGING/IVUS T6,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204092,C1753,HC CATHETER US IMAGING/IVUS T7,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204093,C1753,HC CATHETER US IMAGING/IVUS T8,272,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204094,C1753,HC CATHETER US IMAGING/IVUS T9,272,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204095,C1753,HC CATHETER US IMAGING/IVUS T10,272,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204096,C1753,HC CATHETER US IMAGING/IVUS T11,272,1 ,"$5,700.00 ","$3,705.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$4,246.50 ","$3,733.50 ", N/A ,"$1,596.00 ","$2,878.50 ", N/A ,"$3,516.90 ", N/A ,"$3,516.90 ","$3,516.90 ", N/A ,"$3,516.90 ", N/A ,"$5,130.00 ","$4,275.00 ", N/A , N/A ,"$5,016.00 ", N/A ,"$4,275.00 ","$4,275.00 ","$4,845.00 ","$4,845.00 ", N/A ,"$4,845.00 ", N/A ,"$4,446.00 ","$4,446.00 ","$4,446.00 ","$5,130.00 ", N/A ,"$5,130.00 ", N/A ,"$5,700.00 ","$3,733.50 ", N/A ,"$2,371.20 ", N/A , N/A , N/A ,"$5,130.00 ", N/A ,"$3,516.90 ","$1,596.00 ","$5,130.00 ", N/A ,"$5,130.00 ","$5,130.00 ", N/A ,"$3,705.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204097,C1753,HC CATHETER US IMAGING/IVUS T12,272,1 ,"$6,300.00 ","$4,095.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,693.50 ","$4,126.50 ", N/A ,"$1,764.00 ","$3,181.50 ", N/A ,"$3,887.10 ", N/A ,"$3,887.10 ","$3,887.10 ", N/A ,"$3,887.10 ", N/A ,"$5,670.00 ","$4,725.00 ", N/A , N/A ,"$5,544.00 ", N/A ,"$4,725.00 ","$4,725.00 ","$5,355.00 ","$5,355.00 ", N/A ,"$5,355.00 ", N/A ,"$4,914.00 ","$4,914.00 ","$4,914.00 ","$5,670.00 ", N/A ,"$5,670.00 ", N/A ,"$6,300.00 ","$4,126.50 ", N/A ,"$2,620.80 ", N/A , N/A , N/A ,"$5,670.00 ", N/A ,"$3,887.10 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,670.00 ","$5,670.00 ", N/A ,"$4,095.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204112,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204113,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204115,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204116,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204117,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204118,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204119,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204120,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204121,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204122,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T22,272,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204123,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T23,272,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204124,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T24,272,1 ,"$5,700.00 ","$3,705.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$4,246.50 ","$3,733.50 ", N/A ,"$1,596.00 ","$2,878.50 ", N/A ,"$3,516.90 ", N/A ,"$3,516.90 ","$3,516.90 ", N/A ,"$3,516.90 ", N/A ,"$5,130.00 ","$4,275.00 ", N/A , N/A ,"$5,016.00 ", N/A ,"$4,275.00 ","$4,275.00 ","$4,845.00 ","$4,845.00 ", N/A ,"$4,845.00 ", N/A ,"$4,446.00 ","$4,446.00 ","$4,446.00 ","$5,130.00 ", N/A ,"$5,130.00 ", N/A ,"$5,700.00 ","$3,733.50 ", N/A ,"$2,371.20 ", N/A , N/A , N/A ,"$5,130.00 ", N/A ,"$3,516.90 ","$1,596.00 ","$5,130.00 ", N/A ,"$5,130.00 ","$5,130.00 ", N/A ,"$3,705.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204125,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T25,272,1 ,"$6,300.00 ","$4,095.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,693.50 ","$4,126.50 ", N/A ,"$1,764.00 ","$3,181.50 ", N/A ,"$3,887.10 ", N/A ,"$3,887.10 ","$3,887.10 ", N/A ,"$3,887.10 ", N/A ,"$5,670.00 ","$4,725.00 ", N/A , N/A ,"$5,544.00 ", N/A ,"$4,725.00 ","$4,725.00 ","$5,355.00 ","$5,355.00 ", N/A ,"$5,355.00 ", N/A ,"$4,914.00 ","$4,914.00 ","$4,914.00 ","$5,670.00 ", N/A ,"$5,670.00 ", N/A ,"$6,300.00 ","$4,126.50 ", N/A ,"$2,620.80 ", N/A , N/A , N/A ,"$5,670.00 ", N/A ,"$3,887.10 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,670.00 ","$5,670.00 ", N/A ,"$4,095.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204126,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T26,272,1 ,"$6,900.00 ","$4,485.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$5,140.50 ","$4,519.50 ", N/A ,"$1,932.00 ","$3,484.50 ", N/A ,"$4,257.30 ", N/A ,"$4,257.30 ","$4,257.30 ", N/A ,"$4,257.30 ", N/A ,"$6,210.00 ","$5,175.00 ", N/A , N/A ,"$6,072.00 ", N/A ,"$5,175.00 ","$5,175.00 ","$5,865.00 ","$5,865.00 ", N/A ,"$5,865.00 ", N/A ,"$5,382.00 ","$5,382.00 ","$5,382.00 ","$6,210.00 ", N/A ,"$6,210.00 ", N/A ,"$6,900.00 ","$4,519.50 ", N/A ,"$2,870.40 ", N/A , N/A , N/A ,"$6,210.00 ", N/A ,"$4,257.30 ","$1,932.00 ","$6,210.00 ", N/A ,"$6,210.00 ","$6,210.00 ", N/A ,"$4,485.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204127,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T27,272,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204131,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T31,272,1 ,"$9,900.00 ","$6,435.00 ","$2,772.00 ","$9,900.00 ", N/A ,"$7,375.50 ","$6,484.50 ", N/A ,"$2,772.00 ","$4,999.50 ", N/A ,"$6,108.30 ", N/A ,"$6,108.30 ","$6,108.30 ", N/A ,"$6,108.30 ", N/A ,"$8,910.00 ","$7,425.00 ", N/A , N/A ,"$8,712.00 ", N/A ,"$7,425.00 ","$7,425.00 ","$8,415.00 ","$8,415.00 ", N/A ,"$8,415.00 ", N/A ,"$7,722.00 ","$7,722.00 ","$7,722.00 ","$8,910.00 ", N/A ,"$8,910.00 ", N/A ,"$9,900.00 ","$6,484.50 ", N/A ,"$4,118.40 ", N/A , N/A , N/A ,"$8,910.00 ", N/A ,"$6,108.30 ","$2,772.00 ","$8,910.00 ", N/A ,"$8,910.00 ","$8,910.00 ", N/A ,"$6,435.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204166,C1760,HC DEVICE VASCULAR CLOSURE T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204167,C1760,HC DEVICE VASCULAR CLOSURE T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204168,C1760,HC DEVICE VASCULAR CLOSURE T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204169,C1760,HC DEVICE VASCULAR CLOSURE T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204170,C1760,HC DEVICE VASCULAR CLOSURE T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204171,C1760,HC DEVICE VASCULAR CLOSURE T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204172,C1760,HC DEVICE VASCULAR CLOSURE T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204173,C1760,HC DEVICE VASCULAR CLOSURE T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204174,C1760,HC DEVICE VASCULAR CLOSURE T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204175,C1760,HC DEVICE VASCULAR CLOSURE T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204177,C1760,HC DEVICE VASCULAR CLOSURE T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204201,C1769,HC GUIDEWIRE GLIDEWIRE T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204218,C1769,HC GUIDEWIRE T1,272,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204219,C1769,HC GUIDEWIRE T2,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204220,C1769,HC GUIDEWIRE T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204221,C1769,HC GUIDEWIRE T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204222,C1769,HC GUIDEWIRE T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204223,C1769,HC GUIDEWIRE T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204224,C1769,HC GUIDEWIRE T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204225,C1769,HC GUIDEWIRE T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204226,C1769,HC GUIDEWIRE T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204227,C1769,HC GUIDEWIRE T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204228,C1769,HC GUIDEWIRE T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204229,C1769,HC GUIDEWIRE T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204230,C1769,HC GUIDEWIRE T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204231,C1769,HC GUIDEWIRE T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204232,C1769,HC GUIDEWIRE T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204251,C1773,HC DEVICE RETRIEVAL INSERTABLE T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204252,C1773,HC DEVICE RETRIEVAL INSERTABLE T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204253,C1773,HC DEVICE RETRIEVAL INSERTABLE T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204254,C1773,HC DEVICE RETRIEVAL INSERTABLE T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204255,C1773,HC DEVICE RETRIEVAL INSERTABLE T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204256,C1773,HC DEVICE RETRIEVAL INSERTABLE T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204257,C1773,HC DEVICE RETRIEVAL INSERTABLE T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204258,C1773,HC DEVICE RETRIEVAL INSERTABLE T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204259,C1773,HC DEVICE RETRIEVAL INSERTABLE T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204260,C1773,HC DEVICE RETRIEVAL INSERTABLE T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204289,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204290,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204291,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204292,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204293,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204294,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204295,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204296,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204297,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204298,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204299,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T22,272,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204326,C1887,HC CATHETER GUIDING T2,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204327,C1887,HC CATHETER GUIDING T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204328,C1887,HC CATHETER GUIDING T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204329,C1887,HC CATHETER GUIDING T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204330,C1887,HC CATHETER GUIDING T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204331,C1887,HC CATHETER GUIDING T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204332,C1887,HC CATHETER GUIDING T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204333,C1887,HC CATHETER GUIDING T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204334,C1887,HC CATHETER GUIDING T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204335,C1887,HC CATHETER GUIDING T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204336,C1887,HC CATHETER GUIDING T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204337,C1887,HC CATHETER GUIDING T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204338,C1887,HC CATHETER GUIDING T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204339,C1887,HC CATHETER GUIDING T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204340,C1887,HC CATHETER GUIDING T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204341,C1887,HC CATHETER GUIDING T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204342,C1887,HC CATHETER GUIDING T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204343,C1887,HC CATHETER GUIDING T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204370,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204371,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204372,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204373,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204374,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204406,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T1,272,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204407,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T2,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204408,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204409,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204410,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204411,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204412,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204413,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204414,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204415,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204416,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204417,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204418,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204419,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204420,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204447,N/A,HC SUTURE T1,272,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204448,N/A,HC SUTURE T2,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204449,N/A,HC SUTURE T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204450,N/A,HC SUTURE T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204451,N/A,HC SURGICAL STERILE SUPPLY T1,272,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204452,N/A,HC SURGICAL STERILE SUPPLY T2,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204453,N/A,HC SURGICAL STERILE SUPPLY T3,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204454,N/A,HC SURGICAL STERILE SUPPLY T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204455,N/A,HC SURGICAL STERILE SUPPLY T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204456,N/A,HC SURGICAL STERILE SUPPLY T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204457,N/A,HC SURGICAL STERILE SUPPLY T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204458,N/A,HC SURGICAL STERILE SUPPLY T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204459,N/A,HC SURGICAL STERILE SUPPLY T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204460,N/A,HC SURGICAL STERILE SUPPLY T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204461,N/A,HC SURGICAL STERILE SUPPLY T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204462,N/A,HC SURGICAL STERILE SUPPLY T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204463,N/A,HC SURGICAL STERILE SUPPLY T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204464,N/A,HC SURGICAL STERILE SUPPLY T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204465,N/A,HC SURGICAL STERILE SUPPLY T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204466,N/A,HC SURGICAL STERILE SUPPLY T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204467,N/A,HC SURGICAL STERILE SUPPLY T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204468,N/A,HC SURGICAL STERILE SUPPLY T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204469,N/A,HC SURGICAL STERILE SUPPLY T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204470,N/A,HC SURGICAL STERILE SUPPLY T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204477,N/A,HC SURGICAL STERILE SUPPLY T27,272,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204551,C1752,HC CATHETER HEMODIALYSIS/PERITONEAL SHORT TERM T7,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204560,C1729,HC CATHETER DRAINAGE T4,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204561,C1729,HC CATHETER DRAINAGE T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204562,C1729,HC CATHETER DRAINAGE T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204563,C1729,HC CATHETER DRAINAGE T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204564,C1729,HC CATHETER DRAINAGE T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204565,C1729,HC CATHETER DRAINAGE T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204566,C1729,HC CATHETER DRAINAGE T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204567,C1729,HC CATHETER DRAINAGE T11,272,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204568,C1729,HC CATHETER DRAINAGE T12,272,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204569,C1729,HC CATHETER DRAINAGE T13,272,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204570,C1729,HC CATHETER DRAINAGE T14,272,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204571,C1729,HC CATHETER DRAINAGE T15,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204572,C1729,HC CATHETER DRAINAGE T16,272,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204573,C1729,HC CATHETER DRAINAGE T17,272,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204575,N/A,HC LARYNGEAL MASK AIRWAY SUPREME,272,1 ,$192.47 ,$125.11 ,$53.89 ,$192.47 , N/A ,$143.39 ,$126.07 , N/A ,$53.89 ,$97.20 , N/A ,$118.75 , N/A ,$118.75 ,$118.75 , N/A ,$118.75 , N/A ,$173.22 ,$144.35 , N/A , N/A ,$169.37 , N/A ,$144.35 ,$144.35 ,$163.60 ,$163.60 , N/A ,$163.60 , N/A ,$150.13 ,$150.13 ,$150.13 ,$173.22 , N/A ,$173.22 , N/A ,$192.47 ,$126.07 , N/A ,$80.07 , N/A , N/A , N/A ,$173.22 , N/A ,$118.75 ,$53.89 ,$173.22 , N/A ,$173.22 ,$173.22 , N/A ,$125.11 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204578,N/A,HC CONNECTOR ANESTHESIA SWIVEL,272,1 ,$1.57 ,$1.02 ,$0.44 ,$1.57 , N/A ,$1.17 ,$1.03 , N/A ,$0.44 ,$0.79 , N/A ,$0.97 , N/A ,$0.97 ,$0.97 , N/A ,$0.97 , N/A ,$1.41 ,$1.18 , N/A , N/A ,$1.38 , N/A ,$1.18 ,$1.18 ,$1.33 ,$1.33 , N/A ,$1.33 , N/A ,$1.22 ,$1.22 ,$1.22 ,$1.41 , N/A ,$1.41 , N/A ,$1.57 ,$1.03 , N/A ,$0.65 , N/A , N/A , N/A ,$1.41 , N/A ,$0.97 ,$0.44 ,$1.41 , N/A ,$1.41 ,$1.41 , N/A ,$1.02 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204579,N/A,HC DIALYZER,272,1 ,$27.30 ,$17.75 ,$7.64 ,$27.30 , N/A ,$20.34 ,$17.88 , N/A ,$7.64 ,$13.79 , N/A ,$16.84 , N/A ,$16.84 ,$16.84 , N/A ,$16.84 , N/A ,$24.57 ,$20.48 , N/A , N/A ,$24.02 , N/A ,$20.48 ,$20.48 ,$23.21 ,$23.21 , N/A ,$23.21 , N/A ,$21.29 ,$21.29 ,$21.29 ,$24.57 , N/A ,$24.57 , N/A ,$27.30 ,$17.88 , N/A ,$11.36 , N/A , N/A , N/A ,$24.57 , N/A ,$16.84 ,$7.64 ,$24.57 , N/A ,$24.57 ,$24.57 , N/A ,$17.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204582,N/A,HC FILTER IV,272,1 ,$8.58 ,$5.58 ,$2.40 ,$8.58 , N/A ,$6.39 ,$5.62 , N/A ,$2.40 ,$4.33 , N/A ,$5.29 , N/A ,$5.29 ,$5.29 , N/A ,$5.29 , N/A ,$7.72 ,$6.44 , N/A , N/A ,$7.55 , N/A ,$6.44 ,$6.44 ,$7.29 ,$7.29 , N/A ,$7.29 , N/A ,$6.69 ,$6.69 ,$6.69 ,$7.72 , N/A ,$7.72 , N/A ,$8.58 ,$5.62 , N/A ,$3.57 , N/A , N/A , N/A ,$7.72 , N/A ,$5.29 ,$2.40 ,$7.72 , N/A ,$7.72 ,$7.72 , N/A ,$5.58 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204583,N/A,HC LARYNGOSCOPE GLIDESCOPE,272,1 ,$24.00 ,$15.60 ,$6.72 ,$24.00 , N/A ,$17.88 ,$15.72 , N/A ,$6.72 ,$12.12 , N/A ,$14.81 , N/A ,$14.81 ,$14.81 , N/A ,$14.81 , N/A ,$21.60 ,$18.00 , N/A , N/A ,$21.12 , N/A ,$18.00 ,$18.00 ,$20.40 ,$20.40 , N/A ,$20.40 , N/A ,$18.72 ,$18.72 ,$18.72 ,$21.60 , N/A ,$21.60 , N/A ,$24.00 ,$15.72 , N/A ,$9.98 , N/A , N/A , N/A ,$21.60 , N/A ,$14.81 ,$6.72 ,$21.60 , N/A ,$21.60 ,$21.60 , N/A ,$15.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204590,N/A,HC PACK C-SECTION,272,1 ,$153.37 ,$99.69 ,$42.94 ,$153.37 , N/A ,$114.26 ,$100.46 , N/A ,$42.94 ,$77.45 , N/A ,$94.63 , N/A ,$94.63 ,$94.63 , N/A ,$94.63 , N/A ,$138.03 ,$115.03 , N/A , N/A ,$134.97 , N/A ,$115.03 ,$115.03 ,$130.36 ,$130.36 , N/A ,$130.36 , N/A ,$119.63 ,$119.63 ,$119.63 ,$138.03 , N/A ,$138.03 , N/A ,$153.37 ,$100.46 , N/A ,$63.80 , N/A , N/A , N/A ,$138.03 , N/A ,$94.63 ,$42.94 ,$138.03 , N/A ,$138.03 ,$138.03 , N/A ,$99.69 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204607,N/A,HC TUBE NASOGASTRIC,272,1 ,$50.16 ,$32.60 ,$14.04 ,$50.16 , N/A ,$37.37 ,$32.85 , N/A ,$14.04 ,$25.33 , N/A ,$30.95 , N/A ,$30.95 ,$30.95 , N/A ,$30.95 , N/A ,$45.14 ,$37.62 , N/A , N/A ,$44.14 , N/A ,$37.62 ,$37.62 ,$42.64 ,$42.64 , N/A ,$42.64 , N/A ,$39.12 ,$39.12 ,$39.12 ,$45.14 , N/A ,$45.14 , N/A ,$50.16 ,$32.85 , N/A ,$20.87 , N/A , N/A , N/A ,$45.14 , N/A ,$30.95 ,$14.04 ,$45.14 , N/A ,$45.14 ,$45.14 , N/A ,$32.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204616,N/A,HC TUBING SUCTION,272,1 ,$35.89 ,$23.33 ,$10.05 ,$35.89 , N/A ,$26.74 ,$23.51 , N/A ,$10.05 ,$18.12 , N/A ,$22.14 , N/A ,$22.14 ,$22.14 , N/A ,$22.14 , N/A ,$32.30 ,$26.92 , N/A , N/A ,$31.58 , N/A ,$26.92 ,$26.92 ,$30.51 ,$30.51 , N/A ,$30.51 , N/A ,$27.99 ,$27.99 ,$27.99 ,$32.30 , N/A ,$32.30 , N/A ,$35.89 ,$23.51 , N/A ,$14.93 , N/A , N/A , N/A ,$32.30 , N/A ,$22.14 ,$10.05 ,$32.30 , N/A ,$32.30 ,$32.30 , N/A ,$23.33 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204622,N/A,HC MARKER BIOPSY SITE,272,1 ,$175.91 ,$114.34 ,$49.25 ,$175.91 , N/A ,$131.05 ,$115.22 , N/A ,$49.25 ,$88.83 , N/A ,$108.54 , N/A ,$108.54 ,$108.54 , N/A ,$108.54 , N/A ,$158.32 ,$131.93 , N/A , N/A ,$154.80 , N/A ,$131.93 ,$131.93 ,$149.52 ,$149.52 , N/A ,$149.52 , N/A ,$137.21 ,$137.21 ,$137.21 ,$158.32 , N/A ,$158.32 , N/A ,$175.91 ,$115.22 , N/A ,$73.18 , N/A , N/A , N/A ,$158.32 , N/A ,$108.54 ,$49.25 ,$158.32 , N/A ,$158.32 ,$158.32 , N/A ,$114.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204623,N/A,HC NEEDLE GUIDE,272,1 ,$32.66 ,$21.23 ,$9.14 ,$32.66 , N/A ,$24.33 ,$21.39 , N/A ,$9.14 ,$16.49 , N/A ,$20.15 , N/A ,$20.15 ,$20.15 , N/A ,$20.15 , N/A ,$29.39 ,$24.50 , N/A , N/A ,$28.74 , N/A ,$24.50 ,$24.50 ,$27.76 ,$27.76 , N/A ,$27.76 , N/A ,$25.47 ,$25.47 ,$25.47 ,$29.39 , N/A ,$29.39 , N/A ,$32.66 ,$21.39 , N/A ,$13.59 , N/A , N/A , N/A ,$29.39 , N/A ,$20.15 ,$9.14 ,$29.39 , N/A ,$29.39 ,$29.39 , N/A ,$21.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204625,N/A,HC TRAY BREAST BIOPSY,272,1 ,$41.69 ,$27.10 ,$11.67 ,$41.69 , N/A ,$31.06 ,$27.31 , N/A ,$11.67 ,$21.05 , N/A ,$25.72 , N/A ,$25.72 ,$25.72 , N/A ,$25.72 , N/A ,$37.52 ,$31.27 , N/A , N/A ,$36.69 , N/A ,$31.27 ,$31.27 ,$35.44 ,$35.44 , N/A ,$35.44 , N/A ,$32.52 ,$32.52 ,$32.52 ,$37.52 , N/A ,$37.52 , N/A ,$41.69 ,$27.31 , N/A ,$17.34 , N/A , N/A , N/A ,$37.52 , N/A ,$25.72 ,$11.67 ,$37.52 , N/A ,$37.52 ,$37.52 , N/A ,$27.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204654,N/A,HC BAG RESUSCITATE INFANT,272,1 ,$33.00 ,$21.45 ,$9.24 ,$33.00 , N/A ,$24.59 ,$21.62 , N/A ,$9.24 ,$16.67 , N/A ,$20.36 , N/A ,$20.36 ,$20.36 , N/A ,$20.36 , N/A ,$29.70 ,$24.75 , N/A , N/A ,$29.04 , N/A ,$24.75 ,$24.75 ,$28.05 ,$28.05 , N/A ,$28.05 , N/A ,$25.74 ,$25.74 ,$25.74 ,$29.70 , N/A ,$29.70 , N/A ,$33.00 ,$21.62 , N/A ,$13.73 , N/A , N/A , N/A ,$29.70 , N/A ,$20.36 ,$9.24 ,$29.70 , N/A ,$29.70 ,$29.70 , N/A ,$21.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204656,N/A,HC BAG RESUSCITOR,272,1 ,$90.70 ,$58.96 ,$25.40 ,$90.70 , N/A ,$67.57 ,$59.41 , N/A ,$25.40 ,$45.80 , N/A ,$55.96 , N/A ,$55.96 ,$55.96 , N/A ,$55.96 , N/A ,$81.63 ,$68.03 , N/A , N/A ,$79.82 , N/A ,$68.03 ,$68.03 ,$77.10 ,$77.10 , N/A ,$77.10 , N/A ,$70.75 ,$70.75 ,$70.75 ,$81.63 , N/A ,$81.63 , N/A ,$90.70 ,$59.41 , N/A ,$37.73 , N/A , N/A , N/A ,$81.63 , N/A ,$55.96 ,$25.40 ,$81.63 , N/A ,$81.63 ,$81.63 , N/A ,$58.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204657,N/A,HC CANISTER V.A.C.,272,1 ,$387.47 ,$251.86 ,$108.49 ,$387.47 , N/A ,$288.67 ,$253.79 , N/A ,$108.49 ,$195.67 , N/A ,$239.07 , N/A ,$239.07 ,$239.07 , N/A ,$239.07 , N/A ,$348.72 ,$290.60 , N/A , N/A ,$340.97 , N/A ,$290.60 ,$290.60 ,$329.35 ,$329.35 , N/A ,$329.35 , N/A ,$302.23 ,$302.23 ,$302.23 ,$348.72 , N/A ,$348.72 , N/A ,$387.47 ,$253.79 , N/A ,$161.19 , N/A , N/A , N/A ,$348.72 , N/A ,$239.07 ,$108.49 ,$348.72 , N/A ,$348.72 ,$348.72 , N/A ,$251.86 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204660,N/A,HC CANNULA NASAL OXYGEN,272,1 ,$23.40 ,$15.21 ,$6.55 ,$23.40 , N/A ,$17.43 ,$15.33 , N/A ,$6.55 ,$11.82 , N/A ,$14.44 , N/A ,$14.44 ,$14.44 , N/A ,$14.44 , N/A ,$21.06 ,$17.55 , N/A , N/A ,$20.59 , N/A ,$17.55 ,$17.55 ,$19.89 ,$19.89 , N/A ,$19.89 , N/A ,$18.25 ,$18.25 ,$18.25 ,$21.06 , N/A ,$21.06 , N/A ,$23.40 ,$15.33 , N/A ,$9.73 , N/A , N/A , N/A ,$21.06 , N/A ,$14.44 ,$6.55 ,$21.06 , N/A ,$21.06 ,$21.06 , N/A ,$15.21 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204675,N/A,HC ELECTRODE ADULT,272,1 ,$7.28 ,$4.73 ,$2.04 ,$7.28 , N/A ,$5.42 ,$4.77 , N/A ,$2.04 ,$3.68 , N/A ,$4.49 , N/A ,$4.49 ,$4.49 , N/A ,$4.49 , N/A ,$6.55 ,$5.46 , N/A , N/A ,$6.41 , N/A ,$5.46 ,$5.46 ,$6.19 ,$6.19 , N/A ,$6.19 , N/A ,$5.68 ,$5.68 ,$5.68 ,$6.55 , N/A ,$6.55 , N/A ,$7.28 ,$4.77 , N/A ,$3.03 , N/A , N/A , N/A ,$6.55 , N/A ,$4.49 ,$2.04 ,$6.55 , N/A ,$6.55 ,$6.55 , N/A ,$4.73 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204707,N/A,HC PAD DEFRIBILLATOR GEL,272,1 ,$21.36 ,$13.88 ,$5.98 ,$21.36 , N/A ,$15.91 ,$13.99 , N/A ,$5.98 ,$10.79 , N/A ,$13.18 , N/A ,$13.18 ,$13.18 , N/A ,$13.18 , N/A ,$19.22 ,$16.02 , N/A , N/A ,$18.80 , N/A ,$16.02 ,$16.02 ,$18.16 ,$18.16 , N/A ,$18.16 , N/A ,$16.66 ,$16.66 ,$16.66 ,$19.22 , N/A ,$19.22 , N/A ,$21.36 ,$13.99 , N/A ,$8.89 , N/A , N/A , N/A ,$19.22 , N/A ,$13.18 ,$5.98 ,$19.22 , N/A ,$19.22 ,$19.22 , N/A ,$13.88 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204737,C1729,HC CATHETER DRAINAGE T18,272,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204738,C1729,HC CATHETER DRAINAGE T19,272,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204739,C1729,HC CATHETER DRAINAGE T20,272,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204740,C1729,HC CATHETER DRAINAGE T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204756,N/A,HC CLIP BREAST BIOPSY,272,1 ,$132.18 ,$85.92 ,$37.01 ,$132.18 , N/A ,$98.47 ,$86.58 , N/A ,$37.01 ,$66.75 , N/A ,$81.56 , N/A ,$81.56 ,$81.56 , N/A ,$81.56 , N/A ,$118.96 ,$99.14 , N/A , N/A ,$116.32 , N/A ,$99.14 ,$99.14 ,$112.35 ,$112.35 , N/A ,$112.35 , N/A ,$103.10 ,$103.10 ,$103.10 ,$118.96 , N/A ,$118.96 , N/A ,$132.18 ,$86.58 , N/A ,$54.99 , N/A , N/A , N/A ,$118.96 , N/A ,$81.56 ,$37.01 ,$118.96 , N/A ,$118.96 ,$118.96 , N/A ,$85.92 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204760,N/A,HC BLANKET BAIR HUGGER,272,1 ,$39.00 ,$25.35 ,$10.92 ,$39.00 , N/A ,$29.06 ,$25.55 , N/A ,$10.92 ,$19.70 , N/A ,$24.06 , N/A ,$24.06 ,$24.06 , N/A ,$24.06 , N/A ,$35.10 ,$29.25 , N/A , N/A ,$34.32 , N/A ,$29.25 ,$29.25 ,$33.15 ,$33.15 , N/A ,$33.15 , N/A ,$30.42 ,$30.42 ,$30.42 ,$35.10 , N/A ,$35.10 , N/A ,$39.00 ,$25.55 , N/A ,$16.22 , N/A , N/A , N/A ,$35.10 , N/A ,$24.06 ,$10.92 ,$35.10 , N/A ,$35.10 ,$35.10 , N/A ,$25.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204771,N/A,HC BLADE LARYNGOSCOPE,272,1 ,$56.70 ,$36.86 ,$15.88 ,$56.70 , N/A ,$42.24 ,$37.14 , N/A ,$15.88 ,$28.63 , N/A ,$34.98 , N/A ,$34.98 ,$34.98 , N/A ,$34.98 , N/A ,$51.03 ,$42.53 , N/A , N/A ,$49.90 , N/A ,$42.53 ,$42.53 ,$48.20 ,$48.20 , N/A ,$48.20 , N/A ,$44.23 ,$44.23 ,$44.23 ,$51.03 , N/A ,$51.03 , N/A ,$56.70 ,$37.14 , N/A ,$23.59 , N/A , N/A , N/A ,$51.03 , N/A ,$34.98 ,$15.88 ,$51.03 , N/A ,$51.03 ,$51.03 , N/A ,$36.86 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204772,N/A,HC BLADE LARYNGEAL,272,1 ,$24.34 ,$15.82 ,$6.82 ,$24.34 , N/A ,$18.13 ,$15.94 , N/A ,$6.82 ,$12.29 , N/A ,$15.02 , N/A ,$15.02 ,$15.02 , N/A ,$15.02 , N/A ,$21.91 ,$18.26 , N/A , N/A ,$21.42 , N/A ,$18.26 ,$18.26 ,$20.69 ,$20.69 , N/A ,$20.69 , N/A ,$18.99 ,$18.99 ,$18.99 ,$21.91 , N/A ,$21.91 , N/A ,$24.34 ,$15.94 , N/A ,$10.13 , N/A , N/A , N/A ,$21.91 , N/A ,$15.02 ,$6.82 ,$21.91 , N/A ,$21.91 ,$21.91 , N/A ,$15.82 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204773,N/A,HC CAUTERY PEN HIGH TEMP,272,1 ,$74.42 ,$48.37 ,$20.84 ,$74.42 , N/A ,$55.44 ,$48.75 , N/A ,$20.84 ,$37.58 , N/A ,$45.92 , N/A ,$45.92 ,$45.92 , N/A ,$45.92 , N/A ,$66.98 ,$55.82 , N/A , N/A ,$65.49 , N/A ,$55.82 ,$55.82 ,$63.26 ,$63.26 , N/A ,$63.26 , N/A ,$58.05 ,$58.05 ,$58.05 ,$66.98 , N/A ,$66.98 , N/A ,$74.42 ,$48.75 , N/A ,$30.96 , N/A , N/A , N/A ,$66.98 , N/A ,$45.92 ,$20.84 ,$66.98 , N/A ,$66.98 ,$66.98 , N/A ,$48.37 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204774,N/A,HC SENSOR OXIMETRY CEREBRAL,272,1 ,$27.00 ,$17.55 ,$7.56 ,$27.00 , N/A ,$20.12 ,$17.69 , N/A ,$7.56 ,$13.64 , N/A ,$16.66 , N/A ,$16.66 ,$16.66 , N/A ,$16.66 , N/A ,$24.30 ,$20.25 , N/A , N/A ,$23.76 , N/A ,$20.25 ,$20.25 ,$22.95 ,$22.95 , N/A ,$22.95 , N/A ,$21.06 ,$21.06 ,$21.06 ,$24.30 , N/A ,$24.30 , N/A ,$27.00 ,$17.69 , N/A ,$11.23 , N/A , N/A , N/A ,$24.30 , N/A ,$16.66 ,$7.56 ,$24.30 , N/A ,$24.30 ,$24.30 , N/A ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204818,N/A,HC COMPRESSION COBAN 2 LAYER,272,1 ,$104.31 ,$67.80 ,$29.21 ,$104.31 , N/A ,$77.71 ,$68.32 , N/A ,$29.21 ,$52.68 , N/A ,$64.36 , N/A ,$64.36 ,$64.36 , N/A ,$64.36 , N/A ,$93.88 ,$78.23 , N/A , N/A ,$91.79 , N/A ,$78.23 ,$78.23 ,$88.66 ,$88.66 , N/A ,$88.66 , N/A ,$81.36 ,$81.36 ,$81.36 ,$93.88 , N/A ,$93.88 , N/A ,$104.31 ,$68.32 , N/A ,$43.39 , N/A , N/A , N/A ,$93.88 , N/A ,$64.36 ,$29.21 ,$93.88 , N/A ,$93.88 ,$93.88 , N/A ,$67.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204819,N/A,HC COMPRESSION WRAP SETOPRESS,272,1 ,$301.56 ,$196.01 ,$84.44 ,$301.56 , N/A ,$224.66 ,$197.52 , N/A ,$84.44 ,$152.29 , N/A ,$186.06 , N/A ,$186.06 ,$186.06 , N/A ,$186.06 , N/A ,$271.40 ,$226.17 , N/A , N/A ,$265.37 , N/A ,$226.17 ,$226.17 ,$256.33 ,$256.33 , N/A ,$256.33 , N/A ,$235.22 ,$235.22 ,$235.22 ,$271.40 , N/A ,$271.40 , N/A ,$301.56 ,$197.52 , N/A ,$125.45 , N/A , N/A , N/A ,$271.40 , N/A ,$186.06 ,$84.44 ,$271.40 , N/A ,$271.40 ,$271.40 , N/A ,$196.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204833,N/A,HC CANNULA NASAL ETCO2 LONG TERM,272,1 ,$45.00 ,$29.25 ,$12.60 ,$45.00 , N/A ,$33.53 ,$29.48 , N/A ,$12.60 ,$22.73 , N/A ,$27.77 , N/A ,$27.77 ,$27.77 , N/A ,$27.77 , N/A ,$40.50 ,$33.75 , N/A , N/A ,$39.60 , N/A ,$33.75 ,$33.75 ,$38.25 ,$38.25 , N/A ,$38.25 , N/A ,$35.10 ,$35.10 ,$35.10 ,$40.50 , N/A ,$40.50 , N/A ,$45.00 ,$29.48 , N/A ,$18.72 , N/A , N/A , N/A ,$40.50 , N/A ,$27.77 ,$12.60 ,$40.50 , N/A ,$40.50 ,$40.50 , N/A ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204858,N/A,HC HEEL PROTECTOR WAFFLE CUSTOM,270,1 ,$235.99 ,$153.39 ,$66.08 ,$235.99 , N/A ,$175.81 ,$154.57 , N/A ,$66.08 ,$119.18 , N/A ,$145.61 , N/A ,$145.61 ,$145.61 , N/A ,$145.61 , N/A ,$212.39 ,$176.99 , N/A , N/A ,$207.67 , N/A ,$176.99 ,$176.99 ,$200.59 ,$200.59 , N/A ,$200.59 , N/A ,$184.07 ,$184.07 ,$184.07 ,$212.39 , N/A ,$212.39 , N/A ,$235.99 ,$154.57 , N/A ,$98.17 , N/A , N/A , N/A ,$212.39 , N/A ,$145.61 ,$66.08 ,$212.39 , N/A ,$212.39 ,$212.39 , N/A ,$153.39 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204859,N/A,HC HEMOSTAT SURGICAL,272,1 ,$883.00 ,$573.95 ,$247.24 ,$883.00 , N/A ,$657.84 ,$578.37 , N/A ,$247.24 ,$445.92 , N/A ,$544.81 , N/A ,$544.81 ,$544.81 , N/A ,$544.81 , N/A ,$794.70 ,$662.25 , N/A , N/A ,$777.04 , N/A ,$662.25 ,$662.25 ,$750.55 ,$750.55 , N/A ,$750.55 , N/A ,$688.74 ,$688.74 ,$688.74 ,$794.70 , N/A ,$794.70 , N/A ,$883.00 ,$578.37 , N/A ,$367.33 , N/A , N/A , N/A ,$794.70 , N/A ,$544.81 ,$247.24 ,$794.70 , N/A ,$794.70 ,$794.70 , N/A ,$573.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204860,N/A,HC HEMOSTAT MATRIX,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204865,N/A,HC INTRODUCER/SHEATH,272,1 ,$4.53 ,$2.94 ,$1.27 ,$4.53 , N/A ,$3.37 ,$2.97 , N/A ,$1.27 ,$2.29 , N/A ,$2.80 , N/A ,$2.80 ,$2.80 , N/A ,$2.80 , N/A ,$4.08 ,$3.40 , N/A , N/A ,$3.99 , N/A ,$3.40 ,$3.40 ,$3.85 ,$3.85 , N/A ,$3.85 , N/A ,$3.53 ,$3.53 ,$3.53 ,$4.08 , N/A ,$4.08 , N/A ,$4.53 ,$2.97 , N/A ,$1.88 , N/A , N/A , N/A ,$4.08 , N/A ,$2.80 ,$1.27 ,$4.08 , N/A ,$4.08 ,$4.08 , N/A ,$2.94 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204866,N/A,HC AIRWAY INTUBATING W/OXYGEN DELIVERY,272,1 ,$145.09 ,$94.31 ,$40.63 ,$145.09 , N/A ,$108.09 ,$95.03 , N/A ,$40.63 ,$73.27 , N/A ,$89.52 , N/A ,$89.52 ,$89.52 , N/A ,$89.52 , N/A ,$130.58 ,$108.82 , N/A , N/A ,$127.68 , N/A ,$108.82 ,$108.82 ,$123.33 ,$123.33 , N/A ,$123.33 , N/A ,$113.17 ,$113.17 ,$113.17 ,$130.58 , N/A ,$130.58 , N/A ,$145.09 ,$95.03 , N/A ,$60.36 , N/A , N/A , N/A ,$130.58 , N/A ,$89.52 ,$40.63 ,$130.58 , N/A ,$130.58 ,$130.58 , N/A ,$94.31 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204869,N/A,HC IV ANGIOCATH,272,1 ,$9.44 ,$6.14 ,$2.64 ,$9.44 , N/A ,$7.03 ,$6.18 , N/A ,$2.64 ,$4.77 , N/A ,$5.82 , N/A ,$5.82 ,$5.82 , N/A ,$5.82 , N/A ,$8.50 ,$7.08 , N/A , N/A ,$8.31 , N/A ,$7.08 ,$7.08 ,$8.02 ,$8.02 , N/A ,$8.02 , N/A ,$7.36 ,$7.36 ,$7.36 ,$8.50 , N/A ,$8.50 , N/A ,$9.44 ,$6.18 , N/A ,$3.93 , N/A , N/A , N/A ,$8.50 , N/A ,$5.82 ,$2.64 ,$8.50 , N/A ,$8.50 ,$8.50 , N/A ,$6.14 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204887,N/A,HC KIT CATHETER FEMALE,272,1 ,$20.78 ,$13.51 ,$5.82 ,$20.78 , N/A ,$15.48 ,$13.61 , N/A ,$5.82 ,$10.49 , N/A ,$12.82 , N/A ,$12.82 ,$12.82 , N/A ,$12.82 , N/A ,$18.70 ,$15.59 , N/A , N/A ,$18.29 , N/A ,$15.59 ,$15.59 ,$17.66 ,$17.66 , N/A ,$17.66 , N/A ,$16.21 ,$16.21 ,$16.21 ,$18.70 , N/A ,$18.70 , N/A ,$20.78 ,$13.61 , N/A ,$8.64 , N/A , N/A , N/A ,$18.70 , N/A ,$12.82 ,$5.82 ,$18.70 , N/A ,$18.70 ,$18.70 , N/A ,$13.51 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204936,N/A,HC NEEDLE NERVE BLOCK ECHOGENIC,272,1 ,$119.74 ,$77.83 ,$33.53 ,$119.74 , N/A ,$89.21 ,$78.43 , N/A ,$33.53 ,$60.47 , N/A ,$73.88 , N/A ,$73.88 ,$73.88 , N/A ,$73.88 , N/A ,$107.77 ,$89.81 , N/A , N/A ,$105.37 , N/A ,$89.81 ,$89.81 ,$101.78 ,$101.78 , N/A ,$101.78 , N/A ,$93.40 ,$93.40 ,$93.40 ,$107.77 , N/A ,$107.77 , N/A ,$119.74 ,$78.43 , N/A ,$49.81 , N/A , N/A , N/A ,$107.77 , N/A ,$73.88 ,$33.53 ,$107.77 , N/A ,$107.77 ,$107.77 , N/A ,$77.83 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204941,N/A,HC NEEDLE EPIDURAL,272,1 ,$22.53 ,$14.64 ,$6.31 ,$22.53 , N/A ,$16.78 ,$14.76 , N/A ,$6.31 ,$11.38 , N/A ,$13.90 , N/A ,$13.90 ,$13.90 , N/A ,$13.90 , N/A ,$20.28 ,$16.90 , N/A , N/A ,$19.83 , N/A ,$16.90 ,$16.90 ,$19.15 ,$19.15 , N/A ,$19.15 , N/A ,$17.57 ,$17.57 ,$17.57 ,$20.28 , N/A ,$20.28 , N/A ,$22.53 ,$14.76 , N/A ,$9.37 , N/A , N/A , N/A ,$20.28 , N/A ,$13.90 ,$6.31 ,$20.28 , N/A ,$20.28 ,$20.28 , N/A ,$14.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204948,N/A,HC NEEDLE MONOPTY,272,1 ,$41.36 ,$26.88 ,$11.58 ,$41.36 , N/A ,$30.81 ,$27.09 , N/A ,$11.58 ,$20.89 , N/A ,$25.52 , N/A ,$25.52 ,$25.52 , N/A ,$25.52 , N/A ,$37.22 ,$31.02 , N/A , N/A ,$36.40 , N/A ,$31.02 ,$31.02 ,$35.16 ,$35.16 , N/A ,$35.16 , N/A ,$32.26 ,$32.26 ,$32.26 ,$37.22 , N/A ,$37.22 , N/A ,$41.36 ,$27.09 , N/A ,$17.21 , N/A , N/A , N/A ,$37.22 , N/A ,$25.52 ,$11.58 ,$37.22 , N/A ,$37.22 ,$37.22 , N/A ,$26.88 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204949,N/A,HC HOLDER ENDOTRACH NEOBAR,272,1 ,$81.14 ,$52.74 ,$22.72 ,$81.14 , N/A ,$60.45 ,$53.15 , N/A ,$22.72 ,$40.98 , N/A ,$50.06 , N/A ,$50.06 ,$50.06 , N/A ,$50.06 , N/A ,$73.03 ,$60.86 , N/A , N/A ,$71.40 , N/A ,$60.86 ,$60.86 ,$68.97 ,$68.97 , N/A ,$68.97 , N/A ,$63.29 ,$63.29 ,$63.29 ,$73.03 , N/A ,$73.03 , N/A ,$81.14 ,$53.15 , N/A ,$33.75 , N/A , N/A , N/A ,$73.03 , N/A ,$50.06 ,$22.72 ,$73.03 , N/A ,$73.03 ,$73.03 , N/A ,$52.74 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204965,N/A,HC OSTOMY CONE IRRIGATOR KIT,272,1 ,$15.48 ,$10.06 ,$4.33 ,$15.48 , N/A ,$11.53 ,$10.14 , N/A ,$4.33 ,$7.82 , N/A ,$9.55 , N/A ,$9.55 ,$9.55 , N/A ,$9.55 , N/A ,$13.93 ,$11.61 , N/A , N/A ,$13.62 , N/A ,$11.61 ,$11.61 ,$13.16 ,$13.16 , N/A ,$13.16 , N/A ,$12.07 ,$12.07 ,$12.07 ,$13.93 , N/A ,$13.93 , N/A ,$15.48 ,$10.14 , N/A ,$6.44 , N/A , N/A , N/A ,$13.93 , N/A ,$9.55 ,$4.33 ,$13.93 , N/A ,$13.93 ,$13.93 , N/A ,$10.06 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204988,N/A,HC BAG INFUSION PRESSURE,272,1 ,$192.00 ,$124.80 ,$53.76 ,$192.00 , N/A ,$143.04 ,$125.76 , N/A ,$53.76 ,$96.96 , N/A ,$118.46 , N/A ,$118.46 ,$118.46 , N/A ,$118.46 , N/A ,$172.80 ,$144.00 , N/A , N/A ,$168.96 , N/A ,$144.00 ,$144.00 ,$163.20 ,$163.20 , N/A ,$163.20 , N/A ,$149.76 ,$149.76 ,$149.76 ,$172.80 , N/A ,$172.80 , N/A ,$192.00 ,$125.76 , N/A ,$79.87 , N/A , N/A , N/A ,$172.80 , N/A ,$118.46 ,$53.76 ,$172.80 , N/A ,$172.80 ,$172.80 , N/A ,$124.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204996,N/A,HC PROBE TEMP SENSOR,272,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27204999,N/A,HC SENSOR PULSE OX,272,1 ,$129.41 ,$84.12 ,$36.23 ,$129.41 , N/A ,$96.41 ,$84.76 , N/A ,$36.23 ,$65.35 , N/A ,$79.85 , N/A ,$79.85 ,$79.85 , N/A ,$79.85 , N/A ,$116.47 ,$97.06 , N/A , N/A ,$113.88 , N/A ,$97.06 ,$97.06 ,$110.00 ,$110.00 , N/A ,$110.00 , N/A ,$100.94 ,$100.94 ,$100.94 ,$116.47 , N/A ,$116.47 , N/A ,$129.41 ,$84.76 , N/A ,$53.83 , N/A , N/A , N/A ,$116.47 , N/A ,$79.85 ,$36.23 ,$116.47 , N/A ,$116.47 ,$116.47 , N/A ,$84.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205010,N/A,HC VALVE ANTI-REFLUX SALEM,272,1 ,$57.41 ,$37.32 ,$16.07 ,$57.41 , N/A ,$42.77 ,$37.60 , N/A ,$16.07 ,$28.99 , N/A ,$35.42 , N/A ,$35.42 ,$35.42 , N/A ,$35.42 , N/A ,$51.67 ,$43.06 , N/A , N/A ,$50.52 , N/A ,$43.06 ,$43.06 ,$48.80 ,$48.80 , N/A ,$48.80 , N/A ,$44.78 ,$44.78 ,$44.78 ,$51.67 , N/A ,$51.67 , N/A ,$57.41 ,$37.60 , N/A ,$23.88 , N/A , N/A , N/A ,$51.67 , N/A ,$35.42 ,$16.07 ,$51.67 , N/A ,$51.67 ,$51.67 , N/A ,$37.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205019,N/A,HC PROTECTOR SHEEPSKIN,272,1 ,$58.00 ,$37.70 ,$16.24 ,$58.00 , N/A ,$43.21 ,$37.99 , N/A ,$16.24 ,$29.29 , N/A ,$35.79 , N/A ,$35.79 ,$35.79 , N/A ,$35.79 , N/A ,$52.20 ,$43.50 , N/A , N/A ,$51.04 , N/A ,$43.50 ,$43.50 ,$49.30 ,$49.30 , N/A ,$49.30 , N/A ,$45.24 ,$45.24 ,$45.24 ,$52.20 , N/A ,$52.20 , N/A ,$58.00 ,$37.99 , N/A ,$24.13 , N/A , N/A , N/A ,$52.20 , N/A ,$35.79 ,$16.24 ,$52.20 , N/A ,$52.20 ,$52.20 , N/A ,$37.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205026,N/A,HC SPLINT CAST CONFORMABLE MEDIUM,272,1 ,$31.00 ,$20.15 ,$8.68 ,$31.00 , N/A ,$23.10 ,$20.31 , N/A ,$8.68 ,$15.66 , N/A ,$19.13 , N/A ,$19.13 ,$19.13 , N/A ,$19.13 , N/A ,$27.90 ,$23.25 , N/A , N/A ,$27.28 , N/A ,$23.25 ,$23.25 ,$26.35 ,$26.35 , N/A ,$26.35 , N/A ,$24.18 ,$24.18 ,$24.18 ,$27.90 , N/A ,$27.90 , N/A ,$31.00 ,$20.31 , N/A ,$12.90 , N/A , N/A , N/A ,$27.90 , N/A ,$19.13 ,$8.68 ,$27.90 , N/A ,$27.90 ,$27.90 , N/A ,$20.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205034,N/A,HC SET INFUSION SUBCUTANEOUS,272,1 ,$62.81 ,$40.83 ,$17.59 ,$62.81 , N/A ,$46.79 ,$41.14 , N/A ,$17.59 ,$31.72 , N/A ,$38.75 , N/A ,$38.75 ,$38.75 , N/A ,$38.75 , N/A ,$56.53 ,$47.11 , N/A , N/A ,$55.27 , N/A ,$47.11 ,$47.11 ,$53.39 ,$53.39 , N/A ,$53.39 , N/A ,$48.99 ,$48.99 ,$48.99 ,$56.53 , N/A ,$56.53 , N/A ,$62.81 ,$41.14 , N/A ,$26.13 , N/A , N/A , N/A ,$56.53 , N/A ,$38.75 ,$17.59 ,$56.53 , N/A ,$56.53 ,$56.53 , N/A ,$40.83 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205046,N/A,HC SYRINGE ATOMIZER MUCOSAL,272,1 ,$26.91 ,$17.49 ,$7.53 ,$26.91 , N/A ,$20.05 ,$17.63 , N/A ,$7.53 ,$13.59 , N/A ,$16.60 , N/A ,$16.60 ,$16.60 , N/A ,$16.60 , N/A ,$24.22 ,$20.18 , N/A , N/A ,$23.68 , N/A ,$20.18 ,$20.18 ,$22.87 ,$22.87 , N/A ,$22.87 , N/A ,$20.99 ,$20.99 ,$20.99 ,$24.22 , N/A ,$24.22 , N/A ,$26.91 ,$17.63 , N/A ,$11.19 , N/A , N/A , N/A ,$24.22 , N/A ,$16.60 ,$7.53 ,$24.22 , N/A ,$24.22 ,$24.22 , N/A ,$17.49 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205059,N/A,HC TRAY HYSTEROSALPINGOGRAM,272,1 ,$97.86 ,$63.61 ,$27.40 ,$97.86 , N/A ,$72.91 ,$64.10 , N/A ,$27.40 ,$49.42 , N/A ,$60.38 , N/A ,$60.38 ,$60.38 , N/A ,$60.38 , N/A ,$88.07 ,$73.40 , N/A , N/A ,$86.12 , N/A ,$73.40 ,$73.40 ,$83.18 ,$83.18 , N/A ,$83.18 , N/A ,$76.33 ,$76.33 ,$76.33 ,$88.07 , N/A ,$88.07 , N/A ,$97.86 ,$64.10 , N/A ,$40.71 , N/A , N/A , N/A ,$88.07 , N/A ,$60.38 ,$27.40 ,$88.07 , N/A ,$88.07 ,$88.07 , N/A ,$63.61 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205060,N/A,HC TRAY PICC LINE,272,1 ,$109.75 ,$71.34 ,$30.73 ,$109.75 , N/A ,$81.76 ,$71.89 , N/A ,$30.73 ,$55.42 , N/A ,$67.72 , N/A ,$67.72 ,$67.72 , N/A ,$67.72 , N/A ,$98.78 ,$82.31 , N/A , N/A ,$96.58 , N/A ,$82.31 ,$82.31 ,$93.29 ,$93.29 , N/A ,$93.29 , N/A ,$85.61 ,$85.61 ,$85.61 ,$98.78 , N/A ,$98.78 , N/A ,$109.75 ,$71.89 , N/A ,$45.66 , N/A , N/A , N/A ,$98.78 , N/A ,$67.72 ,$30.73 ,$98.78 , N/A ,$98.78 ,$98.78 , N/A ,$71.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205074,N/A,HC TUBE TRACH,272,1 ,$372.48 ,$242.11 ,$104.29 ,$372.48 , N/A ,$277.50 ,$243.97 , N/A ,$104.29 ,$188.10 , N/A ,$229.82 , N/A ,$229.82 ,$229.82 , N/A ,$229.82 , N/A ,$335.23 ,$279.36 , N/A , N/A ,$327.78 , N/A ,$279.36 ,$279.36 ,$316.61 ,$316.61 , N/A ,$316.61 , N/A ,$290.53 ,$290.53 ,$290.53 ,$335.23 , N/A ,$335.23 , N/A ,$372.48 ,$243.97 , N/A ,$154.95 , N/A , N/A , N/A ,$335.23 , N/A ,$229.82 ,$104.29 ,$335.23 , N/A ,$335.23 ,$335.23 , N/A ,$242.11 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205078,N/A,HC TUBE RECTAL,272,1 ,$141.94 ,$92.26 ,$39.74 ,$141.94 , N/A ,$105.75 ,$92.97 , N/A ,$39.74 ,$71.68 , N/A ,$87.58 , N/A ,$87.58 ,$87.58 , N/A ,$87.58 , N/A ,$127.75 ,$106.46 , N/A , N/A ,$124.91 , N/A ,$106.46 ,$106.46 ,$120.65 ,$120.65 , N/A ,$120.65 , N/A ,$110.71 ,$110.71 ,$110.71 ,$127.75 , N/A ,$127.75 , N/A ,$141.94 ,$92.97 , N/A ,$59.05 , N/A , N/A , N/A ,$127.75 , N/A ,$87.58 ,$39.74 ,$127.75 , N/A ,$127.75 ,$127.75 , N/A ,$92.26 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205083,N/A,HC TUBING BLOOD WARMING,272,1 ,$179.63 ,$116.76 ,$50.30 ,$179.63 , N/A ,$133.82 ,$117.66 , N/A ,$50.30 ,$90.71 , N/A ,$110.83 , N/A ,$110.83 ,$110.83 , N/A ,$110.83 , N/A ,$161.67 ,$134.72 , N/A , N/A ,$158.07 , N/A ,$134.72 ,$134.72 ,$152.69 ,$152.69 , N/A ,$152.69 , N/A ,$140.11 ,$140.11 ,$140.11 ,$161.67 , N/A ,$161.67 , N/A ,$179.63 ,$117.66 , N/A ,$74.73 , N/A , N/A , N/A ,$161.67 , N/A ,$110.83 ,$50.30 ,$161.67 , N/A ,$161.67 ,$161.67 , N/A ,$116.76 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205086,N/A,HC CANISTER WOUND VAC,272,1 ,$69.15 ,$44.95 ,$19.36 ,$69.15 , N/A ,$51.52 ,$45.29 , N/A ,$19.36 ,$34.92 , N/A ,$42.67 , N/A ,$42.67 ,$42.67 , N/A ,$42.67 , N/A ,$62.24 ,$51.86 , N/A , N/A ,$60.85 , N/A ,$51.86 ,$51.86 ,$58.78 ,$58.78 , N/A ,$58.78 , N/A ,$53.94 ,$53.94 ,$53.94 ,$62.24 , N/A ,$62.24 , N/A ,$69.15 ,$45.29 , N/A ,$28.77 , N/A , N/A , N/A ,$62.24 , N/A ,$42.67 ,$19.36 ,$62.24 , N/A ,$62.24 ,$62.24 , N/A ,$44.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205091,N/A,HC KIT DRESSING WOUND VAC PREVENA PEEL N PLACE,272,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205111,N/A,HC DRESSING HYDROFERA BLUE,272,1 ,$18.09 ,$11.76 ,$5.07 ,$18.09 , N/A ,$13.48 ,$11.85 , N/A ,$5.07 ,$9.14 , N/A ,$11.16 , N/A ,$11.16 ,$11.16 , N/A ,$11.16 , N/A ,$16.28 ,$13.57 , N/A , N/A ,$15.92 , N/A ,$13.57 ,$13.57 ,$15.38 ,$15.38 , N/A ,$15.38 , N/A ,$14.11 ,$14.11 ,$14.11 ,$16.28 , N/A ,$16.28 , N/A ,$18.09 ,$11.85 , N/A ,$7.53 , N/A , N/A , N/A ,$16.28 , N/A ,$11.16 ,$5.07 ,$16.28 , N/A ,$16.28 ,$16.28 , N/A ,$11.76 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205181,N/A,HC STRYKER AIR 2 MATTRESS OVERLAY,272,1 ,$111.00 ,$72.15 ,$31.08 ,$111.00 , N/A ,$82.70 ,$72.71 , N/A ,$31.08 ,$56.06 , N/A ,$68.49 , N/A ,$68.49 ,$68.49 , N/A ,$68.49 , N/A ,$99.90 ,$83.25 , N/A , N/A ,$97.68 , N/A ,$83.25 ,$83.25 ,$94.35 ,$94.35 , N/A ,$94.35 , N/A ,$86.58 ,$86.58 ,$86.58 ,$99.90 , N/A ,$99.90 , N/A ,$111.00 ,$72.71 , N/A ,$46.18 , N/A , N/A , N/A ,$99.90 , N/A ,$68.49 ,$31.08 ,$99.90 , N/A ,$99.90 ,$99.90 , N/A ,$72.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205201,N/A,HC SUTURE T5,272,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205202,N/A,HC SUTURE T6,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205203,N/A,HC SUTURE T7,272,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205204,N/A,HC SUTURE T8,272,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205205,N/A,HC SUTURE T9,272,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205206,N/A,HC SUTURE T10,272,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205250,N/A,HC DEVICE FASTENER CATHETER,272,1 ,$47.87 ,$31.12 ,$13.40 ,$47.87 , N/A ,$35.66 ,$31.35 , N/A ,$13.40 ,$24.17 , N/A ,$29.54 , N/A ,$29.54 ,$29.54 , N/A ,$29.54 , N/A ,$43.08 ,$35.90 , N/A , N/A ,$42.13 , N/A ,$35.90 ,$35.90 ,$40.69 ,$40.69 , N/A ,$40.69 , N/A ,$37.34 ,$37.34 ,$37.34 ,$43.08 , N/A ,$43.08 , N/A ,$47.87 ,$31.35 , N/A ,$19.91 , N/A , N/A , N/A ,$43.08 , N/A ,$29.54 ,$13.40 ,$43.08 , N/A ,$43.08 ,$43.08 , N/A ,$31.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205255,C1729,HC CATHETER MULTIPURPOSE,272,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205267,N/A,HC SYSTEM CIRCUIT BREATHING W/NEB KIT,272,1 ,$63.60 ,$41.34 ,$17.81 ,$63.60 , N/A ,$47.38 ,$41.66 , N/A ,$17.81 ,$32.12 , N/A ,$39.24 , N/A ,$39.24 ,$39.24 , N/A ,$39.24 , N/A ,$57.24 ,$47.70 , N/A , N/A ,$55.97 , N/A ,$47.70 ,$47.70 ,$54.06 ,$54.06 , N/A ,$54.06 , N/A ,$49.61 ,$49.61 ,$49.61 ,$57.24 , N/A ,$57.24 , N/A ,$63.60 ,$41.66 , N/A ,$26.46 , N/A , N/A , N/A ,$57.24 , N/A ,$39.24 ,$17.81 ,$57.24 , N/A ,$57.24 ,$57.24 , N/A ,$41.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205278,N/A,HC ADAPTER URETERAL DRAINAGE,272,1 ,$286.14 ,$185.99 ,$80.12 ,$286.14 , N/A ,$213.17 ,$187.42 , N/A ,$80.12 ,$144.50 , N/A ,$176.55 , N/A ,$176.55 ,$176.55 , N/A ,$176.55 , N/A ,$257.53 ,$214.61 , N/A , N/A ,$251.80 , N/A ,$214.61 ,$214.61 ,$243.22 ,$243.22 , N/A ,$243.22 , N/A ,$223.19 ,$223.19 ,$223.19 ,$257.53 , N/A ,$257.53 , N/A ,$286.14 ,$187.42 , N/A ,$119.03 , N/A , N/A , N/A ,$257.53 , N/A ,$176.55 ,$80.12 ,$257.53 , N/A ,$257.53 ,$257.53 , N/A ,$185.99 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205280,N/A,HC ADAPTER VENTILATOR,272,1 ,$18.83 ,$12.24 ,$5.27 ,$18.83 , N/A ,$14.03 ,$12.33 , N/A ,$5.27 ,$9.51 , N/A ,$11.62 , N/A ,$11.62 ,$11.62 , N/A ,$11.62 , N/A ,$16.95 ,$14.12 , N/A , N/A ,$16.57 , N/A ,$14.12 ,$14.12 ,$16.01 ,$16.01 , N/A ,$16.01 , N/A ,$14.69 ,$14.69 ,$14.69 ,$16.95 , N/A ,$16.95 , N/A ,$18.83 ,$12.33 , N/A ,$7.83 , N/A , N/A , N/A ,$16.95 , N/A ,$11.62 ,$5.27 ,$16.95 , N/A ,$16.95 ,$16.95 , N/A ,$12.24 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205281,N/A,HC ADAPTER Y,272,1 ,$68.44 ,$44.49 ,$19.16 ,$68.44 , N/A ,$50.99 ,$44.83 , N/A ,$19.16 ,$34.56 , N/A ,$42.23 , N/A ,$42.23 ,$42.23 , N/A ,$42.23 , N/A ,$61.60 ,$51.33 , N/A , N/A ,$60.23 , N/A ,$51.33 ,$51.33 ,$58.17 ,$58.17 , N/A ,$58.17 , N/A ,$53.38 ,$53.38 ,$53.38 ,$61.60 , N/A ,$61.60 , N/A ,$68.44 ,$44.83 , N/A ,$28.47 , N/A , N/A , N/A ,$61.60 , N/A ,$42.23 ,$19.16 ,$61.60 , N/A ,$61.60 ,$61.60 , N/A ,$44.49 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205284,N/A,HC APPLICATOR SEPP,272,1 ,$12.34 ,$8.02 ,$3.46 ,$12.34 , N/A ,$9.19 ,$8.08 , N/A ,$3.46 ,$6.23 , N/A ,$7.61 , N/A ,$7.61 ,$7.61 , N/A ,$7.61 , N/A ,$11.11 ,$9.26 , N/A , N/A ,$10.86 , N/A ,$9.26 ,$9.26 ,$10.49 ,$10.49 , N/A ,$10.49 , N/A ,$9.63 ,$9.63 ,$9.63 ,$11.11 , N/A ,$11.11 , N/A ,$12.34 ,$8.08 , N/A ,$5.13 , N/A , N/A , N/A ,$11.11 , N/A ,$7.61 ,$3.46 ,$11.11 , N/A ,$11.11 ,$11.11 , N/A ,$8.02 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205285,N/A,HC DRESSING ARTIFLEX,272,1 ,$5.51 ,$3.58 ,$1.54 ,$5.51 , N/A ,$4.11 ,$3.61 , N/A ,$1.54 ,$2.78 , N/A ,$3.40 , N/A ,$3.40 ,$3.40 , N/A ,$3.40 , N/A ,$4.96 ,$4.13 , N/A , N/A ,$4.85 , N/A ,$4.13 ,$4.13 ,$4.68 ,$4.68 , N/A ,$4.68 , N/A ,$4.30 ,$4.30 ,$4.30 ,$4.96 , N/A ,$4.96 , N/A ,$5.51 ,$3.61 , N/A ,$2.29 , N/A , N/A , N/A ,$4.96 , N/A ,$3.40 ,$1.54 ,$4.96 , N/A ,$4.96 ,$4.96 , N/A ,$3.58 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205286,N/A,HC BAG INFUSION PRESSURE SMALL,272,1 ,$107.00 ,$69.55 ,$29.96 ,$107.00 , N/A ,$79.72 ,$70.09 , N/A ,$29.96 ,$54.04 , N/A ,$66.02 , N/A ,$66.02 ,$66.02 , N/A ,$66.02 , N/A ,$96.30 ,$80.25 , N/A , N/A ,$94.16 , N/A ,$80.25 ,$80.25 ,$90.95 ,$90.95 , N/A ,$90.95 , N/A ,$83.46 ,$83.46 ,$83.46 ,$96.30 , N/A ,$96.30 , N/A ,$107.00 ,$70.09 , N/A ,$44.51 , N/A , N/A , N/A ,$96.30 , N/A ,$66.02 ,$29.96 ,$96.30 , N/A ,$96.30 ,$96.30 , N/A ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205296,C1729,HC CATHETER URETHRAL SPIRAL TIP,272,1 ,$538.75 ,$350.19 ,$150.85 ,$538.75 , N/A ,$401.37 ,$352.88 , N/A ,$150.85 ,$272.07 , N/A ,$332.41 , N/A ,$332.41 ,$332.41 , N/A ,$332.41 , N/A ,$484.88 ,$404.06 , N/A , N/A ,$474.10 , N/A ,$404.06 ,$404.06 ,$457.94 ,$457.94 , N/A ,$457.94 , N/A ,$420.23 ,$420.23 ,$420.23 ,$484.88 , N/A ,$484.88 , N/A ,$538.75 ,$352.88 , N/A ,$224.12 , N/A , N/A , N/A ,$484.88 , N/A ,$332.41 ,$150.85 ,$484.88 , N/A ,$484.88 ,$484.88 , N/A ,$350.19 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205297,C1758,HC CATHETER URETERAL FLEXI-TIP,272,1 ,$150.78 ,$98.01 ,$42.22 ,$150.78 , N/A ,$112.33 ,$98.76 , N/A ,$42.22 ,$76.14 , N/A ,$93.03 , N/A ,$93.03 ,$93.03 , N/A ,$93.03 , N/A ,$135.70 ,$113.09 , N/A , N/A ,$132.69 , N/A ,$113.09 ,$113.09 ,$128.16 ,$128.16 , N/A ,$128.16 , N/A ,$117.61 ,$117.61 ,$117.61 ,$135.70 , N/A ,$135.70 , N/A ,$150.78 ,$98.76 , N/A ,$62.72 , N/A , N/A , N/A ,$135.70 , N/A ,$93.03 ,$42.22 ,$135.70 , N/A ,$135.70 ,$135.70 , N/A ,$98.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205298,N/A,HC CATHETER FOLEY COUDE,272,1 ,$112.86 ,$73.36 ,$31.60 ,$112.86 , N/A ,$84.08 ,$73.92 , N/A ,$31.60 ,$56.99 , N/A ,$69.63 , N/A ,$69.63 ,$69.63 , N/A ,$69.63 , N/A ,$101.57 ,$84.65 , N/A , N/A ,$99.32 , N/A ,$84.65 ,$84.65 ,$95.93 ,$95.93 , N/A ,$95.93 , N/A ,$88.03 ,$88.03 ,$88.03 ,$101.57 , N/A ,$101.57 , N/A ,$112.86 ,$73.92 , N/A ,$46.95 , N/A , N/A , N/A ,$101.57 , N/A ,$69.63 ,$31.60 ,$101.57 , N/A ,$101.57 ,$101.57 , N/A ,$73.36 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205299,C1726,HC CATHETER DILATION FOLLOWER,272,1 ,$291.69 ,$189.60 ,$81.67 ,$291.69 , N/A ,$217.31 ,$191.06 , N/A ,$81.67 ,$147.30 , N/A ,$179.97 , N/A ,$179.97 ,$179.97 , N/A ,$179.97 , N/A ,$262.52 ,$218.77 , N/A , N/A ,$256.69 , N/A ,$218.77 ,$218.77 ,$247.94 ,$247.94 , N/A ,$247.94 , N/A ,$227.52 ,$227.52 ,$227.52 ,$262.52 , N/A ,$262.52 , N/A ,$291.69 ,$191.06 , N/A ,$121.34 , N/A , N/A , N/A ,$262.52 , N/A ,$179.97 ,$81.67 ,$262.52 , N/A ,$262.52 ,$262.52 , N/A ,$189.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205300,N/A,HC CAUTERY PEN LOW TEMP,272,1 ,$63.70 ,$41.41 ,$17.84 ,$63.70 , N/A ,$47.46 ,$41.72 , N/A ,$17.84 ,$32.17 , N/A ,$39.30 , N/A ,$39.30 ,$39.30 , N/A ,$39.30 , N/A ,$57.33 ,$47.78 , N/A , N/A ,$56.06 , N/A ,$47.78 ,$47.78 ,$54.15 ,$54.15 , N/A ,$54.15 , N/A ,$49.69 ,$49.69 ,$49.69 ,$57.33 , N/A ,$57.33 , N/A ,$63.70 ,$41.72 , N/A ,$26.50 , N/A , N/A , N/A ,$57.33 , N/A ,$39.30 ,$17.84 ,$57.33 , N/A ,$57.33 ,$57.33 , N/A ,$41.41 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205308,N/A,HC TUBING LUER LOCK,272,1 ,$62.00 ,$40.30 ,$17.36 ,$62.00 , N/A ,$46.19 ,$40.61 , N/A ,$17.36 ,$31.31 , N/A ,$38.25 , N/A ,$38.25 ,$38.25 , N/A ,$38.25 , N/A ,$55.80 ,$46.50 , N/A , N/A ,$54.56 , N/A ,$46.50 ,$46.50 ,$52.70 ,$52.70 , N/A ,$52.70 , N/A ,$48.36 ,$48.36 ,$48.36 ,$55.80 , N/A ,$55.80 , N/A ,$62.00 ,$40.61 , N/A ,$25.79 , N/A , N/A , N/A ,$55.80 , N/A ,$38.25 ,$17.36 ,$55.80 , N/A ,$55.80 ,$55.80 , N/A ,$40.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205309,N/A,HC NEEDLE BLUNT HAWKINS,272,1 ,$95.09 ,$61.81 ,$26.63 ,$95.09 , N/A ,$70.84 ,$62.28 , N/A ,$26.63 ,$48.02 , N/A ,$58.67 , N/A ,$58.67 ,$58.67 , N/A ,$58.67 , N/A ,$85.58 ,$71.32 , N/A , N/A ,$83.68 , N/A ,$71.32 ,$71.32 ,$80.83 ,$80.83 , N/A ,$80.83 , N/A ,$74.17 ,$74.17 ,$74.17 ,$85.58 , N/A ,$85.58 , N/A ,$95.09 ,$62.28 , N/A ,$39.56 , N/A , N/A , N/A ,$85.58 , N/A ,$58.67 ,$26.63 ,$85.58 , N/A ,$85.58 ,$85.58 , N/A ,$61.81 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205311,N/A,HC KIT HOLTER MONITOR,272,1 ,$39.72 ,$25.82 ,$11.12 ,$39.72 , N/A ,$29.59 ,$26.02 , N/A ,$11.12 ,$20.06 , N/A ,$24.51 , N/A ,$24.51 ,$24.51 , N/A ,$24.51 , N/A ,$35.75 ,$29.79 , N/A , N/A ,$34.95 , N/A ,$29.79 ,$29.79 ,$33.76 ,$33.76 , N/A ,$33.76 , N/A ,$30.98 ,$30.98 ,$30.98 ,$35.75 , N/A ,$35.75 , N/A ,$39.72 ,$26.02 , N/A ,$16.52 , N/A , N/A , N/A ,$35.75 , N/A ,$24.51 ,$11.12 ,$35.75 , N/A ,$35.75 ,$35.75 , N/A ,$25.82 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205314,N/A,HC KIT RT APNEA MONITORING,272,1 ,$25.38 ,$16.50 ,$7.11 ,$25.38 , N/A ,$18.91 ,$16.62 , N/A ,$7.11 ,$12.82 , N/A ,$15.66 , N/A ,$15.66 ,$15.66 , N/A ,$15.66 , N/A ,$22.84 ,$19.04 , N/A , N/A ,$22.33 , N/A ,$19.04 ,$19.04 ,$21.57 ,$21.57 , N/A ,$21.57 , N/A ,$19.80 ,$19.80 ,$19.80 ,$22.84 , N/A ,$22.84 , N/A ,$25.38 ,$16.62 , N/A ,$10.56 , N/A , N/A , N/A ,$22.84 , N/A ,$15.66 ,$7.11 ,$22.84 , N/A ,$22.84 ,$22.84 , N/A ,$16.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205315,N/A,HC KIT RT NONINVASIVE VENT,272,1 ,$108.16 ,$70.30 ,$30.28 ,$108.16 , N/A ,$80.58 ,$70.84 , N/A ,$30.28 ,$54.62 , N/A ,$66.73 , N/A ,$66.73 ,$66.73 , N/A ,$66.73 , N/A ,$97.34 ,$81.12 , N/A , N/A ,$95.18 , N/A ,$81.12 ,$81.12 ,$91.94 ,$91.94 , N/A ,$91.94 , N/A ,$84.36 ,$84.36 ,$84.36 ,$97.34 , N/A ,$97.34 , N/A ,$108.16 ,$70.84 , N/A ,$44.99 , N/A , N/A , N/A ,$97.34 , N/A ,$66.73 ,$30.28 ,$97.34 , N/A ,$97.34 ,$97.34 , N/A ,$70.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205316,N/A,HC KIT RT VENTILATOR,272,1 ,$101.47 ,$65.96 ,$28.41 ,$101.47 , N/A ,$75.60 ,$66.46 , N/A ,$28.41 ,$51.24 , N/A ,$62.61 , N/A ,$62.61 ,$62.61 , N/A ,$62.61 , N/A ,$91.32 ,$76.10 , N/A , N/A ,$89.29 , N/A ,$76.10 ,$76.10 ,$86.25 ,$86.25 , N/A ,$86.25 , N/A ,$79.15 ,$79.15 ,$79.15 ,$91.32 , N/A ,$91.32 , N/A ,$101.47 ,$66.46 , N/A ,$42.21 , N/A , N/A , N/A ,$91.32 , N/A ,$62.61 ,$28.41 ,$91.32 , N/A ,$91.32 ,$91.32 , N/A ,$65.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205319,C1819,HC NEEDLE KOPANS LOCAL,272,1 ,$81.49 ,$52.97 ,$22.82 ,$81.49 , N/A ,$60.71 ,$53.38 , N/A ,$22.82 ,$41.15 , N/A ,$50.28 , N/A ,$50.28 ,$50.28 , N/A ,$50.28 , N/A ,$73.34 ,$61.12 , N/A , N/A ,$71.71 , N/A ,$61.12 ,$61.12 ,$69.27 ,$69.27 , N/A ,$69.27 , N/A ,$63.56 ,$63.56 ,$63.56 ,$73.34 , N/A ,$73.34 , N/A ,$81.49 ,$53.38 , N/A ,$33.90 , N/A , N/A , N/A ,$73.34 , N/A ,$50.28 ,$22.82 ,$73.34 , N/A ,$73.34 ,$73.34 , N/A ,$52.97 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205323,N/A,HC NEEDLE TEMNO,272,1 ,$189.83 ,$123.39 ,$53.15 ,$189.83 , N/A ,$141.42 ,$124.34 , N/A ,$53.15 ,$95.86 , N/A ,$117.13 , N/A ,$117.13 ,$117.13 , N/A ,$117.13 , N/A ,$170.85 ,$142.37 , N/A , N/A ,$167.05 , N/A ,$142.37 ,$142.37 ,$161.36 ,$161.36 , N/A ,$161.36 , N/A ,$148.07 ,$148.07 ,$148.07 ,$170.85 , N/A ,$170.85 , N/A ,$189.83 ,$124.34 , N/A ,$78.97 , N/A , N/A , N/A ,$170.85 , N/A ,$117.13 ,$53.15 ,$170.85 , N/A ,$170.85 ,$170.85 , N/A ,$123.39 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205326,N/A,HC SENSOR INFANT ADHESIVE,272,1 ,$165.40 ,$107.51 ,$46.31 ,$165.40 , N/A ,$123.22 ,$108.34 , N/A ,$46.31 ,$83.53 , N/A ,$102.05 , N/A ,$102.05 ,$102.05 , N/A ,$102.05 , N/A ,$148.86 ,$124.05 , N/A , N/A ,$145.55 , N/A ,$124.05 ,$124.05 ,$140.59 ,$140.59 , N/A ,$140.59 , N/A ,$129.01 ,$129.01 ,$129.01 ,$148.86 , N/A ,$148.86 , N/A ,$165.40 ,$108.34 , N/A ,$68.81 , N/A , N/A , N/A ,$148.86 , N/A ,$102.05 ,$46.31 ,$148.86 , N/A ,$148.86 ,$148.86 , N/A ,$107.51 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205328,N/A,HC SUTURE ETHILON,272,1 ,$73.63 ,$47.86 ,$20.62 ,$73.63 , N/A ,$54.85 ,$48.23 , N/A ,$20.62 ,$37.18 , N/A ,$45.43 , N/A ,$45.43 ,$45.43 , N/A ,$45.43 , N/A ,$66.27 ,$55.22 , N/A , N/A ,$64.79 , N/A ,$55.22 ,$55.22 ,$62.59 ,$62.59 , N/A ,$62.59 , N/A ,$57.43 ,$57.43 ,$57.43 ,$66.27 , N/A ,$66.27 , N/A ,$73.63 ,$48.23 , N/A ,$30.63 , N/A , N/A , N/A ,$66.27 , N/A ,$45.43 ,$20.62 ,$66.27 , N/A ,$66.27 ,$66.27 , N/A ,$47.86 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205331,N/A,HC SYRINGE BRACCO CONTRAST,272,1 ,$47.83 ,$31.09 ,$13.39 ,$47.83 , N/A ,$35.63 ,$31.33 , N/A ,$13.39 ,$24.15 , N/A ,$29.51 , N/A ,$29.51 ,$29.51 , N/A ,$29.51 , N/A ,$43.05 ,$35.87 , N/A , N/A ,$42.09 , N/A ,$35.87 ,$35.87 ,$40.66 ,$40.66 , N/A ,$40.66 , N/A ,$37.31 ,$37.31 ,$37.31 ,$43.05 , N/A ,$43.05 , N/A ,$47.83 ,$31.33 , N/A ,$19.90 , N/A , N/A , N/A ,$43.05 , N/A ,$29.51 ,$13.39 ,$43.05 , N/A ,$43.05 ,$43.05 , N/A ,$31.09 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205337,N/A,HC TUBE TRACH NASAL,272,1 ,$39.00 ,$25.35 ,$10.92 ,$39.00 , N/A ,$29.06 ,$25.55 , N/A ,$10.92 ,$19.70 , N/A ,$24.06 , N/A ,$24.06 ,$24.06 , N/A ,$24.06 , N/A ,$35.10 ,$29.25 , N/A , N/A ,$34.32 , N/A ,$29.25 ,$29.25 ,$33.15 ,$33.15 , N/A ,$33.15 , N/A ,$30.42 ,$30.42 ,$30.42 ,$35.10 , N/A ,$35.10 , N/A ,$39.00 ,$25.55 , N/A ,$16.22 , N/A , N/A , N/A ,$35.10 , N/A ,$24.06 ,$10.92 ,$35.10 , N/A ,$35.10 ,$35.10 , N/A ,$25.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205342,N/A,HC DRESSING TEGADERM,272,1 ,$16.23 ,$10.55 ,$4.54 ,$16.23 , N/A ,$12.09 ,$10.63 , N/A ,$4.54 ,$8.20 , N/A ,$10.01 , N/A ,$10.01 ,$10.01 , N/A ,$10.01 , N/A ,$14.61 ,$12.17 , N/A , N/A ,$14.28 , N/A ,$12.17 ,$12.17 ,$13.80 ,$13.80 , N/A ,$13.80 , N/A ,$12.66 ,$12.66 ,$12.66 ,$14.61 , N/A ,$14.61 , N/A ,$16.23 ,$10.63 , N/A ,$6.75 , N/A , N/A , N/A ,$14.61 , N/A ,$10.01 ,$4.54 ,$14.61 , N/A ,$14.61 ,$14.61 , N/A ,$10.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205343,N/A,HC DRESSING COMPRILAN,272,1 ,$15.00 ,$9.75 ,$4.20 ,$15.00 , N/A ,$11.18 ,$9.83 , N/A ,$4.20 ,$7.58 , N/A ,$9.26 , N/A ,$9.26 ,$9.26 , N/A ,$9.26 , N/A ,$13.50 ,$11.25 , N/A , N/A ,$13.20 , N/A ,$11.25 ,$11.25 ,$12.75 ,$12.75 , N/A ,$12.75 , N/A ,$11.70 ,$11.70 ,$11.70 ,$13.50 , N/A ,$13.50 , N/A ,$15.00 ,$9.83 , N/A ,$6.24 , N/A , N/A , N/A ,$13.50 , N/A ,$9.26 ,$4.20 ,$13.50 , N/A ,$13.50 ,$13.50 , N/A ,$9.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205344,N/A,HC DRESSING MEPILEX,272,1 ,$77.68 ,$50.49 ,$21.75 ,$77.68 , N/A ,$57.87 ,$50.88 , N/A ,$21.75 ,$39.23 , N/A ,$47.93 , N/A ,$47.93 ,$47.93 , N/A ,$47.93 , N/A ,$69.91 ,$58.26 , N/A , N/A ,$68.36 , N/A ,$58.26 ,$58.26 ,$66.03 ,$66.03 , N/A ,$66.03 , N/A ,$60.59 ,$60.59 ,$60.59 ,$69.91 , N/A ,$69.91 , N/A ,$77.68 ,$50.88 , N/A ,$32.31 , N/A , N/A , N/A ,$69.91 , N/A ,$47.93 ,$21.75 ,$69.91 , N/A ,$69.91 ,$69.91 , N/A ,$50.49 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205345,N/A,HC DRESSING GAUZE STRETCH,272,1 ,$6.27 ,$4.08 ,$1.76 ,$6.27 , N/A ,$4.67 ,$4.11 , N/A ,$1.76 ,$3.17 , N/A ,$3.87 , N/A ,$3.87 ,$3.87 , N/A ,$3.87 , N/A ,$5.64 ,$4.70 , N/A , N/A ,$5.52 , N/A ,$4.70 ,$4.70 ,$5.33 ,$5.33 , N/A ,$5.33 , N/A ,$4.89 ,$4.89 ,$4.89 ,$5.64 , N/A ,$5.64 , N/A ,$6.27 ,$4.11 , N/A ,$2.61 , N/A , N/A , N/A ,$5.64 , N/A ,$3.87 ,$1.76 ,$5.64 , N/A ,$5.64 ,$5.64 , N/A ,$4.08 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205366,N/A,HC SENSOR NASAL PULSE OX ALAR,272,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205374,C1751,HC KIT IV RADIAL ARTERY W/GUIDEWIRE,272,1 ,$34.00 ,$22.10 ,$9.52 ,$34.00 , N/A ,$25.33 ,$22.27 , N/A ,$9.52 ,$17.17 , N/A ,$20.98 , N/A ,$20.98 ,$20.98 , N/A ,$20.98 , N/A ,$30.60 ,$25.50 , N/A , N/A ,$29.92 , N/A ,$25.50 ,$25.50 ,$28.90 ,$28.90 , N/A ,$28.90 , N/A ,$26.52 ,$26.52 ,$26.52 ,$30.60 , N/A ,$30.60 , N/A ,$34.00 ,$22.27 , N/A ,$14.14 , N/A , N/A , N/A ,$30.60 , N/A ,$20.98 ,$9.52 ,$30.60 , N/A ,$30.60 ,$30.60 , N/A ,$22.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205378,N/A,HC MARKER BIOPSY BREAST STEREOTATIC,272,1 ,$546.00 ,$354.90 ,$152.88 ,$546.00 , N/A ,$406.77 ,$357.63 , N/A ,$152.88 ,$275.73 , N/A ,$336.88 , N/A ,$336.88 ,$336.88 , N/A ,$336.88 , N/A ,$491.40 ,$409.50 , N/A , N/A ,$480.48 , N/A ,$409.50 ,$409.50 ,$464.10 ,$464.10 , N/A ,$464.10 , N/A ,$425.88 ,$425.88 ,$425.88 ,$491.40 , N/A ,$491.40 , N/A ,$546.00 ,$357.63 , N/A ,$227.14 , N/A , N/A , N/A ,$491.40 , N/A ,$336.88 ,$152.88 ,$491.40 , N/A ,$491.40 ,$491.40 , N/A ,$354.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205379,N/A,HC SYSTEM BIOPSY BREAST STEREOTATIC,272,1 ,$481.00 ,$312.65 ,$134.68 ,$481.00 , N/A ,$358.35 ,$315.06 , N/A ,$134.68 ,$242.91 , N/A ,$296.78 , N/A ,$296.78 ,$296.78 , N/A ,$296.78 , N/A ,$432.90 ,$360.75 , N/A , N/A ,$423.28 , N/A ,$360.75 ,$360.75 ,$408.85 ,$408.85 , N/A ,$408.85 , N/A ,$375.18 ,$375.18 ,$375.18 ,$432.90 , N/A ,$432.90 , N/A ,$481.00 ,$315.06 , N/A ,$200.10 , N/A , N/A , N/A ,$432.90 , N/A ,$296.78 ,$134.68 ,$432.90 , N/A ,$432.90 ,$432.90 , N/A ,$312.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205380,N/A,HC FILTER BIOPSY BREAST STEREOTATIC,272,1 ,$26.00 ,$16.90 ,$7.28 ,$26.00 , N/A ,$19.37 ,$17.03 , N/A ,$7.28 ,$13.13 , N/A ,$16.04 , N/A ,$16.04 ,$16.04 , N/A ,$16.04 , N/A ,$23.40 ,$19.50 , N/A , N/A ,$22.88 , N/A ,$19.50 ,$19.50 ,$22.10 ,$22.10 , N/A ,$22.10 , N/A ,$20.28 ,$20.28 ,$20.28 ,$23.40 , N/A ,$23.40 , N/A ,$26.00 ,$17.03 , N/A ,$10.82 , N/A , N/A , N/A ,$23.40 , N/A ,$16.04 ,$7.28 ,$23.40 , N/A ,$23.40 ,$23.40 , N/A ,$16.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205386,N/A,HC HANDLE LARYNGEAL BLADE,272,1 ,$70.00 ,$45.50 ,$19.60 ,$70.00 , N/A ,$52.15 ,$45.85 , N/A ,$19.60 ,$35.35 , N/A ,$43.19 , N/A ,$43.19 ,$43.19 , N/A ,$43.19 , N/A ,$63.00 ,$52.50 , N/A , N/A ,$61.60 , N/A ,$52.50 ,$52.50 ,$59.50 ,$59.50 , N/A ,$59.50 , N/A ,$54.60 ,$54.60 ,$54.60 ,$63.00 , N/A ,$63.00 , N/A ,$70.00 ,$45.85 , N/A ,$29.12 , N/A , N/A , N/A ,$63.00 , N/A ,$43.19 ,$19.60 ,$63.00 , N/A ,$63.00 ,$63.00 , N/A ,$45.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205387,N/A,HC IRRIGATION SOL W/WATER/SODIUM CHLORIDE,272,1 ,$27.09 ,$17.61 ,$7.59 ,$27.09 , N/A ,$20.18 ,$17.74 , N/A ,$7.59 ,$13.68 , N/A ,$16.71 , N/A ,$16.71 ,$16.71 , N/A ,$16.71 , N/A ,$24.38 ,$20.32 , N/A , N/A ,$23.84 , N/A ,$20.32 ,$20.32 ,$23.03 ,$23.03 , N/A ,$23.03 , N/A ,$21.13 ,$21.13 ,$21.13 ,$24.38 , N/A ,$24.38 , N/A ,$27.09 ,$17.74 , N/A ,$11.27 , N/A , N/A , N/A ,$24.38 , N/A ,$16.71 ,$7.59 ,$24.38 , N/A ,$24.38 ,$24.38 , N/A ,$17.61 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205389,N/A,HC FORCEPS LIGHTED,272,1 ,$19.00 ,$12.35 ,$5.32 ,$19.00 , N/A ,$14.16 ,$12.45 , N/A ,$5.32 ,$9.60 , N/A ,$11.72 , N/A ,$11.72 ,$11.72 , N/A ,$11.72 , N/A ,$17.10 ,$14.25 , N/A , N/A ,$16.72 , N/A ,$14.25 ,$14.25 ,$16.15 ,$16.15 , N/A ,$16.15 , N/A ,$14.82 ,$14.82 ,$14.82 ,$17.10 , N/A ,$17.10 , N/A ,$19.00 ,$12.45 , N/A ,$7.90 , N/A , N/A , N/A ,$17.10 , N/A ,$11.72 ,$5.32 ,$17.10 , N/A ,$17.10 ,$17.10 , N/A ,$12.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205392,N/A,HC FORCEP JAW RADIAL W/NEEDLE,272,1 ,$55.00 ,$35.75 ,$15.40 ,$55.00 , N/A ,$40.98 ,$36.03 , N/A ,$15.40 ,$27.78 , N/A ,$33.94 , N/A ,$33.94 ,$33.94 , N/A ,$33.94 , N/A ,$49.50 ,$41.25 , N/A , N/A ,$48.40 , N/A ,$41.25 ,$41.25 ,$46.75 ,$46.75 , N/A ,$46.75 , N/A ,$42.90 ,$42.90 ,$42.90 ,$49.50 , N/A ,$49.50 , N/A ,$55.00 ,$36.03 , N/A ,$22.88 , N/A , N/A , N/A ,$49.50 , N/A ,$33.94 ,$15.40 ,$49.50 , N/A ,$49.50 ,$49.50 , N/A ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205393,N/A,HC PENCIL ELECTROSURGICAL W/SMOKE EVACUATOR,272,1 ,$75.18 ,$48.87 ,$21.05 ,$75.18 , N/A ,$56.01 ,$49.24 , N/A ,$21.05 ,$37.97 , N/A ,$46.39 , N/A ,$46.39 ,$46.39 , N/A ,$46.39 , N/A ,$67.66 ,$56.39 , N/A , N/A ,$66.16 , N/A ,$56.39 ,$56.39 ,$63.90 ,$63.90 , N/A ,$63.90 , N/A ,$58.64 ,$58.64 ,$58.64 ,$67.66 , N/A ,$67.66 , N/A ,$75.18 ,$49.24 , N/A ,$31.27 , N/A , N/A , N/A ,$67.66 , N/A ,$46.39 ,$21.05 ,$67.66 , N/A ,$67.66 ,$67.66 , N/A ,$48.87 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205398,N/A,HC SURGICEL HEMOSTAT 2X3,272,1 ,$90.54 ,$58.85 ,$25.35 ,$90.54 , N/A ,$67.45 ,$59.30 , N/A ,$25.35 ,$45.72 , N/A ,$55.86 , N/A ,$55.86 ,$55.86 , N/A ,$55.86 , N/A ,$81.49 ,$67.91 , N/A , N/A ,$79.68 , N/A ,$67.91 ,$67.91 ,$76.96 ,$76.96 , N/A ,$76.96 , N/A ,$70.62 ,$70.62 ,$70.62 ,$81.49 , N/A ,$81.49 , N/A ,$90.54 ,$59.30 , N/A ,$37.66 , N/A , N/A , N/A ,$81.49 , N/A ,$55.86 ,$25.35 ,$81.49 , N/A ,$81.49 ,$81.49 , N/A ,$58.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205407,N/A,HC PRONG NASAL INFANT CPAP,272,1 ,$23.00 ,$14.95 ,$6.44 ,$23.00 , N/A ,$17.14 ,$15.07 , N/A ,$6.44 ,$11.62 , N/A ,$14.19 , N/A ,$14.19 ,$14.19 , N/A ,$14.19 , N/A ,$20.70 ,$17.25 , N/A , N/A ,$20.24 , N/A ,$17.25 ,$17.25 ,$19.55 ,$19.55 , N/A ,$19.55 , N/A ,$17.94 ,$17.94 ,$17.94 ,$20.70 , N/A ,$20.70 , N/A ,$23.00 ,$15.07 , N/A ,$9.57 , N/A , N/A , N/A ,$20.70 , N/A ,$14.19 ,$6.44 ,$20.70 , N/A ,$20.70 ,$20.70 , N/A ,$14.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205408,N/A,HC BONNET INFANT CPAP,272,1 ,$33.00 ,$21.45 ,$9.24 ,$33.00 , N/A ,$24.59 ,$21.62 , N/A ,$9.24 ,$16.67 , N/A ,$20.36 , N/A ,$20.36 ,$20.36 , N/A ,$20.36 , N/A ,$29.70 ,$24.75 , N/A , N/A ,$29.04 , N/A ,$24.75 ,$24.75 ,$28.05 ,$28.05 , N/A ,$28.05 , N/A ,$25.74 ,$25.74 ,$25.74 ,$29.70 , N/A ,$29.70 , N/A ,$33.00 ,$21.62 , N/A ,$13.73 , N/A , N/A , N/A ,$29.70 , N/A ,$20.36 ,$9.24 ,$29.70 , N/A ,$29.70 ,$29.70 , N/A ,$21.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205417,N/A,HC HEADGEAR INFANT CPAP,272,1 ,$58.81 ,$38.23 ,$16.47 ,$58.81 , N/A ,$43.81 ,$38.52 , N/A ,$16.47 ,$29.70 , N/A ,$36.29 , N/A ,$36.29 ,$36.29 , N/A ,$36.29 , N/A ,$52.93 ,$44.11 , N/A , N/A ,$51.75 , N/A ,$44.11 ,$44.11 ,$49.99 ,$49.99 , N/A ,$49.99 , N/A ,$45.87 ,$45.87 ,$45.87 ,$52.93 , N/A ,$52.93 , N/A ,$58.81 ,$38.52 , N/A ,$24.47 , N/A , N/A , N/A ,$52.93 , N/A ,$36.29 ,$16.47 ,$52.93 , N/A ,$52.93 ,$52.93 , N/A ,$38.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205423,N/A,HC CANISTER WOUND VAC 150ML,272,1 ,$60.84 ,$39.55 ,$17.04 ,$60.84 , N/A ,$45.33 ,$39.85 , N/A ,$17.04 ,$30.72 , N/A ,$37.54 , N/A ,$37.54 ,$37.54 , N/A ,$37.54 , N/A ,$54.76 ,$45.63 , N/A , N/A ,$53.54 , N/A ,$45.63 ,$45.63 ,$51.71 ,$51.71 , N/A ,$51.71 , N/A ,$47.46 ,$47.46 ,$47.46 ,$54.76 , N/A ,$54.76 , N/A ,$60.84 ,$39.85 , N/A ,$25.31 , N/A , N/A , N/A ,$54.76 , N/A ,$37.54 ,$17.04 ,$54.76 , N/A ,$54.76 ,$54.76 , N/A ,$39.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205424,N/A,HC LIGHTED FORGEIN BODY REMOVAL FORCEPS,272,1 ,$30.55 ,$19.86 ,$8.55 ,$30.55 , N/A ,$22.76 ,$20.01 , N/A ,$8.55 ,$15.43 , N/A ,$18.85 , N/A ,$18.85 ,$18.85 , N/A ,$18.85 , N/A ,$27.50 ,$22.91 , N/A , N/A ,$26.88 , N/A ,$22.91 ,$22.91 ,$25.97 ,$25.97 , N/A ,$25.97 , N/A ,$23.83 ,$23.83 ,$23.83 ,$27.50 , N/A ,$27.50 , N/A ,$30.55 ,$20.01 , N/A ,$12.71 , N/A , N/A , N/A ,$27.50 , N/A ,$18.85 ,$8.55 ,$27.50 , N/A ,$27.50 ,$27.50 , N/A ,$19.86 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205430,N/A,HC NEO PUFF TUBING,272,1 ,$33.93 ,$22.05 ,$9.50 ,$33.93 , N/A ,$25.28 ,$22.22 , N/A ,$9.50 ,$17.13 , N/A ,$20.93 , N/A ,$20.93 ,$20.93 , N/A ,$20.93 , N/A ,$30.54 ,$25.45 , N/A , N/A ,$29.86 , N/A ,$25.45 ,$25.45 ,$28.84 ,$28.84 , N/A ,$28.84 , N/A ,$26.47 ,$26.47 ,$26.47 ,$30.54 , N/A ,$30.54 , N/A ,$33.93 ,$22.22 , N/A ,$14.11 , N/A , N/A , N/A ,$30.54 , N/A ,$20.93 ,$9.50 ,$30.54 , N/A ,$30.54 ,$30.54 , N/A ,$22.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205431,N/A,HC NEO PUFF MASK ERG,272,1 ,$32.91 ,$21.39 ,$9.21 ,$32.91 , N/A ,$24.52 ,$21.56 , N/A ,$9.21 ,$16.62 , N/A ,$20.31 , N/A ,$20.31 ,$20.31 , N/A ,$20.31 , N/A ,$29.62 ,$24.68 , N/A , N/A ,$28.96 , N/A ,$24.68 ,$24.68 ,$27.97 ,$27.97 , N/A ,$27.97 , N/A ,$25.67 ,$25.67 ,$25.67 ,$29.62 , N/A ,$29.62 , N/A ,$32.91 ,$21.56 , N/A ,$13.69 , N/A , N/A , N/A ,$29.62 , N/A ,$20.31 ,$9.21 ,$29.62 , N/A ,$29.62 ,$29.62 , N/A ,$21.39 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205432,N/A,HC NEO PUFF MASK DISPOSABLE,272,1 ,$17.00 ,$11.05 ,$4.76 ,$17.00 , N/A ,$12.67 ,$11.14 , N/A ,$4.76 ,$8.59 , N/A ,$10.49 , N/A ,$10.49 ,$10.49 , N/A ,$10.49 , N/A ,$15.30 ,$12.75 , N/A , N/A ,$14.96 , N/A ,$12.75 ,$12.75 ,$14.45 ,$14.45 , N/A ,$14.45 , N/A ,$13.26 ,$13.26 ,$13.26 ,$15.30 , N/A ,$15.30 , N/A ,$17.00 ,$11.14 , N/A ,$7.07 , N/A , N/A , N/A ,$15.30 , N/A ,$10.49 ,$4.76 ,$15.30 , N/A ,$15.30 ,$15.30 , N/A ,$11.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205433,N/A,HC CPAP BUBBLE SYSTEM,272,1 ,$226.92 ,$147.50 ,$63.54 ,$226.92 , N/A ,$169.06 ,$148.63 , N/A ,$63.54 ,$114.59 , N/A ,$140.01 , N/A ,$140.01 ,$140.01 , N/A ,$140.01 , N/A ,$204.23 ,$170.19 , N/A , N/A ,$199.69 , N/A ,$170.19 ,$170.19 ,$192.88 ,$192.88 , N/A ,$192.88 , N/A ,$177.00 ,$177.00 ,$177.00 ,$204.23 , N/A ,$204.23 , N/A ,$226.92 ,$148.63 , N/A ,$94.40 , N/A , N/A , N/A ,$204.23 , N/A ,$140.01 ,$63.54 ,$204.23 , N/A ,$204.23 ,$204.23 , N/A ,$147.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205436,N/A,HC THERAPY PUTTY,272,1 ,$106.62 ,$69.30 ,$29.85 ,$106.62 , N/A ,$79.43 ,$69.84 , N/A ,$29.85 ,$53.84 , N/A ,$65.78 , N/A ,$65.78 ,$65.78 , N/A ,$65.78 , N/A ,$95.96 ,$79.97 , N/A , N/A ,$93.83 , N/A ,$79.97 ,$79.97 ,$90.63 ,$90.63 , N/A ,$90.63 , N/A ,$83.16 ,$83.16 ,$83.16 ,$95.96 , N/A ,$95.96 , N/A ,$106.62 ,$69.84 , N/A ,$44.35 , N/A , N/A , N/A ,$95.96 , N/A ,$65.78 ,$29.85 ,$95.96 , N/A ,$95.96 ,$95.96 , N/A ,$69.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205437,N/A,HC PUMP MODULE ADMIN SET NEEDLESS VALVES,272,1 ,$16.00 ,$10.40 ,$4.48 ,$16.00 , N/A ,$11.92 ,$10.48 , N/A ,$4.48 ,$8.08 , N/A ,$9.87 , N/A ,$9.87 ,$9.87 , N/A ,$9.87 , N/A ,$14.40 ,$12.00 , N/A , N/A ,$14.08 , N/A ,$12.00 ,$12.00 ,$13.60 ,$13.60 , N/A ,$13.60 , N/A ,$12.48 ,$12.48 ,$12.48 ,$14.40 , N/A ,$14.40 , N/A ,$16.00 ,$10.48 , N/A ,$6.66 , N/A , N/A , N/A ,$14.40 , N/A ,$9.87 ,$4.48 ,$14.40 , N/A ,$14.40 ,$14.40 , N/A ,$10.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205438,N/A,"HC 2"" TAPE ADHESIVE KINESIO",272,1 ,$24.27 ,$15.78 ,$6.80 ,$24.27 , N/A ,$18.08 ,$15.90 , N/A ,$6.80 ,$12.26 , N/A ,$14.97 , N/A ,$14.97 ,$14.97 , N/A ,$14.97 , N/A ,$21.84 ,$18.20 , N/A , N/A ,$21.36 , N/A ,$18.20 ,$18.20 ,$20.63 ,$20.63 , N/A ,$20.63 , N/A ,$18.93 ,$18.93 ,$18.93 ,$21.84 , N/A ,$21.84 , N/A ,$24.27 ,$15.90 , N/A ,$10.10 , N/A , N/A , N/A ,$21.84 , N/A ,$14.97 ,$6.80 ,$21.84 , N/A ,$21.84 ,$21.84 , N/A ,$15.78 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205439,N/A,HC ROSIDAL SOFT FOAM PADDING BANDAGE,272,1 ,$16.59 ,$10.78 ,$4.65 ,$16.59 , N/A ,$12.36 ,$10.87 , N/A ,$4.65 ,$8.38 , N/A ,$10.24 , N/A ,$10.24 ,$10.24 , N/A ,$10.24 , N/A ,$14.93 ,$12.44 , N/A , N/A ,$14.60 , N/A ,$12.44 ,$12.44 ,$14.10 ,$14.10 , N/A ,$14.10 , N/A ,$12.94 ,$12.94 ,$12.94 ,$14.93 , N/A ,$14.93 , N/A ,$16.59 ,$10.87 , N/A ,$6.90 , N/A , N/A , N/A ,$14.93 , N/A ,$10.24 ,$4.65 ,$14.93 , N/A ,$14.93 ,$14.93 , N/A ,$10.78 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205443,N/A,HC SENSOR PEDIATRIC ADHESIVE,272,1 ,$21.18 ,$13.77 ,$5.93 ,$21.18 , N/A ,$15.78 ,$13.87 , N/A ,$5.93 ,$10.70 , N/A ,$13.07 , N/A ,$13.07 ,$13.07 , N/A ,$13.07 , N/A ,$19.06 ,$15.89 , N/A , N/A ,$18.64 , N/A ,$15.89 ,$15.89 ,$18.00 ,$18.00 , N/A ,$18.00 , N/A ,$16.52 ,$16.52 ,$16.52 ,$19.06 , N/A ,$19.06 , N/A ,$21.18 ,$13.87 , N/A ,$8.81 , N/A , N/A , N/A ,$19.06 , N/A ,$13.07 ,$5.93 ,$19.06 , N/A ,$19.06 ,$19.06 , N/A ,$13.77 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205445,N/A,HC CLOT BUSTER INSTRUMENT CLEANER,272,1 ,$16.76 ,$10.89 ,$4.69 ,$16.76 , N/A ,$12.49 ,$10.98 , N/A ,$4.69 ,$8.46 , N/A ,$10.34 , N/A ,$10.34 ,$10.34 , N/A ,$10.34 , N/A ,$15.08 ,$12.57 , N/A , N/A ,$14.75 , N/A ,$12.57 ,$12.57 ,$14.25 ,$14.25 , N/A ,$14.25 , N/A ,$13.07 ,$13.07 ,$13.07 ,$15.08 , N/A ,$15.08 , N/A ,$16.76 ,$10.98 , N/A ,$6.97 , N/A , N/A , N/A ,$15.08 , N/A ,$10.34 ,$4.69 ,$15.08 , N/A ,$15.08 ,$15.08 , N/A ,$10.89 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205464,N/A,HC PACEMAKER PACK,272,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205491,N/A,HC ESOPHAGEAL TUBE,272,1 ,"$1,214.85 ",$789.65 ,$340.16 ,"$1,214.85 ", N/A ,$905.06 ,$795.73 , N/A ,$340.16 ,$613.50 , N/A ,$749.56 , N/A ,$749.56 ,$749.56 , N/A ,$749.56 , N/A ,"$1,093.37 ",$911.14 , N/A , N/A ,"$1,069.07 ", N/A ,$911.14 ,$911.14 ,"$1,032.62 ","$1,032.62 ", N/A ,"$1,032.62 ", N/A ,$947.58 ,$947.58 ,$947.58 ,"$1,093.37 ", N/A ,"$1,093.37 ", N/A ,"$1,214.85 ",$795.73 , N/A ,$505.38 , N/A , N/A , N/A ,"$1,093.37 ", N/A ,$749.56 ,$340.16 ,"$1,093.37 ", N/A ,"$1,093.37 ","$1,093.37 ", N/A ,$789.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27205498,N/A,HC MICROBIOLOGY QUICK TEST KIT,272,1 ,$806.25 ,$524.06 ,$225.75 ,$806.25 , N/A ,$600.66 ,$528.09 , N/A ,$225.75 ,$407.16 , N/A ,$497.46 , N/A ,$497.46 ,$497.46 , N/A ,$497.46 , N/A ,$725.63 ,$604.69 , N/A , N/A ,$709.50 , N/A ,$604.69 ,$604.69 ,$685.31 ,$685.31 , N/A ,$685.31 , N/A ,$628.88 ,$628.88 ,$628.88 ,$725.63 , N/A ,$725.63 , N/A ,$806.25 ,$528.09 , N/A ,$335.40 , N/A , N/A , N/A ,$725.63 , N/A ,$497.46 ,$225.75 ,$725.63 , N/A ,$725.63 ,$725.63 , N/A ,$524.06 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27272900,S2900,HC SURGERY ROBOTIC TECHNICAL SYSTEM,272,1 ,$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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27282055,N/A,HC SPLINT TRACTION,272,1 ,$60.00 ,$39.00 ,$16.80 ,$60.00 , N/A ,$44.70 ,$39.30 , N/A ,$16.80 ,$30.30 , N/A ,$37.02 , N/A ,$37.02 ,$37.02 , N/A ,$37.02 , N/A ,$54.00 ,$45.00 , N/A , N/A ,$52.80 , N/A ,$45.00 ,$45.00 ,$51.00 ,$51.00 , N/A ,$51.00 , N/A ,$46.80 ,$46.80 ,$46.80 ,$54.00 , N/A ,$54.00 , N/A ,$60.00 ,$39.30 , N/A ,$24.96 , N/A , N/A , N/A ,$54.00 , N/A ,$37.02 ,$16.80 ,$54.00 , N/A ,$54.00 ,$54.00 , N/A ,$39.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400001,A4378,HC POUCH UROSTOMY,274,1 ,$31.87 ,$20.72 ,$8.92 ,$31.87 , N/A ,$23.74 ,$20.87 , N/A ,$8.92 ,$16.09 , N/A ,$19.66 , N/A ,$19.66 ,$19.66 , N/A ,$19.66 , N/A ,$28.68 ,$23.90 , N/A , N/A ,$28.05 , N/A ,$23.90 ,$23.90 ,$27.09 ,$27.09 , N/A ,$27.09 , N/A ,$24.86 ,$24.86 ,$24.86 ,$28.68 , N/A ,$28.68 , N/A ,$31.87 ,$20.87 , N/A ,$13.26 , N/A , N/A , N/A ,$28.68 , N/A ,$19.66 ,$8.92 ,$28.68 , N/A ,$28.68 ,$28.68 , N/A ,$20.72 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400104,L1830,HC KNEE IMMOBILIZER,274,1 ,$209.03 ,$135.87 ,$58.53 ,$230.91 ,$209.03 ,$155.73 ,$136.91 ,$106.55 ,$58.53 ,$105.56 ,$106.55 ,$128.97 ,$106.55 ,$128.97 ,$128.97 ,$106.55 ,$128.97 ,$202.45 ,$188.13 ,$156.77 ,$209.03 ,$106.55 ,$183.95 ,$106.55 ,$156.77 ,$156.77 ,$177.68 ,$177.68 ,$106.55 ,$177.68 ,$106.55 ,$163.04 ,$163.04 ,$163.04 ,$188.13 ,$209.03 ,$188.13 ,$106.55 ,$209.03 ,$136.91 ,$106.55 ,$86.96 , N/A , N/A ,$111.52 ,$188.13 ,$230.91 ,$128.97 ,$58.53 ,$188.13 ,$106.55 ,$188.13 ,$188.13 ,$106.55 ,$135.87 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400210,L8000,HC PROSTH BREAST BRA W/O FORM COTTON,274,1 ,$46.74 ,$30.38 ,$13.09 ,$104.81 ,$46.74 ,$34.82 ,$30.61 ,$46.74 ,$13.09 ,$23.60 ,$46.74 ,$28.84 ,$46.74 ,$28.84 ,$28.84 ,$46.74 ,$28.84 ,$91.88 ,$42.07 ,$35.06 ,$46.74 ,$46.74 ,$41.13 ,$46.74 ,$35.06 ,$35.06 ,$39.73 ,$39.73 ,$46.74 ,$39.73 ,$46.74 ,$36.46 ,$36.46 ,$36.46 ,$42.07 ,$46.74 ,$42.07 ,$46.74 ,$46.74 ,$30.61 ,$46.74 ,$19.44 , N/A , N/A ,$46.74 ,$42.07 ,$104.81 ,$28.84 ,$13.09 ,$42.07 ,$46.74 ,$42.07 ,$42.07 ,$46.74 ,$30.38 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400211,L8000,HC PROSTH BREAST BRA W/O FORM OTHER,274,1 ,$59.18 ,$38.47 ,$16.57 ,$110.58 ,$59.18 ,$44.09 ,$38.76 ,$51.03 ,$16.57 ,$29.89 ,$51.03 ,$36.51 ,$51.03 ,$36.51 ,$36.51 ,$51.03 ,$36.51 ,$96.96 ,$53.26 ,$44.39 ,$59.18 ,$51.03 ,$52.08 ,$51.03 ,$44.39 ,$44.39 ,$50.30 ,$50.30 ,$51.03 ,$50.30 ,$51.03 ,$46.16 ,$46.16 ,$46.16 ,$53.26 ,$59.18 ,$53.26 ,$51.03 ,$59.18 ,$38.76 ,$51.03 ,$24.62 , N/A , N/A ,$53.41 ,$53.26 ,$110.58 ,$36.51 ,$16.57 ,$53.26 ,$51.03 ,$53.26 ,$53.26 ,$51.03 ,$38.47 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400212,L8015,HC PROSTH BREAST EXTERNAL W/FORM POST MASTECTOMY,274,1 ,$160.96 ,$104.62 ,$45.07 ,$192.36 ,$160.96 ,$119.92 ,$105.43 ,$88.76 ,$45.07 ,$81.28 ,$88.76 ,$99.31 ,$88.76 ,$99.31 ,$99.31 ,$88.76 ,$99.31 ,$168.64 ,$144.86 ,$120.72 ,$160.96 ,$88.76 ,$141.64 ,$88.76 ,$120.72 ,$120.72 ,$136.82 ,$136.82 ,$88.76 ,$136.82 ,$88.76 ,$125.55 ,$125.55 ,$125.55 ,$144.86 ,$160.96 ,$144.86 ,$88.76 ,$160.96 ,$105.43 ,$88.76 ,$66.96 , N/A , N/A ,$92.91 ,$144.86 ,$192.36 ,$99.31 ,$45.07 ,$144.86 ,$88.76 ,$144.86 ,$144.86 ,$88.76 ,$104.62 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400213,L8020,HC PROSTH BREAST MASTECTOMY FORM,274,1 ,$398.95 ,$259.32 ,$111.71 ,$628.97 ,$398.95 ,$297.22 ,$261.31 ,$290.23 ,$111.71 ,$201.47 ,$290.23 ,$246.15 ,$290.23 ,$246.15 ,$246.15 ,$290.23 ,$246.15 ,$551.44 ,$359.06 ,$299.21 ,$398.95 ,$290.23 ,$351.08 ,$290.23 ,$299.21 ,$299.21 ,$339.11 ,$339.11 ,$290.23 ,$339.11 ,$290.23 ,$311.18 ,$311.18 ,$311.18 ,$359.06 ,$398.95 ,$359.06 ,$290.23 ,$398.95 ,$261.31 ,$290.23 ,$165.96 , N/A , N/A ,$303.78 ,$359.06 ,$628.97 ,$246.15 ,$111.71 ,$359.06 ,$290.23 ,$359.06 ,$359.06 ,$290.23 ,$259.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400214,L8030,HC PROSTH BREAST W/O INTEGRAL ADHESIVE,274,1 ,$525.78 ,$341.76 ,$147.22 ,$930.12 ,$525.78 ,$391.71 ,$344.39 ,$429.19 ,$147.22 ,$265.52 ,$429.19 ,$324.41 ,$429.19 ,$324.41 ,$324.41 ,$429.19 ,$324.41 ,$815.46 ,$473.20 ,$394.34 ,$525.78 ,$429.19 ,$462.69 ,$429.19 ,$394.34 ,$394.34 ,$446.91 ,$446.91 ,$429.19 ,$446.91 ,$429.19 ,$410.11 ,$410.11 ,$410.11 ,$473.20 ,$525.78 ,$473.20 ,$429.19 ,$525.78 ,$344.39 ,$429.19 ,$218.72 , N/A , N/A ,$449.23 ,$473.20 ,$930.12 ,$324.41 ,$147.22 ,$473.20 ,$429.19 ,$473.20 ,$473.20 ,$429.19 ,$341.76 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400215,L8030,HC PROSTH BREAST W/O INTEGRAL PARTIAL,274,1 ,$290.47 ,$188.81 ,$81.33 ,$820.89 ,$290.47 ,$216.40 ,$190.26 ,$290.47 ,$81.33 ,$146.69 ,$290.47 ,$179.22 ,$290.47 ,$179.22 ,$179.22 ,$290.47 ,$179.22 ,$719.70 ,$261.42 ,$217.85 ,$290.47 ,$290.47 ,$255.61 ,$290.47 ,$217.85 ,$217.85 ,$246.90 ,$246.90 ,$290.47 ,$246.90 ,$290.47 ,$226.57 ,$226.57 ,$226.57 ,$261.42 ,$290.47 ,$261.42 ,$290.47 ,$290.47 ,$190.26 ,$290.47 ,$120.84 , N/A , N/A ,$290.47 ,$261.42 ,$820.89 ,$179.22 ,$81.33 ,$261.42 ,$290.47 ,$261.42 ,$261.42 ,$290.47 ,$188.81 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27400216,L8031,HC PROSTH BREAST W/ADHESIVE,274,1 ,$533.91 ,$347.04 ,$149.49 ,$933.89 ,$533.91 ,$397.76 ,$349.71 ,$430.93 ,$149.49 ,$269.62 ,$430.93 ,$329.42 ,$430.93 ,$329.42 ,$329.42 ,$430.93 ,$329.42 ,$818.77 ,$480.52 ,$400.43 ,$533.91 ,$430.93 ,$469.84 ,$430.93 ,$400.43 ,$400.43 ,$453.82 ,$453.82 ,$430.93 ,$453.82 ,$430.93 ,$416.45 ,$416.45 ,$416.45 ,$480.52 ,$533.91 ,$480.52 ,$430.93 ,$533.91 ,$349.71 ,$430.93 ,$222.11 , N/A , N/A ,$451.05 ,$480.52 ,$933.89 ,$329.42 ,$149.49 ,$480.52 ,$430.93 ,$480.52 ,$480.52 ,$430.93 ,$347.04 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500049,C1721,HC ICD DEFIB DUAL CHAMBER T7,275,1 ,"$34,500.00 ","$22,425.00 ","$9,660.00 ","$34,500.00 ", N/A ,"$25,702.50 ","$22,597.50 ", N/A ,"$9,660.00 ","$17,422.50 ", N/A ,"$21,286.50 ", N/A ,"$21,286.50 ","$21,286.50 ", N/A ,"$21,286.50 ", N/A ,"$31,050.00 ","$25,875.00 ", N/A , N/A ,"$30,360.00 ", N/A ,"$25,875.00 ","$25,875.00 ","$29,325.00 ","$29,325.00 ", N/A ,"$29,325.00 ", N/A ,"$26,910.00 ","$26,910.00 ","$26,910.00 ","$31,050.00 ", N/A ,"$31,050.00 ", N/A ,"$34,500.00 ","$22,597.50 ", N/A ,"$14,352.00 ", N/A , N/A , N/A ,"$31,050.00 ", N/A ,"$21,286.50 ","$9,660.00 ","$31,050.00 ", N/A ,"$31,050.00 ","$31,050.00 ", N/A ,"$22,425.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500069,C1722,HC ICD DEFIB SINGLE CHAMBER T5,275,1 ,"$31,500.00 ","$20,475.00 ","$8,820.00 ","$31,500.00 ", N/A ,"$23,467.50 ","$20,632.50 ", N/A ,"$8,820.00 ","$15,907.50 ", N/A ,"$19,435.50 ", N/A ,"$19,435.50 ","$19,435.50 ", N/A ,"$19,435.50 ", N/A ,"$28,350.00 ","$23,625.00 ", N/A , N/A ,"$27,720.00 ", N/A ,"$23,625.00 ","$23,625.00 ","$26,775.00 ","$26,775.00 ", N/A ,"$26,775.00 ", N/A ,"$24,570.00 ","$24,570.00 ","$24,570.00 ","$28,350.00 ", N/A ,"$28,350.00 ", N/A ,"$31,500.00 ","$20,632.50 ", N/A ,"$13,104.00 ", N/A , N/A , N/A ,"$28,350.00 ", N/A ,"$19,435.50 ","$8,820.00 ","$28,350.00 ", N/A ,"$28,350.00 ","$28,350.00 ", N/A ,"$20,475.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500078,C1722,HC ICD DEFIB SINGLE CHAMBER T14,275,1 ,"$31,500.00 ","$20,475.00 ","$8,820.00 ","$31,500.00 ", N/A ,"$23,467.50 ","$20,632.50 ", N/A ,"$8,820.00 ","$15,907.50 ", N/A ,"$19,435.50 ", N/A ,"$19,435.50 ","$19,435.50 ", N/A ,"$19,435.50 ", N/A ,"$28,350.00 ","$23,625.00 ", N/A , N/A ,"$27,720.00 ", N/A ,"$23,625.00 ","$23,625.00 ","$26,775.00 ","$26,775.00 ", N/A ,"$26,775.00 ", N/A ,"$24,570.00 ","$24,570.00 ","$24,570.00 ","$28,350.00 ", N/A ,"$28,350.00 ", N/A ,"$31,500.00 ","$20,632.50 ", N/A ,"$13,104.00 ", N/A , N/A , N/A ,"$28,350.00 ", N/A ,"$19,435.50 ","$8,820.00 ","$28,350.00 ", N/A ,"$28,350.00 ","$28,350.00 ", N/A ,"$20,475.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500091,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T5,275,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500092,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T6,275,1 ,"$8,100.00 ","$5,265.00 ","$2,268.00 ","$8,100.00 ", N/A ,"$6,034.50 ","$5,305.50 ", N/A ,"$2,268.00 ","$4,090.50 ", N/A ,"$4,997.70 ", N/A ,"$4,997.70 ","$4,997.70 ", N/A ,"$4,997.70 ", N/A ,"$7,290.00 ","$6,075.00 ", N/A , N/A ,"$7,128.00 ", N/A ,"$6,075.00 ","$6,075.00 ","$6,885.00 ","$6,885.00 ", N/A ,"$6,885.00 ", N/A ,"$6,318.00 ","$6,318.00 ","$6,318.00 ","$7,290.00 ", N/A ,"$7,290.00 ", N/A ,"$8,100.00 ","$5,305.50 ", N/A ,"$3,369.60 ", N/A , N/A , N/A ,"$7,290.00 ", N/A ,"$4,997.70 ","$2,268.00 ","$7,290.00 ", N/A ,"$7,290.00 ","$7,290.00 ", N/A ,"$5,265.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500093,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T7,275,1 ,"$8,700.00 ","$5,655.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$6,481.50 ","$5,698.50 ", N/A ,"$2,436.00 ","$4,393.50 ", N/A ,"$5,367.90 ", N/A ,"$5,367.90 ","$5,367.90 ", N/A ,"$5,367.90 ", N/A ,"$7,830.00 ","$6,525.00 ", N/A , N/A ,"$7,656.00 ", N/A ,"$6,525.00 ","$6,525.00 ","$7,395.00 ","$7,395.00 ", N/A ,"$7,395.00 ", N/A ,"$6,786.00 ","$6,786.00 ","$6,786.00 ","$7,830.00 ", N/A ,"$7,830.00 ", N/A ,"$8,700.00 ","$5,698.50 ", N/A ,"$3,619.20 ", N/A , N/A , N/A ,"$7,830.00 ", N/A ,"$5,367.90 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,830.00 ","$7,830.00 ", N/A ,"$5,655.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500094,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T8,275,1 ,"$9,300.00 ","$6,045.00 ","$2,604.00 ","$9,300.00 ", N/A ,"$6,928.50 ","$6,091.50 ", N/A ,"$2,604.00 ","$4,696.50 ", N/A ,"$5,738.10 ", N/A ,"$5,738.10 ","$5,738.10 ", N/A ,"$5,738.10 ", N/A ,"$8,370.00 ","$6,975.00 ", N/A , N/A ,"$8,184.00 ", N/A ,"$6,975.00 ","$6,975.00 ","$7,905.00 ","$7,905.00 ", N/A ,"$7,905.00 ", N/A ,"$7,254.00 ","$7,254.00 ","$7,254.00 ","$8,370.00 ", N/A ,"$8,370.00 ", N/A ,"$9,300.00 ","$6,091.50 ", N/A ,"$3,868.80 ", N/A , N/A , N/A ,"$8,370.00 ", N/A ,"$5,738.10 ","$2,604.00 ","$8,370.00 ", N/A ,"$8,370.00 ","$8,370.00 ", N/A ,"$6,045.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500095,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T9,275,1 ,"$9,900.00 ","$6,435.00 ","$2,772.00 ","$9,900.00 ", N/A ,"$7,375.50 ","$6,484.50 ", N/A ,"$2,772.00 ","$4,999.50 ", N/A ,"$6,108.30 ", N/A ,"$6,108.30 ","$6,108.30 ", N/A ,"$6,108.30 ", N/A ,"$8,910.00 ","$7,425.00 ", N/A , N/A ,"$8,712.00 ", N/A ,"$7,425.00 ","$7,425.00 ","$8,415.00 ","$8,415.00 ", N/A ,"$8,415.00 ", N/A ,"$7,722.00 ","$7,722.00 ","$7,722.00 ","$8,910.00 ", N/A ,"$8,910.00 ", N/A ,"$9,900.00 ","$6,484.50 ", N/A ,"$4,118.40 ", N/A , N/A , N/A ,"$8,910.00 ", N/A ,"$6,108.30 ","$2,772.00 ","$8,910.00 ", N/A ,"$8,910.00 ","$8,910.00 ", N/A ,"$6,435.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500096,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T10,275,1 ,"$10,500.00 ","$6,825.00 ","$2,940.00 ","$10,500.00 ", N/A ,"$7,822.50 ","$6,877.50 ", N/A ,"$2,940.00 ","$5,302.50 ", N/A ,"$6,478.50 ", N/A ,"$6,478.50 ","$6,478.50 ", N/A ,"$6,478.50 ", N/A ,"$9,450.00 ","$7,875.00 ", N/A , N/A ,"$9,240.00 ", N/A ,"$7,875.00 ","$7,875.00 ","$8,925.00 ","$8,925.00 ", N/A ,"$8,925.00 ", N/A ,"$8,190.00 ","$8,190.00 ","$8,190.00 ","$9,450.00 ", N/A ,"$9,450.00 ", N/A ,"$10,500.00 ","$6,877.50 ", N/A ,"$4,368.00 ", N/A , N/A , N/A ,"$9,450.00 ", N/A ,"$6,478.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$9,450.00 ","$9,450.00 ", N/A ,"$6,825.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500097,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T11,275,1 ,"$11,100.00 ","$7,215.00 ","$3,108.00 ","$11,100.00 ", N/A ,"$8,269.50 ","$7,270.50 ", N/A ,"$3,108.00 ","$5,605.50 ", N/A ,"$6,848.70 ", N/A ,"$6,848.70 ","$6,848.70 ", N/A ,"$6,848.70 ", N/A ,"$9,990.00 ","$8,325.00 ", N/A , N/A ,"$9,768.00 ", N/A ,"$8,325.00 ","$8,325.00 ","$9,435.00 ","$9,435.00 ", N/A ,"$9,435.00 ", N/A ,"$8,658.00 ","$8,658.00 ","$8,658.00 ","$9,990.00 ", N/A ,"$9,990.00 ", N/A ,"$11,100.00 ","$7,270.50 ", N/A ,"$4,617.60 ", N/A , N/A , N/A ,"$9,990.00 ", N/A ,"$6,848.70 ","$3,108.00 ","$9,990.00 ", N/A ,"$9,990.00 ","$9,990.00 ", N/A ,"$7,215.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500098,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T12,275,1 ,"$11,700.00 ","$7,605.00 ","$3,276.00 ","$11,700.00 ", N/A ,"$8,716.50 ","$7,663.50 ", N/A ,"$3,276.00 ","$5,908.50 ", N/A ,"$7,218.90 ", N/A ,"$7,218.90 ","$7,218.90 ", N/A ,"$7,218.90 ", N/A ,"$10,530.00 ","$8,775.00 ", N/A , N/A ,"$10,296.00 ", N/A ,"$8,775.00 ","$8,775.00 ","$9,945.00 ","$9,945.00 ", N/A ,"$9,945.00 ", N/A ,"$9,126.00 ","$9,126.00 ","$9,126.00 ","$10,530.00 ", N/A ,"$10,530.00 ", N/A ,"$11,700.00 ","$7,663.50 ", N/A ,"$4,867.20 ", N/A , N/A , N/A ,"$10,530.00 ", N/A ,"$7,218.90 ","$3,276.00 ","$10,530.00 ", N/A ,"$10,530.00 ","$10,530.00 ", N/A ,"$7,605.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500099,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T13,275,1 ,"$12,300.00 ","$7,995.00 ","$3,444.00 ","$12,300.00 ", N/A ,"$9,163.50 ","$8,056.50 ", N/A ,"$3,444.00 ","$6,211.50 ", N/A ,"$7,589.10 ", N/A ,"$7,589.10 ","$7,589.10 ", N/A ,"$7,589.10 ", N/A ,"$11,070.00 ","$9,225.00 ", N/A , N/A ,"$10,824.00 ", N/A ,"$9,225.00 ","$9,225.00 ","$10,455.00 ","$10,455.00 ", N/A ,"$10,455.00 ", N/A ,"$9,594.00 ","$9,594.00 ","$9,594.00 ","$11,070.00 ", N/A ,"$11,070.00 ", N/A ,"$12,300.00 ","$8,056.50 ", N/A ,"$5,116.80 ", N/A , N/A , N/A ,"$11,070.00 ", N/A ,"$7,589.10 ","$3,444.00 ","$11,070.00 ", N/A ,"$11,070.00 ","$11,070.00 ", N/A ,"$7,995.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500100,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T14,275,1 ,"$12,900.00 ","$8,385.00 ","$3,612.00 ","$12,900.00 ", N/A ,"$9,610.50 ","$8,449.50 ", N/A ,"$3,612.00 ","$6,514.50 ", N/A ,"$7,959.30 ", N/A ,"$7,959.30 ","$7,959.30 ", N/A ,"$7,959.30 ", N/A ,"$11,610.00 ","$9,675.00 ", N/A , N/A ,"$11,352.00 ", N/A ,"$9,675.00 ","$9,675.00 ","$10,965.00 ","$10,965.00 ", N/A ,"$10,965.00 ", N/A ,"$10,062.00 ","$10,062.00 ","$10,062.00 ","$11,610.00 ", N/A ,"$11,610.00 ", N/A ,"$12,900.00 ","$8,449.50 ", N/A ,"$5,366.40 ", N/A , N/A , N/A ,"$11,610.00 ", N/A ,"$7,959.30 ","$3,612.00 ","$11,610.00 ", N/A ,"$11,610.00 ","$11,610.00 ", N/A ,"$8,385.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500101,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T15,275,1 ,"$13,500.00 ","$8,775.00 ","$3,780.00 ","$13,500.00 ", N/A ,"$10,057.50 ","$8,842.50 ", N/A ,"$3,780.00 ","$6,817.50 ", N/A ,"$8,329.50 ", N/A ,"$8,329.50 ","$8,329.50 ", N/A ,"$8,329.50 ", N/A ,"$12,150.00 ","$10,125.00 ", N/A , N/A ,"$11,880.00 ", N/A ,"$10,125.00 ","$10,125.00 ","$11,475.00 ","$11,475.00 ", N/A ,"$11,475.00 ", N/A ,"$10,530.00 ","$10,530.00 ","$10,530.00 ","$12,150.00 ", N/A ,"$12,150.00 ", N/A ,"$13,500.00 ","$8,842.50 ", N/A ,"$5,616.00 ", N/A , N/A , N/A ,"$12,150.00 ", N/A ,"$8,329.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$12,150.00 ","$12,150.00 ", N/A ,"$8,775.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500102,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T16,275,1 ,"$14,100.00 ","$9,165.00 ","$3,948.00 ","$14,100.00 ", N/A ,"$10,504.50 ","$9,235.50 ", N/A ,"$3,948.00 ","$7,120.50 ", N/A ,"$8,699.70 ", N/A ,"$8,699.70 ","$8,699.70 ", N/A ,"$8,699.70 ", N/A ,"$12,690.00 ","$10,575.00 ", N/A , N/A ,"$12,408.00 ", N/A ,"$10,575.00 ","$10,575.00 ","$11,985.00 ","$11,985.00 ", N/A ,"$11,985.00 ", N/A ,"$10,998.00 ","$10,998.00 ","$10,998.00 ","$12,690.00 ", N/A ,"$12,690.00 ", N/A ,"$14,100.00 ","$9,235.50 ", N/A ,"$5,865.60 ", N/A , N/A , N/A ,"$12,690.00 ", N/A ,"$8,699.70 ","$3,948.00 ","$12,690.00 ", N/A ,"$12,690.00 ","$12,690.00 ", N/A ,"$9,165.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500103,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T17,275,1 ,"$14,700.00 ","$9,555.00 ","$4,116.00 ","$14,700.00 ", N/A ,"$10,951.50 ","$9,628.50 ", N/A ,"$4,116.00 ","$7,423.50 ", N/A ,"$9,069.90 ", N/A ,"$9,069.90 ","$9,069.90 ", N/A ,"$9,069.90 ", N/A ,"$13,230.00 ","$11,025.00 ", N/A , N/A ,"$12,936.00 ", N/A ,"$11,025.00 ","$11,025.00 ","$12,495.00 ","$12,495.00 ", N/A ,"$12,495.00 ", N/A ,"$11,466.00 ","$11,466.00 ","$11,466.00 ","$13,230.00 ", N/A ,"$13,230.00 ", N/A ,"$14,700.00 ","$9,628.50 ", N/A ,"$6,115.20 ", N/A , N/A , N/A ,"$13,230.00 ", N/A ,"$9,069.90 ","$4,116.00 ","$13,230.00 ", N/A ,"$13,230.00 ","$13,230.00 ", N/A ,"$9,555.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500104,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T18,275,1 ,"$15,300.00 ","$9,945.00 ","$4,284.00 ","$15,300.00 ", N/A ,"$11,398.50 ","$10,021.50 ", N/A ,"$4,284.00 ","$7,726.50 ", N/A ,"$9,440.10 ", N/A ,"$9,440.10 ","$9,440.10 ", N/A ,"$9,440.10 ", N/A ,"$13,770.00 ","$11,475.00 ", N/A , N/A ,"$13,464.00 ", N/A ,"$11,475.00 ","$11,475.00 ","$13,005.00 ","$13,005.00 ", N/A ,"$13,005.00 ", N/A ,"$11,934.00 ","$11,934.00 ","$11,934.00 ","$13,770.00 ", N/A ,"$13,770.00 ", N/A ,"$15,300.00 ","$10,021.50 ", N/A ,"$6,364.80 ", N/A , N/A , N/A ,"$13,770.00 ", N/A ,"$9,440.10 ","$4,284.00 ","$13,770.00 ", N/A ,"$13,770.00 ","$13,770.00 ", N/A ,"$9,945.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500105,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T19,275,1 ,"$15,900.00 ","$10,335.00 ","$4,452.00 ","$15,900.00 ", N/A ,"$11,845.50 ","$10,414.50 ", N/A ,"$4,452.00 ","$8,029.50 ", N/A ,"$9,810.30 ", N/A ,"$9,810.30 ","$9,810.30 ", N/A ,"$9,810.30 ", N/A ,"$14,310.00 ","$11,925.00 ", N/A , N/A ,"$13,992.00 ", N/A ,"$11,925.00 ","$11,925.00 ","$13,515.00 ","$13,515.00 ", N/A ,"$13,515.00 ", N/A ,"$12,402.00 ","$12,402.00 ","$12,402.00 ","$14,310.00 ", N/A ,"$14,310.00 ", N/A ,"$15,900.00 ","$10,414.50 ", N/A ,"$6,614.40 ", N/A , N/A , N/A ,"$14,310.00 ", N/A ,"$9,810.30 ","$4,452.00 ","$14,310.00 ", N/A ,"$14,310.00 ","$14,310.00 ", N/A ,"$10,335.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500106,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T20,275,1 ,"$16,500.00 ","$10,725.00 ","$4,620.00 ","$16,500.00 ", N/A ,"$12,292.50 ","$10,807.50 ", N/A ,"$4,620.00 ","$8,332.50 ", N/A ,"$10,180.50 ", N/A ,"$10,180.50 ","$10,180.50 ", N/A ,"$10,180.50 ", N/A ,"$14,850.00 ","$12,375.00 ", N/A , N/A ,"$14,520.00 ", N/A ,"$12,375.00 ","$12,375.00 ","$14,025.00 ","$14,025.00 ", N/A ,"$14,025.00 ", N/A ,"$12,870.00 ","$12,870.00 ","$12,870.00 ","$14,850.00 ", N/A ,"$14,850.00 ", N/A ,"$16,500.00 ","$10,807.50 ", N/A ,"$6,864.00 ", N/A , N/A , N/A ,"$14,850.00 ", N/A ,"$10,180.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$14,850.00 ","$14,850.00 ", N/A ,"$10,725.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500107,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T21,275,1 ,"$17,100.00 ","$11,115.00 ","$4,788.00 ","$17,100.00 ", N/A ,"$12,739.50 ","$11,200.50 ", N/A ,"$4,788.00 ","$8,635.50 ", N/A ,"$10,550.70 ", N/A ,"$10,550.70 ","$10,550.70 ", N/A ,"$10,550.70 ", N/A ,"$15,390.00 ","$12,825.00 ", N/A , N/A ,"$15,048.00 ", N/A ,"$12,825.00 ","$12,825.00 ","$14,535.00 ","$14,535.00 ", N/A ,"$14,535.00 ", N/A ,"$13,338.00 ","$13,338.00 ","$13,338.00 ","$15,390.00 ", N/A ,"$15,390.00 ", N/A ,"$17,100.00 ","$11,200.50 ", N/A ,"$7,113.60 ", N/A , N/A , N/A ,"$15,390.00 ", N/A ,"$10,550.70 ","$4,788.00 ","$15,390.00 ", N/A ,"$15,390.00 ","$15,390.00 ", N/A ,"$11,115.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500120,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T10,275,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500121,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T11,275,1 ,"$8,100.00 ","$5,265.00 ","$2,268.00 ","$8,100.00 ", N/A ,"$6,034.50 ","$5,305.50 ", N/A ,"$2,268.00 ","$4,090.50 ", N/A ,"$4,997.70 ", N/A ,"$4,997.70 ","$4,997.70 ", N/A ,"$4,997.70 ", N/A ,"$7,290.00 ","$6,075.00 ", N/A , N/A ,"$7,128.00 ", N/A ,"$6,075.00 ","$6,075.00 ","$6,885.00 ","$6,885.00 ", N/A ,"$6,885.00 ", N/A ,"$6,318.00 ","$6,318.00 ","$6,318.00 ","$7,290.00 ", N/A ,"$7,290.00 ", N/A ,"$8,100.00 ","$5,305.50 ", N/A ,"$3,369.60 ", N/A , N/A , N/A ,"$7,290.00 ", N/A ,"$4,997.70 ","$2,268.00 ","$7,290.00 ", N/A ,"$7,290.00 ","$7,290.00 ", N/A ,"$5,265.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500122,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T12,275,1 ,"$8,700.00 ","$5,655.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$6,481.50 ","$5,698.50 ", N/A ,"$2,436.00 ","$4,393.50 ", N/A ,"$5,367.90 ", N/A ,"$5,367.90 ","$5,367.90 ", N/A ,"$5,367.90 ", N/A ,"$7,830.00 ","$6,525.00 ", N/A , N/A ,"$7,656.00 ", N/A ,"$6,525.00 ","$6,525.00 ","$7,395.00 ","$7,395.00 ", N/A ,"$7,395.00 ", N/A ,"$6,786.00 ","$6,786.00 ","$6,786.00 ","$7,830.00 ", N/A ,"$7,830.00 ", N/A ,"$8,700.00 ","$5,698.50 ", N/A ,"$3,619.20 ", N/A , N/A , N/A ,"$7,830.00 ", N/A ,"$5,367.90 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,830.00 ","$7,830.00 ", N/A ,"$5,655.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500123,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T13,275,1 ,"$9,300.00 ","$6,045.00 ","$2,604.00 ","$9,300.00 ", N/A ,"$6,928.50 ","$6,091.50 ", N/A ,"$2,604.00 ","$4,696.50 ", N/A ,"$5,738.10 ", N/A ,"$5,738.10 ","$5,738.10 ", N/A ,"$5,738.10 ", N/A ,"$8,370.00 ","$6,975.00 ", N/A , N/A ,"$8,184.00 ", N/A ,"$6,975.00 ","$6,975.00 ","$7,905.00 ","$7,905.00 ", N/A ,"$7,905.00 ", N/A ,"$7,254.00 ","$7,254.00 ","$7,254.00 ","$8,370.00 ", N/A ,"$8,370.00 ", N/A ,"$9,300.00 ","$6,091.50 ", N/A ,"$3,868.80 ", N/A , N/A , N/A ,"$8,370.00 ", N/A ,"$5,738.10 ","$2,604.00 ","$8,370.00 ", N/A ,"$8,370.00 ","$8,370.00 ", N/A ,"$6,045.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500124,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T14,275,1 ,"$9,900.00 ","$6,435.00 ","$2,772.00 ","$9,900.00 ", N/A ,"$7,375.50 ","$6,484.50 ", N/A ,"$2,772.00 ","$4,999.50 ", N/A ,"$6,108.30 ", N/A ,"$6,108.30 ","$6,108.30 ", N/A ,"$6,108.30 ", N/A ,"$8,910.00 ","$7,425.00 ", N/A , N/A ,"$8,712.00 ", N/A ,"$7,425.00 ","$7,425.00 ","$8,415.00 ","$8,415.00 ", N/A ,"$8,415.00 ", N/A ,"$7,722.00 ","$7,722.00 ","$7,722.00 ","$8,910.00 ", N/A ,"$8,910.00 ", N/A ,"$9,900.00 ","$6,484.50 ", N/A ,"$4,118.40 ", N/A , N/A , N/A ,"$8,910.00 ", N/A ,"$6,108.30 ","$2,772.00 ","$8,910.00 ", N/A ,"$8,910.00 ","$8,910.00 ", N/A ,"$6,435.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500125,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T15,275,1 ,"$10,500.00 ","$6,825.00 ","$2,940.00 ","$10,500.00 ", N/A ,"$7,822.50 ","$6,877.50 ", N/A ,"$2,940.00 ","$5,302.50 ", N/A ,"$6,478.50 ", N/A ,"$6,478.50 ","$6,478.50 ", N/A ,"$6,478.50 ", N/A ,"$9,450.00 ","$7,875.00 ", N/A , N/A ,"$9,240.00 ", N/A ,"$7,875.00 ","$7,875.00 ","$8,925.00 ","$8,925.00 ", N/A ,"$8,925.00 ", N/A ,"$8,190.00 ","$8,190.00 ","$8,190.00 ","$9,450.00 ", N/A ,"$9,450.00 ", N/A ,"$10,500.00 ","$6,877.50 ", N/A ,"$4,368.00 ", N/A , N/A , N/A ,"$9,450.00 ", N/A ,"$6,478.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$9,450.00 ","$9,450.00 ", N/A ,"$6,825.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500189,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T19,275,1 ,"$16,500.00 ","$10,725.00 ","$4,620.00 ","$16,500.00 ", N/A ,"$12,292.50 ","$10,807.50 ", N/A ,"$4,620.00 ","$8,332.50 ", N/A ,"$10,180.50 ", N/A ,"$10,180.50 ","$10,180.50 ", N/A ,"$10,180.50 ", N/A ,"$14,850.00 ","$12,375.00 ", N/A , N/A ,"$14,520.00 ", N/A ,"$12,375.00 ","$12,375.00 ","$14,025.00 ","$14,025.00 ", N/A ,"$14,025.00 ", N/A ,"$12,870.00 ","$12,870.00 ","$12,870.00 ","$14,850.00 ", N/A ,"$14,850.00 ", N/A ,"$16,500.00 ","$10,807.50 ", N/A ,"$6,864.00 ", N/A , N/A , N/A ,"$14,850.00 ", N/A ,"$10,180.50 ","$4,620.00 ","$14,850.00 ", N/A ,"$14,850.00 ","$14,850.00 ", N/A ,"$10,725.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27500210,C1785,HC AZURE XT DR - MRI SURESCAN PACEMAKER,275,1 ,"$12,900.00 ","$8,385.00 ","$3,612.00 ","$12,900.00 ", N/A ,"$9,610.50 ","$8,449.50 ", N/A ,"$3,612.00 ","$6,514.50 ", N/A ,"$7,959.30 ", N/A ,"$7,959.30 ","$7,959.30 ", N/A ,"$7,959.30 ", N/A ,"$11,610.00 ","$9,675.00 ", N/A , N/A ,"$11,352.00 ", N/A ,"$9,675.00 ","$9,675.00 ","$10,965.00 ","$10,965.00 ", N/A ,"$10,965.00 ", N/A ,"$10,062.00 ","$10,062.00 ","$10,062.00 ","$11,610.00 ", N/A ,"$11,610.00 ", N/A ,"$12,900.00 ","$8,449.50 ", N/A ,"$5,366.40 ", N/A , N/A , N/A ,"$11,610.00 ", N/A ,"$7,959.30 ","$3,612.00 ","$11,610.00 ", N/A ,"$11,610.00 ","$11,610.00 ", N/A ,"$8,385.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27800553,A4648,HC TISSUE MARKER IMPLANTABLE,278,1 ,$92.99 ,$60.44 ,$26.04 ,$92.99 , N/A ,$69.28 ,$60.91 , N/A ,$26.04 ,$46.96 , N/A ,$57.37 , N/A ,$57.37 ,$57.37 , N/A ,$57.37 , N/A ,$83.69 ,$69.74 , N/A , N/A ,$81.83 , N/A ,$69.74 ,$69.74 ,$79.04 ,$79.04 , N/A ,$79.04 , N/A ,$72.53 ,$72.53 ,$72.53 ,$83.69 , N/A ,$83.69 , N/A ,$92.99 ,$60.91 , N/A ,$38.68 , N/A , N/A , N/A ,$83.69 , N/A ,$57.37 ,$26.04 ,$83.69 , N/A ,$83.69 ,$83.69 , N/A ,$60.44 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801484,C1894,HC INTRODUCER MICROPUNCTURE SET,278,1 ,$99.24 ,$64.51 ,$27.79 ,$99.24 , N/A ,$73.93 ,$65.00 , N/A ,$27.79 ,$50.12 , N/A ,$61.23 , N/A ,$61.23 ,$61.23 , N/A ,$61.23 , N/A ,$89.32 ,$74.43 , N/A , N/A ,$87.33 , N/A ,$74.43 ,$74.43 ,$84.35 ,$84.35 , N/A ,$84.35 , N/A ,$77.41 ,$77.41 ,$77.41 ,$89.32 , N/A ,$89.32 , N/A ,$99.24 ,$65.00 , N/A ,$41.28 , N/A , N/A , N/A ,$89.32 , N/A ,$61.23 ,$27.79 ,$89.32 , N/A ,$89.32 ,$89.32 , N/A ,$64.51 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801599,C1764,HC RECORDER CARDIAC EVENT IMPLANT T17,278,1 ,"$10,912.00 ","$7,092.80 ","$3,055.36 ","$10,912.00 ", N/A ,"$8,129.44 ","$7,147.36 ", N/A ,"$3,055.36 ","$5,510.56 ", N/A ,"$6,732.70 ", N/A ,"$6,732.70 ","$6,732.70 ", N/A ,"$6,732.70 ", N/A ,"$9,820.80 ","$8,184.00 ", N/A , N/A ,"$9,602.56 ", N/A ,"$8,184.00 ","$8,184.00 ","$9,275.20 ","$9,275.20 ", N/A ,"$9,275.20 ", N/A ,"$8,511.36 ","$8,511.36 ","$8,511.36 ","$9,820.80 ", N/A ,"$9,820.80 ", N/A ,"$10,912.00 ","$7,147.36 ", N/A ,"$4,539.39 ", N/A , N/A , N/A ,"$9,820.80 ", N/A ,"$6,732.70 ","$3,055.36 ","$9,820.80 ", N/A ,"$9,820.80 ","$9,820.80 ", N/A ,"$7,092.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801671,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T7,278,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801672,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T8,278,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801673,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T9,278,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801674,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T10,278,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801675,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T11,278,1 ,"$5,700.00 ","$3,705.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$4,246.50 ","$3,733.50 ", N/A ,"$1,596.00 ","$2,878.50 ", N/A ,"$3,516.90 ", N/A ,"$3,516.90 ","$3,516.90 ", N/A ,"$3,516.90 ", N/A ,"$5,130.00 ","$4,275.00 ", N/A , N/A ,"$5,016.00 ", N/A ,"$4,275.00 ","$4,275.00 ","$4,845.00 ","$4,845.00 ", N/A ,"$4,845.00 ", N/A ,"$4,446.00 ","$4,446.00 ","$4,446.00 ","$5,130.00 ", N/A ,"$5,130.00 ", N/A ,"$5,700.00 ","$3,733.50 ", N/A ,"$2,371.20 ", N/A , N/A , N/A ,"$5,130.00 ", N/A ,"$3,516.90 ","$1,596.00 ","$5,130.00 ", N/A ,"$5,130.00 ","$5,130.00 ", N/A ,"$3,705.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801676,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T12,278,1 ,"$6,300.00 ","$4,095.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,693.50 ","$4,126.50 ", N/A ,"$1,764.00 ","$3,181.50 ", N/A ,"$3,887.10 ", N/A ,"$3,887.10 ","$3,887.10 ", N/A ,"$3,887.10 ", N/A ,"$5,670.00 ","$4,725.00 ", N/A , N/A ,"$5,544.00 ", N/A ,"$4,725.00 ","$4,725.00 ","$5,355.00 ","$5,355.00 ", N/A ,"$5,355.00 ", N/A ,"$4,914.00 ","$4,914.00 ","$4,914.00 ","$5,670.00 ", N/A ,"$5,670.00 ", N/A ,"$6,300.00 ","$4,126.50 ", N/A ,"$2,620.80 ", N/A , N/A , N/A ,"$5,670.00 ", N/A ,"$3,887.10 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,670.00 ","$5,670.00 ", N/A ,"$4,095.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801677,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T13,278,1 ,"$6,900.00 ","$4,485.00 ","$1,932.00 ","$6,900.00 ", N/A ,"$5,140.50 ","$4,519.50 ", N/A ,"$1,932.00 ","$3,484.50 ", N/A ,"$4,257.30 ", N/A ,"$4,257.30 ","$4,257.30 ", N/A ,"$4,257.30 ", N/A ,"$6,210.00 ","$5,175.00 ", N/A , N/A ,"$6,072.00 ", N/A ,"$5,175.00 ","$5,175.00 ","$5,865.00 ","$5,865.00 ", N/A ,"$5,865.00 ", N/A ,"$5,382.00 ","$5,382.00 ","$5,382.00 ","$6,210.00 ", N/A ,"$6,210.00 ", N/A ,"$6,900.00 ","$4,519.50 ", N/A ,"$2,870.40 ", N/A , N/A , N/A ,"$6,210.00 ", N/A ,"$4,257.30 ","$1,932.00 ","$6,210.00 ", N/A ,"$6,210.00 ","$6,210.00 ", N/A ,"$4,485.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801678,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T14,278,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801679,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T15,278,1 ,"$8,100.00 ","$5,265.00 ","$2,268.00 ","$8,100.00 ", N/A ,"$6,034.50 ","$5,305.50 ", N/A ,"$2,268.00 ","$4,090.50 ", N/A ,"$4,997.70 ", N/A ,"$4,997.70 ","$4,997.70 ", N/A ,"$4,997.70 ", N/A ,"$7,290.00 ","$6,075.00 ", N/A , N/A ,"$7,128.00 ", N/A ,"$6,075.00 ","$6,075.00 ","$6,885.00 ","$6,885.00 ", N/A ,"$6,885.00 ", N/A ,"$6,318.00 ","$6,318.00 ","$6,318.00 ","$7,290.00 ", N/A ,"$7,290.00 ", N/A ,"$8,100.00 ","$5,305.50 ", N/A ,"$3,369.60 ", N/A , N/A , N/A ,"$7,290.00 ", N/A ,"$4,997.70 ","$2,268.00 ","$7,290.00 ", N/A ,"$7,290.00 ","$7,290.00 ", N/A ,"$5,265.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801680,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T16,278,1 ,"$8,700.00 ","$5,655.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$6,481.50 ","$5,698.50 ", N/A ,"$2,436.00 ","$4,393.50 ", N/A ,"$5,367.90 ", N/A ,"$5,367.90 ","$5,367.90 ", N/A ,"$5,367.90 ", N/A ,"$7,830.00 ","$6,525.00 ", N/A , N/A ,"$7,656.00 ", N/A ,"$6,525.00 ","$6,525.00 ","$7,395.00 ","$7,395.00 ", N/A ,"$7,395.00 ", N/A ,"$6,786.00 ","$6,786.00 ","$6,786.00 ","$7,830.00 ", N/A ,"$7,830.00 ", N/A ,"$8,700.00 ","$5,698.50 ", N/A ,"$3,619.20 ", N/A , N/A , N/A ,"$7,830.00 ", N/A ,"$5,367.90 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,830.00 ","$7,830.00 ", N/A ,"$5,655.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801681,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T17,278,1 ,"$9,300.00 ","$6,045.00 ","$2,604.00 ","$9,300.00 ", N/A ,"$6,928.50 ","$6,091.50 ", N/A ,"$2,604.00 ","$4,696.50 ", N/A ,"$5,738.10 ", N/A ,"$5,738.10 ","$5,738.10 ", N/A ,"$5,738.10 ", N/A ,"$8,370.00 ","$6,975.00 ", N/A , N/A ,"$8,184.00 ", N/A ,"$6,975.00 ","$6,975.00 ","$7,905.00 ","$7,905.00 ", N/A ,"$7,905.00 ", N/A ,"$7,254.00 ","$7,254.00 ","$7,254.00 ","$8,370.00 ", N/A ,"$8,370.00 ", N/A ,"$9,300.00 ","$6,091.50 ", N/A ,"$3,868.80 ", N/A , N/A , N/A ,"$8,370.00 ", N/A ,"$5,738.10 ","$2,604.00 ","$8,370.00 ", N/A ,"$8,370.00 ","$8,370.00 ", N/A ,"$6,045.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801682,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T18,278,1 ,"$9,900.00 ","$6,435.00 ","$2,772.00 ","$9,900.00 ", N/A ,"$7,375.50 ","$6,484.50 ", N/A ,"$2,772.00 ","$4,999.50 ", N/A ,"$6,108.30 ", N/A ,"$6,108.30 ","$6,108.30 ", N/A ,"$6,108.30 ", N/A ,"$8,910.00 ","$7,425.00 ", N/A , N/A ,"$8,712.00 ", N/A ,"$7,425.00 ","$7,425.00 ","$8,415.00 ","$8,415.00 ", N/A ,"$8,415.00 ", N/A ,"$7,722.00 ","$7,722.00 ","$7,722.00 ","$8,910.00 ", N/A ,"$8,910.00 ", N/A ,"$9,900.00 ","$6,484.50 ", N/A ,"$4,118.40 ", N/A , N/A , N/A ,"$8,910.00 ", N/A ,"$6,108.30 ","$2,772.00 ","$8,910.00 ", N/A ,"$8,910.00 ","$8,910.00 ", N/A ,"$6,435.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801683,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T19,278,1 ,"$10,500.00 ","$6,825.00 ","$2,940.00 ","$10,500.00 ", N/A ,"$7,822.50 ","$6,877.50 ", N/A ,"$2,940.00 ","$5,302.50 ", N/A ,"$6,478.50 ", N/A ,"$6,478.50 ","$6,478.50 ", N/A ,"$6,478.50 ", N/A ,"$9,450.00 ","$7,875.00 ", N/A , N/A ,"$9,240.00 ", N/A ,"$7,875.00 ","$7,875.00 ","$8,925.00 ","$8,925.00 ", N/A ,"$8,925.00 ", N/A ,"$8,190.00 ","$8,190.00 ","$8,190.00 ","$9,450.00 ", N/A ,"$9,450.00 ", N/A ,"$10,500.00 ","$6,877.50 ", N/A ,"$4,368.00 ", N/A , N/A , N/A ,"$9,450.00 ", N/A ,"$6,478.50 ","$2,940.00 ","$9,450.00 ", N/A ,"$9,450.00 ","$9,450.00 ", N/A ,"$6,825.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801684,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T20,278,1 ,"$11,100.00 ","$7,215.00 ","$3,108.00 ","$11,100.00 ", N/A ,"$8,269.50 ","$7,270.50 ", N/A ,"$3,108.00 ","$5,605.50 ", N/A ,"$6,848.70 ", N/A ,"$6,848.70 ","$6,848.70 ", N/A ,"$6,848.70 ", N/A ,"$9,990.00 ","$8,325.00 ", N/A , N/A ,"$9,768.00 ", N/A ,"$8,325.00 ","$8,325.00 ","$9,435.00 ","$9,435.00 ", N/A ,"$9,435.00 ", N/A ,"$8,658.00 ","$8,658.00 ","$8,658.00 ","$9,990.00 ", N/A ,"$9,990.00 ", N/A ,"$11,100.00 ","$7,270.50 ", N/A ,"$4,617.60 ", N/A , N/A , N/A ,"$9,990.00 ", N/A ,"$6,848.70 ","$3,108.00 ","$9,990.00 ", N/A ,"$9,990.00 ","$9,990.00 ", N/A ,"$7,215.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801685,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T21,278,1 ,"$11,700.00 ","$7,605.00 ","$3,276.00 ","$11,700.00 ", N/A ,"$8,716.50 ","$7,663.50 ", N/A ,"$3,276.00 ","$5,908.50 ", N/A ,"$7,218.90 ", N/A ,"$7,218.90 ","$7,218.90 ", N/A ,"$7,218.90 ", N/A ,"$10,530.00 ","$8,775.00 ", N/A , N/A ,"$10,296.00 ", N/A ,"$8,775.00 ","$8,775.00 ","$9,945.00 ","$9,945.00 ", N/A ,"$9,945.00 ", N/A ,"$9,126.00 ","$9,126.00 ","$9,126.00 ","$10,530.00 ", N/A ,"$10,530.00 ", N/A ,"$11,700.00 ","$7,663.50 ", N/A ,"$4,867.20 ", N/A , N/A , N/A ,"$10,530.00 ", N/A ,"$7,218.90 ","$3,276.00 ","$10,530.00 ", N/A ,"$10,530.00 ","$10,530.00 ", N/A ,"$7,605.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801686,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T22,278,1 ,"$12,300.00 ","$7,995.00 ","$3,444.00 ","$12,300.00 ", N/A ,"$9,163.50 ","$8,056.50 ", N/A ,"$3,444.00 ","$6,211.50 ", N/A ,"$7,589.10 ", N/A ,"$7,589.10 ","$7,589.10 ", N/A ,"$7,589.10 ", N/A ,"$11,070.00 ","$9,225.00 ", N/A , N/A ,"$10,824.00 ", N/A ,"$9,225.00 ","$9,225.00 ","$10,455.00 ","$10,455.00 ", N/A ,"$10,455.00 ", N/A ,"$9,594.00 ","$9,594.00 ","$9,594.00 ","$11,070.00 ", N/A ,"$11,070.00 ", N/A ,"$12,300.00 ","$8,056.50 ", N/A ,"$5,116.80 ", N/A , N/A , N/A ,"$11,070.00 ", N/A ,"$7,589.10 ","$3,444.00 ","$11,070.00 ", N/A ,"$11,070.00 ","$11,070.00 ", N/A ,"$7,995.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801687,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T23,278,1 ,"$12,900.00 ","$8,385.00 ","$3,612.00 ","$12,900.00 ", N/A ,"$9,610.50 ","$8,449.50 ", N/A ,"$3,612.00 ","$6,514.50 ", N/A ,"$7,959.30 ", N/A ,"$7,959.30 ","$7,959.30 ", N/A ,"$7,959.30 ", N/A ,"$11,610.00 ","$9,675.00 ", N/A , N/A ,"$11,352.00 ", N/A ,"$9,675.00 ","$9,675.00 ","$10,965.00 ","$10,965.00 ", N/A ,"$10,965.00 ", N/A ,"$10,062.00 ","$10,062.00 ","$10,062.00 ","$11,610.00 ", N/A ,"$11,610.00 ", N/A ,"$12,900.00 ","$8,449.50 ", N/A ,"$5,366.40 ", N/A , N/A , N/A ,"$11,610.00 ", N/A ,"$7,959.30 ","$3,612.00 ","$11,610.00 ", N/A ,"$11,610.00 ","$11,610.00 ", N/A ,"$8,385.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801688,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T24,278,1 ,"$13,500.00 ","$8,775.00 ","$3,780.00 ","$13,500.00 ", N/A ,"$10,057.50 ","$8,842.50 ", N/A ,"$3,780.00 ","$6,817.50 ", N/A ,"$8,329.50 ", N/A ,"$8,329.50 ","$8,329.50 ", N/A ,"$8,329.50 ", N/A ,"$12,150.00 ","$10,125.00 ", N/A , N/A ,"$11,880.00 ", N/A ,"$10,125.00 ","$10,125.00 ","$11,475.00 ","$11,475.00 ", N/A ,"$11,475.00 ", N/A ,"$10,530.00 ","$10,530.00 ","$10,530.00 ","$12,150.00 ", N/A ,"$12,150.00 ", N/A ,"$13,500.00 ","$8,842.50 ", N/A ,"$5,616.00 ", N/A , N/A , N/A ,"$12,150.00 ", N/A ,"$8,329.50 ","$3,780.00 ","$12,150.00 ", N/A ,"$12,150.00 ","$12,150.00 ", N/A ,"$8,775.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801689,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T25,278,1 ,"$14,100.00 ","$9,165.00 ","$3,948.00 ","$14,100.00 ", N/A ,"$10,504.50 ","$9,235.50 ", N/A ,"$3,948.00 ","$7,120.50 ", N/A ,"$8,699.70 ", N/A ,"$8,699.70 ","$8,699.70 ", N/A ,"$8,699.70 ", N/A ,"$12,690.00 ","$10,575.00 ", N/A , N/A ,"$12,408.00 ", N/A ,"$10,575.00 ","$10,575.00 ","$11,985.00 ","$11,985.00 ", N/A ,"$11,985.00 ", N/A ,"$10,998.00 ","$10,998.00 ","$10,998.00 ","$12,690.00 ", N/A ,"$12,690.00 ", N/A ,"$14,100.00 ","$9,235.50 ", N/A ,"$5,865.60 ", N/A , N/A , N/A ,"$12,690.00 ", N/A ,"$8,699.70 ","$3,948.00 ","$12,690.00 ", N/A ,"$12,690.00 ","$12,690.00 ", N/A ,"$9,165.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801690,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T26,278,1 ,"$14,700.00 ","$9,555.00 ","$4,116.00 ","$14,700.00 ", N/A ,"$10,951.50 ","$9,628.50 ", N/A ,"$4,116.00 ","$7,423.50 ", N/A ,"$9,069.90 ", N/A ,"$9,069.90 ","$9,069.90 ", N/A ,"$9,069.90 ", N/A ,"$13,230.00 ","$11,025.00 ", N/A , N/A ,"$12,936.00 ", N/A ,"$11,025.00 ","$11,025.00 ","$12,495.00 ","$12,495.00 ", N/A ,"$12,495.00 ", N/A ,"$11,466.00 ","$11,466.00 ","$11,466.00 ","$13,230.00 ", N/A ,"$13,230.00 ", N/A ,"$14,700.00 ","$9,628.50 ", N/A ,"$6,115.20 ", N/A , N/A , N/A ,"$13,230.00 ", N/A ,"$9,069.90 ","$4,116.00 ","$13,230.00 ", N/A ,"$13,230.00 ","$13,230.00 ", N/A ,"$9,555.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801709,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T6,278,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801713,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T10,278,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801714,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T11,278,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801715,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T12,278,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801716,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T13,278,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801717,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T14,278,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801718,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T15,278,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801719,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T16,278,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801720,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T17,278,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801721,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T18,278,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801722,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T19,278,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801723,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T20,278,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801724,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T21,278,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801725,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T22,278,1 ,"$4,500.00 ","$2,925.00 ","$1,260.00 ","$4,500.00 ", N/A ,"$3,352.50 ","$2,947.50 ", N/A ,"$1,260.00 ","$2,272.50 ", N/A ,"$2,776.50 ", N/A ,"$2,776.50 ","$2,776.50 ", N/A ,"$2,776.50 ", N/A ,"$4,050.00 ","$3,375.00 ", N/A , N/A ,"$3,960.00 ", N/A ,"$3,375.00 ","$3,375.00 ","$3,825.00 ","$3,825.00 ", N/A ,"$3,825.00 ", N/A ,"$3,510.00 ","$3,510.00 ","$3,510.00 ","$4,050.00 ", N/A ,"$4,050.00 ", N/A ,"$4,500.00 ","$2,947.50 ", N/A ,"$1,872.00 ", N/A , N/A , N/A ,"$4,050.00 ", N/A ,"$2,776.50 ","$1,260.00 ","$4,050.00 ", N/A ,"$4,050.00 ","$4,050.00 ", N/A ,"$2,925.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801730,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T27,278,1 ,"$7,500.00 ","$4,875.00 ","$2,100.00 ","$7,500.00 ", N/A ,"$5,587.50 ","$4,912.50 ", N/A ,"$2,100.00 ","$3,787.50 ", N/A ,"$4,627.50 ", N/A ,"$4,627.50 ","$4,627.50 ", N/A ,"$4,627.50 ", N/A ,"$6,750.00 ","$5,625.00 ", N/A , N/A ,"$6,600.00 ", N/A ,"$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ", N/A ,"$6,375.00 ", N/A ,"$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ", N/A ,"$6,750.00 ", N/A ,"$7,500.00 ","$4,912.50 ", N/A ,"$3,120.00 ", N/A , N/A , N/A ,"$6,750.00 ", N/A ,"$4,627.50 ","$2,100.00 ","$6,750.00 ", N/A ,"$6,750.00 ","$6,750.00 ", N/A ,"$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801732,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T29,278,1 ,"$8,700.00 ","$5,655.00 ","$2,436.00 ","$8,700.00 ", N/A ,"$6,481.50 ","$5,698.50 ", N/A ,"$2,436.00 ","$4,393.50 ", N/A ,"$5,367.90 ", N/A ,"$5,367.90 ","$5,367.90 ", N/A ,"$5,367.90 ", N/A ,"$7,830.00 ","$6,525.00 ", N/A , N/A ,"$7,656.00 ", N/A ,"$6,525.00 ","$6,525.00 ","$7,395.00 ","$7,395.00 ", N/A ,"$7,395.00 ", N/A ,"$6,786.00 ","$6,786.00 ","$6,786.00 ","$7,830.00 ", N/A ,"$7,830.00 ", N/A ,"$8,700.00 ","$5,698.50 ", N/A ,"$3,619.20 ", N/A , N/A , N/A ,"$7,830.00 ", N/A ,"$5,367.90 ","$2,436.00 ","$7,830.00 ", N/A ,"$7,830.00 ","$7,830.00 ", N/A ,"$5,655.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801769,C1880,HC FILTER VENA CAVA T7,278,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801770,C1880,HC FILTER VENA CAVA T8,278,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801816,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T4,278,1 ,"$7,000.00 ","$4,550.00 ","$1,960.00 ","$7,000.00 ", N/A ,"$5,215.00 ","$4,585.00 ", N/A ,"$1,960.00 ","$3,535.00 ", N/A ,"$4,319.00 ", N/A ,"$4,319.00 ","$4,319.00 ", N/A ,"$4,319.00 ", N/A ,"$6,300.00 ","$5,250.00 ", N/A , N/A ,"$6,160.00 ", N/A ,"$5,250.00 ","$5,250.00 ","$5,950.00 ","$5,950.00 ", N/A ,"$5,950.00 ", N/A ,"$5,460.00 ","$5,460.00 ","$5,460.00 ","$6,300.00 ", N/A ,"$6,300.00 ", N/A ,"$7,000.00 ","$4,585.00 ", N/A ,"$2,912.00 ", N/A , N/A , N/A ,"$6,300.00 ", N/A ,"$4,319.00 ","$1,960.00 ","$6,300.00 ", N/A ,"$6,300.00 ","$6,300.00 ", N/A ,"$4,550.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801972,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T6,278,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801973,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T7,278,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801974,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T8,278,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801975,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T9,278,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801976,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T10,278,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27801987,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T1,278,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802016,N/A,HC IMPLANT SURGICAL T1,278,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802017,N/A,HC IMPLANT SURGICAL T2,278,1 ,$20.00 ,$13.00 ,$5.60 ,$20.00 , N/A ,$14.90 ,$13.10 , N/A ,$5.60 ,$10.10 , N/A ,$12.34 , N/A ,$12.34 ,$12.34 , N/A ,$12.34 , N/A ,$18.00 ,$15.00 , N/A , N/A ,$17.60 , N/A ,$15.00 ,$15.00 ,$17.00 ,$17.00 , N/A ,$17.00 , N/A ,$15.60 ,$15.60 ,$15.60 ,$18.00 , N/A ,$18.00 , N/A ,$20.00 ,$13.10 , N/A ,$8.32 , N/A , N/A , N/A ,$18.00 , N/A ,$12.34 ,$5.60 ,$18.00 , N/A ,$18.00 ,$18.00 , N/A ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802018,N/A,HC IMPLANT SURGICAL T3,278,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802019,N/A,HC IMPLANT SURGICAL T4,278,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 , N/A , N/A , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802020,N/A,HC IMPLANT SURGICAL T5,278,1 ,$150.00 ,$97.50 ,$42.00 ,$150.00 , N/A ,$111.75 ,$98.25 , N/A ,$42.00 ,$75.75 , N/A ,$92.55 , N/A ,$92.55 ,$92.55 , N/A ,$92.55 , N/A ,$135.00 ,$112.50 , N/A , N/A ,$132.00 , N/A ,$112.50 ,$112.50 ,$127.50 ,$127.50 , N/A ,$127.50 , N/A ,$117.00 ,$117.00 ,$117.00 ,$135.00 , N/A ,$135.00 , N/A ,$150.00 ,$98.25 , N/A ,$62.40 , N/A , N/A , N/A ,$135.00 , N/A ,$92.55 ,$42.00 ,$135.00 , N/A ,$135.00 ,$135.00 , N/A ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802021,N/A,HC IMPLANT SURGICAL T6,278,1 ,$225.00 ,$146.25 ,$63.00 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 , N/A , N/A , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802022,N/A,HC IMPLANT SURGICAL T7,278,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 , N/A ,$223.50 ,$196.50 , N/A ,$84.00 ,$151.50 , N/A ,$185.10 , N/A ,$185.10 ,$185.10 , N/A ,$185.10 , N/A ,$270.00 ,$225.00 , N/A , N/A ,$264.00 , N/A ,$225.00 ,$225.00 ,$255.00 ,$255.00 , N/A ,$255.00 , N/A ,$234.00 ,$234.00 ,$234.00 ,$270.00 , N/A ,$270.00 , N/A ,$300.00 ,$196.50 , N/A ,$124.80 , N/A , N/A , N/A ,$270.00 , N/A ,$185.10 ,$84.00 ,$270.00 , N/A ,$270.00 ,$270.00 , N/A ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802023,N/A,HC IMPLANT SURGICAL T8,278,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802024,N/A,HC IMPLANT SURGICAL T9,278,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802025,N/A,HC IMPLANT SURGICAL T10,278,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802026,N/A,HC IMPLANT SURGICAL T11,278,1 ,$600.00 ,$390.00 ,$168.00 ,$600.00 , N/A ,$447.00 ,$393.00 , N/A ,$168.00 ,$303.00 , N/A ,$370.20 , N/A ,$370.20 ,$370.20 , N/A ,$370.20 , N/A ,$540.00 ,$450.00 , N/A , N/A ,$528.00 , N/A ,$450.00 ,$450.00 ,$510.00 ,$510.00 , N/A ,$510.00 , N/A ,$468.00 ,$468.00 ,$468.00 ,$540.00 , N/A ,$540.00 , N/A ,$600.00 ,$393.00 , N/A ,$249.60 , N/A , N/A , N/A ,$540.00 , N/A ,$370.20 ,$168.00 ,$540.00 , N/A ,$540.00 ,$540.00 , N/A ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802027,N/A,HC IMPLANT SURGICAL T12,278,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 , N/A ,$558.75 ,$491.25 , N/A ,$210.00 ,$378.75 , N/A ,$462.75 , N/A ,$462.75 ,$462.75 , N/A ,$462.75 , N/A ,$675.00 ,$562.50 , N/A , N/A ,$660.00 , N/A ,$562.50 ,$562.50 ,$637.50 ,$637.50 , N/A ,$637.50 , N/A ,$585.00 ,$585.00 ,$585.00 ,$675.00 , N/A ,$675.00 , N/A ,$750.00 ,$491.25 , N/A ,$312.00 , N/A , N/A , N/A ,$675.00 , N/A ,$462.75 ,$210.00 ,$675.00 , N/A ,$675.00 ,$675.00 , N/A ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802028,N/A,HC IMPLANT SURGICAL T13,278,1 ,$900.00 ,$585.00 ,$252.00 ,$900.00 , N/A ,$670.50 ,$589.50 , N/A ,$252.00 ,$454.50 , N/A ,$555.30 , N/A ,$555.30 ,$555.30 , N/A ,$555.30 , N/A ,$810.00 ,$675.00 , N/A , N/A ,$792.00 , N/A ,$675.00 ,$675.00 ,$765.00 ,$765.00 , N/A ,$765.00 , N/A ,$702.00 ,$702.00 ,$702.00 ,$810.00 , N/A ,$810.00 , N/A ,$900.00 ,$589.50 , N/A ,$374.40 , N/A , N/A , N/A ,$810.00 , N/A ,$555.30 ,$252.00 ,$810.00 , N/A ,$810.00 ,$810.00 , N/A ,$585.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802029,N/A,HC IMPLANT SURGICAL T14,278,1 ,"$1,050.00 ",$682.50 ,$294.00 ,"$1,050.00 ", N/A ,$782.25 ,$687.75 , N/A ,$294.00 ,$530.25 , N/A ,$647.85 , N/A ,$647.85 ,$647.85 , N/A ,$647.85 , N/A ,$945.00 ,$787.50 , N/A , N/A ,$924.00 , N/A ,$787.50 ,$787.50 ,$892.50 ,$892.50 , N/A ,$892.50 , N/A ,$819.00 ,$819.00 ,$819.00 ,$945.00 , N/A ,$945.00 , N/A ,"$1,050.00 ",$687.75 , N/A ,$436.80 , N/A , N/A , N/A ,$945.00 , N/A ,$647.85 ,$294.00 ,$945.00 , N/A ,$945.00 ,$945.00 , N/A ,$682.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802030,N/A,HC IMPLANT SURGICAL T15,278,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802031,N/A,HC IMPLANT SURGICAL T16,278,1 ,"$1,350.00 ",$877.50 ,$378.00 ,"$1,350.00 ", N/A ,"$1,005.75 ",$884.25 , N/A ,$378.00 ,$681.75 , N/A ,$832.95 , N/A ,$832.95 ,$832.95 , N/A ,$832.95 , N/A ,"$1,215.00 ","$1,012.50 ", N/A , N/A ,"$1,188.00 ", N/A ,"$1,012.50 ","$1,012.50 ","$1,147.50 ","$1,147.50 ", N/A ,"$1,147.50 ", N/A ,"$1,053.00 ","$1,053.00 ","$1,053.00 ","$1,215.00 ", N/A ,"$1,215.00 ", N/A ,"$1,350.00 ",$884.25 , N/A ,$561.60 , N/A , N/A , N/A ,"$1,215.00 ", N/A ,$832.95 ,$378.00 ,"$1,215.00 ", N/A ,"$1,215.00 ","$1,215.00 ", N/A ,$877.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802032,N/A,HC IMPLANT SURGICAL T17,278,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802033,N/A,HC IMPLANT SURGICAL T18,278,1 ,"$2,100.00 ","$1,365.00 ",$588.00 ,"$2,100.00 ", N/A ,"$1,564.50 ","$1,375.50 ", N/A ,$588.00 ,"$1,060.50 ", N/A ,"$1,295.70 ", N/A ,"$1,295.70 ","$1,295.70 ", N/A ,"$1,295.70 ", N/A ,"$1,890.00 ","$1,575.00 ", N/A , N/A ,"$1,848.00 ", N/A ,"$1,575.00 ","$1,575.00 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ", N/A ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,890.00 ", N/A ,"$1,890.00 ", N/A ,"$2,100.00 ","$1,375.50 ", N/A ,$873.60 , N/A , N/A , N/A ,"$1,890.00 ", N/A ,"$1,295.70 ",$588.00 ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ", N/A ,"$1,365.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802034,N/A,HC IMPLANT SURGICAL T19,278,1 ,"$2,700.00 ","$1,755.00 ",$756.00 ,"$2,700.00 ", N/A ,"$2,011.50 ","$1,768.50 ", N/A ,$756.00 ,"$1,363.50 ", N/A ,"$1,665.90 ", N/A ,"$1,665.90 ","$1,665.90 ", N/A ,"$1,665.90 ", N/A ,"$2,430.00 ","$2,025.00 ", N/A , N/A ,"$2,376.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,295.00 ","$2,295.00 ", N/A ,"$2,295.00 ", N/A ,"$2,106.00 ","$2,106.00 ","$2,106.00 ","$2,430.00 ", N/A ,"$2,430.00 ", N/A ,"$2,700.00 ","$1,768.50 ", N/A ,"$1,123.20 ", N/A , N/A , N/A ,"$2,430.00 ", N/A ,"$1,665.90 ",$756.00 ,"$2,430.00 ", N/A ,"$2,430.00 ","$2,430.00 ", N/A ,"$1,755.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802035,N/A,HC IMPLANT SURGICAL T20,278,1 ,"$3,300.00 ","$2,145.00 ",$924.00 ,"$3,300.00 ", N/A ,"$2,458.50 ","$2,161.50 ", N/A ,$924.00 ,"$1,666.50 ", N/A ,"$2,036.10 ", N/A ,"$2,036.10 ","$2,036.10 ", N/A ,"$2,036.10 ", N/A ,"$2,970.00 ","$2,475.00 ", N/A , N/A ,"$2,904.00 ", N/A ,"$2,475.00 ","$2,475.00 ","$2,805.00 ","$2,805.00 ", N/A ,"$2,805.00 ", N/A ,"$2,574.00 ","$2,574.00 ","$2,574.00 ","$2,970.00 ", N/A ,"$2,970.00 ", N/A ,"$3,300.00 ","$2,161.50 ", N/A ,"$1,372.80 ", N/A , N/A , N/A ,"$2,970.00 ", N/A ,"$2,036.10 ",$924.00 ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ", N/A ,"$2,145.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802104,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T1,278,1 ,"$5,100.00 ","$3,315.00 ","$1,428.00 ","$5,100.00 ", N/A ,"$3,799.50 ","$3,340.50 ", N/A ,"$1,428.00 ","$2,575.50 ", N/A ,"$3,146.70 ", N/A ,"$3,146.70 ","$3,146.70 ", N/A ,"$3,146.70 ", N/A ,"$4,590.00 ","$3,825.00 ", N/A , N/A ,"$4,488.00 ", N/A ,"$3,825.00 ","$3,825.00 ","$4,335.00 ","$4,335.00 ", N/A ,"$4,335.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,590.00 ", N/A ,"$4,590.00 ", N/A ,"$5,100.00 ","$3,340.50 ", N/A ,"$2,121.60 ", N/A , N/A , N/A ,"$4,590.00 ", N/A ,"$3,146.70 ","$1,428.00 ","$4,590.00 ", N/A ,"$4,590.00 ","$4,590.00 ", N/A ,"$3,315.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802105,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T2,278,1 ,"$5,700.00 ","$3,705.00 ","$1,596.00 ","$5,700.00 ", N/A ,"$4,246.50 ","$3,733.50 ", N/A ,"$1,596.00 ","$2,878.50 ", N/A ,"$3,516.90 ", N/A ,"$3,516.90 ","$3,516.90 ", N/A ,"$3,516.90 ", N/A ,"$5,130.00 ","$4,275.00 ", N/A , N/A ,"$5,016.00 ", N/A ,"$4,275.00 ","$4,275.00 ","$4,845.00 ","$4,845.00 ", N/A ,"$4,845.00 ", N/A ,"$4,446.00 ","$4,446.00 ","$4,446.00 ","$5,130.00 ", N/A ,"$5,130.00 ", N/A ,"$5,700.00 ","$3,733.50 ", N/A ,"$2,371.20 ", N/A , N/A , N/A ,"$5,130.00 ", N/A ,"$3,516.90 ","$1,596.00 ","$5,130.00 ", N/A ,"$5,130.00 ","$5,130.00 ", N/A ,"$3,705.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802106,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T3,278,1 ,"$6,300.00 ","$4,095.00 ","$1,764.00 ","$6,300.00 ", N/A ,"$4,693.50 ","$4,126.50 ", N/A ,"$1,764.00 ","$3,181.50 ", N/A ,"$3,887.10 ", N/A ,"$3,887.10 ","$3,887.10 ", N/A ,"$3,887.10 ", N/A ,"$5,670.00 ","$4,725.00 ", N/A , N/A ,"$5,544.00 ", N/A ,"$4,725.00 ","$4,725.00 ","$5,355.00 ","$5,355.00 ", N/A ,"$5,355.00 ", N/A ,"$4,914.00 ","$4,914.00 ","$4,914.00 ","$5,670.00 ", N/A ,"$5,670.00 ", N/A ,"$6,300.00 ","$4,126.50 ", N/A ,"$2,620.80 ", N/A , N/A , N/A ,"$5,670.00 ", N/A ,"$3,887.10 ","$1,764.00 ","$5,670.00 ", N/A ,"$5,670.00 ","$5,670.00 ", N/A ,"$4,095.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802124,C1788,HC PORT VASCULAR ACCESS,278,1 ,"$1,500.00 ",$975.00 ,$420.00 ,"$1,500.00 ", N/A ,"$1,117.50 ",$982.50 , N/A ,$420.00 ,$757.50 , N/A ,$925.50 , N/A ,$925.50 ,$925.50 , N/A ,$925.50 , N/A ,"$1,350.00 ","$1,125.00 ", N/A , N/A ,"$1,320.00 ", N/A ,"$1,125.00 ","$1,125.00 ","$1,275.00 ","$1,275.00 ", N/A ,"$1,275.00 ", N/A ,"$1,170.00 ","$1,170.00 ","$1,170.00 ","$1,350.00 ", N/A ,"$1,350.00 ", N/A ,"$1,500.00 ",$982.50 , N/A ,$624.00 , N/A , N/A , N/A ,"$1,350.00 ", N/A ,$925.50 ,$420.00 ,"$1,350.00 ", N/A ,"$1,350.00 ","$1,350.00 ", N/A ,$975.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802153,C2617,HC STENT NONCORONARY TEMPORARY W/O DELIVERY SYSTEM T1,278,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$156.00 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A ,$337.50 ,$337.50 , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802157,C2617,HC STENT NONCORONARY TEMPORARY W/O DELIVERY SYSTEM T2,278,1 ,$450.00 ,$292.50 ,$126.00 ,$450.00 , N/A ,$335.25 ,$294.75 , N/A ,$126.00 ,$227.25 , N/A ,$277.65 , N/A ,$277.65 ,$277.65 , N/A ,$277.65 , N/A ,$405.00 ,$337.50 , N/A , N/A ,$396.00 , N/A ,$337.50 ,$337.50 ,$382.50 ,$382.50 , N/A ,$382.50 , N/A ,$351.00 ,$351.00 ,$351.00 ,$405.00 , N/A ,$405.00 , N/A ,$450.00 ,$294.75 , N/A ,$187.20 , N/A , N/A , N/A ,$405.00 , N/A ,$277.65 ,$126.00 ,$405.00 , N/A ,$405.00 ,$405.00 , N/A ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27802158,C2617,HC STENT NONCORONARY TEMPORARY W/O DELIVERY SYSTEM T3,278,1 ,$525.00 ,$341.25 ,$147.00 ,$525.00 , N/A ,$391.13 ,$343.88 , N/A ,$147.00 ,$265.13 , N/A ,$323.93 , N/A ,$323.93 ,$323.93 , N/A ,$323.93 , N/A ,$472.50 ,$393.75 , N/A , N/A ,$462.00 , N/A ,$393.75 ,$393.75 ,$446.25 ,$446.25 , N/A ,$446.25 , N/A ,$409.50 ,$409.50 ,$409.50 ,$472.50 , N/A ,$472.50 , N/A ,$525.00 ,$343.88 , N/A ,$218.40 , N/A , N/A , N/A ,$472.50 , N/A ,$323.93 ,$147.00 ,$472.50 , N/A ,$472.50 ,$472.50 , N/A ,$341.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),27864122,Q4122,HC DERMACELL PER SQ CM,278,1 ,"$14,700.00 ","$9,555.00 ",$321.15 ,"$14,700.00 ", N/A ,"$10,951.50 ","$9,628.50 ", N/A ,"$4,116.00 ","$7,423.50 ", N/A ,"$9,069.90 ", N/A ,"$9,069.90 ","$9,069.90 ", N/A ,"$9,069.90 ", N/A ,"$13,230.00 ","$11,025.00 ", N/A , N/A ,"$12,936.00 ", N/A ,"$11,025.00 ","$11,025.00 ","$12,495.00 ","$12,495.00 ", N/A ,"$12,495.00 ", N/A ,"$11,466.00 ","$11,466.00 ","$11,466.00 ","$13,230.00 ", N/A ,"$13,230.00 ", N/A ,"$14,700.00 ","$9,628.50 ", N/A ,"$6,115.20 ",$336.45 ,$321.15 , N/A ,"$13,230.00 ", N/A ,"$9,069.90 ","$4,116.00 ","$13,230.00 ", N/A ,"$13,230.00 ","$13,230.00 ", N/A ,"$9,555.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$7.00 ,$4.55 ,$1.96 ,$7.00 , N/A ,$5.22 ,$4.59 , N/A ,$1.96 ,$3.54 , N/A ,$4.32 , N/A ,$4.32 ,$4.32 , N/A ,$4.32 , N/A ,$6.30 ,$5.25 , N/A , N/A ,$6.16 , N/A ,$5.25 ,$5.25 ,$5.95 ,$5.95 , N/A ,$5.95 , N/A ,$5.46 ,$5.46 ,$5.46 ,$6.30 , N/A ,$6.30 , N/A ,$7.00 ,$4.59 , N/A ,$2.91 , N/A , N/A , N/A ,$6.30 , N/A ,$4.32 ,$1.96 ,$6.30 , N/A ,$6.30 ,$6.30 , N/A ,$4.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000010,36415,HC VENIPUNCTURE,300,1 ,$27.00 ,$17.55 ,$1.64 ,$27.00 ,$7.50 ,$20.12 ,$17.69 ,$3.00 ,$7.56 ,$13.64 ,$3.00 ,$16.66 ,$3.00 ,$16.66 ,$16.66 ,$3.00 ,$16.66 ,$5.70 ,$24.30 ,$20.25 ,$7.50 ,$3.00 ,$23.76 ,$3.00 ,$20.25 , N/A , N/A , N/A ,$3.00 , N/A ,$3.00 ,$21.06 ,$21.06 ,$21.06 ,$24.30 ,$7.50 ,$24.30 ,$3.00 ,$3.00 ,$17.69 ,$3.00 ,$11.23 ,$1.72 ,$1.64 ,$3.15 ,$24.30 ,$6.75 ,$16.66 ,$7.56 ,$24.30 ,$3.00 ,$24.30 ,$24.30 ,$3.00 ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$140.00 ,$91.00 ,$33.69 ,$250.12 ,$140.00 ,$104.30 ,$91.70 ,$111.17 ,$39.20 ,$70.70 ,$111.17 ,$86.38 ,$111.17 ,$86.38 ,$86.38 ,$111.17 ,$86.38 ,$211.22 ,$126.00 ,$105.00 ,$140.00 ,$111.17 ,$123.20 ,$111.17 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$111.17 ,$119.00 ,$111.17 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$140.00 ,$126.00 ,$111.17 ,$140.00 ,$91.70 ,$111.17 ,$58.24 ,$35.30 ,$33.69 ,$116.72 ,$126.00 ,$250.12 ,$86.38 ,$39.20 ,$126.00 ,$111.17 ,$126.00 ,$126.00 ,$111.17 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000213,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$205.00 ,$133.25 ,$33.69 ,$250.12 ,$205.00 ,$152.73 ,$134.28 ,$111.17 ,$57.40 ,$103.53 ,$111.17 ,$126.49 ,$111.17 ,$126.49 ,$126.49 ,$111.17 ,$126.49 ,$211.22 ,$184.50 ,$153.75 ,$205.00 ,$111.17 ,$180.40 ,$111.17 ,$153.75 ,$153.75 ,$174.25 ,$174.25 ,$111.17 ,$174.25 ,$111.17 ,$159.90 ,$159.90 ,$159.90 ,$184.50 ,$205.00 ,$184.50 ,$111.17 ,$205.00 ,$134.28 ,$111.17 ,$85.28 ,$35.30 ,$33.69 ,$116.72 ,$184.50 ,$250.12 ,$126.49 ,$57.40 ,$184.50 ,$111.17 ,$184.50 ,$184.50 ,$111.17 ,$133.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000214,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$335.85 ,$218.30 ,$33.69 ,$335.85 ,$277.92 ,$250.21 ,$219.98 ,$111.17 ,$94.04 ,$169.60 ,$111.17 ,$207.22 ,$111.17 ,$207.22 ,$207.22 ,$111.17 ,$207.22 ,$211.22 ,$302.27 ,$251.89 ,$277.92 ,$111.17 ,$295.55 ,$111.17 ,$251.89 ,$251.89 ,$285.47 ,$285.47 ,$111.17 ,$285.47 ,$111.17 ,$261.96 ,$261.96 ,$261.96 ,$302.27 ,$277.92 ,$302.27 ,$111.17 ,$335.85 ,$219.98 ,$111.17 ,$139.71 ,$35.30 ,$33.69 ,$116.72 ,$302.27 ,$250.12 ,$207.22 ,$94.04 ,$302.27 ,$111.17 ,$302.27 ,$302.27 ,$111.17 ,$218.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000218,86927,HC FFP THAWING EACH UNIT,300,1 ,$50.00 ,$32.50 ,$14.00 ,$330.83 ,$50.00 ,$37.25 ,$32.75 ,$50.00 ,$14.00 ,$25.25 ,$50.00 ,$30.85 ,$50.00 ,$30.85 ,$30.85 ,$50.00 ,$30.85 ,$279.38 ,$45.00 ,$37.50 ,$50.00 ,$50.00 ,$44.00 ,$50.00 ,$37.50 ,$37.50 ,$42.50 ,$42.50 ,$50.00 ,$42.50 ,$50.00 ,$39.00 ,$39.00 ,$39.00 ,$45.00 ,$50.00 ,$45.00 ,$50.00 ,$50.00 ,$32.75 ,$50.00 ,$20.80 ,$29.66 ,$28.31 ,$50.00 ,$45.00 ,$330.83 ,$30.85 ,$14.00 ,$45.00 ,$50.00 ,$45.00 ,$45.00 ,$50.00 ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000223,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$190.00 ,$123.50 ,$5.60 ,$190.00 ,$14.00 ,$141.55 ,$124.45 ,$5.60 ,$53.20 ,$95.95 ,$5.60 ,$117.23 ,$5.60 ,$117.23 ,$117.23 ,$5.60 ,$117.23 ,$10.64 ,$171.00 ,$142.50 ,$14.00 ,$5.60 ,$167.20 ,$5.60 ,$142.50 ,$142.50 ,$161.50 ,$161.50 ,$5.60 ,$161.50 ,$5.60 ,$148.20 ,$148.20 ,$148.20 ,$171.00 ,$14.00 ,$171.00 ,$5.60 ,$190.00 ,$124.45 ,$5.60 ,$79.04 ,$23.44 ,$22.38 ,$5.88 ,$171.00 ,$12.60 ,$117.23 ,$53.20 ,$171.00 ,$5.60 ,$171.00 ,$171.00 ,$5.60 ,$123.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000225,89190,HC SMEAR NASAL EOSINOPHILS,300,1 ,$79.00 ,$51.35 ,$5.79 ,$79.00 ,$14.48 ,$58.86 ,$51.75 ,$5.79 ,$22.12 ,$39.90 ,$5.79 ,$48.74 ,$5.79 ,$48.74 ,$48.74 ,$5.79 ,$48.74 ,$11.00 ,$71.10 ,$59.25 ,$14.48 ,$5.79 ,$69.52 ,$5.79 ,$59.25 ,$59.25 ,$67.15 ,$67.15 ,$5.79 ,$67.15 ,$5.79 ,$61.62 ,$61.62 ,$61.62 ,$71.10 ,$14.48 ,$71.10 ,$5.79 ,$79.00 ,$51.75 ,$5.79 ,$32.86 ,$23.44 ,$22.38 ,$6.08 ,$71.10 ,$13.03 ,$48.74 ,$22.12 ,$71.10 ,$5.79 ,$71.10 ,$71.10 ,$5.79 ,$51.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000245,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$79.00 ,$51.35 ,$4.27 ,$79.00 ,$10.68 ,$58.86 ,$51.75 ,$4.27 ,$22.12 ,$39.90 ,$4.27 ,$48.74 ,$4.27 ,$48.74 ,$48.74 ,$4.27 ,$48.74 ,$8.11 ,$71.10 ,$59.25 ,$10.68 ,$4.27 ,$69.52 ,$4.27 ,$59.25 ,$59.25 ,$67.15 ,$67.15 ,$4.27 ,$67.15 ,$4.27 ,$61.62 ,$61.62 ,$61.62 ,$71.10 ,$10.68 ,$71.10 ,$4.27 ,$79.00 ,$51.75 ,$4.27 ,$32.86 ,$5.09 ,$4.86 ,$4.48 ,$71.10 ,$9.61 ,$48.74 ,$22.12 ,$71.10 ,$4.27 ,$71.10 ,$71.10 ,$4.27 ,$51.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000246,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$145.00 ,$94.25 ,$7.33 ,$145.00 ,$18.33 ,$108.03 ,$94.98 ,$7.33 ,$40.60 ,$73.23 ,$7.33 ,$89.47 ,$7.33 ,$89.47 ,$89.47 ,$7.33 ,$89.47 ,$13.93 ,$130.50 ,$108.75 ,$18.33 ,$7.33 ,$127.60 ,$7.33 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$7.33 ,$123.25 ,$7.33 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$18.33 ,$130.50 ,$7.33 ,$145.00 ,$94.98 ,$7.33 ,$60.32 ,$23.44 ,$22.38 ,$7.70 ,$130.50 ,$16.49 ,$89.47 ,$40.60 ,$130.50 ,$7.33 ,$130.50 ,$130.50 ,$7.33 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000249,89320,HC SEMEN ANALYSIS COMPLETE,300,1 ,$616.00 ,$400.40 ,$12.31 ,$616.00 ,$30.78 ,$458.92 ,$403.48 ,$12.31 ,$172.48 ,$311.08 ,$12.31 ,$380.07 ,$12.31 ,$380.07 ,$380.07 ,$12.31 ,$380.07 ,$23.39 ,$554.40 ,$462.00 ,$30.78 ,$12.31 ,$542.08 ,$12.31 ,$462.00 ,$462.00 ,$523.60 ,$523.60 ,$12.31 ,$523.60 ,$12.31 ,$480.48 ,$480.48 ,$480.48 ,$554.40 ,$30.78 ,$554.40 ,$12.31 ,$616.00 ,$403.48 ,$12.31 ,$256.26 ,$23.44 ,$22.38 ,$12.93 ,$554.40 ,$27.70 ,$380.07 ,$172.48 ,$554.40 ,$12.31 ,$554.40 ,$554.40 ,$12.31 ,$400.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000250,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$130.00 ,$84.50 ,$12.05 ,$130.00 ,$30.13 ,$96.85 ,$85.15 ,$12.05 ,$36.40 ,$65.65 ,$12.05 ,$80.21 ,$12.05 ,$80.21 ,$80.21 ,$12.05 ,$80.21 ,$22.90 ,$117.00 ,$97.50 ,$30.13 ,$12.05 ,$114.40 ,$12.05 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$12.05 ,$110.50 ,$12.05 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$30.13 ,$117.00 ,$12.05 ,$130.00 ,$85.15 ,$12.05 ,$54.08 ,$23.44 ,$22.38 ,$12.65 ,$117.00 ,$27.11 ,$80.21 ,$36.40 ,$117.00 ,$12.05 ,$117.00 ,$117.00 ,$12.05 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000260,36600,HC ARTERIAL PUNCTURE,300,1 ,$29.00 ,$18.85 ,$8.12 ,$250.12 ,$29.00 ,$21.61 ,$19.00 ,$29.00 ,$8.12 ,$14.65 ,$29.00 ,$17.89 ,$29.00 ,$17.89 ,$17.89 ,$29.00 ,$17.89 ,$211.22 ,$26.10 ,$21.75 ,$29.00 ,$29.00 ,$25.52 ,$29.00 ,$21.75 ,$21.75 ,$24.65 ,$24.65 ,$29.00 ,$24.65 ,$29.00 ,$22.62 ,$22.62 ,$22.62 ,$26.10 ,$29.00 ,$26.10 ,$29.00 ,$29.00 ,$19.00 ,$29.00 ,$12.06 ,$29.00 ,$29.00 ,$29.00 ,$26.10 ,$250.12 ,$17.89 ,$8.12 ,$26.10 ,$29.00 ,$26.10 ,$26.10 ,$29.00 ,$18.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30000261,N/A,HC LAB HANDLING  AND  TRANSPORT,300,1 ,$17.00 ,$11.05 ,$4.76 ,$17.00 , N/A ,$12.67 ,$11.14 , N/A ,$4.76 ,$8.59 , N/A ,$10.49 , N/A ,$10.49 ,$10.49 , N/A ,$10.49 , N/A ,$15.30 ,$12.75 , N/A , N/A ,$14.96 , N/A ,$12.75 ,$12.75 ,$14.45 ,$14.45 , N/A ,$14.45 , N/A ,$13.26 ,$13.26 ,$13.26 ,$15.30 , N/A ,$15.30 , N/A ,$17.00 ,$11.14 , N/A ,$7.07 , N/A , N/A , N/A ,$15.30 , N/A ,$10.49 ,$4.76 ,$15.30 , N/A ,$15.30 ,$15.30 , N/A ,$11.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30002018,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$39.00 ,$25.35 ,$7.33 ,$39.00 ,$18.33 ,$29.06 ,$25.55 ,$7.33 ,$10.92 ,$19.70 ,$7.33 ,$24.06 ,$7.33 ,$24.06 ,$24.06 ,$7.33 ,$24.06 ,$13.93 ,$35.10 ,$29.25 ,$18.33 ,$7.33 ,$34.32 ,$7.33 ,$29.25 ,$29.25 ,$33.15 ,$33.15 ,$7.33 ,$33.15 ,$7.33 ,$30.42 ,$30.42 ,$30.42 ,$35.10 ,$18.33 ,$35.10 ,$7.33 ,$39.00 ,$25.55 ,$7.33 ,$16.22 ,$23.44 ,$22.38 ,$7.70 ,$35.10 ,$16.49 ,$24.06 ,$10.92 ,$35.10 ,$7.33 ,$35.10 ,$35.10 ,$7.33 ,$25.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30002020,89291,HC BX OOCYTE POLAR/EMBRYO>5 EMB -90,300,1 ,$212.00 ,$137.80 ,$24.61 ,$330.83 ,$212.00 ,$157.94 ,$138.86 ,$147.04 ,$59.36 ,$107.06 ,$147.04 ,$130.80 ,$147.04 ,$130.80 ,$130.80 ,$147.04 ,$130.80 ,$279.38 ,$190.80 ,$159.00 ,$212.00 ,$147.04 ,$186.56 ,$147.04 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$147.04 ,$180.20 ,$147.04 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$147.04 ,$212.00 ,$138.86 ,$147.04 ,$88.19 ,$25.78 ,$24.61 ,$154.39 ,$190.80 ,$330.83 ,$130.80 ,$59.36 ,$190.80 ,$147.04 ,$190.80 ,$190.80 ,$147.04 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30002021,89310,HC SPERM COUNT,300,1 ,$235.00 ,$152.75 ,$8.61 ,$235.00 ,$21.53 ,$175.08 ,$153.93 ,$8.61 ,$65.80 ,$118.68 ,$8.61 ,$145.00 ,$8.61 ,$145.00 ,$145.00 ,$8.61 ,$145.00 ,$16.36 ,$211.50 ,$176.25 ,$21.53 ,$8.61 ,$206.80 ,$8.61 ,$176.25 ,$176.25 ,$199.75 ,$199.75 ,$8.61 ,$199.75 ,$8.61 ,$183.30 ,$183.30 ,$183.30 ,$211.50 ,$21.53 ,$211.50 ,$8.61 ,$235.00 ,$153.93 ,$8.61 ,$97.76 ,$23.44 ,$22.38 ,$9.04 ,$211.50 ,$19.37 ,$145.00 ,$65.80 ,$211.50 ,$8.61 ,$211.50 ,$211.50 ,$8.61 ,$152.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30002026,N/A,HC UA DRUG COLLECTION FEE,300,1 ,$72.00 ,$46.80 ,$20.16 ,$72.00 , N/A ,$53.64 ,$47.16 , N/A ,$20.16 ,$36.36 , N/A ,$44.42 , N/A ,$44.42 ,$44.42 , N/A ,$44.42 , N/A ,$64.80 ,$54.00 , N/A , N/A ,$63.36 , N/A ,$54.00 ,$54.00 ,$61.20 ,$61.20 , N/A ,$61.20 , N/A ,$56.16 ,$56.16 ,$56.16 ,$64.80 , N/A ,$64.80 , N/A ,$72.00 ,$47.16 , N/A ,$29.95 , N/A , N/A , N/A ,$64.80 , N/A ,$44.42 ,$20.16 ,$64.80 , N/A ,$64.80 ,$64.80 , N/A ,$46.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30002028,N/A,HC HEALTH PROFILE PACKAGE CLIENT ONLY,300,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$12.48 , N/A , N/A , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A ,$27.00 ,$27.00 , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30002039,86999,HC TRANSFUSION UNLISTED PROCEDURE -90,300,1 ,$63.00 ,$40.95 ,$17.64 ,$63.00 ,$60.89 ,$46.94 ,$41.27 ,$24.36 ,$17.64 ,$31.82 ,$24.36 ,$38.87 ,$24.36 ,$38.87 ,$38.87 ,$24.36 ,$38.87 ,$46.28 ,$56.70 ,$47.25 ,$60.89 ,$24.36 ,$55.44 ,$24.36 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$24.36 ,$53.55 ,$24.36 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$60.89 ,$56.70 ,$24.36 ,$63.00 ,$41.27 ,$24.36 ,$26.21 ,$29.66 ,$28.31 ,$25.57 ,$56.70 ,$54.80 ,$38.87 ,$17.64 ,$56.70 ,$24.36 ,$56.70 ,$56.70 ,$24.36 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30040115,99001,HC SPECIMEN HAND/CONVEY OTHER,300,1 ,$58.00 ,$37.70 ,$16.24 ,$58.00 , N/A ,$43.21 ,$37.99 , N/A ,$16.24 ,$29.29 , N/A ,$35.79 , N/A ,$35.79 ,$35.79 , N/A ,$35.79 , N/A ,$52.20 ,$43.50 , N/A , N/A ,$51.04 , N/A ,$43.50 ,$43.50 ,$49.30 ,$49.30 , N/A ,$49.30 , N/A ,$45.24 ,$45.24 ,$45.24 ,$52.20 , N/A ,$52.20 , N/A ,$58.00 ,$37.99 , N/A ,$24.13 , N/A , N/A , N/A ,$52.20 , N/A ,$35.79 ,$16.24 ,$52.20 , N/A ,$52.20 ,$52.20 , N/A ,$37.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100101,80048,HC BASIC METABOLIC PANEL,301,1 ,$112.00 ,$72.80 ,$7.14 ,$112.00 ,$21.15 ,$83.44 ,$73.36 ,$8.46 ,$31.36 ,$56.56 ,$8.46 ,$69.10 ,$8.46 ,$69.10 ,$69.10 ,$8.46 ,$69.10 ,$16.07 ,$100.80 ,$84.00 ,$21.15 ,$8.46 ,$98.56 ,$8.46 ,$84.00 ,$84.00 ,$95.20 ,$95.20 ,$8.46 ,$95.20 ,$8.46 ,$87.36 ,$87.36 ,$87.36 ,$100.80 ,$21.15 ,$100.80 ,$8.46 ,$8.46 ,$73.36 ,$8.46 ,$46.59 ,$7.48 ,$7.14 ,$8.88 ,$100.80 ,$19.04 ,$69.10 ,$31.36 ,$100.80 ,$8.46 ,$100.80 ,$100.80 ,$8.46 ,$72.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100103,80051,HC ELECTROLYTE PANEL,301,1 ,$161.00 ,$104.65 ,$7.01 ,$161.00 ,$17.53 ,$119.95 ,$105.46 ,$7.01 ,$45.08 ,$81.31 ,$7.01 ,$99.34 ,$7.01 ,$99.34 ,$99.34 ,$7.01 ,$99.34 ,$13.32 ,$144.90 ,$120.75 ,$17.53 ,$7.01 ,$141.68 ,$7.01 ,$120.75 ,$120.75 ,$136.85 ,$136.85 ,$7.01 ,$136.85 ,$7.01 ,$125.58 ,$125.58 ,$125.58 ,$144.90 ,$17.53 ,$144.90 ,$7.01 ,$161.00 ,$105.46 ,$7.01 ,$66.98 ,$7.48 ,$7.14 ,$7.36 ,$144.90 ,$15.77 ,$99.34 ,$45.08 ,$144.90 ,$7.01 ,$144.90 ,$144.90 ,$7.01 ,$104.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$120.00 ,$78.00 ,$7.14 ,$120.00 ,$26.40 ,$89.40 ,$78.60 ,$10.56 ,$33.60 ,$60.60 ,$10.56 ,$74.04 ,$10.56 ,$74.04 ,$74.04 ,$10.56 ,$74.04 ,$20.06 ,$108.00 ,$90.00 ,$26.40 ,$10.56 ,$105.60 ,$10.56 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$10.56 ,$102.00 ,$10.56 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$26.40 ,$108.00 ,$10.56 ,$10.56 ,$78.60 ,$10.56 ,$49.92 ,$7.48 ,$7.14 ,$11.09 ,$108.00 ,$23.76 ,$74.04 ,$33.60 ,$108.00 ,$10.56 ,$108.00 ,$108.00 ,$10.56 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100106,80055,HC PRENATAL PANEL,301,1 ,$494.00 ,$321.10 ,$7.14 ,$494.00 ,$119.53 ,$368.03 ,$323.57 ,$47.81 ,$138.32 ,$249.47 ,$47.81 ,$304.80 ,$47.81 ,$304.80 ,$304.80 ,$47.81 ,$304.80 ,$90.84 ,$444.60 ,$370.50 ,$119.53 ,$47.81 ,$434.72 ,$47.81 ,$370.50 ,$370.50 ,$419.90 ,$419.90 ,$47.81 ,$419.90 ,$47.81 ,$385.32 ,$385.32 ,$385.32 ,$444.60 ,$119.53 ,$444.60 ,$47.81 ,$494.00 ,$323.57 ,$47.81 ,$205.50 ,$7.48 ,$7.14 ,$50.20 ,$444.60 ,$107.57 ,$304.80 ,$138.32 ,$444.60 ,$47.81 ,$444.60 ,$444.60 ,$47.81 ,$321.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100107,80061,HC LIPID PANEL,301,1 ,$177.00 ,$115.05 ,$7.14 ,$177.00 ,$33.48 ,$131.87 ,$115.94 ,$13.39 ,$49.56 ,$89.39 ,$13.39 ,$109.21 ,$13.39 ,$109.21 ,$109.21 ,$13.39 ,$109.21 ,$25.44 ,$159.30 ,$132.75 ,$33.48 ,$13.39 ,$155.76 ,$13.39 ,$132.75 ,$132.75 ,$150.45 ,$150.45 ,$13.39 ,$150.45 ,$13.39 ,$138.06 ,$138.06 ,$138.06 ,$159.30 ,$33.48 ,$159.30 ,$13.39 ,$177.00 ,$115.94 ,$13.39 ,$73.63 ,$7.48 ,$7.14 ,$14.06 ,$159.30 ,$30.13 ,$109.21 ,$49.56 ,$159.30 ,$13.39 ,$159.30 ,$159.30 ,$13.39 ,$115.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100108,80069,HC RENAL PANEL,301,1 ,$228.00 ,$148.20 ,$7.14 ,$228.00 ,$21.70 ,$169.86 ,$149.34 ,$8.68 ,$63.84 ,$115.14 ,$8.68 ,$140.68 ,$8.68 ,$140.68 ,$140.68 ,$8.68 ,$140.68 ,$16.49 ,$205.20 ,$171.00 ,$21.70 ,$8.68 ,$200.64 ,$8.68 ,$171.00 ,$171.00 ,$193.80 ,$193.80 ,$8.68 ,$193.80 ,$8.68 ,$177.84 ,$177.84 ,$177.84 ,$205.20 ,$21.70 ,$205.20 ,$8.68 ,$228.00 ,$149.34 ,$8.68 ,$94.85 ,$7.48 ,$7.14 ,$9.11 ,$205.20 ,$19.53 ,$140.68 ,$63.84 ,$205.20 ,$8.68 ,$205.20 ,$205.20 ,$8.68 ,$148.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100109,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$478.00 ,$310.70 ,$7.14 ,$478.00 ,$119.08 ,$356.11 ,$313.09 ,$47.63 ,$133.84 ,$241.39 ,$47.63 ,$294.93 ,$47.63 ,$294.93 ,$294.93 ,$47.63 ,$294.93 ,$90.50 ,$430.20 ,$358.50 ,$119.08 ,$47.63 ,$420.64 ,$47.63 ,$358.50 ,$358.50 ,$406.30 ,$406.30 ,$47.63 ,$406.30 ,$47.63 ,$372.84 ,$372.84 ,$372.84 ,$430.20 ,$119.08 ,$430.20 ,$47.63 ,$478.00 ,$313.09 ,$47.63 ,$198.85 ,$7.48 ,$7.14 ,$50.01 ,$430.20 ,$107.17 ,$294.93 ,$133.84 ,$430.20 ,$47.63 ,$430.20 ,$430.20 ,$47.63 ,$310.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100110,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$174.00 ,$113.10 ,$7.14 ,$174.00 ,$20.43 ,$129.63 ,$113.97 ,$8.17 ,$48.72 ,$87.87 ,$8.17 ,$107.36 ,$8.17 ,$107.36 ,$107.36 ,$8.17 ,$107.36 ,$15.52 ,$156.60 ,$130.50 ,$20.43 ,$8.17 ,$153.12 ,$8.17 ,$130.50 ,$130.50 ,$147.90 ,$147.90 ,$8.17 ,$147.90 ,$8.17 ,$135.72 ,$135.72 ,$135.72 ,$156.60 ,$20.43 ,$156.60 ,$8.17 ,$174.00 ,$113.97 ,$8.17 ,$72.38 ,$7.48 ,$7.14 ,$8.58 ,$156.60 ,$18.38 ,$107.36 ,$48.72 ,$156.60 ,$8.17 ,$156.60 ,$156.60 ,$8.17 ,$113.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100116,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$168.00 ,$109.20 ,$8.99 ,$168.00 ,$36.43 ,$125.16 ,$110.04 ,$14.57 ,$47.04 ,$84.84 ,$14.57 ,$103.66 ,$14.57 ,$103.66 ,$103.66 ,$14.57 ,$103.66 ,$27.68 ,$151.20 ,$126.00 ,$36.43 ,$14.57 ,$147.84 ,$14.57 ,$126.00 ,$126.00 ,$142.80 ,$142.80 ,$14.57 ,$142.80 ,$14.57 ,$131.04 ,$131.04 ,$131.04 ,$151.20 ,$36.43 ,$151.20 ,$14.57 ,$168.00 ,$110.04 ,$14.57 ,$69.89 ,$9.42 ,$8.99 ,$15.30 ,$151.20 ,$32.78 ,$103.66 ,$47.04 ,$151.20 ,$14.57 ,$151.20 ,$151.20 ,$14.57 ,$109.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100120,80162,HC DIGOXIN LEVELS,301,1 ,$154.00 ,$100.10 ,$8.99 ,$154.00 ,$33.20 ,$114.73 ,$100.87 ,$13.28 ,$43.12 ,$77.77 ,$13.28 ,$95.02 ,$13.28 ,$95.02 ,$95.02 ,$13.28 ,$95.02 ,$25.23 ,$138.60 ,$115.50 ,$33.20 ,$13.28 ,$135.52 ,$13.28 ,$115.50 ,$115.50 ,$130.90 ,$130.90 ,$13.28 ,$130.90 ,$13.28 ,$120.12 ,$120.12 ,$120.12 ,$138.60 ,$33.20 ,$138.60 ,$13.28 ,$154.00 ,$100.87 ,$13.28 ,$64.06 ,$9.42 ,$8.99 ,$13.94 ,$138.60 ,$29.88 ,$95.02 ,$43.12 ,$138.60 ,$13.28 ,$138.60 ,$138.60 ,$13.28 ,$100.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100121,80164,HC VALPROIC ACID,301,1 ,$160.00 ,$104.00 ,$8.99 ,$160.00 ,$33.85 ,$119.20 ,$104.80 ,$13.54 ,$44.80 ,$80.80 ,$13.54 ,$98.72 ,$13.54 ,$98.72 ,$98.72 ,$13.54 ,$98.72 ,$25.73 ,$144.00 ,$120.00 ,$33.85 ,$13.54 ,$140.80 ,$13.54 ,$120.00 ,$120.00 ,$136.00 ,$136.00 ,$13.54 ,$136.00 ,$13.54 ,$124.80 ,$124.80 ,$124.80 ,$144.00 ,$33.85 ,$144.00 ,$13.54 ,$160.00 ,$104.80 ,$13.54 ,$66.56 ,$9.42 ,$8.99 ,$14.22 ,$144.00 ,$30.47 ,$98.72 ,$44.80 ,$144.00 ,$13.54 ,$144.00 ,$144.00 ,$13.54 ,$104.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100124,80170,HC GENTAMICIN,301,1 ,$217.00 ,$141.05 ,$8.99 ,$217.00 ,$40.95 ,$161.67 ,$142.14 ,$16.38 ,$60.76 ,$109.59 ,$16.38 ,$133.89 ,$16.38 ,$133.89 ,$133.89 ,$16.38 ,$133.89 ,$31.12 ,$195.30 ,$162.75 ,$40.95 ,$16.38 ,$190.96 ,$16.38 ,$162.75 ,$162.75 ,$184.45 ,$184.45 ,$16.38 ,$184.45 ,$16.38 ,$169.26 ,$169.26 ,$169.26 ,$195.30 ,$40.95 ,$195.30 ,$16.38 ,$217.00 ,$142.14 ,$16.38 ,$90.27 ,$9.42 ,$8.99 ,$17.20 ,$195.30 ,$36.86 ,$133.89 ,$60.76 ,$195.30 ,$16.38 ,$195.30 ,$195.30 ,$16.38 ,$141.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100127,80178,HC LITHIUM,301,1 ,$90.00 ,$58.50 ,$6.61 ,$90.00 ,$16.53 ,$67.05 ,$58.95 ,$6.61 ,$25.20 ,$45.45 ,$6.61 ,$55.53 ,$6.61 ,$55.53 ,$55.53 ,$6.61 ,$55.53 ,$12.56 ,$81.00 ,$67.50 ,$16.53 ,$6.61 ,$79.20 ,$6.61 ,$67.50 ,$67.50 ,$76.50 ,$76.50 ,$6.61 ,$76.50 ,$6.61 ,$70.20 ,$70.20 ,$70.20 ,$81.00 ,$16.53 ,$81.00 ,$6.61 ,$90.00 ,$58.95 ,$6.61 ,$37.44 ,$9.42 ,$8.99 ,$6.94 ,$81.00 ,$14.87 ,$55.53 ,$25.20 ,$81.00 ,$6.61 ,$81.00 ,$81.00 ,$6.61 ,$58.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100129,80184,HC PHENOBARBITAL,301,1 ,$153.00 ,$99.45 ,$8.99 ,$153.00 ,$38.25 ,$113.99 ,$100.22 ,$15.30 ,$42.84 ,$77.27 ,$15.30 ,$94.40 ,$15.30 ,$94.40 ,$94.40 ,$15.30 ,$94.40 ,$29.07 ,$137.70 ,$114.75 ,$38.25 ,$15.30 ,$134.64 ,$15.30 ,$114.75 ,$114.75 ,$130.05 ,$130.05 ,$15.30 ,$130.05 ,$15.30 ,$119.34 ,$119.34 ,$119.34 ,$137.70 ,$38.25 ,$137.70 ,$15.30 ,$153.00 ,$100.22 ,$15.30 ,$63.65 ,$9.42 ,$8.99 ,$16.07 ,$137.70 ,$34.43 ,$94.40 ,$42.84 ,$137.70 ,$15.30 ,$137.70 ,$137.70 ,$15.30 ,$99.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100130,80185,HC PHENYTOIN TOTAL,301,1 ,$160.00 ,$104.00 ,$8.99 ,$160.00 ,$33.13 ,$119.20 ,$104.80 ,$13.25 ,$44.80 ,$80.80 ,$13.25 ,$98.72 ,$13.25 ,$98.72 ,$98.72 ,$13.25 ,$98.72 ,$25.18 ,$144.00 ,$120.00 ,$33.13 ,$13.25 ,$140.80 ,$13.25 ,$120.00 ,$120.00 ,$136.00 ,$136.00 ,$13.25 ,$136.00 ,$13.25 ,$124.80 ,$124.80 ,$124.80 ,$144.00 ,$33.13 ,$144.00 ,$13.25 ,$160.00 ,$104.80 ,$13.25 ,$66.56 ,$9.42 ,$8.99 ,$13.91 ,$144.00 ,$29.81 ,$98.72 ,$44.80 ,$144.00 ,$13.25 ,$144.00 ,$144.00 ,$13.25 ,$104.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100138,80198,HC THEOPHYLLINE,301,1 ,$159.00 ,$103.35 ,$8.99 ,$159.00 ,$35.35 ,$118.46 ,$104.15 ,$14.14 ,$44.52 ,$80.30 ,$14.14 ,$98.10 ,$14.14 ,$98.10 ,$98.10 ,$14.14 ,$98.10 ,$26.87 ,$143.10 ,$119.25 ,$35.35 ,$14.14 ,$139.92 ,$14.14 ,$119.25 ,$119.25 ,$135.15 ,$135.15 ,$14.14 ,$135.15 ,$14.14 ,$124.02 ,$124.02 ,$124.02 ,$143.10 ,$35.35 ,$143.10 ,$14.14 ,$159.00 ,$104.15 ,$14.14 ,$66.14 ,$9.42 ,$8.99 ,$14.85 ,$143.10 ,$31.82 ,$98.10 ,$44.52 ,$143.10 ,$14.14 ,$143.10 ,$143.10 ,$14.14 ,$103.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100139,80200,HC TOBRAMYCIN,301,1 ,$174.00 ,$113.10 ,$8.99 ,$174.00 ,$40.33 ,$129.63 ,$113.97 ,$16.13 ,$48.72 ,$87.87 ,$16.13 ,$107.36 ,$16.13 ,$107.36 ,$107.36 ,$16.13 ,$107.36 ,$30.65 ,$156.60 ,$130.50 ,$40.33 ,$16.13 ,$153.12 ,$16.13 ,$130.50 ,$130.50 ,$147.90 ,$147.90 ,$16.13 ,$147.90 ,$16.13 ,$135.72 ,$135.72 ,$135.72 ,$156.60 ,$40.33 ,$156.60 ,$16.13 ,$174.00 ,$113.97 ,$16.13 ,$72.38 ,$9.42 ,$8.99 ,$16.94 ,$156.60 ,$36.29 ,$107.36 ,$48.72 ,$156.60 ,$16.13 ,$156.60 ,$156.60 ,$16.13 ,$113.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100141,80202,HC VANCOMYCIN,301,1 ,$225.00 ,$146.25 ,$8.99 ,$225.00 ,$33.85 ,$167.63 ,$147.38 ,$13.54 ,$63.00 ,$113.63 ,$13.54 ,$138.83 ,$13.54 ,$138.83 ,$138.83 ,$13.54 ,$138.83 ,$25.73 ,$202.50 ,$168.75 ,$33.85 ,$13.54 ,$198.00 ,$13.54 ,$168.75 ,$168.75 ,$191.25 ,$191.25 ,$13.54 ,$191.25 ,$13.54 ,$175.50 ,$175.50 ,$175.50 ,$202.50 ,$33.85 ,$202.50 ,$13.54 ,$225.00 ,$147.38 ,$13.54 ,$93.60 ,$9.42 ,$8.99 ,$14.22 ,$202.50 ,$30.47 ,$138.83 ,$63.00 ,$202.50 ,$13.54 ,$202.50 ,$202.50 ,$13.54 ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100157,82009,HC ACETONE SERUM,301,1 ,$69.00 ,$44.85 ,$3.49 ,$69.00 ,$11.30 ,$51.41 ,$45.20 ,$4.52 ,$19.32 ,$34.85 ,$4.52 ,$42.57 ,$4.52 ,$42.57 ,$42.57 ,$4.52 ,$42.57 ,$8.59 ,$62.10 ,$51.75 ,$11.30 ,$4.52 ,$60.72 ,$4.52 ,$51.75 ,$51.75 ,$58.65 ,$58.65 ,$4.52 ,$58.65 ,$4.52 ,$53.82 ,$53.82 ,$53.82 ,$62.10 ,$11.30 ,$62.10 ,$4.52 ,$69.00 ,$45.20 ,$4.52 ,$28.70 ,$3.65 ,$3.49 ,$4.75 ,$62.10 ,$10.17 ,$42.57 ,$19.32 ,$62.10 ,$4.52 ,$62.10 ,$62.10 ,$4.52 ,$44.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100165,82040,HC ALBUMIN SERUM,301,1 ,$63.00 ,$40.95 ,$3.49 ,$63.00 ,$12.38 ,$46.94 ,$41.27 ,$4.95 ,$17.64 ,$31.82 ,$4.95 ,$38.87 ,$4.95 ,$38.87 ,$38.87 ,$4.95 ,$38.87 ,$9.41 ,$56.70 ,$47.25 ,$12.38 ,$4.95 ,$55.44 ,$4.95 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$4.95 ,$53.55 ,$4.95 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$12.38 ,$56.70 ,$4.95 ,$63.00 ,$41.27 ,$4.95 ,$26.21 ,$3.65 ,$3.49 ,$5.20 ,$56.70 ,$11.14 ,$38.87 ,$17.64 ,$56.70 ,$4.95 ,$56.70 ,$56.70 ,$4.95 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$146.00 ,$94.90 ,$2.79 ,$146.00 ,$14.45 ,$108.77 ,$95.63 ,$5.78 ,$40.88 ,$73.73 ,$5.78 ,$90.08 ,$5.78 ,$90.08 ,$90.08 ,$5.78 ,$90.08 ,$10.98 ,$131.40 ,$109.50 ,$14.45 ,$5.78 ,$128.48 ,$5.78 ,$109.50 ,$109.50 ,$124.10 ,$124.10 ,$5.78 ,$124.10 ,$5.78 ,$113.88 ,$113.88 ,$113.88 ,$131.40 ,$14.45 ,$131.40 ,$5.78 ,$146.00 ,$95.63 ,$5.78 ,$60.74 ,$2.93 ,$2.79 ,$6.07 ,$131.40 ,$13.01 ,$90.08 ,$40.88 ,$131.40 ,$5.78 ,$131.40 ,$131.40 ,$5.78 ,$94.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100186,82140,HC AMMONIA,301,1 ,$183.00 ,$118.95 ,$7.83 ,$183.00 ,$36.43 ,$136.34 ,$119.87 ,$14.57 ,$51.24 ,$92.42 ,$14.57 ,$112.91 ,$14.57 ,$112.91 ,$112.91 ,$14.57 ,$112.91 ,$27.68 ,$164.70 ,$137.25 ,$36.43 ,$14.57 ,$161.04 ,$14.57 ,$137.25 ,$137.25 ,$155.55 ,$155.55 ,$14.57 ,$155.55 ,$14.57 ,$142.74 ,$142.74 ,$142.74 ,$164.70 ,$36.43 ,$164.70 ,$14.57 ,$183.00 ,$119.87 ,$14.57 ,$76.13 ,$8.21 ,$7.83 ,$15.30 ,$164.70 ,$32.78 ,$112.91 ,$51.24 ,$164.70 ,$14.57 ,$164.70 ,$164.70 ,$14.57 ,$118.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100188,82150,HC AMYLASE,301,1 ,$97.00 ,$63.05 ,$6.48 ,$97.00 ,$16.20 ,$72.27 ,$63.54 ,$6.48 ,$27.16 ,$48.99 ,$6.48 ,$59.85 ,$6.48 ,$59.85 ,$59.85 ,$6.48 ,$59.85 ,$12.31 ,$87.30 ,$72.75 ,$16.20 ,$6.48 ,$85.36 ,$6.48 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$6.48 ,$82.45 ,$6.48 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$16.20 ,$87.30 ,$6.48 ,$97.00 ,$63.54 ,$6.48 ,$40.35 ,$8.21 ,$7.83 ,$6.80 ,$87.30 ,$14.58 ,$59.85 ,$27.16 ,$87.30 ,$6.48 ,$87.30 ,$87.30 ,$6.48 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$107.00 ,$69.55 ,$3.49 ,$107.00 ,$12.55 ,$79.72 ,$70.09 ,$5.02 ,$29.96 ,$54.04 ,$5.02 ,$66.02 ,$5.02 ,$66.02 ,$66.02 ,$5.02 ,$66.02 ,$9.54 ,$96.30 ,$80.25 ,$12.55 ,$5.02 ,$94.16 ,$5.02 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$5.02 ,$90.95 ,$5.02 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$12.55 ,$96.30 ,$5.02 ,$107.00 ,$70.09 ,$5.02 ,$44.51 ,$3.65 ,$3.49 ,$5.27 ,$96.30 ,$11.30 ,$66.02 ,$29.96 ,$96.30 ,$5.02 ,$96.30 ,$96.30 ,$5.02 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$92.00 ,$59.80 ,$3.49 ,$92.00 ,$12.55 ,$68.54 ,$60.26 ,$5.02 ,$25.76 ,$46.46 ,$5.02 ,$56.76 ,$5.02 ,$56.76 ,$56.76 ,$5.02 ,$56.76 ,$9.54 ,$82.80 ,$69.00 ,$12.55 ,$5.02 ,$80.96 ,$5.02 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$5.02 ,$78.20 ,$5.02 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$12.55 ,$82.80 ,$5.02 ,$92.00 ,$60.26 ,$5.02 ,$38.27 ,$3.65 ,$3.49 ,$5.27 ,$82.80 ,$11.30 ,$56.76 ,$25.76 ,$82.80 ,$5.02 ,$82.80 ,$82.80 ,$5.02 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100212,82306,HC VITAMIN D 25 OH,301,1 ,$112.00 ,$72.80 ,$21.08 ,$112.00 ,$74.00 ,$83.44 ,$73.36 ,$29.60 ,$31.36 ,$56.56 ,$29.60 ,$69.10 ,$29.60 ,$69.10 ,$69.10 ,$29.60 ,$69.10 ,$56.24 ,$100.80 ,$84.00 ,$74.00 ,$29.60 ,$98.56 ,$29.60 ,$84.00 ,$84.00 ,$95.20 ,$95.20 ,$29.60 ,$95.20 ,$29.60 ,$87.36 ,$87.36 ,$87.36 ,$100.80 ,$74.00 ,$100.80 ,$29.60 ,$112.00 ,$73.36 ,$29.60 ,$46.59 ,$22.09 ,$21.08 ,$31.08 ,$100.80 ,$66.60 ,$69.10 ,$31.36 ,$100.80 ,$29.60 ,$100.80 ,$100.80 ,$29.60 ,$72.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100214,82310,HC CALCIUM,301,1 ,$69.00 ,$44.85 ,$3.49 ,$69.00 ,$12.90 ,$51.41 ,$45.20 ,$5.16 ,$19.32 ,$34.85 ,$5.16 ,$42.57 ,$5.16 ,$42.57 ,$42.57 ,$5.16 ,$42.57 ,$9.80 ,$62.10 ,$51.75 ,$12.90 ,$5.16 ,$60.72 ,$5.16 ,$51.75 ,$51.75 ,$58.65 ,$58.65 ,$5.16 ,$58.65 ,$5.16 ,$53.82 ,$53.82 ,$53.82 ,$62.10 ,$12.90 ,$62.10 ,$5.16 ,$69.00 ,$45.20 ,$5.16 ,$28.70 ,$3.65 ,$3.49 ,$5.42 ,$62.10 ,$11.61 ,$42.57 ,$19.32 ,$62.10 ,$5.16 ,$62.10 ,$62.10 ,$5.16 ,$44.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100215,82330,HC CALCIUM IONIZED,301,1 ,$177.00 ,$115.05 ,$7.83 ,$177.00 ,$34.20 ,$131.87 ,$115.94 ,$13.68 ,$49.56 ,$89.39 ,$13.68 ,$109.21 ,$13.68 ,$109.21 ,$109.21 ,$13.68 ,$109.21 ,$25.99 ,$159.30 ,$132.75 ,$34.20 ,$13.68 ,$155.76 ,$13.68 ,$132.75 ,$132.75 ,$150.45 ,$150.45 ,$13.68 ,$150.45 ,$13.68 ,$138.06 ,$138.06 ,$138.06 ,$159.30 ,$34.20 ,$159.30 ,$13.68 ,$177.00 ,$115.94 ,$13.68 ,$73.63 ,$8.21 ,$7.83 ,$14.36 ,$159.30 ,$30.78 ,$109.21 ,$49.56 ,$159.30 ,$13.68 ,$159.30 ,$159.30 ,$13.68 ,$115.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$148.00 ,$96.20 ,$6.03 ,$148.00 ,$15.08 ,$110.26 ,$96.94 ,$6.03 ,$41.44 ,$74.74 ,$6.03 ,$91.32 ,$6.03 ,$91.32 ,$91.32 ,$6.03 ,$91.32 ,$11.46 ,$133.20 ,$111.00 ,$15.08 ,$6.03 ,$130.24 ,$6.03 ,$111.00 ,$111.00 ,$125.80 ,$125.80 ,$6.03 ,$125.80 ,$6.03 ,$115.44 ,$115.44 ,$115.44 ,$133.20 ,$15.08 ,$133.20 ,$6.03 ,$148.00 ,$96.94 ,$6.03 ,$61.57 ,$8.21 ,$7.83 ,$6.33 ,$133.20 ,$13.57 ,$91.32 ,$41.44 ,$133.20 ,$6.03 ,$133.20 ,$133.20 ,$6.03 ,$96.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100222,82374,HC BICARBONATE,301,1 ,$45.00 ,$29.25 ,$3.49 ,$45.00 ,$12.20 ,$33.53 ,$29.48 ,$4.88 ,$12.60 ,$22.73 ,$4.88 ,$27.77 ,$4.88 ,$27.77 ,$27.77 ,$4.88 ,$27.77 ,$9.27 ,$40.50 ,$33.75 ,$12.20 ,$4.88 ,$39.60 ,$4.88 ,$33.75 ,$33.75 ,$38.25 ,$38.25 ,$4.88 ,$38.25 ,$4.88 ,$35.10 ,$35.10 ,$35.10 ,$40.50 ,$12.20 ,$40.50 ,$4.88 ,$45.00 ,$29.48 ,$4.88 ,$18.72 ,$3.65 ,$3.49 ,$5.12 ,$40.50 ,$10.98 ,$27.77 ,$12.60 ,$40.50 ,$4.88 ,$40.50 ,$40.50 ,$4.88 ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100226,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$207.00 ,$134.55 ,$7.83 ,$207.00 ,$47.40 ,$154.22 ,$135.59 ,$18.96 ,$57.96 ,$104.54 ,$18.96 ,$127.72 ,$18.96 ,$127.72 ,$127.72 ,$18.96 ,$127.72 ,$36.02 ,$186.30 ,$155.25 ,$47.40 ,$18.96 ,$182.16 ,$18.96 ,$155.25 ,$155.25 ,$175.95 ,$175.95 ,$18.96 ,$175.95 ,$18.96 ,$161.46 ,$161.46 ,$161.46 ,$186.30 ,$47.40 ,$186.30 ,$18.96 ,$207.00 ,$135.59 ,$18.96 ,$86.11 ,$8.21 ,$7.83 ,$19.91 ,$186.30 ,$42.66 ,$127.72 ,$57.96 ,$186.30 ,$18.96 ,$186.30 ,$186.30 ,$18.96 ,$134.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100237,82435,HC CHLORIDE,301,1 ,$63.00 ,$40.95 ,$3.49 ,$63.00 ,$11.50 ,$46.94 ,$41.27 ,$4.60 ,$17.64 ,$31.82 ,$4.60 ,$38.87 ,$4.60 ,$38.87 ,$38.87 ,$4.60 ,$38.87 ,$8.74 ,$56.70 ,$47.25 ,$11.50 ,$4.60 ,$55.44 ,$4.60 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$4.60 ,$53.55 ,$4.60 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$11.50 ,$56.70 ,$4.60 ,$63.00 ,$41.27 ,$4.60 ,$26.21 ,$3.65 ,$3.49 ,$4.83 ,$56.70 ,$10.35 ,$38.87 ,$17.64 ,$56.70 ,$4.60 ,$56.70 ,$56.70 ,$4.60 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100238,82436,HC CHLORIDE URINE,301,1 ,$64.00 ,$41.60 ,$3.49 ,$64.00 ,$14.38 ,$47.68 ,$41.92 ,$5.75 ,$17.92 ,$32.32 ,$5.75 ,$39.49 ,$5.75 ,$39.49 ,$39.49 ,$5.75 ,$39.49 ,$10.93 ,$57.60 ,$48.00 ,$14.38 ,$5.75 ,$56.32 ,$5.75 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$5.75 ,$54.40 ,$5.75 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$14.38 ,$57.60 ,$5.75 ,$64.00 ,$41.92 ,$5.75 ,$26.62 ,$3.65 ,$3.49 ,$6.04 ,$57.60 ,$12.94 ,$39.49 ,$17.92 ,$57.60 ,$5.75 ,$57.60 ,$57.60 ,$5.75 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100240,82438,HC CHLORIDE OTHER SOURCE,301,1 ,$38.00 ,$24.70 ,$3.49 ,$38.00 ,$12.50 ,$28.31 ,$24.89 ,$5.00 ,$10.64 ,$19.19 ,$5.00 ,$23.45 ,$5.00 ,$23.45 ,$23.45 ,$5.00 ,$23.45 ,$9.50 ,$34.20 ,$28.50 ,$12.50 ,$5.00 ,$33.44 ,$5.00 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$5.00 ,$32.30 ,$5.00 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$12.50 ,$34.20 ,$5.00 ,$38.00 ,$24.89 ,$5.00 ,$15.81 ,$3.65 ,$3.49 ,$5.25 ,$34.20 ,$11.25 ,$23.45 ,$10.64 ,$34.20 ,$5.00 ,$34.20 ,$34.20 ,$5.00 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100241,82465,HC CHOLESTEROL,301,1 ,$63.00 ,$40.95 ,$3.49 ,$63.00 ,$10.88 ,$46.94 ,$41.27 ,$4.35 ,$17.64 ,$31.82 ,$4.35 ,$38.87 ,$4.35 ,$38.87 ,$38.87 ,$4.35 ,$38.87 ,$8.27 ,$56.70 ,$47.25 ,$10.88 ,$4.35 ,$55.44 ,$4.35 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$4.35 ,$53.55 ,$4.35 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$10.88 ,$56.70 ,$4.35 ,$63.00 ,$41.27 ,$4.35 ,$26.21 ,$3.65 ,$3.49 ,$4.57 ,$56.70 ,$9.79 ,$38.87 ,$17.64 ,$56.70 ,$4.35 ,$56.70 ,$56.70 ,$4.35 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100254,82533,HC CORTISOL TOTAL,301,1 ,$230.00 ,$149.50 ,$16.30 ,$230.00 ,$40.75 ,$171.35 ,$150.65 ,$16.30 ,$64.40 ,$116.15 ,$16.30 ,$141.91 ,$16.30 ,$141.91 ,$141.91 ,$16.30 ,$141.91 ,$30.97 ,$207.00 ,$172.50 ,$40.75 ,$16.30 ,$202.40 ,$16.30 ,$172.50 ,$172.50 ,$195.50 ,$195.50 ,$16.30 ,$195.50 ,$16.30 ,$179.40 ,$179.40 ,$179.40 ,$207.00 ,$40.75 ,$207.00 ,$16.30 ,$230.00 ,$150.65 ,$16.30 ,$95.68 ,$19.21 ,$18.33 ,$17.12 ,$207.00 ,$36.68 ,$141.91 ,$64.40 ,$207.00 ,$16.30 ,$207.00 ,$207.00 ,$16.30 ,$149.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$98.00 ,$63.70 ,$3.49 ,$98.00 ,$16.28 ,$73.01 ,$64.19 ,$6.51 ,$27.44 ,$49.49 ,$6.51 ,$60.47 ,$6.51 ,$60.47 ,$60.47 ,$6.51 ,$60.47 ,$12.37 ,$88.20 ,$73.50 ,$16.28 ,$6.51 ,$86.24 ,$6.51 ,$73.50 ,$73.50 ,$83.30 ,$83.30 ,$6.51 ,$83.30 ,$6.51 ,$76.44 ,$76.44 ,$76.44 ,$88.20 ,$16.28 ,$88.20 ,$6.51 ,$98.00 ,$64.19 ,$6.51 ,$40.77 ,$3.65 ,$3.49 ,$6.84 ,$88.20 ,$14.65 ,$60.47 ,$27.44 ,$88.20 ,$6.51 ,$88.20 ,$88.20 ,$6.51 ,$63.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$227.00 ,$147.55 ,$7.83 ,$227.00 ,$28.88 ,$169.12 ,$148.69 ,$11.55 ,$63.56 ,$114.64 ,$11.55 ,$140.06 ,$11.55 ,$140.06 ,$140.06 ,$11.55 ,$140.06 ,$21.95 ,$204.30 ,$170.25 ,$28.88 ,$11.55 ,$199.76 ,$11.55 ,$170.25 ,$170.25 ,$192.95 ,$192.95 ,$11.55 ,$192.95 ,$11.55 ,$177.06 ,$177.06 ,$177.06 ,$204.30 ,$28.88 ,$204.30 ,$11.55 ,$227.00 ,$148.69 ,$11.55 ,$94.43 ,$8.21 ,$7.83 ,$12.13 ,$204.30 ,$25.99 ,$140.06 ,$63.56 ,$204.30 ,$11.55 ,$204.30 ,$204.30 ,$11.55 ,$147.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100262,82565,HC CREATININE,301,1 ,$63.00 ,$40.95 ,$3.49 ,$63.00 ,$12.80 ,$46.94 ,$41.27 ,$5.12 ,$17.64 ,$31.82 ,$5.12 ,$38.87 ,$5.12 ,$38.87 ,$38.87 ,$5.12 ,$38.87 ,$9.73 ,$56.70 ,$47.25 ,$12.80 ,$5.12 ,$55.44 ,$5.12 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$5.12 ,$53.55 ,$5.12 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$12.80 ,$56.70 ,$5.12 ,$5.12 ,$41.27 ,$5.12 ,$26.21 ,$3.65 ,$3.49 ,$5.38 ,$56.70 ,$11.52 ,$38.87 ,$17.64 ,$56.70 ,$5.12 ,$56.70 ,$56.70 ,$5.12 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$130.00 ,$84.50 ,$3.49 ,$130.00 ,$12.95 ,$96.85 ,$85.15 ,$5.18 ,$36.40 ,$65.65 ,$5.18 ,$80.21 ,$5.18 ,$80.21 ,$80.21 ,$5.18 ,$80.21 ,$9.84 ,$117.00 ,$97.50 ,$12.95 ,$5.18 ,$114.40 ,$5.18 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$5.18 ,$110.50 ,$5.18 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$12.95 ,$117.00 ,$5.18 ,$130.00 ,$85.15 ,$5.18 ,$54.08 ,$3.65 ,$3.49 ,$5.44 ,$117.00 ,$11.66 ,$80.21 ,$36.40 ,$117.00 ,$5.18 ,$117.00 ,$117.00 ,$5.18 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100266,82575,HC CREATININE CLEARANCE,301,1 ,$189.00 ,$122.85 ,$7.83 ,$189.00 ,$23.65 ,$140.81 ,$123.80 ,$9.46 ,$52.92 ,$95.45 ,$9.46 ,$116.61 ,$9.46 ,$116.61 ,$116.61 ,$9.46 ,$116.61 ,$17.97 ,$170.10 ,$141.75 ,$23.65 ,$9.46 ,$166.32 ,$9.46 ,$141.75 ,$141.75 ,$160.65 ,$160.65 ,$9.46 ,$160.65 ,$9.46 ,$147.42 ,$147.42 ,$147.42 ,$170.10 ,$23.65 ,$170.10 ,$9.46 ,$189.00 ,$123.80 ,$9.46 ,$78.62 ,$8.21 ,$7.83 ,$9.93 ,$170.10 ,$21.29 ,$116.61 ,$52.92 ,$170.10 ,$9.46 ,$170.10 ,$170.10 ,$9.46 ,$122.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100269,82607,HC VITAMIN B12,301,1 ,$86.00 ,$55.90 ,$10.54 ,$86.00 ,$37.70 ,$64.07 ,$56.33 ,$15.08 ,$24.08 ,$43.43 ,$15.08 ,$53.06 ,$15.08 ,$53.06 ,$53.06 ,$15.08 ,$53.06 ,$28.65 ,$77.40 ,$64.50 ,$37.70 ,$15.08 ,$75.68 ,$15.08 ,$64.50 ,$64.50 ,$73.10 ,$73.10 ,$15.08 ,$73.10 ,$15.08 ,$67.08 ,$67.08 ,$67.08 ,$77.40 ,$37.70 ,$77.40 ,$15.08 ,$86.00 ,$56.33 ,$15.08 ,$35.78 ,$11.04 ,$10.54 ,$15.83 ,$77.40 ,$33.93 ,$53.06 ,$24.08 ,$77.40 ,$15.08 ,$77.40 ,$77.40 ,$15.08 ,$55.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100276,82670,HC ESTRADIOL,301,1 ,$294.00 ,$191.10 ,$18.33 ,$294.00 ,$69.85 ,$219.03 ,$192.57 ,$27.94 ,$82.32 ,$148.47 ,$27.94 ,$181.40 ,$27.94 ,$181.40 ,$181.40 ,$27.94 ,$181.40 ,$53.09 ,$264.60 ,$220.50 ,$69.85 ,$27.94 ,$258.72 ,$27.94 ,$220.50 ,$220.50 ,$249.90 ,$249.90 ,$27.94 ,$249.90 ,$27.94 ,$229.32 ,$229.32 ,$229.32 ,$264.60 ,$69.85 ,$264.60 ,$27.94 ,$294.00 ,$192.57 ,$27.94 ,$122.30 ,$19.21 ,$18.33 ,$29.34 ,$264.60 ,$62.87 ,$181.40 ,$82.32 ,$264.60 ,$27.94 ,$264.60 ,$264.60 ,$27.94 ,$191.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100290,82728,HC FERRITIN,301,1 ,$205.00 ,$133.25 ,$7.83 ,$205.00 ,$34.08 ,$152.73 ,$134.28 ,$13.63 ,$57.40 ,$103.53 ,$13.63 ,$126.49 ,$13.63 ,$126.49 ,$126.49 ,$13.63 ,$126.49 ,$25.90 ,$184.50 ,$153.75 ,$34.08 ,$13.63 ,$180.40 ,$13.63 ,$153.75 ,$153.75 ,$174.25 ,$174.25 ,$13.63 ,$174.25 ,$13.63 ,$159.90 ,$159.90 ,$159.90 ,$184.50 ,$34.08 ,$184.50 ,$13.63 ,$205.00 ,$134.28 ,$13.63 ,$85.28 ,$8.21 ,$7.83 ,$14.31 ,$184.50 ,$30.67 ,$126.49 ,$57.40 ,$184.50 ,$13.63 ,$184.50 ,$184.50 ,$13.63 ,$133.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100291,82731,HC FETAL FIBRONECTIN,301,1 ,$567.00 ,$368.55 ,$21.08 ,$567.00 ,$161.03 ,$422.42 ,$371.39 ,$64.41 ,$158.76 ,$286.34 ,$64.41 ,$349.84 ,$64.41 ,$349.84 ,$349.84 ,$64.41 ,$349.84 ,$122.38 ,$510.30 ,$425.25 ,$161.03 ,$64.41 ,$498.96 ,$64.41 ,$425.25 ,$425.25 ,$481.95 ,$481.95 ,$64.41 ,$481.95 ,$64.41 ,$442.26 ,$442.26 ,$442.26 ,$510.30 ,$161.03 ,$510.30 ,$64.41 ,$567.00 ,$371.39 ,$64.41 ,$235.87 ,$22.09 ,$21.08 ,$67.63 ,$510.30 ,$144.92 ,$349.84 ,$158.76 ,$510.30 ,$64.41 ,$510.30 ,$510.30 ,$64.41 ,$368.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100292,82746,HC FOLIC ACID SERUM,301,1 ,$156.00 ,$101.40 ,$7.83 ,$156.00 ,$36.75 ,$116.22 ,$102.18 ,$14.70 ,$43.68 ,$78.78 ,$14.70 ,$96.25 ,$14.70 ,$96.25 ,$96.25 ,$14.70 ,$96.25 ,$27.93 ,$140.40 ,$117.00 ,$36.75 ,$14.70 ,$137.28 ,$14.70 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$14.70 ,$132.60 ,$14.70 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$36.75 ,$140.40 ,$14.70 ,$156.00 ,$102.18 ,$14.70 ,$64.90 ,$8.21 ,$7.83 ,$15.44 ,$140.40 ,$33.08 ,$96.25 ,$43.68 ,$140.40 ,$14.70 ,$140.40 ,$140.40 ,$14.70 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100295,82784,HC GAMMAGLOBULIN,301,1 ,$144.00 ,$93.60 ,$7.83 ,$144.00 ,$23.25 ,$107.28 ,$94.32 ,$9.30 ,$40.32 ,$72.72 ,$9.30 ,$88.85 ,$9.30 ,$88.85 ,$88.85 ,$9.30 ,$88.85 ,$17.67 ,$129.60 ,$108.00 ,$23.25 ,$9.30 ,$126.72 ,$9.30 ,$108.00 ,$108.00 ,$122.40 ,$122.40 ,$9.30 ,$122.40 ,$9.30 ,$112.32 ,$112.32 ,$112.32 ,$129.60 ,$23.25 ,$129.60 ,$9.30 ,$144.00 ,$94.32 ,$9.30 ,$59.90 ,$8.21 ,$7.83 ,$9.77 ,$129.60 ,$20.93 ,$88.85 ,$40.32 ,$129.60 ,$9.30 ,$129.60 ,$129.60 ,$9.30 ,$93.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100308,82810,HC BLOOD GAS O2 SAT ONLY,301,1 ,$413.00 ,$268.45 ,$7.83 ,$413.00 ,$24.43 ,$307.69 ,$270.52 ,$9.77 ,$115.64 ,$208.57 ,$9.77 ,$254.82 ,$9.77 ,$254.82 ,$254.82 ,$9.77 ,$254.82 ,$18.56 ,$371.70 ,$309.75 ,$24.43 ,$9.77 ,$363.44 ,$9.77 ,$309.75 ,$309.75 ,$351.05 ,$351.05 ,$9.77 ,$351.05 ,$9.77 ,$322.14 ,$322.14 ,$322.14 ,$371.70 ,$24.43 ,$371.70 ,$9.77 ,$413.00 ,$270.52 ,$9.77 ,$171.81 ,$8.21 ,$7.83 ,$10.26 ,$371.70 ,$21.98 ,$254.82 ,$115.64 ,$371.70 ,$9.77 ,$371.70 ,$371.70 ,$9.77 ,$268.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$133.00 ,$86.45 ,$3.49 ,$133.00 ,$9.83 ,$99.09 ,$87.12 ,$3.93 ,$37.24 ,$67.17 ,$3.93 ,$82.06 ,$3.93 ,$82.06 ,$82.06 ,$3.93 ,$82.06 ,$7.47 ,$119.70 ,$99.75 ,$9.83 ,$3.93 ,$117.04 ,$3.93 ,$99.75 ,$99.75 ,$113.05 ,$113.05 ,$3.93 ,$113.05 ,$3.93 ,$103.74 ,$103.74 ,$103.74 ,$119.70 ,$9.83 ,$119.70 ,$3.93 ,$133.00 ,$87.12 ,$3.93 ,$55.33 ,$3.65 ,$3.49 ,$4.13 ,$119.70 ,$8.84 ,$82.06 ,$37.24 ,$119.70 ,$3.93 ,$119.70 ,$119.70 ,$3.93 ,$86.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100312,82947,HC GLUCOSE,301,1 ,$78.00 ,$50.70 ,$3.49 ,$78.00 ,$9.83 ,$58.11 ,$51.09 ,$3.93 ,$21.84 ,$39.39 ,$3.93 ,$48.13 ,$3.93 ,$48.13 ,$48.13 ,$3.93 ,$48.13 ,$7.47 ,$70.20 ,$58.50 ,$9.83 ,$3.93 ,$68.64 ,$3.93 ,$58.50 ,$58.50 ,$66.30 ,$66.30 ,$3.93 ,$66.30 ,$3.93 ,$60.84 ,$60.84 ,$60.84 ,$70.20 ,$9.83 ,$70.20 ,$3.93 ,$78.00 ,$51.09 ,$3.93 ,$32.45 ,$3.65 ,$3.49 ,$4.13 ,$70.20 ,$8.84 ,$48.13 ,$21.84 ,$70.20 ,$3.93 ,$70.20 ,$70.20 ,$3.93 ,$50.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100313,82950,HC GLUCOSE SCREEN,301,1 ,$105.00 ,$68.25 ,$3.49 ,$105.00 ,$11.88 ,$78.23 ,$68.78 ,$4.75 ,$29.40 ,$53.03 ,$4.75 ,$64.79 ,$4.75 ,$64.79 ,$64.79 ,$4.75 ,$64.79 ,$9.03 ,$94.50 ,$78.75 ,$11.88 ,$4.75 ,$92.40 ,$4.75 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$4.75 ,$89.25 ,$4.75 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$11.88 ,$94.50 ,$4.75 ,$105.00 ,$68.78 ,$4.75 ,$43.68 ,$3.65 ,$3.49 ,$4.99 ,$94.50 ,$10.69 ,$64.79 ,$29.40 ,$94.50 ,$4.75 ,$94.50 ,$94.50 ,$4.75 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$212.00 ,$137.80 ,$7.83 ,$212.00 ,$32.18 ,$157.94 ,$138.86 ,$12.87 ,$59.36 ,$107.06 ,$12.87 ,$130.80 ,$12.87 ,$130.80 ,$130.80 ,$12.87 ,$130.80 ,$24.45 ,$190.80 ,$159.00 ,$32.18 ,$12.87 ,$186.56 ,$12.87 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$12.87 ,$180.20 ,$12.87 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$32.18 ,$190.80 ,$12.87 ,$212.00 ,$138.86 ,$12.87 ,$88.19 ,$8.21 ,$7.83 ,$13.51 ,$190.80 ,$28.96 ,$130.80 ,$59.36 ,$190.80 ,$12.87 ,$190.80 ,$190.80 ,$12.87 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$52.00 ,$33.80 ,$3.92 ,$52.00 ,$9.80 ,$38.74 ,$34.06 ,$3.92 ,$14.56 ,$26.26 ,$3.92 ,$32.08 ,$3.92 ,$32.08 ,$32.08 ,$3.92 ,$32.08 ,$7.45 ,$46.80 ,$39.00 ,$9.80 ,$3.92 ,$45.76 ,$3.92 ,$39.00 ,$39.00 ,$44.20 ,$44.20 ,$3.92 ,$44.20 ,$3.92 ,$40.56 ,$40.56 ,$40.56 ,$46.80 ,$9.80 ,$46.80 ,$3.92 ,$52.00 ,$34.06 ,$3.92 ,$21.63 ,$8.21 ,$7.83 ,$4.12 ,$46.80 ,$8.82 ,$32.08 ,$14.56 ,$46.80 ,$3.92 ,$46.80 ,$46.80 ,$3.92 ,$33.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100318,82962,HC GLUCOSE BY DEVICE,301,1 ,$20.00 ,$13.00 ,$3.28 ,$20.00 ,$8.20 ,$14.90 ,$13.10 ,$3.28 ,$5.60 ,$10.10 ,$3.28 ,$12.34 ,$3.28 ,$12.34 ,$12.34 ,$3.28 ,$12.34 ,$6.23 ,$18.00 ,$15.00 ,$8.20 ,$3.28 ,$17.60 ,$3.28 ,$15.00 ,$15.00 ,$17.00 ,$17.00 ,$3.28 ,$17.00 ,$3.28 ,$15.60 ,$15.60 ,$15.60 ,$18.00 ,$8.20 ,$18.00 ,$3.28 ,$20.00 ,$13.10 ,$3.28 ,$8.32 ,$3.65 ,$3.49 ,$3.44 ,$18.00 ,$7.38 ,$12.34 ,$5.60 ,$18.00 ,$3.28 ,$18.00 ,$18.00 ,$3.28 ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100319,82977,HC GGT/GGTP,301,1 ,$84.00 ,$54.60 ,$3.49 ,$84.00 ,$18.00 ,$62.58 ,$55.02 ,$7.20 ,$23.52 ,$42.42 ,$7.20 ,$51.83 ,$7.20 ,$51.83 ,$51.83 ,$7.20 ,$51.83 ,$13.68 ,$75.60 ,$63.00 ,$18.00 ,$7.20 ,$73.92 ,$7.20 ,$63.00 ,$63.00 ,$71.40 ,$71.40 ,$7.20 ,$71.40 ,$7.20 ,$65.52 ,$65.52 ,$65.52 ,$75.60 ,$18.00 ,$75.60 ,$7.20 ,$84.00 ,$55.02 ,$7.20 ,$34.94 ,$3.65 ,$3.49 ,$7.56 ,$75.60 ,$16.20 ,$51.83 ,$23.52 ,$75.60 ,$7.20 ,$75.60 ,$75.60 ,$7.20 ,$54.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100322,83001,HC FSH,301,1 ,$179.00 ,$116.35 ,$18.33 ,$179.00 ,$46.45 ,$133.36 ,$117.25 ,$18.58 ,$50.12 ,$90.40 ,$18.58 ,$110.44 ,$18.58 ,$110.44 ,$110.44 ,$18.58 ,$110.44 ,$35.30 ,$161.10 ,$134.25 ,$46.45 ,$18.58 ,$157.52 ,$18.58 ,$134.25 ,$134.25 ,$152.15 ,$152.15 ,$18.58 ,$152.15 ,$18.58 ,$139.62 ,$139.62 ,$139.62 ,$161.10 ,$46.45 ,$161.10 ,$18.58 ,$179.00 ,$117.25 ,$18.58 ,$74.46 ,$19.21 ,$18.33 ,$19.51 ,$161.10 ,$41.81 ,$110.44 ,$50.12 ,$161.10 ,$18.58 ,$161.10 ,$161.10 ,$18.58 ,$116.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100325,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$177.00 ,$115.05 ,$18.33 ,$177.00 ,$46.30 ,$131.87 ,$115.94 ,$18.52 ,$49.56 ,$89.39 ,$18.52 ,$109.21 ,$18.52 ,$109.21 ,$109.21 ,$18.52 ,$109.21 ,$35.19 ,$159.30 ,$132.75 ,$46.30 ,$18.52 ,$155.76 ,$18.52 ,$132.75 ,$132.75 ,$150.45 ,$150.45 ,$18.52 ,$150.45 ,$18.52 ,$138.06 ,$138.06 ,$138.06 ,$159.30 ,$46.30 ,$159.30 ,$18.52 ,$177.00 ,$115.94 ,$18.52 ,$73.63 ,$19.21 ,$18.33 ,$19.45 ,$159.30 ,$41.67 ,$109.21 ,$49.56 ,$159.30 ,$18.52 ,$159.30 ,$159.30 ,$18.52 ,$115.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100327,83010,HC HAPTOGLOBIN,301,1 ,$179.00 ,$116.35 ,$7.83 ,$179.00 ,$31.45 ,$133.36 ,$117.25 ,$12.58 ,$50.12 ,$90.40 ,$12.58 ,$110.44 ,$12.58 ,$110.44 ,$110.44 ,$12.58 ,$110.44 ,$23.90 ,$161.10 ,$134.25 ,$31.45 ,$12.58 ,$157.52 ,$12.58 ,$134.25 ,$134.25 ,$152.15 ,$152.15 ,$12.58 ,$152.15 ,$12.58 ,$139.62 ,$139.62 ,$139.62 ,$161.10 ,$31.45 ,$161.10 ,$12.58 ,$179.00 ,$117.25 ,$12.58 ,$74.46 ,$8.21 ,$7.83 ,$13.21 ,$161.10 ,$28.31 ,$110.44 ,$50.12 ,$161.10 ,$12.58 ,$161.10 ,$161.10 ,$12.58 ,$116.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$97.00 ,$63.05 ,$7.83 ,$97.00 ,$24.28 ,$72.27 ,$63.54 ,$9.71 ,$27.16 ,$48.99 ,$9.71 ,$59.85 ,$9.71 ,$59.85 ,$59.85 ,$9.71 ,$59.85 ,$18.45 ,$87.30 ,$72.75 ,$24.28 ,$9.71 ,$85.36 ,$9.71 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$9.71 ,$82.45 ,$9.71 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$24.28 ,$87.30 ,$9.71 ,$97.00 ,$63.54 ,$9.71 ,$40.35 ,$8.21 ,$7.83 ,$10.20 ,$87.30 ,$21.85 ,$59.85 ,$27.16 ,$87.30 ,$9.71 ,$87.30 ,$87.30 ,$9.71 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100392,83525,HC INSULIN TOTAL,301,1 ,$110.00 ,$71.50 ,$10.54 ,$110.00 ,$28.58 ,$81.95 ,$72.05 ,$11.43 ,$30.80 ,$55.55 ,$11.43 ,$67.87 ,$11.43 ,$67.87 ,$67.87 ,$11.43 ,$67.87 ,$21.72 ,$99.00 ,$82.50 ,$28.58 ,$11.43 ,$96.80 ,$11.43 ,$82.50 ,$82.50 ,$93.50 ,$93.50 ,$11.43 ,$93.50 ,$11.43 ,$85.80 ,$85.80 ,$85.80 ,$99.00 ,$28.58 ,$99.00 ,$11.43 ,$110.00 ,$72.05 ,$11.43 ,$45.76 ,$11.04 ,$10.54 ,$12.00 ,$99.00 ,$25.72 ,$67.87 ,$30.80 ,$99.00 ,$11.43 ,$99.00 ,$99.00 ,$11.43 ,$71.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100393,83540,HC IRON TOTAL,301,1 ,$87.00 ,$56.55 ,$3.49 ,$87.00 ,$16.18 ,$64.82 ,$56.99 ,$6.47 ,$24.36 ,$43.94 ,$6.47 ,$53.68 ,$6.47 ,$53.68 ,$53.68 ,$6.47 ,$53.68 ,$12.29 ,$78.30 ,$65.25 ,$16.18 ,$6.47 ,$76.56 ,$6.47 ,$65.25 ,$65.25 ,$73.95 ,$73.95 ,$6.47 ,$73.95 ,$6.47 ,$67.86 ,$67.86 ,$67.86 ,$78.30 ,$16.18 ,$78.30 ,$6.47 ,$87.00 ,$56.99 ,$6.47 ,$36.19 ,$3.65 ,$3.49 ,$6.79 ,$78.30 ,$14.56 ,$53.68 ,$24.36 ,$78.30 ,$6.47 ,$78.30 ,$78.30 ,$6.47 ,$56.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$102.00 ,$66.30 ,$7.83 ,$102.00 ,$21.85 ,$75.99 ,$66.81 ,$8.74 ,$28.56 ,$51.51 ,$8.74 ,$62.93 ,$8.74 ,$62.93 ,$62.93 ,$8.74 ,$62.93 ,$16.61 ,$91.80 ,$76.50 ,$21.85 ,$8.74 ,$89.76 ,$8.74 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$8.74 ,$86.70 ,$8.74 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$21.85 ,$91.80 ,$8.74 ,$102.00 ,$66.81 ,$8.74 ,$42.43 ,$8.21 ,$7.83 ,$9.18 ,$91.80 ,$19.67 ,$62.93 ,$28.56 ,$91.80 ,$8.74 ,$91.80 ,$91.80 ,$8.74 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$150.00 ,$97.50 ,$7.83 ,$150.00 ,$28.93 ,$111.75 ,$98.25 ,$11.57 ,$42.00 ,$75.75 ,$11.57 ,$92.55 ,$11.57 ,$92.55 ,$92.55 ,$11.57 ,$92.55 ,$21.98 ,$135.00 ,$112.50 ,$28.93 ,$11.57 ,$132.00 ,$11.57 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$11.57 ,$127.50 ,$11.57 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$28.93 ,$135.00 ,$11.57 ,$150.00 ,$98.25 ,$11.57 ,$62.40 ,$8.21 ,$7.83 ,$12.15 ,$135.00 ,$26.03 ,$92.55 ,$42.00 ,$135.00 ,$11.57 ,$135.00 ,$135.00 ,$11.57 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$135.00 ,$87.75 ,$3.49 ,$135.00 ,$15.10 ,$100.58 ,$88.43 ,$6.04 ,$37.80 ,$68.18 ,$6.04 ,$83.30 ,$6.04 ,$83.30 ,$83.30 ,$6.04 ,$83.30 ,$11.48 ,$121.50 ,$101.25 ,$15.10 ,$6.04 ,$118.80 ,$6.04 ,$101.25 ,$101.25 ,$114.75 ,$114.75 ,$6.04 ,$114.75 ,$6.04 ,$105.30 ,$105.30 ,$105.30 ,$121.50 ,$15.10 ,$121.50 ,$6.04 ,$135.00 ,$88.43 ,$6.04 ,$56.16 ,$3.65 ,$3.49 ,$6.34 ,$121.50 ,$13.59 ,$83.30 ,$37.80 ,$121.50 ,$6.04 ,$121.50 ,$121.50 ,$6.04 ,$87.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100409,83690,HC LIPASE,301,1 ,$98.00 ,$63.70 ,$3.49 ,$98.00 ,$17.23 ,$73.01 ,$64.19 ,$6.89 ,$27.44 ,$49.49 ,$6.89 ,$60.47 ,$6.89 ,$60.47 ,$60.47 ,$6.89 ,$60.47 ,$13.09 ,$88.20 ,$73.50 ,$17.23 ,$6.89 ,$86.24 ,$6.89 ,$73.50 ,$73.50 ,$83.30 ,$83.30 ,$6.89 ,$83.30 ,$6.89 ,$76.44 ,$76.44 ,$76.44 ,$88.20 ,$17.23 ,$88.20 ,$6.89 ,$98.00 ,$64.19 ,$6.89 ,$40.77 ,$3.65 ,$3.49 ,$7.23 ,$88.20 ,$15.50 ,$60.47 ,$27.44 ,$88.20 ,$6.89 ,$88.20 ,$88.20 ,$6.89 ,$63.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100415,83718,HC CHOLESTEROL HDL,301,1 ,$136.00 ,$88.40 ,$7.83 ,$136.00 ,$20.48 ,$101.32 ,$89.08 ,$8.19 ,$38.08 ,$68.68 ,$8.19 ,$83.91 ,$8.19 ,$83.91 ,$83.91 ,$8.19 ,$83.91 ,$15.56 ,$122.40 ,$102.00 ,$20.48 ,$8.19 ,$119.68 ,$8.19 ,$102.00 ,$102.00 ,$115.60 ,$115.60 ,$8.19 ,$115.60 ,$8.19 ,$106.08 ,$106.08 ,$106.08 ,$122.40 ,$20.48 ,$122.40 ,$8.19 ,$136.00 ,$89.08 ,$8.19 ,$56.58 ,$8.21 ,$7.83 ,$8.60 ,$122.40 ,$18.43 ,$83.91 ,$38.08 ,$122.40 ,$8.19 ,$122.40 ,$122.40 ,$8.19 ,$88.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100416,83721,HC CHOLESTEROL LDL,301,1 ,$114.00 ,$74.10 ,$7.83 ,$114.00 ,$26.25 ,$84.93 ,$74.67 ,$10.50 ,$31.92 ,$57.57 ,$10.50 ,$70.34 ,$10.50 ,$70.34 ,$70.34 ,$10.50 ,$70.34 ,$19.95 ,$102.60 ,$85.50 ,$26.25 ,$10.50 ,$100.32 ,$10.50 ,$85.50 ,$85.50 ,$96.90 ,$96.90 ,$10.50 ,$96.90 ,$10.50 ,$88.92 ,$88.92 ,$88.92 ,$102.60 ,$26.25 ,$102.60 ,$10.50 ,$114.00 ,$74.67 ,$10.50 ,$47.42 ,$8.21 ,$7.83 ,$11.03 ,$102.60 ,$23.63 ,$70.34 ,$31.92 ,$102.60 ,$10.50 ,$102.60 ,$102.60 ,$10.50 ,$74.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100417,83735,HC MAGNESIUM,301,1 ,$68.00 ,$44.20 ,$3.49 ,$68.00 ,$16.75 ,$50.66 ,$44.54 ,$6.70 ,$19.04 ,$34.34 ,$6.70 ,$41.96 ,$6.70 ,$41.96 ,$41.96 ,$6.70 ,$41.96 ,$12.73 ,$61.20 ,$51.00 ,$16.75 ,$6.70 ,$59.84 ,$6.70 ,$51.00 ,$51.00 ,$57.80 ,$57.80 ,$6.70 ,$57.80 ,$6.70 ,$53.04 ,$53.04 ,$53.04 ,$61.20 ,$16.75 ,$61.20 ,$6.70 ,$68.00 ,$44.54 ,$6.70 ,$28.29 ,$3.65 ,$3.49 ,$7.04 ,$61.20 ,$15.08 ,$41.96 ,$19.04 ,$61.20 ,$6.70 ,$61.20 ,$61.20 ,$6.70 ,$44.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$179.00 ,$116.35 ,$21.08 ,$179.00 ,$98.15 ,$133.36 ,$117.25 ,$39.26 ,$50.12 ,$90.40 ,$39.26 ,$110.44 ,$39.26 ,$110.44 ,$110.44 ,$39.26 ,$110.44 ,$74.59 ,$161.10 ,$134.25 ,$98.15 ,$39.26 ,$157.52 ,$39.26 ,$134.25 ,$134.25 ,$152.15 ,$152.15 ,$39.26 ,$152.15 ,$39.26 ,$139.62 ,$139.62 ,$139.62 ,$161.10 ,$98.15 ,$161.10 ,$39.26 ,$179.00 ,$117.25 ,$39.26 ,$74.46 ,$22.09 ,$21.08 ,$41.22 ,$161.10 ,$88.34 ,$110.44 ,$50.12 ,$161.10 ,$39.26 ,$161.10 ,$161.10 ,$39.26 ,$116.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100668,83930,HC OSMOLALITY BLOOD,301,1 ,$102.00 ,$66.30 ,$3.49 ,$102.00 ,$16.53 ,$75.99 ,$66.81 ,$6.61 ,$28.56 ,$51.51 ,$6.61 ,$62.93 ,$6.61 ,$62.93 ,$62.93 ,$6.61 ,$62.93 ,$12.56 ,$91.80 ,$76.50 ,$16.53 ,$6.61 ,$89.76 ,$6.61 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$6.61 ,$86.70 ,$6.61 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$16.53 ,$91.80 ,$6.61 ,$102.00 ,$66.81 ,$6.61 ,$42.43 ,$3.65 ,$3.49 ,$6.94 ,$91.80 ,$14.87 ,$62.93 ,$28.56 ,$91.80 ,$6.61 ,$91.80 ,$91.80 ,$6.61 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100669,83935,HC OSMOLALITY URINE,301,1 ,$100.00 ,$65.00 ,$3.49 ,$100.00 ,$17.05 ,$74.50 ,$65.50 ,$6.82 ,$28.00 ,$50.50 ,$6.82 ,$61.70 ,$6.82 ,$61.70 ,$61.70 ,$6.82 ,$61.70 ,$12.96 ,$90.00 ,$75.00 ,$17.05 ,$6.82 ,$88.00 ,$6.82 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$6.82 ,$85.00 ,$6.82 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$17.05 ,$90.00 ,$6.82 ,$100.00 ,$65.50 ,$6.82 ,$41.60 ,$3.65 ,$3.49 ,$7.16 ,$90.00 ,$15.35 ,$61.70 ,$28.00 ,$90.00 ,$6.82 ,$90.00 ,$90.00 ,$6.82 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100672,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$266.00 ,$172.90 ,$18.33 ,$266.00 ,$103.20 ,$198.17 ,$174.23 ,$41.28 ,$74.48 ,$134.33 ,$41.28 ,$164.12 ,$41.28 ,$164.12 ,$164.12 ,$41.28 ,$164.12 ,$78.43 ,$239.40 ,$199.50 ,$103.20 ,$41.28 ,$234.08 ,$41.28 ,$199.50 ,$199.50 ,$226.10 ,$226.10 ,$41.28 ,$226.10 ,$41.28 ,$207.48 ,$207.48 ,$207.48 ,$239.40 ,$103.20 ,$239.40 ,$41.28 ,$266.00 ,$174.23 ,$41.28 ,$110.66 ,$19.21 ,$18.33 ,$43.34 ,$239.40 ,$92.88 ,$164.12 ,$74.48 ,$239.40 ,$41.28 ,$239.40 ,$239.40 ,$41.28 ,$172.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100673,83986,HC PH BODY FLUID,301,1 ,$66.00 ,$42.90 ,$3.49 ,$66.00 ,$8.95 ,$49.17 ,$43.23 ,$3.58 ,$18.48 ,$33.33 ,$3.58 ,$40.72 ,$3.58 ,$40.72 ,$40.72 ,$3.58 ,$40.72 ,$6.80 ,$59.40 ,$49.50 ,$8.95 ,$3.58 ,$58.08 ,$3.58 ,$49.50 ,$49.50 ,$56.10 ,$56.10 ,$3.58 ,$56.10 ,$3.58 ,$51.48 ,$51.48 ,$51.48 ,$59.40 ,$8.95 ,$59.40 ,$3.58 ,$66.00 ,$43.23 ,$3.58 ,$27.46 ,$3.65 ,$3.49 ,$3.76 ,$59.40 ,$8.06 ,$40.72 ,$18.48 ,$59.40 ,$3.58 ,$59.40 ,$59.40 ,$3.58 ,$42.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$89.00 ,$57.85 ,$3.49 ,$89.00 ,$12.95 ,$66.31 ,$58.30 ,$5.18 ,$24.92 ,$44.95 ,$5.18 ,$54.91 ,$5.18 ,$54.91 ,$54.91 ,$5.18 ,$54.91 ,$9.84 ,$80.10 ,$66.75 ,$12.95 ,$5.18 ,$78.32 ,$5.18 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$5.18 ,$75.65 ,$5.18 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$12.95 ,$80.10 ,$5.18 ,$89.00 ,$58.30 ,$5.18 ,$37.02 ,$3.65 ,$3.49 ,$5.44 ,$80.10 ,$11.66 ,$54.91 ,$24.92 ,$80.10 ,$5.18 ,$80.10 ,$80.10 ,$5.18 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100684,84100,HC PHOSPHORUS,301,1 ,$68.00 ,$44.20 ,$3.49 ,$68.00 ,$11.85 ,$50.66 ,$44.54 ,$4.74 ,$19.04 ,$34.34 ,$4.74 ,$41.96 ,$4.74 ,$41.96 ,$41.96 ,$4.74 ,$41.96 ,$9.01 ,$61.20 ,$51.00 ,$11.85 ,$4.74 ,$59.84 ,$4.74 ,$51.00 ,$51.00 ,$57.80 ,$57.80 ,$4.74 ,$57.80 ,$4.74 ,$53.04 ,$53.04 ,$53.04 ,$61.20 ,$11.85 ,$61.20 ,$4.74 ,$68.00 ,$44.54 ,$4.74 ,$28.29 ,$3.65 ,$3.49 ,$4.98 ,$61.20 ,$10.67 ,$41.96 ,$19.04 ,$61.20 ,$4.74 ,$61.20 ,$61.20 ,$4.74 ,$44.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100688,84112,HC PLACENTAL ALPHA MICROGLOBULIN,301,1 ,$277.00 ,$180.05 ,$21.08 ,$277.00 ,$245.28 ,$206.37 ,$181.44 ,$98.11 ,$77.56 ,$139.89 ,$98.11 ,$170.91 ,$98.11 ,$170.91 ,$170.91 ,$98.11 ,$170.91 ,$186.41 ,$249.30 ,$207.75 ,$245.28 ,$98.11 ,$243.76 ,$98.11 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$98.11 ,$235.45 ,$98.11 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$245.28 ,$249.30 ,$98.11 ,$277.00 ,$181.44 ,$98.11 ,$115.23 ,$22.09 ,$21.08 ,$103.02 ,$249.30 ,$220.75 ,$170.91 ,$77.56 ,$249.30 ,$98.11 ,$249.30 ,$249.30 ,$98.11 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100691,84132,HC POTASSIUM,301,1 ,$66.00 ,$42.90 ,$3.49 ,$66.00 ,$11.90 ,$49.17 ,$43.23 ,$4.76 ,$18.48 ,$33.33 ,$4.76 ,$40.72 ,$4.76 ,$40.72 ,$40.72 ,$4.76 ,$40.72 ,$9.04 ,$59.40 ,$49.50 ,$11.90 ,$4.76 ,$58.08 ,$4.76 ,$49.50 ,$49.50 ,$56.10 ,$56.10 ,$4.76 ,$56.10 ,$4.76 ,$51.48 ,$51.48 ,$51.48 ,$59.40 ,$11.90 ,$59.40 ,$4.76 ,$66.00 ,$43.23 ,$4.76 ,$27.46 ,$3.65 ,$3.49 ,$5.00 ,$59.40 ,$10.71 ,$40.72 ,$18.48 ,$59.40 ,$4.76 ,$59.40 ,$59.40 ,$4.76 ,$42.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100694,84133,HC POTASSIUM URINE,301,1 ,$70.00 ,$45.50 ,$3.49 ,$70.00 ,$11.83 ,$52.15 ,$45.85 ,$4.73 ,$19.60 ,$35.35 ,$4.73 ,$43.19 ,$4.73 ,$43.19 ,$43.19 ,$4.73 ,$43.19 ,$8.99 ,$63.00 ,$52.50 ,$11.83 ,$4.73 ,$61.60 ,$4.73 ,$52.50 ,$52.50 ,$59.50 ,$59.50 ,$4.73 ,$59.50 ,$4.73 ,$54.60 ,$54.60 ,$54.60 ,$63.00 ,$11.83 ,$63.00 ,$4.73 ,$70.00 ,$45.85 ,$4.73 ,$29.12 ,$3.65 ,$3.49 ,$4.97 ,$63.00 ,$10.64 ,$43.19 ,$19.60 ,$63.00 ,$4.73 ,$63.00 ,$63.00 ,$4.73 ,$45.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100695,84134,HC PREALBUMIN,301,1 ,$129.00 ,$83.85 ,$7.83 ,$129.00 ,$36.48 ,$96.11 ,$84.50 ,$14.59 ,$36.12 ,$65.15 ,$14.59 ,$79.59 ,$14.59 ,$79.59 ,$79.59 ,$14.59 ,$79.59 ,$27.72 ,$116.10 ,$96.75 ,$36.48 ,$14.59 ,$113.52 ,$14.59 ,$96.75 ,$96.75 ,$109.65 ,$109.65 ,$14.59 ,$109.65 ,$14.59 ,$100.62 ,$100.62 ,$100.62 ,$116.10 ,$36.48 ,$116.10 ,$14.59 ,$129.00 ,$84.50 ,$14.59 ,$53.66 ,$8.21 ,$7.83 ,$15.32 ,$116.10 ,$32.83 ,$79.59 ,$36.12 ,$116.10 ,$14.59 ,$116.10 ,$116.10 ,$14.59 ,$83.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100696,84144,HC PROGESTERONE,301,1 ,$202.00 ,$131.30 ,$10.54 ,$202.00 ,$52.15 ,$150.49 ,$132.31 ,$20.86 ,$56.56 ,$102.01 ,$20.86 ,$124.63 ,$20.86 ,$124.63 ,$124.63 ,$20.86 ,$124.63 ,$39.63 ,$181.80 ,$151.50 ,$52.15 ,$20.86 ,$177.76 ,$20.86 ,$151.50 ,$151.50 ,$171.70 ,$171.70 ,$20.86 ,$171.70 ,$20.86 ,$157.56 ,$157.56 ,$157.56 ,$181.80 ,$52.15 ,$181.80 ,$20.86 ,$202.00 ,$132.31 ,$20.86 ,$84.03 ,$11.04 ,$10.54 ,$21.90 ,$181.80 ,$46.94 ,$124.63 ,$56.56 ,$181.80 ,$20.86 ,$181.80 ,$181.80 ,$20.86 ,$131.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100697,84146,HC PROLACTIN,301,1 ,$196.00 ,$127.40 ,$18.33 ,$196.00 ,$48.45 ,$146.02 ,$128.38 ,$19.38 ,$54.88 ,$98.98 ,$19.38 ,$120.93 ,$19.38 ,$120.93 ,$120.93 ,$19.38 ,$120.93 ,$36.82 ,$176.40 ,$147.00 ,$48.45 ,$19.38 ,$172.48 ,$19.38 ,$147.00 ,$147.00 ,$166.60 ,$166.60 ,$19.38 ,$166.60 ,$19.38 ,$152.88 ,$152.88 ,$152.88 ,$176.40 ,$48.45 ,$176.40 ,$19.38 ,$196.00 ,$128.38 ,$19.38 ,$81.54 ,$19.21 ,$18.33 ,$20.35 ,$176.40 ,$43.61 ,$120.93 ,$54.88 ,$176.40 ,$19.38 ,$176.40 ,$176.40 ,$19.38 ,$127.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100698,84153,HC PSA TOTAL,301,1 ,$306.00 ,$198.90 ,$7.83 ,$306.00 ,$45.98 ,$227.97 ,$200.43 ,$18.39 ,$85.68 ,$154.53 ,$18.39 ,$188.80 ,$18.39 ,$188.80 ,$188.80 ,$18.39 ,$188.80 ,$34.94 ,$275.40 ,$229.50 ,$45.98 ,$18.39 ,$269.28 ,$18.39 ,$229.50 ,$229.50 ,$260.10 ,$260.10 ,$18.39 ,$260.10 ,$18.39 ,$238.68 ,$238.68 ,$238.68 ,$275.40 ,$45.98 ,$275.40 ,$18.39 ,$306.00 ,$200.43 ,$18.39 ,$127.30 ,$8.21 ,$7.83 ,$19.31 ,$275.40 ,$41.38 ,$188.80 ,$85.68 ,$275.40 ,$18.39 ,$275.40 ,$275.40 ,$18.39 ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100700,84155,HC PROTEIN TOTAL,301,1 ,$58.00 ,$37.70 ,$3.49 ,$58.00 ,$9.18 ,$43.21 ,$37.99 ,$3.67 ,$16.24 ,$29.29 ,$3.67 ,$35.79 ,$3.67 ,$35.79 ,$35.79 ,$3.67 ,$35.79 ,$6.97 ,$52.20 ,$43.50 ,$9.18 ,$3.67 ,$51.04 ,$3.67 ,$43.50 ,$43.50 ,$49.30 ,$49.30 ,$3.67 ,$49.30 ,$3.67 ,$45.24 ,$45.24 ,$45.24 ,$52.20 ,$9.18 ,$52.20 ,$3.67 ,$58.00 ,$37.99 ,$3.67 ,$24.13 ,$3.65 ,$3.49 ,$3.85 ,$52.20 ,$8.26 ,$35.79 ,$16.24 ,$52.20 ,$3.67 ,$52.20 ,$52.20 ,$3.67 ,$37.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$105.00 ,$68.25 ,$3.49 ,$105.00 ,$9.18 ,$78.23 ,$68.78 ,$3.67 ,$29.40 ,$53.03 ,$3.67 ,$64.79 ,$3.67 ,$64.79 ,$64.79 ,$3.67 ,$64.79 ,$6.97 ,$94.50 ,$78.75 ,$9.18 ,$3.67 ,$92.40 ,$3.67 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$3.67 ,$89.25 ,$3.67 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$9.18 ,$94.50 ,$3.67 ,$105.00 ,$68.78 ,$3.67 ,$43.68 ,$3.65 ,$3.49 ,$3.85 ,$94.50 ,$8.26 ,$64.79 ,$29.40 ,$94.50 ,$3.67 ,$94.50 ,$94.50 ,$3.67 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$144.00 ,$93.60 ,$3.49 ,$144.00 ,$10.00 ,$107.28 ,$94.32 ,$4.00 ,$40.32 ,$72.72 ,$4.00 ,$88.85 ,$4.00 ,$88.85 ,$88.85 ,$4.00 ,$88.85 ,$7.60 ,$129.60 ,$108.00 ,$10.00 ,$4.00 ,$126.72 ,$4.00 ,$108.00 ,$108.00 ,$122.40 ,$122.40 ,$4.00 ,$122.40 ,$4.00 ,$112.32 ,$112.32 ,$112.32 ,$129.60 ,$10.00 ,$129.60 ,$4.00 ,$144.00 ,$94.32 ,$4.00 ,$59.90 ,$3.65 ,$3.49 ,$4.20 ,$129.60 ,$9.00 ,$88.85 ,$40.32 ,$129.60 ,$4.00 ,$129.60 ,$129.60 ,$4.00 ,$93.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100721,84295,HC SODIUM,301,1 ,$61.00 ,$39.65 ,$3.49 ,$61.00 ,$12.03 ,$45.45 ,$39.96 ,$4.81 ,$17.08 ,$30.81 ,$4.81 ,$37.64 ,$4.81 ,$37.64 ,$37.64 ,$4.81 ,$37.64 ,$9.14 ,$54.90 ,$45.75 ,$12.03 ,$4.81 ,$53.68 ,$4.81 ,$45.75 ,$45.75 ,$51.85 ,$51.85 ,$4.81 ,$51.85 ,$4.81 ,$47.58 ,$47.58 ,$47.58 ,$54.90 ,$12.03 ,$54.90 ,$4.81 ,$61.00 ,$39.96 ,$4.81 ,$25.38 ,$3.65 ,$3.49 ,$5.05 ,$54.90 ,$10.82 ,$37.64 ,$17.08 ,$54.90 ,$4.81 ,$54.90 ,$54.90 ,$4.81 ,$39.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100724,84300,HC SODIUM URINE,301,1 ,$76.00 ,$49.40 ,$3.49 ,$76.00 ,$12.65 ,$56.62 ,$49.78 ,$5.06 ,$21.28 ,$38.38 ,$5.06 ,$46.89 ,$5.06 ,$46.89 ,$46.89 ,$5.06 ,$46.89 ,$9.61 ,$68.40 ,$57.00 ,$12.65 ,$5.06 ,$66.88 ,$5.06 ,$57.00 ,$57.00 ,$64.60 ,$64.60 ,$5.06 ,$64.60 ,$5.06 ,$59.28 ,$59.28 ,$59.28 ,$68.40 ,$12.65 ,$68.40 ,$5.06 ,$76.00 ,$49.78 ,$5.06 ,$31.62 ,$3.65 ,$3.49 ,$5.31 ,$68.40 ,$11.39 ,$46.89 ,$21.28 ,$68.40 ,$5.06 ,$68.40 ,$68.40 ,$5.06 ,$49.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100730,84315,HC SPEC GRAVITY NON UR,301,1 ,$47.00 ,$30.55 ,$3.28 ,$47.00 ,$8.20 ,$35.02 ,$30.79 ,$3.28 ,$13.16 ,$23.74 ,$3.28 ,$29.00 ,$3.28 ,$29.00 ,$29.00 ,$3.28 ,$29.00 ,$6.23 ,$42.30 ,$35.25 ,$8.20 ,$3.28 ,$41.36 ,$3.28 ,$35.25 ,$35.25 ,$39.95 ,$39.95 ,$3.28 ,$39.95 ,$3.28 ,$36.66 ,$36.66 ,$36.66 ,$42.30 ,$8.20 ,$42.30 ,$3.28 ,$47.00 ,$30.79 ,$3.28 ,$19.55 ,$3.65 ,$3.49 ,$3.44 ,$42.30 ,$7.38 ,$29.00 ,$13.16 ,$42.30 ,$3.28 ,$42.30 ,$42.30 ,$3.28 ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100739,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$101.00 ,$65.65 ,$6.87 ,$101.00 ,$17.18 ,$75.25 ,$66.16 ,$6.87 ,$28.28 ,$51.01 ,$6.87 ,$62.32 ,$6.87 ,$62.32 ,$62.32 ,$6.87 ,$62.32 ,$13.05 ,$90.90 ,$75.75 ,$17.18 ,$6.87 ,$88.88 ,$6.87 ,$75.75 ,$75.75 ,$85.85 ,$85.85 ,$6.87 ,$85.85 ,$6.87 ,$78.78 ,$78.78 ,$78.78 ,$90.90 ,$17.18 ,$90.90 ,$6.87 ,$101.00 ,$66.16 ,$6.87 ,$42.02 ,$11.04 ,$10.54 ,$7.21 ,$90.90 ,$15.46 ,$62.32 ,$28.28 ,$90.90 ,$6.87 ,$90.90 ,$90.90 ,$6.87 ,$65.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100740,84439,HC T4 FREE,301,1 ,$123.00 ,$79.95 ,$9.02 ,$123.00 ,$22.55 ,$91.64 ,$80.57 ,$9.02 ,$34.44 ,$62.12 ,$9.02 ,$75.89 ,$9.02 ,$75.89 ,$75.89 ,$9.02 ,$75.89 ,$17.14 ,$110.70 ,$92.25 ,$22.55 ,$9.02 ,$108.24 ,$9.02 ,$92.25 ,$92.25 ,$104.55 ,$104.55 ,$9.02 ,$104.55 ,$9.02 ,$95.94 ,$95.94 ,$95.94 ,$110.70 ,$22.55 ,$110.70 ,$9.02 ,$123.00 ,$80.57 ,$9.02 ,$51.17 ,$11.04 ,$10.54 ,$9.47 ,$110.70 ,$20.30 ,$75.89 ,$34.44 ,$110.70 ,$9.02 ,$110.70 ,$110.70 ,$9.02 ,$79.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$124.00 ,$80.60 ,$10.54 ,$124.00 ,$42.00 ,$92.38 ,$81.22 ,$16.80 ,$34.72 ,$62.62 ,$16.80 ,$76.51 ,$16.80 ,$76.51 ,$76.51 ,$16.80 ,$76.51 ,$31.92 ,$111.60 ,$93.00 ,$42.00 ,$16.80 ,$109.12 ,$16.80 ,$93.00 ,$93.00 ,$105.40 ,$105.40 ,$16.80 ,$105.40 ,$16.80 ,$96.72 ,$96.72 ,$96.72 ,$111.60 ,$42.00 ,$111.60 ,$16.80 ,$124.00 ,$81.22 ,$16.80 ,$51.58 ,$11.04 ,$10.54 ,$17.64 ,$111.60 ,$37.80 ,$76.51 ,$34.72 ,$111.60 ,$16.80 ,$111.60 ,$111.60 ,$16.80 ,$80.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100746,84450,HC AST,301,1 ,$110.00 ,$71.50 ,$3.49 ,$110.00 ,$12.95 ,$81.95 ,$72.05 ,$5.18 ,$30.80 ,$55.55 ,$5.18 ,$67.87 ,$5.18 ,$67.87 ,$67.87 ,$5.18 ,$67.87 ,$9.84 ,$99.00 ,$82.50 ,$12.95 ,$5.18 ,$96.80 ,$5.18 ,$82.50 ,$82.50 ,$93.50 ,$93.50 ,$5.18 ,$93.50 ,$5.18 ,$85.80 ,$85.80 ,$85.80 ,$99.00 ,$12.95 ,$99.00 ,$5.18 ,$110.00 ,$72.05 ,$5.18 ,$45.76 ,$3.65 ,$3.49 ,$5.44 ,$99.00 ,$11.66 ,$67.87 ,$30.80 ,$99.00 ,$5.18 ,$99.00 ,$99.00 ,$5.18 ,$71.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100747,84460,HC ALT,301,1 ,$110.00 ,$71.50 ,$3.49 ,$110.00 ,$13.25 ,$81.95 ,$72.05 ,$5.30 ,$30.80 ,$55.55 ,$5.30 ,$67.87 ,$5.30 ,$67.87 ,$67.87 ,$5.30 ,$67.87 ,$10.07 ,$99.00 ,$82.50 ,$13.25 ,$5.30 ,$96.80 ,$5.30 ,$82.50 ,$82.50 ,$93.50 ,$93.50 ,$5.30 ,$93.50 ,$5.30 ,$85.80 ,$85.80 ,$85.80 ,$99.00 ,$13.25 ,$99.00 ,$5.30 ,$110.00 ,$72.05 ,$5.30 ,$45.76 ,$3.65 ,$3.49 ,$5.57 ,$99.00 ,$11.93 ,$67.87 ,$30.80 ,$99.00 ,$5.30 ,$99.00 ,$99.00 ,$5.30 ,$71.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100748,84466,HC TRANSFERRIN,301,1 ,$208.00 ,$135.20 ,$7.83 ,$208.00 ,$31.90 ,$154.96 ,$136.24 ,$12.76 ,$58.24 ,$105.04 ,$12.76 ,$128.34 ,$12.76 ,$128.34 ,$128.34 ,$12.76 ,$128.34 ,$24.24 ,$187.20 ,$156.00 ,$31.90 ,$12.76 ,$183.04 ,$12.76 ,$156.00 ,$156.00 ,$176.80 ,$176.80 ,$12.76 ,$176.80 ,$12.76 ,$162.24 ,$162.24 ,$162.24 ,$187.20 ,$31.90 ,$187.20 ,$12.76 ,$208.00 ,$136.24 ,$12.76 ,$86.53 ,$8.21 ,$7.83 ,$13.40 ,$187.20 ,$28.71 ,$128.34 ,$58.24 ,$187.20 ,$12.76 ,$187.20 ,$187.20 ,$12.76 ,$135.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100750,84478,HC TRIGLYCERIDES,301,1 ,$75.00 ,$48.75 ,$3.49 ,$75.00 ,$14.35 ,$55.88 ,$49.13 ,$5.74 ,$21.00 ,$37.88 ,$5.74 ,$46.28 ,$5.74 ,$46.28 ,$46.28 ,$5.74 ,$46.28 ,$10.91 ,$67.50 ,$56.25 ,$14.35 ,$5.74 ,$66.00 ,$5.74 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$5.74 ,$63.75 ,$5.74 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$14.35 ,$67.50 ,$5.74 ,$75.00 ,$49.13 ,$5.74 ,$31.20 ,$3.65 ,$3.49 ,$6.03 ,$67.50 ,$12.92 ,$46.28 ,$21.00 ,$67.50 ,$5.74 ,$67.50 ,$67.50 ,$5.74 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100753,84479,HC T3 UPTAKE,301,1 ,$21.00 ,$13.65 ,$5.88 ,$21.00 ,$16.18 ,$15.65 ,$13.76 ,$6.47 ,$5.88 ,$10.61 ,$6.47 ,$12.96 ,$6.47 ,$12.96 ,$12.96 ,$6.47 ,$12.96 ,$12.29 ,$18.90 ,$15.75 ,$16.18 ,$6.47 ,$18.48 ,$6.47 ,$15.75 ,$15.75 ,$17.85 ,$17.85 ,$6.47 ,$17.85 ,$6.47 ,$16.38 ,$16.38 ,$16.38 ,$18.90 ,$16.18 ,$18.90 ,$6.47 ,$21.00 ,$13.76 ,$6.47 ,$8.74 ,$11.04 ,$10.54 ,$6.79 ,$18.90 ,$14.56 ,$12.96 ,$5.88 ,$18.90 ,$6.47 ,$18.90 ,$18.90 ,$6.47 ,$13.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100754,84480,HC T3 TOTAL,301,1 ,$240.00 ,$156.00 ,$10.54 ,$240.00 ,$35.45 ,$178.80 ,$157.20 ,$14.18 ,$67.20 ,$121.20 ,$14.18 ,$148.08 ,$14.18 ,$148.08 ,$148.08 ,$14.18 ,$148.08 ,$26.94 ,$216.00 ,$180.00 ,$35.45 ,$14.18 ,$211.20 ,$14.18 ,$180.00 ,$180.00 ,$204.00 ,$204.00 ,$14.18 ,$204.00 ,$14.18 ,$187.20 ,$187.20 ,$187.20 ,$216.00 ,$35.45 ,$216.00 ,$14.18 ,$240.00 ,$157.20 ,$14.18 ,$99.84 ,$11.04 ,$10.54 ,$14.89 ,$216.00 ,$31.91 ,$148.08 ,$67.20 ,$216.00 ,$14.18 ,$216.00 ,$216.00 ,$14.18 ,$156.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100755,84481,HC T3 FREE,301,1 ,$170.00 ,$110.50 ,$10.54 ,$170.00 ,$42.35 ,$126.65 ,$111.35 ,$16.94 ,$47.60 ,$85.85 ,$16.94 ,$104.89 ,$16.94 ,$104.89 ,$104.89 ,$16.94 ,$104.89 ,$32.19 ,$153.00 ,$127.50 ,$42.35 ,$16.94 ,$149.60 ,$16.94 ,$127.50 ,$127.50 ,$144.50 ,$144.50 ,$16.94 ,$144.50 ,$16.94 ,$132.60 ,$132.60 ,$132.60 ,$153.00 ,$42.35 ,$153.00 ,$16.94 ,$170.00 ,$111.35 ,$16.94 ,$70.72 ,$11.04 ,$10.54 ,$17.79 ,$153.00 ,$38.12 ,$104.89 ,$47.60 ,$153.00 ,$16.94 ,$153.00 ,$153.00 ,$16.94 ,$110.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100758,84484,HC TROPONIN QN,301,1 ,$160.00 ,$104.00 ,$7.83 ,$160.00 ,$31.18 ,$119.20 ,$104.80 ,$12.47 ,$44.80 ,$80.80 ,$12.47 ,$98.72 ,$12.47 ,$98.72 ,$98.72 ,$12.47 ,$98.72 ,$23.69 ,$144.00 ,$120.00 ,$31.18 ,$12.47 ,$140.80 ,$12.47 ,$120.00 ,$120.00 ,$136.00 ,$136.00 ,$12.47 ,$136.00 ,$12.47 ,$124.80 ,$124.80 ,$124.80 ,$144.00 ,$31.18 ,$144.00 ,$12.47 ,$160.00 ,$104.80 ,$12.47 ,$66.56 ,$8.21 ,$7.83 ,$13.09 ,$144.00 ,$28.06 ,$98.72 ,$44.80 ,$144.00 ,$12.47 ,$144.00 ,$144.00 ,$12.47 ,$104.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100761,84520,HC BUN,301,1 ,$80.00 ,$52.00 ,$3.49 ,$80.00 ,$9.88 ,$59.60 ,$52.40 ,$3.95 ,$22.40 ,$40.40 ,$3.95 ,$49.36 ,$3.95 ,$49.36 ,$49.36 ,$3.95 ,$49.36 ,$7.51 ,$72.00 ,$60.00 ,$9.88 ,$3.95 ,$70.40 ,$3.95 ,$60.00 ,$60.00 ,$68.00 ,$68.00 ,$3.95 ,$68.00 ,$3.95 ,$62.40 ,$62.40 ,$62.40 ,$72.00 ,$9.88 ,$72.00 ,$3.95 ,$3.95 ,$52.40 ,$3.95 ,$33.28 ,$3.65 ,$3.49 ,$4.15 ,$72.00 ,$8.89 ,$49.36 ,$22.40 ,$72.00 ,$3.95 ,$72.00 ,$72.00 ,$3.95 ,$52.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100765,84550,HC URIC ACID,301,1 ,$56.00 ,$36.40 ,$3.49 ,$56.00 ,$11.30 ,$41.72 ,$36.68 ,$4.52 ,$15.68 ,$28.28 ,$4.52 ,$34.55 ,$4.52 ,$34.55 ,$34.55 ,$4.52 ,$34.55 ,$8.59 ,$50.40 ,$42.00 ,$11.30 ,$4.52 ,$49.28 ,$4.52 ,$42.00 ,$42.00 ,$47.60 ,$47.60 ,$4.52 ,$47.60 ,$4.52 ,$43.68 ,$43.68 ,$43.68 ,$50.40 ,$11.30 ,$50.40 ,$4.52 ,$56.00 ,$36.68 ,$4.52 ,$23.30 ,$3.65 ,$3.49 ,$4.75 ,$50.40 ,$10.17 ,$34.55 ,$15.68 ,$50.40 ,$4.52 ,$50.40 ,$50.40 ,$4.52 ,$36.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100802,84702,HC HCG QN,301,1 ,$317.00 ,$206.05 ,$10.54 ,$317.00 ,$37.63 ,$236.17 ,$207.64 ,$15.05 ,$88.76 ,$160.09 ,$15.05 ,$195.59 ,$15.05 ,$195.59 ,$195.59 ,$15.05 ,$195.59 ,$28.60 ,$285.30 ,$237.75 ,$37.63 ,$15.05 ,$278.96 ,$15.05 ,$237.75 ,$237.75 ,$269.45 ,$269.45 ,$15.05 ,$269.45 ,$15.05 ,$247.26 ,$247.26 ,$247.26 ,$285.30 ,$37.63 ,$285.30 ,$15.05 ,$317.00 ,$207.64 ,$15.05 ,$131.87 ,$11.04 ,$10.54 ,$15.80 ,$285.30 ,$33.86 ,$195.59 ,$88.76 ,$285.30 ,$15.05 ,$285.30 ,$285.30 ,$15.05 ,$206.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100808,84703,HC HCG QL,301,1 ,$130.00 ,$84.50 ,$7.52 ,$130.00 ,$18.80 ,$96.85 ,$85.15 ,$7.52 ,$36.40 ,$65.65 ,$7.52 ,$80.21 ,$7.52 ,$80.21 ,$80.21 ,$7.52 ,$80.21 ,$14.29 ,$117.00 ,$97.50 ,$18.80 ,$7.52 ,$114.40 ,$7.52 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$7.52 ,$110.50 ,$7.52 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$18.80 ,$117.00 ,$7.52 ,$130.00 ,$85.15 ,$7.52 ,$54.08 ,$8.21 ,$7.83 ,$7.90 ,$117.00 ,$16.92 ,$80.21 ,$36.40 ,$117.00 ,$7.52 ,$117.00 ,$117.00 ,$7.52 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30100810,88720,HC BILICHECK TEST,301,1 ,$94.00 ,$61.10 ,$3.49 ,$94.00 ,$12.55 ,$70.03 ,$61.57 ,$5.02 ,$26.32 ,$47.47 ,$5.02 ,$58.00 ,$5.02 ,$58.00 ,$58.00 ,$5.02 ,$58.00 ,$9.54 ,$84.60 ,$70.50 ,$12.55 ,$5.02 ,$82.72 ,$5.02 ,$70.50 ,$70.50 ,$79.90 ,$79.90 ,$5.02 ,$79.90 ,$5.02 ,$73.32 ,$73.32 ,$73.32 ,$84.60 ,$12.55 ,$84.60 ,$5.02 ,$94.00 ,$61.57 ,$5.02 ,$39.10 ,$3.65 ,$3.49 ,$5.27 ,$84.60 ,$11.30 ,$58.00 ,$26.32 ,$84.60 ,$5.02 ,$84.60 ,$84.60 ,$5.02 ,$61.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$358.00 ,$232.70 ,$7.83 ,$358.00 ,$48.28 ,$266.71 ,$234.49 ,$19.31 ,$100.24 ,$180.79 ,$19.31 ,$220.89 ,$19.31 ,$220.89 ,$220.89 ,$19.31 ,$220.89 ,$36.69 ,$322.20 ,$268.50 ,$48.28 ,$19.31 ,$315.04 ,$19.31 ,$268.50 ,$268.50 ,$304.30 ,$304.30 ,$19.31 ,$304.30 ,$19.31 ,$279.24 ,$279.24 ,$279.24 ,$322.20 ,$48.28 ,$322.20 ,$19.31 ,$358.00 ,$234.49 ,$19.31 ,$148.93 ,$8.21 ,$7.83 ,$20.28 ,$322.20 ,$43.45 ,$220.89 ,$100.24 ,$322.20 ,$19.31 ,$322.20 ,$322.20 ,$19.31 ,$232.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101063,83519,HC ACETYLCHOLINE RECEPTR AB TIER 1-90,301,1 ,$144.00 ,$93.60 ,$7.01 ,$144.00 ,$46.00 ,$107.28 ,$94.32 ,$18.40 ,$40.32 ,$72.72 ,$18.40 ,$88.85 ,$18.40 ,$88.85 ,$88.85 ,$18.40 ,$88.85 ,$34.96 ,$129.60 ,$108.00 ,$46.00 ,$18.40 ,$126.72 ,$18.40 ,$108.00 ,$108.00 ,$122.40 ,$122.40 ,$18.40 ,$122.40 ,$18.40 ,$112.32 ,$112.32 ,$112.32 ,$129.60 ,$46.00 ,$129.60 ,$18.40 ,$144.00 ,$94.32 ,$18.40 ,$59.90 ,$7.35 ,$7.01 ,$19.32 ,$129.60 ,$41.40 ,$88.85 ,$40.32 ,$129.60 ,$18.40 ,$129.60 ,$129.60 ,$18.40 ,$93.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101064,83519,HC ACETYLCHOLINE RECEPTR AB TIER 2-90,301,1 ,$426.00 ,$276.90 ,$7.01 ,$426.00 ,$46.00 ,$317.37 ,$279.03 ,$18.40 ,$119.28 ,$215.13 ,$18.40 ,$262.84 ,$18.40 ,$262.84 ,$262.84 ,$18.40 ,$262.84 ,$34.96 ,$383.40 ,$319.50 ,$46.00 ,$18.40 ,$374.88 ,$18.40 ,$319.50 ,$319.50 ,$362.10 ,$362.10 ,$18.40 ,$362.10 ,$18.40 ,$332.28 ,$332.28 ,$332.28 ,$383.40 ,$46.00 ,$383.40 ,$18.40 ,$426.00 ,$279.03 ,$18.40 ,$177.22 ,$7.35 ,$7.01 ,$19.32 ,$383.40 ,$41.40 ,$262.84 ,$119.28 ,$383.40 ,$18.40 ,$383.40 ,$383.40 ,$18.40 ,$276.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101065,83520,HC ANTI-NEURONAL CELL AB-90,301,1 ,$187.20 ,$121.68 ,$7.01 ,$187.20 ,$43.18 ,$139.46 ,$122.62 ,$17.27 ,$52.42 ,$94.54 ,$17.27 ,$115.50 ,$17.27 ,$115.50 ,$115.50 ,$17.27 ,$115.50 ,$32.81 ,$168.48 ,$140.40 ,$43.18 ,$17.27 ,$164.74 ,$17.27 ,$140.40 ,$140.40 ,$159.12 ,$159.12 ,$17.27 ,$159.12 ,$17.27 ,$146.02 ,$146.02 ,$146.02 ,$168.48 ,$43.18 ,$168.48 ,$17.27 ,$187.20 ,$122.62 ,$17.27 ,$77.88 ,$7.35 ,$7.01 ,$18.13 ,$168.48 ,$38.86 ,$115.50 ,$52.42 ,$168.48 ,$17.27 ,$168.48 ,$168.48 ,$17.27 ,$121.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101089,80150,HC AMIKACIN - 90,301,1 ,$107.00 ,$69.55 ,$8.99 ,$107.00 ,$37.70 ,$79.72 ,$70.09 ,$15.08 ,$29.96 ,$54.04 ,$15.08 ,$66.02 ,$15.08 ,$66.02 ,$66.02 ,$15.08 ,$66.02 ,$28.65 ,$96.30 ,$80.25 ,$37.70 ,$15.08 ,$94.16 ,$15.08 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$15.08 ,$90.95 ,$15.08 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$37.70 ,$96.30 ,$15.08 ,$107.00 ,$70.09 ,$15.08 ,$44.51 ,$9.42 ,$8.99 ,$15.83 ,$96.30 ,$33.93 ,$66.02 ,$29.96 ,$96.30 ,$15.08 ,$96.30 ,$96.30 ,$15.08 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101093,80157,HC CARBAMAZEPINE FREE - 90,301,1 ,$117.00 ,$76.05 ,$8.99 ,$117.00 ,$33.13 ,$87.17 ,$76.64 ,$13.25 ,$32.76 ,$59.09 ,$13.25 ,$72.19 ,$13.25 ,$72.19 ,$72.19 ,$13.25 ,$72.19 ,$25.18 ,$105.30 ,$87.75 ,$33.13 ,$13.25 ,$102.96 ,$13.25 ,$87.75 ,$87.75 ,$99.45 ,$99.45 ,$13.25 ,$99.45 ,$13.25 ,$91.26 ,$91.26 ,$91.26 ,$105.30 ,$33.13 ,$105.30 ,$13.25 ,$117.00 ,$76.64 ,$13.25 ,$48.67 ,$9.42 ,$8.99 ,$13.91 ,$105.30 ,$29.81 ,$72.19 ,$32.76 ,$105.30 ,$13.25 ,$105.30 ,$105.30 ,$13.25 ,$76.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$264.00 ,$171.60 ,$8.99 ,$264.00 ,$45.13 ,$196.68 ,$172.92 ,$18.05 ,$73.92 ,$133.32 ,$18.05 ,$162.89 ,$18.05 ,$162.89 ,$162.89 ,$18.05 ,$162.89 ,$34.30 ,$237.60 ,$198.00 ,$45.13 ,$18.05 ,$232.32 ,$18.05 ,$198.00 ,$198.00 ,$224.40 ,$224.40 ,$18.05 ,$224.40 ,$18.05 ,$205.92 ,$205.92 ,$205.92 ,$237.60 ,$45.13 ,$237.60 ,$18.05 ,$264.00 ,$172.92 ,$18.05 ,$109.82 ,$9.42 ,$8.99 ,$18.95 ,$237.60 ,$40.61 ,$162.89 ,$73.92 ,$237.60 ,$18.05 ,$237.60 ,$237.60 ,$18.05 ,$171.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101095,80159,HC CLOZAPINE - 90,301,1 ,$99.00 ,$64.35 ,$8.99 ,$99.00 ,$50.38 ,$73.76 ,$64.85 ,$20.15 ,$27.72 ,$50.00 ,$20.15 ,$61.08 ,$20.15 ,$61.08 ,$61.08 ,$20.15 ,$61.08 ,$38.29 ,$89.10 ,$74.25 ,$50.38 ,$20.15 ,$87.12 ,$20.15 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$20.15 ,$84.15 ,$20.15 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$50.38 ,$89.10 ,$20.15 ,$99.00 ,$64.85 ,$20.15 ,$41.18 ,$9.42 ,$8.99 ,$21.16 ,$89.10 ,$45.34 ,$61.08 ,$27.72 ,$89.10 ,$20.15 ,$89.10 ,$89.10 ,$20.15 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101099,80168,HC ETHOSUXIMIDE - 90,301,1 ,$116.00 ,$75.40 ,$8.99 ,$116.00 ,$40.85 ,$86.42 ,$75.98 ,$16.34 ,$32.48 ,$58.58 ,$16.34 ,$71.57 ,$16.34 ,$71.57 ,$71.57 ,$16.34 ,$71.57 ,$31.05 ,$104.40 ,$87.00 ,$40.85 ,$16.34 ,$102.08 ,$16.34 ,$87.00 ,$87.00 ,$98.60 ,$98.60 ,$16.34 ,$98.60 ,$16.34 ,$90.48 ,$90.48 ,$90.48 ,$104.40 ,$40.85 ,$104.40 ,$16.34 ,$116.00 ,$75.98 ,$16.34 ,$48.26 ,$9.42 ,$8.99 ,$17.16 ,$104.40 ,$36.77 ,$71.57 ,$32.48 ,$104.40 ,$16.34 ,$104.40 ,$104.40 ,$16.34 ,$75.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101100,80169,HC EVEROLIMUS - 90,301,1 ,$140.00 ,$91.00 ,$8.99 ,$140.00 ,$34.33 ,$104.30 ,$91.70 ,$13.73 ,$39.20 ,$70.70 ,$13.73 ,$86.38 ,$13.73 ,$86.38 ,$86.38 ,$13.73 ,$86.38 ,$26.09 ,$126.00 ,$105.00 ,$34.33 ,$13.73 ,$123.20 ,$13.73 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$13.73 ,$119.00 ,$13.73 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$34.33 ,$126.00 ,$13.73 ,$140.00 ,$91.70 ,$13.73 ,$58.24 ,$9.42 ,$8.99 ,$14.42 ,$126.00 ,$30.89 ,$86.38 ,$39.20 ,$126.00 ,$13.73 ,$126.00 ,$126.00 ,$13.73 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101102,80171,HC GABAPENTIN PLASMA - 90,301,1 ,$94.00 ,$61.10 ,$8.99 ,$94.00 ,$54.18 ,$70.03 ,$61.57 ,$21.67 ,$26.32 ,$47.47 ,$21.67 ,$58.00 ,$21.67 ,$58.00 ,$58.00 ,$21.67 ,$58.00 ,$41.17 ,$84.60 ,$70.50 ,$54.18 ,$21.67 ,$82.72 ,$21.67 ,$70.50 ,$70.50 ,$79.90 ,$79.90 ,$21.67 ,$79.90 ,$21.67 ,$73.32 ,$73.32 ,$73.32 ,$84.60 ,$54.18 ,$84.60 ,$21.67 ,$94.00 ,$61.57 ,$21.67 ,$39.10 ,$9.42 ,$8.99 ,$22.75 ,$84.60 ,$48.76 ,$58.00 ,$26.32 ,$84.60 ,$21.67 ,$84.60 ,$84.60 ,$21.67 ,$61.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101103,80173,HC HALOPERIDOL - 90,301,1 ,$252.00 ,$163.80 ,$8.99 ,$252.00 ,$39.45 ,$187.74 ,$165.06 ,$15.78 ,$70.56 ,$127.26 ,$15.78 ,$155.48 ,$15.78 ,$155.48 ,$155.48 ,$15.78 ,$155.48 ,$29.98 ,$226.80 ,$189.00 ,$39.45 ,$15.78 ,$221.76 ,$15.78 ,$189.00 ,$189.00 ,$214.20 ,$214.20 ,$15.78 ,$214.20 ,$15.78 ,$196.56 ,$196.56 ,$196.56 ,$226.80 ,$39.45 ,$226.80 ,$15.78 ,$252.00 ,$165.06 ,$15.78 ,$104.83 ,$9.42 ,$8.99 ,$16.57 ,$226.80 ,$35.51 ,$155.48 ,$70.56 ,$226.80 ,$15.78 ,$226.80 ,$226.80 ,$15.78 ,$163.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101104,80175,HC LAMOTRIGINE - 90,301,1 ,$158.00 ,$102.70 ,$8.99 ,$158.00 ,$33.13 ,$117.71 ,$103.49 ,$13.25 ,$44.24 ,$79.79 ,$13.25 ,$97.49 ,$13.25 ,$97.49 ,$97.49 ,$13.25 ,$97.49 ,$25.18 ,$142.20 ,$118.50 ,$33.13 ,$13.25 ,$139.04 ,$13.25 ,$118.50 ,$118.50 ,$134.30 ,$134.30 ,$13.25 ,$134.30 ,$13.25 ,$123.24 ,$123.24 ,$123.24 ,$142.20 ,$33.13 ,$142.20 ,$13.25 ,$158.00 ,$103.49 ,$13.25 ,$65.73 ,$9.42 ,$8.99 ,$13.91 ,$142.20 ,$29.81 ,$97.49 ,$44.24 ,$142.20 ,$13.25 ,$142.20 ,$142.20 ,$13.25 ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101106,80177,HC LEVETIRACETAM - 90,301,1 ,$158.00 ,$102.70 ,$8.99 ,$158.00 ,$33.13 ,$117.71 ,$103.49 ,$13.25 ,$44.24 ,$79.79 ,$13.25 ,$97.49 ,$13.25 ,$97.49 ,$97.49 ,$13.25 ,$97.49 ,$25.18 ,$142.20 ,$118.50 ,$33.13 ,$13.25 ,$139.04 ,$13.25 ,$118.50 ,$118.50 ,$134.30 ,$134.30 ,$13.25 ,$134.30 ,$13.25 ,$123.24 ,$123.24 ,$123.24 ,$142.20 ,$33.13 ,$142.20 ,$13.25 ,$158.00 ,$103.49 ,$13.25 ,$65.73 ,$9.42 ,$8.99 ,$13.91 ,$142.20 ,$29.81 ,$97.49 ,$44.24 ,$142.20 ,$13.25 ,$142.20 ,$142.20 ,$13.25 ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$71.00 ,$46.15 ,$8.99 ,$71.00 ,$33.13 ,$52.90 ,$46.51 ,$13.25 ,$19.88 ,$35.86 ,$13.25 ,$43.81 ,$13.25 ,$43.81 ,$43.81 ,$13.25 ,$43.81 ,$25.18 ,$63.90 ,$53.25 ,$33.13 ,$13.25 ,$62.48 ,$13.25 ,$53.25 ,$53.25 ,$60.35 ,$60.35 ,$13.25 ,$60.35 ,$13.25 ,$55.38 ,$55.38 ,$55.38 ,$63.90 ,$33.13 ,$63.90 ,$13.25 ,$71.00 ,$46.51 ,$13.25 ,$29.54 ,$9.42 ,$8.99 ,$13.91 ,$63.90 ,$29.81 ,$43.81 ,$19.88 ,$63.90 ,$13.25 ,$63.90 ,$63.90 ,$13.25 ,$46.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$89.00 ,$57.85 ,$8.99 ,$89.00 ,$38.25 ,$66.31 ,$58.30 ,$15.30 ,$24.92 ,$44.95 ,$15.30 ,$54.91 ,$15.30 ,$54.91 ,$54.91 ,$15.30 ,$54.91 ,$29.07 ,$80.10 ,$66.75 ,$38.25 ,$15.30 ,$78.32 ,$15.30 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$15.30 ,$75.65 ,$15.30 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$38.25 ,$80.10 ,$15.30 ,$89.00 ,$58.30 ,$15.30 ,$37.02 ,$9.42 ,$8.99 ,$16.07 ,$80.10 ,$34.43 ,$54.91 ,$24.92 ,$80.10 ,$15.30 ,$80.10 ,$80.10 ,$15.30 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101113,80185,HC PHENYTOIN TOTAL - 90,301,1 ,$46.00 ,$29.90 ,$8.99 ,$46.00 ,$33.13 ,$34.27 ,$30.13 ,$13.25 ,$12.88 ,$23.23 ,$13.25 ,$28.38 ,$13.25 ,$28.38 ,$28.38 ,$13.25 ,$28.38 ,$25.18 ,$41.40 ,$34.50 ,$33.13 ,$13.25 ,$40.48 ,$13.25 ,$34.50 ,$34.50 ,$39.10 ,$39.10 ,$13.25 ,$39.10 ,$13.25 ,$35.88 ,$35.88 ,$35.88 ,$41.40 ,$33.13 ,$41.40 ,$13.25 ,$46.00 ,$30.13 ,$13.25 ,$19.14 ,$9.42 ,$8.99 ,$13.91 ,$41.40 ,$29.81 ,$28.38 ,$12.88 ,$41.40 ,$13.25 ,$41.40 ,$41.40 ,$13.25 ,$29.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101114,80186,HC PHENYTOIN FREE - 90,301,1 ,$47.00 ,$30.55 ,$8.99 ,$47.00 ,$34.40 ,$35.02 ,$30.79 ,$13.76 ,$13.16 ,$23.74 ,$13.76 ,$29.00 ,$13.76 ,$29.00 ,$29.00 ,$13.76 ,$29.00 ,$26.14 ,$42.30 ,$35.25 ,$34.40 ,$13.76 ,$41.36 ,$13.76 ,$35.25 ,$35.25 ,$39.95 ,$39.95 ,$13.76 ,$39.95 ,$13.76 ,$36.66 ,$36.66 ,$36.66 ,$42.30 ,$34.40 ,$42.30 ,$13.76 ,$47.00 ,$30.79 ,$13.76 ,$19.55 ,$9.42 ,$8.99 ,$14.45 ,$42.30 ,$30.96 ,$29.00 ,$13.16 ,$42.30 ,$13.76 ,$42.30 ,$42.30 ,$13.76 ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101115,80188,HC PRIMIDONE - 90,301,1 ,$117.00 ,$76.05 ,$8.99 ,$117.00 ,$41.48 ,$87.17 ,$76.64 ,$16.59 ,$32.76 ,$59.09 ,$16.59 ,$72.19 ,$16.59 ,$72.19 ,$72.19 ,$16.59 ,$72.19 ,$31.52 ,$105.30 ,$87.75 ,$41.48 ,$16.59 ,$102.96 ,$16.59 ,$87.75 ,$87.75 ,$99.45 ,$99.45 ,$16.59 ,$99.45 ,$16.59 ,$91.26 ,$91.26 ,$91.26 ,$105.30 ,$41.48 ,$105.30 ,$16.59 ,$117.00 ,$76.64 ,$16.59 ,$48.67 ,$9.42 ,$8.99 ,$17.42 ,$105.30 ,$37.33 ,$72.19 ,$32.76 ,$105.30 ,$16.59 ,$105.30 ,$105.30 ,$16.59 ,$76.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101116,80192,HC PROCAINEAMIDE - 90,301,1 ,$128.00 ,$83.20 ,$8.99 ,$128.00 ,$41.88 ,$95.36 ,$83.84 ,$16.75 ,$35.84 ,$64.64 ,$16.75 ,$78.98 ,$16.75 ,$78.98 ,$78.98 ,$16.75 ,$78.98 ,$31.83 ,$115.20 ,$96.00 ,$41.88 ,$16.75 ,$112.64 ,$16.75 ,$96.00 ,$96.00 ,$108.80 ,$108.80 ,$16.75 ,$108.80 ,$16.75 ,$99.84 ,$99.84 ,$99.84 ,$115.20 ,$41.88 ,$115.20 ,$16.75 ,$128.00 ,$83.84 ,$16.75 ,$53.25 ,$9.42 ,$8.99 ,$17.59 ,$115.20 ,$37.69 ,$78.98 ,$35.84 ,$115.20 ,$16.75 ,$115.20 ,$115.20 ,$16.75 ,$83.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101117,80194,HC QUINIDINE - 90,301,1 ,$104.00 ,$67.60 ,$8.99 ,$104.00 ,$36.50 ,$77.48 ,$68.12 ,$14.60 ,$29.12 ,$52.52 ,$14.60 ,$64.17 ,$14.60 ,$64.17 ,$64.17 ,$14.60 ,$64.17 ,$27.74 ,$93.60 ,$78.00 ,$36.50 ,$14.60 ,$91.52 ,$14.60 ,$78.00 ,$78.00 ,$88.40 ,$88.40 ,$14.60 ,$88.40 ,$14.60 ,$81.12 ,$81.12 ,$81.12 ,$93.60 ,$36.50 ,$93.60 ,$14.60 ,$104.00 ,$68.12 ,$14.60 ,$43.26 ,$9.42 ,$8.99 ,$15.33 ,$93.60 ,$32.85 ,$64.17 ,$29.12 ,$93.60 ,$14.60 ,$93.60 ,$93.60 ,$14.60 ,$67.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$160.00 ,$104.00 ,$8.99 ,$160.00 ,$34.33 ,$119.20 ,$104.80 ,$13.73 ,$44.80 ,$80.80 ,$13.73 ,$98.72 ,$13.73 ,$98.72 ,$98.72 ,$13.73 ,$98.72 ,$26.09 ,$144.00 ,$120.00 ,$34.33 ,$13.73 ,$140.80 ,$13.73 ,$120.00 ,$120.00 ,$136.00 ,$136.00 ,$13.73 ,$136.00 ,$13.73 ,$124.80 ,$124.80 ,$124.80 ,$144.00 ,$34.33 ,$144.00 ,$13.73 ,$160.00 ,$104.80 ,$13.73 ,$66.56 ,$9.42 ,$8.99 ,$14.42 ,$144.00 ,$30.89 ,$98.72 ,$44.80 ,$144.00 ,$13.73 ,$144.00 ,$144.00 ,$13.73 ,$104.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101119,80197,HC TACROLIMUS - 90,301,1 ,$153.00 ,$99.45 ,$8.99 ,$153.00 ,$34.33 ,$113.99 ,$100.22 ,$13.73 ,$42.84 ,$77.27 ,$13.73 ,$94.40 ,$13.73 ,$94.40 ,$94.40 ,$13.73 ,$94.40 ,$26.09 ,$137.70 ,$114.75 ,$34.33 ,$13.73 ,$134.64 ,$13.73 ,$114.75 ,$114.75 ,$130.05 ,$130.05 ,$13.73 ,$130.05 ,$13.73 ,$119.34 ,$119.34 ,$119.34 ,$137.70 ,$34.33 ,$137.70 ,$13.73 ,$153.00 ,$100.22 ,$13.73 ,$63.65 ,$9.42 ,$8.99 ,$14.42 ,$137.70 ,$30.89 ,$94.40 ,$42.84 ,$137.70 ,$13.73 ,$137.70 ,$137.70 ,$13.73 ,$99.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101124,80201,HC TOPIRAMATE - 90,301,1 ,$85.00 ,$55.25 ,$8.99 ,$85.00 ,$29.80 ,$63.33 ,$55.68 ,$11.92 ,$23.80 ,$42.93 ,$11.92 ,$52.45 ,$11.92 ,$52.45 ,$52.45 ,$11.92 ,$52.45 ,$22.65 ,$76.50 ,$63.75 ,$29.80 ,$11.92 ,$74.80 ,$11.92 ,$63.75 ,$63.75 ,$72.25 ,$72.25 ,$11.92 ,$72.25 ,$11.92 ,$66.30 ,$66.30 ,$66.30 ,$76.50 ,$29.80 ,$76.50 ,$11.92 ,$85.00 ,$55.68 ,$11.92 ,$35.36 ,$9.42 ,$8.99 ,$12.52 ,$76.50 ,$26.82 ,$52.45 ,$23.80 ,$76.50 ,$11.92 ,$76.50 ,$76.50 ,$11.92 ,$55.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101126,80203,HC ZONISAMIDE - 90,301,1 ,$119.00 ,$77.35 ,$8.99 ,$119.00 ,$33.13 ,$88.66 ,$77.95 ,$13.25 ,$33.32 ,$60.10 ,$13.25 ,$73.42 ,$13.25 ,$73.42 ,$73.42 ,$13.25 ,$73.42 ,$25.18 ,$107.10 ,$89.25 ,$33.13 ,$13.25 ,$104.72 ,$13.25 ,$89.25 ,$89.25 ,$101.15 ,$101.15 ,$13.25 ,$101.15 ,$13.25 ,$92.82 ,$92.82 ,$92.82 ,$107.10 ,$33.13 ,$107.10 ,$13.25 ,$119.00 ,$77.95 ,$13.25 ,$49.50 ,$9.42 ,$8.99 ,$13.91 ,$107.10 ,$29.81 ,$73.42 ,$33.32 ,$107.10 ,$13.25 ,$107.10 ,$107.10 ,$13.25 ,$77.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101130,80299,HC ITRACONAZOLE HPLC - 90,301,1 ,$107.00 ,$69.55 ,$8.99 ,$107.00 ,$46.60 ,$79.72 ,$70.09 ,$18.64 ,$29.96 ,$54.04 ,$18.64 ,$66.02 ,$18.64 ,$66.02 ,$66.02 ,$18.64 ,$66.02 ,$35.42 ,$96.30 ,$80.25 ,$46.60 ,$18.64 ,$94.16 ,$18.64 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$18.64 ,$90.95 ,$18.64 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$46.60 ,$96.30 ,$18.64 ,$107.00 ,$70.09 ,$18.64 ,$44.51 ,$9.42 ,$8.99 ,$19.57 ,$96.30 ,$41.94 ,$66.02 ,$29.96 ,$96.30 ,$18.64 ,$96.30 ,$96.30 ,$18.64 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$154.00 ,$100.10 ,$8.99 ,$154.00 ,$46.60 ,$114.73 ,$100.87 ,$18.64 ,$43.12 ,$77.77 ,$18.64 ,$95.02 ,$18.64 ,$95.02 ,$95.02 ,$18.64 ,$95.02 ,$35.42 ,$138.60 ,$115.50 ,$46.60 ,$18.64 ,$135.52 ,$18.64 ,$115.50 ,$115.50 ,$130.90 ,$130.90 ,$18.64 ,$130.90 ,$18.64 ,$120.12 ,$120.12 ,$120.12 ,$138.60 ,$46.60 ,$138.60 ,$18.64 ,$154.00 ,$100.87 ,$18.64 ,$64.06 ,$9.42 ,$8.99 ,$19.57 ,$138.60 ,$41.94 ,$95.02 ,$43.12 ,$138.60 ,$18.64 ,$138.60 ,$138.60 ,$18.64 ,$100.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101133,80306,HC DRUG SCREEN PRESUMPTIVE INSTRMNT ASSIST DIR OPTICAL T2,301,1 ,$87.00 ,$56.55 ,$7.83 ,$87.00 ,$42.85 ,$64.82 ,$56.99 ,$17.14 ,$24.36 ,$43.94 ,$17.14 ,$53.68 ,$17.14 ,$53.68 ,$53.68 ,$17.14 ,$53.68 ,$32.57 ,$78.30 ,$65.25 ,$42.85 ,$17.14 ,$76.56 ,$17.14 ,$65.25 ,$65.25 ,$73.95 ,$73.95 ,$17.14 ,$73.95 ,$17.14 ,$67.86 ,$67.86 ,$67.86 ,$78.30 ,$42.85 ,$78.30 ,$17.14 ,$87.00 ,$56.99 ,$17.14 ,$36.19 ,$8.21 ,$7.83 ,$18.00 ,$78.30 ,$38.57 ,$53.68 ,$24.36 ,$78.30 ,$17.14 ,$78.30 ,$78.30 ,$17.14 ,$56.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101135,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2,301,1 ,$325.00 ,$211.25 ,$21.08 ,$325.00 ,$155.35 ,$242.13 ,$212.88 ,$62.14 ,$91.00 ,$164.13 ,$62.14 ,$200.53 ,$62.14 ,$200.53 ,$200.53 ,$62.14 ,$200.53 ,$118.07 ,$292.50 ,$243.75 ,$155.35 ,$62.14 ,$286.00 ,$62.14 ,$243.75 ,$243.75 ,$276.25 ,$276.25 ,$62.14 ,$276.25 ,$62.14 ,$253.50 ,$253.50 ,$253.50 ,$292.50 ,$155.35 ,$292.50 ,$62.14 ,$325.00 ,$212.88 ,$62.14 ,$135.20 ,$22.09 ,$21.08 ,$65.25 ,$292.50 ,$139.82 ,$200.53 ,$91.00 ,$292.50 ,$62.14 ,$292.50 ,$292.50 ,$62.14 ,$211.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101137,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4,301,1 ,$325.00 ,$211.25 ,$21.08 ,$325.00 ,$155.35 ,$242.13 ,$212.88 ,$62.14 ,$91.00 ,$164.13 ,$62.14 ,$200.53 ,$62.14 ,$200.53 ,$200.53 ,$62.14 ,$200.53 ,$118.07 ,$292.50 ,$243.75 ,$155.35 ,$62.14 ,$286.00 ,$62.14 ,$243.75 ,$243.75 ,$276.25 ,$276.25 ,$62.14 ,$276.25 ,$62.14 ,$253.50 ,$253.50 ,$253.50 ,$292.50 ,$155.35 ,$292.50 ,$62.14 ,$325.00 ,$212.88 ,$62.14 ,$135.20 ,$22.09 ,$21.08 ,$65.25 ,$292.50 ,$139.82 ,$200.53 ,$91.00 ,$292.50 ,$62.14 ,$292.50 ,$292.50 ,$62.14 ,$211.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$325.00 ,$211.25 ,$21.08 ,$325.00 ,$155.35 ,$242.13 ,$212.88 ,$62.14 ,$91.00 ,$164.13 ,$62.14 ,$200.53 ,$62.14 ,$200.53 ,$200.53 ,$62.14 ,$200.53 ,$118.07 ,$292.50 ,$243.75 ,$155.35 ,$62.14 ,$286.00 ,$62.14 ,$243.75 ,$243.75 ,$276.25 ,$276.25 ,$62.14 ,$276.25 ,$62.14 ,$253.50 ,$253.50 ,$253.50 ,$292.50 ,$155.35 ,$292.50 ,$62.14 ,$325.00 ,$212.88 ,$62.14 ,$135.20 ,$22.09 ,$21.08 ,$65.25 ,$292.50 ,$139.82 ,$200.53 ,$91.00 ,$292.50 ,$62.14 ,$292.50 ,$292.50 ,$62.14 ,$211.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101141,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2-90,301,1 ,$50.00 ,$32.50 ,$14.00 ,$112.50 ,$50.00 ,$37.25 ,$32.75 ,$50.00 ,$14.00 ,$25.25 ,$50.00 ,$30.85 ,$50.00 ,$30.85 ,$30.85 ,$50.00 ,$30.85 ,$95.00 ,$45.00 ,$37.50 ,$50.00 ,$50.00 ,$44.00 ,$50.00 ,$37.50 ,$37.50 ,$42.50 ,$42.50 ,$50.00 ,$42.50 ,$50.00 ,$39.00 ,$39.00 ,$39.00 ,$45.00 ,$50.00 ,$45.00 ,$50.00 ,$50.00 ,$32.75 ,$50.00 ,$20.80 ,$22.09 ,$21.08 ,$50.00 ,$45.00 ,$112.50 ,$30.85 ,$14.00 ,$45.00 ,$50.00 ,$45.00 ,$45.00 ,$50.00 ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101142,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T3-90,301,1 ,$96.00 ,$62.40 ,$21.08 ,$139.82 ,$96.00 ,$71.52 ,$62.88 ,$62.14 ,$26.88 ,$48.48 ,$62.14 ,$59.23 ,$62.14 ,$59.23 ,$59.23 ,$62.14 ,$59.23 ,$118.07 ,$86.40 ,$72.00 ,$96.00 ,$62.14 ,$84.48 ,$62.14 ,$72.00 ,$72.00 ,$81.60 ,$81.60 ,$62.14 ,$81.60 ,$62.14 ,$74.88 ,$74.88 ,$74.88 ,$86.40 ,$96.00 ,$86.40 ,$62.14 ,$96.00 ,$62.88 ,$62.14 ,$39.94 ,$22.09 ,$21.08 ,$65.25 ,$86.40 ,$139.82 ,$59.23 ,$26.88 ,$86.40 ,$62.14 ,$86.40 ,$86.40 ,$62.14 ,$62.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101144,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T5-90,301,1 ,$460.00 ,$299.00 ,$21.08 ,$460.00 ,$155.35 ,$342.70 ,$301.30 ,$62.14 ,$128.80 ,$232.30 ,$62.14 ,$283.82 ,$62.14 ,$283.82 ,$283.82 ,$62.14 ,$283.82 ,$118.07 ,$414.00 ,$345.00 ,$155.35 ,$62.14 ,$404.80 ,$62.14 ,$345.00 ,$345.00 ,$391.00 ,$391.00 ,$62.14 ,$391.00 ,$62.14 ,$358.80 ,$358.80 ,$358.80 ,$414.00 ,$155.35 ,$414.00 ,$62.14 ,$460.00 ,$301.30 ,$62.14 ,$191.36 ,$22.09 ,$21.08 ,$65.25 ,$414.00 ,$139.82 ,$283.82 ,$128.80 ,$414.00 ,$62.14 ,$414.00 ,$414.00 ,$62.14 ,$299.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101145,80320,HC ALCOHOLS - 90,301,1 ,$15.64 ,$10.17 ,$4.38 ,$15.64 , N/A ,$11.65 ,$10.24 , N/A ,$4.38 ,$7.90 , N/A ,$9.65 , N/A ,$9.65 ,$9.65 , N/A ,$9.65 , N/A ,$14.08 ,$11.73 , N/A , N/A ,$13.76 , N/A ,$11.73 ,$11.73 ,$13.29 ,$13.29 , N/A ,$13.29 , N/A ,$12.20 ,$12.20 ,$12.20 ,$14.08 , N/A ,$14.08 , N/A ,$15.64 ,$10.24 , N/A ,$6.51 ,$8.21 ,$7.83 , N/A ,$14.08 , N/A ,$9.65 ,$4.38 ,$14.08 , N/A ,$14.08 ,$14.08 , N/A ,$10.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101146,80323,HC NICOTINE - 90,301,1 ,$84.00 ,$54.60 ,$21.08 ,$84.00 , N/A ,$62.58 ,$55.02 , N/A ,$23.52 ,$42.42 , N/A ,$51.83 , N/A ,$51.83 ,$51.83 , N/A ,$51.83 , N/A ,$75.60 ,$63.00 , N/A , N/A ,$73.92 , N/A ,$63.00 ,$63.00 ,$71.40 ,$71.40 , N/A ,$71.40 , N/A ,$65.52 ,$65.52 ,$65.52 ,$75.60 , N/A ,$75.60 , N/A ,$84.00 ,$55.02 , N/A ,$34.94 ,$22.09 ,$21.08 , N/A ,$75.60 , N/A ,$51.83 ,$23.52 ,$75.60 , N/A ,$75.60 ,$75.60 , N/A ,$54.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101150,80346,HC BENZODIAZEPINES 1-12  -90,301,1 ,$184.00 ,$119.60 ,$21.08 ,$184.00 , N/A ,$137.08 ,$120.52 , N/A ,$51.52 ,$92.92 , N/A ,$113.53 , N/A ,$113.53 ,$113.53 , N/A ,$113.53 , N/A ,$165.60 ,$138.00 , N/A , N/A ,$161.92 , N/A ,$138.00 ,$138.00 ,$156.40 ,$156.40 , N/A ,$156.40 , N/A ,$143.52 ,$143.52 ,$143.52 ,$165.60 , N/A ,$165.60 , N/A ,$184.00 ,$120.52 , N/A ,$76.54 ,$22.09 ,$21.08 , N/A ,$165.60 , N/A ,$113.53 ,$51.52 ,$165.60 , N/A ,$165.60 ,$165.60 , N/A ,$119.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101151,80349,HC CANNABINOIDS NATURAL -90,301,1 ,$184.00 ,$119.60 ,$7.83 ,$184.00 , N/A ,$137.08 ,$120.52 , N/A ,$51.52 ,$92.92 , N/A ,$113.53 , N/A ,$113.53 ,$113.53 , N/A ,$113.53 , N/A ,$165.60 ,$138.00 , N/A , N/A ,$161.92 , N/A ,$138.00 ,$138.00 ,$156.40 ,$156.40 , N/A ,$156.40 , N/A ,$143.52 ,$143.52 ,$143.52 ,$165.60 , N/A ,$165.60 , N/A ,$184.00 ,$120.52 , N/A ,$76.54 ,$8.21 ,$7.83 , N/A ,$165.60 , N/A ,$113.53 ,$51.52 ,$165.60 , N/A ,$165.60 ,$165.60 , N/A ,$119.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101152,80353,HC COCAINE QN -90,301,1 ,$229.00 ,$148.85 ,$7.83 ,$229.00 , N/A ,$170.61 ,$150.00 , N/A ,$64.12 ,$115.65 , N/A ,$141.29 , N/A ,$141.29 ,$141.29 , N/A ,$141.29 , N/A ,$206.10 ,$171.75 , N/A , N/A ,$201.52 , N/A ,$171.75 ,$171.75 ,$194.65 ,$194.65 , N/A ,$194.65 , N/A ,$178.62 ,$178.62 ,$178.62 ,$206.10 , N/A ,$206.10 , N/A ,$229.00 ,$150.00 , N/A ,$95.26 ,$8.21 ,$7.83 , N/A ,$206.10 , N/A ,$141.29 ,$64.12 ,$206.10 , N/A ,$206.10 ,$206.10 , N/A ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101153,80359,HC METHYLENEDIOXYAMPHETAMINES MDA MDEA MDMA -90,301,1 ,$458.00 ,$297.70 ,$7.83 ,$458.00 , N/A ,$341.21 ,$299.99 , N/A ,$128.24 ,$231.29 , N/A ,$282.59 , N/A ,$282.59 ,$282.59 , N/A ,$282.59 , N/A ,$412.20 ,$343.50 , N/A , N/A ,$403.04 , N/A ,$343.50 ,$343.50 ,$389.30 ,$389.30 , N/A ,$389.30 , N/A ,$357.24 ,$357.24 ,$357.24 ,$412.20 , N/A ,$412.20 , N/A ,$458.00 ,$299.99 , N/A ,$190.53 ,$8.21 ,$7.83 , N/A ,$412.20 , N/A ,$282.59 ,$128.24 ,$412.20 , N/A ,$412.20 ,$412.20 , N/A ,$297.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101154,80361,HC OPIATES 1 OR MORE -90,301,1 ,$367.00 ,$238.55 ,$21.08 ,$367.00 , N/A ,$273.42 ,$240.39 , N/A ,$102.76 ,$185.34 , N/A ,$226.44 , N/A ,$226.44 ,$226.44 , N/A ,$226.44 , N/A ,$330.30 ,$275.25 , N/A , N/A ,$322.96 , N/A ,$275.25 ,$275.25 ,$311.95 ,$311.95 , N/A ,$311.95 , N/A ,$286.26 ,$286.26 ,$286.26 ,$330.30 , N/A ,$330.30 , N/A ,$367.00 ,$240.39 , N/A ,$152.67 ,$22.09 ,$21.08 , N/A ,$330.30 , N/A ,$226.44 ,$102.76 ,$330.30 , N/A ,$330.30 ,$330.30 , N/A ,$238.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101157,82017,HC ACYLCARNITINES QN EA SPEC-90,301,1 ,$334.00 ,$217.10 ,$7.83 ,$334.00 ,$42.18 ,$248.83 ,$218.77 ,$16.87 ,$93.52 ,$168.67 ,$16.87 ,$206.08 ,$16.87 ,$206.08 ,$206.08 ,$16.87 ,$206.08 ,$32.05 ,$300.60 ,$250.50 ,$42.18 ,$16.87 ,$293.92 ,$16.87 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$16.87 ,$283.90 ,$16.87 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$42.18 ,$300.60 ,$16.87 ,$334.00 ,$218.77 ,$16.87 ,$138.94 ,$8.21 ,$7.83 ,$17.71 ,$300.60 ,$37.96 ,$206.08 ,$93.52 ,$300.60 ,$16.87 ,$300.60 ,$300.60 ,$16.87 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101158,82024,HC ACTH -90,301,1 ,$306.00 ,$198.90 ,$18.33 ,$306.00 ,$96.55 ,$227.97 ,$200.43 ,$38.62 ,$85.68 ,$154.53 ,$38.62 ,$188.80 ,$38.62 ,$188.80 ,$188.80 ,$38.62 ,$188.80 ,$73.38 ,$275.40 ,$229.50 ,$96.55 ,$38.62 ,$269.28 ,$38.62 ,$229.50 ,$229.50 ,$260.10 ,$260.10 ,$38.62 ,$260.10 ,$38.62 ,$238.68 ,$238.68 ,$238.68 ,$275.40 ,$96.55 ,$275.40 ,$38.62 ,$306.00 ,$200.43 ,$38.62 ,$127.30 ,$19.21 ,$18.33 ,$40.55 ,$275.40 ,$86.90 ,$188.80 ,$85.68 ,$275.40 ,$38.62 ,$275.40 ,$275.40 ,$38.62 ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101159,82040,HC ALBUMIN-90,301,1 ,$92.00 ,$59.80 ,$3.49 ,$92.00 ,$12.38 ,$68.54 ,$60.26 ,$4.95 ,$25.76 ,$46.46 ,$4.95 ,$56.76 ,$4.95 ,$56.76 ,$56.76 ,$4.95 ,$56.76 ,$9.41 ,$82.80 ,$69.00 ,$12.38 ,$4.95 ,$80.96 ,$4.95 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$4.95 ,$78.20 ,$4.95 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$12.38 ,$82.80 ,$4.95 ,$92.00 ,$60.26 ,$4.95 ,$38.27 ,$3.65 ,$3.49 ,$5.20 ,$82.80 ,$11.14 ,$56.76 ,$25.76 ,$82.80 ,$4.95 ,$82.80 ,$82.80 ,$4.95 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101160,82042,HC ALBUMIN OTHER SOURCE-90,301,1 ,$27.00 ,$17.55 ,$3.49 ,$27.00 ,$19.45 ,$20.12 ,$17.69 ,$7.78 ,$7.56 ,$13.64 ,$7.78 ,$16.66 ,$7.78 ,$16.66 ,$16.66 ,$7.78 ,$16.66 ,$14.78 ,$24.30 ,$20.25 ,$19.45 ,$7.78 ,$23.76 ,$7.78 ,$20.25 ,$20.25 ,$22.95 ,$22.95 ,$7.78 ,$22.95 ,$7.78 ,$21.06 ,$21.06 ,$21.06 ,$24.30 ,$19.45 ,$24.30 ,$7.78 ,$27.00 ,$17.69 ,$7.78 ,$11.23 ,$3.65 ,$3.49 ,$8.17 ,$24.30 ,$17.51 ,$16.66 ,$7.56 ,$24.30 ,$7.78 ,$24.30 ,$24.30 ,$7.78 ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101162,82085,HC ALDOLASE-90,301,1 ,$82.00 ,$53.30 ,$7.83 ,$82.00 ,$24.28 ,$61.09 ,$53.71 ,$9.71 ,$22.96 ,$41.41 ,$9.71 ,$50.59 ,$9.71 ,$50.59 ,$50.59 ,$9.71 ,$50.59 ,$18.45 ,$73.80 ,$61.50 ,$24.28 ,$9.71 ,$72.16 ,$9.71 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$9.71 ,$69.70 ,$9.71 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$24.28 ,$73.80 ,$9.71 ,$82.00 ,$53.71 ,$9.71 ,$34.11 ,$8.21 ,$7.83 ,$10.20 ,$73.80 ,$21.85 ,$50.59 ,$22.96 ,$73.80 ,$9.71 ,$73.80 ,$73.80 ,$9.71 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101163,82088,HC ALDOSTERONE-90,301,1 ,$292.00 ,$189.80 ,$18.33 ,$292.00 ,$101.88 ,$217.54 ,$191.26 ,$40.75 ,$81.76 ,$147.46 ,$40.75 ,$180.16 ,$40.75 ,$180.16 ,$180.16 ,$40.75 ,$180.16 ,$77.43 ,$262.80 ,$219.00 ,$101.88 ,$40.75 ,$256.96 ,$40.75 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$40.75 ,$248.20 ,$40.75 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$101.88 ,$262.80 ,$40.75 ,$292.00 ,$191.26 ,$40.75 ,$121.47 ,$19.21 ,$18.33 ,$42.79 ,$262.80 ,$91.69 ,$180.16 ,$81.76 ,$262.80 ,$40.75 ,$262.80 ,$262.80 ,$40.75 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$167.00 ,$108.55 ,$7.83 ,$167.00 ,$33.60 ,$124.42 ,$109.39 ,$13.44 ,$46.76 ,$84.34 ,$13.44 ,$103.04 ,$13.44 ,$103.04 ,$103.04 ,$13.44 ,$103.04 ,$25.54 ,$150.30 ,$125.25 ,$33.60 ,$13.44 ,$146.96 ,$13.44 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$13.44 ,$141.95 ,$13.44 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$33.60 ,$150.30 ,$13.44 ,$167.00 ,$109.39 ,$13.44 ,$69.47 ,$8.21 ,$7.83 ,$14.11 ,$150.30 ,$30.24 ,$103.04 ,$46.76 ,$150.30 ,$13.44 ,$150.30 ,$150.30 ,$13.44 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$102.00 ,$66.30 ,$7.83 ,$102.00 ,$36.15 ,$75.99 ,$66.81 ,$14.46 ,$28.56 ,$51.51 ,$14.46 ,$62.93 ,$14.46 ,$62.93 ,$62.93 ,$14.46 ,$62.93 ,$27.47 ,$91.80 ,$76.50 ,$36.15 ,$14.46 ,$89.76 ,$14.46 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$14.46 ,$86.70 ,$14.46 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$36.15 ,$91.80 ,$14.46 ,$102.00 ,$66.81 ,$14.46 ,$42.43 ,$8.21 ,$7.83 ,$15.18 ,$91.80 ,$32.54 ,$62.93 ,$28.56 ,$91.80 ,$14.46 ,$91.80 ,$91.80 ,$14.46 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$205.00 ,$133.25 ,$7.83 ,$205.00 ,$41.93 ,$152.73 ,$134.28 ,$16.77 ,$57.40 ,$103.53 ,$16.77 ,$126.49 ,$16.77 ,$126.49 ,$126.49 ,$16.77 ,$126.49 ,$31.86 ,$184.50 ,$153.75 ,$41.93 ,$16.77 ,$180.40 ,$16.77 ,$153.75 ,$153.75 ,$174.25 ,$174.25 ,$16.77 ,$174.25 ,$16.77 ,$159.90 ,$159.90 ,$159.90 ,$184.50 ,$41.93 ,$184.50 ,$16.77 ,$205.00 ,$134.28 ,$16.77 ,$85.28 ,$8.21 ,$7.83 ,$17.61 ,$184.50 ,$37.73 ,$126.49 ,$57.40 ,$184.50 ,$16.77 ,$184.50 ,$184.50 ,$16.77 ,$133.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101167,82105,HC ALPHA FETOPROTEIN SERUM SINGLE-90,301,1 ,$18.00 ,$11.70 ,$5.04 ,$37.73 ,$18.00 ,$13.41 ,$11.79 ,$16.77 ,$5.04 ,$9.09 ,$16.77 ,$11.11 ,$16.77 ,$11.11 ,$11.11 ,$16.77 ,$11.11 ,$31.86 ,$16.20 ,$13.50 ,$18.00 ,$16.77 ,$15.84 ,$16.77 ,$13.50 ,$13.50 ,$15.30 ,$15.30 ,$16.77 ,$15.30 ,$16.77 ,$14.04 ,$14.04 ,$14.04 ,$16.20 ,$18.00 ,$16.20 ,$16.77 ,$18.00 ,$11.79 ,$16.77 ,$7.49 ,$8.21 ,$7.83 ,$17.61 ,$16.20 ,$37.73 ,$11.11 ,$5.04 ,$16.20 ,$16.77 ,$16.20 ,$16.20 ,$16.77 ,$11.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101169,82108,HC ALUMINUM-90,301,1 ,$181.00 ,$117.65 ,$9.56 ,$181.00 ,$63.70 ,$134.85 ,$118.56 ,$25.48 ,$50.68 ,$91.41 ,$25.48 ,$111.68 ,$25.48 ,$111.68 ,$111.68 ,$25.48 ,$111.68 ,$48.41 ,$162.90 ,$135.75 ,$63.70 ,$25.48 ,$159.28 ,$25.48 ,$135.75 ,$135.75 ,$153.85 ,$153.85 ,$25.48 ,$153.85 ,$25.48 ,$141.18 ,$141.18 ,$141.18 ,$162.90 ,$63.70 ,$162.90 ,$25.48 ,$181.00 ,$118.56 ,$25.48 ,$75.30 ,$10.01 ,$9.56 ,$26.75 ,$162.90 ,$57.33 ,$111.68 ,$50.68 ,$162.90 ,$25.48 ,$162.90 ,$162.90 ,$25.48 ,$117.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$132.00 ,$85.80 ,$7.83 ,$132.00 ,$57.45 ,$98.34 ,$86.46 ,$22.98 ,$36.96 ,$66.66 ,$22.98 ,$81.44 ,$22.98 ,$81.44 ,$81.44 ,$22.98 ,$81.44 ,$43.66 ,$118.80 ,$99.00 ,$57.45 ,$22.98 ,$116.16 ,$22.98 ,$99.00 ,$99.00 ,$112.20 ,$112.20 ,$22.98 ,$112.20 ,$22.98 ,$102.96 ,$102.96 ,$102.96 ,$118.80 ,$57.45 ,$118.80 ,$22.98 ,$132.00 ,$86.46 ,$22.98 ,$54.91 ,$8.21 ,$7.83 ,$24.13 ,$118.80 ,$51.71 ,$81.44 ,$36.96 ,$118.80 ,$22.98 ,$118.80 ,$118.80 ,$22.98 ,$85.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$264.00 ,$171.60 ,$7.83 ,$264.00 ,$42.18 ,$196.68 ,$172.92 ,$16.87 ,$73.92 ,$133.32 ,$16.87 ,$162.89 ,$16.87 ,$162.89 ,$162.89 ,$16.87 ,$162.89 ,$32.05 ,$237.60 ,$198.00 ,$42.18 ,$16.87 ,$232.32 ,$16.87 ,$198.00 ,$198.00 ,$224.40 ,$224.40 ,$16.87 ,$224.40 ,$16.87 ,$205.92 ,$205.92 ,$205.92 ,$237.60 ,$42.18 ,$237.60 ,$16.87 ,$264.00 ,$172.92 ,$16.87 ,$109.82 ,$8.21 ,$7.83 ,$17.71 ,$237.60 ,$37.96 ,$162.89 ,$73.92 ,$237.60 ,$16.87 ,$237.60 ,$237.60 ,$16.87 ,$171.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101176,82140,HC AMMONIA-90,301,1 ,$22.36 ,$14.53 ,$6.26 ,$32.78 ,$22.36 ,$16.66 ,$14.65 ,$14.57 ,$6.26 ,$11.29 ,$14.57 ,$13.80 ,$14.57 ,$13.80 ,$13.80 ,$14.57 ,$13.80 ,$27.68 ,$20.12 ,$16.77 ,$22.36 ,$14.57 ,$19.68 ,$14.57 ,$16.77 ,$16.77 ,$19.01 ,$19.01 ,$14.57 ,$19.01 ,$14.57 ,$17.44 ,$17.44 ,$17.44 ,$20.12 ,$22.36 ,$20.12 ,$14.57 ,$22.36 ,$14.65 ,$14.57 ,$9.30 ,$8.21 ,$7.83 ,$15.30 ,$20.12 ,$32.78 ,$13.80 ,$6.26 ,$20.12 ,$14.57 ,$20.12 ,$20.12 ,$14.57 ,$14.53 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$208.00 ,$135.20 ,$18.33 ,$208.00 ,$73.20 ,$154.96 ,$136.24 ,$29.28 ,$58.24 ,$105.04 ,$29.28 ,$128.34 ,$29.28 ,$128.34 ,$128.34 ,$29.28 ,$128.34 ,$55.63 ,$187.20 ,$156.00 ,$73.20 ,$29.28 ,$183.04 ,$29.28 ,$156.00 ,$156.00 ,$176.80 ,$176.80 ,$29.28 ,$176.80 ,$29.28 ,$162.24 ,$162.24 ,$162.24 ,$187.20 ,$73.20 ,$187.20 ,$29.28 ,$208.00 ,$136.24 ,$29.28 ,$86.53 ,$19.21 ,$18.33 ,$30.74 ,$187.20 ,$65.88 ,$128.34 ,$58.24 ,$187.20 ,$29.28 ,$187.20 ,$187.20 ,$29.28 ,$135.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$152.00 ,$98.80 ,$7.83 ,$152.00 ,$36.50 ,$113.24 ,$99.56 ,$14.60 ,$42.56 ,$76.76 ,$14.60 ,$93.78 ,$14.60 ,$93.78 ,$93.78 ,$14.60 ,$93.78 ,$27.74 ,$136.80 ,$114.00 ,$36.50 ,$14.60 ,$133.76 ,$14.60 ,$114.00 ,$114.00 ,$129.20 ,$129.20 ,$14.60 ,$129.20 ,$14.60 ,$118.56 ,$118.56 ,$118.56 ,$136.80 ,$36.50 ,$136.80 ,$14.60 ,$152.00 ,$99.56 ,$14.60 ,$63.23 ,$8.21 ,$7.83 ,$15.33 ,$136.80 ,$32.85 ,$93.78 ,$42.56 ,$136.80 ,$14.60 ,$136.80 ,$136.80 ,$14.60 ,$98.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$12.08 ,$7.85 ,$3.38 ,$27.18 ,$12.08 ,$9.00 ,$7.91 ,$12.08 ,$3.38 ,$6.10 ,$12.08 ,$7.45 ,$12.08 ,$7.45 ,$7.45 ,$12.08 ,$7.45 ,$22.95 ,$10.87 ,$9.06 ,$12.08 ,$12.08 ,$10.63 ,$12.08 ,$9.06 ,$9.06 ,$10.27 ,$10.27 ,$12.08 ,$10.27 ,$12.08 ,$9.42 ,$9.42 ,$9.42 ,$10.87 ,$12.08 ,$10.87 ,$12.08 ,$12.08 ,$7.91 ,$12.08 ,$5.03 ,$8.21 ,$7.83 ,$12.08 ,$10.87 ,$27.18 ,$7.45 ,$3.38 ,$10.87 ,$12.08 ,$10.87 ,$10.87 ,$12.08 ,$7.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101181,82175,HC ARSENIC-90,301,1 ,$135.00 ,$87.75 ,$9.56 ,$135.00 ,$47.43 ,$100.58 ,$88.43 ,$18.97 ,$37.80 ,$68.18 ,$18.97 ,$83.30 ,$18.97 ,$83.30 ,$83.30 ,$18.97 ,$83.30 ,$36.04 ,$121.50 ,$101.25 ,$47.43 ,$18.97 ,$118.80 ,$18.97 ,$101.25 ,$101.25 ,$114.75 ,$114.75 ,$18.97 ,$114.75 ,$18.97 ,$105.30 ,$105.30 ,$105.30 ,$121.50 ,$47.43 ,$121.50 ,$18.97 ,$135.00 ,$88.43 ,$18.97 ,$56.16 ,$10.01 ,$9.56 ,$19.92 ,$121.50 ,$42.68 ,$83.30 ,$37.80 ,$121.50 ,$18.97 ,$121.50 ,$121.50 ,$18.97 ,$87.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101182,82180,HC VITAMIN C (ASCORBIC ACID)-90,301,1 ,$70.00 ,$45.50 ,$7.83 ,$70.00 ,$24.73 ,$52.15 ,$45.85 ,$9.89 ,$19.60 ,$35.35 ,$9.89 ,$43.19 ,$9.89 ,$43.19 ,$43.19 ,$9.89 ,$43.19 ,$18.79 ,$63.00 ,$52.50 ,$24.73 ,$9.89 ,$61.60 ,$9.89 ,$52.50 ,$52.50 ,$59.50 ,$59.50 ,$9.89 ,$59.50 ,$9.89 ,$54.60 ,$54.60 ,$54.60 ,$63.00 ,$24.73 ,$63.00 ,$9.89 ,$70.00 ,$45.85 ,$9.89 ,$29.12 ,$8.21 ,$7.83 ,$10.38 ,$63.00 ,$22.25 ,$43.19 ,$19.60 ,$63.00 ,$9.89 ,$63.00 ,$63.00 ,$9.89 ,$45.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$115.00 ,$74.75 ,$16.18 ,$115.00 ,$40.45 ,$85.68 ,$75.33 ,$16.18 ,$32.20 ,$58.08 ,$16.18 ,$70.96 ,$16.18 ,$70.96 ,$70.96 ,$16.18 ,$70.96 ,$30.74 ,$103.50 ,$86.25 ,$40.45 ,$16.18 ,$101.20 ,$16.18 ,$86.25 ,$86.25 ,$97.75 ,$97.75 ,$16.18 ,$97.75 ,$16.18 ,$89.70 ,$89.70 ,$89.70 ,$103.50 ,$40.45 ,$103.50 ,$16.18 ,$115.00 ,$75.33 ,$16.18 ,$47.84 ,$19.21 ,$18.33 ,$16.99 ,$103.50 ,$36.41 ,$70.96 ,$32.20 ,$103.50 ,$16.18 ,$103.50 ,$103.50 ,$16.18 ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101185,82239,HC BILE ACID TOTAL-90,301,1 ,$34.00 ,$22.10 ,$7.83 ,$38.52 ,$34.00 ,$25.33 ,$22.27 ,$17.12 ,$9.52 ,$17.17 ,$17.12 ,$20.98 ,$17.12 ,$20.98 ,$20.98 ,$17.12 ,$20.98 ,$32.53 ,$30.60 ,$25.50 ,$34.00 ,$17.12 ,$29.92 ,$17.12 ,$25.50 ,$25.50 ,$28.90 ,$28.90 ,$17.12 ,$28.90 ,$17.12 ,$26.52 ,$26.52 ,$26.52 ,$30.60 ,$34.00 ,$30.60 ,$17.12 ,$34.00 ,$22.27 ,$17.12 ,$14.14 ,$8.21 ,$7.83 ,$17.98 ,$30.60 ,$38.52 ,$20.98 ,$9.52 ,$30.60 ,$17.12 ,$30.60 ,$30.60 ,$17.12 ,$22.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101191,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$60.00 ,$39.00 ,$3.49 ,$60.00 ,$13.30 ,$44.70 ,$39.30 ,$5.32 ,$16.80 ,$30.30 ,$5.32 ,$37.02 ,$5.32 ,$37.02 ,$37.02 ,$5.32 ,$37.02 ,$10.11 ,$54.00 ,$45.00 ,$13.30 ,$5.32 ,$52.80 ,$5.32 ,$45.00 ,$45.00 ,$51.00 ,$51.00 ,$5.32 ,$51.00 ,$5.32 ,$46.80 ,$46.80 ,$46.80 ,$54.00 ,$13.30 ,$54.00 ,$5.32 ,$60.00 ,$39.30 ,$5.32 ,$24.96 ,$3.65 ,$3.49 ,$5.59 ,$54.00 ,$11.97 ,$37.02 ,$16.80 ,$54.00 ,$5.32 ,$54.00 ,$54.00 ,$5.32 ,$39.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101196,82300,HC CADMIUM-90,301,1 ,$67.00 ,$43.55 ,$9.56 ,$67.00 ,$59.10 ,$49.92 ,$43.89 ,$23.64 ,$18.76 ,$33.84 ,$23.64 ,$41.34 ,$23.64 ,$41.34 ,$41.34 ,$23.64 ,$41.34 ,$44.92 ,$60.30 ,$50.25 ,$59.10 ,$23.64 ,$58.96 ,$23.64 ,$50.25 ,$50.25 ,$56.95 ,$56.95 ,$23.64 ,$56.95 ,$23.64 ,$52.26 ,$52.26 ,$52.26 ,$60.30 ,$59.10 ,$60.30 ,$23.64 ,$67.00 ,$43.89 ,$23.64 ,$27.87 ,$10.01 ,$9.56 ,$24.82 ,$60.30 ,$53.19 ,$41.34 ,$18.76 ,$60.30 ,$23.64 ,$60.30 ,$60.30 ,$23.64 ,$43.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101197,82306,HC VITAMIN D 25 OH-90,301,1 ,$21.00 ,$13.65 ,$5.88 ,$47.25 ,$21.00 ,$15.65 ,$13.76 ,$21.00 ,$5.88 ,$10.61 ,$21.00 ,$12.96 ,$21.00 ,$12.96 ,$12.96 ,$21.00 ,$12.96 ,$39.90 ,$18.90 ,$15.75 ,$21.00 ,$21.00 ,$18.48 ,$21.00 ,$15.75 ,$15.75 ,$17.85 ,$17.85 ,$21.00 ,$17.85 ,$21.00 ,$16.38 ,$16.38 ,$16.38 ,$18.90 ,$21.00 ,$18.90 ,$21.00 ,$21.00 ,$13.76 ,$21.00 ,$8.74 ,$21.00 ,$21.00 ,$21.00 ,$18.90 ,$47.25 ,$12.96 ,$5.88 ,$18.90 ,$21.00 ,$18.90 ,$18.90 ,$21.00 ,$13.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101199,82308,HC CALCITONIN-90,301,1 ,$153.00 ,$99.45 ,$18.33 ,$153.00 ,$66.98 ,$113.99 ,$100.22 ,$26.79 ,$42.84 ,$77.27 ,$26.79 ,$94.40 ,$26.79 ,$94.40 ,$94.40 ,$26.79 ,$94.40 ,$50.90 ,$137.70 ,$114.75 ,$66.98 ,$26.79 ,$134.64 ,$26.79 ,$114.75 ,$114.75 ,$130.05 ,$130.05 ,$26.79 ,$130.05 ,$26.79 ,$119.34 ,$119.34 ,$119.34 ,$137.70 ,$66.98 ,$137.70 ,$26.79 ,$153.00 ,$100.22 ,$26.79 ,$63.65 ,$19.21 ,$18.33 ,$28.13 ,$137.70 ,$60.28 ,$94.40 ,$42.84 ,$137.70 ,$26.79 ,$137.70 ,$137.70 ,$26.79 ,$99.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101200,82310,HC CALCIUM-90,301,1 ,$334.00 ,$217.10 ,$3.49 ,$334.00 ,$12.90 ,$248.83 ,$218.77 ,$5.16 ,$93.52 ,$168.67 ,$5.16 ,$206.08 ,$5.16 ,$206.08 ,$206.08 ,$5.16 ,$206.08 ,$9.80 ,$300.60 ,$250.50 ,$12.90 ,$5.16 ,$293.92 ,$5.16 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$5.16 ,$283.90 ,$5.16 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$12.90 ,$300.60 ,$5.16 ,$334.00 ,$218.77 ,$5.16 ,$138.94 ,$3.65 ,$3.49 ,$5.42 ,$300.60 ,$11.61 ,$206.08 ,$93.52 ,$300.60 ,$5.16 ,$300.60 ,$300.60 ,$5.16 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$162.00 ,$105.30 ,$7.83 ,$162.00 ,$32.25 ,$120.69 ,$106.11 ,$12.90 ,$45.36 ,$81.81 ,$12.90 ,$99.95 ,$12.90 ,$99.95 ,$99.95 ,$12.90 ,$99.95 ,$24.51 ,$145.80 ,$121.50 ,$32.25 ,$12.90 ,$142.56 ,$12.90 ,$121.50 ,$121.50 ,$137.70 ,$137.70 ,$12.90 ,$137.70 ,$12.90 ,$126.36 ,$126.36 ,$126.36 ,$145.80 ,$32.25 ,$145.80 ,$12.90 ,$162.00 ,$106.11 ,$12.90 ,$67.39 ,$8.21 ,$7.83 ,$13.55 ,$145.80 ,$29.03 ,$99.95 ,$45.36 ,$145.80 ,$12.90 ,$145.80 ,$145.80 ,$12.90 ,$105.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$344.00 ,$223.60 ,$7.83 ,$344.00 ,$42.18 ,$256.28 ,$225.32 ,$16.87 ,$96.32 ,$173.72 ,$16.87 ,$212.25 ,$16.87 ,$212.25 ,$212.25 ,$16.87 ,$212.25 ,$32.05 ,$309.60 ,$258.00 ,$42.18 ,$16.87 ,$302.72 ,$16.87 ,$258.00 ,$258.00 ,$292.40 ,$292.40 ,$16.87 ,$292.40 ,$16.87 ,$268.32 ,$268.32 ,$268.32 ,$309.60 ,$42.18 ,$309.60 ,$16.87 ,$344.00 ,$225.32 ,$16.87 ,$143.10 ,$8.21 ,$7.83 ,$17.71 ,$309.60 ,$37.96 ,$212.25 ,$96.32 ,$309.60 ,$16.87 ,$309.60 ,$309.60 ,$16.87 ,$223.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101210,82380,HC CAROTENE-90,301,1 ,$66.00 ,$42.90 ,$7.83 ,$66.00 ,$23.05 ,$49.17 ,$43.23 ,$9.22 ,$18.48 ,$33.33 ,$9.22 ,$40.72 ,$9.22 ,$40.72 ,$40.72 ,$9.22 ,$40.72 ,$17.52 ,$59.40 ,$49.50 ,$23.05 ,$9.22 ,$58.08 ,$9.22 ,$49.50 ,$49.50 ,$56.10 ,$56.10 ,$9.22 ,$56.10 ,$9.22 ,$51.48 ,$51.48 ,$51.48 ,$59.40 ,$23.05 ,$59.40 ,$9.22 ,$66.00 ,$43.23 ,$9.22 ,$27.46 ,$8.21 ,$7.83 ,$9.68 ,$59.40 ,$20.75 ,$40.72 ,$18.48 ,$59.40 ,$9.22 ,$59.40 ,$59.40 ,$9.22 ,$42.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$267.00 ,$173.55 ,$18.33 ,$267.00 ,$63.13 ,$198.92 ,$174.89 ,$25.25 ,$74.76 ,$134.84 ,$25.25 ,$164.74 ,$25.25 ,$164.74 ,$164.74 ,$25.25 ,$164.74 ,$47.98 ,$240.30 ,$200.25 ,$63.13 ,$25.25 ,$234.96 ,$25.25 ,$200.25 ,$200.25 ,$226.95 ,$226.95 ,$25.25 ,$226.95 ,$25.25 ,$208.26 ,$208.26 ,$208.26 ,$240.30 ,$63.13 ,$240.30 ,$25.25 ,$267.00 ,$174.89 ,$25.25 ,$111.07 ,$19.21 ,$18.33 ,$26.51 ,$240.30 ,$56.81 ,$164.74 ,$74.76 ,$240.30 ,$25.25 ,$240.30 ,$240.30 ,$25.25 ,$173.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101212,82390,HC CERULOPLASMIN-90,301,1 ,$138.00 ,$89.70 ,$7.83 ,$138.00 ,$26.85 ,$102.81 ,$90.39 ,$10.74 ,$38.64 ,$69.69 ,$10.74 ,$85.15 ,$10.74 ,$85.15 ,$85.15 ,$10.74 ,$85.15 ,$20.41 ,$124.20 ,$103.50 ,$26.85 ,$10.74 ,$121.44 ,$10.74 ,$103.50 ,$103.50 ,$117.30 ,$117.30 ,$10.74 ,$117.30 ,$10.74 ,$107.64 ,$107.64 ,$107.64 ,$124.20 ,$26.85 ,$124.20 ,$10.74 ,$138.00 ,$90.39 ,$10.74 ,$57.41 ,$8.21 ,$7.83 ,$11.28 ,$124.20 ,$24.17 ,$85.15 ,$38.64 ,$124.20 ,$10.74 ,$124.20 ,$124.20 ,$10.74 ,$89.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101213,82397,HC CHEMILUMINESCENT ASSAY-90,301,1 ,$55.00 ,$35.75 ,$7.83 ,$55.00 ,$35.30 ,$40.98 ,$36.03 ,$14.12 ,$15.40 ,$27.78 ,$14.12 ,$33.94 ,$14.12 ,$33.94 ,$33.94 ,$14.12 ,$33.94 ,$26.83 ,$49.50 ,$41.25 ,$35.30 ,$14.12 ,$48.40 ,$14.12 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$14.12 ,$46.75 ,$14.12 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$35.30 ,$49.50 ,$14.12 ,$55.00 ,$36.03 ,$14.12 ,$22.88 ,$8.21 ,$7.83 ,$14.83 ,$49.50 ,$31.77 ,$33.94 ,$15.40 ,$49.50 ,$14.12 ,$49.50 ,$49.50 ,$14.12 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101215,82438,HC CHLORIDE OTHER SOURCE-90,301,1 ,$38.00 ,$24.70 ,$3.49 ,$38.00 ,$12.50 ,$28.31 ,$24.89 ,$5.00 ,$10.64 ,$19.19 ,$5.00 ,$23.45 ,$5.00 ,$23.45 ,$23.45 ,$5.00 ,$23.45 ,$9.50 ,$34.20 ,$28.50 ,$12.50 ,$5.00 ,$33.44 ,$5.00 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$5.00 ,$32.30 ,$5.00 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$12.50 ,$34.20 ,$5.00 ,$38.00 ,$24.89 ,$5.00 ,$15.81 ,$3.65 ,$3.49 ,$5.25 ,$34.20 ,$11.25 ,$23.45 ,$10.64 ,$34.20 ,$5.00 ,$34.20 ,$34.20 ,$5.00 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$145.00 ,$94.25 ,$9.56 ,$145.00 ,$50.70 ,$108.03 ,$94.98 ,$20.28 ,$40.60 ,$73.23 ,$20.28 ,$89.47 ,$20.28 ,$89.47 ,$89.47 ,$20.28 ,$89.47 ,$38.53 ,$130.50 ,$108.75 ,$50.70 ,$20.28 ,$127.60 ,$20.28 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$20.28 ,$123.25 ,$20.28 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$50.70 ,$130.50 ,$20.28 ,$145.00 ,$94.98 ,$20.28 ,$60.32 ,$10.01 ,$9.56 ,$21.29 ,$130.50 ,$45.63 ,$89.47 ,$40.60 ,$130.50 ,$20.28 ,$130.50 ,$130.50 ,$20.28 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101219,82507,HC CITRATE-90,301,1 ,$23.00 ,$14.95 ,$6.44 ,$51.75 ,$23.00 ,$17.14 ,$15.07 ,$23.00 ,$6.44 ,$11.62 ,$23.00 ,$14.19 ,$23.00 ,$14.19 ,$14.19 ,$23.00 ,$14.19 ,$43.70 ,$20.70 ,$17.25 ,$23.00 ,$23.00 ,$20.24 ,$23.00 ,$17.25 ,$17.25 ,$19.55 ,$19.55 ,$23.00 ,$19.55 ,$23.00 ,$17.94 ,$17.94 ,$17.94 ,$20.70 ,$23.00 ,$20.70 ,$23.00 ,$23.00 ,$15.07 ,$23.00 ,$9.57 ,$8.21 ,$7.83 ,$23.00 ,$20.70 ,$51.75 ,$14.19 ,$6.44 ,$20.70 ,$23.00 ,$20.70 ,$20.70 ,$23.00 ,$14.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$132.00 ,$85.80 ,$12.09 ,$132.00 ,$46.70 ,$98.34 ,$86.46 ,$18.68 ,$36.96 ,$66.66 ,$18.68 ,$81.44 ,$18.68 ,$81.44 ,$81.44 ,$18.68 ,$81.44 ,$35.49 ,$118.80 ,$99.00 ,$46.70 ,$18.68 ,$116.16 ,$18.68 ,$99.00 ,$99.00 ,$112.20 ,$112.20 ,$18.68 ,$112.20 ,$18.68 ,$102.96 ,$102.96 ,$102.96 ,$118.80 ,$46.70 ,$118.80 ,$18.68 ,$132.00 ,$86.46 ,$18.68 ,$54.91 ,$12.66 ,$12.09 ,$19.61 ,$118.80 ,$42.03 ,$81.44 ,$36.96 ,$118.80 ,$18.68 ,$118.80 ,$118.80 ,$18.68 ,$85.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101221,82525,HC COPPER-90,301,1 ,$124.00 ,$80.60 ,$9.56 ,$124.00 ,$31.03 ,$92.38 ,$81.22 ,$12.41 ,$34.72 ,$62.62 ,$12.41 ,$76.51 ,$12.41 ,$76.51 ,$76.51 ,$12.41 ,$76.51 ,$23.58 ,$111.60 ,$93.00 ,$31.03 ,$12.41 ,$109.12 ,$12.41 ,$93.00 ,$93.00 ,$105.40 ,$105.40 ,$12.41 ,$105.40 ,$12.41 ,$96.72 ,$96.72 ,$96.72 ,$111.60 ,$31.03 ,$111.60 ,$12.41 ,$124.00 ,$81.22 ,$12.41 ,$51.58 ,$10.01 ,$9.56 ,$13.03 ,$111.60 ,$27.92 ,$76.51 ,$34.72 ,$111.60 ,$12.41 ,$111.60 ,$111.60 ,$12.41 ,$80.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101222,82530,HC CORTISOL FREE-90,301,1 ,$118.00 ,$76.70 ,$7.83 ,$118.00 ,$41.78 ,$87.91 ,$77.29 ,$16.71 ,$33.04 ,$59.59 ,$16.71 ,$72.81 ,$16.71 ,$72.81 ,$72.81 ,$16.71 ,$72.81 ,$31.75 ,$106.20 ,$88.50 ,$41.78 ,$16.71 ,$103.84 ,$16.71 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$16.71 ,$100.30 ,$16.71 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$41.78 ,$106.20 ,$16.71 ,$118.00 ,$77.29 ,$16.71 ,$49.09 ,$8.21 ,$7.83 ,$17.55 ,$106.20 ,$37.60 ,$72.81 ,$33.04 ,$106.20 ,$16.71 ,$106.20 ,$106.20 ,$16.71 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101223,82533,HC CORTISOL TOTAL-90,301,1 ,$21.00 ,$13.65 ,$5.88 ,$36.68 ,$21.00 ,$15.65 ,$13.76 ,$16.30 ,$5.88 ,$10.61 ,$16.30 ,$12.96 ,$16.30 ,$12.96 ,$12.96 ,$16.30 ,$12.96 ,$30.97 ,$18.90 ,$15.75 ,$21.00 ,$16.30 ,$18.48 ,$16.30 ,$15.75 ,$15.75 ,$17.85 ,$17.85 ,$16.30 ,$17.85 ,$16.30 ,$16.38 ,$16.38 ,$16.38 ,$18.90 ,$21.00 ,$18.90 ,$16.30 ,$21.00 ,$13.76 ,$16.30 ,$8.74 ,$19.21 ,$18.33 ,$17.12 ,$18.90 ,$36.68 ,$12.96 ,$5.88 ,$18.90 ,$16.30 ,$18.90 ,$18.90 ,$16.30 ,$13.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$145.00 ,$94.25 ,$7.83 ,$145.00 ,$60.23 ,$108.03 ,$94.98 ,$24.09 ,$40.60 ,$73.23 ,$24.09 ,$89.47 ,$24.09 ,$89.47 ,$89.47 ,$24.09 ,$89.47 ,$45.77 ,$130.50 ,$108.75 ,$60.23 ,$24.09 ,$127.60 ,$24.09 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$24.09 ,$123.25 ,$24.09 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$60.23 ,$130.50 ,$24.09 ,$145.00 ,$94.98 ,$24.09 ,$60.32 ,$8.21 ,$7.83 ,$25.29 ,$130.50 ,$54.20 ,$89.47 ,$40.60 ,$130.50 ,$24.09 ,$130.50 ,$130.50 ,$24.09 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101225,82550,HC CREATINE KINASE (CPK) TOTAL-90,301,1 ,$46.00 ,$29.90 ,$3.49 ,$46.00 ,$16.28 ,$34.27 ,$30.13 ,$6.51 ,$12.88 ,$23.23 ,$6.51 ,$28.38 ,$6.51 ,$28.38 ,$28.38 ,$6.51 ,$28.38 ,$12.37 ,$41.40 ,$34.50 ,$16.28 ,$6.51 ,$40.48 ,$6.51 ,$34.50 ,$34.50 ,$39.10 ,$39.10 ,$6.51 ,$39.10 ,$6.51 ,$35.88 ,$35.88 ,$35.88 ,$41.40 ,$16.28 ,$41.40 ,$6.51 ,$46.00 ,$30.13 ,$6.51 ,$19.14 ,$3.65 ,$3.49 ,$6.84 ,$41.40 ,$14.65 ,$28.38 ,$12.88 ,$41.40 ,$6.51 ,$41.40 ,$41.40 ,$6.51 ,$29.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$95.00 ,$61.75 ,$7.83 ,$95.00 ,$33.48 ,$70.78 ,$62.23 ,$13.39 ,$26.60 ,$47.98 ,$13.39 ,$58.62 ,$13.39 ,$58.62 ,$58.62 ,$13.39 ,$58.62 ,$25.44 ,$85.50 ,$71.25 ,$33.48 ,$13.39 ,$83.60 ,$13.39 ,$71.25 ,$71.25 ,$80.75 ,$80.75 ,$13.39 ,$80.75 ,$13.39 ,$74.10 ,$74.10 ,$74.10 ,$85.50 ,$33.48 ,$85.50 ,$13.39 ,$95.00 ,$62.23 ,$13.39 ,$39.52 ,$8.21 ,$7.83 ,$14.06 ,$85.50 ,$30.13 ,$58.62 ,$26.60 ,$85.50 ,$13.39 ,$85.50 ,$85.50 ,$13.39 ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101227,82565,HC CREATININE-QW,301,1 ,$63.00 ,$40.95 ,$3.49 ,$63.00 ,$12.80 ,$46.94 ,$41.27 ,$5.12 ,$17.64 ,$31.82 ,$5.12 ,$38.87 ,$5.12 ,$38.87 ,$38.87 ,$5.12 ,$38.87 ,$9.73 ,$56.70 ,$47.25 ,$12.80 ,$5.12 ,$55.44 ,$5.12 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$5.12 ,$53.55 ,$5.12 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$12.80 ,$56.70 ,$5.12 ,$5.12 ,$41.27 ,$5.12 ,$26.21 ,$3.65 ,$3.49 ,$5.38 ,$56.70 ,$11.52 ,$38.87 ,$17.64 ,$56.70 ,$5.12 ,$56.70 ,$56.70 ,$5.12 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$130.00 ,$84.50 ,$3.49 ,$130.00 ,$12.95 ,$96.85 ,$85.15 ,$5.18 ,$36.40 ,$65.65 ,$5.18 ,$80.21 ,$5.18 ,$80.21 ,$80.21 ,$5.18 ,$80.21 ,$9.84 ,$117.00 ,$97.50 ,$12.95 ,$5.18 ,$114.40 ,$5.18 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$5.18 ,$110.50 ,$5.18 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$12.95 ,$117.00 ,$5.18 ,$130.00 ,$85.15 ,$5.18 ,$54.08 ,$3.65 ,$3.49 ,$5.44 ,$117.00 ,$11.66 ,$80.21 ,$36.40 ,$117.00 ,$5.18 ,$117.00 ,$117.00 ,$5.18 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$46.00 ,$29.90 ,$6.47 ,$46.00 ,$16.18 ,$34.27 ,$30.13 ,$6.47 ,$12.88 ,$23.23 ,$6.47 ,$28.38 ,$6.47 ,$28.38 ,$28.38 ,$6.47 ,$28.38 ,$12.29 ,$41.40 ,$34.50 ,$16.18 ,$6.47 ,$40.48 ,$6.47 ,$34.50 ,$34.50 ,$39.10 ,$39.10 ,$6.47 ,$39.10 ,$6.47 ,$35.88 ,$35.88 ,$35.88 ,$41.40 ,$16.18 ,$41.40 ,$6.47 ,$46.00 ,$30.13 ,$6.47 ,$19.14 ,$8.21 ,$7.83 ,$6.79 ,$41.40 ,$14.56 ,$28.38 ,$12.88 ,$41.40 ,$6.47 ,$41.40 ,$41.40 ,$6.47 ,$29.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101236,82608,HC VITAMIN B-12 BINDING CAPACITY-90,301,1 ,$20.00 ,$13.00 ,$5.60 ,$32.22 ,$20.00 ,$14.90 ,$13.10 ,$14.32 ,$5.60 ,$10.10 ,$14.32 ,$12.34 ,$14.32 ,$12.34 ,$12.34 ,$14.32 ,$12.34 ,$27.21 ,$18.00 ,$15.00 ,$20.00 ,$14.32 ,$17.60 ,$14.32 ,$15.00 ,$15.00 ,$17.00 ,$17.00 ,$14.32 ,$17.00 ,$14.32 ,$15.60 ,$15.60 ,$15.60 ,$18.00 ,$20.00 ,$18.00 ,$14.32 ,$20.00 ,$13.10 ,$14.32 ,$8.32 ,$8.21 ,$7.83 ,$15.04 ,$18.00 ,$32.22 ,$12.34 ,$5.60 ,$18.00 ,$14.32 ,$18.00 ,$18.00 ,$14.32 ,$13.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101238,82627,HC DHEA SULFATE-90,301,1 ,$109.00 ,$70.85 ,$18.33 ,$109.00 ,$55.58 ,$81.21 ,$71.40 ,$22.23 ,$30.52 ,$55.05 ,$22.23 ,$67.25 ,$22.23 ,$67.25 ,$67.25 ,$22.23 ,$67.25 ,$42.24 ,$98.10 ,$81.75 ,$55.58 ,$22.23 ,$95.92 ,$22.23 ,$81.75 ,$81.75 ,$92.65 ,$92.65 ,$22.23 ,$92.65 ,$22.23 ,$85.02 ,$85.02 ,$85.02 ,$98.10 ,$55.58 ,$98.10 ,$22.23 ,$109.00 ,$71.40 ,$22.23 ,$45.34 ,$19.21 ,$18.33 ,$23.34 ,$98.10 ,$50.02 ,$67.25 ,$30.52 ,$98.10 ,$22.23 ,$98.10 ,$98.10 ,$22.23 ,$70.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101239,82634,HC DEOXYCORTISOL-90,301,1 ,$107.00 ,$69.55 ,$18.33 ,$107.00 ,$73.20 ,$79.72 ,$70.09 ,$29.28 ,$29.96 ,$54.04 ,$29.28 ,$66.02 ,$29.28 ,$66.02 ,$66.02 ,$29.28 ,$66.02 ,$55.63 ,$96.30 ,$80.25 ,$73.20 ,$29.28 ,$94.16 ,$29.28 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$29.28 ,$90.95 ,$29.28 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$73.20 ,$96.30 ,$29.28 ,$107.00 ,$70.09 ,$29.28 ,$44.51 ,$19.21 ,$18.33 ,$30.74 ,$96.30 ,$65.88 ,$66.02 ,$29.96 ,$96.30 ,$29.28 ,$96.30 ,$96.30 ,$29.28 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$210.00 ,$136.50 ,$21.08 ,$210.00 ,$96.25 ,$156.45 ,$137.55 ,$38.50 ,$58.80 ,$106.05 ,$38.50 ,$129.57 ,$38.50 ,$129.57 ,$129.57 ,$38.50 ,$129.57 ,$73.15 ,$189.00 ,$157.50 ,$96.25 ,$38.50 ,$184.80 ,$38.50 ,$157.50 ,$157.50 ,$178.50 ,$178.50 ,$38.50 ,$178.50 ,$38.50 ,$163.80 ,$163.80 ,$163.80 ,$189.00 ,$96.25 ,$189.00 ,$38.50 ,$210.00 ,$137.55 ,$38.50 ,$87.36 ,$22.09 ,$21.08 ,$40.43 ,$189.00 ,$86.63 ,$129.57 ,$58.80 ,$189.00 ,$38.50 ,$189.00 ,$189.00 ,$38.50 ,$136.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$90.00 ,$58.50 ,$7.83 ,$90.00 ,$28.83 ,$67.05 ,$58.95 ,$11.53 ,$25.20 ,$45.45 ,$11.53 ,$55.53 ,$11.53 ,$55.53 ,$55.53 ,$11.53 ,$55.53 ,$21.91 ,$81.00 ,$67.50 ,$28.83 ,$11.53 ,$79.20 ,$11.53 ,$67.50 ,$67.50 ,$76.50 ,$76.50 ,$11.53 ,$76.50 ,$11.53 ,$70.20 ,$70.20 ,$70.20 ,$81.00 ,$28.83 ,$81.00 ,$11.53 ,$90.00 ,$58.95 ,$11.53 ,$37.44 ,$8.21 ,$7.83 ,$12.11 ,$81.00 ,$25.94 ,$55.53 ,$25.20 ,$81.00 ,$11.53 ,$81.00 ,$81.00 ,$11.53 ,$58.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101242,82657,HC ENZYME ACT NONRAD SUBS-90,301,1 ,$633.00 ,$411.45 ,$7.83 ,$633.00 ,$55.43 ,$471.59 ,$414.62 ,$22.17 ,$177.24 ,$319.67 ,$22.17 ,$390.56 ,$22.17 ,$390.56 ,$390.56 ,$22.17 ,$390.56 ,$42.12 ,$569.70 ,$474.75 ,$55.43 ,$22.17 ,$557.04 ,$22.17 ,$474.75 ,$474.75 ,$538.05 ,$538.05 ,$22.17 ,$538.05 ,$22.17 ,$493.74 ,$493.74 ,$493.74 ,$569.70 ,$55.43 ,$569.70 ,$22.17 ,$633.00 ,$414.62 ,$22.17 ,$263.33 ,$8.21 ,$7.83 ,$23.28 ,$569.70 ,$49.88 ,$390.56 ,$177.24 ,$569.70 ,$22.17 ,$569.70 ,$569.70 ,$22.17 ,$411.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$222.00 ,$144.30 ,$7.83 ,$222.00 ,$46.98 ,$165.39 ,$145.41 ,$18.79 ,$62.16 ,$112.11 ,$18.79 ,$136.97 ,$18.79 ,$136.97 ,$136.97 ,$18.79 ,$136.97 ,$35.70 ,$199.80 ,$166.50 ,$46.98 ,$18.79 ,$195.36 ,$18.79 ,$166.50 ,$166.50 ,$188.70 ,$188.70 ,$18.79 ,$188.70 ,$18.79 ,$173.16 ,$173.16 ,$173.16 ,$199.80 ,$46.98 ,$199.80 ,$18.79 ,$222.00 ,$145.41 ,$18.79 ,$92.35 ,$8.21 ,$7.83 ,$19.73 ,$199.80 ,$42.28 ,$136.97 ,$62.16 ,$199.80 ,$18.79 ,$199.80 ,$199.80 ,$18.79 ,$144.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101246,82670,HC ESTRADIOL-90,301,1 ,$294.00 ,$191.10 ,$18.33 ,$294.00 ,$69.85 ,$219.03 ,$192.57 ,$27.94 ,$82.32 ,$148.47 ,$27.94 ,$181.40 ,$27.94 ,$181.40 ,$181.40 ,$27.94 ,$181.40 ,$53.09 ,$264.60 ,$220.50 ,$69.85 ,$27.94 ,$258.72 ,$27.94 ,$220.50 ,$220.50 ,$249.90 ,$249.90 ,$27.94 ,$249.90 ,$27.94 ,$229.32 ,$229.32 ,$229.32 ,$264.60 ,$69.85 ,$264.60 ,$27.94 ,$294.00 ,$192.57 ,$27.94 ,$122.30 ,$19.21 ,$18.33 ,$29.34 ,$264.60 ,$62.87 ,$181.40 ,$82.32 ,$264.60 ,$27.94 ,$264.60 ,$264.60 ,$27.94 ,$191.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101247,82670,HC ESTRADIOL FREE-90,301,1 ,$56.40 ,$36.66 ,$15.79 ,$62.87 ,$56.40 ,$42.02 ,$36.94 ,$27.94 ,$15.79 ,$28.48 ,$27.94 ,$34.80 ,$27.94 ,$34.80 ,$34.80 ,$27.94 ,$34.80 ,$53.09 ,$50.76 ,$42.30 ,$56.40 ,$27.94 ,$49.63 ,$27.94 ,$42.30 ,$42.30 ,$47.94 ,$47.94 ,$27.94 ,$47.94 ,$27.94 ,$43.99 ,$43.99 ,$43.99 ,$50.76 ,$56.40 ,$50.76 ,$27.94 ,$56.40 ,$36.94 ,$27.94 ,$23.46 ,$19.21 ,$18.33 ,$29.34 ,$50.76 ,$62.87 ,$34.80 ,$15.79 ,$50.76 ,$27.94 ,$50.76 ,$50.76 ,$27.94 ,$36.66 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101248,82671,HC ESTROGEN FRACTIONATED-90,301,1 ,$66.40 ,$43.16 ,$18.33 ,$72.68 ,$66.40 ,$49.47 ,$43.49 ,$32.30 ,$18.59 ,$33.53 ,$32.30 ,$40.97 ,$32.30 ,$40.97 ,$40.97 ,$32.30 ,$40.97 ,$61.37 ,$59.76 ,$49.80 ,$66.40 ,$32.30 ,$58.43 ,$32.30 ,$49.80 ,$49.80 ,$56.44 ,$56.44 ,$32.30 ,$56.44 ,$32.30 ,$51.79 ,$51.79 ,$51.79 ,$59.76 ,$66.40 ,$59.76 ,$32.30 ,$66.40 ,$43.49 ,$32.30 ,$27.62 ,$19.21 ,$18.33 ,$33.92 ,$59.76 ,$72.68 ,$40.97 ,$18.59 ,$59.76 ,$32.30 ,$59.76 ,$59.76 ,$32.30 ,$43.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$95.00 ,$61.75 ,$18.33 ,$95.00 ,$54.25 ,$70.78 ,$62.23 ,$21.70 ,$26.60 ,$47.98 ,$21.70 ,$58.62 ,$21.70 ,$58.62 ,$58.62 ,$21.70 ,$58.62 ,$41.23 ,$85.50 ,$71.25 ,$54.25 ,$21.70 ,$83.60 ,$21.70 ,$71.25 ,$71.25 ,$80.75 ,$80.75 ,$21.70 ,$80.75 ,$21.70 ,$74.10 ,$74.10 ,$74.10 ,$85.50 ,$54.25 ,$85.50 ,$21.70 ,$95.00 ,$62.23 ,$21.70 ,$39.52 ,$19.21 ,$18.33 ,$22.79 ,$85.50 ,$48.83 ,$58.62 ,$26.60 ,$85.50 ,$21.70 ,$85.50 ,$85.50 ,$21.70 ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101250,82677,HC ESTRIOL-90,301,1 ,$117.00 ,$76.05 ,$18.33 ,$117.00 ,$60.45 ,$87.17 ,$76.64 ,$24.18 ,$32.76 ,$59.09 ,$24.18 ,$72.19 ,$24.18 ,$72.19 ,$72.19 ,$24.18 ,$72.19 ,$45.94 ,$105.30 ,$87.75 ,$60.45 ,$24.18 ,$102.96 ,$24.18 ,$87.75 ,$87.75 ,$99.45 ,$99.45 ,$24.18 ,$99.45 ,$24.18 ,$91.26 ,$91.26 ,$91.26 ,$105.30 ,$60.45 ,$105.30 ,$24.18 ,$117.00 ,$76.64 ,$24.18 ,$48.67 ,$19.21 ,$18.33 ,$25.39 ,$105.30 ,$54.41 ,$72.19 ,$32.76 ,$105.30 ,$24.18 ,$105.30 ,$105.30 ,$24.18 ,$76.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101251,82679,HC ESTRONE-90,301,1 ,$112.00 ,$72.80 ,$18.33 ,$112.00 ,$62.38 ,$83.44 ,$73.36 ,$24.95 ,$31.36 ,$56.56 ,$24.95 ,$69.10 ,$24.95 ,$69.10 ,$69.10 ,$24.95 ,$69.10 ,$47.41 ,$100.80 ,$84.00 ,$62.38 ,$24.95 ,$98.56 ,$24.95 ,$84.00 ,$84.00 ,$95.20 ,$95.20 ,$24.95 ,$95.20 ,$24.95 ,$87.36 ,$87.36 ,$87.36 ,$100.80 ,$62.38 ,$100.80 ,$24.95 ,$112.00 ,$73.36 ,$24.95 ,$46.59 ,$19.21 ,$18.33 ,$26.20 ,$100.80 ,$56.14 ,$69.10 ,$31.36 ,$100.80 ,$24.95 ,$100.80 ,$100.80 ,$24.95 ,$72.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101252,82693,HC ETHYLENE GLYCOL-90,301,1 ,$36.00 ,$23.40 ,$9.56 ,$36.00 ,$36.00 ,$26.82 ,$23.58 ,$14.90 ,$10.08 ,$18.18 ,$14.90 ,$22.21 ,$14.90 ,$22.21 ,$22.21 ,$14.90 ,$22.21 ,$28.31 ,$32.40 ,$27.00 ,$36.00 ,$14.90 ,$31.68 ,$14.90 ,$27.00 ,$27.00 ,$30.60 ,$30.60 ,$14.90 ,$30.60 ,$14.90 ,$28.08 ,$28.08 ,$28.08 ,$32.40 ,$36.00 ,$32.40 ,$14.90 ,$36.00 ,$23.58 ,$14.90 ,$14.98 ,$10.01 ,$9.56 ,$15.65 ,$32.40 ,$33.53 ,$22.21 ,$10.08 ,$32.40 ,$14.90 ,$32.40 ,$32.40 ,$14.90 ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$36.00 ,$23.40 ,$3.49 ,$36.00 ,$12.75 ,$26.82 ,$23.58 ,$5.10 ,$10.08 ,$18.18 ,$5.10 ,$22.21 ,$5.10 ,$22.21 ,$22.21 ,$5.10 ,$22.21 ,$9.69 ,$32.40 ,$27.00 ,$12.75 ,$5.10 ,$31.68 ,$5.10 ,$27.00 ,$27.00 ,$30.60 ,$30.60 ,$5.10 ,$30.60 ,$5.10 ,$28.08 ,$28.08 ,$28.08 ,$32.40 ,$12.75 ,$32.40 ,$5.10 ,$36.00 ,$23.58 ,$5.10 ,$14.98 ,$3.65 ,$3.49 ,$5.36 ,$32.40 ,$11.48 ,$22.21 ,$10.08 ,$32.40 ,$5.10 ,$32.40 ,$32.40 ,$5.10 ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101256,82728,HC FERRITIN-90,301,1 ,$108.00 ,$70.20 ,$7.83 ,$108.00 ,$34.08 ,$80.46 ,$70.74 ,$13.63 ,$30.24 ,$54.54 ,$13.63 ,$66.64 ,$13.63 ,$66.64 ,$66.64 ,$13.63 ,$66.64 ,$25.90 ,$97.20 ,$81.00 ,$34.08 ,$13.63 ,$95.04 ,$13.63 ,$81.00 ,$81.00 ,$91.80 ,$91.80 ,$13.63 ,$91.80 ,$13.63 ,$84.24 ,$84.24 ,$84.24 ,$97.20 ,$34.08 ,$97.20 ,$13.63 ,$108.00 ,$70.74 ,$13.63 ,$44.93 ,$8.21 ,$7.83 ,$14.31 ,$97.20 ,$30.67 ,$66.64 ,$30.24 ,$97.20 ,$13.63 ,$97.20 ,$97.20 ,$13.63 ,$70.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$169.00 ,$109.85 ,$4.86 ,$169.00 ,$44.13 ,$125.91 ,$110.70 ,$17.65 ,$47.32 ,$85.35 ,$17.65 ,$104.27 ,$17.65 ,$104.27 ,$104.27 ,$17.65 ,$104.27 ,$33.54 ,$152.10 ,$126.75 ,$44.13 ,$17.65 ,$148.72 ,$17.65 ,$126.75 ,$126.75 ,$143.65 ,$143.65 ,$17.65 ,$143.65 ,$17.65 ,$131.82 ,$131.82 ,$131.82 ,$152.10 ,$44.13 ,$152.10 ,$17.65 ,$169.00 ,$110.70 ,$17.65 ,$70.30 ,$5.09 ,$4.86 ,$18.53 ,$152.10 ,$39.71 ,$104.27 ,$47.32 ,$152.10 ,$17.65 ,$152.10 ,$152.10 ,$17.65 ,$109.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$144.00 ,$93.60 ,$7.83 ,$144.00 ,$23.25 ,$107.28 ,$94.32 ,$9.30 ,$40.32 ,$72.72 ,$9.30 ,$88.85 ,$9.30 ,$88.85 ,$88.85 ,$9.30 ,$88.85 ,$17.67 ,$129.60 ,$108.00 ,$23.25 ,$9.30 ,$126.72 ,$9.30 ,$108.00 ,$108.00 ,$122.40 ,$122.40 ,$9.30 ,$122.40 ,$9.30 ,$112.32 ,$112.32 ,$112.32 ,$129.60 ,$23.25 ,$129.60 ,$9.30 ,$144.00 ,$94.32 ,$9.30 ,$59.90 ,$8.21 ,$7.83 ,$9.77 ,$129.60 ,$20.93 ,$88.85 ,$40.32 ,$129.60 ,$9.30 ,$129.60 ,$129.60 ,$9.30 ,$93.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101263,82785,HC GAMMAGLOBULIN IGE-90,301,1 ,$132.00 ,$85.80 ,$7.83 ,$132.00 ,$41.15 ,$98.34 ,$86.46 ,$16.46 ,$36.96 ,$66.66 ,$16.46 ,$81.44 ,$16.46 ,$81.44 ,$81.44 ,$16.46 ,$81.44 ,$31.27 ,$118.80 ,$99.00 ,$41.15 ,$16.46 ,$116.16 ,$16.46 ,$99.00 ,$99.00 ,$112.20 ,$112.20 ,$16.46 ,$112.20 ,$16.46 ,$102.96 ,$102.96 ,$102.96 ,$118.80 ,$41.15 ,$118.80 ,$16.46 ,$132.00 ,$86.46 ,$16.46 ,$54.91 ,$8.21 ,$7.83 ,$17.28 ,$118.80 ,$37.04 ,$81.44 ,$36.96 ,$118.80 ,$16.46 ,$118.80 ,$118.80 ,$16.46 ,$85.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$172.00 ,$111.80 ,$8.02 ,$172.00 ,$20.05 ,$128.14 ,$112.66 ,$8.02 ,$48.16 ,$86.86 ,$8.02 ,$106.12 ,$8.02 ,$106.12 ,$106.12 ,$8.02 ,$106.12 ,$15.24 ,$154.80 ,$129.00 ,$20.05 ,$8.02 ,$151.36 ,$8.02 ,$129.00 ,$129.00 ,$146.20 ,$146.20 ,$8.02 ,$146.20 ,$8.02 ,$134.16 ,$134.16 ,$134.16 ,$154.80 ,$20.05 ,$154.80 ,$8.02 ,$172.00 ,$112.66 ,$8.02 ,$71.55 ,$12.66 ,$12.09 ,$8.42 ,$154.80 ,$18.05 ,$106.12 ,$48.16 ,$154.80 ,$8.02 ,$154.80 ,$154.80 ,$8.02 ,$111.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101268,82941,HC GASTRIN-90,301,1 ,$123.00 ,$79.95 ,$17.63 ,$123.00 ,$44.08 ,$91.64 ,$80.57 ,$17.63 ,$34.44 ,$62.12 ,$17.63 ,$75.89 ,$17.63 ,$75.89 ,$75.89 ,$17.63 ,$75.89 ,$33.50 ,$110.70 ,$92.25 ,$44.08 ,$17.63 ,$108.24 ,$17.63 ,$92.25 ,$92.25 ,$104.55 ,$104.55 ,$17.63 ,$104.55 ,$17.63 ,$95.94 ,$95.94 ,$95.94 ,$110.70 ,$44.08 ,$110.70 ,$17.63 ,$123.00 ,$80.57 ,$17.63 ,$51.17 ,$19.21 ,$18.33 ,$18.51 ,$110.70 ,$39.67 ,$75.89 ,$34.44 ,$110.70 ,$17.63 ,$110.70 ,$110.70 ,$17.63 ,$79.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101269,82945,HC GLUCOSE BODY FLUID-90,301,1 ,$17.00 ,$11.05 ,$3.49 ,$17.00 ,$9.83 ,$12.67 ,$11.14 ,$3.93 ,$4.76 ,$8.59 ,$3.93 ,$10.49 ,$3.93 ,$10.49 ,$10.49 ,$3.93 ,$10.49 ,$7.47 ,$15.30 ,$12.75 ,$9.83 ,$3.93 ,$14.96 ,$3.93 ,$12.75 ,$12.75 ,$14.45 ,$14.45 ,$3.93 ,$14.45 ,$3.93 ,$13.26 ,$13.26 ,$13.26 ,$15.30 ,$9.83 ,$15.30 ,$3.93 ,$17.00 ,$11.14 ,$3.93 ,$7.07 ,$3.65 ,$3.49 ,$4.13 ,$15.30 ,$8.84 ,$10.49 ,$4.76 ,$15.30 ,$3.93 ,$15.30 ,$15.30 ,$3.93 ,$11.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$13.00 ,$8.45 ,$3.64 ,$21.83 ,$13.00 ,$9.69 ,$8.52 ,$9.70 ,$3.64 ,$6.57 ,$9.70 ,$8.02 ,$9.70 ,$8.02 ,$8.02 ,$9.70 ,$8.02 ,$18.43 ,$11.70 ,$9.75 ,$13.00 ,$9.70 ,$11.44 ,$9.70 ,$9.75 ,$9.75 ,$11.05 ,$11.05 ,$9.70 ,$11.05 ,$9.70 ,$10.14 ,$10.14 ,$10.14 ,$11.70 ,$13.00 ,$11.70 ,$9.70 ,$13.00 ,$8.52 ,$9.70 ,$5.41 ,$8.21 ,$7.83 ,$10.19 ,$11.70 ,$21.83 ,$8.02 ,$3.64 ,$11.70 ,$9.70 ,$11.70 ,$11.70 ,$9.70 ,$8.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$107.00 ,$69.55 ,$7.83 ,$107.00 ,$41.90 ,$79.72 ,$70.09 ,$16.76 ,$29.96 ,$54.04 ,$16.76 ,$66.02 ,$16.76 ,$66.02 ,$66.02 ,$16.76 ,$66.02 ,$31.84 ,$96.30 ,$80.25 ,$41.90 ,$16.76 ,$94.16 ,$16.76 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$16.76 ,$90.95 ,$16.76 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$41.90 ,$96.30 ,$16.76 ,$107.00 ,$70.09 ,$16.76 ,$44.51 ,$8.21 ,$7.83 ,$17.60 ,$96.30 ,$37.71 ,$66.02 ,$29.96 ,$96.30 ,$16.76 ,$96.30 ,$96.30 ,$16.76 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$10.00 ,$6.50 ,$2.80 ,$22.50 ,$10.00 ,$7.45 ,$6.55 ,$10.00 ,$2.80 ,$5.05 ,$10.00 ,$6.17 ,$10.00 ,$6.17 ,$6.17 ,$10.00 ,$6.17 ,$19.00 ,$9.00 ,$7.50 ,$10.00 ,$10.00 ,$8.80 ,$10.00 ,$7.50 ,$7.50 ,$8.50 ,$8.50 ,$10.00 ,$8.50 ,$10.00 ,$7.80 ,$7.80 ,$7.80 ,$9.00 ,$10.00 ,$9.00 ,$10.00 ,$10.00 ,$6.55 ,$10.00 ,$4.16 ,$10.00 ,$10.00 ,$10.00 ,$9.00 ,$22.50 ,$6.17 ,$2.80 ,$9.00 ,$10.00 ,$9.00 ,$9.00 ,$10.00 ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101280,83003,HC GROWTH HORMONE (HGH) STIM-90,301,1 ,$118.00 ,$76.70 ,$16.67 ,$118.00 ,$41.68 ,$87.91 ,$77.29 ,$16.67 ,$33.04 ,$59.59 ,$16.67 ,$72.81 ,$16.67 ,$72.81 ,$72.81 ,$16.67 ,$72.81 ,$31.67 ,$106.20 ,$88.50 ,$41.68 ,$16.67 ,$103.84 ,$16.67 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$16.67 ,$100.30 ,$16.67 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$41.68 ,$106.20 ,$16.67 ,$118.00 ,$77.29 ,$16.67 ,$49.09 ,$19.21 ,$18.33 ,$17.50 ,$106.20 ,$37.51 ,$72.81 ,$33.04 ,$106.20 ,$16.67 ,$106.20 ,$106.20 ,$16.67 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$220.00 ,$143.00 ,$21.08 ,$220.00 ,$168.40 ,$163.90 ,$144.10 ,$67.36 ,$61.60 ,$111.10 ,$67.36 ,$135.74 ,$67.36 ,$135.74 ,$135.74 ,$67.36 ,$135.74 ,$127.98 ,$198.00 ,$165.00 ,$168.40 ,$67.36 ,$193.60 ,$67.36 ,$165.00 ,$165.00 ,$187.00 ,$187.00 ,$67.36 ,$187.00 ,$67.36 ,$171.60 ,$171.60 ,$171.60 ,$198.00 ,$168.40 ,$198.00 ,$67.36 ,$220.00 ,$144.10 ,$67.36 ,$91.52 ,$22.09 ,$21.08 ,$70.73 ,$198.00 ,$151.56 ,$135.74 ,$61.60 ,$198.00 ,$67.36 ,$198.00 ,$198.00 ,$67.36 ,$143.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$158.00 ,$102.70 ,$9.56 ,$158.00 ,$54.90 ,$117.71 ,$103.49 ,$21.96 ,$44.24 ,$79.79 ,$21.96 ,$97.49 ,$21.96 ,$97.49 ,$97.49 ,$21.96 ,$97.49 ,$41.72 ,$142.20 ,$118.50 ,$54.90 ,$21.96 ,$139.04 ,$21.96 ,$118.50 ,$118.50 ,$134.30 ,$134.30 ,$21.96 ,$134.30 ,$21.96 ,$123.24 ,$123.24 ,$123.24 ,$142.20 ,$54.90 ,$142.20 ,$21.96 ,$158.00 ,$103.49 ,$21.96 ,$65.73 ,$10.01 ,$9.56 ,$23.06 ,$142.20 ,$49.41 ,$97.49 ,$44.24 ,$142.20 ,$21.96 ,$142.20 ,$142.20 ,$21.96 ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101284,83020,HC HGB ELECTROPHORESIS-90,301,1 ,$91.00 ,$59.15 ,$7.83 ,$91.00 ,$32.18 ,$67.80 ,$59.61 ,$12.87 ,$25.48 ,$45.96 ,$12.87 ,$56.15 ,$12.87 ,$56.15 ,$56.15 ,$12.87 ,$56.15 ,$24.45 ,$81.90 ,$68.25 ,$32.18 ,$12.87 ,$80.08 ,$12.87 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$12.87 ,$77.35 ,$12.87 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$32.18 ,$81.90 ,$12.87 ,$91.00 ,$59.61 ,$12.87 ,$37.86 ,$8.21 ,$7.83 ,$13.51 ,$81.90 ,$28.96 ,$56.15 ,$25.48 ,$81.90 ,$12.87 ,$81.90 ,$81.90 ,$12.87 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101285,83021,HC HEMOGLOBIN FRACT QN-90,301,1 ,$113.00 ,$73.45 ,$7.40 ,$113.00 ,$45.15 ,$84.19 ,$74.02 ,$18.06 ,$31.64 ,$57.07 ,$18.06 ,$69.72 ,$18.06 ,$69.72 ,$69.72 ,$18.06 ,$69.72 ,$34.31 ,$101.70 ,$84.75 ,$45.15 ,$18.06 ,$99.44 ,$18.06 ,$84.75 ,$84.75 ,$96.05 ,$96.05 ,$18.06 ,$96.05 ,$18.06 ,$88.14 ,$88.14 ,$88.14 ,$101.70 ,$45.15 ,$101.70 ,$18.06 ,$113.00 ,$74.02 ,$18.06 ,$47.01 ,$7.76 ,$7.40 ,$18.96 ,$101.70 ,$40.64 ,$69.72 ,$31.64 ,$101.70 ,$18.06 ,$101.70 ,$101.70 ,$18.06 ,$73.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101289,83051,HC HEMOGLOBIN PLASMA-90,301,1 ,$26.00 ,$16.90 ,$7.28 ,$26.00 ,$18.28 ,$19.37 ,$17.03 ,$7.31 ,$7.28 ,$13.13 ,$7.31 ,$16.04 ,$7.31 ,$16.04 ,$16.04 ,$7.31 ,$16.04 ,$13.89 ,$23.40 ,$19.50 ,$18.28 ,$7.31 ,$22.88 ,$7.31 ,$19.50 ,$19.50 ,$22.10 ,$22.10 ,$7.31 ,$22.10 ,$7.31 ,$20.28 ,$20.28 ,$20.28 ,$23.40 ,$18.28 ,$23.40 ,$7.31 ,$26.00 ,$17.03 ,$7.31 ,$10.82 ,$8.21 ,$7.83 ,$7.68 ,$23.40 ,$16.45 ,$16.04 ,$7.28 ,$23.40 ,$7.31 ,$23.40 ,$23.40 ,$7.31 ,$16.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101291,83088,HC HISTAMINE-90,301,1 ,$263.00 ,$170.95 ,$21.08 ,$263.00 ,$73.83 ,$195.94 ,$172.27 ,$29.53 ,$73.64 ,$132.82 ,$29.53 ,$162.27 ,$29.53 ,$162.27 ,$162.27 ,$29.53 ,$162.27 ,$56.11 ,$236.70 ,$197.25 ,$73.83 ,$29.53 ,$231.44 ,$29.53 ,$197.25 ,$197.25 ,$223.55 ,$223.55 ,$29.53 ,$223.55 ,$29.53 ,$205.14 ,$205.14 ,$205.14 ,$236.70 ,$73.83 ,$236.70 ,$29.53 ,$263.00 ,$172.27 ,$29.53 ,$109.41 ,$22.09 ,$21.08 ,$31.01 ,$236.70 ,$66.44 ,$162.27 ,$73.64 ,$236.70 ,$29.53 ,$236.70 ,$236.70 ,$29.53 ,$170.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101292,83090,HC HOMOCYSTEINE-90,301,1 ,$27.00 ,$17.55 ,$7.56 ,$40.32 ,$27.00 ,$20.12 ,$17.69 ,$17.92 ,$7.56 ,$13.64 ,$17.92 ,$16.66 ,$17.92 ,$16.66 ,$16.66 ,$17.92 ,$16.66 ,$34.05 ,$24.30 ,$20.25 ,$27.00 ,$17.92 ,$23.76 ,$17.92 ,$20.25 ,$20.25 ,$22.95 ,$22.95 ,$17.92 ,$22.95 ,$17.92 ,$21.06 ,$21.06 ,$21.06 ,$24.30 ,$27.00 ,$24.30 ,$17.92 ,$27.00 ,$17.69 ,$17.92 ,$11.23 ,$19.21 ,$18.33 ,$18.82 ,$24.30 ,$40.32 ,$16.66 ,$7.56 ,$24.30 ,$17.92 ,$24.30 ,$24.30 ,$17.92 ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$115.00 ,$74.75 ,$10.54 ,$115.00 ,$32.25 ,$85.68 ,$75.33 ,$12.90 ,$32.20 ,$58.08 ,$12.90 ,$70.96 ,$12.90 ,$70.96 ,$70.96 ,$12.90 ,$70.96 ,$24.51 ,$103.50 ,$86.25 ,$32.25 ,$12.90 ,$101.20 ,$12.90 ,$86.25 ,$86.25 ,$97.75 ,$97.75 ,$12.90 ,$97.75 ,$12.90 ,$89.70 ,$89.70 ,$89.70 ,$103.50 ,$32.25 ,$103.50 ,$12.90 ,$115.00 ,$75.33 ,$12.90 ,$47.84 ,$11.04 ,$10.54 ,$13.55 ,$103.50 ,$29.03 ,$70.96 ,$32.20 ,$103.50 ,$12.90 ,$103.50 ,$103.50 ,$12.90 ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$184.00 ,$119.60 ,$18.33 ,$184.00 ,$67.93 ,$137.08 ,$120.52 ,$27.17 ,$51.52 ,$92.92 ,$27.17 ,$113.53 ,$27.17 ,$113.53 ,$113.53 ,$27.17 ,$113.53 ,$51.62 ,$165.60 ,$138.00 ,$67.93 ,$27.17 ,$161.92 ,$27.17 ,$138.00 ,$138.00 ,$156.40 ,$156.40 ,$27.17 ,$156.40 ,$27.17 ,$143.52 ,$143.52 ,$143.52 ,$165.60 ,$67.93 ,$165.60 ,$27.17 ,$184.00 ,$120.52 ,$27.17 ,$76.54 ,$19.21 ,$18.33 ,$28.53 ,$165.60 ,$61.13 ,$113.53 ,$51.52 ,$165.60 ,$27.17 ,$165.60 ,$165.60 ,$27.17 ,$119.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$146.00 ,$94.90 ,$7.01 ,$146.00 ,$28.83 ,$108.77 ,$95.63 ,$11.53 ,$40.88 ,$73.73 ,$11.53 ,$90.08 ,$11.53 ,$90.08 ,$90.08 ,$11.53 ,$90.08 ,$21.91 ,$131.40 ,$109.50 ,$28.83 ,$11.53 ,$128.48 ,$11.53 ,$109.50 ,$109.50 ,$124.10 ,$124.10 ,$11.53 ,$124.10 ,$11.53 ,$113.88 ,$113.88 ,$113.88 ,$131.40 ,$28.83 ,$131.40 ,$11.53 ,$146.00 ,$95.63 ,$11.53 ,$60.74 ,$7.35 ,$7.01 ,$12.11 ,$131.40 ,$25.94 ,$90.08 ,$40.88 ,$131.40 ,$11.53 ,$131.40 ,$131.40 ,$11.53 ,$94.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101300,83516,HC MLT NON INFECT QL/SQ TTG-90,301,1 ,$146.00 ,$94.90 ,$7.01 ,$146.00 ,$28.83 ,$108.77 ,$95.63 ,$11.53 ,$40.88 ,$73.73 ,$11.53 ,$90.08 ,$11.53 ,$90.08 ,$90.08 ,$11.53 ,$90.08 ,$21.91 ,$131.40 ,$109.50 ,$28.83 ,$11.53 ,$128.48 ,$11.53 ,$109.50 ,$109.50 ,$124.10 ,$124.10 ,$11.53 ,$124.10 ,$11.53 ,$113.88 ,$113.88 ,$113.88 ,$131.40 ,$28.83 ,$131.40 ,$11.53 ,$146.00 ,$95.63 ,$11.53 ,$60.74 ,$7.35 ,$7.01 ,$12.11 ,$131.40 ,$25.94 ,$90.08 ,$40.88 ,$131.40 ,$11.53 ,$131.40 ,$131.40 ,$11.53 ,$94.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101302,83519,HC QN RIA-90,301,1 ,$106.00 ,$68.90 ,$7.01 ,$106.00 ,$46.00 ,$78.97 ,$69.43 ,$18.40 ,$29.68 ,$53.53 ,$18.40 ,$65.40 ,$18.40 ,$65.40 ,$65.40 ,$18.40 ,$65.40 ,$34.96 ,$95.40 ,$79.50 ,$46.00 ,$18.40 ,$93.28 ,$18.40 ,$79.50 ,$79.50 ,$90.10 ,$90.10 ,$18.40 ,$90.10 ,$18.40 ,$82.68 ,$82.68 ,$82.68 ,$95.40 ,$46.00 ,$95.40 ,$18.40 ,$106.00 ,$69.43 ,$18.40 ,$44.10 ,$7.35 ,$7.01 ,$19.32 ,$95.40 ,$41.40 ,$65.40 ,$29.68 ,$95.40 ,$18.40 ,$95.40 ,$95.40 ,$18.40 ,$68.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$79.00 ,$51.35 ,$7.01 ,$79.00 ,$43.18 ,$58.86 ,$51.75 ,$17.27 ,$22.12 ,$39.90 ,$17.27 ,$48.74 ,$17.27 ,$48.74 ,$48.74 ,$17.27 ,$48.74 ,$32.81 ,$71.10 ,$59.25 ,$43.18 ,$17.27 ,$69.52 ,$17.27 ,$59.25 ,$59.25 ,$67.15 ,$67.15 ,$17.27 ,$67.15 ,$17.27 ,$61.62 ,$61.62 ,$61.62 ,$71.10 ,$43.18 ,$71.10 ,$17.27 ,$79.00 ,$51.75 ,$17.27 ,$32.86 ,$7.35 ,$7.01 ,$18.13 ,$71.10 ,$38.86 ,$48.74 ,$22.12 ,$71.10 ,$17.27 ,$71.10 ,$71.10 ,$17.27 ,$51.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101305,83520,HC IMMUNOASSAY QN OTHER MBL-90,301,1 ,$247.00 ,$160.55 ,$7.01 ,$247.00 ,$43.18 ,$184.02 ,$161.79 ,$17.27 ,$69.16 ,$124.74 ,$17.27 ,$152.40 ,$17.27 ,$152.40 ,$152.40 ,$17.27 ,$152.40 ,$32.81 ,$222.30 ,$185.25 ,$43.18 ,$17.27 ,$217.36 ,$17.27 ,$185.25 ,$185.25 ,$209.95 ,$209.95 ,$17.27 ,$209.95 ,$17.27 ,$192.66 ,$192.66 ,$192.66 ,$222.30 ,$43.18 ,$222.30 ,$17.27 ,$247.00 ,$161.79 ,$17.27 ,$102.75 ,$7.35 ,$7.01 ,$18.13 ,$222.30 ,$38.86 ,$152.40 ,$69.16 ,$222.30 ,$17.27 ,$222.30 ,$222.30 ,$17.27 ,$160.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101306,83520,HC IMMUNOASSAY QN ENZYME-90,301,1 ,$400.00 ,$260.00 ,$7.01 ,$400.00 ,$43.18 ,$298.00 ,$262.00 ,$17.27 ,$112.00 ,$202.00 ,$17.27 ,$246.80 ,$17.27 ,$246.80 ,$246.80 ,$17.27 ,$246.80 ,$32.81 ,$360.00 ,$300.00 ,$43.18 ,$17.27 ,$352.00 ,$17.27 ,$300.00 ,$300.00 ,$340.00 ,$340.00 ,$17.27 ,$340.00 ,$17.27 ,$312.00 ,$312.00 ,$312.00 ,$360.00 ,$43.18 ,$360.00 ,$17.27 ,$400.00 ,$262.00 ,$17.27 ,$166.40 ,$7.35 ,$7.01 ,$18.13 ,$360.00 ,$38.86 ,$246.80 ,$112.00 ,$360.00 ,$17.27 ,$360.00 ,$360.00 ,$17.27 ,$260.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101307,83525,HC INSULIN TOTAL-90,301,1 ,$45.00 ,$29.25 ,$10.54 ,$45.00 ,$28.58 ,$33.53 ,$29.48 ,$11.43 ,$12.60 ,$22.73 ,$11.43 ,$27.77 ,$11.43 ,$27.77 ,$27.77 ,$11.43 ,$27.77 ,$21.72 ,$40.50 ,$33.75 ,$28.58 ,$11.43 ,$39.60 ,$11.43 ,$33.75 ,$33.75 ,$38.25 ,$38.25 ,$11.43 ,$38.25 ,$11.43 ,$35.10 ,$35.10 ,$35.10 ,$40.50 ,$28.58 ,$40.50 ,$11.43 ,$45.00 ,$29.48 ,$11.43 ,$18.72 ,$11.04 ,$10.54 ,$12.00 ,$40.50 ,$25.72 ,$27.77 ,$12.60 ,$40.50 ,$11.43 ,$40.50 ,$40.50 ,$11.43 ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101308,83527,HC INSULIN FREE-90,301,1 ,$29.00 ,$18.85 ,$8.12 ,$29.14 ,$29.00 ,$21.61 ,$19.00 ,$12.95 ,$8.12 ,$14.65 ,$12.95 ,$17.89 ,$12.95 ,$17.89 ,$17.89 ,$12.95 ,$17.89 ,$24.61 ,$26.10 ,$21.75 ,$29.00 ,$12.95 ,$25.52 ,$12.95 ,$21.75 ,$21.75 ,$24.65 ,$24.65 ,$12.95 ,$24.65 ,$12.95 ,$22.62 ,$22.62 ,$22.62 ,$26.10 ,$29.00 ,$26.10 ,$12.95 ,$29.00 ,$19.00 ,$12.95 ,$12.06 ,$19.21 ,$18.33 ,$13.60 ,$26.10 ,$29.14 ,$17.89 ,$8.12 ,$26.10 ,$12.95 ,$26.10 ,$26.10 ,$12.95 ,$18.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101309,83540,HC IRON TOTAL-90,301,1 ,$130.00 ,$84.50 ,$3.49 ,$130.00 ,$16.18 ,$96.85 ,$85.15 ,$6.47 ,$36.40 ,$65.65 ,$6.47 ,$80.21 ,$6.47 ,$80.21 ,$80.21 ,$6.47 ,$80.21 ,$12.29 ,$117.00 ,$97.50 ,$16.18 ,$6.47 ,$114.40 ,$6.47 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$6.47 ,$110.50 ,$6.47 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$16.18 ,$117.00 ,$6.47 ,$130.00 ,$85.15 ,$6.47 ,$54.08 ,$3.65 ,$3.49 ,$6.79 ,$117.00 ,$14.56 ,$80.21 ,$36.40 ,$117.00 ,$6.47 ,$117.00 ,$117.00 ,$6.47 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101310,83586,HC KETOSTEROIDS (17-KS)-90,301,1 ,$91.00 ,$59.15 ,$10.54 ,$91.00 ,$32.00 ,$67.80 ,$59.61 ,$12.80 ,$25.48 ,$45.96 ,$12.80 ,$56.15 ,$12.80 ,$56.15 ,$56.15 ,$12.80 ,$56.15 ,$24.32 ,$81.90 ,$68.25 ,$32.00 ,$12.80 ,$80.08 ,$12.80 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$12.80 ,$77.35 ,$12.80 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$32.00 ,$81.90 ,$12.80 ,$91.00 ,$59.61 ,$12.80 ,$37.86 ,$11.04 ,$10.54 ,$13.44 ,$81.90 ,$28.80 ,$56.15 ,$25.48 ,$81.90 ,$12.80 ,$81.90 ,$81.90 ,$12.80 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$135.00 ,$87.75 ,$3.49 ,$135.00 ,$15.10 ,$100.58 ,$88.43 ,$6.04 ,$37.80 ,$68.18 ,$6.04 ,$83.30 ,$6.04 ,$83.30 ,$83.30 ,$6.04 ,$83.30 ,$11.48 ,$121.50 ,$101.25 ,$15.10 ,$6.04 ,$118.80 ,$6.04 ,$101.25 ,$101.25 ,$114.75 ,$114.75 ,$6.04 ,$114.75 ,$6.04 ,$105.30 ,$105.30 ,$105.30 ,$121.50 ,$15.10 ,$121.50 ,$6.04 ,$135.00 ,$88.43 ,$6.04 ,$56.16 ,$3.65 ,$3.49 ,$6.34 ,$121.50 ,$13.59 ,$83.30 ,$37.80 ,$121.50 ,$6.04 ,$121.50 ,$121.50 ,$6.04 ,$87.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101313,83625,HC LDH ISOENZYMES-90,301,1 ,$91.00 ,$59.15 ,$7.83 ,$91.00 ,$31.98 ,$67.80 ,$59.61 ,$12.79 ,$25.48 ,$45.96 ,$12.79 ,$56.15 ,$12.79 ,$56.15 ,$56.15 ,$12.79 ,$56.15 ,$24.30 ,$81.90 ,$68.25 ,$31.98 ,$12.79 ,$80.08 ,$12.79 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$12.79 ,$77.35 ,$12.79 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$31.98 ,$81.90 ,$12.79 ,$91.00 ,$59.61 ,$12.79 ,$37.86 ,$8.21 ,$7.83 ,$13.43 ,$81.90 ,$28.78 ,$56.15 ,$25.48 ,$81.90 ,$12.79 ,$81.90 ,$81.90 ,$12.79 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101316,83655,HC LEAD-90,301,1 ,$98.00 ,$63.70 ,$9.56 ,$98.00 ,$30.28 ,$73.01 ,$64.19 ,$12.11 ,$27.44 ,$49.49 ,$12.11 ,$60.47 ,$12.11 ,$60.47 ,$60.47 ,$12.11 ,$60.47 ,$23.01 ,$88.20 ,$73.50 ,$30.28 ,$12.11 ,$86.24 ,$12.11 ,$73.50 ,$73.50 ,$83.30 ,$83.30 ,$12.11 ,$83.30 ,$12.11 ,$76.44 ,$76.44 ,$76.44 ,$88.20 ,$30.28 ,$88.20 ,$12.11 ,$98.00 ,$64.19 ,$12.11 ,$40.77 ,$10.01 ,$9.56 ,$12.72 ,$88.20 ,$27.25 ,$60.47 ,$27.44 ,$88.20 ,$12.11 ,$88.20 ,$88.20 ,$12.11 ,$63.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101319,83695,HC LIPOPROTEIN-90,301,1 ,$129.00 ,$83.85 ,$7.83 ,$129.00 ,$35.80 ,$96.11 ,$84.50 ,$14.32 ,$36.12 ,$65.15 ,$14.32 ,$79.59 ,$14.32 ,$79.59 ,$79.59 ,$14.32 ,$79.59 ,$27.21 ,$116.10 ,$96.75 ,$35.80 ,$14.32 ,$113.52 ,$14.32 ,$96.75 ,$96.75 ,$109.65 ,$109.65 ,$14.32 ,$109.65 ,$14.32 ,$100.62 ,$100.62 ,$100.62 ,$116.10 ,$35.80 ,$116.10 ,$14.32 ,$129.00 ,$84.50 ,$14.32 ,$53.66 ,$8.21 ,$7.83 ,$15.04 ,$116.10 ,$32.22 ,$79.59 ,$36.12 ,$116.10 ,$14.32 ,$116.10 ,$116.10 ,$14.32 ,$83.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101322,83704,HC NMR LIPOPROFILE LIP-90,301,1 ,$63.28 ,$41.13 ,$17.72 ,$76.93 ,$63.28 ,$47.14 ,$41.45 ,$34.19 ,$17.72 ,$31.96 ,$34.19 ,$39.04 ,$34.19 ,$39.04 ,$39.04 ,$34.19 ,$39.04 ,$64.96 ,$56.95 ,$47.46 ,$63.28 ,$34.19 ,$55.69 ,$34.19 ,$47.46 ,$47.46 ,$53.79 ,$53.79 ,$34.19 ,$53.79 ,$34.19 ,$49.36 ,$49.36 ,$49.36 ,$56.95 ,$63.28 ,$56.95 ,$34.19 ,$63.28 ,$41.45 ,$34.19 ,$26.32 ,$22.09 ,$21.08 ,$35.90 ,$56.95 ,$76.93 ,$39.04 ,$17.72 ,$56.95 ,$34.19 ,$56.95 ,$56.95 ,$34.19 ,$41.13 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101326,83735,HC MAGNESIUM-90,301,1 ,$16.00 ,$10.40 ,$3.49 ,$16.00 ,$16.00 ,$11.92 ,$10.48 ,$6.70 ,$4.48 ,$8.08 ,$6.70 ,$9.87 ,$6.70 ,$9.87 ,$9.87 ,$6.70 ,$9.87 ,$12.73 ,$14.40 ,$12.00 ,$16.00 ,$6.70 ,$14.08 ,$6.70 ,$12.00 ,$12.00 ,$13.60 ,$13.60 ,$6.70 ,$13.60 ,$6.70 ,$12.48 ,$12.48 ,$12.48 ,$14.40 ,$16.00 ,$14.40 ,$6.70 ,$16.00 ,$10.48 ,$6.70 ,$6.66 ,$3.65 ,$3.49 ,$7.04 ,$14.40 ,$15.08 ,$9.87 ,$4.48 ,$14.40 ,$6.70 ,$14.40 ,$14.40 ,$6.70 ,$10.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101327,83785,HC MANGANESE-90,301,1 ,$175.00 ,$113.75 ,$9.56 ,$175.00 ,$66.63 ,$130.38 ,$114.63 ,$26.65 ,$49.00 ,$88.38 ,$26.65 ,$107.98 ,$26.65 ,$107.98 ,$107.98 ,$26.65 ,$107.98 ,$50.64 ,$157.50 ,$131.25 ,$66.63 ,$26.65 ,$154.00 ,$26.65 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$26.65 ,$148.75 ,$26.65 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$66.63 ,$157.50 ,$26.65 ,$175.00 ,$114.63 ,$26.65 ,$72.80 ,$10.01 ,$9.56 ,$27.98 ,$157.50 ,$59.96 ,$107.98 ,$49.00 ,$157.50 ,$26.65 ,$157.50 ,$157.50 ,$26.65 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101328,83789,HC MASS SPEC QN EACH-90,301,1 ,$202.00 ,$131.30 ,$7.83 ,$202.00 ,$60.28 ,$150.49 ,$132.31 ,$24.11 ,$56.56 ,$102.01 ,$24.11 ,$124.63 ,$24.11 ,$124.63 ,$124.63 ,$24.11 ,$124.63 ,$45.81 ,$181.80 ,$151.50 ,$60.28 ,$24.11 ,$177.76 ,$24.11 ,$151.50 ,$151.50 ,$171.70 ,$171.70 ,$24.11 ,$171.70 ,$24.11 ,$157.56 ,$157.56 ,$157.56 ,$181.80 ,$60.28 ,$181.80 ,$24.11 ,$202.00 ,$132.31 ,$24.11 ,$84.03 ,$8.21 ,$7.83 ,$25.32 ,$181.80 ,$54.25 ,$124.63 ,$56.56 ,$181.80 ,$24.11 ,$181.80 ,$181.80 ,$24.11 ,$131.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101329,83825,HC MERCURY-90,301,1 ,$115.00 ,$74.75 ,$9.56 ,$115.00 ,$40.65 ,$85.68 ,$75.33 ,$16.26 ,$32.20 ,$58.08 ,$16.26 ,$70.96 ,$16.26 ,$70.96 ,$70.96 ,$16.26 ,$70.96 ,$30.89 ,$103.50 ,$86.25 ,$40.65 ,$16.26 ,$101.20 ,$16.26 ,$86.25 ,$86.25 ,$97.75 ,$97.75 ,$16.26 ,$97.75 ,$16.26 ,$89.70 ,$89.70 ,$89.70 ,$103.50 ,$40.65 ,$103.50 ,$16.26 ,$115.00 ,$75.33 ,$16.26 ,$47.84 ,$10.01 ,$9.56 ,$17.07 ,$103.50 ,$36.59 ,$70.96 ,$32.20 ,$103.50 ,$16.26 ,$103.50 ,$103.50 ,$16.26 ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101330,83835,HC METANEPHRINES-90,301,1 ,$186.00 ,$120.90 ,$16.94 ,$186.00 ,$42.35 ,$138.57 ,$121.83 ,$16.94 ,$52.08 ,$93.93 ,$16.94 ,$114.76 ,$16.94 ,$114.76 ,$114.76 ,$16.94 ,$114.76 ,$32.19 ,$167.40 ,$139.50 ,$42.35 ,$16.94 ,$163.68 ,$16.94 ,$139.50 ,$139.50 ,$158.10 ,$158.10 ,$16.94 ,$158.10 ,$16.94 ,$145.08 ,$145.08 ,$145.08 ,$167.40 ,$42.35 ,$167.40 ,$16.94 ,$186.00 ,$121.83 ,$16.94 ,$77.38 ,$19.21 ,$18.33 ,$17.79 ,$167.40 ,$38.12 ,$114.76 ,$52.08 ,$167.40 ,$16.94 ,$167.40 ,$167.40 ,$16.94 ,$120.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101333,83873,HC MYELIN BASIC PROTEIN (CSF)-90,301,1 ,$176.00 ,$114.40 ,$7.83 ,$176.00 ,$43.00 ,$131.12 ,$115.28 ,$17.20 ,$49.28 ,$88.88 ,$17.20 ,$108.59 ,$17.20 ,$108.59 ,$108.59 ,$17.20 ,$108.59 ,$32.68 ,$158.40 ,$132.00 ,$43.00 ,$17.20 ,$154.88 ,$17.20 ,$132.00 ,$132.00 ,$149.60 ,$149.60 ,$17.20 ,$149.60 ,$17.20 ,$137.28 ,$137.28 ,$137.28 ,$158.40 ,$43.00 ,$158.40 ,$17.20 ,$176.00 ,$115.28 ,$17.20 ,$73.22 ,$8.21 ,$7.83 ,$18.06 ,$158.40 ,$38.70 ,$108.59 ,$49.28 ,$158.40 ,$17.20 ,$158.40 ,$158.40 ,$17.20 ,$114.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101334,83874,HC MYOGLOBIN-90,301,1 ,$156.00 ,$101.40 ,$7.83 ,$156.00 ,$32.30 ,$116.22 ,$102.18 ,$12.92 ,$43.68 ,$78.78 ,$12.92 ,$96.25 ,$12.92 ,$96.25 ,$96.25 ,$12.92 ,$96.25 ,$24.55 ,$140.40 ,$117.00 ,$32.30 ,$12.92 ,$137.28 ,$12.92 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$12.92 ,$132.60 ,$12.92 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$32.30 ,$140.40 ,$12.92 ,$156.00 ,$102.18 ,$12.92 ,$64.90 ,$8.21 ,$7.83 ,$13.57 ,$140.40 ,$29.07 ,$96.25 ,$43.68 ,$140.40 ,$12.92 ,$140.40 ,$140.40 ,$12.92 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$161.00 ,$104.65 ,$12.09 ,$161.00 ,$34.00 ,$119.95 ,$105.46 ,$13.60 ,$45.08 ,$81.31 ,$13.60 ,$99.34 ,$13.60 ,$99.34 ,$99.34 ,$13.60 ,$99.34 ,$25.84 ,$144.90 ,$120.75 ,$34.00 ,$13.60 ,$141.68 ,$13.60 ,$120.75 ,$120.75 ,$136.85 ,$136.85 ,$13.60 ,$136.85 ,$13.60 ,$125.58 ,$125.58 ,$125.58 ,$144.90 ,$34.00 ,$144.90 ,$13.60 ,$161.00 ,$105.46 ,$13.60 ,$66.98 ,$12.66 ,$12.09 ,$14.28 ,$144.90 ,$30.60 ,$99.34 ,$45.08 ,$144.90 ,$13.60 ,$144.90 ,$144.90 ,$13.60 ,$104.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$70.00 ,$45.50 ,$7.83 ,$70.00 ,$27.88 ,$52.15 ,$45.85 ,$11.15 ,$19.60 ,$35.35 ,$11.15 ,$43.19 ,$11.15 ,$43.19 ,$43.19 ,$11.15 ,$43.19 ,$21.19 ,$63.00 ,$52.50 ,$27.88 ,$11.15 ,$61.60 ,$11.15 ,$52.50 ,$52.50 ,$59.50 ,$59.50 ,$11.15 ,$59.50 ,$11.15 ,$54.60 ,$54.60 ,$54.60 ,$63.00 ,$27.88 ,$63.00 ,$11.15 ,$70.00 ,$45.85 ,$11.15 ,$29.12 ,$8.21 ,$7.83 ,$11.71 ,$63.00 ,$25.09 ,$43.19 ,$19.60 ,$63.00 ,$11.15 ,$63.00 ,$63.00 ,$11.15 ,$45.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101340,83916,HC OLIGOCLONAL BANDS-90,301,1 ,$191.00 ,$124.15 ,$7.83 ,$191.00 ,$68.48 ,$142.30 ,$125.11 ,$27.39 ,$53.48 ,$96.46 ,$27.39 ,$117.85 ,$27.39 ,$117.85 ,$117.85 ,$27.39 ,$117.85 ,$52.04 ,$171.90 ,$143.25 ,$68.48 ,$27.39 ,$168.08 ,$27.39 ,$143.25 ,$143.25 ,$162.35 ,$162.35 ,$27.39 ,$162.35 ,$27.39 ,$148.98 ,$148.98 ,$148.98 ,$171.90 ,$68.48 ,$171.90 ,$27.39 ,$191.00 ,$125.11 ,$27.39 ,$79.46 ,$8.21 ,$7.83 ,$28.76 ,$171.90 ,$61.63 ,$117.85 ,$53.48 ,$171.90 ,$27.39 ,$171.90 ,$171.90 ,$27.39 ,$124.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101345,83945,HC OXALATE-90,301,1 ,$91.00 ,$59.15 ,$7.83 ,$91.00 ,$36.13 ,$67.80 ,$59.61 ,$14.45 ,$25.48 ,$45.96 ,$14.45 ,$56.15 ,$14.45 ,$56.15 ,$56.15 ,$14.45 ,$56.15 ,$27.46 ,$81.90 ,$68.25 ,$36.13 ,$14.45 ,$80.08 ,$14.45 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$14.45 ,$77.35 ,$14.45 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$36.13 ,$81.90 ,$14.45 ,$91.00 ,$59.61 ,$14.45 ,$37.86 ,$8.21 ,$7.83 ,$15.17 ,$81.90 ,$32.51 ,$56.15 ,$25.48 ,$81.90 ,$14.45 ,$81.90 ,$81.90 ,$14.45 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101347,83970,HC PARATHYROID HORMONE (PTH)-90,301,1 ,$95.00 ,$61.75 ,$18.33 ,$95.00 ,$95.00 ,$70.78 ,$62.23 ,$41.28 ,$26.60 ,$47.98 ,$41.28 ,$58.62 ,$41.28 ,$58.62 ,$58.62 ,$41.28 ,$58.62 ,$78.43 ,$85.50 ,$71.25 ,$95.00 ,$41.28 ,$83.60 ,$41.28 ,$71.25 ,$71.25 ,$80.75 ,$80.75 ,$41.28 ,$80.75 ,$41.28 ,$74.10 ,$74.10 ,$74.10 ,$85.50 ,$95.00 ,$85.50 ,$41.28 ,$95.00 ,$62.23 ,$41.28 ,$39.52 ,$19.21 ,$18.33 ,$43.34 ,$85.50 ,$92.88 ,$58.62 ,$26.60 ,$85.50 ,$41.28 ,$85.50 ,$85.50 ,$41.28 ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101349,83992,HC PHENCYCLIDINE (PCP)-90,301,1 ,$263.00 ,$170.95 ,$9.56 ,$263.00 , N/A ,$195.94 ,$172.27 , N/A ,$73.64 ,$132.82 , N/A ,$162.27 , N/A ,$162.27 ,$162.27 , N/A ,$162.27 , N/A ,$236.70 ,$197.25 , N/A , N/A ,$231.44 , N/A ,$197.25 ,$197.25 ,$223.55 ,$223.55 , N/A ,$223.55 , N/A ,$205.14 ,$205.14 ,$205.14 ,$236.70 , N/A ,$236.70 , N/A ,$263.00 ,$172.27 , N/A ,$109.41 ,$10.01 ,$9.56 , N/A ,$236.70 , N/A ,$162.27 ,$73.64 ,$236.70 , N/A ,$236.70 ,$236.70 , N/A ,$170.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$302.00 ,$196.30 ,$7.83 ,$302.00 ,$49.08 ,$224.99 ,$197.81 ,$19.63 ,$84.56 ,$152.51 ,$19.63 ,$186.33 ,$19.63 ,$186.33 ,$186.33 ,$19.63 ,$186.33 ,$37.30 ,$271.80 ,$226.50 ,$49.08 ,$19.63 ,$265.76 ,$19.63 ,$226.50 ,$226.50 ,$256.70 ,$256.70 ,$19.63 ,$256.70 ,$19.63 ,$235.56 ,$235.56 ,$235.56 ,$271.80 ,$49.08 ,$271.80 ,$19.63 ,$302.00 ,$197.81 ,$19.63 ,$125.63 ,$8.21 ,$7.83 ,$20.61 ,$271.80 ,$44.17 ,$186.33 ,$84.56 ,$271.80 ,$19.63 ,$271.80 ,$271.80 ,$19.63 ,$196.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$268.00 ,$174.20 ,$3.49 ,$268.00 ,$13.75 ,$199.66 ,$175.54 ,$5.50 ,$75.04 ,$135.34 ,$5.50 ,$165.36 ,$5.50 ,$165.36 ,$165.36 ,$5.50 ,$165.36 ,$10.45 ,$241.20 ,$201.00 ,$13.75 ,$5.50 ,$235.84 ,$5.50 ,$201.00 ,$201.00 ,$227.80 ,$227.80 ,$5.50 ,$227.80 ,$5.50 ,$209.04 ,$209.04 ,$209.04 ,$241.20 ,$13.75 ,$241.20 ,$5.50 ,$268.00 ,$175.54 ,$5.50 ,$111.49 ,$3.65 ,$3.49 ,$5.78 ,$241.20 ,$12.38 ,$165.36 ,$75.04 ,$241.20 ,$5.50 ,$241.20 ,$241.20 ,$5.50 ,$174.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$78.00 ,$50.70 ,$7.83 ,$78.00 ,$24.15 ,$58.11 ,$51.09 ,$9.66 ,$21.84 ,$39.39 ,$9.66 ,$48.13 ,$9.66 ,$48.13 ,$48.13 ,$9.66 ,$48.13 ,$18.35 ,$70.20 ,$58.50 ,$24.15 ,$9.66 ,$68.64 ,$9.66 ,$58.50 ,$58.50 ,$66.30 ,$66.30 ,$9.66 ,$66.30 ,$9.66 ,$60.84 ,$60.84 ,$60.84 ,$70.20 ,$24.15 ,$70.20 ,$9.66 ,$78.00 ,$51.09 ,$9.66 ,$32.45 ,$8.21 ,$7.83 ,$10.14 ,$70.20 ,$21.74 ,$48.13 ,$21.84 ,$70.20 ,$9.66 ,$70.20 ,$70.20 ,$9.66 ,$50.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$37.00 ,$24.05 ,$3.49 ,$37.00 ,$12.95 ,$27.57 ,$24.24 ,$5.18 ,$10.36 ,$18.69 ,$5.18 ,$22.83 ,$5.18 ,$22.83 ,$22.83 ,$5.18 ,$22.83 ,$9.84 ,$33.30 ,$27.75 ,$12.95 ,$5.18 ,$32.56 ,$5.18 ,$27.75 ,$27.75 ,$31.45 ,$31.45 ,$5.18 ,$31.45 ,$5.18 ,$28.86 ,$28.86 ,$28.86 ,$33.30 ,$12.95 ,$33.30 ,$5.18 ,$37.00 ,$24.24 ,$5.18 ,$15.39 ,$3.65 ,$3.49 ,$5.44 ,$33.30 ,$11.66 ,$22.83 ,$10.36 ,$33.30 ,$5.18 ,$33.30 ,$33.30 ,$5.18 ,$24.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$105.00 ,$68.25 ,$7.83 ,$105.00 ,$36.95 ,$78.23 ,$68.78 ,$14.78 ,$29.40 ,$53.03 ,$14.78 ,$64.79 ,$14.78 ,$64.79 ,$64.79 ,$14.78 ,$64.79 ,$28.08 ,$94.50 ,$78.75 ,$36.95 ,$14.78 ,$92.40 ,$14.78 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$14.78 ,$89.25 ,$14.78 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$36.95 ,$94.50 ,$14.78 ,$105.00 ,$68.78 ,$14.78 ,$43.68 ,$8.21 ,$7.83 ,$15.52 ,$94.50 ,$33.26 ,$64.79 ,$29.40 ,$94.50 ,$14.78 ,$94.50 ,$94.50 ,$14.78 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101359,84110,HC PORPHOBILINOGEN QN-90,301,1 ,$101.00 ,$65.65 ,$7.83 ,$101.00 ,$21.10 ,$75.25 ,$66.16 ,$8.44 ,$28.28 ,$51.01 ,$8.44 ,$62.32 ,$8.44 ,$62.32 ,$62.32 ,$8.44 ,$62.32 ,$16.04 ,$90.90 ,$75.75 ,$21.10 ,$8.44 ,$88.88 ,$8.44 ,$75.75 ,$75.75 ,$85.85 ,$85.85 ,$8.44 ,$85.85 ,$8.44 ,$78.78 ,$78.78 ,$78.78 ,$90.90 ,$21.10 ,$90.90 ,$8.44 ,$101.00 ,$66.16 ,$8.44 ,$42.02 ,$8.21 ,$7.83 ,$8.86 ,$90.90 ,$18.99 ,$62.32 ,$28.28 ,$90.90 ,$8.44 ,$90.90 ,$90.90 ,$8.44 ,$65.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101366,84140,HC PREGNENOLONE-90,301,1 ,$124.00 ,$80.60 ,$18.33 ,$124.00 ,$51.68 ,$92.38 ,$81.22 ,$20.67 ,$34.72 ,$62.62 ,$20.67 ,$76.51 ,$20.67 ,$76.51 ,$76.51 ,$20.67 ,$76.51 ,$39.27 ,$111.60 ,$93.00 ,$51.68 ,$20.67 ,$109.12 ,$20.67 ,$93.00 ,$93.00 ,$105.40 ,$105.40 ,$20.67 ,$105.40 ,$20.67 ,$96.72 ,$96.72 ,$96.72 ,$111.60 ,$51.68 ,$111.60 ,$20.67 ,$124.00 ,$81.22 ,$20.67 ,$51.58 ,$19.21 ,$18.33 ,$21.70 ,$111.60 ,$46.51 ,$76.51 ,$34.72 ,$111.60 ,$20.67 ,$111.60 ,$111.60 ,$20.67 ,$80.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101367,84143,HC 17-HYDROXYPREGNENOLONE-90,301,1 ,$198.00 ,$128.70 ,$18.33 ,$198.00 ,$57.03 ,$147.51 ,$129.69 ,$22.81 ,$55.44 ,$99.99 ,$22.81 ,$122.17 ,$22.81 ,$122.17 ,$122.17 ,$22.81 ,$122.17 ,$43.34 ,$178.20 ,$148.50 ,$57.03 ,$22.81 ,$174.24 ,$22.81 ,$148.50 ,$148.50 ,$168.30 ,$168.30 ,$22.81 ,$168.30 ,$22.81 ,$154.44 ,$154.44 ,$154.44 ,$178.20 ,$57.03 ,$178.20 ,$22.81 ,$198.00 ,$129.69 ,$22.81 ,$82.37 ,$19.21 ,$18.33 ,$23.95 ,$178.20 ,$51.32 ,$122.17 ,$55.44 ,$178.20 ,$22.81 ,$178.20 ,$178.20 ,$22.81 ,$128.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101369,84145,HC PROCALCITONIN (PCT)-90,301,1 ,$264.00 ,$171.60 ,$18.33 ,$264.00 ,$68.05 ,$196.68 ,$172.92 ,$27.22 ,$73.92 ,$133.32 ,$27.22 ,$162.89 ,$27.22 ,$162.89 ,$162.89 ,$27.22 ,$162.89 ,$51.72 ,$237.60 ,$198.00 ,$68.05 ,$27.22 ,$232.32 ,$27.22 ,$198.00 ,$198.00 ,$224.40 ,$224.40 ,$27.22 ,$224.40 ,$27.22 ,$205.92 ,$205.92 ,$205.92 ,$237.60 ,$68.05 ,$237.60 ,$27.22 ,$264.00 ,$172.92 ,$27.22 ,$109.82 ,$19.21 ,$18.33 ,$28.58 ,$237.60 ,$61.25 ,$162.89 ,$73.92 ,$237.60 ,$27.22 ,$237.60 ,$237.60 ,$27.22 ,$171.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101373,84156,HC PROTEIN TOTAL URINE-90,301,1 ,$105.00 ,$68.25 ,$3.49 ,$105.00 ,$9.18 ,$78.23 ,$68.78 ,$3.67 ,$29.40 ,$53.03 ,$3.67 ,$64.79 ,$3.67 ,$64.79 ,$64.79 ,$3.67 ,$64.79 ,$6.97 ,$94.50 ,$78.75 ,$9.18 ,$3.67 ,$92.40 ,$3.67 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$3.67 ,$89.25 ,$3.67 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$9.18 ,$94.50 ,$3.67 ,$105.00 ,$68.78 ,$3.67 ,$43.68 ,$3.65 ,$3.49 ,$3.85 ,$94.50 ,$8.26 ,$64.79 ,$29.40 ,$94.50 ,$3.67 ,$94.50 ,$94.50 ,$3.67 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101379,84181,HC PROTEIN WESTERN BLOT-90,301,1 ,$115.00 ,$74.75 ,$7.01 ,$115.00 ,$42.58 ,$85.68 ,$75.33 ,$17.03 ,$32.20 ,$58.08 ,$17.03 ,$70.96 ,$17.03 ,$70.96 ,$70.96 ,$17.03 ,$70.96 ,$32.36 ,$103.50 ,$86.25 ,$42.58 ,$17.03 ,$101.20 ,$17.03 ,$86.25 ,$86.25 ,$97.75 ,$97.75 ,$17.03 ,$97.75 ,$17.03 ,$89.70 ,$89.70 ,$89.70 ,$103.50 ,$42.58 ,$103.50 ,$17.03 ,$115.00 ,$75.33 ,$17.03 ,$47.84 ,$7.35 ,$7.01 ,$17.88 ,$103.50 ,$38.32 ,$70.96 ,$32.20 ,$103.50 ,$17.03 ,$103.50 ,$103.50 ,$17.03 ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101381,84202,HC PROTOPORPHYRIN-90,301,1 ,$22.00 ,$14.30 ,$6.16 ,$32.29 ,$22.00 ,$16.39 ,$14.41 ,$14.35 ,$6.16 ,$11.11 ,$14.35 ,$13.57 ,$14.35 ,$13.57 ,$13.57 ,$14.35 ,$13.57 ,$27.27 ,$19.80 ,$16.50 ,$22.00 ,$14.35 ,$19.36 ,$14.35 ,$16.50 ,$16.50 ,$18.70 ,$18.70 ,$14.35 ,$18.70 ,$14.35 ,$17.16 ,$17.16 ,$17.16 ,$19.80 ,$22.00 ,$19.80 ,$14.35 ,$22.00 ,$14.41 ,$14.35 ,$9.15 ,$8.21 ,$7.83 ,$15.07 ,$19.80 ,$32.29 ,$13.57 ,$6.16 ,$19.80 ,$14.35 ,$19.80 ,$19.80 ,$14.35 ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101382,84206,HC PROINSULIN-90,301,1 ,$128.00 ,$83.20 ,$18.33 ,$128.00 ,$66.73 ,$95.36 ,$83.84 ,$26.69 ,$35.84 ,$64.64 ,$26.69 ,$78.98 ,$26.69 ,$78.98 ,$78.98 ,$26.69 ,$78.98 ,$50.71 ,$115.20 ,$96.00 ,$66.73 ,$26.69 ,$112.64 ,$26.69 ,$96.00 ,$96.00 ,$108.80 ,$108.80 ,$26.69 ,$108.80 ,$26.69 ,$99.84 ,$99.84 ,$99.84 ,$115.20 ,$66.73 ,$115.20 ,$26.69 ,$128.00 ,$83.84 ,$26.69 ,$53.25 ,$19.21 ,$18.33 ,$28.02 ,$115.20 ,$60.05 ,$78.98 ,$35.84 ,$115.20 ,$26.69 ,$115.20 ,$115.20 ,$26.69 ,$83.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101383,84207,HC VITAMIN B6-90,301,1 ,$200.00 ,$130.00 ,$7.83 ,$200.00 ,$70.25 ,$149.00 ,$131.00 ,$28.10 ,$56.00 ,$101.00 ,$28.10 ,$123.40 ,$28.10 ,$123.40 ,$123.40 ,$28.10 ,$123.40 ,$53.39 ,$180.00 ,$150.00 ,$70.25 ,$28.10 ,$176.00 ,$28.10 ,$150.00 ,$150.00 ,$170.00 ,$170.00 ,$28.10 ,$170.00 ,$28.10 ,$156.00 ,$156.00 ,$156.00 ,$180.00 ,$70.25 ,$180.00 ,$28.10 ,$200.00 ,$131.00 ,$28.10 ,$83.20 ,$8.21 ,$7.83 ,$29.51 ,$180.00 ,$63.23 ,$123.40 ,$56.00 ,$180.00 ,$28.10 ,$180.00 ,$180.00 ,$28.10 ,$130.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101384,84210,HC PYRUVATE-90,301,1 ,$18.00 ,$11.70 ,$5.04 ,$32.58 ,$18.00 ,$13.41 ,$11.79 ,$14.48 ,$5.04 ,$9.09 ,$14.48 ,$11.11 ,$14.48 ,$11.11 ,$11.11 ,$14.48 ,$11.11 ,$27.51 ,$16.20 ,$13.50 ,$18.00 ,$14.48 ,$15.84 ,$14.48 ,$13.50 ,$13.50 ,$15.30 ,$15.30 ,$14.48 ,$15.30 ,$14.48 ,$14.04 ,$14.04 ,$14.04 ,$16.20 ,$18.00 ,$16.20 ,$14.48 ,$18.00 ,$11.79 ,$14.48 ,$7.49 ,$8.21 ,$7.83 ,$15.20 ,$16.20 ,$32.58 ,$11.11 ,$5.04 ,$16.20 ,$14.48 ,$16.20 ,$16.20 ,$14.48 ,$11.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101387,84244,HC RENIN-90,301,1 ,$230.00 ,$149.50 ,$18.33 ,$230.00 ,$54.98 ,$171.35 ,$150.65 ,$21.99 ,$64.40 ,$116.15 ,$21.99 ,$141.91 ,$21.99 ,$141.91 ,$141.91 ,$21.99 ,$141.91 ,$41.78 ,$207.00 ,$172.50 ,$54.98 ,$21.99 ,$202.40 ,$21.99 ,$172.50 ,$172.50 ,$195.50 ,$195.50 ,$21.99 ,$195.50 ,$21.99 ,$179.40 ,$179.40 ,$179.40 ,$207.00 ,$54.98 ,$207.00 ,$21.99 ,$230.00 ,$150.65 ,$21.99 ,$95.68 ,$19.21 ,$18.33 ,$23.09 ,$207.00 ,$49.48 ,$141.91 ,$64.40 ,$207.00 ,$21.99 ,$207.00 ,$207.00 ,$21.99 ,$149.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101388,84255,HC SELENIUM-90,301,1 ,$182.00 ,$118.30 ,$7.83 ,$182.00 ,$63.83 ,$135.59 ,$119.21 ,$25.53 ,$50.96 ,$91.91 ,$25.53 ,$112.29 ,$25.53 ,$112.29 ,$112.29 ,$25.53 ,$112.29 ,$48.51 ,$163.80 ,$136.50 ,$63.83 ,$25.53 ,$160.16 ,$25.53 ,$136.50 ,$136.50 ,$154.70 ,$154.70 ,$25.53 ,$154.70 ,$25.53 ,$141.96 ,$141.96 ,$141.96 ,$163.80 ,$63.83 ,$163.80 ,$25.53 ,$182.00 ,$119.21 ,$25.53 ,$75.71 ,$8.21 ,$7.83 ,$26.81 ,$163.80 ,$57.44 ,$112.29 ,$50.96 ,$163.80 ,$25.53 ,$163.80 ,$163.80 ,$25.53 ,$118.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101389,84252,HC VITAMIN B-2 (RIBOFLAVIN)-90,301,1 ,$54.00 ,$35.10 ,$7.83 ,$54.00 ,$50.60 ,$40.23 ,$35.37 ,$20.24 ,$15.12 ,$27.27 ,$20.24 ,$33.32 ,$20.24 ,$33.32 ,$33.32 ,$20.24 ,$33.32 ,$38.46 ,$48.60 ,$40.50 ,$50.60 ,$20.24 ,$47.52 ,$20.24 ,$40.50 ,$40.50 ,$45.90 ,$45.90 ,$20.24 ,$45.90 ,$20.24 ,$42.12 ,$42.12 ,$42.12 ,$48.60 ,$50.60 ,$48.60 ,$20.24 ,$54.00 ,$35.37 ,$20.24 ,$22.46 ,$8.21 ,$7.83 ,$21.25 ,$48.60 ,$45.54 ,$33.32 ,$15.12 ,$48.60 ,$20.24 ,$48.60 ,$48.60 ,$20.24 ,$35.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$65.19 ,$42.37 ,$7.83 ,$65.19 ,$54.33 ,$48.57 ,$42.70 ,$21.73 ,$18.25 ,$32.92 ,$21.73 ,$40.22 ,$21.73 ,$40.22 ,$40.22 ,$21.73 ,$40.22 ,$41.29 ,$58.67 ,$48.89 ,$54.33 ,$21.73 ,$57.37 ,$21.73 ,$48.89 ,$48.89 ,$55.41 ,$55.41 ,$21.73 ,$55.41 ,$21.73 ,$50.85 ,$50.85 ,$50.85 ,$58.67 ,$54.33 ,$58.67 ,$21.73 ,$65.19 ,$42.70 ,$21.73 ,$27.12 ,$8.21 ,$7.83 ,$22.82 ,$58.67 ,$48.89 ,$40.22 ,$18.25 ,$58.67 ,$21.73 ,$58.67 ,$58.67 ,$21.73 ,$42.37 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$38.00 ,$24.70 ,$3.49 ,$38.00 ,$12.15 ,$28.31 ,$24.89 ,$4.86 ,$10.64 ,$19.19 ,$4.86 ,$23.45 ,$4.86 ,$23.45 ,$23.45 ,$4.86 ,$23.45 ,$9.23 ,$34.20 ,$28.50 ,$12.15 ,$4.86 ,$33.44 ,$4.86 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$4.86 ,$32.30 ,$4.86 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$12.15 ,$34.20 ,$4.86 ,$38.00 ,$24.89 ,$4.86 ,$15.81 ,$3.65 ,$3.49 ,$5.10 ,$34.20 ,$10.94 ,$23.45 ,$10.64 ,$34.20 ,$4.86 ,$34.20 ,$34.20 ,$4.86 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101396,84305,HC SOMATOMEDIN-90,301,1 ,$151.00 ,$98.15 ,$18.33 ,$151.00 ,$53.15 ,$112.50 ,$98.91 ,$21.26 ,$42.28 ,$76.26 ,$21.26 ,$93.17 ,$21.26 ,$93.17 ,$93.17 ,$21.26 ,$93.17 ,$40.39 ,$135.90 ,$113.25 ,$53.15 ,$21.26 ,$132.88 ,$21.26 ,$113.25 ,$113.25 ,$128.35 ,$128.35 ,$21.26 ,$128.35 ,$21.26 ,$117.78 ,$117.78 ,$117.78 ,$135.90 ,$53.15 ,$135.90 ,$21.26 ,$151.00 ,$98.91 ,$21.26 ,$62.82 ,$19.21 ,$18.33 ,$22.32 ,$135.90 ,$47.84 ,$93.17 ,$42.28 ,$135.90 ,$21.26 ,$135.90 ,$135.90 ,$21.26 ,$98.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101397,84307,HC SOMATOSTATIN-90,301,1 ,$404.00 ,$262.60 ,$18.28 ,$404.00 ,$45.70 ,$300.98 ,$264.62 ,$18.28 ,$113.12 ,$204.02 ,$18.28 ,$249.27 ,$18.28 ,$249.27 ,$249.27 ,$18.28 ,$249.27 ,$34.73 ,$363.60 ,$303.00 ,$45.70 ,$18.28 ,$355.52 ,$18.28 ,$303.00 ,$303.00 ,$343.40 ,$343.40 ,$18.28 ,$343.40 ,$18.28 ,$315.12 ,$315.12 ,$315.12 ,$363.60 ,$45.70 ,$363.60 ,$18.28 ,$404.00 ,$264.62 ,$18.28 ,$168.06 ,$19.21 ,$18.33 ,$19.19 ,$363.60 ,$41.13 ,$249.27 ,$113.12 ,$363.60 ,$18.28 ,$363.60 ,$363.60 ,$18.28 ,$262.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$55.00 ,$35.75 ,$7.83 ,$55.00 ,$20.25 ,$40.98 ,$36.03 ,$8.10 ,$15.40 ,$27.78 ,$8.10 ,$33.94 ,$8.10 ,$33.94 ,$33.94 ,$8.10 ,$33.94 ,$15.39 ,$49.50 ,$41.25 ,$20.25 ,$8.10 ,$48.40 ,$8.10 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$8.10 ,$46.75 ,$8.10 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$20.25 ,$49.50 ,$8.10 ,$55.00 ,$36.03 ,$8.10 ,$22.88 ,$8.21 ,$7.83 ,$8.51 ,$49.50 ,$18.23 ,$33.94 ,$15.40 ,$49.50 ,$8.10 ,$49.50 ,$49.50 ,$8.10 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101399,84311,HC SPECTROPHOTOMETRY FECAL-90,301,1 ,$250.78 ,$163.01 ,$7.83 ,$250.78 ,$20.25 ,$186.83 ,$164.26 ,$8.10 ,$70.22 ,$126.64 ,$8.10 ,$154.73 ,$8.10 ,$154.73 ,$154.73 ,$8.10 ,$154.73 ,$15.39 ,$225.70 ,$188.09 ,$20.25 ,$8.10 ,$220.69 ,$8.10 ,$188.09 ,$188.09 ,$213.16 ,$213.16 ,$8.10 ,$213.16 ,$8.10 ,$195.61 ,$195.61 ,$195.61 ,$225.70 ,$20.25 ,$225.70 ,$8.10 ,$250.78 ,$164.26 ,$8.10 ,$104.32 ,$8.21 ,$7.83 ,$8.51 ,$225.70 ,$18.23 ,$154.73 ,$70.22 ,$225.70 ,$8.10 ,$225.70 ,$225.70 ,$8.10 ,$163.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$133.00 ,$86.45 ,$18.33 ,$133.00 ,$63.68 ,$99.09 ,$87.12 ,$25.47 ,$37.24 ,$67.17 ,$25.47 ,$82.06 ,$25.47 ,$82.06 ,$82.06 ,$25.47 ,$82.06 ,$48.39 ,$119.70 ,$99.75 ,$63.68 ,$25.47 ,$117.04 ,$25.47 ,$99.75 ,$99.75 ,$113.05 ,$113.05 ,$25.47 ,$113.05 ,$25.47 ,$103.74 ,$103.74 ,$103.74 ,$119.70 ,$63.68 ,$119.70 ,$25.47 ,$133.00 ,$87.12 ,$25.47 ,$55.33 ,$19.21 ,$18.33 ,$26.74 ,$119.70 ,$57.31 ,$82.06 ,$37.24 ,$119.70 ,$25.47 ,$119.70 ,$119.70 ,$25.47 ,$86.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$192.00 ,$124.80 ,$18.33 ,$192.00 ,$64.53 ,$143.04 ,$125.76 ,$25.81 ,$53.76 ,$96.96 ,$25.81 ,$118.46 ,$25.81 ,$118.46 ,$118.46 ,$25.81 ,$118.46 ,$49.04 ,$172.80 ,$144.00 ,$64.53 ,$25.81 ,$168.96 ,$25.81 ,$144.00 ,$144.00 ,$163.20 ,$163.20 ,$25.81 ,$163.20 ,$25.81 ,$149.76 ,$149.76 ,$149.76 ,$172.80 ,$64.53 ,$172.80 ,$25.81 ,$192.00 ,$125.76 ,$25.81 ,$79.87 ,$19.21 ,$18.33 ,$27.10 ,$172.80 ,$58.07 ,$118.46 ,$53.76 ,$172.80 ,$25.81 ,$172.80 ,$172.80 ,$25.81 ,$124.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101408,84425,HC VITAMIN B1-90,301,1 ,$150.00 ,$97.50 ,$7.83 ,$150.00 ,$53.08 ,$111.75 ,$98.25 ,$21.23 ,$42.00 ,$75.75 ,$21.23 ,$92.55 ,$21.23 ,$92.55 ,$92.55 ,$21.23 ,$92.55 ,$40.34 ,$135.00 ,$112.50 ,$53.08 ,$21.23 ,$132.00 ,$21.23 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$21.23 ,$127.50 ,$21.23 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$53.08 ,$135.00 ,$21.23 ,$150.00 ,$98.25 ,$21.23 ,$62.40 ,$8.21 ,$7.83 ,$22.29 ,$135.00 ,$47.77 ,$92.55 ,$42.00 ,$135.00 ,$21.23 ,$135.00 ,$135.00 ,$21.23 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101410,84432,HC THYROGLOBULIN-90,301,1 ,$75.00 ,$48.75 ,$16.06 ,$75.00 ,$40.15 ,$55.88 ,$49.13 ,$16.06 ,$21.00 ,$37.88 ,$16.06 ,$46.28 ,$16.06 ,$46.28 ,$46.28 ,$16.06 ,$46.28 ,$30.51 ,$67.50 ,$56.25 ,$40.15 ,$16.06 ,$66.00 ,$16.06 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$16.06 ,$63.75 ,$16.06 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$40.15 ,$67.50 ,$16.06 ,$75.00 ,$49.13 ,$16.06 ,$31.20 ,$19.21 ,$18.33 ,$16.86 ,$67.50 ,$36.14 ,$46.28 ,$21.00 ,$67.50 ,$16.06 ,$67.50 ,$67.50 ,$16.06 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101413,84439,HC T4 FREE-90,301,1 ,$24.00 ,$15.60 ,$6.72 ,$24.00 ,$22.55 ,$17.88 ,$15.72 ,$9.02 ,$6.72 ,$12.12 ,$9.02 ,$14.81 ,$9.02 ,$14.81 ,$14.81 ,$9.02 ,$14.81 ,$17.14 ,$21.60 ,$18.00 ,$22.55 ,$9.02 ,$21.12 ,$9.02 ,$18.00 ,$18.00 ,$20.40 ,$20.40 ,$9.02 ,$20.40 ,$9.02 ,$18.72 ,$18.72 ,$18.72 ,$21.60 ,$22.55 ,$21.60 ,$9.02 ,$24.00 ,$15.72 ,$9.02 ,$9.98 ,$11.04 ,$10.54 ,$9.47 ,$21.60 ,$20.30 ,$14.81 ,$6.72 ,$21.60 ,$9.02 ,$21.60 ,$21.60 ,$9.02 ,$15.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$361.00 ,$234.65 ,$18.33 ,$361.00 ,$127.15 ,$268.95 ,$236.46 ,$50.86 ,$101.08 ,$182.31 ,$50.86 ,$222.74 ,$50.86 ,$222.74 ,$222.74 ,$50.86 ,$222.74 ,$96.63 ,$324.90 ,$270.75 ,$127.15 ,$50.86 ,$317.68 ,$50.86 ,$270.75 ,$270.75 ,$306.85 ,$306.85 ,$50.86 ,$306.85 ,$50.86 ,$281.58 ,$281.58 ,$281.58 ,$324.90 ,$127.15 ,$324.90 ,$50.86 ,$361.00 ,$236.46 ,$50.86 ,$150.18 ,$19.21 ,$18.33 ,$53.40 ,$324.90 ,$114.44 ,$222.74 ,$101.08 ,$324.90 ,$50.86 ,$324.90 ,$324.90 ,$50.86 ,$234.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101418,84446,HC VITAMIN E-90,301,1 ,$101.00 ,$65.65 ,$7.83 ,$101.00 ,$35.45 ,$75.25 ,$66.16 ,$14.18 ,$28.28 ,$51.01 ,$14.18 ,$62.32 ,$14.18 ,$62.32 ,$62.32 ,$14.18 ,$62.32 ,$26.94 ,$90.90 ,$75.75 ,$35.45 ,$14.18 ,$88.88 ,$14.18 ,$75.75 ,$75.75 ,$85.85 ,$85.85 ,$14.18 ,$85.85 ,$14.18 ,$78.78 ,$78.78 ,$78.78 ,$90.90 ,$35.45 ,$90.90 ,$14.18 ,$101.00 ,$66.16 ,$14.18 ,$42.02 ,$8.21 ,$7.83 ,$14.89 ,$90.90 ,$31.91 ,$62.32 ,$28.28 ,$90.90 ,$14.18 ,$90.90 ,$90.90 ,$14.18 ,$65.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101419,84460,HC ALT-90,301,1 ,$4.72 ,$3.07 ,$1.32 ,$10.62 ,$4.72 ,$3.52 ,$3.09 ,$4.72 ,$1.32 ,$2.38 ,$4.72 ,$2.91 ,$4.72 ,$2.91 ,$2.91 ,$4.72 ,$2.91 ,$8.97 ,$4.25 ,$3.54 ,$4.72 ,$4.72 ,$4.15 ,$4.72 ,$3.54 ,$3.54 ,$4.01 ,$4.01 ,$4.72 ,$4.01 ,$4.72 ,$3.68 ,$3.68 ,$3.68 ,$4.25 ,$4.72 ,$4.25 ,$4.72 ,$4.72 ,$3.09 ,$4.72 ,$1.96 ,$3.65 ,$3.49 ,$4.72 ,$4.25 ,$10.62 ,$2.91 ,$1.32 ,$4.25 ,$4.72 ,$4.25 ,$4.25 ,$4.72 ,$3.07 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101422,84479,HC T3 UPTAKE-90,301,1 ,$125.00 ,$81.25 ,$6.47 ,$125.00 ,$16.18 ,$93.13 ,$81.88 ,$6.47 ,$35.00 ,$63.13 ,$6.47 ,$77.13 ,$6.47 ,$77.13 ,$77.13 ,$6.47 ,$77.13 ,$12.29 ,$112.50 ,$93.75 ,$16.18 ,$6.47 ,$110.00 ,$6.47 ,$93.75 ,$93.75 ,$106.25 ,$106.25 ,$6.47 ,$106.25 ,$6.47 ,$97.50 ,$97.50 ,$97.50 ,$112.50 ,$16.18 ,$112.50 ,$6.47 ,$125.00 ,$81.88 ,$6.47 ,$52.00 ,$11.04 ,$10.54 ,$6.79 ,$112.50 ,$14.56 ,$77.13 ,$35.00 ,$112.50 ,$6.47 ,$112.50 ,$112.50 ,$6.47 ,$81.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101425,84482,HC T3 REVERSE-90,301,1 ,$112.00 ,$72.80 ,$10.54 ,$112.00 ,$39.40 ,$83.44 ,$73.36 ,$15.76 ,$31.36 ,$56.56 ,$15.76 ,$69.10 ,$15.76 ,$69.10 ,$69.10 ,$15.76 ,$69.10 ,$29.94 ,$100.80 ,$84.00 ,$39.40 ,$15.76 ,$98.56 ,$15.76 ,$84.00 ,$84.00 ,$95.20 ,$95.20 ,$15.76 ,$95.20 ,$15.76 ,$87.36 ,$87.36 ,$87.36 ,$100.80 ,$39.40 ,$100.80 ,$15.76 ,$112.00 ,$73.36 ,$15.76 ,$46.59 ,$11.04 ,$10.54 ,$16.55 ,$100.80 ,$35.46 ,$69.10 ,$31.36 ,$100.80 ,$15.76 ,$100.80 ,$100.80 ,$15.76 ,$72.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101429,84510,HC TYROSINE-90,301,1 ,$162.00 ,$105.30 ,$7.83 ,$162.00 ,$26.58 ,$120.69 ,$106.11 ,$10.63 ,$45.36 ,$81.81 ,$10.63 ,$99.95 ,$10.63 ,$99.95 ,$99.95 ,$10.63 ,$99.95 ,$20.20 ,$145.80 ,$121.50 ,$26.58 ,$10.63 ,$142.56 ,$10.63 ,$121.50 ,$121.50 ,$137.70 ,$137.70 ,$10.63 ,$137.70 ,$10.63 ,$126.36 ,$126.36 ,$126.36 ,$145.80 ,$26.58 ,$145.80 ,$10.63 ,$162.00 ,$106.11 ,$10.63 ,$67.39 ,$8.21 ,$7.83 ,$11.16 ,$145.80 ,$23.92 ,$99.95 ,$45.36 ,$145.80 ,$10.63 ,$145.80 ,$145.80 ,$10.63 ,$105.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$11.00 ,$7.15 ,$3.08 ,$11.43 ,$11.00 ,$8.20 ,$7.21 ,$5.08 ,$3.08 ,$5.56 ,$5.08 ,$6.79 ,$5.08 ,$6.79 ,$6.79 ,$5.08 ,$6.79 ,$9.65 ,$9.90 ,$8.25 ,$11.00 ,$5.08 ,$9.68 ,$5.08 ,$8.25 ,$8.25 ,$9.35 ,$9.35 ,$5.08 ,$9.35 ,$5.08 ,$8.58 ,$8.58 ,$8.58 ,$9.90 ,$11.00 ,$9.90 ,$5.08 ,$11.00 ,$7.21 ,$5.08 ,$4.58 ,$3.65 ,$3.49 ,$5.33 ,$9.90 ,$11.43 ,$6.79 ,$3.08 ,$9.90 ,$5.08 ,$9.90 ,$9.90 ,$5.08 ,$7.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$221.00 ,$143.65 ,$15.50 ,$221.00 ,$38.75 ,$164.65 ,$144.76 ,$15.50 ,$61.88 ,$111.61 ,$15.50 ,$136.36 ,$15.50 ,$136.36 ,$136.36 ,$15.50 ,$136.36 ,$29.45 ,$198.90 ,$165.75 ,$38.75 ,$15.50 ,$194.48 ,$15.50 ,$165.75 ,$165.75 ,$187.85 ,$187.85 ,$15.50 ,$187.85 ,$15.50 ,$172.38 ,$172.38 ,$172.38 ,$198.90 ,$38.75 ,$198.90 ,$15.50 ,$221.00 ,$144.76 ,$15.50 ,$91.94 ,$19.21 ,$18.33 ,$16.28 ,$198.90 ,$34.88 ,$136.36 ,$61.88 ,$198.90 ,$15.50 ,$198.90 ,$198.90 ,$15.50 ,$143.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101436,84586,HC VASOACTIVE INTEST PEPTIDE-90,301,1 ,$199.00 ,$129.35 ,$18.33 ,$199.00 ,$88.33 ,$148.26 ,$130.35 ,$35.33 ,$55.72 ,$100.50 ,$35.33 ,$122.78 ,$35.33 ,$122.78 ,$122.78 ,$35.33 ,$122.78 ,$67.13 ,$179.10 ,$149.25 ,$88.33 ,$35.33 ,$175.12 ,$35.33 ,$149.25 ,$149.25 ,$169.15 ,$169.15 ,$35.33 ,$169.15 ,$35.33 ,$155.22 ,$155.22 ,$155.22 ,$179.10 ,$88.33 ,$179.10 ,$35.33 ,$199.00 ,$130.35 ,$35.33 ,$82.78 ,$19.21 ,$18.33 ,$37.10 ,$179.10 ,$79.49 ,$122.78 ,$55.72 ,$179.10 ,$35.33 ,$179.10 ,$179.10 ,$35.33 ,$129.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101437,84588,HC VASOPRESSIN (ADH)-90,301,1 ,$145.00 ,$94.25 ,$18.33 ,$145.00 ,$84.85 ,$108.03 ,$94.98 ,$33.94 ,$40.60 ,$73.23 ,$33.94 ,$89.47 ,$33.94 ,$89.47 ,$89.47 ,$33.94 ,$89.47 ,$64.49 ,$130.50 ,$108.75 ,$84.85 ,$33.94 ,$127.60 ,$33.94 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$33.94 ,$123.25 ,$33.94 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$84.85 ,$130.50 ,$33.94 ,$145.00 ,$94.98 ,$33.94 ,$60.32 ,$19.21 ,$18.33 ,$35.64 ,$130.50 ,$76.37 ,$89.47 ,$40.60 ,$130.50 ,$33.94 ,$130.50 ,$130.50 ,$33.94 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101438,84590,HC VITAMIN A-90,301,1 ,$83.00 ,$53.95 ,$7.83 ,$83.00 ,$29.03 ,$61.84 ,$54.37 ,$11.61 ,$23.24 ,$41.92 ,$11.61 ,$51.21 ,$11.61 ,$51.21 ,$51.21 ,$11.61 ,$51.21 ,$22.06 ,$74.70 ,$62.25 ,$29.03 ,$11.61 ,$73.04 ,$11.61 ,$62.25 ,$62.25 ,$70.55 ,$70.55 ,$11.61 ,$70.55 ,$11.61 ,$64.74 ,$64.74 ,$64.74 ,$74.70 ,$29.03 ,$74.70 ,$11.61 ,$83.00 ,$54.37 ,$11.61 ,$34.53 ,$8.21 ,$7.83 ,$12.19 ,$74.70 ,$26.12 ,$51.21 ,$23.24 ,$74.70 ,$11.61 ,$74.70 ,$74.70 ,$11.61 ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101440,84597,HC VITAMIN K-90,301,1 ,$104.00 ,$67.60 ,$7.83 ,$104.00 ,$34.30 ,$77.48 ,$68.12 ,$13.72 ,$29.12 ,$52.52 ,$13.72 ,$64.17 ,$13.72 ,$64.17 ,$64.17 ,$13.72 ,$64.17 ,$26.07 ,$93.60 ,$78.00 ,$34.30 ,$13.72 ,$91.52 ,$13.72 ,$78.00 ,$78.00 ,$88.40 ,$88.40 ,$13.72 ,$88.40 ,$13.72 ,$81.12 ,$81.12 ,$81.12 ,$93.60 ,$34.30 ,$93.60 ,$13.72 ,$104.00 ,$68.12 ,$13.72 ,$43.26 ,$8.21 ,$7.83 ,$14.41 ,$93.60 ,$30.87 ,$64.17 ,$29.12 ,$93.60 ,$13.72 ,$93.60 ,$93.60 ,$13.72 ,$67.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101442,84630,HC ZINC-90,301,1 ,$118.00 ,$76.70 ,$9.56 ,$118.00 ,$28.48 ,$87.91 ,$77.29 ,$11.39 ,$33.04 ,$59.59 ,$11.39 ,$72.81 ,$11.39 ,$72.81 ,$72.81 ,$11.39 ,$72.81 ,$21.64 ,$106.20 ,$88.50 ,$28.48 ,$11.39 ,$103.84 ,$11.39 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$11.39 ,$100.30 ,$11.39 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$28.48 ,$106.20 ,$11.39 ,$118.00 ,$77.29 ,$11.39 ,$49.09 ,$10.01 ,$9.56 ,$11.96 ,$106.20 ,$25.63 ,$72.81 ,$33.04 ,$106.20 ,$11.39 ,$106.20 ,$106.20 ,$11.39 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101443,84681,HC C PEPTIDE-90,301,1 ,$202.00 ,$131.30 ,$7.83 ,$202.00 ,$52.03 ,$150.49 ,$132.31 ,$20.81 ,$56.56 ,$102.01 ,$20.81 ,$124.63 ,$20.81 ,$124.63 ,$124.63 ,$20.81 ,$124.63 ,$39.54 ,$181.80 ,$151.50 ,$52.03 ,$20.81 ,$177.76 ,$20.81 ,$151.50 ,$151.50 ,$171.70 ,$171.70 ,$20.81 ,$171.70 ,$20.81 ,$157.56 ,$157.56 ,$157.56 ,$181.80 ,$52.03 ,$181.80 ,$20.81 ,$202.00 ,$132.31 ,$20.81 ,$84.03 ,$8.21 ,$7.83 ,$21.85 ,$181.80 ,$46.82 ,$124.63 ,$56.56 ,$181.80 ,$20.81 ,$181.80 ,$181.80 ,$20.81 ,$131.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101444,84702,HC HCG QN-90,301,1 ,$317.00 ,$206.05 ,$10.54 ,$317.00 ,$37.63 ,$236.17 ,$207.64 ,$15.05 ,$88.76 ,$160.09 ,$15.05 ,$195.59 ,$15.05 ,$195.59 ,$195.59 ,$15.05 ,$195.59 ,$28.60 ,$285.30 ,$237.75 ,$37.63 ,$15.05 ,$278.96 ,$15.05 ,$237.75 ,$237.75 ,$269.45 ,$269.45 ,$15.05 ,$269.45 ,$15.05 ,$247.26 ,$247.26 ,$247.26 ,$285.30 ,$37.63 ,$285.30 ,$15.05 ,$317.00 ,$207.64 ,$15.05 ,$131.87 ,$11.04 ,$10.54 ,$15.80 ,$285.30 ,$33.86 ,$195.59 ,$88.76 ,$285.30 ,$15.05 ,$285.30 ,$285.30 ,$15.05 ,$206.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101455,G0480,HC DRUG SCRN DEFNT 1-7 CLS T1-90,301,1 ,$240.00 ,$156.00 ,$21.08 ,$257.47 ,$240.00 ,$178.80 ,$157.20 ,$114.43 ,$67.20 ,$121.20 ,$114.43 ,$148.08 ,$114.43 ,$148.08 ,$148.08 ,$114.43 ,$148.08 ,$217.42 ,$216.00 ,$180.00 ,$240.00 ,$114.43 ,$211.20 ,$114.43 ,$180.00 ,$180.00 ,$204.00 ,$204.00 ,$114.43 ,$204.00 ,$114.43 ,$187.20 ,$187.20 ,$187.20 ,$216.00 ,$240.00 ,$216.00 ,$114.43 ,$240.00 ,$157.20 ,$114.43 ,$99.84 ,$22.09 ,$21.08 ,$120.15 ,$216.00 ,$257.47 ,$148.08 ,$67.20 ,$216.00 ,$114.43 ,$216.00 ,$216.00 ,$114.43 ,$156.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101465,83921,HC ORGANIC ACIDS QN SINGLE-90,301,1 ,$162.00 ,$105.30 ,$7.83 ,$162.00 ,$53.03 ,$120.69 ,$106.11 ,$21.21 ,$45.36 ,$81.81 ,$21.21 ,$99.95 ,$21.21 ,$99.95 ,$99.95 ,$21.21 ,$99.95 ,$40.30 ,$145.80 ,$121.50 ,$53.03 ,$21.21 ,$142.56 ,$21.21 ,$121.50 ,$121.50 ,$137.70 ,$137.70 ,$21.21 ,$137.70 ,$21.21 ,$126.36 ,$126.36 ,$126.36 ,$145.80 ,$53.03 ,$145.80 ,$21.21 ,$162.00 ,$106.11 ,$21.21 ,$67.39 ,$8.21 ,$7.83 ,$22.27 ,$145.80 ,$47.72 ,$99.95 ,$45.36 ,$145.80 ,$21.21 ,$145.80 ,$145.80 ,$21.21 ,$105.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101473,80339,HC ANTIEPILIPTICS NOS 1-3 -90,301,1 ,$137.00 ,$89.05 ,$21.08 ,$137.00 , N/A ,$102.07 ,$89.74 , N/A ,$38.36 ,$69.19 , N/A ,$84.53 , N/A ,$84.53 ,$84.53 , N/A ,$84.53 , N/A ,$123.30 ,$102.75 , N/A , N/A ,$120.56 , N/A ,$102.75 ,$102.75 ,$116.45 ,$116.45 , N/A ,$116.45 , N/A ,$106.86 ,$106.86 ,$106.86 ,$123.30 , N/A ,$123.30 , N/A ,$137.00 ,$89.74 , N/A ,$56.99 ,$22.09 ,$21.08 , N/A ,$123.30 , N/A ,$84.53 ,$38.36 ,$123.30 , N/A ,$123.30 ,$123.30 , N/A ,$89.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101474,80360,HC METHYLPHENIDATE -90,301,1 ,$56.00 ,$36.40 ,$7.83 ,$56.00 , N/A ,$41.72 ,$36.68 , N/A ,$15.68 ,$28.28 , N/A ,$34.55 , N/A ,$34.55 ,$34.55 , N/A ,$34.55 , N/A ,$50.40 ,$42.00 , N/A , N/A ,$49.28 , N/A ,$42.00 ,$42.00 ,$47.60 ,$47.60 , N/A ,$47.60 , N/A ,$43.68 ,$43.68 ,$43.68 ,$50.40 , N/A ,$50.40 , N/A ,$56.00 ,$36.68 , N/A ,$23.30 ,$8.21 ,$7.83 , N/A ,$50.40 , N/A ,$34.55 ,$15.68 ,$50.40 , N/A ,$50.40 ,$50.40 , N/A ,$36.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101476,82610,HC CYSTATIN C -90,301,1 ,$107.00 ,$69.55 ,$7.83 ,$107.00 ,$46.30 ,$79.72 ,$70.09 ,$18.52 ,$29.96 ,$54.04 ,$18.52 ,$66.02 ,$18.52 ,$66.02 ,$66.02 ,$18.52 ,$66.02 ,$35.19 ,$96.30 ,$80.25 ,$46.30 ,$18.52 ,$94.16 ,$18.52 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$18.52 ,$90.95 ,$18.52 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$46.30 ,$96.30 ,$18.52 ,$107.00 ,$70.09 ,$18.52 ,$44.51 ,$8.21 ,$7.83 ,$19.45 ,$96.30 ,$41.67 ,$66.02 ,$29.96 ,$96.30 ,$18.52 ,$96.30 ,$96.30 ,$18.52 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101477,83519,HC QN RIA MUSK-90,301,1 ,"$2,291.00 ","$1,489.15 ",$7.01 ,"$2,291.00 ",$46.00 ,"$1,706.80 ","$1,500.61 ",$18.40 ,$641.48 ,"$1,156.96 ",$18.40 ,"$1,413.55 ",$18.40 ,"$1,413.55 ","$1,413.55 ",$18.40 ,"$1,413.55 ",$34.96 ,"$2,061.90 ","$1,718.25 ",$46.00 ,$18.40 ,"$2,016.08 ",$18.40 ,"$1,718.25 ","$1,718.25 ","$1,947.35 ","$1,947.35 ",$18.40 ,"$1,947.35 ",$18.40 ,"$1,786.98 ","$1,786.98 ","$1,786.98 ","$2,061.90 ",$46.00 ,"$2,061.90 ",$18.40 ,"$2,291.00 ","$1,500.61 ",$18.40 ,$953.06 ,$7.35 ,$7.01 ,$19.32 ,"$2,061.90 ",$41.40 ,"$1,413.55 ",$641.48 ,"$2,061.90 ",$18.40 ,"$2,061.90 ","$2,061.90 ",$18.40 ,"$1,489.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101479,82803,HC BLOOD GAS PH PO2  AND /OR PCO2,301,1 ,$298.00 ,$193.70 ,$7.83 ,$298.00 ,$65.18 ,$222.01 ,$195.19 ,$26.07 ,$83.44 ,$150.49 ,$26.07 ,$183.87 ,$26.07 ,$183.87 ,$183.87 ,$26.07 ,$183.87 ,$49.53 ,$268.20 ,$223.50 ,$65.18 ,$26.07 ,$262.24 ,$26.07 ,$223.50 ,$223.50 ,$253.30 ,$253.30 ,$26.07 ,$253.30 ,$26.07 ,$232.44 ,$232.44 ,$232.44 ,$268.20 ,$65.18 ,$268.20 ,$26.07 ,$298.00 ,$195.19 ,$26.07 ,$123.97 ,$8.21 ,$7.83 ,$27.37 ,$268.20 ,$58.66 ,$183.87 ,$83.44 ,$268.20 ,$26.07 ,$268.20 ,$268.20 ,$26.07 ,$193.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101480,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$406.00 ,$263.90 ,$7.83 ,$406.00 ,$196.93 ,$302.47 ,$265.93 ,$78.77 ,$113.68 ,$205.03 ,$78.77 ,$250.50 ,$78.77 ,$250.50 ,$250.50 ,$78.77 ,$250.50 ,$149.66 ,$365.40 ,$304.50 ,$196.93 ,$78.77 ,$357.28 ,$78.77 ,$304.50 ,$304.50 ,$345.10 ,$345.10 ,$78.77 ,$345.10 ,$78.77 ,$316.68 ,$316.68 ,$316.68 ,$365.40 ,$196.93 ,$365.40 ,$78.77 ,$406.00 ,$265.93 ,$78.77 ,$168.90 ,$8.21 ,$7.83 ,$82.71 ,$365.40 ,$177.23 ,$250.50 ,$113.68 ,$365.40 ,$78.77 ,$365.40 ,$365.40 ,$78.77 ,$263.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101496,82679,HC ESTRONE/ESTROGEN -90,301,1 ,$297.58 ,$193.43 ,$18.33 ,$297.58 ,$62.38 ,$221.70 ,$194.91 ,$24.95 ,$83.32 ,$150.28 ,$24.95 ,$183.61 ,$24.95 ,$183.61 ,$183.61 ,$24.95 ,$183.61 ,$47.41 ,$267.82 ,$223.19 ,$62.38 ,$24.95 ,$261.87 ,$24.95 ,$223.19 ,$223.19 ,$252.94 ,$252.94 ,$24.95 ,$252.94 ,$24.95 ,$232.11 ,$232.11 ,$232.11 ,$267.82 ,$62.38 ,$267.82 ,$24.95 ,$297.58 ,$194.91 ,$24.95 ,$123.79 ,$19.21 ,$18.33 ,$26.20 ,$267.82 ,$56.14 ,$183.61 ,$83.32 ,$267.82 ,$24.95 ,$267.82 ,$267.82 ,$24.95 ,$193.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101498,80354,HC FENTANYL -90,301,1 ,$47.00 ,$30.55 ,$7.83 ,$47.00 , N/A ,$35.02 ,$30.79 , N/A ,$13.16 ,$23.74 , N/A ,$29.00 , N/A ,$29.00 ,$29.00 , N/A ,$29.00 , N/A ,$42.30 ,$35.25 , N/A , N/A ,$41.36 , N/A ,$35.25 ,$35.25 ,$39.95 ,$39.95 , N/A ,$39.95 , N/A ,$36.66 ,$36.66 ,$36.66 ,$42.30 , N/A ,$42.30 , N/A ,$47.00 ,$30.79 , N/A ,$19.55 ,$8.21 ,$7.83 , N/A ,$42.30 , N/A ,$29.00 ,$13.16 ,$42.30 , N/A ,$42.30 ,$42.30 , N/A ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101500,82943,HC GLUCAGON-90,301,1 ,$89.00 ,$57.85 ,$14.29 ,$89.00 ,$35.73 ,$66.31 ,$58.30 ,$14.29 ,$24.92 ,$44.95 ,$14.29 ,$54.91 ,$14.29 ,$54.91 ,$54.91 ,$14.29 ,$54.91 ,$27.15 ,$80.10 ,$66.75 ,$35.73 ,$14.29 ,$78.32 ,$14.29 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$14.29 ,$75.65 ,$14.29 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$35.73 ,$80.10 ,$14.29 ,$89.00 ,$58.30 ,$14.29 ,$37.02 ,$19.21 ,$18.33 ,$15.00 ,$80.10 ,$32.15 ,$54.91 ,$24.92 ,$80.10 ,$14.29 ,$80.10 ,$80.10 ,$14.29 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101509,82330,HC CALCIUM IONIZED STAT -90,301,1 ,$25.00 ,$16.25 ,$7.00 ,$30.78 ,$25.00 ,$18.63 ,$16.38 ,$13.68 ,$7.00 ,$12.63 ,$13.68 ,$15.43 ,$13.68 ,$15.43 ,$15.43 ,$13.68 ,$15.43 ,$25.99 ,$22.50 ,$18.75 ,$25.00 ,$13.68 ,$22.00 ,$13.68 ,$18.75 ,$18.75 ,$21.25 ,$21.25 ,$13.68 ,$21.25 ,$13.68 ,$19.50 ,$19.50 ,$19.50 ,$22.50 ,$25.00 ,$22.50 ,$13.68 ,$25.00 ,$16.38 ,$13.68 ,$10.40 ,$8.21 ,$7.83 ,$14.36 ,$22.50 ,$30.78 ,$15.43 ,$7.00 ,$22.50 ,$13.68 ,$22.50 ,$22.50 ,$13.68 ,$16.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101511,80345,HC BARBITURATE -90,301,1 ,$229.00 ,$148.85 ,$7.83 ,$229.00 , N/A ,$170.61 ,$150.00 , N/A ,$64.12 ,$115.65 , N/A ,$141.29 , N/A ,$141.29 ,$141.29 , N/A ,$141.29 , N/A ,$206.10 ,$171.75 , N/A , N/A ,$201.52 , N/A ,$171.75 ,$171.75 ,$194.65 ,$194.65 , N/A ,$194.65 , N/A ,$178.62 ,$178.62 ,$178.62 ,$206.10 , N/A ,$206.10 , N/A ,$229.00 ,$150.00 , N/A ,$95.26 ,$8.21 ,$7.83 , N/A ,$206.10 , N/A ,$141.29 ,$64.12 ,$206.10 , N/A ,$206.10 ,$206.10 , N/A ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101512,80324,HC AMPHETAMINE 1-2 -90,301,1 ,$229.00 ,$148.85 ,$21.08 ,$229.00 , N/A ,$170.61 ,$150.00 , N/A ,$64.12 ,$115.65 , N/A ,$141.29 , N/A ,$141.29 ,$141.29 , N/A ,$141.29 , N/A ,$206.10 ,$171.75 , N/A , N/A ,$201.52 , N/A ,$171.75 ,$171.75 ,$194.65 ,$194.65 , N/A ,$194.65 , N/A ,$178.62 ,$178.62 ,$178.62 ,$206.10 , N/A ,$206.10 , N/A ,$229.00 ,$150.00 , N/A ,$95.26 ,$22.09 ,$21.08 , N/A ,$206.10 , N/A ,$141.29 ,$64.12 ,$206.10 , N/A ,$206.10 ,$206.10 , N/A ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101513,80365,HC OXYCODONE -90,301,1 ,$252.00 ,$163.80 ,$7.83 ,$252.00 , N/A ,$187.74 ,$165.06 , N/A ,$70.56 ,$127.26 , N/A ,$155.48 , N/A ,$155.48 ,$155.48 , N/A ,$155.48 , N/A ,$226.80 ,$189.00 , N/A , N/A ,$221.76 , N/A ,$189.00 ,$189.00 ,$214.20 ,$214.20 , N/A ,$214.20 , N/A ,$196.56 ,$196.56 ,$196.56 ,$226.80 , N/A ,$226.80 , N/A ,$252.00 ,$165.06 , N/A ,$104.83 ,$8.21 ,$7.83 , N/A ,$226.80 , N/A ,$155.48 ,$70.56 ,$226.80 , N/A ,$226.80 ,$226.80 , N/A ,$163.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101520,80356,HC HEROIN METABOLITE-90,301,1 ,$229.00 ,$148.85 ,$7.83 ,$229.00 , N/A ,$170.61 ,$150.00 , N/A ,$64.12 ,$115.65 , N/A ,$141.29 , N/A ,$141.29 ,$141.29 , N/A ,$141.29 , N/A ,$206.10 ,$171.75 , N/A , N/A ,$201.52 , N/A ,$171.75 ,$171.75 ,$194.65 ,$194.65 , N/A ,$194.65 , N/A ,$178.62 ,$178.62 ,$178.62 ,$206.10 , N/A ,$206.10 , N/A ,$229.00 ,$150.00 , N/A ,$95.26 ,$8.21 ,$7.83 , N/A ,$206.10 , N/A ,$141.29 ,$64.12 ,$206.10 , N/A ,$206.10 ,$206.10 , N/A ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101529,82725,HC FATTY ACIDS NONESTERIFIED-90,301,1 ,$24.00 ,$15.60 ,$6.72 ,$42.23 ,$24.00 ,$17.88 ,$15.72 ,$18.77 ,$6.72 ,$12.12 ,$18.77 ,$14.81 ,$18.77 ,$14.81 ,$14.81 ,$18.77 ,$14.81 ,$35.66 ,$21.60 ,$18.00 ,$24.00 ,$18.77 ,$21.12 ,$18.77 ,$18.00 ,$18.00 ,$20.40 ,$20.40 ,$18.77 ,$20.40 ,$18.77 ,$18.72 ,$18.72 ,$18.72 ,$21.60 ,$24.00 ,$21.60 ,$18.77 ,$24.00 ,$15.72 ,$18.77 ,$9.98 ,$8.21 ,$7.83 ,$19.71 ,$21.60 ,$42.23 ,$14.81 ,$6.72 ,$21.60 ,$18.77 ,$21.60 ,$21.60 ,$18.77 ,$15.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101534,80377,HC PANEL HYPOGLYCEMIC QL-90,301,1 ,$315.00 ,$204.75 ,$21.08 ,$315.00 , N/A ,$234.68 ,$206.33 , N/A ,$88.20 ,$159.08 , N/A ,$194.36 , N/A ,$194.36 ,$194.36 , N/A ,$194.36 , N/A ,$283.50 ,$236.25 , N/A , N/A ,$277.20 , N/A ,$236.25 ,$236.25 ,$267.75 ,$267.75 , N/A ,$267.75 , N/A ,$245.70 ,$245.70 ,$245.70 ,$283.50 , N/A ,$283.50 , N/A ,$315.00 ,$206.33 , N/A ,$131.04 ,$22.09 ,$21.08 , N/A ,$283.50 , N/A ,$194.36 ,$88.20 ,$283.50 , N/A ,$283.50 ,$283.50 , N/A ,$204.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101536,84443,HC THYROID STIMULATING HORM-90,301,1 ,$362.40 ,$235.56 ,$10.54 ,$362.40 ,$42.00 ,$269.99 ,$237.37 ,$16.80 ,$101.47 ,$183.01 ,$16.80 ,$223.60 ,$16.80 ,$223.60 ,$223.60 ,$16.80 ,$223.60 ,$31.92 ,$326.16 ,$271.80 ,$42.00 ,$16.80 ,$318.91 ,$16.80 ,$271.80 ,$271.80 ,$308.04 ,$308.04 ,$16.80 ,$308.04 ,$16.80 ,$282.67 ,$282.67 ,$282.67 ,$326.16 ,$42.00 ,$326.16 ,$16.80 ,$362.40 ,$237.37 ,$16.80 ,$150.76 ,$11.04 ,$10.54 ,$17.64 ,$326.16 ,$37.80 ,$223.60 ,$101.47 ,$326.16 ,$16.80 ,$326.16 ,$326.16 ,$16.80 ,$235.56 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101542,80047,HC BASIC METABOLIC PANEL IONIZED CALCIUM,301,1 ,$204.00 ,$132.60 ,$7.14 ,$204.00 ,$34.33 ,$151.98 ,$133.62 ,$13.73 ,$57.12 ,$103.02 ,$13.73 ,$125.87 ,$13.73 ,$125.87 ,$125.87 ,$13.73 ,$125.87 ,$26.09 ,$183.60 ,$153.00 ,$34.33 ,$13.73 ,$179.52 ,$13.73 ,$153.00 ,$153.00 ,$173.40 ,$173.40 ,$13.73 ,$173.40 ,$13.73 ,$159.12 ,$159.12 ,$159.12 ,$183.60 ,$34.33 ,$183.60 ,$13.73 ,$204.00 ,$133.62 ,$13.73 ,$84.86 ,$7.48 ,$7.14 ,$14.42 ,$183.60 ,$30.89 ,$125.87 ,$57.12 ,$183.60 ,$13.73 ,$183.60 ,$183.60 ,$13.73 ,$132.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101553,80299,HC THERAPEUTIC DRUG OTHER,301,1 ,$107.00 ,$69.55 ,$8.99 ,$107.00 ,$46.60 ,$79.72 ,$70.09 ,$18.64 ,$29.96 ,$54.04 ,$18.64 ,$66.02 ,$18.64 ,$66.02 ,$66.02 ,$18.64 ,$66.02 ,$35.42 ,$96.30 ,$80.25 ,$46.60 ,$18.64 ,$94.16 ,$18.64 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$18.64 ,$90.95 ,$18.64 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$46.60 ,$96.30 ,$18.64 ,$107.00 ,$70.09 ,$18.64 ,$44.51 ,$9.42 ,$8.99 ,$19.57 ,$96.30 ,$41.94 ,$66.02 ,$29.96 ,$96.30 ,$18.64 ,$96.30 ,$96.30 ,$18.64 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101554,80306,HC DRUG SCREEN PRESUMPTIVE INSTRMNT ASSIST DIR OPTICAL -90,301,1 ,$100.00 ,$65.00 ,$7.83 ,$100.00 ,$42.85 ,$74.50 ,$65.50 ,$17.14 ,$28.00 ,$50.50 ,$17.14 ,$61.70 ,$17.14 ,$61.70 ,$61.70 ,$17.14 ,$61.70 ,$32.57 ,$90.00 ,$75.00 ,$42.85 ,$17.14 ,$88.00 ,$17.14 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$17.14 ,$85.00 ,$17.14 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$42.85 ,$90.00 ,$17.14 ,$100.00 ,$65.50 ,$17.14 ,$41.60 ,$8.21 ,$7.83 ,$18.00 ,$90.00 ,$38.57 ,$61.70 ,$28.00 ,$90.00 ,$17.14 ,$90.00 ,$90.00 ,$17.14 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101555,81479,HC IDH GENE MUTATION ASSAY - 90,301,1 ,$215.00 ,$139.75 ,$27.79 ,$215.00 , N/A ,$160.18 ,$140.83 , N/A ,$60.20 ,$108.58 , N/A ,$132.66 , N/A ,$132.66 ,$132.66 , N/A ,$132.66 , N/A ,$193.50 ,$161.25 , N/A , N/A ,$189.20 , N/A ,$161.25 ,$161.25 ,$182.75 ,$182.75 , N/A ,$182.75 , N/A ,$167.70 ,$167.70 ,$167.70 ,$193.50 , N/A ,$193.50 , N/A ,$215.00 ,$140.83 , N/A ,$89.44 ,$29.12 ,$27.79 , N/A ,$193.50 , N/A ,$132.66 ,$60.20 ,$193.50 , N/A ,$193.50 ,$193.50 , N/A ,$139.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101556,82042,HC ALBUMIN OTHER SOURCE,301,1 ,$61.00 ,$39.65 ,$3.49 ,$61.00 ,$19.45 ,$45.45 ,$39.96 ,$7.78 ,$17.08 ,$30.81 ,$7.78 ,$37.64 ,$7.78 ,$37.64 ,$37.64 ,$7.78 ,$37.64 ,$14.78 ,$54.90 ,$45.75 ,$19.45 ,$7.78 ,$53.68 ,$7.78 ,$45.75 ,$45.75 ,$51.85 ,$51.85 ,$7.78 ,$51.85 ,$7.78 ,$47.58 ,$47.58 ,$47.58 ,$54.90 ,$19.45 ,$54.90 ,$7.78 ,$61.00 ,$39.96 ,$7.78 ,$25.38 ,$3.65 ,$3.49 ,$8.17 ,$54.90 ,$17.51 ,$37.64 ,$17.08 ,$54.90 ,$7.78 ,$54.90 ,$54.90 ,$7.78 ,$39.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101557,82075,HC ALCOHOL BREATH -90,301,1 ,$82.00 ,$53.30 ,$7.83 ,$82.00 ,$75.00 ,$61.09 ,$53.71 ,$30.00 ,$22.96 ,$41.41 ,$30.00 ,$50.59 ,$30.00 ,$50.59 ,$50.59 ,$30.00 ,$50.59 ,$57.00 ,$73.80 ,$61.50 ,$75.00 ,$30.00 ,$72.16 ,$30.00 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$30.00 ,$69.70 ,$30.00 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$75.00 ,$73.80 ,$30.00 ,$82.00 ,$53.71 ,$30.00 ,$34.11 ,$8.21 ,$7.83 ,$31.50 ,$73.80 ,$67.50 ,$50.59 ,$22.96 ,$73.80 ,$30.00 ,$73.80 ,$73.80 ,$30.00 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101560,82172,HC APOLIPOPROTEIN SERUM,301,1 ,$120.00 ,$78.00 ,$7.83 ,$120.00 ,$52.73 ,$89.40 ,$78.60 ,$21.09 ,$33.60 ,$60.60 ,$21.09 ,$74.04 ,$21.09 ,$74.04 ,$74.04 ,$21.09 ,$74.04 ,$40.07 ,$108.00 ,$90.00 ,$52.73 ,$21.09 ,$105.60 ,$21.09 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$21.09 ,$102.00 ,$21.09 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$52.73 ,$108.00 ,$21.09 ,$120.00 ,$78.60 ,$21.09 ,$49.92 ,$8.21 ,$7.83 ,$22.14 ,$108.00 ,$47.45 ,$74.04 ,$33.60 ,$108.00 ,$21.09 ,$108.00 ,$108.00 ,$21.09 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101561,82247,HC BILIRUBIN TOTAL,301,1 ,$107.00 ,$69.55 ,$3.49 ,$107.00 ,$12.55 ,$79.72 ,$70.09 ,$5.02 ,$29.96 ,$54.04 ,$5.02 ,$66.02 ,$5.02 ,$66.02 ,$66.02 ,$5.02 ,$66.02 ,$9.54 ,$96.30 ,$80.25 ,$12.55 ,$5.02 ,$94.16 ,$5.02 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$5.02 ,$90.95 ,$5.02 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$12.55 ,$96.30 ,$5.02 ,$107.00 ,$70.09 ,$5.02 ,$44.51 ,$3.65 ,$3.49 ,$5.27 ,$96.30 ,$11.30 ,$66.02 ,$29.96 ,$96.30 ,$5.02 ,$96.30 ,$96.30 ,$5.02 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101563,82274,HC OCCULT BLOOD FECAL HGB-QW,301,1 ,$116.00 ,$75.40 ,$7.83 ,$116.00 ,$39.80 ,$86.42 ,$75.98 ,$15.92 ,$32.48 ,$58.58 ,$15.92 ,$71.57 ,$15.92 ,$71.57 ,$71.57 ,$15.92 ,$71.57 ,$30.25 ,$104.40 ,$87.00 ,$39.80 ,$15.92 ,$102.08 ,$15.92 ,$87.00 ,$87.00 ,$98.60 ,$98.60 ,$15.92 ,$98.60 ,$15.92 ,$90.48 ,$90.48 ,$90.48 ,$104.40 ,$39.80 ,$104.40 ,$15.92 ,$116.00 ,$75.98 ,$15.92 ,$48.26 ,$8.21 ,$7.83 ,$16.72 ,$104.40 ,$35.82 ,$71.57 ,$32.48 ,$104.40 ,$15.92 ,$104.40 ,$104.40 ,$15.92 ,$75.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101570,82465,HC CHOLESTEROL,301,1 ,$63.00 ,$40.95 ,$3.49 ,$63.00 ,$10.88 ,$46.94 ,$41.27 ,$4.35 ,$17.64 ,$31.82 ,$4.35 ,$38.87 ,$4.35 ,$38.87 ,$38.87 ,$4.35 ,$38.87 ,$8.27 ,$56.70 ,$47.25 ,$10.88 ,$4.35 ,$55.44 ,$4.35 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$4.35 ,$53.55 ,$4.35 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$10.88 ,$56.70 ,$4.35 ,$63.00 ,$41.27 ,$4.35 ,$26.21 ,$3.65 ,$3.49 ,$4.57 ,$56.70 ,$9.79 ,$38.87 ,$17.64 ,$56.70 ,$4.35 ,$56.70 ,$56.70 ,$4.35 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101572,82570,HC CREATININE OTH SOURCE,301,1 ,$130.00 ,$84.50 ,$3.49 ,$130.00 ,$12.95 ,$96.85 ,$85.15 ,$5.18 ,$36.40 ,$65.65 ,$5.18 ,$80.21 ,$5.18 ,$80.21 ,$80.21 ,$5.18 ,$80.21 ,$9.84 ,$117.00 ,$97.50 ,$12.95 ,$5.18 ,$114.40 ,$5.18 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$5.18 ,$110.50 ,$5.18 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$12.95 ,$117.00 ,$5.18 ,$130.00 ,$85.15 ,$5.18 ,$54.08 ,$3.65 ,$3.49 ,$5.44 ,$117.00 ,$11.66 ,$80.21 ,$36.40 ,$117.00 ,$5.18 ,$117.00 ,$117.00 ,$5.18 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$175.00 ,$113.75 ,$7.83 ,$175.00 ,$41.15 ,$130.38 ,$114.63 ,$16.46 ,$49.00 ,$88.38 ,$16.46 ,$107.98 ,$16.46 ,$107.98 ,$107.98 ,$16.46 ,$107.98 ,$31.27 ,$157.50 ,$131.25 ,$41.15 ,$16.46 ,$154.00 ,$16.46 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$16.46 ,$148.75 ,$16.46 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$41.15 ,$157.50 ,$16.46 ,$175.00 ,$114.63 ,$16.46 ,$72.80 ,$8.21 ,$7.83 ,$17.28 ,$157.50 ,$37.04 ,$107.98 ,$49.00 ,$157.50 ,$16.46 ,$157.50 ,$157.50 ,$16.46 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101583,82960,HC G6PD SCREEN -90,301,1 ,$100.00 ,$65.00 ,$6.05 ,$100.00 ,$15.13 ,$74.50 ,$65.50 ,$6.05 ,$28.00 ,$50.50 ,$6.05 ,$61.70 ,$6.05 ,$61.70 ,$61.70 ,$6.05 ,$61.70 ,$11.50 ,$90.00 ,$75.00 ,$15.13 ,$6.05 ,$88.00 ,$6.05 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$6.05 ,$85.00 ,$6.05 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$15.13 ,$90.00 ,$6.05 ,$100.00 ,$65.50 ,$6.05 ,$41.60 ,$8.21 ,$7.83 ,$6.35 ,$90.00 ,$13.61 ,$61.70 ,$28.00 ,$90.00 ,$6.05 ,$90.00 ,$90.00 ,$6.05 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101589,83036,HC GLYCOSYLATED HGB -90,301,1 ,$97.00 ,$63.05 ,$7.83 ,$97.00 ,$24.28 ,$72.27 ,$63.54 ,$9.71 ,$27.16 ,$48.99 ,$9.71 ,$59.85 ,$9.71 ,$59.85 ,$59.85 ,$9.71 ,$59.85 ,$18.45 ,$87.30 ,$72.75 ,$24.28 ,$9.71 ,$85.36 ,$9.71 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$9.71 ,$82.45 ,$9.71 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$24.28 ,$87.30 ,$9.71 ,$97.00 ,$63.54 ,$9.71 ,$40.35 ,$8.21 ,$7.83 ,$10.20 ,$87.30 ,$21.85 ,$59.85 ,$27.16 ,$87.30 ,$9.71 ,$87.30 ,$87.30 ,$9.71 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101591,83090,HC HOMOCYSTEINE,301,1 ,$179.00 ,$116.35 ,$17.92 ,$179.00 ,$44.80 ,$133.36 ,$117.25 ,$17.92 ,$50.12 ,$90.40 ,$17.92 ,$110.44 ,$17.92 ,$110.44 ,$110.44 ,$17.92 ,$110.44 ,$34.05 ,$161.10 ,$134.25 ,$44.80 ,$17.92 ,$157.52 ,$17.92 ,$134.25 ,$134.25 ,$152.15 ,$152.15 ,$17.92 ,$152.15 ,$17.92 ,$139.62 ,$139.62 ,$139.62 ,$161.10 ,$44.80 ,$161.10 ,$17.92 ,$179.00 ,$117.25 ,$17.92 ,$74.46 ,$19.21 ,$18.33 ,$18.82 ,$161.10 ,$40.32 ,$110.44 ,$50.12 ,$161.10 ,$17.92 ,$161.10 ,$161.10 ,$17.92 ,$116.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101595,83690,HC LIPASE,301,1 ,$98.00 ,$63.70 ,$3.49 ,$98.00 ,$17.23 ,$73.01 ,$64.19 ,$6.89 ,$27.44 ,$49.49 ,$6.89 ,$60.47 ,$6.89 ,$60.47 ,$60.47 ,$6.89 ,$60.47 ,$13.09 ,$88.20 ,$73.50 ,$17.23 ,$6.89 ,$86.24 ,$6.89 ,$73.50 ,$73.50 ,$83.30 ,$83.30 ,$6.89 ,$83.30 ,$6.89 ,$76.44 ,$76.44 ,$76.44 ,$88.20 ,$17.23 ,$88.20 ,$6.89 ,$98.00 ,$64.19 ,$6.89 ,$40.77 ,$3.65 ,$3.49 ,$7.23 ,$88.20 ,$15.50 ,$60.47 ,$27.44 ,$88.20 ,$6.89 ,$88.20 ,$88.20 ,$6.89 ,$63.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101602,84105,HC PHOSPHORUS UR,301,1 ,$94.00 ,$61.10 ,$3.49 ,$94.00 ,$14.45 ,$70.03 ,$61.57 ,$5.78 ,$26.32 ,$47.47 ,$5.78 ,$58.00 ,$5.78 ,$58.00 ,$58.00 ,$5.78 ,$58.00 ,$10.98 ,$84.60 ,$70.50 ,$14.45 ,$5.78 ,$82.72 ,$5.78 ,$70.50 ,$70.50 ,$79.90 ,$79.90 ,$5.78 ,$79.90 ,$5.78 ,$73.32 ,$73.32 ,$73.32 ,$84.60 ,$14.45 ,$84.60 ,$5.78 ,$94.00 ,$61.57 ,$5.78 ,$39.10 ,$3.65 ,$3.49 ,$6.07 ,$84.60 ,$13.01 ,$58.00 ,$26.32 ,$84.60 ,$5.78 ,$84.60 ,$84.60 ,$5.78 ,$61.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101609,84153,HC PSA TOTAL,301,1 ,$306.00 ,$198.90 ,$7.83 ,$306.00 ,$45.98 ,$227.97 ,$200.43 ,$18.39 ,$85.68 ,$154.53 ,$18.39 ,$188.80 ,$18.39 ,$188.80 ,$188.80 ,$18.39 ,$188.80 ,$34.94 ,$275.40 ,$229.50 ,$45.98 ,$18.39 ,$269.28 ,$18.39 ,$229.50 ,$229.50 ,$260.10 ,$260.10 ,$18.39 ,$260.10 ,$18.39 ,$238.68 ,$238.68 ,$238.68 ,$275.40 ,$45.98 ,$275.40 ,$18.39 ,$306.00 ,$200.43 ,$18.39 ,$127.30 ,$8.21 ,$7.83 ,$19.31 ,$275.40 ,$41.38 ,$188.80 ,$85.68 ,$275.40 ,$18.39 ,$275.40 ,$275.40 ,$18.39 ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101610,84154,HC PSA FREE,301,1 ,$252.00 ,$163.80 ,$7.83 ,$252.00 ,$45.98 ,$187.74 ,$165.06 ,$18.39 ,$70.56 ,$127.26 ,$18.39 ,$155.48 ,$18.39 ,$155.48 ,$155.48 ,$18.39 ,$155.48 ,$34.94 ,$226.80 ,$189.00 ,$45.98 ,$18.39 ,$221.76 ,$18.39 ,$189.00 ,$189.00 ,$214.20 ,$214.20 ,$18.39 ,$214.20 ,$18.39 ,$196.56 ,$196.56 ,$196.56 ,$226.80 ,$45.98 ,$226.80 ,$18.39 ,$252.00 ,$165.06 ,$18.39 ,$104.83 ,$8.21 ,$7.83 ,$19.31 ,$226.80 ,$41.38 ,$155.48 ,$70.56 ,$226.80 ,$18.39 ,$226.80 ,$226.80 ,$18.39 ,$163.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101611,84155,HC PROTEIN TOTAL,301,1 ,$58.00 ,$37.70 ,$3.49 ,$58.00 ,$9.18 ,$43.21 ,$37.99 ,$3.67 ,$16.24 ,$29.29 ,$3.67 ,$35.79 ,$3.67 ,$35.79 ,$35.79 ,$3.67 ,$35.79 ,$6.97 ,$52.20 ,$43.50 ,$9.18 ,$3.67 ,$51.04 ,$3.67 ,$43.50 ,$43.50 ,$49.30 ,$49.30 ,$3.67 ,$49.30 ,$3.67 ,$45.24 ,$45.24 ,$45.24 ,$52.20 ,$9.18 ,$52.20 ,$3.67 ,$58.00 ,$37.99 ,$3.67 ,$24.13 ,$3.65 ,$3.49 ,$3.85 ,$52.20 ,$8.26 ,$35.79 ,$16.24 ,$52.20 ,$3.67 ,$52.20 ,$52.20 ,$3.67 ,$37.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101612,84156,HC PROTEIN TOTAL URINE,301,1 ,$105.00 ,$68.25 ,$3.49 ,$105.00 ,$9.18 ,$78.23 ,$68.78 ,$3.67 ,$29.40 ,$53.03 ,$3.67 ,$64.79 ,$3.67 ,$64.79 ,$64.79 ,$3.67 ,$64.79 ,$6.97 ,$94.50 ,$78.75 ,$9.18 ,$3.67 ,$92.40 ,$3.67 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$3.67 ,$89.25 ,$3.67 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$9.18 ,$94.50 ,$3.67 ,$105.00 ,$68.78 ,$3.67 ,$43.68 ,$3.65 ,$3.49 ,$3.85 ,$94.50 ,$8.26 ,$64.79 ,$29.40 ,$94.50 ,$3.67 ,$94.50 ,$94.50 ,$3.67 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101614,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$163.00 ,$105.95 ,$7.83 ,$163.00 ,$26.85 ,$121.44 ,$106.77 ,$10.74 ,$45.64 ,$82.32 ,$10.74 ,$100.57 ,$10.74 ,$100.57 ,$100.57 ,$10.74 ,$100.57 ,$20.41 ,$146.70 ,$122.25 ,$26.85 ,$10.74 ,$143.44 ,$10.74 ,$122.25 ,$122.25 ,$138.55 ,$138.55 ,$10.74 ,$138.55 ,$10.74 ,$127.14 ,$127.14 ,$127.14 ,$146.70 ,$26.85 ,$146.70 ,$10.74 ,$163.00 ,$106.77 ,$10.74 ,$67.81 ,$8.21 ,$7.83 ,$11.28 ,$146.70 ,$24.17 ,$100.57 ,$45.64 ,$146.70 ,$10.74 ,$146.70 ,$146.70 ,$10.74 ,$105.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101615,84166,HC PROTEIN EP OTH FLUID,301,1 ,$128.00 ,$83.20 ,$7.83 ,$128.00 ,$44.58 ,$95.36 ,$83.84 ,$17.83 ,$35.84 ,$64.64 ,$17.83 ,$78.98 ,$17.83 ,$78.98 ,$78.98 ,$17.83 ,$78.98 ,$33.88 ,$115.20 ,$96.00 ,$44.58 ,$17.83 ,$112.64 ,$17.83 ,$96.00 ,$96.00 ,$108.80 ,$108.80 ,$17.83 ,$108.80 ,$17.83 ,$99.84 ,$99.84 ,$99.84 ,$115.20 ,$44.58 ,$115.20 ,$17.83 ,$128.00 ,$83.84 ,$17.83 ,$53.25 ,$8.21 ,$7.83 ,$18.72 ,$115.20 ,$40.12 ,$78.98 ,$35.84 ,$115.20 ,$17.83 ,$115.20 ,$115.20 ,$17.83 ,$83.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101616,84270,HC SEX HORMONE BIND GLOB,301,1 ,$74.00 ,$48.10 ,$7.83 ,$74.00 ,$54.33 ,$55.13 ,$48.47 ,$21.73 ,$20.72 ,$37.37 ,$21.73 ,$45.66 ,$21.73 ,$45.66 ,$45.66 ,$21.73 ,$45.66 ,$41.29 ,$66.60 ,$55.50 ,$54.33 ,$21.73 ,$65.12 ,$21.73 ,$55.50 ,$55.50 ,$62.90 ,$62.90 ,$21.73 ,$62.90 ,$21.73 ,$57.72 ,$57.72 ,$57.72 ,$66.60 ,$54.33 ,$66.60 ,$21.73 ,$74.00 ,$48.47 ,$21.73 ,$30.78 ,$8.21 ,$7.83 ,$22.82 ,$66.60 ,$48.89 ,$45.66 ,$20.72 ,$66.60 ,$21.73 ,$66.60 ,$66.60 ,$21.73 ,$48.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101623,84478,HC TRIGLYCERIDES,301,1 ,$75.00 ,$48.75 ,$3.49 ,$75.00 ,$14.35 ,$55.88 ,$49.13 ,$5.74 ,$21.00 ,$37.88 ,$5.74 ,$46.28 ,$5.74 ,$46.28 ,$46.28 ,$5.74 ,$46.28 ,$10.91 ,$67.50 ,$56.25 ,$14.35 ,$5.74 ,$66.00 ,$5.74 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$5.74 ,$63.75 ,$5.74 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$14.35 ,$67.50 ,$5.74 ,$75.00 ,$49.13 ,$5.74 ,$31.20 ,$3.65 ,$3.49 ,$6.03 ,$67.50 ,$12.92 ,$46.28 ,$21.00 ,$67.50 ,$5.74 ,$67.50 ,$67.50 ,$5.74 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101627,84540,HC UREA URINE,301,1 ,$109.00 ,$70.85 ,$3.49 ,$109.00 ,$13.90 ,$81.21 ,$71.40 ,$5.56 ,$30.52 ,$55.05 ,$5.56 ,$67.25 ,$5.56 ,$67.25 ,$67.25 ,$5.56 ,$67.25 ,$10.56 ,$98.10 ,$81.75 ,$13.90 ,$5.56 ,$95.92 ,$5.56 ,$81.75 ,$81.75 ,$92.65 ,$92.65 ,$5.56 ,$92.65 ,$5.56 ,$85.02 ,$85.02 ,$85.02 ,$98.10 ,$13.90 ,$98.10 ,$5.56 ,$109.00 ,$71.40 ,$5.56 ,$45.34 ,$3.65 ,$3.49 ,$5.84 ,$98.10 ,$12.51 ,$67.25 ,$30.52 ,$98.10 ,$5.56 ,$98.10 ,$98.10 ,$5.56 ,$70.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101628,84560,HC URIC ACID OTH SRC,301,1 ,$68.00 ,$44.20 ,$3.49 ,$68.00 ,$12.70 ,$50.66 ,$44.54 ,$5.08 ,$19.04 ,$34.34 ,$5.08 ,$41.96 ,$5.08 ,$41.96 ,$41.96 ,$5.08 ,$41.96 ,$9.65 ,$61.20 ,$51.00 ,$12.70 ,$5.08 ,$59.84 ,$5.08 ,$51.00 ,$51.00 ,$57.80 ,$57.80 ,$5.08 ,$57.80 ,$5.08 ,$53.04 ,$53.04 ,$53.04 ,$61.20 ,$12.70 ,$61.20 ,$5.08 ,$68.00 ,$44.54 ,$5.08 ,$28.29 ,$3.65 ,$3.49 ,$5.33 ,$61.20 ,$11.43 ,$41.96 ,$19.04 ,$61.20 ,$5.08 ,$61.20 ,$61.20 ,$5.08 ,$44.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101631,G0328,HC OCCULT BLOOD FECAL SCREEN,301,1 ,$89.00 ,$57.85 ,$7.83 ,$89.00 ,$45.13 ,$66.31 ,$58.30 ,$18.05 ,$24.92 ,$44.95 ,$18.05 ,$54.91 ,$18.05 ,$54.91 ,$54.91 ,$18.05 ,$54.91 ,$34.30 ,$80.10 ,$66.75 ,$45.13 ,$18.05 ,$78.32 ,$18.05 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$18.05 ,$75.65 ,$18.05 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$45.13 ,$80.10 ,$18.05 ,$89.00 ,$58.30 ,$18.05 ,$37.02 ,$8.21 ,$7.83 ,$18.95 ,$80.10 ,$40.61 ,$54.91 ,$24.92 ,$80.10 ,$18.05 ,$80.10 ,$80.10 ,$18.05 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101632,G0328,HC OCCULT BLOOD FECAL SCRN - AMB-QW,301,1 ,$89.00 ,$57.85 ,$7.83 ,$89.00 ,$45.13 ,$66.31 ,$58.30 ,$18.05 ,$24.92 ,$44.95 ,$18.05 ,$54.91 ,$18.05 ,$54.91 ,$54.91 ,$18.05 ,$54.91 ,$34.30 ,$80.10 ,$66.75 ,$45.13 ,$18.05 ,$78.32 ,$18.05 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$18.05 ,$75.65 ,$18.05 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$45.13 ,$80.10 ,$18.05 ,$89.00 ,$58.30 ,$18.05 ,$37.02 ,$8.21 ,$7.83 ,$18.95 ,$80.10 ,$40.61 ,$54.91 ,$24.92 ,$80.10 ,$18.05 ,$80.10 ,$80.10 ,$18.05 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101633,83070,HC HEMOSIDERIN QL - 90,301,1 ,$46.00 ,$29.90 ,$4.75 ,$46.00 ,$11.88 ,$34.27 ,$30.13 ,$4.75 ,$12.88 ,$23.23 ,$4.75 ,$28.38 ,$4.75 ,$28.38 ,$28.38 ,$4.75 ,$28.38 ,$9.03 ,$41.40 ,$34.50 ,$11.88 ,$4.75 ,$40.48 ,$4.75 ,$34.50 ,$34.50 ,$39.10 ,$39.10 ,$4.75 ,$39.10 ,$4.75 ,$35.88 ,$35.88 ,$35.88 ,$41.40 ,$11.88 ,$41.40 ,$4.75 ,$46.00 ,$30.13 ,$4.75 ,$19.14 ,$8.21 ,$7.83 ,$4.99 ,$41.40 ,$10.69 ,$28.38 ,$12.88 ,$41.40 ,$4.75 ,$41.40 ,$41.40 ,$4.75 ,$29.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101634,80348,HC BUPRENORPHINE -90,301,1 ,$76.00 ,$49.40 ,$7.83 ,$76.00 , N/A ,$56.62 ,$49.78 , N/A ,$21.28 ,$38.38 , N/A ,$46.89 , N/A ,$46.89 ,$46.89 , N/A ,$46.89 , N/A ,$68.40 ,$57.00 , N/A , N/A ,$66.88 , N/A ,$57.00 ,$57.00 ,$64.60 ,$64.60 , N/A ,$64.60 , N/A ,$59.28 ,$59.28 ,$59.28 ,$68.40 , N/A ,$68.40 , N/A ,$76.00 ,$49.78 , N/A ,$31.62 ,$8.21 ,$7.83 , N/A ,$68.40 , N/A ,$46.89 ,$21.28 ,$68.40 , N/A ,$68.40 ,$68.40 , N/A ,$49.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101636,83735,HC MAGNESIUM,301,1 ,$68.00 ,$44.20 ,$3.49 ,$68.00 ,$16.75 ,$50.66 ,$44.54 ,$6.70 ,$19.04 ,$34.34 ,$6.70 ,$41.96 ,$6.70 ,$41.96 ,$41.96 ,$6.70 ,$41.96 ,$12.73 ,$61.20 ,$51.00 ,$16.75 ,$6.70 ,$59.84 ,$6.70 ,$51.00 ,$51.00 ,$57.80 ,$57.80 ,$6.70 ,$57.80 ,$6.70 ,$53.04 ,$53.04 ,$53.04 ,$61.20 ,$16.75 ,$61.20 ,$6.70 ,$68.00 ,$44.54 ,$6.70 ,$28.29 ,$3.65 ,$3.49 ,$7.04 ,$61.20 ,$15.08 ,$41.96 ,$19.04 ,$61.20 ,$6.70 ,$61.20 ,$61.20 ,$6.70 ,$44.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101642,84999,HC OSMOLALITY FECAL-90,301,1 ,$718.00 ,$466.70 ,$7.83 ,$718.00 , N/A ,$534.91 ,$470.29 , N/A ,$201.04 ,$362.59 , N/A ,$443.01 , N/A ,$443.01 ,$443.01 , N/A ,$443.01 , N/A ,$646.20 ,$538.50 , N/A , N/A ,$631.84 , N/A ,$538.50 ,$538.50 ,$610.30 ,$610.30 , N/A ,$610.30 , N/A ,$560.04 ,$560.04 ,$560.04 ,$646.20 , N/A ,$646.20 , N/A ,$718.00 ,$470.29 , N/A ,$298.69 ,$8.21 ,$7.83 , N/A ,$646.20 , N/A ,$443.01 ,$201.04 ,$646.20 , N/A ,$646.20 ,$646.20 , N/A ,$466.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101643,81596,HC CHRONIC HEP C VIRUS ASSAYS-90,301,1 ,$532.00 ,$345.80 ,$27.79 ,$532.00 ,$180.48 ,$396.34 ,$348.46 ,$72.19 ,$148.96 ,$268.66 ,$72.19 ,$328.24 ,$72.19 ,$328.24 ,$328.24 ,$72.19 ,$328.24 ,$137.16 ,$478.80 ,$399.00 ,$180.48 ,$72.19 ,$468.16 ,$72.19 ,$399.00 ,$399.00 ,$452.20 ,$452.20 ,$72.19 ,$452.20 ,$72.19 ,$414.96 ,$414.96 ,$414.96 ,$478.80 ,$180.48 ,$478.80 ,$72.19 ,$532.00 ,$348.46 ,$72.19 ,$221.31 ,$29.12 ,$27.79 ,$75.80 ,$478.80 ,$162.43 ,$328.24 ,$148.96 ,$478.80 ,$72.19 ,$478.80 ,$478.80 ,$72.19 ,$345.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101651,84150,HC PROSTAGLANDIN-90,301,1 ,$765.00 ,$497.25 ,$18.33 ,$765.00 ,$104.43 ,$569.93 ,$501.08 ,$41.77 ,$214.20 ,$386.33 ,$41.77 ,$472.01 ,$41.77 ,$472.01 ,$472.01 ,$41.77 ,$472.01 ,$79.36 ,$688.50 ,$573.75 ,$104.43 ,$41.77 ,$673.20 ,$41.77 ,$573.75 ,$573.75 ,$650.25 ,$650.25 ,$41.77 ,$650.25 ,$41.77 ,$596.70 ,$596.70 ,$596.70 ,$688.50 ,$104.43 ,$688.50 ,$41.77 ,$765.00 ,$501.08 ,$41.77 ,$318.24 ,$19.21 ,$18.33 ,$43.86 ,$688.50 ,$93.98 ,$472.01 ,$214.20 ,$688.50 ,$41.77 ,$688.50 ,$688.50 ,$41.77 ,$497.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101652,83698,HC LIPOPROTEIN ASSOC PHOSPHOLIPASE A2-90,301,1 ,$86.96 ,$56.52 ,$21.08 ,$104.20 ,$86.96 ,$64.79 ,$56.96 ,$46.31 ,$24.35 ,$43.91 ,$46.31 ,$53.65 ,$46.31 ,$53.65 ,$53.65 ,$46.31 ,$53.65 ,$87.99 ,$78.26 ,$65.22 ,$86.96 ,$46.31 ,$76.52 ,$46.31 ,$65.22 ,$65.22 ,$73.92 ,$73.92 ,$46.31 ,$73.92 ,$46.31 ,$67.83 ,$67.83 ,$67.83 ,$78.26 ,$86.96 ,$78.26 ,$46.31 ,$86.96 ,$56.96 ,$46.31 ,$36.18 ,$22.09 ,$21.08 ,$48.63 ,$78.26 ,$104.20 ,$53.65 ,$24.35 ,$78.26 ,$46.31 ,$78.26 ,$78.26 ,$46.31 ,$56.52 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101669,81500,HC ONCOLOGY OVARIAN BIOCHEMICAL ASSAY CA-125/HE4 -90,301,1 ,$958.00 ,$622.70 ,$27.79 ,$958.00 ,$651.25 ,$713.71 ,$627.49 ,$260.50 ,$268.24 ,$483.79 ,$260.50 ,$591.09 ,$260.50 ,$591.09 ,$591.09 ,$260.50 ,$591.09 ,$494.95 ,$862.20 ,$718.50 ,$651.25 ,$260.50 ,$843.04 ,$260.50 ,$718.50 ,$718.50 ,$814.30 ,$814.30 ,$260.50 ,$814.30 ,$260.50 ,$747.24 ,$747.24 ,$747.24 ,$862.20 ,$651.25 ,$862.20 ,$260.50 ,$958.00 ,$627.49 ,$260.50 ,$398.53 ,$29.12 ,$27.79 ,$273.53 ,$862.20 ,$586.13 ,$591.09 ,$268.24 ,$862.20 ,$260.50 ,$862.20 ,$862.20 ,$260.50 ,$622.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101671,80299,HC VORICONAZOLE-90,301,1 ,$230.00 ,$149.50 ,$8.99 ,$230.00 ,$46.60 ,$171.35 ,$150.65 ,$18.64 ,$64.40 ,$116.15 ,$18.64 ,$141.91 ,$18.64 ,$141.91 ,$141.91 ,$18.64 ,$141.91 ,$35.42 ,$207.00 ,$172.50 ,$46.60 ,$18.64 ,$202.40 ,$18.64 ,$172.50 ,$172.50 ,$195.50 ,$195.50 ,$18.64 ,$195.50 ,$18.64 ,$179.40 ,$179.40 ,$179.40 ,$207.00 ,$46.60 ,$207.00 ,$18.64 ,$230.00 ,$150.65 ,$18.64 ,$95.68 ,$9.42 ,$8.99 ,$19.57 ,$207.00 ,$41.94 ,$141.91 ,$64.40 ,$207.00 ,$18.64 ,$207.00 ,$207.00 ,$18.64 ,$149.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101675,83050,HC METHEMOGLOBIN-90,301,1 ,$17.00 ,$11.05 ,$4.76 ,$18.45 ,$17.00 ,$12.67 ,$11.14 ,$8.20 ,$4.76 ,$8.59 ,$8.20 ,$10.49 ,$8.20 ,$10.49 ,$10.49 ,$8.20 ,$10.49 ,$15.58 ,$15.30 ,$12.75 ,$17.00 ,$8.20 ,$14.96 ,$8.20 ,$12.75 ,$12.75 ,$14.45 ,$14.45 ,$8.20 ,$14.45 ,$8.20 ,$13.26 ,$13.26 ,$13.26 ,$15.30 ,$17.00 ,$15.30 ,$8.20 ,$17.00 ,$11.14 ,$8.20 ,$7.07 ,$8.21 ,$7.83 ,$8.61 ,$15.30 ,$18.45 ,$10.49 ,$4.76 ,$15.30 ,$8.20 ,$15.30 ,$15.30 ,$8.20 ,$11.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101676,82375,HC CARBON MONOXIDE-90,301,1 ,$21.00 ,$13.65 ,$5.88 ,$27.72 ,$21.00 ,$15.65 ,$13.76 ,$12.32 ,$5.88 ,$10.61 ,$12.32 ,$12.96 ,$12.32 ,$12.96 ,$12.96 ,$12.32 ,$12.96 ,$23.41 ,$18.90 ,$15.75 ,$21.00 ,$12.32 ,$18.48 ,$12.32 ,$15.75 ,$15.75 ,$17.85 ,$17.85 ,$12.32 ,$17.85 ,$12.32 ,$16.38 ,$16.38 ,$16.38 ,$18.90 ,$21.00 ,$18.90 ,$12.32 ,$21.00 ,$13.76 ,$12.32 ,$8.74 ,$8.21 ,$7.83 ,$12.94 ,$18.90 ,$27.72 ,$12.96 ,$5.88 ,$18.90 ,$12.32 ,$18.90 ,$18.90 ,$12.32 ,$13.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101678,83516,HC FLUOR AB SCR AQUAPORIN 4-90,301,1 ,"$1,012.00 ",$657.80 ,$7.01 ,"$1,012.00 ",$28.83 ,$753.94 ,$662.86 ,$11.53 ,$283.36 ,$511.06 ,$11.53 ,$624.40 ,$11.53 ,$624.40 ,$624.40 ,$11.53 ,$624.40 ,$21.91 ,$910.80 ,$759.00 ,$28.83 ,$11.53 ,$890.56 ,$11.53 ,$759.00 ,$759.00 ,$860.20 ,$860.20 ,$11.53 ,$860.20 ,$11.53 ,$789.36 ,$789.36 ,$789.36 ,$910.80 ,$28.83 ,$910.80 ,$11.53 ,"$1,012.00 ",$662.86 ,$11.53 ,$420.99 ,$7.35 ,$7.01 ,$12.11 ,$910.80 ,$25.94 ,$624.40 ,$283.36 ,$910.80 ,$11.53 ,$910.80 ,$910.80 ,$11.53 ,$657.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101679,83500,HC HYDROXYPROLINE FREE-90,301,1 ,$130.00 ,$84.50 ,$18.33 ,$130.00 ,$56.63 ,$96.85 ,$85.15 ,$22.65 ,$36.40 ,$65.65 ,$22.65 ,$80.21 ,$22.65 ,$80.21 ,$80.21 ,$22.65 ,$80.21 ,$43.04 ,$117.00 ,$97.50 ,$56.63 ,$22.65 ,$114.40 ,$22.65 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$22.65 ,$110.50 ,$22.65 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$56.63 ,$117.00 ,$22.65 ,$130.00 ,$85.15 ,$22.65 ,$54.08 ,$19.21 ,$18.33 ,$23.78 ,$117.00 ,$50.96 ,$80.21 ,$36.40 ,$117.00 ,$22.65 ,$117.00 ,$117.00 ,$22.65 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101682,82963,HC GLUCOSIDASE BETA ASSAY-90,301,1 ,$883.00 ,$573.95 ,$7.83 ,$883.00 ,$53.70 ,$657.84 ,$578.37 ,$21.48 ,$247.24 ,$445.92 ,$21.48 ,$544.81 ,$21.48 ,$544.81 ,$544.81 ,$21.48 ,$544.81 ,$40.81 ,$794.70 ,$662.25 ,$53.70 ,$21.48 ,$777.04 ,$21.48 ,$662.25 ,$662.25 ,$750.55 ,$750.55 ,$21.48 ,$750.55 ,$21.48 ,$688.74 ,$688.74 ,$688.74 ,$794.70 ,$53.70 ,$794.70 ,$21.48 ,$883.00 ,$578.37 ,$21.48 ,$367.33 ,$8.21 ,$7.83 ,$22.55 ,$794.70 ,$48.33 ,$544.81 ,$247.24 ,$794.70 ,$21.48 ,$794.70 ,$794.70 ,$21.48 ,$573.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101685,80235,HC LACOSAMIDE -90,301,1 ,$134.00 ,$87.10 ,$8.99 ,$134.00 ,$67.78 ,$99.83 ,$87.77 ,$27.11 ,$37.52 ,$67.67 ,$27.11 ,$82.68 ,$27.11 ,$82.68 ,$82.68 ,$27.11 ,$82.68 ,$51.51 ,$120.60 ,$100.50 ,$67.78 ,$27.11 ,$117.92 ,$27.11 ,$100.50 ,$100.50 ,$113.90 ,$113.90 ,$27.11 ,$113.90 ,$27.11 ,$104.52 ,$104.52 ,$104.52 ,$120.60 ,$67.78 ,$120.60 ,$27.11 ,$134.00 ,$87.77 ,$27.11 ,$55.74 ,$9.42 ,$8.99 ,$28.47 ,$120.60 ,$61.00 ,$82.68 ,$37.52 ,$120.60 ,$27.11 ,$120.60 ,$120.60 ,$27.11 ,$87.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101686,83721,HC CHOLESTEROL LDL -90,301,1 ,$13.00 ,$8.45 ,$3.64 ,$23.63 ,$13.00 ,$9.69 ,$8.52 ,$10.50 ,$3.64 ,$6.57 ,$10.50 ,$8.02 ,$10.50 ,$8.02 ,$8.02 ,$10.50 ,$8.02 ,$19.95 ,$11.70 ,$9.75 ,$13.00 ,$10.50 ,$11.44 ,$10.50 ,$9.75 ,$9.75 ,$11.05 ,$11.05 ,$10.50 ,$11.05 ,$10.50 ,$10.14 ,$10.14 ,$10.14 ,$11.70 ,$13.00 ,$11.70 ,$10.50 ,$13.00 ,$8.52 ,$10.50 ,$5.41 ,$8.21 ,$7.83 ,$11.03 ,$11.70 ,$23.63 ,$8.02 ,$3.64 ,$11.70 ,$10.50 ,$11.70 ,$11.70 ,$10.50 ,$8.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101696,80338,HC ANTIDEPRESSANT NOS-90,301,1 ,$331.00 ,$215.15 ,$7.83 ,$331.00 , N/A ,$246.60 ,$216.81 , N/A ,$92.68 ,$167.16 , N/A ,$204.23 , N/A ,$204.23 ,$204.23 , N/A ,$204.23 , N/A ,$297.90 ,$248.25 , N/A , N/A ,$291.28 , N/A ,$248.25 ,$248.25 ,$281.35 ,$281.35 , N/A ,$281.35 , N/A ,$258.18 ,$258.18 ,$258.18 ,$297.90 , N/A ,$297.90 , N/A ,$331.00 ,$216.81 , N/A ,$137.70 ,$8.21 ,$7.83 , N/A ,$297.90 , N/A ,$204.23 ,$92.68 ,$297.90 , N/A ,$297.90 ,$297.90 , N/A ,$215.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101705,80145,HC DRUG ASSAY ADALIMUMAB -90,301,1 ,$366.66 ,$238.33 ,$8.99 ,$366.66 ,$96.43 ,$273.16 ,$240.16 ,$38.57 ,$102.66 ,$185.16 ,$38.57 ,$226.23 ,$38.57 ,$226.23 ,$226.23 ,$38.57 ,$226.23 ,$73.28 ,$329.99 ,$275.00 ,$96.43 ,$38.57 ,$322.66 ,$38.57 ,$275.00 ,$275.00 ,$311.66 ,$311.66 ,$38.57 ,$311.66 ,$38.57 ,$285.99 ,$285.99 ,$285.99 ,$329.99 ,$96.43 ,$329.99 ,$38.57 ,$366.66 ,$240.16 ,$38.57 ,$152.53 ,$9.42 ,$8.99 ,$40.50 ,$329.99 ,$86.78 ,$226.23 ,$102.66 ,$329.99 ,$38.57 ,$329.99 ,$329.99 ,$38.57 ,$238.33 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101706,80230,HC DRUG ASSAY INFLIXIMAB-90,301,1 ,$367.00 ,$238.55 ,$8.99 ,$367.00 ,$96.43 ,$273.42 ,$240.39 ,$38.57 ,$102.76 ,$185.34 ,$38.57 ,$226.44 ,$38.57 ,$226.44 ,$226.44 ,$38.57 ,$226.44 ,$73.28 ,$330.30 ,$275.25 ,$96.43 ,$38.57 ,$322.96 ,$38.57 ,$275.25 ,$275.25 ,$311.95 ,$311.95 ,$38.57 ,$311.95 ,$38.57 ,$286.26 ,$286.26 ,$286.26 ,$330.30 ,$96.43 ,$330.30 ,$38.57 ,$367.00 ,$240.39 ,$38.57 ,$152.67 ,$9.42 ,$8.99 ,$40.50 ,$330.30 ,$86.78 ,$226.44 ,$102.76 ,$330.30 ,$38.57 ,$330.30 ,$330.30 ,$38.57 ,$238.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101710,83864,HC MUCOPOLYSACCHARIDE QUANT - 90,301,1 ,$285.00 ,$185.25 ,$7.83 ,$285.00 ,$71.25 ,$212.33 ,$186.68 ,$28.50 ,$79.80 ,$143.93 ,$28.50 ,$175.85 ,$28.50 ,$175.85 ,$175.85 ,$28.50 ,$175.85 ,$54.15 ,$256.50 ,$213.75 ,$71.25 ,$28.50 ,$250.80 ,$28.50 ,$213.75 ,$213.75 ,$242.25 ,$242.25 ,$28.50 ,$242.25 ,$28.50 ,$222.30 ,$222.30 ,$222.30 ,$256.50 ,$71.25 ,$256.50 ,$28.50 ,$285.00 ,$186.68 ,$28.50 ,$118.56 ,$8.21 ,$7.83 ,$29.93 ,$256.50 ,$64.13 ,$175.85 ,$79.80 ,$256.50 ,$28.50 ,$256.50 ,$256.50 ,$28.50 ,$185.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101711,84377,HC OLIGOSACCHARIDE SCREEN URINE - 90,301,1 ,$106.00 ,$68.90 ,$3.49 ,$106.00 ,$13.75 ,$78.97 ,$69.43 ,$5.50 ,$29.68 ,$53.53 ,$5.50 ,$65.40 ,$5.50 ,$65.40 ,$65.40 ,$5.50 ,$65.40 ,$10.45 ,$95.40 ,$79.50 ,$13.75 ,$5.50 ,$93.28 ,$5.50 ,$79.50 ,$79.50 ,$90.10 ,$90.10 ,$5.50 ,$90.10 ,$5.50 ,$82.68 ,$82.68 ,$82.68 ,$95.40 ,$13.75 ,$95.40 ,$5.50 ,$106.00 ,$69.43 ,$5.50 ,$44.10 ,$3.65 ,$3.49 ,$5.78 ,$95.40 ,$12.38 ,$65.40 ,$29.68 ,$95.40 ,$5.50 ,$95.40 ,$95.40 ,$5.50 ,$68.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101712,84445,HC ASSAY OF TSI GLOBULINS,301,1 ,"$1,411.00 ",$917.15 ,$18.33 ,"$1,411.00 ",$127.15 ,"$1,051.20 ",$924.21 ,$50.86 ,$395.08 ,$712.56 ,$50.86 ,$870.59 ,$50.86 ,$870.59 ,$870.59 ,$50.86 ,$870.59 ,$96.63 ,"$1,269.90 ","$1,058.25 ",$127.15 ,$50.86 ,"$1,241.68 ",$50.86 ,"$1,058.25 ","$1,058.25 ","$1,199.35 ","$1,199.35 ",$50.86 ,"$1,199.35 ",$50.86 ,"$1,100.58 ","$1,100.58 ","$1,100.58 ","$1,269.90 ",$127.15 ,"$1,269.90 ",$50.86 ,"$1,411.00 ",$924.21 ,$50.86 ,$586.98 ,$19.21 ,$18.33 ,$53.40 ,"$1,269.90 ",$114.44 ,$870.59 ,$395.08 ,"$1,269.90 ",$50.86 ,"$1,269.90 ","$1,269.90 ",$50.86 ,$917.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101716,80187,HC POSACONAZOLE -90,301,1 ,$306.00 ,$198.90 ,$8.99 ,$306.00 ,$67.78 ,$227.97 ,$200.43 ,$27.11 ,$85.68 ,$154.53 ,$27.11 ,$188.80 ,$27.11 ,$188.80 ,$188.80 ,$27.11 ,$188.80 ,$51.51 ,$275.40 ,$229.50 ,$67.78 ,$27.11 ,$269.28 ,$27.11 ,$229.50 ,$229.50 ,$260.10 ,$260.10 ,$27.11 ,$260.10 ,$27.11 ,$238.68 ,$238.68 ,$238.68 ,$275.40 ,$67.78 ,$275.40 ,$27.11 ,$306.00 ,$200.43 ,$27.11 ,$127.30 ,$9.42 ,$8.99 ,$28.47 ,$275.40 ,$61.00 ,$188.80 ,$85.68 ,$275.40 ,$27.11 ,$275.40 ,$275.40 ,$27.11 ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101720,80307,HC CORD BLOOD DRUG SCREEN,301,1 ,$325.00 ,$211.25 ,$21.08 ,$325.00 ,$155.35 ,$242.13 ,$212.88 ,$62.14 ,$91.00 ,$164.13 ,$62.14 ,$200.53 ,$62.14 ,$200.53 ,$200.53 ,$62.14 ,$200.53 ,$118.07 ,$292.50 ,$243.75 ,$155.35 ,$62.14 ,$286.00 ,$62.14 ,$243.75 ,$243.75 ,$276.25 ,$276.25 ,$62.14 ,$276.25 ,$62.14 ,$253.50 ,$253.50 ,$253.50 ,$292.50 ,$155.35 ,$292.50 ,$62.14 ,$325.00 ,$212.88 ,$62.14 ,$135.20 ,$22.09 ,$21.08 ,$65.25 ,$292.50 ,$139.82 ,$200.53 ,$91.00 ,$292.50 ,$62.14 ,$292.50 ,$292.50 ,$62.14 ,$211.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101722,82542,HC COL CHROMOTOGRAPHY QUAL/QUAN-90,301,1 ,$462.00 ,$300.30 ,$7.83 ,$462.00 ,$60.23 ,$344.19 ,$302.61 ,$24.09 ,$129.36 ,$233.31 ,$24.09 ,$285.05 ,$24.09 ,$285.05 ,$285.05 ,$24.09 ,$285.05 ,$45.77 ,$415.80 ,$346.50 ,$60.23 ,$24.09 ,$406.56 ,$24.09 ,$346.50 ,$346.50 ,$392.70 ,$392.70 ,$24.09 ,$392.70 ,$24.09 ,$360.36 ,$360.36 ,$360.36 ,$415.80 ,$60.23 ,$415.80 ,$24.09 ,$462.00 ,$302.61 ,$24.09 ,$192.19 ,$8.21 ,$7.83 ,$25.29 ,$415.80 ,$54.20 ,$285.05 ,$129.36 ,$415.80 ,$24.09 ,$415.80 ,$415.80 ,$24.09 ,$300.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101723,82397,HC ANTIMULLERIAN ASSAY-90,301,1 ,$400.00 ,$260.00 ,$7.83 ,$400.00 ,$35.30 ,$298.00 ,$262.00 ,$14.12 ,$112.00 ,$202.00 ,$14.12 ,$246.80 ,$14.12 ,$246.80 ,$246.80 ,$14.12 ,$246.80 ,$26.83 ,$360.00 ,$300.00 ,$35.30 ,$14.12 ,$352.00 ,$14.12 ,$300.00 ,$300.00 ,$340.00 ,$340.00 ,$14.12 ,$340.00 ,$14.12 ,$312.00 ,$312.00 ,$312.00 ,$360.00 ,$35.30 ,$360.00 ,$14.12 ,$400.00 ,$262.00 ,$14.12 ,$166.40 ,$8.21 ,$7.83 ,$14.83 ,$360.00 ,$31.77 ,$246.80 ,$112.00 ,$360.00 ,$14.12 ,$360.00 ,$360.00 ,$14.12 ,$260.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101725,80354,HC FENTANYL URINE - 90,301,1 ,$216.00 ,$140.40 ,$7.83 ,$216.00 , N/A ,$160.92 ,$141.48 , N/A ,$60.48 ,$109.08 , N/A ,$133.27 , N/A ,$133.27 ,$133.27 , N/A ,$133.27 , N/A ,$194.40 ,$162.00 , N/A , N/A ,$190.08 , N/A ,$162.00 ,$162.00 ,$183.60 ,$183.60 , N/A ,$183.60 , N/A ,$168.48 ,$168.48 ,$168.48 ,$194.40 , N/A ,$194.40 , N/A ,$216.00 ,$141.48 , N/A ,$89.86 ,$8.21 ,$7.83 , N/A ,$194.40 , N/A ,$133.27 ,$60.48 ,$194.40 , N/A ,$194.40 ,$194.40 , N/A ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101739,80280,HC DRUG ASSAY VEDOLIZUMAB-90,301,1 ,$116.00 ,$75.40 ,$8.99 ,$116.00 ,$96.43 ,$86.42 ,$75.98 ,$38.57 ,$32.48 ,$58.58 ,$38.57 ,$71.57 ,$38.57 ,$71.57 ,$71.57 ,$38.57 ,$71.57 ,$73.28 ,$104.40 ,$87.00 ,$96.43 ,$38.57 ,$102.08 ,$38.57 ,$87.00 ,$87.00 ,$98.60 ,$98.60 ,$38.57 ,$98.60 ,$38.57 ,$90.48 ,$90.48 ,$90.48 ,$104.40 ,$96.43 ,$104.40 ,$38.57 ,$116.00 ,$75.98 ,$38.57 ,$48.26 ,$9.42 ,$8.99 ,$40.50 ,$104.40 ,$86.78 ,$71.57 ,$32.48 ,$104.40 ,$38.57 ,$104.40 ,$104.40 ,$38.57 ,$75.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101740,82271,HC OCCULT BLOOD GATRIC-90,301,1 ,$6.44 ,$4.19 ,$1.80 ,$11.97 ,$6.44 ,$4.80 ,$4.22 ,$5.32 ,$1.80 ,$3.25 ,$5.32 ,$3.97 ,$5.32 ,$3.97 ,$3.97 ,$5.32 ,$3.97 ,$10.11 ,$5.80 ,$4.83 ,$6.44 ,$5.32 ,$5.67 ,$5.32 ,$4.83 ,$4.83 ,$5.47 ,$5.47 ,$5.32 ,$5.47 ,$5.32 ,$5.02 ,$5.02 ,$5.02 ,$5.80 ,$6.44 ,$5.80 ,$5.32 ,$6.44 ,$4.22 ,$5.32 ,$2.68 ,$3.65 ,$3.49 ,$5.59 ,$5.80 ,$11.97 ,$3.97 ,$1.80 ,$5.80 ,$5.32 ,$5.80 ,$5.80 ,$5.32 ,$4.19 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101743,82777,HC GALECTIN-3 - 90,301,1 ,$110.00 ,$71.50 ,$7.83 ,$110.00 ,$110.00 ,$81.95 ,$72.05 ,$44.25 ,$30.80 ,$55.55 ,$44.25 ,$67.87 ,$44.25 ,$67.87 ,$67.87 ,$44.25 ,$67.87 ,$84.08 ,$99.00 ,$82.50 ,$110.00 ,$44.25 ,$96.80 ,$44.25 ,$82.50 ,$82.50 ,$93.50 ,$93.50 ,$44.25 ,$93.50 ,$44.25 ,$85.80 ,$85.80 ,$85.80 ,$99.00 ,$110.00 ,$99.00 ,$44.25 ,$110.00 ,$72.05 ,$44.25 ,$45.76 ,$8.21 ,$7.83 ,$46.46 ,$99.00 ,$99.56 ,$67.87 ,$30.80 ,$99.00 ,$44.25 ,$99.00 ,$99.00 ,$44.25 ,$71.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101744,83876,HC MYELOPEROXIDASE (MPO)-90,301,1 ,$53.00 ,$34.45 ,$14.84 ,$114.44 ,$53.00 ,$39.49 ,$34.72 ,$50.86 ,$14.84 ,$26.77 ,$50.86 ,$32.70 ,$50.86 ,$32.70 ,$32.70 ,$50.86 ,$32.70 ,$96.63 ,$47.70 ,$39.75 ,$53.00 ,$50.86 ,$46.64 ,$50.86 ,$39.75 ,$39.75 ,$45.05 ,$45.05 ,$50.86 ,$45.05 ,$50.86 ,$41.34 ,$41.34 ,$41.34 ,$47.70 ,$53.00 ,$47.70 ,$50.86 ,$53.00 ,$34.72 ,$50.86 ,$22.05 ,$22.09 ,$21.08 ,$53.00 ,$47.70 ,$114.44 ,$32.70 ,$14.84 ,$47.70 ,$50.86 ,$47.70 ,$47.70 ,$50.86 ,$34.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101750,80189,HC ITRACONAZOLE - 90,301,1 ,$447.20 ,$290.68 ,$8.99 ,$447.20 ,$67.78 ,$333.16 ,$292.92 ,$27.11 ,$125.22 ,$225.84 ,$27.11 ,$275.92 ,$27.11 ,$275.92 ,$275.92 ,$27.11 ,$275.92 ,$51.51 ,$402.48 ,$335.40 ,$67.78 ,$27.11 ,$393.54 ,$27.11 ,$335.40 ,$335.40 ,$380.12 ,$380.12 ,$27.11 ,$380.12 ,$27.11 ,$348.82 ,$348.82 ,$348.82 ,$402.48 ,$67.78 ,$402.48 ,$27.11 ,$447.20 ,$292.92 ,$27.11 ,$186.04 ,$9.42 ,$8.99 ,$28.47 ,$402.48 ,$61.00 ,$275.92 ,$125.22 ,$402.48 ,$27.11 ,$402.48 ,$402.48 ,$27.11 ,$290.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101751,83519,HC ACETYLCHOLINE RECEPTR AB TIER 3-90,301,1 ,"$1,732.50 ","$1,126.13 ",$7.01 ,"$1,732.50 ",$46.00 ,"$1,290.71 ","$1,134.79 ",$18.40 ,$485.10 ,$874.91 ,$18.40 ,"$1,068.95 ",$18.40 ,"$1,068.95 ","$1,068.95 ",$18.40 ,"$1,068.95 ",$34.96 ,"$1,559.25 ","$1,299.38 ",$46.00 ,$18.40 ,"$1,524.60 ",$18.40 ,"$1,299.38 ","$1,299.38 ","$1,472.63 ","$1,472.63 ",$18.40 ,"$1,472.63 ",$18.40 ,"$1,351.35 ","$1,351.35 ","$1,351.35 ","$1,559.25 ",$46.00 ,"$1,559.25 ",$18.40 ,"$1,732.50 ","$1,134.79 ",$18.40 ,$720.72 ,$7.35 ,$7.01 ,$19.32 ,"$1,559.25 ",$41.40 ,"$1,068.95 ",$485.10 ,"$1,559.25 ",$18.40 ,"$1,559.25 ","$1,559.25 ",$18.40 ,"$1,126.13 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101753,80305,HC DRUG SCREEN PRESUM DIRECT OPTICAL-90,301,1 ,$126.00 ,$81.90 ,$7.83 ,$126.00 ,$31.50 ,$93.87 ,$82.53 ,$12.60 ,$35.28 ,$63.63 ,$12.60 ,$77.74 ,$12.60 ,$77.74 ,$77.74 ,$12.60 ,$77.74 ,$23.94 ,$113.40 ,$94.50 ,$31.50 ,$12.60 ,$110.88 ,$12.60 ,$94.50 ,$94.50 ,$107.10 ,$107.10 ,$12.60 ,$107.10 ,$12.60 ,$98.28 ,$98.28 ,$98.28 ,$113.40 ,$31.50 ,$113.40 ,$12.60 ,$126.00 ,$82.53 ,$12.60 ,$52.42 ,$8.21 ,$7.83 ,$13.23 ,$113.40 ,$28.35 ,$77.74 ,$35.28 ,$113.40 ,$12.60 ,$113.40 ,$113.40 ,$12.60 ,$81.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101760,80362,HC OPIOIDS  AND  OPIATE ANALOGS 1/2-90,301,1 ,$41.40 ,$26.91 ,$11.59 ,$41.40 , N/A ,$30.84 ,$27.12 , N/A ,$11.59 ,$20.91 , N/A ,$25.54 , N/A ,$25.54 ,$25.54 , N/A ,$25.54 , N/A ,$37.26 ,$31.05 , N/A , N/A ,$36.43 , N/A ,$31.05 ,$31.05 ,$35.19 ,$35.19 , N/A ,$35.19 , N/A ,$32.29 ,$32.29 ,$32.29 ,$37.26 , N/A ,$37.26 , N/A ,$41.40 ,$27.12 , N/A ,$17.22 ,$22.09 ,$21.08 , N/A ,$37.26 , N/A ,$25.54 ,$11.59 ,$37.26 , N/A ,$37.26 ,$37.26 , N/A ,$26.91 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101762,82951,HC GLUCOSE TOLERANCE-90,301,1 ,$38.61 ,$25.10 ,$7.83 ,$38.61 ,$32.18 ,$28.76 ,$25.29 ,$12.87 ,$10.81 ,$19.50 ,$12.87 ,$23.82 ,$12.87 ,$23.82 ,$23.82 ,$12.87 ,$23.82 ,$24.45 ,$34.75 ,$28.96 ,$32.18 ,$12.87 ,$33.98 ,$12.87 ,$28.96 ,$28.96 ,$32.82 ,$32.82 ,$12.87 ,$32.82 ,$12.87 ,$30.12 ,$30.12 ,$30.12 ,$34.75 ,$32.18 ,$34.75 ,$12.87 ,$38.61 ,$25.29 ,$12.87 ,$16.06 ,$8.21 ,$7.83 ,$13.51 ,$34.75 ,$28.96 ,$23.82 ,$10.81 ,$34.75 ,$12.87 ,$34.75 ,$34.75 ,$12.87 ,$25.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101763,82952,HC GLUCOSE TOLERANCE ADDL SPEC-90,301,1 ,$11.76 ,$7.64 ,$3.29 ,$11.76 ,$9.80 ,$8.76 ,$7.70 ,$3.92 ,$3.29 ,$5.94 ,$3.92 ,$7.26 ,$3.92 ,$7.26 ,$7.26 ,$3.92 ,$7.26 ,$7.45 ,$10.58 ,$8.82 ,$9.80 ,$3.92 ,$10.35 ,$3.92 ,$8.82 ,$8.82 ,$10.00 ,$10.00 ,$3.92 ,$10.00 ,$3.92 ,$9.17 ,$9.17 ,$9.17 ,$10.58 ,$9.80 ,$10.58 ,$3.92 ,$11.76 ,$7.70 ,$3.92 ,$4.89 ,$8.21 ,$7.83 ,$4.12 ,$10.58 ,$8.82 ,$7.26 ,$3.29 ,$10.58 ,$3.92 ,$10.58 ,$10.58 ,$3.92 ,$7.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101767,80347,HC DRUG SCREENING BENZODIAZEPINES 13 OR MORE-90,301,1 ,$48.16 ,$31.30 ,$13.48 ,$48.16 , N/A ,$35.88 ,$31.54 , N/A ,$13.48 ,$24.32 , N/A ,$29.71 , N/A ,$29.71 ,$29.71 , N/A ,$29.71 , N/A ,$43.34 ,$36.12 , N/A , N/A ,$42.38 , N/A ,$36.12 ,$36.12 ,$40.94 ,$40.94 , N/A ,$40.94 , N/A ,$37.56 ,$37.56 ,$37.56 ,$43.34 , N/A ,$43.34 , N/A ,$48.16 ,$31.54 , N/A ,$20.03 ,$22.09 ,$21.08 , N/A ,$43.34 , N/A ,$29.71 ,$13.48 ,$43.34 , N/A ,$43.34 ,$43.34 , N/A ,$31.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101770,83521,HC IMMUNOGLOBULIN LIGHT CHAINS- 90,301,1 ,$137.20 ,$89.18 ,$7.83 ,$137.20 ,$43.18 ,$102.21 ,$89.87 ,$17.27 ,$38.42 ,$69.29 ,$17.27 ,$84.65 ,$17.27 ,$84.65 ,$84.65 ,$17.27 ,$84.65 ,$32.81 ,$123.48 ,$102.90 ,$43.18 ,$17.27 ,$120.74 ,$17.27 ,$102.90 ,$102.90 ,$116.62 ,$116.62 ,$17.27 ,$116.62 ,$17.27 ,$107.02 ,$107.02 ,$107.02 ,$123.48 ,$43.18 ,$123.48 ,$17.27 ,$137.20 ,$89.87 ,$17.27 ,$57.08 ,$8.21 ,$7.83 ,$18.13 ,$123.48 ,$38.86 ,$84.65 ,$38.42 ,$123.48 ,$17.27 ,$123.48 ,$123.48 ,$17.27 ,$89.18 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30101771,82653,HC EL-1 FECAL QUANTITATIVE-90,301,1 ,$110.00 ,$71.50 ,$7.83 ,$110.00 ,$57.43 ,$81.95 ,$72.05 ,$22.97 ,$30.80 ,$55.55 ,$22.97 ,$67.87 ,$22.97 ,$67.87 ,$67.87 ,$22.97 ,$67.87 ,$43.64 ,$99.00 ,$82.50 ,$57.43 ,$22.97 ,$96.80 ,$22.97 ,$82.50 ,$82.50 ,$93.50 ,$93.50 ,$22.97 ,$93.50 ,$22.97 ,$85.80 ,$85.80 ,$85.80 ,$99.00 ,$57.43 ,$99.00 ,$22.97 ,$110.00 ,$72.05 ,$22.97 ,$45.76 ,$8.21 ,$7.83 ,$24.12 ,$99.00 ,$51.68 ,$67.87 ,$30.80 ,$99.00 ,$22.97 ,$99.00 ,$99.00 ,$22.97 ,$71.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$197.00 ,$128.05 ,$5.18 ,$197.00 ,$12.95 ,$146.77 ,$129.04 ,$5.18 ,$55.16 ,$99.49 ,$5.18 ,$121.55 ,$5.18 ,$121.55 ,$121.55 ,$5.18 ,$121.55 ,$9.84 ,$177.30 ,$147.75 ,$12.95 ,$5.18 ,$173.36 ,$5.18 ,$147.75 ,$147.75 ,$167.45 ,$167.45 ,$5.18 ,$167.45 ,$5.18 ,$153.66 ,$153.66 ,$153.66 ,$177.30 ,$12.95 ,$177.30 ,$5.18 ,$197.00 ,$129.04 ,$5.18 ,$81.95 ,$7.35 ,$7.01 ,$5.44 ,$177.30 ,$11.66 ,$121.55 ,$55.16 ,$177.30 ,$5.18 ,$177.30 ,$177.30 ,$5.18 ,$128.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200191,86403,HC PARTICLE AGG SCREEN,302,1 ,$181.00 ,$117.65 ,$7.01 ,$181.00 ,$28.85 ,$134.85 ,$118.56 ,$11.54 ,$50.68 ,$91.41 ,$11.54 ,$111.68 ,$11.54 ,$111.68 ,$111.68 ,$11.54 ,$111.68 ,$21.93 ,$162.90 ,$135.75 ,$28.85 ,$11.54 ,$159.28 ,$11.54 ,$135.75 ,$135.75 ,$153.85 ,$153.85 ,$11.54 ,$153.85 ,$11.54 ,$141.18 ,$141.18 ,$141.18 ,$162.90 ,$28.85 ,$162.90 ,$11.54 ,$181.00 ,$118.56 ,$11.54 ,$75.30 ,$7.35 ,$7.01 ,$12.12 ,$162.90 ,$25.97 ,$111.68 ,$50.68 ,$162.90 ,$11.54 ,$162.90 ,$162.90 ,$11.54 ,$117.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200201,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$118.00 ,$76.70 ,$4.27 ,$118.00 ,$10.68 ,$87.91 ,$77.29 ,$4.27 ,$33.04 ,$59.59 ,$4.27 ,$72.81 ,$4.27 ,$72.81 ,$72.81 ,$4.27 ,$72.81 ,$8.11 ,$106.20 ,$88.50 ,$10.68 ,$4.27 ,$103.84 ,$4.27 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$4.27 ,$100.30 ,$4.27 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$10.68 ,$106.20 ,$4.27 ,$118.00 ,$77.29 ,$4.27 ,$49.09 ,$7.35 ,$7.01 ,$4.48 ,$106.20 ,$9.61 ,$72.81 ,$33.04 ,$106.20 ,$4.27 ,$106.20 ,$106.20 ,$4.27 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200288,86762,HC RUBELLA AB,302,1 ,$140.00 ,$91.00 ,$7.01 ,$140.00 ,$35.98 ,$104.30 ,$91.70 ,$14.39 ,$39.20 ,$70.70 ,$14.39 ,$86.38 ,$14.39 ,$86.38 ,$86.38 ,$14.39 ,$86.38 ,$27.34 ,$126.00 ,$105.00 ,$35.98 ,$14.39 ,$123.20 ,$14.39 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$14.39 ,$119.00 ,$14.39 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$35.98 ,$126.00 ,$14.39 ,$140.00 ,$91.70 ,$14.39 ,$58.24 ,$7.35 ,$7.01 ,$15.11 ,$126.00 ,$32.38 ,$86.38 ,$39.20 ,$126.00 ,$14.39 ,$126.00 ,$126.00 ,$14.39 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200506,86060,HC ASO,302,1 ,$229.00 ,$148.85 ,$7.01 ,$229.00 ,$18.25 ,$170.61 ,$150.00 ,$7.30 ,$64.12 ,$115.65 ,$7.30 ,$141.29 ,$7.30 ,$141.29 ,$141.29 ,$7.30 ,$141.29 ,$13.87 ,$206.10 ,$171.75 ,$18.25 ,$7.30 ,$201.52 ,$7.30 ,$171.75 ,$171.75 ,$194.65 ,$194.65 ,$7.30 ,$194.65 ,$7.30 ,$178.62 ,$178.62 ,$178.62 ,$206.10 ,$18.25 ,$206.10 ,$7.30 ,$229.00 ,$150.00 ,$7.30 ,$95.26 ,$7.35 ,$7.01 ,$7.67 ,$206.10 ,$16.43 ,$141.29 ,$64.12 ,$206.10 ,$7.30 ,$206.10 ,$206.10 ,$7.30 ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200507,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$150.00 ,$97.50 ,$7.01 ,$150.00 ,$32.38 ,$111.75 ,$98.25 ,$12.95 ,$42.00 ,$75.75 ,$12.95 ,$92.55 ,$12.95 ,$92.55 ,$92.55 ,$12.95 ,$92.55 ,$24.61 ,$135.00 ,$112.50 ,$32.38 ,$12.95 ,$132.00 ,$12.95 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$12.95 ,$127.50 ,$12.95 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$32.38 ,$135.00 ,$12.95 ,$150.00 ,$98.25 ,$12.95 ,$62.40 ,$7.35 ,$7.01 ,$13.60 ,$135.00 ,$29.14 ,$92.55 ,$42.00 ,$135.00 ,$12.95 ,$135.00 ,$135.00 ,$12.95 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200523,86431,HC RHEUMATOID FACTOR QN,302,1 ,$216.00 ,$140.40 ,$5.67 ,$216.00 ,$14.18 ,$160.92 ,$141.48 ,$5.67 ,$60.48 ,$109.08 ,$5.67 ,$133.27 ,$5.67 ,$133.27 ,$133.27 ,$5.67 ,$133.27 ,$10.77 ,$194.40 ,$162.00 ,$14.18 ,$5.67 ,$190.08 ,$5.67 ,$162.00 ,$162.00 ,$183.60 ,$183.60 ,$5.67 ,$183.60 ,$5.67 ,$168.48 ,$168.48 ,$168.48 ,$194.40 ,$14.18 ,$194.40 ,$5.67 ,$216.00 ,$141.48 ,$5.67 ,$89.86 ,$7.35 ,$7.01 ,$5.95 ,$194.40 ,$12.76 ,$133.27 ,$60.48 ,$194.40 ,$5.67 ,$194.40 ,$194.40 ,$5.67 ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200542,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$283.00 ,$183.95 ,$7.01 ,$283.00 ,$34.28 ,$210.84 ,$185.37 ,$13.71 ,$79.24 ,$142.92 ,$13.71 ,$174.61 ,$13.71 ,$174.61 ,$174.61 ,$13.71 ,$174.61 ,$26.05 ,$254.70 ,$212.25 ,$34.28 ,$13.71 ,$249.04 ,$13.71 ,$212.25 ,$212.25 ,$240.55 ,$240.55 ,$13.71 ,$240.55 ,$13.71 ,$220.74 ,$220.74 ,$220.74 ,$254.70 ,$34.28 ,$254.70 ,$13.71 ,$283.00 ,$185.37 ,$13.71 ,$117.73 ,$7.35 ,$7.01 ,$14.40 ,$254.70 ,$30.85 ,$174.61 ,$79.24 ,$254.70 ,$13.71 ,$254.70 ,$254.70 ,$13.71 ,$183.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200544,86705,HC HEP B CORE IGM,302,1 ,$99.00 ,$64.35 ,$7.01 ,$99.00 ,$29.43 ,$73.76 ,$64.85 ,$11.77 ,$27.72 ,$50.00 ,$11.77 ,$61.08 ,$11.77 ,$61.08 ,$61.08 ,$11.77 ,$61.08 ,$22.36 ,$89.10 ,$74.25 ,$29.43 ,$11.77 ,$87.12 ,$11.77 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$11.77 ,$84.15 ,$11.77 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$29.43 ,$89.10 ,$11.77 ,$99.00 ,$64.85 ,$11.77 ,$41.18 ,$7.35 ,$7.01 ,$12.36 ,$89.10 ,$26.48 ,$61.08 ,$27.72 ,$89.10 ,$11.77 ,$89.10 ,$89.10 ,$11.77 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200545,86706,HC HEP B SURFACE AB,302,1 ,$248.00 ,$161.20 ,$7.01 ,$248.00 ,$26.85 ,$184.76 ,$162.44 ,$10.74 ,$69.44 ,$125.24 ,$10.74 ,$153.02 ,$10.74 ,$153.02 ,$153.02 ,$10.74 ,$153.02 ,$20.41 ,$223.20 ,$186.00 ,$26.85 ,$10.74 ,$218.24 ,$10.74 ,$186.00 ,$186.00 ,$210.80 ,$210.80 ,$10.74 ,$210.80 ,$10.74 ,$193.44 ,$193.44 ,$193.44 ,$223.20 ,$26.85 ,$223.20 ,$10.74 ,$248.00 ,$162.44 ,$10.74 ,$103.17 ,$7.35 ,$7.01 ,$11.28 ,$223.20 ,$24.17 ,$153.02 ,$69.44 ,$223.20 ,$10.74 ,$223.20 ,$223.20 ,$10.74 ,$161.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200548,86709,HC HEP A AB IGM,302,1 ,$191.00 ,$124.15 ,$7.01 ,$191.00 ,$28.15 ,$142.30 ,$125.11 ,$11.26 ,$53.48 ,$96.46 ,$11.26 ,$117.85 ,$11.26 ,$117.85 ,$117.85 ,$11.26 ,$117.85 ,$21.39 ,$171.90 ,$143.25 ,$28.15 ,$11.26 ,$168.08 ,$11.26 ,$143.25 ,$143.25 ,$162.35 ,$162.35 ,$11.26 ,$162.35 ,$11.26 ,$148.98 ,$148.98 ,$148.98 ,$171.90 ,$28.15 ,$171.90 ,$11.26 ,$191.00 ,$125.11 ,$11.26 ,$79.46 ,$7.35 ,$7.01 ,$11.82 ,$171.90 ,$25.34 ,$117.85 ,$53.48 ,$171.90 ,$11.26 ,$171.90 ,$171.90 ,$11.26 ,$124.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200559,86850,HC AB SCREEN,302,1 ,$86.00 ,$55.90 ,$7.01 ,$110.23 ,$86.00 ,$64.07 ,$56.33 ,$48.99 ,$24.08 ,$43.43 ,$48.99 ,$53.06 ,$48.99 ,$53.06 ,$53.06 ,$48.99 ,$53.06 ,$93.08 ,$77.40 ,$64.50 ,$86.00 ,$48.99 ,$75.68 ,$48.99 ,$64.50 ,$64.50 ,$73.10 ,$73.10 ,$48.99 ,$73.10 ,$48.99 ,$67.08 ,$67.08 ,$67.08 ,$77.40 ,$86.00 ,$77.40 ,$48.99 ,$86.00 ,$56.33 ,$48.99 ,$35.78 ,$7.35 ,$7.01 ,$51.44 ,$77.40 ,$110.23 ,$53.06 ,$24.08 ,$77.40 ,$48.99 ,$77.40 ,$77.40 ,$48.99 ,$55.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200561,86870,HC RBC AB ID PANEL,302,1 ,$283.00 ,$183.95 ,$7.01 ,$646.05 ,$283.00 ,$210.84 ,$185.37 ,$283.00 ,$79.24 ,$142.92 ,$283.00 ,$174.61 ,$283.00 ,$174.61 ,$174.61 ,$283.00 ,$174.61 ,$545.55 ,$254.70 ,$212.25 ,$283.00 ,$283.00 ,$249.04 ,$283.00 ,$212.25 ,$212.25 ,$240.55 ,$240.55 ,$283.00 ,$240.55 ,$283.00 ,$220.74 ,$220.74 ,$220.74 ,$254.70 ,$283.00 ,$254.70 ,$283.00 ,$283.00 ,$185.37 ,$283.00 ,$117.73 ,$7.35 ,$7.01 ,$283.00 ,$254.70 ,$646.05 ,$174.61 ,$79.24 ,$254.70 ,$283.00 ,$254.70 ,$254.70 ,$283.00 ,$183.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200562,86880,HC COOMBS DIRECT,302,1 ,$80.00 ,$52.00 ,$7.01 ,$123.48 ,$80.00 ,$59.60 ,$52.40 ,$54.88 ,$22.40 ,$40.40 ,$54.88 ,$49.36 ,$54.88 ,$49.36 ,$49.36 ,$54.88 ,$49.36 ,$104.27 ,$72.00 ,$60.00 ,$80.00 ,$54.88 ,$70.40 ,$54.88 ,$60.00 ,$60.00 ,$68.00 ,$68.00 ,$54.88 ,$68.00 ,$54.88 ,$62.40 ,$62.40 ,$62.40 ,$72.00 ,$80.00 ,$72.00 ,$54.88 ,$80.00 ,$52.40 ,$54.88 ,$33.28 ,$7.35 ,$7.01 ,$57.62 ,$72.00 ,$123.48 ,$49.36 ,$22.40 ,$72.00 ,$54.88 ,$72.00 ,$72.00 ,$54.88 ,$52.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200563,86885,HC INDIRECT COOMBS,302,1 ,$67.00 ,$43.55 ,$7.01 ,$330.83 ,$67.00 ,$49.92 ,$43.89 ,$67.00 ,$18.76 ,$33.84 ,$67.00 ,$41.34 ,$67.00 ,$41.34 ,$41.34 ,$67.00 ,$41.34 ,$279.38 ,$60.30 ,$50.25 ,$67.00 ,$67.00 ,$58.96 ,$67.00 ,$50.25 ,$50.25 ,$56.95 ,$56.95 ,$67.00 ,$56.95 ,$67.00 ,$52.26 ,$52.26 ,$52.26 ,$60.30 ,$67.00 ,$60.30 ,$67.00 ,$67.00 ,$43.89 ,$67.00 ,$27.87 ,$7.35 ,$7.01 ,$67.00 ,$60.30 ,$330.83 ,$41.34 ,$18.76 ,$60.30 ,$67.00 ,$60.30 ,$60.30 ,$67.00 ,$43.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200565,86900,HC BLOOD TYPING ABO,302,1 ,$44.00 ,$28.60 ,$4.35 ,$250.12 ,$44.00 ,$32.78 ,$28.82 ,$44.00 ,$12.32 ,$22.22 ,$44.00 ,$27.15 ,$44.00 ,$27.15 ,$27.15 ,$44.00 ,$27.15 ,$211.22 ,$39.60 ,$33.00 ,$44.00 ,$44.00 ,$38.72 ,$44.00 ,$33.00 ,$33.00 ,$37.40 ,$37.40 ,$44.00 ,$37.40 ,$44.00 ,$34.32 ,$34.32 ,$34.32 ,$39.60 ,$44.00 ,$39.60 ,$44.00 ,$44.00 ,$28.82 ,$44.00 ,$18.30 ,$4.55 ,$4.35 ,$44.00 ,$39.60 ,$250.12 ,$27.15 ,$12.32 ,$39.60 ,$44.00 ,$39.60 ,$39.60 ,$44.00 ,$28.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200566,86901,HC BLOOD TYPING RH,302,1 ,$45.00 ,$29.25 ,$4.35 ,$75.08 ,$45.00 ,$33.53 ,$29.48 ,$33.37 ,$12.60 ,$22.73 ,$33.37 ,$27.77 ,$33.37 ,$27.77 ,$27.77 ,$33.37 ,$27.77 ,$63.40 ,$40.50 ,$33.75 ,$45.00 ,$33.37 ,$39.60 ,$33.37 ,$33.75 ,$33.75 ,$38.25 ,$38.25 ,$33.37 ,$38.25 ,$33.37 ,$35.10 ,$35.10 ,$35.10 ,$40.50 ,$45.00 ,$40.50 ,$33.37 ,$45.00 ,$29.48 ,$33.37 ,$18.72 ,$4.55 ,$4.35 ,$35.04 ,$40.50 ,$75.08 ,$27.77 ,$12.60 ,$40.50 ,$33.37 ,$40.50 ,$40.50 ,$33.37 ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200567,86902,HC RBC AG SCR RGT SERUM,302,1 ,$111.00 ,$72.15 ,$4.35 ,$646.05 ,$111.00 ,$82.70 ,$72.71 ,$111.00 ,$31.08 ,$56.06 ,$111.00 ,$68.49 ,$111.00 ,$68.49 ,$68.49 ,$111.00 ,$68.49 ,$545.55 ,$99.90 ,$83.25 ,$111.00 ,$111.00 ,$97.68 ,$111.00 ,$83.25 ,$83.25 ,$94.35 ,$94.35 ,$111.00 ,$94.35 ,$111.00 ,$86.58 ,$86.58 ,$86.58 ,$99.90 ,$111.00 ,$99.90 ,$111.00 ,$111.00 ,$72.71 ,$111.00 ,$46.18 ,$4.55 ,$4.35 ,$111.00 ,$99.90 ,$646.05 ,$68.49 ,$31.08 ,$99.90 ,$111.00 ,$99.90 ,$99.90 ,$111.00 ,$72.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$71.00 ,$46.15 ,$4.35 ,$646.05 ,$71.00 ,$52.90 ,$46.51 ,$71.00 ,$19.88 ,$35.86 ,$71.00 ,$43.81 ,$71.00 ,$43.81 ,$43.81 ,$71.00 ,$43.81 ,$545.55 ,$63.90 ,$53.25 ,$71.00 ,$71.00 ,$62.48 ,$71.00 ,$53.25 ,$53.25 ,$60.35 ,$60.35 ,$71.00 ,$60.35 ,$71.00 ,$55.38 ,$55.38 ,$55.38 ,$63.90 ,$71.00 ,$63.90 ,$71.00 ,$71.00 ,$46.51 ,$71.00 ,$29.54 ,$4.55 ,$4.35 ,$71.00 ,$63.90 ,$646.05 ,$43.81 ,$19.88 ,$63.90 ,$71.00 ,$63.90 ,$63.90 ,$71.00 ,$46.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$111.00 ,$72.15 ,$4.35 ,$330.83 ,$111.00 ,$82.70 ,$72.71 ,$111.00 ,$31.08 ,$56.06 ,$111.00 ,$68.49 ,$111.00 ,$68.49 ,$68.49 ,$111.00 ,$68.49 ,$279.38 ,$99.90 ,$83.25 ,$111.00 ,$111.00 ,$97.68 ,$111.00 ,$83.25 ,$83.25 ,$94.35 ,$94.35 ,$111.00 ,$94.35 ,$111.00 ,$86.58 ,$86.58 ,$86.58 ,$99.90 ,$111.00 ,$99.90 ,$111.00 ,$111.00 ,$72.71 ,$111.00 ,$46.18 ,$4.55 ,$4.35 ,$111.00 ,$99.90 ,$330.83 ,$68.49 ,$31.08 ,$99.90 ,$111.00 ,$99.90 ,$99.90 ,$111.00 ,$72.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200570,86921,HC CROSSMATCH INCUBATION,302,1 ,$57.00 ,$37.05 ,$4.35 ,$330.83 ,$57.00 ,$42.47 ,$37.34 ,$57.00 ,$15.96 ,$28.79 ,$57.00 ,$35.17 ,$57.00 ,$35.17 ,$35.17 ,$57.00 ,$35.17 ,$279.38 ,$51.30 ,$42.75 ,$57.00 ,$57.00 ,$50.16 ,$57.00 ,$42.75 ,$42.75 ,$48.45 ,$48.45 ,$57.00 ,$48.45 ,$57.00 ,$44.46 ,$44.46 ,$44.46 ,$51.30 ,$57.00 ,$51.30 ,$57.00 ,$57.00 ,$37.34 ,$57.00 ,$23.71 ,$4.55 ,$4.35 ,$57.00 ,$51.30 ,$330.83 ,$35.17 ,$15.96 ,$51.30 ,$57.00 ,$51.30 ,$51.30 ,$57.00 ,$37.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200571,86922,HC CROSSMATCH AHG,302,1 ,$103.00 ,$66.95 ,$28.31 ,$330.83 ,$103.00 ,$76.74 ,$67.47 ,$103.00 ,$28.84 ,$52.02 ,$103.00 ,$63.55 ,$103.00 ,$63.55 ,$63.55 ,$103.00 ,$63.55 ,$279.38 ,$92.70 ,$77.25 ,$103.00 ,$103.00 ,$90.64 ,$103.00 ,$77.25 ,$77.25 ,$87.55 ,$87.55 ,$103.00 ,$87.55 ,$103.00 ,$80.34 ,$80.34 ,$80.34 ,$92.70 ,$103.00 ,$92.70 ,$103.00 ,$103.00 ,$67.47 ,$103.00 ,$42.85 ,$29.66 ,$28.31 ,$103.00 ,$92.70 ,$330.83 ,$63.55 ,$28.84 ,$92.70 ,$103.00 ,$92.70 ,$92.70 ,$103.00 ,$66.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200839,86003,HC ALLERGEN IGE QN EA - 90,302,1 ,$285.40 ,$185.51 ,$5.22 ,$285.40 ,$13.05 ,$212.62 ,$186.94 ,$5.22 ,$79.91 ,$144.13 ,$5.22 ,$176.09 ,$5.22 ,$176.09 ,$176.09 ,$5.22 ,$176.09 ,$9.92 ,$256.86 ,$214.05 ,$13.05 ,$5.22 ,$251.15 ,$5.22 ,$214.05 ,$214.05 ,$242.59 ,$242.59 ,$5.22 ,$242.59 ,$5.22 ,$222.61 ,$222.61 ,$222.61 ,$256.86 ,$13.05 ,$256.86 ,$5.22 ,$285.40 ,$186.94 ,$5.22 ,$118.73 ,$7.35 ,$7.01 ,$5.48 ,$256.86 ,$11.75 ,$176.09 ,$79.91 ,$256.86 ,$5.22 ,$256.86 ,$256.86 ,$5.22 ,$185.51 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200843,86000,HC AGGLUTININS FEBRILE EA AG-90,302,1 ,$100.00 ,$65.00 ,$6.98 ,$100.00 ,$17.45 ,$74.50 ,$65.50 ,$6.98 ,$28.00 ,$50.50 ,$6.98 ,$61.70 ,$6.98 ,$61.70 ,$61.70 ,$6.98 ,$61.70 ,$13.26 ,$90.00 ,$75.00 ,$17.45 ,$6.98 ,$88.00 ,$6.98 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$6.98 ,$85.00 ,$6.98 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$17.45 ,$90.00 ,$6.98 ,$100.00 ,$65.50 ,$6.98 ,$41.60 ,$7.35 ,$7.01 ,$7.33 ,$90.00 ,$15.71 ,$61.70 ,$28.00 ,$90.00 ,$6.98 ,$90.00 ,$90.00 ,$6.98 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200844,86001,HC RAST ALLERGEN IGG QN SQ EA-90,302,1 ,$9.76 ,$6.34 ,$2.73 ,$17.60 ,$9.76 ,$7.27 ,$6.39 ,$7.82 ,$2.73 ,$4.93 ,$7.82 ,$6.02 ,$7.82 ,$6.02 ,$6.02 ,$7.82 ,$6.02 ,$14.86 ,$8.78 ,$7.32 ,$9.76 ,$7.82 ,$8.59 ,$7.82 ,$7.32 ,$7.32 ,$8.30 ,$8.30 ,$7.82 ,$8.30 ,$7.82 ,$7.61 ,$7.61 ,$7.61 ,$8.78 ,$9.76 ,$8.78 ,$7.82 ,$9.76 ,$6.39 ,$7.82 ,$4.06 ,$7.35 ,$7.01 ,$8.21 ,$8.78 ,$17.60 ,$6.02 ,$2.73 ,$8.78 ,$7.82 ,$8.78 ,$8.78 ,$7.82 ,$6.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$28.00 ,$18.20 ,$5.22 ,$28.00 ,$13.05 ,$20.86 ,$18.34 ,$5.22 ,$7.84 ,$14.14 ,$5.22 ,$17.28 ,$5.22 ,$17.28 ,$17.28 ,$5.22 ,$17.28 ,$9.92 ,$25.20 ,$21.00 ,$13.05 ,$5.22 ,$24.64 ,$5.22 ,$21.00 ,$21.00 ,$23.80 ,$23.80 ,$5.22 ,$23.80 ,$5.22 ,$21.84 ,$21.84 ,$21.84 ,$25.20 ,$13.05 ,$25.20 ,$5.22 ,$28.00 ,$18.34 ,$5.22 ,$11.65 ,$7.35 ,$7.01 ,$5.48 ,$25.20 ,$11.75 ,$17.28 ,$7.84 ,$25.20 ,$5.22 ,$25.20 ,$25.20 ,$5.22 ,$18.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200847,86021,HC LEUKO AB ID-90,302,1 ,$107.00 ,$69.55 ,$7.01 ,$107.00 ,$37.63 ,$79.72 ,$70.09 ,$15.05 ,$29.96 ,$54.04 ,$15.05 ,$66.02 ,$15.05 ,$66.02 ,$66.02 ,$15.05 ,$66.02 ,$28.60 ,$96.30 ,$80.25 ,$37.63 ,$15.05 ,$94.16 ,$15.05 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$15.05 ,$90.95 ,$15.05 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$37.63 ,$96.30 ,$15.05 ,$107.00 ,$70.09 ,$15.05 ,$44.51 ,$7.35 ,$7.01 ,$15.80 ,$96.30 ,$33.86 ,$66.02 ,$29.96 ,$96.30 ,$15.05 ,$96.30 ,$96.30 ,$15.05 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200851,86022,HC PLATELET AB ID-90,302,1 ,$578.00 ,$375.70 ,$7.01 ,$578.00 ,$45.93 ,$430.61 ,$378.59 ,$18.37 ,$161.84 ,$291.89 ,$18.37 ,$356.63 ,$18.37 ,$356.63 ,$356.63 ,$18.37 ,$356.63 ,$34.90 ,$520.20 ,$433.50 ,$45.93 ,$18.37 ,$508.64 ,$18.37 ,$433.50 ,$433.50 ,$491.30 ,$491.30 ,$18.37 ,$491.30 ,$18.37 ,$450.84 ,$450.84 ,$450.84 ,$520.20 ,$45.93 ,$520.20 ,$18.37 ,$578.00 ,$378.59 ,$18.37 ,$240.45 ,$7.35 ,$7.01 ,$19.29 ,$520.20 ,$41.33 ,$356.63 ,$161.84 ,$520.20 ,$18.37 ,$520.20 ,$520.20 ,$18.37 ,$375.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200852,86022,HC PLATE AB SEROTONIN RELEASE-90,302,1 ,$130.00 ,$84.50 ,$7.01 ,$130.00 ,$45.93 ,$96.85 ,$85.15 ,$18.37 ,$36.40 ,$65.65 ,$18.37 ,$80.21 ,$18.37 ,$80.21 ,$80.21 ,$18.37 ,$80.21 ,$34.90 ,$117.00 ,$97.50 ,$45.93 ,$18.37 ,$114.40 ,$18.37 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$18.37 ,$110.50 ,$18.37 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$45.93 ,$117.00 ,$18.37 ,$130.00 ,$85.15 ,$18.37 ,$54.08 ,$7.35 ,$7.01 ,$19.29 ,$117.00 ,$41.33 ,$80.21 ,$36.40 ,$117.00 ,$18.37 ,$117.00 ,$117.00 ,$18.37 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200858,86038,HC ANA SCREEN-90,302,1 ,$7.00 ,$4.55 ,$1.96 ,$15.75 ,$7.00 ,$5.22 ,$4.59 ,$7.00 ,$1.96 ,$3.54 ,$7.00 ,$4.32 ,$7.00 ,$4.32 ,$4.32 ,$7.00 ,$4.32 ,$13.30 ,$6.30 ,$5.25 ,$7.00 ,$7.00 ,$6.16 ,$7.00 ,$5.25 ,$5.25 ,$5.95 ,$5.95 ,$7.00 ,$5.95 ,$7.00 ,$5.46 ,$5.46 ,$5.46 ,$6.30 ,$7.00 ,$6.30 ,$7.00 ,$7.00 ,$4.59 ,$7.00 ,$2.91 ,$7.00 ,$7.00 ,$7.00 ,$6.30 ,$15.75 ,$4.32 ,$1.96 ,$6.30 ,$7.00 ,$6.30 ,$6.30 ,$7.00 ,$4.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200859,86039,HC ANA TITER-90,302,1 ,$238.00 ,$154.70 ,$7.01 ,$238.00 ,$27.90 ,$177.31 ,$155.89 ,$11.16 ,$66.64 ,$120.19 ,$11.16 ,$146.85 ,$11.16 ,$146.85 ,$146.85 ,$11.16 ,$146.85 ,$21.20 ,$214.20 ,$178.50 ,$27.90 ,$11.16 ,$209.44 ,$11.16 ,$178.50 ,$178.50 ,$202.30 ,$202.30 ,$11.16 ,$202.30 ,$11.16 ,$185.64 ,$185.64 ,$185.64 ,$214.20 ,$27.90 ,$214.20 ,$11.16 ,$238.00 ,$155.89 ,$11.16 ,$99.01 ,$7.35 ,$7.01 ,$11.72 ,$214.20 ,$25.11 ,$146.85 ,$66.64 ,$214.20 ,$11.16 ,$214.20 ,$214.20 ,$11.16 ,$154.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200861,86140,HC C-REACTIVE PROTEIN-90,302,1 ,$178.00 ,$115.70 ,$5.18 ,$178.00 ,$12.95 ,$132.61 ,$116.59 ,$5.18 ,$49.84 ,$89.89 ,$5.18 ,$109.83 ,$5.18 ,$109.83 ,$109.83 ,$5.18 ,$109.83 ,$9.84 ,$160.20 ,$133.50 ,$12.95 ,$5.18 ,$156.64 ,$5.18 ,$133.50 ,$133.50 ,$151.30 ,$151.30 ,$5.18 ,$151.30 ,$5.18 ,$138.84 ,$138.84 ,$138.84 ,$160.20 ,$12.95 ,$160.20 ,$5.18 ,$178.00 ,$116.59 ,$5.18 ,$74.05 ,$7.35 ,$7.01 ,$5.44 ,$160.20 ,$11.66 ,$109.83 ,$49.84 ,$160.20 ,$5.18 ,$160.20 ,$160.20 ,$5.18 ,$115.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200862,86140,HC C-REACTIVE PROTEIN,302,1 ,$178.00 ,$115.70 ,$5.18 ,$178.00 ,$12.95 ,$132.61 ,$116.59 ,$5.18 ,$49.84 ,$89.89 ,$5.18 ,$109.83 ,$5.18 ,$109.83 ,$109.83 ,$5.18 ,$109.83 ,$9.84 ,$160.20 ,$133.50 ,$12.95 ,$5.18 ,$156.64 ,$5.18 ,$133.50 ,$133.50 ,$151.30 ,$151.30 ,$5.18 ,$151.30 ,$5.18 ,$138.84 ,$138.84 ,$138.84 ,$160.20 ,$12.95 ,$160.20 ,$5.18 ,$178.00 ,$116.59 ,$5.18 ,$74.05 ,$7.35 ,$7.01 ,$5.44 ,$160.20 ,$11.66 ,$109.83 ,$49.84 ,$160.20 ,$5.18 ,$160.20 ,$160.20 ,$5.18 ,$115.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$181.00 ,$117.65 ,$7.83 ,$181.00 ,$63.63 ,$134.85 ,$118.56 ,$25.45 ,$50.68 ,$91.41 ,$25.45 ,$111.68 ,$25.45 ,$111.68 ,$111.68 ,$25.45 ,$111.68 ,$48.36 ,$162.90 ,$135.75 ,$63.63 ,$25.45 ,$159.28 ,$25.45 ,$135.75 ,$135.75 ,$153.85 ,$153.85 ,$25.45 ,$153.85 ,$25.45 ,$141.18 ,$141.18 ,$141.18 ,$162.90 ,$63.63 ,$162.90 ,$25.45 ,$181.00 ,$118.56 ,$25.45 ,$75.30 ,$8.21 ,$7.83 ,$26.72 ,$162.90 ,$57.26 ,$111.68 ,$50.68 ,$162.90 ,$25.45 ,$162.90 ,$162.90 ,$25.45 ,$117.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$227.00 ,$147.55 ,$12.09 ,$227.00 ,$63.63 ,$169.12 ,$148.69 ,$25.45 ,$63.56 ,$114.64 ,$25.45 ,$140.06 ,$25.45 ,$140.06 ,$140.06 ,$25.45 ,$140.06 ,$48.36 ,$204.30 ,$170.25 ,$63.63 ,$25.45 ,$199.76 ,$25.45 ,$170.25 ,$170.25 ,$192.95 ,$192.95 ,$25.45 ,$192.95 ,$25.45 ,$177.06 ,$177.06 ,$177.06 ,$204.30 ,$63.63 ,$204.30 ,$25.45 ,$227.00 ,$148.69 ,$25.45 ,$94.43 ,$12.66 ,$12.09 ,$26.72 ,$204.30 ,$57.26 ,$140.06 ,$63.56 ,$204.30 ,$25.45 ,$204.30 ,$204.30 ,$25.45 ,$147.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200866,86148,HC ANTI-PHOSPHATIDYLSERINE AB-90,302,1 ,$69.00 ,$44.85 ,$7.83 ,$69.00 ,$40.18 ,$51.41 ,$45.20 ,$16.07 ,$19.32 ,$34.85 ,$16.07 ,$42.57 ,$16.07 ,$42.57 ,$42.57 ,$16.07 ,$42.57 ,$30.53 ,$62.10 ,$51.75 ,$40.18 ,$16.07 ,$60.72 ,$16.07 ,$51.75 ,$51.75 ,$58.65 ,$58.65 ,$16.07 ,$58.65 ,$16.07 ,$53.82 ,$53.82 ,$53.82 ,$62.10 ,$40.18 ,$62.10 ,$16.07 ,$69.00 ,$45.20 ,$16.07 ,$28.70 ,$8.21 ,$7.83 ,$16.87 ,$62.10 ,$36.16 ,$42.57 ,$19.32 ,$62.10 ,$16.07 ,$62.10 ,$62.10 ,$16.07 ,$44.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$163.00 ,$105.95 ,$7.01 ,$163.00 ,$20.15 ,$121.44 ,$106.77 ,$8.06 ,$45.64 ,$82.32 ,$8.06 ,$100.57 ,$8.06 ,$100.57 ,$100.57 ,$8.06 ,$100.57 ,$15.31 ,$146.70 ,$122.25 ,$20.15 ,$8.06 ,$143.44 ,$8.06 ,$122.25 ,$122.25 ,$138.55 ,$138.55 ,$8.06 ,$138.55 ,$8.06 ,$127.14 ,$127.14 ,$127.14 ,$146.70 ,$20.15 ,$146.70 ,$8.06 ,$163.00 ,$106.77 ,$8.06 ,$67.81 ,$7.35 ,$7.01 ,$8.46 ,$146.70 ,$18.14 ,$100.57 ,$45.64 ,$146.70 ,$8.06 ,$146.70 ,$146.70 ,$8.06 ,$105.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$85.00 ,$55.25 ,$7.01 ,$85.00 ,$30.00 ,$63.33 ,$55.68 ,$12.00 ,$23.80 ,$42.93 ,$12.00 ,$52.45 ,$12.00 ,$52.45 ,$52.45 ,$12.00 ,$52.45 ,$22.80 ,$76.50 ,$63.75 ,$30.00 ,$12.00 ,$74.80 ,$12.00 ,$63.75 ,$63.75 ,$72.25 ,$72.25 ,$12.00 ,$72.25 ,$12.00 ,$66.30 ,$66.30 ,$66.30 ,$76.50 ,$30.00 ,$76.50 ,$12.00 ,$85.00 ,$55.68 ,$12.00 ,$35.36 ,$7.35 ,$7.01 ,$12.60 ,$76.50 ,$27.00 ,$52.45 ,$23.80 ,$76.50 ,$12.00 ,$76.50 ,$76.50 ,$12.00 ,$55.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200870,86161,HC C1 ESTERASE INHIBITOR-90,302,1 ,$35.00 ,$22.75 ,$7.01 ,$35.00 ,$30.00 ,$26.08 ,$22.93 ,$12.00 ,$9.80 ,$17.68 ,$12.00 ,$21.60 ,$12.00 ,$21.60 ,$21.60 ,$12.00 ,$21.60 ,$22.80 ,$31.50 ,$26.25 ,$30.00 ,$12.00 ,$30.80 ,$12.00 ,$26.25 ,$26.25 ,$29.75 ,$29.75 ,$12.00 ,$29.75 ,$12.00 ,$27.30 ,$27.30 ,$27.30 ,$31.50 ,$30.00 ,$31.50 ,$12.00 ,$35.00 ,$22.93 ,$12.00 ,$14.56 ,$7.35 ,$7.01 ,$12.60 ,$31.50 ,$27.00 ,$21.60 ,$9.80 ,$31.50 ,$12.00 ,$31.50 ,$31.50 ,$12.00 ,$22.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$175.00 ,$113.75 ,$7.01 ,$175.00 ,$50.80 ,$130.38 ,$114.63 ,$20.32 ,$49.00 ,$88.38 ,$20.32 ,$107.98 ,$20.32 ,$107.98 ,$107.98 ,$20.32 ,$107.98 ,$38.61 ,$157.50 ,$131.25 ,$50.80 ,$20.32 ,$154.00 ,$20.32 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$20.32 ,$148.75 ,$20.32 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$50.80 ,$157.50 ,$20.32 ,$175.00 ,$114.63 ,$20.32 ,$72.80 ,$7.35 ,$7.01 ,$21.34 ,$157.50 ,$45.72 ,$107.98 ,$49.00 ,$157.50 ,$20.32 ,$157.50 ,$157.50 ,$20.32 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200873,86200,HC CCP AB-90,302,1 ,$292.00 ,$189.80 ,$7.01 ,$292.00 ,$32.38 ,$217.54 ,$191.26 ,$12.95 ,$81.76 ,$147.46 ,$12.95 ,$180.16 ,$12.95 ,$180.16 ,$180.16 ,$12.95 ,$180.16 ,$24.61 ,$262.80 ,$219.00 ,$32.38 ,$12.95 ,$256.96 ,$12.95 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$12.95 ,$248.20 ,$12.95 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$32.38 ,$262.80 ,$12.95 ,$292.00 ,$191.26 ,$12.95 ,$121.47 ,$7.35 ,$7.01 ,$13.60 ,$262.80 ,$29.14 ,$180.16 ,$81.76 ,$262.80 ,$12.95 ,$262.80 ,$262.80 ,$12.95 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200874,86215,HC DEOXYRIBONUCLEASE AB-90,302,1 ,$58.00 ,$37.70 ,$7.01 ,$58.00 ,$33.13 ,$43.21 ,$37.99 ,$13.25 ,$16.24 ,$29.29 ,$13.25 ,$35.79 ,$13.25 ,$35.79 ,$35.79 ,$13.25 ,$35.79 ,$25.18 ,$52.20 ,$43.50 ,$33.13 ,$13.25 ,$51.04 ,$13.25 ,$43.50 ,$43.50 ,$49.30 ,$49.30 ,$13.25 ,$49.30 ,$13.25 ,$45.24 ,$45.24 ,$45.24 ,$52.20 ,$33.13 ,$52.20 ,$13.25 ,$58.00 ,$37.99 ,$13.25 ,$24.13 ,$7.35 ,$7.01 ,$13.91 ,$52.20 ,$29.81 ,$35.79 ,$16.24 ,$52.20 ,$13.25 ,$52.20 ,$52.20 ,$13.25 ,$37.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200875,86225,HC DNA DOUBLE STRAND AB-90,302,1 ,$47.00 ,$30.55 ,$7.01 ,$47.00 ,$34.35 ,$35.02 ,$30.79 ,$13.74 ,$13.16 ,$23.74 ,$13.74 ,$29.00 ,$13.74 ,$29.00 ,$29.00 ,$13.74 ,$29.00 ,$26.11 ,$42.30 ,$35.25 ,$34.35 ,$13.74 ,$41.36 ,$13.74 ,$35.25 ,$35.25 ,$39.95 ,$39.95 ,$13.74 ,$39.95 ,$13.74 ,$36.66 ,$36.66 ,$36.66 ,$42.30 ,$34.35 ,$42.30 ,$13.74 ,$47.00 ,$30.79 ,$13.74 ,$19.55 ,$7.35 ,$7.01 ,$14.43 ,$42.30 ,$30.92 ,$29.00 ,$13.16 ,$42.30 ,$13.74 ,$42.30 ,$42.30 ,$13.74 ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200877,86235,HC ENA AB-90,302,1 ,$154.00 ,$100.10 ,$12.09 ,$154.00 ,$44.83 ,$114.73 ,$100.87 ,$17.93 ,$43.12 ,$77.77 ,$17.93 ,$95.02 ,$17.93 ,$95.02 ,$95.02 ,$17.93 ,$95.02 ,$34.07 ,$138.60 ,$115.50 ,$44.83 ,$17.93 ,$135.52 ,$17.93 ,$115.50 ,$115.50 ,$130.90 ,$130.90 ,$17.93 ,$130.90 ,$17.93 ,$120.12 ,$120.12 ,$120.12 ,$138.60 ,$44.83 ,$138.60 ,$17.93 ,$154.00 ,$100.87 ,$17.93 ,$64.06 ,$12.66 ,$12.09 ,$18.83 ,$138.60 ,$40.34 ,$95.02 ,$43.12 ,$138.60 ,$17.93 ,$138.60 ,$138.60 ,$17.93 ,$100.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200878,86255,HC FLUOR AB SCR-90,302,1 ,$926.00 ,$601.90 ,$12.05 ,$926.00 ,$30.13 ,$689.87 ,$606.53 ,$12.05 ,$259.28 ,$467.63 ,$12.05 ,$571.34 ,$12.05 ,$571.34 ,$571.34 ,$12.05 ,$571.34 ,$22.90 ,$833.40 ,$694.50 ,$30.13 ,$12.05 ,$814.88 ,$12.05 ,$694.50 ,$694.50 ,$787.10 ,$787.10 ,$12.05 ,$787.10 ,$12.05 ,$722.28 ,$722.28 ,$722.28 ,$833.40 ,$30.13 ,$833.40 ,$12.05 ,$926.00 ,$606.53 ,$12.05 ,$385.22 ,$12.66 ,$12.09 ,$12.65 ,$833.40 ,$27.11 ,$571.34 ,$259.28 ,$833.40 ,$12.05 ,$833.40 ,$833.40 ,$12.05 ,$601.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200879,86256,HC FLUOR AB TITER-90,302,1 ,$158.00 ,$102.70 ,$12.05 ,$158.00 ,$30.13 ,$117.71 ,$103.49 ,$12.05 ,$44.24 ,$79.79 ,$12.05 ,$97.49 ,$12.05 ,$97.49 ,$97.49 ,$12.05 ,$97.49 ,$22.90 ,$142.20 ,$118.50 ,$30.13 ,$12.05 ,$139.04 ,$12.05 ,$118.50 ,$118.50 ,$134.30 ,$134.30 ,$12.05 ,$134.30 ,$12.05 ,$123.24 ,$123.24 ,$123.24 ,$142.20 ,$30.13 ,$142.20 ,$12.05 ,$158.00 ,$103.49 ,$12.05 ,$65.73 ,$12.66 ,$12.09 ,$12.65 ,$142.20 ,$27.11 ,$97.49 ,$44.24 ,$142.20 ,$12.05 ,$142.20 ,$142.20 ,$12.05 ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$201.00 ,$130.65 ,$18.59 ,$201.00 ,$52.03 ,$149.75 ,$131.66 ,$20.81 ,$56.28 ,$101.51 ,$20.81 ,$124.02 ,$20.81 ,$124.02 ,$124.02 ,$20.81 ,$124.02 ,$39.54 ,$180.90 ,$150.75 ,$52.03 ,$20.81 ,$176.88 ,$20.81 ,$150.75 ,$150.75 ,$170.85 ,$170.85 ,$20.81 ,$170.85 ,$20.81 ,$156.78 ,$156.78 ,$156.78 ,$180.90 ,$52.03 ,$180.90 ,$20.81 ,$201.00 ,$131.66 ,$20.81 ,$83.62 ,$19.47 ,$18.59 ,$21.85 ,$180.90 ,$46.82 ,$124.02 ,$56.28 ,$180.90 ,$20.81 ,$180.90 ,$180.90 ,$20.81 ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200881,86301,HC TUMOR AG CA 19-9  -90,302,1 ,$172.00 ,$111.80 ,$18.59 ,$172.00 ,$52.03 ,$128.14 ,$112.66 ,$20.81 ,$48.16 ,$86.86 ,$20.81 ,$106.12 ,$20.81 ,$106.12 ,$106.12 ,$20.81 ,$106.12 ,$39.54 ,$154.80 ,$129.00 ,$52.03 ,$20.81 ,$151.36 ,$20.81 ,$129.00 ,$129.00 ,$146.20 ,$146.20 ,$20.81 ,$146.20 ,$20.81 ,$134.16 ,$134.16 ,$134.16 ,$154.80 ,$52.03 ,$154.80 ,$20.81 ,$172.00 ,$112.66 ,$20.81 ,$71.55 ,$19.47 ,$18.59 ,$21.85 ,$154.80 ,$46.82 ,$106.12 ,$48.16 ,$154.80 ,$20.81 ,$154.80 ,$154.80 ,$20.81 ,$111.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200882,86304,HC TUMOR AG CA 125 -90,302,1 ,$212.00 ,$137.80 ,$18.59 ,$212.00 ,$52.03 ,$157.94 ,$138.86 ,$20.81 ,$59.36 ,$107.06 ,$20.81 ,$130.80 ,$20.81 ,$130.80 ,$130.80 ,$20.81 ,$130.80 ,$39.54 ,$190.80 ,$159.00 ,$52.03 ,$20.81 ,$186.56 ,$20.81 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$20.81 ,$180.20 ,$20.81 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$52.03 ,$190.80 ,$20.81 ,$212.00 ,$138.86 ,$20.81 ,$88.19 ,$19.47 ,$18.59 ,$21.85 ,$190.80 ,$46.82 ,$130.80 ,$59.36 ,$190.80 ,$20.81 ,$190.80 ,$190.80 ,$20.81 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200883,86305,HC HE4 OVARIAN CANCER-90,302,1 ,$171.00 ,$111.15 ,$18.59 ,$171.00 ,$52.03 ,$127.40 ,$112.01 ,$20.81 ,$47.88 ,$86.36 ,$20.81 ,$105.51 ,$20.81 ,$105.51 ,$105.51 ,$20.81 ,$105.51 ,$39.54 ,$153.90 ,$128.25 ,$52.03 ,$20.81 ,$150.48 ,$20.81 ,$128.25 ,$128.25 ,$145.35 ,$145.35 ,$20.81 ,$145.35 ,$20.81 ,$133.38 ,$133.38 ,$133.38 ,$153.90 ,$52.03 ,$153.90 ,$20.81 ,$171.00 ,$112.01 ,$20.81 ,$71.14 ,$19.47 ,$18.59 ,$21.85 ,$153.90 ,$46.82 ,$105.51 ,$47.88 ,$153.90 ,$20.81 ,$153.90 ,$153.90 ,$20.81 ,$111.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$151.00 ,$98.15 ,$11.47 ,$151.00 ,$28.68 ,$112.50 ,$98.91 ,$11.47 ,$42.28 ,$76.26 ,$11.47 ,$93.17 ,$11.47 ,$93.17 ,$93.17 ,$11.47 ,$93.17 ,$21.79 ,$135.90 ,$113.25 ,$28.68 ,$11.47 ,$132.88 ,$11.47 ,$113.25 ,$113.25 ,$128.35 ,$128.35 ,$11.47 ,$128.35 ,$11.47 ,$117.78 ,$117.78 ,$117.78 ,$135.90 ,$28.68 ,$135.90 ,$11.47 ,$151.00 ,$98.91 ,$11.47 ,$62.82 ,$12.66 ,$12.09 ,$12.04 ,$135.90 ,$25.81 ,$93.17 ,$42.28 ,$135.90 ,$11.47 ,$135.90 ,$135.90 ,$11.47 ,$98.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200888,86638,HC Q FEVER AB-90,302,1 ,$115.00 ,$74.75 ,$12.09 ,$115.00 ,$30.30 ,$85.68 ,$75.33 ,$12.12 ,$32.20 ,$58.08 ,$12.12 ,$70.96 ,$12.12 ,$70.96 ,$70.96 ,$12.12 ,$70.96 ,$23.03 ,$103.50 ,$86.25 ,$30.30 ,$12.12 ,$101.20 ,$12.12 ,$86.25 ,$86.25 ,$97.75 ,$97.75 ,$12.12 ,$97.75 ,$12.12 ,$89.70 ,$89.70 ,$89.70 ,$103.50 ,$30.30 ,$103.50 ,$12.12 ,$115.00 ,$75.33 ,$12.12 ,$47.84 ,$12.66 ,$12.09 ,$12.73 ,$103.50 ,$27.27 ,$70.96 ,$32.20 ,$103.50 ,$12.12 ,$103.50 ,$103.50 ,$12.12 ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200890,86644,HC CMV AB-90,302,1 ,$102.00 ,$66.30 ,$12.09 ,$102.00 ,$35.98 ,$75.99 ,$66.81 ,$14.39 ,$28.56 ,$51.51 ,$14.39 ,$62.93 ,$14.39 ,$62.93 ,$62.93 ,$14.39 ,$62.93 ,$27.34 ,$91.80 ,$76.50 ,$35.98 ,$14.39 ,$89.76 ,$14.39 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$14.39 ,$86.70 ,$14.39 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$35.98 ,$91.80 ,$14.39 ,$102.00 ,$66.81 ,$14.39 ,$42.43 ,$12.66 ,$12.09 ,$15.11 ,$91.80 ,$32.38 ,$62.93 ,$28.56 ,$91.80 ,$14.39 ,$91.80 ,$91.80 ,$14.39 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200891,86645,HC CMV AB IGM-90,302,1 ,$120.00 ,$78.00 ,$12.09 ,$120.00 ,$42.13 ,$89.40 ,$78.60 ,$16.85 ,$33.60 ,$60.60 ,$16.85 ,$74.04 ,$16.85 ,$74.04 ,$74.04 ,$16.85 ,$74.04 ,$32.02 ,$108.00 ,$90.00 ,$42.13 ,$16.85 ,$105.60 ,$16.85 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$16.85 ,$102.00 ,$16.85 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$42.13 ,$108.00 ,$16.85 ,$120.00 ,$78.60 ,$16.85 ,$49.92 ,$12.66 ,$12.09 ,$17.69 ,$108.00 ,$37.91 ,$74.04 ,$33.60 ,$108.00 ,$16.85 ,$108.00 ,$108.00 ,$16.85 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200892,86648,HC DIPTHERIA-90,302,1 ,$201.00 ,$130.65 ,$12.09 ,$201.00 ,$38.03 ,$149.75 ,$131.66 ,$15.21 ,$56.28 ,$101.51 ,$15.21 ,$124.02 ,$15.21 ,$124.02 ,$124.02 ,$15.21 ,$124.02 ,$28.90 ,$180.90 ,$150.75 ,$38.03 ,$15.21 ,$176.88 ,$15.21 ,$150.75 ,$150.75 ,$170.85 ,$170.85 ,$15.21 ,$170.85 ,$15.21 ,$156.78 ,$156.78 ,$156.78 ,$180.90 ,$38.03 ,$180.90 ,$15.21 ,$201.00 ,$131.66 ,$15.21 ,$83.62 ,$12.66 ,$12.09 ,$15.97 ,$180.90 ,$34.22 ,$124.02 ,$56.28 ,$180.90 ,$15.21 ,$180.90 ,$180.90 ,$15.21 ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200897,86658,HC ENTEROVIRUS AB-90,302,1 ,$55.00 ,$35.75 ,$12.09 ,$55.00 ,$32.58 ,$40.98 ,$36.03 ,$13.03 ,$15.40 ,$27.78 ,$13.03 ,$33.94 ,$13.03 ,$33.94 ,$33.94 ,$13.03 ,$33.94 ,$24.76 ,$49.50 ,$41.25 ,$32.58 ,$13.03 ,$48.40 ,$13.03 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$13.03 ,$46.75 ,$13.03 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$32.58 ,$49.50 ,$13.03 ,$55.00 ,$36.03 ,$13.03 ,$22.88 ,$12.66 ,$12.09 ,$13.68 ,$49.50 ,$29.32 ,$33.94 ,$15.40 ,$49.50 ,$13.03 ,$49.50 ,$49.50 ,$13.03 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$154.00 ,$100.10 ,$12.09 ,$154.00 ,$38.23 ,$114.73 ,$100.87 ,$15.29 ,$43.12 ,$77.77 ,$15.29 ,$95.02 ,$15.29 ,$95.02 ,$95.02 ,$15.29 ,$95.02 ,$29.05 ,$138.60 ,$115.50 ,$38.23 ,$15.29 ,$135.52 ,$15.29 ,$115.50 ,$115.50 ,$130.90 ,$130.90 ,$15.29 ,$130.90 ,$15.29 ,$120.12 ,$120.12 ,$120.12 ,$138.60 ,$38.23 ,$138.60 ,$15.29 ,$154.00 ,$100.87 ,$15.29 ,$64.06 ,$12.66 ,$12.09 ,$16.05 ,$138.60 ,$34.40 ,$95.02 ,$43.12 ,$138.60 ,$15.29 ,$138.60 ,$138.60 ,$15.29 ,$100.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$187.00 ,$121.55 ,$12.09 ,$187.00 ,$45.35 ,$139.32 ,$122.49 ,$18.14 ,$52.36 ,$94.44 ,$18.14 ,$115.38 ,$18.14 ,$115.38 ,$115.38 ,$18.14 ,$115.38 ,$34.47 ,$168.30 ,$140.25 ,$45.35 ,$18.14 ,$164.56 ,$18.14 ,$140.25 ,$140.25 ,$158.95 ,$158.95 ,$18.14 ,$158.95 ,$18.14 ,$145.86 ,$145.86 ,$145.86 ,$168.30 ,$45.35 ,$168.30 ,$18.14 ,$187.00 ,$122.49 ,$18.14 ,$77.79 ,$12.66 ,$12.09 ,$19.05 ,$168.30 ,$40.82 ,$115.38 ,$52.36 ,$168.30 ,$18.14 ,$168.30 ,$168.30 ,$18.14 ,$121.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200901,86666,HC EHRLICHIA AB-90,302,1 ,$101.00 ,$65.65 ,$10.18 ,$101.00 ,$25.45 ,$75.25 ,$66.16 ,$10.18 ,$28.28 ,$51.01 ,$10.18 ,$62.32 ,$10.18 ,$62.32 ,$62.32 ,$10.18 ,$62.32 ,$19.34 ,$90.90 ,$75.75 ,$25.45 ,$10.18 ,$88.88 ,$10.18 ,$75.75 ,$75.75 ,$85.85 ,$85.85 ,$10.18 ,$85.85 ,$10.18 ,$78.78 ,$78.78 ,$78.78 ,$90.90 ,$25.45 ,$90.90 ,$10.18 ,$101.00 ,$66.16 ,$10.18 ,$42.02 ,$12.66 ,$12.09 ,$10.69 ,$90.90 ,$22.91 ,$62.32 ,$28.28 ,$90.90 ,$10.18 ,$90.90 ,$90.90 ,$10.18 ,$65.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$36.75 ,$23.89 ,$7.01 ,$36.75 ,$30.63 ,$27.38 ,$24.07 ,$12.25 ,$10.29 ,$18.56 ,$12.25 ,$22.67 ,$12.25 ,$22.67 ,$22.67 ,$12.25 ,$22.67 ,$23.28 ,$33.08 ,$27.56 ,$30.63 ,$12.25 ,$32.34 ,$12.25 ,$27.56 ,$27.56 ,$31.24 ,$31.24 ,$12.25 ,$31.24 ,$12.25 ,$28.67 ,$28.67 ,$28.67 ,$33.08 ,$30.63 ,$33.08 ,$12.25 ,$36.75 ,$24.07 ,$12.25 ,$15.29 ,$7.35 ,$7.01 ,$12.86 ,$33.08 ,$27.56 ,$22.67 ,$10.29 ,$33.08 ,$12.25 ,$33.08 ,$33.08 ,$12.25 ,$23.89 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200906,86682,HC HELMINTH ANTIBODY-90,302,1 ,$124.00 ,$80.60 ,$7.01 ,$124.00 ,$32.53 ,$92.38 ,$81.22 ,$13.01 ,$34.72 ,$62.62 ,$13.01 ,$76.51 ,$13.01 ,$76.51 ,$76.51 ,$13.01 ,$76.51 ,$24.72 ,$111.60 ,$93.00 ,$32.53 ,$13.01 ,$109.12 ,$13.01 ,$93.00 ,$93.00 ,$105.40 ,$105.40 ,$13.01 ,$105.40 ,$13.01 ,$96.72 ,$96.72 ,$96.72 ,$111.60 ,$32.53 ,$111.60 ,$13.01 ,$124.00 ,$81.22 ,$13.01 ,$51.58 ,$7.35 ,$7.01 ,$13.66 ,$111.60 ,$29.27 ,$76.51 ,$34.72 ,$111.60 ,$13.01 ,$111.60 ,$111.60 ,$13.01 ,$80.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200907,86684,HC HAEMOPHILUS INFLUENZA AB-90,302,1 ,$218.00 ,$141.70 ,$7.01 ,$218.00 ,$39.60 ,$162.41 ,$142.79 ,$15.84 ,$61.04 ,$110.09 ,$15.84 ,$134.51 ,$15.84 ,$134.51 ,$134.51 ,$15.84 ,$134.51 ,$30.10 ,$196.20 ,$163.50 ,$39.60 ,$15.84 ,$191.84 ,$15.84 ,$163.50 ,$163.50 ,$185.30 ,$185.30 ,$15.84 ,$185.30 ,$15.84 ,$170.04 ,$170.04 ,$170.04 ,$196.20 ,$39.60 ,$196.20 ,$15.84 ,$218.00 ,$142.79 ,$15.84 ,$90.69 ,$7.35 ,$7.01 ,$16.63 ,$196.20 ,$35.64 ,$134.51 ,$61.04 ,$196.20 ,$15.84 ,$196.20 ,$196.20 ,$15.84 ,$141.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$108.00 ,$70.20 ,$12.09 ,$108.00 ,$32.98 ,$80.46 ,$70.74 ,$13.19 ,$30.24 ,$54.54 ,$13.19 ,$66.64 ,$13.19 ,$66.64 ,$66.64 ,$13.19 ,$66.64 ,$25.06 ,$97.20 ,$81.00 ,$32.98 ,$13.19 ,$95.04 ,$13.19 ,$81.00 ,$81.00 ,$91.80 ,$91.80 ,$13.19 ,$91.80 ,$13.19 ,$84.24 ,$84.24 ,$84.24 ,$97.20 ,$32.98 ,$97.20 ,$13.19 ,$108.00 ,$70.74 ,$13.19 ,$44.93 ,$12.66 ,$12.09 ,$13.85 ,$97.20 ,$29.68 ,$66.64 ,$30.24 ,$97.20 ,$13.19 ,$97.20 ,$97.20 ,$13.19 ,$70.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$159.00 ,$103.35 ,$7.01 ,$159.00 ,$48.38 ,$118.46 ,$104.15 ,$19.35 ,$44.52 ,$80.30 ,$19.35 ,$98.10 ,$19.35 ,$98.10 ,$98.10 ,$19.35 ,$98.10 ,$36.77 ,$143.10 ,$119.25 ,$48.38 ,$19.35 ,$139.92 ,$19.35 ,$119.25 ,$119.25 ,$135.15 ,$135.15 ,$19.35 ,$135.15 ,$19.35 ,$124.02 ,$124.02 ,$124.02 ,$143.10 ,$48.38 ,$143.10 ,$19.35 ,$159.00 ,$104.15 ,$19.35 ,$66.14 ,$7.35 ,$7.01 ,$20.32 ,$143.10 ,$43.54 ,$98.10 ,$44.52 ,$143.10 ,$19.35 ,$143.10 ,$143.10 ,$19.35 ,$103.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$89.00 ,$57.85 ,$12.09 ,$89.00 ,$34.48 ,$66.31 ,$58.30 ,$13.79 ,$24.92 ,$44.95 ,$13.79 ,$54.91 ,$13.79 ,$54.91 ,$54.91 ,$13.79 ,$54.91 ,$26.20 ,$80.10 ,$66.75 ,$34.48 ,$13.79 ,$78.32 ,$13.79 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$13.79 ,$75.65 ,$13.79 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$34.48 ,$80.10 ,$13.79 ,$89.00 ,$58.30 ,$13.79 ,$37.02 ,$12.66 ,$12.09 ,$14.48 ,$80.10 ,$31.03 ,$54.91 ,$24.92 ,$80.10 ,$13.79 ,$80.10 ,$80.10 ,$13.79 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200915,86701,HC HIV-1 AB-90,302,1 ,$190.00 ,$123.50 ,$7.01 ,$190.00 ,$22.23 ,$141.55 ,$124.45 ,$8.89 ,$53.20 ,$95.95 ,$8.89 ,$117.23 ,$8.89 ,$117.23 ,$117.23 ,$8.89 ,$117.23 ,$16.89 ,$171.00 ,$142.50 ,$22.23 ,$8.89 ,$167.20 ,$8.89 ,$142.50 ,$142.50 ,$161.50 ,$161.50 ,$8.89 ,$161.50 ,$8.89 ,$148.20 ,$148.20 ,$148.20 ,$171.00 ,$22.23 ,$171.00 ,$8.89 ,$190.00 ,$124.45 ,$8.89 ,$79.04 ,$7.35 ,$7.01 ,$9.33 ,$171.00 ,$20.00 ,$117.23 ,$53.20 ,$171.00 ,$8.89 ,$171.00 ,$171.00 ,$8.89 ,$123.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200918,86702,HC HIV-2 AB-90,302,1 ,$190.00 ,$123.50 ,$7.01 ,$190.00 ,$33.80 ,$141.55 ,$124.45 ,$13.52 ,$53.20 ,$95.95 ,$13.52 ,$117.23 ,$13.52 ,$117.23 ,$117.23 ,$13.52 ,$117.23 ,$25.69 ,$171.00 ,$142.50 ,$33.80 ,$13.52 ,$167.20 ,$13.52 ,$142.50 ,$142.50 ,$161.50 ,$161.50 ,$13.52 ,$161.50 ,$13.52 ,$148.20 ,$148.20 ,$148.20 ,$171.00 ,$33.80 ,$171.00 ,$13.52 ,$190.00 ,$124.45 ,$13.52 ,$79.04 ,$7.35 ,$7.01 ,$14.20 ,$171.00 ,$30.42 ,$117.23 ,$53.20 ,$171.00 ,$13.52 ,$171.00 ,$171.00 ,$13.52 ,$123.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200919,86704,HC HEP CORE AB-90,302,1 ,$97.00 ,$63.05 ,$7.01 ,$97.00 ,$30.13 ,$72.27 ,$63.54 ,$12.05 ,$27.16 ,$48.99 ,$12.05 ,$59.85 ,$12.05 ,$59.85 ,$59.85 ,$12.05 ,$59.85 ,$22.90 ,$87.30 ,$72.75 ,$30.13 ,$12.05 ,$85.36 ,$12.05 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$12.05 ,$82.45 ,$12.05 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$30.13 ,$87.30 ,$12.05 ,$97.00 ,$63.54 ,$12.05 ,$40.35 ,$7.35 ,$7.01 ,$12.65 ,$87.30 ,$27.11 ,$59.85 ,$27.16 ,$87.30 ,$12.05 ,$87.30 ,$87.30 ,$12.05 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200921,86706,HC HEP B SURFACE AB-90,302,1 ,$32.22 ,$20.94 ,$7.01 ,$32.22 ,$26.85 ,$24.00 ,$21.10 ,$10.74 ,$9.02 ,$16.27 ,$10.74 ,$19.88 ,$10.74 ,$19.88 ,$19.88 ,$10.74 ,$19.88 ,$20.41 ,$29.00 ,$24.17 ,$26.85 ,$10.74 ,$28.35 ,$10.74 ,$24.17 ,$24.17 ,$27.39 ,$27.39 ,$10.74 ,$27.39 ,$10.74 ,$25.13 ,$25.13 ,$25.13 ,$29.00 ,$26.85 ,$29.00 ,$10.74 ,$32.22 ,$21.10 ,$10.74 ,$13.40 ,$7.35 ,$7.01 ,$11.28 ,$29.00 ,$24.17 ,$19.88 ,$9.02 ,$29.00 ,$10.74 ,$29.00 ,$29.00 ,$10.74 ,$20.94 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200923,86707,HC HEP B E AB-90,302,1 ,$82.00 ,$53.30 ,$7.01 ,$82.00 ,$28.93 ,$61.09 ,$53.71 ,$11.57 ,$22.96 ,$41.41 ,$11.57 ,$50.59 ,$11.57 ,$50.59 ,$50.59 ,$11.57 ,$50.59 ,$21.98 ,$73.80 ,$61.50 ,$28.93 ,$11.57 ,$72.16 ,$11.57 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$11.57 ,$69.70 ,$11.57 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$28.93 ,$73.80 ,$11.57 ,$82.00 ,$53.71 ,$11.57 ,$34.11 ,$7.35 ,$7.01 ,$12.15 ,$73.80 ,$26.03 ,$50.59 ,$22.96 ,$73.80 ,$11.57 ,$73.80 ,$73.80 ,$11.57 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$87.00 ,$56.55 ,$7.01 ,$87.00 ,$30.98 ,$64.82 ,$56.99 ,$12.39 ,$24.36 ,$43.94 ,$12.39 ,$53.68 ,$12.39 ,$53.68 ,$53.68 ,$12.39 ,$53.68 ,$23.54 ,$78.30 ,$65.25 ,$30.98 ,$12.39 ,$76.56 ,$12.39 ,$65.25 ,$65.25 ,$73.95 ,$73.95 ,$12.39 ,$73.95 ,$12.39 ,$67.86 ,$67.86 ,$67.86 ,$78.30 ,$30.98 ,$78.30 ,$12.39 ,$87.00 ,$56.99 ,$12.39 ,$36.19 ,$7.35 ,$7.01 ,$13.01 ,$78.30 ,$27.88 ,$53.68 ,$24.36 ,$78.30 ,$12.39 ,$78.30 ,$78.30 ,$12.39 ,$56.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200926,86710,HC INFLUENZA AB-90,302,1 ,$97.00 ,$63.05 ,$7.01 ,$97.00 ,$33.88 ,$72.27 ,$63.54 ,$13.55 ,$27.16 ,$48.99 ,$13.55 ,$59.85 ,$13.55 ,$59.85 ,$59.85 ,$13.55 ,$59.85 ,$25.75 ,$87.30 ,$72.75 ,$33.88 ,$13.55 ,$85.36 ,$13.55 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$13.55 ,$82.45 ,$13.55 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$33.88 ,$87.30 ,$13.55 ,$97.00 ,$63.54 ,$13.55 ,$40.35 ,$7.35 ,$7.01 ,$14.23 ,$87.30 ,$30.49 ,$59.85 ,$27.16 ,$87.30 ,$13.55 ,$87.30 ,$87.30 ,$13.55 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200931,86735,HC MUMPS AB-90,302,1 ,$14.34 ,$9.32 ,$4.02 ,$29.36 ,$14.34 ,$10.68 ,$9.39 ,$13.05 ,$4.02 ,$7.24 ,$13.05 ,$8.85 ,$13.05 ,$8.85 ,$8.85 ,$13.05 ,$8.85 ,$24.80 ,$12.91 ,$10.76 ,$14.34 ,$13.05 ,$12.62 ,$13.05 ,$10.76 ,$10.76 ,$12.19 ,$12.19 ,$13.05 ,$12.19 ,$13.05 ,$11.19 ,$11.19 ,$11.19 ,$12.91 ,$14.34 ,$12.91 ,$13.05 ,$14.34 ,$9.39 ,$13.05 ,$5.97 ,$7.35 ,$7.01 ,$13.70 ,$12.91 ,$29.36 ,$8.85 ,$4.02 ,$12.91 ,$13.05 ,$12.91 ,$12.91 ,$13.05 ,$9.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$208.00 ,$135.20 ,$12.09 ,$208.00 ,$33.10 ,$154.96 ,$136.24 ,$13.24 ,$58.24 ,$105.04 ,$13.24 ,$128.34 ,$13.24 ,$128.34 ,$128.34 ,$13.24 ,$128.34 ,$25.16 ,$187.20 ,$156.00 ,$33.10 ,$13.24 ,$183.04 ,$13.24 ,$156.00 ,$156.00 ,$176.80 ,$176.80 ,$13.24 ,$176.80 ,$13.24 ,$162.24 ,$162.24 ,$162.24 ,$187.20 ,$33.10 ,$187.20 ,$13.24 ,$208.00 ,$136.24 ,$13.24 ,$86.53 ,$12.66 ,$12.09 ,$13.90 ,$187.20 ,$29.79 ,$128.34 ,$58.24 ,$187.20 ,$13.24 ,$187.20 ,$187.20 ,$13.24 ,$135.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200933,86738,HC MYCOPLASMA AB IFA-90,302,1 ,$208.00 ,$135.20 ,$12.09 ,$208.00 ,$33.10 ,$154.96 ,$136.24 ,$13.24 ,$58.24 ,$105.04 ,$13.24 ,$128.34 ,$13.24 ,$128.34 ,$128.34 ,$13.24 ,$128.34 ,$25.16 ,$187.20 ,$156.00 ,$33.10 ,$13.24 ,$183.04 ,$13.24 ,$156.00 ,$156.00 ,$176.80 ,$176.80 ,$13.24 ,$176.80 ,$13.24 ,$162.24 ,$162.24 ,$162.24 ,$187.20 ,$33.10 ,$187.20 ,$13.24 ,$208.00 ,$136.24 ,$13.24 ,$86.53 ,$12.66 ,$12.09 ,$13.90 ,$187.20 ,$29.79 ,$128.34 ,$58.24 ,$187.20 ,$13.24 ,$187.20 ,$187.20 ,$13.24 ,$135.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$185.00 ,$120.25 ,$12.09 ,$185.00 ,$37.58 ,$137.83 ,$121.18 ,$15.03 ,$51.80 ,$93.43 ,$15.03 ,$114.15 ,$15.03 ,$114.15 ,$114.15 ,$15.03 ,$114.15 ,$28.56 ,$166.50 ,$138.75 ,$37.58 ,$15.03 ,$162.80 ,$15.03 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$15.03 ,$157.25 ,$15.03 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$37.58 ,$166.50 ,$15.03 ,$185.00 ,$121.18 ,$15.03 ,$76.96 ,$12.66 ,$12.09 ,$15.78 ,$166.50 ,$33.82 ,$114.15 ,$51.80 ,$166.50 ,$15.03 ,$166.50 ,$166.50 ,$15.03 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200937,86753,HC PROTOZOA AB-90,302,1 ,$118.00 ,$76.70 ,$7.01 ,$118.00 ,$30.98 ,$87.91 ,$77.29 ,$12.39 ,$33.04 ,$59.59 ,$12.39 ,$72.81 ,$12.39 ,$72.81 ,$72.81 ,$12.39 ,$72.81 ,$23.54 ,$106.20 ,$88.50 ,$30.98 ,$12.39 ,$103.84 ,$12.39 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$12.39 ,$100.30 ,$12.39 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$30.98 ,$106.20 ,$12.39 ,$118.00 ,$77.29 ,$12.39 ,$49.09 ,$7.35 ,$7.01 ,$13.01 ,$106.20 ,$27.88 ,$72.81 ,$33.04 ,$106.20 ,$12.39 ,$106.20 ,$106.20 ,$12.39 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200939,86757,HC RICKETTSIA AB-90,302,1 ,$79.00 ,$51.35 ,$12.09 ,$79.00 ,$48.38 ,$58.86 ,$51.75 ,$19.35 ,$22.12 ,$39.90 ,$19.35 ,$48.74 ,$19.35 ,$48.74 ,$48.74 ,$19.35 ,$48.74 ,$36.77 ,$71.10 ,$59.25 ,$48.38 ,$19.35 ,$69.52 ,$19.35 ,$59.25 ,$59.25 ,$67.15 ,$67.15 ,$19.35 ,$67.15 ,$19.35 ,$61.62 ,$61.62 ,$61.62 ,$71.10 ,$48.38 ,$71.10 ,$19.35 ,$79.00 ,$51.75 ,$19.35 ,$32.86 ,$12.66 ,$12.09 ,$20.32 ,$71.10 ,$43.54 ,$48.74 ,$22.12 ,$71.10 ,$19.35 ,$71.10 ,$71.10 ,$19.35 ,$51.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200941,86765,HC RUBEOLA AB-90,302,1 ,$92.00 ,$59.80 ,$7.01 ,$92.00 ,$32.20 ,$68.54 ,$60.26 ,$12.88 ,$25.76 ,$46.46 ,$12.88 ,$56.76 ,$12.88 ,$56.76 ,$56.76 ,$12.88 ,$56.76 ,$24.47 ,$82.80 ,$69.00 ,$32.20 ,$12.88 ,$80.96 ,$12.88 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$12.88 ,$78.20 ,$12.88 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$32.20 ,$82.80 ,$12.88 ,$92.00 ,$60.26 ,$12.88 ,$38.27 ,$7.35 ,$7.01 ,$13.52 ,$82.80 ,$28.98 ,$56.76 ,$25.76 ,$82.80 ,$12.88 ,$82.80 ,$82.80 ,$12.88 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200943,86774,HC TETANUS AB-90,302,1 ,$105.00 ,$68.25 ,$12.09 ,$105.00 ,$37.00 ,$78.23 ,$68.78 ,$14.80 ,$29.40 ,$53.03 ,$14.80 ,$64.79 ,$14.80 ,$64.79 ,$64.79 ,$14.80 ,$64.79 ,$28.12 ,$94.50 ,$78.75 ,$37.00 ,$14.80 ,$92.40 ,$14.80 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$14.80 ,$89.25 ,$14.80 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$37.00 ,$94.50 ,$14.80 ,$105.00 ,$68.78 ,$14.80 ,$43.68 ,$12.66 ,$12.09 ,$15.54 ,$94.50 ,$33.30 ,$64.79 ,$29.40 ,$94.50 ,$14.80 ,$94.50 ,$94.50 ,$14.80 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200944,86777,HC TOXOPLASMA AB-90,302,1 ,$102.00 ,$66.30 ,$12.09 ,$102.00 ,$35.98 ,$75.99 ,$66.81 ,$14.39 ,$28.56 ,$51.51 ,$14.39 ,$62.93 ,$14.39 ,$62.93 ,$62.93 ,$14.39 ,$62.93 ,$27.34 ,$91.80 ,$76.50 ,$35.98 ,$14.39 ,$89.76 ,$14.39 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$14.39 ,$86.70 ,$14.39 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$35.98 ,$91.80 ,$14.39 ,$102.00 ,$66.81 ,$14.39 ,$42.43 ,$12.66 ,$12.09 ,$15.11 ,$91.80 ,$32.38 ,$62.93 ,$28.56 ,$91.80 ,$14.39 ,$91.80 ,$91.80 ,$14.39 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$102.00 ,$66.30 ,$12.09 ,$102.00 ,$36.03 ,$75.99 ,$66.81 ,$14.41 ,$28.56 ,$51.51 ,$14.41 ,$62.93 ,$14.41 ,$62.93 ,$62.93 ,$14.41 ,$62.93 ,$27.38 ,$91.80 ,$76.50 ,$36.03 ,$14.41 ,$89.76 ,$14.41 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$14.41 ,$86.70 ,$14.41 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$36.03 ,$91.80 ,$14.41 ,$102.00 ,$66.81 ,$14.41 ,$42.43 ,$12.66 ,$12.09 ,$15.13 ,$91.80 ,$32.42 ,$62.93 ,$28.56 ,$91.80 ,$14.41 ,$91.80 ,$91.80 ,$14.41 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$28.00 ,$18.20 ,$7.84 ,$29.79 ,$28.00 ,$20.86 ,$18.34 ,$13.24 ,$7.84 ,$14.14 ,$13.24 ,$17.28 ,$13.24 ,$17.28 ,$17.28 ,$13.24 ,$17.28 ,$25.16 ,$25.20 ,$21.00 ,$28.00 ,$13.24 ,$24.64 ,$13.24 ,$21.00 ,$21.00 ,$23.80 ,$23.80 ,$13.24 ,$23.80 ,$13.24 ,$21.84 ,$21.84 ,$21.84 ,$25.20 ,$28.00 ,$25.20 ,$13.24 ,$28.00 ,$18.34 ,$13.24 ,$11.65 ,$12.66 ,$12.09 ,$13.90 ,$25.20 ,$29.79 ,$17.28 ,$7.84 ,$25.20 ,$13.24 ,$25.20 ,$25.20 ,$13.24 ,$18.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$92.00 ,$59.80 ,$7.01 ,$92.00 ,$32.20 ,$68.54 ,$60.26 ,$12.88 ,$25.76 ,$46.46 ,$12.88 ,$56.76 ,$12.88 ,$56.76 ,$56.76 ,$12.88 ,$56.76 ,$24.47 ,$82.80 ,$69.00 ,$32.20 ,$12.88 ,$80.96 ,$12.88 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$12.88 ,$78.20 ,$12.88 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$32.20 ,$82.80 ,$12.88 ,$92.00 ,$60.26 ,$12.88 ,$38.27 ,$7.35 ,$7.01 ,$13.52 ,$82.80 ,$28.98 ,$56.76 ,$25.76 ,$82.80 ,$12.88 ,$82.80 ,$82.80 ,$12.88 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200949,86788,HC WEST NILE VIRUS AB IGM-90,302,1 ,$250.00 ,$162.50 ,$12.09 ,$250.00 ,$42.13 ,$186.25 ,$163.75 ,$16.85 ,$70.00 ,$126.25 ,$16.85 ,$154.25 ,$16.85 ,$154.25 ,$154.25 ,$16.85 ,$154.25 ,$32.02 ,$225.00 ,$187.50 ,$42.13 ,$16.85 ,$220.00 ,$16.85 ,$187.50 ,$187.50 ,$212.50 ,$212.50 ,$16.85 ,$212.50 ,$16.85 ,$195.00 ,$195.00 ,$195.00 ,$225.00 ,$42.13 ,$225.00 ,$16.85 ,$250.00 ,$163.75 ,$16.85 ,$104.00 ,$12.66 ,$12.09 ,$17.69 ,$225.00 ,$37.91 ,$154.25 ,$70.00 ,$225.00 ,$16.85 ,$225.00 ,$225.00 ,$16.85 ,$162.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200950,86789,HC WEST NILE AB-90,302,1 ,$250.00 ,$162.50 ,$12.09 ,$250.00 ,$35.98 ,$186.25 ,$163.75 ,$14.39 ,$70.00 ,$126.25 ,$14.39 ,$154.25 ,$14.39 ,$154.25 ,$154.25 ,$14.39 ,$154.25 ,$27.34 ,$225.00 ,$187.50 ,$35.98 ,$14.39 ,$220.00 ,$14.39 ,$187.50 ,$187.50 ,$212.50 ,$212.50 ,$14.39 ,$212.50 ,$14.39 ,$195.00 ,$195.00 ,$195.00 ,$225.00 ,$35.98 ,$225.00 ,$14.39 ,$250.00 ,$163.75 ,$14.39 ,$104.00 ,$12.66 ,$12.09 ,$15.11 ,$225.00 ,$32.38 ,$154.25 ,$70.00 ,$225.00 ,$14.39 ,$225.00 ,$225.00 ,$14.39 ,$162.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200951,86790,HC VIRUS AB NOT SPECIFIED-90,302,1 ,$196.00 ,$127.40 ,$7.01 ,$196.00 ,$32.20 ,$146.02 ,$128.38 ,$12.88 ,$54.88 ,$98.98 ,$12.88 ,$120.93 ,$12.88 ,$120.93 ,$120.93 ,$12.88 ,$120.93 ,$24.47 ,$176.40 ,$147.00 ,$32.20 ,$12.88 ,$172.48 ,$12.88 ,$147.00 ,$147.00 ,$166.60 ,$166.60 ,$12.88 ,$166.60 ,$12.88 ,$152.88 ,$152.88 ,$152.88 ,$176.40 ,$32.20 ,$176.40 ,$12.88 ,$196.00 ,$128.38 ,$12.88 ,$81.54 ,$7.35 ,$7.01 ,$13.52 ,$176.40 ,$28.98 ,$120.93 ,$54.88 ,$176.40 ,$12.88 ,$176.40 ,$176.40 ,$12.88 ,$127.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$113.00 ,$73.45 ,$15.91 ,$113.00 ,$39.78 ,$84.19 ,$74.02 ,$15.91 ,$31.64 ,$57.07 ,$15.91 ,$69.72 ,$15.91 ,$69.72 ,$69.72 ,$15.91 ,$69.72 ,$30.23 ,$101.70 ,$84.75 ,$39.78 ,$15.91 ,$99.44 ,$15.91 ,$84.75 ,$84.75 ,$96.05 ,$96.05 ,$15.91 ,$96.05 ,$15.91 ,$88.14 ,$88.14 ,$88.14 ,$101.70 ,$39.78 ,$101.70 ,$15.91 ,$113.00 ,$74.02 ,$15.91 ,$47.01 ,$19.21 ,$18.33 ,$16.71 ,$101.70 ,$35.80 ,$69.72 ,$31.64 ,$101.70 ,$15.91 ,$101.70 ,$101.70 ,$15.91 ,$73.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200954,86803,HC HEP C AB-90,302,1 ,$12.00 ,$7.80 ,$3.36 ,$27.00 ,$12.00 ,$8.94 ,$7.86 ,$12.00 ,$3.36 ,$6.06 ,$12.00 ,$7.40 ,$12.00 ,$7.40 ,$7.40 ,$12.00 ,$7.40 ,$22.80 ,$10.80 ,$9.00 ,$12.00 ,$12.00 ,$10.56 ,$12.00 ,$9.00 ,$9.00 ,$10.20 ,$10.20 ,$12.00 ,$10.20 ,$12.00 ,$9.36 ,$9.36 ,$9.36 ,$10.80 ,$12.00 ,$10.80 ,$12.00 ,$12.00 ,$7.86 ,$12.00 ,$4.99 ,$12.00 ,$12.00 ,$12.00 ,$10.80 ,$27.00 ,$7.40 ,$3.36 ,$10.80 ,$12.00 ,$10.80 ,$10.80 ,$12.00 ,$7.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200955,86803,HC HEP C AB,302,1 ,$246.00 ,$159.90 ,$12.09 ,$246.00 ,$35.68 ,$183.27 ,$161.13 ,$14.27 ,$68.88 ,$124.23 ,$14.27 ,$151.78 ,$14.27 ,$151.78 ,$151.78 ,$14.27 ,$151.78 ,$27.11 ,$221.40 ,$184.50 ,$35.68 ,$14.27 ,$216.48 ,$14.27 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$14.27 ,$209.10 ,$14.27 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$35.68 ,$221.40 ,$14.27 ,$246.00 ,$161.13 ,$14.27 ,$102.34 ,$12.66 ,$12.09 ,$14.98 ,$221.40 ,$32.11 ,$151.78 ,$68.88 ,$221.40 ,$14.27 ,$221.40 ,$221.40 ,$14.27 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$359.00 ,$233.35 ,$25.81 ,$359.00 ,$64.53 ,$267.46 ,$235.15 ,$25.81 ,$100.52 ,$181.30 ,$25.81 ,$221.50 ,$25.81 ,$221.50 ,$221.50 ,$25.81 ,$221.50 ,$49.04 ,$323.10 ,$269.25 ,$64.53 ,$25.81 ,$315.92 ,$25.81 ,$269.25 ,$269.25 ,$305.15 ,$305.15 ,$25.81 ,$305.15 ,$25.81 ,$280.02 ,$280.02 ,$280.02 ,$323.10 ,$64.53 ,$323.10 ,$25.81 ,$359.00 ,$235.15 ,$25.81 ,$149.34 ,$29.66 ,$28.31 ,$27.10 ,$323.10 ,$58.07 ,$221.50 ,$100.52 ,$323.10 ,$25.81 ,$323.10 ,$323.10 ,$25.81 ,$233.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200966,86850,HC AB SCREEN-90,302,1 ,$100.00 ,$65.00 ,$7.01 ,$110.23 ,$100.00 ,$74.50 ,$65.50 ,$48.99 ,$28.00 ,$50.50 ,$48.99 ,$61.70 ,$48.99 ,$61.70 ,$61.70 ,$48.99 ,$61.70 ,$93.08 ,$90.00 ,$75.00 ,$100.00 ,$48.99 ,$88.00 ,$48.99 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$48.99 ,$85.00 ,$48.99 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$100.00 ,$90.00 ,$48.99 ,$100.00 ,$65.50 ,$48.99 ,$41.60 ,$7.35 ,$7.01 ,$51.44 ,$90.00 ,$110.23 ,$61.70 ,$28.00 ,$90.00 ,$48.99 ,$90.00 ,$90.00 ,$48.99 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200970,86860,HC ELUTION-90,302,1 ,$225.00 ,$146.25 ,$7.01 ,$330.83 ,$225.00 ,$167.63 ,$147.38 ,$147.04 ,$63.00 ,$113.63 ,$147.04 ,$138.83 ,$147.04 ,$138.83 ,$138.83 ,$147.04 ,$138.83 ,$279.38 ,$202.50 ,$168.75 ,$225.00 ,$147.04 ,$198.00 ,$147.04 ,$168.75 ,$168.75 ,$191.25 ,$191.25 ,$147.04 ,$191.25 ,$147.04 ,$175.50 ,$175.50 ,$175.50 ,$202.50 ,$225.00 ,$202.50 ,$147.04 ,$225.00 ,$147.38 ,$147.04 ,$93.60 ,$7.35 ,$7.01 ,$154.39 ,$202.50 ,$330.83 ,$138.83 ,$63.00 ,$202.50 ,$147.04 ,$202.50 ,$202.50 ,$147.04 ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200974,86870,HC RBC AB ID PANEL-90,302,1 ,$75.00 ,$48.75 ,$7.01 ,$646.05 ,$75.00 ,$55.88 ,$49.13 ,$75.00 ,$21.00 ,$37.88 ,$75.00 ,$46.28 ,$75.00 ,$46.28 ,$46.28 ,$75.00 ,$46.28 ,$545.55 ,$67.50 ,$56.25 ,$75.00 ,$75.00 ,$66.00 ,$75.00 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$75.00 ,$63.75 ,$75.00 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$75.00 ,$67.50 ,$75.00 ,$75.00 ,$49.13 ,$75.00 ,$31.20 ,$7.35 ,$7.01 ,$75.00 ,$67.50 ,$646.05 ,$46.28 ,$21.00 ,$67.50 ,$75.00 ,$67.50 ,$67.50 ,$75.00 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200976,86880,HC COOMBS DIRECT-90,302,1 ,$75.00 ,$48.75 ,$7.01 ,$123.48 ,$75.00 ,$55.88 ,$49.13 ,$54.88 ,$21.00 ,$37.88 ,$54.88 ,$46.28 ,$54.88 ,$46.28 ,$46.28 ,$54.88 ,$46.28 ,$104.27 ,$67.50 ,$56.25 ,$75.00 ,$54.88 ,$66.00 ,$54.88 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$54.88 ,$63.75 ,$54.88 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$75.00 ,$67.50 ,$54.88 ,$75.00 ,$49.13 ,$54.88 ,$31.20 ,$7.35 ,$7.01 ,$57.62 ,$67.50 ,$123.48 ,$46.28 ,$21.00 ,$67.50 ,$54.88 ,$67.50 ,$67.50 ,$54.88 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200981,86900,HC BLOOD TYPING ABO-90,302,1 ,$38.00 ,$24.70 ,$4.35 ,$250.12 ,$38.00 ,$28.31 ,$24.89 ,$38.00 ,$10.64 ,$19.19 ,$38.00 ,$23.45 ,$38.00 ,$23.45 ,$23.45 ,$38.00 ,$23.45 ,$211.22 ,$34.20 ,$28.50 ,$38.00 ,$38.00 ,$33.44 ,$38.00 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$38.00 ,$32.30 ,$38.00 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$38.00 ,$34.20 ,$38.00 ,$38.00 ,$24.89 ,$38.00 ,$15.81 ,$4.55 ,$4.35 ,$38.00 ,$34.20 ,$250.12 ,$23.45 ,$10.64 ,$34.20 ,$38.00 ,$34.20 ,$34.20 ,$38.00 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30200983,86901,HC BLOOD TYPING RH-90,302,1 ,$38.00 ,$24.70 ,$4.35 ,$75.08 ,$38.00 ,$28.31 ,$24.89 ,$33.37 ,$10.64 ,$19.19 ,$33.37 ,$23.45 ,$33.37 ,$23.45 ,$23.45 ,$33.37 ,$23.45 ,$63.40 ,$34.20 ,$28.50 ,$38.00 ,$33.37 ,$33.44 ,$33.37 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$33.37 ,$32.30 ,$33.37 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$38.00 ,$34.20 ,$33.37 ,$38.00 ,$24.89 ,$33.37 ,$15.81 ,$4.55 ,$4.35 ,$35.04 ,$34.20 ,$75.08 ,$23.45 ,$10.64 ,$34.20 ,$33.37 ,$34.20 ,$34.20 ,$33.37 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201003,86970,HC RBC PRETREAT CHEM-90,302,1 ,$138.00 ,$89.70 ,$28.31 ,$138.00 ,$83.43 ,$102.81 ,$90.39 ,$33.37 ,$38.64 ,$69.69 ,$33.37 ,$85.15 ,$33.37 ,$85.15 ,$85.15 ,$33.37 ,$85.15 ,$63.40 ,$124.20 ,$103.50 ,$83.43 ,$33.37 ,$121.44 ,$33.37 ,$103.50 ,$103.50 ,$117.30 ,$117.30 ,$33.37 ,$117.30 ,$33.37 ,$107.64 ,$107.64 ,$107.64 ,$124.20 ,$83.43 ,$124.20 ,$33.37 ,$138.00 ,$90.39 ,$33.37 ,$57.41 ,$29.66 ,$28.31 ,$35.04 ,$124.20 ,$75.08 ,$85.15 ,$38.64 ,$124.20 ,$33.37 ,$124.20 ,$124.20 ,$33.37 ,$89.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201005,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$50.00 ,$32.50 ,$14.00 ,$646.05 ,$50.00 ,$37.25 ,$32.75 ,$50.00 ,$14.00 ,$25.25 ,$50.00 ,$30.85 ,$50.00 ,$30.85 ,$30.85 ,$50.00 ,$30.85 ,$545.55 ,$45.00 ,$37.50 ,$50.00 ,$50.00 ,$44.00 ,$50.00 ,$37.50 ,$37.50 ,$42.50 ,$42.50 ,$50.00 ,$42.50 ,$50.00 ,$39.00 ,$39.00 ,$39.00 ,$45.00 ,$50.00 ,$45.00 ,$50.00 ,$50.00 ,$32.75 ,$50.00 ,$20.80 ,$29.66 ,$28.31 ,$50.00 ,$45.00 ,$646.05 ,$30.85 ,$14.00 ,$45.00 ,$50.00 ,$45.00 ,$45.00 ,$50.00 ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201007,86972,HC RBC PRETREAT DENSITY SEP-90,302,1 ,$113.00 ,$73.45 ,$28.31 ,$330.83 ,$113.00 ,$84.19 ,$74.02 ,$113.00 ,$31.64 ,$57.07 ,$113.00 ,$69.72 ,$113.00 ,$69.72 ,$69.72 ,$113.00 ,$69.72 ,$279.38 ,$101.70 ,$84.75 ,$113.00 ,$113.00 ,$99.44 ,$113.00 ,$84.75 ,$84.75 ,$96.05 ,$96.05 ,$113.00 ,$96.05 ,$113.00 ,$88.14 ,$88.14 ,$88.14 ,$101.70 ,$113.00 ,$101.70 ,$113.00 ,$113.00 ,$74.02 ,$113.00 ,$47.01 ,$29.66 ,$28.31 ,$113.00 ,$101.70 ,$330.83 ,$69.72 ,$31.64 ,$101.70 ,$113.00 ,$101.70 ,$101.70 ,$113.00 ,$73.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201020,86978,HC RBC PRETREAT ABSOR-90,302,1 ,$138.00 ,$89.70 ,$4.35 ,$138.00 ,$83.43 ,$102.81 ,$90.39 ,$33.37 ,$38.64 ,$69.69 ,$33.37 ,$85.15 ,$33.37 ,$85.15 ,$85.15 ,$33.37 ,$85.15 ,$63.40 ,$124.20 ,$103.50 ,$83.43 ,$33.37 ,$121.44 ,$33.37 ,$103.50 ,$103.50 ,$117.30 ,$117.30 ,$33.37 ,$117.30 ,$33.37 ,$107.64 ,$107.64 ,$107.64 ,$124.20 ,$83.43 ,$124.20 ,$33.37 ,$138.00 ,$90.39 ,$33.37 ,$57.41 ,$4.55 ,$4.35 ,$35.04 ,$124.20 ,$75.08 ,$85.15 ,$38.64 ,$124.20 ,$33.37 ,$124.20 ,$124.20 ,$33.37 ,$89.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201022,87801,HC INFECT MLT  ORG AMP-90,302,1 ,$450.00 ,$292.50 ,$5.60 ,$450.00 ,$175.50 ,$335.25 ,$294.75 ,$70.20 ,$126.00 ,$227.25 ,$70.20 ,$277.65 ,$70.20 ,$277.65 ,$277.65 ,$70.20 ,$277.65 ,$133.38 ,$405.00 ,$337.50 ,$175.50 ,$70.20 ,$396.00 ,$70.20 ,$337.50 ,$337.50 ,$382.50 ,$382.50 ,$70.20 ,$382.50 ,$70.20 ,$351.00 ,$351.00 ,$351.00 ,$405.00 ,$175.50 ,$405.00 ,$70.20 ,$450.00 ,$294.75 ,$70.20 ,$187.20 ,$5.86 ,$5.60 ,$73.71 ,$405.00 ,$157.95 ,$277.65 ,$126.00 ,$405.00 ,$70.20 ,$405.00 ,$405.00 ,$70.20 ,$292.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$148.00 ,$96.20 ,$7.83 ,$148.00 ,$52.03 ,$110.26 ,$96.94 ,$20.81 ,$41.44 ,$74.74 ,$20.81 ,$91.32 ,$20.81 ,$91.32 ,$91.32 ,$20.81 ,$91.32 ,$39.54 ,$133.20 ,$111.00 ,$52.03 ,$20.81 ,$130.24 ,$20.81 ,$111.00 ,$111.00 ,$125.80 ,$125.80 ,$20.81 ,$125.80 ,$20.81 ,$115.44 ,$115.44 ,$115.44 ,$133.20 ,$52.03 ,$133.20 ,$20.81 ,$148.00 ,$96.94 ,$20.81 ,$61.57 ,$8.21 ,$7.83 ,$21.85 ,$133.20 ,$46.82 ,$91.32 ,$41.44 ,$133.20 ,$20.81 ,$133.20 ,$133.20 ,$20.81 ,$96.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201026,86317,HC INFECTIOUS AB QN-90,302,1 ,$71.40 ,$46.41 ,$12.09 ,$71.40 ,$37.48 ,$53.19 ,$46.77 ,$14.99 ,$19.99 ,$36.06 ,$14.99 ,$44.05 ,$14.99 ,$44.05 ,$44.05 ,$14.99 ,$44.05 ,$28.48 ,$64.26 ,$53.55 ,$37.48 ,$14.99 ,$62.83 ,$14.99 ,$53.55 ,$53.55 ,$60.69 ,$60.69 ,$14.99 ,$60.69 ,$14.99 ,$55.69 ,$55.69 ,$55.69 ,$64.26 ,$37.48 ,$64.26 ,$14.99 ,$71.40 ,$46.77 ,$14.99 ,$29.70 ,$12.66 ,$12.09 ,$15.74 ,$64.26 ,$33.73 ,$44.05 ,$19.99 ,$64.26 ,$14.99 ,$64.26 ,$64.26 ,$14.99 ,$46.41 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201028,86329,HC IMMUNODIFFUSION NOS-90,302,1 ,$115.00 ,$74.75 ,$12.09 ,$115.00 ,$35.13 ,$85.68 ,$75.33 ,$14.05 ,$32.20 ,$58.08 ,$14.05 ,$70.96 ,$14.05 ,$70.96 ,$70.96 ,$14.05 ,$70.96 ,$26.70 ,$103.50 ,$86.25 ,$35.13 ,$14.05 ,$101.20 ,$14.05 ,$86.25 ,$86.25 ,$97.75 ,$97.75 ,$14.05 ,$97.75 ,$14.05 ,$89.70 ,$89.70 ,$89.70 ,$103.50 ,$35.13 ,$103.50 ,$14.05 ,$115.00 ,$75.33 ,$14.05 ,$47.84 ,$12.66 ,$12.09 ,$14.75 ,$103.50 ,$31.61 ,$70.96 ,$32.20 ,$103.50 ,$14.05 ,$103.50 ,$103.50 ,$14.05 ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$247.00 ,$160.55 ,$12.09 ,$247.00 ,$55.85 ,$184.02 ,$161.79 ,$22.34 ,$69.16 ,$124.74 ,$22.34 ,$152.40 ,$22.34 ,$152.40 ,$152.40 ,$22.34 ,$152.40 ,$42.45 ,$222.30 ,$185.25 ,$55.85 ,$22.34 ,$217.36 ,$22.34 ,$185.25 ,$185.25 ,$209.95 ,$209.95 ,$22.34 ,$209.95 ,$22.34 ,$192.66 ,$192.66 ,$192.66 ,$222.30 ,$55.85 ,$222.30 ,$22.34 ,$247.00 ,$161.79 ,$22.34 ,$102.75 ,$12.66 ,$12.09 ,$23.46 ,$222.30 ,$50.27 ,$152.40 ,$69.16 ,$222.30 ,$22.34 ,$222.30 ,$222.30 ,$22.34 ,$160.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201032,86335,HC IMMUNOFIX ELECTRO OTH-90,302,1 ,$227.00 ,$147.55 ,$12.09 ,$227.00 ,$73.38 ,$169.12 ,$148.69 ,$29.35 ,$63.56 ,$114.64 ,$29.35 ,$140.06 ,$29.35 ,$140.06 ,$140.06 ,$29.35 ,$140.06 ,$55.77 ,$204.30 ,$170.25 ,$73.38 ,$29.35 ,$199.76 ,$29.35 ,$170.25 ,$170.25 ,$192.95 ,$192.95 ,$29.35 ,$192.95 ,$29.35 ,$177.06 ,$177.06 ,$177.06 ,$204.30 ,$73.38 ,$204.30 ,$29.35 ,$227.00 ,$148.69 ,$29.35 ,$94.43 ,$12.66 ,$12.09 ,$30.82 ,$204.30 ,$66.04 ,$140.06 ,$63.56 ,$204.30 ,$29.35 ,$204.30 ,$204.30 ,$29.35 ,$147.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201033,86336,HC INHIBIN A-90,302,1 ,$133.00 ,$86.45 ,$7.83 ,$133.00 ,$38.98 ,$99.09 ,$87.12 ,$15.59 ,$37.24 ,$67.17 ,$15.59 ,$82.06 ,$15.59 ,$82.06 ,$82.06 ,$15.59 ,$82.06 ,$29.62 ,$119.70 ,$99.75 ,$38.98 ,$15.59 ,$117.04 ,$15.59 ,$99.75 ,$99.75 ,$113.05 ,$113.05 ,$15.59 ,$113.05 ,$15.59 ,$103.74 ,$103.74 ,$103.74 ,$119.70 ,$38.98 ,$119.70 ,$15.59 ,$133.00 ,$87.12 ,$15.59 ,$55.33 ,$8.21 ,$7.83 ,$16.37 ,$119.70 ,$35.08 ,$82.06 ,$37.24 ,$119.70 ,$15.59 ,$119.70 ,$119.70 ,$15.59 ,$86.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201034,86337,HC INSULIN AB-90,302,1 ,$238.00 ,$154.70 ,$18.33 ,$238.00 ,$53.53 ,$177.31 ,$155.89 ,$21.41 ,$66.64 ,$120.19 ,$21.41 ,$146.85 ,$21.41 ,$146.85 ,$146.85 ,$21.41 ,$146.85 ,$40.68 ,$214.20 ,$178.50 ,$53.53 ,$21.41 ,$209.44 ,$21.41 ,$178.50 ,$178.50 ,$202.30 ,$202.30 ,$21.41 ,$202.30 ,$21.41 ,$185.64 ,$185.64 ,$185.64 ,$214.20 ,$53.53 ,$214.20 ,$21.41 ,$238.00 ,$155.89 ,$21.41 ,$99.01 ,$19.21 ,$18.33 ,$22.48 ,$214.20 ,$48.17 ,$146.85 ,$66.64 ,$214.20 ,$21.41 ,$214.20 ,$214.20 ,$21.41 ,$154.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$107.00 ,$69.55 ,$15.08 ,$107.00 ,$37.70 ,$79.72 ,$70.09 ,$15.08 ,$29.96 ,$54.04 ,$15.08 ,$66.02 ,$15.08 ,$66.02 ,$66.02 ,$15.08 ,$66.02 ,$28.65 ,$96.30 ,$80.25 ,$37.70 ,$15.08 ,$94.16 ,$15.08 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$15.08 ,$90.95 ,$15.08 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$37.70 ,$96.30 ,$15.08 ,$107.00 ,$70.09 ,$15.08 ,$44.51 ,$19.21 ,$18.33 ,$15.83 ,$96.30 ,$33.93 ,$66.02 ,$29.96 ,$96.30 ,$15.08 ,$96.30 ,$96.30 ,$15.08 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201036,86341,HC ISLET CELL AB-90,302,1 ,$140.00 ,$91.00 ,$12.09 ,$140.00 ,$58.93 ,$104.30 ,$91.70 ,$23.57 ,$39.20 ,$70.70 ,$23.57 ,$86.38 ,$23.57 ,$86.38 ,$86.38 ,$23.57 ,$86.38 ,$44.78 ,$126.00 ,$105.00 ,$58.93 ,$23.57 ,$123.20 ,$23.57 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$23.57 ,$119.00 ,$23.57 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$58.93 ,$126.00 ,$23.57 ,$140.00 ,$91.70 ,$23.57 ,$58.24 ,$12.66 ,$12.09 ,$24.75 ,$126.00 ,$53.03 ,$86.38 ,$39.20 ,$126.00 ,$23.57 ,$126.00 ,$126.00 ,$23.57 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201037,86343,HC LEUKOCYTE HISTAMINE RELEASE-90,302,1 ,$200.00 ,$130.00 ,$12.09 ,$200.00 ,$31.15 ,$149.00 ,$131.00 ,$12.46 ,$56.00 ,$101.00 ,$12.46 ,$123.40 ,$12.46 ,$123.40 ,$123.40 ,$12.46 ,$123.40 ,$23.67 ,$180.00 ,$150.00 ,$31.15 ,$12.46 ,$176.00 ,$12.46 ,$150.00 ,$150.00 ,$170.00 ,$170.00 ,$12.46 ,$170.00 ,$12.46 ,$156.00 ,$156.00 ,$156.00 ,$180.00 ,$31.15 ,$180.00 ,$12.46 ,$200.00 ,$131.00 ,$12.46 ,$83.20 ,$12.66 ,$12.09 ,$13.08 ,$180.00 ,$28.04 ,$123.40 ,$56.00 ,$180.00 ,$12.46 ,$180.00 ,$180.00 ,$12.46 ,$130.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201040,86355,HC B CELLS TOTAL COUNT-90,302,1 ,$167.00 ,$108.55 ,$12.09 ,$167.00 ,$94.33 ,$124.42 ,$109.39 ,$37.73 ,$46.76 ,$84.34 ,$37.73 ,$103.04 ,$37.73 ,$103.04 ,$103.04 ,$37.73 ,$103.04 ,$71.69 ,$150.30 ,$125.25 ,$94.33 ,$37.73 ,$146.96 ,$37.73 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$37.73 ,$141.95 ,$37.73 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$94.33 ,$150.30 ,$37.73 ,$167.00 ,$109.39 ,$37.73 ,$69.47 ,$12.66 ,$12.09 ,$39.62 ,$150.30 ,$84.89 ,$103.04 ,$46.76 ,$150.30 ,$37.73 ,$150.30 ,$150.30 ,$37.73 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201041,86356,HC MOL ANTIGEN QN EA-90,302,1 ,$310.00 ,$201.50 ,$12.09 ,$310.00 ,$66.95 ,$230.95 ,$203.05 ,$26.78 ,$86.80 ,$156.55 ,$26.78 ,$191.27 ,$26.78 ,$191.27 ,$191.27 ,$26.78 ,$191.27 ,$50.88 ,$279.00 ,$232.50 ,$66.95 ,$26.78 ,$272.80 ,$26.78 ,$232.50 ,$232.50 ,$263.50 ,$263.50 ,$26.78 ,$263.50 ,$26.78 ,$241.80 ,$241.80 ,$241.80 ,$279.00 ,$66.95 ,$279.00 ,$26.78 ,$310.00 ,$203.05 ,$26.78 ,$128.96 ,$12.66 ,$12.09 ,$28.12 ,$279.00 ,$60.26 ,$191.27 ,$86.80 ,$279.00 ,$26.78 ,$279.00 ,$279.00 ,$26.78 ,$201.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201043,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$167.00 ,$108.55 ,$12.09 ,$167.00 ,$94.33 ,$124.42 ,$109.39 ,$37.73 ,$46.76 ,$84.34 ,$37.73 ,$103.04 ,$37.73 ,$103.04 ,$103.04 ,$37.73 ,$103.04 ,$71.69 ,$150.30 ,$125.25 ,$94.33 ,$37.73 ,$146.96 ,$37.73 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$37.73 ,$141.95 ,$37.73 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$94.33 ,$150.30 ,$37.73 ,$167.00 ,$109.39 ,$37.73 ,$69.47 ,$12.66 ,$12.09 ,$39.62 ,$150.30 ,$84.89 ,$103.04 ,$46.76 ,$150.30 ,$37.73 ,$150.30 ,$150.30 ,$37.73 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$230.00 ,$149.50 ,$12.09 ,$230.00 ,$117.45 ,$171.35 ,$150.65 ,$46.98 ,$64.40 ,$116.15 ,$46.98 ,$141.91 ,$46.98 ,$141.91 ,$141.91 ,$46.98 ,$141.91 ,$89.26 ,$207.00 ,$172.50 ,$117.45 ,$46.98 ,$202.40 ,$46.98 ,$172.50 ,$172.50 ,$195.50 ,$195.50 ,$46.98 ,$195.50 ,$46.98 ,$179.40 ,$179.40 ,$179.40 ,$207.00 ,$117.45 ,$207.00 ,$46.98 ,$230.00 ,$150.65 ,$46.98 ,$95.68 ,$12.66 ,$12.09 ,$49.33 ,$207.00 ,$105.71 ,$141.91 ,$64.40 ,$207.00 ,$46.98 ,$207.00 ,$207.00 ,$46.98 ,$149.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201046,86361,HC T CELLS CD4 COUNT-90,302,1 ,$36.00 ,$23.40 ,$10.08 ,$60.26 ,$36.00 ,$26.82 ,$23.58 ,$26.78 ,$10.08 ,$18.18 ,$26.78 ,$22.21 ,$26.78 ,$22.21 ,$22.21 ,$26.78 ,$22.21 ,$50.88 ,$32.40 ,$27.00 ,$36.00 ,$26.78 ,$31.68 ,$26.78 ,$27.00 ,$27.00 ,$30.60 ,$30.60 ,$26.78 ,$30.60 ,$26.78 ,$28.08 ,$28.08 ,$28.08 ,$32.40 ,$36.00 ,$32.40 ,$26.78 ,$36.00 ,$23.58 ,$26.78 ,$14.98 ,$12.66 ,$12.09 ,$28.12 ,$32.40 ,$60.26 ,$22.21 ,$10.08 ,$32.40 ,$26.78 ,$32.40 ,$32.40 ,$26.78 ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201047,86376,HC MICROSOMAL AB-90,302,1 ,$104.00 ,$67.60 ,$14.55 ,$104.00 ,$36.38 ,$77.48 ,$68.12 ,$14.55 ,$29.12 ,$52.52 ,$14.55 ,$64.17 ,$14.55 ,$64.17 ,$64.17 ,$14.55 ,$64.17 ,$27.65 ,$93.60 ,$78.00 ,$36.38 ,$14.55 ,$91.52 ,$14.55 ,$78.00 ,$78.00 ,$88.40 ,$88.40 ,$14.55 ,$88.40 ,$14.55 ,$81.12 ,$81.12 ,$81.12 ,$93.60 ,$36.38 ,$93.60 ,$14.55 ,$104.00 ,$68.12 ,$14.55 ,$43.26 ,$19.21 ,$18.33 ,$15.28 ,$93.60 ,$32.74 ,$64.17 ,$29.12 ,$93.60 ,$14.55 ,$93.60 ,$93.60 ,$14.55 ,$67.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201049,86403,HC PARTICLE AGG SCREEN-90,302,1 ,$25.00 ,$16.25 ,$7.00 ,$25.97 ,$25.00 ,$18.63 ,$16.38 ,$11.54 ,$7.00 ,$12.63 ,$11.54 ,$15.43 ,$11.54 ,$15.43 ,$15.43 ,$11.54 ,$15.43 ,$21.93 ,$22.50 ,$18.75 ,$25.00 ,$11.54 ,$22.00 ,$11.54 ,$18.75 ,$18.75 ,$21.25 ,$21.25 ,$11.54 ,$21.25 ,$11.54 ,$19.50 ,$19.50 ,$19.50 ,$22.50 ,$25.00 ,$22.50 ,$11.54 ,$25.00 ,$16.38 ,$11.54 ,$10.40 ,$7.35 ,$7.01 ,$12.12 ,$22.50 ,$25.97 ,$15.43 ,$7.00 ,$22.50 ,$11.54 ,$22.50 ,$22.50 ,$11.54 ,$16.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201051,86406,HC PARTICLE AGGLUT TITER-90,302,1 ,$68.50 ,$44.53 ,$7.01 ,$68.50 ,$26.60 ,$51.03 ,$44.87 ,$10.64 ,$19.18 ,$34.59 ,$10.64 ,$42.26 ,$10.64 ,$42.26 ,$42.26 ,$10.64 ,$42.26 ,$20.22 ,$61.65 ,$51.38 ,$26.60 ,$10.64 ,$60.28 ,$10.64 ,$51.38 ,$51.38 ,$58.23 ,$58.23 ,$10.64 ,$58.23 ,$10.64 ,$53.43 ,$53.43 ,$53.43 ,$61.65 ,$26.60 ,$61.65 ,$10.64 ,$68.50 ,$44.87 ,$10.64 ,$28.50 ,$7.35 ,$7.01 ,$11.17 ,$61.65 ,$23.94 ,$42.26 ,$19.18 ,$61.65 ,$10.64 ,$61.65 ,$61.65 ,$10.64 ,$44.53 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$216.00 ,$140.40 ,$5.67 ,$216.00 ,$14.18 ,$160.92 ,$141.48 ,$5.67 ,$60.48 ,$109.08 ,$5.67 ,$133.27 ,$5.67 ,$133.27 ,$133.27 ,$5.67 ,$133.27 ,$10.77 ,$194.40 ,$162.00 ,$14.18 ,$5.67 ,$190.08 ,$5.67 ,$162.00 ,$162.00 ,$183.60 ,$183.60 ,$5.67 ,$183.60 ,$5.67 ,$168.48 ,$168.48 ,$168.48 ,$194.40 ,$14.18 ,$194.40 ,$5.67 ,$216.00 ,$141.48 ,$5.67 ,$89.86 ,$7.35 ,$7.01 ,$5.95 ,$194.40 ,$12.76 ,$133.27 ,$60.48 ,$194.40 ,$5.67 ,$194.40 ,$194.40 ,$5.67 ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201053,86480,HC TB QUANTIFERON GOLD-90,302,1 ,$78.00 ,$50.70 ,$12.09 ,$139.46 ,$78.00 ,$58.11 ,$51.09 ,$61.98 ,$21.84 ,$39.39 ,$61.98 ,$48.13 ,$61.98 ,$48.13 ,$48.13 ,$61.98 ,$48.13 ,$117.76 ,$70.20 ,$58.50 ,$78.00 ,$61.98 ,$68.64 ,$61.98 ,$58.50 ,$58.50 ,$66.30 ,$66.30 ,$61.98 ,$66.30 ,$61.98 ,$60.84 ,$60.84 ,$60.84 ,$70.20 ,$78.00 ,$70.20 ,$61.98 ,$78.00 ,$51.09 ,$61.98 ,$32.45 ,$12.66 ,$12.09 ,$65.08 ,$70.20 ,$139.46 ,$48.13 ,$21.84 ,$70.20 ,$61.98 ,$70.20 ,$70.20 ,$61.98 ,$50.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201054,86592,HC SYPHILIS VDRL RPR QL-90,302,1 ,$136.00 ,$88.40 ,$4.27 ,$136.00 ,$10.68 ,$101.32 ,$89.08 ,$4.27 ,$38.08 ,$68.68 ,$4.27 ,$83.91 ,$4.27 ,$83.91 ,$83.91 ,$4.27 ,$83.91 ,$8.11 ,$122.40 ,$102.00 ,$10.68 ,$4.27 ,$119.68 ,$4.27 ,$102.00 ,$102.00 ,$115.60 ,$115.60 ,$4.27 ,$115.60 ,$4.27 ,$106.08 ,$106.08 ,$106.08 ,$122.40 ,$10.68 ,$122.40 ,$4.27 ,$136.00 ,$89.08 ,$4.27 ,$56.58 ,$7.35 ,$7.01 ,$4.48 ,$122.40 ,$9.61 ,$83.91 ,$38.08 ,$122.40 ,$4.27 ,$122.40 ,$122.40 ,$4.27 ,$88.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201055,86603,HC ADENOVIRUS AB-90,302,1 ,$91.00 ,$59.15 ,$12.09 ,$91.00 ,$32.18 ,$67.80 ,$59.61 ,$12.87 ,$25.48 ,$45.96 ,$12.87 ,$56.15 ,$12.87 ,$56.15 ,$56.15 ,$12.87 ,$56.15 ,$24.45 ,$81.90 ,$68.25 ,$32.18 ,$12.87 ,$80.08 ,$12.87 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$12.87 ,$77.35 ,$12.87 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$32.18 ,$81.90 ,$12.87 ,$91.00 ,$59.61 ,$12.87 ,$37.86 ,$12.66 ,$12.09 ,$13.51 ,$81.90 ,$28.96 ,$56.15 ,$25.48 ,$81.90 ,$12.87 ,$81.90 ,$81.90 ,$12.87 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$209.00 ,$135.85 ,$12.09 ,$209.00 ,$37.63 ,$155.71 ,$136.90 ,$15.05 ,$58.52 ,$105.55 ,$15.05 ,$128.95 ,$15.05 ,$128.95 ,$128.95 ,$15.05 ,$128.95 ,$28.60 ,$188.10 ,$156.75 ,$37.63 ,$15.05 ,$183.92 ,$15.05 ,$156.75 ,$156.75 ,$177.65 ,$177.65 ,$15.05 ,$177.65 ,$15.05 ,$163.02 ,$163.02 ,$163.02 ,$188.10 ,$37.63 ,$188.10 ,$15.05 ,$209.00 ,$136.90 ,$15.05 ,$86.94 ,$12.66 ,$12.09 ,$15.80 ,$188.10 ,$33.86 ,$128.95 ,$58.52 ,$188.10 ,$15.05 ,$188.10 ,$188.10 ,$15.05 ,$135.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$83.00 ,$53.95 ,$10.18 ,$83.00 ,$25.45 ,$61.84 ,$54.37 ,$10.18 ,$23.24 ,$41.92 ,$10.18 ,$51.21 ,$10.18 ,$51.21 ,$51.21 ,$10.18 ,$51.21 ,$19.34 ,$74.70 ,$62.25 ,$25.45 ,$10.18 ,$73.04 ,$10.18 ,$62.25 ,$62.25 ,$70.55 ,$70.55 ,$10.18 ,$70.55 ,$10.18 ,$64.74 ,$64.74 ,$64.74 ,$74.70 ,$25.45 ,$74.70 ,$10.18 ,$83.00 ,$54.37 ,$10.18 ,$34.53 ,$12.66 ,$12.09 ,$10.69 ,$74.70 ,$22.91 ,$51.21 ,$23.24 ,$74.70 ,$10.18 ,$74.70 ,$74.70 ,$10.18 ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$82.00 ,$53.30 ,$12.09 ,$82.00 ,$32.25 ,$61.09 ,$53.71 ,$12.90 ,$22.96 ,$41.41 ,$12.90 ,$50.59 ,$12.90 ,$50.59 ,$50.59 ,$12.90 ,$50.59 ,$24.51 ,$73.80 ,$61.50 ,$32.25 ,$12.90 ,$72.16 ,$12.90 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$12.90 ,$69.70 ,$12.90 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$32.25 ,$73.80 ,$12.90 ,$82.00 ,$53.71 ,$12.90 ,$34.11 ,$12.66 ,$12.09 ,$13.55 ,$73.80 ,$29.03 ,$50.59 ,$22.96 ,$73.80 ,$12.90 ,$73.80 ,$73.80 ,$12.90 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201061,86615,HC BORDETELLA AB-90,302,1 ,$140.00 ,$91.00 ,$12.09 ,$140.00 ,$32.98 ,$104.30 ,$91.70 ,$13.19 ,$39.20 ,$70.70 ,$13.19 ,$86.38 ,$13.19 ,$86.38 ,$86.38 ,$13.19 ,$86.38 ,$25.06 ,$126.00 ,$105.00 ,$32.98 ,$13.19 ,$123.20 ,$13.19 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$13.19 ,$119.00 ,$13.19 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$32.98 ,$126.00 ,$13.19 ,$140.00 ,$91.70 ,$13.19 ,$58.24 ,$12.66 ,$12.09 ,$13.85 ,$126.00 ,$29.68 ,$86.38 ,$39.20 ,$126.00 ,$13.19 ,$126.00 ,$126.00 ,$13.19 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$201.00 ,$130.65 ,$12.09 ,$201.00 ,$38.73 ,$149.75 ,$131.66 ,$15.49 ,$56.28 ,$101.51 ,$15.49 ,$124.02 ,$15.49 ,$124.02 ,$124.02 ,$15.49 ,$124.02 ,$29.43 ,$180.90 ,$150.75 ,$38.73 ,$15.49 ,$176.88 ,$15.49 ,$150.75 ,$150.75 ,$170.85 ,$170.85 ,$15.49 ,$170.85 ,$15.49 ,$156.78 ,$156.78 ,$156.78 ,$180.90 ,$38.73 ,$180.90 ,$15.49 ,$201.00 ,$131.66 ,$15.49 ,$83.62 ,$12.66 ,$12.09 ,$16.26 ,$180.90 ,$34.85 ,$124.02 ,$56.28 ,$180.90 ,$15.49 ,$180.90 ,$180.90 ,$15.49 ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201063,86618,HC LYME AB-90,302,1 ,$176.00 ,$114.40 ,$12.09 ,$176.00 ,$42.58 ,$131.12 ,$115.28 ,$17.03 ,$49.28 ,$88.88 ,$17.03 ,$108.59 ,$17.03 ,$108.59 ,$108.59 ,$17.03 ,$108.59 ,$32.36 ,$158.40 ,$132.00 ,$42.58 ,$17.03 ,$154.88 ,$17.03 ,$132.00 ,$132.00 ,$149.60 ,$149.60 ,$17.03 ,$149.60 ,$17.03 ,$137.28 ,$137.28 ,$137.28 ,$158.40 ,$42.58 ,$158.40 ,$17.03 ,$176.00 ,$115.28 ,$17.03 ,$73.22 ,$12.66 ,$12.09 ,$17.88 ,$158.40 ,$38.32 ,$108.59 ,$49.28 ,$158.40 ,$17.03 ,$158.40 ,$158.40 ,$17.03 ,$114.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201066,86628,HC CANDIDA AB-90,302,1 ,$59.00 ,$38.35 ,$5.60 ,$59.00 ,$30.03 ,$43.96 ,$38.65 ,$12.01 ,$16.52 ,$29.80 ,$12.01 ,$36.40 ,$12.01 ,$36.40 ,$36.40 ,$12.01 ,$36.40 ,$22.82 ,$53.10 ,$44.25 ,$30.03 ,$12.01 ,$51.92 ,$12.01 ,$44.25 ,$44.25 ,$50.15 ,$50.15 ,$12.01 ,$50.15 ,$12.01 ,$46.02 ,$46.02 ,$46.02 ,$53.10 ,$30.03 ,$53.10 ,$12.01 ,$59.00 ,$38.65 ,$12.01 ,$24.54 ,$5.86 ,$5.60 ,$12.61 ,$53.10 ,$27.02 ,$36.40 ,$16.52 ,$53.10 ,$12.01 ,$53.10 ,$53.10 ,$12.01 ,$38.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201074,86695,HC HERPES SIMPLEX AB I W/O TITER-90,302,1 ,$93.00 ,$60.45 ,$12.09 ,$93.00 ,$32.98 ,$69.29 ,$60.92 ,$13.19 ,$26.04 ,$46.97 ,$13.19 ,$57.38 ,$13.19 ,$57.38 ,$57.38 ,$13.19 ,$57.38 ,$25.06 ,$83.70 ,$69.75 ,$32.98 ,$13.19 ,$81.84 ,$13.19 ,$69.75 ,$69.75 ,$79.05 ,$79.05 ,$13.19 ,$79.05 ,$13.19 ,$72.54 ,$72.54 ,$72.54 ,$83.70 ,$32.98 ,$83.70 ,$13.19 ,$93.00 ,$60.92 ,$13.19 ,$38.69 ,$12.66 ,$12.09 ,$13.85 ,$83.70 ,$29.68 ,$57.38 ,$26.04 ,$83.70 ,$13.19 ,$83.70 ,$83.70 ,$13.19 ,$60.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201075,86696,HC HERPES SIMPLEX AB II W/O TITER-90,302,1 ,$138.00 ,$89.70 ,$7.01 ,$138.00 ,$48.38 ,$102.81 ,$90.39 ,$19.35 ,$38.64 ,$69.69 ,$19.35 ,$85.15 ,$19.35 ,$85.15 ,$85.15 ,$19.35 ,$85.15 ,$36.77 ,$124.20 ,$103.50 ,$48.38 ,$19.35 ,$121.44 ,$19.35 ,$103.50 ,$103.50 ,$117.30 ,$117.30 ,$19.35 ,$117.30 ,$19.35 ,$107.64 ,$107.64 ,$107.64 ,$124.20 ,$48.38 ,$124.20 ,$19.35 ,$138.00 ,$90.39 ,$19.35 ,$57.41 ,$7.35 ,$7.01 ,$20.32 ,$124.20 ,$43.54 ,$85.15 ,$38.64 ,$124.20 ,$19.35 ,$124.20 ,$124.20 ,$19.35 ,$89.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201079,86711,HC AB JOHN CUNNINGHAM VIRUS-90,302,1 ,"$2,635.00 ","$1,712.75 ",$7.01 ,"$2,635.00 ",$42.23 ,"$1,963.08 ","$1,725.93 ",$16.89 ,$737.80 ,"$1,330.68 ",$16.89 ,"$1,625.80 ",$16.89 ,"$1,625.80 ","$1,625.80 ",$16.89 ,"$1,625.80 ",$32.09 ,"$2,371.50 ","$1,976.25 ",$42.23 ,$16.89 ,"$2,318.80 ",$16.89 ,"$1,976.25 ","$1,976.25 ","$2,239.75 ","$2,239.75 ",$16.89 ,"$2,239.75 ",$16.89 ,"$2,055.30 ","$2,055.30 ","$2,055.30 ","$2,371.50 ",$42.23 ,"$2,371.50 ",$16.89 ,"$2,635.00 ","$1,725.93 ",$16.89 ,"$1,096.16 ",$7.35 ,$7.01 ,$17.73 ,"$2,371.50 ",$38.00 ,"$1,625.80 ",$737.80 ,"$2,371.50 ",$16.89 ,"$2,371.50 ","$2,371.50 ",$16.89 ,"$1,712.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201088,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA-90,302,1 ,$11.00 ,$7.15 ,$3.08 ,$24.75 ,$11.00 ,$8.20 ,$7.21 ,$11.00 ,$3.08 ,$5.56 ,$11.00 ,$6.79 ,$11.00 ,$6.79 ,$6.79 ,$11.00 ,$6.79 ,$20.90 ,$9.90 ,$8.25 ,$11.00 ,$11.00 ,$9.68 ,$11.00 ,$8.25 ,$8.25 ,$9.35 ,$9.35 ,$11.00 ,$9.35 ,$11.00 ,$8.58 ,$8.58 ,$8.58 ,$9.90 ,$11.00 ,$9.90 ,$11.00 ,$11.00 ,$7.21 ,$11.00 ,$4.58 ,$7.35 ,$7.01 ,$11.00 ,$9.90 ,$24.75 ,$6.79 ,$3.08 ,$9.90 ,$11.00 ,$9.90 ,$9.90 ,$11.00 ,$7.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201092,86593,HC SYPHILIS VDRL RPR QN-90,302,1 ,$3.01 ,$1.96 ,$0.84 ,$6.77 ,$3.01 ,$2.24 ,$1.97 ,$3.01 ,$0.84 ,$1.52 ,$3.01 ,$1.86 ,$3.01 ,$1.86 ,$1.86 ,$3.01 ,$1.86 ,$5.72 ,$2.71 ,$2.26 ,$3.01 ,$3.01 ,$2.65 ,$3.01 ,$2.26 ,$2.26 ,$2.56 ,$2.56 ,$3.01 ,$2.56 ,$3.01 ,$2.35 ,$2.35 ,$2.35 ,$2.71 ,$3.01 ,$2.71 ,$3.01 ,$3.01 ,$1.97 ,$3.01 ,$1.25 ,$3.01 ,$3.01 ,$3.01 ,$2.71 ,$6.77 ,$1.86 ,$0.84 ,$2.71 ,$3.01 ,$2.71 ,$2.71 ,$3.01 ,$1.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201094,86038,HC ANA SCREEN,302,1 ,$207.00 ,$134.55 ,$7.01 ,$207.00 ,$30.23 ,$154.22 ,$135.59 ,$12.09 ,$57.96 ,$104.54 ,$12.09 ,$127.72 ,$12.09 ,$127.72 ,$127.72 ,$12.09 ,$127.72 ,$22.97 ,$186.30 ,$155.25 ,$30.23 ,$12.09 ,$182.16 ,$12.09 ,$155.25 ,$155.25 ,$175.95 ,$175.95 ,$12.09 ,$175.95 ,$12.09 ,$161.46 ,$161.46 ,$161.46 ,$186.30 ,$30.23 ,$186.30 ,$12.09 ,$207.00 ,$135.59 ,$12.09 ,$86.11 ,$7.35 ,$7.01 ,$12.69 ,$186.30 ,$27.20 ,$127.72 ,$57.96 ,$186.30 ,$12.09 ,$186.30 ,$186.30 ,$12.09 ,$134.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201098,86225,HC DNA DOUBLE STRAND AB,302,1 ,$251.00 ,$163.15 ,$7.01 ,$251.00 ,$34.35 ,$187.00 ,$164.41 ,$13.74 ,$70.28 ,$126.76 ,$13.74 ,$154.87 ,$13.74 ,$154.87 ,$154.87 ,$13.74 ,$154.87 ,$26.11 ,$225.90 ,$188.25 ,$34.35 ,$13.74 ,$220.88 ,$13.74 ,$188.25 ,$188.25 ,$213.35 ,$213.35 ,$13.74 ,$213.35 ,$13.74 ,$195.78 ,$195.78 ,$195.78 ,$225.90 ,$34.35 ,$225.90 ,$13.74 ,$251.00 ,$164.41 ,$13.74 ,$104.42 ,$7.35 ,$7.01 ,$14.43 ,$225.90 ,$30.92 ,$154.87 ,$70.28 ,$225.90 ,$13.74 ,$225.90 ,$225.90 ,$13.74 ,$163.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201099,86235,HC ENA AB,302,1 ,$154.00 ,$100.10 ,$12.09 ,$154.00 ,$44.83 ,$114.73 ,$100.87 ,$17.93 ,$43.12 ,$77.77 ,$17.93 ,$95.02 ,$17.93 ,$95.02 ,$95.02 ,$17.93 ,$95.02 ,$34.07 ,$138.60 ,$115.50 ,$44.83 ,$17.93 ,$135.52 ,$17.93 ,$115.50 ,$115.50 ,$130.90 ,$130.90 ,$17.93 ,$130.90 ,$17.93 ,$120.12 ,$120.12 ,$120.12 ,$138.60 ,$44.83 ,$138.60 ,$17.93 ,$154.00 ,$100.87 ,$17.93 ,$64.06 ,$12.66 ,$12.09 ,$18.83 ,$138.60 ,$40.34 ,$95.02 ,$43.12 ,$138.60 ,$17.93 ,$138.60 ,$138.60 ,$17.93 ,$100.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201100,86300,HC TUMOR AG CA 15-3 (27.29),302,1 ,$201.00 ,$130.65 ,$18.59 ,$201.00 ,$52.03 ,$149.75 ,$131.66 ,$20.81 ,$56.28 ,$101.51 ,$20.81 ,$124.02 ,$20.81 ,$124.02 ,$124.02 ,$20.81 ,$124.02 ,$39.54 ,$180.90 ,$150.75 ,$52.03 ,$20.81 ,$176.88 ,$20.81 ,$150.75 ,$150.75 ,$170.85 ,$170.85 ,$20.81 ,$170.85 ,$20.81 ,$156.78 ,$156.78 ,$156.78 ,$180.90 ,$52.03 ,$180.90 ,$20.81 ,$201.00 ,$131.66 ,$20.81 ,$83.62 ,$19.47 ,$18.59 ,$21.85 ,$180.90 ,$46.82 ,$124.02 ,$56.28 ,$180.90 ,$20.81 ,$180.90 ,$180.90 ,$20.81 ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201101,86304,HC TUMOR AG CA 125,302,1 ,$100.00 ,$65.00 ,$18.59 ,$100.00 ,$52.03 ,$74.50 ,$65.50 ,$20.81 ,$28.00 ,$50.50 ,$20.81 ,$61.70 ,$20.81 ,$61.70 ,$61.70 ,$20.81 ,$61.70 ,$39.54 ,$90.00 ,$75.00 ,$52.03 ,$20.81 ,$88.00 ,$20.81 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$20.81 ,$85.00 ,$20.81 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$52.03 ,$90.00 ,$20.81 ,$100.00 ,$65.50 ,$20.81 ,$41.60 ,$19.47 ,$18.59 ,$21.85 ,$90.00 ,$46.82 ,$61.70 ,$28.00 ,$90.00 ,$20.81 ,$90.00 ,$90.00 ,$20.81 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201102,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$247.00 ,$160.55 ,$12.09 ,$247.00 ,$55.85 ,$184.02 ,$161.79 ,$22.34 ,$69.16 ,$124.74 ,$22.34 ,$152.40 ,$22.34 ,$152.40 ,$152.40 ,$22.34 ,$152.40 ,$42.45 ,$222.30 ,$185.25 ,$55.85 ,$22.34 ,$217.36 ,$22.34 ,$185.25 ,$185.25 ,$209.95 ,$209.95 ,$22.34 ,$209.95 ,$22.34 ,$192.66 ,$192.66 ,$192.66 ,$222.30 ,$55.85 ,$222.30 ,$22.34 ,$247.00 ,$161.79 ,$22.34 ,$102.75 ,$12.66 ,$12.09 ,$23.46 ,$222.30 ,$50.27 ,$152.40 ,$69.16 ,$222.30 ,$22.34 ,$222.30 ,$222.30 ,$22.34 ,$160.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201103,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$247.00 ,$160.55 ,$12.09 ,$247.00 ,$73.38 ,$184.02 ,$161.79 ,$29.35 ,$69.16 ,$124.74 ,$29.35 ,$152.40 ,$29.35 ,$152.40 ,$152.40 ,$29.35 ,$152.40 ,$55.77 ,$222.30 ,$185.25 ,$73.38 ,$29.35 ,$217.36 ,$29.35 ,$185.25 ,$185.25 ,$209.95 ,$209.95 ,$29.35 ,$209.95 ,$29.35 ,$192.66 ,$192.66 ,$192.66 ,$222.30 ,$73.38 ,$222.30 ,$29.35 ,$247.00 ,$161.79 ,$29.35 ,$102.75 ,$12.66 ,$12.09 ,$30.82 ,$222.30 ,$66.04 ,$152.40 ,$69.16 ,$222.30 ,$29.35 ,$222.30 ,$222.30 ,$29.35 ,$160.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201106,86376,HC MICROSOMAL AB,302,1 ,$198.00 ,$128.70 ,$14.55 ,$198.00 ,$36.38 ,$147.51 ,$129.69 ,$14.55 ,$55.44 ,$99.99 ,$14.55 ,$122.17 ,$14.55 ,$122.17 ,$122.17 ,$14.55 ,$122.17 ,$27.65 ,$178.20 ,$148.50 ,$36.38 ,$14.55 ,$174.24 ,$14.55 ,$148.50 ,$148.50 ,$168.30 ,$168.30 ,$14.55 ,$168.30 ,$14.55 ,$154.44 ,$154.44 ,$154.44 ,$178.20 ,$36.38 ,$178.20 ,$14.55 ,$198.00 ,$129.69 ,$14.55 ,$82.37 ,$19.21 ,$18.33 ,$15.28 ,$178.20 ,$32.74 ,$122.17 ,$55.44 ,$178.20 ,$14.55 ,$178.20 ,$178.20 ,$14.55 ,$128.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201109,86480,HC TB QUANTIFERON GOLD,302,1 ,$310.00 ,$201.50 ,$12.09 ,$310.00 ,$154.95 ,$230.95 ,$203.05 ,$61.98 ,$86.80 ,$156.55 ,$61.98 ,$191.27 ,$61.98 ,$191.27 ,$191.27 ,$61.98 ,$191.27 ,$117.76 ,$279.00 ,$232.50 ,$154.95 ,$61.98 ,$272.80 ,$61.98 ,$232.50 ,$232.50 ,$263.50 ,$263.50 ,$61.98 ,$263.50 ,$61.98 ,$241.80 ,$241.80 ,$241.80 ,$279.00 ,$154.95 ,$279.00 ,$61.98 ,$310.00 ,$203.05 ,$61.98 ,$128.96 ,$12.66 ,$12.09 ,$65.08 ,$279.00 ,$139.46 ,$191.27 ,$86.80 ,$279.00 ,$61.98 ,$279.00 ,$279.00 ,$61.98 ,$201.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201112,86606,HC ASPERGILLUS AB,302,1 ,$107.00 ,$69.55 ,$12.09 ,$107.00 ,$37.63 ,$79.72 ,$70.09 ,$15.05 ,$29.96 ,$54.04 ,$15.05 ,$66.02 ,$15.05 ,$66.02 ,$66.02 ,$15.05 ,$66.02 ,$28.60 ,$96.30 ,$80.25 ,$37.63 ,$15.05 ,$94.16 ,$15.05 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$15.05 ,$90.95 ,$15.05 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$37.63 ,$96.30 ,$15.05 ,$107.00 ,$70.09 ,$15.05 ,$44.51 ,$12.66 ,$12.09 ,$15.80 ,$96.30 ,$33.86 ,$66.02 ,$29.96 ,$96.30 ,$15.05 ,$96.30 ,$96.30 ,$15.05 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201113,86612,HC BLASTOMYCES AB,302,1 ,$92.00 ,$59.80 ,$12.09 ,$92.00 ,$32.25 ,$68.54 ,$60.26 ,$12.90 ,$25.76 ,$46.46 ,$12.90 ,$56.76 ,$12.90 ,$56.76 ,$56.76 ,$12.90 ,$56.76 ,$24.51 ,$82.80 ,$69.00 ,$32.25 ,$12.90 ,$80.96 ,$12.90 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$12.90 ,$78.20 ,$12.90 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$32.25 ,$82.80 ,$12.90 ,$92.00 ,$60.26 ,$12.90 ,$38.27 ,$12.66 ,$12.09 ,$13.55 ,$82.80 ,$29.03 ,$56.76 ,$25.76 ,$82.80 ,$12.90 ,$82.80 ,$82.80 ,$12.90 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201114,86618,HC LYME AB,302,1 ,$153.00 ,$99.45 ,$12.09 ,$153.00 ,$42.58 ,$113.99 ,$100.22 ,$17.03 ,$42.84 ,$77.27 ,$17.03 ,$94.40 ,$17.03 ,$94.40 ,$94.40 ,$17.03 ,$94.40 ,$32.36 ,$137.70 ,$114.75 ,$42.58 ,$17.03 ,$134.64 ,$17.03 ,$114.75 ,$114.75 ,$130.05 ,$130.05 ,$17.03 ,$130.05 ,$17.03 ,$119.34 ,$119.34 ,$119.34 ,$137.70 ,$42.58 ,$137.70 ,$17.03 ,$153.00 ,$100.22 ,$17.03 ,$63.65 ,$12.66 ,$12.09 ,$17.88 ,$137.70 ,$38.32 ,$94.40 ,$42.84 ,$137.70 ,$17.03 ,$137.70 ,$137.70 ,$17.03 ,$99.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201115,86635,HC COCCIDIOIDES AB,302,1 ,$82.00 ,$53.30 ,$11.47 ,$82.00 ,$28.68 ,$61.09 ,$53.71 ,$11.47 ,$22.96 ,$41.41 ,$11.47 ,$50.59 ,$11.47 ,$50.59 ,$50.59 ,$11.47 ,$50.59 ,$21.79 ,$73.80 ,$61.50 ,$28.68 ,$11.47 ,$72.16 ,$11.47 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$11.47 ,$69.70 ,$11.47 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$28.68 ,$73.80 ,$11.47 ,$82.00 ,$53.71 ,$11.47 ,$34.11 ,$12.66 ,$12.09 ,$12.04 ,$73.80 ,$25.81 ,$50.59 ,$22.96 ,$73.80 ,$11.47 ,$73.80 ,$73.80 ,$11.47 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201117,86644,HC CMV AB,302,1 ,$178.00 ,$115.70 ,$12.09 ,$178.00 ,$35.98 ,$132.61 ,$116.59 ,$14.39 ,$49.84 ,$89.89 ,$14.39 ,$109.83 ,$14.39 ,$109.83 ,$109.83 ,$14.39 ,$109.83 ,$27.34 ,$160.20 ,$133.50 ,$35.98 ,$14.39 ,$156.64 ,$14.39 ,$133.50 ,$133.50 ,$151.30 ,$151.30 ,$14.39 ,$151.30 ,$14.39 ,$138.84 ,$138.84 ,$138.84 ,$160.20 ,$35.98 ,$160.20 ,$14.39 ,$178.00 ,$116.59 ,$14.39 ,$74.05 ,$12.66 ,$12.09 ,$15.11 ,$160.20 ,$32.38 ,$109.83 ,$49.84 ,$160.20 ,$14.39 ,$160.20 ,$160.20 ,$14.39 ,$115.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201118,86645,HC CMV AB IGM,302,1 ,$143.00 ,$92.95 ,$12.09 ,$143.00 ,$42.13 ,$106.54 ,$93.67 ,$16.85 ,$40.04 ,$72.22 ,$16.85 ,$88.23 ,$16.85 ,$88.23 ,$88.23 ,$16.85 ,$88.23 ,$32.02 ,$128.70 ,$107.25 ,$42.13 ,$16.85 ,$125.84 ,$16.85 ,$107.25 ,$107.25 ,$121.55 ,$121.55 ,$16.85 ,$121.55 ,$16.85 ,$111.54 ,$111.54 ,$111.54 ,$128.70 ,$42.13 ,$128.70 ,$16.85 ,$143.00 ,$93.67 ,$16.85 ,$59.49 ,$12.66 ,$12.09 ,$17.69 ,$128.70 ,$37.91 ,$88.23 ,$40.04 ,$128.70 ,$16.85 ,$128.70 ,$128.70 ,$16.85 ,$92.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201119,86677,HC H PYLORI AB,302,1 ,$104.00 ,$67.60 ,$12.09 ,$104.00 ,$42.13 ,$77.48 ,$68.12 ,$16.85 ,$29.12 ,$52.52 ,$16.85 ,$64.17 ,$16.85 ,$64.17 ,$64.17 ,$16.85 ,$64.17 ,$32.02 ,$93.60 ,$78.00 ,$42.13 ,$16.85 ,$91.52 ,$16.85 ,$78.00 ,$78.00 ,$88.40 ,$88.40 ,$16.85 ,$88.40 ,$16.85 ,$81.12 ,$81.12 ,$81.12 ,$93.60 ,$42.13 ,$93.60 ,$16.85 ,$104.00 ,$68.12 ,$16.85 ,$43.26 ,$12.66 ,$12.09 ,$17.69 ,$93.60 ,$37.91 ,$64.17 ,$29.12 ,$93.60 ,$16.85 ,$93.60 ,$93.60 ,$16.85 ,$67.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201122,86705,HC HEP B CORE IGM,302,1 ,$99.00 ,$64.35 ,$7.01 ,$99.00 ,$29.43 ,$73.76 ,$64.85 ,$11.77 ,$27.72 ,$50.00 ,$11.77 ,$61.08 ,$11.77 ,$61.08 ,$61.08 ,$11.77 ,$61.08 ,$22.36 ,$89.10 ,$74.25 ,$29.43 ,$11.77 ,$87.12 ,$11.77 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$11.77 ,$84.15 ,$11.77 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$29.43 ,$89.10 ,$11.77 ,$99.00 ,$64.85 ,$11.77 ,$41.18 ,$7.35 ,$7.01 ,$12.36 ,$89.10 ,$26.48 ,$61.08 ,$27.72 ,$89.10 ,$11.77 ,$89.10 ,$89.10 ,$11.77 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201125,86709,HC HEP A AB (HAAB) IGM,302,1 ,$191.00 ,$124.15 ,$7.01 ,$191.00 ,$28.15 ,$142.30 ,$125.11 ,$11.26 ,$53.48 ,$96.46 ,$11.26 ,$117.85 ,$11.26 ,$117.85 ,$117.85 ,$11.26 ,$117.85 ,$21.39 ,$171.90 ,$143.25 ,$28.15 ,$11.26 ,$168.08 ,$11.26 ,$143.25 ,$143.25 ,$162.35 ,$162.35 ,$11.26 ,$162.35 ,$11.26 ,$148.98 ,$148.98 ,$148.98 ,$171.90 ,$28.15 ,$171.90 ,$11.26 ,$191.00 ,$125.11 ,$11.26 ,$79.46 ,$7.35 ,$7.01 ,$11.82 ,$171.90 ,$25.34 ,$117.85 ,$53.48 ,$171.90 ,$11.26 ,$171.90 ,$171.90 ,$11.26 ,$124.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201126,86735,HC MUMPS AB,302,1 ,$107.00 ,$69.55 ,$7.01 ,$107.00 ,$32.63 ,$79.72 ,$70.09 ,$13.05 ,$29.96 ,$54.04 ,$13.05 ,$66.02 ,$13.05 ,$66.02 ,$66.02 ,$13.05 ,$66.02 ,$24.80 ,$96.30 ,$80.25 ,$32.63 ,$13.05 ,$94.16 ,$13.05 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$13.05 ,$90.95 ,$13.05 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$32.63 ,$96.30 ,$13.05 ,$107.00 ,$70.09 ,$13.05 ,$44.51 ,$7.35 ,$7.01 ,$13.70 ,$96.30 ,$29.36 ,$66.02 ,$29.96 ,$96.30 ,$13.05 ,$96.30 ,$96.30 ,$13.05 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201127,86762,HC RUBELLA AB,302,1 ,$140.00 ,$91.00 ,$7.01 ,$140.00 ,$35.98 ,$104.30 ,$91.70 ,$14.39 ,$39.20 ,$70.70 ,$14.39 ,$86.38 ,$14.39 ,$86.38 ,$86.38 ,$14.39 ,$86.38 ,$27.34 ,$126.00 ,$105.00 ,$35.98 ,$14.39 ,$123.20 ,$14.39 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$14.39 ,$119.00 ,$14.39 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$35.98 ,$126.00 ,$14.39 ,$140.00 ,$91.70 ,$14.39 ,$58.24 ,$7.35 ,$7.01 ,$15.11 ,$126.00 ,$32.38 ,$86.38 ,$39.20 ,$126.00 ,$14.39 ,$126.00 ,$126.00 ,$14.39 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201128,86765,HC RUBEOLA AB,302,1 ,$152.00 ,$98.80 ,$7.01 ,$152.00 ,$32.20 ,$113.24 ,$99.56 ,$12.88 ,$42.56 ,$76.76 ,$12.88 ,$93.78 ,$12.88 ,$93.78 ,$93.78 ,$12.88 ,$93.78 ,$24.47 ,$136.80 ,$114.00 ,$32.20 ,$12.88 ,$133.76 ,$12.88 ,$114.00 ,$114.00 ,$129.20 ,$129.20 ,$12.88 ,$129.20 ,$12.88 ,$118.56 ,$118.56 ,$118.56 ,$136.80 ,$32.20 ,$136.80 ,$12.88 ,$152.00 ,$99.56 ,$12.88 ,$63.23 ,$7.35 ,$7.01 ,$13.52 ,$136.80 ,$28.98 ,$93.78 ,$42.56 ,$136.80 ,$12.88 ,$136.80 ,$136.80 ,$12.88 ,$98.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201129,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$3.44 ,$2.24 ,$0.96 ,$7.74 ,$3.44 ,$2.56 ,$2.25 ,$3.44 ,$0.96 ,$1.74 ,$3.44 ,$2.12 ,$3.44 ,$2.12 ,$2.12 ,$3.44 ,$2.12 ,$6.54 ,$3.10 ,$2.58 ,$3.44 ,$3.44 ,$3.03 ,$3.44 ,$2.58 ,$2.58 ,$2.92 ,$2.92 ,$3.44 ,$2.92 ,$3.44 ,$2.68 ,$2.68 ,$2.68 ,$3.10 ,$3.44 ,$3.10 ,$3.44 ,$3.44 ,$2.25 ,$3.44 ,$1.43 ,$3.44 ,$3.44 ,$3.44 ,$3.10 ,$7.74 ,$2.12 ,$0.96 ,$3.10 ,$3.44 ,$3.10 ,$3.10 ,$3.44 ,$2.24 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201130,86787,HC VARICELLA ZOSTER AB,302,1 ,$183.00 ,$118.95 ,$7.01 ,$183.00 ,$32.20 ,$136.34 ,$119.87 ,$12.88 ,$51.24 ,$92.42 ,$12.88 ,$112.91 ,$12.88 ,$112.91 ,$112.91 ,$12.88 ,$112.91 ,$24.47 ,$164.70 ,$137.25 ,$32.20 ,$12.88 ,$161.04 ,$12.88 ,$137.25 ,$137.25 ,$155.55 ,$155.55 ,$12.88 ,$155.55 ,$12.88 ,$142.74 ,$142.74 ,$142.74 ,$164.70 ,$32.20 ,$164.70 ,$12.88 ,$183.00 ,$119.87 ,$12.88 ,$76.13 ,$7.35 ,$7.01 ,$13.52 ,$164.70 ,$28.98 ,$112.91 ,$51.24 ,$164.70 ,$12.88 ,$164.70 ,$164.70 ,$12.88 ,$118.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201131,86800,HC THYROGLOBULIN AB,302,1 ,$225.00 ,$146.25 ,$15.91 ,$225.00 ,$39.78 ,$167.63 ,$147.38 ,$15.91 ,$63.00 ,$113.63 ,$15.91 ,$138.83 ,$15.91 ,$138.83 ,$138.83 ,$15.91 ,$138.83 ,$30.23 ,$202.50 ,$168.75 ,$39.78 ,$15.91 ,$198.00 ,$15.91 ,$168.75 ,$168.75 ,$191.25 ,$191.25 ,$15.91 ,$191.25 ,$15.91 ,$175.50 ,$175.50 ,$175.50 ,$202.50 ,$39.78 ,$202.50 ,$15.91 ,$225.00 ,$147.38 ,$15.91 ,$93.60 ,$19.21 ,$18.33 ,$16.71 ,$202.50 ,$35.80 ,$138.83 ,$63.00 ,$202.50 ,$15.91 ,$202.50 ,$202.50 ,$15.91 ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201134,86902,HC RBC AG SCR RGT SERUM T1-90,302,1 ,$100.00 ,$65.00 ,$4.35 ,$646.05 ,$100.00 ,$74.50 ,$65.50 ,$100.00 ,$28.00 ,$50.50 ,$100.00 ,$61.70 ,$100.00 ,$61.70 ,$61.70 ,$100.00 ,$61.70 ,$545.55 ,$90.00 ,$75.00 ,$100.00 ,$100.00 ,$88.00 ,$100.00 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$100.00 ,$85.00 ,$100.00 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$100.00 ,$90.00 ,$100.00 ,$100.00 ,$65.50 ,$100.00 ,$41.60 ,$4.55 ,$4.35 ,$100.00 ,$90.00 ,$646.05 ,$61.70 ,$28.00 ,$90.00 ,$100.00 ,$90.00 ,$90.00 ,$100.00 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201135,86902,HC RBC AG SCR RGT SERUM T2-90,302,1 ,$175.00 ,$113.75 ,$4.35 ,$646.05 ,$175.00 ,$130.38 ,$114.63 ,$175.00 ,$49.00 ,$88.38 ,$175.00 ,$107.98 ,$175.00 ,$107.98 ,$107.98 ,$175.00 ,$107.98 ,$545.55 ,$157.50 ,$131.25 ,$175.00 ,$175.00 ,$154.00 ,$175.00 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$175.00 ,$148.75 ,$175.00 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$175.00 ,$175.00 ,$114.63 ,$175.00 ,$72.80 ,$4.55 ,$4.35 ,$175.00 ,$157.50 ,$646.05 ,$107.98 ,$49.00 ,$157.50 ,$175.00 ,$157.50 ,$157.50 ,$175.00 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201136,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$225.00 ,$146.25 ,$4.35 ,$646.05 ,$225.00 ,$167.63 ,$147.38 ,$225.00 ,$63.00 ,$113.63 ,$225.00 ,$138.83 ,$225.00 ,$138.83 ,$138.83 ,$225.00 ,$138.83 ,$545.55 ,$202.50 ,$168.75 ,$225.00 ,$225.00 ,$198.00 ,$225.00 ,$168.75 ,$168.75 ,$191.25 ,$191.25 ,$225.00 ,$191.25 ,$225.00 ,$175.50 ,$175.50 ,$175.50 ,$202.50 ,$225.00 ,$202.50 ,$225.00 ,$225.00 ,$147.38 ,$225.00 ,$93.60 ,$4.55 ,$4.35 ,$225.00 ,$202.50 ,$646.05 ,$138.83 ,$63.00 ,$202.50 ,$225.00 ,$202.50 ,$202.50 ,$225.00 ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201137,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$275.00 ,$178.75 ,$4.35 ,$646.05 ,$275.00 ,$204.88 ,$180.13 ,$275.00 ,$77.00 ,$138.88 ,$275.00 ,$169.68 ,$275.00 ,$169.68 ,$169.68 ,$275.00 ,$169.68 ,$545.55 ,$247.50 ,$206.25 ,$275.00 ,$275.00 ,$242.00 ,$275.00 ,$206.25 ,$206.25 ,$233.75 ,$233.75 ,$275.00 ,$233.75 ,$275.00 ,$214.50 ,$214.50 ,$214.50 ,$247.50 ,$275.00 ,$247.50 ,$275.00 ,$275.00 ,$180.13 ,$275.00 ,$114.40 ,$4.55 ,$4.35 ,$275.00 ,$247.50 ,$646.05 ,$169.68 ,$77.00 ,$247.50 ,$275.00 ,$247.50 ,$247.50 ,$275.00 ,$178.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201138,86905,HC RBC AG TYPING NON ABO/RH T1-90,302,1 ,$100.00 ,$65.00 ,$4.35 ,$646.05 ,$100.00 ,$74.50 ,$65.50 ,$100.00 ,$28.00 ,$50.50 ,$100.00 ,$61.70 ,$100.00 ,$61.70 ,$61.70 ,$100.00 ,$61.70 ,$545.55 ,$90.00 ,$75.00 ,$100.00 ,$100.00 ,$88.00 ,$100.00 ,$75.00 ,$75.00 ,$85.00 ,$85.00 ,$100.00 ,$85.00 ,$100.00 ,$78.00 ,$78.00 ,$78.00 ,$90.00 ,$100.00 ,$90.00 ,$100.00 ,$100.00 ,$65.50 ,$100.00 ,$41.60 ,$4.55 ,$4.35 ,$100.00 ,$90.00 ,$646.05 ,$61.70 ,$28.00 ,$90.00 ,$100.00 ,$90.00 ,$90.00 ,$100.00 ,$65.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201139,86905,HC RBC AG TYPING NON ABO/RH T2-90,302,1 ,$175.00 ,$113.75 ,$4.35 ,$646.05 ,$175.00 ,$130.38 ,$114.63 ,$175.00 ,$49.00 ,$88.38 ,$175.00 ,$107.98 ,$175.00 ,$107.98 ,$107.98 ,$175.00 ,$107.98 ,$545.55 ,$157.50 ,$131.25 ,$175.00 ,$175.00 ,$154.00 ,$175.00 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$175.00 ,$148.75 ,$175.00 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$175.00 ,$175.00 ,$114.63 ,$175.00 ,$72.80 ,$4.55 ,$4.35 ,$175.00 ,$157.50 ,$646.05 ,$107.98 ,$49.00 ,$157.50 ,$175.00 ,$157.50 ,$157.50 ,$175.00 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201140,86905,HC RBC AG TYPING NON ABO/RH T3-90,302,1 ,$225.00 ,$146.25 ,$4.35 ,$646.05 ,$225.00 ,$167.63 ,$147.38 ,$225.00 ,$63.00 ,$113.63 ,$225.00 ,$138.83 ,$225.00 ,$138.83 ,$138.83 ,$225.00 ,$138.83 ,$545.55 ,$202.50 ,$168.75 ,$225.00 ,$225.00 ,$198.00 ,$225.00 ,$168.75 ,$168.75 ,$191.25 ,$191.25 ,$225.00 ,$191.25 ,$225.00 ,$175.50 ,$175.50 ,$175.50 ,$202.50 ,$225.00 ,$202.50 ,$225.00 ,$225.00 ,$147.38 ,$225.00 ,$93.60 ,$4.55 ,$4.35 ,$225.00 ,$202.50 ,$646.05 ,$138.83 ,$63.00 ,$202.50 ,$225.00 ,$202.50 ,$202.50 ,$225.00 ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201141,86905,HC RBC AG TYPING NON ABO/RH T4-90,302,1 ,$275.00 ,$178.75 ,$4.35 ,$646.05 ,$275.00 ,$204.88 ,$180.13 ,$275.00 ,$77.00 ,$138.88 ,$275.00 ,$169.68 ,$275.00 ,$169.68 ,$169.68 ,$275.00 ,$169.68 ,$545.55 ,$247.50 ,$206.25 ,$275.00 ,$275.00 ,$242.00 ,$275.00 ,$206.25 ,$206.25 ,$233.75 ,$233.75 ,$275.00 ,$233.75 ,$275.00 ,$214.50 ,$214.50 ,$214.50 ,$247.50 ,$275.00 ,$247.50 ,$275.00 ,$275.00 ,$180.13 ,$275.00 ,$114.40 ,$4.55 ,$4.35 ,$275.00 ,$247.50 ,$646.05 ,$169.68 ,$77.00 ,$247.50 ,$275.00 ,$247.50 ,$247.50 ,$275.00 ,$178.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201142,86039,HC ANA TITER,302,1 ,$207.00 ,$134.55 ,$7.01 ,$207.00 ,$27.90 ,$154.22 ,$135.59 ,$11.16 ,$57.96 ,$104.54 ,$11.16 ,$127.72 ,$11.16 ,$127.72 ,$127.72 ,$11.16 ,$127.72 ,$21.20 ,$186.30 ,$155.25 ,$27.90 ,$11.16 ,$182.16 ,$11.16 ,$155.25 ,$155.25 ,$175.95 ,$175.95 ,$11.16 ,$175.95 ,$11.16 ,$161.46 ,$161.46 ,$161.46 ,$186.30 ,$27.90 ,$186.30 ,$11.16 ,$207.00 ,$135.59 ,$11.16 ,$86.11 ,$7.35 ,$7.01 ,$11.72 ,$186.30 ,$25.11 ,$127.72 ,$57.96 ,$186.30 ,$11.16 ,$186.30 ,$186.30 ,$11.16 ,$134.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201144,86160,HC COMPLEMENT AG EA,302,1 ,$221.00 ,$143.65 ,$7.01 ,$221.00 ,$30.00 ,$164.65 ,$144.76 ,$12.00 ,$61.88 ,$111.61 ,$12.00 ,$136.36 ,$12.00 ,$136.36 ,$136.36 ,$12.00 ,$136.36 ,$22.80 ,$198.90 ,$165.75 ,$30.00 ,$12.00 ,$194.48 ,$12.00 ,$165.75 ,$165.75 ,$187.85 ,$187.85 ,$12.00 ,$187.85 ,$12.00 ,$172.38 ,$172.38 ,$172.38 ,$198.90 ,$30.00 ,$198.90 ,$12.00 ,$221.00 ,$144.76 ,$12.00 ,$91.94 ,$7.35 ,$7.01 ,$12.60 ,$198.90 ,$27.00 ,$136.36 ,$61.88 ,$198.90 ,$12.00 ,$198.90 ,$198.90 ,$12.00 ,$143.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201146,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$159.00 ,$103.35 ,$12.09 ,$159.00 ,$33.10 ,$118.46 ,$104.15 ,$13.24 ,$44.52 ,$80.30 ,$13.24 ,$98.10 ,$13.24 ,$98.10 ,$98.10 ,$13.24 ,$98.10 ,$25.16 ,$143.10 ,$119.25 ,$33.10 ,$13.24 ,$139.92 ,$13.24 ,$119.25 ,$119.25 ,$135.15 ,$135.15 ,$13.24 ,$135.15 ,$13.24 ,$124.02 ,$124.02 ,$124.02 ,$143.10 ,$33.10 ,$143.10 ,$13.24 ,$159.00 ,$104.15 ,$13.24 ,$66.14 ,$12.66 ,$12.09 ,$13.90 ,$143.10 ,$29.79 ,$98.10 ,$44.52 ,$143.10 ,$13.24 ,$143.10 ,$143.10 ,$13.24 ,$103.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201147,86870,HC RBC AB ID PANEL SERUM-90,302,1 ,$50.00 ,$32.50 ,$7.01 ,$646.05 ,$50.00 ,$37.25 ,$32.75 ,$50.00 ,$14.00 ,$25.25 ,$50.00 ,$30.85 ,$50.00 ,$30.85 ,$30.85 ,$50.00 ,$30.85 ,$545.55 ,$45.00 ,$37.50 ,$50.00 ,$50.00 ,$44.00 ,$50.00 ,$37.50 ,$37.50 ,$42.50 ,$42.50 ,$50.00 ,$42.50 ,$50.00 ,$39.00 ,$39.00 ,$39.00 ,$45.00 ,$50.00 ,$45.00 ,$50.00 ,$50.00 ,$32.75 ,$50.00 ,$20.80 ,$7.35 ,$7.01 ,$50.00 ,$45.00 ,$646.05 ,$30.85 ,$14.00 ,$45.00 ,$50.00 ,$45.00 ,$45.00 ,$50.00 ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201152,86255,HC FLUOR AB SCR AQUAPORIN-90,302,1 ,$21.00 ,$13.65 ,$5.88 ,$27.11 ,$21.00 ,$15.65 ,$13.76 ,$12.05 ,$5.88 ,$10.61 ,$12.05 ,$12.96 ,$12.05 ,$12.96 ,$12.96 ,$12.05 ,$12.96 ,$22.90 ,$18.90 ,$15.75 ,$21.00 ,$12.05 ,$18.48 ,$12.05 ,$15.75 ,$15.75 ,$17.85 ,$17.85 ,$12.05 ,$17.85 ,$12.05 ,$16.38 ,$16.38 ,$16.38 ,$18.90 ,$21.00 ,$18.90 ,$12.05 ,$21.00 ,$13.76 ,$12.05 ,$8.74 ,$12.66 ,$12.09 ,$12.65 ,$18.90 ,$27.11 ,$12.96 ,$5.88 ,$18.90 ,$12.05 ,$18.90 ,$18.90 ,$12.05 ,$13.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201163,87427,HC SHIGA-LIKE TOXIN -90,302,1 ,$112.00 ,$72.80 ,$7.01 ,$112.00 ,$29.95 ,$83.44 ,$73.36 ,$11.98 ,$31.36 ,$56.56 ,$11.98 ,$69.10 ,$11.98 ,$69.10 ,$69.10 ,$11.98 ,$69.10 ,$22.76 ,$100.80 ,$84.00 ,$29.95 ,$11.98 ,$98.56 ,$11.98 ,$84.00 ,$84.00 ,$95.20 ,$95.20 ,$11.98 ,$95.20 ,$11.98 ,$87.36 ,$87.36 ,$87.36 ,$100.80 ,$29.95 ,$100.80 ,$11.98 ,$112.00 ,$73.36 ,$11.98 ,$46.59 ,$7.35 ,$7.01 ,$12.58 ,$100.80 ,$26.96 ,$69.10 ,$31.36 ,$100.80 ,$11.98 ,$100.80 ,$100.80 ,$11.98 ,$72.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201164,86008,HC ALLERGEN SPEC IGE RECOMBINANT/PURIFIED COMPNT EA-90,302,1 ,$92.00 ,$59.80 ,$7.01 ,$92.00 ,$44.83 ,$68.54 ,$60.26 ,$17.93 ,$25.76 ,$46.46 ,$17.93 ,$56.76 ,$17.93 ,$56.76 ,$56.76 ,$17.93 ,$56.76 ,$34.07 ,$82.80 ,$69.00 ,$44.83 ,$17.93 ,$80.96 ,$17.93 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$17.93 ,$78.20 ,$17.93 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$44.83 ,$82.80 ,$17.93 ,$92.00 ,$60.26 ,$17.93 ,$38.27 ,$7.35 ,$7.01 ,$18.83 ,$82.80 ,$40.34 ,$56.76 ,$25.76 ,$82.80 ,$17.93 ,$82.80 ,$82.80 ,$17.93 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201166,86780,HC ANTIBODY TREPONEMA PALLIDUM-90,302,1 ,$117.00 ,$76.05 ,$12.09 ,$117.00 ,$33.10 ,$87.17 ,$76.64 ,$13.24 ,$32.76 ,$59.09 ,$13.24 ,$72.19 ,$13.24 ,$72.19 ,$72.19 ,$13.24 ,$72.19 ,$25.16 ,$105.30 ,$87.75 ,$33.10 ,$13.24 ,$102.96 ,$13.24 ,$87.75 ,$87.75 ,$99.45 ,$99.45 ,$13.24 ,$99.45 ,$13.24 ,$91.26 ,$91.26 ,$91.26 ,$105.30 ,$33.10 ,$105.30 ,$13.24 ,$117.00 ,$76.64 ,$13.24 ,$48.67 ,$12.66 ,$12.09 ,$13.90 ,$105.30 ,$29.79 ,$72.19 ,$32.76 ,$105.30 ,$13.24 ,$105.30 ,$105.30 ,$13.24 ,$76.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201189,86015,HC ACTIN SMOOTH MUSC ANTIBODY- 90,302,1 ,$14.40 ,$9.36 ,$4.03 ,$25.94 ,$14.40 ,$10.73 ,$9.43 ,$11.53 ,$4.03 ,$7.27 ,$11.53 ,$8.88 ,$11.53 ,$8.88 ,$8.88 ,$11.53 ,$8.88 ,$21.91 ,$12.96 ,$10.80 ,$14.40 ,$11.53 ,$12.67 ,$11.53 ,$10.80 ,$10.80 ,$12.24 ,$12.24 ,$11.53 ,$12.24 ,$11.53 ,$11.23 ,$11.23 ,$11.23 ,$12.96 ,$14.40 ,$12.96 ,$11.53 ,$14.40 ,$9.43 ,$11.53 ,$5.99 ,$7.35 ,$7.01 ,$12.11 ,$12.96 ,$25.94 ,$8.88 ,$4.03 ,$12.96 ,$11.53 ,$12.96 ,$12.96 ,$11.53 ,$9.36 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201190,86036,HC ANTINEUTROPHIL CYTO ANTB SCREEN- 90,302,1 ,$28.50 ,$18.53 ,$7.01 ,$28.50 ,$28.50 ,$21.23 ,$18.67 ,$12.05 ,$7.98 ,$14.39 ,$12.05 ,$17.58 ,$12.05 ,$17.58 ,$17.58 ,$12.05 ,$17.58 ,$22.90 ,$25.65 ,$21.38 ,$28.50 ,$12.05 ,$25.08 ,$12.05 ,$21.38 ,$21.38 ,$24.23 ,$24.23 ,$12.05 ,$24.23 ,$12.05 ,$22.23 ,$22.23 ,$22.23 ,$25.65 ,$28.50 ,$25.65 ,$12.05 ,$28.50 ,$18.67 ,$12.05 ,$11.86 ,$7.35 ,$7.01 ,$12.65 ,$25.65 ,$27.11 ,$17.58 ,$7.98 ,$25.65 ,$12.05 ,$25.65 ,$25.65 ,$12.05 ,$18.53 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201192,86364,HC TISS TRANSGLUTAMINASE EA IMMUNO- 90,302,1 ,$50.00 ,$32.50 ,$7.01 ,$50.00 ,$28.83 ,$37.25 ,$32.75 ,$11.53 ,$14.00 ,$25.25 ,$11.53 ,$30.85 ,$11.53 ,$30.85 ,$30.85 ,$11.53 ,$30.85 ,$21.91 ,$45.00 ,$37.50 ,$28.83 ,$11.53 ,$44.00 ,$11.53 ,$37.50 ,$37.50 ,$42.50 ,$42.50 ,$11.53 ,$42.50 ,$11.53 ,$39.00 ,$39.00 ,$39.00 ,$45.00 ,$28.83 ,$45.00 ,$11.53 ,$50.00 ,$32.75 ,$11.53 ,$20.80 ,$7.35 ,$7.01 ,$12.11 ,$45.00 ,$25.94 ,$30.85 ,$14.00 ,$45.00 ,$11.53 ,$45.00 ,$45.00 ,$11.53 ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201193,86231,HC EMA EACH IG CLASS- 90,302,1 ,$24.00 ,$15.60 ,$6.72 ,$27.20 ,$24.00 ,$17.88 ,$15.72 ,$12.09 ,$6.72 ,$12.12 ,$12.09 ,$14.81 ,$12.09 ,$14.81 ,$14.81 ,$12.09 ,$14.81 ,$22.97 ,$21.60 ,$18.00 ,$24.00 ,$12.09 ,$21.12 ,$12.09 ,$18.00 ,$18.00 ,$20.40 ,$20.40 ,$12.09 ,$20.40 ,$12.09 ,$18.72 ,$18.72 ,$18.72 ,$21.60 ,$24.00 ,$21.60 ,$12.09 ,$24.00 ,$15.72 ,$12.09 ,$9.98 ,$7.35 ,$7.01 ,$12.69 ,$21.60 ,$27.20 ,$14.81 ,$6.72 ,$21.60 ,$12.09 ,$21.60 ,$21.60 ,$12.09 ,$15.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201194,86258,HC GLIADIN ANTIBODY EA- 90,302,1 ,$32.00 ,$20.80 ,$7.01 ,$32.00 ,$28.83 ,$23.84 ,$20.96 ,$11.53 ,$8.96 ,$16.16 ,$11.53 ,$19.74 ,$11.53 ,$19.74 ,$19.74 ,$11.53 ,$19.74 ,$21.91 ,$28.80 ,$24.00 ,$28.83 ,$11.53 ,$28.16 ,$11.53 ,$24.00 ,$24.00 ,$27.20 ,$27.20 ,$11.53 ,$27.20 ,$11.53 ,$24.96 ,$24.96 ,$24.96 ,$28.80 ,$28.83 ,$28.80 ,$11.53 ,$32.00 ,$20.96 ,$11.53 ,$13.31 ,$7.35 ,$7.01 ,$12.11 ,$28.80 ,$25.94 ,$19.74 ,$8.96 ,$28.80 ,$11.53 ,$28.80 ,$28.80 ,$11.53 ,$20.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30201195,86381,HC MITOCHONDRIAL ANTIBODY- 90,302,1 ,$12.56 ,$8.16 ,$3.52 ,$28.26 ,$12.56 ,$9.36 ,$8.23 ,$12.56 ,$3.52 ,$6.34 ,$12.56 ,$7.75 ,$12.56 ,$7.75 ,$7.75 ,$12.56 ,$7.75 ,$23.86 ,$11.30 ,$9.42 ,$12.56 ,$12.56 ,$11.05 ,$12.56 ,$9.42 ,$9.42 ,$10.68 ,$10.68 ,$12.56 ,$10.68 ,$12.56 ,$9.80 ,$9.80 ,$9.80 ,$11.30 ,$12.56 ,$11.30 ,$12.56 ,$12.56 ,$8.23 ,$12.56 ,$5.23 ,$7.35 ,$7.01 ,$12.56 ,$11.30 ,$28.26 ,$7.75 ,$3.52 ,$11.30 ,$12.56 ,$11.30 ,$11.30 ,$12.56 ,$8.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$25.00 ,$16.25 ,$3.80 ,$25.00 ,$9.50 ,$18.63 ,$16.38 ,$3.80 ,$7.00 ,$12.63 ,$3.80 ,$15.43 ,$3.80 ,$15.43 ,$15.43 ,$3.80 ,$15.43 ,$7.22 ,$22.50 ,$18.75 ,$9.50 ,$3.80 ,$22.00 ,$3.80 ,$18.75 ,$18.75 ,$21.25 ,$21.25 ,$3.80 ,$21.25 ,$3.80 ,$19.50 ,$19.50 ,$19.50 ,$22.50 ,$9.50 ,$22.50 ,$3.80 ,$25.00 ,$16.38 ,$3.80 ,$10.40 ,$5.09 ,$4.86 ,$3.99 ,$22.50 ,$8.55 ,$15.43 ,$7.00 ,$22.50 ,$3.80 ,$22.50 ,$22.50 ,$3.80 ,$16.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500104,85014,HC HEMATOCRIT,305,1 ,$18.00 ,$11.70 ,$2.37 ,$18.00 ,$5.93 ,$13.41 ,$11.79 ,$2.37 ,$5.04 ,$9.09 ,$2.37 ,$11.11 ,$2.37 ,$11.11 ,$11.11 ,$2.37 ,$11.11 ,$4.50 ,$16.20 ,$13.50 ,$5.93 ,$2.37 ,$15.84 ,$2.37 ,$13.50 ,$13.50 ,$15.30 ,$15.30 ,$2.37 ,$15.30 ,$2.37 ,$14.04 ,$14.04 ,$14.04 ,$16.20 ,$5.93 ,$16.20 ,$2.37 ,$2.37 ,$11.79 ,$2.37 ,$7.49 ,$5.09 ,$4.86 ,$2.49 ,$16.20 ,$5.33 ,$11.11 ,$5.04 ,$16.20 ,$2.37 ,$16.20 ,$16.20 ,$2.37 ,$11.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500106,85018,HC HGB,305,1 ,$18.00 ,$11.70 ,$2.37 ,$18.00 ,$5.93 ,$13.41 ,$11.79 ,$2.37 ,$5.04 ,$9.09 ,$2.37 ,$11.11 ,$2.37 ,$11.11 ,$11.11 ,$2.37 ,$11.11 ,$4.50 ,$16.20 ,$13.50 ,$5.93 ,$2.37 ,$15.84 ,$2.37 ,$13.50 ,$13.50 ,$15.30 ,$15.30 ,$2.37 ,$15.30 ,$2.37 ,$14.04 ,$14.04 ,$14.04 ,$16.20 ,$5.93 ,$16.20 ,$2.37 ,$2.37 ,$11.79 ,$2.37 ,$7.49 ,$5.09 ,$4.86 ,$2.49 ,$16.20 ,$5.33 ,$11.11 ,$5.04 ,$16.20 ,$2.37 ,$16.20 ,$16.20 ,$2.37 ,$11.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$40.00 ,$26.00 ,$4.86 ,$40.00 ,$19.43 ,$29.80 ,$26.20 ,$7.77 ,$11.20 ,$20.20 ,$7.77 ,$24.68 ,$7.77 ,$24.68 ,$24.68 ,$7.77 ,$24.68 ,$14.76 ,$36.00 ,$30.00 ,$19.43 ,$7.77 ,$35.20 ,$7.77 ,$30.00 ,$30.00 ,$34.00 ,$34.00 ,$7.77 ,$34.00 ,$7.77 ,$31.20 ,$31.20 ,$31.20 ,$36.00 ,$19.43 ,$36.00 ,$7.77 ,$7.77 ,$26.20 ,$7.77 ,$16.64 ,$5.09 ,$4.86 ,$8.16 ,$36.00 ,$17.48 ,$24.68 ,$11.20 ,$36.00 ,$7.77 ,$36.00 ,$36.00 ,$7.77 ,$26.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500108,85027,HC CBC W/O DIFF,305,1 ,$33.00 ,$21.45 ,$4.86 ,$33.00 ,$16.18 ,$24.59 ,$21.62 ,$6.47 ,$9.24 ,$16.67 ,$6.47 ,$20.36 ,$6.47 ,$20.36 ,$20.36 ,$6.47 ,$20.36 ,$12.29 ,$29.70 ,$24.75 ,$16.18 ,$6.47 ,$29.04 ,$6.47 ,$24.75 ,$24.75 ,$28.05 ,$28.05 ,$6.47 ,$28.05 ,$6.47 ,$25.74 ,$25.74 ,$25.74 ,$29.70 ,$16.18 ,$29.70 ,$6.47 ,$6.47 ,$21.62 ,$6.47 ,$13.73 ,$5.09 ,$4.86 ,$6.79 ,$29.70 ,$14.56 ,$20.36 ,$9.24 ,$29.70 ,$6.47 ,$29.70 ,$29.70 ,$6.47 ,$21.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$42.00 ,$27.30 ,$2.54 ,$42.00 ,$6.35 ,$31.29 ,$27.51 ,$2.54 ,$11.76 ,$21.21 ,$2.54 ,$25.91 ,$2.54 ,$25.91 ,$25.91 ,$2.54 ,$25.91 ,$4.83 ,$37.80 ,$31.50 ,$6.35 ,$2.54 ,$36.96 ,$2.54 ,$31.50 ,$31.50 ,$35.70 ,$35.70 ,$2.54 ,$35.70 ,$2.54 ,$32.76 ,$32.76 ,$32.76 ,$37.80 ,$6.35 ,$37.80 ,$2.54 ,$42.00 ,$27.51 ,$2.54 ,$17.47 ,$5.09 ,$4.86 ,$2.67 ,$37.80 ,$5.72 ,$25.91 ,$11.76 ,$37.80 ,$2.54 ,$37.80 ,$37.80 ,$2.54 ,$27.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$69.00 ,$44.85 ,$4.48 ,$69.00 ,$11.20 ,$51.41 ,$45.20 ,$4.48 ,$19.32 ,$34.85 ,$4.48 ,$42.57 ,$4.48 ,$42.57 ,$42.57 ,$4.48 ,$42.57 ,$8.51 ,$62.10 ,$51.75 ,$11.20 ,$4.48 ,$60.72 ,$4.48 ,$51.75 ,$51.75 ,$58.65 ,$58.65 ,$4.48 ,$58.65 ,$4.48 ,$53.82 ,$53.82 ,$53.82 ,$62.10 ,$11.20 ,$62.10 ,$4.48 ,$69.00 ,$45.20 ,$4.48 ,$28.70 ,$5.09 ,$4.86 ,$4.70 ,$62.10 ,$10.08 ,$42.57 ,$19.32 ,$62.10 ,$4.48 ,$62.10 ,$62.10 ,$4.48 ,$44.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500168,85347,HC ACTIVATED CLOTTING TIME,305,1 ,$113.00 ,$73.45 ,$2.84 ,$113.00 ,$10.70 ,$84.19 ,$74.02 ,$4.28 ,$31.64 ,$57.07 ,$4.28 ,$69.72 ,$4.28 ,$69.72 ,$69.72 ,$4.28 ,$69.72 ,$8.13 ,$101.70 ,$84.75 ,$10.70 ,$4.28 ,$99.44 ,$4.28 ,$84.75 ,$84.75 ,$96.05 ,$96.05 ,$4.28 ,$96.05 ,$4.28 ,$88.14 ,$88.14 ,$88.14 ,$101.70 ,$10.70 ,$101.70 ,$4.28 ,$113.00 ,$74.02 ,$4.28 ,$47.01 ,$2.97 ,$2.84 ,$4.49 ,$101.70 ,$9.63 ,$69.72 ,$31.64 ,$101.70 ,$4.28 ,$101.70 ,$101.70 ,$4.28 ,$73.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500175,85379,HC D DIMER QN,305,1 ,$84.00 ,$54.60 ,$8.43 ,$84.00 ,$25.45 ,$62.58 ,$55.02 ,$10.18 ,$23.52 ,$42.42 ,$10.18 ,$51.83 ,$10.18 ,$51.83 ,$51.83 ,$10.18 ,$51.83 ,$19.34 ,$75.60 ,$63.00 ,$25.45 ,$10.18 ,$73.92 ,$10.18 ,$63.00 ,$63.00 ,$71.40 ,$71.40 ,$10.18 ,$71.40 ,$10.18 ,$65.52 ,$65.52 ,$65.52 ,$75.60 ,$25.45 ,$75.60 ,$10.18 ,$84.00 ,$55.02 ,$10.18 ,$34.94 ,$8.83 ,$8.43 ,$10.69 ,$75.60 ,$22.91 ,$51.83 ,$23.52 ,$75.60 ,$10.18 ,$75.60 ,$75.60 ,$10.18 ,$54.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500176,85384,HC FIBRINOGEN,305,1 ,$93.00 ,$60.45 ,$2.84 ,$93.00 ,$24.30 ,$69.29 ,$60.92 ,$9.72 ,$26.04 ,$46.97 ,$9.72 ,$57.38 ,$9.72 ,$57.38 ,$57.38 ,$9.72 ,$57.38 ,$18.47 ,$83.70 ,$69.75 ,$24.30 ,$9.72 ,$81.84 ,$9.72 ,$69.75 ,$69.75 ,$79.05 ,$79.05 ,$9.72 ,$79.05 ,$9.72 ,$72.54 ,$72.54 ,$72.54 ,$83.70 ,$24.30 ,$83.70 ,$9.72 ,$93.00 ,$60.92 ,$9.72 ,$38.69 ,$2.97 ,$2.84 ,$10.21 ,$83.70 ,$21.87 ,$57.38 ,$26.04 ,$83.70 ,$9.72 ,$83.70 ,$83.70 ,$9.72 ,$60.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500185,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$242.00 ,$157.30 ,$7.40 ,$242.00 ,$19.33 ,$180.29 ,$158.51 ,$7.73 ,$67.76 ,$122.21 ,$7.73 ,$149.31 ,$7.73 ,$149.31 ,$149.31 ,$7.73 ,$149.31 ,$14.69 ,$217.80 ,$181.50 ,$19.33 ,$7.73 ,$212.96 ,$7.73 ,$181.50 ,$181.50 ,$205.70 ,$205.70 ,$7.73 ,$205.70 ,$7.73 ,$188.76 ,$188.76 ,$188.76 ,$217.80 ,$19.33 ,$217.80 ,$7.73 ,$242.00 ,$158.51 ,$7.73 ,$100.67 ,$7.76 ,$7.40 ,$8.12 ,$217.80 ,$17.39 ,$149.31 ,$67.76 ,$217.80 ,$7.73 ,$217.80 ,$217.80 ,$7.73 ,$157.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$26.00 ,$16.90 ,$2.84 ,$26.00 ,$10.73 ,$19.37 ,$17.03 ,$4.29 ,$7.28 ,$13.13 ,$4.29 ,$16.04 ,$4.29 ,$16.04 ,$16.04 ,$4.29 ,$16.04 ,$8.15 ,$23.40 ,$19.50 ,$10.73 ,$4.29 ,$22.88 ,$4.29 ,$19.50 ,$19.50 ,$22.10 ,$22.10 ,$4.29 ,$22.10 ,$4.29 ,$20.28 ,$20.28 ,$20.28 ,$23.40 ,$10.73 ,$23.40 ,$4.29 ,$26.00 ,$17.03 ,$4.29 ,$10.82 ,$2.97 ,$2.84 ,$4.50 ,$23.40 ,$9.65 ,$16.04 ,$7.28 ,$23.40 ,$4.29 ,$23.40 ,$23.40 ,$4.29 ,$16.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500205,85652,HC SED RATE AUTO,305,1 ,$43.00 ,$27.95 ,$2.70 ,$43.00 ,$6.75 ,$32.04 ,$28.17 ,$2.70 ,$12.04 ,$21.72 ,$2.70 ,$26.53 ,$2.70 ,$26.53 ,$26.53 ,$2.70 ,$26.53 ,$5.13 ,$38.70 ,$32.25 ,$6.75 ,$2.70 ,$37.84 ,$2.70 ,$32.25 ,$32.25 ,$36.55 ,$36.55 ,$2.70 ,$36.55 ,$2.70 ,$33.54 ,$33.54 ,$33.54 ,$38.70 ,$6.75 ,$38.70 ,$2.70 ,$43.00 ,$28.17 ,$2.70 ,$17.89 ,$5.09 ,$4.86 ,$2.84 ,$38.70 ,$6.08 ,$26.53 ,$12.04 ,$38.70 ,$2.70 ,$38.70 ,$38.70 ,$2.70 ,$27.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500211,85730,HC PTT,305,1 ,$42.00 ,$27.30 ,$2.84 ,$42.00 ,$15.03 ,$31.29 ,$27.51 ,$6.01 ,$11.76 ,$21.21 ,$6.01 ,$25.91 ,$6.01 ,$25.91 ,$25.91 ,$6.01 ,$25.91 ,$11.42 ,$37.80 ,$31.50 ,$15.03 ,$6.01 ,$36.96 ,$6.01 ,$31.50 ,$31.50 ,$35.70 ,$35.70 ,$6.01 ,$35.70 ,$6.01 ,$32.76 ,$32.76 ,$32.76 ,$37.80 ,$15.03 ,$37.80 ,$6.01 ,$42.00 ,$27.51 ,$6.01 ,$17.47 ,$2.97 ,$2.84 ,$6.31 ,$37.80 ,$13.52 ,$25.91 ,$11.76 ,$37.80 ,$6.01 ,$37.80 ,$37.80 ,$6.01 ,$27.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500234,85014,HC HEMATOCRIT-90,305,1 ,$38.00 ,$24.70 ,$2.37 ,$38.00 ,$5.93 ,$28.31 ,$24.89 ,$2.37 ,$10.64 ,$19.19 ,$2.37 ,$23.45 ,$2.37 ,$23.45 ,$23.45 ,$2.37 ,$23.45 ,$4.50 ,$34.20 ,$28.50 ,$5.93 ,$2.37 ,$33.44 ,$2.37 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$2.37 ,$32.30 ,$2.37 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$5.93 ,$34.20 ,$2.37 ,$2.37 ,$24.89 ,$2.37 ,$15.81 ,$5.09 ,$4.86 ,$2.49 ,$34.20 ,$5.33 ,$23.45 ,$10.64 ,$34.20 ,$2.37 ,$34.20 ,$34.20 ,$2.37 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500238,85018,HC HGB-90,305,1 ,$38.00 ,$24.70 ,$2.37 ,$38.00 ,$5.93 ,$28.31 ,$24.89 ,$2.37 ,$10.64 ,$19.19 ,$2.37 ,$23.45 ,$2.37 ,$23.45 ,$23.45 ,$2.37 ,$23.45 ,$4.50 ,$34.20 ,$28.50 ,$5.93 ,$2.37 ,$33.44 ,$2.37 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$2.37 ,$32.30 ,$2.37 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$5.93 ,$34.20 ,$2.37 ,$2.37 ,$24.89 ,$2.37 ,$15.81 ,$5.09 ,$4.86 ,$2.49 ,$34.20 ,$5.33 ,$23.45 ,$10.64 ,$34.20 ,$2.37 ,$34.20 ,$34.20 ,$2.37 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$29.00 ,$18.85 ,$3.02 ,$29.00 ,$7.55 ,$21.61 ,$19.00 ,$3.02 ,$8.12 ,$14.65 ,$3.02 ,$17.89 ,$3.02 ,$17.89 ,$17.89 ,$3.02 ,$17.89 ,$5.74 ,$26.10 ,$21.75 ,$7.55 ,$3.02 ,$25.52 ,$3.02 ,$21.75 ,$21.75 ,$24.65 ,$24.65 ,$3.02 ,$24.65 ,$3.02 ,$22.62 ,$22.62 ,$22.62 ,$26.10 ,$7.55 ,$26.10 ,$3.02 ,$29.00 ,$19.00 ,$3.02 ,$12.06 ,$5.09 ,$4.86 ,$3.17 ,$26.10 ,$6.80 ,$17.89 ,$8.12 ,$26.10 ,$3.02 ,$26.10 ,$26.10 ,$3.02 ,$18.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500250,85220,HC FACTOR V-90,305,1 ,$95.00 ,$61.75 ,$8.43 ,$95.00 ,$44.13 ,$70.78 ,$62.23 ,$17.65 ,$26.60 ,$47.98 ,$17.65 ,$58.62 ,$17.65 ,$58.62 ,$58.62 ,$17.65 ,$58.62 ,$33.54 ,$85.50 ,$71.25 ,$44.13 ,$17.65 ,$83.60 ,$17.65 ,$71.25 ,$71.25 ,$80.75 ,$80.75 ,$17.65 ,$80.75 ,$17.65 ,$74.10 ,$74.10 ,$74.10 ,$85.50 ,$44.13 ,$85.50 ,$17.65 ,$95.00 ,$62.23 ,$17.65 ,$39.52 ,$8.83 ,$8.43 ,$18.53 ,$85.50 ,$39.71 ,$58.62 ,$26.60 ,$85.50 ,$17.65 ,$85.50 ,$85.50 ,$17.65 ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500251,85230,HC FACTOR VII-90,305,1 ,$96.00 ,$62.40 ,$8.43 ,$96.00 ,$44.75 ,$71.52 ,$62.88 ,$17.90 ,$26.88 ,$48.48 ,$17.90 ,$59.23 ,$17.90 ,$59.23 ,$59.23 ,$17.90 ,$59.23 ,$34.01 ,$86.40 ,$72.00 ,$44.75 ,$17.90 ,$84.48 ,$17.90 ,$72.00 ,$72.00 ,$81.60 ,$81.60 ,$17.90 ,$81.60 ,$17.90 ,$74.88 ,$74.88 ,$74.88 ,$86.40 ,$44.75 ,$86.40 ,$17.90 ,$96.00 ,$62.88 ,$17.90 ,$39.94 ,$8.83 ,$8.43 ,$18.80 ,$86.40 ,$40.28 ,$59.23 ,$26.88 ,$86.40 ,$17.90 ,$86.40 ,$86.40 ,$17.90 ,$62.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500252,85240,HC FACTOR VIII AHG-90,305,1 ,$148.00 ,$96.20 ,$8.43 ,$148.00 ,$44.75 ,$110.26 ,$96.94 ,$17.90 ,$41.44 ,$74.74 ,$17.90 ,$91.32 ,$17.90 ,$91.32 ,$91.32 ,$17.90 ,$91.32 ,$34.01 ,$133.20 ,$111.00 ,$44.75 ,$17.90 ,$130.24 ,$17.90 ,$111.00 ,$111.00 ,$125.80 ,$125.80 ,$17.90 ,$125.80 ,$17.90 ,$115.44 ,$115.44 ,$115.44 ,$133.20 ,$44.75 ,$133.20 ,$17.90 ,$148.00 ,$96.94 ,$17.90 ,$61.57 ,$8.83 ,$8.43 ,$18.80 ,$133.20 ,$40.28 ,$91.32 ,$41.44 ,$133.20 ,$17.90 ,$133.20 ,$133.20 ,$17.90 ,$96.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500253,85245,HC FACTOR VIII VW RISTO-90,305,1 ,$123.00 ,$79.95 ,$8.43 ,$123.00 ,$57.35 ,$91.64 ,$80.57 ,$22.94 ,$34.44 ,$62.12 ,$22.94 ,$75.89 ,$22.94 ,$75.89 ,$75.89 ,$22.94 ,$75.89 ,$43.59 ,$110.70 ,$92.25 ,$57.35 ,$22.94 ,$108.24 ,$22.94 ,$92.25 ,$92.25 ,$104.55 ,$104.55 ,$22.94 ,$104.55 ,$22.94 ,$95.94 ,$95.94 ,$95.94 ,$110.70 ,$57.35 ,$110.70 ,$22.94 ,$123.00 ,$80.57 ,$22.94 ,$51.17 ,$8.83 ,$8.43 ,$24.09 ,$110.70 ,$51.62 ,$75.89 ,$34.44 ,$110.70 ,$22.94 ,$110.70 ,$110.70 ,$22.94 ,$79.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500254,85246,HC FACTOR VIII VW AG-90,305,1 ,$123.00 ,$79.95 ,$8.43 ,$123.00 ,$57.35 ,$91.64 ,$80.57 ,$22.94 ,$34.44 ,$62.12 ,$22.94 ,$75.89 ,$22.94 ,$75.89 ,$75.89 ,$22.94 ,$75.89 ,$43.59 ,$110.70 ,$92.25 ,$57.35 ,$22.94 ,$108.24 ,$22.94 ,$92.25 ,$92.25 ,$104.55 ,$104.55 ,$22.94 ,$104.55 ,$22.94 ,$95.94 ,$95.94 ,$95.94 ,$110.70 ,$57.35 ,$110.70 ,$22.94 ,$123.00 ,$80.57 ,$22.94 ,$51.17 ,$8.83 ,$8.43 ,$24.09 ,$110.70 ,$51.62 ,$75.89 ,$34.44 ,$110.70 ,$22.94 ,$110.70 ,$110.70 ,$22.94 ,$79.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500255,85247,HC FACTOR VW MULTIM ANALY-90,305,1 ,$122.00 ,$79.30 ,$8.43 ,$122.00 ,$57.35 ,$90.89 ,$79.91 ,$22.94 ,$34.16 ,$61.61 ,$22.94 ,$75.27 ,$22.94 ,$75.27 ,$75.27 ,$22.94 ,$75.27 ,$43.59 ,$109.80 ,$91.50 ,$57.35 ,$22.94 ,$107.36 ,$22.94 ,$91.50 ,$91.50 ,$103.70 ,$103.70 ,$22.94 ,$103.70 ,$22.94 ,$95.16 ,$95.16 ,$95.16 ,$109.80 ,$57.35 ,$109.80 ,$22.94 ,$122.00 ,$79.91 ,$22.94 ,$50.75 ,$8.83 ,$8.43 ,$24.09 ,$109.80 ,$51.62 ,$75.27 ,$34.16 ,$109.80 ,$22.94 ,$109.80 ,$109.80 ,$22.94 ,$79.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500256,85250,HC FACTOR IX-90,305,1 ,$102.00 ,$66.30 ,$8.43 ,$102.00 ,$47.60 ,$75.99 ,$66.81 ,$19.04 ,$28.56 ,$51.51 ,$19.04 ,$62.93 ,$19.04 ,$62.93 ,$62.93 ,$19.04 ,$62.93 ,$36.18 ,$91.80 ,$76.50 ,$47.60 ,$19.04 ,$89.76 ,$19.04 ,$76.50 ,$76.50 ,$86.70 ,$86.70 ,$19.04 ,$86.70 ,$19.04 ,$79.56 ,$79.56 ,$79.56 ,$91.80 ,$47.60 ,$91.80 ,$19.04 ,$102.00 ,$66.81 ,$19.04 ,$42.43 ,$8.83 ,$8.43 ,$19.99 ,$91.80 ,$42.84 ,$62.93 ,$28.56 ,$91.80 ,$19.04 ,$91.80 ,$91.80 ,$19.04 ,$66.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500257,85260,HC FACTOR X-90,305,1 ,$96.00 ,$62.40 ,$8.43 ,$96.00 ,$44.75 ,$71.52 ,$62.88 ,$17.90 ,$26.88 ,$48.48 ,$17.90 ,$59.23 ,$17.90 ,$59.23 ,$59.23 ,$17.90 ,$59.23 ,$34.01 ,$86.40 ,$72.00 ,$44.75 ,$17.90 ,$84.48 ,$17.90 ,$72.00 ,$72.00 ,$81.60 ,$81.60 ,$17.90 ,$81.60 ,$17.90 ,$74.88 ,$74.88 ,$74.88 ,$86.40 ,$44.75 ,$86.40 ,$17.90 ,$96.00 ,$62.88 ,$17.90 ,$39.94 ,$8.83 ,$8.43 ,$18.80 ,$86.40 ,$40.28 ,$59.23 ,$26.88 ,$86.40 ,$17.90 ,$86.40 ,$86.40 ,$17.90 ,$62.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500258,85270,HC FACTOR XI-90,305,1 ,$96.00 ,$62.40 ,$8.43 ,$96.00 ,$44.75 ,$71.52 ,$62.88 ,$17.90 ,$26.88 ,$48.48 ,$17.90 ,$59.23 ,$17.90 ,$59.23 ,$59.23 ,$17.90 ,$59.23 ,$34.01 ,$86.40 ,$72.00 ,$44.75 ,$17.90 ,$84.48 ,$17.90 ,$72.00 ,$72.00 ,$81.60 ,$81.60 ,$17.90 ,$81.60 ,$17.90 ,$74.88 ,$74.88 ,$74.88 ,$86.40 ,$44.75 ,$86.40 ,$17.90 ,$96.00 ,$62.88 ,$17.90 ,$39.94 ,$8.83 ,$8.43 ,$18.80 ,$86.40 ,$40.28 ,$59.23 ,$26.88 ,$86.40 ,$17.90 ,$86.40 ,$86.40 ,$17.90 ,$62.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500259,85280,HC FACTOR XI-90,305,1 ,$104.00 ,$67.60 ,$8.43 ,$104.00 ,$48.38 ,$77.48 ,$68.12 ,$19.35 ,$29.12 ,$52.52 ,$19.35 ,$64.17 ,$19.35 ,$64.17 ,$64.17 ,$19.35 ,$64.17 ,$36.77 ,$93.60 ,$78.00 ,$48.38 ,$19.35 ,$91.52 ,$19.35 ,$78.00 ,$78.00 ,$88.40 ,$88.40 ,$19.35 ,$88.40 ,$19.35 ,$81.12 ,$81.12 ,$81.12 ,$93.60 ,$48.38 ,$93.60 ,$19.35 ,$104.00 ,$68.12 ,$19.35 ,$43.26 ,$8.83 ,$8.43 ,$20.32 ,$93.60 ,$43.54 ,$64.17 ,$29.12 ,$93.60 ,$19.35 ,$93.60 ,$93.60 ,$19.35 ,$67.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500261,85300,HC ANTITHROMBIN III ACT-90,305,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 ,$29.63 ,$22.35 ,$19.65 ,$11.85 ,$8.40 ,$15.15 ,$11.85 ,$18.51 ,$11.85 ,$18.51 ,$18.51 ,$11.85 ,$18.51 ,$22.52 ,$27.00 ,$22.50 ,$29.63 ,$11.85 ,$26.40 ,$11.85 ,$22.50 ,$22.50 ,$25.50 ,$25.50 ,$11.85 ,$25.50 ,$11.85 ,$23.40 ,$23.40 ,$23.40 ,$27.00 ,$29.63 ,$27.00 ,$11.85 ,$30.00 ,$19.65 ,$11.85 ,$12.48 ,$8.83 ,$8.43 ,$12.44 ,$27.00 ,$26.66 ,$18.51 ,$8.40 ,$27.00 ,$11.85 ,$27.00 ,$27.00 ,$11.85 ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500262,85301,HC ANTITHROMBIN III AG-90,305,1 ,$58.00 ,$37.70 ,$8.43 ,$58.00 ,$27.03 ,$43.21 ,$37.99 ,$10.81 ,$16.24 ,$29.29 ,$10.81 ,$35.79 ,$10.81 ,$35.79 ,$35.79 ,$10.81 ,$35.79 ,$20.54 ,$52.20 ,$43.50 ,$27.03 ,$10.81 ,$51.04 ,$10.81 ,$43.50 ,$43.50 ,$49.30 ,$49.30 ,$10.81 ,$49.30 ,$10.81 ,$45.24 ,$45.24 ,$45.24 ,$52.20 ,$27.03 ,$52.20 ,$10.81 ,$58.00 ,$37.99 ,$10.81 ,$24.13 ,$8.83 ,$8.43 ,$11.35 ,$52.20 ,$24.32 ,$35.79 ,$16.24 ,$52.20 ,$10.81 ,$52.20 ,$52.20 ,$10.81 ,$37.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500263,85302,HC PROTEIN C AG-90,305,1 ,$65.00 ,$42.25 ,$8.43 ,$65.00 ,$30.03 ,$48.43 ,$42.58 ,$12.01 ,$18.20 ,$32.83 ,$12.01 ,$40.11 ,$12.01 ,$40.11 ,$40.11 ,$12.01 ,$40.11 ,$22.82 ,$58.50 ,$48.75 ,$30.03 ,$12.01 ,$57.20 ,$12.01 ,$48.75 ,$48.75 ,$55.25 ,$55.25 ,$12.01 ,$55.25 ,$12.01 ,$50.70 ,$50.70 ,$50.70 ,$58.50 ,$30.03 ,$58.50 ,$12.01 ,$65.00 ,$42.58 ,$12.01 ,$27.04 ,$8.83 ,$8.43 ,$12.61 ,$58.50 ,$27.02 ,$40.11 ,$18.20 ,$58.50 ,$12.01 ,$58.50 ,$58.50 ,$12.01 ,$42.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$66.00 ,$42.90 ,$8.43 ,$66.00 ,$34.60 ,$49.17 ,$43.23 ,$13.84 ,$18.48 ,$33.33 ,$13.84 ,$40.72 ,$13.84 ,$40.72 ,$40.72 ,$13.84 ,$40.72 ,$26.30 ,$59.40 ,$49.50 ,$34.60 ,$13.84 ,$58.08 ,$13.84 ,$49.50 ,$49.50 ,$56.10 ,$56.10 ,$13.84 ,$56.10 ,$13.84 ,$51.48 ,$51.48 ,$51.48 ,$59.40 ,$34.60 ,$59.40 ,$13.84 ,$66.00 ,$43.23 ,$13.84 ,$27.46 ,$8.83 ,$8.43 ,$14.53 ,$59.40 ,$31.14 ,$40.72 ,$18.48 ,$59.40 ,$13.84 ,$59.40 ,$59.40 ,$13.84 ,$42.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$62.00 ,$40.30 ,$8.43 ,$62.00 ,$29.03 ,$46.19 ,$40.61 ,$11.61 ,$17.36 ,$31.31 ,$11.61 ,$38.25 ,$11.61 ,$38.25 ,$38.25 ,$11.61 ,$38.25 ,$22.06 ,$55.80 ,$46.50 ,$29.03 ,$11.61 ,$54.56 ,$11.61 ,$46.50 ,$46.50 ,$52.70 ,$52.70 ,$11.61 ,$52.70 ,$11.61 ,$48.36 ,$48.36 ,$48.36 ,$55.80 ,$29.03 ,$55.80 ,$11.61 ,$62.00 ,$40.61 ,$11.61 ,$25.79 ,$8.83 ,$8.43 ,$12.19 ,$55.80 ,$26.12 ,$38.25 ,$17.36 ,$55.80 ,$11.61 ,$55.80 ,$55.80 ,$11.61 ,$40.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500266,85306,HC PROTEIN S FREE-90,305,1 ,$82.00 ,$53.30 ,$8.43 ,$82.00 ,$38.30 ,$61.09 ,$53.71 ,$15.32 ,$22.96 ,$41.41 ,$15.32 ,$50.59 ,$15.32 ,$50.59 ,$50.59 ,$15.32 ,$50.59 ,$29.11 ,$73.80 ,$61.50 ,$38.30 ,$15.32 ,$72.16 ,$15.32 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$15.32 ,$69.70 ,$15.32 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$38.30 ,$73.80 ,$15.32 ,$82.00 ,$53.71 ,$15.32 ,$34.11 ,$8.83 ,$8.43 ,$16.09 ,$73.80 ,$34.47 ,$50.59 ,$22.96 ,$73.80 ,$15.32 ,$73.80 ,$73.80 ,$15.32 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$82.00 ,$53.30 ,$7.83 ,$82.00 ,$38.30 ,$61.09 ,$53.71 ,$15.32 ,$22.96 ,$41.41 ,$15.32 ,$50.59 ,$15.32 ,$50.59 ,$50.59 ,$15.32 ,$50.59 ,$29.11 ,$73.80 ,$61.50 ,$38.30 ,$15.32 ,$72.16 ,$15.32 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$15.32 ,$69.70 ,$15.32 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$38.30 ,$73.80 ,$15.32 ,$82.00 ,$53.71 ,$15.32 ,$34.11 ,$8.21 ,$7.83 ,$16.09 ,$73.80 ,$34.47 ,$50.59 ,$22.96 ,$73.80 ,$15.32 ,$73.80 ,$73.80 ,$15.32 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500276,85397,HC COAGUL/FIBRINOLYSIS CLOT ACT-90,305,1 ,$370.24 ,$240.66 ,$8.43 ,$370.24 ,$77.15 ,$275.83 ,$242.51 ,$30.86 ,$103.67 ,$186.97 ,$30.86 ,$228.44 ,$30.86 ,$228.44 ,$228.44 ,$30.86 ,$228.44 ,$58.63 ,$333.22 ,$277.68 ,$77.15 ,$30.86 ,$325.81 ,$30.86 ,$277.68 ,$277.68 ,$314.70 ,$314.70 ,$30.86 ,$314.70 ,$30.86 ,$288.79 ,$288.79 ,$288.79 ,$333.22 ,$77.15 ,$333.22 ,$30.86 ,$370.24 ,$242.51 ,$30.86 ,$154.02 ,$8.83 ,$8.43 ,$32.40 ,$333.22 ,$69.44 ,$228.44 ,$103.67 ,$333.22 ,$30.86 ,$333.22 ,$333.22 ,$30.86 ,$240.66 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500282,85461,HC FETAL HGB ROSETTE,305,1 ,$60.00 ,$39.00 ,$4.86 ,$60.00 ,$23.40 ,$44.70 ,$39.30 ,$9.36 ,$16.80 ,$30.30 ,$9.36 ,$37.02 ,$9.36 ,$37.02 ,$37.02 ,$9.36 ,$37.02 ,$17.78 ,$54.00 ,$45.00 ,$23.40 ,$9.36 ,$52.80 ,$9.36 ,$45.00 ,$45.00 ,$51.00 ,$51.00 ,$9.36 ,$51.00 ,$9.36 ,$46.80 ,$46.80 ,$46.80 ,$54.00 ,$23.40 ,$54.00 ,$9.36 ,$60.00 ,$39.30 ,$9.36 ,$24.96 ,$5.09 ,$4.86 ,$9.83 ,$54.00 ,$21.06 ,$37.02 ,$16.80 ,$54.00 ,$9.36 ,$54.00 ,$54.00 ,$9.36 ,$39.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500289,85597,HC PLATELET NEUTRALIZATION-90,305,1 ,$84.00 ,$54.60 ,$8.43 ,$84.00 ,$44.95 ,$62.58 ,$55.02 ,$17.98 ,$23.52 ,$42.42 ,$17.98 ,$51.83 ,$17.98 ,$51.83 ,$51.83 ,$17.98 ,$51.83 ,$34.16 ,$75.60 ,$63.00 ,$44.95 ,$17.98 ,$73.92 ,$17.98 ,$63.00 ,$63.00 ,$71.40 ,$71.40 ,$17.98 ,$71.40 ,$17.98 ,$65.52 ,$65.52 ,$65.52 ,$75.60 ,$44.95 ,$75.60 ,$17.98 ,$84.00 ,$55.02 ,$17.98 ,$34.94 ,$8.83 ,$8.43 ,$18.88 ,$75.60 ,$40.46 ,$51.83 ,$23.52 ,$75.60 ,$17.98 ,$75.60 ,$75.60 ,$17.98 ,$54.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500290,85598,HC HEXAGN NEUTRALIZATION PHOSPH-90,305,1 ,$84.00 ,$54.60 ,$8.43 ,$84.00 ,$44.95 ,$62.58 ,$55.02 ,$17.98 ,$23.52 ,$42.42 ,$17.98 ,$51.83 ,$17.98 ,$51.83 ,$51.83 ,$17.98 ,$51.83 ,$34.16 ,$75.60 ,$63.00 ,$44.95 ,$17.98 ,$73.92 ,$17.98 ,$63.00 ,$63.00 ,$71.40 ,$71.40 ,$17.98 ,$71.40 ,$17.98 ,$65.52 ,$65.52 ,$65.52 ,$75.60 ,$44.95 ,$75.60 ,$17.98 ,$84.00 ,$55.02 ,$17.98 ,$34.94 ,$8.83 ,$8.43 ,$18.88 ,$75.60 ,$40.46 ,$51.83 ,$23.52 ,$75.60 ,$17.98 ,$75.60 ,$75.60 ,$17.98 ,$54.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$45.00 ,$29.25 ,$8.43 ,$45.00 ,$23.95 ,$33.53 ,$29.48 ,$9.58 ,$12.60 ,$22.73 ,$9.58 ,$27.77 ,$9.58 ,$27.77 ,$27.77 ,$9.58 ,$27.77 ,$18.20 ,$40.50 ,$33.75 ,$23.95 ,$9.58 ,$39.60 ,$9.58 ,$33.75 ,$33.75 ,$38.25 ,$38.25 ,$9.58 ,$38.25 ,$9.58 ,$35.10 ,$35.10 ,$35.10 ,$40.50 ,$23.95 ,$40.50 ,$9.58 ,$45.00 ,$29.48 ,$9.58 ,$18.72 ,$8.83 ,$8.43 ,$10.06 ,$40.50 ,$21.56 ,$27.77 ,$12.60 ,$40.50 ,$9.58 ,$40.50 ,$40.50 ,$9.58 ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$38.00 ,$24.70 ,$2.84 ,$38.00 ,$14.43 ,$28.31 ,$24.89 ,$5.77 ,$10.64 ,$19.19 ,$5.77 ,$23.45 ,$5.77 ,$23.45 ,$23.45 ,$5.77 ,$23.45 ,$10.96 ,$34.20 ,$28.50 ,$14.43 ,$5.77 ,$33.44 ,$5.77 ,$28.50 ,$28.50 ,$32.30 ,$32.30 ,$5.77 ,$32.30 ,$5.77 ,$29.64 ,$29.64 ,$29.64 ,$34.20 ,$14.43 ,$34.20 ,$5.77 ,$38.00 ,$24.89 ,$5.77 ,$15.81 ,$2.97 ,$2.84 ,$6.06 ,$34.20 ,$12.98 ,$23.45 ,$10.64 ,$34.20 ,$5.77 ,$34.20 ,$34.20 ,$5.77 ,$24.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500305,85730,HC PTT-90,305,1 ,$42.00 ,$27.30 ,$2.84 ,$42.00 ,$15.03 ,$31.29 ,$27.51 ,$6.01 ,$11.76 ,$21.21 ,$6.01 ,$25.91 ,$6.01 ,$25.91 ,$25.91 ,$6.01 ,$25.91 ,$11.42 ,$37.80 ,$31.50 ,$15.03 ,$6.01 ,$36.96 ,$6.01 ,$31.50 ,$31.50 ,$35.70 ,$35.70 ,$6.01 ,$35.70 ,$6.01 ,$32.76 ,$32.76 ,$32.76 ,$37.80 ,$15.03 ,$37.80 ,$6.01 ,$42.00 ,$27.51 ,$6.01 ,$17.47 ,$2.97 ,$2.84 ,$6.31 ,$37.80 ,$13.52 ,$25.91 ,$11.76 ,$37.80 ,$6.01 ,$37.80 ,$37.80 ,$6.01 ,$27.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500341,85046,HC BLOOD COUNT RETICULOCYTES AUTO,305,1 ,$56.00 ,$36.40 ,$4.86 ,$56.00 ,$13.93 ,$41.72 ,$36.68 ,$5.57 ,$15.68 ,$28.28 ,$5.57 ,$34.55 ,$5.57 ,$34.55 ,$34.55 ,$5.57 ,$34.55 ,$10.58 ,$50.40 ,$42.00 ,$13.93 ,$5.57 ,$49.28 ,$5.57 ,$42.00 ,$42.00 ,$47.60 ,$47.60 ,$5.57 ,$47.60 ,$5.57 ,$43.68 ,$43.68 ,$43.68 ,$50.40 ,$13.93 ,$50.40 ,$5.57 ,$56.00 ,$36.68 ,$5.57 ,$23.30 ,$5.09 ,$4.86 ,$5.85 ,$50.40 ,$12.53 ,$34.55 ,$15.68 ,$50.40 ,$5.57 ,$50.40 ,$50.40 ,$5.57 ,$36.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500829,85300,HC ANTITHROMBIN III ACT,305,1 ,$164.00 ,$106.60 ,$8.43 ,$164.00 ,$29.63 ,$122.18 ,$107.42 ,$11.85 ,$45.92 ,$82.82 ,$11.85 ,$101.19 ,$11.85 ,$101.19 ,$101.19 ,$11.85 ,$101.19 ,$22.52 ,$147.60 ,$123.00 ,$29.63 ,$11.85 ,$144.32 ,$11.85 ,$123.00 ,$123.00 ,$139.40 ,$139.40 ,$11.85 ,$139.40 ,$11.85 ,$127.92 ,$127.92 ,$127.92 ,$147.60 ,$29.63 ,$147.60 ,$11.85 ,$164.00 ,$107.42 ,$11.85 ,$68.22 ,$8.83 ,$8.43 ,$12.44 ,$147.60 ,$26.66 ,$101.19 ,$45.92 ,$147.60 ,$11.85 ,$147.60 ,$147.60 ,$11.85 ,$106.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500830,85362,HC FDP/FSP AGGLUT SQ,305,1 ,$75.00 ,$48.75 ,$2.84 ,$75.00 ,$17.23 ,$55.88 ,$49.13 ,$6.89 ,$21.00 ,$37.88 ,$6.89 ,$46.28 ,$6.89 ,$46.28 ,$46.28 ,$6.89 ,$46.28 ,$13.09 ,$67.50 ,$56.25 ,$17.23 ,$6.89 ,$66.00 ,$6.89 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$6.89 ,$63.75 ,$6.89 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$17.23 ,$67.50 ,$6.89 ,$75.00 ,$49.13 ,$6.89 ,$31.20 ,$2.97 ,$2.84 ,$7.23 ,$67.50 ,$15.50 ,$46.28 ,$21.00 ,$67.50 ,$6.89 ,$67.50 ,$67.50 ,$6.89 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500833,85520,HC HEPARIN ASSAY,305,1 ,$245.00 ,$159.25 ,$8.43 ,$245.00 ,$32.73 ,$182.53 ,$160.48 ,$13.09 ,$68.60 ,$123.73 ,$13.09 ,$151.17 ,$13.09 ,$151.17 ,$151.17 ,$13.09 ,$151.17 ,$24.87 ,$220.50 ,$183.75 ,$32.73 ,$13.09 ,$215.60 ,$13.09 ,$183.75 ,$183.75 ,$208.25 ,$208.25 ,$13.09 ,$208.25 ,$13.09 ,$191.10 ,$191.10 ,$191.10 ,$220.50 ,$32.73 ,$220.50 ,$13.09 ,$245.00 ,$160.48 ,$13.09 ,$101.92 ,$8.83 ,$8.43 ,$13.74 ,$220.50 ,$29.45 ,$151.17 ,$68.60 ,$220.50 ,$13.09 ,$220.50 ,$220.50 ,$13.09 ,$159.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30500837,85610,HC PROTHROMBIN TIME (PT)-QW,305,1 ,$26.00 ,$16.90 ,$2.84 ,$26.00 ,$10.73 ,$19.37 ,$17.03 ,$4.29 ,$7.28 ,$13.13 ,$4.29 ,$16.04 ,$4.29 ,$16.04 ,$16.04 ,$4.29 ,$16.04 ,$8.15 ,$23.40 ,$19.50 ,$10.73 ,$4.29 ,$22.88 ,$4.29 ,$19.50 ,$19.50 ,$22.10 ,$22.10 ,$4.29 ,$22.10 ,$4.29 ,$20.28 ,$20.28 ,$20.28 ,$23.40 ,$10.73 ,$23.40 ,$4.29 ,$26.00 ,$17.03 ,$4.29 ,$10.82 ,$2.97 ,$2.84 ,$4.50 ,$23.40 ,$9.65 ,$16.04 ,$7.28 ,$23.40 ,$4.29 ,$23.40 ,$23.40 ,$4.29 ,$16.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30530231,85675,HC THROMBIN TIME TITER-90,305,1 ,$8.00 ,$5.20 ,$2.24 ,$15.41 ,$8.00 ,$5.96 ,$5.24 ,$6.85 ,$2.24 ,$4.04 ,$6.85 ,$4.94 ,$6.85 ,$4.94 ,$4.94 ,$6.85 ,$4.94 ,$13.02 ,$7.20 ,$6.00 ,$8.00 ,$6.85 ,$7.04 ,$6.85 ,$6.00 ,$6.00 ,$6.80 ,$6.80 ,$6.85 ,$6.80 ,$6.85 ,$6.24 ,$6.24 ,$6.24 ,$7.20 ,$8.00 ,$7.20 ,$6.85 ,$8.00 ,$5.24 ,$6.85 ,$3.33 ,$2.97 ,$2.84 ,$7.19 ,$7.20 ,$15.41 ,$4.94 ,$2.24 ,$7.20 ,$6.85 ,$7.20 ,$7.20 ,$6.85 ,$5.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600101,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$44.00 ,$28.60 ,$5.60 ,$44.00 ,$16.70 ,$32.78 ,$28.82 ,$6.68 ,$12.32 ,$22.22 ,$6.68 ,$27.15 ,$6.68 ,$27.15 ,$27.15 ,$6.68 ,$27.15 ,$12.69 ,$39.60 ,$33.00 ,$16.70 ,$6.68 ,$38.72 ,$6.68 ,$33.00 ,$33.00 ,$37.40 ,$37.40 ,$6.68 ,$37.40 ,$6.68 ,$34.32 ,$34.32 ,$34.32 ,$39.60 ,$16.70 ,$39.60 ,$6.68 ,$44.00 ,$28.82 ,$6.68 ,$18.30 ,$5.86 ,$5.60 ,$7.01 ,$39.60 ,$15.03 ,$27.15 ,$12.32 ,$39.60 ,$6.68 ,$39.60 ,$39.60 ,$6.68 ,$28.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600102,87040,HC BLOOD CULTURE,306,1 ,$80.00 ,$52.00 ,$10.32 ,$80.00 ,$25.80 ,$59.60 ,$52.40 ,$10.32 ,$22.40 ,$40.40 ,$10.32 ,$49.36 ,$10.32 ,$49.36 ,$49.36 ,$10.32 ,$49.36 ,$19.61 ,$72.00 ,$60.00 ,$25.80 ,$10.32 ,$70.40 ,$10.32 ,$60.00 ,$60.00 ,$68.00 ,$68.00 ,$10.32 ,$68.00 ,$10.32 ,$62.40 ,$62.40 ,$62.40 ,$72.00 ,$25.80 ,$72.00 ,$10.32 ,$80.00 ,$52.40 ,$10.32 ,$33.28 ,$19.47 ,$18.59 ,$10.84 ,$72.00 ,$23.22 ,$49.36 ,$22.40 ,$72.00 ,$10.32 ,$72.00 ,$72.00 ,$10.32 ,$52.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600109,87070,HC BODY FLUID CULTURE,306,1 ,$119.00 ,$77.35 ,$5.60 ,$119.00 ,$21.55 ,$88.66 ,$77.95 ,$8.62 ,$33.32 ,$60.10 ,$8.62 ,$73.42 ,$8.62 ,$73.42 ,$73.42 ,$8.62 ,$73.42 ,$16.38 ,$107.10 ,$89.25 ,$21.55 ,$8.62 ,$104.72 ,$8.62 ,$89.25 ,$89.25 ,$101.15 ,$101.15 ,$8.62 ,$101.15 ,$8.62 ,$92.82 ,$92.82 ,$92.82 ,$107.10 ,$21.55 ,$107.10 ,$8.62 ,$119.00 ,$77.95 ,$8.62 ,$49.50 ,$5.86 ,$5.60 ,$9.05 ,$107.10 ,$19.40 ,$73.42 ,$33.32 ,$107.10 ,$8.62 ,$107.10 ,$107.10 ,$8.62 ,$77.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600119,87075,HC CULTURE ANAEROBIC,306,1 ,$231.00 ,$150.15 ,$5.60 ,$231.00 ,$23.68 ,$172.10 ,$151.31 ,$9.47 ,$64.68 ,$116.66 ,$9.47 ,$142.53 ,$9.47 ,$142.53 ,$142.53 ,$9.47 ,$142.53 ,$17.99 ,$207.90 ,$173.25 ,$23.68 ,$9.47 ,$203.28 ,$9.47 ,$173.25 ,$173.25 ,$196.35 ,$196.35 ,$9.47 ,$196.35 ,$9.47 ,$180.18 ,$180.18 ,$180.18 ,$207.90 ,$23.68 ,$207.90 ,$9.47 ,$231.00 ,$151.31 ,$9.47 ,$96.10 ,$5.86 ,$5.60 ,$9.94 ,$207.90 ,$21.31 ,$142.53 ,$64.68 ,$207.90 ,$9.47 ,$207.90 ,$207.90 ,$9.47 ,$150.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600125,87081,HC CULTURE SCR (GRP B STREP),306,1 ,$66.00 ,$42.90 ,$5.60 ,$66.00 ,$16.58 ,$49.17 ,$43.23 ,$6.63 ,$18.48 ,$33.33 ,$6.63 ,$40.72 ,$6.63 ,$40.72 ,$40.72 ,$6.63 ,$40.72 ,$12.60 ,$59.40 ,$49.50 ,$16.58 ,$6.63 ,$58.08 ,$6.63 ,$49.50 ,$49.50 ,$56.10 ,$56.10 ,$6.63 ,$56.10 ,$6.63 ,$51.48 ,$51.48 ,$51.48 ,$59.40 ,$16.58 ,$59.40 ,$6.63 ,$66.00 ,$43.23 ,$6.63 ,$27.46 ,$5.86 ,$5.60 ,$6.96 ,$59.40 ,$14.92 ,$40.72 ,$18.48 ,$59.40 ,$6.63 ,$59.40 ,$59.40 ,$6.63 ,$42.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600134,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$107.00 ,$69.55 ,$5.60 ,$107.00 ,$20.18 ,$79.72 ,$70.09 ,$8.07 ,$29.96 ,$54.04 ,$8.07 ,$66.02 ,$8.07 ,$66.02 ,$66.02 ,$8.07 ,$66.02 ,$15.33 ,$96.30 ,$80.25 ,$20.18 ,$8.07 ,$94.16 ,$8.07 ,$80.25 ,$80.25 ,$90.95 ,$90.95 ,$8.07 ,$90.95 ,$8.07 ,$83.46 ,$83.46 ,$83.46 ,$96.30 ,$20.18 ,$96.30 ,$8.07 ,$107.00 ,$70.09 ,$8.07 ,$44.51 ,$5.86 ,$5.60 ,$8.47 ,$96.30 ,$18.16 ,$66.02 ,$29.96 ,$96.30 ,$8.07 ,$96.30 ,$96.30 ,$8.07 ,$69.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600135,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$42.00 ,$27.30 ,$5.60 ,$42.00 ,$20.23 ,$31.29 ,$27.51 ,$8.09 ,$11.76 ,$21.21 ,$8.09 ,$25.91 ,$8.09 ,$25.91 ,$25.91 ,$8.09 ,$25.91 ,$15.37 ,$37.80 ,$31.50 ,$20.23 ,$8.09 ,$36.96 ,$8.09 ,$31.50 ,$31.50 ,$35.70 ,$35.70 ,$8.09 ,$35.70 ,$8.09 ,$32.76 ,$32.76 ,$32.76 ,$37.80 ,$20.23 ,$37.80 ,$8.09 ,$42.00 ,$27.51 ,$8.09 ,$17.47 ,$5.86 ,$5.60 ,$8.49 ,$37.80 ,$18.20 ,$25.91 ,$11.76 ,$37.80 ,$8.09 ,$37.80 ,$37.80 ,$8.09 ,$27.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600160,87150,HC ID NUCLEAR ACID PROBE,306,1 ,$55.00 ,$35.75 ,$5.60 ,$78.95 ,$55.00 ,$40.98 ,$36.03 ,$35.09 ,$15.40 ,$27.78 ,$35.09 ,$33.94 ,$35.09 ,$33.94 ,$33.94 ,$35.09 ,$33.94 ,$66.67 ,$49.50 ,$41.25 ,$55.00 ,$35.09 ,$48.40 ,$35.09 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$35.09 ,$46.75 ,$35.09 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$55.00 ,$49.50 ,$35.09 ,$55.00 ,$36.03 ,$35.09 ,$22.88 ,$5.86 ,$5.60 ,$36.84 ,$49.50 ,$78.95 ,$33.94 ,$15.40 ,$49.50 ,$35.09 ,$49.50 ,$49.50 ,$35.09 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600161,87168,HC EXAM ARTHROPOD,306,1 ,$104.00 ,$67.60 ,$4.27 ,$104.00 ,$10.68 ,$77.48 ,$68.12 ,$4.27 ,$29.12 ,$52.52 ,$4.27 ,$64.17 ,$4.27 ,$64.17 ,$64.17 ,$4.27 ,$64.17 ,$8.11 ,$93.60 ,$78.00 ,$10.68 ,$4.27 ,$91.52 ,$4.27 ,$78.00 ,$78.00 ,$88.40 ,$88.40 ,$4.27 ,$88.40 ,$4.27 ,$81.12 ,$81.12 ,$81.12 ,$93.60 ,$10.68 ,$93.60 ,$4.27 ,$104.00 ,$68.12 ,$4.27 ,$43.26 ,$5.86 ,$5.60 ,$4.48 ,$93.60 ,$9.61 ,$64.17 ,$29.12 ,$93.60 ,$4.27 ,$93.60 ,$93.60 ,$4.27 ,$67.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600163,87172,HC PINWORM EXAM,306,1 ,$54.00 ,$35.10 ,$4.27 ,$54.00 ,$10.68 ,$40.23 ,$35.37 ,$4.27 ,$15.12 ,$27.27 ,$4.27 ,$33.32 ,$4.27 ,$33.32 ,$33.32 ,$4.27 ,$33.32 ,$8.11 ,$48.60 ,$40.50 ,$10.68 ,$4.27 ,$47.52 ,$4.27 ,$40.50 ,$40.50 ,$45.90 ,$45.90 ,$4.27 ,$45.90 ,$4.27 ,$42.12 ,$42.12 ,$42.12 ,$48.60 ,$10.68 ,$48.60 ,$4.27 ,$54.00 ,$35.37 ,$4.27 ,$22.46 ,$5.86 ,$5.60 ,$4.48 ,$48.60 ,$9.61 ,$33.32 ,$15.12 ,$48.60 ,$4.27 ,$48.60 ,$48.60 ,$4.27 ,$35.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600166,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$22.00 ,$14.30 ,$4.75 ,$22.00 ,$11.88 ,$16.39 ,$14.41 ,$4.75 ,$6.16 ,$11.11 ,$4.75 ,$13.57 ,$4.75 ,$13.57 ,$13.57 ,$4.75 ,$13.57 ,$9.03 ,$19.80 ,$16.50 ,$11.88 ,$4.75 ,$19.36 ,$4.75 ,$16.50 ,$16.50 ,$18.70 ,$18.70 ,$4.75 ,$18.70 ,$4.75 ,$17.16 ,$17.16 ,$17.16 ,$19.80 ,$11.88 ,$19.80 ,$4.75 ,$22.00 ,$14.41 ,$4.75 ,$9.15 ,$5.86 ,$5.60 ,$4.99 ,$19.80 ,$10.69 ,$13.57 ,$6.16 ,$19.80 ,$4.75 ,$19.80 ,$19.80 ,$4.75 ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600172,87186,HC SENSITIVITY MIC,306,1 ,$54.00 ,$35.10 ,$5.60 ,$54.00 ,$21.63 ,$40.23 ,$35.37 ,$8.65 ,$15.12 ,$27.27 ,$8.65 ,$33.32 ,$8.65 ,$33.32 ,$33.32 ,$8.65 ,$33.32 ,$16.44 ,$48.60 ,$40.50 ,$21.63 ,$8.65 ,$47.52 ,$8.65 ,$40.50 ,$40.50 ,$45.90 ,$45.90 ,$8.65 ,$45.90 ,$8.65 ,$42.12 ,$42.12 ,$42.12 ,$48.60 ,$21.63 ,$48.60 ,$8.65 ,$54.00 ,$35.37 ,$8.65 ,$22.46 ,$5.86 ,$5.60 ,$9.08 ,$48.60 ,$19.46 ,$33.32 ,$15.12 ,$48.60 ,$8.65 ,$48.60 ,$48.60 ,$8.65 ,$35.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$43.00 ,$27.95 ,$4.27 ,$43.00 ,$10.68 ,$32.04 ,$28.17 ,$4.27 ,$12.04 ,$21.72 ,$4.27 ,$26.53 ,$4.27 ,$26.53 ,$26.53 ,$4.27 ,$26.53 ,$8.11 ,$38.70 ,$32.25 ,$10.68 ,$4.27 ,$37.84 ,$4.27 ,$32.25 ,$32.25 ,$36.55 ,$36.55 ,$4.27 ,$36.55 ,$4.27 ,$33.54 ,$33.54 ,$33.54 ,$38.70 ,$10.68 ,$38.70 ,$4.27 ,$43.00 ,$28.17 ,$4.27 ,$17.89 ,$5.86 ,$5.60 ,$4.48 ,$38.70 ,$9.61 ,$26.53 ,$12.04 ,$38.70 ,$4.27 ,$38.70 ,$38.70 ,$4.27 ,$27.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600183,87210,HC SMEAR WET MOUNT,306,1 ,$74.00 ,$48.10 ,$5.60 ,$74.00 ,$14.55 ,$55.13 ,$48.47 ,$5.82 ,$20.72 ,$37.37 ,$5.82 ,$45.66 ,$5.82 ,$45.66 ,$45.66 ,$5.82 ,$45.66 ,$11.06 ,$66.60 ,$55.50 ,$14.55 ,$5.82 ,$65.12 ,$5.82 ,$55.50 ,$55.50 ,$62.90 ,$62.90 ,$5.82 ,$62.90 ,$5.82 ,$57.72 ,$57.72 ,$57.72 ,$66.60 ,$14.55 ,$66.60 ,$5.82 ,$74.00 ,$48.47 ,$5.82 ,$30.78 ,$5.86 ,$5.60 ,$6.11 ,$66.60 ,$13.10 ,$45.66 ,$20.72 ,$66.60 ,$5.82 ,$66.60 ,$66.60 ,$5.82 ,$48.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$40.00 ,$26.00 ,$7.01 ,$40.00 ,$29.95 ,$29.80 ,$26.20 ,$11.98 ,$11.20 ,$20.20 ,$11.98 ,$24.68 ,$11.98 ,$24.68 ,$24.68 ,$11.98 ,$24.68 ,$22.76 ,$36.00 ,$30.00 ,$29.95 ,$11.98 ,$35.20 ,$11.98 ,$30.00 ,$30.00 ,$34.00 ,$34.00 ,$11.98 ,$34.00 ,$11.98 ,$31.20 ,$31.20 ,$31.20 ,$36.00 ,$29.95 ,$36.00 ,$11.98 ,$40.00 ,$26.20 ,$11.98 ,$16.64 ,$7.35 ,$7.01 ,$12.58 ,$36.00 ,$26.96 ,$24.68 ,$11.20 ,$36.00 ,$11.98 ,$36.00 ,$36.00 ,$11.98 ,$26.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600217,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$111.00 ,$72.15 ,$7.01 ,$111.00 ,$35.95 ,$82.70 ,$72.71 ,$14.38 ,$31.08 ,$56.06 ,$14.38 ,$68.49 ,$14.38 ,$68.49 ,$68.49 ,$14.38 ,$68.49 ,$27.32 ,$99.90 ,$83.25 ,$35.95 ,$14.38 ,$97.68 ,$14.38 ,$83.25 ,$83.25 ,$94.35 ,$94.35 ,$14.38 ,$94.35 ,$14.38 ,$86.58 ,$86.58 ,$86.58 ,$99.90 ,$35.95 ,$99.90 ,$14.38 ,$111.00 ,$72.71 ,$14.38 ,$46.18 ,$7.35 ,$7.01 ,$15.10 ,$99.90 ,$32.36 ,$68.49 ,$31.08 ,$99.90 ,$14.38 ,$99.90 ,$99.90 ,$14.38 ,$72.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600225,87400,HC EIA QL INFLUENZA A/B AG,306,1 ,$42.39 ,$27.55 ,$11.87 ,$42.39 ,$35.33 ,$31.58 ,$27.77 ,$14.13 ,$11.87 ,$21.41 ,$14.13 ,$26.15 ,$14.13 ,$26.15 ,$26.15 ,$14.13 ,$26.15 ,$26.85 ,$38.15 ,$31.79 ,$35.33 ,$14.13 ,$37.30 ,$14.13 ,$31.79 ,$31.79 ,$36.03 ,$36.03 ,$14.13 ,$36.03 ,$14.13 ,$33.06 ,$33.06 ,$33.06 ,$38.15 ,$35.33 ,$38.15 ,$14.13 ,$42.39 ,$27.77 ,$14.13 ,$17.63 ,$12.66 ,$12.09 ,$14.84 ,$38.15 ,$31.79 ,$26.15 ,$11.87 ,$38.15 ,$14.13 ,$38.15 ,$38.15 ,$14.13 ,$27.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600226,87420,HC RSV AG QL,306,1 ,$41.73 ,$27.12 ,$11.68 ,$41.73 ,$34.78 ,$31.09 ,$27.33 ,$13.91 ,$11.68 ,$21.07 ,$13.91 ,$25.75 ,$13.91 ,$25.75 ,$25.75 ,$13.91 ,$25.75 ,$26.43 ,$37.56 ,$31.30 ,$34.78 ,$13.91 ,$36.72 ,$13.91 ,$31.30 ,$31.30 ,$35.47 ,$35.47 ,$13.91 ,$35.47 ,$13.91 ,$32.55 ,$32.55 ,$32.55 ,$37.56 ,$34.78 ,$37.56 ,$13.91 ,$41.73 ,$27.33 ,$13.91 ,$17.36 ,$19.47 ,$18.59 ,$14.61 ,$37.56 ,$31.30 ,$25.75 ,$11.68 ,$37.56 ,$13.91 ,$37.56 ,$37.56 ,$13.91 ,$27.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600228,87430,HC RAPID STREP,306,1 ,$57.00 ,$37.05 ,$7.01 ,$57.00 ,$42.03 ,$42.47 ,$37.34 ,$16.81 ,$15.96 ,$28.79 ,$16.81 ,$35.17 ,$16.81 ,$35.17 ,$35.17 ,$16.81 ,$35.17 ,$31.94 ,$51.30 ,$42.75 ,$42.03 ,$16.81 ,$50.16 ,$16.81 ,$42.75 ,$42.75 ,$48.45 ,$48.45 ,$16.81 ,$48.45 ,$16.81 ,$44.46 ,$44.46 ,$44.46 ,$51.30 ,$42.03 ,$51.30 ,$16.81 ,$57.00 ,$37.34 ,$16.81 ,$23.71 ,$7.35 ,$7.01 ,$17.65 ,$51.30 ,$37.82 ,$35.17 ,$15.96 ,$51.30 ,$16.81 ,$51.30 ,$51.30 ,$16.81 ,$37.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600237,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$208.00 ,$135.20 ,$7.01 ,$208.00 ,$93.18 ,$154.96 ,$136.24 ,$37.27 ,$58.24 ,$105.04 ,$37.27 ,$128.34 ,$37.27 ,$128.34 ,$128.34 ,$37.27 ,$128.34 ,$70.81 ,$187.20 ,$156.00 ,$93.18 ,$37.27 ,$183.04 ,$37.27 ,$156.00 ,$156.00 ,$176.80 ,$176.80 ,$37.27 ,$176.80 ,$37.27 ,$162.24 ,$162.24 ,$162.24 ,$187.20 ,$93.18 ,$187.20 ,$37.27 ,$208.00 ,$136.24 ,$37.27 ,$86.53 ,$7.35 ,$7.01 ,$39.13 ,$187.20 ,$83.86 ,$128.34 ,$58.24 ,$187.20 ,$37.27 ,$187.20 ,$187.20 ,$37.27 ,$135.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600252,87624,HC HPV AMP,306,1 ,$137.00 ,$89.05 ,$18.59 ,$137.00 ,$87.73 ,$102.07 ,$89.74 ,$35.09 ,$38.36 ,$69.19 ,$35.09 ,$84.53 ,$35.09 ,$84.53 ,$84.53 ,$35.09 ,$84.53 ,$66.67 ,$123.30 ,$102.75 ,$87.73 ,$35.09 ,$120.56 ,$35.09 ,$102.75 ,$102.75 ,$116.45 ,$116.45 ,$35.09 ,$116.45 ,$35.09 ,$106.86 ,$106.86 ,$106.86 ,$123.30 ,$87.73 ,$123.30 ,$35.09 ,$35.09 ,$89.74 ,$35.09 ,$56.99 ,$19.47 ,$18.59 ,$36.84 ,$123.30 ,$78.95 ,$84.53 ,$38.36 ,$123.30 ,$35.09 ,$123.30 ,$123.30 ,$35.09 ,$89.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600255,87641,HC MRSA AMP,306,1 ,$171.00 ,$111.15 ,$18.59 ,$171.00 ,$87.73 ,$127.40 ,$112.01 ,$35.09 ,$47.88 ,$86.36 ,$35.09 ,$105.51 ,$35.09 ,$105.51 ,$105.51 ,$35.09 ,$105.51 ,$66.67 ,$153.90 ,$128.25 ,$87.73 ,$35.09 ,$150.48 ,$35.09 ,$128.25 ,$128.25 ,$145.35 ,$145.35 ,$35.09 ,$145.35 ,$35.09 ,$133.38 ,$133.38 ,$133.38 ,$153.90 ,$87.73 ,$153.90 ,$35.09 ,$171.00 ,$112.01 ,$35.09 ,$71.14 ,$19.47 ,$18.59 ,$36.84 ,$153.90 ,$78.95 ,$105.51 ,$47.88 ,$153.90 ,$35.09 ,$153.90 ,$153.90 ,$35.09 ,$111.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600257,87653,HC INFECT AMP (GRP B STREP),306,1 ,$78.00 ,$50.70 ,$18.59 ,$78.95 ,$78.00 ,$58.11 ,$51.09 ,$35.09 ,$21.84 ,$39.39 ,$35.09 ,$48.13 ,$35.09 ,$48.13 ,$48.13 ,$35.09 ,$48.13 ,$66.67 ,$70.20 ,$58.50 ,$78.00 ,$35.09 ,$68.64 ,$35.09 ,$58.50 ,$58.50 ,$66.30 ,$66.30 ,$35.09 ,$66.30 ,$35.09 ,$60.84 ,$60.84 ,$60.84 ,$70.20 ,$78.00 ,$70.20 ,$35.09 ,$78.00 ,$51.09 ,$35.09 ,$32.45 ,$19.47 ,$18.59 ,$36.84 ,$70.20 ,$78.95 ,$48.13 ,$21.84 ,$70.20 ,$35.09 ,$70.20 ,$70.20 ,$35.09 ,$50.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600269,87807,HC QL RSV,306,1 ,$129.00 ,$83.85 ,$5.60 ,$129.00 ,$32.75 ,$96.11 ,$84.50 ,$13.10 ,$36.12 ,$65.15 ,$13.10 ,$79.59 ,$13.10 ,$79.59 ,$79.59 ,$13.10 ,$79.59 ,$24.89 ,$116.10 ,$96.75 ,$32.75 ,$13.10 ,$113.52 ,$13.10 ,$96.75 ,$96.75 ,$109.65 ,$109.65 ,$13.10 ,$109.65 ,$13.10 ,$100.62 ,$100.62 ,$100.62 ,$116.10 ,$32.75 ,$116.10 ,$13.10 ,$129.00 ,$84.50 ,$13.10 ,$53.66 ,$5.86 ,$5.60 ,$13.76 ,$116.10 ,$29.48 ,$79.59 ,$36.12 ,$116.10 ,$13.10 ,$116.10 ,$116.10 ,$13.10 ,$83.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600283,87804,HC QL INFLUENZA A/B,306,1 ,$62.00 ,$40.30 ,$5.60 ,$62.00 ,$41.38 ,$46.19 ,$40.61 ,$16.55 ,$17.36 ,$31.31 ,$16.55 ,$38.25 ,$16.55 ,$38.25 ,$38.25 ,$16.55 ,$38.25 ,$31.45 ,$55.80 ,$46.50 ,$41.38 ,$16.55 ,$54.56 ,$16.55 ,$46.50 ,$46.50 ,$52.70 ,$52.70 ,$16.55 ,$52.70 ,$16.55 ,$48.36 ,$48.36 ,$48.36 ,$55.80 ,$41.38 ,$55.80 ,$16.55 ,$62.00 ,$40.61 ,$16.55 ,$25.79 ,$5.86 ,$5.60 ,$17.38 ,$55.80 ,$37.24 ,$38.25 ,$17.36 ,$55.80 ,$16.55 ,$55.80 ,$55.80 ,$16.55 ,$40.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600314,87340,HC EIA QL HEPATITIS B AG,306,1 ,$123.00 ,$79.95 ,$7.01 ,$123.00 ,$25.83 ,$91.64 ,$80.57 ,$10.33 ,$34.44 ,$62.12 ,$10.33 ,$75.89 ,$10.33 ,$75.89 ,$75.89 ,$10.33 ,$75.89 ,$19.63 ,$110.70 ,$92.25 ,$25.83 ,$10.33 ,$108.24 ,$10.33 ,$92.25 ,$92.25 ,$104.55 ,$104.55 ,$10.33 ,$104.55 ,$10.33 ,$95.94 ,$95.94 ,$95.94 ,$110.70 ,$25.83 ,$110.70 ,$10.33 ,$123.00 ,$80.57 ,$10.33 ,$51.17 ,$7.35 ,$7.01 ,$10.85 ,$110.70 ,$23.24 ,$75.89 ,$34.44 ,$110.70 ,$10.33 ,$110.70 ,$110.70 ,$10.33 ,$79.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600316,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB,306,1 ,$129.00 ,$83.85 ,$7.01 ,$129.00 ,$60.20 ,$96.11 ,$84.50 ,$24.08 ,$36.12 ,$65.15 ,$24.08 ,$79.59 ,$24.08 ,$79.59 ,$79.59 ,$24.08 ,$79.59 ,$45.75 ,$116.10 ,$96.75 ,$60.20 ,$24.08 ,$113.52 ,$24.08 ,$96.75 ,$96.75 ,$109.65 ,$109.65 ,$24.08 ,$109.65 ,$24.08 ,$100.62 ,$100.62 ,$100.62 ,$116.10 ,$60.20 ,$116.10 ,$24.08 ,$129.00 ,$84.50 ,$24.08 ,$53.66 ,$7.35 ,$7.01 ,$25.28 ,$116.10 ,$54.18 ,$79.59 ,$36.12 ,$116.10 ,$24.08 ,$116.10 ,$116.10 ,$24.08 ,$83.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600318,87449,HC EIA QL MLT AG INF,306,1 ,$36.00 ,$23.40 ,$7.01 ,$36.00 ,$29.95 ,$26.82 ,$23.58 ,$11.98 ,$10.08 ,$18.18 ,$11.98 ,$22.21 ,$11.98 ,$22.21 ,$22.21 ,$11.98 ,$22.21 ,$22.76 ,$32.40 ,$27.00 ,$29.95 ,$11.98 ,$31.68 ,$11.98 ,$27.00 ,$27.00 ,$30.60 ,$30.60 ,$11.98 ,$30.60 ,$11.98 ,$28.08 ,$28.08 ,$28.08 ,$32.40 ,$29.95 ,$32.40 ,$11.98 ,$36.00 ,$23.58 ,$11.98 ,$14.98 ,$7.35 ,$7.01 ,$12.58 ,$32.40 ,$26.96 ,$22.21 ,$10.08 ,$32.40 ,$11.98 ,$32.40 ,$32.40 ,$11.98 ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600332,87651,HC INFECT AMP (GRP A STREP),306,1 ,$105.27 ,$68.43 ,$18.59 ,$105.27 ,$87.73 ,$78.43 ,$68.95 ,$35.09 ,$29.48 ,$53.16 ,$35.09 ,$64.95 ,$35.09 ,$64.95 ,$64.95 ,$35.09 ,$64.95 ,$66.67 ,$94.74 ,$78.95 ,$87.73 ,$35.09 ,$92.64 ,$35.09 ,$78.95 ,$78.95 ,$89.48 ,$89.48 ,$35.09 ,$89.48 ,$35.09 ,$82.11 ,$82.11 ,$82.11 ,$94.74 ,$87.73 ,$94.74 ,$35.09 ,$105.27 ,$68.95 ,$35.09 ,$43.79 ,$19.47 ,$18.59 ,$36.84 ,$94.74 ,$78.95 ,$64.95 ,$29.48 ,$94.74 ,$35.09 ,$94.74 ,$94.74 ,$35.09 ,$68.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600333,87808,HC TRICHOMONAS VAGINITIS OPTICAL,306,1 ,$74.00 ,$48.10 ,$5.60 ,$74.00 ,$38.23 ,$55.13 ,$48.47 ,$15.29 ,$20.72 ,$37.37 ,$15.29 ,$45.66 ,$15.29 ,$45.66 ,$45.66 ,$15.29 ,$45.66 ,$29.05 ,$66.60 ,$55.50 ,$38.23 ,$15.29 ,$65.12 ,$15.29 ,$55.50 ,$55.50 ,$62.90 ,$62.90 ,$15.29 ,$62.90 ,$15.29 ,$57.72 ,$57.72 ,$57.72 ,$66.60 ,$38.23 ,$66.60 ,$15.29 ,$74.00 ,$48.47 ,$15.29 ,$30.78 ,$5.86 ,$5.60 ,$16.05 ,$66.60 ,$34.40 ,$45.66 ,$20.72 ,$66.60 ,$15.29 ,$66.60 ,$66.60 ,$15.29 ,$48.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600336,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,$653.00 ,$424.45 ,$18.59 ,$937.76 ,$653.00 ,$486.49 ,$427.72 ,$416.78 ,$182.84 ,$329.77 ,$416.78 ,$402.90 ,$416.78 ,$402.90 ,$402.90 ,$416.78 ,$402.90 ,$791.88 ,$587.70 ,$489.75 ,$653.00 ,$416.78 ,$574.64 ,$416.78 ,$489.75 ,$489.75 ,$555.05 ,$555.05 ,$416.78 ,$555.05 ,$416.78 ,$509.34 ,$509.34 ,$509.34 ,$587.70 ,$653.00 ,$587.70 ,$416.78 ,$653.00 ,$427.72 ,$416.78 ,$271.65 ,$19.47 ,$18.59 ,$437.62 ,$587.70 ,$937.76 ,$402.90 ,$182.84 ,$587.70 ,$416.78 ,$587.70 ,$587.70 ,$416.78 ,$424.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600338,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$55.00 ,$35.75 ,$15.40 ,$78.95 ,$55.00 ,$40.98 ,$36.03 ,$35.09 ,$15.40 ,$27.78 ,$35.09 ,$33.94 ,$35.09 ,$33.94 ,$33.94 ,$35.09 ,$33.94 ,$66.67 ,$49.50 ,$41.25 ,$55.00 ,$35.09 ,$48.40 ,$35.09 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$35.09 ,$46.75 ,$35.09 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$55.00 ,$49.50 ,$35.09 ,$55.00 ,$36.03 ,$35.09 ,$22.88 ,$19.47 ,$18.59 ,$36.84 ,$49.50 ,$78.95 ,$33.94 ,$15.40 ,$49.50 ,$35.09 ,$49.50 ,$49.50 ,$35.09 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600339,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,$653.00 ,$424.45 ,$18.59 ,$937.76 ,$653.00 ,$486.49 ,$427.72 ,$416.78 ,$182.84 ,$329.77 ,$416.78 ,$402.90 ,$416.78 ,$402.90 ,$402.90 ,$416.78 ,$402.90 ,$791.88 ,$587.70 ,$489.75 ,$653.00 ,$416.78 ,$574.64 ,$416.78 ,$489.75 ,$489.75 ,$555.05 ,$555.05 ,$416.78 ,$555.05 ,$416.78 ,$509.34 ,$509.34 ,$509.34 ,$587.70 ,$653.00 ,$587.70 ,$416.78 ,$653.00 ,$427.72 ,$416.78 ,$271.65 ,$19.47 ,$18.59 ,$437.62 ,$587.70 ,$937.76 ,$402.90 ,$182.84 ,$587.70 ,$416.78 ,$587.70 ,$587.70 ,$416.78 ,$424.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600348,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,$697.00 ,$453.05 ,$18.59 ,$937.76 ,$697.00 ,$519.27 ,$456.54 ,$416.78 ,$195.16 ,$351.99 ,$416.78 ,$430.05 ,$416.78 ,$430.05 ,$430.05 ,$416.78 ,$430.05 ,$791.88 ,$627.30 ,$522.75 ,$697.00 ,$416.78 ,$613.36 ,$416.78 ,$522.75 ,$522.75 ,$592.45 ,$592.45 ,$416.78 ,$592.45 ,$416.78 ,$543.66 ,$543.66 ,$543.66 ,$627.30 ,$697.00 ,$627.30 ,$416.78 ,$697.00 ,$456.54 ,$416.78 ,$289.95 ,$19.47 ,$18.59 ,$437.62 ,$627.30 ,$937.76 ,$430.05 ,$195.16 ,$627.30 ,$416.78 ,$627.30 ,$627.30 ,$416.78 ,$453.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600353,87015,HC CONCENTRATION INFECTIOUS AGENT-90,306,1 ,$30.00 ,$19.50 ,$5.60 ,$30.00 ,$16.70 ,$22.35 ,$19.65 ,$6.68 ,$8.40 ,$15.15 ,$6.68 ,$18.51 ,$6.68 ,$18.51 ,$18.51 ,$6.68 ,$18.51 ,$12.69 ,$27.00 ,$22.50 ,$16.70 ,$6.68 ,$26.40 ,$6.68 ,$22.50 ,$22.50 ,$25.50 ,$25.50 ,$6.68 ,$25.50 ,$6.68 ,$23.40 ,$23.40 ,$23.40 ,$27.00 ,$16.70 ,$27.00 ,$6.68 ,$30.00 ,$19.65 ,$6.68 ,$12.48 ,$5.86 ,$5.60 ,$7.01 ,$27.00 ,$15.03 ,$18.51 ,$8.40 ,$27.00 ,$6.68 ,$27.00 ,$27.00 ,$6.68 ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600357,87077,HC CULTURE AEROBIC ID ADDL T1,306,1 ,$12.00 ,$7.80 ,$3.36 ,$18.18 ,$12.00 ,$8.94 ,$7.86 ,$8.08 ,$3.36 ,$6.06 ,$8.08 ,$7.40 ,$8.08 ,$7.40 ,$7.40 ,$8.08 ,$7.40 ,$15.35 ,$10.80 ,$9.00 ,$12.00 ,$8.08 ,$10.56 ,$8.08 ,$9.00 ,$9.00 ,$10.20 ,$10.20 ,$8.08 ,$10.20 ,$8.08 ,$9.36 ,$9.36 ,$9.36 ,$10.80 ,$12.00 ,$10.80 ,$8.08 ,$12.00 ,$7.86 ,$8.08 ,$4.99 ,$5.86 ,$5.60 ,$8.48 ,$10.80 ,$18.18 ,$7.40 ,$3.36 ,$10.80 ,$8.08 ,$10.80 ,$10.80 ,$8.08 ,$7.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600359,87081,HC CULTURE SCR PRESUMP PATHOGENS-90,306,1 ,$150.00 ,$97.50 ,$5.60 ,$150.00 ,$16.58 ,$111.75 ,$98.25 ,$6.63 ,$42.00 ,$75.75 ,$6.63 ,$92.55 ,$6.63 ,$92.55 ,$92.55 ,$6.63 ,$92.55 ,$12.60 ,$135.00 ,$112.50 ,$16.58 ,$6.63 ,$132.00 ,$6.63 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$6.63 ,$127.50 ,$6.63 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$16.58 ,$135.00 ,$6.63 ,$150.00 ,$98.25 ,$6.63 ,$62.40 ,$5.86 ,$5.60 ,$6.96 ,$135.00 ,$14.92 ,$92.55 ,$42.00 ,$135.00 ,$6.63 ,$135.00 ,$135.00 ,$6.63 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600360,87081,HC CULTURE SCR PRESUMP PATHOGENS T1,306,1 ,$66.00 ,$42.90 ,$5.60 ,$66.00 ,$16.58 ,$49.17 ,$43.23 ,$6.63 ,$18.48 ,$33.33 ,$6.63 ,$40.72 ,$6.63 ,$40.72 ,$40.72 ,$6.63 ,$40.72 ,$12.60 ,$59.40 ,$49.50 ,$16.58 ,$6.63 ,$58.08 ,$6.63 ,$49.50 ,$49.50 ,$56.10 ,$56.10 ,$6.63 ,$56.10 ,$6.63 ,$51.48 ,$51.48 ,$51.48 ,$59.40 ,$16.58 ,$59.40 ,$6.63 ,$66.00 ,$43.23 ,$6.63 ,$27.46 ,$5.86 ,$5.60 ,$6.96 ,$59.40 ,$14.92 ,$40.72 ,$18.48 ,$59.40 ,$6.63 ,$59.40 ,$59.40 ,$6.63 ,$42.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600363,87103,HC CULTURE FUNGUS BLOOD-90,306,1 ,$25.00 ,$16.25 ,$7.00 ,$46.04 ,$25.00 ,$18.63 ,$16.38 ,$20.46 ,$7.00 ,$12.63 ,$20.46 ,$15.43 ,$20.46 ,$15.43 ,$15.43 ,$20.46 ,$15.43 ,$38.87 ,$22.50 ,$18.75 ,$25.00 ,$20.46 ,$22.00 ,$20.46 ,$18.75 ,$18.75 ,$21.25 ,$21.25 ,$20.46 ,$21.25 ,$20.46 ,$19.50 ,$19.50 ,$19.50 ,$22.50 ,$25.00 ,$22.50 ,$20.46 ,$25.00 ,$16.38 ,$20.46 ,$10.40 ,$19.47 ,$18.59 ,$21.48 ,$22.50 ,$46.04 ,$15.43 ,$7.00 ,$22.50 ,$20.46 ,$22.50 ,$22.50 ,$20.46 ,$16.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600364,87106,HC CULTURE FUNGUS ID YEAST-90,306,1 ,$30.96 ,$20.12 ,$5.60 ,$30.96 ,$25.80 ,$23.07 ,$20.28 ,$10.32 ,$8.67 ,$15.63 ,$10.32 ,$19.10 ,$10.32 ,$19.10 ,$19.10 ,$10.32 ,$19.10 ,$19.61 ,$27.86 ,$23.22 ,$25.80 ,$10.32 ,$27.24 ,$10.32 ,$23.22 ,$23.22 ,$26.32 ,$26.32 ,$10.32 ,$26.32 ,$10.32 ,$24.15 ,$24.15 ,$24.15 ,$27.86 ,$25.80 ,$27.86 ,$10.32 ,$30.96 ,$20.28 ,$10.32 ,$12.88 ,$5.86 ,$5.60 ,$10.84 ,$27.86 ,$23.22 ,$19.10 ,$8.67 ,$27.86 ,$10.32 ,$27.86 ,$27.86 ,$10.32 ,$20.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600368,87116,HC CULTURE AFB/TB/MYCOBACT-90,306,1 ,$87.00 ,$56.55 ,$10.80 ,$87.00 ,$27.00 ,$64.82 ,$56.99 ,$10.80 ,$24.36 ,$43.94 ,$10.80 ,$53.68 ,$10.80 ,$53.68 ,$53.68 ,$10.80 ,$53.68 ,$20.52 ,$78.30 ,$65.25 ,$27.00 ,$10.80 ,$76.56 ,$10.80 ,$65.25 ,$65.25 ,$73.95 ,$73.95 ,$10.80 ,$73.95 ,$10.80 ,$67.86 ,$67.86 ,$67.86 ,$78.30 ,$27.00 ,$78.30 ,$10.80 ,$87.00 ,$56.99 ,$10.80 ,$36.19 ,$19.47 ,$18.59 ,$11.34 ,$78.30 ,$24.30 ,$53.68 ,$24.36 ,$78.30 ,$10.80 ,$78.30 ,$78.30 ,$10.80 ,$56.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600369,87118,HC CULTURE MYCOBACTERIA ID-90,306,1 ,$105.00 ,$68.25 ,$14.61 ,$105.00 ,$36.53 ,$78.23 ,$68.78 ,$14.61 ,$29.40 ,$53.03 ,$14.61 ,$64.79 ,$14.61 ,$64.79 ,$64.79 ,$14.61 ,$64.79 ,$27.76 ,$94.50 ,$78.75 ,$36.53 ,$14.61 ,$92.40 ,$14.61 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$14.61 ,$89.25 ,$14.61 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$36.53 ,$94.50 ,$14.61 ,$105.00 ,$68.78 ,$14.61 ,$43.68 ,$19.47 ,$18.59 ,$15.34 ,$94.50 ,$32.87 ,$64.79 ,$29.40 ,$94.50 ,$14.61 ,$94.50 ,$94.50 ,$14.61 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$9.00 ,$5.85 ,$2.52 ,$12.53 ,$9.00 ,$6.71 ,$5.90 ,$5.57 ,$2.52 ,$4.55 ,$5.57 ,$5.55 ,$5.57 ,$5.55 ,$5.55 ,$5.57 ,$5.55 ,$10.58 ,$8.10 ,$6.75 ,$9.00 ,$5.57 ,$7.92 ,$5.57 ,$6.75 ,$6.75 ,$7.65 ,$7.65 ,$5.57 ,$7.65 ,$5.57 ,$7.02 ,$7.02 ,$7.02 ,$8.10 ,$9.00 ,$8.10 ,$5.57 ,$9.00 ,$5.90 ,$5.57 ,$3.74 ,$9.00 ,$9.00 ,$5.85 ,$8.10 ,$12.53 ,$5.55 ,$2.52 ,$8.10 ,$5.57 ,$8.10 ,$8.10 ,$5.57 ,$5.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$99.00 ,$64.35 ,$5.60 ,$99.00 ,$22.25 ,$73.76 ,$64.85 ,$8.90 ,$27.72 ,$50.00 ,$8.90 ,$61.08 ,$8.90 ,$61.08 ,$61.08 ,$8.90 ,$61.08 ,$16.91 ,$89.10 ,$74.25 ,$22.25 ,$8.90 ,$87.12 ,$8.90 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$8.90 ,$84.15 ,$8.90 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$22.25 ,$89.10 ,$8.90 ,$99.00 ,$64.85 ,$8.90 ,$41.18 ,$5.86 ,$5.60 ,$9.35 ,$89.10 ,$20.03 ,$61.08 ,$27.72 ,$89.10 ,$8.90 ,$89.10 ,$89.10 ,$8.90 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600389,87186,HC SENSITIVITY MIC EA AD PLATE-90,306,1 ,$54.00 ,$35.10 ,$5.60 ,$54.00 ,$21.63 ,$40.23 ,$35.37 ,$8.65 ,$15.12 ,$27.27 ,$8.65 ,$33.32 ,$8.65 ,$33.32 ,$33.32 ,$8.65 ,$33.32 ,$16.44 ,$48.60 ,$40.50 ,$21.63 ,$8.65 ,$47.52 ,$8.65 ,$40.50 ,$40.50 ,$45.90 ,$45.90 ,$8.65 ,$45.90 ,$8.65 ,$42.12 ,$42.12 ,$42.12 ,$48.60 ,$21.63 ,$48.60 ,$8.65 ,$54.00 ,$35.37 ,$8.65 ,$22.46 ,$5.86 ,$5.60 ,$9.08 ,$48.60 ,$19.46 ,$33.32 ,$15.12 ,$48.60 ,$8.65 ,$48.60 ,$48.60 ,$8.65 ,$35.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600395,87206,HC SMEAR ACID FAST/FLUOR-90,306,1 ,$167.00 ,$108.55 ,$5.39 ,$167.00 ,$13.48 ,$124.42 ,$109.39 ,$5.39 ,$46.76 ,$84.34 ,$5.39 ,$103.04 ,$5.39 ,$103.04 ,$103.04 ,$5.39 ,$103.04 ,$10.24 ,$150.30 ,$125.25 ,$13.48 ,$5.39 ,$146.96 ,$5.39 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$5.39 ,$141.95 ,$5.39 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$13.48 ,$150.30 ,$5.39 ,$167.00 ,$109.39 ,$5.39 ,$69.47 ,$5.86 ,$5.60 ,$5.66 ,$150.30 ,$12.13 ,$103.04 ,$46.76 ,$150.30 ,$5.39 ,$150.30 ,$150.30 ,$5.39 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$36.60 ,$23.79 ,$5.60 ,$36.60 ,$14.98 ,$27.27 ,$23.97 ,$5.99 ,$10.25 ,$18.48 ,$5.99 ,$22.58 ,$5.99 ,$22.58 ,$22.58 ,$5.99 ,$22.58 ,$11.38 ,$32.94 ,$27.45 ,$14.98 ,$5.99 ,$32.21 ,$5.99 ,$27.45 ,$27.45 ,$31.11 ,$31.11 ,$5.99 ,$31.11 ,$5.99 ,$28.55 ,$28.55 ,$28.55 ,$32.94 ,$14.98 ,$32.94 ,$5.99 ,$36.60 ,$23.97 ,$5.99 ,$15.23 ,$5.86 ,$5.60 ,$6.29 ,$32.94 ,$13.48 ,$22.58 ,$10.25 ,$32.94 ,$5.99 ,$32.94 ,$32.94 ,$5.99 ,$23.79 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600402,87252,HC CULTURE VIRUS ID TISSUE-90,306,1 ,$214.00 ,$139.10 ,$18.59 ,$214.00 ,$65.18 ,$159.43 ,$140.17 ,$26.07 ,$59.92 ,$108.07 ,$26.07 ,$132.04 ,$26.07 ,$132.04 ,$132.04 ,$26.07 ,$132.04 ,$49.53 ,$192.60 ,$160.50 ,$65.18 ,$26.07 ,$188.32 ,$26.07 ,$160.50 ,$160.50 ,$181.90 ,$181.90 ,$26.07 ,$181.90 ,$26.07 ,$166.92 ,$166.92 ,$166.92 ,$192.60 ,$65.18 ,$192.60 ,$26.07 ,$214.00 ,$140.17 ,$26.07 ,$89.02 ,$19.47 ,$18.59 ,$27.37 ,$192.60 ,$58.66 ,$132.04 ,$59.92 ,$192.60 ,$26.07 ,$192.60 ,$192.60 ,$26.07 ,$139.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$105.00 ,$68.25 ,$18.59 ,$105.00 ,$48.90 ,$78.23 ,$68.78 ,$19.56 ,$29.40 ,$53.03 ,$19.56 ,$64.79 ,$19.56 ,$64.79 ,$64.79 ,$19.56 ,$64.79 ,$37.16 ,$94.50 ,$78.75 ,$48.90 ,$19.56 ,$92.40 ,$19.56 ,$78.75 ,$78.75 ,$89.25 ,$89.25 ,$19.56 ,$89.25 ,$19.56 ,$81.90 ,$81.90 ,$81.90 ,$94.50 ,$48.90 ,$94.50 ,$19.56 ,$105.00 ,$68.78 ,$19.56 ,$43.68 ,$19.47 ,$18.59 ,$20.54 ,$94.50 ,$44.01 ,$64.79 ,$29.40 ,$94.50 ,$19.56 ,$94.50 ,$94.50 ,$19.56 ,$68.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600415,87305,HC EIA QL ASPERGILLUS AG-90,306,1 ,$160.00 ,$104.00 ,$5.60 ,$160.00 ,$29.95 ,$119.20 ,$104.80 ,$11.98 ,$44.80 ,$80.80 ,$11.98 ,$98.72 ,$11.98 ,$98.72 ,$98.72 ,$11.98 ,$98.72 ,$22.76 ,$144.00 ,$120.00 ,$29.95 ,$11.98 ,$140.80 ,$11.98 ,$120.00 ,$120.00 ,$136.00 ,$136.00 ,$11.98 ,$136.00 ,$11.98 ,$124.80 ,$124.80 ,$124.80 ,$144.00 ,$29.95 ,$144.00 ,$11.98 ,$160.00 ,$104.80 ,$11.98 ,$66.56 ,$5.86 ,$5.60 ,$12.58 ,$144.00 ,$26.96 ,$98.72 ,$44.80 ,$144.00 ,$11.98 ,$144.00 ,$144.00 ,$11.98 ,$104.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600421,87340,HC EIA QL HEPATITIS B AG-90,306,1 ,$30.99 ,$20.14 ,$7.01 ,$30.99 ,$25.83 ,$23.09 ,$20.30 ,$10.33 ,$8.68 ,$15.65 ,$10.33 ,$19.12 ,$10.33 ,$19.12 ,$19.12 ,$10.33 ,$19.12 ,$19.63 ,$27.89 ,$23.24 ,$25.83 ,$10.33 ,$27.27 ,$10.33 ,$23.24 ,$23.24 ,$26.34 ,$26.34 ,$10.33 ,$26.34 ,$10.33 ,$24.17 ,$24.17 ,$24.17 ,$27.89 ,$25.83 ,$27.89 ,$10.33 ,$30.99 ,$20.30 ,$10.33 ,$12.89 ,$7.35 ,$7.01 ,$10.85 ,$27.89 ,$23.24 ,$19.12 ,$8.68 ,$27.89 ,$10.33 ,$27.89 ,$27.89 ,$10.33 ,$20.14 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$62.00 ,$40.30 ,$7.01 ,$62.00 ,$28.83 ,$46.19 ,$40.61 ,$11.53 ,$17.36 ,$31.31 ,$11.53 ,$38.25 ,$11.53 ,$38.25 ,$38.25 ,$11.53 ,$38.25 ,$21.91 ,$55.80 ,$46.50 ,$28.83 ,$11.53 ,$54.56 ,$11.53 ,$46.50 ,$46.50 ,$52.70 ,$52.70 ,$11.53 ,$52.70 ,$11.53 ,$48.36 ,$48.36 ,$48.36 ,$55.80 ,$28.83 ,$55.80 ,$11.53 ,$62.00 ,$40.61 ,$11.53 ,$25.79 ,$7.35 ,$7.01 ,$12.11 ,$55.80 ,$25.94 ,$38.25 ,$17.36 ,$55.80 ,$11.53 ,$55.80 ,$55.80 ,$11.53 ,$40.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$142.00 ,$92.30 ,$7.01 ,$142.00 ,$33.13 ,$105.79 ,$93.01 ,$13.25 ,$39.76 ,$71.71 ,$13.25 ,$87.61 ,$13.25 ,$87.61 ,$87.61 ,$13.25 ,$87.61 ,$25.18 ,$127.80 ,$106.50 ,$33.13 ,$13.25 ,$124.96 ,$13.25 ,$106.50 ,$106.50 ,$120.70 ,$120.70 ,$13.25 ,$120.70 ,$13.25 ,$110.76 ,$110.76 ,$110.76 ,$127.80 ,$33.13 ,$127.80 ,$13.25 ,$142.00 ,$93.01 ,$13.25 ,$59.07 ,$7.35 ,$7.01 ,$13.91 ,$127.80 ,$29.81 ,$87.61 ,$39.76 ,$127.80 ,$13.25 ,$127.80 ,$127.80 ,$13.25 ,$92.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600432,87449,HC EIA QL MLT AG INF-90,306,1 ,$64.00 ,$41.60 ,$7.01 ,$64.00 ,$29.95 ,$47.68 ,$41.92 ,$11.98 ,$17.92 ,$32.32 ,$11.98 ,$39.49 ,$11.98 ,$39.49 ,$39.49 ,$11.98 ,$39.49 ,$22.76 ,$57.60 ,$48.00 ,$29.95 ,$11.98 ,$56.32 ,$11.98 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$11.98 ,$54.40 ,$11.98 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$29.95 ,$57.60 ,$11.98 ,$64.00 ,$41.92 ,$11.98 ,$26.62 ,$7.35 ,$7.01 ,$12.58 ,$57.60 ,$26.96 ,$39.49 ,$17.92 ,$57.60 ,$11.98 ,$57.60 ,$57.60 ,$11.98 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600433,87450,HC EIA QL SGL AG-90,306,1 ,$112.32 ,$73.01 ,$31.45 ,$112.32 , N/A ,$83.68 ,$73.57 , N/A ,$31.45 ,$56.72 , N/A ,$69.30 , N/A ,$69.30 ,$69.30 , N/A ,$69.30 , N/A ,$101.09 ,$84.24 , N/A , N/A ,$98.84 , N/A ,$84.24 ,$84.24 ,$95.47 ,$95.47 , N/A ,$95.47 , N/A ,$87.61 ,$87.61 ,$87.61 ,$101.09 , N/A ,$101.09 , N/A ,$112.32 ,$73.57 , N/A ,$46.73 , N/A , N/A , N/A ,$101.09 , N/A ,$69.30 ,$31.45 ,$101.09 , N/A ,$101.09 ,$101.09 , N/A ,$73.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600437,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$55.00 ,$35.75 ,$15.40 ,$78.95 ,$55.00 ,$40.98 ,$36.03 ,$35.09 ,$15.40 ,$27.78 ,$35.09 ,$33.94 ,$35.09 ,$33.94 ,$33.94 ,$35.09 ,$33.94 ,$66.67 ,$49.50 ,$41.25 ,$55.00 ,$35.09 ,$48.40 ,$35.09 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$35.09 ,$46.75 ,$35.09 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$55.00 ,$49.50 ,$35.09 ,$55.00 ,$36.03 ,$35.09 ,$22.88 ,$19.47 ,$18.59 ,$36.84 ,$49.50 ,$78.95 ,$33.94 ,$15.40 ,$49.50 ,$35.09 ,$49.50 ,$49.50 ,$35.09 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$48.00 ,$31.20 ,$7.01 ,$78.95 ,$48.00 ,$35.76 ,$31.44 ,$35.09 ,$13.44 ,$24.24 ,$35.09 ,$29.62 ,$35.09 ,$29.62 ,$29.62 ,$35.09 ,$29.62 ,$66.67 ,$43.20 ,$36.00 ,$48.00 ,$35.09 ,$42.24 ,$35.09 ,$36.00 ,$36.00 ,$40.80 ,$40.80 ,$35.09 ,$40.80 ,$35.09 ,$37.44 ,$37.44 ,$37.44 ,$43.20 ,$48.00 ,$43.20 ,$35.09 ,$48.00 ,$31.44 ,$35.09 ,$19.97 ,$7.35 ,$7.01 ,$36.84 ,$43.20 ,$78.95 ,$29.62 ,$13.44 ,$43.20 ,$35.09 ,$43.20 ,$43.20 ,$35.09 ,$31.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,$164.00 ,$106.60 ,$18.59 ,$164.00 ,$87.73 ,$122.18 ,$107.42 ,$35.09 ,$45.92 ,$82.82 ,$35.09 ,$101.19 ,$35.09 ,$101.19 ,$101.19 ,$35.09 ,$101.19 ,$66.67 ,$147.60 ,$123.00 ,$87.73 ,$35.09 ,$144.32 ,$35.09 ,$123.00 ,$123.00 ,$139.40 ,$139.40 ,$35.09 ,$139.40 ,$35.09 ,$127.92 ,$127.92 ,$127.92 ,$147.60 ,$87.73 ,$147.60 ,$35.09 ,$164.00 ,$107.42 ,$35.09 ,$68.22 ,$19.47 ,$18.59 ,$36.84 ,$147.60 ,$78.95 ,$101.19 ,$45.92 ,$147.60 ,$35.09 ,$147.60 ,$147.60 ,$35.09 ,$106.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600443,87497,HC CMV QN-90,306,1 ,$230.00 ,$149.50 ,$18.59 ,$230.00 ,$107.10 ,$171.35 ,$150.65 ,$42.84 ,$64.40 ,$116.15 ,$42.84 ,$141.91 ,$42.84 ,$141.91 ,$141.91 ,$42.84 ,$141.91 ,$81.40 ,$207.00 ,$172.50 ,$107.10 ,$42.84 ,$202.40 ,$42.84 ,$172.50 ,$172.50 ,$195.50 ,$195.50 ,$42.84 ,$195.50 ,$42.84 ,$179.40 ,$179.40 ,$179.40 ,$207.00 ,$107.10 ,$207.00 ,$42.84 ,$230.00 ,$150.65 ,$42.84 ,$95.68 ,$19.47 ,$18.59 ,$44.98 ,$207.00 ,$96.39 ,$141.91 ,$64.40 ,$207.00 ,$42.84 ,$207.00 ,$207.00 ,$42.84 ,$149.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600448,87517,HC HEPATITIS B QN-90,306,1 ,$140.00 ,$91.00 ,$18.59 ,$140.00 ,$107.10 ,$104.30 ,$91.70 ,$42.84 ,$39.20 ,$70.70 ,$42.84 ,$86.38 ,$42.84 ,$86.38 ,$86.38 ,$42.84 ,$86.38 ,$81.40 ,$126.00 ,$105.00 ,$107.10 ,$42.84 ,$123.20 ,$42.84 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$42.84 ,$119.00 ,$42.84 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$107.10 ,$126.00 ,$42.84 ,$140.00 ,$91.70 ,$42.84 ,$58.24 ,$19.47 ,$18.59 ,$44.98 ,$126.00 ,$96.39 ,$86.38 ,$39.20 ,$126.00 ,$42.84 ,$126.00 ,$126.00 ,$42.84 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600449,87521,HC HEPATITIS C PROBE AND RVRS TRNSC-90,306,1 ,$200.00 ,$130.00 ,$18.59 ,$200.00 ,$87.73 ,$149.00 ,$131.00 ,$35.09 ,$56.00 ,$101.00 ,$35.09 ,$123.40 ,$35.09 ,$123.40 ,$123.40 ,$35.09 ,$123.40 ,$66.67 ,$180.00 ,$150.00 ,$87.73 ,$35.09 ,$176.00 ,$35.09 ,$150.00 ,$150.00 ,$170.00 ,$170.00 ,$35.09 ,$170.00 ,$35.09 ,$156.00 ,$156.00 ,$156.00 ,$180.00 ,$87.73 ,$180.00 ,$35.09 ,$200.00 ,$131.00 ,$35.09 ,$83.20 ,$19.47 ,$18.59 ,$36.84 ,$180.00 ,$78.95 ,$123.40 ,$56.00 ,$180.00 ,$35.09 ,$180.00 ,$180.00 ,$35.09 ,$130.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600451,87522,HC HEPATITIS C QN-90,306,1 ,$201.00 ,$130.65 ,$18.59 ,$201.00 ,$107.10 ,$149.75 ,$131.66 ,$42.84 ,$56.28 ,$101.51 ,$42.84 ,$124.02 ,$42.84 ,$124.02 ,$124.02 ,$42.84 ,$124.02 ,$81.40 ,$180.90 ,$150.75 ,$107.10 ,$42.84 ,$176.88 ,$42.84 ,$150.75 ,$150.75 ,$170.85 ,$170.85 ,$42.84 ,$170.85 ,$42.84 ,$156.78 ,$156.78 ,$156.78 ,$180.90 ,$107.10 ,$180.90 ,$42.84 ,$201.00 ,$131.66 ,$42.84 ,$83.62 ,$19.47 ,$18.59 ,$44.98 ,$180.90 ,$96.39 ,$124.02 ,$56.28 ,$180.90 ,$42.84 ,$180.90 ,$180.90 ,$42.84 ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$291.00 ,$189.15 ,$18.59 ,$291.00 ,$87.73 ,$216.80 ,$190.61 ,$35.09 ,$81.48 ,$146.96 ,$35.09 ,$179.55 ,$35.09 ,$179.55 ,$179.55 ,$35.09 ,$179.55 ,$66.67 ,$261.90 ,$218.25 ,$87.73 ,$35.09 ,$256.08 ,$35.09 ,$218.25 ,$218.25 ,$247.35 ,$247.35 ,$35.09 ,$247.35 ,$35.09 ,$226.98 ,$226.98 ,$226.98 ,$261.90 ,$87.73 ,$261.90 ,$35.09 ,$291.00 ,$190.61 ,$35.09 ,$121.06 ,$19.47 ,$18.59 ,$36.84 ,$261.90 ,$78.95 ,$179.55 ,$81.48 ,$261.90 ,$35.09 ,$261.90 ,$261.90 ,$35.09 ,$189.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600455,87532,HC INFECT AMP (HHSV6) MENI-90,306,1 ,$222.40 ,$144.56 ,$18.59 ,$222.40 ,$87.73 ,$165.69 ,$145.67 ,$35.09 ,$62.27 ,$112.31 ,$35.09 ,$137.22 ,$35.09 ,$137.22 ,$137.22 ,$35.09 ,$137.22 ,$66.67 ,$200.16 ,$166.80 ,$87.73 ,$35.09 ,$195.71 ,$35.09 ,$166.80 ,$166.80 ,$189.04 ,$189.04 ,$35.09 ,$189.04 ,$35.09 ,$173.47 ,$173.47 ,$173.47 ,$200.16 ,$87.73 ,$200.16 ,$35.09 ,$222.40 ,$145.67 ,$35.09 ,$92.52 ,$19.47 ,$18.59 ,$36.84 ,$200.16 ,$78.95 ,$137.22 ,$62.27 ,$200.16 ,$35.09 ,$200.16 ,$200.16 ,$35.09 ,$144.56 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600457,87535,HC PROBE HIV-1 RNA QUAL TMA-90,306,1 ,$500.00 ,$325.00 ,$18.59 ,$500.00 ,$87.73 ,$372.50 ,$327.50 ,$35.09 ,$140.00 ,$252.50 ,$35.09 ,$308.50 ,$35.09 ,$308.50 ,$308.50 ,$35.09 ,$308.50 ,$66.67 ,$450.00 ,$375.00 ,$87.73 ,$35.09 ,$440.00 ,$35.09 ,$375.00 ,$375.00 ,$425.00 ,$425.00 ,$35.09 ,$425.00 ,$35.09 ,$390.00 ,$390.00 ,$390.00 ,$450.00 ,$87.73 ,$450.00 ,$35.09 ,$500.00 ,$327.50 ,$35.09 ,$208.00 ,$19.47 ,$18.59 ,$36.84 ,$450.00 ,$78.95 ,$308.50 ,$140.00 ,$450.00 ,$35.09 ,$450.00 ,$450.00 ,$35.09 ,$325.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600458,87536,HC HIV-1 QN-90,306,1 ,$130.00 ,$84.50 ,$18.59 ,$191.48 ,$130.00 ,$96.85 ,$85.15 ,$85.10 ,$36.40 ,$65.65 ,$85.10 ,$80.21 ,$85.10 ,$80.21 ,$80.21 ,$85.10 ,$80.21 ,$161.69 ,$117.00 ,$97.50 ,$130.00 ,$85.10 ,$114.40 ,$85.10 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$85.10 ,$110.50 ,$85.10 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$130.00 ,$117.00 ,$85.10 ,$130.00 ,$85.15 ,$85.10 ,$54.08 ,$19.47 ,$18.59 ,$89.36 ,$117.00 ,$191.48 ,$80.21 ,$36.40 ,$117.00 ,$85.10 ,$117.00 ,$117.00 ,$85.10 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600469,87661,HC TRICHOMONAS VAG AMP PROBE-90,306,1 ,$180.00 ,$117.00 ,$18.59 ,$180.00 ,$87.73 ,$134.10 ,$117.90 ,$35.09 ,$50.40 ,$90.90 ,$35.09 ,$111.06 ,$35.09 ,$111.06 ,$111.06 ,$35.09 ,$111.06 ,$66.67 ,$162.00 ,$135.00 ,$87.73 ,$35.09 ,$158.40 ,$35.09 ,$135.00 ,$135.00 ,$153.00 ,$153.00 ,$35.09 ,$153.00 ,$35.09 ,$140.40 ,$140.40 ,$140.40 ,$162.00 ,$87.73 ,$162.00 ,$35.09 ,$180.00 ,$117.90 ,$35.09 ,$74.88 ,$19.47 ,$18.59 ,$36.84 ,$162.00 ,$78.95 ,$111.06 ,$50.40 ,$162.00 ,$35.09 ,$162.00 ,$162.00 ,$35.09 ,$117.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600471,87798,HC INFECT AMP-90,306,1 ,$188.00 ,$122.20 ,$18.59 ,$188.00 ,$87.73 ,$140.06 ,$123.14 ,$35.09 ,$52.64 ,$94.94 ,$35.09 ,$116.00 ,$35.09 ,$116.00 ,$116.00 ,$35.09 ,$116.00 ,$66.67 ,$169.20 ,$141.00 ,$87.73 ,$35.09 ,$165.44 ,$35.09 ,$141.00 ,$141.00 ,$159.80 ,$159.80 ,$35.09 ,$159.80 ,$35.09 ,$146.64 ,$146.64 ,$146.64 ,$169.20 ,$87.73 ,$169.20 ,$35.09 ,$188.00 ,$123.14 ,$35.09 ,$78.21 ,$19.47 ,$18.59 ,$36.84 ,$169.20 ,$78.95 ,$116.00 ,$52.64 ,$169.20 ,$35.09 ,$169.20 ,$169.20 ,$35.09 ,$122.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600476,87798,HC INFECT AMP T1,306,1 ,$55.00 ,$35.75 ,$15.40 ,$78.95 ,$55.00 ,$40.98 ,$36.03 ,$35.09 ,$15.40 ,$27.78 ,$35.09 ,$33.94 ,$35.09 ,$33.94 ,$33.94 ,$35.09 ,$33.94 ,$66.67 ,$49.50 ,$41.25 ,$55.00 ,$35.09 ,$48.40 ,$35.09 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$35.09 ,$46.75 ,$35.09 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$55.00 ,$49.50 ,$35.09 ,$55.00 ,$36.03 ,$35.09 ,$22.88 ,$19.47 ,$18.59 ,$36.84 ,$49.50 ,$78.95 ,$33.94 ,$15.40 ,$49.50 ,$35.09 ,$49.50 ,$49.50 ,$35.09 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600478,87799,HC INFECT AGENT QN-90,306,1 ,$201.00 ,$130.65 ,$18.59 ,$201.00 ,$107.10 ,$149.75 ,$131.66 ,$42.84 ,$56.28 ,$101.51 ,$42.84 ,$124.02 ,$42.84 ,$124.02 ,$124.02 ,$42.84 ,$124.02 ,$81.40 ,$180.90 ,$150.75 ,$107.10 ,$42.84 ,$176.88 ,$42.84 ,$150.75 ,$150.75 ,$170.85 ,$170.85 ,$42.84 ,$170.85 ,$42.84 ,$156.78 ,$156.78 ,$156.78 ,$180.90 ,$107.10 ,$180.90 ,$42.84 ,$201.00 ,$131.66 ,$42.84 ,$83.62 ,$19.47 ,$18.59 ,$44.98 ,$180.90 ,$96.39 ,$124.02 ,$56.28 ,$180.90 ,$42.84 ,$180.90 ,$180.90 ,$42.84 ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600480,87899,HC INFECT AGENT DETECT OPTICAL-90,306,1 ,$82.00 ,$53.30 ,$5.60 ,$82.00 ,$40.18 ,$61.09 ,$53.71 ,$16.07 ,$22.96 ,$41.41 ,$16.07 ,$50.59 ,$16.07 ,$50.59 ,$50.59 ,$16.07 ,$50.59 ,$30.53 ,$73.80 ,$61.50 ,$40.18 ,$16.07 ,$72.16 ,$16.07 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$16.07 ,$69.70 ,$16.07 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$40.18 ,$73.80 ,$16.07 ,$82.00 ,$53.71 ,$16.07 ,$34.11 ,$5.86 ,$5.60 ,$16.87 ,$73.80 ,$36.16 ,$50.59 ,$22.96 ,$73.80 ,$16.07 ,$73.80 ,$73.80 ,$16.07 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600481,87900,HC PHENOTYPE INFCT AGT DRG SUS-90,306,1 ,$391.00 ,$254.15 ,$18.59 ,$391.00 ,$325.88 ,$291.30 ,$256.11 ,$130.35 ,$109.48 ,$197.46 ,$130.35 ,$241.25 ,$130.35 ,$241.25 ,$241.25 ,$130.35 ,$241.25 ,$247.67 ,$351.90 ,$293.25 ,$325.88 ,$130.35 ,$344.08 ,$130.35 ,$293.25 ,$293.25 ,$332.35 ,$332.35 ,$130.35 ,$332.35 ,$130.35 ,$304.98 ,$304.98 ,$304.98 ,$351.90 ,$325.88 ,$351.90 ,$130.35 ,$391.00 ,$256.11 ,$130.35 ,$162.66 ,$19.47 ,$18.59 ,$136.87 ,$351.90 ,$293.29 ,$241.25 ,$109.48 ,$351.90 ,$130.35 ,$351.90 ,$351.90 ,$130.35 ,$254.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600482,87901,HC GENOTYPE HIV 1-90,306,1 ,$772.00 ,$501.80 ,$18.59 ,$772.00 ,$643.63 ,$575.14 ,$505.66 ,$257.45 ,$216.16 ,$389.86 ,$257.45 ,$476.32 ,$257.45 ,$476.32 ,$476.32 ,$257.45 ,$476.32 ,$489.16 ,$694.80 ,$579.00 ,$643.63 ,$257.45 ,$679.36 ,$257.45 ,$579.00 ,$579.00 ,$656.20 ,$656.20 ,$257.45 ,$656.20 ,$257.45 ,$602.16 ,$602.16 ,$602.16 ,$694.80 ,$643.63 ,$694.80 ,$257.45 ,$772.00 ,$505.66 ,$257.45 ,$321.15 ,$19.47 ,$18.59 ,$270.32 ,$694.80 ,$579.26 ,$476.32 ,$216.16 ,$694.80 ,$257.45 ,$694.80 ,$694.80 ,$257.45 ,$501.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600483,87902,HC GENTOYPE HEP C-90,306,1 ,$634.00 ,$412.10 ,$18.59 ,$634.00 ,$634.00 ,$472.33 ,$415.27 ,$257.45 ,$177.52 ,$320.17 ,$257.45 ,$391.18 ,$257.45 ,$391.18 ,$391.18 ,$257.45 ,$391.18 ,$489.16 ,$570.60 ,$475.50 ,$634.00 ,$257.45 ,$557.92 ,$257.45 ,$475.50 ,$475.50 ,$538.90 ,$538.90 ,$257.45 ,$538.90 ,$257.45 ,$494.52 ,$494.52 ,$494.52 ,$570.60 ,$634.00 ,$570.60 ,$257.45 ,$634.00 ,$415.27 ,$257.45 ,$263.74 ,$19.47 ,$18.59 ,$270.32 ,$570.60 ,$579.26 ,$391.18 ,$177.52 ,$570.60 ,$257.45 ,$570.60 ,$570.60 ,$257.45 ,$412.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600486,87906,HC GENOTYPE DNA/RNA HIV1-90,306,1 ,"$1,342.00 ",$872.30 ,$12.09 ,"$1,342.00 ",$321.83 ,$999.79 ,$879.01 ,$128.73 ,$375.76 ,$677.71 ,$128.73 ,$828.01 ,$128.73 ,$828.01 ,$828.01 ,$128.73 ,$828.01 ,$244.59 ,"$1,207.80 ","$1,006.50 ",$321.83 ,$128.73 ,"$1,180.96 ",$128.73 ,"$1,006.50 ","$1,006.50 ","$1,140.70 ","$1,140.70 ",$128.73 ,"$1,140.70 ",$128.73 ,"$1,046.76 ","$1,046.76 ","$1,046.76 ","$1,207.80 ",$321.83 ,"$1,207.80 ",$128.73 ,"$1,342.00 ",$879.01 ,$128.73 ,$558.27 ,$12.66 ,$12.09 ,$135.17 ,"$1,207.80 ",$289.64 ,$828.01 ,$375.76 ,"$1,207.80 ",$128.73 ,"$1,207.80 ","$1,207.80 ",$128.73 ,$872.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600503,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB-90,306,1 ,$457.80 ,$297.57 ,$7.01 ,$457.80 ,$60.20 ,$341.06 ,$299.86 ,$24.08 ,$128.18 ,$231.19 ,$24.08 ,$282.46 ,$24.08 ,$282.46 ,$282.46 ,$24.08 ,$282.46 ,$45.75 ,$412.02 ,$343.35 ,$60.20 ,$24.08 ,$402.86 ,$24.08 ,$343.35 ,$343.35 ,$389.13 ,$389.13 ,$24.08 ,$389.13 ,$24.08 ,$357.08 ,$357.08 ,$357.08 ,$412.02 ,$60.20 ,$412.02 ,$24.08 ,$457.80 ,$299.86 ,$24.08 ,$190.44 ,$7.35 ,$7.01 ,$25.28 ,$412.02 ,$54.18 ,$282.46 ,$128.18 ,$412.02 ,$24.08 ,$412.02 ,$412.02 ,$24.08 ,$297.57 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600504,87046,HC STOOL CULTURE ADD ISO-90,306,1 ,$94.00 ,$61.10 ,$5.60 ,$94.00 ,$23.60 ,$70.03 ,$61.57 ,$9.44 ,$26.32 ,$47.47 ,$9.44 ,$58.00 ,$9.44 ,$58.00 ,$58.00 ,$9.44 ,$58.00 ,$17.94 ,$84.60 ,$70.50 ,$23.60 ,$9.44 ,$82.72 ,$9.44 ,$70.50 ,$70.50 ,$79.90 ,$79.90 ,$9.44 ,$79.90 ,$9.44 ,$73.32 ,$73.32 ,$73.32 ,$84.60 ,$23.60 ,$84.60 ,$9.44 ,$94.00 ,$61.57 ,$9.44 ,$39.10 ,$5.86 ,$5.60 ,$9.91 ,$84.60 ,$21.24 ,$58.00 ,$26.32 ,$84.60 ,$9.44 ,$84.60 ,$84.60 ,$9.44 ,$61.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600505,87329,HC EIA QL GIARDIA AG-90,306,1 ,$22.00 ,$14.30 ,$6.16 ,$26.96 ,$22.00 ,$16.39 ,$14.41 ,$11.98 ,$6.16 ,$11.11 ,$11.98 ,$13.57 ,$11.98 ,$13.57 ,$13.57 ,$11.98 ,$13.57 ,$22.76 ,$19.80 ,$16.50 ,$22.00 ,$11.98 ,$19.36 ,$11.98 ,$16.50 ,$16.50 ,$18.70 ,$18.70 ,$11.98 ,$18.70 ,$11.98 ,$17.16 ,$17.16 ,$17.16 ,$19.80 ,$22.00 ,$19.80 ,$11.98 ,$22.00 ,$14.41 ,$11.98 ,$9.15 ,$7.35 ,$7.01 ,$12.58 ,$19.80 ,$26.96 ,$13.57 ,$6.16 ,$19.80 ,$11.98 ,$19.80 ,$19.80 ,$11.98 ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600513,87533,HC HHV-6 DNA QUANT-90,306,1 ,$550.00 ,$357.50 ,$18.59 ,$550.00 ,$104.40 ,$409.75 ,$360.25 ,$41.76 ,$154.00 ,$277.75 ,$41.76 ,$339.35 ,$41.76 ,$339.35 ,$339.35 ,$41.76 ,$339.35 ,$79.34 ,$495.00 ,$412.50 ,$104.40 ,$41.76 ,$484.00 ,$41.76 ,$412.50 ,$412.50 ,$467.50 ,$467.50 ,$41.76 ,$467.50 ,$41.76 ,$429.00 ,$429.00 ,$429.00 ,$495.00 ,$104.40 ,$495.00 ,$41.76 ,$550.00 ,$360.25 ,$41.76 ,$228.80 ,$19.47 ,$18.59 ,$43.85 ,$495.00 ,$93.96 ,$339.35 ,$154.00 ,$495.00 ,$41.76 ,$495.00 ,$495.00 ,$41.76 ,$357.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600515,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$44.00 ,$28.60 ,$5.60 ,$44.00 ,$16.70 ,$32.78 ,$28.82 ,$6.68 ,$12.32 ,$22.22 ,$6.68 ,$27.15 ,$6.68 ,$27.15 ,$27.15 ,$6.68 ,$27.15 ,$12.69 ,$39.60 ,$33.00 ,$16.70 ,$6.68 ,$38.72 ,$6.68 ,$33.00 ,$33.00 ,$37.40 ,$37.40 ,$6.68 ,$37.40 ,$6.68 ,$34.32 ,$34.32 ,$34.32 ,$39.60 ,$16.70 ,$39.60 ,$6.68 ,$44.00 ,$28.82 ,$6.68 ,$18.30 ,$5.86 ,$5.60 ,$7.01 ,$39.60 ,$15.03 ,$27.15 ,$12.32 ,$39.60 ,$6.68 ,$39.60 ,$39.60 ,$6.68 ,$28.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$95.00 ,$61.75 ,$5.60 ,$95.00 ,$20.20 ,$70.78 ,$62.23 ,$8.08 ,$26.60 ,$47.98 ,$8.08 ,$58.62 ,$8.08 ,$58.62 ,$58.62 ,$8.08 ,$58.62 ,$15.35 ,$85.50 ,$71.25 ,$20.20 ,$8.08 ,$83.60 ,$8.08 ,$71.25 ,$71.25 ,$80.75 ,$80.75 ,$8.08 ,$80.75 ,$8.08 ,$74.10 ,$74.10 ,$74.10 ,$85.50 ,$20.20 ,$85.50 ,$8.08 ,$95.00 ,$62.23 ,$8.08 ,$39.52 ,$5.86 ,$5.60 ,$8.48 ,$85.50 ,$18.18 ,$58.62 ,$26.60 ,$85.50 ,$8.08 ,$85.50 ,$85.50 ,$8.08 ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$12.00 ,$7.80 ,$3.36 ,$18.18 ,$12.00 ,$8.94 ,$7.86 ,$8.08 ,$3.36 ,$6.06 ,$8.08 ,$7.40 ,$8.08 ,$7.40 ,$7.40 ,$8.08 ,$7.40 ,$15.35 ,$10.80 ,$9.00 ,$12.00 ,$8.08 ,$10.56 ,$8.08 ,$9.00 ,$9.00 ,$10.20 ,$10.20 ,$8.08 ,$10.20 ,$8.08 ,$9.36 ,$9.36 ,$9.36 ,$10.80 ,$12.00 ,$10.80 ,$8.08 ,$12.00 ,$7.86 ,$8.08 ,$4.99 ,$5.86 ,$5.60 ,$8.48 ,$10.80 ,$18.18 ,$7.40 ,$3.36 ,$10.80 ,$8.08 ,$10.80 ,$10.80 ,$8.08 ,$7.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600529,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL -90,306,1 ,$30.00 ,$19.50 ,$5.60 ,$30.00 ,$19.28 ,$22.35 ,$19.65 ,$7.71 ,$8.40 ,$15.15 ,$7.71 ,$18.51 ,$7.71 ,$18.51 ,$18.51 ,$7.71 ,$18.51 ,$14.65 ,$27.00 ,$22.50 ,$19.28 ,$7.71 ,$26.40 ,$7.71 ,$22.50 ,$22.50 ,$25.50 ,$25.50 ,$7.71 ,$25.50 ,$7.71 ,$23.40 ,$23.40 ,$23.40 ,$27.00 ,$19.28 ,$27.00 ,$7.71 ,$30.00 ,$19.65 ,$7.71 ,$12.48 ,$5.86 ,$5.60 ,$8.10 ,$27.00 ,$17.35 ,$18.51 ,$8.40 ,$27.00 ,$7.71 ,$27.00 ,$27.00 ,$7.71 ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600530,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL,306,1 ,$36.00 ,$23.40 ,$5.60 ,$36.00 ,$19.28 ,$26.82 ,$23.58 ,$7.71 ,$10.08 ,$18.18 ,$7.71 ,$22.21 ,$7.71 ,$22.21 ,$22.21 ,$7.71 ,$22.21 ,$14.65 ,$32.40 ,$27.00 ,$19.28 ,$7.71 ,$31.68 ,$7.71 ,$27.00 ,$27.00 ,$30.60 ,$30.60 ,$7.71 ,$30.60 ,$7.71 ,$28.08 ,$28.08 ,$28.08 ,$32.40 ,$19.28 ,$32.40 ,$7.71 ,$36.00 ,$23.58 ,$7.71 ,$14.98 ,$5.86 ,$5.60 ,$8.10 ,$32.40 ,$17.35 ,$22.21 ,$10.08 ,$32.40 ,$7.71 ,$32.40 ,$32.40 ,$7.71 ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600531,87102,HC CULTURE FUNGUS OTHER,306,1 ,$135.00 ,$87.75 ,$5.60 ,$135.00 ,$21.03 ,$100.58 ,$88.43 ,$8.41 ,$37.80 ,$68.18 ,$8.41 ,$83.30 ,$8.41 ,$83.30 ,$83.30 ,$8.41 ,$83.30 ,$15.98 ,$121.50 ,$101.25 ,$21.03 ,$8.41 ,$118.80 ,$8.41 ,$101.25 ,$101.25 ,$114.75 ,$114.75 ,$8.41 ,$114.75 ,$8.41 ,$105.30 ,$105.30 ,$105.30 ,$121.50 ,$21.03 ,$121.50 ,$8.41 ,$135.00 ,$88.43 ,$8.41 ,$56.16 ,$5.86 ,$5.60 ,$8.83 ,$121.50 ,$18.92 ,$83.30 ,$37.80 ,$121.50 ,$8.41 ,$121.50 ,$121.50 ,$8.41 ,$87.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600532,87103,HC CULTURE FUNGUS BLOOD,306,1 ,$91.00 ,$59.15 ,$18.59 ,$91.00 ,$51.15 ,$67.80 ,$59.61 ,$20.46 ,$25.48 ,$45.96 ,$20.46 ,$56.15 ,$20.46 ,$56.15 ,$56.15 ,$20.46 ,$56.15 ,$38.87 ,$81.90 ,$68.25 ,$51.15 ,$20.46 ,$80.08 ,$20.46 ,$68.25 ,$68.25 ,$77.35 ,$77.35 ,$20.46 ,$77.35 ,$20.46 ,$70.98 ,$70.98 ,$70.98 ,$81.90 ,$51.15 ,$81.90 ,$20.46 ,$91.00 ,$59.61 ,$20.46 ,$37.86 ,$19.47 ,$18.59 ,$21.48 ,$81.90 ,$46.04 ,$56.15 ,$25.48 ,$81.90 ,$20.46 ,$81.90 ,$81.90 ,$20.46 ,$59.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$82.00 ,$53.30 ,$5.60 ,$82.00 ,$25.80 ,$61.09 ,$53.71 ,$10.32 ,$22.96 ,$41.41 ,$10.32 ,$50.59 ,$10.32 ,$50.59 ,$50.59 ,$10.32 ,$50.59 ,$19.61 ,$73.80 ,$61.50 ,$25.80 ,$10.32 ,$72.16 ,$10.32 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$10.32 ,$69.70 ,$10.32 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$25.80 ,$73.80 ,$10.32 ,$82.00 ,$53.71 ,$10.32 ,$34.11 ,$5.86 ,$5.60 ,$10.84 ,$73.80 ,$23.22 ,$50.59 ,$22.96 ,$73.80 ,$10.32 ,$73.80 ,$73.80 ,$10.32 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600534,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 ,$25.80 ,$22.35 ,$19.65 ,$10.32 ,$8.40 ,$15.15 ,$10.32 ,$18.51 ,$10.32 ,$18.51 ,$18.51 ,$10.32 ,$18.51 ,$19.61 ,$27.00 ,$22.50 ,$25.80 ,$10.32 ,$26.40 ,$10.32 ,$22.50 ,$22.50 ,$25.50 ,$25.50 ,$10.32 ,$25.50 ,$10.32 ,$23.40 ,$23.40 ,$23.40 ,$27.00 ,$25.80 ,$27.00 ,$10.32 ,$30.00 ,$19.65 ,$10.32 ,$12.48 ,$19.47 ,$18.59 ,$10.84 ,$27.00 ,$23.22 ,$18.51 ,$8.40 ,$27.00 ,$10.32 ,$27.00 ,$27.00 ,$10.32 ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600535,87116,HC CULTURE AFB/TB/MYCOBACT,306,1 ,$101.00 ,$65.65 ,$10.80 ,$101.00 ,$27.00 ,$75.25 ,$66.16 ,$10.80 ,$28.28 ,$51.01 ,$10.80 ,$62.32 ,$10.80 ,$62.32 ,$62.32 ,$10.80 ,$62.32 ,$20.52 ,$90.90 ,$75.75 ,$27.00 ,$10.80 ,$88.88 ,$10.80 ,$75.75 ,$75.75 ,$85.85 ,$85.85 ,$10.80 ,$85.85 ,$10.80 ,$78.78 ,$78.78 ,$78.78 ,$90.90 ,$27.00 ,$90.90 ,$10.80 ,$101.00 ,$66.16 ,$10.80 ,$42.02 ,$19.47 ,$18.59 ,$11.34 ,$90.90 ,$24.30 ,$62.32 ,$28.28 ,$90.90 ,$10.80 ,$90.90 ,$90.90 ,$10.80 ,$65.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$15.54 ,$10.10 ,$4.35 ,$15.54 ,$12.95 ,$11.58 ,$10.18 ,$5.18 ,$4.35 ,$7.85 ,$5.18 ,$9.59 ,$5.18 ,$9.59 ,$9.59 ,$5.18 ,$9.59 ,$9.84 ,$13.99 ,$11.66 ,$12.95 ,$5.18 ,$13.68 ,$5.18 ,$11.66 ,$11.66 ,$13.21 ,$13.21 ,$5.18 ,$13.21 ,$5.18 ,$12.12 ,$12.12 ,$12.12 ,$13.99 ,$12.95 ,$13.99 ,$5.18 ,$15.54 ,$10.18 ,$5.18 ,$6.46 ,$5.86 ,$5.60 ,$5.44 ,$13.99 ,$11.66 ,$9.59 ,$4.35 ,$13.99 ,$5.18 ,$13.99 ,$13.99 ,$5.18 ,$10.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$328.00 ,$213.20 ,$5.60 ,$328.00 ,$50.13 ,$244.36 ,$214.84 ,$20.05 ,$91.84 ,$165.64 ,$20.05 ,$202.38 ,$20.05 ,$202.38 ,$202.38 ,$20.05 ,$202.38 ,$38.10 ,$295.20 ,$246.00 ,$50.13 ,$20.05 ,$288.64 ,$20.05 ,$246.00 ,$246.00 ,$278.80 ,$278.80 ,$20.05 ,$278.80 ,$20.05 ,$255.84 ,$255.84 ,$255.84 ,$295.20 ,$50.13 ,$295.20 ,$20.05 ,$328.00 ,$214.84 ,$20.05 ,$136.45 ,$5.86 ,$5.60 ,$21.05 ,$295.20 ,$45.11 ,$202.38 ,$91.84 ,$295.20 ,$20.05 ,$295.20 ,$295.20 ,$20.05 ,$213.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600539,87153,HC ID NUCLEAR ACID SEQ METH ID,306,1 ,"$1,156.00 ",$751.40 ,$18.59 ,"$1,156.00 ",$288.40 ,$861.22 ,$757.18 ,$115.36 ,$323.68 ,$583.78 ,$115.36 ,$713.25 ,$115.36 ,$713.25 ,$713.25 ,$115.36 ,$713.25 ,$219.18 ,"$1,040.40 ",$867.00 ,$288.40 ,$115.36 ,"$1,017.28 ",$115.36 ,$867.00 ,$867.00 ,$982.60 ,$982.60 ,$115.36 ,$982.60 ,$115.36 ,$901.68 ,$901.68 ,$901.68 ,"$1,040.40 ",$288.40 ,"$1,040.40 ",$115.36 ,"$1,156.00 ",$757.18 ,$115.36 ,$480.90 ,$19.47 ,$18.59 ,$121.13 ,"$1,040.40 ",$259.56 ,$713.25 ,$323.68 ,"$1,040.40 ",$115.36 ,"$1,040.40 ","$1,040.40 ",$115.36 ,$751.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$22.00 ,$14.30 ,$4.75 ,$22.00 ,$11.88 ,$16.39 ,$14.41 ,$4.75 ,$6.16 ,$11.11 ,$4.75 ,$13.57 ,$4.75 ,$13.57 ,$13.57 ,$4.75 ,$13.57 ,$9.03 ,$19.80 ,$16.50 ,$11.88 ,$4.75 ,$19.36 ,$4.75 ,$16.50 ,$16.50 ,$18.70 ,$18.70 ,$4.75 ,$18.70 ,$4.75 ,$17.16 ,$17.16 ,$17.16 ,$19.80 ,$11.88 ,$19.80 ,$4.75 ,$22.00 ,$14.41 ,$4.75 ,$9.15 ,$5.86 ,$5.60 ,$4.99 ,$19.80 ,$10.69 ,$13.57 ,$6.16 ,$19.80 ,$4.75 ,$19.80 ,$19.80 ,$4.75 ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600547,87186,HC SENSITIVITY MIC,306,1 ,$54.00 ,$35.10 ,$5.60 ,$54.00 ,$21.63 ,$40.23 ,$35.37 ,$8.65 ,$15.12 ,$27.27 ,$8.65 ,$33.32 ,$8.65 ,$33.32 ,$33.32 ,$8.65 ,$33.32 ,$16.44 ,$48.60 ,$40.50 ,$21.63 ,$8.65 ,$47.52 ,$8.65 ,$40.50 ,$40.50 ,$45.90 ,$45.90 ,$8.65 ,$45.90 ,$8.65 ,$42.12 ,$42.12 ,$42.12 ,$48.60 ,$21.63 ,$48.60 ,$8.65 ,$54.00 ,$35.37 ,$8.65 ,$22.46 ,$5.86 ,$5.60 ,$9.08 ,$48.60 ,$19.46 ,$33.32 ,$15.12 ,$48.60 ,$8.65 ,$48.60 ,$48.60 ,$8.65 ,$35.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600549,87188,HC MACROTUBE DIL METH EA AGNT,306,1 ,$75.00 ,$48.75 ,$5.60 ,$75.00 ,$16.60 ,$55.88 ,$49.13 ,$6.64 ,$21.00 ,$37.88 ,$6.64 ,$46.28 ,$6.64 ,$46.28 ,$46.28 ,$6.64 ,$46.28 ,$12.62 ,$67.50 ,$56.25 ,$16.60 ,$6.64 ,$66.00 ,$6.64 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$6.64 ,$63.75 ,$6.64 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$16.60 ,$67.50 ,$6.64 ,$75.00 ,$49.13 ,$6.64 ,$31.20 ,$5.86 ,$5.60 ,$6.97 ,$67.50 ,$14.94 ,$46.28 ,$21.00 ,$67.50 ,$6.64 ,$67.50 ,$67.50 ,$6.64 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600551,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$43.00 ,$27.95 ,$4.27 ,$43.00 ,$10.68 ,$32.04 ,$28.17 ,$4.27 ,$12.04 ,$21.72 ,$4.27 ,$26.53 ,$4.27 ,$26.53 ,$26.53 ,$4.27 ,$26.53 ,$8.11 ,$38.70 ,$32.25 ,$10.68 ,$4.27 ,$37.84 ,$4.27 ,$32.25 ,$32.25 ,$36.55 ,$36.55 ,$4.27 ,$36.55 ,$4.27 ,$33.54 ,$33.54 ,$33.54 ,$38.70 ,$10.68 ,$38.70 ,$4.27 ,$43.00 ,$28.17 ,$4.27 ,$17.89 ,$5.86 ,$5.60 ,$4.48 ,$38.70 ,$9.61 ,$26.53 ,$12.04 ,$38.70 ,$4.27 ,$38.70 ,$38.70 ,$4.27 ,$27.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$55.00 ,$35.75 ,$5.39 ,$55.00 ,$13.48 ,$40.98 ,$36.03 ,$5.39 ,$15.40 ,$27.78 ,$5.39 ,$33.94 ,$5.39 ,$33.94 ,$33.94 ,$5.39 ,$33.94 ,$10.24 ,$49.50 ,$41.25 ,$13.48 ,$5.39 ,$48.40 ,$5.39 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$5.39 ,$46.75 ,$5.39 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$13.48 ,$49.50 ,$5.39 ,$55.00 ,$36.03 ,$5.39 ,$22.88 ,$5.86 ,$5.60 ,$5.66 ,$49.50 ,$12.13 ,$33.94 ,$15.40 ,$49.50 ,$5.39 ,$49.50 ,$49.50 ,$5.39 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600553,87207,HC SPECIAL STAIN INCL BODIES/PARASITES,306,1 ,$55.00 ,$35.75 ,$5.60 ,$55.00 ,$14.98 ,$40.98 ,$36.03 ,$5.99 ,$15.40 ,$27.78 ,$5.99 ,$33.94 ,$5.99 ,$33.94 ,$33.94 ,$5.99 ,$33.94 ,$11.38 ,$49.50 ,$41.25 ,$14.98 ,$5.99 ,$48.40 ,$5.99 ,$41.25 ,$41.25 ,$46.75 ,$46.75 ,$5.99 ,$46.75 ,$5.99 ,$42.90 ,$42.90 ,$42.90 ,$49.50 ,$14.98 ,$49.50 ,$5.99 ,$55.00 ,$36.03 ,$5.99 ,$22.88 ,$5.86 ,$5.60 ,$6.29 ,$49.50 ,$13.48 ,$33.94 ,$15.40 ,$49.50 ,$5.99 ,$49.50 ,$49.50 ,$5.99 ,$35.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600554,87254,HC VIRUS ISOL SHELL ID,306,1 ,$92.00 ,$59.80 ,$18.59 ,$92.00 ,$48.90 ,$68.54 ,$60.26 ,$19.56 ,$25.76 ,$46.46 ,$19.56 ,$56.76 ,$19.56 ,$56.76 ,$56.76 ,$19.56 ,$56.76 ,$37.16 ,$82.80 ,$69.00 ,$48.90 ,$19.56 ,$80.96 ,$19.56 ,$69.00 ,$69.00 ,$78.20 ,$78.20 ,$19.56 ,$78.20 ,$19.56 ,$71.76 ,$71.76 ,$71.76 ,$82.80 ,$48.90 ,$82.80 ,$19.56 ,$92.00 ,$60.26 ,$19.56 ,$38.27 ,$19.47 ,$18.59 ,$20.54 ,$82.80 ,$44.01 ,$56.76 ,$25.76 ,$82.80 ,$19.56 ,$82.80 ,$82.80 ,$19.56 ,$59.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600555,87255,HC VIRUS ID NON-IMMUNOLOGIC OTHER THAN CYTOPATHIC-90,306,1 ,$16.00 ,$10.40 ,$4.48 ,$36.00 ,$16.00 ,$11.92 ,$10.48 ,$16.00 ,$4.48 ,$8.08 ,$16.00 ,$9.87 ,$16.00 ,$9.87 ,$9.87 ,$16.00 ,$9.87 ,$30.40 ,$14.40 ,$12.00 ,$16.00 ,$16.00 ,$14.08 ,$16.00 ,$12.00 ,$12.00 ,$13.60 ,$13.60 ,$16.00 ,$13.60 ,$16.00 ,$12.48 ,$12.48 ,$12.48 ,$14.40 ,$16.00 ,$14.40 ,$16.00 ,$16.00 ,$10.48 ,$16.00 ,$6.66 ,$16.00 ,$16.00 ,$16.00 ,$14.40 ,$36.00 ,$9.87 ,$4.48 ,$14.40 ,$16.00 ,$14.40 ,$14.40 ,$16.00 ,$10.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600564,87430,HC RAPID STREP -QW,306,1 ,$57.00 ,$37.05 ,$7.01 ,$57.00 ,$42.03 ,$42.47 ,$37.34 ,$16.81 ,$15.96 ,$28.79 ,$16.81 ,$35.17 ,$16.81 ,$35.17 ,$35.17 ,$16.81 ,$35.17 ,$31.94 ,$51.30 ,$42.75 ,$42.03 ,$16.81 ,$50.16 ,$16.81 ,$42.75 ,$42.75 ,$48.45 ,$48.45 ,$16.81 ,$48.45 ,$16.81 ,$44.46 ,$44.46 ,$44.46 ,$51.30 ,$42.03 ,$51.30 ,$16.81 ,$57.00 ,$37.34 ,$16.81 ,$23.71 ,$7.35 ,$7.01 ,$17.65 ,$51.30 ,$37.82 ,$35.17 ,$15.96 ,$51.30 ,$16.81 ,$51.30 ,$51.30 ,$16.81 ,$37.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600570,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$122.00 ,$79.30 ,$7.01 ,$122.00 ,$87.73 ,$90.89 ,$79.91 ,$35.09 ,$34.16 ,$61.61 ,$35.09 ,$75.27 ,$35.09 ,$75.27 ,$75.27 ,$35.09 ,$75.27 ,$66.67 ,$109.80 ,$91.50 ,$87.73 ,$35.09 ,$107.36 ,$35.09 ,$91.50 ,$91.50 ,$103.70 ,$103.70 ,$35.09 ,$103.70 ,$35.09 ,$95.16 ,$95.16 ,$95.16 ,$109.80 ,$87.73 ,$109.80 ,$35.09 ,$122.00 ,$79.91 ,$35.09 ,$50.75 ,$7.35 ,$7.01 ,$36.84 ,$109.80 ,$78.95 ,$75.27 ,$34.16 ,$109.80 ,$35.09 ,$109.80 ,$109.80 ,$35.09 ,$79.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600575,87591,HC NEISSERIA AMP,306,1 ,$118.00 ,$76.70 ,$18.59 ,$118.00 ,$87.73 ,$87.91 ,$77.29 ,$35.09 ,$33.04 ,$59.59 ,$35.09 ,$72.81 ,$35.09 ,$72.81 ,$72.81 ,$35.09 ,$72.81 ,$66.67 ,$106.20 ,$88.50 ,$87.73 ,$35.09 ,$103.84 ,$35.09 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$35.09 ,$100.30 ,$35.09 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$87.73 ,$106.20 ,$35.09 ,$118.00 ,$77.29 ,$35.09 ,$49.09 ,$19.47 ,$18.59 ,$36.84 ,$106.20 ,$78.95 ,$72.81 ,$33.04 ,$106.20 ,$35.09 ,$106.20 ,$106.20 ,$35.09 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600584,87905,HC IF AGT ENZYMATIC ACT/OTH VIRUS,306,1 ,$76.00 ,$49.40 ,$12.22 ,$76.00 ,$30.55 ,$56.62 ,$49.78 ,$12.22 ,$21.28 ,$38.38 ,$12.22 ,$46.89 ,$12.22 ,$46.89 ,$46.89 ,$12.22 ,$46.89 ,$23.22 ,$68.40 ,$57.00 ,$30.55 ,$12.22 ,$66.88 ,$12.22 ,$57.00 ,$57.00 ,$64.60 ,$64.60 ,$12.22 ,$64.60 ,$12.22 ,$59.28 ,$59.28 ,$59.28 ,$68.40 ,$30.55 ,$68.40 ,$12.22 ,$76.00 ,$49.78 ,$12.22 ,$31.62 ,$19.47 ,$18.59 ,$12.83 ,$68.40 ,$27.50 ,$46.89 ,$21.28 ,$68.40 ,$12.22 ,$68.40 ,$68.40 ,$12.22 ,$49.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600586,87147,HC CULTURE TYPE SEROLOGIC-91,306,1 ,$15.54 ,$10.10 ,$4.35 ,$15.54 ,$12.95 ,$11.58 ,$10.18 ,$5.18 ,$4.35 ,$7.85 ,$5.18 ,$9.59 ,$5.18 ,$9.59 ,$9.59 ,$5.18 ,$9.59 ,$9.84 ,$13.99 ,$11.66 ,$12.95 ,$5.18 ,$13.68 ,$5.18 ,$11.66 ,$11.66 ,$13.21 ,$13.21 ,$5.18 ,$13.21 ,$5.18 ,$12.12 ,$12.12 ,$12.12 ,$13.99 ,$12.95 ,$13.99 ,$5.18 ,$15.54 ,$10.18 ,$5.18 ,$6.46 ,$5.86 ,$5.60 ,$5.44 ,$13.99 ,$11.66 ,$9.59 ,$4.35 ,$13.99 ,$5.18 ,$13.99 ,$13.99 ,$5.18 ,$10.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600607,87661,HC TRICHOMONAS BAG AMP PROBE,306,1 ,$47.00 ,$30.55 ,$13.16 ,$78.95 ,$47.00 ,$35.02 ,$30.79 ,$35.09 ,$13.16 ,$23.74 ,$35.09 ,$29.00 ,$35.09 ,$29.00 ,$29.00 ,$35.09 ,$29.00 ,$66.67 ,$42.30 ,$35.25 ,$47.00 ,$35.09 ,$41.36 ,$35.09 ,$35.25 ,$35.25 ,$39.95 ,$39.95 ,$35.09 ,$39.95 ,$35.09 ,$36.66 ,$36.66 ,$36.66 ,$42.30 ,$47.00 ,$42.30 ,$35.09 ,$47.00 ,$30.79 ,$35.09 ,$19.55 ,$19.47 ,$18.59 ,$36.84 ,$42.30 ,$78.95 ,$29.00 ,$13.16 ,$42.30 ,$35.09 ,$42.30 ,$42.30 ,$35.09 ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600608,87045,HC STOOL CULTURE -90,306,1 ,$198.00 ,$128.70 ,$5.60 ,$198.00 ,$23.60 ,$147.51 ,$129.69 ,$9.44 ,$55.44 ,$99.99 ,$9.44 ,$122.17 ,$9.44 ,$122.17 ,$122.17 ,$9.44 ,$122.17 ,$17.94 ,$178.20 ,$148.50 ,$23.60 ,$9.44 ,$174.24 ,$9.44 ,$148.50 ,$148.50 ,$168.30 ,$168.30 ,$9.44 ,$168.30 ,$9.44 ,$154.44 ,$154.44 ,$154.44 ,$178.20 ,$23.60 ,$178.20 ,$9.44 ,$198.00 ,$129.69 ,$9.44 ,$82.37 ,$5.86 ,$5.60 ,$9.91 ,$178.20 ,$21.24 ,$122.17 ,$55.44 ,$178.20 ,$9.44 ,$178.20 ,$178.20 ,$9.44 ,$128.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600609,87529,HC HERPES SIMPLEX AMP,306,1 ,$291.00 ,$189.15 ,$18.59 ,$291.00 ,$87.73 ,$216.80 ,$190.61 ,$35.09 ,$81.48 ,$146.96 ,$35.09 ,$179.55 ,$35.09 ,$179.55 ,$179.55 ,$35.09 ,$179.55 ,$66.67 ,$261.90 ,$218.25 ,$87.73 ,$35.09 ,$256.08 ,$35.09 ,$218.25 ,$218.25 ,$247.35 ,$247.35 ,$35.09 ,$247.35 ,$35.09 ,$226.98 ,$226.98 ,$226.98 ,$261.90 ,$87.73 ,$261.90 ,$35.09 ,$291.00 ,$190.61 ,$35.09 ,$121.06 ,$19.47 ,$18.59 ,$36.84 ,$261.90 ,$78.95 ,$179.55 ,$81.48 ,$261.90 ,$35.09 ,$261.90 ,$261.90 ,$35.09 ,$189.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600615,87169,HC PARASITE ID-90,306,1 ,$22.00 ,$14.30 ,$4.31 ,$22.00 ,$10.78 ,$16.39 ,$14.41 ,$4.31 ,$6.16 ,$11.11 ,$4.31 ,$13.57 ,$4.31 ,$13.57 ,$13.57 ,$4.31 ,$13.57 ,$8.19 ,$19.80 ,$16.50 ,$10.78 ,$4.31 ,$19.36 ,$4.31 ,$16.50 ,$16.50 ,$18.70 ,$18.70 ,$4.31 ,$18.70 ,$4.31 ,$17.16 ,$17.16 ,$17.16 ,$19.80 ,$10.78 ,$19.80 ,$4.31 ,$22.00 ,$14.41 ,$4.31 ,$9.15 ,$5.86 ,$5.60 ,$4.53 ,$19.80 ,$9.70 ,$13.57 ,$6.16 ,$19.80 ,$4.31 ,$19.80 ,$19.80 ,$4.31 ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600621,87551,HC MYCOBACTERIA DAN AMP PROBE-90,306,1 ,$180.00 ,$117.00 ,$18.59 ,$180.00 ,$120.60 ,$134.10 ,$117.90 ,$48.24 ,$50.40 ,$90.90 ,$48.24 ,$111.06 ,$48.24 ,$111.06 ,$111.06 ,$48.24 ,$111.06 ,$91.66 ,$162.00 ,$135.00 ,$120.60 ,$48.24 ,$158.40 ,$48.24 ,$135.00 ,$135.00 ,$153.00 ,$153.00 ,$48.24 ,$153.00 ,$48.24 ,$140.40 ,$140.40 ,$140.40 ,$162.00 ,$120.60 ,$162.00 ,$48.24 ,$180.00 ,$117.90 ,$48.24 ,$74.88 ,$19.47 ,$18.59 ,$50.65 ,$162.00 ,$108.54 ,$111.06 ,$50.40 ,$162.00 ,$48.24 ,$162.00 ,$162.00 ,$48.24 ,$117.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600623,87635,HC COVID-19 LAB TEST CDC-90,306,1 ,$458.00 ,$297.70 ,$18.59 ,$458.00 ,$128.28 ,$341.21 ,$299.99 ,$51.31 ,$128.24 ,$231.29 ,$51.31 ,$282.59 ,$51.31 ,$282.59 ,$282.59 ,$51.31 ,$282.59 ,$97.49 ,$412.20 ,$51.31 ,$128.28 ,$51.31 ,$403.04 ,$51.31 ,$343.50 ,$343.50 ,$389.30 ,$389.30 ,$51.31 ,$389.30 ,$51.31 ,$357.24 ,$357.24 ,$357.24 ,$412.20 ,$128.28 ,$412.20 ,$51.31 ,$51.31 ,$299.99 ,$51.31 ,$190.53 ,$19.47 ,$18.59 ,$53.88 ,$412.20 ,$115.45 ,$282.59 ,$128.24 ,$412.20 ,$51.31 ,$412.20 ,$412.20 ,$51.31 ,$297.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600630,87481,HC IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ,306,1 ,$19.00 ,$12.35 ,$5.32 ,$42.75 ,$19.00 ,$14.16 ,$12.45 ,$19.00 ,$5.32 ,$9.60 ,$19.00 ,$11.72 ,$19.00 ,$11.72 ,$11.72 ,$19.00 ,$11.72 ,$36.10 ,$17.10 ,$14.25 ,$19.00 ,$19.00 ,$16.72 ,$19.00 ,$14.25 ,$14.25 ,$16.15 ,$16.15 ,$19.00 ,$16.15 ,$19.00 ,$14.82 ,$14.82 ,$14.82 ,$17.10 ,$19.00 ,$17.10 ,$19.00 ,$19.00 ,$12.45 ,$19.00 ,$7.90 ,$7.35 ,$7.01 ,$19.00 ,$17.10 ,$42.75 ,$11.72 ,$5.32 ,$17.10 ,$19.00 ,$17.10 ,$17.10 ,$19.00 ,$12.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600631,87563,HC IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH,306,1 ,$36.00 ,$23.40 ,$10.08 ,$78.95 ,$36.00 ,$26.82 ,$23.58 ,$35.09 ,$10.08 ,$18.18 ,$35.09 ,$22.21 ,$35.09 ,$22.21 ,$22.21 ,$35.09 ,$22.21 ,$66.67 ,$32.40 ,$27.00 ,$36.00 ,$35.09 ,$31.68 ,$35.09 ,$27.00 ,$27.00 ,$30.60 ,$30.60 ,$35.09 ,$30.60 ,$35.09 ,$28.08 ,$28.08 ,$28.08 ,$32.40 ,$36.00 ,$32.40 ,$35.09 ,$36.00 ,$23.58 ,$35.09 ,$14.98 ,$19.47 ,$18.59 ,$36.00 ,$32.40 ,$78.95 ,$22.21 ,$10.08 ,$32.40 ,$35.09 ,$32.40 ,$32.40 ,$35.09 ,$23.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600632,87801,HC IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,306,1 ,$27.00 ,$17.55 ,$5.60 ,$60.75 ,$27.00 ,$20.12 ,$17.69 ,$27.00 ,$7.56 ,$13.64 ,$27.00 ,$16.66 ,$27.00 ,$16.66 ,$16.66 ,$27.00 ,$16.66 ,$51.30 ,$24.30 ,$20.25 ,$27.00 ,$27.00 ,$23.76 ,$27.00 ,$20.25 ,$20.25 ,$22.95 ,$22.95 ,$27.00 ,$22.95 ,$27.00 ,$21.06 ,$21.06 ,$21.06 ,$24.30 ,$27.00 ,$24.30 ,$27.00 ,$27.00 ,$17.69 ,$27.00 ,$11.23 ,$5.86 ,$5.60 ,$27.00 ,$24.30 ,$60.75 ,$16.66 ,$7.56 ,$24.30 ,$27.00 ,$24.30 ,$24.30 ,$27.00 ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600633,87168,HC TICK AND OTHER ANTROPODS- 90,306,1 ,$22.00 ,$14.30 ,$4.27 ,$22.00 ,$10.68 ,$16.39 ,$14.41 ,$4.27 ,$6.16 ,$11.11 ,$4.27 ,$13.57 ,$4.27 ,$13.57 ,$13.57 ,$4.27 ,$13.57 ,$8.11 ,$19.80 ,$16.50 ,$10.68 ,$4.27 ,$19.36 ,$4.27 ,$16.50 ,$16.50 ,$18.70 ,$18.70 ,$4.27 ,$18.70 ,$4.27 ,$17.16 ,$17.16 ,$17.16 ,$19.80 ,$10.68 ,$19.80 ,$4.27 ,$22.00 ,$14.41 ,$4.27 ,$9.15 ,$5.86 ,$5.60 ,$4.48 ,$19.80 ,$9.61 ,$13.57 ,$6.16 ,$19.80 ,$4.27 ,$19.80 ,$19.80 ,$4.27 ,$14.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$125.00 ,$81.25 ,$5.60 ,$125.00 ,$103.45 ,$93.13 ,$81.88 ,$41.38 ,$35.00 ,$63.13 ,$41.38 ,$77.13 ,$41.38 ,$77.13 ,$77.13 ,$41.38 ,$77.13 ,$78.62 ,$112.50 ,$41.38 ,$103.45 ,$41.38 ,$110.00 ,$41.38 ,$93.75 ,$93.75 ,$106.25 ,$106.25 ,$41.38 ,$106.25 ,$41.38 ,$97.50 ,$97.50 ,$97.50 ,$112.50 ,$103.45 ,$112.50 ,$41.38 ,$125.00 ,$81.88 ,$41.38 ,$52.00 ,$5.86 ,$5.60 ,$43.45 ,$112.50 ,$93.11 ,$77.13 ,$35.00 ,$112.50 ,$41.38 ,$112.50 ,$112.50 ,$41.38 ,$81.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600637,87635,HC COVID-19 LAB PCR TEST,306,1 ,$458.00 ,$297.70 ,$18.59 ,$458.00 ,$128.28 ,$341.21 ,$299.99 ,$51.31 ,$128.24 ,$231.29 ,$51.31 ,$282.59 ,$51.31 ,$282.59 ,$282.59 ,$51.31 ,$282.59 ,$97.49 ,$412.20 ,$51.31 ,$128.28 ,$51.31 ,$403.04 ,$51.31 ,$343.50 ,$343.50 ,$389.30 ,$389.30 ,$51.31 ,$389.30 ,$51.31 ,$357.24 ,$357.24 ,$357.24 ,$412.20 ,$128.28 ,$412.20 ,$51.31 ,$51.31 ,$299.99 ,$51.31 ,$190.53 ,$19.47 ,$18.59 ,$53.88 ,$412.20 ,$115.45 ,$282.59 ,$128.24 ,$412.20 ,$51.31 ,$412.20 ,$412.20 ,$51.31 ,$297.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30600638,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION - 90,306,1 ,$86.00 ,$55.90 ,$18.59 ,$115.45 ,$86.00 ,$64.07 ,$56.33 ,$51.31 ,$24.08 ,$43.43 ,$51.31 ,$53.06 ,$51.31 ,$53.06 ,$53.06 ,$51.31 ,$53.06 ,$97.49 ,$77.40 ,$51.31 ,$86.00 ,$51.31 ,$75.68 ,$51.31 ,$64.50 ,$64.50 ,$73.10 ,$73.10 ,$51.31 ,$73.10 ,$51.31 ,$67.08 ,$67.08 ,$67.08 ,$77.40 ,$86.00 ,$77.40 ,$51.31 ,$51.31 ,$56.33 ,$51.31 ,$35.78 ,$19.47 ,$18.59 ,$53.88 ,$77.40 ,$115.45 ,$53.06 ,$24.08 ,$77.40 ,$51.31 ,$77.40 ,$77.40 ,$51.31 ,$55.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682010,87635,HC COVID-19 LAB TEST NON-CDC-90,306,1 ,$458.00 ,$297.70 ,$18.59 ,$458.00 ,$128.28 ,$341.21 ,$299.99 ,$51.31 ,$128.24 ,$231.29 ,$51.31 ,$282.59 ,$51.31 ,$282.59 ,$282.59 ,$51.31 ,$282.59 ,$97.49 ,$412.20 ,$51.31 ,$128.28 ,$51.31 ,$403.04 ,$51.31 ,$343.50 ,$343.50 ,$389.30 ,$389.30 ,$51.31 ,$389.30 ,$51.31 ,$357.24 ,$357.24 ,$357.24 ,$412.20 ,$128.28 ,$412.20 ,$51.31 ,$51.31 ,$299.99 ,$51.31 ,$190.53 ,$19.47 ,$18.59 ,$53.88 ,$412.20 ,$115.45 ,$282.59 ,$128.24 ,$412.20 ,$51.31 ,$412.20 ,$412.20 ,$51.31 ,$297.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682012,87635,HC COVID-19 LAB TEST,306,1 ,$398.00 ,$258.70 ,$18.59 ,$398.00 ,$128.28 ,$296.51 ,$260.69 ,$51.31 ,$111.44 ,$200.99 ,$51.31 ,$245.57 ,$51.31 ,$245.57 ,$245.57 ,$51.31 ,$245.57 ,$97.49 ,$358.20 ,$51.31 ,$128.28 ,$51.31 ,$350.24 ,$51.31 ,$298.50 ,$298.50 ,$338.30 ,$338.30 ,$51.31 ,$338.30 ,$51.31 ,$310.44 ,$310.44 ,$310.44 ,$358.20 ,$128.28 ,$358.20 ,$51.31 ,$51.31 ,$260.69 ,$51.31 ,$165.57 ,$19.47 ,$18.59 ,$53.88 ,$358.20 ,$115.45 ,$245.57 ,$111.44 ,$358.20 ,$51.31 ,$358.20 ,$358.20 ,$51.31 ,$258.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682013,87635,HC COVID-19 LAB TEST,306,1 ,$75.00 ,$48.75 ,$18.59 ,$115.45 ,$75.00 ,$55.88 ,$49.13 ,$51.31 ,$21.00 ,$37.88 ,$51.31 ,$46.28 ,$51.31 ,$46.28 ,$46.28 ,$51.31 ,$46.28 ,$97.49 ,$67.50 ,$51.31 ,$75.00 ,$51.31 ,$66.00 ,$51.31 ,$56.25 ,$56.25 ,$63.75 ,$63.75 ,$51.31 ,$63.75 ,$51.31 ,$58.50 ,$58.50 ,$58.50 ,$67.50 ,$75.00 ,$67.50 ,$51.31 ,$51.31 ,$49.13 ,$51.31 ,$31.20 ,$19.47 ,$18.59 ,$53.88 ,$67.50 ,$115.45 ,$46.28 ,$21.00 ,$67.50 ,$51.31 ,$67.50 ,$67.50 ,$51.31 ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682015,86769,HC SARS-COV-2 COVID-19 ANTIBODY-90,306,1 ,$260.00 ,$169.00 ,$7.01 ,$260.00 ,$105.33 ,$193.70 ,$170.30 ,$42.13 ,$72.80 ,$131.30 ,$42.13 ,$160.42 ,$42.13 ,$160.42 ,$160.42 ,$42.13 ,$160.42 ,$80.05 ,$234.00 ,$42.13 ,$105.33 ,$42.13 ,$228.80 ,$42.13 ,$195.00 ,$195.00 ,$221.00 ,$221.00 ,$42.13 ,$221.00 ,$42.13 ,$202.80 ,$202.80 ,$202.80 ,$234.00 ,$105.33 ,$234.00 ,$42.13 ,$260.00 ,$170.30 ,$42.13 ,$108.16 ,$7.35 ,$7.01 ,$44.24 ,$234.00 ,$94.79 ,$160.42 ,$72.80 ,$234.00 ,$42.13 ,$234.00 ,$234.00 ,$42.13 ,$169.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682022,87102,HC CULTURE FUNGUS OTHER-90,306,1 ,$30.00 ,$19.50 ,$5.60 ,$30.00 ,$21.03 ,$22.35 ,$19.65 ,$8.41 ,$8.40 ,$15.15 ,$8.41 ,$18.51 ,$8.41 ,$18.51 ,$18.51 ,$8.41 ,$18.51 ,$15.98 ,$27.00 ,$22.50 ,$21.03 ,$8.41 ,$26.40 ,$8.41 ,$22.50 ,$22.50 ,$25.50 ,$25.50 ,$8.41 ,$25.50 ,$8.41 ,$23.40 ,$23.40 ,$23.40 ,$27.00 ,$21.03 ,$27.00 ,$8.41 ,$30.00 ,$19.65 ,$8.41 ,$12.48 ,$5.86 ,$5.60 ,$8.83 ,$27.00 ,$18.92 ,$18.51 ,$8.40 ,$27.00 ,$8.41 ,$27.00 ,$27.00 ,$8.41 ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682024,87635,HC SARS-COV-2 COVID-19 TEST,306,1 ,$86.00 ,$55.90 ,$18.59 ,$115.45 ,$86.00 ,$64.07 ,$56.33 ,$51.31 ,$24.08 ,$43.43 ,$51.31 ,$53.06 ,$51.31 ,$53.06 ,$53.06 ,$51.31 ,$53.06 ,$97.49 ,$77.40 ,$51.31 ,$86.00 ,$51.31 ,$75.68 ,$51.31 ,$64.50 ,$64.50 ,$73.10 ,$73.10 ,$51.31 ,$73.10 ,$51.31 ,$67.08 ,$67.08 ,$67.08 ,$77.40 ,$86.00 ,$77.40 ,$51.31 ,$51.31 ,$56.33 ,$51.31 ,$35.78 ,$19.47 ,$18.59 ,$53.88 ,$77.40 ,$115.45 ,$53.06 ,$24.08 ,$77.40 ,$51.31 ,$77.40 ,$77.40 ,$51.31 ,$55.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682025,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION,306,1 ,$86.00 ,$55.90 ,$18.59 ,$115.45 ,$86.00 ,$64.07 ,$56.33 ,$51.31 ,$24.08 ,$43.43 ,$51.31 ,$53.06 ,$51.31 ,$53.06 ,$53.06 ,$51.31 ,$53.06 ,$97.49 ,$77.40 ,$51.31 ,$86.00 ,$51.31 ,$75.68 ,$51.31 ,$64.50 ,$64.50 ,$73.10 ,$73.10 ,$51.31 ,$73.10 ,$51.31 ,$67.08 ,$67.08 ,$67.08 ,$77.40 ,$86.00 ,$77.40 ,$51.31 ,$51.31 ,$56.33 ,$51.31 ,$35.78 ,$19.47 ,$18.59 ,$53.88 ,$77.40 ,$115.45 ,$53.06 ,$24.08 ,$77.40 ,$51.31 ,$77.40 ,$77.40 ,$51.31 ,$55.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30682028,87102,HC FUNGUS ISOLATION CULTURE-90,306,1 ,$308.00 ,$200.20 ,$5.60 ,$308.00 ,$21.03 ,$229.46 ,$201.74 ,$8.41 ,$86.24 ,$155.54 ,$8.41 ,$190.04 ,$8.41 ,$190.04 ,$190.04 ,$8.41 ,$190.04 ,$15.98 ,$277.20 ,$231.00 ,$21.03 ,$8.41 ,$271.04 ,$8.41 ,$231.00 ,$231.00 ,$261.80 ,$261.80 ,$8.41 ,$261.80 ,$8.41 ,$240.24 ,$240.24 ,$240.24 ,$277.20 ,$21.03 ,$277.20 ,$8.41 ,$308.00 ,$201.74 ,$8.41 ,$128.13 ,$5.86 ,$5.60 ,$8.83 ,$277.20 ,$18.92 ,$190.04 ,$86.24 ,$277.20 ,$8.41 ,$277.20 ,$277.20 ,$8.41 ,$200.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30700121,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$77.00 ,$50.05 ,$2.79 ,$77.00 ,$7.93 ,$57.37 ,$50.44 ,$3.17 ,$21.56 ,$38.89 ,$3.17 ,$47.51 ,$3.17 ,$47.51 ,$47.51 ,$3.17 ,$47.51 ,$6.02 ,$69.30 ,$57.75 ,$7.93 ,$3.17 ,$67.76 ,$3.17 ,$57.75 ,$57.75 ,$65.45 ,$65.45 ,$3.17 ,$65.45 ,$3.17 ,$60.06 ,$60.06 ,$60.06 ,$69.30 ,$7.93 ,$69.30 ,$3.17 ,$3.17 ,$50.44 ,$3.17 ,$32.03 ,$2.93 ,$2.79 ,$3.33 ,$69.30 ,$7.13 ,$47.51 ,$21.56 ,$69.30 ,$3.17 ,$69.30 ,$69.30 ,$3.17 ,$50.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30700125,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$47.00 ,$30.55 ,$1.76 ,$47.00 ,$5.63 ,$35.02 ,$30.79 ,$2.25 ,$13.16 ,$23.74 ,$2.25 ,$29.00 ,$2.25 ,$29.00 ,$29.00 ,$2.25 ,$29.00 ,$4.28 ,$42.30 ,$35.25 ,$5.63 ,$2.25 ,$41.36 ,$2.25 ,$35.25 ,$35.25 ,$39.95 ,$39.95 ,$2.25 ,$39.95 ,$2.25 ,$36.66 ,$36.66 ,$36.66 ,$42.30 ,$5.63 ,$42.30 ,$2.25 ,$47.00 ,$30.79 ,$2.25 ,$19.55 ,$1.85 ,$1.76 ,$2.36 ,$42.30 ,$5.06 ,$29.00 ,$13.16 ,$42.30 ,$2.25 ,$42.30 ,$42.30 ,$2.25 ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30700127,81005,HC URINALYSIS QL/SEMI QN -90,307,1 ,$45.00 ,$29.25 ,$2.17 ,$45.00 ,$5.43 ,$33.53 ,$29.48 ,$2.17 ,$12.60 ,$22.73 ,$2.17 ,$27.77 ,$2.17 ,$27.77 ,$27.77 ,$2.17 ,$27.77 ,$4.12 ,$40.50 ,$33.75 ,$5.43 ,$2.17 ,$39.60 ,$2.17 ,$33.75 ,$33.75 ,$38.25 ,$38.25 ,$2.17 ,$38.25 ,$2.17 ,$35.10 ,$35.10 ,$35.10 ,$40.50 ,$5.43 ,$40.50 ,$2.17 ,$45.00 ,$29.48 ,$2.17 ,$18.72 ,$2.93 ,$2.79 ,$2.28 ,$40.50 ,$4.88 ,$27.77 ,$12.60 ,$40.50 ,$2.17 ,$40.50 ,$40.50 ,$2.17 ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30700128,81025,HC URINE PREGNANCY TEST,307,1 ,$109.00 ,$70.85 ,$2.79 ,$109.00 ,$21.53 ,$81.21 ,$71.40 ,$8.61 ,$30.52 ,$55.05 ,$8.61 ,$67.25 ,$8.61 ,$67.25 ,$67.25 ,$8.61 ,$67.25 ,$16.36 ,$98.10 ,$81.75 ,$21.53 ,$8.61 ,$95.92 ,$8.61 ,$81.75 ,$81.75 ,$92.65 ,$92.65 ,$8.61 ,$92.65 ,$8.61 ,$85.02 ,$85.02 ,$85.02 ,$98.10 ,$21.53 ,$98.10 ,$8.61 ,$8.61 ,$71.40 ,$8.61 ,$45.34 ,$2.93 ,$2.79 ,$9.04 ,$98.10 ,$19.37 ,$67.25 ,$30.52 ,$98.10 ,$8.61 ,$98.10 ,$98.10 ,$8.61 ,$70.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30700129,81025,HC URINE PREGNANCY TEST,307,1 ,$109.00 ,$70.85 ,$2.79 ,$109.00 ,$21.53 ,$81.21 ,$71.40 ,$8.61 ,$30.52 ,$55.05 ,$8.61 ,$67.25 ,$8.61 ,$67.25 ,$67.25 ,$8.61 ,$67.25 ,$16.36 ,$98.10 ,$81.75 ,$21.53 ,$8.61 ,$95.92 ,$8.61 ,$81.75 ,$81.75 ,$92.65 ,$92.65 ,$8.61 ,$92.65 ,$8.61 ,$85.02 ,$85.02 ,$85.02 ,$98.10 ,$21.53 ,$98.10 ,$8.61 ,$8.61 ,$71.40 ,$8.61 ,$45.34 ,$2.93 ,$2.79 ,$9.04 ,$98.10 ,$19.37 ,$67.25 ,$30.52 ,$98.10 ,$8.61 ,$98.10 ,$98.10 ,$8.61 ,$70.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),30700133,81002,HC URINALYSIS NON AUTO W/O MICRO-QW,307,1 ,$45.00 ,$29.25 ,$1.76 ,$45.00 ,$8.70 ,$33.53 ,$29.48 ,$3.48 ,$12.60 ,$22.73 ,$3.48 ,$27.77 ,$3.48 ,$27.77 ,$27.77 ,$3.48 ,$27.77 ,$6.61 ,$40.50 ,$33.75 ,$8.70 ,$3.48 ,$39.60 ,$3.48 ,$33.75 ,$33.75 ,$38.25 ,$38.25 ,$3.48 ,$38.25 ,$3.48 ,$35.10 ,$35.10 ,$35.10 ,$40.50 ,$8.70 ,$40.50 ,$3.48 ,$45.00 ,$29.48 ,$3.48 ,$18.72 ,$1.85 ,$1.76 ,$3.65 ,$40.50 ,$7.83 ,$27.77 ,$12.60 ,$40.50 ,$3.48 ,$40.50 ,$40.50 ,$3.48 ,$29.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000125,80500,HC CLINAL PATH CONSULT LTD -90,310,1 ,$125.20 ,$81.38 ,$35.06 ,$125.20 , N/A ,$93.27 ,$82.01 , N/A ,$35.06 ,$63.23 , N/A ,$77.25 , N/A ,$77.25 ,$77.25 , N/A ,$77.25 , N/A ,$112.68 ,$93.90 , N/A , N/A ,$110.18 , N/A ,$93.90 ,$93.90 ,$106.42 ,$106.42 , N/A ,$106.42 , N/A ,$97.66 ,$97.66 ,$97.66 ,$112.68 , N/A ,$112.68 , N/A ,$125.20 ,$82.01 , N/A ,$52.08 , N/A , N/A , N/A ,$112.68 , N/A ,$77.25 ,$35.06 ,$112.68 , N/A ,$112.68 ,$112.68 , N/A ,$81.38 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000127,80500,HC CLINAL PATH CONSULT LTD,310,1 ,$922.00 ,$599.30 ,$258.16 ,$922.00 , N/A ,$686.89 ,$603.91 , N/A ,$258.16 ,$465.61 , N/A ,$568.87 , N/A ,$568.87 ,$568.87 , N/A ,$568.87 , N/A ,$829.80 ,$691.50 , N/A , N/A ,$811.36 , N/A ,$691.50 ,$691.50 ,$783.70 ,$783.70 , N/A ,$783.70 , N/A ,$719.16 ,$719.16 ,$719.16 ,$829.80 , N/A ,$829.80 , N/A ,$922.00 ,$603.91 , N/A ,$383.55 , N/A , N/A , N/A ,$829.80 , N/A ,$568.87 ,$258.16 ,$829.80 , N/A ,$829.80 ,$829.80 , N/A ,$599.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000128,81162,HC BRCA1  AND  BRCA2 FULL SEQ/DUPE/DEL ANALYSIS -90,310,1 ,"$4,361.00 ","$2,834.65 ",$256.79 ,"$4,361.00 ","$4,361.00 ","$3,248.95 ","$2,856.46 ","$1,824.88 ","$1,221.08 ","$2,202.31 ","$1,824.88 ","$2,690.74 ","$1,824.88 ","$2,690.74 ","$2,690.74 ","$1,824.88 ","$2,690.74 ","$3,467.27 ","$3,924.90 ","$3,270.75 ","$4,361.00 ","$1,824.88 ","$3,837.68 ","$1,824.88 ","$3,270.75 ","$3,270.75 ","$3,706.85 ","$3,706.85 ","$1,824.88 ","$3,706.85 ","$1,824.88 ","$3,401.58 ","$3,401.58 ","$3,401.58 ","$3,924.90 ","$4,361.00 ","$3,924.90 ","$1,824.88 ","$4,361.00 ","$2,856.46 ","$1,824.88 ","$1,814.18 ",$269.02 ,$256.79 ,"$1,916.12 ","$3,924.90 ","$4,105.98 ","$2,690.74 ","$1,221.08 ","$3,924.90 ","$1,824.88 ","$3,924.90 ","$3,924.90 ","$1,824.88 ","$2,834.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$858.48 ,$558.01 ,$90.49 ,$858.48 ,$409.90 ,$639.57 ,$562.30 ,$163.96 ,$240.37 ,$433.53 ,$163.96 ,$529.68 ,$163.96 ,$529.68 ,$529.68 ,$163.96 ,$529.68 ,$311.52 ,$772.63 ,$643.86 ,$409.90 ,$163.96 ,$755.46 ,$163.96 ,$643.86 ,$643.86 ,$729.71 ,$729.71 ,$163.96 ,$729.71 ,$163.96 ,$669.61 ,$669.61 ,$669.61 ,$772.63 ,$409.90 ,$772.63 ,$163.96 ,$858.48 ,$562.30 ,$163.96 ,$357.13 ,$94.80 ,$90.49 ,$172.16 ,$772.63 ,$368.91 ,$529.68 ,$240.37 ,$772.63 ,$163.96 ,$772.63 ,$772.63 ,$163.96 ,$558.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$494.00 ,$321.10 ,$90.49 ,$494.00 ,$362.10 ,$368.03 ,$323.57 ,$144.84 ,$138.32 ,$249.47 ,$144.84 ,$304.80 ,$144.84 ,$304.80 ,$304.80 ,$144.84 ,$304.80 ,$275.20 ,$444.60 ,$370.50 ,$362.10 ,$144.84 ,$434.72 ,$144.84 ,$370.50 ,$370.50 ,$419.90 ,$419.90 ,$144.84 ,$419.90 ,$144.84 ,$385.32 ,$385.32 ,$385.32 ,$444.60 ,$362.10 ,$444.60 ,$144.84 ,$494.00 ,$323.57 ,$144.84 ,$205.50 ,$94.80 ,$90.49 ,$152.08 ,$444.60 ,$325.89 ,$304.80 ,$138.32 ,$444.60 ,$144.84 ,$444.60 ,$444.60 ,$144.84 ,$321.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000132,81207,HC BCR/ABL1 GENE MINOR BP MONITOR -90,310,1 ,$150.00 ,$97.50 ,$42.00 ,$325.89 ,$150.00 ,$111.75 ,$98.25 ,$144.84 ,$42.00 ,$75.75 ,$144.84 ,$92.55 ,$144.84 ,$92.55 ,$92.55 ,$144.84 ,$92.55 ,$275.20 ,$135.00 ,$112.50 ,$150.00 ,$144.84 ,$132.00 ,$144.84 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$144.84 ,$127.50 ,$144.84 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$150.00 ,$135.00 ,$144.84 ,$150.00 ,$98.25 ,$144.84 ,$62.40 ,$94.80 ,$90.49 ,$150.00 ,$135.00 ,$325.89 ,$92.55 ,$42.00 ,$135.00 ,$144.84 ,$135.00 ,$135.00 ,$144.84 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000133,81208,HC BCR/ABL1 GENE OTH BP QL/QN-90,310,1 ,$606.00 ,$393.90 ,$90.49 ,$606.00 ,$536.55 ,$451.47 ,$396.93 ,$214.62 ,$169.68 ,$306.03 ,$214.62 ,$373.90 ,$214.62 ,$373.90 ,$373.90 ,$214.62 ,$373.90 ,$407.78 ,$545.40 ,$454.50 ,$536.55 ,$214.62 ,$533.28 ,$214.62 ,$454.50 ,$454.50 ,$515.10 ,$515.10 ,$214.62 ,$515.10 ,$214.62 ,$472.68 ,$472.68 ,$472.68 ,$545.40 ,$536.55 ,$545.40 ,$214.62 ,$606.00 ,$396.93 ,$214.62 ,$252.10 ,$94.80 ,$90.49 ,$225.35 ,$545.40 ,$482.90 ,$373.90 ,$169.68 ,$545.40 ,$214.62 ,$545.40 ,$545.40 ,$214.62 ,$393.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,"$1,159.00 ",$753.35 ,$27.79 ,"$1,252.35 ","$1,159.00 ",$863.46 ,$759.15 ,$556.60 ,$324.52 ,$585.30 ,$556.60 ,$715.10 ,$556.60 ,$715.10 ,$715.10 ,$556.60 ,$715.10 ,"$1,057.54 ","$1,043.10 ",$869.25 ,"$1,159.00 ",$556.60 ,"$1,019.92 ",$556.60 ,$869.25 ,$869.25 ,$985.15 ,$985.15 ,$556.60 ,$985.15 ,$556.60 ,$904.02 ,$904.02 ,$904.02 ,"$1,043.10 ","$1,159.00 ","$1,043.10 ",$556.60 ,"$1,159.00 ",$759.15 ,$556.60 ,$482.14 ,$29.12 ,$27.79 ,$584.43 ,"$1,043.10 ","$1,252.35 ",$715.10 ,$324.52 ,"$1,043.10 ",$556.60 ,"$1,043.10 ","$1,043.10 ",$556.60 ,$753.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000139,81229,HC CYTOGENOMIC MICROARRY ASSAY-90,310,1 ,"$3,968.00 ","$2,579.20 ",$256.79 ,"$3,968.00 ","$2,900.00 ","$2,956.16 ","$2,599.04 ","$1,160.00 ","$1,111.04 ","$2,003.84 ","$1,160.00 ","$2,448.26 ","$1,160.00 ","$2,448.26 ","$2,448.26 ","$1,160.00 ","$2,448.26 ","$2,204.00 ","$3,571.20 ","$2,976.00 ","$2,900.00 ","$1,160.00 ","$3,491.84 ","$1,160.00 ","$2,976.00 ","$2,976.00 ","$3,372.80 ","$3,372.80 ","$1,160.00 ","$3,372.80 ","$1,160.00 ","$3,095.04 ","$3,095.04 ","$3,095.04 ","$3,571.20 ","$2,900.00 ","$3,571.20 ","$1,160.00 ","$3,968.00 ","$2,599.04 ","$1,160.00 ","$1,650.69 ",$269.02 ,$256.79 ,"$1,218.00 ","$3,571.20 ","$2,610.00 ","$2,448.26 ","$1,111.04 ","$3,571.20 ","$1,160.00 ","$3,571.20 ","$3,571.20 ","$1,160.00 ","$2,579.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000140,81225,HC CYP2C19 GENE ANYL COMMON VARIANTS-90,310,1 ,$600.00 ,$390.00 ,$90.49 ,$655.56 ,$600.00 ,$447.00 ,$393.00 ,$291.36 ,$168.00 ,$303.00 ,$291.36 ,$370.20 ,$291.36 ,$370.20 ,$370.20 ,$291.36 ,$370.20 ,$553.58 ,$540.00 ,$450.00 ,$600.00 ,$291.36 ,$528.00 ,$291.36 ,$450.00 ,$450.00 ,$510.00 ,$510.00 ,$291.36 ,$510.00 ,$291.36 ,$468.00 ,$468.00 ,$468.00 ,$540.00 ,$600.00 ,$540.00 ,$291.36 ,$600.00 ,$393.00 ,$291.36 ,$249.60 ,$94.80 ,$90.49 ,$305.93 ,$540.00 ,$655.56 ,$370.20 ,$168.00 ,$540.00 ,$291.36 ,$540.00 ,$540.00 ,$291.36 ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$405.00 ,$263.25 ,$27.79 ,$405.00 ,$164.23 ,$301.73 ,$265.28 ,$65.69 ,$113.40 ,$204.53 ,$65.69 ,$249.89 ,$65.69 ,$249.89 ,$249.89 ,$65.69 ,$249.89 ,$124.81 ,$364.50 ,$303.75 ,$164.23 ,$65.69 ,$356.40 ,$65.69 ,$303.75 ,$303.75 ,$344.25 ,$344.25 ,$65.69 ,$344.25 ,$65.69 ,$315.90 ,$315.90 ,$315.90 ,$364.50 ,$164.23 ,$364.50 ,$65.69 ,$405.00 ,$265.28 ,$65.69 ,$168.48 ,$29.12 ,$27.79 ,$68.97 ,$364.50 ,$147.80 ,$249.89 ,$113.40 ,$364.50 ,$65.69 ,$364.50 ,$364.50 ,$65.69 ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$468.00 ,$304.20 ,$27.79 ,$468.00 ,$183.43 ,$348.66 ,$306.54 ,$73.37 ,$131.04 ,$236.34 ,$73.37 ,$288.76 ,$73.37 ,$288.76 ,$288.76 ,$73.37 ,$288.76 ,$139.40 ,$421.20 ,$351.00 ,$183.43 ,$73.37 ,$411.84 ,$73.37 ,$351.00 ,$351.00 ,$397.80 ,$397.80 ,$73.37 ,$397.80 ,$73.37 ,$365.04 ,$365.04 ,$365.04 ,$421.20 ,$183.43 ,$421.20 ,$73.37 ,$468.00 ,$306.54 ,$73.37 ,$194.69 ,$29.12 ,$27.79 ,$77.04 ,$421.20 ,$165.08 ,$288.76 ,$131.04 ,$421.20 ,$73.37 ,$421.20 ,$421.20 ,$73.37 ,$304.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000149,81256,HC HFE GENE ANALYSIS -90,310,1 ,$465.00 ,$302.25 ,$27.79 ,$465.00 ,$163.40 ,$346.43 ,$304.58 ,$65.36 ,$130.20 ,$234.83 ,$65.36 ,$286.91 ,$65.36 ,$286.91 ,$286.91 ,$65.36 ,$286.91 ,$124.18 ,$418.50 ,$348.75 ,$163.40 ,$65.36 ,$409.20 ,$65.36 ,$348.75 ,$348.75 ,$395.25 ,$395.25 ,$65.36 ,$395.25 ,$65.36 ,$362.70 ,$362.70 ,$362.70 ,$418.50 ,$163.40 ,$418.50 ,$65.36 ,$465.00 ,$304.58 ,$65.36 ,$193.44 ,$29.12 ,$27.79 ,$68.63 ,$418.50 ,$147.06 ,$286.91 ,$130.20 ,$418.50 ,$65.36 ,$418.50 ,$418.50 ,$65.36 ,$302.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000150,81257,HC HBA1/HBA2 GENE ANALYSIS COM DELETE OR VARIANTS -90,310,1 ,$690.00 ,$448.50 ,$27.79 ,$690.00 , N/A ,$514.05 ,$451.95 , N/A ,$193.20 ,$348.45 , N/A ,$425.73 , N/A ,$425.73 ,$425.73 , N/A ,$425.73 , N/A ,$621.00 ,$517.50 , N/A , N/A ,$607.20 , N/A ,$517.50 ,$517.50 ,$586.50 ,$586.50 , N/A ,$586.50 , N/A ,$538.20 ,$538.20 ,$538.20 ,$621.00 , N/A ,$621.00 , N/A ,$690.00 ,$451.95 , N/A ,$287.04 ,$29.12 ,$27.79 , N/A ,$621.00 , N/A ,$425.73 ,$193.20 ,$621.00 , N/A ,$621.00 ,$621.00 , N/A ,$448.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,$651.00 ,$423.15 ,$27.79 ,$651.00 ,$229.15 ,$485.00 ,$426.41 ,$91.66 ,$182.28 ,$328.76 ,$91.66 ,$401.67 ,$91.66 ,$401.67 ,$401.67 ,$91.66 ,$401.67 ,$174.15 ,$585.90 ,$488.25 ,$229.15 ,$91.66 ,$572.88 ,$91.66 ,$488.25 ,$488.25 ,$553.35 ,$553.35 ,$91.66 ,$553.35 ,$91.66 ,$507.78 ,$507.78 ,$507.78 ,$585.90 ,$229.15 ,$585.90 ,$91.66 ,$651.00 ,$426.41 ,$91.66 ,$270.82 ,$29.12 ,$27.79 ,$96.24 ,$585.90 ,$206.24 ,$401.67 ,$182.28 ,$585.90 ,$91.66 ,$585.90 ,$585.90 ,$91.66 ,$423.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$172.00 ,$111.80 ,$27.79 ,$172.00 ,$163.35 ,$128.14 ,$112.66 ,$65.34 ,$48.16 ,$86.86 ,$65.34 ,$106.12 ,$65.34 ,$106.12 ,$106.12 ,$65.34 ,$106.12 ,$124.15 ,$154.80 ,$129.00 ,$163.35 ,$65.34 ,$151.36 ,$65.34 ,$129.00 ,$129.00 ,$146.20 ,$146.20 ,$65.34 ,$146.20 ,$65.34 ,$134.16 ,$134.16 ,$134.16 ,$154.80 ,$163.35 ,$154.80 ,$65.34 ,$172.00 ,$112.66 ,$65.34 ,$71.55 ,$29.12 ,$27.79 ,$68.61 ,$154.80 ,$147.02 ,$106.12 ,$48.16 ,$154.80 ,$65.34 ,$154.80 ,$154.80 ,$65.34 ,$111.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000162,81299,HC MLH2 GENE FAMILIAL VARIANT-90,310,1 ,"$3,450.00 ","$2,242.50 ",$90.49 ,"$3,450.00 ",$770.00 ,"$2,570.25 ","$2,259.75 ",$308.00 ,$966.00 ,"$1,742.25 ",$308.00 ,"$2,128.65 ",$308.00 ,"$2,128.65 ","$2,128.65 ",$308.00 ,"$2,128.65 ",$585.20 ,"$3,105.00 ","$2,587.50 ",$770.00 ,$308.00 ,"$3,036.00 ",$308.00 ,"$2,587.50 ","$2,587.50 ","$2,932.50 ","$2,932.50 ",$308.00 ,"$2,932.50 ",$308.00 ,"$2,691.00 ","$2,691.00 ","$2,691.00 ","$3,105.00 ",$770.00 ,"$3,105.00 ",$308.00 ,"$3,450.00 ","$2,259.75 ",$308.00 ,"$1,435.20 ",$94.80 ,$90.49 ,$323.40 ,"$3,105.00 ",$693.00 ,"$2,128.65 ",$966.00 ,"$3,105.00 ",$308.00 ,"$3,105.00 ","$3,105.00 ",$308.00 ,"$2,242.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000171,81332,HC SERPINA 1 GENE ANALYSIS-90,310,1 ,$310.00 ,$201.50 ,$27.79 ,$310.00 ,$109.13 ,$230.95 ,$203.05 ,$43.65 ,$86.80 ,$156.55 ,$43.65 ,$191.27 ,$43.65 ,$191.27 ,$191.27 ,$43.65 ,$191.27 ,$82.94 ,$279.00 ,$232.50 ,$109.13 ,$43.65 ,$272.80 ,$43.65 ,$232.50 ,$232.50 ,$263.50 ,$263.50 ,$43.65 ,$263.50 ,$43.65 ,$241.80 ,$241.80 ,$241.80 ,$279.00 ,$109.13 ,$279.00 ,$43.65 ,$310.00 ,$203.05 ,$43.65 ,$128.96 ,$29.12 ,$27.79 ,$45.83 ,$279.00 ,$98.21 ,$191.27 ,$86.80 ,$279.00 ,$43.65 ,$279.00 ,$279.00 ,$43.65 ,$201.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000179,81381,HC HLA 1 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,$340.00 ,$221.00 ,$27.79 ,$382.28 ,$340.00 ,$253.30 ,$222.70 ,$169.90 ,$95.20 ,$171.70 ,$169.90 ,$209.78 ,$169.90 ,$209.78 ,$209.78 ,$169.90 ,$209.78 ,$322.81 ,$306.00 ,$255.00 ,$340.00 ,$169.90 ,$299.20 ,$169.90 ,$255.00 ,$255.00 ,$289.00 ,$289.00 ,$169.90 ,$289.00 ,$169.90 ,$265.20 ,$265.20 ,$265.20 ,$306.00 ,$340.00 ,$306.00 ,$169.90 ,$340.00 ,$222.70 ,$169.90 ,$141.44 ,$29.12 ,$27.79 ,$178.40 ,$306.00 ,$382.28 ,$209.78 ,$95.20 ,$306.00 ,$169.90 ,$306.00 ,$306.00 ,$169.90 ,$221.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000181,81400,HC MOLECULAR PATH PROC LEVEL 1-90,310,1 ,$693.00 ,$450.45 ,$27.79 ,$693.00 ,$159.90 ,$516.29 ,$453.92 ,$63.96 ,$194.04 ,$349.97 ,$63.96 ,$427.58 ,$63.96 ,$427.58 ,$427.58 ,$63.96 ,$427.58 ,$121.52 ,$623.70 ,$519.75 ,$159.90 ,$63.96 ,$609.84 ,$63.96 ,$519.75 ,$519.75 ,$589.05 ,$589.05 ,$63.96 ,$589.05 ,$63.96 ,$540.54 ,$540.54 ,$540.54 ,$623.70 ,$159.90 ,$623.70 ,$63.96 ,$693.00 ,$453.92 ,$63.96 ,$288.29 ,$29.12 ,$27.79 ,$67.16 ,$623.70 ,$143.91 ,$427.58 ,$194.04 ,$623.70 ,$63.96 ,$623.70 ,$623.70 ,$63.96 ,$450.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000183,81401,HC MOLECULAR PATH PROC LEVEL 2-90,310,1 ,"$1,324.00 ",$860.60 ,$27.79 ,"$1,324.00 ", N/A ,$986.38 ,$867.22 , N/A ,$370.72 ,$668.62 , N/A ,$816.91 , N/A ,$816.91 ,$816.91 , N/A ,$816.91 , N/A ,"$1,191.60 ",$993.00 , N/A , N/A ,"$1,165.12 ", N/A ,$993.00 ,$993.00 ,"$1,125.40 ","$1,125.40 ", N/A ,"$1,125.40 ", N/A ,"$1,032.72 ","$1,032.72 ","$1,032.72 ","$1,191.60 ", N/A ,"$1,191.60 ", N/A ,"$1,324.00 ",$867.22 , N/A ,$550.78 ,$29.12 ,$27.79 , N/A ,"$1,191.60 ", N/A ,$816.91 ,$370.72 ,"$1,191.60 ", N/A ,"$1,191.60 ","$1,191.60 ", N/A ,$860.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,"$1,065.00 ",$692.25 ,$27.79 ,"$1,065.00 ", N/A ,$793.43 ,$697.58 , N/A ,$298.20 ,$537.83 , N/A ,$657.11 , N/A ,$657.11 ,$657.11 , N/A ,$657.11 , N/A ,$958.50 ,$798.75 , N/A , N/A ,$937.20 , N/A ,$798.75 ,$798.75 ,$905.25 ,$905.25 , N/A ,$905.25 , N/A ,$830.70 ,$830.70 ,$830.70 ,$958.50 , N/A ,$958.50 , N/A ,"$1,065.00 ",$697.58 , N/A ,$443.04 ,$29.12 ,$27.79 , N/A ,$958.50 , N/A ,$657.11 ,$298.20 ,$958.50 , N/A ,$958.50 ,$958.50 , N/A ,$692.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000190,81408,HC MOLECULAR PATH PROC LEVEL 9-90,310,1 ,"$4,542.00 ","$2,952.30 ",$90.49 ,"$4,542.00 ", N/A ,"$3,383.79 ","$2,975.01 ", N/A ,"$1,271.76 ","$2,293.71 ", N/A ,"$2,802.41 ", N/A ,"$2,802.41 ","$2,802.41 ", N/A ,"$2,802.41 ", N/A ,"$4,087.80 ","$3,406.50 ", N/A , N/A ,"$3,996.96 ", N/A ,"$3,406.50 ","$3,406.50 ","$3,860.70 ","$3,860.70 ", N/A ,"$3,860.70 ", N/A ,"$3,542.76 ","$3,542.76 ","$3,542.76 ","$4,087.80 ", N/A ,"$4,087.80 ", N/A ,"$4,542.00 ","$2,975.01 ", N/A ,"$1,889.47 ",$94.80 ,$90.49 , N/A ,"$4,087.80 ", N/A ,"$2,802.41 ","$1,271.76 ","$4,087.80 ", N/A ,"$4,087.80 ","$4,087.80 ", N/A ,"$2,952.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000242,81329,HC SMN1 GENE DOSAGE/DELETION ANALYSIS-90,310,1 ,"$1,017.00 ",$661.05 ,$27.79 ,"$1,017.00 ",$342.50 ,$757.67 ,$666.14 ,$137.00 ,$284.76 ,$513.59 ,$137.00 ,$627.49 ,$137.00 ,$627.49 ,$627.49 ,$137.00 ,$627.49 ,$260.30 ,$915.30 ,$762.75 ,$342.50 ,$137.00 ,$894.96 ,$137.00 ,$762.75 ,$762.75 ,$864.45 ,$864.45 ,$137.00 ,$864.45 ,$137.00 ,$793.26 ,$793.26 ,$793.26 ,$915.30 ,$342.50 ,$915.30 ,$137.00 ,"$1,017.00 ",$666.14 ,$137.00 ,$423.07 ,$29.12 ,$27.79 ,$143.85 ,$915.30 ,$308.25 ,$627.49 ,$284.76 ,$915.30 ,$137.00 ,$915.30 ,$915.30 ,$137.00 ,$661.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000245,81271,HC HTT GENE ANALYSIS DETECT ABNORMAL ALLELES-90,310,1 ,$502.00 ,$326.30 ,$27.79 ,$502.00 ,$342.50 ,$373.99 ,$328.81 ,$137.00 ,$140.56 ,$253.51 ,$137.00 ,$309.73 ,$137.00 ,$309.73 ,$309.73 ,$137.00 ,$309.73 ,$260.30 ,$451.80 ,$376.50 ,$342.50 ,$137.00 ,$441.76 ,$137.00 ,$376.50 ,$376.50 ,$426.70 ,$426.70 ,$137.00 ,$426.70 ,$137.00 ,$391.56 ,$391.56 ,$391.56 ,$451.80 ,$342.50 ,$451.80 ,$137.00 ,$502.00 ,$328.81 ,$137.00 ,$208.83 ,$29.12 ,$27.79 ,$143.85 ,$451.80 ,$308.25 ,$309.73 ,$140.56 ,$451.80 ,$137.00 ,$451.80 ,$451.80 ,$137.00 ,$326.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000253,81420,HC FETAL CHROMOSOME ANEUPLOIDY -90,310,1 ,"$1,322.00 ",$859.30 ,$256.79 ,"$1,707.86 ","$1,322.00 ",$984.89 ,$865.91 ,$759.05 ,$370.16 ,$667.61 ,$759.05 ,$815.67 ,$759.05 ,$815.67 ,$815.67 ,$759.05 ,$815.67 ,"$1,442.20 ","$1,189.80 ",$991.50 ,"$1,322.00 ",$759.05 ,"$1,163.36 ",$759.05 ,$991.50 ,$991.50 ,"$1,123.70 ","$1,123.70 ",$759.05 ,"$1,123.70 ",$759.05 ,"$1,031.16 ","$1,031.16 ","$1,031.16 ","$1,189.80 ","$1,322.00 ","$1,189.80 ",$759.05 ,"$1,322.00 ",$865.91 ,$759.05 ,$549.95 ,$269.02 ,$256.79 ,$797.00 ,"$1,189.80 ","$1,707.86 ",$815.67 ,$370.16 ,"$1,189.80 ",$759.05 ,"$1,189.80 ","$1,189.80 ",$759.05 ,$859.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000257,81512,HC FETAL CONGENITAL ABNORMAL ASSAY 5 ANALYTES-90,310,1 ,$200.00 ,$130.00 ,$27.79 ,$200.00 ,$173.80 ,$149.00 ,$131.00 ,$69.52 ,$56.00 ,$101.00 ,$69.52 ,$123.40 ,$69.52 ,$123.40 ,$123.40 ,$69.52 ,$123.40 ,$132.09 ,$180.00 ,$150.00 ,$173.80 ,$69.52 ,$176.00 ,$69.52 ,$150.00 ,$150.00 ,$170.00 ,$170.00 ,$69.52 ,$170.00 ,$69.52 ,$156.00 ,$156.00 ,$156.00 ,$180.00 ,$173.80 ,$180.00 ,$69.52 ,$200.00 ,$131.00 ,$69.52 ,$83.20 ,$29.12 ,$27.79 ,$73.00 ,$180.00 ,$156.42 ,$123.40 ,$56.00 ,$180.00 ,$69.52 ,$180.00 ,$180.00 ,$69.52 ,$130.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000259,81265,HC SHORT TANDEM REPEAT MARKERS SPECIMEN ANAL-90,310,1 ,$600.00 ,$390.00 ,$90.49 ,$600.00 ,$582.68 ,$447.00 ,$393.00 ,$233.07 ,$168.00 ,$303.00 ,$233.07 ,$370.20 ,$233.07 ,$370.20 ,$370.20 ,$233.07 ,$370.20 ,$442.83 ,$540.00 ,$450.00 ,$582.68 ,$233.07 ,$528.00 ,$233.07 ,$450.00 ,$450.00 ,$510.00 ,$510.00 ,$233.07 ,$510.00 ,$233.07 ,$468.00 ,$468.00 ,$468.00 ,$540.00 ,$582.68 ,$540.00 ,$233.07 ,$600.00 ,$393.00 ,$233.07 ,$249.60 ,$94.80 ,$90.49 ,$244.72 ,$540.00 ,$524.41 ,$370.20 ,$168.00 ,$540.00 ,$233.07 ,$540.00 ,$540.00 ,$233.07 ,$390.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000275,81209,HC BLM GENE ANALYSIS 2281DEL6INS7 VARIANT-90,310,1 ,$136.00 ,$88.40 ,$27.79 ,$136.00 ,$98.28 ,$101.32 ,$89.08 ,$39.31 ,$38.08 ,$68.68 ,$39.31 ,$83.91 ,$39.31 ,$83.91 ,$83.91 ,$39.31 ,$83.91 ,$74.69 ,$122.40 ,$102.00 ,$98.28 ,$39.31 ,$119.68 ,$39.31 ,$102.00 ,$102.00 ,$115.60 ,$115.60 ,$39.31 ,$115.60 ,$39.31 ,$106.08 ,$106.08 ,$106.08 ,$122.40 ,$98.28 ,$122.40 ,$39.31 ,$136.00 ,$89.08 ,$39.31 ,$56.58 ,$29.12 ,$27.79 ,$41.28 ,$122.40 ,$88.45 ,$83.91 ,$38.08 ,$122.40 ,$39.31 ,$122.40 ,$122.40 ,$39.31 ,$88.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000280,81403,HC MOLECULAR PATHOLOGY PROC LEVEL 4-90,310,1 ,$574.00 ,$373.10 ,$27.79 ,$574.00 , N/A ,$427.63 ,$375.97 , N/A ,$160.72 ,$289.87 , N/A ,$354.16 , N/A ,$354.16 ,$354.16 , N/A ,$354.16 , N/A ,$516.60 ,$430.50 , N/A , N/A ,$505.12 , N/A ,$430.50 ,$430.50 ,$487.90 ,$487.90 , N/A ,$487.90 , N/A ,$447.72 ,$447.72 ,$447.72 ,$516.60 , N/A ,$516.60 , N/A ,$574.00 ,$375.97 , N/A ,$238.78 ,$29.12 ,$27.79 , N/A ,$516.60 , N/A ,$354.16 ,$160.72 ,$516.60 , N/A ,$516.60 ,$516.60 , N/A ,$373.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000282,81220,HC CYSTIC FIBROSIS GENE ANALYSIS COMMON VARIANTS - 90,310,1 ,$130.00 ,$84.50 ,$27.79 ,$292.50 ,$130.00 ,$96.85 ,$85.15 ,$130.00 ,$36.40 ,$65.65 ,$130.00 ,$80.21 ,$130.00 ,$80.21 ,$80.21 ,$130.00 ,$80.21 ,$247.00 ,$117.00 ,$97.50 ,$130.00 ,$130.00 ,$114.40 ,$130.00 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$130.00 ,$110.50 ,$130.00 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$130.00 ,$117.00 ,$130.00 ,$130.00 ,$85.15 ,$130.00 ,$54.08 ,$29.12 ,$27.79 ,$130.00 ,$117.00 ,$292.50 ,$80.21 ,$36.40 ,$117.00 ,$130.00 ,$117.00 ,$117.00 ,$130.00 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31000283,81220,HC CFTR GENE ANALYSIS-90,310,1 ,$130.00 ,$84.50 ,$27.79 ,$292.50 ,$130.00 ,$96.85 ,$85.15 ,$130.00 ,$36.40 ,$65.65 ,$130.00 ,$80.21 ,$130.00 ,$80.21 ,$80.21 ,$130.00 ,$80.21 ,$247.00 ,$117.00 ,$97.50 ,$130.00 ,$130.00 ,$114.40 ,$130.00 ,$97.50 ,$97.50 ,$110.50 ,$110.50 ,$130.00 ,$110.50 ,$130.00 ,$101.40 ,$101.40 ,$101.40 ,$117.00 ,$130.00 ,$117.00 ,$130.00 ,$130.00 ,$85.15 ,$130.00 ,$54.08 ,$29.12 ,$27.79 ,$130.00 ,$117.00 ,$292.50 ,$80.21 ,$36.40 ,$117.00 ,$130.00 ,$117.00 ,$117.00 ,$130.00 ,$84.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100101,88104,HC CYTOPATH FLD SMEAR,311,1 ,$138.00 ,$89.70 ,$22.38 ,$138.00 ,$83.43 ,$102.81 ,$90.39 ,$33.37 ,$38.64 ,$69.69 ,$33.37 ,$85.15 ,$33.37 ,$85.15 ,$85.15 ,$33.37 ,$85.15 ,$63.40 ,$124.20 ,$103.50 ,$83.43 ,$33.37 ,$121.44 ,$33.37 ,$103.50 ,$103.50 ,$117.30 ,$117.30 ,$33.37 ,$117.30 ,$33.37 ,$107.64 ,$107.64 ,$107.64 ,$124.20 ,$83.43 ,$124.20 ,$33.37 ,$138.00 ,$90.39 ,$33.37 ,$57.41 ,$23.44 ,$22.38 ,$35.04 ,$124.20 ,$75.08 ,$85.15 ,$38.64 ,$124.20 ,$33.37 ,$124.20 ,$124.20 ,$33.37 ,$89.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100102,88108,HC CYTOPATH CONCENTRATION,311,1 ,$167.00 ,$108.55 ,$22.38 ,$167.00 ,$83.43 ,$124.42 ,$109.39 ,$33.37 ,$46.76 ,$84.34 ,$33.37 ,$103.04 ,$33.37 ,$103.04 ,$103.04 ,$33.37 ,$103.04 ,$63.40 ,$150.30 ,$125.25 ,$83.43 ,$33.37 ,$146.96 ,$33.37 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$33.37 ,$141.95 ,$33.37 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$83.43 ,$150.30 ,$33.37 ,$167.00 ,$109.39 ,$33.37 ,$69.47 ,$23.44 ,$22.38 ,$35.04 ,$150.30 ,$75.08 ,$103.04 ,$46.76 ,$150.30 ,$33.37 ,$150.30 ,$150.30 ,$33.37 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$193.00 ,$125.45 ,$24.61 ,$193.00 ,$122.48 ,$143.79 ,$126.42 ,$48.99 ,$54.04 ,$97.47 ,$48.99 ,$119.08 ,$48.99 ,$119.08 ,$119.08 ,$48.99 ,$119.08 ,$93.08 ,$173.70 ,$144.75 ,$122.48 ,$48.99 ,$169.84 ,$48.99 ,$144.75 ,$144.75 ,$164.05 ,$164.05 ,$48.99 ,$164.05 ,$48.99 ,$150.54 ,$150.54 ,$150.54 ,$173.70 ,$122.48 ,$173.70 ,$48.99 ,$193.00 ,$126.42 ,$48.99 ,$80.29 ,$25.78 ,$24.61 ,$51.44 ,$173.70 ,$110.23 ,$119.08 ,$54.04 ,$173.70 ,$48.99 ,$173.70 ,$173.70 ,$48.99 ,$125.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100110,88160,HC CYTOPATH SMEAR NON GYN,311,1 ,$56.00 ,$36.40 ,$15.68 ,$56.00 ,$56.00 ,$41.72 ,$36.68 ,$24.36 ,$15.68 ,$28.28 ,$24.36 ,$34.55 ,$24.36 ,$34.55 ,$34.55 ,$24.36 ,$34.55 ,$46.28 ,$50.40 ,$42.00 ,$56.00 ,$24.36 ,$49.28 ,$24.36 ,$42.00 ,$42.00 ,$47.60 ,$47.60 ,$24.36 ,$47.60 ,$24.36 ,$43.68 ,$43.68 ,$43.68 ,$50.40 ,$56.00 ,$50.40 ,$24.36 ,$56.00 ,$36.68 ,$24.36 ,$23.30 ,$23.44 ,$22.38 ,$25.57 ,$50.40 ,$54.80 ,$34.55 ,$15.68 ,$50.40 ,$24.36 ,$50.40 ,$50.40 ,$24.36 ,$36.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100114,88172,HC FINE NEEDLE EVAL,311,1 ,$49.00 ,$31.85 ,$13.72 ,$330.83 ,$49.00 ,$36.51 ,$32.10 ,$49.00 ,$13.72 ,$24.75 ,$49.00 ,$30.23 ,$49.00 ,$30.23 ,$30.23 ,$49.00 ,$30.23 ,$279.38 ,$44.10 ,$36.75 ,$49.00 ,$49.00 ,$43.12 ,$49.00 ,$36.75 ,$36.75 ,$41.65 ,$41.65 ,$49.00 ,$41.65 ,$49.00 ,$38.22 ,$38.22 ,$38.22 ,$44.10 ,$49.00 ,$44.10 ,$49.00 ,$21.05 ,$32.10 ,$49.00 ,$20.38 ,$23.44 ,$22.38 ,$49.00 ,$44.10 ,$330.83 ,$30.23 ,$13.72 ,$44.10 ,$49.00 ,$44.10 ,$44.10 ,$49.00 ,$31.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100115,88173,HC FINE NEEDLE INTERP,311,1 ,$443.00 ,$287.95 ,$22.38 ,$443.00 ,$122.48 ,$330.04 ,$290.17 ,$48.99 ,$124.04 ,$223.72 ,$48.99 ,$273.33 ,$48.99 ,$273.33 ,$273.33 ,$48.99 ,$273.33 ,$93.08 ,$398.70 ,$332.25 ,$122.48 ,$48.99 ,$389.84 ,$48.99 ,$332.25 ,$332.25 ,$376.55 ,$376.55 ,$48.99 ,$376.55 ,$48.99 ,$345.54 ,$345.54 ,$345.54 ,$398.70 ,$122.48 ,$398.70 ,$48.99 ,$89.83 ,$290.17 ,$48.99 ,$184.29 ,$23.44 ,$22.38 ,$51.44 ,$398.70 ,$110.23 ,$273.33 ,$124.04 ,$398.70 ,$48.99 ,$398.70 ,$398.70 ,$48.99 ,$287.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100116,88177,HC FINE NEEDLE EVAL ADDL,311,1 ,$49.00 ,$31.85 ,$13.72 ,$49.00 , N/A ,$36.51 ,$32.10 , N/A ,$13.72 ,$24.75 , N/A ,$30.23 , N/A ,$30.23 ,$30.23 , N/A ,$30.23 , N/A ,$44.10 ,$36.75 , N/A , N/A ,$43.12 , N/A ,$36.75 ,$36.75 ,$41.65 ,$41.65 , N/A ,$41.65 , N/A ,$38.22 ,$38.22 ,$38.22 ,$44.10 , N/A ,$44.10 , N/A ,$49.00 ,$32.10 , N/A ,$20.38 ,$23.44 ,$22.38 , N/A ,$44.10 , N/A ,$30.23 ,$13.72 ,$44.10 , N/A ,$44.10 ,$44.10 , N/A ,$31.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100242,88175,HC CYTOPATH PAP DIAG INIT/REDO,311,1 ,$187.00 ,$121.55 ,$16.22 ,$187.00 ,$66.53 ,$139.32 ,$122.49 ,$26.61 ,$52.36 ,$94.44 ,$26.61 ,$115.38 ,$26.61 ,$115.38 ,$115.38 ,$26.61 ,$115.38 ,$50.56 ,$168.30 ,$140.25 ,$66.53 ,$26.61 ,$164.56 ,$26.61 ,$140.25 ,$140.25 ,$158.95 ,$158.95 ,$26.61 ,$158.95 ,$26.61 ,$145.86 ,$145.86 ,$145.86 ,$168.30 ,$66.53 ,$168.30 ,$26.61 ,$20.26 ,$122.49 ,$26.61 ,$77.79 ,$17.00 ,$16.22 ,$27.94 ,$168.30 ,$59.87 ,$115.38 ,$52.36 ,$168.30 ,$26.61 ,$168.30 ,$168.30 ,$26.61 ,$121.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$197.00 ,$128.05 ,$24.61 ,$646.05 ,$197.00 ,$146.77 ,$129.04 ,$197.00 ,$55.16 ,$99.49 ,$197.00 ,$121.55 ,$197.00 ,$121.55 ,$121.55 ,$197.00 ,$121.55 ,$545.55 ,$177.30 ,$147.75 ,$197.00 ,$197.00 ,$173.36 ,$197.00 ,$147.75 ,$147.75 ,$167.45 ,$167.45 ,$197.00 ,$167.45 ,$197.00 ,$153.66 ,$153.66 ,$153.66 ,$177.30 ,$197.00 ,$177.30 ,$197.00 ,$197.00 ,$129.04 ,$197.00 ,$81.95 ,$25.78 ,$24.61 ,$197.00 ,$177.30 ,$646.05 ,$121.55 ,$55.16 ,$177.30 ,$197.00 ,$177.30 ,$177.30 ,$197.00 ,$128.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$75.00 ,$48.75 ,$21.00 ,$75.00 , N/A ,$55.88 ,$49.13 , N/A ,$21.00 ,$37.88 , N/A ,$46.28 , N/A ,$46.28 ,$46.28 , N/A ,$46.28 , N/A ,$67.50 ,$56.25 , N/A , N/A ,$66.00 , N/A ,$56.25 ,$56.25 ,$63.75 ,$63.75 , N/A ,$63.75 , N/A ,$58.50 ,$58.50 ,$58.50 ,$67.50 , N/A ,$67.50 , N/A ,$75.00 ,$49.13 , N/A ,$31.20 ,$25.78 ,$24.61 , N/A ,$67.50 , N/A ,$46.28 ,$21.00 ,$67.50 , N/A ,$67.50 ,$67.50 , N/A ,$48.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100251,88230,HC TISSUE CULT NONNEO LYMPHOCYTE-90,311,1 ,$558.00 ,$362.70 ,$24.61 ,$558.00 ,$291.23 ,$415.71 ,$365.49 ,$116.49 ,$156.24 ,$281.79 ,$116.49 ,$344.29 ,$116.49 ,$344.29 ,$344.29 ,$116.49 ,$344.29 ,$221.33 ,$502.20 ,$418.50 ,$291.23 ,$116.49 ,$491.04 ,$116.49 ,$418.50 ,$418.50 ,$474.30 ,$474.30 ,$116.49 ,$474.30 ,$116.49 ,$435.24 ,$435.24 ,$435.24 ,$502.20 ,$291.23 ,$502.20 ,$116.49 ,$558.00 ,$365.49 ,$116.49 ,$232.13 ,$25.78 ,$24.61 ,$122.31 ,$502.20 ,$262.10 ,$344.29 ,$156.24 ,$502.20 ,$116.49 ,$502.20 ,$502.20 ,$116.49 ,$362.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100256,88239,HC TISSUE CULT TUMOR-90,311,1 ,"$1,697.00 ","$1,103.05 ",$24.61 ,"$1,697.00 ",$368.80 ,"$1,264.27 ","$1,111.54 ",$147.52 ,$475.16 ,$856.99 ,$147.52 ,"$1,047.05 ",$147.52 ,"$1,047.05 ","$1,047.05 ",$147.52 ,"$1,047.05 ",$280.29 ,"$1,527.30 ","$1,272.75 ",$368.80 ,$147.52 ,"$1,493.36 ",$147.52 ,"$1,272.75 ","$1,272.75 ","$1,442.45 ","$1,442.45 ",$147.52 ,"$1,442.45 ",$147.52 ,"$1,323.66 ","$1,323.66 ","$1,323.66 ","$1,527.30 ",$368.80 ,"$1,527.30 ",$147.52 ,"$1,697.00 ","$1,111.54 ",$147.52 ,$705.95 ,$25.78 ,$24.61 ,$154.90 ,"$1,527.30 ",$331.92 ,"$1,047.05 ",$475.16 ,"$1,527.30 ",$147.52 ,"$1,527.30 ","$1,527.30 ",$147.52 ,"$1,103.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100257,88262,HC CHROM COUNT 15-20/2-90,311,1 ,"$1,436.00 ",$933.40 ,$27.79 ,"$1,436.00 ",$313.73 ,"$1,069.82 ",$940.58 ,$125.49 ,$402.08 ,$725.18 ,$125.49 ,$886.01 ,$125.49 ,$886.01 ,$886.01 ,$125.49 ,$886.01 ,$238.43 ,"$1,292.40 ","$1,077.00 ",$313.73 ,$125.49 ,"$1,263.68 ",$125.49 ,"$1,077.00 ","$1,077.00 ","$1,220.60 ","$1,220.60 ",$125.49 ,"$1,220.60 ",$125.49 ,"$1,120.08 ","$1,120.08 ","$1,120.08 ","$1,292.40 ",$313.73 ,"$1,292.40 ",$125.49 ,"$1,436.00 ",$940.58 ,$125.49 ,$597.38 ,$29.12 ,$27.79 ,$131.76 ,"$1,292.40 ",$282.35 ,$886.01 ,$402.08 ,"$1,292.40 ",$125.49 ,"$1,292.40 ","$1,292.40 ",$125.49 ,$933.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100261,88271,HC MCG DNA PROBE(FISH)-90,311,1 ,$168.00 ,$109.20 ,$21.42 ,$168.00 ,$53.55 ,$125.16 ,$110.04 ,$21.42 ,$47.04 ,$84.84 ,$21.42 ,$103.66 ,$21.42 ,$103.66 ,$103.66 ,$21.42 ,$103.66 ,$40.70 ,$151.20 ,$126.00 ,$53.55 ,$21.42 ,$147.84 ,$21.42 ,$126.00 ,$126.00 ,$142.80 ,$142.80 ,$21.42 ,$142.80 ,$21.42 ,$131.04 ,$131.04 ,$131.04 ,$151.20 ,$53.55 ,$151.20 ,$21.42 ,$168.00 ,$110.04 ,$21.42 ,$69.89 ,$29.12 ,$27.79 ,$22.49 ,$151.20 ,$48.20 ,$103.66 ,$47.04 ,$151.20 ,$21.42 ,$151.20 ,$151.20 ,$21.42 ,$109.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100270,88275,HC MCG INTERPH INSITU FISH 100-90,311,1 ,$252.00 ,$163.80 ,$27.79 ,$252.00 ,$127.98 ,$187.74 ,$165.06 ,$51.19 ,$70.56 ,$127.26 ,$51.19 ,$155.48 ,$51.19 ,$155.48 ,$155.48 ,$51.19 ,$155.48 ,$97.26 ,$226.80 ,$189.00 ,$127.98 ,$51.19 ,$221.76 ,$51.19 ,$189.00 ,$189.00 ,$214.20 ,$214.20 ,$51.19 ,$214.20 ,$51.19 ,$196.56 ,$196.56 ,$196.56 ,$226.80 ,$127.98 ,$226.80 ,$51.19 ,$252.00 ,$165.06 ,$51.19 ,$104.83 ,$29.12 ,$27.79 ,$53.75 ,$226.80 ,$115.18 ,$155.48 ,$70.56 ,$226.80 ,$51.19 ,$226.80 ,$226.80 ,$51.19 ,$163.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100274,88289,HC CHROM ADDL HIGH RES-90,311,1 ,$138.00 ,$89.70 ,$27.79 ,$138.00 ,$86.08 ,$102.81 ,$90.39 ,$34.43 ,$38.64 ,$69.69 ,$34.43 ,$85.15 ,$34.43 ,$85.15 ,$85.15 ,$34.43 ,$85.15 ,$65.42 ,$124.20 ,$103.50 ,$86.08 ,$34.43 ,$121.44 ,$34.43 ,$103.50 ,$103.50 ,$117.30 ,$117.30 ,$34.43 ,$117.30 ,$34.43 ,$107.64 ,$107.64 ,$107.64 ,$124.20 ,$86.08 ,$124.20 ,$34.43 ,$138.00 ,$90.39 ,$34.43 ,$57.41 ,$29.12 ,$27.79 ,$36.15 ,$124.20 ,$77.47 ,$85.15 ,$38.64 ,$124.20 ,$34.43 ,$124.20 ,$124.20 ,$34.43 ,$89.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100275,88291,HC INTERPRETATION-90,311,1 ,$79.00 ,$51.35 ,$22.12 ,$79.00 , N/A ,$58.86 ,$51.75 , N/A ,$22.12 ,$39.90 , N/A ,$48.74 , N/A ,$48.74 ,$48.74 , N/A ,$48.74 , N/A ,$71.10 ,$59.25 , N/A , N/A ,$69.52 , N/A ,$59.25 ,$59.25 ,$67.15 ,$67.15 , N/A ,$67.15 , N/A ,$61.62 ,$61.62 ,$61.62 ,$71.10 , N/A ,$71.10 , N/A ,$79.00 ,$51.75 , N/A ,$32.86 ,$29.12 ,$27.79 , N/A ,$71.10 , N/A ,$48.74 ,$22.12 ,$71.10 , N/A ,$71.10 ,$71.10 , N/A ,$51.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100280,G0145,HC CYTOPATH PAP SCREEN INIT/REDO,311,1 ,$216.00 ,$140.40 ,$16.22 ,$216.00 ,$66.23 ,$160.92 ,$141.48 ,$26.49 ,$60.48 ,$109.08 ,$26.49 ,$133.27 ,$26.49 ,$133.27 ,$133.27 ,$26.49 ,$133.27 ,$50.33 ,$194.40 ,$162.00 ,$66.23 ,$26.49 ,$190.08 ,$26.49 ,$162.00 ,$162.00 ,$183.60 ,$183.60 ,$26.49 ,$183.60 ,$26.49 ,$168.48 ,$168.48 ,$168.48 ,$194.40 ,$66.23 ,$194.40 ,$26.49 ,$216.00 ,$141.48 ,$26.49 ,$89.86 ,$17.00 ,$16.22 ,$27.81 ,$194.40 ,$59.60 ,$133.27 ,$60.48 ,$194.40 ,$26.49 ,$194.40 ,$194.40 ,$26.49 ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31100312,88189,HC FLOW CYTO INT >16 MARKERS-90,311,1 ,$662.00 ,$430.30 ,$22.38 ,$662.00 , N/A ,$493.19 ,$433.61 , N/A ,$185.36 ,$334.31 , N/A ,$408.45 , N/A ,$408.45 ,$408.45 , N/A ,$408.45 , N/A ,$595.80 ,$496.50 , N/A , N/A ,$582.56 , N/A ,$496.50 ,$496.50 ,$562.70 ,$562.70 , N/A ,$562.70 , N/A ,$516.36 ,$516.36 ,$516.36 ,$595.80 , N/A ,$595.80 , N/A ,$662.00 ,$433.61 , N/A ,$275.39 ,$23.44 ,$22.38 , N/A ,$595.80 , N/A ,$408.45 ,$185.36 ,$595.80 , N/A ,$595.80 ,$595.80 , N/A ,$430.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200101,88300,HC GROSS ONLY LEVEL I,312,1 ,$125.00 ,$81.25 ,$22.38 ,$125.00 ,$60.89 ,$93.13 ,$81.88 ,$24.36 ,$35.00 ,$63.13 ,$24.36 ,$77.13 ,$24.36 ,$77.13 ,$77.13 ,$24.36 ,$77.13 ,$46.28 ,$112.50 ,$93.75 ,$60.89 ,$24.36 ,$110.00 ,$24.36 ,$93.75 ,$93.75 ,$106.25 ,$106.25 ,$24.36 ,$106.25 ,$24.36 ,$97.50 ,$97.50 ,$97.50 ,$112.50 ,$60.89 ,$112.50 ,$24.36 ,$125.00 ,$81.88 ,$24.36 ,$52.00 ,$23.44 ,$22.38 ,$25.57 ,$112.50 ,$54.80 ,$77.13 ,$35.00 ,$112.50 ,$24.36 ,$112.50 ,$112.50 ,$24.36 ,$81.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200102,88302,HC GROSS  AND  MICRO LEVEL II,312,1 ,$169.00 ,$109.85 ,$22.38 ,$169.00 ,$60.89 ,$125.91 ,$110.70 ,$24.36 ,$47.32 ,$85.35 ,$24.36 ,$104.27 ,$24.36 ,$104.27 ,$104.27 ,$24.36 ,$104.27 ,$46.28 ,$152.10 ,$126.75 ,$60.89 ,$24.36 ,$148.72 ,$24.36 ,$126.75 ,$126.75 ,$143.65 ,$143.65 ,$24.36 ,$143.65 ,$24.36 ,$131.82 ,$131.82 ,$131.82 ,$152.10 ,$60.89 ,$152.10 ,$24.36 ,$169.00 ,$110.70 ,$24.36 ,$70.30 ,$23.44 ,$22.38 ,$25.57 ,$152.10 ,$54.80 ,$104.27 ,$47.32 ,$152.10 ,$24.36 ,$152.10 ,$152.10 ,$24.36 ,$109.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200103,88304,HC GROSS  AND  MICRO LEVEL III,312,1 ,$300.00 ,$195.00 ,$22.38 ,$300.00 ,$122.48 ,$223.50 ,$196.50 ,$48.99 ,$84.00 ,$151.50 ,$48.99 ,$185.10 ,$48.99 ,$185.10 ,$185.10 ,$48.99 ,$185.10 ,$93.08 ,$270.00 ,$225.00 ,$122.48 ,$48.99 ,$264.00 ,$48.99 ,$225.00 ,$225.00 ,$255.00 ,$255.00 ,$48.99 ,$255.00 ,$48.99 ,$234.00 ,$234.00 ,$234.00 ,$270.00 ,$122.48 ,$270.00 ,$48.99 ,$300.00 ,$196.50 ,$48.99 ,$124.80 ,$23.44 ,$22.38 ,$51.44 ,$270.00 ,$110.23 ,$185.10 ,$84.00 ,$270.00 ,$48.99 ,$270.00 ,$270.00 ,$48.99 ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200108,88305,HC GROSS  AND  MICRO LEVEL IV,312,1 ,$300.00 ,$195.00 ,$22.38 ,$300.00 ,$122.48 ,$223.50 ,$196.50 ,$48.99 ,$84.00 ,$151.50 ,$48.99 ,$185.10 ,$48.99 ,$185.10 ,$185.10 ,$48.99 ,$185.10 ,$93.08 ,$270.00 ,$225.00 ,$122.48 ,$48.99 ,$264.00 ,$48.99 ,$225.00 ,$225.00 ,$255.00 ,$255.00 ,$48.99 ,$255.00 ,$48.99 ,$234.00 ,$234.00 ,$234.00 ,$270.00 ,$122.48 ,$270.00 ,$48.99 ,$35.62 ,$196.50 ,$48.99 ,$124.80 ,$23.44 ,$22.38 ,$51.44 ,$270.00 ,$110.23 ,$185.10 ,$84.00 ,$270.00 ,$48.99 ,$270.00 ,$270.00 ,$48.99 ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200110,88307,HC GROSS  AND  MICRO LEVEL V,312,1 ,$922.00 ,$599.30 ,$24.61 ,$922.00 ,$717.84 ,$686.89 ,$603.91 ,$287.13 ,$258.16 ,$465.61 ,$287.13 ,$568.87 ,$287.13 ,$568.87 ,$568.87 ,$287.13 ,$568.87 ,$545.55 ,$829.80 ,$691.50 ,$717.84 ,$287.13 ,$811.36 ,$287.13 ,$691.50 ,$691.50 ,$783.70 ,$783.70 ,$287.13 ,$783.70 ,$287.13 ,$719.16 ,$719.16 ,$719.16 ,$829.80 ,$717.84 ,$829.80 ,$287.13 ,$217.17 ,$603.91 ,$287.13 ,$383.55 ,$25.78 ,$24.61 ,$301.49 ,$829.80 ,$646.05 ,$568.87 ,$258.16 ,$829.80 ,$287.13 ,$829.80 ,$829.80 ,$287.13 ,$599.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200113,88309,HC GROSS  AND  MICRO LEVEL VI,312,1 ,"$1,478.00 ",$960.70 ,$24.61 ,"$1,478.00 ","$1,478.00 ","$1,101.11 ",$968.09 ,$646.08 ,$413.84 ,$746.39 ,$646.08 ,$911.93 ,$646.08 ,$911.93 ,$911.93 ,$646.08 ,$911.93 ,"$1,227.55 ","$1,330.20 ","$1,108.50 ","$1,478.00 ",$646.08 ,"$1,300.64 ",$646.08 ,"$1,108.50 ","$1,108.50 ","$1,256.30 ","$1,256.30 ",$646.08 ,"$1,256.30 ",$646.08 ,"$1,152.84 ","$1,152.84 ","$1,152.84 ","$1,330.20 ","$1,478.00 ","$1,330.20 ",$646.08 ,"$1,478.00 ",$968.09 ,$646.08 ,$614.85 ,$25.78 ,$24.61 ,$678.38 ,"$1,330.20 ","$1,453.68 ",$911.93 ,$413.84 ,"$1,330.20 ",$646.08 ,"$1,330.20 ","$1,330.20 ",$646.08 ,$960.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200116,88311,HC DECALCIFICATION,312,1 ,$113.00 ,$73.45 ,$22.38 ,$113.00 , N/A ,$84.19 ,$74.02 , N/A ,$31.64 ,$57.07 , N/A ,$69.72 , N/A ,$69.72 ,$69.72 , N/A ,$69.72 , N/A ,$101.70 ,$84.75 , N/A , N/A ,$99.44 , N/A ,$84.75 ,$84.75 ,$96.05 ,$96.05 , N/A ,$96.05 , N/A ,$88.14 ,$88.14 ,$88.14 ,$101.70 , N/A ,$101.70 , N/A ,$113.00 ,$74.02 , N/A ,$47.01 ,$23.44 ,$22.38 , N/A ,$101.70 , N/A ,$69.72 ,$31.64 ,$101.70 , N/A ,$101.70 ,$101.70 , N/A ,$73.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200123,88312,HC SPECIAL STAIN I,312,1 ,$216.00 ,$140.40 ,$22.38 ,$216.00 ,$122.48 ,$160.92 ,$141.48 ,$48.99 ,$60.48 ,$109.08 ,$48.99 ,$133.27 ,$48.99 ,$133.27 ,$133.27 ,$48.99 ,$133.27 ,$93.08 ,$194.40 ,$162.00 ,$122.48 ,$48.99 ,$190.08 ,$48.99 ,$162.00 ,$162.00 ,$183.60 ,$183.60 ,$48.99 ,$183.60 ,$48.99 ,$168.48 ,$168.48 ,$168.48 ,$194.40 ,$122.48 ,$194.40 ,$48.99 ,$216.00 ,$141.48 ,$48.99 ,$89.86 ,$23.44 ,$22.38 ,$51.44 ,$194.40 ,$110.23 ,$133.27 ,$60.48 ,$194.40 ,$48.99 ,$194.40 ,$194.40 ,$48.99 ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200125,88313,HC SPECIAL STAIN II,312,1 ,$216.00 ,$140.40 ,$22.38 ,$216.00 ,$83.43 ,$160.92 ,$141.48 ,$33.37 ,$60.48 ,$109.08 ,$33.37 ,$133.27 ,$33.37 ,$133.27 ,$133.27 ,$33.37 ,$133.27 ,$63.40 ,$194.40 ,$162.00 ,$83.43 ,$33.37 ,$190.08 ,$33.37 ,$162.00 ,$162.00 ,$183.60 ,$183.60 ,$33.37 ,$183.60 ,$33.37 ,$168.48 ,$168.48 ,$168.48 ,$194.40 ,$83.43 ,$194.40 ,$33.37 ,$216.00 ,$141.48 ,$33.37 ,$89.86 ,$23.44 ,$22.38 ,$35.04 ,$194.40 ,$75.08 ,$133.27 ,$60.48 ,$194.40 ,$33.37 ,$194.40 ,$194.40 ,$33.37 ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200159,88321,HC CONSULT REFERRED SLIDES,312,1 ,$140.00 ,$91.00 ,$22.38 ,$140.00 ,$83.43 ,$104.30 ,$91.70 ,$33.37 ,$39.20 ,$70.70 ,$33.37 ,$86.38 ,$33.37 ,$86.38 ,$86.38 ,$33.37 ,$86.38 ,$63.40 ,$126.00 ,$105.00 ,$83.43 ,$33.37 ,$123.20 ,$33.37 ,$105.00 ,$105.00 ,$119.00 ,$119.00 ,$33.37 ,$119.00 ,$33.37 ,$109.20 ,$109.20 ,$109.20 ,$126.00 ,$83.43 ,$126.00 ,$33.37 ,$140.00 ,$91.70 ,$33.37 ,$58.24 ,$23.44 ,$22.38 ,$35.04 ,$126.00 ,$75.08 ,$86.38 ,$39.20 ,$126.00 ,$33.37 ,$126.00 ,$126.00 ,$33.37 ,$91.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200172,88329,HC CONSULT PATH SURGERY,312,1 ,$147.00 ,$95.55 ,$22.38 ,$147.00 ,$83.43 ,$109.52 ,$96.29 ,$33.37 ,$41.16 ,$74.24 ,$33.37 ,$90.70 ,$33.37 ,$90.70 ,$90.70 ,$33.37 ,$90.70 ,$63.40 ,$132.30 ,$110.25 ,$83.43 ,$33.37 ,$129.36 ,$33.37 ,$110.25 ,$110.25 ,$124.95 ,$124.95 ,$33.37 ,$124.95 ,$33.37 ,$114.66 ,$114.66 ,$114.66 ,$132.30 ,$83.43 ,$132.30 ,$33.37 ,$147.00 ,$96.29 ,$33.37 ,$61.15 ,$23.44 ,$22.38 ,$35.04 ,$132.30 ,$75.08 ,$90.70 ,$41.16 ,$132.30 ,$33.37 ,$132.30 ,$132.30 ,$33.37 ,$95.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200173,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,$922.00 ,$599.30 ,$22.38 ,$922.00 ,$367.59 ,$686.89 ,$603.91 ,$147.04 ,$258.16 ,$465.61 ,$147.04 ,$568.87 ,$147.04 ,$568.87 ,$568.87 ,$147.04 ,$568.87 ,$279.38 ,$829.80 ,$691.50 ,$367.59 ,$147.04 ,$811.36 ,$147.04 ,$691.50 ,$691.50 ,$783.70 ,$783.70 ,$147.04 ,$783.70 ,$147.04 ,$719.16 ,$719.16 ,$719.16 ,$829.80 ,$367.59 ,$829.80 ,$147.04 ,$44.37 ,$603.91 ,$147.04 ,$383.55 ,$23.44 ,$22.38 ,$154.39 ,$829.80 ,$330.83 ,$568.87 ,$258.16 ,$829.80 ,$147.04 ,$829.80 ,$829.80 ,$147.04 ,$599.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200174,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$123.00 ,$79.95 ,$22.38 ,$123.00 , N/A ,$91.64 ,$80.57 , N/A ,$34.44 ,$62.12 , N/A ,$75.89 , N/A ,$75.89 ,$75.89 , N/A ,$75.89 , N/A ,$110.70 ,$92.25 , N/A , N/A ,$108.24 , N/A ,$92.25 ,$92.25 ,$104.55 ,$104.55 , N/A ,$104.55 , N/A ,$95.94 ,$95.94 ,$95.94 ,$110.70 , N/A ,$110.70 , N/A ,$25.42 ,$80.57 , N/A ,$51.17 ,$23.44 ,$22.38 , N/A ,$110.70 , N/A ,$75.89 ,$34.44 ,$110.70 , N/A ,$110.70 ,$110.70 , N/A ,$79.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200175,88333,HC CONSULT PATH SURG CYTO INIT,312,1 ,"$1,404.00 ",$912.60 ,$22.38 ,"$1,453.68 ","$1,404.00 ","$1,045.98 ",$919.62 ,$646.08 ,$393.12 ,$709.02 ,$646.08 ,$866.27 ,$646.08 ,$866.27 ,$866.27 ,$646.08 ,$866.27 ,"$1,227.55 ","$1,263.60 ","$1,053.00 ","$1,404.00 ",$646.08 ,"$1,235.52 ",$646.08 ,"$1,053.00 ","$1,053.00 ","$1,193.40 ","$1,193.40 ",$646.08 ,"$1,193.40 ",$646.08 ,"$1,095.12 ","$1,095.12 ","$1,095.12 ","$1,263.60 ","$1,404.00 ","$1,263.60 ",$646.08 ,"$1,404.00 ",$919.62 ,$646.08 ,$584.06 ,$23.44 ,$22.38 ,$678.38 ,"$1,263.60 ","$1,453.68 ",$866.27 ,$393.12 ,"$1,263.60 ",$646.08 ,"$1,263.60 ","$1,263.60 ",$646.08 ,$912.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200176,88334,HC CONSULT PATH SURG EA ADDL,312,1 ,$225.00 ,$146.25 ,$22.38 ,$225.00 , N/A ,$167.63 ,$147.38 , N/A ,$63.00 ,$113.63 , N/A ,$138.83 , N/A ,$138.83 ,$138.83 , N/A ,$138.83 , N/A ,$202.50 ,$168.75 , N/A , N/A ,$198.00 , N/A ,$168.75 ,$168.75 ,$191.25 ,$191.25 , N/A ,$191.25 , N/A ,$175.50 ,$175.50 ,$175.50 ,$202.50 , N/A ,$202.50 , N/A ,$225.00 ,$147.38 , N/A ,$93.60 ,$23.44 ,$22.38 , N/A ,$202.50 , N/A ,$138.83 ,$63.00 ,$202.50 , N/A ,$202.50 ,$202.50 , N/A ,$146.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200220,88342,HC IMMUNOHISTOCHEM AB-INITIAL,312,1 ,$838.00 ,$544.70 ,$22.38 ,$838.00 ,$367.59 ,$624.31 ,$548.89 ,$147.04 ,$234.64 ,$423.19 ,$147.04 ,$517.05 ,$147.04 ,$517.05 ,$517.05 ,$147.04 ,$517.05 ,$279.38 ,$754.20 ,$628.50 ,$367.59 ,$147.04 ,$737.44 ,$147.04 ,$628.50 ,$628.50 ,$712.30 ,$712.30 ,$147.04 ,$712.30 ,$147.04 ,$653.64 ,$653.64 ,$653.64 ,$754.20 ,$367.59 ,$754.20 ,$147.04 ,$74.24 ,$548.89 ,$147.04 ,$348.61 ,$23.44 ,$22.38 ,$154.39 ,$754.20 ,$330.83 ,$517.05 ,$234.64 ,$754.20 ,$147.04 ,$754.20 ,$754.20 ,$147.04 ,$544.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200249,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$697.00 ,$453.05 ,$22.38 ,$697.00 ,$697.00 ,$519.27 ,$456.54 ,$287.13 ,$195.16 ,$351.99 ,$287.13 ,$430.05 ,$287.13 ,$430.05 ,$430.05 ,$287.13 ,$430.05 ,$545.55 ,$627.30 ,$522.75 ,$697.00 ,$287.13 ,$613.36 ,$287.13 ,$522.75 ,$522.75 ,$592.45 ,$592.45 ,$287.13 ,$592.45 ,$287.13 ,$543.66 ,$543.66 ,$543.66 ,$627.30 ,$697.00 ,$627.30 ,$287.13 ,$697.00 ,$456.54 ,$287.13 ,$289.95 ,$23.44 ,$22.38 ,$301.49 ,$627.30 ,$646.05 ,$430.05 ,$195.16 ,$627.30 ,$287.13 ,$627.30 ,$627.30 ,$287.13 ,$453.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200253,88305,HC CELLIENT CELL BLOCK,312,1 ,$300.00 ,$195.00 ,$22.38 ,$300.00 ,$122.48 ,$223.50 ,$196.50 ,$48.99 ,$84.00 ,$151.50 ,$48.99 ,$185.10 ,$48.99 ,$185.10 ,$185.10 ,$48.99 ,$185.10 ,$93.08 ,$270.00 ,$225.00 ,$122.48 ,$48.99 ,$264.00 ,$48.99 ,$225.00 ,$225.00 ,$255.00 ,$255.00 ,$48.99 ,$255.00 ,$48.99 ,$234.00 ,$234.00 ,$234.00 ,$270.00 ,$122.48 ,$270.00 ,$48.99 ,$35.62 ,$196.50 ,$48.99 ,$124.80 ,$23.44 ,$22.38 ,$51.44 ,$270.00 ,$110.23 ,$185.10 ,$84.00 ,$270.00 ,$48.99 ,$270.00 ,$270.00 ,$48.99 ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200256,88313,HC SPECIAL STAIN II-90,312,1 ,$352.00 ,$228.80 ,$22.38 ,$352.00 ,$83.43 ,$262.24 ,$230.56 ,$33.37 ,$98.56 ,$177.76 ,$33.37 ,$217.18 ,$33.37 ,$217.18 ,$217.18 ,$33.37 ,$217.18 ,$63.40 ,$316.80 ,$264.00 ,$83.43 ,$33.37 ,$309.76 ,$33.37 ,$264.00 ,$264.00 ,$299.20 ,$299.20 ,$33.37 ,$299.20 ,$33.37 ,$274.56 ,$274.56 ,$274.56 ,$316.80 ,$83.43 ,$316.80 ,$33.37 ,$352.00 ,$230.56 ,$33.37 ,$146.43 ,$23.44 ,$22.38 ,$35.04 ,$316.80 ,$75.08 ,$217.18 ,$98.56 ,$316.80 ,$33.37 ,$316.80 ,$316.80 ,$33.37 ,$228.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200266,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$922.00 ,$599.30 ,$22.38 ,$922.00 , N/A ,$686.89 ,$603.91 , N/A ,$258.16 ,$465.61 , N/A ,$568.87 , N/A ,$568.87 ,$568.87 , N/A ,$568.87 , N/A ,$829.80 ,$691.50 , N/A , N/A ,$811.36 , N/A ,$691.50 ,$691.50 ,$783.70 ,$783.70 , N/A ,$783.70 , N/A ,$719.16 ,$719.16 ,$719.16 ,$829.80 , N/A ,$829.80 , N/A ,$68.12 ,$603.91 , N/A ,$383.55 ,$23.44 ,$22.38 , N/A ,$829.80 , N/A ,$568.87 ,$258.16 ,$829.80 , N/A ,$829.80 ,$829.80 , N/A ,$599.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200270,88342,HC IMMUNOHISOCHEMIST EA AB REPEAT,312,1 ,$838.00 ,$544.70 ,$22.38 ,$838.00 ,$367.59 ,$624.31 ,$548.89 ,$147.04 ,$234.64 ,$423.19 ,$147.04 ,$517.05 ,$147.04 ,$517.05 ,$517.05 ,$147.04 ,$517.05 ,$279.38 ,$754.20 ,$628.50 ,$367.59 ,$147.04 ,$737.44 ,$147.04 ,$628.50 ,$628.50 ,$712.30 ,$712.30 ,$147.04 ,$712.30 ,$147.04 ,$653.64 ,$653.64 ,$653.64 ,$754.20 ,$367.59 ,$754.20 ,$147.04 ,$74.24 ,$548.89 ,$147.04 ,$348.61 ,$23.44 ,$22.38 ,$154.39 ,$754.20 ,$330.83 ,$517.05 ,$234.64 ,$754.20 ,$147.04 ,$754.20 ,$754.20 ,$147.04 ,$544.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200272,88346,HC IF DIRECT-90,312,1 ,$238.00 ,$154.70 ,$22.38 ,$646.05 ,$238.00 ,$177.31 ,$155.89 ,$238.00 ,$66.64 ,$120.19 ,$238.00 ,$146.85 ,$238.00 ,$146.85 ,$146.85 ,$238.00 ,$146.85 ,$545.55 ,$214.20 ,$178.50 ,$238.00 ,$238.00 ,$209.44 ,$238.00 ,$178.50 ,$178.50 ,$202.30 ,$202.30 ,$238.00 ,$202.30 ,$238.00 ,$185.64 ,$185.64 ,$185.64 ,$214.20 ,$238.00 ,$214.20 ,$238.00 ,$238.00 ,$155.89 ,$238.00 ,$99.01 ,$23.44 ,$22.38 ,$238.00 ,$214.20 ,$646.05 ,$146.85 ,$66.64 ,$214.20 ,$238.00 ,$214.20 ,$214.20 ,$238.00 ,$154.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200274,88350,HC IMMUNOFLUOR PER SPEC EA ADDN SINGLE STAIN-90,312,1 ,$238.00 ,$154.70 ,$22.38 ,$238.00 , N/A ,$177.31 ,$155.89 , N/A ,$66.64 ,$120.19 , N/A ,$146.85 , N/A ,$146.85 ,$146.85 , N/A ,$146.85 , N/A ,$214.20 ,$178.50 , N/A , N/A ,$209.44 , N/A ,$178.50 ,$178.50 ,$202.30 ,$202.30 , N/A ,$202.30 , N/A ,$185.64 ,$185.64 ,$185.64 ,$214.20 , N/A ,$214.20 , N/A ,$238.00 ,$155.89 , N/A ,$99.01 ,$23.44 ,$22.38 , N/A ,$214.20 , N/A ,$146.85 ,$66.64 ,$214.20 , N/A ,$214.20 ,$214.20 , N/A ,$154.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200275,88360,HC MORPHO ANLYS TUMOR MAN-90,312,1 ,$651.00 ,$423.15 ,$24.61 ,$651.00 ,$367.59 ,$485.00 ,$426.41 ,$147.04 ,$182.28 ,$328.76 ,$147.04 ,$401.67 ,$147.04 ,$401.67 ,$401.67 ,$147.04 ,$401.67 ,$279.38 ,$585.90 ,$488.25 ,$367.59 ,$147.04 ,$572.88 ,$147.04 ,$488.25 ,$488.25 ,$553.35 ,$553.35 ,$147.04 ,$553.35 ,$147.04 ,$507.78 ,$507.78 ,$507.78 ,$585.90 ,$367.59 ,$585.90 ,$147.04 ,$86.62 ,$426.41 ,$147.04 ,$270.82 ,$25.78 ,$24.61 ,$154.39 ,$585.90 ,$330.83 ,$401.67 ,$182.28 ,$585.90 ,$147.04 ,$585.90 ,$585.90 ,$147.04 ,$423.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200287,88387,HC TISSUE EXAM MOLECULAR STUDY,312,1 ,$176.00 ,$114.40 ,$22.38 ,$176.00 , N/A ,$131.12 ,$115.28 , N/A ,$49.28 ,$88.88 , N/A ,$108.59 , N/A ,$108.59 ,$108.59 , N/A ,$108.59 , N/A ,$158.40 ,$132.00 , N/A , N/A ,$154.88 , N/A ,$132.00 ,$132.00 ,$149.60 ,$149.60 , N/A ,$149.60 , N/A ,$137.28 ,$137.28 ,$137.28 ,$158.40 , N/A ,$158.40 , N/A ,$176.00 ,$115.28 , N/A ,$73.22 ,$23.44 ,$22.38 , N/A ,$158.40 , N/A ,$108.59 ,$49.28 ,$158.40 , N/A ,$158.40 ,$158.40 , N/A ,$114.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200288,88388,HC TISSUE EXAM MOLECULR ST ADD ON,312,1 ,$201.00 ,$130.65 ,$22.38 ,$201.00 , N/A ,$149.75 ,$131.66 , N/A ,$56.28 ,$101.51 , N/A ,$124.02 , N/A ,$124.02 ,$124.02 , N/A ,$124.02 , N/A ,$180.90 ,$150.75 , N/A , N/A ,$176.88 , N/A ,$150.75 ,$150.75 ,$170.85 ,$170.85 , N/A ,$170.85 , N/A ,$156.78 ,$156.78 ,$156.78 ,$180.90 , N/A ,$180.90 , N/A ,$201.00 ,$131.66 , N/A ,$83.62 ,$23.44 ,$22.38 , N/A ,$180.90 , N/A ,$124.02 ,$56.28 ,$180.90 , N/A ,$180.90 ,$180.90 , N/A ,$130.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),31200317,88305,HC GROSS  AND  MICRO LEVEL IV,312,1 ,$13.00 ,$8.45 ,$3.64 ,$110.23 ,$13.00 ,$9.69 ,$8.52 ,$13.00 ,$3.64 ,$6.57 ,$13.00 ,$8.02 ,$13.00 ,$8.02 ,$8.02 ,$13.00 ,$8.02 ,$93.08 ,$11.70 ,$9.75 ,$13.00 ,$13.00 ,$11.44 ,$13.00 ,$9.75 ,$9.75 ,$11.05 ,$11.05 ,$13.00 ,$11.05 ,$13.00 ,$10.14 ,$10.14 ,$10.14 ,$11.70 ,$13.00 ,$11.70 ,$13.00 ,$13.00 ,$8.52 ,$13.00 ,$5.41 ,$13.00 ,$13.00 ,$13.00 ,$11.70 ,$110.23 ,$8.02 ,$3.64 ,$11.70 ,$13.00 ,$11.70 ,$11.70 ,$13.00 ,$8.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000003,22510,HC VERTEBROPLASTY INJ PERC THOR,320,1 ,"$7,901.00 ","$5,135.65 ","$2,212.28 ","$7,901.00 ","$7,178.17 ","$5,886.25 ","$5,175.16 ","$2,990.21 ","$2,212.28 ","$3,990.01 ","$2,990.21 ","$4,874.92 ","$2,990.21 ","$4,874.92 ","$4,874.92 ","$2,990.21 ","$4,874.92 ","$5,681.40 ","$7,110.90 ","$5,925.75 ","$7,178.17 ","$2,990.21 ","$6,952.88 ","$2,990.21 ","$5,925.75 ","$5,925.75 ","$6,715.85 ","$6,715.85 ","$2,990.21 ","$6,715.85 ","$2,990.21 ","$6,162.78 ","$6,162.78 ","$6,162.78 ","$7,110.90 ","$7,178.17 ","$7,110.90 ","$2,990.21 ","$7,901.00 ","$5,175.16 ","$2,990.21 ","$3,286.82 ","$3,570.18 ","$3,407.90 ","$3,129.80 ","$7,110.90 ","$6,480.18 ","$4,874.92 ","$2,212.28 ","$7,110.90 ","$2,990.21 ","$7,110.90 ","$7,110.90 ","$2,990.21 ","$5,135.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000005,22512,HC VERTEBROPLASTY INJ PERC ADDL,320,1 ,"$1,608.00 ","$1,045.20 ",$450.24 ,"$1,608.00 ", N/A ,"$1,197.96 ","$1,053.24 ", N/A ,$450.24 ,$812.04 , N/A ,$992.14 , N/A ,$992.14 ,$992.14 , N/A ,$992.14 , N/A ,"$1,447.20 ","$1,206.00 ", N/A , N/A ,"$1,415.04 ", N/A ,"$1,206.00 ","$1,206.00 ","$1,366.80 ","$1,366.80 ", N/A ,"$1,366.80 ", N/A ,"$1,254.24 ","$1,254.24 ","$1,254.24 ","$1,447.20 ", N/A ,"$1,447.20 ", N/A ,"$1,608.00 ","$1,053.24 ", N/A ,$668.93 ,"$1,608.00 ","$1,608.00 ", N/A ,"$1,447.20 ", N/A ,$992.14 ,$450.24 ,"$1,447.20 ", N/A ,"$1,447.20 ","$1,447.20 ", N/A ,"$1,045.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$355.00 ,$230.75 ,$99.40 ,$355.00 , N/A ,$264.48 ,$232.53 , N/A ,$99.40 ,$179.28 , N/A ,$219.04 , N/A ,$219.04 ,$219.04 , N/A ,$219.04 , N/A ,$319.50 ,$266.25 , N/A , N/A ,$312.40 , N/A ,$266.25 ,$266.25 ,$301.75 ,$301.75 , N/A ,$301.75 , N/A ,$276.90 ,$276.90 ,$276.90 ,$319.50 , N/A ,$319.50 , N/A ,$355.00 ,$232.53 , N/A ,$147.68 , N/A , N/A , N/A ,$319.50 , N/A ,$219.04 ,$99.40 ,$319.50 , N/A ,$319.50 ,$319.50 , N/A ,$230.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000010,24220,HC ARTHROGRAM INJ ELBOW,320,1 ,$355.00 ,$230.75 ,$99.40 ,$355.00 , N/A ,$264.48 ,$232.53 , N/A ,$99.40 ,$179.28 , N/A ,$219.04 , N/A ,$219.04 ,$219.04 , N/A ,$219.04 , N/A ,$319.50 ,$266.25 , N/A , N/A ,$312.40 , N/A ,$266.25 ,$266.25 ,$301.75 ,$301.75 , N/A ,$301.75 , N/A ,$276.90 ,$276.90 ,$276.90 ,$319.50 , N/A ,$319.50 , N/A ,$355.00 ,$232.53 , N/A ,$147.68 , N/A , N/A , N/A ,$319.50 , N/A ,$219.04 ,$99.40 ,$319.50 , N/A ,$319.50 ,$319.50 , N/A ,$230.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$529.00 ,$343.85 ,$148.12 ,$529.00 , N/A ,$394.11 ,$346.50 , N/A ,$148.12 ,$267.15 , N/A ,$326.39 , N/A ,$326.39 ,$326.39 , N/A ,$326.39 , N/A ,$476.10 ,$396.75 , N/A , N/A ,$465.52 , N/A ,$396.75 ,$396.75 ,$449.65 ,$449.65 , N/A ,$449.65 , N/A ,$412.62 ,$412.62 ,$412.62 ,$476.10 , N/A ,$476.10 , N/A ,$529.00 ,$346.50 , N/A ,$220.06 ,$252.78 ,$241.29 , N/A ,$476.10 , N/A ,$326.39 ,$148.12 ,$476.10 , N/A ,$476.10 ,$476.10 , N/A ,$343.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$496.00 ,$322.40 ,$138.88 ,$496.00 , N/A ,$369.52 ,$324.88 , N/A ,$138.88 ,$250.48 , N/A ,$306.03 , N/A ,$306.03 ,$306.03 , N/A ,$306.03 , N/A ,$446.40 ,$372.00 , N/A , N/A ,$436.48 , N/A ,$372.00 ,$372.00 ,$421.60 ,$421.60 , N/A ,$421.60 , N/A ,$386.88 ,$386.88 ,$386.88 ,$446.40 , N/A ,$446.40 , N/A ,$496.00 ,$324.88 , N/A ,$206.34 ,$252.78 ,$241.29 , N/A ,$446.40 , N/A ,$306.03 ,$138.88 ,$446.40 , N/A ,$446.40 ,$446.40 , N/A ,$322.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 , N/A , N/A , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000016,27648,HC ARTHROGRAM INJ ANKLE,320,1 ,$232.00 ,$150.80 ,$64.96 ,$232.00 , N/A ,$172.84 ,$151.96 , N/A ,$64.96 ,$117.16 , N/A ,$143.14 , N/A ,$143.14 ,$143.14 , N/A ,$143.14 , N/A ,$208.80 ,$174.00 , N/A , N/A ,$204.16 , N/A ,$174.00 ,$174.00 ,$197.20 ,$197.20 , N/A ,$197.20 , N/A ,$180.96 ,$180.96 ,$180.96 ,$208.80 , N/A ,$208.80 , N/A ,$232.00 ,$151.96 , N/A ,$96.51 ,$232.00 ,$232.00 , N/A ,$208.80 , N/A ,$143.14 ,$64.96 ,$208.80 , N/A ,$208.80 ,$208.80 , N/A ,$150.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000018,32550,HC INSERT CATH PLEURAL INDWELL W/,320,1 ,"$6,690.00 ","$4,348.50 ",$480.83 ,"$7,280.19 ","$6,690.00 ","$4,984.05 ","$4,381.95 ","$3,359.37 ","$1,873.20 ","$3,378.45 ","$3,359.37 ","$4,127.73 ","$3,359.37 ","$4,127.73 ","$4,127.73 ","$3,359.37 ","$4,127.73 ","$6,382.80 ","$6,021.00 ","$5,017.50 ","$6,690.00 ","$3,359.37 ","$5,887.20 ","$3,359.37 ","$5,017.50 ","$5,017.50 ","$5,686.50 ","$5,686.50 ","$3,359.37 ","$5,686.50 ","$3,359.37 ","$5,218.20 ","$5,218.20 ","$5,218.20 ","$6,021.00 ","$6,690.00 ","$6,021.00 ","$3,359.37 ","$6,690.00 ","$4,381.95 ","$3,359.37 ","$2,783.04 ",$503.72 ,$480.83 ,"$3,516.20 ","$6,021.00 ","$7,280.19 ","$4,127.73 ","$1,873.20 ","$6,021.00 ","$3,359.37 ","$6,021.00 ","$6,021.00 ","$3,359.37 ","$4,348.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$4,676.00 ","$3,039.40 ",$480.83 ,"$4,676.00 ","$3,564.32 ","$3,483.62 ","$3,062.78 ","$1,484.79 ","$1,309.28 ","$2,361.38 ","$1,484.79 ","$2,885.09 ","$1,484.79 ","$2,885.09 ","$2,885.09 ","$1,484.79 ","$2,885.09 ","$2,821.10 ","$4,208.40 ","$3,507.00 ","$3,564.32 ","$1,484.79 ","$4,114.88 ","$1,484.79 ","$3,507.00 ","$3,507.00 ","$3,974.60 ","$3,974.60 ","$1,484.79 ","$3,974.60 ","$1,484.79 ","$3,647.28 ","$3,647.28 ","$3,647.28 ","$4,208.40 ","$3,564.32 ","$4,208.40 ","$1,484.79 ","$4,676.00 ","$3,062.78 ","$1,484.79 ","$1,945.22 ",$503.72 ,$480.83 ,"$1,554.10 ","$4,208.40 ","$3,217.73 ","$2,885.09 ","$1,309.28 ","$4,208.40 ","$1,484.79 ","$4,208.40 ","$4,208.40 ","$1,484.79 ","$3,039.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000020,32552,HC REMOVAL TUNNELED PLEURAL CATH,320,1 ,"$1,892.00 ","$1,229.80 ",$480.83 ,"$1,892.00 ","$1,370.07 ","$1,409.54 ","$1,239.26 ",$570.73 ,$529.76 ,$955.46 ,$570.73 ,"$1,167.36 ",$570.73 ,"$1,167.36 ","$1,167.36 ",$570.73 ,"$1,167.36 ","$1,084.39 ","$1,702.80 ","$1,419.00 ","$1,370.07 ",$570.73 ,"$1,664.96 ",$570.73 ,"$1,419.00 ","$1,419.00 ","$1,608.20 ","$1,608.20 ",$570.73 ,"$1,608.20 ",$570.73 ,"$1,475.76 ","$1,475.76 ","$1,475.76 ","$1,702.80 ","$1,370.07 ","$1,702.80 ",$570.73 ,"$1,892.00 ","$1,239.26 ",$570.73 ,$787.07 ,$503.72 ,$480.83 ,$597.38 ,"$1,702.80 ","$1,236.85 ","$1,167.36 ",$529.76 ,"$1,702.80 ",$570.73 ,"$1,702.80 ","$1,702.80 ",$570.73 ,"$1,229.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000026,36000,HC IV START > 3YR OLD,320,1 ,$318.00 ,$206.70 ,$89.04 ,$318.00 , N/A ,$236.91 ,$208.29 , N/A ,$89.04 ,$160.59 , N/A ,$196.21 , N/A ,$196.21 ,$196.21 , N/A ,$196.21 , N/A ,$286.20 ,$238.50 , N/A , N/A ,$279.84 , N/A ,$238.50 ,$238.50 ,$270.30 ,$270.30 , N/A ,$270.30 , N/A ,$248.04 ,$248.04 ,$248.04 ,$286.20 , N/A ,$286.20 , N/A ,$318.00 ,$208.29 , N/A ,$132.29 ,$203.12 ,$193.88 , N/A ,$286.20 , N/A ,$196.21 ,$89.04 ,$286.20 , N/A ,$286.20 ,$286.20 , N/A ,$206.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000026,36000,HC IV START > 3YR OLD,320,1 ,$478.00 ,$310.70 ,$133.84 ,$478.00 , N/A ,$356.11 ,$313.09 , N/A ,$133.84 ,$241.39 , N/A ,$294.93 , N/A ,$294.93 ,$294.93 , N/A ,$294.93 , N/A ,$430.20 ,$358.50 , N/A , N/A ,$420.64 , N/A ,$358.50 ,$358.50 ,$406.30 ,$406.30 , N/A ,$406.30 , N/A ,$372.84 ,$372.84 ,$372.84 ,$430.20 , N/A ,$430.20 , N/A ,$478.00 ,$313.09 , N/A ,$198.85 ,$203.12 ,$193.88 , N/A ,$430.20 , N/A ,$294.93 ,$133.84 ,$430.20 , N/A ,$430.20 ,$430.20 , N/A ,$310.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000028,36005,HC VENOGRAM INJECTION 36005,320,1 ,"$1,864.00 ","$1,211.60 ",$361.95 ,"$1,864.00 ", N/A ,"$1,388.68 ","$1,220.92 ", N/A ,$521.92 ,$941.32 , N/A ,"$1,150.09 ", N/A ,"$1,150.09 ","$1,150.09 ", N/A ,"$1,150.09 ", N/A ,"$1,677.60 ","$1,398.00 ", N/A , N/A ,"$1,640.32 ", N/A ,"$1,398.00 ","$1,398.00 ","$1,584.40 ","$1,584.40 ", N/A ,"$1,584.40 ", N/A ,"$1,453.92 ","$1,453.92 ","$1,453.92 ","$1,677.60 ", N/A ,"$1,677.60 ", N/A ,"$1,864.00 ","$1,220.92 ", N/A ,$775.42 ,$379.18 ,$361.95 , N/A ,"$1,677.60 ", N/A ,"$1,150.09 ",$521.92 ,"$1,677.60 ", N/A ,"$1,677.60 ","$1,677.60 ", N/A ,"$1,211.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000028,36005,HC VENOGRAM INJECTION 36005,320,1 ,"$1,242.00 ",$807.30 ,$241.29 ,"$1,242.00 ", N/A ,$925.29 ,$813.51 , N/A ,$347.76 ,$627.21 , N/A ,$766.31 , N/A ,$766.31 ,$766.31 , N/A ,$766.31 , N/A ,"$1,117.80 ",$931.50 , N/A , N/A ,"$1,092.96 ", N/A ,$931.50 ,$931.50 ,"$1,055.70 ","$1,055.70 ", N/A ,"$1,055.70 ", N/A ,$968.76 ,$968.76 ,$968.76 ,"$1,117.80 ", N/A ,"$1,117.80 ", N/A ,"$1,242.00 ",$813.51 , N/A ,$516.67 ,$252.78 ,$241.29 , N/A ,"$1,117.80 ", N/A ,$766.31 ,$347.76 ,"$1,117.80 ", N/A ,"$1,117.80 ","$1,117.80 ", N/A ,$807.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,361,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 ,$10.00 ,$10.00 , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$463.00 ,$300.95 ,$129.64 ,$468.11 ,$463.00 ,$344.94 ,$303.27 ,$216.00 ,$129.64 ,$233.82 ,$216.00 ,$285.67 ,$216.00 ,$285.67 ,$285.67 ,$216.00 ,$285.67 ,$410.40 ,$416.70 ,$347.25 ,$463.00 ,$216.00 ,$407.44 ,$216.00 ,$347.25 ,$347.25 ,$393.55 ,$393.55 ,$216.00 ,$393.55 ,$216.00 ,$361.14 ,$361.14 ,$361.14 ,$416.70 ,$463.00 ,$416.70 ,$216.00 ,$463.00 ,$303.27 ,$216.00 ,$192.61 ,$463.00 ,$463.00 ,$226.09 ,$416.70 ,$468.11 ,$285.67 ,$129.64 ,$416.70 ,$216.00 ,$416.70 ,$416.70 ,$216.00 ,$300.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000031,36598,HC CONTRAST INJ CENTRAL VENOUS CATH W/FLUORO,320,1 ,$463.00 ,$300.95 ,$129.64 ,$468.11 ,$463.00 ,$344.94 ,$303.27 ,$216.00 ,$129.64 ,$233.82 ,$216.00 ,$285.67 ,$216.00 ,$285.67 ,$285.67 ,$216.00 ,$285.67 ,$410.40 ,$416.70 ,$347.25 ,$463.00 ,$216.00 ,$407.44 ,$216.00 ,$347.25 ,$347.25 ,$393.55 ,$393.55 ,$216.00 ,$393.55 ,$216.00 ,$361.14 ,$361.14 ,$361.14 ,$416.70 ,$463.00 ,$416.70 ,$216.00 ,$463.00 ,$303.27 ,$216.00 ,$192.61 ,$463.00 ,$463.00 ,$226.09 ,$416.70 ,$468.11 ,$285.67 ,$129.64 ,$416.70 ,$216.00 ,$416.70 ,$416.70 ,$216.00 ,$300.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$284.00 ,$184.60 ,$79.52 ,$621.02 ,$284.00 ,$211.58 ,$186.02 ,$284.00 ,$79.52 ,$143.42 ,$284.00 ,$175.23 ,$284.00 ,$175.23 ,$175.23 ,$284.00 ,$175.23 ,$544.46 ,$255.60 ,$213.00 ,$284.00 ,$284.00 ,$249.92 ,$284.00 ,$213.00 ,$213.00 ,$241.40 ,$241.40 ,$284.00 ,$241.40 ,$284.00 ,$221.52 ,$221.52 ,$221.52 ,$255.60 ,$284.00 ,$255.60 ,$284.00 ,$284.00 ,$186.02 ,$284.00 ,$118.14 ,$284.00 ,$284.00 ,$284.00 ,$255.60 ,$621.02 ,$175.23 ,$79.52 ,$255.60 ,$284.00 ,$255.60 ,$255.60 ,$284.00 ,$184.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000036,43761,HC REPOSITION G-TUBE,320,1 ,$798.42 ,$518.97 ,$83.00 ,$798.42 ,$674.49 ,$594.82 ,$522.97 ,$280.97 ,$223.56 ,$403.20 ,$280.97 ,$492.63 ,$280.97 ,$492.63 ,$492.63 ,$280.97 ,$492.63 ,$533.84 ,$718.58 ,$598.82 ,$674.49 ,$280.97 ,$702.61 ,$280.97 ,$598.82 ,$598.82 ,$678.66 ,$678.66 ,$280.97 ,$678.66 ,$280.97 ,$622.77 ,$622.77 ,$622.77 ,$718.58 ,$674.49 ,$718.58 ,$280.97 ,$798.42 ,$522.97 ,$280.97 ,$332.14 ,$86.96 ,$83.00 ,$294.09 ,$718.58 ,$608.90 ,$492.63 ,$223.56 ,$718.58 ,$280.97 ,$718.58 ,$718.58 ,$280.97 ,$518.97 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000044,47535,HC REVISE/REINSERT TUBE TRNSHEPAT,320,1 ,"$6,146.00 ","$3,994.90 ","$1,170.12 ","$7,280.19 ","$6,146.00 ","$4,578.77 ","$4,025.63 ","$3,359.37 ","$1,720.88 ","$3,103.73 ","$3,359.37 ","$3,792.08 ","$3,359.37 ","$3,792.08 ","$3,792.08 ","$3,359.37 ","$3,792.08 ","$6,382.80 ","$5,531.40 ","$4,609.50 ","$6,146.00 ","$3,359.37 ","$5,408.48 ","$3,359.37 ","$4,609.50 ","$4,609.50 ","$5,224.10 ","$5,224.10 ","$3,359.37 ","$5,224.10 ","$3,359.37 ","$4,793.88 ","$4,793.88 ","$4,793.88 ","$5,531.40 ","$6,146.00 ","$5,531.40 ","$3,359.37 ","$6,146.00 ","$4,025.63 ","$3,359.37 ","$2,556.74 ","$1,225.84 ","$1,170.12 ","$3,516.20 ","$5,531.40 ","$7,280.19 ","$3,792.08 ","$1,720.88 ","$5,531.40 ","$3,359.37 ","$5,531.40 ","$5,531.40 ","$3,359.37 ","$3,994.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000051,49406,HC DRN ABSC RETROPERITONEAL PERC,320,1 ,"$4,043.00 ","$2,627.95 ",$480.83 ,"$4,043.00 ","$3,566.38 ","$3,012.04 ","$2,648.17 ","$1,485.64 ","$1,132.04 ","$2,041.72 ","$1,485.64 ","$2,494.53 ","$1,485.64 ","$2,494.53 ","$2,494.53 ","$1,485.64 ","$2,494.53 ","$2,822.72 ","$3,638.70 ","$3,032.25 ","$3,566.38 ","$1,485.64 ","$3,557.84 ","$1,485.64 ","$3,032.25 ","$3,032.25 ","$3,436.55 ","$3,436.55 ","$1,485.64 ","$3,436.55 ","$1,485.64 ","$3,153.54 ","$3,153.54 ","$3,153.54 ","$3,638.70 ","$3,566.38 ","$3,638.70 ","$1,485.64 ","$4,043.00 ","$2,648.17 ","$1,485.64 ","$1,681.89 ",$503.72 ,$480.83 ,"$1,555.00 ","$3,638.70 ","$3,219.59 ","$2,494.53 ","$1,132.04 ","$3,638.70 ","$1,485.64 ","$3,638.70 ","$3,638.70 ","$1,485.64 ","$2,627.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000053,49423,HC EXCHG CATH ABSC/CYST DRAIN,320,1 ,"$1,847.00 ","$1,200.55 ",$480.83 ,"$3,716.58 ","$1,847.00 ","$1,376.02 ","$1,209.79 ","$1,714.97 ",$517.16 ,$932.74 ,"$1,714.97 ","$1,139.60 ","$1,714.97 ","$1,139.60 ","$1,139.60 ","$1,714.97 ","$1,139.60 ","$3,258.44 ","$1,662.30 ","$1,385.25 ","$1,847.00 ","$1,714.97 ","$1,625.36 ","$1,714.97 ","$1,385.25 ","$1,385.25 ","$1,569.95 ","$1,569.95 ","$1,714.97 ","$1,569.95 ","$1,714.97 ","$1,440.66 ","$1,440.66 ","$1,440.66 ","$1,662.30 ","$1,847.00 ","$1,662.30 ","$1,714.97 ","$1,847.00 ","$1,209.79 ","$1,714.97 ",$768.35 ,$503.72 ,$480.83 ,"$1,795.04 ","$1,662.30 ","$3,716.58 ","$1,139.60 ",$517.16 ,"$1,662.30 ","$1,714.97 ","$1,662.30 ","$1,662.30 ","$1,714.97 ","$1,200.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000054,49424,HC INJ CONTRAST ABSC/CYST,320,1 ,"$1,528.00 ",$993.20 ,$241.29 ,"$1,528.00 ", N/A ,"$1,138.36 ","$1,000.84 ", N/A ,$427.84 ,$771.64 , N/A ,$942.78 , N/A ,$942.78 ,$942.78 , N/A ,$942.78 , N/A ,"$1,375.20 ","$1,146.00 ", N/A , N/A ,"$1,344.64 ", N/A ,"$1,146.00 ","$1,146.00 ","$1,298.80 ","$1,298.80 ", N/A ,"$1,298.80 ", N/A ,"$1,191.84 ","$1,191.84 ","$1,191.84 ","$1,375.20 ", N/A ,"$1,375.20 ", N/A ,"$1,528.00 ","$1,000.84 ", N/A ,$635.65 ,$252.78 ,$241.29 , N/A ,"$1,375.20 ", N/A ,$942.78 ,$427.84 ,"$1,375.20 ", N/A ,"$1,375.20 ","$1,375.20 ", N/A ,$993.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000060,49450,HC RPLC G/CEC/OTH TB UNDER FLUORO,320,1 ,"$1,830.00 ","$1,189.50 ",$418.52 ,"$1,851.53 ","$1,830.00 ","$1,363.35 ","$1,198.65 ",$854.37 ,$512.40 ,$924.15 ,$854.37 ,"$1,129.11 ",$854.37 ,"$1,129.11 ","$1,129.11 ",$854.37 ,"$1,129.11 ","$1,623.30 ","$1,647.00 ","$1,372.50 ","$1,830.00 ",$854.37 ,"$1,610.40 ",$854.37 ,"$1,372.50 ","$1,372.50 ","$1,555.50 ","$1,555.50 ",$854.37 ,"$1,555.50 ",$854.37 ,"$1,427.40 ","$1,427.40 ","$1,427.40 ","$1,647.00 ","$1,830.00 ","$1,647.00 ",$854.37 ,"$1,830.00 ","$1,198.65 ",$854.37 ,$761.28 ,$438.45 ,$418.52 ,$894.26 ,"$1,647.00 ","$1,851.53 ","$1,129.11 ",$512.40 ,"$1,647.00 ",$854.37 ,"$1,647.00 ","$1,647.00 ",$854.37 ,"$1,189.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000062,49452,HC RPLC GASTRO-JEJUN TB FLUORO,361,1 ,"$2,184.00 ","$1,419.60 ",$418.52 ,"$2,184.00 ","$2,050.97 ","$1,627.08 ","$1,430.52 ",$854.37 ,$611.52 ,"$1,102.92 ",$854.37 ,"$1,347.53 ",$854.37 ,"$1,347.53 ","$1,347.53 ",$854.37 ,"$1,347.53 ","$1,623.30 ","$1,965.60 ","$1,638.00 ","$2,050.97 ",$854.37 ,"$1,921.92 ",$854.37 ,"$1,638.00 ","$1,638.00 ","$1,856.40 ","$1,856.40 ",$854.37 ,"$1,856.40 ",$854.37 ,"$1,703.52 ","$1,703.52 ","$1,703.52 ","$1,965.60 ","$2,050.97 ","$1,965.60 ",$854.37 ,"$2,184.00 ","$1,430.52 ",$854.37 ,$908.54 ,$438.45 ,$418.52 ,$894.26 ,"$1,965.60 ","$1,851.53 ","$1,347.53 ",$611.52 ,"$1,965.60 ",$854.37 ,"$1,965.60 ","$1,965.60 ",$854.37 ,"$1,419.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,$706.00 ,$458.90 ,$197.68 ,$706.00 ,$583.23 ,$525.97 ,$462.43 ,$242.96 ,$197.68 ,$356.53 ,$242.96 ,$435.60 ,$242.96 ,$435.60 ,$435.60 ,$242.96 ,$435.60 ,$461.62 ,$635.40 ,$529.50 ,$583.23 ,$242.96 ,$621.28 ,$242.96 ,$529.50 ,$529.50 ,$600.10 ,$600.10 ,$242.96 ,$600.10 ,$242.96 ,$550.68 ,$550.68 ,$550.68 ,$635.40 ,$583.23 ,$635.40 ,$242.96 ,$706.00 ,$462.43 ,$242.96 ,$293.70 ,$252.78 ,$241.29 ,$254.30 ,$635.40 ,$526.52 ,$435.60 ,$197.68 ,$635.40 ,$242.96 ,$635.40 ,$635.40 ,$242.96 ,$458.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000066,49405,HC DRN ABSC PERIRENAL  PERC,320,1 ,"$2,924.00 ","$1,900.60 ",$480.83 ,"$3,219.59 ","$2,924.00 ","$2,178.38 ","$1,915.22 ","$1,485.64 ",$818.72 ,"$1,476.62 ","$1,485.64 ","$1,804.11 ","$1,485.64 ","$1,804.11 ","$1,804.11 ","$1,485.64 ","$1,804.11 ","$2,822.72 ","$2,631.60 ","$2,193.00 ","$2,924.00 ","$1,485.64 ","$2,573.12 ","$1,485.64 ","$2,193.00 ","$2,193.00 ","$2,485.40 ","$2,485.40 ","$1,485.64 ","$2,485.40 ","$1,485.64 ","$2,280.72 ","$2,280.72 ","$2,280.72 ","$2,631.60 ","$2,924.00 ","$2,631.60 ","$1,485.64 ","$2,924.00 ","$1,915.22 ","$1,485.64 ","$1,216.38 ",$503.72 ,$480.83 ,"$1,555.00 ","$2,631.60 ","$3,219.59 ","$1,804.11 ",$818.72 ,"$2,631.60 ","$1,485.64 ","$2,631.60 ","$2,631.60 ","$1,485.64 ","$1,900.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000071,50387,HC CHANGE EXT/INT URET STENT,320,1 ,"$3,213.00 ","$2,088.45 ",$754.44 ,"$4,097.10 ","$3,213.00 ","$2,393.69 ","$2,104.52 ","$1,890.56 ",$899.64 ,"$1,622.57 ","$1,890.56 ","$1,982.42 ","$1,890.56 ","$1,982.42 ","$1,982.42 ","$1,890.56 ","$1,982.42 ","$3,592.06 ","$2,891.70 ","$2,409.75 ","$3,213.00 ","$1,890.56 ","$2,827.44 ","$1,890.56 ","$2,409.75 ","$2,409.75 ","$2,731.05 ","$2,731.05 ","$1,890.56 ","$2,731.05 ","$1,890.56 ","$2,506.14 ","$2,506.14 ","$2,506.14 ","$2,891.70 ","$3,213.00 ","$2,891.70 ","$1,890.56 ","$3,213.00 ","$2,104.52 ","$1,890.56 ","$1,336.61 ",$790.36 ,$754.44 ,"$1,978.83 ","$2,891.70 ","$4,097.10 ","$1,982.42 ",$899.64 ,"$2,891.70 ","$1,890.56 ","$2,891.70 ","$2,891.70 ","$1,890.56 ","$2,088.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000072,50389,HC REM NEPHRO TUBE FLUORO,320,1 ,"$1,291.00 ",$839.15 ,$361.48 ,"$1,316.43 ","$1,291.00 ",$961.80 ,$845.61 ,$607.45 ,$361.48 ,$651.96 ,$607.45 ,$796.55 ,$607.45 ,$796.55 ,$796.55 ,$607.45 ,$796.55 ,"$1,154.16 ","$1,161.90 ",$968.25 ,"$1,291.00 ",$607.45 ,"$1,136.08 ",$607.45 ,$968.25 ,$968.25 ,"$1,097.35 ","$1,097.35 ",$607.45 ,"$1,097.35 ",$607.45 ,"$1,006.98 ","$1,006.98 ","$1,006.98 ","$1,161.90 ","$1,291.00 ","$1,161.90 ",$607.45 ,"$1,291.00 ",$845.61 ,$607.45 ,$537.06 ,$790.36 ,$754.44 ,$635.81 ,"$1,161.90 ","$1,316.43 ",$796.55 ,$361.48 ,"$1,161.90 ",$607.45 ,"$1,161.90 ","$1,161.90 ",$607.45 ,$839.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000077,50693,HC INTRO GUIDE RENAL PELVIS URET DIL,320,1 ,"$6,331.00 ","$4,115.15 ","$1,604.78 ","$7,035.28 ","$6,331.00 ","$4,716.60 ","$4,146.81 ","$3,246.35 ","$1,772.68 ","$3,197.16 ","$3,246.35 ","$3,906.23 ","$3,246.35 ","$3,906.23 ","$3,906.23 ","$3,246.35 ","$3,906.23 ","$6,168.07 ","$5,697.90 ","$4,748.25 ","$6,331.00 ","$3,246.35 ","$5,571.28 ","$3,246.35 ","$4,748.25 ","$4,748.25 ","$5,381.35 ","$5,381.35 ","$3,246.35 ","$5,381.35 ","$3,246.35 ","$4,938.18 ","$4,938.18 ","$4,938.18 ","$5,697.90 ","$6,331.00 ","$5,697.90 ","$3,246.35 ","$6,331.00 ","$4,146.81 ","$3,246.35 ","$2,633.70 ","$1,681.20 ","$1,604.78 ","$3,397.91 ","$5,697.90 ","$7,035.28 ","$3,906.23 ","$1,772.68 ","$5,697.90 ","$3,246.35 ","$5,697.90 ","$5,697.90 ","$3,246.35 ","$4,115.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$5,012.00 ","$3,257.80 ",$754.44 ,"$5,012.00 ","$4,538.41 ","$3,733.94 ","$3,282.86 ","$1,890.56 ","$1,403.36 ","$2,531.06 ","$1,890.56 ","$3,092.40 ","$1,890.56 ","$3,092.40 ","$3,092.40 ","$1,890.56 ","$3,092.40 ","$3,592.06 ","$4,510.80 ","$3,759.00 ","$4,538.41 ","$1,890.56 ","$4,410.56 ","$1,890.56 ","$3,759.00 ","$3,759.00 ","$4,260.20 ","$4,260.20 ","$1,890.56 ","$4,260.20 ","$1,890.56 ","$3,909.36 ","$3,909.36 ","$3,909.36 ","$4,510.80 ","$4,538.41 ","$4,510.80 ","$1,890.56 ","$5,012.00 ","$3,282.86 ","$1,890.56 ","$2,084.99 ",$790.36 ,$754.44 ,"$1,978.83 ","$4,510.80 ","$4,097.10 ","$3,092.40 ","$1,403.36 ","$4,510.80 ","$1,890.56 ","$4,510.80 ","$4,510.80 ","$1,890.56 ","$3,257.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$7,518.00 ","$4,886.70 ","$1,131.65 ","$7,518.00 ","$4,538.41 ","$5,600.91 ","$4,924.29 ","$1,890.56 ","$2,105.04 ","$3,796.59 ","$1,890.56 ","$4,638.61 ","$1,890.56 ","$4,638.61 ","$4,638.61 ","$1,890.56 ","$4,638.61 ","$3,592.06 ","$6,766.20 ","$5,638.50 ","$4,538.41 ","$1,890.56 ","$6,615.84 ","$1,890.56 ","$5,638.50 ","$5,638.50 ","$6,390.30 ","$6,390.30 ","$1,890.56 ","$6,390.30 ","$1,890.56 ","$5,864.04 ","$5,864.04 ","$5,864.04 ","$6,766.20 ","$4,538.41 ","$6,766.20 ","$1,890.56 ","$7,518.00 ","$4,924.29 ","$1,890.56 ","$3,127.49 ","$1,185.54 ","$1,131.65 ","$1,978.83 ","$6,766.20 ","$4,097.10 ","$4,638.61 ","$2,105.04 ","$6,766.20 ","$1,890.56 ","$6,766.20 ","$6,766.20 ","$1,890.56 ","$4,886.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000083,50690,HC INJ ILEAL CONDUIT,320,1 ,$256.00 ,$166.40 ,$71.68 ,$256.00 , N/A ,$190.72 ,$167.68 , N/A ,$71.68 ,$129.28 , N/A ,$157.95 , N/A ,$157.95 ,$157.95 , N/A ,$157.95 , N/A ,$230.40 ,$192.00 , N/A , N/A ,$225.28 , N/A ,$192.00 ,$192.00 ,$217.60 ,$217.60 , N/A ,$217.60 , N/A ,$199.68 ,$199.68 ,$199.68 ,$230.40 , N/A ,$230.40 , N/A ,$256.00 ,$167.68 , N/A ,$106.50 ,$252.78 ,$241.29 , N/A ,$230.40 , N/A ,$157.95 ,$71.68 ,$230.40 , N/A ,$230.40 ,$230.40 , N/A ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000085,51600,HC INJ CYSTOGRAM,320,1 ,$645.00 ,$419.25 ,$180.60 ,$645.00 , N/A ,$480.53 ,$422.48 , N/A ,$180.60 ,$325.73 , N/A ,$397.97 , N/A ,$397.97 ,$397.97 , N/A ,$397.97 , N/A ,$580.50 ,$483.75 , N/A , N/A ,$567.60 , N/A ,$483.75 ,$483.75 ,$548.25 ,$548.25 , N/A ,$548.25 , N/A ,$503.10 ,$503.10 ,$503.10 ,$580.50 , N/A ,$580.50 , N/A ,$645.00 ,$422.48 , N/A ,$268.32 ,$252.78 ,$241.29 , N/A ,$580.50 , N/A ,$397.97 ,$180.60 ,$580.50 , N/A ,$580.50 ,$580.50 , N/A ,$419.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,$297.00 ,$193.05 ,$83.16 ,$297.00 , N/A ,$221.27 ,$194.54 , N/A ,$83.16 ,$149.99 , N/A ,$183.25 , N/A ,$183.25 ,$183.25 , N/A ,$183.25 , N/A ,$267.30 ,$222.75 , N/A , N/A ,$261.36 , N/A ,$222.75 ,$222.75 ,$252.45 ,$252.45 , N/A ,$252.45 , N/A ,$231.66 ,$231.66 ,$231.66 ,$267.30 , N/A ,$267.30 , N/A ,$297.00 ,$194.54 , N/A ,$123.55 ,$252.78 ,$241.29 , N/A ,$267.30 , N/A ,$183.25 ,$83.16 ,$267.30 , N/A ,$267.30 ,$267.30 , N/A ,$193.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$612.00 ,$397.80 ,$171.36 ,$612.00 , N/A ,$455.94 ,$400.86 , N/A ,$171.36 ,$309.06 , N/A ,$377.60 , N/A ,$377.60 ,$377.60 , N/A ,$377.60 , N/A ,$550.80 ,$459.00 , N/A , N/A ,$538.56 , N/A ,$459.00 ,$459.00 ,$520.20 ,$520.20 , N/A ,$520.20 , N/A ,$477.36 ,$477.36 ,$477.36 ,$550.80 , N/A ,$550.80 , N/A ,$612.00 ,$400.86 , N/A ,$254.59 ,$252.78 ,$241.29 , N/A ,$550.80 , N/A ,$377.60 ,$171.36 ,$550.80 , N/A ,$550.80 ,$550.80 , N/A ,$397.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$649.00 ,$421.85 ,$38.68 ,$649.00 ,$205.02 ,$483.51 ,$425.10 ,$85.41 ,$181.72 ,$327.75 ,$85.41 ,$400.43 ,$85.41 ,$400.43 ,$400.43 ,$85.41 ,$400.43 ,$162.28 ,$584.10 ,$486.75 ,$205.02 ,$85.41 ,$571.12 ,$85.41 ,$486.75 ,$486.75 ,$551.65 ,$551.65 ,$85.41 ,$551.65 ,$85.41 ,$506.22 ,$506.22 ,$506.22 ,$584.10 ,$205.02 ,$584.10 ,$85.41 ,$649.00 ,$425.10 ,$85.41 ,$269.98 ,$40.52 ,$38.68 ,$89.39 ,$584.10 ,$185.09 ,$400.43 ,$181.72 ,$584.10 ,$85.41 ,$584.10 ,$584.10 ,$85.41 ,$421.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$958.00 ,$622.70 ,$38.68 ,$958.00 ,$275.96 ,$713.71 ,$627.49 ,$114.95 ,$268.24 ,$483.79 ,$114.95 ,$591.09 ,$114.95 ,$591.09 ,$591.09 ,$114.95 ,$591.09 ,$218.41 ,$862.20 ,$718.50 ,$275.96 ,$114.95 ,$843.04 ,$114.95 ,$718.50 ,$718.50 ,$814.30 ,$814.30 ,$114.95 ,$814.30 ,$114.95 ,$747.24 ,$747.24 ,$747.24 ,$862.20 ,$275.96 ,$862.20 ,$114.95 ,$958.00 ,$627.49 ,$114.95 ,$398.53 ,$40.52 ,$38.68 ,$120.32 ,$862.20 ,$249.12 ,$591.09 ,$268.24 ,$862.20 ,$114.95 ,$862.20 ,$862.20 ,$114.95 ,$622.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$313.00 ,$203.45 ,$38.68 ,$313.00 ,$205.02 ,$233.19 ,$205.02 ,$85.41 ,$87.64 ,$158.07 ,$85.41 ,$193.12 ,$85.41 ,$193.12 ,$193.12 ,$85.41 ,$193.12 ,$162.28 ,$281.70 ,$234.75 ,$205.02 ,$85.41 ,$275.44 ,$85.41 ,$234.75 ,$234.75 ,$266.05 ,$266.05 ,$85.41 ,$266.05 ,$85.41 ,$244.14 ,$244.14 ,$244.14 ,$281.70 ,$205.02 ,$281.70 ,$85.41 ,$313.00 ,$205.02 ,$85.41 ,$130.21 ,$40.52 ,$38.68 ,$89.39 ,$281.70 ,$185.09 ,$193.12 ,$87.64 ,$281.70 ,$85.41 ,$281.70 ,$281.70 ,$85.41 ,$203.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$911.00 ,$592.15 ,$38.68 ,$911.00 ,$275.96 ,$678.70 ,$596.71 ,$114.95 ,$255.08 ,$460.06 ,$114.95 ,$562.09 ,$114.95 ,$562.09 ,$562.09 ,$114.95 ,$562.09 ,$218.41 ,$819.90 ,$683.25 ,$275.96 ,$114.95 ,$801.68 ,$114.95 ,$683.25 ,$683.25 ,$774.35 ,$774.35 ,$114.95 ,$774.35 ,$114.95 ,$710.58 ,$710.58 ,$710.58 ,$819.90 ,$275.96 ,$819.90 ,$114.95 ,$911.00 ,$596.71 ,$114.95 ,$378.98 ,$40.52 ,$38.68 ,$120.32 ,$819.90 ,$249.12 ,$562.09 ,$255.08 ,$819.90 ,$114.95 ,$819.90 ,$819.90 ,$114.95 ,$592.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$659.00 ,$428.35 ,$38.68 ,$659.00 ,$205.02 ,$490.96 ,$431.65 ,$85.41 ,$184.52 ,$332.80 ,$85.41 ,$406.60 ,$85.41 ,$406.60 ,$406.60 ,$85.41 ,$406.60 ,$162.28 ,$593.10 ,$494.25 ,$205.02 ,$85.41 ,$579.92 ,$85.41 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$85.41 ,$560.15 ,$85.41 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$205.02 ,$593.10 ,$85.41 ,$659.00 ,$431.65 ,$85.41 ,$274.14 ,$40.52 ,$38.68 ,$89.39 ,$593.10 ,$185.09 ,$406.60 ,$184.52 ,$593.10 ,$85.41 ,$593.10 ,$593.10 ,$85.41 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$709.00 ,$460.85 ,$38.68 ,$709.00 ,$275.96 ,$528.21 ,$464.40 ,$114.95 ,$198.52 ,$358.05 ,$114.95 ,$437.45 ,$114.95 ,$437.45 ,$437.45 ,$114.95 ,$437.45 ,$218.41 ,$638.10 ,$531.75 ,$275.96 ,$114.95 ,$623.92 ,$114.95 ,$531.75 ,$531.75 ,$602.65 ,$602.65 ,$114.95 ,$602.65 ,$114.95 ,$553.02 ,$553.02 ,$553.02 ,$638.10 ,$275.96 ,$638.10 ,$114.95 ,$709.00 ,$464.40 ,$114.95 ,$294.94 ,$40.52 ,$38.68 ,$120.32 ,$638.10 ,$249.12 ,$437.45 ,$198.52 ,$638.10 ,$114.95 ,$638.10 ,$638.10 ,$114.95 ,$460.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$266.00 ,$172.90 ,$38.68 ,$266.00 ,$205.02 ,$198.17 ,$174.23 ,$85.41 ,$74.48 ,$134.33 ,$85.41 ,$164.12 ,$85.41 ,$164.12 ,$164.12 ,$85.41 ,$164.12 ,$162.28 ,$239.40 ,$199.50 ,$205.02 ,$85.41 ,$234.08 ,$85.41 ,$199.50 ,$199.50 ,$226.10 ,$226.10 ,$85.41 ,$226.10 ,$85.41 ,$207.48 ,$207.48 ,$207.48 ,$239.40 ,$205.02 ,$239.40 ,$85.41 ,$266.00 ,$174.23 ,$85.41 ,$110.66 ,$40.52 ,$38.68 ,$89.39 ,$239.40 ,$185.09 ,$164.12 ,$74.48 ,$239.40 ,$85.41 ,$239.40 ,$239.40 ,$85.41 ,$172.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$764.00 ,$496.60 ,$38.68 ,$764.00 ,$205.02 ,$569.18 ,$500.42 ,$85.41 ,$213.92 ,$385.82 ,$85.41 ,$471.39 ,$85.41 ,$471.39 ,$471.39 ,$85.41 ,$471.39 ,$162.28 ,$687.60 ,$573.00 ,$205.02 ,$85.41 ,$672.32 ,$85.41 ,$573.00 ,$573.00 ,$649.40 ,$649.40 ,$85.41 ,$649.40 ,$85.41 ,$595.92 ,$595.92 ,$595.92 ,$687.60 ,$205.02 ,$687.60 ,$85.41 ,$764.00 ,$500.42 ,$85.41 ,$317.82 ,$40.52 ,$38.68 ,$89.39 ,$687.60 ,$185.09 ,$471.39 ,$213.92 ,$687.60 ,$85.41 ,$687.60 ,$687.60 ,$85.41 ,$496.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$404.00 ,$262.60 ,$38.68 ,$404.00 ,$275.96 ,$300.98 ,$264.62 ,$114.95 ,$113.12 ,$204.02 ,$114.95 ,$249.27 ,$114.95 ,$249.27 ,$249.27 ,$114.95 ,$249.27 ,$218.41 ,$363.60 ,$303.00 ,$275.96 ,$114.95 ,$355.52 ,$114.95 ,$303.00 ,$303.00 ,$343.40 ,$343.40 ,$114.95 ,$343.40 ,$114.95 ,$315.12 ,$315.12 ,$315.12 ,$363.60 ,$275.96 ,$363.60 ,$114.95 ,$404.00 ,$264.62 ,$114.95 ,$168.06 ,$40.52 ,$38.68 ,$120.32 ,$363.60 ,$249.12 ,$249.27 ,$113.12 ,$363.60 ,$114.95 ,$363.60 ,$363.60 ,$114.95 ,$262.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$901.00 ,$585.65 ,$38.68 ,$901.00 ,$275.96 ,$671.25 ,$590.16 ,$114.95 ,$252.28 ,$455.01 ,$114.95 ,$555.92 ,$114.95 ,$555.92 ,$555.92 ,$114.95 ,$555.92 ,$218.41 ,$810.90 ,$675.75 ,$275.96 ,$114.95 ,$792.88 ,$114.95 ,$675.75 ,$675.75 ,$765.85 ,$765.85 ,$114.95 ,$765.85 ,$114.95 ,$702.78 ,$702.78 ,$702.78 ,$810.90 ,$275.96 ,$810.90 ,$114.95 ,$901.00 ,$590.16 ,$114.95 ,$374.82 ,$40.52 ,$38.68 ,$120.32 ,$810.90 ,$249.12 ,$555.92 ,$252.28 ,$810.90 ,$114.95 ,$810.90 ,$810.90 ,$114.95 ,$585.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$677.00 ,$440.05 ,$38.68 ,$677.00 ,$205.02 ,$504.37 ,$443.44 ,$85.41 ,$189.56 ,$341.89 ,$85.41 ,$417.71 ,$85.41 ,$417.71 ,$417.71 ,$85.41 ,$417.71 ,$162.28 ,$609.30 ,$507.75 ,$205.02 ,$85.41 ,$595.76 ,$85.41 ,$507.75 ,$507.75 ,$575.45 ,$575.45 ,$85.41 ,$575.45 ,$85.41 ,$528.06 ,$528.06 ,$528.06 ,$609.30 ,$205.02 ,$609.30 ,$85.41 ,$677.00 ,$443.44 ,$85.41 ,$281.63 ,$40.52 ,$38.68 ,$89.39 ,$609.30 ,$185.09 ,$417.71 ,$189.56 ,$609.30 ,$85.41 ,$609.30 ,$609.30 ,$85.41 ,$440.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000114,70336,HC MRI TMJ,320,1 ,"$2,783.00 ","$1,808.95 ",$162.51 ,"$2,783.00 ",$583.23 ,"$2,073.34 ","$1,822.87 ",$242.96 ,$779.24 ,"$1,405.42 ",$242.96 ,"$1,717.11 ",$242.96 ,"$1,717.11 ","$1,717.11 ",$242.96 ,"$1,717.11 ",$461.62 ,"$2,504.70 ","$2,087.25 ",$583.23 ,$242.96 ,"$2,449.04 ",$242.96 ,"$2,087.25 ","$2,087.25 ","$2,365.55 ","$2,365.55 ",$242.96 ,"$2,365.55 ",$242.96 ,"$2,170.74 ","$2,170.74 ","$2,170.74 ","$2,504.70 ",$583.23 ,"$2,504.70 ",$242.96 ,"$2,783.00 ","$1,822.87 ",$242.96 ,"$1,157.73 ",$170.25 ,$162.51 ,$254.30 ,"$2,504.70 ",$526.52 ,"$1,717.11 ",$779.24 ,"$2,504.70 ",$242.96 ,"$2,504.70 ","$2,504.70 ",$242.96 ,"$1,808.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000115,70355,HC XRAY PAN MANDIBLE/MAXLA,320,1 ,$369.00 ,$239.85 ,$38.68 ,$369.00 ,$205.02 ,$274.91 ,$241.70 ,$85.41 ,$103.32 ,$186.35 ,$85.41 ,$227.67 ,$85.41 ,$227.67 ,$227.67 ,$85.41 ,$227.67 ,$162.28 ,$332.10 ,$276.75 ,$205.02 ,$85.41 ,$324.72 ,$85.41 ,$276.75 ,$276.75 ,$313.65 ,$313.65 ,$85.41 ,$313.65 ,$85.41 ,$287.82 ,$287.82 ,$287.82 ,$332.10 ,$205.02 ,$332.10 ,$85.41 ,$369.00 ,$241.70 ,$85.41 ,$153.50 ,$40.52 ,$38.68 ,$89.39 ,$332.10 ,$185.09 ,$227.67 ,$103.32 ,$332.10 ,$85.41 ,$332.10 ,$332.10 ,$85.41 ,$239.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$533.00 ,$346.45 ,$38.68 ,$533.00 ,$205.02 ,$397.09 ,$349.12 ,$85.41 ,$149.24 ,$269.17 ,$85.41 ,$328.86 ,$85.41 ,$328.86 ,$328.86 ,$85.41 ,$328.86 ,$162.28 ,$479.70 ,$399.75 ,$205.02 ,$85.41 ,$469.04 ,$85.41 ,$399.75 ,$399.75 ,$453.05 ,$453.05 ,$85.41 ,$453.05 ,$85.41 ,$415.74 ,$415.74 ,$415.74 ,$479.70 ,$205.02 ,$479.70 ,$85.41 ,$533.00 ,$349.12 ,$85.41 ,$221.73 ,$40.52 ,$38.68 ,$89.39 ,$479.70 ,$185.09 ,$328.86 ,$149.24 ,$479.70 ,$85.41 ,$479.70 ,$479.70 ,$85.41 ,$346.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000121,71045,HC XR CHEST 1V,320,1 ,$390.00 ,$253.50 ,$18.14 ,$390.00 ,$205.02 ,$290.55 ,$255.45 ,$85.41 ,$109.20 ,$196.95 ,$85.41 ,$240.63 ,$85.41 ,$240.63 ,$240.63 ,$85.41 ,$240.63 ,$162.28 ,$351.00 ,$292.50 ,$205.02 ,$85.41 ,$343.20 ,$85.41 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$85.41 ,$331.50 ,$85.41 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$205.02 ,$351.00 ,$85.41 ,$18.14 ,$255.45 ,$85.41 ,$162.24 ,$40.52 ,$38.68 ,$89.39 ,$351.00 ,$185.09 ,$240.63 ,$109.20 ,$351.00 ,$85.41 ,$351.00 ,$351.00 ,$85.41 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000127,71046,HC XR CHEST 2V,320,1 ,$524.00 ,$340.60 ,$24.70 ,$524.00 ,$205.02 ,$390.38 ,$343.22 ,$85.41 ,$146.72 ,$264.62 ,$85.41 ,$323.31 ,$85.41 ,$323.31 ,$323.31 ,$85.41 ,$323.31 ,$162.28 ,$471.60 ,$393.00 ,$205.02 ,$85.41 ,$461.12 ,$85.41 ,$393.00 ,$393.00 ,$445.40 ,$445.40 ,$85.41 ,$445.40 ,$85.41 ,$408.72 ,$408.72 ,$408.72 ,$471.60 ,$205.02 ,$471.60 ,$85.41 ,$24.70 ,$343.22 ,$85.41 ,$217.98 ,$40.52 ,$38.68 ,$89.39 ,$471.60 ,$185.09 ,$323.31 ,$146.72 ,$471.60 ,$85.41 ,$471.60 ,$471.60 ,$85.41 ,$340.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$537.00 ,$349.05 ,$38.68 ,$537.00 ,$205.02 ,$400.07 ,$351.74 ,$85.41 ,$150.36 ,$271.19 ,$85.41 ,$331.33 ,$85.41 ,$331.33 ,$331.33 ,$85.41 ,$331.33 ,$162.28 ,$483.30 ,$402.75 ,$205.02 ,$85.41 ,$472.56 ,$85.41 ,$402.75 ,$402.75 ,$456.45 ,$456.45 ,$85.41 ,$456.45 ,$85.41 ,$418.86 ,$418.86 ,$418.86 ,$483.30 ,$205.02 ,$483.30 ,$85.41 ,$537.00 ,$351.74 ,$85.41 ,$223.39 ,$40.52 ,$38.68 ,$89.39 ,$483.30 ,$185.09 ,$331.33 ,$150.36 ,$483.30 ,$85.41 ,$483.30 ,$483.30 ,$85.41 ,$349.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000133,71048,HC XR CHEST 4+V,320,1 ,$551.00 ,$358.15 ,$38.68 ,$551.00 ,$275.96 ,$410.50 ,$360.91 ,$114.95 ,$154.28 ,$278.26 ,$114.95 ,$339.97 ,$114.95 ,$339.97 ,$339.97 ,$114.95 ,$339.97 ,$218.41 ,$495.90 ,$413.25 ,$275.96 ,$114.95 ,$484.88 ,$114.95 ,$413.25 ,$413.25 ,$468.35 ,$468.35 ,$114.95 ,$468.35 ,$114.95 ,$429.78 ,$429.78 ,$429.78 ,$495.90 ,$275.96 ,$495.90 ,$114.95 ,$551.00 ,$360.91 ,$114.95 ,$229.22 ,$40.52 ,$38.68 ,$120.32 ,$495.90 ,$249.12 ,$339.97 ,$154.28 ,$495.90 ,$114.95 ,$495.90 ,$495.90 ,$114.95 ,$358.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$524.00 ,$340.60 ,$24.70 ,$524.00 ,$205.02 ,$390.38 ,$343.22 ,$85.41 ,$146.72 ,$264.62 ,$85.41 ,$323.31 ,$85.41 ,$323.31 ,$323.31 ,$85.41 ,$323.31 ,$162.28 ,$471.60 ,$393.00 ,$205.02 ,$85.41 ,$461.12 ,$85.41 ,$393.00 ,$393.00 ,$445.40 ,$445.40 ,$85.41 ,$445.40 ,$85.41 ,$408.72 ,$408.72 ,$408.72 ,$471.60 ,$205.02 ,$471.60 ,$85.41 ,$24.70 ,$343.22 ,$85.41 ,$217.98 ,$40.52 ,$38.68 ,$89.39 ,$471.60 ,$185.09 ,$323.31 ,$146.72 ,$471.60 ,$85.41 ,$471.60 ,$471.60 ,$85.41 ,$340.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000137,71100,HC XR RIBS 2V UNI,320,1 ,$615.00 ,$399.75 ,$38.68 ,$615.00 ,$205.02 ,$458.18 ,$402.83 ,$85.41 ,$172.20 ,$310.58 ,$85.41 ,$379.46 ,$85.41 ,$379.46 ,$379.46 ,$85.41 ,$379.46 ,$162.28 ,$553.50 ,$461.25 ,$205.02 ,$85.41 ,$541.20 ,$85.41 ,$461.25 ,$461.25 ,$522.75 ,$522.75 ,$85.41 ,$522.75 ,$85.41 ,$479.70 ,$479.70 ,$479.70 ,$553.50 ,$205.02 ,$553.50 ,$85.41 ,$615.00 ,$402.83 ,$85.41 ,$255.84 ,$40.52 ,$38.68 ,$89.39 ,$553.50 ,$185.09 ,$379.46 ,$172.20 ,$553.50 ,$85.41 ,$553.50 ,$553.50 ,$85.41 ,$399.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$735.00 ,$477.75 ,$38.68 ,$735.00 ,$275.96 ,$547.58 ,$481.43 ,$114.95 ,$205.80 ,$371.18 ,$114.95 ,$453.50 ,$114.95 ,$453.50 ,$453.50 ,$114.95 ,$453.50 ,$218.41 ,$661.50 ,$551.25 ,$275.96 ,$114.95 ,$646.80 ,$114.95 ,$551.25 ,$551.25 ,$624.75 ,$624.75 ,$114.95 ,$624.75 ,$114.95 ,$573.30 ,$573.30 ,$573.30 ,$661.50 ,$275.96 ,$661.50 ,$114.95 ,$735.00 ,$481.43 ,$114.95 ,$305.76 ,$40.52 ,$38.68 ,$120.32 ,$661.50 ,$249.12 ,$453.50 ,$205.80 ,$661.50 ,$114.95 ,$661.50 ,$661.50 ,$114.95 ,$477.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000139,71110,HC XR RIBS 3 V BIL,320,1 ,"$1,021.00 ",$663.65 ,$38.68 ,"$1,021.00 ",$275.96 ,$760.65 ,$668.76 ,$114.95 ,$285.88 ,$515.61 ,$114.95 ,$629.96 ,$114.95 ,$629.96 ,$629.96 ,$114.95 ,$629.96 ,$218.41 ,$918.90 ,$765.75 ,$275.96 ,$114.95 ,$898.48 ,$114.95 ,$765.75 ,$765.75 ,$867.85 ,$867.85 ,$114.95 ,$867.85 ,$114.95 ,$796.38 ,$796.38 ,$796.38 ,$918.90 ,$275.96 ,$918.90 ,$114.95 ,"$1,021.00 ",$668.76 ,$114.95 ,$424.74 ,$40.52 ,$38.68 ,$120.32 ,$918.90 ,$249.12 ,$629.96 ,$285.88 ,$918.90 ,$114.95 ,$918.90 ,$918.90 ,$114.95 ,$663.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,"$1,061.00 ",$689.65 ,$38.68 ,"$1,061.00 ",$275.96 ,$790.45 ,$694.96 ,$114.95 ,$297.08 ,$535.81 ,$114.95 ,$654.64 ,$114.95 ,$654.64 ,$654.64 ,$114.95 ,$654.64 ,$218.41 ,$954.90 ,$795.75 ,$275.96 ,$114.95 ,$933.68 ,$114.95 ,$795.75 ,$795.75 ,$901.85 ,$901.85 ,$114.95 ,$901.85 ,$114.95 ,$827.58 ,$827.58 ,$827.58 ,$954.90 ,$275.96 ,$954.90 ,$114.95 ,"$1,061.00 ",$694.96 ,$114.95 ,$441.38 ,$40.52 ,$38.68 ,$120.32 ,$954.90 ,$249.12 ,$654.64 ,$297.08 ,$954.90 ,$114.95 ,$954.90 ,$954.90 ,$114.95 ,$689.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000141,71120,HC XR STERNUM 2+V,320,1 ,$654.00 ,$425.10 ,$38.68 ,$654.00 ,$205.02 ,$487.23 ,$428.37 ,$85.41 ,$183.12 ,$330.27 ,$85.41 ,$403.52 ,$85.41 ,$403.52 ,$403.52 ,$85.41 ,$403.52 ,$162.28 ,$588.60 ,$490.50 ,$205.02 ,$85.41 ,$575.52 ,$85.41 ,$490.50 ,$490.50 ,$555.90 ,$555.90 ,$85.41 ,$555.90 ,$85.41 ,$510.12 ,$510.12 ,$510.12 ,$588.60 ,$205.02 ,$588.60 ,$85.41 ,$654.00 ,$428.37 ,$85.41 ,$272.06 ,$40.52 ,$38.68 ,$89.39 ,$588.60 ,$185.09 ,$403.52 ,$183.12 ,$588.60 ,$85.41 ,$588.60 ,$588.60 ,$85.41 ,$425.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$405.00 ,$263.25 ,$38.68 ,$405.00 ,$205.02 ,$301.73 ,$265.28 ,$85.41 ,$113.40 ,$204.53 ,$85.41 ,$249.89 ,$85.41 ,$249.89 ,$249.89 ,$85.41 ,$249.89 ,$162.28 ,$364.50 ,$303.75 ,$205.02 ,$85.41 ,$356.40 ,$85.41 ,$303.75 ,$303.75 ,$344.25 ,$344.25 ,$85.41 ,$344.25 ,$85.41 ,$315.90 ,$315.90 ,$315.90 ,$364.50 ,$205.02 ,$364.50 ,$85.41 ,$405.00 ,$265.28 ,$85.41 ,$168.48 ,$40.52 ,$38.68 ,$89.39 ,$364.50 ,$185.09 ,$249.89 ,$113.40 ,$364.50 ,$85.41 ,$364.50 ,$364.50 ,$85.41 ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$2,672.00 ","$1,736.80 ",$96.51 ,"$2,672.00 ",$275.96 ,"$1,990.64 ","$1,750.16 ",$114.95 ,$748.16 ,"$1,349.36 ",$114.95 ,"$1,648.62 ",$114.95 ,"$1,648.62 ","$1,648.62 ",$114.95 ,"$1,648.62 ",$218.41 ,"$2,404.80 ","$2,004.00 ",$275.96 ,$114.95 ,"$2,351.36 ",$114.95 ,"$2,004.00 ","$2,004.00 ","$2,271.20 ","$2,271.20 ",$114.95 ,"$2,271.20 ",$114.95 ,"$2,084.16 ","$2,084.16 ","$2,084.16 ","$2,404.80 ",$275.96 ,"$2,404.80 ",$114.95 ,"$2,672.00 ","$1,750.16 ",$114.95 ,"$1,111.55 ",$101.10 ,$96.51 ,$120.32 ,"$2,404.80 ",$249.12 ,"$1,648.62 ",$748.16 ,"$2,404.80 ",$114.95 ,"$2,404.80 ","$2,404.80 ",$114.95 ,"$1,736.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$3,072.00 ","$1,996.80 ",$96.51 ,"$3,072.00 ",$452.76 ,"$2,288.64 ","$2,012.16 ",$188.61 ,$860.16 ,"$1,551.36 ",$188.61 ,"$1,895.42 ",$188.61 ,"$1,895.42 ","$1,895.42 ",$188.61 ,"$1,895.42 ",$358.36 ,"$2,764.80 ","$2,304.00 ",$452.76 ,$188.61 ,"$2,703.36 ",$188.61 ,"$2,304.00 ","$2,304.00 ","$2,611.20 ","$2,611.20 ",$188.61 ,"$2,611.20 ",$188.61 ,"$2,396.16 ","$2,396.16 ","$2,396.16 ","$2,764.80 ",$452.76 ,"$2,764.80 ",$188.61 ,"$3,072.00 ","$2,012.16 ",$188.61 ,"$1,277.95 ",$101.10 ,$96.51 ,$197.41 ,"$2,764.80 ",$408.74 ,"$1,895.42 ",$860.16 ,"$2,764.80 ",$188.61 ,"$2,764.80 ","$2,764.80 ",$188.61 ,"$1,996.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$4,165.00 ","$2,707.25 ",$96.51 ,"$4,165.00 ",$452.76 ,"$3,102.93 ","$2,728.08 ",$188.61 ,"$1,166.20 ","$2,103.33 ",$188.61 ,"$2,569.81 ",$188.61 ,"$2,569.81 ","$2,569.81 ",$188.61 ,"$2,569.81 ",$358.36 ,"$3,748.50 ","$3,123.75 ",$452.76 ,$188.61 ,"$3,665.20 ",$188.61 ,"$3,123.75 ","$3,123.75 ","$3,540.25 ","$3,540.25 ",$188.61 ,"$3,540.25 ",$188.61 ,"$3,248.70 ","$3,248.70 ","$3,248.70 ","$3,748.50 ",$452.76 ,"$3,748.50 ",$188.61 ,"$4,165.00 ","$2,728.08 ",$188.61 ,"$1,732.64 ",$101.10 ,$96.51 ,$197.41 ,"$3,748.50 ",$408.74 ,"$2,569.81 ","$1,166.20 ","$3,748.50 ",$188.61 ,"$3,748.50 ","$3,748.50 ",$188.61 ,"$2,707.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$5,338.00 ","$3,469.70 ",$188.61 ,"$5,338.00 ",$452.76 ,"$3,976.81 ","$3,496.39 ",$188.61 ,"$1,494.64 ","$2,695.69 ",$188.61 ,"$3,293.55 ",$188.61 ,"$3,293.55 ","$3,293.55 ",$188.61 ,"$3,293.55 ",$358.36 ,"$4,804.20 ","$4,003.50 ",$452.76 ,$188.61 ,"$4,697.44 ",$188.61 ,"$4,003.50 ","$4,003.50 ","$4,537.30 ","$4,537.30 ",$188.61 ,"$4,537.30 ",$188.61 ,"$4,163.64 ","$4,163.64 ","$4,163.64 ","$4,804.20 ",$452.76 ,"$4,804.20 ",$188.61 ,"$5,338.00 ","$3,496.39 ",$188.61 ,"$2,220.61 ",$228.49 ,$218.11 ,$197.41 ,"$4,804.20 ",$408.74 ,"$3,293.55 ","$1,494.64 ","$4,804.20 ",$188.61 ,"$4,804.20 ","$4,804.20 ",$188.61 ,"$3,469.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$3,238.00 ","$2,104.70 ",$242.96 ,"$3,238.00 ",$583.23 ,"$2,412.31 ","$2,120.89 ",$242.96 ,$906.64 ,"$1,635.19 ",$242.96 ,"$1,997.85 ",$242.96 ,"$1,997.85 ","$1,997.85 ",$242.96 ,"$1,997.85 ",$461.62 ,"$2,914.20 ","$2,428.50 ",$583.23 ,$242.96 ,"$2,849.44 ",$242.96 ,"$2,428.50 ","$2,428.50 ","$2,752.30 ","$2,752.30 ",$242.96 ,"$2,752.30 ",$242.96 ,"$2,525.64 ","$2,525.64 ","$2,525.64 ","$2,914.20 ",$583.23 ,"$2,914.20 ",$242.96 ,"$3,238.00 ","$2,120.89 ",$242.96 ,"$1,347.01 ",$346.76 ,$331.00 ,$254.30 ,"$2,914.20 ",$526.52 ,"$1,997.85 ",$906.64 ,"$2,914.20 ",$242.96 ,"$2,914.20 ","$2,914.20 ",$242.96 ,"$2,104.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$3,775.00 ","$2,453.75 ",$331.00 ,"$3,775.00 ","$1,813.40 ","$2,812.38 ","$2,472.63 ",$755.41 ,"$1,057.00 ","$1,906.38 ",$755.41 ,"$2,329.18 ",$755.41 ,"$2,329.18 ","$2,329.18 ",$755.41 ,"$2,329.18 ","$1,435.28 ","$3,397.50 ","$2,831.25 ","$1,813.40 ",$755.41 ,"$3,322.00 ",$755.41 ,"$2,831.25 ","$2,831.25 ","$3,208.75 ","$3,208.75 ",$755.41 ,"$3,208.75 ",$755.41 ,"$2,944.50 ","$2,944.50 ","$2,944.50 ","$3,397.50 ","$1,813.40 ","$3,397.50 ",$755.41 ,"$3,775.00 ","$2,472.63 ",$755.41 ,"$1,570.40 ",$346.76 ,$331.00 ,$790.68 ,"$3,397.50 ","$1,637.07 ","$2,329.18 ","$1,057.00 ","$3,397.50 ",$755.41 ,"$3,397.50 ","$3,397.50 ",$755.41 ,"$2,453.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$3,904.00 ","$2,537.60 ",$331.00 ,"$3,904.00 ",$933.39 ,"$2,908.48 ","$2,557.12 ",$388.82 ,"$1,093.12 ","$1,971.52 ",$388.82 ,"$2,408.77 ",$388.82 ,"$2,408.77 ","$2,408.77 ",$388.82 ,"$2,408.77 ",$738.76 ,"$3,513.60 ","$2,928.00 ",$933.39 ,$388.82 ,"$3,435.52 ",$388.82 ,"$2,928.00 ","$2,928.00 ","$3,318.40 ","$3,318.40 ",$388.82 ,"$3,318.40 ",$388.82 ,"$3,045.12 ","$3,045.12 ","$3,045.12 ","$3,513.60 ",$933.39 ,"$3,513.60 ",$388.82 ,"$3,904.00 ","$2,557.12 ",$388.82 ,"$1,624.06 ",$346.76 ,$331.00 ,$406.98 ,"$3,513.60 ",$842.63 ,"$2,408.77 ","$1,093.12 ","$3,513.60 ",$388.82 ,"$3,513.60 ","$3,513.60 ",$388.82 ,"$2,537.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$608.00 ,$395.20 ,$38.68 ,$608.00 ,$205.02 ,$452.96 ,$398.24 ,$85.41 ,$170.24 ,$307.04 ,$85.41 ,$375.14 ,$85.41 ,$375.14 ,$375.14 ,$85.41 ,$375.14 ,$162.28 ,$547.20 ,$456.00 ,$205.02 ,$85.41 ,$535.04 ,$85.41 ,$456.00 ,$456.00 ,$516.80 ,$516.80 ,$85.41 ,$516.80 ,$85.41 ,$474.24 ,$474.24 ,$474.24 ,$547.20 ,$205.02 ,$547.20 ,$85.41 ,$608.00 ,$398.24 ,$85.41 ,$252.93 ,$40.52 ,$38.68 ,$89.39 ,$547.20 ,$185.09 ,$375.14 ,$170.24 ,$547.20 ,$85.41 ,$547.20 ,$547.20 ,$85.41 ,$395.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000161,72020,HC XR L-SPINE 1V,320,1 ,$608.00 ,$395.20 ,$38.68 ,$608.00 ,$205.02 ,$452.96 ,$398.24 ,$85.41 ,$170.24 ,$307.04 ,$85.41 ,$375.14 ,$85.41 ,$375.14 ,$375.14 ,$85.41 ,$375.14 ,$162.28 ,$547.20 ,$456.00 ,$205.02 ,$85.41 ,$535.04 ,$85.41 ,$456.00 ,$456.00 ,$516.80 ,$516.80 ,$85.41 ,$516.80 ,$85.41 ,$474.24 ,$474.24 ,$474.24 ,$547.20 ,$205.02 ,$547.20 ,$85.41 ,$608.00 ,$398.24 ,$85.41 ,$252.93 ,$40.52 ,$38.68 ,$89.39 ,$547.20 ,$185.09 ,$375.14 ,$170.24 ,$547.20 ,$85.41 ,$547.20 ,$547.20 ,$85.41 ,$395.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$731.00 ,$475.15 ,$38.68 ,$731.00 ,$205.02 ,$544.60 ,$478.81 ,$85.41 ,$204.68 ,$369.16 ,$85.41 ,$451.03 ,$85.41 ,$451.03 ,$451.03 ,$85.41 ,$451.03 ,$162.28 ,$657.90 ,$548.25 ,$205.02 ,$85.41 ,$643.28 ,$85.41 ,$548.25 ,$548.25 ,$621.35 ,$621.35 ,$85.41 ,$621.35 ,$85.41 ,$570.18 ,$570.18 ,$570.18 ,$657.90 ,$205.02 ,$657.90 ,$85.41 ,$731.00 ,$478.81 ,$85.41 ,$304.10 ,$40.52 ,$38.68 ,$89.39 ,$657.90 ,$185.09 ,$451.03 ,$204.68 ,$657.90 ,$85.41 ,$657.90 ,$657.90 ,$85.41 ,$475.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$855.00 ,$555.75 ,$38.68 ,$855.00 ,$275.96 ,$636.98 ,$560.03 ,$114.95 ,$239.40 ,$431.78 ,$114.95 ,$527.54 ,$114.95 ,$527.54 ,$527.54 ,$114.95 ,$527.54 ,$218.41 ,$769.50 ,$641.25 ,$275.96 ,$114.95 ,$752.40 ,$114.95 ,$641.25 ,$641.25 ,$726.75 ,$726.75 ,$114.95 ,$726.75 ,$114.95 ,$666.90 ,$666.90 ,$666.90 ,$769.50 ,$275.96 ,$769.50 ,$114.95 ,$855.00 ,$560.03 ,$114.95 ,$355.68 ,$40.52 ,$38.68 ,$120.32 ,$769.50 ,$249.12 ,$527.54 ,$239.40 ,$769.50 ,$114.95 ,$769.50 ,$769.50 ,$114.95 ,$555.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,"$1,311.00 ",$852.15 ,$38.68 ,"$1,311.00 ",$275.96 ,$976.70 ,$858.71 ,$114.95 ,$367.08 ,$662.06 ,$114.95 ,$808.89 ,$114.95 ,$808.89 ,$808.89 ,$114.95 ,$808.89 ,$218.41 ,"$1,179.90 ",$983.25 ,$275.96 ,$114.95 ,"$1,153.68 ",$114.95 ,$983.25 ,$983.25 ,"$1,114.35 ","$1,114.35 ",$114.95 ,"$1,114.35 ",$114.95 ,"$1,022.58 ","$1,022.58 ","$1,022.58 ","$1,179.90 ",$275.96 ,"$1,179.90 ",$114.95 ,"$1,311.00 ",$858.71 ,$114.95 ,$545.38 ,$40.52 ,$38.68 ,$120.32 ,"$1,179.90 ",$249.12 ,$808.89 ,$367.08 ,"$1,179.90 ",$114.95 ,"$1,179.90 ","$1,179.90 ",$114.95 ,$852.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000172,72070,HC XR T-SPINE 2V,320,1 ,$385.00 ,$250.25 ,$38.68 ,$385.00 ,$275.96 ,$286.83 ,$252.18 ,$114.95 ,$107.80 ,$194.43 ,$114.95 ,$237.55 ,$114.95 ,$237.55 ,$237.55 ,$114.95 ,$237.55 ,$218.41 ,$346.50 ,$288.75 ,$275.96 ,$114.95 ,$338.80 ,$114.95 ,$288.75 ,$288.75 ,$327.25 ,$327.25 ,$114.95 ,$327.25 ,$114.95 ,$300.30 ,$300.30 ,$300.30 ,$346.50 ,$275.96 ,$346.50 ,$114.95 ,$385.00 ,$252.18 ,$114.95 ,$160.16 ,$40.52 ,$38.68 ,$120.32 ,$346.50 ,$249.12 ,$237.55 ,$107.80 ,$346.50 ,$114.95 ,$346.50 ,$346.50 ,$114.95 ,$250.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000174,72072,HC XR T-SPINE 3V,320,1 ,$897.00 ,$583.05 ,$38.68 ,$897.00 ,$275.96 ,$668.27 ,$587.54 ,$114.95 ,$251.16 ,$452.99 ,$114.95 ,$553.45 ,$114.95 ,$553.45 ,$553.45 ,$114.95 ,$553.45 ,$218.41 ,$807.30 ,$672.75 ,$275.96 ,$114.95 ,$789.36 ,$114.95 ,$672.75 ,$672.75 ,$762.45 ,$762.45 ,$114.95 ,$762.45 ,$114.95 ,$699.66 ,$699.66 ,$699.66 ,$807.30 ,$275.96 ,$807.30 ,$114.95 ,$897.00 ,$587.54 ,$114.95 ,$373.15 ,$40.52 ,$38.68 ,$120.32 ,$807.30 ,$249.12 ,$553.45 ,$251.16 ,$807.30 ,$114.95 ,$807.30 ,$807.30 ,$114.95 ,$583.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$742.00 ,$482.30 ,$38.68 ,$742.00 ,$275.96 ,$552.79 ,$486.01 ,$114.95 ,$207.76 ,$374.71 ,$114.95 ,$457.81 ,$114.95 ,$457.81 ,$457.81 ,$114.95 ,$457.81 ,$218.41 ,$667.80 ,$556.50 ,$275.96 ,$114.95 ,$652.96 ,$114.95 ,$556.50 ,$556.50 ,$630.70 ,$630.70 ,$114.95 ,$630.70 ,$114.95 ,$578.76 ,$578.76 ,$578.76 ,$667.80 ,$275.96 ,$667.80 ,$114.95 ,$742.00 ,$486.01 ,$114.95 ,$308.67 ,$40.52 ,$38.68 ,$120.32 ,$667.80 ,$249.12 ,$457.81 ,$207.76 ,$667.80 ,$114.95 ,$667.80 ,$667.80 ,$114.95 ,$482.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000181,72110,HC XR L-SPINE 4+V,320,1 ,"$1,062.00 ",$690.30 ,$38.68 ,"$1,062.00 ",$275.96 ,$791.19 ,$695.61 ,$114.95 ,$297.36 ,$536.31 ,$114.95 ,$655.25 ,$114.95 ,$655.25 ,$655.25 ,$114.95 ,$655.25 ,$218.41 ,$955.80 ,$796.50 ,$275.96 ,$114.95 ,$934.56 ,$114.95 ,$796.50 ,$796.50 ,$902.70 ,$902.70 ,$114.95 ,$902.70 ,$114.95 ,$828.36 ,$828.36 ,$828.36 ,$955.80 ,$275.96 ,$955.80 ,$114.95 ,"$1,062.00 ",$695.61 ,$114.95 ,$441.79 ,$40.52 ,$38.68 ,$120.32 ,$955.80 ,$249.12 ,$655.25 ,$297.36 ,$955.80 ,$114.95 ,$955.80 ,$955.80 ,$114.95 ,$690.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$694.00 ,$451.10 ,$38.68 ,$694.00 ,$275.96 ,$517.03 ,$454.57 ,$114.95 ,$194.32 ,$350.47 ,$114.95 ,$428.20 ,$114.95 ,$428.20 ,$428.20 ,$114.95 ,$428.20 ,$218.41 ,$624.60 ,$520.50 ,$275.96 ,$114.95 ,$610.72 ,$114.95 ,$520.50 ,$520.50 ,$589.90 ,$589.90 ,$114.95 ,$589.90 ,$114.95 ,$541.32 ,$541.32 ,$541.32 ,$624.60 ,$275.96 ,$624.60 ,$114.95 ,$694.00 ,$454.57 ,$114.95 ,$288.70 ,$40.52 ,$38.68 ,$120.32 ,$624.60 ,$249.12 ,$428.20 ,$194.32 ,$624.60 ,$114.95 ,$624.60 ,$624.60 ,$114.95 ,$451.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,"$1,235.00 ",$802.75 ,$38.68 ,"$1,235.00 ",$275.96 ,$920.08 ,$808.93 ,$114.95 ,$345.80 ,$623.68 ,$114.95 ,$762.00 ,$114.95 ,$762.00 ,$762.00 ,$114.95 ,$762.00 ,$218.41 ,"$1,111.50 ",$926.25 ,$275.96 ,$114.95 ,"$1,086.80 ",$114.95 ,$926.25 ,$926.25 ,"$1,049.75 ","$1,049.75 ",$114.95 ,"$1,049.75 ",$114.95 ,$963.30 ,$963.30 ,$963.30 ,"$1,111.50 ",$275.96 ,"$1,111.50 ",$114.95 ,"$1,235.00 ",$808.93 ,$114.95 ,$513.76 ,$40.52 ,$38.68 ,$120.32 ,"$1,111.50 ",$249.12 ,$762.00 ,$345.80 ,"$1,111.50 ",$114.95 ,"$1,111.50 ","$1,111.50 ",$114.95 ,$802.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000186,72170,HC XR PELVIS 1-2V,320,1 ,$475.00 ,$308.75 ,$38.68 ,$475.00 ,$275.96 ,$353.88 ,$311.13 ,$114.95 ,$133.00 ,$239.88 ,$114.95 ,$293.08 ,$114.95 ,$293.08 ,$293.08 ,$114.95 ,$293.08 ,$218.41 ,$427.50 ,$356.25 ,$275.96 ,$114.95 ,$418.00 ,$114.95 ,$356.25 ,$356.25 ,$403.75 ,$403.75 ,$114.95 ,$403.75 ,$114.95 ,$370.50 ,$370.50 ,$370.50 ,$427.50 ,$275.96 ,$427.50 ,$114.95 ,$475.00 ,$311.13 ,$114.95 ,$197.60 ,$40.52 ,$38.68 ,$120.32 ,$427.50 ,$249.12 ,$293.08 ,$133.00 ,$427.50 ,$114.95 ,$427.50 ,$427.50 ,$114.95 ,$308.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$580.00 ,$377.00 ,$38.68 ,$580.00 ,$275.96 ,$432.10 ,$379.90 ,$114.95 ,$162.40 ,$292.90 ,$114.95 ,$357.86 ,$114.95 ,$357.86 ,$357.86 ,$114.95 ,$357.86 ,$218.41 ,$522.00 ,$435.00 ,$275.96 ,$114.95 ,$510.40 ,$114.95 ,$435.00 ,$435.00 ,$493.00 ,$493.00 ,$114.95 ,$493.00 ,$114.95 ,$452.40 ,$452.40 ,$452.40 ,$522.00 ,$275.96 ,$522.00 ,$114.95 ,$580.00 ,$379.90 ,$114.95 ,$241.28 ,$40.52 ,$38.68 ,$120.32 ,$522.00 ,$249.12 ,$357.86 ,$162.40 ,$522.00 ,$114.95 ,$522.00 ,$522.00 ,$114.95 ,$377.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$656.00 ,$426.40 ,$38.68 ,$656.00 ,$275.96 ,$488.72 ,$429.68 ,$114.95 ,$183.68 ,$331.28 ,$114.95 ,$404.75 ,$114.95 ,$404.75 ,$404.75 ,$114.95 ,$404.75 ,$218.41 ,$590.40 ,$492.00 ,$275.96 ,$114.95 ,$577.28 ,$114.95 ,$492.00 ,$492.00 ,$557.60 ,$557.60 ,$114.95 ,$557.60 ,$114.95 ,$511.68 ,$511.68 ,$511.68 ,$590.40 ,$275.96 ,$590.40 ,$114.95 ,$656.00 ,$429.68 ,$114.95 ,$272.90 ,$40.52 ,$38.68 ,$120.32 ,$590.40 ,$249.12 ,$404.75 ,$183.68 ,$590.40 ,$114.95 ,$590.40 ,$590.40 ,$114.95 ,$426.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$629.00 ,$408.85 ,$38.68 ,$629.00 ,$205.02 ,$468.61 ,$412.00 ,$85.41 ,$176.12 ,$317.65 ,$85.41 ,$388.09 ,$85.41 ,$388.09 ,$388.09 ,$85.41 ,$388.09 ,$162.28 ,$566.10 ,$471.75 ,$205.02 ,$85.41 ,$553.52 ,$85.41 ,$471.75 ,$471.75 ,$534.65 ,$534.65 ,$85.41 ,$534.65 ,$85.41 ,$490.62 ,$490.62 ,$490.62 ,$566.10 ,$205.02 ,$566.10 ,$85.41 ,$629.00 ,$412.00 ,$85.41 ,$261.66 ,$40.52 ,$38.68 ,$89.39 ,$566.10 ,$185.09 ,$388.09 ,$176.12 ,$566.10 ,$85.41 ,$566.10 ,$566.10 ,$85.41 ,$408.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000194,62302,HC XR MYELOGRAM C-SPINE,320,1 ,"$2,136.00 ","$1,388.40 ",$420.93 ,"$2,136.00 ","$1,813.40 ","$1,591.32 ","$1,399.08 ",$755.41 ,$598.08 ,"$1,078.68 ",$755.41 ,"$1,317.91 ",$755.41 ,"$1,317.91 ","$1,317.91 ",$755.41 ,"$1,317.91 ","$1,435.28 ","$1,922.40 ","$1,602.00 ","$1,813.40 ",$755.41 ,"$1,879.68 ",$755.41 ,"$1,602.00 ","$1,602.00 ","$1,815.60 ","$1,815.60 ",$755.41 ,"$1,815.60 ",$755.41 ,"$1,666.08 ","$1,666.08 ","$1,666.08 ","$1,922.40 ","$1,813.40 ","$1,922.40 ",$755.41 ,"$2,136.00 ","$1,399.08 ",$755.41 ,$888.58 ,$440.98 ,$420.93 ,$790.68 ,"$1,922.40 ","$1,637.07 ","$1,317.91 ",$598.08 ,"$1,922.40 ",$755.41 ,"$1,922.40 ","$1,922.40 ",$755.41 ,"$1,388.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000195,62303,HC XR MYELOGRAM T-SPINE,320,1 ,"$2,038.00 ","$1,324.70 ",$420.93 ,"$2,038.00 ","$1,813.40 ","$1,518.31 ","$1,334.89 ",$755.41 ,$570.64 ,"$1,029.19 ",$755.41 ,"$1,257.45 ",$755.41 ,"$1,257.45 ","$1,257.45 ",$755.41 ,"$1,257.45 ","$1,435.28 ","$1,834.20 ","$1,528.50 ","$1,813.40 ",$755.41 ,"$1,793.44 ",$755.41 ,"$1,528.50 ","$1,528.50 ","$1,732.30 ","$1,732.30 ",$755.41 ,"$1,732.30 ",$755.41 ,"$1,589.64 ","$1,589.64 ","$1,589.64 ","$1,834.20 ","$1,813.40 ","$1,834.20 ",$755.41 ,"$2,038.00 ","$1,334.89 ",$755.41 ,$847.81 ,$440.98 ,$420.93 ,$790.68 ,"$1,834.20 ","$1,637.07 ","$1,257.45 ",$570.64 ,"$1,834.20 ",$755.41 ,"$1,834.20 ","$1,834.20 ",$755.41 ,"$1,324.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000196,62304,HC XR MYELOGRAM L-SPINE,320,1 ,"$2,386.00 ","$1,550.90 ",$420.93 ,"$2,386.00 ","$1,813.40 ","$1,777.57 ","$1,562.83 ",$755.41 ,$668.08 ,"$1,204.93 ",$755.41 ,"$1,472.16 ",$755.41 ,"$1,472.16 ","$1,472.16 ",$755.41 ,"$1,472.16 ","$1,435.28 ","$2,147.40 ","$1,789.50 ","$1,813.40 ",$755.41 ,"$2,099.68 ",$755.41 ,"$1,789.50 ","$1,789.50 ","$2,028.10 ","$2,028.10 ",$755.41 ,"$2,028.10 ",$755.41 ,"$1,861.08 ","$1,861.08 ","$1,861.08 ","$2,147.40 ","$1,813.40 ","$2,147.40 ",$755.41 ,"$2,386.00 ","$1,562.83 ",$755.41 ,$992.58 ,$440.98 ,$420.93 ,$790.68 ,"$2,147.40 ","$1,637.07 ","$1,472.16 ",$668.08 ,"$2,147.40 ",$755.41 ,"$2,147.40 ","$2,147.40 ",$755.41 ,"$1,550.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000197,62305,HC XR MYELOGRAM >2 REGIONS,320,1 ,"$3,196.00 ","$2,077.40 ",$420.93 ,"$3,196.00 ","$1,813.40 ","$2,381.02 ","$2,093.38 ",$755.41 ,$894.88 ,"$1,613.98 ",$755.41 ,"$1,971.93 ",$755.41 ,"$1,971.93 ","$1,971.93 ",$755.41 ,"$1,971.93 ","$1,435.28 ","$2,876.40 ","$2,397.00 ","$1,813.40 ",$755.41 ,"$2,812.48 ",$755.41 ,"$2,397.00 ","$2,397.00 ","$2,716.60 ","$2,716.60 ",$755.41 ,"$2,716.60 ",$755.41 ,"$2,492.88 ","$2,492.88 ","$2,492.88 ","$2,876.40 ","$1,813.40 ","$2,876.40 ",$755.41 ,"$3,196.00 ","$2,093.38 ",$755.41 ,"$1,329.54 ",$440.98 ,$420.93 ,$790.68 ,"$2,876.40 ","$1,637.07 ","$1,971.93 ",$894.88 ,"$2,876.40 ",$755.41 ,"$2,876.40 ","$2,876.40 ",$755.41 ,"$2,077.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000200,72295,HC XR DISKOGRAM L-SPINE,320,1 ,"$3,497.00 ","$2,273.05 ",$220.43 ,"$4,017.92 ","$3,497.00 ","$2,605.27 ","$2,290.54 ","$1,854.03 ",$979.16 ,"$1,765.99 ","$1,854.03 ","$2,157.65 ","$1,854.03 ","$2,157.65 ","$2,157.65 ","$1,854.03 ","$2,157.65 ","$3,522.66 ","$3,147.30 ","$2,622.75 ","$3,497.00 ","$1,854.03 ","$3,077.36 ","$1,854.03 ","$2,622.75 ","$2,622.75 ","$2,972.45 ","$2,972.45 ","$1,854.03 ","$2,972.45 ","$1,854.03 ","$2,727.66 ","$2,727.66 ","$2,727.66 ","$3,147.30 ","$3,497.00 ","$3,147.30 ","$1,854.03 ","$3,497.00 ","$2,290.54 ","$1,854.03 ","$1,454.75 ",$230.92 ,$220.43 ,"$1,940.58 ","$3,147.30 ","$4,017.92 ","$2,157.65 ",$979.16 ,"$3,147.30 ","$1,854.03 ","$3,147.30 ","$3,147.30 ","$1,854.03 ","$2,273.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000201,73000,HC XRAY CLAVICLE,320,1 ,$637.00 ,$414.05 ,$58.02 ,$637.00 ,$205.02 ,$474.57 ,$417.24 ,$85.41 ,$178.36 ,$321.69 ,$85.41 ,$393.03 ,$85.41 ,$393.03 ,$393.03 ,$85.41 ,$393.03 ,$162.28 ,$573.30 ,$477.75 ,$205.02 ,$85.41 ,$560.56 ,$85.41 ,$477.75 ,$477.75 ,$541.45 ,$541.45 ,$85.41 ,$541.45 ,$85.41 ,$496.86 ,$496.86 ,$496.86 ,$573.30 ,$205.02 ,$573.30 ,$85.41 ,$637.00 ,$417.24 ,$85.41 ,$264.99 ,$60.79 ,$58.02 ,$89.39 ,$573.30 ,$185.09 ,$393.03 ,$178.36 ,$573.30 ,$85.41 ,$573.30 ,$573.30 ,$85.41 ,$414.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000201,73000,HC XRAY CLAVICLE,320,1 ,$425.00 ,$276.25 ,$38.68 ,$425.00 ,$205.02 ,$316.63 ,$278.38 ,$85.41 ,$119.00 ,$214.63 ,$85.41 ,$262.23 ,$85.41 ,$262.23 ,$262.23 ,$85.41 ,$262.23 ,$162.28 ,$382.50 ,$318.75 ,$205.02 ,$85.41 ,$374.00 ,$85.41 ,$318.75 ,$318.75 ,$361.25 ,$361.25 ,$85.41 ,$361.25 ,$85.41 ,$331.50 ,$331.50 ,$331.50 ,$382.50 ,$205.02 ,$382.50 ,$85.41 ,$425.00 ,$278.38 ,$85.41 ,$176.80 ,$40.52 ,$38.68 ,$89.39 ,$382.50 ,$185.09 ,$262.23 ,$119.00 ,$382.50 ,$85.41 ,$382.50 ,$382.50 ,$85.41 ,$276.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000204,73010,HC XRAY SCAPULA,320,1 ,$574.00 ,$373.10 ,$38.68 ,$574.00 ,$275.96 ,$427.63 ,$375.97 ,$114.95 ,$160.72 ,$289.87 ,$114.95 ,$354.16 ,$114.95 ,$354.16 ,$354.16 ,$114.95 ,$354.16 ,$218.41 ,$516.60 ,$430.50 ,$275.96 ,$114.95 ,$505.12 ,$114.95 ,$430.50 ,$430.50 ,$487.90 ,$487.90 ,$114.95 ,$487.90 ,$114.95 ,$447.72 ,$447.72 ,$447.72 ,$516.60 ,$275.96 ,$516.60 ,$114.95 ,$574.00 ,$375.97 ,$114.95 ,$238.78 ,$40.52 ,$38.68 ,$120.32 ,$516.60 ,$249.12 ,$354.16 ,$160.72 ,$516.60 ,$114.95 ,$516.60 ,$516.60 ,$114.95 ,$373.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$493.00 ,$320.45 ,$58.02 ,$493.00 ,$205.02 ,$367.29 ,$322.92 ,$85.41 ,$138.04 ,$248.97 ,$85.41 ,$304.18 ,$85.41 ,$304.18 ,$304.18 ,$85.41 ,$304.18 ,$162.28 ,$443.70 ,$369.75 ,$205.02 ,$85.41 ,$433.84 ,$85.41 ,$369.75 ,$369.75 ,$419.05 ,$419.05 ,$85.41 ,$419.05 ,$85.41 ,$384.54 ,$384.54 ,$384.54 ,$443.70 ,$205.02 ,$443.70 ,$85.41 ,$493.00 ,$322.92 ,$85.41 ,$205.09 ,$60.79 ,$58.02 ,$89.39 ,$443.70 ,$185.09 ,$304.18 ,$138.04 ,$443.70 ,$85.41 ,$443.70 ,$443.70 ,$85.41 ,$320.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$306.00 ,$198.90 ,$38.68 ,$306.00 ,$205.02 ,$227.97 ,$200.43 ,$85.41 ,$85.68 ,$154.53 ,$85.41 ,$188.80 ,$85.41 ,$188.80 ,$188.80 ,$85.41 ,$188.80 ,$162.28 ,$275.40 ,$229.50 ,$205.02 ,$85.41 ,$269.28 ,$85.41 ,$229.50 ,$229.50 ,$260.10 ,$260.10 ,$85.41 ,$260.10 ,$85.41 ,$238.68 ,$238.68 ,$238.68 ,$275.40 ,$205.02 ,$275.40 ,$85.41 ,$306.00 ,$200.43 ,$85.41 ,$127.30 ,$40.52 ,$38.68 ,$89.39 ,$275.40 ,$185.09 ,$188.80 ,$85.68 ,$275.40 ,$85.41 ,$275.40 ,$275.40 ,$85.41 ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$689.00 ,$447.85 ,$38.68 ,$689.00 ,$205.02 ,$513.31 ,$451.30 ,$85.41 ,$192.92 ,$347.95 ,$85.41 ,$425.11 ,$85.41 ,$425.11 ,$425.11 ,$85.41 ,$425.11 ,$162.28 ,$620.10 ,$516.75 ,$205.02 ,$85.41 ,$606.32 ,$85.41 ,$516.75 ,$516.75 ,$585.65 ,$585.65 ,$85.41 ,$585.65 ,$85.41 ,$537.42 ,$537.42 ,$537.42 ,$620.10 ,$205.02 ,$620.10 ,$85.41 ,$689.00 ,$451.30 ,$85.41 ,$286.62 ,$40.52 ,$38.68 ,$89.39 ,$620.10 ,$185.09 ,$425.11 ,$192.92 ,$620.10 ,$85.41 ,$620.10 ,$620.10 ,$85.41 ,$447.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,"$1,251.00 ",$813.15 ,$58.02 ,"$1,251.00 ",$205.02 ,$932.00 ,$819.41 ,$85.41 ,$350.28 ,$631.76 ,$85.41 ,$771.87 ,$85.41 ,$771.87 ,$771.87 ,$85.41 ,$771.87 ,$162.28 ,"$1,125.90 ",$938.25 ,$205.02 ,$85.41 ,"$1,100.88 ",$85.41 ,$938.25 ,$938.25 ,"$1,063.35 ","$1,063.35 ",$85.41 ,"$1,063.35 ",$85.41 ,$975.78 ,$975.78 ,$975.78 ,"$1,125.90 ",$205.02 ,"$1,125.90 ",$85.41 ,"$1,251.00 ",$819.41 ,$85.41 ,$520.42 ,$60.79 ,$58.02 ,$89.39 ,"$1,125.90 ",$185.09 ,$771.87 ,$350.28 ,"$1,125.90 ",$85.41 ,"$1,125.90 ","$1,125.90 ",$85.41 ,$813.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,$978.00 ,$635.70 ,$220.43 ,$978.00 ,$933.39 ,$728.61 ,$640.59 ,$388.82 ,$273.84 ,$493.89 ,$388.82 ,$603.43 ,$388.82 ,$603.43 ,$603.43 ,$388.82 ,$603.43 ,$738.76 ,$880.20 ,$733.50 ,$933.39 ,$388.82 ,$860.64 ,$388.82 ,$733.50 ,$733.50 ,$831.30 ,$831.30 ,$388.82 ,$831.30 ,$388.82 ,$762.84 ,$762.84 ,$762.84 ,$880.20 ,$933.39 ,$880.20 ,$388.82 ,$978.00 ,$640.59 ,$388.82 ,$406.85 ,$230.92 ,$220.43 ,$406.98 ,$880.20 ,$842.63 ,$603.43 ,$273.84 ,$880.20 ,$388.82 ,$880.20 ,$880.20 ,$388.82 ,$635.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$668.00 ,$434.20 ,$38.68 ,$668.00 ,$205.02 ,$497.66 ,$437.54 ,$85.41 ,$187.04 ,$337.34 ,$85.41 ,$412.16 ,$85.41 ,$412.16 ,$412.16 ,$85.41 ,$412.16 ,$162.28 ,$601.20 ,$501.00 ,$205.02 ,$85.41 ,$587.84 ,$85.41 ,$501.00 ,$501.00 ,$567.80 ,$567.80 ,$85.41 ,$567.80 ,$85.41 ,$521.04 ,$521.04 ,$521.04 ,$601.20 ,$205.02 ,$601.20 ,$85.41 ,$668.00 ,$437.54 ,$85.41 ,$277.89 ,$40.52 ,$38.68 ,$89.39 ,$601.20 ,$185.09 ,$412.16 ,$187.04 ,$601.20 ,$85.41 ,$601.20 ,$601.20 ,$85.41 ,$434.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$907.00 ,$589.55 ,$38.68 ,$907.00 ,$205.02 ,$675.72 ,$594.09 ,$85.41 ,$253.96 ,$458.04 ,$85.41 ,$559.62 ,$85.41 ,$559.62 ,$559.62 ,$85.41 ,$559.62 ,$162.28 ,$816.30 ,$680.25 ,$205.02 ,$85.41 ,$798.16 ,$85.41 ,$680.25 ,$680.25 ,$770.95 ,$770.95 ,$85.41 ,$770.95 ,$85.41 ,$707.46 ,$707.46 ,$707.46 ,$816.30 ,$205.02 ,$816.30 ,$85.41 ,$907.00 ,$594.09 ,$85.41 ,$377.31 ,$40.52 ,$38.68 ,$89.39 ,$816.30 ,$185.09 ,$559.62 ,$253.96 ,$816.30 ,$85.41 ,$816.30 ,$816.30 ,$85.41 ,$589.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$605.00 ,$393.25 ,$38.68 ,$605.00 ,$205.02 ,$450.73 ,$396.28 ,$85.41 ,$169.40 ,$305.53 ,$85.41 ,$373.29 ,$85.41 ,$373.29 ,$373.29 ,$85.41 ,$373.29 ,$162.28 ,$544.50 ,$453.75 ,$205.02 ,$85.41 ,$532.40 ,$85.41 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$85.41 ,$514.25 ,$85.41 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$205.02 ,$544.50 ,$85.41 ,$605.00 ,$396.28 ,$85.41 ,$251.68 ,$40.52 ,$38.68 ,$89.39 ,$544.50 ,$185.09 ,$373.29 ,$169.40 ,$544.50 ,$85.41 ,$544.50 ,$544.50 ,$85.41 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$405.00 ,$263.25 ,$38.68 ,$405.00 ,$205.02 ,$301.73 ,$265.28 ,$85.41 ,$113.40 ,$204.53 ,$85.41 ,$249.89 ,$85.41 ,$249.89 ,$249.89 ,$85.41 ,$249.89 ,$162.28 ,$364.50 ,$303.75 ,$205.02 ,$85.41 ,$356.40 ,$85.41 ,$303.75 ,$303.75 ,$344.25 ,$344.25 ,$85.41 ,$344.25 ,$85.41 ,$315.90 ,$315.90 ,$315.90 ,$364.50 ,$205.02 ,$364.50 ,$85.41 ,$405.00 ,$265.28 ,$85.41 ,$168.48 ,$40.52 ,$38.68 ,$89.39 ,$364.50 ,$185.09 ,$249.89 ,$113.40 ,$364.50 ,$85.41 ,$364.50 ,$364.50 ,$85.41 ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$606.00 ,$393.90 ,$58.02 ,$606.00 ,$205.02 ,$451.47 ,$396.93 ,$85.41 ,$169.68 ,$306.03 ,$85.41 ,$373.90 ,$85.41 ,$373.90 ,$373.90 ,$85.41 ,$373.90 ,$162.28 ,$545.40 ,$454.50 ,$205.02 ,$85.41 ,$533.28 ,$85.41 ,$454.50 ,$454.50 ,$515.10 ,$515.10 ,$85.41 ,$515.10 ,$85.41 ,$472.68 ,$472.68 ,$472.68 ,$545.40 ,$205.02 ,$545.40 ,$85.41 ,$606.00 ,$396.93 ,$85.41 ,$252.10 ,$60.79 ,$58.02 ,$89.39 ,$545.40 ,$185.09 ,$373.90 ,$169.68 ,$545.40 ,$85.41 ,$545.40 ,$545.40 ,$85.41 ,$393.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$585.00 ,$380.25 ,$38.68 ,$585.00 ,$205.02 ,$435.83 ,$383.18 ,$85.41 ,$163.80 ,$295.43 ,$85.41 ,$360.95 ,$85.41 ,$360.95 ,$360.95 ,$85.41 ,$360.95 ,$162.28 ,$526.50 ,$438.75 ,$205.02 ,$85.41 ,$514.80 ,$85.41 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$85.41 ,$497.25 ,$85.41 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$205.02 ,$526.50 ,$85.41 ,$585.00 ,$383.18 ,$85.41 ,$243.36 ,$40.52 ,$38.68 ,$89.39 ,$526.50 ,$185.09 ,$360.95 ,$163.80 ,$526.50 ,$85.41 ,$526.50 ,$526.50 ,$85.41 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$877.00 ,$570.05 ,$58.02 ,$877.00 ,$205.02 ,$653.37 ,$574.44 ,$85.41 ,$245.56 ,$442.89 ,$85.41 ,$541.11 ,$85.41 ,$541.11 ,$541.11 ,$85.41 ,$541.11 ,$162.28 ,$789.30 ,$657.75 ,$205.02 ,$85.41 ,$771.76 ,$85.41 ,$657.75 ,$657.75 ,$745.45 ,$745.45 ,$85.41 ,$745.45 ,$85.41 ,$684.06 ,$684.06 ,$684.06 ,$789.30 ,$205.02 ,$789.30 ,$85.41 ,$877.00 ,$574.44 ,$85.41 ,$364.83 ,$60.79 ,$58.02 ,$89.39 ,$789.30 ,$185.09 ,$541.11 ,$245.56 ,$789.30 ,$85.41 ,$789.30 ,$789.30 ,$85.41 ,$570.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000222,73085,HC XRAY ELBOW ARTHRO,320,1 ,$542.00 ,$352.30 ,$151.76 ,$842.63 ,$542.00 ,$403.79 ,$355.01 ,$388.82 ,$151.76 ,$273.71 ,$388.82 ,$334.41 ,$388.82 ,$334.41 ,$334.41 ,$388.82 ,$334.41 ,$738.76 ,$487.80 ,$406.50 ,$542.00 ,$388.82 ,$476.96 ,$388.82 ,$406.50 ,$406.50 ,$460.70 ,$460.70 ,$388.82 ,$460.70 ,$388.82 ,$422.76 ,$422.76 ,$422.76 ,$487.80 ,$542.00 ,$487.80 ,$388.82 ,$542.00 ,$355.01 ,$388.82 ,$225.47 ,$230.92 ,$220.43 ,$406.98 ,$487.80 ,$842.63 ,$334.41 ,$151.76 ,$487.80 ,$388.82 ,$487.80 ,$487.80 ,$388.82 ,$352.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$694.00 ,$451.10 ,$58.02 ,$694.00 ,$205.02 ,$517.03 ,$454.57 ,$85.41 ,$194.32 ,$350.47 ,$85.41 ,$428.20 ,$85.41 ,$428.20 ,$428.20 ,$85.41 ,$428.20 ,$162.28 ,$624.60 ,$520.50 ,$205.02 ,$85.41 ,$610.72 ,$85.41 ,$520.50 ,$520.50 ,$589.90 ,$589.90 ,$85.41 ,$589.90 ,$85.41 ,$541.32 ,$541.32 ,$541.32 ,$624.60 ,$205.02 ,$624.60 ,$85.41 ,$694.00 ,$454.57 ,$85.41 ,$288.70 ,$60.79 ,$58.02 ,$89.39 ,$624.60 ,$185.09 ,$428.20 ,$194.32 ,$624.60 ,$85.41 ,$624.60 ,$624.60 ,$85.41 ,$451.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$462.00 ,$300.30 ,$38.68 ,$462.00 ,$205.02 ,$344.19 ,$302.61 ,$85.41 ,$129.36 ,$233.31 ,$85.41 ,$285.05 ,$85.41 ,$285.05 ,$285.05 ,$85.41 ,$285.05 ,$162.28 ,$415.80 ,$346.50 ,$205.02 ,$85.41 ,$406.56 ,$85.41 ,$346.50 ,$346.50 ,$392.70 ,$392.70 ,$85.41 ,$392.70 ,$85.41 ,$360.36 ,$360.36 ,$360.36 ,$415.80 ,$205.02 ,$415.80 ,$85.41 ,$462.00 ,$302.61 ,$85.41 ,$192.19 ,$40.52 ,$38.68 ,$89.39 ,$415.80 ,$185.09 ,$285.05 ,$129.36 ,$415.80 ,$85.41 ,$415.80 ,$415.80 ,$85.41 ,$300.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$293.00 ,$190.45 ,$38.68 ,$293.00 ,$275.96 ,$218.29 ,$191.92 ,$114.95 ,$82.04 ,$147.97 ,$114.95 ,$180.78 ,$114.95 ,$180.78 ,$180.78 ,$114.95 ,$180.78 ,$218.41 ,$263.70 ,$219.75 ,$275.96 ,$114.95 ,$257.84 ,$114.95 ,$219.75 ,$219.75 ,$249.05 ,$249.05 ,$114.95 ,$249.05 ,$114.95 ,$228.54 ,$228.54 ,$228.54 ,$263.70 ,$275.96 ,$263.70 ,$114.95 ,$293.00 ,$191.92 ,$114.95 ,$121.89 ,$40.52 ,$38.68 ,$120.32 ,$263.70 ,$249.12 ,$180.78 ,$82.04 ,$263.70 ,$114.95 ,$263.70 ,$263.70 ,$114.95 ,$190.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$440.00 ,$286.00 ,$58.02 ,$440.00 ,$275.96 ,$327.80 ,$288.20 ,$114.95 ,$123.20 ,$222.20 ,$114.95 ,$271.48 ,$114.95 ,$271.48 ,$271.48 ,$114.95 ,$271.48 ,$218.41 ,$396.00 ,$330.00 ,$275.96 ,$114.95 ,$387.20 ,$114.95 ,$330.00 ,$330.00 ,$374.00 ,$374.00 ,$114.95 ,$374.00 ,$114.95 ,$343.20 ,$343.20 ,$343.20 ,$396.00 ,$275.96 ,$396.00 ,$114.95 ,$440.00 ,$288.20 ,$114.95 ,$183.04 ,$60.79 ,$58.02 ,$120.32 ,$396.00 ,$249.12 ,$271.48 ,$123.20 ,$396.00 ,$114.95 ,$396.00 ,$396.00 ,$114.95 ,$286.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$393.00 ,$255.45 ,$38.68 ,$393.00 ,$205.02 ,$292.79 ,$257.42 ,$85.41 ,$110.04 ,$198.47 ,$85.41 ,$242.48 ,$85.41 ,$242.48 ,$242.48 ,$85.41 ,$242.48 ,$162.28 ,$353.70 ,$294.75 ,$205.02 ,$85.41 ,$345.84 ,$85.41 ,$294.75 ,$294.75 ,$334.05 ,$334.05 ,$85.41 ,$334.05 ,$85.41 ,$306.54 ,$306.54 ,$306.54 ,$353.70 ,$205.02 ,$353.70 ,$85.41 ,$393.00 ,$257.42 ,$85.41 ,$163.49 ,$40.52 ,$38.68 ,$89.39 ,$353.70 ,$185.09 ,$242.48 ,$110.04 ,$353.70 ,$85.41 ,$353.70 ,$353.70 ,$85.41 ,$255.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$590.00 ,$383.50 ,$58.02 ,$590.00 ,$205.02 ,$439.55 ,$386.45 ,$85.41 ,$165.20 ,$297.95 ,$85.41 ,$364.03 ,$85.41 ,$364.03 ,$364.03 ,$85.41 ,$364.03 ,$162.28 ,$531.00 ,$442.50 ,$205.02 ,$85.41 ,$519.20 ,$85.41 ,$442.50 ,$442.50 ,$501.50 ,$501.50 ,$85.41 ,$501.50 ,$85.41 ,$460.20 ,$460.20 ,$460.20 ,$531.00 ,$205.02 ,$531.00 ,$85.41 ,$590.00 ,$386.45 ,$85.41 ,$245.44 ,$60.79 ,$58.02 ,$89.39 ,$531.00 ,$185.09 ,$364.03 ,$165.20 ,$531.00 ,$85.41 ,$531.00 ,$531.00 ,$85.41 ,$383.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$907.00 ,$589.55 ,$58.02 ,$907.00 ,$205.02 ,$675.72 ,$594.09 ,$85.41 ,$253.96 ,$458.04 ,$85.41 ,$559.62 ,$85.41 ,$559.62 ,$559.62 ,$85.41 ,$559.62 ,$162.28 ,$816.30 ,$680.25 ,$205.02 ,$85.41 ,$798.16 ,$85.41 ,$680.25 ,$680.25 ,$770.95 ,$770.95 ,$85.41 ,$770.95 ,$85.41 ,$707.46 ,$707.46 ,$707.46 ,$816.30 ,$205.02 ,$816.30 ,$85.41 ,$907.00 ,$594.09 ,$85.41 ,$377.31 ,$60.79 ,$58.02 ,$89.39 ,$816.30 ,$185.09 ,$559.62 ,$253.96 ,$816.30 ,$85.41 ,$816.30 ,$816.30 ,$85.41 ,$589.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$605.00 ,$393.25 ,$38.68 ,$605.00 ,$205.02 ,$450.73 ,$396.28 ,$85.41 ,$169.40 ,$305.53 ,$85.41 ,$373.29 ,$85.41 ,$373.29 ,$373.29 ,$85.41 ,$373.29 ,$162.28 ,$544.50 ,$453.75 ,$205.02 ,$85.41 ,$532.40 ,$85.41 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$85.41 ,$514.25 ,$85.41 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$205.02 ,$544.50 ,$85.41 ,$605.00 ,$396.28 ,$85.41 ,$251.68 ,$40.52 ,$38.68 ,$89.39 ,$544.50 ,$185.09 ,$373.29 ,$169.40 ,$544.50 ,$85.41 ,$544.50 ,$544.50 ,$85.41 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,$647.00 ,$420.55 ,$181.16 ,$842.63 ,$647.00 ,$482.02 ,$423.79 ,$388.82 ,$181.16 ,$326.74 ,$388.82 ,$399.20 ,$388.82 ,$399.20 ,$399.20 ,$388.82 ,$399.20 ,$738.76 ,$582.30 ,$485.25 ,$647.00 ,$388.82 ,$569.36 ,$388.82 ,$485.25 ,$485.25 ,$549.95 ,$549.95 ,$388.82 ,$549.95 ,$388.82 ,$504.66 ,$504.66 ,$504.66 ,$582.30 ,$647.00 ,$582.30 ,$388.82 ,$647.00 ,$423.79 ,$388.82 ,$269.15 ,$230.92 ,$220.43 ,$406.98 ,$582.30 ,$842.63 ,$399.20 ,$181.16 ,$582.30 ,$388.82 ,$582.30 ,$582.30 ,$388.82 ,$420.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$440.00 ,$286.00 ,$58.02 ,$440.00 ,$275.96 ,$327.80 ,$288.20 ,$114.95 ,$123.20 ,$222.20 ,$114.95 ,$271.48 ,$114.95 ,$271.48 ,$271.48 ,$114.95 ,$271.48 ,$218.41 ,$396.00 ,$330.00 ,$275.96 ,$114.95 ,$387.20 ,$114.95 ,$330.00 ,$330.00 ,$374.00 ,$374.00 ,$114.95 ,$374.00 ,$114.95 ,$343.20 ,$343.20 ,$343.20 ,$396.00 ,$275.96 ,$396.00 ,$114.95 ,$440.00 ,$288.20 ,$114.95 ,$183.04 ,$60.79 ,$58.02 ,$120.32 ,$396.00 ,$249.12 ,$271.48 ,$123.20 ,$396.00 ,$114.95 ,$396.00 ,$396.00 ,$114.95 ,$286.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$293.00 ,$190.45 ,$38.68 ,$293.00 ,$275.96 ,$218.29 ,$191.92 ,$114.95 ,$82.04 ,$147.97 ,$114.95 ,$180.78 ,$114.95 ,$180.78 ,$180.78 ,$114.95 ,$180.78 ,$218.41 ,$263.70 ,$219.75 ,$275.96 ,$114.95 ,$257.84 ,$114.95 ,$219.75 ,$219.75 ,$249.05 ,$249.05 ,$114.95 ,$249.05 ,$114.95 ,$228.54 ,$228.54 ,$228.54 ,$263.70 ,$275.96 ,$263.70 ,$114.95 ,$293.00 ,$191.92 ,$114.95 ,$121.89 ,$40.52 ,$38.68 ,$120.32 ,$263.70 ,$249.12 ,$180.78 ,$82.04 ,$263.70 ,$114.95 ,$263.70 ,$263.70 ,$114.95 ,$190.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$605.00 ,$393.25 ,$38.68 ,$605.00 ,$205.02 ,$450.73 ,$396.28 ,$85.41 ,$169.40 ,$305.53 ,$85.41 ,$373.29 ,$85.41 ,$373.29 ,$373.29 ,$85.41 ,$373.29 ,$162.28 ,$544.50 ,$453.75 ,$205.02 ,$85.41 ,$532.40 ,$85.41 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$85.41 ,$514.25 ,$85.41 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$205.02 ,$544.50 ,$85.41 ,$605.00 ,$396.28 ,$85.41 ,$251.68 ,$40.52 ,$38.68 ,$89.39 ,$544.50 ,$185.09 ,$373.29 ,$169.40 ,$544.50 ,$85.41 ,$544.50 ,$544.50 ,$85.41 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$907.00 ,$589.55 ,$58.02 ,$907.00 ,$205.02 ,$675.72 ,$594.09 ,$85.41 ,$253.96 ,$458.04 ,$85.41 ,$559.62 ,$85.41 ,$559.62 ,$559.62 ,$85.41 ,$559.62 ,$162.28 ,$816.30 ,$680.25 ,$205.02 ,$85.41 ,$798.16 ,$85.41 ,$680.25 ,$680.25 ,$770.95 ,$770.95 ,$85.41 ,$770.95 ,$85.41 ,$707.46 ,$707.46 ,$707.46 ,$816.30 ,$205.02 ,$816.30 ,$85.41 ,$907.00 ,$594.09 ,$85.41 ,$377.31 ,$60.79 ,$58.02 ,$89.39 ,$816.30 ,$185.09 ,$559.62 ,$253.96 ,$816.30 ,$85.41 ,$816.30 ,$816.30 ,$85.41 ,$589.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$405.00 ,$263.25 ,$38.68 ,$405.00 ,$205.02 ,$301.73 ,$265.28 ,$85.41 ,$113.40 ,$204.53 ,$85.41 ,$249.89 ,$85.41 ,$249.89 ,$249.89 ,$85.41 ,$249.89 ,$162.28 ,$364.50 ,$303.75 ,$205.02 ,$85.41 ,$356.40 ,$85.41 ,$303.75 ,$303.75 ,$344.25 ,$344.25 ,$85.41 ,$344.25 ,$85.41 ,$315.90 ,$315.90 ,$315.90 ,$364.50 ,$205.02 ,$364.50 ,$85.41 ,$405.00 ,$265.28 ,$85.41 ,$168.48 ,$40.52 ,$38.68 ,$89.39 ,$364.50 ,$185.09 ,$249.89 ,$113.40 ,$364.50 ,$85.41 ,$364.50 ,$364.50 ,$85.41 ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,$978.00 ,$635.70 ,$220.43 ,$978.00 ,$933.39 ,$728.61 ,$640.59 ,$388.82 ,$273.84 ,$493.89 ,$388.82 ,$603.43 ,$388.82 ,$603.43 ,$603.43 ,$388.82 ,$603.43 ,$738.76 ,$880.20 ,$733.50 ,$933.39 ,$388.82 ,$860.64 ,$388.82 ,$733.50 ,$733.50 ,$831.30 ,$831.30 ,$388.82 ,$831.30 ,$388.82 ,$762.84 ,$762.84 ,$762.84 ,$880.20 ,$933.39 ,$880.20 ,$388.82 ,$978.00 ,$640.59 ,$388.82 ,$406.85 ,$230.92 ,$220.43 ,$406.98 ,$880.20 ,$842.63 ,$603.43 ,$273.84 ,$880.20 ,$388.82 ,$880.20 ,$880.20 ,$388.82 ,$635.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$311.00 ,$202.15 ,$38.68 ,$311.00 ,$205.02 ,$231.70 ,$203.71 ,$85.41 ,$87.08 ,$157.06 ,$85.41 ,$191.89 ,$85.41 ,$191.89 ,$191.89 ,$85.41 ,$191.89 ,$162.28 ,$279.90 ,$233.25 ,$205.02 ,$85.41 ,$273.68 ,$85.41 ,$233.25 ,$233.25 ,$264.35 ,$264.35 ,$85.41 ,$264.35 ,$85.41 ,$242.58 ,$242.58 ,$242.58 ,$279.90 ,$205.02 ,$279.90 ,$85.41 ,$311.00 ,$203.71 ,$85.41 ,$129.38 ,$40.52 ,$38.68 ,$89.39 ,$279.90 ,$185.09 ,$191.89 ,$87.08 ,$279.90 ,$85.41 ,$279.90 ,$279.90 ,$85.41 ,$202.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$468.00 ,$304.20 ,$58.02 ,$468.00 ,$205.02 ,$348.66 ,$306.54 ,$85.41 ,$131.04 ,$236.34 ,$85.41 ,$288.76 ,$85.41 ,$288.76 ,$288.76 ,$85.41 ,$288.76 ,$162.28 ,$421.20 ,$351.00 ,$205.02 ,$85.41 ,$411.84 ,$85.41 ,$351.00 ,$351.00 ,$397.80 ,$397.80 ,$85.41 ,$397.80 ,$85.41 ,$365.04 ,$365.04 ,$365.04 ,$421.20 ,$205.02 ,$421.20 ,$85.41 ,$468.00 ,$306.54 ,$85.41 ,$194.69 ,$60.79 ,$58.02 ,$89.39 ,$421.20 ,$185.09 ,$288.76 ,$131.04 ,$421.20 ,$85.41 ,$421.20 ,$421.20 ,$85.41 ,$304.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000263,73562,HC XRAY KNEE (3 V),320,1 ,$585.00 ,$380.25 ,$38.68 ,$585.00 ,$205.02 ,$435.83 ,$383.18 ,$85.41 ,$163.80 ,$295.43 ,$85.41 ,$360.95 ,$85.41 ,$360.95 ,$360.95 ,$85.41 ,$360.95 ,$162.28 ,$526.50 ,$438.75 ,$205.02 ,$85.41 ,$514.80 ,$85.41 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$85.41 ,$497.25 ,$85.41 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$205.02 ,$526.50 ,$85.41 ,$585.00 ,$383.18 ,$85.41 ,$243.36 ,$40.52 ,$38.68 ,$89.39 ,$526.50 ,$185.09 ,$360.95 ,$163.80 ,$526.50 ,$85.41 ,$526.50 ,$526.50 ,$85.41 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000263,73562,HC XRAY KNEE (3 V),320,1 ,$877.00 ,$570.05 ,$58.02 ,$877.00 ,$205.02 ,$653.37 ,$574.44 ,$85.41 ,$245.56 ,$442.89 ,$85.41 ,$541.11 ,$85.41 ,$541.11 ,$541.11 ,$85.41 ,$541.11 ,$162.28 ,$789.30 ,$657.75 ,$205.02 ,$85.41 ,$771.76 ,$85.41 ,$657.75 ,$657.75 ,$745.45 ,$745.45 ,$85.41 ,$745.45 ,$85.41 ,$684.06 ,$684.06 ,$684.06 ,$789.30 ,$205.02 ,$789.30 ,$85.41 ,$877.00 ,$574.44 ,$85.41 ,$364.83 ,$60.79 ,$58.02 ,$89.39 ,$789.30 ,$185.09 ,$541.11 ,$245.56 ,$789.30 ,$85.41 ,$789.30 ,$789.30 ,$85.41 ,$570.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$605.00 ,$393.25 ,$38.68 ,$605.00 ,$275.96 ,$450.73 ,$396.28 ,$114.95 ,$169.40 ,$305.53 ,$114.95 ,$373.29 ,$114.95 ,$373.29 ,$373.29 ,$114.95 ,$373.29 ,$218.41 ,$544.50 ,$453.75 ,$275.96 ,$114.95 ,$532.40 ,$114.95 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$114.95 ,$514.25 ,$114.95 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$275.96 ,$544.50 ,$114.95 ,$605.00 ,$396.28 ,$114.95 ,$251.68 ,$40.52 ,$38.68 ,$120.32 ,$544.50 ,$249.12 ,$373.29 ,$169.40 ,$544.50 ,$114.95 ,$544.50 ,$544.50 ,$114.95 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$907.00 ,$589.55 ,$58.02 ,$907.00 ,$275.96 ,$675.72 ,$594.09 ,$114.95 ,$253.96 ,$458.04 ,$114.95 ,$559.62 ,$114.95 ,$559.62 ,$559.62 ,$114.95 ,$559.62 ,$218.41 ,$816.30 ,$680.25 ,$275.96 ,$114.95 ,$798.16 ,$114.95 ,$680.25 ,$680.25 ,$770.95 ,$770.95 ,$114.95 ,$770.95 ,$114.95 ,$707.46 ,$707.46 ,$707.46 ,$816.30 ,$275.96 ,$816.30 ,$114.95 ,$907.00 ,$594.09 ,$114.95 ,$377.31 ,$60.79 ,$58.02 ,$120.32 ,$816.30 ,$249.12 ,$559.62 ,$253.96 ,$816.30 ,$114.95 ,$816.30 ,$816.30 ,$114.95 ,$589.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000267,73565,HC XR KNEE STAND,320,1 ,$366.00 ,$237.90 ,$38.68 ,$366.00 ,$205.02 ,$272.67 ,$239.73 ,$85.41 ,$102.48 ,$184.83 ,$85.41 ,$225.82 ,$85.41 ,$225.82 ,$225.82 ,$85.41 ,$225.82 ,$162.28 ,$329.40 ,$274.50 ,$205.02 ,$85.41 ,$322.08 ,$85.41 ,$274.50 ,$274.50 ,$311.10 ,$311.10 ,$85.41 ,$311.10 ,$85.41 ,$285.48 ,$285.48 ,$285.48 ,$329.40 ,$205.02 ,$329.40 ,$85.41 ,$366.00 ,$239.73 ,$85.41 ,$152.26 ,$40.52 ,$38.68 ,$89.39 ,$329.40 ,$185.09 ,$225.82 ,$102.48 ,$329.40 ,$85.41 ,$329.40 ,$329.40 ,$85.41 ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,$915.00 ,$594.75 ,$220.43 ,$915.00 ,$915.00 ,$681.68 ,$599.33 ,$388.82 ,$256.20 ,$462.08 ,$388.82 ,$564.56 ,$388.82 ,$564.56 ,$564.56 ,$388.82 ,$564.56 ,$738.76 ,$823.50 ,$686.25 ,$915.00 ,$388.82 ,$805.20 ,$388.82 ,$686.25 ,$686.25 ,$777.75 ,$777.75 ,$388.82 ,$777.75 ,$388.82 ,$713.70 ,$713.70 ,$713.70 ,$823.50 ,$915.00 ,$823.50 ,$388.82 ,$915.00 ,$599.33 ,$388.82 ,$380.64 ,$230.92 ,$220.43 ,$406.98 ,$823.50 ,$842.63 ,$564.56 ,$256.20 ,$823.50 ,$388.82 ,$823.50 ,$823.50 ,$388.82 ,$594.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$489.00 ,$317.85 ,$38.68 ,$489.00 ,$205.02 ,$364.31 ,$320.30 ,$85.41 ,$136.92 ,$246.95 ,$85.41 ,$301.71 ,$85.41 ,$301.71 ,$301.71 ,$85.41 ,$301.71 ,$162.28 ,$440.10 ,$366.75 ,$205.02 ,$85.41 ,$430.32 ,$85.41 ,$366.75 ,$366.75 ,$415.65 ,$415.65 ,$85.41 ,$415.65 ,$85.41 ,$381.42 ,$381.42 ,$381.42 ,$440.10 ,$205.02 ,$440.10 ,$85.41 ,$489.00 ,$320.30 ,$85.41 ,$203.42 ,$40.52 ,$38.68 ,$89.39 ,$440.10 ,$185.09 ,$301.71 ,$136.92 ,$440.10 ,$85.41 ,$440.10 ,$440.10 ,$85.41 ,$317.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$732.00 ,$475.80 ,$58.02 ,$732.00 ,$205.02 ,$545.34 ,$479.46 ,$85.41 ,$204.96 ,$369.66 ,$85.41 ,$451.64 ,$85.41 ,$451.64 ,$451.64 ,$85.41 ,$451.64 ,$162.28 ,$658.80 ,$549.00 ,$205.02 ,$85.41 ,$644.16 ,$85.41 ,$549.00 ,$549.00 ,$622.20 ,$622.20 ,$85.41 ,$622.20 ,$85.41 ,$570.96 ,$570.96 ,$570.96 ,$658.80 ,$205.02 ,$658.80 ,$85.41 ,$732.00 ,$479.46 ,$85.41 ,$304.51 ,$60.79 ,$58.02 ,$89.39 ,$658.80 ,$185.09 ,$451.64 ,$204.96 ,$658.80 ,$85.41 ,$658.80 ,$658.80 ,$85.41 ,$475.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$489.00 ,$317.85 ,$58.02 ,$489.00 ,$205.02 ,$364.31 ,$320.30 ,$85.41 ,$136.92 ,$246.95 ,$85.41 ,$301.71 ,$85.41 ,$301.71 ,$301.71 ,$85.41 ,$301.71 ,$162.28 ,$440.10 ,$366.75 ,$205.02 ,$85.41 ,$430.32 ,$85.41 ,$366.75 ,$366.75 ,$415.65 ,$415.65 ,$85.41 ,$415.65 ,$85.41 ,$381.42 ,$381.42 ,$381.42 ,$440.10 ,$205.02 ,$440.10 ,$85.41 ,$489.00 ,$320.30 ,$85.41 ,$203.42 ,$60.79 ,$58.02 ,$89.39 ,$440.10 ,$185.09 ,$301.71 ,$136.92 ,$440.10 ,$85.41 ,$440.10 ,$440.10 ,$85.41 ,$317.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$326.00 ,$211.90 ,$38.68 ,$326.00 ,$205.02 ,$242.87 ,$213.53 ,$85.41 ,$91.28 ,$164.63 ,$85.41 ,$201.14 ,$85.41 ,$201.14 ,$201.14 ,$85.41 ,$201.14 ,$162.28 ,$293.40 ,$244.50 ,$205.02 ,$85.41 ,$286.88 ,$85.41 ,$244.50 ,$244.50 ,$277.10 ,$277.10 ,$85.41 ,$277.10 ,$85.41 ,$254.28 ,$254.28 ,$254.28 ,$293.40 ,$205.02 ,$293.40 ,$85.41 ,$326.00 ,$213.53 ,$85.41 ,$135.62 ,$40.52 ,$38.68 ,$89.39 ,$293.40 ,$185.09 ,$201.14 ,$91.28 ,$293.40 ,$85.41 ,$293.40 ,$293.40 ,$85.41 ,$211.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$405.00 ,$263.25 ,$38.68 ,$405.00 ,$205.02 ,$301.73 ,$265.28 ,$85.41 ,$113.40 ,$204.53 ,$85.41 ,$249.89 ,$85.41 ,$249.89 ,$249.89 ,$85.41 ,$249.89 ,$162.28 ,$364.50 ,$303.75 ,$205.02 ,$85.41 ,$356.40 ,$85.41 ,$303.75 ,$303.75 ,$344.25 ,$344.25 ,$85.41 ,$344.25 ,$85.41 ,$315.90 ,$315.90 ,$315.90 ,$364.50 ,$205.02 ,$364.50 ,$85.41 ,$405.00 ,$265.28 ,$85.41 ,$168.48 ,$40.52 ,$38.68 ,$89.39 ,$364.50 ,$185.09 ,$249.89 ,$113.40 ,$364.50 ,$85.41 ,$364.50 ,$364.50 ,$85.41 ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$606.00 ,$393.90 ,$58.02 ,$606.00 ,$205.02 ,$451.47 ,$396.93 ,$85.41 ,$169.68 ,$306.03 ,$85.41 ,$373.90 ,$85.41 ,$373.90 ,$373.90 ,$85.41 ,$373.90 ,$162.28 ,$545.40 ,$454.50 ,$205.02 ,$85.41 ,$533.28 ,$85.41 ,$454.50 ,$454.50 ,$515.10 ,$515.10 ,$85.41 ,$515.10 ,$85.41 ,$472.68 ,$472.68 ,$472.68 ,$545.40 ,$205.02 ,$545.40 ,$85.41 ,$606.00 ,$396.93 ,$85.41 ,$252.10 ,$60.79 ,$58.02 ,$89.39 ,$545.40 ,$185.09 ,$373.90 ,$169.68 ,$545.40 ,$85.41 ,$545.40 ,$545.40 ,$85.41 ,$393.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$768.00 ,$499.20 ,$58.02 ,$768.00 ,$205.02 ,$572.16 ,$503.04 ,$85.41 ,$215.04 ,$387.84 ,$85.41 ,$473.86 ,$85.41 ,$473.86 ,$473.86 ,$85.41 ,$473.86 ,$162.28 ,$691.20 ,$576.00 ,$205.02 ,$85.41 ,$675.84 ,$85.41 ,$576.00 ,$576.00 ,$652.80 ,$652.80 ,$85.41 ,$652.80 ,$85.41 ,$599.04 ,$599.04 ,$599.04 ,$691.20 ,$205.02 ,$691.20 ,$85.41 ,$768.00 ,$503.04 ,$85.41 ,$319.49 ,$60.79 ,$58.02 ,$89.39 ,$691.20 ,$185.09 ,$473.86 ,$215.04 ,$691.20 ,$85.41 ,$691.20 ,$691.20 ,$85.41 ,$499.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$512.00 ,$332.80 ,$38.68 ,$512.00 ,$205.02 ,$381.44 ,$335.36 ,$85.41 ,$143.36 ,$258.56 ,$85.41 ,$315.90 ,$85.41 ,$315.90 ,$315.90 ,$85.41 ,$315.90 ,$162.28 ,$460.80 ,$384.00 ,$205.02 ,$85.41 ,$450.56 ,$85.41 ,$384.00 ,$384.00 ,$435.20 ,$435.20 ,$85.41 ,$435.20 ,$85.41 ,$399.36 ,$399.36 ,$399.36 ,$460.80 ,$205.02 ,$460.80 ,$85.41 ,$512.00 ,$335.36 ,$85.41 ,$212.99 ,$40.52 ,$38.68 ,$89.39 ,$460.80 ,$185.09 ,$315.90 ,$143.36 ,$460.80 ,$85.41 ,$460.80 ,$460.80 ,$85.41 ,$332.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000278,73615,HC XRAY ARTHRO ANKLE,320,1 ,$556.00 ,$361.40 ,$155.68 ,$842.63 ,$556.00 ,$414.22 ,$364.18 ,$388.82 ,$155.68 ,$280.78 ,$388.82 ,$343.05 ,$388.82 ,$343.05 ,$343.05 ,$388.82 ,$343.05 ,$738.76 ,$500.40 ,$417.00 ,$556.00 ,$388.82 ,$489.28 ,$388.82 ,$417.00 ,$417.00 ,$472.60 ,$472.60 ,$388.82 ,$472.60 ,$388.82 ,$433.68 ,$433.68 ,$433.68 ,$500.40 ,$556.00 ,$500.40 ,$388.82 ,$556.00 ,$364.18 ,$388.82 ,$231.30 ,$230.92 ,$220.43 ,$406.98 ,$500.40 ,$842.63 ,$343.05 ,$155.68 ,$500.40 ,$388.82 ,$500.40 ,$500.40 ,$388.82 ,$361.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000279,73620,HC XRAY FOOT (2 V),320,1 ,$370.00 ,$240.50 ,$38.68 ,$370.00 ,$205.02 ,$275.65 ,$242.35 ,$85.41 ,$103.60 ,$186.85 ,$85.41 ,$228.29 ,$85.41 ,$228.29 ,$228.29 ,$85.41 ,$228.29 ,$162.28 ,$333.00 ,$277.50 ,$205.02 ,$85.41 ,$325.60 ,$85.41 ,$277.50 ,$277.50 ,$314.50 ,$314.50 ,$85.41 ,$314.50 ,$85.41 ,$288.60 ,$288.60 ,$288.60 ,$333.00 ,$205.02 ,$333.00 ,$85.41 ,$370.00 ,$242.35 ,$85.41 ,$153.92 ,$40.52 ,$38.68 ,$89.39 ,$333.00 ,$185.09 ,$228.29 ,$103.60 ,$333.00 ,$85.41 ,$333.00 ,$333.00 ,$85.41 ,$240.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000279,73620,HC XRAY FOOT (2 V),320,1 ,$555.00 ,$360.75 ,$58.02 ,$555.00 ,$205.02 ,$413.48 ,$363.53 ,$85.41 ,$155.40 ,$280.28 ,$85.41 ,$342.44 ,$85.41 ,$342.44 ,$342.44 ,$85.41 ,$342.44 ,$162.28 ,$499.50 ,$416.25 ,$205.02 ,$85.41 ,$488.40 ,$85.41 ,$416.25 ,$416.25 ,$471.75 ,$471.75 ,$85.41 ,$471.75 ,$85.41 ,$432.90 ,$432.90 ,$432.90 ,$499.50 ,$205.02 ,$499.50 ,$85.41 ,$555.00 ,$363.53 ,$85.41 ,$230.88 ,$60.79 ,$58.02 ,$89.39 ,$499.50 ,$185.09 ,$342.44 ,$155.40 ,$499.50 ,$85.41 ,$499.50 ,$499.50 ,$85.41 ,$360.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$585.00 ,$380.25 ,$38.68 ,$585.00 ,$205.02 ,$435.83 ,$383.18 ,$85.41 ,$163.80 ,$295.43 ,$85.41 ,$360.95 ,$85.41 ,$360.95 ,$360.95 ,$85.41 ,$360.95 ,$162.28 ,$526.50 ,$438.75 ,$205.02 ,$85.41 ,$514.80 ,$85.41 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$85.41 ,$497.25 ,$85.41 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$205.02 ,$526.50 ,$85.41 ,$585.00 ,$383.18 ,$85.41 ,$243.36 ,$40.52 ,$38.68 ,$89.39 ,$526.50 ,$185.09 ,$360.95 ,$163.80 ,$526.50 ,$85.41 ,$526.50 ,$526.50 ,$85.41 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$877.00 ,$570.05 ,$58.02 ,$877.00 ,$205.02 ,$653.37 ,$574.44 ,$85.41 ,$245.56 ,$442.89 ,$85.41 ,$541.11 ,$85.41 ,$541.11 ,$541.11 ,$85.41 ,$541.11 ,$162.28 ,$789.30 ,$657.75 ,$205.02 ,$85.41 ,$771.76 ,$85.41 ,$657.75 ,$657.75 ,$745.45 ,$745.45 ,$85.41 ,$745.45 ,$85.41 ,$684.06 ,$684.06 ,$684.06 ,$789.30 ,$205.02 ,$789.30 ,$85.41 ,$877.00 ,$574.44 ,$85.41 ,$364.83 ,$60.79 ,$58.02 ,$89.39 ,$789.30 ,$185.09 ,$541.11 ,$245.56 ,$789.30 ,$85.41 ,$789.30 ,$789.30 ,$85.41 ,$570.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$405.00 ,$263.25 ,$38.68 ,$405.00 ,$205.02 ,$301.73 ,$265.28 ,$85.41 ,$113.40 ,$204.53 ,$85.41 ,$249.89 ,$85.41 ,$249.89 ,$249.89 ,$85.41 ,$249.89 ,$162.28 ,$364.50 ,$303.75 ,$205.02 ,$85.41 ,$356.40 ,$85.41 ,$303.75 ,$303.75 ,$344.25 ,$344.25 ,$85.41 ,$344.25 ,$85.41 ,$315.90 ,$315.90 ,$315.90 ,$364.50 ,$205.02 ,$364.50 ,$85.41 ,$405.00 ,$265.28 ,$85.41 ,$168.48 ,$40.52 ,$38.68 ,$89.39 ,$364.50 ,$185.09 ,$249.89 ,$113.40 ,$364.50 ,$85.41 ,$364.50 ,$364.50 ,$85.41 ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$606.00 ,$393.90 ,$58.02 ,$606.00 ,$205.02 ,$451.47 ,$396.93 ,$85.41 ,$169.68 ,$306.03 ,$85.41 ,$373.90 ,$85.41 ,$373.90 ,$373.90 ,$85.41 ,$373.90 , N/A ,$545.40 ,$454.50 ,$205.02 , N/A ,$533.28 ,$85.41 ,$454.50 ,$454.50 ,$515.10 ,$515.10 ,$85.41 ,$515.10 ,$85.41 ,$472.68 ,$472.68 ,$472.68 ,$545.40 ,$205.02 ,$545.40 ,$85.41 ,$606.00 ,$396.93 ,$85.41 ,$252.10 ,$60.79 ,$58.02 ,$89.39 ,$545.40 ,$185.09 ,$373.90 ,$169.68 ,$545.40 ,$85.41 ,$545.40 ,$545.40 ,$85.41 ,$393.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$393.00 ,$255.45 ,$38.68 ,$393.00 ,$205.02 ,$292.79 ,$257.42 ,$85.41 ,$110.04 ,$198.47 ,$85.41 ,$242.48 ,$85.41 ,$242.48 ,$242.48 ,$85.41 ,$242.48 ,$162.28 ,$353.70 ,$294.75 ,$205.02 ,$85.41 ,$345.84 ,$85.41 ,$294.75 ,$294.75 ,$334.05 ,$334.05 ,$85.41 ,$334.05 ,$85.41 ,$306.54 ,$306.54 ,$306.54 ,$353.70 ,$205.02 ,$353.70 ,$85.41 ,$393.00 ,$257.42 ,$85.41 ,$163.49 ,$40.52 ,$38.68 ,$89.39 ,$353.70 ,$185.09 ,$242.48 ,$110.04 ,$353.70 ,$85.41 ,$353.70 ,$353.70 ,$85.41 ,$255.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$575.00 ,$373.75 ,$38.68 ,$575.00 ,$205.02 ,$428.38 ,$376.63 ,$85.41 ,$161.00 ,$290.38 ,$85.41 ,$354.78 ,$85.41 ,$354.78 ,$354.78 ,$85.41 ,$354.78 ,$162.28 ,$517.50 ,$431.25 ,$205.02 ,$85.41 ,$506.00 ,$85.41 ,$431.25 ,$431.25 ,$488.75 ,$488.75 ,$85.41 ,$488.75 ,$85.41 ,$448.50 ,$448.50 ,$448.50 ,$517.50 ,$205.02 ,$517.50 ,$85.41 ,$575.00 ,$376.63 ,$85.41 ,$239.20 ,$40.52 ,$38.68 ,$89.39 ,$517.50 ,$185.09 ,$354.78 ,$161.00 ,$517.50 ,$85.41 ,$517.50 ,$517.50 ,$85.41 ,$373.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000294,74019,HC XRAY ABDOMEN AP  AND  LAT (2 V OR 3 V),320,1 ,$607.00 ,$394.55 ,$38.68 ,$607.00 ,$275.96 ,$452.22 ,$397.59 ,$114.95 ,$169.96 ,$306.54 ,$114.95 ,$374.52 ,$114.95 ,$374.52 ,$374.52 ,$114.95 ,$374.52 ,$218.41 ,$546.30 ,$455.25 ,$275.96 ,$114.95 ,$534.16 ,$114.95 ,$455.25 ,$455.25 ,$515.95 ,$515.95 ,$114.95 ,$515.95 ,$114.95 ,$473.46 ,$473.46 ,$473.46 ,$546.30 ,$275.96 ,$546.30 ,$114.95 ,$607.00 ,$397.59 ,$114.95 ,$252.51 ,$40.52 ,$38.68 ,$120.32 ,$546.30 ,$249.12 ,$374.52 ,$169.96 ,$546.30 ,$114.95 ,$546.30 ,$546.30 ,$114.95 ,$394.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,"$1,221.00 ",$793.65 ,$38.68 ,"$1,221.00 ",$275.96 ,$909.65 ,$799.76 ,$114.95 ,$341.88 ,$616.61 ,$114.95 ,$753.36 ,$114.95 ,$753.36 ,$753.36 ,$114.95 ,$753.36 ,$218.41 ,"$1,098.90 ",$915.75 ,$275.96 ,$114.95 ,"$1,074.48 ",$114.95 ,$915.75 ,$915.75 ,"$1,037.85 ","$1,037.85 ",$114.95 ,"$1,037.85 ",$114.95 ,$952.38 ,$952.38 ,$952.38 ,"$1,098.90 ",$275.96 ,"$1,098.90 ",$114.95 ,"$1,221.00 ",$799.76 ,$114.95 ,$507.94 ,$40.52 ,$38.68 ,$120.32 ,"$1,098.90 ",$249.12 ,$753.36 ,$341.88 ,"$1,098.90 ",$114.95 ,"$1,098.90 ","$1,098.90 ",$114.95 ,$793.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$911.00 ,$592.15 ,$38.68 ,$911.00 ,$452.76 ,$678.70 ,$596.71 ,$188.61 ,$255.08 ,$460.06 ,$188.61 ,$562.09 ,$188.61 ,$562.09 ,$562.09 ,$188.61 ,$562.09 ,$358.36 ,$819.90 ,$683.25 ,$452.76 ,$188.61 ,$801.68 ,$188.61 ,$683.25 ,$683.25 ,$774.35 ,$774.35 ,$188.61 ,$774.35 ,$188.61 ,$710.58 ,$710.58 ,$710.58 ,$819.90 ,$452.76 ,$819.90 ,$188.61 ,$911.00 ,$596.71 ,$188.61 ,$378.98 ,$40.52 ,$38.68 ,$197.41 ,$819.90 ,$408.74 ,$562.09 ,$255.08 ,$819.90 ,$188.61 ,$819.90 ,$819.90 ,$188.61 ,$592.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,"$1,278.00 ",$830.70 ,$85.06 ,"$1,278.00 ",$452.76 ,$952.11 ,$837.09 ,$188.61 ,$357.84 ,$645.39 ,$188.61 ,$788.53 ,$188.61 ,$788.53 ,$788.53 ,$188.61 ,$788.53 ,$358.36 ,"$1,150.20 ",$958.50 ,$452.76 ,$188.61 ,"$1,124.64 ",$188.61 ,$958.50 ,$958.50 ,"$1,086.30 ","$1,086.30 ",$188.61 ,"$1,086.30 ",$188.61 ,$996.84 ,$996.84 ,$996.84 ,"$1,150.20 ",$452.76 ,"$1,150.20 ",$188.61 ,"$1,278.00 ",$837.09 ,$188.61 ,$531.65 ,$89.11 ,$85.06 ,$197.41 ,"$1,150.20 ",$408.74 ,$788.53 ,$357.84 ,"$1,150.20 ",$188.61 ,"$1,150.20 ","$1,150.20 ",$188.61 ,$830.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,"$1,664.00 ","$1,081.60 ",$85.06 ,"$1,664.00 ",$452.76 ,"$1,239.68 ","$1,089.92 ",$188.61 ,$465.92 ,$840.32 ,$188.61 ,"$1,026.69 ",$188.61 ,"$1,026.69 ","$1,026.69 ",$188.61 ,"$1,026.69 ",$358.36 ,"$1,497.60 ","$1,248.00 ",$452.76 ,$188.61 ,"$1,464.32 ",$188.61 ,"$1,248.00 ","$1,248.00 ","$1,414.40 ","$1,414.40 ",$188.61 ,"$1,414.40 ",$188.61 ,"$1,297.92 ","$1,297.92 ","$1,297.92 ","$1,497.60 ",$452.76 ,"$1,497.60 ",$188.61 ,"$1,664.00 ","$1,089.92 ",$188.61 ,$692.22 ,$89.11 ,$85.06 ,$197.41 ,"$1,497.60 ",$408.74 ,"$1,026.69 ",$465.92 ,"$1,497.60 ",$188.61 ,"$1,497.60 ","$1,497.60 ",$188.61 ,"$1,081.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,"$2,386.00 ","$1,550.90 ",$85.06 ,"$2,386.00 ",$452.76 ,"$1,777.57 ","$1,562.83 ",$188.61 ,$668.08 ,"$1,204.93 ",$188.61 ,"$1,472.16 ",$188.61 ,"$1,472.16 ","$1,472.16 ",$188.61 ,"$1,472.16 ",$358.36 ,"$2,147.40 ","$1,789.50 ",$452.76 ,$188.61 ,"$2,099.68 ",$188.61 ,"$1,789.50 ","$1,789.50 ","$2,028.10 ","$2,028.10 ",$188.61 ,"$2,028.10 ",$188.61 ,"$1,861.08 ","$1,861.08 ","$1,861.08 ","$2,147.40 ",$452.76 ,"$2,147.40 ",$188.61 ,"$2,386.00 ","$1,562.83 ",$188.61 ,$992.58 ,$89.11 ,$85.06 ,$197.41 ,"$2,147.40 ",$408.74 ,"$1,472.16 ",$668.08 ,"$2,147.40 ",$188.61 ,"$2,147.40 ","$2,147.40 ",$188.61 ,"$1,550.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000307,74246,HC XRAY ESOPHAGUS/UGI W AIR,320,1 ,$673.00 ,$437.45 ,$85.06 ,$673.00 ,$452.76 ,$501.39 ,$440.82 ,$188.61 ,$188.44 ,$339.87 ,$188.61 ,$415.24 ,$188.61 ,$415.24 ,$415.24 ,$188.61 ,$415.24 ,$358.36 ,$605.70 ,$504.75 ,$452.76 ,$188.61 ,$592.24 ,$188.61 ,$504.75 ,$504.75 ,$572.05 ,$572.05 ,$188.61 ,$572.05 ,$188.61 ,$524.94 ,$524.94 ,$524.94 ,$605.70 ,$452.76 ,$605.70 ,$188.61 ,$673.00 ,$440.82 ,$188.61 ,$279.97 ,$89.11 ,$85.06 ,$197.41 ,$605.70 ,$408.74 ,$415.24 ,$188.44 ,$605.70 ,$188.61 ,$605.70 ,$605.70 ,$188.61 ,$437.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$967.00 ,$628.55 ,$85.06 ,$967.00 ,$452.76 ,$720.42 ,$633.39 ,$188.61 ,$270.76 ,$488.34 ,$188.61 ,$596.64 ,$188.61 ,$596.64 ,$596.64 ,$188.61 ,$596.64 ,$358.36 ,$870.30 ,$725.25 ,$452.76 ,$188.61 ,$850.96 ,$188.61 ,$725.25 ,$725.25 ,$821.95 ,$821.95 ,$188.61 ,$821.95 ,$188.61 ,$754.26 ,$754.26 ,$754.26 ,$870.30 ,$452.76 ,$870.30 ,$188.61 ,$967.00 ,$633.39 ,$188.61 ,$402.27 ,$89.11 ,$85.06 ,$197.41 ,$870.30 ,$408.74 ,$596.64 ,$270.76 ,$870.30 ,$188.61 ,$870.30 ,$870.30 ,$188.61 ,$628.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000312,74018,HC SITZ MARKER STUDY,320,1 ,$575.00 ,$373.75 ,$38.68 ,$575.00 ,$205.02 ,$428.38 ,$376.63 ,$85.41 ,$161.00 ,$290.38 ,$85.41 ,$354.78 ,$85.41 ,$354.78 ,$354.78 ,$85.41 ,$354.78 ,$162.28 ,$517.50 ,$431.25 ,$205.02 ,$85.41 ,$506.00 ,$85.41 ,$431.25 ,$431.25 ,$488.75 ,$488.75 ,$85.41 ,$488.75 ,$85.41 ,$448.50 ,$448.50 ,$448.50 ,$517.50 ,$205.02 ,$517.50 ,$85.41 ,$575.00 ,$376.63 ,$85.41 ,$239.20 ,$40.52 ,$38.68 ,$89.39 ,$517.50 ,$185.09 ,$354.78 ,$161.00 ,$517.50 ,$85.41 ,$517.50 ,$517.50 ,$85.41 ,$373.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000315,74270,HC XRAY COLON BARIUM,320,1 ,"$1,434.00 ",$932.10 ,$85.06 ,"$1,434.00 ",$452.76 ,"$1,068.33 ",$939.27 ,$188.61 ,$401.52 ,$724.17 ,$188.61 ,$884.78 ,$188.61 ,$884.78 ,$884.78 ,$188.61 ,$884.78 ,$358.36 ,"$1,290.60 ","$1,075.50 ",$452.76 ,$188.61 ,"$1,261.92 ",$188.61 ,"$1,075.50 ","$1,075.50 ","$1,218.90 ","$1,218.90 ",$188.61 ,"$1,218.90 ",$188.61 ,"$1,118.52 ","$1,118.52 ","$1,118.52 ","$1,290.60 ",$452.76 ,"$1,290.60 ",$188.61 ,"$1,434.00 ",$939.27 ,$188.61 ,$596.54 ,$89.11 ,$85.06 ,$197.41 ,"$1,290.60 ",$408.74 ,$884.78 ,$401.52 ,"$1,290.60 ",$188.61 ,"$1,290.60 ","$1,290.60 ",$188.61 ,$932.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,"$1,434.00 ",$932.10 ,$85.06 ,"$1,434.00 ",$452.76 ,"$1,068.33 ",$939.27 ,$188.61 ,$401.52 ,$724.17 ,$188.61 ,$884.78 ,$188.61 ,$884.78 ,$884.78 ,$188.61 ,$884.78 ,$358.36 ,"$1,290.60 ","$1,075.50 ",$452.76 ,$188.61 ,"$1,261.92 ",$188.61 ,"$1,075.50 ","$1,075.50 ","$1,218.90 ","$1,218.90 ",$188.61 ,"$1,218.90 ",$188.61 ,"$1,118.52 ","$1,118.52 ","$1,118.52 ","$1,290.60 ",$452.76 ,"$1,290.60 ",$188.61 ,"$1,434.00 ",$939.27 ,$188.61 ,$596.54 ,$89.11 ,$85.06 ,$197.41 ,"$1,290.60 ",$408.74 ,$884.78 ,$401.52 ,"$1,290.60 ",$188.61 ,"$1,290.60 ","$1,290.60 ",$188.61 ,$932.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,"$1,434.00 ",$932.10 ,$85.06 ,"$1,434.00 ",$452.76 ,"$1,068.33 ",$939.27 ,$188.61 ,$401.52 ,$724.17 ,$188.61 ,$884.78 ,$188.61 ,$884.78 ,$884.78 ,$188.61 ,$884.78 ,$358.36 ,"$1,290.60 ","$1,075.50 ",$452.76 ,$188.61 ,"$1,261.92 ",$188.61 ,"$1,075.50 ","$1,075.50 ","$1,218.90 ","$1,218.90 ",$188.61 ,"$1,218.90 ",$188.61 ,"$1,118.52 ","$1,118.52 ","$1,118.52 ","$1,290.60 ",$452.76 ,"$1,290.60 ",$188.61 ,"$1,434.00 ",$939.27 ,$188.61 ,$596.54 ,$89.11 ,$85.06 ,$197.41 ,"$1,290.60 ",$408.74 ,$884.78 ,$401.52 ,"$1,290.60 ",$188.61 ,"$1,290.60 ","$1,290.60 ",$188.61 ,$932.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,"$1,574.00 ","$1,023.10 ",$85.06 ,"$1,574.00 ",$452.76 ,"$1,172.63 ","$1,030.97 ",$188.61 ,$440.72 ,$794.87 ,$188.61 ,$971.16 ,$188.61 ,$971.16 ,$971.16 ,$188.61 ,$971.16 ,$358.36 ,"$1,416.60 ","$1,180.50 ",$452.76 ,$188.61 ,"$1,385.12 ",$188.61 ,"$1,180.50 ","$1,180.50 ","$1,337.90 ","$1,337.90 ",$188.61 ,"$1,337.90 ",$188.61 ,"$1,227.72 ","$1,227.72 ","$1,227.72 ","$1,416.60 ",$452.76 ,"$1,416.60 ",$188.61 ,"$1,574.00 ","$1,030.97 ",$188.61 ,$654.78 ,$89.11 ,$85.06 ,$197.41 ,"$1,416.60 ",$408.74 ,$971.16 ,$440.72 ,"$1,416.60 ",$188.61 ,"$1,416.60 ","$1,416.60 ",$188.61 ,"$1,023.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,"$1,418.00 ",$921.70 ,$220.43 ,"$1,418.00 ", N/A ,"$1,056.41 ",$928.79 , N/A ,$397.04 ,$716.09 , N/A ,$874.91 , N/A ,$874.91 ,$874.91 , N/A ,$874.91 , N/A ,"$1,276.20 ","$1,063.50 ", N/A , N/A ,"$1,247.84 ", N/A ,"$1,063.50 ","$1,063.50 ","$1,205.30 ","$1,205.30 ", N/A ,"$1,205.30 ", N/A ,"$1,106.04 ","$1,106.04 ","$1,106.04 ","$1,276.20 ", N/A ,"$1,276.20 ", N/A ,"$1,418.00 ",$928.79 , N/A ,$589.89 ,$230.92 ,$220.43 , N/A ,"$1,276.20 ", N/A ,$874.91 ,$397.04 ,"$1,276.20 ", N/A ,"$1,276.20 ","$1,276.20 ", N/A ,$921.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000325,47531,HC XRAY CHOLANGIOGRAM THRU CATH,320,1 ,"$3,805.00 ","$2,473.25 ",$85.06 ,"$7,280.19 ","$3,805.00 ","$2,834.73 ","$2,492.28 ","$3,359.37 ","$1,065.40 ","$1,921.53 ","$3,359.37 ","$2,347.69 ","$3,359.37 ","$2,347.69 ","$2,347.69 ","$3,359.37 ","$2,347.69 ","$6,382.80 ","$3,424.50 ","$2,853.75 ","$3,805.00 ","$3,359.37 ","$3,348.40 ","$3,359.37 ","$2,853.75 ","$2,853.75 ","$3,234.25 ","$3,234.25 ","$3,359.37 ","$3,234.25 ","$3,359.37 ","$2,967.90 ","$2,967.90 ","$2,967.90 ","$3,424.50 ","$3,805.00 ","$3,424.50 ","$3,359.37 ","$3,805.00 ","$2,492.28 ","$3,359.37 ","$1,582.88 ",$89.11 ,$85.06 ,"$3,516.20 ","$3,424.50 ","$7,280.19 ","$2,347.69 ","$1,065.40 ","$3,424.50 ","$3,359.37 ","$3,424.50 ","$3,424.50 ","$3,359.37 ","$2,473.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000331,74340,HC INTRODUCTION LONG GI TUBE,320,1 ,$903.00 ,$586.95 ,$220.43 ,$903.00 , N/A ,$672.74 ,$591.47 , N/A ,$252.84 ,$456.02 , N/A ,$557.15 , N/A ,$557.15 ,$557.15 , N/A ,$557.15 , N/A ,$812.70 ,$677.25 , N/A , N/A ,$794.64 , N/A ,$677.25 ,$677.25 ,$767.55 ,$767.55 , N/A ,$767.55 , N/A ,$704.34 ,$704.34 ,$704.34 ,$812.70 , N/A ,$812.70 , N/A ,$903.00 ,$591.47 , N/A ,$375.65 ,$230.92 ,$220.43 , N/A ,$812.70 , N/A ,$557.15 ,$252.84 ,$812.70 , N/A ,$812.70 ,$812.70 , N/A ,$586.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,"$1,313.00 ",$853.45 ,$241.29 ,"$1,313.00 ",$933.39 ,$978.19 ,$860.02 ,$388.82 ,$367.64 ,$663.07 ,$388.82 ,$810.12 ,$388.82 ,$810.12 ,$810.12 ,$388.82 ,$810.12 ,$738.76 ,"$1,181.70 ",$984.75 ,$933.39 ,$388.82 ,"$1,155.44 ",$388.82 ,$984.75 ,$984.75 ,"$1,116.05 ","$1,116.05 ",$388.82 ,"$1,116.05 ",$388.82 ,"$1,024.14 ","$1,024.14 ","$1,024.14 ","$1,181.70 ",$933.39 ,"$1,181.70 ",$388.82 ,"$1,313.00 ",$860.02 ,$388.82 ,$546.21 ,$252.78 ,$241.29 ,$406.98 ,"$1,181.70 ",$842.63 ,$810.12 ,$367.64 ,"$1,181.70 ",$388.82 ,"$1,181.70 ","$1,181.70 ",$388.82 ,$853.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000340,74425,HC XRAY UROGRAM ANTEGRADE,320,1 ,"$1,043.00 ",$677.95 ,$220.43 ,"$1,043.00 ",$933.39 ,$777.04 ,$683.17 ,$388.82 ,$292.04 ,$526.72 ,$388.82 ,$643.53 ,$388.82 ,$643.53 ,$643.53 ,$388.82 ,$643.53 ,$738.76 ,$938.70 ,$782.25 ,$933.39 ,$388.82 ,$917.84 ,$388.82 ,$782.25 ,$782.25 ,$886.55 ,$886.55 ,$388.82 ,$886.55 ,$388.82 ,$813.54 ,$813.54 ,$813.54 ,$938.70 ,$933.39 ,$938.70 ,$388.82 ,"$1,043.00 ",$683.17 ,$388.82 ,$433.89 ,$230.92 ,$220.43 ,$406.98 ,$938.70 ,$842.63 ,$643.53 ,$292.04 ,$938.70 ,$388.82 ,$938.70 ,$938.70 ,$388.82 ,$677.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000341,50431,HC ANGIO NEPHROSTGRAM,320,1 ,"$5,622.00 ","$3,654.30 ",$241.29 ,"$5,622.00 ","$1,458.23 ","$4,188.39 ","$3,682.41 ",$607.45 ,"$1,574.16 ","$2,839.11 ",$607.45 ,"$3,468.77 ",$607.45 ,"$3,468.77 ","$3,468.77 ",$607.45 ,"$3,468.77 ","$1,154.16 ","$5,059.80 ","$4,216.50 ","$1,458.23 ",$607.45 ,"$4,947.36 ",$607.45 ,"$4,216.50 ","$4,216.50 ","$4,778.70 ","$4,778.70 ",$607.45 ,"$4,778.70 ",$607.45 ,"$4,385.16 ","$4,385.16 ","$4,385.16 ","$5,059.80 ","$1,458.23 ","$5,059.80 ",$607.45 ,"$5,622.00 ","$3,682.41 ",$607.45 ,"$2,338.75 ",$252.78 ,$241.29 ,$635.81 ,"$5,059.80 ","$1,316.43 ","$3,468.77 ","$1,574.16 ","$5,059.80 ",$607.45 ,"$5,059.80 ","$5,059.80 ",$607.45 ,"$3,654.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000341,50431,HC ANGIO NEPHROSTGRAM,320,1 ,"$8,432.00 ","$5,480.80 ",$361.95 ,"$8,432.00 ","$1,458.23 ","$6,281.84 ","$5,522.96 ",$607.45 ,"$2,360.96 ","$4,258.16 ",$607.45 ,"$5,202.54 ",$607.45 ,"$5,202.54 ","$5,202.54 ",$607.45 ,"$5,202.54 ","$1,154.16 ","$7,588.80 ","$6,324.00 ","$1,458.23 ",$607.45 ,"$7,420.16 ",$607.45 ,"$6,324.00 ","$6,324.00 ","$7,167.20 ","$7,167.20 ",$607.45 ,"$7,167.20 ",$607.45 ,"$6,576.96 ","$6,576.96 ","$6,576.96 ","$7,588.80 ","$1,458.23 ","$7,588.80 ",$607.45 ,"$8,432.00 ","$5,522.96 ",$607.45 ,"$3,507.71 ",$379.18 ,$361.95 ,$635.81 ,"$7,588.80 ","$1,316.43 ","$5,202.54 ","$2,360.96 ","$7,588.80 ",$607.45 ,"$7,588.80 ","$7,588.80 ",$607.45 ,"$5,480.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,$855.00 ,$555.75 ,$220.43 ,$855.00 ,$855.00 ,$636.98 ,$560.03 ,$388.82 ,$239.40 ,$431.78 ,$388.82 ,$527.54 ,$388.82 ,$527.54 ,$527.54 ,$388.82 ,$527.54 ,$738.76 ,$769.50 ,$641.25 ,$855.00 ,$388.82 ,$752.40 ,$388.82 ,$641.25 ,$641.25 ,$726.75 ,$726.75 ,$388.82 ,$726.75 ,$388.82 ,$666.90 ,$666.90 ,$666.90 ,$769.50 ,$855.00 ,$769.50 ,$388.82 ,$855.00 ,$560.03 ,$388.82 ,$355.68 ,$230.92 ,$220.43 ,$406.98 ,$769.50 ,$842.63 ,$527.54 ,$239.40 ,$769.50 ,$388.82 ,$769.50 ,$769.50 ,$388.82 ,$555.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,$920.00 ,$598.00 ,$220.43 ,$920.00 ,$583.23 ,$685.40 ,$602.60 ,$242.96 ,$257.60 ,$464.60 ,$242.96 ,$567.64 ,$242.96 ,$567.64 ,$567.64 ,$242.96 ,$567.64 ,$461.62 ,$828.00 ,$690.00 ,$583.23 ,$242.96 ,$809.60 ,$242.96 ,$690.00 ,$690.00 ,$782.00 ,$782.00 ,$242.96 ,$782.00 ,$242.96 ,$717.60 ,$717.60 ,$717.60 ,$828.00 ,$583.23 ,$828.00 ,$242.96 ,$920.00 ,$602.60 ,$242.96 ,$382.72 ,$230.92 ,$220.43 ,$254.30 ,$828.00 ,$526.52 ,$567.64 ,$257.60 ,$828.00 ,$242.96 ,$828.00 ,$828.00 ,$242.96 ,$598.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,"$1,580.00 ","$1,027.00 ",$220.43 ,"$1,580.00 ",$583.23 ,"$1,177.10 ","$1,034.90 ",$242.96 ,$442.40 ,$797.90 ,$242.96 ,$974.86 ,$242.96 ,$974.86 ,$974.86 ,$242.96 ,$974.86 ,$461.62 ,"$1,422.00 ","$1,185.00 ",$583.23 ,$242.96 ,"$1,390.40 ",$242.96 ,"$1,185.00 ","$1,185.00 ","$1,343.00 ","$1,343.00 ",$242.96 ,"$1,343.00 ",$242.96 ,"$1,232.40 ","$1,232.40 ","$1,232.40 ","$1,422.00 ",$583.23 ,"$1,422.00 ",$242.96 ,"$1,580.00 ","$1,034.90 ",$242.96 ,$657.28 ,$230.92 ,$220.43 ,$254.30 ,"$1,422.00 ",$526.52 ,$974.86 ,$442.40 ,"$1,422.00 ",$242.96 ,"$1,422.00 ","$1,422.00 ",$242.96 ,"$1,027.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$4,251.00 ","$2,763.15 ",$754.44 ,"$4,251.00 ","$4,251.00 ","$3,167.00 ","$2,784.41 ","$1,890.56 ","$1,190.28 ","$2,146.76 ","$1,890.56 ","$2,622.87 ","$1,890.56 ","$2,622.87 ","$2,622.87 ","$1,890.56 ","$2,622.87 ","$3,592.06 ","$3,825.90 ","$3,188.25 ","$4,251.00 ","$1,890.56 ","$3,740.88 ","$1,890.56 ","$3,188.25 ","$3,188.25 ","$3,613.35 ","$3,613.35 ","$1,890.56 ","$3,613.35 ","$1,890.56 ","$3,315.78 ","$3,315.78 ","$3,315.78 ","$3,825.90 ","$4,251.00 ","$3,825.90 ","$1,890.56 ","$4,251.00 ","$2,784.41 ","$1,890.56 ","$1,768.42 ",$790.36 ,$754.44 ,"$1,978.83 ","$3,825.90 ","$4,097.10 ","$2,622.87 ","$1,190.28 ","$3,825.90 ","$1,890.56 ","$3,825.90 ","$3,825.90 ","$1,890.56 ","$2,763.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$6,376.00 ","$4,144.40 ","$1,131.65 ","$7,035.28 ","$6,376.00 ","$4,750.12 ","$4,176.28 ","$3,246.35 ","$1,785.28 ","$3,219.88 ","$3,246.35 ","$3,933.99 ","$3,246.35 ","$3,933.99 ","$3,933.99 ","$3,246.35 ","$3,933.99 ","$6,168.07 ","$5,738.40 ","$4,782.00 ","$6,376.00 ","$3,246.35 ","$5,610.88 ","$3,246.35 ","$4,782.00 ","$4,782.00 ","$5,419.60 ","$5,419.60 ","$3,246.35 ","$5,419.60 ","$3,246.35 ","$4,973.28 ","$4,973.28 ","$4,973.28 ","$5,738.40 ","$6,376.00 ","$5,738.40 ","$3,246.35 ","$6,376.00 ","$4,176.28 ","$3,246.35 ","$2,652.42 ","$1,185.54 ","$1,131.65 ","$3,397.91 ","$5,738.40 ","$7,035.28 ","$3,933.99 ","$1,785.28 ","$5,738.40 ","$3,246.35 ","$5,738.40 ","$5,738.40 ","$3,246.35 ","$4,144.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000352,74485,"HC DILITATN NEPHRO,URETER,URETHRA",320,1 ,"$3,744.00 ","$2,433.60 ",$220.43 ,"$4,097.10 ","$3,744.00 ","$2,789.28 ","$2,452.32 ","$1,890.56 ","$1,048.32 ","$1,890.72 ","$1,890.56 ","$2,310.05 ","$1,890.56 ","$2,310.05 ","$2,310.05 ","$1,890.56 ","$2,310.05 ","$3,592.06 ","$3,369.60 ","$2,808.00 ","$3,744.00 ","$1,890.56 ","$3,294.72 ","$1,890.56 ","$2,808.00 ","$2,808.00 ","$3,182.40 ","$3,182.40 ","$1,890.56 ","$3,182.40 ","$1,890.56 ","$2,920.32 ","$2,920.32 ","$2,920.32 ","$3,369.60 ","$3,744.00 ","$3,369.60 ","$1,890.56 ","$3,744.00 ","$2,452.32 ","$1,890.56 ","$1,557.50 ",$230.92 ,$220.43 ,"$1,978.83 ","$3,369.60 ","$4,097.10 ","$2,310.05 ","$1,048.32 ","$3,369.60 ","$1,890.56 ","$3,369.60 ","$3,369.60 ","$1,890.56 ","$2,433.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,"$1,453.00 ",$944.45 ,$220.43 ,"$1,453.00 ",$583.23 ,"$1,082.49 ",$951.72 ,$242.96 ,$406.84 ,$733.77 ,$242.96 ,$896.50 ,$242.96 ,$896.50 ,$896.50 ,$242.96 ,$896.50 ,$461.62 ,"$1,307.70 ","$1,089.75 ",$583.23 ,$242.96 ,"$1,278.64 ",$242.96 ,"$1,089.75 ","$1,089.75 ","$1,235.05 ","$1,235.05 ",$242.96 ,"$1,235.05 ",$242.96 ,"$1,133.34 ","$1,133.34 ","$1,133.34 ","$1,307.70 ",$583.23 ,"$1,307.70 ",$242.96 ,"$1,453.00 ",$951.72 ,$242.96 ,$604.45 ,$230.92 ,$220.43 ,$254.30 ,"$1,307.70 ",$526.52 ,$896.50 ,$406.84 ,"$1,307.70 ",$242.96 ,"$1,307.70 ","$1,307.70 ",$242.96 ,$944.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000355,75605,HC THORACIC AORTA,320,1 ,"$5,548.00 ","$3,606.20 ",$220.43 ,"$10,911.83 ","$5,548.00 ","$4,133.26 ","$3,633.94 ","$5,035.15 ","$1,553.44 ","$2,801.74 ","$5,035.15 ","$3,423.12 ","$5,035.15 ","$3,423.12 ","$3,423.12 ","$5,035.15 ","$3,423.12 ","$9,566.79 ","$4,993.20 ","$4,161.00 ","$5,548.00 ","$5,035.15 ","$4,882.24 ","$5,035.15 ","$4,161.00 ","$4,161.00 ","$4,715.80 ","$4,715.80 ","$5,035.15 ","$4,715.80 ","$5,035.15 ","$4,327.44 ","$4,327.44 ","$4,327.44 ","$4,993.20 ","$5,548.00 ","$4,993.20 ","$5,035.15 ","$5,548.00 ","$3,633.94 ","$5,035.15 ","$2,307.97 ",$230.92 ,$220.43 ,"$5,270.21 ","$4,993.20 ","$10,911.83 ","$3,423.12 ","$1,553.44 ","$4,993.20 ","$5,035.15 ","$4,993.20 ","$4,993.20 ","$5,035.15 ","$3,606.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000356,75625,HC ABDOMINAL AORTAGRAM 75625,320,1 ,"$5,734.00 ","$3,727.10 ",$220.43 ,"$6,550.42 ","$5,734.00 ","$4,271.83 ","$3,755.77 ","$3,022.62 ","$1,605.52 ","$2,895.67 ","$3,022.62 ","$3,537.88 ","$3,022.62 ","$3,537.88 ","$3,537.88 ","$3,022.62 ","$3,537.88 ","$5,742.98 ","$5,160.60 ","$4,300.50 ","$5,734.00 ","$3,022.62 ","$5,045.92 ","$3,022.62 ","$4,300.50 ","$4,300.50 ","$4,873.90 ","$4,873.90 ","$3,022.62 ","$4,873.90 ","$3,022.62 ","$4,472.52 ","$4,472.52 ","$4,472.52 ","$5,160.60 ","$5,734.00 ","$5,160.60 ","$3,022.62 ","$5,734.00 ","$3,755.77 ","$3,022.62 ","$2,385.34 ",$230.92 ,$220.43 ,"$3,163.73 ","$5,160.60 ","$6,550.42 ","$3,537.88 ","$1,605.52 ","$5,160.60 ","$3,022.62 ","$5,160.60 ","$5,160.60 ","$3,022.62 ","$3,727.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000357,75630,HC AORTA WITH RUNOFF 75630,320,1 ,"$6,439.00 ","$4,185.35 ",$220.43 ,"$6,550.42 ","$6,439.00 ","$4,797.06 ","$4,217.55 ","$3,022.62 ","$1,802.92 ","$3,251.70 ","$3,022.62 ","$3,972.86 ","$3,022.62 ","$3,972.86 ","$3,972.86 ","$3,022.62 ","$3,972.86 ","$5,742.98 ","$5,795.10 ","$4,829.25 ","$6,439.00 ","$3,022.62 ","$5,666.32 ","$3,022.62 ","$4,829.25 ","$4,829.25 ","$5,473.15 ","$5,473.15 ","$3,022.62 ","$5,473.15 ","$3,022.62 ","$5,022.42 ","$5,022.42 ","$5,022.42 ","$5,795.10 ","$6,439.00 ","$5,795.10 ","$3,022.62 ","$6,439.00 ","$4,217.55 ","$3,022.62 ","$2,678.62 ",$230.92 ,$220.43 ,"$3,163.73 ","$5,795.10 ","$6,550.42 ","$3,972.86 ","$1,802.92 ","$5,795.10 ","$3,022.62 ","$5,795.10 ","$5,795.10 ","$3,022.62 ","$4,185.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000371,75710,HC ANGIO EXTREMITY UNI 75710,320,1 ,"$5,532.00 ","$3,595.80 ",$220.43 ,"$6,550.42 ","$5,532.00 ","$4,121.34 ","$3,623.46 ","$3,022.62 ","$1,548.96 ","$2,793.66 ","$3,022.62 ","$3,413.24 ","$3,022.62 ","$3,413.24 ","$3,413.24 ","$3,022.62 ","$3,413.24 ","$5,742.98 ","$4,978.80 ","$4,149.00 ","$5,532.00 ","$3,022.62 ","$4,868.16 ","$3,022.62 ","$4,149.00 ","$4,149.00 ","$4,702.20 ","$4,702.20 ","$3,022.62 ","$4,702.20 ","$3,022.62 ","$4,314.96 ","$4,314.96 ","$4,314.96 ","$4,978.80 ","$5,532.00 ","$4,978.80 ","$3,022.62 ","$5,532.00 ","$3,623.46 ","$3,022.62 ","$2,301.31 ",$230.92 ,$220.43 ,"$3,163.73 ","$4,978.80 ","$6,550.42 ","$3,413.24 ","$1,548.96 ","$4,978.80 ","$3,022.62 ","$4,978.80 ","$4,978.80 ","$3,022.62 ","$3,595.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000373,75716,HC ANGIO EXTREMITY BILAT 75716,320,1 ,"$6,182.00 ","$4,018.30 ",$220.43 ,"$6,550.42 ","$6,182.00 ","$4,605.59 ","$4,049.21 ","$3,022.62 ","$1,730.96 ","$3,121.91 ","$3,022.62 ","$3,814.29 ","$3,022.62 ","$3,814.29 ","$3,814.29 ","$3,022.62 ","$3,814.29 ","$5,742.98 ","$5,563.80 ","$4,636.50 ","$6,182.00 ","$3,022.62 ","$5,440.16 ","$3,022.62 ","$4,636.50 ","$4,636.50 ","$5,254.70 ","$5,254.70 ","$3,022.62 ","$5,254.70 ","$3,022.62 ","$4,821.96 ","$4,821.96 ","$4,821.96 ","$5,563.80 ","$6,182.00 ","$5,563.80 ","$3,022.62 ","$6,182.00 ","$4,049.21 ","$3,022.62 ","$2,571.71 ",$230.92 ,$220.43 ,"$3,163.73 ","$5,563.80 ","$6,550.42 ","$3,814.29 ","$1,730.96 ","$5,563.80 ","$3,022.62 ","$5,563.80 ","$5,563.80 ","$3,022.62 ","$4,018.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000375,36251,HC ANGIO SEL RENAL UNILA 36251,320,1 ,"$4,041.00 ","$2,626.65 ","$1,131.48 ","$6,550.42 ","$4,041.00 ","$3,010.55 ","$2,646.86 ","$3,022.62 ","$1,131.48 ","$2,040.71 ","$3,022.62 ","$2,493.30 ","$3,022.62 ","$2,493.30 ","$2,493.30 ","$3,022.62 ","$2,493.30 ","$5,742.98 ","$3,636.90 ","$3,030.75 ","$4,041.00 ","$3,022.62 ","$3,556.08 ","$3,022.62 ","$3,030.75 ","$3,030.75 ","$3,434.85 ","$3,434.85 ","$3,022.62 ","$3,434.85 ","$3,022.62 ","$3,151.98 ","$3,151.98 ","$3,151.98 ","$3,636.90 ","$4,041.00 ","$3,636.90 ","$3,022.62 ","$4,041.00 ","$2,646.86 ","$3,022.62 ","$1,681.06 ","$1,948.40 ","$1,859.83 ","$3,163.73 ","$3,636.90 ","$6,550.42 ","$2,493.30 ","$1,131.48 ","$3,636.90 ","$3,022.62 ","$3,636.90 ","$3,636.90 ","$3,022.62 ","$2,626.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000376,36252,HC ANGIO SEL RENAL BILAT 36252,320,1 ,"$5,655.00 ","$3,675.75 ","$1,583.40 ","$6,550.42 ","$5,655.00 ","$4,212.98 ","$3,704.03 ","$3,022.62 ","$1,583.40 ","$2,855.78 ","$3,022.62 ","$3,489.14 ","$3,022.62 ","$3,489.14 ","$3,489.14 ","$3,022.62 ","$3,489.14 ","$5,742.98 ","$5,089.50 ","$4,241.25 ","$5,655.00 ","$3,022.62 ","$4,976.40 ","$3,022.62 ","$4,241.25 ","$4,241.25 ","$4,806.75 ","$4,806.75 ","$3,022.62 ","$4,806.75 ","$3,022.62 ","$4,410.90 ","$4,410.90 ","$4,410.90 ","$5,089.50 ","$5,655.00 ","$5,089.50 ","$3,022.62 ","$5,655.00 ","$3,704.03 ","$3,022.62 ","$2,352.48 ","$1,948.40 ","$1,859.83 ","$3,163.73 ","$5,089.50 ","$6,550.42 ","$3,489.14 ","$1,583.40 ","$5,089.50 ","$3,022.62 ","$5,089.50 ","$5,089.50 ","$3,022.62 ","$3,675.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000378,75726,"HC ANGIO VISERAL, SEL, OR SUPRASEL 75726",320,1 ,"$6,569.00 ","$4,269.85 ",$220.43 ,"$10,911.83 ","$6,569.00 ","$4,893.91 ","$4,302.70 ","$5,035.15 ","$1,839.32 ","$3,317.35 ","$5,035.15 ","$4,053.07 ","$5,035.15 ","$4,053.07 ","$4,053.07 ","$5,035.15 ","$4,053.07 ","$9,566.79 ","$5,912.10 ","$4,926.75 ","$6,569.00 ","$5,035.15 ","$5,780.72 ","$5,035.15 ","$4,926.75 ","$4,926.75 ","$5,583.65 ","$5,583.65 ","$5,035.15 ","$5,583.65 ","$5,035.15 ","$5,123.82 ","$5,123.82 ","$5,123.82 ","$5,912.10 ","$6,569.00 ","$5,912.10 ","$5,035.15 ","$6,569.00 ","$4,302.70 ","$5,035.15 ","$2,732.70 ",$230.92 ,$220.43 ,"$5,270.21 ","$5,912.10 ","$10,911.83 ","$4,053.07 ","$1,839.32 ","$5,912.10 ","$5,035.15 ","$5,912.10 ","$5,912.10 ","$5,035.15 ","$4,269.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000384,75736,HC ANGIO PELVIC SELECT,320,1 ,"$5,698.00 ","$3,703.70 ",$220.43 ,"$10,911.83 ","$5,698.00 ","$4,245.01 ","$3,732.19 ","$5,035.15 ","$1,595.44 ","$2,877.49 ","$5,035.15 ","$3,515.67 ","$5,035.15 ","$3,515.67 ","$3,515.67 ","$5,035.15 ","$3,515.67 ","$9,566.79 ","$5,128.20 ","$4,273.50 ","$5,698.00 ","$5,035.15 ","$5,014.24 ","$5,035.15 ","$4,273.50 ","$4,273.50 ","$4,843.30 ","$4,843.30 ","$5,035.15 ","$4,843.30 ","$5,035.15 ","$4,444.44 ","$4,444.44 ","$4,444.44 ","$5,128.20 ","$5,698.00 ","$5,128.20 ","$5,035.15 ","$5,698.00 ","$3,732.19 ","$5,035.15 ","$2,370.37 ",$230.92 ,$220.43 ,"$5,270.21 ","$5,128.20 ","$10,911.83 ","$3,515.67 ","$1,595.44 ","$5,128.20 ","$5,035.15 ","$5,128.20 ","$5,128.20 ","$5,035.15 ","$3,703.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000389,75774,HC ANGIO EA VESSEL ADDL 75774,320,1 ,"$2,645.00 ","$1,719.25 ",$220.43 ,"$2,645.00 ", N/A ,"$1,970.53 ","$1,732.48 ", N/A ,$740.60 ,"$1,335.73 ", N/A ,"$1,631.97 ", N/A ,"$1,631.97 ","$1,631.97 ", N/A ,"$1,631.97 ", N/A ,"$2,380.50 ","$1,983.75 ", N/A , N/A ,"$2,327.60 ", N/A ,"$1,983.75 ","$1,983.75 ","$2,248.25 ","$2,248.25 ", N/A ,"$2,248.25 ", N/A ,"$2,063.10 ","$2,063.10 ","$2,063.10 ","$2,380.50 ", N/A ,"$2,380.50 ", N/A ,"$2,645.00 ","$1,732.48 ", N/A ,"$1,100.32 ",$230.92 ,$220.43 , N/A ,"$2,380.50 ", N/A ,"$1,631.97 ",$740.60 ,"$2,380.50 ", N/A ,"$2,380.50 ","$2,380.50 ", N/A ,"$1,719.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000395,75820,HC VENOGRAM EXTREMITY UNI 75820,320,1 ,"$2,129.00 ","$1,383.85 ",$220.43 ,"$3,217.73 ","$2,129.00 ","$1,586.11 ","$1,394.50 ","$1,484.79 ",$596.12 ,"$1,075.15 ","$1,484.79 ","$1,313.59 ","$1,484.79 ","$1,313.59 ","$1,313.59 ","$1,484.79 ","$1,313.59 ","$2,821.10 ","$1,916.10 ","$1,596.75 ","$2,129.00 ","$1,484.79 ","$1,873.52 ","$1,484.79 ","$1,596.75 ","$1,596.75 ","$1,809.65 ","$1,809.65 ","$1,484.79 ","$1,809.65 ","$1,484.79 ","$1,660.62 ","$1,660.62 ","$1,660.62 ","$1,916.10 ","$2,129.00 ","$1,916.10 ","$1,484.79 ","$2,129.00 ","$1,394.50 ","$1,484.79 ",$885.66 ,$230.92 ,$220.43 ,"$1,554.10 ","$1,916.10 ","$3,217.73 ","$1,313.59 ",$596.12 ,"$1,916.10 ","$1,484.79 ","$1,916.10 ","$1,916.10 ","$1,484.79 ","$1,383.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000397,75822,HC VENOGRAM EXTREMITY BILAT,320,1 ,"$2,613.00 ","$1,698.45 ",$220.43 ,"$3,217.73 ","$2,613.00 ","$1,946.69 ","$1,711.52 ","$1,484.79 ",$731.64 ,"$1,319.57 ","$1,484.79 ","$1,612.22 ","$1,484.79 ","$1,612.22 ","$1,612.22 ","$1,484.79 ","$1,612.22 ","$2,821.10 ","$2,351.70 ","$1,959.75 ","$2,613.00 ","$1,484.79 ","$2,299.44 ","$1,484.79 ","$1,959.75 ","$1,959.75 ","$2,221.05 ","$2,221.05 ","$1,484.79 ","$2,221.05 ","$1,484.79 ","$2,038.14 ","$2,038.14 ","$2,038.14 ","$2,351.70 ","$2,613.00 ","$2,351.70 ","$1,484.79 ","$2,613.00 ","$1,711.52 ","$1,484.79 ","$1,087.01 ",$230.92 ,$220.43 ,"$1,554.10 ","$2,351.70 ","$3,217.73 ","$1,612.22 ",$731.64 ,"$2,351.70 ","$1,484.79 ","$2,351.70 ","$2,351.70 ","$1,484.79 ","$1,698.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000398,75825,HC VENOGRAPHY CAVAL INFERIOR,320,1 ,"$4,079.00 ","$2,651.35 ",$220.43 ,"$6,550.42 ","$4,079.00 ","$3,038.86 ","$2,671.75 ","$3,022.62 ","$1,142.12 ","$2,059.90 ","$3,022.62 ","$2,516.74 ","$3,022.62 ","$2,516.74 ","$2,516.74 ","$3,022.62 ","$2,516.74 ","$5,742.98 ","$3,671.10 ","$3,059.25 ","$4,079.00 ","$3,022.62 ","$3,589.52 ","$3,022.62 ","$3,059.25 ","$3,059.25 ","$3,467.15 ","$3,467.15 ","$3,022.62 ","$3,467.15 ","$3,022.62 ","$3,181.62 ","$3,181.62 ","$3,181.62 ","$3,671.10 ","$4,079.00 ","$3,671.10 ","$3,022.62 ","$4,079.00 ","$2,671.75 ","$3,022.62 ","$1,696.86 ",$230.92 ,$220.43 ,"$3,163.73 ","$3,671.10 ","$6,550.42 ","$2,516.74 ","$1,142.12 ","$3,671.10 ","$3,022.62 ","$3,671.10 ","$3,671.10 ","$3,022.62 ","$2,651.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000399,75827,HC VENOGRAPHY CAVAL SUPERIOR,320,1 ,"$2,759.00 ","$1,793.35 ",$220.43 ,"$3,217.73 ","$2,759.00 ","$2,055.46 ","$1,807.15 ","$1,484.79 ",$772.52 ,"$1,393.30 ","$1,484.79 ","$1,702.30 ","$1,484.79 ","$1,702.30 ","$1,702.30 ","$1,484.79 ","$1,702.30 ","$2,821.10 ","$2,483.10 ","$2,069.25 ","$2,759.00 ","$1,484.79 ","$2,427.92 ","$1,484.79 ","$2,069.25 ","$2,069.25 ","$2,345.15 ","$2,345.15 ","$1,484.79 ","$2,345.15 ","$1,484.79 ","$2,152.02 ","$2,152.02 ","$2,152.02 ","$2,483.10 ","$2,759.00 ","$2,483.10 ","$1,484.79 ","$2,759.00 ","$1,807.15 ","$1,484.79 ","$1,147.74 ",$230.92 ,$220.43 ,"$1,554.10 ","$2,483.10 ","$3,217.73 ","$1,702.30 ",$772.52 ,"$2,483.10 ","$1,484.79 ","$2,483.10 ","$2,483.10 ","$1,484.79 ","$1,793.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000411,75889,HC VENOGRAM HEPATIC W/HEMO,320,1 ,"$5,220.00 ","$3,393.00 ",$220.43 ,"$6,550.42 ","$5,220.00 ","$3,888.90 ","$3,419.10 ","$3,022.62 ","$1,461.60 ","$2,636.10 ","$3,022.62 ","$3,220.74 ","$3,022.62 ","$3,220.74 ","$3,220.74 ","$3,022.62 ","$3,220.74 ","$5,742.98 ","$4,698.00 ","$3,915.00 ","$5,220.00 ","$3,022.62 ","$4,593.60 ","$3,022.62 ","$3,915.00 ","$3,915.00 ","$4,437.00 ","$4,437.00 ","$3,022.62 ","$4,437.00 ","$3,022.62 ","$4,071.60 ","$4,071.60 ","$4,071.60 ","$4,698.00 ","$5,220.00 ","$4,698.00 ","$3,022.62 ","$5,220.00 ","$3,419.10 ","$3,022.62 ","$2,171.52 ",$230.92 ,$220.43 ,"$3,163.73 ","$4,698.00 ","$6,550.42 ","$3,220.74 ","$1,461.60 ","$4,698.00 ","$3,022.62 ","$4,698.00 ","$4,698.00 ","$3,022.62 ","$3,393.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000413,75893,HC VENOGRAM SAMPLING CATH,320,1 ,"$4,237.00 ","$2,754.05 ",$220.43 ,"$10,911.83 ","$4,237.00 ","$3,156.57 ","$2,775.24 ","$4,237.00 ","$1,186.36 ","$2,139.69 ","$4,237.00 ","$2,614.23 ","$4,237.00 ","$2,614.23 ","$2,614.23 ","$4,237.00 ","$2,614.23 ","$9,566.79 ","$3,813.30 ","$3,177.75 ","$4,237.00 ","$4,237.00 ","$3,728.56 ","$4,237.00 ","$3,177.75 ","$3,177.75 ","$3,601.45 ","$3,601.45 ","$4,237.00 ","$3,601.45 ","$4,237.00 ","$3,304.86 ","$3,304.86 ","$3,304.86 ","$3,813.30 ","$4,237.00 ","$3,813.30 ","$4,237.00 ","$4,237.00 ","$2,775.24 ","$4,237.00 ","$1,762.59 ",$230.92 ,$220.43 ,"$4,237.00 ","$3,813.30 ","$10,911.83 ","$2,614.23 ","$1,186.36 ","$3,813.30 ","$4,237.00 ","$3,813.30 ","$3,813.30 ","$4,237.00 ","$2,754.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000414,75894,HC TRANSCATH EMBOLIZATION 75894,320,1 ,"$9,213.00 ","$5,988.45 ",$220.43 ,"$9,213.00 ", N/A ,"$6,863.69 ","$6,034.52 ", N/A ,"$2,579.64 ","$4,652.57 ", N/A ,"$5,684.42 ", N/A ,"$5,684.42 ","$5,684.42 ", N/A ,"$5,684.42 ", N/A ,"$8,291.70 ","$6,909.75 ", N/A , N/A ,"$8,107.44 ", N/A ,"$6,909.75 ","$6,909.75 ","$7,831.05 ","$7,831.05 ", N/A ,"$7,831.05 ", N/A ,"$7,186.14 ","$7,186.14 ","$7,186.14 ","$8,291.70 ", N/A ,"$8,291.70 ", N/A ,"$9,213.00 ","$6,034.52 ", N/A ,"$3,832.61 ",$230.92 ,$220.43 , N/A ,"$8,291.70 ", N/A ,"$5,684.42 ","$2,579.64 ","$8,291.70 ", N/A ,"$8,291.70 ","$8,291.70 ", N/A ,"$5,988.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000421,75901,HC REMOVE PERICATH OBST CV CATH,320,1 ,"$1,319.00 ",$857.35 ,$220.43 ,"$1,319.00 ", N/A ,$982.66 ,$863.95 , N/A ,$369.32 ,$666.10 , N/A ,$813.82 , N/A ,$813.82 ,$813.82 , N/A ,$813.82 , N/A ,"$1,187.10 ",$989.25 , N/A , N/A ,"$1,160.72 ", N/A ,$989.25 ,$989.25 ,"$1,121.15 ","$1,121.15 ", N/A ,"$1,121.15 ", N/A ,"$1,028.82 ","$1,028.82 ","$1,028.82 ","$1,187.10 ", N/A ,"$1,187.10 ", N/A ,"$1,319.00 ",$863.95 , N/A ,$548.70 ,$230.92 ,$220.43 , N/A ,"$1,187.10 ", N/A ,$813.82 ,$369.32 ,"$1,187.10 ", N/A ,"$1,187.10 ","$1,187.10 ", N/A ,$857.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000435,75970,HC TRANSCATH BX,320,1 ,"$6,059.00 ","$3,938.35 ",$220.43 ,"$6,059.00 ", N/A ,"$4,513.96 ","$3,968.65 ", N/A ,"$1,696.52 ","$3,059.80 ", N/A ,"$3,738.40 ", N/A ,"$3,738.40 ","$3,738.40 ", N/A ,"$3,738.40 ", N/A ,"$5,453.10 ","$4,544.25 ", N/A , N/A ,"$5,331.92 ", N/A ,"$4,544.25 ","$4,544.25 ","$5,150.15 ","$5,150.15 ", N/A ,"$5,150.15 ", N/A ,"$4,726.02 ","$4,726.02 ","$4,726.02 ","$5,453.10 ", N/A ,"$5,453.10 ", N/A ,"$6,059.00 ","$3,968.65 ", N/A ,"$2,520.54 ",$230.92 ,$220.43 , N/A ,"$5,453.10 ", N/A ,"$3,738.40 ","$1,696.52 ","$5,453.10 ", N/A ,"$5,453.10 ","$5,453.10 ", N/A ,"$3,938.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000440,75984,HC CHANGE PERC DRAINAGE TUBE OR CATH,320,1 ,"$2,085.00 ","$1,355.25 ",$220.43 ,"$2,085.00 ", N/A ,"$1,553.33 ","$1,365.68 ", N/A ,$583.80 ,"$1,052.93 ", N/A ,"$1,286.45 ", N/A ,"$1,286.45 ","$1,286.45 ", N/A ,"$1,286.45 ", N/A ,"$1,876.50 ","$1,563.75 ", N/A , N/A ,"$1,834.80 ", N/A ,"$1,563.75 ","$1,563.75 ","$1,772.25 ","$1,772.25 ", N/A ,"$1,772.25 ", N/A ,"$1,626.30 ","$1,626.30 ","$1,626.30 ","$1,876.50 ", N/A ,"$1,876.50 ", N/A ,"$2,085.00 ","$1,365.68 ", N/A ,$867.36 ,$230.92 ,$220.43 , N/A ,"$1,876.50 ", N/A ,"$1,286.45 ",$583.80 ,"$1,876.50 ", N/A ,"$1,876.50 ","$1,876.50 ", N/A ,"$1,355.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000444,49406,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER,320,1 ,"$4,043.00 ","$2,627.95 ",$480.83 ,"$4,043.00 ","$3,566.38 ","$3,012.04 ","$2,648.17 ","$1,485.64 ","$1,132.04 ","$2,041.72 ","$1,485.64 ","$2,494.53 ","$1,485.64 ","$2,494.53 ","$2,494.53 ","$1,485.64 ","$2,494.53 ","$2,822.72 ","$3,638.70 ","$3,032.25 ","$3,566.38 ","$1,485.64 ","$3,557.84 ","$1,485.64 ","$3,032.25 ","$3,032.25 ","$3,436.55 ","$3,436.55 ","$1,485.64 ","$3,436.55 ","$1,485.64 ","$3,153.54 ","$3,153.54 ","$3,153.54 ","$3,638.70 ","$3,566.38 ","$3,638.70 ","$1,485.64 ","$4,043.00 ","$2,648.17 ","$1,485.64 ","$1,681.89 ",$503.72 ,$480.83 ,"$1,555.00 ","$3,638.70 ","$3,219.59 ","$2,494.53 ","$1,132.04 ","$3,638.70 ","$1,485.64 ","$3,638.70 ","$3,638.70 ","$1,485.64 ","$2,627.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,"$2,336.00 ","$1,518.40 ",$220.43 ,"$2,336.00 ", N/A ,"$1,740.32 ","$1,530.08 ", N/A ,$654.08 ,"$1,179.68 ", N/A ,"$1,441.31 ", N/A ,"$1,441.31 ","$1,441.31 ", N/A ,"$1,441.31 ", N/A ,"$2,102.40 ","$1,752.00 ", N/A , N/A ,"$2,055.68 ", N/A ,"$1,752.00 ","$1,752.00 ","$1,985.60 ","$1,985.60 ", N/A ,"$1,985.60 ", N/A ,"$1,822.08 ","$1,822.08 ","$1,822.08 ","$2,102.40 ", N/A ,"$2,102.40 ", N/A ,"$2,336.00 ","$1,530.08 ", N/A ,$971.78 ,$230.92 ,$220.43 , N/A ,"$2,102.40 ", N/A ,"$1,441.31 ",$654.08 ,"$2,102.40 ", N/A ,"$2,102.40 ","$2,102.40 ", N/A ,"$1,518.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$945.00 ,$614.25 ,$38.68 ,$945.00 ,$583.23 ,$704.03 ,$618.98 ,$242.96 ,$264.60 ,$477.23 ,$242.96 ,$583.07 ,$242.96 ,$583.07 ,$583.07 ,$242.96 ,$583.07 ,$461.62 ,$850.50 ,$708.75 ,$583.23 ,$242.96 ,$831.60 ,$242.96 ,$708.75 ,$708.75 ,$803.25 ,$803.25 ,$242.96 ,$803.25 ,$242.96 ,$737.10 ,$737.10 ,$737.10 ,$850.50 ,$583.23 ,$850.50 ,$242.96 ,$945.00 ,$618.98 ,$242.96 ,$393.12 ,$40.52 ,$38.68 ,$254.30 ,$850.50 ,$526.52 ,$583.07 ,$264.60 ,$850.50 ,$242.96 ,$850.50 ,$850.50 ,$242.96 ,$614.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000464,76010,HC BABYGRAM,320,1 ,$422.00 ,$274.30 ,$38.68 ,$422.00 ,$205.02 ,$314.39 ,$276.41 ,$85.41 ,$118.16 ,$213.11 ,$85.41 ,$260.37 ,$85.41 ,$260.37 ,$260.37 ,$85.41 ,$260.37 ,$162.28 ,$379.80 ,$316.50 ,$205.02 ,$85.41 ,$371.36 ,$85.41 ,$316.50 ,$316.50 ,$358.70 ,$358.70 ,$85.41 ,$358.70 ,$85.41 ,$329.16 ,$329.16 ,$329.16 ,$379.80 ,$205.02 ,$379.80 ,$85.41 ,$422.00 ,$276.41 ,$85.41 ,$175.55 ,$40.52 ,$38.68 ,$89.39 ,$379.80 ,$185.09 ,$260.37 ,$118.16 ,$379.80 ,$85.41 ,$379.80 ,$379.80 ,$85.41 ,$274.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000465,76080,HC ABSCESS FISTULA OR SINUS TRACT,320,1 ,"$1,369.00 ",$889.85 ,$220.43 ,"$1,369.00 ","$1,224.74 ","$1,019.91 ",$896.70 ,$510.19 ,$383.32 ,$691.35 ,$510.19 ,$844.67 ,$510.19 ,$844.67 ,$844.67 ,$510.19 ,$844.67 ,$969.36 ,"$1,232.10 ","$1,026.75 ","$1,224.74 ",$510.19 ,"$1,204.72 ",$510.19 ,"$1,026.75 ","$1,026.75 ","$1,163.65 ","$1,163.65 ",$510.19 ,"$1,163.65 ",$510.19 ,"$1,067.82 ","$1,067.82 ","$1,067.82 ","$1,232.10 ","$1,224.74 ","$1,232.10 ",$510.19 ,"$1,369.00 ",$896.70 ,$510.19 ,$569.50 ,$230.92 ,$220.43 ,$534.01 ,"$1,232.10 ","$1,105.65 ",$844.67 ,$383.32 ,"$1,232.10 ",$510.19 ,"$1,232.10 ","$1,232.10 ",$510.19 ,$889.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$841.00 ,$546.65 ,$28.70 ,"$1,105.65 ",$841.00 ,$626.55 ,$550.86 ,$510.19 ,$235.48 ,$424.71 ,$510.19 ,$518.90 ,$510.19 ,$518.90 ,$518.90 ,$510.19 ,$518.90 ,$969.36 ,$756.90 ,$630.75 ,$841.00 ,$510.19 ,$740.08 ,$510.19 ,$630.75 ,$630.75 ,$714.85 ,$714.85 ,$510.19 ,$714.85 ,$510.19 ,$655.98 ,$655.98 ,$655.98 ,$756.90 ,$841.00 ,$756.90 ,$510.19 ,$28.70 ,$550.86 ,$510.19 ,$349.86 ,$40.52 ,$38.68 ,$534.01 ,$756.90 ,"$1,105.65 ",$518.90 ,$235.48 ,$756.90 ,$510.19 ,$756.90 ,$756.90 ,$510.19 ,$546.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,$269.00 ,$174.85 ,$75.32 ,$269.00 , N/A ,$200.41 ,$176.20 , N/A ,$75.32 ,$135.85 , N/A ,$165.97 , N/A ,$165.97 ,$165.97 , N/A ,$165.97 , N/A ,$242.10 ,$201.75 , N/A , N/A ,$236.72 , N/A ,$201.75 ,$201.75 ,$228.65 ,$228.65 , N/A ,$228.65 , N/A ,$209.82 ,$209.82 ,$209.82 ,$242.10 , N/A ,$242.10 , N/A ,$269.00 ,$176.20 , N/A ,$111.90 ,$230.92 ,$220.43 , N/A ,$242.10 , N/A ,$165.97 ,$75.32 ,$242.10 , N/A ,$242.10 ,$242.10 , N/A ,$174.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$754.00 ,$490.10 ,$211.12 ,$754.00 , N/A ,$561.73 ,$493.87 , N/A ,$211.12 ,$380.77 , N/A ,$465.22 , N/A ,$465.22 ,$465.22 , N/A ,$465.22 , N/A ,$678.60 ,$565.50 , N/A , N/A ,$663.52 , N/A ,$565.50 ,$565.50 ,$640.90 ,$640.90 , N/A ,$640.90 , N/A ,$588.12 ,$588.12 ,$588.12 ,$678.60 , N/A ,$678.60 , N/A ,$754.00 ,$493.87 , N/A ,$313.66 ,$230.92 ,$220.43 , N/A ,$678.60 , N/A ,$465.22 ,$211.12 ,$678.60 , N/A ,$678.60 ,$678.60 , N/A ,$490.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,"$1,341.00 ",$871.65 ,$220.43 ,"$1,341.00 ", N/A ,$999.05 ,$878.36 , N/A ,$375.48 ,$677.21 , N/A ,$827.40 , N/A ,$827.40 ,$827.40 , N/A ,$827.40 , N/A ,"$1,206.90 ","$1,005.75 ", N/A , N/A ,"$1,180.08 ", N/A ,"$1,005.75 ","$1,005.75 ","$1,139.85 ","$1,139.85 ", N/A ,"$1,139.85 ", N/A ,"$1,045.98 ","$1,045.98 ","$1,045.98 ","$1,206.90 ", N/A ,"$1,206.90 ", N/A ,"$1,341.00 ",$878.36 , N/A ,$557.86 ,$230.92 ,$220.43 , N/A ,"$1,206.90 ", N/A ,$827.40 ,$375.48 ,"$1,206.90 ", N/A ,"$1,206.90 ","$1,206.90 ", N/A ,$871.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000483,19283,HC MAMM STER GUIDE BRST NDL PL,320,1 ,"$1,004.00 ",$652.60 ,$83.00 ,"$1,423.93 ","$1,004.00 ",$747.98 ,$657.62 ,$657.06 ,$281.12 ,$507.02 ,$657.06 ,$619.47 ,$657.06 ,$619.47 ,$619.47 ,$657.06 ,$619.47 ,"$1,248.41 ",$903.60 ,$753.00 ,"$1,004.00 ",$657.06 ,$883.52 ,$657.06 ,$753.00 ,$753.00 ,$853.40 ,$853.40 ,$657.06 ,$853.40 ,$657.06 ,$783.12 ,$783.12 ,$783.12 ,$903.60 ,"$1,004.00 ",$903.60 ,$657.06 ,$294.90 ,$657.62 ,$657.06 ,$417.66 ,$86.96 ,$83.00 ,$687.73 ,$903.60 ,"$1,423.93 ",$619.47 ,$281.12 ,$903.60 ,$657.06 ,$903.60 ,$903.60 ,$657.06 ,$652.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000483,19283,HC MAMM STER GUIDE BRST NDL PL,320,1 ,"$1,507.00 ",$979.55 ,$124.50 ,"$1,507.00 ","$1,507.00 ","$1,122.72 ",$987.09 ,$657.06 ,$421.96 ,$761.04 ,$657.06 ,$929.82 ,$657.06 ,$929.82 ,$929.82 ,$657.06 ,$929.82 ,"$1,248.41 ","$1,356.30 ","$1,130.25 ","$1,507.00 ",$657.06 ,"$1,326.16 ",$657.06 ,"$1,130.25 ","$1,130.25 ","$1,280.95 ","$1,280.95 ",$657.06 ,"$1,280.95 ",$657.06 ,"$1,175.46 ","$1,175.46 ","$1,175.46 ","$1,356.30 ","$1,507.00 ","$1,356.30 ",$657.06 ,$294.90 ,$987.09 ,$657.06 ,$626.91 ,$130.43 ,$124.50 ,$687.73 ,"$1,356.30 ","$1,423.93 ",$929.82 ,$421.96 ,"$1,356.30 ",$657.06 ,"$1,356.30 ","$1,356.30 ",$657.06 ,$979.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$3,906.00 ","$2,538.90 ",$619.99 ,"$3,906.00 ","$3,566.38 ","$2,909.97 ","$2,558.43 ","$1,485.64 ","$1,093.68 ","$1,972.53 ","$1,485.64 ","$2,410.00 ","$1,485.64 ","$2,410.00 ","$2,410.00 ","$1,485.64 ","$2,410.00 ","$2,822.72 ","$3,515.40 ","$2,929.50 ","$3,566.38 ","$1,485.64 ","$3,437.28 ","$1,485.64 ","$2,929.50 ","$2,929.50 ","$3,320.10 ","$3,320.10 ","$1,485.64 ","$3,320.10 ","$1,485.64 ","$3,046.68 ","$3,046.68 ","$3,046.68 ","$3,515.40 ","$3,566.38 ","$3,515.40 ","$1,485.64 ",$619.99 ,"$2,558.43 ","$1,485.64 ","$1,624.90 ",$897.59 ,$856.79 ,"$1,555.00 ","$3,515.40 ","$3,219.59 ","$2,410.00 ","$1,093.68 ","$3,515.40 ","$1,485.64 ","$3,515.40 ","$3,515.40 ","$1,485.64 ","$2,538.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$5,859.00 ","$3,808.35 ",$619.99 ,"$5,859.00 ","$5,859.00 ","$4,364.96 ","$3,837.65 ","$2,503.54 ","$1,640.52 ","$2,958.80 ","$2,503.54 ","$3,615.00 ","$2,503.54 ","$3,615.00 ","$3,615.00 ","$2,503.54 ","$3,615.00 ","$4,756.73 ","$5,273.10 ","$4,394.25 ","$5,859.00 ","$2,503.54 ","$5,155.92 ","$2,503.54 ","$4,394.25 ","$4,394.25 ","$4,980.15 ","$4,980.15 ","$2,503.54 ","$4,980.15 ","$2,503.54 ","$4,570.02 ","$4,570.02 ","$4,570.02 ","$5,273.10 ","$5,859.00 ","$5,273.10 ","$2,503.54 ",$619.99 ,"$3,837.65 ","$2,503.54 ","$2,437.34 ","$1,346.39 ","$1,285.19 ","$2,620.42 ","$5,273.10 ","$5,425.50 ","$3,615.00 ","$1,640.52 ","$5,273.10 ","$2,503.54 ","$5,273.10 ","$5,273.10 ","$2,503.54 ","$3,808.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,$875.00 ,$568.75 ,$83.00 ,"$1,423.93 ",$875.00 ,$651.88 ,$573.13 ,$657.06 ,$245.00 ,$441.88 ,$657.06 ,$539.88 ,$657.06 ,$539.88 ,$539.88 ,$657.06 ,$539.88 ,"$1,248.41 ",$787.50 ,$656.25 ,$875.00 ,$657.06 ,$770.00 ,$657.06 ,$656.25 ,$656.25 ,$743.75 ,$743.75 ,$657.06 ,$743.75 ,$657.06 ,$682.50 ,$682.50 ,$682.50 ,$787.50 ,$875.00 ,$787.50 ,$657.06 ,$266.06 ,$573.13 ,$657.06 ,$364.00 ,$86.96 ,$83.00 ,$687.73 ,$787.50 ,"$1,423.93 ",$539.88 ,$245.00 ,$787.50 ,$657.06 ,$787.50 ,$787.50 ,$657.06 ,$568.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$1,313.00 ",$853.45 ,$124.50 ,"$1,423.93 ","$1,313.00 ",$978.19 ,$860.02 ,$657.06 ,$367.64 ,$663.07 ,$657.06 ,$810.12 ,$657.06 ,$810.12 ,$810.12 ,$657.06 ,$810.12 ,"$1,248.41 ","$1,181.70 ",$984.75 ,"$1,313.00 ",$657.06 ,"$1,155.44 ",$657.06 ,$984.75 ,$984.75 ,"$1,116.05 ","$1,116.05 ",$657.06 ,"$1,116.05 ",$657.06 ,"$1,024.14 ","$1,024.14 ","$1,024.14 ","$1,181.70 ","$1,313.00 ","$1,181.70 ",$657.06 ,$266.06 ,$860.02 ,$657.06 ,$546.21 ,$130.43 ,$124.50 ,$687.73 ,"$1,181.70 ","$1,423.93 ",$810.12 ,$367.64 ,"$1,181.70 ",$657.06 ,"$1,181.70 ","$1,181.70 ",$657.06 ,$853.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$729.00 ,$473.85 ,$38.68 ,$729.00 ,$275.96 ,$543.11 ,$477.50 ,$114.95 ,$204.12 ,$368.15 ,$114.95 ,$449.79 ,$114.95 ,$449.79 ,$449.79 ,$114.95 ,$449.79 ,$218.41 ,$656.10 ,$546.75 ,$275.96 ,$114.95 ,$641.52 ,$114.95 ,$546.75 ,$546.75 ,$619.65 ,$619.65 ,$114.95 ,$619.65 ,$114.95 ,$568.62 ,$568.62 ,$568.62 ,$656.10 ,$275.96 ,$656.10 ,$114.95 ,$729.00 ,$477.50 ,$114.95 ,$303.26 ,$40.52 ,$38.68 ,$120.32 ,$656.10 ,$249.12 ,$449.79 ,$204.12 ,$656.10 ,$114.95 ,$656.10 ,$656.10 ,$114.95 ,$473.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,"$1,104.00 ",$717.60 ,$38.68 ,"$1,104.00 ",$275.96 ,$822.48 ,$723.12 ,$114.95 ,$309.12 ,$557.52 ,$114.95 ,$681.17 ,$114.95 ,$681.17 ,$681.17 ,$114.95 ,$681.17 ,$218.41 ,$993.60 ,$828.00 ,$275.96 ,$114.95 ,$971.52 ,$114.95 ,$828.00 ,$828.00 ,$938.40 ,$938.40 ,$114.95 ,$938.40 ,$114.95 ,$861.12 ,$861.12 ,$861.12 ,$993.60 ,$275.96 ,$993.60 ,$114.95 ,"$1,104.00 ",$723.12 ,$114.95 ,$459.26 ,$40.52 ,$38.68 ,$120.32 ,$993.60 ,$249.12 ,$681.17 ,$309.12 ,$993.60 ,$114.95 ,$993.60 ,$993.60 ,$114.95 ,$717.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$936.00 ,$608.40 ,$38.68 ,$936.00 ,$275.96 ,$697.32 ,$613.08 ,$114.95 ,$262.08 ,$472.68 ,$114.95 ,$577.51 ,$114.95 ,$577.51 ,$577.51 ,$114.95 ,$577.51 ,$218.41 ,$842.40 ,$702.00 ,$275.96 ,$114.95 ,$823.68 ,$114.95 ,$702.00 ,$702.00 ,$795.60 ,$795.60 ,$114.95 ,$795.60 ,$114.95 ,$730.08 ,$730.08 ,$730.08 ,$842.40 ,$275.96 ,$842.40 ,$114.95 ,$936.00 ,$613.08 ,$114.95 ,$389.38 ,$40.52 ,$38.68 ,$120.32 ,$842.40 ,$249.12 ,$577.51 ,$262.08 ,$842.40 ,$114.95 ,$842.40 ,$842.40 ,$114.95 ,$608.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000496,77080,HC BONE DENSITY DXA,320,1 ,$851.00 ,$553.15 ,$61.10 ,$851.00 ,$275.96 ,$634.00 ,$557.41 ,$114.95 ,$238.28 ,$429.76 ,$114.95 ,$525.07 ,$114.95 ,$525.07 ,$525.07 ,$114.95 ,$525.07 ,$218.41 ,$765.90 ,$638.25 ,$275.96 ,$114.95 ,$748.88 ,$114.95 ,$638.25 ,$638.25 ,$723.35 ,$723.35 ,$114.95 ,$723.35 ,$114.95 ,$663.78 ,$663.78 ,$663.78 ,$765.90 ,$275.96 ,$765.90 ,$114.95 ,$851.00 ,$557.41 ,$114.95 ,$354.02 ,$64.01 ,$61.10 ,$120.32 ,$765.90 ,$249.12 ,$525.07 ,$238.28 ,$765.90 ,$114.95 ,$765.90 ,$765.90 ,$114.95 ,$553.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000497,77081,HC BONE DENSITY PERIPHERAL,320,1 ,$617.00 ,$401.05 ,$61.10 ,$617.00 ,$205.02 ,$459.67 ,$404.14 ,$85.41 ,$172.76 ,$311.59 ,$85.41 ,$380.69 ,$85.41 ,$380.69 ,$380.69 ,$85.41 ,$380.69 ,$162.28 ,$555.30 ,$462.75 ,$205.02 ,$85.41 ,$542.96 ,$85.41 ,$462.75 ,$462.75 ,$524.45 ,$524.45 ,$85.41 ,$524.45 ,$85.41 ,$481.26 ,$481.26 ,$481.26 ,$555.30 ,$205.02 ,$555.30 ,$85.41 ,$617.00 ,$404.14 ,$85.41 ,$256.67 ,$64.01 ,$61.10 ,$89.39 ,$555.30 ,$185.09 ,$380.69 ,$172.76 ,$555.30 ,$85.41 ,$555.30 ,$555.30 ,$85.41 ,$401.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000499,0238T,HC TRNLUM PERIP ATHRC ILIAC ARTY 0238T,320,1 ,"$48,724.00 ","$31,670.60 ","$3,439.40 ","$48,724.00 ","$40,707.87 ","$36,299.38 ","$31,914.22 ","$16,957.65 ","$13,642.72 ","$24,605.62 ","$16,957.65 ","$30,062.71 ","$16,957.65 ","$30,062.71 ","$30,062.71 ","$16,957.65 ","$30,062.71 ","$32,219.54 ","$43,851.60 ","$36,543.00 ","$40,707.87 ","$16,957.65 ","$42,877.12 ","$16,957.65 ","$36,543.00 ","$36,543.00 ","$41,415.40 ","$41,415.40 ","$16,957.65 ","$41,415.40 ","$16,957.65 ","$38,004.72 ","$38,004.72 ","$38,004.72 ","$43,851.60 ","$40,707.87 ","$43,851.60 ","$16,957.65 ","$48,724.00 ","$31,914.22 ","$16,957.65 ","$20,269.18 ","$3,603.18 ","$3,439.40 ","$17,749.33 ","$43,851.60 ","$36,749.50 ","$30,062.71 ","$13,642.72 ","$43,851.60 ","$16,957.65 ","$43,851.60 ","$43,851.60 ","$16,957.65 ","$31,670.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$945.00 ,$614.25 ,$38.68 ,$945.00 ,$583.23 ,$704.03 ,$618.98 ,$242.96 ,$264.60 ,$477.23 ,$242.96 ,$583.07 ,$242.96 ,$583.07 ,$583.07 ,$242.96 ,$583.07 , N/A ,$850.50 ,$708.75 ,$583.23 , N/A ,$831.60 ,$242.96 ,$708.75 ,$708.75 ,$803.25 ,$803.25 ,$242.96 ,$803.25 ,$242.96 ,$737.10 ,$737.10 ,$737.10 ,$850.50 ,$583.23 ,$850.50 ,$242.96 ,$945.00 ,$618.98 ,$242.96 ,$393.12 ,$40.52 ,$38.68 ,$254.30 ,$850.50 ,$526.52 ,$583.07 ,$264.60 ,$850.50 ,$242.96 ,$850.50 ,$850.50 ,$242.96 ,$614.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000503,20501,HC INJ TRACT SINOGRAM DIAG,320,1 ,$792.00 ,$514.80 ,$221.76 ,$792.00 , N/A ,$590.04 ,$518.76 , N/A ,$221.76 ,$399.96 , N/A ,$488.66 , N/A ,$488.66 ,$488.66 , N/A ,$488.66 , N/A ,$712.80 ,$594.00 , N/A , N/A ,$696.96 , N/A ,$594.00 ,$594.00 ,$673.20 ,$673.20 , N/A ,$673.20 , N/A ,$617.76 ,$617.76 ,$617.76 ,$712.80 , N/A ,$712.80 , N/A ,$792.00 ,$518.76 , N/A ,$329.47 ,$252.78 ,$241.29 , N/A ,$712.80 , N/A ,$488.66 ,$221.76 ,$712.80 , N/A ,$712.80 ,$712.80 , N/A ,$514.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$670.00 ,$435.50 ,$187.60 ,$670.00 ,$662.23 ,$499.15 ,$438.85 ,$275.86 ,$187.60 ,$338.35 ,$275.86 ,$413.39 ,$275.86 ,$413.39 ,$413.39 ,$275.86 ,$413.39 ,$524.13 ,$603.00 ,$502.50 ,$662.23 ,$275.86 ,$589.60 ,$275.86 ,$502.50 ,$502.50 ,$569.50 ,$569.50 ,$275.86 ,$569.50 ,$275.86 ,$522.60 ,$522.60 ,$522.60 ,$603.00 ,$662.23 ,$603.00 ,$275.86 ,$670.00 ,$438.85 ,$275.86 ,$278.72 ,$235.70 ,$224.98 ,$288.74 ,$603.00 ,$597.83 ,$413.39 ,$187.60 ,$603.00 ,$275.86 ,$603.00 ,$603.00 ,$275.86 ,$435.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$921.00 ,$598.65 ,$224.98 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$235.70 ,$224.98 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000506,20553,HC INJ TRIGGER PT 3+ MUSC GROUP,320,1 ,$921.00 ,$598.65 ,$224.98 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$235.70 ,$224.98 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000509,77072,HC BONE AGE STUDIES,320,1 ,$712.00 ,$462.80 ,$38.68 ,$712.00 ,$275.96 ,$530.44 ,$466.36 ,$114.95 ,$199.36 ,$359.56 ,$114.95 ,$439.30 ,$114.95 ,$439.30 ,$439.30 ,$114.95 ,$439.30 ,$218.41 ,$640.80 ,$534.00 ,$275.96 ,$114.95 ,$626.56 ,$114.95 ,$534.00 ,$534.00 ,$605.20 ,$605.20 ,$114.95 ,$605.20 ,$114.95 ,$555.36 ,$555.36 ,$555.36 ,$640.80 ,$275.96 ,$640.80 ,$114.95 ,$712.00 ,$466.36 ,$114.95 ,$296.19 ,$40.52 ,$38.68 ,$120.32 ,$640.80 ,$249.12 ,$439.30 ,$199.36 ,$640.80 ,$114.95 ,$640.80 ,$640.80 ,$114.95 ,$462.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000515,G0278,HC ILIAC ARTERY ANGIO W CATH G0278,320,1 ,"$7,062.00 ","$4,590.30 ","$1,977.36 ","$7,062.00 ", N/A ,"$5,261.19 ","$4,625.61 ", N/A ,"$1,977.36 ","$3,566.31 ", N/A ,"$4,357.25 ", N/A ,"$4,357.25 ","$4,357.25 ", N/A ,"$4,357.25 ", N/A ,"$6,355.80 ","$5,296.50 ", N/A , N/A ,"$6,214.56 ", N/A ,"$5,296.50 ","$5,296.50 ","$6,002.70 ","$6,002.70 ", N/A ,"$6,002.70 ", N/A ,"$5,508.36 ","$5,508.36 ","$5,508.36 ","$6,355.80 ", N/A ,"$6,355.80 ", N/A ,"$7,062.00 ","$4,625.61 ", N/A ,"$2,937.79 ", N/A , N/A , N/A ,"$6,355.80 ", N/A ,"$4,357.25 ","$1,977.36 ","$6,355.80 ", N/A ,"$6,355.80 ","$6,355.80 ", N/A ,"$4,590.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,"$1,731.00 ","$1,125.15 ",$480.83 ,"$1,731.00 ","$1,370.07 ","$1,289.60 ","$1,133.81 ",$570.73 ,$484.68 ,$874.16 ,$570.73 ,"$1,068.03 ",$570.73 ,"$1,068.03 ","$1,068.03 ",$570.73 ,"$1,068.03 ","$1,084.39 ","$1,557.90 ","$1,298.25 ","$1,370.07 ",$570.73 ,"$1,523.28 ",$570.73 ,"$1,298.25 ","$1,298.25 ","$1,471.35 ","$1,471.35 ",$570.73 ,"$1,471.35 ",$570.73 ,"$1,350.18 ","$1,350.18 ","$1,350.18 ","$1,557.90 ","$1,370.07 ","$1,557.90 ",$570.73 ,"$1,731.00 ","$1,133.81 ",$570.73 ,$720.10 ,$503.72 ,$480.83 ,$597.38 ,"$1,557.90 ","$1,236.85 ","$1,068.03 ",$484.68 ,"$1,557.90 ",$570.73 ,"$1,557.90 ","$1,557.90 ",$570.73 ,"$1,125.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,"$1,905.00 ","$1,238.25 ",$480.83 ,"$1,905.00 ","$1,370.07 ","$1,419.23 ","$1,247.78 ",$570.73 ,$533.40 ,$962.03 ,$570.73 ,"$1,175.39 ",$570.73 ,"$1,175.39 ","$1,175.39 ",$570.73 ,"$1,175.39 ","$1,084.39 ","$1,714.50 ","$1,428.75 ","$1,370.07 ",$570.73 ,"$1,676.40 ",$570.73 ,"$1,428.75 ","$1,428.75 ","$1,619.25 ","$1,619.25 ",$570.73 ,"$1,619.25 ",$570.73 ,"$1,485.90 ","$1,485.90 ","$1,485.90 ","$1,714.50 ","$1,370.07 ","$1,714.50 ",$570.73 ,"$1,905.00 ","$1,247.78 ",$570.73 ,$792.48 ,$503.72 ,$480.83 ,$597.38 ,"$1,714.50 ","$1,236.85 ","$1,175.39 ",$533.40 ,"$1,714.50 ",$570.73 ,"$1,714.50 ","$1,714.50 ",$570.73 ,"$1,238.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000532,32556,HC PLEURAL DRAINAGE W/O IMAGING 32556,450,1 ,"$2,137.00 ","$1,389.05 ",$598.36 ,"$3,716.58 ","$2,137.00 ","$1,592.07 ","$1,399.74 ","$1,714.97 ",$598.36 ,"$1,079.19 ","$1,714.97 ","$1,318.53 ","$1,714.97 ","$1,318.53 ","$1,318.53 ","$1,714.97 ","$1,318.53 ","$3,258.44 ","$1,923.30 ","$1,602.75 ","$2,137.00 ","$1,714.97 ","$1,880.56 ","$1,714.97 ","$1,602.75 ","$1,602.75 ","$1,816.45 ","$1,816.45 ","$1,714.97 ","$1,816.45 ","$1,714.97 ","$1,666.86 ","$1,666.86 ","$1,666.86 ","$1,923.30 ","$2,137.00 ","$1,923.30 ","$1,714.97 ","$2,137.00 ","$1,399.74 ","$1,714.97 ",$888.99 , N/A , N/A ,"$1,795.04 ","$1,923.30 ","$3,716.58 ","$1,318.53 ",$598.36 ,"$1,923.30 ","$1,714.97 ","$1,923.30 ","$1,923.30 ","$1,714.97 ","$1,389.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000533,32557,HC PLEURAL DRAINAGE W/IMAGING 32557,320,1 ,"$3,347.00 ","$2,175.55 ",$480.83 ,"$3,347.00 ","$3,347.00 ","$2,493.52 ","$2,192.29 ","$1,484.79 ",$937.16 ,"$1,690.24 ","$1,484.79 ","$2,065.10 ","$1,484.79 ","$2,065.10 ","$2,065.10 ","$1,484.79 ","$2,065.10 ","$2,821.10 ","$3,012.30 ","$2,510.25 ","$3,347.00 ","$1,484.79 ","$2,945.36 ","$1,484.79 ","$2,510.25 ","$2,510.25 ","$2,844.95 ","$2,844.95 ","$1,484.79 ","$2,844.95 ","$1,484.79 ","$2,610.66 ","$2,610.66 ","$2,610.66 ","$3,012.30 ","$3,347.00 ","$3,012.30 ","$1,484.79 ","$3,347.00 ","$2,192.29 ","$1,484.79 ","$1,392.35 ",$503.72 ,$480.83 ,"$1,554.10 ","$3,012.30 ","$3,217.73 ","$2,065.10 ",$937.16 ,"$3,012.30 ","$1,484.79 ","$3,012.30 ","$3,012.30 ","$1,484.79 ","$2,175.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000542,20551,HC INJ TENDON ORIGIN,320,1 ,$750.00 ,$487.50 ,$210.00 ,$750.00 ,$662.23 ,$558.75 ,$491.25 ,$275.86 ,$210.00 ,$378.75 ,$275.86 ,$462.75 ,$275.86 ,$462.75 ,$462.75 ,$275.86 ,$462.75 ,$524.13 ,$675.00 ,$562.50 ,$662.23 ,$275.86 ,$660.00 ,$275.86 ,$562.50 ,$562.50 ,$637.50 ,$637.50 ,$275.86 ,$637.50 ,$275.86 ,$585.00 ,$585.00 ,$585.00 ,$675.00 ,$662.23 ,$675.00 ,$275.86 ,$750.00 ,$491.25 ,$275.86 ,$312.00 ,$235.70 ,$224.98 ,$288.74 ,$675.00 ,$597.83 ,$462.75 ,$210.00 ,$675.00 ,$275.86 ,$675.00 ,$675.00 ,$275.86 ,$487.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000551,77077,HC XR JOINT SRVY SINGLE 2 JOINTS,320,1 ,$334.00 ,$217.10 ,$38.68 ,$334.00 ,$275.96 ,$248.83 ,$218.77 ,$114.95 ,$93.52 ,$168.67 ,$114.95 ,$206.08 ,$114.95 ,$206.08 ,$206.08 ,$114.95 ,$206.08 ,$218.41 ,$300.60 ,$250.50 ,$275.96 ,$114.95 ,$293.92 ,$114.95 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$114.95 ,$283.90 ,$114.95 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$275.96 ,$300.60 ,$114.95 ,$334.00 ,$218.77 ,$114.95 ,$138.94 ,$40.52 ,$38.68 ,$120.32 ,$300.60 ,$249.12 ,$206.08 ,$93.52 ,$300.60 ,$114.95 ,$300.60 ,$300.60 ,$114.95 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000552,70100,HC XR MANDIBLE <3V,320,1 ,$515.00 ,$334.75 ,$38.68 ,$515.00 ,$205.02 ,$383.68 ,$337.33 ,$85.41 ,$144.20 ,$260.08 ,$85.41 ,$317.76 ,$85.41 ,$317.76 ,$317.76 ,$85.41 ,$317.76 ,$162.28 ,$463.50 ,$386.25 ,$205.02 ,$85.41 ,$453.20 ,$85.41 ,$386.25 ,$386.25 ,$437.75 ,$437.75 ,$85.41 ,$437.75 ,$85.41 ,$401.70 ,$401.70 ,$401.70 ,$463.50 ,$205.02 ,$463.50 ,$85.41 ,$515.00 ,$337.33 ,$85.41 ,$214.24 ,$40.52 ,$38.68 ,$89.39 ,$463.50 ,$185.09 ,$317.76 ,$144.20 ,$463.50 ,$85.41 ,$463.50 ,$463.50 ,$85.41 ,$334.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000561,49405,HC ABSCESS DRAIN KIDN/LIV/SPLN/LUNG VISERAL 49405,320,1 ,"$2,924.00 ","$1,900.60 ",$480.83 ,"$3,219.59 ","$2,924.00 ","$2,178.38 ","$1,915.22 ","$1,485.64 ",$818.72 ,"$1,476.62 ","$1,485.64 ","$1,804.11 ","$1,485.64 ","$1,804.11 ","$1,804.11 ","$1,485.64 ","$1,804.11 ","$2,822.72 ","$2,631.60 ","$2,193.00 ","$2,924.00 ","$1,485.64 ","$2,573.12 ","$1,485.64 ","$2,193.00 ","$2,193.00 ","$2,485.40 ","$2,485.40 ","$1,485.64 ","$2,485.40 ","$1,485.64 ","$2,280.72 ","$2,280.72 ","$2,280.72 ","$2,631.60 ","$2,924.00 ","$2,631.60 ","$1,485.64 ","$2,924.00 ","$1,915.22 ","$1,485.64 ","$1,216.38 ",$503.72 ,$480.83 ,"$1,555.00 ","$2,631.60 ","$3,219.59 ","$1,804.11 ",$818.72 ,"$2,631.60 ","$1,485.64 ","$2,631.60 ","$2,631.60 ","$1,485.64 ","$1,900.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000562,49406,HC ABSCESS DRAIN PERI/ RETROPER PERC 49406,320,1 ,"$4,043.00 ","$2,627.95 ",$480.83 ,"$4,043.00 ","$3,566.38 ","$3,012.04 ","$2,648.17 ","$1,485.64 ","$1,132.04 ","$2,041.72 ","$1,485.64 ","$2,494.53 ","$1,485.64 ","$2,494.53 ","$2,494.53 ","$1,485.64 ","$2,494.53 ","$2,822.72 ","$3,638.70 ","$3,032.25 ","$3,566.38 ","$1,485.64 ","$3,557.84 ","$1,485.64 ","$3,032.25 ","$3,032.25 ","$3,436.55 ","$3,436.55 ","$1,485.64 ","$3,436.55 ","$1,485.64 ","$3,153.54 ","$3,153.54 ","$3,153.54 ","$3,638.70 ","$3,566.38 ","$3,638.70 ","$1,485.64 ","$4,043.00 ","$2,648.17 ","$1,485.64 ","$1,681.89 ",$503.72 ,$480.83 ,"$1,555.00 ","$3,638.70 ","$3,219.59 ","$2,494.53 ","$1,132.04 ","$3,638.70 ","$1,485.64 ","$3,638.70 ","$3,638.70 ","$1,485.64 ","$2,627.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$515.00 ,$334.75 ,$38.68 ,$515.00 ,$205.02 ,$383.68 ,$337.33 ,$85.41 ,$144.20 ,$260.08 ,$85.41 ,$317.76 ,$85.41 ,$317.76 ,$317.76 ,$85.41 ,$317.76 ,$162.28 ,$463.50 ,$386.25 ,$205.02 ,$85.41 ,$453.20 ,$85.41 ,$386.25 ,$386.25 ,$437.75 ,$437.75 ,$85.41 ,$437.75 ,$85.41 ,$401.70 ,$401.70 ,$401.70 ,$463.50 ,$205.02 ,$463.50 ,$85.41 ,$515.00 ,$337.33 ,$85.41 ,$214.24 ,$40.52 ,$38.68 ,$89.39 ,$463.50 ,$185.09 ,$317.76 ,$144.20 ,$463.50 ,$85.41 ,$463.50 ,$463.50 ,$85.41 ,$334.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$292.00 ,$189.80 ,$38.68 ,$292.00 ,$205.02 ,$217.54 ,$191.26 ,$85.41 ,$81.76 ,$147.46 ,$85.41 ,$180.16 ,$85.41 ,$180.16 ,$180.16 ,$85.41 ,$180.16 ,$162.28 ,$262.80 ,$219.00 ,$205.02 ,$85.41 ,$256.96 ,$85.41 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$85.41 ,$248.20 ,$85.41 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$205.02 ,$262.80 ,$85.41 ,$292.00 ,$191.26 ,$85.41 ,$121.47 ,$40.52 ,$38.68 ,$89.39 ,$262.80 ,$185.09 ,$180.16 ,$81.76 ,$262.80 ,$85.41 ,$262.80 ,$262.80 ,$85.41 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$482.00 ,$313.30 ,$38.68 ,$482.00 ,$275.96 ,$359.09 ,$315.71 ,$114.95 ,$134.96 ,$243.41 ,$114.95 ,$297.39 ,$114.95 ,$297.39 ,$297.39 ,$114.95 ,$297.39 ,$218.41 ,$433.80 ,$361.50 ,$275.96 ,$114.95 ,$424.16 ,$114.95 ,$361.50 ,$361.50 ,$409.70 ,$409.70 ,$114.95 ,$409.70 ,$114.95 ,$375.96 ,$375.96 ,$375.96 ,$433.80 ,$275.96 ,$433.80 ,$114.95 ,$482.00 ,$315.71 ,$114.95 ,$200.51 ,$40.52 ,$38.68 ,$120.32 ,$433.80 ,$249.12 ,$297.39 ,$134.96 ,$433.80 ,$114.95 ,$433.80 ,$433.80 ,$114.95 ,$313.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000572,72083,HC XR SPINE/CERV SCOLIOSIS 4-5VW,320,1 ,$854.00 ,$555.10 ,$38.68 ,$854.00 ,$275.96 ,$636.23 ,$559.37 ,$114.95 ,$239.12 ,$431.27 ,$114.95 ,$526.92 ,$114.95 ,$526.92 ,$526.92 ,$114.95 ,$526.92 ,$218.41 ,$768.60 ,$640.50 ,$275.96 ,$114.95 ,$751.52 ,$114.95 ,$640.50 ,$640.50 ,$725.90 ,$725.90 ,$114.95 ,$725.90 ,$114.95 ,$666.12 ,$666.12 ,$666.12 ,$768.60 ,$275.96 ,$768.60 ,$114.95 ,$854.00 ,$559.37 ,$114.95 ,$355.26 ,$40.52 ,$38.68 ,$120.32 ,$768.60 ,$249.12 ,$526.92 ,$239.12 ,$768.60 ,$114.95 ,$768.60 ,$768.60 ,$114.95 ,$555.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$292.00 ,$189.80 ,$38.68 ,$292.00 ,$205.02 ,$217.54 ,$191.26 ,$85.41 ,$81.76 ,$147.46 ,$85.41 ,$180.16 ,$85.41 ,$180.16 ,$180.16 ,$85.41 ,$180.16 ,$162.28 ,$262.80 ,$219.00 ,$205.02 ,$85.41 ,$256.96 ,$85.41 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$85.41 ,$248.20 ,$85.41 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$205.02 ,$262.80 ,$85.41 ,$292.00 ,$191.26 ,$85.41 ,$121.47 ,$40.52 ,$38.68 ,$89.39 ,$262.80 ,$185.09 ,$180.16 ,$81.76 ,$262.80 ,$85.41 ,$262.80 ,$262.80 ,$85.41 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$292.00 ,$189.80 ,$38.68 ,$292.00 ,$205.02 ,$217.54 ,$191.26 ,$85.41 ,$81.76 ,$147.46 ,$85.41 ,$180.16 ,$85.41 ,$180.16 ,$180.16 ,$85.41 ,$180.16 ,$162.28 ,$262.80 ,$219.00 ,$205.02 ,$85.41 ,$256.96 ,$85.41 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$85.41 ,$248.20 ,$85.41 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$205.02 ,$262.80 ,$85.41 ,$292.00 ,$191.26 ,$85.41 ,$121.47 ,$40.52 ,$38.68 ,$89.39 ,$262.80 ,$185.09 ,$180.16 ,$81.76 ,$262.80 ,$85.41 ,$262.80 ,$262.80 ,$85.41 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000576,73503,HC XR HIP W/PELVIS UNI 4+VWS,320,1 ,$338.00 ,$219.70 ,$38.68 ,$338.00 ,$275.96 ,$251.81 ,$221.39 ,$114.95 ,$94.64 ,$170.69 ,$114.95 ,$208.55 ,$114.95 ,$208.55 ,$208.55 ,$114.95 ,$208.55 ,$218.41 ,$304.20 ,$253.50 ,$275.96 ,$114.95 ,$297.44 ,$114.95 ,$253.50 ,$253.50 ,$287.30 ,$287.30 ,$114.95 ,$287.30 ,$114.95 ,$263.64 ,$263.64 ,$263.64 ,$304.20 ,$275.96 ,$304.20 ,$114.95 ,$338.00 ,$221.39 ,$114.95 ,$140.61 ,$40.52 ,$38.68 ,$120.32 ,$304.20 ,$249.12 ,$208.55 ,$94.64 ,$304.20 ,$114.95 ,$304.20 ,$304.20 ,$114.95 ,$219.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$543.00 ,$352.95 ,$38.68 ,$543.00 ,$275.96 ,$404.54 ,$355.67 ,$114.95 ,$152.04 ,$274.22 ,$114.95 ,$335.03 ,$114.95 ,$335.03 ,$335.03 ,$114.95 ,$335.03 ,$218.41 ,$488.70 ,$407.25 ,$275.96 ,$114.95 ,$477.84 ,$114.95 ,$407.25 ,$407.25 ,$461.55 ,$461.55 ,$114.95 ,$461.55 ,$114.95 ,$423.54 ,$423.54 ,$423.54 ,$488.70 ,$275.96 ,$488.70 ,$114.95 ,$543.00 ,$355.67 ,$114.95 ,$225.89 ,$40.52 ,$38.68 ,$120.32 ,$488.70 ,$249.12 ,$335.03 ,$152.04 ,$488.70 ,$114.95 ,$488.70 ,$488.70 ,$114.95 ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$543.00 ,$352.95 ,$38.68 ,$543.00 ,$275.96 ,$404.54 ,$355.67 ,$114.95 ,$152.04 ,$274.22 ,$114.95 ,$335.03 ,$114.95 ,$335.03 ,$335.03 ,$114.95 ,$335.03 ,$218.41 ,$488.70 ,$407.25 ,$275.96 ,$114.95 ,$477.84 ,$114.95 ,$407.25 ,$407.25 ,$461.55 ,$461.55 ,$114.95 ,$461.55 ,$114.95 ,$423.54 ,$423.54 ,$423.54 ,$488.70 ,$275.96 ,$488.70 ,$114.95 ,$543.00 ,$355.67 ,$114.95 ,$225.89 ,$40.52 ,$38.68 ,$120.32 ,$488.70 ,$249.12 ,$335.03 ,$152.04 ,$488.70 ,$114.95 ,$488.70 ,$488.70 ,$114.95 ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$543.00 ,$352.95 ,$38.68 ,$543.00 ,$275.96 ,$404.54 ,$355.67 ,$114.95 ,$152.04 ,$274.22 ,$114.95 ,$335.03 ,$114.95 ,$335.03 ,$335.03 ,$114.95 ,$335.03 ,$218.41 ,$488.70 ,$407.25 ,$275.96 ,$114.95 ,$477.84 ,$114.95 ,$407.25 ,$407.25 ,$461.55 ,$461.55 ,$114.95 ,$461.55 ,$114.95 ,$423.54 ,$423.54 ,$423.54 ,$488.70 ,$275.96 ,$488.70 ,$114.95 ,$543.00 ,$355.67 ,$114.95 ,$225.89 ,$40.52 ,$38.68 ,$120.32 ,$488.70 ,$249.12 ,$335.03 ,$152.04 ,$488.70 ,$114.95 ,$488.70 ,$488.70 ,$114.95 ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$292.00 ,$189.80 ,$38.68 ,$292.00 ,$205.02 ,$217.54 ,$191.26 ,$85.41 ,$81.76 ,$147.46 ,$85.41 ,$180.16 ,$85.41 ,$180.16 ,$180.16 ,$85.41 ,$180.16 ,$162.28 ,$262.80 ,$219.00 ,$205.02 ,$85.41 ,$256.96 ,$85.41 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$85.41 ,$248.20 ,$85.41 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$205.02 ,$262.80 ,$85.41 ,$292.00 ,$191.26 ,$85.41 ,$121.47 ,$40.52 ,$38.68 ,$89.39 ,$262.80 ,$185.09 ,$180.16 ,$81.76 ,$262.80 ,$85.41 ,$262.80 ,$262.80 ,$85.41 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$438.00 ,$284.70 ,$58.02 ,$438.00 ,$205.02 ,$326.31 ,$286.89 ,$85.41 ,$122.64 ,$221.19 ,$85.41 ,$270.25 ,$85.41 ,$270.25 ,$270.25 ,$85.41 ,$270.25 ,$162.28 ,$394.20 ,$328.50 ,$205.02 ,$85.41 ,$385.44 ,$85.41 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$85.41 ,$372.30 ,$85.41 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$205.02 ,$394.20 ,$85.41 ,$438.00 ,$286.89 ,$85.41 ,$182.21 ,$60.79 ,$58.02 ,$89.39 ,$394.20 ,$185.09 ,$270.25 ,$122.64 ,$394.20 ,$85.41 ,$394.20 ,$394.20 ,$85.41 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$292.00 ,$189.80 ,$38.68 ,$292.00 ,$205.02 ,$217.54 ,$191.26 ,$85.41 ,$81.76 ,$147.46 ,$85.41 ,$180.16 ,$85.41 ,$180.16 ,$180.16 ,$85.41 ,$180.16 ,$162.28 ,$262.80 ,$219.00 ,$205.02 ,$85.41 ,$256.96 ,$85.41 ,$219.00 ,$219.00 ,$248.20 ,$248.20 ,$85.41 ,$248.20 ,$85.41 ,$227.76 ,$227.76 ,$227.76 ,$262.80 ,$205.02 ,$262.80 ,$85.41 ,$292.00 ,$191.26 ,$85.41 ,$121.47 ,$40.52 ,$38.68 ,$89.39 ,$262.80 ,$185.09 ,$180.16 ,$81.76 ,$262.80 ,$85.41 ,$262.80 ,$262.80 ,$85.41 ,$189.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$438.00 ,$284.70 ,$58.02 ,$438.00 ,$205.02 ,$326.31 ,$286.89 ,$85.41 ,$122.64 ,$221.19 ,$85.41 ,$270.25 ,$85.41 ,$270.25 ,$270.25 ,$85.41 ,$270.25 ,$162.28 ,$394.20 ,$328.50 ,$205.02 ,$85.41 ,$385.44 ,$85.41 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$85.41 ,$372.30 ,$85.41 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$205.02 ,$394.20 ,$85.41 ,$438.00 ,$286.89 ,$85.41 ,$182.21 ,$60.79 ,$58.02 ,$89.39 ,$394.20 ,$185.09 ,$270.25 ,$122.64 ,$394.20 ,$85.41 ,$394.20 ,$394.20 ,$85.41 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000584,72240,HC XR MYELOGRAPHY C-SPINE,320,1 ,"$2,036.49 ","$1,323.72 ",$220.43 ,"$2,036.49 ","$1,813.40 ","$1,517.19 ","$1,333.90 ",$755.41 ,$570.22 ,"$1,028.43 ",$755.41 ,"$1,256.51 ",$755.41 ,"$1,256.51 ","$1,256.51 ",$755.41 ,"$1,256.51 ","$1,435.28 ","$1,832.84 ","$1,527.37 ","$1,813.40 ",$755.41 ,"$1,792.11 ",$755.41 ,"$1,527.37 ","$1,527.37 ","$1,731.02 ","$1,731.02 ",$755.41 ,"$1,731.02 ",$755.41 ,"$1,588.46 ","$1,588.46 ","$1,588.46 ","$1,832.84 ","$1,813.40 ","$1,832.84 ",$755.41 ,"$2,036.49 ","$1,333.90 ",$755.41 ,$847.18 ,$230.92 ,$220.43 ,$790.68 ,"$1,832.84 ","$1,637.07 ","$1,256.51 ",$570.22 ,"$1,832.84 ",$755.41 ,"$1,832.84 ","$1,832.84 ",$755.41 ,"$1,323.72 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000586,72265,HC XR MYELOGRAPHY L-SPINE,320,1 ,"$2,036.49 ","$1,323.72 ",$220.43 ,"$2,036.49 ","$1,813.40 ","$1,517.19 ","$1,333.90 ",$755.41 ,$570.22 ,"$1,028.43 ",$755.41 ,"$1,256.51 ",$755.41 ,"$1,256.51 ","$1,256.51 ",$755.41 ,"$1,256.51 ","$1,435.28 ","$1,832.84 ","$1,527.37 ","$1,813.40 ",$755.41 ,"$1,792.11 ",$755.41 ,"$1,527.37 ","$1,527.37 ","$1,731.02 ","$1,731.02 ",$755.41 ,"$1,731.02 ",$755.41 ,"$1,588.46 ","$1,588.46 ","$1,588.46 ","$1,832.84 ","$1,813.40 ","$1,832.84 ",$755.41 ,"$2,036.49 ","$1,333.90 ",$755.41 ,$847.18 ,$230.92 ,$220.43 ,$790.68 ,"$1,832.84 ","$1,637.07 ","$1,256.51 ",$570.22 ,"$1,832.84 ",$755.41 ,"$1,832.84 ","$1,832.84 ",$755.41 ,"$1,323.72 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000589,74019,HC XR ABDOMEN 2V,320,1 ,$607.00 ,$394.55 ,$38.68 ,$607.00 ,$275.96 ,$452.22 ,$397.59 ,$114.95 ,$169.96 ,$306.54 ,$114.95 ,$374.52 ,$114.95 ,$374.52 ,$374.52 ,$114.95 ,$374.52 ,$218.41 ,$546.30 ,$455.25 ,$275.96 ,$114.95 ,$534.16 ,$114.95 ,$455.25 ,$455.25 ,$515.95 ,$515.95 ,$114.95 ,$515.95 ,$114.95 ,$473.46 ,$473.46 ,$473.46 ,$546.30 ,$275.96 ,$546.30 ,$114.95 ,$607.00 ,$397.59 ,$114.95 ,$252.51 ,$40.52 ,$38.68 ,$120.32 ,$546.30 ,$249.12 ,$374.52 ,$169.96 ,$546.30 ,$114.95 ,$546.30 ,$546.30 ,$114.95 ,$394.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000595,76000,HC FLUOROSCOPY >1HR,320,1 ,$945.00 ,$614.25 ,$38.68 ,$945.00 ,$583.23 ,$704.03 ,$618.98 ,$242.96 ,$264.60 ,$477.23 ,$242.96 ,$583.07 ,$242.96 ,$583.07 ,$583.07 ,$242.96 ,$583.07 ,$461.62 ,$850.50 ,$708.75 ,$583.23 ,$242.96 ,$831.60 ,$242.96 ,$708.75 ,$708.75 ,$803.25 ,$803.25 ,$242.96 ,$803.25 ,$242.96 ,$737.10 ,$737.10 ,$737.10 ,$850.50 ,$583.23 ,$850.50 ,$242.96 ,$945.00 ,$618.98 ,$242.96 ,$393.12 ,$40.52 ,$38.68 ,$254.30 ,$850.50 ,$526.52 ,$583.07 ,$264.60 ,$850.50 ,$242.96 ,$850.50 ,$850.50 ,$242.96 ,$614.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000609,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT-BIL,320,1 ,"$6,376.00 ","$4,144.40 ","$1,131.65 ","$7,035.28 ","$6,376.00 ","$4,750.12 ","$4,176.28 ","$3,246.35 ","$1,785.28 ","$3,219.88 ","$3,246.35 ","$3,933.99 ","$3,246.35 ","$3,933.99 ","$3,933.99 ","$3,246.35 ","$3,933.99 ","$6,168.07 ","$5,738.40 ","$4,782.00 ","$6,376.00 ","$3,246.35 ","$5,610.88 ","$3,246.35 ","$4,782.00 ","$4,782.00 ","$5,419.60 ","$5,419.60 ","$3,246.35 ","$5,419.60 ","$3,246.35 ","$4,973.28 ","$4,973.28 ","$4,973.28 ","$5,738.40 ","$6,376.00 ","$5,738.40 ","$3,246.35 ","$6,376.00 ","$4,176.28 ","$3,246.35 ","$2,652.42 ","$1,185.54 ","$1,131.65 ","$3,397.91 ","$5,738.40 ","$7,035.28 ","$3,933.99 ","$1,785.28 ","$5,738.40 ","$3,246.35 ","$5,738.40 ","$5,738.40 ","$3,246.35 ","$4,144.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,664.00 ","$1,081.60 ",$38.68 ,"$1,664.00 ", N/A ,"$1,239.68 ","$1,089.92 ", N/A ,$465.92 ,$840.32 , N/A ,"$1,026.69 ", N/A ,"$1,026.69 ","$1,026.69 ", N/A ,"$1,026.69 ", N/A ,"$1,497.60 ","$1,248.00 ", N/A , N/A ,"$1,464.32 ", N/A ,"$1,248.00 ","$1,248.00 ","$1,414.40 ","$1,414.40 ", N/A ,"$1,414.40 ", N/A ,"$1,297.92 ","$1,297.92 ","$1,297.92 ","$1,497.60 ", N/A ,"$1,497.60 ", N/A ,"$1,664.00 ","$1,089.92 ", N/A ,$692.22 ,$40.52 ,$38.68 , N/A ,"$1,497.60 ", N/A ,"$1,026.69 ",$465.92 ,"$1,497.60 ", N/A ,"$1,497.60 ","$1,497.60 ", N/A ,"$1,081.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$145.00 ,$94.25 ,$40.60 ,$145.00 ,$145.00 ,$108.03 ,$94.98 ,$65.46 ,$40.60 ,$73.23 ,$65.46 ,$89.47 ,$65.46 ,$89.47 ,$89.47 ,$65.46 ,$89.47 ,$124.37 ,$130.50 ,$108.75 ,$145.00 ,$65.46 ,$127.60 ,$65.46 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$65.46 ,$123.25 ,$65.46 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$145.00 ,$130.50 ,$65.46 ,$145.00 ,$94.98 ,$65.46 ,$60.32 , N/A , N/A ,$68.52 ,$130.50 ,$141.87 ,$89.47 ,$40.60 ,$130.50 ,$65.46 ,$130.50 ,$130.50 ,$65.46 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$290.00 ,$188.50 ,$81.20 ,$468.11 ,$290.00 ,$216.05 ,$189.95 ,$216.00 ,$81.20 ,$146.45 ,$216.00 ,$178.93 ,$216.00 ,$178.93 ,$178.93 ,$216.00 ,$178.93 ,$410.40 ,$261.00 ,$217.50 ,$290.00 ,$216.00 ,$255.20 ,$216.00 ,$217.50 ,$217.50 ,$246.50 ,$246.50 ,$216.00 ,$246.50 ,$216.00 ,$226.20 ,$226.20 ,$226.20 ,$261.00 ,$290.00 ,$261.00 ,$216.00 ,$290.00 ,$189.95 ,$216.00 ,$120.64 , N/A , N/A ,$226.09 ,$261.00 ,$468.11 ,$178.93 ,$81.20 ,$261.00 ,$216.00 ,$261.00 ,$261.00 ,$216.00 ,$188.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500004,96411,HC CHEMO IV PUSH ADDL DRUG,335,1 ,$290.00 ,$188.50 ,$65.46 ,$290.00 ,$157.15 ,$216.05 ,$189.95 ,$65.46 ,$81.20 ,$146.45 ,$65.46 ,$178.93 ,$65.46 ,$178.93 ,$178.93 ,$65.46 ,$178.93 ,$124.37 ,$261.00 ,$217.50 ,$157.15 ,$65.46 ,$255.20 ,$65.46 ,$217.50 ,$217.50 ,$246.50 ,$246.50 ,$65.46 ,$246.50 ,$65.46 ,$226.20 ,$226.20 ,$226.20 ,$261.00 ,$157.15 ,$261.00 ,$65.46 ,$290.00 ,$189.95 ,$65.46 ,$120.64 , N/A , N/A ,$68.52 ,$261.00 ,$141.87 ,$178.93 ,$81.20 ,$261.00 ,$65.46 ,$261.00 ,$261.00 ,$65.46 ,$188.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$448.00 ,$291.20 ,$125.44 ,$729.60 ,$448.00 ,$333.76 ,$293.44 ,$336.67 ,$125.44 ,$226.24 ,$336.67 ,$276.42 ,$336.67 ,$276.42 ,$276.42 ,$336.67 ,$276.42 ,$639.67 ,$403.20 ,$336.00 ,$448.00 ,$336.67 ,$394.24 ,$336.67 ,$336.00 ,$336.00 ,$380.80 ,$380.80 ,$336.67 ,$380.80 ,$336.67 ,$349.44 ,$349.44 ,$349.44 ,$403.20 ,$448.00 ,$403.20 ,$336.67 ,$448.00 ,$293.44 ,$336.67 ,$186.37 ,$227.81 ,$217.46 ,$352.38 ,$403.20 ,$729.60 ,$276.42 ,$125.44 ,$403.20 ,$336.67 ,$403.20 ,$403.20 ,$336.67 ,$291.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$145.00 ,$94.25 ,$40.60 ,$145.00 ,$145.00 ,$108.03 ,$94.98 ,$65.46 ,$40.60 ,$73.23 ,$65.46 ,$89.47 ,$65.46 ,$89.47 ,$89.47 ,$65.46 ,$89.47 ,$124.37 ,$130.50 ,$108.75 ,$145.00 ,$65.46 ,$127.60 ,$65.46 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$65.46 ,$123.25 ,$65.46 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$145.00 ,$130.50 ,$65.46 ,$145.00 ,$94.98 ,$65.46 ,$60.32 ,$145.00 ,$145.00 ,$68.52 ,$130.50 ,$141.87 ,$89.47 ,$40.60 ,$130.50 ,$65.46 ,$130.50 ,$130.50 ,$65.46 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500008,96417,HC CHEMO IV INFUSION EA ADDL <1H,335,1 ,$218.00 ,$141.70 ,$61.04 ,$218.00 ,$157.15 ,$162.41 ,$142.79 ,$65.46 ,$61.04 ,$110.09 ,$65.46 ,$134.51 ,$65.46 ,$134.51 ,$134.51 ,$65.46 ,$134.51 ,$124.37 ,$196.20 ,$163.50 ,$157.15 ,$65.46 ,$191.84 ,$65.46 ,$163.50 ,$163.50 ,$185.30 ,$185.30 ,$65.46 ,$185.30 ,$65.46 ,$170.04 ,$170.04 ,$170.04 ,$196.20 ,$157.15 ,$196.20 ,$65.46 ,$218.00 ,$142.79 ,$65.46 ,$90.69 ,$218.00 ,$217.46 ,$68.52 ,$196.20 ,$141.87 ,$134.51 ,$61.04 ,$196.20 ,$65.46 ,$196.20 ,$196.20 ,$65.46 ,$141.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$145.00 ,$94.25 ,$40.60 ,$145.00 ,$145.00 ,$108.03 ,$94.98 ,$65.46 ,$40.60 ,$73.23 ,$65.46 ,$89.47 ,$65.46 ,$89.47 ,$89.47 ,$65.46 ,$89.47 ,$124.37 ,$130.50 ,$108.75 ,$145.00 ,$65.46 ,$127.60 ,$65.46 ,$108.75 ,$108.75 ,$123.25 ,$123.25 ,$65.46 ,$123.25 ,$65.46 ,$113.10 ,$113.10 ,$113.10 ,$130.50 ,$145.00 ,$130.50 ,$65.46 ,$145.00 ,$94.98 ,$65.46 ,$60.32 , N/A , N/A ,$68.52 ,$130.50 ,$141.87 ,$89.47 ,$40.60 ,$130.50 ,$65.46 ,$130.50 ,$130.50 ,$65.46 ,$94.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,715.00 ","$1,114.75 ",$292.50 ,"$1,715.00 ",$955.48 ,"$1,277.68 ","$1,123.33 ",$398.02 ,$480.20 ,$866.08 ,$398.02 ,"$1,058.16 ",$398.02 ,"$1,058.16 ","$1,058.16 ",$398.02 ,"$1,058.16 ",$756.24 ,"$1,543.50 ","$1,286.25 ",$955.48 ,$398.02 ,"$1,509.20 ",$398.02 ,"$1,286.25 ","$1,286.25 ","$1,457.75 ","$1,457.75 ",$398.02 ,"$1,457.75 ",$398.02 ,"$1,337.70 ","$1,337.70 ","$1,337.70 ","$1,543.50 ",$955.48 ,"$1,543.50 ",$398.02 ,"$1,715.00 ","$1,123.33 ",$398.02 ,$713.44 ,$306.43 ,$292.50 ,$416.61 ,"$1,543.50 ",$862.57 ,"$1,058.16 ",$480.20 ,"$1,543.50 ",$398.02 ,"$1,543.50 ","$1,543.50 ",$398.02 ,"$1,114.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000007,78018,HC NM THYROID CA METS WHOLE BODY,340,1 ,"$1,664.00 ","$1,081.60 ",$292.50 ,"$1,664.00 ","$1,240.37 ","$1,239.68 ","$1,089.92 ",$516.70 ,$465.92 ,$840.32 ,$516.70 ,"$1,026.69 ",$516.70 ,"$1,026.69 ","$1,026.69 ",$516.70 ,"$1,026.69 ",$981.73 ,"$1,497.60 ","$1,248.00 ","$1,240.37 ",$516.70 ,"$1,464.32 ",$516.70 ,"$1,248.00 ","$1,248.00 ","$1,414.40 ","$1,414.40 ",$516.70 ,"$1,414.40 ",$516.70 ,"$1,297.92 ","$1,297.92 ","$1,297.92 ","$1,497.60 ","$1,240.37 ","$1,497.60 ",$516.70 ,"$1,664.00 ","$1,089.92 ",$516.70 ,$692.22 ,$306.43 ,$292.50 ,$540.82 ,"$1,497.60 ","$1,119.76 ","$1,026.69 ",$465.92 ,"$1,497.60 ",$516.70 ,"$1,497.60 ","$1,497.60 ",$516.70 ,"$1,081.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$1,908.00 ","$1,240.20 ",$292.50 ,"$1,908.00 ","$1,240.37 ","$1,421.46 ","$1,249.74 ",$516.70 ,$534.24 ,$963.54 ,$516.70 ,"$1,177.24 ",$516.70 ,"$1,177.24 ","$1,177.24 ",$516.70 ,"$1,177.24 ",$981.73 ,"$1,717.20 ","$1,431.00 ","$1,240.37 ",$516.70 ,"$1,679.04 ",$516.70 ,"$1,431.00 ","$1,431.00 ","$1,621.80 ","$1,621.80 ",$516.70 ,"$1,621.80 ",$516.70 ,"$1,488.24 ","$1,488.24 ","$1,488.24 ","$1,717.20 ","$1,240.37 ","$1,717.20 ",$516.70 ,"$1,908.00 ","$1,249.74 ",$516.70 ,$793.73 ,$306.43 ,$292.50 ,$540.82 ,"$1,717.20 ","$1,119.76 ","$1,177.24 ",$534.24 ,"$1,717.20 ",$516.70 ,"$1,717.20 ","$1,717.20 ",$516.70 ,"$1,240.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,$994.00 ,$646.10 ,$261.04 ,$994.00 ,$955.48 ,$740.53 ,$651.07 ,$398.02 ,$278.32 ,$501.97 ,$398.02 ,$613.30 ,$398.02 ,$613.30 ,$613.30 ,$398.02 ,$613.30 ,$756.24 ,$894.60 ,$745.50 ,$955.48 ,$398.02 ,$874.72 ,$398.02 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$398.02 ,$844.90 ,$398.02 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$955.48 ,$894.60 ,$398.02 ,$994.00 ,$651.07 ,$398.02 ,$413.50 ,$273.47 ,$261.04 ,$416.61 ,$894.60 ,$862.57 ,$613.30 ,$278.32 ,$894.60 ,$398.02 ,$894.60 ,$894.60 ,$398.02 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$1,660.00 ","$1,079.00 ",$292.50 ,"$1,660.00 ",$955.48 ,"$1,236.70 ","$1,087.30 ",$398.02 ,$464.80 ,$838.30 ,$398.02 ,"$1,024.22 ",$398.02 ,"$1,024.22 ","$1,024.22 ",$398.02 ,"$1,024.22 ",$756.24 ,"$1,494.00 ","$1,245.00 ",$955.48 ,$398.02 ,"$1,460.80 ",$398.02 ,"$1,245.00 ","$1,245.00 ","$1,411.00 ","$1,411.00 ",$398.02 ,"$1,411.00 ",$398.02 ,"$1,294.80 ","$1,294.80 ","$1,294.80 ","$1,494.00 ",$955.48 ,"$1,494.00 ",$398.02 ,"$1,660.00 ","$1,087.30 ",$398.02 ,$690.56 ,$306.43 ,$292.50 ,$416.61 ,"$1,494.00 ",$862.57 ,"$1,024.22 ",$464.80 ,"$1,494.00 ",$398.02 ,"$1,494.00 ","$1,494.00 ",$398.02 ,"$1,079.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$1,848.00 ","$1,201.20 ",$292.50 ,"$1,848.00 ",$955.48 ,"$1,376.76 ","$1,210.44 ",$398.02 ,$517.44 ,$933.24 ,$398.02 ,"$1,140.22 ",$398.02 ,"$1,140.22 ","$1,140.22 ",$398.02 ,"$1,140.22 ",$756.24 ,"$1,663.20 ","$1,386.00 ",$955.48 ,$398.02 ,"$1,626.24 ",$398.02 ,"$1,386.00 ","$1,386.00 ","$1,570.80 ","$1,570.80 ",$398.02 ,"$1,570.80 ",$398.02 ,"$1,441.44 ","$1,441.44 ","$1,441.44 ","$1,663.20 ",$955.48 ,"$1,663.20 ",$398.02 ,"$1,848.00 ","$1,210.44 ",$398.02 ,$768.77 ,$306.43 ,$292.50 ,$416.61 ,"$1,663.20 ",$862.57 ,"$1,140.22 ",$517.44 ,"$1,663.20 ",$398.02 ,"$1,663.20 ","$1,663.20 ",$398.02 ,"$1,201.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000027,78278,HC GI BLEED SCAN,340,1 ,$927.00 ,$602.55 ,$259.56 ,$927.00 ,$927.00 ,$690.62 ,$607.19 ,$398.02 ,$259.56 ,$468.14 ,$398.02 ,$571.96 ,$398.02 ,$571.96 ,$571.96 ,$398.02 ,$571.96 ,$756.24 ,$834.30 ,$695.25 ,$927.00 ,$398.02 ,$815.76 ,$398.02 ,$695.25 ,$695.25 ,$787.95 ,$787.95 ,$398.02 ,$787.95 ,$398.02 ,$723.06 ,$723.06 ,$723.06 ,$834.30 ,$927.00 ,$834.30 ,$398.02 ,$927.00 ,$607.19 ,$398.02 ,$385.63 ,$306.43 ,$292.50 ,$416.61 ,$834.30 ,$862.57 ,$571.96 ,$259.56 ,$834.30 ,$398.02 ,$834.30 ,$834.30 ,$398.02 ,$602.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,117.00 ",$726.05 ,$261.04 ,"$1,117.00 ",$955.48 ,$832.17 ,$731.64 ,$398.02 ,$312.76 ,$564.09 ,$398.02 ,$689.19 ,$398.02 ,$689.19 ,$689.19 ,$398.02 ,$689.19 ,$756.24 ,"$1,005.30 ",$837.75 ,$955.48 ,$398.02 ,$982.96 ,$398.02 ,$837.75 ,$837.75 ,$949.45 ,$949.45 ,$398.02 ,$949.45 ,$398.02 ,$871.26 ,$871.26 ,$871.26 ,"$1,005.30 ",$955.48 ,"$1,005.30 ",$398.02 ,"$1,117.00 ",$731.64 ,$398.02 ,$464.67 ,$273.47 ,$261.04 ,$416.61 ,"$1,005.30 ",$862.57 ,$689.19 ,$312.76 ,"$1,005.30 ",$398.02 ,"$1,005.30 ","$1,005.30 ",$398.02 ,$726.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,137.00 ",$739.05 ,$261.04 ,"$1,137.00 ",$955.48 ,$847.07 ,$744.74 ,$398.02 ,$318.36 ,$574.19 ,$398.02 ,$701.53 ,$398.02 ,$701.53 ,$701.53 ,$398.02 ,$701.53 ,$756.24 ,"$1,023.30 ",$852.75 ,$955.48 ,$398.02 ,"$1,000.56 ",$398.02 ,$852.75 ,$852.75 ,$966.45 ,$966.45 ,$398.02 ,$966.45 ,$398.02 ,$886.86 ,$886.86 ,$886.86 ,"$1,023.30 ",$955.48 ,"$1,023.30 ",$398.02 ,"$1,137.00 ",$744.74 ,$398.02 ,$472.99 ,$273.47 ,$261.04 ,$416.61 ,"$1,023.30 ",$862.57 ,$701.53 ,$318.36 ,"$1,023.30 ",$398.02 ,"$1,023.30 ","$1,023.30 ",$398.02 ,$739.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,351.00 ",$878.15 ,$261.04 ,"$1,351.00 ",$955.48 ,"$1,006.50 ",$884.91 ,$398.02 ,$378.28 ,$682.26 ,$398.02 ,$833.57 ,$398.02 ,$833.57 ,$833.57 ,$398.02 ,$833.57 ,$756.24 ,"$1,215.90 ","$1,013.25 ",$955.48 ,$398.02 ,"$1,188.88 ",$398.02 ,"$1,013.25 ","$1,013.25 ","$1,148.35 ","$1,148.35 ",$398.02 ,"$1,148.35 ",$398.02 ,"$1,053.78 ","$1,053.78 ","$1,053.78 ","$1,215.90 ",$955.48 ,"$1,215.90 ",$398.02 ,"$1,351.00 ",$884.91 ,$398.02 ,$562.02 ,$273.47 ,$261.04 ,$416.61 ,"$1,215.90 ",$862.57 ,$833.57 ,$378.28 ,"$1,215.90 ",$398.02 ,"$1,215.90 ","$1,215.90 ",$398.02 ,$878.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$1,524.00 ",$990.60 ,$261.04 ,"$1,524.00 ",$955.48 ,"$1,135.38 ",$998.22 ,$398.02 ,$426.72 ,$769.62 ,$398.02 ,$940.31 ,$398.02 ,$940.31 ,$940.31 ,$398.02 ,$940.31 ,$756.24 ,"$1,371.60 ","$1,143.00 ",$955.48 ,$398.02 ,"$1,341.12 ",$398.02 ,"$1,143.00 ","$1,143.00 ","$1,295.40 ","$1,295.40 ",$398.02 ,"$1,295.40 ",$398.02 ,"$1,188.72 ","$1,188.72 ","$1,188.72 ","$1,371.60 ",$955.48 ,"$1,371.60 ",$398.02 ,"$1,524.00 ",$998.22 ,$398.02 ,$633.98 ,$273.47 ,$261.04 ,$416.61 ,"$1,371.60 ",$862.57 ,$940.31 ,$426.72 ,"$1,371.60 ",$398.02 ,"$1,371.60 ","$1,371.60 ",$398.02 ,$990.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000032,78315,HC BONE SCAN FLOW WHOLE BODY STATICS,340,1 ,"$1,775.00 ","$1,153.75 ",$261.04 ,"$1,775.00 ",$955.48 ,"$1,322.38 ","$1,162.63 ",$398.02 ,$497.00 ,$896.38 ,$398.02 ,"$1,095.18 ",$398.02 ,"$1,095.18 ","$1,095.18 ",$398.02 ,"$1,095.18 ",$756.24 ,"$1,597.50 ","$1,331.25 ",$955.48 ,$398.02 ,"$1,562.00 ",$398.02 ,"$1,331.25 ","$1,331.25 ","$1,508.75 ","$1,508.75 ",$398.02 ,"$1,508.75 ",$398.02 ,"$1,384.50 ","$1,384.50 ","$1,384.50 ","$1,597.50 ",$955.48 ,"$1,597.50 ",$398.02 ,"$1,775.00 ","$1,162.63 ",$398.02 ,$738.40 ,$273.47 ,$261.04 ,$416.61 ,"$1,597.50 ",$862.57 ,"$1,095.18 ",$497.00 ,"$1,597.50 ",$398.02 ,"$1,597.50 ","$1,597.50 ",$398.02 ,"$1,153.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,603.00 ","$1,041.95 ",$130.53 ,"$1,603.00 ",$477.74 ,"$1,194.24 ","$1,049.97 ",$199.01 ,$448.84 ,$809.52 ,$199.01 ,$989.05 ,$199.01 ,$989.05 ,$989.05 ,$199.01 ,$989.05 ,$378.12 ,"$1,442.70 ","$1,202.25 ",$477.74 ,$199.01 ,"$1,410.64 ",$199.01 ,"$1,202.25 ","$1,202.25 ","$1,362.55 ","$1,362.55 ",$199.01 ,"$1,362.55 ",$199.01 ,"$1,250.34 ","$1,250.34 ","$1,250.34 ","$1,442.70 ",$477.74 ,"$1,442.70 ",$199.01 ,"$1,603.00 ","$1,049.97 ",$199.01 ,$666.85 ,$136.74 ,$130.53 ,$208.30 ,"$1,442.70 ",$431.29 ,$989.05 ,$448.84 ,"$1,442.70 ",$199.01 ,"$1,442.70 ","$1,442.70 ",$199.01 ,"$1,041.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,775.00 ","$1,153.75 ",$261.04 ,"$1,775.00 ",$955.48 ,"$1,322.38 ","$1,162.63 ",$398.02 ,$497.00 ,$896.38 ,$398.02 ,"$1,095.18 ",$398.02 ,"$1,095.18 ","$1,095.18 ",$398.02 ,"$1,095.18 ",$756.24 ,"$1,597.50 ","$1,331.25 ",$955.48 ,$398.02 ,"$1,562.00 ",$398.02 ,"$1,331.25 ","$1,331.25 ","$1,508.75 ","$1,508.75 ",$398.02 ,"$1,508.75 ",$398.02 ,"$1,384.50 ","$1,384.50 ","$1,384.50 ","$1,597.50 ",$955.48 ,"$1,597.50 ",$398.02 ,"$1,775.00 ","$1,162.63 ",$398.02 ,$738.40 ,$273.47 ,$261.04 ,$416.61 ,"$1,597.50 ",$862.57 ,"$1,095.18 ",$497.00 ,"$1,597.50 ",$398.02 ,"$1,597.50 ","$1,597.50 ",$398.02 ,"$1,153.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$3,286.00 ","$2,135.90 ",$292.50 ,"$3,286.00 ","$3,286.00 ","$2,448.07 ","$2,152.33 ","$1,379.81 ",$920.08 ,"$1,659.43 ","$1,379.81 ","$2,027.46 ","$1,379.81 ","$2,027.46 ","$2,027.46 ","$1,379.81 ","$2,027.46 ","$2,621.64 ","$2,957.40 ","$2,464.50 ","$3,286.00 ","$1,379.81 ","$2,891.68 ","$1,379.81 ","$2,464.50 ","$2,464.50 ","$2,793.10 ","$2,793.10 ","$1,379.81 ","$2,793.10 ","$1,379.81 ","$2,563.08 ","$2,563.08 ","$2,563.08 ","$2,957.40 ","$3,286.00 ","$2,957.40 ","$1,379.81 ","$3,286.00 ","$2,152.33 ","$1,379.81 ","$1,366.98 ",$306.43 ,$292.50 ,"$1,444.22 ","$2,957.40 ","$2,990.23 ","$2,027.46 ",$920.08 ,"$2,957.40 ","$1,379.81 ","$2,957.40 ","$2,957.40 ","$1,379.81 ","$2,135.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$6,570.00 ","$4,270.50 ",$640.42 ,"$6,570.00 ","$3,312.31 ","$4,894.65 ","$4,303.35 ","$1,379.81 ","$1,839.60 ","$3,317.85 ","$1,379.81 ","$4,053.69 ","$1,379.81 ","$4,053.69 ","$4,053.69 ","$1,379.81 ","$4,053.69 ","$2,621.64 ","$5,913.00 ","$4,927.50 ","$3,312.31 ","$1,379.81 ","$5,781.60 ","$1,379.81 ","$4,927.50 ","$4,927.50 ","$5,584.50 ","$5,584.50 ","$1,379.81 ","$5,584.50 ","$1,379.81 ","$5,124.60 ","$5,124.60 ","$5,124.60 ","$5,913.00 ","$3,312.31 ","$5,913.00 ","$1,379.81 ","$6,570.00 ","$4,303.35 ","$1,379.81 ","$2,733.12 ",$670.91 ,$640.42 ,"$1,444.22 ","$5,913.00 ","$2,990.23 ","$4,053.69 ","$1,839.60 ","$5,913.00 ","$1,379.81 ","$5,913.00 ","$5,913.00 ","$1,379.81 ","$4,270.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,301.00 ","$1,495.65 ",$261.04 ,"$2,301.00 ",$955.48 ,"$1,714.25 ","$1,507.16 ",$398.02 ,$644.28 ,"$1,162.01 ",$398.02 ,"$1,419.72 ",$398.02 ,"$1,419.72 ","$1,419.72 ",$398.02 ,"$1,419.72 ",$756.24 ,"$2,070.90 ","$1,725.75 ",$955.48 ,$398.02 ,"$2,024.88 ",$398.02 ,"$1,725.75 ","$1,725.75 ","$1,955.85 ","$1,955.85 ",$398.02 ,"$1,955.85 ",$398.02 ,"$1,794.78 ","$1,794.78 ","$1,794.78 ","$2,070.90 ",$955.48 ,"$2,070.90 ",$398.02 ,"$2,301.00 ","$1,507.16 ",$398.02 ,$957.22 ,$273.47 ,$261.04 ,$416.61 ,"$2,070.90 ",$862.57 ,"$1,419.72 ",$644.28 ,"$2,070.90 ",$398.02 ,"$2,070.90 ","$2,070.90 ",$398.02 ,"$1,495.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000047,78580,HC LUNG PERFUS,340,1 ,$977.00 ,$635.05 ,$273.56 ,$977.00 ,$955.48 ,$727.87 ,$639.94 ,$398.02 ,$273.56 ,$493.39 ,$398.02 ,$602.81 ,$398.02 ,$602.81 ,$602.81 ,$398.02 ,$602.81 ,$756.24 ,$879.30 ,$732.75 ,$955.48 ,$398.02 ,$859.76 ,$398.02 ,$732.75 ,$732.75 ,$830.45 ,$830.45 ,$398.02 ,$830.45 ,$398.02 ,$762.06 ,$762.06 ,$762.06 ,$879.30 ,$955.48 ,$879.30 ,$398.02 ,$977.00 ,$639.94 ,$398.02 ,$406.43 ,$306.43 ,$292.50 ,$416.61 ,$879.30 ,$862.57 ,$602.81 ,$273.56 ,$879.30 ,$398.02 ,$879.30 ,$879.30 ,$398.02 ,$635.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$1,519.00 ",$987.35 ,$292.50 ,"$1,519.00 ","$1,240.37 ","$1,131.66 ",$994.95 ,$516.70 ,$425.32 ,$767.10 ,$516.70 ,$937.22 ,$516.70 ,$937.22 ,$937.22 ,$516.70 ,$937.22 ,$981.73 ,"$1,367.10 ","$1,139.25 ","$1,240.37 ",$516.70 ,"$1,336.72 ",$516.70 ,"$1,139.25 ","$1,139.25 ","$1,291.15 ","$1,291.15 ",$516.70 ,"$1,291.15 ",$516.70 ,"$1,184.82 ","$1,184.82 ","$1,184.82 ","$1,367.10 ","$1,240.37 ","$1,367.10 ",$516.70 ,"$1,519.00 ",$994.95 ,$516.70 ,$631.90 ,$306.43 ,$292.50 ,$540.82 ,"$1,367.10 ","$1,119.76 ",$937.22 ,$425.32 ,"$1,367.10 ",$516.70 ,"$1,367.10 ","$1,367.10 ",$516.70 ,$987.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000058,78650,HC CSF LEAK DETECTION,340,1 ,"$3,538.00 ","$2,299.70 ",$261.04 ,"$3,538.00 ","$3,312.31 ","$2,635.81 ","$2,317.39 ","$1,379.81 ",$990.64 ,"$1,786.69 ","$1,379.81 ","$2,182.95 ","$1,379.81 ","$2,182.95 ","$2,182.95 ","$1,379.81 ","$2,182.95 ","$2,621.64 ","$3,184.20 ","$2,653.50 ","$3,312.31 ","$1,379.81 ","$3,113.44 ","$1,379.81 ","$2,653.50 ","$2,653.50 ","$3,007.30 ","$3,007.30 ","$1,379.81 ","$3,007.30 ","$1,379.81 ","$2,759.64 ","$2,759.64 ","$2,759.64 ","$3,184.20 ","$3,312.31 ","$3,184.20 ","$1,379.81 ","$3,538.00 ","$2,317.39 ","$1,379.81 ","$1,471.81 ",$273.47 ,$261.04 ,"$1,444.22 ","$3,184.20 ","$2,990.23 ","$2,182.95 ",$990.64 ,"$3,184.20 ","$1,379.81 ","$3,184.20 ","$3,184.20 ","$1,379.81 ","$2,299.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000060,78700,HC KIDNEY SCAN,340,1 ,"$1,073.00 ",$697.45 ,$261.04 ,"$1,073.00 ",$955.48 ,$799.39 ,$702.82 ,$398.02 ,$300.44 ,$541.87 ,$398.02 ,$662.04 ,$398.02 ,$662.04 ,$662.04 ,$398.02 ,$662.04 ,$756.24 ,$965.70 ,$804.75 ,$955.48 ,$398.02 ,$944.24 ,$398.02 ,$804.75 ,$804.75 ,$912.05 ,$912.05 ,$398.02 ,$912.05 ,$398.02 ,$836.94 ,$836.94 ,$836.94 ,$965.70 ,$955.48 ,$965.70 ,$398.02 ,"$1,073.00 ",$702.82 ,$398.02 ,$446.37 ,$273.47 ,$261.04 ,$416.61 ,$965.70 ,$862.57 ,$662.04 ,$300.44 ,$965.70 ,$398.02 ,$965.70 ,$965.70 ,$398.02 ,$697.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$1,014.00 ",$659.10 ,$261.04 ,"$1,119.76 ","$1,014.00 ",$755.43 ,$664.17 ,$516.70 ,$283.92 ,$512.07 ,$516.70 ,$625.64 ,$516.70 ,$625.64 ,$625.64 ,$516.70 ,$625.64 ,$981.73 ,$912.60 ,$760.50 ,"$1,014.00 ",$516.70 ,$892.32 ,$516.70 ,$760.50 ,$760.50 ,$861.90 ,$861.90 ,$516.70 ,$861.90 ,$516.70 ,$790.92 ,$790.92 ,$790.92 ,$912.60 ,"$1,014.00 ",$912.60 ,$516.70 ,"$1,014.00 ",$664.17 ,$516.70 ,$421.82 ,$273.47 ,$261.04 ,$540.82 ,$912.60 ,"$1,119.76 ",$625.64 ,$283.92 ,$912.60 ,$516.70 ,$912.60 ,$912.60 ,$516.70 ,$659.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$1,400.00 ",$910.00 ,$261.04 ,"$1,400.00 ","$1,240.37 ","$1,043.00 ",$917.00 ,$516.70 ,$392.00 ,$707.00 ,$516.70 ,$863.80 ,$516.70 ,$863.80 ,$863.80 ,$516.70 ,$863.80 ,$981.73 ,"$1,260.00 ","$1,050.00 ","$1,240.37 ",$516.70 ,"$1,232.00 ",$516.70 ,"$1,050.00 ","$1,050.00 ","$1,190.00 ","$1,190.00 ",$516.70 ,"$1,190.00 ",$516.70 ,"$1,092.00 ","$1,092.00 ","$1,092.00 ","$1,260.00 ","$1,240.37 ","$1,260.00 ",$516.70 ,"$1,400.00 ",$917.00 ,$516.70 ,$582.40 ,$273.47 ,$261.04 ,$540.82 ,"$1,260.00 ","$1,119.76 ",$863.80 ,$392.00 ,"$1,260.00 ",$516.70 ,"$1,260.00 ","$1,260.00 ",$516.70 ,$910.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$1,382.00 ",$898.30 ,$261.04 ,"$1,382.00 ","$1,240.37 ","$1,029.59 ",$905.21 ,$516.70 ,$386.96 ,$697.91 ,$516.70 ,$852.69 ,$516.70 ,$852.69 ,$852.69 ,$516.70 ,$852.69 ,$981.73 ,"$1,243.80 ","$1,036.50 ","$1,240.37 ",$516.70 ,"$1,216.16 ",$516.70 ,"$1,036.50 ","$1,036.50 ","$1,174.70 ","$1,174.70 ",$516.70 ,"$1,174.70 ",$516.70 ,"$1,077.96 ","$1,077.96 ","$1,077.96 ","$1,243.80 ","$1,240.37 ","$1,243.80 ",$516.70 ,"$1,382.00 ",$905.21 ,$516.70 ,$574.91 ,$273.47 ,$261.04 ,$540.82 ,"$1,243.80 ","$1,119.76 ",$852.69 ,$386.96 ,"$1,243.80 ",$516.70 ,"$1,243.80 ","$1,243.80 ",$516.70 ,$898.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000068,78800,HC TUMOR LOCAL LIMITED,340,1 ,"$1,017.00 ",$661.05 ,$284.76 ,"$1,017.00 ",$955.48 ,$757.67 ,$666.14 ,$398.02 ,$284.76 ,$513.59 ,$398.02 ,$627.49 ,$398.02 ,$627.49 ,$627.49 ,$398.02 ,$627.49 ,$756.24 ,$915.30 ,$762.75 ,$955.48 ,$398.02 ,$894.96 ,$398.02 ,$762.75 ,$762.75 ,$864.45 ,$864.45 ,$398.02 ,$864.45 ,$398.02 ,$793.26 ,$793.26 ,$793.26 ,$915.30 ,$955.48 ,$915.30 ,$398.02 ,"$1,017.00 ",$666.14 ,$398.02 ,$423.07 ,$306.43 ,$292.50 ,$416.61 ,$915.30 ,$862.57 ,$627.49 ,$284.76 ,$915.30 ,$398.02 ,$915.30 ,$915.30 ,$398.02 ,$661.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000069,78801,HC TUMOR LOCAL MULTIPLE,340,1 ,"$1,303.00 ",$846.95 ,$292.50 ,"$1,303.00 ",$955.48 ,$970.74 ,$853.47 ,$398.02 ,$364.84 ,$658.02 ,$398.02 ,$803.95 ,$398.02 ,$803.95 ,$803.95 ,$398.02 ,$803.95 ,$756.24 ,"$1,172.70 ",$977.25 ,$955.48 ,$398.02 ,"$1,146.64 ",$398.02 ,$977.25 ,$977.25 ,"$1,107.55 ","$1,107.55 ",$398.02 ,"$1,107.55 ",$398.02 ,"$1,016.34 ","$1,016.34 ","$1,016.34 ","$1,172.70 ",$955.48 ,"$1,172.70 ",$398.02 ,"$1,303.00 ",$853.47 ,$398.02 ,$542.05 ,$306.43 ,$292.50 ,$416.61 ,"$1,172.70 ",$862.57 ,$803.95 ,$364.84 ,"$1,172.70 ",$398.02 ,"$1,172.70 ","$1,172.70 ",$398.02 ,$846.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000070,78802,HC TUMOR IMAGE-WHOLE BODY-1 DAY,340,1 ,"$2,466.00 ","$1,602.90 ",$640.42 ,"$2,990.23 ","$2,466.00 ","$1,837.17 ","$1,615.23 ","$1,379.81 ",$690.48 ,"$1,245.33 ","$1,379.81 ","$1,521.52 ","$1,379.81 ","$1,521.52 ","$1,521.52 ","$1,379.81 ","$1,521.52 ","$2,621.64 ","$2,219.40 ","$1,849.50 ","$2,466.00 ","$1,379.81 ","$2,170.08 ","$1,379.81 ","$1,849.50 ","$1,849.50 ","$2,096.10 ","$2,096.10 ","$1,379.81 ","$2,096.10 ","$1,379.81 ","$1,923.48 ","$1,923.48 ","$1,923.48 ","$2,219.40 ","$2,466.00 ","$2,219.40 ","$1,379.81 ","$2,466.00 ","$1,615.23 ","$1,379.81 ","$1,025.86 ",$670.91 ,$640.42 ,"$1,444.22 ","$2,219.40 ","$2,990.23 ","$1,521.52 ",$690.48 ,"$2,219.40 ","$1,379.81 ","$2,219.40 ","$2,219.40 ","$1,379.81 ","$1,602.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$2,142.00 ","$1,392.30 ",$599.76 ,"$2,990.23 ","$2,142.00 ","$1,595.79 ","$1,403.01 ","$1,379.81 ",$599.76 ,"$1,081.71 ","$1,379.81 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$2,621.64 ","$1,927.80 ","$1,606.50 ","$2,142.00 ","$1,379.81 ","$1,884.96 ","$1,379.81 ","$1,606.50 ","$1,606.50 ","$1,820.70 ","$1,820.70 ","$1,379.81 ","$1,820.70 ","$1,379.81 ","$1,670.76 ","$1,670.76 ","$1,670.76 ","$1,927.80 ","$2,142.00 ","$1,927.80 ","$1,379.81 ","$2,142.00 ","$1,403.01 ","$1,379.81 ",$891.07 ,$670.91 ,$640.42 ,"$1,444.22 ","$1,927.80 ","$2,990.23 ","$1,321.61 ",$599.76 ,"$1,927.80 ","$1,379.81 ","$1,927.80 ","$1,927.80 ","$1,379.81 ","$1,392.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000072,78803,HC TUMOR IMAGING (SPECT) MIBG,340,1 ,"$2,142.00 ","$1,392.30 ",$599.76 ,"$2,990.23 ","$2,142.00 ","$1,595.79 ","$1,403.01 ","$1,379.81 ",$599.76 ,"$1,081.71 ","$1,379.81 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$2,621.64 ","$1,927.80 ","$1,606.50 ","$2,142.00 ","$1,379.81 ","$1,884.96 ","$1,379.81 ","$1,606.50 ","$1,606.50 ","$1,820.70 ","$1,820.70 ","$1,379.81 ","$1,820.70 ","$1,379.81 ","$1,670.76 ","$1,670.76 ","$1,670.76 ","$1,927.80 ","$2,142.00 ","$1,927.80 ","$1,379.81 ","$2,142.00 ","$1,403.01 ","$1,379.81 ",$891.07 ,$670.91 ,$640.42 ,"$1,444.22 ","$1,927.80 ","$2,990.23 ","$1,321.61 ",$599.76 ,"$1,927.80 ","$1,379.81 ","$1,927.80 ","$1,927.80 ","$1,379.81 ","$1,392.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000073,78803,HC TUMOR IMAGING (SPECT) GALLIUM,340,1 ,"$2,142.00 ","$1,392.30 ",$599.76 ,"$2,990.23 ","$2,142.00 ","$1,595.79 ","$1,403.01 ","$1,379.81 ",$599.76 ,"$1,081.71 ","$1,379.81 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$2,621.64 ","$1,927.80 ","$1,606.50 ","$2,142.00 ","$1,379.81 ","$1,884.96 ","$1,379.81 ","$1,606.50 ","$1,606.50 ","$1,820.70 ","$1,820.70 ","$1,379.81 ","$1,820.70 ","$1,379.81 ","$1,670.76 ","$1,670.76 ","$1,670.76 ","$1,927.80 ","$2,142.00 ","$1,927.80 ","$1,379.81 ","$2,142.00 ","$1,403.01 ","$1,379.81 ",$891.07 ,$670.91 ,$640.42 ,"$1,444.22 ","$1,927.80 ","$2,990.23 ","$1,321.61 ",$599.76 ,"$1,927.80 ","$1,379.81 ","$1,927.80 ","$1,927.80 ","$1,379.81 ","$1,392.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000074,78803,HC TUMOR IMAGING (SPECT) NON GATED,340,1 ,"$2,142.00 ","$1,392.30 ",$599.76 ,"$2,990.23 ","$2,142.00 ","$1,595.79 ","$1,403.01 ","$1,379.81 ",$599.76 ,"$1,081.71 ","$1,379.81 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$2,621.64 ","$1,927.80 ","$1,606.50 ","$2,142.00 ","$1,379.81 ","$1,884.96 ","$1,379.81 ","$1,606.50 ","$1,606.50 ","$1,820.70 ","$1,820.70 ","$1,379.81 ","$1,820.70 ","$1,379.81 ","$1,670.76 ","$1,670.76 ","$1,670.76 ","$1,927.80 ","$2,142.00 ","$1,927.80 ","$1,379.81 ","$2,142.00 ","$1,403.01 ","$1,379.81 ",$891.07 ,$670.91 ,$640.42 ,"$1,444.22 ","$1,927.80 ","$2,990.23 ","$1,321.61 ",$599.76 ,"$1,927.80 ","$1,379.81 ","$1,927.80 ","$1,927.80 ","$1,379.81 ","$1,392.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000075,78803,HC TUMOR IMAGING (SPECT) OCTREO,340,1 ,"$3,202.00 ","$2,081.30 ",$640.42 ,"$3,202.00 ","$3,202.00 ","$2,385.49 ","$2,097.31 ","$1,379.81 ",$896.56 ,"$1,617.01 ","$1,379.81 ","$1,975.63 ","$1,379.81 ","$1,975.63 ","$1,975.63 ","$1,379.81 ","$1,975.63 ","$2,621.64 ","$2,881.80 ","$2,401.50 ","$3,202.00 ","$1,379.81 ","$2,817.76 ","$1,379.81 ","$2,401.50 ","$2,401.50 ","$2,721.70 ","$2,721.70 ","$1,379.81 ","$2,721.70 ","$1,379.81 ","$2,497.56 ","$2,497.56 ","$2,497.56 ","$2,881.80 ","$3,202.00 ","$2,881.80 ","$1,379.81 ","$3,202.00 ","$2,097.31 ","$1,379.81 ","$1,332.03 ",$670.91 ,$640.42 ,"$1,444.22 ","$2,881.80 ","$2,990.23 ","$1,975.63 ",$896.56 ,"$2,881.80 ","$1,379.81 ","$2,881.80 ","$2,881.80 ","$1,379.81 ","$2,081.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000076,78803,HC TUMOR IMAGING (SPECT) PARATHYROID,340,1 ,"$2,142.00 ","$1,392.30 ",$599.76 ,"$2,990.23 ","$2,142.00 ","$1,595.79 ","$1,403.01 ","$1,379.81 ",$599.76 ,"$1,081.71 ","$1,379.81 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$1,321.61 ","$1,379.81 ","$1,321.61 ","$2,621.64 ","$1,927.80 ","$1,606.50 ","$2,142.00 ","$1,379.81 ","$1,884.96 ","$1,379.81 ","$1,606.50 ","$1,606.50 ","$1,820.70 ","$1,820.70 ","$1,379.81 ","$1,820.70 ","$1,379.81 ","$1,670.76 ","$1,670.76 ","$1,670.76 ","$1,927.80 ","$2,142.00 ","$1,927.80 ","$1,379.81 ","$2,142.00 ","$1,403.01 ","$1,379.81 ",$891.07 ,$670.91 ,$640.42 ,"$1,444.22 ","$1,927.80 ","$2,990.23 ","$1,321.61 ",$599.76 ,"$1,927.80 ","$1,379.81 ","$1,927.80 ","$1,927.80 ","$1,379.81 ","$1,392.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000077,78804,HC TUMOR/INF-WHOLE BODY-MULT DAY,340,1 ,"$3,537.00 ","$2,299.05 ",$640.42 ,"$3,537.00 ","$3,312.31 ","$2,635.07 ","$2,316.74 ","$1,379.81 ",$990.36 ,"$1,786.19 ","$1,379.81 ","$2,182.33 ","$1,379.81 ","$2,182.33 ","$2,182.33 ","$1,379.81 ","$2,182.33 ","$2,621.64 ","$3,183.30 ","$2,652.75 ","$3,312.31 ","$1,379.81 ","$3,112.56 ","$1,379.81 ","$2,652.75 ","$2,652.75 ","$3,006.45 ","$3,006.45 ","$1,379.81 ","$3,006.45 ","$1,379.81 ","$2,758.86 ","$2,758.86 ","$2,758.86 ","$3,183.30 ","$3,312.31 ","$3,183.30 ","$1,379.81 ","$3,537.00 ","$2,316.74 ","$1,379.81 ","$1,471.39 ",$670.91 ,$640.42 ,"$1,444.22 ","$3,183.30 ","$2,990.23 ","$2,182.33 ",$990.36 ,"$3,183.30 ","$1,379.81 ","$3,183.30 ","$3,183.30 ","$1,379.81 ","$2,299.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000081,79005,HC NM RADIOPAHARM THRPY ORAL,340,1 ,"$1,170.00 ",$760.50 ,$212.43 ,"$1,170.00 ",$641.36 ,$871.65 ,$766.35 ,$267.17 ,$327.60 ,$590.85 ,$267.17 ,$721.89 ,$267.17 ,$721.89 ,$721.89 ,$267.17 ,$721.89 ,$507.62 ,"$1,053.00 ",$877.50 ,$641.36 ,$267.17 ,"$1,029.60 ",$267.17 ,$877.50 ,$877.50 ,$994.50 ,$994.50 ,$267.17 ,$994.50 ,$267.17 ,$912.60 ,$912.60 ,$912.60 ,"$1,053.00 ",$641.36 ,"$1,053.00 ",$267.17 ,"$1,170.00 ",$766.35 ,$267.17 ,$486.72 ,$222.54 ,$212.43 ,$279.64 ,"$1,053.00 ",$578.99 ,$721.89 ,$327.60 ,"$1,053.00 ",$267.17 ,"$1,053.00 ","$1,053.00 ",$267.17 ,$760.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,"$1,646.00 ","$1,069.90 ",$292.50 ,"$1,646.00 ",$955.48 ,"$1,226.27 ","$1,078.13 ",$398.02 ,$460.88 ,$831.23 ,$398.02 ,"$1,015.58 ",$398.02 ,"$1,015.58 ","$1,015.58 ",$398.02 ,"$1,015.58 ",$756.24 ,"$1,481.40 ","$1,234.50 ",$955.48 ,$398.02 ,"$1,448.48 ",$398.02 ,"$1,234.50 ","$1,234.50 ","$1,399.10 ","$1,399.10 ",$398.02 ,"$1,399.10 ",$398.02 ,"$1,283.88 ","$1,283.88 ","$1,283.88 ","$1,481.40 ",$955.48 ,"$1,481.40 ",$398.02 ,"$1,646.00 ","$1,078.13 ",$398.02 ,$684.74 ,$306.43 ,$292.50 ,$416.61 ,"$1,481.40 ",$862.57 ,"$1,015.58 ",$460.88 ,"$1,481.40 ",$398.02 ,"$1,481.40 ","$1,481.40 ",$398.02 ,"$1,069.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000091,78598,HC NM PULM VENT AND PERF DIFF W/IMG,340,1 ,"$2,085.00 ","$1,355.25 ",$292.50 ,"$2,085.00 ","$1,240.37 ","$1,553.33 ","$1,365.68 ",$516.70 ,$583.80 ,"$1,052.93 ",$516.70 ,"$1,286.45 ",$516.70 ,"$1,286.45 ","$1,286.45 ",$516.70 ,"$1,286.45 ",$981.73 ,"$1,876.50 ","$1,563.75 ","$1,240.37 ",$516.70 ,"$1,834.80 ",$516.70 ,"$1,563.75 ","$1,563.75 ","$1,772.25 ","$1,772.25 ",$516.70 ,"$1,772.25 ",$516.70 ,"$1,626.30 ","$1,626.30 ","$1,626.30 ","$1,876.50 ","$1,240.37 ","$1,876.50 ",$516.70 ,"$2,085.00 ","$1,365.68 ",$516.70 ,$867.36 ,$306.43 ,$292.50 ,$540.82 ,"$1,876.50 ","$1,119.76 ","$1,286.45 ",$583.80 ,"$1,876.50 ",$516.70 ,"$1,876.50 ","$1,876.50 ",$516.70 ,"$1,355.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$1,750.00 ","$1,137.50 ",$292.50 ,"$1,750.00 ","$1,240.37 ","$1,303.75 ","$1,146.25 ",$516.70 ,$490.00 ,$883.75 ,$516.70 ,"$1,079.75 ",$516.70 ,"$1,079.75 ","$1,079.75 ",$516.70 ,"$1,079.75 ",$981.73 ,"$1,575.00 ","$1,312.50 ","$1,240.37 ",$516.70 ,"$1,540.00 ",$516.70 ,"$1,312.50 ","$1,312.50 ","$1,487.50 ","$1,487.50 ",$516.70 ,"$1,487.50 ",$516.70 ,"$1,365.00 ","$1,365.00 ","$1,365.00 ","$1,575.00 ","$1,240.37 ","$1,575.00 ",$516.70 ,"$1,750.00 ","$1,146.25 ",$516.70 ,$728.00 ,$306.43 ,$292.50 ,$540.82 ,"$1,575.00 ","$1,119.76 ","$1,079.75 ",$490.00 ,"$1,575.00 ",$516.70 ,"$1,575.00 ","$1,575.00 ",$516.70 ,"$1,137.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$2,449.00 ","$1,591.85 ",$261.04 ,"$2,449.00 ",$955.48 ,"$1,824.51 ","$1,604.10 ",$398.02 ,$685.72 ,"$1,236.75 ",$398.02 ,"$1,511.03 ",$398.02 ,"$1,511.03 ","$1,511.03 ",$398.02 ,"$1,511.03 ",$756.24 ,"$2,204.10 ","$1,836.75 ",$955.48 ,$398.02 ,"$2,155.12 ",$398.02 ,"$1,836.75 ","$1,836.75 ","$2,081.65 ","$2,081.65 ",$398.02 ,"$2,081.65 ",$398.02 ,"$1,910.22 ","$1,910.22 ","$1,910.22 ","$2,204.10 ",$955.48 ,"$2,204.10 ",$398.02 ,"$2,449.00 ","$1,604.10 ",$398.02 ,"$1,018.78 ",$273.47 ,$261.04 ,$416.61 ,"$2,204.10 ",$862.57 ,"$1,511.03 ",$685.72 ,"$2,204.10 ",$398.02 ,"$2,204.10 ","$2,204.10 ",$398.02 ,"$1,591.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34100033,78831,HC TUMOR LOCAL SPECT MULT AREA 1 DAY OR SGL AREA W/MULT DAYS,341,1 ,"$3,537.00 ","$2,299.05 ",$640.42 ,"$3,537.00 ","$3,312.31 ","$2,635.07 ","$2,316.74 ","$1,379.81 ",$990.36 ,"$1,786.19 ","$1,379.81 ","$2,182.33 ","$1,379.81 ","$2,182.33 ","$2,182.33 ","$1,379.81 ","$2,182.33 ","$2,621.64 ","$3,183.30 ","$2,652.75 ","$3,312.31 ","$1,379.81 ","$3,112.56 ","$1,379.81 ","$2,652.75 ","$2,652.75 ","$3,006.45 ","$3,006.45 ","$1,379.81 ","$3,006.45 ","$1,379.81 ","$2,758.86 ","$2,758.86 ","$2,758.86 ","$3,183.30 ","$3,312.31 ","$3,183.30 ","$1,379.81 ","$3,537.00 ","$2,316.74 ","$1,379.81 ","$1,471.39 ",$670.91 ,$640.42 ,"$1,444.22 ","$3,183.30 ","$2,990.23 ","$2,182.33 ",$990.36 ,"$3,183.30 ","$1,379.81 ","$3,183.30 ","$3,183.30 ","$1,379.81 ","$2,299.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34100034,78830,HC TUMOR IMAGING SPECT W/CT SGL AREA 1 DAY,341,1 ,"$3,537.00 ","$2,299.05 ",$640.42 ,"$3,537.00 ","$3,312.31 ","$2,635.07 ","$2,316.74 ","$1,379.81 ",$990.36 ,"$1,786.19 ","$1,379.81 ","$2,182.33 ","$1,379.81 ","$2,182.33 ","$2,182.33 ","$1,379.81 ","$2,182.33 ","$2,621.64 ","$3,183.30 ","$2,652.75 ","$3,312.31 ","$1,379.81 ","$3,112.56 ","$1,379.81 ","$2,652.75 ","$2,652.75 ","$3,006.45 ","$3,006.45 ","$1,379.81 ","$3,006.45 ","$1,379.81 ","$2,758.86 ","$2,758.86 ","$2,758.86 ","$3,183.30 ","$3,312.31 ","$3,183.30 ","$1,379.81 ","$3,537.00 ","$2,316.74 ","$1,379.81 ","$1,471.39 ",$670.91 ,$640.42 ,"$1,444.22 ","$3,183.30 ","$2,990.23 ","$2,182.33 ",$990.36 ,"$3,183.30 ","$1,379.81 ","$3,183.30 ","$3,183.30 ","$1,379.81 ","$2,299.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$813.00 ,$528.45 ,$227.64 ,$813.00 , N/A ,$605.69 ,$532.52 , N/A ,$227.64 ,$410.57 , N/A ,$501.62 , N/A ,$501.62 ,$501.62 , N/A ,$501.62 , N/A ,$731.70 ,$609.75 , N/A , N/A ,$715.44 , N/A ,$609.75 ,$609.75 ,$691.05 ,$691.05 , N/A ,$691.05 , N/A ,$634.14 ,$634.14 ,$634.14 ,$731.70 , N/A ,$731.70 , N/A ,$813.00 ,$532.52 , N/A ,$338.21 , N/A , N/A , N/A ,$731.70 , N/A ,$501.62 ,$227.64 ,$731.70 , N/A ,$584.10 ,$584.10 , N/A ,$528.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$189.00 ,$122.85 ,$26.83 ,$189.00 , N/A ,$140.81 ,$123.80 , N/A ,$52.92 ,$95.45 , N/A ,$116.61 , N/A ,$116.61 ,$116.61 , N/A ,$116.61 , N/A ,$170.10 ,$141.75 , N/A , N/A ,$166.32 , N/A ,$141.75 ,$141.75 ,$160.65 ,$160.65 , N/A ,$160.65 , N/A ,$147.42 ,$147.42 ,$147.42 ,$170.10 , N/A ,$170.10 , N/A ,$189.00 ,$123.80 , N/A ,$78.62 , N/A , N/A , N/A ,$170.10 , N/A ,$116.61 ,$52.92 ,$170.10 , N/A ,$26.83 ,$26.83 , N/A ,$122.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$175.00 ,$113.75 ,$49.00 ,$175.00 , N/A ,$130.38 ,$114.63 , N/A ,$49.00 ,$88.38 , N/A ,$107.98 , N/A ,$107.98 ,$107.98 , N/A ,$107.98 , N/A ,$157.50 ,$131.25 , N/A , N/A ,$154.00 , N/A ,$131.25 ,$131.25 ,$148.75 ,$148.75 , N/A ,$148.75 , N/A ,$136.50 ,$136.50 ,$136.50 ,$157.50 , N/A ,$157.50 , N/A ,$175.00 ,$114.63 , N/A ,$72.80 , N/A , N/A , N/A ,$157.50 , N/A ,$107.98 ,$49.00 ,$157.50 , N/A ,$175.00 ,$175.00 , N/A ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$2.71 ,$1.76 ,$0.76 ,$2.71 , N/A ,$2.02 ,$1.78 , N/A ,$0.76 ,$1.37 , N/A ,$1.67 , N/A ,$1.67 ,$1.67 , N/A ,$1.67 , N/A ,$2.44 ,$2.03 , N/A , N/A ,$2.38 , N/A ,$2.03 ,$2.03 ,$2.30 ,$2.30 , N/A ,$2.30 , N/A ,$2.11 ,$2.11 ,$2.11 ,$2.44 , N/A ,$2.44 , N/A ,$2.71 ,$1.78 , N/A ,$1.13 , N/A , N/A , N/A ,$2.44 , N/A ,$1.67 ,$0.76 ,$2.44 , N/A ,$2.71 ,$2.71 , N/A ,$1.76 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$239.00 ,$155.35 ,$66.92 ,$239.00 , N/A ,$178.06 ,$156.55 , N/A ,$66.92 ,$120.70 , N/A ,$147.46 , N/A ,$147.46 ,$147.46 , N/A ,$147.46 , N/A ,$215.10 ,$179.25 , N/A , N/A ,$210.32 , N/A ,$179.25 ,$179.25 ,$203.15 ,$203.15 , N/A ,$203.15 , N/A ,$186.42 ,$186.42 ,$186.42 ,$215.10 , N/A ,$215.10 , N/A ,$239.00 ,$156.55 , N/A ,$99.42 , N/A , N/A , N/A ,$215.10 , N/A ,$147.46 ,$66.92 ,$215.10 , N/A ,$186.71 ,$186.71 , N/A ,$155.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300011,A9517,HC DIAGNUCLIDE I131 CAPS PER MCI,343,1 ,$39.00 ,$25.35 ,$10.92 ,$45.27 ,$39.00 ,$29.06 ,$25.55 ,$20.12 ,$10.92 ,$19.70 ,$20.12 ,$24.06 ,$20.12 ,$24.06 ,$24.06 ,$20.12 ,$24.06 ,$38.23 ,$35.10 ,$29.25 ,$39.00 ,$20.12 ,$34.32 ,$20.12 ,$29.25 ,$29.25 ,$33.15 ,$33.15 ,$20.12 ,$33.15 ,$20.12 ,$30.42 ,$30.42 ,$30.42 ,$35.10 ,$39.00 ,$35.10 ,$20.12 ,$39.00 ,$25.55 ,$20.12 ,$16.22 ,$39.00 ,$39.00 ,$21.13 ,$35.10 ,$45.27 ,$24.06 ,$10.92 ,$35.10 ,$20.12 ,$33.20 ,$33.20 ,$20.12 ,$25.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$275.00 ,$178.75 ,$77.00 ,$275.00 , N/A ,$204.88 ,$180.13 , N/A ,$77.00 ,$138.88 , N/A ,$169.68 , N/A ,$169.68 ,$169.68 , N/A ,$169.68 , N/A ,$247.50 ,$206.25 , N/A , N/A ,$242.00 , N/A ,$206.25 ,$206.25 ,$233.75 ,$233.75 , N/A ,$233.75 , N/A ,$214.50 ,$214.50 ,$214.50 ,$247.50 , N/A ,$247.50 , N/A ,$275.00 ,$180.13 , N/A ,$114.40 , N/A , N/A , N/A ,$247.50 , N/A ,$169.68 ,$77.00 ,$247.50 , N/A ,$138.60 ,$138.60 , N/A ,$178.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300017,A9539,HC DIAGNUCLIDE DTPA KIDNEY PER DOSE,343,1 ,$240.00 ,$156.00 ,$51.96 ,$240.00 , N/A ,$178.80 ,$157.20 , N/A ,$67.20 ,$121.20 , N/A ,$148.08 , N/A ,$148.08 ,$148.08 , N/A ,$148.08 , N/A ,$216.00 ,$180.00 , N/A , N/A ,$211.20 , N/A ,$180.00 ,$180.00 ,$204.00 ,$204.00 , N/A ,$204.00 , N/A ,$187.20 ,$187.20 ,$187.20 ,$216.00 , N/A ,$216.00 , N/A ,$240.00 ,$157.20 , N/A ,$99.84 , N/A , N/A , N/A ,$216.00 , N/A ,$148.08 ,$67.20 ,$216.00 , N/A ,$51.96 ,$51.96 , N/A ,$156.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$159.00 ,$103.35 ,$44.52 ,$159.00 , N/A ,$118.46 ,$104.15 , N/A ,$44.52 ,$80.30 , N/A ,$98.10 , N/A ,$98.10 ,$98.10 , N/A ,$98.10 , N/A ,$143.10 ,$119.25 , N/A , N/A ,$139.92 , N/A ,$119.25 ,$119.25 ,$135.15 ,$135.15 , N/A ,$135.15 , N/A ,$124.02 ,$124.02 ,$124.02 ,$143.10 , N/A ,$143.10 , N/A ,$159.00 ,$104.15 , N/A ,$66.14 , N/A , N/A , N/A ,$143.10 , N/A ,$98.10 ,$44.52 ,$143.10 , N/A ,$55.95 ,$55.95 , N/A ,$103.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$350.00 ,$227.50 ,$98.00 ,$350.00 , N/A ,$260.75 ,$229.25 , N/A ,$98.00 ,$176.75 , N/A ,$215.95 , N/A ,$215.95 ,$215.95 , N/A ,$215.95 , N/A ,$315.00 ,$262.50 , N/A , N/A ,$308.00 , N/A ,$262.50 ,$262.50 ,$297.50 ,$297.50 , N/A ,$297.50 , N/A ,$273.00 ,$273.00 ,$273.00 ,$315.00 , N/A ,$315.00 , N/A ,$350.00 ,$229.25 , N/A ,$145.60 , N/A , N/A , N/A ,$315.00 , N/A ,$215.95 ,$98.00 ,$315.00 , N/A ,$350.00 ,$350.00 , N/A ,$227.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300029,A9552,HC DIAGNUCLIDE 18FDG,343,1 ,"$1,633.00 ","$1,061.45 ",$457.24 ,"$1,633.00 ", N/A ,"$1,216.59 ","$1,069.62 ", N/A ,$457.24 ,$824.67 , N/A ,"$1,007.56 ", N/A ,"$1,007.56 ","$1,007.56 ", N/A ,"$1,007.56 ", N/A ,"$1,469.70 ","$1,224.75 ", N/A , N/A ,"$1,437.04 ", N/A ,"$1,224.75 ","$1,224.75 ","$1,388.05 ","$1,388.05 ", N/A ,"$1,388.05 ", N/A ,"$1,273.74 ","$1,273.74 ","$1,273.74 ","$1,469.70 ", N/A ,"$1,469.70 ", N/A ,"$1,633.00 ","$1,069.62 ", N/A ,$679.33 , N/A , N/A , N/A ,"$1,469.70 ", N/A ,"$1,007.56 ",$457.24 ,"$1,469.70 ", N/A ,$491.06 ,$491.06 , N/A ,"$1,061.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300033,A9558,HC DIAGNUCLIDE XE133 10 MCI,343,1 ,$143.00 ,$92.95 ,$40.04 ,$143.00 , N/A ,$106.54 ,$93.67 , N/A ,$40.04 ,$72.22 , N/A ,$88.23 , N/A ,$88.23 ,$88.23 , N/A ,$88.23 , N/A ,$128.70 ,$107.25 , N/A , N/A ,$125.84 , N/A ,$107.25 ,$107.25 ,$121.55 ,$121.55 , N/A ,$121.55 , N/A ,$111.54 ,$111.54 ,$111.54 ,$128.70 , N/A ,$128.70 , N/A ,$143.00 ,$93.67 , N/A ,$59.49 , N/A , N/A , N/A ,$128.70 , N/A ,$88.23 ,$40.04 ,$128.70 , N/A ,$143.00 ,$143.00 , N/A ,$92.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$308.00 ,$200.20 ,$86.24 ,$308.00 , N/A ,$229.46 ,$201.74 , N/A ,$86.24 ,$155.54 , N/A ,$190.04 , N/A ,$190.04 ,$190.04 , N/A ,$190.04 , N/A ,$277.20 ,$231.00 , N/A , N/A ,$271.04 , N/A ,$231.00 ,$231.00 ,$261.80 ,$261.80 , N/A ,$261.80 , N/A ,$240.24 ,$240.24 ,$240.24 ,$277.20 , N/A ,$277.20 , N/A ,$308.00 ,$201.74 , N/A ,$128.13 , N/A , N/A , N/A ,$277.20 , N/A ,$190.04 ,$86.24 ,$277.20 , N/A ,$165.59 ,$165.59 , N/A ,$200.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300038,A9572,HC DIAGNUCLIDE OCTREOTIDE PER DOSE UP TO 6MCI,343,1 ,"$6,845.00 ","$4,449.25 ","$1,916.60 ","$6,845.00 ", N/A ,"$5,099.53 ","$4,483.48 ", N/A ,"$1,916.60 ","$3,456.73 ", N/A ,"$4,223.37 ", N/A ,"$4,223.37 ","$4,223.37 ", N/A ,"$4,223.37 ", N/A ,"$6,160.50 ","$5,133.75 ", N/A , N/A ,"$6,023.60 ", N/A ,"$5,133.75 ","$5,133.75 ","$5,818.25 ","$5,818.25 ", N/A ,"$5,818.25 ", N/A ,"$5,339.10 ","$5,339.10 ","$5,339.10 ","$6,160.50 ", N/A ,"$6,160.50 ", N/A ,"$6,845.00 ","$4,483.48 ", N/A ,"$2,847.52 ", N/A , N/A , N/A ,"$6,160.50 ", N/A ,"$4,223.37 ","$1,916.60 ","$6,160.50 ", N/A ,"$6,845.00 ","$6,845.00 ", N/A ,"$4,449.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$202.04 ,$131.33 ,$56.57 ,$202.04 , N/A ,$150.52 ,$132.34 , N/A ,$56.57 ,$102.03 , N/A ,$124.66 , N/A ,$124.66 ,$124.66 , N/A ,$124.66 , N/A ,$181.84 ,$151.53 , N/A , N/A ,$177.80 , N/A ,$151.53 ,$151.53 ,$171.73 ,$171.73 , N/A ,$171.73 , N/A ,$157.59 ,$157.59 ,$157.59 ,$181.84 , N/A ,$181.84 , N/A ,$202.04 ,$132.34 , N/A ,$84.05 ,$99.40 ,$94.88 , N/A ,$181.84 , N/A ,$124.66 ,$56.57 ,$181.84 , N/A ,$190.82 ,$190.82 , N/A ,$131.33 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300049,A9509,HC DIAGNUCLIDE I123 CAP PER MILLICURIE,343,1 ,"$1,011.00 ",$657.15 ,$283.08 ,"$1,011.00 ", N/A ,$753.20 ,$662.21 , N/A ,$283.08 ,$510.56 , N/A ,$623.79 , N/A ,$623.79 ,$623.79 , N/A ,$623.79 , N/A ,$909.90 ,$758.25 , N/A , N/A ,$889.68 , N/A ,$758.25 ,$758.25 ,$859.35 ,$859.35 , N/A ,$859.35 , N/A ,$788.58 ,$788.58 ,$788.58 ,$909.90 , N/A ,$909.90 , N/A ,"$1,011.00 ",$662.21 , N/A ,$420.58 , N/A , N/A , N/A ,$909.90 , N/A ,$623.79 ,$283.08 ,$909.90 , N/A ,$525.33 ,$525.33 , N/A ,$657.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300057,A9569,HC TC99M EXAMETAZIME CERETEC DX PER DOSE,343,1 ,"$2,576.00 ","$1,674.40 ",$721.28 ,"$2,576.00 ", N/A ,"$1,919.12 ","$1,687.28 ", N/A ,$721.28 ,"$1,300.88 ", N/A ,"$1,589.39 ", N/A ,"$1,589.39 ","$1,589.39 ", N/A ,"$1,589.39 ", N/A ,"$2,318.40 ","$1,932.00 ", N/A , N/A ,"$2,266.88 ", N/A ,"$1,932.00 ","$1,932.00 ","$2,189.60 ","$2,189.60 ", N/A ,"$2,189.60 ", N/A ,"$2,009.28 ","$2,009.28 ","$2,009.28 ","$2,318.40 ", N/A ,"$2,318.40 ", N/A ,"$2,576.00 ","$1,687.28 ", N/A ,"$1,071.62 ", N/A , N/A , N/A ,"$2,318.40 ", N/A ,"$1,589.39 ",$721.28 ,"$2,318.40 ", N/A ,"$2,576.00 ","$2,576.00 ", N/A ,"$1,674.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300058,A9500,HC SESTAMIBI PER STUDY DOSE,343,1 ,$813.00 ,$528.45 ,$227.64 ,$813.00 , N/A ,$605.69 ,$532.52 , N/A ,$227.64 ,$410.57 , N/A ,$501.62 , N/A ,$501.62 ,$501.62 , N/A ,$501.62 , N/A ,$731.70 ,$609.75 , N/A , N/A ,$715.44 , N/A ,$609.75 ,$609.75 ,$691.05 ,$691.05 , N/A ,$691.05 , N/A ,$634.14 ,$634.14 ,$634.14 ,$731.70 , N/A ,$731.70 , N/A ,$813.00 ,$532.52 , N/A ,$338.21 , N/A , N/A , N/A ,$731.70 , N/A ,$501.62 ,$227.64 ,$731.70 , N/A ,$584.10 ,$584.10 , N/A ,$528.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300060,A9520,HC DIAGNUCLIDE TC-99 TILMANOCEPT DIAG UP TO 0.5 MCI,343,1 ,"$1,193.00 ",$775.45 ,$334.04 ,"$1,193.00 ", N/A ,$888.79 ,$781.42 , N/A ,$334.04 ,$602.47 , N/A ,$736.08 , N/A ,$736.08 ,$736.08 , N/A ,$736.08 , N/A ,"$1,073.70 ",$894.75 , N/A , N/A ,"$1,049.84 ", N/A ,$894.75 ,$894.75 ,"$1,014.05 ","$1,014.05 ", N/A ,"$1,014.05 ", N/A ,$930.54 ,$930.54 ,$930.54 ,"$1,073.70 ", N/A ,"$1,073.70 ", N/A ,"$1,193.00 ",$781.42 , N/A ,$496.29 , N/A , N/A , N/A ,"$1,073.70 ", N/A ,$736.08 ,$334.04 ,"$1,073.70 ", N/A , N/A , N/A , N/A ,$775.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300064,A9570,HC DIAGNUCLIDE INDIUM IN-111 WBC DIAG PER STUDY,343,1 ,"$2,812.00 ","$1,827.80 ",$787.36 ,"$2,812.00 ", N/A ,"$2,094.94 ","$1,841.86 ", N/A ,$787.36 ,"$1,420.06 ", N/A ,"$1,735.00 ", N/A ,"$1,735.00 ","$1,735.00 ", N/A ,"$1,735.00 ", N/A ,"$2,530.80 ","$2,109.00 ", N/A , N/A ,"$2,474.56 ", N/A ,"$2,109.00 ","$2,109.00 ","$2,390.20 ","$2,390.20 ", N/A ,"$2,390.20 ", N/A ,"$2,193.36 ","$2,193.36 ","$2,193.36 ","$2,530.80 ", N/A ,"$2,530.80 ", N/A ,"$2,812.00 ","$1,841.86 ", N/A ,"$1,169.79 ", N/A , N/A , N/A ,"$2,530.80 ", N/A ,"$1,735.00 ",$787.36 ,"$2,530.80 ", N/A ,"$2,812.00 ","$2,812.00 ", N/A ,"$1,827.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),34300072,A9595,"HC PIFLUFOLASTAT F-18, DIAGNOSTIC, 1 MILLICURIE",343,1 ,"$1,579.00 ","$1,026.35 ",$442.12 ,"$1,579.00 ","$1,354.45 ","$1,176.36 ","$1,034.25 ",$541.78 ,$442.12 ,$797.40 ,$541.78 ,$974.24 ,$541.78 ,$974.24 ,$974.24 ,$541.78 ,$974.24 ,"$1,029.38 ","$1,421.10 ","$1,184.25 ","$1,354.45 ",$541.78 ,"$1,389.52 ",$541.78 ,"$1,184.25 ","$1,184.25 ","$1,342.15 ","$1,342.15 ",$541.78 ,"$1,342.15 ",$541.78 ,"$1,231.62 ","$1,231.62 ","$1,231.62 ","$1,421.10 ","$1,354.45 ","$1,421.10 ",$541.78 ,"$1,579.00 ","$1,034.25 ",$541.78 ,$656.86 , N/A , N/A ,$568.87 ,"$1,421.10 ","$1,219.00 ",$974.24 ,$442.12 ,"$1,421.10 ",$541.78 ,$893.94 ,$893.94 ,$541.78 ,"$1,026.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000006,21550,HC BX TISSUE NECK/THORAX,350,1 ,"$4,204.00 ","$2,732.60 ",$447.91 ,"$4,204.00 ","$3,566.38 ","$3,131.98 ","$2,753.62 ","$1,485.64 ","$1,177.12 ","$2,123.02 ","$1,485.64 ","$2,593.87 ","$1,485.64 ","$2,593.87 ","$2,593.87 ","$1,485.64 ","$2,593.87 ","$2,822.72 ","$3,783.60 ","$3,153.00 ","$3,566.38 ","$1,485.64 ","$3,699.52 ","$1,485.64 ","$3,153.00 ","$3,153.00 ","$3,573.40 ","$3,573.40 ","$1,485.64 ","$3,573.40 ","$1,485.64 ","$3,279.12 ","$3,279.12 ","$3,279.12 ","$3,783.60 ","$3,566.38 ","$3,783.60 ","$1,485.64 ","$4,204.00 ","$2,753.62 ","$1,485.64 ","$1,748.86 ",$469.24 ,$447.91 ,"$1,555.00 ","$3,783.60 ","$3,219.59 ","$2,593.87 ","$1,177.12 ","$3,783.60 ","$1,485.64 ","$3,783.60 ","$3,783.60 ","$1,485.64 ","$2,732.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000013,32400,HC BX PLEURA NEEDLE PERC,350,1 ,"$1,060.00 ",$689.00 ,$296.80 ,"$3,219.59 ","$1,060.00 ",$789.70 ,$694.30 ,"$1,060.00 ",$296.80 ,$535.30 ,"$1,060.00 ",$654.02 ,"$1,060.00 ",$654.02 ,$654.02 ,"$1,060.00 ",$654.02 ,"$2,822.72 ",$954.00 ,$795.00 ,"$1,060.00 ","$1,060.00 ",$932.80 ,"$1,060.00 ",$795.00 ,$795.00 ,$901.00 ,$901.00 ,"$1,060.00 ",$901.00 ,"$1,060.00 ",$826.80 ,$826.80 ,$826.80 ,$954.00 ,"$1,060.00 ",$954.00 ,"$1,060.00 ","$1,060.00 ",$694.30 ,"$1,060.00 ",$440.96 ,$503.72 ,$480.83 ,"$1,060.00 ",$954.00 ,"$3,219.59 ",$654.02 ,$296.80 ,$954.00 ,"$1,060.00 ",$954.00 ,$954.00 ,"$1,060.00 ",$689.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000018,47000,HC BX LIVER NEEDLE PERC,350,1 ,"$1,216.00 ",$790.40 ,$340.48 ,"$3,219.59 ","$1,216.00 ",$905.92 ,$796.48 ,"$1,216.00 ",$340.48 ,$614.08 ,"$1,216.00 ",$750.27 ,"$1,216.00 ",$750.27 ,$750.27 ,"$1,216.00 ",$750.27 ,"$2,822.72 ","$1,094.40 ",$912.00 ,"$1,216.00 ","$1,216.00 ","$1,070.08 ","$1,216.00 ",$912.00 ,$912.00 ,"$1,033.60 ","$1,033.60 ","$1,216.00 ","$1,033.60 ","$1,216.00 ",$948.48 ,$948.48 ,$948.48 ,"$1,094.40 ","$1,216.00 ","$1,094.40 ","$1,216.00 ","$1,216.00 ",$796.48 ,"$1,216.00 ",$505.86 ,$503.72 ,$480.83 ,"$1,216.00 ","$1,094.40 ","$3,219.59 ",$750.27 ,$340.48 ,"$1,094.40 ","$1,216.00 ","$1,094.40 ","$1,094.40 ","$1,216.00 ",$790.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000020,49405,HC PERC DRN ABSC/HEM/CYST VISCERAL,350,1 ,"$2,924.00 ","$1,900.60 ",$480.83 ,"$3,219.59 ","$2,924.00 ","$2,178.38 ","$1,915.22 ","$1,485.64 ",$818.72 ,"$1,476.62 ","$1,485.64 ","$1,804.11 ","$1,485.64 ","$1,804.11 ","$1,804.11 ","$1,485.64 ","$1,804.11 ","$2,822.72 ","$2,631.60 ","$2,193.00 ","$2,924.00 ","$1,485.64 ","$2,573.12 ","$1,485.64 ","$2,193.00 ","$2,193.00 ","$2,485.40 ","$2,485.40 ","$1,485.64 ","$2,485.40 ","$1,485.64 ","$2,280.72 ","$2,280.72 ","$2,280.72 ","$2,631.60 ","$2,924.00 ","$2,631.60 ","$1,485.64 ","$2,924.00 ","$1,915.22 ","$1,485.64 ","$1,216.38 ",$503.72 ,$480.83 ,"$1,555.00 ","$2,631.60 ","$3,219.59 ","$1,804.11 ",$818.72 ,"$2,631.60 ","$1,485.64 ","$2,631.60 ","$2,631.60 ","$1,485.64 ","$1,900.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000023,48102,HC BX PANCREAS NEEDLE PERC,350,1 ,"$2,239.00 ","$1,455.35 ",$480.83 ,"$3,219.59 ","$2,239.00 ","$1,668.06 ","$1,466.55 ","$1,485.64 ",$626.92 ,"$1,130.70 ","$1,485.64 ","$1,381.46 ","$1,485.64 ","$1,381.46 ","$1,381.46 ","$1,485.64 ","$1,381.46 ","$2,822.72 ","$2,015.10 ","$1,679.25 ","$2,239.00 ","$1,485.64 ","$1,970.32 ","$1,485.64 ","$1,679.25 ","$1,679.25 ","$1,903.15 ","$1,903.15 ","$1,485.64 ","$1,903.15 ","$1,485.64 ","$1,746.42 ","$1,746.42 ","$1,746.42 ","$2,015.10 ","$2,239.00 ","$2,015.10 ","$1,485.64 ","$2,239.00 ","$1,466.55 ","$1,485.64 ",$931.42 ,$503.72 ,$480.83 ,"$1,555.00 ","$2,015.10 ","$3,219.59 ","$1,381.46 ",$626.92 ,"$2,015.10 ","$1,485.64 ","$2,015.10 ","$2,015.10 ","$1,485.64 ","$1,455.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000025,49180,HC ABDOM/RETRO/MASS BIOP,350,1 ,"$2,475.00 ","$1,608.75 ",$422.78 ,"$3,219.59 ","$2,475.00 ","$1,843.88 ","$1,621.13 ","$1,485.64 ",$693.00 ,"$1,249.88 ","$1,485.64 ","$1,527.08 ","$1,485.64 ","$1,527.08 ","$1,527.08 ","$1,485.64 ","$1,527.08 ","$2,822.72 ","$2,227.50 ","$1,856.25 ","$2,475.00 ","$1,485.64 ","$2,178.00 ","$1,485.64 ","$1,856.25 ","$1,856.25 ","$2,103.75 ","$2,103.75 ","$1,485.64 ","$2,103.75 ","$1,485.64 ","$1,930.50 ","$1,930.50 ","$1,930.50 ","$2,227.50 ","$2,475.00 ","$2,227.50 ","$1,485.64 ","$2,475.00 ","$1,621.13 ","$1,485.64 ","$1,029.60 ",$442.92 ,$422.78 ,"$1,555.00 ","$2,227.50 ","$3,219.59 ","$1,527.08 ",$693.00 ,"$2,227.50 ","$1,485.64 ","$2,227.50 ","$2,227.50 ","$1,485.64 ","$1,608.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000026,50200,"HC PERC BIOPSY/KIDNEY, NEEDLE",350,1 ,"$1,461.00 ",$949.65 ,$409.08 ,"$3,219.59 ","$1,461.00 ","$1,088.45 ",$956.96 ,"$1,461.00 ",$409.08 ,$737.81 ,"$1,461.00 ",$901.44 ,"$1,461.00 ",$901.44 ,$901.44 ,"$1,461.00 ",$901.44 ,"$2,822.72 ","$1,314.90 ","$1,095.75 ","$1,461.00 ","$1,461.00 ","$1,285.68 ","$1,461.00 ","$1,095.75 ","$1,095.75 ","$1,241.85 ","$1,241.85 ","$1,461.00 ","$1,241.85 ","$1,461.00 ","$1,139.58 ","$1,139.58 ","$1,139.58 ","$1,314.90 ","$1,461.00 ","$1,314.90 ","$1,461.00 ","$1,461.00 ",$956.96 ,"$1,461.00 ",$607.78 ,$442.92 ,$422.78 ,"$1,461.00 ","$1,314.90 ","$3,219.59 ",$901.44 ,$409.08 ,"$1,314.90 ","$1,461.00 ","$1,314.90 ","$1,314.90 ","$1,461.00 ",$949.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000026,50200,"HC PERC BIOPSY/KIDNEY, NEEDLE",350,1 ,"$2,192.00 ","$1,424.80 ",$613.76 ,"$3,219.59 ","$2,192.00 ","$1,633.04 ","$1,435.76 ","$1,485.64 ",$613.76 ,"$1,106.96 ","$1,485.64 ","$1,352.46 ","$1,485.64 ","$1,352.46 ","$1,352.46 ","$1,485.64 ","$1,352.46 ","$2,822.72 ","$1,972.80 ","$1,644.00 ","$2,192.00 ","$1,485.64 ","$1,928.96 ","$1,485.64 ","$1,644.00 ","$1,644.00 ","$1,863.20 ","$1,863.20 ","$1,485.64 ","$1,863.20 ","$1,485.64 ","$1,709.76 ","$1,709.76 ","$1,709.76 ","$1,972.80 ","$2,192.00 ","$1,972.80 ","$1,485.64 ","$2,192.00 ","$1,435.76 ","$1,485.64 ",$911.87 ,$664.37 ,$634.17 ,"$1,555.00 ","$1,972.80 ","$3,219.59 ","$1,352.46 ",$613.76 ,"$1,972.80 ","$1,485.64 ","$1,972.80 ","$1,972.80 ","$1,485.64 ","$1,424.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000027,50390,HC RENAL CYST/PELVIS ASP/INJ,350,1 ,"$2,979.00 ","$1,936.35 ",$634.17 ,"$2,979.00 ","$2,365.96 ","$2,219.36 ","$1,951.25 ",$985.59 ,$834.12 ,"$1,504.40 ",$985.59 ,"$1,838.04 ",$985.59 ,"$1,838.04 ","$1,838.04 ",$985.59 ,"$1,838.04 ","$1,872.62 ","$2,681.10 ","$2,234.25 ","$2,365.96 ",$985.59 ,"$2,621.52 ",$985.59 ,"$2,234.25 ","$2,234.25 ","$2,532.15 ","$2,532.15 ",$985.59 ,"$2,532.15 ",$985.59 ,"$2,323.62 ","$2,323.62 ","$2,323.62 ","$2,681.10 ","$2,365.96 ","$2,681.10 ",$985.59 ,"$2,979.00 ","$1,951.25 ",$985.59 ,"$1,239.26 ",$664.37 ,$634.17 ,"$1,031.60 ","$2,681.10 ","$2,135.90 ","$1,838.04 ",$834.12 ,"$2,681.10 ",$985.59 ,"$2,681.10 ","$2,681.10 ",$985.59 ,"$1,936.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000027,50390,HC RENAL CYST/PELVIS ASP/INJ,350,1 ,"$1,986.00 ","$1,290.90 ",$422.78 ,"$1,986.00 ","$1,577.31 ","$1,479.57 ","$1,300.83 ",$657.06 ,$556.08 ,"$1,002.93 ",$657.06 ,"$1,225.36 ",$657.06 ,"$1,225.36 ","$1,225.36 ",$657.06 ,"$1,225.36 ","$1,248.41 ","$1,787.40 ","$1,489.50 ","$1,577.31 ",$657.06 ,"$1,747.68 ",$657.06 ,"$1,489.50 ","$1,489.50 ","$1,688.10 ","$1,688.10 ",$657.06 ,"$1,688.10 ",$657.06 ,"$1,549.08 ","$1,549.08 ","$1,549.08 ","$1,787.40 ","$1,577.31 ","$1,787.40 ",$657.06 ,"$1,986.00 ","$1,300.83 ",$657.06 ,$826.18 ,$442.92 ,$422.78 ,$687.73 ,"$1,787.40 ","$1,423.93 ","$1,225.36 ",$556.08 ,"$1,787.40 ",$657.06 ,"$1,787.40 ","$1,787.40 ",$657.06 ,"$1,290.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000028,60100,HC BX THYROID NEEDLE PERC,350,1 ,"$1,495.00 ",$971.75 ,$418.60 ,"$1,495.00 ","$1,495.00 ","$1,113.78 ",$979.23 ,$657.06 ,$418.60 ,$754.98 ,$657.06 ,$922.42 ,$657.06 ,$922.42 ,$922.42 ,$657.06 ,$922.42 ,"$1,248.41 ","$1,345.50 ","$1,121.25 ","$1,495.00 ",$657.06 ,"$1,315.60 ",$657.06 ,"$1,121.25 ","$1,121.25 ","$1,270.75 ","$1,270.75 ",$657.06 ,"$1,270.75 ",$657.06 ,"$1,166.10 ","$1,166.10 ","$1,166.10 ","$1,345.50 ","$1,495.00 ","$1,345.50 ",$657.06 ,"$1,495.00 ",$979.23 ,$657.06 ,$621.92 ,$442.92 ,$422.78 ,$687.73 ,"$1,345.50 ","$1,423.93 ",$922.42 ,$418.60 ,"$1,345.50 ",$657.06 ,"$1,345.50 ","$1,345.50 ",$657.06 ,$971.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000032,64430,HC INJ ANEST AGENT PUDENDAL NERVE,350,1 ,"$1,994.00 ","$1,296.10 ",$305.67 ,"$1,994.00 ","$1,994.00 ","$1,485.53 ","$1,306.07 ",$869.20 ,$558.32 ,"$1,006.97 ",$869.20 ,"$1,230.30 ",$869.20 ,"$1,230.30 ","$1,230.30 ",$869.20 ,"$1,230.30 ","$1,651.48 ","$1,794.60 ","$1,495.50 ","$1,994.00 ",$869.20 ,"$1,754.72 ",$869.20 ,"$1,495.50 ","$1,495.50 ","$1,694.90 ","$1,694.90 ",$869.20 ,"$1,694.90 ",$869.20 ,"$1,555.32 ","$1,555.32 ","$1,555.32 ","$1,794.60 ","$1,994.00 ","$1,794.60 ",$869.20 ,"$1,994.00 ","$1,306.07 ",$869.20 ,$829.50 ,$320.22 ,$305.67 ,$909.77 ,"$1,794.60 ","$1,883.66 ","$1,230.30 ",$558.32 ,"$1,794.60 ",$869.20 ,"$1,794.60 ","$1,794.60 ",$869.20 ,"$1,296.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$2,302.00 ","$1,496.30 ",$114.95 ,"$2,302.00 ",$275.96 ,"$1,714.99 ","$1,507.81 ",$114.95 ,$644.56 ,"$1,162.51 ",$114.95 ,"$1,420.33 ",$114.95 ,"$1,420.33 ","$1,420.33 ",$114.95 ,"$1,420.33 ",$218.41 ,"$2,071.80 ","$1,726.50 ",$275.96 ,$114.95 ,"$2,025.76 ",$114.95 ,"$1,726.50 ","$1,726.50 ","$1,956.70 ","$1,956.70 ",$114.95 ,"$1,956.70 ",$114.95 ,"$1,795.56 ","$1,795.56 ","$1,795.56 ","$2,071.80 ",$275.96 ,"$2,071.80 ",$114.95 ,"$2,302.00 ","$1,507.81 ",$114.95 ,$957.63 ,$208.07 ,$198.61 ,$120.32 ,"$2,071.80 ",$249.12 ,"$1,420.33 ",$644.56 ,"$2,071.80 ",$114.95 ,"$2,071.80 ","$2,071.80 ",$114.95 ,"$1,496.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$3,177.00 ","$2,065.05 ",$188.61 ,"$3,177.00 ",$452.76 ,"$2,366.87 ","$2,080.94 ",$188.61 ,$889.56 ,"$1,604.39 ",$188.61 ,"$1,960.21 ",$188.61 ,"$1,960.21 ","$1,960.21 ",$188.61 ,"$1,960.21 ",$358.36 ,"$2,859.30 ","$2,382.75 ",$452.76 ,$188.61 ,"$2,795.76 ",$188.61 ,"$2,382.75 ","$2,382.75 ","$2,700.45 ","$2,700.45 ",$188.61 ,"$2,700.45 ",$188.61 ,"$2,478.06 ","$2,478.06 ","$2,478.06 ","$2,859.30 ",$452.76 ,"$2,859.30 ",$188.61 ,"$3,177.00 ","$2,080.94 ",$188.61 ,"$1,321.63 ",$208.07 ,$198.61 ,$197.41 ,"$2,859.30 ",$408.74 ,"$1,960.21 ",$889.56 ,"$2,859.30 ",$188.61 ,"$2,859.30 ","$2,859.30 ",$188.61 ,"$2,065.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$3,496.00 ","$2,272.40 ",$188.61 ,"$3,496.00 ",$452.76 ,"$2,604.52 ","$2,289.88 ",$188.61 ,$978.88 ,"$1,765.48 ",$188.61 ,"$2,157.03 ",$188.61 ,"$2,157.03 ","$2,157.03 ",$188.61 ,"$2,157.03 ",$358.36 ,"$3,146.40 ","$2,622.00 ",$452.76 ,$188.61 ,"$3,076.48 ",$188.61 ,"$2,622.00 ","$2,622.00 ","$2,971.60 ","$2,971.60 ",$188.61 ,"$2,971.60 ",$188.61 ,"$2,726.88 ","$2,726.88 ","$2,726.88 ","$3,146.40 ",$452.76 ,"$3,146.40 ",$188.61 ,"$3,496.00 ","$2,289.88 ",$188.61 ,"$1,454.34 ",$208.07 ,$198.61 ,$197.41 ,"$3,146.40 ",$408.74 ,"$2,157.03 ",$978.88 ,"$3,146.40 ",$188.61 ,"$3,146.40 ","$3,146.40 ",$188.61 ,"$2,272.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$2,947.00 ","$1,915.55 ",$96.51 ,"$2,947.00 ",$275.96 ,"$2,195.52 ","$1,930.29 ",$114.95 ,$825.16 ,"$1,488.24 ",$114.95 ,"$1,818.30 ",$114.95 ,"$1,818.30 ","$1,818.30 ",$114.95 ,"$1,818.30 ",$218.41 ,"$2,652.30 ","$2,210.25 ",$275.96 ,$114.95 ,"$2,593.36 ",$114.95 ,"$2,210.25 ","$2,210.25 ","$2,504.95 ","$2,504.95 ",$114.95 ,"$2,504.95 ",$114.95 ,"$2,298.66 ","$2,298.66 ","$2,298.66 ","$2,652.30 ",$275.96 ,"$2,652.30 ",$114.95 ,"$2,947.00 ","$1,930.29 ",$114.95 ,"$1,225.95 ",$101.10 ,$96.51 ,$120.32 ,"$2,652.30 ",$249.12 ,"$1,818.30 ",$825.16 ,"$2,652.30 ",$114.95 ,"$2,652.30 ","$2,652.30 ",$114.95 ,"$1,915.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$3,536.00 ","$2,298.40 ",$96.51 ,"$3,536.00 ",$452.76 ,"$2,634.32 ","$2,316.08 ",$188.61 ,$990.08 ,"$1,785.68 ",$188.61 ,"$2,181.71 ",$188.61 ,"$2,181.71 ","$2,181.71 ",$188.61 ,"$2,181.71 ",$358.36 ,"$3,182.40 ","$2,652.00 ",$452.76 ,$188.61 ,"$3,111.68 ",$188.61 ,"$2,652.00 ","$2,652.00 ","$3,005.60 ","$3,005.60 ",$188.61 ,"$3,005.60 ",$188.61 ,"$2,758.08 ","$2,758.08 ","$2,758.08 ","$3,182.40 ",$452.76 ,"$3,182.40 ",$188.61 ,"$3,536.00 ","$2,316.08 ",$188.61 ,"$1,470.98 ",$101.10 ,$96.51 ,$197.41 ,"$3,182.40 ",$408.74 ,"$2,181.71 ",$990.08 ,"$3,182.40 ",$188.61 ,"$3,182.40 ","$3,182.40 ",$188.61 ,"$2,298.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$4,126.00 ","$2,681.90 ",$96.51 ,"$4,126.00 ",$452.76 ,"$3,073.87 ","$2,702.53 ",$188.61 ,"$1,155.28 ","$2,083.63 ",$188.61 ,"$2,545.74 ",$188.61 ,"$2,545.74 ","$2,545.74 ",$188.61 ,"$2,545.74 ",$358.36 ,"$3,713.40 ","$3,094.50 ",$452.76 ,$188.61 ,"$3,630.88 ",$188.61 ,"$3,094.50 ","$3,094.50 ","$3,507.10 ","$3,507.10 ",$188.61 ,"$3,507.10 ",$188.61 ,"$3,218.28 ","$3,218.28 ","$3,218.28 ","$3,713.40 ",$452.76 ,"$3,713.40 ",$188.61 ,"$4,126.00 ","$2,702.53 ",$188.61 ,"$1,716.42 ",$101.10 ,$96.51 ,$197.41 ,"$3,713.40 ",$408.74 ,"$2,545.74 ","$1,155.28 ","$3,713.40 ",$188.61 ,"$3,713.40 ","$3,713.40 ",$188.61 ,"$2,681.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$3,205.00 ","$2,083.25 ",$96.51 ,"$3,205.00 ",$275.96 ,"$2,387.73 ","$2,099.28 ",$114.95 ,$897.40 ,"$1,618.53 ",$114.95 ,"$1,977.49 ",$114.95 ,"$1,977.49 ","$1,977.49 ",$114.95 ,"$1,977.49 ",$218.41 ,"$2,884.50 ","$2,403.75 ",$275.96 ,$114.95 ,"$2,820.40 ",$114.95 ,"$2,403.75 ","$2,403.75 ","$2,724.25 ","$2,724.25 ",$114.95 ,"$2,724.25 ",$114.95 ,"$2,499.90 ","$2,499.90 ","$2,499.90 ","$2,884.50 ",$275.96 ,"$2,884.50 ",$114.95 ,"$3,205.00 ","$2,099.28 ",$114.95 ,"$1,333.28 ",$101.10 ,$96.51 ,$120.32 ,"$2,884.50 ",$249.12 ,"$1,977.49 ",$897.40 ,"$2,884.50 ",$114.95 ,"$2,884.50 ","$2,884.50 ",$114.95 ,"$2,083.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$3,847.00 ","$2,500.55 ",$96.51 ,"$3,847.00 ",$452.76 ,"$2,866.02 ","$2,519.79 ",$188.61 ,"$1,077.16 ","$1,942.74 ",$188.61 ,"$2,373.60 ",$188.61 ,"$2,373.60 ","$2,373.60 ",$188.61 ,"$2,373.60 ",$358.36 ,"$3,462.30 ","$2,885.25 ",$452.76 ,$188.61 ,"$3,385.36 ",$188.61 ,"$2,885.25 ","$2,885.25 ","$3,269.95 ","$3,269.95 ",$188.61 ,"$3,269.95 ",$188.61 ,"$3,000.66 ","$3,000.66 ","$3,000.66 ","$3,462.30 ",$452.76 ,"$3,462.30 ",$188.61 ,"$3,847.00 ","$2,519.79 ",$188.61 ,"$1,600.35 ",$101.10 ,$96.51 ,$197.41 ,"$3,462.30 ",$408.74 ,"$2,373.60 ","$1,077.16 ","$3,462.30 ",$188.61 ,"$3,462.30 ","$3,462.30 ",$188.61 ,"$2,500.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$4,488.00 ","$2,917.20 ",$96.51 ,"$4,488.00 ",$452.76 ,"$3,343.56 ","$2,939.64 ",$188.61 ,"$1,256.64 ","$2,266.44 ",$188.61 ,"$2,769.10 ",$188.61 ,"$2,769.10 ","$2,769.10 ",$188.61 ,"$2,769.10 ",$358.36 ,"$4,039.20 ","$3,366.00 ",$452.76 ,$188.61 ,"$3,949.44 ",$188.61 ,"$3,366.00 ","$3,366.00 ","$3,814.80 ","$3,814.80 ",$188.61 ,"$3,814.80 ",$188.61 ,"$3,500.64 ","$3,500.64 ","$3,500.64 ","$4,039.20 ",$452.76 ,"$4,039.20 ",$188.61 ,"$4,488.00 ","$2,939.64 ",$188.61 ,"$1,867.01 ",$101.10 ,$96.51 ,$197.41 ,"$4,039.20 ",$408.74 ,"$2,769.10 ","$1,256.64 ","$4,039.20 ",$188.61 ,"$4,039.20 ","$4,039.20 ",$188.61 ,"$2,917.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$2,471.00 ","$1,606.15 ",$96.51 ,"$2,471.00 ",$275.96 ,"$1,840.90 ","$1,618.51 ",$114.95 ,$691.88 ,"$1,247.86 ",$114.95 ,"$1,524.61 ",$114.95 ,"$1,524.61 ","$1,524.61 ",$114.95 ,"$1,524.61 ",$218.41 ,"$2,223.90 ","$1,853.25 ",$275.96 ,$114.95 ,"$2,174.48 ",$114.95 ,"$1,853.25 ","$1,853.25 ","$2,100.35 ","$2,100.35 ",$114.95 ,"$2,100.35 ",$114.95 ,"$1,927.38 ","$1,927.38 ","$1,927.38 ","$2,223.90 ",$275.96 ,"$2,223.90 ",$114.95 ,"$2,471.00 ","$1,618.51 ",$114.95 ,"$1,027.94 ",$101.10 ,$96.51 ,$120.32 ,"$2,223.90 ",$249.12 ,"$1,524.61 ",$691.88 ,"$2,223.90 ",$114.95 ,"$2,223.90 ","$2,223.90 ",$114.95 ,"$1,606.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$3,505.00 ","$2,278.25 ",$96.51 ,"$3,505.00 ",$452.76 ,"$2,611.23 ","$2,295.78 ",$188.61 ,$981.40 ,"$1,770.03 ",$188.61 ,"$2,162.59 ",$188.61 ,"$2,162.59 ","$2,162.59 ",$188.61 ,"$2,162.59 ",$358.36 ,"$3,154.50 ","$2,628.75 ",$452.76 ,$188.61 ,"$3,084.40 ",$188.61 ,"$2,628.75 ","$2,628.75 ","$2,979.25 ","$2,979.25 ",$188.61 ,"$2,979.25 ",$188.61 ,"$2,733.90 ","$2,733.90 ","$2,733.90 ","$3,154.50 ",$452.76 ,"$3,154.50 ",$188.61 ,"$3,505.00 ","$2,295.78 ",$188.61 ,"$1,458.08 ",$101.10 ,$96.51 ,$197.41 ,"$3,154.50 ",$408.74 ,"$2,162.59 ",$981.40 ,"$3,154.50 ",$188.61 ,"$3,154.50 ","$3,154.50 ",$188.61 ,"$2,278.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$4,687.00 ","$3,046.55 ",$96.51 ,"$4,687.00 ",$452.76 ,"$3,491.82 ","$3,069.99 ",$188.61 ,"$1,312.36 ","$2,366.94 ",$188.61 ,"$2,891.88 ",$188.61 ,"$2,891.88 ","$2,891.88 ",$188.61 ,"$2,891.88 ",$358.36 ,"$4,218.30 ","$3,515.25 ",$452.76 ,$188.61 ,"$4,124.56 ",$188.61 ,"$3,515.25 ","$3,515.25 ","$3,983.95 ","$3,983.95 ",$188.61 ,"$3,983.95 ",$188.61 ,"$3,655.86 ","$3,655.86 ","$3,655.86 ","$4,218.30 ",$452.76 ,"$4,218.30 ",$188.61 ,"$4,687.00 ","$3,069.99 ",$188.61 ,"$1,949.79 ",$101.10 ,$96.51 ,$197.41 ,"$4,218.30 ",$408.74 ,"$2,891.88 ","$1,312.36 ","$4,218.30 ",$188.61 ,"$4,218.30 ","$4,218.30 ",$188.61 ,"$3,046.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$5,423.00 ","$3,524.95 ",$188.61 ,"$5,423.00 ",$452.76 ,"$4,040.14 ","$3,552.07 ",$188.61 ,"$1,518.44 ","$2,738.62 ",$188.61 ,"$3,345.99 ",$188.61 ,"$3,345.99 ","$3,345.99 ",$188.61 ,"$3,345.99 ",$358.36 ,"$4,880.70 ","$4,067.25 ",$452.76 ,$188.61 ,"$4,772.24 ",$188.61 ,"$4,067.25 ","$4,067.25 ","$4,609.55 ","$4,609.55 ",$188.61 ,"$4,609.55 ",$188.61 ,"$4,229.94 ","$4,229.94 ","$4,229.94 ","$4,880.70 ",$452.76 ,"$4,880.70 ",$188.61 ,"$5,423.00 ","$3,552.07 ",$188.61 ,"$2,255.97 ",$266.49 ,$254.37 ,$197.41 ,"$4,880.70 ",$408.74 ,"$3,345.99 ","$1,518.44 ","$4,880.70 ",$188.61 ,"$4,880.70 ","$4,880.70 ",$188.61 ,"$3,524.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$2,542.00 ","$1,652.30 ",$96.51 ,"$2,542.00 ",$452.76 ,"$1,893.79 ","$1,665.01 ",$188.61 ,$711.76 ,"$1,283.71 ",$188.61 ,"$1,568.41 ",$188.61 ,"$1,568.41 ","$1,568.41 ",$188.61 ,"$1,568.41 ",$358.36 ,"$2,287.80 ","$1,906.50 ",$452.76 ,$188.61 ,"$2,236.96 ",$188.61 ,"$1,906.50 ","$1,906.50 ","$2,160.70 ","$2,160.70 ",$188.61 ,"$2,160.70 ",$188.61 ,"$1,982.76 ","$1,982.76 ","$1,982.76 ","$2,287.80 ",$452.76 ,"$2,287.80 ",$188.61 ,"$2,542.00 ","$1,665.01 ",$188.61 ,"$1,057.47 ",$101.10 ,$96.51 ,$197.41 ,"$2,287.80 ",$408.74 ,"$1,568.41 ",$711.76 ,"$2,287.80 ",$188.61 ,"$2,287.80 ","$2,287.80 ",$188.61 ,"$1,652.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,235.00 ","$2,102.75 ",$240.78 ,"$3,235.00 ",$583.23 ,"$2,410.08 ","$2,118.93 ",$242.96 ,$905.80 ,"$1,633.68 ",$242.96 ,"$1,996.00 ",$242.96 ,"$1,996.00 ","$1,996.00 ",$242.96 ,"$1,996.00 ",$461.62 ,"$2,911.50 ","$2,426.25 ",$583.23 ,$242.96 ,"$2,846.80 ",$242.96 ,"$2,426.25 ","$2,426.25 ","$2,749.75 ","$2,749.75 ",$242.96 ,"$2,749.75 ",$242.96 ,"$2,523.30 ","$2,523.30 ","$2,523.30 ","$2,911.50 ",$583.23 ,"$2,911.50 ",$242.96 ,"$3,235.00 ","$2,118.93 ",$242.96 ,"$1,345.76 ",$252.24 ,$240.78 ,$254.30 ,"$2,911.50 ",$526.52 ,"$1,996.00 ",$905.80 ,"$2,911.50 ",$242.96 ,"$2,911.50 ","$2,911.50 ",$242.96 ,"$2,102.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$3,859.00 ","$2,508.35 ",$109.55 ,"$3,859.00 ",$275.96 ,"$2,874.96 ","$2,527.65 ",$114.95 ,"$1,080.52 ","$1,948.80 ",$114.95 ,"$2,381.00 ",$114.95 ,"$2,381.00 ","$2,381.00 ",$114.95 ,"$2,381.00 ",$218.41 ,"$3,473.10 ","$2,894.25 ",$275.96 ,$114.95 ,"$3,395.92 ",$114.95 ,"$2,894.25 ","$2,894.25 ","$3,280.15 ","$3,280.15 ",$114.95 ,"$3,280.15 ",$114.95 ,"$3,010.02 ","$3,010.02 ","$3,010.02 ","$3,473.10 ",$275.96 ,"$3,473.10 ",$114.95 ,"$3,859.00 ","$2,527.65 ",$114.95 ,"$1,605.34 ",$114.76 ,$109.55 ,$120.32 ,"$3,473.10 ",$249.12 ,"$2,381.00 ","$1,080.52 ","$3,473.10 ",$114.95 ,"$3,473.10 ","$3,473.10 ",$114.95 ,"$2,508.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$4,397.00 ","$2,858.05 ",$109.55 ,"$4,397.00 ",$933.39 ,"$3,275.77 ","$2,880.04 ",$388.82 ,"$1,231.16 ","$2,220.49 ",$388.82 ,"$2,712.95 ",$388.82 ,"$2,712.95 ","$2,712.95 ",$388.82 ,"$2,712.95 ",$738.76 ,"$3,957.30 ","$3,297.75 ",$933.39 ,$388.82 ,"$3,869.36 ",$388.82 ,"$3,297.75 ","$3,297.75 ","$3,737.45 ","$3,737.45 ",$388.82 ,"$3,737.45 ",$388.82 ,"$3,429.66 ","$3,429.66 ","$3,429.66 ","$3,957.30 ",$933.39 ,"$3,957.30 ",$388.82 ,"$4,397.00 ","$2,880.04 ",$388.82 ,"$1,829.15 ",$114.76 ,$109.55 ,$406.98 ,"$3,957.30 ",$842.63 ,"$2,712.95 ","$1,231.16 ","$3,957.30 ",$388.82 ,"$3,957.30 ","$3,957.30 ",$388.82 ,"$2,858.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,"$5,288.00 ","$3,437.20 ",$109.55 ,"$5,288.00 ",$452.76 ,"$3,939.56 ","$3,463.64 ",$188.61 ,"$1,480.64 ","$2,670.44 ",$188.61 ,"$3,262.70 ",$188.61 ,"$3,262.70 ","$3,262.70 ",$188.61 ,"$3,262.70 ",$358.36 ,"$4,759.20 ","$3,966.00 ",$452.76 ,$188.61 ,"$4,653.44 ",$188.61 ,"$3,966.00 ","$3,966.00 ","$4,494.80 ","$4,494.80 ",$188.61 ,"$4,494.80 ",$188.61 ,"$4,124.64 ","$4,124.64 ","$4,124.64 ","$4,759.20 ",$452.76 ,"$4,759.20 ",$188.61 ,"$5,288.00 ","$3,463.64 ",$188.61 ,"$2,199.81 ",$114.76 ,$109.55 ,$197.41 ,"$4,759.20 ",$408.74 ,"$3,262.70 ","$1,480.64 ","$4,759.20 ",$188.61 ,"$4,759.20 ","$4,759.20 ",$188.61 ,"$3,437.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$3,505.00 ","$2,278.25 ",$109.55 ,"$3,505.00 ",$275.96 ,"$2,611.23 ","$2,295.78 ",$114.95 ,$981.40 ,"$1,770.03 ",$114.95 ,"$2,162.59 ",$114.95 ,"$2,162.59 ","$2,162.59 ",$114.95 ,"$2,162.59 ",$218.41 ,"$3,154.50 ","$2,628.75 ",$275.96 ,$114.95 ,"$3,084.40 ",$114.95 ,"$2,628.75 ","$2,628.75 ","$2,979.25 ","$2,979.25 ",$114.95 ,"$2,979.25 ",$114.95 ,"$2,733.90 ","$2,733.90 ","$2,733.90 ","$3,154.50 ",$275.96 ,"$3,154.50 ",$114.95 ,"$3,505.00 ","$2,295.78 ",$114.95 ,"$1,458.08 ",$114.76 ,$109.55 ,$120.32 ,"$3,154.50 ",$249.12 ,"$2,162.59 ",$981.40 ,"$3,154.50 ",$114.95 ,"$3,154.50 ","$3,154.50 ",$114.95 ,"$2,278.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$4,205.00 ","$2,733.25 ",$109.55 ,"$4,205.00 ",$452.76 ,"$3,132.73 ","$2,754.28 ",$188.61 ,"$1,177.40 ","$2,123.53 ",$188.61 ,"$2,594.49 ",$188.61 ,"$2,594.49 ","$2,594.49 ",$188.61 ,"$2,594.49 ",$358.36 ,"$3,784.50 ","$3,153.75 ",$452.76 ,$188.61 ,"$3,700.40 ",$188.61 ,"$3,153.75 ","$3,153.75 ","$3,574.25 ","$3,574.25 ",$188.61 ,"$3,574.25 ",$188.61 ,"$3,279.90 ","$3,279.90 ","$3,279.90 ","$3,784.50 ",$452.76 ,"$3,784.50 ",$188.61 ,"$4,205.00 ","$2,754.28 ",$188.61 ,"$1,749.28 ",$114.76 ,$109.55 ,$197.41 ,"$3,784.50 ",$408.74 ,"$2,594.49 ","$1,177.40 ","$3,784.50 ",$188.61 ,"$3,784.50 ","$3,784.50 ",$188.61 ,"$2,733.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,"$4,497.00 ","$2,923.05 ",$109.55 ,"$4,497.00 ",$452.76 ,"$3,350.27 ","$2,945.54 ",$188.61 ,"$1,259.16 ","$2,270.99 ",$188.61 ,"$2,774.65 ",$188.61 ,"$2,774.65 ","$2,774.65 ",$188.61 ,"$2,774.65 ",$358.36 ,"$4,047.30 ","$3,372.75 ",$452.76 ,$188.61 ,"$3,957.36 ",$188.61 ,"$3,372.75 ","$3,372.75 ","$3,822.45 ","$3,822.45 ",$188.61 ,"$3,822.45 ",$188.61 ,"$3,507.66 ","$3,507.66 ","$3,507.66 ","$4,047.30 ",$452.76 ,"$4,047.30 ",$188.61 ,"$4,497.00 ","$2,945.54 ",$188.61 ,"$1,870.75 ",$114.76 ,$109.55 ,$197.41 ,"$4,047.30 ",$408.74 ,"$2,774.65 ","$1,259.16 ","$4,047.30 ",$188.61 ,"$4,047.30 ","$4,047.30 ",$188.61 ,"$2,923.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$3,500.00 ","$2,275.00 ",$109.55 ,"$3,500.00 ",$275.96 ,"$2,607.50 ","$2,292.50 ",$114.95 ,$980.00 ,"$1,767.50 ",$114.95 ,"$2,159.50 ",$114.95 ,"$2,159.50 ","$2,159.50 ",$114.95 ,"$2,159.50 ",$218.41 ,"$3,150.00 ","$2,625.00 ",$275.96 ,$114.95 ,"$3,080.00 ",$114.95 ,"$2,625.00 ","$2,625.00 ","$2,975.00 ","$2,975.00 ",$114.95 ,"$2,975.00 ",$114.95 ,"$2,730.00 ","$2,730.00 ","$2,730.00 ","$3,150.00 ",$275.96 ,"$3,150.00 ",$114.95 ,"$3,500.00 ","$2,292.50 ",$114.95 ,"$1,456.00 ",$114.76 ,$109.55 ,$120.32 ,"$3,150.00 ",$249.12 ,"$2,159.50 ",$980.00 ,"$3,150.00 ",$114.95 ,"$3,150.00 ","$3,150.00 ",$114.95 ,"$2,275.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$4,620.00 ","$3,003.00 ",$109.55 ,"$4,620.00 ",$933.39 ,"$3,441.90 ","$3,026.10 ",$388.82 ,"$1,293.60 ","$2,333.10 ",$388.82 ,"$2,850.54 ",$388.82 ,"$2,850.54 ","$2,850.54 ",$388.82 ,"$2,850.54 ",$738.76 ,"$4,158.00 ","$3,465.00 ",$933.39 ,$388.82 ,"$4,065.60 ",$388.82 ,"$3,465.00 ","$3,465.00 ","$3,927.00 ","$3,927.00 ",$388.82 ,"$3,927.00 ",$388.82 ,"$3,603.60 ","$3,603.60 ","$3,603.60 ","$4,158.00 ",$933.39 ,"$4,158.00 ",$388.82 ,"$4,620.00 ","$3,026.10 ",$388.82 ,"$1,921.92 ",$114.76 ,$109.55 ,$406.98 ,"$4,158.00 ",$842.63 ,"$2,850.54 ","$1,293.60 ","$4,158.00 ",$388.82 ,"$4,158.00 ","$4,158.00 ",$388.82 ,"$3,003.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$5,296.00 ","$3,442.40 ",$109.55 ,"$5,296.00 ",$452.76 ,"$3,945.52 ","$3,468.88 ",$188.61 ,"$1,482.88 ","$2,674.48 ",$188.61 ,"$3,267.63 ",$188.61 ,"$3,267.63 ","$3,267.63 ",$188.61 ,"$3,267.63 ",$358.36 ,"$4,766.40 ","$3,972.00 ",$452.76 ,$188.61 ,"$4,660.48 ",$188.61 ,"$3,972.00 ","$3,972.00 ","$4,501.60 ","$4,501.60 ",$188.61 ,"$4,501.60 ",$188.61 ,"$4,130.88 ","$4,130.88 ","$4,130.88 ","$4,766.40 ",$452.76 ,"$4,766.40 ",$188.61 ,"$5,296.00 ","$3,468.88 ",$188.61 ,"$2,203.14 ",$114.76 ,$109.55 ,$197.41 ,"$4,766.40 ",$408.74 ,"$3,267.63 ","$1,482.88 ","$4,766.40 ",$188.61 ,"$4,766.40 ","$4,766.40 ",$188.61 ,"$3,442.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$5,070.00 ","$3,295.50 ",$188.61 ,"$5,070.00 ",$452.76 ,"$3,777.15 ","$3,320.85 ",$188.61 ,"$1,419.60 ","$2,560.35 ",$188.61 ,"$3,128.19 ",$188.61 ,"$3,128.19 ","$3,128.19 ",$188.61 ,"$3,128.19 ",$358.36 ,"$4,563.00 ","$3,802.50 ",$452.76 ,$188.61 ,"$4,461.60 ",$188.61 ,"$3,802.50 ","$3,802.50 ","$4,309.50 ","$4,309.50 ",$188.61 ,"$4,309.50 ",$188.61 ,"$3,954.60 ","$3,954.60 ","$3,954.60 ","$4,563.00 ",$452.76 ,"$4,563.00 ",$188.61 ,"$5,070.00 ","$3,320.85 ",$188.61 ,"$2,109.12 ",$228.49 ,$218.11 ,$197.41 ,"$4,563.00 ",$408.74 ,"$3,128.19 ","$1,419.60 ","$4,563.00 ",$188.61 ,"$4,563.00 ","$4,563.00 ",$188.61 ,"$3,295.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$2,801.00 ","$1,820.65 ",$114.95 ,"$2,801.00 ",$275.96 ,"$2,086.75 ","$1,834.66 ",$114.95 ,$784.28 ,"$1,414.51 ",$114.95 ,"$1,728.22 ",$114.95 ,"$1,728.22 ","$1,728.22 ",$114.95 ,"$1,728.22 ",$218.41 ,"$2,520.90 ","$2,100.75 ",$275.96 ,$114.95 ,"$2,464.88 ",$114.95 ,"$2,100.75 ","$2,100.75 ","$2,380.85 ","$2,380.85 ",$114.95 ,"$2,380.85 ",$114.95 ,"$2,184.78 ","$2,184.78 ","$2,184.78 ","$2,520.90 ",$275.96 ,"$2,520.90 ",$114.95 ,"$2,801.00 ","$1,834.66 ",$114.95 ,"$1,165.22 ",$228.71 ,$218.32 ,$120.32 ,"$2,520.90 ",$249.12 ,"$1,728.22 ",$784.28 ,"$2,520.90 ",$114.95 ,"$2,520.90 ","$2,520.90 ",$114.95 ,"$1,820.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$3,332.00 ","$2,165.80 ",$188.61 ,"$3,332.00 ",$452.76 ,"$2,482.34 ","$2,182.46 ",$188.61 ,$932.96 ,"$1,682.66 ",$188.61 ,"$2,055.84 ",$188.61 ,"$2,055.84 ","$2,055.84 ",$188.61 ,"$2,055.84 ",$358.36 ,"$2,998.80 ","$2,499.00 ",$452.76 ,$188.61 ,"$2,932.16 ",$188.61 ,"$2,499.00 ","$2,499.00 ","$2,832.20 ","$2,832.20 ",$188.61 ,"$2,832.20 ",$188.61 ,"$2,598.96 ","$2,598.96 ","$2,598.96 ","$2,998.80 ",$452.76 ,"$2,998.80 ",$188.61 ,"$3,332.00 ","$2,182.46 ",$188.61 ,"$1,386.11 ",$228.71 ,$218.32 ,$197.41 ,"$2,998.80 ",$408.74 ,"$2,055.84 ",$932.96 ,"$2,998.80 ",$188.61 ,"$2,998.80 ","$2,998.80 ",$188.61 ,"$2,165.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$3,730.00 ","$2,424.50 ",$188.61 ,"$3,730.00 ",$452.76 ,"$2,778.85 ","$2,443.15 ",$188.61 ,"$1,044.40 ","$1,883.65 ",$188.61 ,"$2,301.41 ",$188.61 ,"$2,301.41 ","$2,301.41 ",$188.61 ,"$2,301.41 ",$358.36 ,"$3,357.00 ","$2,797.50 ",$452.76 ,$188.61 ,"$3,282.40 ",$188.61 ,"$2,797.50 ","$2,797.50 ","$3,170.50 ","$3,170.50 ",$188.61 ,"$3,170.50 ",$188.61 ,"$2,909.40 ","$2,909.40 ","$2,909.40 ","$3,357.00 ",$452.76 ,"$3,357.00 ",$188.61 ,"$3,730.00 ","$2,443.15 ",$188.61 ,"$1,551.68 ",$228.71 ,$218.32 ,$197.41 ,"$3,357.00 ",$408.74 ,"$2,301.41 ","$1,044.40 ","$3,357.00 ",$188.61 ,"$3,357.00 ","$3,357.00 ",$188.61 ,"$2,424.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,418.00 ","$1,571.70 ",$96.51 ,"$2,418.00 ",$275.96 ,"$1,801.41 ","$1,583.79 ",$114.95 ,$677.04 ,"$1,221.09 ",$114.95 ,"$1,491.91 ",$114.95 ,"$1,491.91 ","$1,491.91 ",$114.95 ,"$1,491.91 ",$218.41 ,"$2,176.20 ","$1,813.50 ",$275.96 ,$114.95 ,"$2,127.84 ",$114.95 ,"$1,813.50 ","$1,813.50 ","$2,055.30 ","$2,055.30 ",$114.95 ,"$2,055.30 ",$114.95 ,"$1,886.04 ","$1,886.04 ","$1,886.04 ","$2,176.20 ",$275.96 ,"$2,176.20 ",$114.95 ,"$2,418.00 ","$1,583.79 ",$114.95 ,"$1,005.89 ",$101.10 ,$96.51 ,$120.32 ,"$2,176.20 ",$249.12 ,"$1,491.91 ",$677.04 ,"$2,176.20 ",$114.95 ,"$2,176.20 ","$2,176.20 ",$114.95 ,"$1,571.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$3,628.00 ","$2,358.20 ",$144.76 ,"$3,628.00 ",$568.46 ,"$2,702.86 ","$2,376.34 ",$236.81 ,"$1,015.84 ","$1,832.14 ",$236.81 ,"$2,238.48 ",$236.81 ,"$2,238.48 ","$2,238.48 ",$236.81 ,"$2,238.48 ",$449.94 ,"$3,265.20 ","$2,721.00 ",$568.46 ,$236.81 ,"$3,192.64 ",$236.81 ,"$2,721.00 ","$2,721.00 ","$3,083.80 ","$3,083.80 ",$236.81 ,"$3,083.80 ",$236.81 ,"$2,829.84 ","$2,829.84 ","$2,829.84 ","$3,265.20 ",$568.46 ,"$3,265.20 ",$236.81 ,"$3,628.00 ","$2,376.34 ",$236.81 ,"$1,509.25 ",$151.66 ,$144.76 ,$247.86 ,"$3,265.20 ",$513.19 ,"$2,238.48 ","$1,015.84 ","$3,265.20 ",$236.81 ,"$3,265.20 ","$3,265.20 ",$236.81 ,"$2,358.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$2,822.00 ","$1,834.30 ",$96.51 ,"$2,822.00 ",$933.39 ,"$2,102.39 ","$1,848.41 ",$388.82 ,$790.16 ,"$1,425.11 ",$388.82 ,"$1,741.17 ",$388.82 ,"$1,741.17 ","$1,741.17 ",$388.82 ,"$1,741.17 ",$738.76 ,"$2,539.80 ","$2,116.50 ",$933.39 ,$388.82 ,"$2,483.36 ",$388.82 ,"$2,116.50 ","$2,116.50 ","$2,398.70 ","$2,398.70 ",$388.82 ,"$2,398.70 ",$388.82 ,"$2,201.16 ","$2,201.16 ","$2,201.16 ","$2,539.80 ",$933.39 ,"$2,539.80 ",$388.82 ,"$2,822.00 ","$1,848.41 ",$388.82 ,"$1,173.95 ",$101.10 ,$96.51 ,$406.98 ,"$2,539.80 ",$842.63 ,"$1,741.17 ",$790.16 ,"$2,539.80 ",$388.82 ,"$2,539.80 ","$2,539.80 ",$388.82 ,"$1,834.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$3,443.00 ","$2,237.95 ",$96.51 ,"$3,443.00 ",$452.76 ,"$2,565.04 ","$2,255.17 ",$188.61 ,$964.04 ,"$1,738.72 ",$188.61 ,"$2,124.33 ",$188.61 ,"$2,124.33 ","$2,124.33 ",$188.61 ,"$2,124.33 ",$358.36 ,"$3,098.70 ","$2,582.25 ",$452.76 ,$188.61 ,"$3,029.84 ",$188.61 ,"$2,582.25 ","$2,582.25 ","$2,926.55 ","$2,926.55 ",$188.61 ,"$2,926.55 ",$188.61 ,"$2,685.54 ","$2,685.54 ","$2,685.54 ","$3,098.70 ",$452.76 ,"$3,098.70 ",$188.61 ,"$3,443.00 ","$2,255.17 ",$188.61 ,"$1,432.29 ",$101.10 ,$96.51 ,$197.41 ,"$3,098.70 ",$408.74 ,"$2,124.33 ",$964.04 ,"$3,098.70 ",$188.61 ,"$3,098.70 ","$3,098.70 ",$188.61 ,"$2,237.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$5,164.00 ","$3,356.60 ",$144.76 ,"$5,164.00 ","$1,103.33 ","$3,847.18 ","$3,382.42 ",$459.61 ,"$1,445.92 ","$2,607.82 ",$459.61 ,"$3,186.19 ",$459.61 ,"$3,186.19 ","$3,186.19 ",$459.61 ,"$3,186.19 ",$873.26 ,"$4,647.60 ","$3,873.00 ","$1,103.33 ",$459.61 ,"$4,544.32 ",$459.61 ,"$3,873.00 ","$3,873.00 ","$4,389.40 ","$4,389.40 ",$459.61 ,"$4,389.40 ",$459.61 ,"$4,027.92 ","$4,027.92 ","$4,027.92 ","$4,647.60 ","$1,103.33 ","$4,647.60 ",$459.61 ,"$5,164.00 ","$3,382.42 ",$459.61 ,"$2,148.22 ",$151.66 ,$144.76 ,$481.07 ,"$4,647.60 ",$996.04 ,"$3,186.19 ","$1,445.92 ","$4,647.60 ",$459.61 ,"$4,647.60 ","$4,647.60 ",$459.61 ,"$3,356.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$4,944.00 ","$3,213.60 ",$188.61 ,"$4,944.00 ",$452.76 ,"$3,683.28 ","$3,238.32 ",$188.61 ,"$1,384.32 ","$2,496.72 ",$188.61 ,"$3,050.45 ",$188.61 ,"$3,050.45 ","$3,050.45 ",$188.61 ,"$3,050.45 ",$358.36 ,"$4,449.60 ","$3,708.00 ",$452.76 ,$188.61 ,"$4,350.72 ",$188.61 ,"$3,708.00 ","$3,708.00 ","$4,202.40 ","$4,202.40 ",$188.61 ,"$4,202.40 ",$188.61 ,"$3,856.32 ","$3,856.32 ","$3,856.32 ","$4,449.60 ",$452.76 ,"$4,449.60 ",$188.61 ,"$4,944.00 ","$3,238.32 ",$188.61 ,"$2,056.70 ",$228.49 ,$218.11 ,$197.41 ,"$4,449.60 ",$408.74 ,"$3,050.45 ","$1,384.32 ","$4,449.60 ",$188.61 ,"$4,449.60 ","$4,449.60 ",$188.61 ,"$3,213.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,695.00 ","$1,751.75 ",$96.51 ,"$2,695.00 ",$275.96 ,"$2,007.78 ","$1,765.23 ",$114.95 ,$754.60 ,"$1,360.98 ",$114.95 ,"$1,662.82 ",$114.95 ,"$1,662.82 ","$1,662.82 ",$114.95 ,"$1,662.82 ",$218.41 ,"$2,425.50 ","$2,021.25 ",$275.96 ,$114.95 ,"$2,371.60 ",$114.95 ,"$2,021.25 ","$2,021.25 ","$2,290.75 ","$2,290.75 ",$114.95 ,"$2,290.75 ",$114.95 ,"$2,102.10 ","$2,102.10 ","$2,102.10 ","$2,425.50 ",$275.96 ,"$2,425.50 ",$114.95 ,"$2,695.00 ","$1,765.23 ",$114.95 ,"$1,121.12 ",$101.10 ,$96.51 ,$120.32 ,"$2,425.50 ",$249.12 ,"$1,662.82 ",$754.60 ,"$2,425.50 ",$114.95 ,"$2,425.50 ","$2,425.50 ",$114.95 ,"$1,751.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$4,042.00 ","$2,627.30 ",$144.76 ,"$4,042.00 ",$568.46 ,"$3,011.29 ","$2,647.51 ",$236.81 ,"$1,131.76 ","$2,041.21 ",$236.81 ,"$2,493.91 ",$236.81 ,"$2,493.91 ","$2,493.91 ",$236.81 ,"$2,493.91 ",$449.94 ,"$3,637.80 ","$3,031.50 ",$568.46 ,$236.81 ,"$3,556.96 ",$236.81 ,"$3,031.50 ","$3,031.50 ","$3,435.70 ","$3,435.70 ",$236.81 ,"$3,435.70 ",$236.81 ,"$3,152.76 ","$3,152.76 ","$3,152.76 ","$3,637.80 ",$568.46 ,"$3,637.80 ",$236.81 ,"$4,042.00 ","$2,647.51 ",$236.81 ,"$1,681.47 ",$151.66 ,$144.76 ,$247.86 ,"$3,637.80 ",$513.19 ,"$2,493.91 ","$1,131.76 ","$3,637.80 ",$236.81 ,"$3,637.80 ","$3,637.80 ",$236.81 ,"$2,627.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,965.00 ","$1,927.25 ",$96.51 ,"$2,965.00 ",$452.76 ,"$2,208.93 ","$1,942.08 ",$188.61 ,$830.20 ,"$1,497.33 ",$188.61 ,"$1,829.41 ",$188.61 ,"$1,829.41 ","$1,829.41 ",$188.61 ,"$1,829.41 ",$358.36 ,"$2,668.50 ","$2,223.75 ",$452.76 ,$188.61 ,"$2,609.20 ",$188.61 ,"$2,223.75 ","$2,223.75 ","$2,520.25 ","$2,520.25 ",$188.61 ,"$2,520.25 ",$188.61 ,"$2,312.70 ","$2,312.70 ","$2,312.70 ","$2,668.50 ",$452.76 ,"$2,668.50 ",$188.61 ,"$2,965.00 ","$1,942.08 ",$188.61 ,"$1,233.44 ",$101.10 ,$96.51 ,$197.41 ,"$2,668.50 ",$408.74 ,"$1,829.41 ",$830.20 ,"$2,668.50 ",$188.61 ,"$2,668.50 ","$2,668.50 ",$188.61 ,"$1,927.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$4,727.00 ","$3,072.55 ",$144.76 ,"$4,727.00 ","$1,103.33 ","$3,521.62 ","$3,096.19 ",$459.61 ,"$1,323.56 ","$2,387.14 ",$459.61 ,"$2,916.56 ",$459.61 ,"$2,916.56 ","$2,916.56 ",$459.61 ,"$2,916.56 ",$873.26 ,"$4,254.30 ","$3,545.25 ","$1,103.33 ",$459.61 ,"$4,159.76 ",$459.61 ,"$3,545.25 ","$3,545.25 ","$4,017.95 ","$4,017.95 ",$459.61 ,"$4,017.95 ",$459.61 ,"$3,687.06 ","$3,687.06 ","$3,687.06 ","$4,254.30 ","$1,103.33 ","$4,254.30 ",$459.61 ,"$4,727.00 ","$3,096.19 ",$459.61 ,"$1,966.43 ",$151.66 ,$144.76 ,$481.07 ,"$4,254.30 ",$996.04 ,"$2,916.56 ","$1,323.56 ","$4,254.30 ",$459.61 ,"$4,254.30 ","$4,254.30 ",$459.61 ,"$3,072.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$3,151.00 ","$2,048.15 ",$96.51 ,"$3,151.00 ",$452.76 ,"$2,347.50 ","$2,063.91 ",$188.61 ,$882.28 ,"$1,591.26 ",$188.61 ,"$1,944.17 ",$188.61 ,"$1,944.17 ","$1,944.17 ",$188.61 ,"$1,944.17 ",$358.36 ,"$2,835.90 ","$2,363.25 ",$452.76 ,$188.61 ,"$2,772.88 ",$188.61 ,"$2,363.25 ","$2,363.25 ","$2,678.35 ","$2,678.35 ",$188.61 ,"$2,678.35 ",$188.61 ,"$2,457.78 ","$2,457.78 ","$2,457.78 ","$2,835.90 ",$452.76 ,"$2,835.90 ",$188.61 ,"$3,151.00 ","$2,063.91 ",$188.61 ,"$1,310.82 ",$101.10 ,$96.51 ,$197.41 ,"$2,835.90 ",$408.74 ,"$1,944.17 ",$882.28 ,"$2,835.90 ",$188.61 ,"$2,835.90 ","$2,835.90 ",$188.61 ,"$2,048.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$5,949.00 ","$3,866.85 ",$188.61 ,"$5,949.00 ",$452.76 ,"$4,432.01 ","$3,896.60 ",$188.61 ,"$1,665.72 ","$3,004.25 ",$188.61 ,"$3,670.53 ",$188.61 ,"$3,670.53 ","$3,670.53 ",$188.61 ,"$3,670.53 ",$358.36 ,"$5,354.10 ","$4,461.75 ",$452.76 ,$188.61 ,"$5,235.12 ",$188.61 ,"$4,461.75 ","$4,461.75 ","$5,056.65 ","$5,056.65 ",$188.61 ,"$5,056.65 ",$188.61 ,"$4,640.22 ","$4,640.22 ","$4,640.22 ","$5,354.10 ",$452.76 ,"$5,354.10 ",$188.61 ,"$5,949.00 ","$3,896.60 ",$188.61 ,"$2,474.78 ",$228.49 ,$218.11 ,$197.41 ,"$5,354.10 ",$408.74 ,"$3,670.53 ","$1,665.72 ","$5,354.10 ",$188.61 ,"$5,354.10 ","$5,354.10 ",$188.61 ,"$3,866.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$3,054.00 ","$1,985.10 ",$114.95 ,"$3,054.00 ",$275.96 ,"$2,275.23 ","$2,000.37 ",$114.95 ,$855.12 ,"$1,542.27 ",$114.95 ,"$1,884.32 ",$114.95 ,"$1,884.32 ","$1,884.32 ",$114.95 ,"$1,884.32 ",$218.41 ,"$2,748.60 ","$2,290.50 ",$275.96 ,$114.95 ,"$2,687.52 ",$114.95 ,"$2,290.50 ","$2,290.50 ","$2,595.90 ","$2,595.90 ",$114.95 ,"$2,595.90 ",$114.95 ,"$2,382.12 ","$2,382.12 ","$2,382.12 ","$2,748.60 ",$275.96 ,"$2,748.60 ",$114.95 ,"$3,054.00 ","$2,000.37 ",$114.95 ,"$1,270.46 ",$228.71 ,$218.32 ,$120.32 ,"$2,748.60 ",$249.12 ,"$1,884.32 ",$855.12 ,"$2,748.60 ",$114.95 ,"$2,748.60 ","$2,748.60 ",$114.95 ,"$1,985.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$3,512.00 ","$2,282.80 ",$188.61 ,"$3,512.00 ",$452.76 ,"$2,616.44 ","$2,300.36 ",$188.61 ,$983.36 ,"$1,773.56 ",$188.61 ,"$2,166.90 ",$188.61 ,"$2,166.90 ","$2,166.90 ",$188.61 ,"$2,166.90 ",$358.36 ,"$3,160.80 ","$2,634.00 ",$452.76 ,$188.61 ,"$3,090.56 ",$188.61 ,"$2,634.00 ","$2,634.00 ","$2,985.20 ","$2,985.20 ",$188.61 ,"$2,985.20 ",$188.61 ,"$2,739.36 ","$2,739.36 ","$2,739.36 ","$3,160.80 ",$452.76 ,"$3,160.80 ",$188.61 ,"$3,512.00 ","$2,300.36 ",$188.61 ,"$1,460.99 ",$228.71 ,$218.32 ,$197.41 ,"$3,160.80 ",$408.74 ,"$2,166.90 ",$983.36 ,"$3,160.80 ",$188.61 ,"$3,160.80 ","$3,160.80 ",$188.61 ,"$2,282.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$4,751.00 ","$3,088.15 ",$188.61 ,"$4,751.00 ",$452.76 ,"$3,539.50 ","$3,111.91 ",$188.61 ,"$1,330.28 ","$2,399.26 ",$188.61 ,"$2,931.37 ",$188.61 ,"$2,931.37 ","$2,931.37 ",$188.61 ,"$2,931.37 ",$358.36 ,"$4,275.90 ","$3,563.25 ",$452.76 ,$188.61 ,"$4,180.88 ",$188.61 ,"$3,563.25 ","$3,563.25 ","$4,038.35 ","$4,038.35 ",$188.61 ,"$4,038.35 ",$188.61 ,"$3,705.78 ","$3,705.78 ","$3,705.78 ","$4,275.90 ",$452.76 ,"$4,275.90 ",$188.61 ,"$4,751.00 ","$3,111.91 ",$188.61 ,"$1,976.42 ",$228.71 ,$218.32 ,$197.41 ,"$4,275.90 ",$408.74 ,"$2,931.37 ","$1,330.28 ","$4,275.90 ",$188.61 ,"$4,275.90 ","$4,275.90 ",$188.61 ,"$3,088.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,563.00 ","$2,315.95 ",$188.61 ,"$3,563.00 ",$452.76 ,"$2,654.44 ","$2,333.77 ",$188.61 ,$997.64 ,"$1,799.32 ",$188.61 ,"$2,198.37 ",$188.61 ,"$2,198.37 ","$2,198.37 ",$188.61 ,"$2,198.37 ",$358.36 ,"$3,206.70 ","$2,672.25 ",$452.76 ,$188.61 ,"$3,135.44 ",$188.61 ,"$2,672.25 ","$2,672.25 ","$3,028.55 ","$3,028.55 ",$188.61 ,"$3,028.55 ",$188.61 ,"$2,779.14 ","$2,779.14 ","$2,779.14 ","$3,206.70 ",$452.76 ,"$3,206.70 ",$188.61 ,"$3,563.00 ","$2,333.77 ",$188.61 ,"$1,482.21 ",$228.49 ,$218.11 ,$197.41 ,"$3,206.70 ",$408.74 ,"$2,198.37 ",$997.64 ,"$3,206.70 ",$188.61 ,"$3,206.70 ","$3,206.70 ",$188.61 ,"$2,315.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$3,748.00 ","$2,436.20 ",$218.32 ,"$3,748.00 ",$583.23 ,"$2,792.26 ","$2,454.94 ",$242.96 ,"$1,049.44 ","$1,892.74 ",$242.96 ,"$2,312.52 ",$242.96 ,"$2,312.52 ","$2,312.52 ",$242.96 ,"$2,312.52 ",$461.62 ,"$3,373.20 ","$2,811.00 ",$583.23 ,$242.96 ,"$3,298.24 ",$242.96 ,"$2,811.00 ","$2,811.00 ","$3,185.80 ","$3,185.80 ",$242.96 ,"$3,185.80 ",$242.96 ,"$2,923.44 ","$2,923.44 ","$2,923.44 ","$3,373.20 ",$583.23 ,"$3,373.20 ",$242.96 ,"$3,748.00 ","$2,454.94 ",$242.96 ,"$1,559.17 ",$228.71 ,$218.32 ,$254.30 ,"$3,373.20 ",$526.52 ,"$2,312.52 ","$1,049.44 ","$3,373.20 ",$242.96 ,"$3,373.20 ","$3,373.20 ",$242.96 ,"$2,436.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$6,389.00 ","$4,152.85 ",$218.32 ,"$6,389.00 ",$933.39 ,"$4,759.81 ","$4,184.80 ",$388.82 ,"$1,788.92 ","$3,226.45 ",$388.82 ,"$3,942.01 ",$388.82 ,"$3,942.01 ","$3,942.01 ",$388.82 ,"$3,942.01 ",$738.76 ,"$5,750.10 ","$4,791.75 ",$933.39 ,$388.82 ,"$5,622.32 ",$388.82 ,"$4,791.75 ","$4,791.75 ","$5,430.65 ","$5,430.65 ",$388.82 ,"$5,430.65 ",$388.82 ,"$4,983.42 ","$4,983.42 ","$4,983.42 ","$5,750.10 ",$933.39 ,"$5,750.10 ",$388.82 ,"$6,389.00 ","$4,184.80 ",$388.82 ,"$2,657.82 ",$228.71 ,$218.32 ,$406.98 ,"$5,750.10 ",$842.63 ,"$3,942.01 ","$1,788.92 ","$5,750.10 ",$388.82 ,"$5,750.10 ","$5,750.10 ",$388.82 ,"$4,152.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$8,527.00 ","$5,542.55 ",$218.32 ,"$8,527.00 ",$933.39 ,"$6,352.62 ","$5,585.19 ",$388.82 ,"$2,387.56 ","$4,306.14 ",$388.82 ,"$5,261.16 ",$388.82 ,"$5,261.16 ","$5,261.16 ",$388.82 ,"$5,261.16 ",$738.76 ,"$7,674.30 ","$6,395.25 ",$933.39 ,$388.82 ,"$7,503.76 ",$388.82 ,"$6,395.25 ","$6,395.25 ","$7,247.95 ","$7,247.95 ",$388.82 ,"$7,247.95 ",$388.82 ,"$6,651.06 ","$6,651.06 ","$6,651.06 ","$7,674.30 ",$933.39 ,"$7,674.30 ",$388.82 ,"$8,527.00 ","$5,585.19 ",$388.82 ,"$3,547.23 ",$228.71 ,$218.32 ,$406.98 ,"$7,674.30 ",$842.63 ,"$5,261.16 ","$2,387.56 ","$7,674.30 ",$388.82 ,"$7,674.30 ","$7,674.30 ",$388.82 ,"$5,542.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$111.00 ,$72.15 ,$31.08 ,$185.09 ,$111.00 ,$82.70 ,$72.71 ,$85.41 ,$31.08 ,$56.06 ,$85.41 ,$68.49 ,$85.41 ,$68.49 ,$68.49 ,$85.41 ,$68.49 ,$162.28 ,$99.90 ,$83.25 ,$111.00 ,$85.41 ,$97.68 ,$85.41 ,$83.25 ,$83.25 ,$94.35 ,$94.35 ,$85.41 ,$94.35 ,$85.41 ,$86.58 ,$86.58 ,$86.58 ,$99.90 ,$111.00 ,$99.90 ,$85.41 ,$111.00 ,$72.71 ,$85.41 ,$46.18 , N/A , N/A ,$89.39 ,$99.90 ,$185.09 ,$68.49 ,$31.08 ,$99.90 ,$85.41 ,$99.90 ,$99.90 ,$85.41 ,$72.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$5,794.00 ","$3,766.10 ",$188.61 ,"$5,794.00 ",$452.76 ,"$4,316.53 ","$3,795.07 ",$188.61 ,"$1,622.32 ","$2,925.97 ",$188.61 ,"$3,574.90 ",$188.61 ,"$3,574.90 ","$3,574.90 ",$188.61 ,"$3,574.90 ",$358.36 ,"$5,214.60 ","$4,345.50 ",$452.76 ,$188.61 ,"$5,098.72 ",$188.61 ,"$4,345.50 ","$4,345.50 ","$4,924.90 ","$4,924.90 ",$188.61 ,"$4,924.90 ",$188.61 ,"$4,519.32 ","$4,519.32 ","$4,519.32 ","$5,214.60 ",$452.76 ,"$5,214.60 ",$188.61 ,"$5,794.00 ","$3,795.07 ",$188.61 ,"$2,410.30 ",$228.49 ,$218.11 ,$197.41 ,"$5,214.60 ",$408.74 ,"$3,574.90 ","$1,622.32 ","$5,214.60 ",$188.61 ,"$5,214.60 ","$5,214.60 ",$188.61 ,"$3,766.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000099,76376,HC 3D RENDER CT NOT REQUIRE INDEP,350,1 ,$918.00 ,$596.70 ,$257.04 ,$918.00 , N/A ,$683.91 ,$601.29 , N/A ,$257.04 ,$463.59 , N/A ,$566.41 , N/A ,$566.41 ,$566.41 , N/A ,$566.41 , N/A ,$826.20 ,$688.50 , N/A , N/A ,$807.84 , N/A ,$688.50 ,$688.50 ,$780.30 ,$780.30 , N/A ,$780.30 , N/A ,$716.04 ,$716.04 ,$716.04 ,$826.20 , N/A ,$826.20 , N/A ,$918.00 ,$601.29 , N/A ,$381.89 , N/A , N/A , N/A ,$826.20 , N/A ,$566.41 ,$257.04 ,$826.20 , N/A ,$826.20 ,$826.20 , N/A ,$596.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,"$1,070.00 ",$695.50 ,$299.60 ,"$1,070.00 ", N/A ,$797.15 ,$700.85 , N/A ,$299.60 ,$540.35 , N/A ,$660.19 , N/A ,$660.19 ,$660.19 , N/A ,$660.19 , N/A ,$963.00 ,$802.50 , N/A , N/A ,$941.60 , N/A ,$802.50 ,$802.50 ,$909.50 ,$909.50 , N/A ,$909.50 , N/A ,$834.60 ,$834.60 ,$834.60 ,$963.00 , N/A ,$963.00 , N/A ,"$1,070.00 ",$700.85 , N/A ,$445.12 , N/A , N/A , N/A ,$963.00 , N/A ,$660.19 ,$299.60 ,$963.00 , N/A ,$963.00 ,$963.00 , N/A ,$695.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000101,76380,HC CT LMTD OR LOCALIZ FU STUDY,350,1 ,"$1,462.00 ",$950.30 ,$85.41 ,"$1,462.00 ",$205.02 ,"$1,089.19 ",$957.61 ,$85.41 ,$409.36 ,$738.31 ,$85.41 ,$902.05 ,$85.41 ,$902.05 ,$902.05 ,$85.41 ,$902.05 ,$162.28 ,"$1,315.80 ","$1,096.50 ",$205.02 ,$85.41 ,"$1,286.56 ",$85.41 ,"$1,096.50 ","$1,096.50 ","$1,242.70 ","$1,242.70 ",$85.41 ,"$1,242.70 ",$85.41 ,"$1,140.36 ","$1,140.36 ","$1,140.36 ","$1,315.80 ",$205.02 ,"$1,315.80 ",$85.41 ,"$1,462.00 ",$957.61 ,$85.41 ,$608.19 ,$101.10 ,$96.51 ,$89.39 ,"$1,315.80 ",$185.09 ,$902.05 ,$409.36 ,"$1,315.80 ",$85.41 ,"$1,315.80 ","$1,315.80 ",$85.41 ,$950.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$4,433.00 ","$2,881.45 ",$74.43 ,"$4,433.00 ", N/A ,"$3,302.59 ","$2,903.62 ", N/A ,"$1,241.24 ","$2,238.67 ", N/A ,"$2,735.16 ", N/A ,"$2,735.16 ","$2,735.16 ", N/A ,"$2,735.16 ", N/A ,"$3,989.70 ","$3,324.75 ", N/A , N/A ,"$3,901.04 ", N/A ,"$3,324.75 ","$3,324.75 ","$3,768.05 ","$3,768.05 ", N/A ,"$3,768.05 ", N/A ,"$3,457.74 ","$3,457.74 ","$3,457.74 ","$3,989.70 ", N/A ,"$3,989.70 ", N/A ,"$4,433.00 ","$2,903.62 ", N/A ,"$1,844.13 ",$77.98 ,$74.43 , N/A ,"$3,989.70 ", N/A ,"$2,735.16 ","$1,241.24 ","$3,989.70 ", N/A ,"$3,989.70 ","$3,989.70 ", N/A ,"$2,881.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000116,64510,HC INJECT STELLATE GANGLION,350,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000120,74174,HC CT ANGIO ABD/PELV W  AND  WO CONTRAST,350,1 ,"$7,112.00 ","$4,622.80 ",$218.32 ,"$7,112.00 ",$933.39 ,"$5,298.44 ","$4,658.36 ",$388.82 ,"$1,991.36 ","$3,591.56 ",$388.82 ,"$4,388.10 ",$388.82 ,"$4,388.10 ","$4,388.10 ",$388.82 ,"$4,388.10 ",$738.76 ,"$6,400.80 ","$5,334.00 ",$933.39 ,$388.82 ,"$6,258.56 ",$388.82 ,"$5,334.00 ","$5,334.00 ","$6,045.20 ","$6,045.20 ",$388.82 ,"$6,045.20 ",$388.82 ,"$5,547.36 ","$5,547.36 ","$5,547.36 ","$6,400.80 ",$933.39 ,"$6,400.80 ",$388.82 ,"$7,112.00 ","$4,658.36 ",$388.82 ,"$2,958.59 ",$228.71 ,$218.32 ,$406.98 ,"$6,400.80 ",$842.63 ,"$4,388.10 ","$1,991.36 ","$6,400.80 ",$388.82 ,"$6,400.80 ","$6,400.80 ",$388.82 ,"$4,622.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000152,0503T,HC CORONARY FFR CTA DATA ANALYSIS,350,1 ,"$4,142.00 ","$2,692.30 ",$176.06 ,"$4,142.00 ","$2,358.99 ","$3,085.79 ","$2,713.01 ",$982.68 ,"$1,159.76 ","$2,091.71 ",$982.68 ,"$2,555.61 ",$982.68 ,"$2,555.61 ","$2,555.61 ",$982.68 ,"$2,555.61 ","$1,867.09 ","$3,727.80 ","$3,106.50 ","$2,358.99 ",$982.68 ,"$3,644.96 ",$982.68 ,"$3,106.50 ","$3,106.50 ","$3,520.70 ","$3,520.70 ",$982.68 ,"$3,520.70 ",$982.68 ,"$3,230.76 ","$3,230.76 ","$3,230.76 ","$3,727.80 ","$2,358.99 ","$3,727.80 ",$982.68 ,"$4,142.00 ","$2,713.01 ",$982.68 ,"$1,723.07 ",$184.45 ,$176.06 ,"$1,028.56 ","$3,727.80 ","$2,129.60 ","$2,555.61 ","$1,159.76 ","$3,727.80 ",$982.68 ,"$3,727.80 ","$3,727.80 ",$982.68 ,"$2,692.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000153,0502T,HC CORONARY FFR CTA DATA PREP  AND  TRANSMISSION,350,1 ,$302.00 ,$196.30 ,$84.56 ,$302.00 , N/A ,$224.99 ,$197.81 , N/A ,$84.56 ,$152.51 , N/A ,$186.33 , N/A ,$186.33 ,$186.33 , N/A ,$186.33 , N/A ,$271.80 ,$226.50 , N/A , N/A ,$265.76 , N/A ,$226.50 ,$226.50 ,$256.70 ,$256.70 , N/A ,$256.70 , N/A ,$235.56 ,$235.56 ,$235.56 ,$271.80 , N/A ,$271.80 , N/A ,$302.00 ,$197.81 , N/A ,$125.63 ,$184.45 ,$176.06 , N/A ,$271.80 , N/A ,$186.33 ,$84.56 ,$271.80 , N/A ,$271.80 ,$271.80 , N/A ,$196.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$257.00 ,$167.05 ,$71.96 ,$257.00 ,$257.00 ,$191.47 ,$168.34 ,$114.95 ,$71.96 ,$129.79 ,$114.95 ,$158.57 ,$114.95 ,$158.57 ,$158.57 ,$114.95 ,$158.57 ,$218.41 ,$231.30 ,$192.75 ,$257.00 ,$114.95 ,$226.16 ,$114.95 ,$192.75 ,$192.75 ,$218.45 ,$218.45 ,$114.95 ,$218.45 ,$114.95 ,$200.46 ,$200.46 ,$200.46 ,$231.30 ,$257.00 ,$231.30 ,$114.95 ,$257.00 ,$168.34 ,$114.95 ,$106.91 ,$101.10 ,$96.51 ,$120.32 ,$231.30 ,$249.12 ,$158.57 ,$71.96 ,$231.30 ,$114.95 ,$231.30 ,$231.30 ,$114.95 ,$167.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$573.00 ,$372.45 ,$160.44 ,$573.00 ,$455.17 ,$426.89 ,$375.32 ,$189.61 ,$160.44 ,$289.37 ,$189.61 ,$353.54 ,$189.61 ,$353.54 ,$353.54 ,$189.61 ,$353.54 ,$360.26 ,$515.70 ,$429.75 ,$455.17 ,$189.61 ,$504.24 ,$189.61 ,$429.75 ,$429.75 ,$487.05 ,$487.05 ,$189.61 ,$487.05 ,$189.61 ,$446.94 ,$446.94 ,$446.94 ,$515.70 ,$455.17 ,$515.70 ,$189.61 ,$573.00 ,$375.32 ,$189.61 ,$238.37 ,$218.80 ,$208.86 ,$198.46 ,$515.70 ,$410.91 ,$353.54 ,$160.44 ,$515.70 ,$189.61 ,$515.70 ,$515.70 ,$189.61 ,$372.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,"$3,881.00 ","$2,522.65 ",$728.45 ,"$3,881.00 ","$3,566.38 ","$2,891.35 ","$2,542.06 ","$1,485.64 ","$1,086.68 ","$1,959.91 ","$1,485.64 ","$2,394.58 ","$1,485.64 ","$2,394.58 ","$2,394.58 ","$1,485.64 ","$2,394.58 ","$2,822.72 ","$3,492.90 ","$2,910.75 ","$3,566.38 ","$1,485.64 ","$3,415.28 ","$1,485.64 ","$2,910.75 ","$2,910.75 ","$3,298.85 ","$3,298.85 ","$1,485.64 ","$3,298.85 ","$1,485.64 ","$3,027.18 ","$3,027.18 ","$3,027.18 ","$3,492.90 ","$3,566.38 ","$3,492.90 ","$1,485.64 ","$3,881.00 ","$2,542.06 ","$1,485.64 ","$1,614.50 ",$763.14 ,$728.45 ,"$1,555.00 ","$3,492.90 ","$3,219.59 ","$2,394.58 ","$1,086.68 ","$3,492.90 ","$1,485.64 ","$3,492.90 ","$3,492.90 ","$1,485.64 ","$2,522.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$573.00 ,$372.45 ,$160.44 ,$790.90 ,$573.00 ,$426.89 ,$375.32 ,$364.95 ,$160.44 ,$289.37 ,$364.95 ,$353.54 ,$364.95 ,$353.54 ,$353.54 ,$364.95 ,$353.54 ,$693.41 ,$515.70 ,$429.75 ,$573.00 ,$364.95 ,$504.24 ,$364.95 ,$429.75 ,$429.75 ,$487.05 ,$487.05 ,$364.95 ,$487.05 ,$364.95 ,$446.94 ,$446.94 ,$446.94 ,$515.70 ,$573.00 ,$515.70 ,$364.95 ,$573.00 ,$375.32 ,$364.95 ,$238.37 ,$218.80 ,$208.86 ,$381.99 ,$515.70 ,$790.90 ,$353.54 ,$160.44 ,$515.70 ,$364.95 ,$515.70 ,$515.70 ,$364.95 ,$372.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000078,19000,HC ASP CYST BREAST,360,1 ,"$1,124.00 ",$730.60 ,$177.68 ,"$1,423.93 ","$1,124.00 ",$837.38 ,$736.22 ,$657.06 ,$314.72 ,$567.62 ,$657.06 ,$693.51 ,$657.06 ,$693.51 ,$693.51 ,$657.06 ,$693.51 ,"$1,248.41 ","$1,011.60 ",$843.00 ,"$1,124.00 ",$657.06 ,$989.12 ,$657.06 ,$843.00 ,$843.00 ,$955.40 ,$955.40 ,$657.06 ,$955.40 ,$657.06 ,$876.72 ,$876.72 ,$876.72 ,"$1,011.60 ","$1,124.00 ","$1,011.60 ",$657.06 ,$177.68 ,$736.22 ,$657.06 ,$467.58 ,$442.92 ,$422.78 ,$687.73 ,"$1,011.60 ","$1,423.93 ",$693.51 ,$314.72 ,"$1,011.60 ",$657.06 ,"$1,011.60 ","$1,011.60 ",$657.06 ,$730.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$203.00 ,$131.95 ,$29.74 ,$203.00 , N/A ,$151.24 ,$132.97 , N/A ,$56.84 ,$102.52 , N/A ,$125.25 , N/A ,$125.25 ,$125.25 , N/A ,$125.25 , N/A ,$182.70 ,$152.25 , N/A , N/A ,$178.64 , N/A ,$152.25 ,$152.25 ,$172.55 ,$172.55 , N/A ,$172.55 , N/A ,$158.34 ,$158.34 ,$158.34 ,$182.70 , N/A ,$182.70 , N/A ,$29.74 ,$132.97 , N/A ,$84.45 ,$203.00 ,$203.00 , N/A ,$182.70 , N/A ,$125.25 ,$56.84 ,$182.70 , N/A ,$182.70 ,$182.70 , N/A ,$131.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$2,821.00 ","$1,833.65 ",$620.94 ,"$5,425.50 ","$2,821.00 ","$2,101.65 ","$1,847.76 ","$2,503.54 ",$789.88 ,"$1,424.61 ","$2,503.54 ","$1,740.56 ","$2,503.54 ","$1,740.56 ","$1,740.56 ","$2,503.54 ","$1,740.56 ","$4,756.73 ","$2,538.90 ","$2,115.75 ","$2,821.00 ","$2,503.54 ","$2,482.48 ","$2,503.54 ","$2,115.75 ","$2,115.75 ","$2,397.85 ","$2,397.85 ","$2,503.54 ","$2,397.85 ","$2,503.54 ","$2,200.38 ","$2,200.38 ","$2,200.38 ","$2,538.90 ","$2,821.00 ","$2,538.90 ","$2,503.54 ",$620.94 ,"$1,847.76 ","$2,503.54 ","$1,173.54 ","$1,346.39 ","$1,285.19 ","$2,620.42 ","$2,538.90 ","$5,425.50 ","$1,740.56 ",$789.88 ,"$2,538.90 ","$2,503.54 ","$2,538.90 ","$2,538.90 ","$2,503.54 ","$1,833.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$1,881.00 ","$1,222.65 ",$526.68 ,"$3,219.59 ","$1,881.00 ","$1,401.35 ","$1,232.06 ","$1,485.64 ",$526.68 ,$949.91 ,"$1,485.64 ","$1,160.58 ","$1,485.64 ","$1,160.58 ","$1,160.58 ","$1,485.64 ","$1,160.58 ","$2,822.72 ","$1,692.90 ","$1,410.75 ","$1,881.00 ","$1,485.64 ","$1,655.28 ","$1,485.64 ","$1,410.75 ","$1,410.75 ","$1,598.85 ","$1,598.85 ","$1,485.64 ","$1,598.85 ","$1,485.64 ","$1,467.18 ","$1,467.18 ","$1,467.18 ","$1,692.90 ","$1,881.00 ","$1,692.90 ","$1,485.64 ",$620.94 ,"$1,232.06 ","$1,485.64 ",$782.50 ,$897.59 ,$856.79 ,"$1,555.00 ","$1,692.90 ","$3,219.59 ","$1,160.58 ",$526.68 ,"$1,692.90 ","$1,485.64 ","$1,692.90 ","$1,692.90 ","$1,485.64 ","$1,222.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$2,174.00 ","$1,413.10 ",$124.50 ,"$2,174.00 ","$1,577.31 ","$1,619.63 ","$1,423.97 ",$657.06 ,$608.72 ,"$1,097.87 ",$657.06 ,"$1,341.36 ",$657.06 ,"$1,341.36 ","$1,341.36 ",$657.06 ,"$1,341.36 ","$1,248.41 ","$1,956.60 ","$1,630.50 ","$1,577.31 ",$657.06 ,"$1,913.12 ",$657.06 ,"$1,630.50 ","$1,630.50 ","$1,847.90 ","$1,847.90 ",$657.06 ,"$1,847.90 ",$657.06 ,"$1,695.72 ","$1,695.72 ","$1,695.72 ","$1,956.60 ","$1,577.31 ","$1,956.60 ",$657.06 ,$464.28 ,"$1,423.97 ",$657.06 ,$904.38 ,$130.43 ,$124.50 ,$687.73 ,"$1,956.60 ","$1,423.93 ","$1,341.36 ",$608.72 ,"$1,956.60 ",$657.06 ,"$1,956.60 ","$1,956.60 ",$657.06 ,"$1,413.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$1,449.00 ",$941.85 ,$83.00 ,"$1,449.00 ","$1,449.00 ","$1,079.51 ",$949.10 ,$657.06 ,$405.72 ,$731.75 ,$657.06 ,$894.03 ,$657.06 ,$894.03 ,$894.03 ,$657.06 ,$894.03 ,"$1,248.41 ","$1,304.10 ","$1,086.75 ","$1,449.00 ",$657.06 ,"$1,275.12 ",$657.06 ,"$1,086.75 ","$1,086.75 ","$1,231.65 ","$1,231.65 ",$657.06 ,"$1,231.65 ",$657.06 ,"$1,130.22 ","$1,130.22 ","$1,130.22 ","$1,304.10 ","$1,449.00 ","$1,304.10 ",$657.06 ,$464.28 ,$949.10 ,$657.06 ,$602.78 ,$86.96 ,$83.00 ,$687.73 ,"$1,304.10 ","$1,423.93 ",$894.03 ,$405.72 ,"$1,304.10 ",$657.06 ,"$1,304.10 ","$1,304.10 ",$657.06 ,$941.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,$935.00 ,$607.75 ,$261.80 ,"$3,219.59 ",$935.00 ,$696.58 ,$612.43 ,$935.00 ,$261.80 ,$472.18 ,$935.00 ,$576.90 ,$935.00 ,$576.90 ,$576.90 ,$935.00 ,$576.90 ,"$2,822.72 ",$841.50 ,$701.25 ,$935.00 ,$935.00 ,$822.80 ,$935.00 ,$701.25 ,$701.25 ,$794.75 ,$794.75 ,$935.00 ,$794.75 ,$935.00 ,$729.30 ,$729.30 ,$729.30 ,$841.50 ,$935.00 ,$841.50 ,$935.00 ,$935.00 ,$612.43 ,$935.00 ,$388.96 ,$442.92 ,$422.78 ,$935.00 ,$841.50 ,"$3,219.59 ",$576.90 ,$261.80 ,$841.50 ,$935.00 ,$841.50 ,$841.50 ,$935.00 ,$607.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000089,20220,HC BX BONE NEEDLE SUPERFIC FAC,360,1 ,"$2,290.00 ","$1,488.50 ",$447.91 ,"$3,219.59 ","$2,290.00 ","$1,706.05 ","$1,499.95 ","$1,485.64 ",$641.20 ,"$1,156.45 ","$1,485.64 ","$1,412.93 ","$1,485.64 ","$1,412.93 ","$1,412.93 ","$1,485.64 ","$1,412.93 ","$2,822.72 ","$2,061.00 ","$1,717.50 ","$2,290.00 ","$1,485.64 ","$2,015.20 ","$1,485.64 ","$1,717.50 ","$1,717.50 ","$1,946.50 ","$1,946.50 ","$1,485.64 ","$1,946.50 ","$1,485.64 ","$1,786.20 ","$1,786.20 ","$1,786.20 ","$2,061.00 ","$2,290.00 ","$2,061.00 ","$1,485.64 ","$2,290.00 ","$1,499.95 ","$1,485.64 ",$952.64 ,$469.24 ,$447.91 ,"$1,555.00 ","$2,061.00 ","$3,219.59 ","$1,412.93 ",$641.20 ,"$2,061.00 ","$1,485.64 ","$2,061.00 ","$2,061.00 ","$1,485.64 ","$1,488.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000090,20225,HC BX BONE NEEDLE DEEP,360,1 ,"$3,404.00 ","$2,212.60 ",$447.91 ,"$3,404.00 ","$3,404.00 ","$2,535.98 ","$2,229.62 ","$1,485.64 ",$953.12 ,"$1,719.02 ","$1,485.64 ","$2,100.27 ","$1,485.64 ","$2,100.27 ","$2,100.27 ","$1,485.64 ","$2,100.27 ","$2,822.72 ","$3,063.60 ","$2,553.00 ","$3,404.00 ","$1,485.64 ","$2,995.52 ","$1,485.64 ","$2,553.00 ","$2,553.00 ","$2,893.40 ","$2,893.40 ","$1,485.64 ","$2,893.40 ","$1,485.64 ","$2,655.12 ","$2,655.12 ","$2,655.12 ","$3,063.60 ","$3,404.00 ","$3,063.60 ","$1,485.64 ","$3,404.00 ","$2,229.62 ","$1,485.64 ","$1,416.06 ",$469.24 ,$447.91 ,"$1,555.00 ","$3,063.60 ","$3,219.59 ","$2,100.27 ",$953.12 ,"$3,063.60 ","$1,485.64 ","$3,063.60 ","$3,063.60 ","$1,485.64 ","$2,212.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000108,19082,HC BREAST LOC BX PERC STEREO ADDN LESION,360,1 ,"$1,953.00 ","$1,269.45 ",$494.86 ,"$1,953.00 ", N/A ,"$1,454.99 ","$1,279.22 ", N/A ,$546.84 ,$986.27 , N/A ,"$1,205.00 ", N/A ,"$1,205.00 ","$1,205.00 ", N/A ,"$1,205.00 ", N/A ,"$1,757.70 ","$1,464.75 ", N/A , N/A ,"$1,718.64 ", N/A ,"$1,464.75 ","$1,464.75 ","$1,660.05 ","$1,660.05 ", N/A ,"$1,660.05 ", N/A ,"$1,523.34 ","$1,523.34 ","$1,523.34 ","$1,757.70 ", N/A ,"$1,757.70 ", N/A ,$494.86 ,"$1,279.22 ", N/A ,$812.45 ,$897.59 ,$856.79 , N/A ,"$1,757.70 ", N/A ,"$1,205.00 ",$546.84 ,"$1,757.70 ", N/A ,"$1,757.70 ","$1,757.70 ", N/A ,"$1,269.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,$986.00 ,$640.90 ,$276.08 ,$986.00 , N/A ,$734.57 ,$645.83 , N/A ,$276.08 ,$497.93 , N/A ,$608.36 , N/A ,$608.36 ,$608.36 , N/A ,$608.36 , N/A ,$887.40 ,$739.50 , N/A , N/A ,$867.68 , N/A ,$739.50 ,$739.50 ,$838.10 ,$838.10 , N/A ,$838.10 , N/A ,$769.08 ,$769.08 ,$769.08 ,$887.40 , N/A ,$887.40 , N/A ,$485.95 ,$645.83 , N/A ,$410.18 ,$897.59 ,$856.79 , N/A ,$887.40 , N/A ,$608.36 ,$276.08 ,$887.40 , N/A ,$887.40 ,$887.40 , N/A ,$640.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,"$1,479.00 ",$961.35 ,$414.12 ,"$1,479.00 ", N/A ,"$1,101.86 ",$968.75 , N/A ,$414.12 ,$746.90 , N/A ,$912.54 , N/A ,$912.54 ,$912.54 , N/A ,$912.54 , N/A ,"$1,331.10 ","$1,109.25 ", N/A , N/A ,"$1,301.52 ", N/A ,"$1,109.25 ","$1,109.25 ","$1,257.15 ","$1,257.15 ", N/A ,"$1,257.15 ", N/A ,"$1,153.62 ","$1,153.62 ","$1,153.62 ","$1,331.10 ", N/A ,"$1,331.10 ", N/A ,$485.95 ,$968.75 , N/A ,$615.26 ,$897.59 ,$856.79 , N/A ,"$1,331.10 ", N/A ,$912.54 ,$414.12 ,"$1,331.10 ", N/A ,"$1,331.10 ","$1,331.10 ", N/A ,$961.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,$436.38 ,$283.65 ,$83.00 ,$436.38 , N/A ,$325.10 ,$285.83 , N/A ,$122.19 ,$220.37 , N/A ,$269.25 , N/A ,$269.25 ,$269.25 , N/A ,$269.25 , N/A ,$392.74 ,$327.29 , N/A , N/A ,$384.01 , N/A ,$327.29 ,$327.29 ,$370.92 ,$370.92 , N/A ,$370.92 , N/A ,$340.38 ,$340.38 ,$340.38 ,$392.74 , N/A ,$392.74 , N/A ,$189.78 ,$285.83 , N/A ,$181.53 ,$86.96 ,$83.00 , N/A ,$392.74 , N/A ,$269.25 ,$122.19 ,$392.74 , N/A ,$392.74 ,$392.74 , N/A ,$283.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000116,19286,HC BREAST NDL LOC BX ULTRA  ADDN LESION,360,1 ,$640.00 ,$416.00 ,$83.00 ,$640.00 , N/A ,$476.80 ,$419.20 , N/A ,$179.20 ,$323.20 , N/A ,$394.88 , N/A ,$394.88 ,$394.88 , N/A ,$394.88 , N/A ,$576.00 ,$480.00 , N/A , N/A ,$563.20 , N/A ,$480.00 ,$480.00 ,$544.00 ,$544.00 , N/A ,$544.00 , N/A ,$499.20 ,$499.20 ,$499.20 ,$576.00 , N/A ,$576.00 , N/A ,$391.77 ,$419.20 , N/A ,$266.24 ,$86.96 ,$83.00 , N/A ,$576.00 , N/A ,$394.88 ,$179.20 ,$576.00 , N/A ,$576.00 ,$576.00 , N/A ,$416.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000116,19286,HC BREAST NDL LOC BX ULTRA  ADDN LESION,360,1 ,$959.00 ,$623.35 ,$83.00 ,$959.00 , N/A ,$714.46 ,$628.15 , N/A ,$268.52 ,$484.30 , N/A ,$591.70 , N/A ,$591.70 ,$591.70 , N/A ,$591.70 , N/A ,$863.10 ,$719.25 , N/A , N/A ,$843.92 , N/A ,$719.25 ,$719.25 ,$815.15 ,$815.15 , N/A ,$815.15 , N/A ,$748.02 ,$748.02 ,$748.02 ,$863.10 , N/A ,$863.10 , N/A ,$391.77 ,$628.15 , N/A ,$398.94 ,$86.96 ,$83.00 , N/A ,$863.10 , N/A ,$591.70 ,$268.52 ,$863.10 , N/A ,$863.10 ,$863.10 , N/A ,$623.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000118,36470,HC INJ SCLEROSING SOLUTION SINGLE VEIN,360,1 ,"$1,275.00 ",$828.75 ,$357.00 ,"$1,275.00 ",$876.09 ,$949.88 ,$835.13 ,$364.95 ,$357.00 ,$643.88 ,$364.95 ,$786.68 ,$364.95 ,$786.68 ,$786.68 ,$364.95 ,$786.68 ,$693.41 ,"$1,147.50 ",$956.25 ,$876.09 ,$364.95 ,"$1,122.00 ",$364.95 ,$956.25 ,$956.25 ,"$1,083.75 ","$1,083.75 ",$364.95 ,"$1,083.75 ",$364.95 ,$994.50 ,$994.50 ,$994.50 ,"$1,147.50 ",$876.09 ,"$1,147.50 ",$364.95 ,"$1,275.00 ",$835.13 ,$364.95 ,$530.40 ,$639.05 ,$610.00 ,$381.99 ,"$1,147.50 ",$790.90 ,$786.68 ,$357.00 ,"$1,147.50 ",$364.95 ,"$1,147.50 ","$1,147.50 ",$364.95 ,$828.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000119,36471,HC INJ SCLEROSING SOLUTN MULT VEIN,360,1 ,"$1,241.00 ",$806.65 ,$347.48 ,"$1,241.00 ",$876.09 ,$924.55 ,$812.86 ,$364.95 ,$347.48 ,$626.71 ,$364.95 ,$765.70 ,$364.95 ,$765.70 ,$765.70 ,$364.95 ,$765.70 ,$693.41 ,"$1,116.90 ",$930.75 ,$876.09 ,$364.95 ,"$1,092.08 ",$364.95 ,$930.75 ,$930.75 ,"$1,054.85 ","$1,054.85 ",$364.95 ,"$1,054.85 ",$364.95 ,$967.98 ,$967.98 ,$967.98 ,"$1,116.90 ",$876.09 ,"$1,116.90 ",$364.95 ,"$1,241.00 ",$812.86 ,$364.95 ,$516.26 ,$639.05 ,$610.00 ,$381.99 ,"$1,116.90 ",$790.90 ,$765.70 ,$347.48 ,"$1,116.90 ",$364.95 ,"$1,116.90 ","$1,116.90 ",$364.95 ,$806.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000122,36555,HC INS CATH CV NON-TUNL <5 YRS,360,1 ,"$8,584.98 ","$5,580.24 ","$2,403.79 ","$8,584.98 ","$7,255.98 ","$6,395.81 ","$5,623.16 ","$3,022.62 ","$2,403.79 ","$4,335.41 ","$3,022.62 ","$5,296.93 ","$3,022.62 ","$5,296.93 ","$5,296.93 ","$3,022.62 ","$5,296.93 ","$5,742.98 ","$7,726.48 ","$6,438.74 ","$7,255.98 ","$3,022.62 ","$7,554.78 ","$3,022.62 ","$6,438.74 ","$6,438.74 ","$7,297.23 ","$7,297.23 ","$3,022.62 ","$7,297.23 ","$3,022.62 ","$6,696.28 ","$6,696.28 ","$6,696.28 ","$7,726.48 ","$7,255.98 ","$7,726.48 ","$3,022.62 ","$8,584.98 ","$5,623.16 ","$3,022.62 ","$3,571.35 ", N/A , N/A ,"$3,163.73 ","$7,726.48 ","$6,550.42 ","$5,296.93 ","$2,403.79 ","$7,726.48 ","$3,022.62 ","$7,726.48 ","$7,726.48 ","$3,022.62 ","$5,580.24 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$2,984.00 ","$1,939.60 ",$835.52 ,"$6,550.42 ","$2,984.00 ","$2,223.08 ","$1,954.52 ","$2,984.00 ",$835.52 ,"$1,506.92 ","$2,984.00 ","$1,841.13 ","$2,984.00 ","$1,841.13 ","$1,841.13 ","$2,984.00 ","$1,841.13 ","$5,742.98 ","$2,685.60 ","$2,238.00 ","$2,984.00 ","$2,984.00 ","$2,625.92 ","$2,984.00 ","$2,238.00 ","$2,238.00 ","$2,536.40 ","$2,536.40 ","$2,984.00 ","$2,536.40 ","$2,984.00 ","$2,327.52 ","$2,327.52 ","$2,327.52 ","$2,685.60 ","$2,984.00 ","$2,685.60 ","$2,984.00 ","$2,984.00 ","$1,954.52 ","$2,984.00 ","$1,241.34 ","$1,239.40 ","$1,183.07 ","$2,984.00 ","$2,685.60 ","$6,550.42 ","$1,841.13 ",$835.52 ,"$2,685.60 ","$2,984.00 ","$2,685.60 ","$2,685.60 ","$2,984.00 ","$1,939.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$5,051.00 ","$3,283.15 ","$1,183.07 ","$6,550.42 ","$5,051.00 ","$3,763.00 ","$3,308.41 ","$3,022.62 ","$1,414.28 ","$2,550.76 ","$3,022.62 ","$3,116.47 ","$3,022.62 ","$3,116.47 ","$3,116.47 ","$3,022.62 ","$3,116.47 ","$5,742.98 ","$4,545.90 ","$3,788.25 ","$5,051.00 ","$3,022.62 ","$4,444.88 ","$3,022.62 ","$3,788.25 ","$3,788.25 ","$4,293.35 ","$4,293.35 ","$3,022.62 ","$4,293.35 ","$3,022.62 ","$3,939.78 ","$3,939.78 ","$3,939.78 ","$4,545.90 ","$5,051.00 ","$4,545.90 ","$3,022.62 ","$5,051.00 ","$3,308.41 ","$3,022.62 ","$2,101.22 ","$1,239.40 ","$1,183.07 ","$3,163.73 ","$4,545.90 ","$6,550.42 ","$3,116.47 ","$1,414.28 ","$4,545.90 ","$3,022.62 ","$4,545.90 ","$4,545.90 ","$3,022.62 ","$3,283.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$7,576.00 ","$4,924.40 ","$1,774.61 ","$10,911.83 ","$7,576.00 ","$5,644.12 ","$4,962.28 ","$5,035.15 ","$2,121.28 ","$3,825.88 ","$5,035.15 ","$4,674.39 ","$5,035.15 ","$4,674.39 ","$4,674.39 ","$5,035.15 ","$4,674.39 ","$9,566.79 ","$6,818.40 ","$5,682.00 ","$7,576.00 ","$5,035.15 ","$6,666.88 ","$5,035.15 ","$5,682.00 ","$5,682.00 ","$6,439.60 ","$6,439.60 ","$5,035.15 ","$6,439.60 ","$5,035.15 ","$5,909.28 ","$5,909.28 ","$5,909.28 ","$6,818.40 ","$7,576.00 ","$6,818.40 ","$5,035.15 ","$7,576.00 ","$4,962.28 ","$5,035.15 ","$3,151.62 ","$1,859.11 ","$1,774.61 ","$5,270.21 ","$6,818.40 ","$10,911.83 ","$4,674.39 ","$2,121.28 ","$6,818.40 ","$5,035.15 ","$6,818.40 ","$6,818.40 ","$5,035.15 ","$4,924.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000127,36561,HC INSERT TUNEL CV CATH>5YR W/PORT,360,1 ,"$1,577.00 ","$1,025.05 ",$441.56 ,"$6,550.42 ","$1,577.00 ","$1,174.87 ","$1,032.94 ","$1,577.00 ",$441.56 ,$796.39 ,"$1,577.00 ",$973.01 ,"$1,577.00 ",$973.01 ,$973.01 ,"$1,577.00 ",$973.01 ,"$5,742.98 ","$1,419.30 ","$1,182.75 ","$1,577.00 ","$1,577.00 ","$1,387.76 ","$1,577.00 ","$1,182.75 ","$1,182.75 ","$1,340.45 ","$1,340.45 ","$1,577.00 ","$1,340.45 ","$1,577.00 ","$1,230.06 ","$1,230.06 ","$1,230.06 ","$1,419.30 ","$1,577.00 ","$1,419.30 ","$1,577.00 ","$1,577.00 ","$1,032.94 ","$1,577.00 ",$656.03 ,"$1,577.00 ","$1,577.00 ","$1,577.00 ","$1,419.30 ","$6,550.42 ",$973.01 ,$441.56 ,"$1,419.30 ","$1,577.00 ","$1,419.30 ","$1,419.30 ","$1,577.00 ","$1,025.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000127,36561,HC INSERT TUNEL CV CATH>5YR W/PORT,360,1 ,"$6,246.00 ","$4,059.90 ","$1,183.07 ","$6,550.42 ","$6,246.00 ","$4,653.27 ","$4,091.13 ","$3,022.62 ","$1,748.88 ","$3,154.23 ","$3,022.62 ","$3,853.78 ","$3,022.62 ","$3,853.78 ","$3,853.78 ","$3,022.62 ","$3,853.78 ","$5,742.98 ","$5,621.40 ","$4,684.50 ","$6,246.00 ","$3,022.62 ","$5,496.48 ","$3,022.62 ","$4,684.50 ","$4,684.50 ","$5,309.10 ","$5,309.10 ","$3,022.62 ","$5,309.10 ","$3,022.62 ","$4,871.88 ","$4,871.88 ","$4,871.88 ","$5,621.40 ","$6,246.00 ","$5,621.40 ","$3,022.62 ","$6,246.00 ","$4,091.13 ","$3,022.62 ","$2,598.34 ","$1,239.40 ","$1,183.07 ","$3,163.73 ","$5,621.40 ","$6,550.42 ","$3,853.78 ","$1,748.88 ","$5,621.40 ","$3,022.62 ","$5,621.40 ","$5,621.40 ","$3,022.62 ","$4,059.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$2,153.00 ","$1,399.45 ",$344.39 ,"$3,217.73 ","$2,153.00 ","$1,603.99 ","$1,410.22 ","$1,484.79 ",$602.84 ,"$1,087.27 ","$1,484.79 ","$1,328.40 ","$1,484.79 ","$1,328.40 ","$1,328.40 ","$1,484.79 ","$1,328.40 ","$2,821.10 ","$1,937.70 ","$1,614.75 ","$2,153.00 ","$1,484.79 ","$1,894.64 ","$1,484.79 ","$1,614.75 ","$1,614.75 ","$1,830.05 ","$1,830.05 ","$1,484.79 ","$1,830.05 ","$1,484.79 ","$1,679.34 ","$1,679.34 ","$1,679.34 ","$1,937.70 ","$2,153.00 ","$1,937.70 ","$1,484.79 ","$2,153.00 ","$1,410.22 ","$1,484.79 ",$895.65 ,$360.79 ,$344.39 ,"$1,554.10 ","$1,937.70 ","$3,217.73 ","$1,328.40 ",$602.84 ,"$1,937.70 ","$1,484.79 ","$1,937.70 ","$1,937.70 ","$1,484.79 ","$1,399.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000135,36580,HC REPL CATH CV NON-TNL W/O PORT,360,1 ,"$3,231.00 ","$2,100.15 ",$344.39 ,"$3,231.00 ","$3,231.00 ","$2,407.10 ","$2,116.31 ","$1,484.79 ",$904.68 ,"$1,631.66 ","$1,484.79 ","$1,993.53 ","$1,484.79 ","$1,993.53 ","$1,993.53 ","$1,484.79 ","$1,993.53 ","$2,821.10 ","$2,907.90 ","$2,423.25 ","$3,231.00 ","$1,484.79 ","$2,843.28 ","$1,484.79 ","$2,423.25 ","$2,423.25 ","$2,746.35 ","$2,746.35 ","$1,484.79 ","$2,746.35 ","$1,484.79 ","$2,520.18 ","$2,520.18 ","$2,520.18 ","$2,907.90 ","$3,231.00 ","$2,907.90 ","$1,484.79 ","$3,231.00 ","$2,116.31 ","$1,484.79 ","$1,344.10 ",$360.79 ,$344.39 ,"$1,554.10 ","$2,907.90 ","$3,217.73 ","$1,993.53 ",$904.68 ,"$2,907.90 ","$1,484.79 ","$2,907.90 ","$2,907.90 ","$1,484.79 ","$2,100.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000136,36581,HC REPL CATH CV TNL W/O PORT,360,1 ,"$4,555.00 ","$2,960.75 ","$1,183.07 ","$6,550.42 ","$4,555.00 ","$3,393.48 ","$2,983.53 ","$3,022.62 ","$1,275.40 ","$2,300.28 ","$3,022.62 ","$2,810.44 ","$3,022.62 ","$2,810.44 ","$2,810.44 ","$3,022.62 ","$2,810.44 ","$5,742.98 ","$4,099.50 ","$3,416.25 ","$4,555.00 ","$3,022.62 ","$4,008.40 ","$3,022.62 ","$3,416.25 ","$3,416.25 ","$3,871.75 ","$3,871.75 ","$3,022.62 ","$3,871.75 ","$3,022.62 ","$3,552.90 ","$3,552.90 ","$3,552.90 ","$4,099.50 ","$4,555.00 ","$4,099.50 ","$3,022.62 ","$4,555.00 ","$2,983.53 ","$3,022.62 ","$1,894.88 ","$1,239.40 ","$1,183.07 ","$3,163.73 ","$4,099.50 ","$6,550.42 ","$2,810.44 ","$1,275.40 ","$4,099.50 ","$3,022.62 ","$4,099.50 ","$4,099.50 ","$3,022.62 ","$2,960.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000137,36582,HC REPL DEVICE CV TNL W/PORT,360,1 ,"$6,673.00 ","$4,337.45 ","$1,183.07 ","$6,673.00 ","$6,673.00 ","$4,971.39 ","$4,370.82 ","$3,022.62 ","$1,868.44 ","$3,369.87 ","$3,022.62 ","$4,117.24 ","$3,022.62 ","$4,117.24 ","$4,117.24 ","$3,022.62 ","$4,117.24 ","$5,742.98 ","$6,005.70 ","$5,004.75 ","$6,673.00 ","$3,022.62 ","$5,872.24 ","$3,022.62 ","$5,004.75 ","$5,004.75 ","$5,672.05 ","$5,672.05 ","$3,022.62 ","$5,672.05 ","$3,022.62 ","$5,204.94 ","$5,204.94 ","$5,204.94 ","$6,005.70 ","$6,673.00 ","$6,005.70 ","$3,022.62 ","$6,673.00 ","$4,370.82 ","$3,022.62 ","$2,775.97 ","$1,239.40 ","$1,183.07 ","$3,163.73 ","$6,005.70 ","$6,550.42 ","$4,117.24 ","$1,868.44 ","$6,005.70 ","$3,022.62 ","$6,005.70 ","$6,005.70 ","$3,022.62 ","$4,337.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000139,36584,HC REPL PICC W/O PORT/PUMP,360,1 ,"$1,409.00 ",$915.85 ,$98.57 ,"$3,217.73 ","$1,409.00 ","$1,049.71 ",$922.90 ,"$1,409.00 ",$394.52 ,$711.55 ,"$1,409.00 ",$869.35 ,"$1,409.00 ",$869.35 ,$869.35 ,"$1,409.00 ",$869.35 ,"$2,821.10 ","$1,268.10 ","$1,056.75 ","$1,409.00 ","$1,409.00 ","$1,239.92 ","$1,409.00 ","$1,056.75 ","$1,056.75 ","$1,197.65 ","$1,197.65 ","$1,409.00 ","$1,197.65 ","$1,409.00 ","$1,099.02 ","$1,099.02 ","$1,099.02 ","$1,268.10 ","$1,409.00 ","$1,268.10 ","$1,409.00 ","$1,409.00 ",$922.90 ,"$1,409.00 ",$586.14 ,$103.27 ,$98.57 ,"$1,409.00 ","$1,268.10 ","$3,217.73 ",$869.35 ,$394.52 ,"$1,268.10 ","$1,409.00 ","$1,268.10 ","$1,268.10 ","$1,409.00 ",$915.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,"$1,783.00 ","$1,158.95 ",$98.57 ,"$1,783.00 ","$1,370.07 ","$1,328.34 ","$1,167.87 ",$570.73 ,$499.24 ,$900.42 ,$570.73 ,"$1,100.11 ",$570.73 ,"$1,100.11 ","$1,100.11 ",$570.73 ,"$1,100.11 ","$1,084.39 ","$1,604.70 ","$1,337.25 ","$1,370.07 ",$570.73 ,"$1,569.04 ",$570.73 ,"$1,337.25 ","$1,337.25 ","$1,515.55 ","$1,515.55 ",$570.73 ,"$1,515.55 ",$570.73 ,"$1,390.74 ","$1,390.74 ","$1,390.74 ","$1,604.70 ","$1,370.07 ","$1,604.70 ",$570.73 ,"$1,783.00 ","$1,167.87 ",$570.73 ,$741.73 ,$103.27 ,$98.57 ,$597.38 ,"$1,604.70 ","$1,236.85 ","$1,100.11 ",$499.24 ,"$1,604.70 ",$570.73 ,"$1,604.70 ","$1,604.70 ",$570.73 ,"$1,158.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,"$2,675.00 ","$1,738.75 ",$98.57 ,"$2,675.00 ","$1,370.07 ","$1,992.88 ","$1,752.13 ",$570.73 ,$749.00 ,"$1,350.88 ",$570.73 ,"$1,650.48 ",$570.73 ,"$1,650.48 ","$1,650.48 ",$570.73 ,"$1,650.48 ","$1,084.39 ","$2,407.50 ","$2,006.25 ","$1,370.07 ",$570.73 ,"$2,354.00 ",$570.73 ,"$2,006.25 ","$2,006.25 ","$2,273.75 ","$2,273.75 ",$570.73 ,"$2,273.75 ",$570.73 ,"$2,086.50 ","$2,086.50 ","$2,086.50 ","$2,407.50 ","$1,370.07 ","$2,407.50 ",$570.73 ,"$2,675.00 ","$1,752.13 ",$570.73 ,"$1,112.80 ",$103.27 ,$98.57 ,$597.38 ,"$2,407.50 ","$1,236.85 ","$1,650.48 ",$749.00 ,"$2,407.50 ",$570.73 ,"$2,407.50 ","$2,407.50 ",$570.73 ,"$1,738.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000142,36590,HC REM TNL CV ACC W/PORT/PUMP,360,1 ,"$2,133.00 ","$1,386.45 ",$597.24 ,"$3,217.73 ","$2,133.00 ","$1,589.09 ","$1,397.12 ","$1,484.79 ",$597.24 ,"$1,077.17 ","$1,484.79 ","$1,316.06 ","$1,484.79 ","$1,316.06 ","$1,316.06 ","$1,484.79 ","$1,316.06 ","$2,821.10 ","$1,919.70 ","$1,599.75 ","$2,133.00 ","$1,484.79 ","$1,877.04 ","$1,484.79 ","$1,599.75 ","$1,599.75 ","$1,813.05 ","$1,813.05 ","$1,484.79 ","$1,813.05 ","$1,484.79 ","$1,663.74 ","$1,663.74 ","$1,663.74 ","$1,919.70 ","$2,133.00 ","$1,919.70 ","$1,484.79 ","$2,133.00 ","$1,397.12 ","$1,484.79 ",$887.33 ,$938.48 ,$895.82 ,"$1,554.10 ","$1,919.70 ","$3,217.73 ","$1,316.06 ",$597.24 ,"$1,919.70 ","$1,484.79 ","$1,919.70 ","$1,919.70 ","$1,484.79 ","$1,386.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000148,36620,HC CATH/CANN ARTERY PERC 36620,360,1 ,"$1,604.00 ","$1,042.60 ",$449.12 ,"$1,604.00 ", N/A ,"$1,194.98 ","$1,050.62 ", N/A ,$449.12 ,$810.02 , N/A ,$989.67 , N/A ,$989.67 ,$989.67 , N/A ,$989.67 , N/A ,"$1,443.60 ","$1,203.00 ", N/A , N/A ,"$1,411.52 ", N/A ,"$1,203.00 ","$1,203.00 ","$1,363.40 ","$1,363.40 ", N/A ,"$1,363.40 ", N/A ,"$1,251.12 ","$1,251.12 ","$1,251.12 ","$1,443.60 ", N/A ,"$1,443.60 ", N/A ,"$1,604.00 ","$1,050.62 ", N/A ,$667.26 ,"$1,604.00 ","$1,604.00 ", N/A ,"$1,443.60 ", N/A ,$989.67 ,$449.12 ,"$1,443.60 ", N/A ,"$1,443.60 ","$1,443.60 ", N/A ,"$1,042.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000158,38221,HC BX BONE MARROW ONLY,360,1 ,"$3,935.00 ","$2,557.75 ",$422.78 ,"$3,935.00 ","$3,566.38 ","$2,931.58 ","$2,577.43 ","$1,485.64 ","$1,101.80 ","$1,987.18 ","$1,485.64 ","$2,427.90 ","$1,485.64 ","$2,427.90 ","$2,427.90 ","$1,485.64 ","$2,427.90 ","$2,822.72 ","$3,541.50 ","$2,951.25 ","$3,566.38 ","$1,485.64 ","$3,462.80 ","$1,485.64 ","$2,951.25 ","$2,951.25 ","$3,344.75 ","$3,344.75 ","$1,485.64 ","$3,344.75 ","$1,485.64 ","$3,069.30 ","$3,069.30 ","$3,069.30 ","$3,541.50 ","$3,566.38 ","$3,541.50 ","$1,485.64 ","$3,935.00 ","$2,577.43 ","$1,485.64 ","$1,636.96 ",$442.92 ,$422.78 ,"$1,555.00 ","$3,541.50 ","$3,219.59 ","$2,427.90 ","$1,101.80 ","$3,541.50 ","$1,485.64 ","$3,541.50 ","$3,541.50 ","$1,485.64 ","$2,557.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$1,576.00 ","$1,024.40 ",$441.28 ,"$3,219.59 ","$1,576.00 ","$1,174.12 ","$1,032.28 ","$1,485.64 ",$441.28 ,$795.88 ,"$1,485.64 ",$972.39 ,"$1,485.64 ",$972.39 ,$972.39 ,"$1,485.64 ",$972.39 ,"$2,822.72 ","$1,418.40 ","$1,182.00 ","$1,576.00 ","$1,485.64 ","$1,386.88 ","$1,485.64 ","$1,182.00 ","$1,182.00 ","$1,339.60 ","$1,339.60 ","$1,485.64 ","$1,339.60 ","$1,485.64 ","$1,229.28 ","$1,229.28 ","$1,229.28 ","$1,418.40 ","$1,576.00 ","$1,418.40 ","$1,485.64 ","$1,576.00 ","$1,032.28 ","$1,485.64 ",$655.62 ,$703.86 ,$671.86 ,"$1,555.00 ","$1,418.40 ","$3,219.59 ",$972.39 ,$441.28 ,"$1,418.40 ","$1,485.64 ","$1,418.40 ","$1,418.40 ","$1,485.64 ","$1,024.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$1,051.00 ",$683.15 ,$294.28 ,"$3,219.59 ","$1,051.00 ",$783.00 ,$688.41 ,"$1,051.00 ",$294.28 ,$530.76 ,"$1,051.00 ",$648.47 ,"$1,051.00 ",$648.47 ,$648.47 ,"$1,051.00 ",$648.47 ,"$2,822.72 ",$945.90 ,$788.25 ,"$1,051.00 ","$1,051.00 ",$924.88 ,"$1,051.00 ",$788.25 ,$788.25 ,$893.35 ,$893.35 ,"$1,051.00 ",$893.35 ,"$1,051.00 ",$819.78 ,$819.78 ,$819.78 ,$945.90 ,"$1,051.00 ",$945.90 ,"$1,051.00 ","$1,051.00 ",$688.41 ,"$1,051.00 ",$437.22 ,$469.24 ,$447.91 ,"$1,051.00 ",$945.90 ,"$3,219.59 ",$648.47 ,$294.28 ,$945.90 ,"$1,051.00 ",$945.90 ,$945.90 ,"$1,051.00 ",$683.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,"$1,086.00 ",$705.90 ,$304.08 ,"$1,086.00 ",$955.48 ,$809.07 ,$711.33 ,$398.02 ,$304.08 ,$548.43 ,$398.02 ,$670.06 ,$398.02 ,$670.06 ,$670.06 ,$398.02 ,$670.06 ,$756.24 ,$977.40 ,$814.50 ,$955.48 ,$398.02 ,$955.68 ,$398.02 ,$814.50 ,$814.50 ,$923.10 ,$923.10 ,$398.02 ,$923.10 ,$398.02 ,$847.08 ,$847.08 ,$847.08 ,$977.40 ,$955.48 ,$977.40 ,$398.02 ,"$1,086.00 ",$711.33 ,$398.02 ,$451.78 , N/A , N/A ,$416.61 ,$977.40 ,$862.57 ,$670.06 ,$304.08 ,$977.40 ,$398.02 ,$977.40 ,$977.40 ,$398.02 ,$705.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000176,49418,HC INSERT INTRAPERITONEAL CATH,360,1 ,"$7,252.00 ","$4,713.80 ",$418.52 ,"$7,280.19 ","$7,252.00 ","$5,402.74 ","$4,750.06 ","$3,359.37 ","$2,030.56 ","$3,662.26 ","$3,359.37 ","$4,474.48 ","$3,359.37 ","$4,474.48 ","$4,474.48 ","$3,359.37 ","$4,474.48 ","$6,382.80 ","$6,526.80 ","$5,439.00 ","$7,252.00 ","$3,359.37 ","$6,381.76 ","$3,359.37 ","$5,439.00 ","$5,439.00 ","$6,164.20 ","$6,164.20 ","$3,359.37 ","$6,164.20 ","$3,359.37 ","$5,656.56 ","$5,656.56 ","$5,656.56 ","$6,526.80 ","$7,252.00 ","$6,526.80 ","$3,359.37 ","$7,252.00 ","$4,750.06 ","$3,359.37 ","$3,016.83 ",$438.45 ,$418.52 ,"$3,516.20 ","$6,526.80 ","$7,280.19 ","$4,474.48 ","$2,030.56 ","$6,526.80 ","$3,359.37 ","$6,526.80 ","$6,526.80 ","$3,359.37 ","$4,713.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000177,49421,HC INS CATH DRAIN PERITONEAL PERM,360,1 ,"$6,089.00 ","$3,957.85 ",$480.83 ,"$7,280.19 ","$6,089.00 ","$4,536.31 ","$3,988.30 ","$3,359.37 ","$1,704.92 ","$3,074.95 ","$3,359.37 ","$3,756.91 ","$3,359.37 ","$3,756.91 ","$3,756.91 ","$3,359.37 ","$3,756.91 ","$6,382.80 ","$5,480.10 ","$4,566.75 ","$6,089.00 ","$3,359.37 ","$5,358.32 ","$3,359.37 ","$4,566.75 ","$4,566.75 ","$5,175.65 ","$5,175.65 ","$3,359.37 ","$5,175.65 ","$3,359.37 ","$4,749.42 ","$4,749.42 ","$4,749.42 ","$5,480.10 ","$6,089.00 ","$5,480.10 ","$3,359.37 ","$6,089.00 ","$3,988.30 ","$3,359.37 ","$2,533.02 ",$503.72 ,$480.83 ,"$3,516.20 ","$5,480.10 ","$7,280.19 ","$3,756.91 ","$1,704.92 ","$5,480.10 ","$3,359.37 ","$5,480.10 ","$5,480.10 ","$3,359.37 ","$3,957.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000178,49422,HC REM CATH INTRAPERITONEAL,360,1 ,"$5,537.00 ","$3,599.05 ",$480.83 ,"$6,550.42 ","$5,537.00 ","$4,125.07 ","$3,626.74 ","$3,022.62 ","$1,550.36 ","$2,796.19 ","$3,022.62 ","$3,416.33 ","$3,022.62 ","$3,416.33 ","$3,416.33 ","$3,022.62 ","$3,416.33 ","$5,742.98 ","$4,983.30 ","$4,152.75 ","$5,537.00 ","$3,022.62 ","$4,872.56 ","$3,022.62 ","$4,152.75 ","$4,152.75 ","$4,706.45 ","$4,706.45 ","$3,022.62 ","$4,706.45 ","$3,022.62 ","$4,318.86 ","$4,318.86 ","$4,318.86 ","$4,983.30 ","$5,537.00 ","$4,983.30 ","$3,022.62 ","$5,537.00 ","$3,626.74 ","$3,022.62 ","$2,303.39 ",$503.72 ,$480.83 ,"$3,163.73 ","$4,983.30 ","$6,550.42 ","$3,416.33 ","$1,550.36 ","$4,983.30 ","$3,022.62 ","$4,983.30 ","$4,983.30 ","$3,022.62 ","$3,599.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000187,54150,HC CIRCUMCISION OP,360,1 ,$745.00 ,$484.25 ,$208.60 ,"$4,097.10 ",$745.00 ,$555.03 ,$487.98 ,$745.00 ,$208.60 ,$376.23 ,$745.00 ,$459.67 ,$745.00 ,$459.67 ,$459.67 ,$745.00 ,$459.67 ,"$3,592.06 ",$670.50 ,$558.75 ,$745.00 ,$745.00 ,$655.60 ,$745.00 ,$558.75 ,$558.75 ,$633.25 ,$633.25 ,$745.00 ,$633.25 ,$745.00 ,$581.10 ,$581.10 ,$581.10 ,$670.50 ,$745.00 ,$670.50 ,$745.00 ,$745.00 ,$487.98 ,$745.00 ,$309.92 ,$745.00 ,$745.00 ,$745.00 ,$670.50 ,"$4,097.10 ",$459.67 ,$208.60 ,$670.50 ,$745.00 ,$670.50 ,$670.50 ,$745.00 ,$484.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000194,62270,HC LUMBAR PUNCTURE,360,1 ,"$1,319.00 ",$857.35 ,$359.10 ,"$1,453.01 ","$1,319.00 ",$982.66 ,$863.95 ,$670.48 ,$369.32 ,$666.10 ,$670.48 ,$813.82 ,$670.48 ,$813.82 ,$813.82 ,$670.48 ,$813.82 ,"$1,273.91 ","$1,187.10 ",$989.25 ,"$1,319.00 ",$670.48 ,"$1,160.72 ",$670.48 ,$989.25 ,$989.25 ,"$1,121.15 ","$1,121.15 ",$670.48 ,"$1,121.15 ",$670.48 ,"$1,028.82 ","$1,028.82 ","$1,028.82 ","$1,187.10 ","$1,319.00 ","$1,187.10 ",$670.48 ,"$1,319.00 ",$863.95 ,$670.48 ,$548.70 ,$376.20 ,$359.10 ,$701.78 ,"$1,187.10 ","$1,453.01 ",$813.82 ,$369.32 ,"$1,187.10 ",$670.48 ,"$1,187.10 ","$1,187.10 ",$670.48 ,$857.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000222,36571,HC INS CATH PERIPH CV W/PORT >5,360,1 ,"$4,205.00 ","$2,733.25 ","$1,177.40 ","$6,550.42 ","$4,205.00 ","$3,132.73 ","$2,754.28 ","$3,022.62 ","$1,177.40 ","$2,123.53 ","$3,022.62 ","$2,594.49 ","$3,022.62 ","$2,594.49 ","$2,594.49 ","$3,022.62 ","$2,594.49 ","$5,742.98 ","$3,784.50 ","$3,153.75 ","$4,205.00 ","$3,022.62 ","$3,700.40 ","$3,022.62 ","$3,153.75 ","$3,153.75 ","$3,574.25 ","$3,574.25 ","$3,022.62 ","$3,574.25 ","$3,022.62 ","$3,279.90 ","$3,279.90 ","$3,279.90 ","$3,784.50 ","$4,205.00 ","$3,784.50 ","$3,022.62 ","$4,205.00 ","$2,754.28 ","$3,022.62 ","$1,749.28 ","$1,239.40 ","$1,183.07 ","$3,163.73 ","$3,784.50 ","$6,550.42 ","$2,594.49 ","$1,177.40 ","$3,784.50 ","$3,022.62 ","$3,784.50 ","$3,784.50 ","$3,022.62 ","$2,733.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000222,36571,HC INS CATH PERIPH CV W/PORT >5,360,1 ,"$6,308.00 ","$4,100.20 ","$1,766.24 ","$6,550.42 ","$6,308.00 ","$4,699.46 ","$4,131.74 ","$3,022.62 ","$1,766.24 ","$3,185.54 ","$3,022.62 ","$3,892.04 ","$3,022.62 ","$3,892.04 ","$3,892.04 ","$3,022.62 ","$3,892.04 ","$5,742.98 ","$5,677.20 ","$4,731.00 ","$6,308.00 ","$3,022.62 ","$5,551.04 ","$3,022.62 ","$4,731.00 ","$4,731.00 ","$5,361.80 ","$5,361.80 ","$3,022.62 ","$5,361.80 ","$3,022.62 ","$4,920.24 ","$4,920.24 ","$4,920.24 ","$5,677.20 ","$6,308.00 ","$5,677.20 ","$3,022.62 ","$6,308.00 ","$4,131.74 ","$3,022.62 ","$2,624.13 ","$1,859.11 ","$1,774.61 ","$3,163.73 ","$5,677.20 ","$6,550.42 ","$3,892.04 ","$1,766.24 ","$5,677.20 ","$3,022.62 ","$5,677.20 ","$5,677.20 ","$3,022.62 ","$4,100.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000310,64421,HC INJ ANES INTERCOSTAL NERVE EA ADDNT LEVEL,360,1 ,"$4,569.00 ","$2,969.85 ",$305.67 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$320.22 ,$305.67 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000311,64420,HC INJ INTERCOSTAL NERVE;SINGLE,360,1 ,"$1,875.00 ","$1,218.75 ",$305.67 ,"$1,875.00 ","$1,609.52 ","$1,396.88 ","$1,228.13 ",$670.48 ,$525.00 ,$946.88 ,$670.48 ,"$1,156.88 ",$670.48 ,"$1,156.88 ","$1,156.88 ",$670.48 ,"$1,156.88 ","$1,273.91 ","$1,687.50 ","$1,406.25 ","$1,609.52 ",$670.48 ,"$1,650.00 ",$670.48 ,"$1,406.25 ","$1,406.25 ","$1,593.75 ","$1,593.75 ",$670.48 ,"$1,593.75 ",$670.48 ,"$1,462.50 ","$1,462.50 ","$1,462.50 ","$1,687.50 ","$1,609.52 ","$1,687.50 ",$670.48 ,"$1,875.00 ","$1,228.13 ",$670.48 ,$780.00 ,$320.22 ,$305.67 ,$701.78 ,"$1,687.50 ","$1,453.01 ","$1,156.88 ",$525.00 ,"$1,687.50 ",$670.48 ,"$1,687.50 ","$1,687.50 ",$670.48 ,"$1,218.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000327,64445,HC NERVE BLOCK;SCIATIC SINGLE,360,1 ,"$3,372.00 ","$2,191.80 ",$458.49 ,"$3,372.00 ","$2,414.28 ","$2,512.14 ","$2,208.66 ","$1,005.72 ",$944.16 ,"$1,702.86 ","$1,005.72 ","$2,080.52 ","$1,005.72 ","$2,080.52 ","$2,080.52 ","$1,005.72 ","$2,080.52 ","$1,910.87 ","$3,034.80 ","$2,529.00 ","$2,414.28 ","$1,005.72 ","$2,967.36 ","$1,005.72 ","$2,529.00 ","$2,529.00 ","$2,866.20 ","$2,866.20 ","$1,005.72 ","$2,866.20 ","$1,005.72 ","$2,630.16 ","$2,630.16 ","$2,630.16 ","$3,034.80 ","$2,414.28 ","$3,034.80 ","$1,005.72 ","$3,372.00 ","$2,208.66 ","$1,005.72 ","$1,402.75 ",$480.33 ,$458.49 ,"$1,052.67 ","$3,034.80 ","$2,179.52 ","$2,080.52 ",$944.16 ,"$3,034.80 ","$1,005.72 ","$3,034.80 ","$3,034.80 ","$1,005.72 ","$2,191.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000327,64445,HC NERVE BLOCK;SCIATIC SINGLE,360,1 ,"$2,248.00 ","$1,461.20 ",$305.67 ,"$2,248.00 ","$1,609.52 ","$1,674.76 ","$1,472.44 ",$670.48 ,$629.44 ,"$1,135.24 ",$670.48 ,"$1,387.02 ",$670.48 ,"$1,387.02 ","$1,387.02 ",$670.48 ,"$1,387.02 ","$1,273.91 ","$2,023.20 ","$1,686.00 ","$1,609.52 ",$670.48 ,"$1,978.24 ",$670.48 ,"$1,686.00 ","$1,686.00 ","$1,910.80 ","$1,910.80 ",$670.48 ,"$1,910.80 ",$670.48 ,"$1,753.44 ","$1,753.44 ","$1,753.44 ","$2,023.20 ","$1,609.52 ","$2,023.20 ",$670.48 ,"$2,248.00 ","$1,472.44 ",$670.48 ,$935.17 ,$320.22 ,$305.67 ,$701.78 ,"$2,023.20 ","$1,453.01 ","$1,387.02 ",$629.44 ,"$2,023.20 ",$670.48 ,"$2,023.20 ","$2,023.20 ",$670.48 ,"$1,461.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000331,64520,HC NERVE BLOCK;L/S PARAVERTEBAL SYMP,360,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000334,63650,HC IMPLANT NEUROELECTRODES,360,1 ,"$17,089.00 ","$11,107.85 ","$3,407.90 ","$17,089.00 ","$15,624.29 ","$12,731.31 ","$11,193.30 ","$6,508.60 ","$4,784.92 ","$8,629.95 ","$6,508.60 ","$10,543.91 ","$6,508.60 ","$10,543.91 ","$10,543.91 ","$6,508.60 ","$10,543.91 ","$12,366.34 ","$15,380.10 ","$12,816.75 ","$15,624.29 ","$6,508.60 ","$15,038.32 ","$6,508.60 ","$12,816.75 ","$12,816.75 ","$14,525.65 ","$14,525.65 ","$6,508.60 ","$14,525.65 ","$6,508.60 ","$13,329.42 ","$13,329.42 ","$13,329.42 ","$15,380.10 ","$15,624.29 ","$15,380.10 ","$6,508.60 ","$17,089.00 ","$11,193.30 ","$6,508.60 ","$7,109.02 ","$3,570.18 ","$3,407.90 ","$6,812.46 ","$15,380.10 ","$14,105.00 ","$10,543.91 ","$4,784.92 ","$15,380.10 ","$6,508.60 ","$15,380.10 ","$15,380.10 ","$6,508.60 ","$11,107.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000352,37192,HC IVC FILTER REPOSITIONING 37192,360,1 ,"$3,225.00 ","$2,096.25 ",$903.00 ,"$6,550.42 ","$3,225.00 ","$2,402.63 ","$2,112.38 ","$3,022.62 ",$903.00 ,"$1,628.63 ","$3,022.62 ","$1,989.83 ","$3,022.62 ","$1,989.83 ","$1,989.83 ","$3,022.62 ","$1,989.83 ","$5,742.98 ","$2,902.50 ","$2,418.75 ","$3,225.00 ","$3,022.62 ","$2,838.00 ","$3,022.62 ","$2,418.75 ","$2,418.75 ","$2,741.25 ","$2,741.25 ","$3,022.62 ","$2,741.25 ","$3,022.62 ","$2,515.50 ","$2,515.50 ","$2,515.50 ","$2,902.50 ","$3,225.00 ","$2,902.50 ","$3,022.62 ","$3,225.00 ","$2,112.38 ","$3,022.62 ","$1,341.60 ","$2,268.89 ","$2,165.76 ","$3,163.73 ","$2,902.50 ","$6,550.42 ","$1,989.83 ",$903.00 ,"$2,902.50 ","$3,022.62 ","$2,902.50 ","$2,902.50 ","$3,022.62 ","$2,096.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000397,27301,HC I AND D ABSC/BURSA THIGH/KNEE,360,1 ,"$6,648.00 ","$4,321.20 ",$728.45 ,"$6,648.00 ","$6,009.89 ","$4,952.76 ","$4,354.44 ","$2,503.54 ","$1,861.44 ","$3,357.24 ","$2,503.54 ","$4,101.82 ","$2,503.54 ","$4,101.82 ","$4,101.82 ","$2,503.54 ","$4,101.82 ","$4,756.73 ","$5,983.20 ","$4,986.00 ","$6,009.89 ","$2,503.54 ","$5,850.24 ","$2,503.54 ","$4,986.00 ","$4,986.00 ","$5,650.80 ","$5,650.80 ","$2,503.54 ","$5,650.80 ","$2,503.54 ","$5,185.44 ","$5,185.44 ","$5,185.44 ","$5,983.20 ","$6,009.89 ","$5,983.20 ","$2,503.54 ","$6,648.00 ","$4,354.44 ","$2,503.54 ","$2,765.57 ",$763.14 ,$728.45 ,"$2,620.42 ","$5,983.20 ","$5,425.50 ","$4,101.82 ","$1,861.44 ","$5,983.20 ","$2,503.54 ","$5,983.20 ","$5,983.20 ","$2,503.54 ","$4,321.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000420,26735,HC TX FX OPEN SHAFT FINGER/THUMB W/INT FIX EACH,360,1 ,"$7,848.00 ","$5,101.20 ","$2,197.44 ","$7,848.00 ","$7,178.17 ","$5,846.76 ","$5,140.44 ","$2,990.21 ","$2,197.44 ","$3,963.24 ","$2,990.21 ","$4,842.22 ","$2,990.21 ","$4,842.22 ","$4,842.22 ","$2,990.21 ","$4,842.22 ","$5,681.40 ","$7,063.20 ","$5,886.00 ","$7,178.17 ","$2,990.21 ","$6,906.24 ","$2,990.21 ","$5,886.00 ","$5,886.00 ","$6,670.80 ","$6,670.80 ","$2,990.21 ","$6,670.80 ","$2,990.21 ","$6,121.44 ","$6,121.44 ","$6,121.44 ","$7,063.20 ","$7,178.17 ","$7,063.20 ","$2,990.21 ","$7,848.00 ","$5,140.44 ","$2,990.21 ","$3,264.77 ","$3,263.67 ","$3,115.32 ","$3,129.80 ","$7,063.20 ","$6,480.18 ","$4,842.22 ","$2,197.44 ","$7,063.20 ","$2,990.21 ","$7,063.20 ","$7,063.20 ","$2,990.21 ","$5,101.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000465,54161,HC CIRCUMCISION W/O DEVICE  >28 DAYS,360,1 ,"$5,325.00 ","$3,461.25 ","$1,041.85 ","$5,325.00 ","$4,538.41 ","$3,967.13 ","$3,487.88 ","$1,890.56 ","$1,491.00 ","$2,689.13 ","$1,890.56 ","$3,285.53 ","$1,890.56 ","$3,285.53 ","$3,285.53 ","$1,890.56 ","$3,285.53 ","$3,592.06 ","$4,792.50 ","$3,993.75 ","$4,538.41 ","$1,890.56 ","$4,686.00 ","$1,890.56 ","$3,993.75 ","$3,993.75 ","$4,526.25 ","$4,526.25 ","$1,890.56 ","$4,526.25 ","$1,890.56 ","$4,153.50 ","$4,153.50 ","$4,153.50 ","$4,792.50 ","$4,538.41 ","$4,792.50 ","$1,890.56 ","$5,325.00 ","$3,487.88 ","$1,890.56 ","$2,215.20 ","$1,091.46 ","$1,041.85 ","$1,978.83 ","$4,792.50 ","$4,097.10 ","$3,285.53 ","$1,491.00 ","$4,792.50 ","$1,890.56 ","$4,792.50 ","$4,792.50 ","$1,890.56 ","$3,461.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000569,64486,HC TAP BLOCK W/INJ UNILT,360,1 ,"$2,248.00 ","$1,461.20 ",$305.67 ,"$2,248.00 ", N/A ,"$1,674.76 ","$1,472.44 ", N/A ,$629.44 ,"$1,135.24 ", N/A ,"$1,387.02 ", N/A ,"$1,387.02 ","$1,387.02 ", N/A ,"$1,387.02 ", N/A ,"$2,023.20 ","$1,686.00 ", N/A , N/A ,"$1,978.24 ", N/A ,"$1,686.00 ","$1,686.00 ","$1,910.80 ","$1,910.80 ", N/A ,"$1,910.80 ", N/A ,"$1,753.44 ","$1,753.44 ","$1,753.44 ","$2,023.20 ", N/A ,"$2,023.20 ", N/A ,"$2,248.00 ","$1,472.44 ", N/A ,$935.17 ,$320.22 ,$305.67 , N/A ,"$2,023.20 ", N/A ,"$1,387.02 ",$629.44 ,"$2,023.20 ", N/A ,"$2,023.20 ","$2,023.20 ", N/A ,"$1,461.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000583,33221,HC INSERT PACEMAKER PULSE GENERATOR MULT LEADS,360,1 ,"$50,203.00 ","$32,631.95 ","$5,591.26 ","$50,203.00 ","$47,206.51 ","$37,401.24 ","$32,882.97 ","$19,664.79 ","$14,056.84 ","$25,352.52 ","$19,664.79 ","$30,975.25 ","$19,664.79 ","$30,975.25 ","$30,975.25 ","$19,664.79 ","$30,975.25 ","$37,363.10 ","$45,182.70 ","$37,652.25 ","$47,206.51 ","$19,664.79 ","$44,178.64 ","$19,664.79 ","$37,652.25 ","$37,652.25 ","$42,672.55 ","$42,672.55 ","$19,664.79 ","$42,672.55 ","$19,664.79 ","$39,158.34 ","$39,158.34 ","$39,158.34 ","$45,182.70 ","$47,206.51 ","$45,182.70 ","$19,664.79 ","$50,203.00 ","$32,882.97 ","$19,664.79 ","$20,884.45 ","$5,857.51 ","$5,591.26 ","$20,582.85 ","$45,182.70 ","$42,616.23 ","$30,975.25 ","$14,056.84 ","$45,182.70 ","$19,664.79 ","$45,182.70 ","$45,182.70 ","$19,664.79 ","$32,631.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000642,36002,HC INJ TX PSEUDOANEURYSM EXTREMITY PERC-LT,360,1 ,$936.00 ,$608.40 ,$262.08 ,"$1,236.85 ",$936.00 ,$697.32 ,$613.08 ,$570.73 ,$262.08 ,$472.68 ,$570.73 ,$577.51 ,$570.73 ,$577.51 ,$577.51 ,$570.73 ,$577.51 ,"$1,084.39 ",$842.40 ,$702.00 ,$936.00 ,$570.73 ,$823.68 ,$570.73 ,$702.00 ,$702.00 ,$795.60 ,$795.60 ,$570.73 ,$795.60 ,$570.73 ,$730.08 ,$730.08 ,$730.08 ,$842.40 ,$936.00 ,$842.40 ,$570.73 ,$936.00 ,$613.08 ,$570.73 ,$389.38 , N/A , N/A ,$597.38 ,$842.40 ,"$1,236.85 ",$577.51 ,$262.08 ,$842.40 ,$570.73 ,$842.40 ,$842.40 ,$570.73 ,$608.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000643,36002,HC INJ TX PSEUDOANEURYSM EXTREMITY PERC-RT,360,1 ,$936.00 ,$608.40 ,$262.08 ,"$1,236.85 ",$936.00 ,$697.32 ,$613.08 ,$570.73 ,$262.08 ,$472.68 ,$570.73 ,$577.51 ,$570.73 ,$577.51 ,$577.51 ,$570.73 ,$577.51 ,"$1,084.39 ",$842.40 ,$702.00 ,$936.00 ,$570.73 ,$823.68 ,$570.73 ,$702.00 ,$702.00 ,$795.60 ,$795.60 ,$570.73 ,$795.60 ,$570.73 ,$730.08 ,$730.08 ,$730.08 ,$842.40 ,$936.00 ,$842.40 ,$570.73 ,$936.00 ,$613.08 ,$570.73 ,$389.38 , N/A , N/A ,$597.38 ,$842.40 ,"$1,236.85 ",$577.51 ,$262.08 ,$842.40 ,$570.73 ,$842.40 ,$842.40 ,$570.73 ,$608.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000644,36002,HC INJ TX PSEUDOANEURYSM EXTREMITY PERC-BIL,360,1 ,"$1,310.00 ",$851.50 ,$366.80 ,"$1,855.28 ","$1,310.00 ",$975.95 ,$858.05 ,$856.10 ,$366.80 ,$661.55 ,$856.10 ,$808.27 ,$856.10 ,$808.27 ,$808.27 ,$856.10 ,$808.27 ,"$1,626.59 ","$1,179.00 ",$982.50 ,"$1,310.00 ",$856.10 ,"$1,152.80 ",$856.10 ,$982.50 ,$982.50 ,"$1,113.50 ","$1,113.50 ",$856.10 ,"$1,113.50 ",$856.10 ,"$1,021.80 ","$1,021.80 ","$1,021.80 ","$1,179.00 ","$1,310.00 ","$1,179.00 ",$856.10 ,"$1,310.00 ",$858.05 ,$856.10 ,$544.96 , N/A , N/A ,$896.06 ,"$1,179.00 ","$1,855.28 ",$808.27 ,$366.80 ,"$1,179.00 ",$856.10 ,"$1,179.00 ","$1,179.00 ",$856.10 ,$851.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000650,36475,HC ABLATION THPY EXTREM PERC RADFQ INIT VEIN,360,1 ,"$8,695.00 ","$5,651.75 ","$1,676.50 ","$8,695.00 ","$7,255.98 ","$6,477.78 ","$5,695.23 ","$3,022.62 ","$2,434.60 ","$4,390.98 ","$3,022.62 ","$5,364.82 ","$3,022.62 ","$5,364.82 ","$5,364.82 ","$3,022.62 ","$5,364.82 ","$5,742.98 ","$7,825.50 ","$6,521.25 ","$7,255.98 ","$3,022.62 ","$7,651.60 ","$3,022.62 ","$6,521.25 ","$6,521.25 ","$7,390.75 ","$7,390.75 ","$3,022.62 ","$7,390.75 ","$3,022.62 ","$6,782.10 ","$6,782.10 ","$6,782.10 ","$7,825.50 ","$7,255.98 ","$7,825.50 ","$3,022.62 ","$8,695.00 ","$5,695.23 ","$3,022.62 ","$3,617.12 ","$1,756.34 ","$1,676.50 ","$3,163.73 ","$7,825.50 ","$6,550.42 ","$5,364.82 ","$2,434.60 ","$7,825.50 ","$3,022.62 ","$7,825.50 ","$7,825.50 ","$3,022.62 ","$5,651.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000651,36476,HC ABLATION THPY EXTREM PERC RADFQ ADDL VEIN,360,1 ,"$3,733.00 ","$2,426.45 ","$1,045.24 ","$3,733.00 ", N/A ,"$2,781.09 ","$2,445.12 ", N/A ,"$1,045.24 ","$1,885.17 ", N/A ,"$2,303.26 ", N/A ,"$2,303.26 ","$2,303.26 ", N/A ,"$2,303.26 ", N/A ,"$3,359.70 ","$2,799.75 ", N/A , N/A ,"$3,285.04 ", N/A ,"$2,799.75 ","$2,799.75 ","$3,173.05 ","$3,173.05 ", N/A ,"$3,173.05 ", N/A ,"$2,911.74 ","$2,911.74 ","$2,911.74 ","$3,359.70 ", N/A ,"$3,359.70 ", N/A ,"$3,733.00 ","$2,445.12 ", N/A ,"$1,552.93 ","$1,756.34 ","$1,676.50 ", N/A ,"$3,359.70 ", N/A ,"$2,303.26 ","$1,045.24 ","$3,359.70 ", N/A ,"$3,359.70 ","$3,359.70 ", N/A ,"$2,426.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000652,36478,HC ABLATION THPY EXTREM PERC LASER INIT VEIN,360,1 ,"$7,500.00 ","$4,875.00 ","$1,676.50 ","$7,500.00 ","$7,255.98 ","$5,587.50 ","$4,912.50 ","$3,022.62 ","$2,100.00 ","$3,787.50 ","$3,022.62 ","$4,627.50 ","$3,022.62 ","$4,627.50 ","$4,627.50 ","$3,022.62 ","$4,627.50 ","$5,742.98 ","$6,750.00 ","$5,625.00 ","$7,255.98 ","$3,022.62 ","$6,600.00 ","$3,022.62 ","$5,625.00 ","$5,625.00 ","$6,375.00 ","$6,375.00 ","$3,022.62 ","$6,375.00 ","$3,022.62 ","$5,850.00 ","$5,850.00 ","$5,850.00 ","$6,750.00 ","$7,255.98 ","$6,750.00 ","$3,022.62 ","$7,500.00 ","$4,912.50 ","$3,022.62 ","$3,120.00 ","$1,756.34 ","$1,676.50 ","$3,163.73 ","$6,750.00 ","$6,550.42 ","$4,627.50 ","$2,100.00 ","$6,750.00 ","$3,022.62 ","$6,750.00 ","$6,750.00 ","$3,022.62 ","$4,875.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000653,36479,HC ABLATION THPY EXTREM PERC LASER ADDL VEIN,360,1 ,"$3,750.00 ","$2,437.50 ","$1,050.00 ","$3,750.00 ", N/A ,"$2,793.75 ","$2,456.25 ", N/A ,"$1,050.00 ","$1,893.75 ", N/A ,"$2,313.75 ", N/A ,"$2,313.75 ","$2,313.75 ", N/A ,"$2,313.75 ", N/A ,"$3,375.00 ","$2,812.50 ", N/A , N/A ,"$3,300.00 ", N/A ,"$2,812.50 ","$2,812.50 ","$3,187.50 ","$3,187.50 ", N/A ,"$3,187.50 ", N/A ,"$2,925.00 ","$2,925.00 ","$2,925.00 ","$3,375.00 ", N/A ,"$3,375.00 ", N/A ,"$3,750.00 ","$2,456.25 ", N/A ,"$1,560.00 ","$1,756.34 ","$1,676.50 ", N/A ,"$3,375.00 ", N/A ,"$2,313.75 ","$1,050.00 ","$3,375.00 ", N/A ,"$3,375.00 ","$3,375.00 ", N/A ,"$2,437.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000656,36660,HC CATHERIZATION UMBILICAL ARTERY NEWBORN,360,1 ,$153.00 ,$99.45 ,$42.84 ,$153.00 , N/A ,$113.99 ,$100.22 , N/A ,$42.84 ,$77.27 , N/A ,$94.40 , N/A ,$94.40 ,$94.40 , N/A ,$94.40 , N/A ,$137.70 ,$114.75 , N/A , N/A ,$134.64 , N/A ,$114.75 ,$114.75 ,$130.05 ,$130.05 , N/A ,$130.05 , N/A ,$119.34 ,$119.34 ,$119.34 ,$137.70 , N/A ,$137.70 , N/A ,$153.00 ,$100.22 , N/A ,$63.65 , N/A , N/A , N/A ,$137.70 , N/A ,$94.40 ,$42.84 ,$137.70 , N/A ,$137.70 ,$137.70 , N/A ,$99.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000667,37765,HC STAB PHLEBECTOMRY VEINS EXTREM 10-20 INCISIONS,360,1 ,"$7,582.00 ","$4,928.30 ",$610.00 ,"$7,582.00 ","$7,255.98 ","$5,648.59 ","$4,966.21 ","$3,022.62 ","$2,122.96 ","$3,828.91 ","$3,022.62 ","$4,678.09 ","$3,022.62 ","$4,678.09 ","$4,678.09 ","$3,022.62 ","$4,678.09 ","$5,742.98 ","$6,823.80 ","$5,686.50 ","$7,255.98 ","$3,022.62 ","$6,672.16 ","$3,022.62 ","$5,686.50 ","$5,686.50 ","$6,444.70 ","$6,444.70 ","$3,022.62 ","$6,444.70 ","$3,022.62 ","$5,913.96 ","$5,913.96 ","$5,913.96 ","$6,823.80 ","$7,255.98 ","$6,823.80 ","$3,022.62 ","$7,582.00 ","$4,966.21 ","$3,022.62 ","$3,154.11 ",$639.05 ,$610.00 ,"$3,163.73 ","$6,823.80 ","$6,550.42 ","$4,678.09 ","$2,122.96 ","$6,823.80 ","$3,022.62 ","$6,823.80 ","$6,823.80 ","$3,022.62 ","$4,928.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000668,37766,HC STAB PHLEBECTOMRY VEINS EXTREM >20 INCISIONS,360,1 ,"$8,488.00 ","$5,517.20 ",$610.00 ,"$8,488.00 ","$7,255.98 ","$6,323.56 ","$5,559.64 ","$3,022.62 ","$2,376.64 ","$4,286.44 ","$3,022.62 ","$5,237.10 ","$3,022.62 ","$5,237.10 ","$5,237.10 ","$3,022.62 ","$5,237.10 ","$5,742.98 ","$7,639.20 ","$6,366.00 ","$7,255.98 ","$3,022.62 ","$7,469.44 ","$3,022.62 ","$6,366.00 ","$6,366.00 ","$7,214.80 ","$7,214.80 ","$3,022.62 ","$7,214.80 ","$3,022.62 ","$6,620.64 ","$6,620.64 ","$6,620.64 ","$7,639.20 ","$7,255.98 ","$7,639.20 ","$3,022.62 ","$8,488.00 ","$5,559.64 ","$3,022.62 ","$3,531.01 ",$639.05 ,$610.00 ,"$3,163.73 ","$7,639.20 ","$6,550.42 ","$5,237.10 ","$2,376.64 ","$7,639.20 ","$3,022.62 ","$7,639.20 ","$7,639.20 ","$3,022.62 ","$5,517.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000680,50590,HC LITHOTRIPSY EXTRCORPOREAL SHOCK WAVE UNI,360,1 ,"$16,225.00 ","$10,546.25 ","$1,789.91 ","$16,225.00 ","$7,793.07 ","$12,087.63 ","$10,627.38 ","$3,246.35 ","$4,543.00 ","$8,193.63 ","$3,246.35 ","$10,010.83 ","$3,246.35 ","$10,010.83 ","$10,010.83 ","$3,246.35 ","$10,010.83 ","$6,168.07 ","$14,602.50 ","$12,168.75 ","$7,793.07 ","$3,246.35 ","$14,278.00 ","$3,246.35 ","$12,168.75 ","$12,168.75 ","$13,791.25 ","$13,791.25 ","$3,246.35 ","$13,791.25 ","$3,246.35 ","$12,655.50 ","$12,655.50 ","$12,655.50 ","$14,602.50 ","$7,793.07 ","$14,602.50 ","$3,246.35 ","$16,225.00 ","$10,627.38 ","$3,246.35 ","$6,749.60 ","$1,875.15 ","$1,789.91 ","$3,397.91 ","$14,602.50 ","$7,035.28 ","$10,010.83 ","$4,543.00 ","$14,602.50 ","$3,246.35 ","$14,602.50 ","$14,602.50 ","$3,246.35 ","$10,546.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000681,50590,HC LITHOTRIPSY EXTRCORPOREAL SHOCK WAVE BIL,360,1 ,"$17,848.00 ","$11,601.20 ","$1,789.91 ","$17,848.00 ","$7,793.07 ","$13,296.76 ","$11,690.44 ","$3,246.35 ","$4,997.44 ","$9,013.24 ","$3,246.35 ","$11,012.22 ","$3,246.35 ","$11,012.22 ","$11,012.22 ","$3,246.35 ","$11,012.22 ","$6,168.07 ","$16,063.20 ","$13,386.00 ","$7,793.07 ","$3,246.35 ","$15,706.24 ","$3,246.35 ","$13,386.00 ","$13,386.00 ","$15,170.80 ","$15,170.80 ","$3,246.35 ","$15,170.80 ","$3,246.35 ","$13,921.44 ","$13,921.44 ","$13,921.44 ","$16,063.20 ","$7,793.07 ","$16,063.20 ","$3,246.35 ","$17,848.00 ","$11,690.44 ","$3,246.35 ","$7,424.77 ","$1,875.15 ","$1,789.91 ","$3,397.91 ","$16,063.20 ","$7,035.28 ","$11,012.22 ","$4,997.44 ","$16,063.20 ","$3,246.35 ","$16,063.20 ","$16,063.20 ","$3,246.35 ","$11,601.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000685,28825,HC AMPUTATION INTERPHALANGEAL JOINT,360,1 ,"$7,609.00 ","$4,945.85 ","$1,311.63 ","$7,609.00 ","$7,178.17 ","$5,668.71 ","$4,983.90 ","$2,990.21 ","$2,130.52 ","$3,842.55 ","$2,990.21 ","$4,694.75 ","$2,990.21 ","$4,694.75 ","$4,694.75 ","$2,990.21 ","$4,694.75 ","$5,681.40 ","$6,848.10 ","$5,706.75 ","$7,178.17 ","$2,990.21 ","$6,695.92 ","$2,990.21 ","$5,706.75 ","$5,706.75 ","$6,467.65 ","$6,467.65 ","$2,990.21 ","$6,467.65 ","$2,990.21 ","$5,935.02 ","$5,935.02 ","$5,935.02 ","$6,848.10 ","$7,178.17 ","$6,848.10 ","$2,990.21 ","$7,609.00 ","$4,983.90 ","$2,990.21 ","$3,165.34 ","$1,374.09 ","$1,311.63 ","$3,129.80 ","$6,848.10 ","$6,480.18 ","$4,694.75 ","$2,130.52 ","$6,848.10 ","$2,990.21 ","$6,848.10 ","$6,848.10 ","$2,990.21 ","$4,945.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000755,41018,HC I AND D MASTICATOR SPACE,360,1 ,"$4,058.37 ","$2,637.94 ",$889.50 ,"$4,058.37 ","$3,428.76 ","$3,023.49 ","$2,658.23 ","$1,428.32 ","$1,136.34 ","$2,049.48 ","$1,428.32 ","$2,504.01 ","$1,428.32 ","$2,504.01 ","$2,504.01 ","$1,428.32 ","$2,504.01 ","$2,713.81 ","$3,652.53 ","$3,043.78 ","$3,428.76 ","$1,428.32 ","$3,571.37 ","$1,428.32 ","$3,043.78 ","$3,043.78 ","$3,449.61 ","$3,449.61 ","$1,428.32 ","$3,449.61 ","$1,428.32 ","$3,165.53 ","$3,165.53 ","$3,165.53 ","$3,652.53 ","$3,428.76 ","$3,652.53 ","$1,428.32 ","$4,058.37 ","$2,658.23 ","$1,428.32 ","$1,688.28 ",$931.85 ,$889.50 ,"$1,495.00 ","$3,652.53 ","$3,095.35 ","$2,504.01 ","$1,136.34 ","$3,652.53 ","$1,428.32 ","$3,652.53 ","$3,652.53 ","$1,428.32 ","$2,637.94 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000758,43460,HC PRESSURE TREATMENT ESOPHAGUS,360,1 ,"$1,569.12 ","$1,019.93 ",$439.35 ,"$1,569.12 ", N/A ,"$1,168.99 ","$1,027.77 ", N/A ,$439.35 ,$792.41 , N/A ,$968.15 , N/A ,$968.15 ,$968.15 , N/A ,$968.15 , N/A ,"$1,412.21 ","$1,176.84 ", N/A , N/A ,"$1,380.83 ", N/A ,"$1,176.84 ","$1,176.84 ","$1,333.75 ","$1,333.75 ", N/A ,"$1,333.75 ", N/A ,"$1,223.91 ","$1,223.91 ","$1,223.91 ","$1,412.21 ", N/A ,"$1,412.21 ", N/A ,"$1,569.12 ","$1,027.77 ", N/A ,$652.75 , N/A , N/A , N/A ,"$1,412.21 ", N/A ,$968.15 ,$439.35 ,"$1,412.21 ", N/A ,"$1,412.21 ","$1,412.21 ", N/A ,"$1,019.93 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36000761,54115,HC REMOVAL FOREIGN BODY DEEP PENILE TISSUE,360,1 ,"$6,748.71 ","$4,386.66 ","$1,662.77 ","$6,748.71 ","$6,009.89 ","$5,027.79 ","$4,420.41 ","$2,503.54 ","$1,889.64 ","$3,408.10 ","$2,503.54 ","$4,163.95 ","$2,503.54 ","$4,163.95 ","$4,163.95 ","$2,503.54 ","$4,163.95 ","$4,756.73 ","$6,073.84 ","$5,061.53 ","$6,009.89 ","$2,503.54 ","$5,938.86 ","$2,503.54 ","$5,061.53 ","$5,061.53 ","$5,736.40 ","$5,736.40 ","$2,503.54 ","$5,736.40 ","$2,503.54 ","$5,263.99 ","$5,263.99 ","$5,263.99 ","$6,073.84 ","$6,009.89 ","$6,073.84 ","$2,503.54 ","$6,748.71 ","$4,420.41 ","$2,503.54 ","$2,807.46 ","$1,741.95 ","$1,662.77 ","$2,620.42 ","$6,073.84 ","$5,425.50 ","$4,163.95 ","$1,889.64 ","$6,073.84 ","$2,503.54 ","$6,073.84 ","$6,073.84 ","$2,503.54 ","$4,386.66 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,$990.00 ,$643.50 ,$277.20 ,$990.00 , N/A ,$737.55 ,$648.45 , N/A ,$277.20 ,$499.95 , N/A ,$610.83 , N/A ,$610.83 ,$610.83 , N/A ,$610.83 , N/A ,$891.00 ,$742.50 , N/A , N/A ,$871.20 , N/A ,$742.50 ,$742.50 ,$841.50 ,$841.50 , N/A ,$841.50 , N/A ,$772.20 ,$772.20 ,$772.20 ,$891.00 , N/A ,$891.00 , N/A ,$990.00 ,$648.45 , N/A ,$411.84 , N/A , N/A , N/A ,$891.00 , N/A ,$610.83 ,$277.20 ,$891.00 , N/A ,$891.00 ,$891.00 , N/A ,$643.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,"$1,129.00 ",$733.85 ,$316.12 ,"$1,129.00 ", N/A ,$841.11 ,$739.50 , N/A ,$316.12 ,$570.15 , N/A ,$696.59 , N/A ,$696.59 ,$696.59 , N/A ,$696.59 , N/A ,"$1,016.10 ",$846.75 , N/A , N/A ,$993.52 , N/A ,$846.75 ,$846.75 ,$959.65 ,$959.65 , N/A ,$959.65 , N/A ,$880.62 ,$880.62 ,$880.62 ,"$1,016.10 ", N/A ,"$1,016.10 ", N/A ,"$1,129.00 ",$739.50 , N/A ,$469.66 , N/A , N/A , N/A ,"$1,016.10 ", N/A ,$696.59 ,$316.12 ,"$1,016.10 ", N/A ,"$1,016.10 ","$1,016.10 ", N/A ,$733.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,317.00 ",$856.05 ,$368.76 ,"$1,317.00 ", N/A ,$981.17 ,$862.64 , N/A ,$368.76 ,$665.09 , N/A ,$812.59 , N/A ,$812.59 ,$812.59 , N/A ,$812.59 , N/A ,"$1,185.30 ",$987.75 , N/A , N/A ,"$1,158.96 ", N/A ,$987.75 ,$987.75 ,"$1,119.45 ","$1,119.45 ", N/A ,"$1,119.45 ", N/A ,"$1,027.26 ","$1,027.26 ","$1,027.26 ","$1,185.30 ", N/A ,"$1,185.30 ", N/A ,"$1,317.00 ",$862.64 , N/A ,$547.87 , N/A , N/A , N/A ,"$1,185.30 ", N/A ,$812.59 ,$368.76 ,"$1,185.30 ", N/A ,"$1,185.30 ","$1,185.30 ", N/A ,$856.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,486.00 ",$965.90 ,$416.08 ,"$1,486.00 ", N/A ,"$1,107.07 ",$973.33 , N/A ,$416.08 ,$750.43 , N/A ,$916.86 , N/A ,$916.86 ,$916.86 , N/A ,$916.86 , N/A ,"$1,337.40 ","$1,114.50 ", N/A , N/A ,"$1,307.68 ", N/A ,"$1,114.50 ","$1,114.50 ","$1,263.10 ","$1,263.10 ", N/A ,"$1,263.10 ", N/A ,"$1,159.08 ","$1,159.08 ","$1,159.08 ","$1,337.40 ", N/A ,"$1,337.40 ", N/A ,"$1,486.00 ",$973.33 , N/A ,$618.18 , N/A , N/A , N/A ,"$1,337.40 ", N/A ,$916.86 ,$416.08 ,"$1,337.40 ", N/A ,"$1,337.40 ","$1,337.40 ", N/A ,$965.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$1,657.00 ","$1,077.05 ",$463.96 ,"$1,657.00 ", N/A ,"$1,234.47 ","$1,085.34 ", N/A ,$463.96 ,$836.79 , N/A ,"$1,022.37 ", N/A ,"$1,022.37 ","$1,022.37 ", N/A ,"$1,022.37 ", N/A ,"$1,491.30 ","$1,242.75 ", N/A , N/A ,"$1,458.16 ", N/A ,"$1,242.75 ","$1,242.75 ","$1,408.45 ","$1,408.45 ", N/A ,"$1,408.45 ", N/A ,"$1,292.46 ","$1,292.46 ","$1,292.46 ","$1,491.30 ", N/A ,"$1,491.30 ", N/A ,"$1,657.00 ","$1,085.34 ", N/A ,$689.31 , N/A , N/A , N/A ,"$1,491.30 ", N/A ,"$1,022.37 ",$463.96 ,"$1,491.30 ", N/A ,"$1,491.30 ","$1,491.30 ", N/A ,"$1,077.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060024,N/A,HC OR LEVEL 6 ADDL 15MIN,360,1 ,"$1,827.00 ","$1,187.55 ",$511.56 ,"$1,827.00 ", N/A ,"$1,361.12 ","$1,196.69 ", N/A ,$511.56 ,$922.64 , N/A ,"$1,127.26 ", N/A ,"$1,127.26 ","$1,127.26 ", N/A ,"$1,127.26 ", N/A ,"$1,644.30 ","$1,370.25 ", N/A , N/A ,"$1,607.76 ", N/A ,"$1,370.25 ","$1,370.25 ","$1,552.95 ","$1,552.95 ", N/A ,"$1,552.95 ", N/A ,"$1,425.06 ","$1,425.06 ","$1,425.06 ","$1,644.30 ", N/A ,"$1,644.30 ", N/A ,"$1,827.00 ","$1,196.69 ", N/A ,$760.03 , N/A , N/A , N/A ,"$1,644.30 ", N/A ,"$1,127.26 ",$511.56 ,"$1,644.30 ", N/A ,"$1,644.30 ","$1,644.30 ", N/A ,"$1,187.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060025,N/A,HC OR LEVEL 1 INITIAL 30MIN,360,1 ,"$2,066.00 ","$1,342.90 ",$578.48 ,"$2,066.00 ", N/A ,"$1,539.17 ","$1,353.23 ", N/A ,$578.48 ,"$1,043.33 ", N/A ,"$1,274.72 ", N/A ,"$1,274.72 ","$1,274.72 ", N/A ,"$1,274.72 ", N/A ,"$1,859.40 ","$1,549.50 ", N/A , N/A ,"$1,818.08 ", N/A ,"$1,549.50 ","$1,549.50 ","$1,756.10 ","$1,756.10 ", N/A ,"$1,756.10 ", N/A ,"$1,611.48 ","$1,611.48 ","$1,611.48 ","$1,859.40 ", N/A ,"$1,859.40 ", N/A ,"$2,066.00 ","$1,353.23 ", N/A ,$859.46 , N/A , N/A , N/A ,"$1,859.40 ", N/A ,"$1,274.72 ",$578.48 ,"$1,859.40 ", N/A ,"$1,859.40 ","$1,859.40 ", N/A ,"$1,342.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060026,N/A,HC OR LEVEL 2 INITIAL 30MIN,360,1 ,"$2,256.00 ","$1,466.40 ",$631.68 ,"$2,256.00 ", N/A ,"$1,680.72 ","$1,477.68 ", N/A ,$631.68 ,"$1,139.28 ", N/A ,"$1,391.95 ", N/A ,"$1,391.95 ","$1,391.95 ", N/A ,"$1,391.95 ", N/A ,"$2,030.40 ","$1,692.00 ", N/A , N/A ,"$1,985.28 ", N/A ,"$1,692.00 ","$1,692.00 ","$1,917.60 ","$1,917.60 ", N/A ,"$1,917.60 ", N/A ,"$1,759.68 ","$1,759.68 ","$1,759.68 ","$2,030.40 ", N/A ,"$2,030.40 ", N/A ,"$2,256.00 ","$1,477.68 ", N/A ,$938.50 , N/A , N/A , N/A ,"$2,030.40 ", N/A ,"$1,391.95 ",$631.68 ,"$2,030.40 ", N/A ,"$2,030.40 ","$2,030.40 ", N/A ,"$1,466.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060027,N/A,HC OR LEVEL 3 INITIAL 30MIN,360,1 ,"$2,940.00 ","$1,911.00 ",$823.20 ,"$2,940.00 ", N/A ,"$2,190.30 ","$1,925.70 ", N/A ,$823.20 ,"$1,484.70 ", N/A ,"$1,813.98 ", N/A ,"$1,813.98 ","$1,813.98 ", N/A ,"$1,813.98 ", N/A ,"$2,646.00 ","$2,205.00 ", N/A , N/A ,"$2,587.20 ", N/A ,"$2,205.00 ","$2,205.00 ","$2,499.00 ","$2,499.00 ", N/A ,"$2,499.00 ", N/A ,"$2,293.20 ","$2,293.20 ","$2,293.20 ","$2,646.00 ", N/A ,"$2,646.00 ", N/A ,"$2,940.00 ","$1,925.70 ", N/A ,"$1,223.04 ", N/A , N/A , N/A ,"$2,646.00 ", N/A ,"$1,813.98 ",$823.20 ,"$2,646.00 ", N/A ,"$2,646.00 ","$2,646.00 ", N/A ,"$1,911.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060028,N/A,HC OR LEVEL 4 INITIAL 30MIN,360,1 ,"$4,231.00 ","$2,750.15 ","$1,184.68 ","$4,231.00 ", N/A ,"$3,152.10 ","$2,771.31 ", N/A ,"$1,184.68 ","$2,136.66 ", N/A ,"$2,610.53 ", N/A ,"$2,610.53 ","$2,610.53 ", N/A ,"$2,610.53 ", N/A ,"$3,807.90 ","$3,173.25 ", N/A , N/A ,"$3,723.28 ", N/A ,"$3,173.25 ","$3,173.25 ","$3,596.35 ","$3,596.35 ", N/A ,"$3,596.35 ", N/A ,"$3,300.18 ","$3,300.18 ","$3,300.18 ","$3,807.90 ", N/A ,"$3,807.90 ", N/A ,"$4,231.00 ","$2,771.31 ", N/A ,"$1,760.10 ", N/A , N/A , N/A ,"$3,807.90 ", N/A ,"$2,610.53 ","$1,184.68 ","$3,807.90 ", N/A ,"$3,807.90 ","$3,807.90 ", N/A ,"$2,750.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060029,N/A,HC OR LEVEL 5 INITIAL 30MIN,360,1 ,"$5,369.00 ","$3,489.85 ","$1,503.32 ","$5,369.00 ", N/A ,"$3,999.91 ","$3,516.70 ", N/A ,"$1,503.32 ","$2,711.35 ", N/A ,"$3,312.67 ", N/A ,"$3,312.67 ","$3,312.67 ", N/A ,"$3,312.67 ", N/A ,"$4,832.10 ","$4,026.75 ", N/A , N/A ,"$4,724.72 ", N/A ,"$4,026.75 ","$4,026.75 ","$4,563.65 ","$4,563.65 ", N/A ,"$4,563.65 ", N/A ,"$4,187.82 ","$4,187.82 ","$4,187.82 ","$4,832.10 ", N/A ,"$4,832.10 ", N/A ,"$5,369.00 ","$3,516.70 ", N/A ,"$2,233.50 ", N/A , N/A , N/A ,"$4,832.10 ", N/A ,"$3,312.67 ","$1,503.32 ","$4,832.10 ", N/A ,"$4,832.10 ","$4,832.10 ", N/A ,"$3,489.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060030,N/A,HC OR LEVEL 6 INITIAL 30MIN,360,1 ,"$6,283.00 ","$4,083.95 ","$1,759.24 ","$6,283.00 ", N/A ,"$4,680.84 ","$4,115.37 ", N/A ,"$1,759.24 ","$3,172.92 ", N/A ,"$3,876.61 ", N/A ,"$3,876.61 ","$3,876.61 ", N/A ,"$3,876.61 ", N/A ,"$5,654.70 ","$4,712.25 ", N/A , N/A ,"$5,529.04 ", N/A ,"$4,712.25 ","$4,712.25 ","$5,340.55 ","$5,340.55 ", N/A ,"$5,340.55 ", N/A ,"$4,900.74 ","$4,900.74 ","$4,900.74 ","$5,654.70 ", N/A ,"$5,654.70 ", N/A ,"$6,283.00 ","$4,115.37 ", N/A ,"$2,613.73 ", N/A , N/A , N/A ,"$5,654.70 ", N/A ,"$3,876.61 ","$1,759.24 ","$5,654.70 ", N/A ,"$5,654.70 ","$5,654.70 ", N/A ,"$4,083.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060040,N/A,HC OR LEVEL LITHOTRIPSY INITIAL 45 MIN,360,1 ,"$17,523.00 ","$11,389.95 ","$4,906.44 ","$17,523.00 ", N/A ,"$13,054.64 ","$11,477.57 ", N/A ,"$4,906.44 ","$8,849.12 ", N/A ,"$10,811.69 ", N/A ,"$10,811.69 ","$10,811.69 ", N/A ,"$10,811.69 ", N/A ,"$15,770.70 ","$13,142.25 ", N/A , N/A ,"$15,420.24 ", N/A ,"$13,142.25 ","$13,142.25 ","$14,894.55 ","$14,894.55 ", N/A ,"$14,894.55 ", N/A ,"$13,667.94 ","$13,667.94 ","$13,667.94 ","$15,770.70 ", N/A ,"$15,770.70 ", N/A ,"$17,523.00 ","$11,477.57 ", N/A ,"$7,289.57 ", N/A , N/A , N/A ,"$15,770.70 ", N/A ,"$10,811.69 ","$4,906.44 ","$15,770.70 ", N/A ,"$15,770.70 ","$15,770.70 ", N/A ,"$11,389.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36060041,N/A,HC OR LEVEL LITHOTRIPSY ADDL 15 MIN,360,1 ,"$1,218.00 ",$791.70 ,$341.04 ,"$1,218.00 ", N/A ,$907.41 ,$797.79 , N/A ,$341.04 ,$615.09 , N/A ,$751.51 , N/A ,$751.51 ,$751.51 , N/A ,$751.51 , N/A ,"$1,096.20 ",$913.50 , N/A , N/A ,"$1,071.84 ", N/A ,$913.50 ,$913.50 ,"$1,035.30 ","$1,035.30 ", N/A ,"$1,035.30 ", N/A ,$950.04 ,$950.04 ,$950.04 ,"$1,096.20 ", N/A ,"$1,096.20 ", N/A ,"$1,218.00 ",$797.79 , N/A ,$506.69 , N/A , N/A , N/A ,"$1,096.20 ", N/A ,$751.51 ,$341.04 ,"$1,096.20 ", N/A ,"$1,096.20 ","$1,096.20 ", N/A ,$791.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36080006,64400,HC NERVE BLOCK TRIGEMINAL,360,1 ,$758.00 ,$492.70 ,$212.24 ,$758.00 ,$662.23 ,$564.71 ,$496.49 ,$275.86 ,$212.24 ,$382.79 ,$275.86 ,$467.69 ,$275.86 ,$467.69 ,$467.69 ,$275.86 ,$467.69 ,$524.13 ,$682.20 ,$568.50 ,$662.23 ,$275.86 ,$667.04 ,$275.86 ,$568.50 ,$568.50 ,$644.30 ,$644.30 ,$275.86 ,$644.30 ,$275.86 ,$591.24 ,$591.24 ,$591.24 ,$682.20 ,$662.23 ,$682.20 ,$275.86 ,$758.00 ,$496.49 ,$275.86 ,$315.33 ,$320.22 ,$305.67 ,$288.74 ,$682.20 ,$597.83 ,$467.69 ,$212.24 ,$682.20 ,$275.86 ,$682.20 ,$682.20 ,$275.86 ,$492.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36080008,64417,HC NERVE BLOCK AXILLARY NERVE,360,1 ,"$2,248.00 ","$1,461.20 ",$305.67 ,"$2,248.00 ","$2,086.56 ","$1,674.76 ","$1,472.44 ",$869.20 ,$629.44 ,"$1,135.24 ",$869.20 ,"$1,387.02 ",$869.20 ,"$1,387.02 ","$1,387.02 ",$869.20 ,"$1,387.02 ","$1,651.48 ","$2,023.20 ","$1,686.00 ","$2,086.56 ",$869.20 ,"$1,978.24 ",$869.20 ,"$1,686.00 ","$1,686.00 ","$1,910.80 ","$1,910.80 ",$869.20 ,"$1,910.80 ",$869.20 ,"$1,753.44 ","$1,753.44 ","$1,753.44 ","$2,023.20 ","$2,086.56 ","$2,023.20 ",$869.20 ,"$2,248.00 ","$1,472.44 ",$869.20 ,$935.17 ,$320.22 ,$305.67 ,$909.77 ,"$2,023.20 ","$1,883.66 ","$1,387.02 ",$629.44 ,"$2,023.20 ",$869.20 ,"$2,023.20 ","$2,023.20 ",$869.20 ,"$1,461.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100004,50430,HC INJ NEPH URET W G SI NEW ACCESS,361,1 ,"$5,622.00 ","$3,654.30 ",$241.29 ,"$5,622.00 ","$1,458.23 ","$4,188.39 ","$3,682.41 ",$607.45 ,"$1,574.16 ","$2,839.11 ",$607.45 ,"$3,468.77 ",$607.45 ,"$3,468.77 ","$3,468.77 ",$607.45 ,"$3,468.77 ","$1,154.16 ","$5,059.80 ","$4,216.50 ","$1,458.23 ",$607.45 ,"$4,947.36 ",$607.45 ,"$4,216.50 ","$4,216.50 ","$4,778.70 ","$4,778.70 ",$607.45 ,"$4,778.70 ",$607.45 ,"$4,385.16 ","$4,385.16 ","$4,385.16 ","$5,059.80 ","$1,458.23 ","$5,059.80 ",$607.45 ,"$5,622.00 ","$3,682.41 ",$607.45 ,"$2,338.75 ",$252.78 ,$241.29 ,$635.81 ,"$5,059.80 ","$1,316.43 ","$3,468.77 ","$1,574.16 ","$5,059.80 ",$607.45 ,"$5,059.80 ","$5,059.80 ",$607.45 ,"$3,654.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100004,50430,HC INJ NEPH URET W G SI NEW ACCESS,361,1 ,"$8,432.00 ","$5,480.80 ",$361.95 ,"$8,432.00 ","$1,458.23 ","$6,281.84 ","$5,522.96 ",$607.45 ,"$2,360.96 ","$4,258.16 ",$607.45 ,"$5,202.54 ",$607.45 ,"$5,202.54 ","$5,202.54 ",$607.45 ,"$5,202.54 ","$1,154.16 ","$7,588.80 ","$6,324.00 ","$1,458.23 ",$607.45 ,"$7,420.16 ",$607.45 ,"$6,324.00 ","$6,324.00 ","$7,167.20 ","$7,167.20 ",$607.45 ,"$7,167.20 ",$607.45 ,"$6,576.96 ","$6,576.96 ","$6,576.96 ","$7,588.80 ","$1,458.23 ","$7,588.80 ",$607.45 ,"$8,432.00 ","$5,522.96 ",$607.45 ,"$3,507.71 ",$379.18 ,$361.95 ,$635.81 ,"$7,588.80 ","$1,316.43 ","$5,202.54 ","$2,360.96 ","$7,588.80 ",$607.45 ,"$7,588.80 ","$7,588.80 ",$607.45 ,"$5,480.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100006,50434,HC CONVERT NEPH CTH NEPHUR CTH WG S AND I EXST TRACT,361,1 ,"$4,251.00 ","$2,763.15 ",$754.44 ,"$4,251.00 ","$4,251.00 ","$3,167.00 ","$2,784.41 ","$1,890.56 ","$1,190.28 ","$2,146.76 ","$1,890.56 ","$2,622.87 ","$1,890.56 ","$2,622.87 ","$2,622.87 ","$1,890.56 ","$2,622.87 ","$3,592.06 ","$3,825.90 ","$3,188.25 ","$4,251.00 ","$1,890.56 ","$3,740.88 ","$1,890.56 ","$3,188.25 ","$3,188.25 ","$3,613.35 ","$3,613.35 ","$1,890.56 ","$3,613.35 ","$1,890.56 ","$3,315.78 ","$3,315.78 ","$3,315.78 ","$3,825.90 ","$4,251.00 ","$3,825.90 ","$1,890.56 ","$4,251.00 ","$2,784.41 ","$1,890.56 ","$1,768.42 ",$790.36 ,$754.44 ,"$1,978.83 ","$3,825.90 ","$4,097.10 ","$2,622.87 ","$1,190.28 ","$3,825.90 ","$1,890.56 ","$3,825.90 ","$3,825.90 ","$1,890.56 ","$2,763.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100009,50695,HC PL URT STNT W G SI NEW ACCESS WITH NEPH CATH,361,1 ,"$6,331.00 ","$4,115.15 ","$1,604.78 ","$7,035.28 ","$6,331.00 ","$4,716.60 ","$4,146.81 ","$3,246.35 ","$1,772.68 ","$3,197.16 ","$3,246.35 ","$3,906.23 ","$3,246.35 ","$3,906.23 ","$3,906.23 ","$3,246.35 ","$3,906.23 ","$6,168.07 ","$5,697.90 ","$4,748.25 ","$6,331.00 ","$3,246.35 ","$5,571.28 ","$3,246.35 ","$4,748.25 ","$4,748.25 ","$5,381.35 ","$5,381.35 ","$3,246.35 ","$5,381.35 ","$3,246.35 ","$4,938.18 ","$4,938.18 ","$4,938.18 ","$5,697.90 ","$6,331.00 ","$5,697.90 ","$3,246.35 ","$6,331.00 ","$4,146.81 ","$3,246.35 ","$2,633.70 ","$1,681.20 ","$1,604.78 ","$3,397.91 ","$5,697.90 ","$7,035.28 ","$3,906.23 ","$1,772.68 ","$5,697.90 ","$3,246.35 ","$5,697.90 ","$5,697.90 ","$3,246.35 ","$4,115.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100026,36510,HC UMBILICAL CATHETER INSERTION NEWBORN,361,1 ,$153.00 ,$99.45 ,$42.84 ,$153.00 , N/A ,$113.99 ,$100.22 , N/A ,$42.84 ,$77.27 , N/A ,$94.40 , N/A ,$94.40 ,$94.40 , N/A ,$94.40 , N/A ,$137.70 ,$114.75 , N/A , N/A ,$134.64 , N/A ,$114.75 ,$114.75 ,$130.05 ,$130.05 , N/A ,$130.05 , N/A ,$119.34 ,$119.34 ,$119.34 ,$137.70 , N/A ,$137.70 , N/A ,$153.00 ,$100.22 , N/A ,$63.65 , N/A , N/A , N/A ,$137.70 , N/A ,$94.40 ,$42.84 ,$137.70 , N/A ,$137.70 ,$137.70 , N/A ,$99.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100039,63663,HC REVISE SPINE ELECTRD PERQ ARRAY W/FLUORO,361,1 ,"$14,799.00 ","$9,619.35 ","$2,738.19 ","$14,799.00 ","$14,799.00 ","$11,025.26 ","$9,693.35 ","$6,508.60 ","$4,143.72 ","$7,473.50 ","$6,508.60 ","$9,130.98 ","$6,508.60 ","$9,130.98 ","$9,130.98 ","$6,508.60 ","$9,130.98 ","$12,366.34 ","$13,319.10 ","$11,099.25 ","$14,799.00 ","$6,508.60 ","$13,023.12 ","$6,508.60 ","$11,099.25 ","$11,099.25 ","$12,579.15 ","$12,579.15 ","$6,508.60 ","$12,579.15 ","$6,508.60 ","$11,543.22 ","$11,543.22 ","$11,543.22 ","$13,319.10 ","$14,799.00 ","$13,319.10 ","$6,508.60 ","$14,799.00 ","$9,693.35 ","$6,508.60 ","$6,156.38 ","$2,868.58 ","$2,738.19 ","$6,812.46 ","$13,319.10 ","$14,105.00 ","$9,130.98 ","$4,143.72 ","$13,319.10 ","$6,508.60 ","$13,319.10 ","$13,319.10 ","$6,508.60 ","$9,619.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100040,63685,HC INSERT/REPLACE SPINAL NEURO GEN/RECR,361,1 ,"$78,710.00 ","$51,161.50 ","$8,652.37 ","$78,710.00 ","$74,612.68 ","$58,638.95 ","$51,555.05 ","$31,081.36 ","$22,038.80 ","$39,748.55 ","$31,081.36 ","$48,564.07 ","$31,081.36 ","$48,564.07 ","$48,564.07 ","$31,081.36 ","$48,564.07 ","$59,054.58 ","$70,839.00 ","$59,032.50 ","$74,612.68 ","$31,081.36 ","$69,264.80 ","$31,081.36 ","$59,032.50 ","$59,032.50 ","$66,903.50 ","$66,903.50 ","$31,081.36 ","$66,903.50 ","$31,081.36 ","$61,393.80 ","$61,393.80 ","$61,393.80 ","$70,839.00 ","$74,612.68 ","$70,839.00 ","$31,081.36 ","$78,710.00 ","$51,555.05 ","$31,081.36 ","$32,743.36 ","$9,064.39 ","$8,652.37 ","$32,532.40 ","$70,839.00 ","$67,357.46 ","$48,564.07 ","$22,038.80 ","$70,839.00 ","$31,081.36 ","$70,839.00 ","$70,839.00 ","$31,081.36 ","$51,161.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100042,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-BIL,361,1 ,"$1,121.00 ",$728.65 ,$313.88 ,"$1,121.00 ",$993.34 ,$835.15 ,$734.26 ,$413.80 ,$313.88 ,$566.11 ,$413.80 ,$691.66 ,$413.80 ,$691.66 ,$691.66 ,$413.80 ,$691.66 ,$786.22 ,"$1,008.90 ",$840.75 ,$993.34 ,$413.80 ,$986.48 ,$413.80 ,$840.75 ,$840.75 ,$952.85 ,$952.85 ,$413.80 ,$952.85 ,$413.80 ,$874.38 ,$874.38 ,$874.38 ,"$1,008.90 ",$993.34 ,"$1,008.90 ",$413.80 ,"$1,121.00 ",$734.26 ,$413.80 ,$466.34 ,$353.55 ,$337.48 ,$433.11 ,"$1,008.90 ",$896.75 ,$691.66 ,$313.88 ,"$1,008.90 ",$413.80 ,"$1,008.90 ","$1,008.90 ",$413.80 ,$728.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100043,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-BIL,361,1 ,"$1,382.00 ",$898.30 ,$337.48 ,"$1,382.00 ",$993.34 ,"$1,029.59 ",$905.21 ,$413.80 ,$386.96 ,$697.91 ,$413.80 ,$852.69 ,$413.80 ,$852.69 ,$852.69 ,$413.80 ,$852.69 ,$786.22 ,"$1,243.80 ","$1,036.50 ",$993.34 ,$413.80 ,"$1,216.16 ",$413.80 ,"$1,036.50 ","$1,036.50 ","$1,174.70 ","$1,174.70 ",$413.80 ,"$1,174.70 ",$413.80 ,"$1,077.96 ","$1,077.96 ","$1,077.96 ","$1,243.80 ",$993.34 ,"$1,243.80 ",$413.80 ,"$1,382.00 ",$905.21 ,$413.80 ,$574.91 ,$353.55 ,$337.48 ,$433.11 ,"$1,243.80 ",$896.75 ,$852.69 ,$386.96 ,"$1,243.80 ",$413.80 ,"$1,243.80 ","$1,243.80 ",$413.80 ,$898.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,"$1,382.00 ",$898.30 ,$337.48 ,"$1,382.00 ",$993.34 ,"$1,029.59 ",$905.21 ,$413.80 ,$386.96 ,$697.91 ,$413.80 ,$852.69 ,$413.80 ,$852.69 ,$852.69 ,$413.80 ,$852.69 ,$786.22 ,"$1,243.80 ","$1,036.50 ",$993.34 ,$413.80 ,"$1,216.16 ",$413.80 ,"$1,036.50 ","$1,036.50 ","$1,174.70 ","$1,174.70 ",$413.80 ,"$1,174.70 ",$413.80 ,"$1,077.96 ","$1,077.96 ","$1,077.96 ","$1,243.80 ",$993.34 ,"$1,243.80 ",$413.80 ,"$1,382.00 ",$905.21 ,$413.80 ,$574.91 ,$353.55 ,$337.48 ,$433.11 ,"$1,243.80 ",$896.75 ,$852.69 ,$386.96 ,"$1,243.80 ",$413.80 ,"$1,243.80 ","$1,243.80 ",$413.80 ,$898.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100046,15271,HC APPL SKIN SUB TAL <100 INIT 25CM-LT,361,1 ,$994.00 ,$646.10 ,$278.32 ,"$3,919.23 ",$994.00 ,$740.53 ,$651.07 ,$994.00 ,$278.32 ,$501.97 ,$994.00 ,$613.30 ,$994.00 ,$613.30 ,$613.30 ,$994.00 ,$613.30 ,"$3,436.13 ",$894.60 ,$745.50 ,$994.00 ,$994.00 ,$874.72 ,$994.00 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$994.00 ,$844.90 ,$994.00 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$994.00 ,$894.60 ,$994.00 ,$994.00 ,$651.07 ,$994.00 ,$413.50 ,$994.00 ,$994.00 ,$994.00 ,$894.60 ,"$3,919.23 ",$613.30 ,$278.32 ,$894.60 ,$994.00 ,$894.60 ,$894.60 ,$994.00 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100047,15271,HC APPL SKIN SUB TAL <100 INIT 25CM-RT,361,1 ,$994.00 ,$646.10 ,$278.32 ,"$3,919.23 ",$994.00 ,$740.53 ,$651.07 ,$994.00 ,$278.32 ,$501.97 ,$994.00 ,$613.30 ,$994.00 ,$613.30 ,$613.30 ,$994.00 ,$613.30 ,"$3,436.13 ",$894.60 ,$745.50 ,$994.00 ,$994.00 ,$874.72 ,$994.00 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$994.00 ,$844.90 ,$994.00 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$994.00 ,$894.60 ,$994.00 ,$994.00 ,$651.07 ,$994.00 ,$413.50 ,$994.00 ,$994.00 ,$994.00 ,$894.60 ,"$3,919.23 ",$613.30 ,$278.32 ,$894.60 ,$994.00 ,$894.60 ,$894.60 ,$994.00 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100048,15272,HC APPL SKIN SUB TAL <100 ADDL 25CM-LT,361,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 ,$366.00 ,$366.00 , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100049,15272,HC APPL SKIN SUB TAL <100 ADDL 25CM-RT,361,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 ,$366.00 ,$366.00 , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100050,15273,HC APPL SKIN SUB TAL >100 INIT 100CM-LT,361,1 ,"$1,514.00 ",$984.10 ,$423.92 ,"$8,057.36 ","$1,514.00 ","$1,127.93 ",$991.67 ,"$1,514.00 ",$423.92 ,$764.57 ,"$1,514.00 ",$934.14 ,"$1,514.00 ",$934.14 ,$934.14 ,"$1,514.00 ",$934.14 ,"$7,064.16 ","$1,362.60 ","$1,135.50 ","$1,514.00 ","$1,514.00 ","$1,332.32 ","$1,514.00 ","$1,135.50 ","$1,135.50 ","$1,286.90 ","$1,286.90 ","$1,514.00 ","$1,286.90 ","$1,514.00 ","$1,180.92 ","$1,180.92 ","$1,180.92 ","$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,514.00 ","$1,514.00 ",$991.67 ,"$1,514.00 ",$629.82 ,"$1,153.41 ","$1,100.98 ","$1,514.00 ","$1,362.60 ","$8,057.36 ",$934.14 ,$423.92 ,"$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,362.60 ","$1,514.00 ",$984.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100051,15273,HC APPL SKIN SUB TAL >100 INIT 100CM-RT,361,1 ,"$1,514.00 ",$984.10 ,$423.92 ,"$8,057.36 ","$1,514.00 ","$1,127.93 ",$991.67 ,"$1,514.00 ",$423.92 ,$764.57 ,"$1,514.00 ",$934.14 ,"$1,514.00 ",$934.14 ,$934.14 ,"$1,514.00 ",$934.14 ,"$7,064.16 ","$1,362.60 ","$1,135.50 ","$1,514.00 ","$1,514.00 ","$1,332.32 ","$1,514.00 ","$1,135.50 ","$1,135.50 ","$1,286.90 ","$1,286.90 ","$1,514.00 ","$1,286.90 ","$1,514.00 ","$1,180.92 ","$1,180.92 ","$1,180.92 ","$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,514.00 ","$1,514.00 ",$991.67 ,"$1,514.00 ",$629.82 ,"$1,153.41 ","$1,100.98 ","$1,514.00 ","$1,362.60 ","$8,057.36 ",$934.14 ,$423.92 ,"$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,362.60 ","$1,514.00 ",$984.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100052,15274,HC APPL SKIN SUB TAL >100 ADDL 100CM-LT,361,1 ,$994.00 ,$646.10 ,$278.32 ,$994.00 , N/A ,$740.53 ,$651.07 , N/A ,$278.32 ,$501.97 , N/A ,$613.30 , N/A ,$613.30 ,$613.30 , N/A ,$613.30 , N/A ,$894.60 ,$745.50 , N/A , N/A ,$874.72 , N/A ,$745.50 ,$745.50 ,$844.90 ,$844.90 , N/A ,$844.90 , N/A ,$775.32 ,$775.32 ,$775.32 ,$894.60 , N/A ,$894.60 , N/A ,$994.00 ,$651.07 , N/A ,$413.50 ,$994.00 ,$994.00 , N/A ,$894.60 , N/A ,$613.30 ,$278.32 ,$894.60 , N/A ,$894.60 ,$894.60 , N/A ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100053,15274,HC APPL SKIN SUB TAL >100 ADDL 100CM-RT,361,1 ,$994.00 ,$646.10 ,$278.32 ,$994.00 , N/A ,$740.53 ,$651.07 , N/A ,$278.32 ,$501.97 , N/A ,$613.30 , N/A ,$613.30 ,$613.30 , N/A ,$613.30 , N/A ,$894.60 ,$745.50 , N/A , N/A ,$874.72 , N/A ,$745.50 ,$745.50 ,$844.90 ,$844.90 , N/A ,$844.90 , N/A ,$775.32 ,$775.32 ,$775.32 ,$894.60 , N/A ,$894.60 , N/A ,$994.00 ,$651.07 , N/A ,$413.50 ,$994.00 ,$994.00 , N/A ,$894.60 , N/A ,$613.30 ,$278.32 ,$894.60 , N/A ,$894.60 ,$894.60 , N/A ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100054,15275,HC APPL SKIN SUB OTH <100 INIT 25CM-LT,361,1 ,$994.00 ,$646.10 ,$278.32 ,"$3,919.23 ",$994.00 ,$740.53 ,$651.07 ,$994.00 ,$278.32 ,$501.97 ,$994.00 ,$613.30 ,$994.00 ,$613.30 ,$613.30 ,$994.00 ,$613.30 ,"$3,436.13 ",$894.60 ,$745.50 ,$994.00 ,$994.00 ,$874.72 ,$994.00 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$994.00 ,$844.90 ,$994.00 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$994.00 ,$894.60 ,$994.00 ,$994.00 ,$651.07 ,$994.00 ,$413.50 ,$994.00 ,$994.00 ,$994.00 ,$894.60 ,"$3,919.23 ",$613.30 ,$278.32 ,$894.60 ,$994.00 ,$894.60 ,$894.60 ,$994.00 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100055,15275,HC APPL SKIN SUB OTH <100 INIT 25CM-RT,361,1 ,$994.00 ,$646.10 ,$278.32 ,"$3,919.23 ",$994.00 ,$740.53 ,$651.07 ,$994.00 ,$278.32 ,$501.97 ,$994.00 ,$613.30 ,$994.00 ,$613.30 ,$613.30 ,$994.00 ,$613.30 ,"$3,436.13 ",$894.60 ,$745.50 ,$994.00 ,$994.00 ,$874.72 ,$994.00 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$994.00 ,$844.90 ,$994.00 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$994.00 ,$894.60 ,$994.00 ,$994.00 ,$651.07 ,$994.00 ,$413.50 ,$994.00 ,$994.00 ,$994.00 ,$894.60 ,"$3,919.23 ",$613.30 ,$278.32 ,$894.60 ,$994.00 ,$894.60 ,$894.60 ,$994.00 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100056,15276,HC APPL SKIN SUB OTH <100 ADDL 25CM-LT,361,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 ,$366.00 ,$366.00 , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100057,15276,HC APPL SKIN SUB OTH <100 ADDL 25CM-RT,361,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 ,$366.00 ,$366.00 , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100058,15277,HC APPL SKIN SUB OTH >100 INIT 100CM-LT,361,1 ,"$1,514.00 ",$984.10 ,$423.92 ,"$3,919.23 ","$1,514.00 ","$1,127.93 ",$991.67 ,"$1,514.00 ",$423.92 ,$764.57 ,"$1,514.00 ",$934.14 ,"$1,514.00 ",$934.14 ,$934.14 ,"$1,514.00 ",$934.14 ,"$3,436.13 ","$1,362.60 ","$1,135.50 ","$1,514.00 ","$1,514.00 ","$1,332.32 ","$1,514.00 ","$1,135.50 ","$1,135.50 ","$1,286.90 ","$1,286.90 ","$1,514.00 ","$1,286.90 ","$1,514.00 ","$1,180.92 ","$1,180.92 ","$1,180.92 ","$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,514.00 ","$1,514.00 ",$991.67 ,"$1,514.00 ",$629.82 ,"$1,153.41 ","$1,100.98 ","$1,514.00 ","$1,362.60 ","$3,919.23 ",$934.14 ,$423.92 ,"$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,362.60 ","$1,514.00 ",$984.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100059,15277,HC APPL SKIN SUB OTH >100 INIT 100CM-RT,361,1 ,"$1,514.00 ",$984.10 ,$423.92 ,"$3,919.23 ","$1,514.00 ","$1,127.93 ",$991.67 ,"$1,514.00 ",$423.92 ,$764.57 ,"$1,514.00 ",$934.14 ,"$1,514.00 ",$934.14 ,$934.14 ,"$1,514.00 ",$934.14 ,"$3,436.13 ","$1,362.60 ","$1,135.50 ","$1,514.00 ","$1,514.00 ","$1,332.32 ","$1,514.00 ","$1,135.50 ","$1,135.50 ","$1,286.90 ","$1,286.90 ","$1,514.00 ","$1,286.90 ","$1,514.00 ","$1,180.92 ","$1,180.92 ","$1,180.92 ","$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,514.00 ","$1,514.00 ",$991.67 ,"$1,514.00 ",$629.82 ,"$1,153.41 ","$1,100.98 ","$1,514.00 ","$1,362.60 ","$3,919.23 ",$934.14 ,$423.92 ,"$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,362.60 ","$1,514.00 ",$984.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100060,15278,HC APPL SKIN SUB OTH >100 ADDL 100CM-LT,361,1 ,$994.00 ,$646.10 ,$278.32 ,$994.00 , N/A ,$740.53 ,$651.07 , N/A ,$278.32 ,$501.97 , N/A ,$613.30 , N/A ,$613.30 ,$613.30 , N/A ,$613.30 , N/A ,$894.60 ,$745.50 , N/A , N/A ,$874.72 , N/A ,$745.50 ,$745.50 ,$844.90 ,$844.90 , N/A ,$844.90 , N/A ,$775.32 ,$775.32 ,$775.32 ,$894.60 , N/A ,$894.60 , N/A ,$994.00 ,$651.07 , N/A ,$413.50 ,$994.00 ,$994.00 , N/A ,$894.60 , N/A ,$613.30 ,$278.32 ,$894.60 , N/A ,$894.60 ,$894.60 , N/A ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100061,15278,HC APPL SKIN SUB OTH >100 ADDL 100CM-RT,361,1 ,$994.00 ,$646.10 ,$278.32 ,$994.00 , N/A ,$740.53 ,$651.07 , N/A ,$278.32 ,$501.97 , N/A ,$613.30 , N/A ,$613.30 ,$613.30 , N/A ,$613.30 , N/A ,$894.60 ,$745.50 , N/A , N/A ,$874.72 , N/A ,$745.50 ,$745.50 ,$844.90 ,$844.90 , N/A ,$844.90 , N/A ,$775.32 ,$775.32 ,$775.32 ,$894.60 , N/A ,$894.60 , N/A ,$994.00 ,$651.07 , N/A ,$413.50 ,$994.00 ,$994.00 , N/A ,$894.60 , N/A ,$613.30 ,$278.32 ,$894.60 , N/A ,$894.60 ,$894.60 , N/A ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100065,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,361,1 ,$921.00 ,$598.65 ,$224.98 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$235.70 ,$224.98 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100066,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,361,1 ,$921.00 ,$598.65 ,$224.98 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$235.70 ,$224.98 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,$921.00 ,$598.65 ,$224.98 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$235.70 ,$224.98 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,$921.00 ,$598.65 ,$224.98 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$235.70 ,$224.98 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100074,64616,HC CHEM/DEST NERVE MUSCLE NECK-LT,361,1 ,$758.00 ,$492.70 ,$212.24 ,$758.00 ,$662.23 ,$564.71 ,$496.49 ,$275.86 ,$212.24 ,$382.79 ,$275.86 ,$467.69 ,$275.86 ,$467.69 ,$467.69 ,$275.86 ,$467.69 ,$524.13 ,$682.20 ,$568.50 ,$662.23 ,$275.86 ,$667.04 ,$275.86 ,$568.50 ,$568.50 ,$644.30 ,$644.30 ,$275.86 ,$644.30 ,$275.86 ,$591.24 ,$591.24 ,$591.24 ,$682.20 ,$662.23 ,$682.20 ,$275.86 ,$758.00 ,$496.49 ,$275.86 ,$315.33 ,$320.22 ,$305.67 ,$288.74 ,$682.20 ,$597.83 ,$467.69 ,$212.24 ,$682.20 ,$275.86 ,$682.20 ,$682.20 ,$275.86 ,$492.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100075,64616,HC CHEM/DEST NERVE MUSCLE NECK-RT,361,1 ,$758.00 ,$492.70 ,$212.24 ,$758.00 ,$662.23 ,$564.71 ,$496.49 ,$275.86 ,$212.24 ,$382.79 ,$275.86 ,$467.69 ,$275.86 ,$467.69 ,$467.69 ,$275.86 ,$467.69 ,$524.13 ,$682.20 ,$568.50 ,$662.23 ,$275.86 ,$667.04 ,$275.86 ,$568.50 ,$568.50 ,$644.30 ,$644.30 ,$275.86 ,$644.30 ,$275.86 ,$591.24 ,$591.24 ,$591.24 ,$682.20 ,$662.23 ,$682.20 ,$275.86 ,$758.00 ,$496.49 ,$275.86 ,$315.33 ,$320.22 ,$305.67 ,$288.74 ,$682.20 ,$597.83 ,$467.69 ,$212.24 ,$682.20 ,$275.86 ,$682.20 ,$682.20 ,$275.86 ,$492.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100076,C5271,HC APPL SKIN SUB TAL LOW <100 INIT 25CM-LT,361,1 ,"$2,201.00 ","$1,430.65 ",$553.00 ,"$2,201.00 ","$1,327.51 ","$1,639.75 ","$1,441.66 ",$553.00 ,$616.28 ,"$1,111.51 ",$553.00 ,"$1,358.02 ",$553.00 ,"$1,358.02 ","$1,358.02 ",$553.00 ,"$1,358.02 ","$1,050.70 ","$1,980.90 ","$1,650.75 ","$1,327.51 ",$553.00 ,"$1,936.88 ",$553.00 ,"$1,650.75 ","$1,650.75 ","$1,870.85 ","$1,870.85 ",$553.00 ,"$1,870.85 ",$553.00 ,"$1,716.78 ","$1,716.78 ","$1,716.78 ","$1,980.90 ","$1,327.51 ","$1,980.90 ",$553.00 ,"$2,201.00 ","$1,441.66 ",$553.00 ,$915.62 ,"$1,153.41 ","$1,100.98 ",$578.82 ,"$1,980.90 ","$1,198.43 ","$1,358.02 ",$616.28 ,"$1,980.90 ",$553.00 ,"$1,980.90 ","$1,980.90 ",$553.00 ,"$1,430.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100077,C5271,HC APPL SKIN SUB TAL LOW <100 INIT 25CM-RT,361,1 ,"$2,201.00 ","$1,430.65 ",$553.00 ,"$2,201.00 ","$1,327.51 ","$1,639.75 ","$1,441.66 ",$553.00 ,$616.28 ,"$1,111.51 ",$553.00 ,"$1,358.02 ",$553.00 ,"$1,358.02 ","$1,358.02 ",$553.00 ,"$1,358.02 ","$1,050.70 ","$1,980.90 ","$1,650.75 ","$1,327.51 ",$553.00 ,"$1,936.88 ",$553.00 ,"$1,650.75 ","$1,650.75 ","$1,870.85 ","$1,870.85 ",$553.00 ,"$1,870.85 ",$553.00 ,"$1,716.78 ","$1,716.78 ","$1,716.78 ","$1,980.90 ","$1,327.51 ","$1,980.90 ",$553.00 ,"$2,201.00 ","$1,441.66 ",$553.00 ,$915.62 ,"$1,153.41 ","$1,100.98 ",$578.82 ,"$1,980.90 ","$1,198.43 ","$1,358.02 ",$616.28 ,"$1,980.90 ",$553.00 ,"$1,980.90 ","$1,980.90 ",$553.00 ,"$1,430.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100078,C5272,HC APPL SKIN SUB TAL LOW<100 ADDL 25CM-LT,361,1 ,$751.00 ,$488.15 ,$210.28 ,$751.00 , N/A ,$559.50 ,$491.91 , N/A ,$210.28 ,$379.26 , N/A ,$463.37 , N/A ,$463.37 ,$463.37 , N/A ,$463.37 , N/A ,$675.90 ,$563.25 , N/A , N/A ,$660.88 , N/A ,$563.25 ,$563.25 ,$638.35 ,$638.35 , N/A ,$638.35 , N/A ,$585.78 ,$585.78 ,$585.78 ,$675.90 , N/A ,$675.90 , N/A ,$751.00 ,$491.91 , N/A ,$312.42 ,$751.00 ,$751.00 , N/A ,$675.90 , N/A ,$463.37 ,$210.28 ,$675.90 , N/A ,$675.90 ,$675.90 , N/A ,$488.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100079,C5272,HC APPL SKIN SUB TAL LOW<100 ADDL 25CM-RT,361,1 ,$751.00 ,$488.15 ,$210.28 ,$751.00 , N/A ,$559.50 ,$491.91 , N/A ,$210.28 ,$379.26 , N/A ,$463.37 , N/A ,$463.37 ,$463.37 , N/A ,$463.37 , N/A ,$675.90 ,$563.25 , N/A , N/A ,$660.88 , N/A ,$563.25 ,$563.25 ,$638.35 ,$638.35 , N/A ,$638.35 , N/A ,$585.78 ,$585.78 ,$585.78 ,$675.90 , N/A ,$675.90 , N/A ,$751.00 ,$491.91 , N/A ,$312.42 ,$751.00 ,$751.00 , N/A ,$675.90 , N/A ,$463.37 ,$210.28 ,$675.90 , N/A ,$675.90 ,$675.90 , N/A ,$488.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100080,C5273,HC APPL SKIN SUB TAL LOW>100 INIT 100CM-LT,361,1 ,"$7,372.00 ","$4,791.80 ","$1,100.98 ","$7,372.00 ","$4,341.38 ","$5,492.14 ","$4,828.66 ","$1,808.49 ","$2,064.16 ","$3,722.86 ","$1,808.49 ","$4,548.52 ","$1,808.49 ","$4,548.52 ","$4,548.52 ","$1,808.49 ","$4,548.52 ","$3,436.13 ","$6,634.80 ","$5,529.00 ","$4,341.38 ","$1,808.49 ","$6,487.36 ","$1,808.49 ","$5,529.00 ","$5,529.00 ","$6,266.20 ","$6,266.20 ","$1,808.49 ","$6,266.20 ","$1,808.49 ","$5,750.16 ","$5,750.16 ","$5,750.16 ","$6,634.80 ","$4,341.38 ","$6,634.80 ","$1,808.49 ","$7,372.00 ","$4,828.66 ","$1,808.49 ","$3,066.75 ","$1,153.41 ","$1,100.98 ","$1,892.92 ","$6,634.80 ","$3,919.23 ","$4,548.52 ","$2,064.16 ","$6,634.80 ","$1,808.49 ","$6,634.80 ","$6,634.80 ","$1,808.49 ","$4,791.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100081,C5273,HC APPL SKIN SUB TAL LOW>100 INIT 100CM-RT,361,1 ,"$7,372.00 ","$4,791.80 ","$1,100.98 ","$7,372.00 ","$4,341.38 ","$5,492.14 ","$4,828.66 ","$1,808.49 ","$2,064.16 ","$3,722.86 ","$1,808.49 ","$4,548.52 ","$1,808.49 ","$4,548.52 ","$4,548.52 ","$1,808.49 ","$4,548.52 ","$3,436.13 ","$6,634.80 ","$5,529.00 ","$4,341.38 ","$1,808.49 ","$6,487.36 ","$1,808.49 ","$5,529.00 ","$5,529.00 ","$6,266.20 ","$6,266.20 ","$1,808.49 ","$6,266.20 ","$1,808.49 ","$5,750.16 ","$5,750.16 ","$5,750.16 ","$6,634.80 ","$4,341.38 ","$6,634.80 ","$1,808.49 ","$7,372.00 ","$4,828.66 ","$1,808.49 ","$3,066.75 ","$1,153.41 ","$1,100.98 ","$1,892.92 ","$6,634.80 ","$3,919.23 ","$4,548.52 ","$2,064.16 ","$6,634.80 ","$1,808.49 ","$6,634.80 ","$6,634.80 ","$1,808.49 ","$4,791.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100082,C5274,HC APPL SKIN SUB TAL LOW>100 ADDL 100CM-LT,361,1 ,"$4,713.00 ","$3,063.45 ","$1,100.98 ","$4,713.00 ", N/A ,"$3,511.19 ","$3,087.02 ", N/A ,"$1,319.64 ","$2,380.07 ", N/A ,"$2,907.92 ", N/A ,"$2,907.92 ","$2,907.92 ", N/A ,"$2,907.92 ", N/A ,"$4,241.70 ","$3,534.75 ", N/A , N/A ,"$4,147.44 ", N/A ,"$3,534.75 ","$3,534.75 ","$4,006.05 ","$4,006.05 ", N/A ,"$4,006.05 ", N/A ,"$3,676.14 ","$3,676.14 ","$3,676.14 ","$4,241.70 ", N/A ,"$4,241.70 ", N/A ,"$4,713.00 ","$3,087.02 ", N/A ,"$1,960.61 ","$1,153.41 ","$1,100.98 ", N/A ,"$4,241.70 ", N/A ,"$2,907.92 ","$1,319.64 ","$4,241.70 ", N/A ,"$4,241.70 ","$4,241.70 ", N/A ,"$3,063.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100083,C5274,HC APPL SKIN SUB TAL LOW>100 ADDL 100CM-RT,361,1 ,"$4,713.00 ","$3,063.45 ","$1,100.98 ","$4,713.00 ", N/A ,"$3,511.19 ","$3,087.02 ", N/A ,"$1,319.64 ","$2,380.07 ", N/A ,"$2,907.92 ", N/A ,"$2,907.92 ","$2,907.92 ", N/A ,"$2,907.92 ", N/A ,"$4,241.70 ","$3,534.75 ", N/A , N/A ,"$4,147.44 ", N/A ,"$3,534.75 ","$3,534.75 ","$4,006.05 ","$4,006.05 ", N/A ,"$4,006.05 ", N/A ,"$3,676.14 ","$3,676.14 ","$3,676.14 ","$4,241.70 ", N/A ,"$4,241.70 ", N/A ,"$4,713.00 ","$3,087.02 ", N/A ,"$1,960.61 ","$1,153.41 ","$1,100.98 ", N/A ,"$4,241.70 ", N/A ,"$2,907.92 ","$1,319.64 ","$4,241.70 ", N/A ,"$4,241.70 ","$4,241.70 ", N/A ,"$3,063.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100084,C5275,HC APPL SKIN SUB OTH LOW<100 INIT 25CM-LT,361,1 ,"$2,201.00 ","$1,430.65 ",$553.00 ,"$2,201.00 ","$1,327.51 ","$1,639.75 ","$1,441.66 ",$553.00 ,$616.28 ,"$1,111.51 ",$553.00 ,"$1,358.02 ",$553.00 ,"$1,358.02 ","$1,358.02 ",$553.00 ,"$1,358.02 ","$1,050.70 ","$1,980.90 ","$1,650.75 ","$1,327.51 ",$553.00 ,"$1,936.88 ",$553.00 ,"$1,650.75 ","$1,650.75 ","$1,870.85 ","$1,870.85 ",$553.00 ,"$1,870.85 ",$553.00 ,"$1,716.78 ","$1,716.78 ","$1,716.78 ","$1,980.90 ","$1,327.51 ","$1,980.90 ",$553.00 ,"$2,201.00 ","$1,441.66 ",$553.00 ,$915.62 ,"$1,153.41 ","$1,100.98 ",$578.82 ,"$1,980.90 ","$1,198.43 ","$1,358.02 ",$616.28 ,"$1,980.90 ",$553.00 ,"$1,980.90 ","$1,980.90 ",$553.00 ,"$1,430.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100085,C5275,HC APPL SKIN SUB OTH LOW<100 INIT 25CM-RT,361,1 ,"$2,201.00 ","$1,430.65 ",$553.00 ,"$2,201.00 ","$1,327.51 ","$1,639.75 ","$1,441.66 ",$553.00 ,$616.28 ,"$1,111.51 ",$553.00 ,"$1,358.02 ",$553.00 ,"$1,358.02 ","$1,358.02 ",$553.00 ,"$1,358.02 ","$1,050.70 ","$1,980.90 ","$1,650.75 ","$1,327.51 ",$553.00 ,"$1,936.88 ",$553.00 ,"$1,650.75 ","$1,650.75 ","$1,870.85 ","$1,870.85 ",$553.00 ,"$1,870.85 ",$553.00 ,"$1,716.78 ","$1,716.78 ","$1,716.78 ","$1,980.90 ","$1,327.51 ","$1,980.90 ",$553.00 ,"$2,201.00 ","$1,441.66 ",$553.00 ,$915.62 ,"$1,153.41 ","$1,100.98 ",$578.82 ,"$1,980.90 ","$1,198.43 ","$1,358.02 ",$616.28 ,"$1,980.90 ",$553.00 ,"$1,980.90 ","$1,980.90 ",$553.00 ,"$1,430.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100086,C5276,HC APPL SKIN SUB OTH LOW<100 ADDL 25CM-LT,361,1 ,$751.00 ,$488.15 ,$210.28 ,$751.00 , N/A ,$559.50 ,$491.91 , N/A ,$210.28 ,$379.26 , N/A ,$463.37 , N/A ,$463.37 ,$463.37 , N/A ,$463.37 , N/A ,$675.90 ,$563.25 , N/A , N/A ,$660.88 , N/A ,$563.25 ,$563.25 ,$638.35 ,$638.35 , N/A ,$638.35 , N/A ,$585.78 ,$585.78 ,$585.78 ,$675.90 , N/A ,$675.90 , N/A ,$751.00 ,$491.91 , N/A ,$312.42 ,$751.00 ,$751.00 , N/A ,$675.90 , N/A ,$463.37 ,$210.28 ,$675.90 , N/A ,$675.90 ,$675.90 , N/A ,$488.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100087,C5276,HC APPL SKIN SUB OTH LOW<100 ADDL 25CM-RT,361,1 ,$751.00 ,$488.15 ,$210.28 ,$751.00 , N/A ,$559.50 ,$491.91 , N/A ,$210.28 ,$379.26 , N/A ,$463.37 , N/A ,$463.37 ,$463.37 , N/A ,$463.37 , N/A ,$675.90 ,$563.25 , N/A , N/A ,$660.88 , N/A ,$563.25 ,$563.25 ,$638.35 ,$638.35 , N/A ,$638.35 , N/A ,$585.78 ,$585.78 ,$585.78 ,$675.90 , N/A ,$675.90 , N/A ,$751.00 ,$491.91 , N/A ,$312.42 ,$751.00 ,$751.00 , N/A ,$675.90 , N/A ,$463.37 ,$210.28 ,$675.90 , N/A ,$675.90 ,$675.90 , N/A ,$488.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100088,C5277,HC APPL SKIN SUB OTH LOW>100 INIT 100CM-LT,361,1 ,"$2,201.00 ","$1,430.65 ",$553.00 ,"$2,201.00 ","$1,327.51 ","$1,639.75 ","$1,441.66 ",$553.00 ,$616.28 ,"$1,111.51 ",$553.00 ,"$1,358.02 ",$553.00 ,"$1,358.02 ","$1,358.02 ",$553.00 ,"$1,358.02 ","$1,050.70 ","$1,980.90 ","$1,650.75 ","$1,327.51 ",$553.00 ,"$1,936.88 ",$553.00 ,"$1,650.75 ","$1,650.75 ","$1,870.85 ","$1,870.85 ",$553.00 ,"$1,870.85 ",$553.00 ,"$1,716.78 ","$1,716.78 ","$1,716.78 ","$1,980.90 ","$1,327.51 ","$1,980.90 ",$553.00 ,"$2,201.00 ","$1,441.66 ",$553.00 ,$915.62 ,"$1,153.41 ","$1,100.98 ",$578.82 ,"$1,980.90 ","$1,198.43 ","$1,358.02 ",$616.28 ,"$1,980.90 ",$553.00 ,"$1,980.90 ","$1,980.90 ",$553.00 ,"$1,430.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100089,C5277,HC APPL SKIN SUB OTH LOW>100 INIT 100CM-RT,361,1 ,"$2,201.00 ","$1,430.65 ",$553.00 ,"$2,201.00 ","$1,327.51 ","$1,639.75 ","$1,441.66 ",$553.00 ,$616.28 ,"$1,111.51 ",$553.00 ,"$1,358.02 ",$553.00 ,"$1,358.02 ","$1,358.02 ",$553.00 ,"$1,358.02 ","$1,050.70 ","$1,980.90 ","$1,650.75 ","$1,327.51 ",$553.00 ,"$1,936.88 ",$553.00 ,"$1,650.75 ","$1,650.75 ","$1,870.85 ","$1,870.85 ",$553.00 ,"$1,870.85 ",$553.00 ,"$1,716.78 ","$1,716.78 ","$1,716.78 ","$1,980.90 ","$1,327.51 ","$1,980.90 ",$553.00 ,"$2,201.00 ","$1,441.66 ",$553.00 ,$915.62 ,"$1,153.41 ","$1,100.98 ",$578.82 ,"$1,980.90 ","$1,198.43 ","$1,358.02 ",$616.28 ,"$1,980.90 ",$553.00 ,"$1,980.90 ","$1,980.90 ",$553.00 ,"$1,430.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100090,C5278,HC APPL SKIN SUB OTH LOW>100 ADDL 100CM-LT,361,1 ,"$1,407.00 ",$914.55 ,$393.96 ,"$1,407.00 ", N/A ,"$1,048.22 ",$921.59 , N/A ,$393.96 ,$710.54 , N/A ,$868.12 , N/A ,$868.12 ,$868.12 , N/A ,$868.12 , N/A ,"$1,266.30 ","$1,055.25 ", N/A , N/A ,"$1,238.16 ", N/A ,"$1,055.25 ","$1,055.25 ","$1,195.95 ","$1,195.95 ", N/A ,"$1,195.95 ", N/A ,"$1,097.46 ","$1,097.46 ","$1,097.46 ","$1,266.30 ", N/A ,"$1,266.30 ", N/A ,"$1,407.00 ",$921.59 , N/A ,$585.31 ,"$1,153.41 ","$1,100.98 ", N/A ,"$1,266.30 ", N/A ,$868.12 ,$393.96 ,"$1,266.30 ", N/A ,"$1,266.30 ","$1,266.30 ", N/A ,$914.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100091,C5278,HC APPL SKIN SUB OTH LOW>100 ADDL 100CM-RT,361,1 ,"$1,407.00 ",$914.55 ,$393.96 ,"$1,407.00 ", N/A ,"$1,048.22 ",$921.59 , N/A ,$393.96 ,$710.54 , N/A ,$868.12 , N/A ,$868.12 ,$868.12 , N/A ,$868.12 , N/A ,"$1,266.30 ","$1,055.25 ", N/A , N/A ,"$1,238.16 ", N/A ,"$1,055.25 ","$1,055.25 ","$1,195.95 ","$1,195.95 ", N/A ,"$1,195.95 ", N/A ,"$1,097.46 ","$1,097.46 ","$1,097.46 ","$1,266.30 ", N/A ,"$1,266.30 ", N/A ,"$1,407.00 ",$921.59 , N/A ,$585.31 ,"$1,153.41 ","$1,100.98 ", N/A ,"$1,266.30 ", N/A ,$868.12 ,$393.96 ,"$1,266.30 ", N/A ,"$1,266.30 ","$1,266.30 ", N/A ,$914.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100092,N/A,HC BEDSIDE SURG PROC LEVEL 1,361,1 ,$596.00 ,$387.40 ,$166.88 ,$596.00 , N/A ,$444.02 ,$390.38 , N/A ,$166.88 ,$300.98 , N/A ,$367.73 , N/A ,$367.73 ,$367.73 , N/A ,$367.73 , N/A ,$536.40 ,$447.00 , N/A , N/A ,$524.48 , N/A ,$447.00 ,$447.00 ,$506.60 ,$506.60 , N/A ,$506.60 , N/A ,$464.88 ,$464.88 ,$464.88 ,$536.40 , N/A ,$536.40 , N/A ,$596.00 ,$390.38 , N/A ,$247.94 , N/A , N/A , N/A ,$536.40 , N/A ,$367.73 ,$166.88 ,$536.40 , N/A ,$536.40 ,$536.40 , N/A ,$387.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100100,62320,HC INJ INTRLAMNR CERV/THOR W/O GUIDE,361,1 ,"$1,833.00 ","$1,191.45 ",$305.67 ,"$1,833.00 ","$1,609.52 ","$1,365.59 ","$1,200.62 ",$670.48 ,$513.24 ,$925.67 ,$670.48 ,"$1,130.96 ",$670.48 ,"$1,130.96 ","$1,130.96 ",$670.48 ,"$1,130.96 ","$1,273.91 ","$1,649.70 ","$1,374.75 ","$1,609.52 ",$670.48 ,"$1,613.04 ",$670.48 ,"$1,374.75 ","$1,374.75 ","$1,558.05 ","$1,558.05 ",$670.48 ,"$1,558.05 ",$670.48 ,"$1,429.74 ","$1,429.74 ","$1,429.74 ","$1,649.70 ","$1,609.52 ","$1,649.70 ",$670.48 ,"$1,833.00 ","$1,200.62 ",$670.48 ,$762.53 ,$320.22 ,$305.67 ,$701.78 ,"$1,649.70 ","$1,453.01 ","$1,130.96 ",$513.24 ,"$1,649.70 ",$670.48 ,"$1,649.70 ","$1,649.70 ",$670.48 ,"$1,191.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100101,62321,HC INJ INTRLAMNR CERV/THOR W/GUIDE,361,1 ,"$3,894.00 ","$2,531.10 ",$305.67 ,"$3,894.00 ","$1,609.52 ","$2,901.03 ","$2,550.57 ",$670.48 ,"$1,090.32 ","$1,966.47 ",$670.48 ,"$2,402.60 ",$670.48 ,"$2,402.60 ","$2,402.60 ",$670.48 ,"$2,402.60 ","$1,273.91 ","$3,504.60 ","$2,920.50 ","$1,609.52 ",$670.48 ,"$3,426.72 ",$670.48 ,"$2,920.50 ","$2,920.50 ","$3,309.90 ","$3,309.90 ",$670.48 ,"$3,309.90 ",$670.48 ,"$3,037.32 ","$3,037.32 ","$3,037.32 ","$3,504.60 ","$1,609.52 ","$3,504.60 ",$670.48 ,"$3,894.00 ","$2,550.57 ",$670.48 ,"$1,619.90 ",$320.22 ,$305.67 ,$701.78 ,"$3,504.60 ","$1,453.01 ","$2,402.60 ","$1,090.32 ","$3,504.60 ",$670.48 ,"$3,504.60 ","$3,504.60 ",$670.48 ,"$2,531.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100102,62322,HC INJ INTRLAMNR LUM/SAC W/O GUIDE,361,1 ,"$3,461.00 ","$2,249.65 ",$305.67 ,"$3,461.00 ","$1,609.52 ","$2,578.45 ","$2,266.96 ",$670.48 ,$969.08 ,"$1,747.81 ",$670.48 ,"$2,135.44 ",$670.48 ,"$2,135.44 ","$2,135.44 ",$670.48 ,"$2,135.44 ","$1,273.91 ","$3,114.90 ","$2,595.75 ","$1,609.52 ",$670.48 ,"$3,045.68 ",$670.48 ,"$2,595.75 ","$2,595.75 ","$2,941.85 ","$2,941.85 ",$670.48 ,"$2,941.85 ",$670.48 ,"$2,699.58 ","$2,699.58 ","$2,699.58 ","$3,114.90 ","$1,609.52 ","$3,114.90 ",$670.48 ,"$3,461.00 ","$2,266.96 ",$670.48 ,"$1,439.78 ",$320.22 ,$305.67 ,$701.78 ,"$3,114.90 ","$1,453.01 ","$2,135.44 ",$969.08 ,"$3,114.90 ",$670.48 ,"$3,114.90 ","$3,114.90 ",$670.48 ,"$2,249.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100103,62323,HC INJ INTRLAMNR LUM/SAC W/GUIDE,361,1 ,"$3,790.00 ","$2,463.50 ",$305.67 ,"$3,790.00 ","$1,609.52 ","$2,823.55 ","$2,482.45 ",$670.48 ,"$1,061.20 ","$1,913.95 ",$670.48 ,"$2,338.43 ",$670.48 ,"$2,338.43 ","$2,338.43 ",$670.48 ,"$2,338.43 ","$1,273.91 ","$3,411.00 ","$2,842.50 ","$1,609.52 ",$670.48 ,"$3,335.20 ",$670.48 ,"$2,842.50 ","$2,842.50 ","$3,221.50 ","$3,221.50 ",$670.48 ,"$3,221.50 ",$670.48 ,"$2,956.20 ","$2,956.20 ","$2,956.20 ","$3,411.00 ","$1,609.52 ","$3,411.00 ",$670.48 ,"$3,790.00 ","$2,482.45 ",$670.48 ,"$1,576.64 ",$320.22 ,$305.67 ,$701.78 ,"$3,411.00 ","$1,453.01 ","$2,338.43 ","$1,061.20 ","$3,411.00 ",$670.48 ,"$3,411.00 ","$3,411.00 ",$670.48 ,"$2,463.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100106,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$1,322.00 ",$859.30 ,$370.16 ,"$1,883.66 ","$1,322.00 ",$984.89 ,$865.91 ,$869.20 ,$370.16 ,$667.61 ,$869.20 ,$815.67 ,$869.20 ,$815.67 ,$815.67 ,$869.20 ,$815.67 ,"$1,651.48 ","$1,189.80 ",$991.50 ,"$1,322.00 ",$869.20 ,"$1,163.36 ",$869.20 ,$991.50 ,$991.50 ,"$1,123.70 ","$1,123.70 ",$869.20 ,"$1,123.70 ",$869.20 ,"$1,031.16 ","$1,031.16 ","$1,031.16 ","$1,189.80 ","$1,322.00 ","$1,189.80 ",$869.20 ,"$1,322.00 ",$865.91 ,$869.20 ,$549.95 ,$580.76 ,$554.36 ,$909.77 ,"$1,189.80 ","$1,883.66 ",$815.67 ,$370.16 ,"$1,189.80 ",$869.20 ,"$1,189.80 ","$1,189.80 ",$869.20 ,$859.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100109,29445,HC APPL CAST LEG RIGID CONTACT -LT,361,1 ,$905.00 ,$588.25 ,$225.98 ,$905.00 ,$611.48 ,$674.23 ,$592.78 ,$254.72 ,$253.40 ,$457.03 ,$254.72 ,$558.39 ,$254.72 ,$558.39 ,$558.39 ,$254.72 ,$558.39 ,$483.97 ,$814.50 ,$678.75 ,$611.48 ,$254.72 ,$796.40 ,$254.72 ,$678.75 ,$678.75 ,$769.25 ,$769.25 ,$254.72 ,$769.25 ,$254.72 ,$705.90 ,$705.90 ,$705.90 ,$814.50 ,$611.48 ,$814.50 ,$254.72 ,$905.00 ,$592.78 ,$254.72 ,$376.48 ,$236.74 ,$225.98 ,$266.61 ,$814.50 ,$552.02 ,$558.39 ,$253.40 ,$814.50 ,$254.72 ,$814.50 ,$814.50 ,$254.72 ,$588.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100110,29445,HC APPL CAST LEG RIGID CONTACT -RT,361,1 ,$905.00 ,$588.25 ,$225.98 ,$905.00 ,$611.48 ,$674.23 ,$592.78 ,$254.72 ,$253.40 ,$457.03 ,$254.72 ,$558.39 ,$254.72 ,$558.39 ,$558.39 ,$254.72 ,$558.39 ,$483.97 ,$814.50 ,$678.75 ,$611.48 ,$254.72 ,$796.40 ,$254.72 ,$678.75 ,$678.75 ,$769.25 ,$769.25 ,$254.72 ,$769.25 ,$254.72 ,$705.90 ,$705.90 ,$705.90 ,$814.50 ,$611.48 ,$814.50 ,$254.72 ,$905.00 ,$592.78 ,$254.72 ,$376.48 ,$236.74 ,$225.98 ,$266.61 ,$814.50 ,$552.02 ,$558.39 ,$253.40 ,$814.50 ,$254.72 ,$814.50 ,$814.50 ,$254.72 ,$588.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100119,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-BIL,361,1 ,$878.00 ,$570.70 ,$245.84 ,$878.00 , N/A ,$654.11 ,$575.09 , N/A ,$245.84 ,$443.39 , N/A ,$541.73 , N/A ,$541.73 ,$541.73 , N/A ,$541.73 , N/A ,$790.20 ,$658.50 , N/A , N/A ,$772.64 , N/A ,$658.50 ,$658.50 ,$746.30 ,$746.30 , N/A ,$746.30 , N/A ,$684.84 ,$684.84 ,$684.84 ,$790.20 , N/A ,$790.20 , N/A ,$878.00 ,$575.09 , N/A ,$365.25 ,$871.13 ,$831.54 , N/A ,$790.20 , N/A ,$541.73 ,$245.84 ,$790.20 , N/A ,$790.20 ,$790.20 , N/A ,$570.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100120,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-LT,361,1 ,$585.00 ,$380.25 ,$163.80 ,$585.00 , N/A ,$435.83 ,$383.18 , N/A ,$163.80 ,$295.43 , N/A ,$360.95 , N/A ,$360.95 ,$360.95 , N/A ,$360.95 , N/A ,$526.50 ,$438.75 , N/A , N/A ,$514.80 , N/A ,$438.75 ,$438.75 ,$497.25 ,$497.25 , N/A ,$497.25 , N/A ,$456.30 ,$456.30 ,$456.30 ,$526.50 , N/A ,$526.50 , N/A ,$585.00 ,$383.18 , N/A ,$243.36 ,$580.76 ,$554.36 , N/A ,$526.50 , N/A ,$360.95 ,$163.80 ,$526.50 , N/A ,$526.50 ,$526.50 , N/A ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100121,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-RT,361,1 ,$585.00 ,$380.25 ,$163.80 ,$585.00 , N/A ,$435.83 ,$383.18 , N/A ,$163.80 ,$295.43 , N/A ,$360.95 , N/A ,$360.95 ,$360.95 , N/A ,$360.95 , N/A ,$526.50 ,$438.75 , N/A , N/A ,$514.80 , N/A ,$438.75 ,$438.75 ,$497.25 ,$497.25 , N/A ,$497.25 , N/A ,$456.30 ,$456.30 ,$456.30 ,$526.50 , N/A ,$526.50 , N/A ,$585.00 ,$383.18 , N/A ,$243.36 ,$580.76 ,$554.36 , N/A ,$526.50 , N/A ,$360.95 ,$163.80 ,$526.50 , N/A ,$526.50 ,$526.50 , N/A ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100122,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-BIL,361,1 ,"$6,817.00 ","$4,431.05 ",$831.54 ,"$6,817.00 ","$4,450.70 ","$5,078.67 ","$4,465.14 ","$1,854.03 ","$1,908.76 ","$3,442.59 ","$1,854.03 ","$4,206.09 ","$1,854.03 ","$4,206.09 ","$4,206.09 ","$1,854.03 ","$4,206.09 ","$3,522.66 ","$6,135.30 ","$5,112.75 ","$4,450.70 ","$1,854.03 ","$5,998.96 ","$1,854.03 ","$5,112.75 ","$5,112.75 ","$5,794.45 ","$5,794.45 ","$1,854.03 ","$5,794.45 ","$1,854.03 ","$5,317.26 ","$5,317.26 ","$5,317.26 ","$6,135.30 ","$4,450.70 ","$6,135.30 ","$1,854.03 ","$6,817.00 ","$4,465.14 ","$1,854.03 ","$2,835.87 ",$871.13 ,$831.54 ,"$1,940.58 ","$6,135.30 ","$4,017.92 ","$4,206.09 ","$1,908.76 ","$6,135.30 ","$1,854.03 ","$6,135.30 ","$6,135.30 ","$1,854.03 ","$4,431.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100123,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-LT,361,1 ,"$4,545.00 ","$2,954.25 ",$554.36 ,"$4,545.00 ","$4,450.70 ","$3,386.03 ","$2,976.98 ","$1,854.03 ","$1,272.60 ","$2,295.23 ","$1,854.03 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$3,522.66 ","$4,090.50 ","$3,408.75 ","$4,450.70 ","$1,854.03 ","$3,999.60 ","$1,854.03 ","$3,408.75 ","$3,408.75 ","$3,863.25 ","$3,863.25 ","$1,854.03 ","$3,863.25 ","$1,854.03 ","$3,545.10 ","$3,545.10 ","$3,545.10 ","$4,090.50 ","$4,450.70 ","$4,090.50 ","$1,854.03 ","$4,545.00 ","$2,976.98 ","$1,854.03 ","$1,890.72 ",$580.76 ,$554.36 ,"$1,940.58 ","$4,090.50 ","$4,017.92 ","$2,804.27 ","$1,272.60 ","$4,090.50 ","$1,854.03 ","$4,090.50 ","$4,090.50 ","$1,854.03 ","$2,954.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100124,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-RT,361,1 ,"$4,545.00 ","$2,954.25 ",$554.36 ,"$4,545.00 ","$4,450.70 ","$3,386.03 ","$2,976.98 ","$1,854.03 ","$1,272.60 ","$2,295.23 ","$1,854.03 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$3,522.66 ","$4,090.50 ","$3,408.75 ","$4,450.70 ","$1,854.03 ","$3,999.60 ","$1,854.03 ","$3,408.75 ","$3,408.75 ","$3,863.25 ","$3,863.25 ","$1,854.03 ","$3,863.25 ","$1,854.03 ","$3,545.10 ","$3,545.10 ","$3,545.10 ","$4,090.50 ","$4,450.70 ","$4,090.50 ","$1,854.03 ","$4,545.00 ","$2,976.98 ","$1,854.03 ","$1,890.72 ",$580.76 ,$554.36 ,"$1,940.58 ","$4,090.50 ","$4,017.92 ","$2,804.27 ","$1,272.60 ","$4,090.50 ","$1,854.03 ","$4,090.50 ","$4,090.50 ","$1,854.03 ","$2,954.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100125,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-BIL,361,1 ,"$1,218.00 ",$791.70 ,$341.04 ,"$1,218.00 ", N/A ,$907.41 ,$797.79 , N/A ,$341.04 ,$615.09 , N/A ,$751.51 , N/A ,$751.51 ,$751.51 , N/A ,$751.51 , N/A ,"$1,096.20 ",$913.50 , N/A , N/A ,"$1,071.84 ", N/A ,$913.50 ,$913.50 ,"$1,035.30 ","$1,035.30 ", N/A ,"$1,035.30 ", N/A ,$950.04 ,$950.04 ,$950.04 ,"$1,096.20 ", N/A ,"$1,096.20 ", N/A ,"$1,218.00 ",$797.79 , N/A ,$506.69 ,$871.13 ,$831.54 , N/A ,"$1,096.20 ", N/A ,$751.51 ,$341.04 ,"$1,096.20 ", N/A ,"$1,096.20 ","$1,096.20 ", N/A ,$791.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100126,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-LT,361,1 ,$812.00 ,$527.80 ,$227.36 ,$812.00 , N/A ,$604.94 ,$531.86 , N/A ,$227.36 ,$410.06 , N/A ,$501.00 , N/A ,$501.00 ,$501.00 , N/A ,$501.00 , N/A ,$730.80 ,$609.00 , N/A , N/A ,$714.56 , N/A ,$609.00 ,$609.00 ,$690.20 ,$690.20 , N/A ,$690.20 , N/A ,$633.36 ,$633.36 ,$633.36 ,$730.80 , N/A ,$730.80 , N/A ,$812.00 ,$531.86 , N/A ,$337.79 ,$580.76 ,$554.36 , N/A ,$730.80 , N/A ,$501.00 ,$227.36 ,$730.80 , N/A ,$730.80 ,$730.80 , N/A ,$527.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100127,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-RT,361,1 ,$812.00 ,$527.80 ,$227.36 ,$812.00 , N/A ,$604.94 ,$531.86 , N/A ,$227.36 ,$410.06 , N/A ,$501.00 , N/A ,$501.00 ,$501.00 , N/A ,$501.00 , N/A ,$730.80 ,$609.00 , N/A , N/A ,$714.56 , N/A ,$609.00 ,$609.00 ,$690.20 ,$690.20 , N/A ,$690.20 , N/A ,$633.36 ,$633.36 ,$633.36 ,$730.80 , N/A ,$730.80 , N/A ,$812.00 ,$531.86 , N/A ,$337.79 ,$580.76 ,$554.36 , N/A ,$730.80 , N/A ,$501.00 ,$227.36 ,$730.80 , N/A ,$730.80 ,$730.80 , N/A ,$527.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100128,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-BIL,361,1 ,"$6,817.00 ","$4,431.05 ",$831.54 ,"$6,817.00 ","$4,450.70 ","$5,078.67 ","$4,465.14 ","$1,854.03 ","$1,908.76 ","$3,442.59 ","$1,854.03 ","$4,206.09 ","$1,854.03 ","$4,206.09 ","$4,206.09 ","$1,854.03 ","$4,206.09 ","$3,522.66 ","$6,135.30 ","$5,112.75 ","$4,450.70 ","$1,854.03 ","$5,998.96 ","$1,854.03 ","$5,112.75 ","$5,112.75 ","$5,794.45 ","$5,794.45 ","$1,854.03 ","$5,794.45 ","$1,854.03 ","$5,317.26 ","$5,317.26 ","$5,317.26 ","$6,135.30 ","$4,450.70 ","$6,135.30 ","$1,854.03 ","$6,817.00 ","$4,465.14 ","$1,854.03 ","$2,835.87 ",$871.13 ,$831.54 ,"$1,940.58 ","$6,135.30 ","$4,017.92 ","$4,206.09 ","$1,908.76 ","$6,135.30 ","$1,854.03 ","$6,135.30 ","$6,135.30 ","$1,854.03 ","$4,431.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100129,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-LT,361,1 ,"$4,545.00 ","$2,954.25 ",$554.36 ,"$4,545.00 ","$4,450.70 ","$3,386.03 ","$2,976.98 ","$1,854.03 ","$1,272.60 ","$2,295.23 ","$1,854.03 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$3,522.66 ","$4,090.50 ","$3,408.75 ","$4,450.70 ","$1,854.03 ","$3,999.60 ","$1,854.03 ","$3,408.75 ","$3,408.75 ","$3,863.25 ","$3,863.25 ","$1,854.03 ","$3,863.25 ","$1,854.03 ","$3,545.10 ","$3,545.10 ","$3,545.10 ","$4,090.50 ","$4,450.70 ","$4,090.50 ","$1,854.03 ","$4,545.00 ","$2,976.98 ","$1,854.03 ","$1,890.72 ",$580.76 ,$554.36 ,"$1,940.58 ","$4,090.50 ","$4,017.92 ","$2,804.27 ","$1,272.60 ","$4,090.50 ","$1,854.03 ","$4,090.50 ","$4,090.50 ","$1,854.03 ","$2,954.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100130,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-RT,361,1 ,"$4,545.00 ","$2,954.25 ",$554.36 ,"$4,545.00 ","$4,450.70 ","$3,386.03 ","$2,976.98 ","$1,854.03 ","$1,272.60 ","$2,295.23 ","$1,854.03 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$2,804.27 ","$1,854.03 ","$2,804.27 ","$3,522.66 ","$4,090.50 ","$3,408.75 ","$4,450.70 ","$1,854.03 ","$3,999.60 ","$1,854.03 ","$3,408.75 ","$3,408.75 ","$3,863.25 ","$3,863.25 ","$1,854.03 ","$3,863.25 ","$1,854.03 ","$3,545.10 ","$3,545.10 ","$3,545.10 ","$4,090.50 ","$4,450.70 ","$4,090.50 ","$1,854.03 ","$4,545.00 ","$2,976.98 ","$1,854.03 ","$1,890.72 ",$580.76 ,$554.36 ,"$1,940.58 ","$4,090.50 ","$4,017.92 ","$2,804.27 ","$1,272.60 ","$4,090.50 ","$1,854.03 ","$4,090.50 ","$4,090.50 ","$1,854.03 ","$2,954.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100132,64640,HC DESTROY NERVE PERIPHERAL-LT,361,1 ,"$4,317.00 ","$2,806.05 ",$554.36 ,"$4,317.00 ","$2,086.56 ","$3,216.17 ","$2,827.64 ",$869.20 ,"$1,208.76 ","$2,180.09 ",$869.20 ,"$2,663.59 ",$869.20 ,"$2,663.59 ","$2,663.59 ",$869.20 ,"$2,663.59 ","$1,651.48 ","$3,885.30 ","$3,237.75 ","$2,086.56 ",$869.20 ,"$3,798.96 ",$869.20 ,"$3,237.75 ","$3,237.75 ","$3,669.45 ","$3,669.45 ",$869.20 ,"$3,669.45 ",$869.20 ,"$3,367.26 ","$3,367.26 ","$3,367.26 ","$3,885.30 ","$2,086.56 ","$3,885.30 ",$869.20 ,"$4,317.00 ","$2,827.64 ",$869.20 ,"$1,795.87 ",$580.76 ,$554.36 ,$909.77 ,"$3,885.30 ","$1,883.66 ","$2,663.59 ","$1,208.76 ","$3,885.30 ",$869.20 ,"$3,885.30 ","$3,885.30 ",$869.20 ,"$2,806.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100133,64640,HC DESTROY NERVE PERIPHERAL-RT,361,1 ,"$4,317.00 ","$2,806.05 ",$554.36 ,"$4,317.00 ","$2,086.56 ","$3,216.17 ","$2,827.64 ",$869.20 ,"$1,208.76 ","$2,180.09 ",$869.20 ,"$2,663.59 ",$869.20 ,"$2,663.59 ","$2,663.59 ",$869.20 ,"$2,663.59 ","$1,651.48 ","$3,885.30 ","$3,237.75 ","$2,086.56 ",$869.20 ,"$3,798.96 ",$869.20 ,"$3,237.75 ","$3,237.75 ","$3,669.45 ","$3,669.45 ",$869.20 ,"$3,669.45 ",$869.20 ,"$3,367.26 ","$3,367.26 ","$3,367.26 ","$3,885.30 ","$2,086.56 ","$3,885.30 ",$869.20 ,"$4,317.00 ","$2,827.64 ",$869.20 ,"$1,795.87 ",$580.76 ,$554.36 ,$909.77 ,"$3,885.30 ","$1,883.66 ","$2,663.59 ","$1,208.76 ","$3,885.30 ",$869.20 ,"$3,885.30 ","$3,885.30 ",$869.20 ,"$2,806.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100146,51720,HC INSTILL ANTICARCINOG BLADDER,361,1 ,$756.00 ,$491.40 ,$211.68 ,$756.00 ,$674.49 ,$563.22 ,$495.18 ,$280.97 ,$211.68 ,$381.78 ,$280.97 ,$466.45 ,$280.97 ,$466.45 ,$466.45 ,$280.97 ,$466.45 ,$533.84 ,$680.40 ,$567.00 ,$674.49 ,$280.97 ,$665.28 ,$280.97 ,$567.00 ,$567.00 ,$642.60 ,$642.60 ,$280.97 ,$642.60 ,$280.97 ,$589.68 ,$589.68 ,$589.68 ,$680.40 ,$674.49 ,$680.40 ,$280.97 ,$756.00 ,$495.18 ,$280.97 ,$314.50 ,$756.00 ,$754.44 ,$294.09 ,$680.40 ,$608.90 ,$466.45 ,$211.68 ,$680.40 ,$280.97 ,$680.40 ,$680.40 ,$280.97 ,$491.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100148,64488,HC INJ TAP BLOCK W/GUIDE- BIL,361,1 ,"$3,372.00 ","$2,191.80 ",$305.67 ,"$3,372.00 ", N/A ,"$2,512.14 ","$2,208.66 ", N/A ,$944.16 ,"$1,702.86 ", N/A ,"$2,080.52 ", N/A ,"$2,080.52 ","$2,080.52 ", N/A ,"$2,080.52 ", N/A ,"$3,034.80 ","$2,529.00 ", N/A , N/A ,"$2,967.36 ", N/A ,"$2,529.00 ","$2,529.00 ","$2,866.20 ","$2,866.20 ", N/A ,"$2,866.20 ", N/A ,"$2,630.16 ","$2,630.16 ","$2,630.16 ","$3,034.80 ", N/A ,"$3,034.80 ", N/A ,"$3,372.00 ","$2,208.66 ", N/A ,"$1,402.75 ",$320.22 ,$305.67 , N/A ,"$3,034.80 ", N/A ,"$2,080.52 ",$944.16 ,"$3,034.80 ", N/A ,"$3,034.80 ","$3,034.80 ", N/A ,"$2,191.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100164,N/A,HC BEDSIDE SURG PROC LEVEL 2,361,1 ,"$1,192.00 ",$774.80 ,$333.76 ,"$1,192.00 ", N/A ,$888.04 ,$780.76 , N/A ,$333.76 ,$601.96 , N/A ,$735.46 , N/A ,$735.46 ,$735.46 , N/A ,$735.46 , N/A ,"$1,072.80 ",$894.00 , N/A , N/A ,"$1,048.96 ", N/A ,$894.00 ,$894.00 ,"$1,013.20 ","$1,013.20 ", N/A ,"$1,013.20 ", N/A ,$929.76 ,$929.76 ,$929.76 ,"$1,072.80 ", N/A ,"$1,072.80 ", N/A ,"$1,192.00 ",$780.76 , N/A ,$495.87 , N/A , N/A , N/A ,"$1,072.80 ", N/A ,$735.46 ,$333.76 ,"$1,072.80 ", N/A ,"$1,072.80 ","$1,072.80 ", N/A ,$774.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100165,N/A,HC BEDSIDE SURG PROC LEVEL 3,361,1 ,"$1,788.00 ","$1,162.20 ",$500.64 ,"$1,788.00 ", N/A ,"$1,332.06 ","$1,171.14 ", N/A ,$500.64 ,$902.94 , N/A ,"$1,103.20 ", N/A ,"$1,103.20 ","$1,103.20 ", N/A ,"$1,103.20 ", N/A ,"$1,609.20 ","$1,341.00 ", N/A , N/A ,"$1,573.44 ", N/A ,"$1,341.00 ","$1,341.00 ","$1,519.80 ","$1,519.80 ", N/A ,"$1,519.80 ", N/A ,"$1,394.64 ","$1,394.64 ","$1,394.64 ","$1,609.20 ", N/A ,"$1,609.20 ", N/A ,"$1,788.00 ","$1,171.14 ", N/A ,$743.81 , N/A , N/A , N/A ,"$1,609.20 ", N/A ,"$1,103.20 ",$500.64 ,"$1,609.20 ", N/A ,"$1,609.20 ","$1,609.20 ", N/A ,"$1,162.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100166,N/A,HC BEDSIDE SURG PROC LEVEL 4,361,1 ,"$2,385.00 ","$1,550.25 ",$667.80 ,"$2,385.00 ", N/A ,"$1,776.83 ","$1,562.18 ", N/A ,$667.80 ,"$1,204.43 ", N/A ,"$1,471.55 ", N/A ,"$1,471.55 ","$1,471.55 ", N/A ,"$1,471.55 ", N/A ,"$2,146.50 ","$1,788.75 ", N/A , N/A ,"$2,098.80 ", N/A ,"$1,788.75 ","$1,788.75 ","$2,027.25 ","$2,027.25 ", N/A ,"$2,027.25 ", N/A ,"$1,860.30 ","$1,860.30 ","$1,860.30 ","$2,146.50 ", N/A ,"$2,146.50 ", N/A ,"$2,385.00 ","$1,562.18 ", N/A ,$992.16 , N/A , N/A , N/A ,"$2,146.50 ", N/A ,"$1,471.55 ",$667.80 ,"$2,146.50 ", N/A ,"$2,146.50 ","$2,146.50 ", N/A ,"$1,550.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100167,N/A,HC BEDSIDE SURG PROC LEVEL 5,361,1 ,"$2,981.00 ","$1,937.65 ",$834.68 ,"$2,981.00 ", N/A ,"$2,220.85 ","$1,952.56 ", N/A ,$834.68 ,"$1,505.41 ", N/A ,"$1,839.28 ", N/A ,"$1,839.28 ","$1,839.28 ", N/A ,"$1,839.28 ", N/A ,"$2,682.90 ","$2,235.75 ", N/A , N/A ,"$2,623.28 ", N/A ,"$2,235.75 ","$2,235.75 ","$2,533.85 ","$2,533.85 ", N/A ,"$2,533.85 ", N/A ,"$2,325.18 ","$2,325.18 ","$2,325.18 ","$2,682.90 ", N/A ,"$2,682.90 ", N/A ,"$2,981.00 ","$1,952.56 ", N/A ,"$1,240.10 ", N/A , N/A , N/A ,"$2,682.90 ", N/A ,"$1,839.28 ",$834.68 ,"$2,682.90 ", N/A ,"$2,682.90 ","$2,682.90 ", N/A ,"$1,937.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100187,64415,HC INTRASCALENE BLOCK SINGLE-LT,361,1 ,"$3,634.00 ","$2,362.10 ",$305.67 ,"$3,634.00 ","$2,086.56 ","$2,707.33 ","$2,380.27 ",$869.20 ,"$1,017.52 ","$1,835.17 ",$869.20 ,"$2,242.18 ",$869.20 ,"$2,242.18 ","$2,242.18 ",$869.20 ,"$2,242.18 ","$1,651.48 ","$3,270.60 ","$2,725.50 ","$2,086.56 ",$869.20 ,"$3,197.92 ",$869.20 ,"$2,725.50 ","$2,725.50 ","$3,088.90 ","$3,088.90 ",$869.20 ,"$3,088.90 ",$869.20 ,"$2,834.52 ","$2,834.52 ","$2,834.52 ","$3,270.60 ","$2,086.56 ","$3,270.60 ",$869.20 ,"$3,634.00 ","$2,380.27 ",$869.20 ,"$1,511.74 ",$320.22 ,$305.67 ,$909.77 ,"$3,270.60 ","$1,883.66 ","$2,242.18 ","$1,017.52 ","$3,270.60 ",$869.20 ,"$3,270.60 ","$3,270.60 ",$869.20 ,"$2,362.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100188,64415,HC INTRASCALENE BLOCK SINGLE-RT,361,1 ,"$3,634.00 ","$2,362.10 ",$305.67 ,"$3,634.00 ","$2,086.56 ","$2,707.33 ","$2,380.27 ",$869.20 ,"$1,017.52 ","$1,835.17 ",$869.20 ,"$2,242.18 ",$869.20 ,"$2,242.18 ","$2,242.18 ",$869.20 ,"$2,242.18 ","$1,651.48 ","$3,270.60 ","$2,725.50 ","$2,086.56 ",$869.20 ,"$3,197.92 ",$869.20 ,"$2,725.50 ","$2,725.50 ","$3,088.90 ","$3,088.90 ",$869.20 ,"$3,088.90 ",$869.20 ,"$2,834.52 ","$2,834.52 ","$2,834.52 ","$3,270.60 ","$2,086.56 ","$3,270.60 ",$869.20 ,"$3,634.00 ","$2,380.27 ",$869.20 ,"$1,511.74 ",$320.22 ,$305.67 ,$909.77 ,"$3,270.60 ","$1,883.66 ","$2,242.18 ","$1,017.52 ","$3,270.60 ",$869.20 ,"$3,270.60 ","$3,270.60 ",$869.20 ,"$2,362.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100189,64415,HC INTRASCALENE BLOCK SINGLE,361,1 ,"$3,634.00 ","$2,362.10 ",$305.67 ,"$3,634.00 ","$2,086.56 ","$2,707.33 ","$2,380.27 ",$869.20 ,"$1,017.52 ","$1,835.17 ",$869.20 ,"$2,242.18 ",$869.20 ,"$2,242.18 ","$2,242.18 ",$869.20 ,"$2,242.18 ","$1,651.48 ","$3,270.60 ","$2,725.50 ","$2,086.56 ",$869.20 ,"$3,197.92 ",$869.20 ,"$2,725.50 ","$2,725.50 ","$3,088.90 ","$3,088.90 ",$869.20 ,"$3,088.90 ",$869.20 ,"$2,834.52 ","$2,834.52 ","$2,834.52 ","$3,270.60 ","$2,086.56 ","$3,270.60 ",$869.20 ,"$3,634.00 ","$2,380.27 ",$869.20 ,"$1,511.74 ",$320.22 ,$305.67 ,$909.77 ,"$3,270.60 ","$1,883.66 ","$2,242.18 ","$1,017.52 ","$3,270.60 ",$869.20 ,"$3,270.60 ","$3,270.60 ",$869.20 ,"$2,362.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100191,64418,HC NERVE BLOCK;SUPRACAPULAR-LT,361,1 ,"$3,634.00 ","$2,362.10 ",$305.67 ,"$3,634.00 ","$1,609.52 ","$2,707.33 ","$2,380.27 ",$670.48 ,"$1,017.52 ","$1,835.17 ",$670.48 ,"$2,242.18 ",$670.48 ,"$2,242.18 ","$2,242.18 ",$670.48 ,"$2,242.18 ","$1,273.91 ","$3,270.60 ","$2,725.50 ","$1,609.52 ",$670.48 ,"$3,197.92 ",$670.48 ,"$2,725.50 ","$2,725.50 ","$3,088.90 ","$3,088.90 ",$670.48 ,"$3,088.90 ",$670.48 ,"$2,834.52 ","$2,834.52 ","$2,834.52 ","$3,270.60 ","$1,609.52 ","$3,270.60 ",$670.48 ,"$3,634.00 ","$2,380.27 ",$670.48 ,"$1,511.74 ",$320.22 ,$305.67 ,$701.78 ,"$3,270.60 ","$1,453.01 ","$2,242.18 ","$1,017.52 ","$3,270.60 ",$670.48 ,"$3,270.60 ","$3,270.60 ",$670.48 ,"$2,362.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100196,64447,HC FEMORAL NERVE BLOCK SINGLE,361,1 ,"$1,818.00 ","$1,181.70 ",$305.67 ,"$1,818.00 ","$1,609.52 ","$1,354.41 ","$1,190.79 ",$670.48 ,$509.04 ,$918.09 ,$670.48 ,"$1,121.71 ",$670.48 ,"$1,121.71 ","$1,121.71 ",$670.48 ,"$1,121.71 ","$1,273.91 ","$1,636.20 ","$1,363.50 ","$1,609.52 ",$670.48 ,"$1,599.84 ",$670.48 ,"$1,363.50 ","$1,363.50 ","$1,545.30 ","$1,545.30 ",$670.48 ,"$1,545.30 ",$670.48 ,"$1,418.04 ","$1,418.04 ","$1,418.04 ","$1,636.20 ","$1,609.52 ","$1,636.20 ",$670.48 ,"$1,818.00 ","$1,190.79 ",$670.48 ,$756.29 ,$320.22 ,$305.67 ,$701.78 ,"$1,636.20 ","$1,453.01 ","$1,121.71 ",$509.04 ,"$1,636.20 ",$670.48 ,"$1,636.20 ","$1,636.20 ",$670.48 ,"$1,181.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100197,64450,HC INJ ANES NERVE PERIPHERAL,361,1 ,"$1,698.00 ","$1,103.70 ",$305.67 ,"$1,698.00 ","$1,609.52 ","$1,265.01 ","$1,112.19 ",$670.48 ,$475.44 ,$857.49 ,$670.48 ,"$1,047.67 ",$670.48 ,"$1,047.67 ","$1,047.67 ",$670.48 ,"$1,047.67 ","$1,273.91 ","$1,528.20 ","$1,273.50 ","$1,609.52 ",$670.48 ,"$1,494.24 ",$670.48 ,"$1,273.50 ","$1,273.50 ","$1,443.30 ","$1,443.30 ",$670.48 ,"$1,443.30 ",$670.48 ,"$1,324.44 ","$1,324.44 ","$1,324.44 ","$1,528.20 ","$1,609.52 ","$1,528.20 ",$670.48 ,"$1,698.00 ","$1,112.19 ",$670.48 ,$706.37 ,$320.22 ,$305.67 ,$701.78 ,"$1,528.20 ","$1,453.01 ","$1,047.67 ",$475.44 ,"$1,528.20 ",$670.48 ,"$1,528.20 ","$1,528.20 ",$670.48 ,"$1,103.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100229,45020,HC I AND D ABSCESS RECTAL,361,1 ,"$2,124.00 ","$1,380.60 ",$594.72 ,"$5,590.16 ","$2,124.00 ","$1,582.38 ","$1,391.22 ","$2,124.00 ",$594.72 ,"$1,072.62 ","$2,124.00 ","$1,310.51 ","$2,124.00 ","$1,310.51 ","$1,310.51 ","$2,124.00 ","$1,310.51 ","$4,901.09 ","$1,911.60 ","$1,593.00 ","$2,124.00 ","$2,124.00 ","$1,869.12 ","$2,124.00 ","$1,593.00 ","$1,593.00 ","$1,805.40 ","$1,805.40 ","$2,124.00 ","$1,805.40 ","$2,124.00 ","$1,656.72 ","$1,656.72 ","$1,656.72 ","$1,911.60 ","$2,124.00 ","$1,911.60 ","$2,124.00 ","$2,124.00 ","$1,391.22 ","$2,124.00 ",$883.58 ,"$1,442.65 ","$1,377.08 ","$2,124.00 ","$1,911.60 ","$5,590.16 ","$1,310.51 ",$594.72 ,"$1,911.60 ","$2,124.00 ","$1,911.60 ","$1,911.60 ","$2,124.00 ","$1,380.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100231,50437,HC DILATION EXIST TRACT ENDOURAL W/GUIDE  AND  NEW RENAL ACCESS,361,1 ,"$4,641.00 ","$3,016.65 ","$1,299.48 ","$7,035.28 ","$4,641.00 ","$3,457.55 ","$3,039.86 ","$3,246.35 ","$1,299.48 ","$2,343.71 ","$3,246.35 ","$2,863.50 ","$3,246.35 ","$2,863.50 ","$2,863.50 ","$3,246.35 ","$2,863.50 ","$6,168.07 ","$4,176.90 ","$3,480.75 ","$4,641.00 ","$3,246.35 ","$4,084.08 ","$3,246.35 ","$3,480.75 ","$3,480.75 ","$3,944.85 ","$3,944.85 ","$3,246.35 ","$3,944.85 ","$3,246.35 ","$3,619.98 ","$3,619.98 ","$3,619.98 ","$4,176.90 ","$4,641.00 ","$4,176.90 ","$3,246.35 ","$4,641.00 ","$3,039.86 ","$3,246.35 ","$1,930.66 ","$1,681.20 ","$1,604.78 ","$3,397.91 ","$4,176.90 ","$7,035.28 ","$2,863.50 ","$1,299.48 ","$4,176.90 ","$3,246.35 ","$4,176.90 ","$4,176.90 ","$3,246.35 ","$3,016.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100232,11103,HC BIOPSY SKIN TANGENTIAL ADDL LESN,361,1 ,$306.00 ,$198.90 ,$85.68 ,$306.00 , N/A ,$227.97 ,$200.43 , N/A ,$85.68 ,$154.53 , N/A ,$188.80 , N/A ,$188.80 ,$188.80 , N/A ,$188.80 , N/A ,$275.40 ,$229.50 , N/A , N/A ,$269.28 , N/A ,$229.50 ,$229.50 ,$260.10 ,$260.10 , N/A ,$260.10 , N/A ,$238.68 ,$238.68 ,$238.68 ,$275.40 , N/A ,$275.40 , N/A ,$306.00 ,$200.43 , N/A ,$127.30 ,$306.00 ,$306.00 , N/A ,$275.40 , N/A ,$188.80 ,$85.68 ,$275.40 , N/A ,$275.40 ,$275.40 , N/A ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100233,11105,HC BIOPSY SKIN PUNCH ADDL LESN,361,1 ,$352.00 ,$228.80 ,$98.56 ,$352.00 , N/A ,$262.24 ,$230.56 , N/A ,$98.56 ,$177.76 , N/A ,$217.18 , N/A ,$217.18 ,$217.18 , N/A ,$217.18 , N/A ,$316.80 ,$264.00 , N/A , N/A ,$309.76 , N/A ,$264.00 ,$264.00 ,$299.20 ,$299.20 , N/A ,$299.20 , N/A ,$274.56 ,$274.56 ,$274.56 ,$316.80 , N/A ,$316.80 , N/A ,$352.00 ,$230.56 , N/A ,$146.43 ,$352.00 ,$352.00 , N/A ,$316.80 , N/A ,$217.18 ,$98.56 ,$316.80 , N/A ,$316.80 ,$316.80 , N/A ,$228.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100234,11107,HC BIOPSY SKIN INCISIONAL ADDL LESN,361,1 ,$306.00 ,$198.90 ,$85.68 ,$306.00 , N/A ,$227.97 ,$200.43 , N/A ,$85.68 ,$154.53 , N/A ,$188.80 , N/A ,$188.80 ,$188.80 , N/A ,$188.80 , N/A ,$275.40 ,$229.50 , N/A , N/A ,$269.28 , N/A ,$229.50 ,$229.50 ,$260.10 ,$260.10 , N/A ,$260.10 , N/A ,$238.68 ,$238.68 ,$238.68 ,$275.40 , N/A ,$275.40 , N/A ,$306.00 ,$200.43 , N/A ,$127.30 ,$306.00 ,$306.00 , N/A ,$275.40 , N/A ,$188.80 ,$85.68 ,$275.40 , N/A ,$275.40 ,$275.40 , N/A ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100235,11102,HC BIOPSY SKIN TANGENTIAL INIT LESN,361,1 ,$605.00 ,$393.25 ,$169.40 ,$605.00 ,$455.17 ,$450.73 ,$396.28 ,$189.61 ,$169.40 ,$305.53 ,$189.61 ,$373.29 ,$189.61 ,$373.29 ,$373.29 ,$189.61 ,$373.29 ,$360.26 ,$544.50 ,$453.75 ,$455.17 ,$189.61 ,$532.40 ,$189.61 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$189.61 ,$514.25 ,$189.61 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$455.17 ,$544.50 ,$189.61 ,$605.00 ,$396.28 ,$189.61 ,$251.68 ,$469.24 ,$447.91 ,$198.46 ,$544.50 ,$410.91 ,$373.29 ,$169.40 ,$544.50 ,$189.61 ,$544.50 ,$544.50 ,$189.61 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100236,11104,HC BIOPSY SKIN PUNCH INIT LESN,361,1 ,$695.00 ,$451.75 ,$194.60 ,$790.90 ,$695.00 ,$517.78 ,$455.23 ,$364.95 ,$194.60 ,$350.98 ,$364.95 ,$428.82 ,$364.95 ,$428.82 ,$428.82 ,$364.95 ,$428.82 ,$693.41 ,$625.50 ,$521.25 ,$695.00 ,$364.95 ,$611.60 ,$364.95 ,$521.25 ,$521.25 ,$590.75 ,$590.75 ,$364.95 ,$590.75 ,$364.95 ,$542.10 ,$542.10 ,$542.10 ,$625.50 ,$695.00 ,$625.50 ,$364.95 ,$695.00 ,$455.23 ,$364.95 ,$289.12 ,$469.24 ,$447.91 ,$381.99 ,$625.50 ,$790.90 ,$428.82 ,$194.60 ,$625.50 ,$364.95 ,$625.50 ,$625.50 ,$364.95 ,$451.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100237,11106,HC BIOPSY SKIN INCISIONAL INIT LESN,361,1 ,$605.00 ,$393.25 ,$169.40 ,"$1,198.43 ",$605.00 ,$450.73 ,$396.28 ,$553.00 ,$169.40 ,$305.53 ,$553.00 ,$373.29 ,$553.00 ,$373.29 ,$373.29 ,$553.00 ,$373.29 ,"$1,050.70 ",$544.50 ,$453.75 ,$605.00 ,$553.00 ,$532.40 ,$553.00 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$553.00 ,$514.25 ,$553.00 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$605.00 ,$544.50 ,$553.00 ,$605.00 ,$396.28 ,$553.00 ,$251.68 ,$469.24 ,$447.91 ,$578.82 ,$544.50 ,"$1,198.43 ",$373.29 ,$169.40 ,$544.50 ,$553.00 ,$544.50 ,$544.50 ,$553.00 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,"$1,322.00 ",$859.30 ,$148.00 ,"$1,423.93 ","$1,322.00 ",$984.89 ,$865.91 ,$657.06 ,$370.16 ,$667.61 ,$657.06 ,$815.67 ,$657.06 ,$815.67 ,$815.67 ,$657.06 ,$815.67 ,"$1,248.41 ","$1,189.80 ",$991.50 ,"$1,322.00 ",$657.06 ,"$1,163.36 ",$657.06 ,$991.50 ,$991.50 ,"$1,123.70 ","$1,123.70 ",$657.06 ,"$1,123.70 ",$657.06 ,"$1,031.16 ","$1,031.16 ","$1,031.16 ","$1,189.80 ","$1,322.00 ","$1,189.80 ",$657.06 ,$148.00 ,$865.91 ,$657.06 ,$549.95 ,$442.92 ,$422.78 ,$687.73 ,"$1,189.80 ","$1,423.93 ",$815.67 ,$370.16 ,"$1,189.80 ",$657.06 ,"$1,189.80 ","$1,189.80 ",$657.06 ,$859.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,$862.00 ,$560.30 ,$66.21 ,$862.00 , N/A ,$642.19 ,$564.61 , N/A ,$241.36 ,$435.31 , N/A ,$531.85 , N/A ,$531.85 ,$531.85 , N/A ,$531.85 , N/A ,$775.80 ,$646.50 , N/A , N/A ,$758.56 , N/A ,$646.50 ,$646.50 ,$732.70 ,$732.70 , N/A ,$732.70 , N/A ,$672.36 ,$672.36 ,$672.36 ,$775.80 , N/A ,$775.80 , N/A ,$66.21 ,$564.61 , N/A ,$358.59 ,$442.92 ,$422.78 , N/A ,$775.80 , N/A ,$531.85 ,$241.36 ,$775.80 , N/A ,$775.80 ,$775.80 , N/A ,$560.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100242,10009,HC ASP FINE NDL W/CT GUIDE INIT LESN,361,1 ,"$1,322.00 ",$859.30 ,$370.16 ,"$1,423.93 ","$1,322.00 ",$984.89 ,$865.91 ,$657.06 ,$370.16 ,$667.61 ,$657.06 ,$815.67 ,$657.06 ,$815.67 ,$815.67 ,$657.06 ,$815.67 ,"$1,248.41 ","$1,189.80 ",$991.50 ,"$1,322.00 ",$657.06 ,"$1,163.36 ",$657.06 ,$991.50 ,$991.50 ,"$1,123.70 ","$1,123.70 ",$657.06 ,"$1,123.70 ",$657.06 ,"$1,031.16 ","$1,031.16 ","$1,031.16 ","$1,189.80 ","$1,322.00 ","$1,189.80 ",$657.06 ,$510.18 ,$865.91 ,$657.06 ,$549.95 ,$442.92 ,$422.78 ,$687.73 ,"$1,189.80 ","$1,423.93 ",$815.67 ,$370.16 ,"$1,189.80 ",$657.06 ,"$1,189.80 ","$1,189.80 ",$657.06 ,$859.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100247,36573,HC INS PER CV CATH W/O PORT W/GUIDANCE 5>,361,1 ,$389.00 ,$252.85 ,$108.92 ,"$3,217.73 ",$389.00 ,$289.81 ,$254.80 ,$389.00 ,$108.92 ,$196.45 ,$389.00 ,$240.01 ,$389.00 ,$240.01 ,$240.01 ,$389.00 ,$240.01 ,"$2,821.10 ",$350.10 ,$291.75 ,$389.00 ,$389.00 ,$342.32 ,$389.00 ,$291.75 ,$291.75 ,$330.65 ,$330.65 ,$389.00 ,$330.65 ,$389.00 ,$303.42 ,$303.42 ,$303.42 ,$350.10 ,$389.00 ,$350.10 ,$389.00 ,$389.00 ,$254.80 ,$389.00 ,$161.82 ,$360.79 ,$344.39 ,$389.00 ,$350.10 ,"$3,217.73 ",$240.01 ,$108.92 ,$350.10 ,$389.00 ,$350.10 ,$350.10 ,$389.00 ,$252.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100259,66821,HC LASER (YAG) POST CATARACT,361,1 ,"$1,643.00 ","$1,067.95 ",$380.57 ,"$1,643.00 ","$1,275.62 ","$1,224.04 ","$1,076.17 ",$531.38 ,$460.04 ,$829.72 ,$531.38 ,"$1,013.73 ",$531.38 ,"$1,013.73 ","$1,013.73 ",$531.38 ,"$1,013.73 ","$1,009.62 ","$1,478.70 ","$1,232.25 ","$1,275.62 ",$531.38 ,"$1,445.84 ",$531.38 ,"$1,232.25 ","$1,232.25 ","$1,396.55 ","$1,396.55 ",$531.38 ,"$1,396.55 ",$531.38 ,"$1,281.54 ","$1,281.54 ","$1,281.54 ","$1,478.70 ","$1,275.62 ","$1,478.70 ",$531.38 ,"$1,643.00 ","$1,076.17 ",$531.38 ,$683.49 ,$398.70 ,$380.57 ,$556.19 ,"$1,478.70 ","$1,151.58 ","$1,013.73 ",$460.04 ,"$1,478.70 ",$531.38 ,"$1,478.70 ","$1,478.70 ",$531.38 ,"$1,067.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100262,64616,HC CHEM/DEST NERVE MUSCLE NECK,361,1 ,$758.00 ,$492.70 ,$212.24 ,$758.00 ,$662.23 ,$564.71 ,$496.49 ,$275.86 ,$212.24 ,$382.79 ,$275.86 ,$467.69 ,$275.86 ,$467.69 ,$467.69 ,$275.86 ,$467.69 ,$524.13 ,$682.20 ,$568.50 ,$662.23 ,$275.86 ,$667.04 ,$275.86 ,$568.50 ,$568.50 ,$644.30 ,$644.30 ,$275.86 ,$644.30 ,$275.86 ,$591.24 ,$591.24 ,$591.24 ,$682.20 ,$662.23 ,$682.20 ,$275.86 ,$758.00 ,$496.49 ,$275.86 ,$315.33 ,$320.22 ,$305.67 ,$288.74 ,$682.20 ,$597.83 ,$467.69 ,$212.24 ,$682.20 ,$275.86 ,$682.20 ,$682.20 ,$275.86 ,$492.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100264,33016,HC PERICARDIOCENTESIS W/ OR W/O IMAGING,361,1 ,"$4,218.42 ","$2,741.97 ","$1,181.16 ","$4,218.42 ","$3,564.32 ","$3,142.72 ","$2,763.07 ","$1,484.79 ","$1,181.16 ","$2,130.30 ","$1,484.79 ","$2,602.77 ","$1,484.79 ","$2,602.77 ","$2,602.77 ","$1,484.79 ","$2,602.77 ","$2,821.10 ","$3,796.58 ","$3,163.82 ","$3,564.32 ","$1,484.79 ","$3,712.21 ","$1,484.79 ","$3,163.82 ","$3,163.82 ","$3,585.66 ","$3,585.66 ","$1,484.79 ","$3,585.66 ","$1,484.79 ","$3,290.37 ","$3,290.37 ","$3,290.37 ","$3,796.58 ","$3,564.32 ","$3,796.58 ","$1,484.79 ","$4,218.42 ","$2,763.07 ","$1,484.79 ","$1,754.86 ","$2,268.89 ","$2,165.76 ","$1,554.10 ","$3,796.58 ","$3,217.73 ","$2,602.77 ","$1,181.16 ","$3,796.58 ","$1,484.79 ","$3,796.58 ","$3,796.58 ","$1,484.79 ","$2,741.97 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100265,33017,HC PERICARDIAL DRAINAGE =>6 YRS W/O CONGENITAL CARDIAC ANOMALY,361,1 ,$742.00 ,$482.30 ,$207.76 ,$742.00 , N/A ,$552.79 ,$486.01 , N/A ,$207.76 ,$374.71 , N/A ,$457.81 , N/A ,$457.81 ,$457.81 , N/A ,$457.81 , N/A ,$667.80 ,$556.50 , N/A , N/A ,$652.96 , N/A ,$556.50 ,$556.50 ,$630.70 ,$630.70 , N/A ,$630.70 , N/A ,$578.76 ,$578.76 ,$578.76 ,$667.80 , N/A ,$667.80 , N/A ,$742.00 ,$486.01 , N/A ,$308.67 ,$742.00 ,$742.00 , N/A ,$667.80 , N/A ,$457.81 ,$207.76 ,$667.80 , N/A ,$667.80 ,$667.80 , N/A ,$482.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100270,62328,HC LUMBAR PUNCTURE DIAGNOSTIC W/FLUORO OR CT GUID,361,1 ,"$1,932.00 ","$1,255.80 ",$359.10 ,"$1,932.00 ","$1,609.52 ","$1,439.34 ","$1,265.46 ",$670.48 ,$540.96 ,$975.66 ,$670.48 ,"$1,192.04 ",$670.48 ,"$1,192.04 ","$1,192.04 ",$670.48 ,"$1,192.04 ","$1,273.91 ","$1,738.80 ","$1,449.00 ","$1,609.52 ",$670.48 ,"$1,700.16 ",$670.48 ,"$1,449.00 ","$1,449.00 ","$1,642.20 ","$1,642.20 ",$670.48 ,"$1,642.20 ",$670.48 ,"$1,506.96 ","$1,506.96 ","$1,506.96 ","$1,738.80 ","$1,609.52 ","$1,738.80 ",$670.48 ,"$1,932.00 ","$1,265.46 ",$670.48 ,$803.71 ,$376.20 ,$359.10 ,$701.78 ,"$1,738.80 ","$1,453.01 ","$1,192.04 ",$540.96 ,"$1,738.80 ",$670.48 ,"$1,738.80 ","$1,738.80 ",$670.48 ,"$1,255.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100273,64454,HC INJ ANESTHETIC/STEROID GENICULAR NERVES W/FLUORO OR CT GUID,361,1 ,"$1,792.00 ","$1,164.80 ",$305.67 ,"$1,792.00 ","$1,609.52 ","$1,335.04 ","$1,173.76 ",$670.48 ,$501.76 ,$904.96 ,$670.48 ,"$1,105.66 ",$670.48 ,"$1,105.66 ","$1,105.66 ",$670.48 ,"$1,105.66 ","$1,273.91 ","$1,612.80 ","$1,344.00 ","$1,609.52 ",$670.48 ,"$1,576.96 ",$670.48 ,"$1,344.00 ","$1,344.00 ","$1,523.20 ","$1,523.20 ",$670.48 ,"$1,523.20 ",$670.48 ,"$1,397.76 ","$1,397.76 ","$1,397.76 ","$1,612.80 ","$1,609.52 ","$1,612.80 ",$670.48 ,"$1,792.00 ","$1,173.76 ",$670.48 ,$745.47 ,$320.22 ,$305.67 ,$701.78 ,"$1,612.80 ","$1,453.01 ","$1,105.66 ",$501.76 ,"$1,612.80 ",$670.48 ,"$1,612.80 ","$1,612.80 ",$670.48 ,"$1,164.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100274,64624,HC DESTRUST NEUROLYTIC AGENT GENICULAR NERVE W/IMG GUID,361,1 ,"$5,313.00 ","$3,453.45 ",$554.36 ,"$5,313.00 ","$4,450.70 ","$3,958.19 ","$3,480.02 ","$1,854.03 ","$1,487.64 ","$2,683.07 ","$1,854.03 ","$3,278.12 ","$1,854.03 ","$3,278.12 ","$3,278.12 ","$1,854.03 ","$3,278.12 ","$3,522.66 ","$4,781.70 ","$3,984.75 ","$4,450.70 ","$1,854.03 ","$4,675.44 ","$1,854.03 ","$3,984.75 ","$3,984.75 ","$4,516.05 ","$4,516.05 ","$1,854.03 ","$4,516.05 ","$1,854.03 ","$4,144.14 ","$4,144.14 ","$4,144.14 ","$4,781.70 ","$4,450.70 ","$4,781.70 ","$1,854.03 ","$5,313.00 ","$3,480.02 ","$1,854.03 ","$2,210.21 ",$580.76 ,$554.36 ,"$1,940.58 ","$4,781.70 ","$4,017.92 ","$3,278.12 ","$1,487.64 ","$4,781.70 ","$1,854.03 ","$4,781.70 ","$4,781.70 ","$1,854.03 ","$3,453.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100281,32408,HC CORE NDL BX LUNG/MEDIASTINUM PERQ W IMG,361,1 ,"$4,006.00 ","$2,603.90 ",$480.83 ,"$4,006.00 ","$3,566.38 ","$2,984.47 ","$2,623.93 ","$1,485.64 ","$1,121.68 ","$2,023.03 ","$1,485.64 ","$2,471.70 ","$1,485.64 ","$2,471.70 ","$2,471.70 ","$1,485.64 ","$2,471.70 ","$2,822.72 ","$3,605.40 ","$3,004.50 ","$3,566.38 ","$1,485.64 ","$3,525.28 ","$1,485.64 ","$3,004.50 ","$3,004.50 ","$3,405.10 ","$3,405.10 ","$1,485.64 ","$3,405.10 ","$1,485.64 ","$3,124.68 ","$3,124.68 ","$3,124.68 ","$3,605.40 ","$3,566.38 ","$3,605.40 ","$1,485.64 ","$4,006.00 ","$2,623.93 ","$1,485.64 ","$1,666.50 ",$503.72 ,$480.83 ,"$1,555.00 ","$3,605.40 ","$3,219.59 ","$2,471.70 ","$1,121.68 ","$3,605.40 ","$1,485.64 ","$3,605.40 ","$3,605.40 ","$1,485.64 ","$2,603.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),36100284,53060,HC DRAIN OF SKENE GLAND ABS OR CYST,450,1 ,$238.00 ,$154.70 ,$66.64 ,"$4,097.10 ",$238.00 ,$177.31 ,$155.89 ,$238.00 ,$66.64 ,$120.19 ,$238.00 ,$146.85 ,$238.00 ,$146.85 ,$146.85 ,$238.00 ,$146.85 ,"$3,592.06 ",$214.20 ,$178.50 ,$238.00 ,$238.00 ,$209.44 ,$238.00 ,$178.50 ,$178.50 ,$202.30 ,$202.30 ,$238.00 ,$202.30 ,$238.00 ,$185.64 ,$185.64 ,$185.64 ,$214.20 ,$238.00 ,$214.20 ,$238.00 ,$238.00 ,$155.89 ,$238.00 ,$99.01 , N/A , N/A ,$238.00 ,$214.20 ,"$4,097.10 ",$146.85 ,$66.64 ,$214.20 ,$238.00 ,$214.20 ,$214.20 ,$238.00 ,$154.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$389.00 ,$252.85 ,$108.92 ,$484.11 ,$389.00 ,$289.81 ,$254.80 ,$223.39 ,$108.92 ,$196.45 ,$223.39 ,$240.01 ,$223.39 ,$240.01 ,$240.01 ,$223.39 ,$240.01 ,$424.44 ,$350.10 ,$291.75 ,$389.00 ,$223.39 ,$342.32 ,$223.39 ,$291.75 ,$291.75 ,$330.65 ,$330.65 ,$223.39 ,$330.65 ,$223.39 ,$303.42 ,$303.42 ,$303.42 ,$350.10 ,$389.00 ,$350.10 ,$223.39 ,$389.00 ,$254.80 ,$223.39 ,$161.82 ,$389.00 ,$389.00 ,$233.81 ,$350.10 ,$484.11 ,$240.01 ,$108.92 ,$350.10 ,$223.39 ,$350.10 ,$350.10 ,$223.39 ,$252.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000014,64448,HC FEMORAL NERVE BLOCK CONTINUOUS,370,1 ,"$3,372.00 ","$2,191.80 ",$458.49 ,"$3,372.00 ","$3,129.83 ","$2,512.14 ","$2,208.66 ","$1,303.79 ",$944.16 ,"$1,702.86 ","$1,303.79 ","$2,080.52 ","$1,303.79 ","$2,080.52 ","$2,080.52 ","$1,303.79 ","$2,080.52 ","$2,477.20 ","$3,034.80 ","$2,529.00 ","$3,129.83 ","$1,303.79 ","$2,967.36 ","$1,303.79 ","$2,529.00 ","$2,529.00 ","$2,866.20 ","$2,866.20 ","$1,303.79 ","$2,866.20 ","$1,303.79 ","$2,630.16 ","$2,630.16 ","$2,630.16 ","$3,034.80 ","$3,129.83 ","$3,034.80 ","$1,303.79 ","$3,372.00 ","$2,208.66 ","$1,303.79 ","$1,402.75 ",$480.33 ,$458.49 ,"$1,364.66 ","$3,034.80 ","$2,825.49 ","$2,080.52 ",$944.16 ,"$3,034.80 ","$1,303.79 ","$3,034.80 ","$3,034.80 ","$1,303.79 ","$2,191.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000014,64448,HC FEMORAL NERVE BLOCK CONTINUOUS,370,1 ,"$2,248.00 ","$1,461.20 ",$305.67 ,"$2,248.00 ","$2,086.56 ","$1,674.76 ","$1,472.44 ",$869.20 ,$629.44 ,"$1,135.24 ",$869.20 ,"$1,387.02 ",$869.20 ,"$1,387.02 ","$1,387.02 ",$869.20 ,"$1,387.02 ","$1,651.48 ","$2,023.20 ","$1,686.00 ","$2,086.56 ",$869.20 ,"$1,978.24 ",$869.20 ,"$1,686.00 ","$1,686.00 ","$1,910.80 ","$1,910.80 ",$869.20 ,"$1,910.80 ",$869.20 ,"$1,753.44 ","$1,753.44 ","$1,753.44 ","$2,023.20 ","$2,086.56 ","$2,023.20 ",$869.20 ,"$2,248.00 ","$1,472.44 ",$869.20 ,$935.17 ,$320.22 ,$305.67 ,$909.77 ,"$2,023.20 ","$1,883.66 ","$1,387.02 ",$629.44 ,"$2,023.20 ",$869.20 ,"$2,023.20 ","$2,023.20 ",$869.20 ,"$1,461.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000017,99153,HC MODERATE SEDATION SAME PHY EA ADDL 15MIN,370,1 ,$497.00 ,$323.05 ,$16.39 ,$497.00 , N/A ,$370.27 ,$325.54 , N/A ,$139.16 ,$250.99 , N/A ,$306.65 , N/A ,$306.65 ,$306.65 , N/A ,$306.65 , N/A ,$447.30 ,$372.75 , N/A , N/A ,$437.36 , N/A ,$372.75 ,$372.75 ,$422.45 ,$422.45 , N/A ,$422.45 , N/A ,$387.66 ,$387.66 ,$387.66 ,$447.30 , N/A ,$447.30 , N/A ,$497.00 ,$325.54 , N/A ,$206.75 ,$17.17 ,$16.39 , N/A ,$447.30 , N/A ,$306.65 ,$139.16 ,$447.30 , N/A ,$447.30 ,$447.30 , N/A ,$323.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000023,64416,HC INTRASCALENE BLOCK CONTINUOUS,370,1 ,"$3,634.00 ","$2,362.10 ",$305.67 ,"$3,634.00 ","$2,086.56 ","$2,707.33 ","$2,380.27 ",$869.20 ,"$1,017.52 ","$1,835.17 ",$869.20 ,"$2,242.18 ",$869.20 ,"$2,242.18 ","$2,242.18 ",$869.20 ,"$2,242.18 ","$1,651.48 ","$3,270.60 ","$2,725.50 ","$2,086.56 ",$869.20 ,"$3,197.92 ",$869.20 ,"$2,725.50 ","$2,725.50 ","$3,088.90 ","$3,088.90 ",$869.20 ,"$3,088.90 ",$869.20 ,"$2,834.52 ","$2,834.52 ","$2,834.52 ","$3,270.60 ","$2,086.56 ","$3,270.60 ",$869.20 ,"$3,634.00 ","$2,380.27 ",$869.20 ,"$1,511.74 ",$320.22 ,$305.67 ,$909.77 ,"$3,270.60 ","$1,883.66 ","$2,242.18 ","$1,017.52 ","$3,270.60 ",$869.20 ,"$3,270.60 ","$3,270.60 ",$869.20 ,"$2,362.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000061,N/A,HC ANESTHESIA GENERAL INITIAL 15MIN,370,1 ,$597.00 ,$388.05 ,$167.16 ,$597.00 , N/A ,$444.77 ,$391.04 , N/A ,$167.16 ,$301.49 , N/A ,$368.35 , N/A ,$368.35 ,$368.35 , N/A ,$368.35 , N/A ,$537.30 ,$447.75 , N/A , N/A ,$525.36 , N/A ,$447.75 ,$447.75 ,$507.45 ,$507.45 , N/A ,$507.45 , N/A ,$465.66 ,$465.66 ,$465.66 ,$537.30 , N/A ,$537.30 , N/A ,$597.00 ,$391.04 , N/A ,$248.35 , N/A , N/A , N/A ,$537.30 , N/A ,$368.35 ,$167.16 ,$537.30 , N/A ,$537.30 ,$537.30 , N/A ,$388.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$405.00 ,$263.25 ,$113.40 ,$405.00 , N/A ,$301.73 ,$265.28 , N/A ,$113.40 ,$204.53 , N/A ,$249.89 , N/A ,$249.89 ,$249.89 , N/A ,$249.89 , N/A ,$364.50 ,$303.75 , N/A , N/A ,$356.40 , N/A ,$303.75 ,$303.75 ,$344.25 ,$344.25 , N/A ,$344.25 , N/A ,$315.90 ,$315.90 ,$315.90 ,$364.50 , N/A ,$364.50 , N/A ,$405.00 ,$265.28 , N/A ,$168.48 , N/A , N/A , N/A ,$364.50 , N/A ,$249.89 ,$113.40 ,$364.50 , N/A ,$364.50 ,$364.50 , N/A ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000063,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 15MIN,370,1 ,$527.00 ,$342.55 ,$147.56 ,$527.00 , N/A ,$392.62 ,$345.19 , N/A ,$147.56 ,$266.14 , N/A ,$325.16 , N/A ,$325.16 ,$325.16 , N/A ,$325.16 , N/A ,$474.30 ,$395.25 , N/A , N/A ,$463.76 , N/A ,$395.25 ,$395.25 ,$447.95 ,$447.95 , N/A ,$447.95 , N/A ,$411.06 ,$411.06 ,$411.06 ,$474.30 , N/A ,$474.30 , N/A ,$527.00 ,$345.19 , N/A ,$219.23 , N/A , N/A , N/A ,$474.30 , N/A ,$325.16 ,$147.56 ,$474.30 , N/A ,$474.30 ,$474.30 , N/A ,$342.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$289.00 ,$187.85 ,$80.92 ,$289.00 , N/A ,$215.31 ,$189.30 , N/A ,$80.92 ,$145.95 , N/A ,$178.31 , N/A ,$178.31 ,$178.31 , N/A ,$178.31 , N/A ,$260.10 ,$216.75 , N/A , N/A ,$254.32 , N/A ,$216.75 ,$216.75 ,$245.65 ,$245.65 , N/A ,$245.65 , N/A ,$225.42 ,$225.42 ,$225.42 ,$260.10 , N/A ,$260.10 , N/A ,$289.00 ,$189.30 , N/A ,$120.22 , N/A , N/A , N/A ,$260.10 , N/A ,$178.31 ,$80.92 ,$260.10 , N/A ,$260.10 ,$260.10 , N/A ,$187.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000072,99151,HC MODERATE SEDATION SAME PHY <5YR 1ST 15MIN,370,1 ,$879.00 ,$571.35 ,$16.39 ,$879.00 , N/A ,$654.86 ,$575.75 , N/A ,$246.12 ,$443.90 , N/A ,$542.34 , N/A ,$542.34 ,$542.34 , N/A ,$542.34 , N/A ,$791.10 ,$659.25 , N/A , N/A ,$773.52 , N/A ,$659.25 ,$659.25 ,$747.15 ,$747.15 , N/A ,$747.15 , N/A ,$685.62 ,$685.62 ,$685.62 ,$791.10 , N/A ,$791.10 , N/A ,$879.00 ,$575.75 , N/A ,$365.66 ,$17.17 ,$16.39 , N/A ,$791.10 , N/A ,$542.34 ,$246.12 ,$791.10 , N/A ,$791.10 ,$791.10 , N/A ,$571.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000073,99152,HC MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,$993.00 ,$645.45 ,$16.39 ,$993.00 , N/A ,$739.79 ,$650.42 , N/A ,$278.04 ,$501.47 , N/A ,$612.68 , N/A ,$612.68 ,$612.68 , N/A ,$612.68 , N/A ,$893.70 ,$744.75 , N/A , N/A ,$873.84 , N/A ,$744.75 ,$744.75 ,$844.05 ,$844.05 , N/A ,$844.05 , N/A ,$774.54 ,$774.54 ,$774.54 ,$893.70 , N/A ,$893.70 , N/A ,$993.00 ,$650.42 , N/A ,$413.09 ,$17.17 ,$16.39 , N/A ,$893.70 , N/A ,$612.68 ,$278.04 ,$893.70 , N/A ,$893.70 ,$893.70 , N/A ,$645.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000074,99155,HC MODERATE SEDATION DIFF PHY <5YR 1ST 15MIN,370,1 ,$907.00 ,$589.55 ,$16.39 ,$907.00 , N/A ,$675.72 ,$594.09 , N/A ,$253.96 ,$458.04 , N/A ,$559.62 , N/A ,$559.62 ,$559.62 , N/A ,$559.62 , N/A ,$816.30 ,$680.25 , N/A , N/A ,$798.16 , N/A ,$680.25 ,$680.25 ,$770.95 ,$770.95 , N/A ,$770.95 , N/A ,$707.46 ,$707.46 ,$707.46 ,$816.30 , N/A ,$816.30 , N/A ,$907.00 ,$594.09 , N/A ,$377.31 ,$17.17 ,$16.39 , N/A ,$816.30 , N/A ,$559.62 ,$253.96 ,$816.30 , N/A ,$816.30 ,$816.30 , N/A ,$589.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000076,N/A,HC MONITORED ANESTHESIA INITIAL 15 MINS,370,1 ,$457.00 ,$297.05 ,$127.96 ,$457.00 , N/A ,$340.47 ,$299.34 , N/A ,$127.96 ,$230.79 , N/A ,$281.97 , N/A ,$281.97 ,$281.97 , N/A ,$281.97 , N/A ,$411.30 ,$342.75 , N/A , N/A ,$402.16 , N/A ,$342.75 ,$342.75 ,$388.45 ,$388.45 , N/A ,$388.45 , N/A ,$356.46 ,$356.46 ,$356.46 ,$411.30 , N/A ,$411.30 , N/A ,$457.00 ,$299.34 , N/A ,$190.11 , N/A , N/A , N/A ,$411.30 , N/A ,$281.97 ,$127.96 ,$411.30 , N/A ,$411.30 ,$411.30 , N/A ,$297.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37000077,N/A,HC MONITORED ANESTHESIA ADDL 15 MINS,370,1 ,$252.00 ,$163.80 ,$70.56 ,$252.00 , N/A ,$187.74 ,$165.06 , N/A ,$70.56 ,$127.26 , N/A ,$155.48 , N/A ,$155.48 ,$155.48 , N/A ,$155.48 , N/A ,$226.80 ,$189.00 , N/A , N/A ,$221.76 , N/A ,$189.00 ,$189.00 ,$214.20 ,$214.20 , N/A ,$214.20 , N/A ,$196.56 ,$196.56 ,$196.56 ,$226.80 , N/A ,$226.80 , N/A ,$252.00 ,$165.06 , N/A ,$104.83 , N/A , N/A , N/A ,$226.80 , N/A ,$155.48 ,$70.56 ,$226.80 , N/A ,$226.80 ,$226.80 , N/A ,$163.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37001000,1967,HC EPIDURAL/SPINAL FOR LABOR,370,1 ,$827.10 ,$537.62 ,$231.59 ,$827.10 , N/A ,$616.19 ,$541.75 , N/A ,$231.59 ,$417.69 , N/A ,$510.32 , N/A ,$510.32 ,$510.32 , N/A ,$510.32 , N/A ,$744.39 ,$620.33 , N/A , N/A ,$727.85 , N/A ,$620.33 ,$620.33 ,$703.04 ,$703.04 , N/A ,$703.04 , N/A ,$645.14 ,$645.14 ,$645.14 ,$744.39 , N/A ,$744.39 , N/A ,$827.10 ,$541.75 , N/A ,$344.07 , N/A , N/A , N/A ,$744.39 , N/A ,$510.32 ,$231.59 ,$744.39 , N/A ,$744.39 ,$744.39 , N/A ,$537.62 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37080000,64447,HC FEMORAL NERVE BLOCK SINGLE,360,1 ,"$1,818.00 ","$1,181.70 ",$305.67 ,"$1,818.00 ","$1,609.52 ","$1,354.41 ","$1,190.79 ",$670.48 ,$509.04 ,$918.09 ,$670.48 ,"$1,121.71 ",$670.48 ,"$1,121.71 ","$1,121.71 ",$670.48 ,"$1,121.71 ","$1,273.91 ","$1,636.20 ","$1,363.50 ","$1,609.52 ",$670.48 ,"$1,599.84 ",$670.48 ,"$1,363.50 ","$1,363.50 ","$1,545.30 ","$1,545.30 ",$670.48 ,"$1,545.30 ",$670.48 ,"$1,418.04 ","$1,418.04 ","$1,418.04 ","$1,636.20 ","$1,609.52 ","$1,636.20 ",$670.48 ,"$1,818.00 ","$1,190.79 ",$670.48 ,$756.29 ,$320.22 ,$305.67 ,$701.78 ,"$1,636.20 ","$1,453.01 ","$1,121.71 ",$509.04 ,"$1,636.20 ",$670.48 ,"$1,636.20 ","$1,636.20 ",$670.48 ,"$1,181.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),37080001,64415,HC INTRASCALENE BLOCK SINGLE,360,1 ,"$3,634.00 ","$2,362.10 ",$305.67 ,"$3,634.00 ","$2,086.56 ","$2,707.33 ","$2,380.27 ",$869.20 ,"$1,017.52 ","$1,835.17 ",$869.20 ,"$2,242.18 ",$869.20 ,"$2,242.18 ","$2,242.18 ",$869.20 ,"$2,242.18 ","$1,651.48 ","$3,270.60 ","$2,725.50 ","$2,086.56 ",$869.20 ,"$3,197.92 ",$869.20 ,"$2,725.50 ","$2,725.50 ","$3,088.90 ","$3,088.90 ",$869.20 ,"$3,088.90 ",$869.20 ,"$2,834.52 ","$2,834.52 ","$2,834.52 ","$3,270.60 ","$2,086.56 ","$3,270.60 ",$869.20 ,"$3,634.00 ","$2,380.27 ",$869.20 ,"$1,511.74 ",$320.22 ,$305.67 ,$909.77 ,"$3,270.60 ","$1,883.66 ","$2,242.18 ","$1,017.52 ","$3,270.60 ",$869.20 ,"$3,270.60 ","$3,270.60 ",$869.20 ,"$2,362.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000149,P9021,HC RED CELLS PACKED EA,390,1 ,$467.00 ,$303.55 ,$130.76 ,$467.00 ,$361.30 ,$347.92 ,$305.89 ,$150.51 ,$130.76 ,$235.84 ,$150.51 ,$288.14 ,$150.51 ,$288.14 ,$288.14 ,$150.51 ,$288.14 ,$285.97 ,$420.30 ,$350.25 ,$361.30 ,$150.51 ,$410.96 ,$150.51 ,$350.25 ,$350.25 ,$396.95 ,$396.95 ,$150.51 ,$396.95 ,$150.51 ,$364.26 ,$364.26 ,$364.26 ,$420.30 ,$361.30 ,$420.30 ,$150.51 ,$467.00 ,$305.89 ,$150.51 ,$194.27 ,$467.00 ,$461.38 ,$157.53 ,$420.30 ,$326.17 ,$288.14 ,$130.76 ,$420.30 ,$150.51 ,$420.30 ,$420.30 ,$150.51 ,$303.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000151,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,"$1,248.00 ",$811.20 ,$163.94 ,"$1,248.00 ",$393.54 ,$929.76 ,$817.44 ,$163.94 ,$349.44 ,$630.24 ,$163.94 ,$770.02 ,$163.94 ,$770.02 ,$770.02 ,$163.94 ,$770.02 ,$311.49 ,"$1,123.20 ",$936.00 ,$393.54 ,$163.94 ,"$1,098.24 ",$163.94 ,$936.00 ,$936.00 ,"$1,060.80 ","$1,060.80 ",$163.94 ,"$1,060.80 ",$163.94 ,$973.44 ,$973.44 ,$973.44 ,"$1,123.20 ",$393.54 ,"$1,123.20 ",$163.94 ,"$1,248.00 ",$817.44 ,$163.94 ,$519.17 ,$483.35 ,$461.38 ,$171.59 ,"$1,123.20 ",$355.28 ,$770.02 ,$349.44 ,"$1,123.20 ",$163.94 ,"$1,123.20 ","$1,123.20 ",$163.94 ,$811.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,"$1,248.00 ",$811.20 ,$233.11 ,"$1,248.00 ",$559.60 ,$929.76 ,$817.44 ,$233.11 ,$349.44 ,$630.24 ,$233.11 ,$770.02 ,$233.11 ,$770.02 ,$770.02 ,$233.11 ,$770.02 ,$442.91 ,"$1,123.20 ",$936.00 ,$559.60 ,$233.11 ,"$1,098.24 ",$233.11 ,$936.00 ,$936.00 ,"$1,060.80 ","$1,060.80 ",$233.11 ,"$1,060.80 ",$233.11 ,$973.44 ,$973.44 ,$973.44 ,"$1,123.20 ",$559.60 ,"$1,123.20 ",$233.11 ,"$1,248.00 ",$817.44 ,$233.11 ,$519.17 ,$483.35 ,$461.38 ,$244.00 ,"$1,123.20 ",$505.19 ,$770.02 ,$349.44 ,"$1,123.20 ",$233.11 ,"$1,123.20 ","$1,123.20 ",$233.11 ,$811.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000157,P9052,HC PLT APHER/PHER L/R HLA EA,390,1 ,"$1,710.00 ","$1,111.50 ",$461.38 ,"$1,908.12 ","$1,710.00 ","$1,273.95 ","$1,120.05 ",$880.48 ,$478.80 ,$863.55 ,$880.48 ,"$1,055.07 ",$880.48 ,"$1,055.07 ","$1,055.07 ",$880.48 ,"$1,055.07 ","$1,672.91 ","$1,539.00 ","$1,282.50 ","$1,710.00 ",$880.48 ,"$1,504.80 ",$880.48 ,"$1,282.50 ","$1,282.50 ","$1,453.50 ","$1,453.50 ",$880.48 ,"$1,453.50 ",$880.48 ,"$1,333.80 ","$1,333.80 ","$1,333.80 ","$1,539.00 ","$1,710.00 ","$1,539.00 ",$880.48 ,"$1,710.00 ","$1,120.05 ",$880.48 ,$711.36 ,$483.35 ,$461.38 ,$921.59 ,"$1,539.00 ","$1,908.12 ","$1,055.07 ",$478.80 ,"$1,539.00 ",$880.48 ,"$1,539.00 ","$1,539.00 ",$880.48 ,"$1,111.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$259.00 ,$168.35 ,$72.52 ,$259.00 ,$186.76 ,$192.96 ,$169.65 ,$77.80 ,$72.52 ,$130.80 ,$77.80 ,$159.80 ,$77.80 ,$159.80 ,$159.80 ,$77.80 ,$159.80 ,$147.82 ,$233.10 ,$194.25 ,$186.76 ,$77.80 ,$227.92 ,$77.80 ,$194.25 ,$194.25 ,$220.15 ,$220.15 ,$77.80 ,$220.15 ,$77.80 ,$202.02 ,$202.02 ,$202.02 ,$233.10 ,$186.76 ,$233.10 ,$77.80 ,$259.00 ,$169.65 ,$77.80 ,$107.74 ,$259.00 ,$259.00 ,$81.43 ,$233.10 ,$168.60 ,$159.80 ,$72.52 ,$233.10 ,$77.80 ,$233.10 ,$233.10 ,$77.80 ,$168.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000162,P9012,HC CRYOPRECIPITATE EA UNIT T1,390,1 ,$148.00 ,$96.20 ,$41.44 ,$189.23 ,$148.00 ,$110.26 ,$96.94 ,$87.32 ,$41.44 ,$74.74 ,$87.32 ,$91.32 ,$87.32 ,$91.32 ,$91.32 ,$87.32 ,$91.32 ,$165.91 ,$133.20 ,$111.00 ,$148.00 ,$87.32 ,$130.24 ,$87.32 ,$111.00 ,$111.00 ,$125.80 ,$125.80 ,$87.32 ,$125.80 ,$87.32 ,$115.44 ,$115.44 ,$115.44 ,$133.20 ,$148.00 ,$133.20 ,$87.32 ,$148.00 ,$96.94 ,$87.32 ,$61.57 ,$148.00 ,$148.00 ,$91.40 ,$133.20 ,$189.23 ,$91.32 ,$41.44 ,$133.20 ,$87.32 ,$133.20 ,$133.20 ,$87.32 ,$96.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,$439.00 ,$285.35 ,$122.92 ,$446.54 ,$439.00 ,$327.06 ,$287.55 ,$206.05 ,$122.92 ,$221.70 ,$206.05 ,$270.86 ,$206.05 ,$270.86 ,$270.86 ,$206.05 ,$270.86 ,$391.50 ,$395.10 ,$329.25 ,$439.00 ,$206.05 ,$386.32 ,$206.05 ,$329.25 ,$329.25 ,$373.15 ,$373.15 ,$206.05 ,$373.15 ,$206.05 ,$342.42 ,$342.42 ,$342.42 ,$395.10 ,$439.00 ,$395.10 ,$206.05 ,$439.00 ,$287.55 ,$206.05 ,$182.62 ,$439.00 ,$439.00 ,$215.67 ,$395.10 ,$446.54 ,$270.86 ,$122.92 ,$395.10 ,$206.05 ,$395.10 ,$395.10 ,$206.05 ,$285.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,"$1,338.00 ",$869.70 ,$374.64 ,"$1,338.00 ","$1,277.56 ",$996.81 ,$876.39 ,$532.19 ,$374.64 ,$675.69 ,$532.19 ,$825.55 ,$532.19 ,$825.55 ,$825.55 ,$532.19 ,$825.55 ,"$1,011.16 ","$1,204.20 ","$1,003.50 ","$1,277.56 ",$532.19 ,"$1,177.44 ",$532.19 ,"$1,003.50 ","$1,003.50 ","$1,137.30 ","$1,137.30 ",$532.19 ,"$1,137.30 ",$532.19 ,"$1,043.64 ","$1,043.64 ","$1,043.64 ","$1,204.20 ","$1,277.56 ","$1,204.20 ",$532.19 ,"$1,338.00 ",$876.39 ,$532.19 ,$556.61 ,$483.35 ,$461.38 ,$557.04 ,"$1,204.20 ","$1,153.33 ",$825.55 ,$374.64 ,"$1,204.20 ",$532.19 ,"$1,204.20 ","$1,204.20 ",$532.19 ,$869.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000179,P9037,HC PLATELETS PHER L/R IRR EA T1,390,1 ,"$1,248.00 ",$811.20 ,$349.44 ,"$1,462.97 ","$1,248.00 ",$929.76 ,$817.44 ,$675.07 ,$349.44 ,$630.24 ,$675.07 ,$770.02 ,$675.07 ,$770.02 ,$770.02 ,$675.07 ,$770.02 ,"$1,282.63 ","$1,123.20 ",$936.00 ,"$1,248.00 ",$675.07 ,"$1,098.24 ",$675.07 ,$936.00 ,$936.00 ,"$1,060.80 ","$1,060.80 ",$675.07 ,"$1,060.80 ",$675.07 ,$973.44 ,$973.44 ,$973.44 ,"$1,123.20 ","$1,248.00 ","$1,123.20 ",$675.07 ,"$1,248.00 ",$817.44 ,$675.07 ,$519.17 ,$483.35 ,$461.38 ,$706.59 ,"$1,123.20 ","$1,462.97 ",$770.02 ,$349.44 ,"$1,123.20 ",$675.07 ,"$1,123.20 ","$1,123.20 ",$675.07 ,$811.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,$587.00 ,$381.55 ,$164.36 ,$617.46 ,$587.00 ,$437.32 ,$384.49 ,$284.92 ,$164.36 ,$296.44 ,$284.92 ,$362.18 ,$284.92 ,$362.18 ,$362.18 ,$284.92 ,$362.18 ,$541.35 ,$528.30 ,$440.25 ,$587.00 ,$284.92 ,$516.56 ,$284.92 ,$440.25 ,$440.25 ,$498.95 ,$498.95 ,$284.92 ,$498.95 ,$284.92 ,$457.86 ,$457.86 ,$457.86 ,$528.30 ,$587.00 ,$528.30 ,$284.92 ,$587.00 ,$384.49 ,$284.92 ,$244.19 ,$483.35 ,$461.38 ,$298.22 ,$528.30 ,$617.46 ,$362.18 ,$164.36 ,$528.30 ,$284.92 ,$528.30 ,$528.30 ,$284.92 ,$381.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39000205,P9073,HC PLATELETS PHERESIS PATH REDUCED EA UN T1,390,1 ,"$1,138.00 ",$739.70 ,$318.64 ,"$1,383.62 ","$1,138.00 ",$847.81 ,$745.39 ,$638.46 ,$318.64 ,$574.69 ,$638.46 ,$702.15 ,$638.46 ,$702.15 ,$702.15 ,$638.46 ,$702.15 ,"$1,213.07 ","$1,024.20 ",$853.50 ,"$1,138.00 ",$638.46 ,"$1,001.44 ",$638.46 ,$853.50 ,$853.50 ,$967.30 ,$967.30 ,$638.46 ,$967.30 ,$638.46 ,$887.64 ,$887.64 ,$887.64 ,"$1,024.20 ","$1,138.00 ","$1,024.20 ",$638.46 ,"$1,138.00 ",$745.39 ,$638.46 ,$473.41 ,$483.35 ,$461.38 ,$668.26 ,"$1,024.20 ","$1,383.62 ",$702.15 ,$318.64 ,"$1,024.20 ",$638.46 ,"$1,024.20 ","$1,024.20 ",$638.46 ,$739.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),39100001,36430,HC BLOOD PROD ADMIN,391,1 ,$959.00 ,$623.35 ,$268.52 ,$959.00 ,$959.00 ,$714.46 ,$628.15 ,$419.09 ,$268.52 ,$484.30 ,$419.09 ,$591.70 ,$419.09 ,$591.70 ,$591.70 ,$419.09 ,$591.70 ,$796.27 ,$863.10 ,$719.25 ,$959.00 ,$419.09 ,$843.92 ,$419.09 ,$719.25 ,$719.25 ,$815.15 ,$815.15 ,$419.09 ,$815.15 ,$419.09 ,$748.02 ,$748.02 ,$748.02 ,$863.10 ,$959.00 ,$863.10 ,$419.09 ,$959.00 ,$628.15 ,$419.09 ,$398.94 ,$483.35 ,$461.38 ,$438.66 ,$863.10 ,$908.23 ,$591.70 ,$268.52 ,$863.10 ,$419.09 ,$863.10 ,$863.10 ,$419.09 ,$623.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$554.00 ,$360.10 ,$48.02 ,$554.00 ,$263.78 ,$412.73 ,$362.87 ,$105.51 ,$155.12 ,$279.77 ,$105.51 ,$341.82 ,$105.51 ,$341.82 ,$341.82 ,$105.51 ,$341.82 ,$200.47 ,$498.60 ,$415.50 ,$263.78 ,$105.51 ,$487.52 ,$105.51 ,$415.50 ,$415.50 ,$470.90 ,$470.90 ,$105.51 ,$470.90 ,$105.51 ,$432.12 ,$432.12 ,$432.12 ,$498.60 ,$263.78 ,$498.60 ,$105.51 ,$122.32 ,$362.87 ,$105.51 ,$230.46 ,$50.30 ,$48.02 ,$110.79 ,$498.60 ,$237.40 ,$341.82 ,$155.12 ,$498.60 ,$105.51 ,$498.60 ,$498.60 ,$105.51 ,$360.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$554.00 ,$360.10 ,$48.02 ,$554.00 ,$263.78 ,$412.73 ,$362.87 ,$105.51 ,$155.12 ,$279.77 ,$105.51 ,$341.82 ,$105.51 ,$341.82 ,$341.82 ,$105.51 ,$341.82 ,$200.47 ,$498.60 ,$415.50 ,$263.78 ,$105.51 ,$487.52 ,$105.51 ,$415.50 ,$415.50 ,$470.90 ,$470.90 ,$105.51 ,$470.90 ,$105.51 ,$432.12 ,$432.12 ,$432.12 ,$498.60 ,$263.78 ,$498.60 ,$105.51 ,$122.32 ,$362.87 ,$105.51 ,$230.46 ,$50.30 ,$48.02 ,$110.79 ,$498.60 ,$237.40 ,$341.82 ,$155.12 ,$498.60 ,$105.51 ,$498.60 ,$498.60 ,$105.51 ,$360.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$459.00 ,$298.35 ,$48.02 ,$459.00 ,$206.95 ,$341.96 ,$300.65 ,$82.78 ,$128.52 ,$231.80 ,$82.78 ,$283.20 ,$82.78 ,$283.20 ,$283.20 ,$82.78 ,$283.20 ,$157.28 ,$413.10 ,$344.25 ,$206.95 ,$82.78 ,$403.92 ,$82.78 ,$344.25 ,$344.25 ,$390.15 ,$390.15 ,$82.78 ,$390.15 ,$82.78 ,$358.02 ,$358.02 ,$358.02 ,$413.10 ,$206.95 ,$413.10 ,$82.78 ,$95.73 ,$300.65 ,$82.78 ,$190.94 ,$50.30 ,$48.02 ,$86.92 ,$413.10 ,$186.26 ,$283.20 ,$128.52 ,$413.10 ,$82.78 ,$413.10 ,$413.10 ,$82.78 ,$298.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD  ADDNT VIEW,401,1 ,$459.00 ,$298.35 ,$48.02 ,$459.00 ,$206.95 ,$341.96 ,$300.65 ,$82.78 ,$128.52 ,$231.80 ,$82.78 ,$283.20 ,$82.78 ,$283.20 ,$283.20 ,$82.78 ,$283.20 ,$157.28 ,$413.10 ,$344.25 ,$206.95 ,$82.78 ,$403.92 ,$82.78 ,$344.25 ,$344.25 ,$390.15 ,$390.15 ,$82.78 ,$390.15 ,$82.78 ,$358.02 ,$358.02 ,$358.02 ,$413.10 ,$206.95 ,$413.10 ,$82.78 ,$95.73 ,$300.65 ,$82.78 ,$190.94 ,$50.30 ,$48.02 ,$86.92 ,$413.10 ,$186.26 ,$283.20 ,$128.52 ,$413.10 ,$82.78 ,$413.10 ,$413.10 ,$82.78 ,$298.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$459.00 ,$298.35 ,$48.02 ,$459.00 ,$206.95 ,$341.96 ,$300.65 ,$82.78 ,$128.52 ,$231.80 ,$82.78 ,$283.20 ,$82.78 ,$283.20 ,$283.20 ,$82.78 ,$283.20 ,$157.28 ,$413.10 ,$344.25 ,$206.95 ,$82.78 ,$403.92 ,$82.78 ,$344.25 ,$344.25 ,$390.15 ,$390.15 ,$82.78 ,$390.15 ,$82.78 ,$358.02 ,$358.02 ,$358.02 ,$413.10 ,$206.95 ,$413.10 ,$82.78 ,$95.73 ,$300.65 ,$82.78 ,$190.94 ,$50.30 ,$48.02 ,$86.92 ,$413.10 ,$186.26 ,$283.20 ,$128.52 ,$413.10 ,$82.78 ,$413.10 ,$413.10 ,$82.78 ,$298.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$167.00 ,$108.55 ,$22.09 ,$167.00 ,$55.23 ,$124.42 ,$109.39 ,$22.09 ,$46.76 ,$84.34 ,$22.09 ,$103.04 ,$22.09 ,$103.04 ,$103.04 ,$22.09 ,$103.04 ,$41.97 ,$150.30 ,$125.25 ,$55.23 ,$22.09 ,$146.96 ,$22.09 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$22.09 ,$141.95 ,$22.09 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$55.23 ,$150.30 ,$22.09 ,$26.59 ,$109.39 ,$22.09 ,$69.47 ,$50.30 ,$48.02 ,$23.19 ,$150.30 ,$49.70 ,$103.04 ,$46.76 ,$150.30 ,$22.09 ,$150.30 ,$150.30 ,$22.09 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200004,21920,HC BX SOFT TISSUE BACK/FLANK SUP,402,1 ,"$4,221.00 ","$2,743.65 ",$447.91 ,"$4,221.00 ","$3,566.38 ","$3,144.65 ","$2,764.76 ","$1,485.64 ","$1,181.88 ","$2,131.61 ","$1,485.64 ","$2,604.36 ","$1,485.64 ","$2,604.36 ","$2,604.36 ","$1,485.64 ","$2,604.36 ","$2,822.72 ","$3,798.90 ","$3,165.75 ","$3,566.38 ","$1,485.64 ","$3,714.48 ","$1,485.64 ","$3,165.75 ","$3,165.75 ","$3,587.85 ","$3,587.85 ","$1,485.64 ","$3,587.85 ","$1,485.64 ","$3,292.38 ","$3,292.38 ","$3,292.38 ","$3,798.90 ","$3,566.38 ","$3,798.90 ","$1,485.64 ","$4,221.00 ","$2,764.76 ","$1,485.64 ","$1,755.94 ",$469.24 ,$447.91 ,"$1,555.00 ","$3,798.90 ","$3,219.59 ","$2,604.36 ","$1,181.88 ","$3,798.90 ","$1,485.64 ","$3,798.90 ","$3,798.90 ","$1,485.64 ","$2,743.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200007,51798,HC US BLADDER SCAN,402,1 ,$170.00 ,$110.50 ,$47.60 ,$170.00 ,$141.09 ,$126.65 ,$111.35 ,$58.77 ,$47.60 ,$85.85 ,$58.77 ,$104.89 ,$58.77 ,$104.89 ,$104.89 ,$58.77 ,$104.89 ,$111.66 ,$153.00 ,$127.50 ,$141.09 ,$58.77 ,$149.60 ,$58.77 ,$127.50 ,$127.50 ,$144.50 ,$144.50 ,$58.77 ,$144.50 ,$58.77 ,$132.60 ,$132.60 ,$132.60 ,$153.00 ,$141.09 ,$153.00 ,$58.77 ,$170.00 ,$111.35 ,$58.77 ,$70.72 ,$86.96 ,$83.00 ,$61.52 ,$153.00 ,$127.37 ,$104.89 ,$47.60 ,$153.00 ,$58.77 ,$153.00 ,$153.00 ,$58.77 ,$110.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200009,49407,HC DRAIN ABSC PELVIC TRNSVAG PERC,402,1 ,"$4,221.00 ","$2,743.65 ",$480.83 ,"$4,221.00 ","$3,566.38 ","$3,144.65 ","$2,764.76 ","$1,485.64 ","$1,181.88 ","$2,131.61 ","$1,485.64 ","$2,604.36 ","$1,485.64 ","$2,604.36 ","$2,604.36 ","$1,485.64 ","$2,604.36 ","$2,822.72 ","$3,798.90 ","$3,165.75 ","$3,566.38 ","$1,485.64 ","$3,714.48 ","$1,485.64 ","$3,165.75 ","$3,165.75 ","$3,587.85 ","$3,587.85 ","$1,485.64 ","$3,587.85 ","$1,485.64 ","$3,292.38 ","$3,292.38 ","$3,292.38 ","$3,798.90 ","$3,566.38 ","$3,798.90 ","$1,485.64 ","$4,221.00 ","$2,764.76 ","$1,485.64 ","$1,755.94 ",$503.72 ,$480.83 ,"$1,555.00 ","$3,798.90 ","$3,219.59 ","$2,604.36 ","$1,181.88 ","$3,798.90 ","$1,485.64 ","$3,798.90 ","$3,798.90 ","$1,485.64 ","$2,743.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200010,59000,HC AMNIOCENTESIS DIAGNOSTIC,402,1 ,$526.00 ,$341.90 ,$147.28 ,"$1,450.66 ",$526.00 ,$391.87 ,$344.53 ,$526.00 ,$147.28 ,$265.63 ,$526.00 ,$324.54 ,$526.00 ,$324.54 ,$324.54 ,$526.00 ,$324.54 ,"$1,271.84 ",$473.40 ,$394.50 ,$526.00 ,$526.00 ,$462.88 ,$526.00 ,$394.50 ,$394.50 ,$447.10 ,$447.10 ,$526.00 ,$447.10 ,$526.00 ,$410.28 ,$410.28 ,$410.28 ,$473.40 ,$526.00 ,$473.40 ,$526.00 ,$526.00 ,$344.53 ,$526.00 ,$218.82 , N/A , N/A ,$526.00 ,$473.40 ,"$1,450.66 ",$324.54 ,$147.28 ,$473.40 ,$526.00 ,$473.40 ,$473.40 ,$526.00 ,$341.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200011,60300,HC ASP/INJ CYST THYROID,402,1 ,"$1,170.00 ",$760.50 ,$327.60 ,"$1,423.93 ","$1,170.00 ",$871.65 ,$766.35 ,$657.06 ,$327.60 ,$590.85 ,$657.06 ,$721.89 ,$657.06 ,$721.89 ,$721.89 ,$657.06 ,$721.89 ,"$1,248.41 ","$1,053.00 ",$877.50 ,"$1,170.00 ",$657.06 ,"$1,029.60 ",$657.06 ,$877.50 ,$877.50 ,$994.50 ,$994.50 ,$657.06 ,$994.50 ,$657.06 ,$912.60 ,$912.60 ,$912.60 ,"$1,053.00 ","$1,170.00 ","$1,053.00 ",$657.06 ,"$1,170.00 ",$766.35 ,$657.06 ,$486.72 ,$442.92 ,$422.78 ,$687.73 ,"$1,053.00 ","$1,423.93 ",$721.89 ,$327.60 ,"$1,053.00 ",$657.06 ,"$1,053.00 ","$1,053.00 ",$657.06 ,$760.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200012,76506,HC US ENCEPHALOGRAM,402,1 ,$642.00 ,$417.30 ,$105.71 ,$642.00 ,$275.96 ,$478.29 ,$420.51 ,$114.95 ,$179.76 ,$324.21 ,$114.95 ,$396.11 ,$114.95 ,$396.11 ,$396.11 ,$114.95 ,$396.11 ,$218.41 ,$577.80 ,$481.50 ,$275.96 ,$114.95 ,$564.96 ,$114.95 ,$481.50 ,$481.50 ,$545.70 ,$545.70 ,$114.95 ,$545.70 ,$114.95 ,$500.76 ,$500.76 ,$500.76 ,$577.80 ,$275.96 ,$577.80 ,$114.95 ,$642.00 ,$420.51 ,$114.95 ,$267.07 ,$110.75 ,$105.71 ,$120.32 ,$577.80 ,$249.12 ,$396.11 ,$179.76 ,$577.80 ,$114.95 ,$577.80 ,$577.80 ,$114.95 ,$417.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,"$1,211.00 ",$787.15 ,$105.71 ,"$1,211.00 ",$275.96 ,$902.20 ,$793.21 ,$114.95 ,$339.08 ,$611.56 ,$114.95 ,$747.19 ,$114.95 ,$747.19 ,$747.19 ,$114.95 ,$747.19 ,$218.41 ,"$1,089.90 ",$908.25 ,$275.96 ,$114.95 ,"$1,065.68 ",$114.95 ,$908.25 ,$908.25 ,"$1,029.35 ","$1,029.35 ",$114.95 ,"$1,029.35 ",$114.95 ,$944.58 ,$944.58 ,$944.58 ,"$1,089.90 ",$275.96 ,"$1,089.90 ",$114.95 ,"$1,211.00 ",$793.21 ,$114.95 ,$503.78 ,$110.75 ,$105.71 ,$120.32 ,"$1,089.90 ",$249.12 ,$747.19 ,$339.08 ,"$1,089.90 ",$114.95 ,"$1,089.90 ","$1,089.90 ",$114.95 ,$787.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200014,76604,HC US CHEST,402,1 ,$994.00 ,$646.10 ,$105.71 ,$994.00 ,$275.96 ,$740.53 ,$651.07 ,$114.95 ,$278.32 ,$501.97 ,$114.95 ,$613.30 ,$114.95 ,$613.30 ,$613.30 ,$114.95 ,$613.30 ,$218.41 ,$894.60 ,$745.50 ,$275.96 ,$114.95 ,$874.72 ,$114.95 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$114.95 ,$844.90 ,$114.95 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$275.96 ,$894.60 ,$114.95 ,$994.00 ,$651.07 ,$114.95 ,$413.50 ,$110.75 ,$105.71 ,$120.32 ,$894.60 ,$249.12 ,$613.30 ,$278.32 ,$894.60 ,$114.95 ,$894.60 ,$894.60 ,$114.95 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200015,76641,HC US BREAST COMPLETE,402,1 ,$866.00 ,$562.90 ,$76.42 ,$866.00 ,$275.96 ,$645.17 ,$567.23 ,$114.95 ,$242.48 ,$437.33 ,$114.95 ,$534.32 ,$114.95 ,$534.32 ,$534.32 ,$114.95 ,$534.32 ,$218.41 ,$779.40 ,$649.50 ,$275.96 ,$114.95 ,$762.08 ,$114.95 ,$649.50 ,$649.50 ,$736.10 ,$736.10 ,$114.95 ,$736.10 ,$114.95 ,$675.48 ,$675.48 ,$675.48 ,$779.40 ,$275.96 ,$779.40 ,$114.95 ,$76.42 ,$567.23 ,$114.95 ,$360.26 ,$110.75 ,$105.71 ,$120.32 ,$779.40 ,$249.12 ,$534.32 ,$242.48 ,$779.40 ,$114.95 ,$779.40 ,$779.40 ,$114.95 ,$562.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200015,76641,HC US BREAST COMPLETE,402,1 ,"$1,299.00 ",$844.35 ,$76.42 ,"$1,299.00 ",$275.96 ,$967.76 ,$850.85 ,$114.95 ,$363.72 ,$656.00 ,$114.95 ,$801.48 ,$114.95 ,$801.48 ,$801.48 ,$114.95 ,$801.48 ,$218.41 ,"$1,169.10 ",$974.25 ,$275.96 ,$114.95 ,"$1,143.12 ",$114.95 ,$974.25 ,$974.25 ,"$1,104.15 ","$1,104.15 ",$114.95 ,"$1,104.15 ",$114.95 ,"$1,013.22 ","$1,013.22 ","$1,013.22 ","$1,169.10 ",$275.96 ,"$1,169.10 ",$114.95 ,$76.42 ,$850.85 ,$114.95 ,$540.38 ,$166.12 ,$158.57 ,$120.32 ,"$1,169.10 ",$249.12 ,$801.48 ,$363.72 ,"$1,169.10 ",$114.95 ,"$1,169.10 ","$1,169.10 ",$114.95 ,$844.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200016,76642,HC US BREAST LIMITED,402,1 ,$650.00 ,$422.50 ,$58.57 ,$650.00 ,$205.02 ,$484.25 ,$425.75 ,$85.41 ,$182.00 ,$328.25 ,$85.41 ,$401.05 ,$85.41 ,$401.05 ,$401.05 ,$85.41 ,$401.05 ,$162.28 ,$585.00 ,$487.50 ,$205.02 ,$85.41 ,$572.00 ,$85.41 ,$487.50 ,$487.50 ,$552.50 ,$552.50 ,$85.41 ,$552.50 ,$85.41 ,$507.00 ,$507.00 ,$507.00 ,$585.00 ,$205.02 ,$585.00 ,$85.41 ,$58.57 ,$425.75 ,$85.41 ,$270.40 ,$110.75 ,$105.71 ,$89.39 ,$585.00 ,$185.09 ,$401.05 ,$182.00 ,$585.00 ,$85.41 ,$585.00 ,$585.00 ,$85.41 ,$422.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200016,76642,HC US BREAST LIMITED,402,1 ,$974.00 ,$633.10 ,$58.57 ,$974.00 ,$205.02 ,$725.63 ,$637.97 ,$85.41 ,$272.72 ,$491.87 ,$85.41 ,$600.96 ,$85.41 ,$600.96 ,$600.96 ,$85.41 ,$600.96 ,$162.28 ,$876.60 ,$730.50 ,$205.02 ,$85.41 ,$857.12 ,$85.41 ,$730.50 ,$730.50 ,$827.90 ,$827.90 ,$85.41 ,$827.90 ,$85.41 ,$759.72 ,$759.72 ,$759.72 ,$876.60 ,$205.02 ,$876.60 ,$85.41 ,$58.57 ,$637.97 ,$85.41 ,$405.18 ,$166.12 ,$158.57 ,$89.39 ,$876.60 ,$185.09 ,$600.96 ,$272.72 ,$876.60 ,$85.41 ,$876.60 ,$876.60 ,$85.41 ,$633.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,504.00 ",$977.60 ,$105.71 ,"$1,504.00 ",$275.96 ,"$1,120.48 ",$985.12 ,$114.95 ,$421.12 ,$759.52 ,$114.95 ,$927.97 ,$114.95 ,$927.97 ,$927.97 ,$114.95 ,$927.97 ,$218.41 ,"$1,353.60 ","$1,128.00 ",$275.96 ,$114.95 ,"$1,323.52 ",$114.95 ,"$1,128.00 ","$1,128.00 ","$1,278.40 ","$1,278.40 ",$114.95 ,"$1,278.40 ",$114.95 ,"$1,173.12 ","$1,173.12 ","$1,173.12 ","$1,353.60 ",$275.96 ,"$1,353.60 ",$114.95 ,"$1,504.00 ",$985.12 ,$114.95 ,$625.66 ,$110.75 ,$105.71 ,$120.32 ,"$1,353.60 ",$249.12 ,$927.97 ,$421.12 ,"$1,353.60 ",$114.95 ,"$1,353.60 ","$1,353.60 ",$114.95 ,$977.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200018,76705,HC US ABDOMEN LTD,402,1 ,"$1,432.00 ",$930.80 ,$105.71 ,"$1,432.00 ",$275.96 ,"$1,066.84 ",$937.96 ,$114.95 ,$400.96 ,$723.16 ,$114.95 ,$883.54 ,$114.95 ,$883.54 ,$883.54 ,$114.95 ,$883.54 ,$218.41 ,"$1,288.80 ","$1,074.00 ",$275.96 ,$114.95 ,"$1,260.16 ",$114.95 ,"$1,074.00 ","$1,074.00 ","$1,217.20 ","$1,217.20 ",$114.95 ,"$1,217.20 ",$114.95 ,"$1,116.96 ","$1,116.96 ","$1,116.96 ","$1,288.80 ",$275.96 ,"$1,288.80 ",$114.95 ,"$1,432.00 ",$937.96 ,$114.95 ,$595.71 ,$110.75 ,$105.71 ,$120.32 ,"$1,288.80 ",$249.12 ,$883.54 ,$400.96 ,"$1,288.80 ",$114.95 ,"$1,288.80 ","$1,288.80 ",$114.95 ,$930.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200019,76770,HC US RETROPERITIONEAL,402,1 ,"$1,030.00 ",$669.50 ,$105.71 ,"$1,030.00 ",$275.96 ,$767.35 ,$674.65 ,$114.95 ,$288.40 ,$520.15 ,$114.95 ,$635.51 ,$114.95 ,$635.51 ,$635.51 ,$114.95 ,$635.51 ,$218.41 ,$927.00 ,$772.50 ,$275.96 ,$114.95 ,$906.40 ,$114.95 ,$772.50 ,$772.50 ,$875.50 ,$875.50 ,$114.95 ,$875.50 ,$114.95 ,$803.40 ,$803.40 ,$803.40 ,$927.00 ,$275.96 ,$927.00 ,$114.95 ,"$1,030.00 ",$674.65 ,$114.95 ,$428.48 ,$110.75 ,$105.71 ,$120.32 ,$927.00 ,$249.12 ,$635.51 ,$288.40 ,$927.00 ,$114.95 ,$927.00 ,$927.00 ,$114.95 ,$669.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,$961.00 ,$624.65 ,$105.71 ,$961.00 ,$275.96 ,$715.95 ,$629.46 ,$114.95 ,$269.08 ,$485.31 ,$114.95 ,$592.94 ,$114.95 ,$592.94 ,$592.94 ,$114.95 ,$592.94 ,$218.41 ,$864.90 ,$720.75 ,$275.96 ,$114.95 ,$845.68 ,$114.95 ,$720.75 ,$720.75 ,$816.85 ,$816.85 ,$114.95 ,$816.85 ,$114.95 ,$749.58 ,$749.58 ,$749.58 ,$864.90 ,$275.96 ,$864.90 ,$114.95 ,$961.00 ,$629.46 ,$114.95 ,$399.78 ,$110.75 ,$105.71 ,$120.32 ,$864.90 ,$249.12 ,$592.94 ,$269.08 ,$864.90 ,$114.95 ,$864.90 ,$864.90 ,$114.95 ,$624.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,$327.00 ,$212.55 ,$91.56 ,$327.00 ,$275.96 ,$243.62 ,$214.19 ,$114.95 ,$91.56 ,$165.14 ,$114.95 ,$201.76 ,$114.95 ,$201.76 ,$201.76 ,$114.95 ,$201.76 ,$218.41 ,$294.30 ,$245.25 ,$275.96 ,$114.95 ,$287.76 ,$114.95 ,$245.25 ,$245.25 ,$277.95 ,$277.95 ,$114.95 ,$277.95 ,$114.95 ,$255.06 ,$255.06 ,$255.06 ,$294.30 ,$275.96 ,$294.30 ,$114.95 ,$327.00 ,$214.19 ,$114.95 ,$136.03 ,$110.75 ,$105.71 ,$120.32 ,$294.30 ,$249.12 ,$201.76 ,$91.56 ,$294.30 ,$114.95 ,$294.30 ,$294.30 ,$114.95 ,$212.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200022,76800,HC US SPINAL CANAL  AND  CONTENTS,402,1 ,$559.00 ,$363.35 ,$105.71 ,$559.00 ,$275.96 ,$416.46 ,$366.15 ,$114.95 ,$156.52 ,$282.30 ,$114.95 ,$344.90 ,$114.95 ,$344.90 ,$344.90 ,$114.95 ,$344.90 ,$218.41 ,$503.10 ,$419.25 ,$275.96 ,$114.95 ,$491.92 ,$114.95 ,$419.25 ,$419.25 ,$475.15 ,$475.15 ,$114.95 ,$475.15 ,$114.95 ,$436.02 ,$436.02 ,$436.02 ,$503.10 ,$275.96 ,$503.10 ,$114.95 ,$559.00 ,$366.15 ,$114.95 ,$232.54 ,$110.75 ,$105.71 ,$120.32 ,$503.10 ,$249.12 ,$344.90 ,$156.52 ,$503.10 ,$114.95 ,$503.10 ,$503.10 ,$114.95 ,$363.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,$906.00 ,$588.90 ,$114.95 ,$906.00 ,$275.96 ,$674.97 ,$593.43 ,$114.95 ,$253.68 ,$457.53 ,$114.95 ,$559.00 ,$114.95 ,$559.00 ,$559.00 ,$114.95 ,$559.00 ,$218.41 ,$815.40 ,$679.50 ,$275.96 ,$114.95 ,$797.28 ,$114.95 ,$679.50 ,$679.50 ,$770.10 ,$770.10 ,$114.95 ,$770.10 ,$114.95 ,$706.68 ,$706.68 ,$706.68 ,$815.40 ,$275.96 ,$815.40 ,$114.95 ,$906.00 ,$593.43 ,$114.95 ,$376.90 , N/A , N/A ,$120.32 ,$815.40 ,$249.12 ,$559.00 ,$253.68 ,$815.40 ,$114.95 ,$815.40 ,$815.40 ,$114.95 ,$588.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$195.00 ,$126.75 ,$54.60 ,$195.00 , N/A ,$145.28 ,$127.73 , N/A ,$54.60 ,$98.48 , N/A ,$120.32 , N/A ,$120.32 ,$120.32 , N/A ,$120.32 , N/A ,$175.50 ,$146.25 , N/A , N/A ,$171.60 , N/A ,$146.25 ,$146.25 ,$165.75 ,$165.75 , N/A ,$165.75 , N/A ,$152.10 ,$152.10 ,$152.10 ,$175.50 , N/A ,$175.50 , N/A ,$195.00 ,$127.73 , N/A ,$81.12 , N/A , N/A , N/A ,$175.50 , N/A ,$120.32 ,$54.60 ,$175.50 , N/A ,$175.50 ,$175.50 , N/A ,$126.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,"$1,200.00 ",$780.00 ,$114.95 ,"$1,200.00 ",$275.96 ,$894.00 ,$786.00 ,$114.95 ,$336.00 ,$606.00 ,$114.95 ,$740.40 ,$114.95 ,$740.40 ,$740.40 ,$114.95 ,$740.40 ,$218.41 ,"$1,080.00 ",$900.00 ,$275.96 ,$114.95 ,"$1,056.00 ",$114.95 ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ",$114.95 ,"$1,020.00 ",$114.95 ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ",$275.96 ,"$1,080.00 ",$114.95 ,"$1,200.00 ",$786.00 ,$114.95 ,$499.20 , N/A , N/A ,$120.32 ,"$1,080.00 ",$249.12 ,$740.40 ,$336.00 ,"$1,080.00 ",$114.95 ,"$1,080.00 ","$1,080.00 ",$114.95 ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,"$1,200.00 ",$780.00 ,$336.00 ,"$1,200.00 ", N/A ,$894.00 ,$786.00 , N/A ,$336.00 ,$606.00 , N/A ,$740.40 , N/A ,$740.40 ,$740.40 , N/A ,$740.40 , N/A ,"$1,080.00 ",$900.00 , N/A , N/A ,"$1,056.00 ", N/A ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ", N/A ,"$1,020.00 ", N/A ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ", N/A ,"$1,080.00 ", N/A ,"$1,200.00 ",$786.00 , N/A ,$499.20 , N/A , N/A , N/A ,"$1,080.00 ", N/A ,$740.40 ,$336.00 ,"$1,080.00 ", N/A ,"$1,080.00 ","$1,080.00 ", N/A ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,$655.00 ,$425.75 ,$183.40 ,$655.00 ,$583.23 ,$487.98 ,$429.03 ,$242.96 ,$183.40 ,$330.78 ,$242.96 ,$404.14 ,$242.96 ,$404.14 ,$404.14 ,$242.96 ,$404.14 ,$461.62 ,$589.50 ,$491.25 ,$583.23 ,$242.96 ,$576.40 ,$242.96 ,$491.25 ,$491.25 ,$556.75 ,$556.75 ,$242.96 ,$556.75 ,$242.96 ,$510.90 ,$510.90 ,$510.90 ,$589.50 ,$583.23 ,$589.50 ,$242.96 ,$655.00 ,$429.03 ,$242.96 ,$272.48 , N/A , N/A ,$254.30 ,$589.50 ,$526.52 ,$404.14 ,$183.40 ,$589.50 ,$242.96 ,$589.50 ,$589.50 ,$242.96 ,$425.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200029,76812,HC US PREGNANCY DETAILED ADDL,402,1 ,$706.50 ,$459.23 ,$197.82 ,$706.50 , N/A ,$526.34 ,$462.76 , N/A ,$197.82 ,$356.78 , N/A ,$435.91 , N/A ,$435.91 ,$435.91 , N/A ,$435.91 , N/A ,$635.85 ,$529.88 , N/A , N/A ,$621.72 , N/A ,$529.88 ,$529.88 ,$600.53 ,$600.53 , N/A ,$600.53 , N/A ,$551.07 ,$551.07 ,$551.07 ,$635.85 , N/A ,$635.85 , N/A ,$706.50 ,$462.76 , N/A ,$293.90 , N/A , N/A , N/A ,$635.85 , N/A ,$435.91 ,$197.82 ,$635.85 , N/A ,$635.85 ,$635.85 , N/A ,$459.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$347.00 ,$225.55 ,$97.16 ,$347.00 ,$275.96 ,$258.52 ,$227.29 ,$114.95 ,$97.16 ,$175.24 ,$114.95 ,$214.10 ,$114.95 ,$214.10 ,$214.10 ,$114.95 ,$214.10 ,$218.41 ,$312.30 ,$260.25 ,$275.96 ,$114.95 ,$305.36 ,$114.95 ,$260.25 ,$260.25 ,$294.95 ,$294.95 ,$114.95 ,$294.95 ,$114.95 ,$270.66 ,$270.66 ,$270.66 ,$312.30 ,$275.96 ,$312.30 ,$114.95 ,$347.00 ,$227.29 ,$114.95 ,$144.35 , N/A , N/A ,$120.32 ,$312.30 ,$249.12 ,$214.10 ,$97.16 ,$312.30 ,$114.95 ,$312.30 ,$312.30 ,$114.95 ,$225.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200031,76815,HC US FETAL HEART BEAT,402,1 ,$415.00 ,$269.75 ,$114.95 ,$415.00 ,$275.96 ,$309.18 ,$271.83 ,$114.95 ,$116.20 ,$209.58 ,$114.95 ,$256.06 ,$114.95 ,$256.06 ,$256.06 ,$114.95 ,$256.06 ,$218.41 ,$373.50 ,$311.25 ,$275.96 ,$114.95 ,$365.20 ,$114.95 ,$311.25 ,$311.25 ,$352.75 ,$352.75 ,$114.95 ,$352.75 ,$114.95 ,$323.70 ,$323.70 ,$323.70 ,$373.50 ,$275.96 ,$373.50 ,$114.95 ,$415.00 ,$271.83 ,$114.95 ,$172.64 , N/A , N/A ,$120.32 ,$373.50 ,$249.12 ,$256.06 ,$116.20 ,$373.50 ,$114.95 ,$373.50 ,$373.50 ,$114.95 ,$269.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,"$1,019.00 ",$662.35 ,$114.95 ,"$1,019.00 ",$275.96 ,$759.16 ,$667.45 ,$114.95 ,$285.32 ,$514.60 ,$114.95 ,$628.72 ,$114.95 ,$628.72 ,$628.72 ,$114.95 ,$628.72 ,$218.41 ,$917.10 ,$764.25 ,$275.96 ,$114.95 ,$896.72 ,$114.95 ,$764.25 ,$764.25 ,$866.15 ,$866.15 ,$114.95 ,$866.15 ,$114.95 ,$794.82 ,$794.82 ,$794.82 ,$917.10 ,$275.96 ,$917.10 ,$114.95 ,"$1,019.00 ",$667.45 ,$114.95 ,$423.90 , N/A , N/A ,$120.32 ,$917.10 ,$249.12 ,$628.72 ,$285.32 ,$917.10 ,$114.95 ,$917.10 ,$917.10 ,$114.95 ,$662.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$608.00 ,$395.20 ,$114.95 ,$608.00 ,$275.96 ,$452.96 ,$398.24 ,$114.95 ,$170.24 ,$307.04 ,$114.95 ,$375.14 ,$114.95 ,$375.14 ,$375.14 ,$114.95 ,$375.14 ,$218.41 ,$547.20 ,$456.00 ,$275.96 ,$114.95 ,$535.04 ,$114.95 ,$456.00 ,$456.00 ,$516.80 ,$516.80 ,$114.95 ,$516.80 ,$114.95 ,$474.24 ,$474.24 ,$474.24 ,$547.20 ,$275.96 ,$547.20 ,$114.95 ,$608.00 ,$398.24 ,$114.95 ,$252.93 , N/A , N/A ,$120.32 ,$547.20 ,$249.12 ,$375.14 ,$170.24 ,$547.20 ,$114.95 ,$547.20 ,$547.20 ,$114.95 ,$395.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200036,76820,HC US FETAL DOPLR VELO UMB,402,1 ,$344.00 ,$223.60 ,$96.32 ,$344.00 ,$275.96 ,$256.28 ,$225.32 ,$114.95 ,$96.32 ,$173.72 ,$114.95 ,$212.25 ,$114.95 ,$212.25 ,$212.25 ,$114.95 ,$212.25 ,$218.41 ,$309.60 ,$258.00 ,$275.96 ,$114.95 ,$302.72 ,$114.95 ,$258.00 ,$258.00 ,$292.40 ,$292.40 ,$114.95 ,$292.40 ,$114.95 ,$268.32 ,$268.32 ,$268.32 ,$309.60 ,$275.96 ,$309.60 ,$114.95 ,$344.00 ,$225.32 ,$114.95 ,$143.10 , N/A , N/A ,$120.32 ,$309.60 ,$249.12 ,$212.25 ,$96.32 ,$309.60 ,$114.95 ,$309.60 ,$309.60 ,$114.95 ,$223.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200038,76830,HC US TRANSVAGINAL,402,1 ,"$1,058.00 ",$687.70 ,$105.71 ,"$1,058.00 ",$275.96 ,$788.21 ,$692.99 ,$114.95 ,$296.24 ,$534.29 ,$114.95 ,$652.79 ,$114.95 ,$652.79 ,$652.79 ,$114.95 ,$652.79 ,$218.41 ,$952.20 ,$793.50 ,$275.96 ,$114.95 ,$931.04 ,$114.95 ,$793.50 ,$793.50 ,$899.30 ,$899.30 ,$114.95 ,$899.30 ,$114.95 ,$825.24 ,$825.24 ,$825.24 ,$952.20 ,$275.96 ,$952.20 ,$114.95 ,"$1,058.00 ",$692.99 ,$114.95 ,$440.13 ,$110.75 ,$105.71 ,$120.32 ,$952.20 ,$249.12 ,$652.79 ,$296.24 ,$952.20 ,$114.95 ,$952.20 ,$952.20 ,$114.95 ,$687.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,771.00 ","$1,151.15 ",$81.89 ,"$1,771.00 ",$275.96 ,"$1,319.40 ","$1,160.01 ",$114.95 ,$495.88 ,$894.36 ,$114.95 ,"$1,092.71 ",$114.95 ,"$1,092.71 ","$1,092.71 ",$114.95 ,"$1,092.71 ",$218.41 ,"$1,593.90 ","$1,328.25 ",$275.96 ,$114.95 ,"$1,558.48 ",$114.95 ,"$1,328.25 ","$1,328.25 ","$1,505.35 ","$1,505.35 ",$114.95 ,"$1,505.35 ",$114.95 ,"$1,381.38 ","$1,381.38 ","$1,381.38 ","$1,593.90 ",$275.96 ,"$1,593.90 ",$114.95 ,$81.89 ,"$1,160.01 ",$114.95 ,$736.74 ,$110.75 ,$105.71 ,$120.32 ,"$1,593.90 ",$249.12 ,"$1,092.71 ",$495.88 ,"$1,593.90 ",$114.95 ,"$1,593.90 ","$1,593.90 ",$114.95 ,"$1,151.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$922.00 ,$599.30 ,$105.71 ,$922.00 ,$275.96 ,$686.89 ,$603.91 ,$114.95 ,$258.16 ,$465.61 ,$114.95 ,$568.87 ,$114.95 ,$568.87 ,$568.87 ,$114.95 ,$568.87 ,$218.41 ,$829.80 ,$691.50 ,$275.96 ,$114.95 ,$811.36 ,$114.95 ,$691.50 ,$691.50 ,$783.70 ,$783.70 ,$114.95 ,$783.70 ,$114.95 ,$719.16 ,$719.16 ,$719.16 ,$829.80 ,$275.96 ,$829.80 ,$114.95 ,$922.00 ,$603.91 ,$114.95 ,$383.55 ,$110.75 ,$105.71 ,$120.32 ,$829.80 ,$249.12 ,$568.87 ,$258.16 ,$829.80 ,$114.95 ,$829.80 ,$829.80 ,$114.95 ,$599.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200042,76870,HC US SCROTUM,402,1 ,"$1,259.00 ",$818.35 ,$105.71 ,"$1,259.00 ",$275.96 ,$937.96 ,$824.65 ,$114.95 ,$352.52 ,$635.80 ,$114.95 ,$776.80 ,$114.95 ,$776.80 ,$776.80 ,$114.95 ,$776.80 ,$218.41 ,"$1,133.10 ",$944.25 ,$275.96 ,$114.95 ,"$1,107.92 ",$114.95 ,$944.25 ,$944.25 ,"$1,070.15 ","$1,070.15 ",$114.95 ,"$1,070.15 ",$114.95 ,$982.02 ,$982.02 ,$982.02 ,"$1,133.10 ",$275.96 ,"$1,133.10 ",$114.95 ,"$1,259.00 ",$824.65 ,$114.95 ,$523.74 ,$110.75 ,$105.71 ,$120.32 ,"$1,133.10 ",$249.12 ,$776.80 ,$352.52 ,"$1,133.10 ",$114.95 ,"$1,133.10 ","$1,133.10 ",$114.95 ,$818.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200043,76872,HC ULTRA BX PROS,402,1 ,$784.00 ,$509.60 ,$105.71 ,$784.00 ,$275.96 ,$584.08 ,$513.52 ,$114.95 ,$219.52 ,$395.92 ,$114.95 ,$483.73 ,$114.95 ,$483.73 ,$483.73 ,$114.95 ,$483.73 ,$218.41 ,$705.60 ,$588.00 ,$275.96 ,$114.95 ,$689.92 ,$114.95 ,$588.00 ,$588.00 ,$666.40 ,$666.40 ,$114.95 ,$666.40 ,$114.95 ,$611.52 ,$611.52 ,$611.52 ,$705.60 ,$275.96 ,$705.60 ,$114.95 ,$784.00 ,$513.52 ,$114.95 ,$326.14 ,$110.75 ,$105.71 ,$120.32 ,$705.60 ,$249.12 ,$483.73 ,$219.52 ,$705.60 ,$114.95 ,$705.60 ,$705.60 ,$114.95 ,$509.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$932.00 ,$605.80 ,$105.71 ,$932.00 ,$275.96 ,$694.34 ,$610.46 ,$114.95 ,$260.96 ,$470.66 ,$114.95 ,$575.04 ,$114.95 ,$575.04 ,$575.04 ,$114.95 ,$575.04 ,$218.41 ,$838.80 ,$699.00 ,$275.96 ,$114.95 ,$820.16 ,$114.95 ,$699.00 ,$699.00 ,$792.20 ,$792.20 ,$114.95 ,$792.20 ,$114.95 ,$726.96 ,$726.96 ,$726.96 ,$838.80 ,$275.96 ,$838.80 ,$114.95 ,$932.00 ,$610.46 ,$114.95 ,$387.71 ,$110.75 ,$105.71 ,$120.32 ,$838.80 ,$249.12 ,$575.04 ,$260.96 ,$838.80 ,$114.95 ,$838.80 ,$838.80 ,$114.95 ,$605.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$795.00 ,$516.75 ,$105.71 ,$795.00 ,$275.96 ,$592.28 ,$520.73 ,$114.95 ,$222.60 ,$401.48 ,$114.95 ,$490.52 ,$114.95 ,$490.52 ,$490.52 ,$114.95 ,$490.52 ,$218.41 ,$715.50 ,$596.25 ,$275.96 ,$114.95 ,$699.60 ,$114.95 ,$596.25 ,$596.25 ,$675.75 ,$675.75 ,$114.95 ,$675.75 ,$114.95 ,$620.10 ,$620.10 ,$620.10 ,$715.50 ,$275.96 ,$715.50 ,$114.95 ,$795.00 ,$520.73 ,$114.95 ,$330.72 ,$110.75 ,$105.71 ,$120.32 ,$715.50 ,$249.12 ,$490.52 ,$222.60 ,$715.50 ,$114.95 ,$715.50 ,$715.50 ,$114.95 ,$516.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200048,76885,HC US HIPS INFANT DYNAMIC,402,1 ,$860.00 ,$559.00 ,$85.41 ,$860.00 ,$205.02 ,$640.70 ,$563.30 ,$85.41 ,$240.80 ,$434.30 ,$85.41 ,$530.62 ,$85.41 ,$530.62 ,$530.62 ,$85.41 ,$530.62 ,$162.28 ,$774.00 ,$645.00 ,$205.02 ,$85.41 ,$756.80 ,$85.41 ,$645.00 ,$645.00 ,$731.00 ,$731.00 ,$85.41 ,$731.00 ,$85.41 ,$670.80 ,$670.80 ,$670.80 ,$774.00 ,$205.02 ,$774.00 ,$85.41 ,$860.00 ,$563.30 ,$85.41 ,$357.76 , N/A , N/A ,$89.39 ,$774.00 ,$185.09 ,$530.62 ,$240.80 ,$774.00 ,$85.41 ,$774.00 ,$774.00 ,$85.41 ,$559.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200050,76936,HC US GUIDED COMPRESSION RPR,402,1 ,$887.00 ,$576.55 ,$77.14 ,$887.00 ,$670.82 ,$660.82 ,$580.99 ,$279.44 ,$248.36 ,$447.94 ,$279.44 ,$547.28 ,$279.44 ,$547.28 ,$547.28 ,$279.44 ,$547.28 ,$530.94 ,$798.30 ,$665.25 ,$670.82 ,$279.44 ,$780.56 ,$279.44 ,$665.25 ,$665.25 ,$753.95 ,$753.95 ,$279.44 ,$753.95 ,$279.44 ,$691.86 ,$691.86 ,$691.86 ,$798.30 ,$670.82 ,$798.30 ,$279.44 ,$887.00 ,$580.99 ,$279.44 ,$368.99 ,$80.82 ,$77.14 ,$292.49 ,$798.30 ,$605.59 ,$547.28 ,$248.36 ,$798.30 ,$279.44 ,$798.30 ,$798.30 ,$279.44 ,$576.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$195.00 ,$126.75 ,$54.60 ,$195.00 , N/A ,$145.28 ,$127.73 , N/A ,$54.60 ,$98.48 , N/A ,$120.32 , N/A ,$120.32 ,$120.32 , N/A ,$120.32 , N/A ,$175.50 ,$146.25 , N/A , N/A ,$171.60 , N/A ,$146.25 ,$146.25 ,$165.75 ,$165.75 , N/A ,$165.75 , N/A ,$152.10 ,$152.10 ,$152.10 ,$175.50 , N/A ,$175.50 , N/A ,$195.00 ,$127.73 , N/A ,$81.12 ,$80.82 ,$77.14 , N/A ,$175.50 , N/A ,$120.32 ,$54.60 ,$175.50 , N/A ,$175.50 ,$175.50 , N/A ,$126.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,"$1,075.00 ",$698.75 ,$29.07 ,"$1,075.00 ", N/A ,$800.88 ,$704.13 , N/A ,$301.00 ,$542.88 , N/A ,$663.28 , N/A ,$663.28 ,$663.28 , N/A ,$663.28 , N/A ,$967.50 ,$806.25 , N/A , N/A ,$946.00 , N/A ,$806.25 ,$806.25 ,$913.75 ,$913.75 , N/A ,$913.75 , N/A ,$838.50 ,$838.50 ,$838.50 ,$967.50 , N/A ,$967.50 , N/A ,$29.07 ,$704.13 , N/A ,$447.20 ,$80.82 ,$77.14 , N/A ,$967.50 , N/A ,$663.28 ,$301.00 ,$967.50 , N/A ,$967.50 ,$967.50 , N/A ,$698.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,$559.00 ,$363.35 ,$77.14 ,$559.00 , N/A ,$416.46 ,$366.15 , N/A ,$156.52 ,$282.30 , N/A ,$344.90 , N/A ,$344.90 ,$344.90 , N/A ,$344.90 , N/A ,$503.10 ,$419.25 , N/A , N/A ,$491.92 , N/A ,$419.25 ,$419.25 ,$475.15 ,$475.15 , N/A ,$475.15 , N/A ,$436.02 ,$436.02 ,$436.02 ,$503.10 , N/A ,$503.10 , N/A ,$559.00 ,$366.15 , N/A ,$232.54 ,$80.82 ,$77.14 , N/A ,$503.10 , N/A ,$344.90 ,$156.52 ,$503.10 , N/A ,$503.10 ,$503.10 , N/A ,$363.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200062,76998,HC US INTRAOPERATIVE,402,1 ,$527.00 ,$342.55 ,$77.14 ,$527.00 , N/A ,$392.62 ,$345.19 , N/A ,$147.56 ,$266.14 , N/A ,$325.16 , N/A ,$325.16 ,$325.16 , N/A ,$325.16 , N/A ,$474.30 ,$395.25 , N/A , N/A ,$463.76 , N/A ,$395.25 ,$395.25 ,$447.95 ,$447.95 , N/A ,$447.95 , N/A ,$411.06 ,$411.06 ,$411.06 ,$474.30 , N/A ,$474.30 , N/A ,$527.00 ,$345.19 , N/A ,$219.23 ,$80.82 ,$77.14 , N/A ,$474.30 , N/A ,$325.16 ,$147.56 ,$474.30 , N/A ,$474.30 ,$474.30 , N/A ,$342.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,"$2,089.00 ","$1,357.85 ",$105.71 ,"$2,089.00 ",$583.23 ,"$1,556.31 ","$1,368.30 ",$242.96 ,$584.92 ,"$1,054.95 ",$242.96 ,"$1,288.91 ",$242.96 ,"$1,288.91 ","$1,288.91 ",$242.96 ,"$1,288.91 ",$461.62 ,"$1,880.10 ","$1,566.75 ",$583.23 ,$242.96 ,"$1,838.32 ",$242.96 ,"$1,566.75 ","$1,566.75 ","$1,775.65 ","$1,775.65 ",$242.96 ,"$1,775.65 ",$242.96 ,"$1,629.42 ","$1,629.42 ","$1,629.42 ","$1,880.10 ",$583.23 ,"$1,880.10 ",$242.96 ,"$2,089.00 ","$1,368.30 ",$242.96 ,$869.02 ,$110.75 ,$105.71 ,$254.30 ,"$1,880.10 ",$526.52 ,"$1,288.91 ",$584.92 ,"$1,880.10 ",$242.96 ,"$1,880.10 ","$1,880.10 ",$242.96 ,"$1,357.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,330.00 ",$864.50 ,$105.71 ,"$1,330.00 ",$275.96 ,$990.85 ,$871.15 ,$114.95 ,$372.40 ,$671.65 ,$114.95 ,$820.61 ,$114.95 ,$820.61 ,$820.61 ,$114.95 ,$820.61 ,$218.41 ,"$1,197.00 ",$997.50 ,$275.96 ,$114.95 ,"$1,170.40 ",$114.95 ,$997.50 ,$997.50 ,"$1,130.50 ","$1,130.50 ",$114.95 ,"$1,130.50 ",$114.95 ,"$1,037.40 ","$1,037.40 ","$1,037.40 ","$1,197.00 ",$275.96 ,"$1,197.00 ",$114.95 ,"$1,330.00 ",$871.15 ,$114.95 ,$553.28 ,$110.75 ,$105.71 ,$120.32 ,"$1,197.00 ",$249.12 ,$820.61 ,$372.40 ,"$1,197.00 ",$114.95 ,"$1,197.00 ","$1,197.00 ",$114.95 ,$864.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,"$1,464.00 ",$951.60 ,$105.71 ,"$1,464.00 ",$583.23 ,"$1,090.68 ",$958.92 ,$242.96 ,$409.92 ,$739.32 ,$242.96 ,$903.29 ,$242.96 ,$903.29 ,$903.29 ,$242.96 ,$903.29 ,$461.62 ,"$1,317.60 ","$1,098.00 ",$583.23 ,$242.96 ,"$1,288.32 ",$242.96 ,"$1,098.00 ","$1,098.00 ","$1,244.40 ","$1,244.40 ",$242.96 ,"$1,244.40 ",$242.96 ,"$1,141.92 ","$1,141.92 ","$1,141.92 ","$1,317.60 ",$583.23 ,"$1,317.60 ",$242.96 ,"$1,464.00 ",$958.92 ,$242.96 ,$609.02 ,$110.75 ,$105.71 ,$254.30 ,"$1,317.60 ",$526.52 ,$903.29 ,$409.92 ,"$1,317.60 ",$242.96 ,"$1,317.60 ","$1,317.60 ",$242.96 ,$951.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,"$1,037.00 ",$674.05 ,$105.71 ,"$1,037.00 ",$275.96 ,$772.57 ,$679.24 ,$114.95 ,$290.36 ,$523.69 ,$114.95 ,$639.83 ,$114.95 ,$639.83 ,$639.83 ,$114.95 ,$639.83 ,$218.41 ,$933.30 ,$777.75 ,$275.96 ,$114.95 ,$912.56 ,$114.95 ,$777.75 ,$777.75 ,$881.45 ,$881.45 ,$114.95 ,$881.45 ,$114.95 ,$808.86 ,$808.86 ,$808.86 ,$933.30 ,$275.96 ,$933.30 ,$114.95 ,"$1,037.00 ",$679.24 ,$114.95 ,$431.39 ,$110.75 ,$105.71 ,$120.32 ,$933.30 ,$249.12 ,$639.83 ,$290.36 ,$933.30 ,$114.95 ,$933.30 ,$933.30 ,$114.95 ,$674.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200075,76706,HC US AORTA (SCREENING),402,1 ,$771.00 ,$501.15 ,$105.71 ,$771.00 ,$275.96 ,$574.40 ,$505.01 ,$114.95 ,$215.88 ,$389.36 ,$114.95 ,$475.71 ,$114.95 ,$475.71 ,$475.71 ,$114.95 ,$475.71 ,$218.41 ,$693.90 ,$578.25 ,$275.96 ,$114.95 ,$678.48 ,$114.95 ,$578.25 ,$578.25 ,$655.35 ,$655.35 ,$114.95 ,$655.35 ,$114.95 ,$601.38 ,$601.38 ,$601.38 ,$693.90 ,$275.96 ,$693.90 ,$114.95 ,$771.00 ,$505.01 ,$114.95 ,$320.74 ,$110.75 ,$105.71 ,$120.32 ,$693.90 ,$249.12 ,$475.71 ,$215.88 ,$693.90 ,$114.95 ,$693.90 ,$693.90 ,$114.95 ,$501.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200091,76886,HC US HIPS INFANT STATIC,402,1 ,$393.00 ,$255.45 ,$85.41 ,$393.00 ,$205.02 ,$292.79 ,$257.42 ,$85.41 ,$110.04 ,$198.47 ,$85.41 ,$242.48 ,$85.41 ,$242.48 ,$242.48 ,$85.41 ,$242.48 ,$162.28 ,$353.70 ,$294.75 ,$205.02 ,$85.41 ,$345.84 ,$85.41 ,$294.75 ,$294.75 ,$334.05 ,$334.05 ,$85.41 ,$334.05 ,$85.41 ,$306.54 ,$306.54 ,$306.54 ,$353.70 ,$205.02 ,$353.70 ,$85.41 ,$393.00 ,$257.42 ,$85.41 ,$163.49 , N/A , N/A ,$89.39 ,$353.70 ,$185.09 ,$242.48 ,$110.04 ,$353.70 ,$85.41 ,$353.70 ,$353.70 ,$85.41 ,$255.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40200097,76816,HC US OB GROWTH FOLLOWUP EA ADDN,402,1 ,$310.29 ,$201.69 ,$86.88 ,$310.29 ,$275.96 ,$231.17 ,$203.24 ,$114.95 ,$86.88 ,$156.70 ,$114.95 ,$191.45 ,$114.95 ,$191.45 ,$191.45 ,$114.95 ,$191.45 ,$218.41 ,$279.26 ,$232.72 ,$275.96 ,$114.95 ,$273.06 ,$114.95 ,$232.72 ,$232.72 ,$263.75 ,$263.75 ,$114.95 ,$263.75 ,$114.95 ,$242.03 ,$242.03 ,$242.03 ,$279.26 ,$275.96 ,$279.26 ,$114.95 ,$310.29 ,$203.24 ,$114.95 ,$129.08 , N/A , N/A ,$120.32 ,$279.26 ,$249.12 ,$191.45 ,$86.88 ,$279.26 ,$114.95 ,$279.26 ,$279.26 ,$114.95 ,$201.69 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$582.00 ,$378.30 ,$48.02 ,$582.00 ,$218.00 ,$433.59 ,$381.21 ,$87.20 ,$162.96 ,$293.91 ,$87.20 ,$359.09 ,$87.20 ,$359.09 ,$359.09 ,$87.20 ,$359.09 ,$165.68 ,$523.80 ,$436.50 ,$218.00 ,$87.20 ,$512.16 ,$87.20 ,$436.50 ,$436.50 ,$494.70 ,$494.70 ,$87.20 ,$494.70 ,$87.20 ,$453.96 ,$453.96 ,$453.96 ,$523.80 ,$218.00 ,$523.80 ,$87.20 ,$101.20 ,$381.21 ,$87.20 ,$242.11 ,$50.30 ,$48.02 ,$91.56 ,$523.80 ,$196.20 ,$359.09 ,$162.96 ,$523.80 ,$87.20 ,$523.80 ,$523.80 ,$87.20 ,$378.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$355.00 ,$230.75 ,$24.01 ,$355.00 ,$218.00 ,$264.48 ,$232.53 ,$87.20 ,$99.40 ,$179.28 ,$87.20 ,$219.04 ,$87.20 ,$219.04 ,$219.04 ,$87.20 ,$219.04 ,$165.68 ,$319.50 ,$266.25 ,$218.00 ,$87.20 ,$312.40 ,$87.20 ,$266.25 ,$266.25 ,$301.75 ,$301.75 ,$87.20 ,$301.75 ,$87.20 ,$276.90 ,$276.90 ,$276.90 ,$319.50 ,$218.00 ,$319.50 ,$87.20 ,$101.20 ,$232.53 ,$87.20 ,$147.68 ,$25.16 ,$24.01 ,$91.56 ,$319.50 ,$196.20 ,$219.04 ,$99.40 ,$319.50 ,$87.20 ,$319.50 ,$319.50 ,$87.20 ,$230.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$582.00 ,$378.30 ,$48.02 ,$582.00 ,$218.00 ,$433.59 ,$381.21 ,$87.20 ,$162.96 ,$293.91 ,$87.20 ,$359.09 ,$87.20 ,$359.09 ,$359.09 ,$87.20 ,$359.09 ,$165.68 ,$523.80 ,$436.50 ,$218.00 ,$87.20 ,$512.16 ,$87.20 ,$436.50 ,$436.50 ,$494.70 ,$494.70 ,$87.20 ,$494.70 ,$87.20 ,$453.96 ,$453.96 ,$453.96 ,$523.80 ,$218.00 ,$523.80 ,$87.20 ,$101.20 ,$381.21 ,$87.20 ,$242.11 ,$50.30 ,$48.02 ,$91.56 ,$523.80 ,$196.20 ,$359.09 ,$162.96 ,$523.80 ,$87.20 ,$523.80 ,$523.80 ,$87.20 ,$378.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$167.00 ,$108.55 ,$22.09 ,$167.00 ,$55.23 ,$124.42 ,$109.39 ,$22.09 ,$46.76 ,$84.34 ,$22.09 ,$103.04 ,$22.09 ,$103.04 ,$103.04 ,$22.09 ,$103.04 ,$41.97 ,$150.30 ,$125.25 ,$55.23 ,$22.09 ,$146.96 ,$22.09 ,$125.25 ,$125.25 ,$141.95 ,$141.95 ,$22.09 ,$141.95 ,$22.09 ,$130.26 ,$130.26 ,$130.26 ,$150.30 ,$55.23 ,$150.30 ,$22.09 ,$26.59 ,$109.39 ,$22.09 ,$69.47 ,$50.30 ,$48.02 ,$23.19 ,$150.30 ,$49.70 ,$103.04 ,$46.76 ,$150.30 ,$22.09 ,$150.30 ,$150.30 ,$22.09 ,$108.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40400004,78815,HC PET W/CT TUMR SKULL MID-THIGH,404,1 ,"$6,551.00 ","$4,258.15 ",$850.43 ,"$6,551.00 ","$3,751.45 ","$4,880.50 ","$4,290.91 ","$1,562.74 ","$1,834.28 ","$3,308.26 ","$1,562.74 ","$4,041.97 ","$1,562.74 ","$4,041.97 ","$4,041.97 ","$1,562.74 ","$4,041.97 ","$2,969.21 ","$5,895.90 ","$4,913.25 ","$3,751.45 ","$1,562.74 ","$5,764.88 ","$1,562.74 ","$4,913.25 ","$4,913.25 ","$5,568.35 ","$5,568.35 ","$1,562.74 ","$5,568.35 ","$1,562.74 ","$5,109.78 ","$5,109.78 ","$5,109.78 ","$5,895.90 ","$3,751.45 ","$5,895.90 ","$1,562.74 ","$6,551.00 ","$4,290.91 ","$1,562.74 ","$2,725.22 ",$890.92 ,$850.43 ,"$1,635.69 ","$5,895.90 ","$3,386.66 ","$4,041.97 ","$1,834.28 ","$5,895.90 ","$1,562.74 ","$5,895.90 ","$5,895.90 ","$1,562.74 ","$4,258.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),40400005,78816,HC PET W/CT MELAN IMAG WHOLE BODY,404,1 ,"$6,711.00 ","$4,362.15 ",$850.43 ,"$6,711.00 ","$3,751.45 ","$4,999.70 ","$4,395.71 ","$1,562.74 ","$1,879.08 ","$3,389.06 ","$1,562.74 ","$4,140.69 ","$1,562.74 ","$4,140.69 ","$4,140.69 ","$1,562.74 ","$4,140.69 ","$2,969.21 ","$6,039.90 ","$5,033.25 ","$3,751.45 ","$1,562.74 ","$5,905.68 ","$1,562.74 ","$5,033.25 ","$5,033.25 ","$5,704.35 ","$5,704.35 ","$1,562.74 ","$5,704.35 ","$1,562.74 ","$5,234.58 ","$5,234.58 ","$5,234.58 ","$6,039.90 ","$3,751.45 ","$6,039.90 ","$1,562.74 ","$6,711.00 ","$4,395.71 ","$1,562.74 ","$2,791.78 ",$890.92 ,$850.43 ,"$1,635.69 ","$6,039.90 ","$3,386.66 ","$4,140.69 ","$1,879.08 ","$6,039.90 ","$1,562.74 ","$6,039.90 ","$6,039.90 ","$1,562.74 ","$4,362.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$631.00 ,$410.15 ,$145.26 ,$631.00 ,$536.25 ,$470.10 ,$413.31 ,$223.39 ,$176.68 ,$318.66 ,$223.39 ,$389.33 ,$223.39 ,$389.33 ,$389.33 ,$223.39 ,$389.33 ,$424.44 ,$567.90 ,$473.25 ,$536.25 ,$223.39 ,$555.28 ,$223.39 ,$473.25 ,$473.25 ,$536.35 ,$536.35 ,$223.39 ,$536.35 ,$223.39 ,$492.18 ,$492.18 ,$492.18 ,$567.90 ,$536.25 ,$567.90 ,$223.39 ,$631.00 ,$413.31 ,$223.39 ,$262.50 ,$152.17 ,$145.26 ,$233.81 ,$567.90 ,$484.11 ,$389.33 ,$176.68 ,$567.90 ,$223.39 ,$567.90 ,$567.90 ,$223.39 ,$410.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000005,92950,HC CPR,480,1 ,$607.00 ,$394.55 ,$169.96 ,$607.00 ,$607.00 ,$452.22 ,$397.59 ,$279.44 ,$169.96 ,$306.54 ,$279.44 ,$374.52 ,$279.44 ,$374.52 ,$374.52 ,$279.44 ,$374.52 ,$530.94 ,$546.30 ,$455.25 ,$607.00 ,$279.44 ,$534.16 ,$279.44 ,$455.25 ,$455.25 ,$515.95 ,$515.95 ,$279.44 ,$515.95 ,$279.44 ,$473.46 ,$473.46 ,$473.46 ,$546.30 ,$607.00 ,$546.30 ,$279.44 ,$607.00 ,$397.59 ,$279.44 ,$252.51 ,$491.82 ,$469.47 ,$292.49 ,$546.30 ,$605.59 ,$374.52 ,$169.96 ,$546.30 ,$279.44 ,$546.30 ,$546.30 ,$279.44 ,$394.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,$833.00 ,$541.45 ,$233.24 ,"$1,114.74 ",$833.00 ,$620.59 ,$545.62 ,$514.39 ,$233.24 ,$420.67 ,$514.39 ,$513.96 ,$514.39 ,$513.96 ,$513.96 ,$514.39 ,$513.96 ,$977.34 ,$749.70 ,$624.75 ,$833.00 ,$514.39 ,$733.04 ,$514.39 ,$624.75 ,$624.75 ,$708.05 ,$708.05 ,$514.39 ,$708.05 ,$514.39 ,$649.74 ,$649.74 ,$649.74 ,$749.70 ,$833.00 ,$749.70 ,$514.39 ,$833.00 ,$545.62 ,$514.39 ,$346.53 ,$533.25 ,$509.01 ,$538.40 ,$749.70 ,"$1,114.74 ",$513.96 ,$233.24 ,$749.70 ,$514.39 ,$749.70 ,$749.70 ,$514.39 ,$541.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000014,94002,HC VENT WEANING FIRST DAY,410,1 ,$833.00 ,$541.45 ,$233.24 ,"$1,114.74 ",$833.00 ,$620.59 ,$545.62 ,$514.39 ,$233.24 ,$420.67 ,$514.39 ,$513.96 ,$514.39 ,$513.96 ,$513.96 ,$514.39 ,$513.96 ,$977.34 ,$749.70 ,$624.75 ,$833.00 ,$514.39 ,$733.04 ,$514.39 ,$624.75 ,$624.75 ,$708.05 ,$708.05 ,$514.39 ,$708.05 ,$514.39 ,$649.74 ,$649.74 ,$649.74 ,$749.70 ,$833.00 ,$749.70 ,$514.39 ,$833.00 ,$545.62 ,$514.39 ,$346.53 ,$533.25 ,$509.01 ,$538.40 ,$749.70 ,"$1,114.74 ",$513.96 ,$233.24 ,$749.70 ,$514.39 ,$749.70 ,$749.70 ,$514.39 ,$541.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,$833.00 ,$541.45 ,$233.24 ,"$1,114.74 ",$833.00 ,$620.59 ,$545.62 ,$514.39 ,$233.24 ,$420.67 ,$514.39 ,$513.96 ,$514.39 ,$513.96 ,$513.96 ,$514.39 ,$513.96 ,$977.34 ,$749.70 ,$624.75 ,$833.00 ,$514.39 ,$733.04 ,$514.39 ,$624.75 ,$624.75 ,$708.05 ,$708.05 ,$514.39 ,$708.05 ,$514.39 ,$649.74 ,$649.74 ,$649.74 ,$749.70 ,$833.00 ,$749.70 ,$514.39 ,$833.00 ,$545.62 ,$514.39 ,$346.53 ,$533.25 ,$509.01 ,$538.40 ,$749.70 ,"$1,114.74 ",$513.96 ,$233.24 ,$749.70 ,$514.39 ,$749.70 ,$749.70 ,$514.39 ,$541.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000018,94660,HC VENT NONINVAS PEDS INTL DAY,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,$554.00 ,$360.10 ,$155.12 ,"$1,114.74 ",$554.00 ,$412.73 ,$362.87 ,$514.39 ,$155.12 ,$279.77 ,$514.39 ,$341.82 ,$514.39 ,$341.82 ,$341.82 ,$514.39 ,$341.82 ,$977.34 ,$498.60 ,$415.50 ,$554.00 ,$514.39 ,$487.52 ,$514.39 ,$415.50 ,$415.50 ,$470.90 ,$470.90 ,$514.39 ,$470.90 ,$514.39 ,$432.12 ,$432.12 ,$432.12 ,$498.60 ,$554.00 ,$498.60 ,$514.39 ,$554.00 ,$362.87 ,$514.39 ,$230.46 ,$533.25 ,$509.01 ,$538.40 ,$498.60 ,"$1,114.74 ",$341.82 ,$155.12 ,$498.60 ,$514.39 ,$498.60 ,$498.60 ,$514.39 ,$360.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000033,94660,HC VENT NONINVAS PEDS SUBQ DAY,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000037,94640,HC INCENTIVE SPIROMETER TRT,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000040,94640,HC EZ PAP TREATMENT,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$302.00 ,$196.30 ,$51.98 ,$302.00 ,$285.81 ,$224.99 ,$197.81 ,$119.06 ,$84.56 ,$152.51 ,$119.06 ,$186.33 ,$119.06 ,$186.33 ,$186.33 ,$119.06 ,$186.33 ,$226.21 ,$271.80 ,$226.50 ,$285.81 ,$119.06 ,$265.76 ,$119.06 ,$226.50 ,$226.50 ,$256.70 ,$256.70 ,$119.06 ,$256.70 ,$119.06 ,$235.56 ,$235.56 ,$235.56 ,$271.80 ,$285.81 ,$271.80 ,$119.06 ,$302.00 ,$197.81 ,$119.06 ,$125.63 ,$54.45 ,$51.98 ,$124.62 ,$271.80 ,$258.02 ,$186.33 ,$84.56 ,$271.80 ,$119.06 ,$271.80 ,$271.80 ,$119.06 ,$196.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$318.00 ,$206.70 ,$51.98 ,$318.00 , N/A ,$236.91 ,$208.29 , N/A ,$89.04 ,$160.59 , N/A ,$196.21 , N/A ,$196.21 ,$196.21 , N/A ,$196.21 , N/A ,$286.20 ,$238.50 , N/A , N/A ,$279.84 , N/A ,$238.50 ,$238.50 ,$270.30 ,$270.30 , N/A ,$270.30 , N/A ,$248.04 ,$248.04 ,$248.04 ,$286.20 , N/A ,$286.20 , N/A ,$318.00 ,$208.29 , N/A ,$132.29 ,$54.45 ,$51.98 , N/A ,$286.20 , N/A ,$196.21 ,$89.04 ,$286.20 , N/A ,$286.20 ,$286.20 , N/A ,$206.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000052,94660,HC CPAP,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000054,94660,HC CPAP NEONATAL/DAY,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$41.00 ,$26.65 ,$11.48 ,$430.11 ,$41.00 ,$30.55 ,$26.86 ,$41.00 ,$11.48 ,$20.71 ,$41.00 ,$25.30 ,$41.00 ,$25.30 ,$25.30 ,$41.00 ,$25.30 ,$377.09 ,$36.90 ,$30.75 ,$41.00 ,$41.00 ,$36.08 ,$41.00 ,$30.75 ,$30.75 ,$34.85 ,$34.85 ,$41.00 ,$34.85 ,$41.00 ,$31.98 ,$31.98 ,$31.98 ,$36.90 ,$41.00 ,$36.90 ,$41.00 ,$41.00 ,$26.86 ,$41.00 ,$17.06 ,$26.28 ,$25.08 ,$41.00 ,$36.90 ,$430.11 ,$25.30 ,$11.48 ,$36.90 ,$41.00 ,$36.90 ,$36.90 ,$41.00 ,$26.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$74.00 ,$48.10 ,$20.72 ,$258.02 ,$74.00 ,$55.13 ,$48.47 ,$74.00 ,$20.72 ,$37.37 ,$74.00 ,$45.66 ,$74.00 ,$45.66 ,$45.66 ,$74.00 ,$45.66 ,$226.21 ,$66.60 ,$55.50 ,$74.00 ,$74.00 ,$65.12 ,$74.00 ,$55.50 ,$55.50 ,$62.90 ,$62.90 ,$74.00 ,$62.90 ,$74.00 ,$57.72 ,$57.72 ,$57.72 ,$66.60 ,$74.00 ,$66.60 ,$74.00 ,$74.00 ,$48.47 ,$74.00 ,$30.78 ,$74.00 ,$74.00 ,$74.00 ,$66.60 ,$258.02 ,$45.66 ,$20.72 ,$66.60 ,$74.00 ,$66.60 ,$66.60 ,$74.00 ,$48.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$74.00 ,$48.10 ,$20.72 ,$258.02 ,$74.00 ,$55.13 ,$48.47 ,$74.00 ,$20.72 ,$37.37 ,$74.00 ,$45.66 ,$74.00 ,$45.66 ,$45.66 ,$74.00 ,$45.66 ,$226.21 ,$66.60 ,$55.50 ,$74.00 ,$74.00 ,$65.12 ,$74.00 ,$55.50 ,$55.50 ,$62.90 ,$62.90 ,$74.00 ,$62.90 ,$74.00 ,$57.72 ,$57.72 ,$57.72 ,$66.60 ,$74.00 ,$66.60 ,$74.00 ,$74.00 ,$48.47 ,$74.00 ,$30.78 ,$74.00 ,$74.00 ,$74.00 ,$66.60 ,$258.02 ,$45.66 ,$20.72 ,$66.60 ,$74.00 ,$66.60 ,$66.60 ,$74.00 ,$48.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$65.00 ,$42.25 ,$18.20 ,$258.02 ,$65.00 ,$48.43 ,$42.58 ,$65.00 ,$18.20 ,$32.83 ,$65.00 ,$40.11 ,$65.00 ,$40.11 ,$40.11 ,$65.00 ,$40.11 ,$226.21 ,$58.50 ,$48.75 ,$65.00 ,$65.00 ,$57.20 ,$65.00 ,$48.75 ,$48.75 ,$55.25 ,$55.25 ,$65.00 ,$55.25 ,$65.00 ,$50.70 ,$50.70 ,$50.70 ,$58.50 ,$65.00 ,$58.50 ,$65.00 ,$65.00 ,$42.58 ,$65.00 ,$27.04 ,$65.00 ,$65.00 ,$65.00 ,$58.50 ,$258.02 ,$40.11 ,$18.20 ,$58.50 ,$65.00 ,$58.50 ,$58.50 ,$65.00 ,$42.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$65.00 ,$42.25 ,$18.20 ,$258.02 ,$65.00 ,$48.43 ,$42.58 ,$65.00 ,$18.20 ,$32.83 ,$65.00 ,$40.11 ,$65.00 ,$40.11 ,$40.11 ,$65.00 ,$40.11 ,$226.21 ,$58.50 ,$48.75 ,$65.00 ,$65.00 ,$57.20 ,$65.00 ,$48.75 ,$48.75 ,$55.25 ,$55.25 ,$65.00 ,$55.25 ,$65.00 ,$50.70 ,$50.70 ,$50.70 ,$58.50 ,$65.00 ,$58.50 ,$65.00 ,$65.00 ,$42.58 ,$65.00 ,$27.04 ,$65.00 ,$65.00 ,$65.00 ,$58.50 ,$258.02 ,$40.11 ,$18.20 ,$58.50 ,$65.00 ,$58.50 ,$58.50 ,$65.00 ,$42.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000068,G0237,HC RESP STRENGTH/ENDURANCE,410,1 ,$63.00 ,$40.95 ,$17.64 ,$63.00 ,$62.62 ,$46.94 ,$41.27 ,$26.08 ,$17.64 ,$31.82 ,$26.08 ,$38.87 ,$26.08 ,$38.87 ,$38.87 ,$26.08 ,$38.87 ,$49.55 ,$56.70 ,$47.25 ,$62.62 ,$26.08 ,$55.44 ,$26.08 ,$47.25 ,$47.25 ,$53.55 ,$53.55 ,$26.08 ,$53.55 ,$26.08 ,$49.14 ,$49.14 ,$49.14 ,$56.70 ,$62.62 ,$56.70 ,$26.08 ,$63.00 ,$41.27 ,$26.08 ,$26.21 ,$63.00 ,$63.00 ,$27.30 ,$56.70 ,$56.53 ,$38.87 ,$17.64 ,$56.70 ,$26.08 ,$56.70 ,$56.70 ,$26.08 ,$40.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000069,G0238,HC RESP THRP FUNCTION,410,1 ,$82.00 ,$53.30 ,$22.96 ,$82.00 ,$62.62 ,$61.09 ,$53.71 ,$26.08 ,$22.96 ,$41.41 ,$26.08 ,$50.59 ,$26.08 ,$50.59 ,$50.59 ,$26.08 ,$50.59 ,$49.55 ,$73.80 ,$61.50 ,$62.62 ,$26.08 ,$72.16 ,$26.08 ,$61.50 ,$61.50 ,$69.70 ,$69.70 ,$26.08 ,$69.70 ,$26.08 ,$63.96 ,$63.96 ,$63.96 ,$73.80 ,$62.62 ,$73.80 ,$26.08 ,$82.00 ,$53.71 ,$26.08 ,$34.11 ,$82.00 ,$82.00 ,$27.30 ,$73.80 ,$56.53 ,$50.59 ,$22.96 ,$73.80 ,$26.08 ,$73.80 ,$73.80 ,$26.08 ,$53.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$97.00 ,$63.05 ,$1.64 ,$97.00 ,$85.80 ,$72.27 ,$63.54 ,$35.74 ,$27.16 ,$48.99 ,$35.74 ,$59.85 ,$35.74 ,$59.85 ,$59.85 ,$35.74 ,$59.85 ,$67.91 ,$87.30 ,$72.75 ,$85.80 ,$35.74 ,$85.36 ,$35.74 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$35.74 ,$82.45 ,$35.74 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$85.80 ,$87.30 ,$35.74 ,$97.00 ,$63.54 ,$35.74 ,$40.35 ,$1.72 ,$1.64 ,$37.41 ,$87.30 ,$77.45 ,$59.85 ,$27.16 ,$87.30 ,$35.74 ,$87.30 ,$87.30 ,$35.74 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000077,94762,HC PULSE OX PER DAY,410,1 ,$240.00 ,$156.00 ,$51.98 ,$319.47 ,$240.00 ,$178.80 ,$157.20 ,$147.42 ,$67.20 ,$121.20 ,$147.42 ,$148.08 ,$147.42 ,$148.08 ,$148.08 ,$147.42 ,$148.08 ,$280.10 ,$216.00 ,$180.00 ,$240.00 ,$147.42 ,$211.20 ,$147.42 ,$180.00 ,$180.00 ,$204.00 ,$204.00 ,$147.42 ,$204.00 ,$147.42 ,$187.20 ,$187.20 ,$187.20 ,$216.00 ,$240.00 ,$216.00 ,$147.42 ,$240.00 ,$157.20 ,$147.42 ,$99.84 ,$54.45 ,$51.98 ,$154.30 ,$216.00 ,$319.47 ,$148.08 ,$67.20 ,$216.00 ,$147.42 ,$216.00 ,$216.00 ,$147.42 ,$156.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000082,94640,HC EZPAP TREATMENT SUBSQ,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000089,94660,HC CPAP NEONATAL/DAY SUBSQ,410,1 ,$212.00 ,$137.80 ,$59.36 ,$430.11 ,$212.00 ,$157.94 ,$138.86 ,$198.47 ,$59.36 ,$107.06 ,$198.47 ,$130.80 ,$198.47 ,$130.80 ,$130.80 ,$198.47 ,$130.80 ,$377.09 ,$190.80 ,$159.00 ,$212.00 ,$198.47 ,$186.56 ,$198.47 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$198.47 ,$180.20 ,$198.47 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$198.47 ,$212.00 ,$138.86 ,$198.47 ,$88.19 ,$212.00 ,$212.00 ,$207.74 ,$190.80 ,$430.11 ,$130.80 ,$59.36 ,$190.80 ,$198.47 ,$190.80 ,$190.80 ,$198.47 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41000092,94640,HC AEROSOL INHALATION SUBSQ,410,1 ,$81.00 ,$52.65 ,$22.68 ,$430.11 ,$81.00 ,$60.35 ,$53.06 ,$81.00 ,$22.68 ,$40.91 ,$81.00 ,$49.98 ,$81.00 ,$49.98 ,$49.98 ,$81.00 ,$49.98 ,$377.09 ,$72.90 ,$60.75 ,$81.00 ,$81.00 ,$71.28 ,$81.00 ,$60.75 ,$60.75 ,$68.85 ,$68.85 ,$81.00 ,$68.85 ,$81.00 ,$63.18 ,$63.18 ,$63.18 ,$72.90 ,$81.00 ,$72.90 ,$81.00 ,$81.00 ,$53.06 ,$81.00 ,$33.70 ,$81.00 ,$81.00 ,$81.00 ,$72.90 ,$430.11 ,$49.98 ,$22.68 ,$72.90 ,$81.00 ,$72.90 ,$72.90 ,$81.00 ,$52.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41300000,99183,HC HYPERBARIC O2 PER SESSION,413,1 ,"$2,334.00 ","$1,517.10 ",$653.52 ,"$2,334.00 ", N/A ,"$1,738.83 ","$1,528.77 ", N/A ,$653.52 ,"$1,178.67 ", N/A ,"$1,440.08 ", N/A ,"$1,440.08 ","$1,440.08 ", N/A ,"$1,440.08 ", N/A ,"$2,100.60 ","$1,750.50 ", N/A , N/A ,"$2,053.92 ", N/A ,"$1,750.50 ","$1,750.50 ","$1,983.90 ","$1,983.90 ", N/A ,"$1,983.90 ", N/A ,"$1,820.52 ","$1,820.52 ","$1,820.52 ","$2,100.60 ", N/A ,"$2,100.60 ", N/A ,"$2,334.00 ","$1,528.77 ", N/A ,$970.94 , N/A , N/A , N/A ,"$2,100.60 ", N/A ,"$1,440.08 ",$653.52 ,"$2,100.60 ", N/A ,"$2,100.60 ","$2,100.60 ", N/A ,"$1,517.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),41300002,G0277,HC HYPERBARIC O2 PER 30 MIN,413,1 ,$570.00 ,$370.50 ,$125.92 ,$570.00 ,$302.29 ,$424.65 ,$373.35 ,$125.92 ,$159.60 ,$287.85 ,$125.92 ,$351.69 ,$125.92 ,$351.69 ,$351.69 ,$125.92 ,$351.69 ,$239.25 ,$513.00 ,$427.50 ,$302.29 ,$125.92 ,$501.60 ,$125.92 ,$427.50 ,$427.50 ,$484.50 ,$484.50 ,$125.92 ,$484.50 ,$125.92 ,$444.60 ,$444.60 ,$444.60 ,$513.00 ,$302.29 ,$513.00 ,$125.92 ,$570.00 ,$373.35 ,$125.92 ,$237.12 ,$360.79 ,$344.39 ,$131.80 ,$513.00 ,$272.89 ,$351.69 ,$159.60 ,$513.00 ,$125.92 ,$513.00 ,$513.00 ,$125.92 ,$370.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000008,95992,HC CANNALITH REPOSITIONING,420,1 ,$103.00 ,$66.95 ,$28.84 ,$103.00 ,$103.00 ,$76.74 ,$67.47 ,$43.06 ,$28.84 ,$52.02 ,$43.06 ,$63.55 ,$43.06 ,$63.55 ,$63.55 ,$43.06 ,$63.55 ,$81.81 ,$92.70 ,$77.25 ,$103.00 ,$43.06 ,$90.64 ,$43.06 ,$77.25 ,$77.25 ,$87.55 ,$87.55 ,$43.06 ,$87.55 ,$43.06 ,$80.34 ,$80.34 ,$80.34 ,$92.70 ,$103.00 ,$92.70 ,$43.06 ,$103.00 ,$67.47 ,$43.06 ,$42.85 ,$103.00 ,$103.00 ,$45.21 ,$92.70 ,$96.89 ,$63.55 ,$28.84 ,$92.70 ,$43.06 ,$92.70 ,$92.70 ,$43.06 ,$66.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000016,97022,HC WHIRLPOOL 15 MINUTES,420,1 ,$156.00 ,$101.40 ,$16.71 ,$156.00 ,$41.78 ,$116.22 ,$102.18 ,$16.71 ,$43.68 ,$78.78 ,$16.71 ,$96.25 ,$16.71 ,$96.25 ,$96.25 ,$16.71 ,$96.25 ,$31.75 ,$140.40 ,$117.00 ,$41.78 ,$16.71 ,$137.28 ,$16.71 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$16.71 ,$132.60 ,$16.71 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$41.78 ,$140.40 ,$16.71 ,$156.00 ,$102.18 ,$16.71 ,$64.90 ,$20.11 ,$19.19 ,$17.55 ,$140.40 ,$37.60 ,$96.25 ,$43.68 ,$140.40 ,$16.71 ,$140.40 ,$140.40 ,$16.71 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000017,97022,HC WHIRLPOOL 30 MINUTES,420,1 ,$156.00 ,$101.40 ,$16.71 ,$156.00 ,$41.78 ,$116.22 ,$102.18 ,$16.71 ,$43.68 ,$78.78 ,$16.71 ,$96.25 ,$16.71 ,$96.25 ,$96.25 ,$16.71 ,$96.25 ,$31.75 ,$140.40 ,$117.00 ,$41.78 ,$16.71 ,$137.28 ,$16.71 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$16.71 ,$132.60 ,$16.71 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$41.78 ,$140.40 ,$16.71 ,$156.00 ,$102.18 ,$16.71 ,$64.90 ,$20.11 ,$19.19 ,$17.55 ,$140.40 ,$37.60 ,$96.25 ,$43.68 ,$140.40 ,$16.71 ,$140.40 ,$140.40 ,$16.71 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000018,97022,HC WHIRLPOOL 45 MINUTES,420,1 ,$156.00 ,$101.40 ,$16.71 ,$156.00 ,$41.78 ,$116.22 ,$102.18 ,$16.71 ,$43.68 ,$78.78 ,$16.71 ,$96.25 ,$16.71 ,$96.25 ,$96.25 ,$16.71 ,$96.25 ,$31.75 ,$140.40 ,$117.00 ,$41.78 ,$16.71 ,$137.28 ,$16.71 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$16.71 ,$132.60 ,$16.71 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$41.78 ,$140.40 ,$16.71 ,$156.00 ,$102.18 ,$16.71 ,$64.90 ,$20.11 ,$19.19 ,$17.55 ,$140.40 ,$37.60 ,$96.25 ,$43.68 ,$140.40 ,$16.71 ,$140.40 ,$140.40 ,$16.71 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000019,97022,HC WHIRLPOOL 60 MINUTES,420,1 ,$156.00 ,$101.40 ,$16.71 ,$156.00 ,$41.78 ,$116.22 ,$102.18 ,$16.71 ,$43.68 ,$78.78 ,$16.71 ,$96.25 ,$16.71 ,$96.25 ,$96.25 ,$16.71 ,$96.25 ,$31.75 ,$140.40 ,$117.00 ,$41.78 ,$16.71 ,$137.28 ,$16.71 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$16.71 ,$132.60 ,$16.71 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$41.78 ,$140.40 ,$16.71 ,$156.00 ,$102.18 ,$16.71 ,$64.90 ,$20.11 ,$19.19 ,$17.55 ,$140.40 ,$37.60 ,$96.25 ,$43.68 ,$140.40 ,$16.71 ,$140.40 ,$140.40 ,$16.71 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$113.00 ,$73.45 ,$14.43 ,$113.00 ,$36.08 ,$84.19 ,$74.02 ,$14.43 ,$31.64 ,$57.07 ,$14.43 ,$69.72 ,$14.43 ,$69.72 ,$69.72 ,$14.43 ,$69.72 ,$27.42 ,$101.70 ,$84.75 ,$36.08 ,$14.43 ,$99.44 ,$14.43 ,$84.75 ,$84.75 ,$96.05 ,$96.05 ,$14.43 ,$96.05 ,$14.43 ,$88.14 ,$88.14 ,$88.14 ,$101.70 ,$36.08 ,$101.70 ,$14.43 ,$113.00 ,$74.02 ,$14.43 ,$47.01 ,$113.00 ,$113.00 ,$15.15 ,$101.70 ,$32.47 ,$69.72 ,$31.64 ,$101.70 ,$14.43 ,$101.70 ,$101.70 ,$14.43 ,$73.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$182.00 ,$118.30 ,$19.19 ,$182.00 ,$47.98 ,$135.59 ,$119.21 ,$19.19 ,$50.96 ,$91.91 ,$19.19 ,$112.29 ,$19.19 ,$112.29 ,$112.29 ,$19.19 ,$112.29 ,$36.46 ,$163.80 ,$136.50 ,$47.98 ,$19.19 ,$160.16 ,$19.19 ,$136.50 ,$136.50 ,$154.70 ,$154.70 ,$19.19 ,$154.70 ,$19.19 ,$141.96 ,$141.96 ,$141.96 ,$163.80 ,$47.98 ,$163.80 ,$19.19 ,$182.00 ,$119.21 ,$19.19 ,$75.71 ,$182.00 ,$182.00 ,$20.15 ,$163.80 ,$43.18 ,$112.29 ,$50.96 ,$163.80 ,$19.19 ,$163.80 ,$163.80 ,$19.19 ,$118.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$156.00 ,$101.40 ,$13.99 ,$156.00 ,$34.98 ,$116.22 ,$102.18 ,$13.99 ,$43.68 ,$78.78 ,$13.99 ,$96.25 ,$13.99 ,$96.25 ,$96.25 ,$13.99 ,$96.25 ,$26.58 ,$140.40 ,$117.00 ,$34.98 ,$13.99 ,$137.28 ,$13.99 ,$117.00 ,$117.00 ,$132.60 ,$132.60 ,$13.99 ,$132.60 ,$13.99 ,$121.68 ,$121.68 ,$121.68 ,$140.40 ,$34.98 ,$140.40 ,$13.99 ,$156.00 ,$102.18 ,$13.99 ,$64.90 ,$156.00 ,$156.00 ,$14.69 ,$140.40 ,$31.48 ,$96.25 ,$43.68 ,$140.40 ,$13.99 ,$140.40 ,$140.40 ,$13.99 ,$101.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$72.00 ,$46.80 ,$20.16 ,$72.00 ,$72.00 ,$53.64 ,$47.16 ,$29.02 ,$20.16 ,$36.36 ,$29.02 ,$44.42 ,$29.02 ,$44.42 ,$44.42 ,$29.02 ,$44.42 ,$55.14 ,$64.80 ,$54.00 ,$72.00 ,$29.02 ,$63.36 ,$29.02 ,$54.00 ,$54.00 ,$61.20 ,$61.20 ,$29.02 ,$61.20 ,$29.02 ,$56.16 ,$56.16 ,$56.16 ,$64.80 ,$72.00 ,$64.80 ,$29.02 ,$72.00 ,$47.16 ,$29.02 ,$29.95 ,$72.00 ,$72.00 ,$30.47 ,$64.80 ,$65.30 ,$44.42 ,$20.16 ,$64.80 ,$29.02 ,$64.80 ,$64.80 ,$29.02 ,$46.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$150.00 ,$97.50 ,$33.59 ,$150.00 ,$83.98 ,$111.75 ,$98.25 ,$33.59 ,$42.00 ,$75.75 ,$33.59 ,$92.55 ,$33.59 ,$92.55 ,$92.55 ,$33.59 ,$92.55 ,$63.82 ,$135.00 ,$112.50 ,$83.98 ,$33.59 ,$132.00 ,$33.59 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$33.59 ,$127.50 ,$33.59 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$83.98 ,$135.00 ,$33.59 ,$150.00 ,$98.25 ,$33.59 ,$62.40 ,$150.00 ,$150.00 ,$35.27 ,$135.00 ,$75.58 ,$92.55 ,$42.00 ,$135.00 ,$33.59 ,$135.00 ,$135.00 ,$33.59 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$89.00 ,$57.85 ,$24.92 ,$89.00 ,$72.55 ,$66.31 ,$58.30 ,$29.02 ,$24.92 ,$44.95 ,$29.02 ,$54.91 ,$29.02 ,$54.91 ,$54.91 ,$29.02 ,$54.91 ,$55.14 ,$80.10 ,$66.75 ,$72.55 ,$29.02 ,$78.32 ,$29.02 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$29.02 ,$75.65 ,$29.02 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$72.55 ,$80.10 ,$29.02 ,$89.00 ,$58.30 ,$29.02 ,$37.02 ,$89.00 ,$89.00 ,$30.47 ,$80.10 ,$65.30 ,$54.91 ,$24.92 ,$80.10 ,$29.02 ,$80.10 ,$80.10 ,$29.02 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$114.00 ,$74.10 ,$28.93 ,$114.00 ,$72.33 ,$84.93 ,$74.67 ,$28.93 ,$31.92 ,$57.57 ,$28.93 ,$70.34 ,$28.93 ,$70.34 ,$70.34 ,$28.93 ,$70.34 ,$54.97 ,$102.60 ,$85.50 ,$72.33 ,$28.93 ,$100.32 ,$28.93 ,$85.50 ,$85.50 ,$96.90 ,$96.90 ,$28.93 ,$96.90 ,$28.93 ,$88.92 ,$88.92 ,$88.92 ,$102.60 ,$72.33 ,$102.60 ,$28.93 ,$114.00 ,$74.67 ,$28.93 ,$47.42 ,$114.00 ,$114.00 ,$30.38 ,$102.60 ,$65.09 ,$70.34 ,$31.92 ,$102.60 ,$28.93 ,$102.60 ,$102.60 ,$28.93 ,$74.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$152.00 ,$98.80 ,$26.75 ,$152.00 ,$66.88 ,$113.24 ,$99.56 ,$26.75 ,$42.56 ,$76.76 ,$26.75 ,$93.78 ,$26.75 ,$93.78 ,$93.78 ,$26.75 ,$93.78 ,$50.83 ,$136.80 ,$114.00 ,$66.88 ,$26.75 ,$133.76 ,$26.75 ,$114.00 ,$114.00 ,$129.20 ,$129.20 ,$26.75 ,$129.20 ,$26.75 ,$118.56 ,$118.56 ,$118.56 ,$136.80 ,$66.88 ,$136.80 ,$26.75 ,$152.00 ,$99.56 ,$26.75 ,$63.23 ,$152.00 ,$152.00 ,$28.09 ,$136.80 ,$60.19 ,$93.78 ,$42.56 ,$136.80 ,$26.75 ,$136.80 ,$136.80 ,$26.75 ,$98.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$256.00 ,$166.40 ,$36.24 ,$256.00 ,$90.60 ,$190.72 ,$167.68 ,$36.24 ,$71.68 ,$129.28 ,$36.24 ,$157.95 ,$36.24 ,$157.95 ,$157.95 ,$36.24 ,$157.95 ,$68.86 ,$230.40 ,$192.00 ,$90.60 ,$36.24 ,$225.28 ,$36.24 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$36.24 ,$217.60 ,$36.24 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$90.60 ,$230.40 ,$36.24 ,$256.00 ,$167.68 ,$36.24 ,$106.50 ,$246.07 ,$234.89 ,$38.05 ,$230.40 ,$81.54 ,$157.95 ,$71.68 ,$230.40 ,$36.24 ,$230.40 ,$230.40 ,$36.24 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000083,97598,HC DEBR SKIN PART THICKNESS EA ADDN>20CM FACIL,420,1 ,$523.00 ,$339.95 ,$83.00 ,$523.00 , N/A ,$389.64 ,$342.57 , N/A ,$146.44 ,$264.12 , N/A ,$322.69 , N/A ,$322.69 ,$322.69 , N/A ,$322.69 , N/A ,$470.70 ,$392.25 , N/A , N/A ,$460.24 , N/A ,$392.25 ,$392.25 ,$444.55 ,$444.55 , N/A ,$444.55 , N/A ,$407.94 ,$407.94 ,$407.94 ,$470.70 , N/A ,$470.70 , N/A ,$523.00 ,$342.57 , N/A ,$217.57 ,$86.96 ,$83.00 , N/A ,$470.70 , N/A ,$322.69 ,$146.44 ,$470.70 , N/A ,$470.70 ,$470.70 , N/A ,$339.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$517.00 ,$336.05 ,$144.76 ,$517.00 , N/A ,$385.17 ,$338.64 , N/A ,$144.76 ,$261.09 , N/A ,$318.99 , N/A ,$318.99 ,$318.99 , N/A ,$318.99 , N/A ,$465.30 ,$387.75 , N/A , N/A ,$454.96 , N/A ,$387.75 ,$387.75 ,$439.45 ,$439.45 , N/A ,$439.45 , N/A ,$403.26 ,$403.26 ,$403.26 ,$465.30 , N/A ,$465.30 , N/A ,$517.00 ,$338.64 , N/A ,$215.07 ,$209.46 ,$199.94 , N/A ,$465.30 , N/A ,$318.99 ,$144.76 ,$465.30 , N/A ,$465.30 ,$465.30 , N/A ,$336.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000085,97605,HC NWPT <50 SQ CM FAC,420,1 ,$346.00 ,$224.90 ,$41.31 ,$346.00 ,$103.28 ,$257.77 ,$226.63 ,$41.31 ,$96.88 ,$174.73 ,$41.31 ,$213.48 ,$41.31 ,$213.48 ,$213.48 ,$41.31 ,$213.48 ,$78.49 ,$311.40 ,$259.50 ,$103.28 ,$41.31 ,$304.48 ,$41.31 ,$259.50 ,$259.50 ,$294.10 ,$294.10 ,$41.31 ,$294.10 ,$41.31 ,$269.88 ,$269.88 ,$269.88 ,$311.40 ,$103.28 ,$311.40 ,$41.31 ,$346.00 ,$226.63 ,$41.31 ,$143.94 ,$209.46 ,$199.94 ,$43.38 ,$311.40 ,$92.95 ,$213.48 ,$96.88 ,$311.40 ,$41.31 ,$311.40 ,$311.40 ,$41.31 ,$224.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000089,97606,HC NWPT >50 SQ CM FAC,420,1 ,$552.00 ,$358.80 ,$48.72 ,$552.00 ,$121.80 ,$411.24 ,$361.56 ,$48.72 ,$154.56 ,$278.76 ,$48.72 ,$340.58 ,$48.72 ,$340.58 ,$340.58 ,$48.72 ,$340.58 ,$92.57 ,$496.80 ,$414.00 ,$121.80 ,$48.72 ,$485.76 ,$48.72 ,$414.00 ,$414.00 ,$469.20 ,$469.20 ,$48.72 ,$469.20 ,$48.72 ,$430.56 ,$430.56 ,$430.56 ,$496.80 ,$121.80 ,$496.80 ,$48.72 ,$552.00 ,$361.56 ,$48.72 ,$229.63 ,$209.46 ,$199.94 ,$51.16 ,$496.80 ,$109.62 ,$340.58 ,$154.56 ,$496.80 ,$48.72 ,$496.80 ,$496.80 ,$48.72 ,$358.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$128.00 ,$83.20 ,$32.80 ,$128.00 ,$82.00 ,$95.36 ,$83.84 ,$32.80 ,$35.84 ,$64.64 ,$32.80 ,$78.98 ,$32.80 ,$78.98 ,$78.98 ,$32.80 ,$78.98 ,$62.32 ,$115.20 ,$96.00 ,$82.00 ,$32.80 ,$112.64 ,$32.80 ,$96.00 ,$96.00 ,$108.80 ,$108.80 ,$32.80 ,$108.80 ,$32.80 ,$99.84 ,$99.84 ,$99.84 ,$115.20 ,$82.00 ,$115.20 ,$32.80 ,$128.00 ,$83.84 ,$32.80 ,$53.25 ,$128.00 ,$128.00 ,$34.44 ,$115.20 ,$73.80 ,$78.98 ,$35.84 ,$115.20 ,$32.80 ,$115.20 ,$115.20 ,$32.80 ,$83.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000095,97763,HC ORTHTC/PRSTHTC CHECK EA 15MIN,420,1 ,$99.00 ,$64.35 ,$27.72 ,$117.34 ,$99.00 ,$73.76 ,$64.85 ,$52.15 ,$27.72 ,$50.00 ,$52.15 ,$61.08 ,$52.15 ,$61.08 ,$61.08 ,$52.15 ,$61.08 ,$99.09 ,$89.10 ,$74.25 ,$99.00 ,$52.15 ,$87.12 ,$52.15 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$52.15 ,$84.15 ,$52.15 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$99.00 ,$89.10 ,$52.15 ,$99.00 ,$64.85 ,$52.15 ,$41.18 ,$99.00 ,$99.00 ,$54.76 ,$89.10 ,$117.34 ,$61.08 ,$27.72 ,$89.10 ,$52.15 ,$89.10 ,$89.10 ,$52.15 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000110,G0283,HC ELECT STIM(UNATTEND) OTHER,420,1 ,$64.00 ,$41.60 ,$12.00 ,$64.00 ,$30.00 ,$47.68 ,$41.92 ,$12.00 ,$17.92 ,$32.32 ,$12.00 ,$39.49 ,$12.00 ,$39.49 ,$39.49 ,$12.00 ,$39.49 ,$22.80 ,$57.60 ,$48.00 ,$30.00 ,$12.00 ,$56.32 ,$12.00 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$12.00 ,$54.40 ,$12.00 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$30.00 ,$57.60 ,$12.00 ,$64.00 ,$41.92 ,$12.00 ,$26.62 ,$20.11 ,$19.19 ,$12.60 ,$57.60 ,$27.00 ,$39.49 ,$17.92 ,$57.60 ,$12.00 ,$57.60 ,$57.60 ,$12.00 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000160,97113,HC THERAPEUTIC ACT W/AQUA,420,1 ,$221.00 ,$143.65 ,$36.05 ,$221.00 ,$90.13 ,$164.65 ,$144.76 ,$36.05 ,$61.88 ,$111.61 ,$36.05 ,$136.36 ,$36.05 ,$136.36 ,$136.36 ,$36.05 ,$136.36 ,$68.50 ,$198.90 ,$165.75 ,$90.13 ,$36.05 ,$194.48 ,$36.05 ,$165.75 ,$165.75 ,$187.85 ,$187.85 ,$36.05 ,$187.85 ,$36.05 ,$172.38 ,$172.38 ,$172.38 ,$198.90 ,$90.13 ,$198.90 ,$36.05 ,$221.00 ,$144.76 ,$36.05 ,$91.94 ,$221.00 ,$221.00 ,$37.85 ,$198.90 ,$81.11 ,$136.36 ,$61.88 ,$198.90 ,$36.05 ,$198.90 ,$198.90 ,$36.05 ,$143.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000206,G0283,HC ELECT STIM (UNATTEND) OTHER 15MIN,420,1 ,$64.00 ,$41.60 ,$12.00 ,$64.00 ,$30.00 ,$47.68 ,$41.92 ,$12.00 ,$17.92 ,$32.32 ,$12.00 ,$39.49 ,$12.00 ,$39.49 ,$39.49 ,$12.00 ,$39.49 ,$22.80 ,$57.60 ,$48.00 ,$30.00 ,$12.00 ,$56.32 ,$12.00 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$12.00 ,$54.40 ,$12.00 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$30.00 ,$57.60 ,$12.00 ,$64.00 ,$41.92 ,$12.00 ,$26.62 ,$20.11 ,$19.19 ,$12.60 ,$57.60 ,$27.00 ,$39.49 ,$17.92 ,$57.60 ,$12.00 ,$57.60 ,$57.60 ,$12.00 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000207,G0283,HC ELECT STIM (UNATTEND) OTHER 30MIN,420,1 ,$64.00 ,$41.60 ,$12.00 ,$64.00 ,$30.00 ,$47.68 ,$41.92 ,$12.00 ,$17.92 ,$32.32 ,$12.00 ,$39.49 ,$12.00 ,$39.49 ,$39.49 ,$12.00 ,$39.49 ,$22.80 ,$57.60 ,$48.00 ,$30.00 ,$12.00 ,$56.32 ,$12.00 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$12.00 ,$54.40 ,$12.00 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$30.00 ,$57.60 ,$12.00 ,$64.00 ,$41.92 ,$12.00 ,$26.62 ,$20.11 ,$19.19 ,$12.60 ,$57.60 ,$27.00 ,$39.49 ,$17.92 ,$57.60 ,$12.00 ,$57.60 ,$57.60 ,$12.00 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000208,G0283,HC ELECT STIM (UNATTEND) OTHER 45MIN,420,1 ,$64.00 ,$41.60 ,$12.00 ,$64.00 ,$30.00 ,$47.68 ,$41.92 ,$12.00 ,$17.92 ,$32.32 ,$12.00 ,$39.49 ,$12.00 ,$39.49 ,$39.49 ,$12.00 ,$39.49 ,$22.80 ,$57.60 ,$48.00 ,$30.00 ,$12.00 ,$56.32 ,$12.00 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$12.00 ,$54.40 ,$12.00 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$30.00 ,$57.60 ,$12.00 ,$64.00 ,$41.92 ,$12.00 ,$26.62 ,$20.11 ,$19.19 ,$12.60 ,$57.60 ,$27.00 ,$39.49 ,$17.92 ,$57.60 ,$12.00 ,$57.60 ,$57.60 ,$12.00 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000209,G0283,HC ELECT STIM (UNATTEND) OTHER 60MIN,420,1 ,$64.00 ,$41.60 ,$12.00 ,$64.00 ,$30.00 ,$47.68 ,$41.92 ,$12.00 ,$17.92 ,$32.32 ,$12.00 ,$39.49 ,$12.00 ,$39.49 ,$39.49 ,$12.00 ,$39.49 ,$22.80 ,$57.60 ,$48.00 ,$30.00 ,$12.00 ,$56.32 ,$12.00 ,$48.00 ,$48.00 ,$54.40 ,$54.40 ,$12.00 ,$54.40 ,$12.00 ,$49.92 ,$49.92 ,$49.92 ,$57.60 ,$30.00 ,$57.60 ,$12.00 ,$64.00 ,$41.92 ,$12.00 ,$26.62 ,$20.11 ,$19.19 ,$12.60 ,$57.60 ,$27.00 ,$39.49 ,$17.92 ,$57.60 ,$12.00 ,$57.60 ,$57.60 ,$12.00 ,$41.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000210,97016,HC APPLY VASOPNEUMATIC DEVICE 15MIN,420,1 ,$335.00 ,$217.75 ,$11.69 ,$335.00 ,$29.23 ,$249.58 ,$219.43 ,$11.69 ,$93.80 ,$169.18 ,$11.69 ,$206.70 ,$11.69 ,$206.70 ,$206.70 ,$11.69 ,$206.70 ,$22.21 ,$301.50 ,$251.25 ,$29.23 ,$11.69 ,$294.80 ,$11.69 ,$251.25 ,$251.25 ,$284.75 ,$284.75 ,$11.69 ,$284.75 ,$11.69 ,$261.30 ,$261.30 ,$261.30 ,$301.50 ,$29.23 ,$301.50 ,$11.69 ,$335.00 ,$219.43 ,$11.69 ,$139.36 ,$20.11 ,$19.19 ,$12.27 ,$301.50 ,$26.30 ,$206.70 ,$93.80 ,$301.50 ,$11.69 ,$301.50 ,$301.50 ,$11.69 ,$217.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000211,97016,HC APPLY VASOPNEUMATIC DEVICE 30MIN,420,1 ,$335.00 ,$217.75 ,$11.69 ,$335.00 ,$29.23 ,$249.58 ,$219.43 ,$11.69 ,$93.80 ,$169.18 ,$11.69 ,$206.70 ,$11.69 ,$206.70 ,$206.70 ,$11.69 ,$206.70 ,$22.21 ,$301.50 ,$251.25 ,$29.23 ,$11.69 ,$294.80 ,$11.69 ,$251.25 ,$251.25 ,$284.75 ,$284.75 ,$11.69 ,$284.75 ,$11.69 ,$261.30 ,$261.30 ,$261.30 ,$301.50 ,$29.23 ,$301.50 ,$11.69 ,$335.00 ,$219.43 ,$11.69 ,$139.36 ,$20.11 ,$19.19 ,$12.27 ,$301.50 ,$26.30 ,$206.70 ,$93.80 ,$301.50 ,$11.69 ,$301.50 ,$301.50 ,$11.69 ,$217.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000214,97012,HC TRACTION MECHANICAL APPL 15 MIN,420,1 ,$150.00 ,$97.50 ,$14.11 ,$150.00 ,$35.28 ,$111.75 ,$98.25 ,$14.11 ,$42.00 ,$75.75 ,$14.11 ,$92.55 ,$14.11 ,$92.55 ,$92.55 ,$14.11 ,$92.55 ,$26.81 ,$135.00 ,$112.50 ,$35.28 ,$14.11 ,$132.00 ,$14.11 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$14.11 ,$127.50 ,$14.11 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$35.28 ,$135.00 ,$14.11 ,$150.00 ,$98.25 ,$14.11 ,$62.40 ,$20.11 ,$19.19 ,$14.82 ,$135.00 ,$31.75 ,$92.55 ,$42.00 ,$135.00 ,$14.11 ,$135.00 ,$135.00 ,$14.11 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000215,97012,HC TRACTION MECHANICAL APPL 30 MIN,420,1 ,$150.00 ,$97.50 ,$14.11 ,$150.00 ,$35.28 ,$111.75 ,$98.25 ,$14.11 ,$42.00 ,$75.75 ,$14.11 ,$92.55 ,$14.11 ,$92.55 ,$92.55 ,$14.11 ,$92.55 ,$26.81 ,$135.00 ,$112.50 ,$35.28 ,$14.11 ,$132.00 ,$14.11 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$14.11 ,$127.50 ,$14.11 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$35.28 ,$135.00 ,$14.11 ,$150.00 ,$98.25 ,$14.11 ,$62.40 ,$20.11 ,$19.19 ,$14.82 ,$135.00 ,$31.75 ,$92.55 ,$42.00 ,$135.00 ,$14.11 ,$135.00 ,$135.00 ,$14.11 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000241,97110,HC EARLY INTER THERA PROC TX OFFSITE- 15MIN,420,1 ,$72.00 ,$46.80 ,$20.16 ,$72.00 ,$72.00 ,$53.64 ,$47.16 ,$29.02 ,$20.16 ,$36.36 ,$29.02 ,$44.42 ,$29.02 ,$44.42 ,$44.42 ,$29.02 ,$44.42 ,$55.14 ,$64.80 ,$54.00 ,$72.00 ,$29.02 ,$63.36 ,$29.02 ,$54.00 ,$54.00 ,$61.20 ,$61.20 ,$29.02 ,$61.20 ,$29.02 ,$56.16 ,$56.16 ,$56.16 ,$64.80 ,$72.00 ,$64.80 ,$29.02 ,$72.00 ,$47.16 ,$29.02 ,$29.95 ,$72.00 ,$72.00 ,$30.47 ,$64.80 ,$65.30 ,$44.42 ,$20.16 ,$64.80 ,$29.02 ,$64.80 ,$64.80 ,$29.02 ,$46.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000250,N/A,HC MASSAGE THERAPY ASTYM EXTREMITY UNILAT 30 MIN,420,1 ,$48.00 ,$31.20 ,$13.44 ,$48.00 , N/A ,$35.76 ,$31.44 , N/A ,$13.44 ,$24.24 , N/A ,$29.62 , N/A ,$29.62 ,$29.62 , N/A ,$29.62 , N/A ,$43.20 ,$36.00 , N/A , N/A ,$42.24 , N/A ,$36.00 ,$36.00 ,$40.80 ,$40.80 , N/A ,$40.80 , N/A ,$37.44 ,$37.44 ,$37.44 ,$43.20 , N/A ,$43.20 , N/A ,$48.00 ,$31.44 , N/A ,$19.97 , N/A , N/A , N/A ,$43.20 , N/A ,$29.62 ,$13.44 ,$43.20 , N/A ,$43.20 ,$43.20 , N/A ,$31.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000251,N/A,HC MASSAGE THERAPY ASTYM EXTREMITY BILAT 45 MIN,420,1 ,$83.00 ,$53.95 ,$23.24 ,$83.00 , N/A ,$61.84 ,$54.37 , N/A ,$23.24 ,$41.92 , N/A ,$51.21 , N/A ,$51.21 ,$51.21 , N/A ,$51.21 , N/A ,$74.70 ,$62.25 , N/A , N/A ,$73.04 , N/A ,$62.25 ,$62.25 ,$70.55 ,$70.55 , N/A ,$70.55 , N/A ,$64.74 ,$64.74 ,$64.74 ,$74.70 , N/A ,$74.70 , N/A ,$83.00 ,$54.37 , N/A ,$34.53 , N/A , N/A , N/A ,$74.70 , N/A ,$51.21 ,$23.24 ,$74.70 , N/A ,$74.70 ,$74.70 , N/A ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000252,N/A,HC MASSAGE THERAPY ASTYM LOWER EXTR BILAT W/BACK,420,1 ,$83.00 ,$53.95 ,$23.24 ,$83.00 , N/A ,$61.84 ,$54.37 , N/A ,$23.24 ,$41.92 , N/A ,$51.21 , N/A ,$51.21 ,$51.21 , N/A ,$51.21 , N/A ,$74.70 ,$62.25 , N/A , N/A ,$73.04 , N/A ,$62.25 ,$62.25 ,$70.55 ,$70.55 , N/A ,$70.55 , N/A ,$64.74 ,$64.74 ,$64.74 ,$74.70 , N/A ,$74.70 , N/A ,$83.00 ,$54.37 , N/A ,$34.53 , N/A , N/A , N/A ,$74.70 , N/A ,$51.21 ,$23.24 ,$74.70 , N/A ,$74.70 ,$74.70 , N/A ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000253,N/A,HC MASSAGE THERAPY ASTYM LOWER EXTR BILAT W/BACK/ABDOMEN,420,1 ,$95.00 ,$61.75 ,$26.60 ,$95.00 , N/A ,$70.78 ,$62.23 , N/A ,$26.60 ,$47.98 , N/A ,$58.62 , N/A ,$58.62 ,$58.62 , N/A ,$58.62 , N/A ,$85.50 ,$71.25 , N/A , N/A ,$83.60 , N/A ,$71.25 ,$71.25 ,$80.75 ,$80.75 , N/A ,$80.75 , N/A ,$74.10 ,$74.10 ,$74.10 ,$85.50 , N/A ,$85.50 , N/A ,$95.00 ,$62.23 , N/A ,$39.52 , N/A , N/A , N/A ,$85.50 , N/A ,$58.62 ,$26.60 ,$85.50 , N/A ,$85.50 ,$85.50 , N/A ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000254,N/A,HC MASSAGE THERAPY ASTYM BACK/ABDOMEN,420,1 ,$119.00 ,$77.35 ,$33.32 ,$119.00 , N/A ,$88.66 ,$77.95 , N/A ,$33.32 ,$60.10 , N/A ,$73.42 , N/A ,$73.42 ,$73.42 , N/A ,$73.42 , N/A ,$107.10 ,$89.25 , N/A , N/A ,$104.72 , N/A ,$89.25 ,$89.25 ,$101.15 ,$101.15 , N/A ,$101.15 , N/A ,$92.82 ,$92.82 ,$92.82 ,$107.10 , N/A ,$107.10 , N/A ,$119.00 ,$77.95 , N/A ,$49.50 , N/A , N/A , N/A ,$107.10 , N/A ,$73.42 ,$33.32 ,$107.10 , N/A ,$107.10 ,$107.10 , N/A ,$77.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000255,N/A,HC MASSAGE THERAPY ASTYM PER HOUR,420,1 ,$95.00 ,$61.75 ,$26.60 ,$95.00 , N/A ,$70.78 ,$62.23 , N/A ,$26.60 ,$47.98 , N/A ,$58.62 , N/A ,$58.62 ,$58.62 , N/A ,$58.62 , N/A ,$85.50 ,$71.25 , N/A , N/A ,$83.60 , N/A ,$71.25 ,$71.25 ,$80.75 ,$80.75 , N/A ,$80.75 , N/A ,$74.10 ,$74.10 ,$74.10 ,$85.50 , N/A ,$85.50 , N/A ,$95.00 ,$62.23 , N/A ,$39.52 , N/A , N/A , N/A ,$85.50 , N/A ,$58.62 ,$26.60 ,$85.50 , N/A ,$85.50 ,$85.50 , N/A ,$61.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42000256,N/A,HC EVAL BODY MOTION ANALYSIS DARTFISH,420,1 ,$143.00 ,$92.95 ,$40.04 ,$143.00 , N/A ,$106.54 ,$93.67 , N/A ,$40.04 ,$72.22 , N/A ,$88.23 , N/A ,$88.23 ,$88.23 , N/A ,$88.23 , N/A ,$128.70 ,$107.25 , N/A , N/A ,$125.84 , N/A ,$107.25 ,$107.25 ,$121.55 ,$121.55 , N/A ,$121.55 , N/A ,$111.54 ,$111.54 ,$111.54 ,$128.70 , N/A ,$128.70 , N/A ,$143.00 ,$93.67 , N/A ,$59.49 , N/A , N/A , N/A ,$128.70 , N/A ,$88.23 ,$40.04 ,$128.70 , N/A ,$128.70 ,$128.70 , N/A ,$92.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400047,97161,HC PT EVAL LOW COMPLEXITY 75MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400048,97161,HC PT EVAL LOW COMPLEXITY 90MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400049,97161,HC PT EVAL LOW COMPLEXITY 105MIN,424,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 ,$246.07 ,$234.89 ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400059,97162,HC PT EVAL MOD COMPLEXITY 75MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400060,97162,HC PT EVAL MOD COMPLEXITY 90MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400061,97162,HC PT EVAL MOD COMPLEXITY 105MIN,424,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 ,$246.07 ,$234.89 ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400070,97163,HC PT EVAL HIGH COMPLEXITY 60MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400071,97163,HC PT EVAL HIGH COMPLEXITY 75MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400072,97163,HC PT EVAL HIGH COMPLEXITY 90MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400073,97163,HC PT EVAL HIGH COMPLEXITY 105MIN,424,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 ,$246.07 ,$234.89 ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400083,97164,HC PT RE-EVAL 75MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400084,97164,HC PT RE-EVAL 90MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),42400085,97164,HC PT RE-EVAL 105MIN,424,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 ,$246.00 ,$234.89 ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000013,97034,HC CONTRAST BATH EA 15 MIN,430,1 ,$89.00 ,$57.85 ,$14.30 ,$89.00 ,$35.75 ,$66.31 ,$58.30 ,$14.30 ,$24.92 ,$44.95 ,$14.30 ,$54.91 ,$14.30 ,$54.91 ,$54.91 ,$14.30 ,$54.91 ,$27.17 ,$80.10 ,$66.75 ,$35.75 ,$14.30 ,$78.32 ,$14.30 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$14.30 ,$75.65 ,$14.30 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$35.75 ,$80.10 ,$14.30 ,$89.00 ,$58.30 ,$14.30 ,$37.02 ,$89.00 ,$89.00 ,$15.02 ,$80.10 ,$32.18 ,$54.91 ,$24.92 ,$80.10 ,$14.30 ,$80.10 ,$80.10 ,$14.30 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000015,97533,HC PERCEPTUAL ACTIVITY EA 15 MIN,430,1 ,$108.00 ,$70.20 ,$30.24 ,$139.34 ,$108.00 ,$80.46 ,$70.74 ,$61.93 ,$30.24 ,$54.54 ,$61.93 ,$66.64 ,$61.93 ,$66.64 ,$66.64 ,$61.93 ,$66.64 ,$117.67 ,$97.20 ,$81.00 ,$108.00 ,$61.93 ,$95.04 ,$61.93 ,$81.00 ,$81.00 ,$91.80 ,$91.80 ,$61.93 ,$91.80 ,$61.93 ,$84.24 ,$84.24 ,$84.24 ,$97.20 ,$108.00 ,$97.20 ,$61.93 ,$108.00 ,$70.74 ,$61.93 ,$44.93 ,$108.00 ,$108.00 ,$65.03 ,$97.20 ,$139.34 ,$66.64 ,$30.24 ,$97.20 ,$61.93 ,$97.20 ,$97.20 ,$61.93 ,$70.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$97.00 ,$63.05 ,$27.16 ,$97.00 ,$80.43 ,$72.27 ,$63.54 ,$32.17 ,$27.16 ,$48.99 ,$32.17 ,$59.85 ,$32.17 ,$59.85 ,$59.85 ,$32.17 ,$59.85 ,$61.12 ,$87.30 ,$72.75 ,$80.43 ,$32.17 ,$85.36 ,$32.17 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$32.17 ,$82.45 ,$32.17 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$80.43 ,$87.30 ,$32.17 ,$97.00 ,$63.54 ,$32.17 ,$40.35 ,$97.00 ,$97.00 ,$33.78 ,$87.30 ,$72.38 ,$59.85 ,$27.16 ,$87.30 ,$32.17 ,$87.30 ,$87.30 ,$32.17 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$118.00 ,$76.70 ,$33.04 ,$118.00 ,$117.90 ,$87.91 ,$77.29 ,$47.16 ,$33.04 ,$59.59 ,$47.16 ,$72.81 ,$47.16 ,$72.81 ,$72.81 ,$47.16 ,$72.81 ,$89.60 ,$106.20 ,$88.50 ,$117.90 ,$47.16 ,$103.84 ,$47.16 ,$88.50 ,$88.50 ,$100.30 ,$100.30 ,$47.16 ,$100.30 ,$47.16 ,$92.04 ,$92.04 ,$92.04 ,$106.20 ,$117.90 ,$106.20 ,$47.16 ,$118.00 ,$77.29 ,$47.16 ,$49.09 ,$118.00 ,$118.00 ,$49.52 ,$106.20 ,$106.11 ,$72.81 ,$33.04 ,$106.20 ,$47.16 ,$106.20 ,$106.20 ,$47.16 ,$76.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000035,97545,HC WORK HARDENING/CONDITIONING FIRST 2 HRS,430,1 ,$816.00 ,$530.40 ,$228.48 ,$816.00 , N/A ,$607.92 ,$534.48 , N/A ,$228.48 ,$412.08 , N/A ,$503.47 , N/A ,$503.47 ,$503.47 , N/A ,$503.47 , N/A ,$734.40 ,$612.00 , N/A , N/A ,$718.08 , N/A ,$612.00 ,$612.00 ,$693.60 ,$693.60 , N/A ,$693.60 , N/A ,$636.48 ,$636.48 ,$636.48 ,$734.40 , N/A ,$734.40 , N/A ,$816.00 ,$534.48 , N/A ,$339.46 ,$246.07 ,$234.89 , N/A ,$734.40 , N/A ,$503.47 ,$228.48 ,$734.40 , N/A ,$734.40 ,$734.40 , N/A ,$530.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$99.00 ,$64.35 ,$5.64 ,$99.00 ,$14.10 ,$73.76 ,$64.85 ,$5.64 ,$27.72 ,$50.00 ,$5.64 ,$61.08 ,$5.64 ,$61.08 ,$61.08 ,$5.64 ,$61.08 ,$10.72 ,$89.10 ,$74.25 ,$14.10 ,$5.64 ,$87.12 ,$5.64 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$5.64 ,$84.15 ,$5.64 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$14.10 ,$89.10 ,$5.64 ,$99.00 ,$64.85 ,$5.64 ,$41.18 ,$20.11 ,$19.19 ,$5.92 ,$89.10 ,$12.69 ,$61.08 ,$27.72 ,$89.10 ,$5.64 ,$89.10 ,$89.10 ,$5.64 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$99.00 ,$64.35 ,$5.64 ,$99.00 ,$14.10 ,$73.76 ,$64.85 ,$5.64 ,$27.72 ,$50.00 ,$5.64 ,$61.08 ,$5.64 ,$61.08 ,$61.08 ,$5.64 ,$61.08 ,$10.72 ,$89.10 ,$74.25 ,$14.10 ,$5.64 ,$87.12 ,$5.64 ,$74.25 ,$74.25 ,$84.15 ,$84.15 ,$5.64 ,$84.15 ,$5.64 ,$77.22 ,$77.22 ,$77.22 ,$89.10 ,$14.10 ,$89.10 ,$5.64 ,$99.00 ,$64.85 ,$5.64 ,$41.18 ,$20.11 ,$19.19 ,$5.92 ,$89.10 ,$12.69 ,$61.08 ,$27.72 ,$89.10 ,$5.64 ,$89.10 ,$89.10 ,$5.64 ,$64.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000050,97530,HC EARLY INTER THERA ACTIV TX 15MIN,430,1 ,$256.00 ,$166.40 ,$36.24 ,$256.00 ,$90.60 ,$190.72 ,$167.68 ,$36.24 ,$71.68 ,$129.28 ,$36.24 ,$157.95 ,$36.24 ,$157.95 ,$157.95 ,$36.24 ,$157.95 ,$68.86 ,$230.40 ,$192.00 ,$90.60 ,$36.24 ,$225.28 ,$36.24 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$36.24 ,$217.60 ,$36.24 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$90.60 ,$230.40 ,$36.24 ,$256.00 ,$167.68 ,$36.24 ,$106.50 ,$246.07 ,$234.89 ,$38.05 ,$230.40 ,$81.54 ,$157.95 ,$71.68 ,$230.40 ,$36.24 ,$230.40 ,$230.40 ,$36.24 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000051,97530,HC EARLY INTER THERA ACTIV TX OFFSITE - 15MIN,430,1 ,$256.00 ,$166.40 ,$36.24 ,$256.00 ,$90.60 ,$190.72 ,$167.68 ,$36.24 ,$71.68 ,$129.28 ,$36.24 ,$157.95 ,$36.24 ,$157.95 ,$157.95 ,$36.24 ,$157.95 ,$68.86 ,$230.40 ,$192.00 ,$90.60 ,$36.24 ,$225.28 ,$36.24 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$36.24 ,$217.60 ,$36.24 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$90.60 ,$230.40 ,$36.24 ,$256.00 ,$167.68 ,$36.24 ,$106.50 ,$246.07 ,$234.89 ,$38.05 ,$230.40 ,$81.54 ,$157.95 ,$71.68 ,$230.40 ,$36.24 ,$230.40 ,$230.40 ,$36.24 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$229.00 ,$148.85 ,$19.19 ,$229.00 ,$57.15 ,$170.61 ,$150.00 ,$22.86 ,$64.12 ,$115.65 ,$22.86 ,$141.29 ,$22.86 ,$141.29 ,$141.29 ,$22.86 ,$141.29 ,$43.43 ,$206.10 ,$171.75 ,$57.15 ,$22.86 ,$201.52 ,$22.86 ,$171.75 ,$171.75 ,$194.65 ,$194.65 ,$22.86 ,$194.65 ,$22.86 ,$178.62 ,$178.62 ,$178.62 ,$206.10 ,$57.15 ,$206.10 ,$22.86 ,$229.00 ,$150.00 ,$22.86 ,$95.26 ,$20.11 ,$19.19 ,$24.00 ,$206.10 ,$51.44 ,$141.29 ,$64.12 ,$206.10 ,$22.86 ,$206.10 ,$206.10 ,$22.86 ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$187.00 ,$121.55 ,$19.19 ,$187.00 ,$55.40 ,$139.32 ,$122.49 ,$22.16 ,$52.36 ,$94.44 ,$22.16 ,$115.38 ,$22.16 ,$115.38 ,$115.38 ,$22.16 ,$115.38 ,$42.10 ,$168.30 ,$140.25 ,$55.40 ,$22.16 ,$164.56 ,$22.16 ,$140.25 ,$140.25 ,$158.95 ,$158.95 ,$22.16 ,$158.95 ,$22.16 ,$145.86 ,$145.86 ,$145.86 ,$168.30 ,$55.40 ,$168.30 ,$22.16 ,$187.00 ,$122.49 ,$22.16 ,$77.79 ,$20.11 ,$19.19 ,$23.27 ,$168.30 ,$49.86 ,$115.38 ,$52.36 ,$168.30 ,$22.16 ,$168.30 ,$168.30 ,$22.16 ,$121.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400038,97165,HC OT EVAL LOW COMPLEXITY 75MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400039,97165,HC OT EVAL LOW COMPLEXITY 90MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400040,97165,HC OT EVAL LOW COMPLEXITY 105MIN,434,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 ,$391.44 ,$373.64 ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400050,97166,HC OT EVAL MOD COMPLEXITY 75MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400051,97166,HC OT EVAL MOD COMPLEXITY 90MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400052,97166,HC OT EVAL MOD COMPLEXITY 105MIN,434,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 ,$391.44 ,$373.64 ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400062,97167,HC OT EVAL HIGH COMPLEXITY 75MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400063,97167,HC OT EVAL HIGH COMPLEXITY 90MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400064,97167,HC OT EVAL HIGH COMPLEXITY 105MIN,434,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 ,$391.44 ,$373.64 ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400074,97168,HC OT RE-EVAL 75MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400075,97168,HC OT RE-EVAL 90MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),43400076,97168,HC OT RE-EVAL 105MIN,434,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 ,$246.00 ,$246.00 ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$175.00 ,$113.75 ,$49.00 ,$188.48 ,$175.00 ,$130.38 ,$114.63 ,$83.77 ,$49.00 ,$88.38 ,$83.77 ,$107.98 ,$83.77 ,$107.98 ,$107.98 ,$83.77 ,$107.98 ,$159.16 ,$157.50 ,$131.25 ,$175.00 ,$83.77 ,$154.00 ,$83.77 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$83.77 ,$148.75 ,$83.77 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$83.77 ,$175.00 ,$114.63 ,$83.77 ,$72.80 ,$175.00 ,$173.62 ,$87.96 ,$157.50 ,$188.48 ,$107.98 ,$49.00 ,$157.50 ,$83.77 ,$157.50 ,$157.50 ,$83.77 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$175.00 ,$113.75 ,$49.00 ,$188.48 ,$175.00 ,$130.38 ,$114.63 ,$83.77 ,$49.00 ,$88.38 ,$83.77 ,$107.98 ,$83.77 ,$107.98 ,$107.98 ,$83.77 ,$107.98 ,$159.16 ,$157.50 ,$131.25 ,$175.00 ,$83.77 ,$154.00 ,$83.77 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$83.77 ,$148.75 ,$83.77 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$83.77 ,$175.00 ,$114.63 ,$83.77 ,$72.80 ,$175.00 ,$173.62 ,$87.96 ,$157.50 ,$188.48 ,$107.98 ,$49.00 ,$157.50 ,$83.77 ,$157.50 ,$157.50 ,$83.77 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$175.00 ,$113.75 ,$49.00 ,$188.48 ,$175.00 ,$130.38 ,$114.63 ,$83.77 ,$49.00 ,$88.38 ,$83.77 ,$107.98 ,$83.77 ,$107.98 ,$107.98 ,$83.77 ,$107.98 ,$159.16 ,$157.50 ,$131.25 ,$175.00 ,$83.77 ,$154.00 ,$83.77 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$83.77 ,$148.75 ,$83.77 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$83.77 ,$175.00 ,$114.63 ,$83.77 ,$72.80 ,$175.00 ,$173.62 ,$87.96 ,$157.50 ,$188.48 ,$107.98 ,$49.00 ,$157.50 ,$83.77 ,$157.50 ,$157.50 ,$83.77 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$175.00 ,$113.75 ,$49.00 ,$188.48 ,$175.00 ,$130.38 ,$114.63 ,$83.77 ,$49.00 ,$88.38 ,$83.77 ,$107.98 ,$83.77 ,$107.98 ,$107.98 ,$83.77 ,$107.98 ,$159.16 ,$157.50 ,$131.25 ,$175.00 ,$83.77 ,$154.00 ,$83.77 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$83.77 ,$148.75 ,$83.77 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$83.77 ,$175.00 ,$114.63 ,$83.77 ,$72.80 ,$175.00 ,$173.62 ,$87.96 ,$157.50 ,$188.48 ,$107.98 ,$49.00 ,$157.50 ,$83.77 ,$157.50 ,$157.50 ,$83.77 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000070,92507,HC EARLY INTER SPEECH THPY TX 15MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000071,92507,HC EARLY INTER SPEECH THPY TX 30MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000072,92507,HC EARLY INTER SPEECH THPY TX 45MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000073,92507,HC EARLY INTER SPEECH THPY TX 60MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44000074,92507,HC EARLY INTER SPEECH THPY TX 75MIN,440,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 ,$181.89 ,$173.62 ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$256.00 ,$166.40 ,$71.68 ,$256.00 ,$210.38 ,$190.72 ,$167.68 ,$84.15 ,$71.68 ,$129.28 ,$84.15 ,$157.95 ,$84.15 ,$157.95 ,$157.95 ,$84.15 ,$157.95 ,$159.89 ,$230.40 ,$192.00 ,$210.38 ,$84.15 ,$225.28 ,$84.15 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$84.15 ,$217.60 ,$84.15 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$210.38 ,$230.40 ,$84.15 ,$256.00 ,$167.68 ,$84.15 ,$106.50 ,$181.89 ,$173.62 ,$88.36 ,$230.40 ,$189.34 ,$157.95 ,$71.68 ,$230.40 ,$84.15 ,$230.40 ,$230.40 ,$84.15 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400018,92610,HC DYSPHAGIA EVALUATION  30MIN,444,1 ,$256.00 ,$166.40 ,$71.68 ,$256.00 ,$210.38 ,$190.72 ,$167.68 ,$84.15 ,$71.68 ,$129.28 ,$84.15 ,$157.95 ,$84.15 ,$157.95 ,$157.95 ,$84.15 ,$157.95 ,$159.89 ,$230.40 ,$192.00 ,$210.38 ,$84.15 ,$225.28 ,$84.15 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$84.15 ,$217.60 ,$84.15 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$210.38 ,$230.40 ,$84.15 ,$256.00 ,$167.68 ,$84.15 ,$106.50 ,$181.89 ,$173.62 ,$88.36 ,$230.40 ,$189.34 ,$157.95 ,$71.68 ,$230.40 ,$84.15 ,$230.40 ,$230.40 ,$84.15 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$256.00 ,$166.40 ,$71.68 ,$256.00 ,$210.38 ,$190.72 ,$167.68 ,$84.15 ,$71.68 ,$129.28 ,$84.15 ,$157.95 ,$84.15 ,$157.95 ,$157.95 ,$84.15 ,$157.95 ,$159.89 ,$230.40 ,$192.00 ,$210.38 ,$84.15 ,$225.28 ,$84.15 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$84.15 ,$217.60 ,$84.15 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$210.38 ,$230.40 ,$84.15 ,$256.00 ,$167.68 ,$84.15 ,$106.50 ,$181.89 ,$173.62 ,$88.36 ,$230.40 ,$189.34 ,$157.95 ,$71.68 ,$230.40 ,$84.15 ,$230.40 ,$230.40 ,$84.15 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$256.00 ,$166.40 ,$71.68 ,$256.00 ,$210.38 ,$190.72 ,$167.68 ,$84.15 ,$71.68 ,$129.28 ,$84.15 ,$157.95 ,$84.15 ,$157.95 ,$157.95 ,$84.15 ,$157.95 ,$159.89 ,$230.40 ,$192.00 ,$210.38 ,$84.15 ,$225.28 ,$84.15 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$84.15 ,$217.60 ,$84.15 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$210.38 ,$230.40 ,$84.15 ,$256.00 ,$167.68 ,$84.15 ,$106.50 ,$181.89 ,$173.62 ,$88.36 ,$230.40 ,$189.34 ,$157.95 ,$71.68 ,$230.40 ,$84.15 ,$230.40 ,$230.40 ,$84.15 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$319.00 ,$207.35 ,$38.68 ,$319.00 ,$226.13 ,$237.66 ,$208.95 ,$90.45 ,$89.32 ,$161.10 ,$90.45 ,$196.82 ,$90.45 ,$196.82 ,$196.82 ,$90.45 ,$196.82 ,$171.86 ,$287.10 ,$239.25 ,$226.13 ,$90.45 ,$280.72 ,$90.45 ,$239.25 ,$239.25 ,$271.15 ,$271.15 ,$90.45 ,$271.15 ,$90.45 ,$248.82 ,$248.82 ,$248.82 ,$287.10 ,$226.13 ,$287.10 ,$90.45 ,$319.00 ,$208.95 ,$90.45 ,$132.70 ,$40.52 ,$38.68 ,$94.97 ,$287.10 ,$203.51 ,$196.82 ,$89.32 ,$287.10 ,$90.45 ,$287.10 ,$287.10 ,$90.45 ,$207.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 ,$181.89 ,$173.62 ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 ,$181.89 ,$173.62 ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400054,92521,HC EVALUATION OF SPEECH FLUENCY 60MIN,444,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 ,$181.89 ,$173.62 ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400055,92522,HC EVALUATE SPEECH PRODUCTION 30MIN,444,1 ,$315.00 ,$204.75 ,$88.20 ,$315.00 ,$276.30 ,$234.68 ,$206.33 ,$110.52 ,$88.20 ,$159.08 ,$110.52 ,$194.36 ,$110.52 ,$194.36 ,$194.36 ,$110.52 ,$194.36 ,$209.99 ,$283.50 ,$236.25 ,$276.30 ,$110.52 ,$277.20 ,$110.52 ,$236.25 ,$236.25 ,$267.75 ,$267.75 ,$110.52 ,$267.75 ,$110.52 ,$245.70 ,$245.70 ,$245.70 ,$283.50 ,$276.30 ,$283.50 ,$110.52 ,$315.00 ,$206.33 ,$110.52 ,$131.04 ,$181.89 ,$173.62 ,$116.05 ,$283.50 ,$248.67 ,$194.36 ,$88.20 ,$283.50 ,$110.52 ,$283.50 ,$283.50 ,$110.52 ,$204.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400056,92522,HC EVALUATE SPEECH PRODUCTION 45MIN,444,1 ,$315.00 ,$204.75 ,$88.20 ,$315.00 ,$276.30 ,$234.68 ,$206.33 ,$110.52 ,$88.20 ,$159.08 ,$110.52 ,$194.36 ,$110.52 ,$194.36 ,$194.36 ,$110.52 ,$194.36 ,$209.99 ,$283.50 ,$236.25 ,$276.30 ,$110.52 ,$277.20 ,$110.52 ,$236.25 ,$236.25 ,$267.75 ,$267.75 ,$110.52 ,$267.75 ,$110.52 ,$245.70 ,$245.70 ,$245.70 ,$283.50 ,$276.30 ,$283.50 ,$110.52 ,$315.00 ,$206.33 ,$110.52 ,$131.04 ,$181.89 ,$173.62 ,$116.05 ,$283.50 ,$248.67 ,$194.36 ,$88.20 ,$283.50 ,$110.52 ,$283.50 ,$283.50 ,$110.52 ,$204.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400057,92522,HC EVALUATE SPEECH PRODUCTION 60MIN,444,1 ,$315.00 ,$204.75 ,$88.20 ,$315.00 ,$276.30 ,$234.68 ,$206.33 ,$110.52 ,$88.20 ,$159.08 ,$110.52 ,$194.36 ,$110.52 ,$194.36 ,$194.36 ,$110.52 ,$194.36 ,$209.99 ,$283.50 ,$236.25 ,$276.30 ,$110.52 ,$277.20 ,$110.52 ,$236.25 ,$236.25 ,$267.75 ,$267.75 ,$110.52 ,$267.75 ,$110.52 ,$245.70 ,$245.70 ,$245.70 ,$283.50 ,$276.30 ,$283.50 ,$110.52 ,$315.00 ,$206.33 ,$110.52 ,$131.04 ,$181.89 ,$173.62 ,$116.05 ,$283.50 ,$248.67 ,$194.36 ,$88.20 ,$283.50 ,$110.52 ,$283.50 ,$283.50 ,$110.52 ,$204.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$659.00 ,$428.35 ,$173.62 ,$659.00 ,$559.90 ,$490.96 ,$431.65 ,$223.96 ,$184.52 ,$332.80 ,$223.96 ,$406.60 ,$223.96 ,$406.60 ,$406.60 ,$223.96 ,$406.60 ,$425.52 ,$593.10 ,$494.25 ,$559.90 ,$223.96 ,$579.92 ,$223.96 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$223.96 ,$560.15 ,$223.96 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$559.90 ,$593.10 ,$223.96 ,$659.00 ,$431.65 ,$223.96 ,$274.14 ,$181.89 ,$173.62 ,$235.16 ,$593.10 ,$503.91 ,$406.60 ,$184.52 ,$593.10 ,$223.96 ,$593.10 ,$593.10 ,$223.96 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$659.00 ,$428.35 ,$173.62 ,$659.00 ,$559.90 ,$490.96 ,$431.65 ,$223.96 ,$184.52 ,$332.80 ,$223.96 ,$406.60 ,$223.96 ,$406.60 ,$406.60 ,$223.96 ,$406.60 ,$425.52 ,$593.10 ,$494.25 ,$559.90 ,$223.96 ,$579.92 ,$223.96 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$223.96 ,$560.15 ,$223.96 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$559.90 ,$593.10 ,$223.96 ,$659.00 ,$431.65 ,$223.96 ,$274.14 ,$181.89 ,$173.62 ,$235.16 ,$593.10 ,$503.91 ,$406.60 ,$184.52 ,$593.10 ,$223.96 ,$593.10 ,$593.10 ,$223.96 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$659.00 ,$428.35 ,$173.62 ,$659.00 ,$559.90 ,$490.96 ,$431.65 ,$223.96 ,$184.52 ,$332.80 ,$223.96 ,$406.60 ,$223.96 ,$406.60 ,$406.60 ,$223.96 ,$406.60 ,$425.52 ,$593.10 ,$494.25 ,$559.90 ,$223.96 ,$579.92 ,$223.96 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$223.96 ,$560.15 ,$223.96 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$559.90 ,$593.10 ,$223.96 ,$659.00 ,$431.65 ,$223.96 ,$274.14 ,$181.89 ,$173.62 ,$235.16 ,$593.10 ,$503.91 ,$406.60 ,$184.52 ,$593.10 ,$223.96 ,$593.10 ,$593.10 ,$223.96 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$336.00 ,$218.40 ,$94.08 ,$336.00 ,$272.38 ,$250.32 ,$220.08 ,$108.95 ,$94.08 ,$169.68 ,$108.95 ,$207.31 ,$108.95 ,$207.31 ,$207.31 ,$108.95 ,$207.31 ,$207.01 ,$302.40 ,$252.00 ,$272.38 ,$108.95 ,$295.68 ,$108.95 ,$252.00 ,$252.00 ,$285.60 ,$285.60 ,$108.95 ,$285.60 ,$108.95 ,$262.08 ,$262.08 ,$262.08 ,$302.40 ,$272.38 ,$302.40 ,$108.95 ,$336.00 ,$220.08 ,$108.95 ,$139.78 ,$181.89 ,$173.62 ,$114.40 ,$302.40 ,$245.14 ,$207.31 ,$94.08 ,$302.40 ,$108.95 ,$302.40 ,$302.40 ,$108.95 ,$218.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$336.00 ,$218.40 ,$94.08 ,$336.00 ,$272.38 ,$250.32 ,$220.08 ,$108.95 ,$94.08 ,$169.68 ,$108.95 ,$207.31 ,$108.95 ,$207.31 ,$207.31 ,$108.95 ,$207.31 ,$207.01 ,$302.40 ,$252.00 ,$272.38 ,$108.95 ,$295.68 ,$108.95 ,$252.00 ,$252.00 ,$285.60 ,$285.60 ,$108.95 ,$285.60 ,$108.95 ,$262.08 ,$262.08 ,$262.08 ,$302.40 ,$272.38 ,$302.40 ,$108.95 ,$336.00 ,$220.08 ,$108.95 ,$139.78 ,$181.89 ,$173.62 ,$114.40 ,$302.40 ,$245.14 ,$207.31 ,$94.08 ,$302.40 ,$108.95 ,$302.40 ,$302.40 ,$108.95 ,$218.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$336.00 ,$218.40 ,$94.08 ,$336.00 ,$272.38 ,$250.32 ,$220.08 ,$108.95 ,$94.08 ,$169.68 ,$108.95 ,$207.31 ,$108.95 ,$207.31 ,$207.31 ,$108.95 ,$207.31 ,$207.01 ,$302.40 ,$252.00 ,$272.38 ,$108.95 ,$295.68 ,$108.95 ,$252.00 ,$252.00 ,$285.60 ,$285.60 ,$108.95 ,$285.60 ,$108.95 ,$262.08 ,$262.08 ,$262.08 ,$302.40 ,$272.38 ,$302.40 ,$108.95 ,$336.00 ,$220.08 ,$108.95 ,$139.78 ,$181.89 ,$173.62 ,$114.40 ,$302.40 ,$245.14 ,$207.31 ,$94.08 ,$302.40 ,$108.95 ,$302.40 ,$302.40 ,$108.95 ,$218.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),44400087,92610,HC DYSPHAGIA EVALUATION 90MIN,444,1 ,$256.00 ,$166.40 ,$71.68 ,$256.00 ,$210.38 ,$190.72 ,$167.68 ,$84.15 ,$71.68 ,$129.28 ,$84.15 ,$157.95 ,$84.15 ,$157.95 ,$157.95 ,$84.15 ,$157.95 ,$159.89 ,$230.40 ,$192.00 ,$210.38 ,$84.15 ,$225.28 ,$84.15 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$84.15 ,$217.60 ,$84.15 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$210.38 ,$230.40 ,$84.15 ,$256.00 ,$167.68 ,$84.15 ,$106.50 ,$181.89 ,$173.62 ,$88.36 ,$230.40 ,$189.34 ,$157.95 ,$71.68 ,$230.40 ,$84.15 ,$230.40 ,$230.40 ,$84.15 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$573.00 ,$372.45 ,$160.44 ,$790.90 ,$573.00 ,$426.89 ,$375.32 ,$364.95 ,$160.44 ,$289.37 ,$364.95 ,$353.54 ,$364.95 ,$353.54 ,$353.54 ,$364.95 ,$353.54 ,$693.41 ,$515.70 ,$429.75 ,$573.00 ,$364.95 ,$504.24 ,$364.95 ,$429.75 ,$429.75 ,$487.05 ,$487.05 ,$364.95 ,$487.05 ,$364.95 ,$446.94 ,$446.94 ,$446.94 ,$515.70 ,$573.00 ,$515.70 ,$364.95 ,$573.00 ,$375.32 ,$364.95 ,$238.37 , N/A , N/A ,$381.99 ,$515.70 ,$790.90 ,$353.54 ,$160.44 ,$515.70 ,$364.95 ,$515.70 ,$515.70 ,$364.95 ,$372.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$573.00 ,$372.45 ,$160.44 ,"$1,423.93 ",$573.00 ,$426.89 ,$375.32 ,$573.00 ,$160.44 ,$289.37 ,$573.00 ,$353.54 ,$573.00 ,$353.54 ,$353.54 ,$573.00 ,$353.54 ,"$1,248.41 ",$515.70 ,$429.75 ,$573.00 ,$573.00 ,$504.24 ,$573.00 ,$429.75 ,$429.75 ,$487.05 ,$487.05 ,$573.00 ,$487.05 ,$573.00 ,$446.94 ,$446.94 ,$446.94 ,$515.70 ,$573.00 ,$515.70 ,$573.00 ,$573.00 ,$375.32 ,$573.00 ,$238.37 , N/A , N/A ,$573.00 ,$515.70 ,"$1,423.93 ",$353.54 ,$160.44 ,$515.70 ,$573.00 ,$515.70 ,$515.70 ,$573.00 ,$372.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000004,10081,HC I AND D CYST PILONIDAL CPLX,450,1 ,"$1,749.00 ","$1,136.85 ",$489.72 ,"$1,749.00 ","$1,577.31 ","$1,303.01 ","$1,145.60 ",$657.06 ,$489.72 ,$883.25 ,$657.06 ,"$1,079.13 ",$657.06 ,"$1,079.13 ","$1,079.13 ",$657.06 ,"$1,079.13 ","$1,248.41 ","$1,574.10 ","$1,311.75 ","$1,577.31 ",$657.06 ,"$1,539.12 ",$657.06 ,"$1,311.75 ","$1,311.75 ","$1,486.65 ","$1,486.65 ",$657.06 ,"$1,486.65 ",$657.06 ,"$1,364.22 ","$1,364.22 ","$1,364.22 ","$1,574.10 ","$1,577.31 ","$1,574.10 ",$657.06 ,"$1,749.00 ","$1,145.60 ",$657.06 ,$727.58 , N/A , N/A ,$687.73 ,"$1,574.10 ","$1,423.93 ","$1,079.13 ",$489.72 ,"$1,574.10 ",$657.06 ,"$1,574.10 ","$1,574.10 ",$657.06 ,"$1,136.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$334.00 ,$217.10 ,$93.52 ,$790.90 ,$334.00 ,$248.83 ,$218.77 ,$334.00 ,$93.52 ,$168.67 ,$334.00 ,$206.08 ,$334.00 ,$206.08 ,$206.08 ,$334.00 ,$206.08 ,$693.41 ,$300.60 ,$250.50 ,$334.00 ,$334.00 ,$293.92 ,$334.00 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$334.00 ,$283.90 ,$334.00 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$334.00 ,$300.60 ,$334.00 ,$334.00 ,$218.77 ,$334.00 ,$138.94 , N/A , N/A ,$334.00 ,$300.60 ,$790.90 ,$206.08 ,$93.52 ,$300.60 ,$334.00 ,$300.60 ,$300.60 ,$334.00 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$517.00 ,$336.05 ,$144.76 ,$517.00 ,$455.17 ,$385.17 ,$338.64 ,$189.61 ,$144.76 ,$261.09 ,$189.61 ,$318.99 ,$189.61 ,$318.99 ,$318.99 ,$189.61 ,$318.99 ,$360.26 ,$465.30 ,$387.75 ,$455.17 ,$189.61 ,$454.96 ,$189.61 ,$387.75 ,$387.75 ,$439.45 ,$439.45 ,$189.61 ,$439.45 ,$189.61 ,$403.26 ,$403.26 ,$403.26 ,$465.30 ,$455.17 ,$465.30 ,$189.61 ,$517.00 ,$338.64 ,$189.61 ,$215.07 , N/A , N/A ,$198.46 ,$465.30 ,$410.91 ,$318.99 ,$144.76 ,$465.30 ,$189.61 ,$465.30 ,$465.30 ,$189.61 ,$336.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000010,11732,HC AVULSION NAIL PL PT/CO EA ADDL FAC,450,1 ,$828.00 ,$538.20 ,$231.84 ,$828.00 , N/A ,$616.86 ,$542.34 , N/A ,$231.84 ,$418.14 , N/A ,$510.88 , N/A ,$510.88 ,$510.88 , N/A ,$510.88 , N/A ,$745.20 ,$621.00 , N/A , N/A ,$728.64 , N/A ,$621.00 ,$621.00 ,$703.80 ,$703.80 , N/A ,$703.80 , N/A ,$645.84 ,$645.84 ,$645.84 ,$745.20 , N/A ,$745.20 , N/A ,$828.00 ,$542.34 , N/A ,$344.45 , N/A , N/A , N/A ,$745.20 , N/A ,$510.88 ,$231.84 ,$745.20 , N/A ,$745.20 ,$745.20 , N/A ,$538.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$699.00 ,$454.35 ,$119.06 ,$699.00 ,$285.81 ,$520.76 ,$457.85 ,$119.06 ,$195.72 ,$353.00 ,$119.06 ,$431.28 ,$119.06 ,$431.28 ,$431.28 ,$119.06 ,$431.28 ,$226.21 ,$629.10 ,$524.25 ,$285.81 ,$119.06 ,$615.12 ,$119.06 ,$524.25 ,$524.25 ,$594.15 ,$594.15 ,$119.06 ,$594.15 ,$119.06 ,$545.22 ,$545.22 ,$545.22 ,$629.10 ,$285.81 ,$629.10 ,$119.06 ,$699.00 ,$457.85 ,$119.06 ,$290.78 , N/A , N/A ,$124.62 ,$629.10 ,$258.02 ,$431.28 ,$195.72 ,$629.10 ,$119.06 ,$629.10 ,$629.10 ,$119.06 ,$454.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$174.00 ,$113.10 ,$48.72 ,$258.02 ,$174.00 ,$129.63 ,$113.97 ,$119.06 ,$48.72 ,$87.87 ,$119.06 ,$107.36 ,$119.06 ,$107.36 ,$107.36 ,$119.06 ,$107.36 ,$226.21 ,$156.60 ,$130.50 ,$174.00 ,$119.06 ,$153.12 ,$119.06 ,$130.50 ,$130.50 ,$147.90 ,$147.90 ,$119.06 ,$147.90 ,$119.06 ,$135.72 ,$135.72 ,$135.72 ,$156.60 ,$174.00 ,$156.60 ,$119.06 ,$174.00 ,$113.97 ,$119.06 ,$72.38 , N/A , N/A ,$124.62 ,$156.60 ,$258.02 ,$107.36 ,$48.72 ,$156.60 ,$119.06 ,$156.60 ,$156.60 ,$119.06 ,$113.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000012,11760,HC REPAIR NAIL BED,450,1 ,"$1,414.00 ",$919.10 ,$395.92 ,"$1,414.00 ","$1,327.51 ","$1,053.43 ",$926.17 ,$553.00 ,$395.92 ,$714.07 ,$553.00 ,$872.44 ,$553.00 ,$872.44 ,$872.44 ,$553.00 ,$872.44 ,"$1,050.70 ","$1,272.60 ","$1,060.50 ","$1,327.51 ",$553.00 ,"$1,244.32 ",$553.00 ,"$1,060.50 ","$1,060.50 ","$1,201.90 ","$1,201.90 ",$553.00 ,"$1,201.90 ",$553.00 ,"$1,102.92 ","$1,102.92 ","$1,102.92 ","$1,272.60 ","$1,327.51 ","$1,272.60 ",$553.00 ,"$1,414.00 ",$926.17 ,$553.00 ,$588.22 , N/A , N/A ,$578.82 ,"$1,272.60 ","$1,198.43 ",$872.44 ,$395.92 ,"$1,272.60 ",$553.00 ,"$1,272.60 ","$1,272.60 ",$553.00 ,$919.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000013,11765,HC EXC WEDGE SKIN NAIL FOLD,450,1 ,$984.78 ,$640.11 ,$275.74 ,$984.78 ,$876.09 ,$733.66 ,$645.03 ,$364.95 ,$275.74 ,$497.31 ,$364.95 ,$607.61 ,$364.95 ,$607.61 ,$607.61 ,$364.95 ,$607.61 ,$693.41 ,$886.30 ,$738.59 ,$876.09 ,$364.95 ,$866.61 ,$364.95 ,$738.59 ,$738.59 ,$837.06 ,$837.06 ,$364.95 ,$837.06 ,$364.95 ,$768.13 ,$768.13 ,$768.13 ,$886.30 ,$876.09 ,$886.30 ,$364.95 ,$984.78 ,$645.03 ,$364.95 ,$409.67 , N/A , N/A ,$381.99 ,$886.30 ,$790.90 ,$607.61 ,$275.74 ,$886.30 ,$364.95 ,$886.30 ,$886.30 ,$364.95 ,$640.11 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$348.00 ,$226.20 ,$97.44 ,$410.91 ,$348.00 ,$259.26 ,$227.94 ,$189.61 ,$97.44 ,$175.74 ,$189.61 ,$214.72 ,$189.61 ,$214.72 ,$214.72 ,$189.61 ,$214.72 ,$360.26 ,$313.20 ,$261.00 ,$348.00 ,$189.61 ,$306.24 ,$189.61 ,$261.00 ,$261.00 ,$295.80 ,$295.80 ,$189.61 ,$295.80 ,$189.61 ,$271.44 ,$271.44 ,$271.44 ,$313.20 ,$348.00 ,$313.20 ,$189.61 ,$348.00 ,$227.94 ,$189.61 ,$144.77 , N/A , N/A ,$198.46 ,$313.20 ,$410.91 ,$214.72 ,$97.44 ,$313.20 ,$189.61 ,$313.20 ,$313.20 ,$189.61 ,$226.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$348.00 ,$226.20 ,$97.44 ,$410.91 ,$348.00 ,$259.26 ,$227.94 ,$189.61 ,$97.44 ,$175.74 ,$189.61 ,$214.72 ,$189.61 ,$214.72 ,$214.72 ,$189.61 ,$214.72 ,$360.26 ,$313.20 ,$261.00 ,$348.00 ,$189.61 ,$306.24 ,$189.61 ,$261.00 ,$261.00 ,$295.80 ,$295.80 ,$189.61 ,$295.80 ,$189.61 ,$271.44 ,$271.44 ,$271.44 ,$313.20 ,$348.00 ,$313.20 ,$189.61 ,$348.00 ,$227.94 ,$189.61 ,$144.77 , N/A , N/A ,$198.46 ,$313.20 ,$410.91 ,$214.72 ,$97.44 ,$313.20 ,$189.61 ,$313.20 ,$313.20 ,$189.61 ,$226.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$348.00 ,$226.20 ,$97.44 ,$410.91 ,$348.00 ,$259.26 ,$227.94 ,$189.61 ,$97.44 ,$175.74 ,$189.61 ,$214.72 ,$189.61 ,$214.72 ,$214.72 ,$189.61 ,$214.72 ,$360.26 ,$313.20 ,$261.00 ,$348.00 ,$189.61 ,$306.24 ,$189.61 ,$261.00 ,$261.00 ,$295.80 ,$295.80 ,$189.61 ,$295.80 ,$189.61 ,$271.44 ,$271.44 ,$271.44 ,$313.20 ,$348.00 ,$313.20 ,$189.61 ,$348.00 ,$227.94 ,$189.61 ,$144.77 , N/A , N/A ,$198.46 ,$313.20 ,$410.91 ,$214.72 ,$97.44 ,$313.20 ,$189.61 ,$313.20 ,$313.20 ,$189.61 ,$226.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$517.00 ,$336.05 ,$144.76 ,$790.90 ,$517.00 ,$385.17 ,$338.64 ,$364.95 ,$144.76 ,$261.09 ,$364.95 ,$318.99 ,$364.95 ,$318.99 ,$318.99 ,$364.95 ,$318.99 ,$693.41 ,$465.30 ,$387.75 ,$517.00 ,$364.95 ,$454.96 ,$364.95 ,$387.75 ,$387.75 ,$439.45 ,$439.45 ,$364.95 ,$439.45 ,$364.95 ,$403.26 ,$403.26 ,$403.26 ,$465.30 ,$517.00 ,$465.30 ,$364.95 ,$517.00 ,$338.64 ,$364.95 ,$215.07 , N/A , N/A ,$381.99 ,$465.30 ,$790.90 ,$318.99 ,$144.76 ,$465.30 ,$364.95 ,$465.30 ,$465.30 ,$364.95 ,$336.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$916.00 ,$595.40 ,$256.48 ,$916.00 ,$876.09 ,$682.42 ,$599.98 ,$364.95 ,$256.48 ,$462.58 ,$364.95 ,$565.17 ,$364.95 ,$565.17 ,$565.17 ,$364.95 ,$565.17 ,$693.41 ,$824.40 ,$687.00 ,$876.09 ,$364.95 ,$806.08 ,$364.95 ,$687.00 ,$687.00 ,$778.60 ,$778.60 ,$364.95 ,$778.60 ,$364.95 ,$714.48 ,$714.48 ,$714.48 ,$824.40 ,$876.09 ,$824.40 ,$364.95 ,$916.00 ,$599.98 ,$364.95 ,$381.06 , N/A , N/A ,$381.99 ,$824.40 ,$790.90 ,$565.17 ,$256.48 ,$824.40 ,$364.95 ,$824.40 ,$824.40 ,$364.95 ,$595.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000019,12007,HC SIMP S/N/AX/GN/TRK/EXT > 30CM,450,1 ,$540.00 ,$351.00 ,$151.20 ,$540.00 ,$455.17 ,$402.30 ,$353.70 ,$189.61 ,$151.20 ,$272.70 ,$189.61 ,$333.18 ,$189.61 ,$333.18 ,$333.18 ,$189.61 ,$333.18 ,$360.26 ,$486.00 ,$405.00 ,$455.17 ,$189.61 ,$475.20 ,$189.61 ,$405.00 ,$405.00 ,$459.00 ,$459.00 ,$189.61 ,$459.00 ,$189.61 ,$421.20 ,$421.20 ,$421.20 ,$486.00 ,$455.17 ,$486.00 ,$189.61 ,$540.00 ,$353.70 ,$189.61 ,$224.64 , N/A , N/A ,$198.46 ,$486.00 ,$410.91 ,$333.18 ,$151.20 ,$486.00 ,$189.61 ,$486.00 ,$486.00 ,$189.61 ,$351.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$348.00 ,$226.20 ,$97.44 ,$410.91 ,$348.00 ,$259.26 ,$227.94 ,$189.61 ,$97.44 ,$175.74 ,$189.61 ,$214.72 ,$189.61 ,$214.72 ,$214.72 ,$189.61 ,$214.72 ,$360.26 ,$313.20 ,$261.00 ,$348.00 ,$189.61 ,$306.24 ,$189.61 ,$261.00 ,$261.00 ,$295.80 ,$295.80 ,$189.61 ,$295.80 ,$189.61 ,$271.44 ,$271.44 ,$271.44 ,$313.20 ,$348.00 ,$313.20 ,$189.61 ,$348.00 ,$227.94 ,$189.61 ,$144.77 , N/A , N/A ,$198.46 ,$313.20 ,$410.91 ,$214.72 ,$97.44 ,$313.20 ,$189.61 ,$313.20 ,$313.20 ,$189.61 ,$226.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$348.00 ,$226.20 ,$97.44 ,$410.91 ,$348.00 ,$259.26 ,$227.94 ,$189.61 ,$97.44 ,$175.74 ,$189.61 ,$214.72 ,$189.61 ,$214.72 ,$214.72 ,$189.61 ,$214.72 ,$360.26 ,$313.20 ,$261.00 ,$348.00 ,$189.61 ,$306.24 ,$189.61 ,$261.00 ,$261.00 ,$295.80 ,$295.80 ,$189.61 ,$295.80 ,$189.61 ,$271.44 ,$271.44 ,$271.44 ,$313.20 ,$348.00 ,$313.20 ,$189.61 ,$348.00 ,$227.94 ,$189.61 ,$144.77 , N/A , N/A ,$198.46 ,$313.20 ,$410.91 ,$214.72 ,$97.44 ,$313.20 ,$189.61 ,$313.20 ,$313.20 ,$189.61 ,$226.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$348.00 ,$226.20 ,$97.44 ,$410.91 ,$348.00 ,$259.26 ,$227.94 ,$189.61 ,$97.44 ,$175.74 ,$189.61 ,$214.72 ,$189.61 ,$214.72 ,$214.72 ,$189.61 ,$214.72 ,$360.26 ,$313.20 ,$261.00 ,$348.00 ,$189.61 ,$306.24 ,$189.61 ,$261.00 ,$261.00 ,$295.80 ,$295.80 ,$189.61 ,$295.80 ,$189.61 ,$271.44 ,$271.44 ,$271.44 ,$313.20 ,$348.00 ,$313.20 ,$189.61 ,$348.00 ,$227.94 ,$189.61 ,$144.77 , N/A , N/A ,$198.46 ,$313.20 ,$410.91 ,$214.72 ,$97.44 ,$313.20 ,$189.61 ,$313.20 ,$313.20 ,$189.61 ,$226.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$517.00 ,$336.05 ,$144.76 ,$517.00 ,$455.17 ,$385.17 ,$338.64 ,$189.61 ,$144.76 ,$261.09 ,$189.61 ,$318.99 ,$189.61 ,$318.99 ,$318.99 ,$189.61 ,$318.99 ,$360.26 ,$465.30 ,$387.75 ,$455.17 ,$189.61 ,$454.96 ,$189.61 ,$387.75 ,$387.75 ,$439.45 ,$439.45 ,$189.61 ,$439.45 ,$189.61 ,$403.26 ,$403.26 ,$403.26 ,$465.30 ,$455.17 ,$465.30 ,$189.61 ,$517.00 ,$338.64 ,$189.61 ,$215.07 , N/A , N/A ,$198.46 ,$465.30 ,$410.91 ,$318.99 ,$144.76 ,$465.30 ,$189.61 ,$465.30 ,$465.30 ,$189.61 ,$336.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$517.00 ,$336.05 ,$144.76 ,$790.90 ,$517.00 ,$385.17 ,$338.64 ,$364.95 ,$144.76 ,$261.09 ,$364.95 ,$318.99 ,$364.95 ,$318.99 ,$318.99 ,$364.95 ,$318.99 ,$693.41 ,$465.30 ,$387.75 ,$517.00 ,$364.95 ,$454.96 ,$364.95 ,$387.75 ,$387.75 ,$439.45 ,$439.45 ,$364.95 ,$439.45 ,$364.95 ,$403.26 ,$403.26 ,$403.26 ,$465.30 ,$517.00 ,$465.30 ,$364.95 ,$517.00 ,$338.64 ,$364.95 ,$215.07 , N/A , N/A ,$381.99 ,$465.30 ,$790.90 ,$318.99 ,$144.76 ,$465.30 ,$364.95 ,$465.30 ,$465.30 ,$364.95 ,$336.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000027,12020,HC SIMP SUPERFICIAL DEHISCENCE,450,1 ,"$1,445.00 ",$939.25 ,$404.60 ,"$1,445.00 ","$1,327.51 ","$1,076.53 ",$946.48 ,$553.00 ,$404.60 ,$729.73 ,$553.00 ,$891.57 ,$553.00 ,$891.57 ,$891.57 ,$553.00 ,$891.57 ,"$1,050.70 ","$1,300.50 ","$1,083.75 ","$1,327.51 ",$553.00 ,"$1,271.60 ",$553.00 ,"$1,083.75 ","$1,083.75 ","$1,228.25 ","$1,228.25 ",$553.00 ,"$1,228.25 ",$553.00 ,"$1,127.10 ","$1,127.10 ","$1,127.10 ","$1,300.50 ","$1,327.51 ","$1,300.50 ",$553.00 ,"$1,445.00 ",$946.48 ,$553.00 ,$601.12 , N/A , N/A ,$578.82 ,"$1,300.50 ","$1,198.43 ",$891.57 ,$404.60 ,"$1,300.50 ",$553.00 ,"$1,300.50 ","$1,300.50 ",$553.00 ,$939.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 , N/A ,$700.20 ,$583.50 ,$778.00 , N/A ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,"$1,521.00 ",$988.65 ,$364.95 ,"$1,521.00 ",$876.09 ,"$1,133.15 ",$996.26 ,$364.95 ,$425.88 ,$768.11 ,$364.95 ,$938.46 ,$364.95 ,$938.46 ,$938.46 ,$364.95 ,$938.46 ,$693.41 ,"$1,368.90 ","$1,140.75 ",$876.09 ,$364.95 ,"$1,338.48 ",$364.95 ,"$1,140.75 ","$1,140.75 ","$1,292.85 ","$1,292.85 ",$364.95 ,"$1,292.85 ",$364.95 ,"$1,186.38 ","$1,186.38 ","$1,186.38 ","$1,368.90 ",$876.09 ,"$1,368.90 ",$364.95 ,"$1,521.00 ",$996.26 ,$364.95 ,$632.74 , N/A , N/A ,$381.99 ,"$1,368.90 ",$790.90 ,$938.46 ,$425.88 ,"$1,368.90 ",$364.95 ,"$1,368.90 ","$1,368.90 ",$364.95 ,$988.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000033,12036,HC INTRM S/A/T/EXT 20.1-30.0CM,450,1 ,"$1,478.00 ",$960.70 ,$413.84 ,"$1,478.00 ","$1,327.51 ","$1,101.11 ",$968.09 ,$553.00 ,$413.84 ,$746.39 ,$553.00 ,$911.93 ,$553.00 ,$911.93 ,$911.93 ,$553.00 ,$911.93 ,"$1,050.70 ","$1,330.20 ","$1,108.50 ","$1,327.51 ",$553.00 ,"$1,300.64 ",$553.00 ,"$1,108.50 ","$1,108.50 ","$1,256.30 ","$1,256.30 ",$553.00 ,"$1,256.30 ",$553.00 ,"$1,152.84 ","$1,152.84 ","$1,152.84 ","$1,330.20 ","$1,327.51 ","$1,330.20 ",$553.00 ,"$1,478.00 ",$968.09 ,$553.00 ,$614.85 , N/A , N/A ,$578.82 ,"$1,330.20 ","$1,198.43 ",$911.93 ,$413.84 ,"$1,330.20 ",$553.00 ,"$1,330.20 ","$1,330.20 ",$553.00 ,$960.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$959.00 ,$623.35 ,$268.52 ,$959.00 ,$876.09 ,$714.46 ,$628.15 ,$364.95 ,$268.52 ,$484.30 ,$364.95 ,$591.70 ,$364.95 ,$591.70 ,$591.70 ,$364.95 ,$591.70 ,$693.41 ,$863.10 ,$719.25 ,$876.09 ,$364.95 ,$843.92 ,$364.95 ,$719.25 ,$719.25 ,$815.15 ,$815.15 ,$364.95 ,$815.15 ,$364.95 ,$748.02 ,$748.02 ,$748.02 ,$863.10 ,$876.09 ,$863.10 ,$364.95 ,$959.00 ,$628.15 ,$364.95 ,$398.94 , N/A , N/A ,$381.99 ,$863.10 ,$790.90 ,$591.70 ,$268.52 ,$863.10 ,$364.95 ,$863.10 ,$863.10 ,$364.95 ,$623.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000043,12053,HC INTRM F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000044,12054,HC INTRM F/E/E/N/L/MM 7.6-12.5CM,450,1 ,$778.00 ,$505.70 ,$217.84 ,$790.90 ,$778.00 ,$579.61 ,$509.59 ,$364.95 ,$217.84 ,$392.89 ,$364.95 ,$480.03 ,$364.95 ,$480.03 ,$480.03 ,$364.95 ,$480.03 ,$693.41 ,$700.20 ,$583.50 ,$778.00 ,$364.95 ,$684.64 ,$364.95 ,$583.50 ,$583.50 ,$661.30 ,$661.30 ,$364.95 ,$661.30 ,$364.95 ,$606.84 ,$606.84 ,$606.84 ,$700.20 ,$778.00 ,$700.20 ,$364.95 ,$778.00 ,$509.59 ,$364.95 ,$323.65 , N/A , N/A ,$381.99 ,$700.20 ,$790.90 ,$480.03 ,$217.84 ,$700.20 ,$364.95 ,$700.20 ,$700.20 ,$364.95 ,$505.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,"$1,521.00 ",$988.65 ,$425.88 ,"$1,521.00 ","$1,327.51 ","$1,133.15 ",$996.26 ,$553.00 ,$425.88 ,$768.11 ,$553.00 ,$938.46 ,$553.00 ,$938.46 ,$938.46 ,$553.00 ,$938.46 ,"$1,050.70 ","$1,368.90 ","$1,140.75 ","$1,327.51 ",$553.00 ,"$1,338.48 ",$553.00 ,"$1,140.75 ","$1,140.75 ","$1,292.85 ","$1,292.85 ",$553.00 ,"$1,292.85 ",$553.00 ,"$1,186.38 ","$1,186.38 ","$1,186.38 ","$1,368.90 ","$1,327.51 ","$1,368.90 ",$553.00 ,"$1,521.00 ",$996.26 ,$553.00 ,$632.74 , N/A , N/A ,$578.82 ,"$1,368.90 ","$1,198.43 ",$938.46 ,$425.88 ,"$1,368.90 ",$553.00 ,"$1,368.90 ","$1,368.90 ",$553.00 ,$988.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$537.00 ,$349.05 ,$150.36 ,$537.00 ,$455.17 ,$400.07 ,$351.74 ,$189.61 ,$150.36 ,$271.19 ,$189.61 ,$331.33 ,$189.61 ,$331.33 ,$331.33 ,$189.61 ,$331.33 ,$360.26 ,$483.30 ,$402.75 ,$455.17 ,$189.61 ,$472.56 ,$189.61 ,$402.75 ,$402.75 ,$456.45 ,$456.45 ,$189.61 ,$456.45 ,$189.61 ,$418.86 ,$418.86 ,$418.86 ,$483.30 ,$455.17 ,$483.30 ,$189.61 ,$537.00 ,$351.74 ,$189.61 ,$223.39 , N/A , N/A ,$198.46 ,$483.30 ,$410.91 ,$331.33 ,$150.36 ,$483.30 ,$189.61 ,$483.30 ,$483.30 ,$189.61 ,$349.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000063,16025,HC DRESS/DEB BURN 5-10% TOTAL MED,450,1 ,$561.00 ,$364.65 ,$157.08 ,$561.00 ,$455.17 ,$417.95 ,$367.46 ,$189.61 ,$157.08 ,$283.31 ,$189.61 ,$346.14 ,$189.61 ,$346.14 ,$346.14 ,$189.61 ,$346.14 ,$360.26 ,$504.90 ,$420.75 ,$455.17 ,$189.61 ,$493.68 ,$189.61 ,$420.75 ,$420.75 ,$476.85 ,$476.85 ,$189.61 ,$476.85 ,$189.61 ,$437.58 ,$437.58 ,$437.58 ,$504.90 ,$455.17 ,$504.90 ,$189.61 ,$561.00 ,$367.46 ,$189.61 ,$233.38 , N/A , N/A ,$198.46 ,$504.90 ,$410.91 ,$346.14 ,$157.08 ,$504.90 ,$189.61 ,$504.90 ,$504.90 ,$189.61 ,$364.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,$561.00 ,$364.65 ,$157.08 ,$790.90 ,$561.00 ,$417.95 ,$367.46 ,$364.95 ,$157.08 ,$283.31 ,$364.95 ,$346.14 ,$364.95 ,$346.14 ,$346.14 ,$364.95 ,$346.14 ,$693.41 ,$504.90 ,$420.75 ,$561.00 ,$364.95 ,$493.68 ,$364.95 ,$420.75 ,$420.75 ,$476.85 ,$476.85 ,$364.95 ,$476.85 ,$364.95 ,$437.58 ,$437.58 ,$437.58 ,$504.90 ,$561.00 ,$504.90 ,$364.95 ,$561.00 ,$367.46 ,$364.95 ,$233.38 , N/A , N/A ,$381.99 ,$504.90 ,$790.90 ,$346.14 ,$157.08 ,$504.90 ,$364.95 ,$504.90 ,$504.90 ,$364.95 ,$364.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000067,17250,HC CAUT CHEM TISSUE GRANULATION,450,1 ,$536.00 ,$348.40 ,$150.08 ,$536.00 ,$455.17 ,$399.32 ,$351.08 ,$189.61 ,$150.08 ,$270.68 ,$189.61 ,$330.71 ,$189.61 ,$330.71 ,$330.71 ,$189.61 ,$330.71 ,$360.26 ,$482.40 ,$402.00 ,$455.17 ,$189.61 ,$471.68 ,$189.61 ,$402.00 ,$402.00 ,$455.60 ,$455.60 ,$189.61 ,$455.60 ,$189.61 ,$418.08 ,$418.08 ,$418.08 ,$482.40 ,$455.17 ,$482.40 ,$189.61 ,$536.00 ,$351.08 ,$189.61 ,$222.98 , N/A , N/A ,$198.46 ,$482.40 ,$410.91 ,$330.71 ,$150.08 ,$482.40 ,$189.61 ,$482.40 ,$482.40 ,$189.61 ,$348.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$921.00 ,$598.65 ,$257.88 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 , N/A , N/A ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$921.00 ,$598.65 ,$257.88 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 , N/A , N/A ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,"$1,382.00 ",$898.30 ,$386.96 ,"$1,382.00 ",$993.34 ,"$1,029.59 ",$905.21 ,$413.80 ,$386.96 ,$697.91 ,$413.80 ,$852.69 ,$413.80 ,$852.69 ,$852.69 ,$413.80 ,$852.69 ,$786.22 ,"$1,243.80 ","$1,036.50 ",$993.34 ,$413.80 ,"$1,216.16 ",$413.80 ,"$1,036.50 ","$1,036.50 ","$1,174.70 ","$1,174.70 ",$413.80 ,"$1,174.70 ",$413.80 ,"$1,077.96 ","$1,077.96 ","$1,077.96 ","$1,243.80 ",$993.34 ,"$1,243.80 ",$413.80 ,"$1,382.00 ",$905.21 ,$413.80 ,$574.91 , N/A , N/A ,$433.11 ,"$1,243.80 ",$896.75 ,$852.69 ,$386.96 ,"$1,243.80 ",$413.80 ,"$1,243.80 ","$1,243.80 ",$413.80 ,$898.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$756.00 ,$491.40 ,$211.68 ,$756.00 ,$522.43 ,$563.22 ,$495.18 ,$217.63 ,$211.68 ,$381.78 ,$217.63 ,$466.45 ,$217.63 ,$466.45 ,$466.45 ,$217.63 ,$466.45 ,$413.50 ,$680.40 ,$567.00 ,$522.43 ,$217.63 ,$665.28 ,$217.63 ,$567.00 ,$567.00 ,$642.60 ,$642.60 ,$217.63 ,$642.60 ,$217.63 ,$589.68 ,$589.68 ,$589.68 ,$680.40 ,$522.43 ,$680.40 ,$217.63 ,$756.00 ,$495.18 ,$217.63 ,$314.50 , N/A , N/A ,$227.79 ,$680.40 ,$471.63 ,$466.45 ,$211.68 ,$680.40 ,$217.63 ,$680.40 ,$680.40 ,$217.63 ,$491.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$736.00 ,$478.40 ,$206.08 ,$736.00 ,$522.43 ,$548.32 ,$482.08 ,$217.63 ,$206.08 ,$371.68 ,$217.63 ,$454.11 ,$217.63 ,$454.11 ,$454.11 ,$217.63 ,$454.11 , N/A ,$662.40 ,$552.00 ,$522.43 , N/A ,$647.68 ,$217.63 ,$552.00 ,$552.00 ,$625.60 ,$625.60 ,$217.63 ,$625.60 ,$217.63 ,$574.08 ,$574.08 ,$574.08 ,$662.40 ,$522.43 ,$662.40 ,$217.63 ,$736.00 ,$482.08 ,$217.63 ,$306.18 , N/A , N/A ,$227.79 ,$662.40 ,$471.63 ,$454.11 ,$206.08 ,$662.40 ,$217.63 ,$662.40 ,$662.40 ,$217.63 ,$478.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$711.00 ,$462.15 ,$199.08 ,$711.00 ,$522.43 ,$529.70 ,$465.71 ,$217.63 ,$199.08 ,$359.06 ,$217.63 ,$438.69 ,$217.63 ,$438.69 ,$438.69 ,$217.63 ,$438.69 ,$413.50 ,$639.90 ,$533.25 ,$522.43 ,$217.63 ,$625.68 ,$217.63 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$217.63 ,$604.35 ,$217.63 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$522.43 ,$639.90 ,$217.63 ,$711.00 ,$465.71 ,$217.63 ,$295.78 , N/A , N/A ,$227.79 ,$639.90 ,$471.63 ,$438.69 ,$199.08 ,$639.90 ,$217.63 ,$639.90 ,$639.90 ,$217.63 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000081,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP,450,1 ,"$3,643.00 ","$2,367.95 ","$1,020.04 ","$3,643.00 ","$3,530.44 ","$2,714.04 ","$2,386.17 ","$1,470.67 ","$1,020.04 ","$1,839.72 ","$1,470.67 ","$2,247.73 ","$1,470.67 ","$2,247.73 ","$2,247.73 ","$1,470.67 ","$2,247.73 ","$2,794.27 ","$3,278.70 ","$2,732.25 ","$3,530.44 ","$1,470.67 ","$3,205.84 ","$1,470.67 ","$2,732.25 ","$2,732.25 ","$3,096.55 ","$3,096.55 ","$1,470.67 ","$3,096.55 ","$1,470.67 ","$2,841.54 ","$2,841.54 ","$2,841.54 ","$3,278.70 ","$3,530.44 ","$3,278.70 ","$1,470.67 ","$3,643.00 ","$2,386.17 ","$1,470.67 ","$1,515.49 ", N/A , N/A ,"$1,539.33 ","$3,278.70 ","$3,187.14 ","$2,247.73 ","$1,020.04 ","$3,278.70 ","$1,470.67 ","$3,278.70 ","$3,278.70 ","$1,470.67 ","$2,367.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,"$2,523.00 ","$1,639.95 ",$706.44 ,"$3,187.14 ","$2,523.00 ","$1,879.64 ","$1,652.57 ","$1,470.67 ",$706.44 ,"$1,274.12 ","$1,470.67 ","$1,556.69 ","$1,470.67 ","$1,556.69 ","$1,556.69 ","$1,470.67 ","$1,556.69 ","$2,794.27 ","$2,270.70 ","$1,892.25 ","$2,523.00 ","$1,470.67 ","$2,220.24 ","$1,470.67 ","$1,892.25 ","$1,892.25 ","$2,144.55 ","$2,144.55 ","$1,470.67 ","$2,144.55 ","$1,470.67 ","$1,967.94 ","$1,967.94 ","$1,967.94 ","$2,270.70 ","$2,523.00 ","$2,270.70 ","$1,470.67 ","$2,523.00 ","$1,652.57 ","$1,470.67 ","$1,049.57 ", N/A , N/A ,"$1,539.33 ","$2,270.70 ","$3,187.14 ","$1,556.69 ",$706.44 ,"$2,270.70 ","$1,470.67 ","$2,270.70 ","$2,270.70 ","$1,470.67 ","$1,639.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000084,26011,HC DRAIN ABSC FINGER COMPLCD,450,1 ,"$4,006.50 ","$2,604.23 ","$1,121.82 ","$4,006.50 ","$3,566.38 ","$2,984.84 ","$2,624.26 ","$1,485.64 ","$1,121.82 ","$2,023.28 ","$1,485.64 ","$2,472.01 ","$1,485.64 ","$2,472.01 ","$2,472.01 ","$1,485.64 ","$2,472.01 ","$2,822.72 ","$3,605.85 ","$3,004.88 ","$3,566.38 ","$1,485.64 ","$3,525.72 ","$1,485.64 ","$3,004.88 ","$3,004.88 ","$3,405.53 ","$3,405.53 ","$1,485.64 ","$3,405.53 ","$1,485.64 ","$3,125.07 ","$3,125.07 ","$3,125.07 ","$3,605.85 ","$3,566.38 ","$3,605.85 ","$1,485.64 ","$4,006.50 ","$2,624.26 ","$1,485.64 ","$1,666.70 ", N/A , N/A ,"$1,555.00 ","$3,605.85 ","$3,219.59 ","$2,472.01 ","$1,121.82 ","$3,605.85 ","$1,485.64 ","$3,605.85 ","$3,605.85 ","$1,485.64 ","$2,604.23 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,$618.00 ,$401.70 ,$173.04 ,$618.00 ,$522.43 ,$460.41 ,$404.79 ,$217.63 ,$173.04 ,$312.09 ,$217.63 ,$381.31 ,$217.63 ,$381.31 ,$381.31 ,$217.63 ,$381.31 ,$413.50 ,$556.20 ,$463.50 ,$522.43 ,$217.63 ,$543.84 ,$217.63 ,$463.50 ,$463.50 ,$525.30 ,$525.30 ,$217.63 ,$525.30 ,$217.63 ,$482.04 ,$482.04 ,$482.04 ,$556.20 ,$522.43 ,$556.20 ,$217.63 ,$618.00 ,$404.79 ,$217.63 ,$257.09 , N/A , N/A ,$227.79 ,$556.20 ,$471.63 ,$381.31 ,$173.04 ,$556.20 ,$217.63 ,$556.20 ,$556.20 ,$217.63 ,$401.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$598.00 ,$388.70 ,$167.44 ,$598.00 ,$522.43 ,$445.51 ,$391.69 ,$217.63 ,$167.44 ,$301.99 ,$217.63 ,$368.97 ,$217.63 ,$368.97 ,$368.97 ,$217.63 ,$368.97 ,$413.50 ,$538.20 ,$448.50 ,$522.43 ,$217.63 ,$526.24 ,$217.63 ,$448.50 ,$448.50 ,$508.30 ,$508.30 ,$217.63 ,$508.30 ,$217.63 ,$466.44 ,$466.44 ,$466.44 ,$538.20 ,$522.43 ,$538.20 ,$217.63 ,$598.00 ,$391.69 ,$217.63 ,$248.77 , N/A , N/A ,$227.79 ,$538.20 ,$471.63 ,$368.97 ,$167.44 ,$538.20 ,$217.63 ,$538.20 ,$538.20 ,$217.63 ,$388.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,"$7,848.00 ","$5,101.20 ","$2,197.44 ","$7,848.00 ","$7,178.17 ","$5,846.76 ","$5,140.44 ","$2,990.21 ","$2,197.44 ","$3,963.24 ","$2,990.21 ","$4,842.22 ","$2,990.21 ","$4,842.22 ","$4,842.22 ","$2,990.21 ","$4,842.22 ","$5,681.40 ","$7,063.20 ","$5,886.00 ","$7,178.17 ","$2,990.21 ","$6,906.24 ","$2,990.21 ","$5,886.00 ","$5,886.00 ","$6,670.80 ","$6,670.80 ","$2,990.21 ","$6,670.80 ","$2,990.21 ","$6,121.44 ","$6,121.44 ","$6,121.44 ","$7,063.20 ","$7,178.17 ","$7,063.20 ","$2,990.21 ","$7,848.00 ","$5,140.44 ","$2,990.21 ","$3,264.77 ", N/A , N/A ,"$3,129.80 ","$7,063.20 ","$6,480.18 ","$4,842.22 ","$2,197.44 ","$7,063.20 ","$2,990.21 ","$7,063.20 ","$7,063.20 ","$2,990.21 ","$5,101.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$641.00 ,$416.65 ,$179.48 ,$641.00 ,$522.43 ,$477.55 ,$419.86 ,$217.63 ,$179.48 ,$323.71 ,$217.63 ,$395.50 ,$217.63 ,$395.50 ,$395.50 ,$217.63 ,$395.50 ,$413.50 ,$576.90 ,$480.75 ,$522.43 ,$217.63 ,$564.08 ,$217.63 ,$480.75 ,$480.75 ,$544.85 ,$544.85 ,$217.63 ,$544.85 ,$217.63 ,$499.98 ,$499.98 ,$499.98 ,$576.90 ,$522.43 ,$576.90 ,$217.63 ,$641.00 ,$419.86 ,$217.63 ,$266.66 , N/A , N/A ,$227.79 ,$576.90 ,$471.63 ,$395.50 ,$179.48 ,$576.90 ,$217.63 ,$576.90 ,$576.90 ,$217.63 ,$416.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$599.00 ,$389.35 ,$167.72 ,$599.00 ,$522.43 ,$446.26 ,$392.35 ,$217.63 ,$167.72 ,$302.50 ,$217.63 ,$369.58 ,$217.63 ,$369.58 ,$369.58 ,$217.63 ,$369.58 ,$413.50 ,$539.10 ,$449.25 ,$522.43 ,$217.63 ,$527.12 ,$217.63 ,$449.25 ,$449.25 ,$509.15 ,$509.15 ,$217.63 ,$509.15 ,$217.63 ,$467.22 ,$467.22 ,$467.22 ,$539.10 ,$522.43 ,$539.10 ,$217.63 ,$599.00 ,$392.35 ,$217.63 ,$249.18 , N/A , N/A ,$227.79 ,$539.10 ,$471.63 ,$369.58 ,$167.72 ,$539.10 ,$217.63 ,$539.10 ,$539.10 ,$217.63 ,$389.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$425.00 ,$276.25 ,$119.00 ,$425.00 ,$358.10 ,$316.63 ,$278.38 ,$149.18 ,$119.00 ,$214.63 ,$149.18 ,$262.23 ,$149.18 ,$262.23 ,$262.23 ,$149.18 ,$262.23 ,$283.44 ,$382.50 ,$318.75 ,$358.10 ,$149.18 ,$374.00 ,$149.18 ,$318.75 ,$318.75 ,$361.25 ,$361.25 ,$149.18 ,$361.25 ,$149.18 ,$331.50 ,$331.50 ,$331.50 ,$382.50 ,$358.10 ,$382.50 ,$149.18 ,$425.00 ,$278.38 ,$149.18 ,$176.80 , N/A , N/A ,$156.14 ,$382.50 ,$323.28 ,$262.23 ,$119.00 ,$382.50 ,$149.18 ,$382.50 ,$382.50 ,$149.18 ,$276.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$438.00 ,$284.70 ,$119.06 ,$438.00 ,$285.81 ,$326.31 ,$286.89 ,$119.06 ,$122.64 ,$221.19 ,$119.06 ,$270.25 ,$119.06 ,$270.25 ,$270.25 ,$119.06 ,$270.25 ,$226.21 ,$394.20 ,$328.50 ,$285.81 ,$119.06 ,$385.44 ,$119.06 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$119.06 ,$372.30 ,$119.06 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$285.81 ,$394.20 ,$119.06 ,$438.00 ,$286.89 ,$119.06 ,$182.21 , N/A , N/A ,$124.62 ,$394.20 ,$258.02 ,$270.25 ,$122.64 ,$394.20 ,$119.06 ,$394.20 ,$394.20 ,$119.06 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$313.00 ,$203.45 ,$87.64 ,$313.00 ,$285.81 ,$233.19 ,$205.02 ,$119.06 ,$87.64 ,$158.07 ,$119.06 ,$193.12 ,$119.06 ,$193.12 ,$193.12 ,$119.06 ,$193.12 ,$226.21 ,$281.70 ,$234.75 ,$285.81 ,$119.06 ,$275.44 ,$119.06 ,$234.75 ,$234.75 ,$266.05 ,$266.05 ,$119.06 ,$266.05 ,$119.06 ,$244.14 ,$244.14 ,$244.14 ,$281.70 ,$285.81 ,$281.70 ,$119.06 ,$313.00 ,$205.02 ,$119.06 ,$130.21 , N/A , N/A ,$124.62 ,$281.70 ,$258.02 ,$193.12 ,$87.64 ,$281.70 ,$119.06 ,$281.70 ,$281.70 ,$119.06 ,$203.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$185.00 ,$120.25 ,$51.80 ,$258.02 ,$185.00 ,$137.83 ,$121.18 ,$119.06 ,$51.80 ,$93.43 ,$119.06 ,$114.15 ,$119.06 ,$114.15 ,$114.15 ,$119.06 ,$114.15 ,$226.21 ,$166.50 ,$138.75 ,$185.00 ,$119.06 ,$162.80 ,$119.06 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$119.06 ,$157.25 ,$119.06 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$185.00 ,$166.50 ,$119.06 ,$185.00 ,$121.18 ,$119.06 ,$76.96 , N/A , N/A ,$124.62 ,$166.50 ,$258.02 ,$114.15 ,$51.80 ,$166.50 ,$119.06 ,$166.50 ,$166.50 ,$119.06 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000105,29240,HC STRAPPING SHLDR,450,1 ,$185.00 ,$120.25 ,$51.80 ,$258.02 ,$185.00 ,$137.83 ,$121.18 ,$119.06 ,$51.80 ,$93.43 ,$119.06 ,$114.15 ,$119.06 ,$114.15 ,$114.15 ,$119.06 ,$114.15 ,$226.21 ,$166.50 ,$138.75 ,$185.00 ,$119.06 ,$162.80 ,$119.06 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$119.06 ,$157.25 ,$119.06 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$185.00 ,$166.50 ,$119.06 ,$185.00 ,$121.18 ,$119.06 ,$76.96 , N/A , N/A ,$124.62 ,$166.50 ,$258.02 ,$114.15 ,$51.80 ,$166.50 ,$119.06 ,$166.50 ,$166.50 ,$119.06 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$742.00 ,$482.30 ,$207.76 ,$742.00 ,$611.48 ,$552.79 ,$486.01 ,$254.72 ,$207.76 ,$374.71 ,$254.72 ,$457.81 ,$254.72 ,$457.81 ,$457.81 ,$254.72 ,$457.81 ,$483.97 ,$667.80 ,$556.50 ,$611.48 ,$254.72 ,$652.96 ,$254.72 ,$556.50 ,$556.50 ,$630.70 ,$630.70 ,$254.72 ,$630.70 ,$254.72 ,$578.76 ,$578.76 ,$578.76 ,$667.80 ,$611.48 ,$667.80 ,$254.72 ,$742.00 ,$486.01 ,$254.72 ,$308.67 , N/A , N/A ,$266.61 ,$667.80 ,$552.02 ,$457.81 ,$207.76 ,$667.80 ,$254.72 ,$667.80 ,$667.80 ,$254.72 ,$482.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$425.00 ,$276.25 ,$119.00 ,$425.00 ,$358.10 ,$316.63 ,$278.38 ,$149.18 ,$119.00 ,$214.63 ,$149.18 ,$262.23 ,$149.18 ,$262.23 ,$262.23 ,$149.18 ,$262.23 ,$283.44 ,$382.50 ,$318.75 ,$358.10 ,$149.18 ,$374.00 ,$149.18 ,$318.75 ,$318.75 ,$361.25 ,$361.25 ,$149.18 ,$361.25 ,$149.18 ,$331.50 ,$331.50 ,$331.50 ,$382.50 ,$358.10 ,$382.50 ,$149.18 ,$425.00 ,$278.38 ,$149.18 ,$176.80 , N/A , N/A ,$156.14 ,$382.50 ,$323.28 ,$262.23 ,$119.00 ,$382.50 ,$149.18 ,$382.50 ,$382.50 ,$149.18 ,$276.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$425.00 ,$276.25 ,$119.00 ,$425.00 ,$358.10 ,$316.63 ,$278.38 ,$149.18 ,$119.00 ,$214.63 ,$149.18 ,$262.23 ,$149.18 ,$262.23 ,$262.23 ,$149.18 ,$262.23 ,$283.44 ,$382.50 ,$318.75 ,$358.10 ,$149.18 ,$374.00 ,$149.18 ,$318.75 ,$318.75 ,$361.25 ,$361.25 ,$149.18 ,$361.25 ,$149.18 ,$331.50 ,$331.50 ,$331.50 ,$382.50 ,$358.10 ,$382.50 ,$149.18 ,$425.00 ,$278.38 ,$149.18 ,$176.80 , N/A , N/A ,$156.14 ,$382.50 ,$323.28 ,$262.23 ,$119.00 ,$382.50 ,$149.18 ,$382.50 ,$382.50 ,$149.18 ,$276.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000110,30300,HC REM FB INTRANASAL,450,1 ,$466.00 ,$302.90 ,$119.06 ,$466.00 ,$285.81 ,$347.17 ,$305.23 ,$119.06 ,$130.48 ,$235.33 ,$119.06 ,$287.52 ,$119.06 ,$287.52 ,$287.52 ,$119.06 ,$287.52 ,$226.21 ,$419.40 ,$349.50 ,$285.81 ,$119.06 ,$410.08 ,$119.06 ,$349.50 ,$349.50 ,$396.10 ,$396.10 ,$119.06 ,$396.10 ,$119.06 ,$363.48 ,$363.48 ,$363.48 ,$419.40 ,$285.81 ,$419.40 ,$119.06 ,$466.00 ,$305.23 ,$119.06 ,$193.86 , N/A , N/A ,$124.62 ,$419.40 ,$258.02 ,$287.52 ,$130.48 ,$419.40 ,$119.06 ,$419.40 ,$419.40 ,$119.06 ,$302.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$466.00 ,$302.90 ,$119.06 ,$466.00 ,$285.81 ,$347.17 ,$305.23 ,$119.06 ,$130.48 ,$235.33 ,$119.06 ,$287.52 ,$119.06 ,$287.52 ,$287.52 ,$119.06 ,$287.52 ,$226.21 ,$419.40 ,$349.50 ,$285.81 ,$119.06 ,$410.08 ,$119.06 ,$349.50 ,$349.50 ,$396.10 ,$396.10 ,$119.06 ,$396.10 ,$119.06 ,$363.48 ,$363.48 ,$363.48 ,$419.40 ,$285.81 ,$419.40 ,$119.06 ,$466.00 ,$305.23 ,$119.06 ,$193.86 , N/A , N/A ,$124.62 ,$419.40 ,$258.02 ,$287.52 ,$130.48 ,$419.40 ,$119.06 ,$419.40 ,$419.40 ,$119.06 ,$302.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$319.00 ,$207.35 ,$89.32 ,$319.00 ,$285.81 ,$237.66 ,$208.95 ,$119.06 ,$89.32 ,$161.10 ,$119.06 ,$196.82 ,$119.06 ,$196.82 ,$196.82 ,$119.06 ,$196.82 ,$226.21 ,$287.10 ,$239.25 ,$285.81 ,$119.06 ,$280.72 ,$119.06 ,$239.25 ,$239.25 ,$271.15 ,$271.15 ,$119.06 ,$271.15 ,$119.06 ,$248.82 ,$248.82 ,$248.82 ,$287.10 ,$285.81 ,$287.10 ,$119.06 ,$319.00 ,$208.95 ,$119.06 ,$132.70 , N/A , N/A ,$124.62 ,$287.10 ,$258.02 ,$196.82 ,$89.32 ,$287.10 ,$119.06 ,$287.10 ,$287.10 ,$119.06 ,$207.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$459.00 ,$298.35 ,$119.06 ,$459.00 ,$285.81 ,$341.96 ,$300.65 ,$119.06 ,$128.52 ,$231.80 ,$119.06 ,$283.20 ,$119.06 ,$283.20 ,$283.20 ,$119.06 ,$283.20 ,$226.21 ,$413.10 ,$344.25 ,$285.81 ,$119.06 ,$403.92 ,$119.06 ,$344.25 ,$344.25 ,$390.15 ,$390.15 ,$119.06 ,$390.15 ,$119.06 ,$358.02 ,$358.02 ,$358.02 ,$413.10 ,$285.81 ,$413.10 ,$119.06 ,$459.00 ,$300.65 ,$119.06 ,$190.94 , N/A , N/A ,$124.62 ,$413.10 ,$258.02 ,$283.20 ,$128.52 ,$413.10 ,$119.06 ,$413.10 ,$413.10 ,$119.06 ,$298.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000123,36400,HC IV START < 3 YEARS OLD (MD),450,1 ,$382.00 ,$248.30 ,$106.96 ,$382.00 , N/A ,$284.59 ,$250.21 , N/A ,$106.96 ,$192.91 , N/A ,$235.69 , N/A ,$235.69 ,$235.69 , N/A ,$235.69 , N/A ,$343.80 ,$286.50 , N/A , N/A ,$336.16 , N/A ,$286.50 ,$286.50 ,$324.70 ,$324.70 , N/A ,$324.70 , N/A ,$297.96 ,$297.96 ,$297.96 ,$343.80 , N/A ,$343.80 , N/A ,$382.00 ,$250.21 , N/A ,$158.91 , N/A , N/A , N/A ,$343.80 , N/A ,$235.69 ,$106.96 ,$343.80 , N/A ,$343.80 ,$343.80 , N/A ,$248.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000124,36406,HC VENIPUNCTURE <3YR VEIN OTHR,450,1 ,$10.00 ,$6.50 ,$2.80 ,$10.00 , N/A ,$7.45 ,$6.55 , N/A ,$2.80 ,$5.05 , N/A ,$6.17 , N/A ,$6.17 ,$6.17 , N/A ,$6.17 , N/A ,$9.00 ,$7.50 , N/A , N/A ,$8.80 , N/A ,$7.50 ,$7.50 ,$8.50 ,$8.50 , N/A ,$8.50 , N/A ,$7.80 ,$7.80 ,$7.80 ,$9.00 , N/A ,$9.00 , N/A ,$10.00 ,$6.55 , N/A ,$4.16 , N/A , N/A , N/A ,$9.00 , N/A ,$6.17 ,$2.80 ,$9.00 , N/A ,$9.00 ,$9.00 , N/A ,$6.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$824.00 ,$535.60 ,$230.72 ,$824.00 ,$687.92 ,$613.88 ,$539.72 ,$286.56 ,$230.72 ,$416.12 ,$286.56 ,$508.41 ,$286.56 ,$508.41 ,$508.41 ,$286.56 ,$508.41 ,$544.46 ,$741.60 ,$618.00 ,$687.92 ,$286.56 ,$725.12 ,$286.56 ,$618.00 ,$618.00 ,$700.40 ,$700.40 ,$286.56 ,$700.40 ,$286.56 ,$642.72 ,$642.72 ,$642.72 ,$741.60 ,$687.92 ,$741.60 ,$286.56 ,$824.00 ,$539.72 ,$286.56 ,$342.78 , N/A , N/A ,$299.94 ,$741.60 ,$621.02 ,$508.41 ,$230.72 ,$741.60 ,$286.56 ,$741.60 ,$741.60 ,$286.56 ,$535.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000136,40800,HC DRAINAGE MOUTH LESION,450,1 ,"$1,749.00 ","$1,136.85 ",$489.72 ,"$1,749.00 ","$1,577.31 ","$1,303.01 ","$1,145.60 ",$657.06 ,$489.72 ,$883.25 ,$657.06 ,"$1,079.13 ",$657.06 ,"$1,079.13 ","$1,079.13 ",$657.06 ,"$1,079.13 ","$1,248.41 ","$1,574.10 ","$1,311.75 ","$1,577.31 ",$657.06 ,"$1,539.12 ",$657.06 ,"$1,311.75 ","$1,311.75 ","$1,486.65 ","$1,486.65 ",$657.06 ,"$1,486.65 ",$657.06 ,"$1,364.22 ","$1,364.22 ","$1,364.22 ","$1,574.10 ","$1,577.31 ","$1,574.10 ",$657.06 ,"$1,749.00 ","$1,145.60 ",$657.06 ,$727.58 , N/A , N/A ,$687.73 ,"$1,574.10 ","$1,423.93 ","$1,079.13 ",$489.72 ,"$1,574.10 ",$657.06 ,"$1,574.10 ","$1,574.10 ",$657.06 ,"$1,136.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000137,40830,HC LAC REPAIR VESTIBULE MOUTH 2.5 CM OR LESS,450,1 ,$584.00 ,$379.60 ,$163.52 ,$584.00 ,$536.25 ,$435.08 ,$382.52 ,$223.39 ,$163.52 ,$294.92 ,$223.39 ,$360.33 ,$223.39 ,$360.33 ,$360.33 ,$223.39 ,$360.33 ,$424.44 ,$525.60 ,$438.00 ,$536.25 ,$223.39 ,$513.92 ,$223.39 ,$438.00 ,$438.00 ,$496.40 ,$496.40 ,$223.39 ,$496.40 ,$223.39 ,$455.52 ,$455.52 ,$455.52 ,$525.60 ,$536.25 ,$525.60 ,$223.39 ,$584.00 ,$382.52 ,$223.39 ,$242.94 , N/A , N/A ,$233.81 ,$525.60 ,$484.11 ,$360.33 ,$163.52 ,$525.60 ,$223.39 ,$525.60 ,$525.60 ,$223.39 ,$379.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$337.00 ,$219.05 ,$94.36 ,$621.02 ,$337.00 ,$251.07 ,$220.74 ,$286.56 ,$94.36 ,$170.19 ,$286.56 ,$207.93 ,$286.56 ,$207.93 ,$207.93 ,$286.56 ,$207.93 ,$544.46 ,$303.30 ,$252.75 ,$337.00 ,$286.56 ,$296.56 ,$286.56 ,$252.75 ,$252.75 ,$286.45 ,$286.45 ,$286.56 ,$286.45 ,$286.56 ,$262.86 ,$262.86 ,$262.86 ,$303.30 ,$337.00 ,$303.30 ,$286.56 ,$337.00 ,$220.74 ,$286.56 ,$140.19 , N/A , N/A ,$299.94 ,$303.30 ,$621.02 ,$207.93 ,$94.36 ,$303.30 ,$286.56 ,$303.30 ,$303.30 ,$286.56 ,$219.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$573.00 ,$372.45 ,$119.06 ,$573.00 ,$285.81 ,$426.89 ,$375.32 ,$119.06 ,$160.44 ,$289.37 ,$119.06 ,$353.54 ,$119.06 ,$353.54 ,$353.54 ,$119.06 ,$353.54 ,$226.21 ,$515.70 ,$429.75 ,$285.81 ,$119.06 ,$504.24 ,$119.06 ,$429.75 ,$429.75 ,$487.05 ,$487.05 ,$119.06 ,$487.05 ,$119.06 ,$446.94 ,$446.94 ,$446.94 ,$515.70 ,$285.81 ,$515.70 ,$119.06 ,$573.00 ,$375.32 ,$119.06 ,$238.37 , N/A , N/A ,$124.62 ,$515.70 ,$258.02 ,$353.54 ,$160.44 ,$515.70 ,$119.06 ,$515.70 ,$515.70 ,$119.06 ,$372.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000146,46040,HC INCISION RECTAL ABSCESS,450,1 ,"$2,879.00 ","$1,871.35 ",$806.12 ,"$2,879.00 ","$2,628.42 ","$2,144.86 ","$1,885.75 ","$1,094.92 ",$806.12 ,"$1,453.90 ","$1,094.92 ","$1,776.34 ","$1,094.92 ","$1,776.34 ","$1,776.34 ","$1,094.92 ","$1,776.34 ","$2,080.35 ","$2,591.10 ","$2,159.25 ","$2,628.42 ","$1,094.92 ","$2,533.52 ","$1,094.92 ","$2,159.25 ","$2,159.25 ","$2,447.15 ","$2,447.15 ","$1,094.92 ","$2,447.15 ","$1,094.92 ","$2,245.62 ","$2,245.62 ","$2,245.62 ","$2,591.10 ","$2,628.42 ","$2,591.10 ","$1,094.92 ","$2,879.00 ","$1,885.75 ","$1,094.92 ","$1,197.66 ", N/A , N/A ,"$1,146.03 ","$2,591.10 ","$2,372.83 ","$1,776.34 ",$806.12 ,"$2,591.10 ","$1,094.92 ","$2,591.10 ","$2,591.10 ","$1,094.92 ","$1,871.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,"$2,260.00 ","$1,469.00 ",$632.80 ,"$2,260.00 ","$2,011.48 ","$1,683.70 ","$1,480.30 ",$837.92 ,$632.80 ,"$1,141.30 ",$837.92 ,"$1,394.42 ",$837.92 ,"$1,394.42 ","$1,394.42 ",$837.92 ,"$1,394.42 ","$1,592.05 ","$2,034.00 ","$1,695.00 ","$2,011.48 ",$837.92 ,"$1,988.80 ",$837.92 ,"$1,695.00 ","$1,695.00 ","$1,921.00 ","$1,921.00 ",$837.92 ,"$1,921.00 ",$837.92 ,"$1,762.80 ","$1,762.80 ","$1,762.80 ","$2,034.00 ","$2,011.48 ","$2,034.00 ",$837.92 ,"$2,260.00 ","$1,480.30 ",$837.92 ,$940.16 , N/A , N/A ,$877.04 ,"$2,034.00 ","$1,815.89 ","$1,394.42 ",$632.80 ,"$2,034.00 ",$837.92 ,"$2,034.00 ","$2,034.00 ",$837.92 ,"$1,469.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,$687.00 ,$446.55 ,$192.36 ,$687.00 ,$674.49 ,$511.82 ,$449.99 ,$280.97 ,$192.36 ,$346.94 ,$280.97 ,$423.88 ,$280.97 ,$423.88 ,$423.88 ,$280.97 ,$423.88 ,$533.84 ,$618.30 ,$515.25 ,$674.49 ,$280.97 ,$604.56 ,$280.97 ,$515.25 ,$515.25 ,$583.95 ,$583.95 ,$280.97 ,$583.95 ,$280.97 ,$535.86 ,$535.86 ,$535.86 ,$618.30 ,$674.49 ,$618.30 ,$280.97 ,$687.00 ,$449.99 ,$280.97 ,$285.79 , N/A , N/A ,$294.09 ,$618.30 ,$608.90 ,$423.88 ,$192.36 ,$618.30 ,$280.97 ,$618.30 ,$618.30 ,$280.97 ,$446.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$646.00 ,$419.90 ,$180.88 ,$646.00 ,$646.00 ,$481.27 ,$423.13 ,$280.97 ,$180.88 ,$326.23 ,$280.97 ,$398.58 ,$280.97 ,$398.58 ,$398.58 ,$280.97 ,$398.58 ,$533.84 ,$581.40 ,$484.50 ,$646.00 ,$280.97 ,$568.48 ,$280.97 ,$484.50 ,$484.50 ,$549.10 ,$549.10 ,$280.97 ,$549.10 ,$280.97 ,$503.88 ,$503.88 ,$503.88 ,$581.40 ,$646.00 ,$581.40 ,$280.97 ,$646.00 ,$423.13 ,$280.97 ,$268.74 , N/A , N/A ,$294.09 ,$581.40 ,$608.90 ,$398.58 ,$180.88 ,$581.40 ,$280.97 ,$581.40 ,$581.40 ,$280.97 ,$419.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000157,51705,HC CHG TUBE CYSTOSTOMY SMP,450,1 ,$756.00 ,$491.40 ,$211.68 ,$756.00 ,$674.49 ,$563.22 ,$495.18 ,$280.97 ,$211.68 ,$381.78 ,$280.97 ,$466.45 ,$280.97 ,$466.45 ,$466.45 ,$280.97 ,$466.45 ,$533.84 ,$680.40 ,$567.00 ,$674.49 ,$280.97 ,$665.28 ,$280.97 ,$567.00 ,$567.00 ,$642.60 ,$642.60 ,$280.97 ,$642.60 ,$280.97 ,$589.68 ,$589.68 ,$589.68 ,$680.40 ,$674.49 ,$680.40 ,$280.97 ,$756.00 ,$495.18 ,$280.97 ,$314.50 , N/A , N/A ,$294.09 ,$680.40 ,$608.90 ,$466.45 ,$211.68 ,$680.40 ,$280.97 ,$680.40 ,$680.40 ,$280.97 ,$491.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000159,54220,HC IRRIG CORPORA CAVNOSA,450,1 ,$708.00 ,$460.20 ,$198.24 ,$708.00 ,$674.49 ,$527.46 ,$463.74 ,$280.97 ,$198.24 ,$357.54 ,$280.97 ,$436.84 ,$280.97 ,$436.84 ,$436.84 ,$280.97 ,$436.84 ,$533.84 ,$637.20 ,$531.00 ,$674.49 ,$280.97 ,$623.04 ,$280.97 ,$531.00 ,$531.00 ,$601.80 ,$601.80 ,$280.97 ,$601.80 ,$280.97 ,$552.24 ,$552.24 ,$552.24 ,$637.20 ,$674.49 ,$637.20 ,$280.97 ,$708.00 ,$463.74 ,$280.97 ,$294.53 , N/A , N/A ,$294.09 ,$637.20 ,$608.90 ,$436.84 ,$198.24 ,$637.20 ,$280.97 ,$637.20 ,$637.20 ,$280.97 ,$460.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000160,54450,HC MANIP FORESKIN STRETCH,450,1 ,$708.00 ,$460.20 ,$198.24 ,$708.00 ,$674.49 ,$527.46 ,$463.74 ,$280.97 ,$198.24 ,$357.54 ,$280.97 ,$436.84 ,$280.97 ,$436.84 ,$436.84 ,$280.97 ,$436.84 ,$533.84 ,$637.20 ,$531.00 ,$674.49 ,$280.97 ,$623.04 ,$280.97 ,$531.00 ,$531.00 ,$601.80 ,$601.80 ,$280.97 ,$601.80 ,$280.97 ,$552.24 ,$552.24 ,$552.24 ,$637.20 ,$674.49 ,$637.20 ,$280.97 ,$708.00 ,$463.74 ,$280.97 ,$294.53 , N/A , N/A ,$294.09 ,$637.20 ,$608.90 ,$436.84 ,$198.24 ,$637.20 ,$280.97 ,$637.20 ,$637.20 ,$280.97 ,$460.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000161,54700,HC I AND D EPIDIDYMIS TESTIS OR SCROTAL SPACE,450,1 ,"$5,079.00 ","$3,301.35 ","$1,422.12 ","$5,079.00 ","$4,538.41 ","$3,783.86 ","$3,326.75 ","$1,890.56 ","$1,422.12 ","$2,564.90 ","$1,890.56 ","$3,133.74 ","$1,890.56 ","$3,133.74 ","$3,133.74 ","$1,890.56 ","$3,133.74 ","$3,592.06 ","$4,571.10 ","$3,809.25 ","$4,538.41 ","$1,890.56 ","$4,469.52 ","$1,890.56 ","$3,809.25 ","$3,809.25 ","$4,317.15 ","$4,317.15 ","$1,890.56 ","$4,317.15 ","$1,890.56 ","$3,961.62 ","$3,961.62 ","$3,961.62 ","$4,571.10 ","$4,538.41 ","$4,571.10 ","$1,890.56 ","$5,079.00 ","$3,326.75 ","$1,890.56 ","$2,112.86 ", N/A , N/A ,"$1,978.83 ","$4,571.10 ","$4,097.10 ","$3,133.74 ","$1,422.12 ","$4,571.10 ","$1,890.56 ","$4,571.10 ","$4,571.10 ","$1,890.56 ","$3,301.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$800.00 ,$520.00 ,$224.00 ,$800.00 ,$714.87 ,$596.00 ,$524.00 ,$297.79 ,$224.00 ,$404.00 ,$297.79 ,$493.60 ,$297.79 ,$493.60 ,$493.60 ,$297.79 ,$493.60 ,$565.80 ,$720.00 ,$600.00 ,$714.87 ,$297.79 ,$704.00 ,$297.79 ,$600.00 ,$600.00 ,$680.00 ,$680.00 ,$297.79 ,$680.00 ,$297.79 ,$624.00 ,$624.00 ,$624.00 ,$720.00 ,$714.87 ,$720.00 ,$297.79 ,$800.00 ,$524.00 ,$297.79 ,$332.80 , N/A , N/A ,$311.69 ,$720.00 ,$645.36 ,$493.60 ,$224.00 ,$720.00 ,$297.79 ,$720.00 ,$720.00 ,$297.79 ,$520.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$476.00 ,$309.40 ,$133.28 ,$476.00 ,$431.81 ,$354.62 ,$311.78 ,$179.88 ,$133.28 ,$240.38 ,$179.88 ,$293.69 ,$179.88 ,$293.69 ,$293.69 ,$179.88 ,$293.69 ,$341.77 ,$428.40 ,$357.00 ,$431.81 ,$179.88 ,$418.88 ,$179.88 ,$357.00 ,$357.00 ,$404.60 ,$404.60 ,$179.88 ,$404.60 ,$179.88 ,$371.28 ,$371.28 ,$371.28 ,$428.40 ,$431.81 ,$428.40 ,$179.88 ,$476.00 ,$311.78 ,$179.88 ,$198.02 , N/A , N/A ,$188.28 ,$428.40 ,$389.83 ,$293.69 ,$133.28 ,$428.40 ,$179.88 ,$428.40 ,$428.40 ,$179.88 ,$309.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$497.00 ,$323.05 ,$139.16 ,$597.83 ,$497.00 ,$370.27 ,$325.54 ,$275.86 ,$139.16 ,$250.99 ,$275.86 ,$306.65 ,$275.86 ,$306.65 ,$306.65 ,$275.86 ,$306.65 ,$524.13 ,$447.30 ,$372.75 ,$497.00 ,$275.86 ,$437.36 ,$275.86 ,$372.75 ,$372.75 ,$422.45 ,$422.45 ,$275.86 ,$422.45 ,$275.86 ,$387.66 ,$387.66 ,$387.66 ,$447.30 ,$497.00 ,$447.30 ,$275.86 ,$497.00 ,$325.54 ,$275.86 ,$206.75 , N/A , N/A ,$288.74 ,$447.30 ,$597.83 ,$306.65 ,$139.16 ,$447.30 ,$275.86 ,$447.30 ,$447.30 ,$275.86 ,$323.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$2,548.00 ","$1,656.20 ",$713.44 ,"$2,548.00 ","$2,414.28 ","$1,898.26 ","$1,668.94 ","$1,005.72 ",$713.44 ,"$1,286.74 ","$1,005.72 ","$1,572.12 ","$1,005.72 ","$1,572.12 ","$1,572.12 ","$1,005.72 ","$1,572.12 ","$1,910.87 ","$2,293.20 ","$1,911.00 ","$2,414.28 ","$1,005.72 ","$2,242.24 ","$1,005.72 ","$1,911.00 ","$1,911.00 ","$2,165.80 ","$2,165.80 ","$1,005.72 ","$2,165.80 ","$1,005.72 ","$1,987.44 ","$1,987.44 ","$1,987.44 ","$2,293.20 ","$2,414.28 ","$2,293.20 ","$1,005.72 ","$2,548.00 ","$1,668.94 ","$1,005.72 ","$1,059.97 ", N/A , N/A ,"$1,052.67 ","$2,293.20 ","$2,179.52 ","$1,572.12 ",$713.44 ,"$2,293.20 ","$1,005.72 ","$2,293.20 ","$2,293.20 ","$1,005.72 ","$1,656.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$1,698.00 ","$1,103.70 ",$475.44 ,"$1,698.00 ","$1,609.52 ","$1,265.01 ","$1,112.19 ",$670.48 ,$475.44 ,$857.49 ,$670.48 ,"$1,047.67 ",$670.48 ,"$1,047.67 ","$1,047.67 ",$670.48 ,"$1,047.67 ","$1,273.91 ","$1,528.20 ","$1,273.50 ","$1,609.52 ",$670.48 ,"$1,494.24 ",$670.48 ,"$1,273.50 ","$1,273.50 ","$1,443.30 ","$1,443.30 ",$670.48 ,"$1,443.30 ",$670.48 ,"$1,324.44 ","$1,324.44 ","$1,324.44 ","$1,528.20 ","$1,609.52 ","$1,528.20 ",$670.48 ,"$1,698.00 ","$1,112.19 ",$670.48 ,$706.37 , N/A , N/A ,$701.78 ,"$1,528.20 ","$1,453.01 ","$1,047.67 ",$475.44 ,"$1,528.20 ",$670.48 ,"$1,528.20 ","$1,528.20 ",$670.48 ,"$1,103.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$370.00 ,$240.50 ,$103.60 ,$370.00 ,$285.81 ,$275.65 ,$242.35 ,$119.06 ,$103.60 ,$186.85 ,$119.06 ,$228.29 ,$119.06 ,$228.29 ,$228.29 ,$119.06 ,$228.29 ,$226.21 ,$333.00 ,$277.50 ,$285.81 ,$119.06 ,$325.60 ,$119.06 ,$277.50 ,$277.50 ,$314.50 ,$314.50 ,$119.06 ,$314.50 ,$119.06 ,$288.60 ,$288.60 ,$288.60 ,$333.00 ,$285.81 ,$333.00 ,$119.06 ,$370.00 ,$242.35 ,$119.06 ,$153.92 , N/A , N/A ,$124.62 ,$333.00 ,$258.02 ,$228.29 ,$103.60 ,$333.00 ,$119.06 ,$333.00 ,$333.00 ,$119.06 ,$240.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000172,65210,HC REM EYE FB CONJUCT EMBED,450,1 ,"$1,042.00 ",$677.30 ,$286.56 ,"$1,042.00 ",$687.92 ,$776.29 ,$682.51 ,$286.56 ,$291.76 ,$526.21 ,$286.56 ,$642.91 ,$286.56 ,$642.91 ,$642.91 ,$286.56 ,$642.91 ,$544.46 ,$937.80 ,$781.50 ,$687.92 ,$286.56 ,$916.96 ,$286.56 ,$781.50 ,$781.50 ,$885.70 ,$885.70 ,$286.56 ,$885.70 ,$286.56 ,$812.76 ,$812.76 ,$812.76 ,$937.80 ,$687.92 ,$937.80 ,$286.56 ,"$1,042.00 ",$682.51 ,$286.56 ,$433.47 , N/A , N/A ,$299.94 ,$937.80 ,$621.02 ,$642.91 ,$291.76 ,$937.80 ,$286.56 ,$937.80 ,$937.80 ,$286.56 ,$677.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,$370.00 ,$240.50 ,$103.60 ,$621.02 ,$370.00 ,$275.65 ,$242.35 ,$286.56 ,$103.60 ,$186.85 ,$286.56 ,$228.29 ,$286.56 ,$228.29 ,$228.29 ,$286.56 ,$228.29 ,$544.46 ,$333.00 ,$277.50 ,$370.00 ,$286.56 ,$325.60 ,$286.56 ,$277.50 ,$277.50 ,$314.50 ,$314.50 ,$286.56 ,$314.50 ,$286.56 ,$288.60 ,$288.60 ,$288.60 ,$333.00 ,$370.00 ,$333.00 ,$286.56 ,$370.00 ,$242.35 ,$286.56 ,$153.92 , N/A , N/A ,$299.94 ,$333.00 ,$621.02 ,$228.29 ,$103.60 ,$333.00 ,$286.56 ,$333.00 ,$333.00 ,$286.56 ,$240.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000174,65222,HC REM FB CORNL W/ SLIT LA,450,1 ,$370.00 ,$240.50 ,$103.60 ,$370.00 ,$285.81 ,$275.65 ,$242.35 ,$119.06 ,$103.60 ,$186.85 ,$119.06 ,$228.29 ,$119.06 ,$228.29 ,$228.29 ,$119.06 ,$228.29 ,$226.21 ,$333.00 ,$277.50 ,$285.81 ,$119.06 ,$325.60 ,$119.06 ,$277.50 ,$277.50 ,$314.50 ,$314.50 ,$119.06 ,$314.50 ,$119.06 ,$288.60 ,$288.60 ,$288.60 ,$333.00 ,$285.81 ,$333.00 ,$119.06 ,$370.00 ,$242.35 ,$119.06 ,$153.92 , N/A , N/A ,$124.62 ,$333.00 ,$258.02 ,$228.29 ,$103.60 ,$333.00 ,$119.06 ,$333.00 ,$333.00 ,$119.06 ,$240.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000178,67938,HC REMOVE EMBEDDED FB EYELID,450,1 ,"$1,096.00 ",$712.40 ,$276.21 ,"$1,096.00 ",$663.05 ,$816.52 ,$717.88 ,$276.21 ,$306.88 ,$553.48 ,$276.21 ,$676.23 ,$276.21 ,$676.23 ,$676.23 ,$276.21 ,$676.23 ,$524.80 ,$986.40 ,$822.00 ,$663.05 ,$276.21 ,$964.48 ,$276.21 ,$822.00 ,$822.00 ,$931.60 ,$931.60 ,$276.21 ,$931.60 ,$276.21 ,$854.88 ,$854.88 ,$854.88 ,$986.40 ,$663.05 ,$986.40 ,$276.21 ,"$1,096.00 ",$717.88 ,$276.21 ,$455.94 , N/A , N/A ,$289.10 ,$986.40 ,$598.57 ,$676.23 ,$306.88 ,$986.40 ,$276.21 ,$986.40 ,$986.40 ,$276.21 ,$712.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000179,69000,HC DRAIN ABSC/HEMA EAR EXT SMP,450,1 ,"$1,749.00 ","$1,136.85 ",$489.72 ,"$1,749.00 ","$1,577.31 ","$1,303.01 ","$1,145.60 ",$657.06 ,$489.72 ,$883.25 ,$657.06 ,"$1,079.13 ",$657.06 ,"$1,079.13 ","$1,079.13 ",$657.06 ,"$1,079.13 ","$1,248.41 ","$1,574.10 ","$1,311.75 ","$1,577.31 ",$657.06 ,"$1,539.12 ",$657.06 ,"$1,311.75 ","$1,311.75 ","$1,486.65 ","$1,486.65 ",$657.06 ,"$1,486.65 ",$657.06 ,"$1,364.22 ","$1,364.22 ","$1,364.22 ","$1,574.10 ","$1,577.31 ","$1,574.10 ",$657.06 ,"$1,749.00 ","$1,145.60 ",$657.06 ,$727.58 , N/A , N/A ,$687.73 ,"$1,574.10 ","$1,423.93 ","$1,079.13 ",$489.72 ,"$1,574.10 ",$657.06 ,"$1,574.10 ","$1,574.10 ",$657.06 ,"$1,136.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000181,69200,HC FB REMOVAL EAR,450,1 ,$466.00 ,$302.90 ,$119.06 ,$466.00 ,$285.81 ,$347.17 ,$305.23 ,$119.06 ,$130.48 ,$235.33 ,$119.06 ,$287.52 ,$119.06 ,$287.52 ,$287.52 ,$119.06 ,$287.52 ,$226.21 ,$419.40 ,$349.50 ,$285.81 ,$119.06 ,$410.08 ,$119.06 ,$349.50 ,$349.50 ,$396.10 ,$396.10 ,$119.06 ,$396.10 ,$119.06 ,$363.48 ,$363.48 ,$363.48 ,$419.40 ,$285.81 ,$419.40 ,$119.06 ,$466.00 ,$305.23 ,$119.06 ,$193.86 , N/A , N/A ,$124.62 ,$419.40 ,$258.02 ,$287.52 ,$130.48 ,$419.40 ,$119.06 ,$419.40 ,$419.40 ,$119.06 ,$302.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$185.00 ,$120.25 ,$51.80 ,$185.00 ,$141.09 ,$137.83 ,$121.18 ,$58.77 ,$51.80 ,$93.43 ,$58.77 ,$114.15 ,$58.77 ,$114.15 ,$114.15 ,$58.77 ,$114.15 ,$111.66 ,$166.50 ,$138.75 ,$141.09 ,$58.77 ,$162.80 ,$58.77 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$58.77 ,$157.25 ,$58.77 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$141.09 ,$166.50 ,$58.77 ,$185.00 ,$121.18 ,$58.77 ,$76.96 , N/A , N/A ,$61.52 ,$166.50 ,$127.37 ,$114.15 ,$51.80 ,$166.50 ,$58.77 ,$166.50 ,$166.50 ,$58.77 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000188,99281,HC ER LEVEL 1,450,1 ,$259.00 ,$168.35 ,$72.52 ,$259.00 ,$183.85 ,$192.96 ,$169.65 ,$76.59 ,$72.52 ,$130.80 ,$76.59 ,$159.80 ,$76.59 ,$159.80 ,$159.80 ,$76.59 ,$159.80 ,$145.52 ,$233.10 ,$194.25 ,$183.85 ,$76.59 ,$227.92 ,$76.59 ,$194.25 ,$194.25 ,$220.15 ,$220.15 ,$76.59 ,$220.15 ,$76.59 ,$202.02 ,$202.02 ,$202.02 ,$233.10 ,$183.85 ,$233.10 ,$76.59 ,$259.00 ,$169.65 ,$76.59 ,$107.74 , N/A , N/A ,$80.16 ,$233.10 ,$165.98 ,$159.80 ,$72.52 ,$233.10 ,$76.59 ,$233.10 ,$233.10 ,$76.59 ,$168.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000189,99282,HC ER LEVEL 2,450,1 ,$454.00 ,$295.10 ,$127.12 ,$454.00 ,$332.94 ,$338.23 ,$297.37 ,$138.69 ,$127.12 ,$229.27 ,$138.69 ,$280.12 ,$138.69 ,$280.12 ,$280.12 ,$138.69 ,$280.12 ,$263.51 ,$408.60 ,$340.50 ,$332.94 ,$138.69 ,$399.52 ,$138.69 ,$340.50 ,$340.50 ,$385.90 ,$385.90 ,$138.69 ,$385.90 ,$138.69 ,$354.12 ,$354.12 ,$354.12 ,$408.60 ,$332.94 ,$408.60 ,$138.69 ,$454.00 ,$297.37 ,$138.69 ,$188.86 , N/A , N/A ,$145.17 ,$408.60 ,$300.56 ,$280.12 ,$127.12 ,$408.60 ,$138.69 ,$408.60 ,$408.60 ,$138.69 ,$295.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000190,99283,HC ER LEVEL 3,450,1 ,$827.00 ,$537.55 ,$231.56 ,$827.00 ,$586.58 ,$616.12 ,$541.69 ,$244.35 ,$231.56 ,$417.64 ,$244.35 ,$510.26 ,$244.35 ,$510.26 ,$510.26 ,$244.35 ,$510.26 ,$464.27 ,$744.30 ,$620.25 ,$586.58 ,$244.35 ,$727.76 ,$244.35 ,$620.25 ,$620.25 ,$702.95 ,$702.95 ,$244.35 ,$702.95 ,$244.35 ,$645.06 ,$645.06 ,$645.06 ,$744.30 ,$586.58 ,$744.30 ,$244.35 ,$827.00 ,$541.69 ,$244.35 ,$344.03 , N/A , N/A ,$255.76 ,$744.30 ,$529.54 ,$510.26 ,$231.56 ,$744.30 ,$244.35 ,$744.30 ,$744.30 ,$244.35 ,$537.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000191,99284,HC ER LEVEL 4,450,1 ,"$1,206.00 ",$783.90 ,$97.71 ,"$1,206.00 ",$922.05 ,$898.47 ,$789.93 ,$384.10 ,$337.68 ,$609.03 ,$384.10 ,$744.10 ,$384.10 ,$744.10 ,$744.10 ,$384.10 ,$744.10 ,$729.79 ,"$1,085.40 ",$904.50 ,$922.05 ,$384.10 ,"$1,061.28 ",$384.10 ,$904.50 ,$904.50 ,"$1,025.10 ","$1,025.10 ",$384.10 ,"$1,025.10 ",$384.10 ,$940.68 ,$940.68 ,$940.68 ,"$1,085.40 ",$922.05 ,"$1,085.40 ",$384.10 ,"$1,206.00 ",$789.93 ,$384.10 ,$501.70 ,$102.37 ,$97.71 ,$402.03 ,"$1,085.40 ",$832.39 ,$744.10 ,$337.68 ,"$1,085.40 ",$384.10 ,"$1,085.40 ","$1,085.40 ",$384.10 ,$783.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000192,99285,HC ER LEVEL 5,450,1 ,"$1,746.00 ","$1,134.90 ",$97.71 ,"$1,746.00 ","$1,323.49 ","$1,300.77 ","$1,143.63 ",$551.33 ,$488.88 ,$881.73 ,$551.33 ,"$1,077.28 ",$551.33 ,"$1,077.28 ","$1,077.28 ",$551.33 ,"$1,077.28 ","$1,047.53 ","$1,571.40 ","$1,309.50 ","$1,323.49 ",$551.33 ,"$1,536.48 ",$551.33 ,"$1,309.50 ","$1,309.50 ","$1,484.10 ","$1,484.10 ",$551.33 ,"$1,484.10 ",$551.33 ,"$1,361.88 ","$1,361.88 ","$1,361.88 ","$1,571.40 ","$1,323.49 ","$1,571.40 ",$551.33 ,"$1,746.00 ","$1,143.63 ",$551.33 ,$726.34 ,$102.37 ,$97.71 ,$577.06 ,"$1,571.40 ","$1,194.80 ","$1,077.28 ",$488.88 ,"$1,571.40 ",$551.33 ,"$1,571.40 ","$1,571.40 ",$551.33 ,"$1,134.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$2,727.00 ","$1,772.55 ",$97.71 ,"$2,727.00 ","$1,888.03 ","$2,031.62 ","$1,786.19 ",$786.50 ,$763.56 ,"$1,377.14 ",$786.50 ,"$1,682.56 ",$786.50 ,"$1,682.56 ","$1,682.56 ",$786.50 ,"$1,682.56 ","$1,494.35 ","$2,454.30 ","$2,045.25 ","$1,888.03 ",$786.50 ,"$2,399.76 ",$786.50 ,"$2,045.25 ","$2,045.25 ","$2,317.95 ","$2,317.95 ",$786.50 ,"$2,317.95 ",$786.50 ,"$2,127.06 ","$2,127.06 ","$2,127.06 ","$2,454.30 ","$1,888.03 ","$2,454.30 ",$786.50 ,"$2,727.00 ","$1,786.19 ",$786.50 ,"$1,134.43 ",$102.37 ,$97.71 ,$823.21 ,"$2,454.30 ","$1,704.44 ","$1,682.56 ",$763.56 ,"$2,454.30 ",$786.50 ,"$2,454.30 ","$2,454.30 ",$786.50 ,"$1,772.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,"$1,319.00 ",$857.35 ,$369.32 ,"$1,319.00 ", N/A ,$982.66 ,$863.95 , N/A ,$369.32 ,$666.10 , N/A ,$813.82 , N/A ,$813.82 ,$813.82 , N/A ,$813.82 , N/A ,"$1,187.10 ",$989.25 , N/A , N/A ,"$1,160.72 ", N/A ,$989.25 ,$989.25 ,"$1,121.15 ","$1,121.15 ", N/A ,"$1,121.15 ", N/A ,"$1,028.82 ","$1,028.82 ","$1,028.82 ","$1,187.10 ", N/A ,"$1,187.10 ", N/A ,"$1,319.00 ",$863.95 , N/A ,$548.70 , N/A , N/A , N/A ,"$1,187.10 ", N/A ,$813.82 ,$369.32 ,"$1,187.10 ", N/A ,"$1,187.10 ","$1,187.10 ", N/A ,$857.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,"$3,886.00 ","$2,525.90 ","$1,088.08 ","$3,886.00 ","$3,530.44 ","$2,895.07 ","$2,545.33 ","$1,470.67 ","$1,088.08 ","$1,962.43 ","$1,470.67 ","$2,397.66 ","$1,470.67 ","$2,397.66 ","$2,397.66 ","$1,470.67 ","$2,397.66 ","$2,794.27 ","$3,497.40 ","$2,914.50 ","$3,530.44 ","$1,470.67 ","$3,419.68 ","$1,470.67 ","$2,914.50 ","$2,914.50 ","$3,303.10 ","$3,303.10 ","$1,470.67 ","$3,303.10 ","$1,470.67 ","$3,031.08 ","$3,031.08 ","$3,031.08 ","$3,497.40 ","$3,530.44 ","$3,497.40 ","$1,470.67 ","$3,886.00 ","$2,545.33 ","$1,470.67 ","$1,616.58 ", N/A , N/A ,"$1,539.33 ","$3,497.40 ","$3,187.14 ","$2,397.66 ","$1,088.08 ","$3,497.40 ","$1,470.67 ","$3,497.40 ","$3,497.40 ","$1,470.67 ","$2,525.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$618.00 ,$401.70 ,$173.04 ,$618.00 ,$522.43 ,$460.41 ,$404.79 ,$217.63 ,$173.04 ,$312.09 ,$217.63 ,$381.31 ,$217.63 ,$381.31 ,$381.31 ,$217.63 ,$381.31 ,$413.50 ,$556.20 ,$463.50 ,$522.43 ,$217.63 ,$543.84 ,$217.63 ,$463.50 ,$463.50 ,$525.30 ,$525.30 ,$217.63 ,$525.30 ,$217.63 ,$482.04 ,$482.04 ,$482.04 ,$556.20 ,$522.43 ,$556.20 ,$217.63 ,$618.00 ,$404.79 ,$217.63 ,$257.09 , N/A , N/A ,$227.79 ,$556.20 ,$471.63 ,$381.31 ,$173.04 ,$556.20 ,$217.63 ,$556.20 ,$556.20 ,$217.63 ,$401.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$459.00 ,$298.35 ,$128.52 ,$471.63 ,$459.00 ,$341.96 ,$300.65 ,$217.63 ,$128.52 ,$231.80 ,$217.63 ,$283.20 ,$217.63 ,$283.20 ,$283.20 ,$217.63 ,$283.20 ,$413.50 ,$413.10 ,$344.25 ,$459.00 ,$217.63 ,$403.92 ,$217.63 ,$344.25 ,$344.25 ,$390.15 ,$390.15 ,$217.63 ,$390.15 ,$217.63 ,$358.02 ,$358.02 ,$358.02 ,$413.10 ,$459.00 ,$413.10 ,$217.63 ,$459.00 ,$300.65 ,$217.63 ,$190.94 , N/A , N/A ,$227.79 ,$413.10 ,$471.63 ,$283.20 ,$128.52 ,$413.10 ,$217.63 ,$413.10 ,$413.10 ,$217.63 ,$298.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000203,27840,HC TX DISL ANKE W/O ANES CLS,450,1 ,$756.00 ,$491.40 ,$211.68 ,$756.00 ,$522.43 ,$563.22 ,$495.18 ,$217.63 ,$211.68 ,$381.78 ,$217.63 ,$466.45 ,$217.63 ,$466.45 ,$466.45 ,$217.63 ,$466.45 ,$413.50 ,$680.40 ,$567.00 ,$522.43 ,$217.63 ,$665.28 ,$217.63 ,$567.00 ,$567.00 ,$642.60 ,$642.60 ,$217.63 ,$642.60 ,$217.63 ,$589.68 ,$589.68 ,$589.68 ,$680.40 ,$522.43 ,$680.40 ,$217.63 ,$756.00 ,$495.18 ,$217.63 ,$314.50 , N/A , N/A ,$227.79 ,$680.40 ,$471.63 ,$466.45 ,$211.68 ,$680.40 ,$217.63 ,$680.40 ,$680.40 ,$217.63 ,$491.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,"$4,006.50 ","$2,604.23 ","$1,121.82 ","$4,006.50 ","$3,566.38 ","$2,984.84 ","$2,624.26 ","$1,485.64 ","$1,121.82 ","$2,023.28 ","$1,485.64 ","$2,472.01 ","$1,485.64 ","$2,472.01 ","$2,472.01 ","$1,485.64 ","$2,472.01 ","$2,822.72 ","$3,605.85 ","$3,004.88 ","$3,566.38 ","$1,485.64 ","$3,525.72 ","$1,485.64 ","$3,004.88 ","$3,004.88 ","$3,405.53 ","$3,405.53 ","$1,485.64 ","$3,405.53 ","$1,485.64 ","$3,125.07 ","$3,125.07 ","$3,125.07 ","$3,605.85 ","$3,566.38 ","$3,605.85 ","$1,485.64 ","$4,006.50 ","$2,624.26 ","$1,485.64 ","$1,666.70 ", N/A , N/A ,"$1,555.00 ","$3,605.85 ","$3,219.59 ","$2,472.01 ","$1,121.82 ","$3,605.85 ","$1,485.64 ","$3,605.85 ","$3,605.85 ","$1,485.64 ","$2,604.23 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000206,36405,HC VENIPUNCTURE SCALP VEIN <3YRS,450,1 ,$382.00 ,$248.30 ,$106.96 ,$382.00 , N/A ,$284.59 ,$250.21 , N/A ,$106.96 ,$192.91 , N/A ,$235.69 , N/A ,$235.69 ,$235.69 , N/A ,$235.69 , N/A ,$343.80 ,$286.50 , N/A , N/A ,$336.16 , N/A ,$286.50 ,$286.50 ,$324.70 ,$324.70 , N/A ,$324.70 , N/A ,$297.96 ,$297.96 ,$297.96 ,$343.80 , N/A ,$343.80 , N/A ,$382.00 ,$250.21 , N/A ,$158.91 , N/A , N/A , N/A ,$343.80 , N/A ,$235.69 ,$106.96 ,$343.80 , N/A ,$343.80 ,$343.80 , N/A ,$248.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000212,25690,HC CLSD WRIST DISLOC,450,1 ,"$3,964.77 ","$2,577.10 ","$1,110.14 ","$3,964.77 ","$3,530.44 ","$2,953.75 ","$2,596.92 ","$1,470.67 ","$1,110.14 ","$2,002.21 ","$1,470.67 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,794.27 ","$3,568.29 ","$2,973.58 ","$3,530.44 ","$1,470.67 ","$3,489.00 ","$1,470.67 ","$2,973.58 ","$2,973.58 ","$3,370.05 ","$3,370.05 ","$1,470.67 ","$3,370.05 ","$1,470.67 ","$3,092.52 ","$3,092.52 ","$3,092.52 ","$3,568.29 ","$3,530.44 ","$3,568.29 ","$1,470.67 ","$3,964.77 ","$2,596.92 ","$1,470.67 ","$1,649.34 ", N/A , N/A ,"$1,539.33 ","$3,568.29 ","$3,187.14 ","$2,446.26 ","$1,110.14 ","$3,568.29 ","$1,470.67 ","$3,568.29 ","$3,568.29 ","$1,470.67 ","$2,577.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,$819.00 ,$532.35 ,$229.32 ,$819.00 ,$808.19 ,$610.16 ,$536.45 ,$336.67 ,$229.32 ,$413.60 ,$336.67 ,$505.32 ,$336.67 ,$505.32 ,$505.32 ,$336.67 ,$505.32 ,$639.67 ,$737.10 ,$614.25 ,$808.19 ,$336.67 ,$720.72 ,$336.67 ,$614.25 ,$614.25 ,$696.15 ,$696.15 ,$336.67 ,$696.15 ,$336.67 ,$638.82 ,$638.82 ,$638.82 ,$737.10 ,$808.19 ,$737.10 ,$336.67 ,$819.00 ,$536.45 ,$336.67 ,$340.70 , N/A , N/A ,$352.38 ,$737.10 ,$729.60 ,$505.32 ,$229.32 ,$737.10 ,$336.67 ,$737.10 ,$737.10 ,$336.67 ,$532.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,"$3,094.00 ","$2,011.10 ",$866.32 ,"$3,187.14 ","$3,094.00 ","$2,305.03 ","$2,026.57 ","$1,470.67 ",$866.32 ,"$1,562.47 ","$1,470.67 ","$1,909.00 ","$1,470.67 ","$1,909.00 ","$1,909.00 ","$1,470.67 ","$1,909.00 ","$2,794.27 ","$2,784.60 ","$2,320.50 ","$3,094.00 ","$1,470.67 ","$2,722.72 ","$1,470.67 ","$2,320.50 ","$2,320.50 ","$2,629.90 ","$2,629.90 ","$1,470.67 ","$2,629.90 ","$1,470.67 ","$2,413.32 ","$2,413.32 ","$2,413.32 ","$2,784.60 ","$3,094.00 ","$2,784.60 ","$1,470.67 ","$3,094.00 ","$2,026.57 ","$1,470.67 ","$1,287.10 ", N/A , N/A ,"$1,539.33 ","$2,784.60 ","$3,187.14 ","$1,909.00 ",$866.32 ,"$2,784.60 ","$1,470.67 ","$2,784.60 ","$2,784.60 ","$1,470.67 ","$2,011.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000227,25600,HC CLSD DIS.RADIUS W/O MANIP,450,1 ,$587.13 ,$381.63 ,$164.40 ,$587.13 ,$522.43 ,$437.41 ,$384.57 ,$217.63 ,$164.40 ,$296.50 ,$217.63 ,$362.26 ,$217.63 ,$362.26 ,$362.26 ,$217.63 ,$362.26 ,$413.50 ,$528.42 ,$440.35 ,$522.43 ,$217.63 ,$516.67 ,$217.63 ,$440.35 ,$440.35 ,$499.06 ,$499.06 ,$217.63 ,$499.06 ,$217.63 ,$457.96 ,$457.96 ,$457.96 ,$528.42 ,$522.43 ,$528.42 ,$217.63 ,$587.13 ,$384.57 ,$217.63 ,$244.25 , N/A , N/A ,$227.79 ,$528.42 ,$471.63 ,$362.26 ,$164.40 ,$528.42 ,$217.63 ,$528.42 ,$528.42 ,$217.63 ,$381.63 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$689.00 ,$447.85 ,$192.92 ,$689.00 ,$522.43 ,$513.31 ,$451.30 ,$217.63 ,$192.92 ,$347.95 ,$217.63 ,$425.11 ,$217.63 ,$425.11 ,$425.11 ,$217.63 ,$425.11 ,$413.50 ,$620.10 ,$516.75 ,$522.43 ,$217.63 ,$606.32 ,$217.63 ,$516.75 ,$516.75 ,$585.65 ,$585.65 ,$217.63 ,$585.65 ,$217.63 ,$537.42 ,$537.42 ,$537.42 ,$620.10 ,$522.43 ,$620.10 ,$217.63 ,$689.00 ,$451.30 ,$217.63 ,$286.62 , N/A , N/A ,$227.79 ,$620.10 ,$471.63 ,$425.11 ,$192.92 ,$620.10 ,$217.63 ,$620.10 ,$620.10 ,$217.63 ,$447.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000231,25505,HC RADIUS FX W MANIP,450,1 ,"$3,964.77 ","$2,577.10 ","$1,110.14 ","$3,964.77 ","$3,530.44 ","$2,953.75 ","$2,596.92 ","$1,470.67 ","$1,110.14 ","$2,002.21 ","$1,470.67 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,794.27 ","$3,568.29 ","$2,973.58 ","$3,530.44 ","$1,470.67 ","$3,489.00 ","$1,470.67 ","$2,973.58 ","$2,973.58 ","$3,370.05 ","$3,370.05 ","$1,470.67 ","$3,370.05 ","$1,470.67 ","$3,092.52 ","$3,092.52 ","$3,092.52 ","$3,568.29 ","$3,530.44 ","$3,568.29 ","$1,470.67 ","$3,964.77 ","$2,596.92 ","$1,470.67 ","$1,649.34 ", N/A , N/A ,"$1,539.33 ","$3,568.29 ","$3,187.14 ","$2,446.26 ","$1,110.14 ","$3,568.29 ","$1,470.67 ","$3,568.29 ","$3,568.29 ","$1,470.67 ","$2,577.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000246,24505,HC HUMERAL CLOSED RED FX,450,1 ,"$4,020.00 ","$2,613.00 ","$1,125.60 ","$4,020.00 ","$3,530.44 ","$2,994.90 ","$2,633.10 ","$1,470.67 ","$1,125.60 ","$2,030.10 ","$1,470.67 ","$2,480.34 ","$1,470.67 ","$2,480.34 ","$2,480.34 ","$1,470.67 ","$2,480.34 ","$2,794.27 ","$3,618.00 ","$3,015.00 ","$3,530.44 ","$1,470.67 ","$3,537.60 ","$1,470.67 ","$3,015.00 ","$3,015.00 ","$3,417.00 ","$3,417.00 ","$1,470.67 ","$3,417.00 ","$1,470.67 ","$3,135.60 ","$3,135.60 ","$3,135.60 ","$3,618.00 ","$3,530.44 ","$3,618.00 ","$1,470.67 ","$4,020.00 ","$2,633.10 ","$1,470.67 ","$1,672.32 ", N/A , N/A ,"$1,539.33 ","$3,618.00 ","$3,187.14 ","$2,480.34 ","$1,125.60 ","$3,618.00 ","$1,470.67 ","$3,618.00 ","$3,618.00 ","$1,470.67 ","$2,613.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000248,28475,HC CLSD METATARSAL W/MANIP,450,1 ,$618.00 ,$401.70 ,$173.04 ,$618.00 ,$522.43 ,$460.41 ,$404.79 ,$217.63 ,$173.04 ,$312.09 ,$217.63 ,$381.31 ,$217.63 ,$381.31 ,$381.31 ,$217.63 ,$381.31 ,$413.50 ,$556.20 ,$463.50 ,$522.43 ,$217.63 ,$543.84 ,$217.63 ,$463.50 ,$463.50 ,$525.30 ,$525.30 ,$217.63 ,$525.30 ,$217.63 ,$482.04 ,$482.04 ,$482.04 ,$556.20 ,$522.43 ,$556.20 ,$217.63 ,$618.00 ,$404.79 ,$217.63 ,$257.09 , N/A , N/A ,$227.79 ,$556.20 ,$471.63 ,$381.31 ,$173.04 ,$556.20 ,$217.63 ,$556.20 ,$556.20 ,$217.63 ,$401.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000249,28515,HC TOE FX W/MANIP,450,1 ,$756.00 ,$491.40 ,$211.68 ,$756.00 ,$522.43 ,$563.22 ,$495.18 ,$217.63 ,$211.68 ,$381.78 ,$217.63 ,$466.45 ,$217.63 ,$466.45 ,$466.45 ,$217.63 ,$466.45 ,$413.50 ,$680.40 ,$567.00 ,$522.43 ,$217.63 ,$665.28 ,$217.63 ,$567.00 ,$567.00 ,$642.60 ,$642.60 ,$217.63 ,$642.60 ,$217.63 ,$589.68 ,$589.68 ,$589.68 ,$680.40 ,$522.43 ,$680.40 ,$217.63 ,$756.00 ,$495.18 ,$217.63 ,$314.50 , N/A , N/A ,$227.79 ,$680.40 ,$471.63 ,$466.45 ,$211.68 ,$680.40 ,$217.63 ,$680.40 ,$680.40 ,$217.63 ,$491.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000259,28630,HC FOOT DISCL W/O ANES,450,1 ,$756.00 ,$491.40 ,$211.68 ,$756.00 ,$522.43 ,$563.22 ,$495.18 ,$217.63 ,$211.68 ,$381.78 ,$217.63 ,$466.45 ,$217.63 ,$466.45 ,$466.45 ,$217.63 ,$466.45 ,$413.50 ,$680.40 ,$567.00 ,$522.43 ,$217.63 ,$665.28 ,$217.63 ,$567.00 ,$567.00 ,$642.60 ,$642.60 ,$217.63 ,$642.60 ,$217.63 ,$589.68 ,$589.68 ,$589.68 ,$680.40 ,$522.43 ,$680.40 ,$217.63 ,$756.00 ,$495.18 ,$217.63 ,$314.50 , N/A , N/A ,$227.79 ,$680.40 ,$471.63 ,$466.45 ,$211.68 ,$680.40 ,$217.63 ,$680.40 ,$680.40 ,$217.63 ,$491.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$1,930.00 ","$1,254.50 ",$275.86 ,"$1,930.00 ",$662.23 ,"$1,437.85 ","$1,264.15 ",$275.86 ,$540.40 ,$974.65 ,$275.86 ,"$1,190.81 ",$275.86 ,"$1,190.81 ","$1,190.81 ",$275.86 ,"$1,190.81 ",$524.13 ,"$1,737.00 ","$1,447.50 ",$662.23 ,$275.86 ,"$1,698.40 ",$275.86 ,"$1,447.50 ","$1,447.50 ","$1,640.50 ","$1,640.50 ",$275.86 ,"$1,640.50 ",$275.86 ,"$1,505.40 ","$1,505.40 ","$1,505.40 ","$1,737.00 ",$662.23 ,"$1,737.00 ",$275.86 ,"$1,930.00 ","$1,264.15 ",$275.86 ,$802.88 , N/A , N/A ,$288.74 ,"$1,737.00 ",$597.83 ,"$1,190.81 ",$540.40 ,"$1,737.00 ",$275.86 ,"$1,737.00 ","$1,737.00 ",$275.86 ,"$1,254.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$165.00 ,$107.25 ,$46.20 ,$165.00 ,$141.09 ,$122.93 ,$108.08 ,$58.77 ,$46.20 ,$83.33 ,$58.77 ,$101.81 ,$58.77 ,$101.81 ,$101.81 ,$58.77 ,$101.81 ,$111.66 ,$148.50 ,$123.75 ,$141.09 ,$58.77 ,$145.20 ,$58.77 ,$123.75 ,$123.75 ,$140.25 ,$140.25 ,$58.77 ,$140.25 ,$58.77 ,$128.70 ,$128.70 ,$128.70 ,$148.50 ,$141.09 ,$148.50 ,$58.77 ,$165.00 ,$108.08 ,$58.77 ,$68.64 , N/A , N/A ,$61.52 ,$148.50 ,$127.37 ,$101.81 ,$46.20 ,$148.50 ,$58.77 ,$148.50 ,$148.50 ,$58.77 ,$107.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000303,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP,450,1 ,"$4,017.00 ","$2,611.05 ","$1,124.76 ","$4,017.00 ","$3,530.44 ","$2,992.67 ","$2,631.14 ","$1,470.67 ","$1,124.76 ","$2,028.59 ","$1,470.67 ","$2,478.49 ","$1,470.67 ","$2,478.49 ","$2,478.49 ","$1,470.67 ","$2,478.49 ","$2,794.27 ","$3,615.30 ","$3,012.75 ","$3,530.44 ","$1,470.67 ","$3,534.96 ","$1,470.67 ","$3,012.75 ","$3,012.75 ","$3,414.45 ","$3,414.45 ","$1,470.67 ","$3,414.45 ","$1,470.67 ","$3,133.26 ","$3,133.26 ","$3,133.26 ","$3,615.30 ","$3,530.44 ","$3,615.30 ","$1,470.67 ","$4,017.00 ","$2,631.14 ","$1,470.67 ","$1,671.07 ", N/A , N/A ,"$1,539.33 ","$3,615.30 ","$3,187.14 ","$2,478.49 ","$1,124.76 ","$3,615.30 ","$1,470.67 ","$3,615.30 ","$3,615.30 ","$1,470.67 ","$2,611.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,$618.00 ,$401.70 ,$173.04 ,$618.00 ,$522.43 ,$460.41 ,$404.79 ,$217.63 ,$173.04 ,$312.09 ,$217.63 ,$381.31 ,$217.63 ,$381.31 ,$381.31 ,$217.63 ,$381.31 ,$413.50 ,$556.20 ,$463.50 ,$522.43 ,$217.63 ,$543.84 ,$217.63 ,$463.50 ,$463.50 ,$525.30 ,$525.30 ,$217.63 ,$525.30 ,$217.63 ,$482.04 ,$482.04 ,$482.04 ,$556.20 ,$522.43 ,$556.20 ,$217.63 ,$618.00 ,$404.79 ,$217.63 ,$257.09 , N/A , N/A ,$227.79 ,$556.20 ,$471.63 ,$381.31 ,$173.04 ,$556.20 ,$217.63 ,$556.20 ,$556.20 ,$217.63 ,$401.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000310,31505,HC LARYNGOSCOPY INDIRECT,450,1 ,$493.17 ,$320.56 ,$138.09 ,$493.17 ,$417.25 ,$367.41 ,$323.03 ,$173.81 ,$138.09 ,$249.05 ,$173.81 ,$304.29 ,$173.81 ,$304.29 ,$304.29 ,$173.81 ,$304.29 ,$330.24 ,$443.85 ,$369.88 ,$417.25 ,$173.81 ,$433.99 ,$173.81 ,$369.88 ,$369.88 ,$419.19 ,$419.19 ,$173.81 ,$419.19 ,$173.81 ,$384.67 ,$384.67 ,$384.67 ,$443.85 ,$417.25 ,$443.85 ,$173.81 ,$493.17 ,$323.03 ,$173.81 ,$205.16 , N/A , N/A ,$181.93 ,$443.85 ,$376.67 ,$304.29 ,$138.09 ,$443.85 ,$173.81 ,$443.85 ,$443.85 ,$173.81 ,$320.56 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,$587.13 ,$381.63 ,$164.40 ,$587.13 ,$522.43 ,$437.41 ,$384.57 ,$217.63 ,$164.40 ,$296.50 ,$217.63 ,$362.26 ,$217.63 ,$362.26 ,$362.26 ,$217.63 ,$362.26 ,$413.50 ,$528.42 ,$440.35 ,$522.43 ,$217.63 ,$516.67 ,$217.63 ,$440.35 ,$440.35 ,$499.06 ,$499.06 ,$217.63 ,$499.06 ,$217.63 ,$457.96 ,$457.96 ,$457.96 ,$528.42 ,$522.43 ,$528.42 ,$217.63 ,$587.13 ,$384.57 ,$217.63 ,$244.25 , N/A , N/A ,$227.79 ,$528.42 ,$471.63 ,$362.26 ,$164.40 ,$528.42 ,$217.63 ,$528.42 ,$528.42 ,$217.63 ,$381.63 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000329,27752,HC CLSD TX FX TIBIAL SHAFT W/MANIP,450,1 ,"$3,094.00 ","$2,011.10 ",$866.32 ,"$3,187.14 ","$3,094.00 ","$2,305.03 ","$2,026.57 ","$1,470.67 ",$866.32 ,"$1,562.47 ","$1,470.67 ","$1,909.00 ","$1,470.67 ","$1,909.00 ","$1,909.00 ","$1,470.67 ","$1,909.00 ","$2,794.27 ","$2,784.60 ","$2,320.50 ","$3,094.00 ","$1,470.67 ","$2,722.72 ","$1,470.67 ","$2,320.50 ","$2,320.50 ","$2,629.90 ","$2,629.90 ","$1,470.67 ","$2,629.90 ","$1,470.67 ","$2,413.32 ","$2,413.32 ","$2,413.32 ","$2,784.60 ","$3,094.00 ","$2,784.60 ","$1,470.67 ","$3,094.00 ","$2,026.57 ","$1,470.67 ","$1,287.10 ", N/A , N/A ,"$1,539.33 ","$2,784.60 ","$3,187.14 ","$1,909.00 ",$866.32 ,"$2,784.60 ","$1,470.67 ","$2,784.60 ","$2,784.60 ","$1,470.67 ","$2,011.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,$647.00 ,$420.55 ,$181.16 ,$647.00 ,$522.43 ,$482.02 ,$423.79 ,$217.63 ,$181.16 ,$326.74 ,$217.63 ,$399.20 ,$217.63 ,$399.20 ,$399.20 ,$217.63 ,$399.20 ,$413.50 ,$582.30 ,$485.25 ,$522.43 ,$217.63 ,$569.36 ,$217.63 ,$485.25 ,$485.25 ,$549.95 ,$549.95 ,$217.63 ,$549.95 ,$217.63 ,$504.66 ,$504.66 ,$504.66 ,$582.30 ,$522.43 ,$582.30 ,$217.63 ,$647.00 ,$423.79 ,$217.63 ,$269.15 , N/A , N/A ,$227.79 ,$582.30 ,$471.63 ,$399.20 ,$181.16 ,$582.30 ,$217.63 ,$582.30 ,$582.30 ,$217.63 ,$420.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000335,29530,HC STRAPPING KNEE,450,1 ,$185.00 ,$120.25 ,$51.80 ,$258.02 ,$185.00 ,$137.83 ,$121.18 ,$119.06 ,$51.80 ,$93.43 ,$119.06 ,$114.15 ,$119.06 ,$114.15 ,$114.15 ,$119.06 ,$114.15 ,$226.21 ,$166.50 ,$138.75 ,$185.00 ,$119.06 ,$162.80 ,$119.06 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$119.06 ,$157.25 ,$119.06 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$185.00 ,$166.50 ,$119.06 ,$185.00 ,$121.18 ,$119.06 ,$76.96 , N/A , N/A ,$124.62 ,$166.50 ,$258.02 ,$114.15 ,$51.80 ,$166.50 ,$119.06 ,$166.50 ,$166.50 ,$119.06 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000336,29550,HC STRAPPING TOES,450,1 ,$165.00 ,$107.25 ,$46.20 ,$165.00 ,$141.09 ,$122.93 ,$108.08 ,$58.77 ,$46.20 ,$83.33 ,$58.77 ,$101.81 ,$58.77 ,$101.81 ,$101.81 ,$58.77 ,$101.81 ,$111.66 ,$148.50 ,$123.75 ,$141.09 ,$58.77 ,$145.20 ,$58.77 ,$123.75 ,$123.75 ,$140.25 ,$140.25 ,$58.77 ,$140.25 ,$58.77 ,$128.70 ,$128.70 ,$128.70 ,$148.50 ,$141.09 ,$148.50 ,$58.77 ,$165.00 ,$108.08 ,$58.77 ,$68.64 , N/A , N/A ,$61.52 ,$148.50 ,$127.37 ,$101.81 ,$46.20 ,$148.50 ,$58.77 ,$148.50 ,$148.50 ,$58.77 ,$107.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000338,30906,HC CONTROL NASAL HEMORRHAGE SUBSQ,450,1 ,$603.00 ,$391.95 ,$168.84 ,$603.00 ,$536.25 ,$449.24 ,$394.97 ,$223.39 ,$168.84 ,$304.52 ,$223.39 ,$372.05 ,$223.39 ,$372.05 ,$372.05 ,$223.39 ,$372.05 ,$424.44 ,$542.70 ,$452.25 ,$536.25 ,$223.39 ,$530.64 ,$223.39 ,$452.25 ,$452.25 ,$512.55 ,$512.55 ,$223.39 ,$512.55 ,$223.39 ,$470.34 ,$470.34 ,$470.34 ,$542.70 ,$536.25 ,$542.70 ,$223.39 ,$603.00 ,$394.97 ,$223.39 ,$250.85 , N/A , N/A ,$233.81 ,$542.70 ,$484.11 ,$372.05 ,$168.84 ,$542.70 ,$223.39 ,$542.70 ,$542.70 ,$223.39 ,$391.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000346,23625,HC CLOSED TX GR TUBER HUM FX W/MANIP,450,1 ,"$3,965.00 ","$2,577.25 ","$1,110.20 ","$3,965.00 ","$3,530.44 ","$2,953.93 ","$2,597.08 ","$1,470.67 ","$1,110.20 ","$2,002.33 ","$1,470.67 ","$2,446.41 ","$1,470.67 ","$2,446.41 ","$2,446.41 ","$1,470.67 ","$2,446.41 ","$2,794.27 ","$3,568.50 ","$2,973.75 ","$3,530.44 ","$1,470.67 ","$3,489.20 ","$1,470.67 ","$2,973.75 ","$2,973.75 ","$3,370.25 ","$3,370.25 ","$1,470.67 ","$3,370.25 ","$1,470.67 ","$3,092.70 ","$3,092.70 ","$3,092.70 ","$3,568.50 ","$3,530.44 ","$3,568.50 ","$1,470.67 ","$3,965.00 ","$2,597.08 ","$1,470.67 ","$1,649.44 ", N/A , N/A ,"$1,539.33 ","$3,568.50 ","$3,187.14 ","$2,446.41 ","$1,110.20 ","$3,568.50 ","$1,470.67 ","$3,568.50 ","$3,568.50 ","$1,470.67 ","$2,577.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000350,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-LT,450,1 ,$165.00 ,$107.25 ,$46.20 ,$165.00 ,$141.09 ,$122.93 ,$108.08 ,$58.77 ,$46.20 ,$83.33 ,$58.77 ,$101.81 ,$58.77 ,$101.81 ,$101.81 ,$58.77 ,$101.81 , N/A ,$148.50 ,$123.75 ,$141.09 , N/A ,$145.20 ,$58.77 ,$123.75 ,$123.75 ,$140.25 ,$140.25 ,$58.77 ,$140.25 ,$58.77 ,$128.70 ,$128.70 ,$128.70 ,$148.50 ,$141.09 ,$148.50 ,$58.77 ,$165.00 ,$108.08 ,$58.77 ,$68.64 , N/A , N/A ,$61.52 ,$148.50 ,$127.37 ,$101.81 ,$46.20 ,$148.50 ,$58.77 ,$148.50 ,$148.50 ,$58.77 ,$107.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000351,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-RT,450,1 ,$165.00 ,$107.25 ,$46.20 ,$165.00 ,$141.09 ,$122.93 ,$108.08 ,$58.77 ,$46.20 ,$83.33 ,$58.77 ,$101.81 ,$58.77 ,$101.81 ,$101.81 ,$58.77 ,$101.81 ,$111.66 ,$148.50 ,$123.75 ,$141.09 ,$58.77 ,$145.20 ,$58.77 ,$123.75 ,$123.75 ,$140.25 ,$140.25 ,$58.77 ,$140.25 ,$58.77 ,$128.70 ,$128.70 ,$128.70 ,$148.50 ,$141.09 ,$148.50 ,$58.77 ,$165.00 ,$108.08 ,$58.77 ,$68.64 , N/A , N/A ,$61.52 ,$148.50 ,$127.37 ,$101.81 ,$46.20 ,$148.50 ,$58.77 ,$148.50 ,$148.50 ,$58.77 ,$107.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000352,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-50,450,1 ,$248.00 ,$161.20 ,$58.77 ,$248.00 ,$141.09 ,$184.76 ,$162.44 ,$58.77 ,$69.44 ,$125.24 ,$58.77 ,$153.02 ,$58.77 ,$153.02 ,$153.02 ,$58.77 ,$153.02 ,$111.66 ,$223.20 ,$186.00 ,$141.09 ,$58.77 ,$218.24 ,$58.77 ,$186.00 ,$186.00 ,$210.80 ,$210.80 ,$58.77 ,$210.80 ,$58.77 ,$193.44 ,$193.44 ,$193.44 ,$223.20 ,$141.09 ,$223.20 ,$58.77 ,$248.00 ,$162.44 ,$58.77 ,$103.17 , N/A , N/A ,$61.52 ,$223.20 ,$127.37 ,$153.02 ,$69.44 ,$223.20 ,$58.77 ,$223.20 ,$223.20 ,$58.77 ,$161.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000431,32551,HC TUBE THORACOSTOMY-LT,450,1 ,"$4,676.00 ","$3,039.40 ","$1,309.28 ","$4,676.00 ","$3,564.32 ","$3,483.62 ","$3,062.78 ","$1,484.79 ","$1,309.28 ","$2,361.38 ","$1,484.79 ","$2,885.09 ","$1,484.79 ","$2,885.09 ","$2,885.09 ","$1,484.79 ","$2,885.09 ","$2,821.10 ","$4,208.40 ","$3,507.00 ","$3,564.32 ","$1,484.79 ","$4,114.88 ","$1,484.79 ","$3,507.00 ","$3,507.00 ","$3,974.60 ","$3,974.60 ","$1,484.79 ","$3,974.60 ","$1,484.79 ","$3,647.28 ","$3,647.28 ","$3,647.28 ","$4,208.40 ","$3,564.32 ","$4,208.40 ","$1,484.79 ","$4,676.00 ","$3,062.78 ","$1,484.79 ","$1,945.22 ", N/A , N/A ,"$1,554.10 ","$4,208.40 ","$3,217.73 ","$2,885.09 ","$1,309.28 ","$4,208.40 ","$1,484.79 ","$4,208.40 ","$4,208.40 ","$1,484.79 ","$3,039.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000432,32551,HC TUBE THORACOSTOMY-RT,450,1 ,"$4,676.00 ","$3,039.40 ","$1,309.28 ","$4,676.00 ","$3,564.32 ","$3,483.62 ","$3,062.78 ","$1,484.79 ","$1,309.28 ","$2,361.38 ","$1,484.79 ","$2,885.09 ","$1,484.79 ","$2,885.09 ","$2,885.09 ","$1,484.79 ","$2,885.09 ","$2,821.10 ","$4,208.40 ","$3,507.00 ","$3,564.32 ","$1,484.79 ","$4,114.88 ","$1,484.79 ","$3,507.00 ","$3,507.00 ","$3,974.60 ","$3,974.60 ","$1,484.79 ","$3,974.60 ","$1,484.79 ","$3,647.28 ","$3,647.28 ","$3,647.28 ","$4,208.40 ","$3,564.32 ","$4,208.40 ","$1,484.79 ","$4,676.00 ","$3,062.78 ","$1,484.79 ","$1,945.22 ", N/A , N/A ,"$1,554.10 ","$4,208.40 ","$3,217.73 ","$2,885.09 ","$1,309.28 ","$4,208.40 ","$1,484.79 ","$4,208.40 ","$4,208.40 ","$1,484.79 ","$3,039.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000439,64450,HC INJ ANES OTHER THAN PERIPHERAL-LT,450,1 ,"$1,698.00 ","$1,103.70 ",$475.44 ,"$1,698.00 ","$1,609.52 ","$1,265.01 ","$1,112.19 ",$670.48 ,$475.44 ,$857.49 ,$670.48 ,"$1,047.67 ",$670.48 ,"$1,047.67 ","$1,047.67 ",$670.48 ,"$1,047.67 ","$1,273.91 ","$1,528.20 ","$1,273.50 ","$1,609.52 ",$670.48 ,"$1,494.24 ",$670.48 ,"$1,273.50 ","$1,273.50 ","$1,443.30 ","$1,443.30 ",$670.48 ,"$1,443.30 ",$670.48 ,"$1,324.44 ","$1,324.44 ","$1,324.44 ","$1,528.20 ","$1,609.52 ","$1,528.20 ",$670.48 ,"$1,698.00 ","$1,112.19 ",$670.48 ,$706.37 , N/A , N/A ,$701.78 ,"$1,528.20 ","$1,453.01 ","$1,047.67 ",$475.44 ,"$1,528.20 ",$670.48 ,"$1,528.20 ","$1,528.20 ",$670.48 ,"$1,103.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000440,64450,HC INJ ANES OTHER THAN PERIPHERAL-RT,450,1 ,"$1,698.00 ","$1,103.70 ",$475.44 ,"$1,698.00 ","$1,609.52 ","$1,265.01 ","$1,112.19 ",$670.48 ,$475.44 ,$857.49 ,$670.48 ,"$1,047.67 ",$670.48 ,"$1,047.67 ","$1,047.67 ",$670.48 ,"$1,047.67 ","$1,273.91 ","$1,528.20 ","$1,273.50 ","$1,609.52 ",$670.48 ,"$1,494.24 ",$670.48 ,"$1,273.50 ","$1,273.50 ","$1,443.30 ","$1,443.30 ",$670.48 ,"$1,443.30 ",$670.48 ,"$1,324.44 ","$1,324.44 ","$1,324.44 ","$1,528.20 ","$1,609.52 ","$1,528.20 ",$670.48 ,"$1,698.00 ","$1,112.19 ",$670.48 ,$706.37 , N/A , N/A ,$701.78 ,"$1,528.20 ","$1,453.01 ","$1,047.67 ",$475.44 ,"$1,528.20 ",$670.48 ,"$1,528.20 ","$1,528.20 ",$670.48 ,"$1,103.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000451,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-LT,450,1 ,"$1,749.00 ","$1,136.85 ",$489.72 ,"$1,749.00 ","$1,577.31 ","$1,303.01 ","$1,145.60 ",$657.06 ,$489.72 ,$883.25 ,$657.06 ,"$1,079.13 ",$657.06 ,"$1,079.13 ","$1,079.13 ",$657.06 ,"$1,079.13 ","$1,248.41 ","$1,574.10 ","$1,311.75 ","$1,577.31 ",$657.06 ,"$1,539.12 ",$657.06 ,"$1,311.75 ","$1,311.75 ","$1,486.65 ","$1,486.65 ",$657.06 ,"$1,486.65 ",$657.06 ,"$1,364.22 ","$1,364.22 ","$1,364.22 ","$1,574.10 ","$1,577.31 ","$1,574.10 ",$657.06 ,"$1,749.00 ","$1,145.60 ",$657.06 ,$727.58 , N/A , N/A ,$687.73 ,"$1,574.10 ","$1,423.93 ","$1,079.13 ",$489.72 ,"$1,574.10 ",$657.06 ,"$1,574.10 ","$1,574.10 ",$657.06 ,"$1,136.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000452,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-RT,450,1 ,"$1,749.00 ","$1,136.85 ",$489.72 ,"$1,749.00 ","$1,577.31 ","$1,303.01 ","$1,145.60 ",$657.06 ,$489.72 ,$883.25 ,$657.06 ,"$1,079.13 ",$657.06 ,"$1,079.13 ","$1,079.13 ",$657.06 ,"$1,079.13 ","$1,248.41 ","$1,574.10 ","$1,311.75 ","$1,577.31 ",$657.06 ,"$1,539.12 ",$657.06 ,"$1,311.75 ","$1,311.75 ","$1,486.65 ","$1,486.65 ",$657.06 ,"$1,486.65 ",$657.06 ,"$1,364.22 ","$1,364.22 ","$1,364.22 ","$1,574.10 ","$1,577.31 ","$1,574.10 ",$657.06 ,"$1,749.00 ","$1,145.60 ",$657.06 ,$727.58 , N/A , N/A ,$687.73 ,"$1,574.10 ","$1,423.93 ","$1,079.13 ",$489.72 ,"$1,574.10 ",$657.06 ,"$1,574.10 ","$1,574.10 ",$657.06 ,"$1,136.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000455,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-LT,450,1 ,$185.00 ,$120.25 ,$51.80 ,$185.00 ,$141.09 ,$137.83 ,$121.18 ,$58.77 ,$51.80 ,$93.43 ,$58.77 ,$114.15 ,$58.77 ,$114.15 ,$114.15 ,$58.77 ,$114.15 ,$111.66 ,$166.50 ,$138.75 ,$141.09 ,$58.77 ,$162.80 ,$58.77 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$58.77 ,$157.25 ,$58.77 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$141.09 ,$166.50 ,$58.77 ,$185.00 ,$121.18 ,$58.77 ,$76.96 , N/A , N/A ,$61.52 ,$166.50 ,$127.37 ,$114.15 ,$51.80 ,$166.50 ,$58.77 ,$166.50 ,$166.50 ,$58.77 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000456,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-RT,450,1 ,$185.00 ,$120.25 ,$51.80 ,$185.00 ,$141.09 ,$137.83 ,$121.18 ,$58.77 ,$51.80 ,$93.43 ,$58.77 ,$114.15 ,$58.77 ,$114.15 ,$114.15 ,$58.77 ,$114.15 ,$111.66 ,$166.50 ,$138.75 ,$141.09 ,$58.77 ,$162.80 ,$58.77 ,$138.75 ,$138.75 ,$157.25 ,$157.25 ,$58.77 ,$157.25 ,$58.77 ,$144.30 ,$144.30 ,$144.30 ,$166.50 ,$141.09 ,$166.50 ,$58.77 ,$185.00 ,$121.18 ,$58.77 ,$76.96 , N/A , N/A ,$61.52 ,$166.50 ,$127.37 ,$114.15 ,$51.80 ,$166.50 ,$58.77 ,$166.50 ,$166.50 ,$58.77 ,$120.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000493,36600,HC ARTERIAL PUNCTURE,450,1 ,$29.00 ,$18.85 ,$8.12 ,$258.02 ,$29.00 ,$21.61 ,$19.00 ,$29.00 ,$8.12 ,$14.65 ,$29.00 ,$17.89 ,$29.00 ,$17.89 ,$17.89 ,$29.00 ,$17.89 ,$226.21 ,$26.10 ,$21.75 ,$29.00 ,$29.00 ,$25.52 ,$29.00 ,$21.75 ,$21.75 ,$24.65 ,$24.65 ,$29.00 ,$24.65 ,$29.00 ,$22.62 ,$22.62 ,$22.62 ,$26.10 ,$29.00 ,$26.10 ,$29.00 ,$29.00 ,$19.00 ,$29.00 ,$12.06 , N/A , N/A ,$29.00 ,$26.10 ,$258.02 ,$17.89 ,$8.12 ,$26.10 ,$29.00 ,$26.10 ,$26.10 ,$29.00 ,$18.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000498,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-BIL,450,1 ,$278.00 ,$180.70 ,$58.77 ,$278.00 ,$141.09 ,$207.11 ,$182.09 ,$58.77 ,$77.84 ,$140.39 ,$58.77 ,$171.53 ,$58.77 ,$171.53 ,$171.53 ,$58.77 ,$171.53 ,$111.66 ,$250.20 ,$208.50 ,$141.09 ,$58.77 ,$244.64 ,$58.77 ,$208.50 ,$208.50 ,$236.30 ,$236.30 ,$58.77 ,$236.30 ,$58.77 ,$216.84 ,$216.84 ,$216.84 ,$250.20 ,$141.09 ,$250.20 ,$58.77 ,$278.00 ,$182.09 ,$58.77 ,$115.65 , N/A , N/A ,$61.52 ,$250.20 ,$127.37 ,$171.53 ,$77.84 ,$250.20 ,$58.77 ,$250.20 ,$250.20 ,$58.77 ,$180.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000500,57200,HC REPAIR SUTURE VAGINA COLPORRHAPHY,450,1 ,"$5,538.00 ","$3,599.70 ","$1,550.64 ","$6,003.57 ","$5,538.00 ","$4,125.81 ","$3,627.39 ","$2,770.28 ","$1,550.64 ","$2,796.69 ","$2,770.28 ","$3,416.95 ","$2,770.28 ","$3,416.95 ","$3,416.95 ","$2,770.28 ","$3,416.95 ","$5,263.53 ","$4,984.20 ","$4,153.50 ","$5,538.00 ","$2,770.28 ","$4,873.44 ","$2,770.28 ","$4,153.50 ","$4,153.50 ","$4,707.30 ","$4,707.30 ","$2,770.28 ","$4,707.30 ","$2,770.28 ","$4,319.64 ","$4,319.64 ","$4,319.64 ","$4,984.20 ","$5,538.00 ","$4,984.20 ","$2,770.28 ","$5,538.00 ","$3,627.39 ","$2,770.28 ","$2,303.81 ", N/A , N/A ,"$2,899.62 ","$4,984.20 ","$6,003.57 ","$3,416.95 ","$1,550.64 ","$4,984.20 ","$2,770.28 ","$4,984.20 ","$4,984.20 ","$2,770.28 ","$3,599.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000513,29580,HC APPLY UNNA BOOT-LT,450,1 ,$404.00 ,$262.60 ,$113.12 ,$404.00 ,$358.10 ,$300.98 ,$264.62 ,$149.18 ,$113.12 ,$204.02 ,$149.18 ,$249.27 ,$149.18 ,$249.27 ,$249.27 ,$149.18 ,$249.27 ,$283.44 ,$363.60 ,$303.00 ,$358.10 ,$149.18 ,$355.52 ,$149.18 ,$303.00 ,$303.00 ,$343.40 ,$343.40 ,$149.18 ,$343.40 ,$149.18 ,$315.12 ,$315.12 ,$315.12 ,$363.60 ,$358.10 ,$363.60 ,$149.18 ,$404.00 ,$264.62 ,$149.18 ,$168.06 , N/A , N/A ,$156.14 ,$363.60 ,$323.28 ,$249.27 ,$113.12 ,$363.60 ,$149.18 ,$363.60 ,$363.60 ,$149.18 ,$262.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000514,29580,HC APPLY UNNA BOOT-RT,450,1 ,$404.00 ,$262.60 ,$113.12 ,$404.00 ,$358.10 ,$300.98 ,$264.62 ,$149.18 ,$113.12 ,$204.02 ,$149.18 ,$249.27 ,$149.18 ,$249.27 ,$249.27 ,$149.18 ,$249.27 ,$283.44 ,$363.60 ,$303.00 ,$358.10 ,$149.18 ,$355.52 ,$149.18 ,$303.00 ,$303.00 ,$343.40 ,$343.40 ,$149.18 ,$343.40 ,$149.18 ,$315.12 ,$315.12 ,$315.12 ,$363.60 ,$358.10 ,$363.60 ,$149.18 ,$404.00 ,$264.62 ,$149.18 ,$168.06 , N/A , N/A ,$156.14 ,$363.60 ,$323.28 ,$249.27 ,$113.12 ,$363.60 ,$149.18 ,$363.60 ,$363.60 ,$149.18 ,$262.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000515,32551,HC TUBE THORACOSTOMY-BIL,450,1 ,"$7,014.00 ","$4,559.10 ","$1,963.92 ","$7,014.00 ","$7,014.00 ","$5,225.43 ","$4,594.17 ","$3,022.62 ","$1,963.92 ","$3,542.07 ","$3,022.62 ","$4,327.64 ","$3,022.62 ","$4,327.64 ","$4,327.64 ","$3,022.62 ","$4,327.64 ","$5,742.98 ","$6,312.60 ","$5,260.50 ","$7,014.00 ","$3,022.62 ","$6,172.32 ","$3,022.62 ","$5,260.50 ","$5,260.50 ","$5,961.90 ","$5,961.90 ","$3,022.62 ","$5,961.90 ","$3,022.62 ","$5,470.92 ","$5,470.92 ","$5,470.92 ","$6,312.60 ","$7,014.00 ","$6,312.60 ","$3,022.62 ","$7,014.00 ","$4,594.17 ","$3,022.62 ","$2,917.82 ", N/A , N/A ,"$3,163.73 ","$6,312.60 ","$6,550.42 ","$4,327.64 ","$1,963.92 ","$6,312.60 ","$3,022.62 ","$6,312.60 ","$6,312.60 ","$3,022.62 ","$4,559.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000554,29581,HC APPLY MULTI COMP LOWER LEG-LT,450,1 ,$404.00 ,$262.60 ,$113.12 ,$404.00 ,$358.10 ,$300.98 ,$264.62 ,$149.18 ,$113.12 ,$204.02 ,$149.18 ,$249.27 ,$149.18 ,$249.27 ,$249.27 ,$149.18 ,$249.27 ,$283.44 ,$363.60 ,$303.00 ,$358.10 ,$149.18 ,$355.52 ,$149.18 ,$303.00 ,$303.00 ,$343.40 ,$343.40 ,$149.18 ,$343.40 ,$149.18 ,$315.12 ,$315.12 ,$315.12 ,$363.60 ,$358.10 ,$363.60 ,$149.18 ,$404.00 ,$264.62 ,$149.18 ,$168.06 , N/A , N/A ,$156.14 ,$363.60 ,$323.28 ,$249.27 ,$113.12 ,$363.60 ,$149.18 ,$363.60 ,$363.60 ,$149.18 ,$262.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45000555,29581,HC APPLY MULTI COMP LOWER LEG-RT,450,1 ,$404.00 ,$262.60 ,$113.12 ,$404.00 ,$358.10 ,$300.98 ,$264.62 ,$149.18 ,$113.12 ,$204.02 ,$149.18 ,$249.27 ,$149.18 ,$249.27 ,$249.27 ,$149.18 ,$249.27 ,$283.44 ,$363.60 ,$303.00 ,$358.10 ,$149.18 ,$355.52 ,$149.18 ,$303.00 ,$303.00 ,$343.40 ,$343.40 ,$149.18 ,$343.40 ,$149.18 ,$315.12 ,$315.12 ,$315.12 ,$363.60 ,$358.10 ,$363.60 ,$149.18 ,$404.00 ,$264.62 ,$149.18 ,$168.06 , N/A , N/A ,$156.14 ,$363.60 ,$323.28 ,$249.27 ,$113.12 ,$363.60 ,$149.18 ,$363.60 ,$363.60 ,$149.18 ,$262.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001168,52281,HC CYSTOURETHROSCOPY W/CALIBRATION/DILATION,450,1 ,"$5,105.61 ","$3,318.65 ","$1,429.57 ","$5,105.61 ","$4,538.41 ","$3,803.68 ","$3,344.17 ","$1,890.56 ","$1,429.57 ","$2,578.33 ","$1,890.56 ","$3,150.16 ","$1,890.56 ","$3,150.16 ","$3,150.16 ","$1,890.56 ","$3,150.16 ","$3,592.06 ","$4,595.05 ","$3,829.21 ","$4,538.41 ","$1,890.56 ","$4,492.94 ","$1,890.56 ","$3,829.21 ","$3,829.21 ","$4,339.77 ","$4,339.77 ","$1,890.56 ","$4,339.77 ","$1,890.56 ","$3,982.38 ","$3,982.38 ","$3,982.38 ","$4,595.05 ","$4,538.41 ","$4,595.05 ","$1,890.56 ","$5,105.61 ","$3,344.17 ","$1,890.56 ","$2,123.93 ", N/A , N/A ,"$1,978.83 ","$4,595.05 ","$4,097.10 ","$3,150.16 ","$1,429.57 ","$4,595.05 ","$1,890.56 ","$4,595.05 ","$4,595.05 ","$1,890.56 ","$3,318.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001169,54235,HC INJ PENILE W/RX AGENT,450,1 ,$757.83 ,$492.59 ,$212.19 ,$757.83 ,$674.49 ,$564.58 ,$496.38 ,$280.97 ,$212.19 ,$382.70 ,$280.97 ,$467.58 ,$280.97 ,$467.58 ,$467.58 ,$280.97 ,$467.58 ,$533.84 ,$682.05 ,$568.37 ,$674.49 ,$280.97 ,$666.89 ,$280.97 ,$568.37 ,$568.37 ,$644.16 ,$644.16 ,$280.97 ,$644.16 ,$280.97 ,$591.11 ,$591.11 ,$591.11 ,$682.05 ,$674.49 ,$682.05 ,$280.97 ,$757.83 ,$496.38 ,$280.97 ,$315.26 , N/A , N/A ,$294.09 ,$682.05 ,$608.90 ,$467.58 ,$212.19 ,$682.05 ,$280.97 ,$682.05 ,$682.05 ,$280.97 ,$492.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001272,23665,HC TX FX DISLOC SHOULDER HUMERW/MANIP,450,1 ,"$3,964.77 ","$2,577.10 ","$1,110.14 ","$3,964.77 ","$3,530.44 ","$2,953.75 ","$2,596.92 ","$1,470.67 ","$1,110.14 ","$2,002.21 ","$1,470.67 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,794.27 ","$3,568.29 ","$2,973.58 ","$3,530.44 ","$1,470.67 ","$3,489.00 ","$1,470.67 ","$2,973.58 ","$2,973.58 ","$3,370.05 ","$3,370.05 ","$1,470.67 ","$3,370.05 ","$1,470.67 ","$3,092.52 ","$3,092.52 ","$3,092.52 ","$3,568.29 ","$3,530.44 ","$3,568.29 ","$1,470.67 ","$3,964.77 ","$2,596.92 ","$1,470.67 ","$1,649.34 ", N/A , N/A ,"$1,539.33 ","$3,568.29 ","$3,187.14 ","$2,446.26 ","$1,110.14 ","$3,568.29 ","$1,470.67 ","$3,568.29 ","$3,568.29 ","$1,470.67 ","$2,577.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001273,23675,HC TX FX DISLOC SHOULDER W/PROX HUM W/MANIP,450,1 ,"$3,886.00 ","$2,525.90 ","$1,088.08 ","$3,886.00 ","$3,530.44 ","$2,895.07 ","$2,545.33 ","$1,470.67 ","$1,088.08 ","$1,962.43 ","$1,470.67 ","$2,397.66 ","$1,470.67 ","$2,397.66 ","$2,397.66 ","$1,470.67 ","$2,397.66 ","$2,794.27 ","$3,497.40 ","$2,914.50 ","$3,530.44 ","$1,470.67 ","$3,419.68 ","$1,470.67 ","$2,914.50 ","$2,914.50 ","$3,303.10 ","$3,303.10 ","$1,470.67 ","$3,303.10 ","$1,470.67 ","$3,031.08 ","$3,031.08 ","$3,031.08 ","$3,497.40 ","$3,530.44 ","$3,497.40 ","$1,470.67 ","$3,886.00 ","$2,545.33 ","$1,470.67 ","$1,616.58 ", N/A , N/A ,"$1,539.33 ","$3,497.40 ","$3,187.14 ","$2,397.66 ","$1,088.08 ","$3,497.40 ","$1,470.67 ","$3,497.40 ","$3,497.40 ","$1,470.67 ","$2,525.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001277,24577,HC TX FX HUMERUS CONDYLAR W/MANIP CLOSED,450,1 ,"$3,965.00 ","$2,577.25 ","$1,110.20 ","$3,965.00 ","$3,530.44 ","$2,953.93 ","$2,597.08 ","$1,470.67 ","$1,110.20 ","$2,002.33 ","$1,470.67 ","$2,446.41 ","$1,470.67 ","$2,446.41 ","$2,446.41 ","$1,470.67 ","$2,446.41 ","$2,794.27 ","$3,568.50 ","$2,973.75 ","$3,530.44 ","$1,470.67 ","$3,489.20 ","$1,470.67 ","$2,973.75 ","$2,973.75 ","$3,370.25 ","$3,370.25 ","$1,470.67 ","$3,370.25 ","$1,470.67 ","$3,092.70 ","$3,092.70 ","$3,092.70 ","$3,568.50 ","$3,530.44 ","$3,568.50 ","$1,470.67 ","$3,965.00 ","$2,597.08 ","$1,470.67 ","$1,649.44 ", N/A , N/A ,"$1,539.33 ","$3,568.50 ","$3,187.14 ","$2,446.41 ","$1,110.20 ","$3,568.50 ","$1,470.67 ","$3,568.50 ","$3,568.50 ","$1,470.67 ","$2,577.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,"$3,964.77 ","$2,577.10 ","$1,110.14 ","$3,964.77 ","$3,530.44 ","$2,953.75 ","$2,596.92 ","$1,470.67 ","$1,110.14 ","$2,002.21 ","$1,470.67 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,446.26 ","$1,470.67 ","$2,446.26 ","$2,794.27 ","$3,568.29 ","$2,973.58 ","$3,530.44 ","$1,470.67 ","$3,489.00 ","$1,470.67 ","$2,973.58 ","$2,973.58 ","$3,370.05 ","$3,370.05 ","$1,470.67 ","$3,370.05 ","$1,470.67 ","$3,092.52 ","$3,092.52 ","$3,092.52 ","$3,568.29 ","$3,530.44 ","$3,568.29 ","$1,470.67 ","$3,964.77 ","$2,596.92 ","$1,470.67 ","$1,649.34 ", N/A , N/A ,"$1,539.33 ","$3,568.29 ","$3,187.14 ","$2,446.26 ","$1,110.14 ","$3,568.29 ","$1,470.67 ","$3,568.29 ","$3,568.29 ","$1,470.67 ","$2,577.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001296,27762,HC TX FX CLOSED MEDIAL MALLEOLUS W/MANIP,450,1 ,"$3,094.00 ","$2,011.10 ",$866.32 ,"$3,187.14 ","$3,094.00 ","$2,305.03 ","$2,026.57 ","$1,470.67 ",$866.32 ,"$1,562.47 ","$1,470.67 ","$1,909.00 ","$1,470.67 ","$1,909.00 ","$1,909.00 ","$1,470.67 ","$1,909.00 ","$2,794.27 ","$2,784.60 ","$2,320.50 ","$3,094.00 ","$1,470.67 ","$2,722.72 ","$1,470.67 ","$2,320.50 ","$2,320.50 ","$2,629.90 ","$2,629.90 ","$1,470.67 ","$2,629.90 ","$1,470.67 ","$2,413.32 ","$2,413.32 ","$2,413.32 ","$2,784.60 ","$3,094.00 ","$2,784.60 ","$1,470.67 ","$3,094.00 ","$2,026.57 ","$1,470.67 ","$1,287.10 ", N/A , N/A ,"$1,539.33 ","$2,784.60 ","$3,187.14 ","$1,909.00 ",$866.32 ,"$2,784.60 ","$1,470.67 ","$2,784.60 ","$2,784.60 ","$1,470.67 ","$2,011.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001298,27816,HC TX FX CLOSED TRIMALLEOLAR ANKLE W/O MANIP,450,1 ,$587.00 ,$381.55 ,$164.36 ,$587.00 ,$522.43 ,$437.32 ,$384.49 ,$217.63 ,$164.36 ,$296.44 ,$217.63 ,$362.18 ,$217.63 ,$362.18 ,$362.18 ,$217.63 ,$362.18 ,$413.50 ,$528.30 ,$440.25 ,$522.43 ,$217.63 ,$516.56 ,$217.63 ,$440.25 ,$440.25 ,$498.95 ,$498.95 ,$217.63 ,$498.95 ,$217.63 ,$457.86 ,$457.86 ,$457.86 ,$528.30 ,$522.43 ,$528.30 ,$217.63 ,$587.00 ,$384.49 ,$217.63 ,$244.19 , N/A , N/A ,$227.79 ,$528.30 ,$471.63 ,$362.18 ,$164.36 ,$528.30 ,$217.63 ,$528.30 ,$528.30 ,$217.63 ,$381.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001317,67935,HC REPAIR EYELID WOUND FULL THICKNESS,450,1 ,"$5,548.00 ","$3,606.20 ","$1,553.44 ","$5,548.00 ","$5,072.13 ","$4,133.26 ","$3,633.94 ","$2,112.90 ","$1,553.44 ","$2,801.74 ","$2,112.90 ","$3,423.12 ","$2,112.90 ","$3,423.12 ","$3,423.12 ","$2,112.90 ","$3,423.12 ","$4,014.51 ","$4,993.20 ","$4,161.00 ","$5,072.13 ","$2,112.90 ","$4,882.24 ","$2,112.90 ","$4,161.00 ","$4,161.00 ","$4,715.80 ","$4,715.80 ","$2,112.90 ","$4,715.80 ","$2,112.90 ","$4,327.44 ","$4,327.44 ","$4,327.44 ","$4,993.20 ","$5,072.13 ","$4,993.20 ","$2,112.90 ","$5,548.00 ","$3,633.94 ","$2,112.90 ","$2,307.97 ", N/A , N/A ,"$2,211.54 ","$4,993.20 ","$4,578.93 ","$3,423.12 ","$1,553.44 ","$4,993.20 ","$2,112.90 ","$4,993.20 ","$4,993.20 ","$2,112.90 ","$3,606.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$672.00 ,$436.80 ,$188.16 ,$672.00 ,$672.00 ,$500.64 ,$440.16 ,$280.97 ,$188.16 ,$339.36 ,$280.97 ,$414.62 ,$280.97 ,$414.62 ,$414.62 ,$280.97 ,$414.62 ,$533.84 ,$604.80 ,$504.00 ,$672.00 ,$280.97 ,$591.36 ,$280.97 ,$504.00 ,$504.00 ,$571.20 ,$571.20 ,$280.97 ,$571.20 ,$280.97 ,$524.16 ,$524.16 ,$524.16 ,$604.80 ,$672.00 ,$604.80 ,$280.97 ,$672.00 ,$440.16 ,$280.97 ,$279.55 , N/A , N/A ,$294.09 ,$604.80 ,$608.90 ,$414.62 ,$188.16 ,$604.80 ,$280.97 ,$604.80 ,$604.80 ,$280.97 ,$436.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001332,43763,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT,450,1 ,$825.00 ,$536.25 ,$231.00 ,$825.00 ,$674.49 ,$614.63 ,$540.38 ,$280.97 ,$231.00 ,$416.63 ,$280.97 ,$509.03 ,$280.97 ,$509.03 ,$509.03 ,$280.97 ,$509.03 ,$533.84 ,$742.50 ,$618.75 ,$674.49 ,$280.97 ,$726.00 ,$280.97 ,$618.75 ,$618.75 ,$701.25 ,$701.25 ,$280.97 ,$701.25 ,$280.97 ,$643.50 ,$643.50 ,$643.50 ,$742.50 ,$674.49 ,$742.50 ,$280.97 ,$825.00 ,$540.38 ,$280.97 ,$343.20 , N/A , N/A ,$294.09 ,$742.50 ,$608.90 ,$509.03 ,$231.00 ,$742.50 ,$280.97 ,$742.50 ,$742.50 ,$280.97 ,$536.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001341,42720,HC I AND D ABSCESS PHARYNGEAL INTRAORAL APPROACH,450,1 ,"$7,858.00 ","$5,107.70 ","$2,200.24 ","$7,858.00 ","$6,934.21 ","$5,854.21 ","$5,146.99 ","$2,888.58 ","$2,200.24 ","$3,968.29 ","$2,888.58 ","$4,848.39 ","$2,888.58 ","$4,848.39 ","$4,848.39 ","$2,888.58 ","$4,848.39 ","$5,488.30 ","$7,072.20 ","$5,893.50 ","$6,934.21 ","$2,888.58 ","$6,915.04 ","$2,888.58 ","$5,893.50 ","$5,893.50 ","$6,679.30 ","$6,679.30 ","$2,888.58 ","$6,679.30 ","$2,888.58 ","$6,129.24 ","$6,129.24 ","$6,129.24 ","$7,072.20 ","$6,934.21 ","$7,072.20 ","$2,888.58 ","$7,858.00 ","$5,146.99 ","$2,888.58 ","$3,268.93 ", N/A , N/A ,"$3,023.43 ","$7,072.20 ","$6,259.93 ","$4,848.39 ","$2,200.24 ","$7,072.20 ","$2,888.58 ","$7,072.20 ","$7,072.20 ","$2,888.58 ","$5,107.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001347,27503,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,450,1 ,"$3,886.00 ","$2,525.90 ","$1,088.08 ","$3,886.00 ","$3,530.44 ","$2,895.07 ","$2,545.33 ","$1,470.67 ","$1,088.08 ","$1,962.43 ","$1,470.67 ","$2,397.66 ","$1,470.67 ","$2,397.66 ","$2,397.66 ","$1,470.67 ","$2,397.66 ","$2,794.27 ","$3,497.40 ","$2,914.50 ","$3,530.44 ","$1,470.67 ","$3,419.68 ","$1,470.67 ","$2,914.50 ","$2,914.50 ","$3,303.10 ","$3,303.10 ","$1,470.67 ","$3,303.10 ","$1,470.67 ","$3,031.08 ","$3,031.08 ","$3,031.08 ","$3,497.40 ","$3,530.44 ","$3,497.40 ","$1,470.67 ","$3,886.00 ","$2,545.33 ","$1,470.67 ","$1,616.58 ", N/A , N/A ,"$1,539.33 ","$3,497.40 ","$3,187.14 ","$2,397.66 ","$1,088.08 ","$3,497.40 ","$1,470.67 ","$3,497.40 ","$3,497.40 ","$1,470.67 ","$2,525.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001350,P9612,HC STRAIGHT CATH FOR URINE SPECIMEN,450,1 ,$231.00 ,$150.15 ,$3.21 ,$231.00 ,$7.71 ,$172.10 ,$151.31 ,$3.21 ,$64.68 ,$116.66 ,$3.21 ,$142.53 ,$3.21 ,$142.53 ,$142.53 ,$3.21 ,$142.53 ,$6.10 ,$207.90 ,$173.25 ,$7.71 ,$3.21 ,$203.28 ,$3.21 ,$173.25 ,$173.25 ,$196.35 ,$196.35 ,$3.21 ,$196.35 ,$3.21 ,$180.18 ,$180.18 ,$180.18 ,$207.90 ,$7.71 ,$207.90 ,$3.21 ,$231.00 ,$151.31 ,$3.21 ,$96.10 , N/A , N/A ,$3.36 ,$207.90 ,$6.96 ,$142.53 ,$64.68 ,$207.90 ,$3.21 ,$207.90 ,$207.90 ,$3.21 ,$150.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001352,26545,HC RECONSTRUCT FINGER JOINT,450,1 ,"$7,847.00 ","$5,100.55 ","$2,197.16 ","$7,847.00 ","$7,178.17 ","$5,846.02 ","$5,139.79 ","$2,990.21 ","$2,197.16 ","$3,962.74 ","$2,990.21 ","$4,841.60 ","$2,990.21 ","$4,841.60 ","$4,841.60 ","$2,990.21 ","$4,841.60 ","$5,681.40 ","$7,062.30 ","$5,885.25 ","$7,178.17 ","$2,990.21 ","$6,905.36 ","$2,990.21 ","$5,885.25 ","$5,885.25 ","$6,669.95 ","$6,669.95 ","$2,990.21 ","$6,669.95 ","$2,990.21 ","$6,120.66 ","$6,120.66 ","$6,120.66 ","$7,062.30 ","$7,178.17 ","$7,062.30 ","$2,990.21 ","$7,847.00 ","$5,139.79 ","$2,990.21 ","$3,264.35 ", N/A , N/A ,"$3,129.80 ","$7,062.30 ","$6,480.18 ","$4,841.60 ","$2,197.16 ","$7,062.30 ","$2,990.21 ","$7,062.30 ","$7,062.30 ","$2,990.21 ","$5,100.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001355,25660,HC CLTX RDCRPL/INTERCARPL DISLC 1 >BONES W MAN,450,1 ,$587.13 ,$381.63 ,$164.40 ,$587.13 ,$522.43 ,$437.41 ,$384.57 ,$217.63 ,$164.40 ,$296.50 ,$217.63 ,$362.26 ,$217.63 ,$362.26 ,$362.26 ,$217.63 ,$362.26 ,$413.50 ,$528.42 ,$440.35 ,$522.43 ,$217.63 ,$516.67 ,$217.63 ,$440.35 ,$440.35 ,$499.06 ,$499.06 ,$217.63 ,$499.06 ,$217.63 ,$457.96 ,$457.96 ,$457.96 ,$528.42 ,$522.43 ,$528.42 ,$217.63 ,$587.13 ,$384.57 ,$217.63 ,$244.25 , N/A , N/A ,$227.79 ,$528.42 ,$471.63 ,$362.26 ,$164.40 ,$528.42 ,$217.63 ,$528.42 ,$528.42 ,$217.63 ,$381.63 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),45001360,31577,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),450,1 ,"$1,072.14 ",$696.89 ,$300.20 ,"$1,072.14 ",$952.73 ,$798.74 ,$702.25 ,$396.88 ,$300.20 ,$541.43 ,$396.88 ,$661.51 ,$396.88 ,$661.51 ,$661.51 ,$396.88 ,$661.51 ,$754.07 ,$964.93 ,$804.11 ,$952.73 ,$396.88 ,$943.48 ,$396.88 ,$804.11 ,$804.11 ,$911.32 ,$911.32 ,$396.88 ,$911.32 ,$396.88 ,$836.27 ,$836.27 ,$836.27 ,$964.93 ,$952.73 ,$964.93 ,$396.88 ,"$1,072.14 ",$702.25 ,$396.88 ,$446.01 , N/A , N/A ,$415.41 ,$964.93 ,$860.09 ,$661.51 ,$300.20 ,$964.93 ,$396.88 ,$964.93 ,$964.93 ,$396.88 ,$696.89 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$150.00 ,$97.50 ,$42.00 ,$319.47 ,$150.00 ,$111.75 ,$98.25 ,$147.42 ,$42.00 ,$75.75 ,$147.42 ,$92.55 ,$147.42 ,$92.55 ,$92.55 ,$147.42 ,$92.55 ,$280.10 ,$135.00 ,$112.50 ,$150.00 ,$147.42 ,$132.00 ,$147.42 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$147.42 ,$127.50 ,$147.42 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$150.00 ,$135.00 ,$147.42 ,$150.00 ,$98.25 ,$147.42 ,$62.40 ,$54.45 ,$51.98 ,$150.00 ,$135.00 ,$319.47 ,$92.55 ,$42.00 ,$135.00 ,$147.42 ,$135.00 ,$135.00 ,$147.42 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000004,94060,HC SPIROMETRY/PFT PRE  AND  POST,460,1 ,$574.00 ,$373.10 ,$51.98 ,$605.59 ,$574.00 ,$427.63 ,$375.97 ,$279.44 ,$160.72 ,$289.87 ,$279.44 ,$354.16 ,$279.44 ,$354.16 ,$354.16 ,$279.44 ,$354.16 ,$530.94 ,$516.60 ,$430.50 ,$574.00 ,$279.44 ,$505.12 ,$279.44 ,$430.50 ,$430.50 ,$487.90 ,$487.90 ,$279.44 ,$487.90 ,$279.44 ,$447.72 ,$447.72 ,$447.72 ,$516.60 ,$574.00 ,$516.60 ,$279.44 ,$574.00 ,$375.97 ,$279.44 ,$238.78 ,$54.45 ,$51.98 ,$292.49 ,$516.60 ,$605.59 ,$354.16 ,$160.72 ,$516.60 ,$279.44 ,$516.60 ,$516.60 ,$279.44 ,$373.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000006,94070,HC SPIROMETRY/PFT CPLX,460,1 ,"$1,430.00 ",$929.50 ,$158.81 ,"$1,430.00 ",$670.82 ,"$1,065.35 ",$936.65 ,$279.44 ,$400.40 ,$722.15 ,$279.44 ,$882.31 ,$279.44 ,$882.31 ,$882.31 ,$279.44 ,$882.31 ,$530.94 ,"$1,287.00 ","$1,072.50 ",$670.82 ,$279.44 ,"$1,258.40 ",$279.44 ,"$1,072.50 ","$1,072.50 ","$1,215.50 ","$1,215.50 ",$279.44 ,"$1,215.50 ",$279.44 ,"$1,115.40 ","$1,115.40 ","$1,115.40 ","$1,287.00 ",$670.82 ,"$1,287.00 ",$279.44 ,"$1,430.00 ",$936.65 ,$279.44 ,$594.88 ,$166.38 ,$158.81 ,$292.49 ,"$1,287.00 ",$605.59 ,$882.31 ,$400.40 ,"$1,287.00 ",$279.44 ,"$1,287.00 ","$1,287.00 ",$279.44 ,$929.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000007,94150,HC VITAL CAPACITY TOTAL,460,1 ,$415.00 ,$269.75 ,$51.98 ,$415.00 ,$353.89 ,$309.18 ,$271.83 ,$147.42 ,$116.20 ,$209.58 ,$147.42 ,$256.06 ,$147.42 ,$256.06 ,$256.06 ,$147.42 ,$256.06 ,$280.10 ,$373.50 ,$311.25 ,$353.89 ,$147.42 ,$365.20 ,$147.42 ,$311.25 ,$311.25 ,$352.75 ,$352.75 ,$147.42 ,$352.75 ,$147.42 ,$323.70 ,$323.70 ,$323.70 ,$373.50 ,$353.89 ,$373.50 ,$147.42 ,$415.00 ,$271.83 ,$147.42 ,$172.64 ,$54.45 ,$51.98 ,$154.30 ,$373.50 ,$319.47 ,$256.06 ,$116.20 ,$373.50 ,$147.42 ,$373.50 ,$373.50 ,$147.42 ,$269.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$293.00 ,$190.45 ,$51.98 ,$605.59 ,$293.00 ,$218.29 ,$191.92 ,$279.44 ,$82.04 ,$147.97 ,$279.44 ,$180.78 ,$279.44 ,$180.78 ,$180.78 ,$279.44 ,$180.78 ,$530.94 ,$263.70 ,$219.75 ,$293.00 ,$279.44 ,$257.84 ,$279.44 ,$219.75 ,$219.75 ,$249.05 ,$249.05 ,$279.44 ,$249.05 ,$279.44 ,$228.54 ,$228.54 ,$228.54 ,$263.70 ,$293.00 ,$263.70 ,$279.44 ,$293.00 ,$191.92 ,$279.44 ,$121.89 ,$54.45 ,$51.98 ,$292.49 ,$263.70 ,$605.59 ,$180.78 ,$82.04 ,$263.70 ,$279.44 ,$263.70 ,$263.70 ,$279.44 ,$190.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000014,94618,HC WALK TEST 6 MIN,460,1 ,$456.00 ,$296.40 ,$119.06 ,$456.00 ,$285.81 ,$339.72 ,$298.68 ,$119.06 ,$127.68 ,$230.28 ,$119.06 ,$281.35 ,$119.06 ,$281.35 ,$281.35 ,$119.06 ,$281.35 ,$226.21 ,$410.40 ,$342.00 ,$285.81 ,$119.06 ,$401.28 ,$119.06 ,$342.00 ,$342.00 ,$387.60 ,$387.60 ,$119.06 ,$387.60 ,$119.06 ,$355.68 ,$355.68 ,$355.68 ,$410.40 ,$285.81 ,$410.40 ,$119.06 ,$456.00 ,$298.68 ,$119.06 ,$189.70 ,$166.38 ,$158.81 ,$124.62 ,$410.40 ,$258.02 ,$281.35 ,$127.68 ,$410.40 ,$119.06 ,$410.40 ,$410.40 ,$119.06 ,$296.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$204.00 ,$132.60 ,$51.98 ,$204.00 , N/A ,$151.98 ,$133.62 , N/A ,$57.12 ,$103.02 , N/A ,$125.87 , N/A ,$125.87 ,$125.87 , N/A ,$125.87 , N/A ,$183.60 ,$153.00 , N/A , N/A ,$179.52 , N/A ,$153.00 ,$153.00 ,$173.40 ,$173.40 , N/A ,$173.40 , N/A ,$159.12 ,$159.12 ,$159.12 ,$183.60 , N/A ,$183.60 , N/A ,$204.00 ,$133.62 , N/A ,$84.86 ,$54.45 ,$51.98 , N/A ,$183.60 , N/A ,$125.87 ,$57.12 ,$183.60 , N/A ,$183.60 ,$183.60 , N/A ,$132.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),46000021,94760,HC PULSE OX SINGLE,460,1 ,$70.00 ,$45.50 ,$19.60 ,$70.00 , N/A ,$52.15 ,$45.85 , N/A ,$19.60 ,$35.35 , N/A ,$43.19 , N/A ,$43.19 ,$43.19 , N/A ,$43.19 , N/A ,$63.00 ,$52.50 , N/A , N/A ,$61.60 , N/A ,$52.50 ,$52.50 ,$59.50 ,$59.50 , N/A ,$59.50 , N/A ,$54.60 ,$54.60 ,$54.60 ,$63.00 , N/A ,$63.00 , N/A ,$70.00 ,$45.85 , N/A ,$29.12 , N/A , N/A , N/A ,$63.00 , N/A ,$43.19 ,$19.60 ,$63.00 , N/A ,$63.00 ,$63.00 , N/A ,$45.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),47000001,92587,HC DISTORTION EVOKED POTENT LTD,470,1 ,$48.00 ,$31.20 ,$13.44 ,$605.59 ,$48.00 ,$35.76 ,$31.44 ,$48.00 ,$13.44 ,$24.24 ,$48.00 ,$29.62 ,$48.00 ,$29.62 ,$29.62 ,$48.00 ,$29.62 ,$530.94 ,$43.20 ,$36.00 ,$48.00 ,$48.00 ,$42.24 ,$48.00 ,$36.00 ,$36.00 ,$40.80 ,$40.80 ,$48.00 ,$40.80 ,$48.00 ,$37.44 ,$37.44 ,$37.44 ,$43.20 ,$48.00 ,$43.20 ,$48.00 ,$48.00 ,$31.44 ,$48.00 ,$19.97 ,$48.00 ,$48.00 ,$48.00 ,$43.20 ,$605.59 ,$29.62 ,$13.44 ,$43.20 ,$48.00 ,$43.20 ,$43.20 ,$48.00 ,$31.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),47000003,92586,HC NEWBORN HEARING SCREENING,470,1 ,$415.00 ,$269.75 ,$116.20 ,$415.00 , N/A ,$309.18 ,$271.83 , N/A ,$116.20 ,$209.58 , N/A ,$256.06 , N/A ,$256.06 ,$256.06 , N/A ,$256.06 , N/A ,$373.50 ,$311.25 , N/A , N/A ,$365.20 , N/A ,$311.25 ,$311.25 ,$352.75 ,$352.75 , N/A ,$352.75 , N/A ,$323.70 ,$323.70 ,$323.70 ,$373.50 , N/A ,$373.50 , N/A ,$415.00 ,$271.83 , N/A ,$172.64 , N/A , N/A , N/A ,$373.50 , N/A ,$256.06 ,$116.20 ,$373.50 , N/A ,$373.50 ,$373.50 , N/A ,$269.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),47100009,92558,HC AUD EVOKED OTOACOUS EMISSIONS SCREENING,471,1 ,$253.00 ,$164.45 ,$70.84 ,$253.00 , N/A ,$188.49 ,$165.72 , N/A ,$70.84 ,$127.77 , N/A ,$156.10 , N/A ,$156.10 ,$156.10 , N/A ,$156.10 , N/A ,$227.70 ,$189.75 , N/A , N/A ,$222.64 , N/A ,$189.75 ,$189.75 ,$215.05 ,$215.05 , N/A ,$215.05 , N/A ,$197.34 ,$197.34 ,$197.34 ,$227.70 , N/A ,$227.70 , N/A ,$253.00 ,$165.72 , N/A ,$105.25 ,$100.52 ,$95.95 , N/A ,$227.70 , N/A ,$156.10 ,$70.84 ,$227.70 , N/A ,$227.70 ,$227.70 , N/A ,$164.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$1,627.00 ","$1,057.55 ",$423.48 ,"$1,627.00 ","$1,423.90 ","$1,212.12 ","$1,065.69 ",$593.16 ,$455.56 ,$821.64 ,$593.16 ,"$1,003.86 ",$593.16 ,"$1,003.86 ","$1,003.86 ",$593.16 ,"$1,003.86 ","$1,127.00 ","$1,464.30 ","$1,220.25 ","$1,423.90 ",$593.16 ,"$1,431.76 ",$593.16 ,"$1,220.25 ","$1,220.25 ","$1,382.95 ","$1,382.95 ",$593.16 ,"$1,382.95 ",$593.16 ,"$1,269.06 ","$1,269.06 ","$1,269.06 ","$1,464.30 ","$1,423.90 ","$1,464.30 ",$593.16 ,"$1,627.00 ","$1,065.69 ",$593.16 ,$676.83 ,$443.64 ,$423.48 ,$620.85 ,"$1,464.30 ","$1,285.45 ","$1,003.86 ",$455.56 ,"$1,464.30 ",$593.16 ,"$1,464.30 ","$1,464.30 ",$593.16 ,"$1,057.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48000008,G0269,HC PLACE OCCLUSIVE DEVICE A/VV G0269,480,1 ,"$1,135.00 ",$737.75 ,$317.80 ,"$1,135.00 ", N/A ,$845.58 ,$743.43 , N/A ,$317.80 ,$573.18 , N/A ,$700.30 , N/A ,$700.30 ,$700.30 , N/A ,$700.30 , N/A ,"$1,021.50 ",$851.25 , N/A , N/A ,$998.80 , N/A ,$851.25 ,$851.25 ,$964.75 ,$964.75 , N/A ,$964.75 , N/A ,$885.30 ,$885.30 ,$885.30 ,"$1,021.50 ", N/A ,"$1,021.50 ", N/A ,"$1,135.00 ",$743.43 , N/A ,$472.16 , N/A , N/A , N/A ,"$1,021.50 ", N/A ,$700.30 ,$317.80 ,"$1,021.50 ", N/A ,"$1,021.50 ","$1,021.50 ", N/A ,$737.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48000023,93799,HC RECORDER CARDIOGRAM REAL TIME,480,1 ,$360.00 ,$234.00 ,$17.90 ,$360.00 ,$353.89 ,$268.20 ,$235.80 ,$147.42 ,$100.80 ,$181.80 ,$147.42 ,$222.12 ,$147.42 ,$222.12 ,$222.12 ,$147.42 ,$222.12 ,$280.10 ,$324.00 ,$270.00 ,$353.89 ,$147.42 ,$316.80 ,$147.42 ,$270.00 ,$270.00 ,$306.00 ,$306.00 ,$147.42 ,$306.00 ,$147.42 ,$280.80 ,$280.80 ,$280.80 ,$324.00 ,$353.89 ,$324.00 ,$147.42 ,$360.00 ,$235.80 ,$147.42 ,$149.76 ,$18.76 ,$17.90 ,$154.30 ,$324.00 ,$319.47 ,$222.12 ,$100.80 ,$324.00 ,$147.42 ,$324.00 ,$324.00 ,$147.42 ,$234.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48000024,93668,HC PAD REHAB PER SESSION,480,1 ,$158.00 ,$102.70 ,$44.24 ,$158.00 ,$141.09 ,$117.71 ,$103.49 ,$58.77 ,$44.24 ,$79.79 ,$58.77 ,$97.49 ,$58.77 ,$97.49 ,$97.49 ,$58.77 ,$97.49 ,$111.66 ,$142.20 ,$118.50 ,$141.09 ,$58.77 ,$139.04 ,$58.77 ,$118.50 ,$118.50 ,$134.30 ,$134.30 ,$58.77 ,$134.30 ,$58.77 ,$123.24 ,$123.24 ,$123.24 ,$142.20 ,$141.09 ,$142.20 ,$58.77 ,$158.00 ,$103.49 ,$58.77 ,$65.73 ,$158.00 ,$158.00 ,$61.52 ,$142.20 ,$127.37 ,$97.49 ,$44.24 ,$142.20 ,$58.77 ,$142.20 ,$142.20 ,$58.77 ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100002,33206,HC INS/REPL PCMKR PERM ATRIAL 33206,481,1 ,"$18,303.00 ","$11,896.95 ","$5,124.84 ","$23,792.67 ","$18,303.00 ","$13,635.74 ","$11,988.47 ","$10,978.87 ","$5,124.84 ","$9,243.02 ","$10,978.87 ","$11,292.95 ","$10,978.87 ","$11,292.95 ","$11,292.95 ","$10,978.87 ","$11,292.95 ","$20,859.85 ","$16,472.70 ","$13,727.25 ","$18,303.00 ","$10,978.87 ","$16,106.64 ","$10,978.87 ","$13,727.25 ","$13,727.25 ","$15,557.55 ","$15,557.55 ","$10,978.87 ","$15,557.55 ","$10,978.87 ","$14,276.34 ","$14,276.34 ","$14,276.34 ","$16,472.70 ","$18,303.00 ","$16,472.70 ","$10,978.87 ","$18,303.00 ","$11,988.47 ","$10,978.87 ","$7,614.05 ","$5,857.51 ","$5,591.26 ","$11,491.42 ","$16,472.70 ","$23,792.67 ","$11,292.95 ","$5,124.84 ","$16,472.70 ","$10,978.87 ","$16,472.70 ","$16,472.70 ","$10,978.87 ","$11,896.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100003,33207,HC INS/REPL PACEMKR PERM VENTRIC 33207,481,1 ,"$18,303.00 ","$11,896.95 ","$5,124.84 ","$23,792.67 ","$18,303.00 ","$13,635.74 ","$11,988.47 ","$10,978.87 ","$5,124.84 ","$9,243.02 ","$10,978.87 ","$11,292.95 ","$10,978.87 ","$11,292.95 ","$11,292.95 ","$10,978.87 ","$11,292.95 ","$20,859.85 ","$16,472.70 ","$13,727.25 ","$18,303.00 ","$10,978.87 ","$16,106.64 ","$10,978.87 ","$13,727.25 ","$13,727.25 ","$15,557.55 ","$15,557.55 ","$10,978.87 ","$15,557.55 ","$10,978.87 ","$14,276.34 ","$14,276.34 ","$14,276.34 ","$16,472.70 ","$18,303.00 ","$16,472.70 ","$10,978.87 ","$18,303.00 ","$11,988.47 ","$10,978.87 ","$7,614.05 ","$5,857.51 ","$5,591.26 ","$11,491.42 ","$16,472.70 ","$23,792.67 ","$11,292.95 ","$5,124.84 ","$16,472.70 ","$10,978.87 ","$16,472.70 ","$16,472.70 ","$10,978.87 ","$11,896.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100004,33208,HC INS/REPL PACEMKR PERM A/V 33208,481,1 ,"$19,937.00 ","$12,959.05 ","$5,582.36 ","$23,792.67 ","$19,937.00 ","$14,853.07 ","$13,058.74 ","$10,978.87 ","$5,582.36 ","$10,068.19 ","$10,978.87 ","$12,301.13 ","$10,978.87 ","$12,301.13 ","$12,301.13 ","$10,978.87 ","$12,301.13 ","$20,859.85 ","$17,943.30 ","$14,952.75 ","$19,937.00 ","$10,978.87 ","$17,544.56 ","$10,978.87 ","$14,952.75 ","$14,952.75 ","$16,946.45 ","$16,946.45 ","$10,978.87 ","$16,946.45 ","$10,978.87 ","$15,550.86 ","$15,550.86 ","$15,550.86 ","$17,943.30 ","$19,937.00 ","$17,943.30 ","$10,978.87 ","$19,937.00 ","$13,058.74 ","$10,978.87 ","$8,293.79 ","$5,857.51 ","$5,591.26 ","$11,491.42 ","$17,943.30 ","$23,792.67 ","$12,301.13 ","$5,582.36 ","$17,943.30 ","$10,978.87 ","$17,943.30 ","$17,943.30 ","$10,978.87 ","$12,959.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100005,33210,HC INS/REPL TPM SGL ELEC/CATH 33210,481,1 ,"$2,715.00 ","$1,764.75 ",$760.20 ,"$18,668.74 ","$2,715.00 ","$2,022.68 ","$1,778.33 ","$2,715.00 ",$760.20 ,"$1,371.08 ","$2,715.00 ","$1,675.16 ","$2,715.00 ","$1,675.16 ","$1,675.16 ","$2,715.00 ","$1,675.16 ","$16,367.53 ","$2,443.50 ","$2,036.25 ","$2,715.00 ","$2,715.00 ","$2,389.20 ","$2,715.00 ","$2,036.25 ","$2,036.25 ","$2,307.75 ","$2,307.75 ","$2,715.00 ","$2,307.75 ","$2,715.00 ","$2,117.70 ","$2,117.70 ","$2,117.70 ","$2,443.50 ","$2,715.00 ","$2,443.50 ","$2,715.00 ","$2,715.00 ","$1,778.33 ","$2,715.00 ","$1,129.44 ","$2,268.89 ","$2,165.76 ","$2,715.00 ","$2,443.50 ","$18,668.74 ","$1,675.16 ",$760.20 ,"$2,443.50 ","$2,715.00 ","$2,443.50 ","$2,443.50 ","$2,715.00 ","$1,764.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100006,33212,HC INS PULSE GEN SGL CHAMBER 33212,481,1 ,"$19,879.00 ","$12,921.35 ","$5,566.12 ","$19,879.00 ","$19,879.00 ","$14,809.86 ","$13,020.75 ","$8,614.49 ","$5,566.12 ","$10,038.90 ","$8,614.49 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$16,367.53 ","$17,891.10 ","$14,909.25 ","$19,879.00 ","$8,614.49 ","$17,493.52 ","$8,614.49 ","$14,909.25 ","$14,909.25 ","$16,897.15 ","$16,897.15 ","$8,614.49 ","$16,897.15 ","$8,614.49 ","$15,505.62 ","$15,505.62 ","$15,505.62 ","$17,891.10 ","$19,879.00 ","$17,891.10 ","$8,614.49 ","$19,879.00 ","$13,020.75 ","$8,614.49 ","$8,269.66 ","$5,857.51 ","$5,591.26 ","$9,016.66 ","$17,891.10 ","$18,668.74 ","$12,265.34 ","$5,566.12 ","$17,891.10 ","$8,614.49 ","$17,891.10 ","$17,891.10 ","$8,614.49 ","$12,921.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100007,33213,HC INS PULSE GEN DUAL CHAMBER 33213,481,1 ,"$27,525.00 ","$17,891.25 ","$5,591.26 ","$27,525.00 ","$26,355.43 ","$20,506.13 ","$18,028.88 ","$10,978.87 ","$7,707.00 ","$13,900.13 ","$10,978.87 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$20,859.85 ","$24,772.50 ","$20,643.75 ","$26,355.43 ","$10,978.87 ","$24,222.00 ","$10,978.87 ","$20,643.75 ","$20,643.75 ","$23,396.25 ","$23,396.25 ","$10,978.87 ","$23,396.25 ","$10,978.87 ","$21,469.50 ","$21,469.50 ","$21,469.50 ","$24,772.50 ","$26,355.43 ","$24,772.50 ","$10,978.87 ","$27,525.00 ","$18,028.88 ","$10,978.87 ","$11,450.40 ","$5,857.51 ","$5,591.26 ","$11,491.42 ","$24,772.50 ","$23,792.67 ","$16,982.93 ","$7,707.00 ","$24,772.50 ","$10,978.87 ","$24,772.50 ","$24,772.50 ","$10,978.87 ","$17,891.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100008,33214,HC UPGRADE PACEMAKER SYSTEM 33214,481,1 ,"$27,525.00 ","$17,891.25 ","$5,591.26 ","$27,525.00 ","$26,355.43 ","$20,506.13 ","$18,028.88 ","$10,978.87 ","$7,707.00 ","$13,900.13 ","$10,978.87 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$20,859.85 ","$24,772.50 ","$20,643.75 ","$26,355.43 ","$10,978.87 ","$24,222.00 ","$10,978.87 ","$20,643.75 ","$20,643.75 ","$23,396.25 ","$23,396.25 ","$10,978.87 ","$23,396.25 ","$10,978.87 ","$21,469.50 ","$21,469.50 ","$21,469.50 ","$24,772.50 ","$26,355.43 ","$24,772.50 ","$10,978.87 ","$27,525.00 ","$18,028.88 ","$10,978.87 ","$11,450.40 ","$5,857.51 ","$5,591.26 ","$11,491.42 ","$24,772.50 ","$23,792.67 ","$16,982.93 ","$7,707.00 ","$24,772.50 ","$10,978.87 ","$24,772.50 ","$24,772.50 ","$10,978.87 ","$17,891.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100010,33216,HC INS ELECTRODE SGL CHAMBER 33216,481,1 ,"$19,879.00 ","$12,921.35 ","$2,165.76 ","$19,879.00 ","$19,879.00 ","$14,809.86 ","$13,020.75 ","$8,614.49 ","$5,566.12 ","$10,038.90 ","$8,614.49 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$16,367.53 ","$17,891.10 ","$14,909.25 ","$19,879.00 ","$8,614.49 ","$17,493.52 ","$8,614.49 ","$14,909.25 ","$14,909.25 ","$16,897.15 ","$16,897.15 ","$8,614.49 ","$16,897.15 ","$8,614.49 ","$15,505.62 ","$15,505.62 ","$15,505.62 ","$17,891.10 ","$19,879.00 ","$17,891.10 ","$8,614.49 ","$19,879.00 ","$13,020.75 ","$8,614.49 ","$8,269.66 ","$2,268.89 ","$2,165.76 ","$9,016.66 ","$17,891.10 ","$18,668.74 ","$12,265.34 ","$5,566.12 ","$17,891.10 ","$8,614.49 ","$17,891.10 ","$17,891.10 ","$8,614.49 ","$12,921.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100011,33217,HC INS ELECTRODE DUAL CHAMBER 33217,481,1 ,"$19,879.00 ","$12,921.35 ","$2,165.76 ","$19,879.00 ","$19,879.00 ","$14,809.86 ","$13,020.75 ","$8,614.49 ","$5,566.12 ","$10,038.90 ","$8,614.49 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$16,367.53 ","$17,891.10 ","$14,909.25 ","$19,879.00 ","$8,614.49 ","$17,493.52 ","$8,614.49 ","$14,909.25 ","$14,909.25 ","$16,897.15 ","$16,897.15 ","$8,614.49 ","$16,897.15 ","$8,614.49 ","$15,505.62 ","$15,505.62 ","$15,505.62 ","$17,891.10 ","$19,879.00 ","$17,891.10 ","$8,614.49 ","$19,879.00 ","$13,020.75 ","$8,614.49 ","$8,269.66 ","$2,268.89 ","$2,165.76 ","$9,016.66 ","$17,891.10 ","$18,668.74 ","$12,265.34 ","$5,566.12 ","$17,891.10 ","$8,614.49 ","$17,891.10 ","$17,891.10 ","$8,614.49 ","$12,921.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100014,33224,HC INSERT LV PACING ELECTRODE 33224,481,1 ,"$27,525.00 ","$17,891.25 ","$7,460.91 ","$27,525.00 ","$26,355.43 ","$20,506.13 ","$18,028.88 ","$10,978.87 ","$7,707.00 ","$13,900.13 ","$10,978.87 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$20,859.85 ","$24,772.50 ","$20,643.75 ","$26,355.43 ","$10,978.87 ","$24,222.00 ","$10,978.87 ","$20,643.75 ","$20,643.75 ","$23,396.25 ","$23,396.25 ","$10,978.87 ","$23,396.25 ","$10,978.87 ","$21,469.50 ","$21,469.50 ","$21,469.50 ","$24,772.50 ","$26,355.43 ","$24,772.50 ","$10,978.87 ","$27,525.00 ","$18,028.88 ","$10,978.87 ","$11,450.40 ","$7,816.19 ","$7,460.91 ","$11,491.42 ","$24,772.50 ","$23,792.67 ","$16,982.93 ","$7,707.00 ","$24,772.50 ","$10,978.87 ","$24,772.50 ","$24,772.50 ","$10,978.87 ","$17,891.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100015,33225,HC INS LV PACING ELCT W/C-D/PACE 33225,481,1 ,"$11,262.00 ","$7,320.30 ","$3,153.36 ","$11,262.00 ", N/A ,"$8,390.19 ","$7,376.61 ", N/A ,"$3,153.36 ","$5,687.31 ", N/A ,"$6,948.65 ", N/A ,"$6,948.65 ","$6,948.65 ", N/A ,"$6,948.65 ", N/A ,"$10,135.80 ","$8,446.50 ", N/A , N/A ,"$9,910.56 ", N/A ,"$8,446.50 ","$8,446.50 ","$9,572.70 ","$9,572.70 ", N/A ,"$9,572.70 ", N/A ,"$8,784.36 ","$8,784.36 ","$8,784.36 ","$10,135.80 ", N/A ,"$10,135.80 ", N/A ,"$11,262.00 ","$7,376.61 ", N/A ,"$4,684.99 ", N/A , N/A , N/A ,"$10,135.80 ", N/A ,"$6,948.65 ","$3,153.36 ","$10,135.80 ", N/A ,"$10,135.80 ","$10,135.80 ", N/A ,"$7,320.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100016,33226,HC REPOSITION LV ELECTRODE 33226,481,1 ,"$7,447.00 ","$4,840.55 ","$2,085.16 ","$7,447.00 ","$7,255.98 ","$5,548.02 ","$4,877.79 ","$3,022.62 ","$2,085.16 ","$3,760.74 ","$3,022.62 ","$4,594.80 ","$3,022.62 ","$4,594.80 ","$4,594.80 ","$3,022.62 ","$4,594.80 ","$5,742.98 ","$6,702.30 ","$5,585.25 ","$7,255.98 ","$3,022.62 ","$6,553.36 ","$3,022.62 ","$5,585.25 ","$5,585.25 ","$6,329.95 ","$6,329.95 ","$3,022.62 ","$6,329.95 ","$3,022.62 ","$5,808.66 ","$5,808.66 ","$5,808.66 ","$6,702.30 ","$7,255.98 ","$6,702.30 ","$3,022.62 ","$7,447.00 ","$4,877.79 ","$3,022.62 ","$3,097.95 ","$4,239.55 ","$4,046.85 ","$3,163.73 ","$6,702.30 ","$6,550.42 ","$4,594.80 ","$2,085.16 ","$6,702.30 ","$3,022.62 ","$6,702.30 ","$6,702.30 ","$3,022.62 ","$4,840.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100024,33249,HC INS/REPOS DEFIB LEAD/GEN 33249,481,1 ,"$31,436.00 ","$20,433.40 ","$8,802.08 ","$75,162.38 ","$31,436.00 ","$23,419.82 ","$20,590.58 ","$31,436.00 ","$8,802.08 ","$15,875.18 ","$31,436.00 ","$19,396.01 ","$31,436.00 ","$19,396.01 ","$19,396.01 ","$31,436.00 ","$19,396.01 ","$65,897.43 ","$28,292.40 ","$23,577.00 ","$31,436.00 ","$31,436.00 ","$27,663.68 ","$31,436.00 ","$23,577.00 ","$23,577.00 ","$26,720.60 ","$26,720.60 ","$31,436.00 ","$26,720.60 ","$31,436.00 ","$24,520.08 ","$24,520.08 ","$24,520.08 ","$28,292.40 ","$31,436.00 ","$28,292.40 ","$31,436.00 ","$31,436.00 ","$20,590.58 ","$31,436.00 ","$13,077.38 ","$16,802.05 ","$16,038.32 ","$31,436.00 ","$28,292.40 ","$75,162.38 ","$19,396.01 ","$8,802.08 ","$28,292.40 ","$31,436.00 ","$28,292.40 ","$28,292.40 ","$31,436.00 ","$20,433.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100028,33285,HC IMPLANT CARDIAC EVENT RECORDER,481,1 ,"$21,733.00 ","$14,126.45 ","$2,767.19 ","$21,733.00 ","$20,679.59 ","$16,191.09 ","$14,235.12 ","$8,614.49 ","$6,085.24 ","$10,975.17 ","$8,614.49 ","$13,409.26 ","$8,614.49 ","$13,409.26 ","$13,409.26 ","$8,614.49 ","$13,409.26 ","$16,367.53 ","$19,559.70 ","$16,299.75 ","$20,679.59 ","$8,614.49 ","$19,125.04 ","$8,614.49 ","$16,299.75 ","$16,299.75 ","$18,473.05 ","$18,473.05 ","$8,614.49 ","$18,473.05 ","$8,614.49 ","$16,951.74 ","$16,951.74 ","$16,951.74 ","$19,559.70 ","$20,679.59 ","$19,559.70 ","$8,614.49 ","$21,733.00 ","$14,235.12 ","$8,614.49 ","$9,040.93 ","$2,898.96 ","$2,767.19 ","$9,016.66 ","$19,559.70 ","$18,668.74 ","$13,409.26 ","$6,085.24 ","$19,559.70 ","$8,614.49 ","$19,559.70 ","$19,559.70 ","$8,614.49 ","$14,126.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100029,33286,HC REMOVE CARDIAC EVENT RECORDER,481,1 ,"$2,796.00 ","$1,817.40 ",$447.91 ,"$2,796.00 ","$1,577.31 ","$2,083.02 ","$1,831.38 ",$657.06 ,$782.88 ,"$1,411.98 ",$657.06 ,"$1,725.13 ",$657.06 ,"$1,725.13 ","$1,725.13 ",$657.06 ,"$1,725.13 ","$1,248.41 ","$2,516.40 ","$2,097.00 ","$1,577.31 ",$657.06 ,"$2,460.48 ",$657.06 ,"$2,097.00 ","$2,097.00 ","$2,376.60 ","$2,376.60 ",$657.06 ,"$2,376.60 ",$657.06 ,"$2,180.88 ","$2,180.88 ","$2,180.88 ","$2,516.40 ","$1,577.31 ","$2,516.40 ",$657.06 ,"$2,796.00 ","$1,831.38 ",$657.06 ,"$1,163.14 ",$469.24 ,$447.91 ,$687.73 ,"$2,516.40 ","$1,423.93 ","$1,725.13 ",$782.88 ,"$2,516.40 ",$657.06 ,"$2,516.40 ","$2,516.40 ",$657.06 ,"$1,817.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100030,33967,HC IABP INSERTION 33967,481,1 ,"$6,123.00 ","$3,979.95 ","$1,714.44 ","$6,123.00 ", N/A ,"$4,561.64 ","$4,010.57 ", N/A ,"$1,714.44 ","$3,092.12 ", N/A ,"$3,777.89 ", N/A ,"$3,777.89 ","$3,777.89 ", N/A ,"$3,777.89 ", N/A ,"$5,510.70 ","$4,592.25 ", N/A , N/A ,"$5,388.24 ", N/A ,"$4,592.25 ","$4,592.25 ","$5,204.55 ","$5,204.55 ", N/A ,"$5,204.55 ", N/A ,"$4,775.94 ","$4,775.94 ","$4,775.94 ","$5,510.70 ", N/A ,"$5,510.70 ", N/A ,"$6,123.00 ","$4,010.57 ", N/A ,"$2,547.17 ", N/A , N/A , N/A ,"$5,510.70 ", N/A ,"$3,777.89 ","$1,714.44 ","$5,510.70 ", N/A ,"$5,510.70 ","$5,510.70 ", N/A ,"$3,979.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100039,36010,HC INTRO CATH VENA CAVA SUP/IN,481,1 ,"$2,340.00 ","$1,521.00 ",$655.20 ,"$2,340.00 ", N/A ,"$1,743.30 ","$1,532.70 ", N/A ,$655.20 ,"$1,181.70 ", N/A ,"$1,443.78 ", N/A ,"$1,443.78 ","$1,443.78 ", N/A ,"$1,443.78 ", N/A ,"$2,106.00 ","$1,755.00 ", N/A , N/A ,"$2,059.20 ", N/A ,"$1,755.00 ","$1,755.00 ","$1,989.00 ","$1,989.00 ", N/A ,"$1,989.00 ", N/A ,"$1,825.20 ","$1,825.20 ","$1,825.20 ","$2,106.00 ", N/A ,"$2,106.00 ", N/A ,"$2,340.00 ","$1,532.70 ", N/A ,$973.44 ,"$1,948.40 ","$1,859.83 ", N/A ,"$2,106.00 ", N/A ,"$1,443.78 ",$655.20 ,"$2,106.00 ", N/A ,"$2,106.00 ","$2,106.00 ", N/A ,"$1,521.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100040,36011,"HC CATH PLCMT VENOUS, 1ST ORDER",481,1 ,"$1,925.00 ","$1,251.25 ",$539.00 ,"$1,925.00 ", N/A ,"$1,434.13 ","$1,260.88 ", N/A ,$539.00 ,$972.13 , N/A ,"$1,187.73 ", N/A ,"$1,187.73 ","$1,187.73 ", N/A ,"$1,187.73 ", N/A ,"$1,732.50 ","$1,443.75 ", N/A , N/A ,"$1,694.00 ", N/A ,"$1,443.75 ","$1,443.75 ","$1,636.25 ","$1,636.25 ", N/A ,"$1,636.25 ", N/A ,"$1,501.50 ","$1,501.50 ","$1,501.50 ","$1,732.50 ", N/A ,"$1,732.50 ", N/A ,"$1,925.00 ","$1,260.88 ", N/A ,$800.80 ,"$1,925.00 ","$1,859.83 ", N/A ,"$1,732.50 ", N/A ,"$1,187.73 ",$539.00 ,"$1,732.50 ", N/A ,"$1,732.50 ","$1,732.50 ", N/A ,"$1,251.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100040,36011,"HC CATH PLCMT VENOUS, 1ST ORDER",481,1 ,"$2,888.00 ","$1,877.20 ",$808.64 ,"$2,888.00 ", N/A ,"$2,151.56 ","$1,891.64 ", N/A ,$808.64 ,"$1,458.44 ", N/A ,"$1,781.90 ", N/A ,"$1,781.90 ","$1,781.90 ", N/A ,"$1,781.90 ", N/A ,"$2,599.20 ","$2,166.00 ", N/A , N/A ,"$2,541.44 ", N/A ,"$2,166.00 ","$2,166.00 ","$2,454.80 ","$2,454.80 ", N/A ,"$2,454.80 ", N/A ,"$2,252.64 ","$2,252.64 ","$2,252.64 ","$2,599.20 ", N/A ,"$2,599.20 ", N/A ,"$2,888.00 ","$1,891.64 ", N/A ,"$1,201.41 ","$2,888.00 ","$2,789.76 ", N/A ,"$2,599.20 ", N/A ,"$1,781.90 ",$808.64 ,"$2,599.20 ", N/A ,"$2,599.20 ","$2,599.20 ", N/A ,"$1,877.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,"$2,216.00 ","$1,440.40 ",$620.48 ,"$2,216.00 ", N/A ,"$1,650.92 ","$1,451.48 ", N/A ,$620.48 ,"$1,119.08 ", N/A ,"$1,367.27 ", N/A ,"$1,367.27 ","$1,367.27 ", N/A ,"$1,367.27 ", N/A ,"$1,994.40 ","$1,662.00 ", N/A , N/A ,"$1,950.08 ", N/A ,"$1,662.00 ","$1,662.00 ","$1,883.60 ","$1,883.60 ", N/A ,"$1,883.60 ", N/A ,"$1,728.48 ","$1,728.48 ","$1,728.48 ","$1,994.40 ", N/A ,"$1,994.40 ", N/A ,"$2,216.00 ","$1,451.48 ", N/A ,$921.86 ,"$1,948.40 ","$1,859.83 ", N/A ,"$1,994.40 ", N/A ,"$1,367.27 ",$620.48 ,"$1,994.40 ", N/A ,"$1,994.40 ","$1,994.40 ", N/A ,"$1,440.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,"$3,323.00 ","$2,159.95 ",$930.44 ,"$3,323.00 ", N/A ,"$2,475.64 ","$2,176.57 ", N/A ,$930.44 ,"$1,678.12 ", N/A ,"$2,050.29 ", N/A ,"$2,050.29 ","$2,050.29 ", N/A ,"$2,050.29 ", N/A ,"$2,990.70 ","$2,492.25 ", N/A , N/A ,"$2,924.24 ", N/A ,"$2,492.25 ","$2,492.25 ","$2,824.55 ","$2,824.55 ", N/A ,"$2,824.55 ", N/A ,"$2,591.94 ","$2,591.94 ","$2,591.94 ","$2,990.70 ", N/A ,"$2,990.70 ", N/A ,"$3,323.00 ","$2,176.57 ", N/A ,"$1,382.37 ","$2,922.60 ","$2,789.76 ", N/A ,"$2,990.70 ", N/A ,"$2,050.29 ",$930.44 ,"$2,990.70 ", N/A ,"$2,990.70 ","$2,990.70 ", N/A ,"$2,159.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100047,36140,HC INTRO NDL/CATH ARTERY EXTREM 36140,481,1 ,"$2,354.00 ","$1,530.10 ",$659.12 ,"$2,354.00 ", N/A ,"$1,753.73 ","$1,541.87 ", N/A ,$659.12 ,"$1,188.77 ", N/A ,"$1,452.42 ", N/A ,"$1,452.42 ","$1,452.42 ", N/A ,"$1,452.42 ", N/A ,"$2,118.60 ","$1,765.50 ", N/A , N/A ,"$2,071.52 ", N/A ,"$1,765.50 ","$1,765.50 ","$2,000.90 ","$2,000.90 ", N/A ,"$2,000.90 ", N/A ,"$1,836.12 ","$1,836.12 ","$1,836.12 ","$2,118.60 ", N/A ,"$2,118.60 ", N/A ,"$2,354.00 ","$1,541.87 ", N/A ,$979.26 ,"$1,948.40 ","$1,859.83 ", N/A ,"$2,118.60 ", N/A ,"$1,452.42 ",$659.12 ,"$2,118.60 ", N/A ,"$2,118.60 ","$2,118.60 ", N/A ,"$1,530.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100051,36200,HC INTRO CATH AORTA 36200,481,1 ,"$2,985.00 ","$1,940.25 ",$835.80 ,"$2,985.00 ", N/A ,"$2,223.83 ","$1,955.18 ", N/A ,$835.80 ,"$1,507.43 ", N/A ,"$1,841.75 ", N/A ,"$1,841.75 ","$1,841.75 ", N/A ,"$1,841.75 ", N/A ,"$2,686.50 ","$2,238.75 ", N/A , N/A ,"$2,626.80 ", N/A ,"$2,238.75 ","$2,238.75 ","$2,537.25 ","$2,537.25 ", N/A ,"$2,537.25 ", N/A ,"$2,328.30 ","$2,328.30 ","$2,328.30 ","$2,686.50 ", N/A ,"$2,686.50 ", N/A ,"$2,985.00 ","$1,955.18 ", N/A ,"$1,241.76 ","$1,948.40 ","$1,859.83 ", N/A ,"$2,686.50 ", N/A ,"$1,841.75 ",$835.80 ,"$2,686.50 ", N/A ,"$2,686.50 ","$2,686.50 ", N/A ,"$1,940.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100052,36215,HC PLACE CATH THOR/BRAC 1ST ORDER 36215,481,1 ,"$3,092.00 ","$2,009.80 ",$865.76 ,"$3,092.00 ", N/A ,"$2,303.54 ","$2,025.26 ", N/A ,$865.76 ,"$1,561.46 ", N/A ,"$1,907.76 ", N/A ,"$1,907.76 ","$1,907.76 ", N/A ,"$1,907.76 ", N/A ,"$2,782.80 ","$2,319.00 ", N/A , N/A ,"$2,720.96 ", N/A ,"$2,319.00 ","$2,319.00 ","$2,628.20 ","$2,628.20 ", N/A ,"$2,628.20 ", N/A ,"$2,411.76 ","$2,411.76 ","$2,411.76 ","$2,782.80 ", N/A ,"$2,782.80 ", N/A ,"$3,092.00 ","$2,025.26 ", N/A ,"$1,286.27 ","$1,948.40 ","$1,859.83 ", N/A ,"$2,782.80 ", N/A ,"$1,907.76 ",$865.76 ,"$2,782.80 ", N/A ,"$2,782.80 ","$2,782.80 ", N/A ,"$2,009.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100053,36216,HC PL CATH THOR/BRAC 2ND ORDER 36216,481,1 ,"$3,149.00 ","$2,046.85 ",$881.72 ,"$3,149.00 ", N/A ,"$2,346.01 ","$2,062.60 ", N/A ,$881.72 ,"$1,590.25 ", N/A ,"$1,942.93 ", N/A ,"$1,942.93 ","$1,942.93 ", N/A ,"$1,942.93 ", N/A ,"$2,834.10 ","$2,361.75 ", N/A , N/A ,"$2,771.12 ", N/A ,"$2,361.75 ","$2,361.75 ","$2,676.65 ","$2,676.65 ", N/A ,"$2,676.65 ", N/A ,"$2,456.22 ","$2,456.22 ","$2,456.22 ","$2,834.10 ", N/A ,"$2,834.10 ", N/A ,"$3,149.00 ","$2,062.60 ", N/A ,"$1,309.98 ","$1,948.40 ","$1,859.83 ", N/A ,"$2,834.10 ", N/A ,"$1,942.93 ",$881.72 ,"$2,834.10 ", N/A ,"$2,834.10 ","$2,834.10 ", N/A ,"$2,046.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100054,36217,HC PL CATH THOR/BRAC 3RD ORDER 36217,481,1 ,"$3,487.00 ","$2,266.55 ",$976.36 ,"$3,487.00 ", N/A ,"$2,597.82 ","$2,283.99 ", N/A ,$976.36 ,"$1,760.94 ", N/A ,"$2,151.48 ", N/A ,"$2,151.48 ","$2,151.48 ", N/A ,"$2,151.48 ", N/A ,"$3,138.30 ","$2,615.25 ", N/A , N/A ,"$3,068.56 ", N/A ,"$2,615.25 ","$2,615.25 ","$2,963.95 ","$2,963.95 ", N/A ,"$2,963.95 ", N/A ,"$2,719.86 ","$2,719.86 ","$2,719.86 ","$3,138.30 ", N/A ,"$3,138.30 ", N/A ,"$3,487.00 ","$2,283.99 ", N/A ,"$1,450.59 ","$1,948.40 ","$1,859.83 ", N/A ,"$3,138.30 ", N/A ,"$2,151.48 ",$976.36 ,"$3,138.30 ", N/A ,"$3,138.30 ","$3,138.30 ", N/A ,"$2,266.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100055,36218,HC PL CATH THOR/BRAC ADDL 36218,481,1 ,"$1,585.00 ","$1,030.25 ",$443.80 ,"$1,585.00 ", N/A ,"$1,180.83 ","$1,038.18 ", N/A ,$443.80 ,$800.43 , N/A ,$977.95 , N/A ,$977.95 ,$977.95 , N/A ,$977.95 , N/A ,"$1,426.50 ","$1,188.75 ", N/A , N/A ,"$1,394.80 ", N/A ,"$1,188.75 ","$1,188.75 ","$1,347.25 ","$1,347.25 ", N/A ,"$1,347.25 ", N/A ,"$1,236.30 ","$1,236.30 ","$1,236.30 ","$1,426.50 ", N/A ,"$1,426.50 ", N/A ,"$1,585.00 ","$1,038.18 ", N/A ,$659.36 ,"$1,585.00 ","$1,585.00 ", N/A ,"$1,426.50 ", N/A ,$977.95 ,$443.80 ,"$1,426.50 ", N/A ,"$1,426.50 ","$1,426.50 ", N/A ,"$1,030.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100056,36245,HC ABD 1ST ORDER 36245,481,1 ,"$3,785.00 ","$2,460.25 ","$1,059.80 ","$3,785.00 ", N/A ,"$2,819.83 ","$2,479.18 ", N/A ,"$1,059.80 ","$1,911.43 ", N/A ,"$2,335.35 ", N/A ,"$2,335.35 ","$2,335.35 ", N/A ,"$2,335.35 ", N/A ,"$3,406.50 ","$2,838.75 ", N/A , N/A ,"$3,330.80 ", N/A ,"$2,838.75 ","$2,838.75 ","$3,217.25 ","$3,217.25 ", N/A ,"$3,217.25 ", N/A ,"$2,952.30 ","$2,952.30 ","$2,952.30 ","$3,406.50 ", N/A ,"$3,406.50 ", N/A ,"$3,785.00 ","$2,479.18 ", N/A ,"$1,574.56 ","$1,948.40 ","$1,859.83 ", N/A ,"$3,406.50 ", N/A ,"$2,335.35 ","$1,059.80 ","$3,406.50 ", N/A ,"$3,406.50 ","$3,406.50 ", N/A ,"$2,460.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$5,713.00 ","$3,713.45 ","$1,599.64 ","$5,713.00 ", N/A ,"$4,256.19 ","$3,742.02 ", N/A ,"$1,599.64 ","$2,885.07 ", N/A ,"$3,524.92 ", N/A ,"$3,524.92 ","$3,524.92 ", N/A ,"$3,524.92 ", N/A ,"$5,141.70 ","$4,284.75 ", N/A , N/A ,"$5,027.44 ", N/A ,"$4,284.75 ","$4,284.75 ","$4,856.05 ","$4,856.05 ", N/A ,"$4,856.05 ", N/A ,"$4,456.14 ","$4,456.14 ","$4,456.14 ","$5,141.70 ", N/A ,"$5,141.70 ", N/A ,"$5,713.00 ","$3,742.02 ", N/A ,"$2,376.61 ","$2,922.60 ","$2,789.76 ", N/A ,"$5,141.70 ", N/A ,"$3,524.92 ","$1,599.64 ","$5,141.70 ", N/A ,"$5,141.70 ","$5,141.70 ", N/A ,"$3,713.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$3,809.00 ","$2,475.85 ","$1,066.52 ","$3,809.00 ", N/A ,"$2,837.71 ","$2,494.90 ", N/A ,"$1,066.52 ","$1,923.55 ", N/A ,"$2,350.15 ", N/A ,"$2,350.15 ","$2,350.15 ", N/A ,"$2,350.15 ", N/A ,"$3,428.10 ","$2,856.75 ", N/A , N/A ,"$3,351.92 ", N/A ,"$2,856.75 ","$2,856.75 ","$3,237.65 ","$3,237.65 ", N/A ,"$3,237.65 ", N/A ,"$2,971.02 ","$2,971.02 ","$2,971.02 ","$3,428.10 ", N/A ,"$3,428.10 ", N/A ,"$3,809.00 ","$2,494.90 ", N/A ,"$1,584.54 ","$1,948.40 ","$1,859.83 ", N/A ,"$3,428.10 ", N/A ,"$2,350.15 ","$1,066.52 ","$3,428.10 ", N/A ,"$3,428.10 ","$3,428.10 ", N/A ,"$2,475.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100058,36247,HC ABD INT 3RD/PLUS ORDER 36247,481,1 ,"$4,302.00 ","$2,796.30 ","$1,204.56 ","$4,302.00 ", N/A ,"$3,204.99 ","$2,817.81 ", N/A ,"$1,204.56 ","$2,172.51 ", N/A ,"$2,654.33 ", N/A ,"$2,654.33 ","$2,654.33 ", N/A ,"$2,654.33 ", N/A ,"$3,871.80 ","$3,226.50 ", N/A , N/A ,"$3,785.76 ", N/A ,"$3,226.50 ","$3,226.50 ","$3,656.70 ","$3,656.70 ", N/A ,"$3,656.70 ", N/A ,"$3,355.56 ","$3,355.56 ","$3,355.56 ","$3,871.80 ", N/A ,"$3,871.80 ", N/A ,"$4,302.00 ","$2,817.81 ", N/A ,"$1,789.63 ","$1,948.40 ","$1,859.83 ", N/A ,"$3,871.80 ", N/A ,"$2,654.33 ","$1,204.56 ","$3,871.80 ", N/A ,"$3,871.80 ","$3,871.80 ", N/A ,"$2,796.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100058,36247,HC ABD INT 3RD/PLUS ORDER 36247,481,1 ,"$6,454.00 ","$4,195.10 ","$1,807.12 ","$6,454.00 ", N/A ,"$4,808.23 ","$4,227.37 ", N/A ,"$1,807.12 ","$3,259.27 ", N/A ,"$3,982.12 ", N/A ,"$3,982.12 ","$3,982.12 ", N/A ,"$3,982.12 ", N/A ,"$5,808.60 ","$4,840.50 ", N/A , N/A ,"$5,679.52 ", N/A ,"$4,840.50 ","$4,840.50 ","$5,485.90 ","$5,485.90 ", N/A ,"$5,485.90 ", N/A ,"$5,034.12 ","$5,034.12 ","$5,034.12 ","$5,808.60 ", N/A ,"$5,808.60 ", N/A ,"$6,454.00 ","$4,227.37 ", N/A ,"$2,684.86 ","$2,922.60 ","$2,789.76 ", N/A ,"$5,808.60 ", N/A ,"$3,982.12 ","$1,807.12 ","$5,808.60 ", N/A ,"$5,808.60 ","$5,808.60 ", N/A ,"$4,195.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100059,36248,HC ABD ADDL 2ND/PLUS ORDER 36248,481,1 ,"$1,768.00 ","$1,149.20 ",$495.04 ,"$1,768.00 ", N/A ,"$1,317.16 ","$1,158.04 ", N/A ,$495.04 ,$892.84 , N/A ,"$1,090.86 ", N/A ,"$1,090.86 ","$1,090.86 ", N/A ,"$1,090.86 ", N/A ,"$1,591.20 ","$1,326.00 ", N/A , N/A ,"$1,555.84 ", N/A ,"$1,326.00 ","$1,326.00 ","$1,502.80 ","$1,502.80 ", N/A ,"$1,502.80 ", N/A ,"$1,379.04 ","$1,379.04 ","$1,379.04 ","$1,591.20 ", N/A ,"$1,591.20 ", N/A ,"$1,768.00 ","$1,158.04 ", N/A ,$735.49 ,"$1,768.00 ","$1,768.00 ", N/A ,"$1,591.20 ", N/A ,"$1,090.86 ",$495.04 ,"$1,591.20 ", N/A ,"$1,591.20 ","$1,591.20 ", N/A ,"$1,149.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100069,37241,HC OCCL/EMBOL TRANSCATH PERC 37241,481,1 ,"$26,928.00 ","$17,503.20 ","$7,460.91 ","$26,928.00 ","$25,459.91 ","$20,061.36 ","$17,637.84 ","$10,605.82 ","$7,539.84 ","$13,598.64 ","$10,605.82 ","$16,614.58 ","$10,605.82 ","$16,614.58 ","$16,614.58 ","$10,605.82 ","$16,614.58 ","$20,151.06 ","$24,235.20 ","$20,196.00 ","$25,459.91 ","$10,605.82 ","$23,696.64 ","$10,605.82 ","$20,196.00 ","$20,196.00 ","$22,888.80 ","$22,888.80 ","$10,605.82 ","$22,888.80 ","$10,605.82 ","$21,003.84 ","$21,003.84 ","$21,003.84 ","$24,235.20 ","$25,459.91 ","$24,235.20 ","$10,605.82 ","$26,928.00 ","$17,637.84 ","$10,605.82 ","$11,202.05 ","$7,816.19 ","$7,460.91 ","$11,100.96 ","$24,235.20 ","$22,984.23 ","$16,614.58 ","$7,539.84 ","$24,235.20 ","$10,605.82 ","$24,235.20 ","$24,235.20 ","$10,605.82 ","$17,503.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100077,37220,HC RVC EN PRC ICA W/ANG INT VSL 37220,481,1 ,"$12,465.00 ","$8,102.25 ","$3,439.40 ","$12,465.00 ","$12,465.00 ","$9,286.43 ","$8,164.58 ","$5,233.27 ","$3,490.20 ","$6,294.83 ","$5,233.27 ","$7,690.91 ","$5,233.27 ","$7,690.91 ","$7,690.91 ","$5,233.27 ","$7,690.91 ","$9,943.21 ","$11,218.50 ","$9,348.75 ","$12,465.00 ","$5,233.27 ","$10,969.20 ","$5,233.27 ","$9,348.75 ","$9,348.75 ","$10,595.25 ","$10,595.25 ","$5,233.27 ","$10,595.25 ","$5,233.27 ","$9,722.70 ","$9,722.70 ","$9,722.70 ","$11,218.50 ","$12,465.00 ","$11,218.50 ","$5,233.27 ","$12,465.00 ","$8,164.58 ","$5,233.27 ","$5,185.44 ","$3,603.18 ","$3,439.40 ","$5,477.59 ","$11,218.50 ","$11,341.20 ","$7,690.91 ","$3,490.20 ","$11,218.50 ","$5,233.27 ","$11,218.50 ","$11,218.50 ","$5,233.27 ","$8,102.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100078,37221,HC RVC EN PRC ICA W/TRN SNT INT V 37221,481,1 ,"$16,829.00 ","$10,938.85 ","$3,439.40 ","$22,984.23 ","$16,829.00 ","$12,537.61 ","$11,023.00 ","$10,605.82 ","$4,712.12 ","$8,498.65 ","$10,605.82 ","$10,383.49 ","$10,605.82 ","$10,383.49 ","$10,383.49 ","$10,605.82 ","$10,383.49 ","$20,151.06 ","$15,146.10 ","$12,621.75 ","$16,829.00 ","$10,605.82 ","$14,809.52 ","$10,605.82 ","$12,621.75 ","$12,621.75 ","$14,304.65 ","$14,304.65 ","$10,605.82 ","$14,304.65 ","$10,605.82 ","$13,126.62 ","$13,126.62 ","$13,126.62 ","$15,146.10 ","$16,829.00 ","$15,146.10 ","$10,605.82 ","$16,829.00 ","$11,023.00 ","$10,605.82 ","$7,000.86 ","$3,603.18 ","$3,439.40 ","$11,100.96 ","$15,146.10 ","$22,984.23 ","$10,383.49 ","$4,712.12 ","$15,146.10 ","$10,605.82 ","$15,146.10 ","$15,146.10 ","$10,605.82 ","$10,938.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100079,37222,HC RVC EN PRC ICA W/ANG EA AD VS 37222,481,1 ,"$9,638.00 ","$6,264.70 ","$2,698.64 ","$9,638.00 ", N/A ,"$7,180.31 ","$6,312.89 ", N/A ,"$2,698.64 ","$4,867.19 ", N/A ,"$5,946.65 ", N/A ,"$5,946.65 ","$5,946.65 ", N/A ,"$5,946.65 ", N/A ,"$8,674.20 ","$7,228.50 ", N/A , N/A ,"$8,481.44 ", N/A ,"$7,228.50 ","$7,228.50 ","$8,192.30 ","$8,192.30 ", N/A ,"$8,192.30 ", N/A ,"$7,517.64 ","$7,517.64 ","$7,517.64 ","$8,674.20 ", N/A ,"$8,674.20 ", N/A ,"$9,638.00 ","$6,312.89 ", N/A ,"$4,009.41 ","$3,603.18 ","$3,439.40 ", N/A ,"$8,674.20 ", N/A ,"$5,946.65 ","$2,698.64 ","$8,674.20 ", N/A ,"$8,674.20 ","$8,674.20 ", N/A ,"$6,264.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100080,37223,HC RVC EN PRC ICA W/TRN ST AD VS 37223,481,1 ,"$11,499.00 ","$7,474.35 ","$3,219.72 ","$11,499.00 ", N/A ,"$8,566.76 ","$7,531.85 ", N/A ,"$3,219.72 ","$5,807.00 ", N/A ,"$7,094.88 ", N/A ,"$7,094.88 ","$7,094.88 ", N/A ,"$7,094.88 ", N/A ,"$10,349.10 ","$8,624.25 ", N/A , N/A ,"$10,119.12 ", N/A ,"$8,624.25 ","$8,624.25 ","$9,774.15 ","$9,774.15 ", N/A ,"$9,774.15 ", N/A ,"$8,969.22 ","$8,969.22 ","$8,969.22 ","$10,349.10 ", N/A ,"$10,349.10 ", N/A ,"$11,499.00 ","$7,531.85 ", N/A ,"$4,783.58 ","$3,603.18 ","$3,439.40 ", N/A ,"$10,349.10 ", N/A ,"$7,094.88 ","$3,219.72 ","$10,349.10 ", N/A ,"$10,349.10 ","$10,349.10 ", N/A ,"$7,474.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100081,37224,HC RVC EN PRC R/P W/ANG INT VSL 37224,481,1 ,"$13,362.00 ","$8,685.30 ","$3,439.40 ","$13,362.00 ","$12,562.79 ","$9,954.69 ","$8,752.11 ","$5,233.27 ","$3,741.36 ","$6,747.81 ","$5,233.27 ","$8,244.35 ","$5,233.27 ","$8,244.35 ","$8,244.35 ","$5,233.27 ","$8,244.35 ","$9,943.21 ","$12,025.80 ","$10,021.50 ","$12,562.79 ","$5,233.27 ","$11,758.56 ","$5,233.27 ","$10,021.50 ","$10,021.50 ","$11,357.70 ","$11,357.70 ","$5,233.27 ","$11,357.70 ","$5,233.27 ","$10,422.36 ","$10,422.36 ","$10,422.36 ","$12,025.80 ","$12,562.79 ","$12,025.80 ","$5,233.27 ","$13,362.00 ","$8,752.11 ","$5,233.27 ","$5,558.59 ","$3,603.18 ","$3,439.40 ","$5,477.59 ","$12,025.80 ","$11,341.20 ","$8,244.35 ","$3,741.36 ","$12,025.80 ","$5,233.27 ","$12,025.80 ","$12,025.80 ","$5,233.27 ","$8,685.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100082,37225,HC RVC EN PRC F/P W/ANT INT VSL 37225,481,1 ,"$24,215.00 ","$15,739.75 ","$3,439.40 ","$24,215.00 ","$24,215.00 ","$18,040.18 ","$15,860.83 ","$10,605.82 ","$6,780.20 ","$12,228.58 ","$10,605.82 ","$14,940.66 ","$10,605.82 ","$14,940.66 ","$14,940.66 ","$10,605.82 ","$14,940.66 ","$20,151.06 ","$21,793.50 ","$18,161.25 ","$24,215.00 ","$10,605.82 ","$21,309.20 ","$10,605.82 ","$18,161.25 ","$18,161.25 ","$20,582.75 ","$20,582.75 ","$10,605.82 ","$20,582.75 ","$10,605.82 ","$18,887.70 ","$18,887.70 ","$18,887.70 ","$21,793.50 ","$24,215.00 ","$21,793.50 ","$10,605.82 ","$24,215.00 ","$15,860.83 ","$10,605.82 ","$10,073.44 ","$3,603.18 ","$3,439.40 ","$11,100.96 ","$21,793.50 ","$22,984.23 ","$14,940.66 ","$6,780.20 ","$21,793.50 ","$10,605.82 ","$21,793.50 ","$21,793.50 ","$10,605.82 ","$15,739.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100083,37226,HC RVC EN PRC F/P W/TRN SNT IN VS 37226,481,1 ,"$24,363.00 ","$15,835.95 ","$3,439.40 ","$24,363.00 ","$24,363.00 ","$18,150.44 ","$15,957.77 ","$10,605.82 ","$6,821.64 ","$12,303.32 ","$10,605.82 ","$15,031.97 ","$10,605.82 ","$15,031.97 ","$15,031.97 ","$10,605.82 ","$15,031.97 ","$20,151.06 ","$21,926.70 ","$18,272.25 ","$24,363.00 ","$10,605.82 ","$21,439.44 ","$10,605.82 ","$18,272.25 ","$18,272.25 ","$20,708.55 ","$20,708.55 ","$10,605.82 ","$20,708.55 ","$10,605.82 ","$19,003.14 ","$19,003.14 ","$19,003.14 ","$21,926.70 ","$24,363.00 ","$21,926.70 ","$10,605.82 ","$24,363.00 ","$15,957.77 ","$10,605.82 ","$10,135.01 ","$3,603.18 ","$3,439.40 ","$11,100.96 ","$21,926.70 ","$22,984.23 ","$15,031.97 ","$6,821.64 ","$21,926.70 ","$10,605.82 ","$21,926.70 ","$21,926.70 ","$10,605.82 ","$15,835.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100084,37227,HC RVC EN PRC F/P W/AN/TR ST INT 37227,481,1 ,"$38,196.00 ","$24,827.40 ","$3,439.40 ","$38,196.00 ","$38,196.00 ","$28,456.02 ","$25,018.38 ","$16,957.65 ","$10,694.88 ","$19,288.98 ","$16,957.65 ","$23,566.93 ","$16,957.65 ","$23,566.93 ","$23,566.93 ","$16,957.65 ","$23,566.93 ","$32,219.54 ","$34,376.40 ","$28,647.00 ","$38,196.00 ","$16,957.65 ","$33,612.48 ","$16,957.65 ","$28,647.00 ","$28,647.00 ","$32,466.60 ","$32,466.60 ","$16,957.65 ","$32,466.60 ","$16,957.65 ","$29,792.88 ","$29,792.88 ","$29,792.88 ","$34,376.40 ","$38,196.00 ","$34,376.40 ","$16,957.65 ","$38,196.00 ","$25,018.38 ","$16,957.65 ","$15,889.54 ","$3,603.18 ","$3,439.40 ","$17,749.33 ","$34,376.40 ","$36,749.50 ","$23,566.93 ","$10,694.88 ","$34,376.40 ","$16,957.65 ","$34,376.40 ","$34,376.40 ","$16,957.65 ","$24,827.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100085,37228,HC RVC EN PRC T/P W/ANG INT VSL 37228,481,1 ,"$12,728.00 ","$8,273.20 ","$3,439.40 ","$22,984.23 ","$12,728.00 ","$9,482.36 ","$8,336.84 ","$10,605.82 ","$3,563.84 ","$6,427.64 ","$10,605.82 ","$7,853.18 ","$10,605.82 ","$7,853.18 ","$7,853.18 ","$10,605.82 ","$7,853.18 ","$20,151.06 ","$11,455.20 ","$9,546.00 ","$12,728.00 ","$10,605.82 ","$11,200.64 ","$10,605.82 ","$9,546.00 ","$9,546.00 ","$10,818.80 ","$10,818.80 ","$10,605.82 ","$10,818.80 ","$10,605.82 ","$9,927.84 ","$9,927.84 ","$9,927.84 ","$11,455.20 ","$12,728.00 ","$11,455.20 ","$10,605.82 ","$12,728.00 ","$8,336.84 ","$10,605.82 ","$5,294.85 ","$3,603.18 ","$3,439.40 ","$11,100.96 ","$11,455.20 ","$22,984.23 ","$7,853.18 ","$3,563.84 ","$11,455.20 ","$10,605.82 ","$11,455.20 ","$11,455.20 ","$10,605.82 ","$8,273.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100086,37229,HC RVC EN PRC T/P W/ANT INT VSL 37229,481,1 ,"$22,660.00 ","$14,729.00 ","$3,439.40 ","$36,749.50 ","$22,660.00 ","$16,881.70 ","$14,842.30 ","$16,957.65 ","$6,344.80 ","$11,443.30 ","$16,957.65 ","$13,981.22 ","$16,957.65 ","$13,981.22 ","$13,981.22 ","$16,957.65 ","$13,981.22 ","$32,219.54 ","$20,394.00 ","$16,995.00 ","$22,660.00 ","$16,957.65 ","$19,940.80 ","$16,957.65 ","$16,995.00 ","$16,995.00 ","$19,261.00 ","$19,261.00 ","$16,957.65 ","$19,261.00 ","$16,957.65 ","$17,674.80 ","$17,674.80 ","$17,674.80 ","$20,394.00 ","$22,660.00 ","$20,394.00 ","$16,957.65 ","$22,660.00 ","$14,842.30 ","$16,957.65 ","$9,426.56 ","$3,603.18 ","$3,439.40 ","$17,749.33 ","$20,394.00 ","$36,749.50 ","$13,981.22 ","$6,344.80 ","$20,394.00 ","$16,957.65 ","$20,394.00 ","$20,394.00 ","$16,957.65 ","$14,729.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100088,37231,HC RVC EN PRC T/P W/AN/TR ST IN V 37231,481,1 ,"$34,696.00 ","$22,552.40 ","$3,439.40 ","$36,749.50 ","$34,696.00 ","$25,848.52 ","$22,725.88 ","$16,957.65 ","$9,714.88 ","$17,521.48 ","$16,957.65 ","$21,407.43 ","$16,957.65 ","$21,407.43 ","$21,407.43 ","$16,957.65 ","$21,407.43 ","$32,219.54 ","$31,226.40 ","$26,022.00 ","$34,696.00 ","$16,957.65 ","$30,532.48 ","$16,957.65 ","$26,022.00 ","$26,022.00 ","$29,491.60 ","$29,491.60 ","$16,957.65 ","$29,491.60 ","$16,957.65 ","$27,062.88 ","$27,062.88 ","$27,062.88 ","$31,226.40 ","$34,696.00 ","$31,226.40 ","$16,957.65 ","$34,696.00 ","$22,725.88 ","$16,957.65 ","$14,433.54 ","$3,603.18 ","$3,439.40 ","$17,749.33 ","$31,226.40 ","$36,749.50 ","$21,407.43 ","$9,714.88 ","$31,226.40 ","$16,957.65 ","$31,226.40 ","$31,226.40 ","$16,957.65 ","$22,552.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100089,37232,HC RVC EN PRC T/P W/ANG EA AD VS 37232,481,1 ,"$9,769.00 ","$6,349.85 ","$2,735.32 ","$9,769.00 ", N/A ,"$7,277.91 ","$6,398.70 ", N/A ,"$2,735.32 ","$4,933.35 ", N/A ,"$6,027.47 ", N/A ,"$6,027.47 ","$6,027.47 ", N/A ,"$6,027.47 ", N/A ,"$8,792.10 ","$7,326.75 ", N/A , N/A ,"$8,596.72 ", N/A ,"$7,326.75 ","$7,326.75 ","$8,303.65 ","$8,303.65 ", N/A ,"$8,303.65 ", N/A ,"$7,619.82 ","$7,619.82 ","$7,619.82 ","$8,792.10 ", N/A ,"$8,792.10 ", N/A ,"$9,769.00 ","$6,398.70 ", N/A ,"$4,063.90 ","$3,603.18 ","$3,439.40 ", N/A ,"$8,792.10 ", N/A ,"$6,027.47 ","$2,735.32 ","$8,792.10 ", N/A ,"$8,792.10 ","$8,792.10 ", N/A ,"$6,349.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100090,37233,HC RVC EN PRC T/P W/ANT EA AD VS 37233,481,1 ,"$19,541.00 ","$12,701.65 ","$3,439.40 ","$19,541.00 ", N/A ,"$14,558.05 ","$12,799.36 ", N/A ,"$5,471.48 ","$9,868.21 ", N/A ,"$12,056.80 ", N/A ,"$12,056.80 ","$12,056.80 ", N/A ,"$12,056.80 ", N/A ,"$17,586.90 ","$14,655.75 ", N/A , N/A ,"$17,196.08 ", N/A ,"$14,655.75 ","$14,655.75 ","$16,609.85 ","$16,609.85 ", N/A ,"$16,609.85 ", N/A ,"$15,241.98 ","$15,241.98 ","$15,241.98 ","$17,586.90 ", N/A ,"$17,586.90 ", N/A ,"$19,541.00 ","$12,799.36 ", N/A ,"$8,129.06 ","$3,603.18 ","$3,439.40 ", N/A ,"$17,586.90 ", N/A ,"$12,056.80 ","$5,471.48 ","$17,586.90 ", N/A ,"$17,586.90 ","$17,586.90 ", N/A ,"$12,701.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100092,37235,HC RVC EN PRC T/P W/AN/TR ST AD V 37235,481,1 ,"$20,518.00 ","$13,336.70 ","$3,439.40 ","$20,518.00 ", N/A ,"$15,285.91 ","$13,439.29 ", N/A ,"$5,745.04 ","$10,361.59 ", N/A ,"$12,659.61 ", N/A ,"$12,659.61 ","$12,659.61 ", N/A ,"$12,659.61 ", N/A ,"$18,466.20 ","$15,388.50 ", N/A , N/A ,"$18,055.84 ", N/A ,"$15,388.50 ","$15,388.50 ","$17,440.30 ","$17,440.30 ", N/A ,"$17,440.30 ", N/A ,"$16,004.04 ","$16,004.04 ","$16,004.04 ","$18,466.20 ", N/A ,"$18,466.20 ", N/A ,"$20,518.00 ","$13,439.29 ", N/A ,"$8,535.49 ","$3,603.18 ","$3,439.40 ", N/A ,"$18,466.20 ", N/A ,"$12,659.61 ","$5,745.04 ","$18,466.20 ", N/A ,"$18,466.20 ","$18,466.20 ", N/A ,"$13,336.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100093,37252,HC US VASCULAR NON-CORONARY INIT 37252,481,1 ,"$11,028.00 ","$7,168.20 ",$105.71 ,"$11,028.00 ", N/A ,"$8,215.86 ","$7,223.34 ", N/A ,"$3,087.84 ","$5,569.14 ", N/A ,"$6,804.28 ", N/A ,"$6,804.28 ","$6,804.28 ", N/A ,"$6,804.28 ", N/A ,"$9,925.20 ","$8,271.00 ", N/A , N/A ,"$9,704.64 ", N/A ,"$8,271.00 ","$8,271.00 ","$9,373.80 ","$9,373.80 ", N/A ,"$9,373.80 ", N/A ,"$8,601.84 ","$8,601.84 ","$8,601.84 ","$9,925.20 ", N/A ,"$9,925.20 ", N/A ,"$11,028.00 ","$7,223.34 ", N/A ,"$4,587.65 ",$110.75 ,$105.71 , N/A ,"$9,925.20 ", N/A ,"$6,804.28 ","$3,087.84 ","$9,925.20 ", N/A ,"$9,925.20 ","$9,925.20 ", N/A ,"$7,168.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100094,37253,HC US VASCULAR NON-CORON ADDL EA 37253,481,1 ,"$9,819.00 ","$6,382.35 ",$105.71 ,"$9,819.00 ", N/A ,"$7,315.16 ","$6,431.45 ", N/A ,"$2,749.32 ","$4,958.60 ", N/A ,"$6,058.32 ", N/A ,"$6,058.32 ","$6,058.32 ", N/A ,"$6,058.32 ", N/A ,"$8,837.10 ","$7,364.25 ", N/A , N/A ,"$8,640.72 ", N/A ,"$7,364.25 ","$7,364.25 ","$8,346.15 ","$8,346.15 ", N/A ,"$8,346.15 ", N/A ,"$7,658.82 ","$7,658.82 ","$7,658.82 ","$8,837.10 ", N/A ,"$8,837.10 ", N/A ,"$9,819.00 ","$6,431.45 ", N/A ,"$4,084.70 ",$110.75 ,$105.71 , N/A ,"$8,837.10 ", N/A ,"$6,058.32 ","$2,749.32 ","$8,837.10 ", N/A ,"$8,837.10 ","$8,837.10 ", N/A ,"$6,382.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100095,37191,HC INTERRUPT VENA CAVA INFER,481,1 ,"$8,446.00 ","$5,489.90 ","$2,364.88 ","$10,911.83 ","$8,446.00 ","$6,292.27 ","$5,532.13 ","$5,035.15 ","$2,364.88 ","$4,265.23 ","$5,035.15 ","$5,211.18 ","$5,035.15 ","$5,211.18 ","$5,211.18 ","$5,035.15 ","$5,211.18 ","$9,566.79 ","$7,601.40 ","$6,334.50 ","$8,446.00 ","$5,035.15 ","$7,432.48 ","$5,035.15 ","$6,334.50 ","$6,334.50 ","$7,179.10 ","$7,179.10 ","$5,035.15 ","$7,179.10 ","$5,035.15 ","$6,587.88 ","$6,587.88 ","$6,587.88 ","$7,601.40 ","$8,446.00 ","$7,601.40 ","$5,035.15 ","$8,446.00 ","$5,532.13 ","$5,035.15 ","$3,513.54 ","$2,898.96 ","$2,767.19 ","$5,270.21 ","$7,601.40 ","$10,911.83 ","$5,211.18 ","$2,364.88 ","$7,601.40 ","$5,035.15 ","$7,601.40 ","$7,601.40 ","$5,035.15 ","$5,489.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100107,93451,HC CATH RIGHT HEART 93451,481,1 ,"$8,472.00 ","$5,506.80 ","$1,693.37 ","$8,472.00 ","$7,350.01 ","$6,311.64 ","$5,549.16 ","$3,061.79 ","$2,372.16 ","$4,278.36 ","$3,061.79 ","$5,227.22 ","$3,061.79 ","$5,227.22 ","$5,227.22 ","$3,061.79 ","$5,227.22 ","$5,817.40 ","$7,624.80 ","$6,354.00 ","$7,350.01 ","$3,061.79 ","$7,455.36 ","$3,061.79 ","$6,354.00 ","$6,354.00 ","$7,201.20 ","$7,201.20 ","$3,061.79 ","$7,201.20 ","$3,061.79 ","$6,608.16 ","$6,608.16 ","$6,608.16 ","$7,624.80 ","$7,350.01 ","$7,624.80 ","$3,061.79 ","$8,472.00 ","$5,549.16 ","$3,061.79 ","$3,524.35 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$7,624.80 ","$6,635.31 ","$5,227.22 ","$2,372.16 ","$7,624.80 ","$3,061.79 ","$7,624.80 ","$7,624.80 ","$3,061.79 ","$5,506.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100108,93452,HC LHC ONLY NO COROS 93452,481,1 ,"$9,379.00 ","$6,096.35 ","$1,693.37 ","$9,379.00 ","$7,350.01 ","$6,987.36 ","$6,143.25 ","$3,061.79 ","$2,626.12 ","$4,736.40 ","$3,061.79 ","$5,786.84 ","$3,061.79 ","$5,786.84 ","$5,786.84 ","$3,061.79 ","$5,786.84 ","$5,817.40 ","$8,441.10 ","$7,034.25 ","$7,350.01 ","$3,061.79 ","$8,253.52 ","$3,061.79 ","$7,034.25 ","$7,034.25 ","$7,972.15 ","$7,972.15 ","$3,061.79 ","$7,972.15 ","$3,061.79 ","$7,315.62 ","$7,315.62 ","$7,315.62 ","$8,441.10 ","$7,350.01 ","$8,441.10 ","$3,061.79 ","$9,379.00 ","$6,143.25 ","$3,061.79 ","$3,901.66 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$8,441.10 ","$6,635.31 ","$5,786.84 ","$2,626.12 ","$8,441.10 ","$3,061.79 ","$8,441.10 ","$8,441.10 ","$3,061.79 ","$6,096.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100109,93453,HC RHC/LHC ONLY/NO CORS 93453,481,1 ,"$12,729.00 ","$8,273.85 ","$1,693.37 ","$12,729.00 ","$7,350.01 ","$9,483.11 ","$8,337.50 ","$3,061.79 ","$3,564.12 ","$6,428.15 ","$3,061.79 ","$7,853.79 ","$3,061.79 ","$7,853.79 ","$7,853.79 ","$3,061.79 ","$7,853.79 ","$5,817.40 ","$11,456.10 ","$9,546.75 ","$7,350.01 ","$3,061.79 ","$11,201.52 ","$3,061.79 ","$9,546.75 ","$9,546.75 ","$10,819.65 ","$10,819.65 ","$3,061.79 ","$10,819.65 ","$3,061.79 ","$9,928.62 ","$9,928.62 ","$9,928.62 ","$11,456.10 ","$7,350.01 ","$11,456.10 ","$3,061.79 ","$12,729.00 ","$8,337.50 ","$3,061.79 ","$5,295.26 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$11,456.10 ","$6,635.31 ","$7,853.79 ","$3,564.12 ","$11,456.10 ","$3,061.79 ","$11,456.10 ","$11,456.10 ","$3,061.79 ","$8,273.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100110,93454,HC CORONARY ANGIO ONLY/NO LV 93454,481,1 ,"$10,204.00 ","$6,632.60 ","$1,693.37 ","$10,204.00 ","$7,350.01 ","$7,601.98 ","$6,683.62 ","$3,061.79 ","$2,857.12 ","$5,153.02 ","$3,061.79 ","$6,295.87 ","$3,061.79 ","$6,295.87 ","$6,295.87 ","$3,061.79 ","$6,295.87 ","$5,817.40 ","$9,183.60 ","$7,653.00 ","$7,350.01 ","$3,061.79 ","$8,979.52 ","$3,061.79 ","$7,653.00 ","$7,653.00 ","$8,673.40 ","$8,673.40 ","$3,061.79 ","$8,673.40 ","$3,061.79 ","$7,959.12 ","$7,959.12 ","$7,959.12 ","$9,183.60 ","$7,350.01 ","$9,183.60 ","$3,061.79 ","$10,204.00 ","$6,683.62 ","$3,061.79 ","$4,244.86 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$9,183.60 ","$6,635.31 ","$6,295.87 ","$2,857.12 ","$9,183.60 ","$3,061.79 ","$9,183.60 ","$9,183.60 ","$3,061.79 ","$6,632.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100111,93455,HC CORO ANGIO  AND  GRAFTS ONLY NO LV 93455,481,1 ,"$11,555.00 ","$7,510.75 ","$1,693.37 ","$11,555.00 ","$7,350.01 ","$8,608.48 ","$7,568.53 ","$3,061.79 ","$3,235.40 ","$5,835.28 ","$3,061.79 ","$7,129.44 ","$3,061.79 ","$7,129.44 ","$7,129.44 ","$3,061.79 ","$7,129.44 ","$5,817.40 ","$10,399.50 ","$8,666.25 ","$7,350.01 ","$3,061.79 ","$10,168.40 ","$3,061.79 ","$8,666.25 ","$8,666.25 ","$9,821.75 ","$9,821.75 ","$3,061.79 ","$9,821.75 ","$3,061.79 ","$9,012.90 ","$9,012.90 ","$9,012.90 ","$10,399.50 ","$7,350.01 ","$10,399.50 ","$3,061.79 ","$11,555.00 ","$7,568.53 ","$3,061.79 ","$4,806.88 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$10,399.50 ","$6,635.31 ","$7,129.44 ","$3,235.40 ","$10,399.50 ","$3,061.79 ","$10,399.50 ","$10,399.50 ","$3,061.79 ","$7,510.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100112,93456,HC RHC CORONARY ANGIO/NO LV 93456,481,1 ,"$10,917.00 ","$7,096.05 ","$1,693.37 ","$10,917.00 ","$7,350.01 ","$8,133.17 ","$7,150.64 ","$3,061.79 ","$3,056.76 ","$5,513.09 ","$3,061.79 ","$6,735.79 ","$3,061.79 ","$6,735.79 ","$6,735.79 ","$3,061.79 ","$6,735.79 ","$5,817.40 ","$9,825.30 ","$8,187.75 ","$7,350.01 ","$3,061.79 ","$9,606.96 ","$3,061.79 ","$8,187.75 ","$8,187.75 ","$9,279.45 ","$9,279.45 ","$3,061.79 ","$9,279.45 ","$3,061.79 ","$8,515.26 ","$8,515.26 ","$8,515.26 ","$9,825.30 ","$7,350.01 ","$9,825.30 ","$3,061.79 ","$10,917.00 ","$7,150.64 ","$3,061.79 ","$4,541.47 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$9,825.30 ","$6,635.31 ","$6,735.79 ","$3,056.76 ","$9,825.30 ","$3,061.79 ","$9,825.30 ","$9,825.30 ","$3,061.79 ","$7,096.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100113,93457,HC RHC CORO ANGIO  AND  GRAFTS/NO LV 93457,481,1 ,"$12,230.00 ","$7,949.50 ","$1,693.37 ","$12,230.00 ","$7,350.01 ","$9,111.35 ","$8,010.65 ","$3,061.79 ","$3,424.40 ","$6,176.15 ","$3,061.79 ","$7,545.91 ","$3,061.79 ","$7,545.91 ","$7,545.91 ","$3,061.79 ","$7,545.91 ","$5,817.40 ","$11,007.00 ","$9,172.50 ","$7,350.01 ","$3,061.79 ","$10,762.40 ","$3,061.79 ","$9,172.50 ","$9,172.50 ","$10,395.50 ","$10,395.50 ","$3,061.79 ","$10,395.50 ","$3,061.79 ","$9,539.40 ","$9,539.40 ","$9,539.40 ","$11,007.00 ","$7,350.01 ","$11,007.00 ","$3,061.79 ","$12,230.00 ","$8,010.65 ","$3,061.79 ","$5,087.68 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$11,007.00 ","$6,635.31 ","$7,545.91 ","$3,424.40 ","$11,007.00 ","$3,061.79 ","$11,007.00 ","$11,007.00 ","$3,061.79 ","$7,949.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100114,93458,HC CORONARY ANGIO WITH LV 93458,481,1 ,"$11,675.00 ","$7,588.75 ","$1,693.37 ","$11,675.00 ","$7,350.01 ","$8,697.88 ","$7,647.13 ","$3,061.79 ","$3,269.00 ","$5,895.88 ","$3,061.79 ","$7,203.48 ","$3,061.79 ","$7,203.48 ","$7,203.48 ","$3,061.79 ","$7,203.48 ","$5,817.40 ","$10,507.50 ","$8,756.25 ","$7,350.01 ","$3,061.79 ","$10,274.00 ","$3,061.79 ","$8,756.25 ","$8,756.25 ","$9,923.75 ","$9,923.75 ","$3,061.79 ","$9,923.75 ","$3,061.79 ","$9,106.50 ","$9,106.50 ","$9,106.50 ","$10,507.50 ","$7,350.01 ","$10,507.50 ","$3,061.79 ","$11,675.00 ","$7,647.13 ","$3,061.79 ","$4,856.80 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$10,507.50 ","$6,635.31 ","$7,203.48 ","$3,269.00 ","$10,507.50 ","$3,061.79 ","$10,507.50 ","$10,507.50 ","$3,061.79 ","$7,588.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100115,93459,HC CORONARY ANGIO W GRAFTS AND LV 93459,481,1 ,"$13,939.00 ","$9,060.35 ","$1,693.37 ","$13,939.00 ","$7,350.01 ","$10,384.56 ","$9,130.05 ","$3,061.79 ","$3,902.92 ","$7,039.20 ","$3,061.79 ","$8,600.36 ","$3,061.79 ","$8,600.36 ","$8,600.36 ","$3,061.79 ","$8,600.36 ","$5,817.40 ","$12,545.10 ","$10,454.25 ","$7,350.01 ","$3,061.79 ","$12,266.32 ","$3,061.79 ","$10,454.25 ","$10,454.25 ","$11,848.15 ","$11,848.15 ","$3,061.79 ","$11,848.15 ","$3,061.79 ","$10,872.42 ","$10,872.42 ","$10,872.42 ","$12,545.10 ","$7,350.01 ","$12,545.10 ","$3,061.79 ","$13,939.00 ","$9,130.05 ","$3,061.79 ","$5,798.62 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$12,545.10 ","$6,635.31 ","$8,600.36 ","$3,902.92 ","$12,545.10 ","$3,061.79 ","$12,545.10 ","$12,545.10 ","$3,061.79 ","$9,060.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100116,93460,HC RHC/LHC/CORONAY ANGIO AND LV 93460,481,1 ,"$15,061.00 ","$9,789.65 ","$1,693.37 ","$15,061.00 ","$7,350.01 ","$11,220.45 ","$9,864.96 ","$3,061.79 ","$4,217.08 ","$7,605.81 ","$3,061.79 ","$9,292.64 ","$3,061.79 ","$9,292.64 ","$9,292.64 ","$3,061.79 ","$9,292.64 ","$5,817.40 ","$13,554.90 ","$11,295.75 ","$7,350.01 ","$3,061.79 ","$13,253.68 ","$3,061.79 ","$11,295.75 ","$11,295.75 ","$12,801.85 ","$12,801.85 ","$3,061.79 ","$12,801.85 ","$3,061.79 ","$11,747.58 ","$11,747.58 ","$11,747.58 ","$13,554.90 ","$7,350.01 ","$13,554.90 ","$3,061.79 ","$15,061.00 ","$9,864.96 ","$3,061.79 ","$6,265.38 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$13,554.90 ","$6,635.31 ","$9,292.64 ","$4,217.08 ","$13,554.90 ","$3,061.79 ","$13,554.90 ","$13,554.90 ","$3,061.79 ","$9,789.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100117,93461,HC RHC/LHC/CORON ANGIO GRAFTS  AND LV 93461,481,1 ,"$16,210.00 ","$10,536.50 ","$1,693.37 ","$16,210.00 ","$7,350.01 ","$12,076.45 ","$10,617.55 ","$3,061.79 ","$4,538.80 ","$8,186.05 ","$3,061.79 ","$10,001.57 ","$3,061.79 ","$10,001.57 ","$10,001.57 ","$3,061.79 ","$10,001.57 ","$5,817.40 ","$14,589.00 ","$12,157.50 ","$7,350.01 ","$3,061.79 ","$14,264.80 ","$3,061.79 ","$12,157.50 ","$12,157.50 ","$13,778.50 ","$13,778.50 ","$3,061.79 ","$13,778.50 ","$3,061.79 ","$12,643.80 ","$12,643.80 ","$12,643.80 ","$14,589.00 ","$7,350.01 ","$14,589.00 ","$3,061.79 ","$16,210.00 ","$10,617.55 ","$3,061.79 ","$6,743.36 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$14,589.00 ","$6,635.31 ","$10,001.57 ","$4,538.80 ","$14,589.00 ","$3,061.79 ","$14,589.00 ","$14,589.00 ","$3,061.79 ","$10,536.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100119,93567,HC AORTAGRAM 93567,481,1 ,$636.00 ,$413.40 ,$178.08 ,$636.00 , N/A ,$473.82 ,$416.58 , N/A ,$178.08 ,$321.18 , N/A ,$392.41 , N/A ,$392.41 ,$392.41 , N/A ,$392.41 , N/A ,$572.40 ,$477.00 , N/A , N/A ,$559.68 , N/A ,$477.00 ,$477.00 ,$540.60 ,$540.60 , N/A ,$540.60 , N/A ,$496.08 ,$496.08 ,$496.08 ,$572.40 , N/A ,$572.40 , N/A ,$636.00 ,$416.58 , N/A ,$264.58 , N/A , N/A , N/A ,$572.40 , N/A ,$392.41 ,$178.08 ,$572.40 , N/A ,$572.40 ,$572.40 , N/A ,$413.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100150,93503,HC PLACEMENT SWANZ GAN CATH MONIT 93503,481,1 ,"$4,462.00 ","$2,900.30 ","$1,183.07 ","$4,462.00 ","$3,564.32 ","$3,324.19 ","$2,922.61 ","$1,484.79 ","$1,249.36 ","$2,253.31 ","$1,484.79 ","$2,753.05 ","$1,484.79 ","$2,753.05 ","$2,753.05 ","$1,484.79 ","$2,753.05 ","$2,821.10 ","$4,015.80 ","$3,346.50 ","$3,564.32 ","$1,484.79 ","$3,926.56 ","$1,484.79 ","$3,346.50 ","$3,346.50 ","$3,792.70 ","$3,792.70 ","$1,484.79 ","$3,792.70 ","$1,484.79 ","$3,480.36 ","$3,480.36 ","$3,480.36 ","$4,015.80 ","$3,564.32 ","$4,015.80 ","$1,484.79 ","$4,462.00 ","$2,922.61 ","$1,484.79 ","$1,856.19 ","$1,239.40 ","$1,183.07 ","$1,554.10 ","$4,015.80 ","$3,217.73 ","$2,753.05 ","$1,249.36 ","$4,015.80 ","$1,484.79 ","$4,015.80 ","$4,015.80 ","$1,484.79 ","$2,900.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100151,33227,HC REM/REPL PCMKR PUL GEN SGL 33227,481,1 ,"$19,879.00 ","$12,921.35 ","$5,566.12 ","$19,879.00 ","$19,879.00 ","$14,809.86 ","$13,020.75 ","$8,614.49 ","$5,566.12 ","$10,038.90 ","$8,614.49 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$12,265.34 ","$8,614.49 ","$12,265.34 ","$16,367.53 ","$17,891.10 ","$14,909.25 ","$19,879.00 ","$8,614.49 ","$17,493.52 ","$8,614.49 ","$14,909.25 ","$14,909.25 ","$16,897.15 ","$16,897.15 ","$8,614.49 ","$16,897.15 ","$8,614.49 ","$15,505.62 ","$15,505.62 ","$15,505.62 ","$17,891.10 ","$19,879.00 ","$17,891.10 ","$8,614.49 ","$19,879.00 ","$13,020.75 ","$8,614.49 ","$8,269.66 ","$5,857.51 ","$5,591.26 ","$9,016.66 ","$17,891.10 ","$18,668.74 ","$12,265.34 ","$5,566.12 ","$17,891.10 ","$8,614.49 ","$17,891.10 ","$17,891.10 ","$8,614.49 ","$12,921.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100152,33228,HC REM/REPL PCMKR PUL GEN DUAL 33228,481,1 ,"$27,525.00 ","$17,891.25 ","$5,591.26 ","$27,525.00 ","$26,355.43 ","$20,506.13 ","$18,028.88 ","$10,978.87 ","$7,707.00 ","$13,900.13 ","$10,978.87 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$16,982.93 ","$10,978.87 ","$16,982.93 ","$20,859.85 ","$24,772.50 ","$20,643.75 ","$26,355.43 ","$10,978.87 ","$24,222.00 ","$10,978.87 ","$20,643.75 ","$20,643.75 ","$23,396.25 ","$23,396.25 ","$10,978.87 ","$23,396.25 ","$10,978.87 ","$21,469.50 ","$21,469.50 ","$21,469.50 ","$24,772.50 ","$26,355.43 ","$24,772.50 ","$10,978.87 ","$27,525.00 ","$18,028.88 ","$10,978.87 ","$11,450.40 ","$5,857.51 ","$5,591.26 ","$11,491.42 ","$24,772.50 ","$23,792.67 ","$16,982.93 ","$7,707.00 ","$24,772.50 ","$10,978.87 ","$24,772.50 ","$24,772.50 ","$10,978.87 ","$17,891.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100153,33229,HC REM/REPL PCMKR PUL GEN MULT 33229,481,1 ,"$50,203.00 ","$32,631.95 ","$5,591.26 ","$50,203.00 ","$47,206.51 ","$37,401.24 ","$32,882.97 ","$19,664.79 ","$14,056.84 ","$25,352.52 ","$19,664.79 ","$30,975.25 ","$19,664.79 ","$30,975.25 ","$30,975.25 ","$19,664.79 ","$30,975.25 ","$37,363.10 ","$45,182.70 ","$37,652.25 ","$47,206.51 ","$19,664.79 ","$44,178.64 ","$19,664.79 ","$37,652.25 ","$37,652.25 ","$42,672.55 ","$42,672.55 ","$19,664.79 ","$42,672.55 ","$19,664.79 ","$39,158.34 ","$39,158.34 ","$39,158.34 ","$45,182.70 ","$47,206.51 ","$45,182.70 ","$19,664.79 ","$50,203.00 ","$32,882.97 ","$19,664.79 ","$20,884.45 ","$5,857.51 ","$5,591.26 ","$20,582.85 ","$45,182.70 ","$42,616.23 ","$30,975.25 ","$14,056.84 ","$45,182.70 ","$19,664.79 ","$45,182.70 ","$45,182.70 ","$19,664.79 ","$32,631.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100155,33263,HC REM/REPL DEFIB PUL GEN DUAL 33263,481,1 ,"$31,028.00 ","$20,168.20 ","$8,687.84 ","$52,765.86 ","$31,028.00 ","$23,115.86 ","$20,323.34 ","$24,348.23 ","$8,687.84 ","$15,669.14 ","$24,348.23 ","$19,144.28 ","$24,348.23 ","$19,144.28 ","$19,144.28 ","$24,348.23 ","$19,144.28 ","$46,261.64 ","$27,925.20 ","$23,271.00 ","$31,028.00 ","$24,348.23 ","$27,304.64 ","$24,348.23 ","$23,271.00 ","$23,271.00 ","$26,373.80 ","$26,373.80 ","$24,348.23 ","$26,373.80 ","$24,348.23 ","$24,201.84 ","$24,201.84 ","$24,201.84 ","$27,925.20 ","$31,028.00 ","$27,925.20 ","$24,348.23 ","$31,028.00 ","$20,323.34 ","$24,348.23 ","$12,907.65 ","$16,802.05 ","$16,038.32 ","$25,484.93 ","$27,925.20 ","$52,765.86 ","$19,144.28 ","$8,687.84 ","$27,925.20 ","$24,348.23 ","$27,925.20 ","$27,925.20 ","$24,348.23 ","$20,168.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100171,36253,HC PLC CATH RENAL ANGIO 1< UNI,481,1 ,"$10,120.00 ","$6,578.00 ","$1,859.83 ","$10,911.83 ","$10,120.00 ","$7,539.40 ","$6,628.60 ","$5,035.15 ","$2,833.60 ","$5,110.60 ","$5,035.15 ","$6,244.04 ","$5,035.15 ","$6,244.04 ","$6,244.04 ","$5,035.15 ","$6,244.04 ","$9,566.79 ","$9,108.00 ","$7,590.00 ","$10,120.00 ","$5,035.15 ","$8,905.60 ","$5,035.15 ","$7,590.00 ","$7,590.00 ","$8,602.00 ","$8,602.00 ","$5,035.15 ","$8,602.00 ","$5,035.15 ","$7,893.60 ","$7,893.60 ","$7,893.60 ","$9,108.00 ","$10,120.00 ","$9,108.00 ","$5,035.15 ","$10,120.00 ","$6,628.60 ","$5,035.15 ","$4,209.92 ","$1,948.40 ","$1,859.83 ","$5,270.21 ","$9,108.00 ","$10,911.83 ","$6,244.04 ","$2,833.60 ","$9,108.00 ","$5,035.15 ","$9,108.00 ","$9,108.00 ","$5,035.15 ","$6,578.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100172,36254,HC PLC CATH RENAL ANGIO 1< BIL,481,1 ,"$4,041.00 ","$2,626.65 ","$1,131.48 ","$6,550.42 ","$4,041.00 ","$3,010.55 ","$2,646.86 ","$3,022.62 ","$1,131.48 ","$2,040.71 ","$3,022.62 ","$2,493.30 ","$3,022.62 ","$2,493.30 ","$2,493.30 ","$3,022.62 ","$2,493.30 ","$5,742.98 ","$3,636.90 ","$3,030.75 ","$4,041.00 ","$3,022.62 ","$3,556.08 ","$3,022.62 ","$3,030.75 ","$3,030.75 ","$3,434.85 ","$3,434.85 ","$3,022.62 ","$3,434.85 ","$3,022.62 ","$3,151.98 ","$3,151.98 ","$3,151.98 ","$3,636.90 ","$4,041.00 ","$3,636.90 ","$3,022.62 ","$4,041.00 ","$2,646.86 ","$3,022.62 ","$1,681.06 ","$1,948.40 ","$1,859.83 ","$3,163.73 ","$3,636.90 ","$6,550.42 ","$2,493.30 ","$1,131.48 ","$3,636.90 ","$3,022.62 ","$3,636.90 ","$3,636.90 ","$3,022.62 ","$2,626.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100173,37193,HC FILTER REMOVAL,481,1 ,"$3,494.00 ","$2,271.10 ",$978.32 ,"$6,550.42 ","$3,494.00 ","$2,603.03 ","$2,288.57 ","$3,022.62 ",$978.32 ,"$1,764.47 ","$3,022.62 ","$2,155.80 ","$3,022.62 ","$2,155.80 ","$2,155.80 ","$3,022.62 ","$2,155.80 ","$5,742.98 ","$3,144.60 ","$2,620.50 ","$3,494.00 ","$3,022.62 ","$3,074.72 ","$3,022.62 ","$2,620.50 ","$2,620.50 ","$2,969.90 ","$2,969.90 ","$3,022.62 ","$2,969.90 ","$3,022.62 ","$2,725.32 ","$2,725.32 ","$2,725.32 ","$3,144.60 ","$3,494.00 ","$3,144.60 ","$3,022.62 ","$3,494.00 ","$2,288.57 ","$3,022.62 ","$1,453.50 ","$2,268.89 ","$2,165.76 ","$3,163.73 ","$3,144.60 ","$6,550.42 ","$2,155.80 ",$978.32 ,"$3,144.60 ","$3,022.62 ","$3,144.60 ","$3,144.60 ","$3,022.62 ","$2,271.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100183,36225,HC CATH PLCMT SEL SUBCL/INOM VERTEB UNI 36225,481,1 ,"$11,092.00 ","$7,209.80 ","$1,859.83 ","$11,092.00 ","$7,255.98 ","$8,263.54 ","$7,265.26 ","$3,022.62 ","$3,105.76 ","$5,601.46 ","$3,022.62 ","$6,843.76 ","$3,022.62 ","$6,843.76 ","$6,843.76 ","$3,022.62 ","$6,843.76 ","$5,742.98 ","$9,982.80 ","$8,319.00 ","$7,255.98 ","$3,022.62 ","$9,760.96 ","$3,022.62 ","$8,319.00 ","$8,319.00 ","$9,428.20 ","$9,428.20 ","$3,022.62 ","$9,428.20 ","$3,022.62 ","$8,651.76 ","$8,651.76 ","$8,651.76 ","$9,982.80 ","$7,255.98 ","$9,982.80 ","$3,022.62 ","$11,092.00 ","$7,265.26 ","$3,022.62 ","$4,614.27 ","$1,948.40 ","$1,859.83 ","$3,163.73 ","$9,982.80 ","$6,550.42 ","$6,843.76 ","$3,105.76 ","$9,982.80 ","$3,022.62 ","$9,982.80 ","$9,982.80 ","$3,022.62 ","$7,209.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100184,36228,HC CATH PLCMT SEL EA INTRACRN BRANCH UNI 36228,481,1 ,"$7,853.00 ","$5,104.45 ","$1,859.83 ","$7,853.00 ", N/A ,"$5,850.49 ","$5,143.72 ", N/A ,"$2,198.84 ","$3,965.77 ", N/A ,"$4,845.30 ", N/A ,"$4,845.30 ","$4,845.30 ", N/A ,"$4,845.30 ", N/A ,"$7,067.70 ","$5,889.75 ", N/A , N/A ,"$6,910.64 ", N/A ,"$5,889.75 ","$5,889.75 ","$6,675.05 ","$6,675.05 ", N/A ,"$6,675.05 ", N/A ,"$6,125.34 ","$6,125.34 ","$6,125.34 ","$7,067.70 ", N/A ,"$7,067.70 ", N/A ,"$7,853.00 ","$5,143.72 ", N/A ,"$3,266.85 ","$1,948.40 ","$1,859.83 ", N/A ,"$7,067.70 ", N/A ,"$4,845.30 ","$2,198.84 ","$7,067.70 ", N/A ,"$7,067.70 ","$7,067.70 ", N/A ,"$5,104.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100187,37197,HC TRANSCATH RETRVAL FOREIGN BODY 37197,481,1 ,"$2,963.00 ","$1,925.95 ",$829.64 ,"$6,550.42 ","$2,963.00 ","$2,207.44 ","$1,940.77 ","$2,963.00 ",$829.64 ,"$1,496.32 ","$2,963.00 ","$1,828.17 ","$2,963.00 ","$1,828.17 ","$1,828.17 ","$2,963.00 ","$1,828.17 ","$5,742.98 ","$2,666.70 ","$2,222.25 ","$2,963.00 ","$2,963.00 ","$2,607.44 ","$2,963.00 ","$2,222.25 ","$2,222.25 ","$2,518.55 ","$2,518.55 ","$2,963.00 ","$2,518.55 ","$2,963.00 ","$2,311.14 ","$2,311.14 ","$2,311.14 ","$2,666.70 ","$2,963.00 ","$2,666.70 ","$2,963.00 ","$2,963.00 ","$1,940.77 ","$2,963.00 ","$1,232.61 ","$2,963.00 ","$2,963.00 ","$2,963.00 ","$2,666.70 ","$6,550.42 ","$1,828.17 ",$829.64 ,"$2,666.70 ","$2,963.00 ","$2,666.70 ","$2,666.70 ","$2,963.00 ","$1,925.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100188,36221,HC CATH PLCMT NON SEL THORAC AORTA 36221,481,1 ,"$9,332.00 ","$6,065.80 ","$1,859.83 ","$9,332.00 ","$7,255.98 ","$6,952.34 ","$6,112.46 ","$3,022.62 ","$2,612.96 ","$4,712.66 ","$3,022.62 ","$5,757.84 ","$3,022.62 ","$5,757.84 ","$5,757.84 ","$3,022.62 ","$5,757.84 ","$5,742.98 ","$8,398.80 ","$6,999.00 ","$7,255.98 ","$3,022.62 ","$8,212.16 ","$3,022.62 ","$6,999.00 ","$6,999.00 ","$7,932.20 ","$7,932.20 ","$3,022.62 ","$7,932.20 ","$3,022.62 ","$7,278.96 ","$7,278.96 ","$7,278.96 ","$8,398.80 ","$7,255.98 ","$8,398.80 ","$3,022.62 ","$9,332.00 ","$6,112.46 ","$3,022.62 ","$3,882.11 ","$1,948.40 ","$1,859.83 ","$3,163.73 ","$8,398.80 ","$6,550.42 ","$5,757.84 ","$2,612.96 ","$8,398.80 ","$3,022.62 ","$8,398.80 ","$8,398.80 ","$3,022.62 ","$6,065.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100189,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN UNI 36222,481,1 ,"$12,835.00 ","$8,342.75 ","$1,859.83 ","$12,835.00 ","$7,255.98 ","$9,562.08 ","$8,406.93 ","$3,022.62 ","$3,593.80 ","$6,481.68 ","$3,022.62 ","$7,919.20 ","$3,022.62 ","$7,919.20 ","$7,919.20 ","$3,022.62 ","$7,919.20 ","$5,742.98 ","$11,551.50 ","$9,626.25 ","$7,255.98 ","$3,022.62 ","$11,294.80 ","$3,022.62 ","$9,626.25 ","$9,626.25 ","$10,909.75 ","$10,909.75 ","$3,022.62 ","$10,909.75 ","$3,022.62 ","$10,011.30 ","$10,011.30 ","$10,011.30 ","$11,551.50 ","$7,255.98 ","$11,551.50 ","$3,022.62 ","$12,835.00 ","$8,406.93 ","$3,022.62 ","$5,339.36 ","$1,948.40 ","$1,859.83 ","$3,163.73 ","$11,551.50 ","$6,550.42 ","$7,919.20 ","$3,593.80 ","$11,551.50 ","$3,022.62 ","$11,551.50 ","$11,551.50 ","$3,022.62 ","$8,342.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100190,36223,HC CATH PLCMT SEL COM CAR/INOM INTRACRN UNI 36223,481,1 ,"$14,354.00 ","$9,330.10 ","$1,859.83 ","$14,354.00 ","$12,087.17 ","$10,693.73 ","$9,401.87 ","$5,035.15 ","$4,019.12 ","$7,248.77 ","$5,035.15 ","$8,856.42 ","$5,035.15 ","$8,856.42 ","$8,856.42 ","$5,035.15 ","$8,856.42 ","$9,566.79 ","$12,918.60 ","$10,765.50 ","$12,087.17 ","$5,035.15 ","$12,631.52 ","$5,035.15 ","$10,765.50 ","$10,765.50 ","$12,200.90 ","$12,200.90 ","$5,035.15 ","$12,200.90 ","$5,035.15 ","$11,196.12 ","$11,196.12 ","$11,196.12 ","$12,918.60 ","$12,087.17 ","$12,918.60 ","$5,035.15 ","$14,354.00 ","$9,401.87 ","$5,035.15 ","$5,971.26 ","$1,948.40 ","$1,859.83 ","$5,270.21 ","$12,918.60 ","$10,911.83 ","$8,856.42 ","$4,019.12 ","$12,918.60 ","$5,035.15 ","$12,918.60 ","$12,918.60 ","$5,035.15 ","$9,330.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100191,36224,HC CATH PLCMT SEL INTERNAL CAR UNI 36224,481,1 ,"$18,345.00 ","$11,924.25 ","$1,859.83 ","$18,345.00 ","$12,087.17 ","$13,667.03 ","$12,015.98 ","$5,035.15 ","$5,136.60 ","$9,264.23 ","$5,035.15 ","$11,318.87 ","$5,035.15 ","$11,318.87 ","$11,318.87 ","$5,035.15 ","$11,318.87 ","$9,566.79 ","$16,510.50 ","$13,758.75 ","$12,087.17 ","$5,035.15 ","$16,143.60 ","$5,035.15 ","$13,758.75 ","$13,758.75 ","$15,593.25 ","$15,593.25 ","$5,035.15 ","$15,593.25 ","$5,035.15 ","$14,309.10 ","$14,309.10 ","$14,309.10 ","$16,510.50 ","$12,087.17 ","$16,510.50 ","$5,035.15 ","$18,345.00 ","$12,015.98 ","$5,035.15 ","$7,631.52 ","$1,948.40 ","$1,859.83 ","$5,270.21 ","$16,510.50 ","$10,911.83 ","$11,318.87 ","$5,136.60 ","$16,510.50 ","$5,035.15 ","$16,510.50 ","$16,510.50 ","$5,035.15 ","$11,924.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100192,36226,HC CATH PLCMT SEL VERTEBRAL UNI 36226,481,1 ,"$15,110.00 ","$9,821.50 ","$1,859.83 ","$15,110.00 ","$12,087.17 ","$11,256.95 ","$9,897.05 ","$5,035.15 ","$4,230.80 ","$7,630.55 ","$5,035.15 ","$9,322.87 ","$5,035.15 ","$9,322.87 ","$9,322.87 ","$5,035.15 ","$9,322.87 ","$9,566.79 ","$13,599.00 ","$11,332.50 ","$12,087.17 ","$5,035.15 ","$13,296.80 ","$5,035.15 ","$11,332.50 ","$11,332.50 ","$12,843.50 ","$12,843.50 ","$5,035.15 ","$12,843.50 ","$5,035.15 ","$11,785.80 ","$11,785.80 ","$11,785.80 ","$13,599.00 ","$12,087.17 ","$13,599.00 ","$5,035.15 ","$15,110.00 ","$9,897.05 ","$5,035.15 ","$6,285.76 ","$1,948.40 ","$1,859.83 ","$5,270.21 ","$13,599.00 ","$10,911.83 ","$9,322.87 ","$4,230.80 ","$13,599.00 ","$5,035.15 ","$13,599.00 ","$13,599.00 ","$5,035.15 ","$9,821.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100193,36227,HC CATH PLCMT SEL EXTERNAL CAR UNI 36227,481,1 ,"$8,914.00 ","$5,794.10 ","$1,859.83 ","$8,914.00 ", N/A ,"$6,640.93 ","$5,838.67 ", N/A ,"$2,495.92 ","$4,501.57 ", N/A ,"$5,499.94 ", N/A ,"$5,499.94 ","$5,499.94 ", N/A ,"$5,499.94 ", N/A ,"$8,022.60 ","$6,685.50 ", N/A , N/A ,"$7,844.32 ", N/A ,"$6,685.50 ","$6,685.50 ","$7,576.90 ","$7,576.90 ", N/A ,"$7,576.90 ", N/A ,"$6,952.92 ","$6,952.92 ","$6,952.92 ","$8,022.60 ", N/A ,"$8,022.60 ", N/A ,"$8,914.00 ","$5,838.67 ", N/A ,"$3,708.22 ","$1,948.40 ","$1,859.83 ", N/A ,"$8,022.60 ", N/A ,"$5,499.94 ","$2,495.92 ","$8,022.60 ", N/A ,"$8,022.60 ","$8,022.60 ", N/A ,"$5,794.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100263,36902,HC INTRO CATH/CIRCUIT W/ANGIO 36902,481,1 ,"$15,485.00 ","$10,065.25 ","$3,439.40 ","$15,485.00 ","$12,562.79 ","$11,536.33 ","$10,142.68 ","$5,233.27 ","$4,335.80 ","$7,819.93 ","$5,233.27 ","$9,554.25 ","$5,233.27 ","$9,554.25 ","$9,554.25 ","$5,233.27 ","$9,554.25 ","$9,943.21 ","$13,936.50 ","$11,613.75 ","$12,562.79 ","$5,233.27 ","$13,626.80 ","$5,233.27 ","$11,613.75 ","$11,613.75 ","$13,162.25 ","$13,162.25 ","$5,233.27 ","$13,162.25 ","$5,233.27 ","$12,078.30 ","$12,078.30 ","$12,078.30 ","$13,936.50 ","$12,562.79 ","$13,936.50 ","$5,233.27 ","$15,485.00 ","$10,142.68 ","$5,233.27 ","$6,441.76 ","$3,603.18 ","$3,439.40 ","$5,477.59 ","$13,936.50 ","$11,341.20 ","$9,554.25 ","$4,335.80 ","$13,936.50 ","$5,233.27 ","$13,936.50 ","$13,936.50 ","$5,233.27 ","$10,065.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100265,36907,HC ANGIOPLASTY CTR DIALYSIS SEGMENT 36907,481,1 ,"$2,521.00 ","$1,638.65 ",$705.88 ,"$2,521.00 ", N/A ,"$1,878.15 ","$1,651.26 ", N/A ,$705.88 ,"$1,273.11 ", N/A ,"$1,555.46 ", N/A ,"$1,555.46 ","$1,555.46 ", N/A ,"$1,555.46 ", N/A ,"$2,268.90 ","$1,890.75 ", N/A , N/A ,"$2,218.48 ", N/A ,"$1,890.75 ","$1,890.75 ","$2,142.85 ","$2,142.85 ", N/A ,"$2,142.85 ", N/A ,"$1,966.38 ","$1,966.38 ","$1,966.38 ","$2,268.90 ", N/A ,"$2,268.90 ", N/A ,"$2,521.00 ","$1,651.26 ", N/A ,"$1,048.74 ","$2,521.00 ","$2,521.00 ", N/A ,"$2,268.90 ", N/A ,"$1,555.46 ",$705.88 ,"$2,268.90 ", N/A ,"$2,268.90 ","$2,268.90 ", N/A ,"$1,638.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100270,36908,HC PLACE STENT CENTRAL DIAL SEGMENT 36908,481,1 ,"$1,901.00 ","$1,235.65 ",$532.28 ,"$1,901.00 ", N/A ,"$1,416.25 ","$1,245.16 ", N/A ,$532.28 ,$960.01 , N/A ,"$1,172.92 ", N/A ,"$1,172.92 ","$1,172.92 ", N/A ,"$1,172.92 ", N/A ,"$1,710.90 ","$1,425.75 ", N/A , N/A ,"$1,672.88 ", N/A ,"$1,425.75 ","$1,425.75 ","$1,615.85 ","$1,615.85 ", N/A ,"$1,615.85 ", N/A ,"$1,482.78 ","$1,482.78 ","$1,482.78 ","$1,710.90 ", N/A ,"$1,710.90 ", N/A ,"$1,901.00 ","$1,245.16 ", N/A ,$790.82 ,"$1,901.00 ","$1,901.00 ", N/A ,"$1,710.90 ", N/A ,"$1,172.92 ",$532.28 ,"$1,710.90 ", N/A ,"$1,710.90 ","$1,710.90 ", N/A ,"$1,235.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100271,36909,HC DIAL CIRCUIT VASC EMBOL/OCCUL 36909,481,1 ,"$2,521.00 ","$1,638.65 ",$705.88 ,"$2,521.00 ", N/A ,"$1,878.15 ","$1,651.26 ", N/A ,$705.88 ,"$1,273.11 ", N/A ,"$1,555.46 ", N/A ,"$1,555.46 ","$1,555.46 ", N/A ,"$1,555.46 ", N/A ,"$2,268.90 ","$1,890.75 ", N/A , N/A ,"$2,218.48 ", N/A ,"$1,890.75 ","$1,890.75 ","$2,142.85 ","$2,142.85 ", N/A ,"$2,142.85 ", N/A ,"$1,966.38 ","$1,966.38 ","$1,966.38 ","$2,268.90 ", N/A ,"$2,268.90 ", N/A ,"$2,521.00 ","$1,651.26 ", N/A ,"$1,048.74 ","$2,521.00 ","$2,521.00 ", N/A ,"$2,268.90 ", N/A ,"$1,555.46 ",$705.88 ,"$2,268.90 ", N/A ,"$2,268.90 ","$2,268.90 ", N/A ,"$1,638.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100272,36901,HC INTRO CATH DIALYSIS CIRCUIT 36901,481,1 ,"$2,521.00 ","$1,638.65 ",$705.88 ,"$3,217.73 ","$2,521.00 ","$1,878.15 ","$1,651.26 ","$1,484.79 ",$705.88 ,"$1,273.11 ","$1,484.79 ","$1,555.46 ","$1,484.79 ","$1,555.46 ","$1,555.46 ","$1,484.79 ","$1,555.46 ","$2,821.10 ","$2,268.90 ","$1,890.75 ","$2,521.00 ","$1,484.79 ","$2,218.48 ","$1,484.79 ","$1,890.75 ","$1,890.75 ","$2,142.85 ","$2,142.85 ","$1,484.79 ","$2,142.85 ","$1,484.79 ","$1,966.38 ","$1,966.38 ","$1,966.38 ","$2,268.90 ","$2,521.00 ","$2,268.90 ","$1,484.79 ","$2,521.00 ","$1,651.26 ","$1,484.79 ","$1,048.74 ","$2,268.89 ","$2,165.76 ","$1,554.10 ","$2,268.90 ","$3,217.73 ","$1,555.46 ",$705.88 ,"$2,268.90 ","$1,484.79 ","$2,268.90 ","$2,268.90 ","$1,484.79 ","$1,638.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100323,36245,HC PLACE CATH ABD/PEL 1ST ORDER-BI,360,1 ,"$5,678.00 ","$3,690.70 ","$1,589.84 ","$5,678.00 ", N/A ,"$4,230.11 ","$3,719.09 ", N/A ,"$1,589.84 ","$2,867.39 ", N/A ,"$3,503.33 ", N/A ,"$3,503.33 ","$3,503.33 ", N/A ,"$3,503.33 ", N/A ,"$5,110.20 ","$4,258.50 ", N/A , N/A ,"$4,996.64 ", N/A ,"$4,258.50 ","$4,258.50 ","$4,826.30 ","$4,826.30 ", N/A ,"$4,826.30 ", N/A ,"$4,428.84 ","$4,428.84 ","$4,428.84 ","$5,110.20 ", N/A ,"$5,110.20 ", N/A ,"$5,678.00 ","$3,719.09 ", N/A ,"$2,362.05 ","$2,922.60 ","$2,789.76 ", N/A ,"$5,110.20 ", N/A ,"$3,503.33 ","$1,589.84 ","$5,110.20 ", N/A ,"$5,110.20 ","$5,110.20 ", N/A ,"$3,690.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100324,36245,HC PLACE CATH ABD/PEL 1ST ORDER-LT,360,1 ,"$3,785.00 ","$2,460.25 ","$1,059.80 ","$3,785.00 ", N/A ,"$2,819.83 ","$2,479.18 ", N/A ,"$1,059.80 ","$1,911.43 ", N/A ,"$2,335.35 ", N/A ,"$2,335.35 ","$2,335.35 ", N/A ,"$2,335.35 ", N/A ,"$3,406.50 ","$2,838.75 ", N/A , N/A ,"$3,330.80 ", N/A ,"$2,838.75 ","$2,838.75 ","$3,217.25 ","$3,217.25 ", N/A ,"$3,217.25 ", N/A ,"$2,952.30 ","$2,952.30 ","$2,952.30 ","$3,406.50 ", N/A ,"$3,406.50 ", N/A ,"$3,785.00 ","$2,479.18 ", N/A ,"$1,574.56 ","$1,948.40 ","$1,859.83 ", N/A ,"$3,406.50 ", N/A ,"$2,335.35 ","$1,059.80 ","$3,406.50 ", N/A ,"$3,406.50 ","$3,406.50 ", N/A ,"$2,460.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100325,36245,HC PLACE CATH ABD/PEL 1ST ORDER-RT,360,1 ,"$3,785.00 ","$2,460.25 ","$1,059.80 ","$3,785.00 ", N/A ,"$2,819.83 ","$2,479.18 ", N/A ,"$1,059.80 ","$1,911.43 ", N/A ,"$2,335.35 ", N/A ,"$2,335.35 ","$2,335.35 ", N/A ,"$2,335.35 ", N/A ,"$3,406.50 ","$2,838.75 ", N/A , N/A ,"$3,330.80 ", N/A ,"$2,838.75 ","$2,838.75 ","$3,217.25 ","$3,217.25 ", N/A ,"$3,217.25 ", N/A ,"$2,952.30 ","$2,952.30 ","$2,952.30 ","$3,406.50 ", N/A ,"$3,406.50 ", N/A ,"$3,785.00 ","$2,479.18 ", N/A ,"$1,574.56 ","$1,948.40 ","$1,859.83 ", N/A ,"$3,406.50 ", N/A ,"$2,335.35 ","$1,059.80 ","$3,406.50 ", N/A ,"$3,406.50 ","$3,406.50 ", N/A ,"$2,460.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100421,33211,HC INS/REPL TEMP ELECTRODE DUAL CHAMBER-33211,481,1 ,"$2,048.00 ","$1,331.20 ",$573.44 ,"$18,668.74 ","$2,048.00 ","$1,525.76 ","$1,341.44 ","$2,048.00 ",$573.44 ,"$1,034.24 ","$2,048.00 ","$1,263.62 ","$2,048.00 ","$1,263.62 ","$1,263.62 ","$2,048.00 ","$1,263.62 ","$16,367.53 ","$1,843.20 ","$1,536.00 ","$2,048.00 ","$2,048.00 ","$1,802.24 ","$2,048.00 ","$1,536.00 ","$1,536.00 ","$1,740.80 ","$1,740.80 ","$2,048.00 ","$1,740.80 ","$2,048.00 ","$1,597.44 ","$1,597.44 ","$1,597.44 ","$1,843.20 ","$2,048.00 ","$1,843.20 ","$2,048.00 ","$2,048.00 ","$1,341.44 ","$2,048.00 ",$851.97 ,"$2,048.00 ","$2,048.00 ","$2,048.00 ","$1,843.20 ","$18,668.74 ","$1,263.62 ",$573.44 ,"$1,843.20 ","$2,048.00 ","$1,843.20 ","$1,843.20 ","$2,048.00 ","$1,331.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100456,75600,HC AORTOGRAM THORACIC W/O SERIALOGRAPHY,481,1 ,"$5,337.00 ","$3,469.05 ",$220.43 ,"$6,550.42 ","$5,337.00 ","$3,976.07 ","$3,495.74 ","$3,022.62 ","$1,494.36 ","$2,695.19 ","$3,022.62 ","$3,292.93 ","$3,022.62 ","$3,292.93 ","$3,292.93 ","$3,022.62 ","$3,292.93 ","$5,742.98 ","$4,803.30 ","$4,002.75 ","$5,337.00 ","$3,022.62 ","$4,696.56 ","$3,022.62 ","$4,002.75 ","$4,002.75 ","$4,536.45 ","$4,536.45 ","$3,022.62 ","$4,536.45 ","$3,022.62 ","$4,162.86 ","$4,162.86 ","$4,162.86 ","$4,803.30 ","$5,337.00 ","$4,803.30 ","$3,022.62 ","$5,337.00 ","$3,495.74 ","$3,022.62 ","$2,220.19 ",$230.92 ,$220.43 ,"$3,163.73 ","$4,803.30 ","$6,550.42 ","$3,292.93 ","$1,494.36 ","$4,803.30 ","$3,022.62 ","$4,803.30 ","$4,803.30 ","$3,022.62 ","$3,469.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48100469,93454,HC CORONARY ARTERY ANGIOGRAPHY,481,1 ,"$10,204.00 ","$6,632.60 ","$1,693.37 ","$10,204.00 ","$7,350.01 ","$7,601.98 ","$6,683.62 ","$3,061.79 ","$2,857.12 ","$5,153.02 ","$3,061.79 ","$6,295.87 ","$3,061.79 ","$6,295.87 ","$6,295.87 ","$3,061.79 ","$6,295.87 ","$5,817.40 ","$9,183.60 ","$7,653.00 ","$7,350.01 ","$3,061.79 ","$8,979.52 ","$3,061.79 ","$7,653.00 ","$7,653.00 ","$8,673.40 ","$8,673.40 ","$3,061.79 ","$8,673.40 ","$3,061.79 ","$7,959.12 ","$7,959.12 ","$7,959.12 ","$9,183.60 ","$7,350.01 ","$9,183.60 ","$3,061.79 ","$10,204.00 ","$6,683.62 ","$3,061.79 ","$4,244.86 ","$1,774.00 ","$1,693.37 ","$3,204.73 ","$9,183.60 ","$6,635.31 ","$6,295.87 ","$2,857.12 ","$9,183.60 ","$3,061.79 ","$9,183.60 ","$9,183.60 ","$3,061.79 ","$6,632.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,530.00 ",$994.50 ,$212.16 ,"$1,530.00 ",$670.82 ,"$1,139.85 ","$1,002.15 ",$279.44 ,$428.40 ,$772.65 ,$279.44 ,$944.01 ,$279.44 ,$944.01 ,$944.01 ,$279.44 ,$944.01 ,$530.94 ,"$1,377.00 ","$1,147.50 ",$670.82 ,$279.44 ,"$1,346.40 ",$279.44 ,"$1,147.50 ","$1,147.50 ","$1,300.50 ","$1,300.50 ",$279.44 ,"$1,300.50 ",$279.44 ,"$1,193.40 ","$1,193.40 ","$1,193.40 ","$1,377.00 ",$670.82 ,"$1,377.00 ",$279.44 ,"$1,530.00 ","$1,002.15 ",$279.44 ,$636.48 ,$222.27 ,$212.16 ,$292.49 ,"$1,377.00 ",$605.59 ,$944.01 ,$428.40 ,"$1,377.00 ",$279.44 ,"$1,377.00 ","$1,377.00 ",$279.44 ,$994.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$2,099.00 ","$1,364.35 ",$337.20 ,"$2,099.00 ","$1,224.74 ","$1,563.76 ","$1,374.85 ",$510.19 ,$587.72 ,"$1,060.00 ",$510.19 ,"$1,295.08 ",$510.19 ,"$1,295.08 ","$1,295.08 ",$510.19 ,"$1,295.08 ",$969.36 ,"$1,889.10 ","$1,574.25 ","$1,224.74 ",$510.19 ,"$1,847.12 ",$510.19 ,"$1,574.25 ","$1,574.25 ","$1,784.15 ","$1,784.15 ",$510.19 ,"$1,784.15 ",$510.19 ,"$1,637.22 ","$1,637.22 ","$1,637.22 ","$1,889.10 ","$1,224.74 ","$1,889.10 ",$510.19 ,"$2,099.00 ","$1,374.85 ",$510.19 ,$873.18 ,$353.25 ,$337.20 ,$534.01 ,"$1,889.10 ","$1,105.65 ","$1,295.08 ",$587.72 ,"$1,889.10 ",$510.19 ,"$1,889.10 ","$1,889.10 ",$510.19 ,"$1,364.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$882.00 ,$573.30 ,$242.96 ,$882.00 ,$583.23 ,$657.09 ,$577.71 ,$242.96 ,$246.96 ,$445.41 ,$242.96 ,$544.19 ,$242.96 ,$544.19 ,$544.19 ,$242.96 ,$544.19 ,$461.62 ,$793.80 ,$661.50 ,$583.23 ,$242.96 ,$776.16 ,$242.96 ,$661.50 ,$661.50 ,$749.70 ,$749.70 ,$242.96 ,$749.70 ,$242.96 ,$687.96 ,$687.96 ,$687.96 ,$793.80 ,$583.23 ,$793.80 ,$242.96 ,$882.00 ,$577.71 ,$242.96 ,$366.91 ,$353.25 ,$337.20 ,$254.30 ,$793.80 ,$526.52 ,$544.19 ,$246.96 ,$793.80 ,$242.96 ,$793.80 ,$793.80 ,$242.96 ,$573.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300003,93312,HC ECHO TEE CMPL W/PF,483,1 ,"$3,051.00 ","$1,983.15 ",$337.20 ,"$3,051.00 ","$1,224.74 ","$2,273.00 ","$1,998.41 ",$510.19 ,$854.28 ,"$1,540.76 ",$510.19 ,"$1,882.47 ",$510.19 ,"$1,882.47 ","$1,882.47 ",$510.19 ,"$1,882.47 ",$969.36 ,"$2,745.90 ","$2,288.25 ","$1,224.74 ",$510.19 ,"$2,684.88 ",$510.19 ,"$2,288.25 ","$2,288.25 ","$2,593.35 ","$2,593.35 ",$510.19 ,"$2,593.35 ",$510.19 ,"$2,379.78 ","$2,379.78 ","$2,379.78 ","$2,745.90 ","$1,224.74 ","$2,745.90 ",$510.19 ,"$3,051.00 ","$1,998.41 ",$510.19 ,"$1,269.22 ",$353.25 ,$337.20 ,$534.01 ,"$2,745.90 ","$1,105.65 ","$1,882.47 ",$854.28 ,"$2,745.90 ",$510.19 ,"$2,745.90 ","$2,745.90 ",$510.19 ,"$1,983.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300005,93320,HC ECHO DOPPLER,483,1 ,$408.00 ,$265.20 ,$114.24 ,$408.00 , N/A ,$303.96 ,$267.24 , N/A ,$114.24 ,$206.04 , N/A ,$251.74 , N/A ,$251.74 ,$251.74 , N/A ,$251.74 , N/A ,$367.20 ,$306.00 , N/A , N/A ,$359.04 , N/A ,$306.00 ,$306.00 ,$346.80 ,$346.80 , N/A ,$346.80 , N/A ,$318.24 ,$318.24 ,$318.24 ,$367.20 , N/A ,$367.20 , N/A ,$408.00 ,$267.24 , N/A ,$169.73 ,$353.25 ,$337.20 , N/A ,$367.20 , N/A ,$251.74 ,$114.24 ,$367.20 , N/A ,$367.20 ,$367.20 , N/A ,$265.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$648.00 ,$421.20 ,$181.44 ,$648.00 , N/A ,$482.76 ,$424.44 , N/A ,$181.44 ,$327.24 , N/A ,$399.82 , N/A ,$399.82 ,$399.82 , N/A ,$399.82 , N/A ,$583.20 ,$486.00 , N/A , N/A ,$570.24 , N/A ,$486.00 ,$486.00 ,$550.80 ,$550.80 , N/A ,$550.80 , N/A ,$505.44 ,$505.44 ,$505.44 ,$583.20 , N/A ,$583.20 , N/A ,$648.00 ,$424.44 , N/A ,$269.57 ,$353.25 ,$337.20 , N/A ,$583.20 , N/A ,$399.82 ,$181.44 ,$583.20 , N/A ,$583.20 ,$583.20 , N/A ,$421.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300007,93350,HC ECHO REST  AND  STRESS W/PF,483,1 ,"$3,724.00 ","$2,420.60 ",$337.20 ,"$3,724.00 ","$1,224.74 ","$2,774.38 ","$2,439.22 ",$510.19 ,"$1,042.72 ","$1,880.62 ",$510.19 ,"$2,297.71 ",$510.19 ,"$2,297.71 ","$2,297.71 ",$510.19 ,"$2,297.71 ",$969.36 ,"$3,351.60 ","$2,793.00 ","$1,224.74 ",$510.19 ,"$3,277.12 ",$510.19 ,"$2,793.00 ","$2,793.00 ","$3,165.40 ","$3,165.40 ",$510.19 ,"$3,165.40 ",$510.19 ,"$2,904.72 ","$2,904.72 ","$2,904.72 ","$3,351.60 ","$1,224.74 ","$3,351.60 ",$510.19 ,"$3,724.00 ","$2,439.22 ",$510.19 ,"$1,549.18 ",$353.25 ,$337.20 ,$534.01 ,"$3,351.60 ","$1,105.65 ","$2,297.71 ","$1,042.72 ","$3,351.60 ",$510.19 ,"$3,351.60 ","$3,351.60 ",$510.19 ,"$2,420.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300008,93303,HC ECHO PEDS CONGENITAL,483,1 ,"$2,414.00 ","$1,569.10 ",$337.20 ,"$2,414.00 ","$1,224.74 ","$1,798.43 ","$1,581.17 ",$510.19 ,$675.92 ,"$1,219.07 ",$510.19 ,"$1,489.44 ",$510.19 ,"$1,489.44 ","$1,489.44 ",$510.19 ,"$1,489.44 ",$969.36 ,"$2,172.60 ","$1,810.50 ","$1,224.74 ",$510.19 ,"$2,124.32 ",$510.19 ,"$1,810.50 ","$1,810.50 ","$2,051.90 ","$2,051.90 ",$510.19 ,"$2,051.90 ",$510.19 ,"$1,882.92 ","$1,882.92 ","$1,882.92 ","$2,172.60 ","$1,224.74 ","$2,172.60 ",$510.19 ,"$2,414.00 ","$1,581.17 ",$510.19 ,"$1,004.22 ",$353.25 ,$337.20 ,$534.01 ,"$2,172.60 ","$1,105.65 ","$1,489.44 ",$675.92 ,"$2,172.60 ",$510.19 ,"$2,172.60 ","$2,172.60 ",$510.19 ,"$1,569.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300009,93304,HC ECHO PEDS CONGENITAL LMTD,483,1 ,$969.00 ,$629.85 ,$271.32 ,"$1,105.65 ",$969.00 ,$721.91 ,$634.70 ,$510.19 ,$271.32 ,$489.35 ,$510.19 ,$597.87 ,$510.19 ,$597.87 ,$597.87 ,$510.19 ,$597.87 ,$969.36 ,$872.10 ,$726.75 ,$969.00 ,$510.19 ,$852.72 ,$510.19 ,$726.75 ,$726.75 ,$823.65 ,$823.65 ,$510.19 ,$823.65 ,$510.19 ,$755.82 ,$755.82 ,$755.82 ,$872.10 ,$969.00 ,$872.10 ,$510.19 ,$969.00 ,$634.70 ,$510.19 ,$403.10 ,$353.25 ,$337.20 ,$534.01 ,$872.10 ,"$1,105.65 ",$597.87 ,$271.32 ,$872.10 ,$510.19 ,$872.10 ,$872.10 ,$510.19 ,$629.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$418.00 ,$271.70 ,$117.04 ,$418.00 , N/A ,$311.41 ,$273.79 , N/A ,$117.04 ,$211.09 , N/A ,$257.91 , N/A ,$257.91 ,$257.91 , N/A ,$257.91 , N/A ,$376.20 ,$313.50 , N/A , N/A ,$367.84 , N/A ,$313.50 ,$313.50 ,$355.30 ,$355.30 , N/A ,$355.30 , N/A ,$326.04 ,$326.04 ,$326.04 ,$376.20 , N/A ,$376.20 , N/A ,$418.00 ,$273.79 , N/A ,$173.89 ,$353.25 ,$337.20 , N/A ,$376.20 , N/A ,$257.91 ,$117.04 ,$376.20 , N/A ,$376.20 ,$376.20 , N/A ,$271.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT  AND  W/CONT W/PF,483,1 ,"$2,386.00 ","$1,550.90 ",$337.20 ,"$2,386.00 ","$1,813.40 ","$1,777.57 ","$1,562.83 ",$755.41 ,$668.08 ,"$1,204.93 ",$755.41 ,"$1,472.16 ",$755.41 ,"$1,472.16 ","$1,472.16 ",$755.41 ,"$1,472.16 ","$1,435.28 ","$2,147.40 ","$1,789.50 ","$1,813.40 ",$755.41 ,"$2,099.68 ",$755.41 ,"$1,789.50 ","$1,789.50 ","$2,028.10 ","$2,028.10 ",$755.41 ,"$2,028.10 ",$755.41 ,"$1,861.08 ","$1,861.08 ","$1,861.08 ","$2,147.40 ","$1,813.40 ","$2,147.40 ",$755.41 ,"$2,386.00 ","$1,562.83 ",$755.41 ,$992.58 ,$353.25 ,$337.20 ,$790.68 ,"$2,147.40 ","$1,637.07 ","$1,472.16 ",$668.08 ,"$2,147.40 ",$755.41 ,"$2,147.40 ","$2,147.40 ",$755.41 ,"$1,550.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT  AND  W/CONT,483,1 ,"$2,260.00 ","$1,469.00 ",$337.20 ,"$2,260.00 ","$1,813.40 ","$1,683.70 ","$1,480.30 ",$755.41 ,$632.80 ,"$1,141.30 ",$755.41 ,"$1,394.42 ",$755.41 ,"$1,394.42 ","$1,394.42 ",$755.41 ,"$1,394.42 ","$1,435.28 ","$2,034.00 ","$1,695.00 ","$1,813.40 ",$755.41 ,"$1,988.80 ",$755.41 ,"$1,695.00 ","$1,695.00 ","$1,921.00 ","$1,921.00 ",$755.41 ,"$1,921.00 ",$755.41 ,"$1,762.80 ","$1,762.80 ","$1,762.80 ","$2,034.00 ","$1,813.40 ","$2,034.00 ",$755.41 ,"$2,260.00 ","$1,480.30 ",$755.41 ,$940.16 ,$353.25 ,$337.20 ,$790.68 ,"$2,034.00 ","$1,637.07 ","$1,394.42 ",$632.80 ,"$2,034.00 ",$755.41 ,"$2,034.00 ","$2,034.00 ",$755.41 ,"$1,469.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000005,11042,HC DEBR SKIN/SUBQ TISS INIT 20CM FAC,510,1 ,"$1,011.00 ",$657.15 ,$213.11 ,"$1,011.00 ",$876.09 ,$753.20 ,$662.21 ,$364.95 ,$283.08 ,$510.56 ,$364.95 ,$623.79 ,$364.95 ,$623.79 ,$623.79 ,$364.95 ,$623.79 ,$693.41 ,$909.90 ,$758.25 ,$876.09 ,$364.95 ,$889.68 ,$364.95 ,$758.25 ,$758.25 ,$859.35 ,$859.35 ,$364.95 ,$859.35 ,$364.95 ,$788.58 ,$788.58 ,$788.58 ,$909.90 ,$876.09 ,$909.90 ,$364.95 ,"$1,011.00 ",$662.21 ,$364.95 ,$420.58 ,$223.26 ,$213.11 ,$381.99 ,$909.90 ,$790.90 ,$623.79 ,$283.08 ,$909.90 ,$364.95 ,$909.90 ,$909.90 ,$364.95 ,$657.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000006,11043,HC DEBR SKIN/SUBQ TISSUE/MUSCLE FAC,510,1 ,"$1,193.00 ",$775.45 ,$334.04 ,"$1,198.43 ","$1,193.00 ",$888.79 ,$781.42 ,$553.00 ,$334.04 ,$602.47 ,$553.00 ,$736.08 ,$553.00 ,$736.08 ,$736.08 ,$553.00 ,$736.08 ,"$1,050.70 ","$1,073.70 ",$894.75 ,"$1,193.00 ",$553.00 ,"$1,049.84 ",$553.00 ,$894.75 ,$894.75 ,"$1,014.05 ","$1,014.05 ",$553.00 ,"$1,014.05 ",$553.00 ,$930.54 ,$930.54 ,$930.54 ,"$1,073.70 ","$1,193.00 ","$1,073.70 ",$553.00 ,"$1,193.00 ",$781.42 ,$553.00 ,$496.29 ,$607.40 ,$579.79 ,$578.82 ,"$1,073.70 ","$1,198.43 ",$736.08 ,$334.04 ,"$1,073.70 ",$553.00 ,"$1,073.70 ","$1,073.70 ",$553.00 ,$775.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000007,11044,HC DEBR SKIN/SUB TIS/MUS/BONE INT 20 FAC,510,1 ,"$3,144.00 ","$2,043.60 ",$832.23 ,"$3,219.59 ","$3,144.00 ","$2,342.28 ","$2,059.32 ","$1,485.64 ",$880.32 ,"$1,587.72 ","$1,485.64 ","$1,939.85 ","$1,485.64 ","$1,939.85 ","$1,939.85 ","$1,485.64 ","$1,939.85 ","$2,822.72 ","$2,829.60 ","$2,358.00 ","$3,144.00 ","$1,485.64 ","$2,766.72 ","$1,485.64 ","$2,358.00 ","$2,358.00 ","$2,672.40 ","$2,672.40 ","$1,485.64 ","$2,672.40 ","$1,485.64 ","$2,452.32 ","$2,452.32 ","$2,452.32 ","$2,829.60 ","$3,144.00 ","$2,829.60 ","$1,485.64 ","$3,144.00 ","$2,059.32 ","$1,485.64 ","$1,307.90 ",$871.86 ,$832.23 ,"$1,555.00 ","$2,829.60 ","$3,219.59 ","$1,939.85 ",$880.32 ,"$2,829.60 ","$1,485.64 ","$2,829.60 ","$2,829.60 ","$1,485.64 ","$2,043.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000009,11045,HC DEBR SKIN/SUBQ TIS EA ADL 20CM FAC,510,1 ,"$1,011.00 ",$657.15 ,$283.08 ,"$1,011.00 ", N/A ,$753.20 ,$662.21 , N/A ,$283.08 ,$510.56 , N/A ,$623.79 , N/A ,$623.79 ,$623.79 , N/A ,$623.79 , N/A ,$909.90 ,$758.25 , N/A , N/A ,$889.68 , N/A ,$758.25 ,$758.25 ,$859.35 ,$859.35 , N/A ,$859.35 , N/A ,$788.58 ,$788.58 ,$788.58 ,$909.90 , N/A ,$909.90 , N/A ,"$1,011.00 ",$662.21 , N/A ,$420.58 ,$607.40 ,$579.79 , N/A ,$909.90 , N/A ,$623.79 ,$283.08 ,$909.90 , N/A ,$909.90 ,$909.90 , N/A ,$657.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000010,11046,HC DEBR SKIN/SUBQ MUS/FAS ADL 20C FAC,510,1 ,$997.00 ,$648.05 ,$279.16 ,$997.00 , N/A ,$742.77 ,$653.04 , N/A ,$279.16 ,$503.49 , N/A ,$615.15 , N/A ,$615.15 ,$615.15 , N/A ,$615.15 , N/A ,$897.30 ,$747.75 , N/A , N/A ,$877.36 , N/A ,$747.75 ,$747.75 ,$847.45 ,$847.45 , N/A ,$847.45 , N/A ,$777.66 ,$777.66 ,$777.66 ,$897.30 , N/A ,$897.30 , N/A ,$997.00 ,$653.04 , N/A ,$414.75 ,$607.40 ,$579.79 , N/A ,$897.30 , N/A ,$615.15 ,$279.16 ,$897.30 , N/A ,$897.30 ,$897.30 , N/A ,$648.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000011,11047,HC DEBR SKIN/SUB TIS/MUS/BN ADL 20C FAC,510,1 ,"$3,285.00 ","$2,135.25 ",$832.23 ,"$3,285.00 ", N/A ,"$2,447.33 ","$2,151.68 ", N/A ,$919.80 ,"$1,658.93 ", N/A ,"$2,026.85 ", N/A ,"$2,026.85 ","$2,026.85 ", N/A ,"$2,026.85 ", N/A ,"$2,956.50 ","$2,463.75 ", N/A , N/A ,"$2,890.80 ", N/A ,"$2,463.75 ","$2,463.75 ","$2,792.25 ","$2,792.25 ", N/A ,"$2,792.25 ", N/A ,"$2,562.30 ","$2,562.30 ","$2,562.30 ","$2,956.50 ", N/A ,"$2,956.50 ", N/A ,"$3,285.00 ","$2,151.68 ", N/A ,"$1,366.56 ",$871.86 ,$832.23 , N/A ,"$2,956.50 ", N/A ,"$2,026.85 ",$919.80 ,"$2,956.50 ", N/A ,"$2,956.50 ","$2,956.50 ", N/A ,"$2,135.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000012,11055,HC PARING LESN BENIGN 1 FAC,510,1 ,$334.00 ,$217.10 ,$93.52 ,$410.91 ,$334.00 ,$248.83 ,$218.77 ,$189.61 ,$93.52 ,$168.67 ,$189.61 ,$206.08 ,$189.61 ,$206.08 ,$206.08 ,$189.61 ,$206.08 ,$360.26 ,$300.60 ,$250.50 ,$334.00 ,$189.61 ,$293.92 ,$189.61 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$189.61 ,$283.90 ,$189.61 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$334.00 ,$300.60 ,$189.61 ,$334.00 ,$218.77 ,$189.61 ,$138.94 ,$223.26 ,$213.11 ,$198.46 ,$300.60 ,$410.91 ,$206.08 ,$93.52 ,$300.60 ,$189.61 ,$300.60 ,$300.60 ,$189.61 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000014,11056,HC PARING LESN BENIGN 2-4 FAC,510,1 ,$334.00 ,$217.10 ,$93.52 ,$410.91 ,$334.00 ,$248.83 ,$218.77 ,$189.61 ,$93.52 ,$168.67 ,$189.61 ,$206.08 ,$189.61 ,$206.08 ,$206.08 ,$189.61 ,$206.08 ,$360.26 ,$300.60 ,$250.50 ,$334.00 ,$189.61 ,$293.92 ,$189.61 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$189.61 ,$283.90 ,$189.61 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$334.00 ,$300.60 ,$189.61 ,$334.00 ,$218.77 ,$189.61 ,$138.94 ,$223.26 ,$213.11 ,$198.46 ,$300.60 ,$410.91 ,$206.08 ,$93.52 ,$300.60 ,$189.61 ,$300.60 ,$300.60 ,$189.61 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000021,11719,HC TRIM NAILS NONDYSTROPHIC FAC,510,1 ,$168.00 ,$109.20 ,$47.04 ,$168.00 ,$141.09 ,$125.16 ,$110.04 ,$58.77 ,$47.04 ,$84.84 ,$58.77 ,$103.66 ,$58.77 ,$103.66 ,$103.66 ,$58.77 ,$103.66 ,$111.66 ,$151.20 ,$126.00 ,$141.09 ,$58.77 ,$147.84 ,$58.77 ,$126.00 ,$126.00 ,$142.80 ,$142.80 ,$58.77 ,$142.80 ,$58.77 ,$131.04 ,$131.04 ,$131.04 ,$151.20 ,$141.09 ,$151.20 ,$58.77 ,$168.00 ,$110.04 ,$58.77 ,$69.89 ,$59.73 ,$57.02 ,$61.52 ,$151.20 ,$127.37 ,$103.66 ,$47.04 ,$151.20 ,$58.77 ,$151.20 ,$151.20 ,$58.77 ,$109.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000023,11720,HC DEBR NAIL(S) UP TO 5,510,1 ,$334.00 ,$217.10 ,$57.02 ,$334.00 ,$141.09 ,$248.83 ,$218.77 ,$58.77 ,$93.52 ,$168.67 ,$58.77 ,$206.08 ,$58.77 ,$206.08 ,$206.08 ,$58.77 ,$206.08 ,$111.66 ,$300.60 ,$250.50 ,$141.09 ,$58.77 ,$293.92 ,$58.77 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$58.77 ,$283.90 ,$58.77 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$141.09 ,$300.60 ,$58.77 ,$334.00 ,$218.77 ,$58.77 ,$138.94 ,$59.73 ,$57.02 ,$61.52 ,$300.60 ,$127.37 ,$206.08 ,$93.52 ,$300.60 ,$58.77 ,$300.60 ,$300.60 ,$58.77 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000024,11721,HC DEBR NAIL(S) 6 OR MORE,510,1 ,$334.00 ,$217.10 ,$57.02 ,$334.00 ,$141.09 ,$248.83 ,$218.77 ,$58.77 ,$93.52 ,$168.67 ,$58.77 ,$206.08 ,$58.77 ,$206.08 ,$206.08 ,$58.77 ,$206.08 ,$111.66 ,$300.60 ,$250.50 ,$141.09 ,$58.77 ,$293.92 ,$58.77 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$58.77 ,$283.90 ,$58.77 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$141.09 ,$300.60 ,$58.77 ,$334.00 ,$218.77 ,$58.77 ,$138.94 ,$59.73 ,$57.02 ,$61.52 ,$300.60 ,$127.37 ,$206.08 ,$93.52 ,$300.60 ,$58.77 ,$300.60 ,$300.60 ,$58.77 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000025,11750,HC REMOVE NAIL BED FACIL,510,1 ,"$1,594.00 ","$1,036.10 ",$364.95 ,"$1,594.00 ",$876.09 ,"$1,187.53 ","$1,044.07 ",$364.95 ,$446.32 ,$804.97 ,$364.95 ,$983.50 ,$364.95 ,$983.50 ,$983.50 ,$364.95 ,$983.50 ,$693.41 ,"$1,434.60 ","$1,195.50 ",$876.09 ,$364.95 ,"$1,402.72 ",$364.95 ,"$1,195.50 ","$1,195.50 ","$1,354.90 ","$1,354.90 ",$364.95 ,"$1,354.90 ",$364.95 ,"$1,243.32 ","$1,243.32 ","$1,243.32 ","$1,434.60 ",$876.09 ,"$1,434.60 ",$364.95 ,"$1,594.00 ","$1,044.07 ",$364.95 ,$663.10 ,$469.24 ,$447.91 ,$381.99 ,"$1,434.60 ",$790.90 ,$983.50 ,$446.32 ,"$1,434.60 ",$364.95 ,"$1,434.60 ","$1,434.60 ",$364.95 ,"$1,036.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$883.00 ,$573.95 ,$83.00 ,$883.00 ,$808.19 ,$657.84 ,$578.37 ,$336.67 ,$247.24 ,$445.92 ,$336.67 ,$544.81 ,$336.67 ,$544.81 ,$544.81 ,$336.67 ,$544.81 ,$639.67 ,$794.70 ,$662.25 ,$808.19 ,$336.67 ,$777.04 ,$336.67 ,$662.25 ,$662.25 ,$750.55 ,$750.55 ,$336.67 ,$750.55 ,$336.67 ,$688.74 ,$688.74 ,$688.74 ,$794.70 ,$808.19 ,$794.70 ,$336.67 ,$883.00 ,$578.37 ,$336.67 ,$367.33 ,$86.96 ,$83.00 ,$352.38 ,$794.70 ,$729.60 ,$544.81 ,$247.24 ,$794.70 ,$336.67 ,$794.70 ,$794.70 ,$336.67 ,$573.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$262.00 ,$170.30 ,$65.46 ,$262.00 ,$157.15 ,$195.19 ,$171.61 ,$65.46 ,$73.36 ,$132.31 ,$65.46 ,$161.65 ,$65.46 ,$161.65 ,$161.65 ,$65.46 ,$161.65 ,$124.37 ,$235.80 ,$196.50 ,$157.15 ,$65.46 ,$230.56 ,$65.46 ,$196.50 ,$196.50 ,$222.70 ,$222.70 ,$65.46 ,$222.70 ,$65.46 ,$204.36 ,$204.36 ,$204.36 ,$235.80 ,$157.15 ,$235.80 ,$65.46 ,$262.00 ,$171.61 ,$65.46 ,$108.99 , N/A , N/A ,$68.52 ,$235.80 ,$141.87 ,$161.65 ,$73.36 ,$235.80 ,$65.46 ,$235.80 ,$235.80 ,$65.46 ,$170.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$197.00 ,$128.05 ,$55.16 ,$468.11 ,$197.00 ,$146.77 ,$129.04 ,$197.00 ,$55.16 ,$99.49 ,$197.00 ,$121.55 ,$197.00 ,$121.55 ,$121.55 ,$197.00 ,$121.55 ,$410.40 ,$177.30 ,$147.75 ,$197.00 ,$197.00 ,$173.36 ,$197.00 ,$147.75 ,$147.75 ,$167.45 ,$167.45 ,$197.00 ,$167.45 ,$197.00 ,$153.66 ,$153.66 ,$153.66 ,$177.30 ,$197.00 ,$177.30 ,$197.00 ,$197.00 ,$129.04 ,$197.00 ,$81.95 , N/A , N/A ,$197.00 ,$177.30 ,$468.11 ,$121.55 ,$55.16 ,$177.30 ,$197.00 ,$177.30 ,$177.30 ,$197.00 ,$128.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$169.00 ,$109.85 ,$42.25 ,$169.00 ,$101.43 ,$125.91 ,$110.70 ,$42.25 ,$47.32 ,$85.35 ,$42.25 ,$104.27 ,$42.25 ,$104.27 ,$104.27 ,$42.25 ,$104.27 ,$80.28 ,$152.10 ,$126.75 ,$101.43 ,$42.25 ,$148.72 ,$42.25 ,$126.75 ,$126.75 ,$143.65 ,$143.65 ,$42.25 ,$143.65 ,$42.25 ,$131.82 ,$131.82 ,$131.82 ,$152.10 ,$101.43 ,$152.10 ,$42.25 ,$169.00 ,$110.70 ,$42.25 ,$70.30 , N/A , N/A ,$44.23 ,$152.10 ,$91.57 ,$104.27 ,$47.32 ,$152.10 ,$42.25 ,$152.10 ,$152.10 ,$42.25 ,$109.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$197.00 ,$128.05 ,$55.16 ,$197.00 , N/A ,$146.77 ,$129.04 , N/A ,$55.16 ,$99.49 , N/A ,$121.55 , N/A ,$121.55 ,$121.55 , N/A ,$121.55 , N/A ,$177.30 ,$147.75 , N/A , N/A ,$173.36 , N/A ,$147.75 ,$147.75 ,$167.45 ,$167.45 , N/A ,$167.45 , N/A ,$153.66 ,$153.66 ,$153.66 ,$177.30 , N/A ,$177.30 , N/A ,$197.00 ,$129.04 , N/A ,$81.95 , N/A , N/A , N/A ,$177.30 , N/A ,$121.55 ,$55.16 ,$177.30 , N/A ,$177.30 ,$177.30 , N/A ,$128.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$246.00 ,$159.90 ,$58.77 ,$246.00 ,$141.09 ,$183.27 ,$161.13 ,$58.77 ,$68.88 ,$124.23 ,$58.77 ,$151.78 ,$58.77 ,$151.78 ,$151.78 ,$58.77 ,$151.78 ,$111.66 ,$221.40 ,$184.50 ,$141.09 ,$58.77 ,$216.48 ,$58.77 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$58.77 ,$209.10 ,$58.77 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$141.09 ,$221.40 ,$58.77 ,$246.00 ,$161.13 ,$58.77 ,$102.34 ,$86.96 ,$83.00 ,$61.52 ,$221.40 ,$127.37 ,$151.78 ,$68.88 ,$221.40 ,$58.77 ,$221.40 ,$221.40 ,$58.77 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000072,97597,HC DEBR SKIN PART THICKNESS <20CM FAC,510,1 ,$554.00 ,$360.10 ,$83.00 ,$554.00 ,$455.17 ,$412.73 ,$362.87 ,$189.61 ,$155.12 ,$279.77 ,$189.61 ,$341.82 ,$189.61 ,$341.82 ,$341.82 ,$189.61 ,$341.82 ,$360.26 ,$498.60 ,$415.50 ,$455.17 ,$189.61 ,$487.52 ,$189.61 ,$415.50 ,$415.50 ,$470.90 ,$470.90 ,$189.61 ,$470.90 ,$189.61 ,$432.12 ,$432.12 ,$432.12 ,$498.60 ,$455.17 ,$498.60 ,$189.61 ,$554.00 ,$362.87 ,$189.61 ,$230.46 ,$86.96 ,$83.00 ,$198.46 ,$498.60 ,$410.91 ,$341.82 ,$155.12 ,$498.60 ,$189.61 ,$498.60 ,$498.60 ,$189.61 ,$360.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$330.00 ,$214.50 ,$78.75 ,$330.00 , N/A ,$245.85 ,$216.15 , N/A ,$92.40 ,$166.65 , N/A ,$203.61 , N/A ,$203.61 ,$203.61 , N/A ,$203.61 , N/A ,$297.00 ,$247.50 , N/A , N/A ,$290.40 , N/A ,$247.50 ,$247.50 ,$280.50 ,$280.50 , N/A ,$280.50 , N/A ,$257.40 ,$257.40 ,$257.40 ,$297.00 , N/A ,$297.00 , N/A ,$78.75 ,$216.15 , N/A ,$137.28 ,$102.37 ,$97.71 , N/A ,$297.00 , N/A ,$203.61 ,$92.40 ,$297.00 , N/A ,$297.00 ,$297.00 , N/A ,$214.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$429.00 ,$278.85 ,$97.71 ,$429.00 , N/A ,$319.61 ,$281.00 , N/A ,$120.12 ,$216.65 , N/A ,$264.69 , N/A ,$264.69 ,$264.69 , N/A ,$264.69 , N/A ,$386.10 ,$321.75 , N/A , N/A ,$377.52 , N/A ,$321.75 ,$321.75 ,$364.65 ,$364.65 , N/A ,$364.65 , N/A ,$334.62 ,$334.62 ,$334.62 ,$386.10 , N/A ,$386.10 , N/A ,$121.24 ,$281.00 , N/A ,$178.46 ,$102.37 ,$97.71 , N/A ,$386.10 , N/A ,$264.69 ,$120.12 ,$386.10 , N/A ,$386.10 ,$386.10 , N/A ,$278.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$543.00 ,$352.95 ,$97.71 ,$543.00 , N/A ,$404.54 ,$355.67 , N/A ,$152.04 ,$274.22 , N/A ,$335.03 , N/A ,$335.03 ,$335.03 , N/A ,$335.03 , N/A ,$488.70 ,$407.25 , N/A , N/A ,$477.84 , N/A ,$407.25 ,$407.25 ,$461.55 ,$461.55 , N/A ,$461.55 , N/A ,$423.54 ,$423.54 ,$423.54 ,$488.70 , N/A ,$488.70 , N/A ,$181.05 ,$355.67 , N/A ,$225.89 ,$102.37 ,$97.71 , N/A ,$488.70 , N/A ,$335.03 ,$152.04 ,$488.70 , N/A ,$488.70 ,$488.70 , N/A ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000113,99205,HC CLINIC VISIT COMPREH NEW,510,1 ,$773.00 ,$502.45 ,$97.71 ,$773.00 , N/A ,$575.89 ,$506.32 , N/A ,$216.44 ,$390.37 , N/A ,$476.94 , N/A ,$476.94 ,$476.94 , N/A ,$476.94 , N/A ,$695.70 ,$579.75 , N/A , N/A ,$680.24 , N/A ,$579.75 ,$579.75 ,$657.05 ,$657.05 , N/A ,$657.05 , N/A ,$602.94 ,$602.94 ,$602.94 ,$695.70 , N/A ,$695.70 , N/A ,$239.15 ,$506.32 , N/A ,$321.57 ,$102.37 ,$97.71 , N/A ,$695.70 , N/A ,$476.94 ,$216.44 ,$695.70 , N/A ,$695.70 ,$695.70 , N/A ,$502.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$158.00 ,$102.70 ,$44.24 ,$158.00 , N/A ,$117.71 ,$103.49 , N/A ,$44.24 ,$79.79 , N/A ,$97.49 , N/A ,$97.49 ,$97.49 , N/A ,$97.49 , N/A ,$142.20 ,$118.50 , N/A , N/A ,$139.04 , N/A ,$118.50 ,$118.50 ,$134.30 ,$134.30 , N/A ,$134.30 , N/A ,$123.24 ,$123.24 ,$123.24 ,$142.20 , N/A ,$142.20 , N/A ,$158.00 ,$103.49 , N/A ,$65.73 ,$102.37 ,$97.71 , N/A ,$142.20 , N/A ,$97.49 ,$44.24 ,$142.20 , N/A ,$142.20 ,$142.20 , N/A ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$277.00 ,$180.05 ,$60.02 ,$277.00 , N/A ,$206.37 ,$181.44 , N/A ,$77.56 ,$139.89 , N/A ,$170.91 , N/A ,$170.91 ,$170.91 , N/A ,$170.91 , N/A ,$249.30 ,$207.75 , N/A , N/A ,$243.76 , N/A ,$207.75 ,$207.75 ,$235.45 ,$235.45 , N/A ,$235.45 , N/A ,$216.06 ,$216.06 ,$216.06 ,$249.30 , N/A ,$249.30 , N/A ,$60.02 ,$181.44 , N/A ,$115.23 ,$102.37 ,$97.71 , N/A ,$249.30 , N/A ,$170.91 ,$77.56 ,$249.30 , N/A ,$249.30 ,$249.30 , N/A ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$341.00 ,$221.65 ,$95.48 ,$341.00 , N/A ,$254.05 ,$223.36 , N/A ,$95.48 ,$172.21 , N/A ,$210.40 , N/A ,$210.40 ,$210.40 , N/A ,$210.40 , N/A ,$306.90 ,$255.75 , N/A , N/A ,$300.08 , N/A ,$255.75 ,$255.75 ,$289.85 ,$289.85 , N/A ,$289.85 , N/A ,$265.98 ,$265.98 ,$265.98 ,$306.90 , N/A ,$306.90 , N/A ,$97.92 ,$223.36 , N/A ,$141.86 ,$102.37 ,$97.71 , N/A ,$306.90 , N/A ,$210.40 ,$95.48 ,$306.90 , N/A ,$306.90 ,$306.90 , N/A ,$221.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$429.00 ,$278.85 ,$97.71 ,$429.00 , N/A ,$319.61 ,$281.00 , N/A ,$120.12 ,$216.65 , N/A ,$264.69 , N/A ,$264.69 ,$264.69 , N/A ,$264.69 , N/A ,$386.10 ,$321.75 , N/A , N/A ,$377.52 , N/A ,$321.75 ,$321.75 ,$364.65 ,$364.65 , N/A ,$364.65 , N/A ,$334.62 ,$334.62 ,$334.62 ,$386.10 , N/A ,$386.10 , N/A ,$429.00 ,$281.00 , N/A ,$178.46 ,$102.37 ,$97.71 , N/A ,$386.10 , N/A ,$264.69 ,$120.12 ,$386.10 , N/A ,$386.10 ,$386.10 , N/A ,$278.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$543.00 ,$352.95 ,$97.71 ,$543.00 , N/A ,$404.54 ,$355.67 , N/A ,$152.04 ,$274.22 , N/A ,$335.03 , N/A ,$335.03 ,$335.03 , N/A ,$335.03 , N/A ,$488.70 ,$407.25 , N/A , N/A ,$477.84 , N/A ,$407.25 ,$407.25 ,$461.55 ,$461.55 , N/A ,$461.55 , N/A ,$423.54 ,$423.54 ,$423.54 ,$488.70 , N/A ,$488.70 , N/A ,$543.00 ,$355.67 , N/A ,$225.89 ,$102.37 ,$97.71 , N/A ,$488.70 , N/A ,$335.03 ,$152.04 ,$488.70 , N/A ,$488.70 ,$488.70 , N/A ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$100.50 ,$65.33 ,$3.00 ,$100.50 ,$7.50 ,$74.87 ,$65.83 ,$3.00 ,$28.14 ,$50.75 ,$3.00 ,$62.01 ,$3.00 ,$62.01 ,$62.01 ,$3.00 ,$62.01 ,$5.70 ,$90.45 ,$75.38 ,$7.50 ,$3.00 ,$88.44 ,$3.00 ,$75.38 ,$75.38 ,$85.43 ,$85.43 ,$3.00 ,$85.43 ,$3.00 ,$78.39 ,$78.39 ,$78.39 ,$90.45 ,$7.50 ,$90.45 ,$3.00 ,$100.50 ,$65.83 ,$3.00 ,$41.81 , N/A , N/A ,$3.15 ,$90.45 ,$6.75 ,$62.01 ,$28.14 ,$90.45 ,$3.00 ,$90.45 ,$90.45 ,$3.00 ,$65.33 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$466.00 ,$302.90 ,$83.00 ,$466.00 ,$285.81 ,$347.17 ,$305.23 ,$119.06 ,$130.48 ,$235.33 ,$119.06 ,$287.52 ,$119.06 ,$287.52 ,$287.52 ,$119.06 ,$287.52 ,$226.21 ,$419.40 ,$349.50 ,$285.81 ,$119.06 ,$410.08 ,$119.06 ,$349.50 ,$349.50 ,$396.10 ,$396.10 ,$119.06 ,$396.10 ,$119.06 ,$363.48 ,$363.48 ,$363.48 ,$419.40 ,$285.81 ,$419.40 ,$119.06 ,$466.00 ,$305.23 ,$119.06 ,$193.86 ,$86.96 ,$83.00 ,$124.62 ,$419.40 ,$258.02 ,$287.52 ,$130.48 ,$419.40 ,$119.06 ,$419.40 ,$419.40 ,$119.06 ,$302.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000172,51702,HC CATH BLADDER SMP,510,1 ,$466.00 ,$302.90 ,$83.00 ,$466.00 ,$285.81 ,$347.17 ,$305.23 ,$119.06 ,$130.48 ,$235.33 ,$119.06 ,$287.52 ,$119.06 ,$287.52 ,$287.52 ,$119.06 ,$287.52 ,$226.21 ,$419.40 ,$349.50 ,$285.81 ,$119.06 ,$410.08 ,$119.06 ,$349.50 ,$349.50 ,$396.10 ,$396.10 ,$119.06 ,$396.10 ,$119.06 ,$363.48 ,$363.48 ,$363.48 ,$419.40 ,$285.81 ,$419.40 ,$119.06 ,$466.00 ,$305.23 ,$119.06 ,$193.86 ,$86.96 ,$83.00 ,$124.62 ,$419.40 ,$258.02 ,$287.52 ,$130.48 ,$419.40 ,$119.06 ,$419.40 ,$419.40 ,$119.06 ,$302.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000173,51703,HC CATH BLADDER CPLX,510,1 ,$397.00 ,$258.05 ,$83.00 ,$397.00 ,$353.89 ,$295.77 ,$260.04 ,$147.42 ,$111.16 ,$200.49 ,$147.42 ,$244.95 ,$147.42 ,$244.95 ,$244.95 ,$147.42 ,$244.95 ,$280.10 ,$357.30 ,$297.75 ,$353.89 ,$147.42 ,$349.36 ,$147.42 ,$297.75 ,$297.75 ,$337.45 ,$337.45 ,$147.42 ,$337.45 ,$147.42 ,$309.66 ,$309.66 ,$309.66 ,$357.30 ,$353.89 ,$357.30 ,$147.42 ,$397.00 ,$260.04 ,$147.42 ,$165.15 ,$86.96 ,$83.00 ,$154.30 ,$357.30 ,$319.47 ,$244.95 ,$111.16 ,$357.30 ,$147.42 ,$357.30 ,$357.30 ,$147.42 ,$258.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000207,52000,HC CYSTOURETHROSCOPY,510,1 ,"$1,636.68 ","$1,063.84 ",$458.27 ,"$1,636.68 ","$1,458.23 ","$1,219.33 ","$1,072.03 ",$607.45 ,$458.27 ,$826.52 ,$607.45 ,"$1,009.83 ",$607.45 ,"$1,009.83 ","$1,009.83 ",$607.45 ,"$1,009.83 ","$1,154.16 ","$1,473.01 ","$1,227.51 ","$1,458.23 ",$607.45 ,"$1,440.28 ",$607.45 ,"$1,227.51 ","$1,227.51 ","$1,391.18 ","$1,391.18 ",$607.45 ,"$1,391.18 ",$607.45 ,"$1,276.61 ","$1,276.61 ","$1,276.61 ","$1,473.01 ","$1,458.23 ","$1,473.01 ",$607.45 ,"$1,636.68 ","$1,072.03 ",$607.45 ,$680.86 ,$790.36 ,$754.44 ,$635.81 ,"$1,473.01 ","$1,316.43 ","$1,009.83 ",$458.27 ,"$1,473.01 ",$607.45 ,"$1,473.01 ","$1,473.01 ",$607.45 ,"$1,063.84 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000315,38222,HC BM ASPIRATION (BX/ASP SAME SITE),360,1 ,"$7,110.03 ","$4,621.52 ",$422.78 ,"$7,110.03 ","$6,009.89 ","$5,296.97 ","$4,657.07 ","$2,503.54 ","$1,990.81 ","$3,590.57 ","$2,503.54 ","$4,386.89 ","$2,503.54 ","$4,386.89 ","$4,386.89 ","$2,503.54 ","$4,386.89 ","$4,756.73 ","$6,399.03 ","$5,332.52 ","$6,009.89 ","$2,503.54 ","$6,256.83 ","$2,503.54 ","$5,332.52 ","$5,332.52 ","$6,043.53 ","$6,043.53 ","$2,503.54 ","$6,043.53 ","$2,503.54 ","$5,545.82 ","$5,545.82 ","$5,545.82 ","$6,399.03 ","$6,009.89 ","$6,399.03 ","$2,503.54 ","$7,110.03 ","$4,657.07 ","$2,503.54 ","$2,957.77 ",$442.92 ,$422.78 ,"$2,620.42 ","$6,399.03 ","$5,425.50 ","$4,386.89 ","$1,990.81 ","$6,399.03 ","$2,503.54 ","$6,399.03 ","$6,399.03 ","$2,503.54 ","$4,621.52 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000325,15271,HC APL SKIN SUB TAL<100 INT 25CM,761,1 ,$994.00 ,$646.10 ,$278.32 ,"$3,919.23 ",$994.00 ,$740.53 ,$651.07 ,$994.00 ,$278.32 ,$501.97 ,$994.00 ,$613.30 ,$994.00 ,$613.30 ,$613.30 ,$994.00 ,$613.30 ,"$3,436.13 ",$894.60 ,$745.50 ,$994.00 ,$994.00 ,$874.72 ,$994.00 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$994.00 ,$844.90 ,$994.00 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$994.00 ,$894.60 ,$994.00 ,$994.00 ,$651.07 ,$994.00 ,$413.50 ,$994.00 ,$994.00 ,$994.00 ,$894.60 ,"$3,919.23 ",$613.30 ,$278.32 ,$894.60 ,$994.00 ,$894.60 ,$894.60 ,$994.00 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000326,15272,HC APL SKIN SUB TAL<100 ADL 25CM,761,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 ,$366.00 ,$366.00 , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000327,15273,HC APL SKIN SUB TAL>100 INT 100CM,761,1 ,"$1,514.00 ",$984.10 ,$423.92 ,"$8,057.36 ","$1,514.00 ","$1,127.93 ",$991.67 ,"$1,514.00 ",$423.92 ,$764.57 ,"$1,514.00 ",$934.14 ,"$1,514.00 ",$934.14 ,$934.14 ,"$1,514.00 ",$934.14 ,"$7,064.16 ","$1,362.60 ","$1,135.50 ","$1,514.00 ","$1,514.00 ","$1,332.32 ","$1,514.00 ","$1,135.50 ","$1,135.50 ","$1,286.90 ","$1,286.90 ","$1,514.00 ","$1,286.90 ","$1,514.00 ","$1,180.92 ","$1,180.92 ","$1,180.92 ","$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,514.00 ","$1,514.00 ",$991.67 ,"$1,514.00 ",$629.82 ,"$1,153.41 ","$1,100.98 ","$1,514.00 ","$1,362.60 ","$8,057.36 ",$934.14 ,$423.92 ,"$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,362.60 ","$1,514.00 ",$984.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000328,15274,HC APL SKIN SUB TAL>100 ADL 100CM,761,1 ,$994.00 ,$646.10 ,$278.32 ,$994.00 , N/A ,$740.53 ,$651.07 , N/A ,$278.32 ,$501.97 , N/A ,$613.30 , N/A ,$613.30 ,$613.30 , N/A ,$613.30 , N/A ,$894.60 ,$745.50 , N/A , N/A ,$874.72 , N/A ,$745.50 ,$745.50 ,$844.90 ,$844.90 , N/A ,$844.90 , N/A ,$775.32 ,$775.32 ,$775.32 ,$894.60 , N/A ,$894.60 , N/A ,$994.00 ,$651.07 , N/A ,$413.50 ,$994.00 ,$994.00 , N/A ,$894.60 , N/A ,$613.30 ,$278.32 ,$894.60 , N/A ,$894.60 ,$894.60 , N/A ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000329,15275,HC APL SKIN SUB OTH<100 INT 25CM,761,1 ,$994.00 ,$646.10 ,$278.32 ,"$3,919.23 ",$994.00 ,$740.53 ,$651.07 ,$994.00 ,$278.32 ,$501.97 ,$994.00 ,$613.30 ,$994.00 ,$613.30 ,$613.30 ,$994.00 ,$613.30 ,"$3,436.13 ",$894.60 ,$745.50 ,$994.00 ,$994.00 ,$874.72 ,$994.00 ,$745.50 ,$745.50 ,$844.90 ,$844.90 ,$994.00 ,$844.90 ,$994.00 ,$775.32 ,$775.32 ,$775.32 ,$894.60 ,$994.00 ,$894.60 ,$994.00 ,$994.00 ,$651.07 ,$994.00 ,$413.50 ,$994.00 ,$994.00 ,$994.00 ,$894.60 ,"$3,919.23 ",$613.30 ,$278.32 ,$894.60 ,$994.00 ,$894.60 ,$894.60 ,$994.00 ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000330,15276,HC APL SKIN SUB OTH<100 ADL 25CM,761,1 ,$366.00 ,$237.90 ,$102.48 ,$366.00 , N/A ,$272.67 ,$239.73 , N/A ,$102.48 ,$184.83 , N/A ,$225.82 , N/A ,$225.82 ,$225.82 , N/A ,$225.82 , N/A ,$329.40 ,$274.50 , N/A , N/A ,$322.08 , N/A ,$274.50 ,$274.50 ,$311.10 ,$311.10 , N/A ,$311.10 , N/A ,$285.48 ,$285.48 ,$285.48 ,$329.40 , N/A ,$329.40 , N/A ,$366.00 ,$239.73 , N/A ,$152.26 ,$366.00 ,$366.00 , N/A ,$329.40 , N/A ,$225.82 ,$102.48 ,$329.40 , N/A ,$329.40 ,$329.40 , N/A ,$237.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000331,15277,HC APL SKIN SUB OTH>100 INT 100CM,761,1 ,"$1,514.00 ",$984.10 ,$423.92 ,"$3,919.23 ","$1,514.00 ","$1,127.93 ",$991.67 ,"$1,514.00 ",$423.92 ,$764.57 ,"$1,514.00 ",$934.14 ,"$1,514.00 ",$934.14 ,$934.14 ,"$1,514.00 ",$934.14 ,"$3,436.13 ","$1,362.60 ","$1,135.50 ","$1,514.00 ","$1,514.00 ","$1,332.32 ","$1,514.00 ","$1,135.50 ","$1,135.50 ","$1,286.90 ","$1,286.90 ","$1,514.00 ","$1,286.90 ","$1,514.00 ","$1,180.92 ","$1,180.92 ","$1,180.92 ","$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,514.00 ","$1,514.00 ",$991.67 ,"$1,514.00 ",$629.82 ,"$1,153.41 ","$1,100.98 ","$1,514.00 ","$1,362.60 ","$3,919.23 ",$934.14 ,$423.92 ,"$1,362.60 ","$1,514.00 ","$1,362.60 ","$1,362.60 ","$1,514.00 ",$984.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000332,15278,HC APL SKIN SUB OTH>100 ADL 100CM,761,1 ,$994.00 ,$646.10 ,$278.32 ,$994.00 , N/A ,$740.53 ,$651.07 , N/A ,$278.32 ,$501.97 , N/A ,$613.30 , N/A ,$613.30 ,$613.30 , N/A ,$613.30 , N/A ,$894.60 ,$745.50 , N/A , N/A ,$874.72 , N/A ,$745.50 ,$745.50 ,$844.90 ,$844.90 , N/A ,$844.90 , N/A ,$775.32 ,$775.32 ,$775.32 ,$894.60 , N/A ,$894.60 , N/A ,$994.00 ,$651.07 , N/A ,$413.50 ,$994.00 ,$994.00 , N/A ,$894.60 , N/A ,$613.30 ,$278.32 ,$894.60 , N/A ,$894.60 ,$894.60 , N/A ,$646.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000352,11057,HC PARING LESN BENIGN >4 FAC,510,1 ,$334.00 ,$217.10 ,$93.52 ,$410.91 ,$334.00 ,$248.83 ,$218.77 ,$189.61 ,$93.52 ,$168.67 ,$189.61 ,$206.08 ,$189.61 ,$206.08 ,$206.08 ,$189.61 ,$206.08 ,$360.26 ,$300.60 ,$250.50 ,$334.00 ,$189.61 ,$293.92 ,$189.61 ,$250.50 ,$250.50 ,$283.90 ,$283.90 ,$189.61 ,$283.90 ,$189.61 ,$260.52 ,$260.52 ,$260.52 ,$300.60 ,$334.00 ,$300.60 ,$189.61 ,$334.00 ,$218.77 ,$189.61 ,$138.94 ,$223.26 ,$213.11 ,$198.46 ,$300.60 ,$410.91 ,$206.08 ,$93.52 ,$300.60 ,$189.61 ,$300.60 ,$300.60 ,$189.61 ,$217.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000400,29580,HC APPLY UNNA BOOT BILAT FAC,510,1 ,$605.00 ,$393.25 ,$169.40 ,$605.00 ,$537.16 ,$450.73 ,$396.28 ,$223.76 ,$169.40 ,$305.53 ,$223.76 ,$373.29 ,$223.76 ,$373.29 ,$373.29 ,$223.76 ,$373.29 ,$425.14 ,$544.50 ,$453.75 ,$537.16 ,$223.76 ,$532.40 ,$223.76 ,$453.75 ,$453.75 ,$514.25 ,$514.25 ,$223.76 ,$514.25 ,$223.76 ,$471.90 ,$471.90 ,$471.90 ,$544.50 ,$537.16 ,$544.50 ,$223.76 ,$605.00 ,$396.28 ,$223.76 ,$251.68 ,$275.25 ,$262.74 ,$234.21 ,$544.50 ,$484.92 ,$373.29 ,$169.40 ,$544.50 ,$223.76 ,$544.50 ,$544.50 ,$223.76 ,$393.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000401,29581,HC APPLY MULTI COMP LWR LEG BIL FAC,510,1 ,$565.00 ,$367.25 ,$158.20 ,$565.00 ,$537.16 ,$420.93 ,$370.08 ,$223.76 ,$158.20 ,$285.33 ,$223.76 ,$348.61 ,$223.76 ,$348.61 ,$348.61 ,$223.76 ,$348.61 ,$425.14 ,$508.50 ,$423.75 ,$537.16 ,$223.76 ,$497.20 ,$223.76 ,$423.75 ,$423.75 ,$480.25 ,$480.25 ,$223.76 ,$480.25 ,$223.76 ,$440.70 ,$440.70 ,$440.70 ,$508.50 ,$537.16 ,$508.50 ,$223.76 ,$565.00 ,$370.08 ,$223.76 ,$235.04 ,$275.25 ,$262.74 ,$234.21 ,$508.50 ,$484.92 ,$348.61 ,$158.20 ,$508.50 ,$223.76 ,$508.50 ,$508.50 ,$223.76 ,$367.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000407,11200,HC REMOVAL SKIN TAG LESIONS <=15 FAC,510,1 ,$501.00 ,$325.65 ,$140.28 ,$501.00 ,$455.17 ,$373.25 ,$328.16 ,$189.61 ,$140.28 ,$253.01 ,$189.61 ,$309.12 ,$189.61 ,$309.12 ,$309.12 ,$189.61 ,$309.12 ,$360.26 ,$450.90 ,$375.75 ,$455.17 ,$189.61 ,$440.88 ,$189.61 ,$375.75 ,$375.75 ,$425.85 ,$425.85 ,$189.61 ,$425.85 ,$189.61 ,$390.78 ,$390.78 ,$390.78 ,$450.90 ,$455.17 ,$450.90 ,$189.61 ,$501.00 ,$328.16 ,$189.61 ,$208.42 ,$223.26 ,$213.11 ,$198.46 ,$450.90 ,$410.91 ,$309.12 ,$140.28 ,$450.90 ,$189.61 ,$450.90 ,$450.90 ,$189.61 ,$325.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000445,99202,HC SPORTS PHYSICAL,510,1 ,$50.00 ,$32.50 ,$14.00 ,$50.00 , N/A ,$37.25 ,$32.75 , N/A ,$14.00 ,$25.25 , N/A ,$30.85 , N/A ,$30.85 ,$30.85 , N/A ,$30.85 , N/A ,$45.00 ,$37.50 , N/A , N/A ,$44.00 , N/A ,$37.50 ,$37.50 ,$42.50 ,$42.50 , N/A ,$42.50 , N/A ,$39.00 ,$39.00 ,$39.00 ,$45.00 , N/A ,$45.00 , N/A ,$50.00 ,$32.75 , N/A ,$20.80 ,$50.00 ,$50.00 , N/A ,$45.00 , N/A ,$30.85 ,$14.00 ,$45.00 , N/A ,$45.00 ,$45.00 , N/A ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000446,99211,HC SCHOOL PHYSICAL,510,1 ,$50.00 ,$32.50 ,$14.00 ,$50.00 , N/A ,$37.25 ,$32.75 , N/A ,$14.00 ,$25.25 , N/A ,$30.85 , N/A ,$30.85 ,$30.85 , N/A ,$30.85 , N/A ,$45.00 ,$37.50 , N/A , N/A ,$44.00 , N/A ,$37.50 ,$37.50 ,$42.50 ,$42.50 , N/A ,$42.50 , N/A ,$39.00 ,$39.00 ,$39.00 ,$45.00 , N/A ,$45.00 , N/A ,$50.00 ,$32.75 , N/A ,$20.80 ,$50.00 ,$50.00 , N/A ,$45.00 , N/A ,$30.85 ,$14.00 ,$45.00 , N/A ,$45.00 ,$45.00 , N/A ,$32.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000464,99202,HC CLINIC VISIT LIMITED NEW -25,510,1 ,$330.00 ,$214.50 ,$78.75 ,$330.00 , N/A ,$245.85 ,$216.15 , N/A ,$92.40 ,$166.65 , N/A ,$203.61 , N/A ,$203.61 ,$203.61 , N/A ,$203.61 , N/A ,$297.00 ,$247.50 , N/A , N/A ,$290.40 , N/A ,$247.50 ,$247.50 ,$280.50 ,$280.50 , N/A ,$280.50 , N/A ,$257.40 ,$257.40 ,$257.40 ,$297.00 , N/A ,$297.00 , N/A ,$78.75 ,$216.15 , N/A ,$137.28 ,$102.37 ,$97.71 , N/A ,$297.00 , N/A ,$203.61 ,$92.40 ,$297.00 , N/A ,$297.00 ,$297.00 , N/A ,$214.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000465,99203,HC CLINIC VISIT INTERM NEW -25,510,1 ,$429.00 ,$278.85 ,$97.71 ,$429.00 , N/A ,$319.61 ,$281.00 , N/A ,$120.12 ,$216.65 , N/A ,$264.69 , N/A ,$264.69 ,$264.69 , N/A ,$264.69 , N/A ,$386.10 ,$321.75 , N/A , N/A ,$377.52 , N/A ,$321.75 ,$321.75 ,$364.65 ,$364.65 , N/A ,$364.65 , N/A ,$334.62 ,$334.62 ,$334.62 ,$386.10 , N/A ,$386.10 , N/A ,$121.24 ,$281.00 , N/A ,$178.46 ,$102.37 ,$97.71 , N/A ,$386.10 , N/A ,$264.69 ,$120.12 ,$386.10 , N/A ,$386.10 ,$386.10 , N/A ,$278.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000466,99204,HC CLINIC VISIT COMPLEX NEW -25,510,1 ,$543.00 ,$352.95 ,$97.71 ,$543.00 , N/A ,$404.54 ,$355.67 , N/A ,$152.04 ,$274.22 , N/A ,$335.03 , N/A ,$335.03 ,$335.03 , N/A ,$335.03 , N/A ,$488.70 ,$407.25 , N/A , N/A ,$477.84 , N/A ,$407.25 ,$407.25 ,$461.55 ,$461.55 , N/A ,$461.55 , N/A ,$423.54 ,$423.54 ,$423.54 ,$488.70 , N/A ,$488.70 , N/A ,$181.05 ,$355.67 , N/A ,$225.89 ,$102.37 ,$97.71 , N/A ,$488.70 , N/A ,$335.03 ,$152.04 ,$488.70 , N/A ,$488.70 ,$488.70 , N/A ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000467,99205,HC CLINIC VISIT COMPREH NEW -25,510,1 ,$773.00 ,$502.45 ,$97.71 ,$773.00 , N/A ,$575.89 ,$506.32 , N/A ,$216.44 ,$390.37 , N/A ,$476.94 , N/A ,$476.94 ,$476.94 , N/A ,$476.94 , N/A ,$695.70 ,$579.75 , N/A , N/A ,$680.24 , N/A ,$579.75 ,$579.75 ,$657.05 ,$657.05 , N/A ,$657.05 , N/A ,$602.94 ,$602.94 ,$602.94 ,$695.70 , N/A ,$695.70 , N/A ,$239.15 ,$506.32 , N/A ,$321.57 ,$102.37 ,$97.71 , N/A ,$695.70 , N/A ,$476.94 ,$216.44 ,$695.70 , N/A ,$695.70 ,$695.70 , N/A ,$502.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000468,99211,HC CLINIC VISIT BRIEF ESTAB -25,510,1 ,$158.00 ,$102.70 ,$44.24 ,$158.00 , N/A ,$117.71 ,$103.49 , N/A ,$44.24 ,$79.79 , N/A ,$97.49 , N/A ,$97.49 ,$97.49 , N/A ,$97.49 , N/A ,$142.20 ,$118.50 , N/A , N/A ,$139.04 , N/A ,$118.50 ,$118.50 ,$134.30 ,$134.30 , N/A ,$134.30 , N/A ,$123.24 ,$123.24 ,$123.24 ,$142.20 , N/A ,$142.20 , N/A ,$158.00 ,$103.49 , N/A ,$65.73 ,$102.37 ,$97.71 , N/A ,$142.20 , N/A ,$97.49 ,$44.24 ,$142.20 , N/A ,$142.20 ,$142.20 , N/A ,$102.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000469,99212,HC CLINIC VISIT LIMITED ESTAB -25,510,1 ,$277.00 ,$180.05 ,$60.02 ,$277.00 , N/A ,$206.37 ,$181.44 , N/A ,$77.56 ,$139.89 , N/A ,$170.91 , N/A ,$170.91 ,$170.91 , N/A ,$170.91 , N/A ,$249.30 ,$207.75 , N/A , N/A ,$243.76 , N/A ,$207.75 ,$207.75 ,$235.45 ,$235.45 , N/A ,$235.45 , N/A ,$216.06 ,$216.06 ,$216.06 ,$249.30 , N/A ,$249.30 , N/A ,$60.02 ,$181.44 , N/A ,$115.23 ,$102.37 ,$97.71 , N/A ,$249.30 , N/A ,$170.91 ,$77.56 ,$249.30 , N/A ,$249.30 ,$249.30 , N/A ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000470,99213,HC CLINIC VISIT INTERM EST -25,510,1 ,$341.00 ,$221.65 ,$95.48 ,$341.00 , N/A ,$254.05 ,$223.36 , N/A ,$95.48 ,$172.21 , N/A ,$210.40 , N/A ,$210.40 ,$210.40 , N/A ,$210.40 , N/A ,$306.90 ,$255.75 , N/A , N/A ,$300.08 , N/A ,$255.75 ,$255.75 ,$289.85 ,$289.85 , N/A ,$289.85 , N/A ,$265.98 ,$265.98 ,$265.98 ,$306.90 , N/A ,$306.90 , N/A ,$97.92 ,$223.36 , N/A ,$141.86 ,$102.37 ,$97.71 , N/A ,$306.90 , N/A ,$210.40 ,$95.48 ,$306.90 , N/A ,$306.90 ,$306.90 , N/A ,$221.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000471,99214,HC CLINIC VISIT COMPLEX EST -25,510,1 ,$429.00 ,$278.85 ,$97.71 ,$429.00 , N/A ,$319.61 ,$281.00 , N/A ,$120.12 ,$216.65 , N/A ,$264.69 , N/A ,$264.69 ,$264.69 , N/A ,$264.69 , N/A ,$386.10 ,$321.75 , N/A , N/A ,$377.52 , N/A ,$321.75 ,$321.75 ,$364.65 ,$364.65 , N/A ,$364.65 , N/A ,$334.62 ,$334.62 ,$334.62 ,$386.10 , N/A ,$386.10 , N/A ,$429.00 ,$281.00 , N/A ,$178.46 ,$102.37 ,$97.71 , N/A ,$386.10 , N/A ,$264.69 ,$120.12 ,$386.10 , N/A ,$386.10 ,$386.10 , N/A ,$278.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51000472,99215,HC CLINIC VISIT COMPREH EST -25,510,1 ,$543.00 ,$352.95 ,$97.71 ,$543.00 , N/A ,$404.54 ,$355.67 , N/A ,$152.04 ,$274.22 , N/A ,$335.03 , N/A ,$335.03 ,$335.03 , N/A ,$335.03 , N/A ,$488.70 ,$407.25 , N/A , N/A ,$477.84 , N/A ,$407.25 ,$407.25 ,$461.55 ,$461.55 , N/A ,$461.55 , N/A ,$423.54 ,$423.54 ,$423.54 ,$488.70 , N/A ,$488.70 , N/A ,$543.00 ,$355.67 , N/A ,$225.89 ,$102.37 ,$97.71 , N/A ,$488.70 , N/A ,$335.03 ,$152.04 ,$488.70 , N/A ,$488.70 ,$488.70 , N/A ,$352.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51070001,98960,HC EDUCATION SELF MGNT NON PHY HLTCARE PROF,510,1 ,$115.00 ,$74.75 ,$25.08 ,$115.00 , N/A ,$85.68 ,$75.33 , N/A ,$32.20 ,$58.08 , N/A ,$70.96 , N/A ,$70.96 ,$70.96 , N/A ,$70.96 , N/A ,$103.50 ,$86.25 , N/A , N/A ,$101.20 , N/A ,$86.25 ,$86.25 ,$97.75 ,$97.75 , N/A ,$97.75 , N/A ,$89.70 ,$89.70 ,$89.70 ,$103.50 , N/A ,$103.50 , N/A ,$115.00 ,$75.33 , N/A ,$47.84 ,$26.28 ,$25.08 , N/A ,$103.50 , N/A ,$70.96 ,$32.20 ,$103.50 , N/A ,$103.50 ,$103.50 , N/A ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),51100000,62370,HC ELEC ANLYS REPRGRMING/REFILL SPINAL INF PUMP PHYSICIAN,511,1 ,$777.00 ,$505.05 ,$176.06 ,$777.00 ,$692.09 ,$578.87 ,$508.94 ,$288.30 ,$217.56 ,$392.39 ,$288.30 ,$479.41 ,$288.30 ,$479.41 ,$479.41 ,$288.30 ,$479.41 ,$547.77 ,$699.30 ,$582.75 ,$692.09 ,$288.30 ,$683.76 ,$288.30 ,$582.75 ,$582.75 ,$660.45 ,$660.45 ,$288.30 ,$660.45 ,$288.30 ,$606.06 ,$606.06 ,$606.06 ,$699.30 ,$692.09 ,$699.30 ,$288.30 ,$777.00 ,$508.94 ,$288.30 ,$323.23 ,$184.45 ,$176.06 ,$301.76 ,$699.30 ,$624.79 ,$479.41 ,$217.56 ,$699.30 ,$288.30 ,$699.30 ,$699.30 ,$288.30 ,$505.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),54200001,N/A,HC MEDICAL TRANSPORT/AMBULANCE PER HR,542,1 ,$207.00 ,$134.55 ,$57.96 ,$207.00 , N/A ,$154.22 ,$135.59 , N/A ,$57.96 ,$104.54 , N/A ,$127.72 , N/A ,$127.72 ,$127.72 , N/A ,$127.72 , N/A ,$186.30 ,$155.25 , N/A , N/A ,$182.16 , N/A ,$155.25 ,$155.25 ,$175.95 ,$175.95 , N/A ,$175.95 , N/A ,$161.46 ,$161.46 ,$161.46 ,$186.30 , N/A ,$186.30 , N/A ,$207.00 ,$135.59 , N/A ,$86.11 , N/A , N/A , N/A ,$186.30 , N/A ,$127.72 ,$57.96 ,$186.30 , N/A ,$186.30 ,$186.30 , N/A ,$134.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$4,337.00 ","$2,819.05 ",$240.78 ,"$4,337.00 ",$933.39 ,"$3,231.07 ","$2,840.74 ",$388.82 ,"$1,214.36 ","$2,190.19 ",$388.82 ,"$2,675.93 ",$388.82 ,"$2,675.93 ","$2,675.93 ",$388.82 ,"$2,675.93 ",$738.76 ,"$3,903.30 ","$3,252.75 ",$933.39 ,$388.82 ,"$3,816.56 ",$388.82 ,"$3,252.75 ","$3,252.75 ","$3,686.45 ","$3,686.45 ",$388.82 ,"$3,686.45 ",$388.82 ,"$3,382.86 ","$3,382.86 ","$3,382.86 ","$3,903.30 ",$933.39 ,"$3,903.30 ",$388.82 ,"$4,337.00 ","$2,840.74 ",$388.82 ,"$1,804.19 ",$252.24 ,$240.78 ,$406.98 ,"$3,903.30 ",$842.63 ,"$2,675.93 ","$1,214.36 ","$3,903.30 ",$388.82 ,"$3,903.30 ","$3,903.30 ",$388.82 ,"$2,819.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$3,081.00 ","$2,002.65 ",$242.96 ,"$3,081.00 ",$583.23 ,"$2,295.35 ","$2,018.06 ",$242.96 ,$862.68 ,"$1,555.91 ",$242.96 ,"$1,900.98 ",$242.96 ,"$1,900.98 ","$1,900.98 ",$242.96 ,"$1,900.98 ",$461.62 ,"$2,772.90 ","$2,310.75 ",$583.23 ,$242.96 ,"$2,711.28 ",$242.96 ,"$2,310.75 ","$2,310.75 ","$2,618.85 ","$2,618.85 ",$242.96 ,"$2,618.85 ",$242.96 ,"$2,403.18 ","$2,403.18 ","$2,403.18 ","$2,772.90 ",$583.23 ,"$2,772.90 ",$242.96 ,"$3,081.00 ","$2,018.06 ",$242.96 ,"$1,281.70 ",$308.81 ,$294.78 ,$254.30 ,"$2,772.90 ",$526.52 ,"$1,900.98 ",$862.68 ,"$2,772.90 ",$242.96 ,"$2,772.90 ","$2,772.90 ",$242.96 ,"$2,002.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$3,697.00 ","$2,403.05 ",$294.78 ,"$3,697.00 ",$933.39 ,"$2,754.27 ","$2,421.54 ",$388.82 ,"$1,035.16 ","$1,866.99 ",$388.82 ,"$2,281.05 ",$388.82 ,"$2,281.05 ","$2,281.05 ",$388.82 ,"$2,281.05 ",$738.76 ,"$3,327.30 ","$2,772.75 ",$933.39 ,$388.82 ,"$3,253.36 ",$388.82 ,"$2,772.75 ","$2,772.75 ","$3,142.45 ","$3,142.45 ",$388.82 ,"$3,142.45 ",$388.82 ,"$2,883.66 ","$2,883.66 ","$2,883.66 ","$3,327.30 ",$933.39 ,"$3,327.30 ",$388.82 ,"$3,697.00 ","$2,421.54 ",$388.82 ,"$1,537.95 ",$308.81 ,$294.78 ,$406.98 ,"$3,327.30 ",$842.63 ,"$2,281.05 ","$1,035.16 ","$3,327.30 ",$388.82 ,"$3,327.30 ","$3,327.30 ",$388.82 ,"$2,403.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$4,312.00 ","$2,802.80 ",$294.78 ,"$4,312.00 ",$933.39 ,"$3,212.44 ","$2,824.36 ",$388.82 ,"$1,207.36 ","$2,177.56 ",$388.82 ,"$2,660.50 ",$388.82 ,"$2,660.50 ","$2,660.50 ",$388.82 ,"$2,660.50 ",$738.76 ,"$3,880.80 ","$3,234.00 ",$933.39 ,$388.82 ,"$3,794.56 ",$388.82 ,"$3,234.00 ","$3,234.00 ","$3,665.20 ","$3,665.20 ",$388.82 ,"$3,665.20 ",$388.82 ,"$3,363.36 ","$3,363.36 ","$3,363.36 ","$3,880.80 ",$933.39 ,"$3,880.80 ",$388.82 ,"$4,312.00 ","$2,824.36 ",$388.82 ,"$1,793.79 ",$308.81 ,$294.78 ,$406.98 ,"$3,880.80 ",$842.63 ,"$2,660.50 ","$1,207.36 ","$3,880.80 ",$388.82 ,"$3,880.80 ","$3,880.80 ",$388.82 ,"$2,802.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$2,679.00 ","$1,741.35 ",$242.96 ,"$2,679.00 ",$583.23 ,"$1,995.86 ","$1,754.75 ",$242.96 ,$750.12 ,"$1,352.90 ",$242.96 ,"$1,652.94 ",$242.96 ,"$1,652.94 ","$1,652.94 ",$242.96 ,"$1,652.94 ",$461.62 ,"$2,411.10 ","$2,009.25 ",$583.23 ,$242.96 ,"$2,357.52 ",$242.96 ,"$2,009.25 ","$2,009.25 ","$2,277.15 ","$2,277.15 ",$242.96 ,"$2,277.15 ",$242.96 ,"$2,089.62 ","$2,089.62 ","$2,089.62 ","$2,411.10 ",$583.23 ,"$2,411.10 ",$242.96 ,"$2,679.00 ","$1,754.75 ",$242.96 ,"$1,114.46 ",$308.81 ,$294.78 ,$254.30 ,"$2,411.10 ",$526.52 ,"$1,652.94 ",$750.12 ,"$2,411.10 ",$242.96 ,"$2,411.10 ","$2,411.10 ",$242.96 ,"$1,741.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$3,216.00 ","$2,090.40 ",$294.78 ,"$3,216.00 ",$933.39 ,"$2,395.92 ","$2,106.48 ",$388.82 ,$900.48 ,"$1,624.08 ",$388.82 ,"$1,984.27 ",$388.82 ,"$1,984.27 ","$1,984.27 ",$388.82 ,"$1,984.27 ",$738.76 ,"$2,894.40 ","$2,412.00 ",$933.39 ,$388.82 ,"$2,830.08 ",$388.82 ,"$2,412.00 ","$2,412.00 ","$2,733.60 ","$2,733.60 ",$388.82 ,"$2,733.60 ",$388.82 ,"$2,508.48 ","$2,508.48 ","$2,508.48 ","$2,894.40 ",$933.39 ,"$2,894.40 ",$388.82 ,"$3,216.00 ","$2,106.48 ",$388.82 ,"$1,337.86 ",$308.81 ,$294.78 ,$406.98 ,"$2,894.40 ",$842.63 ,"$1,984.27 ",$900.48 ,"$2,894.40 ",$388.82 ,"$2,894.40 ","$2,894.40 ",$388.82 ,"$2,090.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$4,344.00 ","$2,823.60 ",$294.78 ,"$4,344.00 ",$933.39 ,"$3,236.28 ","$2,845.32 ",$388.82 ,"$1,216.32 ","$2,193.72 ",$388.82 ,"$2,680.25 ",$388.82 ,"$2,680.25 ","$2,680.25 ",$388.82 ,"$2,680.25 ",$738.76 ,"$3,909.60 ","$3,258.00 ",$933.39 ,$388.82 ,"$3,822.72 ",$388.82 ,"$3,258.00 ","$3,258.00 ","$3,692.40 ","$3,692.40 ",$388.82 ,"$3,692.40 ",$388.82 ,"$3,388.32 ","$3,388.32 ","$3,388.32 ","$3,909.60 ",$933.39 ,"$3,909.60 ",$388.82 ,"$4,344.00 ","$2,845.32 ",$388.82 ,"$1,807.10 ",$308.81 ,$294.78 ,$406.98 ,"$3,909.60 ",$842.63 ,"$2,680.25 ","$1,216.32 ","$3,909.60 ",$388.82 ,"$3,909.60 ","$3,909.60 ",$388.82 ,"$2,823.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$3,536.00 ","$2,298.40 ",$242.96 ,"$3,536.00 ",$583.23 ,"$2,634.32 ","$2,316.08 ",$242.96 ,$990.08 ,"$1,785.68 ",$242.96 ,"$2,181.71 ",$242.96 ,"$2,181.71 ","$2,181.71 ",$242.96 ,"$2,181.71 ",$461.62 ,"$3,182.40 ","$2,652.00 ",$583.23 ,$242.96 ,"$3,111.68 ",$242.96 ,"$2,652.00 ","$2,652.00 ","$3,005.60 ","$3,005.60 ",$242.96 ,"$3,005.60 ",$242.96 ,"$2,758.08 ","$2,758.08 ","$2,758.08 ","$3,182.40 ",$583.23 ,"$3,182.40 ",$242.96 ,"$3,536.00 ","$2,316.08 ",$242.96 ,"$1,470.98 ",$282.62 ,$269.78 ,$254.30 ,"$3,182.40 ",$526.52 ,"$2,181.71 ",$990.08 ,"$3,182.40 ",$242.96 ,"$3,182.40 ","$3,182.40 ",$242.96 ,"$2,298.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$4,057.00 ","$2,637.05 ",$269.78 ,"$4,057.00 ",$933.39 ,"$3,022.47 ","$2,657.34 ",$388.82 ,"$1,135.96 ","$2,048.79 ",$388.82 ,"$2,503.17 ",$388.82 ,"$2,503.17 ","$2,503.17 ",$388.82 ,"$2,503.17 ",$738.76 ,"$3,651.30 ","$3,042.75 ",$933.39 ,$388.82 ,"$3,570.16 ",$388.82 ,"$3,042.75 ","$3,042.75 ","$3,448.45 ","$3,448.45 ",$388.82 ,"$3,448.45 ",$388.82 ,"$3,164.46 ","$3,164.46 ","$3,164.46 ","$3,651.30 ",$933.39 ,"$3,651.30 ",$388.82 ,"$4,057.00 ","$2,657.34 ",$388.82 ,"$1,687.71 ",$282.62 ,$269.78 ,$406.98 ,"$3,651.30 ",$842.63 ,"$2,503.17 ","$1,135.96 ","$3,651.30 ",$388.82 ,"$3,651.30 ","$3,651.30 ",$388.82 ,"$2,637.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$5,005.00 ","$3,253.25 ",$269.78 ,"$5,005.00 ",$933.39 ,"$3,728.73 ","$3,278.28 ",$388.82 ,"$1,401.40 ","$2,527.53 ",$388.82 ,"$3,088.09 ",$388.82 ,"$3,088.09 ","$3,088.09 ",$388.82 ,"$3,088.09 ",$738.76 ,"$4,504.50 ","$3,753.75 ",$933.39 ,$388.82 ,"$4,404.40 ",$388.82 ,"$3,753.75 ","$3,753.75 ","$4,254.25 ","$4,254.25 ",$388.82 ,"$4,254.25 ",$388.82 ,"$3,903.90 ","$3,903.90 ","$3,903.90 ","$4,504.50 ",$933.39 ,"$4,504.50 ",$388.82 ,"$5,005.00 ","$3,278.28 ",$388.82 ,"$2,082.08 ",$282.62 ,$269.78 ,$406.98 ,"$4,504.50 ",$842.63 ,"$3,088.09 ","$1,401.40 ","$4,504.50 ",$388.82 ,"$4,504.50 ","$4,504.50 ",$388.82 ,"$3,253.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$5,063.00 ","$3,290.95 ",$194.57 ,"$5,063.00 ",$583.23 ,"$3,771.94 ","$3,316.27 ",$242.96 ,"$1,417.64 ","$2,556.82 ",$242.96 ,"$3,123.87 ",$242.96 ,"$3,123.87 ","$3,123.87 ",$242.96 ,"$3,123.87 ",$461.62 ,"$4,556.70 ","$3,797.25 ",$583.23 ,$242.96 ,"$4,455.44 ",$242.96 ,"$3,797.25 ","$3,797.25 ","$4,303.55 ","$4,303.55 ",$242.96 ,"$4,303.55 ",$242.96 ,"$3,949.14 ","$3,949.14 ","$3,949.14 ","$4,556.70 ",$583.23 ,"$4,556.70 ",$242.96 ,"$5,063.00 ","$3,316.27 ",$242.96 ,"$2,106.21 ",$203.83 ,$194.57 ,$254.30 ,"$4,556.70 ",$526.52 ,"$3,123.87 ","$1,417.64 ","$4,556.70 ",$242.96 ,"$4,556.70 ","$4,556.70 ",$242.96 ,"$3,290.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$6,169.00 ","$4,009.85 ",$194.57 ,"$6,169.00 ",$933.39 ,"$4,595.91 ","$4,040.70 ",$388.82 ,"$1,727.32 ","$3,115.35 ",$388.82 ,"$3,806.27 ",$388.82 ,"$3,806.27 ","$3,806.27 ",$388.82 ,"$3,806.27 ",$738.76 ,"$5,552.10 ","$4,626.75 ",$933.39 ,$388.82 ,"$5,428.72 ",$388.82 ,"$4,626.75 ","$4,626.75 ","$5,243.65 ","$5,243.65 ",$388.82 ,"$5,243.65 ",$388.82 ,"$4,811.82 ","$4,811.82 ","$4,811.82 ","$5,552.10 ",$933.39 ,"$5,552.10 ",$388.82 ,"$6,169.00 ","$4,040.70 ",$388.82 ,"$2,566.30 ",$203.83 ,$194.57 ,$406.98 ,"$5,552.10 ",$842.63 ,"$3,806.27 ","$1,727.32 ","$5,552.10 ",$388.82 ,"$5,552.10 ","$5,552.10 ",$388.82 ,"$4,009.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$3,364.00 ","$2,186.60 ",$194.57 ,"$3,364.00 ",$583.23 ,"$2,506.18 ","$2,203.42 ",$242.96 ,$941.92 ,"$1,698.82 ",$242.96 ,"$2,075.59 ",$242.96 ,"$2,075.59 ","$2,075.59 ",$242.96 ,"$2,075.59 ",$461.62 ,"$3,027.60 ","$2,523.00 ",$583.23 ,$242.96 ,"$2,960.32 ",$242.96 ,"$2,523.00 ","$2,523.00 ","$2,859.40 ","$2,859.40 ",$242.96 ,"$2,859.40 ",$242.96 ,"$2,623.92 ","$2,623.92 ","$2,623.92 ","$3,027.60 ",$583.23 ,"$3,027.60 ",$242.96 ,"$3,364.00 ","$2,203.42 ",$242.96 ,"$1,399.42 ",$203.83 ,$194.57 ,$254.30 ,"$3,027.60 ",$526.52 ,"$2,075.59 ",$941.92 ,"$3,027.60 ",$242.96 ,"$3,027.60 ","$3,027.60 ",$242.96 ,"$2,186.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$4,186.00 ","$2,720.90 ",$194.57 ,"$4,186.00 ",$933.39 ,"$3,118.57 ","$2,741.83 ",$388.82 ,"$1,172.08 ","$2,113.93 ",$388.82 ,"$2,582.76 ",$388.82 ,"$2,582.76 ","$2,582.76 ",$388.82 ,"$2,582.76 ",$738.76 ,"$3,767.40 ","$3,139.50 ",$933.39 ,$388.82 ,"$3,683.68 ",$388.82 ,"$3,139.50 ","$3,139.50 ","$3,558.10 ","$3,558.10 ",$388.82 ,"$3,558.10 ",$388.82 ,"$3,265.08 ","$3,265.08 ","$3,265.08 ","$3,767.40 ",$933.39 ,"$3,767.40 ",$388.82 ,"$4,186.00 ","$2,741.83 ",$388.82 ,"$1,741.38 ",$203.83 ,$194.57 ,$406.98 ,"$3,767.40 ",$842.63 ,"$2,582.76 ","$1,172.08 ","$3,767.40 ",$388.82 ,"$3,767.40 ","$3,767.40 ",$388.82 ,"$2,720.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$3,608.00 ","$2,345.20 ",$194.57 ,"$3,608.00 ",$583.23 ,"$2,687.96 ","$2,363.24 ",$242.96 ,"$1,010.24 ","$1,822.04 ",$242.96 ,"$2,226.14 ",$242.96 ,"$2,226.14 ","$2,226.14 ",$242.96 ,"$2,226.14 ",$461.62 ,"$3,247.20 ","$2,706.00 ",$583.23 ,$242.96 ,"$3,175.04 ",$242.96 ,"$2,706.00 ","$2,706.00 ","$3,066.80 ","$3,066.80 ",$242.96 ,"$3,066.80 ",$242.96 ,"$2,814.24 ","$2,814.24 ","$2,814.24 ","$3,247.20 ",$583.23 ,"$3,247.20 ",$242.96 ,"$3,608.00 ","$2,363.24 ",$242.96 ,"$1,500.93 ",$203.83 ,$194.57 ,$254.30 ,"$3,247.20 ",$526.52 ,"$2,226.14 ","$1,010.24 ","$3,247.20 ",$242.96 ,"$3,247.20 ","$3,247.20 ",$242.96 ,"$2,345.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$4,395.00 ","$2,856.75 ",$194.57 ,"$4,395.00 ",$933.39 ,"$3,274.28 ","$2,878.73 ",$388.82 ,"$1,230.60 ","$2,219.48 ",$388.82 ,"$2,711.72 ",$388.82 ,"$2,711.72 ","$2,711.72 ",$388.82 ,"$2,711.72 ",$738.76 ,"$3,955.50 ","$3,296.25 ",$933.39 ,$388.82 ,"$3,867.60 ",$388.82 ,"$3,296.25 ","$3,296.25 ","$3,735.75 ","$3,735.75 ",$388.82 ,"$3,735.75 ",$388.82 ,"$3,428.10 ","$3,428.10 ","$3,428.10 ","$3,955.50 ",$933.39 ,"$3,955.50 ",$388.82 ,"$4,395.00 ","$2,878.73 ",$388.82 ,"$1,828.32 ",$203.83 ,$194.57 ,$406.98 ,"$3,955.50 ",$842.63 ,"$2,711.72 ","$1,230.60 ","$3,955.50 ",$388.82 ,"$3,955.50 ","$3,955.50 ",$388.82 ,"$2,856.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$6,379.00 ","$4,146.35 ",$194.57 ,"$6,379.00 ",$933.39 ,"$4,752.36 ","$4,178.25 ",$388.82 ,"$1,786.12 ","$3,221.40 ",$388.82 ,"$3,935.84 ",$388.82 ,"$3,935.84 ","$3,935.84 ",$388.82 ,"$3,935.84 ",$738.76 ,"$5,741.10 ","$4,784.25 ",$933.39 ,$388.82 ,"$5,613.52 ",$388.82 ,"$4,784.25 ","$4,784.25 ","$5,422.15 ","$5,422.15 ",$388.82 ,"$5,422.15 ",$388.82 ,"$4,975.62 ","$4,975.62 ","$4,975.62 ","$5,741.10 ",$933.39 ,"$5,741.10 ",$388.82 ,"$6,379.00 ","$4,178.25 ",$388.82 ,"$2,653.66 ",$203.83 ,$194.57 ,$406.98 ,"$5,741.10 ",$842.63 ,"$3,935.84 ","$1,786.12 ","$5,741.10 ",$388.82 ,"$5,741.10 ","$5,741.10 ",$388.82 ,"$4,146.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$4,839.00 ","$3,145.35 ",$194.57 ,"$4,839.00 ",$933.39 ,"$3,605.06 ","$3,169.55 ",$388.82 ,"$1,354.92 ","$2,443.70 ",$388.82 ,"$2,985.66 ",$388.82 ,"$2,985.66 ","$2,985.66 ",$388.82 ,"$2,985.66 ",$738.76 ,"$4,355.10 ","$3,629.25 ",$933.39 ,$388.82 ,"$4,258.32 ",$388.82 ,"$3,629.25 ","$3,629.25 ","$4,113.15 ","$4,113.15 ",$388.82 ,"$4,113.15 ",$388.82 ,"$3,774.42 ","$3,774.42 ","$3,774.42 ","$4,355.10 ",$933.39 ,"$4,355.10 ",$388.82 ,"$4,839.00 ","$3,169.55 ",$388.82 ,"$2,013.02 ",$203.83 ,$194.57 ,$406.98 ,"$4,355.10 ",$842.63 ,"$2,985.66 ","$1,354.92 ","$4,355.10 ",$388.82 ,"$4,355.10 ","$4,355.10 ",$388.82 ,"$3,145.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$5,050.00 ","$3,282.50 ",$194.57 ,"$5,050.00 ",$933.39 ,"$3,762.25 ","$3,307.75 ",$388.82 ,"$1,414.00 ","$2,550.25 ",$388.82 ,"$3,115.85 ",$388.82 ,"$3,115.85 ","$3,115.85 ",$388.82 ,"$3,115.85 ",$738.76 ,"$4,545.00 ","$3,787.50 ",$933.39 ,$388.82 ,"$4,444.00 ",$388.82 ,"$3,787.50 ","$3,787.50 ","$4,292.50 ","$4,292.50 ",$388.82 ,"$4,292.50 ",$388.82 ,"$3,939.00 ","$3,939.00 ","$3,939.00 ","$4,545.00 ",$933.39 ,"$4,545.00 ",$388.82 ,"$5,050.00 ","$3,307.75 ",$388.82 ,"$2,100.80 ",$203.83 ,$194.57 ,$406.98 ,"$4,545.00 ",$842.63 ,"$3,115.85 ","$1,414.00 ","$4,545.00 ",$388.82 ,"$4,545.00 ","$4,545.00 ",$388.82 ,"$3,282.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$4,272.00 ","$2,776.80 ",$240.78 ,"$4,272.00 ",$583.23 ,"$3,182.64 ","$2,798.16 ",$242.96 ,"$1,196.16 ","$2,157.36 ",$242.96 ,"$2,635.82 ",$242.96 ,"$2,635.82 ","$2,635.82 ",$242.96 ,"$2,635.82 ",$461.62 ,"$3,844.80 ","$3,204.00 ",$583.23 ,$242.96 ,"$3,759.36 ",$242.96 ,"$3,204.00 ","$3,204.00 ","$3,631.20 ","$3,631.20 ",$242.96 ,"$3,631.20 ",$242.96 ,"$3,332.16 ","$3,332.16 ","$3,332.16 ","$3,844.80 ",$583.23 ,"$3,844.80 ",$242.96 ,"$4,272.00 ","$2,798.16 ",$242.96 ,"$1,777.15 ",$252.24 ,$240.78 ,$254.30 ,"$3,844.80 ",$526.52 ,"$2,635.82 ","$1,196.16 ","$3,844.80 ",$242.96 ,"$3,844.80 ","$3,844.80 ",$242.96 ,"$2,776.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$4,982.00 ","$3,238.30 ",$240.78 ,"$4,982.00 ",$933.39 ,"$3,711.59 ","$3,263.21 ",$388.82 ,"$1,394.96 ","$2,515.91 ",$388.82 ,"$3,073.89 ",$388.82 ,"$3,073.89 ","$3,073.89 ",$388.82 ,"$3,073.89 ",$738.76 ,"$4,483.80 ","$3,736.50 ",$933.39 ,$388.82 ,"$4,384.16 ",$388.82 ,"$3,736.50 ","$3,736.50 ","$4,234.70 ","$4,234.70 ",$388.82 ,"$4,234.70 ",$388.82 ,"$3,885.96 ","$3,885.96 ","$3,885.96 ","$4,483.80 ",$933.39 ,"$4,483.80 ",$388.82 ,"$4,982.00 ","$3,263.21 ",$388.82 ,"$2,072.51 ",$252.24 ,$240.78 ,$406.98 ,"$4,483.80 ",$842.63 ,"$3,073.89 ","$1,394.96 ","$4,483.80 ",$388.82 ,"$4,483.80 ","$4,483.80 ",$388.82 ,"$3,238.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$5,383.00 ","$3,498.95 ",$240.78 ,"$5,383.00 ",$933.39 ,"$4,010.34 ","$3,525.87 ",$388.82 ,"$1,507.24 ","$2,718.42 ",$388.82 ,"$3,321.31 ",$388.82 ,"$3,321.31 ","$3,321.31 ",$388.82 ,"$3,321.31 ",$738.76 ,"$4,844.70 ","$4,037.25 ",$933.39 ,$388.82 ,"$4,737.04 ",$388.82 ,"$4,037.25 ","$4,037.25 ","$4,575.55 ","$4,575.55 ",$388.82 ,"$4,575.55 ",$388.82 ,"$4,198.74 ","$4,198.74 ","$4,198.74 ","$4,844.70 ",$933.39 ,"$4,844.70 ",$388.82 ,"$5,383.00 ","$3,525.87 ",$388.82 ,"$2,239.33 ",$252.24 ,$240.78 ,$406.98 ,"$4,844.70 ",$842.63 ,"$3,321.31 ","$1,507.24 ","$4,844.70 ",$388.82 ,"$4,844.70 ","$4,844.70 ",$388.82 ,"$3,498.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$4,142.00 ","$2,692.30 ",$240.78 ,"$4,142.00 ",$583.23 ,"$3,085.79 ","$2,713.01 ",$242.96 ,"$1,159.76 ","$2,091.71 ",$242.96 ,"$2,555.61 ",$242.96 ,"$2,555.61 ","$2,555.61 ",$242.96 ,"$2,555.61 ",$461.62 ,"$3,727.80 ","$3,106.50 ",$583.23 ,$242.96 ,"$3,644.96 ",$242.96 ,"$3,106.50 ","$3,106.50 ","$3,520.70 ","$3,520.70 ",$242.96 ,"$3,520.70 ",$242.96 ,"$3,230.76 ","$3,230.76 ","$3,230.76 ","$3,727.80 ",$583.23 ,"$3,727.80 ",$242.96 ,"$4,142.00 ","$2,713.01 ",$242.96 ,"$1,723.07 ",$252.24 ,$240.78 ,$254.30 ,"$3,727.80 ",$526.52 ,"$2,555.61 ","$1,159.76 ","$3,727.80 ",$242.96 ,"$3,727.80 ","$3,727.80 ",$242.96 ,"$2,692.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000025,73219,HC MRI UPPR EXT NONJOINT W/CONTRAST,610,1 ,"$4,556.00 ","$2,961.40 ",$240.78 ,"$4,556.00 ",$933.39 ,"$3,394.22 ","$2,984.18 ",$388.82 ,"$1,275.68 ","$2,300.78 ",$388.82 ,"$2,811.05 ",$388.82 ,"$2,811.05 ","$2,811.05 ",$388.82 ,"$2,811.05 ",$738.76 ,"$4,100.40 ","$3,417.00 ",$933.39 ,$388.82 ,"$4,009.28 ",$388.82 ,"$3,417.00 ","$3,417.00 ","$3,872.60 ","$3,872.60 ",$388.82 ,"$3,872.60 ",$388.82 ,"$3,553.68 ","$3,553.68 ","$3,553.68 ","$4,100.40 ",$933.39 ,"$4,100.40 ",$388.82 ,"$4,556.00 ","$2,984.18 ",$388.82 ,"$1,895.30 ",$252.24 ,$240.78 ,$406.98 ,"$4,100.40 ",$842.63 ,"$2,811.05 ","$1,275.68 ","$4,100.40 ",$388.82 ,"$4,100.40 ","$4,100.40 ",$388.82 ,"$2,961.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$5,799.00 ","$3,769.35 ",$240.78 ,"$5,799.00 ",$933.39 ,"$4,320.26 ","$3,798.35 ",$388.82 ,"$1,623.72 ","$2,928.50 ",$388.82 ,"$3,577.98 ",$388.82 ,"$3,577.98 ","$3,577.98 ",$388.82 ,"$3,577.98 ",$738.76 ,"$5,219.10 ","$4,349.25 ",$933.39 ,$388.82 ,"$5,103.12 ",$388.82 ,"$4,349.25 ","$4,349.25 ","$4,929.15 ","$4,929.15 ",$388.82 ,"$4,929.15 ",$388.82 ,"$4,523.22 ","$4,523.22 ","$4,523.22 ","$5,219.10 ",$933.39 ,"$5,219.10 ",$388.82 ,"$5,799.00 ","$3,798.35 ",$388.82 ,"$2,412.38 ",$252.24 ,$240.78 ,$406.98 ,"$5,219.10 ",$842.63 ,"$3,577.98 ","$1,623.72 ","$5,219.10 ",$388.82 ,"$5,219.10 ","$5,219.10 ",$388.82 ,"$3,769.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,296.00 ","$2,142.40 ",$162.51 ,"$3,296.00 ",$583.23 ,"$2,455.52 ","$2,158.88 ",$242.96 ,$922.88 ,"$1,664.48 ",$242.96 ,"$2,033.63 ",$242.96 ,"$2,033.63 ","$2,033.63 ",$242.96 ,"$2,033.63 ",$461.62 ,"$2,966.40 ","$2,472.00 ",$583.23 ,$242.96 ,"$2,900.48 ",$242.96 ,"$2,472.00 ","$2,472.00 ","$2,801.60 ","$2,801.60 ",$242.96 ,"$2,801.60 ",$242.96 ,"$2,570.88 ","$2,570.88 ","$2,570.88 ","$2,966.40 ",$583.23 ,"$2,966.40 ",$242.96 ,"$3,296.00 ","$2,158.88 ",$242.96 ,"$1,371.14 ",$170.25 ,$162.51 ,$254.30 ,"$2,966.40 ",$526.52 ,"$2,033.63 ",$922.88 ,"$2,966.40 ",$242.96 ,"$2,966.40 ","$2,966.40 ",$242.96 ,"$2,142.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,556.00 ","$2,961.40 ",$162.51 ,"$4,556.00 ","$1,813.40 ","$3,394.22 ","$2,984.18 ",$755.41 ,"$1,275.68 ","$2,300.78 ",$755.41 ,"$2,811.05 ",$755.41 ,"$2,811.05 ","$2,811.05 ",$755.41 ,"$2,811.05 ","$1,435.28 ","$4,100.40 ","$3,417.00 ","$1,813.40 ",$755.41 ,"$4,009.28 ",$755.41 ,"$3,417.00 ","$3,417.00 ","$3,872.60 ","$3,872.60 ",$755.41 ,"$3,872.60 ",$755.41 ,"$3,553.68 ","$3,553.68 ","$3,553.68 ","$4,100.40 ","$1,813.40 ","$4,100.40 ",$755.41 ,"$4,556.00 ","$2,984.18 ",$755.41 ,"$1,895.30 ",$170.25 ,$162.51 ,$790.68 ,"$4,100.40 ","$1,637.07 ","$2,811.05 ","$1,275.68 ","$4,100.40 ",$755.41 ,"$4,100.40 ","$4,100.40 ",$755.41 ,"$2,961.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$5,220.00 ","$3,393.00 ",$162.51 ,"$5,220.00 ",$933.39 ,"$3,888.90 ","$3,419.10 ",$388.82 ,"$1,461.60 ","$2,636.10 ",$388.82 ,"$3,220.74 ",$388.82 ,"$3,220.74 ","$3,220.74 ",$388.82 ,"$3,220.74 ",$738.76 ,"$4,698.00 ","$3,915.00 ",$933.39 ,$388.82 ,"$4,593.60 ",$388.82 ,"$3,915.00 ","$3,915.00 ","$4,437.00 ","$4,437.00 ",$388.82 ,"$4,437.00 ",$388.82 ,"$4,071.60 ","$4,071.60 ","$4,071.60 ","$4,698.00 ",$933.39 ,"$4,698.00 ",$388.82 ,"$5,220.00 ","$3,419.10 ",$388.82 ,"$2,171.52 ",$170.25 ,$162.51 ,$406.98 ,"$4,698.00 ",$842.63 ,"$3,220.74 ","$1,461.60 ","$4,698.00 ",$388.82 ,"$4,698.00 ","$4,698.00 ",$388.82 ,"$3,393.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$4,142.00 ","$2,692.30 ",$240.78 ,"$4,142.00 ",$583.23 ,"$3,085.79 ","$2,713.01 ",$242.96 ,"$1,159.76 ","$2,091.71 ",$242.96 ,"$2,555.61 ",$242.96 ,"$2,555.61 ","$2,555.61 ",$242.96 ,"$2,555.61 ",$461.62 ,"$3,727.80 ","$3,106.50 ",$583.23 ,$242.96 ,"$3,644.96 ",$242.96 ,"$3,106.50 ","$3,106.50 ","$3,520.70 ","$3,520.70 ",$242.96 ,"$3,520.70 ",$242.96 ,"$3,230.76 ","$3,230.76 ","$3,230.76 ","$3,727.80 ",$583.23 ,"$3,727.80 ",$242.96 ,"$4,142.00 ","$2,713.01 ",$242.96 ,"$1,723.07 ",$252.24 ,$240.78 ,$254.30 ,"$3,727.80 ",$526.52 ,"$2,555.61 ","$1,159.76 ","$3,727.80 ",$242.96 ,"$3,727.80 ","$3,727.80 ",$242.96 ,"$2,692.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$4,556.00 ","$2,961.40 ",$240.78 ,"$4,556.00 ",$933.39 ,"$3,394.22 ","$2,984.18 ",$388.82 ,"$1,275.68 ","$2,300.78 ",$388.82 ,"$2,811.05 ",$388.82 ,"$2,811.05 ","$2,811.05 ",$388.82 ,"$2,811.05 ",$738.76 ,"$4,100.40 ","$3,417.00 ",$933.39 ,$388.82 ,"$4,009.28 ",$388.82 ,"$3,417.00 ","$3,417.00 ","$3,872.60 ","$3,872.60 ",$388.82 ,"$3,872.60 ",$388.82 ,"$3,553.68 ","$3,553.68 ","$3,553.68 ","$4,100.40 ",$933.39 ,"$4,100.40 ",$388.82 ,"$4,556.00 ","$2,984.18 ",$388.82 ,"$1,895.30 ",$252.24 ,$240.78 ,$406.98 ,"$4,100.40 ",$842.63 ,"$2,811.05 ","$1,275.68 ","$4,100.40 ",$388.82 ,"$4,100.40 ","$4,100.40 ",$388.82 ,"$2,961.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$5,221.00 ","$3,393.65 ",$240.78 ,"$5,221.00 ",$933.39 ,"$3,889.65 ","$3,419.76 ",$388.82 ,"$1,461.88 ","$2,636.61 ",$388.82 ,"$3,221.36 ",$388.82 ,"$3,221.36 ","$3,221.36 ",$388.82 ,"$3,221.36 ",$738.76 ,"$4,698.90 ","$3,915.75 ",$933.39 ,$388.82 ,"$4,594.48 ",$388.82 ,"$3,915.75 ","$3,915.75 ","$4,437.85 ","$4,437.85 ",$388.82 ,"$4,437.85 ",$388.82 ,"$4,072.38 ","$4,072.38 ","$4,072.38 ","$4,698.90 ",$933.39 ,"$4,698.90 ",$388.82 ,"$5,221.00 ","$3,419.76 ",$388.82 ,"$2,171.94 ",$252.24 ,$240.78 ,$406.98 ,"$4,698.90 ",$842.63 ,"$3,221.36 ","$1,461.88 ","$4,698.90 ",$388.82 ,"$4,698.90 ","$4,698.90 ",$388.82 ,"$3,393.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$3,296.00 ","$2,142.40 ",$162.51 ,"$3,296.00 ",$583.23 ,"$2,455.52 ","$2,158.88 ",$242.96 ,$922.88 ,"$1,664.48 ",$242.96 ,"$2,033.63 ",$242.96 ,"$2,033.63 ","$2,033.63 ",$242.96 ,"$2,033.63 ",$461.62 ,"$2,966.40 ","$2,472.00 ",$583.23 ,$242.96 ,"$2,900.48 ",$242.96 ,"$2,472.00 ","$2,472.00 ","$2,801.60 ","$2,801.60 ",$242.96 ,"$2,801.60 ",$242.96 ,"$2,570.88 ","$2,570.88 ","$2,570.88 ","$2,966.40 ",$583.23 ,"$2,966.40 ",$242.96 ,"$3,296.00 ","$2,158.88 ",$242.96 ,"$1,371.14 ",$170.25 ,$162.51 ,$254.30 ,"$2,966.40 ",$526.52 ,"$2,033.63 ",$922.88 ,"$2,966.40 ",$242.96 ,"$2,966.40 ","$2,966.40 ",$242.96 ,"$2,142.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$4,556.00 ","$2,961.40 ",$162.51 ,"$4,556.00 ","$1,813.40 ","$3,394.22 ","$2,984.18 ",$755.41 ,"$1,275.68 ","$2,300.78 ",$755.41 ,"$2,811.05 ",$755.41 ,"$2,811.05 ","$2,811.05 ",$755.41 ,"$2,811.05 ","$1,435.28 ","$4,100.40 ","$3,417.00 ","$1,813.40 ",$755.41 ,"$4,009.28 ",$755.41 ,"$3,417.00 ","$3,417.00 ","$3,872.60 ","$3,872.60 ",$755.41 ,"$3,872.60 ",$755.41 ,"$3,553.68 ","$3,553.68 ","$3,553.68 ","$4,100.40 ","$1,813.40 ","$4,100.40 ",$755.41 ,"$4,556.00 ","$2,984.18 ",$755.41 ,"$1,895.30 ",$170.25 ,$162.51 ,$790.68 ,"$4,100.40 ","$1,637.07 ","$2,811.05 ","$1,275.68 ","$4,100.40 ",$755.41 ,"$4,100.40 ","$4,100.40 ",$755.41 ,"$2,961.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$5,799.00 ","$3,769.35 ",$162.51 ,"$5,799.00 ",$933.39 ,"$4,320.26 ","$3,798.35 ",$388.82 ,"$1,623.72 ","$2,928.50 ",$388.82 ,"$3,577.98 ",$388.82 ,"$3,577.98 ","$3,577.98 ",$388.82 ,"$3,577.98 ",$738.76 ,"$5,219.10 ","$4,349.25 ",$933.39 ,$388.82 ,"$5,103.12 ",$388.82 ,"$4,349.25 ","$4,349.25 ","$4,929.15 ","$4,929.15 ",$388.82 ,"$4,929.15 ",$388.82 ,"$4,523.22 ","$4,523.22 ","$4,523.22 ","$5,219.10 ",$933.39 ,"$5,219.10 ",$388.82 ,"$5,799.00 ","$3,798.35 ",$388.82 ,"$2,412.38 ",$170.25 ,$162.51 ,$406.98 ,"$5,219.10 ",$842.63 ,"$3,577.98 ","$1,623.72 ","$5,219.10 ",$388.82 ,"$5,219.10 ","$5,219.10 ",$388.82 ,"$3,769.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$2,889.00 ","$1,877.85 ",$242.96 ,"$2,889.00 ",$583.23 ,"$2,152.31 ","$1,892.30 ",$242.96 ,$808.92 ,"$1,458.95 ",$242.96 ,"$1,782.51 ",$242.96 ,"$1,782.51 ","$1,782.51 ",$242.96 ,"$1,782.51 ",$461.62 ,"$2,600.10 ","$2,166.75 ",$583.23 ,$242.96 ,"$2,542.32 ",$242.96 ,"$2,166.75 ","$2,166.75 ","$2,455.65 ","$2,455.65 ",$242.96 ,"$2,455.65 ",$242.96 ,"$2,253.42 ","$2,253.42 ","$2,253.42 ","$2,600.10 ",$583.23 ,"$2,600.10 ",$242.96 ,"$2,889.00 ","$1,892.30 ",$242.96 ,"$1,201.82 ",$302.32 ,$288.58 ,$254.30 ,"$2,600.10 ",$526.52 ,"$1,782.51 ",$808.92 ,"$2,600.10 ",$242.96 ,"$2,600.10 ","$2,600.10 ",$242.96 ,"$1,877.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$4,602.00 ","$2,991.30 ",$288.58 ,"$4,602.00 ",$933.39 ,"$3,428.49 ","$3,014.31 ",$388.82 ,"$1,288.56 ","$2,324.01 ",$388.82 ,"$2,839.43 ",$388.82 ,"$2,839.43 ","$2,839.43 ",$388.82 ,"$2,839.43 ",$738.76 ,"$4,141.80 ","$3,451.50 ",$933.39 ,$388.82 ,"$4,049.76 ",$388.82 ,"$3,451.50 ","$3,451.50 ","$3,911.70 ","$3,911.70 ",$388.82 ,"$3,911.70 ",$388.82 ,"$3,589.56 ","$3,589.56 ","$3,589.56 ","$4,141.80 ",$933.39 ,"$4,141.80 ",$388.82 ,"$4,602.00 ","$3,014.31 ",$388.82 ,"$1,914.43 ",$302.32 ,$288.58 ,$406.98 ,"$4,141.80 ",$842.63 ,"$2,839.43 ","$1,288.56 ","$4,141.80 ",$388.82 ,"$4,141.80 ","$4,141.80 ",$388.82 ,"$2,991.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000050,C8937,HC MRI BREAST CAD,610,1 ,"$1,444.00 ",$938.60 ,$404.32 ,"$1,444.00 ", N/A ,"$1,075.78 ",$945.82 , N/A ,$404.32 ,$729.22 , N/A ,$890.95 , N/A ,$890.95 ,$890.95 , N/A ,$890.95 , N/A ,"$1,299.60 ","$1,083.00 ", N/A , N/A ,"$1,270.72 ", N/A ,"$1,083.00 ","$1,083.00 ","$1,227.40 ","$1,227.40 ", N/A ,"$1,227.40 ", N/A ,"$1,126.32 ","$1,126.32 ","$1,126.32 ","$1,299.60 ", N/A ,"$1,299.60 ", N/A ,"$1,444.00 ",$945.82 , N/A ,$600.70 , N/A , N/A , N/A ,"$1,299.60 ", N/A ,$890.95 ,$404.32 ,"$1,299.60 ", N/A ,"$1,299.60 ","$1,299.60 ", N/A ,$938.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$2,042.00 ","$1,327.30 ",$311.35 ,"$2,042.00 ",$933.39 ,"$1,521.29 ","$1,337.51 ",$388.82 ,$571.76 ,"$1,031.21 ",$388.82 ,"$1,259.91 ",$388.82 ,"$1,259.91 ","$1,259.91 ",$388.82 ,"$1,259.91 ",$738.76 ,"$1,837.80 ","$1,531.50 ",$933.39 ,$388.82 ,"$1,796.96 ",$388.82 ,"$1,531.50 ","$1,531.50 ","$1,735.70 ","$1,735.70 ",$388.82 ,"$1,735.70 ",$388.82 ,"$1,592.76 ","$1,592.76 ","$1,592.76 ","$1,837.80 ",$933.39 ,"$1,837.80 ",$388.82 ,"$2,042.00 ","$1,337.51 ",$388.82 ,$849.47 ,$326.17 ,$311.35 ,$406.98 ,"$1,837.80 ",$842.63 ,"$1,259.91 ",$571.76 ,"$1,837.80 ",$388.82 ,"$1,837.80 ","$1,837.80 ",$388.82 ,"$1,327.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,"$1,750.00 ","$1,137.50 ",$242.96 ,"$1,750.00 ",$583.23 ,"$1,303.75 ","$1,146.25 ",$242.96 ,$490.00 ,$883.75 ,$242.96 ,"$1,079.75 ",$242.96 ,"$1,079.75 ","$1,079.75 ",$242.96 ,"$1,079.75 ",$461.62 ,"$1,575.00 ","$1,312.50 ",$583.23 ,$242.96 ,"$1,540.00 ",$242.96 ,"$1,312.50 ","$1,312.50 ","$1,487.50 ","$1,487.50 ",$242.96 ,"$1,487.50 ",$242.96 ,"$1,365.00 ","$1,365.00 ","$1,365.00 ","$1,575.00 ",$583.23 ,"$1,575.00 ",$242.96 ,"$1,750.00 ","$1,146.25 ",$242.96 ,$728.00 ,$326.17 ,$311.35 ,$254.30 ,"$1,575.00 ",$526.52 ,"$1,079.75 ",$490.00 ,"$1,575.00 ",$242.96 ,"$1,575.00 ","$1,575.00 ",$242.96 ,"$1,137.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$2,981.00 ","$1,937.65 ",$311.35 ,"$2,981.00 ",$933.39 ,"$2,220.85 ","$1,952.56 ",$388.82 ,$834.68 ,"$1,505.41 ",$388.82 ,"$1,839.28 ",$388.82 ,"$1,839.28 ","$1,839.28 ",$388.82 ,"$1,839.28 ",$738.76 ,"$2,682.90 ","$2,235.75 ",$933.39 ,$388.82 ,"$2,623.28 ",$388.82 ,"$2,235.75 ","$2,235.75 ","$2,533.85 ","$2,533.85 ",$388.82 ,"$2,533.85 ",$388.82 ,"$2,325.18 ","$2,325.18 ","$2,325.18 ","$2,682.90 ",$933.39 ,"$2,682.90 ",$388.82 ,"$2,981.00 ","$1,952.56 ",$388.82 ,"$1,240.10 ",$326.17 ,$311.35 ,$406.98 ,"$2,682.90 ",$842.63 ,"$1,839.28 ",$834.68 ,"$2,682.90 ",$388.82 ,"$2,682.90 ","$2,682.90 ",$388.82 ,"$1,937.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000056,C8905,HC MRI BREAST UNI W AND W/O CONTRAST,610,1 ,"$1,276.00 ",$829.40 ,$240.78 ,"$1,276.00 ",$933.39 ,$950.62 ,$835.78 ,$388.82 ,$357.28 ,$644.38 ,$388.82 ,$787.29 ,$388.82 ,$787.29 ,$787.29 ,$388.82 ,$787.29 ,$738.76 ,"$1,148.40 ",$957.00 ,$933.39 ,$388.82 ,"$1,122.88 ",$388.82 ,$957.00 ,$957.00 ,"$1,084.60 ","$1,084.60 ",$388.82 ,"$1,084.60 ",$388.82 ,$995.28 ,$995.28 ,$995.28 ,"$1,148.40 ",$933.39 ,"$1,148.40 ",$388.82 ,"$1,276.00 ",$835.78 ,$388.82 ,$530.82 ,$252.24 ,$240.78 ,$406.98 ,"$1,148.40 ",$842.63 ,$787.29 ,$357.28 ,"$1,148.40 ",$388.82 ,"$1,148.40 ","$1,148.40 ",$388.82 ,$829.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000057,C8906,HC MRI BREAST BIL W/CONTRAST,610,1 ,"$2,529.00 ","$1,643.85 ",$240.78 ,"$2,529.00 ",$933.39 ,"$1,884.11 ","$1,656.50 ",$388.82 ,$708.12 ,"$1,277.15 ",$388.82 ,"$1,560.39 ",$388.82 ,"$1,560.39 ","$1,560.39 ",$388.82 ,"$1,560.39 ",$738.76 ,"$2,276.10 ","$1,896.75 ",$933.39 ,$388.82 ,"$2,225.52 ",$388.82 ,"$1,896.75 ","$1,896.75 ","$2,149.65 ","$2,149.65 ",$388.82 ,"$2,149.65 ",$388.82 ,"$1,972.62 ","$1,972.62 ","$1,972.62 ","$2,276.10 ",$933.39 ,"$2,276.10 ",$388.82 ,"$2,529.00 ","$1,656.50 ",$388.82 ,"$1,052.06 ",$252.24 ,$240.78 ,$406.98 ,"$2,276.10 ",$842.63 ,"$1,560.39 ",$708.12 ,"$2,276.10 ",$388.82 ,"$2,276.10 ","$2,276.10 ",$388.82 ,"$1,643.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000058,77047,HC MRI BREAST BI W/O CON,610,1 ,"$2,429.00 ","$1,578.85 ",$179.80 ,"$2,429.00 ",$583.23 ,"$1,809.61 ","$1,591.00 ",$242.96 ,$680.12 ,"$1,226.65 ",$242.96 ,"$1,498.69 ",$242.96 ,"$1,498.69 ","$1,498.69 ",$242.96 ,"$1,498.69 ",$461.62 ,"$2,186.10 ","$1,821.75 ",$583.23 ,$242.96 ,"$2,137.52 ",$242.96 ,"$1,821.75 ","$1,821.75 ","$2,064.65 ","$2,064.65 ",$242.96 ,"$2,064.65 ",$242.96 ,"$1,894.62 ","$1,894.62 ","$1,894.62 ","$2,186.10 ",$583.23 ,"$2,186.10 ",$242.96 ,$179.80 ,"$1,591.00 ",$242.96 ,"$1,010.46 ",$252.24 ,$240.78 ,$254.30 ,"$2,186.10 ",$526.52 ,"$1,498.69 ",$680.12 ,"$2,186.10 ",$242.96 ,"$2,186.10 ","$2,186.10 ",$242.96 ,"$1,578.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000059,C8908,HC MRI BREAST BI W AND W/O CON,610,1 ,"$3,734.00 ","$2,427.10 ",$240.78 ,"$3,734.00 ",$933.39 ,"$2,781.83 ","$2,445.77 ",$388.82 ,"$1,045.52 ","$1,885.67 ",$388.82 ,"$2,303.88 ",$388.82 ,"$2,303.88 ","$2,303.88 ",$388.82 ,"$2,303.88 ",$738.76 ,"$3,360.60 ","$2,800.50 ",$933.39 ,$388.82 ,"$3,285.92 ",$388.82 ,"$2,800.50 ","$2,800.50 ","$3,173.90 ","$3,173.90 ",$388.82 ,"$3,173.90 ",$388.82 ,"$2,912.52 ","$2,912.52 ","$2,912.52 ","$3,360.60 ",$933.39 ,"$3,360.60 ",$388.82 ,"$3,734.00 ","$2,445.77 ",$388.82 ,"$1,553.34 ",$252.24 ,$240.78 ,$406.98 ,"$3,360.60 ",$842.63 ,"$2,303.88 ","$1,045.52 ","$3,360.60 ",$388.82 ,"$3,360.60 ","$3,360.60 ",$388.82 ,"$2,427.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000060,C8909,HC MRA CHEST W/CONTRAST,610,1 ,"$2,579.00 ","$1,676.35 ",$273.86 ,"$2,579.00 ",$933.39 ,"$1,921.36 ","$1,689.25 ",$388.82 ,$722.12 ,"$1,302.40 ",$388.82 ,"$1,591.24 ",$388.82 ,"$1,591.24 ","$1,591.24 ",$388.82 ,"$1,591.24 ",$738.76 ,"$2,321.10 ","$1,934.25 ",$933.39 ,$388.82 ,"$2,269.52 ",$388.82 ,"$1,934.25 ","$1,934.25 ","$2,192.15 ","$2,192.15 ",$388.82 ,"$2,192.15 ",$388.82 ,"$2,011.62 ","$2,011.62 ","$2,011.62 ","$2,321.10 ",$933.39 ,"$2,321.10 ",$388.82 ,"$2,579.00 ","$1,689.25 ",$388.82 ,"$1,072.86 ",$286.90 ,$273.86 ,$406.98 ,"$2,321.10 ",$842.63 ,"$1,591.24 ",$722.12 ,"$2,321.10 ",$388.82 ,"$2,321.10 ","$2,321.10 ",$388.82 ,"$1,676.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000061,C8910,HC MRA CHEST W/O CONTRAST,610,1 ,"$2,555.00 ","$1,660.75 ",$242.96 ,"$2,555.00 ",$583.23 ,"$1,903.48 ","$1,673.53 ",$242.96 ,$715.40 ,"$1,290.28 ",$242.96 ,"$1,576.44 ",$242.96 ,"$1,576.44 ","$1,576.44 ",$242.96 ,"$1,576.44 ",$461.62 ,"$2,299.50 ","$1,916.25 ",$583.23 ,$242.96 ,"$2,248.40 ",$242.96 ,"$1,916.25 ","$1,916.25 ","$2,171.75 ","$2,171.75 ",$242.96 ,"$2,171.75 ",$242.96 ,"$1,992.90 ","$1,992.90 ","$1,992.90 ","$2,299.50 ",$583.23 ,"$2,299.50 ",$242.96 ,"$2,555.00 ","$1,673.53 ",$242.96 ,"$1,062.88 ",$286.90 ,$273.86 ,$254.30 ,"$2,299.50 ",$526.52 ,"$1,576.44 ",$715.40 ,"$2,299.50 ",$242.96 ,"$2,299.50 ","$2,299.50 ",$242.96 ,"$1,660.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000062,C8911,HC MRA CHEST W AND W/O CONTRAST,610,1 ,"$3,747.00 ","$2,435.55 ",$273.86 ,"$3,747.00 ",$933.39 ,"$2,791.52 ","$2,454.29 ",$388.82 ,"$1,049.16 ","$1,892.24 ",$388.82 ,"$2,311.90 ",$388.82 ,"$2,311.90 ","$2,311.90 ",$388.82 ,"$2,311.90 ",$738.76 ,"$3,372.30 ","$2,810.25 ",$933.39 ,$388.82 ,"$3,297.36 ",$388.82 ,"$2,810.25 ","$2,810.25 ","$3,184.95 ","$3,184.95 ",$388.82 ,"$3,184.95 ",$388.82 ,"$2,922.66 ","$2,922.66 ","$2,922.66 ","$3,372.30 ",$933.39 ,"$3,372.30 ",$388.82 ,"$3,747.00 ","$2,454.29 ",$388.82 ,"$1,558.75 ",$286.90 ,$273.86 ,$406.98 ,"$3,372.30 ",$842.63 ,"$2,311.90 ","$1,049.16 ","$3,372.30 ",$388.82 ,"$3,372.30 ","$3,372.30 ",$388.82 ,"$2,435.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$2,132.00 ","$1,385.80 ",$311.35 ,"$2,132.00 ",$933.39 ,"$1,588.34 ","$1,396.46 ",$388.82 ,$596.96 ,"$1,076.66 ",$388.82 ,"$1,315.44 ",$388.82 ,"$1,315.44 ","$1,315.44 ",$388.82 ,"$1,315.44 ",$738.76 ,"$1,918.80 ","$1,599.00 ",$933.39 ,$388.82 ,"$1,876.16 ",$388.82 ,"$1,599.00 ","$1,599.00 ","$1,812.20 ","$1,812.20 ",$388.82 ,"$1,812.20 ",$388.82 ,"$1,662.96 ","$1,662.96 ","$1,662.96 ","$1,918.80 ",$933.39 ,"$1,918.80 ",$388.82 ,"$2,132.00 ","$1,396.46 ",$388.82 ,$886.91 ,$326.17 ,$311.35 ,$406.98 ,"$1,918.80 ",$842.63 ,"$1,315.44 ",$596.96 ,"$1,918.80 ",$388.82 ,"$1,918.80 ","$1,918.80 ",$388.82 ,"$1,385.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$3,199.00 ","$2,079.35 ",$311.35 ,"$3,199.00 ",$933.39 ,"$2,383.26 ","$2,095.35 ",$388.82 ,$895.72 ,"$1,615.50 ",$388.82 ,"$1,973.78 ",$388.82 ,"$1,973.78 ","$1,973.78 ",$388.82 ,"$1,973.78 ",$738.76 ,"$2,879.10 ","$2,399.25 ",$933.39 ,$388.82 ,"$2,815.12 ",$388.82 ,"$2,399.25 ","$2,399.25 ","$2,719.15 ","$2,719.15 ",$388.82 ,"$2,719.15 ",$388.82 ,"$2,495.22 ","$2,495.22 ","$2,495.22 ","$2,879.10 ",$933.39 ,"$2,879.10 ",$388.82 ,"$3,199.00 ","$2,095.35 ",$388.82 ,"$1,330.78 ",$326.17 ,$311.35 ,$406.98 ,"$2,879.10 ",$842.63 ,"$1,973.78 ",$895.72 ,"$2,879.10 ",$388.82 ,"$2,879.10 ","$2,879.10 ",$388.82 ,"$2,079.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$2,908.00 ","$1,890.20 ",$242.96 ,"$2,908.00 ",$583.23 ,"$2,166.46 ","$1,904.74 ",$242.96 ,$814.24 ,"$1,468.54 ",$242.96 ,"$1,794.24 ",$242.96 ,"$1,794.24 ","$1,794.24 ",$242.96 ,"$1,794.24 ",$461.62 ,"$2,617.20 ","$2,181.00 ",$583.23 ,$242.96 ,"$2,559.04 ",$242.96 ,"$2,181.00 ","$2,181.00 ","$2,471.80 ","$2,471.80 ",$242.96 ,"$2,471.80 ",$242.96 ,"$2,268.24 ","$2,268.24 ","$2,268.24 ","$2,617.20 ",$583.23 ,"$2,617.20 ",$242.96 ,"$2,908.00 ","$1,904.74 ",$242.96 ,"$1,209.73 ",$326.17 ,$311.35 ,$254.30 ,"$2,617.20 ",$526.52 ,"$1,794.24 ",$814.24 ,"$2,617.20 ",$242.96 ,"$2,617.20 ","$2,617.20 ",$242.96 ,"$1,890.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$1,939.00 ","$1,260.35 ",$242.96 ,"$1,939.00 ",$583.23 ,"$1,444.56 ","$1,270.05 ",$242.96 ,$542.92 ,$979.20 ,$242.96 ,"$1,196.36 ",$242.96 ,"$1,196.36 ","$1,196.36 ",$242.96 ,"$1,196.36 ",$461.62 ,"$1,745.10 ","$1,454.25 ",$583.23 ,$242.96 ,"$1,706.32 ",$242.96 ,"$1,454.25 ","$1,454.25 ","$1,648.15 ","$1,648.15 ",$242.96 ,"$1,648.15 ",$242.96 ,"$1,512.42 ","$1,512.42 ","$1,512.42 ","$1,745.10 ",$583.23 ,"$1,745.10 ",$242.96 ,"$1,939.00 ","$1,270.05 ",$242.96 ,$806.62 ,$326.17 ,$311.35 ,$254.30 ,"$1,745.10 ",$526.52 ,"$1,196.36 ",$542.92 ,"$1,745.10 ",$242.96 ,"$1,745.10 ","$1,745.10 ",$242.96 ,"$1,260.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$3,896.00 ","$2,532.40 ",$311.35 ,"$3,896.00 ",$933.39 ,"$2,902.52 ","$2,551.88 ",$388.82 ,"$1,090.88 ","$1,967.48 ",$388.82 ,"$2,403.83 ",$388.82 ,"$2,403.83 ","$2,403.83 ",$388.82 ,"$2,403.83 ",$738.76 ,"$3,506.40 ","$2,922.00 ",$933.39 ,$388.82 ,"$3,428.48 ",$388.82 ,"$2,922.00 ","$2,922.00 ","$3,311.60 ","$3,311.60 ",$388.82 ,"$3,311.60 ",$388.82 ,"$3,038.88 ","$3,038.88 ","$3,038.88 ","$3,506.40 ",$933.39 ,"$3,506.40 ",$388.82 ,"$3,896.00 ","$2,551.88 ",$388.82 ,"$1,620.74 ",$326.17 ,$311.35 ,$406.98 ,"$3,506.40 ",$842.63 ,"$2,403.83 ","$1,090.88 ","$3,506.40 ",$388.82 ,"$3,506.40 ","$3,506.40 ",$388.82 ,"$2,532.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$2,597.00 ","$1,688.05 ",$311.35 ,"$2,597.00 ",$933.39 ,"$1,934.77 ","$1,701.04 ",$388.82 ,$727.16 ,"$1,311.49 ",$388.82 ,"$1,602.35 ",$388.82 ,"$1,602.35 ","$1,602.35 ",$388.82 ,"$1,602.35 ",$738.76 ,"$2,337.30 ","$1,947.75 ",$933.39 ,$388.82 ,"$2,285.36 ",$388.82 ,"$1,947.75 ","$1,947.75 ","$2,207.45 ","$2,207.45 ",$388.82 ,"$2,207.45 ",$388.82 ,"$2,025.66 ","$2,025.66 ","$2,025.66 ","$2,337.30 ",$933.39 ,"$2,337.30 ",$388.82 ,"$2,597.00 ","$1,701.04 ",$388.82 ,"$1,080.35 ",$326.17 ,$311.35 ,$406.98 ,"$2,337.30 ",$842.63 ,"$1,602.35 ",$727.16 ,"$2,337.30 ",$388.82 ,"$2,337.30 ","$2,337.30 ",$388.82 ,"$1,688.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000068,C8918,HC MRA PELVIS W/CON,610,1 ,"$4,252.00 ","$2,763.80 ",$311.35 ,"$4,252.00 ",$933.39 ,"$3,167.74 ","$2,785.06 ",$388.82 ,"$1,190.56 ","$2,147.26 ",$388.82 ,"$2,623.48 ",$388.82 ,"$2,623.48 ","$2,623.48 ",$388.82 ,"$2,623.48 ",$738.76 ,"$3,826.80 ","$3,189.00 ",$933.39 ,$388.82 ,"$3,741.76 ",$388.82 ,"$3,189.00 ","$3,189.00 ","$3,614.20 ","$3,614.20 ",$388.82 ,"$3,614.20 ",$388.82 ,"$3,316.56 ","$3,316.56 ","$3,316.56 ","$3,826.80 ",$933.39 ,"$3,826.80 ",$388.82 ,"$4,252.00 ","$2,785.06 ",$388.82 ,"$1,768.83 ",$326.17 ,$311.35 ,$406.98 ,"$3,826.80 ",$842.63 ,"$2,623.48 ","$1,190.56 ","$3,826.80 ",$388.82 ,"$3,826.80 ","$3,826.80 ",$388.82 ,"$2,763.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$1,939.00 ","$1,260.35 ",$311.35 ,"$1,939.00 ",$933.39 ,"$1,444.56 ","$1,270.05 ",$388.82 ,$542.92 ,$979.20 ,$388.82 ,"$1,196.36 ",$388.82 ,"$1,196.36 ","$1,196.36 ",$388.82 ,"$1,196.36 ",$738.76 ,"$1,745.10 ","$1,454.25 ",$933.39 ,$388.82 ,"$1,706.32 ",$388.82 ,"$1,454.25 ","$1,454.25 ","$1,648.15 ","$1,648.15 ",$388.82 ,"$1,648.15 ",$388.82 ,"$1,512.42 ","$1,512.42 ","$1,512.42 ","$1,745.10 ",$933.39 ,"$1,745.10 ",$388.82 ,"$1,939.00 ","$1,270.05 ",$388.82 ,$806.62 ,$326.17 ,$311.35 ,$406.98 ,"$1,745.10 ",$842.63 ,"$1,196.36 ",$542.92 ,"$1,745.10 ",$388.82 ,"$1,745.10 ","$1,745.10 ",$388.82 ,"$1,260.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000071,C8934,HC MRA UPPR EXT W/CONTRAST,610,1 ,"$1,939.00 ","$1,260.35 ",$311.35 ,"$1,939.00 ",$933.39 ,"$1,444.56 ","$1,270.05 ",$388.82 ,$542.92 ,$979.20 ,$388.82 ,"$1,196.36 ",$388.82 ,"$1,196.36 ","$1,196.36 ",$388.82 ,"$1,196.36 ",$738.76 ,"$1,745.10 ","$1,454.25 ",$933.39 ,$388.82 ,"$1,706.32 ",$388.82 ,"$1,454.25 ","$1,454.25 ","$1,648.15 ","$1,648.15 ",$388.82 ,"$1,648.15 ",$388.82 ,"$1,512.42 ","$1,512.42 ","$1,512.42 ","$1,745.10 ",$933.39 ,"$1,745.10 ",$388.82 ,"$1,939.00 ","$1,270.05 ",$388.82 ,$806.62 ,$326.17 ,$311.35 ,$406.98 ,"$1,745.10 ",$842.63 ,"$1,196.36 ",$542.92 ,"$1,745.10 ",$388.82 ,"$1,745.10 ","$1,745.10 ",$388.82 ,"$1,260.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$5,005.00 ","$3,253.25 ",$269.78 ,"$5,005.00 ",$933.39 ,"$3,728.73 ","$3,278.28 ",$388.82 ,"$1,401.40 ","$2,527.53 ",$388.82 ,"$3,088.09 ",$388.82 ,"$3,088.09 ","$3,088.09 ",$388.82 ,"$3,088.09 ",$738.76 ,"$4,504.50 ","$3,753.75 ",$933.39 ,$388.82 ,"$4,404.40 ",$388.82 ,"$3,753.75 ","$3,753.75 ","$4,254.25 ","$4,254.25 ",$388.82 ,"$4,254.25 ",$388.82 ,"$3,903.90 ","$3,903.90 ","$3,903.90 ","$4,504.50 ",$933.39 ,"$4,504.50 ",$388.82 ,"$5,005.00 ","$3,278.28 ",$388.82 ,"$2,082.08 ",$282.62 ,$269.78 ,$406.98 ,"$4,504.50 ",$842.63 ,"$3,088.09 ","$1,401.40 ","$4,504.50 ",$388.82 ,"$4,504.50 ","$4,504.50 ",$388.82 ,"$3,253.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$3,381.00 ","$2,197.65 ",$240.78 ,"$3,381.00 ",$933.39 ,"$2,518.85 ","$2,214.56 ",$388.82 ,$946.68 ,"$1,707.41 ",$388.82 ,"$2,086.08 ",$388.82 ,"$2,086.08 ","$2,086.08 ",$388.82 ,"$2,086.08 ",$738.76 ,"$3,042.90 ","$2,535.75 ",$933.39 ,$388.82 ,"$2,975.28 ",$388.82 ,"$2,535.75 ","$2,535.75 ","$2,873.85 ","$2,873.85 ",$388.82 ,"$2,873.85 ",$388.82 ,"$2,637.18 ","$2,637.18 ","$2,637.18 ","$3,042.90 ",$933.39 ,"$3,042.90 ",$388.82 ,"$3,381.00 ","$2,214.56 ",$388.82 ,"$1,406.50 ",$252.24 ,$240.78 ,$406.98 ,"$3,042.90 ",$842.63 ,"$2,086.08 ",$946.68 ,"$3,042.90 ",$388.82 ,"$3,042.90 ","$3,042.90 ",$388.82 ,"$2,197.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),62300009,A6022,HC DRESSING COLLAGEN >16 = <48 SQ IN,623,1 ,$79.77 ,$51.85 ,$22.34 ,$79.77 , N/A ,$59.43 ,$52.25 , N/A ,$22.34 ,$40.28 , N/A ,$49.22 , N/A ,$49.22 ,$49.22 , N/A ,$49.22 , N/A ,$71.79 ,$59.83 , N/A , N/A ,$70.20 , N/A ,$59.83 ,$59.83 ,$67.80 ,$67.80 , N/A ,$67.80 , N/A ,$62.22 ,$62.22 ,$62.22 ,$71.79 , N/A ,$71.79 , N/A ,$79.77 ,$52.25 , N/A ,$33.18 , N/A , N/A , N/A ,$71.79 , N/A ,$49.22 ,$22.34 ,$71.79 , N/A ,$71.79 ,$71.79 , N/A ,$51.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),62300010,A6197,HC DRESSING ALGINATE >16 = <48 SQ IN,623,1 ,$115.47 ,$75.06 ,$32.33 ,$115.47 , N/A ,$86.03 ,$75.63 , N/A ,$32.33 ,$58.31 , N/A ,$71.25 , N/A ,$71.25 ,$71.25 , N/A ,$71.25 , N/A ,$103.92 ,$86.60 , N/A , N/A ,$101.61 , N/A ,$86.60 ,$86.60 ,$98.15 ,$98.15 , N/A ,$98.15 , N/A ,$90.07 ,$90.07 ,$90.07 ,$103.92 , N/A ,$103.92 , N/A ,$115.47 ,$75.63 , N/A ,$48.04 , N/A , N/A , N/A ,$103.92 , N/A ,$71.25 ,$32.33 ,$103.92 , N/A ,$103.92 ,$103.92 , N/A ,$75.06 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),62300024,A6211,HC DRESSING FOAM W/O BORDER BURN >48 SQ IN,623,1 ,$85.89 ,$55.83 ,$24.05 ,$85.89 , N/A ,$63.99 ,$56.26 , N/A ,$24.05 ,$43.37 , N/A ,$52.99 , N/A ,$52.99 ,$52.99 , N/A ,$52.99 , N/A ,$77.30 ,$64.42 , N/A , N/A ,$75.58 , N/A ,$64.42 ,$64.42 ,$73.01 ,$73.01 , N/A ,$73.01 , N/A ,$66.99 ,$66.99 ,$66.99 ,$77.30 , N/A ,$77.30 , N/A ,$85.89 ,$56.26 , N/A ,$35.73 , N/A , N/A , N/A ,$77.30 , N/A ,$52.99 ,$24.05 ,$77.30 , N/A ,$77.30 ,$77.30 , N/A ,$55.83 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),62300031,A6448,HC BANDAGE COMPRESSION <3 IN PER YD,623,1 ,$107.33 ,$69.76 ,$30.05 ,$107.33 , N/A ,$79.96 ,$70.30 , N/A ,$30.05 ,$54.20 , N/A ,$66.22 , N/A ,$66.22 ,$66.22 , N/A ,$66.22 , N/A ,$96.60 ,$80.50 , N/A , N/A ,$94.45 , N/A ,$80.50 ,$80.50 ,$91.23 ,$91.23 , N/A ,$91.23 , N/A ,$83.72 ,$83.72 ,$83.72 ,$96.60 , N/A ,$96.60 , N/A ,$107.33 ,$70.30 , N/A ,$44.65 , N/A , N/A , N/A ,$96.60 , N/A ,$66.22 ,$30.05 ,$96.60 , N/A ,$96.60 ,$96.60 , N/A ,$69.76 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),62300039,A6262,HC WOUND FILLER DRY NOS PER GRAM,623,1 ,$19.95 ,$12.97 ,$5.59 ,$19.95 , N/A ,$14.86 ,$13.07 , N/A ,$5.59 ,$10.07 , N/A ,$12.31 , N/A ,$12.31 ,$12.31 , N/A ,$12.31 , N/A ,$17.96 ,$14.96 , N/A , N/A ,$17.56 , N/A ,$14.96 ,$14.96 ,$16.96 ,$16.96 , N/A ,$16.96 , N/A ,$15.56 ,$15.56 ,$15.56 ,$17.96 , N/A ,$17.96 , N/A ,$19.95 ,$13.07 , N/A ,$8.30 , N/A , N/A , N/A ,$17.96 , N/A ,$12.31 ,$5.59 ,$17.96 , N/A ,$17.96 ,$17.96 , N/A ,$12.97 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600009,Q4186,HC EPIFIX PER SQ CM,636,1 ,$857.86 ,$557.61 ,$240.20 ,$857.86 , N/A ,$639.11 ,$561.90 , N/A ,$240.20 ,$433.22 , N/A ,$529.30 , N/A ,$529.30 ,$529.30 , N/A ,$529.30 , N/A ,$772.07 ,$643.40 , N/A , N/A ,$754.92 , N/A ,$643.40 ,$643.40 ,$729.18 ,$729.18 , N/A ,$729.18 , N/A ,$669.13 ,$669.13 ,$669.13 ,$772.07 , N/A ,$772.07 , N/A ,$857.86 ,$561.90 , N/A ,$356.87 ,$336.45 ,$321.15 , N/A ,$772.07 , N/A ,$529.30 ,$240.20 ,$772.07 , N/A ,$254.61 ,$254.61 , N/A ,$557.61 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600019,M1145,"HC MFN DRUG ADD-ON, PER DOSE",636,1 ,$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 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , 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 , N/A , N/A , N/A ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600183,Q4196,HC PURAPLY ANTIMICROBIAL PER SQ CENTIMETER USED - JC,636,1 ,$405.00 ,$263.25 ,$113.40 ,$405.00 , N/A ,$301.73 ,$265.28 , N/A ,$113.40 ,$204.53 , N/A ,$249.89 , N/A ,$249.89 ,$249.89 , N/A ,$249.89 , N/A ,$364.50 ,$303.75 , N/A , N/A ,$356.40 , N/A ,$303.75 ,$303.75 ,$344.25 ,$344.25 , N/A ,$344.25 , N/A ,$315.90 ,$315.90 ,$315.90 ,$364.50 , N/A ,$364.50 , N/A ,$405.00 ,$265.28 , N/A ,$168.48 ,$336.45 ,$321.15 , N/A ,$364.50 , N/A ,$249.89 ,$113.40 ,$364.50 , N/A ,$182.57 ,$182.57 , N/A ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600184,Q4196,HC PURAPLY ANTIMICROBIAL PER SQ CENTIMETER WASTED - JW,636,1 ,$405.00 ,$263.25 ,$113.40 ,$405.00 , N/A ,$301.73 ,$265.28 , N/A ,$113.40 ,$204.53 , N/A ,$249.89 , N/A ,$249.89 ,$249.89 , N/A ,$249.89 , N/A ,$364.50 ,$303.75 , N/A , N/A ,$356.40 , N/A ,$303.75 ,$303.75 ,$344.25 ,$344.25 , N/A ,$344.25 , N/A ,$315.90 ,$315.90 ,$315.90 ,$364.50 , N/A ,$364.50 , N/A ,$405.00 ,$265.28 , N/A ,$168.48 ,$336.45 ,$321.15 , N/A ,$364.50 , N/A ,$249.89 ,$113.40 ,$364.50 , N/A ,$182.57 ,$182.57 , N/A ,$263.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600185,Q4101,HC APLIGRAF PER SQ CM USED -JC,636,1 ,$142.58 ,$92.68 ,$39.92 ,$142.58 , N/A ,$106.22 ,$93.39 , N/A ,$39.92 ,$72.00 , N/A ,$87.97 , N/A ,$87.97 ,$87.97 , N/A ,$87.97 , N/A ,$128.32 ,$106.94 , N/A , N/A ,$125.47 , N/A ,$106.94 ,$106.94 ,$121.19 ,$121.19 , N/A ,$121.19 , N/A ,$111.21 ,$111.21 ,$111.21 ,$128.32 , N/A ,$128.32 , N/A ,$142.58 ,$93.39 , N/A ,$59.31 ,$142.58 ,$142.58 , N/A ,$128.32 , N/A ,$87.97 ,$39.92 ,$128.32 , N/A ,$50.23 ,$50.23 , N/A ,$92.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600186,Q4101,HC APLIGRAF PER SQ CM WASTED - JW,636,1 ,$142.58 ,$92.68 ,$39.92 ,$142.58 , N/A ,$106.22 ,$93.39 , N/A ,$39.92 ,$72.00 , N/A ,$87.97 , N/A ,$87.97 ,$87.97 , N/A ,$87.97 , N/A ,$128.32 ,$106.94 , N/A , N/A ,$125.47 , N/A ,$106.94 ,$106.94 ,$121.19 ,$121.19 , N/A ,$121.19 , N/A ,$111.21 ,$111.21 ,$111.21 ,$128.32 , N/A ,$128.32 , N/A ,$142.58 ,$93.39 , N/A ,$59.31 ,$142.58 ,$142.58 , N/A ,$128.32 , N/A ,$87.97 ,$39.92 ,$128.32 , N/A ,$50.23 ,$50.23 , N/A ,$92.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600187,Q4106,HC DERMAGRAFT PER SQ CM USED -JC,636,1 ,$173.65 ,$112.87 ,$48.62 ,$173.65 , N/A ,$129.37 ,$113.74 , N/A ,$48.62 ,$87.69 , N/A ,$107.14 , N/A ,$107.14 ,$107.14 , N/A ,$107.14 , N/A ,$156.29 ,$130.24 , N/A , N/A ,$152.81 , N/A ,$130.24 ,$130.24 ,$147.60 ,$147.60 , N/A ,$147.60 , N/A ,$135.45 ,$135.45 ,$135.45 ,$156.29 , N/A ,$156.29 , N/A ,$173.65 ,$113.74 , N/A ,$72.24 ,$173.65 ,$173.65 , N/A ,$156.29 , N/A ,$107.14 ,$48.62 ,$156.29 , N/A ,$52.75 ,$52.75 , N/A ,$112.87 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600188,Q4106,HC DERMAGRAFT PER SQ CM WASTED -JW,636,1 ,$173.65 ,$112.87 ,$48.62 ,$173.65 , N/A ,$129.37 ,$113.74 , N/A ,$48.62 ,$87.69 , N/A ,$107.14 , N/A ,$107.14 ,$107.14 , N/A ,$107.14 , N/A ,$156.29 ,$130.24 , N/A , N/A ,$152.81 , N/A ,$130.24 ,$130.24 ,$147.60 ,$147.60 , N/A ,$147.60 , N/A ,$135.45 ,$135.45 ,$135.45 ,$156.29 , N/A ,$156.29 , N/A ,$173.65 ,$113.74 , N/A ,$72.24 ,$173.65 ,$173.65 , N/A ,$156.29 , N/A ,$107.14 ,$48.62 ,$156.29 , N/A ,$52.75 ,$52.75 , N/A ,$112.87 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600190,Q4160,HC NUSHIELD PER SQ CM,636,1 ,$693.15 ,$450.55 ,$158.30 ,$693.15 , N/A ,$516.40 ,$454.01 , N/A ,$194.08 ,$350.04 , N/A ,$427.67 , N/A ,$427.67 ,$427.67 , N/A ,$427.67 , N/A ,$623.84 ,$519.86 , N/A , N/A ,$609.97 , N/A ,$519.86 ,$519.86 ,$589.18 ,$589.18 , N/A ,$589.18 , N/A ,$540.66 ,$540.66 ,$540.66 ,$623.84 , N/A ,$623.84 , N/A ,$693.15 ,$454.01 , N/A ,$288.35 ,$336.45 ,$321.15 , N/A ,$623.84 , N/A ,$427.67 ,$194.08 ,$623.84 , N/A ,$158.30 ,$158.30 , N/A ,$450.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600191,Q4186,HC EPIFIX PER SQ CM USED- JC,636,1 ,$483.99 ,$314.59 ,$135.52 ,$483.99 , N/A ,$360.57 ,$317.01 , N/A ,$135.52 ,$244.42 , N/A ,$298.62 , N/A ,$298.62 ,$298.62 , N/A ,$298.62 , N/A ,$435.59 ,$362.99 , N/A , N/A ,$425.91 , N/A ,$362.99 ,$362.99 ,$411.39 ,$411.39 , N/A ,$411.39 , N/A ,$377.51 ,$377.51 ,$377.51 ,$435.59 , N/A ,$435.59 , N/A ,$483.99 ,$317.01 , N/A ,$201.34 ,$336.45 ,$321.15 , N/A ,$435.59 , N/A ,$298.62 ,$135.52 ,$435.59 , N/A ,$254.61 ,$254.61 , N/A ,$314.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600192,Q4186,HC EPIFIX PER SQ CM WASTED - JW,636,1 ,$483.99 ,$314.59 ,$135.52 ,$483.99 , N/A ,$360.57 ,$317.01 , N/A ,$135.52 ,$244.42 , N/A ,$298.62 , N/A ,$298.62 ,$298.62 , N/A ,$298.62 , N/A ,$435.59 ,$362.99 , N/A , N/A ,$425.91 , N/A ,$362.99 ,$362.99 ,$411.39 ,$411.39 , N/A ,$411.39 , N/A ,$377.51 ,$377.51 ,$377.51 ,$435.59 , N/A ,$435.59 , N/A ,$483.99 ,$317.01 , N/A ,$201.34 ,$336.45 ,$321.15 , N/A ,$435.59 , N/A ,$298.62 ,$135.52 ,$435.59 , N/A ,$254.61 ,$254.61 , N/A ,$314.59 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600195,Q4110,"HC PRIMATRIX, PER SQ CM USED - JC",636,1 ,$172.44 ,$112.09 ,$48.28 ,$172.44 , N/A ,$128.47 ,$112.95 , N/A ,$48.28 ,$87.08 , N/A ,$106.40 , N/A ,$106.40 ,$106.40 , N/A ,$106.40 , N/A ,$155.20 ,$129.33 , N/A , N/A ,$151.75 , N/A ,$129.33 ,$129.33 ,$146.57 ,$146.57 , N/A ,$146.57 , N/A ,$134.50 ,$134.50 ,$134.50 ,$155.20 , N/A ,$155.20 , N/A ,$172.44 ,$112.95 , N/A ,$71.74 ,$172.44 ,$172.44 , N/A ,$155.20 , N/A ,$106.40 ,$48.28 ,$155.20 , N/A ,$70.46 ,$70.46 , N/A ,$112.09 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600196,Q4110,"HC PRIMATRIX, PER SQ CM WASTED - JW",636,1 ,$172.44 ,$112.09 ,$48.28 ,$172.44 , N/A ,$128.47 ,$112.95 , N/A ,$48.28 ,$87.08 , N/A ,$106.40 , N/A ,$106.40 ,$106.40 , N/A ,$106.40 , N/A ,$155.20 ,$129.33 , N/A , N/A ,$151.75 , N/A ,$129.33 ,$129.33 ,$146.57 ,$146.57 , N/A ,$146.57 , N/A ,$134.50 ,$134.50 ,$134.50 ,$155.20 , N/A ,$155.20 , N/A ,$172.44 ,$112.95 , N/A ,$71.74 ,$172.44 ,$172.44 , N/A ,$155.20 , N/A ,$106.40 ,$48.28 ,$155.20 , N/A ,$70.46 ,$70.46 , N/A ,$112.09 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600197,Q4102,HC OASIS PER SQ CENTIMETER USED -JC,636,1 ,$19.18 ,$12.47 ,$5.37 ,$19.18 , N/A ,$14.29 ,$12.56 , N/A ,$5.37 ,$9.69 , N/A ,$11.83 , N/A ,$11.83 ,$11.83 , N/A ,$11.83 , N/A ,$17.26 ,$14.39 , N/A , N/A ,$16.88 , N/A ,$14.39 ,$14.39 ,$16.30 ,$16.30 , N/A ,$16.30 , N/A ,$14.96 ,$14.96 ,$14.96 ,$17.26 , N/A ,$17.26 , N/A ,$19.18 ,$12.56 , N/A ,$7.98 ,$19.18 ,$19.18 , N/A ,$17.26 , N/A ,$11.83 ,$5.37 ,$17.26 , N/A ,$16.17 ,$16.17 , N/A ,$12.47 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600198,Q4102,HC OASIS PER SQ CENTIMETER WASTED -JW,636,1 ,$19.18 ,$12.47 ,$5.37 ,$19.18 , N/A ,$14.29 ,$12.56 , N/A ,$5.37 ,$9.69 , N/A ,$11.83 , N/A ,$11.83 ,$11.83 , N/A ,$11.83 , N/A ,$17.26 ,$14.39 , N/A , N/A ,$16.88 , N/A ,$14.39 ,$14.39 ,$16.30 ,$16.30 , N/A ,$16.30 , N/A ,$14.96 ,$14.96 ,$14.96 ,$17.26 , N/A ,$17.26 , N/A ,$19.18 ,$12.56 , N/A ,$7.98 ,$19.18 ,$19.18 , N/A ,$17.26 , N/A ,$11.83 ,$5.37 ,$17.26 , N/A ,$16.17 ,$16.17 , N/A ,$12.47 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600215,Q4133,HC GRAFIX PER SQ CM USED - JC,636,1 ,$630.00 ,$409.50 ,$176.40 ,$630.00 , N/A ,$469.35 ,$412.65 , N/A ,$176.40 ,$318.15 , N/A ,$388.71 , N/A ,$388.71 ,$388.71 , N/A ,$388.71 , N/A ,$567.00 ,$472.50 , N/A , N/A ,$554.40 , N/A ,$472.50 ,$472.50 ,$535.50 ,$535.50 , N/A ,$535.50 , N/A ,$491.40 ,$491.40 ,$491.40 ,$567.00 , N/A ,$567.00 , N/A ,$630.00 ,$412.65 , N/A ,$262.08 ,$336.45 ,$321.15 , N/A ,$567.00 , N/A ,$388.71 ,$176.40 ,$567.00 , N/A ,$221.20 ,$221.20 , N/A ,$409.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),63600216,Q4133,HC GRAFIX PER SQ CM WASTED - JW,636,1 ,$630.00 ,$409.50 ,$176.40 ,$630.00 , N/A ,$469.35 ,$412.65 , N/A ,$176.40 ,$318.15 , N/A ,$388.71 , N/A ,$388.71 ,$388.71 , N/A ,$388.71 , N/A ,$567.00 ,$472.50 , N/A , N/A ,$554.40 , N/A ,$472.50 ,$472.50 ,$535.50 ,$535.50 , N/A ,$535.50 , N/A ,$491.40 ,$491.40 ,$491.40 ,$567.00 , N/A ,$567.00 , N/A ,$630.00 ,$412.65 , N/A ,$262.08 ,$336.45 ,$321.15 , N/A ,$567.00 , N/A ,$388.71 ,$176.40 ,$567.00 , N/A ,$221.20 ,$221.20 , N/A ,$409.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000220,N/A,HC C-SECTION RECOVERY,710,1 ,"$1,086.00 ",$705.90 ,$304.08 ,"$1,086.00 ", N/A ,$809.07 ,$711.33 , N/A ,$304.08 ,$548.43 , N/A ,$670.06 , N/A ,$670.06 ,$670.06 , N/A ,$670.06 , N/A ,$977.40 ,$814.50 , N/A , N/A ,$955.68 , N/A ,$814.50 ,$814.50 ,$923.10 ,$923.10 , N/A ,$923.10 , N/A ,$847.08 ,$847.08 ,$847.08 ,$977.40 , N/A ,$977.40 , N/A ,"$1,086.00 ",$711.33 , N/A ,$451.78 , N/A , N/A , N/A ,$977.40 , N/A ,$670.06 ,$304.08 ,$977.40 , N/A ,$977.40 ,$977.40 , N/A ,$705.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000230,N/A,HC PHASE II RECOVERY 15 MIN,710,1 ,$171.00 ,$111.15 ,$47.88 ,$171.00 , N/A ,$127.40 ,$112.01 , N/A ,$47.88 ,$86.36 , N/A ,$105.51 , N/A ,$105.51 ,$105.51 , N/A ,$105.51 , N/A ,$153.90 ,$128.25 , N/A , N/A ,$150.48 , N/A ,$128.25 ,$128.25 ,$145.35 ,$145.35 , N/A ,$145.35 , N/A ,$133.38 ,$133.38 ,$133.38 ,$153.90 , N/A ,$153.90 , N/A ,$171.00 ,$112.01 , N/A ,$71.14 , N/A , N/A , N/A ,$153.90 , N/A ,$105.51 ,$47.88 ,$153.90 , N/A ,$153.90 ,$153.90 , N/A ,$111.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000231,N/A,HC RECOVERY <75 MIN,710,1 ,$895.00 ,$581.75 ,$250.60 ,$895.00 , N/A ,$666.78 ,$586.23 , N/A ,$250.60 ,$451.98 , N/A ,$552.22 , N/A ,$552.22 ,$552.22 , N/A ,$552.22 , N/A ,$805.50 ,$671.25 , N/A , N/A ,$787.60 , N/A ,$671.25 ,$671.25 ,$760.75 ,$760.75 , N/A ,$760.75 , N/A ,$698.10 ,$698.10 ,$698.10 ,$805.50 , N/A ,$805.50 , N/A ,$895.00 ,$586.23 , N/A ,$372.32 , N/A , N/A , N/A ,$805.50 , N/A ,$552.22 ,$250.60 ,$805.50 , N/A ,$805.50 ,$805.50 , N/A ,$581.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000232,N/A,HC RECOVERY >75 MIN,710,1 ,$175.00 ,$113.75 ,$49.00 ,$175.00 , N/A ,$130.38 ,$114.63 , N/A ,$49.00 ,$88.38 , N/A ,$107.98 , N/A ,$107.98 ,$107.98 , N/A ,$107.98 , N/A ,$157.50 ,$131.25 , N/A , N/A ,$154.00 , N/A ,$131.25 ,$131.25 ,$148.75 ,$148.75 , N/A ,$148.75 , N/A ,$136.50 ,$136.50 ,$136.50 ,$157.50 , N/A ,$157.50 , N/A ,$175.00 ,$114.63 , N/A ,$72.80 , N/A , N/A , N/A ,$157.50 , N/A ,$107.98 ,$49.00 ,$157.50 , N/A ,$157.50 ,$157.50 , N/A ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000233,N/A,HC PHASE I RECOVERY 30 MIN,710,1 ,"$1,310.00 ",$851.50 ,$366.80 ,"$1,310.00 ", N/A ,$975.95 ,$858.05 , N/A ,$366.80 ,$661.55 , N/A ,$808.27 , N/A ,$808.27 ,$808.27 , N/A ,$808.27 , N/A ,"$1,179.00 ",$982.50 , N/A , N/A ,"$1,152.80 ", N/A ,$982.50 ,$982.50 ,"$1,113.50 ","$1,113.50 ", N/A ,"$1,113.50 ", N/A ,"$1,021.80 ","$1,021.80 ","$1,021.80 ","$1,179.00 ", N/A ,"$1,179.00 ", N/A ,"$1,310.00 ",$858.05 , N/A ,$544.96 , N/A , N/A , N/A ,"$1,179.00 ", N/A ,$808.27 ,$366.80 ,"$1,179.00 ", N/A ,"$1,179.00 ","$1,179.00 ", N/A ,$851.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000234,N/A,HC PHASE I RECOVERY 15 MIN,710,1 ,$556.00 ,$361.40 ,$155.68 ,$556.00 , N/A ,$414.22 ,$364.18 , N/A ,$155.68 ,$280.78 , N/A ,$343.05 , N/A ,$343.05 ,$343.05 , N/A ,$343.05 , N/A ,$500.40 ,$417.00 , N/A , N/A ,$489.28 , N/A ,$417.00 ,$417.00 ,$472.60 ,$472.60 , N/A ,$472.60 , N/A ,$433.68 ,$433.68 ,$433.68 ,$500.40 , N/A ,$500.40 , N/A ,$556.00 ,$364.18 , N/A ,$231.30 , N/A , N/A , N/A ,$500.40 , N/A ,$343.05 ,$155.68 ,$500.40 , N/A ,$500.40 ,$500.40 , N/A ,$361.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000252,N/A,HC RECOVERY EXTENDED INIT HR,710,1 ,$319.00 ,$207.35 ,$89.32 ,$319.00 , N/A ,$237.66 ,$208.95 , N/A ,$89.32 ,$161.10 , N/A ,$196.82 , N/A ,$196.82 ,$196.82 , N/A ,$196.82 , N/A ,$287.10 ,$239.25 , N/A , N/A ,$280.72 , N/A ,$239.25 ,$239.25 ,$271.15 ,$271.15 , N/A ,$271.15 , N/A ,$248.82 ,$248.82 ,$248.82 ,$287.10 , N/A ,$287.10 , N/A ,$319.00 ,$208.95 , N/A ,$132.70 , N/A , N/A , N/A ,$287.10 , N/A ,$196.82 ,$89.32 ,$287.10 , N/A ,$287.10 ,$287.10 , N/A ,$207.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),71000253,N/A,HC RECOVERY EXTENDED ADDL HR,710,1 ,$106.00 ,$68.90 ,$29.68 ,$106.00 , N/A ,$78.97 ,$69.43 , N/A ,$29.68 ,$53.53 , N/A ,$65.40 , N/A ,$65.40 ,$65.40 , N/A ,$65.40 , N/A ,$95.40 ,$79.50 , N/A , N/A ,$93.28 , N/A ,$79.50 ,$79.50 ,$90.10 ,$90.10 , N/A ,$90.10 , N/A ,$82.68 ,$82.68 ,$82.68 ,$95.40 , N/A ,$95.40 , N/A ,$106.00 ,$69.43 , N/A ,$44.10 , N/A , N/A , N/A ,$95.40 , N/A ,$65.40 ,$29.68 ,$95.40 , N/A ,$95.40 ,$95.40 , N/A ,$68.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72000008,59412,HC EXTERNAL CEPHALIC VERSION,720,1 ,"$3,063.00 ","$1,990.95 ",$857.64 ,"$6,003.57 ","$3,063.00 ","$2,281.94 ","$2,006.27 ","$2,770.28 ",$857.64 ,"$1,546.82 ","$2,770.28 ","$1,889.87 ","$2,770.28 ","$1,889.87 ","$1,889.87 ","$2,770.28 ","$1,889.87 ","$5,263.53 ","$2,756.70 ","$2,297.25 ","$3,063.00 ","$2,770.28 ","$2,695.44 ","$2,770.28 ","$2,297.25 ","$2,297.25 ","$2,603.55 ","$2,603.55 ","$2,770.28 ","$2,603.55 ","$2,770.28 ","$2,389.14 ","$2,389.14 ","$2,389.14 ","$2,756.70 ","$3,063.00 ","$2,756.70 ","$2,770.28 ","$3,063.00 ","$2,006.27 ","$2,770.28 ","$1,274.21 ", N/A , N/A ,"$2,899.62 ","$2,756.70 ","$6,003.57 ","$1,889.87 ",$857.64 ,"$2,756.70 ","$2,770.28 ","$2,756.70 ","$2,756.70 ","$2,770.28 ","$1,990.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72000013,N/A,HC DELIVERY COMPLICATED,720,1 ,"$3,855.00 ","$2,505.75 ","$1,079.40 ","$3,855.00 ", N/A ,"$2,871.98 ","$2,525.03 ", N/A ,"$1,079.40 ","$1,946.78 ", N/A ,"$2,378.54 ", N/A ,"$2,378.54 ","$2,378.54 ", N/A ,"$2,378.54 ", N/A ,"$3,469.50 ","$2,891.25 ", N/A , N/A ,"$3,392.40 ", N/A ,"$2,891.25 ","$2,891.25 ","$3,276.75 ","$3,276.75 ", N/A ,"$3,276.75 ", N/A ,"$3,006.90 ","$3,006.90 ","$3,006.90 ","$3,469.50 ", N/A ,"$3,469.50 ", N/A ,"$3,855.00 ","$2,525.03 ", N/A ,"$1,603.68 ", N/A , N/A , N/A ,"$3,469.50 ", N/A ,"$2,378.54 ","$1,079.40 ","$3,469.50 ", N/A ,"$3,469.50 ","$3,469.50 ", N/A ,"$2,505.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72100005,N/A,HC LABOR PER HR,721,1 ,$122.00 ,$79.30 ,$34.16 ,$122.00 , N/A ,$90.89 ,$79.91 , N/A ,$34.16 ,$61.61 , N/A ,$75.27 , N/A ,$75.27 ,$75.27 , N/A ,$75.27 , N/A ,$109.80 ,$91.50 , N/A , N/A ,$107.36 , N/A ,$91.50 ,$91.50 ,$103.70 ,$103.70 , N/A ,$103.70 , N/A ,$95.16 ,$95.16 ,$95.16 ,$109.80 , N/A ,$109.80 , N/A ,$122.00 ,$79.91 , N/A ,$50.75 , N/A , N/A , N/A ,$109.80 , N/A ,$75.27 ,$34.16 ,$109.80 , N/A ,$109.80 ,$109.80 , N/A ,$79.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72200009,N/A,HC DELIVERY,722,1 ,"$2,218.00 ","$1,441.70 ",$621.04 ,"$2,218.00 ", N/A ,"$1,652.41 ","$1,452.79 ", N/A ,$621.04 ,"$1,120.09 ", N/A ,"$1,368.51 ", N/A ,"$1,368.51 ","$1,368.51 ", N/A ,"$1,368.51 ", N/A ,"$1,996.20 ","$1,663.50 ", N/A , N/A ,"$1,951.84 ", N/A ,"$1,663.50 ","$1,663.50 ","$1,885.30 ","$1,885.30 ", N/A ,"$1,885.30 ", N/A ,"$1,730.04 ","$1,730.04 ","$1,730.04 ","$1,996.20 ", N/A ,"$1,996.20 ", N/A ,"$2,218.00 ","$1,452.79 ", N/A ,$922.69 , N/A , N/A , N/A ,"$1,996.20 ", N/A ,"$1,368.51 ",$621.04 ,"$1,996.20 ", N/A ,"$1,996.20 ","$1,996.20 ", N/A ,"$1,441.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72200014,N/A,HC C-SECTION,722,1 ,"$2,841.00 ","$1,846.65 ",$795.48 ,"$2,841.00 ", N/A ,"$2,116.55 ","$1,860.86 ", N/A ,$795.48 ,"$1,434.71 ", N/A ,"$1,752.90 ", N/A ,"$1,752.90 ","$1,752.90 ", N/A ,"$1,752.90 ", N/A ,"$2,556.90 ","$2,130.75 ", N/A , N/A ,"$2,500.08 ", N/A ,"$2,130.75 ","$2,130.75 ","$2,414.85 ","$2,414.85 ", N/A ,"$2,414.85 ", N/A ,"$2,215.98 ","$2,215.98 ","$2,215.98 ","$2,556.90 ", N/A ,"$2,556.90 ", N/A ,"$2,841.00 ","$1,860.86 ", N/A ,"$1,181.86 ", N/A , N/A , N/A ,"$2,556.90 ", N/A ,"$1,752.90 ",$795.48 ,"$2,556.90 ", N/A ,"$2,556.90 ","$2,556.90 ", N/A ,"$1,846.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72200015,N/A,HC C-SECTION COMPLICATED,722,1 ,"$4,711.00 ","$3,062.15 ","$1,319.08 ","$4,711.00 ", N/A ,"$3,509.70 ","$3,085.71 ", N/A ,"$1,319.08 ","$2,379.06 ", N/A ,"$2,906.69 ", N/A ,"$2,906.69 ","$2,906.69 ", N/A ,"$2,906.69 ", N/A ,"$4,239.90 ","$3,533.25 ", N/A , N/A ,"$4,145.68 ", N/A ,"$3,533.25 ","$3,533.25 ","$4,004.35 ","$4,004.35 ", N/A ,"$4,004.35 ", N/A ,"$3,674.58 ","$3,674.58 ","$3,674.58 ","$4,239.90 ", N/A ,"$4,239.90 ", N/A ,"$4,711.00 ","$3,085.71 ", N/A ,"$1,959.78 ", N/A , N/A , N/A ,"$4,239.90 ", N/A ,"$2,906.69 ","$1,319.08 ","$4,239.90 ", N/A ,"$4,239.90 ","$4,239.90 ", N/A ,"$3,062.15 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),72300002,54160,HC CIRCUMCISION,723,1 ,$503.00 ,$326.95 ,$140.84 ,"$1,316.43 ",$503.00 ,$374.74 ,$329.47 ,$503.00 ,$140.84 ,$254.02 ,$503.00 ,$310.35 ,$503.00 ,$310.35 ,$310.35 ,$503.00 ,$310.35 ,"$1,154.16 ",$452.70 ,$377.25 ,$503.00 ,$503.00 ,$442.64 ,$503.00 ,$377.25 ,$377.25 ,$427.55 ,$427.55 ,$503.00 ,$427.55 ,$503.00 ,$392.34 ,$392.34 ,$392.34 ,$452.70 ,$503.00 ,$452.70 ,$503.00 ,$503.00 ,$329.47 ,$503.00 ,$209.25 , N/A , N/A ,$503.00 ,$452.70 ,"$1,316.43 ",$310.35 ,$140.84 ,$452.70 ,$503.00 ,$452.70 ,$452.70 ,$503.00 ,$326.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),73000002,93005,HC EKG,730,1 ,$326.00 ,$211.90 ,$17.90 ,$326.00 ,$141.09 ,$242.87 ,$213.53 ,$58.77 ,$91.28 ,$164.63 ,$58.77 ,$201.14 ,$58.77 ,$201.14 ,$201.14 ,$58.77 ,$201.14 ,$111.66 ,$293.40 ,$244.50 ,$141.09 ,$58.77 ,$286.88 ,$58.77 ,$244.50 ,$244.50 ,$277.10 ,$277.10 ,$58.77 ,$277.10 ,$58.77 ,$254.28 ,$254.28 ,$254.28 ,$293.40 ,$141.09 ,$293.40 ,$58.77 ,$326.00 ,$213.53 ,$58.77 ,$135.62 ,$18.76 ,$17.90 ,$61.52 ,$293.40 ,$127.37 ,$201.14 ,$91.28 ,$293.40 ,$58.77 ,$293.40 ,$293.40 ,$58.77 ,$211.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,$849.00 ,$551.85 ,$48.02 ,$849.00 ,$285.81 ,$632.51 ,$556.10 ,$119.06 ,$237.72 ,$428.75 ,$119.06 ,$523.83 ,$119.06 ,$523.83 ,$523.83 ,$119.06 ,$523.83 ,$226.21 ,$764.10 ,$636.75 ,$285.81 ,$119.06 ,$747.12 ,$119.06 ,$636.75 ,$636.75 ,$721.65 ,$721.65 ,$119.06 ,$721.65 ,$119.06 ,$662.22 ,$662.22 ,$662.22 ,$764.10 ,$285.81 ,$764.10 ,$119.06 ,$849.00 ,$556.10 ,$119.06 ,$353.18 ,$50.30 ,$48.02 ,$124.62 ,$764.10 ,$258.02 ,$523.83 ,$237.72 ,$764.10 ,$119.06 ,$764.10 ,$764.10 ,$119.06 ,$551.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),73100002,93226,HC HOLTER SCAN  AND  REPORT 48 HR,731,1 ,$864.00 ,$561.60 ,$48.02 ,$864.00 ,$285.81 ,$643.68 ,$565.92 ,$119.06 ,$241.92 ,$436.32 ,$119.06 ,$533.09 ,$119.06 ,$533.09 ,$533.09 ,$119.06 ,$533.09 ,$226.21 ,$777.60 ,$648.00 ,$285.81 ,$119.06 ,$760.32 ,$119.06 ,$648.00 ,$648.00 ,$734.40 ,$734.40 ,$119.06 ,$734.40 ,$119.06 ,$673.92 ,$673.92 ,$673.92 ,$777.60 ,$285.81 ,$777.60 ,$119.06 ,$864.00 ,$565.92 ,$119.06 ,$359.42 ,$50.30 ,$48.02 ,$124.62 ,$777.60 ,$258.02 ,$533.09 ,$241.92 ,$777.60 ,$119.06 ,$777.60 ,$777.60 ,$119.06 ,$561.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),73100004,93270,HC CARDIAC EVENT RECORDER,731,1 ,"$1,264.00 ",$821.60 ,$39.32 ,"$1,264.00 ",$94.38 ,$941.68 ,$827.92 ,$39.32 ,$353.92 ,$638.32 ,$39.32 ,$779.89 ,$39.32 ,$779.89 ,$779.89 ,$39.32 ,$779.89 ,$74.71 ,"$1,137.60 ",$948.00 ,$94.38 ,$39.32 ,"$1,112.32 ",$39.32 ,$948.00 ,$948.00 ,"$1,074.40 ","$1,074.40 ",$39.32 ,"$1,074.40 ",$39.32 ,$985.92 ,$985.92 ,$985.92 ,"$1,137.60 ",$94.38 ,"$1,137.60 ",$39.32 ,"$1,264.00 ",$827.92 ,$39.32 ,$525.82 ,$50.30 ,$48.02 ,$41.15 ,"$1,137.60 ",$85.21 ,$779.89 ,$353.92 ,"$1,137.60 ",$39.32 ,"$1,137.60 ","$1,137.60 ",$39.32 ,$821.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$4,907.00 ","$3,189.55 ",$515.41 ,"$4,907.00 ","$1,237.27 ","$3,655.72 ","$3,214.09 ",$515.41 ,"$1,373.96 ","$2,478.04 ",$515.41 ,"$3,027.62 ",$515.41 ,"$3,027.62 ","$3,027.62 ",$515.41 ,"$3,027.62 ",$979.28 ,"$4,416.30 ","$3,680.25 ","$1,237.27 ",$515.41 ,"$4,318.16 ",$515.41 ,"$3,680.25 ","$3,680.25 ","$4,170.95 ","$4,170.95 ",$515.41 ,"$4,170.95 ",$515.41 ,"$3,827.46 ","$3,827.46 ","$3,827.46 ","$4,416.30 ","$1,237.27 ","$4,416.30 ",$515.41 ,"$4,907.00 ","$3,214.09 ",$515.41 ,"$2,041.31 ",$558.71 ,$533.32 ,$539.47 ,"$4,416.30 ","$1,116.96 ","$3,027.62 ","$1,373.96 ","$4,416.30 ",$515.41 ,"$4,416.30 ","$4,416.30 ",$515.41 ,"$3,189.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,$397.00 ,$258.05 ,$111.16 ,$397.00 ,$353.89 ,$295.77 ,$260.04 ,$147.42 ,$111.16 ,$200.49 ,$147.42 ,$244.95 ,$147.42 ,$244.95 ,$244.95 ,$147.42 ,$244.95 ,$280.10 ,$357.30 ,$297.75 ,$353.89 ,$147.42 ,$349.36 ,$147.42 ,$297.75 ,$297.75 ,$337.45 ,$337.45 ,$147.42 ,$337.45 ,$147.42 ,$309.66 ,$309.66 ,$309.66 ,$357.30 ,$353.89 ,$357.30 ,$147.42 ,$397.00 ,$260.04 ,$147.42 ,$165.15 ,$397.00 ,$397.00 ,$154.30 ,$357.30 ,$319.47 ,$244.95 ,$111.16 ,$357.30 ,$147.42 ,$357.30 ,$357.30 ,$147.42 ,$258.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000006,95810,HC SLEEP STUDY,740,1 ,"$4,582.00 ","$2,978.30 ",$533.32 ,"$4,582.00 ","$2,331.96 ","$3,413.59 ","$3,001.21 ",$971.42 ,"$1,282.96 ","$2,313.91 ",$971.42 ,"$2,827.09 ",$971.42 ,"$2,827.09 ","$2,827.09 ",$971.42 ,"$2,827.09 ","$1,845.70 ","$4,123.80 ","$3,436.50 ","$2,331.96 ",$971.42 ,"$4,032.16 ",$971.42 ,"$3,436.50 ","$3,436.50 ","$3,894.70 ","$3,894.70 ",$971.42 ,"$3,894.70 ",$971.42 ,"$3,573.96 ","$3,573.96 ","$3,573.96 ","$4,123.80 ","$2,331.96 ","$4,123.80 ",$971.42 ,"$4,582.00 ","$3,001.21 ",$971.42 ,"$1,906.11 ",$558.71 ,$533.32 ,"$1,016.77 ","$4,123.80 ","$2,105.20 ","$2,827.09 ","$1,282.96 ","$4,123.80 ",$971.42 ,"$4,123.80 ","$4,123.80 ",$971.42 ,"$2,978.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$7,460.00 ","$4,849.00 ",$533.32 ,"$7,460.00 ","$2,331.96 ","$5,557.70 ","$4,886.30 ",$971.42 ,"$2,088.80 ","$3,767.30 ",$971.42 ,"$4,602.82 ",$971.42 ,"$4,602.82 ","$4,602.82 ",$971.42 ,"$4,602.82 ","$1,845.70 ","$6,714.00 ","$5,595.00 ","$2,331.96 ",$971.42 ,"$6,564.80 ",$971.42 ,"$5,595.00 ","$5,595.00 ","$6,341.00 ","$6,341.00 ",$971.42 ,"$6,341.00 ",$971.42 ,"$5,818.80 ","$5,818.80 ","$5,818.80 ","$6,714.00 ","$2,331.96 ","$6,714.00 ",$971.42 ,"$7,460.00 ","$4,886.30 ",$971.42 ,"$3,103.36 ",$558.71 ,$533.32 ,"$1,016.77 ","$6,714.00 ","$2,105.20 ","$4,602.82 ","$2,088.80 ","$6,714.00 ",$971.42 ,"$6,714.00 ","$6,714.00 ",$971.42 ,"$4,849.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,"$1,081.00 ",$702.65 ,$179.98 ,"$1,081.00 ",$670.82 ,$805.35 ,$708.06 ,$279.44 ,$302.68 ,$545.91 ,$279.44 ,$666.98 ,$279.44 ,$666.98 ,$666.98 ,$279.44 ,$666.98 ,$530.94 ,$972.90 ,$810.75 ,$670.82 ,$279.44 ,$951.28 ,$279.44 ,$810.75 ,$810.75 ,$918.85 ,$918.85 ,$279.44 ,$918.85 ,$279.44 ,$843.18 ,$843.18 ,$843.18 ,$972.90 ,$670.82 ,$972.90 ,$279.44 ,"$1,081.00 ",$708.06 ,$279.44 ,$449.70 ,$188.55 ,$179.98 ,$292.49 ,$972.90 ,$605.59 ,$666.98 ,$302.68 ,$972.90 ,$279.44 ,$972.90 ,$972.90 ,$279.44 ,$702.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,"$1,244.00 ",$808.60 ,$179.98 ,"$1,244.00 ",$670.82 ,$926.78 ,$814.82 ,$279.44 ,$348.32 ,$628.22 ,$279.44 ,$767.55 ,$279.44 ,$767.55 ,$767.55 ,$279.44 ,$767.55 ,$530.94 ,"$1,119.60 ",$933.00 ,$670.82 ,$279.44 ,"$1,094.72 ",$279.44 ,$933.00 ,$933.00 ,"$1,057.40 ","$1,057.40 ",$279.44 ,"$1,057.40 ",$279.44 ,$970.32 ,$970.32 ,$970.32 ,"$1,119.60 ",$670.82 ,"$1,119.60 ",$279.44 ,"$1,244.00 ",$814.82 ,$279.44 ,$517.50 ,$188.55 ,$179.98 ,$292.49 ,"$1,119.60 ",$605.59 ,$767.55 ,$348.32 ,"$1,119.60 ",$279.44 ,"$1,119.60 ","$1,119.60 ",$279.44 ,$808.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000023,95928,HC TCMEP UPPER LIMBS,740,1 ,$351.00 ,$228.15 ,$98.28 ,"$2,105.20 ",$351.00 ,$261.50 ,$229.91 ,$351.00 ,$98.28 ,$177.26 ,$351.00 ,$216.57 ,$351.00 ,$216.57 ,$216.57 ,$351.00 ,$216.57 ,"$1,845.70 ",$315.90 ,$263.25 ,$351.00 ,$351.00 ,$308.88 ,$351.00 ,$263.25 ,$263.25 ,$298.35 ,$298.35 ,$351.00 ,$298.35 ,$351.00 ,$273.78 ,$273.78 ,$273.78 ,$315.90 ,$351.00 ,$315.90 ,$351.00 ,$351.00 ,$229.91 ,$351.00 ,$146.02 ,$239.09 ,$228.22 ,$351.00 ,$315.90 ,"$2,105.20 ",$216.57 ,$98.28 ,$315.90 ,$351.00 ,$315.90 ,$315.90 ,$351.00 ,$228.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000024,95929,HC TCMEP LWR LIMBS,740,1 ,$351.00 ,$228.15 ,$98.28 ,"$1,116.96 ",$351.00 ,$261.50 ,$229.91 ,$351.00 ,$98.28 ,$177.26 ,$351.00 ,$216.57 ,$351.00 ,$216.57 ,$216.57 ,$351.00 ,$216.57 ,$979.28 ,$315.90 ,$263.25 ,$351.00 ,$351.00 ,$308.88 ,$351.00 ,$263.25 ,$263.25 ,$298.35 ,$298.35 ,$351.00 ,$298.35 ,$351.00 ,$273.78 ,$273.78 ,$273.78 ,$315.90 ,$351.00 ,$315.90 ,$351.00 ,$351.00 ,$229.91 ,$351.00 ,$146.02 ,$239.09 ,$228.22 ,$351.00 ,$315.90 ,"$1,116.96 ",$216.57 ,$98.28 ,$315.90 ,$351.00 ,$315.90 ,$315.90 ,$351.00 ,$228.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000035,G0399,HC SLEEP STUDY HOME ADULT,740,1 ,"$1,447.00 ",$940.55 ,$83.00 ,"$1,447.00 ",$353.89 ,"$1,078.02 ",$947.79 ,$147.42 ,$405.16 ,$730.74 ,$147.42 ,$892.80 ,$147.42 ,$892.80 ,$892.80 ,$147.42 ,$892.80 ,$280.10 ,"$1,302.30 ","$1,085.25 ",$353.89 ,$147.42 ,"$1,273.36 ",$147.42 ,"$1,085.25 ","$1,085.25 ","$1,229.95 ","$1,229.95 ",$147.42 ,"$1,229.95 ",$147.42 ,"$1,128.66 ","$1,128.66 ","$1,128.66 ","$1,302.30 ",$353.89 ,"$1,302.30 ",$147.42 ,"$1,447.00 ",$947.79 ,$147.42 ,$601.95 ,$86.96 ,$83.00 ,$154.30 ,"$1,302.30 ",$319.47 ,$892.80 ,$405.16 ,"$1,302.30 ",$147.42 ,"$1,302.30 ","$1,302.30 ",$147.42 ,$940.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000043,95940,HC NEURO TEST INTRAOPER PER 15MIN,740,1 ,$137.00 ,$89.05 ,$38.36 ,$137.00 , N/A ,$102.07 ,$89.74 , N/A ,$38.36 ,$69.19 , N/A ,$84.53 , N/A ,$84.53 ,$84.53 , N/A ,$84.53 , N/A ,$123.30 ,$102.75 , N/A , N/A ,$120.56 , N/A ,$102.75 ,$102.75 ,$116.45 ,$116.45 , N/A ,$116.45 , N/A ,$106.86 ,$106.86 ,$106.86 ,$123.30 , N/A ,$123.30 , N/A ,$137.00 ,$89.74 , N/A ,$56.99 , N/A , N/A , N/A ,$123.30 , N/A ,$84.53 ,$38.36 ,$123.30 , N/A ,$123.30 ,$123.30 , N/A ,$89.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000044,95941,HC NEURO TEST INTRAOPER REMOTE/> 1 OR PER HR,740,1 ,$590.00 ,$383.50 ,$165.20 ,$590.00 , N/A ,$439.55 ,$386.45 , N/A ,$165.20 ,$297.95 , N/A ,$364.03 , N/A ,$364.03 ,$364.03 , N/A ,$364.03 , N/A ,$531.00 ,$442.50 , N/A , N/A ,$519.20 , N/A ,$442.50 ,$442.50 ,$501.50 ,$501.50 , N/A ,$501.50 , N/A ,$460.20 ,$460.20 ,$460.20 ,$531.00 , N/A ,$531.00 , N/A ,$590.00 ,$386.45 , N/A ,$245.44 , N/A , N/A , N/A ,$531.00 , N/A ,$364.03 ,$165.20 ,$531.00 , N/A ,$531.00 ,$531.00 , N/A ,$383.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000045,95810,HC SLEEP STUDY PSG 4+ PARAMETERS >6YRS -52,740,1 ,"$4,582.00 ","$2,978.30 ",$266.66 ,"$4,582.00 ","$1,165.98 ","$3,413.59 ","$3,001.21 ",$485.71 ,"$1,282.96 ","$2,313.91 ",$485.71 ,"$2,827.09 ",$485.71 ,"$2,827.09 ","$2,827.09 ",$485.71 ,"$2,827.09 ",$922.85 ,"$4,123.80 ","$3,436.50 ","$1,165.98 ",$485.71 ,"$4,032.16 ",$485.71 ,"$3,436.50 ","$3,436.50 ","$3,894.70 ","$3,894.70 ",$485.71 ,"$3,894.70 ",$485.71 ,"$3,573.96 ","$3,573.96 ","$3,573.96 ","$4,123.80 ","$1,165.98 ","$4,123.80 ",$485.71 ,"$4,582.00 ","$3,001.21 ",$485.71 ,"$1,906.11 ",$279.36 ,$266.66 ,$508.39 ,"$4,123.80 ","$1,052.60 ","$2,827.09 ","$1,282.96 ","$4,123.80 ",$485.71 ,"$4,123.80 ","$4,123.80 ",$485.71 ,"$2,978.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000046,95811,HC SLEEP STUDY PSG 4+ PARAMTRS W/CPAP >6YR-52,740,1 ,"$7,460.00 ","$4,849.00 ",$266.66 ,"$7,460.00 ","$1,165.98 ","$5,557.70 ","$4,886.30 ",$485.71 ,"$2,088.80 ","$3,767.30 ",$485.71 ,"$4,602.82 ",$485.71 ,"$4,602.82 ","$4,602.82 ",$485.71 ,"$4,602.82 ",$922.85 ,"$6,714.00 ","$5,595.00 ","$1,165.98 ",$485.71 ,"$6,564.80 ",$485.71 ,"$5,595.00 ","$5,595.00 ","$6,341.00 ","$6,341.00 ",$485.71 ,"$6,341.00 ",$485.71 ,"$5,818.80 ","$5,818.80 ","$5,818.80 ","$6,714.00 ","$1,165.98 ","$6,714.00 ",$485.71 ,"$7,460.00 ","$4,886.30 ",$485.71 ,"$3,103.36 ",$279.36 ,$266.66 ,$508.39 ,"$6,714.00 ","$1,052.60 ","$4,602.82 ","$2,088.80 ","$6,714.00 ",$485.71 ,"$6,714.00 ","$6,714.00 ",$485.71 ,"$4,849.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),74000073,95807,HC SLEEP STUDY ATTENDED NAP-52,740,1 ,"$2,772.00 ","$1,801.80 ",$257.70 ,"$2,772.00 ",$618.64 ,"$2,065.14 ","$1,815.66 ",$257.70 ,$776.16 ,"$1,399.86 ",$257.70 ,"$1,710.32 ",$257.70 ,"$1,710.32 ","$1,710.32 ",$257.70 ,"$1,710.32 ",$489.63 ,"$2,494.80 ","$2,079.00 ",$618.64 ,$257.70 ,"$2,439.36 ",$257.70 ,"$2,079.00 ","$2,079.00 ","$2,356.20 ","$2,356.20 ",$257.70 ,"$2,356.20 ",$257.70 ,"$2,162.16 ","$2,162.16 ","$2,162.16 ","$2,494.80 ",$618.64 ,"$2,494.80 ",$257.70 ,"$2,772.00 ","$1,815.66 ",$257.70 ,"$1,153.15 ",$279.36 ,$266.66 ,$269.74 ,"$2,494.80 ",$558.48 ,"$1,710.32 ",$776.16 ,"$2,494.80 ",$257.70 ,"$2,494.80 ","$2,494.80 ",$257.70 ,"$1,801.80 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$1,255.00 ",$815.75 ,$351.40 ,"$1,851.53 ","$1,255.00 ",$934.98 ,$822.03 ,$854.37 ,$351.40 ,$633.78 ,$854.37 ,$774.34 ,$854.37 ,$774.34 ,$774.34 ,$854.37 ,$774.34 ,"$1,623.30 ","$1,129.50 ",$941.25 ,"$1,255.00 ",$854.37 ,"$1,104.40 ",$854.37 ,$941.25 ,$941.25 ,"$1,066.75 ","$1,066.75 ",$854.37 ,"$1,066.75 ",$854.37 ,$978.90 ,$978.90 ,$978.90 ,"$1,129.50 ","$1,255.00 ","$1,129.50 ",$854.37 ,"$1,255.00 ",$822.03 ,$854.37 ,$522.08 ,$503.72 ,$480.83 ,$894.26 ,"$1,129.50 ","$1,851.53 ",$774.34 ,$351.40 ,"$1,129.50 ",$854.37 ,"$1,129.50 ","$1,129.50 ",$854.37 ,$815.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75000510,49082,HC PARACENTESIS W/O IMAGING,750,1 ,"$2,305.38 ","$1,498.50 ",$480.83 ,"$2,305.38 ","$2,050.97 ","$1,717.51 ","$1,510.02 ",$854.37 ,$645.51 ,"$1,164.22 ",$854.37 ,"$1,422.42 ",$854.37 ,"$1,422.42 ","$1,422.42 ",$854.37 ,"$1,422.42 ","$1,623.30 ","$2,074.84 ","$1,729.04 ","$2,050.97 ",$854.37 ,"$2,028.73 ",$854.37 ,"$1,729.04 ","$1,729.04 ","$1,959.57 ","$1,959.57 ",$854.37 ,"$1,959.57 ",$854.37 ,"$1,798.20 ","$1,798.20 ","$1,798.20 ","$2,074.84 ","$2,050.97 ","$2,074.84 ",$854.37 ,"$2,305.38 ","$1,510.02 ",$854.37 ,$959.04 ,$503.72 ,$480.83 ,$894.26 ,"$2,074.84 ","$1,851.53 ","$1,422.42 ",$645.51 ,"$2,074.84 ",$854.37 ,"$2,074.84 ","$2,074.84 ",$854.37 ,"$1,498.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001062,N/A,HC ESOPHAGOSCOPY RIGID W/BRUSH/WASH - 43191,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001066,N/A,HC ESOPHAGOSCOPY FLEXIBLE DX W/BRUSH/WASH -43200,750,1 ,"$2,305.38 ","$1,498.50 ",$645.51 ,"$2,305.38 ", N/A ,"$1,717.51 ","$1,510.02 ", N/A ,$645.51 ,"$1,164.22 ", N/A ,"$1,422.42 ", N/A ,"$1,422.42 ","$1,422.42 ", N/A ,"$1,422.42 ", N/A ,"$2,074.84 ","$1,729.04 ", N/A , N/A ,"$2,028.73 ", N/A ,"$1,729.04 ","$1,729.04 ","$1,959.57 ","$1,959.57 ", N/A ,"$1,959.57 ", N/A ,"$1,798.20 ","$1,798.20 ","$1,798.20 ","$2,074.84 ", N/A ,"$2,074.84 ", N/A ,"$2,305.38 ","$1,510.02 ", N/A ,$959.04 , N/A , N/A , N/A ,"$2,074.84 ", N/A ,"$1,422.42 ",$645.51 ,"$2,074.84 ", N/A ,"$2,074.84 ","$2,074.84 ", N/A ,"$1,498.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001067,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/BIOPSY - 43202,750,1 ,"$1,701.00 ","$1,105.65 ",$476.28 ,"$1,701.00 ", N/A ,"$1,267.25 ","$1,114.16 ", N/A ,$476.28 ,$859.01 , N/A ,"$1,049.52 ", N/A ,"$1,049.52 ","$1,049.52 ", N/A ,"$1,049.52 ", N/A ,"$1,530.90 ","$1,275.75 ", N/A , N/A ,"$1,496.88 ", N/A ,"$1,275.75 ","$1,275.75 ","$1,445.85 ","$1,445.85 ", N/A ,"$1,445.85 ", N/A ,"$1,326.78 ","$1,326.78 ","$1,326.78 ","$1,530.90 ", N/A ,"$1,530.90 ", N/A ,"$1,701.00 ","$1,114.16 ", N/A ,$707.62 , N/A , N/A , N/A ,"$1,530.90 ", N/A ,"$1,049.52 ",$476.28 ,"$1,530.90 ", N/A ,"$1,530.90 ","$1,530.90 ", N/A ,"$1,105.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001068,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/FB REMOVAL - 43215,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001069,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/BALLOON DILATION - 43220,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001071,N/A,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001072,N/A,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001073,N/A,HC EGD W/SUBMUCOSAL INJ - 43236,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001076,N/A,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001081,N/A,HC EGD W/DILAT STRICTURE - 43245,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001082,N/A,HC EGD W/PLACEMENT G-TUBE - 43246,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001083,N/A,HC EGD W/FB REMOVAL - 43247,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001084,N/A,HC EGD W/INSERT GUIDEWIRE - 43248,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001085,N/A,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001086,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$4,783.00 ","$3,108.95 ","$1,339.24 ","$4,783.00 ", N/A ,"$3,563.34 ","$3,132.87 ", N/A ,"$1,339.24 ","$2,415.42 ", N/A ,"$2,951.11 ", N/A ,"$2,951.11 ","$2,951.11 ", N/A ,"$2,951.11 ", N/A ,"$4,304.70 ","$3,587.25 ", N/A , N/A ,"$4,209.04 ", N/A ,"$3,587.25 ","$3,587.25 ","$4,065.55 ","$4,065.55 ", N/A ,"$4,065.55 ", N/A ,"$3,730.74 ","$3,730.74 ","$3,730.74 ","$4,304.70 ", N/A ,"$4,304.70 ", N/A ,"$4,783.00 ","$3,132.87 ", N/A ,"$1,989.73 ", N/A , N/A , N/A ,"$4,304.70 ", N/A ,"$2,951.11 ","$1,339.24 ","$4,304.70 ", N/A ,"$4,304.70 ","$4,304.70 ", N/A ,"$3,108.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001087,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001090,N/A,HC EGD W/CONTROL BLEEDING - 43255,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001106,N/A,HC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS - 43450,750,1 ,"$2,102.00 ","$1,366.30 ",$588.56 ,"$2,102.00 ", N/A ,"$1,565.99 ","$1,376.81 ", N/A ,$588.56 ,"$1,061.51 ", N/A ,"$1,296.93 ", N/A ,"$1,296.93 ","$1,296.93 ", N/A ,"$1,296.93 ", N/A ,"$1,891.80 ","$1,576.50 ", N/A , N/A ,"$1,849.76 ", N/A ,"$1,576.50 ","$1,576.50 ","$1,786.70 ","$1,786.70 ", N/A ,"$1,786.70 ", N/A ,"$1,639.56 ","$1,639.56 ","$1,639.56 ","$1,891.80 ", N/A ,"$1,891.80 ", N/A ,"$2,102.00 ","$1,376.81 ", N/A ,$874.43 , N/A , N/A , N/A ,"$1,891.80 ", N/A ,"$1,296.93 ",$588.56 ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ", N/A ,"$1,366.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001122,N/A,HC ILEOSCOPY STOMA W/BIOPSY SGL/MULT - 44382,750,1 ,"$2,433.00 ","$1,581.45 ",$681.24 ,"$2,433.00 ", N/A ,"$1,812.59 ","$1,593.62 ", N/A ,$681.24 ,"$1,228.67 ", N/A ,"$1,501.16 ", N/A ,"$1,501.16 ","$1,501.16 ", N/A ,"$1,501.16 ", N/A ,"$2,189.70 ","$1,824.75 ", N/A , N/A ,"$2,141.04 ", N/A ,"$1,824.75 ","$1,824.75 ","$2,068.05 ","$2,068.05 ", N/A ,"$2,068.05 ", N/A ,"$1,897.74 ","$1,897.74 ","$1,897.74 ","$2,189.70 ", N/A ,"$2,189.70 ", N/A ,"$2,433.00 ","$1,593.62 ", N/A ,"$1,012.13 ", N/A , N/A , N/A ,"$2,189.70 ", N/A ,"$1,501.16 ",$681.24 ,"$2,189.70 ", N/A ,"$2,189.70 ","$2,189.70 ", N/A ,"$1,581.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001124,N/A,HC ENDOSCOPY POUCH W/BIOPSY SGL/MULT - 44386,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001125,N/A,HC COLONOSCOPY STOMA DX W/BRUSH/WASH - 44388,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001126,N/A,HC COLONOSCOPY STOMA W/BX SGL/MULT - 44389,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001130,N/A,HC COLONOSCOPY STOMA W/REM TUMOR SNARE TECH - 44394,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001140,N/A,HC PROCTOSIGMOIDOSCOPY RIGID W/FB REMOVAL - 45307,750,1 ,"$7,762.00 ","$5,045.30 ","$2,173.36 ","$7,762.00 ", N/A ,"$5,782.69 ","$5,084.11 ", N/A ,"$2,173.36 ","$3,919.81 ", N/A ,"$4,789.15 ", N/A ,"$4,789.15 ","$4,789.15 ", N/A ,"$4,789.15 ", N/A ,"$6,985.80 ","$5,821.50 ", N/A , N/A ,"$6,830.56 ", N/A ,"$5,821.50 ","$5,821.50 ","$6,597.70 ","$6,597.70 ", N/A ,"$6,597.70 ", N/A ,"$6,054.36 ","$6,054.36 ","$6,054.36 ","$6,985.80 ", N/A ,"$6,985.80 ", N/A ,"$7,762.00 ","$5,084.11 ", N/A ,"$3,228.99 ", N/A , N/A , N/A ,"$6,985.80 ", N/A ,"$4,789.15 ","$2,173.36 ","$6,985.80 ", N/A ,"$6,985.80 ","$6,985.80 ", N/A ,"$5,045.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001142,N/A,HC SIGMOIDOSCOPY DX W/BRUSH/WASH - 45330,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001143,N/A,HC SIGMOIDOSCOPY W/BIOPSY SGL/MULT -45331,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001144,N/A,HC SIGMOIDOSCOPY W/FB REMOVAL -45332,750,1 ,"$3,136.00 ","$2,038.40 ",$878.08 ,"$3,136.00 ", N/A ,"$2,336.32 ","$2,054.08 ", N/A ,$878.08 ,"$1,583.68 ", N/A ,"$1,934.91 ", N/A ,"$1,934.91 ","$1,934.91 ", N/A ,"$1,934.91 ", N/A ,"$2,822.40 ","$2,352.00 ", N/A , N/A ,"$2,759.68 ", N/A ,"$2,352.00 ","$2,352.00 ","$2,665.60 ","$2,665.60 ", N/A ,"$2,665.60 ", N/A ,"$2,446.08 ","$2,446.08 ","$2,446.08 ","$2,822.40 ", N/A ,"$2,822.40 ", N/A ,"$3,136.00 ","$2,054.08 ", N/A ,"$1,304.58 ", N/A , N/A , N/A ,"$2,822.40 ", N/A ,"$1,934.91 ",$878.08 ,"$2,822.40 ", N/A ,"$2,822.40 ","$2,822.40 ", N/A ,"$2,038.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001145,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN  HOT BIOPSY -45333,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001147,N/A,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJ - 45335,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001149,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45338,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001157,N/A,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001158,N/A,HC COLONOSCOPY W/FB REMOVAL - 45379,750,1 ,"$3,136.00 ","$2,038.40 ",$878.08 ,"$3,136.00 ", N/A ,"$2,336.32 ","$2,054.08 ", N/A ,$878.08 ,"$1,583.68 ", N/A ,"$1,934.91 ", N/A ,"$1,934.91 ","$1,934.91 ", N/A ,"$1,934.91 ", N/A ,"$2,822.40 ","$2,352.00 ", N/A , N/A ,"$2,759.68 ", N/A ,"$2,352.00 ","$2,352.00 ","$2,665.60 ","$2,665.60 ", N/A ,"$2,665.60 ", N/A ,"$2,446.08 ","$2,446.08 ","$2,446.08 ","$2,822.40 ", N/A ,"$2,822.40 ", N/A ,"$3,136.00 ","$2,054.08 ", N/A ,"$1,304.58 ", N/A , N/A , N/A ,"$2,822.40 ", N/A ,"$1,934.91 ",$878.08 ,"$2,822.40 ", N/A ,"$2,822.40 ","$2,822.40 ", N/A ,"$2,038.40 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001159,N/A,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001160,N/A,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001161,N/A,HC COLONOSCOPY W/CONTROL BLEEDING - 45382,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001162,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001163,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001165,N/A,HC COLONOSCOPY W/ABLATION TUMOR - 45388,750,1 ,"$3,109.00 ","$2,020.85 ",$870.52 ,"$3,109.00 ", N/A ,"$2,316.21 ","$2,036.40 ", N/A ,$870.52 ,"$1,570.05 ", N/A ,"$1,918.25 ", N/A ,"$1,918.25 ","$1,918.25 ", N/A ,"$1,918.25 ", N/A ,"$2,798.10 ","$2,331.75 ", N/A , N/A ,"$2,735.92 ", N/A ,"$2,331.75 ","$2,331.75 ","$2,642.65 ","$2,642.65 ", N/A ,"$2,642.65 ", N/A ,"$2,425.02 ","$2,425.02 ","$2,425.02 ","$2,798.10 ", N/A ,"$2,798.10 ", N/A ,"$3,109.00 ","$2,036.40 ", N/A ,"$1,293.34 ", N/A , N/A , N/A ,"$2,798.10 ", N/A ,"$1,918.25 ",$870.52 ,"$2,798.10 ", N/A ,"$2,798.10 ","$2,798.10 ", N/A ,"$2,020.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001167,N/A,HC COLONOSCOPY W/MUCOSAL RESECTION - 45390,750,1 ,"$3,900.00 ","$2,535.00 ","$1,092.00 ","$3,900.00 ", N/A ,"$2,905.50 ","$2,554.50 ", N/A ,"$1,092.00 ","$1,969.50 ", N/A ,"$2,406.30 ", N/A ,"$2,406.30 ","$2,406.30 ", N/A ,"$2,406.30 ", N/A ,"$3,510.00 ","$2,925.00 ", N/A , N/A ,"$3,432.00 ", N/A ,"$2,925.00 ","$2,925.00 ","$3,315.00 ","$3,315.00 ", N/A ,"$3,315.00 ", N/A ,"$3,042.00 ","$3,042.00 ","$3,042.00 ","$3,510.00 ", N/A ,"$3,510.00 ", N/A ,"$3,900.00 ","$2,554.50 ", N/A ,"$1,622.40 ", N/A , N/A , N/A ,"$3,510.00 ", N/A ,"$2,406.30 ","$1,092.00 ","$3,510.00 ", N/A ,"$3,510.00 ","$3,510.00 ", N/A ,"$2,535.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001171,N/A,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$3,304.00 ","$2,147.60 ",$925.12 ,"$3,304.00 ", N/A ,"$2,461.48 ","$2,164.12 ", N/A ,$925.12 ,"$1,668.52 ", N/A ,"$2,038.57 ", N/A ,"$2,038.57 ","$2,038.57 ", N/A ,"$2,038.57 ", N/A ,"$2,973.60 ","$2,478.00 ", N/A , N/A ,"$2,907.52 ", N/A ,"$2,478.00 ","$2,478.00 ","$2,808.40 ","$2,808.40 ", N/A ,"$2,808.40 ", N/A ,"$2,577.12 ","$2,577.12 ","$2,577.12 ","$2,973.60 ", N/A ,"$2,973.60 ", N/A ,"$3,304.00 ","$2,164.12 ", N/A ,"$1,374.46 ", N/A , N/A , N/A ,"$2,973.60 ", N/A ,"$2,038.57 ",$925.12 ,"$2,973.60 ", N/A ,"$2,973.60 ","$2,973.60 ", N/A ,"$2,147.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001173,N/A,HC HERMORRHOIDECTOMY INTERNAL W/LIGATION - 46221,750,1 ,"$2,365.00 ","$1,537.25 ",$662.20 ,"$2,365.00 ", N/A ,"$1,761.93 ","$1,549.08 ", N/A ,$662.20 ,"$1,194.33 ", N/A ,"$1,459.21 ", N/A ,"$1,459.21 ","$1,459.21 ", N/A ,"$1,459.21 ", N/A ,"$2,128.50 ","$1,773.75 ", N/A , N/A ,"$2,081.20 ", N/A ,"$1,773.75 ","$1,773.75 ","$2,010.25 ","$2,010.25 ", N/A ,"$2,010.25 ", N/A ,"$1,844.70 ","$1,844.70 ","$1,844.70 ","$2,128.50 ", N/A ,"$2,128.50 ", N/A ,"$2,365.00 ","$1,549.08 ", N/A ,$983.84 , N/A , N/A , N/A ,"$2,128.50 ", N/A ,"$1,459.21 ",$662.20 ,"$2,128.50 ", N/A ,"$2,128.50 ","$2,128.50 ", N/A ,"$1,537.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001176,N/A,HC ANOSCOPY W/BIOPSY SGL/MULT - 46606,750,1 ,"$2,446.00 ","$1,589.90 ",$684.88 ,"$2,446.00 ", N/A ,"$1,822.27 ","$1,602.13 ", N/A ,$684.88 ,"$1,235.23 ", N/A ,"$1,509.18 ", N/A ,"$1,509.18 ","$1,509.18 ", N/A ,"$1,509.18 ", N/A ,"$2,201.40 ","$1,834.50 ", N/A , N/A ,"$2,152.48 ", N/A ,"$1,834.50 ","$1,834.50 ","$2,079.10 ","$2,079.10 ", N/A ,"$2,079.10 ", N/A ,"$1,907.88 ","$1,907.88 ","$1,907.88 ","$2,201.40 ", N/A ,"$2,201.40 ", N/A ,"$2,446.00 ","$1,602.13 ", N/A ,"$1,017.54 ", N/A , N/A , N/A ,"$2,201.40 ", N/A ,"$1,509.18 ",$684.88 ,"$2,201.40 ", N/A ,"$2,201.40 ","$2,201.40 ", N/A ,"$1,589.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001177,N/A,HC ANOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 46610,750,1 ,"$7,258.00 ","$4,717.70 ","$2,032.24 ","$7,258.00 ", N/A ,"$5,407.21 ","$4,753.99 ", N/A ,"$2,032.24 ","$3,665.29 ", N/A ,"$4,478.19 ", N/A ,"$4,478.19 ","$4,478.19 ", N/A ,"$4,478.19 ", N/A ,"$6,532.20 ","$5,443.50 ", N/A , N/A ,"$6,387.04 ", N/A ,"$5,443.50 ","$5,443.50 ","$6,169.30 ","$6,169.30 ", N/A ,"$6,169.30 ", N/A ,"$5,661.24 ","$5,661.24 ","$5,661.24 ","$6,532.20 ", N/A ,"$6,532.20 ", N/A ,"$7,258.00 ","$4,753.99 ", N/A ,"$3,019.33 ", N/A , N/A , N/A ,"$6,532.20 ", N/A ,"$4,478.19 ","$2,032.24 ","$6,532.20 ", N/A ,"$6,532.20 ","$6,532.20 ", N/A ,"$4,717.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001201,N/A,HC PROCTOSIGMOIDOSCOPY RIGID W/BX - 45305,750,1 ,"$1,930.00 ","$1,254.50 ",$540.40 ,"$1,930.00 ", N/A ,"$1,437.85 ","$1,264.15 ", N/A ,$540.40 ,$974.65 , N/A ,"$1,190.81 ", N/A ,"$1,190.81 ","$1,190.81 ", N/A ,"$1,190.81 ", N/A ,"$1,737.00 ","$1,447.50 ", N/A , N/A ,"$1,698.40 ", N/A ,"$1,447.50 ","$1,447.50 ","$1,640.50 ","$1,640.50 ", N/A ,"$1,640.50 ", N/A ,"$1,505.40 ","$1,505.40 ","$1,505.40 ","$1,737.00 ", N/A ,"$1,737.00 ", N/A ,"$1,930.00 ","$1,264.15 ", N/A ,$802.88 , N/A , N/A , N/A ,"$1,737.00 ", N/A ,"$1,190.81 ",$540.40 ,"$1,737.00 ", N/A ,"$1,737.00 ","$1,737.00 ", N/A ,"$1,254.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001202,N/A,HC REPLACE GASTRO TUBE PERC - 43762,750,1 ,$781.00 ,$507.65 ,$218.68 ,$781.00 , N/A ,$581.85 ,$511.56 , N/A ,$218.68 ,$394.41 , N/A ,$481.88 , N/A ,$481.88 ,$481.88 , N/A ,$481.88 , N/A ,$702.90 ,$585.75 , N/A , N/A ,$687.28 , N/A ,$585.75 ,$585.75 ,$663.85 ,$663.85 , N/A ,$663.85 , N/A ,$609.18 ,$609.18 ,$609.18 ,$702.90 , N/A ,$702.90 , N/A ,$781.00 ,$511.56 , N/A ,$324.90 , N/A , N/A , N/A ,$702.90 , N/A ,$481.88 ,$218.68 ,$702.90 , N/A ,$702.90 ,$702.90 , N/A ,$507.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001203,N/A,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT - 43763,750,1 ,$781.00 ,$507.65 ,$218.68 ,$781.00 , N/A ,$581.85 ,$511.56 , N/A ,$218.68 ,$394.41 , N/A ,$481.88 , N/A ,$481.88 ,$481.88 , N/A ,$481.88 , N/A ,$702.90 ,$585.75 , N/A , N/A ,$687.28 , N/A ,$585.75 ,$585.75 ,$663.85 ,$663.85 , N/A ,$663.85 , N/A ,$609.18 ,$609.18 ,$609.18 ,$702.90 , N/A ,$702.90 , N/A ,$781.00 ,$511.56 , N/A ,$324.90 , N/A , N/A , N/A ,$702.90 , N/A ,$481.88 ,$218.68 ,$702.90 , N/A ,$702.90 ,$702.90 , N/A ,$507.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001204,N/A,HC REMOVE G TUBE W/ANESTHESIA - 43999,750,1 ,"$2,568.00 ","$1,669.20 ",$719.04 ,"$2,568.00 ", N/A ,"$1,913.16 ","$1,682.04 ", N/A ,$719.04 ,"$1,296.84 ", N/A ,"$1,584.46 ", N/A ,"$1,584.46 ","$1,584.46 ", N/A ,"$1,584.46 ", N/A ,"$2,311.20 ","$1,926.00 ", N/A , N/A ,"$2,259.84 ", N/A ,"$1,926.00 ","$1,926.00 ","$2,182.80 ","$2,182.80 ", N/A ,"$2,182.80 ", N/A ,"$2,003.04 ","$2,003.04 ","$2,003.04 ","$2,311.20 ", N/A ,"$2,311.20 ", N/A ,"$2,568.00 ","$1,682.04 ", N/A ,"$1,068.29 ", N/A , N/A , N/A ,"$2,311.20 ", N/A ,"$1,584.46 ",$719.04 ,"$2,311.20 ", N/A ,"$2,311.20 ","$2,311.20 ", N/A ,"$1,669.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001205,N/A,HC REMOVE ANAL FISTULA SUBQ 46270,750,1 ,"$7,258.00 ","$4,717.70 ","$2,032.24 ","$7,258.00 ", N/A ,"$5,407.21 ","$4,753.99 ", N/A ,"$2,032.24 ","$3,665.29 ", N/A ,"$4,478.19 ", N/A ,"$4,478.19 ","$4,478.19 ", N/A ,"$4,478.19 ", N/A ,"$6,532.20 ","$5,443.50 ", N/A , N/A ,"$6,387.04 ", N/A ,"$5,443.50 ","$5,443.50 ","$6,169.30 ","$6,169.30 ", N/A ,"$6,169.30 ", N/A ,"$5,661.24 ","$5,661.24 ","$5,661.24 ","$6,532.20 ", N/A ,"$6,532.20 ", N/A ,"$7,258.00 ","$4,753.99 ", N/A ,"$3,019.33 ", N/A , N/A , N/A ,"$6,532.20 ", N/A ,"$4,478.19 ","$2,032.24 ","$6,532.20 ", N/A ,"$6,532.20 ","$6,532.20 ", N/A ,"$4,717.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001206,N/A,HC HEMORRHOIDECTOMY;EXT 2/MO 46250,750,1 ,"$7,258.00 ","$4,717.70 ","$2,032.24 ","$7,258.00 ", N/A ,"$5,407.21 ","$4,753.99 ", N/A ,"$2,032.24 ","$3,665.29 ", N/A ,"$4,478.19 ", N/A ,"$4,478.19 ","$4,478.19 ", N/A ,"$4,478.19 ", N/A ,"$6,532.20 ","$5,443.50 ", N/A , N/A ,"$6,387.04 ", N/A ,"$5,443.50 ","$5,443.50 ","$6,169.30 ","$6,169.30 ", N/A ,"$6,169.30 ", N/A ,"$5,661.24 ","$5,661.24 ","$5,661.24 ","$6,532.20 ", N/A ,"$6,532.20 ", N/A ,"$7,258.00 ","$4,753.99 ", N/A ,"$3,019.33 ", N/A , N/A , N/A ,"$6,532.20 ", N/A ,"$4,478.19 ","$2,032.24 ","$6,532.20 ", N/A ,"$6,532.20 ","$6,532.20 ", N/A ,"$4,717.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001207,N/A,HC PLACEMENT OF SETON - 46020,750,1 ,"$7,258.00 ","$4,717.70 ","$2,032.24 ","$7,258.00 ", N/A ,"$5,407.21 ","$4,753.99 ", N/A ,"$2,032.24 ","$3,665.29 ", N/A ,"$4,478.19 ", N/A ,"$4,478.19 ","$4,478.19 ", N/A ,"$4,478.19 ", N/A ,"$6,532.20 ","$5,443.50 ", N/A , N/A ,"$6,387.04 ", N/A ,"$5,443.50 ","$5,443.50 ","$6,169.30 ","$6,169.30 ", N/A ,"$6,169.30 ", N/A ,"$5,661.24 ","$5,661.24 ","$5,661.24 ","$6,532.20 ", N/A ,"$6,532.20 ", N/A ,"$7,258.00 ","$4,753.99 ", N/A ,"$3,019.33 ", N/A , N/A , N/A ,"$6,532.20 ", N/A ,"$4,478.19 ","$2,032.24 ","$6,532.20 ", N/A ,"$6,532.20 ","$6,532.20 ", N/A ,"$4,717.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001209,N/A,HC HEMORRHOIDECTOMY INTERNAL W/LIGATION-46221,750,1 ,"$2,365.00 ","$1,537.25 ",$662.20 ,"$2,365.00 ", N/A ,"$1,761.93 ","$1,549.08 ", N/A ,$662.20 ,"$1,194.33 ", N/A ,"$1,459.21 ", N/A ,"$1,459.21 ","$1,459.21 ", N/A ,"$1,459.21 ", N/A ,"$2,128.50 ","$1,773.75 ", N/A , N/A ,"$2,081.20 ", N/A ,"$1,773.75 ","$1,773.75 ","$2,010.25 ","$2,010.25 ", N/A ,"$2,010.25 ", N/A ,"$1,844.70 ","$1,844.70 ","$1,844.70 ","$2,128.50 ", N/A ,"$2,128.50 ", N/A ,"$2,365.00 ","$1,549.08 ", N/A ,$983.84 , N/A , N/A , N/A ,"$2,128.50 ", N/A ,"$1,459.21 ",$662.20 ,"$2,128.50 ", N/A ,"$2,128.50 ","$2,128.50 ", N/A ,"$1,537.25 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),75001223,N/A,HC SMALL BOWEL ENDOSCOPY- 44378,750,1 ,"$1,913.40 ","$1,243.71 ",$535.75 ,"$1,913.40 ", N/A ,"$1,425.48 ","$1,253.28 ", N/A ,$535.75 ,$966.27 , N/A ,"$1,180.57 ", N/A ,"$1,180.57 ","$1,180.57 ", N/A ,"$1,180.57 ", N/A ,"$1,722.06 ","$1,435.05 ", N/A , N/A ,"$1,683.79 ", N/A ,"$1,435.05 ","$1,435.05 ","$1,626.39 ","$1,626.39 ", N/A ,"$1,626.39 ", N/A ,"$1,492.45 ","$1,492.45 ","$1,492.45 ","$1,722.06 ", N/A ,"$1,722.06 ", N/A ,"$1,913.40 ","$1,253.28 ", N/A ,$795.97 , N/A , N/A , N/A ,"$1,722.06 ", N/A ,"$1,180.57 ",$535.75 ,"$1,722.06 ", N/A ,"$1,722.06 ","$1,722.06 ", N/A ,"$1,243.71 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$3,894.00 ","$2,531.10 ",$554.36 ,"$3,894.00 ","$1,609.52 ","$2,901.03 ","$2,550.57 ",$670.48 ,"$1,090.32 ","$1,966.47 ",$670.48 ,"$2,402.60 ",$670.48 ,"$2,402.60 ","$2,402.60 ",$670.48 ,"$2,402.60 ","$1,273.91 ","$3,504.60 ","$2,920.50 ","$1,609.52 ",$670.48 ,"$3,426.72 ",$670.48 ,"$2,920.50 ","$2,920.50 ","$3,309.90 ","$3,309.90 ",$670.48 ,"$3,309.90 ",$670.48 ,"$3,037.32 ","$3,037.32 ","$3,037.32 ","$3,504.60 ","$1,609.52 ","$3,504.60 ",$670.48 ,"$3,894.00 ","$2,550.57 ",$670.48 ,"$1,619.90 ",$580.76 ,$554.36 ,$701.78 ,"$3,504.60 ","$1,453.01 ","$2,402.60 ","$1,090.32 ","$3,504.60 ",$670.48 ,"$3,504.60 ","$3,504.60 ",$670.48 ,"$2,531.10 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100005,64615,HC CHEMODENERVATION FACE/NECK/SPINE MUSCLES BIL,761,1 ,"$1,059.00 ",$688.35 ,$275.86 ,"$1,059.00 ",$662.23 ,$788.96 ,$693.65 ,$275.86 ,$296.52 ,$534.80 ,$275.86 ,$653.40 ,$275.86 ,$653.40 ,$653.40 ,$275.86 ,$653.40 ,$524.13 ,$953.10 ,$794.25 ,$662.23 ,$275.86 ,$931.92 ,$275.86 ,$794.25 ,$794.25 ,$900.15 ,$900.15 ,$275.86 ,$900.15 ,$275.86 ,$826.02 ,$826.02 ,$826.02 ,$953.10 ,$662.23 ,$953.10 ,$275.86 ,"$1,059.00 ",$693.65 ,$275.86 ,$440.54 ,$320.22 ,$305.67 ,$288.74 ,$953.10 ,$597.83 ,$653.40 ,$296.52 ,$953.10 ,$275.86 ,$953.10 ,$953.10 ,$275.86 ,$688.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100006,64447,HC INJ ANES NERVE FEMORAL SINGLE-BI,761,1 ,"$2,548.00 ","$1,656.20 ",$458.49 ,"$2,548.00 ","$2,414.28 ","$1,898.26 ","$1,668.94 ","$1,005.72 ",$713.44 ,"$1,286.74 ","$1,005.72 ","$1,572.12 ","$1,005.72 ","$1,572.12 ","$1,572.12 ","$1,005.72 ","$1,572.12 ","$1,910.87 ","$2,293.20 ","$1,911.00 ","$2,414.28 ","$1,005.72 ","$2,242.24 ","$1,005.72 ","$1,911.00 ","$1,911.00 ","$2,165.80 ","$2,165.80 ","$1,005.72 ","$2,165.80 ","$1,005.72 ","$1,987.44 ","$1,987.44 ","$1,987.44 ","$2,293.20 ","$2,414.28 ","$2,293.20 ","$1,005.72 ","$2,548.00 ","$1,668.94 ","$1,005.72 ","$1,059.97 ",$480.33 ,$458.49 ,"$1,052.67 ","$2,293.20 ","$2,179.52 ","$1,572.12 ",$713.44 ,"$2,293.20 ","$1,005.72 ","$2,293.20 ","$2,293.20 ","$1,005.72 ","$1,656.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100007,64447,HC INJ ANES NERVE FEMORAL SINGLE-LT,761,1 ,"$1,818.00 ","$1,181.70 ",$305.67 ,"$1,818.00 ","$1,609.52 ","$1,354.41 ","$1,190.79 ",$670.48 ,$509.04 ,$918.09 ,$670.48 ,"$1,121.71 ",$670.48 ,"$1,121.71 ","$1,121.71 ",$670.48 ,"$1,121.71 ","$1,273.91 ","$1,636.20 ","$1,363.50 ","$1,609.52 ",$670.48 ,"$1,599.84 ",$670.48 ,"$1,363.50 ","$1,363.50 ","$1,545.30 ","$1,545.30 ",$670.48 ,"$1,545.30 ",$670.48 ,"$1,418.04 ","$1,418.04 ","$1,418.04 ","$1,636.20 ","$1,609.52 ","$1,636.20 ",$670.48 ,"$1,818.00 ","$1,190.79 ",$670.48 ,$756.29 ,$320.22 ,$305.67 ,$701.78 ,"$1,636.20 ","$1,453.01 ","$1,121.71 ",$509.04 ,"$1,636.20 ",$670.48 ,"$1,636.20 ","$1,636.20 ",$670.48 ,"$1,181.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100008,64447,HC INJ ANES NERVE FEMORAL SINGLE-RT,761,1 ,"$1,818.00 ","$1,181.70 ",$305.67 ,"$1,818.00 ","$1,609.52 ","$1,354.41 ","$1,190.79 ",$670.48 ,$509.04 ,$918.09 ,$670.48 ,"$1,121.71 ",$670.48 ,"$1,121.71 ","$1,121.71 ",$670.48 ,"$1,121.71 ","$1,273.91 ","$1,636.20 ","$1,363.50 ","$1,609.52 ",$670.48 ,"$1,599.84 ",$670.48 ,"$1,363.50 ","$1,363.50 ","$1,545.30 ","$1,545.30 ",$670.48 ,"$1,545.30 ",$670.48 ,"$1,418.04 ","$1,418.04 ","$1,418.04 ","$1,636.20 ","$1,609.52 ","$1,636.20 ",$670.48 ,"$1,818.00 ","$1,190.79 ",$670.48 ,$756.29 ,$320.22 ,$305.67 ,$701.78 ,"$1,636.20 ","$1,453.01 ","$1,121.71 ",$509.04 ,"$1,636.20 ",$670.48 ,"$1,636.20 ","$1,636.20 ",$670.48 ,"$1,181.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100009,64425,HC INJ ANES NERVE ILIOINGUINAL-LT,761,1 ,"$1,698.00 ","$1,103.70 ",$305.67 ,"$1,698.00 ","$1,609.52 ","$1,265.01 ","$1,112.19 ",$670.48 ,$475.44 ,$857.49 ,$670.48 ,"$1,047.67 ",$670.48 ,"$1,047.67 ","$1,047.67 ",$670.48 ,"$1,047.67 ","$1,273.91 ","$1,528.20 ","$1,273.50 ","$1,609.52 ",$670.48 ,"$1,494.24 ",$670.48 ,"$1,273.50 ","$1,273.50 ","$1,443.30 ","$1,443.30 ",$670.48 ,"$1,443.30 ",$670.48 ,"$1,324.44 ","$1,324.44 ","$1,324.44 ","$1,528.20 ","$1,609.52 ","$1,528.20 ",$670.48 ,"$1,698.00 ","$1,112.19 ",$670.48 ,$706.37 ,$320.22 ,$305.67 ,$701.78 ,"$1,528.20 ","$1,453.01 ","$1,047.67 ",$475.44 ,"$1,528.20 ",$670.48 ,"$1,528.20 ","$1,528.20 ",$670.48 ,"$1,103.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100010,64425,HC INJ ANES NERVE ILIOINGUINAL-RT,761,1 ,"$1,698.00 ","$1,103.70 ",$305.67 ,"$1,698.00 ","$1,609.52 ","$1,265.01 ","$1,112.19 ",$670.48 ,$475.44 ,$857.49 ,$670.48 ,"$1,047.67 ",$670.48 ,"$1,047.67 ","$1,047.67 ",$670.48 ,"$1,047.67 ","$1,273.91 ","$1,528.20 ","$1,273.50 ","$1,609.52 ",$670.48 ,"$1,494.24 ",$670.48 ,"$1,273.50 ","$1,273.50 ","$1,443.30 ","$1,443.30 ",$670.48 ,"$1,443.30 ",$670.48 ,"$1,324.44 ","$1,324.44 ","$1,324.44 ","$1,528.20 ","$1,609.52 ","$1,528.20 ",$670.48 ,"$1,698.00 ","$1,112.19 ",$670.48 ,$706.37 ,$320.22 ,$305.67 ,$701.78 ,"$1,528.20 ","$1,453.01 ","$1,047.67 ",$475.44 ,"$1,528.20 ",$670.48 ,"$1,528.20 ","$1,528.20 ",$670.48 ,"$1,103.70 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100011,64450,HC INJ ANES NERVE PERIPHERAL-BI,761,1 ,"$2,548.00 ","$1,656.20 ",$458.49 ,"$2,548.00 ","$2,414.28 ","$1,898.26 ","$1,668.94 ","$1,005.72 ",$713.44 ,"$1,286.74 ","$1,005.72 ","$1,572.12 ","$1,005.72 ","$1,572.12 ","$1,572.12 ","$1,005.72 ","$1,572.12 ","$1,910.87 ","$2,293.20 ","$1,911.00 ","$2,414.28 ","$1,005.72 ","$2,242.24 ","$1,005.72 ","$1,911.00 ","$1,911.00 ","$2,165.80 ","$2,165.80 ","$1,005.72 ","$2,165.80 ","$1,005.72 ","$1,987.44 ","$1,987.44 ","$1,987.44 ","$2,293.20 ","$2,414.28 ","$2,293.20 ","$1,005.72 ","$2,548.00 ","$1,668.94 ","$1,005.72 ","$1,059.97 ",$480.33 ,$458.49 ,"$1,052.67 ","$2,293.20 ","$2,179.52 ","$1,572.12 ",$713.44 ,"$2,293.20 ","$1,005.72 ","$2,293.20 ","$2,293.20 ","$1,005.72 ","$1,656.20 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100015,64405,HC INJ ANES NERVE GREAT OCCIPITAL-BI,761,1 ,"$1,382.00 ",$898.30 ,$386.96 ,"$1,382.00 ",$993.34 ,"$1,029.59 ",$905.21 ,$413.80 ,$386.96 ,$697.91 ,$413.80 ,$852.69 ,$413.80 ,$852.69 ,$852.69 ,$413.80 ,$852.69 ,$786.22 ,"$1,243.80 ","$1,036.50 ",$993.34 ,$413.80 ,"$1,216.16 ",$413.80 ,"$1,036.50 ","$1,036.50 ","$1,174.70 ","$1,174.70 ",$413.80 ,"$1,174.70 ",$413.80 ,"$1,077.96 ","$1,077.96 ","$1,077.96 ","$1,243.80 ",$993.34 ,"$1,243.80 ",$413.80 ,"$1,382.00 ",$905.21 ,$413.80 ,$574.91 ,$480.33 ,$458.49 ,$433.11 ,"$1,243.80 ",$896.75 ,$852.69 ,$386.96 ,"$1,243.80 ",$413.80 ,"$1,243.80 ","$1,243.80 ",$413.80 ,$898.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100016,64405,HC INJ ANES NERVE GREAT OCCIPITAL-LT,761,1 ,$921.00 ,$598.65 ,$257.88 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$320.22 ,$305.67 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100017,64405,HC INJ ANES NERVE GREAT OCCIPITAL-RT,761,1 ,$921.00 ,$598.65 ,$257.88 ,$921.00 ,$662.23 ,$686.15 ,$603.26 ,$275.86 ,$257.88 ,$465.11 ,$275.86 ,$568.26 ,$275.86 ,$568.26 ,$568.26 ,$275.86 ,$568.26 ,$524.13 ,$828.90 ,$690.75 ,$662.23 ,$275.86 ,$810.48 ,$275.86 ,$690.75 ,$690.75 ,$782.85 ,$782.85 ,$275.86 ,$782.85 ,$275.86 ,$718.38 ,$718.38 ,$718.38 ,$828.90 ,$662.23 ,$828.90 ,$275.86 ,$921.00 ,$603.26 ,$275.86 ,$383.14 ,$320.22 ,$305.67 ,$288.74 ,$828.90 ,$597.83 ,$568.26 ,$257.88 ,$828.90 ,$275.86 ,$828.90 ,$828.90 ,$275.86 ,$598.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100018,G0260,HC INJ ARTHROGRAM SACROILIAC-BI,761,1 ,"$5,006.00 ","$3,253.90 ",$224.98 ,"$5,006.00 ","$1,609.52 ","$3,729.47 ","$3,278.93 ",$670.48 ,"$1,401.68 ","$2,528.03 ",$670.48 ,"$3,088.70 ",$670.48 ,"$3,088.70 ","$3,088.70 ",$670.48 ,"$3,088.70 ","$1,273.91 ","$4,505.40 ","$3,754.50 ","$1,609.52 ",$670.48 ,"$4,405.28 ",$670.48 ,"$3,754.50 ","$3,754.50 ","$4,255.10 ","$4,255.10 ",$670.48 ,"$4,255.10 ",$670.48 ,"$3,904.68 ","$3,904.68 ","$3,904.68 ","$4,505.40 ","$1,609.52 ","$4,505.40 ",$670.48 ,"$5,006.00 ","$3,278.93 ",$670.48 ,"$2,082.50 ",$235.70 ,$224.98 ,$701.78 ,"$4,505.40 ","$1,453.01 ","$3,088.70 ","$1,401.68 ","$4,505.40 ",$670.48 ,"$4,505.40 ","$4,505.40 ",$670.48 ,"$3,253.90 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100019,G0260,HC INJ ARTHROGRAM SACROILIAC-LT,761,1 ,"$3,337.00 ","$2,169.05 ",$224.98 ,"$3,337.00 ","$1,609.52 ","$2,486.07 ","$2,185.74 ",$670.48 ,$934.36 ,"$1,685.19 ",$670.48 ,"$2,058.93 ",$670.48 ,"$2,058.93 ","$2,058.93 ",$670.48 ,"$2,058.93 ","$1,273.91 ","$3,003.30 ","$2,502.75 ","$1,609.52 ",$670.48 ,"$2,936.56 ",$670.48 ,"$2,502.75 ","$2,502.75 ","$2,836.45 ","$2,836.45 ",$670.48 ,"$2,836.45 ",$670.48 ,"$2,602.86 ","$2,602.86 ","$2,602.86 ","$3,003.30 ","$1,609.52 ","$3,003.30 ",$670.48 ,"$3,337.00 ","$2,185.74 ",$670.48 ,"$1,388.19 ",$235.70 ,$224.98 ,$701.78 ,"$3,003.30 ","$1,453.01 ","$2,058.93 ",$934.36 ,"$3,003.30 ",$670.48 ,"$3,003.30 ","$3,003.30 ",$670.48 ,"$2,169.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100020,G0260,HC INJ ARTHROGRAM SACROILIAC-RT,761,1 ,"$3,337.00 ","$2,169.05 ",$224.98 ,"$3,337.00 ","$1,609.52 ","$2,486.07 ","$2,185.74 ",$670.48 ,$934.36 ,"$1,685.19 ",$670.48 ,"$2,058.93 ",$670.48 ,"$2,058.93 ","$2,058.93 ",$670.48 ,"$2,058.93 ","$1,273.91 ","$3,003.30 ","$2,502.75 ","$1,609.52 ",$670.48 ,"$2,936.56 ",$670.48 ,"$2,502.75 ","$2,502.75 ","$2,836.45 ","$2,836.45 ",$670.48 ,"$2,836.45 ",$670.48 ,"$2,602.86 ","$2,602.86 ","$2,602.86 ","$3,003.30 ","$1,609.52 ","$3,003.30 ",$670.48 ,"$3,337.00 ","$2,185.74 ",$670.48 ,"$1,388.19 ",$235.70 ,$224.98 ,$701.78 ,"$3,003.30 ","$1,453.01 ","$2,058.93 ",$934.36 ,"$3,003.30 ",$670.48 ,"$3,003.30 ","$3,003.30 ",$670.48 ,"$2,169.05 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100021,64484,HC INJ EPID LUMBAR/SACRAL ADDL,761,1 ,"$3,382.00 ","$2,198.30 ",$554.36 ,"$3,382.00 ", N/A ,"$2,519.59 ","$2,215.21 ", N/A ,$946.96 ,"$1,707.91 ", N/A ,"$2,086.69 ", N/A ,"$2,086.69 ","$2,086.69 ", N/A ,"$2,086.69 ", N/A ,"$3,043.80 ","$2,536.50 ", N/A , N/A ,"$2,976.16 ", N/A ,"$2,536.50 ","$2,536.50 ","$2,874.70 ","$2,874.70 ", N/A ,"$2,874.70 ", N/A ,"$2,637.96 ","$2,637.96 ","$2,637.96 ","$3,043.80 ", N/A ,"$3,043.80 ", N/A ,"$3,382.00 ","$2,215.21 ", N/A ,"$1,406.91 ",$580.76 ,$554.36 , N/A ,"$3,043.80 ", N/A ,"$2,086.69 ",$946.96 ,"$3,043.80 ", N/A ,"$3,043.80 ","$3,043.80 ", N/A ,"$2,198.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100022,64484,HC INJ EPID LUMBAR/SACRAL ADDL-LT,761,1 ,"$3,382.00 ","$2,198.30 ",$554.36 ,"$3,382.00 ", N/A ,"$2,519.59 ","$2,215.21 ", N/A ,$946.96 ,"$1,707.91 ", N/A ,"$2,086.69 ", N/A ,"$2,086.69 ","$2,086.69 ", N/A ,"$2,086.69 ", N/A ,"$3,043.80 ","$2,536.50 ", N/A , N/A ,"$2,976.16 ", N/A ,"$2,536.50 ","$2,536.50 ","$2,874.70 ","$2,874.70 ", N/A ,"$2,874.70 ", N/A ,"$2,637.96 ","$2,637.96 ","$2,637.96 ","$3,043.80 ", N/A ,"$3,043.80 ", N/A ,"$3,382.00 ","$2,215.21 ", N/A ,"$1,406.91 ",$580.76 ,$554.36 , N/A ,"$3,043.80 ", N/A ,"$2,086.69 ",$946.96 ,"$3,043.80 ", N/A ,"$3,043.80 ","$3,043.80 ", N/A ,"$2,198.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100023,64484,HC INJ EPID LUMBAR/SACRAL ADDL-RT,761,1 ,"$3,382.00 ","$2,198.30 ",$554.36 ,"$3,382.00 ", N/A ,"$2,519.59 ","$2,215.21 ", N/A ,$946.96 ,"$1,707.91 ", N/A ,"$2,086.69 ", N/A ,"$2,086.69 ","$2,086.69 ", N/A ,"$2,086.69 ", N/A ,"$3,043.80 ","$2,536.50 ", N/A , N/A ,"$2,976.16 ", N/A ,"$2,536.50 ","$2,536.50 ","$2,874.70 ","$2,874.70 ", N/A ,"$2,874.70 ", N/A ,"$2,637.96 ","$2,637.96 ","$2,637.96 ","$3,043.80 ", N/A ,"$3,043.80 ", N/A ,"$3,382.00 ","$2,215.21 ", N/A ,"$1,406.91 ",$580.76 ,$554.36 , N/A ,"$3,043.80 ", N/A ,"$2,086.69 ",$946.96 ,"$3,043.80 ", N/A ,"$3,043.80 ","$3,043.80 ", N/A ,"$2,198.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100024,64483,HC INJ EPID LUMBAR/SACRAL SGL-BI,761,1 ,"$6,670.00 ","$4,335.50 ",$831.54 ,"$6,670.00 ","$3,129.83 ","$4,969.15 ","$4,368.85 ","$1,303.79 ","$1,867.60 ","$3,368.35 ","$1,303.79 ","$4,115.39 ","$1,303.79 ","$4,115.39 ","$4,115.39 ","$1,303.79 ","$4,115.39 ","$2,477.20 ","$6,003.00 ","$5,002.50 ","$3,129.83 ","$1,303.79 ","$5,869.60 ","$1,303.79 ","$5,002.50 ","$5,002.50 ","$5,669.50 ","$5,669.50 ","$1,303.79 ","$5,669.50 ","$1,303.79 ","$5,202.60 ","$5,202.60 ","$5,202.60 ","$6,003.00 ","$3,129.83 ","$6,003.00 ","$1,303.79 ","$6,670.00 ","$4,368.85 ","$1,303.79 ","$2,774.72 ",$871.13 ,$831.54 ,"$1,364.66 ","$6,003.00 ","$2,825.49 ","$4,115.39 ","$1,867.60 ","$6,003.00 ","$1,303.79 ","$6,003.00 ","$6,003.00 ","$1,303.79 ","$4,335.50 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100025,64483,HC INJ EPID LUMBAR/SACRAL SGL-LT,761,1 ,"$4,447.00 ","$2,890.55 ",$554.36 ,"$4,447.00 ","$2,086.56 ","$3,313.02 ","$2,912.79 ",$869.20 ,"$1,245.16 ","$2,245.74 ",$869.20 ,"$2,743.80 ",$869.20 ,"$2,743.80 ","$2,743.80 ",$869.20 ,"$2,743.80 ","$1,651.48 ","$4,002.30 ","$3,335.25 ","$2,086.56 ",$869.20 ,"$3,913.36 ",$869.20 ,"$3,335.25 ","$3,335.25 ","$3,779.95 ","$3,779.95 ",$869.20 ,"$3,779.95 ",$869.20 ,"$3,468.66 ","$3,468.66 ","$3,468.66 ","$4,002.30 ","$2,086.56 ","$4,002.30 ",$869.20 ,"$4,447.00 ","$2,912.79 ",$869.20 ,"$1,849.95 ",$580.76 ,$554.36 ,$909.77 ,"$4,002.30 ","$1,883.66 ","$2,743.80 ","$1,245.16 ","$4,002.30 ",$869.20 ,"$4,002.30 ","$4,002.30 ",$869.20 ,"$2,890.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100026,64483,HC INJ EPID LUMBAR/SACRAL SGL-RT,761,1 ,"$4,447.00 ","$2,890.55 ",$554.36 ,"$4,447.00 ","$2,086.56 ","$3,313.02 ","$2,912.79 ",$869.20 ,"$1,245.16 ","$2,245.74 ",$869.20 ,"$2,743.80 ",$869.20 ,"$2,743.80 ","$2,743.80 ",$869.20 ,"$2,743.80 ","$1,651.48 ","$4,002.30 ","$3,335.25 ","$2,086.56 ",$869.20 ,"$3,913.36 ",$869.20 ,"$3,335.25 ","$3,335.25 ","$3,779.95 ","$3,779.95 ",$869.20 ,"$3,779.95 ",$869.20 ,"$3,468.66 ","$3,468.66 ","$3,468.66 ","$4,002.30 ","$2,086.56 ","$4,002.30 ",$869.20 ,"$4,447.00 ","$2,912.79 ",$869.20 ,"$1,849.95 ",$580.76 ,$554.36 ,$909.77 ,"$4,002.30 ","$1,883.66 ","$2,743.80 ","$1,245.16 ","$4,002.30 ",$869.20 ,"$4,002.30 ","$4,002.30 ",$869.20 ,"$2,890.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100027,64479,HC INJ EPIDURAL CREV/THOR SGL-BI,761,1 ,"$6,853.00 ","$4,454.45 ",$831.54 ,"$6,853.00 ","$3,129.83 ","$5,105.49 ","$4,488.72 ","$1,303.79 ","$1,918.84 ","$3,460.77 ","$1,303.79 ","$4,228.30 ","$1,303.79 ","$4,228.30 ","$4,228.30 ","$1,303.79 ","$4,228.30 ","$2,477.20 ","$6,167.70 ","$5,139.75 ","$3,129.83 ","$1,303.79 ","$6,030.64 ","$1,303.79 ","$5,139.75 ","$5,139.75 ","$5,825.05 ","$5,825.05 ","$1,303.79 ","$5,825.05 ","$1,303.79 ","$5,345.34 ","$5,345.34 ","$5,345.34 ","$6,167.70 ","$3,129.83 ","$6,167.70 ","$1,303.79 ","$6,853.00 ","$4,488.72 ","$1,303.79 ","$2,850.85 ",$871.13 ,$831.54 ,"$1,364.66 ","$6,167.70 ","$2,825.49 ","$4,228.30 ","$1,918.84 ","$6,167.70 ","$1,303.79 ","$6,167.70 ","$6,167.70 ","$1,303.79 ","$4,454.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100028,64479,HC INJ EPIDURAL CREV/THOR SGL-LT,761,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100030,64490,HC INJ PARAVERT F JNT C/T 1 LV-BI,761,1 ,"$6,853.00 ","$4,454.45 ",$831.54 ,"$6,853.00 ","$3,129.83 ","$5,105.49 ","$4,488.72 ","$1,303.79 ","$1,918.84 ","$3,460.77 ","$1,303.79 ","$4,228.30 ","$1,303.79 ","$4,228.30 ","$4,228.30 ","$1,303.79 ","$4,228.30 ","$2,477.20 ","$6,167.70 ","$5,139.75 ","$3,129.83 ","$1,303.79 ","$6,030.64 ","$1,303.79 ","$5,139.75 ","$5,139.75 ","$5,825.05 ","$5,825.05 ","$1,303.79 ","$5,825.05 ","$1,303.79 ","$5,345.34 ","$5,345.34 ","$5,345.34 ","$6,167.70 ","$3,129.83 ","$6,167.70 ","$1,303.79 ","$6,853.00 ","$4,488.72 ","$1,303.79 ","$2,850.85 ",$871.13 ,$831.54 ,"$1,364.66 ","$6,167.70 ","$2,825.49 ","$4,228.30 ","$1,918.84 ","$6,167.70 ","$1,303.79 ","$6,167.70 ","$6,167.70 ","$1,303.79 ","$4,454.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100031,64490,HC INJ PARAVERT F JNT C/T 1 LV-LT,761,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100032,64490,HC INJ PARAVERT F JNT C/T 1 LV-RT,761,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100033,64491,HC INJ PARAVERT F JNT C/T 2 LV,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100034,64491,HC INJ PARAVERT F JNT C/T 2 LV-LT,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100035,64491,HC INJ PARAVERT F JNT C/T 2 LV-RT,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100036,64492,HC INJ PARAVERT F JNT C/T 3 LV,761,1 ,"$1,218.00 ",$791.70 ,$341.04 ,"$1,218.00 ", N/A ,$907.41 ,$797.79 , N/A ,$341.04 ,$615.09 , N/A ,$751.51 , N/A ,$751.51 ,$751.51 , N/A ,$751.51 , N/A ,"$1,096.20 ",$913.50 , N/A , N/A ,"$1,071.84 ", N/A ,$913.50 ,$913.50 ,"$1,035.30 ","$1,035.30 ", N/A ,"$1,035.30 ", N/A ,$950.04 ,$950.04 ,$950.04 ,"$1,096.20 ", N/A ,"$1,096.20 ", N/A ,"$1,218.00 ",$797.79 , N/A ,$506.69 ,$580.76 ,$554.36 , N/A ,"$1,096.20 ", N/A ,$751.51 ,$341.04 ,"$1,096.20 ", N/A ,"$1,096.20 ","$1,096.20 ", N/A ,$791.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100037,64492,HC INJ PARAVERT F JNT C/T 3 LV-LT,761,1 ,"$1,218.00 ",$791.70 ,$341.04 ,"$1,218.00 ", N/A ,$907.41 ,$797.79 , N/A ,$341.04 ,$615.09 , N/A ,$751.51 , N/A ,$751.51 ,$751.51 , N/A ,$751.51 , N/A ,"$1,096.20 ",$913.50 , N/A , N/A ,"$1,071.84 ", N/A ,$913.50 ,$913.50 ,"$1,035.30 ","$1,035.30 ", N/A ,"$1,035.30 ", N/A ,$950.04 ,$950.04 ,$950.04 ,"$1,096.20 ", N/A ,"$1,096.20 ", N/A ,"$1,218.00 ",$797.79 , N/A ,$506.69 ,$580.76 ,$554.36 , N/A ,"$1,096.20 ", N/A ,$751.51 ,$341.04 ,"$1,096.20 ", N/A ,"$1,096.20 ","$1,096.20 ", N/A ,$791.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100038,64492,HC INJ PARAVERT F JNT C/T 3 LV-RT,761,1 ,"$1,218.00 ",$791.70 ,$341.04 ,"$1,218.00 ", N/A ,$907.41 ,$797.79 , N/A ,$341.04 ,$615.09 , N/A ,$751.51 , N/A ,$751.51 ,$751.51 , N/A ,$751.51 , N/A ,"$1,096.20 ",$913.50 , N/A , N/A ,"$1,071.84 ", N/A ,$913.50 ,$913.50 ,"$1,035.30 ","$1,035.30 ", N/A ,"$1,035.30 ", N/A ,$950.04 ,$950.04 ,$950.04 ,"$1,096.20 ", N/A ,"$1,096.20 ", N/A ,"$1,218.00 ",$797.79 , N/A ,$506.69 ,$580.76 ,$554.36 , N/A ,"$1,096.20 ", N/A ,$751.51 ,$341.04 ,"$1,096.20 ", N/A ,"$1,096.20 ","$1,096.20 ", N/A ,$791.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100039,64493,HC INJ PARAVERT F JNT L/S 1 LV-BI,761,1 ,"$6,853.00 ","$4,454.45 ",$831.54 ,"$6,853.00 ","$3,129.83 ","$5,105.49 ","$4,488.72 ","$1,303.79 ","$1,918.84 ","$3,460.77 ","$1,303.79 ","$4,228.30 ","$1,303.79 ","$4,228.30 ","$4,228.30 ","$1,303.79 ","$4,228.30 ","$2,477.20 ","$6,167.70 ","$5,139.75 ","$3,129.83 ","$1,303.79 ","$6,030.64 ","$1,303.79 ","$5,139.75 ","$5,139.75 ","$5,825.05 ","$5,825.05 ","$1,303.79 ","$5,825.05 ","$1,303.79 ","$5,345.34 ","$5,345.34 ","$5,345.34 ","$6,167.70 ","$3,129.83 ","$6,167.70 ","$1,303.79 ","$6,853.00 ","$4,488.72 ","$1,303.79 ","$2,850.85 ",$871.13 ,$831.54 ,"$1,364.66 ","$6,167.70 ","$2,825.49 ","$4,228.30 ","$1,918.84 ","$6,167.70 ","$1,303.79 ","$6,167.70 ","$6,167.70 ","$1,303.79 ","$4,454.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100040,64493,HC INJ PARAVERT F JNT L/S 1 LV-LT,761,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100041,64493,HC INJ PARAVERT F JNT L/S 1 LV-RT,761,1 ,"$4,569.00 ","$2,969.85 ",$554.36 ,"$4,569.00 ","$2,086.56 ","$3,403.91 ","$2,992.70 ",$869.20 ,"$1,279.32 ","$2,307.35 ",$869.20 ,"$2,819.07 ",$869.20 ,"$2,819.07 ","$2,819.07 ",$869.20 ,"$2,819.07 ","$1,651.48 ","$4,112.10 ","$3,426.75 ","$2,086.56 ",$869.20 ,"$4,020.72 ",$869.20 ,"$3,426.75 ","$3,426.75 ","$3,883.65 ","$3,883.65 ",$869.20 ,"$3,883.65 ",$869.20 ,"$3,563.82 ","$3,563.82 ","$3,563.82 ","$4,112.10 ","$2,086.56 ","$4,112.10 ",$869.20 ,"$4,569.00 ","$2,992.70 ",$869.20 ,"$1,900.70 ",$580.76 ,$554.36 ,$909.77 ,"$4,112.10 ","$1,883.66 ","$2,819.07 ","$1,279.32 ","$4,112.10 ",$869.20 ,"$4,112.10 ","$4,112.10 ",$869.20 ,"$2,969.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100042,64494,HC INJ PARAVERT F JNT L/S 2 LV,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100043,64494,HC INJ PARAVERT F JNT L/S 2 LV-LT,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100044,64494,HC INJ PARAVERT F JNT L/S 2 LV-RT,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100045,64495,HC INJ PARAVRT F JNT L/S 3+ LV,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100046,64495,HC INJ PARAVRT F JNT L/S 3+ LV-LT,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100047,64495,HC INJ PARAVRT F JNT L/S 3+ LV-RT,761,1 ,"$1,412.00 ",$917.80 ,$395.36 ,"$1,412.00 ", N/A ,"$1,051.94 ",$924.86 , N/A ,$395.36 ,$713.06 , N/A ,$871.20 , N/A ,$871.20 ,$871.20 , N/A ,$871.20 , N/A ,"$1,270.80 ","$1,059.00 ", N/A , N/A ,"$1,242.56 ", N/A ,"$1,059.00 ","$1,059.00 ","$1,200.20 ","$1,200.20 ", N/A ,"$1,200.20 ", N/A ,"$1,101.36 ","$1,101.36 ","$1,101.36 ","$1,270.80 ", N/A ,"$1,270.80 ", N/A ,"$1,412.00 ",$924.86 , N/A ,$587.39 ,$580.76 ,$554.36 , N/A ,"$1,270.80 ", N/A ,$871.20 ,$395.36 ,"$1,270.80 ", N/A ,"$1,270.80 ","$1,270.80 ", N/A ,$917.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100048,97607,HC NEG PRESS WOUND THERAPY WO DME<50CM,761,1 ,$891.00 ,$579.15 ,$199.94 ,$891.00 ,$876.09 ,$663.80 ,$583.61 ,$364.95 ,$249.48 ,$449.96 ,$364.95 ,$549.75 ,$364.95 ,$549.75 ,$549.75 ,$364.95 ,$549.75 ,$693.41 ,$801.90 ,$668.25 ,$876.09 ,$364.95 ,$784.08 ,$364.95 ,$668.25 ,$668.25 ,$757.35 ,$757.35 ,$364.95 ,$757.35 ,$364.95 ,$694.98 ,$694.98 ,$694.98 ,$801.90 ,$876.09 ,$801.90 ,$364.95 ,$891.00 ,$583.61 ,$364.95 ,$370.66 ,$209.46 ,$199.94 ,$381.99 ,$801.90 ,$790.90 ,$549.75 ,$249.48 ,$801.90 ,$364.95 ,$801.90 ,$801.90 ,$364.95 ,$579.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76100054,64999,HC GANGLION IMPAR BLOCK,761,1 ,"$6,369.00 ","$4,139.85 ",$275.86 ,"$6,369.00 ",$662.23 ,"$4,744.91 ","$4,171.70 ",$275.86 ,"$1,783.32 ","$3,216.35 ",$275.86 ,"$3,929.67 ",$275.86 ,"$3,929.67 ","$3,929.67 ",$275.86 ,"$3,929.67 ",$524.13 ,"$5,732.10 ","$4,776.75 ",$662.23 ,$275.86 ,"$5,604.72 ",$275.86 ,"$4,776.75 ","$4,776.75 ","$5,413.65 ","$5,413.65 ",$275.86 ,"$5,413.65 ",$275.86 ,"$4,967.82 ","$4,967.82 ","$4,967.82 ","$5,732.10 ",$662.23 ,"$5,732.10 ",$275.86 ,"$6,369.00 ","$4,171.70 ",$275.86 ,"$2,649.50 ",$320.22 ,$305.67 ,$288.74 ,"$5,732.10 ",$597.83 ,"$3,929.67 ","$1,783.32 ","$5,732.10 ",$275.86 ,"$5,732.10 ","$5,732.10 ",$275.86 ,"$4,139.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,"$1,823.00 ","$1,184.95 ",$510.44 ,"$1,823.00 ", N/A ,"$1,358.14 ","$1,194.07 ", N/A ,$510.44 ,$920.62 , N/A ,"$1,124.79 ", N/A ,"$1,124.79 ","$1,124.79 ", N/A ,"$1,124.79 ", N/A ,"$1,640.70 ","$1,367.25 ", N/A , N/A ,"$1,604.24 ", N/A ,"$1,367.25 ","$1,367.25 ","$1,549.55 ","$1,549.55 ", N/A ,"$1,549.55 ", N/A ,"$1,421.94 ","$1,421.94 ","$1,421.94 ","$1,640.70 ", N/A ,"$1,640.70 ", N/A ,"$1,823.00 ","$1,194.07 ", N/A ,$758.37 , N/A , N/A , N/A ,"$1,640.70 ", N/A ,"$1,124.79 ",$510.44 ,"$1,640.70 ", N/A ,"$1,640.70 ","$1,640.70 ", N/A ,"$1,184.95 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$83.00 ,$53.95 ,$23.24 ,$83.00 , N/A ,$61.84 ,$54.37 , N/A ,$23.24 ,$41.92 , N/A ,$51.21 , N/A ,$51.21 ,$51.21 , N/A ,$51.21 , N/A ,$74.70 ,$62.25 , N/A , N/A ,$73.04 , N/A ,$62.25 ,$62.25 ,$70.55 ,$70.55 , N/A ,$70.55 , N/A ,$64.74 ,$64.74 ,$64.74 ,$74.70 , N/A ,$74.70 , N/A ,$83.00 ,$54.37 , N/A ,$34.53 , N/A , N/A , N/A ,$74.70 , N/A ,$51.21 ,$23.24 ,$74.70 , N/A ,$74.70 ,$74.70 , N/A ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76200020,G0378,HC OBSERVATION W/INTENSIVE CARE PER HR,762,1 ,$83.00 ,$53.95 ,$23.24 ,$83.00 , N/A ,$61.84 ,$54.37 , N/A ,$23.24 ,$41.92 , N/A ,$51.21 , N/A ,$51.21 ,$51.21 , N/A ,$51.21 , N/A ,$74.70 ,$62.25 , N/A , N/A ,$73.04 , N/A ,$62.25 ,$62.25 ,$70.55 ,$70.55 , N/A ,$70.55 , N/A ,$64.74 ,$64.74 ,$64.74 ,$74.70 , N/A ,$74.70 , N/A ,$83.00 ,$54.37 , N/A ,$34.53 , N/A , N/A , N/A ,$74.70 , N/A ,$51.21 ,$23.24 ,$74.70 , N/A ,$74.70 ,$74.70 , N/A ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76200021,G0378,HC OBSERVATION W/INTERMEDIATE CARE PER HR,762,1 ,$83.00 ,$53.95 ,$23.24 ,$83.00 , N/A ,$61.84 ,$54.37 , N/A ,$23.24 ,$41.92 , N/A ,$51.21 , N/A ,$51.21 ,$51.21 , N/A ,$51.21 , N/A ,$74.70 ,$62.25 , N/A , N/A ,$73.04 , N/A ,$62.25 ,$62.25 ,$70.55 ,$70.55 , N/A ,$70.55 , N/A ,$64.74 ,$64.74 ,$64.74 ,$74.70 , N/A ,$74.70 , N/A ,$83.00 ,$54.37 , N/A ,$34.53 , N/A , N/A , N/A ,$74.70 , N/A ,$51.21 ,$23.24 ,$74.70 , N/A ,$74.70 ,$74.70 , N/A ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),76200022,G0378,HC OBSERVATION W/TELEMETRY PER HR,762,1 ,$83.00 ,$53.95 ,$23.24 ,$83.00 , N/A ,$61.84 ,$54.37 , N/A ,$23.24 ,$41.92 , N/A ,$51.21 , N/A ,$51.21 ,$51.21 , N/A ,$51.21 , N/A ,$74.70 ,$62.25 , N/A , N/A ,$73.04 , N/A ,$62.25 ,$62.25 ,$70.55 ,$70.55 , N/A ,$70.55 , N/A ,$64.74 ,$64.74 ,$64.74 ,$74.70 , N/A ,$74.70 , N/A ,$83.00 ,$54.37 , N/A ,$34.53 , N/A , N/A , N/A ,$74.70 , N/A ,$51.21 ,$23.24 ,$74.70 , N/A ,$74.70 ,$74.70 , N/A ,$53.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$132.00 ,$85.80 ,$36.96 ,$141.87 ,$132.00 ,$98.34 ,$86.46 ,$65.46 ,$36.96 ,$66.66 ,$65.46 ,$81.44 ,$65.46 ,$81.44 ,$81.44 ,$65.46 ,$81.44 ,$124.37 ,$118.80 ,$99.00 ,$132.00 ,$65.46 ,$116.16 ,$65.46 ,$99.00 ,$99.00 ,$112.20 ,$112.20 ,$65.46 ,$112.20 ,$65.46 ,$102.96 ,$102.96 ,$102.96 ,$118.80 ,$132.00 ,$118.80 ,$65.46 ,$132.00 ,$86.46 ,$65.46 ,$54.91 , N/A , N/A ,$68.52 ,$118.80 ,$141.87 ,$81.44 ,$36.96 ,$118.80 ,$65.46 ,$118.80 ,$118.80 ,$65.46 ,$85.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$115.00 ,$74.75 ,$32.20 ,$115.00 , N/A ,$85.68 ,$75.33 , N/A ,$32.20 ,$58.08 , N/A ,$70.96 , N/A ,$70.96 ,$70.96 , N/A ,$70.96 , N/A ,$103.50 ,$86.25 , N/A , N/A ,$101.20 , N/A ,$86.25 ,$86.25 ,$97.75 ,$97.75 , N/A ,$97.75 , N/A ,$89.70 ,$89.70 ,$89.70 ,$103.50 , N/A ,$103.50 , N/A ,$115.00 ,$75.33 , N/A ,$47.84 , N/A , N/A , N/A ,$103.50 , N/A ,$70.96 ,$32.20 ,$103.50 , N/A ,$103.50 ,$103.50 , N/A ,$74.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$126.00 ,$81.90 ,$35.28 ,$126.00 ,$101.43 ,$93.87 ,$82.53 ,$42.25 ,$35.28 ,$63.63 ,$42.25 ,$77.74 ,$42.25 ,$77.74 ,$77.74 ,$42.25 ,$77.74 ,$80.28 ,$113.40 ,$94.50 ,$101.43 ,$42.25 ,$110.88 ,$42.25 ,$94.50 ,$94.50 ,$107.10 ,$107.10 ,$42.25 ,$107.10 ,$42.25 ,$98.28 ,$98.28 ,$98.28 ,$113.40 ,$101.43 ,$113.40 ,$42.25 ,$126.00 ,$82.53 ,$42.25 ,$52.42 , N/A , N/A ,$44.23 ,$113.40 ,$91.57 ,$77.74 ,$35.28 ,$113.40 ,$42.25 ,$113.40 ,$113.40 ,$42.25 ,$81.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$126.00 ,$81.90 ,$35.28 ,$126.00 ,$101.43 ,$93.87 ,$82.53 ,$42.25 ,$35.28 ,$63.63 ,$42.25 ,$77.74 ,$42.25 ,$77.74 ,$77.74 ,$42.25 ,$77.74 ,$80.28 ,$113.40 ,$94.50 ,$101.43 ,$42.25 ,$110.88 ,$42.25 ,$94.50 ,$94.50 ,$107.10 ,$107.10 ,$42.25 ,$107.10 ,$42.25 ,$98.28 ,$98.28 ,$98.28 ,$113.40 ,$101.43 ,$113.40 ,$42.25 ,$126.00 ,$82.53 ,$42.25 ,$52.42 , N/A , N/A ,$44.23 ,$113.40 ,$91.57 ,$77.74 ,$35.28 ,$113.40 ,$42.25 ,$113.40 ,$113.40 ,$42.25 ,$81.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$126.00 ,$81.90 ,$35.28 ,$126.00 ,$101.43 ,$93.87 ,$82.53 ,$42.25 ,$35.28 ,$63.63 ,$42.25 ,$77.74 ,$42.25 ,$77.74 ,$77.74 ,$42.25 ,$77.74 ,$80.28 ,$113.40 ,$94.50 ,$101.43 ,$42.25 ,$110.88 ,$42.25 ,$94.50 ,$94.50 ,$107.10 ,$107.10 ,$42.25 ,$107.10 ,$42.25 ,$98.28 ,$98.28 ,$98.28 ,$113.40 ,$101.43 ,$113.40 ,$42.25 ,$126.00 ,$82.53 ,$42.25 ,$52.42 , N/A , N/A ,$44.23 ,$113.40 ,$91.57 ,$77.74 ,$35.28 ,$113.40 ,$42.25 ,$113.40 ,$113.40 ,$42.25 ,$81.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100009,0001A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$40.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100010,0002A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$40.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100011,0011A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$40.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100012,0012A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5M SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$40.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100013,0021A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 , N/A ,$89.40 ,$78.60 , N/A ,$33.60 ,$60.60 , N/A ,$74.04 , N/A ,$74.04 ,$74.04 , N/A ,$74.04 , N/A ,$108.00 ,$40.00 , N/A , N/A ,$105.60 , N/A ,$90.00 ,$90.00 ,$102.00 ,$102.00 , N/A ,$102.00 , N/A ,$93.60 ,$93.60 ,$93.60 ,$108.00 , N/A ,$108.00 , N/A ,$120.00 ,$78.60 , N/A ,$49.92 , N/A , N/A , N/A ,$108.00 , N/A ,$74.04 ,$33.60 ,$108.00 , N/A ,$108.00 ,$108.00 , N/A ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100014,0022A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 , N/A ,$89.40 ,$78.60 , N/A ,$33.60 ,$60.60 , N/A ,$74.04 , N/A ,$74.04 ,$74.04 , N/A ,$74.04 , N/A ,$108.00 ,$40.00 , N/A , N/A ,$105.60 , N/A ,$90.00 ,$90.00 ,$102.00 ,$102.00 , N/A ,$102.00 , N/A ,$93.60 ,$93.60 ,$93.60 ,$108.00 , N/A ,$108.00 , N/A ,$120.00 ,$78.60 , N/A ,$49.92 , N/A , N/A , N/A ,$108.00 , N/A ,$74.04 ,$33.60 ,$108.00 , N/A ,$108.00 ,$108.00 , N/A ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100015,0031A,HC ADMINISTRATION SARS-COV-2 VACCINE AD26 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$40.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100016,0041A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 , N/A ,$89.40 ,$78.60 , N/A ,$33.60 ,$60.60 , N/A ,$74.04 , N/A ,$74.04 ,$74.04 , N/A ,$74.04 , N/A ,$108.00 ,$90.00 , N/A , N/A ,$105.60 , N/A ,$90.00 ,$90.00 ,$102.00 ,$102.00 , N/A ,$102.00 , N/A ,$93.60 ,$93.60 ,$93.60 ,$108.00 , N/A ,$108.00 , N/A ,$120.00 ,$78.60 , N/A ,$49.92 , N/A , N/A , N/A ,$108.00 , N/A ,$74.04 ,$33.60 ,$108.00 , N/A ,$108.00 ,$108.00 , N/A ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100017,0042A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 , N/A ,$89.40 ,$78.60 , N/A ,$33.60 ,$60.60 , N/A ,$74.04 , N/A ,$74.04 ,$74.04 , N/A ,$74.04 , N/A ,$108.00 ,$90.00 , N/A , N/A ,$105.60 , N/A ,$90.00 ,$90.00 ,$102.00 ,$102.00 , N/A ,$102.00 , N/A ,$93.60 ,$93.60 ,$93.60 ,$108.00 , N/A ,$108.00 , N/A ,$120.00 ,$78.60 , N/A ,$49.92 , N/A , N/A , N/A ,$108.00 , N/A ,$74.04 ,$33.60 ,$108.00 , N/A ,$108.00 ,$108.00 , N/A ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100018,0003A,HC ADM SARSCOV2 30MCG/0.3ML 3RD - PFIZER,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$90.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100019,0013A,HC ADM SARSCOV2 100MCG/0.5ML 3RD - MODERNA,771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$90.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100025,0064A,"HC ADMIN SARS-COV-2 VACCINE 50MCG/0.25ML, BOOSTER DOSE",771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$90.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),77100028,0034A,"HC ADMIN SARS-COV-2 VACCINE JOHNSON  AND  JOHNSON, BOOSTER DOSE",771,1 ,$120.00 ,$78.00 ,$33.60 ,$120.00 ,$99.27 ,$89.40 ,$78.60 ,$41.35 ,$33.60 ,$60.60 ,$41.35 ,$74.04 ,$41.35 ,$74.04 ,$74.04 ,$41.35 ,$74.04 ,$78.57 ,$108.00 ,$90.00 ,$99.27 ,$41.35 ,$105.60 ,$41.35 ,$90.00 ,$90.00 ,$102.00 ,$102.00 ,$41.35 ,$102.00 ,$41.35 ,$93.60 ,$93.60 ,$93.60 ,$108.00 ,$99.27 ,$108.00 ,$41.35 ,$120.00 ,$78.60 ,$41.35 ,$49.92 , N/A , N/A ,$43.28 ,$108.00 ,$89.62 ,$74.04 ,$33.60 ,$108.00 ,$41.35 ,$108.00 ,$108.00 ,$41.35 ,$78.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$80.00 ,$52.00 ,$10.15 ,$80.00 ,$68.98 ,$59.60 ,$52.40 ,$27.59 ,$22.40 ,$40.40 ,$27.59 ,$49.36 ,$27.59 ,$49.36 ,$49.36 ,$27.59 ,$49.36 ,$52.42 ,$72.00 ,$60.00 ,$68.98 ,$27.59 ,$70.40 ,$27.59 ,$60.00 ,$60.00 ,$68.00 ,$68.00 ,$27.59 ,$68.00 ,$27.59 ,$62.40 ,$62.40 ,$62.40 ,$72.00 ,$68.98 ,$72.00 ,$27.59 ,$80.00 ,$52.40 ,$27.59 ,$33.28 ,$10.64 ,$10.15 ,$28.97 ,$72.00 ,$62.08 ,$49.36 ,$22.40 ,$72.00 ,$27.59 ,$72.00 ,$72.00 ,$27.59 ,$52.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000003,97110,HC THERA EXER; EA 15 MIN - 95,780,1 ,$72.00 ,$46.80 ,$20.16 ,$72.00 ,$72.00 ,$53.64 ,$47.16 ,$29.02 ,$20.16 ,$36.36 ,$29.02 ,$44.42 ,$29.02 ,$44.42 ,$44.42 ,$29.02 ,$44.42 ,$55.14 ,$64.80 ,$54.00 ,$72.00 ,$29.02 ,$63.36 ,$29.02 ,$54.00 ,$54.00 ,$61.20 ,$61.20 ,$29.02 ,$61.20 ,$29.02 ,$56.16 ,$56.16 ,$56.16 ,$64.80 ,$72.00 ,$64.80 ,$29.02 ,$72.00 ,$47.16 ,$29.02 ,$29.95 , N/A , N/A ,$30.47 ,$64.80 ,$65.30 ,$44.42 ,$20.16 ,$64.80 ,$29.02 ,$64.80 ,$64.80 ,$29.02 ,$46.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000004,97112,HC NEUROMUSCULAR RE ED EA 15 MIN - 95,780,1 ,$150.00 ,$97.50 ,$33.59 ,$150.00 ,$83.98 ,$111.75 ,$98.25 ,$33.59 ,$42.00 ,$75.75 ,$33.59 ,$92.55 ,$33.59 ,$92.55 ,$92.55 ,$33.59 ,$92.55 ,$63.82 ,$135.00 ,$112.50 ,$83.98 ,$33.59 ,$132.00 ,$33.59 ,$112.50 ,$112.50 ,$127.50 ,$127.50 ,$33.59 ,$127.50 ,$33.59 ,$117.00 ,$117.00 ,$117.00 ,$135.00 ,$83.98 ,$135.00 ,$33.59 ,$150.00 ,$98.25 ,$33.59 ,$62.40 , N/A , N/A ,$35.27 ,$135.00 ,$75.58 ,$92.55 ,$42.00 ,$135.00 ,$33.59 ,$135.00 ,$135.00 ,$33.59 ,$97.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000005,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN - 95,780,1 ,$256.00 ,$166.40 ,$36.24 ,$256.00 ,$90.60 ,$190.72 ,$167.68 ,$36.24 ,$71.68 ,$129.28 ,$36.24 ,$157.95 ,$36.24 ,$157.95 ,$157.95 ,$36.24 ,$157.95 ,$68.86 ,$230.40 ,$192.00 ,$90.60 ,$36.24 ,$225.28 ,$36.24 ,$192.00 ,$192.00 ,$217.60 ,$217.60 ,$36.24 ,$217.60 ,$36.24 ,$199.68 ,$199.68 ,$199.68 ,$230.40 ,$90.60 ,$230.40 ,$36.24 ,$256.00 ,$167.68 ,$36.24 ,$106.50 , N/A , N/A ,$38.05 ,$230.40 ,$81.54 ,$157.95 ,$71.68 ,$230.40 ,$36.24 ,$230.40 ,$230.40 ,$36.24 ,$166.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000006,97535,HC SELF CARE ADL TRAINING EA 15 MIN - 95,780,1 ,$97.00 ,$63.05 ,$27.16 ,$97.00 ,$80.43 ,$72.27 ,$63.54 ,$32.17 ,$27.16 ,$48.99 ,$32.17 ,$59.85 ,$32.17 ,$59.85 ,$59.85 ,$32.17 ,$59.85 ,$61.12 ,$87.30 ,$72.75 ,$80.43 ,$32.17 ,$85.36 ,$32.17 ,$72.75 ,$72.75 ,$82.45 ,$82.45 ,$32.17 ,$82.45 ,$32.17 ,$75.66 ,$75.66 ,$75.66 ,$87.30 ,$80.43 ,$87.30 ,$32.17 ,$97.00 ,$63.54 ,$32.17 ,$40.35 , N/A , N/A ,$33.78 ,$87.30 ,$72.38 ,$59.85 ,$27.16 ,$87.30 ,$32.17 ,$87.30 ,$87.30 ,$32.17 ,$63.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000007,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN - 95,780,1 ,$229.00 ,$148.85 ,$22.86 ,$229.00 ,$57.15 ,$170.61 ,$150.00 ,$22.86 ,$64.12 ,$115.65 ,$22.86 ,$141.29 ,$22.86 ,$141.29 ,$141.29 ,$22.86 ,$141.29 ,$43.43 ,$206.10 ,$171.75 ,$57.15 ,$22.86 ,$201.52 ,$22.86 ,$171.75 ,$171.75 ,$194.65 ,$194.65 ,$22.86 ,$194.65 ,$22.86 ,$178.62 ,$178.62 ,$178.62 ,$206.10 ,$57.15 ,$206.10 ,$22.86 ,$229.00 ,$150.00 ,$22.86 ,$95.26 , N/A , N/A ,$24.00 ,$206.10 ,$51.44 ,$141.29 ,$64.12 ,$206.10 ,$22.86 ,$206.10 ,$206.10 ,$22.86 ,$148.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000008,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN - 95,780,1 ,$187.00 ,$121.55 ,$22.16 ,$187.00 ,$55.40 ,$139.32 ,$122.49 ,$22.16 ,$52.36 ,$94.44 ,$22.16 ,$115.38 ,$22.16 ,$115.38 ,$115.38 ,$22.16 ,$115.38 ,$42.10 ,$168.30 ,$140.25 ,$55.40 ,$22.16 ,$164.56 ,$22.16 ,$140.25 ,$140.25 ,$158.95 ,$158.95 ,$22.16 ,$158.95 ,$22.16 ,$145.86 ,$145.86 ,$145.86 ,$168.30 ,$55.40 ,$168.30 ,$22.16 ,$187.00 ,$122.49 ,$22.16 ,$77.79 , N/A , N/A ,$23.27 ,$168.30 ,$49.86 ,$115.38 ,$52.36 ,$168.30 ,$22.16 ,$168.30 ,$168.30 ,$22.16 ,$121.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000009,97161,HC PT EVAL LOW COMPLEXITY 15 MIN - 95,780,1 ,$438.00 ,$284.70 ,$98.76 ,$438.00 ,$246.90 ,$326.31 ,$286.89 ,$98.76 ,$122.64 ,$221.19 ,$98.76 ,$270.25 ,$98.76 ,$270.25 ,$270.25 ,$98.76 ,$270.25 ,$187.64 ,$394.20 ,$328.50 ,$246.90 ,$98.76 ,$385.44 ,$98.76 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$98.76 ,$372.30 ,$98.76 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$246.90 ,$394.20 ,$98.76 ,$438.00 ,$286.89 ,$98.76 ,$182.21 , N/A , N/A ,$103.70 ,$394.20 ,$222.21 ,$270.25 ,$122.64 ,$394.20 ,$98.76 ,$394.20 ,$394.20 ,$98.76 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000010,97162,HC PT EVAL MOD COMPLEXITY 30 MIN - 95,780,1 ,$509.00 ,$330.85 ,$98.76 ,$509.00 ,$246.90 ,$379.21 ,$333.40 ,$98.76 ,$142.52 ,$257.05 ,$98.76 ,$314.05 ,$98.76 ,$314.05 ,$314.05 ,$98.76 ,$314.05 ,$187.64 ,$458.10 ,$381.75 ,$246.90 ,$98.76 ,$447.92 ,$98.76 ,$381.75 ,$381.75 ,$432.65 ,$432.65 ,$98.76 ,$432.65 ,$98.76 ,$397.02 ,$397.02 ,$397.02 ,$458.10 ,$246.90 ,$458.10 ,$98.76 ,$509.00 ,$333.40 ,$98.76 ,$211.74 , N/A , N/A ,$103.70 ,$458.10 ,$222.21 ,$314.05 ,$142.52 ,$458.10 ,$98.76 ,$458.10 ,$458.10 ,$98.76 ,$330.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000011,97163,HC PT EVAL HIGH COMPLEXITY 45 MIN - 95,780,1 ,$711.00 ,$462.15 ,$98.76 ,$711.00 ,$246.90 ,$529.70 ,$465.71 ,$98.76 ,$199.08 ,$359.06 ,$98.76 ,$438.69 ,$98.76 ,$438.69 ,$438.69 ,$98.76 ,$438.69 ,$187.64 ,$639.90 ,$533.25 ,$246.90 ,$98.76 ,$625.68 ,$98.76 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$98.76 ,$604.35 ,$98.76 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$246.90 ,$639.90 ,$98.76 ,$711.00 ,$465.71 ,$98.76 ,$295.78 , N/A , N/A ,$103.70 ,$639.90 ,$222.21 ,$438.69 ,$199.08 ,$639.90 ,$98.76 ,$639.90 ,$639.90 ,$98.76 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000012,97164,HC PT RE-EVAL 15 MIN - 95,780,1 ,$246.00 ,$159.90 ,$67.68 ,$246.00 ,$169.20 ,$183.27 ,$161.13 ,$67.68 ,$68.88 ,$124.23 ,$67.68 ,$151.78 ,$67.68 ,$151.78 ,$151.78 ,$67.68 ,$151.78 ,$128.59 ,$221.40 ,$184.50 ,$169.20 ,$67.68 ,$216.48 ,$67.68 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$67.68 ,$209.10 ,$67.68 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$169.20 ,$221.40 ,$67.68 ,$246.00 ,$161.13 ,$67.68 ,$102.34 , N/A , N/A ,$71.06 ,$221.40 ,$152.28 ,$151.78 ,$68.88 ,$221.40 ,$67.68 ,$221.40 ,$221.40 ,$67.68 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000013,97165,HC OT EVAL LOW COMPLEXITY 30 MIN - 95,780,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 , N/A , N/A ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000014,97116,HC AMBULATION GAIT TRAIN EA 15 MIN - 95,780,1 ,$89.00 ,$57.85 ,$24.92 ,$89.00 ,$72.55 ,$66.31 ,$58.30 ,$29.02 ,$24.92 ,$44.95 ,$29.02 ,$54.91 ,$29.02 ,$54.91 ,$54.91 ,$29.02 ,$54.91 ,$55.14 ,$80.10 ,$66.75 ,$72.55 ,$29.02 ,$78.32 ,$29.02 ,$66.75 ,$66.75 ,$75.65 ,$75.65 ,$29.02 ,$75.65 ,$29.02 ,$69.42 ,$69.42 ,$69.42 ,$80.10 ,$72.55 ,$80.10 ,$29.02 ,$89.00 ,$58.30 ,$29.02 ,$37.02 , N/A , N/A ,$30.47 ,$80.10 ,$65.30 ,$54.91 ,$24.92 ,$80.10 ,$29.02 ,$80.10 ,$80.10 ,$29.02 ,$57.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000015,97167,HC OT EVAL HIGH COMPLEXITY 60 MIN - 95,780,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 , N/A , N/A ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000016,97168,HC OT RE-EVAL 30 MIN - 95,780,1 ,$246.00 ,$159.90 ,$68.00 ,$246.00 ,$170.00 ,$183.27 ,$161.13 ,$68.00 ,$68.88 ,$124.23 ,$68.00 ,$151.78 ,$68.00 ,$151.78 ,$151.78 ,$68.00 ,$151.78 ,$129.20 ,$221.40 ,$184.50 ,$170.00 ,$68.00 ,$216.48 ,$68.00 ,$184.50 ,$184.50 ,$209.10 ,$209.10 ,$68.00 ,$209.10 ,$68.00 ,$191.88 ,$191.88 ,$191.88 ,$221.40 ,$170.00 ,$221.40 ,$68.00 ,$246.00 ,$161.13 ,$68.00 ,$102.34 , N/A , N/A ,$71.40 ,$221.40 ,$153.00 ,$151.78 ,$68.88 ,$221.40 ,$68.00 ,$221.40 ,$221.40 ,$68.00 ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000017,92507,HC SPEECH THERAPY TREATMENT 15 MIN - 95,780,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 , N/A , N/A ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000018,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN - 95,780,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 , N/A , N/A ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000019,92526,HC DYSPHAGIA TREATMENT 15 MIN - 95,780,1 ,$175.00 ,$113.75 ,$49.00 ,$188.48 ,$175.00 ,$130.38 ,$114.63 ,$83.77 ,$49.00 ,$88.38 ,$83.77 ,$107.98 ,$83.77 ,$107.98 ,$107.98 ,$83.77 ,$107.98 ,$159.16 ,$157.50 ,$131.25 ,$175.00 ,$83.77 ,$154.00 ,$83.77 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$83.77 ,$148.75 ,$83.77 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$83.77 ,$175.00 ,$114.63 ,$83.77 ,$72.80 , N/A , N/A ,$87.96 ,$157.50 ,$188.48 ,$107.98 ,$49.00 ,$157.50 ,$83.77 ,$157.50 ,$157.50 ,$83.77 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000085,99202,PC CLINIC VISIT LIMITED NEW- 95,961,1 ,$147.63 ,$95.96 ,$41.34 ,$147.63 , N/A ,$109.98 ,$96.70 , N/A ,$41.34 ,$74.55 , N/A ,$91.09 , N/A ,$91.09 ,$91.09 , N/A ,$91.09 , N/A ,$132.87 ,$110.72 , N/A , N/A ,$129.91 , N/A ,$110.72 ,$110.72 ,$125.49 ,$125.49 , N/A ,$125.49 , N/A ,$115.15 ,$115.15 ,$115.15 ,$132.87 , N/A ,$132.87 , N/A ,$78.75 ,$96.70 , N/A ,$65.28 ,$102.37 ,$97.71 , N/A ,$132.87 , N/A ,$91.09 ,$41.34 ,$132.87 , N/A , N/A , N/A , N/A ,$95.96 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000086,99203,PC CLINIC VISIT INTERM NEW - 95,961,1 ,$250.02 ,$162.51 ,$70.01 ,$250.02 , N/A ,$186.26 ,$163.76 , N/A ,$70.01 ,$126.26 , N/A ,$154.26 , N/A ,$154.26 ,$154.26 , N/A ,$154.26 , N/A ,$225.02 ,$187.52 , N/A , N/A ,$220.02 , N/A ,$187.52 ,$187.52 ,$212.52 ,$212.52 , N/A ,$212.52 , N/A ,$195.02 ,$195.02 ,$195.02 ,$225.02 , N/A ,$225.02 , N/A ,$121.24 ,$163.76 , N/A ,$97.74 ,$102.37 ,$97.71 , N/A ,$225.02 , N/A ,$154.26 ,$70.01 ,$225.02 , N/A , N/A , N/A , N/A ,$162.51 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000087,99204,PC CLINIC VISIT COMPLEX NEW - 95,961,1 ,$406.59 ,$264.28 ,$97.71 ,$406.59 , N/A ,$302.91 ,$266.32 , N/A ,$113.85 ,$205.33 , N/A ,$250.87 , N/A ,$250.87 ,$250.87 , N/A ,$250.87 , N/A ,$365.93 ,$304.94 , N/A , N/A ,$357.80 , N/A ,$304.94 ,$304.94 ,$345.60 ,$345.60 , N/A ,$345.60 , N/A ,$317.14 ,$317.14 ,$317.14 ,$365.93 , N/A ,$365.93 , N/A ,$181.05 ,$266.32 , N/A ,$167.14 ,$102.37 ,$97.71 , N/A ,$365.93 , N/A ,$250.87 ,$113.85 ,$365.93 , N/A , N/A , N/A , N/A ,$264.28 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000088,99205,PC CLINIC VISIT COMPREH NEW - 95,961,1 ,$551.76 ,$358.64 ,$97.71 ,$551.76 , N/A ,$411.06 ,$361.40 , N/A ,$154.49 ,$278.64 , N/A ,$340.44 , N/A ,$340.44 ,$340.44 , N/A ,$340.44 , N/A ,$496.58 ,$413.82 , N/A , N/A ,$485.55 , N/A ,$413.82 ,$413.82 ,$469.00 ,$469.00 , N/A ,$469.00 , N/A ,$430.37 ,$430.37 ,$430.37 ,$496.58 , N/A ,$496.58 , N/A ,$239.15 ,$361.40 , N/A ,$218.17 ,$102.37 ,$97.71 , N/A ,$496.58 , N/A ,$340.44 ,$154.49 ,$496.58 , N/A , N/A , N/A , N/A ,$358.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000089,99211,PC CLINIC VISIT BRIEF ESTAB - 95,961,1 ,$26.76 ,$17.39 ,$7.49 ,$26.76 , N/A ,$19.94 ,$17.53 , N/A ,$7.49 ,$13.51 , N/A ,$16.51 , N/A ,$16.51 ,$16.51 , N/A ,$16.51 , N/A ,$24.08 ,$20.07 , N/A , N/A ,$23.55 , N/A ,$20.07 ,$20.07 ,$22.75 ,$22.75 , N/A ,$22.75 , N/A ,$20.87 ,$20.87 ,$20.87 ,$24.08 , N/A ,$24.08 , N/A ,$26.76 ,$17.53 , N/A ,$11.83 ,$26.76 ,$26.76 , N/A ,$24.08 , N/A ,$16.51 ,$7.49 ,$24.08 , N/A , N/A , N/A , N/A ,$17.39 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000090,99212,PC CLINIC VISIT LIMITED ESTAB - 95,961,1 ,$107.16 ,$69.65 ,$30.00 ,$107.16 , N/A ,$79.83 ,$70.19 , N/A ,$30.00 ,$54.12 , N/A ,$66.12 , N/A ,$66.12 ,$66.12 , N/A ,$66.12 , N/A ,$96.44 ,$80.37 , N/A , N/A ,$94.30 , N/A ,$80.37 ,$80.37 ,$91.09 ,$91.09 , N/A ,$91.09 , N/A ,$83.58 ,$83.58 ,$83.58 ,$96.44 , N/A ,$96.44 , N/A ,$60.02 ,$70.19 , N/A ,$33.40 ,$102.37 ,$97.71 , N/A ,$96.44 , N/A ,$66.12 ,$30.00 ,$96.44 , N/A , N/A , N/A , N/A ,$69.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000091,99213,PC CLINIC VISIT INTERM ESTAB - 95,961,1 ,$200.97 ,$130.63 ,$56.27 ,$200.97 , N/A ,$149.72 ,$131.64 , N/A ,$56.27 ,$101.49 , N/A ,$124.00 , N/A ,$124.00 ,$124.00 , N/A ,$124.00 , N/A ,$180.87 ,$150.73 , N/A , N/A ,$176.85 , N/A ,$150.73 ,$150.73 ,$170.82 ,$170.82 , N/A ,$170.82 , N/A ,$156.76 ,$156.76 ,$156.76 ,$180.87 , N/A ,$180.87 , N/A ,$97.92 ,$131.64 , N/A ,$66.15 ,$102.37 ,$97.71 , N/A ,$180.87 , N/A ,$124.00 ,$56.27 ,$180.87 , N/A , N/A , N/A , N/A ,$130.63 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000092,99214,PC CLINIC VISIT COMPLEX ESTAB - 95,961,1 ,$296.58 ,$192.78 ,$83.04 ,$296.58 , N/A ,$220.95 ,$194.26 , N/A ,$83.04 ,$149.77 , N/A ,$182.99 , N/A ,$182.99 ,$182.99 , N/A ,$182.99 , N/A ,$266.92 ,$222.44 , N/A , N/A ,$260.99 , N/A ,$222.44 ,$222.44 ,$252.09 ,$252.09 , N/A ,$252.09 , N/A ,$231.33 ,$231.33 ,$231.33 ,$266.92 , N/A ,$266.92 , N/A ,$296.58 ,$194.26 , N/A ,$101.60 ,$102.37 ,$97.71 , N/A ,$266.92 , N/A ,$182.99 ,$83.04 ,$266.92 , N/A , N/A , N/A , N/A ,$192.78 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000093,99215,PC CLINIC VISIT COMPREH ESTAB - 95,983,1 ,$436.50 ,$283.73 ,$97.71 ,$436.50 , N/A ,$325.19 ,$285.91 , N/A ,$122.22 ,$220.43 , N/A ,$269.32 , N/A ,$269.32 ,$269.32 , N/A ,$269.32 , N/A ,$392.85 ,$327.38 , N/A , N/A ,$384.12 , N/A ,$327.38 ,$327.38 ,$371.03 ,$371.03 , N/A ,$371.03 , N/A ,$340.47 ,$340.47 ,$340.47 ,$392.85 , N/A ,$392.85 , N/A ,$436.50 ,$285.91 , N/A ,$143.41 ,$102.37 ,$97.71 , N/A ,$392.85 , N/A ,$269.32 ,$122.22 ,$392.85 , N/A , N/A , N/A , N/A ,$283.73 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000198,92526,PC DYSPHAGIA TREATMENT 30 MIN - 95,780,1 ,$152.00 ,$98.80 ,$42.56 ,$188.48 ,$152.00 ,$113.24 ,$99.56 ,$83.77 ,$42.56 ,$76.76 ,$83.77 ,$93.78 ,$83.77 ,$93.78 ,$93.78 ,$83.77 ,$93.78 ,$159.16 ,$136.80 ,$114.00 ,$152.00 ,$83.77 ,$133.76 ,$83.77 ,$114.00 ,$114.00 ,$129.20 ,$129.20 ,$83.77 ,$129.20 ,$83.77 ,$118.56 ,$118.56 ,$118.56 ,$136.80 ,$152.00 ,$136.80 ,$83.77 ,$152.00 ,$99.56 ,$83.77 ,$63.23 , N/A , N/A ,$87.96 ,$136.80 ,$188.48 ,$93.78 ,$42.56 ,$136.80 ,$83.77 ,$136.80 ,$136.80 ,$83.77 ,$98.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000199,92526,PC DYSPHAGIA TREATMENT 45 MIN - 95,780,1 ,$175.00 ,$113.75 ,$49.00 ,$188.48 ,$175.00 ,$130.38 ,$114.63 ,$83.77 ,$49.00 ,$88.38 ,$83.77 ,$107.98 ,$83.77 ,$107.98 ,$107.98 ,$83.77 ,$107.98 ,$159.16 ,$157.50 ,$131.25 ,$175.00 ,$83.77 ,$154.00 ,$83.77 ,$131.25 ,$131.25 ,$148.75 ,$148.75 ,$83.77 ,$148.75 ,$83.77 ,$136.50 ,$136.50 ,$136.50 ,$157.50 ,$175.00 ,$157.50 ,$83.77 ,$175.00 ,$114.63 ,$83.77 ,$72.80 , N/A , N/A ,$87.96 ,$157.50 ,$188.48 ,$107.98 ,$49.00 ,$157.50 ,$83.77 ,$157.50 ,$157.50 ,$83.77 ,$113.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000201,92507,HC SPEECH THERAPY TREATMENT 30 MIN - 95,780,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 , N/A , N/A ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000202,92507,PC SPEECH THERAPY TREATMENT 45 MIN - 95,780,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 , N/A , N/A ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000203,92507,PC SPEECH THERAPY TREATMENT 60 MIN - 95,780,1 ,$277.00 ,$180.05 ,$75.75 ,$277.00 ,$189.38 ,$206.37 ,$181.44 ,$75.75 ,$77.56 ,$139.89 ,$75.75 ,$170.91 ,$75.75 ,$170.91 ,$170.91 ,$75.75 ,$170.91 ,$143.93 ,$249.30 ,$207.75 ,$189.38 ,$75.75 ,$243.76 ,$75.75 ,$207.75 ,$207.75 ,$235.45 ,$235.45 ,$75.75 ,$235.45 ,$75.75 ,$216.06 ,$216.06 ,$216.06 ,$249.30 ,$189.38 ,$249.30 ,$75.75 ,$277.00 ,$181.44 ,$75.75 ,$115.23 , N/A , N/A ,$79.54 ,$249.30 ,$170.44 ,$170.91 ,$77.56 ,$249.30 ,$75.75 ,$249.30 ,$249.30 ,$75.75 ,$180.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000204,92521,PC EVALUATION OF SPEECH FLUENCY 30 MIN - 95,780,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 , N/A , N/A ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000205,92521,PC EVALUATION OF SPEECH FLUENCY 45 MIN - 95,780,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 , N/A , N/A ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000206,92521,PC EVALUATION OF SPEECH FLUENCY 60 MIN - 95,780,1 ,$390.00 ,$253.50 ,$109.20 ,$390.00 ,$328.45 ,$290.55 ,$255.45 ,$131.38 ,$109.20 ,$196.95 ,$131.38 ,$240.63 ,$131.38 ,$240.63 ,$240.63 ,$131.38 ,$240.63 ,$249.62 ,$351.00 ,$292.50 ,$328.45 ,$131.38 ,$343.20 ,$131.38 ,$292.50 ,$292.50 ,$331.50 ,$331.50 ,$131.38 ,$331.50 ,$131.38 ,$304.20 ,$304.20 ,$304.20 ,$351.00 ,$328.45 ,$351.00 ,$131.38 ,$390.00 ,$255.45 ,$131.38 ,$162.24 , N/A , N/A ,$137.95 ,$351.00 ,$295.61 ,$240.63 ,$109.20 ,$351.00 ,$131.38 ,$351.00 ,$351.00 ,$131.38 ,$253.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000207,97165,PC OT EVAL LOW COMPLEXITY 15 MIN - 95,780,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 , N/A , N/A ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000208,97165,PC OT EVAL LOW COMPLEXITY 45 MIN - 95,780,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 , N/A , N/A ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000209,97165,PC OT EVAL LOW COMPLEXITY 60 MIN - 95,780,1 ,$438.00 ,$284.70 ,$99.40 ,$438.00 ,$248.50 ,$326.31 ,$286.89 ,$99.40 ,$122.64 ,$221.19 ,$99.40 ,$270.25 ,$99.40 ,$270.25 ,$270.25 ,$99.40 ,$270.25 ,$188.86 ,$394.20 ,$328.50 ,$248.50 ,$99.40 ,$385.44 ,$99.40 ,$328.50 ,$328.50 ,$372.30 ,$372.30 ,$99.40 ,$372.30 ,$99.40 ,$341.64 ,$341.64 ,$341.64 ,$394.20 ,$248.50 ,$394.20 ,$99.40 ,$438.00 ,$286.89 ,$99.40 ,$182.21 , N/A , N/A ,$104.37 ,$394.20 ,$223.65 ,$270.25 ,$122.64 ,$394.20 ,$99.40 ,$394.20 ,$394.20 ,$99.40 ,$284.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000210,97166,PC OT EVAL MOD COMPLEXITY 15 MIN - 95,780,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 , N/A , N/A ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000211,97166,HC OT EVAL MOD COMPLEXITY 30 MIN - 95,780,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 , N/A , N/A ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000212,97166,PC OT EVAL MOD COMPLEXITY 60 MIN - 95,780,1 ,$585.00 ,$380.25 ,$99.40 ,$585.00 ,$248.50 ,$435.83 ,$383.18 ,$99.40 ,$163.80 ,$295.43 ,$99.40 ,$360.95 ,$99.40 ,$360.95 ,$360.95 ,$99.40 ,$360.95 ,$188.86 ,$526.50 ,$438.75 ,$248.50 ,$99.40 ,$514.80 ,$99.40 ,$438.75 ,$438.75 ,$497.25 ,$497.25 ,$99.40 ,$497.25 ,$99.40 ,$456.30 ,$456.30 ,$456.30 ,$526.50 ,$248.50 ,$526.50 ,$99.40 ,$585.00 ,$383.18 ,$99.40 ,$243.36 , N/A , N/A ,$104.37 ,$526.50 ,$223.65 ,$360.95 ,$163.80 ,$526.50 ,$99.40 ,$526.50 ,$526.50 ,$99.40 ,$380.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000213,97167,PC OT EVAL HIGH COMPLEXITY 15 MIN - 95,780,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 , N/A , N/A ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000214,97167,PC OT EVAL HIGH COMPLEXITY 30 MIN - 95,961,1 ,$618.00 ,$401.70 ,$106.46 ,$618.00 ,$255.56 ,$460.41 ,$404.79 ,$106.46 ,$173.04 ,$312.09 ,$106.46 ,$381.31 ,$106.46 ,$381.31 ,$381.31 ,$106.46 ,$381.31 ,$202.27 ,$556.20 ,$463.50 ,$255.56 ,$106.46 ,$543.84 ,$106.46 ,$463.50 ,$463.50 ,$525.30 ,$525.30 ,$106.46 ,$525.30 ,$106.46 ,$482.04 ,$482.04 ,$482.04 ,$556.20 ,$255.56 ,$556.20 ,$106.46 ,$618.00 ,$404.79 ,$106.46 ,$115.83 ,$391.44 ,$373.64 ,$111.43 ,$556.20 ,$230.71 ,$381.31 ,$173.04 ,$556.20 ,$106.46 , N/A , N/A ,$106.46 ,$401.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000215,97167,PC OT EVAL HIGH COMPLEXITY 45 MIN - 95,780,1 ,$711.00 ,$462.15 ,$99.40 ,$711.00 ,$248.50 ,$529.70 ,$465.71 ,$99.40 ,$199.08 ,$359.06 ,$99.40 ,$438.69 ,$99.40 ,$438.69 ,$438.69 ,$99.40 ,$438.69 ,$188.86 ,$639.90 ,$533.25 ,$248.50 ,$99.40 ,$625.68 ,$99.40 ,$533.25 ,$533.25 ,$604.35 ,$604.35 ,$99.40 ,$604.35 ,$99.40 ,$554.58 ,$554.58 ,$554.58 ,$639.90 ,$248.50 ,$639.90 ,$99.40 ,$711.00 ,$465.71 ,$99.40 ,$295.78 , N/A , N/A ,$104.37 ,$639.90 ,$223.65 ,$438.69 ,$199.08 ,$639.90 ,$99.40 ,$639.90 ,$639.90 ,$99.40 ,$462.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000216,92523,PC SPEECH SOUND LANGUAGE COMPRHEN 30 MIN - 95,780,1 ,$659.00 ,$428.35 ,$184.52 ,$659.00 ,$559.90 ,$490.96 ,$431.65 ,$223.96 ,$184.52 ,$332.80 ,$223.96 ,$406.60 ,$223.96 ,$406.60 ,$406.60 ,$223.96 ,$406.60 ,$425.52 ,$593.10 ,$494.25 ,$559.90 ,$223.96 ,$579.92 ,$223.96 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$223.96 ,$560.15 ,$223.96 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$559.90 ,$593.10 ,$223.96 ,$659.00 ,$431.65 ,$223.96 ,$274.14 , N/A , N/A ,$235.16 ,$593.10 ,$503.91 ,$406.60 ,$184.52 ,$593.10 ,$223.96 ,$593.10 ,$593.10 ,$223.96 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000217,92523,PC SPEECH SOUND LANGUAGE COMPRHEN 45 MIN - 95,780,1 ,$659.00 ,$428.35 ,$184.52 ,$659.00 ,$559.90 ,$490.96 ,$431.65 ,$223.96 ,$184.52 ,$332.80 ,$223.96 ,$406.60 ,$223.96 ,$406.60 ,$406.60 ,$223.96 ,$406.60 ,$425.52 ,$593.10 ,$494.25 ,$559.90 ,$223.96 ,$579.92 ,$223.96 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$223.96 ,$560.15 ,$223.96 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$559.90 ,$593.10 ,$223.96 ,$659.00 ,$431.65 ,$223.96 ,$274.14 , N/A , N/A ,$235.16 ,$593.10 ,$503.91 ,$406.60 ,$184.52 ,$593.10 ,$223.96 ,$593.10 ,$593.10 ,$223.96 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),78000218,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60 MIN - 95,780,1 ,$659.00 ,$428.35 ,$184.52 ,$659.00 ,$559.90 ,$490.96 ,$431.65 ,$223.96 ,$184.52 ,$332.80 ,$223.96 ,$406.60 ,$223.96 ,$406.60 ,$406.60 ,$223.96 ,$406.60 ,$425.52 ,$593.10 ,$494.25 ,$559.90 ,$223.96 ,$579.92 ,$223.96 ,$494.25 ,$494.25 ,$560.15 ,$560.15 ,$223.96 ,$560.15 ,$223.96 ,$514.02 ,$514.02 ,$514.02 ,$593.10 ,$559.90 ,$593.10 ,$223.96 ,$659.00 ,$431.65 ,$223.96 ,$274.14 , N/A , N/A ,$235.16 ,$593.10 ,$503.91 ,$406.60 ,$184.52 ,$593.10 ,$223.96 ,$593.10 ,$593.10 ,$223.96 ,$428.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),80100011,G0257,HC HEMODIALYSIS INPATIENT,801,1 ,"$1,352.00 ",$878.80 ,$378.56 ,"$1,498.70 ","$1,352.00 ","$1,007.24 ",$885.56 ,$691.56 ,$378.56 ,$682.76 ,$691.56 ,$834.18 ,$691.56 ,$834.18 ,$834.18 ,$691.56 ,$834.18 ,"$1,313.96 ","$1,216.80 ","$1,014.00 ","$1,352.00 ",$691.56 ,"$1,189.76 ",$691.56 ,"$1,014.00 ","$1,014.00 ","$1,149.20 ","$1,149.20 ",$691.56 ,"$1,149.20 ",$691.56 ,"$1,054.56 ","$1,054.56 ","$1,054.56 ","$1,216.80 ","$1,352.00 ","$1,216.80 ",$691.56 ,"$1,352.00 ",$885.56 ,$691.56 ,$562.43 ,$690.75 ,$659.35 ,$723.84 ,"$1,216.80 ","$1,498.70 ",$834.18 ,$378.56 ,"$1,216.80 ",$691.56 ,"$1,216.80 ","$1,216.80 ",$691.56 ,$878.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),82900001,G0257,HC HEMODIALYSIS OUTPATIENT,829,1 ,"$1,352.00 ",$878.80 ,$378.56 ,"$1,498.70 ","$1,352.00 ","$1,007.24 ",$885.56 ,$691.56 ,$378.56 ,$682.76 ,$691.56 ,$834.18 ,$691.56 ,$834.18 ,$834.18 ,$691.56 ,$834.18 ,"$1,313.96 ","$1,216.80 ","$1,014.00 ","$1,352.00 ",$691.56 ,"$1,189.76 ",$691.56 ,"$1,014.00 ","$1,014.00 ","$1,149.20 ","$1,149.20 ",$691.56 ,"$1,149.20 ",$691.56 ,"$1,054.56 ","$1,054.56 ","$1,054.56 ","$1,216.80 ","$1,352.00 ","$1,216.80 ",$691.56 ,"$1,352.00 ",$885.56 ,$691.56 ,$562.43 ,$690.75 ,$659.35 ,$723.84 ,"$1,216.80 ","$1,498.70 ",$834.18 ,$378.56 ,"$1,216.80 ",$691.56 ,"$1,216.80 ","$1,216.80 ",$691.56 ,$878.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92000001,59020,HC TEST STRESS FETAL,920,1 ,"$1,200.00 ",$780.00 ,$179.88 ,"$1,200.00 ",$431.81 ,$894.00 ,$786.00 ,$179.88 ,$336.00 ,$606.00 ,$179.88 ,$740.40 ,$179.88 ,$740.40 ,$740.40 ,$179.88 ,$740.40 ,$341.77 ,"$1,080.00 ",$900.00 ,$431.81 ,$179.88 ,"$1,056.00 ",$179.88 ,$900.00 ,$900.00 ,"$1,020.00 ","$1,020.00 ",$179.88 ,"$1,020.00 ",$179.88 ,$936.00 ,$936.00 ,$936.00 ,"$1,080.00 ",$431.81 ,"$1,080.00 ",$179.88 ,"$1,200.00 ",$786.00 ,$179.88 ,$499.20 , N/A , N/A ,$188.28 ,"$1,080.00 ",$389.83 ,$740.40 ,$336.00 ,"$1,080.00 ",$179.88 ,"$1,080.00 ","$1,080.00 ",$179.88 ,$780.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92000002,59025,HC TEST NON STRESS FETAL,920,1 ,$894.00 ,$581.10 ,$179.88 ,$894.00 ,$431.81 ,$666.03 ,$585.57 ,$179.88 ,$250.32 ,$451.47 ,$179.88 ,$551.60 ,$179.88 ,$551.60 ,$551.60 ,$179.88 ,$551.60 ,$341.77 ,$804.60 ,$670.50 ,$431.81 ,$179.88 ,$786.72 ,$179.88 ,$670.50 ,$670.50 ,$759.90 ,$759.90 ,$179.88 ,$759.90 ,$179.88 ,$697.32 ,$697.32 ,$697.32 ,$804.60 ,$431.81 ,$804.60 ,$179.88 ,$894.00 ,$585.57 ,$179.88 ,$371.90 , N/A , N/A ,$188.28 ,$804.60 ,$389.83 ,$551.60 ,$250.32 ,$804.60 ,$179.88 ,$804.60 ,$804.60 ,$179.88 ,$581.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92000012,93788,HC AMBUL BLOOD PRESS MONITR W/REPORT,920,1 ,$135.00 ,$87.75 ,$37.80 ,$258.02 ,$135.00 ,$100.58 ,$88.43 ,$119.06 ,$37.80 ,$68.18 ,$119.06 ,$83.30 ,$119.06 ,$83.30 ,$83.30 ,$119.06 ,$83.30 ,$226.21 ,$121.50 ,$101.25 ,$135.00 ,$119.06 ,$118.80 ,$119.06 ,$101.25 ,$101.25 ,$114.75 ,$114.75 ,$119.06 ,$114.75 ,$119.06 ,$105.30 ,$105.30 ,$105.30 ,$121.50 ,$135.00 ,$121.50 ,$119.06 ,$135.00 ,$88.43 ,$119.06 ,$56.16 ,$50.30 ,$48.02 ,$124.62 ,$121.50 ,$258.02 ,$83.30 ,$37.80 ,$121.50 ,$119.06 ,$121.50 ,$121.50 ,$119.06 ,$87.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92000030,59020,HC TEST STRESS FETAL EXTENDED,920,1 ,"$1,800.00 ","$1,170.00 ",$179.88 ,"$1,800.00 ",$431.81 ,"$1,341.00 ","$1,179.00 ",$179.88 ,$504.00 ,$909.00 ,$179.88 ,"$1,110.60 ",$179.88 ,"$1,110.60 ","$1,110.60 ",$179.88 ,"$1,110.60 ",$341.77 ,"$1,620.00 ","$1,350.00 ",$431.81 ,$179.88 ,"$1,584.00 ",$179.88 ,"$1,350.00 ","$1,350.00 ","$1,530.00 ","$1,530.00 ",$179.88 ,"$1,530.00 ",$179.88 ,"$1,404.00 ","$1,404.00 ","$1,404.00 ","$1,620.00 ",$431.81 ,"$1,620.00 ",$179.88 ,"$1,800.00 ","$1,179.00 ",$179.88 ,$748.80 , N/A , N/A ,$188.28 ,"$1,620.00 ",$389.83 ,"$1,110.60 ",$504.00 ,"$1,620.00 ",$179.88 ,"$1,620.00 ","$1,620.00 ",$179.88 ,"$1,170.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92000031,59025,HC TEST NON STRESS FETAL EXTENDED,920,1 ,"$1,340.00 ",$871.00 ,$179.88 ,"$1,340.00 ",$431.81 ,$998.30 ,$877.70 ,$179.88 ,$375.20 ,$676.70 ,$179.88 ,$826.78 ,$179.88 ,$826.78 ,$826.78 ,$179.88 ,$826.78 ,$341.77 ,"$1,206.00 ","$1,005.00 ",$431.81 ,$179.88 ,"$1,179.20 ",$179.88 ,"$1,005.00 ","$1,005.00 ","$1,139.00 ","$1,139.00 ",$179.88 ,"$1,139.00 ",$179.88 ,"$1,045.20 ","$1,045.20 ","$1,045.20 ","$1,206.00 ",$431.81 ,"$1,206.00 ",$179.88 ,"$1,340.00 ",$877.70 ,$179.88 ,$557.44 , N/A , N/A ,$188.28 ,"$1,206.00 ",$389.83 ,$826.78 ,$375.20 ,"$1,206.00 ",$179.88 ,"$1,206.00 ","$1,206.00 ",$179.88 ,$871.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,049.00 ",$681.85 ,$105.71 ,"$1,049.00 ",$583.23 ,$781.51 ,$687.10 ,$242.96 ,$293.72 ,$529.75 ,$242.96 ,$647.23 ,$242.96 ,$647.23 ,$647.23 ,$242.96 ,$647.23 ,$461.62 ,$944.10 ,$786.75 ,$583.23 ,$242.96 ,$923.12 ,$242.96 ,$786.75 ,$786.75 ,$891.65 ,$891.65 ,$242.96 ,$891.65 ,$242.96 ,$818.22 ,$818.22 ,$818.22 ,$944.10 ,$583.23 ,$944.10 ,$242.96 ,"$1,049.00 ",$687.10 ,$242.96 ,$436.38 ,$110.75 ,$105.71 ,$254.30 ,$944.10 ,$526.52 ,$647.23 ,$293.72 ,$944.10 ,$242.96 ,$944.10 ,$944.10 ,$242.96 ,$681.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,$775.00 ,$503.75 ,$105.71 ,$775.00 ,$275.96 ,$577.38 ,$507.63 ,$114.95 ,$217.00 ,$391.38 ,$114.95 ,$478.18 ,$114.95 ,$478.18 ,$478.18 ,$114.95 ,$478.18 ,$218.41 ,$697.50 ,$581.25 ,$275.96 ,$114.95 ,$682.00 ,$114.95 ,$581.25 ,$581.25 ,$658.75 ,$658.75 ,$114.95 ,$658.75 ,$114.95 ,$604.50 ,$604.50 ,$604.50 ,$697.50 ,$275.96 ,$697.50 ,$114.95 ,$775.00 ,$507.63 ,$114.95 ,$322.40 ,$110.75 ,$105.71 ,$120.32 ,$697.50 ,$249.12 ,$478.18 ,$217.00 ,$697.50 ,$114.95 ,$697.50 ,$697.50 ,$114.95 ,$503.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$587.00 ,$381.55 ,$98.57 ,$587.00 ,$285.81 ,$437.32 ,$384.49 ,$119.06 ,$164.36 ,$296.44 ,$119.06 ,$362.18 ,$119.06 ,$362.18 ,$362.18 ,$119.06 ,$362.18 ,$226.21 ,$528.30 ,$440.25 ,$285.81 ,$119.06 ,$516.56 ,$119.06 ,$440.25 ,$440.25 ,$498.95 ,$498.95 ,$119.06 ,$498.95 ,$119.06 ,$457.86 ,$457.86 ,$457.86 ,$528.30 ,$285.81 ,$528.30 ,$119.06 ,$587.00 ,$384.49 ,$119.06 ,$244.19 ,$103.27 ,$98.57 ,$124.62 ,$528.30 ,$258.02 ,$362.18 ,$164.36 ,$528.30 ,$119.06 ,$528.30 ,$528.30 ,$119.06 ,$381.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100011,93922,HC TCPO2 UNLIATERAL 1-2 LEVEL - 93922-52,921,1 ,$587.00 ,$381.55 ,$49.29 ,$587.00 ,$142.90 ,$437.32 ,$384.49 ,$59.53 ,$164.36 ,$296.44 ,$59.53 ,$362.18 ,$59.53 ,$362.18 ,$362.18 ,$59.53 ,$362.18 ,$113.11 ,$528.30 ,$440.25 ,$142.90 ,$59.53 ,$516.56 ,$59.53 ,$440.25 ,$440.25 ,$498.95 ,$498.95 ,$59.53 ,$498.95 ,$59.53 ,$457.86 ,$457.86 ,$457.86 ,$528.30 ,$142.90 ,$528.30 ,$59.53 ,$587.00 ,$384.49 ,$59.53 ,$244.19 ,$51.63 ,$49.29 ,$62.31 ,$528.30 ,$129.01 ,$362.18 ,$164.36 ,$528.30 ,$59.53 ,$528.30 ,$528.30 ,$59.53 ,$381.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,"$1,132.00 ",$735.80 ,$98.57 ,"$1,132.00 ",$353.89 ,$843.34 ,$741.46 ,$147.42 ,$316.96 ,$571.66 ,$147.42 ,$698.44 ,$147.42 ,$698.44 ,$698.44 ,$147.42 ,$698.44 ,$280.10 ,"$1,018.80 ",$849.00 ,$353.89 ,$147.42 ,$996.16 ,$147.42 ,$849.00 ,$849.00 ,$962.20 ,$962.20 ,$147.42 ,$962.20 ,$147.42 ,$882.96 ,$882.96 ,$882.96 ,"$1,018.80 ",$353.89 ,"$1,018.80 ",$147.42 ,"$1,132.00 ",$741.46 ,$147.42 ,$470.91 ,$103.27 ,$98.57 ,$154.30 ,"$1,018.80 ",$319.47 ,$698.44 ,$316.96 ,"$1,018.80 ",$147.42 ,"$1,018.80 ","$1,018.80 ",$147.42 ,$735.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100031,93923,HC RESTING ARTERIAL UPPER BILATERAL,921,1 ,"$1,132.00 ",$735.80 ,$98.57 ,"$1,132.00 ",$353.89 ,$843.34 ,$741.46 ,$147.42 ,$316.96 ,$571.66 ,$147.42 ,$698.44 ,$147.42 ,$698.44 ,$698.44 ,$147.42 ,$698.44 ,$280.10 ,"$1,018.80 ",$849.00 ,$353.89 ,$147.42 ,$996.16 ,$147.42 ,$849.00 ,$849.00 ,$962.20 ,$962.20 ,$147.42 ,$962.20 ,$147.42 ,$882.96 ,$882.96 ,$882.96 ,"$1,018.80 ",$353.89 ,"$1,018.80 ",$147.42 ,"$1,132.00 ",$741.46 ,$147.42 ,$470.91 ,$103.27 ,$98.57 ,$154.30 ,"$1,018.80 ",$319.47 ,$698.44 ,$316.96 ,"$1,018.80 ",$147.42 ,"$1,018.80 ","$1,018.80 ",$147.42 ,$735.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,"$1,387.00 ",$901.55 ,$98.57 ,"$1,387.00 ",$670.82 ,"$1,033.32 ",$908.49 ,$279.44 ,$388.36 ,$700.44 ,$279.44 ,$855.78 ,$279.44 ,$855.78 ,$855.78 ,$279.44 ,$855.78 ,$530.94 ,"$1,248.30 ","$1,040.25 ",$670.82 ,$279.44 ,"$1,220.56 ",$279.44 ,"$1,040.25 ","$1,040.25 ","$1,178.95 ","$1,178.95 ",$279.44 ,"$1,178.95 ",$279.44 ,"$1,081.86 ","$1,081.86 ","$1,081.86 ","$1,248.30 ",$670.82 ,"$1,248.30 ",$279.44 ,"$1,387.00 ",$908.49 ,$279.44 ,$576.99 ,$103.27 ,$98.57 ,$292.49 ,"$1,248.30 ",$605.59 ,$855.78 ,$388.36 ,"$1,248.30 ",$279.44 ,"$1,248.30 ","$1,248.30 ",$279.44 ,$901.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$2,564.00 ","$1,666.60 ",$139.15 ,"$2,564.00 ",$583.23 ,"$1,910.18 ","$1,679.42 ",$242.96 ,$717.92 ,"$1,294.82 ",$242.96 ,"$1,581.99 ",$242.96 ,"$1,581.99 ","$1,581.99 ",$242.96 ,"$1,581.99 ",$461.62 ,"$2,307.60 ","$1,923.00 ",$583.23 ,$242.96 ,"$2,256.32 ",$242.96 ,"$1,923.00 ","$1,923.00 ","$2,179.40 ","$2,179.40 ",$242.96 ,"$2,179.40 ",$242.96 ,"$1,999.92 ","$1,999.92 ","$1,999.92 ","$2,307.60 ",$583.23 ,"$2,307.60 ",$242.96 ,"$2,564.00 ","$1,679.42 ",$242.96 ,"$1,066.62 ",$145.77 ,$139.15 ,$254.30 ,"$2,307.60 ",$526.52 ,"$1,581.99 ",$717.92 ,"$2,307.60 ",$242.96 ,"$2,307.60 ","$2,307.60 ",$242.96 ,"$1,666.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,"$1,163.00 ",$755.95 ,$114.95 ,"$1,163.00 ",$275.96 ,$866.44 ,$761.77 ,$114.95 ,$325.64 ,$587.32 ,$114.95 ,$717.57 ,$114.95 ,$717.57 ,$717.57 ,$114.95 ,$717.57 ,$218.41 ,"$1,046.70 ",$872.25 ,$275.96 ,$114.95 ,"$1,023.44 ",$114.95 ,$872.25 ,$872.25 ,$988.55 ,$988.55 ,$114.95 ,$988.55 ,$114.95 ,$907.14 ,$907.14 ,$907.14 ,"$1,046.70 ",$275.96 ,"$1,046.70 ",$114.95 ,"$1,163.00 ",$761.77 ,$114.95 ,$483.81 ,$145.77 ,$139.15 ,$120.32 ,"$1,046.70 ",$249.12 ,$717.57 ,$325.64 ,"$1,046.70 ",$114.95 ,"$1,046.70 ","$1,046.70 ",$114.95 ,$755.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,390.00 ",$903.50 ,$105.71 ,"$1,390.00 ",$583.23 ,"$1,035.55 ",$910.45 ,$242.96 ,$389.20 ,$701.95 ,$242.96 ,$857.63 ,$242.96 ,$857.63 ,$857.63 ,$242.96 ,$857.63 ,$461.62 ,"$1,251.00 ","$1,042.50 ",$583.23 ,$242.96 ,"$1,223.20 ",$242.96 ,"$1,042.50 ","$1,042.50 ","$1,181.50 ","$1,181.50 ",$242.96 ,"$1,181.50 ",$242.96 ,"$1,084.20 ","$1,084.20 ","$1,084.20 ","$1,251.00 ",$583.23 ,"$1,251.00 ",$242.96 ,"$1,390.00 ",$910.45 ,$242.96 ,$578.24 ,$110.75 ,$105.71 ,$254.30 ,"$1,251.00 ",$526.52 ,$857.63 ,$389.20 ,"$1,251.00 ",$242.96 ,"$1,251.00 ","$1,251.00 ",$242.96 ,$903.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,"$1,030.00 ",$669.50 ,$105.71 ,"$1,030.00 ",$275.96 ,$767.35 ,$674.65 ,$114.95 ,$288.40 ,$520.15 ,$114.95 ,$635.51 ,$114.95 ,$635.51 ,$635.51 ,$114.95 ,$635.51 ,$218.41 ,$927.00 ,$772.50 ,$275.96 ,$114.95 ,$906.40 ,$114.95 ,$772.50 ,$772.50 ,$875.50 ,$875.50 ,$114.95 ,$875.50 ,$114.95 ,$803.40 ,$803.40 ,$803.40 ,$927.00 ,$275.96 ,$927.00 ,$114.95 ,"$1,030.00 ",$674.65 ,$114.95 ,$428.48 ,$110.75 ,$105.71 ,$120.32 ,$927.00 ,$249.12 ,$635.51 ,$288.40 ,$927.00 ,$114.95 ,$927.00 ,$927.00 ,$114.95 ,$669.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100039,93931,HC DUPLEX ARTRL UPR EXT PSEUD ONLY,921,1 ,"$1,030.00 ",$669.50 ,$105.71 ,"$1,030.00 ",$275.96 ,$767.35 ,$674.65 ,$114.95 ,$288.40 ,$520.15 ,$114.95 ,$635.51 ,$114.95 ,$635.51 ,$635.51 ,$114.95 ,$635.51 ,$218.41 ,$927.00 ,$772.50 ,$275.96 ,$114.95 ,$906.40 ,$114.95 ,$772.50 ,$772.50 ,$875.50 ,$875.50 ,$114.95 ,$875.50 ,$114.95 ,$803.40 ,$803.40 ,$803.40 ,$927.00 ,$275.96 ,$927.00 ,$114.95 ,"$1,030.00 ",$674.65 ,$114.95 ,$428.48 ,$110.75 ,$105.71 ,$120.32 ,$927.00 ,$249.12 ,$635.51 ,$288.40 ,$927.00 ,$114.95 ,$927.00 ,$927.00 ,$114.95 ,$669.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,354.00 ",$880.10 ,$139.15 ,"$1,354.00 ",$583.23 ,"$1,008.73 ",$886.87 ,$242.96 ,$379.12 ,$683.77 ,$242.96 ,$835.42 ,$242.96 ,$835.42 ,$835.42 ,$242.96 ,$835.42 ,$461.62 ,"$1,218.60 ","$1,015.50 ",$583.23 ,$242.96 ,"$1,191.52 ",$242.96 ,"$1,015.50 ","$1,015.50 ","$1,150.90 ","$1,150.90 ",$242.96 ,"$1,150.90 ",$242.96 ,"$1,056.12 ","$1,056.12 ","$1,056.12 ","$1,218.60 ",$583.23 ,"$1,218.60 ",$242.96 ,"$1,354.00 ",$886.87 ,$242.96 ,$563.26 ,$145.77 ,$139.15 ,$254.30 ,"$1,218.60 ",$526.52 ,$835.42 ,$379.12 ,"$1,218.60 ",$242.96 ,"$1,218.60 ","$1,218.60 ",$242.96 ,$880.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,"$1,061.00 ",$689.65 ,$114.95 ,"$1,061.00 ",$275.96 ,$790.45 ,$694.96 ,$114.95 ,$297.08 ,$535.81 ,$114.95 ,$654.64 ,$114.95 ,$654.64 ,$654.64 ,$114.95 ,$654.64 ,$218.41 ,$954.90 ,$795.75 ,$275.96 ,$114.95 ,$933.68 ,$114.95 ,$795.75 ,$795.75 ,$901.85 ,$901.85 ,$114.95 ,$901.85 ,$114.95 ,$827.58 ,$827.58 ,$827.58 ,$954.90 ,$275.96 ,$954.90 ,$114.95 ,"$1,061.00 ",$694.96 ,$114.95 ,$441.38 ,$145.77 ,$139.15 ,$120.32 ,$954.90 ,$249.12 ,$654.64 ,$297.08 ,$954.90 ,$114.95 ,$954.90 ,$954.90 ,$114.95 ,$689.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100046,93990,HC DUPLEX HEMODIALYSIS ACCESS,921,1 ,$573.00 ,$372.45 ,$105.71 ,$573.00 ,$275.96 ,$426.89 ,$375.32 ,$114.95 ,$160.44 ,$289.37 ,$114.95 ,$353.54 ,$114.95 ,$353.54 ,$353.54 ,$114.95 ,$353.54 ,$218.41 ,$515.70 ,$429.75 ,$275.96 ,$114.95 ,$504.24 ,$114.95 ,$429.75 ,$429.75 ,$487.05 ,$487.05 ,$114.95 ,$487.05 ,$114.95 ,$446.94 ,$446.94 ,$446.94 ,$515.70 ,$275.96 ,$515.70 ,$114.95 ,$573.00 ,$375.32 ,$114.95 ,$238.37 ,$110.75 ,$105.71 ,$120.32 ,$515.70 ,$249.12 ,$353.54 ,$160.44 ,$515.70 ,$114.95 ,$515.70 ,$515.70 ,$114.95 ,$372.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100049,93923,HC RESTING ARTERIAL EXTREMITY COMP -52,921,1 ,"$1,132.00 ",$735.80 ,$49.29 ,"$1,132.00 ",$176.94 ,$843.34 ,$741.46 ,$73.71 ,$316.96 ,$571.66 ,$73.71 ,$698.44 ,$73.71 ,$698.44 ,$698.44 ,$73.71 ,$698.44 ,$140.05 ,"$1,018.80 ",$849.00 ,$176.94 ,$73.71 ,$996.16 ,$73.71 ,$849.00 ,$849.00 ,$962.20 ,$962.20 ,$73.71 ,$962.20 ,$73.71 ,$882.96 ,$882.96 ,$882.96 ,"$1,018.80 ",$176.94 ,"$1,018.80 ",$73.71 ,"$1,132.00 ",$741.46 ,$73.71 ,$470.91 ,$51.63 ,$49.29 ,$77.15 ,"$1,018.80 ",$159.74 ,$698.44 ,$316.96 ,"$1,018.80 ",$73.71 ,"$1,018.80 ","$1,018.80 ",$73.71 ,$735.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100051,93701,HC BIOIMPEDANCE DERIVED PHYSIO CV ANALYSIS,921,1 ,$297.00 ,$193.05 ,$1.64 ,$297.00 ,$285.81 ,$221.27 ,$194.54 ,$119.06 ,$83.16 ,$149.99 ,$119.06 ,$183.25 ,$119.06 ,$183.25 ,$183.25 ,$119.06 ,$183.25 ,$226.21 ,$267.30 ,$222.75 ,$285.81 ,$119.06 ,$261.36 ,$119.06 ,$222.75 ,$222.75 ,$252.45 ,$252.45 ,$119.06 ,$252.45 ,$119.06 ,$231.66 ,$231.66 ,$231.66 ,$267.30 ,$285.81 ,$267.30 ,$119.06 ,$297.00 ,$194.54 ,$119.06 ,$123.55 ,$1.72 ,$1.64 ,$124.62 ,$267.30 ,$258.02 ,$183.25 ,$83.16 ,$267.30 ,$119.06 ,$267.30 ,$267.30 ,$119.06 ,$193.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100053,93985,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL BILATERAL STUDY,921,1 ,"$1,059.00 ",$688.35 ,$105.71 ,"$1,059.00 ",$583.23 ,$788.96 ,$693.65 ,$242.96 ,$296.52 ,$534.80 ,$242.96 ,$653.40 ,$242.96 ,$653.40 ,$653.40 ,$242.96 ,$653.40 ,$461.62 ,$953.10 ,$794.25 ,$583.23 ,$242.96 ,$931.92 ,$242.96 ,$794.25 ,$794.25 ,$900.15 ,$900.15 ,$242.96 ,$900.15 ,$242.96 ,$826.02 ,$826.02 ,$826.02 ,$953.10 ,$583.23 ,$953.10 ,$242.96 ,"$1,059.00 ",$693.65 ,$242.96 ,$440.54 ,$110.75 ,$105.71 ,$254.30 ,$953.10 ,$526.52 ,$653.40 ,$296.52 ,$953.10 ,$242.96 ,$953.10 ,$953.10 ,$242.96 ,$688.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92100054,93986,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL UNILATERAL STUDY,921,1 ,$530.00 ,$344.50 ,$105.71 ,$530.00 ,$275.96 ,$394.85 ,$347.15 ,$114.95 ,$148.40 ,$267.65 ,$114.95 ,$327.01 ,$114.95 ,$327.01 ,$327.01 ,$114.95 ,$327.01 ,$218.41 ,$477.00 ,$397.50 ,$275.96 ,$114.95 ,$466.40 ,$114.95 ,$397.50 ,$397.50 ,$450.50 ,$450.50 ,$114.95 ,$450.50 ,$114.95 ,$413.40 ,$413.40 ,$413.40 ,$477.00 ,$275.96 ,$477.00 ,$114.95 ,$530.00 ,$347.15 ,$114.95 ,$220.48 ,$110.75 ,$105.71 ,$120.32 ,$477.00 ,$249.12 ,$327.01 ,$148.40 ,$477.00 ,$114.95 ,$477.00 ,$477.00 ,$114.95 ,$344.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200000,95860,HC EMG ONE EXTREMITY,922,1 ,$297.00 ,$193.05 ,$83.16 ,$297.00 ,$285.81 ,$221.27 ,$194.54 ,$119.06 ,$83.16 ,$149.99 ,$119.06 ,$183.25 ,$119.06 ,$183.25 ,$183.25 ,$119.06 ,$183.25 ,$226.21 ,$267.30 ,$222.75 ,$285.81 ,$119.06 ,$261.36 ,$119.06 ,$222.75 ,$222.75 ,$252.45 ,$252.45 ,$119.06 ,$252.45 ,$119.06 ,$231.66 ,$231.66 ,$231.66 ,$267.30 ,$285.81 ,$267.30 ,$119.06 ,$297.00 ,$194.54 ,$119.06 ,$123.55 ,$239.09 ,$228.22 ,$124.62 ,$267.30 ,$258.02 ,$183.25 ,$83.16 ,$267.30 ,$119.06 ,$267.30 ,$267.30 ,$119.06 ,$193.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200001,95861,HC EMG TWO EXTREMITIES,922,1 ,$324.00 ,$210.60 ,$90.72 ,$324.00 ,$285.81 ,$241.38 ,$212.22 ,$119.06 ,$90.72 ,$163.62 ,$119.06 ,$199.91 ,$119.06 ,$199.91 ,$199.91 ,$119.06 ,$199.91 ,$226.21 ,$291.60 ,$243.00 ,$285.81 ,$119.06 ,$285.12 ,$119.06 ,$243.00 ,$243.00 ,$275.40 ,$275.40 ,$119.06 ,$275.40 ,$119.06 ,$252.72 ,$252.72 ,$252.72 ,$291.60 ,$285.81 ,$291.60 ,$119.06 ,$324.00 ,$212.22 ,$119.06 ,$134.78 ,$239.09 ,$228.22 ,$124.62 ,$291.60 ,$258.02 ,$199.91 ,$90.72 ,$291.60 ,$119.06 ,$291.60 ,$291.60 ,$119.06 ,$210.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200002,95863,HC EMG THREE EXTREMITIES,922,1 ,$252.00 ,$163.80 ,$70.56 ,$319.47 ,$252.00 ,$187.74 ,$165.06 ,$147.42 ,$70.56 ,$127.26 ,$147.42 ,$155.48 ,$147.42 ,$155.48 ,$155.48 ,$147.42 ,$155.48 ,$280.10 ,$226.80 ,$189.00 ,$252.00 ,$147.42 ,$221.76 ,$147.42 ,$189.00 ,$189.00 ,$214.20 ,$214.20 ,$147.42 ,$214.20 ,$147.42 ,$196.56 ,$196.56 ,$196.56 ,$226.80 ,$252.00 ,$226.80 ,$147.42 ,$252.00 ,$165.06 ,$147.42 ,$104.83 ,$239.09 ,$228.22 ,$154.30 ,$226.80 ,$319.47 ,$155.48 ,$70.56 ,$226.80 ,$147.42 ,$226.80 ,$226.80 ,$147.42 ,$163.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200008,95925,HC SSEP UPPER LIMBS,922,1 ,$603.00 ,$391.95 ,$168.84 ,$605.59 ,$603.00 ,$449.24 ,$394.97 ,$279.44 ,$168.84 ,$304.52 ,$279.44 ,$372.05 ,$279.44 ,$372.05 ,$372.05 ,$279.44 ,$372.05 ,$530.94 ,$542.70 ,$452.25 ,$603.00 ,$279.44 ,$530.64 ,$279.44 ,$452.25 ,$452.25 ,$512.55 ,$512.55 ,$279.44 ,$512.55 ,$279.44 ,$470.34 ,$470.34 ,$470.34 ,$542.70 ,$603.00 ,$542.70 ,$279.44 ,$603.00 ,$394.97 ,$279.44 ,$250.85 ,$239.09 ,$228.22 ,$292.49 ,$542.70 ,$605.59 ,$372.05 ,$168.84 ,$542.70 ,$279.44 ,$542.70 ,$542.70 ,$279.44 ,$391.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200009,95926,HC SSEP LOWER LIMBS,922,1 ,$603.00 ,$391.95 ,$168.84 ,$605.59 ,$603.00 ,$449.24 ,$394.97 ,$279.44 ,$168.84 ,$304.52 ,$279.44 ,$372.05 ,$279.44 ,$372.05 ,$372.05 ,$279.44 ,$372.05 ,$530.94 ,$542.70 ,$452.25 ,$603.00 ,$279.44 ,$530.64 ,$279.44 ,$452.25 ,$452.25 ,$512.55 ,$512.55 ,$279.44 ,$512.55 ,$279.44 ,$470.34 ,$470.34 ,$470.34 ,$542.70 ,$603.00 ,$542.70 ,$279.44 ,$603.00 ,$394.97 ,$279.44 ,$250.85 ,$239.09 ,$228.22 ,$292.49 ,$542.70 ,$605.59 ,$372.05 ,$168.84 ,$542.70 ,$279.44 ,$542.70 ,$542.70 ,$279.44 ,$391.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200011,95886,HC EMG ADD ON >5 MUSCLES,922,1 ,"$1,715.00 ","$1,114.75 ",$228.22 ,"$1,715.00 ", N/A ,"$1,277.68 ","$1,123.33 ", N/A ,$480.20 ,$866.08 , N/A ,"$1,058.16 ", N/A ,"$1,058.16 ","$1,058.16 ", N/A ,"$1,058.16 ", N/A ,"$1,543.50 ","$1,286.25 ", N/A , N/A ,"$1,509.20 ", N/A ,"$1,286.25 ","$1,286.25 ","$1,457.75 ","$1,457.75 ", N/A ,"$1,457.75 ", N/A ,"$1,337.70 ","$1,337.70 ","$1,337.70 ","$1,543.50 ", N/A ,"$1,543.50 ", N/A ,"$1,715.00 ","$1,123.33 ", N/A ,$713.44 ,$239.09 ,$228.22 , N/A ,"$1,543.50 ", N/A ,"$1,058.16 ",$480.20 ,"$1,543.50 ", N/A ,"$1,543.50 ","$1,543.50 ", N/A ,"$1,114.75 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200012,95864,HC EMG 4 EXTREMITIES,922,1 ,$435.00 ,$282.75 ,$121.80 ,$435.00 ,$353.89 ,$324.08 ,$284.93 ,$147.42 ,$121.80 ,$219.68 ,$147.42 ,$268.40 ,$147.42 ,$268.40 ,$268.40 ,$147.42 ,$268.40 ,$280.10 ,$391.50 ,$326.25 ,$353.89 ,$147.42 ,$382.80 ,$147.42 ,$326.25 ,$326.25 ,$369.75 ,$369.75 ,$147.42 ,$369.75 ,$147.42 ,$339.30 ,$339.30 ,$339.30 ,$391.50 ,$353.89 ,$391.50 ,$147.42 ,$435.00 ,$284.93 ,$147.42 ,$180.96 ,$239.09 ,$228.22 ,$154.30 ,$391.50 ,$319.47 ,$268.40 ,$121.80 ,$391.50 ,$147.42 ,$391.50 ,$391.50 ,$147.42 ,$282.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200015,95938,HC SSEP UPPER AND LOWER,922,1 ,"$2,762.00 ","$1,795.30 ",$228.22 ,"$2,762.00 ","$1,237.27 ","$2,057.69 ","$1,809.11 ",$515.41 ,$773.36 ,"$1,394.81 ",$515.41 ,"$1,704.15 ",$515.41 ,"$1,704.15 ","$1,704.15 ",$515.41 ,"$1,704.15 ",$979.28 ,"$2,485.80 ","$2,071.50 ","$1,237.27 ",$515.41 ,"$2,430.56 ",$515.41 ,"$2,071.50 ","$2,071.50 ","$2,347.70 ","$2,347.70 ",$515.41 ,"$2,347.70 ",$515.41 ,"$2,154.36 ","$2,154.36 ","$2,154.36 ","$2,485.80 ","$1,237.27 ","$2,485.80 ",$515.41 ,"$2,762.00 ","$1,809.11 ",$515.41 ,"$1,148.99 ",$239.09 ,$228.22 ,$539.47 ,"$2,485.80 ","$1,116.96 ","$1,704.15 ",$773.36 ,"$2,485.80 ",$515.41 ,"$2,485.80 ","$2,485.80 ",$515.41 ,"$1,795.30 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200016,95885,HC EMG ADD ON <5 MUSCLES,922,1 ,$349.00 ,$226.85 ,$97.72 ,$349.00 , N/A ,$260.01 ,$228.60 , N/A ,$97.72 ,$176.25 , N/A ,$215.33 , N/A ,$215.33 ,$215.33 , N/A ,$215.33 , N/A ,$314.10 ,$261.75 , N/A , N/A ,$307.12 , N/A ,$261.75 ,$261.75 ,$296.65 ,$296.65 , N/A ,$296.65 , N/A ,$272.22 ,$272.22 ,$272.22 ,$314.10 , N/A ,$314.10 , N/A ,$349.00 ,$228.60 , N/A ,$145.18 ,$239.09 ,$228.22 , N/A ,$314.10 , N/A ,$215.33 ,$97.72 ,$314.10 , N/A ,$314.10 ,$314.10 , N/A ,$226.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200017,95887,HC EMG ADD ON CRANIAL,922,1 ,$242.00 ,$157.30 ,$67.76 ,$242.00 , N/A ,$180.29 ,$158.51 , N/A ,$67.76 ,$122.21 , N/A ,$149.31 , N/A ,$149.31 ,$149.31 , N/A ,$149.31 , N/A ,$217.80 ,$181.50 , N/A , N/A ,$212.96 , N/A ,$181.50 ,$181.50 ,$205.70 ,$205.70 , N/A ,$205.70 , N/A ,$188.76 ,$188.76 ,$188.76 ,$217.80 , N/A ,$217.80 , N/A ,$242.00 ,$158.51 , N/A ,$100.67 ,$239.09 ,$228.22 , N/A ,$217.80 , N/A ,$149.31 ,$67.76 ,$217.80 , N/A ,$217.80 ,$217.80 , N/A ,$157.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200021,95907,HC NVR CNDJ TST 1-2 STUDIES,922,1 ,"$1,195.00 ",$776.75 ,$147.42 ,"$1,195.00 ",$353.89 ,$890.28 ,$782.73 ,$147.42 ,$334.60 ,$603.48 ,$147.42 ,$737.32 ,$147.42 ,$737.32 ,$737.32 ,$147.42 ,$737.32 ,$280.10 ,"$1,075.50 ",$896.25 ,$353.89 ,$147.42 ,"$1,051.60 ",$147.42 ,$896.25 ,$896.25 ,"$1,015.75 ","$1,015.75 ",$147.42 ,"$1,015.75 ",$147.42 ,$932.10 ,$932.10 ,$932.10 ,"$1,075.50 ",$353.89 ,"$1,075.50 ",$147.42 ,"$1,195.00 ",$782.73 ,$147.42 ,$497.12 ,$239.09 ,$228.22 ,$154.30 ,"$1,075.50 ",$319.47 ,$737.32 ,$334.60 ,"$1,075.50 ",$147.42 ,"$1,075.50 ","$1,075.50 ",$147.42 ,$776.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200022,95908,HC NVR CNDJ TST 3-4 STUDIES,922,1 ,"$2,389.00 ","$1,552.85 ",$228.22 ,"$2,389.00 ",$670.82 ,"$1,779.81 ","$1,564.80 ",$279.44 ,$668.92 ,"$1,206.45 ",$279.44 ,"$1,474.01 ",$279.44 ,"$1,474.01 ","$1,474.01 ",$279.44 ,"$1,474.01 ",$530.94 ,"$2,150.10 ","$1,791.75 ",$670.82 ,$279.44 ,"$2,102.32 ",$279.44 ,"$1,791.75 ","$1,791.75 ","$2,030.65 ","$2,030.65 ",$279.44 ,"$2,030.65 ",$279.44 ,"$1,863.42 ","$1,863.42 ","$1,863.42 ","$2,150.10 ",$670.82 ,"$2,150.10 ",$279.44 ,"$2,389.00 ","$1,564.80 ",$279.44 ,$993.82 ,$239.09 ,$228.22 ,$292.49 ,"$2,150.10 ",$605.59 ,"$1,474.01 ",$668.92 ,"$2,150.10 ",$279.44 ,"$2,150.10 ","$2,150.10 ",$279.44 ,"$1,552.85 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200023,95909,HC NVR CNDJ TST 5-6 STUDIES,922,1 ,"$3,584.00 ","$2,329.60 ",$228.22 ,"$3,584.00 ",$670.82 ,"$2,670.08 ","$2,347.52 ",$279.44 ,"$1,003.52 ","$1,809.92 ",$279.44 ,"$2,211.33 ",$279.44 ,"$2,211.33 ","$2,211.33 ",$279.44 ,"$2,211.33 ",$530.94 ,"$3,225.60 ","$2,688.00 ",$670.82 ,$279.44 ,"$3,153.92 ",$279.44 ,"$2,688.00 ","$2,688.00 ","$3,046.40 ","$3,046.40 ",$279.44 ,"$3,046.40 ",$279.44 ,"$2,795.52 ","$2,795.52 ","$2,795.52 ","$3,225.60 ",$670.82 ,"$3,225.60 ",$279.44 ,"$3,584.00 ","$2,347.52 ",$279.44 ,"$1,490.94 ",$239.09 ,$228.22 ,$292.49 ,"$3,225.60 ",$605.59 ,"$2,211.33 ","$1,003.52 ","$3,225.60 ",$279.44 ,"$3,225.60 ","$3,225.60 ",$279.44 ,"$2,329.60 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200024,95910,HC NVR CNDJ TST 7-8 STUDIES,922,1 ,"$4,779.00 ","$3,106.35 ",$228.22 ,"$4,779.00 ",$670.82 ,"$3,560.36 ","$3,130.25 ",$279.44 ,"$1,338.12 ","$2,413.40 ",$279.44 ,"$2,948.64 ",$279.44 ,"$2,948.64 ","$2,948.64 ",$279.44 ,"$2,948.64 ",$530.94 ,"$4,301.10 ","$3,584.25 ",$670.82 ,$279.44 ,"$4,205.52 ",$279.44 ,"$3,584.25 ","$3,584.25 ","$4,062.15 ","$4,062.15 ",$279.44 ,"$4,062.15 ",$279.44 ,"$3,727.62 ","$3,727.62 ","$3,727.62 ","$4,301.10 ",$670.82 ,"$4,301.10 ",$279.44 ,"$4,779.00 ","$3,130.25 ",$279.44 ,"$1,988.06 ",$239.09 ,$228.22 ,$292.49 ,"$4,301.10 ",$605.59 ,"$2,948.64 ","$1,338.12 ","$4,301.10 ",$279.44 ,"$4,301.10 ","$4,301.10 ",$279.44 ,"$3,106.35 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200025,95911,HC NVR CNDJ TST 9-10 STUDIES,922,1 ,"$5,973.00 ","$3,882.45 ",$228.22 ,"$5,973.00 ","$1,237.27 ","$4,449.89 ","$3,912.32 ",$515.41 ,"$1,672.44 ","$3,016.37 ",$515.41 ,"$3,685.34 ",$515.41 ,"$3,685.34 ","$3,685.34 ",$515.41 ,"$3,685.34 ",$979.28 ,"$5,375.70 ","$4,479.75 ","$1,237.27 ",$515.41 ,"$5,256.24 ",$515.41 ,"$4,479.75 ","$4,479.75 ","$5,077.05 ","$5,077.05 ",$515.41 ,"$5,077.05 ",$515.41 ,"$4,658.94 ","$4,658.94 ","$4,658.94 ","$5,375.70 ","$1,237.27 ","$5,375.70 ",$515.41 ,"$5,973.00 ","$3,912.32 ",$515.41 ,"$2,484.77 ",$239.09 ,$228.22 ,$539.47 ,"$5,375.70 ","$1,116.96 ","$3,685.34 ","$1,672.44 ","$5,375.70 ",$515.41 ,"$5,375.70 ","$5,375.70 ",$515.41 ,"$3,882.45 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200026,95912,HC NVR CNDJ TST 11-12 STUDIES,922,1 ,"$7,167.00 ","$4,658.55 ",$228.22 ,"$7,167.00 ","$1,237.27 ","$5,339.42 ","$4,694.39 ",$515.41 ,"$2,006.76 ","$3,619.34 ",$515.41 ,"$4,422.04 ",$515.41 ,"$4,422.04 ","$4,422.04 ",$515.41 ,"$4,422.04 ",$979.28 ,"$6,450.30 ","$5,375.25 ","$1,237.27 ",$515.41 ,"$6,306.96 ",$515.41 ,"$5,375.25 ","$5,375.25 ","$6,091.95 ","$6,091.95 ",$515.41 ,"$6,091.95 ",$515.41 ,"$5,590.26 ","$5,590.26 ","$5,590.26 ","$6,450.30 ","$1,237.27 ","$6,450.30 ",$515.41 ,"$7,167.00 ","$4,694.39 ",$515.41 ,"$2,981.47 ",$239.09 ,$228.22 ,$539.47 ,"$6,450.30 ","$1,116.96 ","$4,422.04 ","$2,006.76 ","$6,450.30 ",$515.41 ,"$6,450.30 ","$6,450.30 ",$515.41 ,"$4,658.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200027,95913,HC NVR CNDJ TST 13 AND > STUDIES,922,1 ,"$8,361.00 ","$5,434.65 ",$228.22 ,"$8,361.00 ","$1,237.27 ","$6,228.95 ","$5,476.46 ",$515.41 ,"$2,341.08 ","$4,222.31 ",$515.41 ,"$5,158.74 ",$515.41 ,"$5,158.74 ","$5,158.74 ",$515.41 ,"$5,158.74 ",$979.28 ,"$7,524.90 ","$6,270.75 ","$1,237.27 ",$515.41 ,"$7,357.68 ",$515.41 ,"$6,270.75 ","$6,270.75 ","$7,106.85 ","$7,106.85 ",$515.41 ,"$7,106.85 ",$515.41 ,"$6,521.58 ","$6,521.58 ","$6,521.58 ","$7,524.90 ","$1,237.27 ","$7,524.90 ",$515.41 ,"$8,361.00 ","$5,476.46 ",$515.41 ,"$3,478.18 ",$239.09 ,$228.22 ,$539.47 ,"$7,524.90 ","$1,116.96 ","$5,158.74 ","$2,341.08 ","$7,524.90 ",$515.41 ,"$7,524.90 ","$7,524.90 ",$515.41 ,"$5,434.65 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200029,95870,HC EMG NON LIMB,922,1 ,$272.00 ,$176.80 ,$76.16 ,$272.00 ,$272.00 ,$202.64 ,$178.16 ,$119.06 ,$76.16 ,$137.36 ,$119.06 ,$167.82 ,$119.06 ,$167.82 ,$167.82 ,$119.06 ,$167.82 ,$226.21 ,$244.80 ,$204.00 ,$272.00 ,$119.06 ,$239.36 ,$119.06 ,$204.00 ,$204.00 ,$231.20 ,$231.20 ,$119.06 ,$231.20 ,$119.06 ,$212.16 ,$212.16 ,$212.16 ,$244.80 ,$272.00 ,$244.80 ,$119.06 ,$272.00 ,$178.16 ,$119.06 ,$113.15 ,$239.09 ,$228.22 ,$124.62 ,$244.80 ,$258.02 ,$167.82 ,$76.16 ,$244.80 ,$119.06 ,$244.80 ,$244.80 ,$119.06 ,$176.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),92200031,95927,HC SSEP TRUNK/HEAD,922,1 ,$993.00 ,$645.45 ,$228.22 ,$993.00 ,$670.82 ,$739.79 ,$650.42 ,$279.44 ,$278.04 ,$501.47 ,$279.44 ,$612.68 ,$279.44 ,$612.68 ,$612.68 ,$279.44 ,$612.68 ,$530.94 ,$893.70 ,$744.75 ,$670.82 ,$279.44 ,$873.84 ,$279.44 ,$744.75 ,$744.75 ,$844.05 ,$844.05 ,$279.44 ,$844.05 ,$279.44 ,$774.54 ,$774.54 ,$774.54 ,$893.70 ,$670.82 ,$893.70 ,$279.44 ,$993.00 ,$650.42 ,$279.44 ,$413.09 ,$239.09 ,$228.22 ,$292.49 ,$893.70 ,$605.59 ,$612.68 ,$278.04 ,$893.70 ,$279.44 ,$893.70 ,$893.70 ,$279.44 ,$645.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$154.00 ,$100.10 ,$43.12 ,$258.02 ,$154.00 ,$114.73 ,$100.87 ,$119.06 ,$43.12 ,$77.77 ,$119.06 ,$95.02 ,$119.06 ,$95.02 ,$95.02 ,$119.06 ,$95.02 ,$226.21 ,$138.60 ,$115.50 ,$154.00 ,$119.06 ,$135.52 ,$119.06 ,$115.50 ,$115.50 ,$130.90 ,$130.90 ,$119.06 ,$130.90 ,$119.06 ,$120.12 ,$120.12 ,$120.12 ,$138.60 ,$154.00 ,$138.60 ,$119.06 ,$154.00 ,$100.87 ,$119.06 ,$64.06 ,$64.50 ,$61.57 ,$124.62 ,$138.60 ,$258.02 ,$95.02 ,$43.12 ,$138.60 ,$119.06 ,$138.60 ,$138.60 ,$119.06 ,$100.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94000103,E0202,HC PHOTO THERAPY INITIATE,940,1 ,$108.00 ,$70.20 ,$23.13 ,$108.00 ,$55.53 ,$80.46 ,$70.74 ,$23.13 ,$30.24 ,$54.54 ,$23.13 ,$66.64 ,$23.13 ,$66.64 ,$66.64 ,$23.13 ,$66.64 ,$43.95 ,$97.20 ,$81.00 ,$55.53 ,$23.13 ,$95.04 ,$23.13 ,$81.00 ,$81.00 ,$91.80 ,$91.80 ,$23.13 ,$91.80 ,$23.13 ,$84.24 ,$84.24 ,$84.24 ,$97.20 ,$55.53 ,$97.20 ,$23.13 ,$108.00 ,$70.74 ,$23.13 ,$44.93 , N/A , N/A ,$24.21 ,$97.20 ,$50.13 ,$66.64 ,$30.24 ,$97.20 ,$23.13 ,$97.20 ,$97.20 ,$23.13 ,$70.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94000104,96372,HC INJECTION IM/SUBQ,940,1 ,$262.00 ,$170.30 ,$65.46 ,$262.00 ,$157.15 ,$195.19 ,$171.61 ,$65.46 ,$73.36 ,$132.31 ,$65.46 ,$161.65 ,$65.46 ,$161.65 ,$161.65 ,$65.46 ,$161.65 ,$124.37 ,$235.80 ,$196.50 ,$157.15 ,$65.46 ,$230.56 ,$65.46 ,$196.50 ,$196.50 ,$222.70 ,$222.70 ,$65.46 ,$222.70 ,$65.46 ,$204.36 ,$204.36 ,$204.36 ,$235.80 ,$157.15 ,$235.80 ,$65.46 ,$262.00 ,$171.61 ,$65.46 ,$108.99 , N/A , N/A ,$68.52 ,$235.80 ,$141.87 ,$161.65 ,$73.36 ,$235.80 ,$65.46 ,$235.80 ,$235.80 ,$65.46 ,$170.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94000105,96374,HC INJ IV PUSH SINGL/INITIAL,940,1 ,$197.00 ,$128.05 ,$55.16 ,$468.11 ,$197.00 ,$146.77 ,$129.04 ,$197.00 ,$55.16 ,$99.49 ,$197.00 ,$121.55 ,$197.00 ,$121.55 ,$121.55 ,$197.00 ,$121.55 ,$410.40 ,$177.30 ,$147.75 ,$197.00 ,$197.00 ,$173.36 ,$197.00 ,$147.75 ,$147.75 ,$167.45 ,$167.45 ,$197.00 ,$167.45 ,$197.00 ,$153.66 ,$153.66 ,$153.66 ,$177.30 ,$197.00 ,$177.30 ,$197.00 ,$197.00 ,$129.04 ,$197.00 ,$81.95 , N/A , N/A ,$197.00 ,$177.30 ,$468.11 ,$121.55 ,$55.16 ,$177.30 ,$197.00 ,$177.30 ,$177.30 ,$197.00 ,$128.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94000114,20560,HC NEEDLE INSERTION W/O INJECTION 1-2 MUSCLES,940,1 ,$0.01 ,$0.01 ,$0.01 ,$56.53 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$49.55 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$56.53 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94000115,20561,HC NEEDLE INSERTION W/O INJECTION 3+ MUSCLES,940,1 ,$0.01 ,$0.01 ,$0.01 ,$56.53 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$49.55 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$56.53 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$56.00 ,$36.40 ,$15.68 ,$57.97 ,$30.51 ,$41.72 ,$36.68 ,$30.51 ,$15.68 ,$28.28 ,$30.51 ,$34.55 ,$30.51 ,$34.55 ,$34.55 ,$30.51 ,$34.55 ,$57.97 ,$50.40 ,$42.00 ,$30.51 ,$30.51 ,$49.28 ,$30.51 ,$42.00 ,$42.00 ,$47.60 ,$47.60 ,$30.51 ,$47.60 ,$30.51 ,$43.68 ,$43.68 ,$43.68 ,$50.40 ,$30.51 ,$50.40 ,$30.51 ,$56.00 ,$36.68 ,$30.51 ,$23.30 , N/A , N/A ,$30.51 ,$50.40 ,$30.51 ,$34.55 ,$15.68 ,$50.40 ,$30.51 ,$50.40 ,$50.40 ,$30.51 ,$36.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94200006,97803,HC NUTRITION THRPY RE-EVAL 15 MIN,942,1 ,$47.00 ,$30.55 ,$13.16 ,$50.43 ,$26.54 ,$35.02 ,$30.79 ,$26.54 ,$13.16 ,$23.74 ,$26.54 ,$29.00 ,$26.54 ,$29.00 ,$29.00 ,$26.54 ,$29.00 ,$50.43 ,$42.30 ,$35.25 ,$26.54 ,$26.54 ,$41.36 ,$26.54 ,$35.25 ,$35.25 ,$39.95 ,$39.95 ,$26.54 ,$39.95 ,$26.54 ,$36.66 ,$36.66 ,$36.66 ,$42.30 ,$26.54 ,$42.30 ,$26.54 ,$47.00 ,$30.79 ,$26.54 ,$19.55 , N/A , N/A ,$26.54 ,$42.30 ,$26.54 ,$29.00 ,$13.16 ,$42.30 ,$26.54 ,$42.30 ,$42.30 ,$26.54 ,$30.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94200007,97804,HC MNT GROUP INIT 30 MIN,942,1 ,$60.00 ,$39.00 ,$14.14 ,$60.00 ,$14.14 ,$44.70 ,$39.30 ,$14.14 ,$16.80 ,$30.30 ,$14.14 ,$37.02 ,$14.14 ,$37.02 ,$37.02 ,$14.14 ,$37.02 ,$26.87 ,$54.00 ,$45.00 ,$14.14 ,$14.14 ,$52.80 ,$14.14 ,$45.00 ,$45.00 ,$51.00 ,$51.00 ,$14.14 ,$51.00 ,$14.14 ,$46.80 ,$46.80 ,$46.80 ,$54.00 ,$14.14 ,$54.00 ,$14.14 ,$60.00 ,$39.30 ,$14.14 ,$24.96 , N/A , N/A ,$14.14 ,$54.00 ,$14.14 ,$37.02 ,$16.80 ,$54.00 ,$14.14 ,$54.00 ,$54.00 ,$14.14 ,$39.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94200011,G0108,HC DIABETES SELF MGT ED 30 MIN,942,1 ,$106.00 ,$68.90 ,$29.68 ,$126.12 ,$106.00 ,$78.97 ,$69.43 ,$58.20 ,$29.68 ,$53.53 ,$58.20 ,$65.40 ,$58.20 ,$65.40 ,$65.40 ,$58.20 ,$65.40 ,$110.58 ,$95.40 ,$79.50 ,$106.00 ,$58.20 ,$93.28 ,$58.20 ,$79.50 ,$79.50 ,$90.10 ,$90.10 ,$58.20 ,$90.10 ,$58.20 ,$82.68 ,$82.68 ,$82.68 ,$95.40 ,$106.00 ,$95.40 ,$58.20 ,$106.00 ,$69.43 ,$58.20 ,$44.10 , N/A , N/A ,$60.92 ,$95.40 ,$126.12 ,$65.40 ,$29.68 ,$95.40 ,$58.20 ,$95.40 ,$95.40 ,$58.20 ,$68.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94200013,G0109,HC DIABETES SELF MGT GROUP 30MIN,942,1 ,$53.00 ,$34.45 ,$14.84 ,$53.00 ,$39.52 ,$39.49 ,$34.72 ,$16.46 ,$14.84 ,$26.77 ,$16.46 ,$32.70 ,$16.46 ,$32.70 ,$32.70 ,$16.46 ,$32.70 ,$31.27 ,$47.70 ,$39.75 ,$39.52 ,$16.46 ,$46.64 ,$16.46 ,$39.75 ,$39.75 ,$45.05 ,$45.05 ,$16.46 ,$45.05 ,$16.46 ,$41.34 ,$41.34 ,$41.34 ,$47.70 ,$39.52 ,$47.70 ,$16.46 ,$53.00 ,$34.72 ,$16.46 ,$22.05 , N/A , N/A ,$17.23 ,$47.70 ,$35.67 ,$32.70 ,$14.84 ,$47.70 ,$16.46 ,$47.70 ,$47.70 ,$16.46 ,$34.45 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94300004,93797,HC CARDIAC REHAB W/O EKG SESSION,943,1 ,$180.00 ,$117.00 ,$50.40 ,$265.61 ,$180.00 ,$134.10 ,$117.90 ,$122.56 ,$50.40 ,$90.90 ,$122.56 ,$111.06 ,$122.56 ,$111.06 ,$111.06 ,$122.56 ,$111.06 ,$232.86 ,$162.00 ,$135.00 ,$180.00 ,$122.56 ,$158.40 ,$122.56 ,$135.00 ,$135.00 ,$153.00 ,$153.00 ,$122.56 ,$153.00 ,$122.56 ,$140.40 ,$140.40 ,$140.40 ,$162.00 ,$180.00 ,$162.00 ,$122.56 ,$180.00 ,$117.90 ,$122.56 ,$74.88 , N/A , N/A ,$128.29 ,$162.00 ,$265.61 ,$111.06 ,$50.40 ,$162.00 ,$122.56 ,$162.00 ,$162.00 ,$122.56 ,$117.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94300006,93798,HC CARDIAC REHAB W/EKG SESSION (LV1),943,1 ,$215.00 ,$139.75 ,$60.20 ,$265.61 ,$215.00 ,$160.18 ,$140.83 ,$122.56 ,$60.20 ,$108.58 ,$122.56 ,$132.66 ,$122.56 ,$132.66 ,$132.66 ,$122.56 ,$132.66 ,$232.86 ,$193.50 ,$161.25 ,$215.00 ,$122.56 ,$189.20 ,$122.56 ,$161.25 ,$161.25 ,$182.75 ,$182.75 ,$122.56 ,$182.75 ,$122.56 ,$167.70 ,$167.70 ,$167.70 ,$193.50 ,$215.00 ,$193.50 ,$122.56 ,$215.00 ,$140.83 ,$122.56 ,$89.44 , N/A , N/A ,$128.29 ,$193.50 ,$265.61 ,$132.66 ,$60.20 ,$193.50 ,$122.56 ,$193.50 ,$193.50 ,$122.56 ,$139.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94300014,93798,HC CARD REHAB W/EKG SESS (PH2)-KX,943,1 ,$215.00 ,$139.75 ,$60.20 ,$265.61 ,$215.00 ,$160.18 ,$140.83 ,$122.56 ,$60.20 ,$108.58 ,$122.56 ,$132.66 ,$122.56 ,$132.66 ,$132.66 ,$122.56 ,$132.66 ,$232.86 ,$193.50 ,$161.25 ,$215.00 ,$122.56 ,$189.20 ,$122.56 ,$161.25 ,$161.25 ,$182.75 ,$182.75 ,$122.56 ,$182.75 ,$122.56 ,$167.70 ,$167.70 ,$167.70 ,$193.50 ,$215.00 ,$193.50 ,$122.56 ,$215.00 ,$140.83 ,$122.56 ,$89.44 , N/A , N/A ,$128.29 ,$193.50 ,$265.61 ,$132.66 ,$60.20 ,$193.50 ,$122.56 ,$193.50 ,$193.50 ,$122.56 ,$139.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$67.00 ,$43.55 ,$18.76 ,$67.00 , N/A ,$49.92 ,$43.89 , N/A ,$18.76 ,$33.84 , N/A ,$41.34 , N/A ,$41.34 ,$41.34 , N/A ,$41.34 , N/A ,$60.30 ,$50.25 , N/A , N/A ,$58.96 , N/A ,$50.25 ,$50.25 ,$56.95 ,$56.95 , N/A ,$56.95 , N/A ,$52.26 ,$52.26 ,$52.26 ,$60.30 , N/A ,$60.30 , N/A ,$67.00 ,$43.89 , N/A ,$27.87 , N/A , N/A , N/A ,$60.30 , N/A ,$41.34 ,$18.76 ,$60.30 , N/A ,$60.30 ,$60.30 , N/A ,$43.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),94300021,N/A,HC CARDIAC REHAB EXERCISE PER VISIT,943,1 ,$17.00 ,$11.05 ,$4.76 ,$17.00 , N/A ,$12.67 ,$11.14 , N/A ,$4.76 ,$8.59 , N/A ,$10.49 , N/A ,$10.49 ,$10.49 , N/A ,$10.49 , N/A ,$15.30 ,$12.75 , N/A , N/A ,$14.96 , N/A ,$12.75 ,$12.75 ,$14.45 ,$14.45 , N/A ,$14.45 , N/A ,$13.26 ,$13.26 ,$13.26 ,$15.30 , N/A ,$15.30 , N/A ,$17.00 ,$11.14 , N/A ,$7.07 , N/A , N/A , N/A ,$15.30 , N/A ,$10.49 ,$4.76 ,$15.30 , N/A ,$15.30 ,$15.30 , N/A ,$11.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000010,32550,PC INSERT CATH PLEURAL INDWELL W/CUFF,960,1 ,$650.00 ,$422.50 ,$182.00 ,"$7,280.19 ",$650.00 ,$484.25 ,$425.75 ,$650.00 ,$182.00 ,$328.25 ,$650.00 ,$401.05 ,$650.00 ,$401.05 ,$401.05 ,$650.00 ,$401.05 ,"$6,382.80 ",$585.00 ,$487.50 ,$650.00 ,$650.00 ,$572.00 ,$650.00 ,$487.50 ,$487.50 ,$552.50 ,$552.50 ,$650.00 ,$552.50 ,$650.00 ,$507.00 ,$507.00 ,$507.00 ,$585.00 ,$650.00 ,$585.00 ,$650.00 ,$650.00 ,$425.75 ,$650.00 ,$367.38 ,$503.72 ,$480.83 ,$650.00 ,$585.00 ,"$7,280.19 ",$401.05 ,$182.00 ,$585.00 ,$650.00 , N/A , N/A ,$650.00 ,$422.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000011,32556,PC PLEURAL DRAINAGE W/O IMAGING,960,1 ,$384.00 ,$249.60 ,$107.52 ,"$3,716.58 ",$384.00 ,$286.08 ,$251.52 ,$384.00 ,$107.52 ,$193.92 ,$384.00 ,$236.93 ,$384.00 ,$236.93 ,$236.93 ,$384.00 ,$236.93 ,"$3,258.44 ",$345.60 ,$288.00 ,$384.00 ,$384.00 ,$337.92 ,$384.00 ,$288.00 ,$288.00 ,$326.40 ,$326.40 ,$384.00 ,$326.40 ,$384.00 ,$299.52 ,$299.52 ,$299.52 ,$345.60 ,$384.00 ,$345.60 ,$384.00 ,$384.00 ,$251.52 ,$384.00 ,$219.29 ,$384.00 ,$384.00 ,$384.00 ,$345.60 ,"$3,716.58 ",$236.93 ,$107.52 ,$345.60 ,$384.00 , N/A , N/A ,$384.00 ,$249.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000012,36660,PC CATHERIZATION UMBILICAL ARTERY NEWBORN,960,1 ,$228.00 ,$148.20 ,$63.84 ,$228.00 , N/A ,$169.86 ,$149.34 , N/A ,$63.84 ,$115.14 , N/A ,$140.68 , N/A ,$140.68 ,$140.68 , N/A ,$140.68 , N/A ,$205.20 ,$171.00 , N/A , N/A ,$200.64 , N/A ,$171.00 ,$171.00 ,$193.80 ,$193.80 , N/A ,$193.80 , N/A ,$177.84 ,$177.84 ,$177.84 ,$205.20 , N/A ,$205.20 , N/A ,$228.00 ,$149.34 , N/A ,$120.32 , N/A , N/A , N/A ,$205.20 , N/A ,$140.68 ,$63.84 ,$205.20 , N/A , N/A , N/A , N/A ,$148.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000013,54150,PC CIRCUMCISION W/DEVICE,960,1 ,$303.00 ,$196.95 ,$84.84 ,"$4,097.10 ",$303.00 ,$225.74 ,$198.47 ,$303.00 ,$84.84 ,$153.02 ,$303.00 ,$186.95 ,$303.00 ,$186.95 ,$186.95 ,$303.00 ,$186.95 ,"$3,592.06 ",$272.70 ,$227.25 ,$303.00 ,$303.00 ,$266.64 ,$303.00 ,$227.25 ,$227.25 ,$257.55 ,$257.55 ,$303.00 ,$257.55 ,$303.00 ,$236.34 ,$236.34 ,$236.34 ,$272.70 ,$303.00 ,$272.70 ,$303.00 ,$303.00 ,$198.47 ,$303.00 ,$174.91 ,$303.00 ,$303.00 ,$303.00 ,$272.70 ,"$4,097.10 ",$186.95 ,$84.84 ,$272.70 ,$303.00 , N/A , N/A ,$303.00 ,$196.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000014,36510,PC UMBILICAL CATHETER INSERTION NEWBORN,960,1 ,$174.00 ,$113.10 ,$48.72 ,$174.00 , N/A ,$129.63 ,$113.97 , N/A ,$48.72 ,$87.87 , N/A ,$107.36 , N/A ,$107.36 ,$107.36 , N/A ,$107.36 , N/A ,$156.60 ,$130.50 , N/A , N/A ,$153.12 , N/A ,$130.50 ,$130.50 ,$147.90 ,$147.90 , N/A ,$147.90 , N/A ,$135.72 ,$135.72 ,$135.72 ,$156.60 , N/A ,$156.60 , N/A ,$174.00 ,$113.97 , N/A ,$94.76 , N/A , N/A , N/A ,$156.60 , N/A ,$107.36 ,$48.72 ,$156.60 , N/A , N/A , N/A , N/A ,$113.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000015,76936,PC US GUIDED COMPRESSION RPR -26,960,1 ,$151.75 ,$98.64 ,$42.49 ,$605.59 ,$151.75 ,$113.05 ,$99.40 ,$151.75 ,$42.49 ,$76.63 ,$151.75 ,$93.63 ,$151.75 ,$93.63 ,$93.63 ,$151.75 ,$93.63 ,$530.94 ,$136.58 ,$113.81 ,$151.75 ,$151.75 ,$133.54 ,$151.75 ,$113.81 ,$113.81 ,$128.99 ,$128.99 ,$151.75 ,$128.99 ,$151.75 ,$118.37 ,$118.37 ,$118.37 ,$136.58 ,$151.75 ,$136.58 ,$151.75 ,$151.75 ,$99.40 ,$151.75 ,$151.75 ,$80.82 ,$77.14 ,$151.75 ,$136.58 ,$605.59 ,$93.63 ,$42.49 ,$136.58 ,$151.75 , N/A , N/A ,$151.75 ,$98.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000044,G2061,PC NON PHYSICIAN EST PT 5-10 MIN,960,1 ,$37.47 ,$24.36 ,$10.49 ,$37.47 , N/A ,$27.92 ,$24.54 , N/A ,$10.49 ,$18.92 , N/A ,$23.12 , N/A ,$23.12 ,$23.12 , N/A ,$23.12 , N/A ,$33.72 ,$28.10 , N/A , N/A ,$32.97 , N/A ,$28.10 ,$28.10 ,$31.85 ,$31.85 , N/A ,$31.85 , N/A ,$29.23 ,$29.23 ,$29.23 ,$33.72 , N/A ,$33.72 , N/A ,$37.47 ,$24.54 , N/A ,$15.49 , N/A , N/A , N/A ,$33.72 , N/A ,$23.12 ,$10.49 ,$33.72 , N/A , N/A , N/A , N/A ,$24.36 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000045,G2062,PC NON PHYSICIAN EST PT 11-20 MIN,960,1 ,$66.27 ,$43.08 ,$18.56 ,$66.27 , N/A ,$49.37 ,$43.41 , N/A ,$18.56 ,$33.47 , N/A ,$40.89 , N/A ,$40.89 ,$40.89 , N/A ,$40.89 , N/A ,$59.64 ,$49.70 , N/A , N/A ,$58.32 , N/A ,$49.70 ,$49.70 ,$56.33 ,$56.33 , N/A ,$56.33 , N/A ,$51.69 ,$51.69 ,$51.69 ,$59.64 , N/A ,$59.64 , N/A ,$66.27 ,$43.41 , N/A ,$27.35 , N/A , N/A , N/A ,$59.64 , N/A ,$40.89 ,$18.56 ,$59.64 , N/A , N/A , N/A , N/A ,$43.08 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96000046,G2063,PC NON PHYSICIAN EST PT > 21 MIN,960,1 ,$103.74 ,$67.43 ,$29.05 ,$103.74 , N/A ,$77.29 ,$67.95 , N/A ,$29.05 ,$52.39 , N/A ,$64.01 , N/A ,$64.01 ,$64.01 , N/A ,$64.01 , N/A ,$93.37 ,$77.81 , N/A , N/A ,$91.29 , N/A ,$77.81 ,$77.81 ,$88.18 ,$88.18 , N/A ,$88.18 , N/A ,$80.92 ,$80.92 ,$80.92 ,$93.37 , N/A ,$93.37 , N/A ,$103.74 ,$67.95 , N/A ,$42.42 , N/A , N/A , N/A ,$93.37 , N/A ,$64.01 ,$29.05 ,$93.37 , N/A , N/A , N/A , N/A ,$67.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100001,90791,PC EVAL PSYCH DIAG MD,961,1 ,$424.00 ,$275.60 ,$118.72 ,$424.00 ,$339.14 ,$315.88 ,$277.72 ,$141.28 ,$118.72 ,$214.12 ,$141.28 ,$261.61 ,$141.28 ,$261.61 ,$261.61 ,$141.28 ,$261.61 ,$268.43 ,$381.60 ,$318.00 ,$339.14 ,$141.28 ,$373.12 ,$141.28 ,$318.00 ,$318.00 ,$360.40 ,$360.40 ,$141.28 ,$360.40 ,$141.28 ,$330.72 ,$330.72 ,$330.72 ,$381.60 ,$339.14 ,$381.60 ,$141.28 ,$424.00 ,$277.72 ,$141.28 ,$175.57 ,$200.32 ,$191.22 ,$147.87 ,$381.60 ,$306.17 ,$261.61 ,$118.72 ,$381.60 ,$141.28 , N/A , N/A ,$141.28 ,$275.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100002,90791,PC EVAL PSYCH DIAG PHD,961,1 ,$424.00 ,$275.60 ,$118.72 ,$424.00 ,$339.14 ,$315.88 ,$277.72 ,$141.28 ,$118.72 ,$214.12 ,$141.28 ,$261.61 ,$141.28 ,$261.61 ,$261.61 ,$141.28 ,$261.61 ,$268.43 ,$381.60 ,$318.00 ,$339.14 ,$141.28 ,$373.12 ,$141.28 ,$318.00 ,$318.00 ,$360.40 ,$360.40 ,$141.28 ,$360.40 ,$141.28 ,$330.72 ,$330.72 ,$330.72 ,$381.60 ,$339.14 ,$381.60 ,$141.28 ,$424.00 ,$277.72 ,$141.28 ,$175.57 ,$200.32 ,$191.22 ,$147.87 ,$381.60 ,$306.17 ,$261.61 ,$118.72 ,$381.60 ,$141.28 , N/A , N/A ,$141.28 ,$275.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100004,90832,PC THERAPY INDIVIDUAL PSYCH 30MIN,961,1 ,$189.00 ,$122.85 ,$52.92 ,$306.17 ,$189.00 ,$140.81 ,$123.80 ,$141.28 ,$52.92 ,$95.45 ,$141.28 ,$116.61 ,$141.28 ,$116.61 ,$116.61 ,$141.28 ,$116.61 ,$268.43 ,$170.10 ,$141.75 ,$189.00 ,$141.28 ,$166.32 ,$141.28 ,$141.75 ,$141.75 ,$160.65 ,$160.65 ,$141.28 ,$160.65 ,$141.28 ,$147.42 ,$147.42 ,$147.42 ,$170.10 ,$189.00 ,$170.10 ,$141.28 ,$189.00 ,$123.80 ,$141.28 ,$87.86 ,$107.78 ,$102.88 ,$147.87 ,$170.10 ,$306.17 ,$116.61 ,$52.92 ,$170.10 ,$141.28 , N/A , N/A ,$141.28 ,$122.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100005,90833,PC THERAPY INDIVIDUAL PSYCH W/MED EVAL 30MIN,961,1 ,$195.00 ,$126.75 ,$54.60 ,$195.00 , N/A ,$145.28 ,$127.73 , N/A ,$54.60 ,$98.48 , N/A ,$120.32 , N/A ,$120.32 ,$120.32 , N/A ,$120.32 , N/A ,$175.50 ,$146.25 , N/A , N/A ,$171.60 , N/A ,$146.25 ,$146.25 ,$165.75 ,$165.75 , N/A ,$165.75 , N/A ,$152.10 ,$152.10 ,$152.10 ,$175.50 , N/A ,$175.50 , N/A ,$195.00 ,$127.73 , N/A ,$91.05 ,$107.95 ,$103.05 , N/A ,$175.50 , N/A ,$120.32 ,$54.60 ,$175.50 , N/A , N/A , N/A , N/A ,$126.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100006,90834,PC THERAPY INDIVIDUAL PSYCH 45MIN,961,1 ,$249.00 ,$161.85 ,$69.72 ,$306.17 ,$249.00 ,$185.51 ,$163.10 ,$141.28 ,$69.72 ,$125.75 ,$141.28 ,$153.63 ,$141.28 ,$153.63 ,$153.63 ,$141.28 ,$153.63 ,$268.43 ,$224.10 ,$186.75 ,$249.00 ,$141.28 ,$219.12 ,$141.28 ,$186.75 ,$186.75 ,$211.65 ,$211.65 ,$141.28 ,$211.65 ,$141.28 ,$194.22 ,$194.22 ,$194.22 ,$224.10 ,$249.00 ,$224.10 ,$141.28 ,$249.00 ,$163.10 ,$141.28 ,$117.14 ,$107.95 ,$103.05 ,$147.87 ,$224.10 ,$306.17 ,$153.63 ,$69.72 ,$224.10 ,$141.28 , N/A , N/A ,$141.28 ,$161.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100007,90836,PC THERAPY INDIVIDUAL PSYCH W/MED EVAL 45MIN,961,1 ,$246.00 ,$159.90 ,$68.88 ,$246.00 , N/A ,$183.27 ,$161.13 , N/A ,$68.88 ,$124.23 , N/A ,$151.78 , N/A ,$151.78 ,$151.78 , N/A ,$151.78 , N/A ,$221.40 ,$184.50 , N/A , N/A ,$216.48 , N/A ,$184.50 ,$184.50 ,$209.10 ,$209.10 , N/A ,$209.10 , N/A ,$191.88 ,$191.88 ,$191.88 ,$221.40 , N/A ,$221.40 , N/A ,$246.00 ,$161.13 , N/A ,$115.36 ,$107.95 ,$103.05 , N/A ,$221.40 , N/A ,$151.78 ,$68.88 ,$221.40 , N/A , N/A , N/A , N/A ,$159.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100008,90837,PC THERAPY INDIVIDUAL PSYCH PHD 60MIN,961,1 ,$375.00 ,$243.75 ,$103.05 ,$375.00 ,$339.14 ,$279.38 ,$245.63 ,$141.28 ,$105.00 ,$189.38 ,$141.28 ,$231.38 ,$141.28 ,$231.38 ,$231.38 ,$141.28 ,$231.38 ,$268.43 ,$337.50 ,$281.25 ,$339.14 ,$141.28 ,$330.00 ,$141.28 ,$281.25 ,$281.25 ,$318.75 ,$318.75 ,$141.28 ,$318.75 ,$141.28 ,$292.50 ,$292.50 ,$292.50 ,$337.50 ,$339.14 ,$337.50 ,$141.28 ,$375.00 ,$245.63 ,$141.28 ,$175.12 ,$107.95 ,$103.05 ,$147.87 ,$337.50 ,$306.17 ,$231.38 ,$105.00 ,$337.50 ,$141.28 , N/A , N/A ,$141.28 ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),96100011,90838,PC PSYCH THERAPY INDIV W/MED EVAL 60MIN,961,1 ,$324.00 ,$210.60 ,$90.72 ,$324.00 , N/A ,$241.38 ,$212.22 , N/A ,$90.72 ,$163.62 , N/A ,$199.91 , N/A ,$199.91 ,$199.91 , N/A ,$199.91 , N/A ,$291.60 ,$243.00 , N/A , N/A ,$285.12 , N/A ,$243.00 ,$243.00 ,$275.40 ,$275.40 , N/A ,$275.40 , N/A ,$252.72 ,$252.72 ,$252.72 ,$291.60 , N/A ,$291.60 , N/A ,$324.00 ,$212.22 , N/A ,$151.31 ,$107.95 ,$103.05 , N/A ,$291.60 , N/A ,$199.91 ,$90.72 ,$291.60 , N/A , N/A , N/A , N/A ,$210.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97280006,76706,PC US ABDOMINAL AORTA SCREENING-26,972,1 ,$126.00 ,$81.90 ,$35.28 ,$249.12 ,$126.00 ,$93.87 ,$82.53 ,$114.95 ,$35.28 ,$63.63 ,$114.95 ,$77.74 ,$114.95 ,$77.74 ,$77.74 ,$114.95 ,$77.74 ,$218.41 ,$113.40 ,$94.50 ,$126.00 ,$114.95 ,$110.88 ,$114.95 ,$94.50 ,$94.50 ,$107.10 ,$107.10 ,$114.95 ,$107.10 ,$114.95 ,$98.28 ,$98.28 ,$98.28 ,$113.40 ,$126.00 ,$113.40 ,$114.95 ,$126.00 ,$82.53 ,$114.95 ,$64.10 ,$110.75 ,$105.71 ,$120.32 ,$113.40 ,$249.12 ,$77.74 ,$35.28 ,$113.40 ,$114.95 , N/A , N/A ,$114.95 ,$81.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97400001,78472,PC MUGA RESTING SINGLE -26,974,1 ,$288.00 ,$187.20 ,$80.64 ,$862.57 ,$288.00 ,$214.56 ,$188.64 ,$288.00 ,$80.64 ,$145.44 ,$288.00 ,$177.70 ,$288.00 ,$177.70 ,$177.70 ,$288.00 ,$177.70 ,$756.24 ,$259.20 ,$216.00 ,$288.00 ,$288.00 ,$253.44 ,$288.00 ,$216.00 ,$216.00 ,$244.80 ,$244.80 ,$288.00 ,$244.80 ,$288.00 ,$224.64 ,$224.64 ,$224.64 ,$259.20 ,$288.00 ,$259.20 ,$288.00 ,$288.00 ,$188.64 ,$288.00 ,$112.62 ,$273.47 ,$261.04 ,$288.00 ,$259.20 ,$862.57 ,$177.70 ,$80.64 ,$259.20 ,$288.00 , N/A , N/A ,$288.00 ,$187.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97400002,78451,PC HT MUSCLE IMAGE SPECT SINGLE -26,974,1 ,$688.22 ,$447.34 ,$155.88 ,"$2,990.23 ",$688.22 ,$512.72 ,$450.78 ,$688.22 ,$192.70 ,$347.55 ,$688.22 ,$424.63 ,$688.22 ,$424.63 ,$424.63 ,$688.22 ,$424.63 ,"$2,621.64 ",$619.40 ,$516.17 ,$688.22 ,$688.22 ,$605.63 ,$688.22 ,$516.17 ,$516.17 ,$584.99 ,$584.99 ,$688.22 ,$584.99 ,$688.22 ,$536.81 ,$536.81 ,$536.81 ,$619.40 ,$688.22 ,$619.40 ,$688.22 ,$688.22 ,$450.78 ,$688.22 ,$155.88 ,$306.43 ,$292.50 ,$688.22 ,$619.40 ,"$2,990.23 ",$424.63 ,$192.70 ,$619.40 ,$688.22 , N/A , N/A ,$688.22 ,$447.34 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97400003,78452,PC HT MUSCLE IMAGE SPECT MULTI -26,974,1 ,$866.20 ,$563.03 ,$183.75 ,"$2,990.23 ",$866.20 ,$645.32 ,$567.36 ,$866.20 ,$242.54 ,$437.43 ,$866.20 ,$534.45 ,$866.20 ,$534.45 ,$534.45 ,$866.20 ,$534.45 ,"$2,621.64 ",$779.58 ,$649.65 ,$866.20 ,$866.20 ,$762.26 ,$866.20 ,$649.65 ,$649.65 ,$736.27 ,$736.27 ,$866.20 ,$736.27 ,$866.20 ,$675.64 ,$675.64 ,$675.64 ,$779.58 ,$866.20 ,$779.58 ,$866.20 ,$866.20 ,$567.36 ,$866.20 ,$183.75 ,$670.91 ,$640.42 ,$866.20 ,$779.58 ,"$2,990.23 ",$534.45 ,$242.54 ,$779.58 ,$866.20 , N/A , N/A ,$866.20 ,$563.03 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600002,94010,PC SPIROMETRY PACKAGE-26,976,1 ,$19.44 ,$12.64 ,$5.44 ,$319.47 ,$19.44 ,$14.48 ,$12.73 ,$19.44 ,$5.44 ,$9.82 ,$19.44 ,$11.99 ,$19.44 ,$11.99 ,$11.99 ,$19.44 ,$11.99 ,$280.10 ,$17.50 ,$14.58 ,$19.44 ,$19.44 ,$17.11 ,$19.44 ,$14.58 ,$14.58 ,$16.52 ,$16.52 ,$19.44 ,$16.52 ,$19.44 ,$15.16 ,$15.16 ,$15.16 ,$17.50 ,$19.44 ,$17.50 ,$19.44 ,$19.44 ,$12.73 ,$19.44 ,$15.74 ,$19.44 ,$19.44 ,$19.44 ,$17.50 ,$319.47 ,$11.99 ,$5.44 ,$17.50 ,$19.44 , N/A , N/A ,$19.44 ,$12.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600003,94070,PC SPIROMETRY PFT COMPLEX -26,976,1 ,$82.19 ,$53.42 ,$23.01 ,$605.59 ,$82.19 ,$61.23 ,$53.83 ,$82.19 ,$23.01 ,$41.51 ,$82.19 ,$50.71 ,$82.19 ,$50.71 ,$50.71 ,$82.19 ,$50.71 ,$530.94 ,$73.97 ,$61.64 ,$82.19 ,$82.19 ,$72.33 ,$82.19 ,$61.64 ,$61.64 ,$69.86 ,$69.86 ,$82.19 ,$69.86 ,$82.19 ,$64.11 ,$64.11 ,$64.11 ,$73.97 ,$82.19 ,$73.97 ,$82.19 ,$82.19 ,$53.83 ,$82.19 ,$53.02 ,$82.19 ,$82.19 ,$82.19 ,$73.97 ,$605.59 ,$50.71 ,$23.01 ,$73.97 ,$82.19 , N/A , N/A ,$82.19 ,$53.42 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600004,94060,PC SPIROMETRY/PFT PRE  AND  POST -26,976,1 ,$54.78 ,$35.61 ,$15.34 ,$605.59 ,$54.78 ,$40.81 ,$35.88 ,$54.78 ,$15.34 ,$27.66 ,$54.78 ,$33.80 ,$54.78 ,$33.80 ,$33.80 ,$54.78 ,$33.80 ,$530.94 ,$49.30 ,$41.09 ,$54.78 ,$54.78 ,$48.21 ,$54.78 ,$41.09 ,$41.09 ,$46.56 ,$46.56 ,$54.78 ,$46.56 ,$54.78 ,$42.73 ,$42.73 ,$42.73 ,$49.30 ,$54.78 ,$49.30 ,$54.78 ,$54.78 ,$35.88 ,$54.78 ,$24.21 ,$54.45 ,$51.98 ,$54.78 ,$49.30 ,$605.59 ,$33.80 ,$15.34 ,$49.30 ,$54.78 , N/A , N/A ,$54.78 ,$35.61 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600006,94726,PC PLETHYSMOGRAPHY -26,976,1 ,$79.87 ,$51.92 ,$22.36 ,$605.59 ,$79.87 ,$59.50 ,$52.31 ,$79.87 ,$22.36 ,$40.33 ,$79.87 ,$49.28 ,$79.87 ,$49.28 ,$49.28 ,$79.87 ,$49.28 ,$530.94 ,$71.88 ,$59.90 ,$79.87 ,$79.87 ,$70.29 ,$79.87 ,$59.90 ,$59.90 ,$67.89 ,$67.89 ,$79.87 ,$67.89 ,$79.87 ,$62.30 ,$62.30 ,$62.30 ,$71.88 ,$79.87 ,$71.88 ,$79.87 ,$79.87 ,$52.31 ,$79.87 ,$22.94 ,$54.45 ,$51.98 ,$79.87 ,$71.88 ,$605.59 ,$49.28 ,$22.36 ,$71.88 ,$79.87 , N/A , N/A ,$79.87 ,$51.92 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600008,94729,PC DIFFUSING CAPACITY -26,976,1 ,$39.93 ,$25.95 ,$11.18 ,$39.93 , N/A ,$29.75 ,$26.15 , N/A ,$11.18 ,$20.16 , N/A ,$24.64 , N/A ,$24.64 ,$24.64 , N/A ,$24.64 , N/A ,$35.94 ,$29.95 , N/A , N/A ,$35.14 , N/A ,$29.95 ,$29.95 ,$33.94 ,$33.94 , N/A ,$33.94 , N/A ,$31.15 ,$31.15 ,$31.15 ,$35.94 , N/A ,$35.94 , N/A ,$39.93 ,$26.15 , N/A ,$17.07 ,$39.93 ,$39.93 , N/A ,$35.94 , N/A ,$24.64 ,$11.18 ,$35.94 , N/A , N/A , N/A , N/A ,$25.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600009,94002,PC VENT MANGMNT INPT/OBS INIT DAY,976,1 ,$282.00 ,$183.30 ,$78.96 ,"$1,114.74 ",$282.00 ,$210.09 ,$184.71 ,$282.00 ,$78.96 ,$142.41 ,$282.00 ,$173.99 ,$282.00 ,$173.99 ,$173.99 ,$282.00 ,$173.99 ,$977.34 ,$253.80 ,$211.50 ,$282.00 ,$282.00 ,$248.16 ,$282.00 ,$211.50 ,$211.50 ,$239.70 ,$239.70 ,$282.00 ,$239.70 ,$282.00 ,$219.96 ,$219.96 ,$219.96 ,$253.80 ,$282.00 ,$253.80 ,$282.00 ,$282.00 ,$184.71 ,$282.00 ,$173.95 ,$282.00 ,$282.00 ,$282.00 ,$253.80 ,"$1,114.74 ",$173.99 ,$78.96 ,$253.80 ,$282.00 , N/A , N/A ,$282.00 ,$183.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600010,94003,PC VENT MANGMENT INPT/OBS SUBS DAY,976,1 ,$204.00 ,$132.60 ,$57.12 ,"$1,114.74 ",$204.00 ,$151.98 ,$133.62 ,$204.00 ,$57.12 ,$103.02 ,$204.00 ,$125.87 ,$204.00 ,$125.87 ,$125.87 ,$204.00 ,$125.87 ,$977.34 ,$183.60 ,$153.00 ,$204.00 ,$204.00 ,$179.52 ,$204.00 ,$153.00 ,$153.00 ,$173.40 ,$173.40 ,$204.00 ,$173.40 ,$204.00 ,$159.12 ,$159.12 ,$159.12 ,$183.60 ,$204.00 ,$183.60 ,$204.00 ,$204.00 ,$133.62 ,$204.00 ,$125.32 ,$204.00 ,$204.00 ,$204.00 ,$183.60 ,"$1,114.74 ",$125.87 ,$57.12 ,$183.60 ,$204.00 , N/A , N/A ,$204.00 ,$132.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600011,94610,PC INTRAPULM SURFACTANT ADMIN W/ENDOTRACH TUBE,976,1 ,$171.00 ,$111.15 ,$47.88 ,$430.11 ,$171.00 ,$127.40 ,$112.01 ,$171.00 ,$47.88 ,$86.36 ,$171.00 ,$105.51 ,$171.00 ,$105.51 ,$105.51 ,$171.00 ,$105.51 ,$377.09 ,$153.90 ,$128.25 ,$171.00 ,$171.00 ,$150.48 ,$171.00 ,$128.25 ,$128.25 ,$145.35 ,$145.35 ,$171.00 ,$145.35 ,$171.00 ,$133.38 ,$133.38 ,$133.38 ,$153.90 ,$171.00 ,$153.90 ,$171.00 ,$171.00 ,$112.01 ,$171.00 ,$104.91 ,$171.00 ,$168.58 ,$171.00 ,$153.90 ,$430.11 ,$105.51 ,$47.88 ,$153.90 ,$171.00 , N/A , N/A ,$171.00 ,$111.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),97600012,94660,PC CPAP/BIPAP VENT NONINVAS INIT  AND  MGMT,976,1 ,$117.00 ,$76.05 ,$32.76 ,$430.11 ,$117.00 ,$87.17 ,$76.64 ,$117.00 ,$32.76 ,$59.09 ,$117.00 ,$72.19 ,$117.00 ,$72.19 ,$72.19 ,$117.00 ,$72.19 ,$377.09 ,$105.30 ,$87.75 ,$117.00 ,$117.00 ,$102.96 ,$117.00 ,$87.75 ,$87.75 ,$99.45 ,$99.45 ,$117.00 ,$99.45 ,$117.00 ,$91.26 ,$91.26 ,$91.26 ,$105.30 ,$117.00 ,$105.30 ,$117.00 ,$117.00 ,$76.64 ,$117.00 ,$71.69 ,$117.00 ,$117.00 ,$117.00 ,$105.30 ,$430.11 ,$72.19 ,$32.76 ,$105.30 ,$117.00 , N/A , N/A ,$117.00 ,$76.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180003,10061,PC DRAIN SKIN ABSCESS COMPLIC,981,1 ,$496.25 ,$322.56 ,$138.95 ,$790.90 ,$496.25 ,$369.71 ,$325.04 ,$364.95 ,$138.95 ,$250.61 ,$364.95 ,$306.19 ,$364.95 ,$306.19 ,$306.19 ,$364.95 ,$306.19 ,$693.41 ,$446.63 ,$372.19 ,$496.25 ,$364.95 ,$436.70 ,$364.95 ,$372.19 ,$372.19 ,$421.81 ,$421.81 ,$364.95 ,$421.81 ,$364.95 ,$387.08 ,$387.08 ,$387.08 ,$446.63 ,$496.25 ,$446.63 ,$364.95 ,$496.25 ,$325.04 ,$364.95 ,$313.11 ,$218.80 ,$208.86 ,$381.99 ,$446.63 ,$790.90 ,$306.19 ,$138.95 ,$446.63 ,$364.95 , N/A , N/A ,$364.95 ,$322.56 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180029,11750,PC REMOVAL OF NAIL BED,981,1 ,$631.44 ,$410.44 ,$174.97 ,$790.90 ,$631.44 ,$470.42 ,$413.59 ,$364.95 ,$176.80 ,$318.88 ,$364.95 ,$389.60 ,$364.95 ,$389.60 ,$389.60 ,$364.95 ,$389.60 ,$693.41 ,$568.30 ,$473.58 ,$631.44 ,$364.95 ,$555.67 ,$364.95 ,$473.58 ,$473.58 ,$536.72 ,$536.72 ,$364.95 ,$536.72 ,$364.95 ,$492.52 ,$492.52 ,$492.52 ,$568.30 ,$631.44 ,$568.30 ,$364.95 ,$631.44 ,$413.59 ,$364.95 ,$174.97 ,$469.24 ,$447.91 ,$381.99 ,$568.30 ,$790.90 ,$389.60 ,$176.80 ,$568.30 ,$364.95 , N/A , N/A ,$364.95 ,$410.44 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180329,31500,PC INSERT EMERGENCY ENDOTRACH AIRWAY,981,1 ,$441.00 ,$286.65 ,$123.48 ,$484.11 ,$441.00 ,$328.55 ,$288.86 ,$223.39 ,$123.48 ,$222.71 ,$223.39 ,$272.10 ,$223.39 ,$272.10 ,$272.10 ,$223.39 ,$272.10 ,$424.44 ,$396.90 ,$330.75 ,$441.00 ,$223.39 ,$388.08 ,$223.39 ,$330.75 ,$330.75 ,$374.85 ,$374.85 ,$223.39 ,$374.85 ,$223.39 ,$343.98 ,$343.98 ,$343.98 ,$396.90 ,$441.00 ,$396.90 ,$223.39 ,$441.00 ,$288.86 ,$223.39 ,$257.30 ,$441.00 ,$441.00 ,$233.81 ,$396.90 ,$484.11 ,$272.10 ,$123.48 ,$396.90 ,$223.39 , N/A , N/A ,$223.39 ,$286.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180340,32554,PC THORACENTESIS ASPIRATION WO IMAGING,981,1 ,$279.00 ,$181.35 ,$78.12 ,"$1,236.85 ",$279.00 ,$207.86 ,$182.75 ,$279.00 ,$78.12 ,$140.90 ,$279.00 ,$172.14 ,$279.00 ,$172.14 ,$172.14 ,$279.00 ,$172.14 ,"$1,084.39 ",$251.10 ,$209.25 ,$279.00 ,$279.00 ,$245.52 ,$279.00 ,$209.25 ,$209.25 ,$237.15 ,$237.15 ,$279.00 ,$237.15 ,$279.00 ,$217.62 ,$217.62 ,$217.62 ,$251.10 ,$279.00 ,$251.10 ,$279.00 ,$279.00 ,$182.75 ,$279.00 ,$159.31 ,$279.00 ,$279.00 ,$279.00 ,$251.10 ,"$1,236.85 ",$172.14 ,$78.12 ,$251.10 ,$279.00 , N/A , N/A ,$279.00 ,$181.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180345,32551,PC CHEST TUBE INSERTION,981,1 ,$495.00 ,$321.75 ,$138.60 ,"$3,217.73 ",$495.00 ,$368.78 ,$324.23 ,$495.00 ,$138.60 ,$249.98 ,$495.00 ,$305.42 ,$495.00 ,$305.42 ,$305.42 ,$495.00 ,$305.42 ,"$2,821.10 ",$445.50 ,$371.25 ,$495.00 ,$495.00 ,$435.60 ,$495.00 ,$371.25 ,$371.25 ,$420.75 ,$420.75 ,$495.00 ,$420.75 ,$495.00 ,$386.10 ,$386.10 ,$386.10 ,$445.50 ,$495.00 ,$445.50 ,$495.00 ,$495.00 ,$324.23 ,$495.00 ,$283.01 ,$495.00 ,$480.83 ,$495.00 ,$445.50 ,"$3,217.73 ",$305.42 ,$138.60 ,$445.50 ,$495.00 , N/A , N/A ,$495.00 ,$321.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180355,62270,"PC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC",981,1 ,$240.00 ,$156.00 ,$67.20 ,"$1,453.01 ",$240.00 ,$178.80 ,$157.20 ,$240.00 ,$67.20 ,$121.20 ,$240.00 ,$148.08 ,$240.00 ,$148.08 ,$148.08 ,$240.00 ,$148.08 ,"$1,273.91 ",$216.00 ,$180.00 ,$240.00 ,$240.00 ,$211.20 ,$240.00 ,$180.00 ,$180.00 ,$204.00 ,$204.00 ,$240.00 ,$204.00 ,$240.00 ,$187.20 ,$187.20 ,$187.20 ,$216.00 ,$240.00 ,$216.00 ,$240.00 ,$240.00 ,$157.20 ,$240.00 ,$110.40 ,$240.00 ,$240.00 ,$240.00 ,$216.00 ,"$1,453.01 ",$148.08 ,$67.20 ,$216.00 ,$240.00 , N/A , N/A ,$240.00 ,$156.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180471,99471,PC INIT.PEDIATRIC CRITICAL CARE,981,1 ,"$2,607.00 ","$1,694.55 ",$729.96 ,"$2,607.00 ", N/A ,"$1,942.22 ","$1,707.59 ", N/A ,$729.96 ,"$1,316.54 ", N/A ,"$1,608.52 ", N/A ,"$1,608.52 ","$1,608.52 ", N/A ,"$1,608.52 ", N/A ,"$2,346.30 ","$1,955.25 ", N/A , N/A ,"$2,294.16 ", N/A ,"$1,955.25 ","$1,955.25 ","$2,215.95 ","$2,215.95 ", N/A ,"$2,215.95 ", N/A ,"$2,033.46 ","$2,033.46 ","$2,033.46 ","$2,346.30 ", N/A ,"$2,346.30 ", N/A ,"$2,607.00 ","$1,707.59 ", N/A ,"$1,026.93 ", N/A , N/A , N/A ,"$2,346.30 ", N/A ,"$1,608.52 ",$729.96 ,"$2,346.30 ", N/A , N/A , N/A , N/A ,"$1,694.55 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180472,99472,PC SUBSQ.PEDIATRIC CRIT.CARE,981,1 ,"$1,245.00 ",$809.25 ,$348.60 ,"$1,245.00 ", N/A ,$927.53 ,$815.48 , N/A ,$348.60 ,$628.73 , N/A ,$768.17 , N/A ,$768.17 ,$768.17 , N/A ,$768.17 , N/A ,"$1,120.50 ",$933.75 , N/A , N/A ,"$1,095.60 ", N/A ,$933.75 ,$933.75 ,"$1,058.25 ","$1,058.25 ", N/A ,"$1,058.25 ", N/A ,$971.10 ,$971.10 ,$971.10 ,"$1,120.50 ", N/A ,"$1,120.50 ", N/A ,"$1,245.00 ",$815.48 , N/A ,$519.08 , N/A , N/A , N/A ,"$1,120.50 ", N/A ,$768.17 ,$348.60 ,"$1,120.50 ", N/A , N/A , N/A , N/A ,$809.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180473,99464,"PC ATTENDANCE, BIRTH/INITIAL STABILIZE",981,1 ,$231.00 ,$150.15 ,$64.68 ,$231.00 , N/A ,$172.10 ,$151.31 , N/A ,$64.68 ,$116.66 , N/A ,$142.53 , N/A ,$142.53 ,$142.53 , N/A ,$142.53 , N/A ,$207.90 ,$173.25 , N/A , N/A ,$203.28 , N/A ,$173.25 ,$173.25 ,$196.35 ,$196.35 , N/A ,$196.35 , N/A ,$180.18 ,$180.18 ,$180.18 ,$207.90 , N/A ,$207.90 , N/A ,$231.00 ,$151.31 , N/A ,$96.26 , N/A , N/A , N/A ,$207.90 , N/A ,$142.53 ,$64.68 ,$207.90 , N/A , N/A , N/A , N/A ,$150.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180474,99465,PC NEWBORN RESUSCITATION,981,1 ,$459.00 ,$298.35 ,$128.52 ,"$1,285.45 ",$459.00 ,$341.96 ,$300.65 ,$459.00 ,$128.52 ,$231.80 ,$459.00 ,$283.20 ,$459.00 ,$283.20 ,$283.20 ,$459.00 ,$283.20 ,"$1,127.00 ",$413.10 ,$344.25 ,$459.00 ,$459.00 ,$403.92 ,$459.00 ,$344.25 ,$344.25 ,$390.15 ,$390.15 ,$459.00 ,$390.15 ,$459.00 ,$358.02 ,$358.02 ,$358.02 ,$413.10 ,$459.00 ,$413.10 ,$459.00 ,$459.00 ,$300.65 ,$459.00 ,$188.58 ,$459.00 ,$459.00 ,$459.00 ,$413.10 ,"$1,285.45 ",$283.20 ,$128.52 ,$413.10 ,$459.00 , N/A , N/A ,$459.00 ,$298.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180480,11055,PC PARING LESION BENIGN SINGLE,981,1 ,$128.49 ,$83.52 ,$28.37 ,$410.91 ,$128.49 ,$95.73 ,$84.16 ,$128.49 ,$35.98 ,$64.89 ,$128.49 ,$79.28 ,$128.49 ,$79.28 ,$79.28 ,$128.49 ,$79.28 ,$360.26 ,$115.64 ,$96.37 ,$128.49 ,$128.49 ,$113.07 ,$128.49 ,$96.37 ,$96.37 ,$109.22 ,$109.22 ,$128.49 ,$109.22 ,$128.49 ,$100.22 ,$100.22 ,$100.22 ,$115.64 ,$128.49 ,$115.64 ,$128.49 ,$128.49 ,$84.16 ,$128.49 ,$28.37 ,$128.49 ,$128.49 ,$128.49 ,$115.64 ,$410.91 ,$79.28 ,$35.98 ,$115.64 ,$128.49 , N/A , N/A ,$128.49 ,$83.52 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180481,11056,PC PARING LESION BENIGN 2-4 LESIONS,981,1 ,$153.97 ,$100.08 ,$41.38 ,$410.91 ,$153.97 ,$114.71 ,$100.85 ,$153.97 ,$43.11 ,$77.75 ,$153.97 ,$95.00 ,$153.97 ,$95.00 ,$95.00 ,$153.97 ,$95.00 ,$360.26 ,$138.57 ,$115.48 ,$153.97 ,$153.97 ,$135.49 ,$153.97 ,$115.48 ,$115.48 ,$130.87 ,$130.87 ,$153.97 ,$130.87 ,$153.97 ,$120.10 ,$120.10 ,$120.10 ,$138.57 ,$153.97 ,$138.57 ,$153.97 ,$153.97 ,$100.85 ,$153.97 ,$41.38 ,$153.97 ,$153.97 ,$153.97 ,$138.57 ,$410.91 ,$95.00 ,$43.11 ,$138.57 ,$153.97 , N/A , N/A ,$153.97 ,$100.08 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180482,11057,PC PARING LESION BENIGN 4+ LESIONS,981,1 ,$182.77 ,$118.80 ,$51.18 ,$410.91 ,$182.77 ,$136.16 ,$119.71 ,$182.77 ,$51.18 ,$92.30 ,$182.77 ,$112.77 ,$182.77 ,$112.77 ,$112.77 ,$182.77 ,$112.77 ,$360.26 ,$164.49 ,$137.08 ,$182.77 ,$182.77 ,$160.84 ,$182.77 ,$137.08 ,$137.08 ,$155.35 ,$155.35 ,$182.77 ,$155.35 ,$182.77 ,$142.56 ,$142.56 ,$142.56 ,$164.49 ,$182.77 ,$164.49 ,$182.77 ,$182.77 ,$119.71 ,$182.77 ,$52.34 ,$182.77 ,$182.77 ,$182.77 ,$164.49 ,$410.91 ,$112.77 ,$51.18 ,$164.49 ,$182.77 , N/A , N/A ,$182.77 ,$118.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180497,11732,PC AVULSION NAIL PLATE EA ADDL,981,1 ,$116.31 ,$75.60 ,$30.79 ,$116.31 , N/A ,$86.65 ,$76.18 , N/A ,$32.57 ,$58.74 , N/A ,$71.76 , N/A ,$71.76 ,$71.76 , N/A ,$71.76 , N/A ,$104.68 ,$87.23 , N/A , N/A ,$102.35 , N/A ,$87.23 ,$87.23 ,$98.86 ,$98.86 , N/A ,$98.86 , N/A ,$90.72 ,$90.72 ,$90.72 ,$104.68 , N/A ,$104.68 , N/A ,$116.31 ,$76.18 , N/A ,$30.79 ,$116.31 ,$116.31 , N/A ,$104.68 , N/A ,$71.76 ,$32.57 ,$104.68 , N/A , N/A , N/A , N/A ,$75.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180524,36400,PC IV START < 3 YEARS OLD,981,1 ,$57.00 ,$37.05 ,$15.96 ,$57.00 , N/A ,$42.47 ,$37.34 , N/A ,$15.96 ,$28.79 , N/A ,$35.17 , N/A ,$35.17 ,$35.17 , N/A ,$35.17 , N/A ,$51.30 ,$42.75 , N/A , N/A ,$50.16 , N/A ,$42.75 ,$42.75 ,$48.45 ,$48.45 , N/A ,$48.45 , N/A ,$44.46 ,$44.46 ,$44.46 ,$51.30 , N/A ,$51.30 , N/A ,$57.00 ,$37.34 , N/A ,$33.05 , N/A , N/A , N/A ,$51.30 , N/A ,$35.17 ,$15.96 ,$51.30 , N/A , N/A , N/A , N/A ,$37.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180525,36405,PC IV START < 3 YEARS OLD SCALP VEIN,981,1 ,$51.00 ,$33.15 ,$14.28 ,$51.00 , N/A ,$38.00 ,$33.41 , N/A ,$14.28 ,$25.76 , N/A ,$31.47 , N/A ,$31.47 ,$31.47 , N/A ,$31.47 , N/A ,$45.90 ,$38.25 , N/A , N/A ,$44.88 , N/A ,$38.25 ,$38.25 ,$43.35 ,$43.35 , N/A ,$43.35 , N/A ,$39.78 ,$39.78 ,$39.78 ,$45.90 , N/A ,$45.90 , N/A ,$51.00 ,$33.41 , N/A ,$26.86 , N/A , N/A , N/A ,$45.90 , N/A ,$31.47 ,$14.28 ,$45.90 , N/A , N/A , N/A , N/A ,$33.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180526,36406,PC IV START < 3 YEARS OLD OTHER VEIN,981,1 ,$27.00 ,$17.55 ,$7.56 ,$27.00 , N/A ,$20.12 ,$17.69 , N/A ,$7.56 ,$13.64 , N/A ,$16.66 , N/A ,$16.66 ,$16.66 , N/A ,$16.66 , N/A ,$24.30 ,$20.25 , N/A , N/A ,$23.76 , N/A ,$20.25 ,$20.25 ,$22.95 ,$22.95 , N/A ,$22.95 , N/A ,$21.06 ,$21.06 ,$21.06 ,$24.30 , N/A ,$24.30 , N/A ,$27.00 ,$17.69 , N/A ,$15.26 ,$27.00 ,$27.00 , N/A ,$24.30 , N/A ,$16.66 ,$7.56 ,$24.30 , N/A , N/A , N/A , N/A ,$17.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180527,36410,PC VENIPUNCTURE > AGE 3,981,1 ,$30.00 ,$19.50 ,$8.40 ,$30.00 , N/A ,$22.35 ,$19.65 , N/A ,$8.40 ,$15.15 , N/A ,$18.51 , N/A ,$18.51 ,$18.51 , N/A ,$18.51 , N/A ,$27.00 ,$22.50 , N/A , N/A ,$26.40 , N/A ,$22.50 ,$22.50 ,$25.50 ,$25.50 , N/A ,$25.50 , N/A ,$23.40 ,$23.40 ,$23.40 ,$27.00 , N/A ,$27.00 , N/A ,$30.00 ,$19.65 , N/A ,$16.56 ,$30.00 ,$30.00 , N/A ,$27.00 , N/A ,$18.51 ,$8.40 ,$27.00 , N/A , N/A , N/A , N/A ,$19.50 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180530,36600,PC ARTERIAL PUNCTURE,981,1 ,$48.00 ,$31.20 ,$13.44 ,$258.02 ,$48.00 ,$35.76 ,$31.44 ,$48.00 ,$13.44 ,$24.24 ,$48.00 ,$29.62 ,$48.00 ,$29.62 ,$29.62 ,$48.00 ,$29.62 ,$226.21 ,$43.20 ,$36.00 ,$48.00 ,$48.00 ,$42.24 ,$48.00 ,$36.00 ,$36.00 ,$40.80 ,$40.80 ,$48.00 ,$40.80 ,$48.00 ,$37.44 ,$37.44 ,$37.44 ,$43.20 ,$48.00 ,$43.20 ,$48.00 ,$48.00 ,$31.44 ,$48.00 ,$27.65 ,$35.30 ,$33.69 ,$48.00 ,$43.20 ,$258.02 ,$29.62 ,$13.44 ,$43.20 ,$48.00 , N/A , N/A ,$48.00 ,$31.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180532,36680,PC PLACE NDL INFS INTRAOSSEOUS,981,1 ,$183.00 ,$118.95 ,$51.24 ,$621.02 ,$183.00 ,$136.34 ,$119.87 ,$183.00 ,$51.24 ,$92.42 ,$183.00 ,$112.91 ,$183.00 ,$112.91 ,$112.91 ,$183.00 ,$112.91 ,$544.46 ,$164.70 ,$137.25 ,$183.00 ,$183.00 ,$161.04 ,$183.00 ,$137.25 ,$137.25 ,$155.55 ,$155.55 ,$183.00 ,$155.55 ,$183.00 ,$142.74 ,$142.74 ,$142.74 ,$164.70 ,$183.00 ,$164.70 ,$183.00 ,$183.00 ,$119.87 ,$183.00 ,$108.68 ,$183.00 ,$183.00 ,$183.00 ,$164.70 ,$621.02 ,$112.91 ,$51.24 ,$164.70 ,$183.00 , N/A , N/A ,$183.00 ,$118.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180603,69210,PC REMOVE CERUMEN IMPACTED W/INSTRUMENT,981,1 ,$142.00 ,$92.30 ,$39.76 ,$142.00 ,$141.09 ,$105.79 ,$93.01 ,$58.77 ,$39.76 ,$71.71 ,$58.77 ,$87.61 ,$58.77 ,$87.61 ,$87.61 ,$58.77 ,$87.61 ,$111.66 ,$127.80 ,$106.50 ,$141.09 ,$58.77 ,$124.96 ,$58.77 ,$106.50 ,$106.50 ,$120.70 ,$120.70 ,$58.77 ,$120.70 ,$58.77 ,$110.76 ,$110.76 ,$110.76 ,$127.80 ,$141.09 ,$127.80 ,$58.77 ,$142.00 ,$93.01 ,$58.77 ,$59.05 ,$86.96 ,$83.00 ,$61.52 ,$127.80 ,$127.37 ,$87.61 ,$39.76 ,$127.80 ,$58.77 , N/A , N/A ,$58.77 ,$92.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180861,36000,PC IV START > 3YR OLD,981,1 ,$28.00 ,$18.20 ,$7.84 ,$28.00 , N/A ,$20.86 ,$18.34 , N/A ,$7.84 ,$14.14 , N/A ,$17.28 , N/A ,$17.28 ,$17.28 , N/A ,$17.28 , N/A ,$25.20 ,$21.00 , N/A , N/A ,$24.64 , N/A ,$21.00 ,$21.00 ,$23.80 ,$23.80 , N/A ,$23.80 , N/A ,$21.84 ,$21.84 ,$21.84 ,$25.20 , N/A ,$25.20 , N/A ,$28.00 ,$18.34 , N/A ,$15.82 ,$28.00 ,$28.00 , N/A ,$25.20 , N/A ,$17.28 ,$7.84 ,$25.20 , N/A , N/A , N/A , N/A ,$18.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180864,51702,PC INSERT CATH BLADDER SIMPLE,981,1 ,$78.00 ,$50.70 ,$21.84 ,$258.02 ,$78.00 ,$58.11 ,$51.09 ,$78.00 ,$21.84 ,$39.39 ,$78.00 ,$48.13 ,$78.00 ,$48.13 ,$48.13 ,$78.00 ,$48.13 ,$226.21 ,$70.20 ,$58.50 ,$78.00 ,$78.00 ,$68.64 ,$78.00 ,$58.50 ,$58.50 ,$66.30 ,$66.30 ,$78.00 ,$66.30 ,$78.00 ,$60.84 ,$60.84 ,$60.84 ,$70.20 ,$78.00 ,$70.20 ,$78.00 ,$78.00 ,$51.09 ,$78.00 ,$45.51 ,$78.00 ,$78.00 ,$78.00 ,$70.20 ,$258.02 ,$48.13 ,$21.84 ,$70.20 ,$78.00 , N/A , N/A ,$78.00 ,$50.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180944,69210,PC REMOVE CERUMEN IMPACTED W/INSTRUMENT-LT,981,1 ,$142.00 ,$92.30 ,$39.76 ,$142.00 ,$141.09 ,$105.79 ,$93.01 ,$58.77 ,$39.76 ,$71.71 ,$58.77 ,$87.61 ,$58.77 ,$87.61 ,$87.61 ,$58.77 ,$87.61 ,$111.66 ,$127.80 ,$106.50 ,$141.09 ,$58.77 ,$124.96 ,$58.77 ,$106.50 ,$106.50 ,$120.70 ,$120.70 ,$58.77 ,$120.70 ,$58.77 ,$110.76 ,$110.76 ,$110.76 ,$127.80 ,$141.09 ,$127.80 ,$58.77 ,$142.00 ,$93.01 ,$58.77 ,$59.05 ,$86.96 ,$83.00 ,$61.52 ,$127.80 ,$127.37 ,$87.61 ,$39.76 ,$127.80 ,$58.77 , N/A , N/A ,$58.77 ,$92.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180945,69210,PC REMOVE CERUMEN IMPACTED W/INSTRUMENT-RT,981,1 ,$142.00 ,$92.30 ,$39.76 ,$142.00 ,$141.09 ,$105.79 ,$93.01 ,$58.77 ,$39.76 ,$71.71 ,$58.77 ,$87.61 ,$58.77 ,$87.61 ,$87.61 ,$58.77 ,$87.61 ,$111.66 ,$127.80 ,$106.50 ,$141.09 ,$58.77 ,$124.96 ,$58.77 ,$106.50 ,$106.50 ,$120.70 ,$120.70 ,$58.77 ,$120.70 ,$58.77 ,$110.76 ,$110.76 ,$110.76 ,$127.80 ,$141.09 ,$127.80 ,$58.77 ,$142.00 ,$93.01 ,$58.77 ,$59.05 ,$86.96 ,$83.00 ,$61.52 ,$127.80 ,$127.37 ,$87.61 ,$39.76 ,$127.80 ,$58.77 , N/A , N/A ,$58.77 ,$92.30 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180960,11105,PC BIOPSY SKIN PUNCH ADDL LESN,981,1 ,$88.62 ,$57.60 ,$24.81 ,$88.62 , N/A ,$66.02 ,$58.05 , N/A ,$24.81 ,$44.75 , N/A ,$54.68 , N/A ,$54.68 ,$54.68 , N/A ,$54.68 , N/A ,$79.76 ,$66.47 , N/A , N/A ,$77.99 , N/A ,$66.47 ,$66.47 ,$75.33 ,$75.33 , N/A ,$75.33 , N/A ,$69.12 ,$69.12 ,$69.12 ,$79.76 , N/A ,$79.76 , N/A ,$88.62 ,$58.05 , N/A ,$46.21 ,$88.62 ,$88.62 , N/A ,$79.76 , N/A ,$54.68 ,$24.81 ,$79.76 , N/A , N/A , N/A , N/A ,$57.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98180963,11104,PC BIOPSY SKIN PUNCH INIT LESN,981,1 ,$342.24 ,$222.46 ,$85.10 ,$790.90 ,$342.24 ,$254.97 ,$224.17 ,$342.24 ,$95.83 ,$172.83 ,$342.24 ,$211.16 ,$342.24 ,$211.16 ,$211.16 ,$342.24 ,$211.16 ,$693.41 ,$308.02 ,$256.68 ,$342.24 ,$342.24 ,$301.17 ,$342.24 ,$256.68 ,$256.68 ,$290.90 ,$290.90 ,$342.24 ,$290.90 ,$342.24 ,$266.95 ,$266.95 ,$266.95 ,$308.02 ,$342.24 ,$308.02 ,$342.24 ,$342.24 ,$224.17 ,$342.24 ,$85.10 ,$342.24 ,$342.24 ,$342.24 ,$308.02 ,$790.90 ,$211.16 ,$95.83 ,$308.02 ,$342.24 , N/A , N/A ,$342.24 ,$222.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200002,99202,PC CLINIC VISIT LIMITED NEW PRO,982,1 ,$152.57 ,$99.17 ,$42.72 ,$152.57 , N/A ,$113.66 ,$99.93 , N/A ,$42.72 ,$77.05 , N/A ,$94.14 , N/A ,$94.14 ,$94.14 , N/A ,$94.14 , N/A ,$137.31 ,$114.43 , N/A , N/A ,$134.26 , N/A ,$114.43 ,$114.43 ,$129.68 ,$129.68 , N/A ,$129.68 , N/A ,$119.00 ,$119.00 ,$119.00 ,$137.31 , N/A ,$137.31 , N/A ,$78.75 ,$99.93 , N/A ,$65.28 ,$102.37 ,$97.71 , N/A ,$137.31 , N/A ,$94.14 ,$42.72 ,$137.31 , N/A , N/A , N/A , N/A ,$99.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200003,99203,PC CLINIC VISIT INTERM NEW PRO,982,1 ,$233.45 ,$151.74 ,$65.37 ,$233.45 , N/A ,$173.92 ,$152.91 , N/A ,$65.37 ,$117.89 , N/A ,$144.04 , N/A ,$144.04 ,$144.04 , N/A ,$144.04 , N/A ,$210.11 ,$175.09 , N/A , N/A ,$205.44 , N/A ,$175.09 ,$175.09 ,$198.43 ,$198.43 , N/A ,$198.43 , N/A ,$182.09 ,$182.09 ,$182.09 ,$210.11 , N/A ,$210.11 , N/A ,$121.24 ,$152.91 , N/A ,$97.74 ,$102.37 ,$97.71 , N/A ,$210.11 , N/A ,$144.04 ,$65.37 ,$210.11 , N/A , N/A , N/A , N/A ,$151.74 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200004,99204,PC CLINIC VISIT COMPLEX NEW PRO,982,1 ,$315.11 ,$204.82 ,$88.23 ,$315.11 , N/A ,$234.76 ,$206.40 , N/A ,$88.23 ,$159.13 , N/A ,$194.42 , N/A ,$194.42 ,$194.42 , N/A ,$194.42 , N/A ,$283.60 ,$236.33 , N/A , N/A ,$277.30 , N/A ,$236.33 ,$236.33 ,$267.84 ,$267.84 , N/A ,$267.84 , N/A ,$245.79 ,$245.79 ,$245.79 ,$283.60 , N/A ,$283.60 , N/A ,$181.05 ,$206.40 , N/A ,$167.14 ,$102.37 ,$97.71 , N/A ,$283.60 , N/A ,$194.42 ,$88.23 ,$283.60 , N/A , N/A , N/A , N/A ,$204.82 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200005,99205,PC CLINIC VISIT COMPREH NEW PRO,982,1 ,$414.00 ,$269.10 ,$97.71 ,$414.00 , N/A ,$308.43 ,$271.17 , N/A ,$115.92 ,$209.07 , N/A ,$255.44 , N/A ,$255.44 ,$255.44 , N/A ,$255.44 , N/A ,$372.60 ,$310.50 , N/A , N/A ,$364.32 , N/A ,$310.50 ,$310.50 ,$351.90 ,$351.90 , N/A ,$351.90 , N/A ,$322.92 ,$322.92 ,$322.92 ,$372.60 , N/A ,$372.60 , N/A ,$239.15 ,$271.17 , N/A ,$218.17 ,$102.37 ,$97.71 , N/A ,$372.60 , N/A ,$255.44 ,$115.92 ,$372.60 , N/A , N/A , N/A , N/A ,$269.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200006,99211,PC CLINIC VISIT BRIEF EST PRO,982,1 ,$52.90 ,$34.39 ,$11.83 ,$52.90 , N/A ,$39.41 ,$34.65 , N/A ,$14.81 ,$26.71 , N/A ,$32.64 , N/A ,$32.64 ,$32.64 , N/A ,$32.64 , N/A ,$47.61 ,$39.68 , N/A , N/A ,$46.55 , N/A ,$39.68 ,$39.68 ,$44.97 ,$44.97 , N/A ,$44.97 , N/A ,$41.26 ,$41.26 ,$41.26 ,$47.61 , N/A ,$47.61 , N/A ,$52.90 ,$34.65 , N/A ,$11.83 ,$52.90 ,$52.90 , N/A ,$47.61 , N/A ,$32.64 ,$14.81 ,$47.61 , N/A , N/A , N/A , N/A ,$34.39 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200007,99212,PC CLINIC VISIT LIMIT EST PRO,982,1 ,$112.70 ,$73.26 ,$31.56 ,$112.70 , N/A ,$83.96 ,$73.82 , N/A ,$31.56 ,$56.91 , N/A ,$69.54 , N/A ,$69.54 ,$69.54 , N/A ,$69.54 , N/A ,$101.43 ,$84.53 , N/A , N/A ,$99.18 , N/A ,$84.53 ,$84.53 ,$95.80 ,$95.80 , N/A ,$95.80 , N/A ,$87.91 ,$87.91 ,$87.91 ,$101.43 , N/A ,$101.43 , N/A ,$60.02 ,$73.82 , N/A ,$33.40 ,$102.37 ,$97.71 , N/A ,$101.43 , N/A ,$69.54 ,$31.56 ,$101.43 , N/A , N/A , N/A , N/A ,$73.26 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200008,99213,PC CLINIC VISIT INTERM EST PRO,982,1 ,$186.30 ,$121.10 ,$52.16 ,$186.30 , N/A ,$138.79 ,$122.03 , N/A ,$52.16 ,$94.08 , N/A ,$114.95 , N/A ,$114.95 ,$114.95 , N/A ,$114.95 , N/A ,$167.67 ,$139.73 , N/A , N/A ,$163.94 , N/A ,$139.73 ,$139.73 ,$158.36 ,$158.36 , N/A ,$158.36 , N/A ,$145.31 ,$145.31 ,$145.31 ,$167.67 , N/A ,$167.67 , N/A ,$97.92 ,$122.03 , N/A ,$66.15 ,$102.37 ,$97.71 , N/A ,$167.67 , N/A ,$114.95 ,$52.16 ,$167.67 , N/A , N/A , N/A , N/A ,$121.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200009,99214,PC CLINIC VISIT COMPLX EST PRO,982,1 ,$278.30 ,$180.90 ,$77.92 ,$278.30 , N/A ,$207.33 ,$182.29 , N/A ,$77.92 ,$140.54 , N/A ,$171.71 , N/A ,$171.71 ,$171.71 , N/A ,$171.71 , N/A ,$250.47 ,$208.73 , N/A , N/A ,$244.90 , N/A ,$208.73 ,$208.73 ,$236.56 ,$236.56 , N/A ,$236.56 , N/A ,$217.07 ,$217.07 ,$217.07 ,$250.47 , N/A ,$250.47 , N/A ,$278.30 ,$182.29 , N/A ,$101.60 ,$102.37 ,$97.71 , N/A ,$250.47 , N/A ,$171.71 ,$77.92 ,$250.47 , N/A , N/A , N/A , N/A ,$180.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200010,99215,PC CLINIC VISIT COMPRH EST PRO,982,1 ,$334.92 ,$217.70 ,$93.78 ,$334.92 , N/A ,$249.52 ,$219.37 , N/A ,$93.78 ,$169.13 , N/A ,$206.65 , N/A ,$206.65 ,$206.65 , N/A ,$206.65 , N/A ,$301.43 ,$251.19 , N/A , N/A ,$294.73 , N/A ,$251.19 ,$251.19 ,$284.68 ,$284.68 , N/A ,$284.68 , N/A ,$261.24 ,$261.24 ,$261.24 ,$301.43 , N/A ,$301.43 , N/A ,$334.92 ,$219.37 , N/A ,$143.41 ,$102.37 ,$97.71 , N/A ,$301.43 , N/A ,$206.65 ,$93.78 ,$301.43 , N/A , N/A , N/A , N/A ,$217.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200011,93922,PC DOPPLER ARTERIAL EXTREMITY LIMITED- 26,982,1 ,$67.00 ,$43.55 ,$18.76 ,$258.02 ,$67.00 ,$49.92 ,$43.89 ,$67.00 ,$18.76 ,$33.84 ,$67.00 ,$41.34 ,$67.00 ,$41.34 ,$41.34 ,$67.00 ,$41.34 ,$226.21 ,$60.30 ,$50.25 ,$67.00 ,$67.00 ,$58.96 ,$67.00 ,$50.25 ,$50.25 ,$56.95 ,$56.95 ,$67.00 ,$56.95 ,$67.00 ,$52.26 ,$52.26 ,$52.26 ,$60.30 ,$67.00 ,$60.30 ,$67.00 ,$67.00 ,$43.89 ,$67.00 ,$23.86 ,$67.00 ,$67.00 ,$67.00 ,$60.30 ,$258.02 ,$41.34 ,$18.76 ,$60.30 ,$67.00 , N/A , N/A ,$67.00 ,$43.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200012,93923,PC DOPPLER ARTERIAL EXTREMITY COMPLETE-26,982,1 ,$94.00 ,$61.10 ,$26.32 ,$319.47 ,$94.00 ,$70.03 ,$61.57 ,$94.00 ,$26.32 ,$47.47 ,$94.00 ,$58.00 ,$94.00 ,$58.00 ,$58.00 ,$94.00 ,$58.00 ,$280.10 ,$84.60 ,$70.50 ,$94.00 ,$94.00 ,$82.72 ,$94.00 ,$70.50 ,$70.50 ,$79.90 ,$79.90 ,$94.00 ,$79.90 ,$94.00 ,$73.32 ,$73.32 ,$73.32 ,$84.60 ,$94.00 ,$84.60 ,$94.00 ,$94.00 ,$61.57 ,$94.00 ,$41.78 ,$94.00 ,$94.00 ,$94.00 ,$84.60 ,$319.47 ,$58.00 ,$26.32 ,$84.60 ,$94.00 , N/A , N/A ,$94.00 ,$61.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200013,93922,PC DOPPLER ARTERIAL EXTREMITY LIMITED,982,1 ,$67.00 ,$43.55 ,$18.76 ,$258.02 ,$67.00 ,$49.92 ,$43.89 ,$67.00 ,$18.76 ,$33.84 ,$67.00 ,$41.34 ,$67.00 ,$41.34 ,$41.34 ,$67.00 ,$41.34 ,$226.21 ,$60.30 ,$50.25 ,$67.00 ,$67.00 ,$58.96 ,$67.00 ,$50.25 ,$50.25 ,$56.95 ,$56.95 ,$67.00 ,$56.95 ,$67.00 ,$52.26 ,$52.26 ,$52.26 ,$60.30 ,$67.00 ,$60.30 ,$67.00 ,$67.00 ,$43.89 ,$67.00 ,$67.00 ,$67.00 ,$67.00 ,$67.00 ,$60.30 ,$258.02 ,$41.34 ,$18.76 ,$60.30 ,$67.00 , N/A , N/A ,$67.00 ,$43.55 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200014,93880,PC DUPLEX CAROTID BILAT COMPLETE-26,982,1 ,$53.67 ,$34.89 ,$15.03 ,$526.52 ,$53.67 ,$39.98 ,$35.15 ,$53.67 ,$15.03 ,$27.10 ,$53.67 ,$33.11 ,$53.67 ,$33.11 ,$33.11 ,$53.67 ,$33.11 ,$461.62 ,$48.30 ,$40.25 ,$53.67 ,$53.67 ,$47.23 ,$53.67 ,$40.25 ,$40.25 ,$45.62 ,$45.62 ,$53.67 ,$45.62 ,$53.67 ,$41.86 ,$41.86 ,$41.86 ,$48.30 ,$53.67 ,$48.30 ,$53.67 ,$53.67 ,$35.15 ,$53.67 ,$53.67 ,$53.67 ,$53.67 ,$53.67 ,$48.30 ,$526.52 ,$33.11 ,$15.03 ,$48.30 ,$53.67 , N/A , N/A ,$53.67 ,$34.89 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200015,93924,PC DOPPLER ARTERY LWR EXT STRESS-26,982,1 ,$30.85 ,$20.05 ,$8.64 ,$605.59 ,$30.85 ,$22.98 ,$20.21 ,$30.85 ,$8.64 ,$15.58 ,$30.85 ,$19.03 ,$30.85 ,$19.03 ,$19.03 ,$30.85 ,$19.03 ,$530.94 ,$27.77 ,$23.14 ,$30.85 ,$30.85 ,$27.15 ,$30.85 ,$23.14 ,$23.14 ,$26.22 ,$26.22 ,$30.85 ,$26.22 ,$30.85 ,$24.06 ,$24.06 ,$24.06 ,$27.77 ,$30.85 ,$27.77 ,$30.85 ,$30.85 ,$20.21 ,$30.85 ,$30.85 ,$30.85 ,$30.85 ,$30.85 ,$27.77 ,$605.59 ,$19.03 ,$8.64 ,$27.77 ,$30.85 , N/A , N/A ,$30.85 ,$20.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200016,93925,PC DUPLEX ARTERIAL LWR EXT CMPL BILAT-26,982,1 ,$73.62 ,$47.85 ,$20.61 ,$526.52 ,$73.62 ,$54.85 ,$48.22 ,$73.62 ,$20.61 ,$37.18 ,$73.62 ,$45.42 ,$73.62 ,$45.42 ,$45.42 ,$73.62 ,$45.42 ,$461.62 ,$66.26 ,$55.22 ,$73.62 ,$73.62 ,$64.79 ,$73.62 ,$55.22 ,$55.22 ,$62.58 ,$62.58 ,$73.62 ,$62.58 ,$73.62 ,$57.42 ,$57.42 ,$57.42 ,$66.26 ,$73.62 ,$66.26 ,$73.62 ,$73.62 ,$48.22 ,$73.62 ,$73.13 ,$73.62 ,$73.62 ,$73.62 ,$66.26 ,$526.52 ,$45.42 ,$20.61 ,$66.26 ,$73.62 , N/A , N/A ,$73.62 ,$47.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200017,93926,PC DUPLEX ARTERIAL LWR EXT UNILAT/LIMITED-26,982,1 ,$32.66 ,$21.23 ,$9.14 ,$249.12 ,$32.66 ,$24.33 ,$21.39 ,$32.66 ,$9.14 ,$16.49 ,$32.66 ,$20.15 ,$32.66 ,$20.15 ,$20.15 ,$32.66 ,$20.15 ,$218.41 ,$29.39 ,$24.50 ,$32.66 ,$32.66 ,$28.74 ,$32.66 ,$24.50 ,$24.50 ,$27.76 ,$27.76 ,$32.66 ,$27.76 ,$32.66 ,$25.47 ,$25.47 ,$25.47 ,$29.39 ,$32.66 ,$29.39 ,$32.66 ,$32.66 ,$21.39 ,$32.66 ,$32.66 ,$32.66 ,$32.66 ,$32.66 ,$29.39 ,$249.12 ,$20.15 ,$9.14 ,$29.39 ,$32.66 , N/A , N/A ,$32.66 ,$21.23 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200018,93930,PC DUPLEX ARTERIAL UPR EXT CMPL BILAT-26,982,1 ,$64.11 ,$41.67 ,$17.95 ,$526.52 ,$64.11 ,$47.76 ,$41.99 ,$64.11 ,$17.95 ,$32.38 ,$64.11 ,$39.56 ,$64.11 ,$39.56 ,$39.56 ,$64.11 ,$39.56 ,$461.62 ,$57.70 ,$48.08 ,$64.11 ,$64.11 ,$56.42 ,$64.11 ,$48.08 ,$48.08 ,$54.49 ,$54.49 ,$64.11 ,$54.49 ,$64.11 ,$50.01 ,$50.01 ,$50.01 ,$57.70 ,$64.11 ,$57.70 ,$64.11 ,$64.11 ,$41.99 ,$64.11 ,$64.11 ,$64.11 ,$64.11 ,$64.11 ,$57.70 ,$526.52 ,$39.56 ,$17.95 ,$57.70 ,$64.11 , N/A , N/A ,$64.11 ,$41.67 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200019,93931,PC DUPLEX ARTERIAL UPR EXT UNILAT/LIMITED-26,982,1 ,$28.51 ,$18.53 ,$7.98 ,$249.12 ,$28.51 ,$21.24 ,$18.67 ,$28.51 ,$7.98 ,$14.40 ,$28.51 ,$17.59 ,$28.51 ,$17.59 ,$17.59 ,$28.51 ,$17.59 ,$218.41 ,$25.66 ,$21.38 ,$28.51 ,$28.51 ,$25.09 ,$28.51 ,$21.38 ,$21.38 ,$24.23 ,$24.23 ,$28.51 ,$24.23 ,$28.51 ,$22.24 ,$22.24 ,$22.24 ,$25.66 ,$28.51 ,$25.66 ,$28.51 ,$28.51 ,$18.67 ,$28.51 ,$28.51 ,$28.51 ,$28.51 ,$28.51 ,$25.66 ,$249.12 ,$17.59 ,$7.98 ,$25.66 ,$28.51 , N/A , N/A ,$28.51 ,$18.53 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200020,93970,PC DUPLEX VENOUS EXT CMPL BILAT-26,982,1 ,$83.69 ,$54.40 ,$23.43 ,$526.52 ,$83.69 ,$62.35 ,$54.82 ,$83.69 ,$23.43 ,$42.26 ,$83.69 ,$51.64 ,$83.69 ,$51.64 ,$51.64 ,$83.69 ,$51.64 ,$461.62 ,$75.32 ,$62.77 ,$83.69 ,$83.69 ,$73.65 ,$83.69 ,$62.77 ,$62.77 ,$71.14 ,$71.14 ,$83.69 ,$71.14 ,$83.69 ,$65.28 ,$65.28 ,$65.28 ,$75.32 ,$83.69 ,$75.32 ,$83.69 ,$83.69 ,$54.82 ,$83.69 ,$64.66 ,$83.69 ,$83.69 ,$83.69 ,$75.32 ,$526.52 ,$51.64 ,$23.43 ,$75.32 ,$83.69 , N/A , N/A ,$83.69 ,$54.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200021,93971,PC DUPLEX VENOUS EXT UNILAT/LIMITED-26,982,1 ,$45.10 ,$29.32 ,$12.63 ,$249.12 ,$45.10 ,$33.60 ,$29.54 ,$45.10 ,$12.63 ,$22.78 ,$45.10 ,$27.83 ,$45.10 ,$27.83 ,$27.83 ,$45.10 ,$27.83 ,$218.41 ,$40.59 ,$33.83 ,$45.10 ,$45.10 ,$39.69 ,$45.10 ,$33.83 ,$33.83 ,$38.34 ,$38.34 ,$45.10 ,$38.34 ,$45.10 ,$35.18 ,$35.18 ,$35.18 ,$40.59 ,$45.10 ,$40.59 ,$45.10 ,$45.10 ,$29.54 ,$45.10 ,$41.41 ,$45.10 ,$45.10 ,$45.10 ,$40.59 ,$249.12 ,$27.83 ,$12.63 ,$40.59 ,$45.10 , N/A , N/A ,$45.10 ,$29.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200022,93975,PC DUPLEX ABD/PEL/RETRO CMPL-26,982,1 ,$115.20 ,$74.88 ,$32.26 ,$526.52 ,$115.20 ,$85.82 ,$75.46 ,$115.20 ,$32.26 ,$58.18 ,$115.20 ,$71.08 ,$115.20 ,$71.08 ,$71.08 ,$115.20 ,$71.08 ,$461.62 ,$103.68 ,$86.40 ,$115.20 ,$115.20 ,$101.38 ,$115.20 ,$86.40 ,$86.40 ,$97.92 ,$97.92 ,$115.20 ,$97.92 ,$115.20 ,$89.86 ,$89.86 ,$89.86 ,$103.68 ,$115.20 ,$103.68 ,$115.20 ,$115.20 ,$75.46 ,$115.20 ,$107.34 ,$110.75 ,$105.71 ,$115.20 ,$103.68 ,$526.52 ,$71.08 ,$32.26 ,$103.68 ,$115.20 , N/A , N/A ,$115.20 ,$74.88 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200023,93976,PC DUPLEX ABD/PEL/RETRO LIMITED-26,982,1 ,$86.40 ,$56.16 ,$24.19 ,$249.12 ,$86.40 ,$64.37 ,$56.59 ,$86.40 ,$24.19 ,$43.63 ,$86.40 ,$53.31 ,$86.40 ,$53.31 ,$53.31 ,$86.40 ,$53.31 ,$218.41 ,$77.76 ,$64.80 ,$86.40 ,$86.40 ,$76.03 ,$86.40 ,$64.80 ,$64.80 ,$73.44 ,$73.44 ,$86.40 ,$73.44 ,$86.40 ,$67.39 ,$67.39 ,$67.39 ,$77.76 ,$86.40 ,$77.76 ,$86.40 ,$86.40 ,$56.59 ,$86.40 ,$74.16 ,$86.40 ,$86.40 ,$86.40 ,$77.76 ,$249.12 ,$53.31 ,$24.19 ,$77.76 ,$86.40 , N/A , N/A ,$86.40 ,$56.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200024,93978,PC DUPLEX AORTA/IVC/GRAFT CMPL-26,982,1 ,$251.45 ,$163.44 ,$70.41 ,$526.52 ,$251.45 ,$187.33 ,$164.70 ,$242.96 ,$70.41 ,$126.98 ,$242.96 ,$155.14 ,$242.96 ,$155.14 ,$155.14 ,$242.96 ,$155.14 ,$461.62 ,$226.31 ,$188.59 ,$251.45 ,$242.96 ,$221.28 ,$242.96 ,$188.59 ,$188.59 ,$213.73 ,$213.73 ,$242.96 ,$213.73 ,$242.96 ,$196.13 ,$196.13 ,$196.13 ,$226.31 ,$251.45 ,$226.31 ,$242.96 ,$251.45 ,$164.70 ,$242.96 ,$74.30 ,$110.75 ,$105.71 ,$251.45 ,$226.31 ,$526.52 ,$155.14 ,$70.41 ,$226.31 ,$242.96 , N/A , N/A ,$242.96 ,$163.44 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200025,93979,PC DUPLEX AORTA/IVC/GRAFT LIMITED-26,982,1 ,$172.80 ,$112.32 ,$46.50 ,$249.12 ,$172.80 ,$128.74 ,$113.18 ,$114.95 ,$48.38 ,$87.26 ,$114.95 ,$106.62 ,$114.95 ,$106.62 ,$106.62 ,$114.95 ,$106.62 ,$218.41 ,$155.52 ,$129.60 ,$172.80 ,$114.95 ,$152.06 ,$114.95 ,$129.60 ,$129.60 ,$146.88 ,$146.88 ,$114.95 ,$146.88 ,$114.95 ,$134.78 ,$134.78 ,$134.78 ,$155.52 ,$172.80 ,$155.52 ,$114.95 ,$172.80 ,$113.18 ,$114.95 ,$46.50 ,$110.75 ,$105.71 ,$120.32 ,$155.52 ,$249.12 ,$106.62 ,$48.38 ,$155.52 ,$114.95 , N/A , N/A ,$114.95 ,$112.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200026,93990,PC DUPLEX HEMODIALYSIS ACCESS-26,982,1 ,$27.97 ,$18.18 ,$7.83 ,$249.12 ,$27.97 ,$20.84 ,$18.32 ,$27.97 ,$7.83 ,$14.12 ,$27.97 ,$17.26 ,$27.97 ,$17.26 ,$17.26 ,$27.97 ,$17.26 ,$218.41 ,$25.17 ,$20.98 ,$27.97 ,$27.97 ,$24.61 ,$27.97 ,$20.98 ,$20.98 ,$23.77 ,$23.77 ,$27.97 ,$23.77 ,$27.97 ,$21.82 ,$21.82 ,$21.82 ,$25.17 ,$27.97 ,$25.17 ,$27.97 ,$27.97 ,$18.32 ,$27.97 ,$27.97 ,$27.97 ,$27.97 ,$27.97 ,$25.17 ,$249.12 ,$17.26 ,$7.83 ,$25.17 ,$27.97 , N/A , N/A ,$27.97 ,$18.18 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98200027,93882,PC DUPLEX CAROTID UNI-26,975,1 ,$57.05 ,$37.08 ,$15.97 ,$249.12 ,$57.05 ,$42.50 ,$37.37 ,$57.05 ,$15.97 ,$28.81 ,$57.05 ,$35.20 ,$57.05 ,$35.20 ,$35.20 ,$57.05 ,$35.20 ,$218.41 ,$51.35 ,$42.79 ,$57.05 ,$57.05 ,$50.20 ,$57.05 ,$42.79 ,$42.79 ,$48.49 ,$48.49 ,$57.05 ,$48.49 ,$57.05 ,$44.50 ,$44.50 ,$44.50 ,$51.35 ,$57.05 ,$51.35 ,$57.05 ,$57.05 ,$37.37 ,$57.05 ,$48.09 ,$57.05 ,$57.05 ,$57.05 ,$51.35 ,$249.12 ,$35.20 ,$15.97 ,$51.35 ,$57.05 , N/A , N/A ,$57.05 ,$37.08 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300001,10060,PC I AND D ABSC SMP PRO,983,1 ,$323.04 ,$209.98 ,$90.45 ,$410.91 ,$323.04 ,$240.66 ,$211.59 ,$189.61 ,$90.45 ,$163.14 ,$189.61 ,$199.32 ,$189.61 ,$199.32 ,$199.32 ,$189.61 ,$199.32 ,$360.26 ,$290.74 ,$242.28 ,$323.04 ,$189.61 ,$284.28 ,$189.61 ,$242.28 ,$242.28 ,$274.58 ,$274.58 ,$189.61 ,$274.58 ,$189.61 ,$251.97 ,$251.97 ,$251.97 ,$290.74 ,$323.04 ,$290.74 ,$189.61 ,$323.04 ,$211.59 ,$189.61 ,$171.01 ,$218.80 ,$208.86 ,$198.46 ,$290.74 ,$410.91 ,$199.32 ,$90.45 ,$290.74 ,$189.61 , N/A , N/A ,$189.61 ,$209.98 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300004,11042,PC DEBR SKIN/SUBQ TISS INIT 20CM PRO,983,1 ,$291.18 ,$189.27 ,$81.53 ,$790.90 ,$291.18 ,$216.93 ,$190.72 ,$291.18 ,$81.53 ,$147.05 ,$291.18 ,$179.66 ,$291.18 ,$179.66 ,$179.66 ,$291.18 ,$179.66 ,$693.41 ,$262.06 ,$218.39 ,$291.18 ,$291.18 ,$256.24 ,$291.18 ,$218.39 ,$218.39 ,$247.50 ,$247.50 ,$291.18 ,$247.50 ,$291.18 ,$227.12 ,$227.12 ,$227.12 ,$262.06 ,$291.18 ,$262.06 ,$291.18 ,$291.18 ,$190.72 ,$291.18 ,$106.36 ,$223.26 ,$213.11 ,$291.18 ,$262.06 ,$790.90 ,$179.66 ,$81.53 ,$262.06 ,$291.18 , N/A , N/A ,$291.18 ,$189.27 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300006,11043,PC DEBR SKIN/SUBQ TISSUE/MUSCLE PRO,983,1 ,$570.49 ,$370.82 ,$159.74 ,"$1,198.43 ",$570.49 ,$425.02 ,$373.67 ,$553.00 ,$159.74 ,$288.10 ,$553.00 ,$351.99 ,$553.00 ,$351.99 ,$351.99 ,$553.00 ,$351.99 ,"$1,050.70 ",$513.44 ,$427.87 ,$570.49 ,$553.00 ,$502.03 ,$553.00 ,$427.87 ,$427.87 ,$484.92 ,$484.92 ,$553.00 ,$484.92 ,$553.00 ,$444.98 ,$444.98 ,$444.98 ,$513.44 ,$570.49 ,$513.44 ,$553.00 ,$570.49 ,$373.67 ,$553.00 ,$274.25 ,$570.49 ,$570.49 ,$570.49 ,$513.44 ,"$1,198.43 ",$351.99 ,$159.74 ,$513.44 ,$553.00 , N/A , N/A ,$553.00 ,$370.82 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300008,11044,PC DEBR SKIN/SUB TIS/MUS/BONE INT 20 PRO,983,1 ,$993.60 ,$645.84 ,$278.21 ,"$3,219.59 ",$993.60 ,$740.23 ,$650.81 ,$993.60 ,$278.21 ,$501.77 ,$993.60 ,$613.05 ,$993.60 ,$613.05 ,$613.05 ,$993.60 ,$613.05 ,"$2,822.72 ",$894.24 ,$745.20 ,$993.60 ,$993.60 ,$874.37 ,$993.60 ,$745.20 ,$745.20 ,$844.56 ,$844.56 ,$993.60 ,$844.56 ,$993.60 ,$775.01 ,$775.01 ,$775.01 ,$894.24 ,$993.60 ,$894.24 ,$993.60 ,$993.60 ,$650.81 ,$993.60 ,$403.60 ,$871.86 ,$832.23 ,$993.60 ,$894.24 ,"$3,219.59 ",$613.05 ,$278.21 ,$894.24 ,$993.60 , N/A , N/A ,$993.60 ,$645.84 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300010,11045,PC DEBR SKIN/SUBQ TIS EA ADL 20CM PRO,983,1 ,$104.88 ,$68.17 ,$29.37 ,$104.88 , N/A ,$78.14 ,$68.70 , N/A ,$29.37 ,$52.96 , N/A ,$64.71 , N/A ,$64.71 ,$64.71 , N/A ,$64.71 , N/A ,$94.39 ,$78.66 , N/A , N/A ,$92.29 , N/A ,$78.66 ,$78.66 ,$89.15 ,$89.15 , N/A ,$89.15 , N/A ,$81.81 ,$81.81 ,$81.81 ,$94.39 , N/A ,$94.39 , N/A ,$104.88 ,$68.70 , N/A ,$47.73 ,$104.88 ,$104.88 , N/A ,$94.39 , N/A ,$64.71 ,$29.37 ,$94.39 , N/A , N/A , N/A , N/A ,$68.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300011,11046,PC DEBR SKIN/SUBQ MUS/FAS ADL 20C PRO,983,1 ,$147.32 ,$95.76 ,$41.25 ,$147.32 , N/A ,$109.75 ,$96.49 , N/A ,$41.25 ,$74.40 , N/A ,$90.90 , N/A ,$90.90 ,$90.90 , N/A ,$90.90 , N/A ,$132.59 ,$110.49 , N/A , N/A ,$129.64 , N/A ,$110.49 ,$110.49 ,$125.22 ,$125.22 , N/A ,$125.22 , N/A ,$114.91 ,$114.91 ,$114.91 ,$132.59 , N/A ,$132.59 , N/A ,$147.32 ,$96.49 , N/A ,$100.31 ,$147.32 ,$147.32 , N/A ,$132.59 , N/A ,$90.90 ,$41.25 ,$132.59 , N/A , N/A , N/A , N/A ,$95.76 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300012,11047,PC DEBR SKIN/SUB TIS/MUS/BN ADL 20C PRO,983,1 ,$275.88 ,$179.32 ,$77.25 ,$275.88 , N/A ,$205.53 ,$180.70 , N/A ,$77.25 ,$139.32 , N/A ,$170.22 , N/A ,$170.22 ,$170.22 , N/A ,$170.22 , N/A ,$248.29 ,$206.91 , N/A , N/A ,$242.77 , N/A ,$206.91 ,$206.91 ,$234.50 ,$234.50 , N/A ,$234.50 , N/A ,$215.19 ,$215.19 ,$215.19 ,$248.29 , N/A ,$248.29 , N/A ,$275.88 ,$180.70 , N/A ,$177.25 ,$275.88 ,$275.88 , N/A ,$248.29 , N/A ,$170.22 ,$77.25 ,$248.29 , N/A , N/A , N/A , N/A ,$179.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300015,11100,PC BX LESN SKIN/SUBQ/MUCOUS SGL PRO,983,1 ,$342.24 ,$222.46 ,$95.83 ,$342.24 , N/A ,$254.97 ,$224.17 , N/A ,$95.83 ,$172.83 , N/A ,$211.16 , N/A ,$211.16 ,$211.16 , N/A ,$211.16 , N/A ,$308.02 ,$256.68 , N/A , N/A ,$301.17 , N/A ,$256.68 ,$256.68 ,$290.90 ,$290.90 , N/A ,$290.90 , N/A ,$266.95 ,$266.95 ,$266.95 ,$308.02 , N/A ,$308.02 , N/A ,$342.24 ,$224.17 , N/A ,$239.57 , N/A , N/A , N/A ,$308.02 , N/A ,$211.16 ,$95.83 ,$308.02 , N/A , N/A , N/A , N/A ,$222.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300017,11101,PC PUNCH BIOPSY EA ADD PRO,983,1 ,$88.62 ,$57.60 ,$24.81 ,$88.62 , N/A ,$66.02 ,$58.05 , N/A ,$24.81 ,$44.75 , N/A ,$54.68 , N/A ,$54.68 ,$54.68 , N/A ,$54.68 , N/A ,$79.76 ,$66.47 , N/A , N/A ,$77.99 , N/A ,$66.47 ,$66.47 ,$75.33 ,$75.33 , N/A ,$75.33 , N/A ,$69.12 ,$69.12 ,$69.12 ,$79.76 , N/A ,$79.76 , N/A ,$88.62 ,$58.05 , N/A ,$62.03 , N/A , N/A , N/A ,$79.76 , N/A ,$54.68 ,$24.81 ,$79.76 , N/A , N/A , N/A , N/A ,$57.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300018,11719,PC TRIM NAILS NONDYSTROPHIC PRO,983,1 ,$9.01 ,$5.86 ,$2.52 ,$127.37 ,$9.01 ,$6.71 ,$5.90 ,$9.01 ,$2.52 ,$4.55 ,$9.01 ,$5.56 ,$9.01 ,$5.56 ,$5.56 ,$9.01 ,$5.56 ,$111.66 ,$8.11 ,$6.76 ,$9.01 ,$9.01 ,$7.93 ,$9.01 ,$6.76 ,$6.76 ,$7.66 ,$7.66 ,$9.01 ,$7.66 ,$9.01 ,$7.03 ,$7.03 ,$7.03 ,$8.11 ,$9.01 ,$8.11 ,$9.01 ,$9.01 ,$5.90 ,$9.01 ,$9.01 ,$9.01 ,$9.01 ,$9.01 ,$8.11 ,$127.37 ,$5.56 ,$2.52 ,$8.11 ,$9.01 , N/A , N/A ,$9.01 ,$5.86 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300028,16020,PC BURN DRESS  AND /OR DEBRIDE PRO <5%,983,1 ,$212.00 ,$137.80 ,$59.36 ,$410.91 ,$212.00 ,$157.94 ,$138.86 ,$189.61 ,$59.36 ,$107.06 ,$189.61 ,$130.80 ,$189.61 ,$130.80 ,$130.80 ,$189.61 ,$130.80 ,$360.26 ,$190.80 ,$159.00 ,$212.00 ,$189.61 ,$186.56 ,$189.61 ,$159.00 ,$159.00 ,$180.20 ,$180.20 ,$189.61 ,$180.20 ,$189.61 ,$165.36 ,$165.36 ,$165.36 ,$190.80 ,$212.00 ,$190.80 ,$189.61 ,$212.00 ,$138.86 ,$189.61 ,$93.88 ,$103.44 ,$98.74 ,$198.46 ,$190.80 ,$410.91 ,$130.80 ,$59.36 ,$190.80 ,$189.61 , N/A , N/A ,$189.61 ,$137.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300031,17250,PC CHEM CAUTERY PRO,983,1 ,$199.39 ,$129.60 ,$55.83 ,$410.91 ,$199.39 ,$148.55 ,$130.60 ,$189.61 ,$55.83 ,$100.69 ,$189.61 ,$123.02 ,$189.61 ,$123.02 ,$123.02 ,$189.61 ,$123.02 ,$360.26 ,$179.45 ,$149.54 ,$199.39 ,$189.61 ,$175.46 ,$189.61 ,$149.54 ,$149.54 ,$169.48 ,$169.48 ,$189.61 ,$169.48 ,$189.61 ,$155.52 ,$155.52 ,$155.52 ,$179.45 ,$199.39 ,$179.45 ,$189.61 ,$199.39 ,$130.60 ,$189.61 ,$64.71 ,$199.39 ,$199.39 ,$198.46 ,$179.45 ,$410.91 ,$123.02 ,$55.83 ,$179.45 ,$189.61 , N/A , N/A ,$189.61 ,$129.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300043,97597,PC DEBR SKIN INTL 20CM PRO,983,1 ,$191.82 ,$124.68 ,$53.71 ,$410.91 ,$191.82 ,$142.91 ,$125.64 ,$189.61 ,$53.71 ,$96.87 ,$189.61 ,$118.35 ,$189.61 ,$118.35 ,$118.35 ,$189.61 ,$118.35 ,$360.26 ,$172.64 ,$143.87 ,$191.82 ,$189.61 ,$168.80 ,$189.61 ,$143.87 ,$143.87 ,$163.05 ,$163.05 ,$189.61 ,$163.05 ,$189.61 ,$149.62 ,$149.62 ,$149.62 ,$172.64 ,$191.82 ,$172.64 ,$189.61 ,$191.82 ,$125.64 ,$189.61 ,$64.46 ,$86.96 ,$83.00 ,$191.82 ,$172.64 ,$410.91 ,$118.35 ,$53.71 ,$172.64 ,$189.61 , N/A , N/A ,$189.61 ,$124.68 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300049,97598,PC DEBR SKIN PART THICKNESS EA ADDN>20CM PRO,983,1 ,$202.50 ,$131.63 ,$45.51 ,$202.50 , N/A ,$150.86 ,$132.64 , N/A ,$56.70 ,$102.26 , N/A ,$124.94 , N/A ,$124.94 ,$124.94 , N/A ,$124.94 , N/A ,$182.25 ,$151.88 , N/A , N/A ,$178.20 , N/A ,$151.88 ,$151.88 ,$172.13 ,$172.13 , N/A ,$172.13 , N/A ,$157.95 ,$157.95 ,$157.95 ,$182.25 , N/A ,$182.25 , N/A ,$202.50 ,$132.64 , N/A ,$45.51 ,$86.96 ,$83.00 , N/A ,$182.25 , N/A ,$124.94 ,$56.70 ,$182.25 , N/A , N/A , N/A , N/A ,$131.63 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300050,97605,PC NWPT <50 SQ CM PRO,983,1 ,$95.08 ,$61.80 ,$26.62 ,$410.91 ,$95.08 ,$70.83 ,$62.28 ,$95.08 ,$26.62 ,$48.02 ,$95.08 ,$58.66 ,$95.08 ,$58.66 ,$58.66 ,$95.08 ,$58.66 ,$360.26 ,$85.57 ,$71.31 ,$95.08 ,$95.08 ,$83.67 ,$95.08 ,$71.31 ,$71.31 ,$80.82 ,$80.82 ,$95.08 ,$80.82 ,$95.08 ,$74.16 ,$74.16 ,$74.16 ,$85.57 ,$95.08 ,$85.57 ,$95.08 ,$95.08 ,$62.28 ,$95.08 ,$48.48 ,$95.08 ,$95.08 ,$95.08 ,$85.57 ,$410.91 ,$58.66 ,$26.62 ,$85.57 ,$95.08 , N/A , N/A ,$95.08 ,$61.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300051,97606,PC NWPT >50 SQ CM PRO,983,1 ,$93.05 ,$60.48 ,$26.05 ,$790.90 ,$93.05 ,$69.32 ,$60.95 ,$93.05 ,$26.05 ,$46.99 ,$93.05 ,$57.41 ,$93.05 ,$57.41 ,$57.41 ,$93.05 ,$57.41 ,$693.41 ,$83.75 ,$69.79 ,$93.05 ,$93.05 ,$81.88 ,$93.05 ,$69.79 ,$69.79 ,$79.09 ,$79.09 ,$93.05 ,$79.09 ,$93.05 ,$72.58 ,$72.58 ,$72.58 ,$83.75 ,$93.05 ,$83.75 ,$93.05 ,$93.05 ,$60.95 ,$93.05 ,$52.41 ,$93.05 ,$93.05 ,$93.05 ,$83.75 ,$790.90 ,$57.41 ,$26.05 ,$83.75 ,$93.05 , N/A , N/A ,$93.05 ,$60.48 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300075,99183,PC HYPERBARIC 02 HSHS PRO FEE,983,1 ,$450.83 ,$293.04 ,$126.23 ,$450.83 , N/A ,$335.87 ,$295.29 , N/A ,$126.23 ,$227.67 , N/A ,$278.16 , N/A ,$278.16 ,$278.16 , N/A ,$278.16 , N/A ,$405.75 ,$338.12 , N/A , N/A ,$396.73 , N/A ,$338.12 ,$338.12 ,$383.21 ,$383.21 , N/A ,$383.21 , N/A ,$351.65 ,$351.65 ,$351.65 ,$405.75 , N/A ,$405.75 , N/A ,$450.83 ,$295.29 , N/A ,$209.10 , N/A , N/A , N/A ,$405.75 , N/A ,$278.16 ,$126.23 ,$405.75 , N/A , N/A , N/A , N/A ,$293.04 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300080,15271,PC APL SKIN SUB TAL<100 INT 25CM PRO,983,1 ,$805.60 ,$523.64 ,$150.42 ,"$3,919.23 ",$805.60 ,$600.17 ,$527.67 ,$805.60 ,$225.57 ,$406.83 ,$805.60 ,$497.06 ,$805.60 ,$497.06 ,$497.06 ,$805.60 ,$497.06 ,"$3,436.13 ",$725.04 ,$604.20 ,$805.60 ,$805.60 ,$708.93 ,$805.60 ,$604.20 ,$604.20 ,$684.76 ,$684.76 ,$805.60 ,$684.76 ,$805.60 ,$628.37 ,$628.37 ,$628.37 ,$725.04 ,$805.60 ,$725.04 ,$805.60 ,$805.60 ,$527.67 ,$805.60 ,$150.42 ,$805.60 ,$805.60 ,$805.60 ,$725.04 ,"$3,919.23 ",$497.06 ,$225.57 ,$725.04 ,$805.60 , N/A , N/A ,$805.60 ,$523.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300082,15272,PC APL SKIN SUB TAL<100 ADL 25CM PRO,983,1 ,$137.75 ,$89.54 ,$31.61 ,$137.75 , N/A ,$102.62 ,$90.23 , N/A ,$38.57 ,$69.56 , N/A ,$84.99 , N/A ,$84.99 ,$84.99 , N/A ,$84.99 , N/A ,$123.98 ,$103.31 , N/A , N/A ,$121.22 , N/A ,$103.31 ,$103.31 ,$117.09 ,$117.09 , N/A ,$117.09 , N/A ,$107.45 ,$107.45 ,$107.45 ,$123.98 , N/A ,$123.98 , N/A ,$137.75 ,$90.23 , N/A ,$31.61 ,$137.75 ,$137.75 , N/A ,$123.98 , N/A ,$84.99 ,$38.57 ,$123.98 , N/A , N/A , N/A , N/A ,$89.54 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300083,15273,PC APL SKIN SUB TAL>100 INT 100CM PRO,983,1 ,"$1,005.68 ",$653.69 ,$281.59 ,"$8,057.36 ","$1,005.68 ",$749.23 ,$658.72 ,"$1,005.68 ",$281.59 ,$507.87 ,"$1,005.68 ",$620.50 ,"$1,005.68 ",$620.50 ,$620.50 ,"$1,005.68 ",$620.50 ,"$7,064.16 ",$905.11 ,$754.26 ,"$1,005.68 ","$1,005.68 ",$885.00 ,"$1,005.68 ",$754.26 ,$754.26 ,$854.83 ,$854.83 ,"$1,005.68 ",$854.83 ,"$1,005.68 ",$784.43 ,$784.43 ,$784.43 ,$905.11 ,"$1,005.68 ",$905.11 ,"$1,005.68 ","$1,005.68 ",$658.72 ,"$1,005.68 ",$358.43 ,"$1,005.68 ","$1,005.68 ","$1,005.68 ",$905.11 ,"$8,057.36 ",$620.50 ,$281.59 ,$905.11 ,"$1,005.68 ", N/A , N/A ,"$1,005.68 ",$653.69 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300085,15274,PC APL SKIN SUB TAL>100 ADL 100CM PRO,983,1 ,$210.46 ,$136.80 ,$58.93 ,$210.46 , N/A ,$156.79 ,$137.85 , N/A ,$58.93 ,$106.28 , N/A ,$129.85 , N/A ,$129.85 ,$129.85 , N/A ,$129.85 , N/A ,$189.41 ,$157.85 , N/A , N/A ,$185.20 , N/A ,$157.85 ,$157.85 ,$178.89 ,$178.89 , N/A ,$178.89 , N/A ,$164.16 ,$164.16 ,$164.16 ,$189.41 , N/A ,$189.41 , N/A ,$210.46 ,$137.85 , N/A ,$81.62 ,$210.46 ,$210.46 , N/A ,$189.41 , N/A ,$129.85 ,$58.93 ,$189.41 , N/A , N/A , N/A , N/A ,$136.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300086,15275,PC APL SKIN SUB OTH<100 INT 25CM PRO,983,1 ,$805.60 ,$523.64 ,$168.42 ,"$3,919.23 ",$805.60 ,$600.17 ,$527.67 ,$805.60 ,$225.57 ,$406.83 ,$805.60 ,$497.06 ,$805.60 ,$497.06 ,$497.06 ,$805.60 ,$497.06 ,"$3,436.13 ",$725.04 ,$604.20 ,$805.60 ,$805.60 ,$708.93 ,$805.60 ,$604.20 ,$604.20 ,$684.76 ,$684.76 ,$805.60 ,$684.76 ,$805.60 ,$628.37 ,$628.37 ,$628.37 ,$725.04 ,$805.60 ,$725.04 ,$805.60 ,$805.60 ,$527.67 ,$805.60 ,$168.42 ,$805.60 ,$805.60 ,$805.60 ,$725.04 ,"$3,919.23 ",$497.06 ,$225.57 ,$725.04 ,$805.60 , N/A , N/A ,$805.60 ,$523.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300088,15276,PC APL SKIN SUB OTH<100 ADL 25CM PRO,983,1 ,$125.17 ,$81.36 ,$35.05 ,$125.17 , N/A ,$93.25 ,$81.99 , N/A ,$35.05 ,$63.21 , N/A ,$77.23 , N/A ,$77.23 ,$77.23 , N/A ,$77.23 , N/A ,$112.65 ,$93.88 , N/A , N/A ,$110.15 , N/A ,$93.88 ,$93.88 ,$106.39 ,$106.39 , N/A ,$106.39 , N/A ,$97.63 ,$97.63 ,$97.63 ,$112.65 , N/A ,$112.65 , N/A ,$125.17 ,$81.99 , N/A ,$46.42 ,$125.17 ,$125.17 , N/A ,$112.65 , N/A ,$77.23 ,$35.05 ,$112.65 , N/A , N/A , N/A , N/A ,$81.36 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300089,15277,PC APL SKIN SUB OTH>100 INT 100CM PRO,983,1 ,$913.85 ,$594.00 ,$255.88 ,"$3,919.23 ",$913.85 ,$680.82 ,$598.57 ,$913.85 ,$255.88 ,$461.49 ,$913.85 ,$563.85 ,$913.85 ,$563.85 ,$563.85 ,$913.85 ,$563.85 ,"$3,436.13 ",$822.47 ,$685.39 ,$913.85 ,$913.85 ,$804.19 ,$913.85 ,$685.39 ,$685.39 ,$776.77 ,$776.77 ,$913.85 ,$776.77 ,$913.85 ,$712.80 ,$712.80 ,$712.80 ,$822.47 ,$913.85 ,$822.47 ,$913.85 ,$913.85 ,$598.57 ,$913.85 ,$406.38 ,$913.85 ,$913.85 ,$913.85 ,$822.47 ,"$3,919.23 ",$563.85 ,$255.88 ,$822.47 ,$913.85 , N/A , N/A ,$913.85 ,$594.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300091,15278,PC APL SKIN SUB OTH>100 ADL 100CM PRO,983,1 ,$210.46 ,$136.80 ,$58.93 ,$210.46 , N/A ,$156.79 ,$137.85 , N/A ,$58.93 ,$106.28 , N/A ,$129.85 , N/A ,$129.85 ,$129.85 , N/A ,$129.85 , N/A ,$189.41 ,$157.85 , N/A , N/A ,$185.20 , N/A ,$157.85 ,$157.85 ,$178.89 ,$178.89 , N/A ,$178.89 , N/A ,$164.16 ,$164.16 ,$164.16 ,$189.41 , N/A ,$189.41 , N/A ,$210.46 ,$137.85 , N/A ,$103.33 ,$210.46 ,$210.46 , N/A ,$189.41 , N/A ,$129.85 ,$58.93 ,$189.41 , N/A , N/A , N/A , N/A ,$136.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300093,16030,PC BURN DRESS  AND /OR DEBRIDE PRO >10%,983,1 ,$221.54 ,$144.00 ,$62.03 ,$790.90 ,$221.54 ,$165.05 ,$145.11 ,$221.54 ,$62.03 ,$111.88 ,$221.54 ,$136.69 ,$221.54 ,$136.69 ,$136.69 ,$221.54 ,$136.69 ,$693.41 ,$199.39 ,$166.16 ,$221.54 ,$221.54 ,$194.96 ,$221.54 ,$166.16 ,$166.16 ,$188.31 ,$188.31 ,$221.54 ,$188.31 ,$221.54 ,$172.80 ,$172.80 ,$172.80 ,$199.39 ,$221.54 ,$199.39 ,$221.54 ,$221.54 ,$145.11 ,$221.54 ,$221.54 ,$103.44 ,$98.74 ,$221.54 ,$199.39 ,$790.90 ,$136.69 ,$62.03 ,$199.39 ,$221.54 , N/A , N/A ,$221.54 ,$144.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300094,16025,PC BURN DRESS  AND /OR DEBRIDE PRO 5-10%,983,1 ,$221.54 ,$144.00 ,$62.03 ,$410.91 ,$221.54 ,$165.05 ,$145.11 ,$189.61 ,$62.03 ,$111.88 ,$189.61 ,$136.69 ,$189.61 ,$136.69 ,$136.69 ,$189.61 ,$136.69 ,$360.26 ,$199.39 ,$166.16 ,$221.54 ,$189.61 ,$194.96 ,$189.61 ,$166.16 ,$166.16 ,$188.31 ,$188.31 ,$189.61 ,$188.31 ,$189.61 ,$172.80 ,$172.80 ,$172.80 ,$199.39 ,$221.54 ,$199.39 ,$189.61 ,$221.54 ,$145.11 ,$189.61 ,$193.84 ,$103.44 ,$98.74 ,$198.46 ,$199.39 ,$410.91 ,$136.69 ,$62.03 ,$199.39 ,$189.61 , N/A , N/A ,$189.61 ,$144.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300124,11730,PC AVULSION NAIL PLATE SINGLE PRO,983,1 ,$252.56 ,$164.16 ,$70.72 ,$410.91 ,$252.56 ,$188.16 ,$165.43 ,$189.61 ,$70.72 ,$127.54 ,$189.61 ,$155.83 ,$189.61 ,$155.83 ,$155.83 ,$189.61 ,$155.83 ,$360.26 ,$227.30 ,$189.42 ,$252.56 ,$189.61 ,$222.25 ,$189.61 ,$189.42 ,$189.42 ,$214.68 ,$214.68 ,$189.61 ,$214.68 ,$189.61 ,$197.00 ,$197.00 ,$197.00 ,$227.30 ,$252.56 ,$227.30 ,$189.61 ,$252.56 ,$165.43 ,$189.61 ,$95.86 ,$209.46 ,$199.94 ,$198.46 ,$227.30 ,$410.91 ,$155.83 ,$70.72 ,$227.30 ,$189.61 , N/A , N/A ,$189.61 ,$164.16 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300131,29445,PC APPL CAST LEG RIGID CONTACT,983,1 ,$525.05 ,$341.28 ,$147.01 ,$552.02 ,$525.05 ,$391.16 ,$343.91 ,$254.72 ,$147.01 ,$265.15 ,$254.72 ,$323.96 ,$254.72 ,$323.96 ,$323.96 ,$254.72 ,$323.96 ,$483.97 ,$472.55 ,$393.79 ,$525.05 ,$254.72 ,$462.04 ,$254.72 ,$393.79 ,$393.79 ,$446.29 ,$446.29 ,$254.72 ,$446.29 ,$254.72 ,$409.54 ,$409.54 ,$409.54 ,$472.55 ,$525.05 ,$472.55 ,$254.72 ,$525.05 ,$343.91 ,$254.72 ,$179.43 ,$236.74 ,$225.98 ,$266.61 ,$472.55 ,$552.02 ,$323.96 ,$147.01 ,$472.55 ,$254.72 , N/A , N/A ,$254.72 ,$341.28 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300132,29445,PC APPL CAST LEG RIGID CONTACT -RT,983,1 ,$525.05 ,$341.28 ,$147.01 ,$552.02 ,$525.05 ,$391.16 ,$343.91 ,$254.72 ,$147.01 ,$265.15 ,$254.72 ,$323.96 ,$254.72 ,$323.96 ,$323.96 ,$254.72 ,$323.96 ,$483.97 ,$472.55 ,$393.79 ,$525.05 ,$254.72 ,$462.04 ,$254.72 ,$393.79 ,$393.79 ,$446.29 ,$446.29 ,$254.72 ,$446.29 ,$254.72 ,$409.54 ,$409.54 ,$409.54 ,$472.55 ,$525.05 ,$472.55 ,$254.72 ,$525.05 ,$343.91 ,$254.72 ,$179.43 ,$236.74 ,$225.98 ,$266.61 ,$472.55 ,$552.02 ,$323.96 ,$147.01 ,$472.55 ,$254.72 , N/A , N/A ,$254.72 ,$341.28 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300134,99202,PC CLINIC VISIT LIMITED NEW -25,983,1 ,$152.57 ,$99.17 ,$42.72 ,$152.57 , N/A ,$113.66 ,$99.93 , N/A ,$42.72 ,$77.05 , N/A ,$94.14 , N/A ,$94.14 ,$94.14 , N/A ,$94.14 , N/A ,$137.31 ,$114.43 , N/A , N/A ,$134.26 , N/A ,$114.43 ,$114.43 ,$129.68 ,$129.68 , N/A ,$129.68 , N/A ,$119.00 ,$119.00 ,$119.00 ,$137.31 , N/A ,$137.31 , N/A ,$78.75 ,$99.93 , N/A ,$65.28 ,$102.37 ,$97.71 , N/A ,$137.31 , N/A ,$94.14 ,$42.72 ,$137.31 , N/A , N/A , N/A , N/A ,$99.17 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300135,99203,PC CLINIC VISIT INTERM NEW -25,983,1 ,$233.45 ,$151.74 ,$65.37 ,$233.45 , N/A ,$173.92 ,$152.91 , N/A ,$65.37 ,$117.89 , N/A ,$144.04 , N/A ,$144.04 ,$144.04 , N/A ,$144.04 , N/A ,$210.11 ,$175.09 , N/A , N/A ,$205.44 , N/A ,$175.09 ,$175.09 ,$198.43 ,$198.43 , N/A ,$198.43 , N/A ,$182.09 ,$182.09 ,$182.09 ,$210.11 , N/A ,$210.11 , N/A ,$121.24 ,$152.91 , N/A ,$97.74 ,$102.37 ,$97.71 , N/A ,$210.11 , N/A ,$144.04 ,$65.37 ,$210.11 , N/A , N/A , N/A , N/A ,$151.74 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300136,99204,PC CLINIC VISIT COMPLEX NEW -25,983,1 ,$315.11 ,$204.82 ,$88.23 ,$315.11 , N/A ,$234.76 ,$206.40 , N/A ,$88.23 ,$159.13 , N/A ,$194.42 , N/A ,$194.42 ,$194.42 , N/A ,$194.42 , N/A ,$283.60 ,$236.33 , N/A , N/A ,$277.30 , N/A ,$236.33 ,$236.33 ,$267.84 ,$267.84 , N/A ,$267.84 , N/A ,$245.79 ,$245.79 ,$245.79 ,$283.60 , N/A ,$283.60 , N/A ,$181.05 ,$206.40 , N/A ,$167.14 ,$102.37 ,$97.71 , N/A ,$283.60 , N/A ,$194.42 ,$88.23 ,$283.60 , N/A , N/A , N/A , N/A ,$204.82 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300137,99205,PC CLINIC VISIT COMPREH NEW -25,983,1 ,$414.00 ,$269.10 ,$97.71 ,$414.00 , N/A ,$308.43 ,$271.17 , N/A ,$115.92 ,$209.07 , N/A ,$255.44 , N/A ,$255.44 ,$255.44 , N/A ,$255.44 , N/A ,$372.60 ,$310.50 , N/A , N/A ,$364.32 , N/A ,$310.50 ,$310.50 ,$351.90 ,$351.90 , N/A ,$351.90 , N/A ,$322.92 ,$322.92 ,$322.92 ,$372.60 , N/A ,$372.60 , N/A ,$239.15 ,$271.17 , N/A ,$218.17 ,$102.37 ,$97.71 , N/A ,$372.60 , N/A ,$255.44 ,$115.92 ,$372.60 , N/A , N/A , N/A , N/A ,$269.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300138,99211,PC CLINIC VISIT BRIEF ESTAB -25,983,1 ,$52.90 ,$34.39 ,$11.83 ,$52.90 , N/A ,$39.41 ,$34.65 , N/A ,$14.81 ,$26.71 , N/A ,$32.64 , N/A ,$32.64 ,$32.64 , N/A ,$32.64 , N/A ,$47.61 ,$39.68 , N/A , N/A ,$46.55 , N/A ,$39.68 ,$39.68 ,$44.97 ,$44.97 , N/A ,$44.97 , N/A ,$41.26 ,$41.26 ,$41.26 ,$47.61 , N/A ,$47.61 , N/A ,$52.90 ,$34.65 , N/A ,$11.83 ,$52.90 ,$52.90 , N/A ,$47.61 , N/A ,$32.64 ,$14.81 ,$47.61 , N/A , N/A , N/A , N/A ,$34.39 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300139,99212,PC CLINIC VISIT LIMITED ESTAB -25,983,1 ,$112.70 ,$73.26 ,$31.56 ,$112.70 , N/A ,$83.96 ,$73.82 , N/A ,$31.56 ,$56.91 , N/A ,$69.54 , N/A ,$69.54 ,$69.54 , N/A ,$69.54 , N/A ,$101.43 ,$84.53 , N/A , N/A ,$99.18 , N/A ,$84.53 ,$84.53 ,$95.80 ,$95.80 , N/A ,$95.80 , N/A ,$87.91 ,$87.91 ,$87.91 ,$101.43 , N/A ,$101.43 , N/A ,$60.02 ,$73.82 , N/A ,$33.40 ,$102.37 ,$97.71 , N/A ,$101.43 , N/A ,$69.54 ,$31.56 ,$101.43 , N/A , N/A , N/A , N/A ,$73.26 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300140,99213,PC CLINIC VISIT INTERM ESTAB -25,983,1 ,$186.30 ,$121.10 ,$52.16 ,$186.30 , N/A ,$138.79 ,$122.03 , N/A ,$52.16 ,$94.08 , N/A ,$114.95 , N/A ,$114.95 ,$114.95 , N/A ,$114.95 , N/A ,$167.67 ,$139.73 , N/A , N/A ,$163.94 , N/A ,$139.73 ,$139.73 ,$158.36 ,$158.36 , N/A ,$158.36 , N/A ,$145.31 ,$145.31 ,$145.31 ,$167.67 , N/A ,$167.67 , N/A ,$97.92 ,$122.03 , N/A ,$66.15 ,$102.37 ,$97.71 , N/A ,$167.67 , N/A ,$114.95 ,$52.16 ,$167.67 , N/A , N/A , N/A , N/A ,$121.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300141,99214,PC CLINIC VISIT COMPLEX ESTAB -25,983,1 ,$278.30 ,$180.90 ,$77.92 ,$278.30 , N/A ,$207.33 ,$182.29 , N/A ,$77.92 ,$140.54 , N/A ,$171.71 , N/A ,$171.71 ,$171.71 , N/A ,$171.71 , N/A ,$250.47 ,$208.73 , N/A , N/A ,$244.90 , N/A ,$208.73 ,$208.73 ,$236.56 ,$236.56 , N/A ,$236.56 , N/A ,$217.07 ,$217.07 ,$217.07 ,$250.47 , N/A ,$250.47 , N/A ,$278.30 ,$182.29 , N/A ,$101.60 ,$102.37 ,$97.71 , N/A ,$250.47 , N/A ,$171.71 ,$77.92 ,$250.47 , N/A , N/A , N/A , N/A ,$180.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300142,99215,PC CLINIC VISIT COMPREH ESTAB -25,983,1 ,$334.92 ,$217.70 ,$93.78 ,$334.92 , N/A ,$249.52 ,$219.37 , N/A ,$93.78 ,$169.13 , N/A ,$206.65 , N/A ,$206.65 ,$206.65 , N/A ,$206.65 , N/A ,$301.43 ,$251.19 , N/A , N/A ,$294.73 , N/A ,$251.19 ,$251.19 ,$284.68 ,$284.68 , N/A ,$284.68 , N/A ,$261.24 ,$261.24 ,$261.24 ,$301.43 , N/A ,$301.43 , N/A ,$334.92 ,$219.37 , N/A ,$143.41 ,$102.37 ,$97.71 , N/A ,$301.43 , N/A ,$206.65 ,$93.78 ,$301.43 , N/A , N/A , N/A , N/A ,$217.70 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300143,11721,PC DEBR NAIL(S) 6 OR MORE,983,1 ,$112.99 ,$73.44 ,$31.64 ,$127.37 ,$112.99 ,$84.18 ,$74.01 ,$58.77 ,$31.64 ,$57.06 ,$58.77 ,$69.71 ,$58.77 ,$69.71 ,$69.71 ,$58.77 ,$69.71 ,$111.66 ,$101.69 ,$84.74 ,$112.99 ,$58.77 ,$99.43 ,$58.77 ,$84.74 ,$84.74 ,$96.04 ,$96.04 ,$58.77 ,$96.04 ,$58.77 ,$88.13 ,$88.13 ,$88.13 ,$101.69 ,$112.99 ,$101.69 ,$58.77 ,$112.99 ,$74.01 ,$58.77 ,$44.42 ,$59.73 ,$57.02 ,$61.52 ,$101.69 ,$127.37 ,$69.71 ,$31.64 ,$101.69 ,$58.77 , N/A , N/A ,$58.77 ,$73.44 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300144,11720,PC DEBR NAIL(S) UP TO 5,983,1 ,$81.97 ,$53.28 ,$22.95 ,$127.37 ,$81.97 ,$61.07 ,$53.69 ,$58.77 ,$22.95 ,$41.39 ,$58.77 ,$50.58 ,$58.77 ,$50.58 ,$50.58 ,$58.77 ,$50.58 ,$111.66 ,$73.77 ,$61.48 ,$81.97 ,$58.77 ,$72.13 ,$58.77 ,$61.48 ,$61.48 ,$69.67 ,$69.67 ,$58.77 ,$69.67 ,$58.77 ,$63.94 ,$63.94 ,$63.94 ,$73.77 ,$81.97 ,$73.77 ,$58.77 ,$81.97 ,$53.69 ,$58.77 ,$25.95 ,$59.73 ,$57.02 ,$61.52 ,$73.77 ,$127.37 ,$50.58 ,$22.95 ,$73.77 ,$58.77 , N/A , N/A ,$58.77 ,$53.28 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300145,11102,PC BIOPSY SKIN TANGENTIAL INIT LESN,983,1 ,$342.24 ,$222.46 ,$68.20 ,$410.91 ,$342.24 ,$254.97 ,$224.17 ,$189.61 ,$95.83 ,$172.83 ,$189.61 ,$211.16 ,$189.61 ,$211.16 ,$211.16 ,$189.61 ,$211.16 ,$360.26 ,$308.02 ,$256.68 ,$342.24 ,$189.61 ,$301.17 ,$189.61 ,$256.68 ,$256.68 ,$290.90 ,$290.90 ,$189.61 ,$290.90 ,$189.61 ,$266.95 ,$266.95 ,$266.95 ,$308.02 ,$342.24 ,$308.02 ,$189.61 ,$342.24 ,$224.17 ,$189.61 ,$68.20 ,$342.24 ,$342.24 ,$198.46 ,$308.02 ,$410.91 ,$211.16 ,$95.83 ,$308.02 ,$189.61 , N/A , N/A ,$189.61 ,$222.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300147,11106,PC BIOPSY SKIN INCISIONAL INIT LESN,983,1 ,$342.24 ,$222.46 ,$95.83 ,"$1,198.43 ",$342.24 ,$254.97 ,$224.17 ,$342.24 ,$95.83 ,$172.83 ,$342.24 ,$211.16 ,$342.24 ,$211.16 ,$211.16 ,$342.24 ,$211.16 ,"$1,050.70 ",$308.02 ,$256.68 ,$342.24 ,$342.24 ,$301.17 ,$342.24 ,$256.68 ,$256.68 ,$290.90 ,$290.90 ,$342.24 ,$290.90 ,$342.24 ,$266.95 ,$266.95 ,$266.95 ,$308.02 ,$342.24 ,$308.02 ,$342.24 ,$342.24 ,$224.17 ,$342.24 ,$102.45 ,$342.24 ,$342.24 ,$342.24 ,$308.02 ,"$1,198.43 ",$211.16 ,$95.83 ,$308.02 ,$342.24 , N/A , N/A ,$342.24 ,$222.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300148,11103,PC BIOPSY SKIN TANGENTIAL ADDL LESN,983,1 ,$88.62 ,$57.60 ,$24.81 ,$88.62 , N/A ,$66.02 ,$58.05 , N/A ,$24.81 ,$44.75 , N/A ,$54.68 , N/A ,$54.68 ,$54.68 , N/A ,$54.68 , N/A ,$79.76 ,$66.47 , N/A , N/A ,$77.99 , N/A ,$66.47 ,$66.47 ,$75.33 ,$75.33 , N/A ,$75.33 , N/A ,$69.12 ,$69.12 ,$69.12 ,$79.76 , N/A ,$79.76 , N/A ,$88.62 ,$58.05 , N/A ,$39.62 ,$88.62 ,$88.62 , N/A ,$79.76 , N/A ,$54.68 ,$24.81 ,$79.76 , N/A , N/A , N/A , N/A ,$57.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98300150,11107,PC BIOPSY SKIN INCISIONAL ADDL LESN,983,1 ,$88.62 ,$57.60 ,$24.81 ,$88.62 , N/A ,$66.02 ,$58.05 , N/A ,$24.81 ,$44.75 , N/A ,$54.68 , N/A ,$54.68 ,$54.68 , N/A ,$54.68 , N/A ,$79.76 ,$66.47 , N/A , N/A ,$77.99 , N/A ,$66.47 ,$66.47 ,$75.33 ,$75.33 , N/A ,$75.33 , N/A ,$69.12 ,$69.12 ,$69.12 ,$79.76 , N/A ,$79.76 , N/A ,$88.62 ,$58.05 , N/A ,$55.17 ,$88.62 ,$88.62 , N/A ,$79.76 , N/A ,$54.68 ,$24.81 ,$79.76 , N/A , N/A , N/A , N/A ,$57.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$33.23 ,$21.60 ,$9.30 ,$33.23 , N/A ,$24.76 ,$21.77 , N/A ,$9.30 ,$16.78 , N/A ,$20.50 , N/A ,$20.50 ,$20.50 , N/A ,$20.50 , N/A ,$29.91 ,$24.92 , N/A , N/A ,$29.24 , N/A ,$24.92 ,$24.92 ,$28.25 ,$28.25 , N/A ,$28.25 , N/A ,$25.92 ,$25.92 ,$25.92 ,$29.91 , N/A ,$29.91 , N/A ,$33.23 ,$21.77 , N/A ,$15.74 ,$18.76 ,$17.90 , N/A ,$29.91 , N/A ,$20.50 ,$9.30 ,$29.91 , N/A , N/A , N/A , N/A ,$21.60 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500002,93016,PC CARDIAC STRESS TEST SUPERVISION,985,1 ,$171.14 ,$111.24 ,$41.22 ,$171.14 , N/A ,$127.50 ,$112.10 , N/A ,$47.92 ,$86.43 , N/A ,$105.59 , N/A ,$105.59 ,$105.59 , N/A ,$105.59 , N/A ,$154.03 ,$128.36 , N/A , N/A ,$150.60 , N/A ,$128.36 ,$128.36 ,$145.47 ,$145.47 , N/A ,$145.47 , N/A ,$133.49 ,$133.49 ,$133.49 ,$154.03 , N/A ,$154.03 , N/A ,$171.14 ,$112.10 , N/A ,$41.22 ,$171.14 ,$171.14 , N/A ,$154.03 , N/A ,$105.59 ,$47.92 ,$154.03 , N/A , N/A , N/A , N/A ,$111.24 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500003,93018,PC CARDIOVASCULAR STRESS TEST,985,1 ,$78.21 ,$50.84 ,$21.90 ,$78.21 , N/A ,$58.27 ,$51.23 , N/A ,$21.90 ,$39.50 , N/A ,$48.26 , N/A ,$48.26 ,$48.26 , N/A ,$48.26 , N/A ,$70.39 ,$58.66 , N/A , N/A ,$68.82 , N/A ,$58.66 ,$58.66 ,$66.48 ,$66.48 , N/A ,$66.48 , N/A ,$61.00 ,$61.00 ,$61.00 ,$70.39 , N/A ,$70.39 , N/A ,$78.21 ,$51.23 , N/A ,$27.42 ,$78.21 ,$78.21 , N/A ,$70.39 , N/A ,$48.26 ,$21.90 ,$70.39 , N/A , N/A , N/A , N/A ,$50.84 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500004,93306,PC ECHO/CARDIAC DOP/COLOR FLOW-26,985,1 ,$626.96 ,$407.52 ,$135.89 ,"$1,105.65 ",$626.96 ,$467.09 ,$410.66 ,$510.19 ,$175.55 ,$316.61 ,$510.19 ,$386.83 ,$510.19 ,$386.83 ,$386.83 ,$510.19 ,$386.83 ,$969.36 ,$564.26 ,$470.22 ,$626.96 ,$510.19 ,$551.72 ,$510.19 ,$470.22 ,$470.22 ,$532.92 ,$532.92 ,$510.19 ,$532.92 ,$510.19 ,$489.03 ,$489.03 ,$489.03 ,$564.26 ,$626.96 ,$564.26 ,$510.19 ,$626.96 ,$410.66 ,$510.19 ,$135.89 ,$353.25 ,$337.20 ,$534.01 ,$564.26 ,"$1,105.65 ",$386.83 ,$175.55 ,$564.26 ,$510.19 , N/A , N/A ,$510.19 ,$407.52 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500005,93308,PC ECHO 2D W/W/O M-MODE LTD-26,985,1 ,$228.19 ,$148.32 ,$47.76 ,$526.52 ,$228.19 ,$170.00 ,$149.46 ,$228.19 ,$63.89 ,$115.24 ,$228.19 ,$140.79 ,$228.19 ,$140.79 ,$140.79 ,$228.19 ,$140.79 ,$461.62 ,$205.37 ,$171.14 ,$228.19 ,$228.19 ,$200.81 ,$228.19 ,$171.14 ,$171.14 ,$193.96 ,$193.96 ,$228.19 ,$193.96 ,$228.19 ,$177.99 ,$177.99 ,$177.99 ,$205.37 ,$228.19 ,$205.37 ,$228.19 ,$228.19 ,$149.46 ,$228.19 ,$47.76 ,$228.19 ,$228.19 ,$228.19 ,$205.37 ,$526.52 ,$140.79 ,$63.89 ,$205.37 ,$228.19 , N/A , N/A ,$228.19 ,$148.32 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500007,93325,PC ECHO COLOR FLOW VELOCITY MAPPING-26,985,1 ,$77.54 ,$50.40 ,$5.87 ,$77.54 , N/A ,$57.77 ,$50.79 , N/A ,$21.71 ,$39.16 , N/A ,$47.84 , N/A ,$47.84 ,$47.84 , N/A ,$47.84 , N/A ,$69.79 ,$58.16 , N/A , N/A ,$68.24 , N/A ,$58.16 ,$58.16 ,$65.91 ,$65.91 , N/A ,$65.91 , N/A ,$60.48 ,$60.48 ,$60.48 ,$69.79 , N/A ,$69.79 , N/A ,$77.54 ,$50.79 , N/A ,$5.87 ,$77.54 ,$77.54 , N/A ,$69.79 , N/A ,$47.84 ,$21.71 ,$69.79 , N/A , N/A , N/A , N/A ,$50.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500008,93321,PC ECHO DOPPLER LIMITED-26,985,1 ,$77.54 ,$50.40 ,$13.80 ,$77.54 , N/A ,$57.77 ,$50.79 , N/A ,$21.71 ,$39.16 , N/A ,$47.84 , N/A ,$47.84 ,$47.84 , N/A ,$47.84 , N/A ,$69.79 ,$58.16 , N/A , N/A ,$68.24 , N/A ,$58.16 ,$58.16 ,$65.91 ,$65.91 , N/A ,$65.91 , N/A ,$60.48 ,$60.48 ,$60.48 ,$69.79 , N/A ,$69.79 , N/A ,$77.54 ,$50.79 , N/A ,$13.80 ,$77.54 ,$77.54 , N/A ,$69.79 , N/A ,$47.84 ,$21.71 ,$69.79 , N/A , N/A , N/A , N/A ,$50.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500009,93272,PC EVENT RECORDER 24HRS/30DAYS INTERP,985,1 ,$171.14 ,$111.24 ,$47.09 ,$171.14 , N/A ,$127.50 ,$112.10 , N/A ,$47.92 ,$86.43 , N/A ,$105.59 , N/A ,$105.59 ,$105.59 , N/A ,$105.59 , N/A ,$154.03 ,$128.36 , N/A , N/A ,$150.60 , N/A ,$128.36 ,$128.36 ,$145.47 ,$145.47 , N/A ,$145.47 , N/A ,$133.49 ,$133.49 ,$133.49 ,$154.03 , N/A ,$154.03 , N/A ,$171.14 ,$112.10 , N/A ,$47.09 ,$103.27 ,$98.57 , N/A ,$154.03 , N/A ,$105.59 ,$47.92 ,$154.03 , N/A , N/A , N/A , N/A ,$111.24 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500010,93227,PC HOLTER SCAN =< 48 HOURS,985,1 ,$94.15 ,$61.20 ,$26.36 ,$94.15 , N/A ,$70.14 ,$61.67 , N/A ,$26.36 ,$47.55 , N/A ,$58.09 , N/A ,$58.09 ,$58.09 , N/A ,$58.09 , N/A ,$84.74 ,$70.61 , N/A , N/A ,$82.85 , N/A ,$70.61 ,$70.61 ,$80.03 ,$80.03 , N/A ,$80.03 , N/A ,$73.44 ,$73.44 ,$73.44 ,$84.74 , N/A ,$84.74 , N/A ,$94.15 ,$61.67 , N/A ,$48.92 , N/A , N/A , N/A ,$84.74 , N/A ,$58.09 ,$26.36 ,$84.74 , N/A , N/A , N/A , N/A ,$61.20 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500012,93350,PC ECHO REST  AND  STRESS W/PF-26,985,1 ,$456.37 ,$296.64 ,$127.78 ,"$1,105.65 ",$456.37 ,$340.00 ,$298.92 ,$456.37 ,$127.78 ,$230.47 ,$456.37 ,$281.58 ,$456.37 ,$281.58 ,$281.58 ,$456.37 ,$281.58 ,$969.36 ,$410.73 ,$342.28 ,$456.37 ,$456.37 ,$401.61 ,$456.37 ,$342.28 ,$342.28 ,$387.91 ,$387.91 ,$456.37 ,$387.91 ,$456.37 ,$355.97 ,$355.97 ,$355.97 ,$410.73 ,$456.37 ,$410.73 ,$456.37 ,$456.37 ,$298.92 ,$456.37 ,$132.01 ,$353.25 ,$337.20 ,$456.37 ,$410.73 ,"$1,105.65 ",$281.58 ,$127.78 ,$410.73 ,$456.37 , N/A , N/A ,$456.37 ,$296.64 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98500013,93015,PC CARDIOVASCULAR STRESS TEST W/EKG MONITORING,985,1 ,$206.34 ,$134.12 ,$57.78 ,$206.34 , N/A ,$153.72 ,$135.15 , N/A ,$57.78 ,$104.20 , N/A ,$127.31 , N/A ,$127.31 ,$127.31 , N/A ,$127.31 , N/A ,$185.71 ,$154.76 , N/A , N/A ,$181.58 , N/A ,$154.76 ,$154.76 ,$175.39 ,$175.39 , N/A ,$175.39 , N/A ,$160.95 ,$160.95 ,$160.95 ,$185.71 , N/A ,$185.71 , N/A ,$206.34 ,$135.15 , N/A ,$126.65 ,$206.34 ,$206.34 , N/A ,$185.71 , N/A ,$127.31 ,$57.78 ,$185.71 , N/A , N/A , N/A , N/A ,$134.12 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600001,95806,PC SLEEP STUDY UNATTENDED-26,986,1 ,$138.12 ,$89.78 ,$38.67 ,$319.47 ,$138.12 ,$102.90 ,$90.47 ,$138.12 ,$38.67 ,$69.75 ,$138.12 ,$85.22 ,$138.12 ,$85.22 ,$85.22 ,$138.12 ,$85.22 ,$280.10 ,$124.31 ,$103.59 ,$138.12 ,$138.12 ,$121.55 ,$138.12 ,$103.59 ,$103.59 ,$117.40 ,$117.40 ,$138.12 ,$117.40 ,$138.12 ,$107.73 ,$107.73 ,$107.73 ,$124.31 ,$138.12 ,$124.31 ,$138.12 ,$138.12 ,$90.47 ,$138.12 ,$83.65 ,$138.12 ,$138.12 ,$138.12 ,$124.31 ,$319.47 ,$85.22 ,$38.67 ,$124.31 ,$138.12 , N/A , N/A ,$138.12 ,$89.78 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600002,95810,PC SLEEP STUDY PSG 4+ PARAMETERS >6YRS-26,986,1 ,$373.02 ,$242.46 ,$104.45 ,"$2,105.20 ",$373.02 ,$277.90 ,$244.33 ,$373.02 ,$104.45 ,$188.38 ,$373.02 ,$230.15 ,$373.02 ,$230.15 ,$230.15 ,$373.02 ,$230.15 ,"$1,845.70 ",$335.72 ,$279.77 ,$373.02 ,$373.02 ,$328.26 ,$373.02 ,$279.77 ,$279.77 ,$317.07 ,$317.07 ,$373.02 ,$317.07 ,$373.02 ,$290.96 ,$290.96 ,$290.96 ,$335.72 ,$373.02 ,$335.72 ,$373.02 ,$373.02 ,$244.33 ,$373.02 ,$225.59 ,$373.02 ,$373.02 ,$373.02 ,$335.72 ,"$2,105.20 ",$230.15 ,$104.45 ,$335.72 ,$373.02 , N/A , N/A ,$373.02 ,$242.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600003,95811,PC SLEEP STUDY PSG 4+ PRMTRS W/CPAP>6YR-26,986,1 ,$386.82 ,$251.43 ,$108.31 ,"$2,105.20 ",$386.82 ,$288.18 ,$253.37 ,$386.82 ,$108.31 ,$195.34 ,$386.82 ,$238.67 ,$386.82 ,$238.67 ,$238.67 ,$386.82 ,$238.67 ,"$1,845.70 ",$348.14 ,$290.12 ,$386.82 ,$386.82 ,$340.40 ,$386.82 ,$290.12 ,$290.12 ,$328.80 ,$328.80 ,$386.82 ,$328.80 ,$386.82 ,$301.72 ,$301.72 ,$301.72 ,$348.14 ,$386.82 ,$348.14 ,$386.82 ,$386.82 ,$253.37 ,$386.82 ,$234.06 ,$386.82 ,$386.82 ,$386.82 ,$348.14 ,"$2,105.20 ",$238.67 ,$108.31 ,$348.14 ,$386.82 , N/A , N/A ,$386.82 ,$251.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600004,95805,PC MULTIPLE SLEEP LATENCY TEST-26,986,1 ,$182.07 ,$118.35 ,$50.98 ,"$1,116.96 ",$182.07 ,$135.64 ,$119.26 ,$182.07 ,$50.98 ,$91.95 ,$182.07 ,$112.34 ,$182.07 ,$112.34 ,$112.34 ,$182.07 ,$112.34 ,$979.28 ,$163.86 ,$136.55 ,$182.07 ,$182.07 ,$160.22 ,$182.07 ,$136.55 ,$136.55 ,$154.76 ,$154.76 ,$182.07 ,$154.76 ,$182.07 ,$142.01 ,$142.01 ,$142.01 ,$163.86 ,$182.07 ,$163.86 ,$182.07 ,$182.07 ,$119.26 ,$182.07 ,$109.87 ,$182.07 ,$182.07 ,$182.07 ,$163.86 ,"$1,116.96 ",$112.34 ,$50.98 ,$163.86 ,$182.07 , N/A , N/A ,$182.07 ,$118.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600005,G0399,PC HOME SLEEP STUDY-26,986,1 ,$396.63 ,$257.81 ,$83.00 ,$396.63 ,$353.89 ,$295.49 ,$259.79 ,$147.42 ,$111.06 ,$200.30 ,$147.42 ,$244.72 ,$147.42 ,$244.72 ,$244.72 ,$147.42 ,$244.72 ,$280.10 ,$356.97 ,$297.47 ,$353.89 ,$147.42 ,$349.03 ,$147.42 ,$297.47 ,$297.47 ,$337.14 ,$337.14 ,$147.42 ,$337.14 ,$147.42 ,$309.37 ,$309.37 ,$309.37 ,$356.97 ,$353.89 ,$356.97 ,$147.42 ,$396.63 ,$259.79 ,$147.42 ,$277.64 ,$86.96 ,$83.00 ,$154.30 ,$356.97 ,$319.47 ,$244.72 ,$111.06 ,$356.97 ,$147.42 , N/A , N/A ,$147.42 ,$257.81 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600006,95807,PC SLEEP STUDY ATTENDED NAP - 26,986,1 ,$186.69 ,$121.35 ,$52.27 ,"$1,116.96 ",$186.69 ,$139.08 ,$122.28 ,$186.69 ,$52.27 ,$94.28 ,$186.69 ,$115.19 ,$186.69 ,$115.19 ,$115.19 ,$186.69 ,$115.19 ,$979.28 ,$168.02 ,$140.02 ,$186.69 ,$186.69 ,$164.29 ,$186.69 ,$140.02 ,$140.02 ,$158.69 ,$158.69 ,$186.69 ,$158.69 ,$186.69 ,$145.62 ,$145.62 ,$145.62 ,$168.02 ,$186.69 ,$168.02 ,$186.69 ,$186.69 ,$122.28 ,$186.69 ,$114.58 ,$186.69 ,$186.69 ,$186.69 ,$168.02 ,"$1,116.96 ",$115.19 ,$52.27 ,$168.02 ,$186.69 , N/A , N/A ,$186.69 ,$121.35 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600007,95811,PC SLEEP STUDY PSG 4+ PRMTRS W/CPAP>6YR - 26,986,1 ,$386.82 ,$251.43 ,$108.31 ,"$2,105.20 ",$386.82 ,$288.18 ,$253.37 ,$386.82 ,$108.31 ,$195.34 ,$386.82 ,$238.67 ,$386.82 ,$238.67 ,$238.67 ,$386.82 ,$238.67 ,"$1,845.70 ",$348.14 ,$290.12 ,$386.82 ,$386.82 ,$340.40 ,$386.82 ,$290.12 ,$290.12 ,$328.80 ,$328.80 ,$386.82 ,$328.80 ,$386.82 ,$301.72 ,$301.72 ,$301.72 ,$348.14 ,$386.82 ,$348.14 ,$386.82 ,$386.82 ,$253.37 ,$386.82 ,$386.82 ,$386.82 ,$386.82 ,$386.82 ,$348.14 ,"$2,105.20 ",$238.67 ,$108.31 ,$348.14 ,$386.82 , N/A , N/A ,$386.82 ,$251.43 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98600008,95810,PC SLEEP STUDY PSG 4+ PARAMETERS >6YRS - 26,986,1 ,$373.02 ,$242.46 ,$104.45 ,"$2,105.20 ",$373.02 ,$277.90 ,$244.33 ,$373.02 ,$104.45 ,$188.38 ,$373.02 ,$230.15 ,$373.02 ,$230.15 ,$230.15 ,$373.02 ,$230.15 ,"$1,845.70 ",$335.72 ,$279.77 ,$373.02 ,$373.02 ,$328.26 ,$373.02 ,$279.77 ,$279.77 ,$317.07 ,$317.07 ,$373.02 ,$317.07 ,$373.02 ,$290.96 ,$290.96 ,$290.96 ,$335.72 ,$373.02 ,$335.72 ,$373.02 ,$373.02 ,$244.33 ,$373.02 ,$373.02 ,$373.02 ,$373.02 ,$373.02 ,$335.72 ,"$2,105.20 ",$230.15 ,$104.45 ,$335.72 ,$373.02 , N/A , N/A ,$373.02 ,$242.46 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780006,99238,PC HOSPITAL DISCHARGE DAY <31MIN,987,1 ,$654.00 ,$425.10 ,$93.29 ,$654.00 , N/A ,$487.23 ,$428.37 , N/A ,$183.12 ,$330.27 , N/A ,$403.52 , N/A ,$403.52 ,$403.52 , N/A ,$403.52 , N/A ,$588.60 ,$490.50 , N/A , N/A ,$575.52 , N/A ,$490.50 ,$490.50 ,$555.90 ,$555.90 , N/A ,$555.90 , N/A ,$510.12 ,$510.12 ,$510.12 ,$588.60 , N/A ,$588.60 , N/A ,$654.00 ,$428.37 , N/A ,$93.29 , N/A , N/A , N/A ,$588.60 , N/A ,$403.52 ,$183.12 ,$588.60 , N/A , N/A , N/A , N/A ,$425.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780007,99239,PC HOSPITAL DISCHARGE DAY >30MIN,987,1 ,$654.00 ,$425.10 ,$136.71 ,$654.00 , N/A ,$487.23 ,$428.37 , N/A ,$183.12 ,$330.27 , N/A ,$403.52 , N/A ,$403.52 ,$403.52 , N/A ,$403.52 , N/A ,$588.60 ,$490.50 , N/A , N/A ,$575.52 , N/A ,$490.50 ,$490.50 ,$555.90 ,$555.90 , N/A ,$555.90 , N/A ,$510.12 ,$510.12 ,$510.12 ,$588.60 , N/A ,$588.60 , N/A ,$654.00 ,$428.37 , N/A ,$136.71 , N/A , N/A , N/A ,$588.60 , N/A ,$403.52 ,$183.12 ,$588.60 , N/A , N/A , N/A , N/A ,$425.10 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780009,99225,PC SUBSQ OBSERVATION CARE LEV 2,987,1 ,$212.28 ,$137.98 ,$59.44 ,$212.28 , N/A ,$158.15 ,$139.04 , N/A ,$59.44 ,$107.20 , N/A ,$130.98 , N/A ,$130.98 ,$130.98 , N/A ,$130.98 , N/A ,$191.05 ,$159.21 , N/A , N/A ,$186.81 , N/A ,$159.21 ,$159.21 ,$180.44 ,$180.44 , N/A ,$180.44 , N/A ,$165.58 ,$165.58 ,$165.58 ,$191.05 , N/A ,$191.05 , N/A ,$212.28 ,$139.04 , N/A ,$93.30 ,$102.37 ,$97.71 , N/A ,$191.05 , N/A ,$130.98 ,$59.44 ,$191.05 , N/A , N/A , N/A , N/A ,$137.98 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780011,99460,PC INIT HOSP E AND M NEWBORN CARE PER DAY,987,1 ,$300.00 ,$195.00 ,$84.00 ,$300.00 ,$300.00 ,$223.50 ,$196.50 ,$125.46 ,$84.00 ,$151.50 ,$125.46 ,$185.10 ,$125.46 ,$185.10 ,$185.10 ,$125.46 ,$185.10 ,$238.37 ,$270.00 ,$225.00 ,$300.00 ,$125.46 ,$264.00 ,$125.46 ,$225.00 ,$225.00 ,$255.00 ,$255.00 ,$125.46 ,$255.00 ,$125.46 ,$234.00 ,$234.00 ,$234.00 ,$270.00 ,$300.00 ,$270.00 ,$125.46 ,$300.00 ,$196.50 ,$125.46 ,$123.25 , N/A , N/A ,$131.32 ,$270.00 ,$271.89 ,$185.10 ,$84.00 ,$270.00 ,$125.46 , N/A , N/A ,$125.46 ,$195.00 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780012,99462,PC SUBSQ HOSP E AND M NEWBORN CARE PER DAY,987,1 ,$132.00 ,$85.80 ,$36.96 ,$132.00 , N/A ,$98.34 ,$86.46 , N/A ,$36.96 ,$66.66 , N/A ,$81.44 , N/A ,$81.44 ,$81.44 , N/A ,$81.44 , N/A ,$118.80 ,$99.00 , N/A , N/A ,$116.16 , N/A ,$99.00 ,$99.00 ,$112.20 ,$112.20 , N/A ,$112.20 , N/A ,$102.96 ,$102.96 ,$102.96 ,$118.80 , N/A ,$118.80 , N/A ,$132.00 ,$86.46 , N/A ,$54.39 , N/A , N/A , N/A ,$118.80 , N/A ,$81.44 ,$36.96 ,$118.80 , N/A , N/A , N/A , N/A ,$85.80 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780013,99463,PC INIT HOSP E AND M NEWBORN CARE SAME DAY ADMIT/DISCH,987,1 ,$357.00 ,$232.05 ,$99.96 ,$357.00 ,$301.17 ,$265.97 ,$233.84 ,$125.46 ,$99.96 ,$180.29 ,$125.46 ,$220.27 ,$125.46 ,$220.27 ,$220.27 ,$125.46 ,$220.27 ,$238.37 ,$321.30 ,$267.75 ,$301.17 ,$125.46 ,$314.16 ,$125.46 ,$267.75 ,$267.75 ,$303.45 ,$303.45 ,$125.46 ,$303.45 ,$125.46 ,$278.46 ,$278.46 ,$278.46 ,$321.30 ,$301.17 ,$321.30 ,$125.46 ,$357.00 ,$233.84 ,$125.46 ,$141.96 , N/A , N/A ,$131.32 ,$321.30 ,$271.89 ,$220.27 ,$99.96 ,$321.30 ,$125.46 , N/A , N/A ,$125.46 ,$232.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780014,99468,PC INIT HOSP E AND M CRIT CARE NEONATE<28 DAYS,987,1 ,"$3,000.00 ","$1,950.00 ",$840.00 ,"$3,000.00 ", N/A ,"$2,235.00 ","$1,965.00 ", N/A ,$840.00 ,"$1,515.00 ", N/A ,"$1,851.00 ", N/A ,"$1,851.00 ","$1,851.00 ", N/A ,"$1,851.00 ", N/A ,"$2,700.00 ","$2,250.00 ", N/A , N/A ,"$2,640.00 ", N/A ,"$2,250.00 ","$2,250.00 ","$2,550.00 ","$2,550.00 ", N/A ,"$2,550.00 ", N/A ,"$2,340.00 ","$2,340.00 ","$2,340.00 ","$2,700.00 ", N/A ,"$2,700.00 ", N/A ,"$3,000.00 ","$1,965.00 ", N/A ,"$1,186.17 ", N/A , N/A , N/A ,"$2,700.00 ", N/A ,"$1,851.00 ",$840.00 ,"$2,700.00 ", N/A , N/A , N/A , N/A ,"$1,950.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780015,99469,PC SUBSQ HOSP E AND M CRIT CARE NEONATE<28 DAYS,987,1 ,"$1,203.00 ",$781.95 ,$336.84 ,"$1,203.00 ", N/A ,$896.24 ,$787.97 , N/A ,$336.84 ,$607.52 , N/A ,$742.25 , N/A ,$742.25 ,$742.25 , N/A ,$742.25 , N/A ,"$1,082.70 ",$902.25 , N/A , N/A ,"$1,058.64 ", N/A ,$902.25 ,$902.25 ,"$1,022.55 ","$1,022.55 ", N/A ,"$1,022.55 ", N/A ,$938.34 ,$938.34 ,$938.34 ,"$1,082.70 ", N/A ,"$1,082.70 ", N/A ,"$1,203.00 ",$787.97 , N/A ,$513.61 , N/A , N/A , N/A ,"$1,082.70 ", N/A ,$742.25 ,$336.84 ,"$1,082.70 ", N/A , N/A , N/A , N/A ,$781.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780016,99475,PC INIT HOSP E AND M CRIT CARE PEDS>24 MOS,987,1 ,"$1,740.00 ","$1,131.00 ",$487.20 ,"$1,740.00 ", N/A ,"$1,296.30 ","$1,139.70 ", N/A ,$487.20 ,$878.70 , N/A ,"$1,073.58 ", N/A ,"$1,073.58 ","$1,073.58 ", N/A ,"$1,073.58 ", N/A ,"$1,566.00 ","$1,305.00 ", N/A , N/A ,"$1,531.20 ", N/A ,"$1,305.00 ","$1,305.00 ","$1,479.00 ","$1,479.00 ", N/A ,"$1,479.00 ", N/A ,"$1,357.20 ","$1,357.20 ","$1,357.20 ","$1,566.00 ", N/A ,"$1,566.00 ", N/A ,"$1,740.00 ","$1,139.70 ", N/A ,$722.77 , N/A , N/A , N/A ,"$1,566.00 ", N/A ,"$1,073.58 ",$487.20 ,"$1,566.00 ", N/A , N/A , N/A , N/A ,"$1,131.00 "
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780017,99476,PC SUBSQ HOSP E AND M CRIT CARE PEDS>24 MOS,987,1 ,"$1,041.00 ",$676.65 ,$291.48 ,"$1,041.00 ", N/A ,$775.55 ,$681.86 , N/A ,$291.48 ,$525.71 , N/A ,$642.30 , N/A ,$642.30 ,$642.30 , N/A ,$642.30 , N/A ,$936.90 ,$780.75 , N/A , N/A ,$916.08 , N/A ,$780.75 ,$780.75 ,$884.85 ,$884.85 , N/A ,$884.85 , N/A ,$811.98 ,$811.98 ,$811.98 ,$936.90 , N/A ,$936.90 , N/A ,"$1,041.00 ",$681.86 , N/A ,$447.19 , N/A , N/A , N/A ,$936.90 , N/A ,$642.30 ,$291.48 ,$936.90 , N/A , N/A , N/A , N/A ,$676.65 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780018,99477,PC INIT HOSP E AND M INTENSIVE CARE NEO<28 DAYS,987,1 ,"$1,065.00 ",$692.25 ,$298.20 ,"$1,065.00 ", N/A ,$793.43 ,$697.58 , N/A ,$298.20 ,$537.83 , N/A ,$657.11 , N/A ,$657.11 ,$657.11 , N/A ,$657.11 , N/A ,$958.50 ,$798.75 , N/A , N/A ,$937.20 , N/A ,$798.75 ,$798.75 ,$905.25 ,$905.25 , N/A ,$905.25 , N/A ,$830.70 ,$830.70 ,$830.70 ,$958.50 , N/A ,$958.50 , N/A ,"$1,065.00 ",$697.58 , N/A ,$450.73 , N/A , N/A , N/A ,$958.50 , N/A ,$657.11 ,$298.20 ,$958.50 , N/A , N/A , N/A , N/A ,$692.25 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780019,99478,PC SUBSQ HOSP E AND M INTENSIVE CARE NEO WT<1500GM,987,1 ,$423.00 ,$274.95 ,$118.44 ,$423.00 , N/A ,$315.14 ,$277.07 , N/A ,$118.44 ,$213.62 , N/A ,$260.99 , N/A ,$260.99 ,$260.99 , N/A ,$260.99 , N/A ,$380.70 ,$317.25 , N/A , N/A ,$372.24 , N/A ,$317.25 ,$317.25 ,$359.55 ,$359.55 , N/A ,$359.55 , N/A ,$329.94 ,$329.94 ,$329.94 ,$380.70 , N/A ,$380.70 , N/A ,$423.00 ,$277.07 , N/A ,$177.17 , N/A , N/A , N/A ,$380.70 , N/A ,$260.99 ,$118.44 ,$380.70 , N/A , N/A , N/A , N/A ,$274.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780020,99479,PC SUBSQ HOSP E AND M INTENSIVE CARE NEO WT 1500-2500GM,987,1 ,$375.00 ,$243.75 ,$105.00 ,$375.00 , N/A ,$279.38 ,$245.63 , N/A ,$105.00 ,$189.38 , N/A ,$231.38 , N/A ,$231.38 ,$231.38 , N/A ,$231.38 , N/A ,$337.50 ,$281.25 , N/A , N/A ,$330.00 , N/A ,$281.25 ,$281.25 ,$318.75 ,$318.75 , N/A ,$318.75 , N/A ,$292.50 ,$292.50 ,$292.50 ,$337.50 , N/A ,$337.50 , N/A ,$375.00 ,$245.63 , N/A ,$160.71 , N/A , N/A , N/A ,$337.50 , N/A ,$231.38 ,$105.00 ,$337.50 , N/A , N/A , N/A , N/A ,$243.75 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98780021,99480,PC SUBSQ HOSP E AND M INTENSIVE CARE NEO WT 2501-5000GM,987,1 ,$363.00 ,$235.95 ,$101.64 ,$363.00 , N/A ,$270.44 ,$237.77 , N/A ,$101.64 ,$183.32 , N/A ,$223.97 , N/A ,$223.97 ,$223.97 , N/A ,$223.97 , N/A ,$326.70 ,$272.25 , N/A , N/A ,$319.44 , N/A ,$272.25 ,$272.25 ,$308.55 ,$308.55 , N/A ,$308.55 , N/A ,$283.14 ,$283.14 ,$283.14 ,$326.70 , N/A ,$326.70 , N/A ,$363.00 ,$237.77 , N/A ,$154.27 , N/A , N/A , N/A ,$326.70 , N/A ,$223.97 ,$101.64 ,$326.70 , N/A , N/A , N/A , N/A ,$235.95 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98800013,99221,PC INITIAL HOSPITAL CARE LVL 1 LOW 30MIN,987,1 ,$306.00 ,$198.90 ,$85.68 ,$306.00 , N/A ,$227.97 ,$200.43 , N/A ,$85.68 ,$154.53 , N/A ,$188.80 , N/A ,$188.80 ,$188.80 , N/A ,$188.80 , N/A ,$275.40 ,$229.50 , N/A , N/A ,$269.28 , N/A ,$229.50 ,$229.50 ,$260.10 ,$260.10 , N/A ,$260.10 , N/A ,$238.68 ,$238.68 ,$238.68 ,$275.40 , N/A ,$275.40 , N/A ,$306.00 ,$200.43 , N/A ,$131.76 , N/A , N/A , N/A ,$275.40 , N/A ,$188.80 ,$85.68 ,$275.40 , N/A , N/A , N/A , N/A ,$198.90 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98800015,99222,PC INITIAL HOSPITAL CARE LVL 2 MOD 50MIN,987,1 ,$411.00 ,$267.15 ,$115.08 ,$411.00 , N/A ,$306.20 ,$269.21 , N/A ,$115.08 ,$207.56 , N/A ,$253.59 , N/A ,$253.59 ,$253.59 , N/A ,$253.59 , N/A ,$369.90 ,$308.25 , N/A , N/A ,$361.68 , N/A ,$308.25 ,$308.25 ,$349.35 ,$349.35 , N/A ,$349.35 , N/A ,$320.58 ,$320.58 ,$320.58 ,$369.90 , N/A ,$369.90 , N/A ,$411.00 ,$269.21 , N/A ,$177.57 , N/A , N/A , N/A ,$369.90 , N/A ,$253.59 ,$115.08 ,$369.90 , N/A , N/A , N/A , N/A ,$267.15 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98800016,99223,PC INITIAL HOSPITAL CARE LVL 3 HIGH 70MIN,987,1 ,$609.00 ,$395.85 ,$170.52 ,$609.00 , N/A ,$453.71 ,$398.90 , N/A ,$170.52 ,$307.55 , N/A ,$375.75 , N/A ,$375.75 ,$375.75 , N/A ,$375.75 , N/A ,$548.10 ,$456.75 , N/A , N/A ,$535.92 , N/A ,$456.75 ,$456.75 ,$517.65 ,$517.65 , N/A ,$517.65 , N/A ,$475.02 ,$475.02 ,$475.02 ,$548.10 , N/A ,$548.10 , N/A ,$609.00 ,$398.90 , N/A ,$260.20 , N/A , N/A , N/A ,$548.10 , N/A ,$375.75 ,$170.52 ,$548.10 , N/A , N/A , N/A , N/A ,$395.85 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98800017,99231,PC SUBSQ HOSPITAL CARE LVL 1 LOW 15MIN,987,1 ,$117.00 ,$76.05 ,$32.76 ,$117.00 , N/A ,$87.17 ,$76.64 , N/A ,$32.76 ,$59.09 , N/A ,$72.19 , N/A ,$72.19 ,$72.19 , N/A ,$72.19 , N/A ,$105.30 ,$87.75 , N/A , N/A ,$102.96 , N/A ,$87.75 ,$87.75 ,$99.45 ,$99.45 , N/A ,$99.45 , N/A ,$91.26 ,$91.26 ,$91.26 ,$105.30 , N/A ,$105.30 , N/A ,$117.00 ,$76.64 , N/A ,$50.69 , N/A , N/A , N/A ,$105.30 , N/A ,$72.19 ,$32.76 ,$105.30 , N/A , N/A , N/A , N/A ,$76.05 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98800018,99232,PC SUBSQ HOSPITAL CARE LVL 2 MOD 25MIN,987,1 ,$216.00 ,$140.40 ,$60.48 ,$216.00 , N/A ,$160.92 ,$141.48 , N/A ,$60.48 ,$109.08 , N/A ,$133.27 , N/A ,$133.27 ,$133.27 , N/A ,$133.27 , N/A ,$194.40 ,$162.00 , N/A , N/A ,$190.08 , N/A ,$162.00 ,$162.00 ,$183.60 ,$183.60 , N/A ,$183.60 , N/A ,$168.48 ,$168.48 ,$168.48 ,$194.40 , N/A ,$194.40 , N/A ,$216.00 ,$141.48 , N/A ,$92.87 , N/A , N/A , N/A ,$194.40 , N/A ,$133.27 ,$60.48 ,$194.40 , N/A , N/A , N/A , N/A ,$140.40 
ST. ANTHONY'S MEMORIAL HOSPITAL (ACU),98800019,99233,PC SUBSQ HOSPITAL CARE LVL 3 HIGH 35MIN,987,1 ,$315.00 ,$204.75 ,$88.20 ,$315.00 , N/A ,$234.68 ,$206.33 , N/A ,$88.20 ,$159.08 , N/A ,$194.36 , N/A ,$194.36 ,$194.36 , N/A ,$194.36 , N/A ,$283.50 ,$236.25 , N/A , N/A ,$277.20 , N/A ,$236.25 ,$236.25 ,$267.75 ,$267.75 , N/A ,$267.75 , N/A ,$245.70 ,$245.70 ,$245.70 ,$283.50 , N/A ,$283.50 , N/A ,$315.00 ,$206.33 , N/A ,$133.84 , N/A , N/A , N/A ,$283.50 , N/A ,$194.36 ,$88.20 ,$283.50 , N/A , N/A , N/A , N/A ,$204.75