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
THA ACCOLADE C CS 0127NK 0 THA ACCOLADE C CS 0132NK 0 THA DEFI CEMENTED 0HIPSTEM 0 THA RELIANCE DIST CENTRAL 1 1 THA RELIANCE PF HIP 1STEM 1 THA UHR BIPOLAR 260 0 THA UNITRAX MODU 2ENDOHEAD2 THA UNITR V40 TAPERSLEEVE 0 0 THA TRID ECC X3 HEAD 2 36MM 2 THA DALLM CBL/SLVSET2MMSS 0 0 THA DALLM BEAD CBLSET2MMV 0 0 THA DALL MED GRIP&22MMCBL 0 0 GAMMA TROCHA LOCKING 2 NAIL2 GAMMA LAG SCREW2 2 GAMMA CROSS SCREW2 2 GAMMA SET SCREW 0 0 GAMMA CAP SCREW0 0 GAMMA KIRSCHNER 2WIRE 2 GAMMA DRILL 0 0 GAMMA GUIDE WIRE 1BALL TIP 1 OMEGA STANDARD LAG 0 SCREW 0 OMEGA SUPER LAG SCREW 0 0 OMEGA COMPRESSION 0 SCREW 0 OMEGA 3.6 BONE DRILL 0 0 OMEGA CORT SELF-TAP 0 SCREW 0 OMEGA STD BARREL 02 HOLE 0 OMEGA STD BARREL 03HOLE 0 OMEGA STD BARREL 04HOLE 0 OMEGA STD BARREL 05HOLE 0 OMEGA STD BARREL 06HOLE 0 OMEGA STD BARREL 08HOLE 0 OMEGA STD BARREL 010HOLE 0 OMEGA STD BARREL 012HOLE 0 GELFOAM 0 0 PACK C-SECTION 17 17 GYN INTERCEED 0 0 MCH MIS CATH FOLEY 17 17 MCH STAPLE CRICKET1 1 ONC IV THER 1ST HR68 68 ONC IV THER ADD'L 38 HR 38 INI PLACE PUMP/CASSETTE 19 19 REFILL/MAIN PUMP/CASSETTE 4 4 EACH ADDITIONAL VACCINE 0 0 IV TX ADD'L SQ < 1182 HR 182 SINGLE VACCINE ADMIN 1 1 LUMBAR PUNCTURE 0 0 BONE MARROW ASPIRATION 1 1
BONE MARROW BIOPSY 1 1 IV TX CONCURR INF 7 7 BONE MARROW TRAY1 1 IV TX HYDRAT 31 6025 MIN 25 IV TX HYDRA ADD'L 51 HR 51 ONC INJECTED SC, 100 IM 100 IV PUSH INITIAL 3 3 IVP EACH ADD'L SEQ 7 7 IVP SEQ SAME DRUG>30 0 MIN 0 GLUSOCE CHECK 0 0 INSER FOLEY CATH 0 0 LEVEL I NV 2 2 CHEMO INFUSD 1ST 130 HR 130 CHEMO INFUSD AD'L 44HR 44 CHEMO INF SEQ 1ST 44 HR 44 CHEMO SPINAL INC LUMBAR 0 0 CHEMO IVP INITIAL 1 1 CHEMO IVP EA ADD'L 22 22 CHEMO SC/IM NON-HORM 12 12 CHEMO SC/IM HORMONAL 3 3 BLOOD ADMIN-ONCOLOGY 20 20 PORT FLUSH ONLY 55 55 PNEUMON VACCINE 0ADMIN 0 CONSULT ONLY ONC 0N/C 0 EKG ONCOLOGY 2 2 CHEMOTHERAPY VISIT 144 144 NON CHEMOTHERAPY 258 VISIT 258 VENOUS DRAW THROUGH 28 PORT 28 CHEMO PUMP RENTAL 15 15 CHEMO SPILL KIT 1 1 CHEMO PUMP KIT 15 15 ONCOLOGY OXYGEN 4 4 ONCOLOGY E&M LEVEL 0 3 0 CONSULT ONLY ONC 0N/C 0 BLEOMYCIN 15 UNIT 2VIAL 2 DOXORUBICIN 10MG 40VIAL 40 FLUDARABINE 50 MG 0VIAL 0 VINCRISTINE 1MG/ML 6 2MLVIA 6 VINBLASTINE 10 MG 0VIAL 0 DOCETAXEL 1 MG INJECTION1300 DOXORUBICIN LIPOSOME 0 20MG0 RITUXIMAB 100MG/ML 64 VIAL 64 TRASTUZUMAB 440 718 MG VIAL 718 VINORELBINE 10 MG 0VIAL 0 CARBOPLATIN 10MG/ML 104 VIAL104 CYCLOPHOSPHAMIDE 0100 MG 0 IRINOTECAN 40 MG 126 SDV VIAL 126
- 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 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
THA ACCOLADE C CS 0127NK<br />
0<br />
THA ACCOLADE C CS 0132NK<br />
0<br />
THA DEFI CEMENTED 0HIPSTEM<br />
0<br />
THA RELIANCE DIST CENTRAL 1 1<br />
THA RELIANCE PF HIP 1STEM<br />
1<br />
THA UHR BIPOLAR 260 0<br />
THA UNITRAX MODU 2ENDOHEAD2<br />
THA UNITR V40 TAPERSLEEVE 0 0<br />
THA TRID ECC X3 HEAD 2 36MM 2<br />
THA DALLM CBL/SLVSET2MMSS 0 0<br />
THA DALLM BEAD CBLSET2MMV 0 0<br />
THA DALL MED GRIP&22MMCBL 0 0<br />
GAMMA TROCHA LOCKING 2 NAIL2<br />
GAMMA LAG SCREW2 2<br />
GAMMA CROSS SCREW2 2<br />
GAMMA SET SCREW 0 0<br />
GAMMA CAP SCREW0 0<br />
GAMMA KIRSCHNER 2WIRE<br />
2<br />
GAMMA DRILL 0 0<br />
GAMMA GUIDE WIRE 1BALL TIP 1<br />
OMEGA STANDARD LAG 0 SCREW 0<br />
OMEGA SUPER LAG SCREW 0 0<br />
OMEGA COMPRESSION 0 SCREW 0<br />
OMEGA 3.6 BONE DRILL 0 0<br />
OMEGA CORT SELF-TAP 0 SCREW 0<br />
OMEGA STD BARREL 02 HOLE 0<br />
OMEGA STD BARREL 03HOLE<br />
0<br />
OMEGA STD BARREL 04HOLE<br />
0<br />
OMEGA STD BARREL 05HOLE<br />
0<br />
OMEGA STD BARREL 06HOLE<br />
0<br />
OMEGA STD BARREL 08HOLE<br />
0<br />
OMEGA STD BARREL 010HOLE<br />
0<br />
OMEGA STD BARREL 012HOLE<br />
0<br />
GELFOAM 0 0<br />
PACK C-SE<strong>CT</strong>ION 17 17<br />
GYN INTERCEED 0 0<br />
MCH MIS CATH FOLEY 17 17<br />
MCH STAPLE CRICKET1 1<br />
ONC IV THER 1ST HR68 68<br />
ONC IV THER ADD'L 38 HR 38<br />
INI PLACE PUMP/CASSETTE 19 19<br />
REFILL/MAIN PUMP/CASSETTE 4 4<br />
EACH ADDITIONAL VACCINE 0 0<br />
IV TX ADD'L SQ < 1182 HR 182<br />
SINGLE VACCINE ADMIN 1 1<br />
LUMBAR PUN<strong>CT</strong>URE 0 0<br />
BONE MARROW ASPIRATION 1 1
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