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
SMPL BODY SC 2.6-7.58 8 SMPL BDY SC 7.6-12.51 1 SMPL BDY SC 12.6-201 1 SMPL BDY SC 20.1-300 0 SMPL BODY SC >30.00 0 SMPL FACE < 2.5 5 5 SMPL FACE 2.6-5.0 CM1 1 SMPL FACE 5.1-7.5 CM0 0 SMPL FACE 7.6-12.5CM0 0 SMPL FACE12.6-20.0CM 0 0 TX SUPERFIC WND SMPL 0 0 LYR BDY SCALP
RADIAL SHFT FX W/MAN 0 0 FX CARE W/MAN ULNA 0 0 ULNAR SHFT FX W/MAN 0 0 DISTAL RADIUS FX W/O 0 0 DISTAL RADIUS FX W/M 1 1 NAVICULAR FX W/O MAN 0 0 CARPAL BONE FX W/MAN 0 0 DSTL RADIOULNAR W/M 0 0 I&D ABSC FINGER SMPL 0 0 I&D ABS FINGER CMPLX 0 0 REP EXT TEN HAND PRI 0 0 METACARPAL FX W/MAN 0 0 THUMB DISLOC W/MAN 0 0 METACAR DIS W/M WO 0 A 0 IP JNT DISL W/M WO 0A 0 PHALANGEAL FX W/O 0M 0 PHALANGEAL FX W/MAN 0 0 IP JOINT FX W/MAN 0 0 DIST PHALANX FX W/M0 0 CLS TX TIB/FIB FXW/M0 0 CL TX DIS FEM FXWO/M 0 0 IP JT DIS W/M W/O A0 0 AMP FINGER SGL W/FLA 0 0 AMPU FINGER/THB W/C/ 0 0 HIP DISLOC W/O FIXTN0 0 POST HIP DISLC W/O A0 0 CL TX FEM SHT FX;W/M0 0 TIB PLATEAU FX W/O 0M 0 KNEE DISLOC W/O ANES 0 0 PATELLAR DSLOC W/O 0 A 0 M MALLEOLUS FX W/O 0 M 0 CL TX MED MAL FX W/M 0 0 PROX FIB/SHFT W/O M0 0 DIST FIB FX W/O M 0 0 DIST FIB FX W/MAN 0 0 BIMALLEOLAR FX W/MAN 0 0 TRIMALLEOLAR FX WO 0 M 0 ANKLE DISLOC W/O ANE 0 0 TRIMALLEOLAR FX W/MA 0 0 ANKLE DISLOC W/ANES 0 0 REMOVAL FB FOOT SUBC 0 0 CALCANEAL FX W/O M0 0 TALUS FX W/O M 0 0 METATARSAL FX W/O 0M 0 FX TOE/PHANLANX W/MA 0 0 FX PHALANX W/M 0 0 MTP JNT DIS W/O ANES 0 0
- 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: IV TX HYDRA ADD'L HR0 0 VACCINE INJ
- 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,
RADIAL SHFT FX W/MAN 0 0<br />
FX CARE W/MAN ULNA 0 0<br />
ULNAR SHFT FX W/MAN 0 0<br />
DISTAL RADIUS FX W/O 0 0<br />
DISTAL RADIUS FX W/M 1 1<br />
NAVICULAR FX W/O MAN 0 0<br />
CARPAL BONE FX W/MAN 0 0<br />
DSTL RADIOULNAR W/M 0 0<br />
I&D ABSC FINGER SMPL 0 0<br />
I&D ABS FINGER CMPLX 0 0<br />
REP EXT TEN HAND PRI 0 0<br />
METACARPAL FX W/MAN 0 0<br />
THUMB DISLOC W/MAN 0 0<br />
METACAR DIS W/M WO 0 A 0<br />
IP JNT DISL W/M WO 0A<br />
0<br />
PHALANGEAL FX W/O 0M<br />
0<br />
PHALANGEAL FX W/MAN 0 0<br />
IP JOINT FX W/MAN 0 0<br />
DIST PHALANX FX W/M0 0<br />
CLS TX TIB/FIB FXW/M0 0<br />
CL TX DIS FEM FXWO/M 0 0<br />
IP JT DIS W/M W/O A0 0<br />
AMP FINGER SGL W/FLA 0 0<br />
AMPU FINGER/THB W/C/ 0 0<br />
HIP DISLOC W/O FIXTN0 0<br />
POST HIP DISLC W/O A0 0<br />
CL TX FEM SHT FX;W/M0 0<br />
TIB PLATEAU FX W/O 0M<br />
0<br />
KNEE DISLOC W/O ANES 0 0<br />
PATELLAR DSLOC W/O 0 A 0<br />
M MALLEOLUS FX W/O 0 M 0<br />
CL TX MED MAL FX W/M 0 0<br />
PROX FIB/SHFT W/O M0 0<br />
DIST FIB FX W/O M 0 0<br />
DIST FIB FX W/MAN 0 0<br />
BIMALLEOLAR FX W/MAN 0 0<br />
TRIMALLEOLAR FX WO 0 M 0<br />
ANKLE DISLOC W/O ANE 0 0<br />
TRIMALLEOLAR FX W/MA 0 0<br />
ANKLE DISLOC W/ANES 0 0<br />
REMOVAL FB FOOT SUBC 0 0<br />
CALCANEAL FX W/O M0 0<br />
TALUS FX W/O M 0 0<br />
METATARSAL FX W/O 0M<br />
0<br />
FX TOE/PHANLANX W/MA 0 0<br />
FX PHALANX W/M 0 0<br />
MTP JNT DIS W/O ANES 0 0
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