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
4100590 BILIRUBIN TOTAL 300 0 20.13 4010 4100608 BILIRUBIN DIRECT 300 0 20.13 4010 4100616 BILIRUBIN, INDIRECT 300 0 0 4010 4100624 IRON 300 0 23.03 4010 4100632 TIBC 300 0 0 4010 4100640 UIBC 300 0 36.16 4010 4100657 CALCIUM 300 0 18.1 4010 4100665 FLUID CHLORIDE 300 0 29.77 4010 4100673 CARBON MONOXIDE (CO) 300 0 50.54 4010 4100681 CALCIUM URINE RANDOM 300 0 29.95 4010 4100699 CHLORIDE (CL) 300 0 16.34 4010 4100707 CHOLESTEROL 300 0 17.26 4010 4100715 PCP (TDAS) 300 0 92.43 4010 4100723 BENZO (TDAS) 300 0 92.43 4010 4100731 COCAINE (TDAS) 300 0 92.43 4010 4100749 AMPT (TDAS) 300 0 92.43 4010 4100756 THC (TDAS) 300 0 92.43 4010 4100764 OPIATES (TDAS) 300 0 92.43 4010 4100772 BARBITURATES (TDAS) 300 0 92.43 4010 4100780 CPK 300 0 32.89 4010 4100798 IRON/TIBC 300 0 0 4010 4100806 IRON SATURATION 300 0 0 4010 4100814 CREATININE CLEARANCE 300 0 38.31 4010 4100822 CREAT JP DRAINAGE 300 0 23.64 4010 4100830 CREATININE RANDOM UR 300 0 30.55 4010 4100848 PH BLOOD 300 0 61.63 4010 4100855 BICARBONATE (HCO3) 300 0 17.39 4010 4100863 BLOOD GASES 300 0 68.79 4010 4100871 GGTP 300 0 29.58 4010 4100889 PROTEIN 24HR URINE 300 0 26.71 4010 4100897 CHLORIDE UR RANDOM 300 0 26.43 4010 4100905 LUTEINIZING HORMONE 300 0 75.64 4010 4100913 CALCIUM 24HR URINE 300 0 30.07 4010 4100921 PROLACTIN 300 0 78.51 4010 4100939 HDL PANEL 300 0 54.91 4010 4100947 CHLORIDE 24HR URINE 300 0 26.43 4010 4100954 LIPASE 300 0 28.88 4010 4100970 CREATININE 24HR UR 300 0 23.64 4010 4100988 ELECTROLYTES & MG 300 0 110.7 4010 4100996 LDH 300 0 25.46 4010 4101002 LACTOSE TOL FASTING 300 0 0 4010 4101010 LACTOSE TOL 1/2 HR 300 0 0 4010 4101028 LACTOSE TOL 1HR 300 0 56.36 4010 4101036 LACTOSE TOL 2 HR 300 0 17.18 4010 4101044 LITHIUM LEVEL 300 0 29.52 4010 4101051 MAGNESIUM 300 0 25.55 4010 4101069 MAGNESIUM,UR.RANDOM 300 0 44.27 4010
4101077 OSMOLALITY SERUM 300 0 29.29 4010 4101085 PSA DIAGNOSTIC 300 0 71.93 4010 4101093 PSA SCREENING 300 0 71.93 4010 4101101 ALKALINE PHOS 300 0 20.97 4010 4101119 PHOSPHOROUS 300 0 17.55 4010 4101127 PHOSPHORUS,RANDOM UR 300 0 18.4 4010 4101135 POTASSIUM (K),SERUM 300 0 24.05 4010 4101143 POTASSIUM (K),FLUID 300 0 24.44 4010 4101150 LYTES 300 0 34.62 4010 4101168 COMP.METABOL.PNL NF 300 0 55.55 4010 4101176 COMP.METABOL.PNL FST 300 0 55.55 4010 4101184 BASIC METABOL.PNL NF 300 0 49.88 4010 4101192 BASIC METABOL FSTING 300 0 49.88 4010 4101218 HEPATIC FUNCTION PNL 300 0 53.31 4010 4101226 RENAL FUNCTION PANEL 300 0 65.65 4010 4101234 TOTAL PROTEIN 300 0 19.32 4010 4101242 PROTEIN UR RANDOM 300 0 18.1 4010 4101259 CSF PROTEIN 300 0 13.25 4010 4101267 SALICYLATE 300 0 38.64 4010 4101275 COSTISOL STIMULATION 300 0 220.55 4010 4101283 SODIUM (NA),SERUM 300 0 25.19 4010 4101291 SODIUM (NA),FLUID 300 0 24.44 4010 4101309 GLUCOSE 24HR URINE 300 0 17.01 4010 4101317 POTASSIUM 24HR URINE 300 0 17.44 4010 4101325 GLUCOSE FASTING 300 0 15.88 4010 4101333 IGG 300 0 70.98 4010 4101341 IGA 300 0 70.98 4010 4101358 IGM 300 0 70.98 4010 4101366 RA FACTOR,QUANT 300 0 37.42 4010 4101374 POTASSIUM RANDOM UR 300 0 17.44 4010 4101382 FLUID GLUCOSE 300 0 17.01 4010 4101390 SGOT 300 0 42.97 4010 4101408 SGPT 300 0 18.83 4010 4101416 TRIGLYCERIDES 300 0 20.45 4010 4101424 GLUCOSE 2HHP 300 0 35.1 4010 4101432 BUN 300 0 17.01 4010 4101440 CREATININE 300 0 20.38 4010 4101457 BUN/CREA RATIO 300 0 0 4010 4101465 CREATININE,FLUID 300 0 23.64 4010 4101473 URIC ACID 300 0 16.08 4010 4101481 GLUCOSE RANDOM 300 0 15.88 4010 4101499 PHOSPHOROUS 24HR UR 300 0 18.4 4010 4101507 SODIUM URINE RANDOM 300 0 17.58 4010 4101515 AMYLASE RANDOM URINE 300 0 29.58 4010 4101523 B NATRIURETIC PEPTIDE 300 0 122.01 4010 4101531 FSH SERUM 300 0 75.64 4010 4101549 SODIUM 24HR URINE 300 0 17.58 4010
- 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: 4100046 DIGOXIN 300 0 50.41 4010 41
- 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
4101077 OSMOLALITY SERUM 300 0 29.29 4010<br />
4101085 PSA DIAGNOSTIC 300 0 71.93 4010<br />
4101093 PSA SCREENING 300 0 71.93 4010<br />
4101101 ALKALINE PHOS 300 0 20.97 4010<br />
4101119 PHOSPHOROUS 300 0 17.55 4010<br />
4101127 PHOSPHORUS,RANDOM UR 300 0 18.4 4010<br />
4101135 POTASSIUM (K),SERUM 300 0 24.05 4010<br />
4101143 POTASSIUM (K),FLUID 300 0 24.44 4010<br />
4101150 LYTES 300 0 34.62 4010<br />
4101168 COMP.METABOL.PNL NF 300 0 55.55 4010<br />
4101176 COMP.METABOL.PNL FST 300 0 55.55 4010<br />
4101184 BASIC METABOL.PNL NF 300 0 49.88 4010<br />
4101192 BASIC METABOL FSTING 300 0 49.88 4010<br />
4101218 HEPATIC FUN<strong>CT</strong>ION PNL 300 0 53.31 4010<br />
4101226 RENAL FUN<strong>CT</strong>ION PANEL 300 0 65.65 4010<br />
4101234 TOTAL PROTEIN 300 0 19.32 4010<br />
4101242 PROTEIN UR RANDOM 300 0 18.1 4010<br />
4101259 CSF PROTEIN 300 0 13.25 4010<br />
4101267 SALICYLATE 300 0 38.64 4010<br />
4101275 COSTISOL STIMULATION 300 0 220.55 4010<br />
4101283 SODIUM (NA),SERUM 300 0 25.19 4010<br />
4101291 SODIUM (NA),FLUID 300 0 24.44 4010<br />
4101309 GLUCOSE 24HR URINE 300 0 17.01 4010<br />
4101317 POTASSIUM 24HR URINE 300 0 17.44 4010<br />
4101325 GLUCOSE FASTING 300 0 15.88 4010<br />
4101333 IGG 300 0 70.98 4010<br />
4101341 IGA 300 0 70.98 4010<br />
4101358 IGM 300 0 70.98 4010<br />
4101366 RA FA<strong>CT</strong>OR,QUANT 300 0 37.42 4010<br />
4101374 POTASSIUM RANDOM UR 300 0 17.44 4010<br />
4101382 FLUID GLUCOSE 300 0 17.01 4010<br />
4101390 SGOT 300 0 42.97 4010<br />
4101408 SGPT 300 0 18.83 4010<br />
4101416 TRIGLYCERIDES 300 0 20.45 4010<br />
4101424 GLUCOSE 2HHP 300 0 35.1 4010<br />
4101432 BUN 300 0 17.01 4010<br />
4101440 CREATININE 300 0 20.38 4010<br />
4101457 BUN/CREA RATIO 300 0 0 4010<br />
4101465 CREATININE,FLUID 300 0 23.64 4010<br />
4101473 URIC ACID 300 0 16.08 4010<br />
4101481 GLUCOSE RANDOM 300 0 15.88 4010<br />
4101499 PHOSPHOROUS 24HR UR 300 0 18.4 4010<br />
4101507 SODIUM URINE RANDOM 300 0 17.58 4010<br />
4101515 AMYLASE RANDOM URINE 300 0 29.58 4010<br />
4101523 B NATRIURETIC PEPTIDE 300 0 122.01 4010<br />
4101531 FSH SERUM 300 0 75.64 4010<br />
4101549 SODIUM 24HR URINE 300 0 17.58 4010
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