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
2580322 URO CATH SILIC 22/3WAY* 270 0 0 3800 2580363 URO CATH WHISTLE 4FR 270 0 44.05 3800 2580389 URO CATH WHISTLE 5FR* 270 0 0 3800 2580405 URO CATH WHISTLE 6FR 270 0 41.3 3800 2580421 URO DEV-URINARY W/SLING 278 0 1236 3800 2580447 URO EHL PROBE 3.3-1050 270 0 321.05 3800 2580462 URO EHL PROBE 3.3-770 270 0 405.8 3800 2580488 URO EHL PROBE 5 270 0 533.25 3800 2580504 URO EHL PROBE 9 270 0 351.5 3800 2580629 URO GD WIRE .038 270 0 53.55 3800 2580645 URO GD WIRE RING TORQ 270 0 79.95 3800 2580660 URO GD WIRE SENSOR 270 0 145.25 3800 2580686 URO GD WIRE STIFF 270 0 95.8 3800 2580702 URO GLIDE WIRE .038 270 0 126.7 3800 2580728 URO LEVEEN INFLATOR 270 0 154.5 3800 2580744 URO LEVEL I IRRIGATION 270 0 99.15 3800 2580769 URO LIDOCAINE BRISTO 270 0 0 3800 2580785 URO LONE STAR RETR 270 0 178.2 3800 2580801 URO LONE STAR STAYS 270 0 79.2 3800 2580827 URO MAL REENTRY20 270 0 247.2 3800 2580843 URO NDL FASCIAL INCIS 270 0 78 3800 2580868 URO NEPH KAYE TAMP 270 0 251.2 3800 2580884 URO NEPH LAWSON RETR 270 0 391 3800 2580900 URO NEPH VTC CATH 12FR 270 0 317.95 3800 2580926 URO NEPHRO MAX 270 0 566.5 3800 2580942 URO OCCLUS BAL CATH 270 0 319.3 3800 2580967 URO OPT URETHTOME 270 0 345.05 3800 2580983 URO OPT URETHTOME 1/2 270 0 345.05 3800 2581049 URO PUP STENT 278 0 226.6 3800 2581064 URO S/P CATH INTRODU 270 0 64.25 3800 2581080 URO SAPS 270 0 160.7 3800 2581106 URO SLING GYNECARE TVT 278 0 1537.3 3800 2581122 URO SLING MID URETHRAL 278 0 1274.65 3800 2581148 URO STENT POSITIONER 270 0 49.45 3800 2581163 URO STENT PRC END/PYE 270 0 465.55 3800 2581189 URO STENT PUP 278 0 226.6 3800 2581205 URO STENT PUSHER/POSITIO 270 0 247.2 3800 2581221 URO STENT TAIL 30 278 0 370.8 3800 2581247 URO STENT TAIL 32 278 0 370.8 3800 2581262 URO STENT TAIL 34 278 0 370.8 3800 2581288 URO STENT URET 6X20 278 0 296.65 3800 2581304 URO STENT URET 6x22 278 0 296.65 3800 2581320 URO STENT URET 6x24 278 0 296.65 3800 2581346 URO STENT URET 6x26 278 0 296.65 3800 2581361 URO STENT URET 6x28 278 0 296.65 3800 2581403 URO STONE BSKT 0-TIP 270 0 463.5 3800 2581429 URO STONE BSKT SEG 3 270 0 442.9 3800
2581445 URO STONE BSKT SEG 4 270 0 442.9 3800 2581460 URO STONE CONE RET 270 0 442.9 3800 2581486 URO STONE GRASP TRICP 270 0 426.4 3800 2581502 URO SURSEAL II 270 0 53.5 3800 2581528 URO TOOMEY SYRINGE* 270 0 0 3800 2581544 URO TURP BALL 24 270 0 244.1 3800 2581569 URO TURP BALL 27 270 0 244.1 3800 2581585 URO TURP KNIFE 24FR 270 0 231.75 3800 2581601 URO TURP LOOP 24 270 0 227.1 3800 2581627 URO TURP LOOP 27 270 0 223.15 3800 2581643 URO TURP STAMEY PERC 270 0 134.55 3800 2581684 URO URET ACCS SHEATH 270 0 300.8 3800 2581700 URO URET DUAL LUMEN 278 0 216.3 3800 2581726 URO URETERAL STENT 278 0 296.65 3800 2581742 URO UROST TUBE ADAP* 270 0 0 3800 2590008 SPECIAL ORDERS 270 0 0 3800 2591022 TKA TRIATHLON CR FEMORAL CEMENT 278 0 3960 3800 2591030 TKA TRIATHLON PS FEMORAL CEMENT 278 0 3960 3800 2591048 TKA TRIATHLON CR PA FEM BEADED W/PA 278 0 4660 3800 2591055 TKA TRIATHLON ASYMETRIC+B13 PATELLA 278 0 960 3800 2591063 TKA ASYMETRIC ALL POLY PATELLA 278 0 1180 3800 2591071 TKA TRIATHLON CR TIBIAL INSERT 278 0 1780 3800 2591097 TKA TRIATHLON CR TIBIAL INSERT X3 278 0 2655 3800 2591105 TKA TRIATHLON PS TIBIAL INSERT X3 278 0 2360 3800 2591113 TKA TRIA PRIM TIB BP CRUCIF NON-POR 278 0 2080 3800 2592004 THA TRIDENT HEMI SOLID BACK SHELL 278 0 2805.12 3800 2592012 THA HEMI CLUSTER CEMENTLESS SHELL 278 0 2691.76 3800 2592020 THA VITALOCK CLUSTER SHELL 270 0 1606.2 3800 2592038 THA TRIDENT CROSSFIRE INSERT 278 0 1375.9 3800 2592046 THA TRIDENT ALUMNA ID HEAD 278 0 1990.1 3800 2592053 THA TRIDENT 10 DEG X3 ID HEAD 278 0 2607.64 3800 2592061 THA V40 ALUMNA HEAD 32MM 278 0 1500.1 3800 2592079 THA V40 CORCR LFIT HEAD (METAL) 278 0 964.75 3800 2592087 THA V40 BIOLOX DELTA HEAD 36MM 278 0 2627.52 3800 2592095 THA TI SLEEVE FOR ALUMNA HEAD 278 0 339.55 3800 2592103 THA ALUMNA HEAD V40 36MM 278 0 1707.15 3800 2592111 THA ANATOMIC HEAD V40 COCR LFIT36MM 278 0 2385 3800 2592129 THA ANA C/TAPER BIOLOX D-HEAD 36MM 278 0 1877.95 3800 2592137 THA ANA HEAD V40 BIO DELTA HEAD36MM 278 0 2627.52 3800 2592145 THA CANCELLOUS BONE SCREW 6.5 278 0 281.55 3800 2592152 THA MERIDIAN PA HIP STEM #6/14MM 278 0 5105.9 3800 2592160 THA CITATION TMZF HA#2 LT 278 0 4928.2 3800 2592178 THA ACCOLADE TMZE HIP STEM 278 0 5895 3800 2592186 THA ACCOLADE PLUS TMZF HIP STEM 278 0 7196 3800 2592194 THA ARTISAN BONE PLUG 278 0 267.05 3800 2592202 THA CEMENT PLUG SIZED 278 0 292.7 3800 2592210 THA UNIVERSAL DISTAL SPACER 278 0 306.4 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 and 28: 2552461 TIER 1 INSERTS 278 0 6250 3
- Page 29 and 30: 2555191 BALLOON SINUPLASTY 270 0 23
- Page 31: 2571529 SYN SM PL LCDCP 05 H 278 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
- Page 79 and 80: 4615340 INCUBATION SERUM & DRUGS, E
- Page 81 and 82: 4619177 ALDOLASE 300 0 76.25 4010 4
2580322 URO CATH SILIC 22/3WAY* 270 0 0 3800<br />
2580363 URO CATH WHISTLE 4FR 270 0 44.05 3800<br />
2580389 URO CATH WHISTLE 5FR* 270 0 0 3800<br />
2580405 URO CATH WHISTLE 6FR 270 0 41.3 3800<br />
2580421 URO DEV-URINARY W/SLING 278 0 1236 3800<br />
2580447 URO EHL PROBE 3.3-1050 270 0 321.05 3800<br />
2580462 URO EHL PROBE 3.3-770 270 0 405.8 3800<br />
2580488 URO EHL PROBE 5 270 0 533.25 3800<br />
2580504 URO EHL PROBE 9 270 0 351.5 3800<br />
2580629 URO GD WIRE .038 270 0 53.55 3800<br />
2580645 URO GD WIRE RING TORQ 270 0 79.95 3800<br />
2580660 URO GD WIRE SENSOR 270 0 145.25 3800<br />
2580686 URO GD WIRE STIFF 270 0 95.8 3800<br />
2580702 URO GLIDE WIRE .038 270 0 126.7 3800<br />
2580728 URO LEVEEN INFLATOR 270 0 154.5 3800<br />
2580744 URO LEVEL I IRRIGATION 270 0 99.15 3800<br />
2580769 URO LIDOCAINE BRISTO 270 0 0 3800<br />
2580785 URO LONE STAR RETR 270 0 178.2 3800<br />
2580801 URO LONE STAR STAYS 270 0 79.2 3800<br />
2580827 URO MAL REENTRY20 270 0 247.2 3800<br />
2580843 URO NDL FASCIAL INCIS 270 0 78 3800<br />
2580868 URO NEPH KAYE TAMP 270 0 251.2 3800<br />
2580884 URO NEPH LAWSON RETR 270 0 391 3800<br />
2580900 URO NEPH VTC CATH 12FR 270 0 317.95 3800<br />
2580926 URO NEPHRO MAX 270 0 566.5 3800<br />
2580942 URO OCCLUS BAL CATH 270 0 319.3 3800<br />
2580967 URO OPT URETHTOME 270 0 345.05 3800<br />
2580983 URO OPT URETHTOME 1/2 270 0 345.05 3800<br />
2581049 URO PUP STENT 278 0 226.6 3800<br />
2581064 URO S/P CATH INTRODU 270 0 64.25 3800<br />
2581080 URO SAPS 270 0 160.7 3800<br />
2581106 URO SLING GYNECARE TVT 278 0 1537.3 3800<br />
2581122 URO SLING MID URETHRAL 278 0 1274.65 3800<br />
2581148 URO STENT POSITIONER 270 0 49.45 3800<br />
2581163 URO STENT PRC END/PYE 270 0 465.55 3800<br />
2581189 URO STENT PUP 278 0 226.6 3800<br />
2581205 URO STENT PUSHER/POSITIO 270 0 247.2 3800<br />
2581221 URO STENT TAIL 30 278 0 370.8 3800<br />
2581247 URO STENT TAIL 32 278 0 370.8 3800<br />
2581262 URO STENT TAIL 34 278 0 370.8 3800<br />
2581288 URO STENT URET 6X20 278 0 296.65 3800<br />
2581304 URO STENT URET 6x22 278 0 296.65 3800<br />
2581320 URO STENT URET 6x24 278 0 296.65 3800<br />
2581346 URO STENT URET 6x26 278 0 296.65 3800<br />
2581361 URO STENT URET 6x28 278 0 296.65 3800<br />
2581403 URO STONE BSKT 0-TIP 270 0 463.5 3800<br />
2581429 URO STONE BSKT SEG 3 270 0 442.9 3800
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