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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

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4100046 DIGOXIN 300 0 50.41 4010<br />

4100053 GENTAMYCIN BASELINE 300 0 73.16 4010<br />

4100061 PHENOBARBITAL 300 0 61.77 4010<br />

4100079 FOLIC ACID 300 0 52.27 4010<br />

4100087 TEGRETOL 300 0 61.45 4010<br />

4100095 GLYCOHEMOGLOBIN 300 0 34.52 4010<br />

4100103 T3 UPTAKE 300 0 26.71 4010<br />

4100111 T4 (THYROXINE) 300 0 30.84 4010<br />

4100129 TSH 300 0 68.64 4010<br />

4100137 GENTAMYCIN PEAK 300 0 73.16 4010<br />

4100145 VALPROIC ACID 300 0 50.35 4010<br />

4100160 DILANTIN 300 0 58.13 4010<br />

4100178 VITAMIN B12 300 0 61.25 4010<br />

4100186 ACETOMINOPHEN 300 0 71.93 4010<br />

4100194 TOBRAMYCIN PEAK 300 0 57.29 4010<br />

4100202 FREE T4 300 0 47.67 4010<br />

4100210 TOBRAMYCIN BASELINE 300 0 84.35 4010<br />

4100228 HCG BETA SUBUNIT 300 0 63.44 4010<br />

4100236 THEOPHYLLINE 300 0 54.64 4010<br />

4100244 VANCOMYCIN,RANDOM 300 0 56.02 4010<br />

4100251 VANCOMYCIN TROUGH 300 0 56.02 4010<br />

4100269 VANCOMYCIN PEAK 300 0 56.02 4010<br />

4100277 UREA NITROGEN 24HR 300 0 21.77 4010<br />

4100285 PREG TOXEMIA PANEL 300 0 0 4010<br />

4100293 METHEMOGLOBIN 300 0 55.71 4010<br />

4100301 TROPONIN I LEVEL 300 0 58.24 4010<br />

4100319 FA<strong>CT</strong>ORY MUTUAL PNL 2 300 0 65.39 4010<br />

4100327 POTASSIUM,PLASMA 300 0 16.34 4010<br />

4100335 FA<strong>CT</strong>ORY MUTUAL PNL 3 300 0 82.76 4010<br />

4100418 FLUID APPEARANCE 300 0 26.72 4010<br />

4100426 FLUID PH 300 0 37.38 4010<br />

4100434 GENTAMYCIN,RANDOM 300 0 73.16 4010<br />

4100442 TOBRAMYCIN,RANDOM 300 0 111.41 4010<br />

4100459 LDL,DIRE<strong>CT</strong> 300 0 35.81 4010<br />

4100467 GLUCOSE 1HR,NF 300 0 19.83 4010<br />

4100475 ACETONE (BLOOD) 300 0 24.67 4010<br />

4100483 MICROALB.RANDOM UR 300 0 27.36 4010<br />

4100491 MICROALB.24HR UR 300 0 27.36 4010<br />

4100509 ALBUMIN (BLOOD) 300 0 16.64 4010<br />

4100517 FLUID ALBUMIN 300 0 30.55 4010<br />

4100525 ALCOHOL 300 0 41.93 4010<br />

4100533 HDL 300 0 28.92 4010<br />

4100541 AMMONIA (BLOOD) 300 0 51.81 4010<br />

4100558 AMYLASE 300 0 27.22 4010<br />

4100566 FIBRONE<strong>CT</strong>IN 300 0 487.7 4010<br />

4100574 CSF CHLORIDE 300 0 22.17 4010<br />

4100582 BILIRUBIN, TOTAL, NEONATAL 300 0 20.13 4010

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