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
EPOGEN 1000 UNITS 0WASTAGE 0 EPOGEN 1000 UNITS 0WASTAGE 0 EPOGEN 1000 UNITS 0WASTAGE 0 EPOGEN 1000 UNITS 0WASTAGE 0 ERBITUX 10MG WASTAGE 0 0 ETOPOSIDE 10MG WASTAGE 0 0 FASLODEX 25MG WASTE 0 0 FERRLECIT IV 12.5MG 0WASTE 0 FLUDARABINE PHOSPHAT 0 WAST0 FLUOROURACIL 500MG 0 WASTE 0 IFOSFAMIDE 1GRAM 0WASTE 0 IRINOTECAN HCL 20 WASTE 0 0 IXABEPILONE 1MG VL 0WASTE 0 LEUCOVORIN 50 MG 0WASTE 0 LEVOLEUCOVORIN .5MG 0 WASTE0 LUPRON DEPOT 7.5MG 0 WASTE 0 MESNA 200 MG WASTE 0 0 MITOMYCIN 5MG WASTE 0 0 MITOMYCIN .25 MG WASTE 0 0 INJ INTERFERON ALFA 0 2B 0 FERUMOXYTOL 11020 MG INJ 1020 PEMETREXED 100MG 510VL INJ 510 RASBURICASE .5 MG 0VL INJ 0 HEPARIN SOD PER 10000 UN 0 DENOSUMAB 1201440 MG VIAL 1440 INJ, DENOSUMAB, 1 MG 0 0 BENDAMUSTINE 25200 MG VIAL 200 FOSAPREPITANT DIMEGLUMINE 150 150 OPRELVEKIN 5 MG VIAL 0 0 LEUPROLIDE ACETATE 0 30 MG 0 LEUPROLIDE ACETATE 3 22.5 3 LEUPROLIDE ACETATE 0 45 MG 0 LEUPROLIDE ACETATE 0 7.5 MG 0 LEUPROLIDE ACETATE 0 SUSP 0 ERIBULIN 1 MG/2 ML0 0 CARFILZOMIB 60 MG 0VIAL 0 PERTUZUMAB 420 MG 84 VIAL 84 TEMOZOLOMIDE 1000 MG VIAL 0 VINBLASTINE 1 MG/ML 0 0 DEXRAZOXANE 500 MG 0 VIAL 0 DARBEPOETIN 40 MCG/ML 0 VL 0 HEPARIN 50,000UN/5ML 100 VIAL100 CR PHASE IV-PUTNAM69 69 CARD REHAEB PSE II NO 0 ECG 0 SUPERVISED PH III CARDIAC 3 3 CARDIAC PHASE II 133 133 GLUCOSE REAGENT 49 STRP 49
GLUCOSE STRIP SUBSEQ 49 49 PULM REHAB LEVEL 14 4 14 PULMONARY EVAL 3 3 P/R MD INT DOSE INHL 0 0 P/R ONE TO ONE WALK 4 MONTR 4 P/R ONE TO ONE STAIRS 0 0 P/R GRP ACTIVITY 24 24 CR PHASE IV-PLAINFIELD 17 17 CARDIAC EVAL 6 6 BLINK REFLEX, ORBI OCULI 0 0 REPETITIVE STIM NEURO 5 JXN 5 SENSORY 1 TO 2 SITES0 0 SENSORY 3 TO 4 STUDIES 1 1 SENSORY 5 TO 6 STUDIES 0 0 SENSORY 7 TO 8 STUDIES 15 15 SENSORY 9 TO 10 STUDIES 13 13 SENSORY 11 TO 12 STUDIES 9 9 SENSORY 13 OR MORE7 7 LEVEL 4 GROSS/MICRO 733 733 BM SMEAR INTERPRE4 4 LEVEL 1 GROSS EXAM4 4 LEVEL 2 GROSS/MICRO7 7 LEVEL 3 GROSS/MICRO 104 104 LEVEL 5 GROSS/MICRO 41 41 LEVEL 6 GROSS/MICRO5 5 DECALCIFICATION 29 29 SPECIAL STAIN GP I 71 71 SPECIAL STAIN GP II27 27 MD COMPLETE CONSULT 0 0 CONSULT DURING SURG 0 0 FIRST FROZEN SECTION 2 2 ADDITIONAL FROZEN0 0 PAP SCREEN 0 0 PAP SMEAR MD 0 0 PAP DIAGNOSTIC 0 0 SMEAR TZANK 0 0 SMEAR SEMEN 1 1 SMEAR BREAST DISC 1 1 CYTO THINPREP SCREEN 559 559 THIN PREP MD 73 73 CYTO THINPREP DIAG35 35 CYTO GASTRIC BRUSH0 0 CYTO BREAST CYST 0 0 CYTO BREAST ASPIRATE 2 2 CYTO BRONCH BRUSH1 1 CYTO CSF 2 2 CYTO OVARY CYST 2 2
- 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 516 and 517: THA ACCOLADE C CS 0127NK 0 THA ACCO
- Page 518 and 519: ETOPOSIDE 20 MG/ML 450 VIAL 450 FLU
- 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
- Page 566 and 567: MUMPS ANTIBODIES, 0IGG 0 MYCOPLASMA
- Page 568 and 569: C1 ESTERASE INHIB, FUNC 0 0 CCP ANT
EPOGEN 1000 UNITS 0WASTAGE<br />
0<br />
EPOGEN 1000 UNITS 0WASTAGE<br />
0<br />
EPOGEN 1000 UNITS 0WASTAGE<br />
0<br />
EPOGEN 1000 UNITS 0WASTAGE<br />
0<br />
ERBITUX 10MG WASTAGE 0 0<br />
ETOPOSIDE 10MG WASTAGE 0 0<br />
FASLODEX 25MG WASTE 0 0<br />
FERRLECIT IV 12.5MG 0WASTE<br />
0<br />
FLUDARABINE PHOSPHAT 0 WAST0<br />
FLUOROURACIL 500MG 0 WASTE 0<br />
IFOSFAMIDE 1GRAM 0WASTE<br />
0<br />
IRINOTECAN HCL 20 WASTE 0 0<br />
IXABEPILONE 1MG VL 0WASTE<br />
0<br />
LEUCOVORIN 50 MG 0WASTE<br />
0<br />
LEVOLEUCOVORIN .5MG 0 WASTE0<br />
LUPRON DEPOT 7.5MG 0 WASTE 0<br />
MESNA 200 MG WASTE 0 0<br />
MITOMYCIN 5MG WASTE 0 0<br />
MITOMYCIN .25 MG WASTE 0 0<br />
INJ INTERFERON ALFA 0 2B 0<br />
FERUMOXYTOL 11020 MG INJ 1020<br />
PEMETREXED 100MG 510VL INJ 510<br />
RASBURICASE .5 MG 0VL INJ 0<br />
HEPARIN SOD PER 10000 UN 0<br />
DENOSUMAB 1201440 MG VIAL 1440<br />
INJ, DENOSUMAB, 1 MG 0 0<br />
BENDAMUSTINE 25200 MG VIAL 200<br />
FOSAPREPITANT DIMEGLUMINE<br />
150 150<br />
OPRELVEKIN 5 MG VIAL 0 0<br />
LEUPROLIDE ACETATE 0 30 MG 0<br />
LEUPROLIDE ACETATE 3 22.5 3<br />
LEUPROLIDE ACETATE 0 45 MG 0<br />
LEUPROLIDE ACETATE 0 7.5 MG 0<br />
LEUPROLIDE ACETATE 0 SUSP 0<br />
ERIBULIN 1 MG/2 ML0 0<br />
CARFILZOMIB 60 MG 0VIAL<br />
0<br />
PERTUZUMAB 420 MG 84 VIAL 84<br />
TEMOZOLOMIDE 1000 MG VIAL 0<br />
VINBLASTINE 1 MG/ML 0 0<br />
DEXRAZOXANE 500 MG 0 VIAL 0<br />
DARBEPOETIN 40 MCG/ML 0 VL 0<br />
HEPARIN 50,000UN/5ML 100 VIAL100<br />
CR PHASE IV-PUTNAM69 69<br />
CARD REHAEB PSE II NO 0 ECG 0<br />
SUPERVISED PH III CARDIAC 3 3<br />
CARDIAC PHASE II 133 133<br />
GLUCOSE REAGENT 49 STRP 49
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