vcmc charge description master (chargemaster) …€¦ · broviac 4.2fr. single lumen cv catheter...

270
APPENDIX C VCMC CHARGE DESCRIPTION MASTER ("CHARGEMASTER") County of Ventura – State of California

Upload: others

Post on 22-Jul-2020

4 views

Category:

Documents


0 download

TRANSCRIPT

  • APPENDIX C

    VCMC CHARGE DESCRIPTION MASTER ("CHARGEMASTER")

    County of Ventura – State of California

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    1$

    1$

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    S

    pina

    l Nee

    dles

    25g

    A42

    1517

    8$

    19

    6$

    A

    4253

    Blo

    od g

    luco

    se s

    trips

    , box

    of 5

    0A

    4253

    89$

    98

    $

    Ess

    ure

    Sys

    tem

    A42

    644,

    418

    $

    4,

    860

    $

    A

    4466

    Gar

    men

    , bel

    t sle

    eve

    or o

    ther

    cov

    erin

    g, e

    last

    ic o

    r sim

    ilar s

    tretc

    habl

    e m

    ater

    ial a

    ny ty

    pe e

    ach

    A44

    6631

    $

    34$

    A

    4561

    Pes

    sary

    , rub

    ber,

    any

    type

    A45

    6110

    3$

    11

    3$

    A

    4562

    Pes

    sary

    , non

    rubb

    er, a

    ny ty

    peA

    4562

    69$

    76

    $

    SLI

    NG

    AR

    M M

    ED

    6/B

    XA

    4565

    7$

    8$

    SLI

    NG

    AR

    M X

    L A

    DLT

    A45

    6515

    $

    17$

    S

    LIN

    G A

    RM

    SM

    LA

    4565

    7$

    8$

    SLI

    NG

    AR

    M L

    G 6

    /BX

    A45

    6543

    $

    47$

    U

    NIV

    ER

    SA

    L C

    AN

    NU

    LA S

    ET

    WIT

    H F

    EN

    ES

    TRA

    TIO

    NS

    A46

    1578

    $

    86$

    M

    AA

    KIT

    , VIA

    L/10

    0030

    A46

    4170

    $

    77$

    A

    4931

    Ora

    l the

    rmom

    eter

    , reu

    sabl

    e, a

    ny ty

    pe, e

    ach

    A49

    3114

    $

    15$

    A

    6010

    Col

    lage

    n ba

    sed

    wou

    nd fi

    ller,

    dry

    form

    , ste

    rile,

    per

    g o

    f col

    lage

    nA

    6010

    349

    $

    384

    $

    A60

    11 C

    olla

    gen

    base

    d w

    ound

    fille

    r, ge

    l/pas

    te, p

    er g

    of c

    olla

    gen

    A60

    1132

    $

    35

    $

    A

    6021

    Col

    lage

    n dr

    essi

    ng s

    teril

    e, s

    ize

    16 s

    q in

    or l

    ess,

    eac

    hA

    6021

    17$

    19$

    A60

    22 C

    olla

    gen

    dres

    sing

    , ste

    rile,

    siz

    e m

    ore

    than

    16

    sq in

    but

    less

    than

    or e

    qual

    to 4

    8 sq

    in e

    ach

    A60

    2222

    $

    24

    $

    A

    6023

    Col

    lage

    n dr

    essi

    ng s

    teril

    e, s

    ize

    mor

    e th

    an 4

    8 sq

    in, e

    ach

    A60

    2352

    $

    57

    $

    A

    6024

    Col

    lage

    n dr

    essi

    ng w

    ound

    fille

    r, st

    erile

    , per

    6 in

    A60

    2425

    $

    28

    $

    TC

    99M

    SE

    STA

    MIB

    I, D

    OS

    E/T

    C99

    A95

    0043

    2$

    47

    5$

    Te

    chne

    tium

    TC

    -99m

    tetro

    fosm

    inA

    9502

    404

    $

    444

    $

    A95

    03 T

    echn

    etiu

    m T

    c-99

    mm

    med

    rona

    te d

    iagn

    ostic

    per

    stu

    dy d

    ose

    up to

    30

    mill

    icur

    ies

    A95

    0337

    $

    41$

    M

    DP

    KIT

    , VIA

    L/10

    0050

    A95

    0353

    $

    58$

    TC

    99M

    MD

    P, D

    OS

    E/T

    C99

    50A

    9503

    37$

    41

    $

    THA

    LLO

    US

    CH

    LOR

    IDE

    , MC

    I/TL

    A95

    0572

    $

    79$

    ID

    IUM

    111

    DTP

    AA

    9507

    1,66

    9$

    1,83

    6$

    PR

    OS

    TAS

    CIN

    T,U

    NIT

    DO

    SE

    A95

    0711

    ,838

    $

    13,0

    22$

    I 1

    31 M

    IBG

    150

    -200

    UC

    I(0.1

    8MC

    I)A

    9508

    2,12

    6$

    2,33

    9$

    SO

    D IO

    D 1

    23,C

    AP

    ,200

    UC

    I/11

    A95

    0920

    7$

    22

    8$

    TC

    -99M

    Dis

    ofen

    inA

    9510

    105

    $

    116

    $

    TC99

    M S

    OD

    .PE

    RT.

    , MC

    I/TC

    04A

    9512

    I 131

    TH

    ER

    AP

    Y C

    AP

    S, 2

    9.9

    A95

    161,

    097

    $

    1,

    207

    $

    I 1

    31 T

    HE

    RA

    PY

    CA

    PS

    , 12

    MA

    9517

    524

    $

    576

    $

    LYM

    PH

    OS

    EE

    KA

    9520

    1,83

    6$

    2,02

    0$

    I 131

    TH

    ER

    AP

    Y C

    AP

    S, 1

    0 M

    A95

    2846

    4$

    51

    0$

    I 1

    31 D

    X C

    AP

    SU

    LE,P

    ER

    1 M

    CI

    A95

    2814

    7$

    16

    2$

    TC

    -99M

    Dep

    reot

    ide

    (Neo

    tec)

    A95

    362,

    006

    $

    2,

    207

    $

    TC

    99M

    CH

    OLE

    TEC

    , DO

    SE

    /TC

    99A

    9537

    85$

    94

    $

    TC-9

    9M M

    AA

    A95

    4035

    $

    39$

    TC

    99M

    SLF

    R C

    OLL

    OID

    ,DO

    SE

    /TA

    9541

    188

    $

    207

    $

    IND

    IUM

    IN-1

    11 U

    P T

    O 5

    MC

    IA

    9542

    9,22

    2$

    10,1

    44$

    Y

    TTR

    IUM

    Y-9

    0 U

    P T

    O 4

    0 M

    CI

    A95

    4311

    7,66

    5$

    129,

    432

    $

    IN

    DIU

    M O

    XIN

    E, D

    OS

    EA

    9547

    947

    $

    1,04

    2$

    TC-9

    9M S

    odiu

    m G

    luce

    ptat

    eA

    9550

    35$

    39

    $

    TEC

    H 9

    9M S

    UC

    CIM

    ER

    ,UP

    TO

    10M

    CI

    A95

    5154

    7$

    60

    2$

    FL

    UO

    RO

    DE

    XIG

    LUC

    OS

    E F

    18,D

    OS

    EA

    9552

    1,26

    0$

    1,38

    6$

    GA

    LLIU

    M C

    ITR

    ATE

    , MC

    I/GA

    67A

    9556

    37$

    41

    $

    TC-9

    9M B

    isic

    ate

    (Neu

    rolit

    e)A

    9557

    944

    $

    1,03

    8$

    XE

    NO

    N 1

    33, D

    OS

    E/X

    S25

    0/2

    A95

    5885

    $

    94$

    U

    LTR

    ATA

    G R

    BC

    KIT

    , EA

    CH

    /10

    A95

    6017

    2$

    18

    9$

    TC

    99 M

    ER

    TIA

    TID

    E U

    PTO

    15M

    CI

    A95

    622,

    094

    $

    2,

    303

    $

    TE

    CH

    99M

    FA

    NO

    LES

    OM

    AB

    UP

    TO

    25

    MC

    IA

    9566

    6,54

    7$

    7,20

    2$

    1

    545

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    TC

    -99M

    DTP

    A A

    ER

    OS

    OL

    A95

    6781

    $

    89$

    IN

    DIU

    M W

    BC

    SE

    TUP

    , EA

    CH

    /11

    A95

    7047

    $

    52$

    IN

    DIU

    M W

    BC

    TA

    G C

    HR

    G,E

    A/IN

    A95

    7050

    4$

    55

    4$

    IN

    DIU

    M 1

    11 P

    EN

    TETR

    EO

    TID

    E/O

    CTR

    EO

    TO

    6 M

    CI

    A95

    7210

    ,808

    $

    11,8

    89$

    IN

    DIU

    M II

    I PE

    NTE

    TRE

    OT

    UP

    TO

    6 M

    CI

    A95

    726,

    686

    $

    7,

    355

    $

    S

    M 1

    53 L

    EX

    IDR

    ON

    AM

    TO

    150

    MC

    IA

    9604

    12,3

    16$

    13

    ,548

    $

    Xof

    igo

    (per

    uC

    i)A

    9606

    449

    $

    494

    $

    HE

    RB

    ER

    T C

    AN

    NU

    LATE

    D B

    ON

    E S

    CR

    EW

    3.0

    MM

    X 2

    2MM

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 1

    2mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 1

    4mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 1

    6mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 1

    8mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 2

    0mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 2

    4mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 2

    6mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 2

    8mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    H

    erbe

    rt/W

    hipp

    le B

    one

    Scr

    ew S

    yste

    m/C

    annu

    late

    d B

    one

    Scr

    ew 3

    .0m

    m D

    IA. 3

    0mm

    Len

    gth

    C17

    132,

    058

    $

    2,

    264

    $

    TI

    T25

    Sta

    rdriv

    e Lo

    ckin

    g S

    crew

    4.0

    mm

    x 2

    6mm

    C17

    1381

    1$

    89

    2$

    A

    THE

    RE

    CTO

    MY

    TU

    RB

    OH

    AW

    KC

    1714

    10,2

    80$

    11

    ,308

    $

    ATH

    ER

    EC

    TOM

    Y J

    ETS

    TRE

    AM

    C17

    247,

    260

    $

    7,

    986

    $

    N

    EE

    DLE

    MIC

    RO

    -AC

    CE

    SS

    SE

    T S

    TIFF

    C17

    2514

    1$

    15

    5$

    P

    TA B

    ALL

    OO

    N R

    IVA

    LC

    1725

    612

    $

    673

    $

    PTA

    BA

    LLO

    ON

    MU

    STA

    NG

    C17

    2577

    2$

    84

    9$

    P

    TA B

    ALL

    OO

    N D

    OR

    AD

    OC

    1725

    1,22

    8$

    1,35

    1$

    PTA

    BA

    LLO

    ON

    CO

    NQ

    UE

    ST

    C17

    251,

    066

    $

    1,

    173

    $

    P

    TA B

    ALL

    OO

    N A

    TLA

    SC

    1725

    1,52

    2$

    1,67

    4$

    PTA

    BA

    LLO

    ON

    CO

    YO

    TE .0

    14 1

    00C

    M &

    BE

    LOW

    C17

    251,

    849

    $

    2,

    034

    $

    P

    TA B

    ALL

    OO

    N C

    OY

    OTE

    .014

    150

    CM

    & A

    BO

    VE

    C17

    252,

    308

    $

    2,

    539

    $

    P

    TA B

    ALL

    OO

    N N

    AN

    OC

    RO

    SS

    C17

    251,

    738

    $

    1,

    912

    $

    P

    TCA

    AN

    GIO

    SC

    UP

    LT B

    ALL

    OO

    NC

    1725

    5,22

    6$

    5,74

    9$

    Max

    Forc

    e B

    iliar

    y B

    allo

    on D

    ilata

    tion

    Cat

    hete

    r 8m

    m x

    3cm

    C17

    261,

    741

    $

    1,

    915

    $

    M

    axFo

    rce

    Bili

    ary

    Bal

    loon

    Dila

    tatio

    n C

    athe

    ter 6

    mm

    x 4

    cmC

    1726

    1,74

    1$

    1,91

    5$

    Max

    Forc

    e B

    iliar

    y B

    allo

    on D

    ilata

    tion

    Cat

    hete

    r 4m

    m x

    4cm

    C17

    261,

    741

    $

    1,

    915

    $

    E

    xtra

    ctor

    Pro

    XL

    Ret

    rieva

    l Bal

    loon

    Cat

    hete

    r 9m

    m/1

    2mm

    C17

    2759

    2$

    65

    1$

    E

    xtra

    ctor

    Pro

    XL

    Ret

    rieva

    l Bal

    loon

    Cat

    hete

    r 12m

    m/1

    5mm

    C17

    2759

    2$

    65

    1$

    E

    xtra

    ctor

    Pro

    XL

    Ret

    rieva

    l Bal

    loon

    Cat

    hete

    r 15m

    m/1

    8mm

    C17

    2759

    2$

    65

    1$

    A

    SP

    IRA

    PLE

    UR

    AL/

    PE

    RIT

    ON

    EA

    L D

    RA

    INA

    GE

    KIT

    C17

    294,

    882

    $

    5,

    370

    $

    C

    ATH

    ETE

    R F

    LEX

    IMA

    RE

    G L

    OO

    P K

    ITC

    1729

    1,06

    9$

    1,17

    6$

    CA

    THE

    TER

    NE

    PH

    TE

    MP

    TIP

    C17

    2936

    4$

    40

    0$

    C

    EC

    OS

    TOM

    Y C

    ATH

    ETE

    RC

    1729

    694

    $

    763

    $

    Cat

    hete

    r Nep

    hros

    tom

    yC

    1729

    298

    $

    328

    $

    DR

    AIN

    AG

    E B

    ILIA

    RY

    CA

    THE

    TER

    C17

    2928

    6$

    31

    5$

    D

    RA

    INA

    GE

    CA

    THE

    TER

    DR

    AIN

    ER

    CE

    NTE

    SIS

    C17

    2964

    $

    70$

    FL

    EX

    IM R

    EG

    LO

    OP

    CA

    THE

    TER

    KIT

    C17

    2999

    9$

    1,

    099

    $

    G

    AS

    TRO

    STO

    MY

    FE

    ED

    ING

    TU

    BE

    C17

    2941

    8$

    46

    0$

    M

    ulti-

    Pur

    pose

    Dra

    inag

    e C

    athe

    ter

    C17

    2929

    8$

    32

    8$

    P

    LEU

    RX

    PLE

    UR

    AL

    CA

    TH K

    ITC

    1729

    1,86

    8$

    2,05

    5$

    HE

    MO

    DIA

    LYS

    IS C

    ATH

    ETE

    R C

    EN

    TRO

    S-F

    LOC

    1750

    1,63

    1$

    1,79

    4$

    HE

    MO

    DIA

    LYS

    IS C

    ATH

    ETE

    R P

    ALI

    ND

    RO

    ME

    C17

    501,

    571

    $

    1,

    728

    $

    Q

    uint

    on T

    enck

    hoff

    Per

    itone

    al D

    ialy

    sis

    Cat

    hete

    r with

    2 C

    uffs

    C17

    5022

    8$

    25

    1$

    E

    D In

    serti

    on o

    f PIC

    CC

    1751

    953

    $

    1,04

    8$

    NIC

    U C

    harg

    e P

    ICC

    Kit

    C17

    5195

    3$

    1,

    048

    $

    C

    ATH

    ETE

    R A

    NG

    IO S

    PE

    CIA

    LTY

    C17

    5144

    8$

    49

    3$

    2

    546

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    C

    ATH

    ETE

    R IN

    FUS

    ION

    C17

    5164

    2$

    70

    6$

    C

    ATH

    ETE

    R IN

    FUS

    ION

    5FR

    5-2

    0 C

    MC

    1751

    418

    $

    460

    $

    CA

    THE

    TER

    INFU

    SIO

    N 5

    FR 3

    0-50

    CM

    C17

    5163

    4$

    69

    7$

    C

    ATH

    ETE

    R IN

    FUS

    ION

    4FR

    5-2

    0 C

    MC

    1751

    458

    $

    504

    $

    Bro

    viac

    2.7

    Fr. S

    ingl

    e Lu

    men

    CV

    Cat

    hete

    rC

    1751

    617

    $

    679

    $

    Bro

    viac

    4.2

    Fr. S

    ingl

    e Lu

    men

    CV

    Cat

    hete

    rC

    1751

    699

    $

    769

    $

    Bro

    viac

    6.6

    Fr. S

    ingl

    e Lu

    men

    CV

    Cat

    hete

    rC

    1751

    998

    $

    1,09

    8$

    Gro

    shon

    g 8F

    r. S

    ingl

    e-Lu

    men

    CV

    Cat

    hete

    rC

    1751

    1,80

    2$

    1,98

    2$

    Hem

    odia

    lysi

    s C

    athe

    rizat

    ion

    Kit

    - Qui

    nton

    Cat

    hC

    1752

    474

    $

    521

    $

    Hem

    odia

    lysi

    s C

    athe

    rizat

    ion

    Kit

    - Qui

    nton

    Cat

    h P

    lace

    men

    tC

    1752

    474

    $

    521

    $

    Hem

    odia

    lysi

    s C

    athe

    rizat

    ion

    Kit

    - Ped

    iatri

    c Q

    uint

    on C

    ath

    Pla

    cem

    ent

    C17

    5247

    4$

    52

    1$

    Y

    ou-B

    end

    Two-

    Lum

    en H

    emod

    ialy

    sis

    Cat

    hete

    rizat

    ion

    Kit

    12Fr

    .C

    1752

    498

    $

    548

    $

    CA

    THE

    TER

    TH

    RO

    MB

    EC

    TOM

    Y/E

    MB

    OLE

    CTO

    MY

    C17

    5790

    9$

    1,

    000

    $

    C

    ATH

    ETE

    R P

    RO

    NTO

    EX

    TRA

    CTI

    ON

    XL

    7FR

    C17

    571,

    521

    $

    1,

    673

    $

    C

    ATH

    ETE

    R P

    RO

    NTO

    EX

    TRA

    CTI

    ON

    LP

    C17

    571,

    591

    $

    1,

    750

    $

    C

    LEA

    NE

    R M

    EC

    H T

    HR

    OM

    BE

    CTO

    MY

    LO

    NG

    C17

    573,

    519

    $

    3,

    871

    $

    P

    EN

    UM

    BR

    A S

    EP

    3C

    1757

    715

    $

    787

    $

    PE

    NU

    MB

    RA

    SE

    P6

    C17

    571,

    080

    $

    1,

    188

    $

    P

    EN

    UM

    BR

    A S

    EP

    8C

    1757

    1,88

    0$

    2,06

    8$

    TRE

    RO

    TOLA

    TH

    RO

    MB

    EC

    TOM

    YC

    1757

    2,72

    5$

    2,99

    8$

    CA

    TH E

    MB

    OLE

    CTO

    MY

    3F

    C17

    5724

    4$

    26

    8$

    C

    ATH

    EM

    BO

    LEC

    TOM

    Y 4

    FC

    1757

    244

    $

    268

    $

    CA

    TH F

    OG

    AR

    TY 5

    F E

    MB

    OLE

    CTO

    MY

    C17

    5724

    4$

    26

    8$

    C

    ATH

    FO

    GA

    RTY

    6F

    EM

    BO

    LEC

    TOM

    YC

    1757

    244

    $

    268

    $

    FOG

    AR

    TY V

    EN

    OU

    S T

    HR

    OM

    BE

    CTO

    MY

    CA

    THE

    TER

    8FR

    .C

    1757

    372

    $

    409

    $

    Ure

    tera

    l Ste

    ntC

    1758

    749

    $

    824

    $

    Dua

    l Lum

    en U

    rete

    ral C

    athe

    ter 1

    0Fr.

    C17

    5841

    $

    45$

    O

    PE

    N E

    ND

    UR

    ETE

    RA

    L C

    ATH

    ETE

    RC

    1758

    50$

    55

    $

    Ope

    n E

    nd U

    rete

    ral A

    xxce

    ss C

    athe

    ter 6

    Fr.

    C17

    5864

    $

    70$

    W

    hist

    le T

    ip W

    oven

    Ure

    tera

    l Cat

    hete

    r 3FR

    .C

    1758

    282

    $

    310

    $

    Whi

    stle

    Tip

    Wov

    en U

    rete

    ral C

    athe

    ter 4

    Fr.

    C17

    5828

    $

    31$

    W

    hist

    le T

    ip W

    oven

    Ure

    tera

    l Cat

    hete

    r 5Fr

    .C

    1758

    95$

    10

    5$

    A

    MP

    LATZ

    ER

    VA

    SC

    ULA

    R P

    LUG

    4C

    1760

    4,03

    4$

    4,43

    7$

    AM

    PLA

    TZE

    R V

    AS

    CU

    LAR

    PLU

    G II

    C17

    603,

    539

    $

    3,

    893

    $

    A

    NG

    IO S

    EA

    L C

    LOS

    UR

    E D

    EV

    ICE

    C17

    601,

    022

    $

    1,

    124

    $

    C

    EC

    OS

    TOM

    Y C

    HA

    IT P

    ER

    CU

    TAN

    EO

    US

    SE

    TC

    1769

    1,78

    1$

    1,95

    9$

    GI S

    UTU

    RE

    AN

    CH

    OR

    SE

    TC

    1769

    354

    $

    389

    $

    GU

    IDE

    WIR

    E A

    MP

    LATZ

    SH

    OR

    TC

    1769

    208

    $

    229

    $

    GU

    IDE

    WIR

    E C

    OO

    NS

    C17

    6916

    9$

    18

    6$

    G

    UID

    E W

    IRE

    CO

    ON

    S/S

    TAR

    /RO

    SE

    NC

    1769

    169

    $

    186

    $

    GU

    IDE

    WIR

    E V

    -14

    CO

    NTR

    OL

    C17

    6955

    1$

    60

    6$

    G

    UID

    E W

    IRE

    FA

    THO

    MC

    1769

    1,60

    3$

    1,76

    3$

    GU

    IDE

    WIR

    E T

    HR

    UW

    AY

    SH

    OR

    T TA

    PE

    RC

    1769

    650

    $

    715

    $

    GU

    IDE

    WIR

    E,A

    NG

    LED

    C17

    691,

    337

    $

    1,

    471

    $

    G

    UID

    E W

    IRE

    AM

    PLA

    TZ L

    ON

    GC

    1769

    298

    $

    328

    $

    GU

    IDE

    WIR

    E H

    YD

    RO

    AN

    GLE

    DC

    1769

    273

    $

    300

    $

    GU

    IDE

    WIR

    E J

    OU

    RN

    EY

    .014

    C17

    6963

    8$

    70

    2$

    G

    UID

    E W

    IRE

    MO

    VA

    BLE

    CO

    RE

    C17

    6910

    7$

    11

    8$

    G

    UID

    E W

    IRE

    PLA

    TIN

    UM

    PLU

    SC

    1769

    540

    $

    594

    $

    GU

    IDE

    WIR

    E T

    IP D

    EFL

    EC

    TIN

    G D

    ISP

    OS

    AB

    LEC

    1769

    84$

    92

    $

    GU

    IDE

    WIR

    E V

    -18

    CO

    NTR

    OL

    C17

    6913

    6$

    15

    0$

    G

    UID

    EW

    IRE

    MA

    GIC

    TO

    RQ

    UE

    C17

    6927

    1$

    29

    8$

    G

    UID

    EW

    IRE

    .018

    NIT

    INO

    L 40

    CM

    C17

    6978

    $

    86$

    3

    547

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    G

    UID

    EW

    IRE

    .018

    NIT

    INO

    L 80

    CM

    C17

    6913

    0$

    14

    3$

    G

    UID

    EW

    IRE

    .018

    INQ

    WIR

    E B

    AS

    ICC

    1769

    50$

    55

    $

    Gui

    dew

    ire 1

    5mm

    J T

    ipC

    1769

    151

    $

    166

    $

    Gui

    dew

    ire R

    osen

    C17

    6920

    8$

    22

    9$

    G

    uide

    wire

    Hyd

    ro A

    ngle

    d S

    tiff

    C17

    6954

    $

    59$

    G

    uide

    wire

    Ben

    tson

    C17

    6913

    $

    14$

    H

    EM

    OS

    TAS

    IS V

    ALV

    E G

    UA

    RD

    IAN

    IIC

    1769

    87$

    96

    $

    HE

    MO

    STA

    SIS

    VA

    LVE

    SC

    1769

    195

    $

    215

    $

    1.25

    MM

    TH

    RE

    AD

    ED

    GU

    IDE

    WIR

    E 1

    50M

    MC

    1769

    14$

    15

    $

    1.25

    MM

    NO

    N-T

    HR

    EA

    DE

    D G

    UID

    E W

    IRE

    150

    MM

    C17

    6914

    $

    15$

    2.

    0MM

    NO

    N-T

    HR

    EA

    DE

    D G

    UID

    E W

    IRE

    -230

    MM

    C17

    6918

    4$

    20

    2$

    2.

    8MM

    TH

    RE

    AD

    ED

    GU

    IDE

    WIR

    E T

    RO

    CA

    R P

    OIN

    T 30

    0MM

    C17

    6916

    6$

    18

    3$

    4.

    5MM

    CA

    NN

    ULA

    TED

    1.6

    MM

    TH

    RE

    AD

    ED

    GU

    IDE

    WIR

    E 1

    50M

    MC

    1769

    122

    $

    134

    $

    DH

    S 2

    .5M

    M T

    HR

    EA

    DE

    D G

    UID

    E W

    IRE

    SP

    AD

    E P

    OIN

    T 23

    0MM

    C17

    6923

    5$

    25

    9$

    D

    ream

    wire

    Stra

    ight

    Tip

    Hig

    h P

    erfo

    rman

    ce G

    uide

    wire

    0.0

    35x2

    60cm

    "C

    1769

    254

    $

    279

    $

    FIX

    ED

    CO

    RE

    WIR

    E G

    UID

    E S

    AFE

    T-J

    CU

    RV

    ED

    C17

    6915

    4$

    16

    9$

    FI

    XE

    D C

    OR

    E W

    IRE

    GU

    IDE

    STR

    AIG

    HT

    C17

    6913

    4$

    14

    7$

    Fa

    thom

    -16

    Stra

    ight

    Tip

    Ste

    erab

    le G

    uide

    wire

    180

    cm x

    10c

    mC

    1769

    1,50

    2$

    1,65

    2$

    GU

    IDE

    WIR

    E S

    PR

    ING

    DU

    OFL

    EX

    .025

    C17

    6945

    $

    50$

    G

    lidew

    ire S

    tiff S

    haft

    Stra

    ight

    .025

    C17

    6931

    2$

    34

    3$

    G

    lidew

    ire S

    tiff S

    haft

    Ang

    led

    .025

    C17

    6931

    2$

    34

    3$

    G

    lidew

    ire S

    tiff S

    haft

    Stra

    ight

    .038

    C17

    6931

    2$

    34

    3$

    G

    lidew

    ire S

    tiff S

    haft

    Ang

    led

    .038

    C17

    6931

    2$

    34

    3$

    G

    lidew

    ire B

    ents

    on-T

    ype

    Stif

    f Sha

    ft S

    traig

    ht .0

    35C

    1769

    312

    $

    343

    $

    Glid

    ewire

    Ben

    tson

    -Typ

    e S

    tiff S

    haft

    Ang

    led

    .035

    C17

    6931

    2$

    34

    3$

    G

    lidew

    ire S

    tiff S

    haft

    Stra

    ight

    .035

    C17

    6931

    2$

    34

    3$

    G

    lidew

    ire S

    tiff S

    haft

    Ang

    led

    .035

    C17

    6931

    2$

    34

    3$

    G

    uide

    wire

    .062

    x 6

    in.

    C17

    6946

    $

    51$

    G

    uide

    wire

    Thr

    eade

    d .0

    62 x

    6in

    .C

    1769

    145

    $

    160

    $

    Jagw

    ire S

    traig

    ht T

    ip H

    igh

    Per

    form

    ance

    Gui

    dew

    ire 0

    .035

    x260

    cm"

    C17

    6916

    9$

    18

    6$

    M

    arke

    d S

    prin

    g Ti

    p G

    uide

    wire

    210

    cmC

    1769

    760

    $

    836

    $

    MA

    60A

    C 6

    .0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    6.5

    D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 7

    .0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    7.5

    D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 8

    .0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    8.5

    D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 9

    .0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    9.5

    D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    0.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    10.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    1.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    11.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    2.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    12.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    3.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    13.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    4.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    14.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    5.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    15.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    6.0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    16.

    5D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    4

    548

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    M

    A60

    AC

    17.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    7.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    18.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    8.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    19.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 1

    9.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    20.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    0.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    21.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    1.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    22.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    2.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    23.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    3.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    24.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    4.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    25.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    5.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    26.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    6.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    27.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    7.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    28.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    8.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    29.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60A

    C 2

    9.5D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    AC

    30.

    0D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MA

    60M

    A 2

    .0D

    Acr

    ySof

    Sof

    t Acr

    ylic

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    A60

    MA

    -5.0

    D A

    cryS

    of S

    oft A

    cryl

    ic M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MN

    6AD

    1 14

    .0D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor A

    podi

    zed

    Diff

    ract

    ive

    Mul

    tipie

    ce P

    CL/

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    M

    N6A

    D1

    17.5

    D/+

    3.0

    add

    Acr

    ySof

    IQ R

    esto

    r Apo

    dize

    d D

    iffra

    ctiv

    e M

    ultip

    iece

    PC

    L/IO

    LC

    1780

    3,10

    1$

    3,41

    1$

    MTA

    4U0

    6.0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    7.0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    8.0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    9.0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    10.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 11

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    11.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 12

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    12.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 13

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    13.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 14

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    14.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 15

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    15.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 16

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    16.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 17

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    17.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 18

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    18.5

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 19

    .0D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    5

    549

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    M

    TA4U

    0 19

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    20.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 20

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    21.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 21

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    22.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 22

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    23.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 23

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    24.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 24

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    25.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 25

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    MTA

    4U0

    26.0

    D M

    ultif

    lex

    Sin

    gle-

    Pie

    ce P

    MM

    A A

    CL/

    IOL

    C17

    8046

    8$

    51

    5$

    M

    TA4U

    0 26

    .5D

    Mul

    tifle

    x S

    ingl

    e-P

    iece

    PM

    MA

    AC

    L/IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 6.

    0D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 6.

    5D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 7.

    0D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 7.

    5D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 8.

    0D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 8.

    5D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 9.

    0D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 9.

    5D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 10

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    10.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 11

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    11.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 12

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    12.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 13

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    13.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 14

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    14.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 15

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    15.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 16

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    16.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 17

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    17.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 18

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    18.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 19

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    19.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 20

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    20.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 21

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    21.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 22

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    22.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 23

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    23.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 24

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    24.5

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    6

    550

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    S

    A60

    AT

    25.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 25

    .5D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    26.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 26

    .5D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    27.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 27

    .5D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    28.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 28

    .5D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    29.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 29

    .5D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    30.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 31

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    32.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SA

    60A

    T 33

    .0D

    Acr

    ySof

    Sin

    gle-

    Pie

    ce A

    cryl

    ic F

    olda

    ble

    IOL

    C17

    8046

    8$

    51

    5$

    S

    A60

    AT

    34.0

    D A

    cryS

    of S

    ingl

    e-P

    iece

    Acr

    ylic

    Fol

    dabl

    e IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 7.

    0D A

    cryS

    of IQ

    Asp

    heric

    Nat

    ural

    IOL

    C17

    8046

    8$

    51

    5$

    S

    N60

    WF

    7.5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 14

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 14

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 15

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 18

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 18

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 19

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 20

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 20

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 21

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 21

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 22

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 23

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 23

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 24

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 24

    .5D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    60W

    F 25

    .0D

    Acr

    ySof

    IQ A

    sphe

    ric N

    atur

    al IO

    LC

    1780

    468

    $

    515

    $

    SN

    6AD

    1 10

    .5D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor M

    ultif

    ocal

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    S

    N6A

    D1

    13.5

    D/+

    3.0

    add

    Acr

    ySof

    IQ R

    esto

    r Mul

    tifoc

    al IO

    LC

    1780

    3,10

    1$

    3,41

    1$

    SN

    6AD

    1 14

    .0D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor M

    ultif

    ocal

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    S

    N6A

    D1

    15.0

    D/+

    3.0

    add

    Acr

    ySof

    IQ R

    esto

    r Mul

    tifoc

    al IO

    LC

    1780

    3,10

    1$

    3,41

    1$

    SN

    6AD

    1 15

    .5D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor M

    ultif

    ocal

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    S

    N6A

    D1

    16.5

    D/+

    3.0

    add

    Acr

    ySof

    IQ R

    esto

    r Mul

    tifoc

    al IO

    LC

    1780

    3,10

    1$

    3,41

    1$

    SN

    6AD

    1 18

    .5D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor M

    ultif

    ocal

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    S

    N6A

    D1

    20.5

    D/+

    3.0

    add

    Acr

    ySof

    IQ R

    esto

    r Mul

    tifoc

    al IO

    LC

    1780

    3,10

    1$

    3,41

    1$

    SN

    6AD

    1 22

    .0D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor M

    ultif

    ocal

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    S

    N6A

    D1

    23.5

    D/+

    3.0

    add

    Acr

    ySof

    IQ R

    esto

    r Mul

    tifoc

    al IO

    LC

    1780

    3,10

    1$

    3,41

    1$

    SN

    6AD

    1 26

    .5D

    /+3.

    0 ad

    d A

    cryS

    of IQ

    Res

    tor M

    ultif

    ocal

    IOL

    C17

    803,

    101

    $

    3,

    411

    $

    S

    N6A

    T3 6

    .0D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T5 6

    .0D

    /3.0

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T5 8

    .0D

    /3.0

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T4 1

    0.5D

    /2.2

    5 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T5 1

    3.0D

    /3.0

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 1

    4.0D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 1

    4.5D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T5 1

    5.0D

    /3.0

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 1

    5.5D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    7

    551

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    S

    N6A

    T5 1

    9.0D

    /3.0

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 1

    9.5D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T5 1

    9.5D

    /3.0

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 2

    0.5D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 2

    1.0D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 2

    1.5D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T7 2

    1.5D

    /4.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T3 2

    2.0D

    /1.5

    0 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    S

    N6A

    T4 2

    2.0D

    /2.2

    5 C

    ylin

    der A

    cryS

    of IQ

    Tor

    ic A

    stig

    mat

    ism

    IOL

    C17

    801,

    715

    $

    1,

    887

    $

    G

    OR

    E D

    UA

    L M

    ES

    H B

    IOM

    ATE

    RIA

    L 18

    .0C

    M X

    24.

    0CM

    X 2

    .0M

    MC

    1781

    8,49

    6$

    9,34

    6$

    GO

    RE

    MY

    CR

    OM

    ES

    H B

    IOM

    ATE

    RIA

    L 15

    .0C

    M X

    15.

    0CM

    X 1

    .0M

    MC

    1781

    1,10

    6$

    1,21

    7$

    CA

    THE

    TER

    PO

    RT

    IND

    WE

    LLIN

    G (I

    MP

    LAN

    TAB

    LE)

    C17

    881,

    975

    $

    2,

    173

    $

    P

    OR

    T-A

    -CA

    TH C

    ATH

    ETE

    RC

    1788

    3,81

    5$

    4,19

    7$

    Bar

    dPor

    t MR

    I Low

    -Pro

    file

    Impl

    anta

    ble

    Por

    t 6.6

    Fr.

    C17

    8882

    5$

    90

    8$

    X

    -Por

    t Duo

    MR

    I Im

    plan

    ted

    Por

    t with

    Atta

    chab

    le 9

    .5Fr

    . Gro

    shon

    gC

    1788

    3,63

    4$

    3,99

    7$

    STE

    NT

    VA

    SC

    ULA

    R C

    OV

    D 1

    5CM

    C18

    7416

    ,984

    $

    18,6

    82$

    S

    TEN

    T FL

    AIR

    EN

    DO

    VA

    SC

    ULA

    RC

    1874

    10,2

    21$

    11

    ,243

    $

    STE

    NT

    VA

    SC

    ULA

    R C

    OV

    D 5

    CM

    C18

    743,

    461

    $

    3,

    807

    $

    S

    TEN

    T V

    AS

    CU

    LAR

    CO

    VD

    10C

    MC

    1874

    3,95

    5$

    4,35

    1$

    STE

    NT

    WA

    LL S

    TEN

    TC

    1876

    4,97

    3$

    5,47

    0$

    STE

    NT

    BA

    LLO

    ON

    EX

    PA

    ND

    AB

    LEC

    1876

    4,08

    7$

    4,49

    6$

    STE

    NT

    EP

    IC S

    ELF

    EX

    PA

    ND

    ING

    C18

    764,

    087

    $

    4,

    496

    $

    S

    TEN

    T LI

    FES

    TEN

    T V

    AS

    CU

    LAR

    /BIL

    IAR

    YC

    1876

    13,3

    99$

    14

    ,739

    $

    STE

    NT

    EP

    IC V

    AS

    CU

    LAR

    C18

    764,

    820

    $

    5,

    302

    $

    V

    AS

    CU

    LAR

    STE

    NT

    C18

    769,

    061

    $

    9,

    967

    $

    O

    val P

    erito

    neal

    Dis

    tent

    ion

    Bal

    loon

    & In

    flatio

    n B

    ulb

    C18

    771,

    714

    $

    1,

    885

    $

    S

    oehe

    ndra

    Ste

    nt R

    etrie

    ver 7

    Fr./1

    80cm

    C18

    7762

    7$

    69

    0$

    IV

    C F

    ILTE

    R O

    TWC

    1880

    5,09

    5$

    5,60

    5$

    IVC

    FIL

    TER

    ,OTW

    GR

    EE

    NC

    1880

    5,09

    5$

    5,60

    5$

    IVC

    RE

    TRIE

    VA

    L S

    ET

    GU

    NTH

    ER

    TU

    LIP

    C18

    801,

    318

    $

    1,

    450

    $

    O

    ptio

    n IV

    C F

    ilter

    C18

    803,

    968

    $

    4,

    365

    $

    A

    THE

    RE

    CTO

    MY

    SP

    IDE

    R F

    X E

    MB

    OLI

    C P

    RO

    TEC

    TIO

    NC

    1884

    2,75

    0$

    3,02

    5$

    EM

    BO

    LIZA

    TIO

    N C

    ON

    TOU

    R V

    IAL

    PC

    AC

    1884

    710

    $

    781

    $

    EM

    BO

    LIZA

    TIO

    N E

    MB

    OZE

    NE

    MIC

    RO

    SP

    HE

    RE

    SC

    1884

    683

    $

    751

    $

    EM

    BO

    LIZA

    TIO

    N G

    ELF

    OA

    MC

    1884

    241

    $

    265

    $

    PE

    NU

    MB

    RA

    CA

    T3C

    1884

    1,27

    9$

    1,40

    7$

    PE

    NU

    MB

    RA

    CA

    T6C

    1884

    2,07

    9$

    2,28

    7$

    PE

    NU

    MB

    RA

    CA

    T8C

    1884

    3,17

    9$

    3,49

    7$

    CA

    THE

    TER

    GLI

    DE

    C18

    8723

    0$

    25

    3$

    C

    ATH

    ETE

    R S

    UP

    PO

    RT

    RU

    BIC

    ON

    C18

    8768

    0$

    74

    8$

    C

    athe

    ter D

    iagn

    ostic

    C18

    8718

    $

    20$

    C

    athe

    ter G

    uidi

    ng M

    ach

    1C

    1887

    136

    $

    150

    $

    MIC

    RO

    CA

    THE

    TER

    RE

    NE

    GA

    DE

    CO

    AX

    IAL

    C18

    872,

    082

    $

    2,

    290

    $

    M

    ICR

    OC

    ATH

    ETE

    R P

    RO

    GR

    EA

    T C

    OA

    XIA

    LC

    1887

    2,22

    2$

    2,44

    4$

    SH

    EA

    TH O

    PTI

    -SE

    AL

    LOC

    KIN

    G P

    EE

    L A

    WA

    YC

    1892

    233

    $

    256

    $

    PE

    EL-

    AW

    AY

    INTR

    OD

    UC

    ER

    SE

    T 5.

    0FR

    ./9C

    MC

    1892

    339

    $

    373

    $

    PE

    EL-

    AW

    AY

    INTR

    OD

    UC

    ER

    SE

    T 7.

    0FR

    ./15.

    5CM

    C18

    9219

    8$

    21

    8$

    S

    HE

    ATH

    DE

    STI

    NA

    TIO

    N G

    UID

    ING

    45

    CM

    C18

    9441

    4$

    45

    5$

    S

    HE

    ATH

    DE

    STI

    NA

    TIO

    N G

    UID

    ING

    65

    CM

    C18

    9446

    0$

    50

    6$

    S

    HE

    ATH

    DE

    STI

    NA

    TIO

    N G

    UID

    ING

    90

    CM

    C18

    9450

    5$

    55

    6$

    S

    HE

    ATH

    FLE

    XO

    R R

    AA

    BE

    C18

    9430

    9$

    34

    0$

    S

    HE

    ATH

    PR

    ELU

    DE

    PR

    O S

    HO

    RT

    4CM

    C18

    9410

    7$

    11

    8$

    S

    heat

    h Lo

    ng A

    nsel

    Raa

    be D

    estin

    atio

    nC

    1894

    297

    $

    327

    $

    8

    552

  • 201

    8-20

    19 V

    entu

    ra C

    ount

    y M

    edic

    al C

    ente

    r Cha

    rge

    Des

    crip

    tion

    Mas

    ter

    DES

    CR

    IPTI

    ON

    NO

    TE(S

    ee B

    elow

    )C

    PTH

    CPC

    S F

    Y 20

    17-1

    8 R

    ates

    F

    Y 20

    18-1

    9 R

    ates

    FY

    2017

    -18

    Prof

    essi

    onal

    R

    ates

    FY

    2018

    -19

    Prof

    essi

    onal

    R

    ates

    N

    avig

    ator

    Ure

    tera

    l Acc

    ess

    She

    ath

    Set

    11/

    13 F

    r.x36

    cmC

    1894

    647

    $

    712

    $

    Nav

    igat

    or U

    rete

    ral A

    cces

    s S

    heat

    h S

    et 1

    1/13

    Fr.x

    28cm

    C18

    9464

    7$

    71

    2$

    P

    ER

    ITO

    NE

    AL

    INTR

    OD

    UC

    ER

    SH

    EA

    TH, 4

    6CM

    C18

    9415

    8$

    17

    4$

    P

    erito

    neal

    Intro

    duce

    r She

    ath,

    70c

    mC

    1894

    158

    $

    174

    $

    EM

    OB

    LIZA

    TIO

    N L

    C B

    EA

    DS

    C26

    162,

    132

    $

    2,

    345

    $

    P

    TA B

    ALL

    OO

    N L

    UTO

    NIX

    DC

    BC

    2623

    3,74

    0$

    4,11

    4$

    AM

    PLA

    TZE

    R V

    AS

    CU

    LAR

    PLU

    GC

    2628

    3,53

    9$

    3,89

    3$

    CS

    2292

    Mas

    k re

    spira

    tory

    dis

    posa

    ble

    CS

    2292

    52$

    57$

    Fluo

    ride

    Var

    nish

    PO

    CD

    1206

    51$

    56

    $

    Fluo

    ride

    Var

    nish

    PO

    CD

    1206

    51$

    56

    $

    Lary

    Sea

    l Fle

    xi S

    ize

    2 La

    ryng

    eal A

    irway

    Mas

    kE

    0485

    84$

    92

    $

    Lary

    Sea

    l Fle

    xi S

    ize

    2.5

    Lary

    ngea

    l Airw

    ay M

    ask

    E04

    8584

    $

    92$

    La

    ryS

    eal F

    lexi

    Siz

    e 3

    Lary

    ngea

    l Airw

    ay M

    ask

    E04

    8584

    $

    92$

    La

    ryS

    eal F

    lexi

    Siz

    e 4

    Lary

    ngea

    l Airw

    ay M

    ask

    E04

    8584

    $

    92$

    La

    ryS

    eal F

    lexi

    Siz

    e 5

    Lary

    ngea

    l Airw

    ay M

    ask

    E04

    8584

    $

    92$

    FP

    001

    Life

    styl

    e co

    ndom

    s pa

    ck/3

    item

    sFP

    001

    11$

    12$

    G00

    08 A

    dmin

    istra

    tion

    of In

    fluen

    za v

    acci

    ne%

    >G

    0008

    19$

    18

    2$

    G

    0008

    - A

    MB

    Onl

    y Fl

    u A

    dmin

    %>

    G00

    0821

    $

    182

    $

    G00

    09 A

    dmin

    istra

    tion

    of p

    neum

    ococ

    cal v

    acci

    ne%

    >G

    0009

    19$

    18

    2$

    G

    0009

    - A

    MB

    Onl

    y P

    NE

    AD

    %>

    G00

    0921

    $

    182

    $

    G00

    10 A

    dmin

    istra

    tion

    of h

    epat

    itis

    B v

    acci

    ne%

    >G

    0010

    19$

    18

    2$

    G

    0010

    Med

    icar

    e - A

    MB

    Onl

    y H

    epat

    itis

    B A

    dmin

    %>

    G00

    1021

    $

    182

    $

    G01

    01 C

    ervi

    cal o

    r vag

    inal

    can

    cer s

    cree

    ning

    ; pel

    vic

    and

    clin

    ical

    bre

    ast e

    xam

    inat

    ion

    G01

    0112

    1$

    13

    3$

    G

    0102

    Pro

    stat

    e ca

    ncer

    scr

    eeni

    ng; d

    igita

    l rec

    tal

    G01

    0242

    $

    46

    $

    G

    0108

    Dia

    bete

    s ou

    tpat

    ient

    sel

    f-man

    agem

    ent t

    rain

    ing

    per 3

    0 m

    inut

    esG

    0108

    228

    $

    251

    $

    G01

    17 G

    lauc

    oma

    scre

    enin

    g fo

    r hig

    h ris

    k pa

    tient

    s fu

    rnis

    hed

    by o

    ptom

    etris

    t or o

    phth

    alm

    olog

    ist

    G01

    1724

    4$

    26

    8$

    G

    0118

    Gla

    ucom

    a sc

    reen

    ing

    for h

    igh

    risk

    patie

    nt fu

    rnis

    hed

    unde

    r the

    dire

    ct s

    uper

    visi

    on o

    f an

    opto

    met

    rG

    0118

    208

    $

    229

    $

    FAC

    ED

    Dire

    ct A

    dmis

    sion

    of P

    atie

    nt fo

    r Hos

    pita

    l Obs

    erva

    tion

    Car

    eG

    0379

    1,21

    0$

    1,33

    1$

    FAC

    -CM

    S T

    raum

    a re

    spon

    se te

    am a

    ctiv

    atio

    nG

    0390

    39,6

    00$

    43

    ,560

    $

    FAC

    -TR

    AU

    MA

    AC

    TIV

    ATI

    ON

    LE

    VE

    L II

    G03

    9033

    ,000

    $

    36,3

    00$

    FA

    C-T

    RA

    UM

    A A

    CTI

    VA

    TIO

    N L

    EV

    EL

    IIIG

    0390

    26,4

    00$

    29

    ,040

    $

    G03

    96 A

    lcoh

    ol a

    nd/o

    r sub

    stan

    ce (o

    ther

    than

    toba

    cco)

    abu

    se s

    truct

    ured

    ass

    essm

    ent

    & b

    rief i

    nter

    vent

    ioG

    0396

    191

    $

    210

    $

    G03

    97 A

    lcoh

    ol a

    nd/o

    r sub

    stan

    ce (o

    ther

    than

    toba

    cco)