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
7509060 AMIODARONE HCL 200 MG TAB 250 0 0 4300 7509078 CAFFEINE/SODIUM BENZ VIAL 250 0 0 4300 7509086 CHERRY FLAVOR SYRUP 250 0 0 4300 7509094 CLOMIPRAMINE HCL 25 CAP 250 0 0 4300 7509102 DOXAPRAM HCL 20 MG VIAL 250 0 0 4300 7509110 ESTROGENS CONJUGATED CREAM 250 0 0 4300 7509128 ETOMIDATE 2 MG VIAL 250 0 0 4300 7509136 HEP NA PORCINE/NA CH 1000UN/NS 500M 250 0 0 4300 7509144 INSUL NPH HU REC/INS VIAL 636 0 0 4300 7509151 POTASSIUM IODIDE 1 GM SOLN 250 0 0 4300 7509169 POVIDONE-IODINE SOLN 250 0 0 4300 7509177 ZYVOX 600MG INJ 636 0 0 4300 7509185 KETOCONAZOLE CREAM 250 0 0 4300 7509193 MAGNESIUM OXIDE 140 CAP 250 0 0 4300 7509201 MEPIVACAINE HCL 20 M VIAL 636 0 0 4300 7509219 PROPAFENONE HCL 150 TAB 250 0 0 4300 7509227 RABIES IMMUNE GLOBUL 150U VIAL 636 0 0 4300 7509235 CEFTRIAXONE SODIUM 250 MG VIAL 636 0 0 4300 7509243 ACETAMINOPHEN 80 MG CHWTAB 250 0 0 4300 7509250 AZTREONAM 2 GM VIAL 250 0 0 4300 7509268 BUPIVACAINE HCL/DEXT INJ 250 0 0 4300 7509276 BUPROPION HCL 75 MG TAB 250 0 0 4300 7509284 CLOZAPINE 100 MG TAB 250 0 0 4300 7509292 CLOZAPINE 25 MG TAB 250 0 0 4300 7509300 ESTAZOLAM 1 MG TAB 250 0 0 4300 7509318 INDAPAMIDE 2.5 MG TAB 250 0 0 4300 7509326 LACTULOSE 10 GM SOLN 250 0 0 4300 7509334 MORPHINE SULFATE 15 SR TAB 250 0 0 4300 7509342 NADOLOL 20 MG TAB 250 0 0 4300 7509359 NIFEDIPINE 60 MG TAB 250 0 0 4300 7509367 IBUPROFEN 100 MG SUSP 250 0 0 4300 7509375 FENTANYL 25 MCG/1 PATCH 250 0 0 4300 7509383 FENTANYL 50 MCG/1 PATCH 250 0 0 4300 7509391 FLUMAZENIL 0..5 MG 5 ML VIAL 250 0 0 4300 7509409 CHLORPROMAZINE HCL 10 MG TAB 636 0 0 4300 7509417 ACYCLOVIR 800 MG TAB 250 0 0 4300 7509425 LEVOBUNOLOL HCL DROPS 250 0 0 4300 7509433 AMPICILLIN SODIUM/SU 3 GM VIAL 636 0 0 4300 7509441 DILTIAZEM HCL 240 MG CAP 250 0 0 4300 7509458 DILTIAZEM HCL 180 MG CAP 250 0 0 4300 7509466 DOXAZOSIN MESYLATE 1 TAB 250 0 0 4300 7509474 DOXAZOSIN MESYLATE 2 TAB 250 0 0 4300 7509482 CARBIDOPA/LEVODOPA TAB 250 0 0 4300 7509490 SERTRALINE HCL 50 MG TAB 250 0 0 4300 7509508 BENAZEPRIL HCL 10 MG TAB 250 0 0 4300 7509516 SERTRALINE HCL 25 MG TAB 250 0 0 4300 7509524 FENTANYL 100 MCG/1 PATCH 250 0 0 4300
7509532 ISOSORBIDE MONONITRA T SR 24 250 0 0 4300 7509540 AZATHIOPRINE 50 MG TAB 636 0 0 4300 7509557 VERAPAMIL HCL 120 MG TAB 250 0 0 4300 7509565 IPRATROPIUM BROMIDE SPRAY 250 0 0 4300 7509573 HEP NA PORCINE/NACL 12500 UN/250 ML 250 0 0 4300 7509581 VALSARTAN 80 MG TAB 250 0 0 4300 7509607 D-AMPHETAMINE SULFAT TAB 250 0 0 4300 7509615 LIDOCAINE/PRILOCAINE CREAM 250 0 0 4300 7509623 HEPATITIS A VIRUS VA VIAL 250 0 0 4300 7509631 ESTROGENS CONJUGATED TAB 250 0 0 4300 7509649 IPRATROPIUM BROMIDE SOLN 250 0 0 4300 7509656 CLARITHROMYCIN 250 MG TAB 250 0 0 4300 7509664 TERAZOSIN HCL 1 MG CAP 250 0 0 4300 7509672 LORATADINE 10 MG TAB 250 0 0 4300 7509680 TIMOLOL MALEATE/DORZ DROPS 250 0 0 4300 7509698 ACETAZOLAMIDE 500 MG SR CAPS 250 0 0 4300 7509706 PROGESTERONE 50 MG VIAL 636 0 0 4300 7509714 ONDANSETRON 4 MG TAB 636 0 0 4300 7509722 RALOXIFENE HCL 60 MG TAB 250 0 0 4300 7509730 QUETIAPINE FUMARATE TAB 250 0 0 4300 7509748 VENLAFAXINE HCL 37.5 C SR 24 250 0 0 4300 7509755 DESMOPRESSIN ACETATE 40 MCG VIAL 636 0 0 4300 7509763 DIVALPROEX SODIUM 12 TAB 250 0 0 4300 7509771 OXYCODONE HCL 5 MG TAB 250 0 0 4300 7509789 CARVEDILOL 12.5 MG TAB 250 0 0 4300 7509797 HYDROXYPROPYL METHYL DROPS 250 0 0 4300 7509805 LIDOCAINE HCL 10 MG VIAL 250 0 0 4300 7509813 GUAIFENESIN/P-EPHED SR TAB 250 0 0 4300 7509821 OCTREOTIDE ACETATE 15000 MCG VIAL 636 0 0 4300 7509839 OCTREOTIDE ACETATE 100 MCG INJ 636 0 0 4300 7509854 IMMU GLOBULIN GAMMA 10 ML VIAL 636 0 0 4300 7509862 AZITHROMYCIN 200MG/5 SUS REC 250 0 0 4300 7509870 FAMCICLOVIR 250 MG TAB 250 0 0 4300 7509888 AZITHROMYCIN 100MG SUS REC 250 0 0 4300 7509896 ESTRADIOL 0.05 MG/24 PATCH 250 0 0 4300 7509904 SELEGILINE HCL 5 MG TAB 250 0 0 4300 7509912 LITHIUM CARBONATE 45 SR TAB 250 0 0 4300 7509920 IOPAMIDOL VIAL 250 0 0 4300 7509938 PIPERACILL NA/TAZOBA 2.25 GM VIAL 636 0 0 4300 7509946 HYALURONATE SODIUM 1 SYRINGE 250 0 0 4300 7509953 IMIPENEM/CILASTATIN 500 MG VIAL 636 0 0 4300 7509961 ERYTHROMYCIN BASE 25 TAB 250 0 0 4300 7509979 GLIMEPIRIDE 2 MG TAB 250 0 0 4300 7509995 CEFADROXIL MONOHYDRA 500 MG CAP 250 0 0 4300 7510001 CITALOPRAM HYDROBROM TAB 250 0 0 4300 7510019 AMOX TR/POTASSIUM CL SUSP 250 0 0 4300 7510027 ROPIVACAINE HCL 2 MG INJ 636 0 0 4300
- 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: 7508583 ISOPROPYL ALCOHOL SOLN 250
- 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
7509060 AMIODARONE HCL 200 MG TAB 250 0 0 4300<br />
7509078 CAFFEINE/SODIUM BENZ VIAL 250 0 0 4300<br />
7509086 CHERRY FLAVOR SYRUP 250 0 0 4300<br />
7509094 CLOMIPRAMINE HCL 25 CAP 250 0 0 4300<br />
7509102 DOXAPRAM HCL 20 MG VIAL 250 0 0 4300<br />
7509110 ESTROGENS CONJUGATED CREAM 250 0 0 4300<br />
7509128 ETOMIDATE 2 MG VIAL 250 0 0 4300<br />
7509136 HEP NA PORCINE/NA CH 1000UN/NS 500M 250 0 0 4300<br />
7509144 INSUL NPH HU REC/INS VIAL 636 0 0 4300<br />
7509151 POTASSIUM IODIDE 1 GM SOLN 250 0 0 4300<br />
7509169 POVIDONE-IODINE SOLN 250 0 0 4300<br />
7509177 ZYVOX 600MG INJ 636 0 0 4300<br />
7509185 KETOCONAZOLE CREAM 250 0 0 4300<br />
7509193 MAGNESIUM OXIDE 140 CAP 250 0 0 4300<br />
7509201 MEPIVACAINE HCL 20 M VIAL 636 0 0 4300<br />
7509219 PROPAFENONE HCL 150 TAB 250 0 0 4300<br />
7509227 RABIES IMMUNE GLOBUL 150U VIAL 636 0 0 4300<br />
7509235 CEFTRIAXONE SODIUM 250 MG VIAL 636 0 0 4300<br />
7509243 ACETAMINOPHEN 80 MG CHWTAB 250 0 0 4300<br />
7509250 AZTREONAM 2 GM VIAL 250 0 0 4300<br />
7509268 BUPIVACAINE HCL/DEXT INJ 250 0 0 4300<br />
7509276 BUPROPION HCL 75 MG TAB 250 0 0 4300<br />
7509284 CLOZAPINE 100 MG TAB 250 0 0 4300<br />
7509292 CLOZAPINE 25 MG TAB 250 0 0 4300<br />
7509300 ESTAZOLAM 1 MG TAB 250 0 0 4300<br />
7509318 INDAPAMIDE 2.5 MG TAB 250 0 0 4300<br />
7509326 LA<strong>CT</strong>ULOSE 10 GM SOLN 250 0 0 4300<br />
7509334 MORPHINE SULFATE 15 SR TAB 250 0 0 4300<br />
7509342 NADOLOL 20 MG TAB 250 0 0 4300<br />
7509359 NIFEDIPINE 60 MG TAB 250 0 0 4300<br />
7509367 IBUPROFEN 100 MG SUSP 250 0 0 4300<br />
7509375 FENTANYL 25 MCG/1 PATCH 250 0 0 4300<br />
7509383 FENTANYL 50 MCG/1 PATCH 250 0 0 4300<br />
7509391 FLUMAZENIL 0..5 MG 5 ML VIAL 250 0 0 4300<br />
7509409 CHLORPROMAZINE HCL 10 MG TAB 636 0 0 4300<br />
7509417 ACYCLOVIR 800 MG TAB 250 0 0 4300<br />
7509425 LEVOBUNOLOL HCL DROPS 250 0 0 4300<br />
7509433 AMPICILLIN SODIUM/SU 3 GM VIAL 636 0 0 4300<br />
7509441 DILTIAZEM HCL 240 MG CAP 250 0 0 4300<br />
7509458 DILTIAZEM HCL 180 MG CAP 250 0 0 4300<br />
7509466 DOXAZOSIN MESYLATE 1 TAB 250 0 0 4300<br />
7509474 DOXAZOSIN MESYLATE 2 TAB 250 0 0 4300<br />
7509482 CARBIDOPA/LEVODOPA TAB 250 0 0 4300<br />
7509490 SERTRALINE HCL 50 MG TAB 250 0 0 4300<br />
7509508 BENAZEPRIL HCL 10 MG TAB 250 0 0 4300<br />
7509516 SERTRALINE HCL 25 MG TAB 250 0 0 4300<br />
7509524 FENTANYL 100 MCG/1 PATCH 250 0 0 4300
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