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
2552941 TKA X3 TRIATHLON CS INS 278 0 2655 3800 2552958 TOPAZ WAND 270 0 816.75 3800 2552966 ASNIS MICRO 1.7 CANNULATED DRILL 270 0 486 3800 2552974 MORCELLATOR CUTTER 12 MM 270 0 1105.43 3800 2552982 ASNIS MICRO 2.0 CANNULATED SCREWS 278 0 364.5 3800 2552990 ASNIS MICRO .8 X 100 K WIRE 270 0 64.13 3800 2553006 INTRODUCER KIT 6 FR 270 0 184.5 3800 2553014 TISSUE EXPANDER(BREAST) 278 0 3138.75 3800 2553022 ALLODERM PER CM 278 0 79.7 3800 2553048 NEPTUNE MANIFOLD 4 PORT 270 0 41.33 3800 2553055 NEPTUNE MANIFOLD SINGLE PORT 270 0 24.86 3800 2553063 ART PUSHLOCK 4.5 X 24 MM 278 0 765 3800 2553071 CONTOUR URETERAL STENT 8 X 56 278 0 306.9 3800 2553089 BREAST IMPLANT 278 0 1012.5 3800 2553097 TIER 1 URO SLING 278 0 12500 3800 2553105 TIER 2 URO SLING 278 0 7000 3800 2553113 TIER 3 URO SLING 278 0 2000 3800 2553121 LAP TROCAR 5MM XL 270 0 127.21 3800 2553139 MIS EZ CLEAN CAUTERY TIP 270 0 11.36 3800 2553147 GREENFIELD FILTER 278 0 2137.5 3800 2553154 GREENFIELD FILTER PLAT GUIDE WIRE 278 0 213.75 3800 2553162 GREENFIELD FILTER OTHER GUIDE WIRE 278 0 54.34 3800 2553170 GREENFIELD FILTER REMOVAL SET 270 0 531 3800 2553188 GREENFIELD FILTER ACCESS KIT 270 0 128.25 3800 2553196 GREENFIELD FILTER TRAY 270 0 169.88 3800 2553204 NEPHROSTOMY KIT 270 0 405 3800 2553212 GYN RUMI UTER MANIP TIP 270 0 98.71 3800 2553220 GYN RUMI II UTER MANIP KOH-EFF 270 0 202.5 3800 2553238 POWER PORT VVE MRI 8FR 278 0 850 3800 2553246 ENT SINUFOAM DRESSING 270 0 150.75 3800 2553501 TIER 4 ORTHO IMPLANT 278 0 10000 3800 2555001 PORT DUAL LUMEN HICK 278 0 354.3 3800 2555027 PORT DUAL LUMEN SUBQ 278 0 819.9 3800 2555043 PORT SGL LUMEN HICKM 278 0 300.75 3800 2555068 PORT SGL LUMEN SUB-Q 278 0 513.7 3800 2555076 HYDROSET 3CC 278 0 1381.8 3800 2555084 HYDROSET 5CC 278 0 2350 3800 2555092 HYDROSET 10CC 278 0 4512 3800 2555100 HYDROSET 15CC 278 0 6486 3800 2555118 MIS POWER PORT DUO 9.5 FR 278 0 1383.75 3800 2555126 VITAGEL 270 0 956.25 3800 2555134 TOT VITAGEL PLASMA SEPARATOR 270 0 67.5 3800 2555142 ART SUREFIRE SCORPION NEEDLE 270 0 350 3800 2555159 SONICBEAT-35CM(SB-0535PC)ADAPTOR 270 0 787.5 3800 2555167 THUNDERBEAT 35CM TB0535PC ADAPTOR 270 0 1237.5 3800 2555175 PACEMAKER-AIGIS 270 0 1237.5 3800 2555183 POWER PORT VVE MRI LARGE 8FR 278 0 1103.75 3800
2555191 BALLOON SINUPLASTY 270 0 2328 3800 2555209 ART 6.5 PEEK ZIP ANCHOR 278 0 2756.25 3800 2555217 TOURNIQUET 270 0 46.8 3800 2555225 TROCHANTERIC LONG LOCKING NAIL KIT 278 0 3796.87 3800 2555233 BEADED CABLE & SLEEVE 278 0 894.37 3800 2555241 END CAP 278 0 354.37 3800 2555258 U-BLADE LAG SCREW SET TI 278 0 1434.37 3800 2555266 DISTAL DRILL 270 0 345.93 3800 2555274 GUIDE WIRE BALL 278 0 413.33 3800 2555282 SIDEWINDER 278 0 450.56 3800 2555290 SIDEWINDER DRILL 270 0 324 3800 2555308 CANCELLOUS BONE SCREW 278 0 234 3800 2555316 TRIDENT HEMISHERIC SOLID BACK 300 0 2295 3800 2555324 TRITANIUM HEMISPHERICAL SOLID BACK 278 0 2925 3800 2555332 TRIDENT HEMISPHERICAL CLUSTER 278 0 2925 3800 2555340 TRITANIUM HEMISPHERICAL CLUSTER 278 0 2925 3800 2555357 ACCOLADE TMZF HIP STEM 278 0 5895 3800 2555365 ACCOLADE HFX 278 0 2137.5 3800 2555373 NEUTRAL HOOD 278 0 2092.5 3800 2555381 TRIDENT 0 X3 INSERT 278 0 2092.5 3800 2555399 TRIDENT 0 INSERT 278 0 2092.5 3800 2555407 TRIATHLON TS BASEPLATE 278 0 3735 3800 2555415 TRIATHLON TS PLUS TIBIAL 278 0 2655 3800 2555423 TRIATHLON CEMENTED STEM 278 0 2720.25 3800 2560142 SHAVER FULL RAD 270 0 0 3800 2565000 STAPLE CONTOU 3.5 DLU 278 0 398.25 3800 2565026 STAPLE CONTOU 4.7 DLU 278 0 398.25 3800 2565042 STAPLE CONTOUR 3.5 278 0 1444.6 3800 2565067 STAPLE GIA 80 DLU3.8 278 0 282.75 3800 2565083 STAPLE GIA 80 IN 3.8 278 0 449.8 3800 2565109 STAPLE ILS 21MM EEA 278 0 663.3 3800 2565125 STAPLE ILS 25MM EEA 278 0 658.85 3800 2565141 STAPLE ILS 29MM EEA 278 0 604.9 3800 2565166 STAPLE ILS 33 278 0 604.9 3800 2565182 STAPLE LIGACLIP LG 278 0 186.05 3800 2565208 STAPLE LIGACLIP MED 278 0 196.7 3800 2565224 STAPLE LIGACLIP SM 278 0 196.45 3800 2565240 STAPLE LIN CUT 55 278 0 221.15 3800 2565265 STAPLE LIN CUT 55DLU 278 0 177.8 3800 2565281 STAPLE LIN CUT 80 278 0 334.9 3800 2565307 STAPLE LIN CUT 80DLU 278 0 255.65 3800 2565323 STAPLE LINEAR 30 278 0 212.1 3800 2565349 STAPLE LINEAR 30DLU 278 0 149.8 3800 2565364 STAPLE LINEAR 60 278 0 215.15 3800 2565380 STAPLE LINEAR 60DLU 278 0 161.35 3800 2565406 STAPLE LINEAR 90-4.8 278 0 171.85 3800 2565448 STAPLE POLYROTIC 200 278 0 461.7 3800
- Page 1 and 2: CHRG# CDSC CDEPT CSRV CUPR CREV# 30
- Page 3 and 4: 411124 ITEL IV TX HYDRA ADD'L HOUR
- Page 5 and 6: 590034 ACU VISIT 999 0 0 3720 59004
- Page 7 and 8: 800730 EX MAL LES FACE EAR EYE NOSE
- Page 9 and 10: 1000629 IV TX HYDRA ADD'L HR 260 0
- Page 11 and 12: 1302629 RADIAL SHFT FX W/MAN 450 0
- Page 13 and 14: 1304088 RML FB EXT EYE/CONJL 450 0
- Page 15 and 16: 1400050 PC FACILITY FEE-MIN 456 0 1
- Page 17 and 18: 1403344 EPISTX ANT CMPLX PKG 456 0
- Page 19 and 20: 2201713 MIDLINE CATHETER 278 0 130
- Page 21 and 22: 2510360 ASNIS 6.5 THD G/WIRE 270 0
- Page 23 and 24: 2530244 GYN VAG PACKING* 270 0 0 38
- Page 25 and 26: 2550226 ORT CRV-TC CART MED 270 0 7
- Page 27: 2552461 TIER 1 INSERTS 278 0 6250 3
- Page 31 and 32: 2571529 SYN SM PL LCDCP 05 H 278 0
- Page 33 and 34: 2581445 URO STONE BSKT SEG 4 270 0
- Page 35 and 36: 2902096 BONE MARROW BIOPSY 761 0 63
- Page 37 and 38: 3091105 ARANESP 200MG 1.4ML 636 0 0
- Page 39 and 40: 3300712 GLUCOSE STRIP SUBSEQ 300 0
- Page 41 and 42: 4100046 DIGOXIN 300 0 50.41 4010 41
- Page 43 and 44: 4101077 OSMOLALITY SERUM 300 0 29.2
- Page 45 and 46: 4102026 TIME & VOLUME URINE 300 0 1
- Page 47 and 48: 4300216 TISSUE HOMOGENOUS 300 0 35.
- Page 49 and 50: 4400123 ANTI TITER-ALBUMIN 300 0 24
- Page 51 and 52: 4600094 TESTOSTERONE T & F 300 0 28
- Page 53 and 54: 4601035 FLUPHENAZINE 300 0 145.02 4
- Page 55 and 56: 4601985 RETROVIRAL SEROLOGY 300 0 4
- Page 57 and 58: 4602967 HTLV I/II AB 300 0 100.75 4
- Page 59 and 60: 4604096 ORG ID AEROBIC UMASS 300 0
- Page 61 and 62: 4605101 ASPERGILLUS FUMIGAT. 300 0
- Page 63 and 64: 4606471 PARIETAL CELL AB 300 0 90.8
- Page 65 and 66: 4607453 IGG,SERUM (CSFI) 300 0 70.9
- Page 67 and 68: 4608477 IGG B2 GLYCOPROTEIN 300 0 1
- Page 69 and 70: 4609616 SACCHAROMYCES IGG AB 300 0
- Page 71 and 72: 4610648 PLASMINOGEN ACT INH1 300 0
- Page 73 and 74: 4611703 HYPERCOAG. NON-PREG 300 0 0
- Page 75 and 76: 4613063 TISSUE PREP 300 0 82.42 401
- Page 77 and 78: 4614095 LIDOCAINE AUTO ABS 300 0 26
2555191 BALLOON SINUPLASTY 270 0 2328 3800<br />
2555209 ART 6.5 PEEK ZIP ANCHOR 278 0 2756.25 3800<br />
2555217 TOURNIQUET 270 0 46.8 3800<br />
2555225 TROCHANTERIC LONG LOCKING NAIL KIT 278 0 3796.87 3800<br />
2555233 BEADED CABLE & SLEEVE 278 0 894.37 3800<br />
2555241 END CAP 278 0 354.37 3800<br />
2555258 U-BLADE LAG SCREW SET TI 278 0 1434.37 3800<br />
2555266 DISTAL DRILL 270 0 345.93 3800<br />
2555274 GUIDE WIRE BALL 278 0 413.33 3800<br />
2555282 SIDEWINDER 278 0 450.56 3800<br />
2555290 SIDEWINDER DRILL 270 0 324 3800<br />
2555308 CANCELLOUS BONE SCREW 278 0 234 3800<br />
2555316 TRIDENT HEMISHERIC SOLID BACK 300 0 2295 3800<br />
2555324 TRITANIUM HEMISPHERICAL SOLID BACK 278 0 2925 3800<br />
2555332 TRIDENT HEMISPHERICAL CLUSTER 278 0 2925 3800<br />
2555340 TRITANIUM HEMISPHERICAL CLUSTER 278 0 2925 3800<br />
2555357 ACCOLADE TMZF HIP STEM 278 0 5895 3800<br />
2555365 ACCOLADE HFX 278 0 2137.5 3800<br />
2555373 NEUTRAL HOOD 278 0 2092.5 3800<br />
2555381 TRIDENT 0 X3 INSERT 278 0 2092.5 3800<br />
2555399 TRIDENT 0 INSERT 278 0 2092.5 3800<br />
2555407 TRIATHLON TS BASEPLATE 278 0 3735 3800<br />
2555415 TRIATHLON TS PLUS TIBIAL 278 0 2655 3800<br />
2555423 TRIATHLON CEMENTED STEM 278 0 2720.25 3800<br />
2560142 SHAVER FULL RAD 270 0 0 3800<br />
2565000 STAPLE CONTOU 3.5 DLU 278 0 398.25 3800<br />
2565026 STAPLE CONTOU 4.7 DLU 278 0 398.25 3800<br />
2565042 STAPLE CONTOUR 3.5 278 0 1444.6 3800<br />
2565067 STAPLE GIA 80 DLU3.8 278 0 282.75 3800<br />
2565083 STAPLE GIA 80 IN 3.8 278 0 449.8 3800<br />
2565109 STAPLE ILS 21MM EEA 278 0 663.3 3800<br />
2565125 STAPLE ILS 25MM EEA 278 0 658.85 3800<br />
2565141 STAPLE ILS 29MM EEA 278 0 604.9 3800<br />
2565166 STAPLE ILS 33 278 0 604.9 3800<br />
2565182 STAPLE LIGACLIP LG 278 0 186.05 3800<br />
2565208 STAPLE LIGACLIP MED 278 0 196.7 3800<br />
2565224 STAPLE LIGACLIP SM 278 0 196.45 3800<br />
2565240 STAPLE LIN CUT 55 278 0 221.15 3800<br />
2565265 STAPLE LIN CUT 55DLU 278 0 177.8 3800<br />
2565281 STAPLE LIN CUT 80 278 0 334.9 3800<br />
2565307 STAPLE LIN CUT 80DLU 278 0 255.65 3800<br />
2565323 STAPLE LINEAR 30 278 0 212.1 3800<br />
2565349 STAPLE LINEAR 30DLU 278 0 149.8 3800<br />
2565364 STAPLE LINEAR 60 278 0 215.15 3800<br />
2565380 STAPLE LINEAR 60DLU 278 0 161.35 3800<br />
2565406 STAPLE LINEAR 90-4.8 278 0 171.85 3800<br />
2565448 STAPLE POLYROTIC 200 278 0 461.7 3800
Change language