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
4601514 IGA 300 0 70.98 4010 4601522 IGM 300 0 61.82 4010 4601530 PORPHYRINS, RANDOM U 300 0 86.26 4010 4601548 PROCAINAMIDE NAPA 300 0 112.97 4010 4601555 TRANSFERRIN 300 0 73.26 4010 4601563 LDH ISOENZYMES 300 0 106.86 4010 4601571 ANTIMITOCHONDRIAL AB 300 0 90.81 4010 4601589 MALARIA SMEAR 300 0 57.27 4010 4601597 HERPES SIMPLEX IGM 300 0 191.56 4010 4601605 HERPES TYPE I 300 0 93.86 4010 4601613 ANTI-JO-1 ANTIBODY 300 0 135.07 4010 4601621 ASCARIASIS AB 300 0 207.61 4010 4601639 EFFEXOR/VENLAFAXINE 300 0 83.2 4010 4601647 FIBRONECTIN AGGREGAT 300 0 267.15 4010 4601654 3-A-ANDROSTANEDIOL-G 300 0 138.91 4010 4601662 HLA-DRB,DQB1 TYPING 300 0 430.43 4010 4601670 PHYTANIC ACID, SERUM 300 0 259.48 4010 4601688 FILARIASIS 300 0 245.77 4010 4601696 VISCERAL LARVA MIGRA 300 0 259.48 4010 4601704 STRONGYLOIDES AB 300 0 207.61 4010 4601712 ANTI EXTRACT.NUC.AG 300 0 131.3 4010 4601720 HEINZ BODIES STAIN 300 0 22.17 4010 4601738 FACTOR 8 VW FACTOR 300 0 152.62 4010 4601746 FACTOR IX ACTIVITY 300 0 138.91 4010 4601753 FACTOR VII ACTIVITY 300 0 225.94 4010 4601761 PORPHOBILINOGEN RAND 300 0 80.15 4010 4601779 ANTI THROMBIN 3 300 0 171.73 4010 4601787 FACTOR VIII 300 0 155.68 4010 4601795 FACTOR V 300 0 623.06 4010 4601803 B.PERTUSSIS CULTURE 300 0 64 4010 4601811 CIDAL TROUGH LEVEL 300 0 99.97 4010 4601829 U UREALYTICUM/M HOMI 300 0 116.81 4010 4601837 ACTH 300 0 296.92 4010 4601845 ACID PHOS,PROSTATIC 300 0 64.87 4010 4601852 T3 FREE 300 0 131 4010 4601860 T3 TOTAL 300 0 106.86 4010 4601878 INSULIN 300 0 85.48 4010 4601886 C1Q BINDING ASSAY 300 0 184.73 4010 4601894 ALPHA I ANTITRYPSIN 300 0 92.37 4010 4601902 ZINC SERUM 300 0 79.37 4010 4601910 COMPLEMENT C3 300 0 90.81 4010 4601928 RAJI CELL ASSAY 300 0 206.05 4010 4601936 COMPLEMENT C4 300 0 90.81 4010 4601944 ESTROGEN TOTAL 300 0 163.35 4010 4601951 HAPTOGLOBIN 300 0 84.7 4010 4601969 RHEUMATOID FACTOR QU 300 0 37.42 4010 4601977 HEMOSIDERIN RAND UR 300 0 422.3 4010
4601985 RETROVIRAL SEROLOGY 300 0 45.13 4010 4601993 FEBRILE AGGLUTININS 300 0 112.97 4010 4602009 5HIAA URINE 24HR 300 0 97.7 4010 4602017 AMINOLEVULINIC ACID 300 0 133.58 4010 4602025 VISCOSITY BODY FLUID 300 0 88.53 4010 4602033 THORAZINE LEVEL 300 0 150.35 4010 4602041 VITAMIN B6 300 0 183.86 4010 4602058 OXALATE 24HR URINE 300 0 97.7 4010 4602066 VASO INTESTINAL PEP 300 0 237.38 4010 4602074 ALDOLASE 300 0 58.76 4010 4602082 AMINO ACID SC-PLASMA 300 0 88.53 4010 4602090 ANTI MICROSOMAL AB 300 0 109.92 4010 4602108 ANTI-THYROGLOBULIN 300 0 120.58 4010 4602116 ESTRADIOL E2 NONPREG 300 0 211.45 4010 4602124 B12 BINDING CAPACITY 300 0 116.81 4010 4602132 IONIZED CALCIUM 300 0 89.5 4010 4602140 NORPACE 300 0 92.37 4010 4602157 SUB ABUSE PANEL 300 0 80.15 4010 4602165 17 KETOGENIC STEROID 300 0 101.53 4010 4602173 BETA CAROTENE 300 0 77.87 4010 4602181 CHOLINESTERASE 300 0 144.24 4010 4602199 CLONOPIN/CLONAZEPAM 300 0 44.27 4010 4602207 CRYOGLOBULINS 300 0 44.27 4010 4602215 HLA B27 300 0 125 4010 4602223 HYDROXYPROLINE FREE 300 0 220.55 4010 4602231 ELAVIL 300 0 135.07 4010 4602249 MELLARIL 300 0 103.81 4010 4602256 ANTI SMOOTH MUSCLE 300 0 112.19 4010 4602264 ALDOSTERONE 300 0 278.59 4010 4602272 CATECHOLAMINE,FRAC/U 300 0 170.17 4010 4602280 VMA QUANTITATIVE 300 0 657.41 4010 4602298 METANEPHRINE FRACT. 300 0 128.25 4010 4602306 CORTISOL FREE, URINE 300 0 128.69 4010 4602314 17 KETOSTEROIDS TOT 300 0 98.48 4010 4602322 HUMAN GROWTH HORMONE 300 0 213.6 4010 4602330 PTH C TERM MIDREGION 300 0 248.82 4010 4602348 COMPLEMENT CH50 300 0 154.18 4010 4602355 LACTIC ACID 300 0 72.48 4010 4602363 LEAD ADULT 300 0 81.41 4010 4602389 COMP C1Q NONBINDING 300 0 96.14 4010 4602397 HEAVY METALS 24HR UR 300 0 225.94 4010 4602405 MERCURY URINE 24HR 300 0 158.02 4010 4602413 EBV AB SCREEN 300 0 82.51 4010 4602421 DOXEPIN/SINEQUAN 300 0 127.47 4010 4602439 ALK PHOS ISOENZYMES 300 0 112.19 4010 4602447 ANGIO-CONVERT ENZYME 300 0 109.92 4010 4602454 PROGESTERONE 300 0 119.09 4010
- 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 and 42: 4100046 DIGOXIN 300 0 50.41 4010 41
- Page 43 and 44: 4101077 OSMOLALITY SERUM 300 0 29.2
- 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: 4601035 FLUPHENAZINE 300 0 145.02 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
- Page 93 and 94: 4800041 SPE COLL TRAVEL/MILE 300 0
- Page 95 and 96: 5600689 MRI KEN HIP W/CONT RT 610 0
- Page 97 and 98: 5800313 MULTIPLE SLEEP LATENCY TEST
- Page 99 and 100: 6103758 BONE DENSITY FX EVAL 320 0
- Page 101 and 102: 6108906 CYSTO SCOUT FILM 320 0 108.
- Page 103 and 104: 6113864 SHLDR-ARTH PRO/INS-RT 761 0
4601514 IGA 300 0 70.98 4010<br />
4601522 IGM 300 0 61.82 4010<br />
4601530 PORPHYRINS, RANDOM U 300 0 86.26 4010<br />
4601548 PROCAINAMIDE NAPA 300 0 112.97 4010<br />
4601555 TRANSFERRIN 300 0 73.26 4010<br />
4601563 LDH ISOENZYMES 300 0 106.86 4010<br />
4601571 ANTIMITOCHONDRIAL AB 300 0 90.81 4010<br />
4601589 MALARIA SMEAR 300 0 57.27 4010<br />
4601597 HERPES SIMPLEX IGM 300 0 191.56 4010<br />
4601605 HERPES TYPE I 300 0 93.86 4010<br />
4601613 ANTI-JO-1 ANTIBODY 300 0 135.07 4010<br />
4601621 ASCARIASIS AB 300 0 207.61 4010<br />
4601639 EFFEXOR/VENLAFAXINE 300 0 83.2 4010<br />
4601647 FIBRONE<strong>CT</strong>IN AGGREGAT 300 0 267.15 4010<br />
4601654 3-A-ANDROSTANEDIOL-G 300 0 138.91 4010<br />
4601662 HLA-DRB,DQB1 TYPING 300 0 430.43 4010<br />
4601670 PHYTANIC ACID, SERUM 300 0 259.48 4010<br />
4601688 FILARIASIS 300 0 245.77 4010<br />
4601696 VISCERAL LARVA MIGRA 300 0 259.48 4010<br />
4601704 STRONGYLOIDES AB 300 0 207.61 4010<br />
4601712 ANTI EXTRA<strong>CT</strong>.NUC.AG 300 0 131.3 4010<br />
4601720 HEINZ BODIES STAIN 300 0 22.17 4010<br />
4601738 FA<strong>CT</strong>OR 8 VW FA<strong>CT</strong>OR 300 0 152.62 4010<br />
4601746 FA<strong>CT</strong>OR IX A<strong>CT</strong>IVITY 300 0 138.91 4010<br />
4601753 FA<strong>CT</strong>OR VII A<strong>CT</strong>IVITY 300 0 225.94 4010<br />
4601761 PORPHOBILINOGEN RAND 300 0 80.15 4010<br />
4601779 ANTI THROMBIN 3 300 0 171.73 4010<br />
4601787 FA<strong>CT</strong>OR VIII 300 0 155.68 4010<br />
4601795 FA<strong>CT</strong>OR V 300 0 623.06 4010<br />
4601803 B.PERTUSSIS CULTURE 300 0 64 4010<br />
4601811 CIDAL TROUGH LEVEL 300 0 99.97 4010<br />
4601829 U UREALYTICUM/M HOMI 300 0 116.81 4010<br />
4601837 A<strong>CT</strong>H 300 0 296.92 4010<br />
4601845 ACID PHOS,PROSTATIC 300 0 64.87 4010<br />
4601852 T3 FREE 300 0 131 4010<br />
4601860 T3 TOTAL 300 0 106.86 4010<br />
4601878 INSULIN 300 0 85.48 4010<br />
4601886 C1Q BINDING ASSAY 300 0 184.73 4010<br />
4601894 ALPHA I ANTITRYPSIN 300 0 92.37 4010<br />
4601902 ZINC SERUM 300 0 79.37 4010<br />
4601910 COMPLEMENT C3 300 0 90.81 4010<br />
4601928 RAJI CELL ASSAY 300 0 206.05 4010<br />
4601936 COMPLEMENT C4 300 0 90.81 4010<br />
4601944 ESTROGEN TOTAL 300 0 163.35 4010<br />
4601951 HAPTOGLOBIN 300 0 84.7 4010<br />
4601969 RHEUMATOID FA<strong>CT</strong>OR QU 300 0 37.42 4010<br />
4601977 HEMOSIDERIN RAND UR 300 0 422.3 4010
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