"Procedure"|"Code Type"|"Revenue Code"|"Procedure Description"|"Payer"|"Plan"|"Inpatient Gross Charges"|"Inpatient Expected Reimbursement"|"Inpatient Max Reimbursement"|"Inpatient Minimal Reimbursement"|"Outpatient Gross Charges"|"Outpatient Expected Reimbursement"|"Outpatient Max Reimbursement"|"Outpatient Minimal Reimbursement" 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|3769.86||||3769.86|1696.44|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|3769.86||||3769.86|2827.4|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|FMH BENEFIT SERVICES [1390]|FMH [139000]|3769.86||||3769.86|2827.4|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|TRUSTMARK [2030]|STARMARK [203000]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|3769.86||||3769.86|2827.4|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|CORESOURCE [1315]|CORESOURCE [131501]|3769.86||||3769.86|1444.99|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|3769.86||||3769.86|1696.44|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|3769.86||||3769.86|2310.92|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|3769.86||||3769.86|2827.4|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|3769.86||||3769.86|2073.42|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|3769.86||||3769.86|2310.92|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|3769.86||||3769.86|2186.52|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|3769.86||||3769.86|1331.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|3769.86||||3769.86|1444.99|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|3769.86||||3769.86|2827.4|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GILSBAR [1425]|GILSBAR [142500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHNET [1495]|HEALTHNET [149500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MULTIPLAN [1680]|IHC HS [168011]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|WEB TPA [2115]|WEB TPA [211500]|3769.86||||3769.86|3015.89|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|||3769.86||||3769.86|1130.96|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MEDICA [2910]|MEDICA QUEST [291001]|3769.86||||3769.86|2310.92|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|3769.86||||3769.86|1621.04|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|3769.86||||3769.86|1696.44|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|3769.86||||3769.86|3204.38|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|3769.86||||3769.86|1444.99|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|AETNA [1015]|AETNA ACO WILCO [101532]|3769.86||||3769.86|1444.99|3204.38|1130.96 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BCBS [1155]|TULSA BLUE [115531]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|CIGNA [1260]|CIGNA [126008]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GEHA [1415]|GEHA - ASA [141503]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|CHAMPVA [1240]|CHAMP VA [124000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UMR [2035]|UMR CORE [203505]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|3769.86||||3769.86||| 100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|3769.86||||3769.86||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|370.27|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|453.02|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|604.03||||604.03|271.81|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|453.02|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|||604.03||||604.03|181.21|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|453.02|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|213.4|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|453.02|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|453.02|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|259.73|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|370.27|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|483.23|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|350.34|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|370.27|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|513.43|181.21 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03||| 100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|3320.00||||3320.00|1826|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|3320.00||||3320.00|2490|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|CORESOURCE [1315]|CORESOURCE [131501]|3320.00||||3320.00|1272.56|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|3320.00||||3320.00|1427.6|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|3320.00||||3320.00|1272.56|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|3320.00||||3320.00|1925.6|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|3320.00||||3320.00|2490|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|WEB TPA [2115]|WEB TPA [211500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|3320.00||||3320.00|1172.96|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|3320.00||||3320.00|1494|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|3320.00||||3320.00|2822|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|AETNA [1015]|AETNA ACO WILCO [101532]|3320.00||||3320.00|1272.56|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|||3320.00||||3320.00|996|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|3320.00||||3320.00|1494|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|TRUSTMARK [2030]|STARMARK [203000]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MEDICA [2910]|MEDICA QUEST [291001]|3320.00||||3320.00|2035.16|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|3320.00||||3320.00|1494|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|3320.00||||3320.00|2490|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GILSBAR [1425]|GILSBAR [142500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|3320.00||||3320.00|1272.56|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|3320.00||||3320.00|2490|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHNET [1495]|HEALTHNET [149500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|3320.00||||3320.00|2035.16|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MULTIPLAN [1680]|IHC HS [168011]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|3320.00||||3320.00|2490|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|3320.00||||3320.00|2035.16|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|3320.00||||3320.00|2656|2822|996 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BCBS [1155]|TULSA BLUE [115531]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GEHA [1415]|GEHA - ASA [141503]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UMR [2035]|UMR CORE [203505]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|CHAMPVA [1240]|CHAMP VA [124000]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|3320.00||||3320.00||| 100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|CIGNA [1260]|CIGNA [126008]|3320.00||||3320.00||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHNET [1495]|HEALTHNET [149500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|10997.50||||10997.50|4215.34|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|||10997.50||||10997.50|3299.25|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|10997.50||||10997.50|6741.47|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHFIRST [2395]|HEALTHFIRST [239500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GILSBAR [1425]|GILSBAR [142500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|TRUSTMARK [2030]|STARMARK [203000]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|10997.50||||10997.50|4948.88|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MEDICA [2910]|MEDICA QUEST [291001]|10997.50||||10997.50|6741.47|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MULTIPLAN [1680]|IHC HS [168011]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|AETNA [1015]|AETNA ACO WILCO [101532]|10997.50||||10997.50|4215.34|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|10997.50||||10997.50|3885.42|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|10997.50||||10997.50|4728.93|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|10997.50||||10997.50|4215.34|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|10997.50||||10997.50|8248.13|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|WEB TPA [2115]|WEB TPA [211500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|FMH BENEFIT SERVICES [1390]|FMH [139000]|10997.50||||10997.50|8248.13|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|10997.50||||10997.50|8248.13|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|10997.50||||10997.50|8248.13|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|10997.50||||10997.50|4948.88|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|CORESOURCE [1315]|CORESOURCE [131501]|10997.50||||10997.50|4215.34|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|10997.50||||10997.50|9347.88|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|10997.50||||10997.50|8248.13|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|FIRST HEALTH [1375]|BENVEO/UCS [137512]|10997.50||||10997.50|6741.47|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|10997.50||||10997.50|6378.55|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|10997.50||||10997.50|6048.63|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|10997.50||||10997.50|8798|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|10997.50||||10997.50|4948.88|9347.88|3299.25 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UMR [2035]|UMR CORE [203505]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|CIGNA [1260]|CIGNA [126008]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BCBS [1155]|TULSA BLUE [115531]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|CHAMPVA [1240]|CHAMP VA [124000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GEHA [1415]|GEHA - ASA [141503]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|10997.50||||10997.50||| 100049|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|MESH SURGICAL VENTRALIGHT ST SEPRA POLYPROPYLENE HYDROGEL RECTANGLE L14 IN X W12 IN UNCOATED MONOFILAMENT LIGHTWEIGHT ABSORBABLE LOW PROFILE STERILE LATEX FREE VENTRAL HERNIA REPAIR|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|10997.50||||10997.50||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|11512.52||||11512.52|4412.75|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MEDICA [2910]|MEDICA QUEST [291001]|11512.52||||11512.52|7057.17|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHFIRST [2395]|HEALTHFIRST [239500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|11512.52||||11512.52|8634.39|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|11512.52||||11512.52|6331.88|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|11512.52||||11512.52|5180.63|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|FIRST HEALTH [1375]|BENVEO/UCS [137512]|11512.52||||11512.52|7057.17|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|CORESOURCE [1315]|CORESOURCE [131501]|11512.52||||11512.52|4412.75|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|11512.52||||11512.52|9785.64|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|11512.52||||11512.52|4950.38|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|11512.52||||11512.52|4412.75|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|11512.52||||11512.52|8634.39|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|11512.52||||11512.52|6677.26|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|11512.52||||11512.52|4067.37|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MULTIPLAN [1680]|IHC HS [168011]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|WEB TPA [2115]|WEB TPA [211500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|||11512.52||||11512.52|3453.76|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|AETNA [1015]|AETNA ACO WILCO [101532]|11512.52||||11512.52|4412.75|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|11512.52||||11512.52|7057.17|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|11512.52||||11512.52|5180.63|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|11512.52||||11512.52|8634.39|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHNET [1495]|HEALTHNET [149500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|TRUSTMARK [2030]|STARMARK [203000]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|FMH BENEFIT SERVICES [1390]|FMH [139000]|11512.52||||11512.52|8634.39|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|11512.52||||11512.52|5180.63|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GILSBAR [1425]|GILSBAR [142500]|11512.52||||11512.52|9210.01|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|11512.52||||11512.52|8634.39|9785.64|3453.76 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GEHA [1415]|GEHA - ASA [141503]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|CHAMPVA [1240]|CHAMP VA [124000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BCBS [1155]|TULSA BLUE [115531]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|UMR [2035]|UMR CORE [203505]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|CIGNA [1260]|CIGNA [126008]|11512.52||||11512.52||| 100051|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SLEEVE FEMORAL POROUS UNIVERSAL L34 MM KNEE STERILE LATEX FREE SIGMA LCS S-ROM LPS|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|11512.52||||11512.52||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHNET [1495]|HEALTHNET [149500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|FMH BENEFIT SERVICES [1390]|FMH [139000]|7121.40||||7121.40|5341.05|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7121.40||||7121.40|2729.63|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7121.40||||7121.40|4365.42|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MULTIPLAN [1680]|IHC HS [168011]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7121.40||||7121.40|5341.05|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|WEB TPA [2115]|WEB TPA [211500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7121.40||||7121.40|3204.63|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7121.40||||7121.40|3062.2|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7121.40||||7121.40|2729.63|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|CORESOURCE [1315]|CORESOURCE [131501]|7121.40||||7121.40|2729.63|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7121.40||||7121.40|4365.42|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7121.40||||7121.40|5341.05|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7121.40||||7121.40|3916.77|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7121.40||||7121.40|4130.41|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7121.40||||7121.40|5341.05|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7121.40||||7121.40|6053.19|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7121.40||||7121.40|2515.99|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7121.40||||7121.40|3204.63|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|||7121.40||||7121.40|2136.42|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|AETNA [1015]|AETNA ACO WILCO [101532]|7121.40||||7121.40|2729.63|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MEDICA [2910]|MEDICA QUEST [291001]|7121.40||||7121.40|4365.42|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|TRUSTMARK [2030]|STARMARK [203000]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7121.40||||7121.40|5341.05|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GILSBAR [1425]|GILSBAR [142500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7121.40||||7121.40|5697.12|6053.19|2136.42 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UMR [2035]|UMR CORE [203505]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BCBS [1155]|TULSA BLUE [115531]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|CHAMPVA [1240]|CHAMP VA [124000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GEHA [1415]|GEHA - ASA [141503]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|CIGNA [1260]|CIGNA [126008]|7121.40||||7121.40||| 100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7121.40||||7121.40||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1157.85||||1157.85|521.03|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|FMH BENEFIT SERVICES [1390]|FMH [139000]|1157.85||||1157.85|868.39|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GILSBAR [1425]|GILSBAR [142500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1157.85||||1157.85|562.72|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|TRUSTMARK [2030]|STARMARK [203000]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MEDICA [2910]|MEDICA QUEST [291001]|1157.85||||1157.85|709.76|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1157.85||||1157.85|868.39|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHNET [1495]|HEALTHNET [149500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MULTIPLAN [1680]|IHC HS [168011]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1157.85||||1157.85|709.76|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|||1157.85||||1157.85|347.35|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|WEB TPA [2115]|WEB TPA [211500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1157.85||||1157.85|868.39|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|AETNA [1015]|AETNA ACO WILCO [101532]|1157.85||||1157.85|562.72|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1157.85||||1157.85|868.39|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1157.85||||1157.85|709.76|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|CORESOURCE [1315]|CORESOURCE [131501]|1157.85||||1157.85|562.72|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1157.85||||1157.85|984.17|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1157.85||||1157.85|497.88|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1157.85||||1157.85|562.72|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1157.85||||1157.85|636.82|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1157.85||||1157.85|671.55|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1157.85||||1157.85|868.39|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1157.85||||1157.85|926.28|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1157.85||||1157.85|521.03|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1157.85||||1157.85|409.07|984.17|347.35 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UMR [2035]|UMR CORE [203505]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|CIGNA [1260]|CIGNA [126008]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BCBS [1155]|TULSA BLUE [115531]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GEHA [1415]|GEHA - ASA [141503]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|CHAMPVA [1240]|CHAMP VA [124000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1157.85||||1157.85||| 100066|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|COUNTERSINK DRILL TUFFNEK HOLE COUNTERBORE 3 IN 1|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1157.85||||1157.85||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|763.60||||763.60|649.06|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GILSBAR [1425]|GILSBAR [142500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|763.60||||763.60|343.62|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|FMH BENEFIT SERVICES [1390]|FMH [139000]|763.60||||763.60|572.7|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|763.60||||763.60|371.11|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|TRUSTMARK [2030]|STARMARK [203000]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHFIRST [2395]|HEALTHFIRST [239500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|763.60||||763.60|468.09|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|||763.60||||763.60|229.08|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|763.60||||763.60|572.7|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|AETNA [1015]|AETNA ACO WILCO [101532]|763.60||||763.60|371.11|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|763.60||||763.60|269.78|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|763.60||||763.60|343.62|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|763.60||||763.60|572.7|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|763.60||||763.60|572.7|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|WEB TPA [2115]|WEB TPA [211500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MULTIPLAN [1680]|IHC HS [168011]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MEDICA [2910]|MEDICA QUEST [291001]|763.60||||763.60|468.09|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|763.60||||763.60|442.89|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHNET [1495]|HEALTHNET [149500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|763.60||||763.60|371.11|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|763.60||||763.60|328.35|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|CORESOURCE [1315]|CORESOURCE [131501]|763.60||||763.60|371.11|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|FIRST HEALTH [1375]|BENVEO/UCS [137512]|763.60||||763.60|468.09|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|763.60||||763.60|610.88|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|763.60||||763.60|572.7|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|763.60||||763.60|419.98|649.06|229.08 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UMR [2035]|UMR CORE [203505]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|CIGNA [1260]|CIGNA [126008]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BCBS [1155]|TULSA BLUE [115531]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|CHAMPVA [1240]|CHAMP VA [124000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GEHA [1415]|GEHA - ASA [141503]|763.60||||763.60||| 100068|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DRILL SURGICAL L110 MM OD3.5 MM OVER SOLID AO CONNECTION|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|763.60||||763.60||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|460.65||||460.65|345.49|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|FIRST HEALTH [1375]|BENVEO/UCS [137512]|460.65||||460.65|282.38|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|460.65||||460.65|198.08|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|460.65||||460.65|223.88|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|460.65||||460.65|267.18|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|AETNA [1015]|AETNA ACO WILCO [101532]|460.65||||460.65|223.88|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|460.65||||460.65|345.49|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHFIRST [2395]|HEALTHFIRST [239500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GILSBAR [1425]|GILSBAR [142500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHNET [1495]|HEALTHNET [149500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|FMH BENEFIT SERVICES [1390]|FMH [139000]|460.65||||460.65|345.49|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|460.65||||460.65|207.29|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MEDICA [2910]|MEDICA QUEST [291001]|460.65||||460.65|282.38|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|460.65||||460.65|223.88|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|TRUSTMARK [2030]|STARMARK [203000]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|460.65||||460.65|345.49|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MULTIPLAN [1680]|IHC HS [168011]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|||460.65||||460.65|138.19|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|WEB TPA [2115]|WEB TPA [211500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|460.65||||460.65|162.75|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|460.65||||460.65|207.29|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|460.65||||460.65|282.38|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|460.65||||460.65|345.49|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|460.65||||460.65|391.55|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|CORESOURCE [1315]|CORESOURCE [131501]|460.65||||460.65|223.88|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|460.65||||460.65|368.52|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|460.65||||460.65|253.36|391.55|138.19 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BCBS [1155]|TULSA BLUE [115531]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UMR [2035]|UMR CORE [203505]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|CIGNA [1260]|CIGNA [126008]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|CHAMPVA [1240]|CHAMP VA [124000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|460.65||||460.65||| 100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|GEHA [1415]|GEHA - ASA [141503]|460.65||||460.65||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FMH BENEFIT SERVICES [1390]|FMH [139000]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|86.90||||86.90|39.11|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHNET [1495]|HEALTHNET [149500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GILSBAR [1425]|GILSBAR [142500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GILSBAR [1425]|GILSBAR [142500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHNET [1495]|HEALTHNET [149500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|86.90||||86.90|39.11|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FMH BENEFIT SERVICES [1390]|FMH [139000]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MEDICA [2910]|MEDICA QUEST [291001]|86.90||||86.90|53.27|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MEDICA [2910]|MEDICA QUEST [291001]|86.90||||86.90|53.27|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|TRUSTMARK [2030]|STARMARK [203000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|TRUSTMARK [2030]|STARMARK [203000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHFIRST [2395]|HEALTHFIRST [239500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MULTIPLAN [1680]|IHC HS [168011]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MULTIPLAN [1680]|IHC HS [168011]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|86.90||||86.90|53.27|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|||86.90||||86.90|26.07|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|||86.90||||86.90|26.07|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|WEB TPA [2115]|WEB TPA [211500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|WEB TPA [2115]|WEB TPA [211500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHFIRST [2395]|HEALTHFIRST [239500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AETNA [1015]|AETNA ACO WILCO [101532]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AETNA [1015]|AETNA ACO WILCO [101532]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|86.90||||86.90|39.11|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|86.90||||86.90|50.4|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|86.90||||86.90|50.4|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|86.90||||86.90|53.27|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|86.90||||86.90|37.37|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|86.90||||86.90|37.37|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|86.90||||86.90|30.7|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CORESOURCE [1315]|CORESOURCE [131501]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CORESOURCE [1315]|CORESOURCE [131501]|86.90||||86.90|42.23|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR [2035]|UMR CORE [203505]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR [2035]|UMR CORE [203505]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|TULSA BLUE [115531]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CIGNA [1260]|CIGNA [126008]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CIGNA [1260]|CIGNA [126008]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|86.90||||86.90|65.18|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|86.90||||86.90|30.7|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FIRST HEALTH [1375]|BENVEO/UCS [137512]|86.90||||86.90|53.27|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|86.90||||86.90|47.8|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|86.90||||86.90|73.87|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|86.90||||86.90|47.8|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FIRST HEALTH [1375]|BENVEO/UCS [137512]|86.90||||86.90|53.27|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|86.90||||86.90|73.87|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|86.90||||86.90|39.11|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|86.90||||86.90|69.52|73.87|26.07 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CHAMPVA [1240]|CHAMP VA [124000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CHAMPVA [1240]|CHAMP VA [124000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BCBS [1155]|TULSA BLUE [115531]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GEHA [1415]|GEHA - ASA [141503]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GEHA [1415]|GEHA - ASA [141503]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|86.90||||86.90||| 10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|86.90||||86.90||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|726.25||||726.25|399.44|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|726.25||||726.25|352.96|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|726.25||||726.25|421.23|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHFIRST [2395]|HEALTHFIRST [239500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MULTIPLAN [1680]|IHC HS [168011]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|||726.25||||726.25|217.87|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|TRUSTMARK [2030]|STARMARK [203000]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|726.25||||726.25|352.96|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MEDICA [2910]|MEDICA QUEST [291001]|726.25||||726.25|445.19|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|FMH BENEFIT SERVICES [1390]|FMH [139000]|726.25||||726.25|544.69|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|726.25||||726.25|326.81|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|726.25||||726.25|445.19|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHNET [1495]|HEALTHNET [149500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|726.25||||726.25|544.69|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GILSBAR [1425]|GILSBAR [142500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|726.25||||726.25|544.69|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|WEB TPA [2115]|WEB TPA [211500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|AETNA [1015]|AETNA ACO WILCO [101532]|726.25||||726.25|352.96|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|726.25||||726.25|256.58|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|726.25||||726.25|326.81|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|726.25||||726.25|544.69|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|726.25||||726.25|617.31|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|CORESOURCE [1315]|CORESOURCE [131501]|726.25||||726.25|352.96|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|726.25||||726.25|312.29|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|FIRST HEALTH [1375]|BENVEO/UCS [137512]|726.25||||726.25|445.19|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|726.25||||726.25|544.69|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|726.25||||726.25|581|617.31|217.87 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GEHA [1415]|GEHA - ASA [141503]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|CIGNA [1260]|CIGNA [126008]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UMR [2035]|UMR CORE [203505]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BCBS [1155]|TULSA BLUE [115531]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|CHAMPVA [1240]|CHAMP VA [124000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|726.25||||726.25||| 100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|726.25||||726.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHNET [1495]|HEALTHNET [149500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GILSBAR [1425]|GILSBAR [142500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MEDICA [2910]|MEDICA QUEST [291001]|2884.25||||2884.25|1768.05|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|TRUSTMARK [2030]|STARMARK [203000]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|2884.25||||2884.25|2163.19|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MULTIPLAN [1680]|IHC HS [168011]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|2884.25||||2884.25|1768.05|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|||2884.25||||2884.25|865.27|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|FMH BENEFIT SERVICES [1390]|FMH [139000]|2884.25||||2884.25|2163.19|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|2884.25||||2884.25|2163.19|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|WEB TPA [2115]|WEB TPA [211500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|2884.25||||2884.25|1297.91|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|2884.25||||2884.25|1019.01|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|2884.25||||2884.25|2163.19|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|2884.25||||2884.25|1672.87|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|2884.25||||2884.25|1297.91|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|2884.25||||2884.25|1105.53|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|AETNA [1015]|AETNA ACO WILCO [101532]|2884.25||||2884.25|1105.53|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|2884.25||||2884.25|1105.53|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|2884.25||||2884.25|2451.61|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|CORESOURCE [1315]|CORESOURCE [131501]|2884.25||||2884.25|1105.53|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|2884.25||||2884.25|1240.23|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|2884.25||||2884.25|1768.05|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|2884.25||||2884.25|2163.19|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|2884.25||||2884.25|1586.34|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|2884.25||||2884.25|1297.91|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|2884.25||||2884.25|2307.4|2451.61|865.27 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UMR [2035]|UMR CORE [203505]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|CIGNA [1260]|CIGNA [126008]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|CHAMPVA [1240]|CHAMP VA [124000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BCBS [1155]|TULSA BLUE [115531]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GEHA [1415]|GEHA - ASA [141503]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|2884.25||||2884.25||| 100107|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE ARTHREX TITANIUM T25 XL FULL THREAD L45 MM OD7 MM COMPRESSION CANNULATION HEADLESS HEXALOBE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|2884.25||||2884.25||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|78.00||||78.00|42.9|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|FIRST HEALTH [1375]|BENVEO/UCS [137512]|78.00||||78.00|47.81|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|78.00||||78.00|66.3|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|78.00||||78.00|33.54|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|78.00||||78.00|37.91|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|78.00||||78.00|58.5|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|78.00||||78.00|27.56|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|AETNA [1015]|AETNA ACO WILCO [101532]|78.00||||78.00|37.91|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|WEB TPA [2115]|WEB TPA [211500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|78.00||||78.00|45.24|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|||78.00||||78.00|23.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MULTIPLAN [1680]|IHC HS [168011]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|78.00||||78.00|58.5|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|78.00||||78.00|34.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|CORESOURCE [1315]|CORESOURCE [131501]|78.00||||78.00|37.91|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHFIRST [2395]|HEALTHFIRST [239500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|78.00||||78.00|58.5|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|TRUSTMARK [2030]|STARMARK [203000]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|CIGNA [1260]|CIGNA [126008]|78.00||||78.00|34.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|78.00||||78.00|47.81|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|78.00||||78.00|37.91|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MEDICA [2910]|MEDICA QUEST [291001]|78.00||||78.00|47.81|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|FMH BENEFIT SERVICES [1390]|FMH [139000]|78.00||||78.00|58.5|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|78.00||||78.00|35.1|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|78.00||||78.00|35.1|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHNET [1495]|HEALTHNET [149500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GILSBAR [1425]|GILSBAR [142500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|78.00||||78.00|62.4|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|78.00||||78.00|58.5|66.3|23.4 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|CHAMPVA [1240]|CHAMP VA [124000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BCBS [1155]|TULSA BLUE [115531]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GEHA [1415]|GEHA - ASA [141503]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|78.00||||78.00||| 100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|UMR [2035]|UMR CORE [203505]|78.00||||78.00||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|7.71||||7.71|6.55|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|7.71||||7.71|3.32|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|7.71||||7.71|4.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|7.71||||7.71|2.72|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CHAMPVA [1240]|CHAMP VA [124000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|7.71||||7.71|4.24|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GEHA [1415]|GEHA - ASA [141503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FMH BENEFIT SERVICES [1390]|FMH [139000]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|7.71||||7.71|3.47|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.73|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|||7.71||||7.71|2.31|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS [1155]|TULSA BLUE [115531]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UMR CORE [203505]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|WEB TPA [2115]|WEB TPA [211500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|7.71||||7.71|5.78|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|7.71||||7.71|6.17|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA [1015]|AETNA ACO WILCO [101532]|7.71||||7.71|3.75|6.55|2.31 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|7.71||||7.71||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|24.63||||24.63|18.47|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|24.63||||24.63|15.1|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|CORESOURCE [1315]|CORESOURCE [131501]|24.63||||24.63|11.97|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|24.63||||24.63|20.93|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|24.63||||24.63|10.59|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|24.63||||24.63|11.97|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|24.63||||24.63|14.28|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|24.63||||24.63|18.47|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|24.63||||24.63|8.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|24.63||||24.63|11.08|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|AETNA [1015]|AETNA ACO WILCO [101532]|24.63||||24.63|11.97|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|24.63||||24.63|18.47|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|WEB TPA [2115]|WEB TPA [211500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|||24.63||||24.63|7.39|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MULTIPLAN [1680]|IHC HS [168011]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|24.63||||24.63|15.1|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|24.63||||24.63|18.47|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|TRUSTMARK [2030]|STARMARK [203000]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|24.63||||24.63|13.54|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|24.63||||24.63|11.97|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MEDICA [2910]|MEDICA QUEST [291001]|24.63||||24.63|15.1|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|FMH BENEFIT SERVICES [1390]|FMH [139000]|24.63||||24.63|18.47|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|24.63||||24.63|11.08|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHNET [1495]|HEALTHNET [149500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GILSBAR [1425]|GILSBAR [142500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|24.63||||24.63|19.7|20.93|7.39 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GEHA [1415]|GEHA - ASA [141503]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|CHAMPVA [1240]|CHAMP VA [124000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|TULSA BLUE [115531]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|CIGNA [1260]|CIGNA [126008]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|24.63||||24.63||| 100124|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER METAL 00 ROUND TIP EDGE STERILE LATEX FREE DISPOSABLE|UMR [2035]|UMR CORE [203505]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHNET [1495]|HEALTHNET [149500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|24.63||||24.63|11.08|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|FMH BENEFIT SERVICES [1390]|FMH [139000]|24.63||||24.63|18.47|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|24.63||||24.63|11.97|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|TRUSTMARK [2030]|STARMARK [203000]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHFIRST [2395]|HEALTHFIRST [239500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|24.63||||24.63|15.1|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|||24.63||||24.63|7.39|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|WEB TPA [2115]|WEB TPA [211500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|24.63||||24.63|18.47|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|AETNA [1015]|AETNA ACO WILCO [101532]|24.63||||24.63|11.97|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|24.63||||24.63|11.08|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|24.63||||24.63|8.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|24.63||||24.63|18.47|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|24.63||||24.63|14.28|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MULTIPLAN [1680]|IHC HS [168011]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|24.63||||24.63|11.97|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|24.63||||24.63|10.59|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|24.63||||24.63|20.93|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|CORESOURCE [1315]|CORESOURCE [131501]|24.63||||24.63|11.97|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|24.63||||24.63|18.47|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MEDICA [2910]|MEDICA QUEST [291001]|24.63||||24.63|15.1|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|FIRST HEALTH [1375]|BENVEO/UCS [137512]|24.63||||24.63|15.1|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GILSBAR [1425]|GILSBAR [142500]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|24.63||||24.63|19.7|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|24.63||||24.63|18.47|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|24.63||||24.63|13.54|20.93|7.39 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UMR [2035]|UMR CORE [203505]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|CIGNA [1260]|CIGNA [126008]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BCBS [1155]|TULSA BLUE [115531]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|CHAMPVA [1240]|CHAMP VA [124000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GEHA [1415]|GEHA - ASA [141503]|24.63||||24.63||| 100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|24.63||||24.63|18.47|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|24.63||||24.63|15.1|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|CORESOURCE [1315]|CORESOURCE [131501]|24.63||||24.63|11.97|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|24.63||||24.63|20.93|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|24.63||||24.63|11.97|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|24.63||||24.63|18.47|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|24.63||||24.63|8.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|24.63||||24.63|11.08|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|24.63||||24.63|14.28|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|AETNA [1015]|AETNA ACO WILCO [101532]|24.63||||24.63|11.97|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|24.63||||24.63|18.47|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|WEB TPA [2115]|WEB TPA [211500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|24.63||||24.63|10.59|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|||24.63||||24.63|7.39|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MULTIPLAN [1680]|IHC HS [168011]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|24.63||||24.63|15.1|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|24.63||||24.63|18.47|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|TRUSTMARK [2030]|STARMARK [203000]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|24.63||||24.63|13.54|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|24.63||||24.63|11.97|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MEDICA [2910]|MEDICA QUEST [291001]|24.63||||24.63|15.1|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|FMH BENEFIT SERVICES [1390]|FMH [139000]|24.63||||24.63|18.47|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|24.63||||24.63|11.08|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHNET [1495]|HEALTHNET [149500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GILSBAR [1425]|GILSBAR [142500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|24.63||||24.63|19.7|20.93|7.39 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GEHA [1415]|GEHA - ASA [141503]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|CHAMPVA [1240]|CHAMP VA [124000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|TULSA BLUE [115531]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|CIGNA [1260]|CIGNA [126008]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|24.63||||24.63||| 100126|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNGOSCOPE BRITEBLADE PRO MILLER 1 METAL FIBER OPTIC HIGH INTENSITY ILLUMINATION LOW PROFILE HINGE STERILE LATEX FREE DISPOSABLE|UMR [2035]|UMR CORE [203505]|24.63||||24.63||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GILSBAR [1425]|GILSBAR [142500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GILSBAR [1425]|GILSBAR [142500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHNET [1495]|HEALTHNET [149500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHNET [1495]|HEALTHNET [149500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHNET [1495]|HEALTHNET [149500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|402.29||||402.29|181.03|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|402.29||||402.29|181.03|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|402.29||||402.29|181.03|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FMH BENEFIT SERVICES [1390]|FMH [139000]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FMH BENEFIT SERVICES [1390]|FMH [139000]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MEDICA [2910]|MEDICA QUEST [291001]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MEDICA [2910]|MEDICA QUEST [291001]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MEDICA [2910]|MEDICA QUEST [291001]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|TRUSTMARK [2030]|STARMARK [203000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|TRUSTMARK [2030]|STARMARK [203000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHFIRST [2395]|HEALTHFIRST [239500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHFIRST [2395]|HEALTHFIRST [239500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|IHC HS [168011]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|IHC HS [168011]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|||402.29||||402.29|120.69|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|||402.29||||402.29|120.69|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|WEB TPA [2115]|WEB TPA [211500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|WEB TPA [2115]|WEB TPA [211500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA [1015]|AETNA ACO WILCO [101532]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA [1015]|AETNA ACO WILCO [101532]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|402.29||||402.29|142.13|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|402.29||||402.29|142.13|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|402.29||||402.29|142.13|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|402.29||||402.29|181.03|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|402.29||||402.29|181.03|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA [1015]|AETNA ACO WILCO [101532]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|402.29||||402.29|181.03|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|WEB TPA [2115]|WEB TPA [211500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR [2035]|UMR CORE [203505]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR [2035]|UMR CORE [203505]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR [2035]|UMR CORE [203505]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|TULSA BLUE [115531]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|TULSA BLUE [115531]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA [1260]|CIGNA [126008]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA [1260]|CIGNA [126008]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|402.29||||402.29|233.33|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|402.29||||402.29|233.33|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|402.29||||402.29|233.33|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|||402.29||||402.29|120.69|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|IHC HS [168011]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|402.29||||402.29|172.98|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|402.29||||402.29|172.98|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHFIRST [2395]|HEALTHFIRST [239500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|402.29||||402.29|172.98|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|402.29||||402.29|341.95|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|402.29||||402.29|341.95|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|402.29||||402.29|341.95|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|TRUSTMARK [2030]|STARMARK [203000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CORESOURCE [1315]|CORESOURCE [131501]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CORESOURCE [1315]|CORESOURCE [131501]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CORESOURCE [1315]|CORESOURCE [131501]|402.29||||402.29|195.51|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FMH BENEFIT SERVICES [1390]|FMH [139000]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|BENVEO/UCS [137512]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|BENVEO/UCS [137512]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|BENVEO/UCS [137512]|402.29||||402.29|246.6|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|402.29||||402.29|301.72|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GILSBAR [1425]|GILSBAR [142500]|402.29||||402.29|321.83|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|402.29||||402.29|221.26|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|402.29||||402.29|221.26|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|402.29||||402.29|221.26|341.95|120.69 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA [1260]|CIGNA [126008]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|TULSA BLUE [115531]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CHAMPVA [1240]|CHAMP VA [124000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CHAMPVA [1240]|CHAMP VA [124000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CHAMPVA [1240]|CHAMP VA [124000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GEHA [1415]|GEHA - ASA [141503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GEHA [1415]|GEHA - ASA [141503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GEHA [1415]|GEHA - ASA [141503]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|402.29||||402.29||| 10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|402.29||||402.29||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHNET [1495]|HEALTHNET [149500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|285.94||||285.94|128.67|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FMH BENEFIT SERVICES [1390]|FMH [139000]|285.94||||285.94|214.45|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MEDICA [2910]|MEDICA QUEST [291001]|285.94||||285.94|175.28|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|TRUSTMARK [2030]|STARMARK [203000]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|IHC HS [168011]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|285.94||||285.94|175.28|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|||285.94||||285.94|85.78|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|WEB TPA [2115]|WEB TPA [211500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|285.94||||285.94|214.45|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|285.94||||285.94|128.67|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|285.94||||285.94|101.02|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|285.94||||285.94|214.45|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|285.94||||285.94|165.84|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|285.94||||285.94|214.45|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|285.94||||285.94|122.95|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|285.94||||285.94|243.05|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|285.94||||285.94|175.28|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GILSBAR [1425]|GILSBAR [142500]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|285.94||||285.94|228.75|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|285.94||||285.94|214.45|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|285.94||||285.94|157.27|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|285.94||||285.94|128.67|243.05|85.78 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA [1260]|CIGNA [126008]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA [1015]|AETNA ACO WILCO [101532]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|TULSA BLUE [115531]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CORESOURCE [1315]|CORESOURCE [131501]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UMR CORE [203505]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CHAMPVA [1240]|CHAMP VA [124000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GEHA [1415]|GEHA - ASA [141503]|285.94||||285.94||| 10017|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|285.94||||285.94||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GILSBAR [1425]|GILSBAR [142500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHNET [1495]|HEALTHNET [149500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|285.94||||285.94|128.67|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FMH BENEFIT SERVICES [1390]|FMH [139000]|285.94||||285.94|214.45|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|TRUSTMARK [2030]|STARMARK [203000]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|285.94||||285.94|214.45|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|IHC HS [168011]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|||285.94||||285.94|85.78|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|WEB TPA [2115]|WEB TPA [211500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|285.94||||285.94|214.45|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|285.94||||285.94|128.67|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|285.94||||285.94|101.02|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|285.94||||285.94|214.45|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|285.94||||285.94|165.84|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|285.94||||285.94|175.28|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|285.94||||285.94|122.95|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|285.94||||285.94|243.05|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MEDICA [2910]|MEDICA QUEST [291001]|285.94||||285.94|175.28|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|285.94||||285.94|175.28|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|285.94||||285.94|228.75|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|285.94||||285.94|214.45|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|285.94||||285.94|157.27|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|285.94||||285.94|128.67|243.05|85.78 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA [1260]|CIGNA [126008]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA [1015]|AETNA ACO WILCO [101532]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|TULSA BLUE [115531]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CORESOURCE [1315]|CORESOURCE [131501]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UMR CORE [203505]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CHAMPVA [1240]|CHAMP VA [124000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GEHA [1415]|GEHA - ASA [141503]|285.94||||285.94||| 10018|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L14 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|285.94||||285.94||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100185|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD47 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100188|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD48 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100192|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD49 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100196|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 50MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHNET [1495]|HEALTHNET [149500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|285.94||||285.94|128.67|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FMH BENEFIT SERVICES [1390]|FMH [139000]|285.94||||285.94|214.45|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|TRUSTMARK [2030]|STARMARK [203000]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|IHC HS [168011]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|||285.94||||285.94|85.78|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|WEB TPA [2115]|WEB TPA [211500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|285.94||||285.94|128.67|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|285.94||||285.94|101.02|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|285.94||||285.94|214.45|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|285.94||||285.94|214.45|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|285.94||||285.94|175.28|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|285.94||||285.94|165.84|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|285.94||||285.94|214.45|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|285.94||||285.94|122.95|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|285.94||||285.94|243.05|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MEDICA [2910]|MEDICA QUEST [291001]|285.94||||285.94|175.28|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|285.94||||285.94|175.28|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GILSBAR [1425]|GILSBAR [142500]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|285.94||||285.94|228.75|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|285.94||||285.94|214.45|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|285.94||||285.94|157.27|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|285.94||||285.94|128.67|243.05|85.78 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA [1260]|CIGNA [126008]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA [1015]|AETNA ACO WILCO [101532]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|TULSA BLUE [115531]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CORESOURCE [1315]|CORESOURCE [131501]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UMR CORE [203505]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CHAMPVA [1240]|CHAMP VA [124000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GEHA [1415]|GEHA - ASA [141503]|285.94||||285.94||| 10020|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L18 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|285.94||||285.94||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100200|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD51 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100204|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD52 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100208|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD53 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|285.94||||285.94|175.28|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHNET [1495]|HEALTHNET [149500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|WEB TPA [2115]|WEB TPA [211500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|TRUSTMARK [2030]|STARMARK [203000]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|285.94||||285.94|128.67|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MEDICA [2910]|MEDICA QUEST [291001]|285.94||||285.94|175.28|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GILSBAR [1425]|GILSBAR [142500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FMH BENEFIT SERVICES [1390]|FMH [139000]|285.94||||285.94|214.45|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|285.94||||285.94|101.02|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|285.94||||285.94|128.67|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|285.94||||285.94|214.45|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|||285.94||||285.94|85.78|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|285.94||||285.94|175.28|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MULTIPLAN [1680]|IHC HS [168011]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|285.94||||285.94|122.95|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|285.94||||285.94|243.05|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|285.94||||285.94|214.45|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|285.94||||285.94|128.67|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|285.94||||285.94|214.45|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|285.94||||285.94|228.75|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|285.94||||285.94|157.27|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|285.94||||285.94|214.45|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|285.94||||285.94|165.84|243.05|85.78 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UMR CORE [203505]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA [1260]|CIGNA [126008]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA [1015]|AETNA ACO WILCO [101532]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|TULSA BLUE [115531]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GEHA [1415]|GEHA - ASA [141503]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CHAMPVA [1240]|CHAMP VA [124000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|CORESOURCE [1315]|CORESOURCE [131501]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|285.94||||285.94||| 10021|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L22 MM OD2.7 MM ODSEC5 MM CORTEX SELF TAP SPHERICAL HEAD SMALL HEXAGONAL SOCKET NONSTERILE MODULAR MINI FRAGMENT SET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|285.94||||285.94||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100212|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 54MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|||1612.00||||1612.00|483.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100216|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD55 MM ID28 MM HIP|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|285.94||||285.94|214.45|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|285.94||||285.94|157.27|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|285.94||||285.94|128.67|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|285.94||||285.94|122.95|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|285.94||||285.94|243.05|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|285.94||||285.94|101.02|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|285.94||||285.94|214.45|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|285.94||||285.94|165.84|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|285.94||||285.94|128.67|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|WEB TPA [2115]|WEB TPA [211500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|||285.94||||285.94|85.78|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|285.94||||285.94|175.28|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|285.94||||285.94|214.45|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|285.94||||285.94|175.28|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GILSBAR [1425]|GILSBAR [142500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|285.94||||285.94|214.45|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|285.94||||285.94|214.45|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|285.94||||285.94|175.28|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|285.94||||285.94|128.67|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|285.94||||285.94|228.75|243.05|85.78 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GEHA [1415]|GEHA - ASA [141503]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|CIGNA [1260]|CIGNA [126008]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BCBS [1155]|TULSA BLUE [115531]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UMR [2035]|UMR CORE [203505]|285.94||||285.94||| 10022|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L24 MM OD2.7 MM CORTEX SELF TAP NONSTERILE SMALL FRAGMENT LCP SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|285.94||||285.94||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|693.16|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1209|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|934.96|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1209|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|988.16|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1209|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|988.16|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1209|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|988.16|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|||1612.00||||1612.00|483.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1209|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|569.52|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1289.6|1370.2|483.6 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00||| 100220|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 56MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|158.19||||158.19|87|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|158.19||||158.19|71.18|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|158.19||||158.19|134.46|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|158.19||||158.19|118.64|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|158.19||||158.19|68.02|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|158.19||||158.19|118.64|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|158.19||||158.19|55.89|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|158.19||||158.19|71.18|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|158.19||||158.19|118.64|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|WEB TPA [2115]|WEB TPA [211500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GILSBAR [1425]|GILSBAR [142500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|158.19||||158.19|96.97|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|158.19||||158.19|118.64|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|||158.19||||158.19|47.46|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|158.19||||158.19|71.18|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MEDICA [2910]|MEDICA QUEST [291001]|158.19||||158.19|96.97|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|TRUSTMARK [2030]|STARMARK [203000]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|158.19||||158.19|96.97|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHNET [1495]|HEALTHNET [149500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|158.19||||158.19|91.75|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|158.19||||158.19|118.64|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MULTIPLAN [1680]|IHC HS [168011]|158.19||||158.19|126.55|134.46|47.46 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GEHA [1415]|GEHA - ASA [141503]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|CHAMPVA [1240]|CHAMP VA [124000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|CORESOURCE [1315]|CORESOURCE [131501]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BCBS [1155]|TULSA BLUE [115531]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UMR [2035]|UMR CORE [203505]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|CIGNA [1260]|CIGNA [126008]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|AETNA [1015]|AETNA ACO WILCO [101532]|158.19||||158.19||| 10026|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD3.5 MM CORTEX SELF TAP SMALL HEXAGONAL NONSTERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|158.19||||158.19||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|129.27||||129.27|74.98|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|129.27||||129.27|96.95|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|TRUSTMARK [2030]|STARMARK [203000]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|129.27||||129.27|62.83|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MEDICA [2910]|MEDICA QUEST [291001]|129.27||||129.27|79.24|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|FMH BENEFIT SERVICES [1390]|FMH [139000]|129.27||||129.27|96.95|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|129.27||||129.27|58.17|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|129.27||||129.27|79.24|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GILSBAR [1425]|GILSBAR [142500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MULTIPLAN [1680]|IHC HS [168011]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|129.27||||129.27|96.95|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHFIRST [2395]|HEALTHFIRST [239500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|||129.27||||129.27|38.78|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHNET [1495]|HEALTHNET [149500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|129.27||||129.27|55.59|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|WEB TPA [2115]|WEB TPA [211500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|129.27||||129.27|62.83|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|129.27||||129.27|109.88|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|129.27||||129.27|58.17|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|129.27||||129.27|45.67|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|CORESOURCE [1315]|CORESOURCE [131501]|129.27||||129.27|62.83|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|129.27||||129.27|96.95|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|FIRST HEALTH [1375]|BENVEO/UCS [137512]|129.27||||129.27|79.24|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|129.27||||129.27|71.1|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|129.27||||129.27|103.42|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|AETNA [1015]|AETNA ACO WILCO [101532]|129.27||||129.27|62.83|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|129.27||||129.27|96.95|109.88|38.78 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|CIGNA [1260]|CIGNA [126008]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UMR [2035]|UMR CORE [203505]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BCBS [1155]|TULSA BLUE [115531]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|CHAMPVA [1240]|CHAMP VA [124000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|GEHA [1415]|GEHA - ASA [141503]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|129.27||||129.27||| 100264|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|DEVICE SUTURE STRATAFIX PDO 2-0 SH SPIRAL L14 CM ABSORBABLE KNOTLESS TISSUE CONTROL 2 ARM DYED|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|129.27||||129.27||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|158.19||||158.19|134.46|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|FIRST HEALTH [1375]|BENVEO/UCS [137512]|158.19||||158.19|96.97|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|158.19||||158.19|87|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|158.19||||158.19|118.64|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|158.19||||158.19|71.18|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|158.19||||158.19|68.02|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|158.19||||158.19|71.18|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|158.19||||158.19|118.64|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|WEB TPA [2115]|WEB TPA [211500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MULTIPLAN [1680]|IHC HS [168011]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|158.19||||158.19|96.97|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|158.19||||158.19|118.64|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|FMH BENEFIT SERVICES [1390]|FMH [139000]|158.19||||158.19|118.64|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHNET [1495]|HEALTHNET [149500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|158.19||||158.19|71.18|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GILSBAR [1425]|GILSBAR [142500]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|158.19||||158.19|55.89|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|||158.19||||158.19|47.46|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MEDICA [2910]|MEDICA QUEST [291001]|158.19||||158.19|96.97|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|158.19||||158.19|91.75|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|TRUSTMARK [2030]|STARMARK [203000]|158.19||||158.19|126.55|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|158.19||||158.19|118.64|134.46|47.46 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|CHAMPVA [1240]|CHAMP VA [124000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|CORESOURCE [1315]|CORESOURCE [131501]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GEHA [1415]|GEHA - ASA [141503]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|AETNA [1015]|AETNA ACO WILCO [101532]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|CIGNA [1260]|CIGNA [126008]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UMR [2035]|UMR CORE [203505]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BCBS [1155]|TULSA BLUE [115531]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|158.19||||158.19||| 10027|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL 2.5 MM FULL THREAD L12 MM OD3.5 MM ODSEC6 MM CORTEX SELF TAP LOW PROFILE HEAD SMALL HEXAGONAL SOCKET NONSTERILE SMALL FRAGMENT SET|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|158.19||||158.19||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHNET [1495]|HEALTHNET [149500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GILSBAR [1425]|GILSBAR [142500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|617.50||||617.50|277.88|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MEDICA [2910]|MEDICA QUEST [291001]|617.50||||617.50|378.53|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|617.50||||617.50|463.13|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|TRUSTMARK [2030]|STARMARK [203000]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MULTIPLAN [1680]|IHC HS [168011]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|617.50||||617.50|378.53|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|||617.50||||617.50|185.25|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|WEB TPA [2115]|WEB TPA [211500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|617.50||||617.50|463.13|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|617.50||||617.50|277.88|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|617.50||||617.50|265.53|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|617.50||||617.50|463.13|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|617.50||||617.50|524.88|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|617.50||||617.50|463.13|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|617.50||||617.50|494|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|617.50||||617.50|463.13|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|617.50||||617.50|277.88|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|617.50||||617.50|358.15|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|617.50||||617.50|218.16|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|617.50||||617.50|339.63|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|617.50||||617.50|378.53|524.88|185.25 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UMR [2035]|UMR CORE [203505]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UMR [2035]|UNITED MEDICAL RESOURCES [203503]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|CIGNA [1260]|CIGNA [126008]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|AETNA [1015]|AETNA ACO WILCO [101532]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BCBS [1155]|TULSA BLUE [115531]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|CORESOURCE [1315]|CORESOURCE [131501]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|CHAMPVA [1240]|CHAMP VA [124000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA NNJ PRIME HMO [102003]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GEHA [1415]|GEHA - ASA [141503]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|617.50||||617.50||| 100271|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE REUNION L24 MM OD6.5 MM CENTER STERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|617.50||||617.50||| 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|4829.56||||4829.56|2173.3|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|4829.56||||4829.56|2656.26|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|4829.56||||4829.56|3622.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|4829.56||||4829.56|2173.3|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|4829.56||||4829.56|3622.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|CORESOURCE [1315]|CORESOURCE [131501]|4829.56||||4829.56|1851.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|FIRST HEALTH [1375]|BENVEO/UCS [137512]|4829.56||||4829.56|2960.52|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|4829.56||||4829.56|4105.13|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|4829.56||||4829.56|2076.71|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|4829.56||||4829.56|1851.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|4829.56||||4829.56|2801.15|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MULTIPLAN [1680]|IHC HS [168011]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|WEB TPA [2115]|WEB TPA [211500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|GILSBAR [1425]|GILSBAR [142500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|||4829.56||||4829.56|1448.87|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|4829.56||||4829.56|2960.52|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|4829.56||||4829.56|1706.28|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|FMH BENEFIT SERVICES [1390]|FMH [139000]|4829.56||||4829.56|3622.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|HEALTHFIRST [2395]|HEALTHFIRST [239500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MEDICA [2910]|MEDICA QUEST [291001]|4829.56||||4829.56|2960.52|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|4829.56||||4829.56|3622.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|4829.56||||4829.56|1851.17|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID THK2 MM CONCENTRIC OD32 MM SHOULDER|TRUSTMARK [2030]|STARMARK [203000]|4829.56||||4829.56|3863.65|4105.13|1448.87 100272|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SPHERE GLENOID