chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

14.01.2014 Views
86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86003 0 A A 40109990 40109990 86790 115.36 31800003 A A 40109990 40109990 86710 143.17 31800006 A A 40109990 40109990 86710 142.14 31800007 A A 40109990 40109990 86603 115.36 31800008 A A 40109990 40109990 86756 115.36 31800009 A A 40109990 40109990

86790 115.36 31800010 A A 40109990 40109990 86790 115.36 31800011 A A 40109990 40109990 86756 148.32 31800012 A A 40109990 40109990 86735 133.9 31800014 A A 40109990 40109990 87252 265.74 31800019 A A 40109990 40109990 86765 131.84 31800021 A A 40109990 40109990 86658 118.45 31800037 A A 40109990 40109990 86780 135.96 31800048 A A 40109990 40109990 87252 265.74 31800050 A A 40109990 40109990 86592 52.53 31800051 A A 40109990 40109990 86720 135.96 31800055 A A 40109990 40109990 86612 32.96 31800057 A A 40109990 40109990 86606 133.9 31800058 A A 40109990 40109990 83655 30.9 31800062 A A 40109990 40109990 87106 314.15 31800075 A A 40109990 40109990 86235 182.31 31800095 A A 40109990 40109990 86255 231.75 31800099 A A 40109990 40109990 82355 126.69 31800105 A A 40109990 40109990 82128 143.17 31800106 A A 40109990 40109990 82105 172.01 31800107 A A 40109990 40109990 86618 175.1 31800200 A A 40109990 40109990 86256 148.32 31800203 A A 40109990 40109990 86765 131.84 31800350 A A 40109990 40109990 86611 103 31800497 A A 40109990 40109990 84630 114.33 31810039 A A 40109990 40109990 86235 228.66 31811429 A A 40109990 40109990 86648 604.61 31811736 A A 40109990 40109990 86304 194.67 31823745 A A 40109990 40109990 84275 236.9 31823746 A A 40109990 40109990 83520 114.33 31823747 A A 40109990 40109990 82105 200.85 31823748 A A 40109990 40109990 84702 153.47 31823749 A A 40109990 40109990 82677 247.2 31823750 A A 40109990 40109990 86300 194.67 31823758 A A 40109990 40109990 82677 66.95 31830127 A A 40109990 40109990 81220 94.76 31610147 A A 40109990 40109990 83520 176.13 31610148 A A 40109990 40109990 86688 214.24 31610155 A A 40109990 40109990 81220 36.05 31610157 A A 40109990 40109990 81220 0 31610280 A A 40109990 40109990 88188 109.18 31610909 A A 40109990 40109990 87077 111.24 31680001 A A 40109990 40109990 87076 148.32 31680000 A A 40109990 40109990 82491 0 A A 40109990 40109990 36415 0 31900001 A A 40109990 40109990 0 31900003 A A 40109990 40109990 0 31943210 A A 40109990 40109990

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 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

Page 79 and 80: 4615340 INCUBATION SERUM & DRUGS, E

Page 81 and 82: 4619177 ALDOLASE 300 0 76.25 4010 4

Page 83 and 84: 4620241 HEP BE AG 300 0 90.45 4010

Page 85 and 86: 4621207 FETOMATERNAL HEMORRHAGE SCR

Page 87 and 88: 4622148 THYROID STIM IMMUNOGLOBULIN

Page 89 and 90: 4623146 RUBEOLA ANTIBODIES, IGG 300

Page 91 and 92: 4624086 MUCOR RACEMOSUS, IGE 300 0

Page 93 and 94: 4800041 SPE COLL TRAVEL/MILE 300 0

Page 95 and 96: 5600689 MRI KEN HIP W/CONT RT 610 0

Page 97 and 98: 5800313 MULTIPLE SLEEP LATENCY TEST

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 and 150: 7512486 LANTUS INSULIN VIAL 636 0 0

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 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 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

Page 253 and 254: 28660 0 26600430 A A 37809990 37809

Page 255 and 256: 11305 0 A A 37809990 37809990 11732

Page 257 and 258: 13122 0 26700127 A A 37809990 37809

Page 259 and 260: 0 A A 37809990 37809990 24200 0 A A

Page 261 and 262: 0 A A 38009990 38009990 51059 C1713

Page 263 and 264: 0 A A 38009990 38009990 C1713 0 A A

Page 265 and 266: 0 27570070 A A 38009990 38009990 0

Page 267 and 268: C1713 0 27580842 A A 38009990 38009

Page 269 and 270: C1776 0 A A 38009990 38009990 0 A A

Page 271 and 272: C1713 0 27500061 A A 38009990 38009

Page 273 and 274: 0 27560350 A A 38009990 38009990 50

Page 275 and 276: C1776 0 A A 38009990 38009990 C1776

Page 277 and 278: J9181 0 28100027 A A 42909990 42909

Page 279 and 280: J0886 JW 0 A A 42909990 42909990 J0

Page 281 and 282: 88112 229.69 31791011 A A 40109990

Page 283 and 284: 82247 50.47 31122500 A A 40109990 4

Page 285 and 286: 83986 40.17 31153532 A A 40109990 4

Page 287 and 288: 0 31251522 A A 40109990 40109990 0

Page 289 and 290: 87070 112.27 31370935 A A 40109990

Page 291 and 292: 81003 18.54 31510043 A A 40109990 4

Page 293 and 294: 86658 221.45 31600198 A A 40109990

Page 295 and 296: 82784 95.79 31600539 A A 40109990 4

Page 297 and 298: 83970 335.78 31600719 A A 40109990

Page 299 and 300: 82205 192.61 31610103 A A 40109990

Page 301 and 302: 86003 62.83 31610294 A A 40109990 4

Page 303 and 304: 83840 135.96 31610549 A A 40109990

Page 305 and 306: 85732 19.57 31610663 A A 40109990 4

Page 307 and 308: 86060 90.64 31610780 A A 40109990 4

Page 309 and 310: 86765 179.22 31610938 A A 40109990

Page 311 and 312: 86658 118.45 31611081 A A 40109990

Page 313 and 314: 87591 211.15 31611185 A A 40109990

Page 315 and 316: 82040 25.75 31611304 A A 40109990 4

Page 317 and 318: 84378 184 A A 40109990 40109990 802

Page 319 and 320: 86316 0 A A 40109990 40109990 87497

Page 321 and 322: 83520 0 A A 40109990 40109990 83519

Page 323 and 324: 8325 0 A A 40109990 40109990 83615

Page 325 and 326: 86735 0 A A 40109990 40109990 86738

Page 327 and 328: 86161 0 A A 40109990 40109990 86200

Page 329 and 330: 87109 0 A A 40109990 40109990 87116

Page 331: 86003 0 A A 40109990 40109990 86003

Page 335 and 336: 73721 LT 0 A A 42759990 42759990 73

Page 337 and 338: 73223 RT 0 A A 42759990 42759990 A9

Page 339 and 340: 93016 0 A A 41209990 41209990 93018

Page 341 and 342: 73590 LT 3.502 34021330 A A 4211999

Page 343 and 344: 49450 0 A A 42119990 42119990 49440

Page 345 and 346: 19030 RT 1.566 34061993 A A 4211999

Page 347 and 348: A9538 2.554 35303930 A A 42409990 4

Page 349 and 350: 40.17 36069628 A A 42519990 4251999

Page 351 and 352: 72148 17.757 45101136 A A 42709990

Page 353 and 354: 71250 6.798 46000905 A A 42609990 4

Page 355 and 356: 75989 0 A A 42609990 42609990 49421

Page 357 and 358: 73620 LT 2.348 A A 42129990 4212999

Page 359 and 360: 72040 2.884 A A 42139990 42139990 7

Page 361 and 362: 72114 7.004 A A 42139990 42139990 7

Page 363 and 364: 73221 LT 0 A A 42739990 42739990 73

Page 365 and 366: J3490 0 37000039 A A 43009990 43009

Page 367 and 368: J3490 0 37000193 A A 43009990 43009

Page 369 and 370: J1100 0 37000371 A A 43009990 43009

Page 371 and 372: J3490 0 37000527 A A 43009990 43009

Page 373 and 374: J1815 0 37000670 A A 43009990 43009

Page 375 and 376: J3490 0 37000848 A A 43009990 43009

Page 377 and 378: J3490 0 37001005 A A 43009990 43009

Page 379 and 380: J0780 0 37001148 A A 43009990 43009

Page 381 and 382: J3260 0 37001333 A A 43009990 43009

Page 383 and 384: J3490 0 37001596 A A 43009990 43009

Page 385 and 386: J3490 0 37002285 A A 43009990 43009

Page 387 and 388: J3490 0 37002628 A A 43009990 43009

Page 389 and 390: J3490 0 37003982 A A 43009990 43009

Page 391 and 392: J3490 0 37004115 A A 43009990 43009

Page 393 and 394: J1335 0 A A 43009990 43009990 J3490

Page 395 and 396: C9399 0 A A 43009990 43009990 90632

Page 397 and 398: J3490 0 A A 43009990 43009990 J3490

Page 399 and 400: J3490 0 37404139 A A 43009990 43009

Page 401 and 402: J1450 0 A A 43109990 43109990 J2543

Page 403 and 404: 0 42400221 A A 43729990 43729990 0

Page 405 and 406: 97762 30 A A 43739990 43739990 9754

Page 407 and 408: 97113 15 48000144 A A 43719990 4371

Page 409 and 410: 29520 15 48300131 A A 43739990 4373

Page 411 and 412: 94200 426.42 47000062 A A 43409990

Page 413 and 414: G8998 GN 0 A A 43719990 43719990 G8

Page 415 and 416: G9171 GN 0 A A 43719990 43719990 G9

Page 417 and 418: G8984 GP 0 A A 43719990 43719990 G8

Page 419 and 420: G8986 GO 0 A A 43719990 43719990 G8

Page 421 and 422: 0 A A 51705010 51705220 0 A A 52105

Page 423 and 424: 0 A A 52105010 52105220 0 A A 52105

Page 425 and 426: 0 A A 52505010 52505220 0 A A 52505

Page 427 and 428: 0 A A 12001300 98809400 0 A A 98809

Page 429 and 430: 0 A A 10151000 10001000 0 A A 10061

Page 431 and 432: 0 A A 56205620 10001000 0 A A 56305

Page 433 and 434: 0 A A 70107960 10001000 0 A A 71307

Page 435 and 436: 0 A A 83107960 10001000 0 A A 83207

Page 437 and 438: 0 A A 12101300 12101300 0 A A 10001

Page 439 and 440: 0 A A 10001000 10001000 0 A A 10001

Page 441 and 442: 0 A A 10001000 10001000 0 A A 10001

Page 443 and 444: 0 A A 10001000 10001000 0 A A 10001

Page 445 and 446: 0 D D 43209990 43209990 0 D D 43209

Page 447 and 448: 27200 0 26600325 D D 37809990 37809

Page 449 and 450: 12054 0 26700112 D D 37809990 37809

Page 451 and 452: 32422 0 26700495 D D 37809990 37809

Page 453 and 454: 0 27300121 D D 37219990 37219990 0

Page 455 and 456: 0 27500066 D D 38009990 38009990 0

Page 457 and 458: J9395 0 28100074 D D 42909990 42909

Page 459 and 460: 83912 36.05 31610152 D D 40109990 4

Page 461 and 462: 83912 142.14 31611065 D D 40109990

Page 463 and 464: 83890 0 D D 40109990 40109990 83890

Page 465 and 466: 78452 39.181 35091172 D D 42409990

Page 467 and 468: J3490 0 37001142 D D 43009990 43009

Page 469 and 470: 97010 15 41200107 D D 43709990 4370

Page 471 and 472: L3835 90 41300011 D D 43709990 4370

Page 473 and 474: L0210 90 41000090 D D 43709990 4370

Page 475 and 476: L3860 90 48200015 D D 43909990 4390

Page 477 and 478: 90847 0 D D 44709990 44709990 90849

Page 479 and 480: 0 D D 10001000 10001000 0 D D 10001

Page 481 and 482: 0 I I 38009990 38009990 51180 0 I I

Page 483 and 484: CBDSC MTDQTY YTDQTY MED/SURG, SEMI-

Page 485 and 486: ITEL IV TX HYDRA ADD'L 224 HR 224 I

Page 487 and 488: ACU VISIT 5 5 ENDO DUAL VISIT 0 0 S

Page 489 and 490: EX MAL LES FACE 4.0 0 CM 0 DEBRIDE

Page 491 and 492: IV TX HYDRA ADD'L HR0 0 VACCINE INJ

Page 493: RADIAL SHFT FX W/MAN 0 0 FX CARE W/

Page 496 and 497: SHAVING SKIN LESION 0

Page 498 and 499: CMPLX SC EXTS EA ADD 0 0 CMPLX FACE

Page 500 and 501: SUTURE REMOVAL-DKH 0 0 REMOVAL FB U

Page 502 and 503: ART FASTFIX KNT PSHR2 2 ART FASTFIX

Page 504 and 505: LAP UNIV TROCAR SLVE 14 5MM 14 ART

Page 506 and 507: MIS DRAIN BAKER JEJUN 0 0 MIS DRAIN

Page 508 and 509: ORT MITEK SUPER 0 0 ORT PLATE HUMER

Page 510 and 511: TKA X3 TRIATHLON CS 0 INS 0 TOPAZ W

Page 512 and 513: STAPLE PURSESTRING0 0 STAPLE PURSTR

Page 514 and 515: URO CATH SILIC 22/3WAY* 0 0 URO CAT

Page 516 and 517: THA ACCOLADE C CS 0127NK 0 THA ACCO

Page 518 and 519: ETOPOSIDE 20 MG/ML 450 VIAL 450 FLU

Page 520 and 521: EPOGEN 1000 UNITS 0WASTAGE 0 EPOGEN

Page 522 and 523: CYTO SPUTUM 0 0 CYTO URINE 6 6 CYTO

Page 524 and 525: BILIRUBIN TOTAL 25 25 BILIRUBIN DIR

Page 526 and 527: GASTRIC PH 0 0 CSF GLUCOSE 7 7 FLUI

Page 528 and 529: DIFFERENTIAL/MANUAL 797 797 SMEAR R

Page 530 and 531: WOUND CULTURE124 124 BLOOD CULTURE

Page 532 and 533: PH URINE 0 0 SPEC.GRAVITY URINE0 0

Page 534 and 535: ECHOVIRUS AB 0 0 HLA A,B TYPING DNA

Page 536 and 537: IGA 26 26 IGM 26 26 PORPHYRINS, RAN

Page 538 and 539: PTH N TERM INTACT 0 0 SEROTONIN-SER

Page 540 and 541: BARBITURATES,SERUM0 0 BARBITURATES,

Page 542 and 543: IBT RAST ALLERGEN 24 12 24 SGPG 0 0

Page 544 and 545: METHADONE,UR 0 0 HEPATITIS E IGM 0

Page 546 and 547: SUBSTITUTION PLASMA 0 0 RMSF IGG 0

Page 548 and 549: ANTI-STREPTOLYSIN O3 3 S.CEREVISIAE

Page 550 and 551: RUBEOLA AB,IGG 28 28 SEX HORMONE BI

Page 552 and 553: COXSACKIE B2 AB 0 0 COXSACKIE B3 AB

Page 554 and 555: N.GONORRHOEAE RNA 0 0 CORTISONE,SER

Page 556 and 557: ALBUMIN 0 0 YERSINIA AB 1 1 JANUS K

Page 558 and 559: GLYCOMARK 0 0 STREPTOMYCIN 0 0 THYR

Page 560 and 561: CHROMAGRANIN A 3 3 CMV DNA QUANT RT

Page 562 and 563: ANTI MULLERIAN HORMONE 0 0 TSH ANTI

Page 564 and 565: INSULIN 0 0 LD, BODY FLUID 0 0 LACT

Page 566 and 567: MUMPS ANTIBODIES, 0IGG 0 MYCOPLASMA

Page 568 and 569: C1 ESTERASE INHIB, FUNC 0 0 CCP ANT

Page 570 and 571: UREAPLASMA MYCOPLASMA 0 HOM 0 MYCOB

Page 572 and 573: COCONUT, IGE 0 0 ONIONS, IGE 0 0 PI

Page 574 and 575: PARAINFLUENZA TYPE 0 I 0 PARAINFLUE

Page 576 and 577: MRI KEN KNEE WO CONT 9 LT 9 MRI KEN

Page 578 and 579: MRI KEN UPEXT W/WO 0 CON RT 0 MRI K

Page 580 and 581: PRO FEE STRESS MD SUPERVS 0 0 PRO F

Page 582 and 583: LOWER LEG-LEFT 7 7 LOWER LEG-RIGHT

Page 584 and 585: GASTRO TUBE REPLACEMENT 1 1 INSERT

Page 586 and 587: MAMMO DUCT PROC-RT 1 1 HIP-2 VIEWS

Page 588 and 589: PYROPHOSPHATE 7 7 I 123 - 200 2 2 S

Page 590 and 591: US-BIOPSY PROC-PANCR 0 0 US-BIOPSY-

Page 592 and 593: MRI-LS SPINE W/O CON 43 43 MRI-LS S

Page 594 and 595: CT CHEST HIGH RESOLU 0 W/O 0 CT CHE

Page 596 and 597: CT INTRAPERI CATHETER 0 0 CT INTRAP

Page 598 and 599: FOOT LT(2 VIEWS) 0 0 FOOT RT(2 VIEW

Page 600 and 601: CERV SPINE TWO VIEW0 0 CERV SPINE W

Page 602 and 603: LS SPINE&OBL&FLEX&EX 0 6 VW 0 LS SP

Page 604 and 605: MRI WRIST WO CON 0LT PLF 0 MRI-WRIS

Page 606 and 607: CALCITRIOL 0.25 MCG 5 CAP 5 ALLOPUR

Page 608 and 609: CALCIUM CHLORIDE 10% 0 VIAL 0 CANDE

Page 610 and 611: DEXAMETHASONE 492 4MG/ML VIAL 492 D

Page 612 and 613: FIORINAL CAP GENERIC 2 CAP 2 FLUNIS

Page 614 and 615: HUMALOG MIX 75/250 INSULIN 0 ITRACO

Page 616 and 617: METHENAMINE 1 GM 0TAB 0 METHOCARBAM

Page 618 and 619: NITROGLYCERIN 0.4MG 0 SL SP 0 NITRO

Page 620 and 621: PROCHLORPERAZINE 110 MG VI 1 PROCAI

Page 622 and 623: TOBRAMYCIN 80 MG/2ML 11 VIAL11 TOBR

Page 624 and 625: AMIODARONE 200 MG 16 TAB 16 CAFFEIN

Page 626 and 627: VITAMIN E 200 UNIT 0CAP 0 LAMOTRIGI

Page 628 and 629: ATORVASTATIN 40205 MG TAB 205 GUAIF

Page 630 and 631: FLUVASTATIN 20 MG 0CAP 0 CASTOR OIL

Page 632 and 633: PRAMIPEXOLE .25MG 0TAB 0 AMOXICILLI

Page 634 and 635: ERTAPENEM 1GM ADDV 0 0 GLYCOPYRROLA

Page 636 and 637: FOSPROPOFOL 1050MG/30ML 0 0 HAVRIX

Page 638 and 639: BACITRACIN 50 MU INJ 4 VIAL 4 DRONE

Page 640 and 641: ACETAMINOPH 100MG/ML 0 DROP0 REPAGL

Page 642 and 643: FLUCONAZOLE 400 MG/200 0 ML 0 ZOSYN

Page 644 and 645: SP-CANCEL VISIT DLS0 0 SP-ABSENT DL

Page 646 and 647: CHCKOT ORTH PROS 0PER 15 0 WHEELCHA

Page 648 and 649: OT AQUATIC REHAB/15 0 MIN 0 OT ORTH

Page 650 and 651: HIP STRAP (PROC) PLF0 0 SENSORY INT

Page 652 and 653: M V V 0 0 METHACHOLINE EVAL5 5 ARTE

Page 654 and 655: SWALLOW D/C STATUS 1 1 SWALLOW D/C

Page 656 and 657: VOICE CURRENT STATUS 0 0 VOICE CURR

Page 658 and 659: CARRY CURRENT STATUS 2 2 CARRY CURR

Page 660 and 661: CARRY D/C STATUS 0 0 SELF CARE CURR

Page 662 and 663: SUPP BLUE CROSS -237 ALLOW -237 SUP

Page 664 and 665: GOLDEN RULE ALLOW -38 -38 GREAT WES

Page 666 and 667: H/L SAGA ADMINISTRATION 0 0 H/L SAG

Page 668 and 669: TFR FROM B/D TO A/R3 3 TFR FROM A/R

Page 670 and 671: PHYS PRAC ATHENA CASH 0 0 MEDICAL O

Page 672 and 673: CAFETERIA SALES CAFE 0 0 CAFETERIA

Page 674 and 675: LABORATORY - UTILITIES 0 0 CARDIA R

Page 676 and 677: OPER OF PLANT-GAS0 0 NON MEDICAL SU

Page 678 and 679: PERSONAL PYMT (P/R -37DED) -37 TCOR

Page 680 and 681: BLUE CROSS OF RI PAYMENT -88 -88 OU

Page 682 and 683: SEVEN CORNERS PAYMENT 0 0 IMG PAYME

Page 684 and 685: ZZ OHM UNSPECIFIED 0PYMT 0 ZZ STERL

Page 686 and 687: SITE ASSESSMENT 0 0 SITE ASSESSMENT

Page 688 and 689: TX COCCYGEAL FX 0 0 HIP DISLOCW/O A

Page 690 and 691: CL INTE FACE7.6-12.50 0 LYR FACE 12

Page 692 and 693: THORACENTESIS W/TUBE 0 0 TUBE THOR

Page 694 and 695: POST-OP SHOE 0 0 T-LOOP ELECTRODE 0

Page 696 and 697: SYN L PL DCP BR 07 H0 0 SYN L PL DC

Page 698 and 699: FULVESTRANT 125 MG 0 SYRING 0 CYTAR

Page 700 and 701: KENNEDY DISEASE DNA 0 0 APOLIPO.E G

Page 702 and 703: MEN2/FMTC MUTATIONS 0 0 COMPLETE CM

Page 704 and 705: PCR BY IMUGEN 0 0 A PHAGOCYTOPHILUM

Page 706 and 707: PLANAR CARDIAC RE&EX 0 0 PLANAR CAR

Page 708 and 709: PROCAINAMIDE SR 500 MG TA 0 TEGASER

Page 710 and 711: DLSN MOIST HEAT/CRYO(PROC 0 0 FUNCT

Page 712 and 713: PLFD WHFOADDSPREXT 0 L3835 0 PLFD W

Page 714 and 715: VIDEO FLUORO EVAL I0 0 OT REEVAL CP

Page 716 and 717: DLSN OT WHFOADMPFLXIL3860 0 0 DLSN

Page 718 and 719: PRO FEE FAMILY THERAPY 0 0 PROF FEE

Page 720 and 721: MISC MEDICARE MCO 0 PMT 0 NATIONAL

Page 722 and 723: ART OATS 07MM 0 0 ART OATS 08MM 0 0

vial

allowance

plfd

urine

dlsn

sodium

serum

spine

eval

supp

cdsc

cdept

csrv

cupr

semi

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