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
4604609 IBT RAST ALLERGEN 12 300 0 26.85 4010 4604617 SGPG 300 0 0 4010 4604625 FETAL HGB QUANT. 300 0 83.2 4010 4604633 ANTI-RETICULIN, IGA 300 0 90.81 4010 4604641 TOPAMAX(TOPIRAMATE) 300 0 104.59 4010 4604658 ORGANIC ACIDS,PLASMA 300 0 109.14 4010 4604666 HELICOBACTER AG,STOO 300 0 242.9 4010 4604674 URINE ETP,RANDOM 300 0 106.08 4010 4604682 TOTAL PROT,UR,RANDOM 300 0 52.32 4010 4604690 LISTERIA AB,CSF 300 0 204.56 4010 4604716 AFP 300 0 79.13 4010 4604724 HCG 300 0 32.57 4010 4604732 ESTRIOL 300 0 86 4010 4604740 METHOTREXATE 300 0 77.87 4010 4604757 TETRAHYDROCANNABINOL 300 0 72.09 4010 4604765 CARBOXY-THC 300 0 48.95 4010 4604773 FLUORIDE 300 0 148.85 4010 4604781 CHLAMYDIA,DIRECT AG 300 0 95.42 4010 4604799 IGF BINDING PROTEIN3 300 0 117.52 4010 4604807 HEPATITIS BE AG 300 0 87.04 4010 4604815 HEPATITIS BE AB 300 0 88.53 4010 4604823 NARCOLEPSY ASSOC AG 300 0 430.43 4010 4604831 TRYPSINOGEN,SERUM 300 0 154.18 4010 4604849 ANTI-OVARIAN ANTIBOD 300 0 123.63 4010 4604856 A1 ANTITRYPSIN PHENO 300 0 109.92 4010 4604864 ARYLSULPHATASE A ACT 300 0 269.43 4010 4604872 FK506 300 0 71.78 4010 4604880 RETROVIRAL SEROLOGY 300 0 363.29 4010 4604898 FREE CORTISOL,BLOOD 300 0 145.8 4010 4604906 DEXAMETHASONE 300 0 129.74 4010 4604914 T CELLS,TOTAL CT. 300 0 233.38 4010 4604922 WBC 300 0 14.23 4010 4604930 ABS. CD4 &CD8 300 0 128.14 4010 4604948 FLOW CYTOMETRY 300 0 130.63 4010 4604955 LSD CONFIRM. BY GCMS 300 0 148.85 4010 4604963 LUVOX LEVEL 300 0 109.92 4010 4604989 CHROMOGRANIN-A 300 0 125.91 4010 4604997 HEP B CORE AB, IGM 300 0 97.7 4010 4605002 ADENOSINE DEAMINASE 300 0 66.43 4010 4605010 PNEUMOCYSTIS CARINII 300 0 135.85 4010 4605028 ALPHA SUBUNIT 300 0 127.47 4010 4605036 GLUT.ACID DECARBX AB 300 0 122.14 4010 4605044 COZ PLASTIC OCC HEAL 300 0 154.18 4010 4605069 ALPHA 1 ACID GLYCOPR 300 0 82.42 4010 4605077 MICROPOLYSPORA FAENI 300 0 93.86 4010 4605085 THEROACTINOMYCES SPP 300 0 76.31 4010 4605093 ALTERIA ALTERNATA 300 0 93.86 4010
4605101 ASPERGILLUS FUMIGAT. 300 0 99.19 4010 4605119 AUREOBASIDIUM PULLUL 300 0 93.86 4010 4605127 PENICILLIUM NOTATUM 300 0 93.86 4010 4605135 PHOMA HERBARUM 300 0 93.86 4010 4605143 TRICHODERMA VIRIDE 300 0 93.86 4010 4605184 CAR (WB) 300 0 0 4010 4605200 BUPIVACAINE/MARCAINE 300 0 149.57 4010 4605218 OSTEOCALCIN 300 0 199.23 4010 4605226 AMINO ACID,SINGLE ID 300 0 145.8 4010 4605234 AMINO ACID PANEL,SER 300 0 551.13 4010 4605242 AMINO ACID PANEL,UR 300 0 57.5 4010 4605259 ASPERGILLUS,IGE 300 0 35.88 4010 4605267 CLADOSPORIUM,IGE 300 0 35.88 4010 4605275 PENICILLIUM,IGE 300 0 35.88 4010 4605283 CHAETOMIUM,IGE 300 0 35.88 4010 4605291 MOUSE DROPPINGS,IGE 300 0 35.88 4010 4605309 RAT DROPPINGS,IGE 300 0 35.88 4010 4605317 PIGEON DROPPINGS,IGE 300 0 35.88 4010 4605325 COCKROACH,IGE 300 0 35.88 4010 4605333 PROPOXYPHENE 300 0 112.97 4010 4605341 METHIONINE 300 0 164.13 4010 4605358 BENZODIAZEPINES,SERU 300 0 243.75 4010 4605390 CYSTIC FIBROSIS GENE 300 0 191.25 4010 4605408 FORMIC ACID 300 0 100.75 4010 4605416 PNEUMO.IGG TYPE 1 300 0 97.7 4010 4605424 PNEUMO.IGG TYPE 3 300 0 97.7 4010 4605432 PNEUMO.IGG TYPE 14 300 0 97.7 4010 4605440 PNEUMO.IGG TYPE 19F 300 0 97.7 4010 4605457 PNEUMO.IGG TYPE 23F 300 0 97.7 4010 4605465 PNEUMO.IGG TYPE 51 300 0 97.7 4010 4605473 TRICHINELLA TITER 300 0 44.66 4010 4605507 FACTOR II MUTATION G 300 0 180 4010 4605549 AFP 300 0 73.54 4010 4605556 NORFLUNITRAZEPAM 300 0 54.93 4010 4605564 7-AMINOFLUNITRAZEPAM 300 0 54.93 4010 4605572 FLUNITRAZEPAM 300 0 54.93 4010 4605663 TSH (3RD GENERATION) 300 0 167.12 4010 4605671 VITAMIN K1 300 0 225.16 4010 4605689 METANEPHRINES,PLASMA 300 0 193.83 4010 4605697 LATEX SPECIFIC IGE 300 0 95.42 4010 4605705 DIPHTHERIA AB 300 0 133.58 4010 4605713 ULTRACENTRIFUGATION 300 0 114.47 4010 4605721 LIPOPROTEIN PROFILE 300 0 61.82 4010 4605796 5,10MTHFR C677T INTE 300 0 258.75 4010 4605804 HEMOCHROMATOSIS ANAL 300 0 303.75 4010 4605812 PARASITE CONCENTRA. 300 0 58.22 4010 4605853 SP.STAIN FOR PARASIT 300 0 64.87 4010
- 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 and 56: 4601985 RETROVIRAL SEROLOGY 300 0 4
- Page 57 and 58: 4602967 HTLV I/II AB 300 0 100.75 4
- Page 59: 4604096 ORG ID AEROBIC UMASS 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
- Page 107 and 108: 6306005 COLOR FLOW DOPPLER 480 0 25
- Page 109 and 110: 6390132 US-MIDLINE CATHETER 278 0 1
4604609 IBT RAST ALLERGEN 12 300 0 26.85 4010<br />
4604617 SGPG 300 0 0 4010<br />
4604625 FETAL HGB QUANT. 300 0 83.2 4010<br />
4604633 ANTI-RETICULIN, IGA 300 0 90.81 4010<br />
4604641 TOPAMAX(TOPIRAMATE) 300 0 104.59 4010<br />
4604658 ORGANIC ACIDS,PLASMA 300 0 109.14 4010<br />
4604666 HELICOBA<strong>CT</strong>ER AG,STOO 300 0 242.9 4010<br />
4604674 URINE ETP,RANDOM 300 0 106.08 4010<br />
4604682 TOTAL PROT,UR,RANDOM 300 0 52.32 4010<br />
4604690 LISTERIA AB,CSF 300 0 204.56 4010<br />
4604716 AFP 300 0 79.13 4010<br />
4604724 HCG 300 0 32.57 4010<br />
4604732 ESTRIOL 300 0 86 4010<br />
4604740 METHOTREXATE 300 0 77.87 4010<br />
4604757 TETRAHYDROCANNABINOL 300 0 72.09 4010<br />
4604765 CARBOXY-THC 300 0 48.95 4010<br />
4604773 FLUORIDE 300 0 148.85 4010<br />
4604781 CHLAMYDIA,DIRE<strong>CT</strong> AG 300 0 95.42 4010<br />
4604799 IGF BINDING PROTEIN3 300 0 117.52 4010<br />
4604807 HEPATITIS BE AG 300 0 87.04 4010<br />
4604815 HEPATITIS BE AB 300 0 88.53 4010<br />
4604823 NARCOLEPSY ASSOC AG 300 0 430.43 4010<br />
4604831 TRYPSINOGEN,SERUM 300 0 154.18 4010<br />
4604849 ANTI-OVARIAN ANTIBOD 300 0 123.63 4010<br />
4604856 A1 ANTITRYPSIN PHENO 300 0 109.92 4010<br />
4604864 ARYLSULPHATASE A A<strong>CT</strong> 300 0 269.43 4010<br />
4604872 FK506 300 0 71.78 4010<br />
4604880 RETROVIRAL SEROLOGY 300 0 363.29 4010<br />
4604898 FREE CORTISOL,BLOOD 300 0 145.8 4010<br />
4604906 DEXAMETHASONE 300 0 129.74 4010<br />
4604914 T CELLS,TOTAL <strong>CT</strong>. 300 0 233.38 4010<br />
4604922 WBC 300 0 14.23 4010<br />
4604930 ABS. CD4 &CD8 300 0 128.14 4010<br />
4604948 FLOW CYTOMETRY 300 0 130.63 4010<br />
4604955 LSD CONFIRM. BY GCMS 300 0 148.85 4010<br />
4604963 LUVOX LEVEL 300 0 109.92 4010<br />
4604989 CHROMOGRANIN-A 300 0 125.91 4010<br />
4604997 HEP B CORE AB, IGM 300 0 97.7 4010<br />
4605002 ADENOSINE DEAMINASE 300 0 66.43 4010<br />
4605010 PNEUMOCYSTIS CARINII 300 0 135.85 4010<br />
4605028 ALPHA SUBUNIT 300 0 127.47 4010<br />
4605036 GLUT.ACID DECARBX AB 300 0 122.14 4010<br />
4605044 COZ PLASTIC OCC HEAL 300 0 154.18 4010<br />
4605069 ALPHA 1 ACID GLYCOPR 300 0 82.42 4010<br />
4605077 MICROPOLYSPORA FAENI 300 0 93.86 4010<br />
4605085 THEROA<strong>CT</strong>INOMYCES SPP 300 0 76.31 4010<br />
4605093 ALTERIA ALTERNATA 300 0 93.86 4010
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