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
9968272 ZZ OHM UNSPECIFIED PYMT 0 0 1000 9968280 ZZ STERLING ONECO FIRE DEPT PAYMENT 0 0 1000 9968298 MISC SCHOOL BEHAVIORAL HEALTH 0 0 1000 9970005 UNAPPLIED CASH FY 08 PAYMENT 0 0 1000 9980004 ADMIN REVIEW PAYMENT 0 0 1000 3103 MED/SURG BLOOD ADMIN 391 0 0 3090 6817 EMERGENCY ROOM-HOSPITAL EVENTS 0 0 6780 13094 MED/SURG, PRIVATE 111 0 0 3090 13508 NURSERY, SICK BABY 170 0 0 3500 59014 ENDO VISIT 999 0 0 3720 59022 IV THERAPY VISIT 999 0 0 3720 59030 ACU VISIT 999 0 0 3720 59048 ENDO DUAL VISIT 999 0 0 3720 63628 EB PRESCRIPTION DRUGS 0 0 0 100065 CRYOSURGERY RENAL 1ST 1/2 HOUR 360 0 0 3600 100073 LITHOTRIPSY OR 1ST 1/2 HR 360 0 0 3600 100081 PROSTATE ABLATION OR 1ST 1/2HR 360 0 0 3600 100164 CRYOSURGERY PROSTATE 1ST 1/2HR 360 0 0 3600 130096 PHY FEE-NO CHG 450 0 0 3780 140457 BLADDER IRRIGATION-SIMPLE LAVAGE 456 0 0 3780 180000 NO CHARGE PO 360 0 0 3600 210005 POSTOP PAIN CO SC,IM 710 0 0 3650 210054 POSTOP IVP 710 0 0 3650 210104 POSTOP IVP EA ADD'L 710 0 0 3650 210302 IV THERAPY 1ST HOUR 710 0 0 3650 210310 IV THERAPY ADD HRS 710 0 0 3650 300046 OR C-SECTION 1ST 1/2HR, 1 PERSON 722 0 0 3510 300095 OR C-SECTION 1ST 1/2 HR, 3 PEOPLE 722 0 0 3510 300103 OR C-SECTION EA ADDL 15MIN, 3PEOPLE 722 0 0 3510 300152 NERVE CONDUCTION SENSORY 920 0 0 4200 300376 OCYTOCIN CHALLENGE 720 0 0 3510 300517 NST/FETAL MONITOR 920 0 0 3510 300954 PNEUMOGRAM 460 0 0 3510 301051 VACCINE INJECTION 940 0 0 3510 301465 IVP SEQ SAME DAY >30 MIN 260 0 0 3510 302109 MCH-SPEC PROC RM 1-1/2 HRS 720 0 0 3510 400051 SMEAR DIAPHRAM SCRAP 310 0 0 3090 461893 COBALT, RANDOM URINE 300 0 0 4010 500256 ACU-E&M LEVEL 5 761 0 0 3720 500504 ACU-SPEC PROC RM 1/2 HR 361 0 0 3720 500603 ACU-SPEC PROC RM-1 1/2 HRS 361 0 0 3720 500652 ACU-SPEC PROC RM 2 HRS 361 0 0 3720 500850 MRI KEN UPEX NOJTW/WO RT 610 0 0 4275 501015 COLONOSCOPY 750 0 0 3720 501064 GASTROSCOPY 750 0 0 3720 501114 BRONCHOSCOPY 761 0 0 3720 501155 DUODENSCOPY 360 0 0 3720
501205 LARYNGOSCOPY 361 0 0 3720 501254 TEE PROBE 361 0 0 3720 501353 SIGMOIDOSCOPY 750 0 0 3720 501403 POLYPECTOMY 750 0 0 3720 501551 SPEC PROC MISC-LAZER 361 0 0 3720 502161 VISIT3 IV TX ADD HRS 260 0 0 3720 502203 VISIT 4 IV THER INIT 260 0 0 3720 502211 VISIT4 IV TX ADD HRS 260 0 0 3720 502302 IV TX ADD'L SEQ < 1 HR 260 0 0 3720 502666 IVP SEQ SAME DRUG >30 MIN 940 0 0 3720 502807 IV START 260 0 0 3720 502815 PERIPHERAL DRESSING CHANGE 269 0 0 3720 502823 CENTRAL LINE DRESSING CHANGE 269 0 0 3720 502831 SQ PORT ACCESSING 269 0 0 3720 502849 SQ PORT DE ACCESSING 269 0 0 3720 502864 BLOOD DRAW W/IV START 269 0 0 3720 502872 MIDLINE EVALUATION/INSERTION 269 0 0 3720 502880 PICC LINE REMOVAL 269 0 0 3720 504035 ENTEROSCOPY 750 0 0 3720 504076 BONE MARROW ASPIRATION 360 0 0 3720 504084 G TUBE REPLACEMENT 361 0 0 3720 504092 PEG BUTTON CHANGE 361 0 0 3720 504126 PILL CAM ENDOSCOPY 750 0 0 3720 505016 MED/SURG ROUTINE 270 0 0 3720 560334 MRI KEN ELBOW WO CON LT 610 0 0 4275 580159 NO SHOW N/C 940 0 0 3720 600205 C-ARM PAIN MGT
- 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
- Page 197 and 198: 9915646 SUPP TRICARE PAYMENT 0 0 10
- Page 199 and 200: 9940453 CT CARPENTERS HEALTH FUND P
- Page 201: 9945072 PSYCH DKH CIGNA BEHAV PAYME
- Page 205 and 206: 1301993 LY NECK EXTS 20.1-30 450 0
- Page 207 and 208: 1304385 EXCIS OF X THORB HEM 450 0
- Page 209 and 210: 1402759 THUMB FX W/MAN 456 0 0 3780
- Page 211 and 212: 1800150 JAMSHIDI NEEDLE 270 0 0 375
- Page 213 and 214: 2525640 EYE RETROBULBAR NDL 270 0 0
- Page 215 and 216: 2600153 AMNIO SUPPLIES 270 0 0 3800
- Page 217 and 218: 4100384 BENZODIAZEPINES 300 0 0 401
- Page 219 and 220: 4605929 MUTATION ID ALLELE S 300 0
- Page 221 and 222: 4612685 CX 26 DNA SEQUENCING 300 0
- Page 223 and 224: 5600812 MRI KEN UPEX NO JT WO RT 61
- Page 225 and 226: 6500052 MRI-SPECIAL 352 0 0 4270 65
- Page 227 and 228: 7600570 POTASSIUM ACETATE 2 258 0 0
- Page 229 and 230: 8203465 DLSN HFOWOJT L3913 274 0 0
- Page 231 and 232: 8403263 EWHORTHO L3763 274 0 0 4370
- Page 233 and 234: 8603557 JOINT JACK 274 0 0 4390 860
- Page 235 and 236: 8803306 PLFD OT WHFOADDTHUM L3810 2
- Page 237 and 238: 9742503 TCORS AUTO ALOOWANCE 0 0 52
- Page 239 and 240: 9944786 NATIONAL HEALTH INS NASE PA
- Page 241 and 242: 9709817 CHARITY MEDICARE B/D-COINS
- Page 243 and 244: 90460 0 23000086 A A 35109990 35109
- Page 245 and 246: 99213 0 49000030 A A 37209990 37209
- Page 247 and 248: 10060 0 A A 37309990 37309990 10061
- Page 249 and 250: 0 A A 37309990 37309990 69287 0 A A
- Page 251 and 252: 12002 0 26600071 A A 37809990 37809
501205 LARYNGOSCOPY 361 0 0 3720<br />
501254 TEE PROBE 361 0 0 3720<br />
501353 SIGMOIDOSCOPY 750 0 0 3720<br />
501403 POLYPE<strong>CT</strong>OMY 750 0 0 3720<br />
501551 SPEC PROC MISC-LAZER 361 0 0 3720<br />
502161 VISIT3 IV TX ADD HRS 260 0 0 3720<br />
502203 VISIT 4 IV THER INIT 260 0 0 3720<br />
502211 VISIT4 IV TX ADD HRS 260 0 0 3720<br />
502302 IV TX ADD'L SEQ < 1 HR 260 0 0 3720<br />
502666 IVP SEQ SAME DRUG >30 MIN 940 0 0 3720<br />
502807 IV START 260 0 0 3720<br />
502815 PERIPHERAL DRESSING CHANGE 269 0 0 3720<br />
502823 CENTRAL LINE DRESSING CHANGE 269 0 0 3720<br />
502831 SQ PORT ACCESSING 269 0 0 3720<br />
502849 SQ PORT DE ACCESSING 269 0 0 3720<br />
502864 BLOOD DRAW W/IV START 269 0 0 3720<br />
502872 MIDLINE EVALUATION/INSERTION 269 0 0 3720<br />
502880 PICC LINE REMOVAL 269 0 0 3720<br />
504035 ENTEROSCOPY 750 0 0 3720<br />
504076 BONE MARROW ASPIRATION 360 0 0 3720<br />
504084 G TUBE REPLACEMENT 361 0 0 3720<br />
504092 PEG BUTTON CHANGE 361 0 0 3720<br />
504126 PILL CAM ENDOSCOPY 750 0 0 3720<br />
505016 MED/SURG ROUTINE 270 0 0 3720<br />
560334 MRI KEN ELBOW WO CON LT 610 0 0 4275<br />
580159 NO SHOW N/C 940 0 0 3720<br />
600205 C-ARM PAIN MGT
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