CSR CHARGEABLE SUPPLIES
SERVICE CHARGE CODE	SERVICE DESCRIPTION	SERVICE CHARGE PRICE
1700005	CATHETER THERMOD VIP	695.03
1700006	CATHETER SWAN-GANZ 6FR	278.71
1700007	CATHETER BALLOON VERI PACE	693.83
1700009	LEAD INTRO SUBCLAVIAN 8FR	103.72
1700010	LEAD INTRO SUBCLAVIAN 10FR	490.41
1700011	LEAD INTRO SUBCLAVIAN 9FR	1,001.27
1700012	LEAD INTRO SUBCLAVIAN 11FR	490.41
1700013	LEAD INTRO SUBCLAVIAN 12FR	490.41
1700014	CATHETER DOUBLE LUMEN 4FR	349.28
1700015	MASK FACE SAFETY SHIELD	6.79
1700016	CATHETER DOUBLE LUMEN 5FR	349.28
1700017	CATHETER DOUBLE LUMEN 8FR	349.28
1700018	CUP GRADUATED 1000CC 32OZ	11.86
1700019	ISOLATION CART	9.65
1700024	KIT-MON-1295KM SINGLE LINE	213.16
1700025	KIT-MON-1295KH DOUBLE LINE	236.46
1700026	KIT CATHETER INTRODUCER	301.02
1700027	ABDOMINAL BINDER	3.86
1700028	CATHETER DUAL LUMEN 11FR	817.66
1700030	PAD DEFIBRILLATOR	27.59
1700032	ARMBOARD W/ COVER 9" DISP	3.10
1700033	ARMBOARD W/ COVER 18"	4.39
1700036	BRUSH SCRUB SURG W/LODOPH	4.00
1700037	SYRINGE CANNISTER 2GAL	16.96
1700039	HEMOVAC 400ML D.D. 1/4" 19F	197.56
1700041	SYRINGE ECCENTRIC TIP 60CC	3.38
1700042	SYRINGE INSULIN 1CC M/FINE	1.02
1700043	AIR MATTRESS MACH/D	10.63
1700047	TUBE NASOGAST W/ SENT 18FR	15.15
1700059	BODY RESTRAINT	64.71
1700067	NEEDLE SPINAL 18GAX3-1/2"	11.32
1700069	NEEDLE SPINAL 20GAX3-1/2"	7.19
1700070	NEEDLE SPINAL 22GAX3-1/2"	8.09
1700071	NEEDLE MULTI-SAM 21GAX1"	0.79
1700077	CRUTCH TIP WIDE BASE	11.87
1700079	BAG BODY CADAVER-PEDS	56.53
1700080	COLLECTOR MIDSTREAM URINE	8.80
1700083	NEEDLE BONE MARROW 18GA	117.13
1700085	ARTERIAL LINE ARROW	43.86
1700086	CATHETER 3-LUMEN ARROW	673.31
1700088	TUBING PENROSE 1"X18"	4.05
1700089	TUBING PENROSE 5/8"X18"	5.90
1700090	TUBING PENROSE 1/4"X18"	3.71
1700091	TUBING PENROSE 1/2"X18"	2.41
1700092	SYRINGE ASCEPTO DISP	23.12
1700093	TUBING PENROSE 7/8"X18"	4.07
1700094	TUBING PENROSE 5/16"X18"	4.07
1700095	TUBING PENROSE 3/8"X18"	8.36
1700096	SET ADMIN VENTED PRIM 60DR	22.65
1700097	SYRINGE IRRIG C/TIP 50CC	3.19
1700098	MOTOR PUMP ALTERNATOR	454.28
1700100	BAG BILE	14.41
1700101	GLOVES EXAM LTX PDLESS SML	0.51
1700102	STERI-STRIP 1/2"X4"	6.36
1700103	CATH ANGIOCATH 20GAX2"	5.85
1700104	TUBE ENDOTRACH W/CUFF 3.5M	11.14
1700105	NUGAUZE PLAIN 1"	21.63
1700107	TUBE ENDOTRACH W/ CUFF 6MM	14.77
1700108	TUBE ENDOTRACH W/CUFF 9.5M	20.34
1700109	TUBE ENDOTRACH W/ CUFF 8MM	17.66
1700110	CATH ANGIOCATH 22GAX1"	6.02
1700111	TUBE ENDOTRACH W/CUFF 7.5M	15.60
1700113	TUBE ENDOTRACH W/ CUFF 7MM	17.01
1700114	CATH ANGIOCATH 24GAX3/4"	6.89
1700115	CERVICAL COLLAR FOAM LGE	39.32
1700116	BELT RIBS 42"X48" FEMALE	41.13
1700117	HEAD-HALTER W/O BAR-ADULT	87.48
1700122	GLOVES EXAM LTX PDLESS MED	0.51
1700123	SUSPENSORY SCROTAL LGE	27.76
1700124	GLOVES EXAM LATEX LGE	1.27
1700125	GLOVES SURG S-6 ULTRA	9.33
1700126	COLOSTOMY BAG-PEDS	18.32
1700127	BELT RIBS 36"X42" MEN	821.20
1700128	SUSPENSORY SCROTAL X-LGE	43.25
1700129	GLOVES SURGEON S-6-1/2	2.39
1700130	GLOVES SURG S-6-1/2 ULTRA	3.06
1700131	BANDAGE ELASTOPLAST 4"X5YD	20.39
1700132	GLOVES SURG S-8-1/2 SPEC	3.51
1700133	BELT PELVIC TRACTION 48X64	75.26
1700134	GLOVES SURG S-7 SPEC	2.63
1700135	GLOVES SURGEON S-7	1.17
1700137	BELT RIBS 30"X36" MEN	47.03
1700138	GLOVES SURGEON S-7-1/2	3.27
1700139	BELT RIBS 36"X42" FEMALE	37.06
1700140	BAG BODY CADAVER-WHITE	49.16
1700141	NUGAUZE IODOFORM 1"	25.34
1700142	BAG FEEDING	9.53
1700143	TUBE STOMACH 18FRX50"	3.64
1700144	TUBE TRACHEOSTOMY 36FR SZ-8	413.17
1700145	STERI-STRIP 1/4"X4"	6.74
1700146	CATH ANGIOCATH 18GAX1-1/4"	6.22
1700147	TUBE FEEDING 8FRX42"	4.05
1700148	GLOVES SURGEON S-8-1/2	2.46
1700149	TUBE ENDOTRACH W/CUFF 6.5M	18.54
1700150	TUBE ENDOTRACH W/CUFF 8.5M	20.91
1700151	BUTTERFLY 25GAX3/4"	5.21
1700152	TUBE ENDOTRACH W/ CUFF 9MM	19.09
1700153	CATHETER SUCTION 18FR 22"	2.05
1700154	SLIPPER FOAM YOUTH	2.21
1700155	GLOVES EXAM LTX PDLESS LGE	0.51
1700156	NUGAUZE IODOFORM 8"X10YD	148.15
1700157	CANNULA NASAL O2 7FT-PEDS	7.37
1700158	CANNULA NASAL O2 7FT-INFANT	10.78
1700160	SLIPPER FOAM SMALL	2.21
1700161	GLOVES SURG S-7-1/2 SPEC	3.11
1700162	GLOVES SURG S-6-1/2 SPEC	2.46
1700163	GLOVES SURG S-7-1/2 ULTRA	8.07
1700164	SLIPPER FOAM ADULT X-LGE	3.19
1700165	TUBE ENDOTRACH W/CUFF 4.5M	24.71
1700166	GLOVES SURGEON S-7 ULTRA	3.13
1700168	TUBE ENDOTRACH W/CUFF 10MM	18.74
1700169	PAD TELFA 3"X8"	0.43
1700170	TUBE NASOGAST W/ SENT 14FR	11.40
1700171	TUBE NASOGAST W/ SENT 16FR	11.67
1700172	CATHETER SUCTION 14FR 22"	2.39
1700173	NUGAUZE PLAIN 2"	32.00
1700174	CATH ANGIOCATH 18GAX2"	4.79
1700175	SET UNDERWATER DRAIN	57.30
1700176	CATHETER SUCTION 10FR 22"	2.45
1700177	TUBE ENDOTRACH W/ CUFF 5MM	17.25
1700178	NUGAUZE PLAIN 1/4"	21.19
1700179	TUBE ENDOTRACH W/ CUFF 4MM	25.09
1700180	BELT RIBS 30"X36" FEMALE	47.88
1700182	NUGAUZE PLAIN 1/2"	23.75
1700184	TUBE ENDOTRACH W/CUFF 5.5M	18.06
1700185	TUBE ENDOTRACH W/OCUFF 3MM	10.15
1700186	GLOVES SURG S-8 SPEC	2.55
1700187	GLOVES SURGEON S-8	2.91
1700188	NUGAUZE IODOFORM 2"	42.61
1700189	TUBE TRACHEOSTOMY 39FR SZ-10	239.51
1700190	GLOVES EXAM LATEX MED	0.44
1700191	SET ARTERIAL	13.40
1700192	TUBE TRACHEOSTOMY 30FR SZ-6	324.44
1700193	TUBE NASOGAST W/ SENT 12FR	11.22
1700195	KIT TRANSCERV INTRAUTERINE	19.21
1700241	BANDAGE KERLIX	6.50
1700249	STYLET INTUBATING 6FR	6.87
1700258	SET IV ADMIN HEMO	3.76
1700262	TUBE NASOGASTRIC 20FR-ADULT	456.85
1700308	BANDAGE SLING	5.04
1700369	DRESSING SMALL	6.17
1700371	DRESSING MEDIUM	10.41
1700373	PACEMAKER LEAD INTRO TEMP	45.45
1700378	DRESSING LARGE	14.67
1700380	GAUZE GELFOAM	24.30
1700385	MASK AEROSOL-ADULT	10.21
1700440	BILIRUBIN THERAPY	19.81
1700452	STOMA ADHESIVE 8X8 /EA	24.15
1700464	CATHETER SUCTION 5/6FR	3.59
1700481	STOMA ADHESIVE 4X4 /EA	18.63
1700506	CATHETER URETHRAL	7.59
1700529	NUGAUZE IODOFORM 1/2"	25.09
1700589	GAUZE DRESSING 2X2	1.93
1700605	GAUZE DRESSING 4X4	1.93
1700619	DRESSING TRANSP 2X3	0.81
1700620	DRESSING TRANSP 4X5	2.54
1700647	FAS-TRAC	21.55
1700650	OXYCEL	10.24
1700662	TRAY URETHRAL CATHETERIZATION 14FR	14.47
1700663	TROCAR CATHETER	18.25
1700673	ETHILON BLK MONO 30" 3-0	16.32
1700676	SILK BLK BR 18" 3-0	12.65
1700683	SILK BLK BR 18" 4-0	16.66
1700685	SILK BLK BR 18" 2-0	16.03
1700688	GAUZE FURACIN	4.12
1700690	IV SM20-D STAT MASTER	3.76
1700693	IV SM60-D STAT MASTER	3.97
1700695	TUBE IV EXTENSION	3.41
1700699	ETHILON BLK MONO 18" 4-0	34.81
1700704	GLOVES SURGEON DISP	3.54
1700709	KIT FETAL SCALP PH	12.02
1700738	LEAD PACING PERMANENT	51.65
1700745	LEAD PACING	835.33
1700751	BLANKET BABY	4.23
1700795	PLASTIBELL	1.40
1700796	CONNECTOR PLASTIC	1.76
1700805	AMNIHOOK AMNIOTIC MEMBRANE	8.82
1700823	DOME STERILE DISP	3.66
1700844	FETAL SCALP ELECTRODE	7.32
1700845	NEEDLE INTRACATH	17.75
1700846	NEEDLE INTRAOSSEOUS	22.78
1700850	NEEDLE BIOPSY	20.75
1700860	MINICATH WTIH 19-21	7.43
1700880	NEEDLE LOOSE EYE	1.94
1700916	GLOVES HAND LEATHER	7.23
1700928	PAD ABDOMINAL	1.93
1700935	NUGAUZE IODOFORM 1/4"	22.83
1700944	PAD EYE DRESSING	1.93
1701010	MODULE-OXYGEN DELIVERY	61.03
1701020	MODULE-INTUBATION	154.47
1701024	PROTECTION PACK	6.04
1701025	PROTECTOR POSEY	16.41
1701030	MODULE-IV DELIVERY	159.74
1701040	MODULE-INTRAOSSEOUS	200.96
1701067	RESUSCITATOR MANUAL DISP	9.12
1701076	SET IV CARTRIDGE-ADULT	10.32
1701078	SET IV CARTRIDGE-NEONATAL	10.32
1701080	SET HALF Y MEDSYSTEM III	32.22
1701081	SET 2 Y MEDSYSTEM III	60.85
1701108	SET IV BLOOD-VI9	12.67
1701116	BLOOD PUMP	24.71
1701124	SET ENEMA DISP	7.59
1701249	SET METRI BURRETRO	29.74
1701280	SET IV-PEDS	5.97
1701322	SET IV-ADULT	6.71
1701348	SET TRACHEA CARE	11.51
1701363	SET URI-METER	17.70
1701389	SET UROGATE	8.48
1701421	SITZ BATH	16.18
1701426	CAPNOMETER - ADULT	76.15
1701447	SPLINT FINGER	9.65
1701451	COLOSTOMY FLANGE-PEDS	23.51
1701461	COLOSTOMY FLANGE-ADULT	29.18
1701497	KIT SUCTION CATHETER	21.75
1701603	TAPE UMBILICAL	1.93
1701629	TRAY CERVICAL BIOPSY	21.23
1701645	SET UP TRACTION EQUIPMENT	48.23
1701660	TRAY ANGIOGRAM	14.85
1701669	ETHILON BLK MONO 18" 3-0	34.12
1701686	TRAY ARTERIOGRAM	21.23
1701744	TRAY BURN DRESSING	19.28
1701801	TRAY EAR IRRIGATION	6.37
1701835	TRAY I&D	15.91
1701843	TRAY IRRIGATION	9.45
1701876	TRAY MINOR SUTURE	21.23
1701880	TRAY W/ BETADINE SKIN PREP	16.67
1701900	TRAY MYELOGRAM	83.09
1701926	TRAY OB PRECIPITATE	53.08
1701942	TRAY PARACENTESIS	31.85
1701967	TRAY SALPINGOGRAM	21.23
1701983	TRAY LIVER BIOPSY	15.91
1701991	TRAY EPIDURAL ANESTHESIA	45.17
1702007	TRAY LUMBAR PUNCTURE-ADULT	40.67
1702023	TRAY SPINAL ANESTHESIA	46.82
1702049	TRAY LUMBAR PUNCTURE-PEDS	45.25
1702072	TRAY STEINMANN PIN	67.54
1702080	TRAY THORACENTESIS	152.09
1702106	TRAY THORACOTOMY	31.85
1702122	TRAY TRACHEOTOMY	31.85
1702148	TRAY TROCATH-ADULT	45.93
1702163	TRAY TROCATH-INFANT	45.93
1702189	TRAY VENISECTION	31.85
1702197	INCENTIVE SPIROMETER	50.17
1702205	TUBE BLAKEMORE	127.34
1702288	TUBE FEEDING 5FR	3.76
1702304	TUBE MILLER-ABBOTT	43.21
1702346	TUBE RECTAL	3.97
1702361	TUBE STOMACH 14FR	3.86
1702363	TUBE STOMACH 16FRX50"	4.02
1702365	TUBE FEEDING 8FRX15"	4.22
1702367	GLOVES SURG S-6 SPEC	2.64
1702369	SUSPENSORY SCROTAL MED	40.36
1702370	STYLET INTUBATING 14FR	16.62
1702372	STERI-STRIP 1/4"X3"	4.03
1702373	SLIPPER FOAM ADULT MED	3.56
1702376	PAD TELFA 3"X4"	0.67
1702377	NEEDLE SPINAL 22GAX1-1/2"	9.19
1702379	MASK OXYGEN-ADULT	3.55
1702380	CATH ANGIOCATH 16GAX2"	5.05
1702381	BUTTERFLY 25GAX3/8"	4.47
1702382	HEAD-HALTER W/O BAR-YOUTH	87.48
1702383	CERVICAL COLLAR FOAM MED	49.16
1702384	CATHETER SUCTION 8FR 15"	3.08
1702385	BAG BODY CADAVER-YELLOW	44.35
1702386	BELT RIBS 24"X30" FEMALE	33.71
1702388	BELT PELVIC TRACTION 26X30	66.65
1702389	BANDAGE ELASTOPLAST 3"X5YD	25.61
1702445	UNDERPADS	1.93
1702452	CATHETER UMBILICAL ART 5FR	9.49
1702460	UNIGARD II	3.58
1702486	GAUZE XEROFORM	4.92
1702502	VENOUS PRESSURE	44.04
1702528	HEAD-HALTER	20.74
1702569	WOOL SYNTHETIC	69.94
1703468	GAUZE VASELINE PRE-PACK	2.85
1703744	BAG BODY CADAVER-INFANT	16.37
1706641	SILK BLK BR 18" 2-0	17.12
1710000	BAG SPIKE ADAPTER NEEDLE-FREE	16.39
1710015	AIRWAY 40MM-NEONATAL	1.23
1710016	AIRWAY 60MM-PEDS	1.12
1710017	AIRWAY 80MM-ADULT	1.71
1710018	AIRWAY 90MM-ADULT	1.44
1710019	AIRWAY 100MM-ADULT	1.44
1710120	ARMBOARD W/ COVER 2.5"	4.41
1710121	ARMBOARD W/ COVER 4"	4.18
1710122	ARMBOARD W/ COVER 5"	5.15
1710136	TUBE SALEM SUMP 16FR	2.11
1710215	BANDAGE ELASTOPLAST 2"X5YD	11.17
1710296	STOCKING THIGH HI-LENGTH-MED	33.02
1710297	STOCKING THIGH HI-LENGTH-LGE	36.60
1710310	BANDAGE PLASTER PARIS 2"	6.14
1710314	BANDAGE PLASTER PARIS 6"	20.04
1710325	SPLINT ONE-STEP 2"X10"	40.36
1710330	SPLINT ONE-STEP 3"X12"	46.83
1710335	SPLINT ONE-STEP 4"X15"	68.95
1710340	SPLINT ONE-STEP 5"X30"	105.83
1710341	SPLINT ONE-STEP 5"X45"	130.89
1710386	LIMB STABILIZER WEDGE	32.75
1710445	NEEDLE-FREE VALVE ALARIS	8.13
1710500	CATHETER FOLEY 8FR 3CC	26.44
1710600	KIT CENTRAL VENOUS ACCESS 2-LUMEN	557.77
1710733	CATHETER SUCTION 8FR DELEE	7.78
1711015	PLUG DECANNULATION	37.56
1711131	ELECTRODE EKG QUICK COMBO-PEDS	148.86
1711132	ELECTRODE EKG QUICK COMBO-ADULT	148.86
1711218	GAUZE PETROLATUM 1/2"X72"	7.90
1711280	GAUZE VASELINE PETROLATUM 3"X8"	2.99
1711412	BUTTERFLY 23GAX3/4"	3.84
1711425	CATH ANGIOCATH 14GAX1-1/4"	12.92
1711610	MASK AEROSOL-PEDS	5.34
1711630	MASK MULTI-VENT-PEDS	20.33
1711633	MASK MULTI-VENT-ADULT	9.85
1711634	MASK NON-REBREATHING-PEDS	8.19
1711650	MASK POCKET	74.07
1711651	FILTER-MASK POCKET	6.73
1711692	OXISENSOR-ADULT	91.04
1711774	PAD TELFA 2"X3"	0.40
1712075	STERI-STRIP 1/8"X3"	3.21
1712090	STOCKING ANTI-EMBOLECTOMY-SML	11.06
1712091	STOCKING ANTI-EMBOLECTOMY-MED	26.39
1712092	STOCKING ANTI-EMBOLECTOMY-LGE	13.41
1712093	STOCKING ANTI-EMBOLECTOMY-XLGE	22.76
1712095	STOCKING THIGH HI-LENGTH-SML	50.22
1712096	STOCKING THIGH HI-LENGTH-MED	33.02
1712097	STOCKING THIGH HI-LENGTH-LGE	36.60
1712222	SET PUMP KANGAROO SCREW CAP	13.79
1712234	SET PUMP FLEXIFLO	9.31
1712724	TUBE NASOGASTRIC 8FR	68.99
1712729	TUBE SALEM SUMP W/ SENT 10FR	16.13
1712730	TUBE SALEM SUMP W/ SENT 12FR	16.45
1712731	TUBE SALEM SUMP W/ SENT 14FR	8.65
1712733	TUBE SALEM SUMP W/ SENT 18FR	9.10
1712829	TUBE ENDOTRACH W/ HOLDER 2.0MM	13.25
1712830	TUBE ENDOTRACH W/O CUFF 2.5MM	6.81
1712836	TUBE ENDOTRACH W/ HOLDER 3.0MM	34.19
1712838	TUBE ENDOTRACH W/O CUFF 3.5MM	22.68
1712895	TUBE TRACHEOSTOMY 26FR SZ-4	454.08
1713262	GLOVES SURG S-6 N/ALLERGIC	5.66
1713311	GLOVES SURG S-6.5 N/LATEX	8.04
1713361	GLOVES SURG S-7 N/LATEX	8.04
1713411	GLOVES SURG S-7.5 N/LATEX	8.04
1713461	GLOVES SURG S-8 N/LATEX	9.90
1713462	GLOVES SURG S-8 N/ALLERGIC	3.40
1713512	GLOVES SURG S-8.5 N/ALLERGIC	2.69
1714261	CAPNOMETER - PEDS	76.15
1714462	IMMOBILIZER KNEE 21"	183.47
1716921	OXISENSOR-INFANT	103.65
1726410	COLOSTOMY CLAMP-ADULT	13.47
1726441	IMMOBILIZER KNEE 20"	183.47
1730005	CATHETER DUAL LUMEN 11.5FRX13.5CM	494.53
1730007	CATHETER DUAL LUMEN 11.5FRX19.5CM	525.25
1730030	BLADE SCALPEL #10	1.02
1730035	BLADE SCALPEL #11	1.20
1730040	BLADE SCALPEL #12	0.64
1730045	BLADE SCALPEL #15	1.20
1730050	BLADE SCALPEL #20	0.91
1730055	BLADE SCALPEL #21	0.96
1730100	KIT VESSEL CATHETERIZATION 20GA	120.08
1730289	NEEDLE SPINAL 25GAX3-1/2"	8.66
1730474	RESUSCITATOR-AMBU SET DISP-INFANT	84.15
1730477	RESUSCITATOR-AMBU SET DISP-ADULT	139.82
1730479	RESUSCITATOR-AMBU SET DISP-PEDS	135.98
1733380	CAVILON SKIN CLEANER 8OZ	32.55
1733392	CAVILON CREAM 3.25OZ	29.18
1761733	MEFIX DRESSING 2"X11YD	34.79
1764101	COLOSTOMY BAG-ADULT	14.59
1764800	SILK BLK BR 30" 2-0	6.76
1787970	DUODERM DRESSING 2.5"X2.5"	23.57
1787971	DUODERM DRESSING 6"X6"	37.03
7000638	CATHETER BILIARY STONE REMOVAL 7FR	659.89
7001430	LEAD INTRO PERCUT 7FR-BROVIAC	322.09
7003718	PROBE ELECTRO ENDO UNDERWATER	289.54
7006125	ELECTRODE INSERT MICROTIP ENDO	558.89
7008818	BRUSH CYTOLOGY-GI 1.8CMX160CM	265.98
7011400	CHEST DRAIN VALVE-HEIMLICH	90.90