chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

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BILIRUBIN TOTAL 25 25 BILIRUBIN DIRECT 15 15 BILIRUBIN, INDIRECT0 0 IRON 291 291 TIBC 0 0 UIBC 269 269 CALCIUM 61 61 FLUID CHLORIDE 0 0 CARBON MONOXIDE 8(CO) 8 CALCIUM URINE RANDOM 0 0 CHLORIDE (CL) 3 3 CHOLESTEROL 20 20 PCP (TDAS) 0 0 BENZO (TDAS) 0 0 COCAINE (TDAS) 0 0 AMPT (TDAS) 0 0 THC (TDAS) 0 0 OPIATES (TDAS) 0 0 BARBITURATES (TDAS) 0 0 CPK 986 986 IRON/TIBC 0 0 IRON SATURATION 0 0 CREATININE CLEARANCE 13 13 CREAT JP DRAINAGE 0 0 CREATININE RANDOM 88 UR 88 PH BLOOD 1 1 BICARBONATE (HCO3)3 3 BLOOD GASES 69 69 GGTP 47 47 PROTEIN 24HR URINE 24 24 CHLORIDE UR RANDOM 4 4 LUTEINIZING HORMONE 39 39 CALCIUM 24HR URINE2 2 PROLACTIN 81 81 HDL PANEL 2319 2319 CHLORIDE 24HR URINE 0 0 LIPASE 214 214 CREATININE 24HR UR9 9 ELECTROLYTES & MG0 0 LDH 152 152 LACTOSE TOL FASTING1 1 LACTOSE TOL 1/2 HR1 1 LACTOSE TOL 1HR 1 1 LACTOSE TOL 2 HR 1 1 LITHIUM LEVEL 30 30 MAGNESIUM 373 373 MAGNESIUM,UR.RANDOM 0 0
OSMOLALITY SERUM8 8 PSA DIAGNOSTIC 86 86 PSA SCREENING 256 256 ALKALINE PHOS 21 21 PHOSPHOROUS 154 154 PHOSPHORUS,RANDOM 0 UR 0 POTASSIUM (K),SERUM 49 49 POTASSIUM (K),FLUID0 0 LYTES 182 182 COMP.METABOL.PNL 1716NF 1716 COMP.METABOL.PNL 1243FST 1243 BASIC METABOL.PNL 1083NF 1083 BASIC METABOL FSTING 650 650 HEPATIC FUNCTION 575 PNL 575 RENAL FUNCTION PANEL 20 20 TOTAL PROTEIN 10 10 PROTEIN UR RANDOM 36 36 CSF PROTEIN 7 7 SALICYLATE 136 136 COSTISOL STIMULATION 0 0 SODIUM (NA),SERUM8 8 SODIUM (NA),FLUID 0 0 GLUCOSE 24HR URINE0 0 POTASSIUM 24HR URINE 0 0 GLUCOSE FASTING147 147 IGG 19 19 IGA 32 32 IGM 20 20 RA FACTOR,QUANT72 72 POTASSIUM RANDOM 0 UR 0 FLUID GLUCOSE 5 5 SGOT 506 506 SGPT 555 555 TRIGLYCERIDES 7 7 GLUCOSE 2HHP 0 0 BUN 303 303 CREATININE 364 364 BUN/CREA RATIO 0 0 CREATININE,FLUID 0 0 URIC ACID 262 262 GLUCOSE RANDOM25 25 PHOSPHOROUS 24HR 1UR 1 SODIUM URINE RANDOM 12 12 AMYLASE RANDOM URINE 0 0 B NATRIURETIC PEPTIDE 0 0 FSH SERUM 58 58 SODIUM 24HR URINE3 3
Page 1 and 2:
CHRG# CDSC CDEPT CSRV CUPR CREV# 30
Page 3 and 4:
411124 ITEL IV TX HYDRA ADD'L HOUR
Page 5 and 6:
590034 ACU VISIT 999 0 0 3720 59004
Page 7 and 8:
800730 EX MAL LES FACE EAR EYE NOSE
Page 9 and 10:
1000629 IV TX HYDRA ADD'L HR 260 0
Page 11 and 12:
1302629 RADIAL SHFT FX W/MAN 450 0
Page 13 and 14:
1304088 RML FB EXT EYE/CONJL 450 0
Page 15 and 16:
1400050 PC FACILITY FEE-MIN 456 0 1
Page 17 and 18:
1403344 EPISTX ANT CMPLX PKG 456 0
Page 19 and 20:
2201713 MIDLINE CATHETER 278 0 130
Page 21 and 22:
2510360 ASNIS 6.5 THD G/WIRE 270 0
Page 23 and 24:
2530244 GYN VAG PACKING* 270 0 0 38
Page 25 and 26:
2550226 ORT CRV-TC CART MED 270 0 7
Page 27 and 28:
2552461 TIER 1 INSERTS 278 0 6250 3
Page 29 and 30:
2555191 BALLOON SINUPLASTY 270 0 23
Page 31 and 32:
2571529 SYN SM PL LCDCP 05 H 278 0
Page 33 and 34:
2581445 URO STONE BSKT SEG 4 270 0
Page 35 and 36:
2902096 BONE MARROW BIOPSY 761 0 63
Page 37 and 38:
3091105 ARANESP 200MG 1.4ML 636 0 0
Page 39 and 40:
3300712 GLUCOSE STRIP SUBSEQ 300 0
Page 41 and 42:
4100046 DIGOXIN 300 0 50.41 4010 41
Page 43 and 44:
4101077 OSMOLALITY SERUM 300 0 29.2
Page 45 and 46:
4102026 TIME & VOLUME URINE 300 0 1
Page 47 and 48:
4300216 TISSUE HOMOGENOUS 300 0 35.
Page 49 and 50:
4400123 ANTI TITER-ALBUMIN 300 0 24
Page 51 and 52:
4600094 TESTOSTERONE T & F 300 0 28
Page 53 and 54:
4601035 FLUPHENAZINE 300 0 145.02 4
Page 55 and 56:
4601985 RETROVIRAL SEROLOGY 300 0 4
Page 57 and 58:
4602967 HTLV I/II AB 300 0 100.75 4
Page 59 and 60:
4604096 ORG ID AEROBIC UMASS 300 0
Page 61 and 62:
4605101 ASPERGILLUS FUMIGAT. 300 0
Page 63 and 64:
4606471 PARIETAL CELL AB 300 0 90.8
Page 65 and 66:
4607453 IGG,SERUM (CSFI) 300 0 70.9
Page 67 and 68:
4608477 IGG B2 GLYCOPROTEIN 300 0 1
Page 69 and 70:
4609616 SACCHAROMYCES IGG AB 300 0
Page 71 and 72:
4610648 PLASMINOGEN ACT INH1 300 0
Page 73 and 74:
4611703 HYPERCOAG. NON-PREG 300 0 0
Page 75 and 76:
4613063 TISSUE PREP 300 0 82.42 401
Page 77 and 78:
4614095 LIDOCAINE AUTO ABS 300 0 26
Page 79 and 80:
4615340 INCUBATION SERUM & DRUGS, E
Page 81 and 82:
4619177 ALDOLASE 300 0 76.25 4010 4
Page 83 and 84:
4620241 HEP BE AG 300 0 90.45 4010
Page 85 and 86:
4621207 FETOMATERNAL HEMORRHAGE SCR
Page 87 and 88:
4622148 THYROID STIM IMMUNOGLOBULIN
Page 89 and 90:
4623146 RUBEOLA ANTIBODIES, IGG 300
Page 91 and 92:
4624086 MUCOR RACEMOSUS, IGE 300 0
Page 93 and 94:
4800041 SPE COLL TRAVEL/MILE 300 0
Page 95 and 96:
5600689 MRI KEN HIP W/CONT RT 610 0
Page 97 and 98:
5800313 MULTIPLE SLEEP LATENCY TEST
Page 99 and 100:
6103758 BONE DENSITY FX EVAL 320 0
Page 101 and 102:
6108906 CYSTO SCOUT FILM 320 0 108.
Page 103 and 104:
6113864 SHLDR-ARTH PRO/INS-RT 761 0
Page 105 and 106:
6201206 MYO-IMAGING-INFARCT 340 0 9
Page 107 and 108:
6306005 COLOR FLOW DOPPLER 480 0 25
Page 109 and 110:
6390132 US-MIDLINE CATHETER 278 0 1
Page 111 and 112:
6502124 MRI-UP EX NO JT W-LT 610 0
Page 113 and 114:
6702245 CT UP EXT W/ CON-RT 352 0 1
Page 115 and 116:
6801187 CHEST INS & EXP LAT 320 0 1
Page 117 and 118:
6802128 MAMMO DIAG DIGITAL RIGHT 40
Page 119 and 120:
6901607 FINGER 2 OR MORE RT 320 0 1
Page 121 and 122:
7000094 MRI-CHEST W/WO CONTR PLF 61
Page 123 and 124:
7001084 MRI-LOEX NO JT W/WO RT-PLF
Page 125 and 126:
7500820 ASPIRIN 325 MG TAB 250 0 0
Page 127 and 128:
7501794 CHOLESTYRAMINE/SUCRO PACKET
Page 129 and 130:
7502768 DULOXETINE 30MG. CAP EC 250
Page 131 and 132:
7503741 HALOPERIDOL LACTATE VIAL 63
Page 133 and 134:
7504723 LIDOCAINE HCL/D7.5W INJ 250
Page 135 and 136:
7505704 MULTIVITAMINS THERAP 250 0
Page 137 and 138:
7506645 PHENAZOPYRIDINE HCL TAB 250
Page 139 and 140:
7507601 SODIUM BICARBONATE SYRINGE
Page 141 and 142:
7508583 ISOPROPYL ALCOHOL SOLN 250
Page 143 and 144:
7509532 ISOSORBIDE MONONITRA T SR 2
Page 145 and 146:
7510506 SUMATRIPTAN SUCCINAT TAB 25
Page 147 and 148:
7511488 BUPROPION HCL 100 MG TAB 25
Page 149 and 150:
7512486 LANTUS INSULIN VIAL 636 0 0
Page 151 and 152:
7513500 POVIDONE-IODINE 10% SOLN 25
Page 153 and 154:
7514649 PYRAZINAMIDE 500MG TAB 250
Page 155 and 156:
7515620 BUSPIRONE 2.5 MG TAB 250 0
Page 157 and 158:
7517618 TETANUS AND DIPTHERIA TOX .
Page 159 and 160:
7600398 CONTAINER EMPTY 500 270 0 0
Page 161 and 162:
7690001 RED CAP LUER LOCK MED SUPPL
Page 163 and 164:
8201709 PROSTETIC TRAIN PER 15 MIN
Page 165 and 166:
8403214 WHFOWOJT L3808 274 0 509.69
Page 167 and 168:
8701500 IONTOPHORESIS PER 15 MIN DL
Page 169 and 170:
9003112 INITIAL PSYCH EVAL MD 900 0
Page 171 and 172:
9300518 SWALLOW GOAL STATUS 440 0 0
Page 173 and 174:
9301441 LANG EXPRESS GOAL STATUS 44
Page 175 and 176:
9302381 MOBILITY GOAL STATUS 420 0
Page 177 and 178:
9303330 OTHER PT/OT D/C STATUS 420
Page 179 and 180:
9304296 SUB PT/OT GOAL STATUS 430 0
Page 181 and 182:
9702796 MIC MEDICAID INTGRTY ALLOWA
Page 183 and 184:
9704602 UNITED HLTHCR/UNITED HLTHCR
Page 185 and 186:
9707886 TR PAUL ALLOWANCE 0 0 5210
Page 187 and 188:
9805813 H/L SAGA B/D I/P ALLOWANCE
Page 189 and 190:
9822297 STATE INCOME TAXES WITHHELD
Page 191 and 192:
9826116 RENTAL INCOME LLC - VAN LEA
Page 193 and 194:
9827627 HC HOSPICE MED SUPLS MED/SU
Page 195 and 196:
9829565 MATERIAL MGMT-NON-MED SUP S
Page 197 and 198:
9915646 SUPP TRICARE PAYMENT 0 0 10
Page 199 and 200:
9940453 CT CARPENTERS HEALTH FUND P
Page 201 and 202:
9945072 PSYCH DKH CIGNA BEHAV PAYME
Page 203 and 204:
501205 LARYNGOSCOPY 361 0 0 3720 50
Page 205 and 206:
1301993 LY NECK EXTS 20.1-30 450 0
Page 207 and 208:
1304385 EXCIS OF X THORB HEM 450 0
Page 209 and 210:
1402759 THUMB FX W/MAN 456 0 0 3780
Page 211 and 212:
1800150 JAMSHIDI NEEDLE 270 0 0 375
Page 213 and 214:
2525640 EYE RETROBULBAR NDL 270 0 0
Page 215 and 216:
2600153 AMNIO SUPPLIES 270 0 0 3800
Page 217 and 218:
4100384 BENZODIAZEPINES 300 0 0 401
Page 219 and 220:
4605929 MUTATION ID ALLELE S 300 0
Page 221 and 222:
4612685 CX 26 DNA SEQUENCING 300 0
Page 223 and 224:
5600812 MRI KEN UPEX NO JT WO RT 61
Page 225 and 226:
6500052 MRI-SPECIAL 352 0 0 4270 65
Page 227 and 228:
7600570 POTASSIUM ACETATE 2 258 0 0
Page 229 and 230:
8203465 DLSN HFOWOJT L3913 274 0 0
Page 231 and 232:
8403263 EWHORTHO L3763 274 0 0 4370
Page 233 and 234:
8603557 JOINT JACK 274 0 0 4390 860
Page 235 and 236:
8803306 PLFD OT WHFOADDTHUM L3810 2
Page 237 and 238:
9742503 TCORS AUTO ALOOWANCE 0 0 52
Page 239 and 240:
9944786 NATIONAL HEALTH INS NASE PA
Page 241 and 242:
9709817 CHARITY MEDICARE B/D-COINS
Page 243 and 244:
90460 0 23000086 A A 35109990 35109
Page 245 and 246:
99213 0 49000030 A A 37209990 37209
Page 247 and 248:
10060 0 A A 37309990 37309990 10061
Page 249 and 250:
0 A A 37309990 37309990 69287 0 A A
Page 251 and 252:
12002 0 26600071 A A 37809990 37809
Page 253 and 254:
28660 0 26600430 A A 37809990 37809
Page 255 and 256:
11305 0 A A 37809990 37809990 11732
Page 257 and 258:
13122 0 26700127 A A 37809990 37809
Page 259 and 260:
0 A A 37809990 37809990 24200 0 A A
Page 261 and 262:
0 A A 38009990 38009990 51059 C1713
Page 263 and 264:
0 A A 38009990 38009990 C1713 0 A A
Page 265 and 266:
0 27570070 A A 38009990 38009990 0
Page 267 and 268:
C1713 0 27580842 A A 38009990 38009
Page 269 and 270:
C1776 0 A A 38009990 38009990 0 A A
Page 271 and 272:
C1713 0 27500061 A A 38009990 38009
Page 273 and 274:
0 27560350 A A 38009990 38009990 50
Page 275 and 276:
C1776 0 A A 38009990 38009990 C1776
Page 277 and 278:
J9181 0 28100027 A A 42909990 42909
Page 279 and 280:
J0886 JW 0 A A 42909990 42909990 J0
Page 281 and 282:
88112 229.69 31791011 A A 40109990
Page 283 and 284:
82247 50.47 31122500 A A 40109990 4
Page 285 and 286:
83986 40.17 31153532 A A 40109990 4
Page 287 and 288:
0 31251522 A A 40109990 40109990 0
Page 289 and 290:
87070 112.27 31370935 A A 40109990
Page 291 and 292:
81003 18.54 31510043 A A 40109990 4
Page 293 and 294:
86658 221.45 31600198 A A 40109990
Page 295 and 296:
82784 95.79 31600539 A A 40109990 4
Page 297 and 298:
83970 335.78 31600719 A A 40109990
Page 299 and 300:
82205 192.61 31610103 A A 40109990
Page 301 and 302:
86003 62.83 31610294 A A 40109990 4
Page 303 and 304:
83840 135.96 31610549 A A 40109990
Page 305 and 306:
85732 19.57 31610663 A A 40109990 4
Page 307 and 308:
86060 90.64 31610780 A A 40109990 4
Page 309 and 310:
86765 179.22 31610938 A A 40109990
Page 311 and 312:
86658 118.45 31611081 A A 40109990
Page 313 and 314:
87591 211.15 31611185 A A 40109990
Page 315 and 316:
82040 25.75 31611304 A A 40109990 4
Page 317 and 318:
84378 184 A A 40109990 40109990 802
Page 319 and 320:
86316 0 A A 40109990 40109990 87497
Page 321 and 322:
83520 0 A A 40109990 40109990 83519
Page 323 and 324:
8325 0 A A 40109990 40109990 83615
Page 325 and 326:
86735 0 A A 40109990 40109990 86738
Page 327 and 328:
86161 0 A A 40109990 40109990 86200
Page 329 and 330:
87109 0 A A 40109990 40109990 87116
Page 331 and 332:
86003 0 A A 40109990 40109990 86003
Page 333 and 334:
86790 115.36 31800010 A A 40109990
Page 335 and 336:
73721 LT 0 A A 42759990 42759990 73
Page 337 and 338:
73223 RT 0 A A 42759990 42759990 A9
Page 339 and 340:
93016 0 A A 41209990 41209990 93018
Page 341 and 342:
73590 LT 3.502 34021330 A A 4211999
Page 343 and 344:
49450 0 A A 42119990 42119990 49440
Page 345 and 346:
19030 RT 1.566 34061993 A A 4211999
Page 347 and 348:
A9538 2.554 35303930 A A 42409990 4
Page 349 and 350:
40.17 36069628 A A 42519990 4251999
Page 351 and 352:
72148 17.757 45101136 A A 42709990
Page 353 and 354:
71250 6.798 46000905 A A 42609990 4
Page 355 and 356:
75989 0 A A 42609990 42609990 49421
Page 357 and 358:
73620 LT 2.348 A A 42129990 4212999
Page 359 and 360:
72040 2.884 A A 42139990 42139990 7
Page 361 and 362:
72114 7.004 A A 42139990 42139990 7
Page 363 and 364:
73221 LT 0 A A 42739990 42739990 73
Page 365 and 366:
J3490 0 37000039 A A 43009990 43009
Page 367 and 368:
J3490 0 37000193 A A 43009990 43009
Page 369 and 370:
J1100 0 37000371 A A 43009990 43009
Page 371 and 372:
J3490 0 37000527 A A 43009990 43009
Page 373 and 374:
J1815 0 37000670 A A 43009990 43009
Page 375 and 376:
J3490 0 37000848 A A 43009990 43009
Page 377 and 378:
J3490 0 37001005 A A 43009990 43009
Page 379 and 380:
J0780 0 37001148 A A 43009990 43009
Page 381 and 382:
J3260 0 37001333 A A 43009990 43009
Page 383 and 384:
J3490 0 37001596 A A 43009990 43009
Page 385 and 386:
J3490 0 37002285 A A 43009990 43009
Page 387 and 388:
J3490 0 37002628 A A 43009990 43009
Page 389 and 390:
J3490 0 37003982 A A 43009990 43009
Page 391 and 392:
J3490 0 37004115 A A 43009990 43009
Page 393 and 394:
J1335 0 A A 43009990 43009990 J3490
Page 395 and 396:
C9399 0 A A 43009990 43009990 90632
Page 397 and 398:
J3490 0 A A 43009990 43009990 J3490
Page 399 and 400:
J3490 0 37404139 A A 43009990 43009
Page 401 and 402:
J1450 0 A A 43109990 43109990 J2543
Page 403 and 404:
0 42400221 A A 43729990 43729990 0
Page 405 and 406:
97762 30 A A 43739990 43739990 9754
Page 407 and 408:
97113 15 48000144 A A 43719990 4371
Page 409 and 410:
29520 15 48300131 A A 43739990 4373
Page 411 and 412:
94200 426.42 47000062 A A 43409990
Page 413 and 414:
G8998 GN 0 A A 43719990 43719990 G8
Page 415 and 416:
G9171 GN 0 A A 43719990 43719990 G9
Page 417 and 418:
G8984 GP 0 A A 43719990 43719990 G8
Page 419 and 420:
G8986 GO 0 A A 43719990 43719990 G8
Page 421 and 422:
0 A A 51705010 51705220 0 A A 52105
Page 423 and 424:
0 A A 52105010 52105220 0 A A 52105
Page 425 and 426:
0 A A 52505010 52505220 0 A A 52505
Page 427 and 428:
0 A A 12001300 98809400 0 A A 98809
Page 429 and 430:
0 A A 10151000 10001000 0 A A 10061
Page 431 and 432:
0 A A 56205620 10001000 0 A A 56305
Page 433 and 434:
0 A A 70107960 10001000 0 A A 71307
Page 435 and 436:
0 A A 83107960 10001000 0 A A 83207
Page 437 and 438:
0 A A 12101300 12101300 0 A A 10001
Page 439 and 440:
0 A A 10001000 10001000 0 A A 10001
Page 441 and 442:
0 A A 10001000 10001000 0 A A 10001
Page 443 and 444:
0 A A 10001000 10001000 0 A A 10001
Page 445 and 446:
0 D D 43209990 43209990 0 D D 43209
Page 447 and 448:
27200 0 26600325 D D 37809990 37809
Page 449 and 450:
12054 0 26700112 D D 37809990 37809
Page 451 and 452:
32422 0 26700495 D D 37809990 37809
Page 453 and 454:
0 27300121 D D 37219990 37219990 0
Page 455 and 456:
0 27500066 D D 38009990 38009990 0
Page 457 and 458:
J9395 0 28100074 D D 42909990 42909
Page 459 and 460:
83912 36.05 31610152 D D 40109990 4
Page 461 and 462:
83912 142.14 31611065 D D 40109990
Page 463 and 464:
83890 0 D D 40109990 40109990 83890
Page 465 and 466:
78452 39.181 35091172 D D 42409990
Page 467 and 468:
J3490 0 37001142 D D 43009990 43009
Page 469 and 470:
97010 15 41200107 D D 43709990 4370
Page 471 and 472:
L3835 90 41300011 D D 43709990 4370
Page 473 and 474: L0210 90 41000090 D D 43709990 4370
Page 475 and 476: L3860 90 48200015 D D 43909990 4390
Page 477 and 478: 90847 0 D D 44709990 44709990 90849
Page 479 and 480: 0 D D 10001000 10001000 0 D D 10001
Page 481 and 482: 0 I I 38009990 38009990 51180 0 I I
Page 483 and 484: CBDSC MTDQTY YTDQTY MED/SURG, SEMI-
Page 485 and 486: ITEL IV TX HYDRA ADD'L 224 HR 224 I
Page 487 and 488: ACU VISIT 5 5 ENDO DUAL VISIT 0 0 S
Page 489 and 490: EX MAL LES FACE 4.0 0 CM 0 DEBRIDE
Page 491 and 492: IV TX HYDRA ADD'L HR0 0 VACCINE INJ
Page 493: RADIAL SHFT FX W/MAN 0 0 FX CARE W/
Page 496 and 497: SHAVING SKIN LESION 0
Page 498 and 499: CMPLX SC EXTS EA ADD 0 0 CMPLX FACE
Page 500 and 501: SUTURE REMOVAL-DKH 0 0 REMOVAL FB U
Page 502 and 503: ART FASTFIX KNT PSHR2 2 ART FASTFIX
Page 504 and 505: LAP UNIV TROCAR SLVE 14 5MM 14 ART
Page 506 and 507: MIS DRAIN BAKER JEJUN 0 0 MIS DRAIN
Page 508 and 509: ORT MITEK SUPER 0 0 ORT PLATE HUMER
Page 510 and 511: TKA X3 TRIATHLON CS 0 INS 0 TOPAZ W
Page 512 and 513: STAPLE PURSESTRING0 0 STAPLE PURSTR
Page 514 and 515: URO CATH SILIC 22/3WAY* 0 0 URO CAT
Page 516 and 517: THA ACCOLADE C CS 0127NK 0 THA ACCO
Page 518 and 519: ETOPOSIDE 20 MG/ML 450 VIAL 450 FLU
Page 520 and 521: EPOGEN 1000 UNITS 0WASTAGE 0 EPOGEN
Page 522 and 523: CYTO SPUTUM 0 0 CYTO URINE 6 6 CYTO
Page 526 and 527: GASTRIC PH 0 0 CSF GLUCOSE 7 7 FLUI
Page 528 and 529: DIFFERENTIAL/MANUAL 797 797 SMEAR R
Page 530 and 531: WOUND CULTURE124 124 BLOOD CULTURE
Page 532 and 533: PH URINE 0 0 SPEC.GRAVITY URINE0 0
Page 534 and 535: ECHOVIRUS AB 0 0 HLA A,B TYPING DNA
Page 536 and 537: IGA 26 26 IGM 26 26 PORPHYRINS, RAN
Page 538 and 539: PTH N TERM INTACT 0 0 SEROTONIN-SER
Page 540 and 541: BARBITURATES,SERUM0 0 BARBITURATES,
Page 542 and 543: IBT RAST ALLERGEN 24 12 24 SGPG 0 0
Page 544 and 545: METHADONE,UR 0 0 HEPATITIS E IGM 0
Page 546 and 547: SUBSTITUTION PLASMA 0 0 RMSF IGG 0
Page 548 and 549: ANTI-STREPTOLYSIN O3 3 S.CEREVISIAE
Page 550 and 551: RUBEOLA AB,IGG 28 28 SEX HORMONE BI
Page 552 and 553: COXSACKIE B2 AB 0 0 COXSACKIE B3 AB
Page 554 and 555: N.GONORRHOEAE RNA 0 0 CORTISONE,SER
Page 556 and 557: ALBUMIN 0 0 YERSINIA AB 1 1 JANUS K
Page 558 and 559: GLYCOMARK 0 0 STREPTOMYCIN 0 0 THYR
Page 560 and 561: CHROMAGRANIN A 3 3 CMV DNA QUANT RT
Page 562 and 563: ANTI MULLERIAN HORMONE 0 0 TSH ANTI
Page 564 and 565: INSULIN 0 0 LD, BODY FLUID 0 0 LACT
Page 566 and 567: MUMPS ANTIBODIES, 0IGG 0 MYCOPLASMA
Page 568 and 569: C1 ESTERASE INHIB, FUNC 0 0 CCP ANT
Page 570 and 571: UREAPLASMA MYCOPLASMA 0 HOM 0 MYCOB
Page 572 and 573: COCONUT, IGE 0 0 ONIONS, IGE 0 0 PI
Page 574 and 575:
PARAINFLUENZA TYPE 0 I 0 PARAINFLUE
Page 576 and 577:
MRI KEN KNEE WO CONT 9 LT 9 MRI KEN
Page 578 and 579:
MRI KEN UPEXT W/WO 0 CON RT 0 MRI K
Page 580 and 581:
PRO FEE STRESS MD SUPERVS 0 0 PRO F
Page 582 and 583:
LOWER LEG-LEFT 7 7 LOWER LEG-RIGHT
Page 584 and 585:
GASTRO TUBE REPLACEMENT 1 1 INSERT
Page 586 and 587:
MAMMO DUCT PROC-RT 1 1 HIP-2 VIEWS
Page 588 and 589:
PYROPHOSPHATE 7 7 I 123 - 200 2 2 S
Page 590 and 591:
US-BIOPSY PROC-PANCR 0 0 US-BIOPSY-
Page 592 and 593:
MRI-LS SPINE W/O CON 43 43 MRI-LS S
Page 594 and 595:
CT CHEST HIGH RESOLU 0 W/O 0 CT CHE
Page 596 and 597:
CT INTRAPERI CATHETER 0 0 CT INTRAP
Page 598 and 599:
FOOT LT(2 VIEWS) 0 0 FOOT RT(2 VIEW
Page 600 and 601:
CERV SPINE TWO VIEW0 0 CERV SPINE W
Page 602 and 603:
LS SPINE&OBL&FLEX&EX 0 6 VW 0 LS SP
Page 604 and 605:
MRI WRIST WO CON 0LT PLF 0 MRI-WRIS
Page 606 and 607:
CALCITRIOL 0.25 MCG 5 CAP 5 ALLOPUR
Page 608 and 609:
CALCIUM CHLORIDE 10% 0 VIAL 0 CANDE
Page 610 and 611:
DEXAMETHASONE 492 4MG/ML VIAL 492 D
Page 612 and 613:
FIORINAL CAP GENERIC 2 CAP 2 FLUNIS
Page 614 and 615:
HUMALOG MIX 75/250 INSULIN 0 ITRACO
Page 616 and 617:
METHENAMINE 1 GM 0TAB 0 METHOCARBAM
Page 618 and 619:
NITROGLYCERIN 0.4MG 0 SL SP 0 NITRO
Page 620 and 621:
PROCHLORPERAZINE 110 MG VI 1 PROCAI
Page 622 and 623:
TOBRAMYCIN 80 MG/2ML 11 VIAL11 TOBR
Page 624 and 625:
AMIODARONE 200 MG 16 TAB 16 CAFFEIN
Page 626 and 627:
VITAMIN E 200 UNIT 0CAP 0 LAMOTRIGI
Page 628 and 629:
ATORVASTATIN 40205 MG TAB 205 GUAIF
Page 630 and 631:
FLUVASTATIN 20 MG 0CAP 0 CASTOR OIL
Page 632 and 633:
PRAMIPEXOLE .25MG 0TAB 0 AMOXICILLI
Page 634 and 635:
ERTAPENEM 1GM ADDV 0 0 GLYCOPYRROLA
Page 636 and 637:
FOSPROPOFOL 1050MG/30ML 0 0 HAVRIX
Page 638 and 639:
BACITRACIN 50 MU INJ 4 VIAL 4 DRONE
Page 640 and 641:
ACETAMINOPH 100MG/ML 0 DROP0 REPAGL
Page 642 and 643:
FLUCONAZOLE 400 MG/200 0 ML 0 ZOSYN
Page 644 and 645:
SP-CANCEL VISIT DLS0 0 SP-ABSENT DL
Page 646 and 647:
CHCKOT ORTH PROS 0PER 15 0 WHEELCHA
Page 648 and 649:
OT AQUATIC REHAB/15 0 MIN 0 OT ORTH
Page 650 and 651:
HIP STRAP (PROC) PLF0 0 SENSORY INT
Page 652 and 653:
M V V 0 0 METHACHOLINE EVAL5 5 ARTE
Page 654 and 655:
SWALLOW D/C STATUS 1 1 SWALLOW D/C
Page 656 and 657:
VOICE CURRENT STATUS 0 0 VOICE CURR
Page 658 and 659:
CARRY CURRENT STATUS 2 2 CARRY CURR
Page 660 and 661:
CARRY D/C STATUS 0 0 SELF CARE CURR
Page 662 and 663:
SUPP BLUE CROSS -237 ALLOW -237 SUP
Page 664 and 665:
GOLDEN RULE ALLOW -38 -38 GREAT WES
Page 666 and 667:
H/L SAGA ADMINISTRATION 0 0 H/L SAG
Page 668 and 669:
TFR FROM B/D TO A/R3 3 TFR FROM A/R
Page 670 and 671:
PHYS PRAC ATHENA CASH 0 0 MEDICAL O
Page 672 and 673:
CAFETERIA SALES CAFE 0 0 CAFETERIA
Page 674 and 675:
LABORATORY - UTILITIES 0 0 CARDIA R
Page 676 and 677:
OPER OF PLANT-GAS0 0 NON MEDICAL SU
Page 678 and 679:
PERSONAL PYMT (P/R -37DED) -37 TCOR
Page 680 and 681:
BLUE CROSS OF RI PAYMENT -88 -88 OU
Page 682 and 683:
SEVEN CORNERS PAYMENT 0 0 IMG PAYME
Page 684 and 685:
ZZ OHM UNSPECIFIED 0PYMT 0 ZZ STERL
Page 686 and 687:
SITE ASSESSMENT 0 0 SITE ASSESSMENT
Page 688 and 689:
TX COCCYGEAL FX 0 0 HIP DISLOCW/O A
Page 690 and 691:
CL INTE FACE7.6-12.50 0 LYR FACE 12
Page 692 and 693:
THORACENTESIS W/TUBE 0 0 TUBE THOR
Page 694 and 695:
POST-OP SHOE 0 0 T-LOOP ELECTRODE 0
Page 696 and 697:
SYN L PL DCP BR 07 H0 0 SYN L PL DC
Page 698 and 699:
FULVESTRANT 125 MG 0 SYRING 0 CYTAR
Page 700 and 701:
KENNEDY DISEASE DNA 0 0 APOLIPO.E G
Page 702 and 703:
MEN2/FMTC MUTATIONS 0 0 COMPLETE CM
Page 704 and 705:
PCR BY IMUGEN 0 0 A PHAGOCYTOPHILUM
Page 706 and 707:
PLANAR CARDIAC RE&EX 0 0 PLANAR CAR
Page 708 and 709:
PROCAINAMIDE SR 500 MG TA 0 TEGASER
Page 710 and 711:
DLSN MOIST HEAT/CRYO(PROC 0 0 FUNCT
Page 712 and 713:
PLFD WHFOADDSPREXT 0 L3835 0 PLFD W
Page 714 and 715:
VIDEO FLUORO EVAL I0 0 OT REEVAL CP
Page 716 and 717:
DLSN OT WHFOADMPFLXIL3860 0 0 DLSN
Page 718 and 719:
PRO FEE FAMILY THERAPY 0 0 PROF FEE
Page 720 and 721:
MISC MEDICARE MCO 0 PMT 0 NATIONAL
Page 722 and 723:
ART OATS 07MM 0 0 ART OATS 08MM 0 0
show all

chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

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