chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov
chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov
6310403 US-BIOPSY PROC-PANCR 761 0 1863.68 4251 6310411 US-BIOPSY-PANCREAS GUIDE 402 0 384.03 4251 6310452 US-BIOPSY PROC-RETRO 761 0 1003.52 4251 6310460 US-BIOPSY-RETROPER GUIDE 402 0 384.03 4251 6310478 US-BIOPSY PROC-LUNG ADD'L LESION 761 0 1748.79 4251 6310502 US-GUIDED PROC-DRAIN 761 0 291.33 4251 6310528 US-BIOPSY-LYMPH NODE GUIDE 402 0 384.03 4251 6310536 US-GUIDED DRAINAGE GUIDE 402 0 384.03 4251 6310544 US-BIOPSY PROC-LYMPH NODE 761 0 1437.46 4251 6310551 US-BIOPSY-ABD GUIDE 402 0 384.03 4251 6310577 US-BIO-PROC-BREAST ADD'L LESION 761 0 1105.74 4251 6310619 US-CORE BIOPSY THYROID 761 0 620.99 4251 6310627 US-BIOPSY-THYROID GUIDE 402 0 384.03 4251 6310700 US-BIOPSY PROC-THYROID ADD'L LESION 761 0 620.99 4251 6311013 BREAST CYST ASPIRA GUIDE 402 0 384.03 4251 6311021 US-BIOPSY PROC-BONE DEEP 761 0 3093.14 4251 6311039 US-BIOPSY PROC NECK OR THORAX 761 0 3093.14 4251 6311047 US-BIOPSY PROC-SOFT TISSUE 761 0 774.02 4251 6311054 US-BIOPSY PROC BONE SUPERFICIAL 761 0 865.02 4251 6311062 AV FISTULA OR PSEUDO ANEURYSM 921 0 305.99 4251 6311070 US-BIOPSY-BONE DEEP GUIDE 402 0 384.03 4251 6311088 US-BIOPSY-BONE SUPERFICIAL GUIDE 402 0 384.03 4251 6311096 US-BIOPSY-NECK OR THORAX GUIDE 402 0 384.03 4251 6311112 US-BIOPSY-SOFT TISSUE GUIDE 402 0 384.03 4251 6320063 ARTERIES LOW EXT-LT 921 0 286.44 4251 6320071 ARTERIES LOW EXT-RT 921 0 286.44 4251 6320113 ARTERIES UPP EXT-LT 921 0 286.44 4251 6320121 ARTERIES UPP EXT-RT 921 0 286.44 4251 6320253 ABD LTD ONE ORGAN 402 0 441.67 4251 6320352 U S-INFANT HIPS 402 0 281.34 4251 6320402 U S-INFANT HIPS-LTD 402 0 184.08 4251 6320550 THORACENTESIS GUIDE 402 0 384.03 4251 6320659 ULTRASOUND GUIDANCE 402 0 384.03 4251 6320709 CENTRL LINE PLACEMNT 402 0 77.29 4251 6320758 CENTRAL LINE PROC 761 0 1159.28 4251 6320808 THORACENTESIS PROC 761 0 1037.89 4251 6320907 US-PLEURAL TUNNEL CATH PROC 761 0 4649.84 4251 6320915 US-PLEURAL TUNNEL CATHETER 402 0 1368.44 4251 6320923 US-BREAST CLIP PLACEMENT 761 0 1256.51 4251 6320931 VASCULAR STUDY LIMITED 921 0 515.42 4251 6320949 VASCULAR STUDY COMPLETE 921 0 610.64 4251 6320956 HEAD OR NECK ULTRASOUND 402 0 567.55 4251 6350052 IV START INJECTION 940 0 112.06 4251 6390058 DEFINITY CONT-PERFLU 636 0 208.07 4251 6390108 US VACUUM DRAIN BTL & TUBING SUPPLY 270 0 128.25 4251 6390116 US PLEURAL CATHETER SUPPLY 278 0 1181.25 4251 6390124 US PERITONEAL CATHETER SUPPLY 278 0 1181.25 4251
6390132 US-MIDLINE CATHETER 278 0 130 4251 6390157 PICC KIT 270 0 148 4251 6401210 PET/CT SKULL TO THIGH INITIAL 404 0 6699.84 4220 6401228 PET/CT SKULL TO THIGH SUBSEQUENT 404 0 6699.84 4220 6401251 PET/CT WHOLE BODY MELANOMA INITIAL 404 0 7724.53 4220 6401269 PET/CT WHOLE BODY MELANOMA SUB 404 0 7724.53 4220 6401509 PET/CT-LIMITED AREA 404 0 1775.06 4220 6401608 PET-BRAIN-METAB EVAL 404 0 3732.34 4220 6401616 PET-BRAIN-PERFU EVAL 404 0 3732.34 4220 6401707 PET-MYOCAR META EVAL 404 0 3407.43 4220 6401715 PET-CARD-REST-OR-STR 404 0 3407.43 4220 6401723 PET-CARD FULL MULTI 404 0 3407.43 4220 6401731 PET/CT SKULL TO THIGH INI NOPR 404 0 6699.84 4220 6401749 PET/CT SKULL TO THIGH SUB NOPR 404 0 6699.84 4220 6401756 PET/CT WHOLE BODY MELANOMA IN NOPR 404 0 7724.53 4220 6401764 PET/CT WHOLE BODY MEL SUB NOPR 404 0 7724.53 4220 6490106 PET-FDG-ISOTOPE 343 0 992.77 4220 6500102 MRI-ABDOMEN W/O CONT 610 0 1430 4270 6500110 MRI-ABDOMEN W/CONTRA 610 0 2299.83 4270 6500128 MRI-ABDOMEN W/WO CON 610 0 4516.22 4270 6500219 MRI-C SPINE W/O CONT 612 0 1373.37 4270 6500227 MRI-C SPINE W CONTRA 612 0 1646.07 4270 6500235 MRI-C SPINE W/WO CON 612 0 3051.54 4270 6500300 MRI-CHEST W/O CONTR 610 0 1373.37 4270 6500318 MRI-CHEST W/CONTRAST 610 0 1373.37 4270 6500326 MRI-CHEST W/WO CONTR 610 0 1373.37 4270 6500409 MRI-FACE W/O CONTRAS 611 0 1352.39 4270 6500417 MRI-FACE W/CONTRAST 611 0 1622.64 4270 6500425 MRI-FACE W/WO CONTR 611 0 3003.41 4270 6500508 MRI-HEAD W/O CONTRAS 611 0 1373.37 4270 6500516 MRI-HEAD W CONTRAST 611 0 1646.07 4270 6500524 MRI-HEAD W/WO CONTRA 611 0 3051.54 4270 6500607 MRI-IAC'S W/WO CONTRAST 611 0 3051.54 4270 6500615 MRI-IACS-WO 611 0 1373.37 4270 6500623 MRI-UPEXT JOINT W/CONTRAST LT 610 0 2299.83 4270 6500631 MRI-UPEXT JOINT W/CONTRAST RT 610 0 2299.83 4270 6500649 MRI-UPEXT JOINT W/O CON LT 610 0 1839.86 4270 6500656 MRI-PIT/SELLA W/WO CO 611 0 3051.54 4270 6500664 MRI-UPEXT JOINT W/O CONTRAST RT 610 0 1839.86 4270 6500672 MRI-UPEXT W W/O CONT LT 610 0 3003.41 4270 6500680 MRI-UPEXT W W/O CONT RT 610 0 3003.41 4270 6500706 MRI-HIP WO CONTR-LT 610 0 1839.86 4270 6500714 MRI-HIP WO CONTR-RT 610 0 1839.86 4270 6500722 MRI-HIP W&WO CON-LT 610 0 3003.41 4270 6500730 MRI-HIP W&WO CON-RT 610 0 3003.41 4270 6500748 MRI-HIP-W/CONT-RT 610 0 2299.83 4270 6500755 MRI-HIP-W/CONT-LT 610 0 2299.83 4270
- 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: 6306005 COLOR FLOW DOPPLER 480 0 25
- 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 .
6310403 US-BIOPSY PROC-PANCR 761 0 1863.68 4251<br />
6310411 US-BIOPSY-PANCREAS GUIDE 402 0 384.03 4251<br />
6310452 US-BIOPSY PROC-RETRO 761 0 1003.52 4251<br />
6310460 US-BIOPSY-RETROPER GUIDE 402 0 384.03 4251<br />
6310478 US-BIOPSY PROC-LUNG ADD'L LESION 761 0 1748.79 4251<br />
6310502 US-GUIDED PROC-DRAIN 761 0 291.33 4251<br />
6310528 US-BIOPSY-LYMPH NODE GUIDE 402 0 384.03 4251<br />
6310536 US-GUIDED DRAINAGE GUIDE 402 0 384.03 4251<br />
6310544 US-BIOPSY PROC-LYMPH NODE 761 0 1437.46 4251<br />
6310551 US-BIOPSY-ABD GUIDE 402 0 384.03 4251<br />
6310577 US-BIO-PROC-BREAST ADD'L LESION 761 0 1105.74 4251<br />
6310619 US-CORE BIOPSY THYROID 761 0 620.99 4251<br />
6310627 US-BIOPSY-THYROID GUIDE 402 0 384.03 4251<br />
6310700 US-BIOPSY PROC-THYROID ADD'L LESION 761 0 620.99 4251<br />
6311013 BREAST CYST ASPIRA GUIDE 402 0 384.03 4251<br />
6311021 US-BIOPSY PROC-BONE DEEP 761 0 3093.14 4251<br />
6311039 US-BIOPSY PROC NECK OR THORAX 761 0 3093.14 4251<br />
6311047 US-BIOPSY PROC-SOFT TISSUE 761 0 774.02 4251<br />
6311054 US-BIOPSY PROC BONE SUPERFICIAL 761 0 865.02 4251<br />
6311062 AV FISTULA OR PSEUDO ANEURYSM 921 0 305.99 4251<br />
6311070 US-BIOPSY-BONE DEEP GUIDE 402 0 384.03 4251<br />
6311088 US-BIOPSY-BONE SUPERFICIAL GUIDE 402 0 384.03 4251<br />
6311096 US-BIOPSY-NECK OR THORAX GUIDE 402 0 384.03 4251<br />
6311112 US-BIOPSY-SOFT TISSUE GUIDE 402 0 384.03 4251<br />
6320063 ARTERIES LOW EXT-LT 921 0 286.44 4251<br />
6320071 ARTERIES LOW EXT-RT 921 0 286.44 4251<br />
6320113 ARTERIES UPP EXT-LT 921 0 286.44 4251<br />
6320121 ARTERIES UPP EXT-RT 921 0 286.44 4251<br />
6320253 ABD LTD ONE ORGAN 402 0 441.67 4251<br />
6320352 U S-INFANT HIPS 402 0 281.34 4251<br />
6320402 U S-INFANT HIPS-LTD 402 0 184.08 4251<br />
6320550 THORACENTESIS GUIDE 402 0 384.03 4251<br />
6320659 ULTRASOUND GUIDANCE 402 0 384.03 4251<br />
6320709 CENTRL LINE PLACEMNT 402 0 77.29 4251<br />
6320758 CENTRAL LINE PROC 761 0 1159.28 4251<br />
6320808 THORACENTESIS PROC 761 0 1037.89 4251<br />
6320907 US-PLEURAL TUNNEL CATH PROC 761 0 4649.84 4251<br />
6320915 US-PLEURAL TUNNEL CATHETER 402 0 1368.44 4251<br />
6320923 US-BREAST CLIP PLACEMENT 761 0 1256.51 4251<br />
6320931 VASCULAR STUDY LIMITED 921 0 515.42 4251<br />
6320949 VASCULAR STUDY COMPLETE 921 0 610.64 4251<br />
6320956 HEAD OR NECK ULTRASOUND 402 0 567.55 4251<br />
6350052 IV START INJE<strong>CT</strong>ION 940 0 112.06 4251<br />
6390058 DEFINITY CONT-PERFLU 636 0 208.07 4251<br />
6390108 US VACUUM DRAIN BTL & TUBING SUPPLY 270 0 128.25 4251<br />
6390116 US PLEURAL CATHETER SUPPLY 278 0 1181.25 4251<br />
6390124 US PERITONEAL CATHETER SUPPLY 278 0 1181.25 4251
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