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
4602462 PTH N TERM INTACT 300 0 248.82 4010 4602470 SEROTONIN-SERUM 300 0 258.77 4010 4602488 VITAMIN A 300 0 119.94 4010 4602496 XYLOSE TOLERANCE 300 0 135.85 4010 4602504 IMIPRAMINE 300 0 129.74 4010 4602520 CATECHOLAMINE,FRAC/P 300 0 171.73 4010 4602538 C ESTERASE INHIBITOR 300 0 104.59 4010 4602546 CYANIDE,BLOOD 300 0 145.8 4010 4602553 CRYOFIBRINOGEN 300 0 35.1 4010 4602561 HEPATITIS A AB 300 0 67.15 4010 4602579 THYROID AB GROUP 300 0 155.18 4010 4602587 SOMATOMEDIN C 300 0 196.89 4010 4602595 ALUMINUM 300 0 198.45 4010 4602603 HEP B SURFACE AG 300 0 79.37 4010 4602611 FAT FECES/LIPIDS 72H 300 0 211.45 4010 4602629 HEP B SURFACE AB 300 0 81.64 4010 4602637 IGG SUBCLASSES 300 0 242.71 4010 4602645 HEP B CORE AB 300 0 866.24 4010 4602652 DESIPIRAMINE 300 0 156.46 4010 4602660 GASTRIN 300 0 106.86 4010 4602678 ZARONTIN 300 0 136.63 4010 4602686 VITAMIN D (25 OH) 300 0 105.24 4010 4602694 ARSENIC,URINE 300 0 166.4 4010 4602702 HISTAMINE, BLOOD 300 0 223.6 4010 4602710 HEPATITIS BE AG & AB 300 0 67.15 4010 4602728 ESTRONE 300 0 167.9 4010 4602736 HALDOL 300 0 103.19 4010 4602744 LUNG MATURITY PROF 1 300 0 99.19 4010 4602751 OLIGOCLONAL BANDS 300 0 151.13 4010 4602769 TOCAINIDE 300 0 154.18 4010 4602777 L/S RATIO 300 0 159.51 4010 4602785 CALCITONIN,SERUM 300 0 161.79 4010 4602801 PNEUMONITIS HYPERSEN 300 0 202.48 4010 4602819 17 HYDROXYCORTICOST 300 0 122.85 4010 4602827 ERYTHROPOIETIN 300 0 101.53 4010 4602835 ESTROGEN/PROG RECEPT 300 0 458.71 4010 4602843 GLUCOSE 6 PHOSPHATE 300 0 58.76 4010 4602850 HYDROXYZINE,SERUM 300 0 88.53 4010 4602868 EPI FLUOR AB TISSUE 310 0 271.7 4010 4602876 LAMOTEIGINE, SERUM 300 0 93.86 4010 4602884 PAXIL/PAROXETINE 300 0 109.92 4010 4602892 ATROPINE, RAN URINE 300 0 169.46 4010 4602900 URINE CYTOLOGY MPNJ 310 0 90.81 4010 4602918 AMINO ACID, QUANT 300 0 152.62 4010 4602926 TOXOPLASMOSIS CSF 300 0 63.28 4010 4602942 TEGRETOL EPOXIDE 300 0 128.25 4010 4602959 HEXOSAMINIDASE A ACT 300 0 207.61 4010
4602967 HTLV I/II AB 300 0 100.75 4010 4602975 FATTY ACID/LONGCHAIN 300 0 122.14 4010 4602983 MYCOPLASMA IGG 300 0 87.75 4010 4602991 MYCOPLASMA IGM 300 0 87.75 4010 4603007 AMBIEN (ZOLPIDEM) 300 0 139.69 4010 4603015 HEPATITIS C RIBA 300 0 111.61 4010 4603023 RAST ALLERGEN 1 300 0 18.71 4010 4603031 RAST ALLERGEN 2 300 0 18.71 4010 4603049 RAST ALLERGEN 3 300 0 18.71 4010 4603056 RAST ALLERGEN 4 300 0 18.71 4010 4603064 RAST ALLERGEN 5 300 0 18.71 4010 4603072 RAST ALLERGEN 6 300 0 18.71 4010 4603080 RAST ALLERGEN 7 300 0 18.71 4010 4603098 RAST ALLERGEN 8 300 0 18.71 4010 4603106 RAST ALLERGEN 9 300 0 18.71 4010 4603114 RAST ALLERGEN 10 300 0 18.71 4010 4603122 RAST ALLERGEN 11 300 0 18.71 4010 4603130 RAST ALLERGEN 12 300 0 18.71 4010 4603148 AMIODARONE/DESETHYL. 300 0 131.3 4010 4603155 LORAZEPAM,SERUM 300 0 109.14 4010 4603163 LYMPH SUBSET PROF II 300 0 535.8 4010 4603171 RAST TEST W/ALLERGEN 300 0 45.83 4010 4603189 BETA-GLUCOSIDASE ACT 300 0 274.76 4010 4603197 HEP C RNA, QUAL 300 0 296.92 4010 4603205 RETROVIRAL SEROLOGY 300 0 447.62 4010 4603239 P24 ANTIGEN 300 0 150.35 4010 4603247 CMV EARLY AG/CULTURE 300 0 112.97 4010 4603254 HEP B SURFACE AB/EH 300 0 81.64 4010 4603262 CA 19-9 300 0 136.11 4010 4603270 C PEPTIDE,URINE 300 0 82.42 4010 4603288 HEMOSAMINIDASE A&B 300 0 166.4 4010 4603296 ALDOSTERONE,URINE 300 0 278.59 4010 4603304 ESTROGEN,URINE 300 0 99.19 4010 4603312 T3 FREE BY DIALYSIS 300 0 131.3 4010 4603320 METHOTREXATE 300 0 109.92 4010 4603338 BARBITURATES, ID 300 0 149.57 4010 4603346 MOLYBDENUM,RBC 300 0 76.31 4010 4603353 ANABOLIC STEROIDS 300 0 177.84 4010 4603361 DIBUCAINE NUMBER 300 0 99.97 4010 4603379 LYME EIA/CSF 300 0 129.74 4010 4603395 FACTOR II 300 0 255.71 4010 4603403 FACTOR X 300 0 151.13 4010 4603411 FACTOR XI 300 0 151.13 4010 4603429 FACTOR XII 300 0 255.71 4010 4603452 LEUK/LYMPHOMA EVAL 310 0 148.85 4010 4603460 LIPOPROTEIN (A) 300 0 93.86 4010 4603478 PREGNENOLONE 300 0 171.73 4010
- 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 and 54: 4601035 FLUPHENAZINE 300 0 145.02 4
- Page 55: 4601985 RETROVIRAL SEROLOGY 300 0 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
- Page 105 and 106: 6201206 MYO-IMAGING-INFARCT 340 0 9
4602462 PTH N TERM INTA<strong>CT</strong> 300 0 248.82 4010<br />
4602470 SEROTONIN-SERUM 300 0 258.77 4010<br />
4602488 VITAMIN A 300 0 119.94 4010<br />
4602496 XYLOSE TOLERANCE 300 0 135.85 4010<br />
4602504 IMIPRAMINE 300 0 129.74 4010<br />
4602520 CATECHOLAMINE,FRAC/P 300 0 171.73 4010<br />
4602538 C ESTERASE INHIBITOR 300 0 104.59 4010<br />
4602546 CYANIDE,BLOOD 300 0 145.8 4010<br />
4602553 CRYOFIBRINOGEN 300 0 35.1 4010<br />
4602561 HEPATITIS A AB 300 0 67.15 4010<br />
4602579 THYROID AB GROUP 300 0 155.18 4010<br />
4602587 SOMATOMEDIN C 300 0 196.89 4010<br />
4602595 ALUMINUM 300 0 198.45 4010<br />
4602603 HEP B SURFACE AG 300 0 79.37 4010<br />
4602611 FAT FECES/LIPIDS 72H 300 0 211.45 4010<br />
4602629 HEP B SURFACE AB 300 0 81.64 4010<br />
4602637 IGG SUBCLASSES 300 0 242.71 4010<br />
4602645 HEP B CORE AB 300 0 866.24 4010<br />
4602652 DESIPIRAMINE 300 0 156.46 4010<br />
4602660 GASTRIN 300 0 106.86 4010<br />
4602678 ZARONTIN 300 0 136.63 4010<br />
4602686 VITAMIN D (25 OH) 300 0 105.24 4010<br />
4602694 ARSENIC,URINE 300 0 166.4 4010<br />
4602702 HISTAMINE, BLOOD 300 0 223.6 4010<br />
4602710 HEPATITIS BE AG & AB 300 0 67.15 4010<br />
4602728 ESTRONE 300 0 167.9 4010<br />
4602736 HALDOL 300 0 103.19 4010<br />
4602744 LUNG MATURITY PROF 1 300 0 99.19 4010<br />
4602751 OLIGOCLONAL BANDS 300 0 151.13 4010<br />
4602769 TOCAINIDE 300 0 154.18 4010<br />
4602777 L/S RATIO 300 0 159.51 4010<br />
4602785 CALCITONIN,SERUM 300 0 161.79 4010<br />
4602801 PNEUMONITIS HYPERSEN 300 0 202.48 4010<br />
4602819 17 HYDROXYCORTICOST 300 0 122.85 4010<br />
4602827 ERYTHROPOIETIN 300 0 101.53 4010<br />
4602835 ESTROGEN/PROG RECEPT 300 0 458.71 4010<br />
4602843 GLUCOSE 6 PHOSPHATE 300 0 58.76 4010<br />
4602850 HYDROXYZINE,SERUM 300 0 88.53 4010<br />
4602868 EPI FLUOR AB TISSUE 310 0 271.7 4010<br />
4602876 LAMOTEIGINE, SERUM 300 0 93.86 4010<br />
4602884 PAXIL/PAROXETINE 300 0 109.92 4010<br />
4602892 ATROPINE, RAN URINE 300 0 169.46 4010<br />
4602900 URINE CYTOLOGY MPNJ 310 0 90.81 4010<br />
4602918 AMINO ACID, QUANT 300 0 152.62 4010<br />
4602926 TOXOPLASMOSIS CSF 300 0 63.28 4010<br />
4602942 TEGRETOL EPOXIDE 300 0 128.25 4010<br />
4602959 HEXOSAMINIDASE A A<strong>CT</strong> 300 0 207.61 4010
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