HOLY FAMILY HOSPITAL - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hospital_Cdm_Chg , Self_Pay_Chg , Minimum_Negotiated_Chg , Maximum_Negotiated_Chg , AETNA , 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 OF ILLINOIS MEDICARE ADV , CELTIC INSURANCE COMPANY , CIGNA , CLAIM DOC , CLEAR SPRING HEALTH MEDICARE ADV , COFINITY , CONSOCIATE GROUP ," ESSENCE, L.L.P. ", FIRST HEALTH NETWORK , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE ," HEALTH ALLIANCE MEDICAL PLANS, INC. ", HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTHLINK , HEALTHLINK PPO , HOPETRUST , HUMANA , HUMANA MEDICARE , HUMANA MEDICARE ADVANTAGE , 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 , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , WELLFIRST HSHS HOLY FAMILY HOSPITAL INC (ACU),N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$43,572.74 ","$6,137.62 ","$84,316.32 ","$39,336.51 ","$80,301.26 ","$16,944.96 ","$60,517.70 ","$80,301.26 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$39,941.68 ","$60,517.70 ","$81,104.27 ","$51,440.05 ","$54,465.93 ","$59,307.35 ","$45,388.28 ","$33,284.74 ","$33,284.74 ","$80,301.26 ","$33,284.74 ","$43,572.74 ","$43,572.74 ","$60,517.70 ","$21,000.00 ","$81,940.06 ","$81,940.06 ","$33,950.43 ","$59,307.35 ","$25,175.36 ","$6,429.88 ","$6,137.62 ","$84,316.32 ","$45,388.28 ","$60,517.70 ","$60,517.70 ","$16,944.96 ","$54,465.93 ","$60,517.70 ","$59,307.35 ","$39,336.51 " HSHS HOLY FAMILY HOSPITAL INC (ACU),N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$11,020.10 ","$2,620.18 ","$22,722.37 ","$9,948.71 ","$21,640.35 ","$4,285.60 ","$15,305.70 ","$21,640.35 ","$15,305.70 ","$14,999.59 ","$15,263.84 ","$14,999.59 ","$15,305.70 ","$10,101.76 ","$15,305.70 ","$21,856.75 ","$13,009.85 ","$13,775.13 ","$14,999.59 ","$11,479.28 ","$8,418.14 ","$8,418.14 ","$21,640.35 ","$8,418.14 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$2,800.00 ","$22,081.99 ","$22,081.99 ","$8,586.50 ","$14,999.59 ","$6,367.17 ","$2,744.95 ","$2,620.18 ","$22,722.37 ","$3,000.00 ","$15,305.70 ","$15,263.84 ","$4,285.60 ","$13,775.13 ","$15,305.70 ","$14,999.59 ","$9,948.71 " HSHS HOLY FAMILY HOSPITAL INC (ACU),N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$8,247.72 ","$2,620.18 ","$17,396.10 ","$7,445.85 ","$16,567.71 ","$3,207.44 ","$11,455.16 ","$16,567.71 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$11,226.06 ","$11,455.16 ","$7,560.41 ","$11,455.16 ","$16,733.39 ","$9,736.89 ","$10,309.64 ","$11,226.06 ","$8,591.37 ","$6,300.34 ","$6,300.34 ","$16,567.71 ","$6,300.34 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$2,800.00 ","$16,905.83 ","$16,905.83 ","$6,426.34 ","$11,226.06 ","$4,765.35 ","$2,744.95 ","$2,620.18 ","$17,396.10 ","$3,000.00 ","$11,455.16 ","$11,455.16 ","$3,207.44 ","$10,309.64 ","$11,455.16 ","$11,226.06 ","$7,445.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$17,060.09 ","$2,620.18 ","$33,242.44 ","$15,401.47 ","$31,659.47 ","$6,634.48 ","$23,694.57 ","$31,659.47 ","$23,694.57 ","$23,220.68 ","$22,675.09 ","$23,220.68 ","$23,694.57 ","$15,638.42 ","$23,694.57 ","$31,976.07 ","$20,140.38 ","$21,325.11 ","$23,220.68 ","$17,770.93 ","$13,032.01 ","$13,032.01 ","$31,659.47 ","$13,032.01 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$5,600.00 ","$32,305.58 ","$32,305.58 ","$13,292.65 ","$23,220.68 ","$9,856.94 ","$2,744.95 ","$2,620.18 ","$33,242.44 ","$6,000.00 ","$23,694.57 ","$22,675.09 ","$6,634.48 ","$21,325.11 ","$23,694.57 ","$23,220.68 ","$15,401.47 " HSHS HOLY FAMILY HOSPITAL INC (ACU),N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$4,916.60 ","$1,912.01 ","$11,060.46 ","$4,438.60 ","$10,533.77 ","$1,912.01 ","$6,828.61 ","$10,533.77 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$6,692.04 ","$6,828.61 ","$4,506.88 ","$6,828.61 ","$10,639.11 ","$5,804.32 ","$6,145.75 ","$6,692.04 ","$5,121.46 ","$3,755.74 ","$3,755.74 ","$10,533.77 ","$3,755.74 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$2,800.00 ","$10,748.74 ","$10,748.74 ","$3,830.85 ","$6,692.04 ","$2,840.70 ","$2,744.95 ","$2,620.18 ","$11,060.46 ","$3,000.00 ","$6,828.61 ","$6,828.61 ","$1,912.01 ","$6,145.75 ","$6,828.61 ","$6,692.04 ","$4,438.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,$945.00 ,$680.40 ,$264.60 ,$945.00 ,$614.25 , Inpatient Medicare ,$264.60 ,"$6,355.50 ", Inpatient Medicare ,"$6,690.00 ", Inpatient Medicare ,"$6,021.00 ", Inpatient Medicare , Inpatient Medicare +102% ,$623.70 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$803.25 ,$850.50 , Inpatient Medicare +2% ,$708.75 ,$519.75 ,$519.75 , Inpatient Medicare ,$519.75 ,"$9,566.00 ","$9,566.00 ", Inpatient Medicare +150% ,"$1,400.00 ", Inpatient Medicare , Inpatient Medicare ,$530.15 , Inpatient Medicare ,$393.12 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,500.00 ", Inpatient Medicare +80% ,"$6,021.00 ",$264.60 ,$850.50 ,"$8,672.00 ", Inpatient Medicare ,$614.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),12000002,N/A,HC DAILY SERVICE SWING BED,120,1 ,$543.00 ,$390.96 ,$152.04 ,$543.00 ,$352.95 , Inpatient Medicare ,$152.04 ,"$6,355.50 ", Inpatient Medicare ,"$6,690.00 ", Inpatient Medicare ,"$6,021.00 ", Inpatient Medicare , Inpatient Medicare +102% ,$358.38 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$461.55 ,$488.70 , Inpatient Medicare +2% ,$407.25 ,$298.65 ,$298.65 , Inpatient Medicare ,$298.65 ,"$9,566.00 ","$9,566.00 ", Inpatient Medicare +150% ,"$1,400.00 ", Inpatient Medicare , Inpatient Medicare ,$304.62 , Inpatient Medicare ,$225.89 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,500.00 ", Inpatient Medicare +80% ,"$6,021.00 ",$152.04 ,$488.70 ,"$8,672.00 ", Inpatient Medicare ,$352.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),12000006,N/A,HC DAILY SERVICE W/TELEMETRY,120,1 ,"$1,341.00 ",$965.52 ,$375.48 ,"$1,341.00 ",$871.65 , Inpatient Medicare ,$375.48 ,"$6,355.50 ", Inpatient Medicare ,"$6,690.00 ", Inpatient Medicare ,"$6,021.00 ", Inpatient Medicare , Inpatient Medicare +102% ,$885.06 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,139.85 ","$1,206.90 ", Inpatient Medicare +2% ,"$1,005.75 ",$737.55 ,$737.55 , Inpatient Medicare ,$737.55 ,"$9,566.00 ","$9,566.00 ", Inpatient Medicare +150% ,"$1,400.00 ", Inpatient Medicare , Inpatient Medicare ,$752.30 , Inpatient Medicare ,$557.86 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,500.00 ", Inpatient Medicare +80% ,"$6,021.00 ",$375.48 ,"$1,206.90 ","$8,672.00 ", Inpatient Medicare ,$871.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,$945.00 ,$680.40 ,$264.60 ,$945.00 ,$614.25 , Inpatient Medicare ,$264.60 ,"$6,355.50 ", Inpatient Medicare ,"$6,690.00 ", Inpatient Medicare ,"$6,021.00 ", Inpatient Medicare , Inpatient Medicare +102% ,$623.70 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$803.25 ,$850.50 , Inpatient Medicare +2% ,$708.75 ,$519.75 ,$519.75 , Inpatient Medicare ,$519.75 ,"$9,566.00 ","$9,566.00 ", Inpatient Medicare +150% ,"$1,400.00 ", Inpatient Medicare , Inpatient Medicare ,$530.15 , Inpatient Medicare ,$393.12 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,500.00 ", Inpatient Medicare +80% ,"$6,021.00 ",$264.60 ,$850.50 ,"$8,672.00 ", Inpatient Medicare ,$614.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ACETYLCYSTEINE 20 % SOLN per1 g,250,1 ,$31.00 ,$22.32 ,$8.68 ,$31.00 ,$20.15 , N/A ,$8.68 ,$17.14 , N/A ,$18.04 , N/A ,$16.24 , N/A , N/A ,$28.52 , N/A , N/A ,$26.35 ,$27.90 , N/A ,$23.25 ,$21.70 ,$21.70 , N/A ,$21.70 ,$23.87 ,$23.87 , N/A ,$26.35 , N/A , N/A ,$17.39 ,$12.83 ,$12.90 , N/A , N/A , N/A ,$26.35 , N/A ,$16.24 ,$8.68 ,$27.90 ,$16.37 , N/A ,$20.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,AZTREONAM 1 G SOLR 1 EACH VIAL per,250,1 ,$173.25 ,$124.74 ,$48.51 ,$173.25 ,$112.61 , N/A ,$48.51 ,$95.81 , N/A ,$100.83 , N/A ,$90.78 , N/A , N/A ,$159.39 , N/A , N/A ,$147.26 ,$155.93 , N/A ,$129.94 ,$121.28 ,$121.28 , N/A ,$121.28 ,$133.40 ,$133.40 , N/A ,$147.26 , N/A , N/A ,$97.19 ,$71.73 ,$72.07 , N/A , N/A , N/A ,$147.26 , N/A ,$90.78 ,$48.51 ,$155.93 ,$91.48 , N/A ,$112.61 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BRIMONIDINE 0.2 % SOLN 10 ML BOTTLE per,250,1 ,$68.50 ,$49.32 ,$19.18 ,$68.50 ,$44.53 , N/A ,$19.18 ,$37.88 , N/A ,$39.87 , N/A ,$35.89 , N/A , N/A ,$63.02 , N/A , N/A ,$58.23 ,$61.65 , N/A ,$51.38 ,$47.95 ,$47.95 , N/A ,$47.95 ,$52.75 ,$52.75 , N/A ,$58.23 , N/A , N/A ,$38.43 ,$28.36 ,$28.50 , N/A , N/A , N/A ,$58.23 , N/A ,$35.89 ,$19.18 ,$61.65 ,$36.17 , N/A ,$44.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BRIMONIDINE 0.2 % SOLN 5 ML BOTTLE per,250,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 ,$16.25 , N/A ,$7.00 ,$13.83 , N/A ,$14.55 , N/A ,$13.10 , N/A , N/A ,$23.00 , N/A , N/A ,$21.25 ,$22.50 , N/A ,$18.75 ,$17.50 ,$17.50 , N/A ,$17.50 ,$19.25 ,$19.25 , N/A ,$21.25 , N/A , N/A ,$14.03 ,$10.35 ,$10.40 , N/A , N/A , N/A ,$21.25 , N/A ,$13.10 ,$7.00 ,$22.50 ,$13.20 , N/A ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUDESONIDE 0.5 MG/2ML SUSP per,250,1 ,$22.50 ,$16.20 ,$6.30 ,$22.50 ,$14.63 , N/A ,$6.30 ,$12.44 , N/A ,$13.10 , N/A ,$11.79 , N/A , N/A ,$20.70 , N/A , N/A ,$19.13 ,$20.25 , N/A ,$16.88 ,$15.75 ,$15.75 , N/A ,$15.75 ,$17.33 ,$17.33 , N/A ,$19.13 , N/A , N/A ,$12.62 ,$9.32 ,$9.36 , N/A , N/A , N/A ,$19.13 , N/A ,$11.79 ,$6.30 ,$20.25 ,$11.88 , N/A ,$14.63 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN 10 ML VIAL per,250,1 ,$12.00 ,$8.64 ,$3.36 ,$12.00 ,$7.80 , N/A ,$3.36 ,$6.64 , N/A ,$6.98 , N/A ,$6.29 , N/A , N/A ,$11.04 , N/A , N/A ,$10.20 ,$10.80 , N/A ,$9.00 ,$8.40 ,$8.40 , N/A ,$8.40 ,$9.24 ,$9.24 , N/A ,$10.20 , N/A , N/A ,$6.73 ,$4.97 ,$4.99 , N/A , N/A , N/A ,$10.20 , N/A ,$6.29 ,$3.36 ,$10.80 ,$6.34 , N/A ,$7.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUPIVACAINE-EPINEPHRINE PF 0.5% -1:200000 SOLN per,250,1 ,$48.00 ,$34.56 ,$13.44 ,$48.00 ,$31.20 , N/A ,$13.44 ,$26.54 , N/A ,$27.94 , N/A ,$25.15 , N/A , N/A ,$44.16 , N/A , N/A ,$40.80 ,$43.20 , N/A ,$36.00 ,$33.60 ,$33.60 , N/A ,$33.60 ,$36.96 ,$36.96 , N/A ,$40.80 , N/A , N/A ,$26.93 ,$19.87 ,$19.97 , N/A , N/A , N/A ,$40.80 , N/A ,$25.15 ,$13.44 ,$43.20 ,$25.34 , N/A ,$31.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,CIPROFLOXACIN 0.3 % SOLN 5 ML BOTTLE per,250,1 ,$95.00 ,$68.40 ,$26.60 ,$95.00 ,$61.75 , N/A ,$26.60 ,$52.54 , N/A ,$55.29 , N/A ,$49.78 , N/A , N/A ,$87.40 , N/A , N/A ,$80.75 ,$85.50 , N/A ,$71.25 ,$66.50 ,$66.50 , N/A ,$66.50 ,$73.15 ,$73.15 , N/A ,$80.75 , N/A , N/A ,$53.30 ,$39.33 ,$39.52 , N/A , N/A , N/A ,$80.75 , N/A ,$49.78 ,$26.60 ,$85.50 ,$50.16 , N/A ,$61.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,CLINDAMYCIN 900 MG/6ML SOLN 6 ML VIAL per,250,1 ,$23.00 ,$16.56 ,$6.44 ,$23.00 ,$14.95 , N/A ,$6.44 ,$12.72 , N/A ,$13.39 , N/A ,$12.05 , N/A , N/A ,$21.16 , N/A , N/A ,$19.55 ,$20.70 , N/A ,$17.25 ,$16.10 ,$16.10 , N/A ,$16.10 ,$17.71 ,$17.71 , N/A ,$19.55 , N/A , N/A ,$12.90 ,$9.52 ,$9.57 , N/A , N/A , N/A ,$19.55 , N/A ,$12.05 ,$6.44 ,$20.70 ,$12.14 , N/A ,$14.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,COLLAGENASE 250 UNIT/GM OINT 30 G TUBE per,250,1 ,$658.50 ,$474.12 ,$184.38 ,$658.50 ,$428.03 , N/A ,$184.38 ,$364.15 , N/A ,$383.25 , N/A ,$345.05 , N/A , N/A ,$605.82 , N/A , N/A ,$559.73 ,$592.65 , N/A ,$493.88 ,$460.95 ,$460.95 , N/A ,$460.95 ,$507.05 ,$507.05 , N/A ,$559.73 , N/A , N/A ,$369.42 ,$272.62 ,$273.94 , N/A , N/A , N/A ,$559.73 , N/A ,$345.05 ,$184.38 ,$592.65 ,$347.69 , N/A ,$428.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,DILTIAZEM 125 MG/25ML SOLN 25 ML VIAL per,250,1 ,$55.00 ,$39.60 ,$15.40 ,$55.00 ,$35.75 , N/A ,$15.40 ,$30.42 , N/A ,$32.01 , N/A ,$28.82 , N/A , N/A ,$50.60 , N/A , N/A ,$46.75 ,$49.50 , N/A ,$41.25 ,$38.50 ,$38.50 , N/A ,$38.50 ,$42.35 ,$42.35 , N/A ,$46.75 , N/A , N/A ,$30.86 ,$22.77 ,$22.88 , N/A , N/A , N/A ,$46.75 , N/A ,$28.82 ,$15.40 ,$49.50 ,$29.04 , N/A ,$35.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,DOXYCYCLINE HYCLATE 100 MG SOLR 1 EACH VIAL per,250,1 ,$121.00 ,$87.12 ,$33.88 ,$121.00 ,$78.65 , N/A ,$33.88 ,$66.91 , N/A ,$70.42 , N/A ,$63.40 , N/A , N/A ,$111.32 , N/A , N/A ,$102.85 ,$108.90 , N/A ,$90.75 ,$84.70 ,$84.70 , N/A ,$84.70 ,$93.17 ,$93.17 , N/A ,$102.85 , N/A , N/A ,$67.88 ,$50.09 ,$50.34 , N/A , N/A , N/A ,$102.85 , N/A ,$63.40 ,$33.88 ,$108.90 ,$63.89 , N/A ,$78.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ENALAPRILAT 1.25 MG/ML INJ per,250,1 ,$23.50 ,$16.92 ,$6.58 ,$23.50 ,$15.28 , N/A ,$6.58 ,$13.00 , N/A ,$13.68 , N/A ,$12.31 , N/A , N/A ,$21.62 , N/A , N/A ,$19.98 ,$21.15 , N/A ,$17.63 ,$16.45 ,$16.45 , N/A ,$16.45 ,$18.10 ,$18.10 , N/A ,$19.98 , N/A , N/A ,$13.18 ,$9.73 ,$9.78 , N/A , N/A , N/A ,$19.98 , N/A ,$12.31 ,$6.58 ,$21.15 ,$12.41 , N/A ,$15.28 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ESMOLOL 2500 MG/250ML SOLN per,250,1 ,$574.00 ,$413.28 ,$160.72 ,$574.00 ,$373.10 , N/A ,$160.72 ,$317.42 , N/A ,$334.07 , N/A ,$300.78 , N/A , N/A ,$528.08 , N/A , N/A ,$487.90 ,$516.60 , N/A ,$430.50 ,$401.80 ,$401.80 , N/A ,$401.80 ,$441.98 ,$441.98 , N/A ,$487.90 , N/A , N/A ,$322.01 ,$237.64 ,$238.78 , N/A , N/A , N/A ,$487.90 , N/A ,$300.78 ,$160.72 ,$516.60 ,$303.07 , N/A ,$373.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,INSULIN REGULAR 100 UNITS/100 ML NS SOLN per,250,1 ,$168.00 ,$120.96 ,$47.04 ,$168.00 ,$109.20 , N/A ,$47.04 ,$92.90 , N/A ,$97.78 , N/A ,$88.03 , N/A , N/A ,$154.56 , N/A , N/A ,$142.80 ,$151.20 , N/A ,$126.00 ,$117.60 ,$117.60 , N/A ,$117.60 ,$129.36 ,$129.36 , N/A ,$142.80 , N/A , N/A ,$94.25 ,$69.55 ,$69.89 , N/A , N/A , N/A ,$142.80 , N/A ,$88.03 ,$47.04 ,$151.20 ,$88.70 , N/A ,$109.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,IPRATROPIUM 0.03 % SOLN 30 ML BOTTLE per,250,1 ,$223.50 ,$160.92 ,$62.58 ,$223.50 ,$145.28 , N/A ,$62.58 ,$123.60 , N/A ,$130.08 , N/A ,$117.11 , N/A , N/A ,$205.62 , N/A , N/A ,$189.98 ,$201.15 , N/A ,$167.63 ,$156.45 ,$156.45 , N/A ,$156.45 ,$172.10 ,$172.10 , N/A ,$189.98 , N/A , N/A ,$125.38 ,$92.53 ,$92.98 , N/A , N/A , N/A ,$189.98 , N/A ,$117.11 ,$62.58 ,$201.15 ,$118.01 , N/A ,$145.28 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LEVOTHYROXINE 100 MCG SOLR per,250,1 ,$253.50 ,$182.52 ,$70.98 ,$253.50 ,$164.78 , N/A ,$70.98 ,$140.19 , N/A ,$147.54 , N/A ,$132.83 , N/A , N/A ,$233.22 , N/A , N/A ,$215.48 ,$228.15 , N/A ,$190.13 ,$177.45 ,$177.45 , N/A ,$177.45 ,$195.20 ,$195.20 , N/A ,$215.48 , N/A , N/A ,$142.21 ,$104.95 ,$105.46 , N/A , N/A , N/A ,$215.48 , N/A ,$132.83 ,$70.98 ,$228.15 ,$133.85 , N/A ,$164.78 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE (PF) 1 % SOLN per,250,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 ,$21.45 , N/A ,$9.24 ,$18.25 , N/A ,$19.21 , N/A ,$17.29 , N/A , N/A ,$30.36 , N/A , N/A ,$28.05 ,$29.70 , N/A ,$24.75 ,$23.10 ,$23.10 , N/A ,$23.10 ,$25.41 ,$25.41 , N/A ,$28.05 , N/A , N/A ,$18.51 ,$13.66 ,$13.73 , N/A , N/A , N/A ,$28.05 , N/A ,$17.29 ,$9.24 ,$29.70 ,$17.42 , N/A ,$21.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE (PF) 2 % SOLN per,250,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 , N/A ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.92 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE 0.5 % SOLN per,250,1 ,$24.50 ,$17.64 ,$6.86 ,$24.50 ,$15.93 , N/A ,$6.86 ,$13.55 , N/A ,$14.26 , N/A ,$12.84 , N/A , N/A ,$22.54 , N/A , N/A ,$20.83 ,$22.05 , N/A ,$18.38 ,$17.15 ,$17.15 , N/A ,$17.15 ,$18.87 ,$18.87 , N/A ,$20.83 , N/A , N/A ,$13.74 ,$10.14 ,$10.19 , N/A , N/A , N/A ,$20.83 , N/A ,$12.84 ,$6.86 ,$22.05 ,$12.94 , N/A ,$15.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE 2 % GEL 5 ML TUBE per,250,1 ,$17.00 ,$12.24 ,$4.76 ,$17.00 ,$11.05 , N/A ,$4.76 ,$9.40 , N/A ,$9.89 , N/A ,$8.91 , N/A , N/A ,$15.64 , N/A , N/A ,$14.45 ,$15.30 , N/A ,$12.75 ,$11.90 ,$11.90 , N/A ,$11.90 ,$13.09 ,$13.09 , N/A ,$14.45 , N/A , N/A ,$9.54 ,$7.04 ,$7.07 , N/A , N/A , N/A ,$14.45 , N/A ,$8.91 ,$4.76 ,$15.30 ,$8.98 , N/A ,$11.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE 2 % PRSY 10 ML SYRINGE per,250,1 ,$15.50 ,$11.16 ,$4.34 ,$15.50 ,$10.08 , N/A ,$4.34 ,$8.57 , N/A ,$9.02 , N/A ,$8.12 , N/A , N/A ,$14.26 , N/A , N/A ,$13.18 ,$13.95 , N/A ,$11.63 ,$10.85 ,$10.85 , N/A ,$10.85 ,$11.94 ,$11.94 , N/A ,$13.18 , N/A , N/A ,$8.70 ,$6.42 ,$6.45 , N/A , N/A , N/A ,$13.18 , N/A ,$8.12 ,$4.34 ,$13.95 ,$8.18 , N/A ,$10.08 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE-PRILOCAINE 2.5-2.5 % CREA 5 G TUBE per,250,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,METRONIDAZOLE 500 MG/100ML SOLN per,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 ,$59.15 , N/A ,$25.48 ,$50.32 , N/A ,$52.96 , N/A ,$47.68 , N/A , N/A ,$83.72 , N/A , N/A ,$77.35 ,$81.90 , N/A ,$68.25 ,$63.70 ,$63.70 , N/A ,$63.70 ,$70.07 ,$70.07 , N/A ,$77.35 , N/A , N/A ,$51.05 ,$37.67 ,$37.86 , N/A , N/A , N/A ,$77.35 , N/A ,$47.68 ,$25.48 ,$81.90 ,$48.05 , N/A ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,CLINDAMYCIN 600 MG/50ML SOLN per,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 ,$59.15 , N/A ,$25.48 ,$50.32 , N/A ,$52.96 , N/A ,$47.68 , N/A , N/A ,$83.72 , N/A , N/A ,$77.35 ,$81.90 , N/A ,$68.25 ,$63.70 ,$63.70 , N/A ,$63.70 ,$70.07 ,$70.07 , N/A ,$77.35 , N/A , N/A ,$51.05 ,$37.67 ,$37.86 , N/A , N/A , N/A ,$77.35 , N/A ,$47.68 ,$25.48 ,$81.90 ,$48.05 , N/A ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,CLINDAMYCIN 900 MG/50ML SOLN per,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 ,$59.15 , N/A ,$25.48 ,$50.32 , N/A ,$52.96 , N/A ,$47.68 , N/A , N/A ,$83.72 , N/A , N/A ,$77.35 ,$81.90 , N/A ,$68.25 ,$63.70 ,$63.70 , N/A ,$63.70 ,$70.07 ,$70.07 , N/A ,$77.35 , N/A , N/A ,$51.05 ,$37.67 ,$37.86 , N/A , N/A , N/A ,$77.35 , N/A ,$47.68 ,$25.48 ,$81.90 ,$48.05 , N/A ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,MANNITOL 20 % SOLN per,250,1 ,$91.00 ,$65.52 ,$25.48 ,$91.00 ,$59.15 , N/A ,$25.48 ,$50.32 , N/A ,$52.96 , N/A ,$47.68 , N/A , N/A ,$83.72 , N/A , N/A ,$77.35 ,$81.90 , N/A ,$68.25 ,$63.70 ,$63.70 , N/A ,$63.70 ,$70.07 ,$70.07 , N/A ,$77.35 , N/A , N/A ,$51.05 ,$37.67 ,$37.86 , N/A , N/A , N/A ,$77.35 , N/A ,$47.68 ,$25.48 ,$81.90 ,$48.05 , N/A ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,MOXIFLOXACIN 0.5 % SOLN 3 ML BOTTLE per,250,1 ,$335.00 ,$241.20 ,$93.80 ,$335.00 ,$217.75 , N/A ,$93.80 ,$185.26 , N/A ,$194.97 , N/A ,$175.54 , N/A , N/A ,$308.20 , N/A , N/A ,$284.75 ,$301.50 , N/A ,$251.25 ,$234.50 ,$234.50 , N/A ,$234.50 ,$257.95 ,$257.95 , N/A ,$284.75 , N/A , N/A ,$187.94 ,$138.69 ,$139.36 , N/A , N/A , N/A ,$284.75 , N/A ,$175.54 ,$93.80 ,$301.50 ,$176.88 , N/A ,$217.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,NICARDIPINE HCL IN NACL 20-0.9 MG/200ML-% SOLN per,250,1 ,$390.50 ,$281.16 ,$109.34 ,$390.50 ,$253.83 , N/A ,$109.34 ,$215.95 , N/A ,$227.27 , N/A ,$204.62 , N/A , N/A ,$359.26 , N/A , N/A ,$331.93 ,$351.45 , N/A ,$292.88 ,$273.35 ,$273.35 , N/A ,$273.35 ,$300.69 ,$300.69 , N/A ,$331.93 , N/A , N/A ,$219.07 ,$161.67 ,$162.45 , N/A , N/A , N/A ,$331.93 , N/A ,$204.62 ,$109.34 ,$351.45 ,$206.18 , N/A ,$253.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,NITROGLYCERIN 200-5 MCG/ML-% SOLN per,250,1 ,$99.00 ,$71.28 ,$27.72 ,$99.00 ,$64.35 , N/A ,$27.72 ,$54.75 , N/A ,$57.62 , N/A ,$51.88 , N/A , N/A ,$91.08 , N/A , N/A ,$84.15 ,$89.10 , N/A ,$74.25 ,$69.30 ,$69.30 , N/A ,$69.30 ,$76.23 ,$76.23 , N/A ,$84.15 , N/A , N/A ,$55.54 ,$40.99 ,$41.18 , N/A , N/A , N/A ,$84.15 , N/A ,$51.88 ,$27.72 ,$89.10 ,$52.27 , N/A ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,NOREPINEPHRINE 1 MG/ML SOLN 4 ML VIAL per,250,1 ,$98.50 ,$70.92 ,$27.58 ,$98.50 ,$64.03 , N/A ,$27.58 ,$54.47 , N/A ,$57.33 , N/A ,$51.61 , N/A , N/A ,$90.62 , N/A , N/A ,$83.73 ,$88.65 , N/A ,$73.88 ,$68.95 ,$68.95 , N/A ,$68.95 ,$75.85 ,$75.85 , N/A ,$83.73 , N/A , N/A ,$55.26 ,$40.78 ,$40.98 , N/A , N/A , N/A ,$83.73 , N/A ,$51.61 ,$27.58 ,$88.65 ,$52.01 , N/A ,$64.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,OLANZAPINE 10 MG SOLR per,250,1 ,$90.50 ,$65.16 ,$25.34 ,$90.50 ,$58.83 , N/A ,$25.34 ,$50.05 , N/A ,$52.67 , N/A ,$47.42 , N/A , N/A ,$83.26 , N/A , N/A ,$76.93 ,$81.45 , N/A ,$67.88 ,$63.35 ,$63.35 , N/A ,$63.35 ,$69.69 ,$69.69 , N/A ,$76.93 , N/A , N/A ,$50.77 ,$37.47 ,$37.65 , N/A , N/A , N/A ,$76.93 , N/A ,$47.42 ,$25.34 ,$81.45 ,$47.78 , N/A ,$58.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,OPHTHALMIC IRRIGATION SOLN 118 ML BOTTLE per,250,1 ,$7.50 ,$5.40 ,$2.10 ,$7.50 ,$4.88 , N/A ,$2.10 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 , N/A , N/A ,$6.90 , N/A , N/A ,$6.38 ,$6.75 , N/A ,$5.63 ,$5.25 ,$5.25 , N/A ,$5.25 ,$5.78 ,$5.78 , N/A ,$6.38 , N/A , N/A ,$4.21 ,$3.11 ,$3.12 , N/A , N/A , N/A ,$6.38 , N/A ,$3.93 ,$2.10 ,$6.75 ,$3.96 , N/A ,$4.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,"DIPHENHYDRAMINE 12.5 MG/5ML 20 ML, LIDOCAINE VISCOUS 2 % 20 ML, MAGNESIUM-ALUMINUM-SIMETHICONE 400-400-40 MG/5ML 20 ML SUSPENSION per",250,1 ,$7.50 ,$5.40 ,$2.10 ,$7.50 ,$4.88 , N/A ,$2.10 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 , N/A , N/A ,$6.90 , N/A , N/A ,$6.38 ,$6.75 , N/A ,$5.63 ,$5.25 ,$5.25 , N/A ,$5.25 ,$5.78 ,$5.78 , N/A ,$6.38 , N/A , N/A ,$4.21 ,$3.11 ,$3.12 , N/A , N/A , N/A ,$6.38 , N/A ,$3.93 ,$2.10 ,$6.75 ,$3.96 , N/A ,$4.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,PHENYLEPHRINE 10 % SOLN 5 ML BOTTLE per,250,1 ,$100.00 ,$72.00 ,$28.00 ,$100.00 ,$65.00 , N/A ,$28.00 ,$55.30 , N/A ,$58.20 , N/A ,$52.40 , N/A , N/A ,$92.00 , N/A , N/A ,$85.00 ,$90.00 , N/A ,$75.00 ,$70.00 ,$70.00 , N/A ,$70.00 ,$77.00 ,$77.00 , N/A ,$85.00 , N/A , N/A ,$56.10 ,$41.40 ,$41.60 , N/A , N/A , N/A ,$85.00 , N/A ,$52.40 ,$28.00 ,$90.00 ,$52.80 , N/A ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,PHENYLEPHRINE 2.5 % SOLN 15 ML BOTTLE per,250,1 ,$216.00 ,$155.52 ,$60.48 ,$216.00 ,$140.40 , N/A ,$60.48 ,$119.45 , N/A ,$125.71 , N/A ,$113.18 , N/A , N/A ,$198.72 , N/A , N/A ,$183.60 ,$194.40 , N/A ,$162.00 ,$151.20 ,$151.20 , N/A ,$151.20 ,$166.32 ,$166.32 , N/A ,$183.60 , N/A , N/A ,$121.18 ,$89.42 ,$89.86 , N/A , N/A , N/A ,$183.60 , N/A ,$113.18 ,$60.48 ,$194.40 ,$114.05 , N/A ,$140.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,PHENYLEPHRINE 2.5 % SOLN 2 ML BOTTLE per,250,1 ,$81.50 ,$58.68 ,$22.82 ,$81.50 ,$52.98 , N/A ,$22.82 ,$45.07 , N/A ,$47.43 , N/A ,$42.71 , N/A , N/A ,$74.98 , N/A , N/A ,$69.28 ,$73.35 , N/A ,$61.13 ,$57.05 ,$57.05 , N/A ,$57.05 ,$62.76 ,$62.76 , N/A ,$69.28 , N/A , N/A ,$45.72 ,$33.74 ,$33.90 , N/A , N/A , N/A ,$69.28 , N/A ,$42.71 ,$22.82 ,$73.35 ,$43.03 , N/A ,$52.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,"POLYETHYLENE GLYCOL 236 G SOLR 4,000 ML BOTTLE per",250,1 ,$56.00 ,$40.32 ,$15.68 ,$56.00 ,$36.40 , N/A ,$15.68 ,$30.97 , N/A ,$32.59 , N/A ,$29.34 , N/A , N/A ,$51.52 , N/A , N/A ,$47.60 ,$50.40 , N/A ,$42.00 ,$39.20 ,$39.20 , N/A ,$39.20 ,$43.12 ,$43.12 , N/A ,$47.60 , N/A , N/A ,$31.42 ,$23.18 ,$23.30 , N/A , N/A , N/A ,$47.60 , N/A ,$29.34 ,$15.68 ,$50.40 ,$29.57 , N/A ,$36.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,MULTIVITAMIN (ADULT MVI) INJ 10 ML VIAL per,250,1 ,$56.00 ,$40.32 ,$15.68 ,$56.00 ,$36.40 , N/A ,$15.68 ,$30.97 , N/A ,$32.59 , N/A ,$29.34 , N/A , N/A ,$51.52 , N/A , N/A ,$47.60 ,$50.40 , N/A ,$42.00 ,$39.20 ,$39.20 , N/A ,$39.20 ,$43.12 ,$43.12 , N/A ,$47.60 , N/A , N/A ,$31.42 ,$23.18 ,$23.30 , N/A , N/A , N/A ,$47.60 , N/A ,$29.34 ,$15.68 ,$50.40 ,$29.57 , N/A ,$36.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,PREDNISOLONE ACETATE 1 % SUSP 5 ML BOTTLE per,250,1 ,$111.00 ,$79.92 ,$31.08 ,$111.00 ,$72.15 , N/A ,$31.08 ,$61.38 , N/A ,$64.60 , N/A ,$58.16 , N/A , N/A ,$102.12 , N/A , N/A ,$94.35 ,$99.90 , N/A ,$83.25 ,$77.70 ,$77.70 , N/A ,$77.70 ,$85.47 ,$85.47 , N/A ,$94.35 , N/A , N/A ,$62.27 ,$45.95 ,$46.18 , N/A , N/A , N/A ,$94.35 , N/A ,$58.16 ,$31.08 ,$99.90 ,$58.61 , N/A ,$72.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ATROPINE 1 % SOLN 5 ML BOTTLE per,250,1 ,$111.00 ,$79.92 ,$31.08 ,$111.00 ,$72.15 , N/A ,$31.08 ,$61.38 , N/A ,$64.60 , N/A ,$58.16 , N/A , N/A ,$102.12 , N/A , N/A ,$94.35 ,$99.90 , N/A ,$83.25 ,$77.70 ,$77.70 , N/A ,$77.70 ,$85.47 ,$85.47 , N/A ,$94.35 , N/A , N/A ,$62.27 ,$45.95 ,$46.18 , N/A , N/A , N/A ,$94.35 , N/A ,$58.16 ,$31.08 ,$99.90 ,$58.61 , N/A ,$72.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,PROPARACAINE 0.5 % SOLN 15 ML BOTTLE per,250,1 ,$88.00 ,$63.36 ,$24.64 ,$88.00 ,$57.20 , N/A ,$24.64 ,$48.66 , N/A ,$51.22 , N/A ,$46.11 , N/A , N/A ,$80.96 , N/A , N/A ,$74.80 ,$79.20 , N/A ,$66.00 ,$61.60 ,$61.60 , N/A ,$61.60 ,$67.76 ,$67.76 , N/A ,$74.80 , N/A , N/A ,$49.37 ,$36.43 ,$36.61 , N/A , N/A , N/A ,$74.80 , N/A ,$46.11 ,$24.64 ,$79.20 ,$46.46 , N/A ,$57.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,SCOPOLAMINE 1 MG/3DAYS PT72 per,250,1 ,$40.50 ,$29.16 ,$11.34 ,$40.50 ,$26.33 , N/A ,$11.34 ,$22.40 , N/A ,$23.57 , N/A ,$21.22 , N/A , N/A ,$37.26 , N/A , N/A ,$34.43 ,$36.45 , N/A ,$30.38 ,$28.35 ,$28.35 , N/A ,$28.35 ,$31.19 ,$31.19 , N/A ,$34.43 , N/A , N/A ,$22.72 ,$16.77 ,$16.85 , N/A , N/A , N/A ,$34.43 , N/A ,$21.22 ,$11.34 ,$36.45 ,$21.38 , N/A ,$26.33 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ROCURONIUM 100 MG/10ML SOLN per,250,1 ,$40.50 ,$29.16 ,$11.34 ,$40.50 ,$26.33 , N/A ,$11.34 ,$22.40 , N/A ,$23.57 , N/A ,$21.22 , N/A , N/A ,$37.26 , N/A , N/A ,$34.43 ,$36.45 , N/A ,$30.38 ,$28.35 ,$28.35 , N/A ,$28.35 ,$31.19 ,$31.19 , N/A ,$34.43 , N/A , N/A ,$22.72 ,$16.77 ,$16.85 , N/A , N/A , N/A ,$34.43 , N/A ,$21.22 ,$11.34 ,$36.45 ,$21.38 , N/A ,$26.33 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,SODIUM BICARBONATE 8.4 % SOLN 50 ML VIAL per,250,1 ,$46.83 ,$33.72 ,$13.11 ,$46.83 ,$30.44 , N/A ,$13.11 ,$25.90 , N/A ,$27.26 , N/A ,$24.54 , N/A , N/A ,$43.08 , N/A , N/A ,$39.81 ,$42.15 , N/A ,$35.12 ,$32.78 ,$32.78 , N/A ,$32.78 ,$36.06 ,$36.06 , N/A ,$39.81 , N/A , N/A ,$26.27 ,$19.39 ,$19.48 , N/A , N/A , N/A ,$39.81 , N/A ,$24.54 ,$13.11 ,$42.15 ,$24.73 , N/A ,$30.44 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,SODIUM CHLORIDE 0.45 % SOLN per,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$23.76 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BARIUM SULFATE 105 % SUSP per,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$23.76 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BARIUM SULFATE 98 % SUSR per,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$23.76 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,DEXTROSE 5 % LACTATED RINGERS,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$23.76 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,FORMOTEROL 20 MCG/2ML NEBU per,250,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$23.76 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,SODIUM CHLORIDE 0.9 % NEBU per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ALBUTEROL (2.5 MG/3ML) 0.083% NEBU per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ALBUTEROL 1.25 MG/3ML NEBU per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BENZOCAINE 20 % 20 % AERO per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,FLUORESCEIN 1 MG STRP per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML SOLN per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LEVALBUTEROL 1.25 MG/3ML NEBU per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE 4 % PTCH per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE VISCOUS 2 % SOLN 15 ML CUP per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,RACEPINEPHRINE 2.25 % 2.25 % NEBU per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,SILVER-POTASSIUM NITRATE 75-25 % MISC per,250,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,"SODIUM CHLORIDE 0.9 % SOLN 1,000 ML PLAS CONT per",250,1 ,$10.00 ,$7.20 ,$2.80 ,$10.00 ,$6.50 , N/A ,$2.80 ,$5.53 , N/A ,$5.82 , N/A ,$5.24 , N/A , N/A ,$9.20 , N/A , N/A ,$8.50 ,$9.00 , N/A ,$7.50 ,$7.00 ,$7.00 , N/A ,$7.00 ,$7.70 ,$7.70 , N/A ,$8.50 , N/A , N/A ,$5.61 ,$4.14 ,$4.16 , N/A , N/A , N/A ,$8.50 , N/A ,$5.24 ,$2.80 ,$9.00 ,$5.28 , N/A ,$6.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,STERILE WATER SOLN 10 ML VIAL per,250,1 ,$18.50 ,$13.32 ,$5.18 ,$18.50 ,$12.03 , N/A ,$5.18 ,$10.23 , N/A ,$10.77 , N/A ,$9.69 , N/A , N/A ,$17.02 , N/A , N/A ,$15.73 ,$16.65 , N/A ,$13.88 ,$12.95 ,$12.95 , N/A ,$12.95 ,$14.25 ,$14.25 , N/A ,$15.73 , N/A , N/A ,$10.38 ,$7.66 ,$7.70 , N/A , N/A , N/A ,$15.73 , N/A ,$9.69 ,$5.18 ,$16.65 ,$9.77 , N/A ,$12.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,STERILE WATER SOLN 50 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUMETANIDE 0.25 MG/ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUPIVACAINE (PF) 0.5 % SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUPIVACAINE 0.25 % SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,BUPIVACAINE-EPINEPHRINE (PF) 0.25% -1:200000 SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,CLINDAMYCIN 600 MG/4ML SOLN 4 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,DEXMEDETOMIDINE 200 MCG/2ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,DILTIAZEM 25 MG/5ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ESMOLOL 100 MG/10ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,ETOMIDATE 2 MG/ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,FAMOTIDINE (PF) 20 MG/2ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,FAMOTIDINE 20 MG/2ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,FOLIC ACID 5 MG/ML SOLN 10 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,KETAMINE 10 MG/ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,KETAMINE 50 MG/ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LABETALOL 5 MG/ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE (PF) 1 % SOLN 2 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE (PF) 1 % SOLN 5 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE 1 % SOLN 10 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE 1 % SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:100000 SOLN 20 ML VIAL per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE-EPINEPHRINE 1 %-1:100000 SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,LIDOCAINE-EPINEPHRINE 2 %-1:200000 SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,METOPROLOL TARTRATE 5 MG/5ML SOLN per,250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,"SODIUM CHLORIDE 0.9 % SOLN 1,000 ML FLEX CONT per",250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,"STERILE WATER SOLN 1,000 ML FLEX CONT per",250,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,SUGAMMADEX 200 MG/2ML SOLN per,250,1 ,$540.50 ,$389.16 ,$151.34 ,$540.50 ,$351.33 , N/A ,$151.34 ,$298.90 , N/A ,$314.57 , N/A ,$283.22 , N/A , N/A ,$497.26 , N/A , N/A ,$459.43 ,$486.45 , N/A ,$405.38 ,$378.35 ,$378.35 , N/A ,$378.35 ,$416.19 ,$416.19 , N/A ,$459.43 , N/A , N/A ,$303.22 ,$223.77 ,$224.85 , N/A , N/A , N/A ,$459.43 , N/A ,$283.22 ,$151.34 ,$486.45 ,$285.38 , N/A ,$351.33 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,TETRACAINE 0.5 % SOLN 4 ML PLAS CONT per,250,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 ,$18.20 , N/A ,$7.84 ,$15.48 , N/A ,$16.30 , N/A ,$14.67 , N/A , N/A ,$25.76 , N/A , N/A ,$23.80 ,$25.20 , N/A ,$21.00 ,$19.60 ,$19.60 , N/A ,$19.60 ,$21.56 ,$21.56 , N/A ,$23.80 , N/A , N/A ,$15.71 ,$11.59 ,$11.65 , N/A , N/A , N/A ,$23.80 , N/A ,$14.67 ,$7.84 ,$25.20 ,$14.78 , N/A ,$18.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,TRANEXAMIC ACID 1000 MG/10ML SOLN per,250,1 ,$240.00 ,$172.80 ,$67.20 ,$240.00 ,$156.00 , N/A ,$67.20 ,$132.72 , N/A ,$139.68 , N/A ,$125.76 , N/A , N/A ,$220.80 , N/A , N/A ,$204.00 ,$216.00 , N/A ,$180.00 ,$168.00 ,$168.00 , N/A ,$168.00 ,$184.80 ,$184.80 , N/A ,$204.00 , N/A , N/A ,$134.64 ,$99.36 ,$99.84 , N/A , N/A , N/A ,$204.00 , N/A ,$125.76 ,$67.20 ,$216.00 ,$126.72 , N/A ,$156.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,TROPICAMIDE 1 % SOLN 15 ML BOTTLE per,250,1 ,$71.50 ,$51.48 ,$20.02 ,$71.50 ,$46.48 , N/A ,$20.02 ,$39.54 , N/A ,$41.61 , N/A ,$37.47 , N/A , N/A ,$65.78 , N/A , N/A ,$60.78 ,$64.35 , N/A ,$53.63 ,$50.05 ,$50.05 , N/A ,$50.05 ,$55.06 ,$55.06 , N/A ,$60.78 , N/A , N/A ,$40.11 ,$29.60 ,$29.74 , N/A , N/A , N/A ,$60.78 , N/A ,$37.47 ,$20.02 ,$64.35 ,$37.75 , N/A ,$46.48 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,TROPICAMIDE 1%-PHENYLEPHRINE 2.5% SOLN 1 ML BOTTLE per,250,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,POTASSIUM PHOSPHATE 45 MMOLE/15ML SOLN 15 ML VIAL per,250,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,STERILE WATER SOLN 20 ML VIAL per,250,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000003,N/A,TRYPAN BLUE 0.06 % SOLN 0.5 ML SYRINGE per,250,1 ,$178.00 ,$128.16 ,$49.84 ,$178.00 ,$115.70 , N/A ,$49.84 ,$98.43 , N/A ,$103.60 , N/A ,$93.27 , N/A , N/A ,$163.76 , N/A , N/A ,$151.30 ,$160.20 , N/A ,$133.50 ,$124.60 ,$124.60 , N/A ,$124.60 ,$137.06 ,$137.06 , N/A ,$151.30 , N/A , N/A ,$99.86 ,$73.69 ,$74.05 , N/A , N/A , N/A ,$151.30 , N/A ,$93.27 ,$49.84 ,$160.20 ,$93.98 , N/A ,$115.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),25000225,N/A,HC SILVER NITRATE APPLICATOR STICK,250,1 ,$65.00 ,$46.80 ,$18.20 ,$65.00 ,$42.25 , N/A ,$18.20 ,$35.95 , N/A ,$37.83 , N/A ,$34.06 , N/A , N/A ,$59.80 , N/A , N/A ,$55.25 ,$58.50 , N/A ,$48.75 ,$45.50 ,$45.50 , N/A ,$45.50 ,$50.05 ,$50.05 , N/A ,$55.25 , N/A , N/A ,$36.47 ,$26.91 ,$27.04 , N/A , N/A , N/A ,$55.25 , N/A ,$34.06 ,$18.20 ,$58.50 ,$34.32 , N/A ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),25800000,N/A,DEXTROSE 10 % SOLN 250 ML FLEX CONT,258,1 ,$45.00 ,$32.40 ,$12.60 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$23.76 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$399.00 ,$287.28 ,$111.72 ,$495.94 ,$259.35 ,$194.41 ,$111.72 ,$220.65 ,$194.41 ,$232.22 ,$194.41 ,$209.08 ,$194.41 ,$399.00 , N/A ,$495.94 ,$194.41 ,$339.15 ,$359.10 ,$198.29 ,$299.25 ,$279.30 ,$279.30 ,$194.41 ,$279.30 ,$307.23 ,$307.23 ,$399.00 ,$339.15 ,$198.38 ,$198.38 ,$223.84 ,$165.19 ,$165.98 ,$223.52 ,$221.10 ,$204.13 ,$339.15 ,$426.51 ,$209.08 ,$111.72 ,$359.10 ,$210.67 ,$194.41 ,$259.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$162.00 ,$116.64 ,$39.88 ,$162.00 ,$105.30 ,$39.88 ,$45.36 ,$89.59 ,$39.88 ,$94.28 ,$39.88 ,$84.89 ,$39.88 ,$82.19 , N/A ,$101.72 ,$39.88 ,$137.70 ,$145.80 ,$40.67 ,$121.50 ,$113.40 ,$113.40 ,$39.88 ,$113.40 ,$124.74 ,$124.74 ,$101.72 ,$137.70 ,$40.69 ,$40.69 ,$90.88 ,$67.07 ,$67.39 ,$156.33 ,$162.00 ,$41.87 ,$137.70 ,$87.48 ,$84.89 ,$45.36 ,$145.80 ,$85.54 ,$39.88 ,$105.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$362.00 ,$260.64 ,$101.36 ,$495.94 ,$235.30 ,$194.41 ,$101.36 ,$200.19 ,$194.41 ,$210.68 ,$194.41 ,$189.69 ,$194.41 ,$362.00 , N/A ,$495.94 ,$194.41 ,$307.70 ,$325.80 ,$198.29 ,$271.50 ,$253.40 ,$253.40 ,$194.41 ,$253.40 ,$278.74 ,$278.74 ,$362.00 ,$307.70 ,$198.38 ,$198.38 ,$203.08 ,$149.87 ,$150.59 ,$223.52 ,$221.10 ,$204.13 ,$307.70 ,$426.51 ,$189.69 ,$101.36 ,$325.80 ,$191.14 ,$194.41 ,$235.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$157.00 ,$113.04 ,$39.88 ,$157.00 ,$102.05 ,$39.88 ,$43.96 ,$86.82 ,$39.88 ,$91.37 ,$39.88 ,$82.27 ,$39.88 ,$82.19 , N/A ,$101.72 ,$39.88 ,$133.45 ,$141.30 ,$40.67 ,$117.75 ,$109.90 ,$109.90 ,$39.88 ,$109.90 ,$120.89 ,$120.89 ,$101.72 ,$133.45 ,$40.69 ,$40.69 ,$88.08 ,$65.00 ,$65.31 ,$151.51 ,$157.00 ,$41.87 ,$133.45 ,$87.48 ,$82.27 ,$43.96 ,$141.30 ,$82.90 ,$39.88 ,$102.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$198.00 ,$142.56 ,$55.44 ,$198.00 ,$128.70 ,$63.49 ,$55.44 ,$109.49 ,$63.49 ,$115.24 ,$63.49 ,$103.75 ,$63.49 ,$130.88 , N/A ,$161.99 ,$63.49 ,$168.30 ,$178.20 ,$64.77 ,$148.50 ,$138.60 ,$138.60 ,$63.49 ,$138.60 ,$152.46 ,$152.46 ,$161.99 ,$168.30 ,$64.79 ,$64.79 ,$111.08 ,$81.97 ,$82.37 ,$191.07 ,$198.00 ,$66.67 ,$168.30 ,$139.31 ,$103.75 ,$55.44 ,$178.20 ,$104.54 ,$63.49 ,$128.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),26000005,96368,HC INFUS CONCURRENT,260,1 ,$198.00 ,$142.56 ,$55.44 ,$198.00 ,$128.70 , N/A ,$55.44 ,$109.49 , N/A ,$115.24 , N/A ,$103.75 , N/A , N/A , N/A , N/A , N/A ,$168.30 ,$178.20 , N/A ,$148.50 ,$138.60 ,$138.60 , N/A ,$138.60 ,$152.46 ,$152.46 , N/A ,$168.30 , N/A , N/A ,$111.08 ,$81.97 ,$82.37 ,$191.07 ,$198.00 , N/A ,$168.30 , N/A ,$103.75 ,$55.44 ,$178.20 ,$104.54 , N/A ,$128.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000011,N/A,HC PACK HOT/COLD,270,1 ,$49.00 ,$35.28 ,$13.72 ,$49.00 ,$31.85 , N/A ,$13.72 ,$27.10 , N/A ,$28.52 , N/A ,$25.68 , N/A , N/A ,$45.08 , N/A , N/A ,$41.65 ,$44.10 , N/A ,$36.75 ,$34.30 ,$34.30 , N/A ,$34.30 ,$37.73 ,$37.73 , N/A ,$41.65 , N/A , N/A ,$27.49 ,$20.29 ,$20.38 , N/A , N/A , N/A ,$41.65 , N/A ,$25.68 ,$13.72 ,$44.10 ,$25.87 , N/A ,$31.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000015,N/A,HC SET IV EXTENSION,270,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 , N/A ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000022,N/A,HC TRAY BIOPSY,270,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 ,$21.45 , N/A ,$9.24 ,$18.25 , N/A ,$19.21 , N/A ,$17.29 , N/A , N/A ,$30.36 , N/A , N/A ,$28.05 ,$29.70 , N/A ,$24.75 ,$23.10 ,$23.10 , N/A ,$23.10 ,$25.41 ,$25.41 , N/A ,$28.05 , N/A , N/A ,$18.51 ,$13.66 ,$13.73 , N/A , N/A , N/A ,$28.05 , N/A ,$17.29 ,$9.24 ,$29.70 ,$17.42 , N/A ,$21.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000028,N/A,HC ELECTRODE TIER 1,270,1 ,$19.00 ,$13.68 ,$5.32 ,$19.00 ,$12.35 , N/A ,$5.32 ,$10.51 , N/A ,$11.06 , N/A ,$9.96 , N/A , N/A ,$17.48 , N/A , N/A ,$16.15 ,$17.10 , N/A ,$14.25 ,$13.30 ,$13.30 , N/A ,$13.30 ,$14.63 ,$14.63 , N/A ,$16.15 , N/A , N/A ,$10.66 ,$7.87 ,$7.90 , N/A , N/A , N/A ,$16.15 , N/A ,$9.96 ,$5.32 ,$17.10 ,$10.03 , N/A ,$12.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000033,N/A,HC ELECTRODE TIER 3,270,1 ,$79.00 ,$56.88 ,$22.12 ,$79.00 ,$51.35 , N/A ,$22.12 ,$43.69 , N/A ,$45.98 , N/A ,$41.40 , N/A , N/A ,$72.68 , N/A , N/A ,$67.15 ,$71.10 , N/A ,$59.25 ,$55.30 ,$55.30 , N/A ,$55.30 ,$60.83 ,$60.83 , N/A ,$67.15 , N/A , N/A ,$44.32 ,$32.71 ,$32.86 , N/A , N/A , N/A ,$67.15 , N/A ,$41.40 ,$22.12 ,$71.10 ,$41.71 , N/A ,$51.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000054,N/A,HC KIT BLOOD GLUCOSE,270,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000129,N/A,HC STERILIZATION WRAP,270,1 ,$397.00 ,$285.84 ,$111.16 ,$397.00 ,$258.05 , N/A ,$111.16 ,$219.54 , N/A ,$231.05 , N/A ,$208.03 , N/A , N/A ,$365.24 , N/A , N/A ,$337.45 ,$357.30 , N/A ,$297.75 ,$277.90 ,$277.90 , N/A ,$277.90 ,$305.69 ,$305.69 , N/A ,$337.45 , N/A , N/A ,$222.72 ,$164.36 ,$165.15 , N/A , N/A , N/A ,$337.45 , N/A ,$208.03 ,$111.16 ,$357.30 ,$209.62 , N/A ,$258.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000134,N/A,HC ADAPTER AIRWAY CAP,270,1 ,$88.00 ,$63.36 ,$24.64 ,$88.00 ,$57.20 , N/A ,$24.64 ,$48.66 , N/A ,$51.22 , N/A ,$46.11 , N/A , N/A ,$80.96 , N/A , N/A ,$74.80 ,$79.20 , N/A ,$66.00 ,$61.60 ,$61.60 , N/A ,$61.60 ,$67.76 ,$67.76 , N/A ,$74.80 , N/A , N/A ,$49.37 ,$36.43 ,$36.61 , N/A , N/A , N/A ,$74.80 , N/A ,$46.11 ,$24.64 ,$79.20 ,$46.46 , N/A ,$57.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000136,N/A,HC BIOTESTCELL,270,1 ,$146.00 ,$105.12 ,$40.88 ,$146.00 ,$94.90 , N/A ,$40.88 ,$80.74 , N/A ,$84.97 , N/A ,$76.50 , N/A , N/A ,$134.32 , N/A , N/A ,$124.10 ,$131.40 , N/A ,$109.50 ,$102.20 ,$102.20 , N/A ,$102.20 ,$112.42 ,$112.42 , N/A ,$124.10 , N/A , N/A ,$81.91 ,$60.44 ,$60.74 , N/A , N/A , N/A ,$124.10 , N/A ,$76.50 ,$40.88 ,$131.40 ,$77.09 , N/A ,$94.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000138,N/A,HC NANOSCOPE HANDPIECE,270,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 ,$16.25 , N/A ,$7.00 ,$13.83 , N/A ,$14.55 , N/A ,$13.10 , N/A , N/A ,$23.00 , N/A , N/A ,$21.25 ,$22.50 , N/A ,$18.75 ,$17.50 ,$17.50 , N/A ,$17.50 ,$19.25 ,$19.25 , N/A ,$21.25 , N/A , N/A ,$14.03 ,$10.35 ,$10.40 , N/A , N/A , N/A ,$21.25 , N/A ,$13.10 ,$7.00 ,$22.50 ,$13.20 , N/A ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27000141,N/A,HC QUANTIFY PLUS CONTROL BILEVEL,270,1 ,$130.00 ,$93.60 ,$36.40 ,$130.00 ,$84.50 , N/A ,$36.40 ,$71.89 , N/A ,$75.66 , N/A ,$68.12 , N/A , N/A ,$119.60 , N/A , N/A ,$110.50 ,$117.00 , N/A ,$97.50 ,$91.00 ,$91.00 , N/A ,$91.00 ,$100.10 ,$100.10 , N/A ,$110.50 , N/A , N/A ,$72.93 ,$53.82 ,$54.08 , N/A , N/A , N/A ,$110.50 , N/A ,$68.12 ,$36.40 ,$117.00 ,$68.64 , N/A ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100013,N/A,HC BOOT HEEL LIFT,271,1 ,$63.00 ,$45.36 ,$17.64 ,$63.00 ,$40.95 , N/A ,$17.64 ,$34.84 , N/A ,$36.67 , N/A ,$33.01 , N/A , N/A ,$57.96 , N/A , N/A ,$53.55 ,$56.70 , N/A ,$47.25 ,$44.10 ,$44.10 , N/A ,$44.10 ,$48.51 ,$48.51 , N/A ,$53.55 , N/A , N/A ,$35.34 ,$26.08 ,$26.21 , N/A , N/A , N/A ,$53.55 , N/A ,$33.01 ,$17.64 ,$56.70 ,$33.26 , N/A ,$40.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100038,N/A,HC CPAP MASK,271,1 ,$53.00 ,$38.16 ,$14.84 ,$53.00 ,$34.45 , N/A ,$14.84 ,$29.31 , N/A ,$30.85 , N/A ,$27.77 , N/A , N/A ,$48.76 , N/A , N/A ,$45.05 ,$47.70 , N/A ,$39.75 ,$37.10 ,$37.10 , N/A ,$37.10 ,$40.81 ,$40.81 , N/A ,$45.05 , N/A , N/A ,$29.73 ,$21.94 ,$22.05 , N/A , N/A , N/A ,$45.05 , N/A ,$27.77 ,$14.84 ,$47.70 ,$27.98 , N/A ,$34.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100080,N/A,HC LARYNGEAL MASK AIRWAY,272,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 ,$10.40 , N/A ,$4.48 ,$8.85 , N/A ,$9.31 , N/A ,$8.38 , N/A , N/A ,$14.72 , N/A , N/A ,$13.60 ,$14.40 , N/A ,$12.00 ,$11.20 ,$11.20 , N/A ,$11.20 ,$12.32 ,$12.32 , N/A ,$13.60 , N/A , N/A ,$8.98 ,$6.62 ,$6.66 , N/A , N/A , N/A ,$13.60 , N/A ,$8.38 ,$4.48 ,$14.40 ,$8.45 , N/A ,$10.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100096,N/A,HC NASAL PHANYNGEAL AIRWAY,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100106,N/A,HC OXYGEN DAILY,271,1 ,$386.00 ,$277.92 ,$108.08 ,$386.00 ,$250.90 , N/A ,$108.08 ,$213.46 , N/A ,$224.65 , N/A ,$202.26 , N/A , N/A ,$355.12 , N/A , N/A ,$328.10 ,$347.40 , N/A ,$289.50 ,$270.20 ,$270.20 , N/A ,$270.20 ,$297.22 ,$297.22 , N/A ,$328.10 , N/A , N/A ,$216.55 ,$159.80 ,$160.58 , N/A , N/A , N/A ,$328.10 , N/A ,$202.26 ,$108.08 ,$347.40 ,$203.81 , N/A ,$250.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100107,N/A,HC OXYGEN HOURLY,271,1 ,$17.04 ,$12.27 ,$4.77 ,$17.04 ,$11.08 , N/A ,$4.77 ,$9.42 , N/A ,$9.92 , N/A ,$8.93 , N/A , N/A ,$15.68 , N/A , N/A ,$14.48 ,$15.34 , N/A ,$12.78 ,$11.93 ,$11.93 , N/A ,$11.93 ,$13.12 ,$13.12 , N/A ,$14.48 , N/A , N/A ,$9.56 ,$7.05 ,$7.09 , N/A , N/A , N/A ,$14.48 , N/A ,$8.93 ,$4.77 ,$15.34 ,$9.00 , N/A ,$11.08 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100118,N/A,HC POST OP SHOE,271,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 ,$16.25 , N/A ,$7.00 ,$13.83 , N/A ,$14.55 , N/A ,$13.10 , N/A , N/A ,$23.00 , N/A , N/A ,$21.25 ,$22.50 , N/A ,$18.75 ,$17.50 ,$17.50 , N/A ,$17.50 ,$19.25 ,$19.25 , N/A ,$21.25 , N/A , N/A ,$14.03 ,$10.35 ,$10.40 , N/A , N/A , N/A ,$21.25 , N/A ,$13.10 ,$7.00 ,$22.50 ,$13.20 , N/A ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100125,N/A,HC SHOULDER PULLEY METAL,271,1 ,$68.00 ,$48.96 ,$19.04 ,$68.00 ,$44.20 , N/A ,$19.04 ,$37.60 , N/A ,$39.58 , N/A ,$35.63 , N/A , N/A ,$62.56 , N/A , N/A ,$57.80 ,$61.20 , N/A ,$51.00 ,$47.60 ,$47.60 , N/A ,$47.60 ,$52.36 ,$52.36 , N/A ,$57.80 , N/A , N/A ,$38.15 ,$28.15 ,$28.29 , N/A , N/A , N/A ,$57.80 , N/A ,$35.63 ,$19.04 ,$61.20 ,$35.90 , N/A ,$44.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100132,N/A,HC SPLINT ARM ORTHOGLASS,271,1 ,$167.00 ,$120.24 ,$46.76 ,$167.00 ,$108.55 , N/A ,$46.76 ,$92.35 , N/A ,$97.19 , N/A ,$87.51 , N/A , N/A ,$153.64 , N/A , N/A ,$141.95 ,$150.30 , N/A ,$125.25 ,$116.90 ,$116.90 , N/A ,$116.90 ,$128.59 ,$128.59 , N/A ,$141.95 , N/A , N/A ,$93.69 ,$69.14 ,$69.47 , N/A , N/A , N/A ,$141.95 , N/A ,$87.51 ,$46.76 ,$150.30 ,$88.18 , N/A ,$108.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100137,N/A,HC SPLINT LEG ORTHOGLASS,271,1 ,$250.00 ,$180.00 ,$70.00 ,$250.00 ,$162.50 , N/A ,$70.00 ,$138.25 , N/A ,$145.50 , N/A ,$131.00 , N/A , N/A ,$230.00 , N/A , N/A ,$212.50 ,$225.00 , N/A ,$187.50 ,$175.00 ,$175.00 , N/A ,$175.00 ,$192.50 ,$192.50 , N/A ,$212.50 , N/A , N/A ,$140.25 ,$103.50 ,$104.00 , N/A , N/A , N/A ,$212.50 , N/A ,$131.00 ,$70.00 ,$225.00 ,$132.00 , N/A ,$162.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100155,N/A,HC THERABAND PER FOOT,271,1 ,$5.00 ,$3.60 ,$1.40 ,$5.00 ,$3.25 , N/A ,$1.40 ,$2.77 , N/A ,$2.91 , N/A ,$2.62 , N/A , N/A ,$4.60 , N/A , N/A ,$4.25 ,$4.50 , N/A ,$3.75 ,$3.50 ,$3.50 , N/A ,$3.50 ,$3.85 ,$3.85 , N/A ,$4.25 , N/A , N/A ,$2.81 ,$2.07 ,$2.08 , N/A , N/A , N/A ,$4.25 , N/A ,$2.62 ,$1.40 ,$4.50 ,$2.64 , N/A ,$3.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100182,N/A,HC HAND SPLINT,271,1 ,$83.00 ,$59.76 ,$23.24 ,$83.00 ,$53.95 , N/A ,$23.24 ,$45.90 , N/A ,$48.31 , N/A ,$43.49 , N/A , N/A ,$76.36 , N/A , N/A ,$70.55 ,$74.70 , N/A ,$62.25 ,$58.10 ,$58.10 , N/A ,$58.10 ,$63.91 ,$63.91 , N/A ,$70.55 , N/A , N/A ,$46.56 ,$34.36 ,$34.53 , N/A , N/A , N/A ,$70.55 , N/A ,$43.49 ,$23.24 ,$74.70 ,$43.82 , N/A ,$53.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100204,N/A,HC CIRCUIT BREATHING,271,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 ,$20.80 , N/A ,$8.96 ,$17.70 , N/A ,$18.62 , N/A ,$16.77 , N/A , N/A ,$29.44 , N/A , N/A ,$27.20 ,$28.80 , N/A ,$24.00 ,$22.40 ,$22.40 , N/A ,$22.40 ,$24.64 ,$24.64 , N/A ,$27.20 , N/A , N/A ,$17.95 ,$13.25 ,$13.31 , N/A , N/A , N/A ,$27.20 , N/A ,$16.77 ,$8.96 ,$28.80 ,$16.90 , N/A ,$20.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100234,N/A,HC MASK BIPAP,271,1 ,$65.00 ,$46.80 ,$18.20 ,$65.00 ,$42.25 , N/A ,$18.20 ,$35.95 , N/A ,$37.83 , N/A ,$34.06 , N/A , N/A ,$59.80 , N/A , N/A ,$55.25 ,$58.50 , N/A ,$48.75 ,$45.50 ,$45.50 , N/A ,$45.50 ,$50.05 ,$50.05 , N/A ,$55.25 , N/A , N/A ,$36.47 ,$26.91 ,$27.04 , N/A , N/A , N/A ,$55.25 , N/A ,$34.06 ,$18.20 ,$58.50 ,$34.32 , N/A ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100235,N/A,HC MASK OXYGEN,271,1 ,$23.00 ,$16.56 ,$6.44 ,$23.00 ,$14.95 , N/A ,$6.44 ,$12.72 , N/A ,$13.39 , N/A ,$12.05 , N/A , N/A ,$21.16 , N/A , N/A ,$19.55 ,$20.70 , N/A ,$17.25 ,$16.10 ,$16.10 , N/A ,$16.10 ,$17.71 ,$17.71 , N/A ,$19.55 , N/A , N/A ,$12.90 ,$9.52 ,$9.57 , N/A , N/A , N/A ,$19.55 , N/A ,$12.05 ,$6.44 ,$20.70 ,$12.14 , N/A ,$14.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100254,N/A,HC CUFF BLOOD PRESSURE,271,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 ,$18.20 , N/A ,$7.84 ,$15.48 , N/A ,$16.30 , N/A ,$14.67 , N/A , N/A ,$25.76 , N/A , N/A ,$23.80 ,$25.20 , N/A ,$21.00 ,$19.60 ,$19.60 , N/A ,$19.60 ,$21.56 ,$21.56 , N/A ,$23.80 , N/A , N/A ,$15.71 ,$11.59 ,$11.65 , N/A , N/A , N/A ,$23.80 , N/A ,$14.67 ,$7.84 ,$25.20 ,$14.78 , N/A ,$18.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100263,N/A,HC POSITIONER HEAD,271,1 ,$28.00 ,$20.16 ,$7.84 ,$28.00 ,$18.20 , N/A ,$7.84 ,$15.48 , N/A ,$16.30 , N/A ,$14.67 , N/A , N/A ,$25.76 , N/A , N/A ,$23.80 ,$25.20 , N/A ,$21.00 ,$19.60 ,$19.60 , N/A ,$19.60 ,$21.56 ,$21.56 , N/A ,$23.80 , N/A , N/A ,$15.71 ,$11.59 ,$11.65 , N/A , N/A , N/A ,$23.80 , N/A ,$14.67 ,$7.84 ,$25.20 ,$14.78 , N/A ,$18.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100320,N/A,HC KIT MEDICAL SUPPLY TRANSPORT,271,1 ,$443.00 ,$318.96 ,$124.04 ,$443.00 ,$287.95 , N/A ,$124.04 ,$244.98 , N/A ,$257.83 , N/A ,$232.13 , N/A , N/A ,$407.56 , N/A , N/A ,$376.55 ,$398.70 , N/A ,$332.25 ,$310.10 ,$310.10 , N/A ,$310.10 ,$341.11 ,$341.11 , N/A ,$376.55 , N/A , N/A ,$248.52 ,$183.40 ,$184.29 , N/A , N/A , N/A ,$376.55 , N/A ,$232.13 ,$124.04 ,$398.70 ,$233.90 , N/A ,$287.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27100489,N/A,HC MASK RESPIRATOR,271,1 ,$93.00 ,$66.96 ,$26.04 ,$93.00 ,$60.45 , N/A ,$26.04 ,$51.43 , N/A ,$54.13 , N/A ,$48.73 , N/A , N/A ,$85.56 , N/A , N/A ,$79.05 ,$83.70 , N/A ,$69.75 ,$65.10 ,$65.10 , N/A ,$65.10 ,$71.61 ,$71.61 , N/A ,$79.05 , N/A , N/A ,$52.17 ,$38.50 ,$38.69 , N/A , N/A , N/A ,$79.05 , N/A ,$48.73 ,$26.04 ,$83.70 ,$49.10 , N/A ,$60.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,IMMOBILZER KNEE 16,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,DRESSING STOCKINETTE ORTHO COTTON TUBLR NON-STERILE 25YDX4,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,DRESSING STOCKINETTE WHITE 4,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,IMMOBILIZER ORTHOPEDIC UNIVERSAL 24IN 30IN KNEE CONTOUR STAY BREATHABLE TRIMMABLE ALUMINUM FOAM LATEX FREE,271,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SOLN IRR 0.9 NACL 2000ML BAG,271,1 ,$21.57 ,$15.53 ,$6.04 ,$21.57 ,$14.02 , N/A ,$6.04 ,$11.93 , N/A ,$12.55 , N/A ,$11.30 , N/A , N/A ,$19.84 , N/A , N/A ,$18.33 ,$19.41 , N/A ,$16.18 ,$15.10 ,$15.10 , N/A ,$15.10 ,$16.61 ,$16.61 , N/A ,$18.33 , N/A , N/A ,$12.10 ,$8.93 ,$8.97 , N/A , N/A , N/A ,$18.33 , N/A ,$11.30 ,$6.04 ,$19.41 ,$11.39 , N/A ,$14.02 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SOLN IRR 0.9 NACL 3000ML BAG,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,BAG PRESSURE INFUSION 3000CC,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,BRACE ORTHOPEDIC LARGE 10IN ANKLE ADJUSTABLE HEEL STRAP RIGID SHELL STIRRUP VELCRO THERMOPLASTIC PROCARE SURROUND WHITE,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,BRACE ORTHOPEDIC MEDIUM 9IN ANKLE ADJUSTABLE HEEL STRAP RIGID SHELL AIR GEL BLADDER THERMOPLASTIC PROCARE SURROUND,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,BRACE ORTHOPEDIC SMALL 8.5IN ANKLE ADJUSTABLE HEEL STRAP RIGID SHELL STIRRUP VELCRO THERMOPLASTIC PROCARE SURROUND WHITE,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,CAST PAD SYNTHETIC 2,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,CAST PAD SYNTHETIC 4,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,CAST PAD SYNTHETIC 6,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,"DRESSING STOCKINETTE 2"" UNSTERILE",271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,DRESSING STOCKINETTE 3 TUBE/ YARD,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,IMMOBILIZER ORTHOPEDIC FEMALE MEDIUM CONTOUR OD30-36 IN SHOU,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT ORTHOGLASS 3 WIDE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,CUFF COMPRESSION XL CALF VENAFLOW ELITE 11.5IN BREATHABLE PRESET PRESSURE LIGHTWEIGHT AUTOMATIC DETECTION LATEX FREE DISPOSABLE 22IN UNIVERSAL PUMP,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SLEEVE SCD CALF,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SLING 2XLARGE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SLING ARM BLUE LARGE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SLING PATIENT ARJO LARGE TENOR 154-264LB,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SLING XLARGE,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT ORTHO-GLASS 2 X 15,271,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT ORTHOGLASS 5 WIDE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,CUBE POLAR CARE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,ELECTRODE DEFIBRILLATOR ONESTEP RESUSCITATION CPR PEDIATRIC AMBULATORY CARE R SERIES LATEX FREE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SLING PATIENT REPOSITION LATEX FREE DISPOSABLE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT ORTHOGLASS 4 WIDE,271,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT ORTHOPEDIC 15FTX6IN ROLL FIBERGLASS ORTHO-GLASS LATEX FREE,271,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT PRTHO 15X3,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,BAG PRESSURE INFUSION 1000CC,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,CAST PAD SYNTHETIC 3,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,IRRIG LACTATED RINGERS 3000ML,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27170000,N/A,SPLINT PLASTER GREEN 4 X 15 X-FAST,271,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200054,C1751,HC KIT CATHETER,272,1 ,$157.00 ,$113.04 ,$43.96 ,$157.00 ,$102.05 , N/A ,$43.96 ,$86.82 , N/A ,$91.37 , N/A ,$82.27 , N/A , N/A , N/A , N/A , N/A ,$133.45 ,$141.30 , N/A ,$117.75 ,$109.90 ,$109.90 , N/A ,$109.90 ,$120.89 ,$120.89 , N/A ,$133.45 , N/A , N/A ,$88.08 ,$65.00 ,$65.31 , N/A , N/A , N/A ,$133.45 , N/A ,$82.27 ,$43.96 ,$141.30 ,$82.90 , N/A ,$102.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$49.00 ,$35.28 ,$13.72 ,$49.00 ,$31.85 , N/A ,$13.72 ,$27.10 , N/A ,$28.52 , N/A ,$25.68 , N/A , N/A ,$45.08 , N/A , N/A ,$41.65 ,$44.10 , N/A ,$36.75 ,$34.30 ,$34.30 , N/A ,$34.30 ,$37.73 ,$37.73 , N/A ,$41.65 , N/A , N/A ,$27.49 ,$20.29 ,$20.38 , N/A , N/A , N/A ,$41.65 , N/A ,$25.68 ,$13.72 ,$44.10 ,$25.87 , N/A ,$31.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200288,N/A,HC BAG AMBU,272,1 ,$84.00 ,$60.48 ,$23.52 ,$84.00 ,$54.60 , N/A ,$23.52 ,$46.45 , N/A ,$48.89 , N/A ,$44.02 , N/A , N/A ,$77.28 , N/A , N/A ,$71.40 ,$75.60 , N/A ,$63.00 ,$58.80 ,$58.80 , N/A ,$58.80 ,$64.68 ,$64.68 , N/A ,$71.40 , N/A , N/A ,$47.12 ,$34.78 ,$34.94 , N/A , N/A , N/A ,$71.40 , N/A ,$44.02 ,$23.52 ,$75.60 ,$44.35 , N/A ,$54.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200357,N/A,HC BIS MONITOR STRIP,272,1 ,$47.00 ,$33.84 ,$13.16 ,$47.00 ,$30.55 , N/A ,$13.16 ,$25.99 , N/A ,$27.35 , N/A ,$24.63 , N/A , N/A ,$43.24 , N/A , N/A ,$39.95 ,$42.30 , N/A ,$35.25 ,$32.90 ,$32.90 , N/A ,$32.90 ,$36.19 ,$36.19 , N/A ,$39.95 , N/A , N/A ,$26.37 ,$19.46 ,$19.55 , N/A , N/A , N/A ,$39.95 , N/A ,$24.63 ,$13.16 ,$42.30 ,$24.82 , N/A ,$30.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200543,N/A,HC BLOOD FILTER,272,1 ,$37.00 ,$26.64 ,$10.36 ,$37.00 ,$24.05 , N/A ,$10.36 ,$20.46 , N/A ,$21.53 , N/A ,$19.39 , N/A , N/A ,$34.04 , N/A , N/A ,$31.45 ,$33.30 , N/A ,$27.75 ,$25.90 ,$25.90 , N/A ,$25.90 ,$28.49 ,$28.49 , N/A ,$31.45 , N/A , N/A ,$20.76 ,$15.32 ,$15.39 , N/A , N/A , N/A ,$31.45 , N/A ,$19.39 ,$10.36 ,$33.30 ,$19.54 , N/A ,$24.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200846,N/A,HC CATHETER,272,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200847,N/A,HC CATHETER - 3 WAY,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 ,$17.55 , N/A ,$7.56 ,$14.93 , N/A ,$15.71 , N/A ,$14.15 , N/A , N/A ,$24.84 , N/A , N/A ,$22.95 ,$24.30 , N/A ,$20.25 ,$18.90 ,$18.90 , N/A ,$18.90 ,$20.79 ,$20.79 , N/A ,$22.95 , N/A , N/A ,$15.15 ,$11.18 ,$11.23 , N/A , N/A , N/A ,$22.95 , N/A ,$14.15 ,$7.56 ,$24.30 ,$14.26 , N/A ,$17.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27200849,N/A,HC CATHETER - FOLEY,272,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27201165,N/A,HC MORGAN LENS,272,1 ,$99.00 ,$71.28 ,$27.72 ,$99.00 ,$64.35 , N/A ,$27.72 ,$54.75 , N/A ,$57.62 , N/A ,$51.88 , N/A , N/A ,$91.08 , N/A , N/A ,$84.15 ,$89.10 , N/A ,$74.25 ,$69.30 ,$69.30 , N/A ,$69.30 ,$76.23 ,$76.23 , N/A ,$84.15 , N/A , N/A ,$55.54 ,$40.99 ,$41.18 , N/A , N/A , N/A ,$84.15 , N/A ,$51.88 ,$27.72 ,$89.10 ,$52.27 , N/A ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27201250,N/A,HC EPIDURAL TRAY SNGL USE,272,1 ,$114.00 ,$82.08 ,$31.92 ,$114.00 ,$74.10 , N/A ,$31.92 ,$63.04 , N/A ,$66.35 , N/A ,$59.74 , N/A , N/A ,$104.88 , N/A , N/A ,$96.90 ,$102.60 , N/A ,$85.50 ,$79.80 ,$79.80 , N/A ,$79.80 ,$87.78 ,$87.78 , N/A ,$96.90 , N/A , N/A ,$63.95 ,$47.20 ,$47.42 , N/A , N/A , N/A ,$96.90 , N/A ,$59.74 ,$31.92 ,$102.60 ,$60.19 , N/A ,$74.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),27201251,N/A,HC EPIDURAL/SPINAL TRAY,272,1 ,$110.00 ,$79.20 ,$30.80 ,$110.00 ,$71.50 , N/A ,$30.80 ,$60.83 , N/A ,$64.02 , N/A ,$57.64 , N/A , N/A ,$101.20 , N/A , N/A ,$93.50 ,$99.00 , N/A ,$82.50 ,$77.00 ,$77.00 , N/A ,$77.00 ,$84.70 ,$84.70 , N/A ,$93.50 , N/A , N/A ,$61.71 ,$45.54 ,$45.76 , N/A , N/A , N/A ,$93.50 , N/A ,$57.64 ,$30.80 ,$99.00 ,$58.08 , N/A ,$71.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27201803,N/A,HC PAD ELECTRODE,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 ,$25.35 , N/A ,$10.92 ,$21.57 , N/A ,$22.70 , N/A ,$20.44 , N/A , N/A ,$35.88 , N/A , N/A ,$33.15 ,$35.10 , N/A ,$29.25 ,$27.30 ,$27.30 , N/A ,$27.30 ,$30.03 ,$30.03 , N/A ,$33.15 , N/A , N/A ,$21.88 ,$16.15 ,$16.22 , N/A , N/A , N/A ,$33.15 , N/A ,$20.44 ,$10.92 ,$35.10 ,$20.59 , N/A ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27201832,N/A,HC PEP DEVICE,272,1 ,$93.00 ,$66.96 ,$26.04 ,$93.00 ,$60.45 , N/A ,$26.04 ,$51.43 , N/A ,$54.13 , N/A ,$48.73 , N/A , N/A ,$85.56 , N/A , N/A ,$79.05 ,$83.70 , N/A ,$69.75 ,$65.10 ,$65.10 , N/A ,$65.10 ,$71.61 ,$71.61 , N/A ,$79.05 , N/A , N/A ,$52.17 ,$38.50 ,$38.69 , N/A , N/A , N/A ,$79.05 , N/A ,$48.73 ,$26.04 ,$83.70 ,$49.10 , N/A ,$60.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27202743,N/A,HC TRAY CATH,272,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 ,$14.30 , N/A ,$6.16 ,$12.17 , N/A ,$12.80 , N/A ,$11.53 , N/A , N/A ,$20.24 , N/A , N/A ,$18.70 ,$19.80 , N/A ,$16.50 ,$15.40 ,$15.40 , N/A ,$15.40 ,$16.94 ,$16.94 , N/A ,$18.70 , N/A , N/A ,$12.34 ,$9.11 ,$9.15 , N/A , N/A , N/A ,$18.70 , N/A ,$11.53 ,$6.16 ,$19.80 ,$11.62 , N/A ,$14.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27202759,N/A,HC TRAY EPIDURAL CONTINUOUS,272,1 ,$114.00 ,$82.08 ,$31.92 ,$114.00 ,$74.10 , N/A ,$31.92 ,$63.04 , N/A ,$66.35 , N/A ,$59.74 , N/A , N/A ,$104.88 , N/A , N/A ,$96.90 ,$102.60 , N/A ,$85.50 ,$79.80 ,$79.80 , N/A ,$79.80 ,$87.78 ,$87.78 , N/A ,$96.90 , N/A , N/A ,$63.95 ,$47.20 ,$47.42 , N/A , N/A , N/A ,$96.90 , N/A ,$59.74 ,$31.92 ,$102.60 ,$60.19 , N/A ,$74.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),27202807,N/A,HC TRAY SPINAL,272,1 ,$85.00 ,$61.20 ,$23.80 ,$85.00 ,$55.25 , N/A ,$23.80 ,$47.01 , N/A ,$49.47 , N/A ,$44.54 , N/A , N/A ,$78.20 , N/A , N/A ,$72.25 ,$76.50 , N/A ,$63.75 ,$59.50 ,$59.50 , N/A ,$59.50 ,$65.45 ,$65.45 , N/A ,$72.25 , N/A , N/A ,$47.69 ,$35.19 ,$35.36 , N/A , N/A , N/A ,$72.25 , N/A ,$44.54 ,$23.80 ,$76.50 ,$44.88 , N/A ,$55.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203016,N/A,HC WOUND REPAIR SUTURES TRAY,272,1 ,$43.00 ,$30.96 ,$12.04 ,$43.00 ,$27.95 , N/A ,$12.04 ,$23.78 , N/A ,$25.03 , N/A ,$22.53 , N/A , N/A ,$39.56 , N/A , N/A ,$36.55 ,$38.70 , N/A ,$32.25 ,$30.10 ,$30.10 , N/A ,$30.10 ,$33.11 ,$33.11 , N/A ,$36.55 , N/A , N/A ,$24.12 ,$17.80 ,$17.89 , N/A , N/A , N/A ,$36.55 , N/A ,$22.53 ,$12.04 ,$38.70 ,$22.70 , N/A ,$27.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203106,N/A,HC BIOPSY FORCEPS DISP,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 ,$17.55 , N/A ,$7.56 ,$14.93 , N/A ,$15.71 , N/A ,$14.15 , N/A , N/A ,$24.84 , N/A , N/A ,$22.95 ,$24.30 , N/A ,$20.25 ,$18.90 ,$18.90 , N/A ,$18.90 ,$20.79 ,$20.79 , N/A ,$22.95 , N/A , N/A ,$15.15 ,$11.18 ,$11.23 , N/A , N/A , N/A ,$22.95 , N/A ,$14.15 ,$7.56 ,$24.30 ,$14.26 , N/A ,$17.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203255,N/A,HC CPM PADS,272,1 ,$68.00 ,$48.96 ,$19.04 ,$68.00 ,$44.20 , N/A ,$19.04 ,$37.60 , N/A ,$39.58 , N/A ,$35.63 , N/A , N/A ,$62.56 , N/A , N/A ,$57.80 ,$61.20 , N/A ,$51.00 ,$47.60 ,$47.60 , N/A ,$47.60 ,$52.36 ,$52.36 , N/A ,$57.80 , N/A , N/A ,$38.15 ,$28.15 ,$28.29 , N/A , N/A , N/A ,$57.80 , N/A ,$35.63 ,$19.04 ,$61.20 ,$35.90 , N/A ,$44.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$185.00 ,$133.20 ,$51.80 ,$185.00 ,$120.25 , N/A ,$51.80 ,$102.31 , N/A ,$107.67 , N/A ,$96.94 , N/A , N/A ,$170.20 , N/A , N/A ,$157.25 ,$166.50 , N/A ,$138.75 ,$129.50 ,$129.50 , N/A ,$129.50 ,$142.45 ,$142.45 , N/A ,$157.25 , N/A , N/A ,$103.79 ,$76.59 ,$76.96 , N/A , N/A , N/A ,$157.25 , N/A ,$96.94 ,$51.80 ,$166.50 ,$97.68 , N/A ,$120.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203521,A6234,HC DRESSING DUODERM <16 SQ CM,272,1 ,$19.00 ,$13.68 ,$5.32 ,$19.00 ,$12.35 , N/A ,$5.32 ,$10.51 , N/A ,$11.06 , N/A ,$9.96 , N/A , N/A , N/A , N/A , N/A ,$16.15 ,$17.10 , N/A ,$14.25 ,$13.30 ,$13.30 , N/A ,$13.30 ,$14.63 ,$14.63 , N/A ,$16.15 , N/A , N/A ,$10.66 ,$7.87 ,$7.90 , N/A , N/A , N/A ,$16.15 , N/A ,$9.96 ,$5.32 ,$17.10 ,$10.03 , N/A ,$12.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203531,C1751,HC CATHETER CV TRIPLE-LUMEN,272,1 ,$323.00 ,$232.56 ,$90.44 ,$323.00 ,$209.95 , N/A ,$90.44 ,$178.62 , N/A ,$187.99 , N/A ,$169.25 , N/A , N/A , N/A , N/A , N/A ,$274.55 ,$290.70 , N/A ,$242.25 ,$226.10 ,$226.10 , N/A ,$226.10 ,$248.71 ,$248.71 , N/A ,$274.55 , N/A , N/A ,$181.20 ,$133.72 ,$134.37 , N/A , N/A , N/A ,$274.55 , N/A ,$169.25 ,$90.44 ,$290.70 ,$170.54 , N/A ,$209.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203537,N/A,HC CATHETER RADIAL ARTERY,272,1 ,$13.00 ,$9.36 ,$3.64 ,$13.00 ,$8.45 , N/A ,$3.64 ,$7.19 , N/A ,$7.57 , N/A ,$6.81 , N/A , N/A ,$11.96 , N/A , N/A ,$11.05 ,$11.70 , N/A ,$9.75 ,$9.10 ,$9.10 , N/A ,$9.10 ,$10.01 ,$10.01 , N/A ,$11.05 , N/A , N/A ,$7.29 ,$5.38 ,$5.41 , N/A , N/A , N/A ,$11.05 , N/A ,$6.81 ,$3.64 ,$11.70 ,$6.86 , N/A ,$8.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203568,N/A,HC DRAIN CHEST,272,1 ,$226.00 ,$162.72 ,$63.28 ,$226.00 ,$146.90 , N/A ,$63.28 ,$124.98 , N/A ,$131.53 , N/A ,$118.42 , N/A , N/A ,$207.92 , N/A , N/A ,$192.10 ,$203.40 , N/A ,$169.50 ,$158.20 ,$158.20 , N/A ,$158.20 ,$174.02 ,$174.02 , N/A ,$192.10 , N/A , N/A ,$126.79 ,$93.56 ,$94.02 , N/A , N/A , N/A ,$192.10 , N/A ,$118.42 ,$63.28 ,$203.40 ,$119.33 , N/A ,$146.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203579,N/A,HC KIT CATHETER FEMALE/INFANT/CHILD,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203580,N/A,HC KIT IV START,272,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 , N/A ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.92 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203607,N/A,HC CIRCUIT CPAP/BIPAP,272,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 ,$10.40 , N/A ,$4.48 ,$8.85 , N/A ,$9.31 , N/A ,$8.38 , N/A , N/A ,$14.72 , N/A , N/A ,$13.60 ,$14.40 , N/A ,$12.00 ,$11.20 ,$11.20 , N/A ,$11.20 ,$12.32 ,$12.32 , N/A ,$13.60 , N/A , N/A ,$8.98 ,$6.62 ,$6.66 , N/A , N/A , N/A ,$13.60 , N/A ,$8.38 ,$4.48 ,$14.40 ,$8.45 , N/A ,$10.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),27203844,N/A,HC TRAY CHEST TUBE,272,1 ,$126.00 ,$90.72 ,$35.28 ,$126.00 ,$81.90 , N/A ,$35.28 ,$69.68 , N/A ,$73.33 , N/A ,$66.02 , N/A , N/A ,$115.92 , N/A , N/A ,$107.10 ,$113.40 , N/A ,$94.50 ,$88.20 ,$88.20 , N/A ,$88.20 ,$97.02 ,$97.02 , N/A ,$107.10 , N/A , N/A ,$70.69 ,$52.16 ,$52.42 , N/A , N/A , N/A ,$107.10 , N/A ,$66.02 ,$35.28 ,$113.40 ,$66.53 , N/A ,$81.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204640,N/A,HC AIRWAY NASAL S1,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204668,N/A,HC COLLAR CERVICAL ADJ ADULT,272,1 ,$35.00 ,$25.20 ,$9.80 ,$35.00 ,$22.75 , N/A ,$9.80 ,$19.36 , N/A ,$20.37 , N/A ,$18.34 , N/A , N/A ,$32.20 , N/A , N/A ,$29.75 ,$31.50 , N/A ,$26.25 ,$24.50 ,$24.50 , N/A ,$24.50 ,$26.95 ,$26.95 , N/A ,$29.75 , N/A , N/A ,$19.64 ,$14.49 ,$14.56 , N/A , N/A , N/A ,$29.75 , N/A ,$18.34 ,$9.80 ,$31.50 ,$18.48 , N/A ,$22.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204755,N/A,HC DEVICE BREAST BIOPSY,272,1 ,"$2,163.00 ","$1,557.36 ",$605.64 ,"$2,163.00 ","$1,405.95 ", N/A ,$605.64 ,"$1,196.14 ", N/A ,"$1,258.87 ", N/A ,"$1,133.41 ", N/A , N/A ,"$1,989.96 ", N/A , N/A ,"$1,838.55 ","$1,946.70 ", N/A ,"$1,622.25 ","$1,514.10 ","$1,514.10 ", N/A ,"$1,514.10 ","$1,665.51 ","$1,665.51 ", N/A ,"$1,838.55 ", N/A , N/A ,"$1,213.44 ",$895.48 ,$899.81 , N/A , N/A , N/A ,"$1,838.55 ", N/A ,"$1,133.41 ",$605.64 ,"$1,946.70 ","$1,142.06 ", N/A ,"$1,405.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27204760,N/A,HC BLANKET BAIR HUGGER,272,1 ,$56.00 ,$40.32 ,$15.68 ,$56.00 ,$36.40 , N/A ,$15.68 ,$30.97 , N/A ,$32.59 , N/A ,$29.34 , N/A , N/A ,$51.52 , N/A , N/A ,$47.60 ,$50.40 , N/A ,$42.00 ,$39.20 ,$39.20 , N/A ,$39.20 ,$43.12 ,$43.12 , N/A ,$47.60 , N/A , N/A ,$31.42 ,$23.18 ,$23.30 , N/A , N/A , N/A ,$47.60 , N/A ,$29.34 ,$15.68 ,$50.40 ,$29.57 , N/A ,$36.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204771,N/A,HC BLADE LARYNGOSCOPE,272,1 ,$39.00 ,$28.08 ,$10.92 ,$39.00 ,$25.35 , N/A ,$10.92 ,$21.57 , N/A ,$22.70 , N/A ,$20.44 , N/A , N/A ,$35.88 , N/A , N/A ,$33.15 ,$35.10 , N/A ,$29.25 ,$27.30 ,$27.30 , N/A ,$27.30 ,$30.03 ,$30.03 , N/A ,$33.15 , N/A , N/A ,$21.88 ,$16.15 ,$16.22 , N/A , N/A , N/A ,$33.15 , N/A ,$20.44 ,$10.92 ,$35.10 ,$20.59 , N/A ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204805,N/A,HC CHEST TUBE THAL-QUICK,272,1 ,$542.00 ,$390.24 ,$151.76 ,$542.00 ,$352.30 , N/A ,$151.76 ,$299.73 , N/A ,$315.44 , N/A ,$284.01 , N/A , N/A ,$498.64 , N/A , N/A ,$460.70 ,$487.80 , N/A ,$406.50 ,$379.40 ,$379.40 , N/A ,$379.40 ,$417.34 ,$417.34 , N/A ,$460.70 , N/A , N/A ,$304.06 ,$224.39 ,$225.47 , N/A , N/A , N/A ,$460.70 , N/A ,$284.01 ,$151.76 ,$487.80 ,$286.18 , N/A ,$352.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204859,N/A,HC HEMOSTAT SURGICAL,272,1 ,$170.00 ,$122.40 ,$47.60 ,$170.00 ,$110.50 , N/A ,$47.60 ,$94.01 , N/A ,$98.94 , N/A ,$89.08 , N/A , N/A ,$156.40 , N/A , N/A ,$144.50 ,$153.00 , N/A ,$127.50 ,$119.00 ,$119.00 , N/A ,$119.00 ,$130.90 ,$130.90 , N/A ,$144.50 , N/A , N/A ,$95.37 ,$70.38 ,$70.72 , N/A , N/A , N/A ,$144.50 , N/A ,$89.08 ,$47.60 ,$153.00 ,$89.76 , N/A ,$110.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204923,N/A,HC LIFT SLING LARGE/X-LARGE,272,1 ,$82.00 ,$59.04 ,$22.96 ,$82.00 ,$53.30 , N/A ,$22.96 ,$45.35 , N/A ,$47.72 , N/A ,$42.97 , N/A , N/A ,$75.44 , N/A , N/A ,$69.70 ,$73.80 , N/A ,$61.50 ,$57.40 ,$57.40 , N/A ,$57.40 ,$63.14 ,$63.14 , N/A ,$69.70 , N/A , N/A ,$46.00 ,$33.95 ,$34.11 , N/A , N/A , N/A ,$69.70 , N/A ,$42.97 ,$22.96 ,$73.80 ,$43.30 , N/A ,$53.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204937,N/A,HC NEEDLE NERVE BLOCK STIMULATING,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 ,$17.55 , N/A ,$7.56 ,$14.93 , N/A ,$15.71 , N/A ,$14.15 , N/A , N/A ,$24.84 , N/A , N/A ,$22.95 ,$24.30 , N/A ,$20.25 ,$18.90 ,$18.90 , N/A ,$18.90 ,$20.79 ,$20.79 , N/A ,$22.95 , N/A , N/A ,$15.15 ,$11.18 ,$11.23 , N/A , N/A , N/A ,$22.95 , N/A ,$14.15 ,$7.56 ,$24.30 ,$14.26 , N/A ,$17.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204944,N/A,HC NEEDLE SPINAL WHITACRE,272,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 ,$14.30 , N/A ,$6.16 ,$12.17 , N/A ,$12.80 , N/A ,$11.53 , N/A , N/A ,$20.24 , N/A , N/A ,$18.70 ,$19.80 , N/A ,$16.50 ,$15.40 ,$15.40 , N/A ,$15.40 ,$16.94 ,$16.94 , N/A ,$18.70 , N/A , N/A ,$12.34 ,$9.11 ,$9.15 , N/A , N/A , N/A ,$18.70 , N/A ,$11.53 ,$6.16 ,$19.80 ,$11.62 , N/A ,$14.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204988,N/A,HC BAG INFUSION PRESSURE,272,1 ,$68.00 ,$48.96 ,$19.04 ,$68.00 ,$44.20 , N/A ,$19.04 ,$37.60 , N/A ,$39.58 , N/A ,$35.63 , N/A , N/A ,$62.56 , N/A , N/A ,$57.80 ,$61.20 , N/A ,$51.00 ,$47.60 ,$47.60 , N/A ,$47.60 ,$52.36 ,$52.36 , N/A ,$57.80 , N/A , N/A ,$38.15 ,$28.15 ,$28.29 , N/A , N/A , N/A ,$57.80 , N/A ,$35.63 ,$19.04 ,$61.20 ,$35.90 , N/A ,$44.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204992,N/A,HC PROBE ESOPHAGEAL TEMP SENSOR,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),27204999,N/A,HC SENSOR PULSE OX,272,1 ,$32.00 ,$23.04 ,$8.96 ,$32.00 ,$20.80 , N/A ,$8.96 ,$17.70 , N/A ,$18.62 , N/A ,$16.77 , N/A , N/A ,$29.44 , N/A , N/A ,$27.20 ,$28.80 , N/A ,$24.00 ,$22.40 ,$22.40 , N/A ,$22.40 ,$24.64 ,$24.64 , N/A ,$27.20 , N/A , N/A ,$17.95 ,$13.25 ,$13.31 , N/A , N/A , N/A ,$27.20 , N/A ,$16.77 ,$8.96 ,$28.80 ,$16.90 , N/A ,$20.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205031,N/A,HC STOCKINETTE YARDS,272,1 ,$49.00 ,$35.28 ,$13.72 ,$49.00 ,$31.85 , N/A ,$13.72 ,$27.10 , N/A ,$28.52 , N/A ,$25.68 , N/A , N/A ,$45.08 , N/A , N/A ,$41.65 ,$44.10 , N/A ,$36.75 ,$34.30 ,$34.30 , N/A ,$34.30 ,$37.73 ,$37.73 , N/A ,$41.65 , N/A , N/A ,$27.49 ,$20.29 ,$20.38 , N/A , N/A , N/A ,$41.65 , N/A ,$25.68 ,$13.72 ,$44.10 ,$25.87 , N/A ,$31.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205032,N/A,HC STOCKINETTE TUBE,272,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 ,$14.30 , N/A ,$6.16 ,$12.17 , N/A ,$12.80 , N/A ,$11.53 , N/A , N/A ,$20.24 , N/A , N/A ,$18.70 ,$19.80 , N/A ,$16.50 ,$15.40 ,$15.40 , N/A ,$15.40 ,$16.94 ,$16.94 , N/A ,$18.70 , N/A , N/A ,$12.34 ,$9.11 ,$9.15 , N/A , N/A , N/A ,$18.70 , N/A ,$11.53 ,$6.16 ,$19.80 ,$11.62 , N/A ,$14.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205074,N/A,HC TUBE TRACH,272,1 ,$64.00 ,$46.08 ,$17.92 ,$64.00 ,$41.60 , N/A ,$17.92 ,$35.39 , N/A ,$37.25 , N/A ,$33.54 , N/A , N/A ,$58.88 , N/A , N/A ,$54.40 ,$57.60 , N/A ,$48.00 ,$44.80 ,$44.80 , N/A ,$44.80 ,$49.28 ,$49.28 , N/A ,$54.40 , N/A , N/A ,$35.90 ,$26.50 ,$26.62 , N/A , N/A , N/A ,$54.40 , N/A ,$33.54 ,$17.92 ,$57.60 ,$33.79 , N/A ,$41.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205116,N/A,HC DRESSING AQUACEL AG FOAM/FLAT,272,1 ,$82.00 ,$59.04 ,$22.96 ,$82.00 ,$53.30 , N/A ,$22.96 ,$45.35 , N/A ,$47.72 , N/A ,$42.97 , N/A , N/A ,$75.44 , N/A , N/A ,$69.70 ,$73.80 , N/A ,$61.50 ,$57.40 ,$57.40 , N/A ,$57.40 ,$63.14 ,$63.14 , N/A ,$69.70 , N/A , N/A ,$46.00 ,$33.95 ,$34.11 , N/A , N/A , N/A ,$69.70 , N/A ,$42.97 ,$22.96 ,$73.80 ,$43.30 , N/A ,$53.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205169,N/A,HC CUVETTE BLOOD CLOTTING,272,1 ,$777.00 ,$559.44 ,$217.56 ,$777.00 ,$505.05 , N/A ,$217.56 ,$429.68 , N/A ,$452.21 , N/A ,$407.15 , N/A , N/A ,$714.84 , N/A , N/A ,$660.45 ,$699.30 , N/A ,$582.75 ,$543.90 ,$543.90 , N/A ,$543.90 ,$598.29 ,$598.29 , N/A ,$660.45 , N/A , N/A ,$435.90 ,$321.68 ,$323.23 , N/A , N/A , N/A ,$660.45 , N/A ,$407.15 ,$217.56 ,$699.30 ,$410.26 , N/A ,$505.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205236,N/A,HC SYSTEM BIOPSY NEEDLE/INTRODUCER,272,1 ,$37.00 ,$26.64 ,$10.36 ,$37.00 ,$24.05 , N/A ,$10.36 ,$20.46 , N/A ,$21.53 , N/A ,$19.39 , N/A , N/A ,$34.04 , N/A , N/A ,$31.45 ,$33.30 , N/A ,$27.75 ,$25.90 ,$25.90 , N/A ,$25.90 ,$28.49 ,$28.49 , N/A ,$31.45 , N/A , N/A ,$20.76 ,$15.32 ,$15.39 , N/A , N/A , N/A ,$31.45 , N/A ,$19.39 ,$10.36 ,$33.30 ,$19.54 , N/A ,$24.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205269,N/A,HC CIRCUIT BREATHING W/EXPIRATORY VALVE,272,1 ,$59.00 ,$42.48 ,$16.52 ,$59.00 ,$38.35 , N/A ,$16.52 ,$32.63 , N/A ,$34.34 , N/A ,$30.92 , N/A , N/A ,$54.28 , N/A , N/A ,$50.15 ,$53.10 , N/A ,$44.25 ,$41.30 ,$41.30 , N/A ,$41.30 ,$45.43 ,$45.43 , N/A ,$50.15 , N/A , N/A ,$33.10 ,$24.43 ,$24.54 , N/A , N/A , N/A ,$50.15 , N/A ,$30.92 ,$16.52 ,$53.10 ,$31.15 , N/A ,$38.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205325,N/A,HC PADDING CAST,272,1 ,$27.00 ,$19.44 ,$7.56 ,$27.00 ,$17.55 , N/A ,$7.56 ,$14.93 , N/A ,$15.71 , N/A ,$14.15 , N/A , N/A ,$24.84 , N/A , N/A ,$22.95 ,$24.30 , N/A ,$20.25 ,$18.90 ,$18.90 , N/A ,$18.90 ,$20.79 ,$20.79 , N/A ,$22.95 , N/A , N/A ,$15.15 ,$11.18 ,$11.23 , N/A , N/A , N/A ,$22.95 , N/A ,$14.15 ,$7.56 ,$24.30 ,$14.26 , N/A ,$17.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205326,N/A,HC SENSOR INFANT ADHESIVE,272,1 ,$33.00 ,$23.76 ,$9.24 ,$33.00 ,$21.45 , N/A ,$9.24 ,$18.25 , N/A ,$19.21 , N/A ,$17.29 , N/A , N/A ,$30.36 , N/A , N/A ,$28.05 ,$29.70 , N/A ,$24.75 ,$23.10 ,$23.10 , N/A ,$23.10 ,$25.41 ,$25.41 , N/A ,$28.05 , N/A , N/A ,$18.51 ,$13.66 ,$13.73 , N/A , N/A , N/A ,$28.05 , N/A ,$17.29 ,$9.24 ,$29.70 ,$17.42 , N/A ,$21.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205398,N/A,HC SURGICEL HEMOSTAT 2X3,272,1 ,$94.00 ,$67.68 ,$26.32 ,$94.00 ,$61.10 , N/A ,$26.32 ,$51.98 , N/A ,$54.71 , N/A ,$49.26 , N/A , N/A ,$86.48 , N/A , N/A ,$79.90 ,$84.60 , N/A ,$70.50 ,$65.80 ,$65.80 , N/A ,$65.80 ,$72.38 ,$72.38 , N/A ,$79.90 , N/A , N/A ,$52.73 ,$38.92 ,$39.10 , N/A , N/A , N/A ,$79.90 , N/A ,$49.26 ,$26.32 ,$84.60 ,$49.63 , N/A ,$61.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205411,N/A,HC DRESSING ELASTIC NET,272,1 ,$118.00 ,$84.96 ,$33.04 ,$118.00 ,$76.70 , N/A ,$33.04 ,$65.25 , N/A ,$68.68 , N/A ,$61.83 , N/A , N/A ,$108.56 , N/A , N/A ,$100.30 ,$106.20 , N/A ,$88.50 ,$82.60 ,$82.60 , N/A ,$82.60 ,$90.86 ,$90.86 , N/A ,$100.30 , N/A , N/A ,$66.20 ,$48.85 ,$49.09 , N/A , N/A , N/A ,$100.30 , N/A ,$61.83 ,$33.04 ,$106.20 ,$62.30 , N/A ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205436,N/A,HC THERAPY PUTTY,272,1 ,$64.00 ,$46.08 ,$17.92 ,$64.00 ,$41.60 , N/A ,$17.92 ,$35.39 , N/A ,$37.25 , N/A ,$33.54 , N/A , N/A ,$58.88 , N/A , N/A ,$54.40 ,$57.60 , N/A ,$48.00 ,$44.80 ,$44.80 , N/A ,$44.80 ,$49.28 ,$49.28 , N/A ,$54.40 , N/A , N/A ,$35.90 ,$26.50 ,$26.62 , N/A , N/A , N/A ,$54.40 , N/A ,$33.54 ,$17.92 ,$57.60 ,$33.79 , N/A ,$41.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205494,N/A,HC REPLACEMENT PROC MODULES,272,1 ,$113.00 ,$81.36 ,$31.64 ,$113.00 ,$73.45 , N/A ,$31.64 ,$62.49 , N/A ,$65.77 , N/A ,$59.21 , N/A , N/A ,$103.96 , N/A , N/A ,$96.05 ,$101.70 , N/A ,$84.75 ,$79.10 ,$79.10 , N/A ,$79.10 ,$87.01 ,$87.01 , N/A ,$96.05 , N/A , N/A ,$63.39 ,$46.78 ,$47.01 , N/A , N/A , N/A ,$96.05 , N/A ,$59.21 ,$31.64 ,$101.70 ,$59.66 , N/A ,$73.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205498,N/A,HC MICROBIOLOGY QUICK TEST KIT,272,1 ,$815.00 ,$586.80 ,$228.20 ,$815.00 ,$529.75 , N/A ,$228.20 ,$450.70 , N/A ,$474.33 , N/A ,$427.06 , N/A , N/A ,$749.80 , N/A , N/A ,$692.75 ,$733.50 , N/A ,$611.25 ,$570.50 ,$570.50 , N/A ,$570.50 ,$627.55 ,$627.55 , N/A ,$692.75 , N/A , N/A ,$457.22 ,$337.41 ,$339.04 , N/A , N/A , N/A ,$692.75 , N/A ,$427.06 ,$228.20 ,$733.50 ,$430.32 , N/A ,$529.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205504,N/A,HC STEAM CHEMICAL INTEGRATOR,272,1 ,$23.00 ,$16.56 ,$6.44 ,$23.00 ,$14.95 , N/A ,$6.44 ,$12.72 , N/A ,$13.39 , N/A ,$12.05 , N/A , N/A ,$21.16 , N/A , N/A ,$19.55 ,$20.70 , N/A ,$17.25 ,$16.10 ,$16.10 , N/A ,$16.10 ,$17.71 ,$17.71 , N/A ,$19.55 , N/A , N/A ,$12.90 ,$9.52 ,$9.57 , N/A , N/A , N/A ,$19.55 , N/A ,$12.05 ,$6.44 ,$20.70 ,$12.14 , N/A ,$14.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205505,N/A,HC MEDI-FLOW LENS IRRIGATION SET,272,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 ,$13.65 , N/A ,$5.88 ,$11.61 , N/A ,$12.22 , N/A ,$11.00 , N/A , N/A ,$19.32 , N/A , N/A ,$17.85 ,$18.90 , N/A ,$15.75 ,$14.70 ,$14.70 , N/A ,$14.70 ,$16.17 ,$16.17 , N/A ,$17.85 , N/A , N/A ,$11.78 ,$8.69 ,$8.74 , N/A , N/A , N/A ,$17.85 , N/A ,$11.00 ,$5.88 ,$18.90 ,$11.09 , N/A ,$13.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205506,N/A,HC HEAT SEAL STERILIZATION POUCH,272,1 ,$42.00 ,$30.24 ,$11.76 ,$42.00 ,$27.30 , N/A ,$11.76 ,$23.23 , N/A ,$24.44 , N/A ,$22.01 , N/A , N/A ,$38.64 , N/A , N/A ,$35.70 ,$37.80 , N/A ,$31.50 ,$29.40 ,$29.40 , N/A ,$29.40 ,$32.34 ,$32.34 , N/A ,$35.70 , N/A , N/A ,$23.56 ,$17.39 ,$17.47 , N/A , N/A , N/A ,$35.70 , N/A ,$22.01 ,$11.76 ,$37.80 ,$22.18 , N/A ,$27.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205507,N/A,HC HEAT SEAL STERILIZATION TUBING,272,1 ,$31.00 ,$22.32 ,$8.68 ,$31.00 ,$20.15 , N/A ,$8.68 ,$17.14 , N/A ,$18.04 , N/A ,$16.24 , N/A , N/A ,$28.52 , N/A , N/A ,$26.35 ,$27.90 , N/A ,$23.25 ,$21.70 ,$21.70 , N/A ,$21.70 ,$23.87 ,$23.87 , N/A ,$26.35 , N/A , N/A ,$17.39 ,$12.83 ,$12.90 , N/A , N/A , N/A ,$26.35 , N/A ,$16.24 ,$8.68 ,$27.90 ,$16.37 , N/A ,$20.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),27205509,N/A,HC CT SYRINGE KIT,272,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,APPLICATOR ARISTA AH FLEXITIP XL 38CM,272,1 ,$49.80 ,$35.86 ,$13.94 ,$49.80 ,$32.37 , N/A ,$13.94 ,$27.54 , N/A ,$28.98 , N/A ,$26.10 , N/A , N/A ,$45.82 , N/A , N/A ,$42.33 ,$44.82 , N/A ,$37.35 ,$34.86 ,$34.86 , N/A ,$34.86 ,$38.35 ,$38.35 , N/A ,$42.33 , N/A , N/A ,$27.94 ,$20.62 ,$20.72 , N/A , N/A , N/A ,$42.33 , N/A ,$26.10 ,$13.94 ,$44.82 ,$26.29 , N/A ,$32.37 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SAW 25.5X9.5X4MM MICRO 100 MICROPOWER THK.6MM STAINLESS STEEL SAGITTAL FINE TOOTH STERILE LATEX FREE,272,1 ,$10.00 ,$7.20 ,$2.80 ,$10.00 ,$6.50 , N/A ,$2.80 ,$5.53 , N/A ,$5.82 , N/A ,$5.24 , N/A , N/A ,$9.20 , N/A , N/A ,$8.50 ,$9.00 , N/A ,$7.50 ,$7.00 ,$7.00 , N/A ,$7.00 ,$7.70 ,$7.70 , N/A ,$8.50 , N/A , N/A ,$5.61 ,$4.14 ,$4.16 , N/A , N/A , N/A ,$8.50 , N/A ,$5.24 ,$2.80 ,$9.00 ,$5.28 , N/A ,$6.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BURR 4MM MEDIUM OVAL CARBIDE 48MM,272,1 ,$38.79 ,$27.93 ,$10.86 ,$38.79 ,$25.21 , N/A ,$10.86 ,$21.45 , N/A ,$22.58 , N/A ,$20.33 , N/A , N/A ,$35.69 , N/A , N/A ,$32.97 ,$34.91 , N/A ,$29.09 ,$27.15 ,$27.15 , N/A ,$27.15 ,$29.87 ,$29.87 , N/A ,$32.97 , N/A , N/A ,$21.76 ,$16.06 ,$16.14 , N/A , N/A , N/A ,$32.97 , N/A ,$20.33 ,$10.86 ,$34.91 ,$20.48 , N/A ,$25.21 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CAUTERY LIGASURE HANDPIECE BLUNT TIP 37CM,272,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ",$877.50 , N/A ,$378.00 ,$746.55 , N/A ,$785.70 , N/A ,$707.40 , N/A , N/A ,"$1,242.00 ", N/A , N/A ,"$1,147.50 ","$1,215.00 ", N/A ,"$1,012.50 ",$945.00 ,$945.00 , N/A ,$945.00 ,"$1,039.50 ","$1,039.50 ", N/A ,"$1,147.50 ", N/A , N/A ,$757.35 ,$558.90 ,$561.60 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$707.40 ,$378.00 ,"$1,215.00 ",$712.80 , N/A ,$877.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DEVICE MYOSURE REACH,272,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,742.40 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DEVICE NOVASURE,272,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$2,059.20 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT VANTAGE CATARACT,272,1 ,$865.20 ,$622.94 ,$242.26 ,$865.20 ,$562.38 , N/A ,$242.26 ,$478.46 , N/A ,$503.55 , N/A ,$453.36 , N/A , N/A ,$795.98 , N/A , N/A ,$735.42 ,$778.68 , N/A ,$648.90 ,$605.64 ,$605.64 , N/A ,$605.64 ,$666.20 ,$666.20 , N/A ,$735.42 , N/A , N/A ,$485.38 ,$358.19 ,$359.92 , N/A , N/A , N/A ,$735.42 , N/A ,$453.36 ,$242.26 ,$778.68 ,$456.83 , N/A ,$562.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,Needle SCLEROTHERAPY 23GA,272,1 ,$87.00 ,$62.64 ,$24.36 ,$87.00 ,$56.55 , N/A ,$24.36 ,$48.11 , N/A ,$50.63 , N/A ,$45.59 , N/A , N/A ,$80.04 , N/A , N/A ,$73.95 ,$78.30 , N/A ,$65.25 ,$60.90 ,$60.90 , N/A ,$60.90 ,$66.99 ,$66.99 , N/A ,$73.95 , N/A , N/A ,$48.81 ,$36.02 ,$36.19 , N/A , N/A , N/A ,$73.95 , N/A ,$45.59 ,$24.36 ,$78.30 ,$45.94 , N/A ,$56.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK ASPIRATOR TX1 TISSUE REMOVAL TX SYSTEM CONSOLE,272,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,425.60 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PARTICLES ARISTA HEMOSTATIC 3GM (SM0002-USA),272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 ,$277.20 , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,EXTRACTOR STONE 120CM 12MM 1.9FR URETERAL NITINOL TIPLESS,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 ,$277.20 , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PROBE ELECTROSURGICAL 220CM 2.3MM FIAPC FLEXIBLE SIDEFIRE STERILE DISPOSABLE,272,1 ,$674.85 ,$485.89 ,$188.96 ,$674.85 ,$438.65 , N/A ,$188.96 ,$373.19 , N/A ,$392.76 , N/A ,$353.62 , N/A , N/A ,$620.86 , N/A , N/A ,$573.62 ,$607.37 , N/A ,$506.14 ,$472.40 ,$472.40 , N/A ,$472.40 ,$519.63 ,$519.63 , N/A ,$573.62 , N/A , N/A ,$378.59 ,$279.39 ,$280.74 , N/A , N/A , N/A ,$573.62 , N/A ,$353.62 ,$188.96 ,$607.37 ,$356.32 , N/A ,$438.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,RETRIEVER ROTH NET FOOD BOLUS 4.0CM,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ","$1,108.80 ", N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DEVICE BREAST BIOPSY CELERO,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ","$1,108.80 ", N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,REAMER SURGICAL CROSS PLATE ANCHORAGE NONSTERILE,272,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ","$1,108.80 ", N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,RING MALYUGIN,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BALLOON STONE RETRIEVAL 6-7FR 9-12MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BALLOON STONE RETRIEVAL BALLOON 76-7FR 12-15MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 122MM 3.5MM VARIAX AO NONSTERILE REUSABLE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 135MM 2MM AO FIT SCALE FOR 1113759 NONSTERILE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 2.6MM VARIAX 2,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRILL BIT STRYKER 2.5 X 230MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRILL BIT STRYKER AO T2 4.2 X 180MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT DECOMPRESSION 175CM 14FR 6FR .035IN COLON 10 DRAINAGE SIDEPORT CATHETER GUIDEWIRE STERILE DISPOSABLE,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT SAFETY PEG TUBE 20FR,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET ENDOSCOPIC INSTRUMENT TOPEL,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 2.7MM FIXOS CANNULATED,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 216MM 3.2MM AXSOS 3 SHORT TITANIUM NONLOCK,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 216MM 4.3MM SHORT LOCK NONSTERILE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CLIP RESOLUTION 2.8MM 360 235CM 11MM OPEN,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CLIP RESOLUTION 360 DEG 2.8MM X 235CM,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRIVER SURGICAL TRI-LOBE LONG,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,LIGATOR 2.8MM 8.6-11.5MM SPEEDBAND SUPERVIEW SUPER 7 STRING DEPLOYMENT MOLD BAND ENDOSCOPIC SQUARE LATEX FREE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PROBE ERBE FIAPC STRAIGHT,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLE RELOAD ENDOCUT BLUE 60MM,272,1 ,$357.12 ,$257.13 ,$99.99 ,$357.12 ,$232.13 , N/A ,$99.99 ,$197.49 , N/A ,$207.84 , N/A ,$187.13 , N/A , N/A ,$328.55 , N/A , N/A ,$303.55 ,$321.41 , N/A ,$267.84 ,$249.98 ,$249.98 , N/A ,$249.98 ,$274.98 ,$274.98 , N/A ,$303.55 , N/A , N/A ,$200.34 ,$147.85 ,$148.56 , N/A , N/A , N/A ,$303.55 , N/A ,$187.13 ,$99.99 ,$321.41 ,$188.56 , N/A ,$232.13 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLE RELOAD ENDOPATH ETS 4.1MM WHITE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 70MM 1.1MM K WIRE ATTACHMENT THREAD HOLE NONSTERILE,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DEVICE CLOSURE WECK EFX (ENDO FACIAL),272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRILL BIT SYNTHES 1.1MM,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT LAPAROSCOPIC CHOLANGIOGRAPHY SET ARROW PERCUTANEOUS,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT PINK PAD,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK MAJOR HFG,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,RETRIEVER RESCUENET 30MM 7.5FR,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLE ETS 45-3.5 RELOAD 6R45B,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLER ENDO LINEAR CUTTER 45MM ARTICULATING STANDARD,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 ,$475.20 , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BALLOON DISSECTOR LAPAROSCOPIC ROUND,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 ,$475.20 , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SAW PRECISION FALCON OSCILLATING TIP CARTRIDGE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 ,$475.20 , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SCREWDRIVER T10 AO SELF RETAIN,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 ,$475.20 , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CAUTERY LIGASURE HANDPIECE CURVED SMALL JAW,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 ,$475.20 , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRILL BIT COUNTERSINK QUICK RE,272,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 ,$475.20 , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLER ENDO LINEAR CUTTER EC60A,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ",$682.50 , N/A ,$294.00 ,$580.65 , N/A ,$611.10 , N/A ,$550.20 , N/A , N/A ,$966.00 , N/A , N/A ,$892.50 ,$945.00 , N/A ,$787.50 ,$735.00 ,$735.00 , N/A ,$735.00 ,$808.50 ,$808.50 , N/A ,$892.50 , N/A , N/A ,$589.05 ,$434.70 ,$436.80 , N/A , N/A , N/A ,$892.50 , N/A ,$550.20 ,$294.00 ,$945.00 ,$554.40 , N/A ,$682.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRILL SURGICAL CANNULATED QUICK RELEASE,272,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ",$682.50 , N/A ,$294.00 ,$580.65 , N/A ,$611.10 , N/A ,$550.20 , N/A , N/A ,$966.00 , N/A , N/A ,$892.50 ,$945.00 , N/A ,$787.50 ,$735.00 ,$735.00 , N/A ,$735.00 ,$808.50 ,$808.50 , N/A ,$892.50 , N/A , N/A ,$589.05 ,$434.70 ,$436.80 , N/A , N/A , N/A ,$892.50 , N/A ,$550.20 ,$294.00 ,$945.00 ,$554.40 , N/A ,$682.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLER RELOAD ECHELON 60MM WHITE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL 204MM 3.1MM CALIBRATED 4MM LOCK SCREW NONSTERILE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BRUSH CYTOLOGY 8FR 200CMX2.1MM RAPID EXCHANGE COMBO CATH DISPOSABLE BILIARY ACCEPTS .035IN GUIDEWIRE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CARTER-THOMPSON SUTURE PASSER GUIDE 5MM 10/12MM DISPOSABLE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK ARTHROSCOPY SHOULDER HFG,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK TOTAL HIP SJH,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,RELOAD ECHELON 45MM WHITE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLER RELOAD ECHELON 45MM BLUE,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STENT ADVANIX BILIARY 10FX5CM,272,1 ,$387.00 ,$278.64 ,$108.36 ,$387.00 ,$251.55 , N/A ,$108.36 ,$214.01 , N/A ,$225.23 , N/A ,$202.79 , N/A , N/A ,$356.04 , N/A , N/A ,$328.95 ,$348.30 , N/A ,$290.25 ,$270.90 ,$270.90 , N/A ,$270.90 ,$297.99 ,$297.99 , N/A ,$328.95 , N/A , N/A ,$217.11 ,$160.22 ,$160.99 , N/A , N/A , N/A ,$328.95 , N/A ,$202.79 ,$108.36 ,$348.30 ,$204.34 , N/A ,$251.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TRAY DRAINAGE 41CM 16FR THAL-QUICK 4 SIDEPORT CATHETER CHEST TUBE NEEDLE STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BASKET SPECIMEN RETRIEVAL 1.9FR SKYLITE NITINOL,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BIT DRILL CANNULATED QUICK CONNECT 3/3.5MM BITE COMPRESSION SCREW STERILE REUSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CATHETER BICAP INJECTION 7FR ELECTROHEMOSTASIS,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DILATOR ENDO CRE 180CM 5.5CM,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,LIFTER SURGICAL CLEAR ORISE INTERJECT 23G GEL SYRINGE KIT TWIN PACK 10ML DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,NEEDLE KNIFE SPHINCTERTOME KNIFE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR FIRST ENTRY 11MMX100MM,272,1 ,$81.00 ,$58.32 ,$22.68 ,$81.00 ,$52.65 , N/A ,$22.68 ,$44.79 , N/A ,$47.14 , N/A ,$42.44 , N/A , N/A ,$74.52 , N/A , N/A ,$68.85 ,$72.90 , N/A ,$60.75 ,$56.70 ,$56.70 , N/A ,$56.70 ,$62.37 ,$62.37 , N/A ,$68.85 , N/A , N/A ,$45.44 ,$33.53 ,$33.70 , N/A , N/A , N/A ,$68.85 , N/A ,$42.44 ,$22.68 ,$72.90 ,$42.77 , N/A ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR Z THREADED 5X100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ADHESIVE DERMABOND,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SAW 25X9MM PRECISION THIN OFFSET STRYKER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SAW 31X6.4X.38MM MINI-DRIVER LONG THIN SAGITTAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE STRYKER TPS LONG MEDIUM SAGITTAL 31MM X 9MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BRUSH CYTOLOGY 1.9MM 150CM BULLET TIP WIRE SHAFT CELLEBRITY STERILE DISPOSABLE 2MM STAINLESS STEEL PTFE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CONTAINER IV 1000ML STOPPER PVC FREE DEHP FREE GLASS LATEX FREE STERILE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUFF 30X4.5IN 1 BLADDER 2 PORT PLC SLEEVE TOURNIQUET STERILE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUFF TOURNIQUET 24X4.5IN,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUFF TOURNIQUET BLACK 12X3.5IN ATS 3000 CYLINDER 2 PORT BLADDER POSITIVE LOCK CONNECTOR SLEEVE STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DEVICE BRSTBIO 12GA CELEROMARK,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRAIN JACKSON PRATT 7MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING AQUACEL AG 6X3.5 IN,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING HYDROCOLLOID 4X3.5IN AQUACEL AG COVER ANTIMICROBIAL WATERPROOF HYDROFIBER IONIC SILVER POLYURETHANE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ELECTRODE SURGICAL BLADE PENCIL 10FT 3,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ENDOGATOR PVC CO2,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,FORCEP HOT BIOPSY DISPOSABLE 240CM X 2.2MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,MANIFOLD SUCTION INTELLICART CLOG FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,NEEDLE HYPO IO 14-38MM JAMSHIDI 18GA,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PAD POLAR CARE KNEE/SHOULDER PAD,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PREP HIBICLENS 4% CHLORHEXIDINE GLUCONATE 16OZ LIQUID,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PROTECTOR HEEL UNIVERSAL STRAP ANTIMICROBIAL LATEX FREE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,RETRACTOR VISCERAL (FISH),272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SENSOR INFANT OXISENSOR II OXIMETER ADHESIVE DIGIT STERILE LATEX FREE DISPOSABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE CAPTIVATOR 240CMX27MM 2.4MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE CAPTIVATOR II XL ROUND STIFF 33MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE ROUND 240MM 10MM 2.4MM CAPTIVATOR II,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE SM HEX 240CMX13MM 2.4MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE SMALL OVAL 13MM ROTATABLE,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE XS OVAL 240CM 2.4MM CAPTIFLEX LOOP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,STAPLER SKIN 35W,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SUTURE ETHIBOND 5 LV-37 30 MB66G,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SYSTEM SMOKEVAC PLUME FILTER,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TRAY CENTRAL LINE DRESSING CHA,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TRAY SUTURE CUSTOM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR BALLOON HASSAN 12X100MM BLUNT TIP,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR FIOS ADVANCE 5X100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR LAPAROSCOPIC 150MM 12MM KII Z THREAD SLEEVE RETENTION DISC STERILE LATEX FREE OPTICAL ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR LAPAROSCOPIC 150MM 5MM KII FIOS ADVANCE FIXATION SLEEVE FIRST ENTRY STERILE LATEX FREE ACCESS SYSTEM ABDOMINAL,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TROCAR Z THREADED 12X100MM BLADELESS,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBE GASTROSTOMY14FR REPL BALON STD PR BL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE ARTHROSCOPY TOMCAT 4.0MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SAW 11MM LAPIPLASTY 40MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLADE SHAVER BLACK RED 4MM RESECTOR LATEX FREE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BUR STYRKER FORMULA 5.5MM BARREL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CATCH ENDO POUCH,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CATHETER CHOLANGIOGRAM 19GA PRVW KUMAR CHOLANGIOCATHETER,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CLIP LIGACLIP MCA MEDIUM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUFF TOURNIQUET 4 X 34,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUFF TOURNIQUET 4.5 X 44,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUFF TOURNIQUET CONTOUR 18X4.5IN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CUTTER ARTHROSCOPIC BONE COOLCUT CURVE 13CM STERILE 4MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRAIN HEMOVAC .25IN 5IN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING AQUACEL AG HYDROFIBER 3.5 X11.8,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING AQUACEL AG HYRDOFIBER 3.5 X 10,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING V.A.C. GRANUFOAM - MEDIUM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING VAC GRANUFOAM 10X7.5CM SMALL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,GEL ELECTRODE PRO-PADZ RADIOLUCENT E M R SERIES DEFIBRILLATOR,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,IRRIGATOR STRYKER SURGILAV INTERPULSE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT SHOULDER SUSPENSION,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,MANIPULATOR 2 CUP LOCK SCREW HOLE INFLATE BALLOON HYSTERECTOMY ENDOSCOPIC VCARE SMALL 32MM CERVIX UTERUS STERILE LATEX FREE DISPOSABLE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,MARKER ENDOSPOT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,NEEDLE HYPO INTERJECT 25G X 240CM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK ARTHROSCOPY HFG,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK EXTREMITY HFG,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,RETAINER 8.875X5.625IN SMALL VISCUS STERILE LATEX FREE DISPOSABLE FISH GLASSMAN INTERNAL ORGAN RADIOPAQUE,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SCISSORS LAPAROSCOPIC 2 EDGE BLADE ROTATION DIAL ERGONOMIC HANDLE LOW PROFILE EPIX DIRECT DRIVE STAINLESS STEEL 35CM LATEX FREE DISPOSABLE 5MM,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET TUBING FLOSTEADY ARTHROSCOPY,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SPLINT ORTHOPEDIC MEDIUM 10 7/16IN HAND MASON-ALLEN,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SPONGE SURGICEL 2 X 3,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SUCTION/IRRIGATOR STRYKER ENDOSCOPY STRYKEFLOW II,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SYSTEM 10MM TISSUE RETRIEVAL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TRAY DRAINAGE CHEST TUBE INSERTION,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBE 18FR REPLACEMENT BALLOON STANDARD PROFILE BOLSTER GASTROSTOMY ENDOVIVE STRAIGHT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBE 20FR STANDARD PROFILE REPLACEMENT BALLOON BOLSTER GASTROSTOMY ENDOVIVE STRAIGHT,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBE GASTROSTOMY 16FR STD PR REPL BALON BL,272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBING INSUFFLATION HUMIDIFYING,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DEVICE ENCORE 26 INFLATION DEVICE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRILL BIT SYNTHES 2.0 QC 100MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ELECTRODE DEFIBRILLATOR ONESTEP CODE-READY RESUSCITATION COMPLETE SPEED PACK CONNECTOR R SERIES,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ENDO CLIP APPLIER LIGAMAX 10MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ENDO CLIP APPLIER LIGAMAX M/L 5MM,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,MARKER SECURMARK BREAST BIOPSY CELERO SYSTEM NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,MARKER SECURMARK BRSTBIO CELER,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK GYN HFG,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SPONGE SURGICEL 4 X 8,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SUTURE SURGITIE 0 21IN LGT LOOP SGL-1,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SYSTEM DRAINAGE PLASTIC 16 LPM CONTINUOUS REINFUSION DRY SUCTION PLEUR-EVAC SMALL STATURE 2500ML LATEX FREE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBE JEJUNOSTOMY 51CM 18FR SILICONE MIC SECUR-LOK RADIOPAQUE MEDICATION PORT RETENTION BALLOON TRIMMABLE DISTAL TIP 7-10ML STERILE LATEX FREE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBING ARTHREX ARTHROSCOPY,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TUBING STRYKER CO2,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,ADAPTER AIRWAY DISPOSABLE ZOLL E SERIES,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BINDER ABDOMINAL 12IN MULTIPANEL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BURR SURGICAL 8MM 4MM HALL MEDIUM OVAL SMALL BONE CARBIDE STERILE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CANNULA SLEEVE WITH BALLOON FIXATION,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CATHETER FOLEY 16FR 2 WAY COUDE TIP,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,COAGULATOR SUCTION 6IN 10FR VALLEYLAB HANDSWITCH CORD THERMAL REDUCTION FLUID EVACUATION TUBE ENT STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING GAUZE IODOFORM 2,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,FORCEP BIOPSY RADIAL JAW 4 WITH NEEDLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,IMMOBILIZER ORTHOPEDIC FEMALE LARGE CONTOUR OD36-42 IN SHOUL,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,NEEDLE HYPO INSUFL 12CM 14GA PNMPRT,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PACK CYSTO SAE SJH HFG,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SENSOR INFANT NELLCOR LOSAT 18IN C3-20KG OXIMETER SPO2 ADHESIVE TEAR RESISTANT BANDAGE PVC STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SENSOR NELLCOR OXIMETER SPO2 ADHESIVE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SENSOR PEDIATRIC NELLCOR 18IN OXIMETER SPO2 ADHESIVE TEAR RESISTANT BANDAGE PVC C10-50KG STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET SEAL MYOSURE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SHOE POSTOP LG F BLK NYL SMRG,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SHOE POSTOP SM M BLK NYL SMRG,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE ROUND 2.8CM 240CM 2 LOOP,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SUTURE ETHIBOND 0 MO 6 CR CX45D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SUTURE SILK 3-0 RB-1 18 C053D,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,TRAY CATHETERIZATION BARDEX BARD 16FR DRAINAGE BAG FOLEY ANTIREFLUX CHAMBER CONTROL FIT OUTLET TUBE SILICONE STERILE LATEX FREE DISPOSABLE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,VAC PREVENA WOUND -SMALL,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ",$633.60 , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING PREVENA INCISIONAL MANAGMENT,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ",$633.60 , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,GUIDEWIRE SPHINCTEROTOME HYDRATOME RX44,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ",$633.60 , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,GUIDEWIRE SPHINCTEROTOME HYDRATOME RX44 260CM,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ",$633.60 , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT ENDOSCOPIC INSTRUMENT 1.35-1.6MM DRILL GUIDE GUIDEWIRE DISPOSABLE FIBERTAK DX SUTURE ANCHOR,272,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ",$633.60 , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,WAND ARTHROCARE SHOULDER SUPER TURBO VAC,272,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ",$975.00 , N/A ,$420.00 ,$829.50 , N/A ,$873.00 , N/A ,$786.00 , N/A , N/A ,"$1,380.00 ", N/A , N/A ,"$1,275.00 ","$1,350.00 ", N/A ,"$1,125.00 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,155.00 ","$1,155.00 ", N/A ,"$1,275.00 ", N/A , N/A ,$841.50 ,$621.00 ,$624.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$786.00 ,$420.00 ,"$1,350.00 ",$792.00 , N/A ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,WATER STERILE 2000ML STERILE UROMATIC LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,AIRWAY 18FR 95MM MEDIPRENE NASOPHARYNGEAL,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,AIRWAY ESOPHAGEAL 4 STRAIGHT ADULT LMA-UNIQUE CUFF SYRINGE 30ML DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BLANKET WARMING ADULT 78X24IN,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,BURR SURGICAL 2.3MM MEDIUM CARBIDE ROUND STERILE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,CAUTERY BATTERY BOVIE 2200F HIGH TEMPERATURE FINE TIP STERILE LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING BIOPATCH 2.5CM X 4.0MM,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,DRESSING GAUZE IODOFORM 1,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT CATHETERIZATION PEDIATRIC 5FR LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,KIT PROCEDURE ENDO CARRY-ON DEFENDO DISPOSABLE VALVE CONNECTOR,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,PREP CHLORAPREP 26ML,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET ADMIN 107IN 15 GTT ML 20ML IV PRIM PLMST,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET ADMINISTRATION 107IN 15 GTT/ML 13ML INTRAVENOUS PRIMARY CONVERTIBLE PIERCE PIN DISTAL MICROBORE TUBE SIGHT CHAMBER .054IN NONSTERILE LATEX FREE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET BLOOD ADMINISTRATION 180UM 15 GTT 121IN NEEDLE FREE VALVE 2 MALE LUER LOCK 2 SLIDE CLAMP DEHP FREE INTRAVENOUS STERILE LATEX FREE ALARIS 33ML DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SET Y TUR 96IN NONVENT,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SHOE POSTOP MED F BLK NYL SMRG,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SNARE 230CM 10MM 7FR COLD OVAL,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SPACER MDI 5.75IN 2IN 22MM PROCHAMBER SMALL STANDARD VALVE HOLD CHAMBER HANDHELD MOUTHPIECE 145ML LATEX FREE DISPOSABLE,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27270000,N/A,SUTURE ETHIBOND 2-0 SH 30 MULTIPACK MX833,272,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$10.56 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 18-20MM 6FR,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A , N/A , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 ,$277.20 , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 10-12MM 6FR,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A , N/A , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 ,$277.20 , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 12-15MM 6FR,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A , N/A , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 ,$277.20 , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,BALLOON CRE DILATION ESOPHAGEAL 15-18MM 6FR,272,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A , N/A , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 ,$277.20 , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,DEVICE INFLATION CRE (SYRINGE),272,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A , N/A , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$79.20 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,DILATOR ENDOSCOPIC CRE 240CM 5.5CM 18-19-20MM 7.5FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE PEBAX STERILE LATEX FREE DISPOSABLE 2.8MM 3.2MM 3.7MM 4.2MM,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271726,C1726,DILATOR ENDOSCOPIC CRE 240CM 5.5CM 15-16.5-18MM 7.5FR ESOPHAGEAL PYLORIC BILIARY BALLOON LOW PROFILE GUIDEWIRE PEBAX STERILE LATEX FREE DISPOSABLE,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271727,C1727,BALLOON DISSECTOR LAPAROSCOPIC SPACEMAKER PLUS BTT 65X3FT PNEUMOPERITONEUM BLUNT TIP ACCESS PORT SPRING GRIP LOCK COLLAR FOAM LATEX DISPOSABLE HERNIA REPAIR ROUND BLUE,272,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A , N/A , N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$2,059.20 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27271729,C1729,CATHETER BILI ESOPH PYL 7.5FR 15-1,272,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A , N/A , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 ,$316.80 , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271729,C1729,CATHETER URETERAL LBRSL 24FR SH RND,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A , N/A , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271729,C1729,CATHETER FOLEY BARD 3-WAY 22FR 30ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A , N/A , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271729,C1729,CATHETER FOLEY SILCONE BACTI GUARD 20 FR 3 WAY 30ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A , N/A , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271729,C1729,CATHETER FOLEY SILCONE BACTI GUARD 22 FR 3 WAY 30ML,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A , N/A , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271751,C1751,CATHETER 5FR IV POWERPICC SHERLOCK 3CG 2 LUMEN MAXIMAL BARRIER POLYPROPYLENE LATEX FREE,272,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A , N/A , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271758,C1758,CATHETER URETHRAL PUREWICK FREE FEMALE,272,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A , N/A , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,GUIDEWIRE ORTHO 150MM 1.4MM FIXOS,272,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A , N/A , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 ,$198.00 , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,GUIDEWIRE ORTHOPEDIC 150MM 2MM FIXOS NONSTERILE LATEX FREE DISPOSABLE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A , N/A , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,GUIDEWIRE ENDOSCOPIC .038IN HYBRID FLEXIBLE SOLO NITINOL STRAIGHT LATEX FREE,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A , N/A , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,GUIDEWIRE ORTHO 1.1MM 3/3.5MM BIT,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A , N/A , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,GUIDEWIRE STRYKER GAMMA 3 BALL TIP 3X1000MM,272,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A , N/A , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$237.60 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,WIRE K STRYKER GAMMA 3 3.2X450MM,272,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A , N/A , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 ,$158.40 , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,WIRE KIRSCHNER VARIAX FOOT SYSTEM STRYKER 1.4MMX 270MM,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A , N/A , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271769,C1769,GUIDEWIRE ORTHOPEDIC 4IN .045IN TITANIUM BIOCOMPATIBLE CORROSION RESISTANT CANNULATED SCREW SET,272,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A , N/A , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 ,$39.60 , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27271894,C1894,KIT CATHETER 7FR 18GA 20CM BLUFLTP,272,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A , N/A , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 ,$118.80 , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27280042,N/A,HC ELECTORDE ZOLL STAT PADZ,272,1 ,$24.00 ,$17.28 ,$6.72 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$12.67 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),27280160,N/A,HC DETECTOR CO2,272,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 ,$13.65 , N/A ,$5.88 ,$11.61 , N/A ,$12.22 , N/A ,$11.00 , N/A , N/A ,$19.32 , N/A , N/A ,$17.85 ,$18.90 , N/A ,$15.75 ,$14.70 ,$14.70 , N/A ,$14.70 ,$16.17 ,$16.17 , N/A ,$17.85 , N/A , N/A ,$11.78 ,$8.69 ,$8.74 , N/A , N/A , N/A ,$17.85 , N/A ,$11.00 ,$5.88 ,$18.90 ,$11.09 , N/A ,$13.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),27280183,N/A,HC KIT PATIENT POSITIONING PINK PAD,270,1 ,$263.00 ,$189.36 ,$73.64 ,$263.00 ,$170.95 , N/A ,$73.64 ,$145.44 , N/A ,$153.07 , N/A ,$137.81 , N/A , N/A ,$241.96 , N/A , N/A ,$223.55 ,$236.70 , N/A ,$197.25 ,$184.10 ,$184.10 , N/A ,$184.10 ,$202.51 ,$202.51 , N/A ,$223.55 , N/A , N/A ,$147.54 ,$108.88 ,$109.41 , N/A , N/A , N/A ,$223.55 , N/A ,$137.81 ,$73.64 ,$236.70 ,$138.86 , N/A ,$170.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),27400003,L0120,HC CERVICAL COLLAR,274,1 ,$15.00 ,$10.80 ,$4.20 ,$68.16 ,$9.75 ,$26.71 ,$4.20 ,$8.30 ,$26.71 ,$8.73 ,$14.70 ,$7.86 ,$14.70 ,$15.00 ,$13.80 ,$68.16 ,$26.71 ,$12.75 ,$13.50 ,$14.70 ,$11.25 ,$10.50 ,$10.50 ,$26.71 ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 ,$27.26 ,$27.26 ,$8.42 ,$6.21 ,$6.24 , N/A , N/A ,$28.05 ,$12.75 ,$58.62 ,$7.86 ,$4.20 ,$13.50 , N/A ,$26.71 ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27400017,L1830,HC KNEE IMMOBILIZATION FIT AND ADJ,274,1 ,$71.00 ,$51.12 ,$19.88 ,$183.52 ,$46.15 ,$71.94 ,$19.88 ,$39.26 ,$71.94 ,$41.32 ,$69.58 ,$37.20 ,$69.58 ,$71.00 ,$65.32 ,$183.52 ,$71.94 ,$60.35 ,$63.90 ,$69.58 ,$53.25 ,$49.70 ,$49.70 ,$71.94 ,$49.70 ,$54.67 ,$54.67 ,$71.00 ,$60.35 ,$73.41 ,$73.41 ,$39.83 ,$29.39 ,$29.54 , N/A , N/A ,$75.54 ,$60.35 ,$157.83 ,$37.20 ,$19.88 ,$63.90 , N/A ,$71.94 ,$46.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),27400035,L3650,HC CLAVICLE STRAP/FIT AND ADJ,274,1 ,$28.00 ,$20.16 ,$7.84 ,$164.42 ,$18.20 ,$64.45 ,$7.84 ,$15.48 ,$64.45 ,$16.30 ,$27.44 ,$14.67 ,$27.44 ,$28.00 ,$25.76 ,$164.42 ,$64.45 ,$23.80 ,$25.20 ,$27.44 ,$21.00 ,$19.60 ,$19.60 ,$64.45 ,$19.60 ,$21.56 ,$21.56 ,$28.00 ,$23.80 ,$65.77 ,$65.77 ,$15.71 ,$11.59 ,$11.65 , N/A , N/A ,$67.68 ,$23.80 ,$141.40 ,$14.67 ,$7.84 ,$25.20 , N/A ,$64.45 ,$18.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27400039,L3670,HC SHOULDER IMMOBILIZER FIT AND ADJ,274,1 ,$28.00 ,$20.16 ,$7.84 ,$251.30 ,$18.20 ,$98.51 ,$7.84 ,$15.48 ,$98.51 ,$16.30 ,$27.44 ,$14.67 ,$27.44 ,$28.00 ,$25.76 ,$251.30 ,$98.51 ,$23.80 ,$25.20 ,$27.44 ,$21.00 ,$19.60 ,$19.60 ,$98.51 ,$19.60 ,$21.56 ,$21.56 ,$28.00 ,$23.80 ,$100.52 ,$100.52 ,$15.71 ,$11.59 ,$11.65 , N/A , N/A ,$103.44 ,$23.80 ,$216.12 ,$14.67 ,$7.84 ,$25.20 , N/A ,$98.51 ,$18.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),27400129,L1971,HC AFO ANKLE BRACE PREFAB,274,1 ,$25.00 ,$18.00 ,$7.00 ,"$1,087.66 ",$16.25 ,$426.36 ,$7.00 ,$13.83 ,$426.36 ,$14.55 ,$24.50 ,$13.10 ,$24.50 ,$25.00 ,$23.00 ,"$1,087.66 ",$426.36 ,$21.25 ,$22.50 ,$24.50 ,$18.75 ,$17.50 ,$17.50 ,$426.36 ,$17.50 ,$19.25 ,$19.25 ,$25.00 ,$21.25 ,$435.06 ,$435.06 ,$14.03 ,$10.35 ,$10.40 , N/A , N/A ,$447.67 ,$21.25 ,$935.39 ,$13.10 ,$7.00 ,$22.50 , N/A ,$426.36 ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27662787,V2787,IOL ASTIGMATISM (TORIC) CORRECTING UPGRADE,276,1 ,$370.00 ,$266.40 ,$103.60 ,$388.50 ,$240.50 ,$370.00 ,$103.60 ,$204.61 ,$370.00 ,$215.34 ,$370.00 ,$193.88 ,$370.00 ,$370.00 ,$340.40 , N/A ,$370.00 ,$314.50 ,$333.00 , N/A ,$277.50 ,$259.00 ,$259.00 ,$370.00 ,$259.00 ,$284.90 ,$284.90 ,$370.00 ,$314.50 , N/A , N/A ,$207.57 ,$153.18 ,$153.92 , N/A , N/A ,$388.50 ,$314.50 , N/A ,$193.88 ,$103.60 ,$333.00 , N/A ,$370.00 ,$240.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27662788,V2788,IOL AMO MULTIFOCAL ZLB00,276,1 ,$925.00 ,$666.00 ,$259.00 ,$925.00 ,$601.25 , N/A ,$259.00 ,$511.53 , N/A ,$538.35 , N/A ,$484.70 , N/A , N/A ,$851.00 , N/A , N/A ,$786.25 ,$832.50 , N/A ,$693.75 ,$647.50 ,$647.50 , N/A ,$647.50 ,$712.25 ,$712.25 , N/A ,$786.25 , N/A , N/A ,$518.93 ,$382.95 ,$384.80 , N/A , N/A , N/A ,$786.25 , N/A ,$484.70 ,$259.00 ,$832.50 , N/A , N/A ,$601.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27662788,V2788,IOL PRESBYOPIA (PRESBYOPIA/RESTOR) CORRECTING UPGRADE,276,1 ,$770.00 ,$554.40 ,$215.60 ,$770.00 ,$500.50 , N/A ,$215.60 ,$425.81 , N/A ,$448.14 , N/A ,$403.48 , N/A , N/A ,$708.40 , N/A , N/A ,$654.50 ,$693.00 , N/A ,$577.50 ,$539.00 ,$539.00 , N/A ,$539.00 ,$592.90 ,$592.90 , N/A ,$654.50 , N/A , N/A ,$431.97 ,$318.78 ,$320.32 , N/A , N/A , N/A ,$654.50 , N/A ,$403.48 ,$215.60 ,$693.00 , N/A , N/A ,$500.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL AMO PRECISION MULTIFOCAL ZKB00,276,1 ,$925.00 ,$666.00 ,$259.00 ,$925.00 ,$601.25 , N/A ,$259.00 ,$511.53 , N/A ,$538.35 , N/A ,$484.70 , N/A , N/A ,$851.00 , N/A , N/A ,$786.25 ,$832.50 , N/A ,$693.75 ,$647.50 ,$647.50 , N/A ,$647.50 ,$712.25 ,$712.25 , N/A ,$786.25 , N/A , N/A ,$518.93 ,$382.95 ,$384.80 , N/A , N/A , N/A ,$786.25 , N/A ,$484.70 ,$259.00 ,$832.50 , N/A , N/A ,$601.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL BAUSCH AND LOMB MX60E ENVISTA,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL ALCON MN60AC,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL ALCON MTA3U0,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL ALCON MTA4U0,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL ALCON MTA5UO,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL ALCON SN60AT,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL AMO PRECISION PCB00,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS MULTIFOCAL SYMPHONY ZXR00,276,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL AMO SYMFONY TORIC ZXT150,276,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL AMO SYMFONY TORIC ZXT225,276,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL AMO SYMFONY TORIC ZXT300,276,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT9,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC DIU150,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC DIU300,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC ZCU150,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC ZCU225,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC ZCU375,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC ZCU450,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC ZCU525,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TECNIS TORIC ZCU600,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT3,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT4,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT5,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT6,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT7,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27671780,C1780,IOL TORIC LENS SA6AT8,276,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL ALCON RESTOR SV25T0,276,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL TECNIS DIB00,276,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 , N/A , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL TECNIS SIMPLICITY DCB00,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL ALCON MA60AC,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL ALCON SN60WF,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL AMO PRECISION ZCB00,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL BAUSCH LOMB PRECISION LI61AO,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL LENS Z9002,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27672632,V2632,IOL PRECISION ZA9003,276,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27800181,C1763,HC ALLOGRAFT PASTE,278,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 ,$227.50 , N/A ,$98.00 ,$193.55 , N/A ,$203.70 , N/A ,$183.40 , N/A , N/A ,$322.00 , N/A , N/A ,$297.50 ,$315.00 , N/A ,$262.50 ,$245.00 ,$245.00 , N/A ,$245.00 ,$269.50 ,$269.50 , N/A ,$297.50 , N/A , N/A ,$196.35 ,$144.90 ,$145.60 , N/A , N/A , N/A ,$297.50 , N/A ,$183.40 ,$98.00 ,$315.00 , N/A , N/A ,$227.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27870000,N/A,ALLOGRAFT THERASKIN 3 X 2IN CRYOPRESSURE MESH,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$1,470.30 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27870000,N/A,BARRIER SEPRAFILM 3 X 5,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 , N/A , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27870000,N/A,GRAFT TENDON TIBIALIS FROZEN,278,1 ,"$5,100.00 ","$3,672.00 ","$1,428.00 ","$5,100.00 ","$3,315.00 ", N/A ,"$1,428.00 ","$2,820.30 ", N/A ,"$2,968.20 ", N/A ,"$2,672.40 ", N/A , N/A ,"$4,692.00 ", N/A , N/A ,"$4,335.00 ","$4,590.00 ", N/A ,"$3,825.00 ","$3,570.00 ","$3,570.00 ", N/A ,"$3,570.00 ","$3,927.00 ","$3,927.00 ", N/A ,"$4,335.00 ", N/A , N/A ,"$2,861.10 ","$2,111.40 ","$2,121.60 ", N/A , N/A , N/A ,"$4,335.00 ", N/A ,"$2,672.40 ","$1,428.00 ","$4,590.00 ","$1,922.70 ", N/A ,"$3,315.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27870000,N/A,SUBSTITUTE BONE GRAFT VITOSS BBTRAUMA FOAM 2.5ML STERILE,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,017.90 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,ANCHOR SUTURE 1 FIBERTAK FIBERWIRE NEEDLE,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,ANCHOR SUTURE 4.5MM REELX STT STERILE LATEX FREE DISPOSABLE,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ",$682.50 , N/A ,$294.00 ,$580.65 , N/A ,$611.10 , N/A ,$550.20 , N/A , N/A ,$966.00 , N/A , N/A ,$892.50 ,$945.00 , N/A ,$787.50 ,$735.00 ,$735.00 , N/A ,$735.00 ,$808.50 ,$808.50 , N/A ,$892.50 , N/A , N/A ,$589.05 ,$434.70 ,$436.80 , N/A , N/A , N/A ,$892.50 , N/A ,$550.20 ,$294.00 ,$945.00 , N/A , N/A ,$682.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,ANCHOR ARTHREX MINI BIOCOMPOSITE SUTURE TAK,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ",$682.50 , N/A ,$294.00 ,$580.65 , N/A ,$611.10 , N/A ,$550.20 , N/A , N/A ,$966.00 , N/A , N/A ,$892.50 ,$945.00 , N/A ,$787.50 ,$735.00 ,$735.00 , N/A ,$735.00 ,$808.50 ,$808.50 , N/A ,$892.50 , N/A , N/A ,$589.05 ,$434.70 ,$436.80 , N/A , N/A , N/A ,$892.50 , N/A ,$550.20 ,$294.00 ,$945.00 , N/A , N/A ,$682.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,CEMENT FULL DOSE,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 , N/A , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,K WIRE ZIMMER 9 IN X .062 IN TROCAR PT,278,1 ,$29.40 ,$21.17 ,$8.23 ,$29.40 ,$19.11 , N/A ,$8.23 ,$16.26 , N/A ,$17.11 , N/A ,$15.41 , N/A , N/A ,$27.05 , N/A , N/A ,$24.99 ,$26.46 , N/A ,$22.05 ,$20.58 ,$20.58 , N/A ,$20.58 ,$22.64 ,$22.64 , N/A ,$24.99 , N/A , N/A ,$16.49 ,$12.17 ,$12.23 , N/A , N/A , N/A ,$24.99 , N/A ,$15.41 ,$8.23 ,$26.46 , N/A , N/A ,$19.11 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,NAIL 13MM 400MM FEMUR LEFT GAMMA3 INTRAMEDULLARY 125D R1.5 LOCK TITANIUM STERILE,278,1 ,"$6,300.00 ","$4,536.00 ","$1,764.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$1,764.00 ","$3,483.90 ", N/A ,"$3,666.60 ", N/A ,"$3,301.20 ", N/A , N/A ,"$5,796.00 ", N/A , N/A ,"$5,355.00 ","$5,670.00 ", N/A ,"$4,725.00 ","$4,410.00 ","$4,410.00 ", N/A ,"$4,410.00 ","$4,851.00 ","$4,851.00 ", N/A ,"$5,355.00 ", N/A , N/A ,"$3,534.30 ","$2,608.20 ","$2,620.80 ", N/A , N/A , N/A ,"$5,355.00 ", N/A ,"$3,301.20 ","$1,764.00 ","$5,670.00 ","$2,375.10 ", N/A ,"$4,095.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,NAIL 11MM 420MM FEMUR LEFT GAMMA3 INTRAMEDULLARY 125D LONG R1.5 LOCK TITANIUM STERILE LATEX FREE,278,1 ,"$6,300.00 ","$4,536.00 ","$1,764.00 ","$6,300.00 ","$4,095.00 ", N/A ,"$1,764.00 ","$3,483.90 ", N/A ,"$3,666.60 ", N/A ,"$3,301.20 ", N/A , N/A ,"$5,796.00 ", N/A , N/A ,"$5,355.00 ","$5,670.00 ", N/A ,"$4,725.00 ","$4,410.00 ","$4,410.00 ", N/A ,"$4,410.00 ","$4,851.00 ","$4,851.00 ", N/A ,"$5,355.00 ", N/A , N/A ,"$3,534.30 ","$2,608.20 ","$2,620.80 ", N/A , N/A , N/A ,"$5,355.00 ", N/A ,"$3,301.20 ","$1,764.00 ","$5,670.00 ","$2,375.10 ", N/A ,"$4,095.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE STRYKER 67MM 9 H,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$1,470.30 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE STANDARD 86MM STAINLESS STEEL 3.5/4MM SCREW 3 HOLE LOCK AXSOS BONE HUMERUS LEFT PROXIMAL NONSTERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$1,470.30 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE SYNTHES 2.4 VA-LCP VLR DIST RADIUS 6H HD/2H SHAFT LEFT,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,017.90 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,ANCHOR SUTURE 3.9MM OMEGA 2 ARM KNOTLESS PEEK,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,017.90 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE SYNTHES 6 HOLE 1.5MM,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ",$877.50 , N/A ,$378.00 ,$746.55 , N/A ,$785.70 , N/A ,$707.40 , N/A , N/A ,"$1,242.00 ", N/A , N/A ,"$1,147.50 ","$1,215.00 ", N/A ,"$1,012.50 ",$945.00 ,$945.00 , N/A ,$945.00 ,"$1,039.50 ","$1,039.50 ", N/A ,"$1,147.50 ", N/A , N/A ,$757.35 ,$558.90 ,$561.60 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$707.40 ,$378.00 ,"$1,215.00 ", N/A , N/A ,$877.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,ANCHOR SUTURE OMEGA PEEK OD3.9 MM 1 ARM KNOTLESS,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ",$877.50 , N/A ,$378.00 ,$746.55 , N/A ,$785.70 , N/A ,$707.40 , N/A , N/A ,"$1,242.00 ", N/A , N/A ,"$1,147.50 ","$1,215.00 ", N/A ,"$1,012.50 ",$945.00 ,$945.00 , N/A ,$945.00 ,"$1,039.50 ","$1,039.50 ", N/A ,"$1,147.50 ", N/A , N/A ,$757.35 ,$558.90 ,$561.60 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$707.40 ,$378.00 ,"$1,215.00 ", N/A , N/A ,$877.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 36MM 40MM LAPIPLASTY INTERFRAGMENTARY STERILE,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ",$975.00 , N/A ,$420.00 ,$829.50 , N/A ,$873.00 , N/A ,$786.00 , N/A , N/A ,"$1,380.00 ", N/A , N/A ,"$1,275.00 ","$1,350.00 ", N/A ,"$1,125.00 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,155.00 ","$1,155.00 ", N/A ,"$1,275.00 ", N/A , N/A ,$841.50 ,$621.00 ,$624.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$786.00 ,$420.00 ,"$1,350.00 ", N/A , N/A ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,ANCHOR SUTURE 2.3MM ICONIX XBRAID 2 NEEDLE INTELLIBRAID TECHNOLOGY TITANIUM 2MM STERILE LATEX FREE DISPOSABLE,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ",$975.00 , N/A ,$420.00 ,$829.50 , N/A ,$873.00 , N/A ,$786.00 , N/A , N/A ,"$1,380.00 ", N/A , N/A ,"$1,275.00 ","$1,350.00 ", N/A ,"$1,125.00 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,155.00 ","$1,155.00 ", N/A ,"$1,275.00 ", N/A , N/A ,$841.50 ,$621.00 ,$624.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$786.00 ,$420.00 ,"$1,350.00 ", N/A , N/A ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 10.5MM 105MM GAMMA3 TITANIUM LAG STERILE TROCHANTER NAIL 180,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ",$975.00 , N/A ,$420.00 ,$829.50 , N/A ,$873.00 , N/A ,$786.00 , N/A , N/A ,"$1,380.00 ", N/A , N/A ,"$1,275.00 ","$1,350.00 ", N/A ,"$1,125.00 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,155.00 ","$1,155.00 ", N/A ,"$1,275.00 ", N/A , N/A ,$841.50 ,$621.00 ,$624.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$786.00 ,$420.00 ,"$1,350.00 ", N/A , N/A ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 2.5MM 20MM TITANIUM COMPRESSION HEADLESS STERILE LAPIPLASTY AKIN OSTEOTOMY HALLUX VALGUS,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ",$975.00 , N/A ,$420.00 ,$829.50 , N/A ,$873.00 , N/A ,$786.00 , N/A , N/A ,"$1,380.00 ", N/A , N/A ,"$1,275.00 ","$1,350.00 ", N/A ,"$1,125.00 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,155.00 ","$1,155.00 ", N/A ,"$1,275.00 ", N/A , N/A ,$841.50 ,$621.00 ,$624.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$786.00 ,$420.00 ,"$1,350.00 ", N/A , N/A ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 4.0 AXSOS LOCKING 42MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,GRAFT BONE ALFS + DBM 1CC ALOG,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PIN POSITIONING,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PIN POSITIONING 2MM EASYCLIP,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 1.5MM 10MM TITANIUM T4 HAND SELF TAP VARIABLE ANGLE LOCK STARDRIVE NONSTERILE PURPLE,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 1.5MM 11MM TITANIUM T4 HAND SELF TAP VARIABLE ANGLE LOCK STARDRIVE NONSTERILE PURPLE,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 4.0 AXSOS LOCKING 30MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 4.0 AXSOS LOCKING 36MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 4.0 AXSOS LOCKING 40MM,278,1 ,$375.00 ,$270.00 ,$105.00 ,$375.00 ,$243.75 , N/A ,$105.00 ,$207.38 , N/A ,$218.25 , N/A ,$196.50 , N/A , N/A ,$345.00 , N/A , N/A ,$318.75 ,$337.50 , N/A ,$281.25 ,$262.50 ,$262.50 , N/A ,$262.50 ,$288.75 ,$288.75 , N/A ,$318.75 , N/A , N/A ,$210.38 ,$155.25 ,$156.00 , N/A , N/A , N/A ,$318.75 , N/A ,$196.50 ,$105.00 ,$337.50 , N/A , N/A ,$243.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER ASNIS CANN 2MM 14MM 6MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,COUNTERSINK DRILL QUICK CONNECT CANNULATED 3/3.5MM BITE COMPRESSION SCREW STERILE LATEX FREE REUSABLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,KIT ARTHREX MINI SUTURE TAK DISPOSABLE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 VARIAX 18MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 VARIAX 20MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 VARIAX 22MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 VARIAX 24MM,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3MM 18MM 5MM ASNS T,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER LAG 3.6MM,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 , N/A , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,DRILL BIT COUNTERSINK 3.8MM ASNS MICRO,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 , N/A , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 5MM 25MM T2 ALPHA LOCK STERILE,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 , N/A , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 5MM 52.5MM T2 ALPHA LOCK STERILE,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 , N/A , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 5MM 55MM T2 ALPHA LOCK STERILE,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 , N/A , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 5MM 57.5MM T2 ALPHA LOCK STERILE,278,1 ,$600.00 ,$432.00 ,$168.00 ,$600.00 ,$390.00 , N/A ,$168.00 ,$331.80 , N/A ,$349.20 , N/A ,$314.40 , N/A , N/A ,$552.00 , N/A , N/A ,$510.00 ,$540.00 , N/A ,$450.00 ,$420.00 ,$420.00 , N/A ,$420.00 ,$462.00 ,$462.00 , N/A ,$510.00 , N/A , N/A ,$336.60 ,$248.40 ,$249.60 , N/A , N/A , N/A ,$510.00 , N/A ,$314.40 ,$168.00 ,$540.00 , N/A , N/A ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 24MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 2.7MM 24MM T8 FULL THREAD LOCK STARDRIVE NONSTERILE VARIAX FOOT PLATE SYSTEM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW OSTEOMED 3.0MM X 22MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 2.7MM VARIAX 14MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 2.7MM VARIAX 16MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 2.7MM VARIAX 20MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 20MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 2.4 LOCKING STARDRIVE 22MM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 16MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,K-WIRE 1.2MM X 100MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 4.5MM 24MM TITANIUM CORTEX,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 4.5MM 26MM AXSOS 3 TITANIUM CORTICAL NONSTERILE,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 4.5MM 28MM TITANIUM CORTICAL NONSTERILE AXSOS 3,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 CORTICAL SELF TAPPING FULL TH 26MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 CORTICAL SELF TAPPING FULL TH 28MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 1.5 CORTEX SELF TAP 8MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 1.5 CORTEX STARDRIVE 9MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 1.5 CORTEX STARDRIVE 10MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 2.4 CORTICAL SELF TAP 24MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW SYNTHES 2.7 CORTICAL SELF TAP 14MM,278,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 , N/A , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,STAPLE BONE 10X10X1.2-1.5MM 2M,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,GRAFT BONE WEDGE ALLOGRAFT 24X14,278,1 ,"$3,300.00 ","$2,376.00 ",$924.00 ,"$3,300.00 ","$2,145.00 ", N/A ,$924.00 ,"$1,824.90 ", N/A ,"$1,920.60 ", N/A ,"$1,729.20 ", N/A , N/A ,"$3,036.00 ", N/A , N/A ,"$2,805.00 ","$2,970.00 ", N/A ,"$2,475.00 ","$2,310.00 ","$2,310.00 ", N/A ,"$2,310.00 ","$2,541.00 ","$2,541.00 ", N/A ,"$2,805.00 ", N/A , N/A ,"$1,851.30 ","$1,366.20 ","$1,372.80 ", N/A , N/A , N/A ,"$2,805.00 ", N/A ,"$1,729.20 ",$924.00 ,"$2,970.00 ","$1,244.10 ", N/A ,"$2,145.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,STAPLE STRYKER BONE 6MM EASYSTEP,278,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$1,596.00 ","$3,152.10 ", N/A ,"$3,317.40 ", N/A ,"$2,986.80 ", N/A , N/A ,"$5,244.00 ", N/A , N/A ,"$4,845.00 ","$5,130.00 ", N/A ,"$4,275.00 ","$3,990.00 ","$3,990.00 ", N/A ,"$3,990.00 ","$4,389.00 ","$4,389.00 ", N/A ,"$4,845.00 ", N/A , N/A ,"$3,197.70 ","$2,359.80 ","$2,371.20 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$2,986.80 ","$1,596.00 ","$5,130.00 ","$2,148.90 ", N/A ,"$3,705.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE NARROW 115MM 6 HOLE LOCK COMPRESSION AXSOS BONE NONSTERILE,278,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$1,596.00 ","$3,152.10 ", N/A ,"$3,317.40 ", N/A ,"$2,986.80 ", N/A , N/A ,"$5,244.00 ", N/A , N/A ,"$4,845.00 ","$5,130.00 ", N/A ,"$4,275.00 ","$3,990.00 ","$3,990.00 ", N/A ,"$3,990.00 ","$4,389.00 ","$4,389.00 ", N/A ,"$4,845.00 ", N/A , N/A ,"$3,197.70 ","$2,359.80 ","$2,371.20 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$2,986.80 ","$1,596.00 ","$5,130.00 ","$2,148.90 ", N/A ,"$3,705.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE STRYKER POLYAXIAL LOCKING,278,1 ,"$5,700.00 ","$4,104.00 ","$1,596.00 ","$5,700.00 ","$3,705.00 ", N/A ,"$1,596.00 ","$3,152.10 ", N/A ,"$3,317.40 ", N/A ,"$2,986.80 ", N/A , N/A ,"$5,244.00 ", N/A , N/A ,"$4,845.00 ","$5,130.00 ", N/A ,"$4,275.00 ","$3,990.00 ","$3,990.00 ", N/A ,"$3,990.00 ","$4,389.00 ","$4,389.00 ", N/A ,"$4,845.00 ", N/A , N/A ,"$3,197.70 ","$2,359.80 ","$2,371.20 ", N/A , N/A , N/A ,"$4,845.00 ", N/A ,"$2,986.80 ","$1,596.00 ","$5,130.00 ","$2,148.90 ", N/A ,"$3,705.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SUTURE ARTHREX FIBERWARE 2 C-13 38IN BRAID TIES,278,1 ,$900.00 ,$648.00 ,$252.00 ,$900.00 ,$585.00 , N/A ,$252.00 ,$497.70 , N/A ,$523.80 , N/A ,$471.60 , N/A , N/A ,$828.00 , N/A , N/A ,$765.00 ,$810.00 , N/A ,$675.00 ,$630.00 ,$630.00 , N/A ,$630.00 ,$693.00 ,$693.00 , N/A ,$765.00 , N/A , N/A ,$504.90 ,$372.60 ,$374.40 , N/A , N/A , N/A ,$765.00 , N/A ,$471.60 ,$252.00 ,$810.00 , N/A , N/A ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SYSTEM FIXATION 37CM CAPSURE STRAIGHT PEEK STAINLESS STEEL 15 FASTENER PERMANENT HANDLE LARGE PORE MESH HERNIA REPAIR STERILE DISPOSABLE,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ", N/A , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PLATE STRAIGHT 1.5MM SCREW 6 HOLE BONE,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ", N/A , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE BITE L14 MM OD3 MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ", N/A , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 4MM TI FIXOS 40MM,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ", N/A , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SYSTEM INT FIX 14X3.9MM 2.7MM,278,1 ,"$14,100.00 ","$10,152.00 ","$3,948.00 ","$14,100.00 ","$9,165.00 ", N/A ,"$3,948.00 ","$7,797.30 ", N/A ,"$8,206.20 ", N/A ,"$7,388.40 ", N/A , N/A ,"$12,972.00 ", N/A , N/A ,"$11,985.00 ","$12,690.00 ", N/A ,"$10,575.00 ","$9,870.00 ","$9,870.00 ", N/A ,"$9,870.00 ","$10,857.00 ","$10,857.00 ", N/A ,"$11,985.00 ", N/A , N/A ,"$7,910.10 ","$5,837.40 ","$5,865.60 ", N/A , N/A , N/A ,"$11,985.00 ", N/A ,"$7,388.40 ","$3,948.00 ","$12,690.00 ","$5,315.70 ", N/A ,"$9,165.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,WIRE FIXATION 1.2MM 65MM KIRSCHNER OLIVE SMOOTH TROCAR TIP,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 2.7MM 18MM T8 FULL THREAD STARDRIVE NONSTERILE VARIAX FOOT PLATE SYSTEM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 2.7MM 20MM T8 FULL THREAD STARDRIVE NONSTERILE VARIAX FOOT PLATE SYSTEM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW BONE 2.7MM 24MM T8 FULL THREAD STARDRIVE NONSTERILE VARIAX FOOT PLATE SYSTEM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,SCREW STRYKER 3.5 VARIAX 28MM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,WIRE KIRSCHNER 2MM X 150MM TROCAR POINT,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 , N/A , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,PIN FIXATION 9IN 2MM STEINMANN STAINLESS STEEL SMOOTH PLAIN TROCAR NONSTERILE,278,1 ,$75.00 ,$54.00 ,$21.00 ,$75.00 ,$48.75 , N/A ,$21.00 ,$41.48 , N/A ,$43.65 , N/A ,$39.30 , N/A , N/A ,$69.00 , N/A , N/A ,$63.75 ,$67.50 , N/A ,$56.25 ,$52.50 ,$52.50 , N/A ,$52.50 ,$57.75 ,$57.75 , N/A ,$63.75 , N/A , N/A ,$42.08 ,$31.05 ,$31.20 , N/A , N/A , N/A ,$63.75 , N/A ,$39.30 ,$21.00 ,$67.50 , N/A , N/A ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,WIRE SYNTHES 1.0MM KIRSCHNER W/TROCAR POINT 150MM,278,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 , N/A , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,K WIRE ZIMMER 9 IN X .035 IN,278,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 , N/A , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871713,C1713,WIRE FIX .7MM 127MM KIRSCH SS,278,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 , N/A , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,IMPLANT TOE JOINT REF TOE SYS 3,278,1 ,"$9,300.00 ","$6,696.00 ","$2,604.00 ","$9,300.00 ","$6,045.00 ", N/A ,"$2,604.00 ","$5,142.90 ", N/A ,"$5,412.60 ", N/A ,"$4,873.20 ", N/A , N/A ,"$8,556.00 ", N/A , N/A ,"$7,905.00 ","$8,370.00 ", N/A ,"$6,975.00 ","$6,510.00 ","$6,510.00 ", N/A ,"$6,510.00 ","$7,161.00 ","$7,161.00 ", N/A ,"$7,905.00 ", N/A , N/A ,"$5,217.30 ","$3,850.20 ","$3,868.80 ", N/A , N/A , N/A ,"$7,905.00 ", N/A ,"$4,873.20 ","$2,604.00 ","$8,370.00 ","$3,506.10 ", N/A ,"$6,045.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,INSERT ACETABULAR 36MM 10D F HIP X3 TRIDENT,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,017.90 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,HEAD STRYKER FEMORAL V40 36MM 0MM,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,017.90 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,SHELL ACETABULAR 58MM HIP CLUSTER HOLE TRITANIUM TRIDENT II F STERILE,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$1,470.30 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,IMPLANT FIXATION TOE 14MM 3-4.2MM 3.2MM,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$1,470.30 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,SIZER TOE REF TOE SYS 1-4 FLEX,278,1 ,"$1,500.00 ","$1,080.00 ",$420.00 ,"$1,500.00 ",$975.00 , N/A ,$420.00 ,$829.50 , N/A ,$873.00 , N/A ,$786.00 , N/A , N/A ,"$1,380.00 ", N/A , N/A ,"$1,275.00 ","$1,350.00 ", N/A ,"$1,125.00 ","$1,050.00 ","$1,050.00 ", N/A ,"$1,050.00 ","$1,155.00 ","$1,155.00 ", N/A ,"$1,275.00 ", N/A , N/A ,$841.50 ,$621.00 ,$624.00 , N/A , N/A , N/A ,"$1,275.00 ", N/A ,$786.00 ,$420.00 ,"$1,350.00 ", N/A , N/A ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871776,C1776,STEM FEMORAL 105MM MODULAR ACCOLADE 127D 4 TAPER 35MM HIP STERILE,278,1 ,"$6,900.00 ","$4,968.00 ","$1,932.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$1,932.00 ","$3,815.70 ", N/A ,"$4,015.80 ", N/A ,"$3,615.60 ", N/A , N/A ,"$6,348.00 ", N/A , N/A ,"$5,865.00 ","$6,210.00 ", N/A ,"$5,175.00 ","$4,830.00 ","$4,830.00 ", N/A ,"$4,830.00 ","$5,313.00 ","$5,313.00 ", N/A ,"$5,865.00 ", N/A , N/A ,"$3,870.90 ","$2,856.60 ","$2,870.40 ", N/A , N/A , N/A ,"$5,865.00 ", N/A ,"$3,615.60 ","$1,932.00 ","$6,210.00 ","$2,601.30 ", N/A ,"$4,485.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH BARD PLUG XLARGE 0112780,278,1 ,"$1,026.00 ",$738.72 ,$287.28 ,"$1,026.00 ",$666.90 , N/A ,$287.28 ,$567.38 , N/A ,$597.13 , N/A ,$537.62 , N/A , N/A ,$943.92 , N/A , N/A ,$872.10 ,$923.40 , N/A ,$769.50 ,$718.20 ,$718.20 , N/A ,$718.20 ,$790.02 ,$790.02 , N/A ,$872.10 , N/A , N/A ,$575.59 ,$424.76 ,$426.82 , N/A , N/A , N/A ,$872.10 , N/A ,$537.62 ,$287.28 ,$923.40 , N/A , N/A ,$666.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH COMPOSIX 4X6 '0123460,278,1 ,"$1,050.00 ",$756.00 ,$294.00 ,"$1,050.00 ",$682.50 , N/A ,$294.00 ,$580.65 , N/A ,$611.10 , N/A ,$550.20 , N/A , N/A ,$966.00 , N/A , N/A ,$892.50 ,$945.00 , N/A ,$787.50 ,$735.00 ,$735.00 , N/A ,$735.00 ,$808.50 ,$808.50 , N/A ,$892.50 , N/A , N/A ,$589.05 ,$434.70 ,$436.80 , N/A , N/A , N/A ,$892.50 , N/A ,$550.20 ,$294.00 ,$945.00 , N/A , N/A ,$682.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH COMPOSIX 8X10 '0123810,278,1 ,"$3,900.00 ","$2,808.00 ","$1,092.00 ","$3,900.00 ","$2,535.00 ", N/A ,"$1,092.00 ","$2,156.70 ", N/A ,"$2,269.80 ", N/A ,"$2,043.60 ", N/A , N/A ,"$3,588.00 ", N/A , N/A ,"$3,315.00 ","$3,510.00 ", N/A ,"$2,925.00 ","$2,730.00 ","$2,730.00 ", N/A ,"$2,730.00 ","$3,003.00 ","$3,003.00 ", N/A ,"$3,315.00 ", N/A , N/A ,"$2,187.90 ","$1,614.60 ","$1,622.40 ", N/A , N/A , N/A ,"$3,315.00 ", N/A ,"$2,043.60 ","$1,092.00 ","$3,510.00 ","$1,470.30 ", N/A ,"$2,535.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH MARLEX GROIN 4 X 1.8,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 , N/A , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH BARD MARLEX 5.4X2.4IN,278,1 ,$225.00 ,$162.00 ,$63.00 ,$225.00 ,$146.25 , N/A ,$63.00 ,$124.43 , N/A ,$130.95 , N/A ,$117.90 , N/A , N/A ,$207.00 , N/A , N/A ,$191.25 ,$202.50 , N/A ,$168.75 ,$157.50 ,$157.50 , N/A ,$157.50 ,$173.25 ,$173.25 , N/A ,$191.25 , N/A , N/A ,$126.23 ,$93.15 ,$93.60 , N/A , N/A , N/A ,$191.25 , N/A ,$117.90 ,$63.00 ,$202.50 , N/A , N/A ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH TRELEX BOSTON SCI NATURAL 10IN X 14IN,278,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 , N/A ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 , N/A , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH VENTRALEX LARGE 5950009,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,COMPOSIX KUGEL BARD SMALL OVAL 8 X 12,278,1 ,"$2,100.00 ","$1,512.00 ",$588.00 ,"$2,100.00 ","$1,365.00 ", N/A ,$588.00 ,"$1,161.30 ", N/A ,"$1,222.20 ", N/A ,"$1,100.40 ", N/A , N/A ,"$1,932.00 ", N/A , N/A ,"$1,785.00 ","$1,890.00 ", N/A ,"$1,575.00 ","$1,470.00 ","$1,470.00 ", N/A ,"$1,470.00 ","$1,617.00 ","$1,617.00 ", N/A ,"$1,785.00 ", N/A , N/A ,"$1,178.10 ",$869.40 ,$873.60 , N/A , N/A , N/A ,"$1,785.00 ", N/A ,"$1,100.40 ",$588.00 ,"$1,890.00 ",$791.70 , N/A ,"$1,365.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH VENTRALEX SMALL WITH STRAP 5950007,278,1 ,"$1,200.00 ",$864.00 ,$336.00 ,"$1,200.00 ",$780.00 , N/A ,$336.00 ,$663.60 , N/A ,$698.40 , N/A ,$628.80 , N/A , N/A ,"$1,104.00 ", N/A , N/A ,"$1,020.00 ","$1,080.00 ", N/A ,$900.00 ,$840.00 ,$840.00 , N/A ,$840.00 ,$924.00 ,$924.00 , N/A ,"$1,020.00 ", N/A , N/A ,$673.20 ,$496.80 ,$499.20 , N/A , N/A , N/A ,"$1,020.00 ", N/A ,$628.80 ,$336.00 ,"$1,080.00 ", N/A , N/A ,$780.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH VENTRALEX ST MEDIUM WITH STRAP 5950008,278,1 ,"$1,350.00 ",$972.00 ,$378.00 ,"$1,350.00 ",$877.50 , N/A ,$378.00 ,$746.55 , N/A ,$785.70 , N/A ,$707.40 , N/A , N/A ,"$1,242.00 ", N/A , N/A ,"$1,147.50 ","$1,215.00 ", N/A ,"$1,012.50 ",$945.00 ,$945.00 , N/A ,$945.00 ,"$1,039.50 ","$1,039.50 ", N/A ,"$1,147.50 ", N/A , N/A ,$757.35 ,$558.90 ,$561.60 , N/A , N/A , N/A ,"$1,147.50 ", N/A ,$707.40 ,$378.00 ,"$1,215.00 ", N/A , N/A ,$877.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,MESH VENTRIO ST 4.3 X 5.5 5950040,278,1 ,"$2,700.00 ","$1,944.00 ",$756.00 ,"$2,700.00 ","$1,755.00 ", N/A ,$756.00 ,"$1,493.10 ", N/A ,"$1,571.40 ", N/A ,"$1,414.80 ", N/A , N/A ,"$2,484.00 ", N/A , N/A ,"$2,295.00 ","$2,430.00 ", N/A ,"$2,025.00 ","$1,890.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$2,079.00 ","$2,079.00 ", N/A ,"$2,295.00 ", N/A , N/A ,"$1,514.70 ","$1,117.80 ","$1,123.20 ", N/A , N/A , N/A ,"$2,295.00 ", N/A ,"$1,414.80 ",$756.00 ,"$2,430.00 ","$1,017.90 ", N/A ,"$1,755.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871781,C1781,PLUG LARGE MESH PERFIX 1.6 X 1.90,278,1 ,$426.30 ,$306.94 ,$119.36 ,$426.30 ,$277.10 , N/A ,$119.36 ,$235.74 , N/A ,$248.11 , N/A ,$223.38 , N/A , N/A ,$392.20 , N/A , N/A ,$362.36 ,$383.67 , N/A ,$319.73 ,$298.41 ,$298.41 , N/A ,$298.41 ,$328.25 ,$328.25 , N/A ,$362.36 , N/A , N/A ,$239.15 ,$176.49 ,$177.34 , N/A , N/A , N/A ,$362.36 , N/A ,$223.38 ,$119.36 ,$383.67 , N/A , N/A ,$277.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871874,C1874,STENT ESOPHAGEAL WALLFLEX 18MM X 103MM BOSTON SCIENTIFIC,278,1 ,"$6,900.00 ","$4,968.00 ","$1,932.00 ","$6,900.00 ","$4,485.00 ", N/A ,"$1,932.00 ","$3,815.70 ", N/A ,"$4,015.80 ", N/A ,"$3,615.60 ", N/A , N/A ,"$6,348.00 ", N/A , N/A ,"$5,865.00 ","$6,210.00 ", N/A ,"$5,175.00 ","$4,830.00 ","$4,830.00 ", N/A ,"$4,830.00 ","$5,313.00 ","$5,313.00 ", N/A ,"$5,865.00 ", N/A , N/A ,"$3,870.90 ","$2,856.60 ","$2,870.40 ", N/A , N/A , N/A ,"$5,865.00 ", N/A ,"$3,615.60 ","$1,932.00 ","$6,210.00 ","$2,601.30 ", N/A ,"$4,485.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),27871876,C1876,STENT BILIARY 7FR 5CM DUODENAL BEND DELIVERY SYSTEM RAPID EXCHANGE BARB TO BARB PRELOAD ADVANIX PLASTIC 3.2MM WORK CHANNEL,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27871876,C1876,STENT ADVANIX BILIARY 7FR 7CM,278,1 ,$450.00 ,$324.00 ,$126.00 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 , N/A , N/A , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872617,C2617,STENT BARD OPTIMA 6FR X 26CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872617,C2617,STENT BARD OPTIMA 6FR X 22CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872617,C2617,STENT BARD OPTIMA 6FR X 24CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 7FR 7CM DUODENAL BEND DELIVERY SYSTEM RAPID EXCHANGE PLASTIC ACCEPTS .035IN GUIDEWIRE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 10FR 10CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 10FR 12CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 10FR 5CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 10FR 7CM,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 7FR 10CM DUODENAL BEND RAPID EXCHANGE DELIVERY SYSTEM ACCEPTS .035IN GUIDEWIRE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT BILIARY 7FR 5CM DUODENAL BEND DELIVERY SYSTEM RAPID EXCHANGE ACCEPTS .035IN GUIDEWIRE,278,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 , N/A ,$84.00 ,$165.90 , N/A ,$174.60 , N/A ,$157.20 , N/A , N/A ,$276.00 , N/A , N/A ,$255.00 ,$270.00 , N/A ,$225.00 ,$210.00 ,$210.00 , N/A ,$210.00 ,$231.00 ,$231.00 , N/A ,$255.00 , N/A , N/A ,$168.30 ,$124.20 ,$124.80 , N/A , N/A , N/A ,$255.00 , N/A ,$157.20 ,$84.00 ,$270.00 , N/A , N/A ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),27872625,C2625,STENT PANCREATIC 4FR 4CM STRAIGHT RADIOPAQUE TRAIL MARKER DRAINAGE HOLE COLOR CODED ADVANIX NAVIFLEX DREAMWIRE JAGWIRE HYDRA JAGWIRE POLYMER STERILE ACCEPTS .035IN GUIDEWIRE,278,1 ,$525.00 ,$378.00 ,$147.00 ,$525.00 ,$341.25 , N/A ,$147.00 ,$290.33 , N/A ,$305.55 , N/A ,$275.10 , N/A , N/A ,$483.00 , N/A , N/A ,$446.25 ,$472.50 , N/A ,$393.75 ,$367.50 ,$367.50 , N/A ,$367.50 ,$404.25 ,$404.25 , N/A ,$446.25 , N/A , N/A ,$294.53 ,$217.35 ,$218.40 , N/A , N/A , N/A ,$446.25 , N/A ,$275.10 ,$147.00 ,$472.50 , N/A , N/A ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),29200003,N/A,HC CRUTCHES PER PAIR,271,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 , N/A ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$58.00 ,$41.76 ,$6.28 ,$58.00 ,$37.70 , N/A ,$16.24 ,$32.07 , N/A ,$33.76 , N/A ,$30.39 , N/A , N/A , N/A , N/A , N/A ,$49.30 ,$52.20 , N/A ,$43.50 ,$40.60 ,$40.60 , N/A ,$40.60 ,$44.66 ,$44.66 , N/A ,$49.30 , N/A , N/A ,$32.54 ,$24.01 ,$24.13 , N/A , N/A , N/A ,$49.30 , N/A ,$30.39 ,$16.24 ,$52.20 ,$6.28 , N/A ,$37.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30000010,36415,HC VENIPUNCTURE,300,1 ,$34.00 ,$24.48 ,$1.66 ,$34.00 ,$22.10 ,$8.40 ,$9.52 ,$18.80 ,$8.40 ,$19.79 ,$8.40 ,$17.82 ,$8.40 ,$17.31 , N/A ,$21.43 ,$8.40 ,$28.90 ,$30.60 ,$8.57 ,$25.50 ,$23.80 ,$23.80 ,$8.40 ,$23.80 ,$26.18 ,$26.18 ,$21.43 ,$28.90 ,$8.57 ,$8.57 ,$19.07 ,$14.08 ,$14.14 ,$1.68 ,$1.66 ,$8.82 ,$28.90 ,$18.43 ,$17.82 ,$9.52 ,$30.60 ,$6.00 ,$8.40 ,$22.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30000015,36600,HC ARTERIAL PUNCTURE,300,1 ,$83.00 ,$59.76 ,$23.24 ,$278.76 ,$53.95 ,$109.28 ,$23.24 ,$45.90 ,$109.28 ,$48.31 ,$81.34 ,$43.49 ,$81.34 ,$83.00 ,$76.36 ,$278.76 ,$109.28 ,$70.55 ,$74.70 ,$81.34 ,$62.25 ,$58.10 ,$58.10 ,$109.28 ,$58.10 ,$63.91 ,$63.91 ,$83.00 ,$70.55 ,$111.51 ,$111.51 ,$46.56 ,$34.36 ,$34.53 ,$34.62 ,$34.25 ,$114.75 ,$70.55 ,$239.74 ,$43.49 ,$23.24 ,$74.70 , N/A ,$109.28 ,$53.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30000242,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$221.00 ,$159.12 ,$34.25 ,$278.76 ,$143.65 ,$109.28 ,$61.88 ,$122.21 ,$109.28 ,$128.62 ,$109.28 ,$115.80 ,$109.28 ,$221.00 , N/A ,$278.76 ,$109.28 ,$187.85 ,$198.90 ,$111.47 ,$165.75 ,$154.70 ,$154.70 ,$109.28 ,$154.70 ,$170.17 ,$170.17 ,$221.00 ,$187.85 ,$111.51 ,$111.51 ,$123.98 ,$91.49 ,$91.94 ,$34.62 ,$34.25 ,$114.75 ,$187.85 ,$239.74 ,$115.80 ,$61.88 ,$198.90 , N/A ,$109.28 ,$143.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30002013,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$221.00 ,$159.12 ,$34.25 ,$278.76 ,$143.65 ,$109.28 ,$61.88 ,$122.21 ,$109.28 ,$128.62 ,$109.28 ,$115.80 ,$109.28 ,$221.00 , N/A ,$278.76 ,$109.28 ,$187.85 ,$198.90 ,$111.47 ,$165.75 ,$154.70 ,$154.70 ,$109.28 ,$154.70 ,$170.17 ,$170.17 ,$221.00 ,$187.85 ,$111.51 ,$111.51 ,$123.98 ,$91.49 ,$91.94 ,$34.62 ,$34.25 ,$114.75 ,$187.85 ,$239.74 ,$115.80 ,$61.88 ,$198.90 , N/A ,$109.28 ,$143.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30002016,89051,HC CELL CT BODY FLUID W/DIFF T2,300,1 ,$218.00 ,$156.96 ,$5.49 ,$218.00 ,$141.70 ,$5.49 ,$61.04 ,$120.55 ,$5.49 ,$126.88 ,$5.49 ,$114.23 ,$5.49 ,$11.31 ,$200.56 ,$14.00 ,$5.49 ,$185.30 ,$196.20 ,$5.60 ,$163.50 ,$152.60 ,$152.60 ,$5.49 ,$152.60 ,$167.86 ,$167.86 ,$14.00 ,$185.30 ,$5.60 ,$5.60 ,$122.30 ,$90.25 ,$90.69 ,$23.01 ,$22.75 ,$5.76 ,$185.30 ,$12.04 ,$114.23 ,$61.04 ,$196.20 ,$11.20 ,$5.49 ,$141.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30002018,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$93.00 ,$66.96 ,$7.18 ,$93.00 ,$60.45 ,$7.18 ,$26.04 ,$51.43 ,$7.18 ,$54.13 ,$7.18 ,$48.73 ,$7.18 ,$14.81 ,$85.56 ,$18.33 ,$7.18 ,$79.05 ,$83.70 ,$7.33 ,$69.75 ,$65.10 ,$65.10 ,$7.18 ,$65.10 ,$71.61 ,$71.61 ,$18.33 ,$79.05 ,$7.33 ,$7.33 ,$52.17 ,$38.50 ,$38.69 ,$23.01 ,$22.75 ,$7.55 ,$79.05 ,$15.76 ,$48.73 ,$26.04 ,$83.70 ,$14.66 ,$7.18 ,$60.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30002039,86999,HC TRANSFUSION UNLISTED PROCEDURE -90,300,1 ,$65.00 ,$46.80 ,$18.20 ,$65.00 ,$42.25 ,$23.49 ,$18.20 ,$35.95 ,$23.49 ,$37.83 ,$23.49 ,$34.06 ,$23.49 ,$48.42 ,$59.80 ,$59.93 ,$23.49 ,$55.25 ,$58.50 ,$23.96 ,$48.75 ,$45.50 ,$45.50 ,$23.49 ,$45.50 ,$50.05 ,$50.05 ,$59.93 ,$55.25 ,$23.97 ,$23.97 ,$36.47 ,$26.91 ,$27.04 ,$29.10 ,$28.79 ,$24.67 ,$55.25 ,$51.54 ,$34.06 ,$18.20 ,$58.50 ,$49.34 ,$23.49 ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30002042,85027,HC HEALTH FAIR HEMOGRAM,300,1 ,$5.00 ,$3.60 ,$1.40 ,$12.50 ,$3.25 ,$4.90 ,$1.40 ,$2.77 ,$4.90 ,$2.91 ,$4.90 ,$2.62 ,$4.90 ,$5.00 ,$4.60 ,$12.50 ,$4.90 ,$4.25 ,$4.50 ,$4.90 ,$3.75 ,$3.50 ,$3.50 ,$4.90 ,$3.50 ,$3.85 ,$3.85 ,$5.00 ,$4.25 ,$5.00 ,$5.00 ,$2.81 ,$2.07 ,$2.08 ,$4.83 ,$4.95 ,$5.14 ,$4.25 ,$10.75 ,$2.62 ,$1.40 ,$4.50 ,$5.00 ,$4.90 ,$3.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100121,80164,HC VALPROIC ACID,301,1 ,$182.00 ,$131.04 ,$9.15 ,$182.00 ,$118.30 ,$13.27 ,$50.96 ,$100.65 ,$13.27 ,$105.92 ,$13.27 ,$95.37 ,$13.27 ,$27.35 ,$167.44 ,$33.85 ,$13.27 ,$154.70 ,$163.80 ,$13.53 ,$136.50 ,$127.40 ,$127.40 ,$13.27 ,$127.40 ,$140.14 ,$140.14 ,$33.85 ,$154.70 ,$13.54 ,$13.54 ,$102.10 ,$75.35 ,$75.71 ,$9.24 ,$9.15 ,$13.94 ,$154.70 ,$29.11 ,$95.37 ,$50.96 ,$163.80 ,$27.08 ,$13.27 ,$118.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100157,82009,HC ACETONE SERUM,301,1 ,$74.00 ,$53.28 ,$3.54 ,$74.00 ,$48.10 ,$4.43 ,$20.72 ,$40.92 ,$4.43 ,$43.07 ,$4.43 ,$38.78 ,$4.43 ,$9.13 ,$68.08 ,$11.30 ,$4.43 ,$62.90 ,$66.60 ,$4.52 ,$55.50 ,$51.80 ,$51.80 ,$4.43 ,$51.80 ,$56.98 ,$56.98 ,$11.30 ,$62.90 ,$4.52 ,$4.52 ,$41.51 ,$30.64 ,$30.78 ,$3.58 ,$3.54 ,$4.65 ,$62.90 ,$9.72 ,$38.78 ,$20.72 ,$66.60 ,$9.04 ,$4.43 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100165,82040,HC ALBUMIN SERUM,301,1 ,$77.00 ,$55.44 ,$3.54 ,$77.00 ,$50.05 ,$4.85 ,$21.56 ,$42.58 ,$4.85 ,$44.81 ,$4.85 ,$40.35 ,$4.85 ,$10.00 ,$70.84 ,$12.38 ,$4.85 ,$65.45 ,$69.30 ,$4.95 ,$57.75 ,$53.90 ,$53.90 ,$4.85 ,$53.90 ,$59.29 ,$59.29 ,$12.38 ,$65.45 ,$4.95 ,$4.95 ,$43.20 ,$31.88 ,$32.03 ,$3.58 ,$3.54 ,$5.10 ,$65.45 ,$10.64 ,$40.35 ,$21.56 ,$69.30 ,$9.90 ,$4.85 ,$50.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$103.00 ,$74.16 ,$2.85 ,$103.00 ,$66.95 ,$5.66 ,$28.84 ,$56.96 ,$5.66 ,$59.95 ,$5.66 ,$53.97 ,$5.66 ,$11.68 ,$94.76 ,$14.45 ,$5.66 ,$87.55 ,$92.70 ,$5.78 ,$77.25 ,$72.10 ,$72.10 ,$5.66 ,$72.10 ,$79.31 ,$79.31 ,$14.45 ,$87.55 ,$5.78 ,$5.78 ,$57.78 ,$42.64 ,$42.85 ,$2.88 ,$2.85 ,$5.95 ,$87.55 ,$12.43 ,$53.97 ,$28.84 ,$92.70 ,$11.56 ,$5.66 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100186,82140,HC AMMONIA,301,1 ,$130.00 ,$93.60 ,$7.96 ,$130.00 ,$84.50 ,$14.28 ,$36.40 ,$71.89 ,$14.28 ,$75.66 ,$14.28 ,$68.12 ,$14.28 ,$29.43 ,$119.60 ,$36.43 ,$14.28 ,$110.50 ,$117.00 ,$14.56 ,$97.50 ,$91.00 ,$91.00 ,$14.28 ,$91.00 ,$100.10 ,$100.10 ,$36.43 ,$110.50 ,$14.57 ,$14.57 ,$72.93 ,$53.82 ,$54.08 ,$8.05 ,$7.96 ,$14.99 ,$110.50 ,$31.33 ,$68.12 ,$36.40 ,$117.00 ,$29.14 ,$14.28 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100188,82150,HC AMYLASE,301,1 ,$135.00 ,$97.20 ,$6.35 ,$135.00 ,$87.75 ,$6.35 ,$37.80 ,$74.66 ,$6.35 ,$78.57 ,$6.35 ,$70.74 ,$6.35 ,$13.09 ,$124.20 ,$16.20 ,$6.35 ,$114.75 ,$121.50 ,$6.48 ,$101.25 ,$94.50 ,$94.50 ,$6.35 ,$94.50 ,$103.95 ,$103.95 ,$16.20 ,$114.75 ,$6.48 ,$6.48 ,$75.74 ,$55.89 ,$56.16 ,$8.05 ,$7.96 ,$6.66 ,$114.75 ,$13.93 ,$70.74 ,$37.80 ,$121.50 ,$12.96 ,$6.35 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$79.00 ,$56.88 ,$3.54 ,$79.00 ,$51.35 ,$4.92 ,$22.12 ,$43.69 ,$4.92 ,$45.98 ,$4.92 ,$41.40 ,$4.92 ,$10.14 ,$72.68 ,$12.55 ,$4.92 ,$67.15 ,$71.10 ,$5.02 ,$59.25 ,$55.30 ,$55.30 ,$4.92 ,$55.30 ,$60.83 ,$60.83 ,$12.55 ,$67.15 ,$5.02 ,$5.02 ,$44.32 ,$32.71 ,$32.86 ,$3.58 ,$3.54 ,$5.16 ,$67.15 ,$10.79 ,$41.40 ,$22.12 ,$71.10 ,$10.04 ,$4.92 ,$51.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$90.00 ,$64.80 ,$3.54 ,$90.00 ,$58.50 ,$4.92 ,$25.20 ,$49.77 ,$4.92 ,$52.38 ,$4.92 ,$47.16 ,$4.92 ,$10.14 ,$82.80 ,$12.55 ,$4.92 ,$76.50 ,$81.00 ,$5.02 ,$67.50 ,$63.00 ,$63.00 ,$4.92 ,$63.00 ,$69.30 ,$69.30 ,$12.55 ,$76.50 ,$5.02 ,$5.02 ,$50.49 ,$37.26 ,$37.44 ,$3.58 ,$3.54 ,$5.16 ,$76.50 ,$10.79 ,$47.16 ,$25.20 ,$81.00 ,$10.04 ,$4.92 ,$58.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100212,82306,HC VITAMIN D 25 OH,301,1 ,$299.00 ,$215.28 ,$21.44 ,$299.00 ,$194.35 ,$29.01 ,$83.72 ,$165.35 ,$29.01 ,$174.02 ,$29.01 ,$156.68 ,$29.01 ,$59.79 ,$275.08 ,$74.00 ,$29.01 ,$254.15 ,$269.10 ,$29.59 ,$224.25 ,$209.30 ,$209.30 ,$29.01 ,$209.30 ,$230.23 ,$230.23 ,$74.00 ,$254.15 ,$29.60 ,$29.60 ,$167.74 ,$123.79 ,$124.38 ,$21.67 ,$21.44 ,$30.46 ,$254.15 ,$63.64 ,$156.68 ,$83.72 ,$269.10 ,$59.20 ,$29.01 ,$194.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100214,82310,HC CALCIUM,301,1 ,$101.00 ,$72.72 ,$3.54 ,$101.00 ,$65.65 ,$5.06 ,$28.28 ,$55.85 ,$5.06 ,$58.78 ,$5.06 ,$52.92 ,$5.06 ,$10.42 ,$92.92 ,$12.90 ,$5.06 ,$85.85 ,$90.90 ,$5.15 ,$75.75 ,$70.70 ,$70.70 ,$5.06 ,$70.70 ,$77.77 ,$77.77 ,$12.90 ,$85.85 ,$5.16 ,$5.16 ,$56.66 ,$41.81 ,$42.02 ,$3.58 ,$3.54 ,$5.31 ,$85.85 ,$11.09 ,$52.92 ,$28.28 ,$90.90 ,$10.32 ,$5.06 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$108.00 ,$77.76 ,$5.91 ,$108.00 ,$70.20 ,$5.91 ,$30.24 ,$59.72 ,$5.91 ,$62.86 ,$5.91 ,$56.59 ,$5.91 ,$12.18 ,$99.36 ,$15.08 ,$5.91 ,$91.80 ,$97.20 ,$6.03 ,$81.00 ,$75.60 ,$75.60 ,$5.91 ,$75.60 ,$83.16 ,$83.16 ,$15.08 ,$91.80 ,$6.03 ,$6.03 ,$60.59 ,$44.71 ,$44.93 ,$8.05 ,$7.96 ,$6.20 ,$91.80 ,$12.96 ,$56.59 ,$30.24 ,$97.20 ,$12.06 ,$5.91 ,$70.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100222,82374,HC BICARBONATE,301,1 ,$54.00 ,$38.88 ,$3.54 ,$54.00 ,$35.10 ,$4.78 ,$15.12 ,$29.86 ,$4.78 ,$31.43 ,$4.78 ,$28.30 ,$4.78 ,$9.86 ,$49.68 ,$12.20 ,$4.78 ,$45.90 ,$48.60 ,$4.88 ,$40.50 ,$37.80 ,$37.80 ,$4.78 ,$37.80 ,$41.58 ,$41.58 ,$12.20 ,$45.90 ,$4.88 ,$4.88 ,$30.29 ,$22.36 ,$22.46 ,$3.58 ,$3.54 ,$5.02 ,$45.90 ,$10.49 ,$28.30 ,$15.12 ,$48.60 ,$9.76 ,$4.78 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100237,82435,HC CHLORIDE,301,1 ,$54.00 ,$38.88 ,$3.54 ,$54.00 ,$35.10 ,$4.51 ,$15.12 ,$29.86 ,$4.51 ,$31.43 ,$4.51 ,$28.30 ,$4.51 ,$9.29 ,$49.68 ,$11.50 ,$4.51 ,$45.90 ,$48.60 ,$4.60 ,$40.50 ,$37.80 ,$37.80 ,$4.51 ,$37.80 ,$41.58 ,$41.58 ,$11.50 ,$45.90 ,$4.60 ,$4.60 ,$30.29 ,$22.36 ,$22.46 ,$3.58 ,$3.54 ,$4.73 ,$45.90 ,$9.89 ,$28.30 ,$15.12 ,$48.60 ,$9.20 ,$4.51 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100238,82436,HC CHLORIDE URINE,301,1 ,$62.00 ,$44.64 ,$3.54 ,$62.00 ,$40.30 ,$5.63 ,$17.36 ,$34.29 ,$5.63 ,$36.08 ,$5.63 ,$32.49 ,$5.63 ,$11.62 ,$57.04 ,$14.38 ,$5.63 ,$52.70 ,$55.80 ,$5.75 ,$46.50 ,$43.40 ,$43.40 ,$5.63 ,$43.40 ,$47.74 ,$47.74 ,$14.38 ,$52.70 ,$5.75 ,$5.75 ,$34.78 ,$25.67 ,$25.79 ,$3.58 ,$3.54 ,$5.92 ,$52.70 ,$12.36 ,$32.49 ,$17.36 ,$55.80 ,$11.50 ,$5.63 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100241,82465,HC CHOLESTEROL,301,1 ,$91.00 ,$65.52 ,$3.54 ,$91.00 ,$59.15 ,$4.26 ,$25.48 ,$50.32 ,$4.26 ,$52.96 ,$4.26 ,$47.68 ,$4.26 ,$8.79 ,$83.72 ,$10.88 ,$4.26 ,$77.35 ,$81.90 ,$4.35 ,$68.25 ,$63.70 ,$63.70 ,$4.26 ,$63.70 ,$70.07 ,$70.07 ,$10.88 ,$77.35 ,$4.35 ,$4.35 ,$51.05 ,$37.67 ,$37.86 ,$3.58 ,$3.54 ,$4.48 ,$77.35 ,$9.35 ,$47.68 ,$25.48 ,$81.90 ,$8.70 ,$4.26 ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$135.00 ,$97.20 ,$3.54 ,$135.00 ,$87.75 ,$6.38 ,$37.80 ,$74.66 ,$6.38 ,$78.57 ,$6.38 ,$70.74 ,$6.38 ,$13.15 ,$124.20 ,$16.28 ,$6.38 ,$114.75 ,$121.50 ,$6.51 ,$101.25 ,$94.50 ,$94.50 ,$6.38 ,$94.50 ,$103.95 ,$103.95 ,$16.28 ,$114.75 ,$6.51 ,$6.51 ,$75.74 ,$55.89 ,$56.16 ,$3.58 ,$3.54 ,$6.70 ,$114.75 ,$14.00 ,$70.74 ,$37.80 ,$121.50 ,$13.02 ,$6.38 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100262,82565,HC CREATININE,301,1 ,$81.00 ,$58.32 ,$3.54 ,$81.00 ,$52.65 ,$5.02 ,$22.68 ,$44.79 ,$5.02 ,$47.14 ,$5.02 ,$42.44 ,$5.02 ,$10.34 ,$74.52 ,$12.80 ,$5.02 ,$68.85 ,$72.90 ,$5.12 ,$60.75 ,$56.70 ,$56.70 ,$5.02 ,$56.70 ,$62.37 ,$62.37 ,$12.80 ,$68.85 ,$5.12 ,$5.12 ,$45.44 ,$33.53 ,$33.70 ,$3.58 ,$3.54 ,$5.27 ,$68.85 ,$11.01 ,$42.44 ,$22.68 ,$72.90 ,$10.24 ,$5.02 ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$100.00 ,$72.00 ,$3.54 ,$100.00 ,$65.00 ,$5.08 ,$28.00 ,$55.30 ,$5.08 ,$58.20 ,$5.08 ,$52.40 ,$5.08 ,$10.46 ,$92.00 ,$12.95 ,$5.08 ,$85.00 ,$90.00 ,$5.17 ,$75.00 ,$70.00 ,$70.00 ,$5.08 ,$70.00 ,$77.00 ,$77.00 ,$12.95 ,$85.00 ,$5.18 ,$5.18 ,$56.10 ,$41.40 ,$41.60 ,$3.58 ,$3.54 ,$5.33 ,$85.00 ,$11.14 ,$52.40 ,$28.00 ,$90.00 ,$10.36 ,$5.08 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100266,82575,HC CREATININE CLEARANCE,301,1 ,$41.00 ,$29.52 ,$7.96 ,$41.00 ,$26.65 ,$9.27 ,$11.48 ,$22.67 ,$9.27 ,$23.86 ,$9.27 ,$21.48 ,$9.27 ,$19.11 ,$37.72 ,$23.65 ,$9.27 ,$34.85 ,$36.90 ,$9.46 ,$30.75 ,$28.70 ,$28.70 ,$9.27 ,$28.70 ,$31.57 ,$31.57 ,$23.65 ,$34.85 ,$9.46 ,$9.46 ,$23.00 ,$16.97 ,$17.06 ,$8.05 ,$7.96 ,$9.73 ,$34.85 ,$20.34 ,$21.48 ,$11.48 ,$36.90 ,$18.92 ,$9.27 ,$26.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100269,82607,HC VITAMIN B12,301,1 ,$202.00 ,$145.44 ,$10.72 ,$202.00 ,$131.30 ,$14.78 ,$56.56 ,$111.71 ,$14.78 ,$117.56 ,$14.78 ,$105.85 ,$14.78 ,$30.46 ,$185.84 ,$37.70 ,$14.78 ,$171.70 ,$181.80 ,$15.07 ,$151.50 ,$141.40 ,$141.40 ,$14.78 ,$141.40 ,$155.54 ,$155.54 ,$37.70 ,$171.70 ,$15.08 ,$15.08 ,$113.32 ,$83.63 ,$84.03 ,$10.84 ,$10.72 ,$15.51 ,$171.70 ,$32.42 ,$105.85 ,$56.56 ,$181.80 ,$30.16 ,$14.78 ,$131.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100290,82728,HC FERRITIN,301,1 ,$171.00 ,$123.12 ,$7.96 ,$171.00 ,$111.15 ,$13.36 ,$47.88 ,$94.56 ,$13.36 ,$99.52 ,$13.36 ,$89.60 ,$13.36 ,$27.53 ,$157.32 ,$34.08 ,$13.36 ,$145.35 ,$153.90 ,$13.62 ,$128.25 ,$119.70 ,$119.70 ,$13.36 ,$119.70 ,$131.67 ,$131.67 ,$34.08 ,$145.35 ,$13.63 ,$13.63 ,$95.93 ,$70.79 ,$71.14 ,$8.05 ,$7.96 ,$14.02 ,$145.35 ,$29.30 ,$89.60 ,$47.88 ,$153.90 ,$27.26 ,$13.36 ,$111.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100292,82746,HC FOLIC ACID SERUM,301,1 ,$172.00 ,$123.84 ,$7.96 ,$172.00 ,$111.80 ,$14.41 ,$48.16 ,$95.12 ,$14.41 ,$100.10 ,$14.41 ,$90.13 ,$14.41 ,$29.69 ,$158.24 ,$36.75 ,$14.41 ,$146.20 ,$154.80 ,$14.69 ,$129.00 ,$120.40 ,$120.40 ,$14.41 ,$120.40 ,$132.44 ,$132.44 ,$36.75 ,$146.20 ,$14.70 ,$14.70 ,$96.49 ,$71.21 ,$71.55 ,$8.05 ,$7.96 ,$15.13 ,$146.20 ,$31.61 ,$90.13 ,$48.16 ,$154.80 ,$29.40 ,$14.41 ,$111.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100306,82803,HC BLOOD GAS PH PO2 AND /OR PCO2,301,1 ,$370.00 ,$266.40 ,$7.96 ,$370.00 ,$240.50 ,$25.55 ,$103.60 ,$204.61 ,$25.55 ,$215.34 ,$25.55 ,$193.88 ,$25.55 ,$52.66 ,$340.40 ,$65.18 ,$25.55 ,$314.50 ,$333.00 ,$26.06 ,$277.50 ,$259.00 ,$259.00 ,$25.55 ,$259.00 ,$284.90 ,$284.90 ,$65.18 ,$314.50 ,$26.07 ,$26.07 ,$207.57 ,$153.18 ,$153.92 ,$8.05 ,$7.96 ,$26.82 ,$314.50 ,$56.05 ,$193.88 ,$103.60 ,$333.00 ,$52.14 ,$25.55 ,$240.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100307,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$370.00 ,$266.40 ,$7.96 ,$370.00 ,$240.50 ,$77.19 ,$103.60 ,$204.61 ,$77.19 ,$215.34 ,$77.19 ,$193.88 ,$77.19 ,$159.12 ,$340.40 ,$196.93 ,$77.19 ,$314.50 ,$333.00 ,$78.74 ,$277.50 ,$259.00 ,$259.00 ,$77.19 ,$259.00 ,$284.90 ,$284.90 ,$196.93 ,$314.50 ,$78.77 ,$78.77 ,$207.57 ,$153.18 ,$153.92 ,$8.05 ,$7.96 ,$81.06 ,$314.50 ,$169.36 ,$193.88 ,$103.60 ,$333.00 ,$157.54 ,$77.19 ,$240.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$85.00 ,$61.20 ,$3.54 ,$85.00 ,$55.25 ,$3.85 ,$23.80 ,$47.01 ,$3.85 ,$49.47 ,$3.85 ,$44.54 ,$3.85 ,$7.94 ,$78.20 ,$9.83 ,$3.85 ,$72.25 ,$76.50 ,$3.93 ,$63.75 ,$59.50 ,$59.50 ,$3.85 ,$59.50 ,$65.45 ,$65.45 ,$9.83 ,$72.25 ,$3.93 ,$3.93 ,$47.69 ,$35.19 ,$35.36 ,$3.58 ,$3.54 ,$4.05 ,$72.25 ,$8.45 ,$44.54 ,$23.80 ,$76.50 ,$7.86 ,$3.85 ,$55.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100312,82947,HC GLUCOSE,301,1 ,$67.00 ,$48.24 ,$3.54 ,$67.00 ,$43.55 ,$3.85 ,$18.76 ,$37.05 ,$3.85 ,$38.99 ,$3.85 ,$35.11 ,$3.85 ,$7.94 ,$61.64 ,$9.83 ,$3.85 ,$56.95 ,$60.30 ,$3.93 ,$50.25 ,$46.90 ,$46.90 ,$3.85 ,$46.90 ,$51.59 ,$51.59 ,$9.83 ,$56.95 ,$3.93 ,$3.93 ,$37.59 ,$27.74 ,$27.87 ,$3.58 ,$3.54 ,$4.05 ,$56.95 ,$8.45 ,$35.11 ,$18.76 ,$60.30 ,$7.86 ,$3.85 ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100313,82950,HC GLUCOSE SCREEN,301,1 ,$90.00 ,$64.80 ,$3.54 ,$90.00 ,$58.50 ,$4.65 ,$25.20 ,$49.77 ,$4.65 ,$52.38 ,$4.65 ,$47.16 ,$4.65 ,$9.60 ,$82.80 ,$11.88 ,$4.65 ,$76.50 ,$81.00 ,$4.75 ,$67.50 ,$63.00 ,$63.00 ,$4.65 ,$63.00 ,$69.30 ,$69.30 ,$11.88 ,$76.50 ,$4.75 ,$4.75 ,$50.49 ,$37.26 ,$37.44 ,$3.58 ,$3.54 ,$4.89 ,$76.50 ,$10.21 ,$47.16 ,$25.20 ,$81.00 ,$9.50 ,$4.65 ,$58.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$225.00 ,$162.00 ,$7.96 ,$225.00 ,$146.25 ,$12.61 ,$63.00 ,$124.43 ,$12.61 ,$130.95 ,$12.61 ,$117.90 ,$12.61 ,$26.00 ,$207.00 ,$32.18 ,$12.61 ,$191.25 ,$202.50 ,$12.87 ,$168.75 ,$157.50 ,$157.50 ,$12.61 ,$157.50 ,$173.25 ,$173.25 ,$32.18 ,$191.25 ,$12.87 ,$12.87 ,$126.23 ,$93.15 ,$93.60 ,$8.05 ,$7.96 ,$13.24 ,$191.25 ,$27.67 ,$117.90 ,$63.00 ,$202.50 ,$25.74 ,$12.61 ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$62.00 ,$44.64 ,$3.84 ,$62.00 ,$40.30 ,$3.84 ,$17.36 ,$34.29 ,$3.84 ,$36.08 ,$3.84 ,$32.49 ,$3.84 ,$7.92 ,$57.04 ,$9.80 ,$3.84 ,$52.70 ,$55.80 ,$3.92 ,$46.50 ,$43.40 ,$43.40 ,$3.84 ,$43.40 ,$47.74 ,$47.74 ,$9.80 ,$52.70 ,$3.92 ,$3.92 ,$34.78 ,$25.67 ,$25.79 ,$8.05 ,$7.96 ,$4.04 ,$52.70 ,$8.43 ,$32.49 ,$17.36 ,$55.80 ,$7.84 ,$3.84 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100319,82977,HC GGT/GGTP,301,1 ,$119.00 ,$85.68 ,$3.54 ,$119.00 ,$77.35 ,$7.06 ,$33.32 ,$65.81 ,$7.06 ,$69.26 ,$7.06 ,$62.36 ,$7.06 ,$14.54 ,$109.48 ,$18.00 ,$7.06 ,$101.15 ,$107.10 ,$7.19 ,$89.25 ,$83.30 ,$83.30 ,$7.06 ,$83.30 ,$91.63 ,$91.63 ,$18.00 ,$101.15 ,$7.20 ,$7.20 ,$66.76 ,$49.27 ,$49.50 ,$3.58 ,$3.54 ,$7.41 ,$101.15 ,$15.48 ,$62.36 ,$33.32 ,$107.10 ,$14.40 ,$7.06 ,$77.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$155.00 ,$111.60 ,$7.96 ,$155.00 ,$100.75 ,$9.52 ,$43.40 ,$85.72 ,$9.52 ,$90.21 ,$9.52 ,$81.22 ,$9.52 ,$19.61 ,$142.60 ,$24.28 ,$9.52 ,$131.75 ,$139.50 ,$9.70 ,$116.25 ,$108.50 ,$108.50 ,$9.52 ,$108.50 ,$119.35 ,$119.35 ,$24.28 ,$131.75 ,$9.71 ,$9.71 ,$86.96 ,$64.17 ,$64.48 ,$8.05 ,$7.96 ,$10.00 ,$131.75 ,$20.88 ,$81.22 ,$43.40 ,$139.50 ,$19.42 ,$9.52 ,$100.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100393,83540,HC IRON TOTAL,301,1 ,$124.00 ,$89.28 ,$3.54 ,$124.00 ,$80.60 ,$6.34 ,$34.72 ,$68.57 ,$6.34 ,$72.17 ,$6.34 ,$64.98 ,$6.34 ,$13.07 ,$114.08 ,$16.18 ,$6.34 ,$105.40 ,$111.60 ,$6.47 ,$93.00 ,$86.80 ,$86.80 ,$6.34 ,$86.80 ,$95.48 ,$95.48 ,$16.18 ,$105.40 ,$6.47 ,$6.47 ,$69.56 ,$51.34 ,$51.58 ,$3.58 ,$3.54 ,$6.65 ,$105.40 ,$13.91 ,$64.98 ,$34.72 ,$111.60 ,$12.94 ,$6.34 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$140.00 ,$100.80 ,$7.96 ,$140.00 ,$91.00 ,$8.57 ,$39.20 ,$77.42 ,$8.57 ,$81.48 ,$8.57 ,$73.36 ,$8.57 ,$17.65 ,$128.80 ,$21.85 ,$8.57 ,$119.00 ,$126.00 ,$8.73 ,$105.00 ,$98.00 ,$98.00 ,$8.57 ,$98.00 ,$107.80 ,$107.80 ,$21.85 ,$119.00 ,$8.74 ,$8.74 ,$78.54 ,$57.96 ,$58.24 ,$8.05 ,$7.96 ,$9.00 ,$119.00 ,$18.79 ,$73.36 ,$39.20 ,$126.00 ,$17.48 ,$8.57 ,$91.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$137.00 ,$98.64 ,$7.96 ,$137.00 ,$89.05 ,$11.34 ,$38.36 ,$75.76 ,$11.34 ,$79.73 ,$11.34 ,$71.79 ,$11.34 ,$23.37 ,$126.04 ,$28.93 ,$11.34 ,$116.45 ,$123.30 ,$11.56 ,$102.75 ,$95.90 ,$95.90 ,$11.34 ,$95.90 ,$105.49 ,$105.49 ,$28.93 ,$116.45 ,$11.57 ,$11.57 ,$76.86 ,$56.72 ,$56.99 ,$8.05 ,$7.96 ,$11.91 ,$116.45 ,$24.88 ,$71.79 ,$38.36 ,$123.30 ,$23.14 ,$11.34 ,$89.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$102.00 ,$73.44 ,$3.54 ,$102.00 ,$66.30 ,$5.92 ,$28.56 ,$56.41 ,$5.92 ,$59.36 ,$5.92 ,$53.45 ,$5.92 ,$12.20 ,$93.84 ,$15.10 ,$5.92 ,$86.70 ,$91.80 ,$6.04 ,$76.50 ,$71.40 ,$71.40 ,$5.92 ,$71.40 ,$78.54 ,$78.54 ,$15.10 ,$86.70 ,$6.04 ,$6.04 ,$57.22 ,$42.23 ,$42.43 ,$3.58 ,$3.54 ,$6.21 ,$86.70 ,$12.99 ,$53.45 ,$28.56 ,$91.80 ,$12.08 ,$5.92 ,$66.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100409,83690,HC LIPASE,301,1 ,$160.00 ,$115.20 ,$3.54 ,$160.00 ,$104.00 ,$6.75 ,$44.80 ,$88.48 ,$6.75 ,$93.12 ,$6.75 ,$83.84 ,$6.75 ,$13.92 ,$147.20 ,$17.23 ,$6.75 ,$136.00 ,$144.00 ,$6.89 ,$120.00 ,$112.00 ,$112.00 ,$6.75 ,$112.00 ,$123.20 ,$123.20 ,$17.23 ,$136.00 ,$6.89 ,$6.89 ,$89.76 ,$66.24 ,$66.56 ,$3.58 ,$3.54 ,$7.09 ,$136.00 ,$14.81 ,$83.84 ,$44.80 ,$144.00 ,$13.78 ,$6.75 ,$104.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100415,83718,HC CHOLESTEROL HDL,301,1 ,$74.00 ,$53.28 ,$7.96 ,$74.00 ,$48.10 ,$8.03 ,$20.72 ,$40.92 ,$8.03 ,$43.07 ,$8.03 ,$38.78 ,$8.03 ,$16.54 ,$68.08 ,$20.48 ,$8.03 ,$62.90 ,$66.60 ,$8.18 ,$55.50 ,$51.80 ,$51.80 ,$8.03 ,$51.80 ,$56.98 ,$56.98 ,$20.48 ,$62.90 ,$8.19 ,$8.19 ,$41.51 ,$30.64 ,$30.78 ,$8.05 ,$7.96 ,$8.43 ,$62.90 ,$17.61 ,$38.78 ,$20.72 ,$66.60 ,$16.38 ,$8.03 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100416,83721,HC CHOLESTEROL LDL,301,1 ,$74.00 ,$53.28 ,$7.96 ,$74.00 ,$48.10 ,$10.29 ,$20.72 ,$40.92 ,$10.29 ,$43.07 ,$10.29 ,$38.78 ,$10.29 ,$21.21 ,$68.08 ,$26.25 ,$10.29 ,$62.90 ,$66.60 ,$10.50 ,$55.50 ,$51.80 ,$51.80 ,$10.29 ,$51.80 ,$56.98 ,$56.98 ,$26.25 ,$62.90 ,$10.50 ,$10.50 ,$41.51 ,$30.64 ,$30.78 ,$8.05 ,$7.96 ,$10.81 ,$62.90 ,$22.58 ,$38.78 ,$20.72 ,$66.60 ,$21.00 ,$10.29 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100417,83735,HC MAGNESIUM,301,1 ,$119.00 ,$85.68 ,$3.54 ,$119.00 ,$77.35 ,$6.57 ,$33.32 ,$65.81 ,$6.57 ,$69.26 ,$6.57 ,$62.36 ,$6.57 ,$13.53 ,$109.48 ,$16.75 ,$6.57 ,$101.15 ,$107.10 ,$6.69 ,$89.25 ,$83.30 ,$83.30 ,$6.57 ,$83.30 ,$91.63 ,$91.63 ,$16.75 ,$101.15 ,$6.70 ,$6.70 ,$66.76 ,$49.27 ,$49.50 ,$3.58 ,$3.54 ,$6.90 ,$101.15 ,$14.41 ,$62.36 ,$33.32 ,$107.10 ,$13.40 ,$6.57 ,$77.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$346.00 ,$249.12 ,$21.44 ,$346.00 ,$224.90 ,$38.47 ,$96.88 ,$191.34 ,$38.47 ,$201.37 ,$38.47 ,$181.30 ,$38.47 ,$79.31 ,$318.32 ,$98.15 ,$38.47 ,$294.10 ,$311.40 ,$39.25 ,$259.50 ,$242.20 ,$242.20 ,$38.47 ,$242.20 ,$266.42 ,$266.42 ,$98.15 ,$294.10 ,$39.26 ,$39.26 ,$194.11 ,$143.24 ,$143.94 ,$21.67 ,$21.44 ,$40.40 ,$294.10 ,$84.41 ,$181.30 ,$96.88 ,$311.40 ,$78.52 ,$38.47 ,$224.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$78.00 ,$56.16 ,$3.54 ,$78.00 ,$50.70 ,$5.08 ,$21.84 ,$43.13 ,$5.08 ,$45.40 ,$5.08 ,$40.87 ,$5.08 ,$10.46 ,$71.76 ,$12.95 ,$5.08 ,$66.30 ,$70.20 ,$5.17 ,$58.50 ,$54.60 ,$54.60 ,$5.08 ,$54.60 ,$60.06 ,$60.06 ,$12.95 ,$66.30 ,$5.18 ,$5.18 ,$43.76 ,$32.29 ,$32.45 ,$3.58 ,$3.54 ,$5.33 ,$66.30 ,$11.14 ,$40.87 ,$21.84 ,$70.20 ,$10.36 ,$5.08 ,$50.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100684,84100,HC PHOSPHORUS,301,1 ,$109.00 ,$78.48 ,$3.54 ,$109.00 ,$70.85 ,$4.65 ,$30.52 ,$60.28 ,$4.65 ,$63.44 ,$4.65 ,$57.12 ,$4.65 ,$9.57 ,$100.28 ,$11.85 ,$4.65 ,$92.65 ,$98.10 ,$4.73 ,$81.75 ,$76.30 ,$76.30 ,$4.65 ,$76.30 ,$83.93 ,$83.93 ,$11.85 ,$92.65 ,$4.74 ,$4.74 ,$61.15 ,$45.13 ,$45.34 ,$3.58 ,$3.54 ,$4.88 ,$92.65 ,$10.19 ,$57.12 ,$30.52 ,$98.10 ,$9.48 ,$4.65 ,$70.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100691,84132,HC POTASSIUM,301,1 ,$65.00 ,$46.80 ,$3.54 ,$65.00 ,$42.25 ,$4.66 ,$18.20 ,$35.95 ,$4.66 ,$37.83 ,$4.66 ,$34.06 ,$4.66 ,$9.62 ,$59.80 ,$11.90 ,$4.66 ,$55.25 ,$58.50 ,$4.76 ,$48.75 ,$45.50 ,$45.50 ,$4.66 ,$45.50 ,$50.05 ,$50.05 ,$11.90 ,$55.25 ,$4.76 ,$4.76 ,$36.47 ,$26.91 ,$27.04 ,$3.58 ,$3.54 ,$4.90 ,$55.25 ,$10.23 ,$34.06 ,$18.20 ,$58.50 ,$9.52 ,$4.66 ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100694,84133,HC POTASSIUM URINE,301,1 ,$179.00 ,$128.88 ,$3.54 ,$179.00 ,$116.35 ,$4.64 ,$50.12 ,$98.99 ,$4.64 ,$104.18 ,$4.64 ,$93.80 ,$4.64 ,$9.55 ,$164.68 ,$11.83 ,$4.64 ,$152.15 ,$161.10 ,$4.72 ,$134.25 ,$125.30 ,$125.30 ,$4.64 ,$125.30 ,$137.83 ,$137.83 ,$11.83 ,$152.15 ,$4.73 ,$4.73 ,$100.42 ,$74.11 ,$74.46 ,$3.58 ,$3.54 ,$4.87 ,$152.15 ,$10.17 ,$93.80 ,$50.12 ,$161.10 ,$9.46 ,$4.64 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100698,84153,HC PSA TOTAL,301,1 ,$179.00 ,$128.88 ,$7.96 ,$179.00 ,$116.35 ,$18.02 ,$50.12 ,$98.99 ,$18.02 ,$104.18 ,$18.02 ,$93.80 ,$18.02 ,$37.15 ,$164.68 ,$45.98 ,$18.02 ,$152.15 ,$161.10 ,$18.38 ,$134.25 ,$125.30 ,$125.30 ,$18.02 ,$125.30 ,$137.83 ,$137.83 ,$45.98 ,$152.15 ,$18.39 ,$18.39 ,$100.42 ,$74.11 ,$74.46 ,$8.05 ,$7.96 ,$18.92 ,$152.15 ,$39.54 ,$93.80 ,$50.12 ,$161.10 ,$36.78 ,$18.02 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100700,84155,HC PROTEIN TOTAL,301,1 ,$179.00 ,$128.88 ,$3.54 ,$179.00 ,$116.35 ,$3.60 ,$50.12 ,$98.99 ,$3.60 ,$104.18 ,$3.60 ,$93.80 ,$3.60 ,$7.41 ,$164.68 ,$9.18 ,$3.60 ,$152.15 ,$161.10 ,$3.67 ,$134.25 ,$125.30 ,$125.30 ,$3.60 ,$125.30 ,$137.83 ,$137.83 ,$9.18 ,$152.15 ,$3.67 ,$3.67 ,$100.42 ,$74.11 ,$74.46 ,$3.58 ,$3.54 ,$3.77 ,$152.15 ,$7.89 ,$93.80 ,$50.12 ,$161.10 ,$7.34 ,$3.60 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$105.00 ,$75.60 ,$3.54 ,$105.00 ,$68.25 ,$3.60 ,$29.40 ,$58.07 ,$3.60 ,$61.11 ,$3.60 ,$55.02 ,$3.60 ,$7.41 ,$96.60 ,$9.18 ,$3.60 ,$89.25 ,$94.50 ,$3.67 ,$78.75 ,$73.50 ,$73.50 ,$3.60 ,$73.50 ,$80.85 ,$80.85 ,$9.18 ,$89.25 ,$3.67 ,$3.67 ,$58.91 ,$43.47 ,$43.68 ,$3.58 ,$3.54 ,$3.77 ,$89.25 ,$7.89 ,$55.02 ,$29.40 ,$94.50 ,$7.34 ,$3.60 ,$68.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$179.00 ,$128.88 ,$3.54 ,$179.00 ,$116.35 ,$3.92 ,$50.12 ,$98.99 ,$3.92 ,$104.18 ,$3.92 ,$93.80 ,$3.92 ,$8.08 ,$164.68 ,$10.00 ,$3.92 ,$152.15 ,$161.10 ,$4.00 ,$134.25 ,$125.30 ,$125.30 ,$3.92 ,$125.30 ,$137.83 ,$137.83 ,$10.00 ,$152.15 ,$4.00 ,$4.00 ,$100.42 ,$74.11 ,$74.46 ,$3.58 ,$3.54 ,$4.12 ,$152.15 ,$8.60 ,$93.80 ,$50.12 ,$161.10 ,$8.00 ,$3.92 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100721,84295,HC SODIUM,301,1 ,$76.00 ,$54.72 ,$3.54 ,$76.00 ,$49.40 ,$4.71 ,$21.28 ,$42.03 ,$4.71 ,$44.23 ,$4.71 ,$39.82 ,$4.71 ,$9.72 ,$69.92 ,$12.03 ,$4.71 ,$64.60 ,$68.40 ,$4.81 ,$57.00 ,$53.20 ,$53.20 ,$4.71 ,$53.20 ,$58.52 ,$58.52 ,$12.03 ,$64.60 ,$4.81 ,$4.81 ,$42.64 ,$31.46 ,$31.62 ,$3.58 ,$3.54 ,$4.95 ,$64.60 ,$10.34 ,$39.82 ,$21.28 ,$68.40 ,$9.62 ,$4.71 ,$49.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100724,84300,HC SODIUM URINE,301,1 ,$72.00 ,$51.84 ,$3.54 ,$72.00 ,$46.80 ,$4.96 ,$20.16 ,$39.82 ,$4.96 ,$41.90 ,$4.96 ,$37.73 ,$4.96 ,$10.22 ,$66.24 ,$12.65 ,$4.96 ,$61.20 ,$64.80 ,$5.06 ,$54.00 ,$50.40 ,$50.40 ,$4.96 ,$50.40 ,$55.44 ,$55.44 ,$12.65 ,$61.20 ,$5.06 ,$5.06 ,$40.39 ,$29.81 ,$29.95 ,$3.58 ,$3.54 ,$5.20 ,$61.20 ,$10.88 ,$37.73 ,$20.16 ,$64.80 ,$10.12 ,$4.96 ,$46.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100740,84439,HC T4 FREE,301,1 ,$177.00 ,$127.44 ,$8.84 ,$177.00 ,$115.05 ,$8.84 ,$49.56 ,$97.88 ,$8.84 ,$103.01 ,$8.84 ,$92.75 ,$8.84 ,$18.22 ,$162.84 ,$22.55 ,$8.84 ,$150.45 ,$159.30 ,$9.02 ,$132.75 ,$123.90 ,$123.90 ,$8.84 ,$123.90 ,$136.29 ,$136.29 ,$22.55 ,$150.45 ,$9.02 ,$9.02 ,$99.30 ,$73.28 ,$73.63 ,$10.84 ,$10.72 ,$9.28 ,$150.45 ,$19.39 ,$92.75 ,$49.56 ,$159.30 ,$18.04 ,$8.84 ,$115.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$198.00 ,$142.56 ,$10.72 ,$198.00 ,$128.70 ,$16.46 ,$55.44 ,$109.49 ,$16.46 ,$115.24 ,$16.46 ,$103.75 ,$16.46 ,$33.94 ,$182.16 ,$42.00 ,$16.46 ,$168.30 ,$178.20 ,$16.80 ,$148.50 ,$138.60 ,$138.60 ,$16.46 ,$138.60 ,$152.46 ,$152.46 ,$42.00 ,$168.30 ,$16.80 ,$16.80 ,$111.08 ,$81.97 ,$82.37 ,$10.84 ,$10.72 ,$17.29 ,$168.30 ,$36.12 ,$103.75 ,$55.44 ,$178.20 ,$33.60 ,$16.46 ,$128.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100746,84450,HC AST,301,1 ,$108.00 ,$77.76 ,$3.54 ,$108.00 ,$70.20 ,$5.08 ,$30.24 ,$59.72 ,$5.08 ,$62.86 ,$5.08 ,$56.59 ,$5.08 ,$10.46 ,$99.36 ,$12.95 ,$5.08 ,$91.80 ,$97.20 ,$5.17 ,$81.00 ,$75.60 ,$75.60 ,$5.08 ,$75.60 ,$83.16 ,$83.16 ,$12.95 ,$91.80 ,$5.18 ,$5.18 ,$60.59 ,$44.71 ,$44.93 ,$3.58 ,$3.54 ,$5.33 ,$91.80 ,$11.14 ,$56.59 ,$30.24 ,$97.20 ,$10.36 ,$5.08 ,$70.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100747,84460,HC ALT,301,1 ,$100.00 ,$72.00 ,$3.54 ,$100.00 ,$65.00 ,$5.19 ,$28.00 ,$55.30 ,$5.19 ,$58.20 ,$5.19 ,$52.40 ,$5.19 ,$10.71 ,$92.00 ,$13.25 ,$5.19 ,$85.00 ,$90.00 ,$5.30 ,$75.00 ,$70.00 ,$70.00 ,$5.19 ,$70.00 ,$77.00 ,$77.00 ,$13.25 ,$85.00 ,$5.30 ,$5.30 ,$56.10 ,$41.40 ,$41.60 ,$3.58 ,$3.54 ,$5.46 ,$85.00 ,$11.40 ,$52.40 ,$28.00 ,$90.00 ,$10.60 ,$5.19 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100750,84478,HC TRIGLYCERIDES,301,1 ,$116.00 ,$83.52 ,$3.54 ,$116.00 ,$75.40 ,$5.63 ,$32.48 ,$64.15 ,$5.63 ,$67.51 ,$5.63 ,$60.78 ,$5.63 ,$11.59 ,$106.72 ,$14.35 ,$5.63 ,$98.60 ,$104.40 ,$5.73 ,$87.00 ,$81.20 ,$81.20 ,$5.63 ,$81.20 ,$89.32 ,$89.32 ,$14.35 ,$98.60 ,$5.74 ,$5.74 ,$65.08 ,$48.02 ,$48.26 ,$3.58 ,$3.54 ,$5.91 ,$98.60 ,$12.34 ,$60.78 ,$32.48 ,$104.40 ,$11.48 ,$5.63 ,$75.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100758,84484,HC TROPONIN QN,301,1 ,$229.00 ,$164.88 ,$7.96 ,$229.00 ,$148.85 ,$12.22 ,$64.12 ,$126.64 ,$12.22 ,$133.28 ,$12.22 ,$120.00 ,$12.22 ,$25.19 ,$210.68 ,$31.18 ,$12.22 ,$194.65 ,$206.10 ,$12.47 ,$171.75 ,$160.30 ,$160.30 ,$12.22 ,$160.30 ,$176.33 ,$176.33 ,$31.18 ,$194.65 ,$12.47 ,$12.47 ,$128.47 ,$94.81 ,$95.26 ,$8.05 ,$7.96 ,$12.83 ,$194.65 ,$26.81 ,$120.00 ,$64.12 ,$206.10 ,$24.94 ,$12.22 ,$148.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100761,84520,HC BUN,301,1 ,$74.00 ,$53.28 ,$3.54 ,$74.00 ,$48.10 ,$3.87 ,$20.72 ,$40.92 ,$3.87 ,$43.07 ,$3.87 ,$38.78 ,$3.87 ,$7.98 ,$68.08 ,$9.88 ,$3.87 ,$62.90 ,$66.60 ,$3.95 ,$55.50 ,$51.80 ,$51.80 ,$3.87 ,$51.80 ,$56.98 ,$56.98 ,$9.88 ,$62.90 ,$3.95 ,$3.95 ,$41.51 ,$30.64 ,$30.78 ,$3.58 ,$3.54 ,$4.07 ,$62.90 ,$8.49 ,$38.78 ,$20.72 ,$66.60 ,$7.90 ,$3.87 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100765,84550,HC URIC ACID,301,1 ,$96.00 ,$69.12 ,$3.54 ,$96.00 ,$62.40 ,$4.43 ,$26.88 ,$53.09 ,$4.43 ,$55.87 ,$4.43 ,$50.30 ,$4.43 ,$9.13 ,$88.32 ,$11.30 ,$4.43 ,$81.60 ,$86.40 ,$4.52 ,$72.00 ,$67.20 ,$67.20 ,$4.43 ,$67.20 ,$73.92 ,$73.92 ,$11.30 ,$81.60 ,$4.52 ,$4.52 ,$53.86 ,$39.74 ,$39.94 ,$3.58 ,$3.54 ,$4.65 ,$81.60 ,$9.72 ,$50.30 ,$26.88 ,$86.40 ,$9.04 ,$4.43 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100802,84702,HC HCG QN,301,1 ,$230.00 ,$165.60 ,$10.72 ,$230.00 ,$149.50 ,$14.75 ,$64.40 ,$127.19 ,$14.75 ,$133.86 ,$14.75 ,$120.52 ,$14.75 ,$30.40 ,$211.60 ,$37.63 ,$14.75 ,$195.50 ,$207.00 ,$15.04 ,$172.50 ,$161.00 ,$161.00 ,$14.75 ,$161.00 ,$177.10 ,$177.10 ,$37.63 ,$195.50 ,$15.05 ,$15.05 ,$129.03 ,$95.22 ,$95.68 ,$10.84 ,$10.72 ,$15.48 ,$195.50 ,$32.36 ,$120.52 ,$64.40 ,$207.00 ,$30.10 ,$14.75 ,$149.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100808,84703,HC HCG QL,301,1 ,$147.00 ,$105.84 ,$7.37 ,$147.00 ,$95.55 ,$7.37 ,$41.16 ,$81.29 ,$7.37 ,$85.55 ,$7.37 ,$77.03 ,$7.37 ,$15.19 ,$135.24 ,$18.80 ,$7.37 ,$124.95 ,$132.30 ,$7.52 ,$110.25 ,$102.90 ,$102.90 ,$7.37 ,$102.90 ,$113.19 ,$113.19 ,$18.80 ,$124.95 ,$7.52 ,$7.52 ,$82.47 ,$60.86 ,$61.15 ,$8.05 ,$7.96 ,$7.74 ,$124.95 ,$16.17 ,$77.03 ,$41.16 ,$132.30 ,$15.04 ,$7.37 ,$95.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30100845,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$40.00 ,$28.80 ,$1.80 ,$40.00 ,$26.00 ,$4.94 ,$11.20 ,$22.12 ,$4.94 ,$23.28 ,$4.94 ,$20.96 ,$4.94 ,$10.18 ,$36.80 ,$12.60 ,$4.94 ,$34.00 ,$36.00 ,$5.04 ,$30.00 ,$28.00 ,$28.00 ,$4.94 ,$28.00 ,$30.80 ,$30.80 ,$12.60 ,$34.00 ,$5.04 ,$5.04 ,$22.44 ,$16.56 ,$16.64 ,$1.81 ,$1.80 ,$5.18 ,$34.00 ,$10.84 ,$20.96 ,$11.20 ,$36.00 ,$10.08 ,$4.94 ,$26.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101011,83630,HC LACTOFERRIN FECAL QL,301,1 ,$61.00 ,$43.92 ,$7.96 ,$61.00 ,$39.65 ,$19.31 ,$17.08 ,$33.73 ,$19.31 ,$35.50 ,$19.31 ,$31.96 ,$19.31 ,$39.79 ,$56.12 ,$49.25 ,$19.31 ,$51.85 ,$54.90 ,$19.69 ,$45.75 ,$42.70 ,$42.70 ,$19.31 ,$42.70 ,$46.97 ,$46.97 ,$49.25 ,$51.85 ,$19.70 ,$19.70 ,$34.22 ,$25.25 ,$25.38 ,$8.05 ,$7.96 ,$20.28 ,$51.85 ,$42.36 ,$31.96 ,$17.08 ,$54.90 ,$39.40 ,$19.31 ,$39.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$230.00 ,$165.60 ,$7.96 ,$230.00 ,$149.50 ,$18.92 ,$64.40 ,$127.19 ,$18.92 ,$133.86 ,$18.92 ,$120.52 ,$18.92 ,$39.01 ,$211.60 ,$48.28 ,$18.92 ,$195.50 ,$207.00 ,$19.31 ,$172.50 ,$161.00 ,$161.00 ,$18.92 ,$161.00 ,$177.10 ,$177.10 ,$48.28 ,$195.50 ,$19.31 ,$19.31 ,$129.03 ,$95.22 ,$95.68 ,$8.05 ,$7.96 ,$19.87 ,$195.50 ,$41.52 ,$120.52 ,$64.40 ,$207.00 ,$38.62 ,$18.92 ,$149.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101075,80048,HC BASIC METABOLIC PANEL,301,1 ,$283.00 ,$203.76 ,$7.27 ,$283.00 ,$183.95 ,$8.29 ,$79.24 ,$156.50 ,$8.29 ,$164.71 ,$8.29 ,$148.29 ,$8.29 ,$17.09 ,$260.36 ,$21.15 ,$8.29 ,$240.55 ,$254.70 ,$8.46 ,$212.25 ,$198.10 ,$198.10 ,$8.29 ,$198.10 ,$217.91 ,$217.91 ,$21.15 ,$240.55 ,$8.46 ,$8.46 ,$158.76 ,$117.16 ,$117.73 ,$7.34 ,$7.27 ,$8.70 ,$240.55 ,$18.19 ,$148.29 ,$79.24 ,$254.70 ,$16.92 ,$8.29 ,$183.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101078,80051,HC ELECTROLYTE PANEL,301,1 ,$214.00 ,$154.08 ,$6.87 ,$214.00 ,$139.10 ,$6.87 ,$59.92 ,$118.34 ,$6.87 ,$124.55 ,$6.87 ,$112.14 ,$6.87 ,$14.16 ,$196.88 ,$17.53 ,$6.87 ,$181.90 ,$192.60 ,$7.01 ,$160.50 ,$149.80 ,$149.80 ,$6.87 ,$149.80 ,$164.78 ,$164.78 ,$17.53 ,$181.90 ,$7.01 ,$7.01 ,$120.05 ,$88.60 ,$89.02 ,$7.34 ,$7.27 ,$7.21 ,$181.90 ,$15.07 ,$112.14 ,$59.92 ,$192.60 ,$14.02 ,$6.87 ,$139.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101080,80053,HC COMPREHENSIVE METABOLIC PANEL,301,1 ,$361.00 ,$259.92 ,$7.27 ,$361.00 ,$234.65 ,$10.35 ,$101.08 ,$199.63 ,$10.35 ,$210.10 ,$10.35 ,$189.16 ,$10.35 ,$21.33 ,$332.12 ,$26.40 ,$10.35 ,$306.85 ,$324.90 ,$10.55 ,$270.75 ,$252.70 ,$252.70 ,$10.35 ,$252.70 ,$277.97 ,$277.97 ,$26.40 ,$306.85 ,$10.56 ,$10.56 ,$202.52 ,$149.45 ,$150.18 ,$7.34 ,$7.27 ,$10.87 ,$306.85 ,$22.70 ,$189.16 ,$101.08 ,$324.90 ,$21.12 ,$10.35 ,$234.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101082,80061,HC LIPID PANEL,301,1 ,$283.00 ,$203.76 ,$7.27 ,$283.00 ,$183.95 ,$13.12 ,$79.24 ,$156.50 ,$13.12 ,$164.71 ,$13.12 ,$148.29 ,$13.12 ,$27.05 ,$260.36 ,$33.48 ,$13.12 ,$240.55 ,$254.70 ,$13.39 ,$212.25 ,$198.10 ,$198.10 ,$13.12 ,$198.10 ,$217.91 ,$217.91 ,$33.48 ,$240.55 ,$13.39 ,$13.39 ,$158.76 ,$117.16 ,$117.73 ,$7.34 ,$7.27 ,$13.78 ,$240.55 ,$28.79 ,$148.29 ,$79.24 ,$254.70 ,$26.78 ,$13.12 ,$183.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101084,80069,HC RENAL PANEL,301,1 ,$303.00 ,$218.16 ,$7.27 ,$303.00 ,$196.95 ,$8.51 ,$84.84 ,$167.56 ,$8.51 ,$176.35 ,$8.51 ,$158.77 ,$8.51 ,$17.53 ,$278.76 ,$21.70 ,$8.51 ,$257.55 ,$272.70 ,$8.67 ,$227.25 ,$212.10 ,$212.10 ,$8.51 ,$212.10 ,$233.31 ,$233.31 ,$21.70 ,$257.55 ,$8.68 ,$8.68 ,$169.98 ,$125.44 ,$126.05 ,$7.34 ,$7.27 ,$8.93 ,$257.55 ,$18.66 ,$158.77 ,$84.84 ,$272.70 ,$17.36 ,$8.51 ,$196.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101088,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$307.00 ,$221.04 ,$7.27 ,$307.00 ,$199.55 ,$8.01 ,$85.96 ,$169.77 ,$8.01 ,$178.67 ,$8.01 ,$160.87 ,$8.01 ,$16.50 ,$282.44 ,$20.43 ,$8.01 ,$260.95 ,$276.30 ,$8.16 ,$230.25 ,$214.90 ,$214.90 ,$8.01 ,$214.90 ,$236.39 ,$236.39 ,$20.43 ,$260.95 ,$8.17 ,$8.17 ,$172.23 ,$127.10 ,$127.71 ,$7.34 ,$7.27 ,$8.41 ,$260.95 ,$17.57 ,$160.87 ,$85.96 ,$276.30 ,$16.34 ,$8.01 ,$199.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101089,80150,HC AMIKACIN - 90,301,1 ,$99.00 ,$71.28 ,$9.15 ,$99.00 ,$64.35 ,$14.78 ,$27.72 ,$54.75 ,$14.78 ,$57.62 ,$14.78 ,$51.88 ,$14.78 ,$30.46 ,$91.08 ,$37.70 ,$14.78 ,$84.15 ,$89.10 ,$15.07 ,$74.25 ,$69.30 ,$69.30 ,$14.78 ,$69.30 ,$76.23 ,$76.23 ,$37.70 ,$84.15 ,$15.08 ,$15.08 ,$55.54 ,$40.99 ,$41.18 ,$9.24 ,$9.15 ,$15.51 ,$84.15 ,$32.42 ,$51.88 ,$27.72 ,$89.10 ,$30.16 ,$14.78 ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101091,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$222.00 ,$159.84 ,$9.15 ,$222.00 ,$144.30 ,$14.28 ,$62.16 ,$122.77 ,$14.28 ,$129.20 ,$14.28 ,$116.33 ,$14.28 ,$29.43 ,$204.24 ,$36.43 ,$14.28 ,$188.70 ,$199.80 ,$14.56 ,$166.50 ,$155.40 ,$155.40 ,$14.28 ,$155.40 ,$170.94 ,$170.94 ,$36.43 ,$188.70 ,$14.57 ,$14.57 ,$124.54 ,$91.91 ,$92.35 ,$9.24 ,$9.15 ,$14.99 ,$188.70 ,$31.33 ,$116.33 ,$62.16 ,$199.80 ,$29.14 ,$14.28 ,$144.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101092,80156,HC CARBAMAZEPINE TOTAL - 90,301,1 ,$170.00 ,$122.40 ,$9.15 ,$170.00 ,$110.50 ,$14.28 ,$47.60 ,$94.01 ,$14.28 ,$98.94 ,$14.28 ,$89.08 ,$14.28 ,$29.43 ,$156.40 ,$36.43 ,$14.28 ,$144.50 ,$153.00 ,$14.56 ,$127.50 ,$119.00 ,$119.00 ,$14.28 ,$119.00 ,$130.90 ,$130.90 ,$36.43 ,$144.50 ,$14.57 ,$14.57 ,$95.37 ,$70.38 ,$70.72 ,$9.24 ,$9.15 ,$14.99 ,$144.50 ,$31.33 ,$89.08 ,$47.60 ,$153.00 ,$29.14 ,$14.28 ,$110.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101093,80157,HC CARBAMAZEPINE FREE - 90,301,1 ,$93.00 ,$66.96 ,$9.15 ,$93.00 ,$60.45 ,$12.98 ,$26.04 ,$51.43 ,$12.98 ,$54.13 ,$12.98 ,$48.73 ,$12.98 ,$26.77 ,$85.56 ,$33.13 ,$12.98 ,$79.05 ,$83.70 ,$13.25 ,$69.75 ,$65.10 ,$65.10 ,$12.98 ,$65.10 ,$71.61 ,$71.61 ,$33.13 ,$79.05 ,$13.25 ,$13.25 ,$52.17 ,$38.50 ,$38.69 ,$9.24 ,$9.15 ,$13.63 ,$79.05 ,$28.49 ,$48.73 ,$26.04 ,$83.70 ,$26.50 ,$12.98 ,$60.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$242.00 ,$174.24 ,$9.15 ,$242.00 ,$157.30 ,$17.69 ,$67.76 ,$133.83 ,$17.69 ,$140.84 ,$17.69 ,$126.81 ,$17.69 ,$36.46 ,$222.64 ,$45.13 ,$17.69 ,$205.70 ,$217.80 ,$18.04 ,$181.50 ,$169.40 ,$169.40 ,$17.69 ,$169.40 ,$186.34 ,$186.34 ,$45.13 ,$205.70 ,$18.05 ,$18.05 ,$135.76 ,$100.19 ,$100.67 ,$9.24 ,$9.15 ,$18.57 ,$205.70 ,$38.81 ,$126.81 ,$67.76 ,$217.80 ,$36.10 ,$17.69 ,$157.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101096,80162,HC DIGOXIN LEVELS,301,1 ,$164.00 ,$118.08 ,$9.15 ,$164.00 ,$106.60 ,$13.01 ,$45.92 ,$90.69 ,$13.01 ,$95.45 ,$13.01 ,$85.94 ,$13.01 ,$26.83 ,$150.88 ,$33.20 ,$13.01 ,$139.40 ,$147.60 ,$13.28 ,$123.00 ,$114.80 ,$114.80 ,$13.01 ,$114.80 ,$126.28 ,$126.28 ,$33.20 ,$139.40 ,$13.28 ,$13.28 ,$92.00 ,$67.90 ,$68.22 ,$9.24 ,$9.15 ,$13.66 ,$139.40 ,$28.55 ,$85.94 ,$45.92 ,$147.60 ,$26.56 ,$13.01 ,$106.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101099,80168,HC ETHOSUXIMIDE - 90,301,1 ,$60.00 ,$43.20 ,$9.15 ,$60.00 ,$39.00 ,$16.01 ,$16.80 ,$33.18 ,$16.01 ,$34.92 ,$16.01 ,$31.44 ,$16.01 ,$33.01 ,$55.20 ,$40.85 ,$16.01 ,$51.00 ,$54.00 ,$16.34 ,$45.00 ,$42.00 ,$42.00 ,$16.01 ,$42.00 ,$46.20 ,$46.20 ,$40.85 ,$51.00 ,$16.34 ,$16.34 ,$33.66 ,$24.84 ,$24.96 ,$9.24 ,$9.15 ,$16.82 ,$51.00 ,$35.13 ,$31.44 ,$16.80 ,$54.00 ,$32.68 ,$16.01 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101100,80169,HC EVEROLIMUS - 90,301,1 ,$254.00 ,$182.88 ,$9.15 ,$254.00 ,$165.10 ,$13.46 ,$71.12 ,$140.46 ,$13.46 ,$147.83 ,$13.46 ,$133.10 ,$13.46 ,$27.73 ,$233.68 ,$34.33 ,$13.46 ,$215.90 ,$228.60 ,$13.72 ,$190.50 ,$177.80 ,$177.80 ,$13.46 ,$177.80 ,$195.58 ,$195.58 ,$34.33 ,$215.90 ,$13.73 ,$13.73 ,$142.49 ,$105.16 ,$105.66 ,$9.24 ,$9.15 ,$14.13 ,$215.90 ,$29.52 ,$133.10 ,$71.12 ,$228.60 ,$27.46 ,$13.46 ,$165.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101102,80171,HC GABAPENTIN PLASMA - 90,301,1 ,$152.00 ,$109.44 ,$9.15 ,$152.00 ,$98.80 ,$21.24 ,$42.56 ,$84.06 ,$21.24 ,$88.46 ,$21.24 ,$79.65 ,$21.24 ,$43.77 ,$139.84 ,$54.18 ,$21.24 ,$129.20 ,$136.80 ,$21.66 ,$114.00 ,$106.40 ,$106.40 ,$21.24 ,$106.40 ,$117.04 ,$117.04 ,$54.18 ,$129.20 ,$21.67 ,$21.67 ,$85.27 ,$62.93 ,$63.23 ,$9.24 ,$9.15 ,$22.29 ,$129.20 ,$46.59 ,$79.65 ,$42.56 ,$136.80 ,$43.34 ,$21.24 ,$98.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101104,80175,HC LAMOTRIGINE - 90,301,1 ,$156.00 ,$112.32 ,$9.15 ,$156.00 ,$101.40 ,$12.98 ,$43.68 ,$86.27 ,$12.98 ,$90.79 ,$12.98 ,$81.74 ,$12.98 ,$26.77 ,$143.52 ,$33.13 ,$12.98 ,$132.60 ,$140.40 ,$13.25 ,$117.00 ,$109.20 ,$109.20 ,$12.98 ,$109.20 ,$120.12 ,$120.12 ,$33.13 ,$132.60 ,$13.25 ,$13.25 ,$87.52 ,$64.58 ,$64.90 ,$9.24 ,$9.15 ,$13.63 ,$132.60 ,$28.49 ,$81.74 ,$43.68 ,$140.40 ,$26.50 ,$12.98 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101106,80177,HC LEVETIRACETAM - 90,301,1 ,$156.00 ,$112.32 ,$9.15 ,$156.00 ,$101.40 ,$12.98 ,$43.68 ,$86.27 ,$12.98 ,$90.79 ,$12.98 ,$81.74 ,$12.98 ,$26.77 ,$143.52 ,$33.13 ,$12.98 ,$132.60 ,$140.40 ,$13.25 ,$117.00 ,$109.20 ,$109.20 ,$12.98 ,$109.20 ,$120.12 ,$120.12 ,$33.13 ,$132.60 ,$13.25 ,$13.25 ,$87.52 ,$64.58 ,$64.90 ,$9.24 ,$9.15 ,$13.63 ,$132.60 ,$28.49 ,$81.74 ,$43.68 ,$140.40 ,$26.50 ,$12.98 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101107,80178,HC LITHIUM,301,1 ,$94.00 ,$67.68 ,$6.48 ,$94.00 ,$61.10 ,$6.48 ,$26.32 ,$51.98 ,$6.48 ,$54.71 ,$6.48 ,$49.26 ,$6.48 ,$13.35 ,$86.48 ,$16.53 ,$6.48 ,$79.90 ,$84.60 ,$6.61 ,$70.50 ,$65.80 ,$65.80 ,$6.48 ,$65.80 ,$72.38 ,$72.38 ,$16.53 ,$79.90 ,$6.61 ,$6.61 ,$52.73 ,$38.92 ,$39.10 ,$9.24 ,$9.15 ,$6.80 ,$79.90 ,$14.21 ,$49.26 ,$26.32 ,$84.60 ,$13.22 ,$6.48 ,$61.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$221.00 ,$159.12 ,$9.15 ,$221.00 ,$143.65 ,$12.98 ,$61.88 ,$122.21 ,$12.98 ,$128.62 ,$12.98 ,$115.80 ,$12.98 ,$26.77 ,$203.32 ,$33.13 ,$12.98 ,$187.85 ,$198.90 ,$13.25 ,$165.75 ,$154.70 ,$154.70 ,$12.98 ,$154.70 ,$170.17 ,$170.17 ,$33.13 ,$187.85 ,$13.25 ,$13.25 ,$123.98 ,$91.49 ,$91.94 ,$9.24 ,$9.15 ,$13.63 ,$187.85 ,$28.49 ,$115.80 ,$61.88 ,$198.90 ,$26.50 ,$12.98 ,$143.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$164.00 ,$118.08 ,$9.15 ,$164.00 ,$106.60 ,$14.99 ,$45.92 ,$90.69 ,$14.99 ,$95.45 ,$14.99 ,$85.94 ,$14.99 ,$30.91 ,$150.88 ,$38.25 ,$14.99 ,$139.40 ,$147.60 ,$15.30 ,$123.00 ,$114.80 ,$114.80 ,$14.99 ,$114.80 ,$126.28 ,$126.28 ,$38.25 ,$139.40 ,$15.30 ,$15.30 ,$92.00 ,$67.90 ,$68.22 ,$9.24 ,$9.15 ,$15.75 ,$139.40 ,$32.90 ,$85.94 ,$45.92 ,$147.60 ,$30.60 ,$14.99 ,$106.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101112,80185,HC PHENYTOIN TOTAL,301,1 ,$185.00 ,$133.20 ,$9.15 ,$185.00 ,$120.25 ,$12.98 ,$51.80 ,$102.31 ,$12.98 ,$107.67 ,$12.98 ,$96.94 ,$12.98 ,$26.77 ,$170.20 ,$33.13 ,$12.98 ,$157.25 ,$166.50 ,$13.25 ,$138.75 ,$129.50 ,$129.50 ,$12.98 ,$129.50 ,$142.45 ,$142.45 ,$33.13 ,$157.25 ,$13.25 ,$13.25 ,$103.79 ,$76.59 ,$76.96 ,$9.24 ,$9.15 ,$13.63 ,$157.25 ,$28.49 ,$96.94 ,$51.80 ,$166.50 ,$26.50 ,$12.98 ,$120.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101114,80186,HC PHENYTOIN FREE - 90,301,1 ,$60.00 ,$43.20 ,$9.15 ,$60.00 ,$39.00 ,$13.48 ,$16.80 ,$33.18 ,$13.48 ,$34.92 ,$13.48 ,$31.44 ,$13.48 ,$27.80 ,$55.20 ,$34.40 ,$13.48 ,$51.00 ,$54.00 ,$13.76 ,$45.00 ,$42.00 ,$42.00 ,$13.48 ,$42.00 ,$46.20 ,$46.20 ,$34.40 ,$51.00 ,$13.76 ,$13.76 ,$33.66 ,$24.84 ,$24.96 ,$9.24 ,$9.15 ,$14.16 ,$51.00 ,$29.58 ,$31.44 ,$16.80 ,$54.00 ,$27.52 ,$13.48 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101115,80188,HC PRIMIDONE - 90,301,1 ,$66.00 ,$47.52 ,$9.15 ,$66.00 ,$42.90 ,$16.26 ,$18.48 ,$36.50 ,$16.26 ,$38.41 ,$16.26 ,$34.58 ,$16.26 ,$33.51 ,$60.72 ,$41.48 ,$16.26 ,$56.10 ,$59.40 ,$16.58 ,$49.50 ,$46.20 ,$46.20 ,$16.26 ,$46.20 ,$50.82 ,$50.82 ,$41.48 ,$56.10 ,$16.59 ,$16.59 ,$37.03 ,$27.32 ,$27.46 ,$9.24 ,$9.15 ,$17.07 ,$56.10 ,$35.67 ,$34.58 ,$18.48 ,$59.40 ,$33.18 ,$16.26 ,$42.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101116,80192,HC PROCAINEAMIDE - 90,301,1 ,$61.00 ,$43.92 ,$9.15 ,$61.00 ,$39.65 ,$16.41 ,$17.08 ,$33.73 ,$16.41 ,$35.50 ,$16.41 ,$31.96 ,$16.41 ,$33.84 ,$56.12 ,$41.88 ,$16.41 ,$51.85 ,$54.90 ,$16.75 ,$45.75 ,$42.70 ,$42.70 ,$16.41 ,$42.70 ,$46.97 ,$46.97 ,$41.88 ,$51.85 ,$16.75 ,$16.75 ,$34.22 ,$25.25 ,$25.38 ,$9.24 ,$9.15 ,$17.24 ,$51.85 ,$36.01 ,$31.96 ,$17.08 ,$54.90 ,$33.50 ,$16.41 ,$39.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$93.00 ,$66.96 ,$9.15 ,$93.00 ,$60.45 ,$13.46 ,$26.04 ,$51.43 ,$13.46 ,$54.13 ,$13.46 ,$48.73 ,$13.46 ,$27.73 ,$85.56 ,$34.33 ,$13.46 ,$79.05 ,$83.70 ,$13.72 ,$69.75 ,$65.10 ,$65.10 ,$13.46 ,$65.10 ,$71.61 ,$71.61 ,$34.33 ,$79.05 ,$13.73 ,$13.73 ,$52.17 ,$38.50 ,$38.69 ,$9.24 ,$9.15 ,$14.13 ,$79.05 ,$29.52 ,$48.73 ,$26.04 ,$83.70 ,$27.46 ,$13.46 ,$60.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101119,80197,HC TACROLIMUS - 90,301,1 ,$441.00 ,$317.52 ,$9.15 ,$441.00 ,$286.65 ,$13.46 ,$123.48 ,$243.87 ,$13.46 ,$256.66 ,$13.46 ,$231.08 ,$13.46 ,$27.73 ,$405.72 ,$34.33 ,$13.46 ,$374.85 ,$396.90 ,$13.72 ,$330.75 ,$308.70 ,$308.70 ,$13.46 ,$308.70 ,$339.57 ,$339.57 ,$34.33 ,$374.85 ,$13.73 ,$13.73 ,$247.40 ,$182.57 ,$183.46 ,$9.24 ,$9.15 ,$14.13 ,$374.85 ,$29.52 ,$231.08 ,$123.48 ,$396.90 ,$27.46 ,$13.46 ,$286.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101121,80199,HC TIAGABINE - 90,301,1 ,$117.00 ,$84.24 ,$9.15 ,$117.00 ,$76.05 ,$26.57 ,$32.76 ,$64.70 ,$26.57 ,$68.09 ,$26.57 ,$61.31 ,$26.57 ,$54.76 ,$107.64 ,$67.78 ,$26.57 ,$99.45 ,$105.30 ,$27.10 ,$87.75 ,$81.90 ,$81.90 ,$26.57 ,$81.90 ,$90.09 ,$90.09 ,$67.78 ,$99.45 ,$27.11 ,$27.11 ,$65.64 ,$48.44 ,$48.67 ,$9.24 ,$9.15 ,$27.90 ,$99.45 ,$58.29 ,$61.31 ,$32.76 ,$105.30 ,$54.22 ,$26.57 ,$76.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101124,80201,HC TOPIRAMATE - 90,301,1 ,$184.00 ,$132.48 ,$9.15 ,$184.00 ,$119.60 ,$11.68 ,$51.52 ,$101.75 ,$11.68 ,$107.09 ,$11.68 ,$96.42 ,$11.68 ,$24.08 ,$169.28 ,$29.80 ,$11.68 ,$156.40 ,$165.60 ,$11.92 ,$138.00 ,$128.80 ,$128.80 ,$11.68 ,$128.80 ,$141.68 ,$141.68 ,$29.80 ,$156.40 ,$11.92 ,$11.92 ,$103.22 ,$76.18 ,$76.54 ,$9.24 ,$9.15 ,$12.27 ,$156.40 ,$25.63 ,$96.42 ,$51.52 ,$165.60 ,$23.84 ,$11.68 ,$119.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101125,80202,HC VANCOMYCIN,301,1 ,$205.00 ,$147.60 ,$9.15 ,$205.00 ,$133.25 ,$13.27 ,$57.40 ,$113.37 ,$13.27 ,$119.31 ,$13.27 ,$107.42 ,$13.27 ,$27.35 ,$188.60 ,$33.85 ,$13.27 ,$174.25 ,$184.50 ,$13.53 ,$153.75 ,$143.50 ,$143.50 ,$13.27 ,$143.50 ,$157.85 ,$157.85 ,$33.85 ,$174.25 ,$13.54 ,$13.54 ,$115.01 ,$84.87 ,$85.28 ,$9.24 ,$9.15 ,$13.94 ,$174.25 ,$29.11 ,$107.42 ,$57.40 ,$184.50 ,$27.08 ,$13.27 ,$133.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101126,80203,HC ZONISAMIDE - 90,301,1 ,$135.00 ,$97.20 ,$9.15 ,$135.00 ,$87.75 ,$12.98 ,$37.80 ,$74.66 ,$12.98 ,$78.57 ,$12.98 ,$70.74 ,$12.98 ,$26.77 ,$124.20 ,$33.13 ,$12.98 ,$114.75 ,$121.50 ,$13.25 ,$101.25 ,$94.50 ,$94.50 ,$12.98 ,$94.50 ,$103.95 ,$103.95 ,$33.13 ,$114.75 ,$13.25 ,$13.25 ,$75.74 ,$55.89 ,$56.16 ,$9.24 ,$9.15 ,$13.63 ,$114.75 ,$28.49 ,$70.74 ,$37.80 ,$121.50 ,$26.50 ,$12.98 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$161.00 ,$115.92 ,$9.15 ,$161.00 ,$104.65 ,$18.27 ,$45.08 ,$89.03 ,$18.27 ,$93.70 ,$18.27 ,$84.36 ,$18.27 ,$37.65 ,$148.12 ,$46.60 ,$18.27 ,$136.85 ,$144.90 ,$18.63 ,$120.75 ,$112.70 ,$112.70 ,$18.27 ,$112.70 ,$123.97 ,$123.97 ,$46.60 ,$136.85 ,$18.64 ,$18.64 ,$90.32 ,$66.65 ,$66.98 ,$9.24 ,$9.15 ,$19.18 ,$136.85 ,$40.08 ,$84.36 ,$45.08 ,$144.90 ,$37.28 ,$18.27 ,$104.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101137,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4,301,1 ,$198.00 ,$142.56 ,$21.44 ,$198.00 ,$128.70 ,$60.90 ,$55.44 ,$109.49 ,$60.90 ,$115.24 ,$60.90 ,$103.75 ,$60.90 ,$125.52 ,$182.16 ,$155.35 ,$60.90 ,$168.30 ,$178.20 ,$62.11 ,$148.50 ,$138.60 ,$138.60 ,$60.90 ,$138.60 ,$152.46 ,$152.46 ,$155.35 ,$168.30 ,$62.14 ,$62.14 ,$111.08 ,$81.97 ,$82.37 ,$21.67 ,$21.44 ,$63.94 ,$168.30 ,$133.60 ,$103.75 ,$55.44 ,$178.20 ,$124.28 ,$60.90 ,$128.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$192.00 ,$138.24 ,$21.44 ,$192.00 ,$124.80 ,$60.90 ,$53.76 ,$106.18 ,$60.90 ,$111.74 ,$60.90 ,$100.61 ,$60.90 ,$125.52 ,$176.64 ,$155.35 ,$60.90 ,$163.20 ,$172.80 ,$62.11 ,$144.00 ,$134.40 ,$134.40 ,$60.90 ,$134.40 ,$147.84 ,$147.84 ,$155.35 ,$163.20 ,$62.14 ,$62.14 ,$107.71 ,$79.49 ,$79.87 ,$21.67 ,$21.44 ,$63.94 ,$163.20 ,$133.60 ,$100.61 ,$53.76 ,$172.80 ,$124.28 ,$60.90 ,$124.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101143,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T4-90,301,1 ,$350.00 ,$252.00 ,$21.44 ,$350.00 ,$227.50 ,$60.90 ,$98.00 ,$193.55 ,$60.90 ,$203.70 ,$60.90 ,$183.40 ,$60.90 ,$125.52 ,$322.00 ,$155.35 ,$60.90 ,$297.50 ,$315.00 ,$62.11 ,$262.50 ,$245.00 ,$245.00 ,$60.90 ,$245.00 ,$269.50 ,$269.50 ,$155.35 ,$297.50 ,$62.14 ,$62.14 ,$196.35 ,$144.90 ,$145.60 ,$21.67 ,$21.44 ,$63.94 ,$297.50 ,$133.60 ,$183.40 ,$98.00 ,$315.00 ,$124.28 ,$60.90 ,$227.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101146,80323,HC NICOTINE - 90,301,1 ,$400.00 ,$288.00 ,$21.44 ,$400.00 ,$260.00 , N/A ,$112.00 ,$221.20 , N/A ,$232.80 , N/A ,$209.60 , N/A , N/A ,$368.00 , N/A , N/A ,$340.00 ,$360.00 , N/A ,$300.00 ,$280.00 ,$280.00 , N/A ,$280.00 ,$308.00 ,$308.00 , N/A ,$340.00 , N/A , N/A ,$224.40 ,$165.60 ,$166.40 ,$21.67 ,$21.44 , N/A ,$340.00 , N/A ,$209.60 ,$112.00 ,$360.00 , N/A , N/A ,$260.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101147,80323,HC NICOTINE URINE - 90,301,1 ,$400.00 ,$288.00 ,$21.44 ,$400.00 ,$260.00 , N/A ,$112.00 ,$221.20 , N/A ,$232.80 , N/A ,$209.60 , N/A , N/A ,$368.00 , N/A , N/A ,$340.00 ,$360.00 , N/A ,$300.00 ,$280.00 ,$280.00 , N/A ,$280.00 ,$308.00 ,$308.00 , N/A ,$340.00 , N/A , N/A ,$224.40 ,$165.60 ,$166.40 ,$21.67 ,$21.44 , N/A ,$340.00 , N/A ,$209.60 ,$112.00 ,$360.00 , N/A , N/A ,$260.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101158,82024,HC ACTH -90,301,1 ,$301.00 ,$216.72 ,$18.64 ,$301.00 ,$195.65 ,$37.85 ,$84.28 ,$166.45 ,$37.85 ,$175.18 ,$37.85 ,$157.72 ,$37.85 ,$78.01 ,$276.92 ,$96.55 ,$37.85 ,$255.85 ,$270.90 ,$38.60 ,$225.75 ,$210.70 ,$210.70 ,$37.85 ,$210.70 ,$231.77 ,$231.77 ,$96.55 ,$255.85 ,$38.62 ,$38.62 ,$168.86 ,$124.61 ,$125.22 ,$18.85 ,$18.64 ,$39.74 ,$255.85 ,$83.03 ,$157.72 ,$84.28 ,$270.90 ,$77.24 ,$37.85 ,$195.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101159,82040,HC ALBUMIN-90,301,1 ,$78.00 ,$56.16 ,$3.54 ,$78.00 ,$50.70 ,$4.85 ,$21.84 ,$43.13 ,$4.85 ,$45.40 ,$4.85 ,$40.87 ,$4.85 ,$10.00 ,$71.76 ,$12.38 ,$4.85 ,$66.30 ,$70.20 ,$4.95 ,$58.50 ,$54.60 ,$54.60 ,$4.85 ,$54.60 ,$60.06 ,$60.06 ,$12.38 ,$66.30 ,$4.95 ,$4.95 ,$43.76 ,$32.29 ,$32.45 ,$3.58 ,$3.54 ,$5.10 ,$66.30 ,$10.64 ,$40.87 ,$21.84 ,$70.20 ,$9.90 ,$4.85 ,$50.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101160,82042,HC ALBUMIN OTHER SOURCE-90,301,1 ,$35.00 ,$25.20 ,$3.54 ,$35.00 ,$22.75 ,$7.62 ,$9.80 ,$19.36 ,$7.62 ,$20.37 ,$7.62 ,$18.34 ,$7.62 ,$15.72 ,$32.20 ,$19.45 ,$7.62 ,$29.75 ,$31.50 ,$7.78 ,$26.25 ,$24.50 ,$24.50 ,$7.62 ,$24.50 ,$26.95 ,$26.95 ,$19.45 ,$29.75 ,$7.78 ,$7.78 ,$19.64 ,$14.49 ,$14.56 ,$3.58 ,$3.54 ,$8.01 ,$29.75 ,$16.73 ,$18.34 ,$9.80 ,$31.50 ,$15.56 ,$7.62 ,$22.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101162,82085,HC ALDOLASE-90,301,1 ,$122.00 ,$87.84 ,$7.96 ,$122.00 ,$79.30 ,$9.52 ,$34.16 ,$67.47 ,$9.52 ,$71.00 ,$9.52 ,$63.93 ,$9.52 ,$19.61 ,$112.24 ,$24.28 ,$9.52 ,$103.70 ,$109.80 ,$9.70 ,$91.50 ,$85.40 ,$85.40 ,$9.52 ,$85.40 ,$93.94 ,$93.94 ,$24.28 ,$103.70 ,$9.71 ,$9.71 ,$68.44 ,$50.51 ,$50.75 ,$8.05 ,$7.96 ,$10.00 ,$103.70 ,$20.88 ,$63.93 ,$34.16 ,$109.80 ,$19.42 ,$9.52 ,$79.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101163,82088,HC ALDOSTERONE-90,301,1 ,$199.00 ,$143.28 ,$18.64 ,$199.00 ,$129.35 ,$39.93 ,$55.72 ,$110.05 ,$39.93 ,$115.82 ,$39.93 ,$104.28 ,$39.93 ,$82.32 ,$183.08 ,$101.88 ,$39.93 ,$169.15 ,$179.10 ,$40.74 ,$149.25 ,$139.30 ,$139.30 ,$39.93 ,$139.30 ,$153.23 ,$153.23 ,$101.88 ,$169.15 ,$40.75 ,$40.75 ,$111.64 ,$82.39 ,$82.78 ,$18.85 ,$18.64 ,$41.93 ,$169.15 ,$87.61 ,$104.28 ,$55.72 ,$179.10 ,$81.50 ,$39.93 ,$129.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$135.00 ,$97.20 ,$7.96 ,$135.00 ,$87.75 ,$13.17 ,$37.80 ,$74.66 ,$13.17 ,$78.57 ,$13.17 ,$70.74 ,$13.17 ,$27.15 ,$124.20 ,$33.60 ,$13.17 ,$114.75 ,$121.50 ,$13.44 ,$101.25 ,$94.50 ,$94.50 ,$13.17 ,$94.50 ,$103.95 ,$103.95 ,$33.60 ,$114.75 ,$13.44 ,$13.44 ,$75.74 ,$55.89 ,$56.16 ,$8.05 ,$7.96 ,$13.83 ,$114.75 ,$28.90 ,$70.74 ,$37.80 ,$121.50 ,$26.88 ,$13.17 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$163.00 ,$117.36 ,$7.96 ,$163.00 ,$105.95 ,$14.17 ,$45.64 ,$90.14 ,$14.17 ,$94.87 ,$14.17 ,$85.41 ,$14.17 ,$29.21 ,$149.96 ,$36.15 ,$14.17 ,$138.55 ,$146.70 ,$14.45 ,$122.25 ,$114.10 ,$114.10 ,$14.17 ,$114.10 ,$125.51 ,$125.51 ,$36.15 ,$138.55 ,$14.46 ,$14.46 ,$91.44 ,$67.48 ,$67.81 ,$8.05 ,$7.96 ,$14.88 ,$138.55 ,$31.09 ,$85.41 ,$45.64 ,$146.70 ,$28.92 ,$14.17 ,$105.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$229.00 ,$164.88 ,$7.96 ,$229.00 ,$148.85 ,$16.43 ,$64.12 ,$126.64 ,$16.43 ,$133.28 ,$16.43 ,$120.00 ,$16.43 ,$33.88 ,$210.68 ,$41.93 ,$16.43 ,$194.65 ,$206.10 ,$16.77 ,$171.75 ,$160.30 ,$160.30 ,$16.43 ,$160.30 ,$176.33 ,$176.33 ,$41.93 ,$194.65 ,$16.77 ,$16.77 ,$128.47 ,$94.81 ,$95.26 ,$8.05 ,$7.96 ,$17.26 ,$194.65 ,$36.06 ,$120.00 ,$64.12 ,$206.10 ,$33.54 ,$16.43 ,$148.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101169,82108,HC ALUMINUM-90,301,1 ,$19.00 ,$13.68 ,$5.32 ,$47.50 ,$12.35 ,$18.62 ,$5.32 ,$10.51 ,$18.62 ,$11.06 ,$18.62 ,$9.96 ,$18.62 ,$19.00 ,$17.48 ,$47.50 ,$18.62 ,$16.15 ,$17.10 ,$18.62 ,$14.25 ,$13.30 ,$13.30 ,$18.62 ,$13.30 ,$14.63 ,$14.63 ,$19.00 ,$16.15 ,$19.00 ,$19.00 ,$10.66 ,$7.87 ,$7.90 ,$9.82 ,$9.71 ,$19.55 ,$16.15 ,$40.85 ,$9.96 ,$5.32 ,$17.10 ,$19.00 ,$18.62 ,$12.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$71.00 ,$51.12 ,$7.96 ,$71.00 ,$46.15 ,$22.52 ,$19.88 ,$39.26 ,$22.52 ,$41.32 ,$22.52 ,$37.20 ,$22.52 ,$46.42 ,$65.32 ,$57.45 ,$22.52 ,$60.35 ,$63.90 ,$22.97 ,$53.25 ,$49.70 ,$49.70 ,$22.52 ,$49.70 ,$54.67 ,$54.67 ,$57.45 ,$60.35 ,$22.98 ,$22.98 ,$39.83 ,$29.39 ,$29.54 ,$8.05 ,$7.96 ,$23.65 ,$60.35 ,$49.41 ,$37.20 ,$19.88 ,$63.90 ,$45.96 ,$22.52 ,$46.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$371.00 ,$267.12 ,$7.96 ,$371.00 ,$241.15 ,$16.53 ,$103.88 ,$205.16 ,$16.53 ,$215.92 ,$16.53 ,$194.40 ,$16.53 ,$34.08 ,$341.32 ,$42.18 ,$16.53 ,$315.35 ,$333.90 ,$16.87 ,$278.25 ,$259.70 ,$259.70 ,$16.53 ,$259.70 ,$285.67 ,$285.67 ,$42.18 ,$315.35 ,$16.87 ,$16.87 ,$208.13 ,$153.59 ,$154.34 ,$8.05 ,$7.96 ,$17.36 ,$315.35 ,$36.27 ,$194.40 ,$103.88 ,$333.90 ,$33.74 ,$16.53 ,$241.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101176,82140,HC AMMONIA-90,301,1 ,$215.00 ,$154.80 ,$7.96 ,$215.00 ,$139.75 ,$14.28 ,$60.20 ,$118.90 ,$14.28 ,$125.13 ,$14.28 ,$112.66 ,$14.28 ,$29.43 ,$197.80 ,$36.43 ,$14.28 ,$182.75 ,$193.50 ,$14.56 ,$161.25 ,$150.50 ,$150.50 ,$14.28 ,$150.50 ,$165.55 ,$165.55 ,$36.43 ,$182.75 ,$14.57 ,$14.57 ,$120.62 ,$89.01 ,$89.44 ,$8.05 ,$7.96 ,$14.99 ,$182.75 ,$31.33 ,$112.66 ,$60.20 ,$193.50 ,$29.14 ,$14.28 ,$139.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101177,82150,HC AMYLASE-90,301,1 ,$130.00 ,$93.60 ,$6.35 ,$130.00 ,$84.50 ,$6.35 ,$36.40 ,$71.89 ,$6.35 ,$75.66 ,$6.35 ,$68.12 ,$6.35 ,$13.09 ,$119.60 ,$16.20 ,$6.35 ,$110.50 ,$117.00 ,$6.48 ,$97.50 ,$91.00 ,$91.00 ,$6.35 ,$91.00 ,$100.10 ,$100.10 ,$16.20 ,$110.50 ,$6.48 ,$6.48 ,$72.93 ,$53.82 ,$54.08 ,$8.05 ,$7.96 ,$6.66 ,$110.50 ,$13.93 ,$68.12 ,$36.40 ,$117.00 ,$12.96 ,$6.35 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$113.00 ,$81.36 ,$18.64 ,$113.00 ,$73.45 ,$28.69 ,$31.64 ,$62.49 ,$28.69 ,$65.77 ,$28.69 ,$59.21 ,$28.69 ,$59.15 ,$103.96 ,$73.20 ,$28.69 ,$96.05 ,$101.70 ,$29.27 ,$84.75 ,$79.10 ,$79.10 ,$28.69 ,$79.10 ,$87.01 ,$87.01 ,$73.20 ,$96.05 ,$29.28 ,$29.28 ,$63.39 ,$46.78 ,$47.01 ,$18.85 ,$18.64 ,$30.13 ,$96.05 ,$62.95 ,$59.21 ,$31.64 ,$101.70 ,$58.56 ,$28.69 ,$73.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$100.00 ,$72.00 ,$7.96 ,$100.00 ,$65.00 ,$14.31 ,$28.00 ,$55.30 ,$14.31 ,$58.20 ,$14.31 ,$52.40 ,$14.31 ,$29.49 ,$92.00 ,$36.50 ,$14.31 ,$85.00 ,$90.00 ,$14.59 ,$75.00 ,$70.00 ,$70.00 ,$14.31 ,$70.00 ,$77.00 ,$77.00 ,$36.50 ,$85.00 ,$14.60 ,$14.60 ,$56.10 ,$41.40 ,$41.60 ,$8.05 ,$7.96 ,$15.02 ,$85.00 ,$31.39 ,$52.40 ,$28.00 ,$90.00 ,$29.20 ,$14.31 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$60.00 ,$43.20 ,$7.96 ,$60.00 ,$39.00 ,$20.67 ,$16.80 ,$33.18 ,$20.67 ,$34.92 ,$20.67 ,$31.44 ,$20.67 ,$42.60 ,$55.20 ,$52.73 ,$20.67 ,$51.00 ,$54.00 ,$21.08 ,$45.00 ,$42.00 ,$42.00 ,$20.67 ,$42.00 ,$46.20 ,$46.20 ,$52.73 ,$51.00 ,$21.09 ,$21.09 ,$33.66 ,$24.84 ,$24.96 ,$8.05 ,$7.96 ,$21.70 ,$51.00 ,$45.34 ,$31.44 ,$16.80 ,$54.00 ,$42.18 ,$20.67 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101181,82175,HC ARSENIC-90,301,1 ,$75.00 ,$54.00 ,$9.71 ,$75.00 ,$48.75 ,$18.59 ,$21.00 ,$41.48 ,$18.59 ,$43.65 ,$18.59 ,$39.30 ,$18.59 ,$38.32 ,$69.00 ,$47.43 ,$18.59 ,$63.75 ,$67.50 ,$18.96 ,$56.25 ,$52.50 ,$52.50 ,$18.59 ,$52.50 ,$57.75 ,$57.75 ,$47.43 ,$63.75 ,$18.97 ,$18.97 ,$42.08 ,$31.05 ,$31.20 ,$9.82 ,$9.71 ,$19.52 ,$63.75 ,$40.79 ,$39.30 ,$21.00 ,$67.50 ,$37.94 ,$18.59 ,$48.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101182,82180,HC VITAMIN C (ASCORBIC ACID)-90,301,1 ,$60.00 ,$43.20 ,$7.96 ,$60.00 ,$39.00 ,$9.69 ,$16.80 ,$33.18 ,$9.69 ,$34.92 ,$9.69 ,$31.44 ,$9.69 ,$19.98 ,$55.20 ,$24.73 ,$9.69 ,$51.00 ,$54.00 ,$9.89 ,$45.00 ,$42.00 ,$42.00 ,$9.69 ,$42.00 ,$46.20 ,$46.20 ,$24.73 ,$51.00 ,$9.89 ,$9.89 ,$33.66 ,$24.84 ,$24.96 ,$8.05 ,$7.96 ,$10.17 ,$51.00 ,$21.26 ,$31.44 ,$16.80 ,$54.00 ,$19.78 ,$9.69 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$114.00 ,$82.08 ,$15.86 ,$114.00 ,$74.10 ,$15.86 ,$31.92 ,$63.04 ,$15.86 ,$66.35 ,$15.86 ,$59.74 ,$15.86 ,$32.68 ,$104.88 ,$40.45 ,$15.86 ,$96.90 ,$102.60 ,$16.17 ,$85.50 ,$79.80 ,$79.80 ,$15.86 ,$79.80 ,$87.78 ,$87.78 ,$40.45 ,$96.90 ,$16.18 ,$16.18 ,$63.95 ,$47.20 ,$47.42 ,$18.85 ,$18.64 ,$16.65 ,$96.90 ,$34.79 ,$59.74 ,$31.92 ,$102.60 ,$32.36 ,$15.86 ,$74.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101191,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$67.00 ,$48.24 ,$3.54 ,$67.00 ,$43.55 ,$5.21 ,$18.76 ,$37.05 ,$5.21 ,$38.99 ,$5.21 ,$35.11 ,$5.21 ,$10.75 ,$61.64 ,$13.30 ,$5.21 ,$56.95 ,$60.30 ,$5.32 ,$50.25 ,$46.90 ,$46.90 ,$5.21 ,$46.90 ,$51.59 ,$51.59 ,$13.30 ,$56.95 ,$5.32 ,$5.32 ,$37.59 ,$27.74 ,$27.87 ,$3.58 ,$3.54 ,$5.48 ,$56.95 ,$11.44 ,$35.11 ,$18.76 ,$60.30 ,$10.64 ,$5.21 ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101196,82300,HC CADMIUM-90,301,1 ,$69.00 ,$49.68 ,$9.71 ,$69.00 ,$44.85 ,$23.17 ,$19.32 ,$38.16 ,$23.17 ,$40.16 ,$23.17 ,$36.16 ,$23.17 ,$47.75 ,$63.48 ,$59.10 ,$23.17 ,$58.65 ,$62.10 ,$23.63 ,$51.75 ,$48.30 ,$48.30 ,$23.17 ,$48.30 ,$53.13 ,$53.13 ,$59.10 ,$58.65 ,$23.64 ,$23.64 ,$38.71 ,$28.57 ,$28.70 ,$9.82 ,$9.71 ,$24.32 ,$58.65 ,$50.83 ,$36.16 ,$19.32 ,$62.10 ,$47.28 ,$23.17 ,$44.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101197,82306,HC VITAMIN D 25 OH-90,301,1 ,$110.00 ,$79.20 ,$21.44 ,$110.00 ,$71.50 ,$29.01 ,$30.80 ,$60.83 ,$29.01 ,$64.02 ,$29.01 ,$57.64 ,$29.01 ,$59.79 ,$101.20 ,$74.00 ,$29.01 ,$93.50 ,$99.00 ,$29.59 ,$82.50 ,$77.00 ,$77.00 ,$29.01 ,$77.00 ,$84.70 ,$84.70 ,$74.00 ,$93.50 ,$29.60 ,$29.60 ,$61.71 ,$45.54 ,$45.76 ,$21.67 ,$21.44 ,$30.46 ,$93.50 ,$63.64 ,$57.64 ,$30.80 ,$99.00 ,$59.20 ,$29.01 ,$71.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101199,82308,HC CALCITONIN-90,301,1 ,$81.00 ,$58.32 ,$18.64 ,$81.00 ,$52.65 ,$26.25 ,$22.68 ,$44.79 ,$26.25 ,$47.14 ,$26.25 ,$42.44 ,$26.25 ,$54.12 ,$74.52 ,$66.98 ,$26.25 ,$68.85 ,$72.90 ,$26.78 ,$60.75 ,$56.70 ,$56.70 ,$26.25 ,$56.70 ,$62.37 ,$62.37 ,$66.98 ,$68.85 ,$26.79 ,$26.79 ,$45.44 ,$33.53 ,$33.70 ,$18.85 ,$18.64 ,$27.57 ,$68.85 ,$57.60 ,$42.44 ,$22.68 ,$72.90 ,$53.58 ,$26.25 ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101203,82340,HC CALCIUM URINE QN TIMED-90,301,1 ,$159.00 ,$114.48 ,$5.91 ,$159.00 ,$103.35 ,$5.91 ,$44.52 ,$87.93 ,$5.91 ,$92.54 ,$5.91 ,$83.32 ,$5.91 ,$12.18 ,$146.28 ,$15.08 ,$5.91 ,$135.15 ,$143.10 ,$6.03 ,$119.25 ,$111.30 ,$111.30 ,$5.91 ,$111.30 ,$122.43 ,$122.43 ,$15.08 ,$135.15 ,$6.03 ,$6.03 ,$89.20 ,$65.83 ,$66.14 ,$8.05 ,$7.96 ,$6.20 ,$135.15 ,$12.96 ,$83.32 ,$44.52 ,$143.10 ,$12.06 ,$5.91 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$43.00 ,$30.96 ,$7.96 ,$43.00 ,$27.95 ,$12.64 ,$12.04 ,$23.78 ,$12.64 ,$25.03 ,$12.64 ,$22.53 ,$12.64 ,$26.06 ,$39.56 ,$32.25 ,$12.64 ,$36.55 ,$38.70 ,$12.90 ,$32.25 ,$30.10 ,$30.10 ,$12.64 ,$30.10 ,$33.11 ,$33.11 ,$32.25 ,$36.55 ,$12.90 ,$12.90 ,$24.12 ,$17.80 ,$17.89 ,$8.05 ,$7.96 ,$13.28 ,$36.55 ,$27.74 ,$22.53 ,$12.04 ,$38.70 ,$25.80 ,$12.64 ,$27.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$224.00 ,$161.28 ,$7.96 ,$224.00 ,$145.60 ,$16.53 ,$62.72 ,$123.87 ,$16.53 ,$130.37 ,$16.53 ,$117.38 ,$16.53 ,$34.08 ,$206.08 ,$42.18 ,$16.53 ,$190.40 ,$201.60 ,$16.87 ,$168.00 ,$156.80 ,$156.80 ,$16.53 ,$156.80 ,$172.48 ,$172.48 ,$42.18 ,$190.40 ,$16.87 ,$16.87 ,$125.66 ,$92.74 ,$93.18 ,$8.05 ,$7.96 ,$17.36 ,$190.40 ,$36.27 ,$117.38 ,$62.72 ,$201.60 ,$33.74 ,$16.53 ,$145.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101210,82380,HC CAROTENE-90,301,1 ,$60.00 ,$43.20 ,$7.96 ,$60.00 ,$39.00 ,$9.04 ,$16.80 ,$33.18 ,$9.04 ,$34.92 ,$9.04 ,$31.44 ,$9.04 ,$18.62 ,$55.20 ,$23.05 ,$9.04 ,$51.00 ,$54.00 ,$9.21 ,$45.00 ,$42.00 ,$42.00 ,$9.04 ,$42.00 ,$46.20 ,$46.20 ,$23.05 ,$51.00 ,$9.22 ,$9.22 ,$33.66 ,$24.84 ,$24.96 ,$8.05 ,$7.96 ,$9.49 ,$51.00 ,$19.82 ,$31.44 ,$16.80 ,$54.00 ,$18.44 ,$9.04 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$372.00 ,$267.84 ,$18.64 ,$372.00 ,$241.80 ,$24.74 ,$104.16 ,$205.72 ,$24.74 ,$216.50 ,$24.74 ,$194.93 ,$24.74 ,$51.01 ,$342.24 ,$63.13 ,$24.74 ,$316.20 ,$334.80 ,$25.24 ,$279.00 ,$260.40 ,$260.40 ,$24.74 ,$260.40 ,$286.44 ,$286.44 ,$63.13 ,$316.20 ,$25.25 ,$25.25 ,$208.69 ,$154.01 ,$154.75 ,$18.85 ,$18.64 ,$25.98 ,$316.20 ,$54.29 ,$194.93 ,$104.16 ,$334.80 ,$50.50 ,$24.74 ,$241.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101212,82390,HC CERULOPLASMIN-90,301,1 ,$102.00 ,$73.44 ,$7.96 ,$102.00 ,$66.30 ,$10.53 ,$28.56 ,$56.41 ,$10.53 ,$59.36 ,$10.53 ,$53.45 ,$10.53 ,$21.69 ,$93.84 ,$26.85 ,$10.53 ,$86.70 ,$91.80 ,$10.73 ,$76.50 ,$71.40 ,$71.40 ,$10.53 ,$71.40 ,$78.54 ,$78.54 ,$26.85 ,$86.70 ,$10.74 ,$10.74 ,$57.22 ,$42.23 ,$42.43 ,$8.05 ,$7.96 ,$11.05 ,$86.70 ,$23.09 ,$53.45 ,$28.56 ,$91.80 ,$21.48 ,$10.53 ,$66.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101213,82397,HC CHEMILUMINESCENT ASSAY-90,301,1 ,$159.00 ,$114.48 ,$7.96 ,$159.00 ,$103.35 ,$13.84 ,$44.52 ,$87.93 ,$13.84 ,$92.54 ,$13.84 ,$83.32 ,$13.84 ,$28.52 ,$146.28 ,$35.30 ,$13.84 ,$135.15 ,$143.10 ,$14.11 ,$119.25 ,$111.30 ,$111.30 ,$13.84 ,$111.30 ,$122.43 ,$122.43 ,$35.30 ,$135.15 ,$14.12 ,$14.12 ,$89.20 ,$65.83 ,$66.14 ,$8.05 ,$7.96 ,$14.53 ,$135.15 ,$30.36 ,$83.32 ,$44.52 ,$143.10 ,$28.24 ,$13.84 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101215,82438,HC CHLORIDE OTHER SOURCE-90,301,1 ,$26.00 ,$18.72 ,$3.54 ,$26.00 ,$16.90 ,$4.90 ,$7.28 ,$14.38 ,$4.90 ,$15.13 ,$4.90 ,$13.62 ,$4.90 ,$10.10 ,$23.92 ,$12.50 ,$4.90 ,$22.10 ,$23.40 ,$5.00 ,$19.50 ,$18.20 ,$18.20 ,$4.90 ,$18.20 ,$20.02 ,$20.02 ,$12.50 ,$22.10 ,$5.00 ,$5.00 ,$14.59 ,$10.76 ,$10.82 ,$3.58 ,$3.54 ,$5.14 ,$22.10 ,$10.75 ,$13.62 ,$7.28 ,$23.40 ,$10.00 ,$4.90 ,$16.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101216,82480,HC CHOLINESTERASE PSEUDO-90,301,1 ,$72.00 ,$51.84 ,$7.71 ,$72.00 ,$46.80 ,$7.71 ,$20.16 ,$39.82 ,$7.71 ,$41.90 ,$7.71 ,$37.73 ,$7.71 ,$15.90 ,$66.24 ,$19.68 ,$7.71 ,$61.20 ,$64.80 ,$7.87 ,$54.00 ,$50.40 ,$50.40 ,$7.71 ,$50.40 ,$55.44 ,$55.44 ,$19.68 ,$61.20 ,$7.87 ,$7.87 ,$40.39 ,$29.81 ,$29.95 ,$8.05 ,$7.96 ,$8.09 ,$61.20 ,$16.92 ,$37.73 ,$20.16 ,$64.80 ,$15.74 ,$7.71 ,$46.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$103.00 ,$74.16 ,$9.71 ,$103.00 ,$66.95 ,$19.87 ,$28.84 ,$56.96 ,$19.87 ,$59.95 ,$19.87 ,$53.97 ,$19.87 ,$40.97 ,$94.76 ,$50.70 ,$19.87 ,$87.55 ,$92.70 ,$20.28 ,$77.25 ,$72.10 ,$72.10 ,$19.87 ,$72.10 ,$79.31 ,$79.31 ,$50.70 ,$87.55 ,$20.28 ,$20.28 ,$57.78 ,$42.64 ,$42.85 ,$9.82 ,$9.71 ,$20.86 ,$87.55 ,$43.60 ,$53.97 ,$28.84 ,$92.70 ,$40.56 ,$19.87 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101219,82507,HC CITRATE-90,301,1 ,$316.00 ,$227.52 ,$7.96 ,$316.00 ,$205.40 ,$27.24 ,$88.48 ,$174.75 ,$27.24 ,$183.91 ,$27.24 ,$165.58 ,$27.24 ,$56.16 ,$290.72 ,$69.50 ,$27.24 ,$268.60 ,$284.40 ,$27.79 ,$237.00 ,$221.20 ,$221.20 ,$27.24 ,$221.20 ,$243.32 ,$243.32 ,$69.50 ,$268.60 ,$27.80 ,$27.80 ,$177.28 ,$130.82 ,$131.46 ,$8.05 ,$7.96 ,$28.61 ,$268.60 ,$59.77 ,$165.58 ,$88.48 ,$284.40 ,$55.60 ,$27.24 ,$205.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$145.00 ,$104.40 ,$12.30 ,$145.00 ,$94.25 ,$18.31 ,$40.60 ,$80.19 ,$18.31 ,$84.39 ,$18.31 ,$75.98 ,$18.31 ,$37.73 ,$133.40 ,$46.70 ,$18.31 ,$123.25 ,$130.50 ,$18.67 ,$108.75 ,$101.50 ,$101.50 ,$18.31 ,$101.50 ,$111.65 ,$111.65 ,$46.70 ,$123.25 ,$18.68 ,$18.68 ,$81.35 ,$60.03 ,$60.32 ,$12.43 ,$12.30 ,$19.22 ,$123.25 ,$40.16 ,$75.98 ,$40.60 ,$130.50 ,$37.36 ,$18.31 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101221,82525,HC COPPER-90,301,1 ,$193.00 ,$138.96 ,$9.71 ,$193.00 ,$125.45 ,$12.16 ,$54.04 ,$106.73 ,$12.16 ,$112.33 ,$12.16 ,$101.13 ,$12.16 ,$25.07 ,$177.56 ,$31.03 ,$12.16 ,$164.05 ,$173.70 ,$12.41 ,$144.75 ,$135.10 ,$135.10 ,$12.16 ,$135.10 ,$148.61 ,$148.61 ,$31.03 ,$164.05 ,$12.41 ,$12.41 ,$108.27 ,$79.90 ,$80.29 ,$9.82 ,$9.71 ,$12.77 ,$164.05 ,$26.68 ,$101.13 ,$54.04 ,$173.70 ,$24.82 ,$12.16 ,$125.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101222,82530,HC CORTISOL FREE-90,301,1 ,$236.00 ,$169.92 ,$7.96 ,$236.00 ,$153.40 ,$16.38 ,$66.08 ,$130.51 ,$16.38 ,$137.35 ,$16.38 ,$123.66 ,$16.38 ,$33.75 ,$217.12 ,$41.78 ,$16.38 ,$200.60 ,$212.40 ,$16.70 ,$177.00 ,$165.20 ,$165.20 ,$16.38 ,$165.20 ,$181.72 ,$181.72 ,$41.78 ,$200.60 ,$16.71 ,$16.71 ,$132.40 ,$97.70 ,$98.18 ,$8.05 ,$7.96 ,$17.20 ,$200.60 ,$35.93 ,$123.66 ,$66.08 ,$212.40 ,$33.42 ,$16.38 ,$153.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$197.00 ,$141.84 ,$7.96 ,$197.00 ,$128.05 ,$23.61 ,$55.16 ,$108.94 ,$23.61 ,$114.65 ,$23.61 ,$103.23 ,$23.61 ,$48.66 ,$181.24 ,$60.23 ,$23.61 ,$167.45 ,$177.30 ,$24.08 ,$147.75 ,$137.90 ,$137.90 ,$23.61 ,$137.90 ,$151.69 ,$151.69 ,$60.23 ,$167.45 ,$24.09 ,$24.09 ,$110.52 ,$81.56 ,$81.95 ,$8.05 ,$7.96 ,$24.78 ,$167.45 ,$51.79 ,$103.23 ,$55.16 ,$177.30 ,$48.18 ,$23.61 ,$128.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101225,82550,HC CREATINE KINASE (CPK) TOTAL-90,301,1 ,$130.00 ,$93.60 ,$3.54 ,$130.00 ,$84.50 ,$6.38 ,$36.40 ,$71.89 ,$6.38 ,$75.66 ,$6.38 ,$68.12 ,$6.38 ,$13.15 ,$119.60 ,$16.28 ,$6.38 ,$110.50 ,$117.00 ,$6.51 ,$97.50 ,$91.00 ,$91.00 ,$6.38 ,$91.00 ,$100.10 ,$100.10 ,$16.28 ,$110.50 ,$6.51 ,$6.51 ,$72.93 ,$53.82 ,$54.08 ,$3.58 ,$3.54 ,$6.70 ,$110.50 ,$14.00 ,$68.12 ,$36.40 ,$117.00 ,$13.02 ,$6.38 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$45.00 ,$32.40 ,$7.96 ,$45.00 ,$29.25 ,$13.12 ,$12.60 ,$24.89 ,$13.12 ,$26.19 ,$13.12 ,$23.58 ,$13.12 ,$27.05 ,$41.40 ,$33.48 ,$13.12 ,$38.25 ,$40.50 ,$13.39 ,$33.75 ,$31.50 ,$31.50 ,$13.12 ,$31.50 ,$34.65 ,$34.65 ,$33.48 ,$38.25 ,$13.39 ,$13.39 ,$25.25 ,$18.63 ,$18.72 ,$8.05 ,$7.96 ,$13.78 ,$38.25 ,$28.79 ,$23.58 ,$12.60 ,$40.50 ,$26.78 ,$13.12 ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$80.00 ,$57.60 ,$3.54 ,$80.00 ,$52.00 ,$5.08 ,$22.40 ,$44.24 ,$5.08 ,$46.56 ,$5.08 ,$41.92 ,$5.08 ,$10.46 ,$73.60 ,$12.95 ,$5.08 ,$68.00 ,$72.00 ,$5.17 ,$60.00 ,$56.00 ,$56.00 ,$5.08 ,$56.00 ,$61.60 ,$61.60 ,$12.95 ,$68.00 ,$5.18 ,$5.18 ,$44.88 ,$33.12 ,$33.28 ,$3.58 ,$3.54 ,$5.33 ,$68.00 ,$11.14 ,$41.92 ,$22.40 ,$72.00 ,$10.36 ,$5.08 ,$52.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$98.00 ,$70.56 ,$6.34 ,$98.00 ,$63.70 ,$6.34 ,$27.44 ,$54.19 ,$6.34 ,$57.04 ,$6.34 ,$51.35 ,$6.34 ,$13.07 ,$90.16 ,$16.18 ,$6.34 ,$83.30 ,$88.20 ,$6.47 ,$73.50 ,$68.60 ,$68.60 ,$6.34 ,$68.60 ,$75.46 ,$75.46 ,$16.18 ,$83.30 ,$6.47 ,$6.47 ,$54.98 ,$40.57 ,$40.77 ,$8.05 ,$7.96 ,$6.65 ,$83.30 ,$13.91 ,$51.35 ,$27.44 ,$88.20 ,$12.94 ,$6.34 ,$63.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101234,82600,HC CYANIDE-90,301,1 ,$73.00 ,$52.56 ,$9.71 ,$73.00 ,$47.45 ,$19.01 ,$20.44 ,$40.37 ,$19.01 ,$42.49 ,$19.01 ,$38.25 ,$19.01 ,$39.19 ,$67.16 ,$48.50 ,$19.01 ,$62.05 ,$65.70 ,$19.39 ,$54.75 ,$51.10 ,$51.10 ,$19.01 ,$51.10 ,$56.21 ,$56.21 ,$48.50 ,$62.05 ,$19.40 ,$19.40 ,$40.95 ,$30.22 ,$30.37 ,$9.82 ,$9.71 ,$19.96 ,$62.05 ,$41.71 ,$38.25 ,$20.44 ,$65.70 ,$38.80 ,$19.01 ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101236,82608,HC VITAMIN B-12 BINDING CAPACITY-90,301,1 ,$63.00 ,$45.36 ,$7.96 ,$63.00 ,$40.95 ,$14.03 ,$17.64 ,$34.84 ,$14.03 ,$36.67 ,$14.03 ,$33.01 ,$14.03 ,$28.93 ,$57.96 ,$35.80 ,$14.03 ,$53.55 ,$56.70 ,$14.32 ,$47.25 ,$44.10 ,$44.10 ,$14.03 ,$44.10 ,$48.51 ,$48.51 ,$35.80 ,$53.55 ,$14.32 ,$14.32 ,$35.34 ,$26.08 ,$26.21 ,$8.05 ,$7.96 ,$14.74 ,$53.55 ,$30.79 ,$33.01 ,$17.64 ,$56.70 ,$28.64 ,$14.03 ,$40.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101237,82626,HC DHEA-90,301,1 ,$89.00 ,$64.08 ,$7.96 ,$89.00 ,$57.85 ,$24.76 ,$24.92 ,$49.22 ,$24.76 ,$51.80 ,$24.76 ,$46.64 ,$24.76 ,$51.05 ,$81.88 ,$63.18 ,$24.76 ,$75.65 ,$80.10 ,$25.26 ,$66.75 ,$62.30 ,$62.30 ,$24.76 ,$62.30 ,$68.53 ,$68.53 ,$63.18 ,$75.65 ,$25.27 ,$25.27 ,$49.93 ,$36.85 ,$37.02 ,$8.05 ,$7.96 ,$26.00 ,$75.65 ,$54.33 ,$46.64 ,$24.92 ,$80.10 ,$50.54 ,$24.76 ,$57.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101238,82627,HC DHEA SULFATE-90,301,1 ,$155.00 ,$111.60 ,$18.64 ,$155.00 ,$100.75 ,$21.79 ,$43.40 ,$85.72 ,$21.79 ,$90.21 ,$21.79 ,$81.22 ,$21.79 ,$44.90 ,$142.60 ,$55.58 ,$21.79 ,$131.75 ,$139.50 ,$22.22 ,$116.25 ,$108.50 ,$108.50 ,$21.79 ,$108.50 ,$119.35 ,$119.35 ,$55.58 ,$131.75 ,$22.23 ,$22.23 ,$86.96 ,$64.17 ,$64.48 ,$18.85 ,$18.64 ,$22.87 ,$131.75 ,$47.79 ,$81.22 ,$43.40 ,$139.50 ,$44.46 ,$21.79 ,$100.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$252.00 ,$181.44 ,$21.44 ,$252.00 ,$163.80 ,$37.73 ,$70.56 ,$139.36 ,$37.73 ,$146.66 ,$37.73 ,$132.05 ,$37.73 ,$77.77 ,$231.84 ,$96.25 ,$37.73 ,$214.20 ,$226.80 ,$38.48 ,$189.00 ,$176.40 ,$176.40 ,$37.73 ,$176.40 ,$194.04 ,$194.04 ,$96.25 ,$214.20 ,$38.50 ,$38.50 ,$141.37 ,$104.33 ,$104.83 ,$21.67 ,$21.44 ,$39.62 ,$214.20 ,$82.78 ,$132.05 ,$70.56 ,$226.80 ,$77.00 ,$37.73 ,$163.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$333.00 ,$239.76 ,$7.96 ,$333.00 ,$216.45 ,$11.30 ,$93.24 ,$184.15 ,$11.30 ,$193.81 ,$11.30 ,$174.49 ,$11.30 ,$23.29 ,$306.36 ,$28.83 ,$11.30 ,$283.05 ,$299.70 ,$11.52 ,$249.75 ,$233.10 ,$233.10 ,$11.30 ,$233.10 ,$256.41 ,$256.41 ,$28.83 ,$283.05 ,$11.53 ,$11.53 ,$186.81 ,$137.86 ,$138.53 ,$8.05 ,$7.96 ,$11.87 ,$283.05 ,$24.79 ,$174.49 ,$93.24 ,$299.70 ,$23.06 ,$11.30 ,$216.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$174.00 ,$125.28 ,$7.96 ,$174.00 ,$113.10 ,$18.41 ,$48.72 ,$96.22 ,$18.41 ,$101.27 ,$18.41 ,$91.18 ,$18.41 ,$37.96 ,$160.08 ,$46.98 ,$18.41 ,$147.90 ,$156.60 ,$18.79 ,$130.50 ,$121.80 ,$121.80 ,$18.41 ,$121.80 ,$133.98 ,$133.98 ,$46.98 ,$147.90 ,$18.79 ,$18.79 ,$97.61 ,$72.04 ,$72.38 ,$8.05 ,$7.96 ,$19.34 ,$147.90 ,$40.40 ,$91.18 ,$48.72 ,$156.60 ,$37.58 ,$18.41 ,$113.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101246,82670,HC ESTRADIOL-90,301,1 ,$244.00 ,$175.68 ,$18.64 ,$244.00 ,$158.60 ,$27.38 ,$68.32 ,$134.93 ,$27.38 ,$142.01 ,$27.38 ,$127.86 ,$27.38 ,$56.44 ,$224.48 ,$69.85 ,$27.38 ,$207.40 ,$219.60 ,$27.93 ,$183.00 ,$170.80 ,$170.80 ,$27.38 ,$170.80 ,$187.88 ,$187.88 ,$69.85 ,$207.40 ,$27.94 ,$27.94 ,$136.88 ,$101.02 ,$101.50 ,$18.85 ,$18.64 ,$28.75 ,$207.40 ,$60.07 ,$127.86 ,$68.32 ,$219.60 ,$55.88 ,$27.38 ,$158.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101248,82671,HC ESTROGEN FRACTIONATED-90,301,1 ,$190.00 ,$136.80 ,$18.64 ,$190.00 ,$123.50 ,$31.65 ,$53.20 ,$105.07 ,$31.65 ,$110.58 ,$31.65 ,$99.56 ,$31.65 ,$65.25 ,$174.80 ,$80.75 ,$31.65 ,$161.50 ,$171.00 ,$32.29 ,$142.50 ,$133.00 ,$133.00 ,$31.65 ,$133.00 ,$146.30 ,$146.30 ,$80.75 ,$161.50 ,$32.30 ,$32.30 ,$106.59 ,$78.66 ,$79.04 ,$18.85 ,$18.64 ,$33.24 ,$161.50 ,$69.45 ,$99.56 ,$53.20 ,$171.00 ,$64.60 ,$31.65 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$188.00 ,$135.36 ,$18.64 ,$188.00 ,$122.20 ,$21.27 ,$52.64 ,$103.96 ,$21.27 ,$109.42 ,$21.27 ,$98.51 ,$21.27 ,$43.83 ,$172.96 ,$54.25 ,$21.27 ,$159.80 ,$169.20 ,$21.69 ,$141.00 ,$131.60 ,$131.60 ,$21.27 ,$131.60 ,$144.76 ,$144.76 ,$54.25 ,$159.80 ,$21.70 ,$21.70 ,$105.47 ,$77.83 ,$78.21 ,$18.85 ,$18.64 ,$22.33 ,$159.80 ,$46.66 ,$98.51 ,$52.64 ,$169.20 ,$43.40 ,$21.27 ,$122.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101250,82677,HC ESTRIOL-90,301,1 ,$31.00 ,$22.32 ,$8.68 ,$60.45 ,$20.15 ,$23.70 ,$8.68 ,$17.14 ,$23.70 ,$18.04 ,$23.70 ,$16.24 ,$23.70 ,$31.00 ,$28.52 ,$60.45 ,$23.70 ,$26.35 ,$27.90 ,$24.17 ,$23.25 ,$21.70 ,$21.70 ,$23.70 ,$21.70 ,$23.87 ,$23.87 ,$31.00 ,$26.35 ,$24.18 ,$24.18 ,$17.39 ,$12.83 ,$12.90 ,$18.85 ,$18.64 ,$24.88 ,$26.35 ,$51.99 ,$16.24 ,$8.68 ,$27.90 ,$31.00 ,$23.70 ,$20.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101251,82679,HC ESTRONE-90,301,1 ,$171.00 ,$123.12 ,$18.64 ,$171.00 ,$111.15 ,$24.45 ,$47.88 ,$94.56 ,$24.45 ,$99.52 ,$24.45 ,$89.60 ,$24.45 ,$50.40 ,$157.32 ,$62.38 ,$24.45 ,$145.35 ,$153.90 ,$24.94 ,$128.25 ,$119.70 ,$119.70 ,$24.45 ,$119.70 ,$131.67 ,$131.67 ,$62.38 ,$145.35 ,$24.95 ,$24.95 ,$95.93 ,$70.79 ,$71.14 ,$18.85 ,$18.64 ,$25.68 ,$145.35 ,$53.64 ,$89.60 ,$47.88 ,$153.90 ,$49.90 ,$24.45 ,$111.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$96.00 ,$69.12 ,$3.54 ,$96.00 ,$62.40 ,$5.00 ,$26.88 ,$53.09 ,$5.00 ,$55.87 ,$5.00 ,$50.30 ,$5.00 ,$10.30 ,$88.32 ,$12.75 ,$5.00 ,$81.60 ,$86.40 ,$5.10 ,$72.00 ,$67.20 ,$67.20 ,$5.00 ,$67.20 ,$73.92 ,$73.92 ,$12.75 ,$81.60 ,$5.10 ,$5.10 ,$53.86 ,$39.74 ,$39.94 ,$3.58 ,$3.54 ,$5.25 ,$81.60 ,$10.97 ,$50.30 ,$26.88 ,$86.40 ,$10.20 ,$5.00 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101255,82726,HC FATTY ACIDS VERY LONG CHAIN-90,301,1 ,$239.00 ,$172.08 ,$7.96 ,$239.00 ,$155.35 ,$19.35 ,$66.92 ,$132.17 ,$19.35 ,$139.10 ,$19.35 ,$125.24 ,$19.35 ,$39.90 ,$219.88 ,$49.38 ,$19.35 ,$203.15 ,$215.10 ,$19.75 ,$179.25 ,$167.30 ,$167.30 ,$19.35 ,$167.30 ,$184.03 ,$184.03 ,$49.38 ,$203.15 ,$19.75 ,$19.75 ,$134.08 ,$98.95 ,$99.42 ,$8.05 ,$7.96 ,$20.33 ,$203.15 ,$42.46 ,$125.24 ,$66.92 ,$215.10 ,$39.50 ,$19.35 ,$155.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$98.00 ,$70.56 ,$4.95 ,$98.00 ,$63.70 ,$17.30 ,$27.44 ,$54.19 ,$17.30 ,$57.04 ,$17.30 ,$51.35 ,$17.30 ,$35.65 ,$90.16 ,$44.13 ,$17.30 ,$83.30 ,$88.20 ,$17.64 ,$73.50 ,$68.60 ,$68.60 ,$17.30 ,$68.60 ,$75.46 ,$75.46 ,$44.13 ,$83.30 ,$17.65 ,$17.65 ,$54.98 ,$40.57 ,$40.77 ,$5.00 ,$4.95 ,$18.16 ,$83.30 ,$37.95 ,$51.35 ,$27.44 ,$88.20 ,$35.30 ,$17.30 ,$63.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$150.00 ,$108.00 ,$7.96 ,$150.00 ,$97.50 ,$9.11 ,$42.00 ,$82.95 ,$9.11 ,$87.30 ,$9.11 ,$78.60 ,$9.11 ,$18.79 ,$138.00 ,$23.25 ,$9.11 ,$127.50 ,$135.00 ,$9.30 ,$112.50 ,$105.00 ,$105.00 ,$9.11 ,$105.00 ,$115.50 ,$115.50 ,$23.25 ,$127.50 ,$9.30 ,$9.30 ,$84.15 ,$62.10 ,$62.40 ,$8.05 ,$7.96 ,$9.57 ,$127.50 ,$20.00 ,$78.60 ,$42.00 ,$135.00 ,$18.60 ,$9.11 ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101263,82785,HC GAMMAGLOBULIN IGE-90,301,1 ,$193.00 ,$138.96 ,$7.96 ,$193.00 ,$125.45 ,$16.13 ,$54.04 ,$106.73 ,$16.13 ,$112.33 ,$16.13 ,$101.13 ,$16.13 ,$33.25 ,$177.56 ,$41.15 ,$16.13 ,$164.05 ,$173.70 ,$16.45 ,$144.75 ,$135.10 ,$135.10 ,$16.13 ,$135.10 ,$148.61 ,$148.61 ,$41.15 ,$164.05 ,$16.46 ,$16.46 ,$108.27 ,$79.90 ,$80.29 ,$8.05 ,$7.96 ,$16.93 ,$164.05 ,$35.39 ,$101.13 ,$54.04 ,$173.70 ,$32.92 ,$16.13 ,$125.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$69.00 ,$49.68 ,$7.86 ,$69.00 ,$44.85 ,$7.86 ,$19.32 ,$38.16 ,$7.86 ,$40.16 ,$7.86 ,$36.16 ,$7.86 ,$16.20 ,$63.48 ,$20.05 ,$7.86 ,$58.65 ,$62.10 ,$8.02 ,$51.75 ,$48.30 ,$48.30 ,$7.86 ,$48.30 ,$53.13 ,$53.13 ,$20.05 ,$58.65 ,$8.02 ,$8.02 ,$38.71 ,$28.57 ,$28.70 ,$12.43 ,$12.30 ,$8.25 ,$58.65 ,$17.24 ,$36.16 ,$19.32 ,$62.10 ,$16.04 ,$7.86 ,$44.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101268,82941,HC GASTRIN-90,301,1 ,$116.00 ,$83.52 ,$17.28 ,$116.00 ,$75.40 ,$17.28 ,$32.48 ,$64.15 ,$17.28 ,$67.51 ,$17.28 ,$60.78 ,$17.28 ,$35.61 ,$106.72 ,$44.08 ,$17.28 ,$98.60 ,$104.40 ,$17.62 ,$87.00 ,$81.20 ,$81.20 ,$17.28 ,$81.20 ,$89.32 ,$89.32 ,$44.08 ,$98.60 ,$17.63 ,$17.63 ,$65.08 ,$48.02 ,$48.26 ,$18.85 ,$18.64 ,$18.14 ,$98.60 ,$37.90 ,$60.78 ,$32.48 ,$104.40 ,$35.26 ,$17.28 ,$75.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$19.00 ,$13.68 ,$5.32 ,$24.25 ,$12.35 ,$9.51 ,$5.32 ,$10.51 ,$9.51 ,$11.06 ,$9.51 ,$9.96 ,$9.51 ,$19.00 ,$17.48 ,$24.25 ,$9.51 ,$16.15 ,$17.10 ,$9.69 ,$14.25 ,$13.30 ,$13.30 ,$9.51 ,$13.30 ,$14.63 ,$14.63 ,$19.00 ,$16.15 ,$9.70 ,$9.70 ,$10.66 ,$7.87 ,$7.90 ,$8.05 ,$7.96 ,$9.99 ,$16.15 ,$20.86 ,$9.96 ,$5.32 ,$17.10 ,$19.00 ,$9.51 ,$12.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$80.00 ,$57.60 ,$7.96 ,$80.00 ,$52.00 ,$16.42 ,$22.40 ,$44.24 ,$16.42 ,$46.56 ,$16.42 ,$41.92 ,$16.42 ,$33.86 ,$73.60 ,$41.90 ,$16.42 ,$68.00 ,$72.00 ,$16.76 ,$60.00 ,$56.00 ,$56.00 ,$16.42 ,$56.00 ,$61.60 ,$61.60 ,$41.90 ,$68.00 ,$16.76 ,$16.76 ,$44.88 ,$33.12 ,$33.28 ,$8.05 ,$7.96 ,$17.25 ,$68.00 ,$36.03 ,$41.92 ,$22.40 ,$72.00 ,$33.52 ,$16.42 ,$52.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$176.00 ,$126.72 ,$16.34 ,$176.00 ,$114.40 ,$16.34 ,$49.28 ,$97.33 ,$16.34 ,$102.43 ,$16.34 ,$92.22 ,$16.34 ,$33.67 ,$161.92 ,$41.68 ,$16.34 ,$149.60 ,$158.40 ,$16.66 ,$132.00 ,$123.20 ,$123.20 ,$16.34 ,$123.20 ,$135.52 ,$135.52 ,$41.68 ,$149.60 ,$16.67 ,$16.67 ,$98.74 ,$72.86 ,$73.22 ,$18.85 ,$18.64 ,$17.15 ,$149.60 ,$35.84 ,$92.22 ,$49.28 ,$158.40 ,$33.34 ,$16.34 ,$114.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$293.00 ,$210.96 ,$21.44 ,$293.00 ,$190.45 ,$66.01 ,$82.04 ,$162.03 ,$66.01 ,$170.53 ,$66.01 ,$153.53 ,$66.01 ,$136.07 ,$269.56 ,$168.40 ,$66.01 ,$249.05 ,$263.70 ,$67.34 ,$219.75 ,$205.10 ,$205.10 ,$66.01 ,$205.10 ,$225.61 ,$225.61 ,$168.40 ,$249.05 ,$67.36 ,$67.36 ,$164.37 ,$121.30 ,$121.89 ,$21.67 ,$21.44 ,$69.32 ,$249.05 ,$144.82 ,$153.53 ,$82.04 ,$263.70 ,$134.72 ,$66.01 ,$190.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$138.00 ,$99.36 ,$9.71 ,$138.00 ,$89.70 ,$21.52 ,$38.64 ,$76.31 ,$21.52 ,$80.32 ,$21.52 ,$72.31 ,$21.52 ,$44.36 ,$126.96 ,$54.90 ,$21.52 ,$117.30 ,$124.20 ,$21.95 ,$103.50 ,$96.60 ,$96.60 ,$21.52 ,$96.60 ,$106.26 ,$106.26 ,$54.90 ,$117.30 ,$21.96 ,$21.96 ,$77.42 ,$57.13 ,$57.41 ,$9.82 ,$9.71 ,$22.60 ,$117.30 ,$47.21 ,$72.31 ,$38.64 ,$124.20 ,$43.92 ,$21.52 ,$89.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101284,83020,HC HGB ELECTROPHORESIS-90,301,1 ,$65.00 ,$46.80 ,$7.96 ,$65.00 ,$42.25 ,$12.61 ,$18.20 ,$35.95 ,$12.61 ,$37.83 ,$12.61 ,$34.06 ,$12.61 ,$26.00 ,$59.80 ,$32.18 ,$12.61 ,$55.25 ,$58.50 ,$12.87 ,$48.75 ,$45.50 ,$45.50 ,$12.61 ,$45.50 ,$50.05 ,$50.05 ,$32.18 ,$55.25 ,$12.87 ,$12.87 ,$36.47 ,$26.91 ,$27.04 ,$8.05 ,$7.96 ,$13.24 ,$55.25 ,$27.67 ,$34.06 ,$18.20 ,$58.50 ,$25.74 ,$12.61 ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101289,83051,HC HEMOGLOBIN PLASMA-90,301,1 ,$54.00 ,$38.88 ,$7.16 ,$54.00 ,$35.10 ,$7.16 ,$15.12 ,$29.86 ,$7.16 ,$31.43 ,$7.16 ,$28.30 ,$7.16 ,$14.77 ,$49.68 ,$18.28 ,$7.16 ,$45.90 ,$48.60 ,$7.31 ,$40.50 ,$37.80 ,$37.80 ,$7.16 ,$37.80 ,$41.58 ,$41.58 ,$18.28 ,$45.90 ,$7.31 ,$7.31 ,$30.29 ,$22.36 ,$22.46 ,$8.05 ,$7.96 ,$7.53 ,$45.90 ,$15.72 ,$28.30 ,$15.12 ,$48.60 ,$14.62 ,$7.16 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101292,83090,HC HOMOCYSTEINE-90,301,1 ,$222.00 ,$159.84 ,$17.56 ,$222.00 ,$144.30 ,$17.56 ,$62.16 ,$122.77 ,$17.56 ,$129.20 ,$17.56 ,$116.33 ,$17.56 ,$36.20 ,$204.24 ,$44.80 ,$17.56 ,$188.70 ,$199.80 ,$17.91 ,$166.50 ,$155.40 ,$155.40 ,$17.56 ,$155.40 ,$170.94 ,$170.94 ,$44.80 ,$188.70 ,$17.92 ,$17.92 ,$124.54 ,$91.91 ,$92.35 ,$18.85 ,$18.64 ,$18.44 ,$188.70 ,$38.53 ,$116.33 ,$62.16 ,$199.80 ,$35.84 ,$17.56 ,$144.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$67.00 ,$48.24 ,$10.72 ,$67.00 ,$43.55 ,$12.64 ,$18.76 ,$37.05 ,$12.64 ,$38.99 ,$12.64 ,$35.11 ,$12.64 ,$26.06 ,$61.64 ,$32.25 ,$12.64 ,$56.95 ,$60.30 ,$12.90 ,$50.25 ,$46.90 ,$46.90 ,$12.64 ,$46.90 ,$51.59 ,$51.59 ,$32.25 ,$56.95 ,$12.90 ,$12.90 ,$37.59 ,$27.74 ,$27.87 ,$10.84 ,$10.72 ,$13.28 ,$56.95 ,$27.74 ,$35.11 ,$18.76 ,$60.30 ,$25.80 ,$12.64 ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$283.00 ,$203.76 ,$18.64 ,$283.00 ,$183.95 ,$26.63 ,$79.24 ,$156.50 ,$26.63 ,$164.71 ,$26.63 ,$148.29 ,$26.63 ,$54.88 ,$260.36 ,$67.93 ,$26.63 ,$240.55 ,$254.70 ,$27.16 ,$212.25 ,$198.10 ,$198.10 ,$26.63 ,$198.10 ,$217.91 ,$217.91 ,$67.93 ,$240.55 ,$27.17 ,$27.17 ,$158.76 ,$117.16 ,$117.73 ,$18.85 ,$18.64 ,$27.96 ,$240.55 ,$58.42 ,$148.29 ,$79.24 ,$254.70 ,$54.34 ,$26.63 ,$183.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$125.00 ,$90.00 ,$7.13 ,$125.00 ,$81.25 ,$11.30 ,$35.00 ,$69.13 ,$11.30 ,$72.75 ,$11.30 ,$65.50 ,$11.30 ,$23.29 ,$115.00 ,$28.83 ,$11.30 ,$106.25 ,$112.50 ,$11.52 ,$93.75 ,$87.50 ,$87.50 ,$11.30 ,$87.50 ,$96.25 ,$96.25 ,$28.83 ,$106.25 ,$11.53 ,$11.53 ,$70.13 ,$51.75 ,$52.00 ,$7.21 ,$7.13 ,$11.87 ,$106.25 ,$24.79 ,$65.50 ,$35.00 ,$112.50 ,$23.06 ,$11.30 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101302,83519,HC QN RIA-90,301,1 ,$227.00 ,$163.44 ,$7.13 ,$227.00 ,$147.55 ,$18.03 ,$63.56 ,$125.53 ,$18.03 ,$132.11 ,$18.03 ,$118.95 ,$18.03 ,$37.17 ,$208.84 ,$46.00 ,$18.03 ,$192.95 ,$204.30 ,$18.39 ,$170.25 ,$158.90 ,$158.90 ,$18.03 ,$158.90 ,$174.79 ,$174.79 ,$46.00 ,$192.95 ,$18.40 ,$18.40 ,$127.35 ,$93.98 ,$94.43 ,$7.21 ,$7.13 ,$18.93 ,$192.95 ,$39.56 ,$118.95 ,$63.56 ,$204.30 ,$36.80 ,$18.03 ,$147.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$174.00 ,$125.28 ,$7.13 ,$174.00 ,$113.10 ,$16.92 ,$48.72 ,$96.22 ,$16.92 ,$101.27 ,$16.92 ,$91.18 ,$16.92 ,$34.89 ,$160.08 ,$43.18 ,$16.92 ,$147.90 ,$156.60 ,$17.27 ,$130.50 ,$121.80 ,$121.80 ,$16.92 ,$121.80 ,$133.98 ,$133.98 ,$43.18 ,$147.90 ,$17.27 ,$17.27 ,$97.61 ,$72.04 ,$72.38 ,$7.21 ,$7.13 ,$17.77 ,$147.90 ,$37.13 ,$91.18 ,$48.72 ,$156.60 ,$34.54 ,$16.92 ,$113.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101307,83525,HC INSULIN TOTAL-90,301,1 ,$144.00 ,$103.68 ,$10.72 ,$144.00 ,$93.60 ,$11.20 ,$40.32 ,$79.63 ,$11.20 ,$83.81 ,$11.20 ,$75.46 ,$11.20 ,$23.09 ,$132.48 ,$28.58 ,$11.20 ,$122.40 ,$129.60 ,$11.43 ,$108.00 ,$100.80 ,$100.80 ,$11.20 ,$100.80 ,$110.88 ,$110.88 ,$28.58 ,$122.40 ,$11.43 ,$11.43 ,$80.78 ,$59.62 ,$59.90 ,$10.84 ,$10.72 ,$11.76 ,$122.40 ,$24.57 ,$75.46 ,$40.32 ,$129.60 ,$22.86 ,$11.20 ,$93.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101311,83605,HC LACTATE/LACTIC ACID-90,301,1 ,$24.00 ,$17.28 ,$6.72 ,$28.93 ,$15.60 ,$11.34 ,$6.72 ,$13.27 ,$11.34 ,$13.97 ,$11.34 ,$12.58 ,$11.34 ,$23.37 ,$22.08 ,$28.93 ,$11.34 ,$20.40 ,$21.60 ,$11.56 ,$18.00 ,$16.80 ,$16.80 ,$11.34 ,$16.80 ,$18.48 ,$18.48 ,$24.00 ,$20.40 ,$11.57 ,$11.57 ,$13.46 ,$9.94 ,$9.98 ,$8.05 ,$7.96 ,$11.91 ,$20.40 ,$24.88 ,$12.58 ,$6.72 ,$21.60 ,$23.14 ,$11.34 ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$105.00 ,$75.60 ,$3.54 ,$105.00 ,$68.25 ,$5.92 ,$29.40 ,$58.07 ,$5.92 ,$61.11 ,$5.92 ,$55.02 ,$5.92 ,$12.20 ,$96.60 ,$15.10 ,$5.92 ,$89.25 ,$94.50 ,$6.04 ,$78.75 ,$73.50 ,$73.50 ,$5.92 ,$73.50 ,$80.85 ,$80.85 ,$15.10 ,$89.25 ,$6.04 ,$6.04 ,$58.91 ,$43.47 ,$43.68 ,$3.58 ,$3.54 ,$6.21 ,$89.25 ,$12.99 ,$55.02 ,$29.40 ,$94.50 ,$12.08 ,$5.92 ,$68.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101316,83655,HC LEAD-90,301,1 ,$121.00 ,$87.12 ,$9.71 ,$121.00 ,$78.65 ,$11.87 ,$33.88 ,$66.91 ,$11.87 ,$70.42 ,$11.87 ,$63.40 ,$11.87 ,$24.46 ,$111.32 ,$30.28 ,$11.87 ,$102.85 ,$108.90 ,$12.10 ,$90.75 ,$84.70 ,$84.70 ,$11.87 ,$84.70 ,$93.17 ,$93.17 ,$30.28 ,$102.85 ,$12.11 ,$12.11 ,$67.88 ,$50.09 ,$50.34 ,$9.82 ,$9.71 ,$12.47 ,$102.85 ,$26.04 ,$63.40 ,$33.88 ,$108.90 ,$24.22 ,$11.87 ,$78.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101319,83695,HC LIPOPROTEIN-90,301,1 ,$164.00 ,$118.08 ,$7.96 ,$164.00 ,$106.60 ,$14.03 ,$45.92 ,$90.69 ,$14.03 ,$95.45 ,$14.03 ,$85.94 ,$14.03 ,$28.93 ,$150.88 ,$35.80 ,$14.03 ,$139.40 ,$147.60 ,$14.32 ,$123.00 ,$114.80 ,$114.80 ,$14.03 ,$114.80 ,$126.28 ,$126.28 ,$35.80 ,$139.40 ,$14.32 ,$14.32 ,$92.00 ,$67.90 ,$68.22 ,$8.05 ,$7.96 ,$14.74 ,$139.40 ,$30.79 ,$85.94 ,$45.92 ,$147.60 ,$28.64 ,$14.03 ,$106.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101326,83735,HC MAGNESIUM-90,301,1 ,$82.00 ,$59.04 ,$3.54 ,$82.00 ,$53.30 ,$6.57 ,$22.96 ,$45.35 ,$6.57 ,$47.72 ,$6.57 ,$42.97 ,$6.57 ,$13.53 ,$75.44 ,$16.75 ,$6.57 ,$69.70 ,$73.80 ,$6.69 ,$61.50 ,$57.40 ,$57.40 ,$6.57 ,$57.40 ,$63.14 ,$63.14 ,$16.75 ,$69.70 ,$6.70 ,$6.70 ,$46.00 ,$33.95 ,$34.11 ,$3.58 ,$3.54 ,$6.90 ,$69.70 ,$14.41 ,$42.97 ,$22.96 ,$73.80 ,$13.40 ,$6.57 ,$53.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101327,83785,HC MANGANESE-90,301,1 ,$169.00 ,$121.68 ,$9.71 ,$169.00 ,$109.85 ,$26.12 ,$47.32 ,$93.46 ,$26.12 ,$98.36 ,$26.12 ,$88.56 ,$26.12 ,$53.83 ,$155.48 ,$66.63 ,$26.12 ,$143.65 ,$152.10 ,$26.64 ,$126.75 ,$118.30 ,$118.30 ,$26.12 ,$118.30 ,$130.13 ,$130.13 ,$66.63 ,$143.65 ,$26.65 ,$26.65 ,$94.81 ,$69.97 ,$70.30 ,$9.82 ,$9.71 ,$27.42 ,$143.65 ,$57.30 ,$88.56 ,$47.32 ,$152.10 ,$53.30 ,$26.12 ,$109.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101328,83789,HC MASS SPEC QN EACH-90,301,1 ,$221.00 ,$159.12 ,$7.96 ,$221.00 ,$143.65 ,$23.63 ,$61.88 ,$122.21 ,$23.63 ,$128.62 ,$23.63 ,$115.80 ,$23.63 ,$48.70 ,$203.32 ,$60.28 ,$23.63 ,$187.85 ,$198.90 ,$24.10 ,$165.75 ,$154.70 ,$154.70 ,$23.63 ,$154.70 ,$170.17 ,$170.17 ,$60.28 ,$187.85 ,$24.11 ,$24.11 ,$123.98 ,$91.49 ,$91.94 ,$8.05 ,$7.96 ,$24.81 ,$187.85 ,$51.84 ,$115.80 ,$61.88 ,$198.90 ,$48.22 ,$23.63 ,$143.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101329,83825,HC MERCURY-90,301,1 ,$84.00 ,$60.48 ,$9.71 ,$84.00 ,$54.60 ,$15.93 ,$23.52 ,$46.45 ,$15.93 ,$48.89 ,$15.93 ,$44.02 ,$15.93 ,$32.85 ,$77.28 ,$40.65 ,$15.93 ,$71.40 ,$75.60 ,$16.26 ,$63.00 ,$58.80 ,$58.80 ,$15.93 ,$58.80 ,$64.68 ,$64.68 ,$40.65 ,$71.40 ,$16.26 ,$16.26 ,$47.12 ,$34.78 ,$34.94 ,$9.82 ,$9.71 ,$16.73 ,$71.40 ,$34.96 ,$44.02 ,$23.52 ,$75.60 ,$32.52 ,$15.93 ,$54.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101330,83835,HC METANEPHRINES-90,301,1 ,$114.00 ,$82.08 ,$16.60 ,$114.00 ,$74.10 ,$16.60 ,$31.92 ,$63.04 ,$16.60 ,$66.35 ,$16.60 ,$59.74 ,$16.60 ,$34.22 ,$104.88 ,$42.35 ,$16.60 ,$96.90 ,$102.60 ,$16.93 ,$85.50 ,$79.80 ,$79.80 ,$16.60 ,$79.80 ,$87.78 ,$87.78 ,$42.35 ,$96.90 ,$16.94 ,$16.94 ,$63.95 ,$47.20 ,$47.42 ,$18.85 ,$18.64 ,$17.43 ,$96.90 ,$36.42 ,$59.74 ,$31.92 ,$102.60 ,$33.88 ,$16.60 ,$74.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101333,83873,HC MYELIN BASIC PROTEIN (CSF)-90,301,1 ,$68.00 ,$48.96 ,$7.96 ,$68.00 ,$44.20 ,$16.86 ,$19.04 ,$37.60 ,$16.86 ,$39.58 ,$16.86 ,$35.63 ,$16.86 ,$34.74 ,$62.56 ,$43.00 ,$16.86 ,$57.80 ,$61.20 ,$17.19 ,$51.00 ,$47.60 ,$47.60 ,$16.86 ,$47.60 ,$52.36 ,$52.36 ,$43.00 ,$57.80 ,$17.20 ,$17.20 ,$38.15 ,$28.15 ,$28.29 ,$8.05 ,$7.96 ,$17.70 ,$57.80 ,$36.98 ,$35.63 ,$19.04 ,$61.20 ,$34.40 ,$16.86 ,$44.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101334,83874,HC MYOGLOBIN-90,301,1 ,$117.00 ,$84.24 ,$7.96 ,$117.00 ,$76.05 ,$12.66 ,$32.76 ,$64.70 ,$12.66 ,$68.09 ,$12.66 ,$61.31 ,$12.66 ,$26.10 ,$107.64 ,$32.30 ,$12.66 ,$99.45 ,$105.30 ,$12.92 ,$87.75 ,$81.90 ,$81.90 ,$12.66 ,$81.90 ,$90.09 ,$90.09 ,$32.30 ,$99.45 ,$12.92 ,$12.92 ,$65.64 ,$48.44 ,$48.67 ,$8.05 ,$7.96 ,$13.30 ,$99.45 ,$27.78 ,$61.31 ,$32.76 ,$105.30 ,$25.84 ,$12.66 ,$76.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$141.00 ,$101.52 ,$12.30 ,$141.00 ,$91.65 ,$13.33 ,$39.48 ,$77.97 ,$13.33 ,$82.06 ,$13.33 ,$73.88 ,$13.33 ,$27.47 ,$129.72 ,$34.00 ,$13.33 ,$119.85 ,$126.90 ,$13.59 ,$105.75 ,$98.70 ,$98.70 ,$13.33 ,$98.70 ,$108.57 ,$108.57 ,$34.00 ,$119.85 ,$13.60 ,$13.60 ,$79.10 ,$58.37 ,$58.66 ,$12.43 ,$12.30 ,$13.99 ,$119.85 ,$29.24 ,$73.88 ,$39.48 ,$126.90 ,$27.20 ,$13.33 ,$91.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$121.00 ,$87.12 ,$7.96 ,$121.00 ,$78.65 ,$10.93 ,$33.88 ,$66.91 ,$10.93 ,$70.42 ,$10.93 ,$63.40 ,$10.93 ,$22.52 ,$111.32 ,$27.88 ,$10.93 ,$102.85 ,$108.90 ,$11.14 ,$90.75 ,$84.70 ,$84.70 ,$10.93 ,$84.70 ,$93.17 ,$93.17 ,$27.88 ,$102.85 ,$11.15 ,$11.15 ,$67.88 ,$50.09 ,$50.34 ,$8.05 ,$7.96 ,$11.48 ,$102.85 ,$23.97 ,$63.40 ,$33.88 ,$108.90 ,$22.30 ,$10.93 ,$78.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101340,83916,HC OLIGOCLONAL BANDS-90,301,1 ,$103.00 ,$74.16 ,$7.96 ,$103.00 ,$66.95 ,$26.84 ,$28.84 ,$56.96 ,$26.84 ,$59.95 ,$26.84 ,$53.97 ,$26.84 ,$55.33 ,$94.76 ,$68.48 ,$26.84 ,$87.55 ,$92.70 ,$27.38 ,$77.25 ,$72.10 ,$72.10 ,$26.84 ,$72.10 ,$79.31 ,$79.31 ,$68.48 ,$87.55 ,$27.39 ,$27.39 ,$57.78 ,$42.64 ,$42.85 ,$8.05 ,$7.96 ,$28.18 ,$87.55 ,$58.89 ,$53.97 ,$28.84 ,$92.70 ,$54.78 ,$26.84 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101344,83937,HC OSTEOCALCIN-90,301,1 ,$94.00 ,$67.68 ,$18.64 ,$94.00 ,$61.10 ,$29.25 ,$26.32 ,$51.98 ,$29.25 ,$54.71 ,$29.25 ,$49.26 ,$29.25 ,$60.30 ,$86.48 ,$74.63 ,$29.25 ,$79.90 ,$84.60 ,$29.84 ,$70.50 ,$65.80 ,$65.80 ,$29.25 ,$65.80 ,$72.38 ,$72.38 ,$74.63 ,$79.90 ,$29.85 ,$29.85 ,$52.73 ,$38.92 ,$39.10 ,$18.85 ,$18.64 ,$30.71 ,$79.90 ,$64.18 ,$49.26 ,$26.32 ,$84.60 ,$59.70 ,$29.25 ,$61.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101345,83945,HC OXALATE-90,301,1 ,$155.00 ,$111.60 ,$7.96 ,$155.00 ,$100.75 ,$14.16 ,$43.40 ,$85.72 ,$14.16 ,$90.21 ,$14.16 ,$81.22 ,$14.16 ,$29.19 ,$142.60 ,$36.13 ,$14.16 ,$131.75 ,$139.50 ,$14.45 ,$116.25 ,$108.50 ,$108.50 ,$14.16 ,$108.50 ,$119.35 ,$119.35 ,$36.13 ,$131.75 ,$14.45 ,$14.45 ,$86.96 ,$64.17 ,$64.48 ,$8.05 ,$7.96 ,$14.87 ,$131.75 ,$31.07 ,$81.22 ,$43.40 ,$139.50 ,$28.90 ,$14.16 ,$100.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$293.00 ,$210.96 ,$7.96 ,$293.00 ,$190.45 ,$19.24 ,$82.04 ,$162.03 ,$19.24 ,$170.53 ,$19.24 ,$153.53 ,$19.24 ,$39.65 ,$269.56 ,$49.08 ,$19.24 ,$249.05 ,$263.70 ,$19.62 ,$219.75 ,$205.10 ,$205.10 ,$19.24 ,$205.10 ,$225.61 ,$225.61 ,$49.08 ,$249.05 ,$19.63 ,$19.63 ,$164.37 ,$121.30 ,$121.89 ,$8.05 ,$7.96 ,$20.20 ,$249.05 ,$42.20 ,$153.53 ,$82.04 ,$263.70 ,$39.26 ,$19.24 ,$190.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$155.00 ,$111.60 ,$3.54 ,$155.00 ,$100.75 ,$5.39 ,$43.40 ,$85.72 ,$5.39 ,$90.21 ,$5.39 ,$81.22 ,$5.39 ,$11.11 ,$142.60 ,$13.75 ,$5.39 ,$131.75 ,$139.50 ,$5.50 ,$116.25 ,$108.50 ,$108.50 ,$5.39 ,$108.50 ,$119.35 ,$119.35 ,$13.75 ,$131.75 ,$5.50 ,$5.50 ,$86.96 ,$64.17 ,$64.48 ,$3.58 ,$3.54 ,$5.66 ,$131.75 ,$11.83 ,$81.22 ,$43.40 ,$139.50 ,$11.00 ,$5.39 ,$100.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$60.00 ,$43.20 ,$7.96 ,$60.00 ,$39.00 ,$9.47 ,$16.80 ,$33.18 ,$9.47 ,$34.92 ,$9.47 ,$31.44 ,$9.47 ,$19.51 ,$55.20 ,$24.15 ,$9.47 ,$51.00 ,$54.00 ,$9.65 ,$45.00 ,$42.00 ,$42.00 ,$9.47 ,$42.00 ,$46.20 ,$46.20 ,$24.15 ,$51.00 ,$9.66 ,$9.66 ,$33.66 ,$24.84 ,$24.96 ,$8.05 ,$7.96 ,$9.94 ,$51.00 ,$20.77 ,$31.44 ,$16.80 ,$54.00 ,$19.32 ,$9.47 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$239.00 ,$172.08 ,$3.54 ,$239.00 ,$155.35 ,$5.08 ,$66.92 ,$132.17 ,$5.08 ,$139.10 ,$5.08 ,$125.24 ,$5.08 ,$10.46 ,$219.88 ,$12.95 ,$5.08 ,$203.15 ,$215.10 ,$5.17 ,$179.25 ,$167.30 ,$167.30 ,$5.08 ,$167.30 ,$184.03 ,$184.03 ,$12.95 ,$203.15 ,$5.18 ,$5.18 ,$134.08 ,$98.95 ,$99.42 ,$3.58 ,$3.54 ,$5.33 ,$203.15 ,$11.14 ,$125.24 ,$66.92 ,$215.10 ,$10.36 ,$5.08 ,$155.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$76.00 ,$54.72 ,$7.96 ,$76.00 ,$49.40 ,$14.48 ,$21.28 ,$42.03 ,$14.48 ,$44.23 ,$14.48 ,$39.82 ,$14.48 ,$29.86 ,$69.92 ,$36.95 ,$14.48 ,$64.60 ,$68.40 ,$14.78 ,$57.00 ,$53.20 ,$53.20 ,$14.48 ,$53.20 ,$58.52 ,$58.52 ,$36.95 ,$64.60 ,$14.78 ,$14.78 ,$42.64 ,$31.46 ,$31.62 ,$8.05 ,$7.96 ,$15.21 ,$64.60 ,$31.78 ,$39.82 ,$21.28 ,$68.40 ,$29.56 ,$14.48 ,$49.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101359,84110,HC PORPHOBILINOGEN QN-90,301,1 ,$74.00 ,$53.28 ,$7.96 ,$74.00 ,$48.10 ,$8.27 ,$20.72 ,$40.92 ,$8.27 ,$43.07 ,$8.27 ,$38.78 ,$8.27 ,$17.05 ,$68.08 ,$21.10 ,$8.27 ,$62.90 ,$66.60 ,$8.44 ,$55.50 ,$51.80 ,$51.80 ,$8.27 ,$51.80 ,$56.98 ,$56.98 ,$21.10 ,$62.90 ,$8.44 ,$8.44 ,$41.51 ,$30.64 ,$30.78 ,$8.05 ,$7.96 ,$8.68 ,$62.90 ,$18.15 ,$38.78 ,$20.72 ,$66.60 ,$16.88 ,$8.27 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101361,84120,HC PORPHYRINS QN FRACT-90,301,1 ,$74.00 ,$53.28 ,$7.96 ,$74.00 ,$48.10 ,$14.42 ,$20.72 ,$40.92 ,$14.42 ,$43.07 ,$14.42 ,$38.78 ,$14.42 ,$29.71 ,$68.08 ,$36.78 ,$14.42 ,$62.90 ,$66.60 ,$14.70 ,$55.50 ,$51.80 ,$51.80 ,$14.42 ,$51.80 ,$56.98 ,$56.98 ,$36.78 ,$62.90 ,$14.71 ,$14.71 ,$41.51 ,$30.64 ,$30.78 ,$8.05 ,$7.96 ,$15.14 ,$62.90 ,$31.63 ,$38.78 ,$20.72 ,$66.60 ,$29.42 ,$14.42 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101364,84133,HC POTASSIUM URINE-90,301,1 ,$96.00 ,$69.12 ,$3.54 ,$96.00 ,$62.40 ,$4.64 ,$26.88 ,$53.09 ,$4.64 ,$55.87 ,$4.64 ,$50.30 ,$4.64 ,$9.55 ,$88.32 ,$11.83 ,$4.64 ,$81.60 ,$86.40 ,$4.72 ,$72.00 ,$67.20 ,$67.20 ,$4.64 ,$67.20 ,$73.92 ,$73.92 ,$11.83 ,$81.60 ,$4.73 ,$4.73 ,$53.86 ,$39.74 ,$39.94 ,$3.58 ,$3.54 ,$4.87 ,$81.60 ,$10.17 ,$50.30 ,$26.88 ,$86.40 ,$9.46 ,$4.64 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101365,84134,HC PREALBUMIN-90,301,1 ,$146.00 ,$105.12 ,$7.96 ,$146.00 ,$94.90 ,$14.30 ,$40.88 ,$80.74 ,$14.30 ,$84.97 ,$14.30 ,$76.50 ,$14.30 ,$29.47 ,$134.32 ,$36.48 ,$14.30 ,$124.10 ,$131.40 ,$14.58 ,$109.50 ,$102.20 ,$102.20 ,$14.30 ,$102.20 ,$112.42 ,$112.42 ,$36.48 ,$124.10 ,$14.59 ,$14.59 ,$81.91 ,$60.44 ,$60.74 ,$8.05 ,$7.96 ,$15.01 ,$124.10 ,$31.37 ,$76.50 ,$40.88 ,$131.40 ,$29.18 ,$14.30 ,$94.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101366,84140,HC PREGNENOLONE-90,301,1 ,$282.00 ,$203.04 ,$18.64 ,$282.00 ,$183.30 ,$20.26 ,$78.96 ,$155.95 ,$20.26 ,$164.12 ,$20.26 ,$147.77 ,$20.26 ,$41.75 ,$259.44 ,$51.68 ,$20.26 ,$239.70 ,$253.80 ,$20.66 ,$211.50 ,$197.40 ,$197.40 ,$20.26 ,$197.40 ,$217.14 ,$217.14 ,$51.68 ,$239.70 ,$20.67 ,$20.67 ,$158.20 ,$116.75 ,$117.31 ,$18.85 ,$18.64 ,$21.27 ,$239.70 ,$44.44 ,$147.77 ,$78.96 ,$253.80 ,$41.34 ,$20.26 ,$183.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101368,84144,HC PROGESTERONE-90,301,1 ,$190.00 ,$136.80 ,$10.72 ,$190.00 ,$123.50 ,$20.44 ,$53.20 ,$105.07 ,$20.44 ,$110.58 ,$20.44 ,$99.56 ,$20.44 ,$42.14 ,$174.80 ,$52.15 ,$20.44 ,$161.50 ,$171.00 ,$20.85 ,$142.50 ,$133.00 ,$133.00 ,$20.44 ,$133.00 ,$146.30 ,$146.30 ,$52.15 ,$161.50 ,$20.86 ,$20.86 ,$106.59 ,$78.66 ,$79.04 ,$10.84 ,$10.72 ,$21.46 ,$161.50 ,$44.85 ,$99.56 ,$53.20 ,$171.00 ,$41.72 ,$20.44 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101372,84155,HC PROTEIN TOTAL-90,301,1 ,$60.00 ,$43.20 ,$3.54 ,$60.00 ,$39.00 ,$3.60 ,$16.80 ,$33.18 ,$3.60 ,$34.92 ,$3.60 ,$31.44 ,$3.60 ,$7.41 ,$55.20 ,$9.18 ,$3.60 ,$51.00 ,$54.00 ,$3.67 ,$45.00 ,$42.00 ,$42.00 ,$3.60 ,$42.00 ,$46.20 ,$46.20 ,$9.18 ,$51.00 ,$3.67 ,$3.67 ,$33.66 ,$24.84 ,$24.96 ,$3.58 ,$3.54 ,$3.77 ,$51.00 ,$7.89 ,$31.44 ,$16.80 ,$54.00 ,$7.34 ,$3.60 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101373,84156,HC PROTEIN TOTAL URINE-90,301,1 ,$105.00 ,$75.60 ,$3.54 ,$105.00 ,$68.25 ,$3.60 ,$29.40 ,$58.07 ,$3.60 ,$61.11 ,$3.60 ,$55.02 ,$3.60 ,$7.41 ,$96.60 ,$9.18 ,$3.60 ,$89.25 ,$94.50 ,$3.67 ,$78.75 ,$73.50 ,$73.50 ,$3.60 ,$73.50 ,$80.85 ,$80.85 ,$9.18 ,$89.25 ,$3.67 ,$3.67 ,$58.91 ,$43.47 ,$43.68 ,$3.58 ,$3.54 ,$3.77 ,$89.25 ,$7.89 ,$55.02 ,$29.40 ,$94.50 ,$7.34 ,$3.60 ,$68.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101374,84157,HC PROTEIN TOTAL OTH SRC-90,301,1 ,$30.00 ,$21.60 ,$3.54 ,$30.00 ,$19.50 ,$3.92 ,$8.40 ,$16.59 ,$3.92 ,$17.46 ,$3.92 ,$15.72 ,$3.92 ,$8.08 ,$27.60 ,$10.00 ,$3.92 ,$25.50 ,$27.00 ,$4.00 ,$22.50 ,$21.00 ,$21.00 ,$3.92 ,$21.00 ,$23.10 ,$23.10 ,$10.00 ,$25.50 ,$4.00 ,$4.00 ,$16.83 ,$12.42 ,$12.48 ,$3.58 ,$3.54 ,$4.12 ,$25.50 ,$8.60 ,$15.72 ,$8.40 ,$27.00 ,$8.00 ,$3.92 ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101375,84165,HC PROTEIN ELECTROPHORESIS-90,301,1 ,$185.00 ,$133.20 ,$7.96 ,$185.00 ,$120.25 ,$10.53 ,$51.80 ,$102.31 ,$10.53 ,$107.67 ,$10.53 ,$96.94 ,$10.53 ,$21.69 ,$170.20 ,$26.85 ,$10.53 ,$157.25 ,$166.50 ,$10.73 ,$138.75 ,$129.50 ,$129.50 ,$10.53 ,$129.50 ,$142.45 ,$142.45 ,$26.85 ,$157.25 ,$10.74 ,$10.74 ,$103.79 ,$76.59 ,$76.96 ,$8.05 ,$7.96 ,$11.05 ,$157.25 ,$23.09 ,$96.94 ,$51.80 ,$166.50 ,$21.48 ,$10.53 ,$120.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101377,84166,HC PROTEIN EP OTH FLUID-90,301,1 ,$185.00 ,$133.20 ,$7.96 ,$185.00 ,$120.25 ,$17.47 ,$51.80 ,$102.31 ,$17.47 ,$107.67 ,$17.47 ,$96.94 ,$17.47 ,$36.02 ,$170.20 ,$44.58 ,$17.47 ,$157.25 ,$166.50 ,$17.83 ,$138.75 ,$129.50 ,$129.50 ,$17.47 ,$129.50 ,$142.45 ,$142.45 ,$44.58 ,$157.25 ,$17.83 ,$17.83 ,$103.79 ,$76.59 ,$76.96 ,$8.05 ,$7.96 ,$18.35 ,$157.25 ,$38.33 ,$96.94 ,$51.80 ,$166.50 ,$35.66 ,$17.47 ,$120.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101379,84181,HC PROTEIN WESTERN BLOT-90,301,1 ,"$1,426.00 ","$1,026.72 ",$7.13 ,"$1,426.00 ",$926.90 ,$16.69 ,$399.28 ,$788.58 ,$16.69 ,$829.93 ,$16.69 ,$747.22 ,$16.69 ,$34.40 ,"$1,311.92 ",$42.58 ,$16.69 ,"$1,212.10 ","$1,283.40 ",$17.02 ,"$1,069.50 ",$998.20 ,$998.20 ,$16.69 ,$998.20 ,"$1,098.02 ","$1,098.02 ",$42.58 ,"$1,212.10 ",$17.03 ,$17.03 ,$799.99 ,$590.36 ,$593.22 ,$7.21 ,$7.13 ,$17.52 ,"$1,212.10 ",$36.61 ,$747.22 ,$399.28 ,"$1,283.40 ",$34.06 ,$16.69 ,$926.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101380,84182,HC PROTEIN WEST BLOT BAND ID-90,301,1 ,$109.00 ,$78.48 ,$12.30 ,$109.00 ,$70.85 ,$28.63 ,$30.52 ,$60.28 ,$28.63 ,$63.44 ,$28.63 ,$57.12 ,$28.63 ,$59.00 ,$100.28 ,$73.03 ,$28.63 ,$92.65 ,$98.10 ,$29.19 ,$81.75 ,$76.30 ,$76.30 ,$28.63 ,$76.30 ,$83.93 ,$83.93 ,$73.03 ,$92.65 ,$29.21 ,$29.21 ,$61.15 ,$45.13 ,$45.34 ,$12.43 ,$12.30 ,$30.06 ,$92.65 ,$62.80 ,$57.12 ,$30.52 ,$98.10 ,$58.42 ,$28.63 ,$70.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101381,84202,HC PROTOPORPHYRIN-90,301,1 ,$71.00 ,$51.12 ,$7.96 ,$71.00 ,$46.15 ,$14.06 ,$19.88 ,$39.26 ,$14.06 ,$41.32 ,$14.06 ,$37.20 ,$14.06 ,$28.99 ,$65.32 ,$35.88 ,$14.06 ,$60.35 ,$63.90 ,$14.35 ,$53.25 ,$49.70 ,$49.70 ,$14.06 ,$49.70 ,$54.67 ,$54.67 ,$35.88 ,$60.35 ,$14.35 ,$14.35 ,$39.83 ,$29.39 ,$29.54 ,$8.05 ,$7.96 ,$14.77 ,$60.35 ,$30.85 ,$37.20 ,$19.88 ,$63.90 ,$28.70 ,$14.06 ,$46.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101382,84206,HC PROINSULIN-90,301,1 ,$103.00 ,$74.16 ,$18.64 ,$103.00 ,$66.95 ,$26.16 ,$28.84 ,$56.96 ,$26.16 ,$59.95 ,$26.16 ,$53.97 ,$26.16 ,$53.91 ,$94.76 ,$66.73 ,$26.16 ,$87.55 ,$92.70 ,$26.68 ,$77.25 ,$72.10 ,$72.10 ,$26.16 ,$72.10 ,$79.31 ,$79.31 ,$66.73 ,$87.55 ,$26.69 ,$26.69 ,$57.78 ,$42.64 ,$42.85 ,$18.85 ,$18.64 ,$27.46 ,$87.55 ,$57.38 ,$53.97 ,$28.84 ,$92.70 ,$53.38 ,$26.16 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101383,84207,HC VITAMIN B6-90,301,1 ,$185.00 ,$133.20 ,$7.96 ,$185.00 ,$120.25 ,$27.54 ,$51.80 ,$102.31 ,$27.54 ,$107.67 ,$27.54 ,$96.94 ,$27.54 ,$56.76 ,$170.20 ,$70.25 ,$27.54 ,$157.25 ,$166.50 ,$28.09 ,$138.75 ,$129.50 ,$129.50 ,$27.54 ,$129.50 ,$142.45 ,$142.45 ,$70.25 ,$157.25 ,$28.10 ,$28.10 ,$103.79 ,$76.59 ,$76.96 ,$8.05 ,$7.96 ,$28.92 ,$157.25 ,$60.42 ,$96.94 ,$51.80 ,$166.50 ,$56.20 ,$27.54 ,$120.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101386,84238,HC RECEPTOR ASSAY NON ENDO-90,301,1 ,$240.00 ,$172.80 ,$21.44 ,$240.00 ,$156.00 ,$35.84 ,$67.20 ,$132.72 ,$35.84 ,$139.68 ,$35.84 ,$125.76 ,$35.84 ,$73.87 ,$220.80 ,$91.43 ,$35.84 ,$204.00 ,$216.00 ,$36.55 ,$180.00 ,$168.00 ,$168.00 ,$35.84 ,$168.00 ,$184.80 ,$184.80 ,$91.43 ,$204.00 ,$36.57 ,$36.57 ,$134.64 ,$99.36 ,$99.84 ,$21.67 ,$21.44 ,$37.63 ,$204.00 ,$78.63 ,$125.76 ,$67.20 ,$216.00 ,$73.14 ,$35.84 ,$156.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101387,84244,HC RENIN-90,301,1 ,$240.00 ,$172.80 ,$18.64 ,$240.00 ,$156.00 ,$21.55 ,$67.20 ,$132.72 ,$21.55 ,$139.68 ,$21.55 ,$125.76 ,$21.55 ,$44.42 ,$220.80 ,$54.98 ,$21.55 ,$204.00 ,$216.00 ,$21.98 ,$180.00 ,$168.00 ,$168.00 ,$21.55 ,$168.00 ,$184.80 ,$184.80 ,$54.98 ,$204.00 ,$21.99 ,$21.99 ,$134.64 ,$99.36 ,$99.84 ,$18.85 ,$18.64 ,$22.63 ,$204.00 ,$47.28 ,$125.76 ,$67.20 ,$216.00 ,$43.98 ,$21.55 ,$156.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101388,84255,HC SELENIUM-90,301,1 ,$231.00 ,$166.32 ,$7.96 ,$231.00 ,$150.15 ,$25.02 ,$64.68 ,$127.74 ,$25.02 ,$134.44 ,$25.02 ,$121.04 ,$25.02 ,$51.57 ,$212.52 ,$63.83 ,$25.02 ,$196.35 ,$207.90 ,$25.52 ,$173.25 ,$161.70 ,$161.70 ,$25.02 ,$161.70 ,$177.87 ,$177.87 ,$63.83 ,$196.35 ,$25.53 ,$25.53 ,$129.59 ,$95.63 ,$96.10 ,$8.05 ,$7.96 ,$26.27 ,$196.35 ,$54.89 ,$121.04 ,$64.68 ,$207.90 ,$51.06 ,$25.02 ,$150.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101389,84252,HC VITAMIN B-2 (RIBOFLAVIN)-90,301,1 ,$90.00 ,$64.80 ,$7.96 ,$90.00 ,$58.50 ,$19.84 ,$25.20 ,$49.77 ,$19.84 ,$52.38 ,$19.84 ,$47.16 ,$19.84 ,$40.88 ,$82.80 ,$50.60 ,$19.84 ,$76.50 ,$81.00 ,$20.23 ,$67.50 ,$63.00 ,$63.00 ,$19.84 ,$63.00 ,$69.30 ,$69.30 ,$50.60 ,$76.50 ,$20.24 ,$20.24 ,$50.49 ,$37.26 ,$37.44 ,$8.05 ,$7.96 ,$20.82 ,$76.50 ,$43.52 ,$47.16 ,$25.20 ,$81.00 ,$40.48 ,$19.84 ,$58.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$83.00 ,$59.76 ,$7.96 ,$83.00 ,$53.95 ,$21.30 ,$23.24 ,$45.90 ,$21.30 ,$48.31 ,$21.30 ,$43.49 ,$21.30 ,$43.89 ,$76.36 ,$54.33 ,$21.30 ,$70.55 ,$74.70 ,$21.72 ,$62.25 ,$58.10 ,$58.10 ,$21.30 ,$58.10 ,$63.91 ,$63.91 ,$54.33 ,$70.55 ,$21.73 ,$21.73 ,$46.56 ,$34.36 ,$34.53 ,$8.05 ,$7.96 ,$22.36 ,$70.55 ,$46.72 ,$43.49 ,$23.24 ,$74.70 ,$43.46 ,$21.30 ,$53.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101392,84260,HC SEROTONIN-90,301,1 ,$74.00 ,$53.28 ,$18.64 ,$77.45 ,$48.10 ,$30.36 ,$20.72 ,$40.92 ,$30.36 ,$43.07 ,$30.36 ,$38.78 ,$30.36 ,$62.58 ,$68.08 ,$77.45 ,$30.36 ,$62.90 ,$66.60 ,$30.97 ,$55.50 ,$51.80 ,$51.80 ,$30.36 ,$51.80 ,$56.98 ,$56.98 ,$74.00 ,$62.90 ,$30.98 ,$30.98 ,$41.51 ,$30.64 ,$30.78 ,$18.85 ,$18.64 ,$31.88 ,$62.90 ,$66.61 ,$38.78 ,$20.72 ,$66.60 ,$61.96 ,$30.36 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101394,84300,HC SODIUM URINE-90,301,1 ,$96.00 ,$69.12 ,$3.54 ,$96.00 ,$62.40 ,$4.96 ,$26.88 ,$53.09 ,$4.96 ,$55.87 ,$4.96 ,$50.30 ,$4.96 ,$10.22 ,$88.32 ,$12.65 ,$4.96 ,$81.60 ,$86.40 ,$5.06 ,$72.00 ,$67.20 ,$67.20 ,$4.96 ,$67.20 ,$73.92 ,$73.92 ,$12.65 ,$81.60 ,$5.06 ,$5.06 ,$53.86 ,$39.74 ,$39.94 ,$3.58 ,$3.54 ,$5.20 ,$81.60 ,$10.88 ,$50.30 ,$26.88 ,$86.40 ,$10.12 ,$4.96 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$16.00 ,$11.52 ,$3.54 ,$16.00 ,$10.40 ,$4.76 ,$4.48 ,$8.85 ,$4.76 ,$9.31 ,$4.76 ,$8.38 ,$4.76 ,$9.82 ,$14.72 ,$12.15 ,$4.76 ,$13.60 ,$14.40 ,$4.86 ,$12.00 ,$11.20 ,$11.20 ,$4.76 ,$11.20 ,$12.32 ,$12.32 ,$12.15 ,$13.60 ,$4.86 ,$4.86 ,$8.98 ,$6.62 ,$6.66 ,$3.58 ,$3.54 ,$5.00 ,$13.60 ,$10.45 ,$8.38 ,$4.48 ,$14.40 ,$9.72 ,$4.76 ,$10.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101396,84305,HC SOMATOMEDIN-90,301,1 ,$255.00 ,$183.60 ,$18.64 ,$255.00 ,$165.75 ,$20.83 ,$71.40 ,$141.02 ,$20.83 ,$148.41 ,$20.83 ,$133.62 ,$20.83 ,$42.95 ,$234.60 ,$53.15 ,$20.83 ,$216.75 ,$229.50 ,$21.26 ,$191.25 ,$178.50 ,$178.50 ,$20.83 ,$178.50 ,$196.35 ,$196.35 ,$53.15 ,$216.75 ,$21.26 ,$21.26 ,$143.06 ,$105.57 ,$106.08 ,$18.85 ,$18.64 ,$21.87 ,$216.75 ,$45.71 ,$133.62 ,$71.40 ,$229.50 ,$42.52 ,$20.83 ,$165.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$80.00 ,$57.60 ,$7.94 ,$80.00 ,$52.00 ,$7.94 ,$22.40 ,$44.24 ,$7.94 ,$46.56 ,$7.94 ,$41.92 ,$7.94 ,$16.36 ,$73.60 ,$20.25 ,$7.94 ,$68.00 ,$72.00 ,$8.09 ,$60.00 ,$56.00 ,$56.00 ,$7.94 ,$56.00 ,$61.60 ,$61.60 ,$20.25 ,$68.00 ,$8.10 ,$8.10 ,$44.88 ,$33.12 ,$33.28 ,$8.05 ,$7.96 ,$8.34 ,$68.00 ,$17.42 ,$41.92 ,$22.40 ,$72.00 ,$16.20 ,$7.94 ,$52.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101402,84376,HC SUGARS SINGLE QL-90,301,1 ,$5.00 ,$3.60 ,$1.40 ,$12.50 ,$3.25 ,$4.90 ,$1.40 ,$2.77 ,$4.90 ,$2.91 ,$4.90 ,$2.62 ,$4.90 ,$5.00 ,$4.60 ,$12.50 ,$4.90 ,$4.25 ,$4.50 ,$4.90 ,$3.75 ,$3.50 ,$3.50 ,$4.90 ,$3.50 ,$3.85 ,$3.85 ,$5.00 ,$4.25 ,$5.00 ,$5.00 ,$2.81 ,$2.07 ,$2.08 ,$3.58 ,$3.54 ,$5.14 ,$4.25 ,$10.75 ,$2.62 ,$1.40 ,$4.50 ,$5.00 ,$4.90 ,$3.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101405,84392,HC SULFATE URINE-90,301,1 ,$445.00 ,$320.40 ,$2.85 ,$445.00 ,$289.25 ,$5.38 ,$124.60 ,$246.09 ,$5.38 ,$258.99 ,$5.38 ,$233.18 ,$5.38 ,$11.09 ,$409.40 ,$13.73 ,$5.38 ,$378.25 ,$400.50 ,$5.49 ,$333.75 ,$311.50 ,$311.50 ,$5.38 ,$311.50 ,$342.65 ,$342.65 ,$13.73 ,$378.25 ,$5.49 ,$5.49 ,$249.65 ,$184.23 ,$185.12 ,$2.88 ,$2.85 ,$5.64 ,$378.25 ,$11.80 ,$233.18 ,$124.60 ,$400.50 ,$10.98 ,$5.38 ,$289.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$186.00 ,$133.92 ,$18.64 ,$186.00 ,$120.90 ,$24.96 ,$52.08 ,$102.86 ,$24.96 ,$108.25 ,$24.96 ,$97.46 ,$24.96 ,$51.45 ,$171.12 ,$63.68 ,$24.96 ,$158.10 ,$167.40 ,$25.46 ,$139.50 ,$130.20 ,$130.20 ,$24.96 ,$130.20 ,$143.22 ,$143.22 ,$63.68 ,$158.10 ,$25.47 ,$25.47 ,$104.35 ,$77.00 ,$77.38 ,$18.85 ,$18.64 ,$26.21 ,$158.10 ,$54.76 ,$97.46 ,$52.08 ,$167.40 ,$50.94 ,$24.96 ,$120.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$197.00 ,$141.84 ,$18.64 ,$197.00 ,$128.05 ,$25.29 ,$55.16 ,$108.94 ,$25.29 ,$114.65 ,$25.29 ,$103.23 ,$25.29 ,$52.14 ,$181.24 ,$64.53 ,$25.29 ,$167.45 ,$177.30 ,$25.80 ,$147.75 ,$137.90 ,$137.90 ,$25.29 ,$137.90 ,$151.69 ,$151.69 ,$64.53 ,$167.45 ,$25.81 ,$25.81 ,$110.52 ,$81.56 ,$81.95 ,$18.85 ,$18.64 ,$26.56 ,$167.45 ,$55.49 ,$103.23 ,$55.16 ,$177.30 ,$51.62 ,$25.29 ,$128.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101408,84425,HC VITAMIN B1-90,301,1 ,$241.00 ,$173.52 ,$7.96 ,$241.00 ,$156.65 ,$20.81 ,$67.48 ,$133.27 ,$20.81 ,$140.26 ,$20.81 ,$126.28 ,$20.81 ,$42.88 ,$221.72 ,$53.08 ,$20.81 ,$204.85 ,$216.90 ,$21.22 ,$180.75 ,$168.70 ,$168.70 ,$20.81 ,$168.70 ,$185.57 ,$185.57 ,$53.08 ,$204.85 ,$21.23 ,$21.23 ,$135.20 ,$99.77 ,$100.26 ,$8.05 ,$7.96 ,$21.84 ,$204.85 ,$45.64 ,$126.28 ,$67.48 ,$216.90 ,$42.46 ,$20.81 ,$156.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101409,84430,HC THIOCYANATE-90,301,1 ,$22.00 ,$15.84 ,$6.16 ,$29.08 ,$14.30 ,$11.40 ,$6.16 ,$12.17 ,$11.40 ,$12.80 ,$11.40 ,$11.53 ,$11.40 ,$22.00 ,$20.24 ,$29.08 ,$11.40 ,$18.70 ,$19.80 ,$11.62 ,$16.50 ,$15.40 ,$15.40 ,$11.40 ,$15.40 ,$16.94 ,$16.94 ,$22.00 ,$18.70 ,$11.63 ,$11.63 ,$12.34 ,$9.11 ,$9.15 ,$9.82 ,$9.71 ,$11.97 ,$18.70 ,$25.00 ,$11.53 ,$6.16 ,$19.80 ,$22.00 ,$11.40 ,$14.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101410,84432,HC THYROGLOBULIN-90,301,1 ,$59.00 ,$42.48 ,$15.74 ,$59.00 ,$38.35 ,$15.74 ,$16.52 ,$32.63 ,$15.74 ,$34.34 ,$15.74 ,$30.92 ,$15.74 ,$32.44 ,$54.28 ,$40.15 ,$15.74 ,$50.15 ,$53.10 ,$16.05 ,$44.25 ,$41.30 ,$41.30 ,$15.74 ,$41.30 ,$45.43 ,$45.43 ,$40.15 ,$50.15 ,$16.06 ,$16.06 ,$33.10 ,$24.43 ,$24.54 ,$18.85 ,$18.64 ,$16.52 ,$50.15 ,$34.53 ,$30.92 ,$16.52 ,$53.10 ,$32.12 ,$15.74 ,$38.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101415,84442,HC THYROXINE BIND GLOB-90,301,1 ,$131.00 ,$94.32 ,$10.72 ,$131.00 ,$85.15 ,$14.48 ,$36.68 ,$72.44 ,$14.48 ,$76.24 ,$14.48 ,$68.64 ,$14.48 ,$29.86 ,$120.52 ,$36.95 ,$14.48 ,$111.35 ,$117.90 ,$14.78 ,$98.25 ,$91.70 ,$91.70 ,$14.48 ,$91.70 ,$100.87 ,$100.87 ,$36.95 ,$111.35 ,$14.78 ,$14.78 ,$73.49 ,$54.23 ,$54.50 ,$10.84 ,$10.72 ,$15.21 ,$111.35 ,$31.78 ,$68.64 ,$36.68 ,$117.90 ,$29.56 ,$14.48 ,$85.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$370.00 ,$266.40 ,$18.64 ,$370.00 ,$240.50 ,$49.84 ,$103.60 ,$204.61 ,$49.84 ,$215.34 ,$49.84 ,$193.88 ,$49.84 ,$102.74 ,$340.40 ,$127.15 ,$49.84 ,$314.50 ,$333.00 ,$50.84 ,$277.50 ,$259.00 ,$259.00 ,$49.84 ,$259.00 ,$284.90 ,$284.90 ,$127.15 ,$314.50 ,$50.86 ,$50.86 ,$207.57 ,$153.18 ,$153.92 ,$18.85 ,$18.64 ,$52.33 ,$314.50 ,$109.35 ,$193.88 ,$103.60 ,$333.00 ,$101.72 ,$49.84 ,$240.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101418,84446,HC VITAMIN E-90,301,1 ,$98.00 ,$70.56 ,$7.96 ,$98.00 ,$63.70 ,$13.90 ,$27.44 ,$54.19 ,$13.90 ,$57.04 ,$13.90 ,$51.35 ,$13.90 ,$28.64 ,$90.16 ,$35.45 ,$13.90 ,$83.30 ,$88.20 ,$14.17 ,$73.50 ,$68.60 ,$68.60 ,$13.90 ,$68.60 ,$75.46 ,$75.46 ,$35.45 ,$83.30 ,$14.18 ,$14.18 ,$54.98 ,$40.57 ,$40.77 ,$8.05 ,$7.96 ,$14.59 ,$83.30 ,$30.49 ,$51.35 ,$27.44 ,$88.20 ,$28.36 ,$13.90 ,$63.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101422,84479,HC T3 UPTAKE-90,301,1 ,$67.00 ,$48.24 ,$6.34 ,$67.00 ,$43.55 ,$6.34 ,$18.76 ,$37.05 ,$6.34 ,$38.99 ,$6.34 ,$35.11 ,$6.34 ,$13.07 ,$61.64 ,$16.18 ,$6.34 ,$56.95 ,$60.30 ,$6.47 ,$50.25 ,$46.90 ,$46.90 ,$6.34 ,$46.90 ,$51.59 ,$51.59 ,$16.18 ,$56.95 ,$6.47 ,$6.47 ,$37.59 ,$27.74 ,$27.87 ,$10.84 ,$10.72 ,$6.65 ,$56.95 ,$13.91 ,$35.11 ,$18.76 ,$60.30 ,$12.94 ,$6.34 ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101423,84480,HC T3 TOTAL-90,301,1 ,$156.00 ,$112.32 ,$10.72 ,$156.00 ,$101.40 ,$13.90 ,$43.68 ,$86.27 ,$13.90 ,$90.79 ,$13.90 ,$81.74 ,$13.90 ,$28.64 ,$143.52 ,$35.45 ,$13.90 ,$132.60 ,$140.40 ,$14.17 ,$117.00 ,$109.20 ,$109.20 ,$13.90 ,$109.20 ,$120.12 ,$120.12 ,$35.45 ,$132.60 ,$14.18 ,$14.18 ,$87.52 ,$64.58 ,$64.90 ,$10.84 ,$10.72 ,$14.59 ,$132.60 ,$30.49 ,$81.74 ,$43.68 ,$140.40 ,$28.36 ,$13.90 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101425,84482,HC T3 REVERSE-90,301,1 ,$396.00 ,$285.12 ,$10.72 ,$396.00 ,$257.40 ,$15.44 ,$110.88 ,$218.99 ,$15.44 ,$230.47 ,$15.44 ,$207.50 ,$15.44 ,$31.84 ,$364.32 ,$39.40 ,$15.44 ,$336.60 ,$356.40 ,$15.76 ,$297.00 ,$277.20 ,$277.20 ,$15.44 ,$277.20 ,$304.92 ,$304.92 ,$39.40 ,$336.60 ,$15.76 ,$15.76 ,$222.16 ,$163.94 ,$164.74 ,$10.84 ,$10.72 ,$16.22 ,$336.60 ,$33.88 ,$207.50 ,$110.88 ,$356.40 ,$31.52 ,$15.44 ,$257.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$177.00 ,$127.44 ,$3.54 ,$177.00 ,$115.05 ,$4.98 ,$49.56 ,$97.88 ,$4.98 ,$103.01 ,$4.98 ,$92.75 ,$4.98 ,$10.26 ,$162.84 ,$12.70 ,$4.98 ,$150.45 ,$159.30 ,$5.08 ,$132.75 ,$123.90 ,$123.90 ,$4.98 ,$123.90 ,$136.29 ,$136.29 ,$12.70 ,$150.45 ,$5.08 ,$5.08 ,$99.30 ,$73.28 ,$73.63 ,$3.58 ,$3.54 ,$5.22 ,$150.45 ,$10.92 ,$92.75 ,$49.56 ,$159.30 ,$10.16 ,$4.98 ,$115.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$101.00 ,$72.72 ,$15.19 ,$101.00 ,$65.65 ,$15.19 ,$28.28 ,$55.85 ,$15.19 ,$58.78 ,$15.19 ,$52.92 ,$15.19 ,$31.31 ,$92.92 ,$38.75 ,$15.19 ,$85.85 ,$90.90 ,$15.49 ,$75.75 ,$70.70 ,$70.70 ,$15.19 ,$70.70 ,$77.77 ,$77.77 ,$38.75 ,$85.85 ,$15.50 ,$15.50 ,$56.66 ,$41.81 ,$42.02 ,$18.85 ,$18.64 ,$15.95 ,$85.85 ,$33.33 ,$52.92 ,$28.28 ,$90.90 ,$31.00 ,$15.19 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101436,84586,HC VASOACTIVE INTEST PEPTIDE-90,301,1 ,$163.00 ,$117.36 ,$18.64 ,$163.00 ,$105.95 ,$34.62 ,$45.64 ,$90.14 ,$34.62 ,$94.87 ,$34.62 ,$85.41 ,$34.62 ,$71.37 ,$149.96 ,$88.33 ,$34.62 ,$138.55 ,$146.70 ,$35.32 ,$122.25 ,$114.10 ,$114.10 ,$34.62 ,$114.10 ,$125.51 ,$125.51 ,$88.33 ,$138.55 ,$35.33 ,$35.33 ,$91.44 ,$67.48 ,$67.81 ,$18.85 ,$18.64 ,$36.36 ,$138.55 ,$75.96 ,$85.41 ,$45.64 ,$146.70 ,$70.66 ,$34.62 ,$105.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101438,84590,HC VITAMIN A-90,301,1 ,$69.00 ,$49.68 ,$7.96 ,$69.00 ,$44.85 ,$11.38 ,$19.32 ,$38.16 ,$11.38 ,$40.16 ,$11.38 ,$36.16 ,$11.38 ,$23.45 ,$63.48 ,$29.03 ,$11.38 ,$58.65 ,$62.10 ,$11.60 ,$51.75 ,$48.30 ,$48.30 ,$11.38 ,$48.30 ,$53.13 ,$53.13 ,$29.03 ,$58.65 ,$11.61 ,$11.61 ,$38.71 ,$28.57 ,$28.70 ,$8.05 ,$7.96 ,$11.95 ,$58.65 ,$24.96 ,$36.16 ,$19.32 ,$62.10 ,$23.22 ,$11.38 ,$44.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101439,84591,HC VITAMIN A OTHER-90,301,1 ,$90.00 ,$64.80 ,$9.15 ,$90.00 ,$58.50 ,$16.72 ,$25.20 ,$49.77 ,$16.72 ,$52.38 ,$16.72 ,$47.16 ,$16.72 ,$34.46 ,$82.80 ,$42.65 ,$16.72 ,$76.50 ,$81.00 ,$17.05 ,$67.50 ,$63.00 ,$63.00 ,$16.72 ,$63.00 ,$69.30 ,$69.30 ,$42.65 ,$76.50 ,$17.06 ,$17.06 ,$50.49 ,$37.26 ,$37.44 ,$9.24 ,$9.15 ,$17.55 ,$76.50 ,$36.68 ,$47.16 ,$25.20 ,$81.00 ,$34.12 ,$16.72 ,$58.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101440,84597,HC VITAMIN K-90,301,1 ,$110.00 ,$79.20 ,$7.96 ,$110.00 ,$71.50 ,$13.45 ,$30.80 ,$60.83 ,$13.45 ,$64.02 ,$13.45 ,$57.64 ,$13.45 ,$27.71 ,$101.20 ,$34.30 ,$13.45 ,$93.50 ,$99.00 ,$13.71 ,$82.50 ,$77.00 ,$77.00 ,$13.45 ,$77.00 ,$84.70 ,$84.70 ,$34.30 ,$93.50 ,$13.72 ,$13.72 ,$61.71 ,$45.54 ,$45.76 ,$8.05 ,$7.96 ,$14.12 ,$93.50 ,$29.50 ,$57.64 ,$30.80 ,$99.00 ,$27.44 ,$13.45 ,$71.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101441,84600,HC VOLATILES-90,301,1 ,$60.00 ,$43.20 ,$7.96 ,$60.00 ,$39.00 ,$16.77 ,$16.80 ,$33.18 ,$16.77 ,$34.92 ,$16.77 ,$31.44 ,$16.77 ,$34.56 ,$55.20 ,$42.78 ,$16.77 ,$51.00 ,$54.00 ,$17.10 ,$45.00 ,$42.00 ,$42.00 ,$16.77 ,$42.00 ,$46.20 ,$46.20 ,$42.78 ,$51.00 ,$17.11 ,$17.11 ,$33.66 ,$24.84 ,$24.96 ,$8.05 ,$7.96 ,$17.61 ,$51.00 ,$36.79 ,$31.44 ,$16.80 ,$54.00 ,$34.22 ,$16.77 ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101442,84630,HC ZINC-90,301,1 ,$135.00 ,$97.20 ,$9.71 ,$135.00 ,$87.75 ,$11.16 ,$37.80 ,$74.66 ,$11.16 ,$78.57 ,$11.16 ,$70.74 ,$11.16 ,$23.01 ,$124.20 ,$28.48 ,$11.16 ,$114.75 ,$121.50 ,$11.39 ,$101.25 ,$94.50 ,$94.50 ,$11.16 ,$94.50 ,$103.95 ,$103.95 ,$28.48 ,$114.75 ,$11.39 ,$11.39 ,$75.74 ,$55.89 ,$56.16 ,$9.82 ,$9.71 ,$11.72 ,$114.75 ,$24.49 ,$70.74 ,$37.80 ,$121.50 ,$22.78 ,$11.16 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101443,84681,HC C PEPTIDE-90,301,1 ,$148.00 ,$106.56 ,$7.96 ,$148.00 ,$96.20 ,$20.39 ,$41.44 ,$81.84 ,$20.39 ,$86.14 ,$20.39 ,$77.55 ,$20.39 ,$42.04 ,$136.16 ,$52.03 ,$20.39 ,$125.80 ,$133.20 ,$20.81 ,$111.00 ,$103.60 ,$103.60 ,$20.39 ,$103.60 ,$113.96 ,$113.96 ,$52.03 ,$125.80 ,$20.81 ,$20.81 ,$83.03 ,$61.27 ,$61.57 ,$8.05 ,$7.96 ,$21.41 ,$125.80 ,$44.74 ,$77.55 ,$41.44 ,$133.20 ,$41.62 ,$20.39 ,$96.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101444,84702,HC HCG QN-90,301,1 ,$199.00 ,$143.28 ,$10.72 ,$199.00 ,$129.35 ,$14.75 ,$55.72 ,$110.05 ,$14.75 ,$115.82 ,$14.75 ,$104.28 ,$14.75 ,$30.40 ,$183.08 ,$37.63 ,$14.75 ,$169.15 ,$179.10 ,$15.04 ,$149.25 ,$139.30 ,$139.30 ,$14.75 ,$139.30 ,$153.23 ,$153.23 ,$37.63 ,$169.15 ,$15.05 ,$15.05 ,$111.64 ,$82.39 ,$82.78 ,$10.84 ,$10.72 ,$15.48 ,$169.15 ,$32.36 ,$104.28 ,$55.72 ,$179.10 ,$30.10 ,$14.75 ,$129.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101455,G0480,HC DRUG SCRN DEFNT 1-7 CLS T1-90,301,1 ,$58.00 ,$41.76 ,$16.24 ,$145.00 ,$37.70 ,$56.84 ,$16.24 ,$32.07 ,$56.84 ,$33.76 ,$56.84 ,$30.39 ,$56.84 ,$58.00 ,$53.36 ,$145.00 ,$56.84 ,$49.30 ,$52.20 ,$56.84 ,$43.50 ,$40.60 ,$40.60 ,$56.84 ,$40.60 ,$44.66 ,$44.66 ,$58.00 ,$49.30 ,$58.00 ,$58.00 ,$32.54 ,$24.01 ,$24.13 ,$21.67 ,$21.44 ,$59.68 ,$49.30 ,$124.70 ,$30.39 ,$16.24 ,$52.20 ,$58.00 ,$56.84 ,$37.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101463,G0483,HC DRUG SCRN DEFINT 22+ CLASS-90,301,1 ,$251.00 ,$180.72 ,$21.44 ,$617.30 ,$163.15 ,$241.98 ,$70.28 ,$138.80 ,$241.98 ,$146.08 ,$241.98 ,$131.52 ,$241.98 ,$251.00 ,$230.92 ,$617.30 ,$241.98 ,$213.35 ,$225.90 ,$245.98 ,$188.25 ,$175.70 ,$175.70 ,$241.98 ,$175.70 ,$193.27 ,$193.27 ,$251.00 ,$213.35 ,$246.92 ,$246.92 ,$140.81 ,$103.91 ,$104.42 ,$21.67 ,$21.44 ,$254.08 ,$213.35 ,$530.88 ,$131.52 ,$70.28 ,$225.90 ,$251.00 ,$241.98 ,$163.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101464,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$47.00 ,$33.84 ,$3.54 ,$47.00 ,$30.55 ,$4.15 ,$13.16 ,$25.99 ,$4.15 ,$27.35 ,$4.15 ,$24.63 ,$4.15 ,$8.54 ,$43.24 ,$10.58 ,$4.15 ,$39.95 ,$42.30 ,$4.22 ,$35.25 ,$32.90 ,$32.90 ,$4.15 ,$32.90 ,$36.19 ,$36.19 ,$10.58 ,$39.95 ,$4.23 ,$4.23 ,$26.37 ,$19.46 ,$19.55 ,$3.58 ,$3.54 ,$4.35 ,$39.95 ,$9.09 ,$24.63 ,$13.16 ,$42.30 ,$8.46 ,$4.15 ,$30.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101465,83921,HC ORGANIC ACIDS QN SINGLE-90,301,1 ,$387.00 ,$278.64 ,$7.96 ,$387.00 ,$251.55 ,$20.79 ,$108.36 ,$214.01 ,$20.79 ,$225.23 ,$20.79 ,$202.79 ,$20.79 ,$42.84 ,$356.04 ,$53.03 ,$20.79 ,$328.95 ,$348.30 ,$21.20 ,$290.25 ,$270.90 ,$270.90 ,$20.79 ,$270.90 ,$297.99 ,$297.99 ,$53.03 ,$328.95 ,$21.21 ,$21.21 ,$217.11 ,$160.22 ,$160.99 ,$8.05 ,$7.96 ,$21.82 ,$328.95 ,$45.60 ,$202.79 ,$108.36 ,$348.30 ,$42.42 ,$20.79 ,$251.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101477,83519,HC QN RIA MUSK-90,301,1 ,"$1,920.00 ","$1,382.40 ",$7.13 ,"$1,920.00 ","$1,248.00 ",$18.03 ,$537.60 ,"$1,061.76 ",$18.03 ,"$1,117.44 ",$18.03 ,"$1,006.08 ",$18.03 ,$37.17 ,"$1,766.40 ",$46.00 ,$18.03 ,"$1,632.00 ","$1,728.00 ",$18.39 ,"$1,440.00 ","$1,344.00 ","$1,344.00 ",$18.03 ,"$1,344.00 ","$1,478.40 ","$1,478.40 ",$46.00 ,"$1,632.00 ",$18.40 ,$18.40 ,"$1,077.12 ",$794.88 ,$798.72 ,$7.21 ,$7.13 ,$18.93 ,"$1,632.00 ",$39.56 ,"$1,006.08 ",$537.60 ,"$1,728.00 ",$36.80 ,$18.03 ,"$1,248.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),30101500,82943,HC GLUCAGON-90,301,1 ,$104.00 ,$74.88 ,$14.00 ,$104.00 ,$67.60 ,$14.00 ,$29.12 ,$57.51 ,$14.00 ,$60.53 ,$14.00 ,$54.50 ,$14.00 ,$28.87 ,$95.68 ,$35.73 ,$14.00 ,$88.40 ,$93.60 ,$14.29 ,$78.00 ,$72.80 ,$72.80 ,$14.00 ,$72.80 ,$80.08 ,$80.08 ,$35.73 ,$88.40 ,$14.29 ,$14.29 ,$58.34 ,$43.06 ,$43.26 ,$18.85 ,$18.64 ,$14.70 ,$88.40 ,$30.72 ,$54.50 ,$29.12 ,$93.60 ,$28.58 ,$14.00 ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101509,82330,HC CALCIUM IONIZED STAT -90,301,1 ,$163.00 ,$117.36 ,$7.96 ,$163.00 ,$105.95 ,$13.41 ,$45.64 ,$90.14 ,$13.41 ,$94.87 ,$13.41 ,$85.41 ,$13.41 ,$27.63 ,$149.96 ,$34.20 ,$13.41 ,$138.55 ,$146.70 ,$13.67 ,$122.25 ,$114.10 ,$114.10 ,$13.41 ,$114.10 ,$125.51 ,$125.51 ,$34.20 ,$138.55 ,$13.68 ,$13.68 ,$91.44 ,$67.48 ,$67.81 ,$8.05 ,$7.96 ,$14.07 ,$138.55 ,$29.41 ,$85.41 ,$45.64 ,$146.70 ,$27.36 ,$13.41 ,$105.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101529,82725,HC FATTY ACIDS NONESTERIFIED-90,301,1 ,$110.00 ,$79.20 ,$7.96 ,$110.00 ,$71.50 ,$18.39 ,$30.80 ,$60.83 ,$18.39 ,$64.02 ,$18.39 ,$57.64 ,$18.39 ,$37.92 ,$101.20 ,$46.93 ,$18.39 ,$93.50 ,$99.00 ,$18.77 ,$82.50 ,$77.00 ,$77.00 ,$18.39 ,$77.00 ,$84.70 ,$84.70 ,$46.93 ,$93.50 ,$18.77 ,$18.77 ,$61.71 ,$45.54 ,$45.76 ,$8.05 ,$7.96 ,$19.32 ,$93.50 ,$40.36 ,$57.64 ,$30.80 ,$99.00 ,$37.54 ,$18.39 ,$71.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101534,80377,HC PANEL HYPOGLYCEMIC QL-90,301,1 ,$191.00 ,$137.52 ,$21.44 ,$191.00 ,$124.15 , N/A ,$53.48 ,$105.62 , N/A ,$111.16 , N/A ,$100.08 , N/A , N/A ,$175.72 , N/A , N/A ,$162.35 ,$171.90 , N/A ,$143.25 ,$133.70 ,$133.70 , N/A ,$133.70 ,$147.07 ,$147.07 , N/A ,$162.35 , N/A , N/A ,$107.15 ,$79.07 ,$79.46 ,$21.67 ,$21.44 , N/A ,$162.35 , N/A ,$100.08 ,$53.48 ,$171.90 , N/A , N/A ,$124.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101540,84163,HC PLASMA PROTEIN-A PREGNANCY ASSOCIATED-90,301,1 ,$169.00 ,$121.68 ,$7.96 ,$169.00 ,$109.85 ,$14.75 ,$47.32 ,$93.46 ,$14.75 ,$98.36 ,$14.75 ,$88.56 ,$14.75 ,$30.40 ,$155.48 ,$37.63 ,$14.75 ,$143.65 ,$152.10 ,$15.04 ,$126.75 ,$118.30 ,$118.30 ,$14.75 ,$118.30 ,$130.13 ,$130.13 ,$37.63 ,$143.65 ,$15.05 ,$15.05 ,$94.81 ,$69.97 ,$70.30 ,$8.05 ,$7.96 ,$15.48 ,$143.65 ,$32.36 ,$88.56 ,$47.32 ,$152.10 ,$30.10 ,$14.75 ,$109.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101542,80047,HC BASIC METABOLIC PANEL IONIZED CALCIUM,301,1 ,$111.00 ,$79.92 ,$7.27 ,$111.00 ,$72.15 ,$13.46 ,$31.08 ,$61.38 ,$13.46 ,$64.60 ,$13.46 ,$58.16 ,$13.46 ,$27.73 ,$102.12 ,$34.33 ,$13.46 ,$94.35 ,$99.90 ,$13.72 ,$83.25 ,$77.70 ,$77.70 ,$13.46 ,$77.70 ,$85.47 ,$85.47 ,$34.33 ,$94.35 ,$13.73 ,$13.73 ,$62.27 ,$45.95 ,$46.18 ,$7.34 ,$7.27 ,$14.13 ,$94.35 ,$29.52 ,$58.16 ,$31.08 ,$99.90 ,$27.46 ,$13.46 ,$72.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101543,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$364.00 ,$262.08 ,$7.27 ,$364.00 ,$236.60 ,$46.68 ,$101.92 ,$201.29 ,$46.68 ,$211.85 ,$46.68 ,$190.74 ,$46.68 ,$96.21 ,$334.88 ,$119.08 ,$46.68 ,$309.40 ,$327.60 ,$47.61 ,$273.00 ,$254.80 ,$254.80 ,$46.68 ,$254.80 ,$280.28 ,$280.28 ,$119.08 ,$309.40 ,$47.63 ,$47.63 ,$204.20 ,$150.70 ,$151.42 ,$7.34 ,$7.27 ,$49.01 ,$309.40 ,$102.40 ,$190.74 ,$101.92 ,$327.60 ,$95.26 ,$46.68 ,$236.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101547,80170,HC GENTAMICIN,301,1 ,$203.00 ,$146.16 ,$9.15 ,$203.00 ,$131.95 ,$16.05 ,$56.84 ,$112.26 ,$16.05 ,$118.15 ,$16.05 ,$106.37 ,$16.05 ,$33.09 ,$186.76 ,$40.95 ,$16.05 ,$172.55 ,$182.70 ,$16.38 ,$152.25 ,$142.10 ,$142.10 ,$16.05 ,$142.10 ,$156.31 ,$156.31 ,$40.95 ,$172.55 ,$16.38 ,$16.38 ,$113.88 ,$84.04 ,$84.45 ,$9.24 ,$9.15 ,$16.86 ,$172.55 ,$35.22 ,$106.37 ,$56.84 ,$182.70 ,$32.76 ,$16.05 ,$131.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101549,80184,HC PHENOBARBITAL,301,1 ,$146.00 ,$105.12 ,$9.15 ,$146.00 ,$94.90 ,$14.99 ,$40.88 ,$80.74 ,$14.99 ,$84.97 ,$14.99 ,$76.50 ,$14.99 ,$30.91 ,$134.32 ,$38.25 ,$14.99 ,$124.10 ,$131.40 ,$15.30 ,$109.50 ,$102.20 ,$102.20 ,$14.99 ,$102.20 ,$112.42 ,$112.42 ,$38.25 ,$124.10 ,$15.30 ,$15.30 ,$81.91 ,$60.44 ,$60.74 ,$9.24 ,$9.15 ,$15.75 ,$124.10 ,$32.90 ,$76.50 ,$40.88 ,$131.40 ,$30.60 ,$14.99 ,$94.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101551,80198,HC THEOPHYLLINE,301,1 ,$160.00 ,$115.20 ,$9.15 ,$160.00 ,$104.00 ,$13.86 ,$44.80 ,$88.48 ,$13.86 ,$93.12 ,$13.86 ,$83.84 ,$13.86 ,$28.56 ,$147.20 ,$35.35 ,$13.86 ,$136.00 ,$144.00 ,$14.13 ,$120.00 ,$112.00 ,$112.00 ,$13.86 ,$112.00 ,$123.20 ,$123.20 ,$35.35 ,$136.00 ,$14.14 ,$14.14 ,$89.76 ,$66.24 ,$66.56 ,$9.24 ,$9.15 ,$14.55 ,$136.00 ,$30.40 ,$83.84 ,$44.80 ,$144.00 ,$28.28 ,$13.86 ,$104.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101552,80200,HC TOBRAMYCIN,301,1 ,$159.00 ,$114.48 ,$9.15 ,$159.00 ,$103.35 ,$15.81 ,$44.52 ,$87.93 ,$15.81 ,$92.54 ,$15.81 ,$83.32 ,$15.81 ,$32.58 ,$146.28 ,$40.33 ,$15.81 ,$135.15 ,$143.10 ,$16.12 ,$119.25 ,$111.30 ,$111.30 ,$15.81 ,$111.30 ,$122.43 ,$122.43 ,$40.33 ,$135.15 ,$16.13 ,$16.13 ,$89.20 ,$65.83 ,$66.14 ,$9.24 ,$9.15 ,$16.60 ,$135.15 ,$34.68 ,$83.32 ,$44.52 ,$143.10 ,$32.26 ,$15.81 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101555,81479,HC IDH GENE MUTATION ASSAY - 90,301,1 ,$623.00 ,$448.56 ,$28.27 ,$623.00 ,$404.95 , N/A ,$174.44 ,$344.52 , N/A ,$362.59 , N/A ,$326.45 , N/A ,$280.35 ,$573.16 ,$436.10 , N/A ,$529.55 ,$560.70 , N/A ,$467.25 ,$436.10 ,$436.10 , N/A ,$436.10 ,$479.71 ,$479.71 , N/A ,$529.55 , N/A , N/A ,$349.50 ,$257.92 ,$259.17 ,$28.57 ,$28.27 , N/A ,$529.55 ,$373.80 ,$326.45 ,$174.44 ,$560.70 , N/A , N/A ,$404.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101556,82042,HC ALBUMIN OTHER SOURCE,301,1 ,$50.00 ,$36.00 ,$3.54 ,$50.00 ,$32.50 ,$7.62 ,$14.00 ,$27.65 ,$7.62 ,$29.10 ,$7.62 ,$26.20 ,$7.62 ,$15.72 ,$46.00 ,$19.45 ,$7.62 ,$42.50 ,$45.00 ,$7.78 ,$37.50 ,$35.00 ,$35.00 ,$7.62 ,$35.00 ,$38.50 ,$38.50 ,$19.45 ,$42.50 ,$7.78 ,$7.78 ,$28.05 ,$20.70 ,$20.80 ,$3.58 ,$3.54 ,$8.01 ,$42.50 ,$16.73 ,$26.20 ,$14.00 ,$45.00 ,$15.56 ,$7.62 ,$32.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101559,82150,HC AMYLASE,301,1 ,$114.00 ,$82.08 ,$6.35 ,$114.00 ,$74.10 ,$6.35 ,$31.92 ,$63.04 ,$6.35 ,$66.35 ,$6.35 ,$59.74 ,$6.35 ,$13.09 ,$104.88 ,$16.20 ,$6.35 ,$96.90 ,$102.60 ,$6.48 ,$85.50 ,$79.80 ,$79.80 ,$6.35 ,$79.80 ,$87.78 ,$87.78 ,$16.20 ,$96.90 ,$6.48 ,$6.48 ,$63.95 ,$47.20 ,$47.42 ,$8.05 ,$7.96 ,$6.66 ,$96.90 ,$13.93 ,$59.74 ,$31.92 ,$102.60 ,$12.96 ,$6.35 ,$74.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101564,82306,HC VITAMIN D 25 OH,301,1 ,$97.00 ,$69.84 ,$21.44 ,$97.00 ,$63.05 ,$29.01 ,$27.16 ,$53.64 ,$29.01 ,$56.45 ,$29.01 ,$50.83 ,$29.01 ,$59.79 ,$89.24 ,$74.00 ,$29.01 ,$82.45 ,$87.30 ,$29.59 ,$72.75 ,$67.90 ,$67.90 ,$29.01 ,$67.90 ,$74.69 ,$74.69 ,$74.00 ,$82.45 ,$29.60 ,$29.60 ,$54.42 ,$40.16 ,$40.35 ,$21.67 ,$21.44 ,$30.46 ,$82.45 ,$63.64 ,$50.83 ,$27.16 ,$87.30 ,$59.20 ,$29.01 ,$63.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101565,82310,HC CALCIUM,301,1 ,$73.00 ,$52.56 ,$3.54 ,$73.00 ,$47.45 ,$5.06 ,$20.44 ,$40.37 ,$5.06 ,$42.49 ,$5.06 ,$38.25 ,$5.06 ,$10.42 ,$67.16 ,$12.90 ,$5.06 ,$62.05 ,$65.70 ,$5.15 ,$54.75 ,$51.10 ,$51.10 ,$5.06 ,$51.10 ,$56.21 ,$56.21 ,$12.90 ,$62.05 ,$5.16 ,$5.16 ,$40.95 ,$30.22 ,$30.37 ,$3.58 ,$3.54 ,$5.31 ,$62.05 ,$11.09 ,$38.25 ,$20.44 ,$65.70 ,$10.32 ,$5.06 ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101566,82340,HC CALCIUM URINE QN TIMED,301,1 ,$159.00 ,$114.48 ,$5.91 ,$159.00 ,$103.35 ,$5.91 ,$44.52 ,$87.93 ,$5.91 ,$92.54 ,$5.91 ,$83.32 ,$5.91 ,$12.18 ,$146.28 ,$15.08 ,$5.91 ,$135.15 ,$143.10 ,$6.03 ,$119.25 ,$111.30 ,$111.30 ,$5.91 ,$111.30 ,$122.43 ,$122.43 ,$15.08 ,$135.15 ,$6.03 ,$6.03 ,$89.20 ,$65.83 ,$66.14 ,$8.05 ,$7.96 ,$6.20 ,$135.15 ,$12.96 ,$83.32 ,$44.52 ,$143.10 ,$12.06 ,$5.91 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101568,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$179.00 ,$128.88 ,$7.96 ,$179.00 ,$116.35 ,$18.58 ,$50.12 ,$98.99 ,$18.58 ,$104.18 ,$18.58 ,$93.80 ,$18.58 ,$38.30 ,$164.68 ,$47.40 ,$18.58 ,$152.15 ,$161.10 ,$18.95 ,$134.25 ,$125.30 ,$125.30 ,$18.58 ,$125.30 ,$137.83 ,$137.83 ,$47.40 ,$152.15 ,$18.96 ,$18.96 ,$100.42 ,$74.11 ,$74.46 ,$8.05 ,$7.96 ,$19.51 ,$152.15 ,$40.76 ,$93.80 ,$50.12 ,$161.10 ,$37.92 ,$18.58 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101569,82436,HC CHLORIDE URINE,301,1 ,$104.00 ,$74.88 ,$3.54 ,$104.00 ,$67.60 ,$5.63 ,$29.12 ,$57.51 ,$5.63 ,$60.53 ,$5.63 ,$54.50 ,$5.63 ,$11.62 ,$95.68 ,$14.38 ,$5.63 ,$88.40 ,$93.60 ,$5.75 ,$78.00 ,$72.80 ,$72.80 ,$5.63 ,$72.80 ,$80.08 ,$80.08 ,$14.38 ,$88.40 ,$5.75 ,$5.75 ,$58.34 ,$43.06 ,$43.26 ,$3.58 ,$3.54 ,$5.92 ,$88.40 ,$12.36 ,$54.50 ,$29.12 ,$93.60 ,$11.50 ,$5.63 ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101570,82465,HC CHOLESTEROL,301,1 ,$108.00 ,$77.76 ,$3.54 ,$108.00 ,$70.20 ,$4.26 ,$30.24 ,$59.72 ,$4.26 ,$62.86 ,$4.26 ,$56.59 ,$4.26 ,$8.79 ,$99.36 ,$10.88 ,$4.26 ,$91.80 ,$97.20 ,$4.35 ,$81.00 ,$75.60 ,$75.60 ,$4.26 ,$75.60 ,$83.16 ,$83.16 ,$10.88 ,$91.80 ,$4.35 ,$4.35 ,$60.59 ,$44.71 ,$44.93 ,$3.58 ,$3.54 ,$4.48 ,$91.80 ,$9.35 ,$56.59 ,$30.24 ,$97.20 ,$8.70 ,$4.26 ,$70.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101571,82533,HC CORTISOL TOTAL,301,1 ,$30.00 ,$21.60 ,$8.40 ,$40.75 ,$19.50 ,$15.97 ,$8.40 ,$16.59 ,$15.97 ,$17.46 ,$15.97 ,$15.72 ,$15.97 ,$30.00 ,$27.60 ,$40.75 ,$15.97 ,$25.50 ,$27.00 ,$16.30 ,$22.50 ,$21.00 ,$21.00 ,$15.97 ,$21.00 ,$23.10 ,$23.10 ,$30.00 ,$25.50 ,$16.30 ,$16.30 ,$16.83 ,$12.42 ,$12.48 ,$18.85 ,$18.64 ,$16.78 ,$25.50 ,$35.05 ,$15.72 ,$8.40 ,$27.00 ,$30.00 ,$15.97 ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101572,82570,HC CREATININE OTH SOURCE,301,1 ,$88.00 ,$63.36 ,$3.54 ,$88.00 ,$57.20 ,$5.08 ,$24.64 ,$48.66 ,$5.08 ,$51.22 ,$5.08 ,$46.11 ,$5.08 ,$10.46 ,$80.96 ,$12.95 ,$5.08 ,$74.80 ,$79.20 ,$5.17 ,$66.00 ,$61.60 ,$61.60 ,$5.08 ,$61.60 ,$67.76 ,$67.76 ,$12.95 ,$74.80 ,$5.18 ,$5.18 ,$49.37 ,$36.43 ,$36.61 ,$3.58 ,$3.54 ,$5.33 ,$74.80 ,$11.14 ,$46.11 ,$24.64 ,$79.20 ,$10.36 ,$5.08 ,$57.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$200.00 ,$144.00 ,$7.96 ,$200.00 ,$130.00 ,$16.13 ,$56.00 ,$110.60 ,$16.13 ,$116.40 ,$16.13 ,$104.80 ,$16.13 ,$33.25 ,$184.00 ,$41.15 ,$16.13 ,$170.00 ,$180.00 ,$16.45 ,$150.00 ,$140.00 ,$140.00 ,$16.13 ,$140.00 ,$154.00 ,$154.00 ,$41.15 ,$170.00 ,$16.46 ,$16.46 ,$112.20 ,$82.80 ,$83.20 ,$8.05 ,$7.96 ,$16.93 ,$170.00 ,$35.39 ,$104.80 ,$56.00 ,$180.00 ,$32.92 ,$16.13 ,$130.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101581,82945,HC GLUCOSE BODY FLUID,301,1 ,$13.00 ,$9.36 ,$3.54 ,$13.00 ,$8.45 ,$3.85 ,$3.64 ,$7.19 ,$3.85 ,$7.57 ,$3.85 ,$6.81 ,$3.85 ,$7.94 ,$11.96 ,$9.83 ,$3.85 ,$11.05 ,$11.70 ,$3.93 ,$9.75 ,$9.10 ,$9.10 ,$3.85 ,$9.10 ,$10.01 ,$10.01 ,$9.83 ,$11.05 ,$3.93 ,$3.93 ,$7.29 ,$5.38 ,$5.41 ,$3.58 ,$3.54 ,$4.05 ,$11.05 ,$8.45 ,$6.81 ,$3.64 ,$11.70 ,$7.86 ,$3.85 ,$8.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101585,83001,HC FSH,301,1 ,$83.00 ,$59.76 ,$18.21 ,$83.00 ,$53.95 ,$18.21 ,$23.24 ,$45.90 ,$18.21 ,$48.31 ,$18.21 ,$43.49 ,$18.21 ,$37.53 ,$76.36 ,$46.45 ,$18.21 ,$70.55 ,$74.70 ,$18.57 ,$62.25 ,$58.10 ,$58.10 ,$18.21 ,$58.10 ,$63.91 ,$63.91 ,$46.45 ,$70.55 ,$18.58 ,$18.58 ,$46.56 ,$34.36 ,$34.53 ,$18.85 ,$18.64 ,$19.12 ,$70.55 ,$39.95 ,$43.49 ,$23.24 ,$74.70 ,$37.16 ,$18.21 ,$53.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101586,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$83.00 ,$59.76 ,$18.15 ,$83.00 ,$53.95 ,$18.15 ,$23.24 ,$45.90 ,$18.15 ,$48.31 ,$18.15 ,$43.49 ,$18.15 ,$37.41 ,$76.36 ,$46.30 ,$18.15 ,$70.55 ,$74.70 ,$18.51 ,$62.25 ,$58.10 ,$58.10 ,$18.15 ,$58.10 ,$63.91 ,$63.91 ,$46.30 ,$70.55 ,$18.52 ,$18.52 ,$46.56 ,$34.36 ,$34.53 ,$18.85 ,$18.64 ,$19.06 ,$70.55 ,$39.82 ,$43.49 ,$23.24 ,$74.70 ,$37.04 ,$18.15 ,$53.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101587,83010,HC HAPTOGLOBIN,301,1 ,$151.00 ,$108.72 ,$7.96 ,$151.00 ,$98.15 ,$12.33 ,$42.28 ,$83.50 ,$12.33 ,$87.88 ,$12.33 ,$79.12 ,$12.33 ,$25.41 ,$138.92 ,$31.45 ,$12.33 ,$128.35 ,$135.90 ,$12.57 ,$113.25 ,$105.70 ,$105.70 ,$12.33 ,$105.70 ,$116.27 ,$116.27 ,$31.45 ,$128.35 ,$12.58 ,$12.58 ,$84.71 ,$62.51 ,$62.82 ,$8.05 ,$7.96 ,$12.95 ,$128.35 ,$27.05 ,$79.12 ,$42.28 ,$135.90 ,$25.16 ,$12.33 ,$98.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101594,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$107.00 ,$77.04 ,$3.54 ,$107.00 ,$69.55 ,$5.92 ,$29.96 ,$59.17 ,$5.92 ,$62.27 ,$5.92 ,$56.07 ,$5.92 ,$12.20 ,$98.44 ,$15.10 ,$5.92 ,$90.95 ,$96.30 ,$6.04 ,$80.25 ,$74.90 ,$74.90 ,$5.92 ,$74.90 ,$82.39 ,$82.39 ,$15.10 ,$90.95 ,$6.04 ,$6.04 ,$60.03 ,$44.30 ,$44.51 ,$3.58 ,$3.54 ,$6.21 ,$90.95 ,$12.99 ,$56.07 ,$29.96 ,$96.30 ,$12.08 ,$5.92 ,$69.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101598,83930,HC OSMOLALITY BLOOD,301,1 ,$89.00 ,$64.08 ,$3.54 ,$89.00 ,$57.85 ,$6.48 ,$24.92 ,$49.22 ,$6.48 ,$51.80 ,$6.48 ,$46.64 ,$6.48 ,$13.35 ,$81.88 ,$16.53 ,$6.48 ,$75.65 ,$80.10 ,$6.61 ,$66.75 ,$62.30 ,$62.30 ,$6.48 ,$62.30 ,$68.53 ,$68.53 ,$16.53 ,$75.65 ,$6.61 ,$6.61 ,$49.93 ,$36.85 ,$37.02 ,$3.58 ,$3.54 ,$6.80 ,$75.65 ,$14.21 ,$46.64 ,$24.92 ,$80.10 ,$13.22 ,$6.48 ,$57.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101599,83935,HC OSMOLALITY URINE,301,1 ,$80.00 ,$57.60 ,$3.54 ,$80.00 ,$52.00 ,$6.68 ,$22.40 ,$44.24 ,$6.68 ,$46.56 ,$6.68 ,$41.92 ,$6.68 ,$13.78 ,$73.60 ,$17.05 ,$6.68 ,$68.00 ,$72.00 ,$6.82 ,$60.00 ,$56.00 ,$56.00 ,$6.68 ,$56.00 ,$61.60 ,$61.60 ,$17.05 ,$68.00 ,$6.82 ,$6.82 ,$44.88 ,$33.12 ,$33.28 ,$3.58 ,$3.54 ,$7.02 ,$68.00 ,$14.66 ,$41.92 ,$22.40 ,$72.00 ,$13.64 ,$6.68 ,$52.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101600,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$96.00 ,$69.12 ,$18.64 ,$103.20 ,$62.40 ,$40.45 ,$26.88 ,$53.09 ,$40.45 ,$55.87 ,$40.45 ,$50.30 ,$40.45 ,$83.39 ,$88.32 ,$103.20 ,$40.45 ,$81.60 ,$86.40 ,$41.27 ,$72.00 ,$67.20 ,$67.20 ,$40.45 ,$67.20 ,$73.92 ,$73.92 ,$96.00 ,$81.60 ,$41.28 ,$41.28 ,$53.86 ,$39.74 ,$39.94 ,$18.85 ,$18.64 ,$42.47 ,$81.60 ,$88.75 ,$50.30 ,$26.88 ,$86.40 ,$82.56 ,$40.45 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101602,84105,HC PHOSPHORUS UR,301,1 ,$159.00 ,$114.48 ,$3.54 ,$159.00 ,$103.35 ,$5.66 ,$44.52 ,$87.93 ,$5.66 ,$92.54 ,$5.66 ,$83.32 ,$5.66 ,$11.68 ,$146.28 ,$14.45 ,$5.66 ,$135.15 ,$143.10 ,$5.78 ,$119.25 ,$111.30 ,$111.30 ,$5.66 ,$111.30 ,$122.43 ,$122.43 ,$14.45 ,$135.15 ,$5.78 ,$5.78 ,$89.20 ,$65.83 ,$66.14 ,$3.58 ,$3.54 ,$5.95 ,$135.15 ,$12.43 ,$83.32 ,$44.52 ,$143.10 ,$11.56 ,$5.66 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101604,84133,HC POTASSIUM UR,301,1 ,$103.00 ,$74.16 ,$3.54 ,$103.00 ,$66.95 ,$4.64 ,$28.84 ,$56.96 ,$4.64 ,$59.95 ,$4.64 ,$53.97 ,$4.64 ,$9.55 ,$94.76 ,$11.83 ,$4.64 ,$87.55 ,$92.70 ,$4.72 ,$77.25 ,$72.10 ,$72.10 ,$4.64 ,$72.10 ,$79.31 ,$79.31 ,$11.83 ,$87.55 ,$4.73 ,$4.73 ,$57.78 ,$42.64 ,$42.85 ,$3.58 ,$3.54 ,$4.87 ,$87.55 ,$10.17 ,$53.97 ,$28.84 ,$92.70 ,$9.46 ,$4.64 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101607,84145,HC PROCALCITONIN (PCT),301,1 ,$335.00 ,$241.20 ,$18.64 ,$335.00 ,$217.75 ,$26.68 ,$93.80 ,$185.26 ,$26.68 ,$194.97 ,$26.68 ,$175.54 ,$26.68 ,$54.98 ,$308.20 ,$68.05 ,$26.68 ,$284.75 ,$301.50 ,$27.20 ,$251.25 ,$234.50 ,$234.50 ,$26.68 ,$234.50 ,$257.95 ,$257.95 ,$68.05 ,$284.75 ,$27.22 ,$27.22 ,$187.94 ,$138.69 ,$139.36 ,$18.85 ,$18.64 ,$28.01 ,$284.75 ,$58.52 ,$175.54 ,$93.80 ,$301.50 ,$54.44 ,$26.68 ,$217.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101608,84146,HC PROLACTIN,301,1 ,$219.00 ,$157.68 ,$18.64 ,$219.00 ,$142.35 ,$18.99 ,$61.32 ,$121.11 ,$18.99 ,$127.46 ,$18.99 ,$114.76 ,$18.99 ,$39.15 ,$201.48 ,$48.45 ,$18.99 ,$186.15 ,$197.10 ,$19.37 ,$164.25 ,$153.30 ,$153.30 ,$18.99 ,$153.30 ,$168.63 ,$168.63 ,$48.45 ,$186.15 ,$19.38 ,$19.38 ,$122.86 ,$90.67 ,$91.10 ,$18.85 ,$18.64 ,$19.94 ,$186.15 ,$41.67 ,$114.76 ,$61.32 ,$197.10 ,$38.76 ,$18.99 ,$142.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101609,84153,HC PSA TOTAL,301,1 ,$179.00 ,$128.88 ,$7.96 ,$179.00 ,$116.35 ,$18.02 ,$50.12 ,$98.99 ,$18.02 ,$104.18 ,$18.02 ,$93.80 ,$18.02 ,$37.15 ,$164.68 ,$45.98 ,$18.02 ,$152.15 ,$161.10 ,$18.38 ,$134.25 ,$125.30 ,$125.30 ,$18.02 ,$125.30 ,$137.83 ,$137.83 ,$45.98 ,$152.15 ,$18.39 ,$18.39 ,$100.42 ,$74.11 ,$74.46 ,$8.05 ,$7.96 ,$18.92 ,$152.15 ,$39.54 ,$93.80 ,$50.12 ,$161.10 ,$36.78 ,$18.02 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101610,84154,HC PSA FREE,301,1 ,$130.00 ,$93.60 ,$7.96 ,$130.00 ,$84.50 ,$18.02 ,$36.40 ,$71.89 ,$18.02 ,$75.66 ,$18.02 ,$68.12 ,$18.02 ,$37.15 ,$119.60 ,$45.98 ,$18.02 ,$110.50 ,$117.00 ,$18.38 ,$97.50 ,$91.00 ,$91.00 ,$18.02 ,$91.00 ,$100.10 ,$100.10 ,$45.98 ,$110.50 ,$18.39 ,$18.39 ,$72.93 ,$53.82 ,$54.08 ,$8.05 ,$7.96 ,$18.92 ,$110.50 ,$39.54 ,$68.12 ,$36.40 ,$117.00 ,$36.78 ,$18.02 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101611,84155,HC PROTEIN TOTAL,301,1 ,$26.00 ,$18.72 ,$3.54 ,$26.00 ,$16.90 ,$3.60 ,$7.28 ,$14.38 ,$3.60 ,$15.13 ,$3.60 ,$13.62 ,$3.60 ,$7.41 ,$23.92 ,$9.18 ,$3.60 ,$22.10 ,$23.40 ,$3.67 ,$19.50 ,$18.20 ,$18.20 ,$3.60 ,$18.20 ,$20.02 ,$20.02 ,$9.18 ,$22.10 ,$3.67 ,$3.67 ,$14.59 ,$10.76 ,$10.82 ,$3.58 ,$3.54 ,$3.77 ,$22.10 ,$7.89 ,$13.62 ,$7.28 ,$23.40 ,$7.34 ,$3.60 ,$16.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101612,84156,HC PROTEIN TOTAL URINE,301,1 ,$74.00 ,$53.28 ,$3.54 ,$74.00 ,$48.10 ,$3.60 ,$20.72 ,$40.92 ,$3.60 ,$43.07 ,$3.60 ,$38.78 ,$3.60 ,$7.41 ,$68.08 ,$9.18 ,$3.60 ,$62.90 ,$66.60 ,$3.67 ,$55.50 ,$51.80 ,$51.80 ,$3.60 ,$51.80 ,$56.98 ,$56.98 ,$9.18 ,$62.90 ,$3.67 ,$3.67 ,$41.51 ,$30.64 ,$30.78 ,$3.58 ,$3.54 ,$3.77 ,$62.90 ,$7.89 ,$38.78 ,$20.72 ,$66.60 ,$7.34 ,$3.60 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101613,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$7.00 ,$5.04 ,$1.96 ,$10.00 ,$4.55 ,$3.92 ,$1.96 ,$3.87 ,$3.92 ,$4.07 ,$3.92 ,$3.67 ,$3.92 ,$7.00 ,$6.44 ,$10.00 ,$3.92 ,$5.95 ,$6.30 ,$4.00 ,$5.25 ,$4.90 ,$4.90 ,$3.92 ,$4.90 ,$5.39 ,$5.39 ,$7.00 ,$5.95 ,$4.00 ,$4.00 ,$3.93 ,$2.90 ,$2.91 ,$3.58 ,$3.54 ,$4.12 ,$5.95 ,$8.60 ,$3.67 ,$1.96 ,$6.30 ,$7.00 ,$3.92 ,$4.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101614,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$320.00 ,$230.40 ,$7.96 ,$320.00 ,$208.00 ,$10.53 ,$89.60 ,$176.96 ,$10.53 ,$186.24 ,$10.53 ,$167.68 ,$10.53 ,$21.69 ,$294.40 ,$26.85 ,$10.53 ,$272.00 ,$288.00 ,$10.73 ,$240.00 ,$224.00 ,$224.00 ,$10.53 ,$224.00 ,$246.40 ,$246.40 ,$26.85 ,$272.00 ,$10.74 ,$10.74 ,$179.52 ,$132.48 ,$133.12 ,$8.05 ,$7.96 ,$11.05 ,$272.00 ,$23.09 ,$167.68 ,$89.60 ,$288.00 ,$21.48 ,$10.53 ,$208.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101615,84166,HC PROTEIN EP OTH FLUID,301,1 ,$354.00 ,$254.88 ,$7.96 ,$354.00 ,$230.10 ,$17.47 ,$99.12 ,$195.76 ,$17.47 ,$206.03 ,$17.47 ,$185.50 ,$17.47 ,$36.02 ,$325.68 ,$44.58 ,$17.47 ,$300.90 ,$318.60 ,$17.83 ,$265.50 ,$247.80 ,$247.80 ,$17.47 ,$247.80 ,$272.58 ,$272.58 ,$44.58 ,$300.90 ,$17.83 ,$17.83 ,$198.59 ,$146.56 ,$147.26 ,$8.05 ,$7.96 ,$18.35 ,$300.90 ,$38.33 ,$185.50 ,$99.12 ,$318.60 ,$35.66 ,$17.47 ,$230.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101617,84300,HC SODIUM URINE,301,1 ,$123.00 ,$88.56 ,$3.54 ,$123.00 ,$79.95 ,$4.96 ,$34.44 ,$68.02 ,$4.96 ,$71.59 ,$4.96 ,$64.45 ,$4.96 ,$10.22 ,$113.16 ,$12.65 ,$4.96 ,$104.55 ,$110.70 ,$5.06 ,$92.25 ,$86.10 ,$86.10 ,$4.96 ,$86.10 ,$94.71 ,$94.71 ,$12.65 ,$104.55 ,$5.06 ,$5.06 ,$69.00 ,$50.92 ,$51.17 ,$3.58 ,$3.54 ,$5.20 ,$104.55 ,$10.88 ,$64.45 ,$34.44 ,$110.70 ,$10.12 ,$4.96 ,$79.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101620,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$124.00 ,$89.28 ,$6.73 ,$124.00 ,$80.60 ,$6.73 ,$34.72 ,$68.57 ,$6.73 ,$72.17 ,$6.73 ,$64.98 ,$6.73 ,$13.88 ,$114.08 ,$17.18 ,$6.73 ,$105.40 ,$111.60 ,$6.87 ,$93.00 ,$86.80 ,$86.80 ,$6.73 ,$86.80 ,$95.48 ,$95.48 ,$17.18 ,$105.40 ,$6.87 ,$6.87 ,$69.56 ,$51.34 ,$51.58 ,$10.84 ,$10.72 ,$7.07 ,$105.40 ,$14.77 ,$64.98 ,$34.72 ,$111.60 ,$13.74 ,$6.73 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101622,84466,HC TRANSFERRIN,301,1 ,$127.00 ,$91.44 ,$7.96 ,$127.00 ,$82.55 ,$12.50 ,$35.56 ,$70.23 ,$12.50 ,$73.91 ,$12.50 ,$66.55 ,$12.50 ,$25.78 ,$116.84 ,$31.90 ,$12.50 ,$107.95 ,$114.30 ,$12.76 ,$95.25 ,$88.90 ,$88.90 ,$12.50 ,$88.90 ,$97.79 ,$97.79 ,$31.90 ,$107.95 ,$12.76 ,$12.76 ,$71.25 ,$52.58 ,$52.83 ,$8.05 ,$7.96 ,$13.13 ,$107.95 ,$27.43 ,$66.55 ,$35.56 ,$114.30 ,$25.52 ,$12.50 ,$82.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101625,84481,HC T3 FREE,301,1 ,$318.00 ,$228.96 ,$10.72 ,$318.00 ,$206.70 ,$16.60 ,$89.04 ,$175.85 ,$16.60 ,$185.08 ,$16.60 ,$166.63 ,$16.60 ,$34.22 ,$292.56 ,$42.35 ,$16.60 ,$270.30 ,$286.20 ,$16.93 ,$238.50 ,$222.60 ,$222.60 ,$16.60 ,$222.60 ,$244.86 ,$244.86 ,$42.35 ,$270.30 ,$16.94 ,$16.94 ,$178.40 ,$131.65 ,$132.29 ,$10.84 ,$10.72 ,$17.43 ,$270.30 ,$36.42 ,$166.63 ,$89.04 ,$286.20 ,$33.88 ,$16.60 ,$206.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101627,84540,HC UREA URINE,301,1 ,$106.00 ,$76.32 ,$3.54 ,$106.00 ,$68.90 ,$5.45 ,$29.68 ,$58.62 ,$5.45 ,$61.69 ,$5.45 ,$55.54 ,$5.45 ,$11.23 ,$97.52 ,$13.90 ,$5.45 ,$90.10 ,$95.40 ,$5.56 ,$79.50 ,$74.20 ,$74.20 ,$5.45 ,$74.20 ,$81.62 ,$81.62 ,$13.90 ,$90.10 ,$5.56 ,$5.56 ,$59.47 ,$43.88 ,$44.10 ,$3.58 ,$3.54 ,$5.72 ,$90.10 ,$11.95 ,$55.54 ,$29.68 ,$95.40 ,$11.12 ,$5.45 ,$68.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101628,84560,HC URIC ACID OTH SRC,301,1 ,$74.00 ,$53.28 ,$3.54 ,$74.00 ,$48.10 ,$4.98 ,$20.72 ,$40.92 ,$4.98 ,$43.07 ,$4.98 ,$38.78 ,$4.98 ,$10.26 ,$68.08 ,$12.70 ,$4.98 ,$62.90 ,$66.60 ,$5.08 ,$55.50 ,$51.80 ,$51.80 ,$4.98 ,$51.80 ,$56.98 ,$56.98 ,$12.70 ,$62.90 ,$5.08 ,$5.08 ,$41.51 ,$30.64 ,$30.78 ,$3.58 ,$3.54 ,$5.22 ,$62.90 ,$10.92 ,$38.78 ,$20.72 ,$66.60 ,$10.16 ,$4.98 ,$48.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101630,84702,HC HCG QN,301,1 ,$173.00 ,$124.56 ,$10.72 ,$173.00 ,$112.45 ,$14.75 ,$48.44 ,$95.67 ,$14.75 ,$100.69 ,$14.75 ,$90.65 ,$14.75 ,$30.40 ,$159.16 ,$37.63 ,$14.75 ,$147.05 ,$155.70 ,$15.04 ,$129.75 ,$121.10 ,$121.10 ,$14.75 ,$121.10 ,$133.21 ,$133.21 ,$37.63 ,$147.05 ,$15.05 ,$15.05 ,$97.05 ,$71.62 ,$71.97 ,$10.84 ,$10.72 ,$15.48 ,$147.05 ,$32.36 ,$90.65 ,$48.44 ,$155.70 ,$30.10 ,$14.75 ,$112.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101633,83070,HC HEMOSIDERIN QL - 90,301,1 ,$47.00 ,$33.84 ,$4.65 ,$47.00 ,$30.55 ,$4.65 ,$13.16 ,$25.99 ,$4.65 ,$27.35 ,$4.65 ,$24.63 ,$4.65 ,$9.60 ,$43.24 ,$11.88 ,$4.65 ,$39.95 ,$42.30 ,$4.75 ,$35.25 ,$32.90 ,$32.90 ,$4.65 ,$32.90 ,$36.19 ,$36.19 ,$11.88 ,$39.95 ,$4.75 ,$4.75 ,$26.37 ,$19.46 ,$19.55 ,$8.05 ,$7.96 ,$4.89 ,$39.95 ,$10.21 ,$24.63 ,$13.16 ,$42.30 ,$9.50 ,$4.65 ,$30.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101636,83735,HC MAGNESIUM,301,1 ,$91.00 ,$65.52 ,$3.54 ,$91.00 ,$59.15 ,$6.57 ,$25.48 ,$50.32 ,$6.57 ,$52.96 ,$6.57 ,$47.68 ,$6.57 ,$13.53 ,$83.72 ,$16.75 ,$6.57 ,$77.35 ,$81.90 ,$6.69 ,$68.25 ,$63.70 ,$63.70 ,$6.57 ,$63.70 ,$70.07 ,$70.07 ,$16.75 ,$77.35 ,$6.70 ,$6.70 ,$51.05 ,$37.67 ,$37.86 ,$3.58 ,$3.54 ,$6.90 ,$77.35 ,$14.41 ,$47.68 ,$25.48 ,$81.90 ,$13.40 ,$6.57 ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101638,84100,HC PHOSPHORUS,301,1 ,$101.00 ,$72.72 ,$3.54 ,$101.00 ,$65.65 ,$4.65 ,$28.28 ,$55.85 ,$4.65 ,$58.78 ,$4.65 ,$52.92 ,$4.65 ,$9.57 ,$92.92 ,$11.85 ,$4.65 ,$85.85 ,$90.90 ,$4.73 ,$75.75 ,$70.70 ,$70.70 ,$4.65 ,$70.70 ,$77.77 ,$77.77 ,$11.85 ,$85.85 ,$4.74 ,$4.74 ,$56.66 ,$41.81 ,$42.02 ,$3.58 ,$3.54 ,$4.88 ,$85.85 ,$10.19 ,$52.92 ,$28.28 ,$90.90 ,$9.48 ,$4.65 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101643,81596,HC CHRONIC HEP C VIRUS ASSAYS-90,301,1 ,$630.00 ,$453.60 ,$28.27 ,$630.00 ,$409.50 ,$70.75 ,$176.40 ,$348.39 ,$70.75 ,$366.66 ,$70.75 ,$330.12 ,$70.75 ,$145.82 ,$579.60 ,$180.48 ,$70.75 ,$535.50 ,$567.00 ,$72.16 ,$472.50 ,$441.00 ,$441.00 ,$70.75 ,$441.00 ,$485.10 ,$485.10 ,$180.48 ,$535.50 ,$72.19 ,$72.19 ,$353.43 ,$260.82 ,$262.08 ,$28.57 ,$28.27 ,$74.28 ,$535.50 ,$155.21 ,$330.12 ,$176.40 ,$567.00 ,$144.38 ,$70.75 ,$409.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101653,82642,HC DIHYDROTESTOSTERONE-90,301,1 ,$348.00 ,$250.56 ,$10.72 ,$348.00 ,$226.20 ,$28.69 ,$97.44 ,$192.44 ,$28.69 ,$202.54 ,$28.69 ,$182.35 ,$28.69 ,$59.15 ,$320.16 ,$73.20 ,$28.69 ,$295.80 ,$313.20 ,$29.27 ,$261.00 ,$243.60 ,$243.60 ,$28.69 ,$243.60 ,$267.96 ,$267.96 ,$73.20 ,$295.80 ,$29.28 ,$29.28 ,$195.23 ,$144.07 ,$144.77 ,$10.84 ,$10.72 ,$30.13 ,$295.80 ,$62.95 ,$182.35 ,$97.44 ,$313.20 ,$58.56 ,$28.69 ,$226.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101656,83036,HC HEALTH FAIR HEMOGLOBIN A1C,301,1 ,$10.00 ,$7.20 ,$2.80 ,$24.28 ,$6.50 ,$9.52 ,$2.80 ,$5.53 ,$9.52 ,$5.82 ,$9.52 ,$5.24 ,$9.52 ,$10.00 ,$9.20 ,$24.28 ,$9.52 ,$8.50 ,$9.00 ,$9.70 ,$7.50 ,$7.00 ,$7.00 ,$9.52 ,$7.00 ,$7.70 ,$7.70 ,$10.00 ,$8.50 ,$9.71 ,$9.71 ,$5.61 ,$4.14 ,$4.16 ,$8.05 ,$7.96 ,$10.00 ,$8.50 ,$20.88 ,$5.24 ,$2.80 ,$9.00 ,$10.00 ,$9.52 ,$6.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101657,N/A,HC HEALTH FAIR TOTAL PSA SCREEN,301,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 , N/A ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.50 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101658,N/A,HC HEALTH FAIR VITAMIN D 25-OH,301,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 , N/A ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.50 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101659,84443,HC HEALTH FAIR TSH,301,1 ,$15.00 ,$10.80 ,$4.20 ,$37.50 ,$9.75 ,$14.70 ,$4.20 ,$8.30 ,$14.70 ,$8.73 ,$14.70 ,$7.86 ,$14.70 ,$15.00 ,$13.80 ,$37.50 ,$14.70 ,$12.75 ,$13.50 ,$14.70 ,$11.25 ,$10.50 ,$10.50 ,$14.70 ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 ,$15.00 ,$15.00 ,$8.42 ,$6.21 ,$6.24 ,$10.84 ,$10.72 ,$15.43 ,$12.75 ,$32.25 ,$7.86 ,$4.20 ,$13.50 ,$15.00 ,$14.70 ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101660,N/A,HC HEALTH FAIR LAB PANEL,301,1 ,$31.00 ,$22.32 ,$8.68 ,$31.00 ,$20.15 , N/A ,$8.68 ,$17.14 , N/A ,$18.04 , N/A ,$16.24 , N/A , N/A ,$28.52 , N/A , N/A ,$26.35 ,$27.90 , N/A ,$23.25 ,$21.70 ,$21.70 , N/A ,$21.70 ,$23.87 ,$23.87 , N/A ,$26.35 , N/A , N/A ,$17.39 ,$12.83 ,$12.90 , N/A , N/A , N/A ,$26.35 , N/A ,$16.24 ,$8.68 ,$27.90 ,$15.50 , N/A ,$20.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101661,80061,HC HEALTH FAIR LIPID W/CALC LDL,301,1 ,$15.00 ,$10.80 ,$4.20 ,$33.48 ,$9.75 ,$13.12 ,$4.20 ,$8.30 ,$13.12 ,$8.73 ,$13.12 ,$7.86 ,$13.12 ,$15.00 ,$13.80 ,$33.48 ,$13.12 ,$12.75 ,$13.50 ,$13.39 ,$11.25 ,$10.50 ,$10.50 ,$13.12 ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 ,$13.39 ,$13.39 ,$8.42 ,$6.21 ,$6.24 ,$7.34 ,$7.27 ,$13.78 ,$12.75 ,$28.79 ,$7.86 ,$4.20 ,$13.50 ,$15.00 ,$13.12 ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101665,80307,HC DRUG SCREEN MECONIUM-90,301,1 ,$423.00 ,$304.56 ,$21.44 ,$423.00 ,$274.95 ,$60.90 ,$118.44 ,$233.92 ,$60.90 ,$246.19 ,$60.90 ,$221.65 ,$60.90 ,$125.52 ,$389.16 ,$155.35 ,$60.90 ,$359.55 ,$380.70 ,$62.11 ,$317.25 ,$296.10 ,$296.10 ,$60.90 ,$296.10 ,$325.71 ,$325.71 ,$155.35 ,$359.55 ,$62.14 ,$62.14 ,$237.30 ,$175.12 ,$175.97 ,$21.67 ,$21.44 ,$63.94 ,$359.55 ,$133.60 ,$221.65 ,$118.44 ,$380.70 ,$124.28 ,$60.90 ,$274.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101685,80235,HC LACOSAMIDE -90,301,1 ,$151.00 ,$108.72 ,$9.15 ,$151.00 ,$98.15 ,$26.57 ,$42.28 ,$83.50 ,$26.57 ,$87.88 ,$26.57 ,$79.12 ,$26.57 ,$54.76 ,$138.92 ,$67.78 ,$26.57 ,$128.35 ,$135.90 ,$27.10 ,$113.25 ,$105.70 ,$105.70 ,$26.57 ,$105.70 ,$116.27 ,$116.27 ,$67.78 ,$128.35 ,$27.11 ,$27.11 ,$84.71 ,$62.51 ,$62.82 ,$9.24 ,$9.15 ,$27.90 ,$128.35 ,$58.29 ,$79.12 ,$42.28 ,$135.90 ,$54.22 ,$26.57 ,$98.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101689,82565,HC CREATININE,301,1 ,$15.00 ,$10.80 ,$3.54 ,$15.00 ,$9.75 ,$5.02 ,$4.20 ,$8.30 ,$5.02 ,$8.73 ,$5.02 ,$7.86 ,$5.02 ,$10.34 ,$13.80 ,$12.80 ,$5.02 ,$12.75 ,$13.50 ,$5.12 ,$11.25 ,$10.50 ,$10.50 ,$5.02 ,$10.50 ,$11.55 ,$11.55 ,$12.80 ,$12.75 ,$5.12 ,$5.12 ,$8.42 ,$6.21 ,$6.24 ,$3.58 ,$3.54 ,$5.27 ,$12.75 ,$11.01 ,$7.86 ,$4.20 ,$13.50 ,$10.24 ,$5.02 ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101718,80332,HC ANTIDEPRESSANT SEROTONERGIC CLASS 1 AND 2- 90,301,1 ,$129.00 ,$92.88 ,$21.44 ,$129.00 ,$83.85 , N/A ,$36.12 ,$71.34 , N/A ,$75.08 , N/A ,$67.60 , N/A , N/A ,$118.68 , N/A , N/A ,$109.65 ,$116.10 , N/A ,$96.75 ,$90.30 ,$90.30 , N/A ,$90.30 ,$99.33 ,$99.33 , N/A ,$109.65 , N/A , N/A ,$72.37 ,$53.41 ,$53.66 ,$21.67 ,$21.44 , N/A ,$109.65 , N/A ,$67.60 ,$36.12 ,$116.10 , N/A , N/A ,$83.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101755,82553,HC CREATINE MB FRACTION,301,1 ,$36.00 ,$25.92 ,$7.96 ,$36.00 ,$23.40 ,$11.32 ,$10.08 ,$19.91 ,$11.32 ,$20.95 ,$11.32 ,$18.86 ,$11.32 ,$23.33 ,$33.12 ,$28.88 ,$11.32 ,$30.60 ,$32.40 ,$11.54 ,$27.00 ,$25.20 ,$25.20 ,$11.32 ,$25.20 ,$27.72 ,$27.72 ,$28.88 ,$30.60 ,$11.55 ,$11.55 ,$20.20 ,$14.90 ,$14.98 ,$8.05 ,$7.96 ,$11.89 ,$30.60 ,$24.83 ,$18.86 ,$10.08 ,$32.40 ,$23.10 ,$11.32 ,$23.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101756,83721,HC CHOLESTEROL LDL LEVEL,301,1 ,$33.00 ,$23.76 ,$7.96 ,$33.00 ,$21.45 ,$10.29 ,$9.24 ,$18.25 ,$10.29 ,$19.21 ,$10.29 ,$17.29 ,$10.29 ,$21.21 ,$30.36 ,$26.25 ,$10.29 ,$28.05 ,$29.70 ,$10.50 ,$24.75 ,$23.10 ,$23.10 ,$10.29 ,$23.10 ,$25.41 ,$25.41 ,$26.25 ,$28.05 ,$10.50 ,$10.50 ,$18.51 ,$13.66 ,$13.73 ,$8.05 ,$7.96 ,$10.81 ,$28.05 ,$22.58 ,$17.29 ,$9.24 ,$29.70 ,$21.00 ,$10.29 ,$21.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101770,83521,HC IMMUNOGLOBULIN LIGHT CHAINS- 90,301,1 ,$174.00 ,$125.28 ,$7.96 ,$174.00 ,$113.10 ,$16.92 ,$48.72 ,$96.22 ,$16.92 ,$101.27 ,$16.92 ,$91.18 ,$16.92 ,$34.89 ,$160.08 ,$43.18 ,$16.92 ,$147.90 ,$156.60 ,$17.27 ,$130.50 ,$121.80 ,$121.80 ,$16.92 ,$121.80 ,$133.98 ,$133.98 ,$43.18 ,$147.90 ,$17.27 ,$17.27 ,$97.61 ,$72.04 ,$72.38 ,$8.05 ,$7.96 ,$17.77 ,$147.90 ,$37.13 ,$91.18 ,$48.72 ,$156.60 ,$34.54 ,$16.92 ,$113.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101771,82653,HC EL-1 FECAL QUANTITATIVE-90,301,1 ,$333.00 ,$239.76 ,$7.96 ,$333.00 ,$216.45 ,$22.51 ,$93.24 ,$184.15 ,$22.51 ,$193.81 ,$22.51 ,$174.49 ,$22.51 ,$46.40 ,$306.36 ,$57.43 ,$22.51 ,$283.05 ,$299.70 ,$22.96 ,$249.75 ,$233.10 ,$233.10 ,$22.51 ,$233.10 ,$256.41 ,$256.41 ,$57.43 ,$283.05 ,$22.97 ,$22.97 ,$186.81 ,$137.86 ,$138.53 ,$8.05 ,$7.96 ,$23.64 ,$283.05 ,$49.39 ,$174.49 ,$93.24 ,$299.70 ,$45.94 ,$22.51 ,$216.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101774,80053,HC HEALTH FAIR COMPREHENSIVE METABOLIC PANEL,301,1 ,$10.00 ,$7.20 ,$2.80 ,$25.00 ,$6.50 ,$9.80 ,$2.80 ,$5.53 ,$9.80 ,$5.82 ,$9.80 ,$5.24 ,$9.80 ,$10.00 ,$9.20 ,$25.00 ,$9.80 ,$8.50 ,$9.00 ,$9.80 ,$7.50 ,$7.00 ,$7.00 ,$9.80 ,$7.00 ,$7.70 ,$7.70 ,$10.00 ,$8.50 ,$10.00 ,$10.00 ,$5.61 ,$4.14 ,$4.16 ,$7.34 ,$7.27 ,$10.29 ,$8.50 ,$21.50 ,$5.24 ,$2.80 ,$9.00 ,$10.00 ,$9.80 ,$6.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101788,84146,HC ASSAY OF PROLACTIN-90,301,1 ,$167.00 ,$120.24 ,$18.64 ,$167.00 ,$108.55 ,$18.99 ,$46.76 ,$92.35 ,$18.99 ,$97.19 ,$18.99 ,$87.51 ,$18.99 ,$39.15 ,$153.64 ,$48.45 ,$18.99 ,$141.95 ,$150.30 ,$19.37 ,$125.25 ,$116.90 ,$116.90 ,$18.99 ,$116.90 ,$128.59 ,$128.59 ,$48.45 ,$141.95 ,$19.38 ,$19.38 ,$93.69 ,$69.14 ,$69.47 ,$18.85 ,$18.64 ,$19.94 ,$141.95 ,$41.67 ,$87.51 ,$46.76 ,$150.30 ,$38.76 ,$18.99 ,$108.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101792,80183,HC DRUG SCRN QUANT OXCARBAZEPIN-90,301,1 ,$56.00 ,$40.32 ,$9.15 ,$56.00 ,$36.40 ,$12.98 ,$15.68 ,$30.97 ,$12.98 ,$32.59 ,$12.98 ,$29.34 ,$12.98 ,$26.77 ,$51.52 ,$33.13 ,$12.98 ,$47.60 ,$50.40 ,$13.25 ,$42.00 ,$39.20 ,$39.20 ,$12.98 ,$39.20 ,$43.12 ,$43.12 ,$33.13 ,$47.60 ,$13.25 ,$13.25 ,$31.42 ,$23.18 ,$23.30 ,$9.24 ,$9.15 ,$13.63 ,$47.60 ,$28.49 ,$29.34 ,$15.68 ,$50.40 ,$26.50 ,$12.98 ,$36.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101816,83630,HC LACTOGEN FECAL QL,301,1 ,$62.00 ,$44.64 ,$7.96 ,$62.00 ,$40.30 ,$19.31 ,$17.36 ,$34.29 ,$19.31 ,$36.08 ,$19.31 ,$32.49 ,$19.31 ,$39.79 ,$57.04 ,$49.25 ,$19.31 ,$52.70 ,$55.80 ,$19.69 ,$46.50 ,$43.40 ,$43.40 ,$19.31 ,$43.40 ,$47.74 ,$47.74 ,$49.25 ,$52.70 ,$19.70 ,$19.70 ,$34.78 ,$25.67 ,$25.79 ,$8.05 ,$7.96 ,$20.28 ,$52.70 ,$42.36 ,$32.49 ,$17.36 ,$55.80 ,$39.40 ,$19.31 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101817,84300,HC SODIUM URINE,301,1 ,$123.00 ,$88.56 ,$3.54 ,$123.00 ,$79.95 ,$4.96 ,$34.44 ,$68.02 ,$4.96 ,$71.59 ,$4.96 ,$64.45 ,$4.96 ,$10.22 ,$113.16 ,$12.65 ,$4.96 ,$104.55 ,$110.70 ,$5.06 ,$92.25 ,$86.10 ,$86.10 ,$4.96 ,$86.10 ,$94.71 ,$94.71 ,$12.65 ,$104.55 ,$5.06 ,$5.06 ,$69.00 ,$50.92 ,$51.17 ,$3.58 ,$3.54 ,$5.20 ,$104.55 ,$10.88 ,$64.45 ,$34.44 ,$110.70 ,$10.12 ,$4.96 ,$79.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101818,84133,HC POTASSIUM URI,301,1 ,$103.00 ,$74.16 ,$3.54 ,$103.00 ,$66.95 ,$4.64 ,$28.84 ,$56.96 ,$4.64 ,$59.95 ,$4.64 ,$53.97 ,$4.64 ,$9.55 ,$94.76 ,$11.83 ,$4.64 ,$87.55 ,$92.70 ,$4.72 ,$77.25 ,$72.10 ,$72.10 ,$4.64 ,$72.10 ,$79.31 ,$79.31 ,$11.83 ,$87.55 ,$4.73 ,$4.73 ,$57.78 ,$42.64 ,$42.85 ,$3.58 ,$3.54 ,$4.87 ,$87.55 ,$10.17 ,$53.97 ,$28.84 ,$92.70 ,$9.46 ,$4.64 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101819,82436,HC CHLORIDE URI,301,1 ,$104.00 ,$74.88 ,$3.54 ,$104.00 ,$67.60 ,$5.63 ,$29.12 ,$57.51 ,$5.63 ,$60.53 ,$5.63 ,$54.50 ,$5.63 ,$11.62 ,$95.68 ,$14.38 ,$5.63 ,$88.40 ,$93.60 ,$5.75 ,$78.00 ,$72.80 ,$72.80 ,$5.63 ,$72.80 ,$80.08 ,$80.08 ,$14.38 ,$88.40 ,$5.75 ,$5.75 ,$58.34 ,$43.06 ,$43.26 ,$3.58 ,$3.54 ,$5.92 ,$88.40 ,$12.36 ,$54.50 ,$29.12 ,$93.60 ,$11.50 ,$5.63 ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101820,82340,HC CALCIUM URINE QN TIMED,306,1 ,$159.00 ,$114.48 ,$5.91 ,$159.00 ,$103.35 ,$5.91 ,$44.52 ,$87.93 ,$5.91 ,$92.54 ,$5.91 ,$83.32 ,$5.91 ,$12.18 ,$146.28 ,$15.08 ,$5.91 ,$135.15 ,$143.10 ,$6.03 ,$119.25 ,$111.30 ,$111.30 ,$5.91 ,$111.30 ,$122.43 ,$122.43 ,$15.08 ,$135.15 ,$6.03 ,$6.03 ,$89.20 ,$65.83 ,$66.14 ,$8.05 ,$7.96 ,$6.20 ,$135.15 ,$12.96 ,$83.32 ,$44.52 ,$143.10 ,$12.06 ,$5.91 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30101821,82542,HC BETA-AMYLOID AD-DETECT-90,301,1 ,$950.00 ,$684.00 ,$7.96 ,$950.00 ,$617.50 ,$23.61 ,$266.00 ,$525.35 ,$23.61 ,$552.90 ,$23.61 ,$497.80 ,$23.61 ,$48.66 ,$874.00 ,$60.23 ,$23.61 ,$807.50 ,$855.00 ,$24.08 ,$712.50 ,$665.00 ,$665.00 ,$23.61 ,$665.00 ,$731.50 ,$731.50 ,$60.23 ,$807.50 ,$24.09 ,$24.09 ,$532.95 ,$393.30 ,$395.20 ,$8.05 ,$7.96 ,$24.78 ,$807.50 ,$51.79 ,$497.80 ,$266.00 ,$855.00 ,$48.18 ,$23.61 ,$617.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200123,86140,HC C-REACTIVE PROTEIN,302,1 ,$101.00 ,$72.72 ,$5.08 ,$101.00 ,$65.65 ,$5.08 ,$28.28 ,$55.85 ,$5.08 ,$58.78 ,$5.08 ,$52.92 ,$5.08 ,$10.46 ,$92.92 ,$12.95 ,$5.08 ,$85.85 ,$90.90 ,$5.17 ,$75.75 ,$70.70 ,$70.70 ,$5.08 ,$70.70 ,$77.77 ,$77.77 ,$12.95 ,$85.85 ,$5.18 ,$5.18 ,$56.66 ,$41.81 ,$42.02 ,$7.21 ,$7.13 ,$5.33 ,$85.85 ,$11.14 ,$52.92 ,$28.28 ,$90.90 ,$10.36 ,$5.08 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$140.00 ,$100.80 ,$5.08 ,$140.00 ,$91.00 ,$5.08 ,$39.20 ,$77.42 ,$5.08 ,$81.48 ,$5.08 ,$73.36 ,$5.08 ,$10.46 ,$128.80 ,$12.95 ,$5.08 ,$119.00 ,$126.00 ,$5.17 ,$105.00 ,$98.00 ,$98.00 ,$5.08 ,$98.00 ,$107.80 ,$107.80 ,$12.95 ,$119.00 ,$5.18 ,$5.18 ,$78.54 ,$57.96 ,$58.24 ,$7.21 ,$7.13 ,$5.33 ,$119.00 ,$11.14 ,$73.36 ,$39.20 ,$126.00 ,$10.36 ,$5.08 ,$91.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200270,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$158.00 ,$113.76 ,$7.13 ,$158.00 ,$102.70 ,$13.44 ,$44.24 ,$87.37 ,$13.44 ,$91.96 ,$13.44 ,$82.79 ,$13.44 ,$27.69 ,$145.36 ,$34.28 ,$13.44 ,$134.30 ,$142.20 ,$13.70 ,$118.50 ,$110.60 ,$110.60 ,$13.44 ,$110.60 ,$121.66 ,$121.66 ,$34.28 ,$134.30 ,$13.71 ,$13.71 ,$88.64 ,$65.41 ,$65.73 ,$7.21 ,$7.13 ,$14.11 ,$134.30 ,$29.48 ,$82.79 ,$44.24 ,$142.20 ,$27.42 ,$13.44 ,$102.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200561,86870,HC RBC AB ID PANEL,302,1 ,$283.00 ,$203.76 ,$7.13 ,$778.14 ,$183.95 ,$305.03 ,$79.24 ,$156.50 ,$305.03 ,$164.71 ,$277.34 ,$148.29 ,$277.34 ,$283.00 ,$260.36 ,$778.14 ,$305.03 ,$240.55 ,$254.70 ,$277.34 ,$212.25 ,$198.10 ,$198.10 ,$305.03 ,$198.10 ,$217.91 ,$217.91 ,$283.00 ,$240.55 ,$311.26 ,$311.26 ,$158.76 ,$117.16 ,$117.73 ,$7.21 ,$7.13 ,$320.28 ,$240.55 ,$669.20 ,$148.29 ,$79.24 ,$254.70 ,$283.00 ,$305.03 ,$183.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200562,86880,HC COOMBS DIRECT,302,1 ,$107.00 ,$77.04 ,$7.13 ,$138.00 ,$69.55 ,$54.10 ,$29.96 ,$59.17 ,$54.10 ,$62.27 ,$54.10 ,$56.07 ,$54.10 ,$107.00 ,$98.44 ,$138.00 ,$54.10 ,$90.95 ,$96.30 ,$55.17 ,$80.25 ,$74.90 ,$74.90 ,$54.10 ,$74.90 ,$82.39 ,$82.39 ,$107.00 ,$90.95 ,$55.20 ,$55.20 ,$60.03 ,$44.30 ,$44.51 ,$7.21 ,$7.13 ,$56.80 ,$90.95 ,$118.68 ,$56.07 ,$29.96 ,$96.30 ,$10.78 ,$54.10 ,$69.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200563,86885,HC INDIRECT COOMBS,302,1 ,$118.00 ,$84.96 ,$7.13 ,$377.53 ,$76.70 ,$147.99 ,$33.04 ,$65.25 ,$147.99 ,$68.68 ,$115.64 ,$61.83 ,$115.64 ,$118.00 ,$108.56 ,$377.53 ,$147.99 ,$100.30 ,$106.20 ,$115.64 ,$88.50 ,$82.60 ,$82.60 ,$147.99 ,$82.60 ,$90.86 ,$90.86 ,$118.00 ,$100.30 ,$151.01 ,$151.01 ,$66.20 ,$48.85 ,$49.09 ,$7.21 ,$7.13 ,$155.39 ,$100.30 ,$324.68 ,$61.83 ,$33.04 ,$106.20 ,$11.44 ,$147.99 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200564,86890,HC AUTOLOGOUS PROCESSING FEE,302,1 ,$460.00 ,$331.20 ,$28.79 ,$460.00 ,$299.00 ,$147.99 ,$128.80 ,$254.38 ,$147.99 ,$267.72 ,$147.99 ,$241.04 ,$147.99 ,$305.05 ,$423.20 ,$377.53 ,$147.99 ,$391.00 ,$414.00 ,$150.95 ,$345.00 ,$322.00 ,$322.00 ,$147.99 ,$322.00 ,$354.20 ,$354.20 ,$377.53 ,$391.00 ,$151.01 ,$151.01 ,$258.06 ,$190.44 ,$191.36 ,$29.10 ,$28.79 ,$155.39 ,$391.00 ,$324.68 ,$241.04 ,$128.80 ,$414.00 ,$298.32 ,$147.99 ,$299.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200565,86900,HC BLOOD TYPING ABO,302,1 ,$73.00 ,$52.56 ,$4.42 ,$278.76 ,$47.45 ,$109.28 ,$20.44 ,$40.37 ,$109.28 ,$42.49 ,$71.54 ,$38.25 ,$71.54 ,$73.00 ,$67.16 ,$278.76 ,$109.28 ,$62.05 ,$65.70 ,$71.54 ,$54.75 ,$51.10 ,$51.10 ,$109.28 ,$51.10 ,$56.21 ,$56.21 ,$73.00 ,$62.05 ,$111.51 ,$111.51 ,$40.95 ,$30.22 ,$30.37 ,$4.47 ,$4.42 ,$114.75 ,$62.05 ,$239.74 ,$38.25 ,$20.44 ,$65.70 ,$5.98 ,$109.28 ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200566,86901,HC BLOOD TYPING RH,302,1 ,$69.00 ,$49.68 ,$4.42 ,$81.53 ,$44.85 ,$31.96 ,$19.32 ,$38.16 ,$31.96 ,$40.16 ,$31.96 ,$36.16 ,$31.96 ,$65.88 ,$63.48 ,$81.53 ,$31.96 ,$58.65 ,$62.10 ,$32.60 ,$51.75 ,$48.30 ,$48.30 ,$31.96 ,$48.30 ,$53.13 ,$53.13 ,$69.00 ,$58.65 ,$32.61 ,$32.61 ,$38.71 ,$28.57 ,$28.70 ,$4.47 ,$4.42 ,$33.56 ,$58.65 ,$70.12 ,$36.16 ,$19.32 ,$62.10 ,$5.98 ,$31.96 ,$44.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$54.00 ,$38.88 ,$4.42 ,$377.53 ,$35.10 ,$147.99 ,$15.12 ,$29.86 ,$147.99 ,$31.43 ,$52.92 ,$28.30 ,$52.92 ,$54.00 ,$49.68 ,$377.53 ,$147.99 ,$45.90 ,$48.60 ,$52.92 ,$40.50 ,$37.80 ,$37.80 ,$147.99 ,$37.80 ,$41.58 ,$41.58 ,$54.00 ,$45.90 ,$151.01 ,$151.01 ,$30.29 ,$22.36 ,$22.46 ,$4.47 ,$4.42 ,$155.39 ,$45.90 ,$324.68 ,$28.30 ,$15.12 ,$48.60 ,$54.00 ,$147.99 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200571,86922,HC CROSSMATCH AHG,302,1 ,$139.00 ,$100.08 ,$28.79 ,$377.53 ,$90.35 ,$147.99 ,$38.92 ,$76.87 ,$147.99 ,$80.90 ,$136.22 ,$72.84 ,$136.22 ,$139.00 ,$127.88 ,$377.53 ,$147.99 ,$118.15 ,$125.10 ,$136.22 ,$104.25 ,$97.30 ,$97.30 ,$147.99 ,$97.30 ,$107.03 ,$107.03 ,$139.00 ,$118.15 ,$151.01 ,$151.01 ,$77.98 ,$57.55 ,$57.82 ,$29.10 ,$28.79 ,$155.39 ,$118.15 ,$324.68 ,$72.84 ,$38.92 ,$125.10 ,$139.00 ,$147.99 ,$90.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$65.00 ,$46.80 ,$5.12 ,$65.00 ,$42.25 ,$5.12 ,$18.20 ,$35.95 ,$5.12 ,$37.83 ,$5.12 ,$34.06 ,$5.12 ,$10.54 ,$59.80 ,$13.05 ,$5.12 ,$55.25 ,$58.50 ,$5.21 ,$48.75 ,$45.50 ,$45.50 ,$5.12 ,$45.50 ,$50.05 ,$50.05 ,$13.05 ,$55.25 ,$5.22 ,$5.22 ,$36.47 ,$26.91 ,$27.04 ,$7.21 ,$7.13 ,$5.37 ,$55.25 ,$11.22 ,$34.06 ,$18.20 ,$58.50 ,$10.44 ,$5.12 ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200847,86021,HC LEUKO AB ID-90,302,1 ,$286.00 ,$205.92 ,$7.13 ,$286.00 ,$185.90 ,$14.75 ,$80.08 ,$158.16 ,$14.75 ,$166.45 ,$14.75 ,$149.86 ,$14.75 ,$30.40 ,$263.12 ,$37.63 ,$14.75 ,$243.10 ,$257.40 ,$15.04 ,$214.50 ,$200.20 ,$200.20 ,$14.75 ,$200.20 ,$220.22 ,$220.22 ,$37.63 ,$243.10 ,$15.05 ,$15.05 ,$160.45 ,$118.40 ,$118.98 ,$7.21 ,$7.13 ,$15.48 ,$243.10 ,$32.36 ,$149.86 ,$80.08 ,$257.40 ,$30.10 ,$14.75 ,$185.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200851,86022,HC PLATELET AB ID-90,302,1 ,$179.00 ,$128.88 ,$7.13 ,$179.00 ,$116.35 ,$18.00 ,$50.12 ,$98.99 ,$18.00 ,$104.18 ,$18.00 ,$93.80 ,$18.00 ,$37.11 ,$164.68 ,$45.93 ,$18.00 ,$152.15 ,$161.10 ,$18.37 ,$134.25 ,$125.30 ,$125.30 ,$18.00 ,$125.30 ,$137.83 ,$137.83 ,$45.93 ,$152.15 ,$18.37 ,$18.37 ,$100.42 ,$74.11 ,$74.46 ,$7.21 ,$7.13 ,$18.90 ,$152.15 ,$39.50 ,$93.80 ,$50.12 ,$161.10 ,$36.74 ,$18.00 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200857,86023,HC PLATELET ASSOC AB ID IGG-90,302,1 ,$130.00 ,$93.60 ,$7.13 ,$130.00 ,$84.50 ,$12.21 ,$36.40 ,$71.89 ,$12.21 ,$75.66 ,$12.21 ,$68.12 ,$12.21 ,$25.17 ,$119.60 ,$31.15 ,$12.21 ,$110.50 ,$117.00 ,$12.46 ,$97.50 ,$91.00 ,$91.00 ,$12.21 ,$91.00 ,$100.10 ,$100.10 ,$31.15 ,$110.50 ,$12.46 ,$12.46 ,$72.93 ,$53.82 ,$54.08 ,$7.21 ,$7.13 ,$12.82 ,$110.50 ,$26.79 ,$68.12 ,$36.40 ,$117.00 ,$24.92 ,$12.21 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200858,86038,HC ANA SCREEN-90,302,1 ,$173.00 ,$124.56 ,$7.13 ,$173.00 ,$112.45 ,$11.85 ,$48.44 ,$95.67 ,$11.85 ,$100.69 ,$11.85 ,$90.65 ,$11.85 ,$24.42 ,$159.16 ,$30.23 ,$11.85 ,$147.05 ,$155.70 ,$12.08 ,$129.75 ,$121.10 ,$121.10 ,$11.85 ,$121.10 ,$133.21 ,$133.21 ,$30.23 ,$147.05 ,$12.09 ,$12.09 ,$97.05 ,$71.62 ,$71.97 ,$7.21 ,$7.13 ,$12.44 ,$147.05 ,$25.99 ,$90.65 ,$48.44 ,$155.70 ,$24.18 ,$11.85 ,$112.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200859,86039,HC ANA TITER-90,302,1 ,$121.00 ,$87.12 ,$7.13 ,$121.00 ,$78.65 ,$10.94 ,$33.88 ,$66.91 ,$10.94 ,$70.42 ,$10.94 ,$63.40 ,$10.94 ,$22.54 ,$111.32 ,$27.90 ,$10.94 ,$102.85 ,$108.90 ,$11.15 ,$90.75 ,$84.70 ,$84.70 ,$10.94 ,$84.70 ,$93.17 ,$93.17 ,$27.90 ,$102.85 ,$11.16 ,$11.16 ,$67.88 ,$50.09 ,$50.34 ,$7.21 ,$7.13 ,$11.49 ,$102.85 ,$23.99 ,$63.40 ,$33.88 ,$108.90 ,$22.32 ,$10.94 ,$78.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200860,86060,HC ASO-90,302,1 ,$110.00 ,$79.20 ,$7.13 ,$110.00 ,$71.50 ,$7.15 ,$30.80 ,$60.83 ,$7.15 ,$64.02 ,$7.15 ,$57.64 ,$7.15 ,$14.75 ,$101.20 ,$18.25 ,$7.15 ,$93.50 ,$99.00 ,$7.30 ,$82.50 ,$77.00 ,$77.00 ,$7.15 ,$77.00 ,$84.70 ,$84.70 ,$18.25 ,$93.50 ,$7.30 ,$7.30 ,$61.71 ,$45.54 ,$45.76 ,$7.21 ,$7.13 ,$7.52 ,$93.50 ,$15.70 ,$57.64 ,$30.80 ,$99.00 ,$14.60 ,$7.15 ,$71.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$97.00 ,$69.84 ,$7.96 ,$97.00 ,$63.05 ,$24.94 ,$27.16 ,$53.64 ,$24.94 ,$56.45 ,$24.94 ,$50.83 ,$24.94 ,$51.41 ,$89.24 ,$63.63 ,$24.94 ,$82.45 ,$87.30 ,$25.44 ,$72.75 ,$67.90 ,$67.90 ,$24.94 ,$67.90 ,$74.69 ,$74.69 ,$63.63 ,$82.45 ,$25.45 ,$25.45 ,$54.42 ,$40.16 ,$40.35 ,$8.05 ,$7.96 ,$26.19 ,$82.45 ,$54.72 ,$50.83 ,$27.16 ,$87.30 ,$50.90 ,$24.94 ,$63.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$161.00 ,$115.92 ,$12.30 ,$161.00 ,$104.65 ,$24.94 ,$45.08 ,$89.03 ,$24.94 ,$93.70 ,$24.94 ,$84.36 ,$24.94 ,$51.41 ,$148.12 ,$63.63 ,$24.94 ,$136.85 ,$144.90 ,$25.44 ,$120.75 ,$112.70 ,$112.70 ,$24.94 ,$112.70 ,$123.97 ,$123.97 ,$63.63 ,$136.85 ,$25.45 ,$25.45 ,$90.32 ,$66.65 ,$66.98 ,$12.43 ,$12.30 ,$26.19 ,$136.85 ,$54.72 ,$84.36 ,$45.08 ,$144.90 ,$50.90 ,$24.94 ,$104.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200866,86148,HC ANTI-PHOSPHATIDYLSERINE AB-90,302,1 ,$62.00 ,$44.64 ,$7.96 ,$62.00 ,$40.30 ,$15.75 ,$17.36 ,$34.29 ,$15.75 ,$36.08 ,$15.75 ,$32.49 ,$15.75 ,$32.46 ,$57.04 ,$40.18 ,$15.75 ,$52.70 ,$55.80 ,$16.06 ,$46.50 ,$43.40 ,$43.40 ,$15.75 ,$43.40 ,$47.74 ,$47.74 ,$40.18 ,$52.70 ,$16.07 ,$16.07 ,$34.78 ,$25.67 ,$25.79 ,$8.05 ,$7.96 ,$16.53 ,$52.70 ,$34.55 ,$32.49 ,$17.36 ,$55.80 ,$32.14 ,$15.75 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$228.00 ,$164.16 ,$7.13 ,$228.00 ,$148.20 ,$7.90 ,$63.84 ,$126.08 ,$7.90 ,$132.70 ,$7.90 ,$119.47 ,$7.90 ,$16.28 ,$209.76 ,$20.15 ,$7.90 ,$193.80 ,$205.20 ,$8.06 ,$171.00 ,$159.60 ,$159.60 ,$7.90 ,$159.60 ,$175.56 ,$175.56 ,$20.15 ,$193.80 ,$8.06 ,$8.06 ,$127.91 ,$94.39 ,$94.85 ,$7.21 ,$7.13 ,$8.29 ,$193.80 ,$17.33 ,$119.47 ,$63.84 ,$205.20 ,$16.12 ,$7.90 ,$148.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$167.00 ,$120.24 ,$7.13 ,$167.00 ,$108.55 ,$11.76 ,$46.76 ,$92.35 ,$11.76 ,$97.19 ,$11.76 ,$87.51 ,$11.76 ,$24.24 ,$153.64 ,$30.00 ,$11.76 ,$141.95 ,$150.30 ,$12.00 ,$125.25 ,$116.90 ,$116.90 ,$11.76 ,$116.90 ,$128.59 ,$128.59 ,$30.00 ,$141.95 ,$12.00 ,$12.00 ,$93.69 ,$69.14 ,$69.47 ,$7.21 ,$7.13 ,$12.35 ,$141.95 ,$25.80 ,$87.51 ,$46.76 ,$150.30 ,$24.00 ,$11.76 ,$108.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200870,86161,HC C1 ESTERASE INHIBITOR-90,302,1 ,$284.00 ,$204.48 ,$7.13 ,$284.00 ,$184.60 ,$11.76 ,$79.52 ,$157.05 ,$11.76 ,$165.29 ,$11.76 ,$148.82 ,$11.76 ,$24.24 ,$261.28 ,$30.00 ,$11.76 ,$241.40 ,$255.60 ,$12.00 ,$213.00 ,$198.80 ,$198.80 ,$11.76 ,$198.80 ,$218.68 ,$218.68 ,$30.00 ,$241.40 ,$12.00 ,$12.00 ,$159.32 ,$117.58 ,$118.14 ,$7.21 ,$7.13 ,$12.35 ,$241.40 ,$25.80 ,$148.82 ,$79.52 ,$255.60 ,$24.00 ,$11.76 ,$184.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$285.00 ,$205.20 ,$7.13 ,$285.00 ,$185.25 ,$19.91 ,$79.80 ,$157.61 ,$19.91 ,$165.87 ,$19.91 ,$149.34 ,$19.91 ,$41.05 ,$262.20 ,$50.80 ,$19.91 ,$242.25 ,$256.50 ,$20.32 ,$213.75 ,$199.50 ,$199.50 ,$19.91 ,$199.50 ,$219.45 ,$219.45 ,$50.80 ,$242.25 ,$20.32 ,$20.32 ,$159.89 ,$117.99 ,$118.56 ,$7.21 ,$7.13 ,$20.91 ,$242.25 ,$43.69 ,$149.34 ,$79.80 ,$256.50 ,$40.64 ,$19.91 ,$185.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200873,86200,HC CCP AB-90,302,1 ,$88.00 ,$63.36 ,$7.13 ,$88.00 ,$57.20 ,$12.69 ,$24.64 ,$48.66 ,$12.69 ,$51.22 ,$12.69 ,$46.11 ,$12.69 ,$26.16 ,$80.96 ,$32.38 ,$12.69 ,$74.80 ,$79.20 ,$12.95 ,$66.00 ,$61.60 ,$61.60 ,$12.69 ,$61.60 ,$67.76 ,$67.76 ,$32.38 ,$74.80 ,$12.95 ,$12.95 ,$49.37 ,$36.43 ,$36.61 ,$7.21 ,$7.13 ,$13.33 ,$74.80 ,$27.84 ,$46.11 ,$24.64 ,$79.20 ,$25.90 ,$12.69 ,$57.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200874,86215,HC DEOXYRIBONUCLEASE AB-90,302,1 ,$143.00 ,$102.96 ,$7.13 ,$143.00 ,$92.95 ,$12.98 ,$40.04 ,$79.08 ,$12.98 ,$83.23 ,$12.98 ,$74.93 ,$12.98 ,$26.77 ,$131.56 ,$33.13 ,$12.98 ,$121.55 ,$128.70 ,$13.25 ,$107.25 ,$100.10 ,$100.10 ,$12.98 ,$100.10 ,$110.11 ,$110.11 ,$33.13 ,$121.55 ,$13.25 ,$13.25 ,$80.22 ,$59.20 ,$59.49 ,$7.21 ,$7.13 ,$13.63 ,$121.55 ,$28.49 ,$74.93 ,$40.04 ,$128.70 ,$26.50 ,$12.98 ,$92.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200875,86225,HC DNA DOUBLE STRAND AB-90,302,1 ,$244.00 ,$175.68 ,$7.13 ,$244.00 ,$158.60 ,$13.47 ,$68.32 ,$134.93 ,$13.47 ,$142.01 ,$13.47 ,$127.86 ,$13.47 ,$27.75 ,$224.48 ,$34.35 ,$13.47 ,$207.40 ,$219.60 ,$13.73 ,$183.00 ,$170.80 ,$170.80 ,$13.47 ,$170.80 ,$187.88 ,$187.88 ,$34.35 ,$207.40 ,$13.74 ,$13.74 ,$136.88 ,$101.02 ,$101.50 ,$7.21 ,$7.13 ,$14.14 ,$207.40 ,$29.54 ,$127.86 ,$68.32 ,$219.60 ,$27.48 ,$13.47 ,$158.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200877,86235,HC ENA AB-90,302,1 ,$195.00 ,$140.40 ,$12.30 ,$195.00 ,$126.75 ,$17.57 ,$54.60 ,$107.84 ,$17.57 ,$113.49 ,$17.57 ,$102.18 ,$17.57 ,$36.22 ,$179.40 ,$44.83 ,$17.57 ,$165.75 ,$175.50 ,$17.92 ,$146.25 ,$136.50 ,$136.50 ,$17.57 ,$136.50 ,$150.15 ,$150.15 ,$44.83 ,$165.75 ,$17.93 ,$17.93 ,$109.40 ,$80.73 ,$81.12 ,$12.43 ,$12.30 ,$18.45 ,$165.75 ,$38.55 ,$102.18 ,$54.60 ,$175.50 ,$35.86 ,$17.57 ,$126.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200878,86255,HC FLUOR AB SCR-90,302,1 ,$190.00 ,$136.80 ,$11.81 ,$190.00 ,$123.50 ,$11.81 ,$53.20 ,$105.07 ,$11.81 ,$110.58 ,$11.81 ,$99.56 ,$11.81 ,$24.34 ,$174.80 ,$30.13 ,$11.81 ,$161.50 ,$171.00 ,$12.04 ,$142.50 ,$133.00 ,$133.00 ,$11.81 ,$133.00 ,$146.30 ,$146.30 ,$30.13 ,$161.50 ,$12.05 ,$12.05 ,$106.59 ,$78.66 ,$79.04 ,$12.43 ,$12.30 ,$12.40 ,$161.50 ,$25.91 ,$99.56 ,$53.20 ,$171.00 ,$24.10 ,$11.81 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200879,86256,HC FLUOR AB TITER-90,302,1 ,$58.00 ,$41.76 ,$11.81 ,$58.00 ,$37.70 ,$11.81 ,$16.24 ,$32.07 ,$11.81 ,$33.76 ,$11.81 ,$30.39 ,$11.81 ,$24.34 ,$53.36 ,$30.13 ,$11.81 ,$49.30 ,$52.20 ,$12.04 ,$43.50 ,$40.60 ,$40.60 ,$11.81 ,$40.60 ,$44.66 ,$44.66 ,$30.13 ,$49.30 ,$12.05 ,$12.05 ,$32.54 ,$24.01 ,$24.13 ,$12.43 ,$12.30 ,$12.40 ,$49.30 ,$25.91 ,$30.39 ,$16.24 ,$52.20 ,$24.10 ,$11.81 ,$37.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$184.00 ,$132.48 ,$18.90 ,$184.00 ,$119.60 ,$20.39 ,$51.52 ,$101.75 ,$20.39 ,$107.09 ,$20.39 ,$96.42 ,$20.39 ,$42.04 ,$169.28 ,$52.03 ,$20.39 ,$156.40 ,$165.60 ,$20.81 ,$138.00 ,$128.80 ,$128.80 ,$20.39 ,$128.80 ,$141.68 ,$141.68 ,$52.03 ,$156.40 ,$20.81 ,$20.81 ,$103.22 ,$76.18 ,$76.54 ,$19.11 ,$18.90 ,$21.41 ,$156.40 ,$44.74 ,$96.42 ,$51.52 ,$165.60 ,$41.62 ,$20.39 ,$119.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200881,86301,HC TUMOR AG CA 19-9 -90,302,1 ,$193.00 ,$138.96 ,$18.90 ,$193.00 ,$125.45 ,$20.39 ,$54.04 ,$106.73 ,$20.39 ,$112.33 ,$20.39 ,$101.13 ,$20.39 ,$42.04 ,$177.56 ,$52.03 ,$20.39 ,$164.05 ,$173.70 ,$20.81 ,$144.75 ,$135.10 ,$135.10 ,$20.39 ,$135.10 ,$148.61 ,$148.61 ,$52.03 ,$164.05 ,$20.81 ,$20.81 ,$108.27 ,$79.90 ,$80.29 ,$19.11 ,$18.90 ,$21.41 ,$164.05 ,$44.74 ,$101.13 ,$54.04 ,$173.70 ,$41.62 ,$20.39 ,$125.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200882,86304,HC TUMOR AG CA 125 -90,302,1 ,$226.00 ,$162.72 ,$18.90 ,$226.00 ,$146.90 ,$20.39 ,$63.28 ,$124.98 ,$20.39 ,$131.53 ,$20.39 ,$118.42 ,$20.39 ,$42.04 ,$207.92 ,$52.03 ,$20.39 ,$192.10 ,$203.40 ,$20.81 ,$169.50 ,$158.20 ,$158.20 ,$20.39 ,$158.20 ,$174.02 ,$174.02 ,$52.03 ,$192.10 ,$20.81 ,$20.81 ,$126.79 ,$93.56 ,$94.02 ,$19.11 ,$18.90 ,$21.41 ,$192.10 ,$44.74 ,$118.42 ,$63.28 ,$203.40 ,$41.62 ,$20.39 ,$146.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200883,86305,HC HE4 OVARIAN CANCER-90,302,1 ,"$1,113.00 ",$801.36 ,$18.90 ,"$1,113.00 ",$723.45 ,$20.39 ,$311.64 ,$615.49 ,$20.39 ,$647.77 ,$20.39 ,$583.21 ,$20.39 ,$42.04 ,"$1,023.96 ",$52.03 ,$20.39 ,$946.05 ,"$1,001.70 ",$20.81 ,$834.75 ,$779.10 ,$779.10 ,$20.39 ,$779.10 ,$857.01 ,$857.01 ,$52.03 ,$946.05 ,$20.81 ,$20.81 ,$624.39 ,$460.78 ,$463.01 ,$19.11 ,$18.90 ,$21.41 ,$946.05 ,$44.74 ,$583.21 ,$311.64 ,"$1,001.70 ",$41.62 ,$20.39 ,$723.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200886,86632,HC CHLAMYDIA AB IGM-90,302,1 ,$166.00 ,$119.52 ,$5.69 ,$166.00 ,$107.90 ,$12.43 ,$46.48 ,$91.80 ,$12.43 ,$96.61 ,$12.43 ,$86.98 ,$12.43 ,$25.61 ,$152.72 ,$31.70 ,$12.43 ,$141.10 ,$149.40 ,$12.67 ,$124.50 ,$116.20 ,$116.20 ,$12.43 ,$116.20 ,$127.82 ,$127.82 ,$31.70 ,$141.10 ,$12.68 ,$12.68 ,$93.13 ,$68.72 ,$69.06 ,$5.75 ,$5.69 ,$13.04 ,$141.10 ,$27.26 ,$86.98 ,$46.48 ,$149.40 ,$25.36 ,$12.43 ,$107.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$152.00 ,$109.44 ,$11.24 ,$152.00 ,$98.80 ,$11.24 ,$42.56 ,$84.06 ,$11.24 ,$88.46 ,$11.24 ,$79.65 ,$11.24 ,$23.17 ,$139.84 ,$28.68 ,$11.24 ,$129.20 ,$136.80 ,$11.47 ,$114.00 ,$106.40 ,$106.40 ,$11.24 ,$106.40 ,$117.04 ,$117.04 ,$28.68 ,$129.20 ,$11.47 ,$11.47 ,$85.27 ,$62.93 ,$63.23 ,$12.43 ,$12.30 ,$11.80 ,$129.20 ,$24.66 ,$79.65 ,$42.56 ,$136.80 ,$22.94 ,$11.24 ,$98.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200889,86641,HC CRYPTOCOCCAL AB-90,302,1 ,$21.00 ,$15.12 ,$5.88 ,$36.03 ,$13.65 ,$14.12 ,$5.88 ,$11.61 ,$14.12 ,$12.22 ,$14.12 ,$11.00 ,$14.12 ,$21.00 ,$19.32 ,$36.03 ,$14.12 ,$17.85 ,$18.90 ,$14.41 ,$15.75 ,$14.70 ,$14.70 ,$14.12 ,$14.70 ,$16.17 ,$16.17 ,$21.00 ,$17.85 ,$14.41 ,$14.41 ,$11.78 ,$8.69 ,$8.74 ,$12.43 ,$12.30 ,$14.83 ,$17.85 ,$30.98 ,$11.00 ,$5.88 ,$18.90 ,$21.00 ,$14.12 ,$13.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200890,86644,HC CMV AB-90,302,1 ,$65.00 ,$46.80 ,$12.30 ,$65.00 ,$42.25 ,$14.10 ,$18.20 ,$35.95 ,$14.10 ,$37.83 ,$14.10 ,$34.06 ,$14.10 ,$29.07 ,$59.80 ,$35.98 ,$14.10 ,$55.25 ,$58.50 ,$14.39 ,$48.75 ,$45.50 ,$45.50 ,$14.10 ,$45.50 ,$50.05 ,$50.05 ,$35.98 ,$55.25 ,$14.39 ,$14.39 ,$36.47 ,$26.91 ,$27.04 ,$12.43 ,$12.30 ,$14.81 ,$55.25 ,$30.94 ,$34.06 ,$18.20 ,$58.50 ,$28.78 ,$14.10 ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200891,86645,HC CMV AB IGM-90,302,1 ,$202.00 ,$145.44 ,$12.30 ,$202.00 ,$131.30 ,$16.51 ,$56.56 ,$111.71 ,$16.51 ,$117.56 ,$16.51 ,$105.85 ,$16.51 ,$34.04 ,$185.84 ,$42.13 ,$16.51 ,$171.70 ,$181.80 ,$16.85 ,$151.50 ,$141.40 ,$141.40 ,$16.51 ,$141.40 ,$155.54 ,$155.54 ,$42.13 ,$171.70 ,$16.85 ,$16.85 ,$113.32 ,$83.63 ,$84.03 ,$12.43 ,$12.30 ,$17.34 ,$171.70 ,$36.23 ,$105.85 ,$56.56 ,$181.80 ,$33.70 ,$16.51 ,$131.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200892,86648,HC DIPTHERIA-90,302,1 ,$188.00 ,$135.36 ,$12.30 ,$188.00 ,$122.20 ,$14.91 ,$52.64 ,$103.96 ,$14.91 ,$109.42 ,$14.91 ,$98.51 ,$14.91 ,$30.72 ,$172.96 ,$38.03 ,$14.91 ,$159.80 ,$169.20 ,$15.20 ,$141.00 ,$131.60 ,$131.60 ,$14.91 ,$131.60 ,$144.76 ,$144.76 ,$38.03 ,$159.80 ,$15.21 ,$15.21 ,$105.47 ,$77.83 ,$78.21 ,$12.43 ,$12.30 ,$15.65 ,$159.80 ,$32.70 ,$98.51 ,$52.64 ,$169.20 ,$30.42 ,$14.91 ,$122.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200897,86658,HC ENTEROVIRUS AB-90,302,1 ,$32.00 ,$23.04 ,$8.96 ,$32.58 ,$20.80 ,$12.77 ,$8.96 ,$17.70 ,$12.77 ,$18.62 ,$12.77 ,$16.77 ,$12.77 ,$26.32 ,$29.44 ,$32.58 ,$12.77 ,$27.20 ,$28.80 ,$13.02 ,$24.00 ,$22.40 ,$22.40 ,$12.77 ,$22.40 ,$24.64 ,$24.64 ,$32.00 ,$27.20 ,$13.03 ,$13.03 ,$17.95 ,$13.25 ,$13.31 ,$12.43 ,$12.30 ,$13.41 ,$27.20 ,$28.01 ,$16.77 ,$8.96 ,$28.80 ,$26.06 ,$12.77 ,$20.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200898,86663,HC EBV EARLY AG-90,302,1 ,$200.00 ,$144.00 ,$12.30 ,$200.00 ,$130.00 ,$12.86 ,$56.00 ,$110.60 ,$12.86 ,$116.40 ,$12.86 ,$104.80 ,$12.86 ,$26.50 ,$184.00 ,$32.80 ,$12.86 ,$170.00 ,$180.00 ,$13.11 ,$150.00 ,$140.00 ,$140.00 ,$12.86 ,$140.00 ,$154.00 ,$154.00 ,$32.80 ,$170.00 ,$13.12 ,$13.12 ,$112.20 ,$82.80 ,$83.20 ,$12.43 ,$12.30 ,$13.50 ,$170.00 ,$28.21 ,$104.80 ,$56.00 ,$180.00 ,$26.24 ,$12.86 ,$130.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$66.00 ,$47.52 ,$12.30 ,$66.00 ,$42.90 ,$14.98 ,$18.48 ,$36.50 ,$14.98 ,$38.41 ,$14.98 ,$34.58 ,$14.98 ,$30.89 ,$60.72 ,$38.23 ,$14.98 ,$56.10 ,$59.40 ,$15.29 ,$49.50 ,$46.20 ,$46.20 ,$14.98 ,$46.20 ,$50.82 ,$50.82 ,$38.23 ,$56.10 ,$15.29 ,$15.29 ,$37.03 ,$27.32 ,$27.46 ,$12.43 ,$12.30 ,$15.73 ,$56.10 ,$32.87 ,$34.58 ,$18.48 ,$59.40 ,$30.58 ,$14.98 ,$42.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$122.00 ,$87.84 ,$12.30 ,$122.00 ,$79.30 ,$17.78 ,$34.16 ,$67.47 ,$17.78 ,$71.00 ,$17.78 ,$63.93 ,$17.78 ,$36.64 ,$112.24 ,$45.35 ,$17.78 ,$103.70 ,$109.80 ,$18.13 ,$91.50 ,$85.40 ,$85.40 ,$17.78 ,$85.40 ,$93.94 ,$93.94 ,$45.35 ,$103.70 ,$18.14 ,$18.14 ,$68.44 ,$50.51 ,$50.75 ,$12.43 ,$12.30 ,$18.67 ,$103.70 ,$39.00 ,$63.93 ,$34.16 ,$109.80 ,$36.28 ,$17.78 ,$79.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200901,86666,HC EHRLICHIA AB-90,302,1 ,$156.00 ,$112.32 ,$9.98 ,$156.00 ,$101.40 ,$9.98 ,$43.68 ,$86.27 ,$9.98 ,$90.79 ,$9.98 ,$81.74 ,$9.98 ,$20.56 ,$143.52 ,$25.45 ,$9.98 ,$132.60 ,$140.40 ,$10.17 ,$117.00 ,$109.20 ,$109.20 ,$9.98 ,$109.20 ,$120.12 ,$120.12 ,$25.45 ,$132.60 ,$10.18 ,$10.18 ,$87.52 ,$64.58 ,$64.90 ,$12.43 ,$12.30 ,$10.48 ,$132.60 ,$21.89 ,$81.74 ,$43.68 ,$140.40 ,$20.36 ,$9.98 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200902,86668,HC FRANCISELLA AB-90,302,1 ,$190.00 ,$136.80 ,$12.30 ,$190.00 ,$123.50 ,$13.88 ,$53.20 ,$105.07 ,$13.88 ,$110.58 ,$13.88 ,$99.56 ,$13.88 ,$28.60 ,$174.80 ,$35.40 ,$13.88 ,$161.50 ,$171.00 ,$14.15 ,$142.50 ,$133.00 ,$133.00 ,$13.88 ,$133.00 ,$146.30 ,$146.30 ,$35.40 ,$161.50 ,$14.16 ,$14.16 ,$106.59 ,$78.66 ,$79.04 ,$12.43 ,$12.30 ,$14.57 ,$161.50 ,$30.44 ,$99.56 ,$53.20 ,$171.00 ,$28.32 ,$13.88 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$161.00 ,$115.92 ,$7.13 ,$161.00 ,$104.65 ,$12.00 ,$45.08 ,$89.03 ,$12.00 ,$93.70 ,$12.00 ,$84.36 ,$12.00 ,$24.75 ,$148.12 ,$30.63 ,$12.00 ,$136.85 ,$144.90 ,$12.25 ,$120.75 ,$112.70 ,$112.70 ,$12.00 ,$112.70 ,$123.97 ,$123.97 ,$30.63 ,$136.85 ,$12.25 ,$12.25 ,$90.32 ,$66.65 ,$66.98 ,$7.21 ,$7.13 ,$12.60 ,$136.85 ,$26.34 ,$84.36 ,$45.08 ,$144.90 ,$24.50 ,$12.00 ,$104.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200907,86684,HC HAEMOPHILUS INFLUENZA AB-90,302,1 ,$468.00 ,$336.96 ,$7.13 ,$468.00 ,$304.20 ,$15.52 ,$131.04 ,$258.80 ,$15.52 ,$272.38 ,$15.52 ,$245.23 ,$15.52 ,$32.00 ,$430.56 ,$39.60 ,$15.52 ,$397.80 ,$421.20 ,$15.84 ,$351.00 ,$327.60 ,$327.60 ,$15.52 ,$327.60 ,$360.36 ,$360.36 ,$39.60 ,$397.80 ,$15.84 ,$15.84 ,$262.55 ,$193.75 ,$194.69 ,$7.21 ,$7.13 ,$16.30 ,$397.80 ,$34.06 ,$245.23 ,$131.04 ,$421.20 ,$31.68 ,$15.52 ,$304.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200909,86689,HC HTLV OR HIV AB CONF-90,302,1 ,$128.00 ,$92.16 ,$12.30 ,$128.00 ,$83.20 ,$18.96 ,$35.84 ,$70.78 ,$18.96 ,$74.50 ,$18.96 ,$67.07 ,$18.96 ,$39.09 ,$117.76 ,$48.38 ,$18.96 ,$108.80 ,$115.20 ,$19.35 ,$96.00 ,$89.60 ,$89.60 ,$18.96 ,$89.60 ,$98.56 ,$98.56 ,$48.38 ,$108.80 ,$19.35 ,$19.35 ,$71.81 ,$52.99 ,$53.25 ,$12.43 ,$12.30 ,$19.91 ,$108.80 ,$41.60 ,$67.07 ,$35.84 ,$115.20 ,$38.70 ,$18.96 ,$83.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$187.00 ,$134.64 ,$12.30 ,$187.00 ,$121.55 ,$12.93 ,$52.36 ,$103.41 ,$12.93 ,$108.83 ,$12.93 ,$97.99 ,$12.93 ,$26.64 ,$172.04 ,$32.98 ,$12.93 ,$158.95 ,$168.30 ,$13.18 ,$140.25 ,$130.90 ,$130.90 ,$12.93 ,$130.90 ,$143.99 ,$143.99 ,$32.98 ,$158.95 ,$13.19 ,$13.19 ,$104.91 ,$77.42 ,$77.79 ,$12.43 ,$12.30 ,$13.57 ,$158.95 ,$28.36 ,$97.99 ,$52.36 ,$168.30 ,$26.38 ,$12.93 ,$121.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$122.00 ,$87.84 ,$7.13 ,$122.00 ,$79.30 ,$18.96 ,$34.16 ,$67.47 ,$18.96 ,$71.00 ,$18.96 ,$63.93 ,$18.96 ,$39.09 ,$112.24 ,$48.38 ,$18.96 ,$103.70 ,$109.80 ,$19.35 ,$91.50 ,$85.40 ,$85.40 ,$18.96 ,$85.40 ,$93.94 ,$93.94 ,$48.38 ,$103.70 ,$19.35 ,$19.35 ,$68.44 ,$50.51 ,$50.75 ,$7.21 ,$7.13 ,$19.91 ,$103.70 ,$41.60 ,$63.93 ,$34.16 ,$109.80 ,$38.70 ,$18.96 ,$79.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$157.00 ,$113.04 ,$12.30 ,$157.00 ,$102.05 ,$13.51 ,$43.96 ,$86.82 ,$13.51 ,$91.37 ,$13.51 ,$82.27 ,$13.51 ,$27.86 ,$144.44 ,$34.48 ,$13.51 ,$133.45 ,$141.30 ,$13.79 ,$117.75 ,$109.90 ,$109.90 ,$13.51 ,$109.90 ,$120.89 ,$120.89 ,$34.48 ,$133.45 ,$13.79 ,$13.79 ,$88.08 ,$65.00 ,$65.31 ,$12.43 ,$12.30 ,$14.19 ,$133.45 ,$29.65 ,$82.27 ,$43.96 ,$141.30 ,$27.58 ,$13.51 ,$102.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200915,86701,HC HIV-1 AB-90,302,1 ,$52.00 ,$37.44 ,$7.13 ,$52.00 ,$33.80 ,$8.71 ,$14.56 ,$28.76 ,$8.71 ,$30.26 ,$8.71 ,$27.25 ,$8.71 ,$17.96 ,$47.84 ,$22.23 ,$8.71 ,$44.20 ,$46.80 ,$8.89 ,$39.00 ,$36.40 ,$36.40 ,$8.71 ,$36.40 ,$40.04 ,$40.04 ,$22.23 ,$44.20 ,$8.89 ,$8.89 ,$29.17 ,$21.53 ,$21.63 ,$7.21 ,$7.13 ,$9.14 ,$44.20 ,$19.11 ,$27.25 ,$14.56 ,$46.80 ,$17.78 ,$8.71 ,$33.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200918,86702,HC HIV-2 AB-90,302,1 ,$52.00 ,$37.44 ,$7.13 ,$52.00 ,$33.80 ,$13.25 ,$14.56 ,$28.76 ,$13.25 ,$30.26 ,$13.25 ,$27.25 ,$13.25 ,$27.31 ,$47.84 ,$33.80 ,$13.25 ,$44.20 ,$46.80 ,$13.51 ,$39.00 ,$36.40 ,$36.40 ,$13.25 ,$36.40 ,$40.04 ,$40.04 ,$33.80 ,$44.20 ,$13.52 ,$13.52 ,$29.17 ,$21.53 ,$21.63 ,$7.21 ,$7.13 ,$13.92 ,$44.20 ,$29.07 ,$27.25 ,$14.56 ,$46.80 ,$27.04 ,$13.25 ,$33.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200923,86707,HC HEP B E AB-90,302,1 ,$80.00 ,$57.60 ,$7.13 ,$80.00 ,$52.00 ,$11.34 ,$22.40 ,$44.24 ,$11.34 ,$46.56 ,$11.34 ,$41.92 ,$11.34 ,$23.37 ,$73.60 ,$28.93 ,$11.34 ,$68.00 ,$72.00 ,$11.56 ,$60.00 ,$56.00 ,$56.00 ,$11.34 ,$56.00 ,$61.60 ,$61.60 ,$28.93 ,$68.00 ,$11.57 ,$11.57 ,$44.88 ,$33.12 ,$33.28 ,$7.21 ,$7.13 ,$11.91 ,$68.00 ,$24.88 ,$41.92 ,$22.40 ,$72.00 ,$23.14 ,$11.34 ,$52.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$25.00 ,$18.00 ,$7.00 ,$30.98 ,$16.25 ,$12.14 ,$7.00 ,$13.83 ,$12.14 ,$14.55 ,$12.14 ,$13.10 ,$12.14 ,$25.00 ,$23.00 ,$30.98 ,$12.14 ,$21.25 ,$22.50 ,$12.39 ,$18.75 ,$17.50 ,$17.50 ,$12.14 ,$17.50 ,$19.25 ,$19.25 ,$25.00 ,$21.25 ,$12.39 ,$12.39 ,$14.03 ,$10.35 ,$10.40 ,$7.21 ,$7.13 ,$12.75 ,$21.25 ,$26.64 ,$13.10 ,$7.00 ,$22.50 ,$24.78 ,$12.14 ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200926,86710,HC INFLUENZA AB-90,302,1 ,$149.00 ,$107.28 ,$7.13 ,$149.00 ,$96.85 ,$13.28 ,$41.72 ,$82.40 ,$13.28 ,$86.72 ,$13.28 ,$78.08 ,$13.28 ,$27.37 ,$137.08 ,$33.88 ,$13.28 ,$126.65 ,$134.10 ,$13.54 ,$111.75 ,$104.30 ,$104.30 ,$13.28 ,$104.30 ,$114.73 ,$114.73 ,$33.88 ,$126.65 ,$13.55 ,$13.55 ,$83.59 ,$61.69 ,$61.98 ,$7.21 ,$7.13 ,$13.95 ,$126.65 ,$29.13 ,$78.08 ,$41.72 ,$134.10 ,$27.10 ,$13.28 ,$96.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200927,86713,HC LEGIONELLA AB-90,302,1 ,$89.00 ,$64.08 ,$12.30 ,$89.00 ,$57.85 ,$14.99 ,$24.92 ,$49.22 ,$14.99 ,$51.80 ,$14.99 ,$46.64 ,$14.99 ,$30.91 ,$81.88 ,$38.25 ,$14.99 ,$75.65 ,$80.10 ,$15.30 ,$66.75 ,$62.30 ,$62.30 ,$14.99 ,$62.30 ,$68.53 ,$68.53 ,$38.25 ,$75.65 ,$15.30 ,$15.30 ,$49.93 ,$36.85 ,$37.02 ,$12.43 ,$12.30 ,$15.75 ,$75.65 ,$32.90 ,$46.64 ,$24.92 ,$80.10 ,$30.60 ,$14.99 ,$57.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200931,86735,HC MUMPS AB-90,302,1 ,$130.00 ,$93.60 ,$7.13 ,$130.00 ,$84.50 ,$12.79 ,$36.40 ,$71.89 ,$12.79 ,$75.66 ,$12.79 ,$68.12 ,$12.79 ,$26.36 ,$119.60 ,$32.63 ,$12.79 ,$110.50 ,$117.00 ,$13.04 ,$97.50 ,$91.00 ,$91.00 ,$12.79 ,$91.00 ,$100.10 ,$100.10 ,$32.63 ,$110.50 ,$13.05 ,$13.05 ,$72.93 ,$53.82 ,$54.08 ,$7.21 ,$7.13 ,$13.43 ,$110.50 ,$28.06 ,$68.12 ,$36.40 ,$117.00 ,$26.10 ,$12.79 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$699.00 ,$503.28 ,$12.30 ,$699.00 ,$454.35 ,$12.98 ,$195.72 ,$386.55 ,$12.98 ,$406.82 ,$12.98 ,$366.28 ,$12.98 ,$26.74 ,$643.08 ,$33.10 ,$12.98 ,$594.15 ,$629.10 ,$13.23 ,$524.25 ,$489.30 ,$489.30 ,$12.98 ,$489.30 ,$538.23 ,$538.23 ,$33.10 ,$594.15 ,$13.24 ,$13.24 ,$392.14 ,$289.39 ,$290.78 ,$12.43 ,$12.30 ,$13.62 ,$594.15 ,$28.47 ,$366.28 ,$195.72 ,$629.10 ,$26.48 ,$12.98 ,$454.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$143.00 ,$102.96 ,$12.30 ,$143.00 ,$92.95 ,$14.73 ,$40.04 ,$79.08 ,$14.73 ,$83.23 ,$14.73 ,$74.93 ,$14.73 ,$30.36 ,$131.56 ,$37.58 ,$14.73 ,$121.55 ,$128.70 ,$15.02 ,$107.25 ,$100.10 ,$100.10 ,$14.73 ,$100.10 ,$110.11 ,$110.11 ,$37.58 ,$121.55 ,$15.03 ,$15.03 ,$80.22 ,$59.20 ,$59.49 ,$12.43 ,$12.30 ,$15.46 ,$121.55 ,$32.31 ,$74.93 ,$40.04 ,$128.70 ,$30.06 ,$14.73 ,$92.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200937,86753,HC PROTOZOA AB-90,302,1 ,$122.00 ,$87.84 ,$7.13 ,$122.00 ,$79.30 ,$12.14 ,$34.16 ,$67.47 ,$12.14 ,$71.00 ,$12.14 ,$63.93 ,$12.14 ,$25.03 ,$112.24 ,$30.98 ,$12.14 ,$103.70 ,$109.80 ,$12.39 ,$91.50 ,$85.40 ,$85.40 ,$12.14 ,$85.40 ,$93.94 ,$93.94 ,$30.98 ,$103.70 ,$12.39 ,$12.39 ,$68.44 ,$50.51 ,$50.75 ,$7.21 ,$7.13 ,$12.75 ,$103.70 ,$26.64 ,$63.93 ,$34.16 ,$109.80 ,$24.78 ,$12.14 ,$79.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200939,86757,HC RICKETTSIA AB-90,302,1 ,$61.00 ,$43.92 ,$12.30 ,$61.00 ,$39.65 ,$18.96 ,$17.08 ,$33.73 ,$18.96 ,$35.50 ,$18.96 ,$31.96 ,$18.96 ,$39.09 ,$56.12 ,$48.38 ,$18.96 ,$51.85 ,$54.90 ,$19.35 ,$45.75 ,$42.70 ,$42.70 ,$18.96 ,$42.70 ,$46.97 ,$46.97 ,$48.38 ,$51.85 ,$19.35 ,$19.35 ,$34.22 ,$25.25 ,$25.38 ,$12.43 ,$12.30 ,$19.91 ,$51.85 ,$41.60 ,$31.96 ,$17.08 ,$54.90 ,$38.70 ,$18.96 ,$39.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200940,86762,HC RUBELLA AB-90,302,1 ,$118.00 ,$84.96 ,$7.13 ,$118.00 ,$76.70 ,$14.10 ,$33.04 ,$65.25 ,$14.10 ,$68.68 ,$14.10 ,$61.83 ,$14.10 ,$29.07 ,$108.56 ,$35.98 ,$14.10 ,$100.30 ,$106.20 ,$14.39 ,$88.50 ,$82.60 ,$82.60 ,$14.10 ,$82.60 ,$90.86 ,$90.86 ,$35.98 ,$100.30 ,$14.39 ,$14.39 ,$66.20 ,$48.85 ,$49.09 ,$7.21 ,$7.13 ,$14.81 ,$100.30 ,$30.94 ,$61.83 ,$33.04 ,$106.20 ,$28.78 ,$14.10 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200941,86765,HC RUBEOLA AB-90,302,1 ,$160.00 ,$115.20 ,$7.13 ,$160.00 ,$104.00 ,$12.62 ,$44.80 ,$88.48 ,$12.62 ,$93.12 ,$12.62 ,$83.84 ,$12.62 ,$26.02 ,$147.20 ,$32.20 ,$12.62 ,$136.00 ,$144.00 ,$12.88 ,$120.00 ,$112.00 ,$112.00 ,$12.62 ,$112.00 ,$123.20 ,$123.20 ,$32.20 ,$136.00 ,$12.88 ,$12.88 ,$89.76 ,$66.24 ,$66.56 ,$7.21 ,$7.13 ,$13.25 ,$136.00 ,$27.69 ,$83.84 ,$44.80 ,$144.00 ,$25.76 ,$12.62 ,$104.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200943,86774,HC TETANUS AB-90,302,1 ,$136.00 ,$97.92 ,$12.30 ,$136.00 ,$88.40 ,$14.50 ,$38.08 ,$75.21 ,$14.50 ,$79.15 ,$14.50 ,$71.26 ,$14.50 ,$29.90 ,$125.12 ,$37.00 ,$14.50 ,$115.60 ,$122.40 ,$14.80 ,$102.00 ,$95.20 ,$95.20 ,$14.50 ,$95.20 ,$104.72 ,$104.72 ,$37.00 ,$115.60 ,$14.80 ,$14.80 ,$76.30 ,$56.30 ,$56.58 ,$12.43 ,$12.30 ,$15.23 ,$115.60 ,$31.82 ,$71.26 ,$38.08 ,$122.40 ,$29.60 ,$14.50 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200944,86777,HC TOXOPLASMA AB-90,302,1 ,$118.00 ,$84.96 ,$12.30 ,$118.00 ,$76.70 ,$14.10 ,$33.04 ,$65.25 ,$14.10 ,$68.68 ,$14.10 ,$61.83 ,$14.10 ,$29.07 ,$108.56 ,$35.98 ,$14.10 ,$100.30 ,$106.20 ,$14.39 ,$88.50 ,$82.60 ,$82.60 ,$14.10 ,$82.60 ,$90.86 ,$90.86 ,$35.98 ,$100.30 ,$14.39 ,$14.39 ,$66.20 ,$48.85 ,$49.09 ,$12.43 ,$12.30 ,$14.81 ,$100.30 ,$30.94 ,$61.83 ,$33.04 ,$106.20 ,$28.78 ,$14.10 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$118.00 ,$84.96 ,$12.30 ,$118.00 ,$76.70 ,$14.12 ,$33.04 ,$65.25 ,$14.12 ,$68.68 ,$14.12 ,$61.83 ,$14.12 ,$29.11 ,$108.56 ,$36.03 ,$14.12 ,$100.30 ,$106.20 ,$14.41 ,$88.50 ,$82.60 ,$82.60 ,$14.12 ,$82.60 ,$90.86 ,$90.86 ,$36.03 ,$100.30 ,$14.41 ,$14.41 ,$66.20 ,$48.85 ,$49.09 ,$12.43 ,$12.30 ,$14.83 ,$100.30 ,$30.98 ,$61.83 ,$33.04 ,$106.20 ,$28.82 ,$14.12 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$173.00 ,$124.56 ,$12.30 ,$173.00 ,$112.45 ,$12.98 ,$48.44 ,$95.67 ,$12.98 ,$100.69 ,$12.98 ,$90.65 ,$12.98 ,$26.74 ,$159.16 ,$33.10 ,$12.98 ,$147.05 ,$155.70 ,$13.23 ,$129.75 ,$121.10 ,$121.10 ,$12.98 ,$121.10 ,$133.21 ,$133.21 ,$33.10 ,$147.05 ,$13.24 ,$13.24 ,$97.05 ,$71.62 ,$71.97 ,$12.43 ,$12.30 ,$13.62 ,$147.05 ,$28.47 ,$90.65 ,$48.44 ,$155.70 ,$26.48 ,$12.98 ,$112.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$304.00 ,$218.88 ,$7.13 ,$304.00 ,$197.60 ,$12.62 ,$85.12 ,$168.11 ,$12.62 ,$176.93 ,$12.62 ,$159.30 ,$12.62 ,$26.02 ,$279.68 ,$32.20 ,$12.62 ,$258.40 ,$273.60 ,$12.88 ,$228.00 ,$212.80 ,$212.80 ,$12.62 ,$212.80 ,$234.08 ,$234.08 ,$32.20 ,$258.40 ,$12.88 ,$12.88 ,$170.54 ,$125.86 ,$126.46 ,$7.21 ,$7.13 ,$13.25 ,$258.40 ,$27.69 ,$159.30 ,$85.12 ,$273.60 ,$25.76 ,$12.62 ,$197.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200950,86789,HC WEST NILE AB-90,302,1 ,$107.00 ,$77.04 ,$12.30 ,$107.00 ,$69.55 ,$14.10 ,$29.96 ,$59.17 ,$14.10 ,$62.27 ,$14.10 ,$56.07 ,$14.10 ,$29.07 ,$98.44 ,$35.98 ,$14.10 ,$90.95 ,$96.30 ,$14.39 ,$80.25 ,$74.90 ,$74.90 ,$14.10 ,$74.90 ,$82.39 ,$82.39 ,$35.98 ,$90.95 ,$14.39 ,$14.39 ,$60.03 ,$44.30 ,$44.51 ,$12.43 ,$12.30 ,$14.81 ,$90.95 ,$30.94 ,$56.07 ,$29.96 ,$96.30 ,$28.78 ,$14.10 ,$69.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200951,86790,HC VIRUS AB NOT SPECIFIED-90,302,1 ,$191.00 ,$137.52 ,$7.13 ,$191.00 ,$124.15 ,$12.62 ,$53.48 ,$105.62 ,$12.62 ,$111.16 ,$12.62 ,$100.08 ,$12.62 ,$26.02 ,$175.72 ,$32.20 ,$12.62 ,$162.35 ,$171.90 ,$12.88 ,$143.25 ,$133.70 ,$133.70 ,$12.62 ,$133.70 ,$147.07 ,$147.07 ,$32.20 ,$162.35 ,$12.88 ,$12.88 ,$107.15 ,$79.07 ,$79.46 ,$7.21 ,$7.13 ,$13.25 ,$162.35 ,$27.69 ,$100.08 ,$53.48 ,$171.90 ,$25.76 ,$12.62 ,$124.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$26.00 ,$18.72 ,$7.28 ,$39.78 ,$16.90 ,$15.59 ,$7.28 ,$14.38 ,$15.59 ,$15.13 ,$15.59 ,$13.62 ,$15.59 ,$26.00 ,$23.92 ,$39.78 ,$15.59 ,$22.10 ,$23.40 ,$15.91 ,$19.50 ,$18.20 ,$18.20 ,$15.59 ,$18.20 ,$20.02 ,$20.02 ,$26.00 ,$22.10 ,$15.91 ,$15.91 ,$14.59 ,$10.76 ,$10.82 ,$18.85 ,$18.64 ,$16.38 ,$22.10 ,$34.21 ,$13.62 ,$7.28 ,$23.40 ,$26.00 ,$15.59 ,$16.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$402.00 ,$289.44 ,$25.29 ,$402.00 ,$261.30 ,$25.29 ,$112.56 ,$222.31 ,$25.29 ,$233.96 ,$25.29 ,$210.65 ,$25.29 ,$52.14 ,$369.84 ,$64.53 ,$25.29 ,$341.70 ,$361.80 ,$25.80 ,$301.50 ,$281.40 ,$281.40 ,$25.29 ,$281.40 ,$309.54 ,$309.54 ,$64.53 ,$341.70 ,$25.81 ,$25.81 ,$225.52 ,$166.43 ,$167.23 ,$29.10 ,$28.79 ,$26.56 ,$341.70 ,$55.49 ,$210.65 ,$112.56 ,$361.80 ,$51.62 ,$25.29 ,$261.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200966,86850,HC AB SCREEN-90,302,1 ,$118.00 ,$84.96 ,$7.13 ,$120.38 ,$76.70 ,$47.19 ,$33.04 ,$65.25 ,$47.19 ,$68.68 ,$47.19 ,$61.83 ,$47.19 ,$97.27 ,$108.56 ,$120.38 ,$47.19 ,$100.30 ,$106.20 ,$48.13 ,$88.50 ,$82.60 ,$82.60 ,$47.19 ,$82.60 ,$90.86 ,$90.86 ,$118.00 ,$100.30 ,$48.15 ,$48.15 ,$66.20 ,$48.85 ,$49.09 ,$7.21 ,$7.13 ,$49.55 ,$100.30 ,$103.53 ,$61.83 ,$33.04 ,$106.20 ,$19.54 ,$47.19 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200970,86860,HC ELUTION-90,302,1 ,$118.00 ,$84.96 ,$7.13 ,$377.53 ,$76.70 ,$147.99 ,$33.04 ,$65.25 ,$147.99 ,$68.68 ,$115.64 ,$61.83 ,$115.64 ,$118.00 ,$108.56 ,$377.53 ,$147.99 ,$100.30 ,$106.20 ,$115.64 ,$88.50 ,$82.60 ,$82.60 ,$147.99 ,$82.60 ,$90.86 ,$90.86 ,$118.00 ,$100.30 ,$151.01 ,$151.01 ,$66.20 ,$48.85 ,$49.09 ,$7.21 ,$7.13 ,$155.39 ,$100.30 ,$324.68 ,$61.83 ,$33.04 ,$106.20 ,$118.00 ,$147.99 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200974,86870,HC RBC AB ID PANEL-90,302,1 ,$222.00 ,$159.84 ,$7.13 ,$778.14 ,$144.30 ,$305.03 ,$62.16 ,$122.77 ,$305.03 ,$129.20 ,$217.56 ,$116.33 ,$217.56 ,$222.00 ,$204.24 ,$778.14 ,$305.03 ,$188.70 ,$199.80 ,$217.56 ,$166.50 ,$155.40 ,$155.40 ,$305.03 ,$155.40 ,$170.94 ,$170.94 ,$222.00 ,$188.70 ,$311.26 ,$311.26 ,$124.54 ,$91.91 ,$92.35 ,$7.21 ,$7.13 ,$320.28 ,$188.70 ,$669.20 ,$116.33 ,$62.16 ,$199.80 ,$222.00 ,$305.03 ,$144.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200976,86880,HC COOMBS DIRECT-90,302,1 ,$107.00 ,$77.04 ,$7.13 ,$138.00 ,$69.55 ,$54.10 ,$29.96 ,$59.17 ,$54.10 ,$62.27 ,$54.10 ,$56.07 ,$54.10 ,$107.00 ,$98.44 ,$138.00 ,$54.10 ,$90.95 ,$96.30 ,$55.17 ,$80.25 ,$74.90 ,$74.90 ,$54.10 ,$74.90 ,$82.39 ,$82.39 ,$107.00 ,$90.95 ,$55.20 ,$55.20 ,$60.03 ,$44.30 ,$44.51 ,$7.21 ,$7.13 ,$56.80 ,$90.95 ,$118.68 ,$56.07 ,$29.96 ,$96.30 ,$10.78 ,$54.10 ,$69.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200978,86886,HC INDIRECT TITER-90,302,1 ,$239.00 ,$172.08 ,$7.13 ,$377.53 ,$155.35 ,$147.99 ,$66.92 ,$132.17 ,$147.99 ,$139.10 ,$147.99 ,$125.24 ,$147.99 ,$239.00 ,$219.88 ,$377.53 ,$147.99 ,$203.15 ,$215.10 ,$150.95 ,$179.25 ,$167.30 ,$167.30 ,$147.99 ,$167.30 ,$184.03 ,$184.03 ,$239.00 ,$203.15 ,$151.01 ,$151.01 ,$134.08 ,$98.95 ,$99.42 ,$7.21 ,$7.13 ,$155.39 ,$203.15 ,$324.68 ,$125.24 ,$66.92 ,$215.10 ,$10.36 ,$147.99 ,$155.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200981,86900,HC BLOOD TYPING ABO-90,302,1 ,$78.00 ,$56.16 ,$4.42 ,$278.76 ,$50.70 ,$109.28 ,$21.84 ,$43.13 ,$109.28 ,$45.40 ,$76.44 ,$40.87 ,$76.44 ,$78.00 ,$71.76 ,$278.76 ,$109.28 ,$66.30 ,$70.20 ,$76.44 ,$58.50 ,$54.60 ,$54.60 ,$109.28 ,$54.60 ,$60.06 ,$60.06 ,$78.00 ,$66.30 ,$111.51 ,$111.51 ,$43.76 ,$32.29 ,$32.45 ,$4.47 ,$4.42 ,$114.75 ,$66.30 ,$239.74 ,$40.87 ,$21.84 ,$70.20 ,$5.98 ,$109.28 ,$50.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200983,86901,HC BLOOD TYPING RH-90,302,1 ,$78.00 ,$56.16 ,$4.42 ,$81.53 ,$50.70 ,$31.96 ,$21.84 ,$43.13 ,$31.96 ,$45.40 ,$31.96 ,$40.87 ,$31.96 ,$65.88 ,$71.76 ,$81.53 ,$31.96 ,$66.30 ,$70.20 ,$32.60 ,$58.50 ,$54.60 ,$54.60 ,$31.96 ,$54.60 ,$60.06 ,$60.06 ,$78.00 ,$66.30 ,$32.61 ,$32.61 ,$43.76 ,$32.29 ,$32.45 ,$4.47 ,$4.42 ,$33.56 ,$66.30 ,$70.12 ,$40.87 ,$21.84 ,$70.20 ,$5.98 ,$31.96 ,$50.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200990,86904,HC RBC AG SCR PAT SERUM-90,302,1 ,$79.00 ,$56.88 ,$4.42 ,$81.53 ,$51.35 ,$31.96 ,$22.12 ,$43.69 ,$31.96 ,$45.98 ,$31.96 ,$41.40 ,$31.96 ,$65.88 ,$72.68 ,$81.53 ,$31.96 ,$67.15 ,$71.10 ,$32.60 ,$59.25 ,$55.30 ,$55.30 ,$31.96 ,$55.30 ,$60.83 ,$60.83 ,$79.00 ,$67.15 ,$32.61 ,$32.61 ,$44.32 ,$32.71 ,$32.86 ,$4.47 ,$4.42 ,$33.56 ,$67.15 ,$70.12 ,$41.40 ,$22.12 ,$71.10 ,$32.68 ,$31.96 ,$51.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30200998,86906,HC RH PHENOTYPE COMPLETE-90,302,1 ,$118.00 ,$84.96 ,$4.42 ,$118.00 ,$76.70 ,$31.96 ,$33.04 ,$65.25 ,$31.96 ,$68.68 ,$31.96 ,$61.83 ,$31.96 ,$65.88 ,$108.56 ,$81.53 ,$31.96 ,$100.30 ,$106.20 ,$32.60 ,$88.50 ,$82.60 ,$82.60 ,$31.96 ,$82.60 ,$90.86 ,$90.86 ,$81.53 ,$100.30 ,$32.61 ,$32.61 ,$66.20 ,$48.85 ,$49.09 ,$4.47 ,$4.42 ,$33.56 ,$100.30 ,$70.12 ,$61.83 ,$33.04 ,$106.20 ,$15.50 ,$31.96 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201000,86922,HC CROSSMATCH AHG-90,302,1 ,$96.00 ,$69.12 ,$26.88 ,$377.53 ,$62.40 ,$147.99 ,$26.88 ,$53.09 ,$147.99 ,$55.87 ,$94.08 ,$50.30 ,$94.08 ,$96.00 ,$88.32 ,$377.53 ,$147.99 ,$81.60 ,$86.40 ,$94.08 ,$72.00 ,$67.20 ,$67.20 ,$147.99 ,$67.20 ,$73.92 ,$73.92 ,$96.00 ,$81.60 ,$151.01 ,$151.01 ,$53.86 ,$39.74 ,$39.94 ,$29.10 ,$28.79 ,$155.39 ,$81.60 ,$324.68 ,$50.30 ,$26.88 ,$86.40 ,$96.00 ,$147.99 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201003,86970,HC RBC PRETREAT CHEM-90,302,1 ,$211.00 ,$151.92 ,$28.79 ,$211.00 ,$137.15 ,$31.96 ,$59.08 ,$116.68 ,$31.96 ,$122.80 ,$31.96 ,$110.56 ,$31.96 ,$65.88 ,$194.12 ,$81.53 ,$31.96 ,$179.35 ,$189.90 ,$32.60 ,$158.25 ,$147.70 ,$147.70 ,$31.96 ,$147.70 ,$162.47 ,$162.47 ,$81.53 ,$179.35 ,$32.61 ,$32.61 ,$118.37 ,$87.35 ,$87.78 ,$29.10 ,$28.79 ,$33.56 ,$179.35 ,$70.12 ,$110.56 ,$59.08 ,$189.90 ,$67.68 ,$31.96 ,$137.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201005,86971,HC RBC PRETREAT ENZYME-90,302,1 ,$104.00 ,$74.88 ,$28.79 ,$778.14 ,$67.60 ,$305.03 ,$29.12 ,$57.51 ,$305.03 ,$60.53 ,$101.92 ,$54.50 ,$101.92 ,$104.00 ,$95.68 ,$778.14 ,$305.03 ,$88.40 ,$93.60 ,$101.92 ,$78.00 ,$72.80 ,$72.80 ,$305.03 ,$72.80 ,$80.08 ,$80.08 ,$104.00 ,$88.40 ,$311.26 ,$311.26 ,$58.34 ,$43.06 ,$43.26 ,$29.10 ,$28.79 ,$320.28 ,$88.40 ,$669.20 ,$54.50 ,$29.12 ,$93.60 ,$104.00 ,$305.03 ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201007,86972,HC RBC PRETREAT DENSITY SEP-90,302,1 ,$147.00 ,$105.84 ,$28.79 ,$377.53 ,$95.55 ,$147.99 ,$41.16 ,$81.29 ,$147.99 ,$85.55 ,$144.06 ,$77.03 ,$144.06 ,$147.00 ,$135.24 ,$377.53 ,$147.99 ,$124.95 ,$132.30 ,$144.06 ,$110.25 ,$102.90 ,$102.90 ,$147.99 ,$102.90 ,$113.19 ,$113.19 ,$147.00 ,$124.95 ,$151.01 ,$151.01 ,$82.47 ,$60.86 ,$61.15 ,$29.10 ,$28.79 ,$155.39 ,$124.95 ,$324.68 ,$77.03 ,$41.16 ,$132.30 ,$147.00 ,$147.99 ,$95.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201020,86978,HC RBC PRETREAT ABSOR-90,302,1 ,$212.00 ,$152.64 ,$4.42 ,$212.00 ,$137.80 ,$31.96 ,$59.36 ,$117.24 ,$31.96 ,$123.38 ,$31.96 ,$111.09 ,$31.96 ,$65.88 ,$195.04 ,$81.53 ,$31.96 ,$180.20 ,$190.80 ,$32.60 ,$159.00 ,$148.40 ,$148.40 ,$31.96 ,$148.40 ,$163.24 ,$163.24 ,$81.53 ,$180.20 ,$32.61 ,$32.61 ,$118.93 ,$87.77 ,$88.19 ,$4.47 ,$4.42 ,$33.56 ,$180.20 ,$70.12 ,$111.09 ,$59.36 ,$190.80 ,$67.68 ,$31.96 ,$137.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$457.00 ,$329.04 ,$7.96 ,$457.00 ,$297.05 ,$20.39 ,$127.96 ,$252.72 ,$20.39 ,$265.97 ,$20.39 ,$239.47 ,$20.39 ,$42.04 ,$420.44 ,$52.03 ,$20.39 ,$388.45 ,$411.30 ,$20.81 ,$342.75 ,$319.90 ,$319.90 ,$20.39 ,$319.90 ,$351.89 ,$351.89 ,$52.03 ,$388.45 ,$20.81 ,$20.81 ,$256.38 ,$189.20 ,$190.11 ,$8.05 ,$7.96 ,$21.41 ,$388.45 ,$44.74 ,$239.47 ,$127.96 ,$411.30 ,$41.62 ,$20.39 ,$297.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201026,86317,HC INFECTIOUS AB QN-90,302,1 ,$282.00 ,$203.04 ,$12.30 ,$282.00 ,$183.30 ,$14.69 ,$78.96 ,$155.95 ,$14.69 ,$164.12 ,$14.69 ,$147.77 ,$14.69 ,$30.28 ,$259.44 ,$37.48 ,$14.69 ,$239.70 ,$253.80 ,$14.98 ,$211.50 ,$197.40 ,$197.40 ,$14.69 ,$197.40 ,$217.14 ,$217.14 ,$37.48 ,$239.70 ,$14.99 ,$14.99 ,$158.20 ,$116.75 ,$117.31 ,$12.43 ,$12.30 ,$15.43 ,$239.70 ,$32.23 ,$147.77 ,$78.96 ,$253.80 ,$29.98 ,$14.69 ,$183.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201029,86331,HC IMMUNODIFF EL EA AG AB QL-90,302,1 ,$41.00 ,$29.52 ,$11.48 ,$41.00 ,$26.65 ,$11.74 ,$11.48 ,$22.67 ,$11.74 ,$23.86 ,$11.74 ,$21.48 ,$11.74 ,$24.20 ,$37.72 ,$29.95 ,$11.74 ,$34.85 ,$36.90 ,$11.98 ,$30.75 ,$28.70 ,$28.70 ,$11.74 ,$28.70 ,$31.57 ,$31.57 ,$29.95 ,$34.85 ,$11.98 ,$11.98 ,$23.00 ,$16.97 ,$17.06 ,$12.43 ,$12.30 ,$12.33 ,$34.85 ,$25.76 ,$21.48 ,$11.48 ,$36.90 ,$23.96 ,$11.74 ,$26.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201030,86332,HC IMMUNE COMPLEX ASSAY-90,302,1 ,$54.00 ,$38.88 ,$12.30 ,$60.93 ,$35.10 ,$23.88 ,$15.12 ,$29.86 ,$23.88 ,$31.43 ,$23.88 ,$28.30 ,$23.88 ,$49.23 ,$49.68 ,$60.93 ,$23.88 ,$45.90 ,$48.60 ,$24.36 ,$40.50 ,$37.80 ,$37.80 ,$23.88 ,$37.80 ,$41.58 ,$41.58 ,$54.00 ,$45.90 ,$24.37 ,$24.37 ,$30.29 ,$22.36 ,$22.46 ,$12.43 ,$12.30 ,$25.08 ,$45.90 ,$52.40 ,$28.30 ,$15.12 ,$48.60 ,$48.74 ,$23.88 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$169.00 ,$121.68 ,$12.30 ,$169.00 ,$109.85 ,$21.89 ,$47.32 ,$93.46 ,$21.89 ,$98.36 ,$21.89 ,$88.56 ,$21.89 ,$45.13 ,$155.48 ,$55.85 ,$21.89 ,$143.65 ,$152.10 ,$22.33 ,$126.75 ,$118.30 ,$118.30 ,$21.89 ,$118.30 ,$130.13 ,$130.13 ,$55.85 ,$143.65 ,$22.34 ,$22.34 ,$94.81 ,$69.97 ,$70.30 ,$12.43 ,$12.30 ,$22.99 ,$143.65 ,$48.03 ,$88.56 ,$47.32 ,$152.10 ,$44.68 ,$21.89 ,$109.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201032,86335,HC IMMUNOFIX ELECTRO OTH-90,302,1 ,$141.00 ,$101.52 ,$12.30 ,$141.00 ,$91.65 ,$28.76 ,$39.48 ,$77.97 ,$28.76 ,$82.06 ,$28.76 ,$73.88 ,$28.76 ,$59.29 ,$129.72 ,$73.38 ,$28.76 ,$119.85 ,$126.90 ,$29.34 ,$105.75 ,$98.70 ,$98.70 ,$28.76 ,$98.70 ,$108.57 ,$108.57 ,$73.38 ,$119.85 ,$29.35 ,$29.35 ,$79.10 ,$58.37 ,$58.66 ,$12.43 ,$12.30 ,$30.20 ,$119.85 ,$63.10 ,$73.88 ,$39.48 ,$126.90 ,$58.70 ,$28.76 ,$91.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201033,86336,HC INHIBIN A-90,302,1 ,$161.00 ,$115.92 ,$7.96 ,$161.00 ,$104.65 ,$15.28 ,$45.08 ,$89.03 ,$15.28 ,$93.70 ,$15.28 ,$84.36 ,$15.28 ,$31.49 ,$148.12 ,$38.98 ,$15.28 ,$136.85 ,$144.90 ,$15.58 ,$120.75 ,$112.70 ,$112.70 ,$15.28 ,$112.70 ,$123.97 ,$123.97 ,$38.98 ,$136.85 ,$15.59 ,$15.59 ,$90.32 ,$66.65 ,$66.98 ,$8.05 ,$7.96 ,$16.04 ,$136.85 ,$33.52 ,$84.36 ,$45.08 ,$144.90 ,$31.18 ,$15.28 ,$104.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201034,86337,HC INSULIN AB-90,302,1 ,$159.00 ,$114.48 ,$18.64 ,$159.00 ,$103.35 ,$20.98 ,$44.52 ,$87.93 ,$20.98 ,$92.54 ,$20.98 ,$83.32 ,$20.98 ,$43.25 ,$146.28 ,$53.53 ,$20.98 ,$135.15 ,$143.10 ,$21.40 ,$119.25 ,$111.30 ,$111.30 ,$20.98 ,$111.30 ,$122.43 ,$122.43 ,$53.53 ,$135.15 ,$21.41 ,$21.41 ,$89.20 ,$65.83 ,$66.14 ,$18.85 ,$18.64 ,$22.03 ,$135.15 ,$46.03 ,$83.32 ,$44.52 ,$143.10 ,$42.82 ,$20.98 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$100.00 ,$72.00 ,$14.78 ,$100.00 ,$65.00 ,$14.78 ,$28.00 ,$55.30 ,$14.78 ,$58.20 ,$14.78 ,$52.40 ,$14.78 ,$30.46 ,$92.00 ,$37.70 ,$14.78 ,$85.00 ,$90.00 ,$15.07 ,$75.00 ,$70.00 ,$70.00 ,$14.78 ,$70.00 ,$77.00 ,$77.00 ,$37.70 ,$85.00 ,$15.08 ,$15.08 ,$56.10 ,$41.40 ,$41.60 ,$18.85 ,$18.64 ,$15.51 ,$85.00 ,$32.42 ,$52.40 ,$28.00 ,$90.00 ,$30.16 ,$14.78 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201036,86341,HC ISLET CELL AB-90,302,1 ,$64.00 ,$46.08 ,$12.30 ,$64.00 ,$41.60 ,$23.10 ,$17.92 ,$35.39 ,$23.10 ,$37.25 ,$23.10 ,$33.54 ,$23.10 ,$47.61 ,$58.88 ,$58.93 ,$23.10 ,$54.40 ,$57.60 ,$23.56 ,$48.00 ,$44.80 ,$44.80 ,$23.10 ,$44.80 ,$49.28 ,$49.28 ,$58.93 ,$54.40 ,$23.57 ,$23.57 ,$35.90 ,$26.50 ,$26.62 ,$12.43 ,$12.30 ,$24.25 ,$54.40 ,$50.68 ,$33.54 ,$17.92 ,$57.60 ,$47.14 ,$23.10 ,$41.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201037,86343,HC LEUKOCYTE HISTAMINE RELEASE-90,302,1 ,$285.00 ,$205.20 ,$12.21 ,$285.00 ,$185.25 ,$12.21 ,$79.80 ,$157.61 ,$12.21 ,$165.87 ,$12.21 ,$149.34 ,$12.21 ,$25.17 ,$262.20 ,$31.15 ,$12.21 ,$242.25 ,$256.50 ,$12.46 ,$213.75 ,$199.50 ,$199.50 ,$12.21 ,$199.50 ,$219.45 ,$219.45 ,$31.15 ,$242.25 ,$12.46 ,$12.46 ,$159.89 ,$117.99 ,$118.56 ,$12.43 ,$12.30 ,$12.82 ,$242.25 ,$26.79 ,$149.34 ,$79.80 ,$256.50 ,$24.92 ,$12.21 ,$185.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201040,86355,HC B CELLS TOTAL COUNT-90,302,1 ,$212.00 ,$152.64 ,$12.30 ,$212.00 ,$137.80 ,$36.98 ,$59.36 ,$117.24 ,$36.98 ,$123.38 ,$36.98 ,$111.09 ,$36.98 ,$76.21 ,$195.04 ,$94.33 ,$36.98 ,$180.20 ,$190.80 ,$37.71 ,$159.00 ,$148.40 ,$148.40 ,$36.98 ,$148.40 ,$163.24 ,$163.24 ,$94.33 ,$180.20 ,$37.73 ,$37.73 ,$118.93 ,$87.77 ,$88.19 ,$12.43 ,$12.30 ,$38.83 ,$180.20 ,$81.12 ,$111.09 ,$59.36 ,$190.80 ,$75.46 ,$36.98 ,$137.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201042,86357,HC CD8 TOTAL COUNT-90,302,1 ,$207.00 ,$149.04 ,$12.30 ,$207.00 ,$134.55 ,$36.98 ,$57.96 ,$114.47 ,$36.98 ,$120.47 ,$36.98 ,$108.47 ,$36.98 ,$76.21 ,$190.44 ,$94.33 ,$36.98 ,$175.95 ,$186.30 ,$37.71 ,$155.25 ,$144.90 ,$144.90 ,$36.98 ,$144.90 ,$159.39 ,$159.39 ,$94.33 ,$175.95 ,$37.73 ,$37.73 ,$116.13 ,$85.70 ,$86.11 ,$12.43 ,$12.30 ,$38.83 ,$175.95 ,$81.12 ,$108.47 ,$57.96 ,$186.30 ,$75.46 ,$36.98 ,$134.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201043,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$134.00 ,$96.48 ,$12.30 ,$134.00 ,$87.10 ,$36.98 ,$37.52 ,$74.10 ,$36.98 ,$77.99 ,$36.98 ,$70.22 ,$36.98 ,$76.21 ,$123.28 ,$94.33 ,$36.98 ,$113.90 ,$120.60 ,$37.71 ,$100.50 ,$93.80 ,$93.80 ,$36.98 ,$93.80 ,$103.18 ,$103.18 ,$94.33 ,$113.90 ,$37.73 ,$37.73 ,$75.17 ,$55.48 ,$55.74 ,$12.43 ,$12.30 ,$38.83 ,$113.90 ,$81.12 ,$70.22 ,$37.52 ,$120.60 ,$75.46 ,$36.98 ,$87.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$166.00 ,$119.52 ,$12.30 ,$166.00 ,$107.90 ,$46.04 ,$46.48 ,$91.80 ,$46.04 ,$96.61 ,$46.04 ,$86.98 ,$46.04 ,$94.90 ,$152.72 ,$117.45 ,$46.04 ,$141.10 ,$149.40 ,$46.96 ,$124.50 ,$116.20 ,$116.20 ,$46.04 ,$116.20 ,$127.82 ,$127.82 ,$117.45 ,$141.10 ,$46.98 ,$46.98 ,$93.13 ,$68.72 ,$69.06 ,$12.43 ,$12.30 ,$48.34 ,$141.10 ,$101.01 ,$86.98 ,$46.48 ,$149.40 ,$93.96 ,$46.04 ,$107.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201047,86376,HC MICROSOMAL AB-90,302,1 ,$157.00 ,$113.04 ,$14.26 ,$157.00 ,$102.05 ,$14.26 ,$43.96 ,$86.82 ,$14.26 ,$91.37 ,$14.26 ,$82.27 ,$14.26 ,$29.39 ,$144.44 ,$36.38 ,$14.26 ,$133.45 ,$141.30 ,$14.54 ,$117.75 ,$109.90 ,$109.90 ,$14.26 ,$109.90 ,$120.89 ,$120.89 ,$36.38 ,$133.45 ,$14.55 ,$14.55 ,$88.08 ,$65.00 ,$65.31 ,$18.85 ,$18.64 ,$14.97 ,$133.45 ,$31.28 ,$82.27 ,$43.96 ,$141.30 ,$29.10 ,$14.26 ,$102.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201048,86382,HC NEUTRALIZATION TEST VIRAL-90,302,1 ,$222.00 ,$159.84 ,$12.30 ,$222.00 ,$144.30 ,$16.57 ,$62.16 ,$122.77 ,$16.57 ,$129.20 ,$16.57 ,$116.33 ,$16.57 ,$34.16 ,$204.24 ,$42.28 ,$16.57 ,$188.70 ,$199.80 ,$16.90 ,$166.50 ,$155.40 ,$155.40 ,$16.57 ,$155.40 ,$170.94 ,$170.94 ,$42.28 ,$188.70 ,$16.91 ,$16.91 ,$124.54 ,$91.91 ,$92.35 ,$12.43 ,$12.30 ,$17.40 ,$188.70 ,$36.36 ,$116.33 ,$62.16 ,$199.80 ,$33.82 ,$16.57 ,$144.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$100.00 ,$72.00 ,$5.56 ,$100.00 ,$65.00 ,$5.56 ,$28.00 ,$55.30 ,$5.56 ,$58.20 ,$5.56 ,$52.40 ,$5.56 ,$11.45 ,$92.00 ,$14.18 ,$5.56 ,$85.00 ,$90.00 ,$5.66 ,$75.00 ,$70.00 ,$70.00 ,$5.56 ,$70.00 ,$77.00 ,$77.00 ,$14.18 ,$85.00 ,$5.67 ,$5.67 ,$56.10 ,$41.40 ,$41.60 ,$7.21 ,$7.13 ,$5.83 ,$85.00 ,$12.19 ,$52.40 ,$28.00 ,$90.00 ,$11.34 ,$5.56 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201053,86480,HC TB QUANTIFERON GOLD-90,302,1 ,$116.00 ,$83.52 ,$12.30 ,$154.95 ,$75.40 ,$60.74 ,$32.48 ,$64.15 ,$60.74 ,$67.51 ,$60.74 ,$60.78 ,$60.74 ,$116.00 ,$106.72 ,$154.95 ,$60.74 ,$98.60 ,$104.40 ,$61.96 ,$87.00 ,$81.20 ,$81.20 ,$60.74 ,$81.20 ,$89.32 ,$89.32 ,$116.00 ,$98.60 ,$61.98 ,$61.98 ,$65.08 ,$48.02 ,$48.26 ,$12.43 ,$12.30 ,$63.78 ,$98.60 ,$133.26 ,$60.78 ,$32.48 ,$104.40 ,$116.00 ,$60.74 ,$75.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201054,86592,HC SYPHILIS VDRL RPR QL-90,302,1 ,$144.00 ,$103.68 ,$4.18 ,$144.00 ,$93.60 ,$4.18 ,$40.32 ,$79.63 ,$4.18 ,$83.81 ,$4.18 ,$75.46 ,$4.18 ,$8.63 ,$132.48 ,$10.68 ,$4.18 ,$122.40 ,$129.60 ,$4.27 ,$108.00 ,$100.80 ,$100.80 ,$4.18 ,$100.80 ,$110.88 ,$110.88 ,$10.68 ,$122.40 ,$4.27 ,$4.27 ,$80.78 ,$59.62 ,$59.90 ,$7.21 ,$7.13 ,$4.39 ,$122.40 ,$9.18 ,$75.46 ,$40.32 ,$129.60 ,$8.54 ,$4.18 ,$93.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$159.00 ,$114.48 ,$12.30 ,$159.00 ,$103.35 ,$14.75 ,$44.52 ,$87.93 ,$14.75 ,$92.54 ,$14.75 ,$83.32 ,$14.75 ,$30.40 ,$146.28 ,$37.63 ,$14.75 ,$135.15 ,$143.10 ,$15.04 ,$119.25 ,$111.30 ,$111.30 ,$14.75 ,$111.30 ,$122.43 ,$122.43 ,$37.63 ,$135.15 ,$15.05 ,$15.05 ,$89.20 ,$65.83 ,$66.14 ,$12.43 ,$12.30 ,$15.48 ,$135.15 ,$32.36 ,$83.32 ,$44.52 ,$143.10 ,$30.10 ,$14.75 ,$103.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201057,86609,HC BACTERIUM AB NOS-90,302,1 ,$93.00 ,$66.96 ,$12.62 ,$93.00 ,$60.45 ,$12.62 ,$26.04 ,$51.43 ,$12.62 ,$54.13 ,$12.62 ,$48.73 ,$12.62 ,$26.02 ,$85.56 ,$32.20 ,$12.62 ,$79.05 ,$83.70 ,$12.88 ,$69.75 ,$65.10 ,$65.10 ,$12.62 ,$65.10 ,$71.61 ,$71.61 ,$32.20 ,$79.05 ,$12.88 ,$12.88 ,$52.17 ,$38.50 ,$38.69 ,$19.11 ,$18.90 ,$13.25 ,$79.05 ,$27.69 ,$48.73 ,$26.04 ,$83.70 ,$25.76 ,$12.62 ,$60.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$101.00 ,$72.72 ,$9.98 ,$101.00 ,$65.65 ,$9.98 ,$28.28 ,$55.85 ,$9.98 ,$58.78 ,$9.98 ,$52.92 ,$9.98 ,$20.56 ,$92.92 ,$25.45 ,$9.98 ,$85.85 ,$90.90 ,$10.17 ,$75.75 ,$70.70 ,$70.70 ,$9.98 ,$70.70 ,$77.77 ,$77.77 ,$25.45 ,$85.85 ,$10.18 ,$10.18 ,$56.66 ,$41.81 ,$42.02 ,$12.43 ,$12.30 ,$10.48 ,$85.85 ,$21.89 ,$52.92 ,$28.28 ,$90.90 ,$20.36 ,$9.98 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$73.00 ,$52.56 ,$12.30 ,$73.00 ,$47.45 ,$12.64 ,$20.44 ,$40.37 ,$12.64 ,$42.49 ,$12.64 ,$38.25 ,$12.64 ,$26.06 ,$67.16 ,$32.25 ,$12.64 ,$62.05 ,$65.70 ,$12.90 ,$54.75 ,$51.10 ,$51.10 ,$12.64 ,$51.10 ,$56.21 ,$56.21 ,$32.25 ,$62.05 ,$12.90 ,$12.90 ,$40.95 ,$30.22 ,$30.37 ,$12.43 ,$12.30 ,$13.28 ,$62.05 ,$27.74 ,$38.25 ,$20.44 ,$65.70 ,$25.80 ,$12.64 ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201061,86615,HC BORDETELLA AB-90,302,1 ,$110.00 ,$79.20 ,$12.30 ,$110.00 ,$71.50 ,$12.93 ,$30.80 ,$60.83 ,$12.93 ,$64.02 ,$12.93 ,$57.64 ,$12.93 ,$26.64 ,$101.20 ,$32.98 ,$12.93 ,$93.50 ,$99.00 ,$13.18 ,$82.50 ,$77.00 ,$77.00 ,$12.93 ,$77.00 ,$84.70 ,$84.70 ,$32.98 ,$93.50 ,$13.19 ,$13.19 ,$61.71 ,$45.54 ,$45.76 ,$12.43 ,$12.30 ,$13.57 ,$93.50 ,$28.36 ,$57.64 ,$30.80 ,$99.00 ,$26.38 ,$12.93 ,$71.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$61.00 ,$43.92 ,$12.30 ,$61.00 ,$39.65 ,$15.18 ,$17.08 ,$33.73 ,$15.18 ,$35.50 ,$15.18 ,$31.96 ,$15.18 ,$31.29 ,$56.12 ,$38.73 ,$15.18 ,$51.85 ,$54.90 ,$15.48 ,$45.75 ,$42.70 ,$42.70 ,$15.18 ,$42.70 ,$46.97 ,$46.97 ,$38.73 ,$51.85 ,$15.49 ,$15.49 ,$34.22 ,$25.25 ,$25.38 ,$12.43 ,$12.30 ,$15.93 ,$51.85 ,$33.30 ,$31.96 ,$17.08 ,$54.90 ,$30.98 ,$15.18 ,$39.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201063,86618,HC LYME AB-90,302,1 ,$233.00 ,$167.76 ,$12.30 ,$233.00 ,$151.45 ,$16.69 ,$65.24 ,$128.85 ,$16.69 ,$135.61 ,$16.69 ,$122.09 ,$16.69 ,$34.40 ,$214.36 ,$42.58 ,$16.69 ,$198.05 ,$209.70 ,$17.02 ,$174.75 ,$163.10 ,$163.10 ,$16.69 ,$163.10 ,$179.41 ,$179.41 ,$42.58 ,$198.05 ,$17.03 ,$17.03 ,$130.71 ,$96.46 ,$96.93 ,$12.43 ,$12.30 ,$17.52 ,$198.05 ,$36.61 ,$122.09 ,$65.24 ,$209.70 ,$34.06 ,$16.69 ,$151.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201065,86622,HC BRUCELLA AB-90,302,1 ,$97.00 ,$69.84 ,$8.75 ,$97.00 ,$63.05 ,$8.75 ,$27.16 ,$53.64 ,$8.75 ,$56.45 ,$8.75 ,$50.83 ,$8.75 ,$18.04 ,$89.24 ,$22.33 ,$8.75 ,$82.45 ,$87.30 ,$8.93 ,$72.75 ,$67.90 ,$67.90 ,$8.75 ,$67.90 ,$74.69 ,$74.69 ,$22.33 ,$82.45 ,$8.93 ,$8.93 ,$54.42 ,$40.16 ,$40.35 ,$12.43 ,$12.30 ,$9.19 ,$82.45 ,$19.20 ,$50.83 ,$27.16 ,$87.30 ,$17.86 ,$8.75 ,$63.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201067,86631,HC CHLAMYDIA AB-90,302,1 ,$105.00 ,$75.60 ,$5.69 ,$105.00 ,$68.25 ,$11.58 ,$29.40 ,$58.07 ,$11.58 ,$61.11 ,$11.58 ,$55.02 ,$11.58 ,$23.88 ,$96.60 ,$29.55 ,$11.58 ,$89.25 ,$94.50 ,$11.82 ,$78.75 ,$73.50 ,$73.50 ,$11.58 ,$73.50 ,$80.85 ,$80.85 ,$29.55 ,$89.25 ,$11.82 ,$11.82 ,$58.91 ,$43.47 ,$43.68 ,$5.75 ,$5.69 ,$12.16 ,$89.25 ,$25.41 ,$55.02 ,$29.40 ,$94.50 ,$23.64 ,$11.58 ,$68.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201088,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA-90,302,1 ,$11.00 ,$7.92 ,$3.08 ,$27.50 ,$7.15 ,$10.78 ,$3.08 ,$6.08 ,$10.78 ,$6.40 ,$10.78 ,$5.76 ,$10.78 ,$11.00 ,$10.12 ,$27.50 ,$10.78 ,$9.35 ,$9.90 ,$10.78 ,$8.25 ,$7.70 ,$7.70 ,$10.78 ,$7.70 ,$8.47 ,$8.47 ,$11.00 ,$9.35 ,$11.00 ,$11.00 ,$6.17 ,$4.55 ,$4.58 ,$7.21 ,$7.13 ,$11.32 ,$9.35 ,$23.65 ,$5.76 ,$3.08 ,$9.90 ,$11.00 ,$10.78 ,$7.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201092,86593,HC SYPHILIS VDRL RPR QN-90,302,1 ,$55.00 ,$39.60 ,$4.31 ,$55.00 ,$35.75 ,$4.31 ,$15.40 ,$30.42 ,$4.31 ,$32.01 ,$4.31 ,$28.82 ,$4.31 ,$8.89 ,$50.60 ,$11.00 ,$4.31 ,$46.75 ,$49.50 ,$4.40 ,$41.25 ,$38.50 ,$38.50 ,$4.31 ,$38.50 ,$42.35 ,$42.35 ,$11.00 ,$46.75 ,$4.40 ,$4.40 ,$30.86 ,$22.77 ,$22.88 ,$7.21 ,$7.13 ,$4.53 ,$46.75 ,$9.46 ,$28.82 ,$15.40 ,$49.50 ,$8.80 ,$4.31 ,$35.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201093,86003,HC ALLERGEN IGE QN EA,302,1 ,$120.00 ,$86.40 ,$5.12 ,$120.00 ,$78.00 ,$5.12 ,$33.60 ,$66.36 ,$5.12 ,$69.84 ,$5.12 ,$62.88 ,$5.12 ,$10.54 ,$110.40 ,$13.05 ,$5.12 ,$102.00 ,$108.00 ,$5.21 ,$90.00 ,$84.00 ,$84.00 ,$5.12 ,$84.00 ,$92.40 ,$92.40 ,$13.05 ,$102.00 ,$5.22 ,$5.22 ,$67.32 ,$49.68 ,$49.92 ,$7.21 ,$7.13 ,$5.37 ,$102.00 ,$11.22 ,$62.88 ,$33.60 ,$108.00 ,$10.44 ,$5.12 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201096,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$109.00 ,$78.48 ,$7.13 ,$109.00 ,$70.85 ,$12.69 ,$30.52 ,$60.28 ,$12.69 ,$63.44 ,$12.69 ,$57.12 ,$12.69 ,$26.16 ,$100.28 ,$32.38 ,$12.69 ,$92.65 ,$98.10 ,$12.95 ,$81.75 ,$76.30 ,$76.30 ,$12.69 ,$76.30 ,$83.93 ,$83.93 ,$32.38 ,$92.65 ,$12.95 ,$12.95 ,$61.15 ,$45.13 ,$45.34 ,$7.21 ,$7.13 ,$13.33 ,$92.65 ,$27.84 ,$57.12 ,$30.52 ,$98.10 ,$25.90 ,$12.69 ,$70.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201102,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$304.00 ,$218.88 ,$12.30 ,$304.00 ,$197.60 ,$21.89 ,$85.12 ,$168.11 ,$21.89 ,$176.93 ,$21.89 ,$159.30 ,$21.89 ,$45.13 ,$279.68 ,$55.85 ,$21.89 ,$258.40 ,$273.60 ,$22.33 ,$228.00 ,$212.80 ,$212.80 ,$21.89 ,$212.80 ,$234.08 ,$234.08 ,$55.85 ,$258.40 ,$22.34 ,$22.34 ,$170.54 ,$125.86 ,$126.46 ,$12.43 ,$12.30 ,$22.99 ,$258.40 ,$48.03 ,$159.30 ,$85.12 ,$273.60 ,$44.68 ,$21.89 ,$197.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201103,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$304.00 ,$218.88 ,$12.30 ,$304.00 ,$197.60 ,$28.76 ,$85.12 ,$168.11 ,$28.76 ,$176.93 ,$28.76 ,$159.30 ,$28.76 ,$59.29 ,$279.68 ,$73.38 ,$28.76 ,$258.40 ,$273.60 ,$29.34 ,$228.00 ,$212.80 ,$212.80 ,$28.76 ,$212.80 ,$234.08 ,$234.08 ,$73.38 ,$258.40 ,$29.35 ,$29.35 ,$170.54 ,$125.86 ,$126.46 ,$12.43 ,$12.30 ,$30.20 ,$258.40 ,$63.10 ,$159.30 ,$85.12 ,$273.60 ,$58.70 ,$28.76 ,$197.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201108,86431,HC RHEUMATOID FACTOR QN,302,1 ,$100.00 ,$72.00 ,$5.56 ,$100.00 ,$65.00 ,$5.56 ,$28.00 ,$55.30 ,$5.56 ,$58.20 ,$5.56 ,$52.40 ,$5.56 ,$11.45 ,$92.00 ,$14.18 ,$5.56 ,$85.00 ,$90.00 ,$5.66 ,$75.00 ,$70.00 ,$70.00 ,$5.56 ,$70.00 ,$77.00 ,$77.00 ,$14.18 ,$85.00 ,$5.67 ,$5.67 ,$56.10 ,$41.40 ,$41.60 ,$7.21 ,$7.13 ,$5.83 ,$85.00 ,$12.19 ,$52.40 ,$28.00 ,$90.00 ,$11.34 ,$5.56 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201109,86480,HC TB QUANTIFERON GOLD,302,1 ,$272.00 ,$195.84 ,$12.30 ,$272.00 ,$176.80 ,$60.74 ,$76.16 ,$150.42 ,$60.74 ,$158.30 ,$60.74 ,$142.53 ,$60.74 ,$125.20 ,$250.24 ,$154.95 ,$60.74 ,$231.20 ,$244.80 ,$61.96 ,$204.00 ,$190.40 ,$190.40 ,$60.74 ,$190.40 ,$209.44 ,$209.44 ,$154.95 ,$231.20 ,$61.98 ,$61.98 ,$152.59 ,$112.61 ,$113.15 ,$12.43 ,$12.30 ,$63.78 ,$231.20 ,$133.26 ,$142.53 ,$76.16 ,$244.80 ,$123.96 ,$60.74 ,$176.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201110,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$105.00 ,$75.60 ,$4.18 ,$105.00 ,$68.25 ,$4.18 ,$29.40 ,$58.07 ,$4.18 ,$61.11 ,$4.18 ,$55.02 ,$4.18 ,$8.63 ,$96.60 ,$10.68 ,$4.18 ,$89.25 ,$94.50 ,$4.27 ,$78.75 ,$73.50 ,$73.50 ,$4.18 ,$73.50 ,$80.85 ,$80.85 ,$10.68 ,$89.25 ,$4.27 ,$4.27 ,$58.91 ,$43.47 ,$43.68 ,$7.21 ,$7.13 ,$4.39 ,$89.25 ,$9.18 ,$55.02 ,$29.40 ,$94.50 ,$8.54 ,$4.18 ,$68.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201121,86704,HC HEP CORE AB,302,1 ,$196.00 ,$141.12 ,$7.13 ,$196.00 ,$127.40 ,$11.81 ,$54.88 ,$108.39 ,$11.81 ,$114.07 ,$11.81 ,$102.70 ,$11.81 ,$24.34 ,$180.32 ,$30.13 ,$11.81 ,$166.60 ,$176.40 ,$12.04 ,$147.00 ,$137.20 ,$137.20 ,$11.81 ,$137.20 ,$150.92 ,$150.92 ,$30.13 ,$166.60 ,$12.05 ,$12.05 ,$109.96 ,$81.14 ,$81.54 ,$7.21 ,$7.13 ,$12.40 ,$166.60 ,$25.91 ,$102.70 ,$54.88 ,$176.40 ,$24.10 ,$11.81 ,$127.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201122,86705,HC HEP B CORE IGM,302,1 ,$88.00 ,$63.36 ,$7.13 ,$88.00 ,$57.20 ,$11.53 ,$24.64 ,$48.66 ,$11.53 ,$51.22 ,$11.53 ,$46.11 ,$11.53 ,$23.78 ,$80.96 ,$29.43 ,$11.53 ,$74.80 ,$79.20 ,$11.77 ,$66.00 ,$61.60 ,$61.60 ,$11.53 ,$61.60 ,$67.76 ,$67.76 ,$29.43 ,$74.80 ,$11.77 ,$11.77 ,$49.37 ,$36.43 ,$36.61 ,$7.21 ,$7.13 ,$12.11 ,$74.80 ,$25.31 ,$46.11 ,$24.64 ,$79.20 ,$23.54 ,$11.53 ,$57.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201123,86706,HC HEP B SURFACE AB,302,1 ,$96.00 ,$69.12 ,$7.13 ,$96.00 ,$62.40 ,$10.53 ,$26.88 ,$53.09 ,$10.53 ,$55.87 ,$10.53 ,$50.30 ,$10.53 ,$21.69 ,$88.32 ,$26.85 ,$10.53 ,$81.60 ,$86.40 ,$10.73 ,$72.00 ,$67.20 ,$67.20 ,$10.53 ,$67.20 ,$73.92 ,$73.92 ,$26.85 ,$81.60 ,$10.74 ,$10.74 ,$53.86 ,$39.74 ,$39.94 ,$7.21 ,$7.13 ,$11.05 ,$81.60 ,$23.09 ,$50.30 ,$26.88 ,$86.40 ,$21.48 ,$10.53 ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201125,86709,HC HEP A AB (HAAB) IGM,302,1 ,$198.00 ,$142.56 ,$7.13 ,$198.00 ,$128.70 ,$11.03 ,$55.44 ,$109.49 ,$11.03 ,$115.24 ,$11.03 ,$103.75 ,$11.03 ,$22.75 ,$182.16 ,$28.15 ,$11.03 ,$168.30 ,$178.20 ,$11.26 ,$148.50 ,$138.60 ,$138.60 ,$11.03 ,$138.60 ,$152.46 ,$152.46 ,$28.15 ,$168.30 ,$11.26 ,$11.26 ,$111.08 ,$81.97 ,$82.37 ,$7.21 ,$7.13 ,$11.58 ,$168.30 ,$24.21 ,$103.75 ,$55.44 ,$178.20 ,$22.52 ,$11.03 ,$128.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201127,86762,HC RUBELLA AB,302,1 ,$118.00 ,$84.96 ,$7.13 ,$118.00 ,$76.70 ,$14.10 ,$33.04 ,$65.25 ,$14.10 ,$68.68 ,$14.10 ,$61.83 ,$14.10 ,$29.07 ,$108.56 ,$35.98 ,$14.10 ,$100.30 ,$106.20 ,$14.39 ,$88.50 ,$82.60 ,$82.60 ,$14.10 ,$82.60 ,$90.86 ,$90.86 ,$35.98 ,$100.30 ,$14.39 ,$14.39 ,$66.20 ,$48.85 ,$49.09 ,$7.21 ,$7.13 ,$14.81 ,$100.30 ,$30.94 ,$61.83 ,$33.04 ,$106.20 ,$28.78 ,$14.10 ,$76.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201132,86803,HC HEP C AB,302,1 ,$18.00 ,$12.96 ,$5.04 ,$35.68 ,$11.70 ,$13.98 ,$5.04 ,$9.95 ,$13.98 ,$10.48 ,$13.98 ,$9.43 ,$13.98 ,$18.00 ,$16.56 ,$35.68 ,$13.98 ,$15.30 ,$16.20 ,$14.27 ,$13.50 ,$12.60 ,$12.60 ,$13.98 ,$12.60 ,$13.86 ,$13.86 ,$18.00 ,$15.30 ,$14.27 ,$14.27 ,$10.10 ,$7.45 ,$7.49 ,$12.43 ,$12.30 ,$14.68 ,$15.30 ,$30.68 ,$9.43 ,$5.04 ,$16.20 ,$18.00 ,$13.98 ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201134,86902,HC RBC AG SCR RGT SERUM T1-90,302,1 ,$103.00 ,$74.16 ,$4.42 ,$778.14 ,$66.95 ,$305.03 ,$28.84 ,$56.96 ,$305.03 ,$59.95 ,$100.94 ,$53.97 ,$100.94 ,$103.00 ,$94.76 ,$778.14 ,$305.03 ,$87.55 ,$92.70 ,$100.94 ,$77.25 ,$72.10 ,$72.10 ,$305.03 ,$72.10 ,$79.31 ,$79.31 ,$103.00 ,$87.55 ,$311.26 ,$311.26 ,$57.78 ,$42.64 ,$42.85 ,$4.47 ,$4.42 ,$320.28 ,$87.55 ,$669.20 ,$53.97 ,$28.84 ,$92.70 ,$12.70 ,$305.03 ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201135,86902,HC RBC AG SCR RGT SERUM T2-90,302,1 ,$182.00 ,$131.04 ,$4.42 ,$778.14 ,$118.30 ,$305.03 ,$50.96 ,$100.65 ,$305.03 ,$105.92 ,$178.36 ,$95.37 ,$178.36 ,$182.00 ,$167.44 ,$778.14 ,$305.03 ,$154.70 ,$163.80 ,$178.36 ,$136.50 ,$127.40 ,$127.40 ,$305.03 ,$127.40 ,$140.14 ,$140.14 ,$182.00 ,$154.70 ,$311.26 ,$311.26 ,$102.10 ,$75.35 ,$75.71 ,$4.47 ,$4.42 ,$320.28 ,$154.70 ,$669.20 ,$95.37 ,$50.96 ,$163.80 ,$12.70 ,$305.03 ,$118.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201136,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$235.00 ,$169.20 ,$4.42 ,$778.14 ,$152.75 ,$305.03 ,$65.80 ,$129.96 ,$305.03 ,$136.77 ,$230.30 ,$123.14 ,$230.30 ,$235.00 ,$216.20 ,$778.14 ,$305.03 ,$199.75 ,$211.50 ,$230.30 ,$176.25 ,$164.50 ,$164.50 ,$305.03 ,$164.50 ,$180.95 ,$180.95 ,$235.00 ,$199.75 ,$311.26 ,$311.26 ,$131.84 ,$97.29 ,$97.76 ,$4.47 ,$4.42 ,$320.28 ,$199.75 ,$669.20 ,$123.14 ,$65.80 ,$211.50 ,$12.70 ,$305.03 ,$152.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201137,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$289.00 ,$208.08 ,$4.42 ,$778.14 ,$187.85 ,$305.03 ,$80.92 ,$159.82 ,$305.03 ,$168.20 ,$283.22 ,$151.44 ,$283.22 ,$289.00 ,$265.88 ,$778.14 ,$305.03 ,$245.65 ,$260.10 ,$283.22 ,$216.75 ,$202.30 ,$202.30 ,$305.03 ,$202.30 ,$222.53 ,$222.53 ,$289.00 ,$245.65 ,$311.26 ,$311.26 ,$162.13 ,$119.65 ,$120.22 ,$4.47 ,$4.42 ,$320.28 ,$245.65 ,$669.20 ,$151.44 ,$80.92 ,$260.10 ,$12.70 ,$305.03 ,$187.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201138,86905,HC RBC AG TYPING NON ABO/RH T1-90,302,1 ,$128.00 ,$92.16 ,$4.42 ,$778.14 ,$83.20 ,$305.03 ,$35.84 ,$70.78 ,$305.03 ,$74.50 ,$125.44 ,$67.07 ,$125.44 ,$128.00 ,$117.76 ,$778.14 ,$305.03 ,$108.80 ,$115.20 ,$125.44 ,$96.00 ,$89.60 ,$89.60 ,$305.03 ,$89.60 ,$98.56 ,$98.56 ,$128.00 ,$108.80 ,$311.26 ,$311.26 ,$71.81 ,$52.99 ,$53.25 ,$4.47 ,$4.42 ,$320.28 ,$108.80 ,$669.20 ,$67.07 ,$35.84 ,$115.20 ,$7.66 ,$305.03 ,$83.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201139,86905,HC RBC AG TYPING NON ABO/RH T2-90,302,1 ,$160.00 ,$115.20 ,$4.42 ,$778.14 ,$104.00 ,$305.03 ,$44.80 ,$88.48 ,$305.03 ,$93.12 ,$156.80 ,$83.84 ,$156.80 ,$160.00 ,$147.20 ,$778.14 ,$305.03 ,$136.00 ,$144.00 ,$156.80 ,$120.00 ,$112.00 ,$112.00 ,$305.03 ,$112.00 ,$123.20 ,$123.20 ,$160.00 ,$136.00 ,$311.26 ,$311.26 ,$89.76 ,$66.24 ,$66.56 ,$4.47 ,$4.42 ,$320.28 ,$136.00 ,$669.20 ,$83.84 ,$44.80 ,$144.00 ,$7.66 ,$305.03 ,$104.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201140,86905,HC RBC AG TYPING NON ABO/RH T3-90,302,1 ,$272.00 ,$195.84 ,$4.42 ,$778.14 ,$176.80 ,$305.03 ,$76.16 ,$150.42 ,$305.03 ,$158.30 ,$266.56 ,$142.53 ,$266.56 ,$272.00 ,$250.24 ,$778.14 ,$305.03 ,$231.20 ,$244.80 ,$266.56 ,$204.00 ,$190.40 ,$190.40 ,$305.03 ,$190.40 ,$209.44 ,$209.44 ,$272.00 ,$231.20 ,$311.26 ,$311.26 ,$152.59 ,$112.61 ,$113.15 ,$4.47 ,$4.42 ,$320.28 ,$231.20 ,$669.20 ,$142.53 ,$76.16 ,$244.80 ,$7.66 ,$305.03 ,$176.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201141,86905,HC RBC AG TYPING NON ABO/RH T4-90,302,1 ,$289.00 ,$208.08 ,$4.42 ,$778.14 ,$187.85 ,$305.03 ,$80.92 ,$159.82 ,$305.03 ,$168.20 ,$283.22 ,$151.44 ,$283.22 ,$289.00 ,$265.88 ,$778.14 ,$305.03 ,$245.65 ,$260.10 ,$283.22 ,$216.75 ,$202.30 ,$202.30 ,$305.03 ,$202.30 ,$222.53 ,$222.53 ,$289.00 ,$245.65 ,$311.26 ,$311.26 ,$162.13 ,$119.65 ,$120.22 ,$4.47 ,$4.42 ,$320.28 ,$245.65 ,$669.20 ,$151.44 ,$80.92 ,$260.10 ,$7.66 ,$305.03 ,$187.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201148,83986,HC PH BODY FLUID,302,1 ,$25.00 ,$18.00 ,$3.51 ,$25.00 ,$16.25 ,$3.51 ,$7.00 ,$13.83 ,$3.51 ,$14.55 ,$3.51 ,$13.10 ,$3.51 ,$7.23 ,$23.00 ,$8.95 ,$3.51 ,$21.25 ,$22.50 ,$3.58 ,$18.75 ,$17.50 ,$17.50 ,$3.51 ,$17.50 ,$19.25 ,$19.25 ,$8.95 ,$21.25 ,$3.58 ,$3.58 ,$14.03 ,$10.35 ,$10.40 ,$3.58 ,$3.54 ,$3.68 ,$21.25 ,$7.70 ,$13.10 ,$7.00 ,$22.50 ,$7.16 ,$3.51 ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201189,86015,HC ACTIN SMOOTH MUSC ANTIBODY- 90,302,1 ,$125.00 ,$90.00 ,$7.13 ,$125.00 ,$81.25 ,$11.81 ,$35.00 ,$69.13 ,$11.81 ,$72.75 ,$11.81 ,$65.50 ,$11.81 ,$24.34 ,$115.00 ,$30.13 ,$11.81 ,$106.25 ,$112.50 ,$12.04 ,$93.75 ,$87.50 ,$87.50 ,$11.81 ,$87.50 ,$96.25 ,$96.25 ,$30.13 ,$106.25 ,$12.05 ,$12.05 ,$70.13 ,$51.75 ,$52.00 ,$7.21 ,$7.13 ,$12.40 ,$106.25 ,$25.91 ,$65.50 ,$35.00 ,$112.50 ,$23.06 ,$11.81 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201190,86036,HC ANTINEUTROPHIL CYTO ANTB SCREEN- 90,302,1 ,$230.00 ,$165.60 ,$7.13 ,$230.00 ,$149.50 ,$11.81 ,$64.40 ,$127.19 ,$11.81 ,$133.86 ,$11.81 ,$120.52 ,$11.81 ,$24.34 ,$211.60 ,$30.13 ,$11.81 ,$195.50 ,$207.00 ,$12.04 ,$172.50 ,$161.00 ,$161.00 ,$11.81 ,$161.00 ,$177.10 ,$177.10 ,$30.13 ,$195.50 ,$12.05 ,$12.05 ,$129.03 ,$95.22 ,$95.68 ,$7.21 ,$7.13 ,$12.40 ,$195.50 ,$25.91 ,$120.52 ,$64.40 ,$207.00 ,$24.10 ,$11.81 ,$149.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201191,86037,HC ANTINEUTROPHIL CYTOPLASMIC ANTIBODY TITER- 90,302,1 ,$58.00 ,$41.76 ,$7.13 ,$58.00 ,$37.70 ,$11.81 ,$16.24 ,$32.07 ,$11.81 ,$33.76 ,$11.81 ,$30.39 ,$11.81 ,$24.34 ,$53.36 ,$30.13 ,$11.81 ,$49.30 ,$52.20 ,$12.04 ,$43.50 ,$40.60 ,$40.60 ,$11.81 ,$40.60 ,$44.66 ,$44.66 ,$30.13 ,$49.30 ,$12.05 ,$12.05 ,$32.54 ,$24.01 ,$24.13 ,$7.21 ,$7.13 ,$12.40 ,$49.30 ,$25.91 ,$30.39 ,$16.24 ,$52.20 ,$24.10 ,$11.81 ,$37.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201192,86364,HC TISS TRANSGLUTAMINASE EA IMMUNO- 90,302,1 ,$125.00 ,$90.00 ,$7.13 ,$125.00 ,$81.25 ,$11.30 ,$35.00 ,$69.13 ,$11.30 ,$72.75 ,$11.30 ,$65.50 ,$11.30 ,$23.29 ,$115.00 ,$28.83 ,$11.30 ,$106.25 ,$112.50 ,$11.52 ,$93.75 ,$87.50 ,$87.50 ,$11.30 ,$87.50 ,$96.25 ,$96.25 ,$28.83 ,$106.25 ,$11.53 ,$11.53 ,$70.13 ,$51.75 ,$52.00 ,$7.21 ,$7.13 ,$11.87 ,$106.25 ,$24.79 ,$65.50 ,$35.00 ,$112.50 ,$23.06 ,$11.30 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201193,86231,HC EMA EACH IG CLASS- 90,302,1 ,$190.00 ,$136.80 ,$7.13 ,$190.00 ,$123.50 ,$11.85 ,$53.20 ,$105.07 ,$11.85 ,$110.58 ,$11.85 ,$99.56 ,$11.85 ,$24.42 ,$174.80 ,$30.23 ,$11.85 ,$161.50 ,$171.00 ,$12.08 ,$142.50 ,$133.00 ,$133.00 ,$11.85 ,$133.00 ,$146.30 ,$146.30 ,$30.23 ,$161.50 ,$12.09 ,$12.09 ,$106.59 ,$78.66 ,$79.04 ,$7.21 ,$7.13 ,$12.44 ,$161.50 ,$25.99 ,$99.56 ,$53.20 ,$171.00 ,$24.18 ,$11.85 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201194,86258,HC GLIADIN ANTIBODY EA- 90,302,1 ,$125.00 ,$90.00 ,$7.13 ,$125.00 ,$81.25 ,$11.81 ,$35.00 ,$69.13 ,$11.81 ,$72.75 ,$11.81 ,$65.50 ,$11.81 ,$24.34 ,$115.00 ,$30.13 ,$11.81 ,$106.25 ,$112.50 ,$12.04 ,$93.75 ,$87.50 ,$87.50 ,$11.81 ,$87.50 ,$96.25 ,$96.25 ,$30.13 ,$106.25 ,$12.05 ,$12.05 ,$70.13 ,$51.75 ,$52.00 ,$7.21 ,$7.13 ,$12.40 ,$106.25 ,$25.91 ,$65.50 ,$35.00 ,$112.50 ,$23.06 ,$11.81 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201195,86381,HC MITOCHONDRIAL ANTIBODY- 90,302,1 ,$190.00 ,$136.80 ,$7.13 ,$190.00 ,$123.50 ,$24.94 ,$53.20 ,$105.07 ,$24.94 ,$110.58 ,$24.94 ,$99.56 ,$24.94 ,$51.41 ,$174.80 ,$63.63 ,$24.94 ,$161.50 ,$171.00 ,$25.44 ,$142.50 ,$133.00 ,$133.00 ,$24.94 ,$133.00 ,$146.30 ,$146.30 ,$63.63 ,$161.50 ,$25.45 ,$25.45 ,$106.59 ,$78.66 ,$79.04 ,$7.21 ,$7.13 ,$26.19 ,$161.50 ,$54.72 ,$99.56 ,$53.20 ,$171.00 ,$50.90 ,$24.94 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201201,86596,HC VOLTAGE GTG CALCIUM CHNL- 90,302,1 ,$55.00 ,$39.60 ,$7.13 ,$55.00 ,$35.75 ,$11.81 ,$15.40 ,$30.42 ,$11.81 ,$32.01 ,$11.81 ,$28.82 ,$11.81 ,$24.34 ,$50.60 ,$30.13 ,$11.81 ,$46.75 ,$49.50 ,$12.04 ,$41.25 ,$38.50 ,$38.50 ,$11.81 ,$38.50 ,$42.35 ,$42.35 ,$30.13 ,$46.75 ,$12.05 ,$12.05 ,$30.86 ,$22.77 ,$22.88 ,$7.21 ,$7.13 ,$12.40 ,$46.75 ,$25.91 ,$28.82 ,$15.40 ,$49.50 ,$36.80 ,$11.81 ,$35.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201202,86052,HC AQUAPORIN 4- 90,302,1 ,$525.00 ,$378.00 ,$7.13 ,$525.00 ,$341.25 ,$11.81 ,$147.00 ,$290.33 ,$11.81 ,$305.55 ,$11.81 ,$275.10 ,$11.81 ,$24.34 ,$483.00 ,$30.13 ,$11.81 ,$446.25 ,$472.50 ,$12.04 ,$393.75 ,$367.50 ,$367.50 ,$11.81 ,$367.50 ,$404.25 ,$404.25 ,$30.13 ,$446.25 ,$12.05 ,$12.05 ,$294.53 ,$217.35 ,$218.40 ,$7.21 ,$7.13 ,$12.40 ,$446.25 ,$25.91 ,$275.10 ,$147.00 ,$472.50 ,$24.10 ,$11.81 ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201213,86355,HC B CELLS TOTAL COUNT-90,302,1 ,$39.00 ,$28.08 ,$10.92 ,$94.33 ,$25.35 ,$36.98 ,$10.92 ,$21.57 ,$36.98 ,$22.70 ,$36.98 ,$20.44 ,$36.98 ,$39.00 ,$35.88 ,$94.33 ,$36.98 ,$33.15 ,$35.10 ,$37.71 ,$29.25 ,$27.30 ,$27.30 ,$36.98 ,$27.30 ,$30.03 ,$30.03 ,$39.00 ,$33.15 ,$37.73 ,$37.73 ,$21.88 ,$16.15 ,$16.22 ,$12.43 ,$12.30 ,$38.83 ,$33.15 ,$81.12 ,$20.44 ,$10.92 ,$35.10 ,$39.00 ,$36.98 ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201214,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$39.00 ,$28.08 ,$10.92 ,$94.33 ,$25.35 ,$36.98 ,$10.92 ,$21.57 ,$36.98 ,$22.70 ,$36.98 ,$20.44 ,$36.98 ,$39.00 ,$35.88 ,$94.33 ,$36.98 ,$33.15 ,$35.10 ,$37.71 ,$29.25 ,$27.30 ,$27.30 ,$36.98 ,$27.30 ,$30.03 ,$30.03 ,$39.00 ,$33.15 ,$37.73 ,$37.73 ,$21.88 ,$16.15 ,$16.22 ,$12.43 ,$12.30 ,$38.83 ,$33.15 ,$81.12 ,$20.44 ,$10.92 ,$35.10 ,$39.00 ,$36.98 ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201215,86360,HC T CELLS ABSOLUTE COUNT/RATION-90,302,1 ,$48.00 ,$34.56 ,$12.30 ,$117.45 ,$31.20 ,$46.04 ,$13.44 ,$26.54 ,$46.04 ,$27.94 ,$46.04 ,$25.15 ,$46.04 ,$48.00 ,$44.16 ,$117.45 ,$46.04 ,$40.80 ,$43.20 ,$46.96 ,$36.00 ,$33.60 ,$33.60 ,$46.04 ,$33.60 ,$36.96 ,$36.96 ,$48.00 ,$40.80 ,$46.98 ,$46.98 ,$26.93 ,$19.87 ,$19.97 ,$12.43 ,$12.30 ,$48.34 ,$40.80 ,$101.01 ,$25.15 ,$13.44 ,$43.20 ,$48.00 ,$46.04 ,$31.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30201225,86711,HC JOHN CUNNINGHAM ANTIBODY-90,302,1 ,"$3,129.00 ","$2,252.88 ",$7.13 ,"$3,129.00 ","$2,033.85 ",$16.55 ,$876.12 ,"$1,730.34 ",$16.55 ,"$1,821.08 ",$16.55 ,"$1,639.60 ",$16.55 ,$34.12 ,"$2,878.68 ",$42.23 ,$16.55 ,"$2,659.65 ","$2,816.10 ",$16.89 ,"$2,346.75 ","$2,190.30 ","$2,190.30 ",$16.55 ,"$2,190.30 ","$2,409.33 ","$2,409.33 ",$42.23 ,"$2,659.65 ",$16.89 ,$16.89 ,"$1,755.37 ","$1,295.41 ","$1,301.66 ",$7.21 ,$7.13 ,$17.38 ,"$2,659.65 ",$36.31 ,"$1,639.60 ",$876.12 ,"$2,816.10 ",$33.78 ,$16.55 ,"$2,033.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),30201240,86362,HC MOG-IGG1 ANTB CBA IMFLUOR ASSAY EACH-90,302,1 ,"$1,180.00 ",$849.60 ,$7.13 ,"$1,180.00 ",$767.00 ,$11.81 ,$330.40 ,$652.54 ,$11.81 ,$686.76 ,$11.81 ,$618.32 ,$11.81 ,$24.34 ,"$1,085.60 ",$30.13 ,$11.81 ,"$1,003.00 ","$1,062.00 ",$12.04 ,$885.00 ,$826.00 ,$826.00 ,$11.81 ,$826.00 ,$908.60 ,$908.60 ,$30.13 ,"$1,003.00 ",$12.05 ,$12.05 ,$661.98 ,$488.52 ,$490.88 ,$7.21 ,$7.13 ,$12.40 ,"$1,003.00 ",$25.91 ,$618.32 ,$330.40 ,"$1,062.00 ",$24.10 ,$11.81 ,$767.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$62.00 ,$44.64 ,$3.72 ,$62.00 ,$40.30 ,$3.72 ,$17.36 ,$34.29 ,$3.72 ,$36.08 ,$3.72 ,$32.49 ,$3.72 ,$7.68 ,$57.04 ,$9.50 ,$3.72 ,$52.70 ,$55.80 ,$3.80 ,$46.50 ,$43.40 ,$43.40 ,$3.72 ,$43.40 ,$47.74 ,$47.74 ,$9.50 ,$52.70 ,$3.80 ,$3.80 ,$34.78 ,$25.67 ,$25.79 ,$5.00 ,$4.95 ,$3.91 ,$52.70 ,$8.17 ,$32.49 ,$17.36 ,$55.80 ,$7.60 ,$3.72 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500104,85014,HC HEMATOCRIT,305,1 ,$46.00 ,$33.12 ,$2.32 ,$46.00 ,$29.90 ,$2.32 ,$12.88 ,$25.44 ,$2.32 ,$26.77 ,$2.32 ,$24.10 ,$2.32 ,$4.79 ,$42.32 ,$5.93 ,$2.32 ,$39.10 ,$41.40 ,$2.37 ,$34.50 ,$32.20 ,$32.20 ,$2.32 ,$32.20 ,$35.42 ,$35.42 ,$5.93 ,$39.10 ,$2.37 ,$2.37 ,$25.81 ,$19.04 ,$19.14 ,$5.00 ,$4.95 ,$2.44 ,$39.10 ,$5.10 ,$24.10 ,$12.88 ,$41.40 ,$4.74 ,$2.32 ,$29.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500106,85018,HC HGB,305,1 ,$46.00 ,$33.12 ,$2.32 ,$46.00 ,$29.90 ,$2.32 ,$12.88 ,$25.44 ,$2.32 ,$26.77 ,$2.32 ,$24.10 ,$2.32 ,$4.79 ,$42.32 ,$5.93 ,$2.32 ,$39.10 ,$41.40 ,$2.37 ,$34.50 ,$32.20 ,$32.20 ,$2.32 ,$32.20 ,$35.42 ,$35.42 ,$5.93 ,$39.10 ,$2.37 ,$2.37 ,$25.81 ,$19.04 ,$19.14 ,$5.00 ,$4.95 ,$2.44 ,$39.10 ,$5.10 ,$24.10 ,$12.88 ,$41.40 ,$4.74 ,$2.32 ,$29.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$135.00 ,$97.20 ,$4.95 ,$135.00 ,$87.75 ,$7.61 ,$37.80 ,$74.66 ,$7.61 ,$78.57 ,$7.61 ,$70.74 ,$7.61 ,$15.70 ,$124.20 ,$19.43 ,$7.61 ,$114.75 ,$121.50 ,$7.77 ,$101.25 ,$94.50 ,$94.50 ,$7.61 ,$94.50 ,$103.95 ,$103.95 ,$19.43 ,$114.75 ,$7.77 ,$7.77 ,$75.74 ,$55.89 ,$56.16 ,$5.00 ,$4.95 ,$8.00 ,$114.75 ,$16.71 ,$70.74 ,$37.80 ,$121.50 ,$15.54 ,$7.61 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500108,85027,HC CBC W/O DIFF,305,1 ,$102.00 ,$73.44 ,$4.95 ,$102.00 ,$66.30 ,$6.34 ,$28.56 ,$56.41 ,$6.34 ,$59.36 ,$6.34 ,$53.45 ,$6.34 ,$13.07 ,$93.84 ,$16.18 ,$6.34 ,$86.70 ,$91.80 ,$6.47 ,$76.50 ,$71.40 ,$71.40 ,$6.34 ,$71.40 ,$78.54 ,$78.54 ,$16.18 ,$86.70 ,$6.47 ,$6.47 ,$57.22 ,$42.23 ,$42.43 ,$5.00 ,$4.95 ,$6.65 ,$86.70 ,$13.91 ,$53.45 ,$28.56 ,$91.80 ,$12.94 ,$6.34 ,$66.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$79.00 ,$56.88 ,$2.49 ,$79.00 ,$51.35 ,$2.49 ,$22.12 ,$43.69 ,$2.49 ,$45.98 ,$2.49 ,$41.40 ,$2.49 ,$5.13 ,$72.68 ,$6.35 ,$2.49 ,$67.15 ,$71.10 ,$2.54 ,$59.25 ,$55.30 ,$55.30 ,$2.49 ,$55.30 ,$60.83 ,$60.83 ,$6.35 ,$67.15 ,$2.54 ,$2.54 ,$44.32 ,$32.71 ,$32.86 ,$5.00 ,$4.95 ,$2.62 ,$67.15 ,$5.46 ,$41.40 ,$22.12 ,$71.10 ,$5.08 ,$2.49 ,$51.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$61.00 ,$43.92 ,$4.39 ,$61.00 ,$39.65 ,$4.39 ,$17.08 ,$33.73 ,$4.39 ,$35.50 ,$4.39 ,$31.96 ,$4.39 ,$9.05 ,$56.12 ,$11.20 ,$4.39 ,$51.85 ,$54.90 ,$4.48 ,$45.75 ,$42.70 ,$42.70 ,$4.39 ,$42.70 ,$46.97 ,$46.97 ,$11.20 ,$51.85 ,$4.48 ,$4.48 ,$34.22 ,$25.25 ,$25.38 ,$5.00 ,$4.95 ,$4.61 ,$51.85 ,$9.63 ,$31.96 ,$17.08 ,$54.90 ,$8.96 ,$4.39 ,$39.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500175,85379,HC D DIMER QN,305,1 ,$216.00 ,$155.52 ,$8.58 ,$216.00 ,$140.40 ,$9.98 ,$60.48 ,$119.45 ,$9.98 ,$125.71 ,$9.98 ,$113.18 ,$9.98 ,$20.56 ,$198.72 ,$25.45 ,$9.98 ,$183.60 ,$194.40 ,$10.17 ,$162.00 ,$151.20 ,$151.20 ,$9.98 ,$151.20 ,$166.32 ,$166.32 ,$25.45 ,$183.60 ,$10.18 ,$10.18 ,$121.18 ,$89.42 ,$89.86 ,$8.68 ,$8.58 ,$10.48 ,$183.60 ,$21.89 ,$113.18 ,$60.48 ,$194.40 ,$20.36 ,$9.98 ,$140.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500187,85520,HC HEPARIN ASSAY,305,1 ,$223.00 ,$160.56 ,$8.58 ,$223.00 ,$144.95 ,$12.83 ,$62.44 ,$123.32 ,$12.83 ,$129.79 ,$12.83 ,$116.85 ,$12.83 ,$26.44 ,$205.16 ,$32.73 ,$12.83 ,$189.55 ,$200.70 ,$13.08 ,$167.25 ,$156.10 ,$156.10 ,$12.83 ,$156.10 ,$171.71 ,$171.71 ,$32.73 ,$189.55 ,$13.09 ,$13.09 ,$125.10 ,$92.32 ,$92.77 ,$8.68 ,$8.58 ,$13.47 ,$189.55 ,$28.14 ,$116.85 ,$62.44 ,$200.70 ,$26.18 ,$12.83 ,$144.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$90.00 ,$64.80 ,$2.89 ,$90.00 ,$58.50 ,$4.20 ,$25.20 ,$49.77 ,$4.20 ,$52.38 ,$4.20 ,$47.16 ,$4.20 ,$8.67 ,$82.80 ,$10.73 ,$4.20 ,$76.50 ,$81.00 ,$4.29 ,$67.50 ,$63.00 ,$63.00 ,$4.20 ,$63.00 ,$69.30 ,$69.30 ,$10.73 ,$76.50 ,$4.29 ,$4.29 ,$50.49 ,$37.26 ,$37.44 ,$2.92 ,$2.89 ,$4.41 ,$76.50 ,$9.22 ,$47.16 ,$25.20 ,$81.00 ,$8.58 ,$4.20 ,$58.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500205,85652,HC SED RATE AUTO,305,1 ,$79.00 ,$56.88 ,$2.65 ,$79.00 ,$51.35 ,$2.65 ,$22.12 ,$43.69 ,$2.65 ,$45.98 ,$2.65 ,$41.40 ,$2.65 ,$5.45 ,$72.68 ,$6.75 ,$2.65 ,$67.15 ,$71.10 ,$2.69 ,$59.25 ,$55.30 ,$55.30 ,$2.65 ,$55.30 ,$60.83 ,$60.83 ,$6.75 ,$67.15 ,$2.70 ,$2.70 ,$44.32 ,$32.71 ,$32.86 ,$5.00 ,$4.95 ,$2.78 ,$67.15 ,$5.81 ,$41.40 ,$22.12 ,$71.10 ,$5.40 ,$2.65 ,$51.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500211,85730,HC PTT,305,1 ,$146.00 ,$105.12 ,$2.89 ,$146.00 ,$94.90 ,$5.89 ,$40.88 ,$80.74 ,$5.89 ,$84.97 ,$5.89 ,$76.50 ,$5.89 ,$12.14 ,$134.32 ,$15.03 ,$5.89 ,$124.10 ,$131.40 ,$6.01 ,$109.50 ,$102.20 ,$102.20 ,$5.89 ,$102.20 ,$112.42 ,$112.42 ,$15.03 ,$124.10 ,$6.01 ,$6.01 ,$81.91 ,$60.44 ,$60.74 ,$2.92 ,$2.89 ,$6.18 ,$124.10 ,$12.92 ,$76.50 ,$40.88 ,$131.40 ,$12.02 ,$5.89 ,$94.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500234,85014,HC HEMATOCRIT-90,305,1 ,$39.00 ,$28.08 ,$2.32 ,$39.00 ,$25.35 ,$2.32 ,$10.92 ,$21.57 ,$2.32 ,$22.70 ,$2.32 ,$20.44 ,$2.32 ,$4.79 ,$35.88 ,$5.93 ,$2.32 ,$33.15 ,$35.10 ,$2.37 ,$29.25 ,$27.30 ,$27.30 ,$2.32 ,$27.30 ,$30.03 ,$30.03 ,$5.93 ,$33.15 ,$2.37 ,$2.37 ,$21.88 ,$16.15 ,$16.22 ,$5.00 ,$4.95 ,$2.44 ,$33.15 ,$5.10 ,$20.44 ,$10.92 ,$35.10 ,$4.74 ,$2.32 ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500238,85018,HC HGB-90,305,1 ,$39.00 ,$28.08 ,$2.32 ,$39.00 ,$25.35 ,$2.32 ,$10.92 ,$21.57 ,$2.32 ,$22.70 ,$2.32 ,$20.44 ,$2.32 ,$4.79 ,$35.88 ,$5.93 ,$2.32 ,$33.15 ,$35.10 ,$2.37 ,$29.25 ,$27.30 ,$27.30 ,$2.32 ,$27.30 ,$30.03 ,$30.03 ,$5.93 ,$33.15 ,$2.37 ,$2.37 ,$21.88 ,$16.15 ,$16.22 ,$5.00 ,$4.95 ,$2.44 ,$33.15 ,$5.10 ,$20.44 ,$10.92 ,$35.10 ,$4.74 ,$2.32 ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$30.00 ,$21.60 ,$2.96 ,$30.00 ,$19.50 ,$2.96 ,$8.40 ,$16.59 ,$2.96 ,$17.46 ,$2.96 ,$15.72 ,$2.96 ,$6.10 ,$27.60 ,$7.55 ,$2.96 ,$25.50 ,$27.00 ,$3.02 ,$22.50 ,$21.00 ,$21.00 ,$2.96 ,$21.00 ,$23.10 ,$23.10 ,$7.55 ,$25.50 ,$3.02 ,$3.02 ,$16.83 ,$12.42 ,$12.48 ,$5.00 ,$4.95 ,$3.11 ,$25.50 ,$6.49 ,$15.72 ,$8.40 ,$27.00 ,$6.04 ,$2.96 ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500249,85210,HC FACTOR II PROTHROM SPEC-90,305,1 ,$254.00 ,$182.88 ,$2.89 ,$254.00 ,$165.10 ,$12.72 ,$71.12 ,$140.46 ,$12.72 ,$147.83 ,$12.72 ,$133.10 ,$12.72 ,$26.22 ,$233.68 ,$32.45 ,$12.72 ,$215.90 ,$228.60 ,$12.98 ,$190.50 ,$177.80 ,$177.80 ,$12.72 ,$177.80 ,$195.58 ,$195.58 ,$32.45 ,$215.90 ,$12.98 ,$12.98 ,$142.49 ,$105.16 ,$105.66 ,$2.92 ,$2.89 ,$13.36 ,$215.90 ,$27.91 ,$133.10 ,$71.12 ,$228.60 ,$25.96 ,$12.72 ,$165.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500250,85220,HC FACTOR V CLOTTING FACTOR-90,305,1 ,$156.00 ,$112.32 ,$8.58 ,$156.00 ,$101.40 ,$17.30 ,$43.68 ,$86.27 ,$17.30 ,$90.79 ,$17.30 ,$81.74 ,$17.30 ,$35.65 ,$143.52 ,$44.13 ,$17.30 ,$132.60 ,$140.40 ,$17.64 ,$117.00 ,$109.20 ,$109.20 ,$17.30 ,$109.20 ,$120.12 ,$120.12 ,$44.13 ,$132.60 ,$17.65 ,$17.65 ,$87.52 ,$64.58 ,$64.90 ,$8.68 ,$8.58 ,$18.16 ,$132.60 ,$37.95 ,$81.74 ,$43.68 ,$140.40 ,$35.30 ,$17.30 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500251,85230,HC FACTOR VII PROCONVERTIN-90,305,1 ,$149.00 ,$107.28 ,$8.58 ,$149.00 ,$96.85 ,$17.54 ,$41.72 ,$82.40 ,$17.54 ,$86.72 ,$17.54 ,$78.08 ,$17.54 ,$36.16 ,$137.08 ,$44.75 ,$17.54 ,$126.65 ,$134.10 ,$17.89 ,$111.75 ,$104.30 ,$104.30 ,$17.54 ,$104.30 ,$114.73 ,$114.73 ,$44.75 ,$126.65 ,$17.90 ,$17.90 ,$83.59 ,$61.69 ,$61.98 ,$8.68 ,$8.58 ,$18.42 ,$126.65 ,$38.49 ,$78.08 ,$41.72 ,$134.10 ,$35.80 ,$17.54 ,$96.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500252,85240,HC FACTOR VIII AHG 1 STAGE-90,305,1 ,$172.00 ,$123.84 ,$8.58 ,$172.00 ,$111.80 ,$17.54 ,$48.16 ,$95.12 ,$17.54 ,$100.10 ,$17.54 ,$90.13 ,$17.54 ,$36.16 ,$158.24 ,$44.75 ,$17.54 ,$146.20 ,$154.80 ,$17.89 ,$129.00 ,$120.40 ,$120.40 ,$17.54 ,$120.40 ,$132.44 ,$132.44 ,$44.75 ,$146.20 ,$17.90 ,$17.90 ,$96.49 ,$71.21 ,$71.55 ,$8.68 ,$8.58 ,$18.42 ,$146.20 ,$38.49 ,$90.13 ,$48.16 ,$154.80 ,$35.80 ,$17.54 ,$111.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500253,85245,HC FACTOR VIII VW RISTOCTN-90,305,1 ,$83.00 ,$59.76 ,$8.58 ,$83.00 ,$53.95 ,$22.48 ,$23.24 ,$45.90 ,$22.48 ,$48.31 ,$22.48 ,$43.49 ,$22.48 ,$46.34 ,$76.36 ,$57.35 ,$22.48 ,$70.55 ,$74.70 ,$22.93 ,$62.25 ,$58.10 ,$58.10 ,$22.48 ,$58.10 ,$63.91 ,$63.91 ,$57.35 ,$70.55 ,$22.94 ,$22.94 ,$46.56 ,$34.36 ,$34.53 ,$8.68 ,$8.58 ,$23.61 ,$70.55 ,$49.32 ,$43.49 ,$23.24 ,$74.70 ,$45.88 ,$22.48 ,$53.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500254,85246,HC FACTOR VIII VW ANTIGEN-90,305,1 ,$401.00 ,$288.72 ,$8.58 ,$401.00 ,$260.65 ,$22.48 ,$112.28 ,$221.75 ,$22.48 ,$233.38 ,$22.48 ,$210.12 ,$22.48 ,$46.34 ,$368.92 ,$57.35 ,$22.48 ,$340.85 ,$360.90 ,$22.93 ,$300.75 ,$280.70 ,$280.70 ,$22.48 ,$280.70 ,$308.77 ,$308.77 ,$57.35 ,$340.85 ,$22.94 ,$22.94 ,$224.96 ,$166.01 ,$166.82 ,$8.68 ,$8.58 ,$23.61 ,$340.85 ,$49.32 ,$210.12 ,$112.28 ,$360.90 ,$45.88 ,$22.48 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500255,85247,HC FACTOR VIII VW MULTIM ANALY-90,305,1 ,$126.00 ,$90.72 ,$8.58 ,$126.00 ,$81.90 ,$22.48 ,$35.28 ,$69.68 ,$22.48 ,$73.33 ,$22.48 ,$66.02 ,$22.48 ,$46.34 ,$115.92 ,$57.35 ,$22.48 ,$107.10 ,$113.40 ,$22.93 ,$94.50 ,$88.20 ,$88.20 ,$22.48 ,$88.20 ,$97.02 ,$97.02 ,$57.35 ,$107.10 ,$22.94 ,$22.94 ,$70.69 ,$52.16 ,$52.42 ,$8.68 ,$8.58 ,$23.61 ,$107.10 ,$49.32 ,$66.02 ,$35.28 ,$113.40 ,$45.88 ,$22.48 ,$81.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500256,85250,HC FACTOR IX (PTC OR CHRISTMAS)-90,305,1 ,$137.00 ,$98.64 ,$8.58 ,$137.00 ,$89.05 ,$18.66 ,$38.36 ,$75.76 ,$18.66 ,$79.73 ,$18.66 ,$71.79 ,$18.66 ,$38.46 ,$126.04 ,$47.60 ,$18.66 ,$116.45 ,$123.30 ,$19.03 ,$102.75 ,$95.90 ,$95.90 ,$18.66 ,$95.90 ,$105.49 ,$105.49 ,$47.60 ,$116.45 ,$19.04 ,$19.04 ,$76.86 ,$56.72 ,$56.99 ,$8.68 ,$8.58 ,$19.59 ,$116.45 ,$40.94 ,$71.79 ,$38.36 ,$123.30 ,$38.08 ,$18.66 ,$89.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500257,85260,HC FACTOR X (STUART-POWER)-90,305,1 ,$156.00 ,$112.32 ,$8.58 ,$156.00 ,$101.40 ,$17.54 ,$43.68 ,$86.27 ,$17.54 ,$90.79 ,$17.54 ,$81.74 ,$17.54 ,$36.16 ,$143.52 ,$44.75 ,$17.54 ,$132.60 ,$140.40 ,$17.89 ,$117.00 ,$109.20 ,$109.20 ,$17.54 ,$109.20 ,$120.12 ,$120.12 ,$44.75 ,$132.60 ,$17.90 ,$17.90 ,$87.52 ,$64.58 ,$64.90 ,$8.68 ,$8.58 ,$18.42 ,$132.60 ,$38.49 ,$81.74 ,$43.68 ,$140.40 ,$35.80 ,$17.54 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500258,85270,HC FACTOR XI (PTA)-90,305,1 ,$54.00 ,$38.88 ,$8.58 ,$54.00 ,$35.10 ,$17.54 ,$15.12 ,$29.86 ,$17.54 ,$31.43 ,$17.54 ,$28.30 ,$17.54 ,$36.16 ,$49.68 ,$44.75 ,$17.54 ,$45.90 ,$48.60 ,$17.89 ,$40.50 ,$37.80 ,$37.80 ,$17.54 ,$37.80 ,$41.58 ,$41.58 ,$44.75 ,$45.90 ,$17.90 ,$17.90 ,$30.29 ,$22.36 ,$22.46 ,$8.68 ,$8.58 ,$18.42 ,$45.90 ,$38.49 ,$28.30 ,$15.12 ,$48.60 ,$35.80 ,$17.54 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500259,85280,HC FACTOR XII HAGEMAN-90,305,1 ,$54.00 ,$38.88 ,$8.58 ,$54.00 ,$35.10 ,$18.96 ,$15.12 ,$29.86 ,$18.96 ,$31.43 ,$18.96 ,$28.30 ,$18.96 ,$39.09 ,$49.68 ,$48.38 ,$18.96 ,$45.90 ,$48.60 ,$19.35 ,$40.50 ,$37.80 ,$37.80 ,$18.96 ,$37.80 ,$41.58 ,$41.58 ,$48.38 ,$45.90 ,$19.35 ,$19.35 ,$30.29 ,$22.36 ,$22.46 ,$8.68 ,$8.58 ,$19.91 ,$45.90 ,$41.60 ,$28.30 ,$15.12 ,$48.60 ,$38.70 ,$18.96 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500261,85300,HC ANTITHROMBIN III ACT-90,305,1 ,$182.00 ,$131.04 ,$8.58 ,$182.00 ,$118.30 ,$11.61 ,$50.96 ,$100.65 ,$11.61 ,$105.92 ,$11.61 ,$95.37 ,$11.61 ,$23.94 ,$167.44 ,$29.63 ,$11.61 ,$154.70 ,$163.80 ,$11.85 ,$136.50 ,$127.40 ,$127.40 ,$11.61 ,$127.40 ,$140.14 ,$140.14 ,$29.63 ,$154.70 ,$11.85 ,$11.85 ,$102.10 ,$75.35 ,$75.71 ,$8.68 ,$8.58 ,$12.19 ,$154.70 ,$25.48 ,$95.37 ,$50.96 ,$163.80 ,$23.70 ,$11.61 ,$118.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500262,85301,HC ANTITHROMBIN III AG-90,305,1 ,$319.00 ,$229.68 ,$8.58 ,$319.00 ,$207.35 ,$10.59 ,$89.32 ,$176.41 ,$10.59 ,$185.66 ,$10.59 ,$167.16 ,$10.59 ,$21.84 ,$293.48 ,$27.03 ,$10.59 ,$271.15 ,$287.10 ,$10.81 ,$239.25 ,$223.30 ,$223.30 ,$10.59 ,$223.30 ,$245.63 ,$245.63 ,$27.03 ,$271.15 ,$10.81 ,$10.81 ,$178.96 ,$132.07 ,$132.70 ,$8.68 ,$8.58 ,$11.12 ,$271.15 ,$23.24 ,$167.16 ,$89.32 ,$287.10 ,$21.62 ,$10.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500263,85302,HC PROTEIN C AG-90,305,1 ,$341.00 ,$245.52 ,$8.58 ,$341.00 ,$221.65 ,$11.77 ,$95.48 ,$188.57 ,$11.77 ,$198.46 ,$11.77 ,$178.68 ,$11.77 ,$24.26 ,$313.72 ,$30.03 ,$11.77 ,$289.85 ,$306.90 ,$12.00 ,$255.75 ,$238.70 ,$238.70 ,$11.77 ,$238.70 ,$262.57 ,$262.57 ,$30.03 ,$289.85 ,$12.01 ,$12.01 ,$191.30 ,$141.17 ,$141.86 ,$8.68 ,$8.58 ,$12.36 ,$289.85 ,$25.82 ,$178.68 ,$95.48 ,$306.90 ,$24.02 ,$11.77 ,$221.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$221.00 ,$159.12 ,$8.58 ,$221.00 ,$143.65 ,$13.56 ,$61.88 ,$122.21 ,$13.56 ,$128.62 ,$13.56 ,$115.80 ,$13.56 ,$27.96 ,$203.32 ,$34.60 ,$13.56 ,$187.85 ,$198.90 ,$13.84 ,$165.75 ,$154.70 ,$154.70 ,$13.56 ,$154.70 ,$170.17 ,$170.17 ,$34.60 ,$187.85 ,$13.84 ,$13.84 ,$123.98 ,$91.49 ,$91.94 ,$8.68 ,$8.58 ,$14.24 ,$187.85 ,$29.76 ,$115.80 ,$61.88 ,$198.90 ,$27.68 ,$13.56 ,$143.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$432.00 ,$311.04 ,$8.58 ,$432.00 ,$280.80 ,$11.38 ,$120.96 ,$238.90 ,$11.38 ,$251.42 ,$11.38 ,$226.37 ,$11.38 ,$23.45 ,$397.44 ,$29.03 ,$11.38 ,$367.20 ,$388.80 ,$11.60 ,$324.00 ,$302.40 ,$302.40 ,$11.38 ,$302.40 ,$332.64 ,$332.64 ,$29.03 ,$367.20 ,$11.61 ,$11.61 ,$242.35 ,$178.85 ,$179.71 ,$8.68 ,$8.58 ,$11.95 ,$367.20 ,$24.96 ,$226.37 ,$120.96 ,$388.80 ,$23.22 ,$11.38 ,$280.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500266,85306,HC PROTEIN S FREE-90,305,1 ,$207.00 ,$149.04 ,$8.58 ,$207.00 ,$134.55 ,$15.01 ,$57.96 ,$114.47 ,$15.01 ,$120.47 ,$15.01 ,$108.47 ,$15.01 ,$30.95 ,$190.44 ,$38.30 ,$15.01 ,$175.95 ,$186.30 ,$15.32 ,$155.25 ,$144.90 ,$144.90 ,$15.01 ,$144.90 ,$159.39 ,$159.39 ,$38.30 ,$175.95 ,$15.32 ,$15.32 ,$116.13 ,$85.70 ,$86.11 ,$8.68 ,$8.58 ,$15.77 ,$175.95 ,$32.94 ,$108.47 ,$57.96 ,$186.30 ,$30.64 ,$15.01 ,$134.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$143.00 ,$102.96 ,$7.96 ,$143.00 ,$92.95 ,$15.01 ,$40.04 ,$79.08 ,$15.01 ,$83.23 ,$15.01 ,$74.93 ,$15.01 ,$30.95 ,$131.56 ,$38.30 ,$15.01 ,$121.55 ,$128.70 ,$15.32 ,$107.25 ,$100.10 ,$100.10 ,$15.01 ,$100.10 ,$110.11 ,$110.11 ,$38.30 ,$121.55 ,$15.32 ,$15.32 ,$80.22 ,$59.20 ,$59.49 ,$8.05 ,$7.96 ,$15.77 ,$121.55 ,$32.94 ,$74.93 ,$40.04 ,$128.70 ,$30.64 ,$15.01 ,$92.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500277,85415,HC PLASMINGEN ACTIVATOR INHIB-90,305,1 ,$222.00 ,$159.84 ,$8.58 ,$222.00 ,$144.30 ,$16.85 ,$62.16 ,$122.77 ,$16.85 ,$129.20 ,$16.85 ,$116.33 ,$16.85 ,$34.72 ,$204.24 ,$42.98 ,$16.85 ,$188.70 ,$199.80 ,$17.18 ,$166.50 ,$155.40 ,$155.40 ,$16.85 ,$155.40 ,$170.94 ,$170.94 ,$42.98 ,$188.70 ,$17.19 ,$17.19 ,$124.54 ,$91.91 ,$92.35 ,$8.68 ,$8.58 ,$17.69 ,$188.70 ,$36.96 ,$116.33 ,$62.16 ,$199.80 ,$34.38 ,$16.85 ,$144.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500287,85549,HC MURAMIDASE-90,305,1 ,$72.00 ,$51.84 ,$7.96 ,$72.00 ,$46.80 ,$18.37 ,$20.16 ,$39.82 ,$18.37 ,$41.90 ,$18.37 ,$37.73 ,$18.37 ,$37.88 ,$66.24 ,$46.88 ,$18.37 ,$61.20 ,$64.80 ,$18.75 ,$54.00 ,$50.40 ,$50.40 ,$18.37 ,$50.40 ,$55.44 ,$55.44 ,$46.88 ,$61.20 ,$18.75 ,$18.75 ,$40.39 ,$29.81 ,$29.95 ,$8.05 ,$7.96 ,$19.30 ,$61.20 ,$40.31 ,$37.73 ,$20.16 ,$64.80 ,$37.50 ,$18.37 ,$46.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500289,85597,HC PLATELET NEUTRALIZATION-90,305,1 ,$41.00 ,$29.52 ,$8.58 ,$44.95 ,$26.65 ,$17.62 ,$11.48 ,$22.67 ,$17.62 ,$23.86 ,$17.62 ,$21.48 ,$17.62 ,$36.32 ,$37.72 ,$44.95 ,$17.62 ,$34.85 ,$36.90 ,$17.97 ,$30.75 ,$28.70 ,$28.70 ,$17.62 ,$28.70 ,$31.57 ,$31.57 ,$41.00 ,$34.85 ,$17.98 ,$17.98 ,$23.00 ,$16.97 ,$17.06 ,$8.68 ,$8.58 ,$18.50 ,$34.85 ,$38.66 ,$21.48 ,$11.48 ,$36.90 ,$35.96 ,$17.62 ,$26.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$68.00 ,$48.96 ,$8.58 ,$68.00 ,$44.20 ,$9.39 ,$19.04 ,$37.60 ,$9.39 ,$39.58 ,$9.39 ,$35.63 ,$9.39 ,$19.35 ,$62.56 ,$23.95 ,$9.39 ,$57.80 ,$61.20 ,$9.57 ,$51.00 ,$47.60 ,$47.60 ,$9.39 ,$47.60 ,$52.36 ,$52.36 ,$23.95 ,$57.80 ,$9.58 ,$9.58 ,$38.15 ,$28.15 ,$28.29 ,$8.68 ,$8.58 ,$9.86 ,$57.80 ,$20.60 ,$35.63 ,$19.04 ,$61.20 ,$19.16 ,$9.39 ,$44.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500301,85660,HC SICKLE CELL RBC-90,305,1 ,$73.00 ,$52.56 ,$4.95 ,$73.00 ,$47.45 ,$5.40 ,$20.44 ,$40.37 ,$5.40 ,$42.49 ,$5.40 ,$38.25 ,$5.40 ,$11.13 ,$67.16 ,$13.78 ,$5.40 ,$62.05 ,$65.70 ,$5.51 ,$54.75 ,$51.10 ,$51.10 ,$5.40 ,$51.10 ,$56.21 ,$56.21 ,$13.78 ,$62.05 ,$5.51 ,$5.51 ,$40.95 ,$30.22 ,$30.37 ,$5.00 ,$4.95 ,$5.67 ,$62.05 ,$11.85 ,$38.25 ,$20.44 ,$65.70 ,$11.02 ,$5.40 ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$56.00 ,$40.32 ,$2.89 ,$56.00 ,$36.40 ,$5.65 ,$15.68 ,$30.97 ,$5.65 ,$32.59 ,$5.65 ,$29.34 ,$5.65 ,$11.66 ,$51.52 ,$14.43 ,$5.65 ,$47.60 ,$50.40 ,$5.77 ,$42.00 ,$39.20 ,$39.20 ,$5.65 ,$39.20 ,$43.12 ,$43.12 ,$14.43 ,$47.60 ,$5.77 ,$5.77 ,$31.42 ,$23.18 ,$23.30 ,$2.92 ,$2.89 ,$5.94 ,$47.60 ,$12.41 ,$29.34 ,$15.68 ,$50.40 ,$11.54 ,$5.65 ,$36.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500305,85730,HC PTT-90,305,1 ,$108.00 ,$77.76 ,$2.89 ,$108.00 ,$70.20 ,$5.89 ,$30.24 ,$59.72 ,$5.89 ,$62.86 ,$5.89 ,$56.59 ,$5.89 ,$12.14 ,$99.36 ,$15.03 ,$5.89 ,$91.80 ,$97.20 ,$6.01 ,$81.00 ,$75.60 ,$75.60 ,$5.89 ,$75.60 ,$83.16 ,$83.16 ,$15.03 ,$91.80 ,$6.01 ,$6.01 ,$60.59 ,$44.71 ,$44.93 ,$2.92 ,$2.89 ,$6.18 ,$91.80 ,$12.92 ,$56.59 ,$30.24 ,$97.20 ,$12.02 ,$5.89 ,$70.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500310,85810,HC VISCOSITY-90,305,1 ,$132.00 ,$95.04 ,$7.53 ,$132.00 ,$85.80 ,$11.44 ,$36.96 ,$73.00 ,$11.44 ,$76.82 ,$11.44 ,$69.17 ,$11.44 ,$23.57 ,$121.44 ,$29.18 ,$11.44 ,$112.20 ,$118.80 ,$11.66 ,$99.00 ,$92.40 ,$92.40 ,$11.44 ,$92.40 ,$101.64 ,$101.64 ,$29.18 ,$112.20 ,$11.67 ,$11.67 ,$74.05 ,$54.65 ,$54.91 ,$7.61 ,$7.53 ,$12.00 ,$112.20 ,$25.09 ,$69.17 ,$36.96 ,$118.80 ,$23.34 ,$11.44 ,$85.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500331,85378,HC FDP (D-DIMER) QL/SEMI-QN,305,1 ,$249.00 ,$179.28 ,$8.58 ,$249.00 ,$161.85 ,$9.53 ,$69.72 ,$137.70 ,$9.53 ,$144.92 ,$9.53 ,$130.48 ,$9.53 ,$19.63 ,$229.08 ,$24.30 ,$9.53 ,$211.65 ,$224.10 ,$9.71 ,$186.75 ,$174.30 ,$174.30 ,$9.53 ,$174.30 ,$191.73 ,$191.73 ,$24.30 ,$211.65 ,$9.72 ,$9.72 ,$139.69 ,$103.09 ,$103.58 ,$8.68 ,$8.58 ,$10.01 ,$211.65 ,$20.90 ,$130.48 ,$69.72 ,$224.10 ,$19.44 ,$9.53 ,$161.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500341,85046,HC BLOOD COUNT RETICULOCYTES AUTO,305,1 ,$153.00 ,$110.16 ,$4.95 ,$153.00 ,$99.45 ,$5.46 ,$42.84 ,$84.61 ,$5.46 ,$89.05 ,$5.46 ,$80.17 ,$5.46 ,$11.25 ,$140.76 ,$13.93 ,$5.46 ,$130.05 ,$137.70 ,$5.57 ,$114.75 ,$107.10 ,$107.10 ,$5.46 ,$107.10 ,$117.81 ,$117.81 ,$13.93 ,$130.05 ,$5.57 ,$5.57 ,$85.83 ,$63.34 ,$63.65 ,$5.00 ,$4.95 ,$5.73 ,$130.05 ,$11.98 ,$80.17 ,$42.84 ,$137.70 ,$11.14 ,$5.46 ,$99.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500831,85384,HC FIBRINOGEN,305,1 ,$163.00 ,$117.36 ,$2.89 ,$163.00 ,$105.95 ,$9.53 ,$45.64 ,$90.14 ,$9.53 ,$94.87 ,$9.53 ,$85.41 ,$9.53 ,$19.63 ,$149.96 ,$24.30 ,$9.53 ,$138.55 ,$146.70 ,$9.71 ,$122.25 ,$114.10 ,$114.10 ,$9.53 ,$114.10 ,$125.51 ,$125.51 ,$24.30 ,$138.55 ,$9.72 ,$9.72 ,$91.44 ,$67.48 ,$67.81 ,$2.92 ,$2.89 ,$10.01 ,$138.55 ,$20.90 ,$85.41 ,$45.64 ,$146.70 ,$19.44 ,$9.53 ,$105.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500833,85520,HC HEPARIN ASSAY,305,1 ,$564.00 ,$406.08 ,$8.58 ,$564.00 ,$366.60 ,$12.83 ,$157.92 ,$311.89 ,$12.83 ,$328.25 ,$12.83 ,$295.54 ,$12.83 ,$26.44 ,$518.88 ,$32.73 ,$12.83 ,$479.40 ,$507.60 ,$13.08 ,$423.00 ,$394.80 ,$394.80 ,$12.83 ,$394.80 ,$434.28 ,$434.28 ,$32.73 ,$479.40 ,$13.09 ,$13.09 ,$316.40 ,$233.50 ,$234.62 ,$8.68 ,$8.58 ,$13.47 ,$479.40 ,$28.14 ,$295.54 ,$157.92 ,$507.60 ,$26.18 ,$12.83 ,$366.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500842,85660,HC SICKLE CELL RBC,305,1 ,$120.00 ,$86.40 ,$4.95 ,$120.00 ,$78.00 ,$5.40 ,$33.60 ,$66.36 ,$5.40 ,$69.84 ,$5.40 ,$62.88 ,$5.40 ,$11.13 ,$110.40 ,$13.78 ,$5.40 ,$102.00 ,$108.00 ,$5.51 ,$90.00 ,$84.00 ,$84.00 ,$5.40 ,$84.00 ,$92.40 ,$92.40 ,$13.78 ,$102.00 ,$5.51 ,$5.51 ,$67.32 ,$49.68 ,$49.92 ,$5.00 ,$4.95 ,$5.67 ,$102.00 ,$11.85 ,$62.88 ,$33.60 ,$108.00 ,$11.02 ,$5.40 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30500850,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$62.00 ,$44.64 ,$2.49 ,$62.00 ,$40.30 ,$2.49 ,$17.36 ,$34.29 ,$2.49 ,$36.08 ,$2.49 ,$32.49 ,$2.49 ,$5.13 ,$57.04 ,$6.35 ,$2.49 ,$52.70 ,$55.80 ,$2.54 ,$46.50 ,$43.40 ,$43.40 ,$2.49 ,$43.40 ,$47.74 ,$47.74 ,$6.35 ,$52.70 ,$2.54 ,$2.54 ,$34.78 ,$25.67 ,$25.79 ,$5.00 ,$4.95 ,$2.62 ,$52.70 ,$5.46 ,$32.49 ,$17.36 ,$55.80 ,$5.08 ,$2.49 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600096,87480,HC CANDIDA SPECIES DNA SCREEN,306,1 ,$62.00 ,$44.64 ,$7.13 ,$62.00 ,$40.30 ,$19.65 ,$17.36 ,$34.29 ,$19.65 ,$36.08 ,$19.65 ,$32.49 ,$19.65 ,$40.50 ,$57.04 ,$50.13 ,$19.65 ,$52.70 ,$55.80 ,$20.04 ,$46.50 ,$43.40 ,$43.40 ,$19.65 ,$43.40 ,$47.74 ,$47.74 ,$50.13 ,$52.70 ,$20.05 ,$20.05 ,$34.78 ,$25.67 ,$25.79 ,$7.21 ,$7.13 ,$20.63 ,$52.70 ,$43.11 ,$32.49 ,$17.36 ,$55.80 ,$40.10 ,$19.65 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600097,87660,HC TRICHOMONAS DNA SCREEN,306,1 ,$62.00 ,$44.64 ,$17.36 ,$62.00 ,$40.30 ,$19.65 ,$17.36 ,$34.29 ,$19.65 ,$36.08 ,$19.65 ,$32.49 ,$19.65 ,$40.50 ,$57.04 ,$50.13 ,$19.65 ,$52.70 ,$55.80 ,$20.04 ,$46.50 ,$43.40 ,$43.40 ,$19.65 ,$43.40 ,$47.74 ,$47.74 ,$50.13 ,$52.70 ,$20.05 ,$20.05 ,$34.78 ,$25.67 ,$25.79 ,$19.11 ,$18.90 ,$20.63 ,$52.70 ,$43.11 ,$32.49 ,$17.36 ,$55.80 ,$40.10 ,$19.65 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600098,87510,HC G VAGINALIS DNA SCREEN,306,1 ,$62.00 ,$44.64 ,$17.36 ,$62.00 ,$40.30 ,$19.65 ,$17.36 ,$34.29 ,$19.65 ,$36.08 ,$19.65 ,$32.49 ,$19.65 ,$40.50 ,$57.04 ,$50.13 ,$19.65 ,$52.70 ,$55.80 ,$20.04 ,$46.50 ,$43.40 ,$43.40 ,$19.65 ,$43.40 ,$47.74 ,$47.74 ,$50.13 ,$52.70 ,$20.05 ,$20.05 ,$34.78 ,$25.67 ,$25.79 ,$19.11 ,$18.90 ,$20.63 ,$52.70 ,$43.11 ,$32.49 ,$17.36 ,$55.80 ,$40.10 ,$19.65 ,$40.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$37.00 ,$26.64 ,$7.13 ,$37.00 ,$24.05 ,$11.74 ,$10.36 ,$20.46 ,$11.74 ,$21.53 ,$11.74 ,$19.39 ,$11.74 ,$24.20 ,$34.04 ,$29.95 ,$11.74 ,$31.45 ,$33.30 ,$11.98 ,$27.75 ,$25.90 ,$25.90 ,$11.74 ,$25.90 ,$28.49 ,$28.49 ,$29.95 ,$31.45 ,$11.98 ,$11.98 ,$20.76 ,$15.32 ,$15.39 ,$7.21 ,$7.13 ,$12.33 ,$31.45 ,$25.76 ,$19.39 ,$10.36 ,$33.30 ,$23.96 ,$11.74 ,$24.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600225,87400,HC EIA QL INFLUENZA A/B AG,306,1 ,$150.00 ,$108.00 ,$12.30 ,$150.00 ,$97.50 ,$13.85 ,$42.00 ,$82.95 ,$13.85 ,$87.30 ,$13.85 ,$78.60 ,$13.85 ,$28.54 ,$138.00 ,$35.33 ,$13.85 ,$127.50 ,$135.00 ,$14.12 ,$112.50 ,$105.00 ,$105.00 ,$13.85 ,$105.00 ,$115.50 ,$115.50 ,$35.33 ,$127.50 ,$14.13 ,$14.13 ,$84.15 ,$62.10 ,$62.40 ,$12.43 ,$12.30 ,$14.54 ,$127.50 ,$30.38 ,$78.60 ,$42.00 ,$135.00 ,$28.26 ,$13.85 ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600226,87420,HC RSV AG QL,306,1 ,$175.00 ,$126.00 ,$13.63 ,$175.00 ,$113.75 ,$13.63 ,$49.00 ,$96.78 ,$13.63 ,$101.85 ,$13.63 ,$91.70 ,$13.63 ,$28.10 ,$161.00 ,$34.78 ,$13.63 ,$148.75 ,$157.50 ,$13.91 ,$131.25 ,$122.50 ,$122.50 ,$13.63 ,$122.50 ,$134.75 ,$134.75 ,$34.78 ,$148.75 ,$13.91 ,$13.91 ,$98.18 ,$72.45 ,$72.80 ,$19.11 ,$18.90 ,$14.32 ,$148.75 ,$29.91 ,$91.70 ,$49.00 ,$157.50 ,$27.82 ,$13.63 ,$113.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600270,87880,HC OPTICAL STREP,306,1 ,$120.00 ,$86.40 ,$5.69 ,$120.00 ,$78.00 ,$16.20 ,$33.60 ,$66.36 ,$16.20 ,$69.84 ,$16.20 ,$62.88 ,$16.20 ,$33.39 ,$110.40 ,$41.33 ,$16.20 ,$102.00 ,$108.00 ,$16.52 ,$90.00 ,$84.00 ,$84.00 ,$16.20 ,$84.00 ,$92.40 ,$92.40 ,$41.33 ,$102.00 ,$16.53 ,$16.53 ,$67.32 ,$49.68 ,$49.92 ,$5.75 ,$5.69 ,$17.01 ,$102.00 ,$35.54 ,$62.88 ,$33.60 ,$108.00 ,$33.06 ,$16.20 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600283,87804,HC QL INFLUENZA A/B,306,1 ,$151.00 ,$108.72 ,$5.69 ,$151.00 ,$98.15 ,$16.22 ,$42.28 ,$83.50 ,$16.22 ,$87.88 ,$16.22 ,$79.12 ,$16.22 ,$33.43 ,$138.92 ,$41.38 ,$16.22 ,$128.35 ,$135.90 ,$16.54 ,$113.25 ,$105.70 ,$105.70 ,$16.22 ,$105.70 ,$116.27 ,$116.27 ,$41.38 ,$128.35 ,$16.55 ,$16.55 ,$84.71 ,$62.51 ,$62.82 ,$5.75 ,$5.69 ,$17.03 ,$128.35 ,$35.58 ,$79.12 ,$42.28 ,$135.90 ,$33.10 ,$16.22 ,$98.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600303,87176,HC HOMOGENIZATION TISSUE,306,1 ,$90.00 ,$64.80 ,$5.69 ,$90.00 ,$58.50 ,$5.76 ,$25.20 ,$49.77 ,$5.76 ,$52.38 ,$5.76 ,$47.16 ,$5.76 ,$11.88 ,$82.80 ,$14.70 ,$5.76 ,$76.50 ,$81.00 ,$5.88 ,$67.50 ,$63.00 ,$63.00 ,$5.76 ,$63.00 ,$69.30 ,$69.30 ,$14.70 ,$76.50 ,$5.88 ,$5.88 ,$50.49 ,$37.26 ,$37.44 ,$5.75 ,$5.69 ,$6.05 ,$76.50 ,$12.64 ,$47.16 ,$25.20 ,$81.00 ,$11.76 ,$5.76 ,$58.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600318,87449,HC EIA QL MLT AG INF,306,1 ,$37.00 ,$26.64 ,$7.13 ,$37.00 ,$24.05 ,$11.74 ,$10.36 ,$20.46 ,$11.74 ,$21.53 ,$11.74 ,$19.39 ,$11.74 ,$24.20 ,$34.04 ,$29.95 ,$11.74 ,$31.45 ,$33.30 ,$11.98 ,$27.75 ,$25.90 ,$25.90 ,$11.74 ,$25.90 ,$28.49 ,$28.49 ,$29.95 ,$31.45 ,$11.98 ,$11.98 ,$20.76 ,$15.32 ,$15.39 ,$7.21 ,$7.13 ,$12.33 ,$31.45 ,$25.76 ,$19.39 ,$10.36 ,$33.30 ,$23.96 ,$11.74 ,$24.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600353,87015,HC CONCENTRATION INFECTIOUS AGENT-90,306,1 ,$72.00 ,$51.84 ,$5.69 ,$72.00 ,$46.80 ,$6.55 ,$20.16 ,$39.82 ,$6.55 ,$41.90 ,$6.55 ,$37.73 ,$6.55 ,$13.49 ,$66.24 ,$16.70 ,$6.55 ,$61.20 ,$64.80 ,$6.67 ,$54.00 ,$50.40 ,$50.40 ,$6.55 ,$50.40 ,$55.44 ,$55.44 ,$16.70 ,$61.20 ,$6.68 ,$6.68 ,$40.39 ,$29.81 ,$29.95 ,$5.75 ,$5.69 ,$6.87 ,$61.20 ,$14.36 ,$37.73 ,$20.16 ,$64.80 ,$13.36 ,$6.55 ,$46.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600360,87081,HC CULTURE SCR PRESUMP PATHOGENS T1,306,1 ,$158.00 ,$113.76 ,$5.69 ,$158.00 ,$102.70 ,$6.50 ,$44.24 ,$87.37 ,$6.50 ,$91.96 ,$6.50 ,$82.79 ,$6.50 ,$13.39 ,$145.36 ,$16.58 ,$6.50 ,$134.30 ,$142.20 ,$6.62 ,$118.50 ,$110.60 ,$110.60 ,$6.50 ,$110.60 ,$121.66 ,$121.66 ,$16.58 ,$134.30 ,$6.63 ,$6.63 ,$88.64 ,$65.41 ,$65.73 ,$5.75 ,$5.69 ,$6.82 ,$134.30 ,$14.25 ,$82.79 ,$44.24 ,$142.20 ,$13.26 ,$6.50 ,$102.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600363,87103,HC CULTURE FUNGUS BLOOD-90,306,1 ,$194.00 ,$139.68 ,$18.90 ,$194.00 ,$126.10 ,$20.05 ,$54.32 ,$107.28 ,$20.05 ,$112.91 ,$20.05 ,$101.66 ,$20.05 ,$41.33 ,$178.48 ,$51.15 ,$20.05 ,$164.90 ,$174.60 ,$20.45 ,$145.50 ,$135.80 ,$135.80 ,$20.05 ,$135.80 ,$149.38 ,$149.38 ,$51.15 ,$164.90 ,$20.46 ,$20.46 ,$108.83 ,$80.32 ,$80.70 ,$19.11 ,$18.90 ,$21.05 ,$164.90 ,$43.99 ,$101.66 ,$54.32 ,$174.60 ,$40.92 ,$20.05 ,$126.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600366,87109,HC CULTURE MYCOPLASMA-90,306,1 ,$168.00 ,$120.96 ,$15.08 ,$168.00 ,$109.20 ,$15.08 ,$47.04 ,$92.90 ,$15.08 ,$97.78 ,$15.08 ,$88.03 ,$15.08 ,$31.09 ,$154.56 ,$38.48 ,$15.08 ,$142.80 ,$151.20 ,$15.39 ,$126.00 ,$117.60 ,$117.60 ,$15.08 ,$117.60 ,$129.36 ,$129.36 ,$38.48 ,$142.80 ,$15.39 ,$15.39 ,$94.25 ,$69.55 ,$69.89 ,$19.11 ,$18.90 ,$15.84 ,$142.80 ,$33.09 ,$88.03 ,$47.04 ,$151.20 ,$30.78 ,$15.08 ,$109.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600367,87110,HC CULTURE CHLAMYDIA-90,306,1 ,$105.00 ,$75.60 ,$5.69 ,$105.00 ,$68.25 ,$19.21 ,$29.40 ,$58.07 ,$19.21 ,$61.11 ,$19.21 ,$55.02 ,$19.21 ,$39.59 ,$96.60 ,$49.00 ,$19.21 ,$89.25 ,$94.50 ,$19.59 ,$78.75 ,$73.50 ,$73.50 ,$19.21 ,$73.50 ,$80.85 ,$80.85 ,$49.00 ,$89.25 ,$19.60 ,$19.60 ,$58.91 ,$43.47 ,$43.68 ,$5.75 ,$5.69 ,$20.17 ,$89.25 ,$42.14 ,$55.02 ,$29.40 ,$94.50 ,$39.20 ,$19.21 ,$68.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600368,87116,HC CULTURE AFB/TB/MYCOBACT-90,306,1 ,$186.00 ,$133.92 ,$10.58 ,$186.00 ,$120.90 ,$10.58 ,$52.08 ,$102.86 ,$10.58 ,$108.25 ,$10.58 ,$97.46 ,$10.58 ,$21.82 ,$171.12 ,$27.00 ,$10.58 ,$158.10 ,$167.40 ,$10.80 ,$139.50 ,$130.20 ,$130.20 ,$10.58 ,$130.20 ,$143.22 ,$143.22 ,$27.00 ,$158.10 ,$10.80 ,$10.80 ,$104.35 ,$77.00 ,$77.38 ,$19.11 ,$18.90 ,$11.11 ,$158.10 ,$23.22 ,$97.46 ,$52.08 ,$167.40 ,$21.60 ,$10.58 ,$120.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600369,87118,HC CULTURE MYCOBACTERIA ID-90,306,1 ,$104.00 ,$74.88 ,$14.32 ,$104.00 ,$67.60 ,$14.32 ,$29.12 ,$57.51 ,$14.32 ,$60.53 ,$14.32 ,$54.50 ,$14.32 ,$29.51 ,$95.68 ,$36.53 ,$14.32 ,$88.40 ,$93.60 ,$14.60 ,$78.00 ,$72.80 ,$72.80 ,$14.32 ,$72.80 ,$80.08 ,$80.08 ,$36.53 ,$88.40 ,$14.61 ,$14.61 ,$58.34 ,$43.06 ,$43.26 ,$19.11 ,$18.90 ,$15.03 ,$88.40 ,$31.41 ,$54.50 ,$29.12 ,$93.60 ,$29.22 ,$14.32 ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$55.00 ,$39.60 ,$5.46 ,$55.00 ,$35.75 ,$5.46 ,$15.40 ,$30.42 ,$5.46 ,$32.01 ,$5.46 ,$28.82 ,$5.46 ,$11.25 ,$50.60 ,$13.93 ,$5.46 ,$46.75 ,$49.50 ,$5.57 ,$41.25 ,$38.50 ,$38.50 ,$5.46 ,$38.50 ,$42.35 ,$42.35 ,$13.93 ,$46.75 ,$5.57 ,$5.57 ,$30.86 ,$22.77 ,$22.88 ,$19.11 ,$18.90 ,$5.73 ,$46.75 ,$11.98 ,$28.82 ,$15.40 ,$49.50 ,$11.14 ,$5.46 ,$35.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600375,87149,HC CULTURE TYPING ID NUCLEIC ACID-90,306,1 ,$134.00 ,$96.48 ,$5.69 ,$134.00 ,$87.10 ,$19.65 ,$37.52 ,$74.10 ,$19.65 ,$77.99 ,$19.65 ,$70.22 ,$19.65 ,$40.50 ,$123.28 ,$50.13 ,$19.65 ,$113.90 ,$120.60 ,$20.04 ,$100.50 ,$93.80 ,$93.80 ,$19.65 ,$93.80 ,$103.18 ,$103.18 ,$50.13 ,$113.90 ,$20.05 ,$20.05 ,$75.17 ,$55.48 ,$55.74 ,$5.75 ,$5.69 ,$20.63 ,$113.90 ,$43.11 ,$70.22 ,$37.52 ,$120.60 ,$40.10 ,$19.65 ,$87.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$234.00 ,$168.48 ,$5.69 ,$234.00 ,$152.10 ,$8.72 ,$65.52 ,$129.40 ,$8.72 ,$136.19 ,$8.72 ,$122.62 ,$8.72 ,$17.98 ,$215.28 ,$22.25 ,$8.72 ,$198.90 ,$210.60 ,$8.90 ,$175.50 ,$163.80 ,$163.80 ,$8.72 ,$163.80 ,$180.18 ,$180.18 ,$22.25 ,$198.90 ,$8.90 ,$8.90 ,$131.27 ,$96.88 ,$97.34 ,$5.75 ,$5.69 ,$9.16 ,$198.90 ,$19.14 ,$122.62 ,$65.52 ,$210.60 ,$17.80 ,$8.72 ,$152.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600395,87206,HC SMEAR ACID FAST/FLUOR-90,306,1 ,$115.00 ,$82.80 ,$5.28 ,$115.00 ,$74.75 ,$5.28 ,$32.20 ,$63.60 ,$5.28 ,$66.93 ,$5.28 ,$60.26 ,$5.28 ,$10.89 ,$105.80 ,$13.48 ,$5.28 ,$97.75 ,$103.50 ,$5.39 ,$86.25 ,$80.50 ,$80.50 ,$5.28 ,$80.50 ,$88.55 ,$88.55 ,$13.48 ,$97.75 ,$5.39 ,$5.39 ,$64.52 ,$47.61 ,$47.84 ,$5.75 ,$5.69 ,$5.55 ,$97.75 ,$11.59 ,$60.26 ,$32.20 ,$103.50 ,$10.78 ,$5.28 ,$74.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$119.00 ,$85.68 ,$5.69 ,$119.00 ,$77.35 ,$5.87 ,$33.32 ,$65.81 ,$5.87 ,$69.26 ,$5.87 ,$62.36 ,$5.87 ,$12.10 ,$109.48 ,$14.98 ,$5.87 ,$101.15 ,$107.10 ,$5.99 ,$89.25 ,$83.30 ,$83.30 ,$5.87 ,$83.30 ,$91.63 ,$91.63 ,$14.98 ,$101.15 ,$5.99 ,$5.99 ,$66.76 ,$49.27 ,$49.50 ,$5.75 ,$5.69 ,$6.16 ,$101.15 ,$12.88 ,$62.36 ,$33.32 ,$107.10 ,$11.98 ,$5.87 ,$77.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600399,87209,HC OVA AND PARASITE W/STAIN-90,306,1 ,$149.00 ,$107.28 ,$17.62 ,$149.00 ,$96.85 ,$17.62 ,$41.72 ,$82.40 ,$17.62 ,$86.72 ,$17.62 ,$78.08 ,$17.62 ,$36.32 ,$137.08 ,$44.95 ,$17.62 ,$126.65 ,$134.10 ,$17.97 ,$111.75 ,$104.30 ,$104.30 ,$17.62 ,$104.30 ,$114.73 ,$114.73 ,$44.95 ,$126.65 ,$17.98 ,$17.98 ,$83.59 ,$61.69 ,$61.98 ,$19.11 ,$18.90 ,$18.50 ,$126.65 ,$38.66 ,$78.08 ,$41.72 ,$134.10 ,$35.96 ,$17.62 ,$96.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$134.00 ,$96.48 ,$18.90 ,$134.00 ,$87.10 ,$19.17 ,$37.52 ,$74.10 ,$19.17 ,$77.99 ,$19.17 ,$70.22 ,$19.17 ,$39.51 ,$123.28 ,$48.90 ,$19.17 ,$113.90 ,$120.60 ,$19.55 ,$100.50 ,$93.80 ,$93.80 ,$19.17 ,$93.80 ,$103.18 ,$103.18 ,$48.90 ,$113.90 ,$19.56 ,$19.56 ,$75.17 ,$55.48 ,$55.74 ,$19.11 ,$18.90 ,$20.13 ,$113.90 ,$42.05 ,$70.22 ,$37.52 ,$120.60 ,$39.12 ,$19.17 ,$87.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600407,87260,HC IF ADENOVIRUS AG-90,306,1 ,$245.00 ,$176.40 ,$7.13 ,$245.00 ,$159.25 ,$14.14 ,$68.60 ,$135.49 ,$14.14 ,$142.59 ,$14.14 ,$128.38 ,$14.14 ,$29.15 ,$225.40 ,$36.08 ,$14.14 ,$208.25 ,$220.50 ,$14.43 ,$183.75 ,$171.50 ,$171.50 ,$14.14 ,$171.50 ,$188.65 ,$188.65 ,$36.08 ,$208.25 ,$14.43 ,$14.43 ,$137.45 ,$101.43 ,$101.92 ,$7.21 ,$7.13 ,$14.85 ,$208.25 ,$31.02 ,$128.38 ,$68.60 ,$220.50 ,$28.86 ,$14.14 ,$159.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600415,87305,HC EIA QL ASPERGILLUS AG-90,306,1 ,$136.00 ,$97.92 ,$5.69 ,$136.00 ,$88.40 ,$11.74 ,$38.08 ,$75.21 ,$11.74 ,$79.15 ,$11.74 ,$71.26 ,$11.74 ,$24.20 ,$125.12 ,$29.95 ,$11.74 ,$115.60 ,$122.40 ,$11.98 ,$102.00 ,$95.20 ,$95.20 ,$11.74 ,$95.20 ,$104.72 ,$104.72 ,$29.95 ,$115.60 ,$11.98 ,$11.98 ,$76.30 ,$56.30 ,$56.58 ,$5.75 ,$5.69 ,$12.33 ,$115.60 ,$25.76 ,$71.26 ,$38.08 ,$122.40 ,$23.96 ,$11.74 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600418,87328,HC EIA QL CRYPTOSPORIDIUM AG-90,306,1 ,$205.00 ,$147.60 ,$7.13 ,$205.00 ,$133.25 ,$13.54 ,$57.40 ,$113.37 ,$13.54 ,$119.31 ,$13.54 ,$107.42 ,$13.54 ,$27.92 ,$188.60 ,$34.55 ,$13.54 ,$174.25 ,$184.50 ,$13.82 ,$153.75 ,$143.50 ,$143.50 ,$13.54 ,$143.50 ,$157.85 ,$157.85 ,$34.55 ,$174.25 ,$13.82 ,$13.82 ,$115.01 ,$84.87 ,$85.28 ,$7.21 ,$7.13 ,$14.22 ,$174.25 ,$29.71 ,$107.42 ,$57.40 ,$184.50 ,$27.64 ,$13.54 ,$133.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600419,87338,HC EIA QL H PYLORI AG STOOL-90,306,1 ,$706.00 ,$508.32 ,$7.13 ,$706.00 ,$458.90 ,$14.09 ,$197.68 ,$390.42 ,$14.09 ,$410.89 ,$14.09 ,$369.94 ,$14.09 ,$29.05 ,$649.52 ,$35.95 ,$14.09 ,$600.10 ,$635.40 ,$14.38 ,$529.50 ,$494.20 ,$494.20 ,$14.09 ,$494.20 ,$543.62 ,$543.62 ,$35.95 ,$600.10 ,$14.38 ,$14.38 ,$396.07 ,$292.28 ,$293.70 ,$7.21 ,$7.13 ,$14.80 ,$600.10 ,$30.92 ,$369.94 ,$197.68 ,$635.40 ,$28.76 ,$14.09 ,$458.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$143.00 ,$102.96 ,$7.13 ,$143.00 ,$92.95 ,$11.30 ,$40.04 ,$79.08 ,$11.30 ,$83.23 ,$11.30 ,$74.93 ,$11.30 ,$23.29 ,$131.56 ,$28.83 ,$11.30 ,$121.55 ,$128.70 ,$11.52 ,$107.25 ,$100.10 ,$100.10 ,$11.30 ,$100.10 ,$110.11 ,$110.11 ,$28.83 ,$121.55 ,$11.53 ,$11.53 ,$80.22 ,$59.20 ,$59.49 ,$7.21 ,$7.13 ,$11.87 ,$121.55 ,$24.79 ,$74.93 ,$40.04 ,$128.70 ,$23.06 ,$11.30 ,$92.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$420.00 ,$302.40 ,$7.13 ,$420.00 ,$273.00 ,$12.98 ,$117.60 ,$232.26 ,$12.98 ,$244.44 ,$12.98 ,$220.08 ,$12.98 ,$26.77 ,$386.40 ,$33.13 ,$12.98 ,$357.00 ,$378.00 ,$13.25 ,$315.00 ,$294.00 ,$294.00 ,$12.98 ,$294.00 ,$323.40 ,$323.40 ,$33.13 ,$357.00 ,$13.25 ,$13.25 ,$235.62 ,$173.88 ,$174.72 ,$7.21 ,$7.13 ,$13.63 ,$357.00 ,$28.49 ,$220.08 ,$117.60 ,$378.00 ,$26.50 ,$12.98 ,$273.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600432,87449,HC EIA QL MLT AG INF-90,306,1 ,$128.00 ,$92.16 ,$7.13 ,$128.00 ,$83.20 ,$11.74 ,$35.84 ,$70.78 ,$11.74 ,$74.50 ,$11.74 ,$67.07 ,$11.74 ,$24.20 ,$117.76 ,$29.95 ,$11.74 ,$108.80 ,$115.20 ,$11.98 ,$96.00 ,$89.60 ,$89.60 ,$11.74 ,$89.60 ,$98.56 ,$98.56 ,$29.95 ,$108.80 ,$11.98 ,$11.98 ,$71.81 ,$52.99 ,$53.25 ,$7.21 ,$7.13 ,$12.33 ,$108.80 ,$25.76 ,$67.07 ,$35.84 ,$115.20 ,$23.96 ,$11.74 ,$83.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600437,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$125.00 ,$90.00 ,$18.90 ,$125.00 ,$81.25 ,$34.39 ,$35.00 ,$69.13 ,$34.39 ,$72.75 ,$34.39 ,$65.50 ,$34.39 ,$70.88 ,$115.00 ,$87.73 ,$34.39 ,$106.25 ,$112.50 ,$35.07 ,$93.75 ,$87.50 ,$87.50 ,$34.39 ,$87.50 ,$96.25 ,$96.25 ,$87.73 ,$106.25 ,$35.09 ,$35.09 ,$70.13 ,$51.75 ,$52.00 ,$19.11 ,$18.90 ,$36.10 ,$106.25 ,$75.44 ,$65.50 ,$35.00 ,$112.50 ,$70.18 ,$34.39 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$65.00 ,$46.80 ,$7.13 ,$87.73 ,$42.25 ,$34.39 ,$18.20 ,$35.95 ,$34.39 ,$37.83 ,$34.39 ,$34.06 ,$34.39 ,$65.00 ,$59.80 ,$87.73 ,$34.39 ,$55.25 ,$58.50 ,$35.07 ,$48.75 ,$45.50 ,$45.50 ,$34.39 ,$45.50 ,$50.05 ,$50.05 ,$65.00 ,$55.25 ,$35.09 ,$35.09 ,$36.47 ,$26.91 ,$27.04 ,$7.21 ,$7.13 ,$36.10 ,$55.25 ,$75.44 ,$34.06 ,$18.20 ,$58.50 ,$65.00 ,$34.39 ,$42.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,$758.00 ,$545.76 ,$18.90 ,$758.00 ,$492.70 ,$34.39 ,$212.24 ,$419.17 ,$34.39 ,$441.16 ,$34.39 ,$397.19 ,$34.39 ,$70.88 ,$697.36 ,$87.73 ,$34.39 ,$644.30 ,$682.20 ,$35.07 ,$568.50 ,$530.60 ,$530.60 ,$34.39 ,$530.60 ,$583.66 ,$583.66 ,$87.73 ,$644.30 ,$35.09 ,$35.09 ,$425.24 ,$313.81 ,$315.33 ,$19.11 ,$18.90 ,$36.10 ,$644.30 ,$75.44 ,$397.19 ,$212.24 ,$682.20 ,$70.18 ,$34.39 ,$492.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600443,87497,HC CMV QN-90,306,1 ,"$1,649.00 ","$1,187.28 ",$18.90 ,"$1,649.00 ","$1,071.85 ",$41.98 ,$461.72 ,$911.90 ,$41.98 ,$959.72 ,$41.98 ,$864.08 ,$41.98 ,$86.54 ,"$1,517.08 ",$107.10 ,$41.98 ,"$1,401.65 ","$1,484.10 ",$42.83 ,"$1,236.75 ","$1,154.30 ","$1,154.30 ",$41.98 ,"$1,154.30 ","$1,269.73 ","$1,269.73 ",$107.10 ,"$1,401.65 ",$42.84 ,$42.84 ,$925.09 ,$682.69 ,$685.98 ,$19.11 ,$18.90 ,$44.08 ,"$1,401.65 ",$92.11 ,$864.08 ,$461.72 ,"$1,484.10 ",$85.68 ,$41.98 ,"$1,071.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),30600444,87498,HC ENTEROVIRUS AMP PROBE-90,306,1 ,$196.00 ,$141.12 ,$18.90 ,$196.00 ,$127.40 ,$34.39 ,$54.88 ,$108.39 ,$34.39 ,$114.07 ,$34.39 ,$102.70 ,$34.39 ,$70.88 ,$180.32 ,$87.73 ,$34.39 ,$166.60 ,$176.40 ,$35.07 ,$147.00 ,$137.20 ,$137.20 ,$34.39 ,$137.20 ,$150.92 ,$150.92 ,$87.73 ,$166.60 ,$35.09 ,$35.09 ,$109.96 ,$81.14 ,$81.54 ,$19.11 ,$18.90 ,$36.10 ,$166.60 ,$75.44 ,$102.70 ,$54.88 ,$176.40 ,$70.18 ,$34.39 ,$127.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600448,87517,HC HEPATITIS B QN-90,306,1 ,"$1,422.00 ","$1,023.84 ",$18.90 ,"$1,422.00 ",$924.30 ,$41.98 ,$398.16 ,$786.37 ,$41.98 ,$827.60 ,$41.98 ,$745.13 ,$41.98 ,$86.54 ,"$1,308.24 ",$107.10 ,$41.98 ,"$1,208.70 ","$1,279.80 ",$42.83 ,"$1,066.50 ",$995.40 ,$995.40 ,$41.98 ,$995.40 ,"$1,094.94 ","$1,094.94 ",$107.10 ,"$1,208.70 ",$42.84 ,$42.84 ,$797.74 ,$588.71 ,$591.55 ,$19.11 ,$18.90 ,$44.08 ,"$1,208.70 ",$92.11 ,$745.13 ,$398.16 ,"$1,279.80 ",$85.68 ,$41.98 ,$924.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600451,87522,HC HEPATITIS C QN-90,306,1 ,$751.00 ,$540.72 ,$18.90 ,$751.00 ,$488.15 ,$41.98 ,$210.28 ,$415.30 ,$41.98 ,$437.08 ,$41.98 ,$393.52 ,$41.98 ,$86.54 ,$690.92 ,$107.10 ,$41.98 ,$638.35 ,$675.90 ,$42.83 ,$563.25 ,$525.70 ,$525.70 ,$41.98 ,$525.70 ,$578.27 ,$578.27 ,$107.10 ,$638.35 ,$42.84 ,$42.84 ,$421.31 ,$310.91 ,$312.42 ,$19.11 ,$18.90 ,$44.08 ,$638.35 ,$92.11 ,$393.52 ,$210.28 ,$675.90 ,$85.68 ,$41.98 ,$488.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$725.00 ,$522.00 ,$18.90 ,$725.00 ,$471.25 ,$34.39 ,$203.00 ,$400.93 ,$34.39 ,$421.95 ,$34.39 ,$379.90 ,$34.39 ,$70.88 ,$667.00 ,$87.73 ,$34.39 ,$616.25 ,$652.50 ,$35.07 ,$543.75 ,$507.50 ,$507.50 ,$34.39 ,$507.50 ,$558.25 ,$558.25 ,$87.73 ,$616.25 ,$35.09 ,$35.09 ,$406.73 ,$300.15 ,$301.60 ,$19.11 ,$18.90 ,$36.10 ,$616.25 ,$75.44 ,$379.90 ,$203.00 ,$652.50 ,$70.18 ,$34.39 ,$471.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600454,87530,HC HSV QUANT-90,306,1 ,$317.00 ,$228.24 ,$18.90 ,$317.00 ,$206.05 ,$41.98 ,$88.76 ,$175.30 ,$41.98 ,$184.49 ,$41.98 ,$166.11 ,$41.98 ,$86.54 ,$291.64 ,$107.10 ,$41.98 ,$269.45 ,$285.30 ,$42.83 ,$237.75 ,$221.90 ,$221.90 ,$41.98 ,$221.90 ,$244.09 ,$244.09 ,$107.10 ,$269.45 ,$42.84 ,$42.84 ,$177.84 ,$131.24 ,$131.87 ,$19.11 ,$18.90 ,$44.08 ,$269.45 ,$92.11 ,$166.11 ,$88.76 ,$285.30 ,$85.68 ,$41.98 ,$206.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600458,87536,HC HIV-1 QN-90,306,1 ,$207.00 ,$149.04 ,$18.90 ,$212.75 ,$134.55 ,$83.40 ,$57.96 ,$114.47 ,$83.40 ,$120.47 ,$83.40 ,$108.47 ,$83.40 ,$171.90 ,$190.44 ,$212.75 ,$83.40 ,$175.95 ,$186.30 ,$85.06 ,$155.25 ,$144.90 ,$144.90 ,$83.40 ,$144.90 ,$159.39 ,$159.39 ,$207.00 ,$175.95 ,$85.10 ,$85.10 ,$116.13 ,$85.70 ,$86.11 ,$19.11 ,$18.90 ,$87.57 ,$175.95 ,$182.97 ,$108.47 ,$57.96 ,$186.30 ,$170.20 ,$83.40 ,$134.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600460,87591,HC NEISSERIA AMP-90,306,1 ,$259.00 ,$186.48 ,$18.90 ,$259.00 ,$168.35 ,$34.39 ,$72.52 ,$143.23 ,$34.39 ,$150.74 ,$34.39 ,$135.72 ,$34.39 ,$70.88 ,$238.28 ,$87.73 ,$34.39 ,$220.15 ,$233.10 ,$35.07 ,$194.25 ,$181.30 ,$181.30 ,$34.39 ,$181.30 ,$199.43 ,$199.43 ,$87.73 ,$220.15 ,$35.09 ,$35.09 ,$145.30 ,$107.23 ,$107.74 ,$19.11 ,$18.90 ,$36.10 ,$220.15 ,$75.44 ,$135.72 ,$72.52 ,$233.10 ,$70.18 ,$34.39 ,$168.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600462,87624,HC HPV AMP HIGH RISK ALL OTHERS-90,306,1 ,$293.00 ,$210.96 ,$18.90 ,$293.00 ,$190.45 ,$34.39 ,$82.04 ,$162.03 ,$34.39 ,$170.53 ,$34.39 ,$153.53 ,$34.39 ,$70.88 ,$269.56 ,$87.73 ,$34.39 ,$249.05 ,$263.70 ,$35.07 ,$219.75 ,$205.10 ,$205.10 ,$34.39 ,$205.10 ,$225.61 ,$225.61 ,$87.73 ,$249.05 ,$35.09 ,$35.09 ,$164.37 ,$121.30 ,$121.89 ,$19.11 ,$18.90 ,$36.10 ,$249.05 ,$75.44 ,$153.53 ,$82.04 ,$263.70 ,$70.18 ,$34.39 ,$190.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600463,87625,HC HPV GENOTYPE 16 18/45-90,306,1 ,$266.00 ,$191.52 ,$18.90 ,$266.00 ,$172.90 ,$39.74 ,$74.48 ,$147.10 ,$39.74 ,$154.81 ,$39.74 ,$139.38 ,$39.74 ,$81.91 ,$244.72 ,$101.38 ,$39.74 ,$226.10 ,$239.40 ,$40.53 ,$199.50 ,$186.20 ,$186.20 ,$39.74 ,$186.20 ,$204.82 ,$204.82 ,$101.38 ,$226.10 ,$40.55 ,$40.55 ,$149.23 ,$110.12 ,$110.66 ,$19.11 ,$18.90 ,$41.73 ,$226.10 ,$87.18 ,$139.38 ,$74.48 ,$239.40 ,$81.10 ,$39.74 ,$172.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600467,87651,HC INFECT AMP (GRP A STREP),306,1 ,$213.00 ,$153.36 ,$18.90 ,$213.00 ,$138.45 ,$34.39 ,$59.64 ,$117.79 ,$34.39 ,$123.97 ,$34.39 ,$111.61 ,$34.39 ,$70.88 ,$195.96 ,$87.73 ,$34.39 ,$181.05 ,$191.70 ,$35.07 ,$159.75 ,$149.10 ,$149.10 ,$34.39 ,$149.10 ,$164.01 ,$164.01 ,$87.73 ,$181.05 ,$35.09 ,$35.09 ,$119.49 ,$88.18 ,$88.61 ,$19.11 ,$18.90 ,$36.10 ,$181.05 ,$75.44 ,$111.61 ,$59.64 ,$191.70 ,$70.18 ,$34.39 ,$138.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600469,87661,HC TRICHOMONAS VAG AMP PROBE-90,306,1 ,$260.00 ,$187.20 ,$18.90 ,$260.00 ,$169.00 ,$34.39 ,$72.80 ,$143.78 ,$34.39 ,$151.32 ,$34.39 ,$136.24 ,$34.39 ,$70.88 ,$239.20 ,$87.73 ,$34.39 ,$221.00 ,$234.00 ,$35.07 ,$195.00 ,$182.00 ,$182.00 ,$34.39 ,$182.00 ,$200.20 ,$200.20 ,$87.73 ,$221.00 ,$35.09 ,$35.09 ,$145.86 ,$107.64 ,$108.16 ,$19.11 ,$18.90 ,$36.10 ,$221.00 ,$75.44 ,$136.24 ,$72.80 ,$234.00 ,$70.18 ,$34.39 ,$169.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600471,87798,HC INFECT AMP-90,306,1 ,$576.00 ,$414.72 ,$18.90 ,$576.00 ,$374.40 ,$34.39 ,$161.28 ,$318.53 ,$34.39 ,$335.23 ,$34.39 ,$301.82 ,$34.39 ,$70.88 ,$529.92 ,$87.73 ,$34.39 ,$489.60 ,$518.40 ,$35.07 ,$432.00 ,$403.20 ,$403.20 ,$34.39 ,$403.20 ,$443.52 ,$443.52 ,$87.73 ,$489.60 ,$35.09 ,$35.09 ,$323.14 ,$238.46 ,$239.62 ,$19.11 ,$18.90 ,$36.10 ,$489.60 ,$75.44 ,$301.82 ,$161.28 ,$518.40 ,$70.18 ,$34.39 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600478,87799,HC INFECT AGENT QN-90,306,1 ,$482.00 ,$347.04 ,$18.90 ,$482.00 ,$313.30 ,$41.98 ,$134.96 ,$266.55 ,$41.98 ,$280.52 ,$41.98 ,$252.57 ,$41.98 ,$86.54 ,$443.44 ,$107.10 ,$41.98 ,$409.70 ,$433.80 ,$42.83 ,$361.50 ,$337.40 ,$337.40 ,$41.98 ,$337.40 ,$371.14 ,$371.14 ,$107.10 ,$409.70 ,$42.84 ,$42.84 ,$270.40 ,$199.55 ,$200.51 ,$19.11 ,$18.90 ,$44.08 ,$409.70 ,$92.11 ,$252.57 ,$134.96 ,$433.80 ,$85.68 ,$41.98 ,$313.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600483,87902,HC GENTOYPE HEP C-90,306,1 ,$742.00 ,$534.24 ,$18.90 ,$742.00 ,$482.30 ,$252.30 ,$207.76 ,$410.33 ,$252.30 ,$431.84 ,$252.30 ,$388.81 ,$252.30 ,$520.05 ,$682.64 ,$643.63 ,$252.30 ,$630.70 ,$667.80 ,$257.35 ,$556.50 ,$519.40 ,$519.40 ,$252.30 ,$519.40 ,$571.34 ,$571.34 ,$643.63 ,$630.70 ,$257.45 ,$257.45 ,$416.26 ,$307.19 ,$308.67 ,$19.11 ,$18.90 ,$264.91 ,$630.70 ,$553.52 ,$388.81 ,$207.76 ,$667.80 ,$514.90 ,$252.30 ,$482.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600503,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB-90,306,1 ,$290.00 ,$208.80 ,$7.13 ,$290.00 ,$188.50 ,$23.60 ,$81.20 ,$160.37 ,$23.60 ,$168.78 ,$23.60 ,$151.96 ,$23.60 ,$48.64 ,$266.80 ,$60.20 ,$23.60 ,$246.50 ,$261.00 ,$24.07 ,$217.50 ,$203.00 ,$203.00 ,$23.60 ,$203.00 ,$223.30 ,$223.30 ,$60.20 ,$246.50 ,$24.08 ,$24.08 ,$162.69 ,$120.06 ,$120.64 ,$7.21 ,$7.13 ,$24.77 ,$246.50 ,$51.77 ,$151.96 ,$81.20 ,$261.00 ,$48.16 ,$23.60 ,$188.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600505,87329,HC EIA QL GIARDIA AG-90,306,1 ,$101.00 ,$72.72 ,$7.13 ,$101.00 ,$65.65 ,$11.74 ,$28.28 ,$55.85 ,$11.74 ,$58.78 ,$11.74 ,$52.92 ,$11.74 ,$24.20 ,$92.92 ,$29.95 ,$11.74 ,$85.85 ,$90.90 ,$11.98 ,$75.75 ,$70.70 ,$70.70 ,$11.74 ,$70.70 ,$77.77 ,$77.77 ,$29.95 ,$85.85 ,$11.98 ,$11.98 ,$56.66 ,$41.81 ,$42.02 ,$7.21 ,$7.13 ,$12.33 ,$85.85 ,$25.76 ,$52.92 ,$28.28 ,$90.90 ,$23.96 ,$11.74 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600516,87040,HC BACTERIA BLOOD CULTURE T1,306,1 ,$304.00 ,$218.88 ,$10.11 ,$304.00 ,$197.60 ,$10.11 ,$85.12 ,$168.11 ,$10.11 ,$176.93 ,$10.11 ,$159.30 ,$10.11 ,$20.85 ,$279.68 ,$25.80 ,$10.11 ,$258.40 ,$273.60 ,$10.32 ,$228.00 ,$212.80 ,$212.80 ,$10.11 ,$212.80 ,$234.08 ,$234.08 ,$25.80 ,$258.40 ,$10.32 ,$10.32 ,$170.54 ,$125.86 ,$126.46 ,$19.11 ,$18.90 ,$10.62 ,$258.40 ,$22.19 ,$159.30 ,$85.12 ,$273.60 ,$20.64 ,$10.11 ,$197.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600519,87070,HC BODY FLUID CULTURE,306,1 ,$42.00 ,$30.24 ,$5.69 ,$42.00 ,$27.30 ,$8.45 ,$11.76 ,$23.23 ,$8.45 ,$24.44 ,$8.45 ,$22.01 ,$8.45 ,$17.41 ,$38.64 ,$21.55 ,$8.45 ,$35.70 ,$37.80 ,$8.61 ,$31.50 ,$29.40 ,$29.40 ,$8.45 ,$29.40 ,$32.34 ,$32.34 ,$21.55 ,$35.70 ,$8.62 ,$8.62 ,$23.56 ,$17.39 ,$17.47 ,$5.75 ,$5.69 ,$8.87 ,$35.70 ,$18.53 ,$22.01 ,$11.76 ,$37.80 ,$17.24 ,$8.45 ,$27.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600522,87075,HC CULTURE ANAEROBIC,306,1 ,$251.00 ,$180.72 ,$5.69 ,$251.00 ,$163.15 ,$9.28 ,$70.28 ,$138.80 ,$9.28 ,$146.08 ,$9.28 ,$131.52 ,$9.28 ,$19.13 ,$230.92 ,$23.68 ,$9.28 ,$213.35 ,$225.90 ,$9.47 ,$188.25 ,$175.70 ,$175.70 ,$9.28 ,$175.70 ,$193.27 ,$193.27 ,$23.68 ,$213.35 ,$9.47 ,$9.47 ,$140.81 ,$103.91 ,$104.42 ,$5.75 ,$5.69 ,$9.74 ,$213.35 ,$20.36 ,$131.52 ,$70.28 ,$225.90 ,$18.94 ,$9.28 ,$163.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$161.00 ,$115.92 ,$5.69 ,$161.00 ,$104.65 ,$7.92 ,$45.08 ,$89.03 ,$7.92 ,$93.70 ,$7.92 ,$84.36 ,$7.92 ,$16.32 ,$148.12 ,$20.20 ,$7.92 ,$136.85 ,$144.90 ,$8.08 ,$120.75 ,$112.70 ,$112.70 ,$7.92 ,$112.70 ,$123.97 ,$123.97 ,$20.20 ,$136.85 ,$8.08 ,$8.08 ,$90.32 ,$66.65 ,$66.98 ,$5.75 ,$5.69 ,$8.31 ,$136.85 ,$17.37 ,$84.36 ,$45.08 ,$144.90 ,$16.16 ,$7.92 ,$104.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$219.00 ,$157.68 ,$5.69 ,$219.00 ,$142.35 ,$7.92 ,$61.32 ,$121.11 ,$7.92 ,$127.46 ,$7.92 ,$114.76 ,$7.92 ,$16.32 ,$201.48 ,$20.20 ,$7.92 ,$186.15 ,$197.10 ,$8.08 ,$164.25 ,$153.30 ,$153.30 ,$7.92 ,$153.30 ,$168.63 ,$168.63 ,$20.20 ,$186.15 ,$8.08 ,$8.08 ,$122.86 ,$90.67 ,$91.10 ,$5.75 ,$5.69 ,$8.31 ,$186.15 ,$17.37 ,$114.76 ,$61.32 ,$197.10 ,$16.16 ,$7.92 ,$142.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600526,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$158.00 ,$113.76 ,$5.69 ,$158.00 ,$102.70 ,$6.50 ,$44.24 ,$87.37 ,$6.50 ,$91.96 ,$6.50 ,$82.79 ,$6.50 ,$13.39 ,$145.36 ,$16.58 ,$6.50 ,$134.30 ,$142.20 ,$6.62 ,$118.50 ,$110.60 ,$110.60 ,$6.50 ,$110.60 ,$121.66 ,$121.66 ,$16.58 ,$134.30 ,$6.63 ,$6.63 ,$88.64 ,$65.41 ,$65.73 ,$5.75 ,$5.69 ,$6.82 ,$134.30 ,$14.25 ,$82.79 ,$44.24 ,$142.20 ,$13.26 ,$6.50 ,$102.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600527,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$179.00 ,$128.88 ,$5.69 ,$179.00 ,$116.35 ,$7.91 ,$50.12 ,$98.99 ,$7.91 ,$104.18 ,$7.91 ,$93.80 ,$7.91 ,$16.30 ,$164.68 ,$20.18 ,$7.91 ,$152.15 ,$161.10 ,$8.07 ,$134.25 ,$125.30 ,$125.30 ,$7.91 ,$125.30 ,$137.83 ,$137.83 ,$20.18 ,$152.15 ,$8.07 ,$8.07 ,$100.42 ,$74.11 ,$74.46 ,$5.75 ,$5.69 ,$8.30 ,$152.15 ,$17.35 ,$93.80 ,$50.12 ,$161.10 ,$16.14 ,$7.91 ,$116.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600528,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$101.00 ,$72.72 ,$5.69 ,$101.00 ,$65.65 ,$7.93 ,$28.28 ,$55.85 ,$7.93 ,$58.78 ,$7.93 ,$52.92 ,$7.93 ,$16.34 ,$92.92 ,$20.23 ,$7.93 ,$85.85 ,$90.90 ,$8.08 ,$75.75 ,$70.70 ,$70.70 ,$7.93 ,$70.70 ,$77.77 ,$77.77 ,$20.23 ,$85.85 ,$8.09 ,$8.09 ,$56.66 ,$41.81 ,$42.02 ,$5.75 ,$5.69 ,$8.32 ,$85.85 ,$17.39 ,$52.92 ,$28.28 ,$90.90 ,$16.18 ,$7.93 ,$65.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600530,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL,306,1 ,$85.00 ,$61.20 ,$5.69 ,$85.00 ,$55.25 ,$7.56 ,$23.80 ,$47.01 ,$7.56 ,$49.47 ,$7.56 ,$44.54 ,$7.56 ,$15.57 ,$78.20 ,$19.28 ,$7.56 ,$72.25 ,$76.50 ,$7.70 ,$63.75 ,$59.50 ,$59.50 ,$7.56 ,$59.50 ,$65.45 ,$65.45 ,$19.28 ,$72.25 ,$7.71 ,$7.71 ,$47.69 ,$35.19 ,$35.36 ,$5.75 ,$5.69 ,$7.94 ,$72.25 ,$16.58 ,$44.54 ,$23.80 ,$76.50 ,$15.42 ,$7.56 ,$55.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600531,87102,HC CULTURE FUNGUS OTHER,306,1 ,$216.00 ,$155.52 ,$5.69 ,$216.00 ,$140.40 ,$8.24 ,$60.48 ,$119.45 ,$8.24 ,$125.71 ,$8.24 ,$113.18 ,$8.24 ,$16.99 ,$198.72 ,$21.03 ,$8.24 ,$183.60 ,$194.40 ,$8.41 ,$162.00 ,$151.20 ,$151.20 ,$8.24 ,$151.20 ,$166.32 ,$166.32 ,$21.03 ,$183.60 ,$8.41 ,$8.41 ,$121.18 ,$89.42 ,$89.86 ,$5.75 ,$5.69 ,$8.65 ,$183.60 ,$18.08 ,$113.18 ,$60.48 ,$194.40 ,$16.82 ,$8.24 ,$140.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$168.00 ,$120.96 ,$5.69 ,$168.00 ,$109.20 ,$10.11 ,$47.04 ,$92.90 ,$10.11 ,$97.78 ,$10.11 ,$88.03 ,$10.11 ,$20.85 ,$154.56 ,$25.80 ,$10.11 ,$142.80 ,$151.20 ,$10.32 ,$126.00 ,$117.60 ,$117.60 ,$10.11 ,$117.60 ,$129.36 ,$129.36 ,$25.80 ,$142.80 ,$10.32 ,$10.32 ,$94.25 ,$69.55 ,$69.89 ,$5.75 ,$5.69 ,$10.62 ,$142.80 ,$22.19 ,$88.03 ,$47.04 ,$151.20 ,$20.64 ,$10.11 ,$109.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$180.00 ,$129.60 ,$5.08 ,$180.00 ,$117.00 ,$5.08 ,$50.40 ,$99.54 ,$5.08 ,$104.76 ,$5.08 ,$94.32 ,$5.08 ,$10.46 ,$165.60 ,$12.95 ,$5.08 ,$153.00 ,$162.00 ,$5.17 ,$135.00 ,$126.00 ,$126.00 ,$5.08 ,$126.00 ,$138.60 ,$138.60 ,$12.95 ,$153.00 ,$5.18 ,$5.18 ,$100.98 ,$74.52 ,$74.88 ,$5.75 ,$5.69 ,$5.33 ,$153.00 ,$11.14 ,$94.32 ,$50.40 ,$162.00 ,$10.36 ,$5.08 ,$117.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$97.00 ,$69.84 ,$5.69 ,$97.00 ,$63.05 ,$19.65 ,$27.16 ,$53.64 ,$19.65 ,$56.45 ,$19.65 ,$50.83 ,$19.65 ,$40.50 ,$89.24 ,$50.13 ,$19.65 ,$82.45 ,$87.30 ,$20.04 ,$72.75 ,$67.90 ,$67.90 ,$19.65 ,$67.90 ,$74.69 ,$74.69 ,$50.13 ,$82.45 ,$20.05 ,$20.05 ,$54.42 ,$40.16 ,$40.35 ,$5.75 ,$5.69 ,$20.63 ,$82.45 ,$43.11 ,$50.83 ,$27.16 ,$87.30 ,$40.10 ,$19.65 ,$63.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600542,87176,HC HOMOGENIZATION TISSUE,306,1 ,$77.00 ,$55.44 ,$5.69 ,$77.00 ,$50.05 ,$5.76 ,$21.56 ,$42.58 ,$5.76 ,$44.81 ,$5.76 ,$40.35 ,$5.76 ,$11.88 ,$70.84 ,$14.70 ,$5.76 ,$65.45 ,$69.30 ,$5.88 ,$57.75 ,$53.90 ,$53.90 ,$5.76 ,$53.90 ,$59.29 ,$59.29 ,$14.70 ,$65.45 ,$5.88 ,$5.88 ,$43.20 ,$31.88 ,$32.03 ,$5.75 ,$5.69 ,$6.05 ,$65.45 ,$12.64 ,$40.35 ,$21.56 ,$69.30 ,$11.76 ,$5.76 ,$50.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$28.00 ,$20.16 ,$4.65 ,$28.00 ,$18.20 ,$4.65 ,$7.84 ,$15.48 ,$4.65 ,$16.30 ,$4.65 ,$14.67 ,$4.65 ,$9.60 ,$25.76 ,$11.88 ,$4.65 ,$23.80 ,$25.20 ,$4.75 ,$21.00 ,$19.60 ,$19.60 ,$4.65 ,$19.60 ,$21.56 ,$21.56 ,$11.88 ,$23.80 ,$4.75 ,$4.75 ,$15.71 ,$11.59 ,$11.65 ,$5.75 ,$5.69 ,$4.89 ,$23.80 ,$10.21 ,$14.67 ,$7.84 ,$25.20 ,$9.50 ,$4.65 ,$18.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600545,87184,HC SENSITIVITY DISK KB,306,1 ,$99.00 ,$71.28 ,$5.69 ,$99.00 ,$64.35 ,$7.33 ,$27.72 ,$54.75 ,$7.33 ,$57.62 ,$7.33 ,$51.88 ,$7.33 ,$15.11 ,$91.08 ,$18.70 ,$7.33 ,$84.15 ,$89.10 ,$7.48 ,$74.25 ,$69.30 ,$69.30 ,$7.33 ,$69.30 ,$76.23 ,$76.23 ,$18.70 ,$84.15 ,$7.48 ,$7.48 ,$55.54 ,$40.99 ,$41.18 ,$5.75 ,$5.69 ,$7.69 ,$84.15 ,$16.08 ,$51.88 ,$27.72 ,$89.10 ,$14.96 ,$7.33 ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600546,87185,HC BETA LACTAMASE,306,1 ,$20.00 ,$14.40 ,$4.65 ,$20.00 ,$13.00 ,$4.65 ,$5.60 ,$11.06 ,$4.65 ,$11.64 ,$4.65 ,$10.48 ,$4.65 ,$9.60 ,$18.40 ,$11.88 ,$4.65 ,$17.00 ,$18.00 ,$4.75 ,$15.00 ,$14.00 ,$14.00 ,$4.65 ,$14.00 ,$15.40 ,$15.40 ,$11.88 ,$17.00 ,$4.75 ,$4.75 ,$11.22 ,$8.28 ,$8.32 ,$5.75 ,$5.69 ,$4.89 ,$17.00 ,$10.21 ,$10.48 ,$5.60 ,$18.00 ,$9.50 ,$4.65 ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600547,87186,HC SENSITIVITY MIC,306,1 ,$200.00 ,$144.00 ,$5.69 ,$200.00 ,$130.00 ,$8.48 ,$56.00 ,$110.60 ,$8.48 ,$116.40 ,$8.48 ,$104.80 ,$8.48 ,$17.47 ,$184.00 ,$21.63 ,$8.48 ,$170.00 ,$180.00 ,$8.64 ,$150.00 ,$140.00 ,$140.00 ,$8.48 ,$140.00 ,$154.00 ,$154.00 ,$21.63 ,$170.00 ,$8.65 ,$8.65 ,$112.20 ,$82.80 ,$83.20 ,$5.75 ,$5.69 ,$8.90 ,$170.00 ,$18.60 ,$104.80 ,$56.00 ,$180.00 ,$17.30 ,$8.48 ,$130.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600551,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$130.00 ,$93.60 ,$4.18 ,$130.00 ,$84.50 ,$4.18 ,$36.40 ,$71.89 ,$4.18 ,$75.66 ,$4.18 ,$68.12 ,$4.18 ,$8.63 ,$119.60 ,$10.68 ,$4.18 ,$110.50 ,$117.00 ,$4.27 ,$97.50 ,$91.00 ,$91.00 ,$4.18 ,$91.00 ,$100.10 ,$100.10 ,$10.68 ,$110.50 ,$4.27 ,$4.27 ,$72.93 ,$53.82 ,$54.08 ,$5.75 ,$5.69 ,$4.39 ,$110.50 ,$9.18 ,$68.12 ,$36.40 ,$117.00 ,$8.54 ,$4.18 ,$84.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$81.00 ,$58.32 ,$5.28 ,$81.00 ,$52.65 ,$5.28 ,$22.68 ,$44.79 ,$5.28 ,$47.14 ,$5.28 ,$42.44 ,$5.28 ,$10.89 ,$74.52 ,$13.48 ,$5.28 ,$68.85 ,$72.90 ,$5.39 ,$60.75 ,$56.70 ,$56.70 ,$5.28 ,$56.70 ,$62.37 ,$62.37 ,$13.48 ,$68.85 ,$5.39 ,$5.39 ,$45.44 ,$33.53 ,$33.70 ,$5.75 ,$5.69 ,$5.55 ,$68.85 ,$11.59 ,$42.44 ,$22.68 ,$72.90 ,$10.78 ,$5.28 ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600555,87255,HC VIRUS ID NON-IMMUNOLOGIC OTHER THAN CYTOPATHIC-90,306,1 ,$369.00 ,$265.68 ,$18.90 ,$369.00 ,$239.85 ,$33.18 ,$103.32 ,$204.06 ,$33.18 ,$214.76 ,$33.18 ,$193.36 ,$33.18 ,$68.40 ,$339.48 ,$84.65 ,$33.18 ,$313.65 ,$332.10 ,$33.85 ,$276.75 ,$258.30 ,$258.30 ,$33.18 ,$258.30 ,$284.13 ,$284.13 ,$84.65 ,$313.65 ,$33.86 ,$33.86 ,$207.01 ,$152.77 ,$153.50 ,$19.11 ,$18.90 ,$34.84 ,$313.65 ,$72.80 ,$193.36 ,$103.32 ,$332.10 ,$67.72 ,$33.18 ,$239.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600559,87340,HC EIA QL HEPATITIS B AG,306,1 ,$311.00 ,$223.92 ,$7.13 ,$311.00 ,$202.15 ,$10.12 ,$87.08 ,$171.98 ,$10.12 ,$181.00 ,$10.12 ,$162.96 ,$10.12 ,$20.87 ,$286.12 ,$25.83 ,$10.12 ,$264.35 ,$279.90 ,$10.33 ,$233.25 ,$217.70 ,$217.70 ,$10.12 ,$217.70 ,$239.47 ,$239.47 ,$25.83 ,$264.35 ,$10.33 ,$10.33 ,$174.47 ,$128.75 ,$129.38 ,$7.21 ,$7.13 ,$10.63 ,$264.35 ,$22.21 ,$162.96 ,$87.08 ,$279.90 ,$20.66 ,$10.12 ,$202.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600561,87389,HC HIV-1 AG W/HIV-1 AND HIV-2 AB,306,1 ,$290.00 ,$208.80 ,$7.13 ,$290.00 ,$188.50 ,$23.60 ,$81.20 ,$160.37 ,$23.60 ,$168.78 ,$23.60 ,$151.96 ,$23.60 ,$48.64 ,$266.80 ,$60.20 ,$23.60 ,$246.50 ,$261.00 ,$24.07 ,$217.50 ,$203.00 ,$203.00 ,$23.60 ,$203.00 ,$223.30 ,$223.30 ,$60.20 ,$246.50 ,$24.08 ,$24.08 ,$162.69 ,$120.06 ,$120.64 ,$7.21 ,$7.13 ,$24.77 ,$246.50 ,$51.77 ,$151.96 ,$81.20 ,$261.00 ,$48.16 ,$23.60 ,$188.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600568,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$125.00 ,$90.00 ,$18.90 ,$125.00 ,$81.25 ,$34.39 ,$35.00 ,$69.13 ,$34.39 ,$72.75 ,$34.39 ,$65.50 ,$34.39 ,$70.88 ,$115.00 ,$87.73 ,$34.39 ,$106.25 ,$112.50 ,$35.07 ,$93.75 ,$87.50 ,$87.50 ,$34.39 ,$87.50 ,$96.25 ,$96.25 ,$87.73 ,$106.25 ,$35.09 ,$35.09 ,$70.13 ,$51.75 ,$52.00 ,$19.11 ,$18.90 ,$36.10 ,$106.25 ,$75.44 ,$65.50 ,$35.00 ,$112.50 ,$70.18 ,$34.39 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600570,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$264.00 ,$190.08 ,$7.13 ,$264.00 ,$171.60 ,$34.39 ,$73.92 ,$145.99 ,$34.39 ,$153.65 ,$34.39 ,$138.34 ,$34.39 ,$70.88 ,$242.88 ,$87.73 ,$34.39 ,$224.40 ,$237.60 ,$35.07 ,$198.00 ,$184.80 ,$184.80 ,$34.39 ,$184.80 ,$203.28 ,$203.28 ,$87.73 ,$224.40 ,$35.09 ,$35.09 ,$148.10 ,$109.30 ,$109.82 ,$7.21 ,$7.13 ,$36.10 ,$224.40 ,$75.44 ,$138.34 ,$73.92 ,$237.60 ,$70.18 ,$34.39 ,$171.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600571,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,$721.00 ,$519.12 ,$18.90 ,"$1,041.95 ",$468.65 ,$408.44 ,$201.88 ,$398.71 ,$408.44 ,$419.62 ,$408.44 ,$377.80 ,$408.44 ,$721.00 ,$663.32 ,"$1,041.95 ",$408.44 ,$612.85 ,$648.90 ,$416.62 ,$540.75 ,$504.70 ,$504.70 ,$408.44 ,$504.70 ,$555.17 ,$555.17 ,$721.00 ,$612.85 ,$416.78 ,$416.78 ,$404.48 ,$298.49 ,$299.94 ,$19.11 ,$18.90 ,$428.87 ,$612.85 ,$896.08 ,$377.80 ,$201.88 ,$648.90 ,$721.00 ,$408.44 ,$468.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600573,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$547.00 ,$393.84 ,$18.90 ,$547.00 ,$355.55 ,$34.39 ,$153.16 ,$302.49 ,$34.39 ,$318.35 ,$34.39 ,$286.63 ,$34.39 ,$70.88 ,$503.24 ,$87.73 ,$34.39 ,$464.95 ,$492.30 ,$35.07 ,$410.25 ,$382.90 ,$382.90 ,$34.39 ,$382.90 ,$421.19 ,$421.19 ,$87.73 ,$464.95 ,$35.09 ,$35.09 ,$306.87 ,$226.46 ,$227.55 ,$19.11 ,$18.90 ,$36.10 ,$464.95 ,$75.44 ,$286.63 ,$153.16 ,$492.30 ,$70.18 ,$34.39 ,$355.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600575,87591,HC NEISSERIA AMP,306,1 ,$259.00 ,$186.48 ,$18.90 ,$259.00 ,$168.35 ,$34.39 ,$72.52 ,$143.23 ,$34.39 ,$150.74 ,$34.39 ,$135.72 ,$34.39 ,$70.88 ,$238.28 ,$87.73 ,$34.39 ,$220.15 ,$233.10 ,$35.07 ,$194.25 ,$181.30 ,$181.30 ,$34.39 ,$181.30 ,$199.43 ,$199.43 ,$87.73 ,$220.15 ,$35.09 ,$35.09 ,$145.30 ,$107.23 ,$107.74 ,$19.11 ,$18.90 ,$36.10 ,$220.15 ,$75.44 ,$135.72 ,$72.52 ,$233.10 ,$70.18 ,$34.39 ,$168.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600576,87624,HC HPV HIGH RISK ALL OTHERS,306,1 ,$319.00 ,$229.68 ,$18.90 ,$319.00 ,$207.35 ,$34.39 ,$89.32 ,$176.41 ,$34.39 ,$185.66 ,$34.39 ,$167.16 ,$34.39 ,$70.88 ,$293.48 ,$87.73 ,$34.39 ,$271.15 ,$287.10 ,$35.07 ,$239.25 ,$223.30 ,$223.30 ,$34.39 ,$223.30 ,$245.63 ,$245.63 ,$87.73 ,$271.15 ,$35.09 ,$35.09 ,$178.96 ,$132.07 ,$132.70 ,$19.11 ,$18.90 ,$36.10 ,$271.15 ,$75.44 ,$167.16 ,$89.32 ,$287.10 ,$70.18 ,$34.39 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600577,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,$506.00 ,$364.32 ,$18.90 ,"$1,041.95 ",$328.90 ,$408.44 ,$141.68 ,$279.82 ,$408.44 ,$294.49 ,$408.44 ,$265.14 ,$408.44 ,$506.00 ,$465.52 ,"$1,041.95 ",$408.44 ,$430.10 ,$455.40 ,$416.62 ,$379.50 ,$354.20 ,$354.20 ,$408.44 ,$354.20 ,$389.62 ,$389.62 ,$506.00 ,$430.10 ,$416.78 ,$416.78 ,$283.87 ,$209.48 ,$210.50 ,$19.11 ,$18.90 ,$428.87 ,$430.10 ,$896.08 ,$265.14 ,$141.68 ,$455.40 ,$506.00 ,$408.44 ,$328.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600581,87798,HC INFECT AMP,306,1 ,$523.00 ,$376.56 ,$18.90 ,$523.00 ,$339.95 ,$34.39 ,$146.44 ,$289.22 ,$34.39 ,$304.39 ,$34.39 ,$274.05 ,$34.39 ,$70.88 ,$481.16 ,$87.73 ,$34.39 ,$444.55 ,$470.70 ,$35.07 ,$392.25 ,$366.10 ,$366.10 ,$34.39 ,$366.10 ,$402.71 ,$402.71 ,$87.73 ,$444.55 ,$35.09 ,$35.09 ,$293.40 ,$216.52 ,$217.57 ,$19.11 ,$18.90 ,$36.10 ,$444.55 ,$75.44 ,$274.05 ,$146.44 ,$470.70 ,$70.18 ,$34.39 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600592,87486,HC CHLAMYDIA PNEUM AMP PROBE-90,306,1 ,$424.00 ,$305.28 ,$18.90 ,$424.00 ,$275.60 ,$34.39 ,$118.72 ,$234.47 ,$34.39 ,$246.77 ,$34.39 ,$222.18 ,$34.39 ,$70.88 ,$390.08 ,$87.73 ,$34.39 ,$360.40 ,$381.60 ,$35.07 ,$318.00 ,$296.80 ,$296.80 ,$34.39 ,$296.80 ,$326.48 ,$326.48 ,$87.73 ,$360.40 ,$35.09 ,$35.09 ,$237.86 ,$175.54 ,$176.38 ,$19.11 ,$18.90 ,$36.10 ,$360.40 ,$75.44 ,$222.18 ,$118.72 ,$381.60 ,$70.18 ,$34.39 ,$275.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600593,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$447.00 ,$321.84 ,$5.69 ,$447.00 ,$290.55 ,$15.75 ,$125.16 ,$247.19 ,$15.75 ,$260.15 ,$15.75 ,$234.23 ,$15.75 ,$32.46 ,$411.24 ,$40.18 ,$15.75 ,$379.95 ,$402.30 ,$16.06 ,$335.25 ,$312.90 ,$312.90 ,$15.75 ,$312.90 ,$344.19 ,$344.19 ,$40.18 ,$379.95 ,$16.07 ,$16.07 ,$250.77 ,$185.06 ,$185.95 ,$5.75 ,$5.69 ,$16.53 ,$379.95 ,$34.55 ,$234.23 ,$125.16 ,$402.30 ,$32.14 ,$15.75 ,$290.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600599,87625,HC HPV GENOTYPE 16 18/45,306,1 ,$226.00 ,$162.72 ,$18.90 ,$226.00 ,$146.90 ,$39.74 ,$63.28 ,$124.98 ,$39.74 ,$131.53 ,$39.74 ,$118.42 ,$39.74 ,$81.91 ,$207.92 ,$101.38 ,$39.74 ,$192.10 ,$203.40 ,$40.53 ,$169.50 ,$158.20 ,$158.20 ,$39.74 ,$158.20 ,$174.02 ,$174.02 ,$101.38 ,$192.10 ,$40.55 ,$40.55 ,$126.79 ,$93.56 ,$94.02 ,$19.11 ,$18.90 ,$41.73 ,$192.10 ,$87.18 ,$118.42 ,$63.28 ,$203.40 ,$81.10 ,$39.74 ,$146.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600607,87661,HC TRICHOMONAS VAG AMP PROBE,306,1 ,$260.00 ,$187.20 ,$18.90 ,$260.00 ,$169.00 ,$34.39 ,$72.80 ,$143.78 ,$34.39 ,$151.32 ,$34.39 ,$136.24 ,$34.39 ,$70.88 ,$239.20 ,$87.73 ,$34.39 ,$221.00 ,$234.00 ,$35.07 ,$195.00 ,$182.00 ,$182.00 ,$34.39 ,$182.00 ,$200.20 ,$200.20 ,$87.73 ,$221.00 ,$35.09 ,$35.09 ,$145.86 ,$107.64 ,$108.16 ,$19.11 ,$18.90 ,$36.10 ,$221.00 ,$75.44 ,$136.24 ,$72.80 ,$234.00 ,$70.18 ,$34.39 ,$169.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600614,87220,HC TISSUE KOH PREP,306,1 ,$72.00 ,$51.84 ,$4.18 ,$72.00 ,$46.80 ,$4.18 ,$20.16 ,$39.82 ,$4.18 ,$41.90 ,$4.18 ,$37.73 ,$4.18 ,$8.63 ,$66.24 ,$10.68 ,$4.18 ,$61.20 ,$64.80 ,$4.27 ,$54.00 ,$50.40 ,$50.40 ,$4.18 ,$50.40 ,$55.44 ,$55.44 ,$10.68 ,$61.20 ,$4.27 ,$4.27 ,$40.39 ,$29.81 ,$29.95 ,$5.75 ,$5.69 ,$4.39 ,$61.20 ,$9.18 ,$37.73 ,$20.16 ,$64.80 ,$8.54 ,$4.18 ,$46.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600625,87172,HC PINWORM- 90,306,1 ,$54.00 ,$38.88 ,$4.18 ,$54.00 ,$35.10 ,$4.18 ,$15.12 ,$29.86 ,$4.18 ,$31.43 ,$4.18 ,$28.30 ,$4.18 ,$8.63 ,$49.68 ,$10.68 ,$4.18 ,$45.90 ,$48.60 ,$4.27 ,$40.50 ,$37.80 ,$37.80 ,$4.18 ,$37.80 ,$41.58 ,$41.58 ,$10.68 ,$45.90 ,$4.27 ,$4.27 ,$30.29 ,$22.36 ,$22.46 ,$5.75 ,$5.69 ,$4.39 ,$45.90 ,$9.18 ,$28.30 ,$15.12 ,$48.60 ,$8.54 ,$4.18 ,$35.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600630,87481,HC CANDIDA SPECIES DNA/RNA AMPLIFIED PROBE TECH,306,1 ,$131.00 ,$94.32 ,$7.13 ,$131.00 ,$85.15 ,$34.39 ,$36.68 ,$72.44 ,$34.39 ,$76.24 ,$34.39 ,$68.64 ,$34.39 ,$70.88 ,$120.52 ,$87.73 ,$34.39 ,$111.35 ,$117.90 ,$35.07 ,$98.25 ,$91.70 ,$91.70 ,$34.39 ,$91.70 ,$100.87 ,$100.87 ,$87.73 ,$111.35 ,$35.09 ,$35.09 ,$73.49 ,$54.23 ,$54.50 ,$7.21 ,$7.13 ,$36.10 ,$111.35 ,$75.44 ,$68.64 ,$36.68 ,$117.90 ,$70.18 ,$34.39 ,$85.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$129.00 ,$92.88 ,$5.69 ,$129.00 ,$83.85 ,$40.55 ,$36.12 ,$71.34 ,$40.55 ,$75.08 ,$40.55 ,$67.60 ,$40.55 ,$83.59 ,$118.68 ,$103.45 ,$40.55 ,$109.65 ,$116.10 ,$41.37 ,$96.75 ,$90.30 ,$90.30 ,$40.55 ,$90.30 ,$99.33 ,$99.33 ,$103.45 ,$109.65 ,$41.38 ,$41.38 ,$72.37 ,$53.41 ,$53.66 ,$5.75 ,$5.69 ,$42.58 ,$109.65 ,$88.97 ,$67.60 ,$36.12 ,$116.10 ,$83.04 ,$40.55 ,$83.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600659,87591,HC NEISSERIA AMP,306,1 ,$259.00 ,$186.48 ,$18.90 ,$259.00 ,$168.35 ,$34.39 ,$72.52 ,$143.23 ,$34.39 ,$150.74 ,$34.39 ,$135.72 ,$34.39 ,$70.88 ,$238.28 ,$87.73 ,$34.39 ,$220.15 ,$233.10 ,$35.07 ,$194.25 ,$181.30 ,$181.30 ,$34.39 ,$181.30 ,$199.43 ,$199.43 ,$87.73 ,$220.15 ,$35.09 ,$35.09 ,$145.30 ,$107.23 ,$107.74 ,$19.11 ,$18.90 ,$36.10 ,$220.15 ,$75.44 ,$135.72 ,$72.52 ,$233.10 ,$70.18 ,$34.39 ,$168.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600660,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$264.00 ,$190.08 ,$7.13 ,$264.00 ,$171.60 ,$34.39 ,$73.92 ,$145.99 ,$34.39 ,$153.65 ,$34.39 ,$138.34 ,$34.39 ,$70.88 ,$242.88 ,$87.73 ,$34.39 ,$224.40 ,$237.60 ,$35.07 ,$198.00 ,$184.80 ,$184.80 ,$34.39 ,$184.80 ,$203.28 ,$203.28 ,$87.73 ,$224.40 ,$35.09 ,$35.09 ,$148.10 ,$109.30 ,$109.82 ,$7.21 ,$7.13 ,$36.10 ,$224.40 ,$75.44 ,$138.34 ,$73.92 ,$237.60 ,$70.18 ,$34.39 ,$171.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600661,87661,HC TRICHOMONAS VAG AMP PROBE,306,1 ,$260.00 ,$187.20 ,$18.90 ,$260.00 ,$169.00 ,$34.39 ,$72.80 ,$143.78 ,$34.39 ,$151.32 ,$34.39 ,$136.24 ,$34.39 ,$70.88 ,$239.20 ,$87.73 ,$34.39 ,$221.00 ,$234.00 ,$35.07 ,$195.00 ,$182.00 ,$182.00 ,$34.39 ,$182.00 ,$200.20 ,$200.20 ,$87.73 ,$221.00 ,$35.09 ,$35.09 ,$145.86 ,$107.64 ,$108.16 ,$19.11 ,$18.90 ,$36.10 ,$221.00 ,$75.44 ,$136.24 ,$72.80 ,$234.00 ,$70.18 ,$34.39 ,$169.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),30600662,87593,HC INFECT AMP ORTHOPOXVIRUS/MONKEYPOX DNA-90,306,1 ,$113.00 ,$81.36 ,$18.90 ,$113.00 ,$73.45 , N/A ,$31.64 ,$62.49 , N/A ,$65.77 , N/A ,$59.21 , N/A , N/A ,$103.96 , N/A , N/A ,$96.05 ,$101.70 , N/A ,$84.75 ,$79.10 ,$79.10 , N/A ,$79.10 ,$87.01 ,$87.01 , N/A ,$96.05 , N/A , N/A ,$63.39 ,$46.78 ,$47.01 ,$19.11 ,$18.90 , N/A ,$96.05 , N/A ,$59.21 ,$31.64 ,$101.70 ,$102.34 , N/A ,$73.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),30682004,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$15.00 ,$10.80 ,$4.20 ,$37.50 ,$9.75 ,$14.70 ,$4.20 ,$8.30 ,$14.70 ,$8.73 ,$14.70 ,$7.86 ,$14.70 ,$15.00 ,$13.80 ,$37.50 ,$14.70 ,$12.75 ,$13.50 ,$14.70 ,$11.25 ,$10.50 ,$10.50 ,$14.70 ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 ,$15.00 ,$15.00 ,$8.42 ,$6.21 ,$6.24 ,$7.21 ,$7.13 ,$15.43 ,$12.75 ,$32.25 ,$7.86 ,$4.20 ,$13.50 ,$15.00 ,$14.70 ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30682012,87635,HC COVID-19 LAB TEST,306,1 ,$472.00 ,$339.84 ,$18.90 ,$472.00 ,$306.80 ,$50.28 ,$132.16 ,$261.02 ,$50.28 ,$274.70 ,$50.28 ,$247.33 ,$50.28 ,$103.65 ,$434.24 ,$128.28 ,$50.28 ,$401.20 ,$424.80 ,$51.29 ,$354.00 ,$330.40 ,$330.40 ,$50.28 ,$330.40 ,$363.44 ,$363.44 ,$128.28 ,$401.20 ,$51.31 ,$51.31 ,$264.79 ,$195.41 ,$196.35 ,$19.11 ,$18.90 ,$52.80 ,$401.20 ,$110.32 ,$247.33 ,$132.16 ,$424.80 ,$102.62 ,$50.28 ,$306.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),30682015,86769,HC SARS-COV-2 COVID-19 ANTIBODY-90,306,1 ,$268.00 ,$192.96 ,$7.13 ,$268.00 ,$174.20 ,$41.29 ,$75.04 ,$148.20 ,$41.29 ,$155.98 ,$41.29 ,$140.43 ,$41.29 ,$85.10 ,$246.56 ,$105.33 ,$41.29 ,$227.80 ,$241.20 ,$42.11 ,$201.00 ,$187.60 ,$187.60 ,$41.29 ,$187.60 ,$206.36 ,$206.36 ,$105.33 ,$227.80 ,$42.13 ,$42.13 ,$150.35 ,$110.95 ,$111.49 ,$7.21 ,$7.13 ,$43.36 ,$227.80 ,$90.58 ,$140.43 ,$75.04 ,$241.20 ,$84.26 ,$41.29 ,$174.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),30682025,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION,306,1 ,$89.00 ,$64.08 ,$18.90 ,$128.28 ,$57.85 ,$50.28 ,$24.92 ,$49.22 ,$50.28 ,$51.80 ,$50.28 ,$46.64 ,$50.28 ,$89.00 ,$81.88 ,$128.28 ,$50.28 ,$75.65 ,$80.10 ,$51.29 ,$66.75 ,$62.30 ,$62.30 ,$50.28 ,$62.30 ,$68.53 ,$68.53 ,$89.00 ,$75.65 ,$51.31 ,$51.31 ,$49.93 ,$36.85 ,$37.02 ,$19.11 ,$18.90 ,$52.80 ,$75.65 ,$110.32 ,$46.64 ,$24.92 ,$80.10 ,$89.00 ,$50.28 ,$57.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),30682026,87563,HC MYCROPLASMA GENITALIUM AMP PROBE- 90,306,1 ,$135.00 ,$97.20 ,$18.90 ,$135.00 ,$87.75 ,$34.39 ,$37.80 ,$74.66 ,$34.39 ,$78.57 ,$34.39 ,$70.74 ,$34.39 ,$70.88 ,$124.20 ,$87.73 ,$34.39 ,$114.75 ,$121.50 ,$35.07 ,$101.25 ,$94.50 ,$94.50 ,$34.39 ,$94.50 ,$103.95 ,$103.95 ,$87.73 ,$114.75 ,$35.09 ,$35.09 ,$75.74 ,$55.89 ,$56.16 ,$19.11 ,$18.90 ,$36.10 ,$114.75 ,$75.44 ,$70.74 ,$37.80 ,$121.50 ,$70.18 ,$34.39 ,$87.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$124.00 ,$89.28 ,$2.85 ,$124.00 ,$80.60 ,$3.11 ,$34.72 ,$68.57 ,$3.11 ,$72.17 ,$3.11 ,$64.98 ,$3.11 ,$6.40 ,$114.08 ,$7.93 ,$3.11 ,$105.40 ,$111.60 ,$3.17 ,$93.00 ,$86.80 ,$86.80 ,$3.11 ,$86.80 ,$95.48 ,$95.48 ,$7.93 ,$105.40 ,$3.17 ,$3.17 ,$69.56 ,$51.34 ,$51.58 ,$2.88 ,$2.85 ,$3.26 ,$105.40 ,$6.82 ,$64.98 ,$34.72 ,$111.60 ,$6.34 ,$3.11 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$97.00 ,$69.84 ,$1.80 ,$97.00 ,$63.05 ,$2.20 ,$27.16 ,$53.64 ,$2.20 ,$56.45 ,$2.20 ,$50.83 ,$2.20 ,$4.55 ,$89.24 ,$5.63 ,$2.20 ,$82.45 ,$87.30 ,$2.25 ,$72.75 ,$67.90 ,$67.90 ,$2.20 ,$67.90 ,$74.69 ,$74.69 ,$5.63 ,$82.45 ,$2.25 ,$2.25 ,$54.42 ,$40.16 ,$40.35 ,$1.81 ,$1.80 ,$2.31 ,$82.45 ,$4.84 ,$50.83 ,$27.16 ,$87.30 ,$4.50 ,$2.20 ,$63.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),30700116,81025,HC URINE PREGNANCY TEST,307,1 ,$183.00 ,$131.76 ,$2.85 ,$183.00 ,$118.95 ,$8.44 ,$51.24 ,$101.20 ,$8.44 ,$106.51 ,$8.44 ,$95.89 ,$8.44 ,$17.39 ,$168.36 ,$21.53 ,$8.44 ,$155.55 ,$164.70 ,$8.60 ,$137.25 ,$128.10 ,$128.10 ,$8.44 ,$128.10 ,$140.91 ,$140.91 ,$21.53 ,$155.55 ,$8.61 ,$8.61 ,$102.66 ,$75.76 ,$76.13 ,$2.88 ,$2.85 ,$8.86 ,$155.55 ,$18.51 ,$95.89 ,$51.24 ,$164.70 ,$17.22 ,$8.44 ,$118.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),30700117,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$39.00 ,$28.08 ,$2.85 ,$39.00 ,$25.35 ,$3.57 ,$10.92 ,$21.57 ,$3.57 ,$22.70 ,$3.57 ,$20.44 ,$3.57 ,$7.35 ,$35.88 ,$9.10 ,$3.57 ,$33.15 ,$35.10 ,$3.64 ,$29.25 ,$27.30 ,$27.30 ,$3.57 ,$27.30 ,$30.03 ,$30.03 ,$9.10 ,$33.15 ,$3.64 ,$3.64 ,$21.88 ,$16.15 ,$16.22 ,$2.88 ,$2.85 ,$3.74 ,$33.15 ,$7.83 ,$20.44 ,$10.92 ,$35.10 ,$7.28 ,$3.57 ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),30700131,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$99.00 ,$71.28 ,$2.85 ,$99.00 ,$64.35 ,$3.57 ,$27.72 ,$54.75 ,$3.57 ,$57.62 ,$3.57 ,$51.88 ,$3.57 ,$7.35 ,$91.08 ,$9.10 ,$3.57 ,$84.15 ,$89.10 ,$3.64 ,$74.25 ,$69.30 ,$69.30 ,$3.57 ,$69.30 ,$76.23 ,$76.23 ,$9.10 ,$84.15 ,$3.64 ,$3.64 ,$55.54 ,$40.99 ,$41.18 ,$2.88 ,$2.85 ,$3.74 ,$84.15 ,$7.83 ,$51.88 ,$27.72 ,$89.10 ,$7.28 ,$3.57 ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$893.00 ,$642.96 ,$92.00 ,$893.00 ,$580.45 ,$160.68 ,$250.04 ,$493.83 ,$160.68 ,$519.73 ,$160.68 ,$467.93 ,$160.68 ,$331.20 ,$821.56 ,$409.90 ,$160.68 ,$759.05 ,$803.70 ,$163.90 ,$669.75 ,$625.10 ,$625.10 ,$160.68 ,$625.10 ,$687.61 ,$687.61 ,$409.90 ,$759.05 ,$163.96 ,$163.96 ,$500.97 ,$369.70 ,$371.49 ,$93.01 ,$92.00 ,$168.72 ,$759.05 ,$352.51 ,$467.93 ,$250.04 ,$803.70 ,$327.92 ,$160.68 ,$580.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$622.00 ,$447.84 ,$92.00 ,$622.00 ,$404.30 ,$141.94 ,$174.16 ,$343.97 ,$141.94 ,$362.00 ,$141.94 ,$325.93 ,$141.94 ,$292.58 ,$572.24 ,$362.10 ,$141.94 ,$528.70 ,$559.80 ,$144.79 ,$466.50 ,$435.40 ,$435.40 ,$141.94 ,$435.40 ,$478.94 ,$478.94 ,$362.10 ,$528.70 ,$144.84 ,$144.84 ,$348.94 ,$257.51 ,$258.75 ,$93.01 ,$92.00 ,$149.04 ,$528.70 ,$311.41 ,$325.93 ,$174.16 ,$559.80 ,$289.68 ,$141.94 ,$404.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,$350.00 ,$252.00 ,$28.27 ,$875.00 ,$227.50 ,$343.00 ,$98.00 ,$193.55 ,$343.00 ,$203.70 ,$343.00 ,$183.40 ,$343.00 ,$350.00 ,$322.00 ,$875.00 ,$343.00 ,$297.50 ,$315.00 ,$343.00 ,$262.50 ,$245.00 ,$245.00 ,$343.00 ,$245.00 ,$269.50 ,$269.50 ,$350.00 ,$297.50 ,$350.00 ,$350.00 ,$196.35 ,$144.90 ,$145.60 ,$28.57 ,$28.27 ,$360.15 ,$297.50 ,$752.50 ,$183.40 ,$98.00 ,$315.00 ,$350.00 ,$343.00 ,$227.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000139,81229,HC CYTOGENOMIC MICROARRY ASSAY-90,310,1 ,"$1,292.00 ",$930.24 ,$261.09 ,"$2,900.00 ",$839.80 ,"$1,136.80 ",$361.76 ,$714.48 ,"$1,136.80 ",$751.94 ,"$1,136.80 ",$677.01 ,"$1,136.80 ","$1,292.00 ","$1,188.64 ","$2,900.00 ","$1,136.80 ","$1,098.20 ","$1,162.80 ","$1,159.54 ",$969.00 ,$904.40 ,$904.40 ,"$1,136.80 ",$904.40 ,$994.84 ,$994.84 ,"$1,292.00 ","$1,098.20 ","$1,160.00 ","$1,160.00 ",$724.81 ,$534.89 ,$537.47 ,$263.96 ,$261.09 ,"$1,193.64 ","$1,098.20 ","$2,494.00 ",$677.01 ,$361.76 ,"$1,162.80 ","$1,292.00 ","$1,136.80 ",$839.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$202.00 ,$145.44 ,$28.27 ,$202.00 ,$131.30 ,$64.38 ,$56.56 ,$111.71 ,$64.38 ,$117.56 ,$64.38 ,$105.85 ,$64.38 ,$132.69 ,$185.84 ,$164.23 ,$64.38 ,$171.70 ,$181.80 ,$65.66 ,$151.50 ,$141.40 ,$141.40 ,$64.38 ,$141.40 ,$155.54 ,$155.54 ,$164.23 ,$171.70 ,$65.69 ,$65.69 ,$113.32 ,$83.63 ,$84.03 ,$28.57 ,$28.27 ,$67.59 ,$171.70 ,$141.23 ,$105.85 ,$56.56 ,$181.80 ,$131.38 ,$64.38 ,$131.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$390.00 ,$280.80 ,$28.27 ,$390.00 ,$253.50 ,$71.90 ,$109.20 ,$215.67 ,$71.90 ,$226.98 ,$71.90 ,$204.36 ,$71.90 ,$148.21 ,$358.80 ,$183.43 ,$71.90 ,$331.50 ,$351.00 ,$73.34 ,$292.50 ,$273.00 ,$273.00 ,$71.90 ,$273.00 ,$300.30 ,$300.30 ,$183.43 ,$331.50 ,$73.37 ,$73.37 ,$218.79 ,$161.46 ,$162.24 ,$28.57 ,$28.27 ,$75.50 ,$331.50 ,$157.75 ,$204.36 ,$109.20 ,$351.00 ,$146.74 ,$71.90 ,$253.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000146,81243,HC FMR1 GENE DETECTION -90,310,1 ,$406.00 ,$292.32 ,$28.27 ,$406.00 ,$263.90 , N/A ,$113.68 ,$224.52 , N/A ,$236.29 , N/A ,$212.74 , N/A ,$182.70 ,$373.52 ,$284.20 , N/A ,$345.10 ,$365.40 , N/A ,$304.50 ,$284.20 ,$284.20 , N/A ,$284.20 ,$312.62 ,$312.62 , N/A ,$345.10 , N/A , N/A ,$227.77 ,$168.08 ,$168.90 ,$28.57 ,$28.27 , N/A ,$345.10 ,$243.60 ,$212.74 ,$113.68 ,$365.40 ,$114.08 , N/A ,$263.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000147,81244,HC FMR1 GENE CHARACTERIZATION - 90,310,1 ,$234.00 ,$168.48 ,$28.27 ,$234.00 ,$152.10 ,$43.99 ,$65.52 ,$129.40 ,$43.99 ,$136.19 ,$43.99 ,$122.62 ,$43.99 ,$90.68 ,$215.28 ,$112.23 ,$43.99 ,$198.90 ,$210.60 ,$44.87 ,$175.50 ,$163.80 ,$163.80 ,$43.99 ,$163.80 ,$180.18 ,$180.18 ,$112.23 ,$198.90 ,$44.89 ,$44.89 ,$131.27 ,$96.88 ,$97.34 ,$28.57 ,$28.27 ,$46.19 ,$198.90 ,$96.51 ,$122.62 ,$65.52 ,$210.60 ,$89.78 ,$43.99 ,$152.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,$283.00 ,$203.76 ,$28.27 ,$283.00 ,$183.95 ,$89.83 ,$79.24 ,$156.50 ,$89.83 ,$164.71 ,$89.83 ,$148.29 ,$89.83 ,$185.15 ,$260.36 ,$229.15 ,$89.83 ,$240.55 ,$254.70 ,$91.62 ,$212.25 ,$198.10 ,$198.10 ,$89.83 ,$198.10 ,$217.91 ,$217.91 ,$229.15 ,$240.55 ,$91.66 ,$91.66 ,$158.76 ,$117.16 ,$117.73 ,$28.57 ,$28.27 ,$94.32 ,$240.55 ,$197.07 ,$148.29 ,$79.24 ,$254.70 ,$183.32 ,$89.83 ,$183.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$791.00 ,$569.52 ,$28.27 ,$791.00 ,$514.15 ,$64.03 ,$221.48 ,$437.42 ,$64.03 ,$460.36 ,$64.03 ,$414.48 ,$64.03 ,$131.99 ,$727.72 ,$163.35 ,$64.03 ,$672.35 ,$711.90 ,$65.32 ,$593.25 ,$553.70 ,$553.70 ,$64.03 ,$553.70 ,$609.07 ,$609.07 ,$163.35 ,$672.35 ,$65.34 ,$65.34 ,$443.75 ,$327.47 ,$329.06 ,$28.57 ,$28.27 ,$67.24 ,$672.35 ,$140.48 ,$414.48 ,$221.48 ,$711.90 ,$130.68 ,$64.03 ,$514.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000174,81372,HC CLASS 1 TYPING COMPLETE LOW RESOLUTION-90,310,1 ,$780.00 ,$561.60 ,$92.00 ,"$1,008.98 ",$507.00 ,$395.52 ,$218.40 ,$431.34 ,$395.52 ,$453.96 ,$395.52 ,$408.72 ,$395.52 ,$780.00 ,$717.60 ,"$1,008.98 ",$395.52 ,$663.00 ,$702.00 ,$403.43 ,$585.00 ,$546.00 ,$546.00 ,$395.52 ,$546.00 ,$600.60 ,$600.60 ,$780.00 ,$663.00 ,$403.59 ,$403.59 ,$437.58 ,$322.92 ,$324.48 ,$93.01 ,$92.00 ,$415.29 ,$663.00 ,$867.72 ,$408.72 ,$218.40 ,$702.00 ,$780.00 ,$395.52 ,$507.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000178,81377,HC HLA CLASS 2 TYPE 1 AG EQV LR-90,310,1 ,$929.00 ,$668.88 ,$28.27 ,$929.00 ,$603.85 ,$92.85 ,$260.12 ,$513.74 ,$92.85 ,$540.68 ,$92.85 ,$486.80 ,$92.85 ,$191.37 ,$854.68 ,$236.85 ,$92.85 ,$789.65 ,$836.10 ,$94.70 ,$696.75 ,$650.30 ,$650.30 ,$92.85 ,$650.30 ,$715.33 ,$715.33 ,$236.85 ,$789.65 ,$94.74 ,$94.74 ,$521.17 ,$384.61 ,$386.46 ,$28.57 ,$28.27 ,$97.49 ,$789.65 ,$203.69 ,$486.80 ,$260.12 ,$836.10 ,$189.48 ,$92.85 ,$603.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000180,81383,HC HLA 2 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,$929.00 ,$668.88 ,$28.27 ,$929.00 ,$603.85 ,$106.95 ,$260.12 ,$513.74 ,$106.95 ,$540.68 ,$106.95 ,$486.80 ,$106.95 ,$220.44 ,$854.68 ,$272.83 ,$106.95 ,$789.65 ,$836.10 ,$109.08 ,$696.75 ,$650.30 ,$650.30 ,$106.95 ,$650.30 ,$715.33 ,$715.33 ,$272.83 ,$789.65 ,$109.13 ,$109.13 ,$521.17 ,$384.61 ,$386.46 ,$28.57 ,$28.27 ,$112.30 ,$789.65 ,$234.63 ,$486.80 ,$260.12 ,$836.10 ,$218.26 ,$106.95 ,$603.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000181,81400,HC MOLECULAR PATH PROC LEVEL 1-90,310,1 ,$509.00 ,$366.48 ,$28.27 ,$509.00 ,$330.85 ,$62.68 ,$142.52 ,$281.48 ,$62.68 ,$296.24 ,$62.68 ,$266.72 ,$62.68 ,$129.20 ,$468.28 ,$159.90 ,$62.68 ,$432.65 ,$458.10 ,$63.94 ,$381.75 ,$356.30 ,$356.30 ,$62.68 ,$356.30 ,$391.93 ,$391.93 ,$159.90 ,$432.65 ,$63.96 ,$63.96 ,$285.55 ,$210.73 ,$211.74 ,$28.57 ,$28.27 ,$65.82 ,$432.65 ,$137.51 ,$266.72 ,$142.52 ,$458.10 ,$127.92 ,$62.68 ,$330.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000183,81401,HC MOLECULAR PATH PROC LEVEL 2-90,310,1 ,$893.00 ,$642.96 ,$28.27 ,$893.00 ,$580.45 , N/A ,$250.04 ,$493.83 , N/A ,$519.73 , N/A ,$467.93 , N/A ,$401.85 ,$821.56 ,$625.10 , N/A ,$759.05 ,$803.70 , N/A ,$669.75 ,$625.10 ,$625.10 , N/A ,$625.10 ,$687.61 ,$687.61 , N/A ,$759.05 , N/A , N/A ,$500.97 ,$369.70 ,$371.49 ,$28.57 ,$28.27 , N/A ,$759.05 ,$535.80 ,$467.93 ,$250.04 ,$803.70 ,$274.00 , N/A ,$580.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,"$1,159.00 ",$834.48 ,$28.27 ,"$1,159.00 ",$753.35 , N/A ,$324.52 ,$640.93 , N/A ,$674.54 , N/A ,$607.32 , N/A ,$521.55 ,"$1,066.28 ",$811.30 , N/A ,$985.15 ,"$1,043.10 ", N/A ,$869.25 ,$811.30 ,$811.30 , N/A ,$811.30 ,$892.43 ,$892.43 , N/A ,$985.15 , N/A , N/A ,$650.20 ,$479.83 ,$482.14 ,$28.57 ,$28.27 , N/A ,$985.15 ,$695.40 ,$607.32 ,$324.52 ,"$1,043.10 ",$370.40 , N/A ,$753.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000205,81219,HC CALR GENE ANALYSIS EXON 9-90,310,1 ,$343.00 ,$246.96 ,$92.00 ,$343.00 ,$222.95 ,$119.20 ,$96.04 ,$189.68 ,$119.20 ,$199.63 ,$119.20 ,$179.73 ,$119.20 ,$245.69 ,$315.56 ,$304.08 ,$119.20 ,$291.55 ,$308.70 ,$121.58 ,$257.25 ,$240.10 ,$240.10 ,$119.20 ,$240.10 ,$264.11 ,$264.11 ,$304.08 ,$291.55 ,$121.63 ,$121.63 ,$192.42 ,$142.00 ,$142.69 ,$93.01 ,$92.00 ,$125.16 ,$291.55 ,$261.50 ,$179.73 ,$96.04 ,$308.70 ,$243.26 ,$119.20 ,$222.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),31000284,81339,HC MPL GENE SEQ ANLY EXON- 90,310,1 ,$572.00 ,$411.84 ,$92.00 ,$572.00 ,$371.80 ,$181.50 ,$160.16 ,$316.32 ,$181.50 ,$332.90 ,$181.50 ,$299.73 ,$181.50 ,$374.10 ,$526.24 ,$463.00 ,$181.50 ,$486.20 ,$514.80 ,$185.12 ,$429.00 ,$400.40 ,$400.40 ,$181.50 ,$400.40 ,$440.44 ,$440.44 ,$463.00 ,$486.20 ,$185.20 ,$185.20 ,$320.89 ,$236.81 ,$237.95 ,$93.01 ,$92.00 ,$190.57 ,$486.20 ,$398.18 ,$299.73 ,$160.16 ,$514.80 ,$370.40 ,$181.50 ,$371.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31040112,81279,HC JAK2 GENE TARGETED SEQ ALYS- 90,310,1 ,$572.00 ,$411.84 ,$92.00 ,$572.00 ,$371.80 ,$181.50 ,$160.16 ,$316.32 ,$181.50 ,$332.90 ,$181.50 ,$299.73 ,$181.50 ,$374.10 ,$526.24 ,$463.00 ,$181.50 ,$486.20 ,$514.80 ,$185.12 ,$429.00 ,$400.40 ,$400.40 ,$181.50 ,$400.40 ,$440.44 ,$440.44 ,$463.00 ,$486.20 ,$185.20 ,$185.20 ,$320.89 ,$236.81 ,$237.95 ,$93.01 ,$92.00 ,$190.57 ,$486.20 ,$398.18 ,$299.73 ,$160.16 ,$514.80 ,$370.40 ,$181.50 ,$371.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100107,88142,HC THINPREP PAP,311,1 ,$174.00 ,$125.28 ,$16.50 ,$174.00 ,$113.10 ,$19.85 ,$48.72 ,$96.22 ,$19.85 ,$101.27 ,$19.85 ,$91.18 ,$19.85 ,$40.93 ,$160.08 ,$50.65 ,$19.85 ,$147.90 ,$156.60 ,$20.26 ,$130.50 ,$121.80 ,$121.80 ,$19.85 ,$121.80 ,$133.98 ,$133.98 ,$50.65 ,$147.90 ,$20.26 ,$20.26 ,$97.61 ,$72.04 ,$72.38 ,$16.68 ,$16.50 ,$20.84 ,$147.90 ,$43.56 ,$91.18 ,$48.72 ,$156.60 ,$40.52 ,$19.85 ,$113.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$85.00 ,$61.20 ,$23.80 ,$778.14 ,$55.25 ,$305.03 ,$23.80 ,$47.01 ,$305.03 ,$49.47 ,$83.30 ,$44.54 ,$83.30 ,$85.00 ,$78.20 ,$778.14 ,$305.03 ,$72.25 ,$76.50 ,$83.30 ,$63.75 ,$59.50 ,$59.50 ,$305.03 ,$59.50 ,$65.45 ,$65.45 ,$85.00 ,$72.25 ,$311.26 ,$311.26 ,$47.69 ,$35.19 ,$35.36 ,$25.29 ,$25.02 ,$320.28 ,$72.25 ,$669.20 ,$44.54 ,$23.80 ,$76.50 ,$85.00 ,$305.03 ,$55.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$124.00 ,$89.28 ,$25.02 ,$124.00 ,$80.60 , N/A ,$34.72 ,$68.57 , N/A ,$72.17 , N/A ,$64.98 , N/A , N/A ,$114.08 , N/A , N/A ,$105.40 ,$111.60 , N/A ,$93.00 ,$86.80 ,$86.80 , N/A ,$86.80 ,$95.48 ,$95.48 , N/A ,$105.40 , N/A , N/A ,$69.56 ,$51.34 ,$51.58 ,$25.29 ,$25.02 , N/A ,$105.40 , N/A ,$64.98 ,$34.72 ,$111.60 ,$46.06 , N/A ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100248,88187,HC FLOW CYTO INT 2-8 MARKERS-90,311,1 ,$227.00 ,$163.44 ,$22.75 ,$227.00 ,$147.55 , N/A ,$63.56 ,$125.53 , N/A ,$132.11 , N/A ,$118.95 , N/A , N/A ,$208.84 , N/A , N/A ,$192.95 ,$204.30 , N/A ,$170.25 ,$158.90 ,$158.90 , N/A ,$158.90 ,$174.79 ,$174.79 , N/A ,$192.95 , N/A , N/A ,$127.35 ,$93.98 ,$94.43 ,$23.01 ,$22.75 , N/A ,$192.95 , N/A ,$118.95 ,$63.56 ,$204.30 ,$73.28 , N/A ,$147.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100251,88230,HC TISSUE CULT NONNEO LYMPHOCYTE-90,311,1 ,"$1,687.00 ","$1,214.64 ",$25.02 ,"$1,687.00 ","$1,096.55 ",$114.16 ,$472.36 ,$932.91 ,$114.16 ,$981.83 ,$114.16 ,$883.99 ,$114.16 ,$235.31 ,"$1,552.04 ",$291.23 ,$114.16 ,"$1,433.95 ","$1,518.30 ",$116.44 ,"$1,265.25 ","$1,180.90 ","$1,180.90 ",$114.16 ,"$1,180.90 ","$1,298.99 ","$1,298.99 ",$291.23 ,"$1,433.95 ",$116.49 ,$116.49 ,$946.41 ,$698.42 ,$701.79 ,$25.29 ,$25.02 ,$119.86 ,"$1,433.95 ",$250.45 ,$883.99 ,$472.36 ,"$1,518.30 ",$232.98 ,$114.16 ,"$1,096.55 " HSHS HOLY FAMILY HOSPITAL INC (ACU),31100257,88262,HC CHROM COUNT 15-20/2-90,311,1 ,$661.00 ,$475.92 ,$28.27 ,$661.00 ,$429.65 ,$122.98 ,$185.08 ,$365.53 ,$122.98 ,$384.70 ,$122.98 ,$346.36 ,$122.98 ,$253.49 ,$608.12 ,$313.73 ,$122.98 ,$561.85 ,$594.90 ,$125.44 ,$495.75 ,$462.70 ,$462.70 ,$122.98 ,$462.70 ,$508.97 ,$508.97 ,$313.73 ,$561.85 ,$125.49 ,$125.49 ,$370.82 ,$273.65 ,$274.98 ,$28.57 ,$28.27 ,$129.12 ,$561.85 ,$269.80 ,$346.36 ,$185.08 ,$594.90 ,$250.98 ,$122.98 ,$429.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100262,88271,HC MCG DNA PROBE(BCR/ABL)-90,311,1 ,$100.00 ,$72.00 ,$20.99 ,$100.00 ,$65.00 ,$20.99 ,$28.00 ,$55.30 ,$20.99 ,$58.20 ,$20.99 ,$52.40 ,$20.99 ,$43.27 ,$92.00 ,$53.55 ,$20.99 ,$85.00 ,$90.00 ,$21.41 ,$75.00 ,$70.00 ,$70.00 ,$20.99 ,$70.00 ,$77.00 ,$77.00 ,$53.55 ,$85.00 ,$21.42 ,$21.42 ,$56.10 ,$41.40 ,$41.60 ,$28.57 ,$28.27 ,$22.04 ,$85.00 ,$46.05 ,$52.40 ,$28.00 ,$90.00 ,$42.84 ,$20.99 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100271,88275,HC MCG INTER INSIT BCR/ABL 100-90,311,1 ,$189.00 ,$136.08 ,$28.27 ,$189.00 ,$122.85 ,$50.17 ,$52.92 ,$104.52 ,$50.17 ,$110.00 ,$50.17 ,$99.04 ,$50.17 ,$103.40 ,$173.88 ,$127.98 ,$50.17 ,$160.65 ,$170.10 ,$51.17 ,$141.75 ,$132.30 ,$132.30 ,$50.17 ,$132.30 ,$145.53 ,$145.53 ,$127.98 ,$160.65 ,$51.19 ,$51.19 ,$106.03 ,$78.25 ,$78.62 ,$28.57 ,$28.27 ,$52.67 ,$160.65 ,$110.06 ,$99.04 ,$52.92 ,$170.10 ,$102.38 ,$50.17 ,$122.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100274,88289,HC CHROM ADDL HIGH RES-90,311,1 ,$142.00 ,$102.24 ,$28.27 ,$142.00 ,$92.30 ,$33.74 ,$39.76 ,$78.53 ,$33.74 ,$82.64 ,$33.74 ,$74.41 ,$33.74 ,$69.55 ,$130.64 ,$86.08 ,$33.74 ,$120.70 ,$127.80 ,$34.42 ,$106.50 ,$99.40 ,$99.40 ,$33.74 ,$99.40 ,$109.34 ,$109.34 ,$86.08 ,$120.70 ,$34.43 ,$34.43 ,$79.66 ,$58.79 ,$59.07 ,$28.57 ,$28.27 ,$35.43 ,$120.70 ,$74.02 ,$74.41 ,$39.76 ,$127.80 ,$68.86 ,$33.74 ,$92.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100293,88175,HC CYTOPATH PAP DIAG INIT/REDO,311,1 ,$172.00 ,$123.84 ,$16.50 ,$172.00 ,$111.80 ,$26.08 ,$48.16 ,$95.12 ,$26.08 ,$100.10 ,$26.08 ,$90.13 ,$26.08 ,$53.75 ,$158.24 ,$66.53 ,$26.08 ,$146.20 ,$154.80 ,$26.60 ,$129.00 ,$120.40 ,$120.40 ,$26.08 ,$120.40 ,$132.44 ,$132.44 ,$66.53 ,$146.20 ,$26.61 ,$26.61 ,$96.49 ,$71.21 ,$71.55 ,$16.68 ,$16.50 ,$27.38 ,$146.20 ,$57.21 ,$90.13 ,$48.16 ,$154.80 ,$53.22 ,$26.08 ,$111.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100294,88184,HC FLOW CYTO 1ST MARKER,311,1 ,$121.00 ,$87.12 ,$25.02 ,$778.14 ,$78.65 ,$305.03 ,$33.88 ,$66.91 ,$305.03 ,$70.42 ,$118.58 ,$63.40 ,$118.58 ,$121.00 ,$111.32 ,$778.14 ,$305.03 ,$102.85 ,$108.90 ,$118.58 ,$90.75 ,$84.70 ,$84.70 ,$305.03 ,$84.70 ,$93.17 ,$93.17 ,$121.00 ,$102.85 ,$311.26 ,$311.26 ,$67.88 ,$50.09 ,$50.34 ,$25.29 ,$25.02 ,$320.28 ,$102.85 ,$669.20 ,$63.40 ,$33.88 ,$108.90 ,$121.00 ,$305.03 ,$78.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100295,88185,HC FLOW CYTO EA ADD MARKER,311,1 ,$104.00 ,$74.88 ,$25.02 ,$104.00 ,$67.60 , N/A ,$29.12 ,$57.51 , N/A ,$60.53 , N/A ,$54.50 , N/A , N/A ,$95.68 , N/A , N/A ,$88.40 ,$93.60 , N/A ,$78.00 ,$72.80 ,$72.80 , N/A ,$72.80 ,$80.08 ,$80.08 , N/A ,$88.40 , N/A , N/A ,$58.34 ,$43.06 ,$43.26 ,$25.29 ,$25.02 , N/A ,$88.40 , N/A ,$54.50 ,$29.12 ,$93.60 ,$46.06 , N/A ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100299,88104,HC CYTOPATH FLD SMEAR,311,1 ,$150.00 ,$108.00 ,$22.75 ,$150.00 ,$97.50 ,$31.96 ,$42.00 ,$82.95 ,$31.96 ,$87.30 ,$31.96 ,$78.60 ,$31.96 ,$65.88 ,$138.00 ,$81.53 ,$31.96 ,$127.50 ,$135.00 ,$32.60 ,$112.50 ,$105.00 ,$105.00 ,$31.96 ,$105.00 ,$115.50 ,$115.50 ,$81.53 ,$127.50 ,$32.61 ,$32.61 ,$84.15 ,$62.10 ,$62.40 ,$23.01 ,$22.75 ,$33.56 ,$127.50 ,$70.12 ,$78.60 ,$42.00 ,$135.00 ,$67.68 ,$31.96 ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100300,88106,HC CYTOPATH FLUID SIMP FILTER,311,1 ,$95.00 ,$68.40 ,$22.75 ,$95.00 ,$61.75 ,$23.49 ,$26.60 ,$52.54 ,$23.49 ,$55.29 ,$23.49 ,$49.78 ,$23.49 ,$48.42 ,$87.40 ,$59.93 ,$23.49 ,$80.75 ,$85.50 ,$23.96 ,$71.25 ,$66.50 ,$66.50 ,$23.49 ,$66.50 ,$73.15 ,$73.15 ,$59.93 ,$80.75 ,$23.97 ,$23.97 ,$53.30 ,$39.33 ,$39.52 ,$23.01 ,$22.75 ,$24.67 ,$80.75 ,$51.54 ,$49.78 ,$26.60 ,$85.50 ,$49.34 ,$23.49 ,$61.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100301,88175,HC CYTOPATH PAP SCREEN INIT/REDO,311,1 ,$235.00 ,$169.20 ,$16.50 ,$235.00 ,$152.75 ,$26.08 ,$65.80 ,$129.96 ,$26.08 ,$136.77 ,$26.08 ,$123.14 ,$26.08 ,$53.75 ,$216.20 ,$66.53 ,$26.08 ,$199.75 ,$211.50 ,$26.60 ,$176.25 ,$164.50 ,$164.50 ,$26.08 ,$164.50 ,$180.95 ,$180.95 ,$66.53 ,$199.75 ,$26.61 ,$26.61 ,$131.84 ,$97.29 ,$97.76 ,$16.68 ,$16.50 ,$27.38 ,$199.75 ,$57.21 ,$123.14 ,$65.80 ,$211.50 ,$53.22 ,$26.08 ,$152.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100302,88108,HC CYTOPATH CONCENTRATION,311,1 ,$85.00 ,$61.20 ,$22.75 ,$85.00 ,$55.25 ,$31.96 ,$23.80 ,$47.01 ,$31.96 ,$49.47 ,$31.96 ,$44.54 ,$31.96 ,$65.88 ,$78.20 ,$81.53 ,$31.96 ,$72.25 ,$76.50 ,$32.60 ,$63.75 ,$59.50 ,$59.50 ,$31.96 ,$59.50 ,$65.45 ,$65.45 ,$81.53 ,$72.25 ,$32.61 ,$32.61 ,$47.69 ,$35.19 ,$35.36 ,$23.01 ,$22.75 ,$33.56 ,$72.25 ,$70.12 ,$44.54 ,$23.80 ,$76.50 ,$67.68 ,$31.96 ,$55.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100303,88172,HC FINE NEEDLE EVAL,311,1 ,$526.00 ,$378.72 ,$22.75 ,$526.00 ,$341.90 ,$147.99 ,$147.28 ,$290.88 ,$147.99 ,$306.13 ,$147.99 ,$275.62 ,$147.99 ,$305.05 ,$483.92 ,$377.53 ,$147.99 ,$447.10 ,$473.40 ,$150.95 ,$394.50 ,$368.20 ,$368.20 ,$147.99 ,$368.20 ,$405.02 ,$405.02 ,$377.53 ,$447.10 ,$151.01 ,$151.01 ,$295.09 ,$217.76 ,$218.82 ,$23.01 ,$22.75 ,$155.39 ,$447.10 ,$324.68 ,$275.62 ,$147.28 ,$473.40 ,$298.32 ,$147.99 ,$341.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100304,88173,HC FINE NEEDLE INTERP,311,1 ,$225.00 ,$162.00 ,$22.75 ,$225.00 ,$146.25 ,$47.19 ,$63.00 ,$124.43 ,$47.19 ,$130.95 ,$47.19 ,$117.90 ,$47.19 ,$97.27 ,$207.00 ,$120.38 ,$47.19 ,$191.25 ,$202.50 ,$48.13 ,$168.75 ,$157.50 ,$157.50 ,$47.19 ,$157.50 ,$173.25 ,$173.25 ,$120.38 ,$191.25 ,$48.15 ,$48.15 ,$126.23 ,$93.15 ,$93.60 ,$23.01 ,$22.75 ,$49.55 ,$191.25 ,$103.53 ,$117.90 ,$63.00 ,$202.50 ,$99.52 ,$47.19 ,$146.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100306,88160,HC CYTOPATH SMEAR NON GYN,311,1 ,$89.00 ,$64.08 ,$22.75 ,$89.00 ,$57.85 ,$23.49 ,$24.92 ,$49.22 ,$23.49 ,$51.80 ,$23.49 ,$46.64 ,$23.49 ,$48.42 ,$81.88 ,$59.93 ,$23.49 ,$75.65 ,$80.10 ,$23.96 ,$66.75 ,$62.30 ,$62.30 ,$23.49 ,$62.30 ,$68.53 ,$68.53 ,$59.93 ,$75.65 ,$23.97 ,$23.97 ,$49.93 ,$36.85 ,$37.02 ,$23.01 ,$22.75 ,$24.67 ,$75.65 ,$51.54 ,$46.64 ,$24.92 ,$80.10 ,$49.34 ,$23.49 ,$57.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100310,88121,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC COMP ASSIST-90,311,1 ,$412.00 ,$296.64 ,$25.02 ,$412.00 ,$267.80 ,$147.99 ,$115.36 ,$227.84 ,$147.99 ,$239.78 ,$147.99 ,$215.89 ,$147.99 ,$305.05 ,$379.04 ,$377.53 ,$147.99 ,$350.20 ,$370.80 ,$150.95 ,$309.00 ,$288.40 ,$288.40 ,$147.99 ,$288.40 ,$317.24 ,$317.24 ,$377.53 ,$350.20 ,$151.01 ,$151.01 ,$231.13 ,$170.57 ,$171.39 ,$25.29 ,$25.02 ,$155.39 ,$350.20 ,$324.68 ,$215.89 ,$115.36 ,$370.80 ,$412.00 ,$147.99 ,$267.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100312,88189,HC FLOW CYTO INT >16 MARKERS-90,311,1 ,$252.00 ,$181.44 ,$22.75 ,$252.00 ,$163.80 , N/A ,$70.56 ,$139.36 , N/A ,$146.66 , N/A ,$132.05 , N/A , N/A ,$231.84 , N/A , N/A ,$214.20 ,$226.80 , N/A ,$189.00 ,$176.40 ,$176.40 , N/A ,$176.40 ,$194.04 ,$194.04 , N/A ,$214.20 , N/A , N/A ,$141.37 ,$104.33 ,$104.83 ,$23.01 ,$22.75 , N/A ,$214.20 , N/A ,$132.05 ,$70.56 ,$226.80 ,$170.28 , N/A ,$163.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100314,88142,HC THINPREP PAP,311,1 ,$84.00 ,$60.48 ,$16.50 ,$84.00 ,$54.60 ,$19.85 ,$23.52 ,$46.45 ,$19.85 ,$48.89 ,$19.85 ,$44.02 ,$19.85 ,$40.93 ,$77.28 ,$50.65 ,$19.85 ,$71.40 ,$75.60 ,$20.26 ,$63.00 ,$58.80 ,$58.80 ,$19.85 ,$58.80 ,$64.68 ,$64.68 ,$50.65 ,$71.40 ,$20.26 ,$20.26 ,$47.12 ,$34.78 ,$34.94 ,$16.68 ,$16.50 ,$20.84 ,$71.40 ,$43.56 ,$44.02 ,$23.52 ,$75.60 ,$40.52 ,$19.85 ,$54.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),31100319,88104,HC CYTOPATH FLD SMEAR-90,311,1 ,$150.00 ,$108.00 ,$22.75 ,$150.00 ,$97.50 ,$31.96 ,$42.00 ,$82.95 ,$31.96 ,$87.30 ,$31.96 ,$78.60 ,$31.96 ,$65.88 ,$138.00 ,$81.53 ,$31.96 ,$127.50 ,$135.00 ,$32.60 ,$112.50 ,$105.00 ,$105.00 ,$31.96 ,$105.00 ,$115.50 ,$115.50 ,$81.53 ,$127.50 ,$32.61 ,$32.61 ,$84.15 ,$62.10 ,$62.40 ,$23.01 ,$22.75 ,$33.56 ,$127.50 ,$70.12 ,$78.60 ,$42.00 ,$135.00 ,$67.68 ,$31.96 ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200296,88311,HC DECALCIFICATION,312,1 ,$73.00 ,$52.56 ,$17.44 ,$73.00 ,$47.45 , N/A ,$20.44 ,$40.37 , N/A ,$42.49 , N/A ,$38.25 , N/A , N/A ,$67.16 , N/A , N/A ,$62.05 ,$65.70 , N/A ,$54.75 ,$51.10 ,$51.10 , N/A ,$51.10 ,$56.21 ,$56.21 , N/A ,$62.05 , N/A , N/A ,$40.95 ,$30.22 ,$30.37 ,$23.01 ,$22.75 , N/A ,$62.05 , N/A ,$38.25 ,$20.44 ,$65.70 ,$17.44 , N/A ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200297,88302,HC GROSS AND MICRO LEVEL II,312,1 ,$99.00 ,$71.28 ,$22.75 ,$99.00 ,$64.35 ,$23.49 ,$27.72 ,$54.75 ,$23.49 ,$57.62 ,$23.49 ,$51.88 ,$23.49 ,$48.42 ,$91.08 ,$59.93 ,$23.49 ,$84.15 ,$89.10 ,$23.96 ,$74.25 ,$69.30 ,$69.30 ,$23.49 ,$69.30 ,$76.23 ,$76.23 ,$59.93 ,$84.15 ,$23.97 ,$23.97 ,$55.54 ,$40.99 ,$41.18 ,$23.01 ,$22.75 ,$24.67 ,$84.15 ,$51.54 ,$51.88 ,$27.72 ,$89.10 ,$49.34 ,$23.49 ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200298,88304,HC GROSS AND MICRO LEVEL III,312,1 ,$298.00 ,$214.56 ,$22.75 ,$298.00 ,$193.70 ,$47.19 ,$83.44 ,$164.79 ,$47.19 ,$173.44 ,$47.19 ,$156.15 ,$47.19 ,$97.27 ,$274.16 ,$120.38 ,$47.19 ,$253.30 ,$268.20 ,$48.13 ,$223.50 ,$208.60 ,$208.60 ,$47.19 ,$208.60 ,$229.46 ,$229.46 ,$120.38 ,$253.30 ,$48.15 ,$48.15 ,$167.18 ,$123.37 ,$123.97 ,$23.01 ,$22.75 ,$49.55 ,$253.30 ,$103.53 ,$156.15 ,$83.44 ,$268.20 ,$99.52 ,$47.19 ,$193.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200299,88305,HC GROSS AND MICRO LEVEL IV,312,1 ,$369.00 ,$265.68 ,$22.75 ,$369.00 ,$239.85 ,$47.19 ,$103.32 ,$204.06 ,$47.19 ,$214.76 ,$47.19 ,$193.36 ,$47.19 ,$97.27 ,$339.48 ,$120.38 ,$47.19 ,$313.65 ,$332.10 ,$48.13 ,$276.75 ,$258.30 ,$258.30 ,$47.19 ,$258.30 ,$284.13 ,$284.13 ,$120.38 ,$313.65 ,$48.15 ,$48.15 ,$207.01 ,$152.77 ,$153.50 ,$23.01 ,$22.75 ,$49.55 ,$313.65 ,$103.53 ,$193.36 ,$103.32 ,$332.10 ,$99.52 ,$47.19 ,$239.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200300,88307,HC GROSS AND MICRO LEVEL V,312,1 ,$785.00 ,$565.20 ,$25.02 ,$785.00 ,$510.25 ,$305.03 ,$219.80 ,$434.11 ,$305.03 ,$456.87 ,$305.03 ,$411.34 ,$305.03 ,$628.74 ,$722.20 ,$778.14 ,$305.03 ,$667.25 ,$706.50 ,$311.13 ,$588.75 ,$549.50 ,$549.50 ,$305.03 ,$549.50 ,$604.45 ,$604.45 ,$778.14 ,$667.25 ,$311.26 ,$311.26 ,$440.39 ,$324.99 ,$326.56 ,$25.29 ,$25.02 ,$320.28 ,$667.25 ,$669.20 ,$411.34 ,$219.80 ,$706.50 ,$582.52 ,$305.03 ,$510.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200301,88309,HC GROSS AND MICRO LEVEL VI,312,1 ,$335.00 ,$241.20 ,$25.02 ,"$1,864.28 ",$217.75 ,$730.80 ,$93.80 ,$185.26 ,$730.80 ,$194.97 ,$328.30 ,$175.54 ,$328.30 ,$335.00 ,$308.20 ,"$1,864.28 ",$730.80 ,$284.75 ,$301.50 ,$328.30 ,$251.25 ,$234.50 ,$234.50 ,$730.80 ,$234.50 ,$257.95 ,$257.95 ,$335.00 ,$284.75 ,$745.71 ,$745.71 ,$187.94 ,$138.69 ,$139.36 ,$25.29 ,$25.02 ,$767.34 ,$284.75 ,"$1,603.28 ",$175.54 ,$93.80 ,$301.50 ,$335.00 ,$730.80 ,$217.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200302,88300,HC GROSS ONLY LEVEL I,312,1 ,$77.00 ,$55.44 ,$21.56 ,$77.00 ,$50.05 ,$23.49 ,$21.56 ,$42.58 ,$23.49 ,$44.81 ,$23.49 ,$40.35 ,$23.49 ,$48.42 ,$70.84 ,$59.93 ,$23.49 ,$65.45 ,$69.30 ,$23.96 ,$57.75 ,$53.90 ,$53.90 ,$23.49 ,$53.90 ,$59.29 ,$59.29 ,$59.93 ,$65.45 ,$23.97 ,$23.97 ,$43.20 ,$31.88 ,$32.03 ,$23.01 ,$22.75 ,$24.67 ,$65.45 ,$51.54 ,$40.35 ,$21.56 ,$69.30 ,$49.34 ,$23.49 ,$50.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200303,88312,HC SPECIAL STAIN I,312,1 ,$232.00 ,$167.04 ,$22.75 ,$232.00 ,$150.80 ,$47.19 ,$64.96 ,$128.30 ,$47.19 ,$135.02 ,$47.19 ,$121.57 ,$47.19 ,$97.27 ,$213.44 ,$120.38 ,$47.19 ,$197.20 ,$208.80 ,$48.13 ,$174.00 ,$162.40 ,$162.40 ,$47.19 ,$162.40 ,$178.64 ,$178.64 ,$120.38 ,$197.20 ,$48.15 ,$48.15 ,$130.15 ,$96.05 ,$96.51 ,$23.01 ,$22.75 ,$49.55 ,$197.20 ,$103.53 ,$121.57 ,$64.96 ,$208.80 ,$99.52 ,$47.19 ,$150.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200304,88313,HC SPECIAL STAIN II,312,1 ,$190.00 ,$136.80 ,$22.75 ,$190.00 ,$123.50 ,$31.96 ,$53.20 ,$105.07 ,$31.96 ,$110.58 ,$31.96 ,$99.56 ,$31.96 ,$65.88 ,$174.80 ,$81.53 ,$31.96 ,$161.50 ,$171.00 ,$32.60 ,$142.50 ,$133.00 ,$133.00 ,$31.96 ,$133.00 ,$146.30 ,$146.30 ,$81.53 ,$161.50 ,$32.61 ,$32.61 ,$106.59 ,$78.66 ,$79.04 ,$23.01 ,$22.75 ,$33.56 ,$161.50 ,$70.12 ,$99.56 ,$53.20 ,$171.00 ,$67.68 ,$31.96 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200305,88342,HC IMMUNOHISOCHEMIST EA AB REPEAT,312,1 ,$596.00 ,$429.12 ,$22.75 ,$596.00 ,$387.40 ,$147.99 ,$166.88 ,$329.59 ,$147.99 ,$346.87 ,$147.99 ,$312.30 ,$147.99 ,$305.05 ,$548.32 ,$377.53 ,$147.99 ,$506.60 ,$536.40 ,$150.95 ,$447.00 ,$417.20 ,$417.20 ,$147.99 ,$417.20 ,$458.92 ,$458.92 ,$377.53 ,$506.60 ,$151.01 ,$151.01 ,$334.36 ,$246.74 ,$247.94 ,$23.01 ,$22.75 ,$155.39 ,$506.60 ,$324.68 ,$312.30 ,$166.88 ,$536.40 ,$298.32 ,$147.99 ,$387.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200306,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$728.00 ,$524.16 ,$22.75 ,$778.14 ,$473.20 ,$305.03 ,$203.84 ,$402.58 ,$305.03 ,$423.70 ,$305.03 ,$381.47 ,$305.03 ,$628.74 ,$669.76 ,$778.14 ,$305.03 ,$618.80 ,$655.20 ,$311.13 ,$546.00 ,$509.60 ,$509.60 ,$305.03 ,$509.60 ,$560.56 ,$560.56 ,$728.00 ,$618.80 ,$311.26 ,$311.26 ,$408.41 ,$301.39 ,$302.85 ,$23.01 ,$22.75 ,$320.28 ,$618.80 ,$669.20 ,$381.47 ,$203.84 ,$655.20 ,$582.52 ,$305.03 ,$473.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200307,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$299.00 ,$215.28 ,$22.75 ,$299.00 ,$194.35 , N/A ,$83.72 ,$165.35 , N/A ,$174.02 , N/A ,$156.68 , N/A , N/A ,$275.08 , N/A , N/A ,$254.15 ,$269.10 , N/A ,$224.25 ,$209.30 ,$209.30 , N/A ,$209.30 ,$230.23 ,$230.23 , N/A ,$254.15 , N/A , N/A ,$167.74 ,$123.79 ,$124.38 ,$23.01 ,$22.75 , N/A ,$254.15 , N/A ,$156.68 ,$83.72 ,$269.10 ,$130.50 , N/A ,$194.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200308,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$177.00 ,$127.44 ,$25.02 ,$177.00 ,$115.05 ,$47.19 ,$49.56 ,$97.88 ,$47.19 ,$103.01 ,$47.19 ,$92.75 ,$47.19 ,$97.27 ,$162.84 ,$120.38 ,$47.19 ,$150.45 ,$159.30 ,$48.13 ,$132.75 ,$123.90 ,$123.90 ,$47.19 ,$123.90 ,$136.29 ,$136.29 ,$120.38 ,$150.45 ,$48.15 ,$48.15 ,$99.30 ,$73.28 ,$73.63 ,$25.29 ,$25.02 ,$49.55 ,$150.45 ,$103.53 ,$92.75 ,$49.56 ,$159.30 ,$99.52 ,$47.19 ,$115.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200315,88360,HC MORPHO ANLYS TUMOR MAN,312,1 ,$384.00 ,$276.48 ,$25.02 ,$384.00 ,$249.60 ,$147.99 ,$107.52 ,$212.35 ,$147.99 ,$223.49 ,$147.99 ,$201.22 ,$147.99 ,$305.05 ,$353.28 ,$377.53 ,$147.99 ,$326.40 ,$345.60 ,$150.95 ,$288.00 ,$268.80 ,$268.80 ,$147.99 ,$268.80 ,$295.68 ,$295.68 ,$377.53 ,$326.40 ,$151.01 ,$151.01 ,$215.42 ,$158.98 ,$159.74 ,$25.29 ,$25.02 ,$155.39 ,$326.40 ,$324.68 ,$201.22 ,$107.52 ,$345.60 ,$298.32 ,$147.99 ,$249.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),31200319,88361,HC MORPHO ANLYS COMP ASSIST,312,1 ,$530.00 ,$381.60 ,$25.02 ,$778.14 ,$344.50 ,$305.03 ,$148.40 ,$293.09 ,$305.03 ,$308.46 ,$305.03 ,$277.72 ,$305.03 ,$530.00 ,$487.60 ,$778.14 ,$305.03 ,$450.50 ,$477.00 ,$311.13 ,$397.50 ,$371.00 ,$371.00 ,$305.03 ,$371.00 ,$408.10 ,$408.10 ,$530.00 ,$450.50 ,$311.26 ,$311.26 ,$297.33 ,$219.42 ,$220.48 ,$25.29 ,$25.02 ,$320.28 ,$450.50 ,$669.20 ,$277.72 ,$148.40 ,$477.00 ,$530.00 ,$305.03 ,$344.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$331.00 ,$238.32 ,$92.68 ,$331.00 ,$215.15 , N/A ,$92.68 ,$183.04 , N/A ,$192.64 , N/A ,$173.44 , N/A , N/A ,$304.52 , N/A , N/A ,$281.35 ,$297.90 , N/A ,$248.25 ,$231.70 ,$231.70 , N/A ,$231.70 ,$254.87 ,$254.87 , N/A ,$281.35 , N/A , N/A ,$185.69 ,$137.03 ,$137.70 , N/A , N/A , N/A ,$281.35 , N/A ,$173.44 ,$92.68 ,$297.90 ,$331.00 , N/A ,$215.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000010,24220,HC ARTHROGRAM INJ ELBOW,320,1 ,$761.00 ,$547.92 ,$213.08 ,$761.00 ,$494.65 , N/A ,$213.08 ,$420.83 , N/A ,$442.90 , N/A ,$398.76 , N/A , N/A ,$700.12 , N/A , N/A ,$646.85 ,$684.90 , N/A ,$570.75 ,$532.70 ,$532.70 , N/A ,$532.70 ,$585.97 ,$585.97 , N/A ,$646.85 , N/A , N/A ,$426.92 ,$315.05 ,$316.58 , N/A , N/A , N/A ,$646.85 , N/A ,$398.76 ,$213.08 ,$684.90 ,$505.00 , N/A ,$494.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$331.00 ,$238.32 ,$92.68 ,$331.00 ,$215.15 , N/A ,$92.68 ,$183.04 , N/A ,$192.64 , N/A ,$173.44 , N/A , N/A ,$304.52 , N/A , N/A ,$281.35 ,$297.90 , N/A ,$248.25 ,$231.70 ,$231.70 , N/A ,$231.70 ,$254.87 ,$254.87 , N/A ,$281.35 , N/A , N/A ,$185.69 ,$137.03 ,$137.70 ,$248.03 ,$245.34 , N/A ,$281.35 , N/A ,$173.44 ,$92.68 ,$297.90 ,$331.00 , N/A ,$215.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$331.00 ,$238.32 ,$92.68 ,$331.00 ,$215.15 , N/A ,$92.68 ,$183.04 , N/A ,$192.64 , N/A ,$173.44 , N/A , N/A ,$304.52 , N/A , N/A ,$281.35 ,$297.90 , N/A ,$248.25 ,$231.70 ,$231.70 , N/A ,$231.70 ,$254.87 ,$254.87 , N/A ,$281.35 , N/A , N/A ,$185.69 ,$137.03 ,$137.70 ,$248.03 ,$245.34 , N/A ,$281.35 , N/A ,$173.44 ,$92.68 ,$297.90 ,$331.00 , N/A ,$215.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$731.00 ,$526.32 ,$204.68 ,$731.00 ,$475.15 , N/A ,$204.68 ,$404.24 , N/A ,$425.44 , N/A ,$383.04 , N/A , N/A ,$672.52 , N/A , N/A ,$621.35 ,$657.90 , N/A ,$548.25 ,$511.70 ,$511.70 , N/A ,$511.70 ,$562.87 ,$562.87 , N/A ,$621.35 , N/A , N/A ,$410.09 ,$302.63 ,$304.10 , N/A , N/A , N/A ,$621.35 , N/A ,$383.04 ,$204.68 ,$657.90 ,$505.00 , N/A ,$475.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000016,27648,HC ARTHROGRAM INJ ANKLE,320,1 ,"$1,037.00 ",$746.64 ,$245.34 ,"$1,037.00 ",$674.05 , N/A ,$290.36 ,$573.46 , N/A ,$603.53 , N/A ,$543.39 , N/A , N/A ,$954.04 , N/A , N/A ,$881.45 ,$933.30 , N/A ,$777.75 ,$725.90 ,$725.90 , N/A ,$725.90 ,$798.49 ,$798.49 , N/A ,$881.45 , N/A , N/A ,$581.76 ,$429.32 ,$431.39 ,$248.03 ,$245.34 , N/A ,$881.45 , N/A ,$543.39 ,$290.36 ,$933.30 ,$505.00 , N/A ,$674.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$1,930.00 ","$1,389.60 ",$488.89 ,"$3,572.10 ","$1,254.50 ","$1,400.26 ",$540.40 ,"$1,067.29 ","$1,400.26 ","$1,123.26 ","$1,400.26 ","$1,011.32 ","$1,400.26 ","$1,930.00 ","$1,775.60 ","$3,572.10 ","$1,400.26 ","$1,640.50 ","$1,737.00 ","$1,428.27 ","$1,447.50 ","$1,351.00 ","$1,351.00 ","$1,400.26 ","$1,351.00 ","$1,486.10 ","$1,486.10 ","$1,930.00 ","$1,640.50 ","$1,428.84 ","$1,428.84 ","$1,082.73 ",$799.02 ,$802.88 ,$494.24 ,$488.89 ,"$1,470.27 ","$1,640.50 ","$3,072.01 ","$1,011.32 ",$540.40 ,"$1,737.00 ",$505.00 ,"$1,400.26 ","$1,254.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000027,36002,HC INJ PSEUDOANEURYSM (THROMBIN),320,1 ,"$1,588.00 ","$1,143.36 ",$444.64 ,"$1,588.00 ","$1,032.20 ",$544.45 ,$444.64 ,$878.16 ,$544.45 ,$924.22 ,$544.45 ,$832.11 ,$544.45 ,"$1,122.22 ","$1,460.96 ","$1,388.89 ",$544.45 ,"$1,349.80 ","$1,429.20 ",$555.34 ,"$1,191.00 ","$1,111.60 ","$1,111.60 ",$544.45 ,"$1,111.60 ","$1,222.76 ","$1,222.76 ","$1,388.89 ","$1,349.80 ",$555.56 ,$555.56 ,$890.87 ,$657.43 ,$660.61 , N/A , N/A ,$571.67 ,"$1,349.80 ","$1,194.45 ",$832.11 ,$444.64 ,"$1,429.20 ",$505.00 ,$544.45 ,"$1,032.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,361,1 ,$94.00 ,$67.68 ,$26.32 ,$94.00 ,$61.10 , N/A ,$26.32 ,$51.98 , N/A ,$54.71 , N/A ,$49.26 , N/A , N/A , N/A , N/A , N/A ,$79.90 ,$84.60 , N/A ,$70.50 ,$65.80 ,$65.80 , N/A ,$65.80 ,$72.38 ,$72.38 , N/A ,$79.90 , N/A , N/A ,$52.73 ,$38.92 ,$39.10 ,$34.62 ,$34.25 , N/A ,$79.90 , N/A ,$49.26 ,$26.32 ,$84.60 , N/A , N/A ,$61.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$456.00 ,$328.32 ,$127.68 ,$906.49 ,$296.40 ,$355.35 ,$127.68 ,$252.17 ,$355.35 ,$265.39 ,$355.35 ,$238.94 ,$355.35 ,$456.00 ,$419.52 ,$906.49 ,$355.35 ,$387.60 ,$410.40 ,$362.45 ,$342.00 ,$319.20 ,$319.20 ,$355.35 ,$319.20 ,$351.12 ,$351.12 ,$456.00 ,$387.60 ,$362.60 ,$362.60 ,$255.82 ,$188.78 ,$189.70 ,$430.21 ,$425.54 ,$373.12 ,$387.60 ,$779.58 ,$238.94 ,$127.68 ,$410.40 ,$456.00 ,$355.35 ,$296.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000061,49451,HC RPLC DUODEN/JEJUN TB FLUORO,320,1 ,"$2,465.00 ","$1,774.80 ",$425.54 ,"$2,465.00 ","$1,602.25 ",$776.91 ,$690.20 ,"$1,363.15 ",$776.91 ,"$1,434.63 ",$776.91 ,"$1,291.66 ",$776.91 ,"$1,601.40 ","$2,267.80 ","$1,981.93 ",$776.91 ,"$2,095.25 ","$2,218.50 ",$792.46 ,"$1,848.75 ","$1,725.50 ","$1,725.50 ",$776.91 ,"$1,725.50 ","$1,898.05 ","$1,898.05 ","$1,981.93 ","$2,095.25 ",$792.77 ,$792.77 ,"$1,382.87 ","$1,020.51 ","$1,025.44 ",$430.21 ,$425.54 ,$815.76 ,"$2,095.25 ","$1,704.46 ","$1,291.66 ",$690.20 ,"$2,218.50 ",$505.00 ,$776.91 ,"$1,602.25 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,$675.00 ,$486.00 ,$189.00 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 ,$248.03 ,$245.34 ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$505.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000085,51600,HC INJ CYSTOGRAM,320,1 ,"$1,089.00 ",$784.08 ,$245.34 ,"$1,089.00 ",$707.85 , N/A ,$304.92 ,$602.22 , N/A ,$633.80 , N/A ,$570.64 , N/A , N/A ,"$1,001.88 ", N/A , N/A ,$925.65 ,$980.10 , N/A ,$816.75 ,$762.30 ,$762.30 , N/A ,$762.30 ,$838.53 ,$838.53 , N/A ,$925.65 , N/A , N/A ,$610.93 ,$450.85 ,$453.02 ,$248.03 ,$245.34 , N/A ,$925.65 , N/A ,$570.64 ,$304.92 ,$980.10 ,$505.00 , N/A ,$707.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,"$1,474.00 ","$1,061.28 ",$245.34 ,"$1,474.00 ",$958.10 , N/A ,$412.72 ,$815.12 , N/A ,$857.87 , N/A ,$772.38 , N/A , N/A ,"$1,356.08 ", N/A , N/A ,"$1,252.90 ","$1,326.60 ", N/A ,"$1,105.50 ","$1,031.80 ","$1,031.80 ", N/A ,"$1,031.80 ","$1,134.98 ","$1,134.98 ", N/A ,"$1,252.90 ", N/A , N/A ,$826.91 ,$610.24 ,$613.18 ,$248.03 ,$245.34 , N/A ,"$1,252.90 ", N/A ,$772.38 ,$412.72 ,"$1,326.60 ",$505.00 , N/A ,$958.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$331.00 ,$238.32 ,$92.68 ,$331.00 ,$215.15 , N/A ,$92.68 ,$183.04 , N/A ,$192.64 , N/A ,$173.44 , N/A , N/A ,$304.52 , N/A , N/A ,$281.35 ,$297.90 , N/A ,$248.25 ,$231.70 ,$231.70 , N/A ,$231.70 ,$254.87 ,$254.87 , N/A ,$281.35 , N/A , N/A ,$185.69 ,$137.03 ,$137.70 ,$248.03 ,$245.34 , N/A ,$281.35 , N/A ,$173.44 ,$92.68 ,$297.90 ,$331.00 , N/A ,$215.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$461.00 ,$331.92 ,$39.33 ,$461.00 ,$299.65 ,$81.76 ,$129.08 ,$254.93 ,$81.76 ,$268.30 ,$81.76 ,$241.56 ,$81.76 ,$168.54 ,$424.12 ,$208.59 ,$81.76 ,$391.85 ,$414.90 ,$83.40 ,$345.75 ,$322.70 ,$322.70 ,$81.76 ,$322.70 ,$354.97 ,$354.97 ,$208.59 ,$391.85 ,$83.43 ,$83.43 ,$258.62 ,$190.85 ,$191.78 ,$39.77 ,$39.33 ,$85.85 ,$391.85 ,$179.38 ,$241.56 ,$129.08 ,$414.90 ,$461.00 ,$81.76 ,$299.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$100.59 ,$123.20 ,$243.32 ,$100.59 ,$256.08 ,$100.59 ,$230.56 ,$100.59 ,$207.34 ,$404.80 ,$256.60 ,$100.59 ,$374.00 ,$396.00 ,$102.60 ,$330.00 ,$308.00 ,$308.00 ,$100.59 ,$308.00 ,$338.80 ,$338.80 ,$256.60 ,$374.00 ,$102.64 ,$102.64 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$105.61 ,$374.00 ,$220.68 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$100.59 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$553.00 ,$398.16 ,$39.33 ,$553.00 ,$359.45 ,$100.59 ,$154.84 ,$305.81 ,$100.59 ,$321.85 ,$100.59 ,$289.77 ,$100.59 ,$207.34 ,$508.76 ,$256.60 ,$100.59 ,$470.05 ,$497.70 ,$102.60 ,$414.75 ,$387.10 ,$387.10 ,$100.59 ,$387.10 ,$425.81 ,$425.81 ,$256.60 ,$470.05 ,$102.64 ,$102.64 ,$310.23 ,$228.94 ,$230.05 ,$39.77 ,$39.33 ,$105.61 ,$470.05 ,$220.68 ,$289.77 ,$154.84 ,$497.70 ,$505.00 ,$100.59 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$553.00 ,$398.16 ,$39.33 ,$553.00 ,$359.45 ,$81.76 ,$154.84 ,$305.81 ,$81.76 ,$321.85 ,$81.76 ,$289.77 ,$81.76 ,$168.54 ,$508.76 ,$208.59 ,$81.76 ,$470.05 ,$497.70 ,$83.40 ,$414.75 ,$387.10 ,$387.10 ,$81.76 ,$387.10 ,$425.81 ,$425.81 ,$208.59 ,$470.05 ,$83.43 ,$83.43 ,$310.23 ,$228.94 ,$230.05 ,$39.77 ,$39.33 ,$85.85 ,$470.05 ,$179.38 ,$289.77 ,$154.84 ,$497.70 ,$505.00 ,$81.76 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$100.59 ,$132.72 ,$262.12 ,$100.59 ,$275.87 ,$100.59 ,$248.38 ,$100.59 ,$207.34 ,$436.08 ,$256.60 ,$100.59 ,$402.90 ,$426.60 ,$102.60 ,$355.50 ,$331.80 ,$331.80 ,$100.59 ,$331.80 ,$364.98 ,$364.98 ,$256.60 ,$402.90 ,$102.64 ,$102.64 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$105.61 ,$402.90 ,$220.68 ,$248.38 ,$132.72 ,$426.60 ,$474.00 ,$100.59 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$739.00 ,$532.08 ,$39.33 ,$739.00 ,$480.35 ,$100.59 ,$206.92 ,$408.67 ,$100.59 ,$430.10 ,$100.59 ,$387.24 ,$100.59 ,$207.34 ,$679.88 ,$256.60 ,$100.59 ,$628.15 ,$665.10 ,$102.60 ,$554.25 ,$517.30 ,$517.30 ,$100.59 ,$517.30 ,$569.03 ,$569.03 ,$256.60 ,$628.15 ,$102.64 ,$102.64 ,$414.58 ,$305.95 ,$307.42 ,$39.77 ,$39.33 ,$105.61 ,$628.15 ,$220.68 ,$387.24 ,$206.92 ,$665.10 ,$505.00 ,$100.59 ,$480.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$461.00 ,$331.92 ,$39.33 ,$461.00 ,$299.65 ,$81.76 ,$129.08 ,$254.93 ,$81.76 ,$268.30 ,$81.76 ,$241.56 ,$81.76 ,$168.54 ,$424.12 ,$208.59 ,$81.76 ,$391.85 ,$414.90 ,$83.40 ,$345.75 ,$322.70 ,$322.70 ,$81.76 ,$322.70 ,$354.97 ,$354.97 ,$208.59 ,$391.85 ,$83.43 ,$83.43 ,$258.62 ,$190.85 ,$191.78 ,$39.77 ,$39.33 ,$85.85 ,$391.85 ,$179.38 ,$241.56 ,$129.08 ,$414.90 ,$461.00 ,$81.76 ,$299.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000121,71045,HC XR CHEST 1V,320,1 ,$424.00 ,$305.28 ,$39.33 ,$424.00 ,$275.60 ,$81.76 ,$118.72 ,$234.47 ,$81.76 ,$246.77 ,$81.76 ,$222.18 ,$81.76 ,$168.54 ,$390.08 ,$208.59 ,$81.76 ,$360.40 ,$381.60 ,$83.40 ,$318.00 ,$296.80 ,$296.80 ,$81.76 ,$296.80 ,$326.48 ,$326.48 ,$208.59 ,$360.40 ,$83.43 ,$83.43 ,$237.86 ,$175.54 ,$176.38 ,$39.77 ,$39.33 ,$85.85 ,$360.40 ,$179.38 ,$222.18 ,$118.72 ,$381.60 ,$424.00 ,$81.76 ,$275.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000127,71046,HC XR CHEST 2V,320,1 ,$480.00 ,$345.60 ,$39.33 ,$480.00 ,$312.00 ,$81.76 ,$134.40 ,$265.44 ,$81.76 ,$279.36 ,$81.76 ,$251.52 ,$81.76 ,$168.54 ,$441.60 ,$208.59 ,$81.76 ,$408.00 ,$432.00 ,$83.40 ,$360.00 ,$336.00 ,$336.00 ,$81.76 ,$336.00 ,$369.60 ,$369.60 ,$208.59 ,$408.00 ,$83.43 ,$83.43 ,$269.28 ,$198.72 ,$199.68 ,$39.77 ,$39.33 ,$85.85 ,$408.00 ,$179.38 ,$251.52 ,$134.40 ,$432.00 ,$480.00 ,$81.76 ,$312.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000137,71100,HC XR RIBS 2V UNI,320,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$81.76 ,$132.72 ,$262.12 ,$81.76 ,$275.87 ,$81.76 ,$248.38 ,$81.76 ,$168.54 ,$436.08 ,$208.59 ,$81.76 ,$402.90 ,$426.60 ,$83.40 ,$355.50 ,$331.80 ,$331.80 ,$81.76 ,$331.80 ,$364.98 ,$364.98 ,$208.59 ,$402.90 ,$83.43 ,$83.43 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$85.85 ,$402.90 ,$179.38 ,$248.38 ,$132.72 ,$426.60 ,$474.00 ,$81.76 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$553.00 ,$398.16 ,$39.33 ,$553.00 ,$359.45 ,$100.59 ,$154.84 ,$305.81 ,$100.59 ,$321.85 ,$100.59 ,$289.77 ,$100.59 ,$207.34 ,$508.76 ,$256.60 ,$100.59 ,$470.05 ,$497.70 ,$102.60 ,$414.75 ,$387.10 ,$387.10 ,$100.59 ,$387.10 ,$425.81 ,$425.81 ,$256.60 ,$470.05 ,$102.64 ,$102.64 ,$310.23 ,$228.94 ,$230.05 ,$39.77 ,$39.33 ,$105.61 ,$470.05 ,$220.68 ,$289.77 ,$154.84 ,$497.70 ,$505.00 ,$100.59 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$593.00 ,$426.96 ,$39.33 ,$593.00 ,$385.45 ,$100.59 ,$166.04 ,$327.93 ,$100.59 ,$345.13 ,$100.59 ,$310.73 ,$100.59 ,$207.34 ,$545.56 ,$256.60 ,$100.59 ,$504.05 ,$533.70 ,$102.60 ,$444.75 ,$415.10 ,$415.10 ,$100.59 ,$415.10 ,$456.61 ,$456.61 ,$256.60 ,$504.05 ,$102.64 ,$102.64 ,$332.67 ,$245.50 ,$246.69 ,$39.77 ,$39.33 ,$105.61 ,$504.05 ,$220.68 ,$310.73 ,$166.04 ,$533.70 ,$505.00 ,$100.59 ,$385.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$722.00 ,$519.84 ,$39.33 ,$722.00 ,$469.30 ,$100.59 ,$202.16 ,$399.27 ,$100.59 ,$420.20 ,$100.59 ,$378.33 ,$100.59 ,$207.34 ,$664.24 ,$256.60 ,$100.59 ,$613.70 ,$649.80 ,$102.60 ,$541.50 ,$505.40 ,$505.40 ,$100.59 ,$505.40 ,$555.94 ,$555.94 ,$256.60 ,$613.70 ,$102.64 ,$102.64 ,$405.04 ,$298.91 ,$300.35 ,$39.77 ,$39.33 ,$105.61 ,$613.70 ,$220.68 ,$378.33 ,$202.16 ,$649.80 ,$505.00 ,$100.59 ,$469.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000141,71120,HC XR STERNUM 2+V,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$2,406.00 ","$1,732.32 ",$98.12 ,"$2,406.00 ","$1,563.90 ",$100.59 ,$673.68 ,"$1,330.52 ",$100.59 ,"$1,400.29 ",$100.59 ,"$1,260.74 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$2,045.10 ","$2,165.40 ",$102.60 ,"$1,804.50 ","$1,684.20 ","$1,684.20 ",$100.59 ,"$1,684.20 ","$1,852.62 ","$1,852.62 ",$256.60 ,"$2,045.10 ",$102.64 ,$102.64 ,"$1,349.77 ",$996.08 ,"$1,000.90 ",$99.20 ,$98.12 ,$105.61 ,"$2,045.10 ",$220.68 ,"$1,260.74 ",$673.68 ,"$2,165.40 ",$825.00 ,$100.59 ,"$1,563.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$2,910.00 ","$2,095.20 ",$98.12 ,"$2,910.00 ","$1,891.50 ",$169.73 ,$814.80 ,"$1,609.23 ",$169.73 ,"$1,693.62 ",$169.73 ,"$1,524.84 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,473.50 ","$2,619.00 ",$173.12 ,"$2,182.50 ","$2,037.00 ","$2,037.00 ",$169.73 ,"$2,037.00 ","$2,240.70 ","$2,240.70 ",$432.97 ,"$2,473.50 ",$173.19 ,$173.19 ,"$1,632.51 ","$1,204.74 ","$1,210.56 ",$99.20 ,$98.12 ,$178.21 ,"$2,473.50 ",$372.35 ,"$1,524.84 ",$814.80 ,"$2,619.00 ",$825.00 ,$169.73 ,"$1,891.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$3,268.00 ","$2,352.96 ",$98.12 ,"$3,268.00 ","$2,124.20 ",$169.73 ,$915.04 ,"$1,807.20 ",$169.73 ,"$1,901.98 ",$169.73 ,"$1,712.43 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,777.80 ","$2,941.20 ",$173.12 ,"$2,451.00 ","$2,287.60 ","$2,287.60 ",$169.73 ,"$2,287.60 ","$2,516.36 ","$2,516.36 ",$432.97 ,"$2,777.80 ",$173.19 ,$173.19 ,"$1,833.35 ","$1,352.95 ","$1,359.49 ",$99.20 ,$98.12 ,$178.21 ,"$2,777.80 ",$372.35 ,"$1,712.43 ",$915.04 ,"$2,941.20 ",$825.00 ,$169.73 ,"$2,124.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$3,186.00 ","$2,293.92 ",$169.73 ,"$3,186.00 ","$2,070.90 ",$169.73 ,$892.08 ,"$1,761.86 ",$169.73 ,"$1,854.25 ",$169.73 ,"$1,669.46 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,708.10 ","$2,867.40 ",$173.12 ,"$2,389.50 ","$2,230.20 ","$2,230.20 ",$169.73 ,"$2,230.20 ","$2,453.22 ","$2,453.22 ",$432.97 ,"$2,708.10 ",$173.19 ,$173.19 ,"$1,787.35 ","$1,319.00 ","$1,325.38 ",$224.19 ,$221.76 ,$178.21 ,"$2,708.10 ",$372.35 ,"$1,669.46 ",$892.08 ,"$2,867.40 ",$825.00 ,$169.73 ,"$2,070.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$3,138.00 ","$2,259.36 ",$219.77 ,"$3,138.00 ","$2,039.70 ",$219.77 ,$878.64 ,"$1,735.31 ",$219.77 ,"$1,826.32 ",$219.77 ,"$1,644.31 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,667.30 ","$2,824.20 ",$224.17 ,"$2,353.50 ","$2,196.60 ","$2,196.60 ",$219.77 ,"$2,196.60 ","$2,416.26 ","$2,416.26 ",$560.65 ,"$2,667.30 ",$224.26 ,$224.26 ,"$1,760.42 ","$1,299.13 ","$1,305.41 ",$340.24 ,$336.56 ,$230.76 ,"$2,667.30 ",$482.16 ,"$1,644.31 ",$878.64 ,"$2,824.20 ","$1,490.00 ",$219.77 ,"$2,039.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$3,627.00 ","$2,611.44 ",$336.56 ,"$3,627.00 ","$2,357.55 ",$697.14 ,"$1,015.56 ","$2,005.73 ",$697.14 ,"$2,110.91 ",$697.14 ,"$1,900.55 ",$697.14 ,"$1,436.97 ","$2,500.00 ","$1,778.43 ",$697.14 ,"$3,082.95 ","$3,264.30 ",$711.09 ,"$2,720.25 ","$2,538.90 ","$2,538.90 ",$697.14 ,"$2,538.90 ","$2,792.79 ","$2,792.79 ","$1,778.43 ","$3,082.95 ",$711.37 ,$711.37 ,"$2,034.75 ","$1,501.58 ","$1,508.83 ",$340.24 ,$336.56 ,$732.00 ,"$3,082.95 ","$1,529.45 ","$1,900.55 ","$1,015.56 ","$3,264.30 ","$1,490.00 ",$697.14 ,"$2,357.55 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$4,577.00 ","$3,295.44 ",$336.56 ,"$4,577.00 ","$2,975.05 ",$346.74 ,"$1,281.56 ","$2,531.08 ",$346.74 ,"$2,663.81 ",$346.74 ,"$2,398.35 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,890.45 ","$4,119.30 ",$353.67 ,"$3,432.75 ","$3,203.90 ","$3,203.90 ",$346.74 ,"$3,203.90 ","$3,524.29 ","$3,524.29 ",$884.55 ,"$3,890.45 ",$353.82 ,$353.82 ,"$2,567.70 ","$1,894.88 ","$1,904.03 ",$340.24 ,$336.56 ,$364.08 ,"$3,890.45 ",$760.71 ,"$2,398.35 ","$1,281.56 ","$4,119.30 ","$1,490.00 ",$346.74 ,"$2,975.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000156,72020,HC XR C-SPINE 1V,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000160,72020,HC XR SPINE 1V (T SPINE),320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000161,72020,HC XR L-SPINE 1V,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$739.00 ,$532.08 ,$39.33 ,$739.00 ,$480.35 ,$100.59 ,$206.92 ,$408.67 ,$100.59 ,$430.10 ,$100.59 ,$387.24 ,$100.59 ,$207.34 ,$679.88 ,$256.60 ,$100.59 ,$628.15 ,$665.10 ,$102.60 ,$554.25 ,$517.30 ,$517.30 ,$100.59 ,$517.30 ,$569.03 ,$569.03 ,$256.60 ,$628.15 ,$102.64 ,$102.64 ,$414.58 ,$305.95 ,$307.42 ,$39.77 ,$39.33 ,$105.61 ,$628.15 ,$220.68 ,$387.24 ,$206.92 ,$665.10 ,$505.00 ,$100.59 ,$480.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,$739.00 ,$532.08 ,$39.33 ,$739.00 ,$480.35 ,$100.59 ,$206.92 ,$408.67 ,$100.59 ,$430.10 ,$100.59 ,$387.24 ,$100.59 ,$207.34 ,$679.88 ,$256.60 ,$100.59 ,$628.15 ,$665.10 ,$102.60 ,$554.25 ,$517.30 ,$517.30 ,$100.59 ,$517.30 ,$569.03 ,$569.03 ,$256.60 ,$628.15 ,$102.64 ,$102.64 ,$414.58 ,$305.95 ,$307.42 ,$39.77 ,$39.33 ,$105.61 ,$628.15 ,$220.68 ,$387.24 ,$206.92 ,$665.10 ,$505.00 ,$100.59 ,$480.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000172,72070,HC XR T-SPINE 2V,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$100.59 ,$123.20 ,$243.32 ,$100.59 ,$256.08 ,$100.59 ,$230.56 ,$100.59 ,$207.34 ,$404.80 ,$256.60 ,$100.59 ,$374.00 ,$396.00 ,$102.60 ,$330.00 ,$308.00 ,$308.00 ,$100.59 ,$308.00 ,$338.80 ,$338.80 ,$256.60 ,$374.00 ,$102.64 ,$102.64 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$105.61 ,$374.00 ,$220.68 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$100.59 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000174,72072,HC XR T-SPINE 3V,320,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$100.59 ,$132.72 ,$262.12 ,$100.59 ,$275.87 ,$100.59 ,$248.38 ,$100.59 ,$207.34 ,$436.08 ,$256.60 ,$100.59 ,$402.90 ,$426.60 ,$102.60 ,$355.50 ,$331.80 ,$331.80 ,$100.59 ,$331.80 ,$364.98 ,$364.98 ,$256.60 ,$402.90 ,$102.64 ,$102.64 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$105.61 ,$402.90 ,$220.68 ,$248.38 ,$132.72 ,$426.60 ,$474.00 ,$100.59 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$553.00 ,$398.16 ,$39.33 ,$553.00 ,$359.45 ,$100.59 ,$154.84 ,$305.81 ,$100.59 ,$321.85 ,$100.59 ,$289.77 ,$100.59 ,$207.34 ,$508.76 ,$256.60 ,$100.59 ,$470.05 ,$497.70 ,$102.60 ,$414.75 ,$387.10 ,$387.10 ,$100.59 ,$387.10 ,$425.81 ,$425.81 ,$256.60 ,$470.05 ,$102.64 ,$102.64 ,$310.23 ,$228.94 ,$230.05 ,$39.77 ,$39.33 ,$105.61 ,$470.05 ,$220.68 ,$289.77 ,$154.84 ,$497.70 ,$505.00 ,$100.59 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000181,72110,HC XR L-SPINE 4+V,320,1 ,$876.00 ,$630.72 ,$39.33 ,$876.00 ,$569.40 ,$100.59 ,$245.28 ,$484.43 ,$100.59 ,$509.83 ,$100.59 ,$459.02 ,$100.59 ,$207.34 ,$805.92 ,$256.60 ,$100.59 ,$744.60 ,$788.40 ,$102.60 ,$657.00 ,$613.20 ,$613.20 ,$100.59 ,$613.20 ,$674.52 ,$674.52 ,$256.60 ,$744.60 ,$102.64 ,$102.64 ,$491.44 ,$362.66 ,$364.42 ,$39.77 ,$39.33 ,$105.61 ,$744.60 ,$220.68 ,$459.02 ,$245.28 ,$788.40 ,$505.00 ,$100.59 ,$569.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$467.00 ,$336.24 ,$39.33 ,$467.00 ,$303.55 ,$100.59 ,$130.76 ,$258.25 ,$100.59 ,$271.79 ,$100.59 ,$244.71 ,$100.59 ,$207.34 ,$429.64 ,$256.60 ,$100.59 ,$396.95 ,$420.30 ,$102.60 ,$350.25 ,$326.90 ,$326.90 ,$100.59 ,$326.90 ,$359.59 ,$359.59 ,$256.60 ,$396.95 ,$102.64 ,$102.64 ,$261.99 ,$193.34 ,$194.27 ,$39.77 ,$39.33 ,$105.61 ,$396.95 ,$220.68 ,$244.71 ,$130.76 ,$420.30 ,$467.00 ,$100.59 ,$303.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,$739.00 ,$532.08 ,$39.33 ,$739.00 ,$480.35 ,$100.59 ,$206.92 ,$408.67 ,$100.59 ,$430.10 ,$100.59 ,$387.24 ,$100.59 ,$207.34 ,$679.88 ,$256.60 ,$100.59 ,$628.15 ,$665.10 ,$102.60 ,$554.25 ,$517.30 ,$517.30 ,$100.59 ,$517.30 ,$569.03 ,$569.03 ,$256.60 ,$628.15 ,$102.64 ,$102.64 ,$414.58 ,$305.95 ,$307.42 ,$39.77 ,$39.33 ,$105.61 ,$628.15 ,$220.68 ,$387.24 ,$206.92 ,$665.10 ,$505.00 ,$100.59 ,$480.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000186,72170,HC XR PELVIS 1-2V,320,1 ,$433.00 ,$311.76 ,$39.33 ,$433.00 ,$281.45 ,$100.59 ,$121.24 ,$239.45 ,$100.59 ,$252.01 ,$100.59 ,$226.89 ,$100.59 ,$207.34 ,$398.36 ,$256.60 ,$100.59 ,$368.05 ,$389.70 ,$102.60 ,$324.75 ,$303.10 ,$303.10 ,$100.59 ,$303.10 ,$333.41 ,$333.41 ,$256.60 ,$368.05 ,$102.64 ,$102.64 ,$242.91 ,$179.26 ,$180.13 ,$39.77 ,$39.33 ,$105.61 ,$368.05 ,$220.68 ,$226.89 ,$121.24 ,$389.70 ,$433.00 ,$100.59 ,$281.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$421.00 ,$303.12 ,$39.33 ,$421.00 ,$273.65 ,$100.59 ,$117.88 ,$232.81 ,$100.59 ,$245.02 ,$100.59 ,$220.60 ,$100.59 ,$207.34 ,$387.32 ,$256.60 ,$100.59 ,$357.85 ,$378.90 ,$102.60 ,$315.75 ,$294.70 ,$294.70 ,$100.59 ,$294.70 ,$324.17 ,$324.17 ,$256.60 ,$357.85 ,$102.64 ,$102.64 ,$236.18 ,$174.29 ,$175.14 ,$39.77 ,$39.33 ,$105.61 ,$357.85 ,$220.68 ,$220.60 ,$117.88 ,$378.90 ,$421.00 ,$100.59 ,$273.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000196,62304,HC XR MYELOGRAM L-SPINE,320,1 ,"$2,544.00 ","$1,831.68 ",$427.99 ,"$2,544.00 ","$1,653.60 ",$697.14 ,$712.32 ,"$1,406.83 ",$697.14 ,"$1,480.61 ",$697.14 ,"$1,333.06 ",$697.14 ,"$1,436.97 ","$2,340.48 ","$1,778.43 ",$697.14 ,"$2,162.40 ","$2,289.60 ",$711.09 ,"$1,908.00 ","$1,780.80 ","$1,780.80 ",$697.14 ,"$1,780.80 ","$1,958.88 ","$1,958.88 ","$1,778.43 ","$2,162.40 ",$711.37 ,$711.37 ,"$1,427.18 ","$1,053.22 ","$1,058.30 ",$432.68 ,$427.99 ,$732.00 ,"$2,162.40 ","$1,529.45 ","$1,333.06 ",$712.32 ,"$2,289.60 ",$505.00 ,$697.14 ,"$1,653.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000201,73000,HC XRAY CLAVICLE,320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$81.76 ,$112.28 ,$221.75 ,$81.76 ,$233.38 ,$81.76 ,$210.12 ,$81.76 ,$168.54 ,$368.92 ,$208.59 ,$81.76 ,$340.85 ,$360.90 ,$83.40 ,$300.75 ,$280.70 ,$280.70 ,$81.76 ,$280.70 ,$308.77 ,$308.77 ,$208.59 ,$340.85 ,$83.43 ,$83.43 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$85.85 ,$340.85 ,$179.38 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$81.76 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000204,73010,HC XRAY SCAPULA,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$100.59 ,$123.20 ,$243.32 ,$100.59 ,$256.08 ,$100.59 ,$230.56 ,$100.59 ,$207.34 ,$404.80 ,$256.60 ,$100.59 ,$374.00 ,$396.00 ,$102.60 ,$330.00 ,$308.00 ,$308.00 ,$100.59 ,$308.00 ,$338.80 ,$338.80 ,$256.60 ,$374.00 ,$102.64 ,$102.64 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$105.61 ,$374.00 ,$220.68 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$100.59 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$81.76 ,$112.28 ,$221.75 ,$81.76 ,$233.38 ,$81.76 ,$210.12 ,$81.76 ,$168.54 ,$368.92 ,$208.59 ,$81.76 ,$340.85 ,$360.90 ,$83.40 ,$300.75 ,$280.70 ,$280.70 ,$81.76 ,$280.70 ,$308.77 ,$308.77 ,$208.59 ,$340.85 ,$83.43 ,$83.43 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$85.85 ,$340.85 ,$179.38 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$81.76 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$485.00 ,$349.20 ,$39.33 ,$485.00 ,$315.25 ,$81.76 ,$135.80 ,$268.21 ,$81.76 ,$282.27 ,$81.76 ,$254.14 ,$81.76 ,$168.54 ,$446.20 ,$208.59 ,$81.76 ,$412.25 ,$436.50 ,$83.40 ,$363.75 ,$339.50 ,$339.50 ,$81.76 ,$339.50 ,$373.45 ,$373.45 ,$208.59 ,$412.25 ,$83.43 ,$83.43 ,$272.09 ,$200.79 ,$201.76 ,$39.77 ,$39.33 ,$85.85 ,$412.25 ,$179.38 ,$254.14 ,$135.80 ,$436.50 ,$485.00 ,$81.76 ,$315.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$1,295.00 ",$932.40 ,$224.12 ,"$1,295.00 ",$841.75 ,$346.74 ,$362.60 ,$716.14 ,$346.74 ,$753.69 ,$346.74 ,$678.58 ,$346.74 ,$714.71 ,"$1,191.40 ",$884.55 ,$346.74 ,"$1,100.75 ","$1,165.50 ",$353.67 ,$971.25 ,$906.50 ,$906.50 ,$346.74 ,$906.50 ,$997.15 ,$997.15 ,$884.55 ,"$1,100.75 ",$353.82 ,$353.82 ,$726.50 ,$536.13 ,$538.72 ,$226.58 ,$224.12 ,$364.08 ,"$1,100.75 ",$760.71 ,$678.58 ,$362.60 ,"$1,165.50 ",$505.00 ,$346.74 ,$841.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$81.76 ,$112.28 ,$221.75 ,$81.76 ,$233.38 ,$81.76 ,$210.12 ,$81.76 ,$168.54 ,$368.92 ,$208.59 ,$81.76 ,$340.85 ,$360.90 ,$83.40 ,$300.75 ,$280.70 ,$280.70 ,$81.76 ,$280.70 ,$308.77 ,$308.77 ,$208.59 ,$340.85 ,$83.43 ,$83.43 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$85.85 ,$340.85 ,$179.38 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$81.76 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$253.00 ,$182.16 ,$39.33 ,$253.00 ,$164.45 ,$81.76 ,$70.84 ,$139.91 ,$81.76 ,$147.25 ,$81.76 ,$132.57 ,$81.76 ,$168.54 ,$232.76 ,$208.59 ,$81.76 ,$215.05 ,$227.70 ,$83.40 ,$189.75 ,$177.10 ,$177.10 ,$81.76 ,$177.10 ,$194.81 ,$194.81 ,$208.59 ,$215.05 ,$83.43 ,$83.43 ,$141.93 ,$104.74 ,$105.25 ,$39.77 ,$39.33 ,$85.85 ,$215.05 ,$179.38 ,$132.57 ,$70.84 ,$227.70 ,$253.00 ,$81.76 ,$164.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$433.00 ,$311.76 ,$39.33 ,$433.00 ,$281.45 ,$81.76 ,$121.24 ,$239.45 ,$81.76 ,$252.01 ,$81.76 ,$226.89 ,$81.76 ,$168.54 ,$398.36 ,$208.59 ,$81.76 ,$368.05 ,$389.70 ,$83.40 ,$324.75 ,$303.10 ,$303.10 ,$81.76 ,$303.10 ,$333.41 ,$333.41 ,$208.59 ,$368.05 ,$83.43 ,$83.43 ,$242.91 ,$179.26 ,$180.13 ,$39.77 ,$39.33 ,$85.85 ,$368.05 ,$179.38 ,$226.89 ,$121.24 ,$389.70 ,$433.00 ,$81.76 ,$281.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$433.00 ,$311.76 ,$39.33 ,$433.00 ,$281.45 ,$81.76 ,$121.24 ,$239.45 ,$81.76 ,$252.01 ,$81.76 ,$226.89 ,$81.76 ,$168.54 ,$398.36 ,$208.59 ,$81.76 ,$368.05 ,$389.70 ,$83.40 ,$324.75 ,$303.10 ,$303.10 ,$81.76 ,$303.10 ,$333.41 ,$333.41 ,$208.59 ,$368.05 ,$83.43 ,$83.43 ,$242.91 ,$179.26 ,$180.13 ,$39.77 ,$39.33 ,$85.85 ,$368.05 ,$179.38 ,$226.89 ,$121.24 ,$389.70 ,$433.00 ,$81.76 ,$281.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$502.00 ,$361.44 ,$39.33 ,$502.00 ,$326.30 ,$81.76 ,$140.56 ,$277.61 ,$81.76 ,$292.16 ,$81.76 ,$263.05 ,$81.76 ,$168.54 ,$461.84 ,$208.59 ,$81.76 ,$426.70 ,$451.80 ,$83.40 ,$376.50 ,$351.40 ,$351.40 ,$81.76 ,$351.40 ,$386.54 ,$386.54 ,$208.59 ,$426.70 ,$83.43 ,$83.43 ,$281.62 ,$207.83 ,$208.83 ,$39.77 ,$39.33 ,$85.85 ,$426.70 ,$179.38 ,$263.05 ,$140.56 ,$451.80 ,$502.00 ,$81.76 ,$326.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,"$1,295.00 ",$932.40 ,$224.12 ,"$1,295.00 ",$841.75 ,$346.74 ,$362.60 ,$716.14 ,$346.74 ,$753.69 ,$346.74 ,$678.58 ,$346.74 ,$714.71 ,"$1,191.40 ",$884.55 ,$346.74 ,"$1,100.75 ","$1,165.50 ",$353.67 ,$971.25 ,$906.50 ,$906.50 ,$346.74 ,$906.50 ,$997.15 ,$997.15 ,$884.55 ,"$1,100.75 ",$353.82 ,$353.82 ,$726.50 ,$536.13 ,$538.72 ,$226.58 ,$224.12 ,$364.08 ,"$1,100.75 ",$760.71 ,$678.58 ,$362.60 ,"$1,165.50 ",$505.00 ,$346.74 ,$841.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$433.00 ,$311.76 ,$39.33 ,$433.00 ,$281.45 ,$100.59 ,$121.24 ,$239.45 ,$100.59 ,$252.01 ,$100.59 ,$226.89 ,$100.59 ,$207.34 ,$398.36 ,$256.60 ,$100.59 ,$368.05 ,$389.70 ,$102.60 ,$324.75 ,$303.10 ,$303.10 ,$100.59 ,$303.10 ,$333.41 ,$333.41 ,$256.60 ,$368.05 ,$102.64 ,$102.64 ,$242.91 ,$179.26 ,$180.13 ,$39.77 ,$39.33 ,$105.61 ,$368.05 ,$220.68 ,$226.89 ,$121.24 ,$389.70 ,$433.00 ,$100.59 ,$281.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$472.00 ,$339.84 ,$39.33 ,$472.00 ,$306.80 ,$81.76 ,$132.16 ,$261.02 ,$81.76 ,$274.70 ,$81.76 ,$247.33 ,$81.76 ,$168.54 ,$434.24 ,$208.59 ,$81.76 ,$401.20 ,$424.80 ,$83.40 ,$354.00 ,$330.40 ,$330.40 ,$81.76 ,$330.40 ,$363.44 ,$363.44 ,$208.59 ,$401.20 ,$83.43 ,$83.43 ,$264.79 ,$195.41 ,$196.35 ,$39.77 ,$39.33 ,$85.85 ,$401.20 ,$179.38 ,$247.33 ,$132.16 ,$424.80 ,$472.00 ,$81.76 ,$306.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$81.76 ,$112.28 ,$221.75 ,$81.76 ,$233.38 ,$81.76 ,$210.12 ,$81.76 ,$168.54 ,$368.92 ,$208.59 ,$81.76 ,$340.85 ,$360.90 ,$83.40 ,$300.75 ,$280.70 ,$280.70 ,$81.76 ,$280.70 ,$308.77 ,$308.77 ,$208.59 ,$340.85 ,$83.43 ,$83.43 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$85.85 ,$340.85 ,$179.38 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$81.76 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,"$1,359.00 ",$978.48 ,$224.12 ,"$1,359.00 ",$883.35 ,$346.74 ,$380.52 ,$751.53 ,$346.74 ,$790.94 ,$346.74 ,$712.12 ,$346.74 ,$714.71 ,"$1,250.28 ",$884.55 ,$346.74 ,"$1,155.15 ","$1,223.10 ",$353.67 ,"$1,019.25 ",$951.30 ,$951.30 ,$346.74 ,$951.30 ,"$1,046.43 ","$1,046.43 ",$884.55 ,"$1,155.15 ",$353.82 ,$353.82 ,$762.40 ,$562.63 ,$565.34 ,$226.58 ,$224.12 ,$364.08 ,"$1,155.15 ",$760.71 ,$712.12 ,$380.52 ,"$1,223.10 ",$505.00 ,$346.74 ,$883.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$493.00 ,$354.96 ,$39.33 ,$493.00 ,$320.45 ,$81.76 ,$138.04 ,$272.63 ,$81.76 ,$286.93 ,$81.76 ,$258.33 ,$81.76 ,$168.54 ,$453.56 ,$208.59 ,$81.76 ,$419.05 ,$443.70 ,$83.40 ,$369.75 ,$345.10 ,$345.10 ,$81.76 ,$345.10 ,$379.61 ,$379.61 ,$208.59 ,$419.05 ,$83.43 ,$83.43 ,$276.57 ,$204.10 ,$205.09 ,$39.77 ,$39.33 ,$85.85 ,$419.05 ,$179.38 ,$258.33 ,$138.04 ,$443.70 ,$493.00 ,$81.76 ,$320.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000263,73562,HC XRAY KNEE (3 V),320,1 ,$502.00 ,$361.44 ,$39.33 ,$502.00 ,$326.30 ,$81.76 ,$140.56 ,$277.61 ,$81.76 ,$292.16 ,$81.76 ,$263.05 ,$81.76 ,$168.54 ,$461.84 ,$208.59 ,$81.76 ,$426.70 ,$451.80 ,$83.40 ,$376.50 ,$351.40 ,$351.40 ,$81.76 ,$351.40 ,$386.54 ,$386.54 ,$208.59 ,$426.70 ,$83.43 ,$83.43 ,$281.62 ,$207.83 ,$208.83 ,$39.77 ,$39.33 ,$85.85 ,$426.70 ,$179.38 ,$263.05 ,$140.56 ,$451.80 ,$502.00 ,$81.76 ,$326.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$579.00 ,$416.88 ,$39.33 ,$579.00 ,$376.35 ,$100.59 ,$162.12 ,$320.19 ,$100.59 ,$336.98 ,$100.59 ,$303.40 ,$100.59 ,$207.34 ,$532.68 ,$256.60 ,$100.59 ,$492.15 ,$521.10 ,$102.60 ,$434.25 ,$405.30 ,$405.30 ,$100.59 ,$405.30 ,$445.83 ,$445.83 ,$256.60 ,$492.15 ,$102.64 ,$102.64 ,$324.82 ,$239.71 ,$240.86 ,$39.77 ,$39.33 ,$105.61 ,$492.15 ,$220.68 ,$303.40 ,$162.12 ,$521.10 ,$505.00 ,$100.59 ,$376.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000267,73565,HC XR KNEE STAND,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,"$1,295.00 ",$932.40 ,$224.12 ,"$1,295.00 ",$841.75 ,$346.74 ,$362.60 ,$716.14 ,$346.74 ,$753.69 ,$346.74 ,$678.58 ,$346.74 ,$714.71 ,"$1,191.40 ",$884.55 ,$346.74 ,"$1,100.75 ","$1,165.50 ",$353.67 ,$971.25 ,$906.50 ,$906.50 ,$346.74 ,$906.50 ,$997.15 ,$997.15 ,$884.55 ,"$1,100.75 ",$353.82 ,$353.82 ,$726.50 ,$536.13 ,$538.72 ,$226.58 ,$224.12 ,$364.08 ,"$1,100.75 ",$760.71 ,$678.58 ,$362.60 ,"$1,165.50 ",$505.00 ,$346.74 ,$841.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$433.00 ,$311.76 ,$39.33 ,$433.00 ,$281.45 ,$81.76 ,$121.24 ,$239.45 ,$81.76 ,$252.01 ,$81.76 ,$226.89 ,$81.76 ,$168.54 ,$398.36 ,$208.59 ,$81.76 ,$368.05 ,$389.70 ,$83.40 ,$324.75 ,$303.10 ,$303.10 ,$81.76 ,$303.10 ,$333.41 ,$333.41 ,$208.59 ,$368.05 ,$83.43 ,$83.43 ,$242.91 ,$179.26 ,$180.13 ,$39.77 ,$39.33 ,$85.85 ,$368.05 ,$179.38 ,$226.89 ,$121.24 ,$389.70 ,$433.00 ,$81.76 ,$281.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$472.00 ,$339.84 ,$39.33 ,$472.00 ,$306.80 ,$81.76 ,$132.16 ,$261.02 ,$81.76 ,$274.70 ,$81.76 ,$247.33 ,$81.76 ,$168.54 ,$434.24 ,$208.59 ,$81.76 ,$401.20 ,$424.80 ,$83.40 ,$354.00 ,$330.40 ,$330.40 ,$81.76 ,$330.40 ,$363.44 ,$363.44 ,$208.59 ,$401.20 ,$83.43 ,$83.43 ,$264.79 ,$195.41 ,$196.35 ,$39.77 ,$39.33 ,$85.85 ,$401.20 ,$179.38 ,$247.33 ,$132.16 ,$424.80 ,$472.00 ,$81.76 ,$306.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000279,73620,HC XRAY FOOT (2 V),320,1 ,$433.00 ,$311.76 ,$39.33 ,$433.00 ,$281.45 ,$81.76 ,$121.24 ,$239.45 ,$81.76 ,$252.01 ,$81.76 ,$226.89 ,$81.76 ,$168.54 ,$398.36 ,$208.59 ,$81.76 ,$368.05 ,$389.70 ,$83.40 ,$324.75 ,$303.10 ,$303.10 ,$81.76 ,$303.10 ,$333.41 ,$333.41 ,$208.59 ,$368.05 ,$83.43 ,$83.43 ,$242.91 ,$179.26 ,$180.13 ,$39.77 ,$39.33 ,$85.85 ,$368.05 ,$179.38 ,$226.89 ,$121.24 ,$389.70 ,$433.00 ,$81.76 ,$281.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$502.00 ,$361.44 ,$39.33 ,$502.00 ,$326.30 ,$81.76 ,$140.56 ,$277.61 ,$81.76 ,$292.16 ,$81.76 ,$263.05 ,$81.76 ,$168.54 ,$461.84 ,$208.59 ,$81.76 ,$426.70 ,$451.80 ,$83.40 ,$376.50 ,$351.40 ,$351.40 ,$81.76 ,$351.40 ,$386.54 ,$386.54 ,$208.59 ,$426.70 ,$83.43 ,$83.43 ,$281.62 ,$207.83 ,$208.83 ,$39.77 ,$39.33 ,$85.85 ,$426.70 ,$179.38 ,$263.05 ,$140.56 ,$451.80 ,$502.00 ,$81.76 ,$326.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$81.76 ,$112.28 ,$221.75 ,$81.76 ,$233.38 ,$81.76 ,$210.12 ,$81.76 ,$168.54 ,$368.92 ,$208.59 ,$81.76 ,$340.85 ,$360.90 ,$83.40 ,$300.75 ,$280.70 ,$280.70 ,$81.76 ,$280.70 ,$308.77 ,$308.77 ,$208.59 ,$340.85 ,$83.43 ,$83.43 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$85.85 ,$340.85 ,$179.38 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$81.76 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$81.76 ,$112.28 ,$221.75 ,$81.76 ,$233.38 ,$81.76 ,$210.12 ,$81.76 ,$168.54 ,$368.92 ,$208.59 ,$81.76 ,$340.85 ,$360.90 ,$83.40 ,$300.75 ,$280.70 ,$280.70 ,$81.76 ,$280.70 ,$308.77 ,$308.77 ,$208.59 ,$340.85 ,$83.43 ,$83.43 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$85.85 ,$340.85 ,$179.38 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$81.76 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$461.00 ,$331.92 ,$39.33 ,$461.00 ,$299.65 ,$81.76 ,$129.08 ,$254.93 ,$81.76 ,$268.30 ,$81.76 ,$241.56 ,$81.76 ,$168.54 ,$424.12 ,$208.59 ,$81.76 ,$391.85 ,$414.90 ,$83.40 ,$345.75 ,$322.70 ,$322.70 ,$81.76 ,$322.70 ,$354.97 ,$354.97 ,$208.59 ,$391.85 ,$83.43 ,$83.43 ,$258.62 ,$190.85 ,$191.78 ,$39.77 ,$39.33 ,$85.85 ,$391.85 ,$179.38 ,$241.56 ,$129.08 ,$414.90 ,$461.00 ,$81.76 ,$299.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000294,74019,HC XRAY ABDOMEN AP AND LAT (2 V OR 3 V),320,1 ,$525.00 ,$378.00 ,$39.33 ,$525.00 ,$341.25 ,$100.59 ,$147.00 ,$290.33 ,$100.59 ,$305.55 ,$100.59 ,$275.10 ,$100.59 ,$207.34 ,$483.00 ,$256.60 ,$100.59 ,$446.25 ,$472.50 ,$102.60 ,$393.75 ,$367.50 ,$367.50 ,$100.59 ,$367.50 ,$404.25 ,$404.25 ,$256.60 ,$446.25 ,$102.64 ,$102.64 ,$294.53 ,$217.35 ,$218.40 ,$39.77 ,$39.33 ,$105.61 ,$446.25 ,$220.68 ,$275.10 ,$147.00 ,$472.50 ,$505.00 ,$100.59 ,$341.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$774.00 ,$557.28 ,$39.33 ,$774.00 ,$503.10 ,$100.59 ,$216.72 ,$428.02 ,$100.59 ,$450.47 ,$100.59 ,$405.58 ,$100.59 ,$207.34 ,$712.08 ,$256.60 ,$100.59 ,$657.90 ,$696.60 ,$102.60 ,$580.50 ,$541.80 ,$541.80 ,$100.59 ,$541.80 ,$595.98 ,$595.98 ,$256.60 ,$657.90 ,$102.64 ,$102.64 ,$434.21 ,$320.44 ,$321.98 ,$39.77 ,$39.33 ,$105.61 ,$657.90 ,$220.68 ,$405.58 ,$216.72 ,$696.60 ,$505.00 ,$100.59 ,$503.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$819.00 ,$589.68 ,$39.33 ,$819.00 ,$532.35 ,$169.73 ,$229.32 ,$452.91 ,$169.73 ,$476.66 ,$169.73 ,$429.16 ,$169.73 ,$349.84 ,$753.48 ,$432.97 ,$169.73 ,$696.15 ,$737.10 ,$173.12 ,$614.25 ,$573.30 ,$573.30 ,$169.73 ,$573.30 ,$630.63 ,$630.63 ,$432.97 ,$696.15 ,$173.19 ,$173.19 ,$459.46 ,$339.07 ,$340.70 ,$39.77 ,$39.33 ,$178.21 ,$696.15 ,$372.35 ,$429.16 ,$229.32 ,$737.10 ,$505.00 ,$169.73 ,$532.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$819.00 ,$589.68 ,$86.49 ,$819.00 ,$532.35 ,$169.73 ,$229.32 ,$452.91 ,$169.73 ,$476.66 ,$169.73 ,$429.16 ,$169.73 ,$349.84 ,$753.48 ,$432.97 ,$169.73 ,$696.15 ,$737.10 ,$173.12 ,$614.25 ,$573.30 ,$573.30 ,$169.73 ,$573.30 ,$630.63 ,$630.63 ,$432.97 ,$696.15 ,$173.19 ,$173.19 ,$459.46 ,$339.07 ,$340.70 ,$87.44 ,$86.49 ,$178.21 ,$696.15 ,$372.35 ,$429.16 ,$229.32 ,$737.10 ,$505.00 ,$169.73 ,$532.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,$523.00 ,$376.56 ,$86.49 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$481.16 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 ,$87.44 ,$86.49 ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$505.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,"$1,265.00 ",$910.80 ,$86.49 ,"$1,265.00 ",$822.25 ,$169.73 ,$354.20 ,$699.55 ,$169.73 ,$736.23 ,$169.73 ,$662.86 ,$169.73 ,$349.84 ,"$1,163.80 ",$432.97 ,$169.73 ,"$1,075.25 ","$1,138.50 ",$173.12 ,$948.75 ,$885.50 ,$885.50 ,$169.73 ,$885.50 ,$974.05 ,$974.05 ,$432.97 ,"$1,075.25 ",$173.19 ,$173.19 ,$709.67 ,$523.71 ,$526.24 ,$87.44 ,$86.49 ,$178.21 ,"$1,075.25 ",$372.35 ,$662.86 ,$354.20 ,"$1,138.50 ",$505.00 ,$169.73 ,$822.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$899.00 ,$647.28 ,$86.49 ,$899.00 ,$584.35 ,$169.73 ,$251.72 ,$497.15 ,$169.73 ,$523.22 ,$169.73 ,$471.08 ,$169.73 ,$349.84 ,$827.08 ,$432.97 ,$169.73 ,$764.15 ,$809.10 ,$173.12 ,$674.25 ,$629.30 ,$629.30 ,$169.73 ,$629.30 ,$692.23 ,$692.23 ,$432.97 ,$764.15 ,$173.19 ,$173.19 ,$504.34 ,$372.19 ,$373.98 ,$87.44 ,$86.49 ,$178.21 ,$764.15 ,$372.35 ,$471.08 ,$251.72 ,$809.10 ,$505.00 ,$169.73 ,$584.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000312,74018,HC SITZ MARKER STUDY,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$81.76 ,$89.32 ,$176.41 ,$81.76 ,$185.66 ,$81.76 ,$167.16 ,$81.76 ,$168.54 ,$293.48 ,$208.59 ,$81.76 ,$271.15 ,$287.10 ,$83.40 ,$239.25 ,$223.30 ,$223.30 ,$81.76 ,$223.30 ,$245.63 ,$245.63 ,$208.59 ,$271.15 ,$83.43 ,$83.43 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$85.85 ,$271.15 ,$179.38 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$81.76 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000315,74270,HC XRAY COLON BARIUM,320,1 ,"$1,161.00 ",$835.92 ,$86.49 ,"$1,161.00 ",$754.65 ,$169.73 ,$325.08 ,$642.03 ,$169.73 ,$675.70 ,$169.73 ,$608.36 ,$169.73 ,$349.84 ,"$1,068.12 ",$432.97 ,$169.73 ,$986.85 ,"$1,044.90 ",$173.12 ,$870.75 ,$812.70 ,$812.70 ,$169.73 ,$812.70 ,$893.97 ,$893.97 ,$432.97 ,$986.85 ,$173.19 ,$173.19 ,$651.32 ,$480.65 ,$482.98 ,$87.44 ,$86.49 ,$178.21 ,$986.85 ,$372.35 ,$608.36 ,$325.08 ,"$1,044.90 ",$505.00 ,$169.73 ,$754.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,"$1,161.00 ",$835.92 ,$86.49 ,"$1,161.00 ",$754.65 ,$169.73 ,$325.08 ,$642.03 ,$169.73 ,$675.70 ,$169.73 ,$608.36 ,$169.73 ,$349.84 ,"$1,068.12 ",$432.97 ,$169.73 ,$986.85 ,"$1,044.90 ",$173.12 ,$870.75 ,$812.70 ,$812.70 ,$169.73 ,$812.70 ,$893.97 ,$893.97 ,$432.97 ,$986.85 ,$173.19 ,$173.19 ,$651.32 ,$480.65 ,$482.98 ,$87.44 ,$86.49 ,$178.21 ,$986.85 ,$372.35 ,$608.36 ,$325.08 ,"$1,044.90 ",$505.00 ,$169.73 ,$754.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,"$1,161.00 ",$835.92 ,$86.49 ,"$1,161.00 ",$754.65 ,$169.73 ,$325.08 ,$642.03 ,$169.73 ,$675.70 ,$169.73 ,$608.36 ,$169.73 ,$349.84 ,"$1,068.12 ",$432.97 ,$169.73 ,$986.85 ,"$1,044.90 ",$173.12 ,$870.75 ,$812.70 ,$812.70 ,$169.73 ,$812.70 ,$893.97 ,$893.97 ,$432.97 ,$986.85 ,$173.19 ,$173.19 ,$651.32 ,$480.65 ,$482.98 ,$87.44 ,$86.49 ,$178.21 ,$986.85 ,$372.35 ,$608.36 ,$325.08 ,"$1,044.90 ",$505.00 ,$169.73 ,$754.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,"$1,452.00 ","$1,045.44 ",$86.49 ,"$1,452.00 ",$943.80 ,$169.73 ,$406.56 ,$802.96 ,$169.73 ,$845.06 ,$169.73 ,$760.85 ,$169.73 ,$349.84 ,"$1,335.84 ",$432.97 ,$169.73 ,"$1,234.20 ","$1,306.80 ",$173.12 ,"$1,089.00 ","$1,016.40 ","$1,016.40 ",$169.73 ,"$1,016.40 ","$1,118.04 ","$1,118.04 ",$432.97 ,"$1,234.20 ",$173.19 ,$173.19 ,$814.57 ,$601.13 ,$604.03 ,$87.44 ,$86.49 ,$178.21 ,"$1,234.20 ",$372.35 ,$760.85 ,$406.56 ,"$1,306.80 ",$505.00 ,$169.73 ,$943.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,$959.00 ,$690.48 ,$224.12 ,$959.00 ,$623.35 , N/A ,$268.52 ,$530.33 , N/A ,$558.14 , N/A ,$502.52 , N/A , N/A ,$882.28 , N/A , N/A ,$815.15 ,$863.10 , N/A ,$719.25 ,$671.30 ,$671.30 , N/A ,$671.30 ,$738.43 ,$738.43 , N/A ,$815.15 , N/A , N/A ,$538.00 ,$397.03 ,$398.94 ,$226.58 ,$224.12 , N/A ,$815.15 , N/A ,$502.52 ,$268.52 ,$863.10 ,$505.00 , N/A ,$623.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,"$1,079.00 ",$776.88 ,$245.34 ,"$1,079.00 ",$701.35 ,$346.74 ,$302.12 ,$596.69 ,$346.74 ,$627.98 ,$346.74 ,$565.40 ,$346.74 ,$714.71 ,$992.68 ,$884.55 ,$346.74 ,$917.15 ,$971.10 ,$353.67 ,$809.25 ,$755.30 ,$755.30 ,$346.74 ,$755.30 ,$830.83 ,$830.83 ,$884.55 ,$917.15 ,$353.82 ,$353.82 ,$605.32 ,$446.71 ,$448.86 ,$248.03 ,$245.34 ,$364.08 ,$917.15 ,$760.71 ,$565.40 ,$302.12 ,$971.10 ,$505.00 ,$346.74 ,$701.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000340,74425,HC XRAY UROGRAM ANTEGRADE,320,1 ,"$1,603.00 ","$1,154.16 ",$224.12 ,"$1,603.00 ","$1,041.95 ",$346.74 ,$448.84 ,$886.46 ,$346.74 ,$932.95 ,$346.74 ,$839.97 ,$346.74 ,$714.71 ,"$1,474.76 ",$884.55 ,$346.74 ,"$1,362.55 ","$1,442.70 ",$353.67 ,"$1,202.25 ","$1,122.10 ","$1,122.10 ",$346.74 ,"$1,122.10 ","$1,234.31 ","$1,234.31 ",$884.55 ,"$1,362.55 ",$353.82 ,$353.82 ,$899.28 ,$663.64 ,$666.85 ,$226.58 ,$224.12 ,$364.08 ,"$1,362.55 ",$760.71 ,$839.97 ,$448.84 ,"$1,442.70 ",$505.00 ,$346.74 ,"$1,041.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,"$1,603.00 ","$1,154.16 ",$224.12 ,"$1,603.00 ","$1,041.95 ",$346.74 ,$448.84 ,$886.46 ,$346.74 ,$932.95 ,$346.74 ,$839.97 ,$346.74 ,$714.71 ,"$1,474.76 ",$884.55 ,$346.74 ,"$1,362.55 ","$1,442.70 ",$353.67 ,"$1,202.25 ","$1,122.10 ","$1,122.10 ",$346.74 ,"$1,122.10 ","$1,234.31 ","$1,234.31 ",$884.55 ,"$1,362.55 ",$353.82 ,$353.82 ,$899.28 ,$663.64 ,$666.85 ,$226.58 ,$224.12 ,$364.08 ,"$1,362.55 ",$760.71 ,$839.97 ,$448.84 ,"$1,442.70 ",$505.00 ,$346.74 ,"$1,041.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,"$1,603.00 ","$1,154.16 ",$219.77 ,"$1,603.00 ","$1,041.95 ",$219.77 ,$448.84 ,$886.46 ,$219.77 ,$932.95 ,$219.77 ,$839.97 ,$219.77 ,$453.00 ,"$1,474.76 ",$560.65 ,$219.77 ,"$1,362.55 ","$1,442.70 ",$224.17 ,"$1,202.25 ","$1,122.10 ","$1,122.10 ",$219.77 ,"$1,122.10 ","$1,234.31 ","$1,234.31 ",$560.65 ,"$1,362.55 ",$224.26 ,$224.26 ,$899.28 ,$663.64 ,$666.85 ,$226.58 ,$224.12 ,$230.76 ,"$1,362.55 ",$482.16 ,$839.97 ,$448.84 ,"$1,442.70 ",$505.00 ,$219.77 ,"$1,041.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,"$1,104.00 ",$794.88 ,$219.77 ,"$1,104.00 ",$717.60 ,$219.77 ,$309.12 ,$610.51 ,$219.77 ,$642.53 ,$219.77 ,$578.50 ,$219.77 ,$453.00 ,"$1,015.68 ",$560.65 ,$219.77 ,$938.40 ,$993.60 ,$224.17 ,$828.00 ,$772.80 ,$772.80 ,$219.77 ,$772.80 ,$850.08 ,$850.08 ,$560.65 ,$938.40 ,$224.26 ,$224.26 ,$619.34 ,$457.06 ,$459.26 ,$226.58 ,$224.12 ,$230.76 ,$938.40 ,$482.16 ,$578.50 ,$309.12 ,$993.60 ,$505.00 ,$219.77 ,$717.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000356,75625,HC ABDOMINAL AORTAGRAM 75625,320,1 ,"$8,393.00 ","$6,042.96 ",$224.12 ,"$8,393.00 ","$5,455.45 ","$2,803.60 ","$2,350.04 ","$4,641.33 ","$2,803.60 ","$4,884.73 ","$2,803.60 ","$4,397.93 ","$2,803.60 ","$5,778.86 ","$7,721.56 ","$7,152.06 ","$2,803.60 ","$7,134.05 ","$7,553.70 ","$2,859.68 ","$6,294.75 ","$5,875.10 ","$5,875.10 ","$2,803.60 ","$5,875.10 ","$6,462.61 ","$6,462.61 ","$7,152.06 ","$7,134.05 ","$2,860.82 ","$2,860.82 ","$4,708.47 ","$3,474.70 ","$3,491.49 ",$226.58 ,$224.12 ,"$2,943.78 ","$7,134.05 ","$6,150.77 ","$4,397.93 ","$2,350.04 ","$7,553.70 ",$505.00 ,"$2,803.60 ","$5,455.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000372,75710,HC ANGIO EXTREMITY UNI OR,320,1 ,"$9,569.00 ","$6,889.68 ",$224.12 ,"$9,569.00 ","$6,219.85 ","$2,803.60 ","$2,679.32 ","$5,291.66 ","$2,803.60 ","$5,569.16 ","$2,803.60 ","$5,014.16 ","$2,803.60 ","$5,778.86 ","$8,803.48 ","$7,152.06 ","$2,803.60 ","$8,133.65 ","$8,612.10 ","$2,859.68 ","$7,176.75 ","$6,698.30 ","$6,698.30 ","$2,803.60 ","$6,698.30 ","$7,368.13 ","$7,368.13 ","$7,152.06 ","$8,133.65 ","$2,860.82 ","$2,860.82 ","$5,368.21 ","$3,961.57 ","$3,980.70 ",$226.58 ,$224.12 ,"$2,943.78 ","$8,133.65 ","$6,150.77 ","$5,014.16 ","$2,679.32 ","$8,612.10 ",$505.00 ,"$2,803.60 ","$6,219.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$675.00 ,$486.00 ,$39.33 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 ,$39.77 ,$39.33 ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$505.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$553.00 ,$398.16 ,$39.33 ,"$1,207.94 ",$359.45 ,$473.52 ,$154.84 ,$305.81 ,$473.52 ,$321.85 ,$473.52 ,$289.77 ,$473.52 ,$553.00 ,$508.76 ,"$1,207.94 ",$473.52 ,$470.05 ,$497.70 ,$482.98 ,$414.75 ,$387.10 ,$387.10 ,$473.52 ,$387.10 ,$425.81 ,$425.81 ,$553.00 ,$470.05 ,$483.18 ,$483.18 ,$310.23 ,$228.94 ,$230.05 ,$39.77 ,$39.33 ,$497.19 ,$470.05 ,"$1,038.83 ",$289.77 ,$154.84 ,$497.70 ,$505.00 ,$473.52 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,$715.00 ,$514.80 ,$200.20 ,$715.00 ,$464.75 , N/A ,$200.20 ,$395.40 , N/A ,$416.13 , N/A ,$374.66 , N/A , N/A ,$657.80 , N/A , N/A ,$607.75 ,$643.50 , N/A ,$536.25 ,$500.50 ,$500.50 , N/A ,$500.50 ,$550.55 ,$550.55 , N/A ,$607.75 , N/A , N/A ,$401.12 ,$296.01 ,$297.44 ,$226.58 ,$224.12 , N/A ,$607.75 , N/A ,$374.66 ,$200.20 ,$643.50 ,$505.00 , N/A ,$464.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$182.00 ,$131.04 ,$50.96 ,$182.00 ,$118.30 , N/A ,$50.96 ,$100.65 , N/A ,$105.92 , N/A ,$95.37 , N/A , N/A ,$167.44 , N/A , N/A ,$154.70 ,$163.80 , N/A ,$136.50 ,$127.40 ,$127.40 , N/A ,$127.40 ,$140.14 ,$140.14 , N/A ,$154.70 , N/A , N/A ,$102.10 ,$75.35 ,$75.71 ,$175.63 ,$182.00 , N/A ,$154.70 , N/A ,$95.37 ,$50.96 ,$163.80 ,$182.00 , N/A ,$118.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,$932.00 ,$671.04 ,$224.12 ,$932.00 ,$605.80 , N/A ,$260.96 ,$515.40 , N/A ,$542.42 , N/A ,$488.37 , N/A , N/A ,$857.44 , N/A , N/A ,$792.20 ,$838.80 , N/A ,$699.00 ,$652.40 ,$652.40 , N/A ,$652.40 ,$717.64 ,$717.64 , N/A ,$792.20 , N/A , N/A ,$522.85 ,$385.85 ,$387.71 ,$226.58 ,$224.12 , N/A ,$792.20 , N/A ,$488.37 ,$260.96 ,$838.80 ,$505.00 , N/A ,$605.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,$908.00 ,$653.76 ,$84.39 ,"$3,600.19 ",$590.20 ,"$1,411.28 ",$254.24 ,$502.12 ,"$1,411.28 ",$528.46 ,$889.84 ,$475.79 ,$889.84 ,$908.00 ,$835.36 ,"$3,600.19 ","$1,411.28 ",$771.80 ,$817.20 ,$889.84 ,$681.00 ,$635.60 ,$635.60 ,"$1,411.28 ",$635.60 ,$699.16 ,$699.16 ,$908.00 ,$771.80 ,"$1,440.08 ","$1,440.08 ",$509.39 ,$375.91 ,$377.73 ,$85.32 ,$84.39 ,"$1,481.84 ",$771.80 ,"$3,096.17 ",$475.79 ,$254.24 ,$817.20 ,$505.00 ,"$1,411.28 ",$590.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$553.00 ,$398.16 ,$39.33 ,$553.00 ,$359.45 ,$100.59 ,$154.84 ,$305.81 ,$100.59 ,$321.85 ,$100.59 ,$289.77 ,$100.59 ,$207.34 ,$508.76 ,$256.60 ,$100.59 ,$470.05 ,$497.70 ,$102.60 ,$414.75 ,$387.10 ,$387.10 ,$100.59 ,$387.10 ,$425.81 ,$425.81 ,$256.60 ,$470.05 ,$102.64 ,$102.64 ,$310.23 ,$228.94 ,$230.05 ,$39.77 ,$39.33 ,$105.61 ,$470.05 ,$220.68 ,$289.77 ,$154.84 ,$497.70 ,$505.00 ,$100.59 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000493,77074,HC BONE SURVEY LIMITED,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000496,77080,HC BONE DENSITY DXA,320,1 ,$668.00 ,$480.96 ,$62.12 ,$668.00 ,$434.20 ,$100.59 ,$187.04 ,$369.40 ,$100.59 ,$388.78 ,$100.59 ,$350.03 ,$100.59 ,$207.34 ,$614.56 ,$256.60 ,$100.59 ,$567.80 ,$601.20 ,$102.60 ,$501.00 ,$467.60 ,$467.60 ,$100.59 ,$467.60 ,$514.36 ,$514.36 ,$256.60 ,$567.80 ,$102.64 ,$102.64 ,$374.75 ,$276.55 ,$277.89 ,$62.80 ,$62.12 ,$105.61 ,$567.80 ,$220.68 ,$350.03 ,$187.04 ,$601.20 ,$505.00 ,$100.59 ,$434.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000497,77081,HC BONE DENSITY PERIPHERAL,320,1 ,$729.00 ,$524.88 ,$62.12 ,$729.00 ,$473.85 ,$81.76 ,$204.12 ,$403.14 ,$81.76 ,$424.28 ,$81.76 ,$382.00 ,$81.76 ,$168.54 ,$670.68 ,$208.59 ,$81.76 ,$619.65 ,$656.10 ,$83.40 ,$546.75 ,$510.30 ,$510.30 ,$81.76 ,$510.30 ,$561.33 ,$561.33 ,$208.59 ,$619.65 ,$83.43 ,$83.43 ,$408.97 ,$301.81 ,$303.26 ,$62.80 ,$62.12 ,$85.85 ,$619.65 ,$179.38 ,$382.00 ,$204.12 ,$656.10 ,$505.00 ,$81.76 ,$473.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$675.00 ,$486.00 ,$39.33 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 ,$39.77 ,$39.33 ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$505.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000509,77072,HC BONE AGE STUDIES,320,1 ,$392.00 ,$282.24 ,$39.33 ,$392.00 ,$254.80 ,$100.59 ,$109.76 ,$216.78 ,$100.59 ,$228.14 ,$100.59 ,$205.41 ,$100.59 ,$207.34 ,$360.64 ,$256.60 ,$100.59 ,$333.20 ,$352.80 ,$102.60 ,$294.00 ,$274.40 ,$274.40 ,$100.59 ,$274.40 ,$301.84 ,$301.84 ,$256.60 ,$333.20 ,$102.64 ,$102.64 ,$219.91 ,$162.29 ,$163.07 ,$39.77 ,$39.33 ,$105.61 ,$333.20 ,$220.68 ,$205.41 ,$109.76 ,$352.80 ,$392.00 ,$100.59 ,$254.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000551,77077,HC XR JOINT SRVY SINGLE 2 JOINTS,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000552,70100,HC XR MANDIBLE <3V,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000568,70190,HC XR EYE SOCKETS,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$293.00 ,$210.96 ,$39.33 ,$293.00 ,$190.45 ,$81.76 ,$82.04 ,$162.03 ,$81.76 ,$170.53 ,$81.76 ,$153.53 ,$81.76 ,$168.54 ,$269.56 ,$208.59 ,$81.76 ,$249.05 ,$263.70 ,$83.40 ,$219.75 ,$205.10 ,$205.10 ,$81.76 ,$205.10 ,$225.61 ,$225.61 ,$208.59 ,$249.05 ,$83.43 ,$83.43 ,$164.37 ,$121.30 ,$121.89 ,$39.77 ,$39.33 ,$85.85 ,$249.05 ,$179.38 ,$153.53 ,$82.04 ,$263.70 ,$293.00 ,$81.76 ,$190.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$672.00 ,$483.84 ,$39.33 ,$672.00 ,$436.80 ,$100.59 ,$188.16 ,$371.62 ,$100.59 ,$391.10 ,$100.59 ,$352.13 ,$100.59 ,$207.34 ,$618.24 ,$256.60 ,$100.59 ,$571.20 ,$604.80 ,$102.60 ,$504.00 ,$470.40 ,$470.40 ,$100.59 ,$470.40 ,$517.44 ,$517.44 ,$256.60 ,$571.20 ,$102.64 ,$102.64 ,$376.99 ,$278.21 ,$279.55 ,$39.77 ,$39.33 ,$105.61 ,$571.20 ,$220.68 ,$352.13 ,$188.16 ,$604.80 ,$505.00 ,$100.59 ,$436.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$237.00 ,$170.64 ,$39.33 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$39.77 ,$39.33 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$472.00 ,$339.84 ,$39.33 ,$472.00 ,$306.80 ,$81.76 ,$132.16 ,$261.02 ,$81.76 ,$274.70 ,$81.76 ,$247.33 ,$81.76 ,$168.54 ,$434.24 ,$208.59 ,$81.76 ,$401.20 ,$424.80 ,$83.40 ,$354.00 ,$330.40 ,$330.40 ,$81.76 ,$330.40 ,$363.44 ,$363.44 ,$208.59 ,$401.20 ,$83.43 ,$83.43 ,$264.79 ,$195.41 ,$196.35 ,$39.77 ,$39.33 ,$85.85 ,$401.20 ,$179.38 ,$247.33 ,$132.16 ,$424.80 ,$472.00 ,$81.76 ,$306.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$672.00 ,$483.84 ,$39.33 ,$672.00 ,$436.80 ,$100.59 ,$188.16 ,$371.62 ,$100.59 ,$391.10 ,$100.59 ,$352.13 ,$100.59 ,$207.34 ,$618.24 ,$256.60 ,$100.59 ,$571.20 ,$604.80 ,$102.60 ,$504.00 ,$470.40 ,$470.40 ,$100.59 ,$470.40 ,$517.44 ,$517.44 ,$256.60 ,$571.20 ,$102.64 ,$102.64 ,$376.99 ,$278.21 ,$279.55 ,$39.77 ,$39.33 ,$105.61 ,$571.20 ,$220.68 ,$352.13 ,$188.16 ,$604.80 ,$505.00 ,$100.59 ,$436.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$243.00 ,$174.96 ,$39.33 ,$256.60 ,$157.95 ,$100.59 ,$68.04 ,$134.38 ,$100.59 ,$141.43 ,$100.59 ,$127.33 ,$100.59 ,$207.34 ,$223.56 ,$256.60 ,$100.59 ,$206.55 ,$218.70 ,$102.60 ,$182.25 ,$170.10 ,$170.10 ,$100.59 ,$170.10 ,$187.11 ,$187.11 ,$243.00 ,$206.55 ,$102.64 ,$102.64 ,$136.32 ,$100.60 ,$101.09 ,$39.77 ,$39.33 ,$105.61 ,$206.55 ,$220.68 ,$127.33 ,$68.04 ,$218.70 ,$243.00 ,$100.59 ,$157.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$319.00 ,$229.68 ,$39.33 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$39.77 ,$39.33 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$440.00 ,$316.80 ,$39.33 ,$440.00 ,$286.00 ,$81.76 ,$123.20 ,$243.32 ,$81.76 ,$256.08 ,$81.76 ,$230.56 ,$81.76 ,$168.54 ,$404.80 ,$208.59 ,$81.76 ,$374.00 ,$396.00 ,$83.40 ,$330.00 ,$308.00 ,$308.00 ,$81.76 ,$308.00 ,$338.80 ,$338.80 ,$208.59 ,$374.00 ,$83.43 ,$83.43 ,$246.84 ,$182.16 ,$183.04 ,$39.77 ,$39.33 ,$85.85 ,$374.00 ,$179.38 ,$230.56 ,$123.20 ,$396.00 ,$440.00 ,$81.76 ,$286.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000583,72200,HC XR SACROILIC JOINT <3VIEWS,320,1 ,$401.00 ,$288.72 ,$39.33 ,$401.00 ,$260.65 ,$100.59 ,$112.28 ,$221.75 ,$100.59 ,$233.38 ,$100.59 ,$210.12 ,$100.59 ,$207.34 ,$368.92 ,$256.60 ,$100.59 ,$340.85 ,$360.90 ,$102.60 ,$300.75 ,$280.70 ,$280.70 ,$100.59 ,$280.70 ,$308.77 ,$308.77 ,$256.60 ,$340.85 ,$102.64 ,$102.64 ,$224.96 ,$166.01 ,$166.82 ,$39.77 ,$39.33 ,$105.61 ,$340.85 ,$220.68 ,$210.12 ,$112.28 ,$360.90 ,$401.00 ,$100.59 ,$260.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000589,74019,HC XR ABDOMEN 2V,320,1 ,$409.00 ,$294.48 ,$39.33 ,$409.00 ,$265.85 ,$100.59 ,$114.52 ,$226.18 ,$100.59 ,$238.04 ,$100.59 ,$214.32 ,$100.59 ,$207.34 ,$376.28 ,$256.60 ,$100.59 ,$347.65 ,$368.10 ,$102.60 ,$306.75 ,$286.30 ,$286.30 ,$100.59 ,$286.30 ,$314.93 ,$314.93 ,$256.60 ,$347.65 ,$102.64 ,$102.64 ,$229.45 ,$169.33 ,$170.14 ,$39.77 ,$39.33 ,$105.61 ,$347.65 ,$220.68 ,$214.32 ,$114.52 ,$368.10 ,$409.00 ,$100.59 ,$265.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000595,76000,HC FLUOROSCOPY >1HR,320,1 ,$675.00 ,$486.00 ,$39.33 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 ,$39.77 ,$39.33 ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$505.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000606,76125,HC CINERADIOGRAPHY/VIDEORADIOGRAPHY EXAM,320,1 ,$532.00 ,$383.04 ,$39.33 ,$532.00 ,$345.80 , N/A ,$148.96 ,$294.20 , N/A ,$309.62 , N/A ,$278.77 , N/A , N/A ,$489.44 , N/A , N/A ,$452.20 ,$478.80 , N/A ,$399.00 ,$372.40 ,$372.40 , N/A ,$372.40 ,$409.64 ,$409.64 , N/A ,$452.20 , N/A , N/A ,$298.45 ,$220.25 ,$221.31 ,$39.77 ,$39.33 , N/A ,$452.20 , N/A ,$278.77 ,$148.96 ,$478.80 ,$505.00 , N/A ,$345.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 HSHS HOLY FAMILY HOSPITAL INC (ACU),32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,246.00 ",$897.12 ,$39.33 ,"$1,246.00 ",$809.90 , N/A ,$348.88 ,$689.04 , N/A ,$725.17 , N/A ,$652.90 , N/A , N/A ,"$1,146.32 ", N/A , N/A ,"$1,059.10 ","$1,121.40 ", N/A ,$934.50 ,$872.20 ,$872.20 , N/A ,$872.20 ,$959.42 ,$959.42 , N/A ,"$1,059.10 ", N/A , N/A ,$699.01 ,$515.84 ,$518.34 ,$39.77 ,$39.33 , N/A ,"$1,059.10 ", N/A ,$652.90 ,$348.88 ,"$1,121.40 ",$505.00 , N/A ,$809.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$214.00 ,$154.08 ,$59.92 ,$214.00 ,$139.10 ,$63.49 ,$59.92 ,$118.34 ,$63.49 ,$124.55 ,$63.49 ,$112.14 ,$63.49 ,$130.88 ,$196.88 ,$161.99 ,$63.49 ,$181.90 ,$192.60 ,$64.77 ,$160.50 ,$149.80 ,$149.80 ,$63.49 ,$149.80 ,$164.78 ,$164.78 ,$161.99 ,$181.90 ,$64.79 ,$64.79 ,$120.05 ,$88.60 ,$89.02 , N/A , N/A ,$66.67 ,$181.90 ,$139.31 ,$112.14 ,$59.92 ,$192.60 ,$214.00 ,$63.49 ,$139.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$806.00 ,$580.32 ,$194.41 ,$806.00 ,$523.90 ,$194.41 ,$225.68 ,$445.72 ,$194.41 ,$469.09 ,$194.41 ,$422.34 ,$194.41 ,$400.72 ,$741.52 ,$495.94 ,$194.41 ,$685.10 ,$725.40 ,$198.29 ,$604.50 ,$564.20 ,$564.20 ,$194.41 ,$564.20 ,$620.62 ,$620.62 ,$495.94 ,$685.10 ,$198.38 ,$198.38 ,$452.17 ,$333.68 ,$335.30 , N/A , N/A ,$204.13 ,$685.10 ,$426.51 ,$422.34 ,$225.68 ,$725.40 ,$806.00 ,$194.41 ,$523.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$642.00 ,$462.24 ,$179.76 ,$798.57 ,$417.30 ,$313.04 ,$179.76 ,$355.03 ,$313.04 ,$373.64 ,$313.04 ,$336.41 ,$313.04 ,$642.00 ,$590.64 ,$798.57 ,$313.04 ,$545.70 ,$577.80 ,$319.30 ,$481.50 ,$449.40 ,$449.40 ,$313.04 ,$449.40 ,$494.34 ,$494.34 ,$642.00 ,$545.70 ,$319.43 ,$319.43 ,$360.16 ,$265.79 ,$267.07 ,$223.52 ,$221.10 ,$328.69 ,$545.70 ,$686.77 ,$336.41 ,$179.76 ,$577.80 ,$642.00 ,$313.04 ,$417.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$214.00 ,$154.08 ,$59.92 ,$214.00 ,$139.10 ,$63.49 ,$59.92 ,$118.34 ,$63.49 ,$124.55 ,$63.49 ,$112.14 ,$63.49 ,$130.88 ,$196.88 ,$161.99 ,$63.49 ,$181.90 ,$192.60 ,$64.77 ,$160.50 ,$149.80 ,$149.80 ,$63.49 ,$149.80 ,$164.78 ,$164.78 ,$161.99 ,$181.90 ,$64.79 ,$64.79 ,$120.05 ,$88.60 ,$89.02 ,$206.51 ,$214.00 ,$66.67 ,$181.90 ,$139.31 ,$112.14 ,$59.92 ,$192.60 ,$214.00 ,$63.49 ,$139.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,696.00 ","$1,221.12 ",$297.40 ,"$1,696.00 ","$1,102.40 ",$365.80 ,$474.88 ,$937.89 ,$365.80 ,$987.07 ,$365.80 ,$888.70 ,$365.80 ,$754.00 ,"$1,560.32 ",$933.16 ,$365.80 ,"$1,441.60 ","$1,526.40 ",$373.12 ,"$1,272.00 ","$1,187.20 ","$1,187.20 ",$365.80 ,"$1,187.20 ","$1,305.92 ","$1,305.92 ",$933.16 ,"$1,441.60 ",$373.27 ,$373.27 ,$951.46 ,$702.14 ,$705.54 ,$300.66 ,$297.40 ,$384.09 ,"$1,441.60 ",$802.52 ,$888.70 ,$474.88 ,"$1,526.40 ","$1,186.00 ",$365.80 ,"$1,102.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000006,78013,HC NM THYROID SCAN,340,1 ,"$1,093.00 ",$786.96 ,$297.40 ,"$1,093.00 ",$710.45 ,$365.80 ,$306.04 ,$604.43 ,$365.80 ,$636.13 ,$365.80 ,$572.73 ,$365.80 ,$754.00 ,"$1,005.56 ",$933.16 ,$365.80 ,$929.05 ,$983.70 ,$373.12 ,$819.75 ,$765.10 ,$765.10 ,$365.80 ,$765.10 ,$841.61 ,$841.61 ,$933.16 ,$929.05 ,$373.27 ,$373.27 ,$613.17 ,$452.50 ,$454.69 ,$300.66 ,$297.40 ,$384.09 ,$929.05 ,$802.52 ,$572.73 ,$306.04 ,$983.70 ,"$1,093.00 ",$365.80 ,$710.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,696.00 ","$1,221.12 ",$265.42 ,"$1,696.00 ","$1,102.40 ",$365.80 ,$474.88 ,$937.89 ,$365.80 ,$987.07 ,$365.80 ,$888.70 ,$365.80 ,$754.00 ,"$1,560.32 ",$933.16 ,$365.80 ,"$1,441.60 ","$1,526.40 ",$373.12 ,"$1,272.00 ","$1,187.20 ","$1,187.20 ",$365.80 ,"$1,187.20 ","$1,305.92 ","$1,305.92 ",$933.16 ,"$1,441.60 ",$373.27 ,$373.27 ,$951.46 ,$702.14 ,$705.54 ,$268.33 ,$265.42 ,$384.09 ,"$1,441.60 ",$802.52 ,$888.70 ,$474.88 ,"$1,526.40 ","$1,186.00 ",$365.80 ,"$1,102.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$3,317.00 ","$2,388.24 ",$297.40 ,"$3,317.00 ","$2,156.05 ",$474.80 ,$928.76 ,"$1,834.30 ",$474.80 ,"$1,930.49 ",$474.80 ,"$1,738.11 ",$474.80 ,$978.67 ,"$3,051.64 ","$1,211.23 ",$474.80 ,"$2,819.45 ","$2,985.30 ",$484.30 ,"$2,487.75 ","$2,321.90 ","$2,321.90 ",$474.80 ,"$2,321.90 ","$2,554.09 ","$2,554.09 ","$1,211.23 ","$2,819.45 ",$484.49 ,$484.49 ,"$1,860.84 ","$1,373.24 ","$1,379.87 ",$300.66 ,$297.40 ,$498.54 ,"$2,819.45 ","$1,041.66 ","$1,738.11 ",$928.76 ,"$2,985.30 ","$1,186.00 ",$474.80 ,"$2,156.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$2,289.00 ","$1,648.08 ",$265.42 ,"$2,289.00 ","$1,487.85 ",$365.80 ,$640.92 ,"$1,265.82 ",$365.80 ,"$1,332.20 ",$365.80 ,"$1,199.44 ",$365.80 ,$754.00 ,"$2,105.88 ",$933.16 ,$365.80 ,"$1,945.65 ","$2,060.10 ",$373.12 ,"$1,716.75 ","$1,602.30 ","$1,602.30 ",$365.80 ,"$1,602.30 ","$1,762.53 ","$1,762.53 ",$933.16 ,"$1,945.65 ",$373.27 ,$373.27 ,"$1,284.13 ",$947.65 ,$952.22 ,$268.33 ,$265.42 ,$384.09 ,"$1,945.65 ",$802.52 ,"$1,199.44 ",$640.92 ,"$2,060.10 ","$1,186.00 ",$365.80 ,"$1,487.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$2,289.00 ","$1,648.08 ",$297.40 ,"$2,289.00 ","$1,487.85 ",$365.80 ,$640.92 ,"$1,265.82 ",$365.80 ,"$1,332.20 ",$365.80 ,"$1,199.44 ",$365.80 ,$754.00 ,"$2,105.88 ",$933.16 ,$365.80 ,"$1,945.65 ","$2,060.10 ",$373.12 ,"$1,716.75 ","$1,602.30 ","$1,602.30 ",$365.80 ,"$1,602.30 ","$1,762.53 ","$1,762.53 ",$933.16 ,"$1,945.65 ",$373.27 ,$373.27 ,"$1,284.13 ",$947.65 ,$952.22 ,$300.66 ,$297.40 ,$384.09 ,"$1,945.65 ",$802.52 ,"$1,199.44 ",$640.92 ,"$2,060.10 ","$1,186.00 ",$365.80 ,"$1,487.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$1,869.00 ","$1,345.68 ",$297.40 ,"$1,869.00 ","$1,214.85 ",$365.80 ,$523.32 ,"$1,033.56 ",$365.80 ,"$1,087.76 ",$365.80 ,$979.36 ,$365.80 ,$754.00 ,"$1,719.48 ",$933.16 ,$365.80 ,"$1,588.65 ","$1,682.10 ",$373.12 ,"$1,401.75 ","$1,308.30 ","$1,308.30 ",$365.80 ,"$1,308.30 ","$1,439.13 ","$1,439.13 ",$933.16 ,"$1,588.65 ",$373.27 ,$373.27 ,"$1,048.51 ",$773.77 ,$777.50 ,$300.66 ,$297.40 ,$384.09 ,"$1,588.65 ",$802.52 ,$979.36 ,$523.32 ,"$1,682.10 ","$1,186.00 ",$365.80 ,"$1,214.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,869.00 ","$1,345.68 ",$297.40 ,"$1,869.00 ","$1,214.85 ",$365.80 ,$523.32 ,"$1,033.56 ",$365.80 ,"$1,087.76 ",$365.80 ,$979.36 ,$365.80 ,$754.00 ,"$1,719.48 ",$933.16 ,$365.80 ,"$1,588.65 ","$1,682.10 ",$373.12 ,"$1,401.75 ","$1,308.30 ","$1,308.30 ",$365.80 ,"$1,308.30 ","$1,439.13 ","$1,439.13 ",$933.16 ,"$1,588.65 ",$373.27 ,$373.27 ,"$1,048.51 ",$773.77 ,$777.50 ,$300.66 ,$297.40 ,$384.09 ,"$1,588.65 ",$802.52 ,$979.36 ,$523.32 ,"$1,682.10 ","$1,186.00 ",$365.80 ,"$1,214.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,869.00 ","$1,345.68 ",$265.42 ,"$1,869.00 ","$1,214.85 ",$365.80 ,$523.32 ,"$1,033.56 ",$365.80 ,"$1,087.76 ",$365.80 ,$979.36 ,$365.80 ,$754.00 ,"$1,719.48 ",$933.16 ,$365.80 ,"$1,588.65 ","$1,682.10 ",$373.12 ,"$1,401.75 ","$1,308.30 ","$1,308.30 ",$365.80 ,"$1,308.30 ","$1,439.13 ","$1,439.13 ",$933.16 ,"$1,588.65 ",$373.27 ,$373.27 ,"$1,048.51 ",$773.77 ,$777.50 ,$268.33 ,$265.42 ,$384.09 ,"$1,588.65 ",$802.52 ,$979.36 ,$523.32 ,"$1,682.10 ","$1,186.00 ",$365.80 ,"$1,214.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,904.00 ","$1,370.88 ",$265.42 ,"$1,904.00 ","$1,237.60 ",$365.80 ,$533.12 ,"$1,052.91 ",$365.80 ,"$1,108.13 ",$365.80 ,$997.70 ,$365.80 ,$754.00 ,"$1,751.68 ",$933.16 ,$365.80 ,"$1,618.40 ","$1,713.60 ",$373.12 ,"$1,428.00 ","$1,332.80 ","$1,332.80 ",$365.80 ,"$1,332.80 ","$1,466.08 ","$1,466.08 ",$933.16 ,"$1,618.40 ",$373.27 ,$373.27 ,"$1,068.14 ",$788.26 ,$792.06 ,$268.33 ,$265.42 ,$384.09 ,"$1,618.40 ",$802.52 ,$997.70 ,$533.12 ,"$1,713.60 ","$1,186.00 ",$365.80 ,"$1,237.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,904.00 ","$1,370.88 ",$265.42 ,"$1,904.00 ","$1,237.60 ",$365.80 ,$533.12 ,"$1,052.91 ",$365.80 ,"$1,108.13 ",$365.80 ,$997.70 ,$365.80 ,$754.00 ,"$1,751.68 ",$933.16 ,$365.80 ,"$1,618.40 ","$1,713.60 ",$373.12 ,"$1,428.00 ","$1,332.80 ","$1,332.80 ",$365.80 ,"$1,332.80 ","$1,466.08 ","$1,466.08 ",$933.16 ,"$1,618.40 ",$373.27 ,$373.27 ,"$1,068.14 ",$788.26 ,$792.06 ,$268.33 ,$265.42 ,$384.09 ,"$1,618.40 ",$802.52 ,$997.70 ,$533.12 ,"$1,713.60 ","$1,186.00 ",$365.80 ,"$1,237.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$1,904.00 ","$1,370.88 ",$265.42 ,"$1,904.00 ","$1,237.60 ",$365.80 ,$533.12 ,"$1,052.91 ",$365.80 ,"$1,108.13 ",$365.80 ,$997.70 ,$365.80 ,$754.00 ,"$1,751.68 ",$933.16 ,$365.80 ,"$1,618.40 ","$1,713.60 ",$373.12 ,"$1,428.00 ","$1,332.80 ","$1,332.80 ",$365.80 ,"$1,332.80 ","$1,466.08 ","$1,466.08 ",$933.16 ,"$1,618.40 ",$373.27 ,$373.27 ,"$1,068.14 ",$788.26 ,$792.06 ,$268.33 ,$265.42 ,$384.09 ,"$1,618.40 ",$802.52 ,$997.70 ,$533.12 ,"$1,713.60 ","$1,186.00 ",$365.80 ,"$1,237.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000032,78315,HC BONE SCAN FLOW WHOLE BODY STATICS,340,1 ,"$1,904.00 ","$1,370.88 ",$265.42 ,"$1,904.00 ","$1,237.60 ",$365.80 ,$533.12 ,"$1,052.91 ",$365.80 ,"$1,108.13 ",$365.80 ,$997.70 ,$365.80 ,$754.00 ,"$1,751.68 ",$933.16 ,$365.80 ,"$1,618.40 ","$1,713.60 ",$373.12 ,"$1,428.00 ","$1,332.80 ","$1,332.80 ",$365.80 ,"$1,332.80 ","$1,466.08 ","$1,466.08 ",$933.16 ,"$1,618.40 ",$373.27 ,$373.27 ,"$1,068.14 ",$788.26 ,$792.06 ,$268.33 ,$265.42 ,$384.09 ,"$1,618.40 ",$802.52 ,$997.70 ,$533.12 ,"$1,713.60 ","$1,186.00 ",$365.80 ,"$1,237.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,904.00 ","$1,370.88 ",$265.42 ,"$1,904.00 ","$1,237.60 ",$365.80 ,$533.12 ,"$1,052.91 ",$365.80 ,"$1,108.13 ",$365.80 ,$997.70 ,$365.80 ,$754.00 ,"$1,751.68 ",$933.16 ,$365.80 ,"$1,618.40 ","$1,713.60 ",$373.12 ,"$1,428.00 ","$1,332.80 ","$1,332.80 ",$365.80 ,"$1,332.80 ","$1,466.08 ","$1,466.08 ",$933.16 ,"$1,618.40 ",$373.27 ,$373.27 ,"$1,068.14 ",$788.26 ,$792.06 ,$268.33 ,$265.42 ,$384.09 ,"$1,618.40 ",$802.52 ,$997.70 ,$533.12 ,"$1,713.60 ","$1,186.00 ",$365.80 ,"$1,237.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$2,812.00 ","$2,024.64 ",$297.40 ,"$3,186.58 ","$1,827.80 ","$1,249.14 ",$787.36 ,"$1,555.04 ","$1,249.14 ","$1,636.58 ","$1,249.14 ","$1,473.49 ","$1,249.14 ","$2,574.75 ","$2,587.04 ","$3,186.58 ","$1,249.14 ","$2,390.20 ","$2,530.80 ","$1,274.12 ","$2,109.00 ","$1,968.40 ","$1,968.40 ","$1,249.14 ","$1,968.40 ","$2,165.24 ","$2,165.24 ","$2,812.00 ","$2,390.20 ","$1,274.63 ","$1,274.63 ","$1,577.53 ","$1,164.17 ","$1,169.79 ",$300.66 ,$297.40 ,"$1,311.59 ","$2,390.20 ","$2,740.46 ","$1,473.49 ",$787.36 ,"$2,530.80 ","$1,186.00 ","$1,249.14 ","$1,827.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$5,622.00 ","$4,047.84 ",$651.15 ,"$5,622.00 ","$3,654.30 ","$1,249.14 ","$1,574.16 ","$3,108.97 ","$1,249.14 ","$3,272.00 ","$1,249.14 ","$2,945.93 ","$1,249.14 ","$2,574.75 ","$5,172.24 ","$3,186.58 ","$1,249.14 ","$4,778.70 ","$5,059.80 ","$1,274.12 ","$4,216.50 ","$3,935.40 ","$3,935.40 ","$1,249.14 ","$3,935.40 ","$4,328.94 ","$4,328.94 ","$3,186.58 ","$4,778.70 ","$1,274.63 ","$1,274.63 ","$3,153.94 ","$2,327.51 ","$2,338.75 ",$658.27 ,$651.15 ,"$1,311.59 ","$4,778.70 ","$2,740.46 ","$2,945.93 ","$1,574.16 ","$5,059.80 ","$1,186.00 ","$1,249.14 ","$3,654.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,199.00 ","$1,583.28 ",$265.42 ,"$2,199.00 ","$1,429.35 ",$365.80 ,$615.72 ,"$1,216.05 ",$365.80 ,"$1,279.82 ",$365.80 ,"$1,152.28 ",$365.80 ,$754.00 ,"$2,023.08 ",$933.16 ,$365.80 ,"$1,869.15 ","$1,979.10 ",$373.12 ,"$1,649.25 ","$1,539.30 ","$1,539.30 ",$365.80 ,"$1,539.30 ","$1,693.23 ","$1,693.23 ",$933.16 ,"$1,869.15 ",$373.27 ,$373.27 ,"$1,233.64 ",$910.39 ,$914.78 ,$268.33 ,$265.42 ,$384.09 ,"$1,869.15 ",$802.52 ,"$1,152.28 ",$615.72 ,"$1,979.10 ","$1,186.00 ",$365.80 ,"$1,429.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000047,78580,HC LUNG PERFUS,340,1 ,"$1,484.00 ","$1,068.48 ",$297.40 ,"$1,484.00 ",$964.60 ,$365.80 ,$415.52 ,$820.65 ,$365.80 ,$863.69 ,$365.80 ,$777.62 ,$365.80 ,$754.00 ,"$1,365.28 ",$933.16 ,$365.80 ,"$1,261.40 ","$1,335.60 ",$373.12 ,"$1,113.00 ","$1,038.80 ","$1,038.80 ",$365.80 ,"$1,038.80 ","$1,142.68 ","$1,142.68 ",$933.16 ,"$1,261.40 ",$373.27 ,$373.27 ,$832.52 ,$614.38 ,$617.34 ,$300.66 ,$297.40 ,$384.09 ,"$1,261.40 ",$802.52 ,$777.62 ,$415.52 ,"$1,335.60 ","$1,186.00 ",$365.80 ,$964.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$2,329.00 ","$1,676.88 ",$297.40 ,"$2,329.00 ","$1,513.85 ",$474.80 ,$652.12 ,"$1,287.94 ",$474.80 ,"$1,355.48 ",$474.80 ,"$1,220.40 ",$474.80 ,$978.67 ,"$2,142.68 ","$1,211.23 ",$474.80 ,"$1,979.65 ","$2,096.10 ",$484.30 ,"$1,746.75 ","$1,630.30 ","$1,630.30 ",$474.80 ,"$1,630.30 ","$1,793.33 ","$1,793.33 ","$1,211.23 ","$1,979.65 ",$484.49 ,$484.49 ,"$1,306.57 ",$964.21 ,$968.86 ,$300.66 ,$297.40 ,$498.54 ,"$1,979.65 ","$1,041.66 ","$1,220.40 ",$652.12 ,"$2,096.10 ","$1,186.00 ",$474.80 ,"$1,513.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000052,78579,HC LUNG SCAN-VENTILATION,340,1 ,"$1,106.00 ",$796.32 ,$297.40 ,"$1,106.00 ",$718.90 ,$365.80 ,$309.68 ,$611.62 ,$365.80 ,$643.69 ,$365.80 ,$579.54 ,$365.80 ,$754.00 ,"$1,017.52 ",$933.16 ,$365.80 ,$940.10 ,$995.40 ,$373.12 ,$829.50 ,$774.20 ,$774.20 ,$365.80 ,$774.20 ,$851.62 ,$851.62 ,$933.16 ,$940.10 ,$373.27 ,$373.27 ,$620.47 ,$457.88 ,$460.10 ,$300.66 ,$297.40 ,$384.09 ,$940.10 ,$802.52 ,$579.54 ,$309.68 ,$995.40 ,"$1,106.00 ",$365.80 ,$718.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$2,337.00 ","$1,682.64 ",$265.42 ,"$2,337.00 ","$1,519.05 ",$474.80 ,$654.36 ,"$1,292.36 ",$474.80 ,"$1,360.13 ",$474.80 ,"$1,224.59 ",$474.80 ,$978.67 ,"$2,150.04 ","$1,211.23 ",$474.80 ,"$1,986.45 ","$2,103.30 ",$484.30 ,"$1,752.75 ","$1,635.90 ","$1,635.90 ",$474.80 ,"$1,635.90 ","$1,799.49 ","$1,799.49 ","$1,211.23 ","$1,986.45 ",$484.49 ,$484.49 ,"$1,311.06 ",$967.52 ,$972.19 ,$268.33 ,$265.42 ,$498.54 ,"$1,986.45 ","$1,041.66 ","$1,224.59 ",$654.36 ,"$2,103.30 ","$1,186.00 ",$474.80 ,"$1,519.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$2,337.00 ","$1,682.64 ",$265.42 ,"$2,337.00 ","$1,519.05 ",$474.80 ,$654.36 ,"$1,292.36 ",$474.80 ,"$1,360.13 ",$474.80 ,"$1,224.59 ",$474.80 ,$978.67 ,"$2,150.04 ","$1,211.23 ",$474.80 ,"$1,986.45 ","$2,103.30 ",$484.30 ,"$1,752.75 ","$1,635.90 ","$1,635.90 ",$474.80 ,"$1,635.90 ","$1,799.49 ","$1,799.49 ","$1,211.23 ","$1,986.45 ",$484.49 ,$484.49 ,"$1,311.06 ",$967.52 ,$972.19 ,$268.33 ,$265.42 ,$498.54 ,"$1,986.45 ","$1,041.66 ","$1,224.59 ",$654.36 ,"$2,103.30 ","$1,186.00 ",$474.80 ,"$1,519.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000065,78709,HC KIDNEY W AND W/O PHARM INTERVEN,340,1 ,"$2,337.00 ","$1,682.64 ",$265.42 ,"$2,337.00 ","$1,519.05 ",$474.80 ,$654.36 ,"$1,292.36 ",$474.80 ,"$1,360.13 ",$474.80 ,"$1,224.59 ",$474.80 ,$978.67 ,"$2,150.04 ","$1,211.23 ",$474.80 ,"$1,986.45 ","$2,103.30 ",$484.30 ,"$1,752.75 ","$1,635.90 ","$1,635.90 ",$474.80 ,"$1,635.90 ","$1,799.49 ","$1,799.49 ","$1,211.23 ","$1,986.45 ",$484.49 ,$484.49 ,"$1,311.06 ",$967.52 ,$972.19 ,$268.33 ,$265.42 ,$498.54 ,"$1,986.45 ","$1,041.66 ","$1,224.59 ",$654.36 ,"$2,103.30 ","$1,186.00 ",$474.80 ,"$1,519.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$3,831.00 ","$2,758.32 ",$651.15 ,"$3,831.00 ","$2,490.15 ","$1,249.14 ","$1,072.68 ","$2,118.54 ","$1,249.14 ","$2,229.64 ","$1,249.14 ","$2,007.44 ","$1,249.14 ","$2,574.75 ","$3,524.52 ","$3,186.58 ","$1,249.14 ","$3,256.35 ","$3,447.90 ","$1,274.12 ","$2,873.25 ","$2,681.70 ","$2,681.70 ","$1,249.14 ","$2,681.70 ","$2,949.87 ","$2,949.87 ","$3,186.58 ","$3,256.35 ","$1,274.63 ","$1,274.63 ","$2,149.19 ","$1,586.03 ","$1,593.70 ",$658.27 ,$651.15 ,"$1,311.59 ","$3,256.35 ","$2,740.46 ","$2,007.44 ","$1,072.68 ","$3,447.90 ","$1,186.00 ","$1,249.14 ","$2,490.15 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$2,289.00 ","$1,648.08 ",$297.40 ,"$2,289.00 ","$1,487.85 ",$474.80 ,$640.92 ,"$1,265.82 ",$474.80 ,"$1,332.20 ",$474.80 ,"$1,199.44 ",$474.80 ,$978.67 ,"$2,105.88 ","$1,211.23 ",$474.80 ,"$1,945.65 ","$2,060.10 ",$484.30 ,"$1,716.75 ","$1,602.30 ","$1,602.30 ",$474.80 ,"$1,602.30 ","$1,762.53 ","$1,762.53 ","$1,211.23 ","$1,945.65 ",$484.49 ,$484.49 ,"$1,284.13 ",$947.65 ,$952.22 ,$300.66 ,$297.40 ,$498.54 ,"$1,945.65 ","$1,041.66 ","$1,199.44 ",$640.92 ,"$2,060.10 ","$1,186.00 ",$474.80 ,"$1,487.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$1,106.00 ",$796.32 ,$265.42 ,"$1,106.00 ",$718.90 ,$365.80 ,$309.68 ,$611.62 ,$365.80 ,$643.69 ,$365.80 ,$579.54 ,$365.80 ,$754.00 ,"$1,017.52 ",$933.16 ,$365.80 ,$940.10 ,$995.40 ,$373.12 ,$829.50 ,$774.20 ,$774.20 ,$365.80 ,$774.20 ,$851.62 ,$851.62 ,$933.16 ,$940.10 ,$373.27 ,$373.27 ,$620.47 ,$457.88 ,$460.10 ,$268.33 ,$265.42 ,$384.09 ,$940.10 ,$802.52 ,$579.54 ,$309.68 ,$995.40 ,"$1,106.00 ",$365.80 ,$718.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,$296.00 ,$213.12 ,$82.88 ,$296.00 ,$192.40 , N/A ,$82.88 ,$163.69 , N/A ,$172.27 , N/A ,$155.10 , N/A , N/A , N/A , N/A , N/A ,$251.60 ,$266.40 , N/A ,$222.00 ,$207.20 ,$207.20 , N/A ,$207.20 ,$227.92 ,$227.92 , N/A ,$251.60 , N/A , N/A ,$166.06 ,$122.54 ,$123.14 , N/A , N/A , N/A ,$251.60 , N/A ,$155.10 ,$82.88 ,$266.40 ,$296.00 , N/A ,$192.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$178.00 ,$128.16 ,$33.54 ,$178.00 ,$115.70 , N/A ,$49.84 ,$98.43 , N/A ,$103.60 , N/A ,$93.27 , N/A , N/A , N/A , N/A , N/A ,$151.30 ,$160.20 , N/A ,$133.50 ,$124.60 ,$124.60 , N/A ,$124.60 ,$137.06 ,$137.06 , N/A ,$151.30 , N/A , N/A ,$99.86 ,$73.69 ,$74.05 , N/A , N/A , N/A ,$151.30 , N/A ,$93.27 ,$49.84 ,$160.20 ,$33.54 , N/A ,$115.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$129.00 ,$92.88 ,$36.12 ,$129.00 ,$83.85 , N/A ,$36.12 ,$71.34 , N/A ,$75.08 , N/A ,$67.60 , N/A , N/A , N/A , N/A , N/A ,$109.65 ,$116.10 , N/A ,$96.75 ,$90.30 ,$90.30 , N/A ,$90.30 ,$99.33 ,$99.33 , N/A ,$109.65 , N/A , N/A ,$72.37 ,$53.41 ,$53.66 , N/A , N/A , N/A ,$109.65 , N/A ,$67.60 ,$36.12 ,$116.10 ,$129.00 , N/A ,$83.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$96.00 ,$69.12 ,$26.88 ,$96.00 ,$62.40 , N/A ,$26.88 ,$53.09 , N/A ,$55.87 , N/A ,$50.30 , N/A , N/A , N/A , N/A , N/A ,$81.60 ,$86.40 , N/A ,$72.00 ,$67.20 ,$67.20 , N/A ,$67.20 ,$73.92 ,$73.92 , N/A ,$81.60 , N/A , N/A ,$53.86 ,$39.74 ,$39.94 , N/A , N/A , N/A ,$81.60 , N/A ,$50.30 ,$26.88 ,$86.40 ,$54.80 , N/A ,$62.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$131.00 ,$94.32 ,$36.68 ,$131.00 ,$85.15 , N/A ,$36.68 ,$72.44 , N/A ,$76.24 , N/A ,$68.64 , N/A , N/A , N/A , N/A , N/A ,$111.35 ,$117.90 , N/A ,$98.25 ,$91.70 ,$91.70 , N/A ,$91.70 ,$100.87 ,$100.87 , N/A ,$111.35 , N/A , N/A ,$73.49 ,$54.23 ,$54.50 , N/A , N/A , N/A ,$111.35 , N/A ,$68.64 ,$36.68 ,$117.90 ,$131.00 , N/A ,$85.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,"$1,491.00 ","$1,073.52 ",$417.48 ,"$1,491.00 ",$969.15 , N/A ,$417.48 ,$824.52 , N/A ,$867.76 , N/A ,$781.28 , N/A , N/A , N/A , N/A , N/A ,"$1,267.35 ","$1,341.90 ", N/A ,"$1,118.25 ","$1,043.70 ","$1,043.70 ", N/A ,"$1,043.70 ","$1,148.07 ","$1,148.07 ", N/A ,"$1,267.35 ", N/A , N/A ,$836.45 ,$617.27 ,$620.26 , N/A , N/A , N/A ,"$1,267.35 ", N/A ,$781.28 ,$417.48 ,"$1,341.90 ","$1,327.95 ", N/A ,$969.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),34300058,A9500,HC SESTAMIBI PER STUDY DOSE,343,1 ,$296.00 ,$213.12 ,$82.88 ,$296.00 ,$192.40 , N/A ,$82.88 ,$163.69 , N/A ,$172.27 , N/A ,$155.10 , N/A , N/A , N/A , N/A , N/A ,$251.60 ,$266.40 , N/A ,$222.00 ,$207.20 ,$207.20 , N/A ,$207.20 ,$227.92 ,$227.92 , N/A ,$251.60 , N/A , N/A ,$166.06 ,$122.54 ,$123.14 , N/A , N/A , N/A ,$251.60 , N/A ,$155.10 ,$82.88 ,$266.40 ,$296.00 , N/A ,$192.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$2,419.00 ","$1,741.68 ",$100.59 ,"$2,419.00 ","$1,572.35 ",$100.59 ,$677.32 ,"$1,337.71 ",$100.59 ,"$1,407.86 ",$100.59 ,"$1,267.56 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$2,056.15 ","$2,177.10 ",$102.60 ,"$1,814.25 ","$1,693.30 ","$1,693.30 ",$100.59 ,"$1,693.30 ","$1,862.63 ","$1,862.63 ",$256.60 ,"$2,056.15 ",$102.64 ,$102.64 ,"$1,357.06 ","$1,001.47 ","$1,006.30 ",$204.16 ,$201.95 ,$105.61 ,"$2,056.15 ",$220.68 ,"$1,267.56 ",$677.32 ,"$2,177.10 ",$825.00 ,$100.59 ,"$1,572.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$3,048.00 ","$2,194.56 ",$169.73 ,"$3,048.00 ","$1,981.20 ",$169.73 ,$853.44 ,"$1,685.54 ",$169.73 ,"$1,773.94 ",$169.73 ,"$1,597.15 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,590.80 ","$2,743.20 ",$173.12 ,"$2,286.00 ","$2,133.60 ","$2,133.60 ",$169.73 ,"$2,133.60 ","$2,346.96 ","$2,346.96 ",$432.97 ,"$2,590.80 ",$173.19 ,$173.19 ,"$1,709.93 ","$1,261.87 ","$1,267.97 ",$204.16 ,$201.95 ,$178.21 ,"$2,590.80 ",$372.35 ,"$1,597.15 ",$853.44 ,"$2,743.20 ",$825.00 ,$169.73 ,"$1,981.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$3,424.00 ","$2,465.28 ",$169.73 ,"$3,424.00 ","$2,225.60 ",$169.73 ,$958.72 ,"$1,893.47 ",$169.73 ,"$1,992.77 ",$169.73 ,"$1,794.18 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,910.40 ","$3,081.60 ",$173.12 ,"$2,568.00 ","$2,396.80 ","$2,396.80 ",$169.73 ,"$2,396.80 ","$2,636.48 ","$2,636.48 ",$432.97 ,"$2,910.40 ",$173.19 ,$173.19 ,"$1,920.86 ","$1,417.54 ","$1,424.38 ",$204.16 ,$201.95 ,$178.21 ,"$2,910.40 ",$372.35 ,"$1,794.18 ",$958.72 ,"$3,081.60 ",$825.00 ,$169.73 ,"$2,225.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$2,309.00 ","$1,662.48 ",$98.12 ,"$2,309.00 ","$1,500.85 ",$100.59 ,$646.52 ,"$1,276.88 ",$100.59 ,"$1,343.84 ",$100.59 ,"$1,209.92 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$1,962.65 ","$2,078.10 ",$102.60 ,"$1,731.75 ","$1,616.30 ","$1,616.30 ",$100.59 ,"$1,616.30 ","$1,777.93 ","$1,777.93 ",$256.60 ,"$1,962.65 ",$102.64 ,$102.64 ,"$1,295.35 ",$955.93 ,$960.54 ,$99.20 ,$98.12 ,$105.61 ,"$1,962.65 ",$220.68 ,"$1,209.92 ",$646.52 ,"$2,078.10 ",$825.00 ,$100.59 ,"$1,500.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$3,048.00 ","$2,194.56 ",$98.12 ,"$3,048.00 ","$1,981.20 ",$169.73 ,$853.44 ,"$1,685.54 ",$169.73 ,"$1,773.94 ",$169.73 ,"$1,597.15 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,590.80 ","$2,743.20 ",$173.12 ,"$2,286.00 ","$2,133.60 ","$2,133.60 ",$169.73 ,"$2,133.60 ","$2,346.96 ","$2,346.96 ",$432.97 ,"$2,590.80 ",$173.19 ,$173.19 ,"$1,709.93 ","$1,261.87 ","$1,267.97 ",$99.20 ,$98.12 ,$178.21 ,"$2,590.80 ",$372.35 ,"$1,597.15 ",$853.44 ,"$2,743.20 ",$825.00 ,$169.73 ,"$1,981.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$3,424.00 ","$2,465.28 ",$98.12 ,"$3,424.00 ","$2,225.60 ",$169.73 ,$958.72 ,"$1,893.47 ",$169.73 ,"$1,992.77 ",$169.73 ,"$1,794.18 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,910.40 ","$3,081.60 ",$173.12 ,"$2,568.00 ","$2,396.80 ","$2,396.80 ",$169.73 ,"$2,396.80 ","$2,636.48 ","$2,636.48 ",$432.97 ,"$2,910.40 ",$173.19 ,$173.19 ,"$1,920.86 ","$1,417.54 ","$1,424.38 ",$99.20 ,$98.12 ,$178.21 ,"$2,910.40 ",$372.35 ,"$1,794.18 ",$958.72 ,"$3,081.60 ",$825.00 ,$169.73 ,"$2,225.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$2,309.00 ","$1,662.48 ",$98.12 ,"$2,309.00 ","$1,500.85 ",$100.59 ,$646.52 ,"$1,276.88 ",$100.59 ,"$1,343.84 ",$100.59 ,"$1,209.92 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$1,962.65 ","$2,078.10 ",$102.60 ,"$1,731.75 ","$1,616.30 ","$1,616.30 ",$100.59 ,"$1,616.30 ","$1,777.93 ","$1,777.93 ",$256.60 ,"$1,962.65 ",$102.64 ,$102.64 ,"$1,295.35 ",$955.93 ,$960.54 ,$99.20 ,$98.12 ,$105.61 ,"$1,962.65 ",$220.68 ,"$1,209.92 ",$646.52 ,"$2,078.10 ",$825.00 ,$100.59 ,"$1,500.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,$523.00 ,$376.56 ,$98.12 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$523.00 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 ,$99.20 ,$98.12 ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$523.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,703.00 ","$1,946.16 ",$98.12 ,"$2,703.00 ","$1,756.95 ",$169.73 ,$756.84 ,"$1,494.76 ",$169.73 ,"$1,573.15 ",$169.73 ,"$1,416.37 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,297.55 ","$2,432.70 ",$173.12 ,"$2,027.25 ","$1,892.10 ","$1,892.10 ",$169.73 ,"$1,892.10 ","$2,081.31 ","$2,081.31 ",$432.97 ,"$2,297.55 ",$173.19 ,$173.19 ,"$1,516.38 ","$1,119.04 ","$1,124.45 ",$99.20 ,$98.12 ,$178.21 ,"$2,297.55 ",$372.35 ,"$1,416.37 ",$756.84 ,"$2,432.70 ",$825.00 ,$169.73 ,"$1,756.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$2,204.00 ","$1,586.88 ",$98.12 ,"$2,204.00 ","$1,432.60 ",$100.59 ,$617.12 ,"$1,218.81 ",$100.59 ,"$1,282.73 ",$100.59 ,"$1,154.90 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$1,873.40 ","$1,983.60 ",$102.60 ,"$1,653.00 ","$1,542.80 ","$1,542.80 ",$100.59 ,"$1,542.80 ","$1,697.08 ","$1,697.08 ",$256.60 ,"$1,873.40 ",$102.64 ,$102.64 ,"$1,236.44 ",$912.46 ,$916.86 ,$99.20 ,$98.12 ,$105.61 ,"$1,873.40 ",$220.68 ,"$1,154.90 ",$617.12 ,"$1,983.60 ",$825.00 ,$100.59 ,"$1,432.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$3,048.00 ","$2,194.56 ",$98.12 ,"$3,048.00 ","$1,981.20 ",$169.73 ,$853.44 ,"$1,685.54 ",$169.73 ,"$1,773.94 ",$169.73 ,"$1,597.15 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,590.80 ","$2,743.20 ",$173.12 ,"$2,286.00 ","$2,133.60 ","$2,133.60 ",$169.73 ,"$2,133.60 ","$2,346.96 ","$2,346.96 ",$432.97 ,"$2,590.80 ",$173.19 ,$173.19 ,"$1,709.93 ","$1,261.87 ","$1,267.97 ",$99.20 ,$98.12 ,$178.21 ,"$2,590.80 ",$372.35 ,"$1,597.15 ",$853.44 ,"$2,743.20 ",$825.00 ,$169.73 ,"$1,981.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$3,424.00 ","$2,465.28 ",$98.12 ,"$3,424.00 ","$2,225.60 ",$169.73 ,$958.72 ,"$1,893.47 ",$169.73 ,"$1,992.77 ",$169.73 ,"$1,794.18 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,910.40 ","$3,081.60 ",$173.12 ,"$2,568.00 ","$2,396.80 ","$2,396.80 ",$169.73 ,"$2,396.80 ","$2,636.48 ","$2,636.48 ",$432.97 ,"$2,910.40 ",$173.19 ,$173.19 ,"$1,920.86 ","$1,417.54 ","$1,424.38 ",$99.20 ,$98.12 ,$178.21 ,"$2,910.40 ",$372.35 ,"$1,794.18 ",$958.72 ,"$3,081.60 ",$825.00 ,$169.73 ,"$2,225.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$3,494.00 ","$2,515.68 ",$169.73 ,"$3,494.00 ","$2,271.10 ",$169.73 ,$978.32 ,"$1,932.18 ",$169.73 ,"$2,033.51 ",$169.73 ,"$1,830.86 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,969.90 ","$3,144.60 ",$173.12 ,"$2,620.50 ","$2,445.80 ","$2,445.80 ",$169.73 ,"$2,445.80 ","$2,690.38 ","$2,690.38 ",$432.97 ,"$2,969.90 ",$173.19 ,$173.19 ,"$1,960.13 ","$1,446.52 ","$1,453.50 ",$261.47 ,$258.64 ,$178.21 ,"$2,969.90 ",$372.35 ,"$1,830.86 ",$978.32 ,"$3,144.60 ",$825.00 ,$169.73 ,"$2,271.10 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$3,494.00 ","$2,515.68 ",$98.12 ,"$3,494.00 ","$2,271.10 ",$169.73 ,$978.32 ,"$1,932.18 ",$169.73 ,"$2,033.51 ",$169.73 ,"$1,830.86 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,969.90 ","$3,144.60 ",$173.12 ,"$2,620.50 ","$2,445.80 ","$2,445.80 ",$169.73 ,"$2,445.80 ","$2,690.38 ","$2,690.38 ",$432.97 ,"$2,969.90 ",$173.19 ,$173.19 ,"$1,960.13 ","$1,446.52 ","$1,453.50 ",$99.20 ,$98.12 ,$178.21 ,"$2,969.90 ",$372.35 ,"$1,830.86 ",$978.32 ,"$3,144.60 ",$825.00 ,$169.73 ,"$2,271.10 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,439.00 ","$2,476.08 ",$219.77 ,"$3,439.00 ","$2,235.35 ",$219.77 ,$962.92 ,"$1,901.77 ",$219.77 ,"$2,001.50 ",$219.77 ,"$1,802.04 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,923.15 ","$3,095.10 ",$224.17 ,"$2,579.25 ","$2,407.30 ","$2,407.30 ",$219.77 ,"$2,407.30 ","$2,648.03 ","$2,648.03 ",$560.65 ,"$2,923.15 ",$224.26 ,$224.26 ,"$1,929.28 ","$1,423.75 ","$1,430.62 ",$247.50 ,$244.82 ,$230.76 ,"$2,923.15 ",$482.16 ,"$1,802.04 ",$962.92 ,"$3,095.10 ","$1,490.00 ",$219.77 ,"$2,235.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$3,120.00 ","$2,246.40 ",$100.59 ,"$3,120.00 ","$2,028.00 ",$100.59 ,$873.60 ,"$1,725.36 ",$100.59 ,"$1,815.84 ",$100.59 ,"$1,634.88 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$2,652.00 ","$2,808.00 ",$102.60 ,"$2,340.00 ","$2,184.00 ","$2,184.00 ",$100.59 ,"$2,184.00 ","$2,402.40 ","$2,402.40 ",$256.60 ,"$2,652.00 ",$102.64 ,$102.64 ,"$1,750.32 ","$1,291.68 ","$1,297.92 ",$112.61 ,$111.38 ,$105.61 ,"$2,652.00 ",$220.68 ,"$1,634.88 ",$873.60 ,"$2,808.00 ",$825.00 ,$100.59 ,"$2,028.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,$523.00 ,$376.56 ,$111.38 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$523.00 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 ,$112.61 ,$111.38 ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$523.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$2,872.00 ","$2,067.84 ",$100.59 ,"$2,872.00 ","$1,866.80 ",$100.59 ,$804.16 ,"$1,588.22 ",$100.59 ,"$1,671.50 ",$100.59 ,"$1,504.93 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$2,441.20 ","$2,584.80 ",$102.60 ,"$2,154.00 ","$2,010.40 ","$2,010.40 ",$100.59 ,"$2,010.40 ","$2,211.44 ","$2,211.44 ",$256.60 ,"$2,441.20 ",$102.64 ,$102.64 ,"$1,611.19 ","$1,189.01 ","$1,194.75 ",$112.61 ,$111.38 ,$105.61 ,"$2,441.20 ",$220.68 ,"$1,504.93 ",$804.16 ,"$2,584.80 ",$825.00 ,$100.59 ,"$1,866.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,$523.00 ,$376.56 ,$111.38 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$523.00 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 ,$112.61 ,$111.38 ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$523.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,$523.00 ,$376.56 ,$111.38 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$523.00 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 ,$112.61 ,$111.38 ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$523.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$2,872.00 ","$2,067.84 ",$100.59 ,"$2,872.00 ","$1,866.80 ",$100.59 ,$804.16 ,"$1,588.22 ",$100.59 ,"$1,671.50 ",$100.59 ,"$1,504.93 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$2,441.20 ","$2,584.80 ",$102.60 ,"$2,154.00 ","$2,010.40 ","$2,010.40 ",$100.59 ,"$2,010.40 ","$2,211.44 ","$2,211.44 ",$256.60 ,"$2,441.20 ",$102.64 ,$102.64 ,"$1,611.19 ","$1,189.01 ","$1,194.75 ",$112.61 ,$111.38 ,$105.61 ,"$2,441.20 ",$220.68 ,"$1,504.93 ",$804.16 ,"$2,584.80 ",$825.00 ,$100.59 ,"$1,866.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$3,928.00 ","$2,828.16 ",$111.38 ,"$3,928.00 ","$2,553.20 ",$346.74 ,"$1,099.84 ","$2,172.18 ",$346.74 ,"$2,286.10 ",$346.74 ,"$2,058.27 ",$346.74 ,$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,"$3,338.80 ","$3,535.20 ",$353.67 ,"$2,946.00 ","$2,749.60 ","$2,749.60 ",$346.74 ,"$2,749.60 ","$3,024.56 ","$3,024.56 ",$884.55 ,"$3,338.80 ",$353.82 ,$353.82 ,"$2,203.61 ","$1,626.19 ","$1,634.05 ",$112.61 ,$111.38 ,$364.08 ,"$3,338.80 ",$760.71 ,"$2,058.27 ","$1,099.84 ","$3,535.20 ",$825.00 ,$346.74 ,"$2,553.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$3,267.00 ","$2,352.24 ",$111.38 ,"$3,267.00 ","$2,123.55 ",$169.73 ,$914.76 ,"$1,806.65 ",$169.73 ,"$1,901.39 ",$169.73 ,"$1,711.91 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,776.95 ","$2,940.30 ",$173.12 ,"$2,450.25 ","$2,286.90 ","$2,286.90 ",$169.73 ,"$2,286.90 ","$2,515.59 ","$2,515.59 ",$432.97 ,"$2,776.95 ",$173.19 ,$173.19 ,"$1,832.79 ","$1,352.54 ","$1,359.07 ",$112.61 ,$111.38 ,$178.21 ,"$2,776.95 ",$372.35 ,"$1,711.91 ",$914.76 ,"$2,940.30 ",$825.00 ,$169.73 ,"$2,123.55 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$2,879.00 ","$2,072.88 ",$169.73 ,"$2,879.00 ","$1,871.35 ",$169.73 ,$806.12 ,"$1,592.09 ",$169.73 ,"$1,675.58 ",$169.73 ,"$1,508.60 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,447.15 ","$2,591.10 ",$173.12 ,"$2,159.25 ","$2,015.30 ","$2,015.30 ",$169.73 ,"$2,015.30 ","$2,216.83 ","$2,216.83 ",$432.97 ,"$2,447.15 ",$173.19 ,$173.19 ,"$1,615.12 ","$1,191.91 ","$1,197.66 ",$224.19 ,$221.76 ,$178.21 ,"$2,447.15 ",$372.35 ,"$1,508.60 ",$806.12 ,"$2,591.10 ",$825.00 ,$169.73 ,"$1,871.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$2,192.00 ","$1,578.24 ",$100.59 ,"$2,192.00 ","$1,424.80 ",$100.59 ,$613.76 ,"$1,212.18 ",$100.59 ,"$1,275.74 ",$100.59 ,"$1,148.61 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$1,863.20 ","$1,972.80 ",$102.60 ,"$1,644.00 ","$1,534.40 ","$1,534.40 ",$100.59 ,"$1,534.40 ","$1,687.84 ","$1,687.84 ",$256.60 ,"$1,863.20 ",$102.64 ,$102.64 ,"$1,229.71 ",$907.49 ,$911.87 ,$224.41 ,$221.98 ,$105.61 ,"$1,863.20 ",$220.68 ,"$1,148.61 ",$613.76 ,"$1,972.80 ",$825.00 ,$100.59 ,"$1,424.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$2,780.00 ","$2,001.60 ",$169.73 ,"$2,780.00 ","$1,807.00 ",$169.73 ,$778.40 ,"$1,537.34 ",$169.73 ,"$1,617.96 ",$169.73 ,"$1,456.72 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,363.00 ","$2,502.00 ",$173.12 ,"$2,085.00 ","$1,946.00 ","$1,946.00 ",$169.73 ,"$1,946.00 ","$2,140.60 ","$2,140.60 ",$432.97 ,"$2,363.00 ",$173.19 ,$173.19 ,"$1,559.58 ","$1,150.92 ","$1,156.48 ",$224.41 ,$221.98 ,$178.21 ,"$2,363.00 ",$372.35 ,"$1,456.72 ",$778.40 ,"$2,502.00 ",$825.00 ,$169.73 ,"$1,807.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$3,122.00 ","$2,247.84 ",$169.73 ,"$3,122.00 ","$2,029.30 ",$169.73 ,$874.16 ,"$1,726.47 ",$169.73 ,"$1,817.00 ",$169.73 ,"$1,635.93 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,653.70 ","$2,809.80 ",$173.12 ,"$2,341.50 ","$2,185.40 ","$2,185.40 ",$169.73 ,"$2,185.40 ","$2,403.94 ","$2,403.94 ",$432.97 ,"$2,653.70 ",$173.19 ,$173.19 ,"$1,751.44 ","$1,292.51 ","$1,298.75 ",$224.41 ,$221.98 ,$178.21 ,"$2,653.70 ",$372.35 ,"$1,635.93 ",$874.16 ,"$2,809.80 ",$825.00 ,$169.73 ,"$2,029.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$2,106.00 ","$1,516.32 ",$98.12 ,"$2,106.00 ","$1,368.90 ",$100.59 ,$589.68 ,"$1,164.62 ",$100.59 ,"$1,225.69 ",$100.59 ,"$1,103.54 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$1,790.10 ","$1,895.40 ",$102.60 ,"$1,579.50 ","$1,474.20 ","$1,474.20 ",$100.59 ,"$1,474.20 ","$1,621.62 ","$1,621.62 ",$256.60 ,"$1,790.10 ",$102.64 ,$102.64 ,"$1,181.47 ",$871.88 ,$876.10 ,$99.20 ,$98.12 ,$105.61 ,"$1,790.10 ",$220.68 ,"$1,103.54 ",$589.68 ,"$1,895.40 ",$825.00 ,$100.59 ,"$1,368.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$2,910.00 ","$2,095.20 ",$98.12 ,"$2,910.00 ","$1,891.50 ",$346.74 ,$814.80 ,"$1,609.23 ",$346.74 ,"$1,693.62 ",$346.74 ,"$1,524.84 ",$346.74 ,$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,"$2,473.50 ","$2,619.00 ",$353.67 ,"$2,182.50 ","$2,037.00 ","$2,037.00 ",$346.74 ,"$2,037.00 ","$2,240.70 ","$2,240.70 ",$884.55 ,"$2,473.50 ",$353.82 ,$353.82 ,"$1,632.51 ","$1,204.74 ","$1,210.56 ",$99.20 ,$98.12 ,$364.08 ,"$2,473.50 ",$760.71 ,"$1,524.84 ",$814.80 ,"$2,619.00 ",$825.00 ,$346.74 ,"$1,891.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$3,268.00 ","$2,352.96 ",$98.12 ,"$3,268.00 ","$2,124.20 ",$169.73 ,$915.04 ,"$1,807.20 ",$169.73 ,"$1,901.98 ",$169.73 ,"$1,712.43 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,777.80 ","$2,941.20 ",$173.12 ,"$2,451.00 ","$2,287.60 ","$2,287.60 ",$169.73 ,"$2,287.60 ","$2,516.36 ","$2,516.36 ",$432.97 ,"$2,777.80 ",$173.19 ,$173.19 ,"$1,833.35 ","$1,352.95 ","$1,359.49 ",$99.20 ,$98.12 ,$178.21 ,"$2,777.80 ",$372.35 ,"$1,712.43 ",$915.04 ,"$2,941.20 ",$825.00 ,$169.73 ,"$2,124.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$3,338.00 ","$2,403.36 ",$169.73 ,"$3,338.00 ","$2,169.70 ",$169.73 ,$934.64 ,"$1,845.91 ",$169.73 ,"$1,942.72 ",$169.73 ,"$1,749.11 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,837.30 ","$3,004.20 ",$173.12 ,"$2,503.50 ","$2,336.60 ","$2,336.60 ",$169.73 ,"$2,336.60 ","$2,570.26 ","$2,570.26 ",$432.97 ,"$2,837.30 ",$173.19 ,$173.19 ,"$1,872.62 ","$1,381.93 ","$1,388.61 ",$224.19 ,$221.76 ,$178.21 ,"$2,837.30 ",$372.35 ,"$1,749.11 ",$934.64 ,"$3,004.20 ",$825.00 ,$169.73 ,"$2,169.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$2,106.00 ","$1,516.32 ",$98.12 ,"$2,106.00 ","$1,368.90 ",$100.59 ,$589.68 ,"$1,164.62 ",$100.59 ,"$1,225.69 ",$100.59 ,"$1,103.54 ",$100.59 ,$207.34 ,"$2,000.00 ",$256.60 ,$100.59 ,"$1,790.10 ","$1,895.40 ",$102.60 ,"$1,579.50 ","$1,474.20 ","$1,474.20 ",$100.59 ,"$1,474.20 ","$1,621.62 ","$1,621.62 ",$256.60 ,"$1,790.10 ",$102.64 ,$102.64 ,"$1,181.47 ",$871.88 ,$876.10 ,$99.20 ,$98.12 ,$105.61 ,"$1,790.10 ",$220.68 ,"$1,103.54 ",$589.68 ,"$1,895.40 ",$825.00 ,$100.59 ,"$1,368.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$2,910.00 ","$2,095.20 ",$98.12 ,"$2,910.00 ","$1,891.50 ",$169.73 ,$814.80 ,"$1,609.23 ",$169.73 ,"$1,693.62 ",$169.73 ,"$1,524.84 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,473.50 ","$2,619.00 ",$173.12 ,"$2,182.50 ","$2,037.00 ","$2,037.00 ",$169.73 ,"$2,037.00 ","$2,240.70 ","$2,240.70 ",$432.97 ,"$2,473.50 ",$173.19 ,$173.19 ,"$1,632.51 ","$1,204.74 ","$1,210.56 ",$99.20 ,$98.12 ,$178.21 ,"$2,473.50 ",$372.35 ,"$1,524.84 ",$814.80 ,"$2,619.00 ",$825.00 ,$169.73 ,"$1,891.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$3,268.00 ","$2,352.96 ",$98.12 ,"$3,268.00 ","$2,124.20 ",$169.73 ,$915.04 ,"$1,807.20 ",$169.73 ,"$1,901.98 ",$169.73 ,"$1,712.43 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,777.80 ","$2,941.20 ",$173.12 ,"$2,451.00 ","$2,287.60 ","$2,287.60 ",$169.73 ,"$2,287.60 ","$2,516.36 ","$2,516.36 ",$432.97 ,"$2,777.80 ",$173.19 ,$173.19 ,"$1,833.35 ","$1,352.95 ","$1,359.49 ",$99.20 ,$98.12 ,$178.21 ,"$2,777.80 ",$372.35 ,"$1,712.43 ",$915.04 ,"$2,941.20 ",$825.00 ,$169.73 ,"$2,124.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$3,338.00 ","$2,403.36 ",$169.73 ,"$3,338.00 ","$2,169.70 ",$169.73 ,$934.64 ,"$1,845.91 ",$169.73 ,"$1,942.72 ",$169.73 ,"$1,749.11 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,837.30 ","$3,004.20 ",$173.12 ,"$2,503.50 ","$2,336.60 ","$2,336.60 ",$169.73 ,"$2,336.60 ","$2,570.26 ","$2,570.26 ",$432.97 ,"$2,837.30 ",$173.19 ,$173.19 ,"$1,872.62 ","$1,381.93 ","$1,388.61 ",$224.19 ,$221.76 ,$178.21 ,"$2,837.30 ",$372.35 ,"$1,749.11 ",$934.64 ,"$3,004.20 ",$825.00 ,$169.73 ,"$2,169.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$2,296.00 ","$1,653.12 ",$100.59 ,"$2,296.00 ","$1,492.40 ",$100.59 ,$642.88 ,"$1,269.69 ",$100.59 ,"$1,336.27 ",$100.59 ,"$1,203.10 ",$100.59 ,$207.34 ,"$2,112.32 ",$256.60 ,$100.59 ,"$1,951.60 ","$2,066.40 ",$102.60 ,"$1,722.00 ","$1,607.20 ","$1,607.20 ",$100.59 ,"$1,607.20 ","$1,767.92 ","$1,767.92 ",$256.60 ,"$1,951.60 ",$102.64 ,$102.64 ,"$1,288.06 ",$950.54 ,$955.14 ,$224.41 ,$221.98 ,$105.61 ,"$1,951.60 ",$220.68 ,"$1,203.10 ",$642.88 ,"$2,066.40 ",$825.00 ,$100.59 ,"$1,492.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$2,910.00 ","$2,095.20 ",$169.73 ,"$2,910.00 ","$1,891.50 ",$169.73 ,$814.80 ,"$1,609.23 ",$169.73 ,"$1,693.62 ",$169.73 ,"$1,524.84 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,473.50 ","$2,619.00 ",$173.12 ,"$2,182.50 ","$2,037.00 ","$2,037.00 ",$169.73 ,"$2,037.00 ","$2,240.70 ","$2,240.70 ",$432.97 ,"$2,473.50 ",$173.19 ,$173.19 ,"$1,632.51 ","$1,204.74 ","$1,210.56 ",$224.41 ,$221.98 ,$178.21 ,"$2,473.50 ",$372.35 ,"$1,524.84 ",$814.80 ,"$2,619.00 ",$825.00 ,$169.73 ,"$1,891.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,268.00 ","$2,352.96 ",$169.73 ,"$3,268.00 ","$2,124.20 ",$169.73 ,$915.04 ,"$1,807.20 ",$169.73 ,"$1,901.98 ",$169.73 ,"$1,712.43 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,777.80 ","$2,941.20 ",$173.12 ,"$2,451.00 ","$2,287.60 ","$2,287.60 ",$169.73 ,"$2,287.60 ","$2,516.36 ","$2,516.36 ",$432.97 ,"$2,777.80 ",$173.19 ,$173.19 ,"$1,833.35 ","$1,352.95 ","$1,359.49 ",$224.41 ,$221.98 ,$178.21 ,"$2,777.80 ",$372.35 ,"$1,712.43 ",$915.04 ,"$2,941.20 ",$825.00 ,$169.73 ,"$2,124.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$2,879.00 ","$2,072.88 ",$169.73 ,"$2,879.00 ","$1,871.35 ",$169.73 ,$806.12 ,"$1,592.09 ",$169.73 ,"$1,675.58 ",$169.73 ,"$1,508.60 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,447.15 ","$2,591.10 ",$173.12 ,"$2,159.25 ","$2,015.30 ","$2,015.30 ",$169.73 ,"$2,015.30 ","$2,216.83 ","$2,216.83 ",$432.97 ,"$2,447.15 ",$173.19 ,$173.19 ,"$1,615.12 ","$1,191.91 ","$1,197.66 ",$224.19 ,$221.76 ,$178.21 ,"$2,447.15 ",$372.35 ,"$1,508.60 ",$806.12 ,"$2,591.10 ",$825.00 ,$169.73 ,"$1,871.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$4,931.00 ","$3,550.32 ",$219.77 ,"$4,931.00 ","$3,205.15 ",$219.77 ,"$1,380.68 ","$2,726.84 ",$219.77 ,"$2,869.84 ",$219.77 ,"$2,583.84 ",$219.77 ,$453.00 ,"$2,000.00 ",$560.65 ,$219.77 ,"$4,191.35 ","$4,437.90 ",$224.17 ,"$3,698.25 ","$3,451.70 ","$3,451.70 ",$219.77 ,"$3,451.70 ","$3,796.87 ","$3,796.87 ",$560.65 ,"$4,191.35 ",$224.26 ,$224.26 ,"$2,766.29 ","$2,041.43 ","$2,051.30 ",$224.41 ,$221.98 ,$230.76 ,"$4,191.35 ",$482.16 ,"$2,583.84 ","$1,380.68 ","$4,437.90 ",$825.00 ,$219.77 ,"$3,205.15 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$5,935.00 ","$4,273.20 ",$221.98 ,"$5,935.00 ","$3,857.75 ",$346.74 ,"$1,661.80 ","$3,282.06 ",$346.74 ,"$3,454.17 ",$346.74 ,"$3,109.94 ",$346.74 ,$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,"$5,044.75 ","$5,341.50 ",$353.67 ,"$4,451.25 ","$4,154.50 ","$4,154.50 ",$346.74 ,"$4,154.50 ","$4,569.95 ","$4,569.95 ",$884.55 ,"$5,044.75 ",$353.82 ,$353.82 ,"$3,329.54 ","$2,457.09 ","$2,468.96 ",$224.41 ,$221.98 ,$364.08 ,"$5,044.75 ",$760.71 ,"$3,109.94 ","$1,661.80 ","$5,341.50 ",$825.00 ,$346.74 ,"$3,857.75 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$6,694.00 ","$4,819.68 ",$221.98 ,"$6,694.00 ","$4,351.10 ",$346.74 ,"$1,874.32 ","$3,701.78 ",$346.74 ,"$3,895.91 ",$346.74 ,"$3,507.66 ",$346.74 ,$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,"$5,689.90 ","$6,024.60 ",$353.67 ,"$5,020.50 ","$4,685.80 ","$4,685.80 ",$346.74 ,"$4,685.80 ","$5,154.38 ","$5,154.38 ",$884.55 ,"$5,689.90 ",$353.82 ,$353.82 ,"$3,755.33 ","$2,771.32 ","$2,784.70 ",$224.41 ,$221.98 ,$364.08 ,"$5,689.90 ",$760.71 ,"$3,507.66 ","$1,874.32 ","$6,024.60 ",$825.00 ,$346.74 ,"$4,351.10 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$156.00 ,$112.32 ,$43.68 ,$208.59 ,$101.40 ,$81.76 ,$43.68 ,$86.27 ,$81.76 ,$90.79 ,$81.76 ,$81.74 ,$81.76 ,$156.00 ,$156.00 ,$208.59 ,$81.76 ,$132.60 ,$140.40 ,$83.40 ,$117.00 ,$109.20 ,$109.20 ,$81.76 ,$109.20 ,$120.12 ,$120.12 ,$156.00 ,$132.60 ,$83.43 ,$83.43 ,$87.52 ,$64.58 ,$64.90 , N/A , N/A ,$85.85 ,$132.60 ,$179.38 ,$81.74 ,$43.68 ,$140.40 ,$156.00 ,$81.76 ,$101.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000088,N/A,HC CT HRT W/O DYE W/CA TEST (PROMO),350,1 ,$40.00 ,$28.80 ,$11.20 ,$40.00 ,$26.00 , N/A ,$11.20 ,$22.12 , N/A ,$23.28 , N/A ,$20.96 , N/A , N/A ,$36.80 , N/A , N/A ,$34.00 ,$36.00 , N/A ,$30.00 ,$28.00 ,$28.00 , N/A ,$28.00 ,$30.80 ,$30.80 , N/A ,$34.00 , N/A , N/A ,$22.44 ,$16.56 ,$16.64 , N/A , N/A , N/A ,$34.00 , N/A ,$20.96 ,$11.20 ,$36.00 ,$40.00 , N/A ,$26.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000089,75572,HC CT HEART WO/W CONT FUNCT EVAL,350,1 ,$523.00 ,$376.56 ,$146.44 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$523.00 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 , N/A , N/A ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$523.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000094,75574,HC CTA HEART CORONARY W/CONTRAST 3D POST,350,1 ,$523.00 ,$376.56 ,$146.44 ,$523.00 ,$339.95 ,$169.73 ,$146.44 ,$289.22 ,$169.73 ,$304.39 ,$169.73 ,$274.05 ,$169.73 ,$349.84 ,$523.00 ,$432.97 ,$169.73 ,$444.55 ,$470.70 ,$173.12 ,$392.25 ,$366.10 ,$366.10 ,$169.73 ,$366.10 ,$402.71 ,$402.71 ,$432.97 ,$444.55 ,$173.19 ,$173.19 ,$293.40 ,$216.52 ,$217.57 , N/A , N/A ,$178.21 ,$444.55 ,$372.35 ,$274.05 ,$146.44 ,$470.70 ,$523.00 ,$169.73 ,$339.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$3,338.00 ","$2,403.36 ",$169.73 ,"$3,338.00 ","$2,169.70 ",$169.73 ,$934.64 ,"$1,845.91 ",$169.73 ,"$1,942.72 ",$169.73 ,"$1,749.11 ",$169.73 ,$349.84 ,"$2,000.00 ",$432.97 ,$169.73 ,"$2,837.30 ","$3,004.20 ",$173.12 ,"$2,503.50 ","$2,336.60 ","$2,336.60 ",$169.73 ,"$2,336.60 ","$2,570.26 ","$2,570.26 ",$432.97 ,"$2,837.30 ",$173.19 ,$173.19 ,"$1,872.62 ","$1,381.93 ","$1,388.61 ",$224.19 ,$221.76 ,$178.21 ,"$2,837.30 ",$372.35 ,"$1,749.11 ",$934.64 ,"$3,004.20 ",$825.00 ,$169.73 ,"$2,169.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,"$1,054.00 ",$758.88 ,$295.12 ,"$1,054.00 ",$685.10 , N/A ,$295.12 ,$582.86 , N/A ,$613.43 , N/A ,$552.30 , N/A , N/A ,$969.68 , N/A , N/A ,$895.90 ,$948.60 , N/A ,$790.50 ,$737.80 ,$737.80 , N/A ,$737.80 ,$811.58 ,$811.58 , N/A ,$895.90 , N/A , N/A ,$591.29 ,$436.36 ,$438.46 , N/A , N/A , N/A ,$895.90 , N/A ,$552.30 ,$295.12 ,$948.60 ,$825.00 , N/A ,$685.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000101,76380,HC CT LMTD OR LOCALIZ FU STUDY,350,1 ,$237.00 ,$170.64 ,$66.36 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$237.00 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 ,$99.20 ,$98.12 ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$1,984.00 ","$1,428.48 ",$75.68 ,"$1,984.00 ","$1,289.60 ", N/A ,$555.52 ,"$1,097.15 ", N/A ,"$1,154.69 ", N/A ,"$1,039.62 ", N/A , N/A ,"$1,984.00 ", N/A , N/A ,"$1,686.40 ","$1,785.60 ", N/A ,"$1,488.00 ","$1,388.80 ","$1,388.80 ", N/A ,"$1,388.80 ","$1,527.68 ","$1,527.68 ", N/A ,"$1,686.40 ", N/A , N/A ,"$1,113.02 ",$821.38 ,$825.34 ,$76.51 ,$75.68 , N/A ,"$1,686.40 ", N/A ,"$1,039.62 ",$555.52 ,"$1,785.60 ",$825.00 , N/A ,"$1,289.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000120,74174,HC CT ANGIO ABD/PELV W AND WO CONTRAST,350,1 ,"$4,298.00 ","$3,094.56 ",$221.98 ,"$4,298.00 ","$2,793.70 ",$346.74 ,"$1,203.44 ","$2,376.79 ",$346.74 ,"$2,501.44 ",$346.74 ,"$2,252.15 ",$346.74 ,$714.71 ,"$2,000.00 ",$884.55 ,$346.74 ,"$3,653.30 ","$3,868.20 ",$353.67 ,"$3,223.50 ","$3,008.60 ","$3,008.60 ",$346.74 ,"$3,008.60 ","$3,309.46 ","$3,309.46 ",$884.55 ,"$3,653.30 ",$353.82 ,$353.82 ,"$2,411.18 ","$1,779.37 ","$1,787.97 ",$224.41 ,$221.98 ,$364.08 ,"$3,653.30 ",$760.71 ,"$2,252.15 ","$1,203.44 ","$3,868.20 ",$825.00 ,$346.74 ,"$2,793.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000151,G0288,HC CT RECONSTRUCTION AORTA FOR VASC SURG,350,1 ,"$2,104.00 ","$1,514.88 ",$589.12 ,"$2,104.00 ","$1,367.60 ", N/A ,$589.12 ,"$1,163.51 ", N/A ,"$1,224.53 ", N/A ,"$1,102.50 ", N/A , N/A ,"$1,935.68 ", N/A , N/A ,"$1,788.40 ","$1,893.60 ", N/A ,"$1,578.00 ","$1,472.80 ","$1,472.80 ", N/A ,"$1,472.80 ","$1,620.08 ","$1,620.08 ", N/A ,"$1,788.40 ", N/A , N/A ,"$1,180.34 ",$871.06 ,$875.26 , N/A , N/A , N/A ,"$1,788.40 ", N/A ,"$1,102.50 ",$589.12 ,"$1,893.60 ",$825.00 , N/A ,"$1,367.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$255.00 ,$183.60 ,$71.40 ,$256.60 ,$165.75 ,$100.59 ,$71.40 ,$141.02 ,$100.59 ,$148.41 ,$100.59 ,$133.62 ,$100.59 ,$207.34 ,$255.00 ,$256.60 ,$100.59 ,$216.75 ,$229.50 ,$102.60 ,$191.25 ,$178.50 ,$178.50 ,$100.59 ,$178.50 ,$196.35 ,$196.35 ,$255.00 ,$216.75 ,$102.64 ,$102.64 ,$143.06 ,$105.57 ,$106.08 ,$99.20 ,$98.12 ,$105.61 ,$216.75 ,$220.68 ,$133.62 ,$71.40 ,$229.50 ,$255.00 ,$100.59 ,$165.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,"$4,519.00 ","$3,253.68 ",$740.66 ,"$4,519.00 ","$2,937.35 ","$1,411.28 ","$1,265.32 ","$2,499.01 ","$1,411.28 ","$2,630.06 ","$1,411.28 ","$2,367.96 ","$1,411.28 ","$2,908.96 ","$4,157.48 ","$3,600.19 ","$1,411.28 ","$3,841.15 ","$4,067.10 ","$1,439.50 ","$3,389.25 ","$3,163.30 ","$3,163.30 ","$1,411.28 ","$3,163.30 ","$3,479.63 ","$3,479.63 ","$3,600.19 ","$3,841.15 ","$1,440.08 ","$1,440.08 ","$2,535.16 ","$1,870.87 ","$1,879.90 ",$748.77 ,$740.66 ,"$1,481.84 ","$3,841.15 ","$3,096.17 ","$2,367.96 ","$1,265.32 ","$4,067.10 ","$2,500.00 ","$1,411.28 ","$2,937.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$522.00 ,$375.84 ,$146.16 ,$895.69 ,$339.30 ,$351.10 ,$146.16 ,$288.67 ,$351.10 ,$303.80 ,$351.10 ,$273.53 ,$351.10 ,$522.00 ,$480.24 ,$895.69 ,$351.10 ,$443.70 ,$469.80 ,$358.13 ,$391.50 ,$365.40 ,$365.40 ,$351.10 ,$365.40 ,$401.94 ,$401.94 ,$522.00 ,$443.70 ,$358.27 ,$358.27 ,$292.84 ,$216.11 ,$217.15 ,$214.67 ,$212.35 ,$368.66 ,$443.70 ,$770.29 ,$273.53 ,$146.16 ,$469.80 ,$266.00 ,$351.10 ,$339.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$4,411.00 ","$3,175.92 ",$871.16 ,"$4,411.00 ","$2,867.15 ","$1,411.28 ","$1,235.08 ","$2,439.28 ","$1,411.28 ","$2,567.20 ","$1,411.28 ","$2,311.36 ","$1,411.28 ","$2,908.96 ","$4,058.12 ","$3,600.19 ","$1,411.28 ","$3,749.35 ","$3,969.90 ","$1,439.50 ","$3,308.25 ","$3,087.70 ","$3,087.70 ","$1,411.28 ","$3,087.70 ","$3,396.47 ","$3,396.47 ","$3,600.19 ","$3,749.35 ","$1,440.08 ","$1,440.08 ","$2,474.57 ","$1,826.15 ","$1,834.98 ",$880.71 ,$871.16 ,"$1,481.84 ","$3,749.35 ","$3,096.17 ","$2,311.36 ","$1,235.08 ","$3,969.90 ","$2,500.00 ","$1,411.28 ","$2,867.15 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$1,218.00 ",$876.96 ,$84.39 ,"$1,558.08 ",$791.70 ,$610.77 ,$341.04 ,$673.55 ,$610.77 ,$708.88 ,$610.77 ,$638.23 ,$610.77 ,"$1,218.00 ","$1,120.56 ","$1,558.08 ",$610.77 ,"$1,035.30 ","$1,096.20 ",$622.99 ,$913.50 ,$852.60 ,$852.60 ,$610.77 ,$852.60 ,$937.86 ,$937.86 ,"$1,218.00 ","$1,035.30 ",$623.23 ,$623.23 ,$683.30 ,$504.25 ,$506.69 ,$85.32 ,$84.39 ,$641.30 ,"$1,035.30 ","$1,339.95 ",$638.23 ,$341.04 ,"$1,096.20 ","$1,218.00 ",$610.77 ,$791.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),36000110,19085,HC BX BREAST 1ST LESION MR IMAG,360,1 ,"$4,211.00 ","$3,031.92 ",$871.16 ,"$4,211.00 ","$2,737.15 ","$1,411.28 ","$1,179.08 ","$2,328.68 ","$1,411.28 ","$2,450.80 ","$1,411.28 ","$2,206.56 ","$1,411.28 ","$2,908.96 ","$3,874.12 ","$3,600.19 ","$1,411.28 ","$3,579.35 ","$3,789.90 ","$1,439.50 ","$3,158.25 ","$2,947.70 ","$2,947.70 ","$1,411.28 ","$2,947.70 ","$3,242.47 ","$3,242.47 ","$3,600.19 ","$3,579.35 ","$1,440.08 ","$1,440.08 ","$2,362.37 ","$1,743.35 ","$1,751.78 ",$880.71 ,$871.16 ,"$1,481.84 ","$3,579.35 ","$3,096.17 ","$2,206.56 ","$1,179.08 ","$3,789.90 ","$2,500.00 ","$1,411.28 ","$2,737.15 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000112,19287,HC PERCUTAN DEV BREAST 1ST MR GUIDE,360,1 ,"$1,861.00 ","$1,339.92 ",$84.39 ,"$1,861.00 ","$1,209.65 ",$610.77 ,$521.08 ,"$1,029.13 ",$610.77 ,"$1,083.10 ",$610.77 ,$975.16 ,$610.77 ,"$1,258.93 ","$1,712.12 ","$1,558.08 ",$610.77 ,"$1,581.85 ","$1,674.90 ",$622.99 ,"$1,395.75 ","$1,302.70 ","$1,302.70 ",$610.77 ,"$1,302.70 ","$1,432.97 ","$1,432.97 ","$1,558.08 ","$1,581.85 ",$623.23 ,$623.23 ,"$1,044.02 ",$770.45 ,$774.18 ,$85.32 ,$84.39 ,$641.30 ,"$1,581.85 ","$1,339.95 ",$975.16 ,$521.08 ,"$1,674.90 ","$1,861.00 ",$610.77 ,"$1,209.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$3,997.00 ","$2,877.84 ","$1,119.16 ","$7,152.06 ","$2,598.05 ","$2,803.60 ","$1,119.16 ","$2,210.34 ","$2,803.60 ","$2,326.25 ","$2,803.60 ","$2,094.43 ","$2,803.60 ","$3,997.00 ","$3,677.24 ","$7,152.06 ","$2,803.60 ","$3,397.45 ","$3,597.30 ","$2,859.68 ","$2,997.75 ","$2,797.90 ","$2,797.90 ","$2,803.60 ","$2,797.90 ","$3,077.69 ","$3,077.69 ","$3,997.00 ","$3,397.45 ","$2,860.82 ","$2,860.82 ","$2,242.32 ","$1,654.76 ","$1,662.75 ","$1,216.07 ","$1,202.90 ","$2,943.78 ","$3,397.45 ","$6,150.77 ","$2,094.43 ","$1,119.16 ","$3,597.30 ","$1,862.00 ","$2,803.60 ","$2,598.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$8,843.00 ","$6,366.96 ","$1,202.90 ","$8,843.00 ","$5,747.95 ","$2,803.60 ","$2,476.04 ","$4,890.18 ","$2,803.60 ","$5,146.63 ","$2,803.60 ","$4,633.73 ","$2,803.60 ","$5,778.86 ","$8,135.56 ","$7,152.06 ","$2,803.60 ","$7,516.55 ","$7,958.70 ","$2,859.68 ","$6,632.25 ","$6,190.10 ","$6,190.10 ","$2,803.60 ","$6,190.10 ","$6,809.11 ","$6,809.11 ","$7,152.06 ","$7,516.55 ","$2,860.82 ","$2,860.82 ","$4,960.92 ","$3,661.00 ","$3,678.69 ","$1,216.07 ","$1,202.90 ","$2,943.78 ","$7,516.55 ","$6,150.77 ","$4,633.73 ","$2,476.04 ","$7,958.70 ","$3,458.00 ","$2,803.60 ","$5,747.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$1,410.00 ","$1,015.20 ",$350.16 ,"$3,572.10 ",$916.50 ,"$1,400.26 ",$394.80 ,$779.73 ,"$1,400.26 ",$820.62 ,"$1,381.80 ",$738.84 ,"$1,381.80 ","$1,410.00 ","$1,297.20 ","$3,572.10 ","$1,400.26 ","$1,198.50 ","$1,269.00 ","$1,381.80 ","$1,057.50 ",$987.00 ,$987.00 ,"$1,400.26 ",$987.00 ,"$1,085.70 ","$1,085.70 ","$1,410.00 ","$1,198.50 ","$1,428.84 ","$1,428.84 ",$791.01 ,$583.74 ,$586.56 ,$354.00 ,$350.16 ,"$1,470.27 ","$1,198.50 ","$3,072.01 ",$738.84 ,$394.80 ,"$1,269.00 ","$1,410.00 ","$1,400.26 ",$916.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,"$1,106.00 ",$796.32 ,$266.00 ,"$1,106.00 ",$718.90 ,$365.80 ,$309.68 ,$611.62 ,$365.80 ,$643.69 ,$365.80 ,$579.54 ,$365.80 ,$754.00 ,"$1,017.52 ",$933.16 ,$365.80 ,$940.10 ,$995.40 ,$373.12 ,$829.50 ,$774.20 ,$774.20 ,$365.80 ,$774.20 ,$851.62 ,$851.62 ,$933.16 ,$940.10 ,$373.27 ,$373.27 ,$620.47 ,$457.88 ,$460.10 , N/A , N/A ,$384.09 ,$940.10 ,$802.52 ,$579.54 ,$309.68 ,$995.40 ,$266.00 ,$365.80 ,$718.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),36000194,62270,HC LUMBAR PUNCTURE,360,1 ,"$1,925.00 ","$1,386.00 ",$365.13 ,"$1,925.00 ","$1,251.25 ",$606.41 ,$539.00 ,"$1,064.53 ",$606.41 ,"$1,120.35 ",$606.41 ,"$1,008.70 ",$606.41 ,"$1,249.95 ","$1,771.00 ","$1,546.96 ",$606.41 ,"$1,636.25 ","$1,732.50 ",$618.54 ,"$1,443.75 ","$1,347.50 ","$1,347.50 ",$606.41 ,"$1,347.50 ","$1,482.25 ","$1,482.25 ","$1,546.96 ","$1,636.25 ",$618.79 ,$618.79 ,"$1,079.93 ",$796.95 ,$800.80 ,$369.12 ,$365.13 ,$636.74 ,"$1,636.25 ","$1,330.39 ","$1,008.70 ",$539.00 ,"$1,732.50 ","$1,862.00 ",$606.41 ,"$1,251.25 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000223,36575,HC REPAIR CATH CV W/O PORT/PUMP,360,1 ,"$1,706.00 ","$1,228.32 ",$350.16 ,"$1,706.00 ","$1,108.90 ",$544.45 ,$477.68 ,$943.42 ,$544.45 ,$992.89 ,$544.45 ,$893.94 ,$544.45 ,"$1,122.22 ","$1,569.52 ","$1,388.89 ",$544.45 ,"$1,450.10 ","$1,535.40 ",$555.34 ,"$1,279.50 ","$1,194.20 ","$1,194.20 ",$544.45 ,"$1,194.20 ","$1,313.62 ","$1,313.62 ","$1,388.89 ","$1,450.10 ",$555.56 ,$555.56 ,$957.07 ,$706.28 ,$709.70 ,$354.00 ,$350.16 ,$571.67 ,"$1,450.10 ","$1,194.45 ",$893.94 ,$477.68 ,"$1,535.40 ","$1,706.00 ",$544.45 ,"$1,108.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36000546,11750,HC REMOVE NAIL BED,360,1 ,"$1,564.00 ","$1,126.08 ",$266.00 ,"$1,564.00 ","$1,016.60 ",$351.10 ,$437.92 ,$864.89 ,$351.10 ,$910.25 ,$351.10 ,$819.54 ,$351.10 ,$723.71 ,"$1,438.88 ",$895.69 ,$351.10 ,"$1,329.40 ","$1,407.60 ",$358.13 ,"$1,173.00 ","$1,094.80 ","$1,094.80 ",$351.10 ,"$1,094.80 ","$1,204.28 ","$1,204.28 ",$895.69 ,"$1,329.40 ",$358.27 ,$358.27 ,$877.40 ,$647.50 ,$650.62 ,$460.40 ,$455.42 ,$368.66 ,"$1,329.40 ",$770.29 ,$819.54 ,$437.92 ,"$1,407.60 ",$266.00 ,$351.10 ,"$1,016.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,$821.00 ,$591.12 ,$229.88 ,$821.00 ,$533.65 , N/A ,$229.88 ,$454.01 , N/A ,$477.82 , N/A ,$430.20 , N/A , N/A ,$755.32 , N/A , N/A ,$697.85 ,$738.90 , N/A ,$615.75 ,$574.70 ,$574.70 , N/A ,$574.70 ,$632.17 ,$632.17 , N/A ,$697.85 , N/A , N/A ,$460.58 ,$339.89 ,$341.54 , N/A , N/A , N/A ,$697.85 , N/A ,$430.20 ,$229.88 ,$738.90 , N/A , N/A ,$533.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,$935.00 ,$673.20 ,$261.80 ,$935.00 ,$607.75 , N/A ,$261.80 ,$517.06 , N/A ,$544.17 , N/A ,$489.94 , N/A , N/A ,$860.20 , N/A , N/A ,$794.75 ,$841.50 , N/A ,$701.25 ,$654.50 ,$654.50 , N/A ,$654.50 ,$719.95 ,$719.95 , N/A ,$794.75 , N/A , N/A ,$524.54 ,$387.09 ,$388.96 , N/A , N/A , N/A ,$794.75 , N/A ,$489.94 ,$261.80 ,$841.50 , N/A , N/A ,$607.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,090.00 ",$784.80 ,$305.20 ,"$1,090.00 ",$708.50 , N/A ,$305.20 ,$602.77 , N/A ,$634.38 , N/A ,$571.16 , N/A , N/A ,"$1,002.80 ", N/A , N/A ,$926.50 ,$981.00 , N/A ,$817.50 ,$763.00 ,$763.00 , N/A ,$763.00 ,$839.30 ,$839.30 , N/A ,$926.50 , N/A , N/A ,$611.49 ,$451.26 ,$453.44 , N/A , N/A , N/A ,$926.50 , N/A ,$571.16 ,$305.20 ,$981.00 , N/A , N/A ,$708.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,232.00 ",$887.04 ,$344.96 ,"$1,232.00 ",$800.80 , N/A ,$344.96 ,$681.30 , N/A ,$717.02 , N/A ,$645.57 , N/A , N/A ,"$1,133.44 ", N/A , N/A ,"$1,047.20 ","$1,108.80 ", N/A ,$924.00 ,$862.40 ,$862.40 , N/A ,$862.40 ,$948.64 ,$948.64 , N/A ,"$1,047.20 ", N/A , N/A ,$691.15 ,$510.05 ,$512.51 , N/A , N/A , N/A ,"$1,047.20 ", N/A ,$645.57 ,$344.96 ,"$1,108.80 ", N/A , N/A ,$800.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$1,373.00 ",$988.56 ,$384.44 ,"$1,373.00 ",$892.45 , N/A ,$384.44 ,$759.27 , N/A ,$799.09 , N/A ,$719.45 , N/A , N/A ,"$1,263.16 ", N/A , N/A ,"$1,167.05 ","$1,235.70 ", N/A ,"$1,029.75 ",$961.10 ,$961.10 , N/A ,$961.10 ,"$1,057.21 ","$1,057.21 ", N/A ,"$1,167.05 ", N/A , N/A ,$770.25 ,$568.42 ,$571.17 , N/A , N/A , N/A ,"$1,167.05 ", N/A ,$719.45 ,$384.44 ,"$1,235.70 ", N/A , N/A ,$892.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),36060024,N/A,HC OR LEVEL 6 ADDL 15MIN,360,1 ,"$1,487.00 ","$1,070.64 ",$416.36 ,"$1,487.00 ",$966.55 , N/A ,$416.36 ,$822.31 , N/A ,$865.43 , N/A ,$779.19 , N/A , N/A ,"$1,368.04 ", N/A , N/A ,"$1,263.95 ","$1,338.30 ", N/A ,"$1,115.25 ","$1,040.90 ","$1,040.90 ", N/A ,"$1,040.90 ","$1,144.99 ","$1,144.99 ", N/A ,"$1,263.95 ", N/A , N/A ,$834.21 ,$615.62 ,$618.59 , N/A , N/A , N/A ,"$1,263.95 ", N/A ,$779.19 ,$416.36 ,"$1,338.30 ", N/A , N/A ,$966.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),36060025,N/A,HC OR LEVEL 1 INITIAL 30MIN,360,1 ,"$2,533.00 ","$1,823.76 ",$709.24 ,"$2,533.00 ","$1,646.45 ", N/A ,$709.24 ,"$1,400.75 ", N/A ,"$1,474.21 ", N/A ,"$1,327.29 ", N/A , N/A ,"$2,330.36 ", N/A , N/A ,"$2,153.05 ","$2,279.70 ", N/A ,"$1,899.75 ","$1,773.10 ","$1,773.10 ", N/A ,"$1,773.10 ","$1,950.41 ","$1,950.41 ", N/A ,"$2,153.05 ", N/A , N/A ,"$1,421.01 ","$1,048.66 ","$1,053.73 ", N/A , N/A , N/A ,"$2,153.05 ", N/A ,"$1,327.29 ",$709.24 ,"$2,279.70 ", N/A , N/A ,"$1,646.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060026,N/A,HC OR LEVEL 2 INITIAL 30MIN,360,1 ,"$4,361.00 ","$3,139.92 ","$1,221.08 ","$4,361.00 ","$2,834.65 ", N/A ,"$1,221.08 ","$2,411.63 ", N/A ,"$2,538.10 ", N/A ,"$2,285.16 ", N/A , N/A ,"$4,012.12 ", N/A , N/A ,"$3,706.85 ","$3,924.90 ", N/A ,"$3,270.75 ","$3,052.70 ","$3,052.70 ", N/A ,"$3,052.70 ","$3,357.97 ","$3,357.97 ", N/A ,"$3,706.85 ", N/A , N/A ,"$2,446.52 ","$1,805.45 ","$1,814.18 ", N/A , N/A , N/A ,"$3,706.85 ", N/A ,"$2,285.16 ","$1,221.08 ","$3,924.90 ", N/A , N/A ,"$2,834.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060027,N/A,HC OR LEVEL 3 INITIAL 30MIN,360,1 ,"$5,673.00 ","$4,084.56 ","$1,588.44 ","$5,673.00 ","$3,687.45 ", N/A ,"$1,588.44 ","$3,137.17 ", N/A ,"$3,301.69 ", N/A ,"$2,972.65 ", N/A , N/A ,"$5,219.16 ", N/A , N/A ,"$4,822.05 ","$5,105.70 ", N/A ,"$4,254.75 ","$3,971.10 ","$3,971.10 ", N/A ,"$3,971.10 ","$4,368.21 ","$4,368.21 ", N/A ,"$4,822.05 ", N/A , N/A ,"$3,182.55 ","$2,348.62 ","$2,359.97 ", N/A , N/A , N/A ,"$4,822.05 ", N/A ,"$2,972.65 ","$1,588.44 ","$5,105.70 ", N/A , N/A ,"$3,687.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060028,N/A,HC OR LEVEL 4 INITIAL 30MIN,360,1 ,"$5,936.00 ","$4,273.92 ","$1,662.08 ","$5,936.00 ","$3,858.40 ", N/A ,"$1,662.08 ","$3,282.61 ", N/A ,"$3,454.75 ", N/A ,"$3,110.46 ", N/A , N/A ,"$5,461.12 ", N/A , N/A ,"$5,045.60 ","$5,342.40 ", N/A ,"$4,452.00 ","$4,155.20 ","$4,155.20 ", N/A ,"$4,155.20 ","$4,570.72 ","$4,570.72 ", N/A ,"$5,045.60 ", N/A , N/A ,"$3,330.10 ","$2,457.50 ","$2,469.38 ", N/A , N/A , N/A ,"$5,045.60 ", N/A ,"$3,110.46 ","$1,662.08 ","$5,342.40 ", N/A , N/A ,"$3,858.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060029,N/A,HC OR LEVEL 5 INITIAL 30MIN,360,1 ,"$6,232.00 ","$4,487.04 ","$1,744.96 ","$6,232.00 ","$4,050.80 ", N/A ,"$1,744.96 ","$3,446.30 ", N/A ,"$3,627.02 ", N/A ,"$3,265.57 ", N/A , N/A ,"$5,733.44 ", N/A , N/A ,"$5,297.20 ","$5,608.80 ", N/A ,"$4,674.00 ","$4,362.40 ","$4,362.40 ", N/A ,"$4,362.40 ","$4,798.64 ","$4,798.64 ", N/A ,"$5,297.20 ", N/A , N/A ,"$3,496.15 ","$2,580.05 ","$2,592.51 ", N/A , N/A , N/A ,"$5,297.20 ", N/A ,"$3,265.57 ","$1,744.96 ","$5,608.80 ", N/A , N/A ,"$4,050.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060030,N/A,HC OR LEVEL 6 INITIAL 30MIN,360,1 ,"$8,060.00 ","$5,803.20 ","$2,256.80 ","$8,060.00 ","$5,239.00 ", N/A ,"$2,256.80 ","$4,457.18 ", N/A ,"$4,690.92 ", N/A ,"$4,223.44 ", N/A , N/A ,"$7,415.20 ", N/A , N/A ,"$6,851.00 ","$7,254.00 ", N/A ,"$6,045.00 ","$5,642.00 ","$5,642.00 ", N/A ,"$5,642.00 ","$6,206.20 ","$6,206.20 ", N/A ,"$6,851.00 ", N/A , N/A ,"$4,521.66 ","$3,336.84 ","$3,352.96 ", N/A , N/A , N/A ,"$6,851.00 ", N/A ,"$4,223.44 ","$2,256.80 ","$7,254.00 ", N/A , N/A ,"$5,239.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060040,N/A,HC OR LEVEL LITHOTRIPSY INITIAL 45 MIN,360,1 ,"$11,337.00 ","$8,162.64 ","$3,174.36 ","$11,337.00 ","$7,369.05 ", N/A ,"$3,174.36 ","$6,269.36 ", N/A ,"$6,598.13 ", N/A ,"$5,940.59 ", N/A , N/A ,"$10,430.04 ", N/A , N/A ,"$9,636.45 ","$10,203.30 ", N/A ,"$8,502.75 ","$7,935.90 ","$7,935.90 ", N/A ,"$7,935.90 ","$8,729.49 ","$8,729.49 ", N/A ,"$9,636.45 ", N/A , N/A ,"$6,360.06 ","$4,693.52 ","$4,716.19 ", N/A , N/A , N/A ,"$9,636.45 ", N/A ,"$5,940.59 ","$3,174.36 ","$10,203.30 ", N/A , N/A ,"$7,369.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36060041,N/A,HC OR LEVEL LITHOTRIPSY ADDL 15 MIN,360,1 ,$335.00 ,$241.20 ,$93.80 ,$335.00 ,$217.75 , N/A ,$93.80 ,$185.26 , N/A ,$194.97 , N/A ,$175.54 , N/A , N/A ,$308.20 , N/A , N/A ,$284.75 ,$301.50 , N/A ,$251.25 ,$234.50 ,$234.50 , N/A ,$234.50 ,$257.95 ,$257.95 , N/A ,$284.75 , N/A , N/A ,$187.94 ,$138.69 ,$139.36 , N/A , N/A , N/A ,$284.75 , N/A ,$175.54 ,$93.80 ,$301.50 , N/A , N/A ,$217.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),36080008,64417,HC NERVE BLOCK AXILLARY NERVE,360,1 ,"$2,412.00 ","$1,736.64 ",$310.79 ,"$2,412.00 ","$1,567.80 ",$802.01 ,$675.36 ,"$1,333.84 ",$802.01 ,"$1,403.78 ",$802.01 ,"$1,263.89 ",$802.01 ,"$1,653.13 ","$2,219.04 ","$2,045.96 ",$802.01 ,"$2,050.20 ","$2,170.80 ",$818.05 ,"$1,809.00 ","$1,688.40 ","$1,688.40 ",$802.01 ,"$1,688.40 ","$1,857.24 ","$1,857.24 ","$2,045.96 ","$2,050.20 ",$818.38 ,$818.38 ,"$1,353.13 ",$998.57 ,"$1,003.39 ",$314.19 ,$310.79 ,$842.11 ,"$2,050.20 ","$1,759.52 ","$1,263.89 ",$675.36 ,"$2,170.80 ","$1,862.00 ",$802.01 ,"$1,567.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100043,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-BIL,361,1 ,$914.00 ,$658.08 ,$255.92 ,$979.15 ,$594.10 ,$383.83 ,$255.92 ,$505.44 ,$383.83 ,$531.95 ,$383.83 ,$478.94 ,$383.83 ,$791.15 ,$840.88 ,$979.15 ,$383.83 ,$776.90 ,$822.60 ,$391.50 ,$685.50 ,$639.80 ,$639.80 ,$383.83 ,$639.80 ,$703.78 ,$703.78 ,$914.00 ,$776.90 ,$391.66 ,$391.66 ,$512.75 ,$378.40 ,$380.22 ,$346.90 ,$343.14 ,$403.02 ,$776.90 ,$842.07 ,$478.94 ,$255.92 ,$822.60 ,$399.00 ,$383.83 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,$914.00 ,$658.08 ,$255.92 ,$979.15 ,$594.10 ,$383.83 ,$255.92 ,$505.44 ,$383.83 ,$531.95 ,$383.83 ,$478.94 ,$383.83 ,$791.15 ,$840.88 ,$979.15 ,$383.83 ,$776.90 ,$822.60 ,$391.50 ,$685.50 ,$639.80 ,$639.80 ,$383.83 ,$639.80 ,$703.78 ,$703.78 ,$914.00 ,$776.90 ,$391.66 ,$391.66 ,$512.75 ,$378.40 ,$380.22 ,$346.90 ,$343.14 ,$403.02 ,$776.90 ,$842.07 ,$478.94 ,$255.92 ,$822.60 ,$399.00 ,$383.83 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100065,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,361,1 ,$914.00 ,$658.08 ,$228.76 ,$914.00 ,$594.10 ,$255.89 ,$255.92 ,$505.44 ,$255.89 ,$531.95 ,$255.89 ,$478.94 ,$255.89 ,$527.44 ,$840.88 ,$652.77 ,$255.89 ,$776.90 ,$822.60 ,$261.00 ,$685.50 ,$639.80 ,$639.80 ,$255.89 ,$639.80 ,$703.78 ,$703.78 ,$652.77 ,$776.90 ,$261.11 ,$261.11 ,$512.75 ,$378.40 ,$380.22 ,$231.27 ,$228.76 ,$268.69 ,$776.90 ,$561.38 ,$478.94 ,$255.92 ,$822.60 ,$266.00 ,$255.89 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100066,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,361,1 ,$914.00 ,$658.08 ,$228.76 ,$914.00 ,$594.10 ,$255.89 ,$255.92 ,$505.44 ,$255.89 ,$531.95 ,$255.89 ,$478.94 ,$255.89 ,$527.44 ,$840.88 ,$652.77 ,$255.89 ,$776.90 ,$822.60 ,$261.00 ,$685.50 ,$639.80 ,$639.80 ,$255.89 ,$639.80 ,$703.78 ,$703.78 ,$652.77 ,$776.90 ,$261.11 ,$261.11 ,$512.75 ,$378.40 ,$380.22 ,$231.27 ,$228.76 ,$268.69 ,$776.90 ,$561.38 ,$478.94 ,$255.92 ,$822.60 ,$266.00 ,$255.89 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,$914.00 ,$658.08 ,$228.76 ,$914.00 ,$594.10 ,$255.89 ,$255.92 ,$505.44 ,$255.89 ,$531.95 ,$255.89 ,$478.94 ,$255.89 ,$527.44 ,$840.88 ,$652.77 ,$255.89 ,$776.90 ,$822.60 ,$261.00 ,$685.50 ,$639.80 ,$639.80 ,$255.89 ,$639.80 ,$703.78 ,$703.78 ,$652.77 ,$776.90 ,$261.11 ,$261.11 ,$512.75 ,$378.40 ,$380.22 ,$231.27 ,$228.76 ,$268.69 ,$776.90 ,$561.38 ,$478.94 ,$255.92 ,$822.60 ,$266.00 ,$255.89 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,$914.00 ,$658.08 ,$228.76 ,$914.00 ,$594.10 ,$255.89 ,$255.92 ,$505.44 ,$255.89 ,$531.95 ,$255.89 ,$478.94 ,$255.89 ,$527.44 ,$840.88 ,$652.77 ,$255.89 ,$776.90 ,$822.60 ,$261.00 ,$685.50 ,$639.80 ,$639.80 ,$255.89 ,$639.80 ,$703.78 ,$703.78 ,$652.77 ,$776.90 ,$261.11 ,$261.11 ,$512.75 ,$378.40 ,$380.22 ,$231.27 ,$228.76 ,$268.69 ,$776.90 ,$561.38 ,$478.94 ,$255.92 ,$822.60 ,$266.00 ,$255.89 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100106,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$2,412.00 ","$1,736.64 ",$563.65 ,"$2,412.00 ","$1,567.80 ",$802.01 ,$675.36 ,"$1,333.84 ",$802.01 ,"$1,403.78 ",$802.01 ,"$1,263.89 ",$802.01 ,"$1,653.13 ","$2,219.04 ","$2,045.96 ",$802.01 ,"$2,050.20 ","$2,170.80 ",$818.05 ,"$1,809.00 ","$1,688.40 ","$1,688.40 ",$802.01 ,"$1,688.40 ","$1,857.24 ","$1,857.24 ","$2,045.96 ","$2,050.20 ",$818.38 ,$818.38 ,"$1,353.13 ",$998.57 ,"$1,003.39 ",$569.82 ,$563.65 ,$842.11 ,"$2,050.20 ","$1,759.52 ","$1,263.89 ",$675.36 ,"$2,170.80 ","$1,862.00 ",$802.01 ,"$1,567.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100189,64415,HC INTRASCALENE BLOCK SINGLE,361,1 ,"$2,412.00 ","$1,736.64 ",$310.79 ,"$2,412.00 ","$1,567.80 ",$802.01 ,$675.36 ,"$1,333.84 ",$802.01 ,"$1,403.78 ",$802.01 ,"$1,263.89 ",$802.01 ,"$1,653.13 ","$2,219.04 ","$2,045.96 ",$802.01 ,"$2,050.20 ","$2,170.80 ",$818.05 ,"$1,809.00 ","$1,688.40 ","$1,688.40 ",$802.01 ,"$1,688.40 ","$1,857.24 ","$1,857.24 ","$2,045.96 ","$2,050.20 ",$818.38 ,$818.38 ,"$1,353.13 ",$998.57 ,"$1,003.39 ",$314.19 ,$310.79 ,$842.11 ,"$2,050.20 ","$1,759.52 ","$1,263.89 ",$675.36 ,"$2,170.80 ","$1,862.00 ",$802.01 ,"$1,567.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100197,64450,HC INJ ANES NERVE PERIPHERAL,361,1 ,"$1,861.00 ","$1,339.92 ",$310.79 ,"$1,861.00 ","$1,209.65 ",$606.41 ,$521.08 ,"$1,029.13 ",$606.41 ,"$1,083.10 ",$606.41 ,$975.16 ,$606.41 ,"$1,249.95 ","$1,712.12 ","$1,546.96 ",$606.41 ,"$1,581.85 ","$1,674.90 ",$618.54 ,"$1,395.75 ","$1,302.70 ","$1,302.70 ",$606.41 ,"$1,302.70 ","$1,432.97 ","$1,432.97 ","$1,546.96 ","$1,581.85 ",$618.79 ,$618.79 ,"$1,044.02 ",$770.45 ,$774.18 ,$314.19 ,$310.79 ,$636.74 ,"$1,581.85 ","$1,330.39 ",$975.16 ,$521.08 ,"$1,674.90 ","$1,861.00 ",$606.41 ,"$1,209.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100226,58345,HC TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,361,1 ,"$7,694.00 ","$5,539.68 ",$911.58 ,"$7,694.00 ","$5,001.10 ","$2,660.99 ","$2,154.32 ","$4,254.78 ","$2,660.99 ","$4,477.91 ","$2,660.99 ","$4,031.66 ","$2,660.99 ","$5,484.91 ","$7,078.48 ","$6,788.26 ","$2,660.99 ","$6,539.90 ","$6,924.60 ","$2,714.22 ","$5,770.50 ","$5,385.80 ","$5,385.80 ","$2,660.99 ","$5,385.80 ","$5,924.38 ","$5,924.38 ","$6,788.26 ","$6,539.90 ","$2,715.30 ","$2,715.30 ","$4,316.33 ","$3,185.32 ","$3,200.70 ",$921.57 ,$911.58 ,"$2,794.05 ","$6,539.90 ","$5,837.90 ","$4,031.66 ","$2,154.32 ","$6,924.60 ","$3,032.00 ","$2,660.99 ","$5,001.10 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,"$2,788.00 ","$2,007.36 ",$429.87 ,"$2,788.00 ","$1,812.20 ",$610.77 ,$780.64 ,"$1,541.76 ",$610.77 ,"$1,622.62 ",$610.77 ,"$1,460.91 ",$610.77 ,"$1,258.93 ","$2,564.96 ","$1,558.08 ",$610.77 ,"$2,369.80 ","$2,509.20 ",$622.99 ,"$2,091.00 ","$1,951.60 ","$1,951.60 ",$610.77 ,"$1,951.60 ","$2,146.76 ","$2,146.76 ","$1,558.08 ","$2,369.80 ",$623.23 ,$623.23 ,"$1,564.07 ","$1,154.23 ","$1,159.81 ",$434.58 ,$429.87 ,$641.30 ,"$2,369.80 ","$1,339.95 ","$1,460.91 ",$780.64 ,"$2,509.20 ","$1,862.00 ",$610.77 ,"$1,812.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,"$1,888.00 ","$1,359.36 ",$266.00 ,"$1,888.00 ","$1,227.20 ", N/A ,$528.64 ,"$1,044.06 ", N/A ,"$1,098.82 ", N/A ,$989.31 , N/A , N/A ,"$1,736.96 ", N/A , N/A ,"$1,604.80 ","$1,699.20 ", N/A ,"$1,416.00 ","$1,321.60 ","$1,321.60 ", N/A ,"$1,321.60 ","$1,453.76 ","$1,453.76 ", N/A ,"$1,604.80 ", N/A , N/A ,"$1,059.17 ",$781.63 ,$785.41 ,$434.58 ,$429.87 , N/A ,"$1,604.80 ", N/A ,$989.31 ,$528.64 ,"$1,699.20 ",$266.00 , N/A ,"$1,227.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),36100259,66821,HC LASER (YAG) POST CATARACT,361,1 ,$570.00 ,$410.40 ,$159.60 ,"$1,274.30 ",$370.50 ,$499.53 ,$159.60 ,$315.21 ,$499.53 ,$331.74 ,$499.53 ,$298.68 ,$499.53 ,$570.00 ,$524.40 ,"$1,274.30 ",$499.53 ,$484.50 ,$513.00 ,$509.51 ,$427.50 ,$399.00 ,$399.00 ,$499.53 ,$399.00 ,$438.90 ,$438.90 ,$570.00 ,$484.50 ,$509.72 ,$509.72 ,$319.77 ,$235.98 ,$237.12 ,$391.19 ,$386.96 ,$524.51 ,$484.50 ,"$1,095.90 ",$298.68 ,$159.60 ,$513.00 ,$570.00 ,$499.53 ,$370.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),36100289,43450,HC DILATE ESOPHAGUS 1/MULT PASS,361,1 ,"$2,553.00 ","$1,838.16 ",$488.41 ,"$2,553.00 ","$1,659.45 ",$776.91 ,$714.84 ,"$1,411.81 ",$776.91 ,"$1,485.85 ",$776.91 ,"$1,337.77 ",$776.91 ,"$1,601.40 ","$2,348.76 ","$1,981.93 ",$776.91 ,"$2,170.05 ","$2,297.70 ",$792.46 ,"$1,914.75 ","$1,787.10 ","$1,787.10 ",$776.91 ,"$1,787.10 ","$1,965.81 ","$1,965.81 ","$1,981.93 ","$2,170.05 ",$792.77 ,$792.77 ,"$1,432.23 ","$1,056.94 ","$1,062.05 ",$493.76 ,$488.41 ,$815.76 ,"$2,170.05 ","$1,704.46 ","$1,337.77 ",$714.84 ,"$2,297.70 ","$2,500.00 ",$776.91 ,"$1,659.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$810.00 ,$583.20 ,$195.60 ,$810.00 ,$526.50 ,$195.60 ,$226.80 ,$447.93 ,$195.60 ,$471.42 ,$195.60 ,$424.44 ,$195.60 ,$403.17 ,$745.20 ,$498.97 ,$195.60 ,$688.50 ,$729.00 ,$199.51 ,$607.50 ,$567.00 ,$567.00 ,$195.60 ,$567.00 ,$623.70 ,$623.70 ,$498.97 ,$688.50 ,$199.59 ,$199.59 ,$454.41 ,$335.34 ,$336.96 ,$482.57 ,$477.34 ,$205.38 ,$688.50 ,$429.11 ,$424.44 ,$226.80 ,$729.00 ,$266.00 ,$195.60 ,$526.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),37000061,N/A,HC ANESTHESIA GENERAL INITIAL 15MIN,370,1 ,$470.00 ,$338.40 ,$131.60 ,$470.00 ,$305.50 , N/A ,$131.60 ,$259.91 , N/A ,$273.54 , N/A ,$246.28 , N/A , N/A ,$432.40 , N/A , N/A ,$399.50 ,$423.00 , N/A ,$352.50 ,$329.00 ,$329.00 , N/A ,$329.00 ,$361.90 ,$361.90 , N/A ,$399.50 , N/A , N/A ,$263.67 ,$194.58 ,$195.52 , N/A , N/A , N/A ,$399.50 , N/A ,$246.28 ,$131.60 ,$423.00 ,$248.16 , N/A ,$305.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$295.00 ,$212.40 ,$82.60 ,$295.00 ,$191.75 , N/A ,$82.60 ,$163.14 , N/A ,$171.69 , N/A ,$154.58 , N/A , N/A ,$271.40 , N/A , N/A ,$250.75 ,$265.50 , N/A ,$221.25 ,$206.50 ,$206.50 , N/A ,$206.50 ,$227.15 ,$227.15 , N/A ,$250.75 , N/A , N/A ,$165.50 ,$122.13 ,$122.72 , N/A , N/A , N/A ,$250.75 , N/A ,$154.58 ,$82.60 ,$265.50 ,$155.76 , N/A ,$191.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),37000063,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 15MIN,370,1 ,$492.00 ,$354.24 ,$137.76 ,$492.00 ,$319.80 , N/A ,$137.76 ,$272.08 , N/A ,$286.34 , N/A ,$257.81 , N/A , N/A ,$452.64 , N/A , N/A ,$418.20 ,$442.80 , N/A ,$369.00 ,$344.40 ,$344.40 , N/A ,$344.40 ,$378.84 ,$378.84 , N/A ,$418.20 , N/A , N/A ,$276.01 ,$203.69 ,$204.67 , N/A , N/A , N/A ,$418.20 , N/A ,$257.81 ,$137.76 ,$442.80 ,$259.78 , N/A ,$319.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$281.00 ,$202.32 ,$78.68 ,$281.00 ,$182.65 , N/A ,$78.68 ,$155.39 , N/A ,$163.54 , N/A ,$147.24 , N/A , N/A ,$258.52 , N/A , N/A ,$238.85 ,$252.90 , N/A ,$210.75 ,$196.70 ,$196.70 , N/A ,$196.70 ,$216.37 ,$216.37 , N/A ,$238.85 , N/A , N/A ,$157.64 ,$116.33 ,$116.90 , N/A , N/A , N/A ,$238.85 , N/A ,$147.24 ,$78.68 ,$252.90 ,$148.37 , N/A ,$182.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),37000076,N/A,HC MONITORED ANESTHESIA INITIAL 15 MINS,370,1 ,$469.00 ,$337.68 ,$131.32 ,$469.00 ,$304.85 , N/A ,$131.32 ,$259.36 , N/A ,$272.96 , N/A ,$245.76 , N/A , N/A ,$431.48 , N/A , N/A ,$398.65 ,$422.10 , N/A ,$351.75 ,$328.30 ,$328.30 , N/A ,$328.30 ,$361.13 ,$361.13 , N/A ,$398.65 , N/A , N/A ,$263.11 ,$194.17 ,$195.10 , N/A , N/A , N/A ,$398.65 , N/A ,$245.76 ,$131.32 ,$422.10 ,$247.63 , N/A ,$304.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),37000077,N/A,HC MONITORED ANESTHESIA ADDL 15 MINS,370,1 ,$267.00 ,$192.24 ,$74.76 ,$267.00 ,$173.55 , N/A ,$74.76 ,$147.65 , N/A ,$155.39 , N/A ,$139.91 , N/A , N/A ,$245.64 , N/A , N/A ,$226.95 ,$240.30 , N/A ,$200.25 ,$186.90 ,$186.90 , N/A ,$186.90 ,$205.59 ,$205.59 , N/A ,$226.95 , N/A , N/A ,$149.79 ,$110.54 ,$111.07 , N/A , N/A , N/A ,$226.95 , N/A ,$139.91 ,$74.76 ,$240.30 ,$140.98 , N/A ,$173.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),37080000,64447,HC FEMORAL NERVE BLOCK SINGLE,360,1 ,"$1,861.00 ","$1,339.92 ",$310.79 ,"$1,861.00 ","$1,209.65 ",$606.41 ,$521.08 ,"$1,029.13 ",$606.41 ,"$1,083.10 ",$606.41 ,$975.16 ,$606.41 ,"$1,249.95 ","$1,712.12 ","$1,546.96 ",$606.41 ,"$1,581.85 ","$1,674.90 ",$618.54 ,"$1,395.75 ","$1,302.70 ","$1,302.70 ",$606.41 ,"$1,302.70 ","$1,432.97 ","$1,432.97 ","$1,546.96 ","$1,581.85 ",$618.79 ,$618.79 ,"$1,044.02 ",$770.45 ,$774.18 ,$314.19 ,$310.79 ,$636.74 ,"$1,581.85 ","$1,330.39 ",$975.16 ,$521.08 ,"$1,674.90 ","$1,861.00 ",$606.41 ,"$1,209.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),39000148,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$192.00 ,$138.24 ,$53.76 ,$213.68 ,$124.80 ,$83.76 ,$53.76 ,$106.18 ,$83.76 ,$111.74 ,$83.76 ,$100.61 ,$83.76 ,$172.65 ,$176.64 ,$213.68 ,$83.76 ,$163.20 ,$172.80 ,$85.44 ,$144.00 ,$134.40 ,$134.40 ,$83.76 ,$134.40 ,$147.84 ,$147.84 ,$192.00 ,$163.20 ,$85.47 ,$85.47 ,$107.71 ,$79.49 ,$79.87 ,$185.28 ,$192.00 ,$87.95 ,$163.20 ,$183.76 ,$100.61 ,$53.76 ,$172.80 ,$192.00 ,$83.76 ,$124.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000151,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,"$1,175.00 ",$846.00 ,$128.27 ,"$1,175.00 ",$763.75 ,$128.27 ,$329.00 ,$649.78 ,$128.27 ,$683.85 ,$128.27 ,$615.70 ,$128.27 ,$264.40 ,"$1,081.00 ",$327.23 ,$128.27 ,$998.75 ,"$1,057.50 ",$130.84 ,$881.25 ,$822.50 ,$822.50 ,$128.27 ,$822.50 ,$904.75 ,$904.75 ,$327.23 ,$998.75 ,$130.89 ,$130.89 ,$659.18 ,$486.45 ,$488.80 ,$474.25 ,$469.11 ,$134.68 ,$998.75 ,$281.41 ,$615.70 ,$329.00 ,"$1,057.50 ",$319.00 ,$128.27 ,$763.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,"$1,072.00 ",$771.84 ,$262.99 ,"$1,072.00 ",$696.80 ,$262.99 ,$300.16 ,$592.82 ,$262.99 ,$623.90 ,$262.99 ,$561.73 ,$262.99 ,$542.09 ,$986.24 ,$670.90 ,$262.99 ,$911.20 ,$964.80 ,$268.26 ,$804.00 ,$750.40 ,$750.40 ,$262.99 ,$750.40 ,$825.44 ,$825.44 ,$670.90 ,$911.20 ,$268.36 ,$268.36 ,$601.39 ,$443.81 ,$445.95 ,$474.25 ,$469.11 ,$276.14 ,$911.20 ,$576.97 ,$561.73 ,$300.16 ,$964.80 ,$319.00 ,$262.99 ,$696.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$195.00 ,$140.40 ,$54.60 ,$195.00 ,$126.75 ,$74.68 ,$54.60 ,$107.84 ,$74.68 ,$113.49 ,$74.68 ,$102.18 ,$74.68 ,$153.92 ,$179.40 ,$190.50 ,$74.68 ,$165.75 ,$175.50 ,$76.17 ,$146.25 ,$136.50 ,$136.50 ,$74.68 ,$136.50 ,$150.15 ,$150.15 ,$190.50 ,$165.75 ,$76.20 ,$76.20 ,$109.40 ,$80.73 ,$81.12 ,$188.18 ,$195.00 ,$78.41 ,$165.75 ,$163.83 ,$102.18 ,$54.60 ,$175.50 ,$195.00 ,$74.68 ,$126.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,$670.00 ,$482.40 ,$185.43 ,$670.00 ,$435.50 ,$185.43 ,$187.60 ,$370.51 ,$185.43 ,$389.94 ,$185.43 ,$351.08 ,$185.43 ,$382.20 ,$616.40 ,$473.03 ,$185.43 ,$569.50 ,$603.00 ,$189.13 ,$502.50 ,$469.00 ,$469.00 ,$185.43 ,$469.00 ,$515.90 ,$515.90 ,$473.03 ,$569.50 ,$189.21 ,$189.21 ,$375.87 ,$277.38 ,$278.72 ,$474.25 ,$469.11 ,$194.70 ,$569.50 ,$406.80 ,$351.08 ,$187.60 ,$603.00 ,$319.00 ,$185.43 ,$435.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,"$1,294.00 ",$931.68 ,$319.00 ,"$1,294.00 ",$841.10 ,$475.95 ,$362.32 ,$715.58 ,$475.95 ,$753.11 ,$475.95 ,$678.06 ,$475.95 ,$981.03 ,"$1,190.48 ","$1,214.15 ",$475.95 ,"$1,099.90 ","$1,164.60 ",$485.46 ,$970.50 ,$905.80 ,$905.80 ,$475.95 ,$905.80 ,$996.38 ,$996.38 ,"$1,214.15 ","$1,099.90 ",$485.66 ,$485.66 ,$725.93 ,$535.72 ,$538.30 ,$474.25 ,$469.11 ,$499.74 ,"$1,099.90 ","$1,044.17 ",$678.06 ,$362.32 ,"$1,164.60 ",$319.00 ,$475.95 ,$841.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000179,P9037,HC PLATELETS PHER L/R IRR EA T1,390,1 ,"$1,179.00 ",$848.88 ,$319.00 ,"$1,595.48 ",$766.35 ,$625.43 ,$330.12 ,$651.99 ,$625.43 ,$686.18 ,$625.43 ,$617.80 ,$625.43 ,"$1,179.00 ","$1,084.68 ","$1,595.48 ",$625.43 ,"$1,002.15 ","$1,061.10 ",$637.93 ,$884.25 ,$825.30 ,$825.30 ,$625.43 ,$825.30 ,$907.83 ,$907.83 ,"$1,179.00 ","$1,002.15 ",$638.19 ,$638.19 ,$661.42 ,$488.11 ,$490.46 ,$474.25 ,$469.11 ,$656.70 ,"$1,002.15 ","$1,372.11 ",$617.80 ,$330.12 ,"$1,061.10 ",$319.00 ,$625.43 ,$766.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,$729.00 ,$524.88 ,$204.12 ,$729.00 ,$473.85 ,$253.94 ,$204.12 ,$403.14 ,$253.94 ,$424.28 ,$253.94 ,$382.00 ,$253.94 ,$523.42 ,$670.68 ,$647.80 ,$253.94 ,$619.65 ,$656.10 ,$259.01 ,$546.75 ,$510.30 ,$510.30 ,$253.94 ,$510.30 ,$561.33 ,$561.33 ,$647.80 ,$619.65 ,$259.12 ,$259.12 ,$408.97 ,$301.81 ,$303.26 ,$474.25 ,$469.11 ,$266.64 ,$619.65 ,$557.11 ,$382.00 ,$204.12 ,$656.10 ,$319.00 ,$253.94 ,$473.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),39000205,P9073,HC PLATELETS PHERESIS PATH REDUCED EA UN T1,390,1 ,"$1,172.00 ",$843.84 ,$319.00 ,"$1,444.73 ",$761.80 ,$566.33 ,$328.16 ,$648.12 ,$566.33 ,$682.10 ,$566.33 ,$614.13 ,$566.33 ,"$1,167.34 ","$1,078.24 ","$1,444.73 ",$566.33 ,$996.20 ,"$1,054.80 ",$577.66 ,$879.00 ,$820.40 ,$820.40 ,$566.33 ,$820.40 ,$902.44 ,$902.44 ,"$1,172.00 ",$996.20 ,$577.89 ,$577.89 ,$657.49 ,$485.21 ,$487.55 ,$474.25 ,$469.11 ,$594.64 ,$996.20 ,"$1,242.46 ",$614.13 ,$328.16 ,"$1,054.80 ",$319.00 ,$566.33 ,$761.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),39100001,36430,HC BLOOD PROD ADMIN,391,1 ,$591.00 ,$425.52 ,$165.48 ,$978.95 ,$384.15 ,$383.75 ,$165.48 ,$326.82 ,$383.75 ,$343.96 ,$383.75 ,$309.68 ,$383.75 ,$591.00 ,$543.72 ,$978.95 ,$383.75 ,$502.35 ,$531.90 ,$391.42 ,$443.25 ,$413.70 ,$413.70 ,$383.75 ,$413.70 ,$455.07 ,$455.07 ,$591.00 ,$502.35 ,$391.58 ,$391.58 ,$331.55 ,$244.67 ,$245.86 ,$474.25 ,$469.11 ,$402.94 ,$502.35 ,$841.89 ,$309.68 ,$165.48 ,$531.90 ,$319.00 ,$383.75 ,$384.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$717.00 ,$516.24 ,$48.83 ,$717.00 ,$466.05 ,$103.42 ,$200.76 ,$396.50 ,$103.42 ,$417.29 ,$103.42 ,$375.71 ,$103.42 ,$213.17 ,$659.64 ,$263.83 ,$103.42 ,$609.45 ,$645.30 ,$105.49 ,$537.75 ,$501.90 ,$501.90 ,$103.42 ,$501.90 ,$552.09 ,$552.09 ,$263.83 ,$609.45 ,$105.53 ,$105.53 ,$402.24 ,$296.84 ,$298.27 ,$49.36 ,$48.83 ,$108.59 ,$609.45 ,$226.89 ,$375.71 ,$200.76 ,$645.30 ,$223.00 ,$103.42 ,$466.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$717.00 ,$516.24 ,$48.83 ,$717.00 ,$466.05 ,$103.42 ,$200.76 ,$396.50 ,$103.42 ,$417.29 ,$103.42 ,$375.71 ,$103.42 ,$213.17 ,$659.64 ,$263.83 ,$103.42 ,$609.45 ,$645.30 ,$105.49 ,$537.75 ,$501.90 ,$501.90 ,$103.42 ,$501.90 ,$552.09 ,$552.09 ,$263.83 ,$609.45 ,$105.53 ,$105.53 ,$402.24 ,$296.84 ,$298.27 ,$49.36 ,$48.83 ,$108.59 ,$609.45 ,$226.89 ,$375.71 ,$200.76 ,$645.30 ,$223.00 ,$103.42 ,$466.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$717.00 ,$516.24 ,$48.83 ,$717.00 ,$466.05 ,$103.42 ,$200.76 ,$396.50 ,$103.42 ,$417.29 ,$103.42 ,$375.71 ,$103.42 ,$213.17 ,$659.64 ,$263.83 ,$103.42 ,$609.45 ,$645.30 ,$105.49 ,$537.75 ,$501.90 ,$501.90 ,$103.42 ,$501.90 ,$552.09 ,$552.09 ,$263.83 ,$609.45 ,$105.53 ,$105.53 ,$402.24 ,$296.84 ,$298.27 ,$49.36 ,$48.83 ,$108.59 ,$609.45 ,$226.89 ,$375.71 ,$200.76 ,$645.30 ,$223.00 ,$103.42 ,$466.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$537.00 ,$386.64 ,$48.83 ,$537.00 ,$349.05 ,$81.18 ,$150.36 ,$296.96 ,$81.18 ,$312.53 ,$81.18 ,$281.39 ,$81.18 ,$167.34 ,$494.04 ,$207.10 ,$81.18 ,$456.45 ,$483.30 ,$82.81 ,$402.75 ,$375.90 ,$375.90 ,$81.18 ,$375.90 ,$413.49 ,$413.49 ,$207.10 ,$456.45 ,$82.84 ,$82.84 ,$301.26 ,$222.32 ,$223.39 ,$49.36 ,$48.83 ,$85.24 ,$456.45 ,$178.11 ,$281.39 ,$150.36 ,$483.30 ,$223.00 ,$81.18 ,$349.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD ADDNT VIEW,401,1 ,$537.00 ,$386.64 ,$48.83 ,$537.00 ,$349.05 ,$81.18 ,$150.36 ,$296.96 ,$81.18 ,$312.53 ,$81.18 ,$281.39 ,$81.18 ,$167.34 ,$494.04 ,$207.10 ,$81.18 ,$456.45 ,$483.30 ,$82.81 ,$402.75 ,$375.90 ,$375.90 ,$81.18 ,$375.90 ,$413.49 ,$413.49 ,$207.10 ,$456.45 ,$82.84 ,$82.84 ,$301.26 ,$222.32 ,$223.39 ,$49.36 ,$48.83 ,$85.24 ,$456.45 ,$178.11 ,$281.39 ,$150.36 ,$483.30 ,$223.00 ,$81.18 ,$349.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$537.00 ,$386.64 ,$48.83 ,$537.00 ,$349.05 ,$81.18 ,$150.36 ,$296.96 ,$81.18 ,$312.53 ,$81.18 ,$281.39 ,$81.18 ,$167.34 ,$494.04 ,$207.10 ,$81.18 ,$456.45 ,$483.30 ,$82.81 ,$402.75 ,$375.90 ,$375.90 ,$81.18 ,$375.90 ,$413.49 ,$413.49 ,$207.10 ,$456.45 ,$82.84 ,$82.84 ,$301.26 ,$222.32 ,$223.39 ,$49.36 ,$48.83 ,$85.24 ,$456.45 ,$178.11 ,$281.39 ,$150.36 ,$483.30 ,$223.00 ,$81.18 ,$349.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$136.00 ,$97.92 ,$22.24 ,$136.00 ,$88.40 ,$22.24 ,$38.08 ,$75.21 ,$22.24 ,$79.15 ,$22.24 ,$71.26 ,$22.24 ,$45.83 ,$125.12 ,$56.73 ,$22.24 ,$115.60 ,$122.40 ,$22.68 ,$102.00 ,$95.20 ,$95.20 ,$22.24 ,$95.20 ,$104.72 ,$104.72 ,$56.73 ,$115.60 ,$22.69 ,$22.69 ,$76.30 ,$56.30 ,$56.58 ,$49.36 ,$48.83 ,$23.34 ,$115.60 ,$48.78 ,$71.26 ,$38.08 ,$122.40 ,$136.00 ,$22.24 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200007,51798,HC US BLADDER SCAN,402,1 ,$467.00 ,$336.24 ,$54.10 ,$467.00 ,$303.55 ,$54.10 ,$130.76 ,$258.25 ,$54.10 ,$271.79 ,$54.10 ,$244.71 ,$54.10 ,$111.50 ,$429.64 ,$138.00 ,$54.10 ,$396.95 ,$420.30 ,$55.17 ,$350.25 ,$326.90 ,$326.90 ,$54.10 ,$326.90 ,$359.59 ,$359.59 ,$138.00 ,$396.95 ,$55.20 ,$55.20 ,$261.99 ,$193.34 ,$194.27 ,$85.32 ,$84.39 ,$56.80 ,$396.95 ,$118.68 ,$244.71 ,$130.76 ,$420.30 ,$426.00 ,$54.10 ,$303.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,"$1,118.00 ",$804.96 ,$100.59 ,"$1,118.00 ",$726.70 ,$100.59 ,$313.04 ,$618.25 ,$100.59 ,$650.68 ,$100.59 ,$585.83 ,$100.59 ,$207.34 ,"$1,028.56 ",$256.60 ,$100.59 ,$950.30 ,"$1,006.20 ",$102.60 ,$838.50 ,$782.60 ,$782.60 ,$100.59 ,$782.60 ,$860.86 ,$860.86 ,$256.60 ,$950.30 ,$102.64 ,$102.64 ,$627.20 ,$462.85 ,$465.09 ,$108.67 ,$107.49 ,$105.61 ,$950.30 ,$220.68 ,$585.83 ,$313.04 ,"$1,006.20 ",$426.00 ,$100.59 ,$726.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200014,76604,HC US CHEST,402,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200015,76641,HC US BREAST COMPLETE,402,1 ,$921.00 ,$663.12 ,$100.59 ,$921.00 ,$598.65 ,$100.59 ,$257.88 ,$509.31 ,$100.59 ,$536.02 ,$100.59 ,$482.60 ,$100.59 ,$207.34 ,$847.32 ,$256.60 ,$100.59 ,$782.85 ,$828.90 ,$102.60 ,$690.75 ,$644.70 ,$644.70 ,$100.59 ,$644.70 ,$709.17 ,$709.17 ,$256.60 ,$782.85 ,$102.64 ,$102.64 ,$516.68 ,$381.29 ,$383.14 ,$108.67 ,$107.49 ,$105.61 ,$782.85 ,$220.68 ,$482.60 ,$257.88 ,$828.90 ,$426.00 ,$100.59 ,$598.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200016,76642,HC US BREAST LIMITED,402,1 ,$246.00 ,$177.12 ,$68.88 ,$246.00 ,$159.90 ,$81.76 ,$68.88 ,$136.04 ,$81.76 ,$143.17 ,$81.76 ,$128.90 ,$81.76 ,$168.54 ,$226.32 ,$208.59 ,$81.76 ,$209.10 ,$221.40 ,$83.40 ,$184.50 ,$172.20 ,$172.20 ,$81.76 ,$172.20 ,$189.42 ,$189.42 ,$208.59 ,$209.10 ,$83.43 ,$83.43 ,$138.01 ,$101.84 ,$102.34 ,$108.67 ,$107.49 ,$85.85 ,$209.10 ,$179.38 ,$128.90 ,$68.88 ,$221.40 ,$246.00 ,$81.76 ,$159.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,327.00 ",$955.44 ,$100.59 ,"$1,327.00 ",$862.55 ,$100.59 ,$371.56 ,$733.83 ,$100.59 ,$772.31 ,$100.59 ,$695.35 ,$100.59 ,$207.34 ,"$1,220.84 ",$256.60 ,$100.59 ,"$1,127.95 ","$1,194.30 ",$102.60 ,$995.25 ,$928.90 ,$928.90 ,$100.59 ,$928.90 ,"$1,021.79 ","$1,021.79 ",$256.60 ,"$1,127.95 ",$102.64 ,$102.64 ,$744.45 ,$549.38 ,$552.03 ,$108.67 ,$107.49 ,$105.61 ,"$1,127.95 ",$220.68 ,$695.35 ,$371.56 ,"$1,194.30 ",$426.00 ,$100.59 ,$862.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200018,76705,HC US ABDOMEN LTD,402,1 ,"$1,204.00 ",$866.88 ,$100.59 ,"$1,204.00 ",$782.60 ,$100.59 ,$337.12 ,$665.81 ,$100.59 ,$700.73 ,$100.59 ,$630.90 ,$100.59 ,$207.34 ,"$1,107.68 ",$256.60 ,$100.59 ,"$1,023.40 ","$1,083.60 ",$102.60 ,$903.00 ,$842.80 ,$842.80 ,$100.59 ,$842.80 ,$927.08 ,$927.08 ,$256.60 ,"$1,023.40 ",$102.64 ,$102.64 ,$675.44 ,$498.46 ,$500.86 ,$108.67 ,$107.49 ,$105.61 ,"$1,023.40 ",$220.68 ,$630.90 ,$337.12 ,"$1,083.60 ",$426.00 ,$100.59 ,$782.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200019,76770,HC US RETROPERITIONEAL,402,1 ,"$1,204.00 ",$866.88 ,$100.59 ,"$1,204.00 ",$782.60 ,$100.59 ,$337.12 ,$665.81 ,$100.59 ,$700.73 ,$100.59 ,$630.90 ,$100.59 ,$207.34 ,"$1,107.68 ",$256.60 ,$100.59 ,"$1,023.40 ","$1,083.60 ",$102.60 ,$903.00 ,$842.80 ,$842.80 ,$100.59 ,$842.80 ,$927.08 ,$927.08 ,$256.60 ,"$1,023.40 ",$102.64 ,$102.64 ,$675.44 ,$498.46 ,$500.86 ,$108.67 ,$107.49 ,$105.61 ,"$1,023.40 ",$220.68 ,$630.90 ,$337.12 ,"$1,083.60 ",$426.00 ,$100.59 ,$782.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,"$1,112.00 ",$800.64 ,$100.59 ,"$1,112.00 ",$722.80 ,$100.59 ,$311.36 ,$614.94 ,$100.59 ,$647.18 ,$100.59 ,$582.69 ,$100.59 ,$207.34 ,"$1,023.04 ",$256.60 ,$100.59 ,$945.20 ,"$1,000.80 ",$102.60 ,$834.00 ,$778.40 ,$778.40 ,$100.59 ,$778.40 ,$856.24 ,$856.24 ,$256.60 ,$945.20 ,$102.64 ,$102.64 ,$623.83 ,$460.37 ,$462.59 , N/A , N/A ,$105.61 ,$945.20 ,$220.68 ,$582.69 ,$311.36 ,"$1,000.80 ",$426.00 ,$100.59 ,$722.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$942.00 ,$678.24 ,$263.76 ,$942.00 ,$612.30 , N/A ,$263.76 ,$520.93 , N/A ,$548.24 , N/A ,$493.61 , N/A , N/A ,$866.64 , N/A , N/A ,$800.70 ,$847.80 , N/A ,$706.50 ,$659.40 ,$659.40 , N/A ,$659.40 ,$725.34 ,$725.34 , N/A ,$800.70 , N/A , N/A ,$528.46 ,$389.99 ,$391.87 , N/A , N/A , N/A ,$800.70 , N/A ,$493.61 ,$263.76 ,$847.80 ,$426.00 , N/A ,$612.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,"$1,112.00 ",$800.64 ,$100.59 ,"$1,112.00 ",$722.80 ,$100.59 ,$311.36 ,$614.94 ,$100.59 ,$647.18 ,$100.59 ,$582.69 ,$100.59 ,$207.34 ,"$1,023.04 ",$256.60 ,$100.59 ,$945.20 ,"$1,000.80 ",$102.60 ,$834.00 ,$778.40 ,$778.40 ,$100.59 ,$778.40 ,$856.24 ,$856.24 ,$256.60 ,$945.20 ,$102.64 ,$102.64 ,$623.83 ,$460.37 ,$462.59 , N/A , N/A ,$105.61 ,$945.20 ,$220.68 ,$582.69 ,$311.36 ,"$1,000.80 ",$426.00 ,$100.59 ,$722.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,$415.00 ,$298.80 ,$116.20 ,$415.00 ,$269.75 , N/A ,$116.20 ,$229.50 , N/A ,$241.53 , N/A ,$217.46 , N/A , N/A ,$381.80 , N/A , N/A ,$352.75 ,$373.50 , N/A ,$311.25 ,$290.50 ,$290.50 , N/A ,$290.50 ,$319.55 ,$319.55 , N/A ,$352.75 , N/A , N/A ,$232.82 ,$171.81 ,$172.64 , N/A , N/A , N/A ,$352.75 , N/A ,$217.46 ,$116.20 ,$373.50 ,$415.00 , N/A ,$269.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,$675.00 ,$486.00 ,$189.00 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 , N/A , N/A ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$426.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$938.00 ,$675.36 ,$100.59 ,$938.00 ,$609.70 ,$100.59 ,$262.64 ,$518.71 ,$100.59 ,$545.92 ,$100.59 ,$491.51 ,$100.59 ,$207.34 ,$862.96 ,$256.60 ,$100.59 ,$797.30 ,$844.20 ,$102.60 ,$703.50 ,$656.60 ,$656.60 ,$100.59 ,$656.60 ,$722.26 ,$722.26 ,$256.60 ,$797.30 ,$102.64 ,$102.64 ,$526.22 ,$388.33 ,$390.21 , N/A , N/A ,$105.61 ,$797.30 ,$220.68 ,$491.51 ,$262.64 ,$844.20 ,$426.00 ,$100.59 ,$609.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200031,76815,HC US FETAL HEART BEAT,402,1 ,$796.00 ,$573.12 ,$100.59 ,$796.00 ,$517.40 ,$100.59 ,$222.88 ,$440.19 ,$100.59 ,$463.27 ,$100.59 ,$417.10 ,$100.59 ,$207.34 ,$732.32 ,$256.60 ,$100.59 ,$676.60 ,$716.40 ,$102.60 ,$597.00 ,$557.20 ,$557.20 ,$100.59 ,$557.20 ,$612.92 ,$612.92 ,$256.60 ,$676.60 ,$102.64 ,$102.64 ,$446.56 ,$329.54 ,$331.14 , N/A , N/A ,$105.61 ,$676.60 ,$220.68 ,$417.10 ,$222.88 ,$716.40 ,$426.00 ,$100.59 ,$517.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,$906.00 ,$652.32 ,$100.59 ,$906.00 ,$588.90 ,$100.59 ,$253.68 ,$501.02 ,$100.59 ,$527.29 ,$100.59 ,$474.74 ,$100.59 ,$207.34 ,$833.52 ,$256.60 ,$100.59 ,$770.10 ,$815.40 ,$102.60 ,$679.50 ,$634.20 ,$634.20 ,$100.59 ,$634.20 ,$697.62 ,$697.62 ,$256.60 ,$770.10 ,$102.64 ,$102.64 ,$508.27 ,$375.08 ,$376.90 , N/A , N/A ,$105.61 ,$770.10 ,$220.68 ,$474.74 ,$253.68 ,$815.40 ,$426.00 ,$100.59 ,$588.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200033,76818,HC US FETAL BIO PROFILE W/NST,402,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 , N/A , N/A ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$942.00 ,$678.24 ,$100.59 ,$942.00 ,$612.30 ,$100.59 ,$263.76 ,$520.93 ,$100.59 ,$548.24 ,$100.59 ,$493.61 ,$100.59 ,$207.34 ,$866.64 ,$256.60 ,$100.59 ,$800.70 ,$847.80 ,$102.60 ,$706.50 ,$659.40 ,$659.40 ,$100.59 ,$659.40 ,$725.34 ,$725.34 ,$256.60 ,$800.70 ,$102.64 ,$102.64 ,$528.46 ,$389.99 ,$391.87 , N/A , N/A ,$105.61 ,$800.70 ,$220.68 ,$493.61 ,$263.76 ,$847.80 ,$426.00 ,$100.59 ,$612.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200035,76819,HC US FETAL BIO PROFILE W/O NST EA ADDN,402,1 ,$942.00 ,$678.24 ,$100.59 ,$942.00 ,$612.30 ,$100.59 ,$263.76 ,$520.93 ,$100.59 ,$548.24 ,$100.59 ,$493.61 ,$100.59 ,$207.34 ,$866.64 ,$256.60 ,$100.59 ,$800.70 ,$847.80 ,$102.60 ,$706.50 ,$659.40 ,$659.40 ,$100.59 ,$659.40 ,$725.34 ,$725.34 ,$256.60 ,$800.70 ,$102.64 ,$102.64 ,$528.46 ,$389.99 ,$391.87 , N/A , N/A ,$105.61 ,$800.70 ,$220.68 ,$493.61 ,$263.76 ,$847.80 ,$426.00 ,$100.59 ,$612.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200038,76830,HC US TRANSVAGINAL,402,1 ,$942.00 ,$678.24 ,$100.59 ,$942.00 ,$612.30 ,$100.59 ,$263.76 ,$520.93 ,$100.59 ,$548.24 ,$100.59 ,$493.61 ,$100.59 ,$207.34 ,$866.64 ,$256.60 ,$100.59 ,$800.70 ,$847.80 ,$102.60 ,$706.50 ,$659.40 ,$659.40 ,$100.59 ,$659.40 ,$725.34 ,$725.34 ,$256.60 ,$800.70 ,$102.64 ,$102.64 ,$528.46 ,$389.99 ,$391.87 ,$108.67 ,$107.49 ,$105.61 ,$800.70 ,$220.68 ,$493.61 ,$263.76 ,$847.80 ,$426.00 ,$100.59 ,$612.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,327.00 ",$955.44 ,$100.59 ,"$1,327.00 ",$862.55 ,$100.59 ,$371.56 ,$733.83 ,$100.59 ,$772.31 ,$100.59 ,$695.35 ,$100.59 ,$207.34 ,"$1,220.84 ",$256.60 ,$100.59 ,"$1,127.95 ","$1,194.30 ",$102.60 ,$995.25 ,$928.90 ,$928.90 ,$100.59 ,$928.90 ,"$1,021.79 ","$1,021.79 ",$256.60 ,"$1,127.95 ",$102.64 ,$102.64 ,$744.45 ,$549.38 ,$552.03 ,$108.67 ,$107.49 ,$105.61 ,"$1,127.95 ",$220.68 ,$695.35 ,$371.56 ,"$1,194.30 ",$426.00 ,$100.59 ,$862.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,"$1,204.00 ",$866.88 ,$100.59 ,"$1,204.00 ",$782.60 ,$100.59 ,$337.12 ,$665.81 ,$100.59 ,$700.73 ,$100.59 ,$630.90 ,$100.59 ,$207.34 ,"$1,107.68 ",$256.60 ,$100.59 ,"$1,023.40 ","$1,083.60 ",$102.60 ,$903.00 ,$842.80 ,$842.80 ,$100.59 ,$842.80 ,$927.08 ,$927.08 ,$256.60 ,"$1,023.40 ",$102.64 ,$102.64 ,$675.44 ,$498.46 ,$500.86 ,$108.67 ,$107.49 ,$105.61 ,"$1,023.40 ",$220.68 ,$630.90 ,$337.12 ,"$1,083.60 ",$426.00 ,$100.59 ,$782.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200042,76870,HC US SCROTUM,402,1 ,"$1,034.00 ",$744.48 ,$100.59 ,"$1,034.00 ",$672.10 ,$100.59 ,$289.52 ,$571.80 ,$100.59 ,$601.79 ,$100.59 ,$541.82 ,$100.59 ,$207.34 ,$951.28 ,$256.60 ,$100.59 ,$878.90 ,$930.60 ,$102.60 ,$775.50 ,$723.80 ,$723.80 ,$100.59 ,$723.80 ,$796.18 ,$796.18 ,$256.60 ,$878.90 ,$102.64 ,$102.64 ,$580.07 ,$428.08 ,$430.14 ,$108.67 ,$107.49 ,$105.61 ,$878.90 ,$220.68 ,$541.82 ,$289.52 ,$930.60 ,$426.00 ,$100.59 ,$672.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$942.00 ,$678.24 ,$100.59 ,$942.00 ,$612.30 ,$100.59 ,$263.76 ,$520.93 ,$100.59 ,$548.24 ,$100.59 ,$493.61 ,$100.59 ,$207.34 ,$866.64 ,$256.60 ,$100.59 ,$800.70 ,$847.80 ,$102.60 ,$706.50 ,$659.40 ,$659.40 ,$100.59 ,$659.40 ,$725.34 ,$725.34 ,$256.60 ,$800.70 ,$102.64 ,$102.64 ,$528.46 ,$389.99 ,$391.87 ,$108.67 ,$107.49 ,$105.61 ,$800.70 ,$220.68 ,$493.61 ,$263.76 ,$847.80 ,$426.00 ,$100.59 ,$612.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200048,76885,HC US HIPS INFANT DYNAMIC,402,1 ,$237.00 ,$170.64 ,$66.36 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 , N/A , N/A ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200050,76936,HC US GUIDED COMPRESSION RPR,402,1 ,$776.00 ,$558.72 ,$78.45 ,$776.00 ,$504.40 ,$263.57 ,$217.28 ,$429.13 ,$263.57 ,$451.63 ,$263.57 ,$406.62 ,$263.57 ,$543.28 ,$713.92 ,$672.38 ,$263.57 ,$659.60 ,$698.40 ,$268.84 ,$582.00 ,$543.20 ,$543.20 ,$263.57 ,$543.20 ,$597.52 ,$597.52 ,$672.38 ,$659.60 ,$268.95 ,$268.95 ,$435.34 ,$321.26 ,$322.82 ,$79.30 ,$78.45 ,$276.75 ,$659.60 ,$578.25 ,$406.62 ,$217.28 ,$698.40 ,$426.00 ,$263.57 ,$504.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,"$1,436.00 ","$1,033.92 ",$78.45 ,"$1,436.00 ",$933.40 , N/A ,$402.08 ,$794.11 , N/A ,$835.75 , N/A ,$752.46 , N/A , N/A ,"$1,321.12 ", N/A , N/A ,"$1,220.60 ","$1,292.40 ", N/A ,"$1,077.00 ","$1,005.20 ","$1,005.20 ", N/A ,"$1,005.20 ","$1,105.72 ","$1,105.72 ", N/A ,"$1,220.60 ", N/A , N/A ,$805.60 ,$594.50 ,$597.38 ,$79.30 ,$78.45 , N/A ,"$1,220.60 ", N/A ,$752.46 ,$402.08 ,"$1,292.40 ",$426.00 , N/A ,$933.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,"$1,033.00 ",$743.76 ,$78.45 ,"$1,033.00 ",$671.45 , N/A ,$289.24 ,$571.25 , N/A ,$601.21 , N/A ,$541.29 , N/A , N/A ,$950.36 , N/A , N/A ,$878.05 ,$929.70 , N/A ,$774.75 ,$723.10 ,$723.10 , N/A ,$723.10 ,$795.41 ,$795.41 , N/A ,$878.05 , N/A , N/A ,$579.51 ,$427.66 ,$429.73 ,$79.30 ,$78.45 , N/A ,$878.05 , N/A ,$541.29 ,$289.24 ,$929.70 ,$426.00 , N/A ,$671.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200062,76998,HC US INTRAOPERATIVE,402,1 ,"$1,109.00 ",$798.48 ,$78.45 ,"$1,109.00 ",$720.85 , N/A ,$310.52 ,$613.28 , N/A ,$645.44 , N/A ,$581.12 , N/A , N/A ,"$1,020.28 ", N/A , N/A ,$942.65 ,$998.10 , N/A ,$831.75 ,$776.30 ,$776.30 , N/A ,$776.30 ,$853.93 ,$853.93 , N/A ,$942.65 , N/A , N/A ,$622.15 ,$459.13 ,$461.34 ,$79.30 ,$78.45 , N/A ,$942.65 , N/A ,$581.12 ,$310.52 ,$998.10 ,$426.00 , N/A ,$720.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,$675.00 ,$486.00 ,$107.49 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 ,$108.67 ,$107.49 ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$426.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200068,93976,HC DUPLEX ABD/PEL/RETRO LTD,402,1 ,"$1,500.00 ","$1,080.00 ",$100.59 ,"$1,500.00 ",$975.00 ,$100.59 ,$420.00 ,$829.50 ,$100.59 ,$873.00 ,$100.59 ,$786.00 ,$100.59 ,$207.34 ,"$1,380.00 ",$256.60 ,$100.59 ,"$1,275.00 ","$1,350.00 ",$102.60 ,"$1,125.00 ","$1,050.00 ","$1,050.00 ",$100.59 ,"$1,050.00 ","$1,155.00 ","$1,155.00 ",$256.60 ,"$1,275.00 ",$102.64 ,$102.64 ,$841.50 ,$621.00 ,$624.00 ,$108.67 ,$107.49 ,$105.61 ,"$1,275.00 ",$220.68 ,$786.00 ,$420.00 ,"$1,350.00 ",$426.00 ,$100.59 ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,500.00 ","$1,080.00 ",$100.59 ,"$1,500.00 ",$975.00 ,$100.59 ,$420.00 ,$829.50 ,$100.59 ,$873.00 ,$100.59 ,$786.00 ,$100.59 ,$207.34 ,"$1,380.00 ",$256.60 ,$100.59 ,"$1,275.00 ","$1,350.00 ",$102.60 ,"$1,125.00 ","$1,050.00 ","$1,050.00 ",$100.59 ,"$1,050.00 ","$1,155.00 ","$1,155.00 ",$256.60 ,"$1,275.00 ",$102.64 ,$102.64 ,$841.50 ,$621.00 ,$624.00 ,$108.67 ,$107.49 ,$105.61 ,"$1,275.00 ",$220.68 ,$786.00 ,$420.00 ,"$1,350.00 ",$426.00 ,$100.59 ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,"$1,500.00 ","$1,080.00 ",$107.49 ,"$1,500.00 ",$975.00 ,$219.77 ,$420.00 ,$829.50 ,$219.77 ,$873.00 ,$219.77 ,$786.00 ,$219.77 ,$453.00 ,"$1,380.00 ",$560.65 ,$219.77 ,"$1,275.00 ","$1,350.00 ",$224.17 ,"$1,125.00 ","$1,050.00 ","$1,050.00 ",$219.77 ,"$1,050.00 ","$1,155.00 ","$1,155.00 ",$560.65 ,"$1,275.00 ",$224.26 ,$224.26 ,$841.50 ,$621.00 ,$624.00 ,$108.67 ,$107.49 ,$230.76 ,"$1,275.00 ",$482.16 ,$786.00 ,$420.00 ,"$1,350.00 ",$792.00 ,$219.77 ,$975.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200075,76706,HC US AORTA (SCREENING),402,1 ,$942.00 ,$678.24 ,$100.59 ,$942.00 ,$612.30 ,$100.59 ,$263.76 ,$520.93 ,$100.59 ,$548.24 ,$100.59 ,$493.61 ,$100.59 ,$207.34 ,$866.64 ,$256.60 ,$100.59 ,$800.70 ,$847.80 ,$102.60 ,$706.50 ,$659.40 ,$659.40 ,$100.59 ,$659.40 ,$725.34 ,$725.34 ,$256.60 ,$800.70 ,$102.64 ,$102.64 ,$528.46 ,$389.99 ,$391.87 ,$108.67 ,$107.49 ,$105.61 ,$800.70 ,$220.68 ,$493.61 ,$263.76 ,$847.80 ,$426.00 ,$100.59 ,$612.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200091,76886,HC US HIPS INFANT STATIC,402,1 ,$237.00 ,$170.64 ,$66.36 ,$237.00 ,$154.05 ,$81.76 ,$66.36 ,$131.06 ,$81.76 ,$137.93 ,$81.76 ,$124.19 ,$81.76 ,$168.54 ,$218.04 ,$208.59 ,$81.76 ,$201.45 ,$213.30 ,$83.40 ,$177.75 ,$165.90 ,$165.90 ,$81.76 ,$165.90 ,$182.49 ,$182.49 ,$208.59 ,$201.45 ,$83.43 ,$83.43 ,$132.96 ,$98.12 ,$98.59 , N/A , N/A ,$85.85 ,$201.45 ,$179.38 ,$124.19 ,$66.36 ,$213.30 ,$237.00 ,$81.76 ,$154.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200092,76813,HC US FETAL NUCHAL TRANSLUCENCY SNG,402,1 ,$319.00 ,$229.68 ,$69.56 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$70.33 ,$69.56 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),40200097,76816,HC US OB GROWTH FOLLOWUP EA ADDN,402,1 ,$938.00 ,$675.36 ,$100.59 ,$938.00 ,$609.70 ,$100.59 ,$262.64 ,$518.71 ,$100.59 ,$545.92 ,$100.59 ,$491.51 ,$100.59 ,$207.34 ,$862.96 ,$256.60 ,$100.59 ,$797.30 ,$844.20 ,$102.60 ,$703.50 ,$656.60 ,$656.60 ,$100.59 ,$656.60 ,$722.26 ,$722.26 ,$256.60 ,$797.30 ,$102.64 ,$102.64 ,$526.22 ,$388.33 ,$390.21 , N/A , N/A ,$105.61 ,$797.30 ,$220.68 ,$491.51 ,$262.64 ,$844.20 ,$426.00 ,$100.59 ,$609.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$445.00 ,$320.40 ,$48.83 ,$445.00 ,$289.25 ,$85.82 ,$124.60 ,$246.09 ,$85.82 ,$258.99 ,$85.82 ,$233.18 ,$85.82 ,$176.89 ,$409.40 ,$218.93 ,$85.82 ,$378.25 ,$400.50 ,$87.53 ,$333.75 ,$311.50 ,$311.50 ,$85.82 ,$311.50 ,$342.65 ,$342.65 ,$218.93 ,$378.25 ,$87.57 ,$87.57 ,$249.65 ,$184.23 ,$185.12 ,$49.36 ,$48.83 ,$90.11 ,$378.25 ,$188.28 ,$233.18 ,$124.60 ,$400.50 ,$223.00 ,$85.82 ,$289.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$445.00 ,$320.40 ,$48.83 ,$445.00 ,$289.25 ,$85.82 ,$124.60 ,$246.09 ,$85.82 ,$258.99 ,$85.82 ,$233.18 ,$85.82 ,$176.89 ,$409.40 ,$218.93 ,$85.82 ,$378.25 ,$400.50 ,$87.53 ,$333.75 ,$311.50 ,$311.50 ,$85.82 ,$311.50 ,$342.65 ,$342.65 ,$218.93 ,$378.25 ,$87.57 ,$87.57 ,$249.65 ,$184.23 ,$185.12 ,$49.36 ,$48.83 ,$90.11 ,$378.25 ,$188.28 ,$233.18 ,$124.60 ,$400.50 ,$223.00 ,$85.82 ,$289.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$125.00 ,$90.00 ,$22.24 ,$125.00 ,$81.25 ,$22.24 ,$35.00 ,$69.13 ,$22.24 ,$72.75 ,$22.24 ,$65.50 ,$22.24 ,$45.83 ,$115.00 ,$56.73 ,$22.24 ,$106.25 ,$112.50 ,$22.68 ,$93.75 ,$87.50 ,$87.50 ,$22.24 ,$87.50 ,$96.25 ,$96.25 ,$56.73 ,$106.25 ,$22.69 ,$22.69 ,$70.13 ,$51.75 ,$52.00 ,$49.36 ,$48.83 ,$23.34 ,$106.25 ,$48.78 ,$65.50 ,$35.00 ,$112.50 ,$125.00 ,$22.24 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$645.00 ,$464.40 ,$147.69 ,$645.00 ,$419.25 ,$195.60 ,$180.60 ,$356.69 ,$195.60 ,$375.39 ,$195.60 ,$337.98 ,$195.60 ,$403.17 ,$593.40 ,$498.97 ,$195.60 ,$548.25 ,$580.50 ,$199.51 ,$483.75 ,$451.50 ,$451.50 ,$195.60 ,$451.50 ,$496.65 ,$496.65 ,$498.97 ,$548.25 ,$199.59 ,$199.59 ,$361.85 ,$267.03 ,$268.32 ,$149.31 ,$147.69 ,$205.38 ,$548.25 ,$429.11 ,$337.98 ,$180.60 ,$580.50 ,$186.00 ,$195.60 ,$419.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000005,92950,HC CPR,480,1 ,$730.00 ,$525.60 ,$204.40 ,$730.00 ,$474.50 ,$263.57 ,$204.40 ,$403.69 ,$263.57 ,$424.86 ,$263.57 ,$382.52 ,$263.57 ,$543.28 ,$671.60 ,$672.38 ,$263.57 ,$620.50 ,$657.00 ,$268.84 ,$547.50 ,$511.00 ,$511.00 ,$263.57 ,$511.00 ,$562.10 ,$562.10 ,$672.38 ,$620.50 ,$268.95 ,$268.95 ,$409.53 ,$302.22 ,$303.68 ,$482.57 ,$477.34 ,$276.75 ,$620.50 ,$578.25 ,$382.52 ,$204.40 ,$657.00 ,$730.00 ,$263.57 ,$474.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,"$1,026.00 ",$738.72 ,$186.00 ,"$1,336.60 ",$666.90 ,$523.95 ,$287.28 ,$567.38 ,$523.95 ,$597.13 ,$523.95 ,$537.62 ,$523.95 ,"$1,026.00 ",$943.92 ,"$1,336.60 ",$523.95 ,$872.10 ,$923.40 ,$534.42 ,$769.50 ,$718.20 ,$718.20 ,$523.95 ,$718.20 ,$790.02 ,$790.02 ,"$1,026.00 ",$872.10 ,$534.64 ,$534.64 ,$575.59 ,$424.76 ,$426.82 ,$523.21 ,$517.55 ,$550.14 ,$872.10 ,"$1,149.48 ",$537.62 ,$287.28 ,$923.40 ,$186.00 ,$523.95 ,$666.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000010,94002,HC VENTIL HI FREQ INTL DAY,410,1 ,"$1,026.00 ",$738.72 ,$186.00 ,"$1,336.60 ",$666.90 ,$523.95 ,$287.28 ,$567.38 ,$523.95 ,$597.13 ,$523.95 ,$537.62 ,$523.95 ,"$1,026.00 ",$943.92 ,"$1,336.60 ",$523.95 ,$872.10 ,$923.40 ,$534.42 ,$769.50 ,$718.20 ,$718.20 ,$523.95 ,$718.20 ,$790.02 ,$790.02 ,"$1,026.00 ",$872.10 ,$534.64 ,$534.64 ,$575.59 ,$424.76 ,$426.82 ,$523.21 ,$517.55 ,$550.14 ,$872.10 ,"$1,149.48 ",$537.62 ,$287.28 ,$923.40 ,$186.00 ,$523.95 ,$666.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$615.00 ,$442.80 ,$172.20 ,$615.00 ,$399.75 ,$180.23 ,$172.20 ,$340.10 ,$180.23 ,$357.93 ,$180.23 ,$322.26 ,$180.23 ,$371.49 ,$565.80 ,$459.76 ,$180.23 ,$522.75 ,$553.50 ,$183.83 ,$461.25 ,$430.50 ,$430.50 ,$180.23 ,$430.50 ,$473.55 ,$473.55 ,$459.76 ,$522.75 ,$183.91 ,$183.91 ,$345.02 ,$254.61 ,$255.84 ,$523.21 ,$517.55 ,$189.25 ,$522.75 ,$395.40 ,$322.26 ,$172.20 ,$553.50 ,$186.00 ,$180.23 ,$399.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000014,94002,HC VENT WEANING FIRST DAY,410,1 ,"$1,026.00 ",$738.72 ,$186.00 ,"$1,336.60 ",$666.90 ,$523.95 ,$287.28 ,$567.38 ,$523.95 ,$597.13 ,$523.95 ,$537.62 ,$523.95 ,"$1,026.00 ",$943.92 ,"$1,336.60 ",$523.95 ,$872.10 ,$923.40 ,$534.42 ,$769.50 ,$718.20 ,$718.20 ,$523.95 ,$718.20 ,$790.02 ,$790.02 ,"$1,026.00 ",$872.10 ,$534.64 ,$534.64 ,$575.59 ,$424.76 ,$426.82 ,$523.21 ,$517.55 ,$550.14 ,$872.10 ,"$1,149.48 ",$537.62 ,$287.28 ,$923.40 ,$186.00 ,$523.95 ,$666.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,"$1,026.00 ",$738.72 ,$186.00 ,"$1,336.60 ",$666.90 ,$523.95 ,$287.28 ,$567.38 ,$523.95 ,$597.13 ,$523.95 ,$537.62 ,$523.95 ,"$1,026.00 ",$943.92 ,"$1,336.60 ",$523.95 ,$872.10 ,$923.40 ,$534.42 ,$769.50 ,$718.20 ,$718.20 ,$523.95 ,$718.20 ,$790.02 ,$790.02 ,"$1,026.00 ",$872.10 ,$534.64 ,$534.64 ,$575.59 ,$424.76 ,$426.82 ,$523.21 ,$517.55 ,$550.14 ,$872.10 ,"$1,149.48 ",$537.62 ,$287.28 ,$923.40 ,$186.00 ,$523.95 ,$666.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,"$1,423.00 ","$1,024.56 ",$186.00 ,"$1,423.00 ",$924.95 ,$523.95 ,$398.44 ,$786.92 ,$523.95 ,$828.19 ,$523.95 ,$745.65 ,$523.95 ,"$1,079.97 ","$1,309.16 ","$1,336.60 ",$523.95 ,"$1,209.55 ","$1,280.70 ",$534.42 ,"$1,067.25 ",$996.10 ,$996.10 ,$523.95 ,$996.10 ,"$1,095.71 ","$1,095.71 ","$1,336.60 ","$1,209.55 ",$534.64 ,$534.64 ,$798.30 ,$589.12 ,$591.97 ,$523.21 ,$517.55 ,$550.14 ,"$1,209.55 ","$1,149.48 ",$745.65 ,$398.44 ,"$1,280.70 ",$186.00 ,$523.95 ,$924.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$615.00 ,$442.80 ,$172.20 ,$615.00 ,$399.75 ,$180.23 ,$172.20 ,$340.10 ,$180.23 ,$357.93 ,$180.23 ,$322.26 ,$180.23 ,$371.49 ,$565.80 ,$459.76 ,$180.23 ,$522.75 ,$553.50 ,$183.83 ,$461.25 ,$430.50 ,$430.50 ,$180.23 ,$430.50 ,$473.55 ,$473.55 ,$459.76 ,$522.75 ,$183.91 ,$183.91 ,$345.02 ,$254.61 ,$255.84 ,$523.21 ,$517.55 ,$189.25 ,$522.75 ,$395.40 ,$322.26 ,$172.20 ,$553.50 ,$186.00 ,$180.23 ,$399.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000034,94640,HC IPPB,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000037,94640,HC INCENTIVE SPIROMETER TRT,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000040,94640,HC EZ PAP TREATMENT,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000046,94640,HC HIGH EFF NEB AERO EACH,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$365.00 ,$262.80 ,$52.85 ,$365.00 ,$237.25 ,$109.28 ,$102.20 ,$201.85 ,$109.28 ,$212.43 ,$109.28 ,$191.26 ,$109.28 ,$225.24 ,$335.80 ,$278.76 ,$109.28 ,$310.25 ,$328.50 ,$111.47 ,$273.75 ,$255.50 ,$255.50 ,$109.28 ,$255.50 ,$281.05 ,$281.05 ,$278.76 ,$310.25 ,$111.51 ,$111.51 ,$204.77 ,$151.11 ,$151.84 ,$53.42 ,$52.85 ,$114.75 ,$310.25 ,$239.74 ,$191.26 ,$102.20 ,$328.50 ,$186.00 ,$109.28 ,$237.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$327.00 ,$235.44 ,$52.85 ,$327.00 ,$212.55 , N/A ,$91.56 ,$180.83 , N/A ,$190.31 , N/A ,$171.35 , N/A , N/A ,$300.84 , N/A , N/A ,$277.95 ,$294.30 , N/A ,$245.25 ,$228.90 ,$228.90 , N/A ,$228.90 ,$251.79 ,$251.79 , N/A ,$277.95 , N/A , N/A ,$183.45 ,$135.38 ,$136.03 ,$53.42 ,$52.85 , N/A ,$277.95 , N/A ,$171.35 ,$91.56 ,$294.30 ,$186.00 , N/A ,$212.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000052,94660,HC CPAP,410,1 ,$615.00 ,$442.80 ,$172.20 ,$615.00 ,$399.75 ,$180.23 ,$172.20 ,$340.10 ,$180.23 ,$357.93 ,$180.23 ,$322.26 ,$180.23 ,$371.49 ,$565.80 ,$459.76 ,$180.23 ,$522.75 ,$553.50 ,$183.83 ,$461.25 ,$430.50 ,$430.50 ,$180.23 ,$430.50 ,$473.55 ,$473.55 ,$459.76 ,$522.75 ,$183.91 ,$183.91 ,$345.02 ,$254.61 ,$255.84 ,$523.21 ,$517.55 ,$189.25 ,$522.75 ,$395.40 ,$322.26 ,$172.20 ,$553.50 ,$186.00 ,$180.23 ,$399.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000053,94660,HC CPAP DAILY EST PT,410,1 ,$615.00 ,$442.80 ,$172.20 ,$615.00 ,$399.75 ,$180.23 ,$172.20 ,$340.10 ,$180.23 ,$357.93 ,$180.23 ,$322.26 ,$180.23 ,$371.49 ,$565.80 ,$459.76 ,$180.23 ,$522.75 ,$553.50 ,$183.83 ,$461.25 ,$430.50 ,$430.50 ,$180.23 ,$430.50 ,$473.55 ,$473.55 ,$459.76 ,$522.75 ,$183.91 ,$183.91 ,$345.02 ,$254.61 ,$255.84 ,$523.21 ,$517.55 ,$189.25 ,$522.75 ,$395.40 ,$322.26 ,$172.20 ,$553.50 ,$186.00 ,$180.23 ,$399.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$551.00 ,$396.72 ,$25.50 ,$551.00 ,$358.15 ,$180.23 ,$154.28 ,$304.70 ,$180.23 ,$320.68 ,$180.23 ,$288.72 ,$180.23 ,$371.49 ,$506.92 ,$459.76 ,$180.23 ,$468.35 ,$495.90 ,$183.83 ,$413.25 ,$385.70 ,$385.70 ,$180.23 ,$385.70 ,$424.27 ,$424.27 ,$459.76 ,$468.35 ,$183.91 ,$183.91 ,$309.11 ,$228.11 ,$229.22 ,$25.78 ,$25.50 ,$189.25 ,$468.35 ,$395.40 ,$288.72 ,$154.28 ,$495.90 ,$186.00 ,$180.23 ,$358.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$329.00 ,$236.88 ,$92.12 ,$329.00 ,$213.85 ,$109.28 ,$92.12 ,$181.94 ,$109.28 ,$191.48 ,$109.28 ,$172.40 ,$109.28 ,$225.24 ,$302.68 ,$278.76 ,$109.28 ,$279.65 ,$296.10 ,$111.47 ,$246.75 ,$230.30 ,$230.30 ,$109.28 ,$230.30 ,$253.33 ,$253.33 ,$278.76 ,$279.65 ,$111.51 ,$111.51 ,$184.57 ,$136.21 ,$136.86 ,$173.28 ,$171.40 ,$114.75 ,$279.65 ,$239.74 ,$172.40 ,$92.12 ,$296.10 ,$186.00 ,$109.28 ,$213.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$145.00 ,$104.40 ,$40.60 ,$278.76 ,$94.25 ,$109.28 ,$40.60 ,$80.19 ,$109.28 ,$84.39 ,$109.28 ,$75.98 ,$109.28 ,$145.00 ,$133.40 ,$278.76 ,$109.28 ,$123.25 ,$130.50 ,$111.47 ,$108.75 ,$101.50 ,$101.50 ,$109.28 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$111.51 ,$111.51 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$114.75 ,$123.25 ,$239.74 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$109.28 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000074,94640,HC IPPB SUBSQ,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000075,94640,HC IPV INIT,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000077,94762,HC PULSE OX PER DAY,410,1 ,$432.00 ,$311.04 ,$52.85 ,$432.00 ,$280.80 ,$136.87 ,$120.96 ,$238.90 ,$136.87 ,$251.42 ,$136.87 ,$226.37 ,$136.87 ,$282.12 ,$397.44 ,$349.16 ,$136.87 ,$367.20 ,$388.80 ,$139.61 ,$324.00 ,$302.40 ,$302.40 ,$136.87 ,$302.40 ,$332.64 ,$332.64 ,$349.16 ,$367.20 ,$139.66 ,$139.66 ,$242.35 ,$178.85 ,$179.71 ,$53.42 ,$52.85 ,$143.71 ,$367.20 ,$300.27 ,$226.37 ,$120.96 ,$388.80 ,$186.00 ,$136.87 ,$280.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000082,94640,HC EZPAP TREATMENT SUBSQ,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$615.00 ,$442.80 ,$172.20 ,$615.00 ,$399.75 ,$180.23 ,$172.20 ,$340.10 ,$180.23 ,$357.93 ,$180.23 ,$322.26 ,$180.23 ,$371.49 ,$565.80 ,$459.76 ,$180.23 ,$522.75 ,$553.50 ,$183.83 ,$461.25 ,$430.50 ,$430.50 ,$180.23 ,$430.50 ,$473.55 ,$473.55 ,$459.76 ,$522.75 ,$183.91 ,$183.91 ,$345.02 ,$254.61 ,$255.84 ,$523.21 ,$517.55 ,$189.25 ,$522.75 ,$395.40 ,$322.26 ,$172.20 ,$553.50 ,$186.00 ,$180.23 ,$399.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),41000092,94640,HC AEROSOL INHALATION SUBSQ,410,1 ,$145.00 ,$104.40 ,$40.60 ,$459.76 ,$94.25 ,$180.23 ,$40.60 ,$80.19 ,$180.23 ,$84.39 ,$142.10 ,$75.98 ,$142.10 ,$145.00 ,$133.40 ,$459.76 ,$180.23 ,$123.25 ,$130.50 ,$142.10 ,$108.75 ,$101.50 ,$101.50 ,$180.23 ,$101.50 ,$111.65 ,$111.65 ,$145.00 ,$123.25 ,$183.91 ,$183.91 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$189.25 ,$123.25 ,$395.40 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$180.23 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000018,97022,HC WHIRLPOOL 45 MINUTES,420,1 ,$155.00 ,$111.60 ,$16.41 ,$155.00 ,$100.75 ,$16.41 ,$43.40 ,$85.72 ,$16.41 ,$90.21 ,$16.41 ,$81.22 ,$16.41 ,$33.81 ,$142.60 ,$41.85 ,$16.41 ,$131.75 ,$139.50 ,$16.73 ,$116.25 ,$108.50 ,$108.50 ,$16.41 ,$108.50 ,$119.35 ,$119.35 ,$41.85 ,$131.75 ,$16.74 ,$16.74 ,$86.96 ,$64.17 ,$64.48 ,$19.72 ,$19.51 ,$17.23 ,$131.75 ,$35.99 ,$81.22 ,$43.40 ,$139.50 ,$155.00 ,$16.41 ,$100.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$116.00 ,$83.52 ,$14.12 ,$116.00 ,$75.40 ,$14.12 ,$32.48 ,$64.15 ,$14.12 ,$67.51 ,$14.12 ,$60.78 ,$14.12 ,$29.11 ,$106.72 ,$36.03 ,$14.12 ,$98.60 ,$104.40 ,$14.41 ,$87.00 ,$81.20 ,$81.20 ,$14.12 ,$81.20 ,$89.32 ,$89.32 ,$36.03 ,$98.60 ,$14.41 ,$14.41 ,$65.08 ,$48.02 ,$48.26 ,$111.94 ,$116.00 ,$14.83 ,$98.60 ,$30.98 ,$60.78 ,$32.48 ,$104.40 ,$116.00 ,$14.12 ,$75.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$145.00 ,$104.40 ,$19.09 ,$145.00 ,$94.25 ,$19.09 ,$40.60 ,$80.19 ,$19.09 ,$84.39 ,$19.09 ,$75.98 ,$19.09 ,$39.35 ,$133.40 ,$48.70 ,$19.09 ,$123.25 ,$130.50 ,$19.47 ,$108.75 ,$101.50 ,$101.50 ,$19.09 ,$101.50 ,$111.65 ,$111.65 ,$48.70 ,$123.25 ,$19.48 ,$19.48 ,$81.35 ,$60.03 ,$60.32 ,$139.93 ,$145.00 ,$20.04 ,$123.25 ,$41.88 ,$75.98 ,$40.60 ,$130.50 ,$145.00 ,$19.09 ,$94.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$104.00 ,$74.88 ,$14.03 ,$104.00 ,$67.60 ,$14.03 ,$29.12 ,$57.51 ,$14.03 ,$60.53 ,$14.03 ,$54.50 ,$14.03 ,$28.93 ,$95.68 ,$35.80 ,$14.03 ,$88.40 ,$93.60 ,$14.32 ,$78.00 ,$72.80 ,$72.80 ,$14.03 ,$72.80 ,$80.08 ,$80.08 ,$35.80 ,$88.40 ,$14.32 ,$14.32 ,$58.34 ,$43.06 ,$43.26 ,$100.36 ,$104.00 ,$14.74 ,$88.40 ,$30.79 ,$54.50 ,$29.12 ,$93.60 ,$104.00 ,$14.03 ,$67.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$119.00 ,$85.68 ,$28.49 ,$119.00 ,$77.35 ,$28.49 ,$33.32 ,$65.81 ,$28.49 ,$69.26 ,$28.49 ,$62.36 ,$28.49 ,$58.72 ,$109.48 ,$72.68 ,$28.49 ,$101.15 ,$107.10 ,$29.06 ,$89.25 ,$83.30 ,$83.30 ,$28.49 ,$83.30 ,$91.63 ,$91.63 ,$72.68 ,$101.15 ,$29.07 ,$29.07 ,$66.76 ,$49.27 ,$49.50 ,$114.84 ,$119.00 ,$29.91 ,$101.15 ,$62.50 ,$62.36 ,$33.32 ,$107.10 ,$119.00 ,$28.49 ,$77.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$109.00 ,$78.48 ,$30.52 ,$109.00 ,$70.85 ,$32.62 ,$30.52 ,$60.28 ,$32.62 ,$63.44 ,$32.62 ,$57.12 ,$32.62 ,$67.25 ,$100.28 ,$83.23 ,$32.62 ,$92.65 ,$98.10 ,$33.28 ,$81.75 ,$76.30 ,$76.30 ,$32.62 ,$76.30 ,$83.93 ,$83.93 ,$83.23 ,$92.65 ,$33.29 ,$33.29 ,$61.15 ,$45.13 ,$45.34 ,$105.19 ,$109.00 ,$34.25 ,$92.65 ,$71.57 ,$57.12 ,$30.52 ,$98.10 ,$109.00 ,$32.62 ,$70.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$111.00 ,$79.92 ,$28.49 ,$111.00 ,$72.15 ,$28.49 ,$31.08 ,$61.38 ,$28.49 ,$64.60 ,$28.49 ,$58.16 ,$28.49 ,$58.72 ,$102.12 ,$72.68 ,$28.49 ,$94.35 ,$99.90 ,$29.06 ,$83.25 ,$77.70 ,$77.70 ,$28.49 ,$77.70 ,$85.47 ,$85.47 ,$72.68 ,$94.35 ,$29.07 ,$29.07 ,$62.27 ,$45.95 ,$46.18 ,$107.12 ,$111.00 ,$29.91 ,$94.35 ,$62.50 ,$58.16 ,$31.08 ,$99.90 ,$111.00 ,$28.49 ,$72.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$129.00 ,$92.88 ,$28.87 ,$129.00 ,$83.85 ,$28.87 ,$36.12 ,$71.34 ,$28.87 ,$75.08 ,$28.87 ,$67.60 ,$28.87 ,$59.51 ,$118.68 ,$73.65 ,$28.87 ,$109.65 ,$116.10 ,$29.45 ,$96.75 ,$90.30 ,$90.30 ,$28.87 ,$90.30 ,$99.33 ,$99.33 ,$73.65 ,$109.65 ,$29.46 ,$29.46 ,$72.37 ,$53.41 ,$53.66 ,$124.49 ,$129.00 ,$30.31 ,$109.65 ,$63.34 ,$67.60 ,$36.12 ,$116.10 ,$129.00 ,$28.87 ,$83.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$123.00 ,$88.56 ,$26.28 ,$123.00 ,$79.95 ,$26.28 ,$34.44 ,$68.02 ,$26.28 ,$71.59 ,$26.28 ,$64.45 ,$26.28 ,$54.18 ,$113.16 ,$67.05 ,$26.28 ,$104.55 ,$110.70 ,$26.81 ,$92.25 ,$86.10 ,$86.10 ,$26.28 ,$86.10 ,$94.71 ,$94.71 ,$67.05 ,$104.55 ,$26.82 ,$26.82 ,$69.00 ,$50.92 ,$51.17 ,$118.70 ,$123.00 ,$27.60 ,$104.55 ,$57.66 ,$64.45 ,$34.44 ,$110.70 ,$123.00 ,$26.28 ,$79.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$134.00 ,$96.48 ,$35.56 ,$134.00 ,$87.10 ,$35.56 ,$37.52 ,$74.10 ,$35.56 ,$77.99 ,$35.56 ,$70.22 ,$35.56 ,$73.31 ,$123.28 ,$90.73 ,$35.56 ,$113.90 ,$120.60 ,$36.28 ,$100.50 ,$93.80 ,$93.80 ,$35.56 ,$93.80 ,$103.18 ,$103.18 ,$90.73 ,$113.90 ,$36.29 ,$36.29 ,$75.17 ,$55.48 ,$55.74 ,$129.31 ,$134.00 ,$37.34 ,$113.90 ,$78.02 ,$70.22 ,$37.52 ,$120.60 ,$134.00 ,$35.56 ,$87.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$311.00 ,$223.92 ,$87.08 ,$311.00 ,$202.15 , N/A ,$87.08 ,$171.98 , N/A ,$181.00 , N/A ,$162.96 , N/A , N/A ,$286.12 , N/A , N/A ,$264.35 ,$279.90 , N/A ,$233.25 ,$217.70 ,$217.70 , N/A ,$217.70 ,$239.47 ,$239.47 , N/A ,$264.35 , N/A , N/A ,$174.47 ,$128.75 ,$129.38 ,$205.53 ,$203.30 , N/A ,$264.35 , N/A ,$162.96 ,$87.08 ,$279.90 ,$202.00 , N/A ,$202.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000085,97605,HC NWPT <50 SQ CM FAC,420,1 ,$311.00 ,$223.92 ,$40.77 ,$311.00 ,$202.15 ,$40.77 ,$87.08 ,$171.98 ,$40.77 ,$181.00 ,$40.77 ,$162.96 ,$40.77 ,$84.03 ,$286.12 ,$104.00 ,$40.77 ,$264.35 ,$279.90 ,$41.58 ,$233.25 ,$217.70 ,$217.70 ,$40.77 ,$217.70 ,$239.47 ,$239.47 ,$104.00 ,$264.35 ,$41.60 ,$41.60 ,$174.47 ,$128.75 ,$129.38 ,$205.53 ,$203.30 ,$42.81 ,$264.35 ,$89.44 ,$162.96 ,$87.08 ,$279.90 ,$202.00 ,$40.77 ,$202.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000089,97606,HC NWPT >50 SQ CM FAC,420,1 ,$542.00 ,$390.24 ,$48.60 ,$542.00 ,$352.30 ,$48.60 ,$151.76 ,$299.73 ,$48.60 ,$315.44 ,$48.60 ,$284.01 ,$48.60 ,$100.17 ,$498.64 ,$123.98 ,$48.60 ,$460.70 ,$487.80 ,$49.57 ,$406.50 ,$379.40 ,$379.40 ,$48.60 ,$379.40 ,$417.34 ,$417.34 ,$123.98 ,$460.70 ,$49.59 ,$49.59 ,$304.06 ,$224.39 ,$225.47 ,$205.53 ,$203.30 ,$51.03 ,$460.70 ,$106.62 ,$284.01 ,$151.76 ,$487.80 ,$202.00 ,$48.60 ,$352.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$132.00 ,$95.04 ,$32.51 ,$132.00 ,$85.80 ,$32.51 ,$36.96 ,$73.00 ,$32.51 ,$76.82 ,$32.51 ,$69.17 ,$32.51 ,$67.00 ,$121.44 ,$82.93 ,$32.51 ,$112.20 ,$118.80 ,$33.15 ,$99.00 ,$92.40 ,$92.40 ,$32.51 ,$92.40 ,$101.64 ,$101.64 ,$82.93 ,$112.20 ,$33.17 ,$33.17 ,$74.05 ,$54.65 ,$54.91 ,$127.38 ,$132.00 ,$34.13 ,$112.20 ,$71.32 ,$69.17 ,$36.96 ,$118.80 ,$132.00 ,$32.51 ,$85.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$149.00 ,$107.28 ,$40.03 ,$149.00 ,$96.85 ,$40.03 ,$41.72 ,$82.40 ,$40.03 ,$86.72 ,$40.03 ,$78.08 ,$40.03 ,$82.52 ,$137.08 ,$102.13 ,$40.03 ,$126.65 ,$134.10 ,$40.84 ,$111.75 ,$104.30 ,$104.30 ,$40.03 ,$104.30 ,$114.73 ,$114.73 ,$102.13 ,$126.65 ,$40.85 ,$40.85 ,$83.59 ,$61.69 ,$61.98 ,$143.79 ,$149.00 ,$42.03 ,$126.65 ,$87.83 ,$78.08 ,$41.72 ,$134.10 ,$149.00 ,$40.03 ,$96.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000151,29581,HC APPL MULTI COMP WRAP PT/OT,420,1 ,$414.00 ,$298.08 ,$115.92 ,$414.00 ,$269.10 ,$137.18 ,$115.92 ,$228.94 ,$137.18 ,$240.95 ,$137.18 ,$216.94 ,$137.18 ,$282.76 ,$380.88 ,$349.95 ,$137.18 ,$351.90 ,$372.60 ,$139.92 ,$310.50 ,$289.80 ,$289.80 ,$137.18 ,$289.80 ,$318.78 ,$318.78 ,$349.95 ,$351.90 ,$139.98 ,$139.98 ,$232.25 ,$171.40 ,$172.22 ,$180.05 ,$178.10 ,$144.04 ,$351.90 ,$300.96 ,$216.94 ,$115.92 ,$372.60 ,$202.00 ,$137.18 ,$269.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000206,G0283,HC ELECT STIM (UNATTEND) OTHER 15MIN,420,1 ,$127.00 ,$91.44 ,$11.80 ,$127.00 ,$82.55 ,$11.80 ,$35.56 ,$70.23 ,$11.80 ,$73.91 ,$11.80 ,$66.55 ,$11.80 ,$24.32 ,$116.84 ,$30.10 ,$11.80 ,$107.95 ,$114.30 ,$12.03 ,$95.25 ,$88.90 ,$88.90 ,$11.80 ,$88.90 ,$97.79 ,$97.79 ,$30.10 ,$107.95 ,$12.04 ,$12.04 ,$71.25 ,$52.58 ,$52.83 ,$19.72 ,$19.51 ,$12.39 ,$107.95 ,$25.89 ,$66.55 ,$35.56 ,$114.30 ,$127.00 ,$11.80 ,$82.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000207,G0283,HC ELECT STIM (UNATTEND) OTHER 30MIN,420,1 ,$127.00 ,$91.44 ,$11.80 ,$127.00 ,$82.55 ,$11.80 ,$35.56 ,$70.23 ,$11.80 ,$73.91 ,$11.80 ,$66.55 ,$11.80 ,$24.32 ,$116.84 ,$30.10 ,$11.80 ,$107.95 ,$114.30 ,$12.03 ,$95.25 ,$88.90 ,$88.90 ,$11.80 ,$88.90 ,$97.79 ,$97.79 ,$30.10 ,$107.95 ,$12.04 ,$12.04 ,$71.25 ,$52.58 ,$52.83 ,$19.72 ,$19.51 ,$12.39 ,$107.95 ,$25.89 ,$66.55 ,$35.56 ,$114.30 ,$127.00 ,$11.80 ,$82.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000208,G0283,HC ELECT STIM (UNATTEND) OTHER 45MIN,420,1 ,$127.00 ,$91.44 ,$11.80 ,$127.00 ,$82.55 ,$11.80 ,$35.56 ,$70.23 ,$11.80 ,$73.91 ,$11.80 ,$66.55 ,$11.80 ,$24.32 ,$116.84 ,$30.10 ,$11.80 ,$107.95 ,$114.30 ,$12.03 ,$95.25 ,$88.90 ,$88.90 ,$11.80 ,$88.90 ,$97.79 ,$97.79 ,$30.10 ,$107.95 ,$12.04 ,$12.04 ,$71.25 ,$52.58 ,$52.83 ,$19.72 ,$19.51 ,$12.39 ,$107.95 ,$25.89 ,$66.55 ,$35.56 ,$114.30 ,$127.00 ,$11.80 ,$82.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000209,G0283,HC ELECT STIM (UNATTEND) OTHER 60MIN,420,1 ,$127.00 ,$91.44 ,$11.80 ,$127.00 ,$82.55 ,$11.80 ,$35.56 ,$70.23 ,$11.80 ,$73.91 ,$11.80 ,$66.55 ,$11.80 ,$24.32 ,$116.84 ,$30.10 ,$11.80 ,$107.95 ,$114.30 ,$12.03 ,$95.25 ,$88.90 ,$88.90 ,$11.80 ,$88.90 ,$97.79 ,$97.79 ,$30.10 ,$107.95 ,$12.04 ,$12.04 ,$71.25 ,$52.58 ,$52.83 ,$19.72 ,$19.51 ,$12.39 ,$107.95 ,$25.89 ,$66.55 ,$35.56 ,$114.30 ,$127.00 ,$11.80 ,$82.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000210,97016,HC APPLY VASOPNEUMATIC DEVICE 15MIN,420,1 ,$115.00 ,$82.80 ,$11.50 ,$115.00 ,$74.75 ,$11.50 ,$32.20 ,$63.60 ,$11.50 ,$66.93 ,$11.50 ,$60.26 ,$11.50 ,$23.69 ,$105.80 ,$29.33 ,$11.50 ,$97.75 ,$103.50 ,$11.72 ,$86.25 ,$80.50 ,$80.50 ,$11.50 ,$80.50 ,$88.55 ,$88.55 ,$29.33 ,$97.75 ,$11.73 ,$11.73 ,$64.52 ,$47.61 ,$47.84 ,$19.72 ,$19.51 ,$12.07 ,$97.75 ,$25.22 ,$60.26 ,$32.20 ,$103.50 ,$115.00 ,$11.50 ,$74.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000211,97016,HC APPLY VASOPNEUMATIC DEVICE 30MIN,420,1 ,$115.00 ,$82.80 ,$11.50 ,$115.00 ,$74.75 ,$11.50 ,$32.20 ,$63.60 ,$11.50 ,$66.93 ,$11.50 ,$60.26 ,$11.50 ,$23.69 ,$105.80 ,$29.33 ,$11.50 ,$97.75 ,$103.50 ,$11.72 ,$86.25 ,$80.50 ,$80.50 ,$11.50 ,$80.50 ,$88.55 ,$88.55 ,$29.33 ,$97.75 ,$11.73 ,$11.73 ,$64.52 ,$47.61 ,$47.84 ,$19.72 ,$19.51 ,$12.07 ,$97.75 ,$25.22 ,$60.26 ,$32.20 ,$103.50 ,$115.00 ,$11.50 ,$74.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000212,97016,HC APPLY VASOPNEUMATIC DEVICE 45MIN,420,1 ,$115.00 ,$82.80 ,$11.50 ,$115.00 ,$74.75 ,$11.50 ,$32.20 ,$63.60 ,$11.50 ,$66.93 ,$11.50 ,$60.26 ,$11.50 ,$23.69 ,$105.80 ,$29.33 ,$11.50 ,$97.75 ,$103.50 ,$11.72 ,$86.25 ,$80.50 ,$80.50 ,$11.50 ,$80.50 ,$88.55 ,$88.55 ,$29.33 ,$97.75 ,$11.73 ,$11.73 ,$64.52 ,$47.61 ,$47.84 ,$19.72 ,$19.51 ,$12.07 ,$97.75 ,$25.22 ,$60.26 ,$32.20 ,$103.50 ,$115.00 ,$11.50 ,$74.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000213,97016,HC APPLY VASOPNEUMATIC DEVICE 60MIN,420,1 ,$115.00 ,$82.80 ,$11.50 ,$115.00 ,$74.75 ,$11.50 ,$32.20 ,$63.60 ,$11.50 ,$66.93 ,$11.50 ,$60.26 ,$11.50 ,$23.69 ,$105.80 ,$29.33 ,$11.50 ,$97.75 ,$103.50 ,$11.72 ,$86.25 ,$80.50 ,$80.50 ,$11.50 ,$80.50 ,$88.55 ,$88.55 ,$29.33 ,$97.75 ,$11.73 ,$11.73 ,$64.52 ,$47.61 ,$47.84 ,$19.72 ,$19.51 ,$12.07 ,$97.75 ,$25.22 ,$60.26 ,$32.20 ,$103.50 ,$115.00 ,$11.50 ,$74.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000214,97012,HC TRACTION MECHANICAL APPL 15 MIN,420,1 ,$136.00 ,$97.92 ,$14.12 ,$136.00 ,$88.40 ,$14.12 ,$38.08 ,$75.21 ,$14.12 ,$79.15 ,$14.12 ,$71.26 ,$14.12 ,$29.11 ,$125.12 ,$36.03 ,$14.12 ,$115.60 ,$122.40 ,$14.41 ,$102.00 ,$95.20 ,$95.20 ,$14.12 ,$95.20 ,$104.72 ,$104.72 ,$36.03 ,$115.60 ,$14.41 ,$14.41 ,$76.30 ,$56.30 ,$56.58 ,$19.72 ,$19.51 ,$14.83 ,$115.60 ,$30.98 ,$71.26 ,$38.08 ,$122.40 ,$136.00 ,$14.12 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000215,97012,HC TRACTION MECHANICAL APPL 30 MIN,420,1 ,$136.00 ,$97.92 ,$14.12 ,$136.00 ,$88.40 ,$14.12 ,$38.08 ,$75.21 ,$14.12 ,$79.15 ,$14.12 ,$71.26 ,$14.12 ,$29.11 ,$125.12 ,$36.03 ,$14.12 ,$115.60 ,$122.40 ,$14.41 ,$102.00 ,$95.20 ,$95.20 ,$14.12 ,$95.20 ,$104.72 ,$104.72 ,$36.03 ,$115.60 ,$14.41 ,$14.41 ,$76.30 ,$56.30 ,$56.58 ,$19.72 ,$19.51 ,$14.83 ,$115.60 ,$30.98 ,$71.26 ,$38.08 ,$122.40 ,$136.00 ,$14.12 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000218,97014,HC ELEC STIM UNATTENDED 15MIN,420,1 ,$103.00 ,$74.16 ,$19.51 ,$103.00 ,$66.95 , N/A ,$28.84 ,$56.96 , N/A ,$59.95 , N/A ,$53.97 , N/A , N/A ,$94.76 , N/A , N/A ,$87.55 ,$92.70 , N/A ,$77.25 ,$72.10 ,$72.10 , N/A ,$72.10 ,$79.31 ,$79.31 , N/A ,$87.55 , N/A , N/A ,$57.78 ,$42.64 ,$42.85 ,$19.72 ,$19.51 , N/A ,$87.55 , N/A ,$53.97 ,$28.84 ,$92.70 ,$103.00 , N/A ,$66.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000267,N/A,HC THERAPY ASSESSMENT - SELF PAY,420,1 ,$129.00 ,$92.88 ,$36.12 ,$129.00 ,$83.85 , N/A ,$36.12 ,$71.34 , N/A ,$75.08 , N/A ,$67.60 , N/A , N/A ,$118.68 , N/A , N/A ,$109.65 ,$116.10 , N/A ,$96.75 ,$90.30 ,$90.30 , N/A ,$90.30 ,$99.33 ,$99.33 , N/A ,$109.65 , N/A , N/A ,$72.37 ,$53.41 ,$53.66 , N/A , N/A , N/A ,$109.65 , N/A ,$67.60 ,$36.12 ,$116.10 ,$129.00 , N/A ,$83.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),42000268,N/A,HC THERAPY TREATMENT 30MIN - SELF PAY,420,1 ,$77.00 ,$55.44 ,$21.56 ,$77.00 ,$50.05 , N/A ,$21.56 ,$42.58 , N/A ,$44.81 , N/A ,$40.35 , N/A , N/A ,$70.84 , N/A , N/A ,$65.45 ,$69.30 , N/A ,$57.75 ,$53.90 ,$53.90 , N/A ,$53.90 ,$59.29 ,$59.29 , N/A ,$65.45 , N/A , N/A ,$43.20 ,$31.88 ,$32.03 , N/A , N/A , N/A ,$65.45 , N/A ,$40.35 ,$21.56 ,$69.30 ,$77.00 , N/A ,$50.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400047,97161,HC PT EVAL LOW COMPLEXITY 75MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400048,97161,HC PT EVAL LOW COMPLEXITY 90MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400049,97161,HC PT EVAL LOW COMPLEXITY 105MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400050,97161,HC PT EVAL LOW COMPLEXITY 120MIN,424,1 ,$300.00 ,$216.00 ,$84.00 ,$300.00 ,$195.00 ,$97.28 ,$84.00 ,$165.90 ,$97.28 ,$174.60 ,$97.28 ,$157.20 ,$97.28 ,$200.53 ,$276.00 ,$248.18 ,$97.28 ,$255.00 ,$270.00 ,$99.23 ,$225.00 ,$210.00 ,$210.00 ,$97.28 ,$210.00 ,$231.00 ,$231.00 ,$248.18 ,$255.00 ,$99.27 ,$99.27 ,$168.30 ,$124.20 ,$124.80 ,$241.44 ,$238.82 ,$102.15 ,$255.00 ,$213.43 ,$157.20 ,$84.00 ,$270.00 ,$202.00 ,$97.28 ,$195.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400059,97162,HC PT EVAL MOD COMPLEXITY 75MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400060,97162,HC PT EVAL MOD COMPLEXITY 90MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400061,97162,HC PT EVAL MOD COMPLEXITY 105MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400062,97162,HC PT EVAL MOD COMPLEXITY 120MIN,424,1 ,$600.00 ,$432.00 ,$97.28 ,$600.00 ,$390.00 ,$97.28 ,$168.00 ,$331.80 ,$97.28 ,$349.20 ,$97.28 ,$314.40 ,$97.28 ,$200.53 ,$552.00 ,$248.18 ,$97.28 ,$510.00 ,$540.00 ,$99.23 ,$450.00 ,$420.00 ,$420.00 ,$97.28 ,$420.00 ,$462.00 ,$462.00 ,$248.18 ,$510.00 ,$99.27 ,$99.27 ,$336.60 ,$248.40 ,$249.60 ,$241.44 ,$238.82 ,$102.15 ,$510.00 ,$213.43 ,$314.40 ,$168.00 ,$540.00 ,$202.00 ,$97.28 ,$390.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400070,97163,HC PT EVAL HIGH COMPLEXITY 60MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400071,97163,HC PT EVAL HIGH COMPLEXITY 75MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400072,97163,HC PT EVAL HIGH COMPLEXITY 90MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400073,97163,HC PT EVAL HIGH COMPLEXITY 105MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400074,97163,HC PT EVAL HIGH COMPLEXITY 120MIN,424,1 ,$900.00 ,$648.00 ,$97.28 ,$900.00 ,$585.00 ,$97.28 ,$252.00 ,$497.70 ,$97.28 ,$523.80 ,$97.28 ,$471.60 ,$97.28 ,$200.53 ,$828.00 ,$248.18 ,$97.28 ,$765.00 ,$810.00 ,$99.23 ,$675.00 ,$630.00 ,$630.00 ,$97.28 ,$630.00 ,$693.00 ,$693.00 ,$248.18 ,$765.00 ,$99.27 ,$99.27 ,$504.90 ,$372.60 ,$374.40 ,$241.44 ,$238.82 ,$102.15 ,$765.00 ,$213.43 ,$471.60 ,$252.00 ,$810.00 ,$202.00 ,$97.28 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$231.00 ,$166.32 ,$64.68 ,$231.00 ,$150.15 ,$67.52 ,$64.68 ,$127.74 ,$67.52 ,$134.44 ,$67.52 ,$121.04 ,$67.52 ,$139.18 ,$212.52 ,$172.25 ,$67.52 ,$196.35 ,$207.90 ,$68.87 ,$173.25 ,$161.70 ,$161.70 ,$67.52 ,$161.70 ,$177.87 ,$177.87 ,$172.25 ,$196.35 ,$68.90 ,$68.90 ,$129.59 ,$95.63 ,$96.10 ,$222.92 ,$231.00 ,$70.90 ,$196.35 ,$148.14 ,$121.04 ,$64.68 ,$207.90 ,$202.00 ,$67.52 ,$150.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$231.00 ,$166.32 ,$64.68 ,$231.00 ,$150.15 ,$67.52 ,$64.68 ,$127.74 ,$67.52 ,$134.44 ,$67.52 ,$121.04 ,$67.52 ,$139.18 ,$212.52 ,$172.25 ,$67.52 ,$196.35 ,$207.90 ,$68.87 ,$173.25 ,$161.70 ,$161.70 ,$67.52 ,$161.70 ,$177.87 ,$177.87 ,$172.25 ,$196.35 ,$68.90 ,$68.90 ,$129.59 ,$95.63 ,$96.10 ,$222.92 ,$231.00 ,$70.90 ,$196.35 ,$148.14 ,$121.04 ,$64.68 ,$207.90 ,$202.00 ,$67.52 ,$150.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$231.00 ,$166.32 ,$64.68 ,$231.00 ,$150.15 ,$67.52 ,$64.68 ,$127.74 ,$67.52 ,$134.44 ,$67.52 ,$121.04 ,$67.52 ,$139.18 ,$212.52 ,$172.25 ,$67.52 ,$196.35 ,$207.90 ,$68.87 ,$173.25 ,$161.70 ,$161.70 ,$67.52 ,$161.70 ,$177.87 ,$177.87 ,$172.25 ,$196.35 ,$68.90 ,$68.90 ,$129.59 ,$95.63 ,$96.10 ,$222.92 ,$231.00 ,$70.90 ,$196.35 ,$148.14 ,$121.04 ,$64.68 ,$207.90 ,$202.00 ,$67.52 ,$150.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$231.00 ,$166.32 ,$64.68 ,$231.00 ,$150.15 ,$67.52 ,$64.68 ,$127.74 ,$67.52 ,$134.44 ,$67.52 ,$121.04 ,$67.52 ,$139.18 ,$212.52 ,$172.25 ,$67.52 ,$196.35 ,$207.90 ,$68.87 ,$173.25 ,$161.70 ,$161.70 ,$67.52 ,$161.70 ,$177.87 ,$177.87 ,$172.25 ,$196.35 ,$68.90 ,$68.90 ,$129.59 ,$95.63 ,$96.10 ,$222.92 ,$231.00 ,$70.90 ,$196.35 ,$148.14 ,$121.04 ,$64.68 ,$207.90 ,$202.00 ,$67.52 ,$150.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000015,97533,HC PERCEPTUAL ACTIVITY EA 15 MIN,430,1 ,$134.00 ,$96.48 ,$37.52 ,$153.23 ,$87.10 ,$60.06 ,$37.52 ,$74.10 ,$60.06 ,$77.99 ,$60.06 ,$70.22 ,$60.06 ,$123.81 ,$123.28 ,$153.23 ,$60.06 ,$113.90 ,$120.60 ,$61.27 ,$100.50 ,$93.80 ,$93.80 ,$60.06 ,$93.80 ,$103.18 ,$103.18 ,$134.00 ,$113.90 ,$61.29 ,$61.29 ,$75.17 ,$55.48 ,$55.74 ,$129.31 ,$134.00 ,$63.06 ,$113.90 ,$131.77 ,$70.22 ,$37.52 ,$120.60 ,$134.00 ,$60.06 ,$87.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$134.00 ,$96.48 ,$31.58 ,$134.00 ,$87.10 ,$31.58 ,$37.52 ,$74.10 ,$31.58 ,$77.99 ,$31.58 ,$70.22 ,$31.58 ,$65.08 ,$123.28 ,$80.55 ,$31.58 ,$113.90 ,$120.60 ,$32.20 ,$100.50 ,$93.80 ,$93.80 ,$31.58 ,$93.80 ,$103.18 ,$103.18 ,$80.55 ,$113.90 ,$32.22 ,$32.22 ,$75.17 ,$55.48 ,$55.74 ,$129.31 ,$134.00 ,$33.15 ,$113.90 ,$69.27 ,$70.22 ,$37.52 ,$120.60 ,$134.00 ,$31.58 ,$87.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000024,97542,HC SEATING CLINIC EA 15 MIN,430,1 ,$122.00 ,$87.84 ,$30.72 ,$122.00 ,$79.30 ,$30.72 ,$34.16 ,$67.47 ,$30.72 ,$71.00 ,$30.72 ,$63.93 ,$30.72 ,$63.33 ,$112.24 ,$78.38 ,$30.72 ,$103.70 ,$109.80 ,$31.34 ,$91.50 ,$85.40 ,$85.40 ,$30.72 ,$85.40 ,$93.94 ,$93.94 ,$78.38 ,$103.70 ,$31.35 ,$31.35 ,$68.44 ,$50.51 ,$50.75 ,$117.73 ,$122.00 ,$32.26 ,$103.70 ,$67.40 ,$63.93 ,$34.16 ,$109.80 ,$122.00 ,$30.72 ,$79.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$164.00 ,$118.08 ,$45.92 ,$164.00 ,$106.60 ,$46.21 ,$45.92 ,$90.69 ,$46.21 ,$95.45 ,$46.21 ,$85.94 ,$46.21 ,$95.24 ,$150.88 ,$117.88 ,$46.21 ,$139.40 ,$147.60 ,$47.13 ,$123.00 ,$114.80 ,$114.80 ,$46.21 ,$114.80 ,$126.28 ,$126.28 ,$117.88 ,$139.40 ,$47.15 ,$47.15 ,$92.00 ,$67.90 ,$68.22 ,$158.26 ,$164.00 ,$48.52 ,$139.40 ,$101.37 ,$85.94 ,$45.92 ,$147.60 ,$164.00 ,$46.21 ,$106.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000035,97545,HC WORK HARDENING/CONDITIONING FIRST 2 HRS,430,1 ,$801.00 ,$576.72 ,$202.00 ,$801.00 ,$520.65 , N/A ,$224.28 ,$442.95 , N/A ,$466.18 , N/A ,$419.72 , N/A , N/A ,$736.92 , N/A , N/A ,$680.85 ,$720.90 , N/A ,$600.75 ,$560.70 ,$560.70 , N/A ,$560.70 ,$616.77 ,$616.77 , N/A ,$680.85 , N/A , N/A ,$449.36 ,$331.61 ,$333.22 ,$241.44 ,$238.82 , N/A ,$680.85 , N/A ,$419.72 ,$224.28 ,$720.90 ,$202.00 , N/A ,$520.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000036,97546,HC WORK HARDENING/CONDITIONINS ADD 1 HOUR,430,1 ,$153.00 ,$110.16 ,$42.84 ,$153.00 ,$99.45 , N/A ,$42.84 ,$84.61 , N/A ,$89.05 , N/A ,$80.17 , N/A , N/A ,$140.76 , N/A , N/A ,$130.05 ,$137.70 , N/A ,$114.75 ,$107.10 ,$107.10 , N/A ,$107.10 ,$117.81 ,$117.81 , N/A ,$130.05 , N/A , N/A ,$85.83 ,$63.34 ,$63.65 ,$147.65 ,$153.00 , N/A ,$130.05 , N/A ,$80.17 ,$42.84 ,$137.70 ,$153.00 , N/A ,$99.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$81.00 ,$58.32 ,$5.65 ,$81.00 ,$52.65 ,$5.65 ,$22.68 ,$44.79 ,$5.65 ,$47.14 ,$5.65 ,$42.44 ,$5.65 ,$11.66 ,$74.52 ,$14.43 ,$5.65 ,$68.85 ,$72.90 ,$5.77 ,$60.75 ,$56.70 ,$56.70 ,$5.65 ,$56.70 ,$62.37 ,$62.37 ,$14.43 ,$68.85 ,$5.77 ,$5.77 ,$45.44 ,$33.53 ,$33.70 ,$19.72 ,$19.51 ,$5.94 ,$68.85 ,$12.41 ,$42.44 ,$22.68 ,$72.90 ,$81.00 ,$5.65 ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$81.00 ,$58.32 ,$5.65 ,$81.00 ,$52.65 ,$5.65 ,$22.68 ,$44.79 ,$5.65 ,$47.14 ,$5.65 ,$42.44 ,$5.65 ,$11.66 ,$74.52 ,$14.43 ,$5.65 ,$68.85 ,$72.90 ,$5.77 ,$60.75 ,$56.70 ,$56.70 ,$5.65 ,$56.70 ,$62.37 ,$62.37 ,$14.43 ,$68.85 ,$5.77 ,$5.77 ,$45.44 ,$33.53 ,$33.70 ,$19.72 ,$19.51 ,$5.94 ,$68.85 ,$12.41 ,$42.44 ,$22.68 ,$72.90 ,$81.00 ,$5.65 ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000049,95852,HC RANGE OF MOTION TESTING HAND,430,1 ,$117.00 ,$84.24 ,$16.58 ,$117.00 ,$76.05 ,$16.58 ,$32.76 ,$64.70 ,$16.58 ,$68.09 ,$16.58 ,$61.31 ,$16.58 ,$34.18 ,$107.64 ,$42.30 ,$16.58 ,$99.45 ,$105.30 ,$16.91 ,$87.75 ,$81.90 ,$81.90 ,$16.58 ,$81.90 ,$90.09 ,$90.09 ,$42.30 ,$99.45 ,$16.92 ,$16.92 ,$65.64 ,$48.44 ,$48.67 , N/A , N/A ,$17.41 ,$99.45 ,$36.38 ,$61.31 ,$32.76 ,$105.30 ,$117.00 ,$16.58 ,$76.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$142.00 ,$102.24 ,$19.51 ,$142.00 ,$92.30 ,$22.12 ,$39.76 ,$78.53 ,$22.12 ,$82.64 ,$22.12 ,$74.41 ,$22.12 ,$45.59 ,$130.64 ,$56.43 ,$22.12 ,$120.70 ,$127.80 ,$22.56 ,$106.50 ,$99.40 ,$99.40 ,$22.12 ,$99.40 ,$109.34 ,$109.34 ,$56.43 ,$120.70 ,$22.57 ,$22.57 ,$79.66 ,$58.79 ,$59.07 ,$19.72 ,$19.51 ,$23.23 ,$120.70 ,$48.53 ,$74.41 ,$39.76 ,$127.80 ,$142.00 ,$22.12 ,$92.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$133.00 ,$95.76 ,$19.51 ,$133.00 ,$86.45 ,$21.15 ,$37.24 ,$73.55 ,$21.15 ,$77.41 ,$21.15 ,$69.69 ,$21.15 ,$43.59 ,$122.36 ,$53.95 ,$21.15 ,$113.05 ,$119.70 ,$21.57 ,$99.75 ,$93.10 ,$93.10 ,$21.15 ,$93.10 ,$102.41 ,$102.41 ,$53.95 ,$113.05 ,$21.58 ,$21.58 ,$74.61 ,$55.06 ,$55.33 ,$19.72 ,$19.51 ,$22.21 ,$113.05 ,$46.40 ,$69.69 ,$37.24 ,$119.70 ,$133.00 ,$21.15 ,$86.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400038,97165,HC OT EVAL LOW COMPLEXITY 75MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400039,97165,HC OT EVAL LOW COMPLEXITY 90MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400040,97165,HC OT EVAL LOW COMPLEXITY 105MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400041,97165,HC OT EVAL LOW COMPLEXITY 120MIN,434,1 ,$328.00 ,$236.16 ,$91.84 ,$328.00 ,$213.20 ,$97.28 ,$91.84 ,$181.38 ,$97.28 ,$190.90 ,$97.28 ,$171.87 ,$97.28 ,$200.53 ,$301.76 ,$248.18 ,$97.28 ,$278.80 ,$295.20 ,$99.23 ,$246.00 ,$229.60 ,$229.60 ,$97.28 ,$229.60 ,$252.56 ,$252.56 ,$248.18 ,$278.80 ,$99.27 ,$99.27 ,$184.01 ,$135.79 ,$136.45 ,$316.52 ,$328.00 ,$102.15 ,$278.80 ,$213.43 ,$171.87 ,$91.84 ,$295.20 ,$202.00 ,$97.28 ,$213.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400050,97166,HC OT EVAL MOD COMPLEXITY 75MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400051,97166,HC OT EVAL MOD COMPLEXITY 90MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400052,97166,HC OT EVAL MOD COMPLEXITY 105MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400053,97166,HC OT EVAL MOD COMPLEXITY 120MIN,434,1 ,$656.00 ,$472.32 ,$97.28 ,$656.00 ,$426.40 ,$97.28 ,$183.68 ,$362.77 ,$97.28 ,$381.79 ,$97.28 ,$343.74 ,$97.28 ,$200.53 ,$603.52 ,$248.18 ,$97.28 ,$557.60 ,$590.40 ,$99.23 ,$492.00 ,$459.20 ,$459.20 ,$97.28 ,$459.20 ,$505.12 ,$505.12 ,$248.18 ,$557.60 ,$99.27 ,$99.27 ,$368.02 ,$271.58 ,$272.90 ,$384.07 ,$379.91 ,$102.15 ,$557.60 ,$213.43 ,$343.74 ,$183.68 ,$590.40 ,$202.00 ,$97.28 ,$426.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400062,97167,HC OT EVAL HIGH COMPLEXITY 75MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400063,97167,HC OT EVAL HIGH COMPLEXITY 90MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400064,97167,HC OT EVAL HIGH COMPLEXITY 105MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400065,97167,HC OT EVAL HIGH COMPLEXITY 120MIN,434,1 ,$955.00 ,$687.60 ,$97.28 ,$955.00 ,$620.75 ,$97.28 ,$267.40 ,$528.12 ,$97.28 ,$555.81 ,$97.28 ,$500.42 ,$97.28 ,$200.53 ,$878.60 ,$248.18 ,$97.28 ,$811.75 ,$859.50 ,$99.23 ,$716.25 ,$668.50 ,$668.50 ,$97.28 ,$668.50 ,$735.35 ,$735.35 ,$248.18 ,$811.75 ,$99.27 ,$99.27 ,$535.76 ,$395.37 ,$397.28 ,$384.07 ,$379.91 ,$102.15 ,$811.75 ,$213.43 ,$500.42 ,$267.40 ,$859.50 ,$202.00 ,$97.28 ,$620.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400074,97168,HC OT RE-EVAL 75MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400075,97168,HC OT RE-EVAL 90MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),43400076,97168,HC OT RE-EVAL 105MIN,434,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 ,$67.22 ,$53.20 ,$105.07 ,$67.22 ,$110.58 ,$67.22 ,$99.56 ,$67.22 ,$138.55 ,$174.80 ,$171.48 ,$67.22 ,$161.50 ,$171.00 ,$68.56 ,$142.50 ,$133.00 ,$133.00 ,$67.22 ,$133.00 ,$146.30 ,$146.30 ,$171.48 ,$161.50 ,$68.59 ,$68.59 ,$106.59 ,$78.66 ,$79.04 ,$183.35 ,$190.00 ,$70.58 ,$161.50 ,$147.47 ,$99.56 ,$53.20 ,$171.00 ,$190.00 ,$67.22 ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$282.00 ,$203.04 ,$74.49 ,$282.00 ,$183.30 ,$74.49 ,$78.96 ,$155.95 ,$74.49 ,$164.12 ,$74.49 ,$147.77 ,$74.49 ,$153.54 ,$259.44 ,$190.03 ,$74.49 ,$239.70 ,$253.80 ,$75.98 ,$211.50 ,$197.40 ,$197.40 ,$74.49 ,$197.40 ,$217.14 ,$217.14 ,$190.03 ,$239.70 ,$76.01 ,$76.01 ,$158.20 ,$116.75 ,$117.31 ,$178.46 ,$176.53 ,$78.21 ,$239.70 ,$163.42 ,$147.77 ,$78.96 ,$253.80 ,$202.00 ,$74.49 ,$183.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$282.00 ,$203.04 ,$74.49 ,$282.00 ,$183.30 ,$74.49 ,$78.96 ,$155.95 ,$74.49 ,$164.12 ,$74.49 ,$147.77 ,$74.49 ,$153.54 ,$259.44 ,$190.03 ,$74.49 ,$239.70 ,$253.80 ,$75.98 ,$211.50 ,$197.40 ,$197.40 ,$74.49 ,$197.40 ,$217.14 ,$217.14 ,$190.03 ,$239.70 ,$76.01 ,$76.01 ,$158.20 ,$116.75 ,$117.31 ,$178.46 ,$176.53 ,$78.21 ,$239.70 ,$163.42 ,$147.77 ,$78.96 ,$253.80 ,$202.00 ,$74.49 ,$183.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$282.00 ,$203.04 ,$74.49 ,$282.00 ,$183.30 ,$74.49 ,$78.96 ,$155.95 ,$74.49 ,$164.12 ,$74.49 ,$147.77 ,$74.49 ,$153.54 ,$259.44 ,$190.03 ,$74.49 ,$239.70 ,$253.80 ,$75.98 ,$211.50 ,$197.40 ,$197.40 ,$74.49 ,$197.40 ,$217.14 ,$217.14 ,$190.03 ,$239.70 ,$76.01 ,$76.01 ,$158.20 ,$116.75 ,$117.31 ,$178.46 ,$176.53 ,$78.21 ,$239.70 ,$163.42 ,$147.77 ,$78.96 ,$253.80 ,$202.00 ,$74.49 ,$183.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$282.00 ,$203.04 ,$74.49 ,$282.00 ,$183.30 ,$74.49 ,$78.96 ,$155.95 ,$74.49 ,$164.12 ,$74.49 ,$147.77 ,$74.49 ,$153.54 ,$259.44 ,$190.03 ,$74.49 ,$239.70 ,$253.80 ,$75.98 ,$211.50 ,$197.40 ,$197.40 ,$74.49 ,$197.40 ,$217.14 ,$217.14 ,$190.03 ,$239.70 ,$76.01 ,$76.01 ,$158.20 ,$116.75 ,$117.31 ,$178.46 ,$176.53 ,$78.21 ,$239.70 ,$163.42 ,$147.77 ,$78.96 ,$253.80 ,$202.00 ,$74.49 ,$183.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$248.00 ,$178.56 ,$69.44 ,$248.00 ,$161.20 ,$82.31 ,$69.44 ,$137.14 ,$82.31 ,$144.34 ,$82.31 ,$129.95 ,$82.31 ,$169.66 ,$228.16 ,$209.98 ,$82.31 ,$210.80 ,$223.20 ,$83.96 ,$186.00 ,$173.60 ,$173.60 ,$82.31 ,$173.60 ,$190.96 ,$190.96 ,$209.98 ,$210.80 ,$83.99 ,$83.99 ,$139.13 ,$102.67 ,$103.17 ,$178.46 ,$176.53 ,$86.43 ,$210.80 ,$180.58 ,$129.95 ,$69.44 ,$223.20 ,$202.00 ,$82.31 ,$161.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$248.00 ,$178.56 ,$69.44 ,$248.00 ,$161.20 ,$82.31 ,$69.44 ,$137.14 ,$82.31 ,$144.34 ,$82.31 ,$129.95 ,$82.31 ,$169.66 ,$228.16 ,$209.98 ,$82.31 ,$210.80 ,$223.20 ,$83.96 ,$186.00 ,$173.60 ,$173.60 ,$82.31 ,$173.60 ,$190.96 ,$190.96 ,$209.98 ,$210.80 ,$83.99 ,$83.99 ,$139.13 ,$102.67 ,$103.17 ,$178.46 ,$176.53 ,$86.43 ,$210.80 ,$180.58 ,$129.95 ,$69.44 ,$223.20 ,$202.00 ,$82.31 ,$161.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$248.00 ,$178.56 ,$69.44 ,$248.00 ,$161.20 ,$82.31 ,$69.44 ,$137.14 ,$82.31 ,$144.34 ,$82.31 ,$129.95 ,$82.31 ,$169.66 ,$228.16 ,$209.98 ,$82.31 ,$210.80 ,$223.20 ,$83.96 ,$186.00 ,$173.60 ,$173.60 ,$82.31 ,$173.60 ,$190.96 ,$190.96 ,$209.98 ,$210.80 ,$83.99 ,$83.99 ,$139.13 ,$102.67 ,$103.17 ,$178.46 ,$176.53 ,$86.43 ,$210.80 ,$180.58 ,$129.95 ,$69.44 ,$223.20 ,$202.00 ,$82.31 ,$161.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$248.00 ,$178.56 ,$69.44 ,$248.00 ,$161.20 ,$82.31 ,$69.44 ,$137.14 ,$82.31 ,$144.34 ,$82.31 ,$129.95 ,$82.31 ,$169.66 ,$228.16 ,$209.98 ,$82.31 ,$210.80 ,$223.20 ,$83.96 ,$186.00 ,$173.60 ,$173.60 ,$82.31 ,$173.60 ,$190.96 ,$190.96 ,$209.98 ,$210.80 ,$83.99 ,$83.99 ,$139.13 ,$102.67 ,$103.17 ,$178.46 ,$176.53 ,$86.43 ,$210.80 ,$180.58 ,$129.95 ,$69.44 ,$223.20 ,$202.00 ,$82.31 ,$161.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$346.00 ,$249.12 ,$82.21 ,$346.00 ,$224.90 ,$82.21 ,$96.88 ,$191.34 ,$82.21 ,$201.37 ,$82.21 ,$181.30 ,$82.21 ,$169.46 ,$318.32 ,$209.73 ,$82.21 ,$294.10 ,$311.40 ,$83.86 ,$259.50 ,$242.20 ,$242.20 ,$82.21 ,$242.20 ,$266.42 ,$266.42 ,$209.73 ,$294.10 ,$83.89 ,$83.89 ,$194.11 ,$143.24 ,$143.94 ,$178.46 ,$176.53 ,$86.32 ,$294.10 ,$180.36 ,$181.30 ,$96.88 ,$311.40 ,$202.00 ,$82.21 ,$224.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400018,92610,HC DYSPHAGIA EVALUATION 30MIN,444,1 ,$346.00 ,$249.12 ,$82.21 ,$346.00 ,$224.90 ,$82.21 ,$96.88 ,$191.34 ,$82.21 ,$201.37 ,$82.21 ,$181.30 ,$82.21 ,$169.46 ,$318.32 ,$209.73 ,$82.21 ,$294.10 ,$311.40 ,$83.86 ,$259.50 ,$242.20 ,$242.20 ,$82.21 ,$242.20 ,$266.42 ,$266.42 ,$209.73 ,$294.10 ,$83.89 ,$83.89 ,$194.11 ,$143.24 ,$143.94 ,$178.46 ,$176.53 ,$86.32 ,$294.10 ,$180.36 ,$181.30 ,$96.88 ,$311.40 ,$202.00 ,$82.21 ,$224.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$346.00 ,$249.12 ,$82.21 ,$346.00 ,$224.90 ,$82.21 ,$96.88 ,$191.34 ,$82.21 ,$201.37 ,$82.21 ,$181.30 ,$82.21 ,$169.46 ,$318.32 ,$209.73 ,$82.21 ,$294.10 ,$311.40 ,$83.86 ,$259.50 ,$242.20 ,$242.20 ,$82.21 ,$242.20 ,$266.42 ,$266.42 ,$209.73 ,$294.10 ,$83.89 ,$83.89 ,$194.11 ,$143.24 ,$143.94 ,$178.46 ,$176.53 ,$86.32 ,$294.10 ,$180.36 ,$181.30 ,$96.88 ,$311.40 ,$202.00 ,$82.21 ,$224.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$346.00 ,$249.12 ,$82.21 ,$346.00 ,$224.90 ,$82.21 ,$96.88 ,$191.34 ,$82.21 ,$201.37 ,$82.21 ,$181.30 ,$82.21 ,$169.46 ,$318.32 ,$209.73 ,$82.21 ,$294.10 ,$311.40 ,$83.86 ,$259.50 ,$242.20 ,$242.20 ,$82.21 ,$242.20 ,$266.42 ,$266.42 ,$209.73 ,$294.10 ,$83.89 ,$83.89 ,$194.11 ,$143.24 ,$143.94 ,$178.46 ,$176.53 ,$86.32 ,$294.10 ,$180.36 ,$181.30 ,$96.88 ,$311.40 ,$202.00 ,$82.21 ,$224.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400029,92611,HC DYSPHAGIA EVAL-VIDEO 15MIN,444,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$89.53 ,$132.72 ,$262.12 ,$89.53 ,$275.87 ,$89.53 ,$248.38 ,$89.53 ,$184.55 ,$436.08 ,$228.40 ,$89.53 ,$402.90 ,$426.60 ,$91.33 ,$355.50 ,$331.80 ,$331.80 ,$89.53 ,$331.80 ,$364.98 ,$364.98 ,$228.40 ,$402.90 ,$91.36 ,$91.36 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$94.01 ,$402.90 ,$196.42 ,$248.38 ,$132.72 ,$426.60 ,$202.00 ,$89.53 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400030,92611,HC DYSPHAGIA EVAL-VIDEO 30MIN,444,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$89.53 ,$132.72 ,$262.12 ,$89.53 ,$275.87 ,$89.53 ,$248.38 ,$89.53 ,$184.55 ,$436.08 ,$228.40 ,$89.53 ,$402.90 ,$426.60 ,$91.33 ,$355.50 ,$331.80 ,$331.80 ,$89.53 ,$331.80 ,$364.98 ,$364.98 ,$228.40 ,$402.90 ,$91.36 ,$91.36 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$94.01 ,$402.90 ,$196.42 ,$248.38 ,$132.72 ,$426.60 ,$202.00 ,$89.53 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400031,92611,HC DYSPHAGIA EVAL-VIDEO 45MIN,444,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$89.53 ,$132.72 ,$262.12 ,$89.53 ,$275.87 ,$89.53 ,$248.38 ,$89.53 ,$184.55 ,$436.08 ,$228.40 ,$89.53 ,$402.90 ,$426.60 ,$91.33 ,$355.50 ,$331.80 ,$331.80 ,$89.53 ,$331.80 ,$364.98 ,$364.98 ,$228.40 ,$402.90 ,$91.36 ,$91.36 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$94.01 ,$402.90 ,$196.42 ,$248.38 ,$132.72 ,$426.60 ,$202.00 ,$89.53 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400032,92611,HC DYSPHAGIA EVAL-VIDEO 60MIN,444,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$89.53 ,$132.72 ,$262.12 ,$89.53 ,$275.87 ,$89.53 ,$248.38 ,$89.53 ,$184.55 ,$436.08 ,$228.40 ,$89.53 ,$402.90 ,$426.60 ,$91.33 ,$355.50 ,$331.80 ,$331.80 ,$89.53 ,$331.80 ,$364.98 ,$364.98 ,$228.40 ,$402.90 ,$91.36 ,$91.36 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$94.01 ,$402.90 ,$196.42 ,$248.38 ,$132.72 ,$426.60 ,$202.00 ,$89.53 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$89.53 ,$132.72 ,$262.12 ,$89.53 ,$275.87 ,$89.53 ,$248.38 ,$89.53 ,$184.55 ,$436.08 ,$228.40 ,$89.53 ,$402.90 ,$426.60 ,$91.33 ,$355.50 ,$331.80 ,$331.80 ,$89.53 ,$331.80 ,$364.98 ,$364.98 ,$228.40 ,$402.90 ,$91.36 ,$91.36 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$94.01 ,$402.90 ,$196.42 ,$248.38 ,$132.72 ,$426.60 ,$202.00 ,$89.53 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400036,92611,HC DYSPHAGIA RE-EVAL VIDEO PEDS,444,1 ,$474.00 ,$341.28 ,$39.33 ,$474.00 ,$308.10 ,$89.53 ,$132.72 ,$262.12 ,$89.53 ,$275.87 ,$89.53 ,$248.38 ,$89.53 ,$184.55 ,$436.08 ,$228.40 ,$89.53 ,$402.90 ,$426.60 ,$91.33 ,$355.50 ,$331.80 ,$331.80 ,$89.53 ,$331.80 ,$364.98 ,$364.98 ,$228.40 ,$402.90 ,$91.36 ,$91.36 ,$265.91 ,$196.24 ,$197.18 ,$39.77 ,$39.33 ,$94.01 ,$402.90 ,$196.42 ,$248.38 ,$132.72 ,$426.60 ,$202.00 ,$89.53 ,$308.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400040,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN,444,1 ,$192.00 ,$138.24 ,$53.76 ,$329.33 ,$124.80 ,$129.10 ,$53.76 ,$106.18 ,$129.10 ,$111.74 ,$129.10 ,$100.61 ,$129.10 ,$192.00 ,$176.64 ,$329.33 ,$129.10 ,$163.20 ,$172.80 ,$131.67 ,$144.00 ,$134.40 ,$134.40 ,$129.10 ,$134.40 ,$147.84 ,$147.84 ,$192.00 ,$163.20 ,$131.73 ,$131.73 ,$107.71 ,$79.49 ,$79.87 ,$178.46 ,$176.53 ,$135.55 ,$163.20 ,$283.22 ,$100.61 ,$53.76 ,$172.80 ,$192.00 ,$129.10 ,$124.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$421.00 ,$303.12 ,$117.88 ,$564.45 ,$273.65 ,$221.26 ,$117.88 ,$232.81 ,$221.26 ,$245.02 ,$221.26 ,$220.60 ,$221.26 ,$421.00 ,$387.32 ,$564.45 ,$221.26 ,$357.85 ,$378.90 ,$225.69 ,$315.75 ,$294.70 ,$294.70 ,$221.26 ,$294.70 ,$324.17 ,$324.17 ,$421.00 ,$357.85 ,$225.78 ,$225.78 ,$236.18 ,$174.29 ,$175.14 ,$178.46 ,$176.53 ,$232.33 ,$357.85 ,$485.43 ,$220.60 ,$117.88 ,$378.90 ,$202.00 ,$221.26 ,$273.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400043,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 15MIN,444,1 ,$314.00 ,$226.08 ,$87.92 ,$314.00 ,$204.10 ,$107.30 ,$87.92 ,$173.64 ,$107.30 ,$182.75 ,$107.30 ,$164.54 ,$107.30 ,$221.17 ,$288.88 ,$273.73 ,$107.30 ,$266.90 ,$282.60 ,$109.45 ,$235.50 ,$219.80 ,$219.80 ,$107.30 ,$219.80 ,$241.78 ,$241.78 ,$273.73 ,$266.90 ,$109.49 ,$109.49 ,$176.15 ,$130.00 ,$130.62 ,$178.46 ,$176.53 ,$112.66 ,$266.90 ,$235.40 ,$164.54 ,$87.92 ,$282.60 ,$202.00 ,$107.30 ,$204.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$192.00 ,$138.24 ,$53.76 ,$329.33 ,$124.80 ,$129.10 ,$53.76 ,$106.18 ,$129.10 ,$111.74 ,$129.10 ,$100.61 ,$129.10 ,$192.00 ,$176.64 ,$329.33 ,$129.10 ,$163.20 ,$172.80 ,$131.67 ,$144.00 ,$134.40 ,$134.40 ,$129.10 ,$134.40 ,$147.84 ,$147.84 ,$192.00 ,$163.20 ,$131.73 ,$131.73 ,$107.71 ,$79.49 ,$79.87 ,$178.46 ,$176.53 ,$135.55 ,$163.20 ,$283.22 ,$100.61 ,$53.76 ,$172.80 ,$192.00 ,$129.10 ,$124.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$192.00 ,$138.24 ,$53.76 ,$329.33 ,$124.80 ,$129.10 ,$53.76 ,$106.18 ,$129.10 ,$111.74 ,$129.10 ,$100.61 ,$129.10 ,$192.00 ,$176.64 ,$329.33 ,$129.10 ,$163.20 ,$172.80 ,$131.67 ,$144.00 ,$134.40 ,$134.40 ,$129.10 ,$134.40 ,$147.84 ,$147.84 ,$192.00 ,$163.20 ,$131.73 ,$131.73 ,$107.71 ,$79.49 ,$79.87 ,$178.46 ,$176.53 ,$135.55 ,$163.20 ,$283.22 ,$100.61 ,$53.76 ,$172.80 ,$192.00 ,$129.10 ,$124.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400054,92521,HC EVALUATION OF SPEECH FLUENCY 60MIN,444,1 ,$192.00 ,$138.24 ,$53.76 ,$329.33 ,$124.80 ,$129.10 ,$53.76 ,$106.18 ,$129.10 ,$111.74 ,$129.10 ,$100.61 ,$129.10 ,$192.00 ,$176.64 ,$329.33 ,$129.10 ,$163.20 ,$172.80 ,$131.67 ,$144.00 ,$134.40 ,$134.40 ,$129.10 ,$134.40 ,$147.84 ,$147.84 ,$192.00 ,$163.20 ,$131.73 ,$131.73 ,$107.71 ,$79.49 ,$79.87 ,$178.46 ,$176.53 ,$135.55 ,$163.20 ,$283.22 ,$100.61 ,$53.76 ,$172.80 ,$192.00 ,$129.10 ,$124.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$421.00 ,$303.12 ,$117.88 ,$564.45 ,$273.65 ,$221.26 ,$117.88 ,$232.81 ,$221.26 ,$245.02 ,$221.26 ,$220.60 ,$221.26 ,$421.00 ,$387.32 ,$564.45 ,$221.26 ,$357.85 ,$378.90 ,$225.69 ,$315.75 ,$294.70 ,$294.70 ,$221.26 ,$294.70 ,$324.17 ,$324.17 ,$421.00 ,$357.85 ,$225.78 ,$225.78 ,$236.18 ,$174.29 ,$175.14 ,$178.46 ,$176.53 ,$232.33 ,$357.85 ,$485.43 ,$220.60 ,$117.88 ,$378.90 ,$202.00 ,$221.26 ,$273.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$421.00 ,$303.12 ,$117.88 ,$564.45 ,$273.65 ,$221.26 ,$117.88 ,$232.81 ,$221.26 ,$245.02 ,$221.26 ,$220.60 ,$221.26 ,$421.00 ,$387.32 ,$564.45 ,$221.26 ,$357.85 ,$378.90 ,$225.69 ,$315.75 ,$294.70 ,$294.70 ,$221.26 ,$294.70 ,$324.17 ,$324.17 ,$421.00 ,$357.85 ,$225.78 ,$225.78 ,$236.18 ,$174.29 ,$175.14 ,$178.46 ,$176.53 ,$232.33 ,$357.85 ,$485.43 ,$220.60 ,$117.88 ,$378.90 ,$202.00 ,$221.26 ,$273.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$421.00 ,$303.12 ,$117.88 ,$564.45 ,$273.65 ,$221.26 ,$117.88 ,$232.81 ,$221.26 ,$245.02 ,$221.26 ,$220.60 ,$221.26 ,$421.00 ,$387.32 ,$564.45 ,$221.26 ,$357.85 ,$378.90 ,$225.69 ,$315.75 ,$294.70 ,$294.70 ,$221.26 ,$294.70 ,$324.17 ,$324.17 ,$421.00 ,$357.85 ,$225.78 ,$225.78 ,$236.18 ,$174.29 ,$175.14 ,$178.46 ,$176.53 ,$232.33 ,$357.85 ,$485.43 ,$220.60 ,$117.88 ,$378.90 ,$202.00 ,$221.26 ,$273.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$314.00 ,$226.08 ,$87.92 ,$314.00 ,$204.10 ,$107.30 ,$87.92 ,$173.64 ,$107.30 ,$182.75 ,$107.30 ,$164.54 ,$107.30 ,$221.17 ,$288.88 ,$273.73 ,$107.30 ,$266.90 ,$282.60 ,$109.45 ,$235.50 ,$219.80 ,$219.80 ,$107.30 ,$219.80 ,$241.78 ,$241.78 ,$273.73 ,$266.90 ,$109.49 ,$109.49 ,$176.15 ,$130.00 ,$130.62 ,$178.46 ,$176.53 ,$112.66 ,$266.90 ,$235.40 ,$164.54 ,$87.92 ,$282.60 ,$202.00 ,$107.30 ,$204.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$314.00 ,$226.08 ,$87.92 ,$314.00 ,$204.10 ,$107.30 ,$87.92 ,$173.64 ,$107.30 ,$182.75 ,$107.30 ,$164.54 ,$107.30 ,$221.17 ,$288.88 ,$273.73 ,$107.30 ,$266.90 ,$282.60 ,$109.45 ,$235.50 ,$219.80 ,$219.80 ,$107.30 ,$219.80 ,$241.78 ,$241.78 ,$273.73 ,$266.90 ,$109.49 ,$109.49 ,$176.15 ,$130.00 ,$130.62 ,$178.46 ,$176.53 ,$112.66 ,$266.90 ,$235.40 ,$164.54 ,$87.92 ,$282.60 ,$202.00 ,$107.30 ,$204.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$314.00 ,$226.08 ,$87.92 ,$314.00 ,$204.10 ,$107.30 ,$87.92 ,$173.64 ,$107.30 ,$182.75 ,$107.30 ,$164.54 ,$107.30 ,$221.17 ,$288.88 ,$273.73 ,$107.30 ,$266.90 ,$282.60 ,$109.45 ,$235.50 ,$219.80 ,$219.80 ,$107.30 ,$219.80 ,$241.78 ,$241.78 ,$273.73 ,$266.90 ,$109.49 ,$109.49 ,$176.15 ,$130.00 ,$130.62 ,$178.46 ,$176.53 ,$112.66 ,$266.90 ,$235.40 ,$164.54 ,$87.92 ,$282.60 ,$202.00 ,$107.30 ,$204.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$507.00 ,$365.04 ,$141.96 ,$895.69 ,$329.55 ,$351.10 ,$141.96 ,$280.37 ,$351.10 ,$295.07 ,$351.10 ,$265.67 ,$351.10 ,$507.00 ,$466.44 ,$895.69 ,$351.10 ,$430.95 ,$456.30 ,$358.13 ,$380.25 ,$354.90 ,$354.90 ,$351.10 ,$354.90 ,$390.39 ,$390.39 ,$507.00 ,$430.95 ,$358.27 ,$358.27 ,$284.43 ,$209.90 ,$210.91 , N/A , N/A ,$368.66 ,$430.95 ,$770.29 ,$265.67 ,$141.96 ,$456.30 ,$507.00 ,$351.10 ,$329.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$507.00 ,$365.04 ,$141.96 ,"$1,558.08 ",$329.55 ,$610.77 ,$141.96 ,$280.37 ,$610.77 ,$295.07 ,$496.86 ,$265.67 ,$496.86 ,$507.00 ,$466.44 ,"$1,558.08 ",$610.77 ,$430.95 ,$456.30 ,$496.86 ,$380.25 ,$354.90 ,$354.90 ,$610.77 ,$354.90 ,$390.39 ,$390.39 ,$507.00 ,$430.95 ,$623.23 ,$623.23 ,$284.43 ,$209.90 ,$210.91 , N/A , N/A ,$641.30 ,$430.95 ,"$1,339.95 ",$265.67 ,$141.96 ,$456.30 ,$507.00 ,$610.77 ,$329.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$956.00 ,$688.32 ,$267.68 ,$956.00 ,$621.40 ,$351.10 ,$267.68 ,$528.67 ,$351.10 ,$556.39 ,$351.10 ,$500.94 ,$351.10 ,$723.71 ,$879.52 ,$895.69 ,$351.10 ,$812.60 ,$860.40 ,$358.13 ,$717.00 ,$669.20 ,$669.20 ,$351.10 ,$669.20 ,$736.12 ,$736.12 ,$895.69 ,$812.60 ,$358.27 ,$358.27 ,$536.32 ,$395.78 ,$397.70 , N/A , N/A ,$368.66 ,$812.60 ,$770.29 ,$500.94 ,$267.68 ,$860.40 ,$559.00 ,$351.10 ,$621.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$308.00 ,$221.76 ,$86.24 ,$433.55 ,$200.20 ,$169.95 ,$86.24 ,$170.32 ,$169.95 ,$179.26 ,$169.95 ,$161.39 ,$169.95 ,$308.00 ,$283.36 ,$433.55 ,$169.95 ,$261.80 ,$277.20 ,$173.35 ,$231.00 ,$215.60 ,$215.60 ,$169.95 ,$215.60 ,$237.16 ,$237.16 ,$308.00 ,$261.80 ,$173.42 ,$173.42 ,$172.79 ,$127.51 ,$128.13 , N/A , N/A ,$178.45 ,$261.80 ,$372.85 ,$161.39 ,$86.24 ,$277.20 ,$308.00 ,$169.95 ,$200.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$109.28 ,$89.32 ,$176.41 ,$109.28 ,$185.66 ,$109.28 ,$167.16 ,$109.28 ,$225.24 ,$293.48 ,$278.76 ,$109.28 ,$271.15 ,$287.10 ,$111.47 ,$239.25 ,$223.30 ,$223.30 ,$109.28 ,$223.30 ,$245.63 ,$245.63 ,$278.76 ,$271.15 ,$111.51 ,$111.51 ,$178.96 ,$132.07 ,$132.70 , N/A , N/A ,$114.75 ,$271.15 ,$239.74 ,$167.16 ,$89.32 ,$287.10 ,$319.00 ,$109.28 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000012,11760,HC REPAIR NAIL BED,450,1 ,$666.00 ,$479.52 ,$186.48 ,"$1,394.77 ",$432.90 ,$546.75 ,$186.48 ,$368.30 ,$546.75 ,$387.61 ,$546.75 ,$348.98 ,$546.75 ,$666.00 ,$612.72 ,"$1,394.77 ",$546.75 ,$566.10 ,$599.40 ,$557.69 ,$499.50 ,$466.20 ,$466.20 ,$546.75 ,$466.20 ,$512.82 ,$512.82 ,$666.00 ,$566.10 ,$557.91 ,$557.91 ,$373.63 ,$275.72 ,$277.06 , N/A , N/A ,$574.09 ,$566.10 ,"$1,199.51 ",$348.98 ,$186.48 ,$599.40 ,$559.00 ,$546.75 ,$432.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$334.00 ,$240.48 ,$93.52 ,$433.55 ,$217.10 ,$169.95 ,$93.52 ,$184.70 ,$169.95 ,$194.39 ,$169.95 ,$175.02 ,$169.95 ,$334.00 ,$307.28 ,$433.55 ,$169.95 ,$283.90 ,$300.60 ,$173.35 ,$250.50 ,$233.80 ,$233.80 ,$169.95 ,$233.80 ,$257.18 ,$257.18 ,$334.00 ,$283.90 ,$173.42 ,$173.42 ,$187.37 ,$138.28 ,$138.94 , N/A , N/A ,$178.45 ,$283.90 ,$372.85 ,$175.02 ,$93.52 ,$300.60 ,$334.00 ,$169.95 ,$217.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$367.00 ,$264.24 ,$102.76 ,$433.55 ,$238.55 ,$169.95 ,$102.76 ,$202.95 ,$169.95 ,$213.59 ,$169.95 ,$192.31 ,$169.95 ,$350.30 ,$337.64 ,$433.55 ,$169.95 ,$311.95 ,$330.30 ,$173.35 ,$275.25 ,$256.90 ,$256.90 ,$169.95 ,$256.90 ,$282.59 ,$282.59 ,$367.00 ,$311.95 ,$173.42 ,$173.42 ,$205.89 ,$151.94 ,$152.67 , N/A , N/A ,$178.45 ,$311.95 ,$372.85 ,$192.31 ,$102.76 ,$330.30 ,$367.00 ,$169.95 ,$238.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$403.00 ,$290.16 ,$112.84 ,$433.55 ,$261.95 ,$169.95 ,$112.84 ,$222.86 ,$169.95 ,$234.55 ,$169.95 ,$211.17 ,$169.95 ,$350.30 ,$370.76 ,$433.55 ,$169.95 ,$342.55 ,$362.70 ,$173.35 ,$302.25 ,$282.10 ,$282.10 ,$169.95 ,$282.10 ,$310.31 ,$310.31 ,$403.00 ,$342.55 ,$173.42 ,$173.42 ,$226.08 ,$166.84 ,$167.65 , N/A , N/A ,$178.45 ,$342.55 ,$372.85 ,$211.17 ,$112.84 ,$362.70 ,$403.00 ,$169.95 ,$261.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$443.00 ,$318.96 ,$124.04 ,$895.69 ,$287.95 ,$351.10 ,$124.04 ,$244.98 ,$351.10 ,$257.83 ,$351.10 ,$232.13 ,$351.10 ,$443.00 ,$407.56 ,$895.69 ,$351.10 ,$376.55 ,$398.70 ,$358.13 ,$332.25 ,$310.10 ,$310.10 ,$351.10 ,$310.10 ,$341.11 ,$341.11 ,$443.00 ,$376.55 ,$358.27 ,$358.27 ,$248.52 ,$183.40 ,$184.29 , N/A , N/A ,$368.66 ,$376.55 ,$770.29 ,$232.13 ,$124.04 ,$398.70 ,$443.00 ,$351.10 ,$287.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$503.00 ,$362.16 ,$140.84 ,$895.69 ,$326.95 ,$351.10 ,$140.84 ,$278.16 ,$351.10 ,$292.75 ,$351.10 ,$263.57 ,$351.10 ,$503.00 ,$462.76 ,$895.69 ,$351.10 ,$427.55 ,$452.70 ,$358.13 ,$377.25 ,$352.10 ,$352.10 ,$351.10 ,$352.10 ,$387.31 ,$387.31 ,$503.00 ,$427.55 ,$358.27 ,$358.27 ,$282.18 ,$208.24 ,$209.25 , N/A , N/A ,$368.66 ,$427.55 ,$770.29 ,$263.57 ,$140.84 ,$452.70 ,$503.00 ,$351.10 ,$326.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000019,12007,HC SIMP S/N/AX/GN/TRK/EXT > 30CM,450,1 ,$614.00 ,$442.08 ,$169.95 ,$614.00 ,$399.10 ,$169.95 ,$171.92 ,$339.54 ,$169.95 ,$357.35 ,$169.95 ,$321.74 ,$169.95 ,$350.30 ,$564.88 ,$433.55 ,$169.95 ,$521.90 ,$552.60 ,$173.35 ,$460.50 ,$429.80 ,$429.80 ,$169.95 ,$429.80 ,$472.78 ,$472.78 ,$433.55 ,$521.90 ,$173.42 ,$173.42 ,$344.45 ,$254.20 ,$255.42 , N/A , N/A ,$178.45 ,$521.90 ,$372.85 ,$321.74 ,$171.92 ,$552.60 ,$559.00 ,$169.95 ,$399.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$362.00 ,$260.64 ,$101.36 ,$433.55 ,$235.30 ,$169.95 ,$101.36 ,$200.19 ,$169.95 ,$210.68 ,$169.95 ,$189.69 ,$169.95 ,$350.30 ,$333.04 ,$433.55 ,$169.95 ,$307.70 ,$325.80 ,$173.35 ,$271.50 ,$253.40 ,$253.40 ,$169.95 ,$253.40 ,$278.74 ,$278.74 ,$362.00 ,$307.70 ,$173.42 ,$173.42 ,$203.08 ,$149.87 ,$150.59 , N/A , N/A ,$178.45 ,$307.70 ,$372.85 ,$189.69 ,$101.36 ,$325.80 ,$362.00 ,$169.95 ,$235.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$397.00 ,$285.84 ,$111.16 ,$433.55 ,$258.05 ,$169.95 ,$111.16 ,$219.54 ,$169.95 ,$231.05 ,$169.95 ,$208.03 ,$169.95 ,$350.30 ,$365.24 ,$433.55 ,$169.95 ,$337.45 ,$357.30 ,$173.35 ,$297.75 ,$277.90 ,$277.90 ,$169.95 ,$277.90 ,$305.69 ,$305.69 ,$397.00 ,$337.45 ,$173.42 ,$173.42 ,$222.72 ,$164.36 ,$165.15 , N/A , N/A ,$178.45 ,$337.45 ,$372.85 ,$208.03 ,$111.16 ,$357.30 ,$397.00 ,$169.95 ,$258.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$435.00 ,$313.20 ,$121.80 ,$435.00 ,$282.75 ,$169.95 ,$121.80 ,$240.56 ,$169.95 ,$253.17 ,$169.95 ,$227.94 ,$169.95 ,$350.30 ,$400.20 ,$433.55 ,$169.95 ,$369.75 ,$391.50 ,$173.35 ,$326.25 ,$304.50 ,$304.50 ,$169.95 ,$304.50 ,$334.95 ,$334.95 ,$433.55 ,$369.75 ,$173.42 ,$173.42 ,$244.04 ,$180.09 ,$180.96 , N/A , N/A ,$178.45 ,$369.75 ,$372.85 ,$227.94 ,$121.80 ,$391.50 ,$435.00 ,$169.95 ,$282.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$673.00 ,$484.56 ,$169.95 ,$673.00 ,$437.45 ,$169.95 ,$188.44 ,$372.17 ,$169.95 ,$391.69 ,$169.95 ,$352.65 ,$169.95 ,$350.30 ,$619.16 ,$433.55 ,$169.95 ,$572.05 ,$605.70 ,$173.35 ,$504.75 ,$471.10 ,$471.10 ,$169.95 ,$471.10 ,$518.21 ,$518.21 ,$433.55 ,$572.05 ,$173.42 ,$173.42 ,$377.55 ,$278.62 ,$279.97 , N/A , N/A ,$178.45 ,$572.05 ,$372.85 ,$352.65 ,$188.44 ,$605.70 ,$559.00 ,$169.95 ,$437.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$473.00 ,$340.56 ,$132.44 ,$895.69 ,$307.45 ,$351.10 ,$132.44 ,$261.57 ,$351.10 ,$275.29 ,$351.10 ,$247.85 ,$351.10 ,$473.00 ,$435.16 ,$895.69 ,$351.10 ,$402.05 ,$425.70 ,$358.13 ,$354.75 ,$331.10 ,$331.10 ,$351.10 ,$331.10 ,$364.21 ,$364.21 ,$473.00 ,$402.05 ,$358.27 ,$358.27 ,$265.35 ,$195.82 ,$196.77 , N/A , N/A ,$368.66 ,$402.05 ,$770.29 ,$247.85 ,$132.44 ,$425.70 ,$473.00 ,$351.10 ,$307.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000027,12020,HC SIMP SUPERFICIAL DEHISCENCE,450,1 ,"$1,543.00 ","$1,110.96 ",$432.04 ,"$1,543.00 ","$1,002.95 ",$546.75 ,$432.04 ,$853.28 ,$546.75 ,$898.03 ,$546.75 ,$808.53 ,$546.75 ,"$1,126.98 ","$1,419.56 ","$1,394.77 ",$546.75 ,"$1,311.55 ","$1,388.70 ",$557.69 ,"$1,157.25 ","$1,080.10 ","$1,080.10 ",$546.75 ,"$1,080.10 ","$1,188.11 ","$1,188.11 ","$1,394.77 ","$1,311.55 ",$557.91 ,$557.91 ,$865.62 ,$638.80 ,$641.89 , N/A , N/A ,$574.09 ,"$1,311.55 ","$1,199.51 ",$808.53 ,$432.04 ,"$1,388.70 ",$559.00 ,$546.75 ,"$1,002.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,"$1,024.00 ",$737.28 ,$286.72 ,"$1,024.00 ",$665.60 ,$351.10 ,$286.72 ,$566.27 ,$351.10 ,$595.97 ,$351.10 ,$536.58 ,$351.10 ,$723.71 ,$942.08 ,$895.69 ,$351.10 ,$870.40 ,$921.60 ,$358.13 ,$768.00 ,$716.80 ,$716.80 ,$351.10 ,$716.80 ,$788.48 ,$788.48 ,$895.69 ,$870.40 ,$358.27 ,$358.27 ,$574.46 ,$423.94 ,$425.98 , N/A , N/A ,$368.66 ,$870.40 ,$770.29 ,$536.58 ,$286.72 ,$921.60 ,$559.00 ,$351.10 ,$665.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$648.00 ,$466.56 ,$181.44 ,$895.69 ,$421.20 ,$351.10 ,$181.44 ,$358.34 ,$351.10 ,$377.14 ,$351.10 ,$339.55 ,$351.10 ,$648.00 ,$596.16 ,$895.69 ,$351.10 ,$550.80 ,$583.20 ,$358.13 ,$486.00 ,$453.60 ,$453.60 ,$351.10 ,$453.60 ,$498.96 ,$498.96 ,$648.00 ,$550.80 ,$358.27 ,$358.27 ,$363.53 ,$268.27 ,$269.57 , N/A , N/A ,$368.66 ,$550.80 ,$770.29 ,$339.55 ,$181.44 ,$583.20 ,$559.00 ,$351.10 ,$421.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,"$1,250.00 ",$900.00 ,$350.00 ,"$1,250.00 ",$812.50 ,$351.10 ,$350.00 ,$691.25 ,$351.10 ,$727.50 ,$351.10 ,$655.00 ,$351.10 ,$723.71 ,"$1,150.00 ",$895.69 ,$351.10 ,"$1,062.50 ","$1,125.00 ",$358.13 ,$937.50 ,$875.00 ,$875.00 ,$351.10 ,$875.00 ,$962.50 ,$962.50 ,$895.69 ,"$1,062.50 ",$358.27 ,$358.27 ,$701.25 ,$517.50 ,$520.00 , N/A , N/A ,$368.66 ,"$1,062.50 ",$770.29 ,$655.00 ,$350.00 ,"$1,125.00 ",$559.00 ,$351.10 ,$812.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$791.00 ,$569.52 ,$221.48 ,$895.69 ,$514.15 ,$351.10 ,$221.48 ,$437.42 ,$351.10 ,$460.36 ,$351.10 ,$414.48 ,$351.10 ,$723.71 ,$727.72 ,$895.69 ,$351.10 ,$672.35 ,$711.90 ,$358.13 ,$593.25 ,$553.70 ,$553.70 ,$351.10 ,$553.70 ,$609.07 ,$609.07 ,$791.00 ,$672.35 ,$358.27 ,$358.27 ,$443.75 ,$327.47 ,$329.06 , N/A , N/A ,$368.66 ,$672.35 ,$770.29 ,$414.48 ,$221.48 ,$711.90 ,$559.00 ,$351.10 ,$514.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$613.00 ,$441.36 ,$171.64 ,$895.69 ,$398.45 ,$351.10 ,$171.64 ,$338.99 ,$351.10 ,$356.77 ,$351.10 ,$321.21 ,$351.10 ,$613.00 ,$563.96 ,$895.69 ,$351.10 ,$521.05 ,$551.70 ,$358.13 ,$459.75 ,$429.10 ,$429.10 ,$351.10 ,$429.10 ,$472.01 ,$472.01 ,$613.00 ,$521.05 ,$358.27 ,$358.27 ,$343.89 ,$253.78 ,$255.01 , N/A , N/A ,$368.66 ,$521.05 ,$770.29 ,$321.21 ,$171.64 ,$551.70 ,$559.00 ,$351.10 ,$398.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$558.00 ,$401.76 ,$156.24 ,$895.69 ,$362.70 ,$351.10 ,$156.24 ,$308.57 ,$351.10 ,$324.76 ,$351.10 ,$292.39 ,$351.10 ,$558.00 ,$513.36 ,$895.69 ,$351.10 ,$474.30 ,$502.20 ,$358.13 ,$418.50 ,$390.60 ,$390.60 ,$351.10 ,$390.60 ,$429.66 ,$429.66 ,$558.00 ,$474.30 ,$358.27 ,$358.27 ,$313.04 ,$231.01 ,$232.13 , N/A , N/A ,$368.66 ,$474.30 ,$770.29 ,$292.39 ,$156.24 ,$502.20 ,$558.00 ,$351.10 ,$362.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$487.00 ,$350.64 ,$136.36 ,$895.69 ,$316.55 ,$351.10 ,$136.36 ,$269.31 ,$351.10 ,$283.43 ,$351.10 ,$255.19 ,$351.10 ,$487.00 ,$448.04 ,$895.69 ,$351.10 ,$413.95 ,$438.30 ,$358.13 ,$365.25 ,$340.90 ,$340.90 ,$351.10 ,$340.90 ,$374.99 ,$374.99 ,$487.00 ,$413.95 ,$358.27 ,$358.27 ,$273.21 ,$201.62 ,$202.59 , N/A , N/A ,$368.66 ,$413.95 ,$770.29 ,$255.19 ,$136.36 ,$438.30 ,$487.00 ,$351.10 ,$316.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$308.00 ,$221.76 ,$86.24 ,$433.55 ,$200.20 ,$169.95 ,$86.24 ,$170.32 ,$169.95 ,$179.26 ,$169.95 ,$161.39 ,$169.95 ,$308.00 ,$283.36 ,$433.55 ,$169.95 ,$261.80 ,$277.20 ,$173.35 ,$231.00 ,$215.60 ,$215.60 ,$169.95 ,$215.60 ,$237.16 ,$237.16 ,$308.00 ,$261.80 ,$173.42 ,$173.42 ,$172.79 ,$127.51 ,$128.13 , N/A , N/A ,$178.45 ,$261.80 ,$372.85 ,$161.39 ,$86.24 ,$277.20 ,$308.00 ,$169.95 ,$200.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$537.00 ,$386.64 ,$150.36 ,$537.00 ,$349.05 ,$169.95 ,$150.36 ,$296.96 ,$169.95 ,$312.53 ,$169.95 ,$281.39 ,$169.95 ,$350.30 ,$494.04 ,$433.55 ,$169.95 ,$456.45 ,$483.30 ,$173.35 ,$402.75 ,$375.90 ,$375.90 ,$169.95 ,$375.90 ,$413.49 ,$413.49 ,$433.55 ,$456.45 ,$173.42 ,$173.42 ,$301.26 ,$222.32 ,$223.39 , N/A , N/A ,$178.45 ,$456.45 ,$372.85 ,$281.39 ,$150.36 ,$483.30 ,$537.00 ,$169.95 ,$349.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,$553.00 ,$398.16 ,$154.84 ,$895.69 ,$359.45 ,$351.10 ,$154.84 ,$305.81 ,$351.10 ,$321.85 ,$351.10 ,$289.77 ,$351.10 ,$553.00 ,$508.76 ,$895.69 ,$351.10 ,$470.05 ,$497.70 ,$358.13 ,$414.75 ,$387.10 ,$387.10 ,$351.10 ,$387.10 ,$425.81 ,$425.81 ,$553.00 ,$470.05 ,$358.27 ,$358.27 ,$310.23 ,$228.94 ,$230.05 , N/A , N/A ,$368.66 ,$470.05 ,$770.29 ,$289.77 ,$154.84 ,$497.70 ,$553.00 ,$351.10 ,$359.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,$421.00 ,$303.12 ,$117.88 ,$652.77 ,$273.65 ,$255.89 ,$117.88 ,$232.81 ,$255.89 ,$245.02 ,$255.89 ,$220.60 ,$255.89 ,$421.00 ,$387.32 ,$652.77 ,$255.89 ,$357.85 ,$378.90 ,$261.00 ,$315.75 ,$294.70 ,$294.70 ,$255.89 ,$294.70 ,$324.17 ,$324.17 ,$421.00 ,$357.85 ,$261.11 ,$261.11 ,$236.18 ,$174.29 ,$175.14 , N/A , N/A ,$268.69 ,$357.85 ,$561.38 ,$220.60 ,$117.88 ,$378.90 ,$421.00 ,$255.89 ,$273.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$914.00 ,$658.08 ,$255.89 ,$914.00 ,$594.10 ,$255.89 ,$255.92 ,$505.44 ,$255.89 ,$531.95 ,$255.89 ,$478.94 ,$255.89 ,$527.44 ,$840.88 ,$652.77 ,$255.89 ,$776.90 ,$822.60 ,$261.00 ,$685.50 ,$639.80 ,$639.80 ,$255.89 ,$639.80 ,$703.78 ,$703.78 ,$652.77 ,$776.90 ,$261.11 ,$261.11 ,$512.75 ,$378.40 ,$380.22 , N/A , N/A ,$268.69 ,$776.90 ,$561.38 ,$478.94 ,$255.92 ,$822.60 ,$559.00 ,$255.89 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$914.00 ,$658.08 ,$255.89 ,$914.00 ,$594.10 ,$255.89 ,$255.92 ,$505.44 ,$255.89 ,$531.95 ,$255.89 ,$478.94 ,$255.89 ,$527.44 ,$840.88 ,$652.77 ,$255.89 ,$776.90 ,$822.60 ,$261.00 ,$685.50 ,$639.80 ,$639.80 ,$255.89 ,$639.80 ,$703.78 ,$703.78 ,$652.77 ,$776.90 ,$261.11 ,$261.11 ,$512.75 ,$378.40 ,$380.22 , N/A , N/A ,$268.69 ,$776.90 ,$561.38 ,$478.94 ,$255.92 ,$822.60 ,$559.00 ,$255.89 ,$594.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 ,$393.25 ,$194.82 ,$169.40 ,$334.57 ,$194.82 ,$352.11 ,$194.82 ,$317.02 ,$194.82 ,$401.58 ,$556.60 ,$497.00 ,$194.82 ,$514.25 ,$544.50 ,$198.72 ,$453.75 ,$423.50 ,$423.50 ,$194.82 ,$423.50 ,$465.85 ,$465.85 ,$497.00 ,$514.25 ,$198.80 ,$198.80 ,$339.41 ,$250.47 ,$251.68 , N/A , N/A ,$204.57 ,$514.25 ,$427.42 ,$317.02 ,$169.40 ,$544.50 ,$559.00 ,$194.82 ,$393.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,"$4,084.00 ","$2,940.48 ",$559.00 ,"$4,084.00 ","$2,654.60 ","$1,350.08 ","$1,143.52 ","$2,258.45 ","$1,350.08 ","$2,376.89 ","$1,350.08 ","$2,140.02 ","$1,350.08 ","$2,782.81 ","$3,757.28 ","$3,444.07 ","$1,350.08 ","$3,471.40 ","$3,675.60 ","$1,377.08 ","$3,063.00 ","$2,858.80 ","$2,858.80 ","$1,350.08 ","$2,858.80 ","$3,144.68 ","$3,144.68 ","$3,444.07 ","$3,471.40 ","$1,377.63 ","$1,377.63 ","$2,291.12 ","$1,690.78 ","$1,698.94 ", N/A , N/A ,"$1,417.58 ","$3,471.40 ","$2,961.90 ","$2,140.02 ","$1,143.52 ","$3,675.60 ",$559.00 ,"$1,350.08 ","$2,654.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000089,26755,HC TX FX PHALANX DIST W/MAN CLS,450,1 ,$593.00 ,$426.96 ,$166.04 ,$593.00 ,$385.45 ,$194.82 ,$166.04 ,$327.93 ,$194.82 ,$345.13 ,$194.82 ,$310.73 ,$194.82 ,$401.58 ,$545.56 ,$497.00 ,$194.82 ,$504.05 ,$533.70 ,$198.72 ,$444.75 ,$415.10 ,$415.10 ,$194.82 ,$415.10 ,$456.61 ,$456.61 ,$497.00 ,$504.05 ,$198.80 ,$198.80 ,$332.67 ,$245.50 ,$246.69 , N/A , N/A ,$204.57 ,$504.05 ,$427.42 ,$310.73 ,$166.04 ,$533.70 ,$559.00 ,$194.82 ,$385.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$529.00 ,$380.88 ,$148.12 ,$529.00 ,$343.85 ,$194.82 ,$148.12 ,$292.54 ,$194.82 ,$307.88 ,$194.82 ,$277.20 ,$194.82 ,$401.58 ,$486.68 ,$497.00 ,$194.82 ,$449.65 ,$476.10 ,$198.72 ,$396.75 ,$370.30 ,$370.30 ,$194.82 ,$370.30 ,$407.33 ,$407.33 ,$497.00 ,$449.65 ,$198.80 ,$198.80 ,$296.77 ,$219.01 ,$220.06 , N/A , N/A ,$204.57 ,$449.65 ,$427.42 ,$277.20 ,$148.12 ,$476.10 ,$529.00 ,$194.82 ,$343.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 ,$393.25 ,$194.82 ,$169.40 ,$334.57 ,$194.82 ,$352.11 ,$194.82 ,$317.02 ,$194.82 ,$401.58 ,$556.60 ,$497.00 ,$194.82 ,$514.25 ,$544.50 ,$198.72 ,$453.75 ,$423.50 ,$423.50 ,$194.82 ,$423.50 ,$465.85 ,$465.85 ,$497.00 ,$514.25 ,$198.80 ,$198.80 ,$339.41 ,$250.47 ,$251.68 , N/A , N/A ,$204.57 ,$514.25 ,$427.42 ,$317.02 ,$169.40 ,$544.50 ,$559.00 ,$194.82 ,$393.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000097,28190,HC REM FB FOOT SUBQ,450,1 ,"$2,939.00 ","$2,116.08 ",$559.00 ,"$2,939.00 ","$1,910.35 ",$610.77 ,$822.92 ,"$1,625.27 ",$610.77 ,"$1,710.50 ",$610.77 ,"$1,540.04 ",$610.77 ,"$1,258.93 ","$2,703.88 ","$1,558.08 ",$610.77 ,"$2,498.15 ","$2,645.10 ",$622.99 ,"$2,204.25 ","$2,057.30 ","$2,057.30 ",$610.77 ,"$2,057.30 ","$2,263.03 ","$2,263.03 ","$1,558.08 ","$2,498.15 ",$623.23 ,$623.23 ,"$1,648.78 ","$1,216.75 ","$1,222.62 ", N/A , N/A ,$641.30 ,"$2,498.15 ","$1,339.95 ","$1,540.04 ",$822.92 ,"$2,645.10 ",$559.00 ,$610.77 ,"$1,910.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000098,29065,HC APPL CAST ARM LONG,450,1 ,$301.00 ,$216.72 ,$84.28 ,$575.99 ,$195.65 ,$225.79 ,$84.28 ,$166.45 ,$225.79 ,$175.18 ,$225.79 ,$157.72 ,$225.79 ,$301.00 ,$276.92 ,$575.99 ,$225.79 ,$255.85 ,$270.90 ,$230.30 ,$225.75 ,$210.70 ,$210.70 ,$225.79 ,$210.70 ,$231.77 ,$231.77 ,$301.00 ,$255.85 ,$230.40 ,$230.40 ,$168.86 ,$124.61 ,$125.22 , N/A , N/A ,$237.08 ,$255.85 ,$495.35 ,$157.72 ,$84.28 ,$270.90 ,$301.00 ,$225.79 ,$195.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$301.00 ,$216.72 ,$84.28 ,$575.99 ,$195.65 ,$225.79 ,$84.28 ,$166.45 ,$225.79 ,$175.18 ,$225.79 ,$157.72 ,$225.79 ,$301.00 ,$276.92 ,$575.99 ,$225.79 ,$255.85 ,$270.90 ,$230.30 ,$225.75 ,$210.70 ,$210.70 ,$225.79 ,$210.70 ,$231.77 ,$231.77 ,$301.00 ,$255.85 ,$230.40 ,$230.40 ,$168.86 ,$124.61 ,$125.22 , N/A , N/A ,$237.08 ,$255.85 ,$495.35 ,$157.72 ,$84.28 ,$270.90 ,$301.00 ,$225.79 ,$195.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$371.00 ,$267.12 ,$103.88 ,$371.00 ,$241.15 ,$137.18 ,$103.88 ,$205.16 ,$137.18 ,$215.92 ,$137.18 ,$194.40 ,$137.18 ,$282.76 ,$341.32 ,$349.95 ,$137.18 ,$315.35 ,$333.90 ,$139.92 ,$278.25 ,$259.70 ,$259.70 ,$137.18 ,$259.70 ,$285.67 ,$285.67 ,$349.95 ,$315.35 ,$139.98 ,$139.98 ,$208.13 ,$153.59 ,$154.34 , N/A , N/A ,$144.04 ,$315.35 ,$300.96 ,$194.40 ,$103.88 ,$333.90 ,$371.00 ,$137.18 ,$241.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$371.00 ,$267.12 ,$103.88 ,$371.00 ,$241.15 ,$109.28 ,$103.88 ,$205.16 ,$109.28 ,$215.92 ,$109.28 ,$194.40 ,$109.28 ,$225.24 ,$341.32 ,$278.76 ,$109.28 ,$315.35 ,$333.90 ,$111.47 ,$278.25 ,$259.70 ,$259.70 ,$109.28 ,$259.70 ,$285.67 ,$285.67 ,$278.76 ,$315.35 ,$111.51 ,$111.51 ,$208.13 ,$153.59 ,$154.34 , N/A , N/A ,$114.75 ,$315.35 ,$239.74 ,$194.40 ,$103.88 ,$333.90 ,$371.00 ,$109.28 ,$241.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$369.00 ,$265.68 ,$103.32 ,$369.00 ,$239.85 ,$109.28 ,$103.32 ,$204.06 ,$109.28 ,$214.76 ,$109.28 ,$193.36 ,$109.28 ,$225.24 ,$339.48 ,$278.76 ,$109.28 ,$313.65 ,$332.10 ,$111.47 ,$276.75 ,$258.30 ,$258.30 ,$109.28 ,$258.30 ,$284.13 ,$284.13 ,$278.76 ,$313.65 ,$111.51 ,$111.51 ,$207.01 ,$152.77 ,$153.50 , N/A , N/A ,$114.75 ,$313.65 ,$239.74 ,$193.36 ,$103.32 ,$332.10 ,$369.00 ,$109.28 ,$239.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$369.00 ,$265.68 ,$103.32 ,$369.00 ,$239.85 ,$109.28 ,$103.32 ,$204.06 ,$109.28 ,$214.76 ,$109.28 ,$193.36 ,$109.28 ,$225.24 ,$339.48 ,$278.76 ,$109.28 ,$313.65 ,$332.10 ,$111.47 ,$276.75 ,$258.30 ,$258.30 ,$109.28 ,$258.30 ,$284.13 ,$284.13 ,$278.76 ,$313.65 ,$111.51 ,$111.51 ,$207.01 ,$152.77 ,$153.50 , N/A , N/A ,$114.75 ,$313.65 ,$239.74 ,$193.36 ,$103.32 ,$332.10 ,$369.00 ,$109.28 ,$239.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$301.00 ,$216.72 ,$84.28 ,$575.99 ,$195.65 ,$225.79 ,$84.28 ,$166.45 ,$225.79 ,$175.18 ,$225.79 ,$157.72 ,$225.79 ,$301.00 ,$276.92 ,$575.99 ,$225.79 ,$255.85 ,$270.90 ,$230.30 ,$225.75 ,$210.70 ,$210.70 ,$225.79 ,$210.70 ,$231.77 ,$231.77 ,$301.00 ,$255.85 ,$230.40 ,$230.40 ,$168.86 ,$124.61 ,$125.22 , N/A , N/A ,$237.08 ,$255.85 ,$495.35 ,$157.72 ,$84.28 ,$270.90 ,$301.00 ,$225.79 ,$195.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$369.00 ,$265.68 ,$103.32 ,$369.00 ,$239.85 ,$137.18 ,$103.32 ,$204.06 ,$137.18 ,$214.76 ,$137.18 ,$193.36 ,$137.18 ,$282.76 ,$339.48 ,$349.95 ,$137.18 ,$313.65 ,$332.10 ,$139.92 ,$276.75 ,$258.30 ,$258.30 ,$137.18 ,$258.30 ,$284.13 ,$284.13 ,$349.95 ,$313.65 ,$139.98 ,$139.98 ,$207.01 ,$152.77 ,$153.50 , N/A , N/A ,$144.04 ,$313.65 ,$300.96 ,$193.36 ,$103.32 ,$332.10 ,$369.00 ,$137.18 ,$239.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$452.00 ,$325.44 ,$126.56 ,$452.00 ,$293.80 ,$137.18 ,$126.56 ,$249.96 ,$137.18 ,$263.06 ,$137.18 ,$236.85 ,$137.18 ,$282.76 ,$415.84 ,$349.95 ,$137.18 ,$384.20 ,$406.80 ,$139.92 ,$339.00 ,$316.40 ,$316.40 ,$137.18 ,$316.40 ,$348.04 ,$348.04 ,$349.95 ,$384.20 ,$139.98 ,$139.98 ,$253.57 ,$187.13 ,$188.03 , N/A , N/A ,$144.04 ,$384.20 ,$300.96 ,$236.85 ,$126.56 ,$406.80 ,$452.00 ,$137.18 ,$293.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000110,30300,HC REM FB INTRANASAL,450,1 ,$233.00 ,$167.76 ,$65.24 ,$278.76 ,$151.45 ,$109.28 ,$65.24 ,$128.85 ,$109.28 ,$135.61 ,$109.28 ,$122.09 ,$109.28 ,$225.24 ,$214.36 ,$278.76 ,$109.28 ,$198.05 ,$209.70 ,$111.47 ,$174.75 ,$163.10 ,$163.10 ,$109.28 ,$163.10 ,$179.41 ,$179.41 ,$233.00 ,$198.05 ,$111.51 ,$111.51 ,$130.71 ,$96.46 ,$96.93 , N/A , N/A ,$114.75 ,$198.05 ,$239.74 ,$122.09 ,$65.24 ,$209.70 ,$233.00 ,$109.28 ,$151.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$327.00 ,$235.44 ,$91.56 ,$327.00 ,$212.55 ,$109.28 ,$91.56 ,$180.83 ,$109.28 ,$190.31 ,$109.28 ,$171.35 ,$109.28 ,$225.24 ,$300.84 ,$278.76 ,$109.28 ,$277.95 ,$294.30 ,$111.47 ,$245.25 ,$228.90 ,$228.90 ,$109.28 ,$228.90 ,$251.79 ,$251.79 ,$278.76 ,$277.95 ,$111.51 ,$111.51 ,$183.45 ,$135.38 ,$136.03 , N/A , N/A ,$114.75 ,$277.95 ,$239.74 ,$171.35 ,$91.56 ,$294.30 ,$327.00 ,$109.28 ,$212.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$403.00 ,$290.16 ,$109.28 ,$403.00 ,$261.95 ,$109.28 ,$112.84 ,$222.86 ,$109.28 ,$234.55 ,$109.28 ,$211.17 ,$109.28 ,$225.24 ,$370.76 ,$278.76 ,$109.28 ,$342.55 ,$362.70 ,$111.47 ,$302.25 ,$282.10 ,$282.10 ,$109.28 ,$282.10 ,$310.31 ,$310.31 ,$278.76 ,$342.55 ,$111.51 ,$111.51 ,$226.08 ,$166.84 ,$167.65 , N/A , N/A ,$114.75 ,$342.55 ,$239.74 ,$211.17 ,$112.84 ,$362.70 ,$403.00 ,$109.28 ,$261.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000116,31720,HC ASP CATH NASOTRACHEAL,450,1 ,$141.00 ,$101.52 ,$39.48 ,$459.76 ,$91.65 ,$180.23 ,$39.48 ,$77.97 ,$180.23 ,$82.06 ,$138.18 ,$73.88 ,$138.18 ,$141.00 ,$129.72 ,$459.76 ,$180.23 ,$119.85 ,$126.90 ,$138.18 ,$105.75 ,$98.70 ,$98.70 ,$180.23 ,$98.70 ,$108.57 ,$108.57 ,$141.00 ,$119.85 ,$183.91 ,$183.91 ,$79.10 ,$58.37 ,$58.66 , N/A , N/A ,$189.25 ,$119.85 ,$395.40 ,$73.88 ,$39.48 ,$126.90 ,$141.00 ,$180.23 ,$91.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$827.00 ,$595.44 ,$231.56 ,$906.49 ,$537.55 ,$355.35 ,$231.56 ,$457.33 ,$355.35 ,$481.31 ,$355.35 ,$433.35 ,$355.35 ,$732.44 ,$760.84 ,$906.49 ,$355.35 ,$702.95 ,$744.30 ,$362.45 ,$620.25 ,$578.90 ,$578.90 ,$355.35 ,$578.90 ,$636.79 ,$636.79 ,$827.00 ,$702.95 ,$362.60 ,$362.60 ,$463.95 ,$342.38 ,$344.03 , N/A , N/A ,$373.12 ,$702.95 ,$779.58 ,$433.35 ,$231.56 ,$744.30 ,$559.00 ,$355.35 ,$537.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000133,40650,HC RPR LIP FULL THICK VERMILN,450,1 ,"$1,327.00 ",$955.44 ,$371.56 ,"$1,327.00 ",$862.55 ,$429.93 ,$371.56 ,$733.83 ,$429.93 ,$772.31 ,$429.93 ,$695.35 ,$429.93 ,$886.18 ,"$1,220.84 ","$1,096.76 ",$429.93 ,"$1,127.95 ","$1,194.30 ",$438.53 ,$995.25 ,$928.90 ,$928.90 ,$429.93 ,$928.90 ,"$1,021.79 ","$1,021.79 ","$1,096.76 ","$1,127.95 ",$438.70 ,$438.70 ,$744.45 ,$549.38 ,$552.03 , N/A , N/A ,$451.43 ,"$1,127.95 ",$943.21 ,$695.35 ,$371.56 ,"$1,194.30 ",$559.00 ,$429.93 ,$862.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$871.00 ,$627.12 ,$243.88 ,$906.49 ,$566.15 ,$355.35 ,$243.88 ,$481.66 ,$355.35 ,$506.92 ,$355.35 ,$456.40 ,$355.35 ,$732.44 ,$801.32 ,$906.49 ,$355.35 ,$740.35 ,$783.90 ,$362.45 ,$653.25 ,$609.70 ,$609.70 ,$355.35 ,$609.70 ,$670.67 ,$670.67 ,$871.00 ,$740.35 ,$362.60 ,$362.60 ,$488.63 ,$360.59 ,$362.34 , N/A , N/A ,$373.12 ,$740.35 ,$779.58 ,$456.40 ,$243.88 ,$783.90 ,$559.00 ,$355.35 ,$566.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$507.00 ,$365.04 ,$109.28 ,$507.00 ,$329.55 ,$109.28 ,$141.96 ,$280.37 ,$109.28 ,$295.07 ,$109.28 ,$265.67 ,$109.28 ,$225.24 ,$466.44 ,$278.76 ,$109.28 ,$430.95 ,$456.30 ,$111.47 ,$380.25 ,$354.90 ,$354.90 ,$109.28 ,$354.90 ,$390.39 ,$390.39 ,$278.76 ,$430.95 ,$111.51 ,$111.51 ,$284.43 ,$209.90 ,$210.91 , N/A , N/A ,$114.75 ,$430.95 ,$239.74 ,$265.67 ,$141.96 ,$456.30 ,$507.00 ,$109.28 ,$329.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000143,43753,HC GASTRIC LAVAGE,450,1 ,$776.00 ,$558.72 ,$217.28 ,$776.00 ,$504.40 ,$263.57 ,$217.28 ,$429.13 ,$263.57 ,$451.63 ,$263.57 ,$406.62 ,$263.57 ,$543.28 ,$713.92 ,$672.38 ,$263.57 ,$659.60 ,$698.40 ,$268.84 ,$582.00 ,$543.20 ,$543.20 ,$263.57 ,$543.20 ,$597.52 ,$597.52 ,$672.38 ,$659.60 ,$268.95 ,$268.95 ,$435.34 ,$321.26 ,$322.82 , N/A , N/A ,$276.75 ,$659.60 ,$578.25 ,$406.62 ,$217.28 ,$698.40 ,$559.00 ,$263.57 ,$504.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$295.00 ,$212.40 ,$82.60 ,$515.87 ,$191.75 ,$202.22 ,$82.60 ,$163.14 ,$202.22 ,$171.69 ,$202.22 ,$154.58 ,$202.22 ,$295.00 ,$271.40 ,$515.87 ,$202.22 ,$250.75 ,$265.50 ,$206.27 ,$221.25 ,$206.50 ,$206.50 ,$202.22 ,$206.50 ,$227.15 ,$227.15 ,$295.00 ,$250.75 ,$206.35 ,$206.35 ,$165.50 ,$122.13 ,$122.72 , N/A , N/A ,$212.34 ,$250.75 ,$443.65 ,$154.58 ,$82.60 ,$265.50 ,$295.00 ,$202.22 ,$191.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000161,54700,HC I AND D EPIDIDYMIS TESTIS OR SCROTAL SPACE,450,1 ,"$5,841.00 ","$4,205.52 ",$559.00 ,"$5,841.00 ","$3,796.65 ","$1,745.69 ","$1,635.48 ","$3,230.07 ","$1,745.69 ","$3,399.46 ","$1,745.69 ","$3,060.68 ","$1,745.69 ","$3,598.26 ","$5,373.72 ","$4,453.29 ","$1,745.69 ","$4,964.85 ","$5,256.90 ","$1,780.60 ","$4,380.75 ","$4,088.70 ","$4,088.70 ","$1,745.69 ","$4,088.70 ","$4,497.57 ","$4,497.57 ","$4,453.29 ","$4,964.85 ","$1,781.32 ","$1,781.32 ","$3,276.80 ","$2,418.17 ","$2,429.86 ", N/A , N/A ,"$1,832.98 ","$4,964.85 ","$3,829.83 ","$3,060.68 ","$1,635.48 ","$5,256.90 ",$559.00 ,"$1,745.69 ","$3,796.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$583.00 ,$419.76 ,$163.24 ,$700.95 ,$378.95 ,$274.77 ,$163.24 ,$322.40 ,$274.77 ,$339.31 ,$274.77 ,$305.49 ,$274.77 ,$566.37 ,$536.36 ,$700.95 ,$274.77 ,$495.55 ,$524.70 ,$280.27 ,$437.25 ,$408.10 ,$408.10 ,$274.77 ,$408.10 ,$448.91 ,$448.91 ,$583.00 ,$495.55 ,$280.38 ,$280.38 ,$327.06 ,$241.36 ,$242.53 , N/A , N/A ,$288.51 ,$495.55 ,$602.82 ,$305.49 ,$163.24 ,$524.70 ,$559.00 ,$274.77 ,$378.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$533.00 ,$383.76 ,$149.24 ,$533.00 ,$346.45 ,$167.65 ,$149.24 ,$294.75 ,$167.65 ,$310.21 ,$167.65 ,$279.29 ,$167.65 ,$345.55 ,$490.36 ,$427.66 ,$167.65 ,$453.05 ,$479.70 ,$171.00 ,$399.75 ,$373.10 ,$373.10 ,$167.65 ,$373.10 ,$410.41 ,$410.41 ,$427.66 ,$453.05 ,$171.07 ,$171.07 ,$299.01 ,$220.66 ,$221.73 , N/A , N/A ,$176.03 ,$453.05 ,$367.79 ,$279.29 ,$149.24 ,$479.70 ,$533.00 ,$167.65 ,$346.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$1,861.00 ","$1,339.92 ",$521.08 ,"$1,861.00 ","$1,209.65 ",$606.41 ,$521.08 ,"$1,029.13 ",$606.41 ,"$1,083.10 ",$606.41 ,$975.16 ,$606.41 ,"$1,249.95 ","$1,712.12 ","$1,546.96 ",$606.41 ,"$1,581.85 ","$1,674.90 ",$618.54 ,"$1,395.75 ","$1,302.70 ","$1,302.70 ",$606.41 ,"$1,302.70 ","$1,432.97 ","$1,432.97 ","$1,546.96 ","$1,581.85 ",$618.79 ,$618.79 ,"$1,044.02 ",$770.45 ,$774.18 , N/A , N/A ,$636.74 ,"$1,581.85 ","$1,330.39 ",$975.16 ,$521.08 ,"$1,674.90 ",$559.00 ,$606.41 ,"$1,209.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$477.00 ,$343.44 ,$109.28 ,$477.00 ,$310.05 ,$109.28 ,$133.56 ,$263.78 ,$109.28 ,$277.61 ,$109.28 ,$249.95 ,$109.28 ,$225.24 ,$438.84 ,$278.76 ,$109.28 ,$405.45 ,$429.30 ,$111.47 ,$357.75 ,$333.90 ,$333.90 ,$109.28 ,$333.90 ,$367.29 ,$367.29 ,$278.76 ,$405.45 ,$111.51 ,$111.51 ,$267.60 ,$197.48 ,$198.43 , N/A , N/A ,$114.75 ,$405.45 ,$239.74 ,$249.95 ,$133.56 ,$429.30 ,$477.00 ,$109.28 ,$310.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000181,69200,HC FB REMOVAL EAR,450,1 ,$233.00 ,$167.76 ,$65.24 ,$278.76 ,$151.45 ,$109.28 ,$65.24 ,$128.85 ,$109.28 ,$135.61 ,$109.28 ,$122.09 ,$109.28 ,$225.24 ,$214.36 ,$278.76 ,$109.28 ,$198.05 ,$209.70 ,$111.47 ,$174.75 ,$163.10 ,$163.10 ,$109.28 ,$163.10 ,$179.41 ,$179.41 ,$233.00 ,$198.05 ,$111.51 ,$111.51 ,$130.71 ,$96.46 ,$96.93 , N/A , N/A ,$114.75 ,$198.05 ,$239.74 ,$122.09 ,$65.24 ,$209.70 ,$233.00 ,$109.28 ,$151.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$233.00 ,$167.76 ,$54.10 ,$233.00 ,$151.45 ,$54.10 ,$65.24 ,$128.85 ,$54.10 ,$135.61 ,$54.10 ,$122.09 ,$54.10 ,$111.50 ,$214.36 ,$138.00 ,$54.10 ,$198.05 ,$209.70 ,$55.17 ,$174.75 ,$163.10 ,$163.10 ,$54.10 ,$163.10 ,$179.41 ,$179.41 ,$138.00 ,$198.05 ,$55.20 ,$55.20 ,$130.71 ,$96.46 ,$96.93 , N/A , N/A ,$56.80 ,$198.05 ,$118.68 ,$122.09 ,$65.24 ,$209.70 ,$233.00 ,$54.10 ,$151.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000188,99281,HC ER LEVEL 1,450,1 ,$259.00 ,$186.48 ,$70.67 ,$259.00 ,$168.35 ,$70.67 ,$72.52 ,$143.23 ,$70.67 ,$150.74 ,$70.67 ,$135.72 ,$70.67 ,$145.67 ,$238.28 ,$180.28 ,$70.67 ,$220.15 ,$233.10 ,$72.08 ,$194.25 ,$181.30 ,$181.30 ,$70.67 ,$181.30 ,$199.43 ,$199.43 ,$180.28 ,$220.15 ,$72.11 ,$72.11 ,$145.30 ,$107.23 ,$107.74 , N/A , N/A ,$74.21 ,$220.15 ,$155.04 ,$135.72 ,$72.52 ,$233.10 ,$259.00 ,$70.67 ,$168.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000189,99282,HC ER LEVEL 2,450,1 ,$427.00 ,$307.44 ,$119.56 ,$427.00 ,$277.55 ,$131.47 ,$119.56 ,$236.13 ,$131.47 ,$248.51 ,$131.47 ,$223.75 ,$131.47 ,$270.98 ,$392.84 ,$335.37 ,$131.47 ,$362.95 ,$384.30 ,$134.09 ,$320.25 ,$298.90 ,$298.90 ,$131.47 ,$298.90 ,$328.79 ,$328.79 ,$335.37 ,$362.95 ,$134.15 ,$134.15 ,$239.55 ,$176.78 ,$177.63 , N/A , N/A ,$138.04 ,$362.95 ,$288.42 ,$223.75 ,$119.56 ,$384.30 ,$427.00 ,$131.47 ,$277.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000190,99283,HC ER LEVEL 3,450,1 ,$680.00 ,$489.60 ,$190.40 ,$680.00 ,$442.00 ,$230.60 ,$190.40 ,$376.04 ,$230.60 ,$395.76 ,$230.60 ,$356.32 ,$230.60 ,$475.33 ,$625.60 ,$588.28 ,$230.60 ,$578.00 ,$612.00 ,$235.22 ,$510.00 ,$476.00 ,$476.00 ,$230.60 ,$476.00 ,$523.60 ,$523.60 ,$588.28 ,$578.00 ,$235.31 ,$235.31 ,$381.48 ,$281.52 ,$282.88 , N/A , N/A ,$242.14 ,$578.00 ,$505.92 ,$356.32 ,$190.40 ,$612.00 ,$680.00 ,$230.60 ,$442.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000191,99284,HC ER LEVEL 4,450,1 ,"$1,086.00 ",$781.92 ,$99.35 ,"$1,086.00 ",$705.90 ,$359.15 ,$304.08 ,$600.56 ,$359.15 ,$632.05 ,$359.15 ,$569.06 ,$359.15 ,$740.28 ,$999.12 ,$916.19 ,$359.15 ,$923.10 ,$977.40 ,$366.32 ,$814.50 ,$760.20 ,$760.20 ,$359.15 ,$760.20 ,$836.22 ,$836.22 ,$916.19 ,$923.10 ,$366.48 ,$366.48 ,$609.25 ,$449.60 ,$451.78 ,$100.44 ,$99.35 ,$377.10 ,$923.10 ,$787.92 ,$569.06 ,$304.08 ,$977.40 ,"$1,086.00 ",$359.15 ,$705.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000192,99285,HC ER LEVEL 5,450,1 ,"$1,598.00 ","$1,150.56 ",$99.35 ,"$1,598.00 ","$1,038.70 ",$515.84 ,$447.44 ,$883.69 ,$515.84 ,$930.04 ,$515.84 ,$837.35 ,$515.84 ,"$1,063.27 ","$1,470.16 ","$1,315.93 ",$515.84 ,"$1,358.30 ","$1,438.20 ",$526.16 ,"$1,198.50 ","$1,118.60 ","$1,118.60 ",$515.84 ,"$1,118.60 ","$1,230.46 ","$1,230.46 ","$1,315.93 ","$1,358.30 ",$526.37 ,$526.37 ,$896.48 ,$661.57 ,$664.77 ,$100.44 ,$99.35 ,$541.64 ,"$1,358.30 ","$1,131.70 ",$837.35 ,$447.44 ,"$1,438.20 ","$1,598.00 ",$515.84 ,"$1,038.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$2,223.00 ","$1,600.56 ",$99.35 ,"$2,223.00 ","$1,444.95 ",$722.52 ,$622.44 ,"$1,229.32 ",$722.52 ,"$1,293.79 ",$722.52 ,"$1,164.85 ",$722.52 ,"$1,489.29 ","$2,045.16 ","$1,843.18 ",$722.52 ,"$1,889.55 ","$2,000.70 ",$736.98 ,"$1,667.25 ","$1,556.10 ","$1,556.10 ",$722.52 ,"$1,556.10 ","$1,711.71 ","$1,711.71 ","$1,843.18 ","$1,889.55 ",$737.27 ,$737.27 ,"$1,247.10 ",$920.32 ,$924.77 ,$100.44 ,$99.35 ,$758.65 ,"$1,889.55 ","$1,585.14 ","$1,164.85 ",$622.44 ,"$2,000.70 ","$2,223.00 ",$722.52 ,"$1,444.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,$714.00 ,$514.08 ,$199.92 ,$714.00 ,$464.10 , N/A ,$199.92 ,$394.84 , N/A ,$415.55 , N/A ,$374.14 , N/A , N/A ,$656.88 , N/A , N/A ,$606.90 ,$642.60 , N/A ,$535.50 ,$499.80 ,$499.80 , N/A ,$499.80 ,$549.78 ,$549.78 , N/A ,$606.90 , N/A , N/A ,$400.55 ,$295.60 ,$297.02 , N/A , N/A , N/A ,$606.90 , N/A ,$374.14 ,$199.92 ,$642.60 ,$559.00 , N/A ,$464.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$593.00 ,$426.96 ,$166.04 ,$593.00 ,$385.45 ,$194.82 ,$166.04 ,$327.93 ,$194.82 ,$345.13 ,$194.82 ,$310.73 ,$194.82 ,$401.58 ,$545.56 ,$497.00 ,$194.82 ,$504.05 ,$533.70 ,$198.72 ,$444.75 ,$415.10 ,$415.10 ,$194.82 ,$415.10 ,$456.61 ,$456.61 ,$497.00 ,$504.05 ,$198.80 ,$198.80 ,$332.67 ,$245.50 ,$246.69 , N/A , N/A ,$204.57 ,$504.05 ,$427.42 ,$310.73 ,$166.04 ,$533.70 ,$559.00 ,$194.82 ,$385.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000199,35207,HC RPR VESSEL HAND/FINGER,450,1 ,"$8,245.00 ","$5,936.40 ",$559.00 ,"$8,245.00 ","$5,359.25 ","$2,803.60 ","$2,308.60 ","$4,559.49 ","$2,803.60 ","$4,798.59 ","$2,803.60 ","$4,320.38 ","$2,803.60 ","$5,778.86 ","$7,585.40 ","$7,152.06 ","$2,803.60 ","$7,008.25 ","$7,420.50 ","$2,859.68 ","$6,183.75 ","$5,771.50 ","$5,771.50 ","$2,803.60 ","$5,771.50 ","$6,348.65 ","$6,348.65 ","$7,152.06 ","$7,008.25 ","$2,860.82 ","$2,860.82 ","$4,625.45 ","$3,413.43 ","$3,429.92 ", N/A , N/A ,"$2,943.78 ","$7,008.25 ","$6,150.77 ","$4,320.38 ","$2,308.60 ","$7,420.50 ",$559.00 ,"$2,803.60 ","$5,359.25 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000201,31525,HC LARYNGOSCOPE DIRECT DX,450,1 ,"$3,994.00 ","$2,875.68 ",$559.00 ,"$3,994.00 ","$2,596.10 ","$1,504.46 ","$1,118.32 ","$2,208.68 ","$1,504.46 ","$2,324.51 ","$1,504.46 ","$2,092.86 ","$1,504.46 ","$3,101.03 ","$3,674.48 ","$3,837.90 ","$1,504.46 ","$3,394.90 ","$3,594.60 ","$1,534.54 ","$2,995.50 ","$2,795.80 ","$2,795.80 ","$1,504.46 ","$2,795.80 ","$3,075.38 ","$3,075.38 ","$3,837.90 ","$3,394.90 ","$1,535.16 ","$1,535.16 ","$2,240.63 ","$1,653.52 ","$1,661.50 ", N/A , N/A ,"$1,579.68 ","$3,394.90 ","$3,300.60 ","$2,092.86 ","$1,118.32 ","$3,594.60 ",$559.00 ,"$1,504.46 ","$2,596.10 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000203,27840,HC TX DISL ANKLE W/O ANES CLS,450,1 ,$751.00 ,$540.72 ,$194.82 ,$751.00 ,$488.15 ,$194.82 ,$210.28 ,$415.30 ,$194.82 ,$437.08 ,$194.82 ,$393.52 ,$194.82 ,$401.58 ,$690.92 ,$497.00 ,$194.82 ,$638.35 ,$675.90 ,$198.72 ,$563.25 ,$525.70 ,$525.70 ,$194.82 ,$525.70 ,$578.27 ,$578.27 ,$497.00 ,$638.35 ,$198.80 ,$198.80 ,$421.31 ,$310.91 ,$312.42 , N/A , N/A ,$204.57 ,$638.35 ,$427.42 ,$393.52 ,$210.28 ,$675.90 ,$559.00 ,$194.82 ,$488.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,$903.00 ,$650.16 ,$252.84 ,$903.00 ,$586.95 ,$313.04 ,$252.84 ,$499.36 ,$313.04 ,$525.55 ,$313.04 ,$473.17 ,$313.04 ,$645.25 ,$830.76 ,$798.57 ,$313.04 ,$767.55 ,$812.70 ,$319.30 ,$677.25 ,$632.10 ,$632.10 ,$313.04 ,$632.10 ,$695.31 ,$695.31 ,$798.57 ,$767.55 ,$319.43 ,$319.43 ,$506.58 ,$373.84 ,$375.65 , N/A , N/A ,$328.69 ,$767.55 ,$686.77 ,$473.17 ,$252.84 ,$812.70 ,$559.00 ,$313.04 ,$586.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000225,23540,HC CLOSED ACROM.W/O MANIP,450,1 ,$593.00 ,$426.96 ,$166.04 ,$593.00 ,$385.45 ,$194.82 ,$166.04 ,$327.93 ,$194.82 ,$345.13 ,$194.82 ,$310.73 ,$194.82 ,$401.58 ,$545.56 ,$497.00 ,$194.82 ,$504.05 ,$533.70 ,$198.72 ,$444.75 ,$415.10 ,$415.10 ,$194.82 ,$415.10 ,$456.61 ,$456.61 ,$497.00 ,$504.05 ,$198.80 ,$198.80 ,$332.67 ,$245.50 ,$246.69 , N/A , N/A ,$204.57 ,$504.05 ,$427.42 ,$310.73 ,$166.04 ,$533.70 ,$559.00 ,$194.82 ,$385.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 ,$393.25 ,$194.82 ,$169.40 ,$334.57 ,$194.82 ,$352.11 ,$194.82 ,$317.02 ,$194.82 ,$401.58 ,$556.60 ,$497.00 ,$194.82 ,$514.25 ,$544.50 ,$198.72 ,$453.75 ,$423.50 ,$423.50 ,$194.82 ,$423.50 ,$465.85 ,$465.85 ,$497.00 ,$514.25 ,$198.80 ,$198.80 ,$339.41 ,$250.47 ,$251.68 , N/A , N/A ,$204.57 ,$514.25 ,$427.42 ,$317.02 ,$169.40 ,$544.50 ,$559.00 ,$194.82 ,$393.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000234,25560,HC RADIUS AND ULNA FX W/O MANIP,450,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 ,$393.25 ,$194.82 ,$169.40 ,$334.57 ,$194.82 ,$352.11 ,$194.82 ,$317.02 ,$194.82 ,$401.58 ,$556.60 ,$497.00 ,$194.82 ,$514.25 ,$544.50 ,$198.72 ,$453.75 ,$423.50 ,$423.50 ,$194.82 ,$423.50 ,$465.85 ,$465.85 ,$497.00 ,$514.25 ,$198.80 ,$198.80 ,$339.41 ,$250.47 ,$251.68 , N/A , N/A ,$204.57 ,$514.25 ,$427.42 ,$317.02 ,$169.40 ,$544.50 ,$559.00 ,$194.82 ,$393.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000238,26670,HC HAND DISL W/MANIP W/O ANES,450,1 ,$628.00 ,$452.16 ,$175.84 ,$628.00 ,$408.20 ,$194.82 ,$175.84 ,$347.28 ,$194.82 ,$365.50 ,$194.82 ,$329.07 ,$194.82 ,$401.58 ,$577.76 ,$497.00 ,$194.82 ,$533.80 ,$565.20 ,$198.72 ,$471.00 ,$439.60 ,$439.60 ,$194.82 ,$439.60 ,$483.56 ,$483.56 ,$497.00 ,$533.80 ,$198.80 ,$198.80 ,$352.31 ,$259.99 ,$261.25 , N/A , N/A ,$204.57 ,$533.80 ,$427.42 ,$329.07 ,$175.84 ,$565.20 ,$559.00 ,$194.82 ,$408.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000252,20520,HC MUSCLE FB REM W/ INC,450,1 ,"$1,564.00 ","$1,126.08 ",$437.92 ,"$3,600.19 ","$1,016.60 ","$1,411.28 ",$437.92 ,$864.89 ,"$1,411.28 ",$910.25 ,"$1,411.28 ",$819.54 ,"$1,411.28 ","$1,564.00 ","$1,438.88 ","$3,600.19 ","$1,411.28 ","$1,329.40 ","$1,407.60 ","$1,439.50 ","$1,173.00 ","$1,094.80 ","$1,094.80 ","$1,411.28 ","$1,094.80 ","$1,204.28 ","$1,204.28 ","$1,564.00 ","$1,329.40 ","$1,440.08 ","$1,440.08 ",$877.40 ,$647.50 ,$650.62 , N/A , N/A ,"$1,481.84 ","$1,329.40 ","$3,096.17 ",$819.54 ,$437.92 ,"$1,407.60 ",$559.00 ,"$1,411.28 ","$1,016.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$175.00 ,$126.00 ,$49.00 ,$175.00 ,$113.75 ,$54.10 ,$49.00 ,$96.78 ,$54.10 ,$101.85 ,$54.10 ,$91.70 ,$54.10 ,$111.50 ,$161.00 ,$138.00 ,$54.10 ,$148.75 ,$157.50 ,$55.17 ,$131.25 ,$122.50 ,$122.50 ,$54.10 ,$122.50 ,$134.75 ,$134.75 ,$138.00 ,$148.75 ,$55.20 ,$55.20 ,$98.18 ,$72.45 ,$72.80 , N/A , N/A ,$56.80 ,$148.75 ,$118.68 ,$91.70 ,$49.00 ,$157.50 ,$175.00 ,$54.10 ,$113.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,$593.00 ,$426.96 ,$166.04 ,$593.00 ,$385.45 ,$194.82 ,$166.04 ,$327.93 ,$194.82 ,$345.13 ,$194.82 ,$310.73 ,$194.82 ,$401.58 ,$545.56 ,$497.00 ,$194.82 ,$504.05 ,$533.70 ,$198.72 ,$444.75 ,$415.10 ,$415.10 ,$194.82 ,$415.10 ,$456.61 ,$456.61 ,$497.00 ,$504.05 ,$198.80 ,$198.80 ,$332.67 ,$245.50 ,$246.69 , N/A , N/A ,$204.57 ,$504.05 ,$427.42 ,$310.73 ,$166.04 ,$533.70 ,$559.00 ,$194.82 ,$385.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,$778.00 ,$560.16 ,$194.82 ,$778.00 ,$505.70 ,$194.82 ,$217.84 ,$430.23 ,$194.82 ,$452.80 ,$194.82 ,$407.67 ,$194.82 ,$401.58 ,$715.76 ,$497.00 ,$194.82 ,$661.30 ,$700.20 ,$198.72 ,$583.50 ,$544.60 ,$544.60 ,$194.82 ,$544.60 ,$599.06 ,$599.06 ,$497.00 ,$661.30 ,$198.80 ,$198.80 ,$436.46 ,$322.09 ,$323.65 , N/A , N/A ,$204.57 ,$661.30 ,$427.42 ,$407.67 ,$217.84 ,$700.20 ,$559.00 ,$194.82 ,$505.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,$879.00 ,$632.88 ,$194.82 ,$879.00 ,$571.35 ,$194.82 ,$246.12 ,$486.09 ,$194.82 ,$511.58 ,$194.82 ,$460.60 ,$194.82 ,$401.58 ,$808.68 ,$497.00 ,$194.82 ,$747.15 ,$791.10 ,$198.72 ,$659.25 ,$615.30 ,$615.30 ,$194.82 ,$615.30 ,$676.83 ,$676.83 ,$497.00 ,$747.15 ,$198.80 ,$198.80 ,$493.12 ,$363.91 ,$365.66 , N/A , N/A ,$204.57 ,$747.15 ,$427.42 ,$460.60 ,$246.12 ,$791.10 ,$559.00 ,$194.82 ,$571.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000338,30906,HC CONTROL NASAL HEMORRHAGE SUBSQ,450,1 ,$415.00 ,$298.80 ,$116.20 ,$498.97 ,$269.75 ,$195.60 ,$116.20 ,$229.50 ,$195.60 ,$241.53 ,$195.60 ,$217.46 ,$195.60 ,$403.17 ,$381.80 ,$498.97 ,$195.60 ,$352.75 ,$373.50 ,$199.51 ,$311.25 ,$290.50 ,$290.50 ,$195.60 ,$290.50 ,$319.55 ,$319.55 ,$415.00 ,$352.75 ,$199.59 ,$199.59 ,$232.82 ,$171.81 ,$172.64 , N/A , N/A ,$205.38 ,$352.75 ,$429.11 ,$217.46 ,$116.20 ,$373.50 ,$415.00 ,$195.60 ,$269.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000357,23650,HC TX DISL SHLDR W/MAN CLS-LT,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000358,23650,HC TX DISL SHLDR W/MAN CLS-RT,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000369,24640,HC DISLOCATION NURSEMAID ELBOW-LT,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000370,24640,HC DISLOCATION NURSEMAID ELBOW-RT,450,1 ,$576.00 ,$414.72 ,$161.28 ,$576.00 ,$374.40 ,$194.82 ,$161.28 ,$318.53 ,$194.82 ,$335.23 ,$194.82 ,$301.82 ,$194.82 ,$401.58 ,$529.92 ,$497.00 ,$194.82 ,$489.60 ,$518.40 ,$198.72 ,$432.00 ,$403.20 ,$403.20 ,$194.82 ,$403.20 ,$443.52 ,$443.52 ,$497.00 ,$489.60 ,$198.80 ,$198.80 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$204.57 ,$489.60 ,$427.42 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$194.82 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000387,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-LT,450,1 ,$529.00 ,$380.88 ,$148.12 ,$529.00 ,$343.85 ,$194.82 ,$148.12 ,$292.54 ,$194.82 ,$307.88 ,$194.82 ,$277.20 ,$194.82 ,$401.58 ,$486.68 ,$497.00 ,$194.82 ,$449.65 ,$476.10 ,$198.72 ,$396.75 ,$370.30 ,$370.30 ,$194.82 ,$370.30 ,$407.33 ,$407.33 ,$497.00 ,$449.65 ,$198.80 ,$198.80 ,$296.77 ,$219.01 ,$220.06 , N/A , N/A ,$204.57 ,$449.65 ,$427.42 ,$277.20 ,$148.12 ,$476.10 ,$529.00 ,$194.82 ,$343.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000388,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-RT,450,1 ,$529.00 ,$380.88 ,$148.12 ,$529.00 ,$343.85 ,$194.82 ,$148.12 ,$292.54 ,$194.82 ,$307.88 ,$194.82 ,$277.20 ,$194.82 ,$401.58 ,$486.68 ,$497.00 ,$194.82 ,$449.65 ,$476.10 ,$198.72 ,$396.75 ,$370.30 ,$370.30 ,$194.82 ,$370.30 ,$407.33 ,$407.33 ,$497.00 ,$449.65 ,$198.80 ,$198.80 ,$296.77 ,$219.01 ,$220.06 , N/A , N/A ,$204.57 ,$449.65 ,$427.42 ,$277.20 ,$148.12 ,$476.10 ,$529.00 ,$194.82 ,$343.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000389,27550,HC CLSD TX KNEE DISLOC W/O ANESTH-LT,450,1 ,$778.00 ,$560.16 ,$194.82 ,$778.00 ,$505.70 ,$194.82 ,$217.84 ,$430.23 ,$194.82 ,$452.80 ,$194.82 ,$407.67 ,$194.82 ,$401.58 ,$715.76 ,$497.00 ,$194.82 ,$661.30 ,$700.20 ,$198.72 ,$583.50 ,$544.60 ,$544.60 ,$194.82 ,$544.60 ,$599.06 ,$599.06 ,$497.00 ,$661.30 ,$198.80 ,$198.80 ,$436.46 ,$322.09 ,$323.65 , N/A , N/A ,$204.57 ,$661.30 ,$427.42 ,$407.67 ,$217.84 ,$700.20 ,$559.00 ,$194.82 ,$505.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000390,27550,HC CLSD TX KNEE DISLOC W/O ANESTH-RT,450,1 ,$778.00 ,$560.16 ,$194.82 ,$778.00 ,$505.70 ,$194.82 ,$217.84 ,$430.23 ,$194.82 ,$452.80 ,$194.82 ,$407.67 ,$194.82 ,$401.58 ,$715.76 ,$497.00 ,$194.82 ,$661.30 ,$700.20 ,$198.72 ,$583.50 ,$544.60 ,$544.60 ,$194.82 ,$544.60 ,$599.06 ,$599.06 ,$497.00 ,$661.30 ,$198.80 ,$198.80 ,$436.46 ,$322.09 ,$323.65 , N/A , N/A ,$204.57 ,$661.30 ,$427.42 ,$407.67 ,$217.84 ,$700.20 ,$559.00 ,$194.82 ,$505.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000500,57200,HC REPAIR SUTURE VAGINA COLPORRHAPHY,450,1 ,"$7,993.00 ","$5,754.96 ",$559.00 ,"$7,993.00 ","$5,195.45 ","$2,660.99 ","$2,238.04 ","$4,420.13 ","$2,660.99 ","$4,651.93 ","$2,660.99 ","$4,188.33 ","$2,660.99 ","$5,484.91 ","$7,353.56 ","$6,788.26 ","$2,660.99 ","$6,794.05 ","$7,193.70 ","$2,714.22 ","$5,994.75 ","$5,595.10 ","$5,595.10 ","$2,660.99 ","$5,595.10 ","$6,154.61 ","$6,154.61 ","$6,788.26 ","$6,794.05 ","$2,715.30 ","$2,715.30 ","$4,484.07 ","$3,309.10 ","$3,325.09 ", N/A , N/A ,"$2,794.05 ","$6,794.05 ","$5,837.90 ","$4,188.33 ","$2,238.04 ","$7,193.70 ",$559.00 ,"$2,660.99 ","$5,195.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000515,32551,HC TUBE THORACOSTOMY-BIL,450,1 ,"$2,895.00 ","$2,084.40 ",$559.00 ,"$7,152.06 ","$1,881.75 ","$2,803.60 ",$810.60 ,"$1,600.94 ","$2,803.60 ","$1,684.89 ","$2,803.60 ","$1,516.98 ","$2,803.60 ","$2,895.00 ","$2,663.40 ","$7,152.06 ","$2,803.60 ","$2,460.75 ","$2,605.50 ","$2,837.10 ","$2,171.25 ","$2,026.50 ","$2,026.50 ","$2,803.60 ","$2,026.50 ","$2,229.15 ","$2,229.15 ","$2,895.00 ","$2,460.75 ","$2,860.82 ","$2,860.82 ","$1,624.10 ","$1,198.53 ","$1,204.32 ", N/A , N/A ,"$2,943.78 ","$2,460.75 ","$6,150.77 ","$1,516.98 ",$810.60 ,"$2,605.50 ",$559.00 ,"$2,803.60 ","$1,881.75 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000517,24640,HC DISLOCATION NURSEMAID ELBOW-BIL,450,1 ,$576.00 ,$414.72 ,$161.28 ,$745.50 ,$374.40 ,$292.24 ,$161.28 ,$318.53 ,$292.24 ,$335.23 ,$292.24 ,$301.82 ,$292.24 ,$576.00 ,$529.92 ,$745.50 ,$292.24 ,$489.60 ,$518.40 ,$298.08 ,$432.00 ,$403.20 ,$403.20 ,$292.24 ,$403.20 ,$443.52 ,$443.52 ,$576.00 ,$489.60 ,$298.20 ,$298.20 ,$323.14 ,$238.46 ,$239.62 , N/A , N/A ,$306.85 ,$489.60 ,$641.13 ,$301.82 ,$161.28 ,$518.40 ,$559.00 ,$292.24 ,$374.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),45000561,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$2,939.00 ","$2,116.08 ",$559.00 ,"$2,939.00 ","$1,910.35 ",$610.77 ,$822.92 ,"$1,625.27 ",$610.77 ,"$1,710.50 ",$610.77 ,"$1,540.04 ",$610.77 ,"$1,258.93 ","$2,703.88 ","$1,558.08 ",$610.77 ,"$2,498.15 ","$2,645.10 ",$622.99 ,"$2,204.25 ","$2,057.30 ","$2,057.30 ",$610.77 ,"$2,057.30 ","$2,263.03 ","$2,263.03 ","$1,558.08 ","$2,498.15 ",$623.23 ,$623.23 ,"$1,648.78 ","$1,216.75 ","$1,222.62 ", N/A , N/A ,$641.30 ,"$2,498.15 ","$1,339.95 ","$1,540.04 ",$822.92 ,"$2,645.10 ",$559.00 ,$610.77 ,"$1,910.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45000562,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$2,939.00 ","$2,116.08 ",$559.00 ,"$2,939.00 ","$1,910.35 ",$610.77 ,$822.92 ,"$1,625.27 ",$610.77 ,"$1,710.50 ",$610.77 ,"$1,540.04 ",$610.77 ,"$1,258.93 ","$2,703.88 ","$1,558.08 ",$610.77 ,"$2,498.15 ","$2,645.10 ",$622.99 ,"$2,204.25 ","$2,057.30 ","$2,057.30 ",$610.77 ,"$2,057.30 ","$2,263.03 ","$2,263.03 ","$1,558.08 ","$2,498.15 ",$623.23 ,$623.23 ,"$1,648.78 ","$1,216.75 ","$1,222.62 ", N/A , N/A ,$641.30 ,"$2,498.15 ","$1,339.95 ","$1,540.04 ",$822.92 ,"$2,645.10 ",$559.00 ,$610.77 ,"$1,910.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45001168,52281,HC CYSTOURETHROSCOPY W/CALIBRATION/DILATION,450,1 ,"$5,455.00 ","$3,927.60 ",$559.00 ,"$5,455.00 ","$3,545.75 ","$1,745.69 ","$1,527.40 ","$3,016.62 ","$1,745.69 ","$3,174.81 ","$1,745.69 ","$2,858.42 ","$1,745.69 ","$3,598.26 ","$5,018.60 ","$4,453.29 ","$1,745.69 ","$4,636.75 ","$4,909.50 ","$1,780.60 ","$4,091.25 ","$3,818.50 ","$3,818.50 ","$1,745.69 ","$3,818.50 ","$4,200.35 ","$4,200.35 ","$4,453.29 ","$4,636.75 ","$1,781.32 ","$1,781.32 ","$3,060.26 ","$2,258.37 ","$2,269.28 ", N/A , N/A ,"$1,832.98 ","$4,636.75 ","$3,829.83 ","$2,858.42 ","$1,527.40 ","$4,909.50 ",$559.00 ,"$1,745.69 ","$3,545.75 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,"$1,737.00 ","$1,250.64 ",$486.36 ,"$3,444.07 ","$1,129.05 ","$1,350.08 ",$486.36 ,$960.56 ,"$1,350.08 ","$1,010.93 ","$1,350.08 ",$910.19 ,"$1,350.08 ","$1,737.00 ","$1,598.04 ","$3,444.07 ","$1,350.08 ","$1,476.45 ","$1,563.30 ","$1,377.08 ","$1,302.75 ","$1,215.90 ","$1,215.90 ","$1,350.08 ","$1,215.90 ","$1,337.49 ","$1,337.49 ","$1,737.00 ","$1,476.45 ","$1,377.63 ","$1,377.63 ",$974.46 ,$719.12 ,$722.59 , N/A , N/A ,"$1,417.58 ","$1,476.45 ","$2,961.90 ",$910.19 ,$486.36 ,"$1,563.30 ",$559.00 ,"$1,350.08 ","$1,129.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45001305,28435,HC TX FX CLOSED TALUS W/MANIP,450,1 ,"$4,244.00 ","$3,055.68 ",$559.00 ,"$4,244.00 ","$2,758.60 ","$1,350.08 ","$1,188.32 ","$2,346.93 ","$1,350.08 ","$2,470.01 ","$1,350.08 ","$2,223.86 ","$1,350.08 ","$2,782.81 ","$3,904.48 ","$3,444.07 ","$1,350.08 ","$3,607.40 ","$3,819.60 ","$1,377.08 ","$3,183.00 ","$2,970.80 ","$2,970.80 ","$1,350.08 ","$2,970.80 ","$3,267.88 ","$3,267.88 ","$3,444.07 ","$3,607.40 ","$1,377.63 ","$1,377.63 ","$2,380.88 ","$1,757.02 ","$1,765.50 ", N/A , N/A ,"$1,417.58 ","$3,607.40 ","$2,961.90 ","$2,223.86 ","$1,188.32 ","$3,819.60 ",$559.00 ,"$1,350.08 ","$2,758.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$833.00 ,$599.76 ,$202.22 ,$833.00 ,$541.45 ,$202.22 ,$233.24 ,$460.65 ,$202.22 ,$484.81 ,$202.22 ,$436.49 ,$202.22 ,$416.82 ,$766.36 ,$515.87 ,$202.22 ,$708.05 ,$749.70 ,$206.27 ,$624.75 ,$583.10 ,$583.10 ,$202.22 ,$583.10 ,$641.41 ,$641.41 ,$515.87 ,$708.05 ,$206.35 ,$206.35 ,$467.31 ,$344.86 ,$346.53 , N/A , N/A ,$212.34 ,$708.05 ,$443.65 ,$436.49 ,$233.24 ,$749.70 ,$559.00 ,$202.22 ,$541.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),45001350,P9612,HC STRAIGHT CATH FOR URINE SPECIMEN,450,1 ,$171.00 ,$123.12 ,$8.40 ,$171.00 ,$111.15 ,$8.40 ,$47.88 ,$94.56 ,$8.40 ,$99.52 ,$8.40 ,$89.60 ,$8.40 ,$17.31 ,$157.32 ,$21.43 ,$8.40 ,$145.35 ,$153.90 ,$8.57 ,$128.25 ,$119.70 ,$119.70 ,$8.40 ,$119.70 ,$131.67 ,$131.67 ,$21.43 ,$145.35 ,$8.57 ,$8.57 ,$95.93 ,$70.79 ,$71.14 , N/A , N/A ,$8.82 ,$145.35 ,$18.43 ,$89.60 ,$47.88 ,$153.90 ,$171.00 ,$8.40 ,$111.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),45001367,15853,HC REMOVAL SUTURES OR STAPLES NOT REQ ANESTH,450,1 ,$1.00 ,$0.72 ,$0.28 ,$1.00 ,$0.65 , N/A ,$0.28 ,$0.55 , N/A ,$0.58 , N/A ,$0.52 , N/A , N/A ,$0.92 , N/A , N/A ,$0.85 ,$0.90 , N/A ,$0.75 ,$0.70 ,$0.70 , N/A ,$0.70 ,$0.77 ,$0.77 , N/A ,$0.85 , N/A , N/A ,$0.56 ,$0.41 ,$0.42 , N/A , N/A , N/A ,$0.85 , N/A ,$0.52 ,$0.28 ,$0.90 ,$1.00 , N/A ,$0.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45001368,15854,HC REMOVAL SUTURES AND STAPLES NOT REQ ANESTH,450,1 ,$1.00 ,$0.72 ,$0.28 ,$1.00 ,$0.65 , N/A ,$0.28 ,$0.55 , N/A ,$0.58 , N/A ,$0.52 , N/A , N/A ,$0.92 , N/A , N/A ,$0.85 ,$0.90 , N/A ,$0.75 ,$0.70 ,$0.70 , N/A ,$0.70 ,$0.77 ,$0.77 , N/A ,$0.85 , N/A , N/A ,$0.56 ,$0.41 ,$0.42 , N/A , N/A , N/A ,$0.85 , N/A ,$0.52 ,$0.28 ,$0.90 ,$1.00 , N/A ,$0.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),45080001,10060,HC I AND D ABSC SMP,450,1 ,$555.00 ,$399.60 ,$155.40 ,$555.00 ,$360.75 ,$169.95 ,$155.40 ,$306.92 ,$169.95 ,$323.01 ,$169.95 ,$290.82 ,$169.95 ,$350.30 ,$510.60 ,$433.55 ,$169.95 ,$471.75 ,$499.50 ,$173.35 ,$416.25 ,$388.50 ,$388.50 ,$169.95 ,$388.50 ,$427.35 ,$427.35 ,$433.55 ,$471.75 ,$173.42 ,$173.42 ,$311.36 ,$229.77 ,$230.88 , N/A , N/A ,$178.45 ,$471.75 ,$372.85 ,$290.82 ,$155.40 ,$499.50 ,$555.00 ,$169.95 ,$360.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),45080003,59409,HC DELIVERY VAGINAL,450,1 ,"$5,645.00 ","$4,064.40 ",$559.00 ,"$6,788.26 ","$3,669.25 ","$2,660.99 ","$1,580.60 ","$3,121.69 ","$2,660.99 ","$3,285.39 ","$2,660.99 ","$2,957.98 ","$2,660.99 ","$5,484.91 ","$5,193.40 ","$6,788.26 ","$2,660.99 ","$4,798.25 ","$5,080.50 ","$2,714.22 ","$4,233.75 ","$3,951.50 ","$3,951.50 ","$2,660.99 ","$3,951.50 ","$4,346.65 ","$4,346.65 ","$5,645.00 ","$4,798.25 ","$2,715.30 ","$2,715.30 ","$3,166.85 ","$2,337.03 ","$2,348.32 ", N/A , N/A ,"$2,794.05 ","$4,798.25 ","$5,837.90 ","$2,957.98 ","$1,580.60 ","$5,080.50 ",$559.00 ,"$2,660.99 ","$3,669.25 " HSHS HOLY FAMILY HOSPITAL INC (ACU),45080004,23605,HC CLOSED RX PROX HUMERUS FX MANIP,450,1 ,"$4,396.00 ","$3,165.12 ",$559.00 ,"$4,396.00 ","$2,857.40 ","$1,350.08 ","$1,230.88 ","$2,430.99 ","$1,350.08 ","$2,558.47 ","$1,350.08 ","$2,303.50 ","$1,350.08 ","$2,782.81 ","$4,044.32 ","$3,444.07 ","$1,350.08 ","$3,736.60 ","$3,956.40 ","$1,377.08 ","$3,297.00 ","$3,077.20 ","$3,077.20 ","$1,350.08 ","$3,077.20 ","$3,384.92 ","$3,384.92 ","$3,444.07 ","$3,736.60 ","$1,377.63 ","$1,377.63 ","$2,466.16 ","$1,819.94 ","$1,828.74 ", N/A , N/A ,"$1,417.58 ","$3,736.60 ","$2,961.90 ","$2,303.50 ","$1,230.88 ","$3,956.40 ",$559.00 ,"$1,350.08 ","$2,857.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$291.00 ,$209.52 ,$52.85 ,$349.16 ,$189.15 ,$136.87 ,$81.48 ,$160.92 ,$136.87 ,$169.36 ,$136.87 ,$152.48 ,$136.87 ,$282.12 ,$267.72 ,$349.16 ,$136.87 ,$247.35 ,$261.90 ,$139.61 ,$218.25 ,$203.70 ,$203.70 ,$136.87 ,$203.70 ,$224.07 ,$224.07 ,$291.00 ,$247.35 ,$139.66 ,$139.66 ,$163.25 ,$120.47 ,$121.06 ,$53.42 ,$52.85 ,$143.71 ,$247.35 ,$300.27 ,$152.48 ,$81.48 ,$261.90 ,$291.00 ,$136.87 ,$189.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000004,94060,HC SPIROMETRY/PFT PRE AND POST,460,1 ,$486.00 ,$349.92 ,$52.85 ,$672.38 ,$315.90 ,$263.57 ,$136.08 ,$268.76 ,$263.57 ,$282.85 ,$263.57 ,$254.66 ,$263.57 ,$486.00 ,$447.12 ,$672.38 ,$263.57 ,$413.10 ,$437.40 ,$268.84 ,$364.50 ,$340.20 ,$340.20 ,$263.57 ,$340.20 ,$374.22 ,$374.22 ,$486.00 ,$413.10 ,$268.95 ,$268.95 ,$272.65 ,$201.20 ,$202.18 ,$53.42 ,$52.85 ,$276.75 ,$413.10 ,$578.25 ,$254.66 ,$136.08 ,$437.40 ,$314.00 ,$263.57 ,$315.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000005,94060,HC SPIROMETRY/PFT PRE AND POST UPDRAFT,460,1 ,$900.00 ,$648.00 ,$52.85 ,$900.00 ,$585.00 ,$263.57 ,$252.00 ,$497.70 ,$263.57 ,$523.80 ,$263.57 ,$471.60 ,$263.57 ,$543.28 ,$828.00 ,$672.38 ,$263.57 ,$765.00 ,$810.00 ,$268.84 ,$675.00 ,$630.00 ,$630.00 ,$263.57 ,$630.00 ,$693.00 ,$693.00 ,$672.38 ,$765.00 ,$268.95 ,$268.95 ,$504.90 ,$372.60 ,$374.40 ,$53.42 ,$52.85 ,$276.75 ,$765.00 ,$578.25 ,$471.60 ,$252.00 ,$810.00 ,$314.00 ,$263.57 ,$585.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$450.00 ,$324.00 ,$52.85 ,$672.38 ,$292.50 ,$263.57 ,$126.00 ,$248.85 ,$263.57 ,$261.90 ,$263.57 ,$235.80 ,$263.57 ,$450.00 ,$414.00 ,$672.38 ,$263.57 ,$382.50 ,$405.00 ,$268.84 ,$337.50 ,$315.00 ,$315.00 ,$263.57 ,$315.00 ,$346.50 ,$346.50 ,$450.00 ,$382.50 ,$268.95 ,$268.95 ,$252.45 ,$186.30 ,$187.20 ,$53.42 ,$52.85 ,$276.75 ,$382.50 ,$578.25 ,$235.80 ,$126.00 ,$405.00 ,$314.00 ,$263.57 ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000014,94618,HC WALK TEST 6 MIN,460,1 ,$355.00 ,$255.60 ,$99.40 ,$355.00 ,$230.75 ,$109.28 ,$99.40 ,$196.32 ,$109.28 ,$206.61 ,$109.28 ,$186.02 ,$109.28 ,$225.24 ,$326.60 ,$278.76 ,$109.28 ,$301.75 ,$319.50 ,$111.47 ,$266.25 ,$248.50 ,$248.50 ,$109.28 ,$248.50 ,$273.35 ,$273.35 ,$278.76 ,$301.75 ,$111.51 ,$111.51 ,$199.16 ,$146.97 ,$147.68 ,$163.25 ,$161.48 ,$114.75 ,$301.75 ,$239.74 ,$186.02 ,$99.40 ,$319.50 ,$314.00 ,$109.28 ,$230.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$450.00 ,$324.00 ,$52.85 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$186.30 ,$187.20 ,$53.42 ,$52.85 , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 ,$314.00 , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000021,94760,HC PULSE OX SINGLE,460,1 ,$57.00 ,$41.04 ,$15.96 ,$57.00 ,$37.05 , N/A ,$15.96 ,$31.52 , N/A ,$33.17 , N/A ,$29.87 , N/A , N/A ,$52.44 , N/A , N/A ,$48.45 ,$51.30 , N/A ,$42.75 ,$39.90 ,$39.90 , N/A ,$39.90 ,$43.89 ,$43.89 , N/A ,$48.45 , N/A , N/A ,$31.98 ,$23.60 ,$23.71 , N/A , N/A , N/A ,$48.45 , N/A ,$29.87 ,$15.96 ,$51.30 ,$57.00 , N/A ,$37.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000022,94200,HC MAXIMAL VOL VENTILATION,942,1 ,$163.00 ,$117.36 ,$45.64 ,$163.00 ,$105.95 ,$54.10 ,$45.64 ,$90.14 ,$54.10 ,$94.87 ,$54.10 ,$85.41 ,$54.10 ,$111.50 ,$149.96 ,$138.00 ,$54.10 ,$138.55 ,$146.70 ,$55.17 ,$122.25 ,$114.10 ,$114.10 ,$54.10 ,$114.10 ,$125.51 ,$125.51 ,$138.00 ,$138.55 ,$55.20 ,$55.20 ,$91.44 ,$67.48 ,$67.81 , N/A , N/A ,$56.80 ,$138.55 ,$118.68 ,$85.41 ,$45.64 ,$146.70 ,$101.00 ,$54.10 ,$105.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),46000023,94761,HC PULSE OX MULTI DETERMIN,360,1 ,$133.00 ,$95.76 ,$37.24 ,$133.00 ,$86.45 , N/A ,$37.24 ,$73.55 , N/A ,$77.41 , N/A ,$69.69 , N/A , N/A ,$122.36 , N/A , N/A ,$113.05 ,$119.70 , N/A ,$99.75 ,$93.10 ,$93.10 , N/A ,$93.10 ,$102.41 ,$102.41 , N/A ,$113.05 , N/A , N/A ,$74.61 ,$55.06 ,$55.33 , N/A , N/A , N/A ,$113.05 , N/A ,$69.69 ,$37.24 ,$119.70 , N/A , N/A ,$86.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$1,737.00 ","$1,250.64 ",$430.57 ,"$1,737.00 ","$1,129.05 ",$553.51 ,$486.36 ,$960.56 ,$553.51 ,"$1,010.93 ",$553.51 ,$910.19 ,$553.51 ,"$1,140.93 ","$1,598.04 ","$1,412.04 ",$553.51 ,"$1,476.45 ","$1,563.30 ",$564.59 ,"$1,302.75 ","$1,215.90 ","$1,215.90 ",$553.51 ,"$1,215.90 ","$1,337.49 ","$1,337.49 ","$1,412.04 ","$1,476.45 ",$564.81 ,$564.81 ,$974.46 ,$719.12 ,$722.59 ,$435.29 ,$430.57 ,$581.19 ,"$1,476.45 ","$1,214.35 ",$910.19 ,$486.36 ,"$1,563.30 ","$1,649.00 ",$553.51 ,"$1,129.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),48000024,93668,HC PAD REHAB PER SESSION,480,1 ,$178.00 ,$128.16 ,$49.84 ,$178.00 ,$115.70 ,$54.10 ,$49.84 ,$98.43 ,$54.10 ,$103.60 ,$54.10 ,$93.27 ,$54.10 ,$111.50 ,$163.76 ,$138.00 ,$54.10 ,$151.30 ,$160.20 ,$55.17 ,$133.50 ,$124.60 ,$124.60 ,$54.10 ,$124.60 ,$137.06 ,$137.06 ,$138.00 ,$151.30 ,$55.20 ,$55.20 ,$99.86 ,$73.69 ,$74.05 ,$171.77 ,$178.00 ,$56.80 ,$151.30 ,$118.68 ,$93.27 ,$49.84 ,$160.20 ,$178.00 ,$54.10 ,$115.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,059.00 ",$762.48 ,$215.72 ,"$1,059.00 ",$688.35 ,$263.57 ,$296.52 ,$585.63 ,$263.57 ,$616.34 ,$263.57 ,$554.92 ,$263.57 ,$543.28 ,$974.28 ,$672.38 ,$263.57 ,$900.15 ,$953.10 ,$268.84 ,$794.25 ,$741.30 ,$741.30 ,$263.57 ,$741.30 ,$815.43 ,$815.43 ,$672.38 ,$900.15 ,$268.95 ,$268.95 ,$594.10 ,$438.43 ,$440.54 ,$218.09 ,$215.72 ,$276.75 ,$900.15 ,$578.25 ,$554.92 ,$296.52 ,$953.10 ,"$1,011.00 ",$263.57 ,$688.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$2,642.00 ","$1,902.24 ",$342.86 ,"$2,642.00 ","$1,717.30 ",$473.52 ,$739.76 ,"$1,461.03 ",$473.52 ,"$1,537.64 ",$473.52 ,"$1,384.41 ",$473.52 ,$976.02 ,"$2,430.64 ","$1,207.94 ",$473.52 ,"$2,245.70 ","$2,377.80 ",$482.98 ,"$1,981.50 ","$1,849.40 ","$1,849.40 ",$473.52 ,"$1,849.40 ","$2,034.34 ","$2,034.34 ","$1,207.94 ","$2,245.70 ",$483.18 ,$483.18 ,"$1,482.16 ","$1,093.79 ","$1,099.07 ",$346.61 ,$342.86 ,$497.19 ,"$2,245.70 ","$1,038.83 ","$1,384.41 ",$739.76 ,"$2,377.80 ",$426.00 ,$473.52 ,"$1,717.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),48300001,93307,HC ECHOCARDIOGRAM 2D W/O DOP,483,1 ,$675.00 ,$486.00 ,$189.00 ,$675.00 ,$438.75 ,$219.77 ,$189.00 ,$373.28 ,$219.77 ,$392.85 ,$219.77 ,$353.70 ,$219.77 ,$453.00 ,$621.00 ,$560.65 ,$219.77 ,$573.75 ,$607.50 ,$224.17 ,$506.25 ,$472.50 ,$472.50 ,$219.77 ,$472.50 ,$519.75 ,$519.75 ,$560.65 ,$573.75 ,$224.26 ,$224.26 ,$378.68 ,$279.45 ,$280.80 ,$346.61 ,$342.86 ,$230.76 ,$573.75 ,$482.16 ,$353.70 ,$189.00 ,$607.50 ,$426.00 ,$219.77 ,$438.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$480.00 ,$345.60 ,$134.40 ,$560.65 ,$312.00 ,$219.77 ,$134.40 ,$265.44 ,$219.77 ,$279.36 ,$219.77 ,$251.52 ,$219.77 ,$453.00 ,$441.60 ,$560.65 ,$219.77 ,$408.00 ,$432.00 ,$224.17 ,$360.00 ,$336.00 ,$336.00 ,$219.77 ,$336.00 ,$369.60 ,$369.60 ,$480.00 ,$408.00 ,$224.26 ,$224.26 ,$269.28 ,$198.72 ,$199.68 ,$346.61 ,$342.86 ,$230.76 ,$408.00 ,$482.16 ,$251.52 ,$134.40 ,$432.00 ,$426.00 ,$219.77 ,$312.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300005,93320,HC ECHO DOPPLER,483,1 ,$994.00 ,$715.68 ,$278.32 ,$994.00 ,$646.10 , N/A ,$278.32 ,$549.68 , N/A ,$578.51 , N/A ,$520.86 , N/A , N/A ,$914.48 , N/A , N/A ,$844.90 ,$894.60 , N/A ,$745.50 ,$695.80 ,$695.80 , N/A ,$695.80 ,$765.38 ,$765.38 , N/A ,$844.90 , N/A , N/A ,$557.63 ,$411.52 ,$413.50 ,$346.61 ,$342.86 , N/A ,$844.90 , N/A ,$520.86 ,$278.32 ,$894.60 ,$426.00 , N/A ,$646.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$797.00 ,$573.84 ,$223.16 ,$797.00 ,$518.05 , N/A ,$223.16 ,$440.74 , N/A ,$463.85 , N/A ,$417.63 , N/A , N/A ,$733.24 , N/A , N/A ,$677.45 ,$717.30 , N/A ,$597.75 ,$557.90 ,$557.90 , N/A ,$557.90 ,$613.69 ,$613.69 , N/A ,$677.45 , N/A , N/A ,$447.12 ,$329.96 ,$331.55 ,$346.61 ,$342.86 , N/A ,$677.45 , N/A ,$417.63 ,$223.16 ,$717.30 ,$426.00 , N/A ,$518.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300007,93350,HC ECHO REST AND STRESS W/PF,483,1 ,"$1,833.00 ","$1,319.76 ",$342.86 ,"$1,833.00 ","$1,191.45 ",$473.52 ,$513.24 ,"$1,013.65 ",$473.52 ,"$1,066.81 ",$473.52 ,$960.49 ,$473.52 ,$976.02 ,"$1,686.36 ","$1,207.94 ",$473.52 ,"$1,558.05 ","$1,649.70 ",$482.98 ,"$1,374.75 ","$1,283.10 ","$1,283.10 ",$473.52 ,"$1,283.10 ","$1,411.41 ","$1,411.41 ","$1,207.94 ","$1,558.05 ",$483.18 ,$483.18 ,"$1,028.31 ",$758.86 ,$762.53 ,$346.61 ,$342.86 ,$497.19 ,"$1,558.05 ","$1,038.83 ",$960.49 ,$513.24 ,"$1,649.70 ",$426.00 ,$473.52 ,"$1,191.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),48300008,93303,HC ECHO PEDS CONGENITAL,483,1 ,"$1,416.00 ","$1,019.52 ",$342.86 ,"$1,416.00 ",$920.40 ,$473.52 ,$396.48 ,$783.05 ,$473.52 ,$824.11 ,$473.52 ,$741.98 ,$473.52 ,$976.02 ,"$1,302.72 ","$1,207.94 ",$473.52 ,"$1,203.60 ","$1,274.40 ",$482.98 ,"$1,062.00 ",$991.20 ,$991.20 ,$473.52 ,$991.20 ,"$1,090.32 ","$1,090.32 ","$1,207.94 ","$1,203.60 ",$483.18 ,$483.18 ,$794.38 ,$586.22 ,$589.06 ,$346.61 ,$342.86 ,$497.19 ,"$1,203.60 ","$1,038.83 ",$741.98 ,$396.48 ,"$1,274.40 ",$426.00 ,$473.52 ,$920.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300009,93304,HC ECHO PEDS CONGENITAL LMTD,483,1 ,"$1,416.00 ","$1,019.52 ",$342.86 ,"$1,416.00 ",$920.40 ,$473.52 ,$396.48 ,$783.05 ,$473.52 ,$824.11 ,$473.52 ,$741.98 ,$473.52 ,$976.02 ,"$1,302.72 ","$1,207.94 ",$473.52 ,"$1,203.60 ","$1,274.40 ",$482.98 ,"$1,062.00 ",$991.20 ,$991.20 ,$473.52 ,$991.20 ,"$1,090.32 ","$1,090.32 ","$1,207.94 ","$1,203.60 ",$483.18 ,$483.18 ,$794.38 ,$586.22 ,$589.06 ,$346.61 ,$342.86 ,$497.19 ,"$1,203.60 ","$1,038.83 ",$741.98 ,$396.48 ,"$1,274.40 ",$426.00 ,$473.52 ,$920.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$611.00 ,$439.92 ,$171.08 ,$611.00 ,$397.15 , N/A ,$171.08 ,$337.88 , N/A ,$355.60 , N/A ,$320.16 , N/A , N/A ,$562.12 , N/A , N/A ,$519.35 ,$549.90 , N/A ,$458.25 ,$427.70 ,$427.70 , N/A ,$427.70 ,$470.47 ,$470.47 , N/A ,$519.35 , N/A , N/A ,$342.77 ,$252.95 ,$254.18 ,$346.61 ,$342.86 , N/A ,$519.35 , N/A ,$320.16 ,$171.08 ,$549.90 ,$426.00 , N/A ,$397.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300011,93351,HC ECHO 2D STRESS CONT MONITORING,483,1 ,"$1,416.00 ","$1,019.52 ",$342.86 ,"$1,416.00 ",$920.40 ,$473.52 ,$396.48 ,$783.05 ,$473.52 ,$824.11 ,$473.52 ,$741.98 ,$473.52 ,$976.02 ,"$1,302.72 ","$1,207.94 ",$473.52 ,"$1,203.60 ","$1,274.40 ",$482.98 ,"$1,062.00 ",$991.20 ,$991.20 ,$473.52 ,$991.20 ,"$1,090.32 ","$1,090.32 ","$1,207.94 ","$1,203.60 ",$483.18 ,$483.18 ,$794.38 ,$586.22 ,$589.06 ,$346.61 ,$342.86 ,$497.19 ,"$1,203.60 ","$1,038.83 ",$741.98 ,$396.48 ,"$1,274.40 ",$426.00 ,$473.52 ,$920.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300016,C8924,HC ECHO TTE W/W/O CONT AND W/CONT LIMIT,483,1 ,"$1,229.00 ",$884.88 ,$342.86 ,"$1,229.00 ",$798.85 ,$346.74 ,$344.12 ,$679.64 ,$346.74 ,$715.28 ,$346.74 ,$644.00 ,$346.74 ,$714.71 ,"$1,130.68 ",$884.55 ,$346.74 ,"$1,044.65 ","$1,106.10 ",$353.67 ,$921.75 ,$860.30 ,$860.30 ,$346.74 ,$860.30 ,$946.33 ,$946.33 ,$884.55 ,"$1,044.65 ",$353.82 ,$353.82 ,$689.47 ,$508.81 ,$511.26 ,$346.61 ,$342.86 ,$364.08 ,"$1,044.65 ",$760.71 ,$644.00 ,$344.12 ,"$1,106.10 ",$426.00 ,$346.74 ,$798.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$2,097.00 ","$1,509.84 ",$342.86 ,"$2,097.00 ","$1,363.05 ",$697.14 ,$587.16 ,"$1,159.64 ",$697.14 ,"$1,220.45 ",$697.14 ,"$1,098.83 ",$697.14 ,"$1,436.97 ","$1,929.24 ","$1,778.43 ",$697.14 ,"$1,782.45 ","$1,887.30 ",$711.09 ,"$1,572.75 ","$1,467.90 ","$1,467.90 ",$697.14 ,"$1,467.90 ","$1,614.69 ","$1,614.69 ","$1,778.43 ","$1,782.45 ",$711.37 ,$711.37 ,"$1,176.42 ",$868.16 ,$872.35 ,$346.61 ,$342.86 ,$732.00 ,"$1,782.45 ","$1,529.45 ","$1,098.83 ",$587.16 ,"$1,887.30 ",$426.00 ,$697.14 ,"$1,363.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT AND W/CONT,483,1 ,"$4,002.00 ","$2,881.44 ",$342.86 ,"$4,002.00 ","$2,601.30 ",$697.14 ,"$1,120.56 ","$2,213.11 ",$697.14 ,"$2,329.16 ",$697.14 ,"$2,097.05 ",$697.14 ,"$1,436.97 ","$3,681.84 ","$1,778.43 ",$697.14 ,"$3,401.70 ","$3,601.80 ",$711.09 ,"$3,001.50 ","$2,801.40 ","$2,801.40 ",$697.14 ,"$2,801.40 ","$3,081.54 ","$3,081.54 ","$1,778.43 ","$3,401.70 ",$711.37 ,$711.37 ,"$2,245.12 ","$1,656.83 ","$1,664.83 ",$346.61 ,$342.86 ,$732.00 ,"$3,401.70 ","$1,529.45 ","$2,097.05 ","$1,120.56 ","$3,601.80 ",$426.00 ,$697.14 ,"$2,601.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),48300020,C8930,HC ECHO TTE 2D REST/STRESS W/W/O CONT AND W/CONT W/PF,483,1 ,"$2,097.00 ","$1,509.84 ",$342.86 ,"$2,097.00 ","$1,363.05 ",$697.14 ,$587.16 ,"$1,159.64 ",$697.14 ,"$1,220.45 ",$697.14 ,"$1,098.83 ",$697.14 ,"$1,436.97 ","$1,929.24 ","$1,778.43 ",$697.14 ,"$1,782.45 ","$1,887.30 ",$711.09 ,"$1,572.75 ","$1,467.90 ","$1,467.90 ",$697.14 ,"$1,467.90 ","$1,614.69 ","$1,614.69 ","$1,778.43 ","$1,782.45 ",$711.37 ,$711.37 ,"$1,176.42 ",$868.16 ,$872.35 ,$346.61 ,$342.86 ,$732.00 ,"$1,782.45 ","$1,529.45 ","$1,098.83 ",$587.16 ,"$1,887.30 ",$426.00 ,$697.14 ,"$1,363.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),51000002,95117,HC ALLERGY SHOTS 2 OR MORE,510,1 ,$196.00 ,$141.12 ,$17.37 ,$196.00 ,$127.40 ,$39.88 ,$54.88 ,$108.39 ,$39.88 ,$114.07 ,$39.88 ,$102.70 ,$39.88 ,$82.19 ,$180.32 ,$101.72 ,$39.88 ,$166.60 ,$176.40 ,$40.67 ,$147.00 ,$137.20 ,$137.20 ,$39.88 ,$137.20 ,$150.92 ,$150.92 ,$101.72 ,$166.60 ,$40.69 ,$40.69 ,$109.96 ,$81.14 ,$81.54 ,$17.55 ,$17.37 ,$41.87 ,$166.60 ,$87.48 ,$102.70 ,$54.88 ,$176.40 ,$133.00 ,$39.88 ,$127.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$843.00 ,$606.96 ,$84.39 ,$843.00 ,$547.95 ,$313.04 ,$236.04 ,$466.18 ,$313.04 ,$490.63 ,$313.04 ,$441.73 ,$313.04 ,$645.25 ,$775.56 ,$798.57 ,$313.04 ,$716.55 ,$758.70 ,$319.30 ,$632.25 ,$590.10 ,$590.10 ,$313.04 ,$590.10 ,$649.11 ,$649.11 ,$798.57 ,$716.55 ,$319.43 ,$319.43 ,$472.92 ,$349.00 ,$350.69 ,$85.32 ,$84.39 ,$328.69 ,$716.55 ,$686.77 ,$441.73 ,$236.04 ,$758.70 ,$133.00 ,$313.04 ,$547.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$136.00 ,$97.92 ,$38.08 ,$161.99 ,$88.40 ,$63.49 ,$38.08 ,$75.21 ,$63.49 ,$79.15 ,$63.49 ,$71.26 ,$63.49 ,$130.88 , N/A ,$161.99 ,$63.49 ,$115.60 ,$122.40 ,$64.77 ,$102.00 ,$95.20 ,$95.20 ,$63.49 ,$95.20 ,$104.72 ,$104.72 ,$136.00 ,$115.60 ,$64.79 ,$64.79 ,$76.30 ,$56.30 ,$56.58 , N/A , N/A ,$66.67 ,$115.60 ,$139.31 ,$71.26 ,$38.08 ,$122.40 ,$71.81 ,$63.49 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$294.00 ,$211.68 ,$82.32 ,$495.94 ,$191.10 ,$194.41 ,$82.32 ,$162.58 ,$194.41 ,$171.11 ,$194.41 ,$154.06 ,$194.41 ,$294.00 , N/A ,$495.94 ,$194.41 ,$249.90 ,$264.60 ,$198.29 ,$220.50 ,$205.80 ,$205.80 ,$194.41 ,$205.80 ,$226.38 ,$226.38 ,$294.00 ,$249.90 ,$198.38 ,$198.38 ,$164.93 ,$121.72 ,$122.30 , N/A , N/A ,$204.13 ,$249.90 ,$426.51 ,$154.06 ,$82.32 ,$264.60 ,$155.23 ,$194.41 ,$191.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$177.00 ,$127.44 ,$39.88 ,$177.00 ,$115.05 ,$39.88 ,$49.56 ,$97.88 ,$39.88 ,$103.01 ,$39.88 ,$92.75 ,$39.88 ,$82.19 , N/A ,$101.72 ,$39.88 ,$150.45 ,$159.30 ,$40.67 ,$132.75 ,$123.90 ,$123.90 ,$39.88 ,$123.90 ,$136.29 ,$136.29 ,$101.72 ,$150.45 ,$40.69 ,$40.69 ,$99.30 ,$73.28 ,$73.63 , N/A , N/A ,$41.87 ,$150.45 ,$87.48 ,$92.75 ,$49.56 ,$159.30 ,$93.46 ,$39.88 ,$115.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$177.00 ,$127.44 ,$49.56 ,$177.00 ,$115.05 , N/A ,$49.56 ,$97.88 , N/A ,$103.01 , N/A ,$92.75 , N/A , N/A , N/A , N/A , N/A ,$150.45 ,$159.30 , N/A ,$132.75 ,$123.90 ,$123.90 , N/A ,$123.90 ,$136.29 ,$136.29 , N/A ,$150.45 , N/A , N/A ,$99.30 ,$73.28 ,$73.63 , N/A , N/A , N/A ,$150.45 , N/A ,$92.75 ,$49.56 ,$159.30 ,$93.46 , N/A ,$115.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$166.00 ,$119.52 ,$46.48 ,$166.00 ,$107.90 ,$54.10 ,$46.48 ,$91.80 ,$54.10 ,$96.61 ,$54.10 ,$86.98 ,$54.10 ,$111.50 , N/A ,$138.00 ,$54.10 ,$141.10 ,$149.40 ,$55.17 ,$124.50 ,$116.20 ,$116.20 ,$54.10 ,$116.20 ,$127.82 ,$127.82 ,$138.00 ,$141.10 ,$55.20 ,$55.20 ,$93.13 ,$68.72 ,$69.06 ,$85.32 ,$84.39 ,$56.80 ,$141.10 ,$118.68 ,$86.98 ,$46.48 ,$149.40 ,$133.00 ,$54.10 ,$107.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$249.00 ,$179.28 ,$69.72 ,$249.00 ,$161.85 , N/A ,$69.72 ,$137.70 , N/A ,$144.92 , N/A ,$130.48 , N/A , N/A ,$229.08 , N/A , N/A ,$211.65 ,$224.10 , N/A ,$186.75 ,$174.30 ,$174.30 , N/A ,$174.30 ,$191.73 ,$191.73 , N/A ,$211.65 , N/A , N/A ,$139.69 ,$103.09 ,$103.58 ,$100.44 ,$99.35 , N/A ,$211.65 , N/A ,$130.48 ,$69.72 ,$224.10 ,$133.00 , N/A ,$161.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$215.00 ,$154.80 ,$60.20 ,$278.76 ,$139.75 ,$109.28 ,$60.20 ,$118.90 ,$109.28 ,$125.13 ,$109.28 ,$112.66 ,$109.28 ,$215.00 ,$197.80 ,$278.76 ,$109.28 ,$182.75 ,$193.50 ,$111.47 ,$161.25 ,$150.50 ,$150.50 ,$109.28 ,$150.50 ,$165.55 ,$165.55 ,$215.00 ,$182.75 ,$111.51 ,$111.51 ,$120.62 ,$89.01 ,$89.44 ,$85.32 ,$84.39 ,$114.75 ,$182.75 ,$239.74 ,$112.66 ,$60.20 ,$193.50 ,$133.00 ,$109.28 ,$139.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000172,51702,HC CATH BLADDER SMP,510,1 ,$327.00 ,$235.44 ,$84.39 ,$327.00 ,$212.55 ,$109.28 ,$91.56 ,$180.83 ,$109.28 ,$190.31 ,$109.28 ,$171.35 ,$109.28 ,$225.24 ,$300.84 ,$278.76 ,$109.28 ,$277.95 ,$294.30 ,$111.47 ,$245.25 ,$228.90 ,$228.90 ,$109.28 ,$228.90 ,$251.79 ,$251.79 ,$278.76 ,$277.95 ,$111.51 ,$111.51 ,$183.45 ,$135.38 ,$136.03 ,$85.32 ,$84.39 ,$114.75 ,$277.95 ,$239.74 ,$171.35 ,$91.56 ,$294.30 ,$133.00 ,$109.28 ,$212.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000173,51703,HC CATH BLADDER CPLX,510,1 ,$413.00 ,$297.36 ,$84.39 ,$413.00 ,$268.45 ,$136.87 ,$115.64 ,$228.39 ,$136.87 ,$240.37 ,$136.87 ,$216.41 ,$136.87 ,$282.12 ,$379.96 ,$349.16 ,$136.87 ,$351.05 ,$371.70 ,$139.61 ,$309.75 ,$289.10 ,$289.10 ,$136.87 ,$289.10 ,$318.01 ,$318.01 ,$349.16 ,$351.05 ,$139.66 ,$139.66 ,$231.69 ,$170.98 ,$171.81 ,$85.32 ,$84.39 ,$143.71 ,$351.05 ,$300.27 ,$216.41 ,$115.64 ,$371.70 ,$133.00 ,$136.87 ,$268.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),51000481,98925,HC OSTEOPATHIC MAN 1-2 REGIONS,510,1 ,$81.00 ,$58.32 ,$22.68 ,$81.00 ,$52.65 ,$23.51 ,$22.68 ,$44.79 ,$23.51 ,$47.14 ,$23.51 ,$42.44 ,$23.51 ,$48.46 ,$74.52 ,$59.97 ,$23.51 ,$68.85 ,$72.90 ,$23.98 ,$60.75 ,$56.70 ,$56.70 ,$23.51 ,$56.70 ,$62.37 ,$62.37 ,$59.97 ,$68.85 ,$23.99 ,$23.99 ,$45.44 ,$33.53 ,$33.70 ,$33.13 ,$32.77 ,$24.69 ,$68.85 ,$51.58 ,$42.44 ,$22.68 ,$72.90 ,$81.00 ,$23.51 ,$52.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),51001012,95115,HC ALLERGY SHOTS ONE INJECTION,510,1 ,$125.00 ,$90.00 ,$17.37 ,$125.00 ,$81.25 ,$39.88 ,$35.00 ,$69.13 ,$39.88 ,$72.75 ,$39.88 ,$65.50 ,$39.88 ,$82.19 ,$115.00 ,$101.72 ,$39.88 ,$106.25 ,$112.50 ,$40.67 ,$93.75 ,$87.50 ,$87.50 ,$39.88 ,$87.50 ,$96.25 ,$96.25 ,$101.72 ,$106.25 ,$40.69 ,$40.69 ,$70.13 ,$51.75 ,$52.00 ,$17.55 ,$17.37 ,$41.87 ,$106.25 ,$87.48 ,$65.50 ,$35.00 ,$112.50 ,$125.00 ,$39.88 ,$81.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),51070001,98960,HC EDUCATION SELF MGNT NON PHY HLTCARE PROF,510,1 ,$144.00 ,$103.68 ,$25.50 ,$144.00 ,$93.60 , N/A ,$40.32 ,$79.63 , N/A ,$83.81 , N/A ,$75.46 , N/A , N/A ,$132.48 , N/A , N/A ,$122.40 ,$129.60 , N/A ,$108.00 ,$100.80 ,$100.80 , N/A ,$100.80 ,$110.88 ,$110.88 , N/A ,$122.40 , N/A , N/A ,$80.78 ,$59.62 ,$59.90 ,$25.78 ,$25.50 , N/A ,$122.40 , N/A ,$75.46 ,$40.32 ,$129.60 ,$133.00 , N/A ,$93.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$4,872.00 ","$3,507.84 ",$244.82 ,"$4,872.00 ","$3,166.80 ",$346.74 ,"$1,364.16 ","$2,694.22 ",$346.74 ,"$2,835.50 ",$346.74 ,"$2,552.93 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,141.20 ","$4,384.80 ",$353.67 ,"$3,654.00 ","$3,410.40 ","$3,410.40 ",$346.74 ,"$3,410.40 ","$3,751.44 ","$3,751.44 ",$884.55 ,"$4,141.20 ",$353.82 ,$353.82 ,"$2,733.19 ","$2,017.01 ","$2,026.75 ",$247.50 ,$244.82 ,$364.08 ,"$4,141.20 ",$760.71 ,"$2,552.93 ","$1,364.16 ","$4,384.80 ","$1,490.00 ",$346.74 ,"$3,166.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$3,339.00 ","$2,404.08 ",$219.77 ,"$3,339.00 ","$2,170.35 ",$219.77 ,$934.92 ,"$1,846.47 ",$219.77 ,"$1,943.30 ",$219.77 ,"$1,749.64 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,838.15 ","$3,005.10 ",$224.17 ,"$2,504.25 ","$2,337.30 ","$2,337.30 ",$219.77 ,"$2,337.30 ","$2,571.03 ","$2,571.03 ",$560.65 ,"$2,838.15 ",$224.26 ,$224.26 ,"$1,873.18 ","$1,382.35 ","$1,389.02 ",$303.01 ,$299.72 ,$230.76 ,"$2,838.15 ",$482.16 ,"$1,749.64 ",$934.92 ,"$3,005.10 ","$1,490.00 ",$219.77 ,"$2,170.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$3,976.00 ","$2,862.72 ",$299.72 ,"$3,976.00 ","$2,584.40 ",$346.74 ,"$1,113.28 ","$2,198.73 ",$346.74 ,"$2,314.03 ",$346.74 ,"$2,083.42 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,379.60 ","$3,578.40 ",$353.67 ,"$2,982.00 ","$2,783.20 ","$2,783.20 ",$346.74 ,"$2,783.20 ","$3,061.52 ","$3,061.52 ",$884.55 ,"$3,379.60 ",$353.82 ,$353.82 ,"$2,230.54 ","$1,646.06 ","$1,654.02 ",$303.01 ,$299.72 ,$364.08 ,"$3,379.60 ",$760.71 ,"$2,083.42 ","$1,113.28 ","$3,578.40 ","$1,490.00 ",$346.74 ,"$2,584.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$4,872.00 ","$3,507.84 ",$299.72 ,"$4,872.00 ","$3,166.80 ",$346.74 ,"$1,364.16 ","$2,694.22 ",$346.74 ,"$2,835.50 ",$346.74 ,"$2,552.93 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,141.20 ","$4,384.80 ",$353.67 ,"$3,654.00 ","$3,410.40 ","$3,410.40 ",$346.74 ,"$3,410.40 ","$3,751.44 ","$3,751.44 ",$884.55 ,"$4,141.20 ",$353.82 ,$353.82 ,"$2,733.19 ","$2,017.01 ","$2,026.75 ",$303.01 ,$299.72 ,$364.08 ,"$4,141.20 ",$760.71 ,"$2,552.93 ","$1,364.16 ","$4,384.80 ","$1,490.00 ",$346.74 ,"$3,166.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$3,339.00 ","$2,404.08 ",$219.77 ,"$3,339.00 ","$2,170.35 ",$219.77 ,$934.92 ,"$1,846.47 ",$219.77 ,"$1,943.30 ",$219.77 ,"$1,749.64 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,838.15 ","$3,005.10 ",$224.17 ,"$2,504.25 ","$2,337.30 ","$2,337.30 ",$219.77 ,"$2,337.30 ","$2,571.03 ","$2,571.03 ",$560.65 ,"$2,838.15 ",$224.26 ,$224.26 ,"$1,873.18 ","$1,382.35 ","$1,389.02 ",$303.01 ,$299.72 ,$230.76 ,"$2,838.15 ",$482.16 ,"$1,749.64 ",$934.92 ,"$3,005.10 ","$1,490.00 ",$219.77 ,"$2,170.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$3,976.00 ","$2,862.72 ",$299.72 ,"$3,976.00 ","$2,584.40 ",$346.74 ,"$1,113.28 ","$2,198.73 ",$346.74 ,"$2,314.03 ",$346.74 ,"$2,083.42 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,379.60 ","$3,578.40 ",$353.67 ,"$2,982.00 ","$2,783.20 ","$2,783.20 ",$346.74 ,"$2,783.20 ","$3,061.52 ","$3,061.52 ",$884.55 ,"$3,379.60 ",$353.82 ,$353.82 ,"$2,230.54 ","$1,646.06 ","$1,654.02 ",$303.01 ,$299.72 ,$364.08 ,"$3,379.60 ",$760.71 ,"$2,083.42 ","$1,113.28 ","$3,578.40 ","$1,490.00 ",$346.74 ,"$2,584.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$4,872.00 ","$3,507.84 ",$299.72 ,"$4,872.00 ","$3,166.80 ",$346.74 ,"$1,364.16 ","$2,694.22 ",$346.74 ,"$2,835.50 ",$346.74 ,"$2,552.93 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,141.20 ","$4,384.80 ",$353.67 ,"$3,654.00 ","$3,410.40 ","$3,410.40 ",$346.74 ,"$3,410.40 ","$3,751.44 ","$3,751.44 ",$884.55 ,"$4,141.20 ",$353.82 ,$353.82 ,"$2,733.19 ","$2,017.01 ","$2,026.75 ",$303.01 ,$299.72 ,$364.08 ,"$4,141.20 ",$760.71 ,"$2,552.93 ","$1,364.16 ","$4,384.80 ","$1,490.00 ",$346.74 ,"$3,166.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$3,675.00 ","$2,646.00 ",$219.77 ,"$3,675.00 ","$2,388.75 ",$219.77 ,"$1,029.00 ","$2,032.28 ",$219.77 ,"$2,138.85 ",$219.77 ,"$1,925.70 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$3,123.75 ","$3,307.50 ",$224.17 ,"$2,756.25 ","$2,572.50 ","$2,572.50 ",$219.77 ,"$2,572.50 ","$2,829.75 ","$2,829.75 ",$560.65 ,"$3,123.75 ",$224.26 ,$224.26 ,"$2,061.68 ","$1,521.45 ","$1,528.80 ",$277.30 ,$274.30 ,$230.76 ,"$3,123.75 ",$482.16 ,"$1,925.70 ","$1,029.00 ","$3,307.50 ","$1,490.00 ",$219.77 ,"$2,388.75 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$3,976.00 ","$2,862.72 ",$274.30 ,"$3,976.00 ","$2,584.40 ",$346.74 ,"$1,113.28 ","$2,198.73 ",$346.74 ,"$2,314.03 ",$346.74 ,"$2,083.42 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,379.60 ","$3,578.40 ",$353.67 ,"$2,982.00 ","$2,783.20 ","$2,783.20 ",$346.74 ,"$2,783.20 ","$3,061.52 ","$3,061.52 ",$884.55 ,"$3,379.60 ",$353.82 ,$353.82 ,"$2,230.54 ","$1,646.06 ","$1,654.02 ",$277.30 ,$274.30 ,$364.08 ,"$3,379.60 ",$760.71 ,"$2,083.42 ","$1,113.28 ","$3,578.40 ","$1,490.00 ",$346.74 ,"$2,584.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$4,872.00 ","$3,507.84 ",$274.30 ,"$4,872.00 ","$3,166.80 ",$346.74 ,"$1,364.16 ","$2,694.22 ",$346.74 ,"$2,835.50 ",$346.74 ,"$2,552.93 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,141.20 ","$4,384.80 ",$353.67 ,"$3,654.00 ","$3,410.40 ","$3,410.40 ",$346.74 ,"$3,410.40 ","$3,751.44 ","$3,751.44 ",$884.55 ,"$4,141.20 ",$353.82 ,$353.82 ,"$2,733.19 ","$2,017.01 ","$2,026.75 ",$277.30 ,$274.30 ,$364.08 ,"$4,141.20 ",$760.71 ,"$2,552.93 ","$1,364.16 ","$4,384.80 ","$1,490.00 ",$346.74 ,"$3,166.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$3,928.00 ","$2,828.16 ",$197.83 ,"$3,928.00 ","$2,553.20 ",$219.77 ,"$1,099.84 ","$2,172.18 ",$219.77 ,"$2,286.10 ",$219.77 ,"$2,058.27 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$3,338.80 ","$3,535.20 ",$224.17 ,"$2,946.00 ","$2,749.60 ","$2,749.60 ",$219.77 ,"$2,749.60 ","$3,024.56 ","$3,024.56 ",$560.65 ,"$3,338.80 ",$224.26 ,$224.26 ,"$2,203.61 ","$1,626.19 ","$1,634.05 ",$200.00 ,$197.83 ,$230.76 ,"$3,338.80 ",$482.16 ,"$2,058.27 ","$1,099.84 ","$3,535.20 ","$1,490.00 ",$219.77 ,"$2,553.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$3,609.00 ","$2,598.48 ",$197.83 ,"$3,609.00 ","$2,345.85 ",$346.74 ,"$1,010.52 ","$1,995.78 ",$346.74 ,"$2,100.44 ",$346.74 ,"$1,891.12 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,067.65 ","$3,248.10 ",$353.67 ,"$2,706.75 ","$2,526.30 ","$2,526.30 ",$346.74 ,"$2,526.30 ","$2,778.93 ","$2,778.93 ",$884.55 ,"$3,067.65 ",$353.82 ,$353.82 ,"$2,024.65 ","$1,494.13 ","$1,501.34 ",$200.00 ,$197.83 ,$364.08 ,"$3,067.65 ",$760.71 ,"$1,891.12 ","$1,010.52 ","$3,248.10 ","$1,490.00 ",$346.74 ,"$2,345.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$3,504.00 ","$2,522.88 ",$197.83 ,"$3,504.00 ","$2,277.60 ",$219.77 ,$981.12 ,"$1,937.71 ",$219.77 ,"$2,039.33 ",$219.77 ,"$1,836.10 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,978.40 ","$3,153.60 ",$224.17 ,"$2,628.00 ","$2,452.80 ","$2,452.80 ",$219.77 ,"$2,452.80 ","$2,698.08 ","$2,698.08 ",$560.65 ,"$2,978.40 ",$224.26 ,$224.26 ,"$1,965.74 ","$1,450.66 ","$1,457.66 ",$200.00 ,$197.83 ,$230.76 ,"$2,978.40 ",$482.16 ,"$1,836.10 ",$981.12 ,"$3,153.60 ","$1,490.00 ",$219.77 ,"$2,277.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$3,681.00 ","$2,650.32 ",$197.83 ,"$3,681.00 ","$2,392.65 ",$346.74 ,"$1,030.68 ","$2,035.59 ",$346.74 ,"$2,142.34 ",$346.74 ,"$1,928.84 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,128.85 ","$3,312.90 ",$353.67 ,"$2,760.75 ","$2,576.70 ","$2,576.70 ",$346.74 ,"$2,576.70 ","$2,834.37 ","$2,834.37 ",$884.55 ,"$3,128.85 ",$353.82 ,$353.82 ,"$2,065.04 ","$1,523.93 ","$1,531.30 ",$200.00 ,$197.83 ,$364.08 ,"$3,128.85 ",$760.71 ,"$1,928.84 ","$1,030.68 ","$3,312.90 ","$1,490.00 ",$346.74 ,"$2,392.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$3,504.00 ","$2,522.88 ",$197.83 ,"$3,504.00 ","$2,277.60 ",$219.77 ,$981.12 ,"$1,937.71 ",$219.77 ,"$2,039.33 ",$219.77 ,"$1,836.10 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,978.40 ","$3,153.60 ",$224.17 ,"$2,628.00 ","$2,452.80 ","$2,452.80 ",$219.77 ,"$2,452.80 ","$2,698.08 ","$2,698.08 ",$560.65 ,"$2,978.40 ",$224.26 ,$224.26 ,"$1,965.74 ","$1,450.66 ","$1,457.66 ",$200.00 ,$197.83 ,$230.76 ,"$2,978.40 ",$482.16 ,"$1,836.10 ",$981.12 ,"$3,153.60 ","$1,490.00 ",$219.77 ,"$2,277.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$4,825.00 ","$3,474.00 ",$197.83 ,"$4,825.00 ","$3,136.25 ",$346.74 ,"$1,351.00 ","$2,668.23 ",$346.74 ,"$2,808.15 ",$346.74 ,"$2,528.30 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,101.25 ","$4,342.50 ",$353.67 ,"$3,618.75 ","$3,377.50 ","$3,377.50 ",$346.74 ,"$3,377.50 ","$3,715.25 ","$3,715.25 ",$884.55 ,"$4,101.25 ",$353.82 ,$353.82 ,"$2,706.83 ","$1,997.55 ","$2,007.20 ",$200.00 ,$197.83 ,$364.08 ,"$4,101.25 ",$760.71 ,"$2,528.30 ","$1,351.00 ","$4,342.50 ","$1,490.00 ",$346.74 ,"$3,136.25 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$4,646.00 ","$3,345.12 ",$197.83 ,"$4,646.00 ","$3,019.90 ",$346.74 ,"$1,300.88 ","$2,569.24 ",$346.74 ,"$2,703.97 ",$346.74 ,"$2,434.50 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,949.10 ","$4,181.40 ",$353.67 ,"$3,484.50 ","$3,252.20 ","$3,252.20 ",$346.74 ,"$3,252.20 ","$3,577.42 ","$3,577.42 ",$884.55 ,"$3,949.10 ",$353.82 ,$353.82 ,"$2,606.41 ","$1,923.44 ","$1,932.74 ",$200.00 ,$197.83 ,$364.08 ,"$3,949.10 ",$760.71 ,"$2,434.50 ","$1,300.88 ","$4,181.40 ","$1,490.00 ",$346.74 ,"$3,019.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$4,646.00 ","$3,345.12 ",$197.83 ,"$4,646.00 ","$3,019.90 ",$346.74 ,"$1,300.88 ","$2,569.24 ",$346.74 ,"$2,703.97 ",$346.74 ,"$2,434.50 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,949.10 ","$4,181.40 ",$353.67 ,"$3,484.50 ","$3,252.20 ","$3,252.20 ",$346.74 ,"$3,252.20 ","$3,577.42 ","$3,577.42 ",$884.55 ,"$3,949.10 ",$353.82 ,$353.82 ,"$2,606.41 ","$1,923.44 ","$1,932.74 ",$200.00 ,$197.83 ,$364.08 ,"$3,949.10 ",$760.71 ,"$2,434.50 ","$1,300.88 ","$4,181.40 ","$1,490.00 ",$346.74 ,"$3,019.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$3,353.00 ","$2,414.16 ",$219.77 ,"$3,353.00 ","$2,179.45 ",$219.77 ,$938.84 ,"$1,854.21 ",$219.77 ,"$1,951.45 ",$219.77 ,"$1,756.97 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,850.05 ","$3,017.70 ",$224.17 ,"$2,514.75 ","$2,347.10 ","$2,347.10 ",$219.77 ,"$2,347.10 ","$2,581.81 ","$2,581.81 ",$560.65 ,"$2,850.05 ",$224.26 ,$224.26 ,"$1,881.03 ","$1,388.14 ","$1,394.85 ",$247.50 ,$244.82 ,$230.76 ,"$2,850.05 ",$482.16 ,"$1,756.97 ",$938.84 ,"$3,017.70 ","$1,490.00 ",$219.77 ,"$2,179.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$3,627.00 ","$2,611.44 ",$244.82 ,"$3,627.00 ","$2,357.55 ",$346.74 ,"$1,015.56 ","$2,005.73 ",$346.74 ,"$2,110.91 ",$346.74 ,"$1,900.55 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,082.95 ","$3,264.30 ",$353.67 ,"$2,720.25 ","$2,538.90 ","$2,538.90 ",$346.74 ,"$2,538.90 ","$2,792.79 ","$2,792.79 ",$884.55 ,"$3,082.95 ",$353.82 ,$353.82 ,"$2,034.75 ","$1,501.58 ","$1,508.83 ",$247.50 ,$244.82 ,$364.08 ,"$3,082.95 ",$760.71 ,"$1,900.55 ","$1,015.56 ","$3,264.30 ","$1,490.00 ",$346.74 ,"$2,357.55 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$4,444.00 ","$3,199.68 ",$244.82 ,"$4,444.00 ","$2,888.60 ",$346.74 ,"$1,244.32 ","$2,457.53 ",$346.74 ,"$2,586.41 ",$346.74 ,"$2,328.66 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,777.40 ","$3,999.60 ",$353.67 ,"$3,333.00 ","$3,110.80 ","$3,110.80 ",$346.74 ,"$3,110.80 ","$3,421.88 ","$3,421.88 ",$884.55 ,"$3,777.40 ",$353.82 ,$353.82 ,"$2,493.08 ","$1,839.82 ","$1,848.70 ",$247.50 ,$244.82 ,$364.08 ,"$3,777.40 ",$760.71 ,"$2,328.66 ","$1,244.32 ","$3,999.60 ","$1,490.00 ",$346.74 ,"$2,888.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$3,504.00 ","$2,522.88 ",$219.77 ,"$3,504.00 ","$2,277.60 ",$219.77 ,$981.12 ,"$1,937.71 ",$219.77 ,"$2,039.33 ",$219.77 ,"$1,836.10 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,978.40 ","$3,153.60 ",$224.17 ,"$2,628.00 ","$2,452.80 ","$2,452.80 ",$219.77 ,"$2,452.80 ","$2,698.08 ","$2,698.08 ",$560.65 ,"$2,978.40 ",$224.26 ,$224.26 ,"$1,965.74 ","$1,450.66 ","$1,457.66 ",$247.50 ,$244.82 ,$230.76 ,"$2,978.40 ",$482.16 ,"$1,836.10 ",$981.12 ,"$3,153.60 ","$1,490.00 ",$219.77 ,"$2,277.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000025,73219,HC MRI UPPR EXT NONJOINT W/CONTRAST,610,1 ,"$3,791.00 ","$2,729.52 ",$244.82 ,"$3,791.00 ","$2,464.15 ",$346.74 ,"$1,061.48 ","$2,096.42 ",$346.74 ,"$2,206.36 ",$346.74 ,"$1,986.48 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,222.35 ","$3,411.90 ",$353.67 ,"$2,843.25 ","$2,653.70 ","$2,653.70 ",$346.74 ,"$2,653.70 ","$2,919.07 ","$2,919.07 ",$884.55 ,"$3,222.35 ",$353.82 ,$353.82 ,"$2,126.75 ","$1,569.47 ","$1,577.06 ",$247.50 ,$244.82 ,$364.08 ,"$3,222.35 ",$760.71 ,"$1,986.48 ","$1,061.48 ","$3,411.90 ","$1,490.00 ",$346.74 ,"$2,464.15 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$4,785.00 ","$3,445.20 ",$244.82 ,"$4,785.00 ","$3,110.25 ",$346.74 ,"$1,339.80 ","$2,646.11 ",$346.74 ,"$2,784.87 ",$346.74 ,"$2,507.34 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,067.25 ","$4,306.50 ",$353.67 ,"$3,588.75 ","$3,349.50 ","$3,349.50 ",$346.74 ,"$3,349.50 ","$3,684.45 ","$3,684.45 ",$884.55 ,"$4,067.25 ",$353.82 ,$353.82 ,"$2,684.39 ","$1,980.99 ","$1,990.56 ",$247.50 ,$244.82 ,$364.08 ,"$4,067.25 ",$760.71 ,"$2,507.34 ","$1,339.80 ","$4,306.50 ","$1,490.00 ",$346.74 ,"$3,110.25 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,673.00 ","$2,644.56 ",$165.24 ,"$3,673.00 ","$2,387.45 ",$219.77 ,"$1,028.44 ","$2,031.17 ",$219.77 ,"$2,137.69 ",$219.77 ,"$1,924.65 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$3,122.05 ","$3,305.70 ",$224.17 ,"$2,754.75 ","$2,571.10 ","$2,571.10 ",$219.77 ,"$2,571.10 ","$2,828.21 ","$2,828.21 ",$560.65 ,"$3,122.05 ",$224.26 ,$224.26 ,"$2,060.55 ","$1,520.62 ","$1,527.97 ",$167.05 ,$165.24 ,$230.76 ,"$3,122.05 ",$482.16 ,"$1,924.65 ","$1,028.44 ","$3,305.70 ","$1,490.00 ",$219.77 ,"$2,387.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$3,681.00 ","$2,650.32 ",$165.24 ,"$3,681.00 ","$2,392.65 ",$697.14 ,"$1,030.68 ","$2,035.59 ",$697.14 ,"$2,142.34 ",$697.14 ,"$1,928.84 ",$697.14 ,"$1,436.97 ","$2,500.00 ","$1,778.43 ",$697.14 ,"$3,128.85 ","$3,312.90 ",$711.09 ,"$2,760.75 ","$2,576.70 ","$2,576.70 ",$697.14 ,"$2,576.70 ","$2,834.37 ","$2,834.37 ","$1,778.43 ","$3,128.85 ",$711.37 ,$711.37 ,"$2,065.04 ","$1,523.93 ","$1,531.30 ",$167.05 ,$165.24 ,$732.00 ,"$3,128.85 ","$1,529.45 ","$1,928.84 ","$1,030.68 ","$3,312.90 ","$1,490.00 ",$697.14 ,"$2,392.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,646.00 ","$3,345.12 ",$165.24 ,"$4,646.00 ","$3,019.90 ",$346.74 ,"$1,300.88 ","$2,569.24 ",$346.74 ,"$2,703.97 ",$346.74 ,"$2,434.50 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,949.10 ","$4,181.40 ",$353.67 ,"$3,484.50 ","$3,252.20 ","$3,252.20 ",$346.74 ,"$3,252.20 ","$3,577.42 ","$3,577.42 ",$884.55 ,"$3,949.10 ",$353.82 ,$353.82 ,"$2,606.41 ","$1,923.44 ","$1,932.74 ",$167.05 ,$165.24 ,$364.08 ,"$3,949.10 ",$760.71 ,"$2,434.50 ","$1,300.88 ","$4,181.40 ","$1,490.00 ",$346.74 ,"$3,019.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$3,504.00 ","$2,522.88 ",$219.77 ,"$3,504.00 ","$2,277.60 ",$219.77 ,$981.12 ,"$1,937.71 ",$219.77 ,"$2,039.33 ",$219.77 ,"$1,836.10 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,978.40 ","$3,153.60 ",$224.17 ,"$2,628.00 ","$2,452.80 ","$2,452.80 ",$219.77 ,"$2,452.80 ","$2,698.08 ","$2,698.08 ",$560.65 ,"$2,978.40 ",$224.26 ,$224.26 ,"$1,965.74 ","$1,450.66 ","$1,457.66 ",$247.50 ,$244.82 ,$230.76 ,"$2,978.40 ",$482.16 ,"$1,836.10 ",$981.12 ,"$3,153.60 ","$1,490.00 ",$219.77 ,"$2,277.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$3,791.00 ","$2,729.52 ",$244.82 ,"$3,791.00 ","$2,464.15 ",$346.74 ,"$1,061.48 ","$2,096.42 ",$346.74 ,"$2,206.36 ",$346.74 ,"$1,986.48 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,222.35 ","$3,411.90 ",$353.67 ,"$2,843.25 ","$2,653.70 ","$2,653.70 ",$346.74 ,"$2,653.70 ","$2,919.07 ","$2,919.07 ",$884.55 ,"$3,222.35 ",$353.82 ,$353.82 ,"$2,126.75 ","$1,569.47 ","$1,577.06 ",$247.50 ,$244.82 ,$364.08 ,"$3,222.35 ",$760.71 ,"$1,986.48 ","$1,061.48 ","$3,411.90 ","$1,490.00 ",$346.74 ,"$2,464.15 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$4,646.00 ","$3,345.12 ",$244.82 ,"$4,646.00 ","$3,019.90 ",$346.74 ,"$1,300.88 ","$2,569.24 ",$346.74 ,"$2,703.97 ",$346.74 ,"$2,434.50 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,949.10 ","$4,181.40 ",$353.67 ,"$3,484.50 ","$3,252.20 ","$3,252.20 ",$346.74 ,"$3,252.20 ","$3,577.42 ","$3,577.42 ",$884.55 ,"$3,949.10 ",$353.82 ,$353.82 ,"$2,606.41 ","$1,923.44 ","$1,932.74 ",$247.50 ,$244.82 ,$364.08 ,"$3,949.10 ",$760.71 ,"$2,434.50 ","$1,300.88 ","$4,181.40 ","$1,490.00 ",$346.74 ,"$3,019.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$3,673.00 ","$2,644.56 ",$165.24 ,"$3,673.00 ","$2,387.45 ",$219.77 ,"$1,028.44 ","$2,031.17 ",$219.77 ,"$2,137.69 ",$219.77 ,"$1,924.65 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$3,122.05 ","$3,305.70 ",$224.17 ,"$2,754.75 ","$2,571.10 ","$2,571.10 ",$219.77 ,"$2,571.10 ","$2,828.21 ","$2,828.21 ",$560.65 ,"$3,122.05 ",$224.26 ,$224.26 ,"$2,060.55 ","$1,520.62 ","$1,527.97 ",$167.05 ,$165.24 ,$230.76 ,"$3,122.05 ",$482.16 ,"$1,924.65 ","$1,028.44 ","$3,305.70 ","$1,490.00 ",$219.77 ,"$2,387.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$3,681.00 ","$2,650.32 ",$165.24 ,"$3,681.00 ","$2,392.65 ",$697.14 ,"$1,030.68 ","$2,035.59 ",$697.14 ,"$2,142.34 ",$697.14 ,"$1,928.84 ",$697.14 ,"$1,436.97 ","$2,500.00 ","$1,778.43 ",$697.14 ,"$3,128.85 ","$3,312.90 ",$711.09 ,"$2,760.75 ","$2,576.70 ","$2,576.70 ",$697.14 ,"$2,576.70 ","$2,834.37 ","$2,834.37 ","$1,778.43 ","$3,128.85 ",$711.37 ,$711.37 ,"$2,065.04 ","$1,523.93 ","$1,531.30 ",$167.05 ,$165.24 ,$732.00 ,"$3,128.85 ","$1,529.45 ","$1,928.84 ","$1,030.68 ","$3,312.90 ","$1,490.00 ",$697.14 ,"$2,392.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,646.00 ","$3,345.12 ",$165.24 ,"$4,646.00 ","$3,019.90 ",$346.74 ,"$1,300.88 ","$2,569.24 ",$346.74 ,"$2,703.97 ",$346.74 ,"$2,434.50 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,949.10 ","$4,181.40 ",$353.67 ,"$3,484.50 ","$3,252.20 ","$3,252.20 ",$346.74 ,"$3,252.20 ","$3,577.42 ","$3,577.42 ",$884.55 ,"$3,949.10 ",$353.82 ,$353.82 ,"$2,606.41 ","$1,923.44 ","$1,932.74 ",$167.05 ,$165.24 ,$364.08 ,"$3,949.10 ",$760.71 ,"$2,434.50 ","$1,300.88 ","$4,181.40 ","$1,490.00 ",$346.74 ,"$3,019.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$3,353.00 ","$2,414.16 ",$219.77 ,"$3,353.00 ","$2,179.45 ",$219.77 ,$938.84 ,"$1,854.21 ",$219.77 ,"$1,951.45 ",$219.77 ,"$1,756.97 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,850.05 ","$3,017.70 ",$224.17 ,"$2,514.75 ","$2,347.10 ","$2,347.10 ",$219.77 ,"$2,347.10 ","$2,581.81 ","$2,581.81 ",$560.65 ,"$2,850.05 ",$224.26 ,$224.26 ,"$1,881.03 ","$1,388.14 ","$1,394.85 ",$296.64 ,$293.42 ,$230.76 ,"$2,850.05 ",$482.16 ,"$1,756.97 ",$938.84 ,"$3,017.70 ","$1,490.00 ",$219.77 ,"$2,179.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$4,444.00 ","$3,199.68 ",$293.42 ,"$4,444.00 ","$2,888.60 ",$346.74 ,"$1,244.32 ","$2,457.53 ",$346.74 ,"$2,586.41 ",$346.74 ,"$2,328.66 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,777.40 ","$3,999.60 ",$353.67 ,"$3,333.00 ","$3,110.80 ","$3,110.80 ",$346.74 ,"$3,110.80 ","$3,421.88 ","$3,421.88 ",$884.55 ,"$3,777.40 ",$353.82 ,$353.82 ,"$2,493.08 ","$1,839.82 ","$1,848.70 ",$296.64 ,$293.42 ,$364.08 ,"$3,777.40 ",$760.71 ,"$2,328.66 ","$1,244.32 ","$3,999.60 ","$1,490.00 ",$346.74 ,"$2,888.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000042,75561,HC MRI CARD W/O AND W CON,610,1 ,"$1,102.00 ",$793.44 ,$244.82 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$247.50 ,$244.82 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000050,C8937,HC MRI BREAST CAD,610,1 ,$311.00 ,$223.92 ,$87.08 ,$311.00 ,$202.15 , N/A ,$87.08 ,$171.98 , N/A ,$181.00 , N/A ,$162.96 , N/A , N/A ,$286.12 , N/A , N/A ,$264.35 ,$279.90 , N/A ,$233.25 ,$217.70 ,$217.70 , N/A ,$217.70 ,$239.47 ,$239.47 , N/A ,$264.35 , N/A , N/A ,$174.47 ,$128.75 ,$129.38 , N/A , N/A , N/A ,$264.35 , N/A ,$162.96 ,$87.08 ,$279.90 ,$311.00 , N/A ,$202.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$3,627.00 ","$2,611.44 ",$316.56 ,"$3,627.00 ","$2,357.55 ",$346.74 ,"$1,015.56 ","$2,005.73 ",$346.74 ,"$2,110.91 ",$346.74 ,"$1,900.55 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,082.95 ","$3,264.30 ",$353.67 ,"$2,720.25 ","$2,538.90 ","$2,538.90 ",$346.74 ,"$2,538.90 ","$2,792.79 ","$2,792.79 ",$884.55 ,"$3,082.95 ",$353.82 ,$353.82 ,"$2,034.75 ","$1,501.58 ","$1,508.83 ",$320.03 ,$316.56 ,$364.08 ,"$3,082.95 ",$760.71 ,"$1,900.55 ","$1,015.56 ","$3,264.30 ","$1,490.00 ",$346.74 ,"$2,357.55 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,"$2,853.00 ","$2,054.16 ",$219.77 ,"$2,853.00 ","$1,854.45 ",$219.77 ,$798.84 ,"$1,577.71 ",$219.77 ,"$1,660.45 ",$219.77 ,"$1,494.97 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,425.05 ","$2,567.70 ",$224.17 ,"$2,139.75 ","$1,997.10 ","$1,997.10 ",$219.77 ,"$1,997.10 ","$2,196.81 ","$2,196.81 ",$560.65 ,"$2,425.05 ",$224.26 ,$224.26 ,"$1,600.53 ","$1,181.14 ","$1,186.85 ",$320.03 ,$316.56 ,$230.76 ,"$2,425.05 ",$482.16 ,"$1,494.97 ",$798.84 ,"$2,567.70 ","$1,490.00 ",$219.77 ,"$1,854.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$1,102.00 ",$793.44 ,$308.56 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$320.03 ,$316.56 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000054,C8903,HC MRI BREAST UNI W/CONTRAST,610,1 ,$535.00 ,$385.20 ,$149.80 ,$535.00 ,$347.75 ,$169.73 ,$149.80 ,$295.86 ,$169.73 ,$311.37 ,$169.73 ,$280.34 ,$169.73 ,$349.84 ,$535.00 ,$432.97 ,$169.73 ,$454.75 ,$481.50 ,$173.12 ,$401.25 ,$374.50 ,$374.50 ,$169.73 ,$374.50 ,$411.95 ,$411.95 ,$432.97 ,$454.75 ,$173.19 ,$173.19 ,$300.14 ,$221.49 ,$222.56 ,$247.50 ,$244.82 ,$178.21 ,$454.75 ,$372.35 ,$280.34 ,$149.80 ,$481.50 ,$535.00 ,$169.73 ,$347.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000055,77046,HC MRI BREAST UNI W/O CON,610,1 ,$689.00 ,$496.08 ,$192.92 ,$689.00 ,$447.85 ,$219.77 ,$192.92 ,$381.02 ,$219.77 ,$401.00 ,$219.77 ,$361.04 ,$219.77 ,$453.00 ,$689.00 ,$560.65 ,$219.77 ,$585.65 ,$620.10 ,$224.17 ,$516.75 ,$482.30 ,$482.30 ,$219.77 ,$482.30 ,$530.53 ,$530.53 ,$560.65 ,$585.65 ,$224.26 ,$224.26 ,$386.53 ,$285.25 ,$286.62 ,$247.50 ,$244.82 ,$230.76 ,$585.65 ,$482.16 ,$361.04 ,$192.92 ,$620.10 ,$689.00 ,$219.77 ,$447.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000056,C8905,HC MRI BREAST UNI W AND W/O CONTRAST,610,1 ,"$1,102.00 ",$793.44 ,$244.82 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$247.50 ,$244.82 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000057,C8906,HC MRI BREAST BIL W/CONTRAST,610,1 ,"$1,102.00 ",$793.44 ,$244.82 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$247.50 ,$244.82 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000058,77047,HC MRI BREAST BI W/O CON,610,1 ,$689.00 ,$496.08 ,$192.92 ,$689.00 ,$447.85 ,$219.77 ,$192.92 ,$381.02 ,$219.77 ,$401.00 ,$219.77 ,$361.04 ,$219.77 ,$453.00 ,$689.00 ,$560.65 ,$219.77 ,$585.65 ,$620.10 ,$224.17 ,$516.75 ,$482.30 ,$482.30 ,$219.77 ,$482.30 ,$530.53 ,$530.53 ,$560.65 ,$585.65 ,$224.26 ,$224.26 ,$386.53 ,$285.25 ,$286.62 ,$247.50 ,$244.82 ,$230.76 ,$585.65 ,$482.16 ,$361.04 ,$192.92 ,$620.10 ,$689.00 ,$219.77 ,$447.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000060,C8909,HC MRA CHEST W/CONTRAST,610,1 ,"$1,102.00 ",$793.44 ,$278.46 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$281.51 ,$278.46 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000061,C8910,HC MRA CHEST W/O CONTRAST,610,1 ,"$2,853.00 ","$2,054.16 ",$219.77 ,"$2,853.00 ","$1,854.45 ",$219.77 ,$798.84 ,"$1,577.71 ",$219.77 ,"$1,660.45 ",$219.77 ,"$1,494.97 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,425.05 ","$2,567.70 ",$224.17 ,"$2,139.75 ","$1,997.10 ","$1,997.10 ",$219.77 ,"$1,997.10 ","$2,196.81 ","$2,196.81 ",$560.65 ,"$2,425.05 ",$224.26 ,$224.26 ,"$1,600.53 ","$1,181.14 ","$1,186.85 ",$281.51 ,$278.46 ,$230.76 ,"$2,425.05 ",$482.16 ,"$1,494.97 ",$798.84 ,"$2,567.70 ","$1,490.00 ",$219.77 ,"$1,854.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000062,C8911,HC MRA CHEST W AND W/O CONTRAST,610,1 ,"$1,102.00 ",$793.44 ,$278.46 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$281.51 ,$278.46 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$3,627.00 ","$2,611.44 ",$316.56 ,"$3,627.00 ","$2,357.55 ",$346.74 ,"$1,015.56 ","$2,005.73 ",$346.74 ,"$2,110.91 ",$346.74 ,"$1,900.55 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,082.95 ","$3,264.30 ",$353.67 ,"$2,720.25 ","$2,538.90 ","$2,538.90 ",$346.74 ,"$2,538.90 ","$2,792.79 ","$2,792.79 ",$884.55 ,"$3,082.95 ",$353.82 ,$353.82 ,"$2,034.75 ","$1,501.58 ","$1,508.83 ",$320.03 ,$316.56 ,$364.08 ,"$3,082.95 ",$760.71 ,"$1,900.55 ","$1,015.56 ","$3,264.30 ","$1,490.00 ",$346.74 ,"$2,357.55 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$3,138.00 ","$2,259.36 ",$219.77 ,"$3,138.00 ","$2,039.70 ",$219.77 ,$878.64 ,"$1,735.31 ",$219.77 ,"$1,826.32 ",$219.77 ,"$1,644.31 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,667.30 ","$2,824.20 ",$224.17 ,"$2,353.50 ","$2,196.60 ","$2,196.60 ",$219.77 ,"$2,196.60 ","$2,416.26 ","$2,416.26 ",$560.65 ,"$2,667.30 ",$224.26 ,$224.26 ,"$1,760.42 ","$1,299.13 ","$1,305.41 ",$320.03 ,$316.56 ,$230.76 ,"$2,667.30 ",$482.16 ,"$1,644.31 ",$878.64 ,"$2,824.20 ","$1,490.00 ",$219.77 ,"$2,039.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$4,161.00 ","$2,995.92 ",$316.56 ,"$4,161.00 ","$2,704.65 ",$346.74 ,"$1,165.08 ","$2,301.03 ",$346.74 ,"$2,421.70 ",$346.74 ,"$2,180.36 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,536.85 ","$3,744.90 ",$353.67 ,"$3,120.75 ","$2,912.70 ","$2,912.70 ",$346.74 ,"$2,912.70 ","$3,203.97 ","$3,203.97 ",$884.55 ,"$3,536.85 ",$353.82 ,$353.82 ,"$2,334.32 ","$1,722.65 ","$1,730.98 ",$320.03 ,$316.56 ,$364.08 ,"$3,536.85 ",$760.71 ,"$2,180.36 ","$1,165.08 ","$3,744.90 ","$1,490.00 ",$346.74 ,"$2,704.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000068,C8918,HC MRA PELVIS W/CON,610,1 ,"$3,297.00 ","$2,373.84 ",$316.56 ,"$3,297.00 ","$2,143.05 ",$346.74 ,$923.16 ,"$1,823.24 ",$346.74 ,"$1,918.85 ",$346.74 ,"$1,727.63 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$2,802.45 ","$2,967.30 ",$353.67 ,"$2,472.75 ","$2,307.90 ","$2,307.90 ",$346.74 ,"$2,307.90 ","$2,538.69 ","$2,538.69 ",$884.55 ,"$2,802.45 ",$353.82 ,$353.82 ,"$1,849.62 ","$1,364.96 ","$1,371.55 ",$320.03 ,$316.56 ,$364.08 ,"$2,802.45 ",$760.71 ,"$1,727.63 ",$923.16 ,"$2,967.30 ","$1,490.00 ",$346.74 ,"$2,143.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000069,C8919,HC MRA PELVIS W/O CON,610,1 ,"$2,853.00 ","$2,054.16 ",$219.77 ,"$2,853.00 ","$1,854.45 ",$219.77 ,$798.84 ,"$1,577.71 ",$219.77 ,"$1,660.45 ",$219.77 ,"$1,494.97 ",$219.77 ,$453.00 ,"$2,500.00 ",$560.65 ,$219.77 ,"$2,425.05 ","$2,567.70 ",$224.17 ,"$2,139.75 ","$1,997.10 ","$1,997.10 ",$219.77 ,"$1,997.10 ","$2,196.81 ","$2,196.81 ",$560.65 ,"$2,425.05 ",$224.26 ,$224.26 ,"$1,600.53 ","$1,181.14 ","$1,186.85 ",$320.03 ,$316.56 ,$230.76 ,"$2,425.05 ",$482.16 ,"$1,494.97 ",$798.84 ,"$2,567.70 ","$1,490.00 ",$219.77 ,"$1,854.45 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$4,161.00 ","$2,995.92 ",$316.56 ,"$4,161.00 ","$2,704.65 ",$346.74 ,"$1,165.08 ","$2,301.03 ",$346.74 ,"$2,421.70 ",$346.74 ,"$2,180.36 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,536.85 ","$3,744.90 ",$353.67 ,"$3,120.75 ","$2,912.70 ","$2,912.70 ",$346.74 ,"$2,912.70 ","$3,203.97 ","$3,203.97 ",$884.55 ,"$3,536.85 ",$353.82 ,$353.82 ,"$2,334.32 ","$1,722.65 ","$1,730.98 ",$320.03 ,$316.56 ,$364.08 ,"$3,536.85 ",$760.71 ,"$2,180.36 ","$1,165.08 ","$3,744.90 ","$1,490.00 ",$346.74 ,"$2,704.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000071,C8934,HC MRA UPPR EXT W/CONTRAST,610,1 ,"$1,102.00 ",$793.44 ,$308.56 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$320.03 ,$316.56 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$5,018.00 ","$3,612.96 ",$274.30 ,"$5,018.00 ","$3,261.70 ",$346.74 ,"$1,405.04 ","$2,774.95 ",$346.74 ,"$2,920.48 ",$346.74 ,"$2,629.43 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$4,265.30 ","$4,516.20 ",$353.67 ,"$3,763.50 ","$3,512.60 ","$3,512.60 ",$346.74 ,"$3,512.60 ","$3,863.86 ","$3,863.86 ",$884.55 ,"$4,265.30 ",$353.82 ,$353.82 ,"$2,815.10 ","$2,077.45 ","$2,087.49 ",$277.30 ,$274.30 ,$364.08 ,"$4,265.30 ",$760.71 ,"$2,629.43 ","$1,405.04 ","$4,516.20 ","$1,490.00 ",$346.74 ,"$3,261.70 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$3,976.00 ","$2,862.72 ",$244.82 ,"$3,976.00 ","$2,584.40 ",$346.74 ,"$1,113.28 ","$2,198.73 ",$346.74 ,"$2,314.03 ",$346.74 ,"$2,083.42 ",$346.74 ,$714.71 ,"$2,500.00 ",$884.55 ,$346.74 ,"$3,379.60 ","$3,578.40 ",$353.67 ,"$2,982.00 ","$2,783.20 ","$2,783.20 ",$346.74 ,"$2,783.20 ","$3,061.52 ","$3,061.52 ",$884.55 ,"$3,379.60 ",$353.82 ,$353.82 ,"$2,230.54 ","$1,646.06 ","$1,654.02 ",$247.50 ,$244.82 ,$364.08 ,"$3,379.60 ",$760.71 ,"$2,083.42 ","$1,113.28 ","$3,578.40 ","$1,490.00 ",$346.74 ,"$2,584.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),61000077,74712,HC MRI FETAL PLACENTA/MATERN PELVIC SINGLE,610,1 ,$689.00 ,$496.08 ,$192.92 ,$689.00 ,$447.85 ,$219.77 ,$192.92 ,$381.02 ,$219.77 ,$401.00 ,$219.77 ,$361.04 ,$219.77 ,$453.00 ,$689.00 ,$560.65 ,$219.77 ,$585.65 ,$620.10 ,$224.17 ,$516.75 ,$482.30 ,$482.30 ,$219.77 ,$482.30 ,$530.53 ,$530.53 ,$560.65 ,$585.65 ,$224.26 ,$224.26 ,$386.53 ,$285.25 ,$286.62 , N/A , N/A ,$230.76 ,$585.65 ,$482.16 ,$361.04 ,$192.92 ,$620.10 ,$689.00 ,$219.77 ,$447.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),61800004,C8935,HC MRA UPPR EXT W/O CONTRAST,618,1 ,$689.00 ,$496.08 ,$192.92 ,$689.00 ,$447.85 ,$219.77 ,$192.92 ,$381.02 ,$219.77 ,$401.00 ,$219.77 ,$361.04 ,$219.77 ,$453.00 ,$689.00 ,$560.65 ,$219.77 ,$585.65 ,$620.10 ,$224.17 ,$516.75 ,$482.30 ,$482.30 ,$219.77 ,$482.30 ,$530.53 ,$530.53 ,$560.65 ,$585.65 ,$224.26 ,$224.26 ,$386.53 ,$285.25 ,$286.62 ,$320.03 ,$316.56 ,$230.76 ,$585.65 ,$482.16 ,$361.04 ,$192.92 ,$620.10 ,$689.00 ,$219.77 ,$447.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),61800005,C8936,HC MRA UPPR EXT W/ AND W/O CONTRAST,618,1 ,"$1,102.00 ",$793.44 ,$308.56 ,"$1,102.00 ",$716.30 ,$346.74 ,$308.56 ,$609.41 ,$346.74 ,$641.36 ,$346.74 ,$577.45 ,$346.74 ,$714.71 ,"$1,102.00 ",$884.55 ,$346.74 ,$936.70 ,$991.80 ,$353.67 ,$826.50 ,$771.40 ,$771.40 ,$346.74 ,$771.40 ,$848.54 ,$848.54 ,$884.55 ,$936.70 ,$353.82 ,$353.82 ,$618.22 ,$456.23 ,$458.43 ,$320.03 ,$316.56 ,$364.08 ,$936.70 ,$760.71 ,$577.45 ,$308.56 ,$991.80 ,"$1,102.00 ",$346.74 ,$716.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),62200026,N/A,HC HOT BIOPSY FORCEPS,621,1 ,$73.00 ,$52.56 ,$20.44 ,$73.00 ,$47.45 , N/A ,$20.44 ,$40.37 , N/A ,$42.49 , N/A ,$38.25 , N/A , N/A ,$67.16 , N/A , N/A ,$62.05 ,$65.70 , N/A ,$54.75 ,$51.10 ,$51.10 , N/A ,$51.10 ,$56.21 ,$56.21 , N/A ,$62.05 , N/A , N/A ,$40.95 ,$30.22 ,$30.37 , N/A , N/A , N/A ,$62.05 , N/A ,$38.25 ,$20.44 ,$65.70 ,$38.54 , N/A ,$47.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,0.9 % NACL WITH KCL 40 MEQ 40-0.9 MEQ/L-% SOLN per2 mEq,636,1 ,$2.60 ,$1.87 ,$0.23 ,$2.60 ,$1.69 , N/A ,$0.73 ,$1.44 , N/A ,$1.51 , N/A ,$1.36 , N/A , N/A ,$2.39 , N/A , N/A ,$2.21 ,$2.34 , N/A ,$1.95 ,$1.82 ,$1.82 , N/A ,$1.82 ,$2.00 ,$2.00 , N/A ,$2.21 , N/A , N/A ,$1.46 ,$1.08 ,$1.08 , N/A , N/A , N/A ,$2.21 , N/A ,$1.36 ,$0.73 ,$2.34 ,$0.23 , N/A ,$1.69 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0132,ACETYLCYSTEINE 200 MG/ML SOLN 30 ML VIAL per100 mg,636,1 ,$15.04 ,$10.83 ,$1.63 ,$15.04 ,$9.78 , N/A ,$4.21 ,$8.32 , N/A ,$8.75 , N/A ,$7.88 , N/A , N/A ,$13.84 , N/A , N/A ,$12.78 ,$13.54 , N/A ,$11.28 ,$10.53 ,$10.53 , N/A ,$10.53 ,$11.58 ,$11.58 , N/A ,$12.78 , N/A , N/A ,$8.44 ,$6.23 ,$6.26 , N/A , N/A , N/A ,$12.78 , N/A ,$7.88 ,$4.21 ,$13.54 ,$1.63 , N/A ,$9.78 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0133,ACYCLOVIR 50 MG/ML SOLN 10 ML VIAL per5 mg,636,1 ,$0.64 ,$0.46 ,$0.08 ,$0.64 ,$0.42 , N/A ,$0.18 ,$0.35 , N/A ,$0.37 , N/A ,$0.34 , N/A , N/A ,$0.59 , N/A , N/A ,$0.54 ,$0.58 , N/A ,$0.48 ,$0.45 ,$0.45 , N/A ,$0.45 ,$0.49 ,$0.49 , N/A ,$0.54 , N/A , N/A ,$0.36 ,$0.27 ,$0.27 , N/A , N/A , N/A ,$0.54 , N/A ,$0.34 ,$0.18 ,$0.58 ,$0.08 , N/A ,$0.42 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0153,ADENOSINE 6 MG/2ML SOLN per1 mg,636,1 ,$8.83 ,$6.36 ,$0.86 ,$8.83 ,$5.74 , N/A ,$2.47 ,$4.88 , N/A ,$5.14 , N/A ,$4.63 , N/A , N/A ,$8.12 , N/A , N/A ,$7.51 ,$7.95 , N/A ,$6.62 ,$6.18 ,$6.18 , N/A ,$6.18 ,$6.80 ,$6.80 , N/A ,$7.51 , N/A , N/A ,$4.95 ,$3.66 ,$3.67 , N/A , N/A , N/A ,$7.51 , N/A ,$4.63 ,$2.47 ,$7.95 ,$0.86 , N/A ,$5.74 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,P9047,ALBUMIN HUMAN 25 % SOLN per50 mL,636,1 ,$432.00 ,$311.04 ,$52.02 ,$432.00 ,$280.80 ,$52.02 ,$120.96 ,$238.90 ,$52.02 ,$251.42 ,$52.02 ,$226.37 ,$52.02 ,$107.22 ,$397.44 ,$132.69 ,$52.02 ,$367.20 ,$388.80 ,$53.06 ,$324.00 ,$302.40 ,$302.40 ,$52.02 ,$302.40 ,$332.64 ,$332.64 ,$132.69 ,$367.20 ,$53.08 ,$53.08 ,$242.35 ,$178.85 ,$179.71 ,$416.88 ,$432.00 ,$54.62 ,$367.20 ,$114.12 ,$226.37 ,$120.96 ,$388.80 ,$87.07 ,$52.02 ,$280.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2997,ALTEPLASE 2 MG SOLR per1 mg,636,1 ,$385.75 ,$277.74 ,$56.66 ,$385.75 ,$250.74 ,$85.82 ,$108.01 ,$213.32 ,$85.82 ,$224.51 ,$85.82 ,$202.13 ,$85.82 ,$176.88 ,$354.89 ,$218.91 ,$85.82 ,$327.89 ,$347.18 ,$87.53 ,$289.31 ,$270.03 ,$270.03 ,$85.82 ,$270.03 ,$297.03 ,$297.03 ,$218.91 ,$327.89 ,$87.57 ,$87.57 ,$216.41 ,$159.70 ,$160.47 ,$57.28 ,$56.66 ,$90.11 ,$327.89 ,$188.26 ,$202.13 ,$108.01 ,$347.18 ,$145.25 ,$85.82 ,$250.74 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0280,AMINOPHYLLINE 25 MG/ML SOLN per250 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$18.00 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0282,AMIODARONE 150 MG/3ML SOLN 3 ML VIAL per30 mg,636,1 ,$2.00 ,$1.44 ,$0.56 ,$2.00 ,$1.30 , N/A ,$0.56 ,$1.11 , N/A ,$1.16 , N/A ,$1.05 , N/A , N/A ,$1.84 , N/A , N/A ,$1.70 ,$1.80 , N/A ,$1.50 ,$1.40 ,$1.40 , N/A ,$1.40 ,$1.54 ,$1.54 , N/A ,$1.70 , N/A , N/A ,$1.12 ,$0.83 ,$0.83 , N/A , N/A , N/A ,$1.70 , N/A ,$1.05 ,$0.56 ,$1.80 ,$1.35 , N/A ,$1.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0282,AMIODARONE 360-4.14 MG/200ML-% SOLN per30 mg,636,1 ,$18.50 ,$13.32 ,$1.35 ,$18.50 ,$12.03 , N/A ,$5.18 ,$10.23 , N/A ,$10.77 , N/A ,$9.69 , N/A , N/A ,$17.02 , N/A , N/A ,$15.73 ,$16.65 , N/A ,$13.88 ,$12.95 ,$12.95 , N/A ,$12.95 ,$14.25 ,$14.25 , N/A ,$15.73 , N/A , N/A ,$10.38 ,$7.66 ,$7.70 , N/A , N/A , N/A ,$15.73 , N/A ,$9.69 ,$5.18 ,$16.65 ,$1.35 , N/A ,$12.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0290,AMPICILLIN 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$16.00 ,$11.52 ,$1.20 ,$16.00 ,$10.40 , N/A ,$4.48 ,$8.85 , N/A ,$9.31 , N/A ,$8.38 , N/A , N/A ,$14.72 , N/A , N/A ,$13.60 ,$14.40 , N/A ,$12.00 ,$11.20 ,$11.20 , N/A ,$11.20 ,$12.32 ,$12.32 , N/A ,$13.60 , N/A , N/A ,$8.98 ,$6.62 ,$6.66 , N/A , N/A , N/A ,$13.60 , N/A ,$8.38 ,$4.48 ,$14.40 ,$1.20 , N/A ,$10.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0295,AMPICILLIN-SULBACTAM 3 (2-1) G SOLR 1 EACH VIAL per1.5 g,636,1 ,$38.50 ,$27.72 ,$3.76 ,$38.50 ,$25.03 , N/A ,$10.78 ,$21.29 , N/A ,$22.41 , N/A ,$20.17 , N/A , N/A ,$35.42 , N/A , N/A ,$32.73 ,$34.65 , N/A ,$28.88 ,$26.95 ,$26.95 , N/A ,$26.95 ,$29.65 ,$29.65 , N/A ,$32.73 , N/A , N/A ,$21.60 ,$15.94 ,$16.02 , N/A , N/A , N/A ,$32.73 , N/A ,$20.17 ,$10.78 ,$34.65 ,$3.76 , N/A ,$25.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0295,AMPICILLIN-SULBACTAM 1.5 (1-0.5) G SOLR 1 EACH VIAL per1.5 g,636,1 ,$38.50 ,$27.72 ,$3.76 ,$38.50 ,$25.03 , N/A ,$10.78 ,$21.29 , N/A ,$22.41 , N/A ,$20.17 , N/A , N/A ,$35.42 , N/A , N/A ,$32.73 ,$34.65 , N/A ,$28.88 ,$26.95 ,$26.95 , N/A ,$26.95 ,$29.65 ,$29.65 , N/A ,$32.73 , N/A , N/A ,$21.60 ,$15.94 ,$16.02 , N/A , N/A , N/A ,$32.73 , N/A ,$20.17 ,$10.78 ,$34.65 ,$3.76 , N/A ,$25.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0461,ATROPINE 0.4 MG/ML SOLN per0.01 mg,636,1 ,$0.96 ,$0.69 ,$0.10 ,$0.96 ,$0.62 , N/A ,$0.27 ,$0.53 , N/A ,$0.56 , N/A ,$0.50 , N/A , N/A ,$0.88 , N/A , N/A ,$0.82 ,$0.86 , N/A ,$0.72 ,$0.67 ,$0.67 , N/A ,$0.67 ,$0.74 ,$0.74 , N/A ,$0.82 , N/A , N/A ,$0.54 ,$0.40 ,$0.40 , N/A , N/A , N/A ,$0.82 , N/A ,$0.50 ,$0.27 ,$0.86 ,$0.10 , N/A ,$0.62 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0461,ATROPINE 1 MG/10ML SOSY per0.01 mg,636,1 ,$0.55 ,$0.40 ,$0.10 ,$0.55 ,$0.36 , N/A ,$0.15 ,$0.30 , N/A ,$0.32 , N/A ,$0.29 , N/A , N/A ,$0.51 , N/A , N/A ,$0.47 ,$0.50 , N/A ,$0.41 ,$0.39 ,$0.39 , N/A ,$0.39 ,$0.42 ,$0.42 , N/A ,$0.47 , N/A , N/A ,$0.31 ,$0.23 ,$0.23 , N/A , N/A , N/A ,$0.47 , N/A ,$0.29 ,$0.15 ,$0.50 ,$0.10 , N/A ,$0.36 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7500,AZATHIOPRINE 50 MG TABS per50 mg,636,1 ,$1.70 ,$1.22 ,$0.48 ,$1.70 ,$1.11 , N/A ,$0.48 ,$0.94 , N/A ,$0.99 , N/A ,$0.89 , N/A , N/A ,$1.56 , N/A , N/A ,$1.45 ,$1.53 , N/A ,$1.28 ,$1.19 ,$1.19 , N/A ,$1.19 ,$1.31 ,$1.31 , N/A ,$1.45 , N/A , N/A ,$0.95 ,$0.70 ,$0.71 , N/A , N/A , N/A ,$1.45 , N/A ,$0.89 ,$0.48 ,$1.53 ,$1.70 , N/A ,$1.11 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0456,AZITHROMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$69.50 ,$50.04 ,$4.24 ,$69.50 ,$45.18 , N/A ,$19.46 ,$38.43 , N/A ,$40.45 , N/A ,$36.42 , N/A , N/A ,$63.94 , N/A , N/A ,$59.08 ,$62.55 , N/A ,$52.13 ,$48.65 ,$48.65 , N/A ,$48.65 ,$53.52 ,$53.52 , N/A ,$59.08 , N/A , N/A ,$38.99 ,$28.77 ,$28.91 , N/A , N/A , N/A ,$59.08 , N/A ,$36.42 ,$19.46 ,$62.55 ,$4.24 , N/A ,$45.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0517,BENRALIZUMAB 30 MG/ML SOSY per1 mg,636,1 ,$856.15 ,$616.43 ,$163.78 ,$856.15 ,$556.50 ,$163.78 ,$239.72 ,$473.45 ,$163.78 ,$498.28 ,$163.78 ,$448.62 ,$163.78 ,$337.57 ,$787.66 ,$417.79 ,$163.78 ,$727.73 ,$770.54 ,$167.05 ,$642.11 ,$599.31 ,$599.31 ,$163.78 ,$599.31 ,$659.24 ,$659.24 ,$417.79 ,$727.73 ,$167.12 ,$167.12 ,$480.30 ,$354.45 ,$356.16 ,$826.18 ,$856.15 ,$171.97 ,$727.73 ,$359.30 ,$448.62 ,$239.72 ,$770.54 ,$277.61 ,$163.78 ,$556.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0517,BENRALIZUMAB 30 MG/ML SOAJ per1 mg,636,1 ,$856.15 ,$616.43 ,$163.78 ,$856.15 ,$556.50 ,$163.78 ,$239.72 ,$473.45 ,$163.78 ,$498.28 ,$163.78 ,$448.62 ,$163.78 ,$337.57 ,$787.66 ,$417.79 ,$163.78 ,$727.73 ,$770.54 ,$167.05 ,$642.11 ,$599.31 ,$599.31 ,$163.78 ,$599.31 ,$659.24 ,$659.24 ,$417.79 ,$727.73 ,$167.12 ,$167.12 ,$480.30 ,$354.45 ,$356.16 ,$826.18 ,$856.15 ,$171.97 ,$727.73 ,$359.30 ,$448.62 ,$239.72 ,$770.54 ,$277.61 ,$163.78 ,$556.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0630,CALCITONIN 200 UNIT/ML SOLN per400 Units,636,1 ,"$10,524.00 ","$7,577.28 ","$1,059.67 ","$10,524.00 ","$6,840.60 ","$1,301.44 ","$2,946.72 ","$5,819.77 ","$1,301.44 ","$6,124.97 ","$1,301.44 ","$5,514.58 ","$1,301.44 ","$2,682.55 ","$9,682.08 ","$3,319.99 ","$1,301.44 ","$8,945.40 ","$9,471.60 ","$1,327.46 ","$7,893.00 ","$7,366.80 ","$7,366.80 ","$1,301.44 ","$7,366.80 ","$8,103.48 ","$8,103.48 ","$3,319.99 ","$8,945.40 ","$1,328.00 ","$1,328.00 ","$5,903.96 ","$4,356.94 ","$4,377.98 ","$1,071.28 ","$1,059.67 ","$1,366.51 ","$8,945.40 ","$2,855.19 ","$5,514.58 ","$2,946.72 ","$9,471.60 ","$3,197.52 ","$1,301.44 ","$6,840.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0610,CALCIUM GLUCONATE 10 % SOLN 10 ML VIAL per10 mL,636,1 ,$48.50 ,$34.92 ,$8.53 ,$48.50 ,$31.53 , N/A ,$13.58 ,$26.82 , N/A ,$28.23 , N/A ,$25.41 , N/A , N/A ,$44.62 , N/A , N/A ,$41.23 ,$43.65 , N/A ,$36.38 ,$33.95 ,$33.95 , N/A ,$33.95 ,$37.35 ,$37.35 , N/A ,$41.23 , N/A , N/A ,$27.21 ,$20.08 ,$20.18 , N/A , N/A , N/A ,$41.23 , N/A ,$25.41 ,$13.58 ,$43.65 ,$8.53 , N/A ,$31.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0690,CEFAZOLIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$15.00 ,$10.80 ,$1.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 , N/A ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$1.20 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0690,CEFAZOLIN 10 G SOLR 1 EACH VIAL per500 mg,636,1 ,$5.25 ,$3.78 ,$1.20 ,$5.25 ,$3.41 , N/A ,$1.47 ,$2.90 , N/A ,$3.06 , N/A ,$2.75 , N/A , N/A ,$4.83 , N/A , N/A ,$4.46 ,$4.73 , N/A ,$3.94 ,$3.68 ,$3.68 , N/A ,$3.68 ,$4.04 ,$4.04 , N/A ,$4.46 , N/A , N/A ,$2.95 ,$2.17 ,$2.18 , N/A , N/A , N/A ,$4.46 , N/A ,$2.75 ,$1.47 ,$4.73 ,$1.20 , N/A ,$3.41 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0692,CEFEPIME 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$14.75 ,$10.62 ,$2.13 ,$14.75 ,$9.59 , N/A ,$4.13 ,$8.16 , N/A ,$8.58 , N/A ,$7.73 , N/A , N/A ,$13.57 , N/A , N/A ,$12.54 ,$13.28 , N/A ,$11.06 ,$10.33 ,$10.33 , N/A ,$10.33 ,$11.36 ,$11.36 , N/A ,$12.54 , N/A , N/A ,$8.27 ,$6.11 ,$6.14 , N/A , N/A , N/A ,$12.54 , N/A ,$7.73 ,$4.13 ,$13.28 ,$2.13 , N/A ,$9.59 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0692,CEFEPIME 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$11.88 ,$8.55 ,$2.13 ,$11.88 ,$7.72 , N/A ,$3.33 ,$6.57 , N/A ,$6.91 , N/A ,$6.23 , N/A , N/A ,$10.93 , N/A , N/A ,$10.10 ,$10.69 , N/A ,$8.91 ,$8.32 ,$8.32 , N/A ,$8.32 ,$9.15 ,$9.15 , N/A ,$10.10 , N/A , N/A ,$6.66 ,$4.92 ,$4.94 , N/A , N/A , N/A ,$10.10 , N/A ,$6.23 ,$3.33 ,$10.69 ,$2.13 , N/A ,$7.72 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0712,CEFTAROLINE 600 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$17.80 ,$12.82 ,$3.69 ,$17.80 ,$11.57 ,$3.69 ,$4.98 ,$9.84 ,$3.69 ,$10.36 ,$3.69 ,$9.33 ,$3.69 ,$7.61 ,$16.38 ,$9.41 ,$3.69 ,$15.13 ,$16.02 ,$3.76 ,$13.35 ,$12.46 ,$12.46 ,$3.69 ,$12.46 ,$13.71 ,$13.71 ,$9.41 ,$15.13 ,$3.77 ,$3.77 ,$9.99 ,$7.37 ,$7.40 ,$17.18 ,$17.80 ,$3.88 ,$15.13 ,$8.09 ,$9.33 ,$4.98 ,$16.02 ,$6.24 ,$3.69 ,$11.57 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0713,CEFTAZIDIME 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$10.88 ,$7.83 ,$3.05 ,$10.88 ,$7.07 , N/A ,$3.05 ,$6.02 , N/A ,$6.33 , N/A ,$5.70 , N/A , N/A ,$10.01 , N/A , N/A ,$9.25 ,$9.79 , N/A ,$8.16 ,$7.62 ,$7.62 , N/A ,$7.62 ,$8.38 ,$8.38 , N/A ,$9.25 , N/A , N/A ,$6.10 ,$4.50 ,$4.53 , N/A , N/A , N/A ,$9.25 , N/A ,$5.70 ,$3.05 ,$9.79 ,$3.27 , N/A ,$7.07 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0713,CEFTAZIDIME 2 G SOLR 1 EACH VIAL per500 mg,636,1 ,$12.00 ,$8.64 ,$3.27 ,$12.00 ,$7.80 , N/A ,$3.36 ,$6.64 , N/A ,$6.98 , N/A ,$6.29 , N/A , N/A ,$11.04 , N/A , N/A ,$10.20 ,$10.80 , N/A ,$9.00 ,$8.40 ,$8.40 , N/A ,$8.40 ,$9.24 ,$9.24 , N/A ,$10.20 , N/A , N/A ,$6.73 ,$4.97 ,$4.99 , N/A , N/A , N/A ,$10.20 , N/A ,$6.29 ,$3.36 ,$10.80 ,$3.27 , N/A ,$7.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0696,CEFTRIAXONE 1 G SOLR 1 EACH VIAL per250 mg,636,1 ,$46.00 ,$33.12 ,$0.87 ,$46.00 ,$29.90 , N/A ,$12.88 ,$25.44 , N/A ,$26.77 , N/A ,$24.10 , N/A , N/A ,$42.32 , N/A , N/A ,$39.10 ,$41.40 , N/A ,$34.50 ,$32.20 ,$32.20 , N/A ,$32.20 ,$35.42 ,$35.42 , N/A ,$39.10 , N/A , N/A ,$25.81 ,$19.04 ,$19.14 , N/A , N/A , N/A ,$39.10 , N/A ,$24.10 ,$12.88 ,$41.40 ,$0.87 , N/A ,$29.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0696,CEFTRIAXONE 10 G SOLR 1 EACH VIAL per250 mg,636,1 ,$44.88 ,$32.31 ,$0.87 ,$44.88 ,$29.17 , N/A ,$12.57 ,$24.82 , N/A ,$26.12 , N/A ,$23.52 , N/A , N/A ,$41.29 , N/A , N/A ,$38.15 ,$40.39 , N/A ,$33.66 ,$31.42 ,$31.42 , N/A ,$31.42 ,$34.56 ,$34.56 , N/A ,$38.15 , N/A , N/A ,$25.18 ,$18.58 ,$18.67 , N/A , N/A , N/A ,$38.15 , N/A ,$23.52 ,$12.57 ,$40.39 ,$0.87 , N/A ,$29.17 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0696,CEFTRIAXONE 2 G SOLR 1 EACH VIAL per250 mg,636,1 ,$45.69 ,$32.90 ,$0.87 ,$45.69 ,$29.70 , N/A ,$12.79 ,$25.27 , N/A ,$26.59 , N/A ,$23.94 , N/A , N/A ,$42.03 , N/A , N/A ,$38.84 ,$41.12 , N/A ,$34.27 ,$31.98 ,$31.98 , N/A ,$31.98 ,$35.18 ,$35.18 , N/A ,$38.84 , N/A , N/A ,$25.63 ,$18.92 ,$19.01 , N/A , N/A , N/A ,$38.84 , N/A ,$23.94 ,$12.79 ,$41.12 ,$0.87 , N/A ,$29.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0735,CLONIDINE 100 MCG/ML SOLN per1 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$18.00 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3420,CYANOCOBALAMIN 1000 MCG/ML SOLN per1000 mcg,636,1 ,$18.00 ,$12.96 ,$3.38 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$3.38 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0878,DAPTOMYCIN 500 MG SOLR per1 mg,636,1 ,$0.58 ,$0.42 ,$0.08 ,$0.58 ,$0.38 , N/A ,$0.16 ,$0.32 , N/A ,$0.34 , N/A ,$0.30 , N/A , N/A ,$0.53 , N/A , N/A ,$0.49 ,$0.52 , N/A ,$0.44 ,$0.41 ,$0.41 , N/A ,$0.41 ,$0.45 ,$0.45 , N/A ,$0.49 , N/A , N/A ,$0.33 ,$0.24 ,$0.24 ,$0.56 ,$0.58 , N/A ,$0.49 , N/A ,$0.30 ,$0.16 ,$0.52 ,$0.08 , N/A ,$0.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0897,DENOSUMAB 60 MG/ML SOSY per1 mg,636,1 ,$118.18 ,$85.09 ,$22.56 ,$118.18 ,$76.82 ,$22.56 ,$33.09 ,$65.35 ,$22.56 ,$68.78 ,$22.56 ,$61.93 ,$22.56 ,$46.50 ,$108.73 ,$57.55 ,$22.56 ,$100.45 ,$106.36 ,$23.01 ,$88.64 ,$82.73 ,$82.73 ,$22.56 ,$82.73 ,$91.00 ,$91.00 ,$57.55 ,$100.45 ,$23.02 ,$23.02 ,$66.30 ,$48.93 ,$49.16 ,$114.04 ,$118.18 ,$23.69 ,$100.45 ,$49.49 ,$61.93 ,$33.09 ,$106.36 ,$38.07 ,$22.56 ,$76.82 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1100,DEXAMETHASONE 10 MG/ML SOLN per1 mg,636,1 ,$1.80 ,$1.30 ,$0.21 ,$1.80 ,$1.17 , N/A ,$0.50 ,$1.00 , N/A ,$1.05 , N/A ,$0.94 , N/A , N/A ,$1.66 , N/A , N/A ,$1.53 ,$1.62 , N/A ,$1.35 ,$1.26 ,$1.26 , N/A ,$1.26 ,$1.39 ,$1.39 , N/A ,$1.53 , N/A , N/A ,$1.01 ,$0.75 ,$0.75 , N/A , N/A , N/A ,$1.53 , N/A ,$0.94 ,$0.50 ,$1.62 ,$0.21 , N/A ,$1.17 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J8540,DEXAMETHASONE 4 MG TABS per0.25 mg,636,1 ,$0.19 ,$0.14 ,$0.05 ,$0.19 ,$0.12 , N/A ,$0.05 ,$0.11 , N/A ,$0.11 , N/A ,$0.10 , N/A , N/A ,$0.17 , N/A , N/A ,$0.16 ,$0.17 , N/A ,$0.14 ,$0.13 ,$0.13 , N/A ,$0.13 ,$0.15 ,$0.15 , N/A ,$0.16 , N/A , N/A ,$0.11 ,$0.08 ,$0.08 , N/A , N/A , N/A ,$0.16 , N/A ,$0.10 ,$0.05 ,$0.17 ,$0.18 , N/A ,$0.12 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1100,DEXAMETHASONE 4 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$3.19 ,$2.30 ,$0.21 ,$3.19 ,$2.07 , N/A ,$0.89 ,$1.76 , N/A ,$1.86 , N/A ,$1.67 , N/A , N/A ,$2.93 , N/A , N/A ,$2.71 ,$2.87 , N/A ,$2.39 ,$2.23 ,$2.23 , N/A ,$2.23 ,$2.46 ,$2.46 , N/A ,$2.71 , N/A , N/A ,$1.79 ,$1.32 ,$1.33 , N/A , N/A , N/A ,$2.71 , N/A ,$1.67 ,$0.89 ,$2.87 ,$0.21 , N/A ,$2.07 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1100,DEXAMETHASONE 4 MG/ML SOLN per1 mg,636,1 ,$4.50 ,$3.24 ,$0.21 ,$4.50 ,$2.93 , N/A ,$1.26 ,$2.49 , N/A ,$2.62 , N/A ,$2.36 , N/A , N/A ,$4.14 , N/A , N/A ,$3.83 ,$4.05 , N/A ,$3.38 ,$3.15 ,$3.15 , N/A ,$3.15 ,$3.47 ,$3.47 , N/A ,$3.83 , N/A , N/A ,$2.52 ,$1.86 ,$1.87 , N/A , N/A , N/A ,$3.83 , N/A ,$2.36 ,$1.26 ,$4.05 ,$0.21 , N/A ,$2.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,DEXTROSE 5 % AND 0.45 % NACL WITH KCL 20 MEQ 20-5-0.45 MEQ/L-%-% SOLN per2 mEq,636,1 ,$4.50 ,$3.24 ,$0.23 ,$4.50 ,$2.93 , N/A ,$1.26 ,$2.49 , N/A ,$2.62 , N/A ,$2.36 , N/A , N/A ,$4.14 , N/A , N/A ,$3.83 ,$4.05 , N/A ,$3.38 ,$3.15 ,$3.15 , N/A ,$3.15 ,$3.47 ,$3.47 , N/A ,$3.83 , N/A , N/A ,$2.52 ,$1.86 ,$1.87 , N/A , N/A , N/A ,$3.83 , N/A ,$2.36 ,$1.26 ,$4.05 ,$0.23 , N/A ,$2.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,0.45 % NACL WITH KCL 20 MEQ 20-0.45 MEQ/L-% SOLN per2 mEq,636,1 ,$4.50 ,$3.24 ,$0.23 ,$4.50 ,$2.93 , N/A ,$1.26 ,$2.49 , N/A ,$2.62 , N/A ,$2.36 , N/A , N/A ,$4.14 , N/A , N/A ,$3.83 ,$4.05 , N/A ,$3.38 ,$3.15 ,$3.15 , N/A ,$3.15 ,$3.47 ,$3.47 , N/A ,$3.83 , N/A , N/A ,$2.52 ,$1.86 ,$1.87 , N/A , N/A , N/A ,$3.83 , N/A ,$2.36 ,$1.26 ,$4.05 ,$0.23 , N/A ,$2.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,DEXTROSE 5 % AND 0.45 % NACL WITH KCL 40 MEQ 40-5-0.45 MEQ/L-%-% SOLN per2 mEq,636,1 ,$2.40 ,$1.73 ,$0.23 ,$2.40 ,$1.56 , N/A ,$0.67 ,$1.33 , N/A ,$1.40 , N/A ,$1.26 , N/A , N/A ,$2.21 , N/A , N/A ,$2.04 ,$2.16 , N/A ,$1.80 ,$1.68 ,$1.68 , N/A ,$1.68 ,$1.85 ,$1.85 , N/A ,$2.04 , N/A , N/A ,$1.35 ,$0.99 ,$1.00 , N/A , N/A , N/A ,$2.04 , N/A ,$1.26 ,$0.67 ,$2.16 ,$0.23 , N/A ,$1.56 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,DEXTROSE 5 % AND 0.9 % NACL WITH KCL 20 MEQ 20-5-0.9 MEQ/L-%-% SOLN per2 mEq,636,1 ,$4.80 ,$3.46 ,$0.23 ,$4.80 ,$3.12 , N/A ,$1.34 ,$2.65 , N/A ,$2.79 , N/A ,$2.52 , N/A , N/A ,$4.42 , N/A , N/A ,$4.08 ,$4.32 , N/A ,$3.60 ,$3.36 ,$3.36 , N/A ,$3.36 ,$3.70 ,$3.70 , N/A ,$4.08 , N/A , N/A ,$2.69 ,$1.99 ,$2.00 , N/A , N/A , N/A ,$4.08 , N/A ,$2.52 ,$1.34 ,$4.32 ,$0.23 , N/A ,$3.12 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,0.9 % NACL WITH KCL 20 MEQ 20-0.9 MEQ/L-% SOLN per2 mEq,636,1 ,$4.80 ,$3.46 ,$0.23 ,$4.80 ,$3.12 , N/A ,$1.34 ,$2.65 , N/A ,$2.79 , N/A ,$2.52 , N/A , N/A ,$4.42 , N/A , N/A ,$4.08 ,$4.32 , N/A ,$3.60 ,$3.36 ,$3.36 , N/A ,$3.36 ,$3.70 ,$3.70 , N/A ,$4.08 , N/A , N/A ,$2.69 ,$1.99 ,$2.00 , N/A , N/A , N/A ,$4.08 , N/A ,$2.52 ,$1.34 ,$4.32 ,$0.23 , N/A ,$3.12 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7042,DEXTROSE 5 %-SODIUM CHLORIDE 0.9 % 5-0.9 % SOLN per500 mL,636,1 ,$22.50 ,$16.20 ,$1.75 ,$22.50 ,$14.63 , N/A ,$6.30 ,$12.44 , N/A ,$13.10 , N/A ,$11.79 , N/A , N/A ,$20.70 , N/A , N/A ,$19.13 ,$20.25 , N/A ,$16.88 ,$15.75 ,$15.75 , N/A ,$15.75 ,$17.33 ,$17.33 , N/A ,$19.13 , N/A , N/A ,$12.62 ,$9.32 ,$9.36 , N/A , N/A , N/A ,$19.13 , N/A ,$11.79 ,$6.30 ,$20.25 ,$1.75 , N/A ,$14.63 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7121,DEXTROSE 5% LACTATED RINGERS 5 % SOLN per1000 mL,636,1 ,$45.00 ,$32.40 ,$9.11 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$9.11 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3360,DIAZEPAM 5 MG/ML SOLN per5 mg,636,1 ,$67.00 ,$48.24 ,$14.11 ,$67.00 ,$43.55 , N/A ,$18.76 ,$37.05 , N/A ,$38.99 , N/A ,$35.11 , N/A , N/A ,$61.64 , N/A , N/A ,$56.95 ,$60.30 , N/A ,$50.25 ,$46.90 ,$46.90 , N/A ,$46.90 ,$51.59 ,$51.59 , N/A ,$56.95 , N/A , N/A ,$37.59 ,$27.74 ,$27.87 , N/A , N/A , N/A ,$56.95 , N/A ,$35.11 ,$18.76 ,$60.30 ,$14.11 , N/A ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0500,DICYCLOMINE 10 MG/ML SOLN per20 mg,636,1 ,$403.50 ,$290.52 ,$39.91 ,$403.50 ,$262.28 , N/A ,$112.98 ,$223.14 , N/A ,$234.84 , N/A ,$211.43 , N/A , N/A ,$371.22 , N/A , N/A ,$342.98 ,$363.15 , N/A ,$302.63 ,$282.45 ,$282.45 , N/A ,$282.45 ,$310.70 ,$310.70 , N/A ,$342.98 , N/A , N/A ,$226.36 ,$167.05 ,$167.86 , N/A , N/A , N/A ,$342.98 , N/A ,$211.43 ,$112.98 ,$363.15 ,$39.91 , N/A ,$262.28 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1160,DIGOXIN 0.25 MG/ML SOLN per0.5 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$13.40 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1200,DIPHENHYDRAMINE 50 MG/ML SOLN per50 mg,636,1 ,$18.00 ,$12.96 ,$1.91 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$1.91 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1250,DOBUTAMINE 1 MG/ML SOLN per250 mg,636,1 ,$99.00 ,$71.28 ,$11.50 ,$99.00 ,$64.35 , N/A ,$27.72 ,$54.75 , N/A ,$57.62 , N/A ,$51.88 , N/A , N/A ,$91.08 , N/A , N/A ,$84.15 ,$89.10 , N/A ,$74.25 ,$69.30 ,$69.30 , N/A ,$69.30 ,$76.23 ,$76.23 , N/A ,$84.15 , N/A , N/A ,$55.54 ,$40.99 ,$41.18 , N/A , N/A , N/A ,$84.15 , N/A ,$51.88 ,$27.72 ,$89.10 ,$11.50 , N/A ,$64.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1265,DOPAMINE 1.6-5 MG/ML-% SOLN per40 mg,636,1 ,$9.10 ,$6.55 ,$1.02 ,$9.10 ,$5.92 , N/A ,$2.55 ,$5.03 , N/A ,$5.30 , N/A ,$4.77 , N/A , N/A ,$8.37 , N/A , N/A ,$7.74 ,$8.19 , N/A ,$6.83 ,$6.37 ,$6.37 , N/A ,$6.37 ,$7.01 ,$7.01 , N/A ,$7.74 , N/A , N/A ,$5.11 ,$3.77 ,$3.79 , N/A , N/A , N/A ,$7.74 , N/A ,$4.77 ,$2.55 ,$8.19 ,$1.02 , N/A ,$5.92 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1790,DROPERIDOL 2.5 MG/ML SOLN per5 mg,636,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 ,$13.65 , N/A ,$5.88 ,$11.61 , N/A ,$12.22 , N/A ,$11.00 , N/A , N/A ,$19.32 , N/A , N/A ,$17.85 ,$18.90 , N/A ,$15.75 ,$14.70 ,$14.70 , N/A ,$14.70 ,$16.17 ,$16.17 , N/A ,$17.85 , N/A , N/A ,$11.78 ,$8.69 ,$8.74 , N/A , N/A , N/A ,$17.85 , N/A ,$11.00 ,$5.88 ,$18.90 ,$17.04 , N/A ,$13.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 100 MG/ML SOSY per10 mg,636,1 ,$7.20 ,$5.18 ,$1.34 ,$7.20 ,$4.68 , N/A ,$2.02 ,$3.98 , N/A ,$4.19 , N/A ,$3.77 , N/A , N/A ,$6.62 , N/A , N/A ,$6.12 ,$6.48 , N/A ,$5.40 ,$5.04 ,$5.04 , N/A ,$5.04 ,$5.54 ,$5.54 , N/A ,$6.12 , N/A , N/A ,$4.04 ,$2.98 ,$3.00 , N/A , N/A , N/A ,$6.12 , N/A ,$3.77 ,$2.02 ,$6.48 ,$1.34 , N/A ,$4.68 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 120 MG/0.8ML SOSY per10 mg,636,1 ,$7.21 ,$5.19 ,$1.34 ,$7.21 ,$4.69 , N/A ,$2.02 ,$3.99 , N/A ,$4.20 , N/A ,$3.78 , N/A , N/A ,$6.63 , N/A , N/A ,$6.13 ,$6.49 , N/A ,$5.41 ,$5.05 ,$5.05 , N/A ,$5.05 ,$5.55 ,$5.55 , N/A ,$6.13 , N/A , N/A ,$4.04 ,$2.98 ,$3.00 , N/A , N/A , N/A ,$6.13 , N/A ,$3.78 ,$2.02 ,$6.49 ,$1.34 , N/A ,$4.69 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 30 MG/0.3ML SOLN per10 mg,636,1 ,$9.67 ,$6.96 ,$1.34 ,$9.67 ,$6.29 , N/A ,$2.71 ,$5.35 , N/A ,$5.63 , N/A ,$5.07 , N/A , N/A ,$8.90 , N/A , N/A ,$8.22 ,$8.70 , N/A ,$7.25 ,$6.77 ,$6.77 , N/A ,$6.77 ,$7.45 ,$7.45 , N/A ,$8.22 , N/A , N/A ,$5.42 ,$4.00 ,$4.02 , N/A , N/A , N/A ,$8.22 , N/A ,$5.07 ,$2.71 ,$8.70 ,$1.34 , N/A ,$6.29 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 40 MG/0.4ML SOLN per10 mg,636,1 ,$7.33 ,$5.28 ,$1.34 ,$7.33 ,$4.76 , N/A ,$2.05 ,$4.05 , N/A ,$4.27 , N/A ,$3.84 , N/A , N/A ,$6.74 , N/A , N/A ,$6.23 ,$6.60 , N/A ,$5.50 ,$5.13 ,$5.13 , N/A ,$5.13 ,$5.64 ,$5.64 , N/A ,$6.23 , N/A , N/A ,$4.11 ,$3.03 ,$3.05 , N/A , N/A , N/A ,$6.23 , N/A ,$3.84 ,$2.05 ,$6.60 ,$1.34 , N/A ,$4.76 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 30 MG/0.3ML SOSY per10 mg,636,1 ,$7.33 ,$5.28 ,$1.34 ,$7.33 ,$4.76 , N/A ,$2.05 ,$4.05 , N/A ,$4.27 , N/A ,$3.84 , N/A , N/A ,$6.74 , N/A , N/A ,$6.23 ,$6.60 , N/A ,$5.50 ,$5.13 ,$5.13 , N/A ,$5.13 ,$5.64 ,$5.64 , N/A ,$6.23 , N/A , N/A ,$4.11 ,$3.03 ,$3.05 , N/A , N/A , N/A ,$6.23 , N/A ,$3.84 ,$2.05 ,$6.60 ,$1.34 , N/A ,$4.76 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 40 MG/0.4ML SOSY per10 mg,636,1 ,$11.25 ,$8.10 ,$1.34 ,$11.25 ,$7.31 , N/A ,$3.15 ,$6.22 , N/A ,$6.55 , N/A ,$5.90 , N/A , N/A ,$10.35 , N/A , N/A ,$9.56 ,$10.13 , N/A ,$8.44 ,$7.88 ,$7.88 , N/A ,$7.88 ,$8.66 ,$8.66 , N/A ,$9.56 , N/A , N/A ,$6.31 ,$4.66 ,$4.68 , N/A , N/A , N/A ,$9.56 , N/A ,$5.90 ,$3.15 ,$10.13 ,$1.34 , N/A ,$7.31 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 60 MG/0.6ML SOSY per10 mg,636,1 ,$9.58 ,$6.90 ,$1.34 ,$9.58 ,$6.23 , N/A ,$2.68 ,$5.30 , N/A ,$5.58 , N/A ,$5.02 , N/A , N/A ,$8.81 , N/A , N/A ,$8.14 ,$8.62 , N/A ,$7.19 ,$6.71 ,$6.71 , N/A ,$6.71 ,$7.38 ,$7.38 , N/A ,$8.14 , N/A , N/A ,$5.37 ,$3.97 ,$3.99 , N/A , N/A , N/A ,$8.14 , N/A ,$5.02 ,$2.68 ,$8.62 ,$1.34 , N/A ,$6.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1650,ENOXAPARIN 80 MG/0.8ML SOLN per10 mg,636,1 ,$7.25 ,$5.22 ,$1.34 ,$7.25 ,$4.71 , N/A ,$2.03 ,$4.01 , N/A ,$4.22 , N/A ,$3.80 , N/A , N/A ,$6.67 , N/A , N/A ,$6.16 ,$6.53 , N/A ,$5.44 ,$5.08 ,$5.08 , N/A ,$5.08 ,$5.58 ,$5.58 , N/A ,$6.16 , N/A , N/A ,$4.07 ,$3.00 ,$3.02 , N/A , N/A , N/A ,$6.16 , N/A ,$3.80 ,$2.03 ,$6.53 ,$1.34 , N/A ,$4.71 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3490,EPHEDRINE 50 MG/ML SOLN per50 mg,636,1 ,$56.00 ,$40.32 ,$15.68 ,$56.00 ,$36.40 , N/A ,$15.68 ,$30.97 , N/A ,$32.59 , N/A ,$29.34 , N/A , N/A ,$51.52 , N/A , N/A ,$47.60 ,$50.40 , N/A ,$42.00 ,$39.20 ,$39.20 , N/A ,$39.20 ,$43.12 ,$43.12 , N/A ,$47.60 , N/A , N/A ,$31.42 ,$23.18 ,$23.30 , N/A , N/A , N/A ,$47.60 , N/A ,$29.34 ,$15.68 ,$50.40 , N/A , N/A ,$36.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0171,EPINEPHRINE 1 MG/10 ML SOSY per0.1 mg,636,1 ,$3.05 ,$2.20 ,$0.85 ,$3.05 ,$1.98 , N/A ,$0.85 ,$1.69 , N/A ,$1.78 , N/A ,$1.60 , N/A , N/A ,$2.81 , N/A , N/A ,$2.59 ,$2.75 , N/A ,$2.29 ,$2.14 ,$2.14 , N/A ,$2.14 ,$2.35 ,$2.35 , N/A ,$2.59 , N/A , N/A ,$1.71 ,$1.26 ,$1.27 , N/A , N/A , N/A ,$2.59 , N/A ,$1.60 ,$0.85 ,$2.75 ,$1.19 , N/A ,$1.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0171,EPINEPHRINE 1 MG/10ML SOSY per0.1 mg,636,1 ,$2.53 ,$1.82 ,$0.71 ,$2.53 ,$1.64 , N/A ,$0.71 ,$1.40 , N/A ,$1.47 , N/A ,$1.33 , N/A , N/A ,$2.33 , N/A , N/A ,$2.15 ,$2.28 , N/A ,$1.90 ,$1.77 ,$1.77 , N/A ,$1.77 ,$1.95 ,$1.95 , N/A ,$2.15 , N/A , N/A ,$1.42 ,$1.05 ,$1.05 , N/A , N/A , N/A ,$2.15 , N/A ,$1.33 ,$0.71 ,$2.28 ,$1.19 , N/A ,$1.64 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0171,EPINEPHRINE PF 1 MG/ML SOLN per0.1 mg,636,1 ,$7.00 ,$5.04 ,$1.19 ,$7.00 ,$4.55 , N/A ,$1.96 ,$3.87 , N/A ,$4.07 , N/A ,$3.67 , N/A , N/A ,$6.44 , N/A , N/A ,$5.95 ,$6.30 , N/A ,$5.25 ,$4.90 ,$4.90 , N/A ,$4.90 ,$5.39 ,$5.39 , N/A ,$5.95 , N/A , N/A ,$3.93 ,$2.90 ,$2.91 , N/A , N/A , N/A ,$5.95 , N/A ,$3.67 ,$1.96 ,$6.30 ,$1.19 , N/A ,$4.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0885,EPOETIN ALFA 20000 UNIT/ML SOLN per1000 Units,636,1 ,$128.30 ,$92.38 ,$7.77 ,$128.30 ,$83.40 ,$7.77 ,$35.92 ,$70.95 ,$7.77 ,$74.67 ,$7.77 ,$67.23 ,$7.77 ,$16.01 ,$118.04 ,$19.82 ,$7.77 ,$109.06 ,$115.47 ,$7.93 ,$96.23 ,$89.81 ,$89.81 ,$7.77 ,$89.81 ,$98.79 ,$98.79 ,$19.82 ,$109.06 ,$7.93 ,$7.93 ,$71.98 ,$53.12 ,$53.37 ,$123.81 ,$128.30 ,$8.16 ,$109.06 ,$17.05 ,$67.23 ,$35.92 ,$115.47 ,$13.61 ,$7.77 ,$83.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0885,EPOETIN ALFA 10000 UNIT/ML SOLN per1000 Units,636,1 ,$128.30 ,$92.38 ,$7.77 ,$128.30 ,$83.40 ,$7.77 ,$35.92 ,$70.95 ,$7.77 ,$74.67 ,$7.77 ,$67.23 ,$7.77 ,$16.01 ,$118.04 ,$19.82 ,$7.77 ,$109.06 ,$115.47 ,$7.93 ,$96.23 ,$89.81 ,$89.81 ,$7.77 ,$89.81 ,$98.79 ,$98.79 ,$19.82 ,$109.06 ,$7.93 ,$7.93 ,$71.98 ,$53.12 ,$53.37 ,$123.81 ,$128.30 ,$8.16 ,$109.06 ,$17.05 ,$67.23 ,$35.92 ,$115.47 ,$13.61 ,$7.77 ,$83.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,Q5106,EPOETIN ALFA-EPBX 10000 UNITS/ML SOLN per1000 Units,636,1 ,$52.95 ,$38.12 ,$8.34 ,$52.95 ,$34.42 ,$8.34 ,$14.83 ,$29.28 ,$8.34 ,$30.82 ,$8.34 ,$27.75 ,$8.34 ,$17.20 ,$48.71 ,$21.29 ,$8.34 ,$45.01 ,$47.66 ,$8.51 ,$39.71 ,$37.07 ,$37.07 ,$8.34 ,$37.07 ,$40.77 ,$40.77 ,$21.29 ,$45.01 ,$8.51 ,$8.51 ,$29.71 ,$21.92 ,$22.03 ,$51.10 ,$52.95 ,$8.76 ,$45.01 ,$18.31 ,$27.75 ,$14.83 ,$47.66 ,$13.30 ,$8.34 ,$34.42 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1335,ERTAPENEM 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$281.00 ,$202.32 ,$25.36 ,$281.00 ,$182.65 , N/A ,$78.68 ,$155.39 , N/A ,$163.54 , N/A ,$147.24 , N/A , N/A ,$258.52 , N/A , N/A ,$238.85 ,$252.90 , N/A ,$210.75 ,$196.70 ,$196.70 , N/A ,$196.70 ,$216.37 ,$216.37 , N/A ,$238.85 , N/A , N/A ,$157.64 ,$116.33 ,$116.90 , N/A , N/A , N/A ,$238.85 , N/A ,$147.24 ,$78.68 ,$252.90 ,$25.36 , N/A ,$182.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3010,FENTANYL 250 MCG/5ML SOLN 50 ML VIAL per0.1 mg,636,1 ,$4.80 ,$3.46 ,$1.34 ,$4.80 ,$3.12 , N/A ,$1.34 ,$2.65 , N/A ,$2.79 , N/A ,$2.52 , N/A , N/A ,$4.42 , N/A , N/A ,$4.08 ,$4.32 , N/A ,$3.60 ,$3.36 ,$3.36 , N/A ,$3.36 ,$3.70 ,$3.70 , N/A ,$4.08 , N/A , N/A ,$2.69 ,$1.99 ,$2.00 , N/A , N/A , N/A ,$4.08 , N/A ,$2.52 ,$1.34 ,$4.32 ,$1.52 , N/A ,$3.12 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3010,FENTANYL 250 MCG/5ML SOLN per0.1 mg,636,1 ,$6.00 ,$4.32 ,$1.52 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$1.52 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3010,FENTANYL 50 MCG/ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$1.52 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3010,FENTANYL 100 MCG/2ML SOLN per0.1 mg,636,1 ,$18.00 ,$12.96 ,$1.52 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$1.52 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1439,FERRIC CARBOXYMALTOSE 750 MG/15ML SOLN 15 ML VIAL per1 mg,636,1 ,$7.74 ,$5.57 ,$1.11 ,$7.74 ,$5.03 ,$1.11 ,$2.17 ,$4.28 ,$1.11 ,$4.50 ,$1.11 ,$4.06 ,$1.11 ,$2.29 ,$7.12 ,$2.84 ,$1.11 ,$6.58 ,$6.97 ,$1.14 ,$5.81 ,$5.42 ,$5.42 ,$1.11 ,$5.42 ,$5.96 ,$5.96 ,$2.84 ,$6.58 ,$1.13 ,$1.13 ,$4.34 ,$3.20 ,$3.22 ,$7.47 ,$7.74 ,$1.17 ,$6.58 ,$2.44 ,$4.06 ,$2.17 ,$6.97 ,$1.82 ,$1.11 ,$5.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,Q0138,FERUMOXYTOL 510 MG/17ML SOLN 17 ML VIAL per1 mg,636,1 ,$11.23 ,$8.09 ,$0.47 ,$11.23 ,$7.30 ,$0.47 ,$3.14 ,$6.21 ,$0.47 ,$6.54 ,$0.47 ,$5.88 ,$0.47 ,$0.97 ,$10.33 ,$1.20 ,$0.47 ,$9.55 ,$10.11 ,$0.48 ,$8.42 ,$7.86 ,$7.86 ,$0.47 ,$7.86 ,$8.65 ,$8.65 ,$1.20 ,$9.55 ,$0.48 ,$0.48 ,$6.30 ,$4.65 ,$4.67 ,$10.84 ,$11.23 ,$0.49 ,$9.55 ,$1.03 ,$5.88 ,$3.14 ,$10.11 ,$0.92 ,$0.47 ,$7.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1450,FLUCONAZOLE 200-0.9 MG/100ML-% SOLN per200 mg,636,1 ,$91.00 ,$65.52 ,$3.84 ,$91.00 ,$59.15 , N/A ,$25.48 ,$50.32 , N/A ,$52.96 , N/A ,$47.68 , N/A , N/A ,$83.72 , N/A , N/A ,$77.35 ,$81.90 , N/A ,$68.25 ,$63.70 ,$63.70 , N/A ,$63.70 ,$70.07 ,$70.07 , N/A ,$77.35 , N/A , N/A ,$51.05 ,$37.67 ,$37.86 , N/A , N/A , N/A ,$77.35 , N/A ,$47.68 ,$25.48 ,$81.90 ,$3.84 , N/A ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1940,FUROSEMIDE 10 MG/ML SOLN 10 ML VIAL per20 mg,636,1 ,$3.60 ,$2.59 ,$1.01 ,$3.60 ,$2.34 , N/A ,$1.01 ,$1.99 , N/A ,$2.10 , N/A ,$1.89 , N/A , N/A ,$3.31 , N/A , N/A ,$3.06 ,$3.24 , N/A ,$2.70 ,$2.52 ,$2.52 , N/A ,$2.52 ,$2.77 ,$2.77 , N/A ,$3.06 , N/A , N/A ,$2.02 ,$1.49 ,$1.50 , N/A , N/A , N/A ,$3.06 , N/A ,$1.89 ,$1.01 ,$3.24 ,$1.09 , N/A ,$2.34 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1940,FUROSEMIDE 10 MG/ML SOLN per20 mg,636,1 ,$18.00 ,$12.96 ,$1.09 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$1.09 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1580,GENTAMICIN 40 MG/ML SOLN 2 ML VIAL per80 mg,636,1 ,$17.00 ,$12.24 ,$4.60 ,$17.00 ,$11.05 , N/A ,$4.76 ,$9.40 , N/A ,$9.89 , N/A ,$8.91 , N/A , N/A ,$15.64 , N/A , N/A ,$14.45 ,$15.30 , N/A ,$12.75 ,$11.90 ,$11.90 , N/A ,$11.90 ,$13.09 ,$13.09 , N/A ,$14.45 , N/A , N/A ,$9.54 ,$7.04 ,$7.07 , N/A , N/A , N/A ,$14.45 , N/A ,$8.91 ,$4.76 ,$15.30 ,$4.60 , N/A ,$11.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1610,GLUCAGON 1 MG SOLR per1 mg,636,1 ,$824.00 ,$593.28 ,$56.66 ,$824.00 ,$535.60 ,$186.45 ,$230.72 ,$455.67 ,$186.45 ,$479.57 ,$186.45 ,$431.78 ,$186.45 ,$384.32 ,$758.08 ,$475.65 ,$186.45 ,$700.40 ,$741.60 ,$190.18 ,$618.00 ,$576.80 ,$576.80 ,$186.45 ,$576.80 ,$634.48 ,$634.48 ,$475.65 ,$700.40 ,$190.26 ,$190.26 ,$462.26 ,$341.14 ,$342.78 ,$57.28 ,$56.66 ,$195.77 ,$700.40 ,$409.06 ,$431.78 ,$230.72 ,$741.60 ,$286.74 ,$186.45 ,$535.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3490,GLYCOPYRROLATE 0.2 MG/ML SOLN per1 mg,636,1 ,$195.00 ,$140.40 ,$54.60 ,$195.00 ,$126.75 , N/A ,$54.60 ,$107.84 , N/A ,$113.49 , N/A ,$102.18 , N/A , N/A ,$179.40 , N/A , N/A ,$165.75 ,$175.50 , N/A ,$146.25 ,$136.50 ,$136.50 , N/A ,$136.50 ,$150.15 ,$150.15 , N/A ,$165.75 , N/A , N/A ,$109.40 ,$80.73 ,$81.12 , N/A , N/A , N/A ,$165.75 , N/A ,$102.18 ,$54.60 ,$175.50 , N/A , N/A ,$126.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1602,GOLIMUMAB 50 MG/4ML SOLN 4 ML VIAL per1 mg,636,1 ,$191.54 ,$137.91 ,$13.57 ,$191.54 ,$124.50 ,$13.57 ,$53.63 ,$105.92 ,$13.57 ,$111.48 ,$13.57 ,$100.37 ,$13.57 ,$27.97 ,$176.22 ,$34.62 ,$13.57 ,$162.81 ,$172.39 ,$13.85 ,$143.66 ,$134.08 ,$134.08 ,$13.57 ,$134.08 ,$147.49 ,$147.49 ,$34.62 ,$162.81 ,$13.85 ,$13.85 ,$107.45 ,$79.30 ,$79.68 ,$184.84 ,$191.54 ,$14.25 ,$162.81 ,$29.78 ,$100.37 ,$53.63 ,$172.39 ,$22.85 ,$13.57 ,$124.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1630,HALOPERIDOL LACTATE 5 MG/ML SOLN per5 mg,636,1 ,$29.00 ,$20.88 ,$1.42 ,$29.00 ,$18.85 , N/A ,$8.12 ,$16.04 , N/A ,$16.88 , N/A ,$15.20 , N/A , N/A ,$26.68 , N/A , N/A ,$24.65 ,$26.10 , N/A ,$21.75 ,$20.30 ,$20.30 , N/A ,$20.30 ,$22.33 ,$22.33 , N/A ,$24.65 , N/A , N/A ,$16.27 ,$12.01 ,$12.06 , N/A , N/A , N/A ,$24.65 , N/A ,$15.20 ,$8.12 ,$26.10 ,$1.42 , N/A ,$18.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1644,HEPARIN (PORCINE) 1000 UNIT/ML SOLN 30 ML VIAL per1000 Units,636,1 ,$1.26 ,$0.91 ,$0.21 ,$1.26 ,$0.82 , N/A ,$0.35 ,$0.70 , N/A ,$0.73 , N/A ,$0.66 , N/A , N/A ,$1.16 , N/A , N/A ,$1.07 ,$1.13 , N/A ,$0.95 ,$0.88 ,$0.88 , N/A ,$0.88 ,$0.97 ,$0.97 , N/A ,$1.07 , N/A , N/A ,$0.71 ,$0.52 ,$0.52 , N/A , N/A , N/A ,$1.07 , N/A ,$0.66 ,$0.35 ,$1.13 ,$0.21 , N/A ,$0.82 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1644,HEPARIN (PORCINE) 25000-0.45 UT/250ML-% SOLN per1000 Units,636,1 ,$3.64 ,$2.62 ,$0.21 ,$3.64 ,$2.37 , N/A ,$1.02 ,$2.01 , N/A ,$2.12 , N/A ,$1.91 , N/A , N/A ,$3.35 , N/A , N/A ,$3.09 ,$3.28 , N/A ,$2.73 ,$2.55 ,$2.55 , N/A ,$2.55 ,$2.80 ,$2.80 , N/A ,$3.09 , N/A , N/A ,$2.04 ,$1.51 ,$1.51 , N/A , N/A , N/A ,$3.09 , N/A ,$1.91 ,$1.02 ,$3.28 ,$0.21 , N/A ,$2.37 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1644,HEPARIN (PORCINE) 5000 UNIT/ML SOLN per1000 Units,636,1 ,$4.50 ,$3.24 ,$0.21 ,$4.50 ,$2.93 , N/A ,$1.26 ,$2.49 , N/A ,$2.62 , N/A ,$2.36 , N/A , N/A ,$4.14 , N/A , N/A ,$3.83 ,$4.05 , N/A ,$3.38 ,$3.15 ,$3.15 , N/A ,$3.15 ,$3.47 ,$3.47 , N/A ,$3.83 , N/A , N/A ,$2.52 ,$1.86 ,$1.87 , N/A , N/A , N/A ,$3.83 , N/A ,$2.36 ,$1.26 ,$4.05 ,$0.21 , N/A ,$2.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1642,HEPARIN FLUSH 100 UNIT/ML SOLN per10 Units,636,1 ,$0.12 ,$0.09 ,$0.03 ,$0.12 ,$0.08 , N/A ,$0.03 ,$0.07 , N/A ,$0.07 , N/A ,$0.06 , N/A , N/A , N/A , N/A , N/A ,$0.10 ,$0.11 , N/A ,$0.09 ,$0.08 ,$0.08 , N/A ,$0.08 ,$0.09 ,$0.09 , N/A ,$0.10 , N/A , N/A ,$0.07 ,$0.05 ,$0.05 , N/A , N/A , N/A ,$0.10 , N/A ,$0.06 ,$0.03 ,$0.11 ,$0.03 , N/A ,$0.08 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0360,HYDRALAZINE 20 MG/ML SOLN per20 mg,636,1 ,$106.50 ,$76.68 ,$11.15 ,$106.50 ,$69.23 , N/A ,$29.82 ,$58.89 , N/A ,$61.98 , N/A ,$55.81 , N/A , N/A ,$97.98 , N/A , N/A ,$90.53 ,$95.85 , N/A ,$79.88 ,$74.55 ,$74.55 , N/A ,$74.55 ,$82.01 ,$82.01 , N/A ,$90.53 , N/A , N/A ,$59.75 ,$44.09 ,$44.30 , N/A , N/A , N/A ,$90.53 , N/A ,$55.81 ,$29.82 ,$95.85 ,$11.15 , N/A ,$69.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLR per100 mg,636,1 ,$89.00 ,$64.08 ,$24.92 ,$89.00 ,$57.85 , N/A ,$24.92 ,$49.22 , N/A ,$51.80 , N/A ,$46.64 , N/A , N/A ,$81.88 , N/A , N/A ,$75.65 ,$80.10 , N/A ,$66.75 ,$62.30 ,$62.30 , N/A ,$62.30 ,$68.53 ,$68.53 , N/A ,$75.65 , N/A , N/A ,$49.93 ,$36.85 ,$37.02 , N/A , N/A , N/A ,$75.65 , N/A ,$46.64 ,$24.92 ,$80.10 ,$29.50 , N/A ,$57.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1170,HYDROMORPHONE 1 MG/ML SOLN per4 mg,636,1 ,$20.00 ,$14.40 ,$5.60 ,$20.00 ,$13.00 , N/A ,$5.60 ,$11.06 , N/A ,$11.64 , N/A ,$10.48 , N/A , N/A ,$18.40 , N/A , N/A ,$17.00 ,$18.00 , N/A ,$15.00 ,$14.00 ,$14.00 , N/A ,$14.00 ,$15.40 ,$15.40 , N/A ,$17.00 , N/A , N/A ,$11.22 ,$8.28 ,$8.32 , N/A , N/A , N/A ,$17.00 , N/A ,$10.48 ,$5.60 ,$18.00 ,$6.96 , N/A ,$13.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3410,HYDROXYZINE 50 MG/ML SOLN per25 mg,636,1 ,$61.50 ,$44.28 ,$17.22 ,$61.50 ,$39.98 , N/A ,$17.22 ,$34.01 , N/A ,$35.79 , N/A ,$32.23 , N/A , N/A ,$56.58 , N/A , N/A ,$52.28 ,$55.35 , N/A ,$46.13 ,$43.05 ,$43.05 , N/A ,$43.05 ,$47.36 ,$47.36 , N/A ,$52.28 , N/A , N/A ,$34.50 ,$25.46 ,$25.58 , N/A , N/A , N/A ,$52.28 , N/A ,$32.23 ,$17.22 ,$55.35 ,$17.62 , N/A ,$39.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1745,INFLIXIMAB 100 MG SOLR 1 EACH VIAL per10 mg,636,1 ,$560.56 ,$403.60 ,$33.36 ,$560.56 ,$364.36 ,$33.36 ,$156.96 ,$309.99 ,$33.36 ,$326.25 ,$33.36 ,$293.73 ,$33.36 ,$68.77 ,$515.72 ,$85.11 ,$33.36 ,$476.48 ,$504.50 ,$34.03 ,$420.42 ,$392.39 ,$392.39 ,$33.36 ,$392.39 ,$431.63 ,$431.63 ,$85.11 ,$476.48 ,$34.04 ,$34.04 ,$314.47 ,$232.07 ,$233.19 ,$540.94 ,$560.56 ,$35.03 ,$476.48 ,$73.19 ,$293.73 ,$156.96 ,$504.50 ,$57.52 ,$33.36 ,$364.36 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,90686,INFLUENZA VIRUS VACCINE (QUAD) 0.5 ML SUSY per0.5 mL,636,1 ,$92.50 ,$66.60 ,$15.53 ,$92.50 ,$60.13 ,$21.76 ,$25.90 ,$51.15 ,$21.76 ,$53.84 ,$21.76 ,$48.47 ,$21.76 ,$44.84 ,$85.10 ,$55.50 ,$21.76 ,$78.63 ,$83.25 ,$22.19 ,$69.38 ,$64.75 ,$64.75 ,$21.76 ,$64.75 ,$71.23 ,$71.23 ,$55.50 ,$78.63 ,$22.20 ,$22.20 ,$51.89 ,$38.30 ,$38.48 ,$15.70 ,$15.53 ,$22.84 ,$78.63 ,$47.73 ,$48.47 ,$25.90 ,$83.25 ,$35.51 ,$21.76 ,$60.13 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1756,IRON SUCROSE 20 MG/ML SOLN per1 mg,636,1 ,$2.77 ,$1.99 ,$0.36 ,$2.77 ,$1.80 , N/A ,$0.78 ,$1.53 , N/A ,$1.61 , N/A ,$1.45 , N/A , N/A ,$2.55 , N/A , N/A ,$2.35 ,$2.49 , N/A ,$2.08 ,$1.94 ,$1.94 , N/A ,$1.94 ,$2.13 ,$2.13 , N/A ,$2.35 , N/A , N/A ,$1.55 ,$1.15 ,$1.15 ,$2.67 ,$2.77 , N/A ,$2.35 , N/A ,$1.45 ,$0.78 ,$2.49 ,$0.36 , N/A ,$1.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1885,KETOROLAC 30 MG/ML SOLN per15 mg,636,1 ,$18.00 ,$12.96 ,$0.97 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$0.97 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7120,LACTATED RINGERS SOLN per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.13 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$4.13 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1953,LEVETIRACETAM 500 MG/5ML SOLN 5 ML VIAL per10 mg,636,1 ,$1.01 ,$0.73 ,$0.15 ,$1.01 ,$0.66 , N/A ,$0.28 ,$0.56 , N/A ,$0.59 , N/A ,$0.53 , N/A , N/A ,$0.93 , N/A , N/A ,$0.86 ,$0.91 , N/A ,$0.76 ,$0.71 ,$0.71 , N/A ,$0.71 ,$0.78 ,$0.78 , N/A ,$0.86 , N/A , N/A ,$0.57 ,$0.42 ,$0.42 , N/A , N/A , N/A ,$0.86 , N/A ,$0.53 ,$0.28 ,$0.91 ,$0.15 , N/A ,$0.66 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1956,LEVOFLOXACIN 250 MG/50ML SOLN per250 mg,636,1 ,$91.00 ,$65.52 ,$1.60 ,$91.00 ,$59.15 , N/A ,$25.48 ,$50.32 , N/A ,$52.96 , N/A ,$47.68 , N/A , N/A ,$83.72 , N/A , N/A ,$77.35 ,$81.90 , N/A ,$68.25 ,$63.70 ,$63.70 , N/A ,$63.70 ,$70.07 ,$70.07 , N/A ,$77.35 , N/A , N/A ,$51.05 ,$37.67 ,$37.86 , N/A , N/A , N/A ,$77.35 , N/A ,$47.68 ,$25.48 ,$81.90 ,$1.60 , N/A ,$59.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1956,LEVOFLOXACIN 500 MG/100ML SOLN per250 mg,636,1 ,$45.50 ,$32.76 ,$1.60 ,$45.50 ,$29.58 , N/A ,$12.74 ,$25.16 , N/A ,$26.48 , N/A ,$23.84 , N/A , N/A ,$41.86 , N/A , N/A ,$38.68 ,$40.95 , N/A ,$34.13 ,$31.85 ,$31.85 , N/A ,$31.85 ,$35.04 ,$35.04 , N/A ,$38.68 , N/A , N/A ,$25.53 ,$18.84 ,$18.93 , N/A , N/A , N/A ,$38.68 , N/A ,$23.84 ,$12.74 ,$40.95 ,$1.60 , N/A ,$29.58 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J1956,LEVOFLOXACIN 750 MG/150ML SOLN per250 mg,636,1 ,$30.33 ,$21.84 ,$1.60 ,$30.33 ,$19.71 , N/A ,$8.49 ,$16.77 , N/A ,$17.65 , N/A ,$15.89 , N/A , N/A ,$27.90 , N/A , N/A ,$25.78 ,$27.30 , N/A ,$22.75 ,$21.23 ,$21.23 , N/A ,$21.23 ,$23.35 ,$23.35 , N/A ,$25.78 , N/A , N/A ,$17.02 ,$12.56 ,$12.62 , N/A , N/A , N/A ,$25.78 , N/A ,$15.89 ,$8.49 ,$27.30 ,$1.60 , N/A ,$19.71 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2001,LIDOCAINE (CARDIAC) 20 MG/ML INJ per10 mg,636,1 ,$4.50 ,$3.24 ,$0.05 ,$4.50 ,$2.93 , N/A ,$1.26 ,$2.49 , N/A ,$2.62 , N/A ,$2.36 , N/A , N/A ,$4.14 , N/A , N/A ,$3.83 ,$4.05 , N/A ,$3.38 ,$3.15 ,$3.15 , N/A ,$3.15 ,$3.47 ,$3.47 , N/A ,$3.83 , N/A , N/A ,$2.52 ,$1.86 ,$1.87 , N/A , N/A , N/A ,$3.83 , N/A ,$2.36 ,$1.26 ,$4.05 ,$0.05 , N/A ,$2.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2060,LORAZEPAM 2 MG/ML SOLN per2 mg,636,1 ,$18.00 ,$12.96 ,$1.50 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$1.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3475,MAGNESIUM SULFATE 2 GM/50ML SOLN per500 mg,636,1 ,$22.75 ,$16.38 ,$1.09 ,$22.75 ,$14.79 , N/A ,$6.37 ,$12.58 , N/A ,$13.24 , N/A ,$11.92 , N/A , N/A ,$20.93 , N/A , N/A ,$19.34 ,$20.48 , N/A ,$17.06 ,$15.93 ,$15.93 , N/A ,$15.93 ,$17.52 ,$17.52 , N/A ,$19.34 , N/A , N/A ,$12.76 ,$9.42 ,$9.46 , N/A , N/A , N/A ,$19.34 , N/A ,$11.92 ,$6.37 ,$20.48 ,$1.09 , N/A ,$14.79 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3475,MAGNESIUM SULFATE 4 GM/50ML SOLN per500 mg,636,1 ,$11.38 ,$8.19 ,$1.09 ,$11.38 ,$7.40 , N/A ,$3.19 ,$6.29 , N/A ,$6.62 , N/A ,$5.96 , N/A , N/A ,$10.47 , N/A , N/A ,$9.67 ,$10.24 , N/A ,$8.54 ,$7.97 ,$7.97 , N/A ,$7.97 ,$8.76 ,$8.76 , N/A ,$9.67 , N/A , N/A ,$6.38 ,$4.71 ,$4.73 , N/A , N/A , N/A ,$9.67 , N/A ,$5.96 ,$3.19 ,$10.24 ,$1.09 , N/A ,$7.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3475,MAGNESIUM SULFATE 50 % SOLN 2 ML VIAL per500 mg,636,1 ,$9.00 ,$6.48 ,$1.09 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 , N/A ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$1.09 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2175,MEPERIDINE 50 MG/ML SOLN per100 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$15.82 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2185,MEROPENEM 1 G SOLR 1 EACH VIAL per100 mg,636,1 ,$14.60 ,$10.51 ,$1.02 ,$14.60 ,$9.49 , N/A ,$4.09 ,$8.07 , N/A ,$8.50 , N/A ,$7.65 , N/A , N/A ,$13.43 , N/A , N/A ,$12.41 ,$13.14 , N/A ,$10.95 ,$10.22 ,$10.22 , N/A ,$10.22 ,$11.24 ,$11.24 , N/A ,$12.41 , N/A , N/A ,$8.19 ,$6.04 ,$6.07 , N/A , N/A , N/A ,$12.41 , N/A ,$7.65 ,$4.09 ,$13.14 ,$1.02 , N/A ,$9.49 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J8610,METHOTREXATE 2.5 MG TABS per2.5 mg,636,1 ,$12.50 ,$9.00 ,$0.38 ,$12.50 ,$8.13 , N/A ,$3.50 ,$6.91 , N/A ,$7.28 , N/A ,$6.55 , N/A , N/A ,$11.50 , N/A , N/A ,$10.63 ,$11.25 , N/A ,$9.38 ,$8.75 ,$8.75 , N/A ,$8.75 ,$9.63 ,$9.63 , N/A ,$10.63 , N/A , N/A ,$7.01 ,$5.18 ,$5.20 , N/A , N/A , N/A ,$10.63 , N/A ,$6.55 ,$3.50 ,$11.25 ,$0.38 , N/A ,$8.13 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2210,METHYLERGONOVINE 0.2 MG/ML SOLN per0.2 mg,636,1 ,$95.00 ,$68.40 ,$26.60 ,$95.00 ,$61.75 , N/A ,$26.60 ,$52.54 , N/A ,$55.29 , N/A ,$49.78 , N/A , N/A ,$87.40 , N/A , N/A ,$80.75 ,$85.50 , N/A ,$71.25 ,$66.50 ,$66.50 , N/A ,$66.50 ,$73.15 ,$73.15 , N/A ,$80.75 , N/A , N/A ,$53.30 ,$39.33 ,$39.52 , N/A , N/A , N/A ,$80.75 , N/A ,$49.78 ,$26.60 ,$85.50 ,$33.31 , N/A ,$61.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7509,METHYLPREDNISOLONE (PAK) 4 MG TBPK per4 mg,636,1 ,$6.00 ,$4.32 ,$0.41 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$0.41 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG SOLR 1 EACH VIAL per125 mg,636,1 ,$38.69 ,$27.86 ,$9.82 ,$38.69 ,$25.15 , N/A ,$10.83 ,$21.40 , N/A ,$22.52 , N/A ,$20.27 , N/A , N/A ,$35.59 , N/A , N/A ,$32.89 ,$34.82 , N/A ,$29.02 ,$27.08 ,$27.08 , N/A ,$27.08 ,$29.79 ,$29.79 , N/A ,$32.89 , N/A , N/A ,$21.71 ,$16.02 ,$16.10 , N/A , N/A , N/A ,$32.89 , N/A ,$20.27 ,$10.83 ,$34.82 ,$9.82 , N/A ,$25.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLR per125 mg,636,1 ,$47.00 ,$33.84 ,$9.82 ,$47.00 ,$30.55 , N/A ,$13.16 ,$25.99 , N/A ,$27.35 , N/A ,$24.63 , N/A , N/A ,$43.24 , N/A , N/A ,$39.95 ,$42.30 , N/A ,$35.25 ,$32.90 ,$32.90 , N/A ,$32.90 ,$36.19 ,$36.19 , N/A ,$39.95 , N/A , N/A ,$26.37 ,$19.46 ,$19.55 , N/A , N/A , N/A ,$39.95 , N/A ,$24.63 ,$13.16 ,$42.30 ,$9.82 , N/A ,$30.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2920,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLR per40 mg,636,1 ,$29.50 ,$21.24 ,$6.73 ,$29.50 ,$19.18 , N/A ,$8.26 ,$16.31 , N/A ,$17.17 , N/A ,$15.46 , N/A , N/A ,$27.14 , N/A , N/A ,$25.08 ,$26.55 , N/A ,$22.13 ,$20.65 ,$20.65 , N/A ,$20.65 ,$22.72 ,$22.72 , N/A ,$25.08 , N/A , N/A ,$16.55 ,$12.21 ,$12.27 , N/A , N/A , N/A ,$25.08 , N/A ,$15.46 ,$8.26 ,$26.55 ,$6.73 , N/A ,$19.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2765,METOCLOPRAMIDE 5 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$1.82 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$1.82 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2250,MIDAZOLAM 2 MG/2ML SOLN per1 mg,636,1 ,$9.00 ,$6.48 ,$0.26 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 , N/A ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$0.26 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2270,MORPHINE 2 MG/ML SOLN per10 mg,636,1 ,$41.50 ,$29.88 ,$4.06 ,$41.50 ,$26.98 , N/A ,$11.62 ,$22.95 , N/A ,$24.15 , N/A ,$21.75 , N/A , N/A ,$38.18 , N/A , N/A ,$35.28 ,$37.35 , N/A ,$31.13 ,$29.05 ,$29.05 , N/A ,$29.05 ,$31.96 ,$31.96 , N/A ,$35.28 , N/A , N/A ,$23.28 ,$17.18 ,$17.26 , N/A , N/A , N/A ,$35.28 , N/A ,$21.75 ,$11.62 ,$37.35 ,$4.06 , N/A ,$26.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2270,MORPHINE 4 MG/ML SOLN per10 mg,636,1 ,$18.00 ,$12.96 ,$4.06 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$4.06 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7518,MYCOPHENOLATE EC 360 MG TBEC per180 mg,636,1 ,$10.00 ,$7.20 ,$1.27 ,$10.00 ,$6.50 , N/A ,$2.80 ,$5.53 , N/A ,$5.82 , N/A ,$5.24 , N/A , N/A ,$9.20 , N/A , N/A ,$8.50 ,$9.00 , N/A ,$7.50 ,$7.00 ,$7.00 , N/A ,$7.00 ,$7.70 ,$7.70 , N/A ,$8.50 , N/A , N/A ,$5.61 ,$4.14 ,$4.16 , N/A , N/A , N/A ,$8.50 , N/A ,$5.24 ,$2.80 ,$9.00 ,$1.27 , N/A ,$6.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2310,NALOXONE 0.4 MG/ML SOLN 1 ML VIAL per1 mg,636,1 ,$237.25 ,$170.82 ,$17.00 ,$237.25 ,$154.21 , N/A ,$66.43 ,$131.20 , N/A ,$138.08 , N/A ,$124.32 , N/A , N/A ,$218.27 , N/A , N/A ,$201.66 ,$213.53 , N/A ,$177.94 ,$166.08 ,$166.08 , N/A ,$166.08 ,$182.68 ,$182.68 , N/A ,$201.66 , N/A , N/A ,$133.10 ,$98.22 ,$98.70 , N/A , N/A , N/A ,$201.66 , N/A ,$124.32 ,$66.43 ,$213.53 ,$17.00 , N/A ,$154.21 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2310,NALOXONE 0.4 MG/ML SOLN per1 mg,636,1 ,$60.00 ,$43.20 ,$16.80 ,$60.00 ,$39.00 , N/A ,$16.80 ,$33.18 , N/A ,$34.92 , N/A ,$31.44 , N/A , N/A ,$55.20 , N/A , N/A ,$51.00 ,$54.00 , N/A ,$45.00 ,$42.00 ,$42.00 , N/A ,$42.00 ,$46.20 ,$46.20 , N/A ,$51.00 , N/A , N/A ,$33.66 ,$24.84 ,$24.96 , N/A , N/A , N/A ,$51.00 , N/A ,$31.44 ,$16.80 ,$54.00 ,$17.00 , N/A ,$39.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2310,NALOXONE 2 MG/2ML SOSY 2 ML SYRINGE per1 mg,636,1 ,$79.25 ,$57.06 ,$17.00 ,$79.25 ,$51.51 , N/A ,$22.19 ,$43.83 , N/A ,$46.12 , N/A ,$41.53 , N/A , N/A ,$72.91 , N/A , N/A ,$67.36 ,$71.33 , N/A ,$59.44 ,$55.48 ,$55.48 , N/A ,$55.48 ,$61.02 ,$61.02 , N/A ,$67.36 , N/A , N/A ,$44.46 ,$32.81 ,$32.97 , N/A , N/A , N/A ,$67.36 , N/A ,$41.53 ,$22.19 ,$71.33 ,$17.00 , N/A ,$51.51 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2710,NEOSTIGMINE 5 MG/10ML SOLN per0.5 mg,636,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 , N/A ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$3.15 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2354,OCTREOTIDE 100 MCG/ML SOLN 1 ML VIAL per25 mcg,636,1 ,$11.95 ,$8.60 ,$2.34 ,$11.95 ,$7.77 , N/A ,$3.35 ,$6.61 , N/A ,$6.95 , N/A ,$6.26 , N/A , N/A ,$10.99 , N/A , N/A ,$10.16 ,$10.76 , N/A ,$8.96 ,$8.37 ,$8.37 , N/A ,$8.37 ,$9.20 ,$9.20 , N/A ,$10.16 , N/A , N/A ,$6.70 ,$4.95 ,$4.97 , N/A , N/A , N/A ,$10.16 , N/A ,$6.26 ,$3.35 ,$10.76 ,$2.34 , N/A ,$7.77 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2405,ONDANSETRON 4 MG/2ML SOLN per1 mg,636,1 ,$4.50 ,$3.24 ,$0.15 ,$4.50 ,$2.93 , N/A ,$1.26 ,$2.49 , N/A ,$2.62 , N/A ,$2.36 , N/A , N/A ,$4.14 , N/A , N/A ,$3.83 ,$4.05 , N/A ,$3.38 ,$3.15 ,$3.15 , N/A ,$3.15 ,$3.47 ,$3.47 , N/A ,$3.83 , N/A , N/A ,$2.52 ,$1.86 ,$1.87 , N/A , N/A , N/A ,$3.83 , N/A ,$2.36 ,$1.26 ,$4.05 ,$0.15 , N/A ,$2.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2360,ORPHENADRINE 30 MG/ML SOLN per60 mg,636,1 ,$37.50 ,$27.00 ,$7.08 ,$37.50 ,$24.38 , N/A ,$10.50 ,$20.74 , N/A ,$21.83 , N/A ,$19.65 , N/A , N/A ,$34.50 , N/A , N/A ,$31.88 ,$33.75 , N/A ,$28.13 ,$26.25 ,$26.25 , N/A ,$26.25 ,$28.88 ,$28.88 , N/A ,$31.88 , N/A , N/A ,$21.04 ,$15.53 ,$15.60 , N/A , N/A , N/A ,$31.88 , N/A ,$19.65 ,$10.50 ,$33.75 ,$7.08 , N/A ,$24.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,C9113,PANTOPRAZOLE 40 MG SOLR 1 EACH VIAL per1 vial,636,1 ,$340.00 ,$244.80 ,$95.20 ,$340.00 ,$221.00 , N/A ,$95.20 ,$188.02 , N/A ,$197.88 , N/A ,$178.16 , N/A , N/A ,$312.80 , N/A , N/A ,$289.00 ,$306.00 , N/A ,$255.00 ,$238.00 ,$238.00 , N/A ,$238.00 ,$261.80 ,$261.80 , N/A ,$289.00 , N/A , N/A ,$190.74 ,$140.76 ,$141.44 , N/A , N/A , N/A ,$289.00 , N/A ,$178.16 ,$95.20 ,$306.00 , N/A , N/A ,$221.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2370,PHENYLEPHRINE SOLN per1 mL,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$6.80 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2370,PHENYLEPHRINE 10 MG/ML SOLN per1 mL,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$6.80 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3430,PHYTONADIONE (ADULT) 10 MG/ML SOLN per1 mg,636,1 ,$20.55 ,$14.80 ,$5.26 ,$20.55 ,$13.36 , N/A ,$5.75 ,$11.36 , N/A ,$11.96 , N/A ,$10.77 , N/A , N/A ,$18.91 , N/A , N/A ,$17.47 ,$18.50 , N/A ,$15.41 ,$14.39 ,$14.39 , N/A ,$14.39 ,$15.82 ,$15.82 , N/A ,$17.47 , N/A , N/A ,$11.53 ,$8.51 ,$8.55 , N/A , N/A , N/A ,$17.47 , N/A ,$10.77 ,$5.75 ,$18.50 ,$5.26 , N/A ,$13.36 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3430,PHYTONADIONE (ADULT) 10 MG/ML SOLN 1 ML AMPULE per1 mg,636,1 ,$20.55 ,$14.80 ,$5.26 ,$20.55 ,$13.36 , N/A ,$5.75 ,$11.36 , N/A ,$11.96 , N/A ,$10.77 , N/A , N/A ,$18.91 , N/A , N/A ,$17.47 ,$18.50 , N/A ,$15.41 ,$14.39 ,$14.39 , N/A ,$14.39 ,$15.82 ,$15.82 , N/A ,$17.47 , N/A , N/A ,$11.53 ,$8.51 ,$8.55 , N/A , N/A , N/A ,$17.47 , N/A ,$10.77 ,$5.75 ,$18.50 ,$5.26 , N/A ,$13.36 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2543,PIPERACILLIN-TAZOBACTAM 3.375 (3-0.375) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$29.17 ,$21.00 ,$2.51 ,$29.17 ,$18.96 , N/A ,$8.17 ,$16.13 , N/A ,$16.98 , N/A ,$15.29 , N/A , N/A ,$26.84 , N/A , N/A ,$24.79 ,$26.25 , N/A ,$21.88 ,$20.42 ,$20.42 , N/A ,$20.42 ,$22.46 ,$22.46 , N/A ,$24.79 , N/A , N/A ,$16.36 ,$12.08 ,$12.13 , N/A , N/A , N/A ,$24.79 , N/A ,$15.29 ,$8.17 ,$26.25 ,$2.51 , N/A ,$18.96 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2543,PIPERACILLIN-TAZOBACTAM 4.5 (4-0.5) G SOLR 1 EACH VIAL per1.125 g,636,1 ,$27.63 ,$19.89 ,$2.51 ,$27.63 ,$17.96 , N/A ,$7.74 ,$15.28 , N/A ,$16.08 , N/A ,$14.48 , N/A , N/A ,$25.42 , N/A , N/A ,$23.49 ,$24.87 , N/A ,$20.72 ,$19.34 ,$19.34 , N/A ,$19.34 ,$21.28 ,$21.28 , N/A ,$23.49 , N/A , N/A ,$15.50 ,$11.44 ,$11.49 , N/A , N/A , N/A ,$23.49 , N/A ,$14.48 ,$7.74 ,$24.87 ,$2.51 , N/A ,$17.96 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML SOLN per2 mEq,636,1 ,$18.20 ,$13.10 ,$0.23 ,$18.20 ,$11.83 , N/A ,$5.10 ,$10.06 , N/A ,$10.59 , N/A ,$9.54 , N/A , N/A ,$16.74 , N/A , N/A ,$15.47 ,$16.38 , N/A ,$13.65 ,$12.74 ,$12.74 , N/A ,$12.74 ,$14.01 ,$14.01 , N/A ,$15.47 , N/A , N/A ,$10.21 ,$7.53 ,$7.57 , N/A , N/A , N/A ,$15.47 , N/A ,$9.54 ,$5.10 ,$16.38 ,$0.23 , N/A ,$11.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7510,PREDNISOLONE 15 MG/5ML SOLN per5 mg,636,1 ,$2.00 ,$1.44 ,$0.38 ,$2.00 ,$1.30 , N/A ,$0.56 ,$1.11 , N/A ,$1.16 , N/A ,$1.05 , N/A , N/A ,$1.84 , N/A , N/A ,$1.70 ,$1.80 , N/A ,$1.50 ,$1.40 ,$1.40 , N/A ,$1.40 ,$1.54 ,$1.54 , N/A ,$1.70 , N/A , N/A ,$1.12 ,$0.83 ,$0.83 , N/A , N/A , N/A ,$1.70 , N/A ,$1.05 ,$0.56 ,$1.80 ,$0.38 , N/A ,$1.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7512,PREDNISONE 10 MG TABS per1 mg,636,1 ,$0.60 ,$0.43 ,$0.03 ,$0.60 ,$0.39 , N/A ,$0.17 ,$0.33 , N/A ,$0.35 , N/A ,$0.31 , N/A , N/A ,$0.55 , N/A , N/A ,$0.51 ,$0.54 , N/A ,$0.45 ,$0.42 ,$0.42 , N/A ,$0.42 ,$0.46 ,$0.46 , N/A ,$0.51 , N/A , N/A ,$0.34 ,$0.25 ,$0.25 , N/A , N/A , N/A ,$0.51 , N/A ,$0.31 ,$0.17 ,$0.54 ,$0.03 , N/A ,$0.39 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7512,PREDNISONE 20 MG TABS per1 mg,636,1 ,$0.30 ,$0.22 ,$0.03 ,$0.30 ,$0.20 , N/A ,$0.08 ,$0.17 , N/A ,$0.17 , N/A ,$0.16 , N/A , N/A ,$0.28 , N/A , N/A ,$0.26 ,$0.27 , N/A ,$0.23 ,$0.21 ,$0.21 , N/A ,$0.21 ,$0.23 ,$0.23 , N/A ,$0.26 , N/A , N/A ,$0.17 ,$0.12 ,$0.12 , N/A , N/A , N/A ,$0.26 , N/A ,$0.16 ,$0.08 ,$0.27 ,$0.03 , N/A ,$0.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7512,PREDNISONE 5 MG TABS per1 mg,636,1 ,$1.20 ,$0.86 ,$0.03 ,$1.20 ,$0.78 , N/A ,$0.34 ,$0.66 , N/A ,$0.70 , N/A ,$0.63 , N/A , N/A ,$1.10 , N/A , N/A ,$1.02 ,$1.08 , N/A ,$0.90 ,$0.84 ,$0.84 , N/A ,$0.84 ,$0.92 ,$0.92 , N/A ,$1.02 , N/A , N/A ,$0.67 ,$0.50 ,$0.50 , N/A , N/A , N/A ,$1.02 , N/A ,$0.63 ,$0.34 ,$1.08 ,$0.03 , N/A ,$0.78 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0780,PROCHLORPERAZINE 10 MG/2ML SOLN per10 mg,636,1 ,$86.50 ,$62.28 ,$4.87 ,$86.50 ,$56.23 , N/A ,$24.22 ,$47.83 , N/A ,$50.34 , N/A ,$45.33 , N/A , N/A ,$79.58 , N/A , N/A ,$73.53 ,$77.85 , N/A ,$64.88 ,$60.55 ,$60.55 , N/A ,$60.55 ,$66.61 ,$66.61 , N/A ,$73.53 , N/A , N/A ,$48.53 ,$35.81 ,$35.98 , N/A , N/A , N/A ,$73.53 , N/A ,$45.33 ,$24.22 ,$77.85 ,$4.87 , N/A ,$56.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2550,PROMETHAZINE 25 MG/ML SOLN per50 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$5.31 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2550,PROMETHAZINE 25 MG/ML SOLN 1 ML AMPULE per50 mg,636,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 , N/A ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$5.31 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2704,PROPOFOL 1000 MG/100ML EMUL per10 mg,636,1 ,$1.04 ,$0.75 ,$0.23 ,$1.04 ,$0.68 , N/A ,$0.29 ,$0.58 , N/A ,$0.61 , N/A ,$0.55 , N/A , N/A ,$0.96 , N/A , N/A ,$0.88 ,$0.94 , N/A ,$0.78 ,$0.73 ,$0.73 , N/A ,$0.73 ,$0.80 ,$0.80 , N/A ,$0.88 , N/A , N/A ,$0.58 ,$0.43 ,$0.43 , N/A , N/A , N/A ,$0.88 , N/A ,$0.55 ,$0.29 ,$0.94 ,$0.23 , N/A ,$0.68 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2704,PROPOFOL 200 MG/20ML EMUL per10 mg,636,1 ,$18.20 ,$13.10 ,$0.23 ,$18.20 ,$11.83 , N/A ,$5.10 ,$10.06 , N/A ,$10.59 , N/A ,$9.54 , N/A , N/A ,$16.74 , N/A , N/A ,$15.47 ,$16.38 , N/A ,$13.65 ,$12.74 ,$12.74 , N/A ,$12.74 ,$14.01 ,$14.01 , N/A ,$15.47 , N/A , N/A ,$10.21 ,$7.53 ,$7.57 , N/A , N/A , N/A ,$15.47 , N/A ,$9.54 ,$5.10 ,$16.38 ,$0.23 , N/A ,$11.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7168,PROTHROMBIN COMPLEX CONCENTRATE (HUMAN) 1000 UNITS KIT per1 Int'l Units,636,1 ,$13.04 ,$9.39 ,$2.14 ,$13.04 ,$8.48 ,$2.14 ,$3.65 ,$7.21 ,$2.14 ,$7.59 ,$2.14 ,$6.83 ,$2.14 ,$4.41 ,$12.00 ,$5.46 ,$2.14 ,$11.08 ,$11.74 ,$2.19 ,$9.78 ,$9.13 ,$9.13 ,$2.14 ,$9.13 ,$10.04 ,$10.04 ,$5.46 ,$11.08 ,$2.18 ,$2.18 ,$7.32 ,$5.40 ,$5.42 ,$12.58 ,$13.04 ,$2.24 ,$11.08 ,$4.70 ,$6.83 ,$3.65 ,$11.74 ,$3.45 ,$2.14 ,$8.48 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,90675,RABIES VACCINE SUSR per1 mL,636,1 ,"$1,819.50 ","$1,310.04 ",$65.40 ,"$1,819.50 ","$1,182.68 ",$335.38 ,$509.46 ,"$1,006.18 ",$335.38 ,"$1,058.95 ",$335.38 ,$953.42 ,$335.38 ,$691.29 ,"$1,673.94 ",$855.56 ,$335.38 ,"$1,546.58 ","$1,637.55 ",$342.09 ,"$1,364.63 ","$1,273.65 ","$1,273.65 ",$335.38 ,"$1,273.65 ","$1,401.02 ","$1,401.02 ",$855.56 ,"$1,546.58 ",$342.22 ,$342.22 ,"$1,020.74 ",$753.27 ,$756.91 ,$66.12 ,$65.40 ,$352.14 ,"$1,546.58 ",$735.78 ,$953.42 ,$509.46 ,"$1,637.55 ",$586.11 ,$335.38 ,"$1,182.68 " HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2785,REGADENOSON 0.4 MG/5ML SOLN per0.1 mg,636,1 ,$300.38 ,$216.27 ,$84.11 ,$300.38 ,$195.25 , N/A ,$84.11 ,$166.11 , N/A ,$174.82 , N/A ,$157.40 , N/A , N/A ,$276.35 , N/A , N/A ,$255.32 ,$270.34 , N/A ,$225.29 ,$210.27 ,$210.27 , N/A ,$210.27 ,$231.29 ,$231.29 , N/A ,$255.32 , N/A , N/A ,$168.51 ,$124.36 ,$124.96 , N/A , N/A , N/A ,$255.32 , N/A ,$157.40 ,$84.11 ,$270.34 ,$100.90 , N/A ,$195.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0248,REMDESIVIR 100 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$24.96 ,$17.97 ,$5.40 ,$24.96 ,$16.22 ,$5.40 ,$6.99 ,$13.80 ,$5.40 ,$14.53 ,$5.40 ,$13.08 ,$5.40 ,$11.13 ,$22.96 ,$13.78 ,$5.40 ,$21.22 ,$22.46 ,$5.51 ,$18.72 ,$17.47 ,$17.47 ,$5.40 ,$17.47 ,$19.22 ,$19.22 ,$13.78 ,$21.22 ,$5.51 ,$5.51 ,$14.00 ,$10.33 ,$10.38 ,$24.09 ,$24.96 ,$5.67 ,$21.22 ,$11.85 ,$13.08 ,$6.99 ,$22.46 ,$9.09 ,$5.40 ,$16.22 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2790,RHO D IMMUNE GLOBULIN 1500 UNITS SOSY per300 mcg,636,1 ,$505.00 ,$363.60 ,$56.66 ,$505.00 ,$328.25 , N/A ,$141.40 ,$279.27 , N/A ,$293.91 , N/A ,$264.62 , N/A , N/A ,$464.60 , N/A , N/A ,$429.25 ,$454.50 , N/A ,$378.75 ,$353.50 ,$353.50 , N/A ,$353.50 ,$388.85 ,$388.85 , N/A ,$429.25 , N/A , N/A ,$283.31 ,$209.07 ,$210.08 ,$57.28 ,$56.66 , N/A ,$429.25 , N/A ,$264.62 ,$141.40 ,$454.50 ,$134.92 , N/A ,$328.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J2795,ROPIVACAINE 5 MG/ML SOLN per1 mg,636,1 ,$0.34 ,$0.24 ,$0.10 ,$0.34 ,$0.22 , N/A ,$0.10 ,$0.19 , N/A ,$0.20 , N/A ,$0.18 , N/A , N/A ,$0.31 , N/A , N/A ,$0.29 ,$0.31 , N/A ,$0.26 ,$0.24 ,$0.24 , N/A ,$0.24 ,$0.26 ,$0.26 , N/A ,$0.29 , N/A , N/A ,$0.19 ,$0.14 ,$0.14 , N/A , N/A , N/A ,$0.29 , N/A ,$0.18 ,$0.10 ,$0.31 ,$0.12 , N/A ,$0.22 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7030,SODIUM CHLORIDE 0.9% SOLN per1000 mL,636,1 ,$45.00 ,$32.40 ,$4.36 ,$45.00 ,$29.25 , N/A ,$12.60 ,$24.89 , N/A ,$26.19 , N/A ,$23.58 , N/A , N/A ,$41.40 , N/A , N/A ,$38.25 ,$40.50 , N/A ,$33.75 ,$31.50 ,$31.50 , N/A ,$31.50 ,$34.65 ,$34.65 , N/A ,$38.25 , N/A , N/A ,$25.25 ,$18.63 ,$18.72 , N/A , N/A , N/A ,$38.25 , N/A ,$23.58 ,$12.60 ,$40.50 ,$4.36 , N/A ,$29.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J0330,SUCCINYLCHOLINE 20 MG/ML SOLN per20 mg,636,1 ,$9.30 ,$6.70 ,$2.60 ,$9.30 ,$6.05 , N/A ,$2.60 ,$5.14 , N/A ,$5.41 , N/A ,$4.87 , N/A , N/A ,$8.56 , N/A , N/A ,$7.91 ,$8.37 , N/A ,$6.98 ,$6.51 ,$6.51 , N/A ,$6.51 ,$7.16 ,$7.16 , N/A ,$7.91 , N/A , N/A ,$5.22 ,$3.85 ,$3.87 , N/A , N/A , N/A ,$7.91 , N/A ,$4.87 ,$2.60 ,$8.37 ,$3.12 , N/A ,$6.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3030,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SOLN per6 mg,636,1 ,$340.00 ,$244.80 ,$95.20 ,$340.00 ,$221.00 , N/A ,$95.20 ,$188.02 , N/A ,$197.88 , N/A ,$178.16 , N/A , N/A ,$312.80 , N/A , N/A ,$289.00 ,$306.00 , N/A ,$255.00 ,$238.00 ,$238.00 , N/A ,$238.00 ,$261.80 ,$261.80 , N/A ,$289.00 , N/A , N/A ,$190.74 ,$140.76 ,$141.44 , N/A , N/A , N/A ,$289.00 , N/A ,$178.16 ,$95.20 ,$306.00 ,$272.88 , N/A ,$221.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7507,TACROLIMUS 0.5 MG CAPS per1 mg,636,1 ,$6.00 ,$4.32 ,$0.50 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 , N/A ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$0.50 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J7507,TACROLIMUS 1 MG CAPS per1 mg,636,1 ,$9.00 ,$6.48 ,$0.50 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 , N/A ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$0.50 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,90715,TDAP 5-2-15.5 LF-MCG/0.5 SUSP per0.5 mL,636,1 ,$241.00 ,$173.52 ,$15.53 ,$241.00 ,$156.65 , N/A ,$67.48 ,$133.27 , N/A ,$140.26 , N/A ,$126.28 , N/A , N/A ,$221.72 , N/A , N/A ,$204.85 ,$216.90 , N/A ,$180.75 ,$168.70 ,$168.70 , N/A ,$168.70 ,$185.57 ,$185.57 , N/A ,$204.85 , N/A , N/A ,$135.20 ,$99.77 ,$100.26 ,$15.70 ,$15.53 , N/A ,$204.85 , N/A ,$126.28 ,$67.48 ,$216.90 ,$61.88 , N/A ,$156.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,90715,TDAP 5-2.5-18.5 LF-MCG/0.5 SUSY per0.5 mL,636,1 ,$213.50 ,$153.72 ,$15.53 ,$213.50 ,$138.78 , N/A ,$59.78 ,$118.07 , N/A ,$124.26 , N/A ,$111.87 , N/A , N/A ,$196.42 , N/A , N/A ,$181.48 ,$192.15 , N/A ,$160.13 ,$149.45 ,$149.45 , N/A ,$149.45 ,$164.40 ,$164.40 , N/A ,$181.48 , N/A , N/A ,$119.77 ,$88.39 ,$88.82 ,$15.70 ,$15.53 , N/A ,$181.48 , N/A ,$111.87 ,$59.78 ,$192.15 ,$61.88 , N/A ,$138.78 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3101,TENECTEPLASE 50 MG KIT per1 mg,636,1 ,$665.09 ,$478.86 ,$140.82 ,$665.09 ,$432.31 ,$140.82 ,$186.23 ,$367.79 ,$140.82 ,$387.08 ,$140.82 ,$348.51 ,$140.82 ,$290.26 ,$611.88 ,$359.23 ,$140.82 ,$565.33 ,$598.58 ,$143.64 ,$498.82 ,$465.56 ,$465.56 ,$140.82 ,$465.56 ,$512.12 ,$512.12 ,$359.23 ,$565.33 ,$143.69 ,$143.69 ,$373.12 ,$275.35 ,$276.68 ,$641.81 ,$665.09 ,$147.85 ,$565.33 ,$308.94 ,$348.51 ,$186.23 ,$598.58 ,$237.02 ,$140.82 ,$432.31 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3411,THIAMINE 100 MG/ML SOLN per100 mg,636,1 ,$24.00 ,$17.28 ,$4.62 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$4.62 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3411,THIAMINE 100 MG/ML SOLN 2 ML VIAL per100 mg,636,1 ,$24.00 ,$17.28 ,$4.62 ,$24.00 ,$15.60 , N/A ,$6.72 ,$13.27 , N/A ,$13.97 , N/A ,$12.58 , N/A , N/A ,$22.08 , N/A , N/A ,$20.40 ,$21.60 , N/A ,$18.00 ,$16.80 ,$16.80 , N/A ,$16.80 ,$18.48 ,$18.48 , N/A ,$20.40 , N/A , N/A ,$13.46 ,$9.94 ,$9.98 , N/A , N/A , N/A ,$20.40 , N/A ,$12.58 ,$6.72 ,$21.60 ,$4.62 , N/A ,$15.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3262,TOCILIZUMAB 80 MG/4ML SOLN 4 ML VIAL per1 mg,636,1 ,$29.47 ,$21.22 ,$5.74 ,$29.47 ,$19.16 ,$5.74 ,$8.25 ,$16.30 ,$5.74 ,$17.15 ,$5.74 ,$15.44 ,$5.74 ,$11.84 ,$27.11 ,$14.65 ,$5.74 ,$25.05 ,$26.52 ,$5.86 ,$22.10 ,$20.63 ,$20.63 ,$5.74 ,$20.63 ,$22.69 ,$22.69 ,$14.65 ,$25.05 ,$5.86 ,$5.86 ,$16.53 ,$12.20 ,$12.26 ,$28.44 ,$29.47 ,$6.03 ,$25.05 ,$12.60 ,$15.44 ,$8.25 ,$26.52 ,$9.88 ,$5.74 ,$19.16 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3262,TOCILIZUMAB 200 MG/10ML SOLN 10 ML VIAL per1 mg,636,1 ,$29.47 ,$21.22 ,$5.74 ,$29.47 ,$19.16 ,$5.74 ,$8.25 ,$16.30 ,$5.74 ,$17.15 ,$5.74 ,$15.44 ,$5.74 ,$11.84 ,$27.11 ,$14.65 ,$5.74 ,$25.05 ,$26.52 ,$5.86 ,$22.10 ,$20.63 ,$20.63 ,$5.74 ,$20.63 ,$22.69 ,$22.69 ,$14.65 ,$25.05 ,$5.86 ,$5.86 ,$16.53 ,$12.20 ,$12.26 ,$28.44 ,$29.47 ,$6.03 ,$25.05 ,$12.60 ,$15.44 ,$8.25 ,$26.52 ,$9.88 ,$5.74 ,$19.16 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3262,TOCILIZUMAB 400 MG/20ML SOLN 20 ML VIAL per1 mg,636,1 ,$29.47 ,$21.22 ,$5.74 ,$29.47 ,$19.16 ,$5.74 ,$8.25 ,$16.30 ,$5.74 ,$17.15 ,$5.74 ,$15.44 ,$5.74 ,$11.84 ,$27.11 ,$14.65 ,$5.74 ,$25.05 ,$26.52 ,$5.86 ,$22.10 ,$20.63 ,$20.63 ,$5.74 ,$20.63 ,$22.69 ,$22.69 ,$14.65 ,$25.05 ,$5.86 ,$5.86 ,$16.53 ,$12.20 ,$12.26 ,$28.44 ,$29.47 ,$6.03 ,$25.05 ,$12.60 ,$15.44 ,$8.25 ,$26.52 ,$9.88 ,$5.74 ,$19.16 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSP per10 mg,636,1 ,$10.25 ,$7.38 ,$1.75 ,$10.25 ,$6.66 , N/A ,$2.87 ,$5.67 , N/A ,$5.97 , N/A ,$5.37 , N/A , N/A ,$9.43 , N/A , N/A ,$8.71 ,$9.23 , N/A ,$7.69 ,$7.18 ,$7.18 , N/A ,$7.18 ,$7.89 ,$7.89 , N/A ,$8.71 , N/A , N/A ,$5.75 ,$4.24 ,$4.26 , N/A , N/A , N/A ,$8.71 , N/A ,$5.37 ,$2.87 ,$9.23 ,$1.75 , N/A ,$6.66 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3370,VANCOMYCIN 1 G SOLR 1 EACH VIAL per500 mg,636,1 ,$38.50 ,$27.72 ,$4.72 ,$38.50 ,$25.03 , N/A ,$10.78 ,$21.29 , N/A ,$22.41 , N/A ,$20.17 , N/A , N/A ,$35.42 , N/A , N/A ,$32.73 ,$34.65 , N/A ,$28.88 ,$26.95 ,$26.95 , N/A ,$26.95 ,$29.65 ,$29.65 , N/A ,$32.73 , N/A , N/A ,$21.60 ,$15.94 ,$16.02 , N/A , N/A , N/A ,$32.73 , N/A ,$20.17 ,$10.78 ,$34.65 ,$4.72 , N/A ,$25.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3370,VANCOMYCIN 5 G SOLR 1 EACH VIAL per500 mg,636,1 ,$42.75 ,$30.78 ,$4.72 ,$42.75 ,$27.79 , N/A ,$11.97 ,$23.64 , N/A ,$24.88 , N/A ,$22.40 , N/A , N/A ,$39.33 , N/A , N/A ,$36.34 ,$38.48 , N/A ,$32.06 ,$29.93 ,$29.93 , N/A ,$29.93 ,$32.92 ,$32.92 , N/A ,$36.34 , N/A , N/A ,$23.98 ,$17.70 ,$17.78 , N/A , N/A , N/A ,$36.34 , N/A ,$22.40 ,$11.97 ,$38.48 ,$4.72 , N/A ,$27.79 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3370,VANCOMYCIN 500 MG SOLR 1 EACH VIAL per500 mg,636,1 ,$39.00 ,$28.08 ,$4.72 ,$39.00 ,$25.35 , N/A ,$10.92 ,$21.57 , N/A ,$22.70 , N/A ,$20.44 , N/A , N/A ,$35.88 , N/A , N/A ,$33.15 ,$35.10 , N/A ,$29.25 ,$27.30 ,$27.30 , N/A ,$27.30 ,$30.03 ,$30.03 , N/A ,$33.15 , N/A , N/A ,$21.88 ,$16.15 ,$16.22 , N/A , N/A , N/A ,$33.15 , N/A ,$20.44 ,$10.92 ,$35.10 ,$4.72 , N/A ,$25.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3380,VEDOLIZUMAB 300 MG SOLR 1 EACH VIAL per1 mg,636,1 ,$123.41 ,$88.86 ,$21.40 ,$123.41 ,$80.22 ,$21.40 ,$34.55 ,$68.25 ,$21.40 ,$71.82 ,$21.40 ,$64.67 ,$21.40 ,$44.12 ,$113.54 ,$54.60 ,$21.40 ,$104.90 ,$111.07 ,$21.83 ,$92.56 ,$86.39 ,$86.39 ,$21.40 ,$86.39 ,$95.03 ,$95.03 ,$54.60 ,$104.90 ,$21.84 ,$21.84 ,$69.23 ,$51.09 ,$51.34 ,$119.09 ,$123.41 ,$22.47 ,$104.90 ,$46.96 ,$64.67 ,$34.55 ,$111.07 ,$35.81 ,$21.40 ,$80.22 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600002,J3489,ZOLEDRONIC ACID 5 MG/100ML SOLN per1 mg,636,1 ,$288.00 ,$207.36 ,$18.38 ,$288.00 ,$187.20 , N/A ,$80.64 ,$159.26 , N/A ,$167.62 , N/A ,$150.91 , N/A , N/A ,$264.96 , N/A , N/A ,$244.80 ,$259.20 , N/A ,$216.00 ,$201.60 ,$201.60 , N/A ,$201.60 ,$221.76 ,$221.76 , N/A ,$244.80 , N/A , N/A ,$161.57 ,$119.23 ,$119.81 ,$124.59 ,$123.24 , N/A ,$244.80 , N/A ,$150.91 ,$80.64 ,$259.20 ,$18.38 , N/A ,$187.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600012,Q9963,DIATRIZOATE MEGLUMINE AND SODIUM 66-10 % SOLN per1 mL,636,1 ,$2.17 ,$1.56 ,$0.35 ,$2.17 ,$1.41 , N/A ,$0.61 ,$1.20 , N/A ,$1.26 , N/A ,$1.14 , N/A , N/A , N/A , N/A , N/A ,$1.84 ,$1.95 , N/A ,$1.63 ,$1.52 ,$1.52 , N/A ,$1.52 ,$1.67 ,$1.67 , N/A ,$1.84 , N/A , N/A ,$1.22 ,$0.90 ,$0.90 , N/A , N/A , N/A ,$1.84 , N/A ,$1.14 ,$0.61 ,$1.95 ,$0.35 , N/A ,$1.41 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600012,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML SOLN per1 mL,636,1 ,$21.75 ,$15.66 ,$3.04 ,$21.75 ,$14.14 , N/A ,$6.09 ,$12.03 , N/A ,$12.66 , N/A ,$11.40 , N/A , N/A , N/A , N/A , N/A ,$18.49 ,$19.58 , N/A ,$16.31 ,$15.23 ,$15.23 , N/A ,$15.23 ,$16.75 ,$16.75 , N/A ,$18.49 , N/A , N/A ,$12.20 ,$9.00 ,$9.05 , N/A , N/A , N/A ,$18.49 , N/A ,$11.40 ,$6.09 ,$19.58 ,$3.04 , N/A ,$14.14 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600012,Q9965,IOHEXOL 180 MG/ML SOLN per1 mL,636,1 ,$9.75 ,$7.02 ,$2.46 ,$9.75 ,$6.34 , N/A ,$2.73 ,$5.39 , N/A ,$5.67 , N/A ,$5.11 , N/A , N/A , N/A , N/A , N/A ,$8.29 ,$8.78 , N/A ,$7.31 ,$6.83 ,$6.83 , N/A ,$6.83 ,$7.51 ,$7.51 , N/A ,$8.29 , N/A , N/A ,$5.47 ,$4.04 ,$4.06 , N/A , N/A , N/A ,$8.29 , N/A ,$5.11 ,$2.73 ,$8.78 ,$2.46 , N/A ,$6.34 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600012,Q9967,IOPAMIDOL 61 % SOLN per1 mL,636,1 ,$3.29 ,$2.37 ,$0.28 ,$3.29 ,$2.14 , N/A ,$0.92 ,$1.82 , N/A ,$1.91 , N/A ,$1.72 , N/A , N/A , N/A , N/A , N/A ,$2.80 ,$2.96 , N/A ,$2.47 ,$2.30 ,$2.30 , N/A ,$2.30 ,$2.53 ,$2.53 , N/A ,$2.80 , N/A , N/A ,$1.85 ,$1.36 ,$1.37 , N/A , N/A , N/A ,$2.80 , N/A ,$1.72 ,$0.92 ,$2.96 ,$0.28 , N/A ,$2.14 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600012,Q9967,IOPAMIDOL 76 % SOLN per1 mL,636,1 ,$1.90 ,$1.37 ,$0.28 ,$1.90 ,$1.24 , N/A ,$0.53 ,$1.05 , N/A ,$1.11 , N/A ,$1.00 , N/A , N/A , N/A , N/A , N/A ,$1.62 ,$1.71 , N/A ,$1.43 ,$1.33 ,$1.33 , N/A ,$1.33 ,$1.46 ,$1.46 , N/A ,$1.62 , N/A , N/A ,$1.07 ,$0.79 ,$0.79 , N/A , N/A , N/A ,$1.62 , N/A ,$1.00 ,$0.53 ,$1.71 ,$0.28 , N/A ,$1.24 HSHS HOLY FAMILY HOSPITAL INC (ACU),63600012,Q9957,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML SUSP per1 mL,636,1 ,$438.75 ,$315.90 ,$75.54 ,$438.75 ,$285.19 , N/A ,$122.85 ,$242.63 , N/A ,$255.35 , N/A ,$229.91 , N/A , N/A , N/A , N/A , N/A ,$372.94 ,$394.88 , N/A ,$329.06 ,$307.13 ,$307.13 , N/A ,$307.13 ,$337.84 ,$337.84 , N/A ,$372.94 , N/A , N/A ,$246.14 ,$181.64 ,$182.52 , N/A , N/A , N/A ,$372.94 , N/A ,$229.91 ,$122.85 ,$394.88 ,$75.54 , N/A ,$285.19 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,APIXABAN 5 MG TABS per,637,1 ,$21.50 ,$15.48 ,$6.02 ,$21.50 ,$13.98 , N/A ,$6.02 ,$11.89 , N/A ,$12.51 , N/A ,$11.27 , N/A , N/A ,$19.78 , N/A , N/A ,$18.28 ,$19.35 , N/A ,$16.13 ,$15.05 ,$15.05 , N/A ,$15.05 ,$16.56 ,$16.56 ,$21.50 ,$18.28 , N/A , N/A ,$12.06 ,$8.90 ,$8.94 , N/A , N/A , N/A ,$18.28 , N/A ,$11.27 ,$6.02 ,$19.35 ,$11.35 , N/A ,$13.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ARIPIPRAZOLE 5 MG TABS per,637,1 ,$64.00 ,$46.08 ,$17.92 ,$64.00 ,$41.60 , N/A ,$17.92 ,$35.39 , N/A ,$37.25 , N/A ,$33.54 , N/A , N/A ,$58.88 , N/A , N/A ,$54.40 ,$57.60 , N/A ,$48.00 ,$44.80 ,$44.80 , N/A ,$44.80 ,$49.28 ,$49.28 ,$64.00 ,$54.40 , N/A , N/A ,$35.90 ,$26.50 ,$26.62 , N/A , N/A , N/A ,$54.40 , N/A ,$33.54 ,$17.92 ,$57.60 ,$33.79 , N/A ,$41.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ARTIFICIAL TEARS 83-15 % OINT 3.5 G TUBE per,637,1 ,$23.50 ,$16.92 ,$6.58 ,$23.50 ,$15.28 , N/A ,$6.58 ,$13.00 , N/A ,$13.68 , N/A ,$12.31 , N/A , N/A ,$21.62 , N/A , N/A ,$19.98 ,$21.15 , N/A ,$17.63 ,$16.45 ,$16.45 , N/A ,$16.45 ,$18.10 ,$18.10 ,$23.50 ,$19.98 , N/A , N/A ,$13.18 ,$9.73 ,$9.78 , N/A , N/A , N/A ,$19.98 , N/A ,$12.31 ,$6.58 ,$21.15 ,$12.41 , N/A ,$15.28 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AZELASTINE 0.1 % SOLN 30 ML BOTTLE per,637,1 ,$210.50 ,$151.56 ,$58.94 ,$210.50 ,$136.83 , N/A ,$58.94 ,$116.41 , N/A ,$122.51 , N/A ,$110.30 , N/A , N/A ,$193.66 , N/A , N/A ,$178.93 ,$189.45 , N/A ,$157.88 ,$147.35 ,$147.35 , N/A ,$147.35 ,$162.09 ,$162.09 ,$210.50 ,$178.93 , N/A , N/A ,$118.09 ,$87.15 ,$87.57 , N/A , N/A , N/A ,$178.93 , N/A ,$110.30 ,$58.94 ,$189.45 ,$111.14 , N/A ,$136.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AZITHROMYCIN 100 MG/5ML SUSR per,637,1 ,$40.00 ,$28.80 ,$11.20 ,$40.00 ,$26.00 , N/A ,$11.20 ,$22.12 , N/A ,$23.28 , N/A ,$20.96 , N/A , N/A ,$36.80 , N/A , N/A ,$34.00 ,$36.00 , N/A ,$30.00 ,$28.00 ,$28.00 , N/A ,$28.00 ,$30.80 ,$30.80 ,$40.00 ,$34.00 , N/A , N/A ,$22.44 ,$16.56 ,$16.64 , N/A , N/A , N/A ,$34.00 , N/A ,$20.96 ,$11.20 ,$36.00 ,$21.12 , N/A ,$26.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AZITHROMYCIN 200 MG/5ML SUSR per,637,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 ,$10.40 , N/A ,$4.48 ,$8.85 , N/A ,$9.31 , N/A ,$8.38 , N/A , N/A ,$14.72 , N/A , N/A ,$13.60 ,$14.40 , N/A ,$12.00 ,$11.20 ,$11.20 , N/A ,$11.20 ,$12.32 ,$12.32 ,$16.00 ,$13.60 , N/A , N/A ,$8.98 ,$6.62 ,$6.66 , N/A , N/A , N/A ,$13.60 , N/A ,$8.38 ,$4.48 ,$14.40 ,$8.45 , N/A ,$10.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALOGLIPTIN 12.5 MG TABS per,637,1 ,$16.00 ,$11.52 ,$4.48 ,$16.00 ,$10.40 , N/A ,$4.48 ,$8.85 , N/A ,$9.31 , N/A ,$8.38 , N/A , N/A ,$14.72 , N/A , N/A ,$13.60 ,$14.40 , N/A ,$12.00 ,$11.20 ,$11.20 , N/A ,$11.20 ,$12.32 ,$12.32 ,$16.00 ,$13.60 , N/A , N/A ,$8.98 ,$6.62 ,$6.66 , N/A , N/A , N/A ,$13.60 , N/A ,$8.38 ,$4.48 ,$14.40 ,$8.45 , N/A ,$10.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CEFDINIR 300 MG CAPS per,637,1 ,$10.50 ,$7.56 ,$2.94 ,$10.50 ,$6.83 , N/A ,$2.94 ,$5.81 , N/A ,$6.11 , N/A ,$5.50 , N/A , N/A ,$9.66 , N/A , N/A ,$8.93 ,$9.45 , N/A ,$7.88 ,$7.35 ,$7.35 , N/A ,$7.35 ,$8.09 ,$8.09 ,$10.50 ,$8.93 , N/A , N/A ,$5.89 ,$4.35 ,$4.37 , N/A , N/A , N/A ,$8.93 , N/A ,$5.50 ,$2.94 ,$9.45 ,$5.54 , N/A ,$6.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CELECOXIB 100 MG CAPS per,637,1 ,$9.25 ,$6.66 ,$2.59 ,$9.25 ,$6.01 , N/A ,$2.59 ,$5.12 , N/A ,$5.38 , N/A ,$4.85 , N/A , N/A ,$8.51 , N/A , N/A ,$7.86 ,$8.33 , N/A ,$6.94 ,$6.48 ,$6.48 , N/A ,$6.48 ,$7.12 ,$7.12 ,$9.25 ,$7.86 , N/A , N/A ,$5.19 ,$3.83 ,$3.85 , N/A , N/A , N/A ,$7.86 , N/A ,$4.85 ,$2.59 ,$8.33 ,$4.88 , N/A ,$6.01 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLOPIDOGREL 75 MG TABS per,637,1 ,$14.00 ,$10.08 ,$3.92 ,$14.00 ,$9.10 , N/A ,$3.92 ,$7.74 , N/A ,$8.15 , N/A ,$7.34 , N/A , N/A ,$12.88 , N/A , N/A ,$11.90 ,$12.60 , N/A ,$10.50 ,$9.80 ,$9.80 , N/A ,$9.80 ,$10.78 ,$10.78 ,$14.00 ,$11.90 , N/A , N/A ,$7.85 ,$5.80 ,$5.82 , N/A , N/A , N/A ,$11.90 , N/A ,$7.34 ,$3.92 ,$12.60 ,$7.39 , N/A ,$9.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % CREA 45 G TUBE per,637,1 ,$242.50 ,$174.60 ,$67.90 ,$242.50 ,$157.63 , N/A ,$67.90 ,$134.10 , N/A ,$141.14 , N/A ,$127.07 , N/A , N/A ,$223.10 , N/A , N/A ,$206.13 ,$218.25 , N/A ,$181.88 ,$169.75 ,$169.75 , N/A ,$169.75 ,$186.73 ,$186.73 ,$242.50 ,$206.13 , N/A , N/A ,$136.04 ,$100.40 ,$100.88 , N/A , N/A , N/A ,$206.13 , N/A ,$127.07 ,$67.90 ,$218.25 ,$128.04 , N/A ,$157.63 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DILTIAZEM SR 60 MG CP12 per,637,1 ,$6.38 ,$4.59 ,$1.79 ,$6.38 ,$4.15 , N/A ,$1.79 ,$3.53 , N/A ,$3.71 , N/A ,$3.34 , N/A , N/A ,$5.87 , N/A , N/A ,$5.42 ,$5.74 , N/A ,$4.79 ,$4.47 ,$4.47 , N/A ,$4.47 ,$4.91 ,$4.91 ,$6.38 ,$5.42 , N/A , N/A ,$3.58 ,$2.64 ,$2.65 , N/A , N/A , N/A ,$5.42 , N/A ,$3.34 ,$1.79 ,$5.74 ,$3.37 , N/A ,$4.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML SOLN 10 ML BOTTLE per,637,1 ,$245.50 ,$176.76 ,$68.74 ,$245.50 ,$159.58 , N/A ,$68.74 ,$135.76 , N/A ,$142.88 , N/A ,$128.64 , N/A , N/A ,$225.86 , N/A , N/A ,$208.68 ,$220.95 , N/A ,$184.13 ,$171.85 ,$171.85 , N/A ,$171.85 ,$189.04 ,$189.04 ,$245.50 ,$208.68 , N/A , N/A ,$137.73 ,$101.64 ,$102.13 , N/A , N/A , N/A ,$208.68 , N/A ,$128.64 ,$68.74 ,$220.95 ,$129.62 , N/A ,$159.58 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DULOXETINE 30 MG CPEP per,637,1 ,$15.50 ,$11.16 ,$4.34 ,$15.50 ,$10.08 , N/A ,$4.34 ,$8.57 , N/A ,$9.02 , N/A ,$8.12 , N/A , N/A ,$14.26 , N/A , N/A ,$13.18 ,$13.95 , N/A ,$11.63 ,$10.85 ,$10.85 , N/A ,$10.85 ,$11.94 ,$11.94 ,$15.50 ,$13.18 , N/A , N/A ,$8.70 ,$6.42 ,$6.45 , N/A , N/A , N/A ,$13.18 , N/A ,$8.12 ,$4.34 ,$13.95 ,$8.18 , N/A ,$10.08 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,EMPAGLIFLOZIN 25 MG TABS per,637,1 ,$46.00 ,$33.12 ,$12.88 ,$46.00 ,$29.90 , N/A ,$12.88 ,$25.44 , N/A ,$26.77 , N/A ,$24.10 , N/A , N/A ,$42.32 , N/A , N/A ,$39.10 ,$41.40 , N/A ,$34.50 ,$32.20 ,$32.20 , N/A ,$32.20 ,$35.42 ,$35.42 ,$46.00 ,$39.10 , N/A , N/A ,$25.81 ,$19.04 ,$19.14 , N/A , N/A , N/A ,$39.10 , N/A ,$24.10 ,$12.88 ,$41.40 ,$24.29 , N/A ,$29.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,EMPAGLIFLOZIN 10 MG TABS per,637,1 ,$46.00 ,$33.12 ,$12.88 ,$46.00 ,$29.90 , N/A ,$12.88 ,$25.44 , N/A ,$26.77 , N/A ,$24.10 , N/A , N/A ,$42.32 , N/A , N/A ,$39.10 ,$41.40 , N/A ,$34.50 ,$32.20 ,$32.20 , N/A ,$32.20 ,$35.42 ,$35.42 ,$46.00 ,$39.10 , N/A , N/A ,$25.81 ,$19.04 ,$19.14 , N/A , N/A , N/A ,$39.10 , N/A ,$24.10 ,$12.88 ,$41.40 ,$24.29 , N/A ,$29.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,EPINEPHRINE 0.3 MG/0.3ML SOAJ per,637,1 ,$750.00 ,$540.00 ,$210.00 ,$750.00 ,$487.50 , N/A ,$210.00 ,$414.75 , N/A ,$436.50 , N/A ,$393.00 , N/A , N/A ,$690.00 , N/A , N/A ,$637.50 ,$675.00 , N/A ,$562.50 ,$525.00 ,$525.00 , N/A ,$525.00 ,$577.50 ,$577.50 ,$750.00 ,$637.50 , N/A , N/A ,$420.75 ,$310.50 ,$312.00 , N/A , N/A , N/A ,$637.50 , N/A ,$393.00 ,$210.00 ,$675.00 ,$396.00 , N/A ,$487.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ERYTHROMYCIN 5 MG/GM OINT 1 G TUBE per,637,1 ,$25.00 ,$18.00 ,$7.00 ,$25.00 ,$16.25 , N/A ,$7.00 ,$13.83 , N/A ,$14.55 , N/A ,$13.10 , N/A , N/A ,$23.00 , N/A , N/A ,$21.25 ,$22.50 , N/A ,$18.75 ,$17.50 ,$17.50 , N/A ,$17.50 ,$19.25 ,$19.25 ,$25.00 ,$21.25 , N/A , N/A ,$14.03 ,$10.35 ,$10.40 , N/A , N/A , N/A ,$21.25 , N/A ,$13.10 ,$7.00 ,$22.50 ,$13.20 , N/A ,$16.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ERYTHROMYCIN 5 MG/GM OINT 3.5 G TUBE per,637,1 ,$38.50 ,$27.72 ,$10.78 ,$38.50 ,$25.03 , N/A ,$10.78 ,$21.29 , N/A ,$22.41 , N/A ,$20.17 , N/A , N/A ,$35.42 , N/A , N/A ,$32.73 ,$34.65 , N/A ,$28.88 ,$26.95 ,$26.95 , N/A ,$26.95 ,$29.65 ,$29.65 ,$38.50 ,$32.73 , N/A , N/A ,$21.60 ,$15.94 ,$16.02 , N/A , N/A , N/A ,$32.73 , N/A ,$20.17 ,$10.78 ,$34.65 ,$20.33 , N/A ,$25.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,EZETIMIBE 10 MG TABS per,637,1 ,$21.00 ,$15.12 ,$5.88 ,$21.00 ,$13.65 , N/A ,$5.88 ,$11.61 , N/A ,$12.22 , N/A ,$11.00 , N/A , N/A ,$19.32 , N/A , N/A ,$17.85 ,$18.90 , N/A ,$15.75 ,$14.70 ,$14.70 , N/A ,$14.70 ,$16.17 ,$16.17 ,$21.00 ,$17.85 , N/A , N/A ,$11.78 ,$8.69 ,$8.74 , N/A , N/A , N/A ,$17.85 , N/A ,$11.00 ,$5.88 ,$18.90 ,$11.09 , N/A ,$13.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FENTANYL 12 MCG/HR PT72 per,637,1 ,$41.00 ,$29.52 ,$11.48 ,$41.00 ,$26.65 , N/A ,$11.48 ,$22.67 , N/A ,$23.86 , N/A ,$21.48 , N/A , N/A ,$37.72 , N/A , N/A ,$34.85 ,$36.90 , N/A ,$30.75 ,$28.70 ,$28.70 , N/A ,$28.70 ,$31.57 ,$31.57 ,$41.00 ,$34.85 , N/A , N/A ,$23.00 ,$16.97 ,$17.06 , N/A , N/A , N/A ,$34.85 , N/A ,$21.48 ,$11.48 ,$36.90 ,$21.65 , N/A ,$26.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALENDRONATE 35 MG TABS per,637,1 ,$41.00 ,$29.52 ,$11.48 ,$41.00 ,$26.65 , N/A ,$11.48 ,$22.67 , N/A ,$23.86 , N/A ,$21.48 , N/A , N/A ,$37.72 , N/A , N/A ,$34.85 ,$36.90 , N/A ,$30.75 ,$28.70 ,$28.70 , N/A ,$28.70 ,$31.57 ,$31.57 ,$41.00 ,$34.85 , N/A , N/A ,$23.00 ,$16.97 ,$17.06 , N/A , N/A , N/A ,$34.85 , N/A ,$21.48 ,$11.48 ,$36.90 ,$21.65 , N/A ,$26.65 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FENTANYL 50 MCG/HR PT72 per,637,1 ,$78.00 ,$56.16 ,$21.84 ,$78.00 ,$50.70 , N/A ,$21.84 ,$43.13 , N/A ,$45.40 , N/A ,$40.87 , N/A , N/A ,$71.76 , N/A , N/A ,$66.30 ,$70.20 , N/A ,$58.50 ,$54.60 ,$54.60 , N/A ,$54.60 ,$60.06 ,$60.06 ,$78.00 ,$66.30 , N/A , N/A ,$43.76 ,$32.29 ,$32.45 , N/A , N/A , N/A ,$66.30 , N/A ,$40.87 ,$21.84 ,$70.20 ,$41.18 , N/A ,$50.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FENTANYL 75 MCG/HR PT72 per,637,1 ,$80.50 ,$57.96 ,$22.54 ,$80.50 ,$52.33 , N/A ,$22.54 ,$44.52 , N/A ,$46.85 , N/A ,$42.18 , N/A , N/A ,$74.06 , N/A , N/A ,$68.43 ,$72.45 , N/A ,$60.38 ,$56.35 ,$56.35 , N/A ,$56.35 ,$61.99 ,$61.99 ,$80.50 ,$68.43 , N/A , N/A ,$45.16 ,$33.33 ,$33.49 , N/A , N/A , N/A ,$68.43 , N/A ,$42.18 ,$22.54 ,$72.45 ,$42.50 , N/A ,$52.33 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FIDAXOMICIN 200 MG TABS per,637,1 ,$537.50 ,$387.00 ,$150.50 ,$537.50 ,$349.38 , N/A ,$150.50 ,$297.24 , N/A ,$312.83 , N/A ,$281.65 , N/A , N/A ,$494.50 , N/A , N/A ,$456.88 ,$483.75 , N/A ,$403.13 ,$376.25 ,$376.25 , N/A ,$376.25 ,$413.88 ,$413.88 ,$537.50 ,$456.88 , N/A , N/A ,$301.54 ,$222.53 ,$223.60 , N/A , N/A , N/A ,$456.88 , N/A ,$281.65 ,$150.50 ,$483.75 ,$283.80 , N/A ,$349.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLECAINIDE 100 MG TABS per,637,1 ,$12.00 ,$8.64 ,$3.36 ,$12.00 ,$7.80 , N/A ,$3.36 ,$6.64 , N/A ,$6.98 , N/A ,$6.29 , N/A , N/A ,$11.04 , N/A , N/A ,$10.20 ,$10.80 , N/A ,$9.00 ,$8.40 ,$8.40 , N/A ,$8.40 ,$9.24 ,$9.24 ,$12.00 ,$10.20 , N/A , N/A ,$6.73 ,$4.97 ,$4.99 , N/A , N/A , N/A ,$10.20 , N/A ,$6.29 ,$3.36 ,$10.80 ,$6.34 , N/A ,$7.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUCONAZOLE 100 MG TABS per,637,1 ,$19.25 ,$13.86 ,$5.39 ,$19.25 ,$12.51 , N/A ,$5.39 ,$10.65 , N/A ,$11.20 , N/A ,$10.09 , N/A , N/A ,$17.71 , N/A , N/A ,$16.36 ,$17.33 , N/A ,$14.44 ,$13.48 ,$13.48 , N/A ,$13.48 ,$14.82 ,$14.82 ,$19.25 ,$16.36 , N/A , N/A ,$10.80 ,$7.97 ,$8.01 , N/A , N/A , N/A ,$16.36 , N/A ,$10.09 ,$5.39 ,$17.33 ,$10.16 , N/A ,$12.51 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DABIGATRAN 75 MG CAPS per,637,1 ,$19.25 ,$13.86 ,$5.39 ,$19.25 ,$12.51 , N/A ,$5.39 ,$10.65 , N/A ,$11.20 , N/A ,$10.09 , N/A , N/A ,$17.71 , N/A , N/A ,$16.36 ,$17.33 , N/A ,$14.44 ,$13.48 ,$13.48 , N/A ,$13.48 ,$14.82 ,$14.82 ,$19.25 ,$16.36 , N/A , N/A ,$10.80 ,$7.97 ,$8.01 , N/A , N/A , N/A ,$16.36 , N/A ,$10.09 ,$5.39 ,$17.33 ,$10.16 , N/A ,$12.51 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE 110 MCG/ACT AERO per,637,1 ,$11.00 ,$7.92 ,$3.08 ,$11.00 ,$7.15 , N/A ,$3.08 ,$6.08 , N/A ,$6.40 , N/A ,$5.76 , N/A , N/A ,$10.12 , N/A , N/A ,$9.35 ,$9.90 , N/A ,$8.25 ,$7.70 ,$7.70 , N/A ,$7.70 ,$8.47 ,$8.47 ,$11.00 ,$9.35 , N/A , N/A ,$6.17 ,$4.55 ,$4.58 , N/A , N/A , N/A ,$9.35 , N/A ,$5.76 ,$3.08 ,$9.90 ,$5.81 , N/A ,$7.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE PROPIONATE 50 MCG/ACT SUSP 16 G BOTTLE per,637,1 ,$171.00 ,$123.12 ,$47.88 ,$171.00 ,$111.15 , N/A ,$47.88 ,$94.56 , N/A ,$99.52 , N/A ,$89.60 , N/A , N/A ,$157.32 , N/A , N/A ,$145.35 ,$153.90 , N/A ,$128.25 ,$119.70 ,$119.70 , N/A ,$119.70 ,$131.67 ,$131.67 ,$171.00 ,$145.35 , N/A , N/A ,$95.93 ,$70.79 ,$71.14 , N/A , N/A , N/A ,$145.35 , N/A ,$89.60 ,$47.88 ,$153.90 ,$90.29 , N/A ,$111.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE PROPIONATE 50 MCG/ACT SUSP 9.9 ML BOTTLE per,637,1 ,$12.25 ,$8.82 ,$3.43 ,$12.25 ,$7.96 , N/A ,$3.43 ,$6.77 , N/A ,$7.13 , N/A ,$6.42 , N/A , N/A ,$11.27 , N/A , N/A ,$10.41 ,$11.03 , N/A ,$9.19 ,$8.58 ,$8.58 , N/A ,$8.58 ,$9.43 ,$9.43 ,$12.25 ,$10.41 , N/A , N/A ,$6.87 ,$5.07 ,$5.10 , N/A , N/A , N/A ,$10.41 , N/A ,$6.42 ,$3.43 ,$11.03 ,$6.47 , N/A ,$7.96 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GENTAMICIN 0.3 % SOLN 5 ML BOTTLE per,637,1 ,$86.00 ,$61.92 ,$24.08 ,$86.00 ,$55.90 , N/A ,$24.08 ,$47.56 , N/A ,$50.05 , N/A ,$45.06 , N/A , N/A ,$79.12 , N/A , N/A ,$73.10 ,$77.40 , N/A ,$64.50 ,$60.20 ,$60.20 , N/A ,$60.20 ,$66.22 ,$66.22 ,$86.00 ,$73.10 , N/A , N/A ,$48.25 ,$35.60 ,$35.78 , N/A , N/A , N/A ,$73.10 , N/A ,$45.06 ,$24.08 ,$77.40 ,$45.41 , N/A ,$55.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15ML SOLN per,637,1 ,$10.00 ,$7.20 ,$2.80 ,$10.00 ,$6.50 , N/A ,$2.80 ,$5.53 , N/A ,$5.82 , N/A ,$5.24 , N/A , N/A ,$9.20 , N/A , N/A ,$8.50 ,$9.00 , N/A ,$7.50 ,$7.00 ,$7.00 , N/A ,$7.00 ,$7.70 ,$7.70 ,$10.00 ,$8.50 , N/A , N/A ,$5.61 ,$4.14 ,$4.16 , N/A , N/A , N/A ,$8.50 , N/A ,$5.24 ,$2.80 ,$9.00 ,$5.28 , N/A ,$6.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCORTISONE 2.5 % CREA 30 G TUBE per,637,1 ,$175.00 ,$126.00 ,$49.00 ,$175.00 ,$113.75 , N/A ,$49.00 ,$96.78 , N/A ,$101.85 , N/A ,$91.70 , N/A , N/A ,$161.00 , N/A , N/A ,$148.75 ,$157.50 , N/A ,$131.25 ,$122.50 ,$122.50 , N/A ,$122.50 ,$134.75 ,$134.75 ,$175.00 ,$148.75 , N/A , N/A ,$98.18 ,$72.45 ,$72.80 , N/A , N/A , N/A ,$148.75 , N/A ,$91.70 ,$49.00 ,$157.50 ,$92.40 , N/A ,$113.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROXYCHLOROQUINE 200 MG TABS per,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAZOLAMIDE ER 500 MG CP12 per,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CEFPROZIL 250 MG TABS per,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ESCITALOPRAM 10 MG TABS per,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FERROUS SULFATE 300 (60 FE) MG/5ML SYRP per,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE PROPIONATE 220 MCG/ACT AERO per,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,INDOMETHACIN 50 MG SUPP per,637,1 ,$828.00 ,$596.16 ,$231.84 ,$828.00 ,$538.20 , N/A ,$231.84 ,$457.88 , N/A ,$481.90 , N/A ,$433.87 , N/A , N/A ,$761.76 , N/A , N/A ,$703.80 ,$745.20 , N/A ,$621.00 ,$579.60 ,$579.60 , N/A ,$579.60 ,$637.56 ,$637.56 ,$828.00 ,$703.80 , N/A , N/A ,$464.51 ,$342.79 ,$344.45 , N/A , N/A , N/A ,$703.80 , N/A ,$433.87 ,$231.84 ,$745.20 ,$437.18 , N/A ,$538.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,J1815,INSULIN GLARGINE 100 UNIT/ML SOLN per5 Units,637,1 ,$6.29 ,$4.53 ,$1.76 ,$6.29 ,$4.09 , N/A ,$1.76 ,$3.48 , N/A ,$3.66 , N/A ,$3.30 , N/A , N/A ,$5.79 , N/A , N/A ,$5.35 ,$5.66 , N/A ,$4.72 ,$4.40 ,$4.40 , N/A ,$4.40 ,$4.84 ,$4.84 ,$6.29 ,$5.35 , N/A , N/A ,$3.53 ,$2.60 ,$2.62 , N/A , N/A , N/A ,$5.35 , N/A ,$3.30 ,$1.76 ,$5.66 ,$3.32 , N/A ,$4.09 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,J1815,INSULIN LISPRO 100 UNIT/ML SOLN per5 Units,637,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 ,$18.00 ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,J1815,INSULIN REGULAR 100 UNIT/ML SOLN 3 ML VIAL per5 Units,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,J1815,INSULIN NPH 100 UNIT/ML SUSP per5 Units,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,J1815,INSULIN NPH-INSULIN REGULAR (70-30) 100 UNIT/ML SUSP per5 Units,637,1 ,$9.00 ,$6.48 ,$2.52 ,$9.00 ,$5.85 , N/A ,$2.52 ,$4.98 , N/A ,$5.24 , N/A ,$4.72 , N/A , N/A ,$8.28 , N/A , N/A ,$7.65 ,$8.10 , N/A ,$6.75 ,$6.30 ,$6.30 , N/A ,$6.30 ,$6.93 ,$6.93 ,$9.00 ,$7.65 , N/A , N/A ,$5.05 ,$3.73 ,$3.74 , N/A , N/A , N/A ,$7.65 , N/A ,$4.72 ,$2.52 ,$8.10 ,$4.75 , N/A ,$5.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,KETOCONAZOLE 2 % SHAM 120 ML BOTTLE per,637,1 ,$60.50 ,$43.56 ,$16.94 ,$60.50 ,$39.33 , N/A ,$16.94 ,$33.46 , N/A ,$35.21 , N/A ,$31.70 , N/A , N/A ,$55.66 , N/A , N/A ,$51.43 ,$54.45 , N/A ,$45.38 ,$42.35 ,$42.35 , N/A ,$42.35 ,$46.59 ,$46.59 ,$60.50 ,$51.43 , N/A , N/A ,$33.94 ,$25.05 ,$25.17 , N/A , N/A , N/A ,$51.43 , N/A ,$31.70 ,$16.94 ,$54.45 ,$31.94 , N/A ,$39.33 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,KETOTIFEN 0.025 % SOLN 5 ML BOTTLE per,637,1 ,$24.50 ,$17.64 ,$6.86 ,$24.50 ,$15.93 , N/A ,$6.86 ,$13.55 , N/A ,$14.26 , N/A ,$12.84 , N/A , N/A ,$22.54 , N/A , N/A ,$20.83 ,$22.05 , N/A ,$18.38 ,$17.15 ,$17.15 , N/A ,$17.15 ,$18.87 ,$18.87 ,$24.50 ,$20.83 , N/A , N/A ,$13.74 ,$10.14 ,$10.19 , N/A , N/A , N/A ,$20.83 , N/A ,$12.84 ,$6.86 ,$22.05 ,$12.94 , N/A ,$15.93 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LATANOPROST 0.005 % SOLN 2.5 ML BOTTLE per,637,1 ,$190.00 ,$136.80 ,$53.20 ,$190.00 ,$123.50 , N/A ,$53.20 ,$105.07 , N/A ,$110.58 , N/A ,$99.56 , N/A , N/A ,$174.80 , N/A , N/A ,$161.50 ,$171.00 , N/A ,$142.50 ,$133.00 ,$133.00 , N/A ,$133.00 ,$146.30 ,$146.30 ,$190.00 ,$161.50 , N/A , N/A ,$106.59 ,$78.66 ,$79.04 , N/A , N/A , N/A ,$161.50 , N/A ,$99.56 ,$53.20 ,$171.00 ,$100.32 , N/A ,$123.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LETROZOLE 2.5 MG TABS per,637,1 ,$36.50 ,$26.28 ,$10.22 ,$36.50 ,$23.73 , N/A ,$10.22 ,$20.18 , N/A ,$21.24 , N/A ,$19.13 , N/A , N/A ,$33.58 , N/A , N/A ,$31.03 ,$32.85 , N/A ,$27.38 ,$25.55 ,$25.55 , N/A ,$25.55 ,$28.11 ,$28.11 ,$36.50 ,$31.03 , N/A , N/A ,$20.48 ,$15.11 ,$15.18 , N/A , N/A , N/A ,$31.03 , N/A ,$19.13 ,$10.22 ,$32.85 ,$19.27 , N/A ,$23.73 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVALBUTEROL 45 MCG/ACT AERO 15 G INHALER per,637,1 ,$147.50 ,$106.20 ,$41.30 ,$147.50 ,$95.88 , N/A ,$41.30 ,$81.57 , N/A ,$85.85 , N/A ,$77.29 , N/A , N/A ,$135.70 , N/A , N/A ,$125.38 ,$132.75 , N/A ,$110.63 ,$103.25 ,$103.25 , N/A ,$103.25 ,$113.58 ,$113.58 ,$147.50 ,$125.38 , N/A , N/A ,$82.75 ,$61.07 ,$61.36 , N/A , N/A , N/A ,$125.38 , N/A ,$77.29 ,$41.30 ,$132.75 ,$77.88 , N/A ,$95.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOFLOXACIN 250 MG TABS per,637,1 ,$29.50 ,$21.24 ,$8.26 ,$29.50 ,$19.18 , N/A ,$8.26 ,$16.31 , N/A ,$17.17 , N/A ,$15.46 , N/A , N/A ,$27.14 , N/A , N/A ,$25.08 ,$26.55 , N/A ,$22.13 ,$20.65 ,$20.65 , N/A ,$20.65 ,$22.72 ,$22.72 ,$29.50 ,$25.08 , N/A , N/A ,$16.55 ,$12.21 ,$12.27 , N/A , N/A , N/A ,$25.08 , N/A ,$15.46 ,$8.26 ,$26.55 ,$15.58 , N/A ,$19.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LINEZOLID 600 MG TABS per,637,1 ,$367.50 ,$264.60 ,$102.90 ,$367.50 ,$238.88 , N/A ,$102.90 ,$203.23 , N/A ,$213.89 , N/A ,$192.57 , N/A , N/A ,$338.10 , N/A , N/A ,$312.38 ,$330.75 , N/A ,$275.63 ,$257.25 ,$257.25 , N/A ,$257.25 ,$282.98 ,$282.98 ,$367.50 ,$312.38 , N/A , N/A ,$206.17 ,$152.15 ,$152.88 , N/A , N/A , N/A ,$312.38 , N/A ,$192.57 ,$102.90 ,$330.75 ,$194.04 , N/A ,$238.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MIRABEGRON ER 25 MG TB24 per,637,1 ,$34.50 ,$24.84 ,$9.66 ,$34.50 ,$22.43 , N/A ,$9.66 ,$19.08 , N/A ,$20.08 , N/A ,$18.08 , N/A , N/A ,$31.74 , N/A , N/A ,$29.33 ,$31.05 , N/A ,$25.88 ,$24.15 ,$24.15 , N/A ,$24.15 ,$26.57 ,$26.57 ,$34.50 ,$29.33 , N/A , N/A ,$19.35 ,$14.28 ,$14.35 , N/A , N/A , N/A ,$29.33 , N/A ,$18.08 ,$9.66 ,$31.05 ,$18.22 , N/A ,$22.43 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MODAFINIL 100 MG TABS per,637,1 ,$53.00 ,$38.16 ,$14.84 ,$53.00 ,$34.45 , N/A ,$14.84 ,$29.31 , N/A ,$30.85 , N/A ,$27.77 , N/A , N/A ,$48.76 , N/A , N/A ,$45.05 ,$47.70 , N/A ,$39.75 ,$37.10 ,$37.10 , N/A ,$37.10 ,$40.81 ,$40.81 ,$53.00 ,$45.05 , N/A , N/A ,$29.73 ,$21.94 ,$22.05 , N/A , N/A , N/A ,$45.05 , N/A ,$27.77 ,$14.84 ,$47.70 ,$27.98 , N/A ,$34.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MOISTURIZING SOLN 59 ML BOTTLE per,637,1 ,$14.50 ,$10.44 ,$4.06 ,$14.50 ,$9.43 , N/A ,$4.06 ,$8.02 , N/A ,$8.44 , N/A ,$7.60 , N/A , N/A ,$13.34 , N/A , N/A ,$12.33 ,$13.05 , N/A ,$10.88 ,$10.15 ,$10.15 , N/A ,$10.15 ,$11.17 ,$11.17 ,$14.50 ,$12.33 , N/A , N/A ,$8.13 ,$6.00 ,$6.03 , N/A , N/A , N/A ,$12.33 , N/A ,$7.60 ,$4.06 ,$13.05 ,$7.66 , N/A ,$9.43 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MUPIROCIN 2 % OINT 22 G TUBE per,637,1 ,$85.50 ,$61.56 ,$23.94 ,$85.50 ,$55.58 , N/A ,$23.94 ,$47.28 , N/A ,$49.76 , N/A ,$44.80 , N/A , N/A ,$78.66 , N/A , N/A ,$72.68 ,$76.95 , N/A ,$64.13 ,$59.85 ,$59.85 , N/A ,$59.85 ,$65.84 ,$65.84 ,$85.50 ,$72.68 , N/A , N/A ,$47.97 ,$35.40 ,$35.57 , N/A , N/A , N/A ,$72.68 , N/A ,$44.80 ,$23.94 ,$76.95 ,$45.14 , N/A ,$55.58 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NEOMYCIN-POLYMYXIN-HYDROCORTISONE 3.5-10000-1 SUSP 10 ML BOTTLE per,637,1 ,$201.50 ,$145.08 ,$56.42 ,$201.50 ,$130.98 , N/A ,$56.42 ,$111.43 , N/A ,$117.27 , N/A ,$105.59 , N/A , N/A ,$185.38 , N/A , N/A ,$171.28 ,$181.35 , N/A ,$151.13 ,$141.05 ,$141.05 , N/A ,$141.05 ,$155.16 ,$155.16 ,$201.50 ,$171.28 , N/A , N/A ,$113.04 ,$83.42 ,$83.82 , N/A , N/A , N/A ,$171.28 , N/A ,$105.59 ,$56.42 ,$181.35 ,$106.39 , N/A ,$130.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NYSTATIN 100000 UNIT/GM CREA 15 G TUBE per,637,1 ,$35.50 ,$25.56 ,$9.94 ,$35.50 ,$23.08 , N/A ,$9.94 ,$19.63 , N/A ,$20.66 , N/A ,$18.60 , N/A , N/A ,$32.66 , N/A , N/A ,$30.18 ,$31.95 , N/A ,$26.63 ,$24.85 ,$24.85 , N/A ,$24.85 ,$27.34 ,$27.34 ,$35.50 ,$30.18 , N/A , N/A ,$19.92 ,$14.70 ,$14.77 , N/A , N/A , N/A ,$30.18 , N/A ,$18.60 ,$9.94 ,$31.95 ,$18.74 , N/A ,$23.08 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NYSTATIN 100000 UNIT/GM POWD 15 G BOTTLE per,637,1 ,$55.00 ,$39.60 ,$15.40 ,$55.00 ,$35.75 , N/A ,$15.40 ,$30.42 , N/A ,$32.01 , N/A ,$28.82 , N/A , N/A ,$50.60 , N/A , N/A ,$46.75 ,$49.50 , N/A ,$41.25 ,$38.50 ,$38.50 , N/A ,$38.50 ,$42.35 ,$42.35 ,$55.00 ,$46.75 , N/A , N/A ,$30.86 ,$22.77 ,$22.88 , N/A , N/A , N/A ,$46.75 , N/A ,$28.82 ,$15.40 ,$49.50 ,$29.04 , N/A ,$35.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OLANZAPINE 5 MG TABS per,637,1 ,$22.00 ,$15.84 ,$6.16 ,$22.00 ,$14.30 , N/A ,$6.16 ,$12.17 , N/A ,$12.80 , N/A ,$11.53 , N/A , N/A ,$20.24 , N/A , N/A ,$18.70 ,$19.80 , N/A ,$16.50 ,$15.40 ,$15.40 , N/A ,$15.40 ,$16.94 ,$16.94 ,$22.00 ,$18.70 , N/A , N/A ,$12.34 ,$9.11 ,$9.15 , N/A , N/A , N/A ,$18.70 , N/A ,$11.53 ,$6.16 ,$19.80 ,$11.62 , N/A ,$14.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OLANZAPINE 5 MG TBDP per,637,1 ,$29.00 ,$20.88 ,$8.12 ,$29.00 ,$18.85 , N/A ,$8.12 ,$16.04 , N/A ,$16.88 , N/A ,$15.20 , N/A , N/A ,$26.68 , N/A , N/A ,$24.65 ,$26.10 , N/A ,$21.75 ,$20.30 ,$20.30 , N/A ,$20.30 ,$22.33 ,$22.33 ,$29.00 ,$24.65 , N/A , N/A ,$16.27 ,$12.01 ,$12.06 , N/A , N/A , N/A ,$24.65 , N/A ,$15.20 ,$8.12 ,$26.10 ,$15.31 , N/A ,$18.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FENTANYL 25 MCG/HR PT72 per,637,1 ,$29.00 ,$20.88 ,$8.12 ,$29.00 ,$18.85 , N/A ,$8.12 ,$16.04 , N/A ,$16.88 , N/A ,$15.20 , N/A , N/A ,$26.68 , N/A , N/A ,$24.65 ,$26.10 , N/A ,$21.75 ,$20.30 ,$20.30 , N/A ,$20.30 ,$22.33 ,$22.33 ,$29.00 ,$24.65 , N/A , N/A ,$16.27 ,$12.01 ,$12.06 , N/A , N/A , N/A ,$24.65 , N/A ,$15.20 ,$8.12 ,$26.10 ,$15.31 , N/A ,$18.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCORTISONE 25 MG SUPP per,637,1 ,$29.00 ,$20.88 ,$8.12 ,$29.00 ,$18.85 , N/A ,$8.12 ,$16.04 , N/A ,$16.88 , N/A ,$15.20 , N/A , N/A ,$26.68 , N/A , N/A ,$24.65 ,$26.10 , N/A ,$21.75 ,$20.30 ,$20.30 , N/A ,$20.30 ,$22.33 ,$22.33 ,$29.00 ,$24.65 , N/A , N/A ,$16.27 ,$12.01 ,$12.06 , N/A , N/A , N/A ,$24.65 , N/A ,$15.20 ,$8.12 ,$26.10 ,$15.31 , N/A ,$18.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ONDANSETRON 4 MG TBDP per,637,1 ,$46.50 ,$33.48 ,$13.02 ,$46.50 ,$30.23 , N/A ,$13.02 ,$25.71 , N/A ,$27.06 , N/A ,$24.37 , N/A , N/A ,$42.78 , N/A , N/A ,$39.53 ,$41.85 , N/A ,$34.88 ,$32.55 ,$32.55 , N/A ,$32.55 ,$35.81 ,$35.81 ,$46.50 ,$39.53 , N/A , N/A ,$26.09 ,$19.25 ,$19.34 , N/A , N/A , N/A ,$39.53 , N/A ,$24.37 ,$13.02 ,$41.85 ,$24.55 , N/A ,$30.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OSELTAMIVIR 30 MG CAPS per,637,1 ,$28.50 ,$20.52 ,$7.98 ,$28.50 ,$18.53 , N/A ,$7.98 ,$15.76 , N/A ,$16.59 , N/A ,$14.93 , N/A , N/A ,$26.22 , N/A , N/A ,$24.23 ,$25.65 , N/A ,$21.38 ,$19.95 ,$19.95 , N/A ,$19.95 ,$21.95 ,$21.95 ,$28.50 ,$24.23 , N/A , N/A ,$15.99 ,$11.80 ,$11.86 , N/A , N/A , N/A ,$24.23 , N/A ,$14.93 ,$7.98 ,$25.65 ,$15.05 , N/A ,$18.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUCONAZOLE 150 MG TABS per,637,1 ,$28.50 ,$20.52 ,$7.98 ,$28.50 ,$18.53 , N/A ,$7.98 ,$15.76 , N/A ,$16.59 , N/A ,$14.93 , N/A , N/A ,$26.22 , N/A , N/A ,$24.23 ,$25.65 , N/A ,$21.38 ,$19.95 ,$19.95 , N/A ,$19.95 ,$21.95 ,$21.95 ,$28.50 ,$24.23 , N/A , N/A ,$15.99 ,$11.80 ,$11.86 , N/A , N/A , N/A ,$24.23 , N/A ,$14.93 ,$7.98 ,$25.65 ,$15.05 , N/A ,$18.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE-SALMETEROL 230-21 MCG/ACT AERO per,637,1 ,$28.50 ,$20.52 ,$7.98 ,$28.50 ,$18.53 , N/A ,$7.98 ,$15.76 , N/A ,$16.59 , N/A ,$14.93 , N/A , N/A ,$26.22 , N/A , N/A ,$24.23 ,$25.65 , N/A ,$21.38 ,$19.95 ,$19.95 , N/A ,$19.95 ,$21.95 ,$21.95 ,$28.50 ,$24.23 , N/A , N/A ,$15.99 ,$11.80 ,$11.86 , N/A , N/A , N/A ,$24.23 , N/A ,$14.93 ,$7.98 ,$25.65 ,$15.05 , N/A ,$18.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OSELTAMIVIR 75 MG CAPS per,637,1 ,$31.00 ,$22.32 ,$8.68 ,$31.00 ,$20.15 , N/A ,$8.68 ,$17.14 , N/A ,$18.04 , N/A ,$16.24 , N/A , N/A ,$28.52 , N/A , N/A ,$26.35 ,$27.90 , N/A ,$23.25 ,$21.70 ,$21.70 , N/A ,$21.70 ,$23.87 ,$23.87 ,$31.00 ,$26.35 , N/A , N/A ,$17.39 ,$12.83 ,$12.90 , N/A , N/A , N/A ,$26.35 , N/A ,$16.24 ,$8.68 ,$27.90 ,$16.37 , N/A ,$20.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PIOGLITAZONE 15 MG TABS per,637,1 ,$14.25 ,$10.26 ,$3.99 ,$14.25 ,$9.26 , N/A ,$3.99 ,$7.88 , N/A ,$8.29 , N/A ,$7.47 , N/A , N/A ,$13.11 , N/A , N/A ,$12.11 ,$12.83 , N/A ,$10.69 ,$9.98 ,$9.98 , N/A ,$9.98 ,$10.97 ,$10.97 ,$14.25 ,$12.11 , N/A , N/A ,$7.99 ,$5.90 ,$5.93 , N/A , N/A , N/A ,$12.11 , N/A ,$7.47 ,$3.99 ,$12.83 ,$7.52 , N/A ,$9.26 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PRAVASTATIN 20 MG TABS per,637,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 ,$4.55 , N/A ,$1.96 ,$3.87 , N/A ,$4.07 , N/A ,$3.67 , N/A , N/A ,$6.44 , N/A , N/A ,$5.95 ,$6.30 , N/A ,$5.25 ,$4.90 ,$4.90 , N/A ,$4.90 ,$5.39 ,$5.39 ,$7.00 ,$5.95 , N/A , N/A ,$3.93 ,$2.90 ,$2.91 , N/A , N/A , N/A ,$5.95 , N/A ,$3.67 ,$1.96 ,$6.30 ,$3.70 , N/A ,$4.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCERIN CREAM CREA 113 G TUBE per,637,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 ,$4.55 , N/A ,$1.96 ,$3.87 , N/A ,$4.07 , N/A ,$3.67 , N/A , N/A ,$6.44 , N/A , N/A ,$5.95 ,$6.30 , N/A ,$5.25 ,$4.90 ,$4.90 , N/A ,$4.90 ,$5.39 ,$5.39 ,$7.00 ,$5.95 , N/A , N/A ,$3.93 ,$2.90 ,$2.91 , N/A , N/A , N/A ,$5.95 , N/A ,$3.67 ,$1.96 ,$6.30 ,$3.70 , N/A ,$4.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MENTHOL-METHYL SALICYLATE 10-15 % CREA 85 G TUBE per,637,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 ,$4.55 , N/A ,$1.96 ,$3.87 , N/A ,$4.07 , N/A ,$3.67 , N/A , N/A ,$6.44 , N/A , N/A ,$5.95 ,$6.30 , N/A ,$5.25 ,$4.90 ,$4.90 , N/A ,$4.90 ,$5.39 ,$5.39 ,$7.00 ,$5.95 , N/A , N/A ,$3.93 ,$2.90 ,$2.91 , N/A , N/A , N/A ,$5.95 , N/A ,$3.67 ,$1.96 ,$6.30 ,$3.70 , N/A ,$4.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYBUTYNIN XL 5 MG TB24 per,637,1 ,$7.00 ,$5.04 ,$1.96 ,$7.00 ,$4.55 , N/A ,$1.96 ,$3.87 , N/A ,$4.07 , N/A ,$3.67 , N/A , N/A ,$6.44 , N/A , N/A ,$5.95 ,$6.30 , N/A ,$5.25 ,$4.90 ,$4.90 , N/A ,$4.90 ,$5.39 ,$5.39 ,$7.00 ,$5.95 , N/A , N/A ,$3.93 ,$2.90 ,$2.91 , N/A , N/A , N/A ,$5.95 , N/A ,$3.67 ,$1.96 ,$6.30 ,$3.70 , N/A ,$4.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,QUETIAPINE 100 MG TABS per,637,1 ,$13.00 ,$9.36 ,$3.64 ,$13.00 ,$8.45 , N/A ,$3.64 ,$7.19 , N/A ,$7.57 , N/A ,$6.81 , N/A , N/A ,$11.96 , N/A , N/A ,$11.05 ,$11.70 , N/A ,$9.75 ,$9.10 ,$9.10 , N/A ,$9.10 ,$10.01 ,$10.01 ,$13.00 ,$11.05 , N/A , N/A ,$7.29 ,$5.38 ,$5.41 , N/A , N/A , N/A ,$11.05 , N/A ,$6.81 ,$3.64 ,$11.70 ,$6.86 , N/A ,$8.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCORTISONE 1 % CREA 28.4 G TUBE per,637,1 ,$13.00 ,$9.36 ,$3.64 ,$13.00 ,$8.45 , N/A ,$3.64 ,$7.19 , N/A ,$7.57 , N/A ,$6.81 , N/A , N/A ,$11.96 , N/A , N/A ,$11.05 ,$11.70 , N/A ,$9.75 ,$9.10 ,$9.10 , N/A ,$9.10 ,$10.01 ,$10.01 ,$13.00 ,$11.05 , N/A , N/A ,$7.29 ,$5.38 ,$5.41 , N/A , N/A , N/A ,$11.05 , N/A ,$6.81 ,$3.64 ,$11.70 ,$6.86 , N/A ,$8.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,QUETIAPINE XR 50 MG TB24 per,637,1 ,$17.75 ,$12.78 ,$4.97 ,$17.75 ,$11.54 , N/A ,$4.97 ,$9.82 , N/A ,$10.33 , N/A ,$9.30 , N/A , N/A ,$16.33 , N/A , N/A ,$15.09 ,$15.98 , N/A ,$13.31 ,$12.43 ,$12.43 , N/A ,$12.43 ,$13.67 ,$13.67 ,$17.75 ,$15.09 , N/A , N/A ,$9.96 ,$7.35 ,$7.38 , N/A , N/A , N/A ,$15.09 , N/A ,$9.30 ,$4.97 ,$15.98 ,$9.37 , N/A ,$11.54 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RALOXIFENE 60 MG TABS per,637,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.92 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARBAMIDE PEROXIDE 6.5 % SOLN 15 ML BOTTLE per,637,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.92 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,POLYVINYL ALCOHOL 1.4 % SOLN 15 ML BOTTLE per,637,1 ,$15.00 ,$10.80 ,$4.20 ,$15.00 ,$9.75 , N/A ,$4.20 ,$8.30 , N/A ,$8.73 , N/A ,$7.86 , N/A , N/A ,$13.80 , N/A , N/A ,$12.75 ,$13.50 , N/A ,$11.25 ,$10.50 ,$10.50 , N/A ,$10.50 ,$11.55 ,$11.55 ,$15.00 ,$12.75 , N/A , N/A ,$8.42 ,$6.21 ,$6.24 , N/A , N/A , N/A ,$12.75 , N/A ,$7.86 ,$4.20 ,$13.50 ,$7.92 , N/A ,$9.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RIFAXIMIN 550 MG TABS per,637,1 ,$119.50 ,$86.04 ,$33.46 ,$119.50 ,$77.68 , N/A ,$33.46 ,$66.08 , N/A ,$69.55 , N/A ,$62.62 , N/A , N/A ,$109.94 , N/A , N/A ,$101.58 ,$107.55 , N/A ,$89.63 ,$83.65 ,$83.65 , N/A ,$83.65 ,$92.02 ,$92.02 ,$119.50 ,$101.58 , N/A , N/A ,$67.04 ,$49.47 ,$49.71 , N/A , N/A , N/A ,$101.58 , N/A ,$62.62 ,$33.46 ,$107.55 ,$63.10 , N/A ,$77.68 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RISPERIDONE 1 MG TABS per,637,1 ,$9.50 ,$6.84 ,$2.66 ,$9.50 ,$6.18 , N/A ,$2.66 ,$5.25 , N/A ,$5.53 , N/A ,$4.98 , N/A , N/A ,$8.74 , N/A , N/A ,$8.08 ,$8.55 , N/A ,$7.13 ,$6.65 ,$6.65 , N/A ,$6.65 ,$7.32 ,$7.32 ,$9.50 ,$8.08 , N/A , N/A ,$5.33 ,$3.93 ,$3.95 , N/A , N/A , N/A ,$8.08 , N/A ,$4.98 ,$2.66 ,$8.55 ,$5.02 , N/A ,$6.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUPROPION XL 150 MG TB24 per,637,1 ,$9.50 ,$6.84 ,$2.66 ,$9.50 ,$6.18 , N/A ,$2.66 ,$5.25 , N/A ,$5.53 , N/A ,$4.98 , N/A , N/A ,$8.74 , N/A , N/A ,$8.08 ,$8.55 , N/A ,$7.13 ,$6.65 ,$6.65 , N/A ,$6.65 ,$7.32 ,$7.32 ,$9.50 ,$8.08 , N/A , N/A ,$5.33 ,$3.93 ,$3.95 , N/A , N/A , N/A ,$8.08 , N/A ,$4.98 ,$2.66 ,$8.55 ,$5.02 , N/A ,$6.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MEGESTROL 40 MG/ML SUSP per,637,1 ,$9.50 ,$6.84 ,$2.66 ,$9.50 ,$6.18 , N/A ,$2.66 ,$5.25 , N/A ,$5.53 , N/A ,$4.98 , N/A , N/A ,$8.74 , N/A , N/A ,$8.08 ,$8.55 , N/A ,$7.13 ,$6.65 ,$6.65 , N/A ,$6.65 ,$7.32 ,$7.32 ,$9.50 ,$8.08 , N/A , N/A ,$5.33 ,$3.93 ,$3.95 , N/A , N/A , N/A ,$8.08 , N/A ,$4.98 ,$2.66 ,$8.55 ,$5.02 , N/A ,$6.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MESALAMINE ER 0.375 G CP24 per,637,1 ,$9.50 ,$6.84 ,$2.66 ,$9.50 ,$6.18 , N/A ,$2.66 ,$5.25 , N/A ,$5.53 , N/A ,$4.98 , N/A , N/A ,$8.74 , N/A , N/A ,$8.08 ,$8.55 , N/A ,$7.13 ,$6.65 ,$6.65 , N/A ,$6.65 ,$7.32 ,$7.32 ,$9.50 ,$8.08 , N/A , N/A ,$5.33 ,$3.93 ,$3.95 , N/A , N/A , N/A ,$8.08 , N/A ,$4.98 ,$2.66 ,$8.55 ,$5.02 , N/A ,$6.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PANCRELIPASE (LIP-PROT-AMYL) 10000-32000 UNITS CPEP per,637,1 ,$9.50 ,$6.84 ,$2.66 ,$9.50 ,$6.18 , N/A ,$2.66 ,$5.25 , N/A ,$5.53 , N/A ,$4.98 , N/A , N/A ,$8.74 , N/A , N/A ,$8.08 ,$8.55 , N/A ,$7.13 ,$6.65 ,$6.65 , N/A ,$6.65 ,$7.32 ,$7.32 ,$9.50 ,$8.08 , N/A , N/A ,$5.33 ,$3.93 ,$3.95 , N/A , N/A , N/A ,$8.08 , N/A ,$4.98 ,$2.66 ,$8.55 ,$5.02 , N/A ,$6.18 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RIVAROXABAN 10 MG TABS per,637,1 ,$41.50 ,$29.88 ,$11.62 ,$41.50 ,$26.98 , N/A ,$11.62 ,$22.95 , N/A ,$24.15 , N/A ,$21.75 , N/A , N/A ,$38.18 , N/A , N/A ,$35.28 ,$37.35 , N/A ,$31.13 ,$29.05 ,$29.05 , N/A ,$29.05 ,$31.96 ,$31.96 ,$41.50 ,$35.28 , N/A , N/A ,$23.28 ,$17.18 ,$17.26 , N/A , N/A , N/A ,$35.28 , N/A ,$21.75 ,$11.62 ,$37.35 ,$21.91 , N/A ,$26.98 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ROFLUMILAST 500 MCG TABS per,637,1 ,$33.50 ,$24.12 ,$9.38 ,$33.50 ,$21.78 , N/A ,$9.38 ,$18.53 , N/A ,$19.50 , N/A ,$17.55 , N/A , N/A ,$30.82 , N/A , N/A ,$28.48 ,$30.15 , N/A ,$25.13 ,$23.45 ,$23.45 , N/A ,$23.45 ,$25.80 ,$25.80 ,$33.50 ,$28.48 , N/A , N/A ,$18.79 ,$13.87 ,$13.94 , N/A , N/A , N/A ,$28.48 , N/A ,$17.55 ,$9.38 ,$30.15 ,$17.69 , N/A ,$21.78 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SACUBITRIL-VALSARTAN 24-26 MG TABS per,637,1 ,$25.50 ,$18.36 ,$7.14 ,$25.50 ,$16.58 , N/A ,$7.14 ,$14.10 , N/A ,$14.84 , N/A ,$13.36 , N/A , N/A ,$23.46 , N/A , N/A ,$21.68 ,$22.95 , N/A ,$19.13 ,$17.85 ,$17.85 , N/A ,$17.85 ,$19.64 ,$19.64 ,$25.50 ,$21.68 , N/A , N/A ,$14.31 ,$10.56 ,$10.61 , N/A , N/A , N/A ,$21.68 , N/A ,$13.36 ,$7.14 ,$22.95 ,$13.46 , N/A ,$16.58 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SILVER SULFADIAZINE 1 % CREA 25 G TUBE per,637,1 ,$18.50 ,$13.32 ,$5.18 ,$18.50 ,$12.03 , N/A ,$5.18 ,$10.23 , N/A ,$10.77 , N/A ,$9.69 , N/A , N/A ,$17.02 , N/A , N/A ,$15.73 ,$16.65 , N/A ,$13.88 ,$12.95 ,$12.95 , N/A ,$12.95 ,$14.25 ,$14.25 ,$18.50 ,$15.73 , N/A , N/A ,$10.38 ,$7.66 ,$7.70 , N/A , N/A , N/A ,$15.73 , N/A ,$9.69 ,$5.18 ,$16.65 ,$9.77 , N/A ,$12.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SOD BICARB-CITRIC AC-SIMETH 2.21-1.53-0.04 G PACK per,637,1 ,$6.50 ,$4.68 ,$1.82 ,$6.50 ,$4.23 , N/A ,$1.82 ,$3.59 , N/A ,$3.78 , N/A ,$3.41 , N/A , N/A ,$5.98 , N/A , N/A ,$5.53 ,$5.85 , N/A ,$4.88 ,$4.55 ,$4.55 , N/A ,$4.55 ,$5.01 ,$5.01 ,$6.50 ,$5.53 , N/A , N/A ,$3.65 ,$2.69 ,$2.70 , N/A , N/A , N/A ,$5.53 , N/A ,$3.41 ,$1.82 ,$5.85 ,$3.43 , N/A ,$4.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MELOXICAM 7.5 MG TABS per,637,1 ,$6.50 ,$4.68 ,$1.82 ,$6.50 ,$4.23 , N/A ,$1.82 ,$3.59 , N/A ,$3.78 , N/A ,$3.41 , N/A , N/A ,$5.98 , N/A , N/A ,$5.53 ,$5.85 , N/A ,$4.88 ,$4.55 ,$4.55 , N/A ,$4.55 ,$5.01 ,$5.01 ,$6.50 ,$5.53 , N/A , N/A ,$3.65 ,$2.69 ,$2.70 , N/A , N/A , N/A ,$5.53 , N/A ,$3.41 ,$1.82 ,$5.85 ,$3.43 , N/A ,$4.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PHENOL 1.4 % LIQD 177 ML SPRAY BOTTLE per,637,1 ,$6.50 ,$4.68 ,$1.82 ,$6.50 ,$4.23 , N/A ,$1.82 ,$3.59 , N/A ,$3.78 , N/A ,$3.41 , N/A , N/A ,$5.98 , N/A , N/A ,$5.53 ,$5.85 , N/A ,$4.88 ,$4.55 ,$4.55 , N/A ,$4.55 ,$5.01 ,$5.01 ,$6.50 ,$5.53 , N/A , N/A ,$3.65 ,$2.69 ,$2.70 , N/A , N/A , N/A ,$5.53 , N/A ,$3.41 ,$1.82 ,$5.85 ,$3.43 , N/A ,$4.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SODIUM ZIRCONIUM CYCLOSILICATE 10 G PACK per,637,1 ,$58.50 ,$42.12 ,$16.38 ,$58.50 ,$38.03 , N/A ,$16.38 ,$32.35 , N/A ,$34.05 , N/A ,$30.65 , N/A , N/A ,$53.82 , N/A , N/A ,$49.73 ,$52.65 , N/A ,$43.88 ,$40.95 ,$40.95 , N/A ,$40.95 ,$45.05 ,$45.05 ,$58.50 ,$49.73 , N/A , N/A ,$32.82 ,$24.22 ,$24.34 , N/A , N/A , N/A ,$49.73 , N/A ,$30.65 ,$16.38 ,$52.65 ,$30.89 , N/A ,$38.03 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SOLIFENACIN 5 MG TABS per,637,1 ,$26.50 ,$19.08 ,$7.42 ,$26.50 ,$17.23 , N/A ,$7.42 ,$14.65 , N/A ,$15.42 , N/A ,$13.89 , N/A , N/A ,$24.38 , N/A , N/A ,$22.53 ,$23.85 , N/A ,$19.88 ,$18.55 ,$18.55 , N/A ,$18.55 ,$20.41 ,$20.41 ,$26.50 ,$22.53 , N/A , N/A ,$14.87 ,$10.97 ,$11.02 , N/A , N/A , N/A ,$22.53 , N/A ,$13.89 ,$7.42 ,$23.85 ,$13.99 , N/A ,$17.23 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SUMATRIPTAN 50 MG TABS per,637,1 ,$50.50 ,$36.36 ,$14.14 ,$50.50 ,$32.83 , N/A ,$14.14 ,$27.93 , N/A ,$29.39 , N/A ,$26.46 , N/A , N/A ,$46.46 , N/A , N/A ,$42.93 ,$45.45 , N/A ,$37.88 ,$35.35 ,$35.35 , N/A ,$35.35 ,$38.89 ,$38.89 ,$50.50 ,$42.93 , N/A , N/A ,$28.33 ,$20.91 ,$21.01 , N/A , N/A , N/A ,$42.93 , N/A ,$26.46 ,$14.14 ,$45.45 ,$26.66 , N/A ,$32.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SODIUM POLYSTYRENE 15 GM/60ML SUSP per,637,1 ,$50.50 ,$36.36 ,$14.14 ,$50.50 ,$32.83 , N/A ,$14.14 ,$27.93 , N/A ,$29.39 , N/A ,$26.46 , N/A , N/A ,$46.46 , N/A , N/A ,$42.93 ,$45.45 , N/A ,$37.88 ,$35.35 ,$35.35 , N/A ,$35.35 ,$38.89 ,$38.89 ,$50.50 ,$42.93 , N/A , N/A ,$28.33 ,$20.91 ,$21.01 , N/A , N/A , N/A ,$42.93 , N/A ,$26.46 ,$14.14 ,$45.45 ,$26.66 , N/A ,$32.83 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TICAGRELOR 90 MG TABS per,637,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 ,$11.38 , N/A ,$4.90 ,$9.68 , N/A ,$10.19 , N/A ,$9.17 , N/A , N/A ,$16.10 , N/A , N/A ,$14.88 ,$15.75 , N/A ,$13.13 ,$12.25 ,$12.25 , N/A ,$12.25 ,$13.48 ,$13.48 ,$17.50 ,$14.88 , N/A , N/A ,$9.82 ,$7.25 ,$7.28 , N/A , N/A , N/A ,$14.88 , N/A ,$9.17 ,$4.90 ,$15.75 ,$9.24 , N/A ,$11.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLOTRIMAZOLE 1 % CREA 28.4 G TUBE per,637,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 ,$11.38 , N/A ,$4.90 ,$9.68 , N/A ,$10.19 , N/A ,$9.17 , N/A , N/A ,$16.10 , N/A , N/A ,$14.88 ,$15.75 , N/A ,$13.13 ,$12.25 ,$12.25 , N/A ,$12.25 ,$13.48 ,$13.48 ,$17.50 ,$14.88 , N/A , N/A ,$9.82 ,$7.25 ,$7.28 , N/A , N/A , N/A ,$14.88 , N/A ,$9.17 ,$4.90 ,$15.75 ,$9.24 , N/A ,$11.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE-SALMETEROL 45-21 MCG/ACT AERO per,637,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 ,$11.38 , N/A ,$4.90 ,$9.68 , N/A ,$10.19 , N/A ,$9.17 , N/A , N/A ,$16.10 , N/A , N/A ,$14.88 ,$15.75 , N/A ,$13.13 ,$12.25 ,$12.25 , N/A ,$12.25 ,$13.48 ,$13.48 ,$17.50 ,$14.88 , N/A , N/A ,$9.82 ,$7.25 ,$7.28 , N/A , N/A , N/A ,$14.88 , N/A ,$9.17 ,$4.90 ,$15.75 ,$9.24 , N/A ,$11.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCERIN CREAM CREA 113 G JAR per,637,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 ,$11.38 , N/A ,$4.90 ,$9.68 , N/A ,$10.19 , N/A ,$9.17 , N/A , N/A ,$16.10 , N/A , N/A ,$14.88 ,$15.75 , N/A ,$13.13 ,$12.25 ,$12.25 , N/A ,$12.25 ,$13.48 ,$13.48 ,$17.50 ,$14.88 , N/A , N/A ,$9.82 ,$7.25 ,$7.28 , N/A , N/A , N/A ,$14.88 , N/A ,$9.17 ,$4.90 ,$15.75 ,$9.24 , N/A ,$11.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PHENYTOIN 125 MG/5ML SUSP per,637,1 ,$17.50 ,$12.60 ,$4.90 ,$17.50 ,$11.38 , N/A ,$4.90 ,$9.68 , N/A ,$10.19 , N/A ,$9.17 , N/A , N/A ,$16.10 , N/A , N/A ,$14.88 ,$15.75 , N/A ,$13.13 ,$12.25 ,$12.25 , N/A ,$12.25 ,$13.48 ,$13.48 ,$17.50 ,$14.88 , N/A , N/A ,$9.82 ,$7.25 ,$7.28 , N/A , N/A , N/A ,$14.88 , N/A ,$9.17 ,$4.90 ,$15.75 ,$9.24 , N/A ,$11.38 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TIMOLOL 0.25 % SOLN 5 ML BOTTLE per,637,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 ,$30.00 ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SILVER SULFADIAZINE 1 % CREA 50 G TUBE per,637,1 ,$30.00 ,$21.60 ,$8.40 ,$30.00 ,$19.50 , N/A ,$8.40 ,$16.59 , N/A ,$17.46 , N/A ,$15.72 , N/A , N/A ,$27.60 , N/A , N/A ,$25.50 ,$27.00 , N/A ,$22.50 ,$21.00 ,$21.00 , N/A ,$21.00 ,$23.10 ,$23.10 ,$30.00 ,$25.50 , N/A , N/A ,$16.83 ,$12.42 ,$12.48 , N/A , N/A , N/A ,$25.50 , N/A ,$15.72 ,$8.40 ,$27.00 ,$15.84 , N/A ,$19.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TIMOLOL 0.5 % SOLN 5 ML BOTTLE per,637,1 ,$34.00 ,$24.48 ,$9.52 ,$34.00 ,$22.10 , N/A ,$9.52 ,$18.80 , N/A ,$19.79 , N/A ,$17.82 , N/A , N/A ,$31.28 , N/A , N/A ,$28.90 ,$30.60 , N/A ,$25.50 ,$23.80 ,$23.80 , N/A ,$23.80 ,$26.18 ,$26.18 ,$34.00 ,$28.90 , N/A , N/A ,$19.07 ,$14.08 ,$14.14 , N/A , N/A , N/A ,$28.90 , N/A ,$17.82 ,$9.52 ,$30.60 ,$17.95 , N/A ,$22.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RIVASTIGMINE 4.6 MG/24HR PT24 per,637,1 ,$34.00 ,$24.48 ,$9.52 ,$34.00 ,$22.10 , N/A ,$9.52 ,$18.80 , N/A ,$19.79 , N/A ,$17.82 , N/A , N/A ,$31.28 , N/A , N/A ,$28.90 ,$30.60 , N/A ,$25.50 ,$23.80 ,$23.80 , N/A ,$23.80 ,$26.18 ,$26.18 ,$34.00 ,$28.90 , N/A , N/A ,$19.07 ,$14.08 ,$14.14 , N/A , N/A , N/A ,$28.90 , N/A ,$17.82 ,$9.52 ,$30.60 ,$17.95 , N/A ,$22.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RIVASTIGMINE 9.5 MG/24HR PT24 per,637,1 ,$34.00 ,$24.48 ,$9.52 ,$34.00 ,$22.10 , N/A ,$9.52 ,$18.80 , N/A ,$19.79 , N/A ,$17.82 , N/A , N/A ,$31.28 , N/A , N/A ,$28.90 ,$30.60 , N/A ,$25.50 ,$23.80 ,$23.80 , N/A ,$23.80 ,$26.18 ,$26.18 ,$34.00 ,$28.90 , N/A , N/A ,$19.07 ,$14.08 ,$14.14 , N/A , N/A , N/A ,$28.90 , N/A ,$17.82 ,$9.52 ,$30.60 ,$17.95 , N/A ,$22.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TIOTROPIUM 2.5 MCG/ACT AERS per,637,1 ,$36.00 ,$25.92 ,$10.08 ,$36.00 ,$23.40 , N/A ,$10.08 ,$19.91 , N/A ,$20.95 , N/A ,$18.86 , N/A , N/A ,$33.12 , N/A , N/A ,$30.60 ,$32.40 , N/A ,$27.00 ,$25.20 ,$25.20 , N/A ,$25.20 ,$27.72 ,$27.72 ,$36.00 ,$30.60 , N/A , N/A ,$20.20 ,$14.90 ,$14.98 , N/A , N/A , N/A ,$30.60 , N/A ,$18.86 ,$10.08 ,$32.40 ,$19.01 , N/A ,$23.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRANEXAMIC ACID 1000 MG/ML SOLN per,637,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$78.00 , N/A ,$33.60 ,$66.36 , N/A ,$69.84 , N/A ,$62.88 , N/A , N/A ,$110.40 , N/A , N/A ,$102.00 ,$108.00 , N/A ,$90.00 ,$84.00 ,$84.00 , N/A ,$84.00 ,$92.40 ,$92.40 ,$120.00 ,$102.00 , N/A , N/A ,$67.32 ,$49.68 ,$49.92 , N/A , N/A , N/A ,$102.00 , N/A ,$62.88 ,$33.60 ,$108.00 ,$63.36 , N/A ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRIAMCINOLONE 0.1 % CREA 15 G TUBE per,637,1 ,$11.50 ,$8.28 ,$3.22 ,$11.50 ,$7.48 , N/A ,$3.22 ,$6.36 , N/A ,$6.69 , N/A ,$6.03 , N/A , N/A ,$10.58 , N/A , N/A ,$9.78 ,$10.35 , N/A ,$8.63 ,$8.05 ,$8.05 , N/A ,$8.05 ,$8.86 ,$8.86 ,$11.50 ,$9.78 , N/A , N/A ,$6.45 ,$4.76 ,$4.78 , N/A , N/A , N/A ,$9.78 , N/A ,$6.03 ,$3.22 ,$10.35 ,$6.07 , N/A ,$7.48 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MONTELUKAST 10 MG TABS per,637,1 ,$11.50 ,$8.28 ,$3.22 ,$11.50 ,$7.48 , N/A ,$3.22 ,$6.36 , N/A ,$6.69 , N/A ,$6.03 , N/A , N/A ,$10.58 , N/A , N/A ,$9.78 ,$10.35 , N/A ,$8.63 ,$8.05 ,$8.05 , N/A ,$8.05 ,$8.86 ,$8.86 ,$11.50 ,$9.78 , N/A , N/A ,$6.45 ,$4.76 ,$4.78 , N/A , N/A , N/A ,$9.78 , N/A ,$6.03 ,$3.22 ,$10.35 ,$6.07 , N/A ,$7.48 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NEBIVOLOL 5 MG TABS per,637,1 ,$11.50 ,$8.28 ,$3.22 ,$11.50 ,$7.48 , N/A ,$3.22 ,$6.36 , N/A ,$6.69 , N/A ,$6.03 , N/A , N/A ,$10.58 , N/A , N/A ,$9.78 ,$10.35 , N/A ,$8.63 ,$8.05 ,$8.05 , N/A ,$8.05 ,$8.86 ,$8.86 ,$11.50 ,$9.78 , N/A , N/A ,$6.45 ,$4.76 ,$4.78 , N/A , N/A , N/A ,$9.78 , N/A ,$6.03 ,$3.22 ,$10.35 ,$6.07 , N/A ,$7.48 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYCODONE ER 10 MG T12A per,637,1 ,$11.50 ,$8.28 ,$3.22 ,$11.50 ,$7.48 , N/A ,$3.22 ,$6.36 , N/A ,$6.69 , N/A ,$6.03 , N/A , N/A ,$10.58 , N/A , N/A ,$9.78 ,$10.35 , N/A ,$8.63 ,$8.05 ,$8.05 , N/A ,$8.05 ,$8.86 ,$8.86 ,$11.50 ,$9.78 , N/A , N/A ,$6.45 ,$4.76 ,$4.78 , N/A , N/A , N/A ,$9.78 , N/A ,$6.03 ,$3.22 ,$10.35 ,$6.07 , N/A ,$7.48 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRIAMCINOLONE 0.5 % CREA 15 G TUBE per,637,1 ,$22.50 ,$16.20 ,$6.30 ,$22.50 ,$14.63 , N/A ,$6.30 ,$12.44 , N/A ,$13.10 , N/A ,$11.79 , N/A , N/A ,$20.70 , N/A , N/A ,$19.13 ,$20.25 , N/A ,$16.88 ,$15.75 ,$15.75 , N/A ,$15.75 ,$17.33 ,$17.33 ,$22.50 ,$19.13 , N/A , N/A ,$12.62 ,$9.32 ,$9.36 , N/A , N/A , N/A ,$19.13 , N/A ,$11.79 ,$6.30 ,$20.25 ,$11.88 , N/A ,$14.63 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,COLCHICINE 0.6 MG TABS per,637,1 ,$22.50 ,$16.20 ,$6.30 ,$22.50 ,$14.63 , N/A ,$6.30 ,$12.44 , N/A ,$13.10 , N/A ,$11.79 , N/A , N/A ,$20.70 , N/A , N/A ,$19.13 ,$20.25 , N/A ,$16.88 ,$15.75 ,$15.75 , N/A ,$15.75 ,$17.33 ,$17.33 ,$22.50 ,$19.13 , N/A , N/A ,$12.62 ,$9.32 ,$9.36 , N/A , N/A , N/A ,$19.13 , N/A ,$11.79 ,$6.30 ,$20.25 ,$11.88 , N/A ,$14.63 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRIMETHOPRIM-POLYMYXIN B 10000-0.1 UNIT/ML-% SOLN 10 ML BOTTLE per,637,1 ,$35.00 ,$25.20 ,$9.80 ,$35.00 ,$22.75 , N/A ,$9.80 ,$19.36 , N/A ,$20.37 , N/A ,$18.34 , N/A , N/A ,$32.20 , N/A , N/A ,$29.75 ,$31.50 , N/A ,$26.25 ,$24.50 ,$24.50 , N/A ,$24.50 ,$26.95 ,$26.95 ,$35.00 ,$29.75 , N/A , N/A ,$19.64 ,$14.49 ,$14.56 , N/A , N/A , N/A ,$29.75 , N/A ,$18.34 ,$9.80 ,$31.50 ,$18.48 , N/A ,$22.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TROLAMINE SALICYLATE 10 % CREA 85 G TUBE per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMOXICILLIN-CLAVULANATE 500-125 MG TABS per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DOXYCYCLINE HYCLATE 100 MG CAPS per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GLUCOSE 15 GM/32ML GEL per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MAGNESIUM-ALUMINUM-SIMETHICONE 400-400-40 MG/5ML SUSP 30 ML CUP per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 30 ML BOTTLE per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PANTOPRAZOLE EC 20 MG TBEC per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,QUETIAPINE 25 MG TABS per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RISPERIDONE 0.25 MG TABS per,637,1 ,$8.00 ,$5.76 ,$2.24 ,$8.00 ,$5.20 , N/A ,$2.24 ,$4.42 , N/A ,$4.66 , N/A ,$4.19 , N/A , N/A ,$7.36 , N/A , N/A ,$6.80 ,$7.20 , N/A ,$6.00 ,$5.60 ,$5.60 , N/A ,$5.60 ,$6.16 ,$6.16 ,$8.00 ,$6.80 , N/A , N/A ,$4.49 ,$3.31 ,$3.33 , N/A , N/A , N/A ,$6.80 , N/A ,$4.19 ,$2.24 ,$7.20 ,$4.22 , N/A ,$5.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,URSODIOL 300 MG CAPS per,637,1 ,$14.75 ,$10.62 ,$4.13 ,$14.75 ,$9.59 , N/A ,$4.13 ,$8.16 , N/A ,$8.58 , N/A ,$7.73 , N/A , N/A ,$13.57 , N/A , N/A ,$12.54 ,$13.28 , N/A ,$11.06 ,$10.33 ,$10.33 , N/A ,$10.33 ,$11.36 ,$11.36 ,$14.75 ,$12.54 , N/A , N/A ,$8.27 ,$6.11 ,$6.14 , N/A , N/A , N/A ,$12.54 , N/A ,$7.73 ,$4.13 ,$13.28 ,$7.79 , N/A ,$9.59 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VALACYCLOVIR 1 G TABS per,637,1 ,$12.50 ,$9.00 ,$3.50 ,$12.50 ,$8.13 , N/A ,$3.50 ,$6.91 , N/A ,$7.28 , N/A ,$6.55 , N/A , N/A ,$11.50 , N/A , N/A ,$10.63 ,$11.25 , N/A ,$9.38 ,$8.75 ,$8.75 , N/A ,$8.75 ,$9.63 ,$9.63 ,$12.50 ,$10.63 , N/A , N/A ,$7.01 ,$5.18 ,$5.20 , N/A , N/A , N/A ,$10.63 , N/A ,$6.55 ,$3.50 ,$11.25 ,$6.60 , N/A ,$8.13 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TOPIRAMATE 100 MG TABS per,637,1 ,$12.50 ,$9.00 ,$3.50 ,$12.50 ,$8.13 , N/A ,$3.50 ,$6.91 , N/A ,$7.28 , N/A ,$6.55 , N/A , N/A ,$11.50 , N/A , N/A ,$10.63 ,$11.25 , N/A ,$9.38 ,$8.75 ,$8.75 , N/A ,$8.75 ,$9.63 ,$9.63 ,$12.50 ,$10.63 , N/A , N/A ,$7.01 ,$5.18 ,$5.20 , N/A , N/A , N/A ,$10.63 , N/A ,$6.55 ,$3.50 ,$11.25 ,$6.60 , N/A ,$8.13 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VANCOMYCIN 125 MG CAPS per,637,1 ,$63.00 ,$45.36 ,$17.64 ,$63.00 ,$40.95 , N/A ,$17.64 ,$34.84 , N/A ,$36.67 , N/A ,$33.01 , N/A , N/A ,$57.96 , N/A , N/A ,$53.55 ,$56.70 , N/A ,$47.25 ,$44.10 ,$44.10 , N/A ,$44.10 ,$48.51 ,$48.51 ,$63.00 ,$53.55 , N/A , N/A ,$35.34 ,$26.08 ,$26.21 , N/A , N/A , N/A ,$53.55 , N/A ,$33.01 ,$17.64 ,$56.70 ,$33.26 , N/A ,$40.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VENLAFAXINE XR 37.5 MG CP24 per,637,1 ,$7.50 ,$5.40 ,$2.10 ,$7.50 ,$4.88 , N/A ,$2.10 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 , N/A , N/A ,$6.90 , N/A , N/A ,$6.38 ,$6.75 , N/A ,$5.63 ,$5.25 ,$5.25 , N/A ,$5.25 ,$5.78 ,$5.78 ,$7.50 ,$6.38 , N/A , N/A ,$4.21 ,$3.11 ,$3.12 , N/A , N/A , N/A ,$6.38 , N/A ,$3.93 ,$2.10 ,$6.75 ,$3.96 , N/A ,$4.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NITROFURANTOIN (MACROCRYSTAL-MONOHYDRATE) 100 MG CAPS per,637,1 ,$7.50 ,$5.40 ,$2.10 ,$7.50 ,$4.88 , N/A ,$2.10 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 , N/A , N/A ,$6.90 , N/A , N/A ,$6.38 ,$6.75 , N/A ,$5.63 ,$5.25 ,$5.25 , N/A ,$5.25 ,$5.78 ,$5.78 ,$7.50 ,$6.38 , N/A , N/A ,$4.21 ,$3.11 ,$3.12 , N/A , N/A , N/A ,$6.38 , N/A ,$3.93 ,$2.10 ,$6.75 ,$3.96 , N/A ,$4.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYCODONE-ACETAMINOPHEN 10-325 MG TABS per,637,1 ,$7.50 ,$5.40 ,$2.10 ,$7.50 ,$4.88 , N/A ,$2.10 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 , N/A , N/A ,$6.90 , N/A , N/A ,$6.38 ,$6.75 , N/A ,$5.63 ,$5.25 ,$5.25 , N/A ,$5.25 ,$5.78 ,$5.78 ,$7.50 ,$6.38 , N/A , N/A ,$4.21 ,$3.11 ,$3.12 , N/A , N/A , N/A ,$6.38 , N/A ,$3.93 ,$2.10 ,$6.75 ,$3.96 , N/A ,$4.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TIMOLOL 0.5 % SOLN 2.5 ML BOTTLE per,637,1 ,$7.50 ,$5.40 ,$2.10 ,$7.50 ,$4.88 , N/A ,$2.10 ,$4.15 , N/A ,$4.37 , N/A ,$3.93 , N/A , N/A ,$6.90 , N/A , N/A ,$6.38 ,$6.75 , N/A ,$5.63 ,$5.25 ,$5.25 , N/A ,$5.25 ,$5.78 ,$5.78 ,$7.50 ,$6.38 , N/A , N/A ,$4.21 ,$3.11 ,$3.12 , N/A , N/A , N/A ,$6.38 , N/A ,$3.93 ,$2.10 ,$6.75 ,$3.96 , N/A ,$4.88 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VENLAFAXINE XR 75 MG CP24 per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AZITHROMYCIN 250 MG TABS per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CEFDINIR 125 MG/5ML SUSR per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIPHENHYDRAMINE-ZINC 2-0.1 % CREA 28 G TUBE per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ESCITALOPRAM 5 MG TABS per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCORTISONE 1 % CREA 28 G TUBE per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PANTOPRAZOLE EC 40 MG TBEC per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TAMSULOSIN 0.4 MG CAPS per,637,1 ,$8.50 ,$6.12 ,$2.38 ,$8.50 ,$5.53 , N/A ,$2.38 ,$4.70 , N/A ,$4.95 , N/A ,$4.45 , N/A , N/A ,$7.82 , N/A , N/A ,$7.23 ,$7.65 , N/A ,$6.38 ,$5.95 ,$5.95 , N/A ,$5.95 ,$6.55 ,$6.55 ,$8.50 ,$7.23 , N/A , N/A ,$4.77 ,$3.52 ,$3.54 , N/A , N/A , N/A ,$7.23 , N/A ,$4.45 ,$2.38 ,$7.65 ,$4.49 , N/A ,$5.53 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ZINC OXIDE 20 % OINT 28.4 G TUBE per,637,1 ,$13.50 ,$9.72 ,$3.78 ,$13.50 ,$8.78 , N/A ,$3.78 ,$7.47 , N/A ,$7.86 , N/A ,$7.07 , N/A , N/A ,$12.42 , N/A , N/A ,$11.48 ,$12.15 , N/A ,$10.13 ,$9.45 ,$9.45 , N/A ,$9.45 ,$10.40 ,$10.40 ,$13.50 ,$11.48 , N/A , N/A ,$7.57 ,$5.59 ,$5.62 , N/A , N/A , N/A ,$11.48 , N/A ,$7.07 ,$3.78 ,$12.15 ,$7.13 , N/A ,$8.78 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ZIPRASIDONE 20 MG CAPS per,637,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 ,$18.00 ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ERYTHROMYCIN EC 250 MG TBEC per,637,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 ,$18.00 ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE-SALMETEROL 115-21 MCG/ACT AERO per,637,1 ,$18.00 ,$12.96 ,$5.04 ,$18.00 ,$11.70 , N/A ,$5.04 ,$9.95 , N/A ,$10.48 , N/A ,$9.43 , N/A , N/A ,$16.56 , N/A , N/A ,$15.30 ,$16.20 , N/A ,$13.50 ,$12.60 ,$12.60 , N/A ,$12.60 ,$13.86 ,$13.86 ,$18.00 ,$15.30 , N/A , N/A ,$10.10 ,$7.45 ,$7.49 , N/A , N/A , N/A ,$15.30 , N/A ,$9.43 ,$5.04 ,$16.20 ,$9.50 , N/A ,$11.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ZIPRASIDONE 60 MG CAPS per,637,1 ,$19.75 ,$14.22 ,$5.53 ,$19.75 ,$12.84 , N/A ,$5.53 ,$10.92 , N/A ,$11.49 , N/A ,$10.35 , N/A , N/A ,$18.17 , N/A , N/A ,$16.79 ,$17.78 , N/A ,$14.81 ,$13.83 ,$13.83 , N/A ,$13.83 ,$15.21 ,$15.21 ,$19.75 ,$16.79 , N/A , N/A ,$11.08 ,$8.18 ,$8.22 , N/A , N/A , N/A ,$16.79 , N/A ,$10.35 ,$5.53 ,$17.78 ,$10.43 , N/A ,$12.84 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ZOLPIDEM 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VITAMIN E 180 MG (400 UNIT) CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,WARFARIN 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,WARFARIN 2 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,WARFARIN 2.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,WARFARIN 3 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,WARFARIN 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ZINC OXIDE 20 % OINT 30 G TUBE per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ZINC SULFATE 220 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 120 MG SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 160 MG/5ML SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 325 MG SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 325 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 325 MG/10.15ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 500 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN 650 MG SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN CR 650 MG TBCR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACETAMINOPHEN-CODEINE 300-30 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACIDOPHILUS CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ACYCLOVIR 200 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT AERS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALLOPURINOL 100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALLOPURINOL 300 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALPRAZOLAM 0.25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ALPRAZOLAM 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMIODARONE 200 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMITRIPTYLINE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMLODIPINE 10 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMLODIPINE 5 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMOXICILLIN 250 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMOXICILLIN 250 MG/5ML SUSR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,AMOXICILLIN-CLAVULANATE 600-42.9 MG/5ML SUSR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ASPIRIN 300 MG SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ASPIRIN 325 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ASPIRIN 81 MG CHEW per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ASPIRIN EC 325 MG TBEC per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ASPIRIN EC 81 MG TBEC per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ATENOLOL 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ATORVASTATIN 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ATORVASTATIN 20 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ATORVASTATIN 40 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,B COMPLEX CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,B COMPLEX-C-FOLIC ACID 0.8 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BACITRACIN 500 UNIT/GM OINT 1 EACH PACKET per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BACLOFEN 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BENZOCAINE-MENTHOL 15-3.6 MG LOZG per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BENZONATATE 100 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BENZTROPINE 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BETHANECHOL 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BISACODYL 10 MG SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BISACODYL EC 5 MG TBEC per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BISMUTH SUBSALICYLATE 262 MG/15ML SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BRINZOLAMIDE-BRIMONIDINE 1-0.2 % SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUMETANIDE 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUPROPION 75 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUPROPION SR 100 MG TB12 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUPROPION SR 150 MG TB12 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUSPIRONE 15 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,BUSPIRONE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CALCITRIOL 0.25 MCG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CALCIUM CARBONATE 500 MG CHEW per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CALCIUM CARBONATE-VITAMIN D 500-5 MG-MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARBAMAZEPINE 200 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARBIDOPA-LEVODOPA 10-100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARBIDOPA-LEVODOPA 25-100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARBIDOPA-LEVODOPA 25-250 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARBIDOPA-LEVODOPA CR 25-100 MG TBCR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARVEDILOL 12.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CARVEDILOL 3.125 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CEPHALEXIN 250 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CEPHALEXIN 250 MG/5ML SUSR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CETIRIZINE 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CHLORDIAZEPOXIDE 25 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CHLORDIAZEPOXIDE 5 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CHLORTHALIDONE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CHOLESTYRAMINE 4 G PACK per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CILOSTAZOL 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CITALOPRAM 20 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLINDAMYCIN 150 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLONAZEPAM 0.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLONIDINE 0.1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CLOTRIMAZOLE 1 % CREA 28 G TUBE per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,CYCLOBENZAPRINE 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIAZEPAM 2 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIAZEPAM 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DICLOFENAC EC 75 MG TBEC per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DICYCLOMINE 10 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIGOXIN 0.125 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DILTIAZEM 30 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DILTIAZEM CD 120 MG CP24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DILTIAZEM CD 180 MG CP24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIPHENHYDRAMINE 12.5 MG/5ML LIQD per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIPHENHYDRAMINE 25 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIVALPROEX DR SPRINKLE 125 MG CSDR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIVALPROEX EC 250 MG TBEC per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DIVALPROEX ER 250 MG TB24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DOCUSATE 50 MG/5ML LIQD per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DOCUSATE SODIUM 100 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DONEPEZIL 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,DOXAZOSIN 2 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ESTRADIOL 0.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ETODOLAC 400 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FAMOTIDINE 20 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FENOFIBRATE 145 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FENOFIBRATE 48 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FERROUS SULFATE (65 MG ELEMENTAL) 325 (65 FE) MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FINASTERIDE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FISH OIL 1000 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUDROCORTISONE 0.1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUOXETINE 10 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FLUTICASONE PROPIONATE 44 MCG/ACT AERO per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FOLIC ACID 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FUROSEMIDE 20 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,FUROSEMIDE 40 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GABAPENTIN 100 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GABAPENTIN 100 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GABAPENTIN 300 MG CAPS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GEMFIBROZIL 600 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GLIMEPIRIDE 2 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GLIPIZIDE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GLYBURIDE 2.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GLYCERIN (ADULT) 2 G SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GLYCERIN (PEDS/INFANT) 1.2 G SUPP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GUAIFENESIN 100 MG/5ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GUAIFENESIN ER 600 MG TB12 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GUAIFENESIN-CODEINE 100-10 MG/5ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,GUAIFENESIN-DEXTROMETHORPHAN 100-10 MG/5ML SYRP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HALOPERIDOL 0.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HALOPERIDOL 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDRALAZINE 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDRALAZINE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCHLOROTHIAZIDE 12.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCHLOROTHIAZIDE 25 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCODONE-ACETAMINOPHEN 10-325 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCODONE-ACETAMINOPHEN 5-325 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROMORPHONE 2 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROXYZINE 25 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYDROXYZINE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,HYOSCYAMINE 0.125 MG SUBL per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,IBUPROFEN 100 MG/5ML SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,IBUPROFEN 400 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,IBUPROFEN 600 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,INDAPAMIDE 2.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,INDOMETHACIN 25 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ISOSORBIDE MONONITRATE ER 30 MG TB24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,KETOROLAC 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LABETALOL 100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LACTULOSE 10 GM/15ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LAMOTRIGINE 100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LAMOTRIGINE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVETIRACETAM 250 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 100 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 112 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 125 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 25 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 50 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 75 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LEVOTHYROXINE 88 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LISINOPRIL 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LISINOPRIL 20 MG TABS,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LISINOPRIL 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LITHIUM 300 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LOPERAMIDE 2 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LORAZEPAM 0.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LORAZEPAM 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LOSARTAN 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,LOSARTAN 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MAGNESIUM CITRATE 1.745 GM/30ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MAGNESIUM HYDROXIDE 400 MG/5ML SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MAGNESIUM OXIDE 400 (241.3 MG) MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MECLIZINE 12.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MELATONIN 3 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MEMANTINE 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METFORMIN 1000 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METFORMIN 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METHIMAZOLE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METHOCARBAMOL 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METOCLOPRAMIDE 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METOLAZONE 2.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METOPROLOL SUCCINATE ER 25 MG TB24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METOPROLOL SUCCINATE ER 50 MG TB24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METOPROLOL TARTRATE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METOPROLOL TARTRATE 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,METRONIDAZOLE 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MIDODRINE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MINERAL OIL OIL per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MIRTAZAPINE 15 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MISOPROSTOL 100 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MORPHINE CR 15 MG TBCR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MORPHINE SULFATE 100 MG/5ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,MULTI VITAMIN/MINERALS TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NABUMETONE 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NAPROXEN 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 3.5-400-5000 OINT,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NEOMYCIN-BACITRACIN-POLYMYXIN 3.5-400-5000 OINT 1 EACH PACKET per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NICOTINE 14 MG/24HR PT24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NICOTINE 21 MG/24HR PT24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NIFEDIPINE XL 30 MG TB24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NITROGLYCERIN 0.4 MG SUBL per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NITROGLYCERIN 2 % OINT per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NORTRIPTYLINE 10 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NORTRIPTYLINE 25 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,NYSTATIN 100000 UNIT/ML SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXCARBAZEPINE 150 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXCARBAZEPINE 300 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYBUTYNIN 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYCODONE IMMEDIATE RELEASE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYCODONE-ACETAMINOPHEN 5-325 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OXYMETAZOLINE 0.05 % SOLN 30 ML SPRAY BOTTLE per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,OYSTER SHELL CALCIUM 500 MG (ELEMENTAL) 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PAROXETINE 20 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PHENAZOPYRIDINE 100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PHENOL 1.4 % LIQD 177 ML BOTTLE per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PHENYTOIN ER 100 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PHOSPHORUS 250 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,POLYETHYLENE GLYCOL PACK per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,POTASSIUM AND SODIUM PHOSPHATES 280-160-250 MG PACK per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,POTASSIUM BICARBONATE-CITRIC ACID 10 MEQ TBEF per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,POTASSIUM BICARBONATE-CITRIC ACID 20 MEQ TBEF per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,POTASSIUM CHLORIDE CR 10 MEQ TBCR per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PRAMIPEXOLE 0.25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PRAMIPEXOLE 1 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PRAZOSIN 1 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PREGABALIN 100 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PREGABALIN 25 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PREGABALIN 75 MG CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PRIMIDONE 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PROCHLORPERAZINE 5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PROMETHAZINE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PROPRANOLOL 10 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PSYLLIUM 58.12 % PACK per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,PYRIDOXINE 100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,RANOLAZINE ER 500 MG TB12 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ROPINIROLE 0.5 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,ROPINIROLE 2 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SALINE (FLEET) ADULT 7-19 GM/118ML ENEM per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SALINE ENEMA ADULT 7-19 GM/118ML ENEM per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SENNA 8.6 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SENNA-DOCUSATE 8.6-50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SERTRALINE 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SIMETHICONE 80 MG CHEW per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SODIUM CHLORIDE 0.65 % SOLN 44 ML BOTTLE per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SODIUM CHLORIDE 1 GM TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SOTALOL 80 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SPIRONOLACTONE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SUCRALFATE 1 G TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML SUSP per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,SULFASALAZINE 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TIZANIDINE 4 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TOPIRAMATE 25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TORSEMIDE 20 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRAMADOL 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRAZODONE 50 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VALPROIC ACID 250 MG/5ML SOLN per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VERAPAMIL ER 120 MG CP24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VERAPAMIL ER 180 MG CP24 per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VITAMIN B-1 100 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VITAMIN B-12 500 MCG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VITAMIN C 500 MG TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VITAMIN D2 (ERGOCALCIFEROL) 50000 UNITS CAPS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),63700001,N/A,VITAMIN D3 (CHOLECALCIFEROL) 1000 UNIT TABS per,637,1 ,$6.00 ,$4.32 ,$1.68 ,$6.00 ,$3.90 , N/A ,$1.68 ,$3.32 , N/A ,$3.49 , N/A ,$3.14 , N/A , N/A ,$5.52 , N/A , N/A ,$5.10 ,$5.40 , N/A ,$4.50 ,$4.20 ,$4.20 , N/A ,$4.20 ,$4.62 ,$4.62 ,$6.00 ,$5.10 , N/A , N/A ,$3.37 ,$2.48 ,$2.50 , N/A , N/A , N/A ,$5.10 , N/A ,$3.14 ,$1.68 ,$5.40 ,$3.17 , N/A ,$3.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),71000230,N/A,HC PHASE II RECOVERY 15 MIN,710,1 ,$172.00 ,$123.84 ,$48.16 ,$172.00 ,$111.80 , N/A ,$48.16 ,$95.12 , N/A ,$100.10 , N/A ,$90.13 , N/A , N/A ,$158.24 , N/A , N/A ,$146.20 ,$154.80 , N/A ,$129.00 ,$120.40 ,$120.40 , N/A ,$120.40 ,$132.44 ,$132.44 , N/A ,$146.20 , N/A , N/A ,$96.49 ,$71.21 ,$71.55 , N/A , N/A , N/A ,$146.20 , N/A ,$90.13 ,$48.16 ,$154.80 ,$90.82 , N/A ,$111.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),71000233,N/A,HC PHASE I RECOVERY 30 MIN,710,1 ,"$1,317.00 ",$948.24 ,$368.76 ,"$1,317.00 ",$856.05 , N/A ,$368.76 ,$728.30 , N/A ,$766.49 , N/A ,$690.11 , N/A , N/A ,"$1,211.64 ", N/A , N/A ,"$1,119.45 ","$1,185.30 ", N/A ,$987.75 ,$921.90 ,$921.90 , N/A ,$921.90 ,"$1,014.09 ","$1,014.09 ", N/A ,"$1,119.45 ", N/A , N/A ,$738.84 ,$545.24 ,$547.87 , N/A , N/A , N/A ,"$1,119.45 ", N/A ,$690.11 ,$368.76 ,"$1,185.30 ",$695.38 , N/A ,$856.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),71000234,N/A,HC PHASE I RECOVERY 15 MIN,710,1 ,$254.00 ,$182.88 ,$71.12 ,$254.00 ,$165.10 , N/A ,$71.12 ,$140.46 , N/A ,$147.83 , N/A ,$133.10 , N/A , N/A ,$233.68 , N/A , N/A ,$215.90 ,$228.60 , N/A ,$190.50 ,$177.80 ,$177.80 , N/A ,$177.80 ,$195.58 ,$195.58 , N/A ,$215.90 , N/A , N/A ,$142.49 ,$105.16 ,$105.66 , N/A , N/A , N/A ,$215.90 , N/A ,$133.10 ,$71.12 ,$228.60 ,$134.11 , N/A ,$165.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),73000002,93005,HC EKG,730,1 ,$315.00 ,$226.80 ,$18.20 ,$315.00 ,$204.75 ,$54.10 ,$88.20 ,$174.20 ,$54.10 ,$183.33 ,$54.10 ,$165.06 ,$54.10 ,$111.50 ,$289.80 ,$138.00 ,$54.10 ,$267.75 ,$283.50 ,$55.17 ,$236.25 ,$220.50 ,$220.50 ,$54.10 ,$220.50 ,$242.55 ,$242.55 ,$138.00 ,$267.75 ,$55.20 ,$55.20 ,$176.72 ,$130.41 ,$131.04 ,$18.39 ,$18.20 ,$56.80 ,$267.75 ,$118.68 ,$165.06 ,$88.20 ,$283.50 ,$315.00 ,$54.10 ,$204.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),73000003,93041,HC EKG RHYTHM STRIP TRACING,730,1 ,$236.00 ,$169.92 ,$18.20 ,$236.00 ,$153.40 ,$54.10 ,$66.08 ,$130.51 ,$54.10 ,$137.35 ,$54.10 ,$123.66 ,$54.10 ,$111.50 ,$217.12 ,$138.00 ,$54.10 ,$200.60 ,$212.40 ,$55.17 ,$177.00 ,$165.20 ,$165.20 ,$54.10 ,$165.20 ,$181.72 ,$181.72 ,$138.00 ,$200.60 ,$55.20 ,$55.20 ,$132.40 ,$97.70 ,$98.18 ,$18.39 ,$18.20 ,$56.80 ,$200.60 ,$118.68 ,$123.66 ,$66.08 ,$212.40 ,$236.00 ,$54.10 ,$153.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,"$1,803.00 ","$1,298.16 ",$48.83 ,"$1,803.00 ","$1,171.95 ",$109.28 ,$504.84 ,$997.06 ,$109.28 ,"$1,049.35 ",$109.28 ,$944.77 ,$109.28 ,$225.24 ,"$1,658.76 ",$278.76 ,$109.28 ,"$1,532.55 ","$1,622.70 ",$111.47 ,"$1,352.25 ","$1,262.10 ","$1,262.10 ",$109.28 ,"$1,262.10 ","$1,388.31 ","$1,388.31 ",$278.76 ,"$1,532.55 ",$111.51 ,$111.51 ,"$1,011.48 ",$746.44 ,$750.05 ,$49.36 ,$48.83 ,$114.75 ,"$1,532.55 ",$239.74 ,$944.77 ,$504.84 ,"$1,622.70 ",$771.00 ,$109.28 ,"$1,171.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),73100001,93226,HC HOLTER SCAN AND REPORT 24 HR,731,1 ,$526.00 ,$378.72 ,$48.83 ,$526.00 ,$341.90 ,$109.28 ,$147.28 ,$290.88 ,$109.28 ,$306.13 ,$109.28 ,$275.62 ,$109.28 ,$225.24 ,$483.92 ,$278.76 ,$109.28 ,$447.10 ,$473.40 ,$111.47 ,$394.50 ,$368.20 ,$368.20 ,$109.28 ,$368.20 ,$405.02 ,$405.02 ,$278.76 ,$447.10 ,$111.51 ,$111.51 ,$295.09 ,$217.76 ,$218.82 ,$49.36 ,$48.83 ,$114.75 ,$447.10 ,$239.74 ,$275.62 ,$147.28 ,$473.40 ,$526.00 ,$109.28 ,$341.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),73100002,93226,HC HOLTER SCAN AND REPORT 48 HR,731,1 ,$526.00 ,$378.72 ,$48.83 ,$526.00 ,$341.90 ,$109.28 ,$147.28 ,$290.88 ,$109.28 ,$306.13 ,$109.28 ,$275.62 ,$109.28 ,$225.24 ,$483.92 ,$278.76 ,$109.28 ,$447.10 ,$473.40 ,$111.47 ,$394.50 ,$368.20 ,$368.20 ,$109.28 ,$368.20 ,$405.02 ,$405.02 ,$278.76 ,$447.10 ,$111.51 ,$111.51 ,$295.09 ,$217.76 ,$218.82 ,$49.36 ,$48.83 ,$114.75 ,$447.10 ,$239.74 ,$275.62 ,$147.28 ,$473.40 ,$526.00 ,$109.28 ,$341.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$4,220.00 ","$3,038.40 ",$454.97 ,"$4,220.00 ","$2,743.00 ",$454.97 ,"$1,181.60 ","$2,333.66 ",$454.97 ,"$2,456.04 ",$454.97 ,"$2,211.28 ",$454.97 ,$937.80 ,"$3,882.40 ","$1,160.64 ",$454.97 ,"$3,587.00 ","$3,798.00 ",$464.07 ,"$3,165.00 ","$2,954.00 ","$2,954.00 ",$454.97 ,"$2,954.00 ","$3,249.40 ","$3,249.40 ","$1,160.64 ","$3,587.00 ",$464.26 ,$464.26 ,"$2,367.42 ","$1,747.08 ","$1,755.52 ",$548.20 ,$542.26 ,$477.72 ,"$3,587.00 ",$998.15 ,"$2,211.28 ","$1,181.60 ","$3,798.00 ","$2,669.00 ",$454.97 ,"$2,743.00 " HSHS HOLY FAMILY HOSPITAL INC (ACU),74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,$409.00 ,$294.48 ,$114.52 ,$409.00 ,$265.85 ,$136.87 ,$114.52 ,$226.18 ,$136.87 ,$238.04 ,$136.87 ,$214.32 ,$136.87 ,$282.12 ,$376.28 ,$349.16 ,$136.87 ,$347.65 ,$368.10 ,$139.61 ,$306.75 ,$286.30 ,$286.30 ,$136.87 ,$286.30 ,$314.93 ,$314.93 ,$349.16 ,$347.65 ,$139.66 ,$139.66 ,$229.45 ,$169.33 ,$170.14 ,$394.69 ,$409.00 ,$143.71 ,$347.65 ,$300.27 ,$214.32 ,$114.52 ,$368.10 ,$409.00 ,$136.87 ,$265.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),74000006,95810,HC SLEEP STUDY,740,1 ,"$4,781.00 ","$3,442.32 ",$542.26 ,"$4,781.00 ","$3,107.65 ",$879.37 ,"$1,338.68 ","$2,643.89 ",$879.37 ,"$2,782.54 ",$879.37 ,"$2,505.24 ",$879.37 ,"$1,812.59 ","$4,398.52 ","$2,243.31 ",$879.37 ,"$4,063.85 ","$4,302.90 ",$896.96 ,"$3,585.75 ","$3,346.70 ","$3,346.70 ",$879.37 ,"$3,346.70 ","$3,681.37 ","$3,681.37 ","$2,243.31 ","$4,063.85 ",$897.32 ,$897.32 ,"$2,682.14 ","$1,979.33 ","$1,988.90 ",$548.20 ,$542.26 ,$923.35 ,"$4,063.85 ","$1,929.24 ","$2,505.24 ","$1,338.68 ","$4,302.90 ","$2,669.00 ",$879.37 ,"$3,107.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$5,106.00 ","$3,676.32 ",$542.26 ,"$5,106.00 ","$3,318.90 ",$879.37 ,"$1,429.68 ","$2,823.62 ",$879.37 ,"$2,971.69 ",$879.37 ,"$2,675.54 ",$879.37 ,"$1,812.59 ","$4,697.52 ","$2,243.31 ",$879.37 ,"$4,340.10 ","$4,595.40 ",$896.96 ,"$3,829.50 ","$3,574.20 ","$3,574.20 ",$879.37 ,"$3,574.20 ","$3,931.62 ","$3,931.62 ","$2,243.31 ","$4,340.10 ",$897.32 ,$897.32 ,"$2,864.47 ","$2,113.88 ","$2,124.10 ",$548.20 ,$542.26 ,$923.35 ,"$4,340.10 ","$1,929.24 ","$2,675.54 ","$1,429.68 ","$4,595.40 ","$2,669.00 ",$879.37 ,"$3,318.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),74000035,G0399,HC SLEEP STUDY HOME ADULT,740,1 ,$956.00 ,$688.32 ,$84.39 ,$956.00 ,$621.40 ,$136.87 ,$267.68 ,$528.67 ,$136.87 ,$556.39 ,$136.87 ,$500.94 ,$136.87 ,$282.12 ,$879.52 ,$349.16 ,$136.87 ,$812.60 ,$860.40 ,$139.61 ,$717.00 ,$669.20 ,$669.20 ,$136.87 ,$669.20 ,$736.12 ,$736.12 ,$349.16 ,$812.60 ,$139.66 ,$139.66 ,$536.32 ,$395.78 ,$397.70 ,$85.32 ,$84.39 ,$143.71 ,$812.60 ,$300.27 ,$500.94 ,$267.68 ,$860.40 ,$904.00 ,$136.87 ,$621.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$2,556.00 ","$1,840.32 ",$488.89 ,"$2,556.00 ","$1,661.40 ",$776.91 ,$715.68 ,"$1,413.47 ",$776.91 ,"$1,487.59 ",$776.91 ,"$1,339.34 ",$776.91 ,"$1,601.40 ","$2,351.52 ","$1,981.93 ",$776.91 ,"$2,172.60 ","$2,300.40 ",$792.46 ,"$1,917.00 ","$1,789.20 ","$1,789.20 ",$776.91 ,"$1,789.20 ","$1,968.12 ","$1,968.12 ","$1,981.93 ","$2,172.60 ",$792.77 ,$792.77 ,"$1,433.92 ","$1,058.18 ","$1,063.30 ",$494.24 ,$488.89 ,$815.76 ,"$2,172.60 ","$1,704.46 ","$1,339.34 ",$715.68 ,"$2,300.40 ","$2,500.00 ",$776.91 ,"$1,661.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001071,N/A,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001072,N/A,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$2,502.00 ","$1,801.44 ",$700.56 ,"$2,502.00 ","$1,626.30 ", N/A ,$700.56 ,"$1,383.61 ", N/A ,"$1,456.16 ", N/A ,"$1,311.05 ", N/A , N/A ,"$2,301.84 ", N/A , N/A ,"$2,126.70 ","$2,251.80 ", N/A ,"$1,876.50 ","$1,751.40 ","$1,751.40 ", N/A ,"$1,751.40 ","$1,926.54 ","$1,926.54 ", N/A ,"$2,126.70 ", N/A , N/A ,"$1,403.62 ","$1,035.83 ","$1,040.83 ", N/A , N/A , N/A ,"$2,126.70 ", N/A ,"$1,311.05 ",$700.56 ,"$2,251.80 ", N/A , N/A ,"$1,626.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001073,N/A,HC EGD W/SUBMUCOSAL INJ - 43236,750,1 ,"$2,502.00 ","$1,801.44 ",$700.56 ,"$2,502.00 ","$1,626.30 ", N/A ,$700.56 ,"$1,383.61 ", N/A ,"$1,456.16 ", N/A ,"$1,311.05 ", N/A , N/A ,"$2,301.84 ", N/A , N/A ,"$2,126.70 ","$2,251.80 ", N/A ,"$1,876.50 ","$1,751.40 ","$1,751.40 ", N/A ,"$1,751.40 ","$1,926.54 ","$1,926.54 ", N/A ,"$2,126.70 ", N/A , N/A ,"$1,403.62 ","$1,035.83 ","$1,040.83 ", N/A , N/A , N/A ,"$2,126.70 ", N/A ,"$1,311.05 ",$700.56 ,"$2,251.80 ", N/A , N/A ,"$1,626.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001075,N/A,HC EGD W/US FINE NEEDLE ASPIRATION LIMITED - 43238,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001076,N/A,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$2,502.00 ","$1,801.44 ",$700.56 ,"$2,502.00 ","$1,626.30 ", N/A ,$700.56 ,"$1,383.61 ", N/A ,"$1,456.16 ", N/A ,"$1,311.05 ", N/A , N/A ,"$2,301.84 ", N/A , N/A ,"$2,126.70 ","$2,251.80 ", N/A ,"$1,876.50 ","$1,751.40 ","$1,751.40 ", N/A ,"$1,751.40 ","$1,926.54 ","$1,926.54 ", N/A ,"$2,126.70 ", N/A , N/A ,"$1,403.62 ","$1,035.83 ","$1,040.83 ", N/A , N/A , N/A ,"$2,126.70 ", N/A ,"$1,311.05 ",$700.56 ,"$2,251.80 ", N/A , N/A ,"$1,626.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001077,N/A,HC EGD W/TRANSMURAL DRAIN CYST - 43240,750,1 ,"$9,036.00 ","$6,505.92 ","$2,530.08 ","$9,036.00 ","$5,873.40 ", N/A ,"$2,530.08 ","$4,996.91 ", N/A ,"$5,258.95 ", N/A ,"$4,734.86 ", N/A , N/A ,"$8,313.12 ", N/A , N/A ,"$7,680.60 ","$8,132.40 ", N/A ,"$6,777.00 ","$6,325.20 ","$6,325.20 ", N/A ,"$6,325.20 ","$6,957.72 ","$6,957.72 ", N/A ,"$7,680.60 ", N/A , N/A ,"$5,069.20 ","$3,740.90 ","$3,758.98 ", N/A , N/A , N/A ,"$7,680.60 ", N/A ,"$4,734.86 ","$2,530.08 ","$8,132.40 ", N/A , N/A ,"$5,873.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001078,N/A,HC EGD W/US FINE NEEDLE ASPIRATION - 43242,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001079,N/A,HC EGD W/SCLEROTHERAPY - 43243,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001080,N/A,HC EGD W/BAND LIGATION - 43244,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001081,N/A,HC EGD W/DILAT STRICTURE - 43245,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001083,N/A,HC EGD W/FB REMOVAL - 43247,750,1 ,"$2,502.00 ","$1,801.44 ",$700.56 ,"$2,502.00 ","$1,626.30 ", N/A ,$700.56 ,"$1,383.61 ", N/A ,"$1,456.16 ", N/A ,"$1,311.05 ", N/A , N/A ,"$2,301.84 ", N/A , N/A ,"$2,126.70 ","$2,251.80 ", N/A ,"$1,876.50 ","$1,751.40 ","$1,751.40 ", N/A ,"$1,751.40 ","$1,926.54 ","$1,926.54 ", N/A ,"$2,126.70 ", N/A , N/A ,"$1,403.62 ","$1,035.83 ","$1,040.83 ", N/A , N/A , N/A ,"$2,126.70 ", N/A ,"$1,311.05 ",$700.56 ,"$2,251.80 ", N/A , N/A ,"$1,626.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001085,N/A,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001086,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001087,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001088,N/A,HC EGD W/TRANSMURAL INJ/MARKER - 43253,750,1 ,"$4,766.00 ","$3,431.52 ","$1,334.48 ","$4,766.00 ","$3,097.90 ", N/A ,"$1,334.48 ","$2,635.60 ", N/A ,"$2,773.81 ", N/A ,"$2,497.38 ", N/A , N/A ,"$4,384.72 ", N/A , N/A ,"$4,051.10 ","$4,289.40 ", N/A ,"$3,574.50 ","$3,336.20 ","$3,336.20 ", N/A ,"$3,336.20 ","$3,669.82 ","$3,669.82 ", N/A ,"$4,051.10 ", N/A , N/A ,"$2,673.73 ","$1,973.12 ","$1,982.66 ", N/A , N/A , N/A ,"$4,051.10 ", N/A ,"$2,497.38 ","$1,334.48 ","$4,289.40 ", N/A , N/A ,"$3,097.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001089,N/A,HC EGD W/ENDO MUCOSAL RESECTION - 43254,750,1 ,"$4,766.00 ","$3,431.52 ","$1,334.48 ","$4,766.00 ","$3,097.90 ", N/A ,"$1,334.48 ","$2,635.60 ", N/A ,"$2,773.81 ", N/A ,"$2,497.38 ", N/A , N/A ,"$4,384.72 ", N/A , N/A ,"$4,051.10 ","$4,289.40 ", N/A ,"$3,574.50 ","$3,336.20 ","$3,336.20 ", N/A ,"$3,336.20 ","$3,669.82 ","$3,669.82 ", N/A ,"$4,051.10 ", N/A , N/A ,"$2,673.73 ","$1,973.12 ","$1,982.66 ", N/A , N/A , N/A ,"$4,051.10 ", N/A ,"$2,497.38 ","$1,334.48 ","$4,289.40 ", N/A , N/A ,"$3,097.90 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001090,N/A,HC EGD W/CONTROL BLEEDING - 43255,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001091,N/A,HC EGD W/US DUODENUM/JEJUNUM - 43259,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001092,N/A,HC EGD W/STENT PLACEMENT - 43266,750,1 ,"$15,539.00 ","$11,188.08 ","$4,350.92 ","$15,539.00 ","$10,100.35 ", N/A ,"$4,350.92 ","$8,593.07 ", N/A ,"$9,043.70 ", N/A ,"$8,142.44 ", N/A , N/A ,"$14,295.88 ", N/A , N/A ,"$13,208.15 ","$13,985.10 ", N/A ,"$11,654.25 ","$10,877.30 ","$10,877.30 ", N/A ,"$10,877.30 ","$11,965.03 ","$11,965.03 ", N/A ,"$13,208.15 ", N/A , N/A ,"$8,717.38 ","$6,433.15 ","$6,464.22 ", N/A , N/A , N/A ,"$13,208.15 ", N/A ,"$8,142.44 ","$4,350.92 ","$13,985.10 ", N/A , N/A ,"$10,100.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001093,N/A,HC EGD W/TUMOR ABLATION - 43270,750,1 ,"$5,021.00 ","$3,615.12 ","$1,405.88 ","$5,021.00 ","$3,263.65 ", N/A ,"$1,405.88 ","$2,776.61 ", N/A ,"$2,922.22 ", N/A ,"$2,631.00 ", N/A , N/A ,"$4,619.32 ", N/A , N/A ,"$4,267.85 ","$4,518.90 ", N/A ,"$3,765.75 ","$3,514.70 ","$3,514.70 ", N/A ,"$3,514.70 ","$3,866.17 ","$3,866.17 ", N/A ,"$4,267.85 ", N/A , N/A ,"$2,816.78 ","$2,078.69 ","$2,088.74 ", N/A , N/A , N/A ,"$4,267.85 ", N/A ,"$2,631.00 ","$1,405.88 ","$4,518.90 ", N/A , N/A ,"$3,263.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001094,N/A,HC ERCP W/BRUSH/WASH - 43260,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001095,N/A,HC ERCP W/BIOPSY SGL/MULT - 43261,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001096,N/A,HC ERCP W/SPHINCTEROTOMY - 43262,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001097,N/A,HC ERCP W/SPHINCTER PRESSURE MEASUREMENT - 43263,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001098,N/A,HC ERCP W/STONE REMOVAL DUCT - 43264,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001099,N/A,HC ERCP W/LITHOTRIPSY - 43265,750,1 ,"$15,539.00 ","$11,188.08 ","$4,350.92 ","$15,539.00 ","$10,100.35 ", N/A ,"$4,350.92 ","$8,593.07 ", N/A ,"$9,043.70 ", N/A ,"$8,142.44 ", N/A , N/A ,"$14,295.88 ", N/A , N/A ,"$13,208.15 ","$13,985.10 ", N/A ,"$11,654.25 ","$10,877.30 ","$10,877.30 ", N/A ,"$10,877.30 ","$11,965.03 ","$11,965.03 ", N/A ,"$13,208.15 ", N/A , N/A ,"$8,717.38 ","$6,433.15 ","$6,464.22 ", N/A , N/A , N/A ,"$13,208.15 ", N/A ,"$8,142.44 ","$4,350.92 ","$13,985.10 ", N/A , N/A ,"$10,100.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001100,N/A,HC ERCP W/STENT PLACEMENT DUCT - 43274,750,1 ,"$15,539.00 ","$11,188.08 ","$4,350.92 ","$15,539.00 ","$10,100.35 ", N/A ,"$4,350.92 ","$8,593.07 ", N/A ,"$9,043.70 ", N/A ,"$8,142.44 ", N/A , N/A ,"$14,295.88 ", N/A , N/A ,"$13,208.15 ","$13,985.10 ", N/A ,"$11,654.25 ","$10,877.30 ","$10,877.30 ", N/A ,"$10,877.30 ","$11,965.03 ","$11,965.03 ", N/A ,"$13,208.15 ", N/A , N/A ,"$8,717.38 ","$6,433.15 ","$6,464.22 ", N/A , N/A , N/A ,"$13,208.15 ", N/A ,"$8,142.44 ","$4,350.92 ","$13,985.10 ", N/A , N/A ,"$10,100.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001101,N/A,HC ERCP W/FB OR STENT REMOVAL DUCT - 43275,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001102,N/A,HC ERCP W/REM/EXCHG STENT W/DILAT AND WIRE EA - 43276,750,1 ,"$15,539.00 ","$11,188.08 ","$4,350.92 ","$15,539.00 ","$10,100.35 ", N/A ,"$4,350.92 ","$8,593.07 ", N/A ,"$9,043.70 ", N/A ,"$8,142.44 ", N/A , N/A ,"$14,295.88 ", N/A , N/A ,"$13,208.15 ","$13,985.10 ", N/A ,"$11,654.25 ","$10,877.30 ","$10,877.30 ", N/A ,"$10,877.30 ","$11,965.03 ","$11,965.03 ", N/A ,"$13,208.15 ", N/A , N/A ,"$8,717.38 ","$6,433.15 ","$6,464.22 ", N/A , N/A , N/A ,"$13,208.15 ", N/A ,"$8,142.44 ","$4,350.92 ","$13,985.10 ", N/A , N/A ,"$10,100.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001103,N/A,HC ERCP W/BALL DILAT DUCT/AMPULLA EA -43277,750,1 ,"$9,519.00 ","$6,853.68 ","$2,665.32 ","$9,519.00 ","$6,187.35 ", N/A ,"$2,665.32 ","$5,264.01 ", N/A ,"$5,540.06 ", N/A ,"$4,987.96 ", N/A , N/A ,"$8,757.48 ", N/A , N/A ,"$8,091.15 ","$8,567.10 ", N/A ,"$7,139.25 ","$6,663.30 ","$6,663.30 ", N/A ,"$6,663.30 ","$7,329.63 ","$7,329.63 ", N/A ,"$8,091.15 ", N/A , N/A ,"$5,340.16 ","$3,940.87 ","$3,959.90 ", N/A , N/A , N/A ,"$8,091.15 ", N/A ,"$4,987.96 ","$2,665.32 ","$8,567.10 ", N/A , N/A ,"$6,187.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001104,N/A,HC ERCP W/TUMOR ABLATION W/DILAT AND WIRE - 43278,750,1 ,"$9,036.00 ","$6,505.92 ","$2,530.08 ","$9,036.00 ","$5,873.40 ", N/A ,"$2,530.08 ","$4,996.91 ", N/A ,"$5,258.95 ", N/A ,"$4,734.86 ", N/A , N/A ,"$8,313.12 ", N/A , N/A ,"$7,680.60 ","$8,132.40 ", N/A ,"$6,777.00 ","$6,325.20 ","$6,325.20 ", N/A ,"$6,325.20 ","$6,957.72 ","$6,957.72 ", N/A ,"$7,680.60 ", N/A , N/A ,"$5,069.20 ","$3,740.90 ","$3,758.98 ", N/A , N/A , N/A ,"$7,680.60 ", N/A ,"$4,734.86 ","$2,530.08 ","$8,132.40 ", N/A , N/A ,"$5,873.40 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001106,N/A,HC ESOPHAGUS DILATION UNGUIDED SGL/MULT PASS - 43450,750,1 ,"$2,550.00 ","$1,836.00 ",$714.00 ,"$2,550.00 ","$1,657.50 ", N/A ,$714.00 ,"$1,410.15 ", N/A ,"$1,484.10 ", N/A ,"$1,336.20 ", N/A , N/A ,"$2,346.00 ", N/A , N/A ,"$2,167.50 ","$2,295.00 ", N/A ,"$1,912.50 ","$1,785.00 ","$1,785.00 ", N/A ,"$1,785.00 ","$1,963.50 ","$1,963.50 ", N/A ,"$2,167.50 ", N/A , N/A ,"$1,430.55 ","$1,055.70 ","$1,060.80 ", N/A , N/A , N/A ,"$2,167.50 ", N/A ,"$1,336.20 ",$714.00 ,"$2,295.00 ", N/A , N/A ,"$1,657.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001109,N/A,HC GASTROSTOMY TUBE PLACE OPEN - 43832,750,1 ,"$3,119.00 ","$2,245.68 ",$873.32 ,"$3,119.00 ","$2,027.35 ", N/A ,$873.32 ,"$1,724.81 ", N/A ,"$1,815.26 ", N/A ,"$1,634.36 ", N/A , N/A ,"$2,869.48 ", N/A , N/A ,"$2,651.15 ","$2,807.10 ", N/A ,"$2,339.25 ","$2,183.30 ","$2,183.30 ", N/A ,"$2,183.30 ","$2,401.63 ","$2,401.63 ", N/A ,"$2,651.15 ", N/A , N/A ,"$1,749.76 ","$1,291.27 ","$1,297.50 ", N/A , N/A , N/A ,"$2,651.15 ", N/A ,"$1,634.36 ",$873.32 ,"$2,807.10 ", N/A , N/A ,"$2,027.35 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001123,N/A,HC ENDOSCOPY POUCH DX W/BRUSH/WASH - 44385,750,1 ,"$2,417.00 ","$1,740.24 ",$676.76 ,"$2,417.00 ","$1,571.05 ", N/A ,$676.76 ,"$1,336.60 ", N/A ,"$1,406.69 ", N/A ,"$1,266.51 ", N/A , N/A ,"$2,223.64 ", N/A , N/A ,"$2,054.45 ","$2,175.30 ", N/A ,"$1,812.75 ","$1,691.90 ","$1,691.90 ", N/A ,"$1,691.90 ","$1,861.09 ","$1,861.09 ", N/A ,"$2,054.45 ", N/A , N/A ,"$1,355.94 ","$1,000.64 ","$1,005.47 ", N/A , N/A , N/A ,"$2,054.45 ", N/A ,"$1,266.51 ",$676.76 ,"$2,175.30 ", N/A , N/A ,"$1,571.05 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001125,N/A,HC COLONOSCOPY STOMA DX W/BRUSH/WASH - 44388,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001126,N/A,HC COLONOSCOPY STOMA W/BX SGL/MULT - 44389,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001127,N/A,HC COLONOSCOPY STOMA W/FB REMOVAL - 44390,750,1 ,"$2,328.00 ","$1,676.16 ",$651.84 ,"$2,328.00 ","$1,513.20 ", N/A ,$651.84 ,"$1,287.38 ", N/A ,"$1,354.90 ", N/A ,"$1,219.87 ", N/A , N/A ,"$2,141.76 ", N/A , N/A ,"$1,978.80 ","$2,095.20 ", N/A ,"$1,746.00 ","$1,629.60 ","$1,629.60 ", N/A ,"$1,629.60 ","$1,792.56 ","$1,792.56 ", N/A ,"$1,978.80 ", N/A , N/A ,"$1,306.01 ",$963.79 ,$968.45 , N/A , N/A , N/A ,"$1,978.80 ", N/A ,"$1,219.87 ",$651.84 ,"$2,095.20 ", N/A , N/A ,"$1,513.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001128,N/A,HC COLONOSCOPY STOMA W/CONTROL BLEEDING - 44391,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001130,N/A,HC COLONOSCOPY STOMA W/REM TUMOR SNARE TECH - 44394,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001131,N/A,HC COLONOSCOPY STOMA W/ABLATION - 44401,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001132,N/A,HC COLONOSCOPY STOMA W/STENT PLACEMENT - 44402,750,1 ,"$14,749.00 ","$10,619.28 ","$4,129.72 ","$14,749.00 ","$9,586.85 ", N/A ,"$4,129.72 ","$8,156.20 ", N/A ,"$8,583.92 ", N/A ,"$7,728.48 ", N/A , N/A ,"$13,569.08 ", N/A , N/A ,"$12,536.65 ","$13,274.10 ", N/A ,"$11,061.75 ","$10,324.30 ","$10,324.30 ", N/A ,"$10,324.30 ","$11,356.73 ","$11,356.73 ", N/A ,"$12,536.65 ", N/A , N/A ,"$8,274.19 ","$6,106.09 ","$6,135.58 ", N/A , N/A , N/A ,"$12,536.65 ", N/A ,"$7,728.48 ","$4,129.72 ","$13,274.10 ", N/A , N/A ,"$9,586.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001133,N/A,HC COLONOSCOPY STOMA W/MUCOSAL RESECTION - 44403,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001134,N/A,HC COLONOSCOPY STOMA W/SUBMUCOSAL INJ - 44404,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001135,N/A,HC COLONOSCOPY STOMA W/ENDO US LIMITED - 44406,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001136,N/A,HC COLONOSCOPY STOMA W/US GUID NEEDLE ASP - 44407,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001137,N/A,HC COLONOSCOPY STOMA W/DECOMPRESSION - 44408,750,1 ,"$2,328.00 ","$1,676.16 ",$651.84 ,"$2,328.00 ","$1,513.20 ", N/A ,$651.84 ,"$1,287.38 ", N/A ,"$1,354.90 ", N/A ,"$1,219.87 ", N/A , N/A ,"$2,141.76 ", N/A , N/A ,"$1,978.80 ","$2,095.20 ", N/A ,"$1,746.00 ","$1,629.60 ","$1,629.60 ", N/A ,"$1,629.60 ","$1,792.56 ","$1,792.56 ", N/A ,"$1,978.80 ", N/A , N/A ,"$1,306.01 ",$963.79 ,$968.45 , N/A , N/A , N/A ,"$1,978.80 ", N/A ,"$1,219.87 ",$651.84 ,"$2,095.20 ", N/A , N/A ,"$1,513.20 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001142,N/A,HC SIGMOIDOSCOPY DX W/BRUSH/WASH - 45330,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001143,N/A,HC SIGMOIDOSCOPY W/BIOPSY SGL/MULT -45331,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001144,N/A,HC SIGMOIDOSCOPY W/FB REMOVAL -45332,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001145,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY -45333,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001146,N/A,HC SIGMOIDOSCOPY W/CONTROL BLEEDING - 45334,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001147,N/A,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJ - 45335,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001148,N/A,HC SIGMOIDOSCOPY W/DECOMPRESSION -45337,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001149,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45338,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001150,N/A,HC SIGMOIDOSCOPY W/DILATION - 45340,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001153,N/A,HC SIGMOIDOSCOPY W/ABLATION TUMOR - 45346,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001155,N/A,HC SIGMOIDOSCOPY W/ENDO MUCOSAL RESECTION - 45349,750,1 ,"$7,550.00 ","$5,436.00 ","$2,114.00 ","$7,550.00 ","$4,907.50 ", N/A ,"$2,114.00 ","$4,175.15 ", N/A ,"$4,394.10 ", N/A ,"$3,956.20 ", N/A , N/A ,"$6,946.00 ", N/A , N/A ,"$6,417.50 ","$6,795.00 ", N/A ,"$5,662.50 ","$5,285.00 ","$5,285.00 ", N/A ,"$5,285.00 ","$5,813.50 ","$5,813.50 ", N/A ,"$6,417.50 ", N/A , N/A ,"$4,235.55 ","$3,125.70 ","$3,140.80 ", N/A , N/A , N/A ,"$6,417.50 ", N/A ,"$3,956.20 ","$2,114.00 ","$6,795.00 ", N/A , N/A ,"$4,907.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001156,N/A,HC SIGMOIDOSCOPY W/BAND LIGATION - 45350,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001157,N/A,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$2,452.00 ","$1,765.44 ",$686.56 ,"$2,452.00 ","$1,593.80 ", N/A ,$686.56 ,"$1,355.96 ", N/A ,"$1,427.06 ", N/A ,"$1,284.85 ", N/A , N/A ,"$2,255.84 ", N/A , N/A ,"$2,084.20 ","$2,206.80 ", N/A ,"$1,839.00 ","$1,716.40 ","$1,716.40 ", N/A ,"$1,716.40 ","$1,888.04 ","$1,888.04 ", N/A ,"$2,084.20 ", N/A , N/A ,"$1,375.57 ","$1,015.13 ","$1,020.03 ", N/A , N/A , N/A ,"$2,084.20 ", N/A ,"$1,284.85 ",$686.56 ,"$2,206.80 ", N/A , N/A ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001158,N/A,HC COLONOSCOPY W/FB REMOVAL - 45379,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001159,N/A,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001160,N/A,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001161,N/A,HC COLONOSCOPY W/CONTROL BLEEDING - 45382,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001162,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001163,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001164,N/A,HC COLONOSCOPY W/BALLOON DILATION - 45386,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001165,N/A,HC COLONOSCOPY W/ABLATION TUMOR - 45388,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001166,N/A,HC COLONOSCOPY W/STENT PLACEMENT - 45389,750,1 ,"$14,749.00 ","$10,619.28 ","$4,129.72 ","$14,749.00 ","$9,586.85 ", N/A ,"$4,129.72 ","$8,156.20 ", N/A ,"$8,583.92 ", N/A ,"$7,728.48 ", N/A , N/A ,"$13,569.08 ", N/A , N/A ,"$12,536.65 ","$13,274.10 ", N/A ,"$11,061.75 ","$10,324.30 ","$10,324.30 ", N/A ,"$10,324.30 ","$11,356.73 ","$11,356.73 ", N/A ,"$12,536.65 ", N/A , N/A ,"$8,274.19 ","$6,106.09 ","$6,135.58 ", N/A , N/A , N/A ,"$12,536.65 ", N/A ,"$7,728.48 ","$4,129.72 ","$13,274.10 ", N/A , N/A ,"$9,586.85 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001167,N/A,HC COLONOSCOPY W/MUCOSAL RESECTION - 45390,750,1 ,"$7,550.00 ","$5,436.00 ","$2,114.00 ","$7,550.00 ","$4,907.50 ", N/A ,"$2,114.00 ","$4,175.15 ", N/A ,"$4,394.10 ", N/A ,"$3,956.20 ", N/A , N/A ,"$6,946.00 ", N/A , N/A ,"$6,417.50 ","$6,795.00 ", N/A ,"$5,662.50 ","$5,285.00 ","$5,285.00 ", N/A ,"$5,285.00 ","$5,813.50 ","$5,813.50 ", N/A ,"$6,417.50 ", N/A , N/A ,"$4,235.55 ","$3,125.70 ","$3,140.80 ", N/A , N/A , N/A ,"$6,417.50 ", N/A ,"$3,956.20 ","$2,114.00 ","$6,795.00 ", N/A , N/A ,"$4,907.50 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001168,N/A,HC COLONOSCOPY W/ENDO US LIMITED -45391,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001169,N/A,HC COLONOSCOPY W/NEEDLE BIOPSY W/US EXAM - 45392,750,1 ,"$3,042.00 ","$2,190.24 ",$851.76 ,"$3,042.00 ","$1,977.30 ", N/A ,$851.76 ,"$1,682.23 ", N/A ,"$1,770.44 ", N/A ,"$1,594.01 ", N/A , N/A ,"$2,798.64 ", N/A , N/A ,"$2,585.70 ","$2,737.80 ", N/A ,"$2,281.50 ","$2,129.40 ","$2,129.40 ", N/A ,"$2,129.40 ","$2,342.34 ","$2,342.34 ", N/A ,"$2,585.70 ", N/A , N/A ,"$1,706.56 ","$1,259.39 ","$1,265.47 ", N/A , N/A , N/A ,"$2,585.70 ", N/A ,"$1,594.01 ",$851.76 ,"$2,737.80 ", N/A , N/A ,"$1,977.30 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001171,N/A,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$3,204.00 ","$2,306.88 ",$897.12 ,"$3,204.00 ","$2,082.60 ", N/A ,$897.12 ,"$1,771.81 ", N/A ,"$1,864.73 ", N/A ,"$1,678.90 ", N/A , N/A ,"$2,947.68 ", N/A , N/A ,"$2,723.40 ","$2,883.60 ", N/A ,"$2,403.00 ","$2,242.80 ","$2,242.80 ", N/A ,"$2,242.80 ","$2,467.08 ","$2,467.08 ", N/A ,"$2,723.40 ", N/A , N/A ,"$1,797.44 ","$1,326.46 ","$1,332.86 ", N/A , N/A , N/A ,"$2,723.40 ", N/A ,"$1,678.90 ",$897.12 ,"$2,883.60 ", N/A , N/A ,"$2,082.60 " HSHS HOLY FAMILY HOSPITAL INC (ACU),75001174,N/A,HC ANOSCOPY DX W/SPECIMEN -46600,750,1 ,$346.00 ,$249.12 ,$96.88 ,$346.00 ,$224.90 , N/A ,$96.88 ,$191.34 , N/A ,$201.37 , N/A ,$181.30 , N/A , N/A ,$318.32 , N/A , N/A ,$294.10 ,$311.40 , N/A ,$259.50 ,$242.20 ,$242.20 , N/A ,$242.20 ,$266.42 ,$266.42 , N/A ,$294.10 , N/A , N/A ,$194.11 ,$143.24 ,$143.94 , N/A , N/A , N/A ,$294.10 , N/A ,$181.30 ,$96.88 ,$311.40 , N/A , N/A ,$224.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),75001200,G0104,HC COLONOSCOPY SCREEN W/FLEX SIGMOID - G0104,750,1 ,"$2,452.00 ","$1,765.44 ",$463.55 ,"$2,452.00 ","$1,593.80 ",$782.12 ,$686.56 ,"$1,355.96 ",$782.12 ,"$1,427.06 ",$782.12 ,"$1,284.85 ",$782.12 ,"$1,612.12 ","$2,255.84 ","$1,995.20 ",$782.12 ,"$2,084.20 ","$2,206.80 ",$797.76 ,"$1,839.00 ","$1,716.40 ","$1,716.40 ",$782.12 ,"$1,716.40 ","$1,888.04 ","$1,888.04 ","$1,995.20 ","$2,084.20 ",$798.08 ,$798.08 ,"$1,375.57 ","$1,015.13 ","$1,020.03 ",$468.63 ,$463.55 ,$821.22 ,"$2,084.20 ","$1,715.87 ","$1,284.85 ",$686.56 ,"$2,206.80 ","$1,862.00 ",$782.12 ,"$1,593.80 " HSHS HOLY FAMILY HOSPITAL INC (ACU),76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$1,861.00 ","$1,339.92 ",$521.08 ,"$1,861.00 ","$1,209.65 ",$606.41 ,$521.08 ,"$1,029.13 ",$606.41 ,"$1,083.10 ",$606.41 ,$975.16 ,$606.41 ,"$1,249.95 ","$1,712.12 ","$1,546.96 ",$606.41 ,"$1,581.85 ","$1,674.90 ",$618.54 ,"$1,395.75 ","$1,302.70 ","$1,302.70 ",$606.41 ,"$1,302.70 ","$1,432.97 ","$1,432.97 ","$1,546.96 ","$1,581.85 ",$618.79 ,$618.79 ,"$1,044.02 ",$770.45 ,$774.18 ,$569.82 ,$563.65 ,$636.74 ,"$1,581.85 ","$1,330.39 ",$975.16 ,$521.08 ,"$1,674.90 ",$982.61 ,$606.41 ,"$1,209.65 " HSHS HOLY FAMILY HOSPITAL INC (ACU),76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$150.00 ,$108.00 ,$42.00 ,$150.00 ,$97.50 , N/A ,$42.00 ,$82.95 , N/A ,$87.30 , N/A ,$78.60 , N/A , N/A ,$138.00 , N/A , N/A ,$127.50 ,$135.00 , N/A ,$112.50 ,$105.00 ,$105.00 , N/A ,$105.00 ,$115.50 ,$115.50 , N/A ,$127.50 , N/A , N/A ,$84.15 ,$62.10 ,$62.40 , N/A , N/A , N/A ,$127.50 , N/A ,$78.60 ,$42.00 ,$135.00 ,$150.00 , N/A ,$97.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$67.00 ,$48.24 ,$18.76 ,$67.00 ,$43.55 , N/A ,$18.76 ,$37.05 , N/A ,$38.99 , N/A ,$35.11 , N/A , N/A ,$61.64 , N/A , N/A ,$56.95 ,$60.30 , N/A ,$50.25 ,$46.90 ,$46.90 , N/A ,$46.90 ,$51.59 ,$51.59 , N/A ,$56.95 , N/A , N/A ,$37.59 ,$27.74 ,$27.87 , N/A , N/A , N/A ,$56.95 , N/A ,$35.11 ,$18.76 ,$60.30 ,$67.00 , N/A ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),76200022,G0378,HC OBSERVATION W/TELEMETRY PER HR,762,1 ,$67.00 ,$48.24 ,$18.76 ,$67.00 ,$43.55 , N/A ,$18.76 ,$37.05 , N/A ,$38.99 , N/A ,$35.11 , N/A , N/A ,$61.64 , N/A , N/A ,$56.95 ,$60.30 , N/A ,$50.25 ,$46.90 ,$46.90 , N/A ,$46.90 ,$51.59 ,$51.59 , N/A ,$56.95 , N/A , N/A ,$37.59 ,$27.74 ,$27.87 , N/A , N/A , N/A ,$56.95 , N/A ,$35.11 ,$18.76 ,$60.30 ,$67.00 , N/A ,$43.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$100.00 ,$72.00 ,$28.00 ,$161.99 ,$65.00 ,$63.49 ,$28.00 ,$55.30 ,$63.49 ,$58.20 ,$63.49 ,$52.40 ,$63.49 ,$100.00 ,$92.00 ,$161.99 ,$63.49 ,$85.00 ,$90.00 ,$64.77 ,$75.00 ,$70.00 ,$70.00 ,$63.49 ,$70.00 ,$77.00 ,$77.00 ,$100.00 ,$85.00 ,$64.79 ,$64.79 ,$56.10 ,$41.40 ,$41.60 , N/A , N/A ,$66.67 ,$85.00 ,$139.31 ,$52.40 ,$28.00 ,$90.00 ,$80.00 ,$63.49 ,$65.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$27.00 ,$19.44 ,$7.56 ,$101.72 ,$17.55 ,$39.88 ,$7.56 ,$14.93 ,$39.88 ,$15.71 ,$26.46 ,$14.15 ,$26.46 ,$27.00 ,$24.84 ,$101.72 ,$39.88 ,$22.95 ,$24.30 ,$26.46 ,$20.25 ,$18.90 ,$18.90 ,$39.88 ,$18.90 ,$20.79 ,$20.79 ,$27.00 ,$22.95 ,$40.69 ,$40.69 ,$15.15 ,$11.18 ,$11.23 , N/A , N/A ,$41.87 ,$22.95 ,$87.48 ,$14.15 ,$7.56 ,$24.30 ,$27.00 ,$39.88 ,$17.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$115.00 ,$82.80 ,$32.20 ,$115.00 ,$74.75 ,$39.88 ,$32.20 ,$63.60 ,$39.88 ,$66.93 ,$39.88 ,$60.26 ,$39.88 ,$82.19 ,$105.80 ,$101.72 ,$39.88 ,$97.75 ,$103.50 ,$40.67 ,$86.25 ,$80.50 ,$80.50 ,$39.88 ,$80.50 ,$88.55 ,$88.55 ,$101.72 ,$97.75 ,$40.69 ,$40.69 ,$64.52 ,$47.61 ,$47.84 , N/A , N/A ,$41.87 ,$97.75 ,$87.48 ,$60.26 ,$32.20 ,$103.50 ,$80.00 ,$39.88 ,$74.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$49.00 ,$35.28 ,$13.72 ,$101.72 ,$31.85 ,$39.88 ,$13.72 ,$27.10 ,$39.88 ,$28.52 ,$39.88 ,$25.68 ,$39.88 ,$49.00 ,$45.08 ,$101.72 ,$39.88 ,$41.65 ,$44.10 ,$40.67 ,$36.75 ,$34.30 ,$34.30 ,$39.88 ,$34.30 ,$37.73 ,$37.73 ,$49.00 ,$41.65 ,$40.69 ,$40.69 ,$27.49 ,$20.29 ,$20.38 , N/A , N/A ,$41.87 ,$41.65 ,$87.48 ,$25.68 ,$13.72 ,$44.10 ,$49.00 ,$39.88 ,$31.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100020,0051A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, FIRST DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100021,0052A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, SECOND DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100022,0053A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, THIRD DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100023,0004A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, DILUENT RECONSTITUTED, BOOSTER DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100024,0054A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, BOOSTER DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100025,0064A,"HC ADMIN SARS-COV-2 VACCINE 50MCG/0.25ML, BOOSTER DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100026,0071A,"HC ADMIN SARS-COV-2 VACCINE 10MCG/0.2ML, TRIS-SUCROSE, FIRST DOSE (CHILD 5-11)",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100027,0072A,"HC ADMIN SARS-COV-2 VACCINE 10MCG/0.2ML, TRIS-SUCROSE, SECOND DOSE (CHILD 5-11)",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100028,0034A,"HC ADMIN SARS-COV-2 VACCINE JOHNSON AND JOHNSON, BOOSTER DOSE",771,1 ,$124.00 ,$89.28 ,$34.72 ,$124.00 ,$80.60 ,$39.07 ,$34.72 ,$68.57 ,$39.07 ,$72.17 ,$39.07 ,$64.98 ,$39.07 ,$80.54 ,$114.08 ,$99.68 ,$39.07 ,$105.40 ,$111.60 ,$39.86 ,$93.00 ,$86.80 ,$86.80 ,$39.07 ,$86.80 ,$95.48 ,$95.48 ,$99.68 ,$105.40 ,$39.87 ,$39.87 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$41.02 ,$105.40 ,$85.73 ,$64.98 ,$34.72 ,$111.60 ,$80.00 ,$39.07 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100031,M0222,HC INTRAVENOUS INJECTION BEBTELOVIMAB ADMINISTRATION,260,1 ,$124.00 ,$89.28 ,$34.72 ,$841.50 ,$80.60 ,$329.87 ,$34.72 ,$68.57 ,$329.87 ,$72.17 ,$121.52 ,$64.98 ,$121.52 ,$124.00 ,$114.08 ,$841.50 ,$329.87 ,$105.40 ,$111.60 ,$121.52 ,$93.00 ,$86.80 ,$86.80 ,$329.87 ,$86.80 ,$95.48 ,$95.48 ,$124.00 ,$105.40 ,$336.60 ,$336.60 ,$69.56 ,$51.34 ,$51.58 , N/A , N/A ,$346.36 ,$105.40 ,$723.69 ,$64.98 ,$34.72 ,$111.60 ,$65.47 ,$329.87 ,$80.60 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100036,0134A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT 50MCG/0.5ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$78.00 ,$39.07 ,$33.60 ,$66.36 ,$39.07 ,$69.84 ,$39.07 ,$62.88 ,$39.07 ,$80.54 ,$110.40 ,$99.68 ,$39.07 ,$102.00 ,$108.00 ,$39.86 ,$90.00 ,$84.00 ,$84.00 ,$39.07 ,$84.00 ,$92.40 ,$92.40 ,$99.68 ,$102.00 ,$39.87 ,$39.87 ,$67.32 ,$49.68 ,$49.92 , N/A , N/A ,$41.02 ,$102.00 ,$85.73 ,$62.88 ,$33.60 ,$108.00 ,$80.00 ,$39.07 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100037,0144A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT 25MCG/0.25ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$78.00 ,$39.07 ,$33.60 ,$66.36 ,$39.07 ,$69.84 ,$39.07 ,$62.88 ,$39.07 ,$80.54 ,$110.40 ,$99.68 ,$39.07 ,$102.00 ,$108.00 ,$39.86 ,$90.00 ,$84.00 ,$84.00 ,$39.07 ,$84.00 ,$92.40 ,$92.40 ,$99.68 ,$102.00 ,$39.87 ,$39.87 ,$67.32 ,$49.68 ,$49.92 , N/A , N/A ,$41.02 ,$102.00 ,$85.73 ,$62.88 ,$33.60 ,$108.00 ,$80.00 ,$39.07 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100038,0124A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT TRI-SUCROSE 30MCG/0.3ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$78.00 ,$39.07 ,$33.60 ,$66.36 ,$39.07 ,$69.84 ,$39.07 ,$62.88 ,$39.07 ,$80.54 ,$110.40 ,$99.68 ,$39.07 ,$102.00 ,$108.00 ,$39.86 ,$90.00 ,$84.00 ,$84.00 ,$39.07 ,$84.00 ,$92.40 ,$92.40 ,$99.68 ,$102.00 ,$39.87 ,$39.87 ,$67.32 ,$49.68 ,$49.92 , N/A , N/A ,$41.02 ,$102.00 ,$85.73 ,$62.88 ,$33.60 ,$108.00 ,$80.00 ,$39.07 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),77100039,0154A,HC ADMIN SARS-COV-2 VACCINE SPIKE PROTEIN BIVALENT TRI-SUCROSE 10MCG/0.2ML,771,1 ,$120.00 ,$86.40 ,$33.60 ,$120.00 ,$78.00 ,$39.07 ,$33.60 ,$66.36 ,$39.07 ,$69.84 ,$39.07 ,$62.88 ,$39.07 ,$80.54 ,$110.40 ,$99.68 ,$39.07 ,$102.00 ,$108.00 ,$39.86 ,$90.00 ,$84.00 ,$84.00 ,$39.07 ,$84.00 ,$92.40 ,$92.40 ,$99.68 ,$102.00 ,$39.87 ,$39.87 ,$67.32 ,$49.68 ,$49.92 , N/A , N/A ,$41.02 ,$102.00 ,$85.73 ,$62.88 ,$33.60 ,$108.00 ,$80.00 ,$39.07 ,$78.00 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$42.00 ,$30.24 ,$10.32 ,$71.60 ,$27.30 ,$28.07 ,$11.76 ,$23.23 ,$28.07 ,$24.44 ,$28.07 ,$22.01 ,$28.07 ,$42.00 ,$38.64 ,$71.60 ,$28.07 ,$35.70 ,$37.80 ,$28.63 ,$31.50 ,$29.40 ,$29.40 ,$28.07 ,$29.40 ,$32.34 ,$32.34 ,$42.00 ,$35.70 ,$28.64 ,$28.64 ,$23.56 ,$17.39 ,$17.47 ,$10.43 ,$10.32 ,$29.47 ,$35.70 ,$61.58 ,$22.01 ,$11.76 ,$37.80 ,$22.18 ,$28.07 ,$27.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000098,99221,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 1 LOW 40MIN - 95,960,1 ,$312.00 ,$224.64 ,$87.36 ,$312.00 ,$202.80 , N/A ,$87.36 ,$172.54 , N/A ,$181.58 , N/A ,$163.49 , N/A , N/A ,$287.04 , N/A , N/A ,$265.20 ,$280.80 , N/A ,$234.00 ,$218.40 ,$218.40 , N/A ,$218.40 ,$240.24 ,$240.24 , N/A ,$265.20 , N/A , N/A ,$175.03 ,$141.83 ,$141.83 , N/A , N/A , N/A ,$265.20 , N/A ,$163.49 ,$87.36 ,$280.80 , N/A , N/A ,$202.80 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000099,99222,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 2 MODERATE 55 MIN -95,960,1 ,$415.00 ,$298.80 ,$116.20 ,$415.00 ,$269.75 , N/A ,$116.20 ,$229.50 , N/A ,$241.53 , N/A ,$217.46 , N/A , N/A ,$381.80 , N/A , N/A ,$352.75 ,$373.50 , N/A ,$311.25 ,$290.50 ,$290.50 , N/A ,$290.50 ,$319.55 ,$319.55 , N/A ,$352.75 , N/A , N/A ,$232.82 ,$191.13 ,$191.13 , N/A , N/A , N/A ,$352.75 , N/A ,$217.46 ,$116.20 ,$373.50 , N/A , N/A ,$269.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000100,99223,PC TELEHEALTH INITIAL HOSP INP/OBS CARE LVL 3 HIGH 75 MIN -95,960,1 ,$605.00 ,$435.60 ,$169.40 ,$605.00 ,$393.25 , N/A ,$169.40 ,$334.57 , N/A ,$352.11 , N/A ,$317.02 , N/A , N/A ,$556.60 , N/A , N/A ,$514.25 ,$544.50 , N/A ,$453.75 ,$423.50 ,$423.50 , N/A ,$423.50 ,$465.85 ,$465.85 , N/A ,$514.25 , N/A , N/A ,$339.41 ,$280.08 ,$280.08 , N/A , N/A , N/A ,$514.25 , N/A ,$317.02 ,$169.40 ,$544.50 , N/A , N/A ,$393.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000104,99231,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 1 LOW 25 MIN - 95,960,1 ,$117.00 ,$84.24 ,$32.76 ,$117.00 ,$76.05 , N/A ,$32.76 ,$64.70 , N/A ,$68.09 , N/A ,$61.31 , N/A , N/A ,$107.64 , N/A , N/A ,$99.45 ,$105.30 , N/A ,$87.75 ,$81.90 ,$81.90 , N/A ,$81.90 ,$90.09 ,$90.09 , N/A ,$99.45 , N/A , N/A ,$65.64 ,$54.56 ,$54.56 , N/A , N/A , N/A ,$99.45 , N/A ,$61.31 ,$32.76 ,$105.30 , N/A , N/A ,$76.05 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000105,99232,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 2 MODERATE 35 MIN - 95,960,1 ,$216.00 ,$155.52 ,$60.48 ,$216.00 ,$140.40 , N/A ,$60.48 ,$119.45 , N/A ,$125.71 , N/A ,$113.18 , N/A , N/A ,$198.72 , N/A , N/A ,$183.60 ,$194.40 , N/A ,$162.00 ,$151.20 ,$151.20 , N/A ,$151.20 ,$166.32 ,$166.32 , N/A ,$183.60 , N/A , N/A ,$121.18 ,$99.97 ,$99.97 , N/A , N/A , N/A ,$183.60 , N/A ,$113.18 ,$60.48 ,$194.40 , N/A , N/A ,$140.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000106,99233,PC TELEHEALTH SUBSQ HOSP INP/OBS CARE LVL 3 HIGH 50 MIN - 95,960,1 ,$315.00 ,$226.80 ,$88.20 ,$315.00 ,$204.75 , N/A ,$88.20 ,$174.20 , N/A ,$183.33 , N/A ,$165.06 , N/A , N/A ,$289.80 , N/A , N/A ,$267.75 ,$283.50 , N/A ,$236.25 ,$220.50 ,$220.50 , N/A ,$220.50 ,$242.55 ,$242.55 , N/A ,$267.75 , N/A , N/A ,$176.72 ,$144.07 ,$144.07 , N/A , N/A , N/A ,$267.75 , N/A ,$165.06 ,$88.20 ,$283.50 , N/A , N/A ,$204.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000107,99234,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE LOW 45 MIN- 95,960,1 ,$323.00 ,$232.56 ,$90.44 ,$323.00 ,$209.95 , N/A ,$90.44 ,$178.62 , N/A ,$187.99 , N/A ,$169.25 , N/A , N/A ,$297.16 , N/A , N/A ,$274.55 ,$290.70 , N/A ,$242.25 ,$226.10 ,$226.10 , N/A ,$226.10 ,$248.71 ,$248.71 , N/A ,$274.55 , N/A , N/A ,$181.20 ,$185.32 ,$185.32 ,$100.44 ,$99.35 , N/A ,$274.55 , N/A ,$169.25 ,$90.44 ,$290.70 , N/A , N/A ,$209.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000108,99235,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE MODERATE 70 MIN-95,960,1 ,$505.00 ,$363.60 ,$99.35 ,$505.00 ,$328.25 , N/A ,$141.40 ,$279.27 , N/A ,$293.91 , N/A ,$264.62 , N/A , N/A ,$464.60 , N/A , N/A ,$429.25 ,$454.50 , N/A ,$378.75 ,$353.50 ,$353.50 , N/A ,$353.50 ,$388.85 ,$388.85 , N/A ,$429.25 , N/A , N/A ,$283.31 ,$233.98 ,$233.98 ,$100.44 ,$99.35 , N/A ,$429.25 , N/A ,$264.62 ,$141.40 ,$454.50 , N/A , N/A ,$328.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000109,99236,PC TELEHEALTH HOSP INP/OBS CARE SAME DATE HIGH 85 MIN-95,960,1 ,$565.00 ,$406.80 ,$99.35 ,$565.00 ,$367.25 , N/A ,$158.20 ,$312.45 , N/A ,$328.83 , N/A ,$296.06 , N/A , N/A ,$519.80 , N/A , N/A ,$480.25 ,$508.50 , N/A ,$423.75 ,$395.50 ,$395.50 , N/A ,$395.50 ,$435.05 ,$435.05 , N/A ,$480.25 , N/A , N/A ,$316.97 ,$301.36 ,$301.36 ,$100.44 ,$99.35 , N/A ,$480.25 , N/A ,$296.06 ,$158.20 ,$508.50 , N/A , N/A ,$367.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000110,99238,PC TELEHEALTH HOSP INP/OBS DISCHARGE DAY <31MIN- 95,960,1 ,$218.00 ,$156.96 ,$61.04 ,$218.00 ,$141.70 , N/A ,$61.04 ,$120.55 , N/A ,$126.88 , N/A ,$114.23 , N/A , N/A ,$200.56 , N/A , N/A ,$185.30 ,$196.20 , N/A ,$163.50 ,$152.60 ,$152.60 , N/A ,$152.60 ,$167.86 ,$167.86 , N/A ,$185.30 , N/A , N/A ,$122.30 ,$100.42 ,$100.42 , N/A , N/A , N/A ,$185.30 , N/A ,$114.23 ,$61.04 ,$196.20 , N/A , N/A ,$141.70 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000111,99239,PC TELEHEALTH HOSP INP/OBS DISCHARGE DAY >30MIN- 95,960,1 ,$265.00 ,$190.80 ,$74.20 ,$265.00 ,$172.25 , N/A ,$74.20 ,$146.55 , N/A ,$154.23 , N/A ,$138.86 , N/A , N/A ,$243.80 , N/A , N/A ,$225.25 ,$238.50 , N/A ,$198.75 ,$185.50 ,$185.50 , N/A ,$185.50 ,$204.05 ,$204.05 , N/A ,$225.25 , N/A , N/A ,$148.67 ,$147.15 ,$147.15 , N/A , N/A , N/A ,$225.25 , N/A ,$138.86 ,$74.20 ,$238.50 , N/A , N/A ,$172.25 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000176,G0425,PC TELEHEALTH ED/IP CONSULT 30 MIN - 95,960,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 ,$227.50 , N/A ,$98.00 ,$193.55 , N/A ,$203.70 , N/A ,$183.40 , N/A , N/A ,$322.00 , N/A , N/A ,$297.50 ,$315.00 , N/A ,$262.50 ,$245.00 ,$245.00 , N/A ,$245.00 ,$269.50 ,$269.50 , N/A ,$297.50 , N/A , N/A ,$196.35 ,$198.87 ,$198.87 ,$100.44 ,$99.35 , N/A ,$297.50 , N/A ,$183.40 ,$98.00 ,$315.00 , N/A , N/A ,$227.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000177,G0426,PC TELEHEALTH ED/IP CONSULT 50 MIN - 95,960,1 ,$450.00 ,$324.00 ,$99.35 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$269.77 ,$269.77 ,$100.44 ,$99.35 , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000178,G0427,PC TELEHEALTH ED/IP CONSULT 70 MIN - 95,960,1 ,$550.00 ,$396.00 ,$99.35 ,$550.00 ,$357.50 , N/A ,$154.00 ,$304.15 , N/A ,$320.10 , N/A ,$288.20 , N/A , N/A ,$506.00 , N/A , N/A ,$467.50 ,$495.00 , N/A ,$412.50 ,$385.00 ,$385.00 , N/A ,$385.00 ,$423.50 ,$423.50 , N/A ,$467.50 , N/A , N/A ,$308.55 ,$400.27 ,$400.27 ,$100.44 ,$99.35 , N/A ,$467.50 , N/A ,$288.20 ,$154.00 ,$495.00 , N/A , N/A ,$357.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000191,G0508,PC TELEHEALTH CRITICAL CARE CONSULT 60 MIN - 95,960,1 ,$650.00 ,$468.00 ,$99.35 ,$650.00 ,$422.50 , N/A ,$182.00 ,$359.45 , N/A ,$378.30 , N/A ,$340.60 , N/A , N/A ,$598.00 , N/A , N/A ,$552.50 ,$585.00 , N/A ,$487.50 ,$455.00 ,$455.00 , N/A ,$455.00 ,$500.50 ,$500.50 , N/A ,$552.50 , N/A , N/A ,$364.65 ,$419.54 ,$419.54 ,$100.44 ,$99.35 , N/A ,$552.50 , N/A ,$340.60 ,$182.00 ,$585.00 , N/A , N/A ,$422.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000192,G0509,PC TELEHEALTH CRITICAL CARE CONSULT 50 MIN - 95,960,1 ,$650.00 ,$468.00 ,$99.35 ,$650.00 ,$422.50 , N/A ,$182.00 ,$359.45 , N/A ,$378.30 , N/A ,$340.60 , N/A , N/A ,$598.00 , N/A , N/A ,$552.50 ,$585.00 , N/A ,$487.50 ,$455.00 ,$455.00 , N/A ,$455.00 ,$500.50 ,$500.50 , N/A ,$552.50 , N/A , N/A ,$364.65 ,$388.37 ,$388.37 ,$100.44 ,$99.35 , N/A ,$552.50 , N/A ,$340.60 ,$182.00 ,$585.00 , N/A , N/A ,$422.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000224,G0425,PC TELEHEALTH STROKE ED/IP CONSULT 30 MIN - G0,960,1 ,$350.00 ,$252.00 ,$98.00 ,$350.00 ,$227.50 , N/A ,$98.00 ,$193.55 , N/A ,$203.70 , N/A ,$183.40 , N/A , N/A ,$322.00 , N/A , N/A ,$297.50 ,$315.00 , N/A ,$262.50 ,$245.00 ,$245.00 , N/A ,$245.00 ,$269.50 ,$269.50 , N/A ,$297.50 , N/A , N/A ,$196.35 ,$198.87 ,$198.87 ,$100.44 ,$99.35 , N/A ,$297.50 , N/A ,$183.40 ,$98.00 ,$315.00 , N/A , N/A ,$227.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000225,G0426,PC TELEHEALTH STROKE ED/IP CONSULT 50 MIN - G0,960,1 ,$450.00 ,$324.00 ,$99.35 ,$450.00 ,$292.50 , N/A ,$126.00 ,$248.85 , N/A ,$261.90 , N/A ,$235.80 , N/A , N/A ,$414.00 , N/A , N/A ,$382.50 ,$405.00 , N/A ,$337.50 ,$315.00 ,$315.00 , N/A ,$315.00 ,$346.50 ,$346.50 , N/A ,$382.50 , N/A , N/A ,$252.45 ,$269.77 ,$269.77 ,$100.44 ,$99.35 , N/A ,$382.50 , N/A ,$235.80 ,$126.00 ,$405.00 , N/A , N/A ,$292.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000226,G0427,PC TELEHEALTH STROKE ED/IP CONSULT 70 MIN - G0,960,1 ,$550.00 ,$396.00 ,$99.35 ,$550.00 ,$357.50 , N/A ,$154.00 ,$304.15 , N/A ,$320.10 , N/A ,$288.20 , N/A , N/A ,$506.00 , N/A , N/A ,$467.50 ,$495.00 , N/A ,$412.50 ,$385.00 ,$385.00 , N/A ,$385.00 ,$423.50 ,$423.50 , N/A ,$467.50 , N/A , N/A ,$308.55 ,$400.27 ,$400.27 ,$100.44 ,$99.35 , N/A ,$467.50 , N/A ,$288.20 ,$154.00 ,$495.00 , N/A , N/A ,$357.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000227,G0508,PC TELEHEALTH STROKE CRITICAL CARE CONSULT 60 MIN - G0,960,1 ,$650.00 ,$468.00 ,$99.35 ,$650.00 ,$422.50 , N/A ,$182.00 ,$359.45 , N/A ,$378.30 , N/A ,$340.60 , N/A , N/A ,$598.00 , N/A , N/A ,$552.50 ,$585.00 , N/A ,$487.50 ,$455.00 ,$455.00 , N/A ,$455.00 ,$500.50 ,$500.50 , N/A ,$552.50 , N/A , N/A ,$364.65 ,$419.54 ,$419.54 ,$100.44 ,$99.35 , N/A ,$552.50 , N/A ,$340.60 ,$182.00 ,$585.00 , N/A , N/A ,$422.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),78000228,G0509,PC TELEHEALTH STROKE CRITICAL CARE CONSULT 50 MIN -G0,960,1 ,$650.00 ,$468.00 ,$99.35 ,$650.00 ,$422.50 , N/A ,$182.00 ,$359.45 , N/A ,$378.30 , N/A ,$340.60 , N/A , N/A ,$598.00 , N/A , N/A ,$552.50 ,$585.00 , N/A ,$487.50 ,$455.00 ,$455.00 , N/A ,$455.00 ,$500.50 ,$500.50 , N/A ,$552.50 , N/A , N/A ,$364.65 ,$388.37 ,$388.37 ,$100.44 ,$99.35 , N/A ,$552.50 , N/A ,$340.60 ,$182.00 ,$585.00 , N/A , N/A ,$422.50 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,026.00 ",$738.72 ,$107.49 ,"$1,026.00 ",$666.90 ,$219.77 ,$287.28 ,$567.38 ,$219.77 ,$597.13 ,$219.77 ,$537.62 ,$219.77 ,$453.00 ,$943.92 ,$560.65 ,$219.77 ,$872.10 ,$923.40 ,$224.17 ,$769.50 ,$718.20 ,$718.20 ,$219.77 ,$718.20 ,$790.02 ,$790.02 ,$560.65 ,$872.10 ,$224.26 ,$224.26 ,$575.59 ,$424.76 ,$426.82 ,$108.67 ,$107.49 ,$230.76 ,$872.10 ,$482.16 ,$537.62 ,$287.28 ,$923.40 ,$541.73 ,$219.77 ,$666.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$168.43 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$591.00 ,$425.52 ,$100.22 ,$591.00 ,$384.15 ,$109.28 ,$165.48 ,$326.82 ,$109.28 ,$343.96 ,$109.28 ,$309.68 ,$109.28 ,$225.24 ,$543.72 ,$278.76 ,$109.28 ,$502.35 ,$531.90 ,$111.47 ,$443.25 ,$413.70 ,$413.70 ,$109.28 ,$413.70 ,$455.07 ,$455.07 ,$278.76 ,$502.35 ,$111.51 ,$111.51 ,$331.55 ,$244.67 ,$245.86 ,$101.33 ,$100.22 ,$114.75 ,$502.35 ,$239.74 ,$309.68 ,$165.48 ,$531.90 ,$312.05 ,$109.28 ,$384.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100023,93923,HC TCPO2/ABI/PPG MULT LEVELS,921,1 ,"$1,226.00 ",$882.72 ,$100.22 ,"$1,226.00 ",$796.90 ,$136.87 ,$343.28 ,$677.98 ,$136.87 ,$713.53 ,$136.87 ,$642.42 ,$136.87 ,$282.12 ,"$1,127.92 ",$349.16 ,$136.87 ,"$1,042.10 ","$1,103.40 ",$139.61 ,$919.50 ,$858.20 ,$858.20 ,$136.87 ,$858.20 ,$944.02 ,$944.02 ,$349.16 ,"$1,042.10 ",$139.66 ,$139.66 ,$687.79 ,$507.56 ,$510.02 ,$101.33 ,$100.22 ,$143.71 ,"$1,042.10 ",$300.27 ,$642.42 ,$343.28 ,"$1,103.40 ",$647.33 ,$136.87 ,$796.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,"$1,226.00 ",$882.72 ,$100.22 ,"$1,226.00 ",$796.90 ,$136.87 ,$343.28 ,$677.98 ,$136.87 ,$713.53 ,$136.87 ,$642.42 ,$136.87 ,$282.12 ,"$1,127.92 ",$349.16 ,$136.87 ,"$1,042.10 ","$1,103.40 ",$139.61 ,$919.50 ,$858.20 ,$858.20 ,$136.87 ,$858.20 ,$944.02 ,$944.02 ,$349.16 ,"$1,042.10 ",$139.66 ,$139.66 ,$687.79 ,$507.56 ,$510.02 ,$101.33 ,$100.22 ,$143.71 ,"$1,042.10 ",$300.27 ,$642.42 ,$343.28 ,"$1,103.40 ",$647.33 ,$136.87 ,$796.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100031,93923,HC RESTING ARTERIAL UPPER BILATERAL,921,1 ,"$1,226.00 ",$882.72 ,$100.22 ,"$1,226.00 ",$796.90 ,$136.87 ,$343.28 ,$677.98 ,$136.87 ,$713.53 ,$136.87 ,$642.42 ,$136.87 ,$282.12 ,"$1,127.92 ",$349.16 ,$136.87 ,"$1,042.10 ","$1,103.40 ",$139.61 ,$919.50 ,$858.20 ,$858.20 ,$136.87 ,$858.20 ,$944.02 ,$944.02 ,$349.16 ,"$1,042.10 ",$139.66 ,$139.66 ,$687.79 ,$507.56 ,$510.02 ,$101.33 ,$100.22 ,$143.71 ,"$1,042.10 ",$300.27 ,$642.42 ,$343.28 ,"$1,103.40 ",$647.33 ,$136.87 ,$796.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,$776.00 ,$558.72 ,$100.22 ,$776.00 ,$504.40 ,$263.57 ,$217.28 ,$429.13 ,$263.57 ,$451.63 ,$263.57 ,$406.62 ,$263.57 ,$543.28 ,$713.92 ,$672.38 ,$263.57 ,$659.60 ,$698.40 ,$268.84 ,$582.00 ,$543.20 ,$543.20 ,$263.57 ,$543.20 ,$597.52 ,$597.52 ,$672.38 ,$659.60 ,$268.95 ,$268.95 ,$435.34 ,$321.26 ,$322.82 ,$101.33 ,$100.22 ,$276.75 ,$659.60 ,$578.25 ,$406.62 ,$217.28 ,$698.40 ,$409.73 ,$263.57 ,$504.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,603.00 ","$1,154.16 ",$141.48 ,"$1,603.00 ","$1,041.95 ",$219.77 ,$448.84 ,$886.46 ,$219.77 ,$932.95 ,$219.77 ,$839.97 ,$219.77 ,$453.00 ,"$1,474.76 ",$560.65 ,$219.77 ,"$1,362.55 ","$1,442.70 ",$224.17 ,"$1,202.25 ","$1,122.10 ","$1,122.10 ",$219.77 ,"$1,122.10 ","$1,234.31 ","$1,234.31 ",$560.65 ,"$1,362.55 ",$224.26 ,$224.26 ,$899.28 ,$663.64 ,$666.85 ,$143.02 ,$141.48 ,$230.76 ,"$1,362.55 ",$482.16 ,$839.97 ,$448.84 ,"$1,442.70 ",$846.38 ,$219.77 ,"$1,041.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$143.02 ,$141.48 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$168.43 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,456.00 ","$1,048.32 ",$107.49 ,"$1,456.00 ",$946.40 ,$219.77 ,$407.68 ,$805.17 ,$219.77 ,$847.39 ,$219.77 ,$762.94 ,$219.77 ,$453.00 ,"$1,339.52 ",$560.65 ,$219.77 ,"$1,237.60 ","$1,310.40 ",$224.17 ,"$1,092.00 ","$1,019.20 ","$1,019.20 ",$219.77 ,"$1,019.20 ","$1,121.12 ","$1,121.12 ",$560.65 ,"$1,237.60 ",$224.26 ,$224.26 ,$816.82 ,$602.78 ,$605.70 ,$108.67 ,$107.49 ,$230.76 ,"$1,237.60 ",$482.16 ,$762.94 ,$407.68 ,"$1,310.40 ",$768.77 ,$219.77 ,$946.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$168.43 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100039,93931,HC DUPLEX ARTRL UPR EXT PSEUD ONLY,921,1 ,$319.00 ,$229.68 ,$89.32 ,$319.00 ,$207.35 ,$100.59 ,$89.32 ,$176.41 ,$100.59 ,$185.66 ,$100.59 ,$167.16 ,$100.59 ,$207.34 ,$293.48 ,$256.60 ,$100.59 ,$271.15 ,$287.10 ,$102.60 ,$239.25 ,$223.30 ,$223.30 ,$100.59 ,$223.30 ,$245.63 ,$245.63 ,$256.60 ,$271.15 ,$102.64 ,$102.64 ,$178.96 ,$132.07 ,$132.70 ,$108.67 ,$107.49 ,$105.61 ,$271.15 ,$220.68 ,$167.16 ,$89.32 ,$287.10 ,$168.43 ,$100.59 ,$207.35 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,603.00 ","$1,154.16 ",$141.48 ,"$1,603.00 ","$1,041.95 ",$219.77 ,$448.84 ,$886.46 ,$219.77 ,$932.95 ,$219.77 ,$839.97 ,$219.77 ,$453.00 ,"$1,474.76 ",$560.65 ,$219.77 ,"$1,362.55 ","$1,442.70 ",$224.17 ,"$1,202.25 ","$1,122.10 ","$1,122.10 ",$219.77 ,"$1,122.10 ","$1,234.31 ","$1,234.31 ",$560.65 ,"$1,362.55 ",$224.26 ,$224.26 ,$899.28 ,$663.64 ,$666.85 ,$143.02 ,$141.48 ,$230.76 ,"$1,362.55 ",$482.16 ,$839.97 ,$448.84 ,"$1,442.70 ",$846.38 ,$219.77 ,"$1,041.95 " HSHS HOLY FAMILY HOSPITAL INC (ACU),92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,"$1,155.00 ",$831.60 ,$100.59 ,"$1,155.00 ",$750.75 ,$100.59 ,$323.40 ,$638.72 ,$100.59 ,$672.21 ,$100.59 ,$605.22 ,$100.59 ,$207.34 ,"$1,062.60 ",$256.60 ,$100.59 ,$981.75 ,"$1,039.50 ",$102.60 ,$866.25 ,$808.50 ,$808.50 ,$100.59 ,$808.50 ,$889.35 ,$889.35 ,$256.60 ,$981.75 ,$102.64 ,$102.64 ,$647.96 ,$478.17 ,$480.48 ,$143.02 ,$141.48 ,$105.61 ,$981.75 ,$220.68 ,$605.22 ,$323.40 ,"$1,039.50 ",$609.84 ,$100.59 ,$750.75 HSHS HOLY FAMILY HOSPITAL INC (ACU),92100049,93923,HC RESTING ARTERIAL EXTREMITY COMP -52,921,1 ,"$1,263.00 ",$909.36 ,$50.12 ,"$1,263.00 ",$820.95 ,$68.43 ,$353.64 ,$698.44 ,$68.43 ,$735.07 ,$68.43 ,$661.81 ,$68.43 ,$141.06 ,"$1,161.96 ",$174.58 ,$68.43 ,"$1,073.55 ","$1,136.70 ",$69.81 ,$947.25 ,$884.10 ,$884.10 ,$68.43 ,$884.10 ,$972.51 ,$972.51 ,$174.58 ,"$1,073.55 ",$69.83 ,$69.83 ,$708.54 ,$522.88 ,$525.41 ,$50.66 ,$50.12 ,$71.85 ,"$1,073.55 ",$150.14 ,$661.81 ,$353.64 ,"$1,136.70 ",$666.86 ,$68.43 ,$820.95 HSHS HOLY FAMILY HOSPITAL INC (ACU),94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$267.00 ,$192.24 ,$62.60 ,$278.76 ,$173.55 ,$109.28 ,$74.76 ,$147.65 ,$109.28 ,$155.39 ,$109.28 ,$139.91 ,$109.28 ,$225.24 ,$245.64 ,$278.76 ,$109.28 ,$226.95 ,$240.30 ,$111.47 ,$200.25 ,$186.90 ,$186.90 ,$109.28 ,$186.90 ,$205.59 ,$205.59 ,$267.00 ,$226.95 ,$111.51 ,$111.51 ,$149.79 ,$110.54 ,$111.07 ,$63.28 ,$62.60 ,$114.75 ,$226.95 ,$239.74 ,$139.91 ,$74.76 ,$240.30 ,$140.98 ,$109.28 ,$173.55 HSHS HOLY FAMILY HOSPITAL INC (ACU),94000104,96372,HC INJECTION IM/SUBQ,940,1 ,$136.00 ,$97.92 ,$38.08 ,$161.99 ,$88.40 ,$63.49 ,$38.08 ,$75.21 ,$63.49 ,$79.15 ,$63.49 ,$71.26 ,$63.49 ,$130.88 , N/A ,$161.99 ,$63.49 ,$115.60 ,$122.40 ,$64.77 ,$102.00 ,$95.20 ,$95.20 ,$63.49 ,$95.20 ,$104.72 ,$104.72 ,$136.00 ,$115.60 ,$64.79 ,$64.79 ,$76.30 ,$56.30 ,$56.58 , N/A , N/A ,$66.67 ,$115.60 ,$139.31 ,$71.26 ,$38.08 ,$122.40 ,$71.81 ,$63.49 ,$88.40 HSHS HOLY FAMILY HOSPITAL INC (ACU),94000105,96374,HC INJ IV PUSH SINGL/INITIAL,940,1 ,$294.00 ,$211.68 ,$82.32 ,$495.94 ,$191.10 ,$194.41 ,$82.32 ,$162.58 ,$194.41 ,$171.11 ,$194.41 ,$154.06 ,$194.41 ,$294.00 , N/A ,$495.94 ,$194.41 ,$249.90 ,$264.60 ,$198.29 ,$220.50 ,$205.80 ,$205.80 ,$194.41 ,$205.80 ,$226.38 ,$226.38 ,$294.00 ,$249.90 ,$198.38 ,$198.38 ,$164.93 ,$121.72 ,$122.30 , N/A , N/A ,$204.13 ,$249.90 ,$426.51 ,$154.06 ,$82.32 ,$264.60 ,$155.23 ,$194.41 ,$191.10 HSHS HOLY FAMILY HOSPITAL INC (ACU),94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$48.00 ,$34.56 ,$13.44 ,$89.70 ,$31.20 ,$29.89 ,$13.44 ,$26.54 ,$29.89 ,$27.94 ,$29.89 ,$25.15 ,$29.89 ,$48.00 ,$44.16 ,$89.70 ,$29.89 ,$40.80 ,$43.20 ,$35.87 ,$36.00 ,$33.60 ,$33.60 ,$29.89 ,$33.60 ,$36.96 ,$36.96 ,$30.50 ,$40.80 ,$30.50 ,$30.50 ,$26.93 ,$19.87 ,$19.97 , N/A , N/A ,$31.39 ,$40.80 ,$77.14 ,$25.15 ,$13.44 ,$43.20 ,$48.00 ,$29.89 ,$31.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),94200006,97803,HC NUTRITION THRPY RE-EVAL 15 MIN,942,1 ,$48.00 ,$34.56 ,$13.44 ,$78.20 ,$31.20 ,$26.06 ,$13.44 ,$26.54 ,$26.06 ,$27.94 ,$26.06 ,$25.15 ,$26.06 ,$48.00 ,$44.16 ,$78.20 ,$26.06 ,$40.80 ,$43.20 ,$31.27 ,$36.00 ,$33.60 ,$33.60 ,$26.06 ,$33.60 ,$36.96 ,$36.96 ,$26.59 ,$40.80 ,$26.59 ,$26.59 ,$26.93 ,$19.87 ,$19.97 , N/A , N/A ,$27.36 ,$40.80 ,$67.25 ,$25.15 ,$13.44 ,$43.20 ,$48.00 ,$26.06 ,$31.20 HSHS HOLY FAMILY HOSPITAL INC (ACU),94200011,G0108,HC DIABETES SELF MGT ED 30 MIN,942,1 ,$42.00 ,$30.24 ,$11.76 ,$135.65 ,$27.30 ,$53.17 ,$11.76 ,$23.23 ,$53.17 ,$24.44 ,$41.16 ,$22.01 ,$41.16 ,$42.00 ,$38.64 ,$135.65 ,$53.17 ,$35.70 ,$37.80 ,$41.16 ,$31.50 ,$29.40 ,$29.40 ,$53.17 ,$29.40 ,$32.34 ,$32.34 ,$42.00 ,$35.70 ,$54.26 ,$54.26 ,$23.56 ,$17.39 ,$17.47 , N/A , N/A ,$55.83 ,$35.70 ,$116.66 ,$22.01 ,$11.76 ,$37.80 ,$42.00 ,$53.17 ,$27.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),94200013,G0109,HC DIABETES SELF MGT GROUP 30MIN,942,1 ,$42.00 ,$30.24 ,$11.76 ,$42.00 ,$27.30 ,$15.05 ,$11.76 ,$23.23 ,$15.05 ,$24.44 ,$15.05 ,$22.01 ,$15.05 ,$31.03 ,$38.64 ,$38.40 ,$15.05 ,$35.70 ,$37.80 ,$15.36 ,$31.50 ,$29.40 ,$29.40 ,$15.05 ,$29.40 ,$32.34 ,$32.34 ,$38.40 ,$35.70 ,$15.36 ,$15.36 ,$23.56 ,$17.39 ,$17.47 , N/A , N/A ,$15.81 ,$35.70 ,$33.02 ,$22.01 ,$11.76 ,$37.80 ,$42.00 ,$15.05 ,$27.30 HSHS HOLY FAMILY HOSPITAL INC (ACU),94300004,93797,HC CARDIAC REHAB W/O EKG SESSION,943,1 ,$231.00 ,$166.32 ,$64.68 ,$288.27 ,$150.15 ,$113.00 ,$64.68 ,$127.74 ,$113.00 ,$134.44 ,$113.00 ,$121.04 ,$113.00 ,$231.00 ,$212.52 ,$288.27 ,$113.00 ,$196.35 ,$207.90 ,$115.26 ,$173.25 ,$161.70 ,$161.70 ,$113.00 ,$161.70 ,$177.87 ,$177.87 ,$231.00 ,$196.35 ,$115.31 ,$115.31 ,$129.59 ,$95.63 ,$96.10 , N/A , N/A ,$118.66 ,$196.35 ,$247.91 ,$121.04 ,$64.68 ,$207.90 ,$170.00 ,$113.00 ,$150.15 HSHS HOLY FAMILY HOSPITAL INC (ACU),94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$233.00 ,$167.76 ,$65.24 ,$288.27 ,$151.45 ,$113.00 ,$65.24 ,$128.85 ,$113.00 ,$135.61 ,$113.00 ,$122.09 ,$113.00 ,$232.92 ,$214.36 ,$288.27 ,$113.00 ,$198.05 ,$209.70 ,$115.26 ,$174.75 ,$163.10 ,$163.10 ,$113.00 ,$163.10 ,$179.41 ,$179.41 ,$233.00 ,$198.05 ,$115.31 ,$115.31 ,$130.71 ,$96.46 ,$96.93 , N/A , N/A ,$118.66 ,$198.05 ,$247.91 ,$122.09 ,$65.24 ,$209.70 ,$170.00 ,$113.00 ,$151.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$26.00 ,$18.72 ,$7.28 ,$26.00 ,$16.90 , N/A ,$7.28 ,$14.38 , N/A ,$15.13 , N/A ,$13.62 , N/A , N/A ,$23.92 , N/A , N/A ,$22.10 ,$23.40 , N/A ,$19.50 ,$18.20 ,$18.20 , N/A ,$18.20 ,$20.02 ,$20.02 , N/A ,$22.10 , N/A , N/A ,$14.59 ,$10.76 ,$10.82 , N/A , N/A , N/A ,$22.10 , N/A ,$13.62 ,$7.28 ,$23.40 ,$26.00 , N/A ,$16.90 HSHS HOLY FAMILY HOSPITAL INC (ACU),98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$53.00 ,$38.16 ,$14.84 ,$53.00 ,$34.45 , N/A ,$14.84 ,$29.31 , N/A ,$30.85 , N/A ,$27.77 , N/A , N/A ,$48.76 , N/A , N/A ,$45.05 ,$47.70 , N/A ,$39.75 ,$37.10 ,$37.10 , N/A ,$37.10 ,$40.81 ,$40.81 , N/A ,$45.05 , N/A , N/A ,$29.73 ,$16.94 ,$16.94 ,$18.39 ,$18.20 , N/A ,$45.05 , N/A ,$27.77 ,$14.84 ,$47.70 , N/A , N/A ,$34.45 HSHS HOLY FAMILY HOSPITAL INC (ACU),98500002,93016,PC CARDIAC STRESS TEST SUPERVISION,985,1 ,$109.00 ,$78.48 ,$30.52 ,$109.00 ,$70.85 , N/A ,$30.52 ,$60.28 , N/A ,$63.44 , N/A ,$57.12 , N/A , N/A ,$100.28 , N/A , N/A ,$92.65 ,$98.10 , N/A ,$81.75 ,$76.30 ,$76.30 , N/A ,$76.30 ,$83.93 ,$83.93 , N/A ,$92.65 , N/A , N/A ,$61.15 ,$44.37 ,$44.37 ,$105.19 ,$109.00 , N/A ,$92.65 , N/A ,$57.12 ,$30.52 ,$98.10 , N/A , N/A ,$70.85 HSHS HOLY FAMILY HOSPITAL INC (ACU),98500003,93018,PC CARDIOVASCULAR STRESS TEST,985,1 ,$81.00 ,$58.32 ,$22.68 ,$81.00 ,$52.65 , N/A ,$22.68 ,$44.79 , N/A ,$47.14 , N/A ,$42.44 , N/A , N/A ,$74.52 , N/A , N/A ,$68.85 ,$72.90 , N/A ,$60.75 ,$56.70 ,$56.70 , N/A ,$56.70 ,$62.37 ,$62.37 , N/A ,$68.85 , N/A , N/A ,$45.44 ,$29.52 ,$29.52 ,$78.17 ,$81.00 , N/A ,$68.85 , N/A ,$42.44 ,$22.68 ,$72.90 , N/A , N/A ,$52.65