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
1304815 SHAVING SKIN LESION 1 (
1400050 PC FACILITY FEE-MIN 456 0 136.81 3780 1400100 PC FACILITY FEE-BRIE 456 0 223.76 3780 1400159 PC FACILITY FEE-LIM 456 0 355.12 3780 1400209 PC FACILITY FEE-INTE 456 0 566.09 3780 1400258 PC FACILITY FEE-EXT 456 0 647.27 3780 1400308 PC-FAC FEE-NO CHRG 456 0 0 3780 1400407 PC LWBS-TRIAGE ONLY 098 0 9.8 3780 1401504 I&D ABSCESS SIMPLE 456 0 581.52 3780 1401512 I&D ABSCESS COMPLEX 456 0 697.82 3780 1401520 I&D PILONIDAL CYST S 456 0 318.26 3780 1401538 I&D PILONIDAL CYST C 456 0 1306.38 3780 1401546 RMVL SUBC FB SMPL 456 0 1123.16 3780 1401553 RMVL SUBC FB CMPLX 456 0 1832.09 3780 1401561 I&D HEMATOMA SEROMA 456 0 5184.08 3780 1401579 PUNC ASP ABSC CYST 456 0 717.81 3780 1401587 DEBR SKN UPTO 10%TBS 456 0 254.96 3780 1401595 DEBR SKIN PART THICK 456 0 324.67 3780 1401611 DEBR SKN & SUBC TISS 456 0 1067 3780 1401645 REM SKIN TAGS;UPTO15 456 0 177.23 3780 1401678 DEBR NAILS 1-5 456 0 177.23 3780 1401686 AVUL NAIL PLATE SMPL 456 0 306.76 3780 1401694 EVAC SUBUNGUAL HEMAT 456 0 48.2 3780 1401702 EXC NAIL MATRIX INGE 456 0 860.81 3780 1401710 REPAIR NAIL BED 456 0 396.62 3780 1401728 WDG EXC NAIL FOLD 456 0 95.44 3780 1401736 SMPL BODY SC 30.0 456 0 261.34 3780 1401793 SMPL FACE < 2.5 456 0 648.25 3780 1401801 SMPL FACE 2.6-5.0 CM 456 0 181.51 3780 1401819 SMPL FACE 5.1-7.5 CM 456 0 151.26 3780 1401827 SMPL FACE 7.6-12.5CM 456 0 151.26 3780 1401835 SMPL FACE12.6-20.0CM 456 0 261.34 3780 1401876 LYR BDY SCALP
- 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: 1304088 RML FB EXT EYE/CONJL 450 0
- 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
1304815 SHAVING SKIN LESION 1 (
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