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

ITEL IV TX HYDRA ADD'L 224 HR 224
ITEL IV PUSH INITIAL24 24
ITEL IVP EA DDD'L SEQ 15 15
ITEL IVP SEQ SAME RX>30 35 35
ITEL IV THERAPY ADD'L 6 HR 6
ITEL IV THERAPY 1ST 2HR
2
ITEL IV TX ADD'L SQ 30 9 9
ICU IV THERAPY ADD'L 0 HR 0
ICU IV THERAPY 1ST HR 0 0
ICU IV TX ADD'L SQ < 01 HR 0
ICU IV TX CONCURR INF 0 0
ICU INJECTION SC, IM1 1
ICU OBSERVATION BLOOD 1 ADM 1
ICU NON BILL OBS PER 0 HR 0
ICU TRNSFSN BLOOD/COMPT 2 2
MCH OBSERVATION 103 PER HOUR103
MCH DIRECT OBSERVATION 1 1
MCH IV TX HYDRA 310TO 60 0
MCH IV TX HYDRA ADD'L 0 HR 0
MCH IV PUSH INITIAL1 1
MCH IVP EA ADD'L SEQ0 0
MCH IVP SEQ SAME RX>30MIN 1 1
MCH IV THERAPY ADD'L 0 HR 0
MCH IV THERAPY 1ST 0HR
0
MCH IV TX ADD'L SQ 0