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
7512965 PRAMIPEXOLE .25MG TAB 250 0 0 4300 7512973 AMOXICILLIN 500 MG RX TO GO CAP 250 0 0 4300 7512981 CEPHALEXIN 500 MG RX TO GO CAP 250 0 0 4300 7512999 OVRAL 0.5/50 TAB GENERIC TAB 250 0 0 4300 7513005 CODEINE/APAP #3 RX TO GO TAB 250 0 0 4300 7513047 ROPINIROLE 0.25 MG TAB 250 0 0 4300 7513054 EPLERENONE 25 MG TAB 250 0 0 4300 7513062 TRAVOPROST 0.004% 2.5 ML DROPS 250 0 0 4300 7513070 EDETATE CALCIUM 1000MG AMP INJ 636 0 0 4300 7513088 TRIAMCINOLONE 0.1% OIN 80G 250 0 0 4300 7513096 CYPROHEPTADINE 4 MG TAB 250 0 0 4300 7513104 VALACYCLOVIR 500 MG TAB 250 0 0 4300 7513112 SCOT TUSSIN 100MG/5ML LIQUID 250 0 0 4300 7513120 PODOPHYLLUM RESIN 30 GM POWDER 250 0 0 4300 7513138 VANCOMYCIN 500 MG VIAL 636 0 0 4300 7513146 EPINEPHRINE 1MG/10ML SYR 636 0 0 4300 7513153 HYDROXYZINE PAM 25 MG CAP 250 0 0 4300 7513179 ORA SWEET SF SYRUP 250 0 0 4300 7513187 ORA PLUS SUSP VEHICLE SYRUP 250 0 0 4300 7513195 POVIDONE-IOD 10% OINT 30GM 250 0 0 4300 7513203 HYPERHEP 0.5ML/SYRINGE 250 0 0 4300 7513229 CAFFEINE 200 MG TAB 250 0 0 4300 7513237 NYSTATIN CREAM 30GM TUBE 250 0 0 4300 7513245 CHLOROXYLENOL LIQ BOTTLE 250 0 0 4300 7513252 CANDIDA SKIN TEST 250 0 0 4300 7513278 EMOLLIENT(RADIAGEL) 85GM GEL 250 0 0 4300 7513286 HYDROCERIN CREAM 454GM 250 0 0 4300 7513294 HYDROCERIN CREAM 120GM 250 0 0 4300 7513310 BUMETANIDE 1 MG/4ML VIAL 250 0 0 4300 7513328 BUMETANIDE 2.5MG/10ML VL 250 0 0 4300 7513336 PRENATAL VITAMIN TAB 250 0 0 4300 7513344 MINERAL OIL 10ML VIAL 250 0 0 4300 7513351 VISINE A EYE DROPS 15ML 250 0 0 4300 7513369 VITAMIN D 400 UNIT TAB 250 0 0 4300 7513377 ASCORIC ACID 1 GM/2ML AMP INJ 250 0 0 4300 7513385 CEFAZOLIN 2 GM INJ 636 0 0 4300 7513393 KCL 2 MEQ/ML INJ VL 15ML VIAL 636 0 0 4300 7513401 KCL 2 MEQ/ML INJ VL 10ML VIAL 636 0 0 4300 7513419 KCL 2 MEQ/ML INJ VL 5 ML VIAL 636 0 0 4300 7513427 KCL 2 MEQ/ML INJ VL 20 ML VIAL 636 0 0 4300 7513435 TRACE METALS VIT 10 ML VL 250 0 0 4300 7513443 MVI ADULT INJ VIAL 250 0 0 4300 7513450 POTASSIUM PHOSPH 45 MM VL 250 0 0 4300 7513468 POTASSIUM ACET 40MEQ VIAL 250 0 0 4300 7513476 TETRACAINE 2% SOLN 30 ML 250 0 0 4300 7513484 STERILE WATER IRRIG LITER 250 0 0 4300 7513492 DEXTROSE 25% WATER 10ML INJ SYRINGE 250 0 0 4300
7513500 POVIDONE-IODINE 10% SOLN 250 0 0 4300 7513518 MAGNESIUM 1GM/100ML D5W INFUS 636 0 0 4300 7513526 FLUORESCEIN 10% INJ AMP 250 0 0 4300 7513534 TIMOLOL 0.25% GFS 2.5 ML SOL GEL 250 0 0 4300 7513542 BOTULINUM TOXIN 100 U VIAL 636 0 0 4300 7513559 MIDODRINE 5 MG TAB 250 0 0 4300 7513567 ERGOCALCIFEROL 50M U CAP 250 0 0 4300 7513575 KALETRA TAB 250 0 0 4300 7513583 COMBIVIR TABLET 250 0 0 4300 7513591 ACETYLCYSTEINE 200MG/ML INJ 250 0 0 4300 7513609 OXYBUTYNIN 3.9 MG/PATCH 250 0 0 4300 7513617 SUBOXONE 2MG/0.5MG SL TAB 250 0 0 4300 7513625 BUPRENORPHINE 2 MG TAB 250 0 0 4300 7513633 EPTIFIBATIDE 75MG/100ML VIAL 636 0 0 4300 7513641 EPTIFIBATIDE 20MG/10ML VIAL 636 0 0 4300 7513658 RISPERIDONE 2 MG M TAB 250 0 0 4300 7513666 PIPERACILLIN/TAZO 2.25 GM IVPB 250 0 0 4300 7513674 STERILE WATER INJ VL 50ML 250 0 0 4300 7513765 BUPIVACAINE W/EPI 0.25% VL 250 0 0 4300 7513773 E.E.S 200 MG/5ML SUSP 100ML 250 0 0 4300 7513823 METRONIDAZOLE 250MG IV BAG PB 250 0 0 4300 7513831 FLUCONAZOLE 100MG/D5W 50ML PB 636 0 0 4300 7513849 FLUCONAZOLE 150MG/D5W 75ML PB 636 0 0 4300 7513856 CALCIUM GLUC 23 MEQ INJ 50 ML VIAL 636 0 0 4300 7513864 FLUCONAZOLE 50MG/D5W 25ML PB 636 0 0 4300 7513872 CILOSTAZOL 50 MG TAB 250 0 0 4300 7513880 PANTOPRAZOLE 20 MG TAB 250 0 0 4300 7513898 ALBUTEROL 2.5 MG/0.5ML NEB 250 0 0 4300 7513906 BARIUM (PHARMACY NO CHARGE) SUSP 250 0 0 4300 7513922 ROSUVASTATIN 10 MG TAB 250 0 0 4300 7513930 DIATR MEGLU/DIATRIZOATE SODIUM SOLN 250 0 0 4300 7513948 SODIUM HYPOCHLORITE-DAKINS ML 270 0 0 4300 7513963 PHYTONADIONE 1 MG/0.5ML SYR 636 0 0 4300 7513971 DEXTROSE TABS CHEWABLE 250 0 0 4300 7513989 HALOPERIDOL LACT 5MG/ML VIAL 250 0 0 4300 7513997 QUETIAPINE 50 MG TAB 250 0 0 4300 7514003 MAGNESIUM 20 GM/500ML INFUS 250 0 0 4300 7514011 LACTAID TABLETS 250 0 0 4300 7514029 FIBER TABLET 250 0 0 4300 7514037 RX TO GO PENICILLIN 500G TAB 250 0 0 4300 7514052 BACTROBAN 2% 15GM CREAM 250 0 0 4300 7514078 AZACTAM 1GM VIAL 250 0 0 4300 7514094 HEPARIN 100U/ML 5ML VIAL 636 0 0 4300 7514102 ALTACE 1.25MG CAP 250 0 0 4300 7514110 K-PHOS 5ML 22MEQ INJ VIAL 250 0 0 4300 7514136 OXACILLIN 16M VIAL 636 0 0 4300 7514144 CHLORHAXIDINE GLUCONATE LIQ SCRUB 250 0 0 4300
- 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: 7512486 LANTUS INSULIN VIAL 636 0 0
- 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
7513500 POVIDONE-IODINE 10% SOLN 250 0 0 4300<br />
7513518 MAGNESIUM 1GM/100ML D5W INFUS 636 0 0 4300<br />
7513526 FLUORESCEIN 10% INJ AMP 250 0 0 4300<br />
7513534 TIMOLOL 0.25% GFS 2.5 ML SOL GEL 250 0 0 4300<br />
7513542 BOTULINUM TOXIN 100 U VIAL 636 0 0 4300<br />
7513559 MIDODRINE 5 MG TAB 250 0 0 4300<br />
7513567 ERGOCALCIFEROL 50M U CAP 250 0 0 4300<br />
7513575 KALETRA TAB 250 0 0 4300<br />
7513583 COMBIVIR TABLET 250 0 0 4300<br />
7513591 ACETYLCYSTEINE 200MG/ML INJ 250 0 0 4300<br />
7513609 OXYBUTYNIN 3.9 MG/PATCH 250 0 0 4300<br />
7513617 SUBOXONE 2MG/0.5MG SL TAB 250 0 0 4300<br />
7513625 BUPRENORPHINE 2 MG TAB 250 0 0 4300<br />
7513633 EPTIFIBATIDE 75MG/100ML VIAL 636 0 0 4300<br />
7513641 EPTIFIBATIDE 20MG/10ML VIAL 636 0 0 4300<br />
7513658 RISPERIDONE 2 MG M TAB 250 0 0 4300<br />
7513666 PIPERACILLIN/TAZO 2.25 GM IVPB 250 0 0 4300<br />
7513674 STERILE WATER INJ VL 50ML 250 0 0 4300<br />
7513765 BUPIVACAINE W/EPI 0.25% VL 250 0 0 4300<br />
7513773 E.E.S 200 MG/5ML SUSP 100ML 250 0 0 4300<br />
7513823 METRONIDAZOLE 250MG IV BAG PB 250 0 0 4300<br />
7513831 FLUCONAZOLE 100MG/D5W 50ML PB 636 0 0 4300<br />
7513849 FLUCONAZOLE 150MG/D5W 75ML PB 636 0 0 4300<br />
7513856 CALCIUM GLUC 23 MEQ INJ 50 ML VIAL 636 0 0 4300<br />
7513864 FLUCONAZOLE 50MG/D5W 25ML PB 636 0 0 4300<br />
7513872 CILOSTAZOL 50 MG TAB 250 0 0 4300<br />
7513880 PANTOPRAZOLE 20 MG TAB 250 0 0 4300<br />
7513898 ALBUTEROL 2.5 MG/0.5ML NEB 250 0 0 4300<br />
7513906 BARIUM (PHARMACY NO CHARGE) SUSP 250 0 0 4300<br />
7513922 ROSUVASTATIN 10 MG TAB 250 0 0 4300<br />
7513930 DIATR MEGLU/DIATRIZOATE SODIUM SOLN 250 0 0 4300<br />
7513948 SODIUM HYPOCHLORITE-DAKINS ML 270 0 0 4300<br />
7513963 PHYTONADIONE 1 MG/0.5ML SYR 636 0 0 4300<br />
7513971 DEXTROSE TABS CHEWABLE 250 0 0 4300<br />
7513989 HALOPERIDOL LA<strong>CT</strong> 5MG/ML VIAL 250 0 0 4300<br />
7513997 QUETIAPINE 50 MG TAB 250 0 0 4300<br />
7514003 MAGNESIUM 20 GM/500ML INFUS 250 0 0 4300<br />
7514011 LA<strong>CT</strong>AID TABLETS 250 0 0 4300<br />
7514029 FIBER TABLET 250 0 0 4300<br />
7514037 RX TO GO PENICILLIN 500G TAB 250 0 0 4300<br />
7514052 BA<strong>CT</strong>ROBAN 2% 15GM CREAM 250 0 0 4300<br />
7514078 AZA<strong>CT</strong>AM 1GM VIAL 250 0 0 4300<br />
7514094 HEPARIN 100U/ML 5ML VIAL 636 0 0 4300<br />
7514102 ALTACE 1.25MG CAP 250 0 0 4300<br />
7514110 K-PHOS 5ML 22MEQ INJ VIAL 250 0 0 4300<br />
7514136 OXACILLIN 16M VIAL 636 0 0 4300<br />
7514144 CHLORHAXIDINE GLUCONATE LIQ SCRUB 250 0 0 4300
Change language