"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|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|3769.86||||3769.86|3242.08|3242.08|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|1198.06|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|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|3242.08|3242.08|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|2752|3242.08|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|2243.07|3242.08|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|3242.08|1130.96
100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|<Self-pay>|<Self-pay>|3769.86||||3769.86|1130.96|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|2243.07|3242.08|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|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|1538.1|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|2752|3242.08|1130.96
100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|CIGNA [1260]|CIGNA [126008]|3769.86||||3769.86|1583.34|3242.08|1130.96
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|3242.08|1130.96
100000|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|AXLE FEMORAL KNEE MODULAR ROTATE HINGE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|3769.86||||3769.86|2638.9|3242.08|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|1583.34|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|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|2752|3242.08|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|1884.93|3242.08|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|2243.07|3242.08|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|3242.08|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|2752|3242.08|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|3242.08|3242.08|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|3242.08|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|3242.08|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|3242.08|3242.08|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|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|3242.08|3242.08|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|2752|3242.08|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|3242.08|3242.08|1130.96
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|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|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|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|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|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|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|BCBS [1155]|TULSA BLUE [115531]|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|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|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|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|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|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|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|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|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|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|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 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|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|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|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|GEHA [1415]|GEHA - ASA [141503]|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10001|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L10 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP CRUCIFORM LOW PROFILE HEAD NONSTERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|15.13||||15.13|4.81|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|15.13||||15.13|8.32|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|15.13||||15.13|7.56|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|15.13||||15.13|10.59|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|15.13||||15.13|11.04|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHNET [1495]|HEALTHNET [149500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|15.13||||15.13|11.04|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|15.13||||15.13|12.86|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|15.13||||15.13|6.81|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|15.13||||15.13|6.17|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MULTIPLAN [1680]|IHC HS [168011]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|TRUSTMARK [2030]|STARMARK [203000]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|15.13||||15.13|11.04|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|15.13||||15.13|9|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|<Self-pay>|<Self-pay>|15.13||||15.13|4.54|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|15.13||||15.13|6.81|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GILSBAR [1425]|GILSBAR [142500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|15.13||||15.13|6.81|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MEDICA [2910]|MEDICA QUEST [291001]|15.13||||15.13|9|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|15.13||||15.13|9|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|15.13||||15.13|11.04|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|WEB TPA [2115]|WEB TPA [211500]|15.13||||15.13|13.01|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|15.13||||15.13|11.04|13.01|4.54
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CORESOURCE [1315]|CORESOURCE [131501]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|TULSA BLUE [115531]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AETNA [1015]|AETNA ACO WILCO [101532]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UMR [2035]|UMR CORE [203505]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CHAMPVA [1240]|CHAMP VA [124000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CIGNA [1260]|CIGNA [126008]|15.13||||15.13|||
100012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L6 IN OD.062 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GEHA [1415]|GEHA - ASA [141503]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|15.13||||15.13|11.04|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MULTIPLAN [1680]|IHC HS [168011]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|15.13||||15.13|7.56|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHNET [1495]|HEALTHNET [149500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|15.13||||15.13|4.81|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|15.13||||15.13|11.04|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|15.13||||15.13|10.59|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|15.13||||15.13|8.32|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GILSBAR [1425]|GILSBAR [142500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MEDICA [2910]|MEDICA QUEST [291001]|15.13||||15.13|9|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|15.13||||15.13|6.81|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|WEB TPA [2115]|WEB TPA [211500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|TRUSTMARK [2030]|STARMARK [203000]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|15.13||||15.13|11.04|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|15.13||||15.13|11.04|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|15.13||||15.13|6.17|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|15.13||||15.13|9|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|15.13||||15.13|9|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|15.13||||15.13|6.81|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|15.13||||15.13|6.81|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|15.13||||15.13|11.04|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|15.13||||15.13|13.01|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|15.13||||15.13|12.86|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|<Self-pay>|<Self-pay>|15.13||||15.13|4.54|13.01|4.54
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CIGNA [1260]|CIGNA [126008]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AETNA [1015]|AETNA ACO WILCO [101532]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CHAMPVA [1240]|CHAMP VA [124000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|BCBS [1155]|TULSA BLUE [115531]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GEHA [1415]|GEHA - ASA [141503]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|UMR [2035]|UMR CORE [203505]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|CORESOURCE [1315]|CORESOURCE [131501]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|15.13||||15.13|||
100014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.054 IN 1 END TROCAR POINT SMOOTH PLAIN NONSTERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|15.13||||15.13|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10002|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW CORTICAL 1.5 X 11MM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|5631.55||||5631.55|3942.09|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|AETNA [1015]|AETNA ACO WILCO [101532]|5631.55||||5631.55|2158.57|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|5631.55||||5631.55|2158.57|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|CIGNA [1260]|CIGNA [126008]|5631.55||||5631.55|2365.25|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MULTIPLAN [1680]|IHC HS [168011]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|WEB TPA [2115]|WEB TPA [211500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|5631.55||||5631.55|3350.77|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|5631.55||||5631.55|4111.03|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GILSBAR [1425]|GILSBAR [142500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|5631.55||||5631.55|2365.25|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|5631.55||||5631.55|4111.03|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MEDICA [2910]|MEDICA QUEST [291001]|5631.55||||5631.55|3350.77|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|TRUSTMARK [2030]|STARMARK [203000]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|5631.55||||5631.55|3350.77|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|5631.55||||5631.55|2534.2|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|5631.55||||5631.55|4111.03|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHNET [1495]|HEALTHNET [149500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|5631.55||||5631.55|2815.78|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|5631.55||||5631.55|2534.2|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|5631.55||||5631.55|4786.82|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|5631.55||||5631.55|4111.03|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|FMH BENEFIT SERVICES [1390]|FMH [139000]|5631.55||||5631.55|4111.03|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|5631.55||||5631.55|1789.71|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|5631.55||||5631.55|3097.35|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|CORESOURCE [1315]|CORESOURCE [131501]|5631.55||||5631.55|2158.57|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|5631.55||||5631.55|2534.2|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|<Self-pay>|<Self-pay>|5631.55||||5631.55|1689.46|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|5631.55||||5631.55|2158.57|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|5631.55||||5631.55|2297.67|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|5631.55||||5631.55|4843.13|4843.13|1689.46
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GEHA [1415]|GEHA - ASA [141503]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BCBS [1155]|TULSA BLUE [115531]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|UMR [2035]|UMR CORE [203505]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|CHAMPVA [1240]|CHAMP VA [124000]|5631.55||||5631.55|||
100023|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL OMNIFIT EON COCR 127 D 8 46 MM OFFSET L135 MM OD11.3 MM HIP CEMENT CONDYLAR STABILIZE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|5631.55||||5631.55|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10003|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|191.96|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 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|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|359.4|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|440.94|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|246.45|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|359.4|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|440.94|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|440.94|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|440.94|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|519.47|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|440.94|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|302.02|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|359.4|519.47|181.21
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR [2035]|UMR CORE [203505]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03|||
100038|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L15 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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|519.47|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|519.47|519.47|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|302.02|519.47|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|519.47|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|440.94|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|181.21
100039|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L20 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|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|519.47|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|246.45|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|181.21
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|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|191.96|519.47|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|359.4|519.47|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|519.47|181.21
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|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|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|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|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|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|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|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 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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|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 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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10004|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
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|519.47|519.47|181.21
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|519.47|181.21
100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|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|519.47|519.47|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|246.45|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|302.02|519.47|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|519.47|519.47|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|191.96|519.47|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|519.47|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|519.47|519.47|181.21
100040|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L25 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|359.4|519.47|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|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|181.21
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|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|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|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|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|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|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|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|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|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|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|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|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|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 [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|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|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|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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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 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]|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|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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|246.45|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|359.4|519.47|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 SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|519.47|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|191.96|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|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|302.02|519.47|181.21
100041|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L30 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|181.21
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|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|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|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 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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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 [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|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|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 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|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|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|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|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|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|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|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|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|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|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|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|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|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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|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|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|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|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|TRUSTMARK [2030]|STARMARK [203000]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|604.03||||604.03|440.94|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|BENVEO/UCS [137512]|604.03||||604.03|359.4|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHFIRST [2395]|HEALTHFIRST [239500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|604.03||||604.03|440.94|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|WEB TPA [2115]|WEB TPA [211500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MEDICA [2910]|MEDICA QUEST [291001]|604.03||||604.03|359.4|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|604.03||||604.03|440.94|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GILSBAR [1425]|GILSBAR [142500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|604.03||||604.03|191.96|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|FMH BENEFIT SERVICES [1390]|FMH [139000]|604.03||||604.03|440.94|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|604.03||||604.03|440.94|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|604.03||||604.03|271.81|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|604.03||||604.03|271.81|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHNET [1495]|HEALTHNET [149500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|604.03||||604.03|302.02|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|IHC HS [168011]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|604.03||||604.03|359.4|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 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|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|604.03||||604.03|513.43|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|604.03||||604.03|246.45|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|604.03||||604.03|519.47|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|604.03||||604.03|332.22|519.47|181.21
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA [1015]|AETNA ACO WILCO [101532]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GEHA [1415]|GEHA - ASA [141503]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CIGNA [1260]|CIGNA [126008]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CORESOURCE [1315]|CORESOURCE [131501]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|CHAMPVA [1240]|CHAMP VA [124000]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|TULSA BLUE [115531]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|604.03||||604.03|||
100042|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L35 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|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|604.03||||604.03|519.47|519.47|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|519.47|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|191.96|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|359.4|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|246.45|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|181.21
100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|181.21
100043|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L40 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|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|302.02|519.47|181.21
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|519.47|519.47|181.21
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|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|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 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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|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|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|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|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|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|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|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|604.03||||604.03|519.47|519.47|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|191.96|519.47|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|302.02|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|440.94|519.47|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|519.47|519.47|181.21
100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|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|246.45|519.47|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|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|181.21
100044|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L45 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|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|519.47|181.21
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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|181.21
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|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|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|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|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|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|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|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|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|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|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]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|604.03||||604.03|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|181.21
100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|181.21
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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|359.4|519.47|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|359.4|519.47|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|519.47|519.47|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|519.47|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|246.45|519.47|181.21
100045|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L50 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|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|519.47|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|519.47|519.47|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|191.96|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|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|302.02|519.47|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|519.47|181.21
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|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|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|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|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|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|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|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|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 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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|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|||
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|359.4|519.47|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|519.47|519.47|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|519.47|519.47|181.21
100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|<Self-pay>|<Self-pay>|604.03||||604.03|181.21|519.47|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|519.47|519.47|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|191.96|519.47|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|519.47|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|519.47|519.47|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|302.02|519.47|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|440.94|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|181.21
100046|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE TORX L55 MM OD6.5 MM ACETABULAR CANCELLOUS TRITANIUM MULTIHOLE SHELL|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|604.03||||604.03|422.82|519.47|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|519.47|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|519.47|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|359.4|519.47|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|519.47|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|519.47|519.47|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|246.45|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|440.94|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|440.94|519.47|181.21
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|359.4|519.47|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|519.47|519.47|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|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|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|519.47|519.47|181.21
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 MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|UMR [2035]|UMR CORE [203505]|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|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|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|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|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|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|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|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|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 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|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|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|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|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|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|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|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|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|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|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|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|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|3320.00||||3320.00|2855.2|2855.2|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|2855.2|2855.2|996
100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|3320.00||||3320.00|2324|2855.2|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|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|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|1975.4|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2423.6|2855.2|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|1975.4|2855.2|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|2855.2|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|2855.2|2855.2|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|2855.2|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|2855.2|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|2423.6|2855.2|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|2423.6|2855.2|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|1660|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|996
100048|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|STEM FEMORAL 12MM PRESS FIT ECHO PF TITANIUM STANDARD OFFSET HIP STERILE|<Self-pay>|<Self-pay>|3320.00||||3320.00|996|2855.2|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|2855.2|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|2855.2|2855.2|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|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|1354.56|2855.2|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|2423.6|2855.2|996
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|1394.4|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2423.6|2855.2|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|2855.2|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|2855.2|2855.2|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|1975.4|2855.2|996
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|2855.2|2855.2|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|2855.2|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|2855.2|2855.2|996
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|1394.4|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|2855.2|2855.2|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|1055.1|2855.2|996
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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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 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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|3320.00||||3320.00|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10005|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
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|9900.76|9900.76|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|9900.76|9900.76|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|3658.68|9900.76|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|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|9900.76|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|6849.95|9900.76|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|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|11512.52||||11512.52|8058.76|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|CIGNA [1260]|CIGNA [126008]|11512.52||||11512.52|4835.26|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|8404.14|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|8404.14|9900.76|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|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|11512.52||||11512.52|4835.26|9900.76|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|9900.76|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|6849.95|9900.76|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|4697.11|9900.76|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|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|6849.95|9900.76|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|9900.76|9900.76|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|9900.76|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|9900.76|9900.76|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|9900.76|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|9900.76|9900.76|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|<Self-pay>|<Self-pay>|11512.52||||11512.52|3453.76|9900.76|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|9900.76|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 AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|11512.52||||11512.52|4412.75|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|9900.76|9900.76|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|8404.14|9900.76|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|8404.14|9900.76|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|9900.76|9900.76|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|8404.14|9900.76|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|5756.26|9900.76|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|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|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|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|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|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|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|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 MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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]|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|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|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|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|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|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|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|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|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|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|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|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|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|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|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7121.40||||7121.40|6124.4|6124.4|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|2263.18|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|2136.42
100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|<Self-pay>|<Self-pay>|7121.40||||7121.40|2136.42|6124.4|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|6124.4|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|6124.4|6124.4|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|3560.7|6124.4|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|6124.4|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|6124.4|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|4237.23|6124.4|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|5198.62|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|5198.62|6124.4|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|5198.62|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|2136.42
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|6124.4|6124.4|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|5198.62|6124.4|2136.42
100053|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|GRAFT BONE BIO DBM GEL DEMINERALIZED BONE MATRIX 10 CC ALLOGRAFT SYRINGE CONTAINER|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|7121.40||||7121.40|4984.98|6124.4|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|2905.53|6124.4|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|6124.4|6124.4|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|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|5198.62|6124.4|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|4237.23|6124.4|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|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|4237.23|6124.4|2136.42
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|2990.99|6124.4|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|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|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|6124.4|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|6124.4|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|6124.4|6124.4|2136.42
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|2990.99|6124.4|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|6124.4|6124.4|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|6124.4|6124.4|2136.42
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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|7121.40||||7121.40|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10006|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
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|396.16|396.16|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|146.39|396.16|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|396.16|396.16|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|396.16|396.16|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|396.16|396.16|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|336.27|396.16|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|396.16|396.16|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|396.16|396.16|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|396.16|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|227.56|396.16|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|396.16|396.16|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|396.16|396.16|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|274.09|396.16|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|396.16|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|396.16|396.16|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|396.16|396.16|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|396.16|138.19
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|336.27|396.16|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|336.27|396.16|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|230.33|396.16|138.19
100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|460.65||||460.65|322.46|396.16|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|396.16|396.16|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|187.95|396.16|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|396.16|396.16|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|396.16|396.16|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|396.16|396.16|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|336.27|396.16|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|396.16|396.16|138.19
100069|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|WIRE FIXATION GORILLA OLIVE OD1.4 MM SMOOTH|<Self-pay>|<Self-pay>|460.65||||460.65|138.19|396.16|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|227.56|396.16|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|274.09|396.16|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|396.16|396.16|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|227.56|396.16|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|274.09|396.16|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|396.16|396.16|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|396.16|396.16|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|396.16|396.16|138.19
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|257.5|396.16|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|396.16|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|396.16|396.16|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|396.16|396.16|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|336.27|396.16|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|227.56|396.16|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|396.16|396.16|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|396.16|396.16|138.19
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|257.5|396.16|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|396.16|396.16|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|396.16|396.16|138.19
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|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|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|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|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|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|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|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|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|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|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 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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|GEHA [1415]|GEHA - ASA [141503]|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|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|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|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|UMR [2035]|UMR CORE [203505]|460.65||||460.65|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10007|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L7 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|40.25||||40.25|28.18|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|40.25||||40.25|20.13|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|FMH BENEFIT SERVICES [1390]|FMH [139000]|40.25||||40.25|29.38|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|40.25||||40.25|29.38|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHNET [1495]|HEALTHNET [149500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|40.25||||40.25|18.11|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|40.25||||40.25|18.11|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|40.25||||40.25|23.95|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|40.25||||40.25|34.21|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|40.25||||40.25|16.42|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|40.25||||40.25|29.38|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|TRUSTMARK [2030]|STARMARK [203000]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|40.25||||40.25|29.38|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MULTIPLAN [1680]|IHC HS [168011]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MEDICA [2910]|MEDICA QUEST [291001]|40.25||||40.25|23.95|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|<Self-pay>|<Self-pay>|40.25||||40.25|12.07|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|40.25||||40.25|23.95|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|40.25||||40.25|18.11|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|40.25||||40.25|22.14|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|40.25||||40.25|29.38|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GILSBAR [1425]|GILSBAR [142500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|WEB TPA [2115]|WEB TPA [211500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|40.25||||40.25|34.62|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|40.25||||40.25|12.79|34.62|12.07
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|CORESOURCE [1315]|CORESOURCE [131501]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|CHAMPVA [1240]|CHAMP VA [124000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BCBS [1155]|TULSA BLUE [115531]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UMR [2035]|UMR CORE [203505]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|CIGNA [1260]|CIGNA [126008]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GEHA [1415]|GEHA - ASA [141503]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|AETNA [1015]|AETNA ACO WILCO [101532]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|40.25||||40.25|||
100074|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|WIRE FIXATION KIRSCHNER STAINLESS STEEL L9 IN OD.062 IN 2 END TROCAR POINT THREAD NONSTERILE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|40.25||||40.25|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10008|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|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|27.62|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|86.90||||86.90|60.83|243.86|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|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|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|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|86.90||||86.90|43.45|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FMH BENEFIT SERVICES [1390]|FMH [139000]|86.90||||86.90|63.44|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|86.90||||86.90|63.44|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|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|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|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|42.93|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|<Self-pay>|<Self-pay>|86.90||||86.90|26.07|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|86.90||||86.90|74.73|243.86|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|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|86.90||||86.90|51.71|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MULTIPLAN [1680]|IHC HS [168011]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|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|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|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|35.46|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|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|63.44|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|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|63.44|243.86|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|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|TRUSTMARK [2030]|STARMARK [203000]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CIGNA [1260]|CIGNA [126008]|86.90||||86.90|48.58|243.86|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|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|WEB TPA [2115]|WEB TPA [211500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CORESOURCE [1315]|CORESOURCE [131501]|86.90||||86.90|42.93|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|86.90||||86.90|63.44|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MEDICA [2910]|MEDICA QUEST [291001]|86.90||||86.90|51.71|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|86.90||||86.90|42.93|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CHAMPVA [1240]|CHAMP VA [124000]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
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 CHEROKEE MLR OF OKLAHOMA [115509]|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 ADVANTAGE OF ARKANSAS [115536]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|UMR [2035]|UMR CORE [203505]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
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|GEHA [1415]|GEHA - ASA [141503]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
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|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
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|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
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|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
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|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHNET [1495]|HEALTHNET [149500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FIRST HEALTH [1375]|BENVEO/UCS [137512]|86.90||||86.90|51.71|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|86.90||||86.90|74.73|243.86|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|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|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|74.73|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHFIRST [2395]|HEALTHFIRST [239500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|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|74.73|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AETNA [1015]|AETNA ACO WILCO [101532]|86.90||||86.90|42.93|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GILSBAR [1425]|GILSBAR [142500]|86.90||||86.90|74.73|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|86.90||||86.90|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|26.07
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|86.90||||86.90|48.58|243.86|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|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|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|74.73|243.86|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|74.73|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|26.07
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10009|ERX|0250 - PHARMACY-GENERAL|FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
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|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|86.90||||86.90|||
10009|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L9 MM OD1.5 MM ODSEC3 MM CORTEX SELF TAP LOW PROFILE HEAD CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10010|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L12 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
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|624.58|624.58|217.87
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|624.58|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|230.8|624.58|217.87
100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|726.25||||726.25|508.38|624.58|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|624.58|624.58|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|624.58|624.58|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|363.13|624.58|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|624.58|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|530.16|624.58|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|530.16|624.58|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|624.58|624.58|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|624.58|624.58|217.87
100106|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BIT DRILL STRAIGHT OD5 MM CANNULATED DISPOSABLE 7 MM SCREW|<Self-pay>|<Self-pay>|726.25||||726.25|217.87|624.58|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|624.58|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|624.58|624.58|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|358.77|624.58|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|624.58|624.58|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|624.58|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|624.58|624.58|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|296.31|624.58|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|530.16|624.58|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|624.58|624.58|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|624.58|624.58|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|530.16|624.58|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|432.12|624.58|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|624.58|624.58|217.87
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|405.97|624.58|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|624.58|624.58|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|624.58|624.58|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|624.58|624.58|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|624.58|624.58|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|358.77|624.58|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|624.58|624.58|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|624.58|624.58|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|530.16|624.58|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|432.12|624.58|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|358.77|624.58|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|624.58|624.58|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|624.58|624.58|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|624.58|624.58|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|432.12|624.58|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|624.58|624.58|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|624.58|624.58|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|358.77|624.58|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|624.58|624.58|217.87
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|405.97|624.58|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|624.58|624.58|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|624.58|624.58|217.87
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|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|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|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|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|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|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|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|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|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|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]|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|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|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 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|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|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|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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|726.25||||726.25|||
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|67.08|67.08|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|67.08|67.08|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|67.08|67.08|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|24.79|67.08|23.4
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|67.08|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|67.08|67.08|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|67.08|67.08|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|67.08|67.08|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|43.6|67.08|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|67.08|67.08|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|38.53|67.08|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|67.08|67.08|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|67.08|67.08|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|46.41|67.08|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|67.08|67.08|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|38.53|67.08|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|46.41|67.08|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|67.08|67.08|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|56.94|67.08|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|67.08|67.08|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|67.08|67.08|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|67.08|67.08|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|43.6|67.08|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|67.08|67.08|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|56.94|67.08|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|67.08|67.08|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|56.94|67.08|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|67.08|67.08|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|67.08|67.08|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|31.82|67.08|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|67.08|67.08|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|67.08|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|46.41|67.08|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|67.08|67.08|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|38.53|67.08|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|67.08|67.08|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|67.08|67.08|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|67.08|23.4
100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|78.00||||78.00|54.6|67.08|23.4
100109|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|GUIDEWIRE ORTHOPEDIC OD.094 IN TROCAR TIP DISPOSABLE 7 MM SCREW|<Self-pay>|<Self-pay>|78.00||||78.00|23.4|67.08|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|67.08|67.08|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|38.53|67.08|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|67.08|67.08|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|56.94|67.08|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|67.08|67.08|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|56.94|67.08|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|67.08|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|39|67.08|23.4
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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|UMR [2035]|UMR CORE [203505]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|78.00||||78.00|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|7.71||||7.71|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|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|2.45|243.86|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|2.45|243.86|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|2.45|243.86|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|2.45|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|7.71||||7.71|5.4|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|7.71||||7.71|5.4|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|7.71||||7.71|5.4|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|7.71||||7.71|5.4|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|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|243.86|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|243.86|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|243.86|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|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|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|3.86|243.86|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|3.86|243.86|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|3.86|243.86|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|3.86|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|3.81|243.86|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|3.81|243.86|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|3.81|243.86|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|3.81|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|<Self-pay>|<Self-pay>|7.71||||7.71|2.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|<Self-pay>|<Self-pay>|7.71||||7.71|2.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|<Self-pay>|<Self-pay>|7.71||||7.71|2.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|<Self-pay>|<Self-pay>|7.71||||7.71|2.31|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|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|243.86|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|243.86|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|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.63|243.86|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|4.59|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.63|243.86|2.31
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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|7.71||||7.71|4.59|243.86|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|4.59|243.86|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|4.59|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.63|243.86|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|4.59|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|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|243.86|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|243.86|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|243.86|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|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|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|3.15|243.86|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|3.15|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|3.15|243.86|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|6.63|243.86|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|3.15|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|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|5.63|243.86|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|6.63|243.86|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|5.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|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|5.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.63|243.86|2.31
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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
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]|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 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 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]|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 PREFERRED OF OKLAHOMA [115500]|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 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 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]|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
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|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|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]|UMR CORE [203505]|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
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|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|UMR [2035]|UMR CORE [203505]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
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|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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|TRUSTMARK [2030]|STARMARK [203000]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CIGNA [1260]|CIGNA [126008]|7.71||||7.71|4.31|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|3.15|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|243.86|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|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.63|243.86|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|5.63|243.86|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|6.63|243.86|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|6.63|243.86|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|5.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MULTIPLAN [1680]|IHC HS [168011]|7.71||||7.71|6.63|243.86|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|5.63|243.86|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|6.63|243.86|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|6.63|243.86|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|5.63|243.86|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|5.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|CORESOURCE [1315]|CORESOURCE [131501]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.59|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.59|243.86|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|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.59|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.59|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|MEDICA [2910]|MEDICA QUEST [291001]|7.71||||7.71|4.59|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|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|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|7.71||||7.71|3.81|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|<Self-pay>|<Self-pay>|7.71||||7.71|2.31|243.86|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|6.63|243.86|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|4.59|243.86|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|4.59|243.86|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|3.81|243.86|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|4.59|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
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 TRADITIONAL OF OKLAHOMA [115501]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
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|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|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|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|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|7.71||||7.71|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|7.71||||7.71|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|7.71||||7.71|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|7.71||||7.71|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
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|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
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|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
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|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|7.71||||7.71|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|7.71||||7.71|6.63|243.86|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|6.63|243.86|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|4.59|243.86|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|6.63|243.86|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|4.59|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|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|243.86|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|243.86|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|243.86|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|243.86|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|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHNET [1495]|HEALTHNET [149500]|7.71||||7.71|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|5.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHFIRST [2395]|HEALTHFIRST [239500]|7.71||||7.71|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|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|3.81|243.86|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|3.81|243.86|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|3.81|243.86|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|5.63|243.86|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|3.86|243.86|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|3.81|243.86|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|3.81|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|GILSBAR [1425]|GILSBAR [142500]|7.71||||7.71|6.63|243.86|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|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71|4.31|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|7.71||||7.71|4.31|243.86|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|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|ERX|0637 - PHARMACY-EXTENSION OF 025X-SELF-ADMINISTRAB|FAMOTIDINE 20 MG TABLET|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|7.71||||7.71|5.4|243.86|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|2.45|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|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|6.63|243.86|2.31
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
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|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10011|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
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|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|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L14 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|4495.00||||4495.00|3146.5|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|4495.00||||4495.00|2472.25|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|4495.00||||4495.00|2512.71|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GILSBAR [1425]|GILSBAR [142500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|AETNA [1015]|AETNA ACO WILCO [101532]|4495.00||||4495.00|2220.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHFIRST [2395]|HEALTHFIRST [239500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|4495.00||||4495.00|2022.75|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|4495.00||||4495.00|2220.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MEDICA [2910]|MEDICA QUEST [291001]|4495.00||||4495.00|2674.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|4495.00||||4495.00|3281.35|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|CIGNA [1260]|CIGNA [126008]|4495.00||||4495.00|2512.71|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|TRUSTMARK [2030]|STARMARK [203000]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|4495.00||||4495.00|3281.35|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|WEB TPA [2115]|WEB TPA [211500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|4495.00||||4495.00|3281.35|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|FIRST HEALTH [1375]|BENVEO/UCS [137512]|4495.00||||4495.00|2674.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|4495.00||||4495.00|1833.96|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|4495.00||||4495.00|3820.75|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|4495.00||||4495.00|2674.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MULTIPLAN [1680]|IHC HS [168011]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|CORESOURCE [1315]|CORESOURCE [131501]|4495.00||||4495.00|2220.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|4495.00||||4495.00|2022.75|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|4495.00||||4495.00|1428.51|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|<Self-pay>|<Self-pay>|4495.00||||4495.00|1348.5|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|4495.00||||4495.00|2220.53|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHNET [1495]|HEALTHNET [149500]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|4495.00||||4495.00|3281.35|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|4495.00||||4495.00|3865.7|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|FMH BENEFIT SERVICES [1390]|FMH [139000]|4495.00||||4495.00|3281.35|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|4495.00||||4495.00|2247.5|3865.7|1348.5
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GEHA [1415]|GEHA - ASA [141503]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|UMR [2035]|UMR CORE [203505]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|CHAMPVA [1240]|CHAMP VA [124000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BCBS [1155]|TULSA BLUE [115531]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|4495.00||||4495.00|||
100111|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|CATHETER PERFUSION TRUE FLOW L110 CM L3.5 CM OD18 MM ID11 FR VALVULOPLASTY|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|4495.00||||4495.00|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10012|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L16 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
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|21.18|21.18|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|21.18|21.18|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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|24.63||||24.63|17.24|21.18|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|21.18|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|7.83|21.18|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|21.18|21.18|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|21.18|21.18|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|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|24.63||||24.63|13.77|21.18|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|21.18|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|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|14.65|21.18|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|12.16|21.18|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|14.65|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|CIGNA [1260]|CIGNA [126008]|24.63||||24.63|13.77|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|21.18|21.18|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|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|24.63||||24.63|17.98|21.18|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|21.18|21.18|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|21.18|21.18|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|10.05|21.18|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|21.18|21.18|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|14.65|21.18|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|21.18|21.18|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|21.18|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|21.18|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|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|21.18|21.18|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|<Self-pay>|<Self-pay>|24.63||||24.63|7.39|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|17.98|21.18|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|12.31|21.18|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|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|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|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|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 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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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 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|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 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|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|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|UMR [2035]|UMR CORE [203505]|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|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|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|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|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|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|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|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|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|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|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|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|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|24.63||||24.63|21.18|21.18|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|7.83|21.18|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|21.18|21.18|7.39
100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|24.63||||24.63|17.24|21.18|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|21.18|21.18|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|21.18|21.18|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|12.31|21.18|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|17.98|21.18|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|17.98|21.18|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|21.18|21.18|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|21.18|21.18|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|12.16|21.18|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|21.18|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|12.16|21.18|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|21.18|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|21.18|21.18|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|14.65|21.18|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|21.18|21.18|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|10.05|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|17.98|21.18|7.39
100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|CIGNA [1260]|CIGNA [126008]|24.63||||24.63|13.77|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|7.39
100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|<Self-pay>|<Self-pay>|24.63||||24.63|7.39|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|14.65|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|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|21.18|21.18|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|14.65|21.18|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|21.18|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|21.18|21.18|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|21.18|21.18|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|12.16|21.18|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|21.18|21.18|7.39
100125|SUP|0272 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-STERI|BLADE LARYNG MILLER DISP SZ 0|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|24.63||||24.63|13.77|21.18|7.39
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|21.18|21.18|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|21.18|21.18|7.39
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|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|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|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|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|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|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|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|CHAMPVA [1240]|CHAMP VA [124000]|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|UMR [2035]|UMR CORE [203505]|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|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]|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 ADVANTAGE OF ARKANSAS [115536]|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|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|BCBS [1155]|TULSA BLUE [115531]|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|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|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|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|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|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|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|24.63||||24.63|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|24.63||||24.63|17.24|21.18|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|21.18|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|7.83|21.18|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|21.18|21.18|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|21.18|21.18|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|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|24.63||||24.63|13.77|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|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|14.65|21.18|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|12.16|21.18|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|14.65|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|CIGNA [1260]|CIGNA [126008]|24.63||||24.63|13.77|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|17.98|21.18|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|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|24.63||||24.63|17.98|21.18|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|21.18|21.18|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|21.18|21.18|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|10.05|21.18|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|21.18|21.18|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|21.18|21.18|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|21.18|21.18|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|14.65|21.18|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|21.18|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|21.18|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|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|21.18|21.18|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|<Self-pay>|<Self-pay>|24.63||||24.63|7.39|21.18|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|12.16|21.18|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|21.18|21.18|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|21.18|21.18|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|17.98|21.18|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|21.18|21.18|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|17.98|21.18|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|12.31|21.18|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|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|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|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|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|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 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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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 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 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|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 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|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|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|UMR [2035]|UMR CORE [203505]|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|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|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|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|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|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|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|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|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|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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|24.63||||24.63|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|402.29||||402.29|127.85|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|402.29||||402.29|221.26|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|402.29||||402.29|281.6|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|402.29||||402.29|201.15|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FMH BENEFIT SERVICES [1390]|FMH [139000]|402.29||||402.29|293.67|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHNET [1495]|HEALTHNET [149500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|<Self-pay>|<Self-pay>|402.29||||402.29|120.69|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|402.29||||402.29|181.03|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CORESOURCE [1315]|CORESOURCE [131501]|402.29||||402.29|198.73|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|402.29||||402.29|239.36|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MULTIPLAN [1680]|IHC HS [168011]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|402.29||||402.29|293.67|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|402.29||||402.29|293.67|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|TRUSTMARK [2030]|STARMARK [203000]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA [1260]|CIGNA [126008]|402.29||||402.29|224.88|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|402.29||||402.29|164.13|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|402.29||||402.29|341.95|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|WEB TPA [2115]|WEB TPA [211500]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|402.29||||402.29|293.67|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|402.29||||402.29|198.73|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MEDICA [2910]|MEDICA QUEST [291001]|402.29||||402.29|239.36|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|345.97|85.07
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|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
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|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
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|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
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]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|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 ADVANTAGE OF ARKANSAS [115536]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
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|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
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|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
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|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
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|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|402.29||||402.29|198.73|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|402.29||||402.29|293.67|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|FIRST HEALTH [1375]|BENVEO/UCS [137512]|402.29||||402.29|239.36|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|345.97|85.07
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|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHFIRST [2395]|HEALTHFIRST [239500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|AETNA [1015]|AETNA ACO WILCO [101532]|402.29||||402.29|198.73|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GILSBAR [1425]|GILSBAR [142500]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|402.29||||402.29|224.88|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|402.29||||402.29|345.97|345.97|85.07
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|402.29||||402.29|345.97|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|345.97|85.07
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
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|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10014|ERX|0250 - PHARMACY-GENERAL|FAT EMULSION 20 % INTRAVENOUS|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
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|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|402.29||||402.29|||
10014|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L20 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10015|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L6 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|283.56||||283.56|90.12|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|283.56||||283.56|155.96|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|283.56||||283.56|141.78|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FMH BENEFIT SERVICES [1390]|FMH [139000]|283.56||||283.56|207|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHNET [1495]|HEALTHNET [149500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|283.56||||283.56|127.6|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|<Self-pay>|<Self-pay>|283.56||||283.56|85.07|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|283.56||||283.56|127.6|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|IHC HS [168011]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|283.56||||283.56|168.72|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|283.56||||283.56|115.69|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|283.56||||283.56|207|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|283.56||||283.56|207|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|283.56||||283.56|241.03|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|TRUSTMARK [2030]|STARMARK [203000]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|WEB TPA [2115]|WEB TPA [211500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|283.56||||283.56|207|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|283.56||||283.56|207|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MEDICA [2910]|MEDICA QUEST [291001]|283.56||||283.56|168.72|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|FIRST HEALTH [1375]|BENVEO/UCS [137512]|283.56||||283.56|168.72|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|283.56||||283.56|198.49|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|283.56||||283.56|127.6|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHFIRST [2395]|HEALTHFIRST [239500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GILSBAR [1425]|GILSBAR [142500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|283.56||||283.56|243.86|243.86|85.07
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CORESOURCE [1315]|CORESOURCE [131501]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|TULSA BLUE [115531]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CHAMPVA [1240]|CHAMP VA [124000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UMR [2035]|UMR CORE [203505]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GEHA [1415]|GEHA - ASA [141503]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|CIGNA [1260]|CIGNA [126008]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|AETNA [1015]|AETNA ACO WILCO [101532]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|283.56||||283.56|||
10016|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|SCREW BONE STAINLESS STEEL L8 MM OD2 MM ODSEC3.5 MM CORTEX SELF TAP CRUCIFORM NONSTERILE MINI FRAGMENT SET MODULAR HAND SYSTEM|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|283.56||||283.56|||
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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|1386.32|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|1386.32|1386.32|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|512.29|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|657.7|1386.32|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|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|483.6
100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|483.6
100168|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 41MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|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|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|806|1386.32|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|1386.32|483.6
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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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]|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|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|UMR [2035]|UMR CORE [203505]|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|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|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|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|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|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|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|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|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|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|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|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|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|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|285.94||||285.94|245.91|245.91|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|90.87|245.91|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|245.91|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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|285.94||||285.94|200.16|245.91|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|245.91|245.91|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|245.91|245.91|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|142.97|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|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|<Self-pay>|<Self-pay>|285.94||||285.94|85.78|245.91|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|245.91|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|245.91|245.91|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|245.91|245.91|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|170.13|245.91|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|245.91|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|245.91|245.91|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|116.66|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|170.13|245.91|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|208.73|245.91|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|245.91|245.91|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|245.91|245.91|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|170.13|245.91|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|245.91|245.91|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|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|245.91|245.91|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|245.91|245.91|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|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|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|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|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|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|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|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|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 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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|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|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|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|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|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|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|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|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|285.94||||285.94|||
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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|1386.32|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|1386.32|1386.32|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|512.29|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1176.76|1386.32|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|657.7|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|483.6
100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|483.6
100170|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 42MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|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|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|806|1386.32|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|1386.32|483.6
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|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|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|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|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|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|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|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|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|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|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|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|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 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]|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|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|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|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 MEDICARE REPLACEMENT [102002]|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|||
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|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|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|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|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|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|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|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|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|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|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|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|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|959.14|1386.32|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|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|483.6
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|1386.32|1386.32|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|1386.32|1386.32|483.6
100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|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|1386.32|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|1176.76|1386.32|483.6
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|677.04|1386.32|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|959.14|1386.32|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|806|1386.32|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|1386.32|1386.32|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|657.7|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
100176|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 44MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|512.29|1386.32|483.6
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|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|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|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|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|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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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 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|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|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|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|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|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|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|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|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|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]|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|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|959.14|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1176.76|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|959.14|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00|677.04|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|806|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1176.76|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1176.76|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1176.76|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|657.7|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|959.14|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1176.76|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00|677.04|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|512.29|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1386.32|1386.32|483.6
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OKLAHOMA PROJECT WOMAN [2145]|OKLAHOMA PROJECT WOMAN [214500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00|||
100178|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 45MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|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|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|1386.32|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|1386.32|483.6
100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|483.6
100179|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR UHR COCR UHMWPE UNIVERSAL OD45 MM ID28 MM HIP|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|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|1386.32|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|1386.32|1386.32|483.6
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|1386.32|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|1386.32|1386.32|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|512.29|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|806|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1176.76|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1386.32|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|657.7|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|483.6
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|677.04|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|483.6
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|677.04|1386.32|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|959.14|1386.32|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|1386.32|1386.32|483.6
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|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|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|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|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|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|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|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|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|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 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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|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|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|285.94||||285.94|243.05|245.91|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|116.66|245.91|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|245.91|245.91|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|245.91|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|245.91|245.91|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|<Self-pay>|<Self-pay>|285.94||||285.94|85.78|245.91|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|245.91|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|142.97|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|208.73|245.91|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|170.13|245.91|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|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|285.94||||285.94|245.91|245.91|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|245.91|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|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|285.94||||285.94|200.16|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|170.13|245.91|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|245.91|245.91|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|245.91|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|90.87|245.91|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|208.73|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|208.73|245.91|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|245.91|245.91|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|245.91|245.91|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|245.91|245.91|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|170.13|245.91|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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 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|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|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|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|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 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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCOST SOLUTIONS [2415]|HEALTHCOST SOLUTIONS [241501]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1176.76|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1176.76|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|512.29|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN HEALTH [1655]|MERITAIN HEALTH [165500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTH PLANS INC [221008]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED BENEFIT SYSTEMS INC [1030]|ALLIED BENEFIT SYSTEMS [103000]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNIVERSAL FIDELITY [2085]|UNIVERSAL FIDELITY LIFE [208500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSCOPE BENEFITS [2290]|HEALTHSCOPE BENEFITS [229000]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHNET [1495]|HEALTHNET [149500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ALLIED NATIONAL GLOBAL CARE [1035]|ALLIED NATIONAL [103500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA COMMERCIAL [2140]|HUMANA CHOICECARE [214003]|1612.00||||1612.00|806|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MERITAIN AETNA [3685]|MERITAIN AETNA ARDENT EMPLOYEE [368502]|1612.00||||1612.00|617.88|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1176.76|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|OSMA HEALTH NETWORK [2345]|OSMA HEALTH [234500]|1612.00||||1612.00|725.4|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHSMART [1505]|HEALTHSMART BENEFIT SOLUTIONS [150503]|1612.00||||1612.00|1370.2|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00|677.04|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1176.76|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|KEMPTON GROUP ADMINISTRATORS [2905]|ADVANTAGE HEALTH PLAN-NO PPO NETWORK [290503]|1612.00||||1612.00|725.4|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1176.76|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|959.14|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|959.14|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CORESOURCE [1315]|CORESOURCE [131501]|1612.00||||1612.00|617.88|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00|677.04|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NEW ERA LIFE INSURANCE COMPANY [1705]|PHILADELPHIA AMERICAN LIFE [170501]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|PROVIDENCE HEALTH PLAN [168004]|1612.00||||1612.00|959.14|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE HIGHWAYS [2210]|HEALTHCARE HIGHWAYS HEALTH PLAN [221009]|1612.00||||1612.00|657.7|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1386.32|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1386.32|483.6
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICARE [1100]|AMERIGROUP MEDICARE [110000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MANAGED MEDICARE [1600]|MANAGED MEDICARE OTHER [160000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR [2035]|UMR CORE [203505]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CHAMPVA [1240]|CHAMP VA [124000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS TRADITIONAL OF OKLAHOMA [115501]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS MEDICARE ADVANTAGE [1435]|GLOBAL GENERATIONS MEDICARE ADVANTAGE [143500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA MEDICARE REPLACEMENT [1265]|CIGNA MEDICARE REPLACEMENT [126500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS PREFERRED OF OKLAHOMA [115500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOSPICE [3000]|SOLSTICE HEALTHCARE [300004]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS MEDICARE REPLACEMENT [1160]|BLUE CROSS MEDICARE ADVANTAGE OOS [116005]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GLOBAL HEALTH [1430]|GLOBAL HEALTH COMMERCIAL [143000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE MEDICARE REPLACEMENT [2065]|UHC MEDICARE ADVANTAGE [206511]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UNITED HEALTHCARE CHARTER [206031]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BEACON HEALTH OPTIONS BEHAVIORAL HEALTH [2890]|BEACON HEALTH OPTIONS [289000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MOLINA MEDICARE REPLACEMENT [1675]|MOLINA MEDICARE ADVANTAGE [167500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AMERIGROUP MEDICAID [1095]|AMERIGROUP MEDICAID [109500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS ADVANTAGE OF ARKANSAS [115536]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF REHABILITATION SERVICES [2355]|DEPARTMENT OF REHABILITATION SERVICES [235500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|TULSA BLUE [115531]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED COMMERCIAL [2055]|UNITED COMMERCIAL TRAVELERS [205500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GEHA [1415]|GEHA - ASA [141503]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|BCBS [1155]|BLUE CROSS CHEROKEE MLR OF OKLAHOMA [115509]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UNITED HEALTHCARE [2060]|UHC MEDICA CHOICE [206030]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HUMANA MEDICARE REPLACEMENT [1525]|HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|VA CCN OPTUM [3920]|VA CCN OPTUM [392000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GHI [2835]|GHI MEDICARE REPLACEMENT [283500]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|LIFE SENIOR SERVICES [2425]|LIFE SENIOR SERVICES [242501]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GENERATIONS HEALTHCARE [1420]|GENERATIONS HEALTHCARE [142000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HPSI [1520]|HPSI HEALTHPLAN SERVICE [152000]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE MEDICARE [1125]|COMMUNITY CARE ADVANTAGE MEDICARE [112502]|1612.00||||1612.00|||
100181|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 26MM 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|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|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|1176.76|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|483.6
100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|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|1386.32|1386.32|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|959.14|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|512.29|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
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|677.04|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|657.7|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|959.14|1386.32|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|959.14|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|483.6
100182|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 46MM 28MM UHR UNIVERSAL HIP COCR UHMWPE|<Self-pay>|<Self-pay>|1612.00||||1612.00|483.6|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1176.76|1386.32|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|806|1386.32|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|1176.76|1386.32|483.6
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|1386.32|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|1386.32|1386.32|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|1386.32|1386.32|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|1176.76|1386.32|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|1386.32|483.6
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|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|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|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|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|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|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|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|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|AETNA MEDICARE REPLACEMENT [1020]|AETNA MEDICARE REPLACEMENT [102002]|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|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|UMR [2035]|UMR CORE [203505]|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|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|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|HEALTHCHOICE [1490]|HEALTHCHOICE [149000]|1612.00||||1612.00|||
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|CIGNA [1260]|CIGNA [126008]|1612.00||||1612.00|677.04|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|WEB TPA [2115]|WEB TPA [211500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|TRUSTMARK [2030]|STARMARK [203000]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|LIFESTYLE HEALTH PLANS [178013]|1612.00||||1612.00|1176.76|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HOMETOWN HEALTH [2155]|HOMETOWN HEALTH [215500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PLANNED ADMINISTRATORS INC [2360]|PLANNED ADMINISTRATORS INC [236000]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PHCS [1780]|GROUP HEALTH COOPERATIVE SCW [178012]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHFIRST [2395]|HEALTHFIRST [239500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|ADMINISTRATIVE CONCEPTS [1005]|ADMINISTRATIVE CONCEPTS [100502]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MAYO CLINIC HEALTH SOLUTIONS [2280]|MAYO CLINIC HEALTH SOLUTIONS [228000]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|TALL TREE ADMINISTRATORS [137508]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COVENTRY HEALTHCARE [1320]|COVENTRY [132001]|1612.00||||1612.00|617.88|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MUTUAL OF OMAHA [1685]|MUTUAL OF OMAHA [168500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FIRST HEALTH [1375]|BENVEO/UCS [137512]|1612.00||||1612.00|959.14|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445]|EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501]|1612.00||||1612.00|1176.76|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|COMMUNITY CARE [1290]|COMMUNITY CARE MEDICARE SUPPLEMENT [129003]|1612.00||||1612.00|1176.76|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|RESOURCE ONE ADMINISTRATORS [2815]|RESOURCE ONE ADMINISTRATORS [281500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MEDICA [2910]|MEDICA QUEST [291001]|1612.00||||1612.00|959.14|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|AETNA [1015]|AETNA ACO WILCO [101532]|1612.00||||1612.00|617.88|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GILSBAR [1425]|GILSBAR [142500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|NATIONAL ASSOCIATION OF LETTER CARRIERS [1695]|NALC [169500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHPARTNERS [1500]|HEALTHPARTNERS [150000]|1612.00||||1612.00|677.04|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|DEPARTMENT OF CORRECTIONS [1340]|PARKSIDE [134007]|1612.00||||1612.00|886.6|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PBA [1775]|PROFESSIONAL BENEFIT ADMIN [177500]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|UMR - ARDENT EMPLOYEE [2036]|UMR - ARDENT EMPLOYEE [203601]|1612.00||||1612.00|512.29|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|MULTIPLAN [1680]|IHC HS [168011]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PAN AMERICAN LIFE INSURANCE CO [1770]|PAN AMERICAN LIFE [177000]|1612.00||||1612.00|1386.32|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|GROUP RESOURCES [1455]|GROUP RESOURCES [145004]|1612.00||||1612.00|1176.76|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|HEALTHCARE SOLUTIONS [1485]|HEALTHCARE SOLUTIONS GROUP [148500]|1612.00||||1612.00|725.4|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|PREFERRED COMMUNITY CARE [1825]|PREFERRED COMMUNITY CHOICE [182500]|1612.00||||1612.00|1128.4|1386.32|483.6
100184|SUP|0278 - MEDICAL/SURGICAL SUPPLIES AND DEVICES-OTHER|HEAD BIPOLAR 47MM 26MM UHR UNIVERSAL HIP COCR UHMWPE|FMH BENEFIT SERVICES [1390]|FMH [139000]|1612.00||||1612.00|1176.76|1386.32|483.6
100184|SUP|0278 - MEDIC