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
1403468 THORACENTESIS W/TUBE 456 0 0 3780 1403476 TUBE THOR W/SEAL (HEMOTX) 456 0 0 3780 1403484 THORA MAJ W/CARDI MA 456 0 0 3780 1403500 INS/RE TEM ELE/PM CA 456 0 0 3780 1403518 TRANSFSN BLOOD/COMPT 391 0 0 3780 1403526 INS CNT'L VEN CATH>5 456 0 0 3780 1403534 REM TRIPLE LUMEN CAT 456 0 0 3780 1403542 ARTERIAL BLD DRAW DX 456 0 0 3780 1403559 PLMT INTRAOSSEOUS 456 0 0 3780 1403583 CHEILOPLASTY > V.HGT 456 0 0 3780 1403609 LAC VESTIBULE 2.5 CX 456 0 0 3780 1403633 DENTOGLVEOLAR STRUCT 456 0 0 3780 1403658 RML FB PHARYNX EXS 456 0 0 3780 1403666 CONT OROPHAR HEM SIM 456 0 0 3780 1403682 CHG GASTROSTOMY TUBE W/O IMG/GUID 456 0 0 3780 1403690 PROCTO W/OR WO/ COLL 456 0 0 3780 1403716 INCIS DRAIN PERIA AB 456 0 0 3780 1403732 EXCIS OF X THORB HEM 456 0 0 3780 1403757 ANOSC W/ REMOVAL FB 456 0 0 3780 1403765 EXCIS OF ANUS,SIMPLE 456 0 0 3780 1403773 PERIT ABD PARA OR PE 456 0 0 3780 1403781 ASP OF BLADDER BY NEEDLE 456 0 0 3780 1403815 CMPT CATH/BALLOON 456 0 0 3780 1403823 I&D SCROTAL ABSCESS 456 0 0 3780 1403849 REM IMPACT VAG FB AN 456 0 0 3780 1403856 CAUTERIZA OF CERVIX 456 0 0 3780 1403864 CAUT CERV-INIT OR RP 456 0 0 3780 1403872 REM OF INTRAUT DEVIC 456 0 0 3780 1403880 VAG DELIV W/POSTPART 456 0 0 3780 1403898 LUMBAR TAP/DX 456 0 0 3780 1403914 INJ ANES;INTERCO SGL 456 0 0 3780 1403971 BLEPHAR-I&D ABSC EYE 456 0 0 3780 1404102 IV TX CONCURR INF 260 0 0 3780 1404151 GASTRIC LAVAGE 456 0 0 3780 1404169 NASO W/ENDO (DIAG) 456 0 0 3780 1404177 CPR 456 0 0 3780 1404193 CARDIOVERSION,EXTERN 456 0 0 3780 1404201 ECG 1-3 LEAD INT/REP 456 0 0 3780 1404219 VENT ASSIST&MNG 1STD 456 0 0 3780 1404227 PULSE OX/EAR SINGLE 460 0 0 3780 1404235 PULSE OX/EAR MULTI 460 0 0 3780 1404243 ANOG EXAM W/COLP MAG 456 0 0 3780 1404250 IPECAC FOR EMESIS 456 0 0 3780 1404284 CATH FOR COLLECT OF SPEC-STR CATH 300 0 0 3780 1404300 MONITOR FOR COMPARTMENT SYNDROME 456 0 0 3780 1404482 STRAPPING HIP 456 0 0 3780 1404557 SIMPLE LAC BODY, SCALP>30CM 456 0 0 3780
1800150 JAMSHIDI NEEDLE 270 0 0 3750 2000016 MED SURG/SUP-MS 270 0 0 3800 2000024 MED/SURG SUPP ICU 270 0 0 3800 2000032 ACE BANDAGE 270 0 0 3800 2000040 BIOPSY NEEDLE 270 0 0 3800 2000057 BLOOD GAS KIT 270 0 0 3800 2000073 CUSTOM DSG TRAY 270 0 0 3800 2000081 COBAN 270 0 0 3800 2000099 IRRIGATION TRAY 270 0 0 3800 2000107 SLING 270 0 0 3800 2000115 DRAIN SALEM SUMP 270 0 0 3800 2000131 VASELINE GAUZE 270 0 0 3800 2000149 ZEROFOAM GAUZE 270 0 0 3800 2000156 ANTIEMBOLISM HOSE 270 0 0 3800 2000172 CAST BOOT 270 0 0 3800 2000180 CLEAN CATCH URINE CO 270 0 0 3800 2000206 KLING 270 0 0 3800 2000214 STERI STRIPS 270 0 0 3800 2000222 URINE LEG BAG 270 0 0 3800 2000248 LUMBAR PUNCTURE TRAY 270 0 0 3800 2000321 MED/SURG ROUTINE-PIP 270 0 0 3800 2000347 MED/SURG SUPPLY-MCH 270 0 0 3800 2000354 MED/SURG SUPPLY-NSY 270 0 0 3800 2000362 ROUTINE M&S OR 270 0 0 3800 2001675 PICC 5FR KIT 270 0 0 3800 2100758 ELA-DUAL PCMKER 275 0 0 3800 2100766 ST JUDE-DUAL PCMKER 275 0 0 3800 2100774 MEDTRONI-DUAL PCMKER 275 0 0 3800 2100782 ELA-SINGLE PCMKER 275 0 0 3800 2100790 ST JUDE-SINGLE PCMKE 275 0 0 3800 2100808 MEDTRO-SINGLE PCMKER 275 0 0 3800 2100816 GUIDANT-ENTRA DUAL 275 0 0 3800 2100824 MEDTR-ENPULSE PCMKER 275 0 0 3800 2100832 MEDTRONIC-ENRYTHYM PCMKR 275 0 0 3800 2100857 ELA-PCMKER LEAD 275 0 0 3800 2100865 ST JUDE-PCMKER LEAD 275 0 0 3800 2100873 MEDTRON-PCMKER LEAD 275 0 0 3800 2100907 DUAL PACEMAKER 275 0 0 3800 2100915 SINGLE PACEMAKER 275 0 0 3800 2100923 PACEMAKER LEAD 275 0 0 3800 2102002 LOOP MONITOR 278 0 0 3800 2200103 OXYGEN SUPPLIES-ACU 270 0 0 3721 2201028 CYTOLOGY BRUSH 270 0 0 3711 2201036 DUAL PORT ADAPTOR 270 0 0 3721 2201127 I-NEEDLE (LONG) 270 0 0 3711 2201150 J-TUBE 270 0 0 3711 2201168 20G TUOHY NEEDLE 270 0 0 3711
- 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 and 202: 9945072 PSYCH DKH CIGNA BEHAV PAYME
- Page 203 and 204: 501205 LARYNGOSCOPY 361 0 0 3720 50
- 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: 1402759 THUMB FX W/MAN 456 0 0 3780
- 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
- Page 253 and 254: 28660 0 26600430 A A 37809990 37809
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- Page 259 and 260: 0 A A 37809990 37809990 24200 0 A A
1800150 JAMSHIDI NEEDLE 270 0 0 3750<br />
2000016 MED SURG/SUP-MS 270 0 0 3800<br />
2000024 MED/SURG SUPP ICU 270 0 0 3800<br />
2000032 ACE BANDAGE 270 0 0 3800<br />
2000040 BIOPSY NEEDLE 270 0 0 3800<br />
2000057 BLOOD GAS KIT 270 0 0 3800<br />
2000073 CUSTOM DSG TRAY 270 0 0 3800<br />
2000081 COBAN 270 0 0 3800<br />
2000099 IRRIGATION TRAY 270 0 0 3800<br />
2000107 SLING 270 0 0 3800<br />
2000115 DRAIN SALEM SUMP 270 0 0 3800<br />
2000131 VASELINE GAUZE 270 0 0 3800<br />
2000149 ZEROFOAM GAUZE 270 0 0 3800<br />
2000156 ANTIEMBOLISM HOSE 270 0 0 3800<br />
2000172 CAST BOOT 270 0 0 3800<br />
2000180 CLEAN CATCH URINE CO 270 0 0 3800<br />
2000206 KLING 270 0 0 3800<br />
2000214 STERI STRIPS 270 0 0 3800<br />
2000222 URINE LEG BAG 270 0 0 3800<br />
2000248 LUMBAR PUN<strong>CT</strong>URE TRAY 270 0 0 3800<br />
2000321 MED/SURG ROUTINE-PIP 270 0 0 3800<br />
2000347 MED/SURG SUPPLY-MCH 270 0 0 3800<br />
2000354 MED/SURG SUPPLY-NSY 270 0 0 3800<br />
2000362 ROUTINE M&S OR 270 0 0 3800<br />
2001675 PICC 5FR KIT 270 0 0 3800<br />
2100758 ELA-DUAL PCMKER 275 0 0 3800<br />
2100766 ST JUDE-DUAL PCMKER 275 0 0 3800<br />
2100774 MEDTRONI-DUAL PCMKER 275 0 0 3800<br />
2100782 ELA-SINGLE PCMKER 275 0 0 3800<br />
2100790 ST JUDE-SINGLE PCMKE 275 0 0 3800<br />
2100808 MEDTRO-SINGLE PCMKER 275 0 0 3800<br />
2100816 GUIDANT-ENTRA DUAL 275 0 0 3800<br />
2100824 MEDTR-ENPULSE PCMKER 275 0 0 3800<br />
2100832 MEDTRONIC-ENRYTHYM PCMKR 275 0 0 3800<br />
2100857 ELA-PCMKER LEAD 275 0 0 3800<br />
2100865 ST JUDE-PCMKER LEAD 275 0 0 3800<br />
2100873 MEDTRON-PCMKER LEAD 275 0 0 3800<br />
2100907 DUAL PACEMAKER 275 0 0 3800<br />
2100915 SINGLE PACEMAKER 275 0 0 3800<br />
2100923 PACEMAKER LEAD 275 0 0 3800<br />
2102002 LOOP MONITOR 278 0 0 3800<br />
2200103 OXYGEN SUPPLIES-ACU 270 0 0 3721<br />
2201028 CYTOLOGY BRUSH 270 0 0 3711<br />
2201036 DUAL PORT ADAPTOR 270 0 0 3721<br />
2201127 I-NEEDLE (LONG) 270 0 0 3711<br />
2201150 J-TUBE 270 0 0 3711<br />
2201168 20G TUOHY NEEDLE 270 0 0 3711
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