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
LOWER LEG-LEFT 7 7 LOWER LEG-RIGHT 8 8 ANKLE-BILAT 0 0 KNEE NO TRAUMA-LEFT 12 12 KNEE NO TRAUMA-RIGHT 21 21 KNEE NO TRAUMA-BILAT 7 7 KNEE W/OBLIQ-LEFT33 33 KNEE W/OBLIQ-RIGHT 31 31 KNEE W/OBLIQUE-BILAT 2 2 FEMUR-LEFT 3 3 FEMUR-RIGHT 3 3 HIP (PELV INCL)BILAT6 6 HIP (PELVIS INCL)-LT18 18 HIP (PELVIS INCL)-RT37 37 HIP RECHECK-LEFT 3 3 HIP RECHECK-RIGHT 5 5 ELBOW W/OBLIQ LEFT 13 13 ELBOW W/OBLIQ RIGHT 15 15 HAND/WRIST BONE AGE 0 0 HIPS PEDIATRIC BILAT0 0 SHLDR TRAUMA-LEFT17 17 SHLDR TRAUMA-RIGHT 33 33 SHOULDER TRAUMA-BILAT 0 0 KNEE W/PATELLA-LEFT 1 1 KNEE W/PATELLA-RIGHT 1 1 KNEE W/PATELLA-BILAT 0 0 FEMUR-BILAT 0 0 LOWER LEG-BILAT 1 1 LONG BONE SURVEY 0 0 BONE LENGTH 0 0 ABDOMEN (KUB/FLAT) 52 52 ABDOMEN FLAT&UPRIGHT 43 43 BARIUM SWALLOW15 15 GI SERIES 7 7 BE 3 3 ABDOMEN W/ DECUBITIS 6 6 SMALL BOWEL SERIES1 1 GI WITH SMALL BOWEL 2 2 T TUBE CHOLANGIOGRAM 0 0 OR CHOLANGIOGRAM0 0 OR SCOUT FILM 0 0 RETRO PYELOGRAM 0 0 RETRO PYELOGRAM 0 0 CYSTOGRAPHY 0 0 VOID CYSTO URETHROG 0 0 IVP WITH TOMOGRAPHY 0 0 BE DOUBLE CONTRAST 2 2
CYSTO SCOUT FILM 0 0 ABD/KUB PORTABLE 0 0 STEROID INJ UNDER FLOURO 7 7 VENOGRAPHY ARM/LEG 0 0 VENOGRAPHY ARM/LEG 0 0 VENOGRAPHY ARM/LEG 0 0 VENOGRAPHY ARM/LEG 0 0 CORE BREAST BIO 12 12 CORE BREAST BIO 3 3 COR BRST BIO PROC-LT 12 12 COR BRST BIO PROC-RT 3 3 CORE BIO CLIP PLA-LT 12 12 CORE BIO CLIP PLA-RT3 3 NEEDLE LOC-LEFT 1 1 NEEDLE LOC-RIGHT 1 1 NEEDLE LOC PROC-LT1 1 NEEDLE LOC PROC-RT1 1 NDLE LOC ADDL LES-LT 0 0 NDLE LOC ADDL LES-RT 0 0 MAMMO DIAG DIGITAL 41 41 MAMMO DIAG DIGITAL-RIGHT 20 20 MAMMO DIAG DIGITAL-LEFT 35 35 DKH MAMMO SCREEN 358 DIGITAL 358 FLOURO GUIDE FOR NEEDLE 0 0 DKH MAMMO SCREEN 2 IMPLANTS2 COR BRST BIO PROC ADD'L 0 0 ICAD SCREENING MAMMO 723 723 ICAD DIAGNOSTIC MAMMO 74 74 SINUS TRACT PROCEDURE 0 0 SINUS TRACT INJECTION 0 0 MAMMO DIAG EXTRA 43 VIEWS LT43 ANKLE-ARTH W/RAD-LT 0 0 ANKLE-ARTH W/RAD 0RT 0 ELBOW ARTH W/RAD-LT 0 0 ELBOW ARTH W/RAD-RT 0 0 KNEE-ARTHROGRAM-LT 0 0 KNEE-ARTHROGRAM-RT 0 0 HIP-ARTHROGRAM-LT1 1 HIP-ARTHROGRAM-RT1 1 WRIST-ARTHRO-LT 1 1 WRIST-ARTHRO-RT 0 0 SHLDR-ARTHROGRAM-LT 3 3 SHLDR-ARTHROGRAM-RT 5 5 MAMMO DIAG EXTRA 38 VIEWS RT38 MAMMO DIAG XTRA 8VIEW BILA 8 PORT INJ FOR PATENCY 0 0 CONV TO GASTRO JEJUN 0 TUBE 0
- 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
- Page 570 and 571: UREAPLASMA MYCOPLASMA 0 HOM 0 MYCOB
- Page 572 and 573: COCONUT, IGE 0 0 ONIONS, IGE 0 0 PI
- Page 574 and 575: PARAINFLUENZA TYPE 0 I 0 PARAINFLUE
- Page 576 and 577: MRI KEN KNEE WO CONT 9 LT 9 MRI KEN
- Page 578 and 579: MRI KEN UPEXT W/WO 0 CON RT 0 MRI K
- Page 580 and 581: PRO FEE STRESS MD SUPERVS 0 0 PRO F
- Page 584 and 585: GASTRO TUBE REPLACEMENT 1 1 INSERT
- Page 586 and 587: MAMMO DUCT PROC-RT 1 1 HIP-2 VIEWS
- Page 588 and 589: PYROPHOSPHATE 7 7 I 123 - 200 2 2 S
- Page 590 and 591: US-BIOPSY PROC-PANCR 0 0 US-BIOPSY-
- Page 592 and 593: MRI-LS SPINE W/O CON 43 43 MRI-LS S
- Page 594 and 595: CT CHEST HIGH RESOLU 0 W/O 0 CT CHE
- Page 596 and 597: CT INTRAPERI CATHETER 0 0 CT INTRAP
- Page 598 and 599: FOOT LT(2 VIEWS) 0 0 FOOT RT(2 VIEW
- Page 600 and 601: CERV SPINE TWO VIEW0 0 CERV SPINE W
- Page 602 and 603: LS SPINE&OBL&FLEX&EX 0 6 VW 0 LS SP
- Page 604 and 605: MRI WRIST WO CON 0LT PLF 0 MRI-WRIS
- Page 606 and 607: CALCITRIOL 0.25 MCG 5 CAP 5 ALLOPUR
- Page 608 and 609: CALCIUM CHLORIDE 10% 0 VIAL 0 CANDE
- Page 610 and 611: DEXAMETHASONE 492 4MG/ML VIAL 492 D
- Page 612 and 613: FIORINAL CAP GENERIC 2 CAP 2 FLUNIS
- Page 614 and 615: HUMALOG MIX 75/250 INSULIN 0 ITRACO
- Page 616 and 617: METHENAMINE 1 GM 0TAB 0 METHOCARBAM
- Page 618 and 619: NITROGLYCERIN 0.4MG 0 SL SP 0 NITRO
- Page 620 and 621: PROCHLORPERAZINE 110 MG VI 1 PROCAI
- Page 622 and 623: TOBRAMYCIN 80 MG/2ML 11 VIAL11 TOBR
- Page 624 and 625: AMIODARONE 200 MG 16 TAB 16 CAFFEIN
- Page 626 and 627: VITAMIN E 200 UNIT 0CAP 0 LAMOTRIGI
- Page 628 and 629: ATORVASTATIN 40205 MG TAB 205 GUAIF
- Page 630 and 631: FLUVASTATIN 20 MG 0CAP 0 CASTOR OIL
CYSTO SCOUT FILM 0 0<br />
ABD/KUB PORTABLE 0 0<br />
STEROID INJ UNDER FLOURO 7 7<br />
VENOGRAPHY ARM/LEG 0 0<br />
VENOGRAPHY ARM/LEG 0 0<br />
VENOGRAPHY ARM/LEG 0 0<br />
VENOGRAPHY ARM/LEG 0 0<br />
CORE BREAST BIO 12 12<br />
CORE BREAST BIO 3 3<br />
COR BRST BIO PROC-LT 12 12<br />
COR BRST BIO PROC-RT 3 3<br />
CORE BIO CLIP PLA-LT 12 12<br />
CORE BIO CLIP PLA-RT3 3<br />
NEEDLE LOC-LEFT 1 1<br />
NEEDLE LOC-RIGHT 1 1<br />
NEEDLE LOC PROC-LT1 1<br />
NEEDLE LOC PROC-RT1 1<br />
NDLE LOC ADDL LES-LT 0 0<br />
NDLE LOC ADDL LES-RT 0 0<br />
MAMMO DIAG DIGITAL 41 41<br />
MAMMO DIAG DIGITAL-RIGHT 20 20<br />
MAMMO DIAG DIGITAL-LEFT 35 35<br />
DKH MAMMO SCREEN 358 DIGITAL 358<br />
FLOURO GUIDE FOR NEEDLE 0 0<br />
DKH MAMMO SCREEN 2 IMPLANTS2<br />
COR BRST BIO PROC ADD'L 0 0<br />
ICAD SCREENING MAMMO 723 723<br />
ICAD DIAGNOSTIC MAMMO 74 74<br />
SINUS TRA<strong>CT</strong> PROCEDURE 0 0<br />
SINUS TRA<strong>CT</strong> INJE<strong>CT</strong>ION 0 0<br />
MAMMO DIAG EXTRA 43 VIEWS LT43<br />
ANKLE-ARTH W/RAD-LT 0 0<br />
ANKLE-ARTH W/RAD 0RT<br />
0<br />
ELBOW ARTH W/RAD-LT 0 0<br />
ELBOW ARTH W/RAD-RT 0 0<br />
KNEE-ARTHROGRAM-LT 0 0<br />
KNEE-ARTHROGRAM-RT 0 0<br />
HIP-ARTHROGRAM-LT1 1<br />
HIP-ARTHROGRAM-RT1 1<br />
WRIST-ARTHRO-LT 1 1<br />
WRIST-ARTHRO-RT 0 0<br />
SHLDR-ARTHROGRAM-LT 3 3<br />
SHLDR-ARTHROGRAM-RT 5 5<br />
MAMMO DIAG EXTRA 38 VIEWS RT38<br />
MAMMO DIAG XTRA 8VIEW BILA 8<br />
PORT INJ FOR PATENCY 0 0<br />
CONV TO GASTRO JEJUN 0 TUBE 0
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