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
7511009 LIPITOR 40 MG TAB 250 0 0 4300 7511017 GUAIFENESIN 600 MG SR TAB 250 0 0 4300 7511025 OLANZAPINE 10 MG TAB 250 0 0 4300 7511033 HYALURONATE SODIUM 8 G F 20 16 MG 636 0 0 4300 7511041 SUCRALFATE 1 G TAB 250 0 0 4300 7511058 SUCRALFATE 10MG SUSP 250 0 0 4300 7511066 TAMIFLU 75MG CAP 250 0 0 4300 7511074 TERAZOSIN HCL 5 MG CAP 250 0 0 4300 7511082 BACTERIOSTATIC SODIU VIAL 250 0 0 4300 7511090 METHADONE HCL 10 MG TAB 250 0 0 4300 7511116 HYALURONATE SODIUM 1 SYRINGE 250 0 0 4300 7511124 ISRADIPINE 2.5 MG CAP 250 0 0 4300 7511132 OLANZAPINE 5 MG TAB 250 0 0 4300 7511140 IPRATROPIUM BROMIDE SPRAY 250 0 0 4300 7511157 POTASSIUM CHLORIDE 10 MEQ PB 636 0 0 4300 7511165 VENLAFAXINE HCL 75 M C SR 24 250 0 0 4300 7511173 CLINDAMYCIN PHOSPHAT PB 250 0 0 4300 7511181 SEVOFLURANE LIQUID 250 0 0 4300 7511199 ROPIVACAINE HCL 2 MG INFUS 636 0 0 4300 7511207 FLUPHENAZINE HCL 5 M PO CON 250 0 0 4300 7511215 CLINDAMYCIN PHOSPHAT CRM 250 0 0 4300 7511223 ONDANSETRON HCL 2 MG VIAL 636 0 0 4300 7511231 DORZOLAMIDE HCL DROPS 250 0 0 4300 7511249 CANASA 500 MG SUPP 250 0 0 4300 7511256 TRAMADOL HCL 50 MG TAB 250 0 0 4300 7511264 SENNA/DOCUSATE SODIUM TAB 250 0 0 4300 7511272 SODIUM MORRHUATE 50 VIAL 250 0 0 4300 7511280 DEXAMETHASONE SOD PH 120 MG VIAL 636 0 0 4300 7511298 ASPIRIN 81 MG IVPB 250 0 0 4300 7511306 CEFTRIAXONE 2GM/D5W 50ML 636 0 0 4300 7511314 ANAGRELIDE HCL 0.5 MG CAP 250 0 0 4300 7511322 TIMOLOL MALEATE SOL GEL 250 0 0 4300 7511330 GABAPENTIN 300 MG CAP 250 0 0 4300 7511348 HYOSCYAMINE SULFATE SL TAB 250 0 0 4300 7511355 NICOTINE 7 MG/24 PATCH 250 0 0 4300 7511363 NICOTINE 14 MG/24 PATCH 250 0 0 4300 7511371 NICOTINE 21 MG/24 PATCH 250 0 0 4300 7511389 CEFUROXIME SODIUM 1.5 GM ADDV 636 0 0 4300 7511397 MONTELUKAST SODIUM 1 TAB 250 0 0 4300 7511405 METHIMAZOLE 10 MG TAB 250 0 0 4300 7511413 OXYCODONE HCL 10 MG TAB 250 0 0 4300 7511421 OXYCODONE HCL 40 MG TAB 250 0 0 4300 7511439 AZITHROMYCIN 500 MG VIAL 636 0 0 4300 7511447 CITRIC ACID/SODIUM SOLN 250 0 0 4300 7511454 ROCURONIUM BROMIDE 1 VIAL 250 0 0 4300 7511462 VITAMIN E 400 UN CAP 250 0 0 4300 7511470 CLONIDINE HCL 100 MC VIAL 636 0 0 4300
7511488 BUPROPION HCL 100 MG TAB 250 0 0 4300 7511496 BUPROPION HCL 150 MG TAB 250 0 0 4300 7511504 HYOSCYAMINE SULFATE DROPS 250 0 0 4300 7511512 WELLBUTRIN XL 150MG. TAB 250 0 0 4300 7511520 TRIAMCINOLONE ACETON 40 MG VIAL 636 0 0 4300 7511538 GLIPIZIDE 5 MG TAB OS 250 0 0 4300 7511546 DETROL LA 2MG CAP 250 0 0 4300 7511553 MEXILETINE 150 MG CAP 250 0 0 4300 7511561 BLOOD SUGAR DIAGNOST STRIP 250 0 0 4300 7511579 ERGOTAMINE TARTRATE/ TAB 250 0 0 4300 7511587 NATRECOR 1.5MG VIAL 636 0 0 4300 7511595 CARBAMAZEPINE 200 MG TAB 250 0 0 4300 7511603 HALOPERIDOL DECANOAT 100 MG VIAL 636 0 0 4300 7511611 ACET/CODEINE # 3 TAB 250 0 0 4300 7511629 LOSARTAN POTASSIUM 5 TAB 250 0 0 4300 7511637 AMIODARONE HCL 50 MG VIAL 636 0 0 4300 7511645 MEDROXYPROGESTERONE 150 MG VIAL 636 0 0 4300 7511652 CHLORPROMAZINE HCL 1 TAB 250 0 0 4300 7511660 CEFTAZIDIME PENTAHYD 1 GM ADDV 636 0 0 4300 7511678 CEFTAZIDIME PENTAHYD 2 GM VIAL 636 0 0 4300 7511686 DONEPEZIL HCL 5 MG TAB 250 0 0 4300 7511694 AZITHROMYCIN 250 MG TAB 250 0 0 4300 7511702 FLUOXETINE HCL 10 MG CAP 250 0 0 4300 7511710 DEPAKOTE 125MG SPRIN CAP 250 0 0 4300 7511728 NEFAZODONE HCL 100 M TAB 250 0 0 4300 7511736 WARFARIN SODIUM 5 MG VIAL 250 0 0 4300 7511744 CLARITHROMYCIN 250 M SUS REC 250 0 0 4300 7511751 BISMUTH SUBSALICYLAT SUSP 250 0 0 4300 7511769 PENICILLIN 500 AFTHR TAB 250 0 0 4300 7511777 DILTIAZEM HCL 120 MG C SR 24 250 0 0 4300 7511785 ZOLPIDEM TARTRATE 5 TAB 250 0 0 4300 7511793 AMLODIPINE 2.5MG TAB 250 0 0 4300 7511801 AMLODIPINE 5MG. TAB 250 0 0 4300 7511819 SOTALOL HCL 80 MG TAB 250 0 0 4300 7511835 ALENDRONATE 70 MG TAB 250 0 0 4300 7511843 ENOXAPARIN SODIUM 30 SYRINGE 636 0 0 4300 7511850 IMIPENEM/CILASTATIN 500 MG ADDV 636 0 0 4300 7511868 VENLAFAXINE HCL 25 M TAB 250 0 0 4300 7511876 RIFAMPIN 600 MG VIAL 250 0 0 4300 7511884 NOREPINEPHRINE BITAR VIAL 250 0 0 4300 7511892 MIDAZOLAM HCL 1 MG VIAL 636 0 0 4300 7511900 LEVOTHYROXINE SODIUM TAB 250 0 0 4300 7511918 SIMVASTATIN 10 MG TAB 250 0 0 4300 7511934 ASPIRIN/DIPYRIDAMOLE CAP 250 0 0 4300 7511959 TOPIRAMATE 100 MG TAB 250 0 0 4300 7511967 TOPIRAMATE 25 MG TAB 250 0 0 4300 7511975 LUBRIDERM LOTION 250 0 0 4300
- 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: 7510506 SUMATRIPTAN SUCCINAT 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
7511488 BUPROPION HCL 100 MG TAB 250 0 0 4300<br />
7511496 BUPROPION HCL 150 MG TAB 250 0 0 4300<br />
7511504 HYOSCYAMINE SULFATE DROPS 250 0 0 4300<br />
7511512 WELLBUTRIN XL 150MG. TAB 250 0 0 4300<br />
7511520 TRIAMCINOLONE ACETON 40 MG VIAL 636 0 0 4300<br />
7511538 GLIPIZIDE 5 MG TAB OS 250 0 0 4300<br />
7511546 DETROL LA 2MG CAP 250 0 0 4300<br />
7511553 MEXILETINE 150 MG CAP 250 0 0 4300<br />
7511561 BLOOD SUGAR DIAGNOST STRIP 250 0 0 4300<br />
7511579 ERGOTAMINE TARTRATE/ TAB 250 0 0 4300<br />
7511587 NATRECOR 1.5MG VIAL 636 0 0 4300<br />
7511595 CARBAMAZEPINE 200 MG TAB 250 0 0 4300<br />
7511603 HALOPERIDOL DECANOAT 100 MG VIAL 636 0 0 4300<br />
7511611 ACET/CODEINE # 3 TAB 250 0 0 4300<br />
7511629 LOSARTAN POTASSIUM 5 TAB 250 0 0 4300<br />
7511637 AMIODARONE HCL 50 MG VIAL 636 0 0 4300<br />
7511645 MEDROXYPROGESTERONE 150 MG VIAL 636 0 0 4300<br />
7511652 CHLORPROMAZINE HCL 1 TAB 250 0 0 4300<br />
7511660 CEFTAZIDIME PENTAHYD 1 GM ADDV 636 0 0 4300<br />
7511678 CEFTAZIDIME PENTAHYD 2 GM VIAL 636 0 0 4300<br />
7511686 DONEPEZIL HCL 5 MG TAB 250 0 0 4300<br />
7511694 AZITHROMYCIN 250 MG TAB 250 0 0 4300<br />
7511702 FLUOXETINE HCL 10 MG CAP 250 0 0 4300<br />
7511710 DEPAKOTE 125MG SPRIN CAP 250 0 0 4300<br />
7511728 NEFAZODONE HCL 100 M TAB 250 0 0 4300<br />
7511736 WARFARIN SODIUM 5 MG VIAL 250 0 0 4300<br />
7511744 CLARITHROMYCIN 250 M SUS REC 250 0 0 4300<br />
7511751 BISMUTH SUBSALICYLAT SUSP 250 0 0 4300<br />
7511769 PENICILLIN 500 AFTHR TAB 250 0 0 4300<br />
7511777 DILTIAZEM HCL 120 MG C SR 24 250 0 0 4300<br />
7511785 ZOLPIDEM TARTRATE 5 TAB 250 0 0 4300<br />
7511793 AMLODIPINE 2.5MG TAB 250 0 0 4300<br />
7511801 AMLODIPINE 5MG. TAB 250 0 0 4300<br />
7511819 SOTALOL HCL 80 MG TAB 250 0 0 4300<br />
7511835 ALENDRONATE 70 MG TAB 250 0 0 4300<br />
7511843 ENOXAPARIN SODIUM 30 SYRINGE 636 0 0 4300<br />
7511850 IMIPENEM/CILASTATIN 500 MG ADDV 636 0 0 4300<br />
7511868 VENLAFAXINE HCL 25 M TAB 250 0 0 4300<br />
7511876 RIFAMPIN 600 MG VIAL 250 0 0 4300<br />
7511884 NOREPINEPHRINE BITAR VIAL 250 0 0 4300<br />
7511892 MIDAZOLAM HCL 1 MG VIAL 636 0 0 4300<br />
7511900 LEVOTHYROXINE SODIUM TAB 250 0 0 4300<br />
7511918 SIMVASTATIN 10 MG TAB 250 0 0 4300<br />
7511934 ASPIRIN/DIPYRIDAMOLE CAP 250 0 0 4300<br />
7511959 TOPIRAMATE 100 MG TAB 250 0 0 4300<br />
7511967 TOPIRAMATE 25 MG TAB 250 0 0 4300<br />
7511975 LUBRIDERM LOTION 250 0 0 4300
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