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
PYROPHOSPHATE 7 7 I 123 - 200 2 2 SESTAMIBI ISOTOPE 0 0 SOD CHLORIDE 100ML0 0 THALLIUM 1 MCI 0 0 THALLIUM 1 DOSE RE 0INJECT 0 NEONATAL HEAD 0 0 THYROID ULTRASOUND 28 28 BREAST US UNILAT-LT 46 46 BREAST US UNILAT-RT 45 45 BREAST ULTRAS BILAT 16 16 ECHOCARDIOGRAM 2D+M 0 0 ECHO-2D LIMITED 5 5 DOBUTAMINE-STRESS 24 EC 24 STRESS & REST ECHO40 40 ABDOMINAL ULTRASOUND 86 86 COLOR DOPPLER ABDOM 0 0 COLOR DOPP ABD LTD0 0 DOPPLER ECHO 3 3 PELVIS LTD OR APPEND 10 10 RENAL ULTRASOUND43 43 ABD AORTA ULTRASOUND 20 20 COLOR DOPP AORTA+VC 0 0 OB-2ND TRI 1 FETUS0 0 OB-FOLLOW UP 0 0 FOLLOWUP LEV 2 OB-US 0 0 PELVIC ULTRASOUND 59 59 US-CYST ASPIRATION 1GUIDE 1 US-CYST ASPI PROC 1 1 US-PELVIS-CYST-PROC0 0 TESTICLE 11 11 CHEST PLEURAL EFFUS1 1 BIOPHYSICAL PROFILE0 0 CHEST-ULTRASOUND1 1 US INTRA PERI CATHETER 0 0 US INTRAPERI CATH PROC 0 0 US INTRAPERI CATH REMOVAL 0 0 US INTRAPERI CATH REMOVE 0 0 US PLEURAL TUNNEL 0CATH RV 0 US PLUER TUNNEL CATH 0 RMV 0 US MEDICARE AAA SCREEN 0 0 PRO FEE DOPPLER 185 ECHO ROUT185 PROF FEE CONTRAST 0ADMIN 0 INJ BICEP TENDON SHEATH 0 0 HYSTEROSONOGRAPHY 0 0 HYSTERO-PROCEDURE0 0 ECHO EXT. NON VAS14 14
COLOR FLOW DOPPLER 3 3 PERIVASCU-LEG-BILAT 24 24 PERIVASC-LEG-UNIL 29 LT 29 PERIVASC-LEG-UNIL-RT 18 18 PERIVASCU-ARM-BILAT 0 0 PERIVASC-ARM-UNIL 2LT 2 PERIVASC-ARM-UNIL-RT 5 5 CAROTID DUPLEX W 52 C/F 52 PELVIC-NON OB TRANSV 55 55 OB-TRANSVAGINAL 6 6 TRANSESOPHAGEAL ECHO 3 3 AMNIOCENTESIS W/ULTR 0 0 BREAST CYST ASP PRO0 0 FNA WITH IMAGING GUIDANCE 8 8 RENAL CYS/PEL PRO-LT 0 0 RENAL CYS/PEL PRO-RT 0 0 OB-LIMITED 0 0 OB-1ST TRI 1 FETUS 6 6 OB-1ST TRI ADD FETUS 0 0 OB-2ND TRI ADD FETUS 0 0 OB-3RD TRI 1 FETUS0 0 OB-3RD TRI ADD FETUS 0 0 PARACENTESIS GUIDE0 0 PARACENTESIS PROC 0W/O GDE 0 NEEDLE LOC(US)-LT GUIDE 1 1 NEEDLE LOC(US)-RT GUIDE 1 1 NEEDLE LOC-PROC-LT1 1 NEEDLE LOC PROC-RT1 1 NEEDLE BIOPSY-LT GUIDE 0 0 NEEDLE BIOPSY-RT GUIDE 0 0 DOPPLER ECHO ROUTINE 185 FUL 185 DOPPLER ECHO ROUTINE 0 W/CO 0 AB PARA W/IMAGE GUIDE 0 0 PRO FEE ECHO 2D + M1 1 PRO FEE 2D LIMITED 7 7 US-BIO-MISCELLANEOUS 0 GDE 0 US-BIOPSY PROC-LIVER 3 3 US-BIOPSY-LIVER GUIDE 3 3 US-BIOPSY PROC-ABD0 0 US-BIO PRO BREAST 11 LT 11 US-BIOPSY-BREAST GUIDE 19 19 US-BIO PRO-BREAST RT 8 8 US-BIO-PROC BREAST 0BILAT 0 US-BIOPSY PRO-KIDNEY 0 0 US-BIOPSY-KIDNEY GUIDE 0 0 US-BIOPSY PROC-LUNG 0 0 US-BIOPSY-LUNG GUIDE 0 0
- 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 582 and 583: LOWER LEG-LEFT 7 7 LOWER LEG-RIGHT
- Page 584 and 585: GASTRO TUBE REPLACEMENT 1 1 INSERT
- Page 586 and 587: MAMMO DUCT PROC-RT 1 1 HIP-2 VIEWS
- 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
- Page 632 and 633: PRAMIPEXOLE .25MG 0TAB 0 AMOXICILLI
- Page 634 and 635: ERTAPENEM 1GM ADDV 0 0 GLYCOPYRROLA
- Page 636 and 637: FOSPROPOFOL 1050MG/30ML 0 0 HAVRIX
PYROPHOSPHATE 7 7<br />
I 123 - 200 2 2<br />
SESTAMIBI ISOTOPE 0 0<br />
SOD CHLORIDE 100ML0 0<br />
THALLIUM 1 MCI 0 0<br />
THALLIUM 1 DOSE RE 0INJE<strong>CT</strong><br />
0<br />
NEONATAL HEAD 0 0<br />
THYROID ULTRASOUND 28 28<br />
BREAST US UNILAT-LT 46 46<br />
BREAST US UNILAT-RT 45 45<br />
BREAST ULTRAS BILAT 16 16<br />
ECHOCARDIOGRAM 2D+M 0 0<br />
ECHO-2D LIMITED 5 5<br />
DOBUTAMINE-STRESS 24 EC 24<br />
STRESS & REST ECHO40 40<br />
ABDOMINAL ULTRASOUND 86 86<br />
COLOR DOPPLER ABDOM 0 0<br />
COLOR DOPP ABD LTD0 0<br />
DOPPLER ECHO 3 3<br />
PELVIS LTD OR APPEND 10 10<br />
RENAL ULTRASOUND43 43<br />
ABD AORTA ULTRASOUND 20 20<br />
COLOR DOPP AORTA+VC 0 0<br />
OB-2ND TRI 1 FETUS0 0<br />
OB-FOLLOW UP 0 0<br />
FOLLOWUP LEV 2 OB-US 0 0<br />
PELVIC ULTRASOUND 59 59<br />
US-CYST ASPIRATION 1GUIDE<br />
1<br />
US-CYST ASPI PROC 1 1<br />
US-PELVIS-CYST-PROC0 0<br />
TESTICLE 11 11<br />
CHEST PLEURAL EFFUS1 1<br />
BIOPHYSICAL PROFILE0 0<br />
CHEST-ULTRASOUND1 1<br />
US INTRA PERI CATHETER 0 0<br />
US INTRAPERI CATH PROC 0 0<br />
US INTRAPERI CATH REMOVAL 0 0<br />
US INTRAPERI CATH REMOVE 0 0<br />
US PLEURAL TUNNEL 0CATH RV 0<br />
US PLUER TUNNEL CATH 0 RMV 0<br />
US MEDICARE AAA SCREEN 0 0<br />
PRO FEE DOPPLER 185 ECHO ROUT185<br />
PROF FEE CONTRAST 0ADMIN<br />
0<br />
INJ BICEP TENDON SHEATH 0 0<br />
HYSTEROSONOGRAPHY 0 0<br />
HYSTERO-PROCEDURE0 0<br />
ECHO EXT. NON VAS14 14
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