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
PERSONAL PYMT (P/R -37DED) -37 TCORS PYMNT 0 0 MBSC PAYMENT 0 0 CARE PAYMENT -153 -153 CAREPYMT ADD ON 17 PYMT 17 CARE PAYMENT RECOURSE 0 PYT 0 STATE PENDING PAYMENT 0 0 STATE SPENDDOWN -1 PMT -1 SAGA PENDING PAYMENT 0 0 MEDICARE PMT -5501 -5501 MEDICARE INPT B PMT 0 0 TRAILBLAZER PAYMENT 0 0 MEDICARE APPEALS -1 PYMT -1 HN SMARTCHOICE PMT 0 0 FALLON SENIOR PMT-5 -5 BLUE CHIP MEDICARE -7PMT -7 TUFTS MCR PREF PMT0 0 AMER PROG T/OPTION 0 PMT 0 EVERCARE MEDICARE -1PMT -1 CONNECTICARE MEDICARE -233 PMT -233 HEALTHNET PEARL MCR 0 PMT 0 AETNA MEDICARE ADV -28 PMT -28 MEDICARE MGD CARE 12 PMT 12 CIGNA MEDICARE ADV -1 PMT -1 AARP MED COMPLETE -482 PAYMENT -482 PSYCH NHM MED AV 0PAYMENT 0 PSYCH UNTD BEHV MED 24 PYMT 24 MEDIBLUE PAYMENT -21 -21 PSYCH BEAC HLTH MEDI 0 PAY 0 MEDICARE SECONDARY 27 PMT 27 SUPP STATE PAYMENT -129 -129 SUPP BLUE CROSS -406 PYMT -406 SUPP AARP/UHC PAYMENT -447 -447 SUPP UMR PMT -2 -2 SUPP AETNA PAYMENT 0 0 SUPP OXFORD HEALTHCARE -28 -28 SUPP AMER PROGRESS 1 PYMT 1 SUPP CT CARPENTERS 0LCL 24 0 SUPP BANKERS LIFE -1 PYMT -1 SUPP CELTIC LIFE PYMT 0 0 SUPP CHAMPVA PAYMENT -5 -5 SUPP COMBINE INS PYMT 0 0 SUPP EBPA PAYMENT0 0 SUPP HEALTHNET PYMT 0 0 SUPP MONUMENTAL -3LIFE PYMT-3 SUPP MUTUAL OF OMAHA -12 PYMT -12 SUPP STIRLING & STIR -76 PYMT -76
SUPP TRICARE PAYMENT -91 -91 SUPP UNITED AMERICAN -1 PYMT-1 SUPP UNITED HEALTHCR -31 PYMT-31 SUPP UNITED TEACHERS -3 PYMT -3 SUPP USAA LIFE PAYMENT -3 -3 SUPP MAILHANDLERS -6PYMT -6 SUPP WAUSAU PAYMENT 0 0 SUPP CIGNA PAYMENT -43 -43 SUPP MERITAIN PMT0 0 SUPP OTH/ST MEDICAID -1 PMT -1 SUPP COMMRCL NOT -72LIST PYM-72 PART B REBILL PYMT 2 2 RAC MEDICARE RECY 0PMT 0 FIRST COAST MCR-B -369 PMT -369 MEDICAID PAYMENT -249 -249 MEDICAID HUSKY -1408 A PAYMENT -1408 STATE MLIA PAYMENT -528 -528 MEDICAID HUSKY B -26 PAYMENT -26 PSYCH BEHAV HLTH PAYMENT 0 0 MEDICAID FAMILY PLAN 1 PAY 1 STATE AGENCIES PMT. -5 -5 LMHA PAYMENT 0 0 HEALTHNET MCD PMT0 0 BC FAMILY PLAN MCD 0 PMT 0 COMM HLTH NTWK MCD 0 PMT 0 PR ONE/FIRST CHC MCD 0 PMT 0 AETNA BETTER HLTH 0PMT 0 AMERICHOICE UNHLTHC 0 PMT 0 UNITED HEALTH OF NE -1 PYMT -1 NEIGHBORHOOD RI PAYMENT 1 1 OUT OF ST MEDICAID -1PMT -1 BMC PAYMENT -1 -1 FALLON MASSHEALTH -1 PAYMENT-1 NEIGHBOR MASSHEALTH -1 PYMT-1 NETWORK MASSHEALTH 0 PMT 0 MASS MEDICAID PMT -24 -24 NEW YORK MEDICAID 0PMT 0 MAINE MEDICAID PAYMENT -1 -1 RI MEDICAID PAYMENT -1 -1 CHARTER OAK CHN PAYMENT 0 0 CH OAK AMERICHOICE 0 PMT 0 CH OAK AETNA B/HLTH 0 PMT 0 CHARTER OAK HUSKY -24PAYMENT -24 MIC MEDICAID INTGRTY 0 PMT 0 BLUE CROSS ANTHEM -1835PMT -1835 BLUE CROSS/BC PAYMENT -14 -14 BLUE CROSS OF MA -252 PAYMENT-252
- 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
- Page 638 and 639: BACITRACIN 50 MU INJ 4 VIAL 4 DRONE
- Page 640 and 641: ACETAMINOPH 100MG/ML 0 DROP0 REPAGL
- Page 642 and 643: FLUCONAZOLE 400 MG/200 0 ML 0 ZOSYN
- Page 644 and 645: SP-CANCEL VISIT DLS0 0 SP-ABSENT DL
- Page 646 and 647: CHCKOT ORTH PROS 0PER 15 0 WHEELCHA
- Page 648 and 649: OT AQUATIC REHAB/15 0 MIN 0 OT ORTH
- Page 650 and 651: HIP STRAP (PROC) PLF0 0 SENSORY INT
- Page 652 and 653: M V V 0 0 METHACHOLINE EVAL5 5 ARTE
- Page 654 and 655: SWALLOW D/C STATUS 1 1 SWALLOW D/C
- Page 656 and 657: VOICE CURRENT STATUS 0 0 VOICE CURR
- Page 658 and 659: CARRY CURRENT STATUS 2 2 CARRY CURR
- Page 660 and 661: CARRY D/C STATUS 0 0 SELF CARE CURR
- Page 662 and 663: SUPP BLUE CROSS -237 ALLOW -237 SUP
- Page 664 and 665: GOLDEN RULE ALLOW -38 -38 GREAT WES
- Page 666 and 667: H/L SAGA ADMINISTRATION 0 0 H/L SAG
- Page 668 and 669: TFR FROM B/D TO A/R3 3 TFR FROM A/R
- Page 670 and 671: PHYS PRAC ATHENA CASH 0 0 MEDICAL O
- Page 672 and 673: CAFETERIA SALES CAFE 0 0 CAFETERIA
- Page 674 and 675: LABORATORY - UTILITIES 0 0 CARDIA R
- Page 676 and 677: OPER OF PLANT-GAS0 0 NON MEDICAL SU
- Page 680 and 681: BLUE CROSS OF RI PAYMENT -88 -88 OU
- Page 682 and 683: SEVEN CORNERS PAYMENT 0 0 IMG PAYME
- Page 684 and 685: ZZ OHM UNSPECIFIED 0PYMT 0 ZZ STERL
- Page 686 and 687: SITE ASSESSMENT 0 0 SITE ASSESSMENT
- Page 688 and 689: TX COCCYGEAL FX 0 0 HIP DISLOCW/O A
- Page 690 and 691: CL INTE FACE7.6-12.50 0 LYR FACE 12
- Page 692 and 693: THORACENTESIS W/TUBE 0 0 TUBE THOR
- Page 694 and 695: POST-OP SHOE 0 0 T-LOOP ELECTRODE 0
- Page 696 and 697: SYN L PL DCP BR 07 H0 0 SYN L PL DC
- Page 698 and 699: FULVESTRANT 125 MG 0 SYRING 0 CYTAR
- Page 700 and 701: KENNEDY DISEASE DNA 0 0 APOLIPO.E G
- Page 702 and 703: MEN2/FMTC MUTATIONS 0 0 COMPLETE CM
- Page 704 and 705: PCR BY IMUGEN 0 0 A PHAGOCYTOPHILUM
- Page 706 and 707: PLANAR CARDIAC RE&EX 0 0 PLANAR CAR
- Page 708 and 709: PROCAINAMIDE SR 500 MG TA 0 TEGASER
- Page 710 and 711: DLSN MOIST HEAT/CRYO(PROC 0 0 FUNCT
- Page 712 and 713: PLFD WHFOADDSPREXT 0 L3835 0 PLFD W
- Page 714 and 715: VIDEO FLUORO EVAL I0 0 OT REEVAL CP
- Page 716 and 717: DLSN OT WHFOADMPFLXIL3860 0 0 DLSN
- Page 718 and 719: PRO FEE FAMILY THERAPY 0 0 PROF FEE
- Page 720 and 721: MISC MEDICARE MCO 0 PMT 0 NATIONAL
- Page 722 and 723: ART OATS 07MM 0 0 ART OATS 08MM 0 0
SUPP TRICARE PAYMENT -91 -91<br />
SUPP UNITED AMERICAN -1 PYMT-1<br />
SUPP UNITED HEALTHCR -31 PYMT-31<br />
SUPP UNITED TEACHERS -3 PYMT -3<br />
SUPP USAA LIFE PAYMENT -3 -3<br />
SUPP MAILHANDLERS -6PYMT<br />
-6<br />
SUPP WAUSAU PAYMENT 0 0<br />
SUPP CIGNA PAYMENT -43 -43<br />
SUPP MERITAIN PMT0 0<br />
SUPP OTH/ST MEDICAID -1 PMT -1<br />
SUPP COMMRCL NOT -72LIST PYM-72<br />
PART B REBILL PYMT 2 2<br />
RAC MEDICARE RECY 0PMT<br />
0<br />
FIRST COAST MCR-B -369 PMT -369<br />
MEDICAID PAYMENT -249 -249<br />
MEDICAID HUSKY -1408 A PAYMENT -1408<br />
STATE MLIA PAYMENT -528 -528<br />
MEDICAID HUSKY B -26 PAYMENT -26<br />
PSYCH BEHAV HLTH PAYMENT 0 0<br />
MEDICAID FAMILY PLAN 1 PAY 1<br />
STATE AGENCIES PMT. -5 -5<br />
LMHA PAYMENT 0 0<br />
HEALTHNET MCD PMT0 0<br />
BC FAMILY PLAN MCD 0 PMT 0<br />
COMM HLTH NTWK MCD 0 PMT 0<br />
PR ONE/FIRST CHC MCD 0 PMT 0<br />
AETNA BETTER HLTH 0PMT<br />
0<br />
AMERICHOICE UNHLTHC 0 PMT 0<br />
UNITED HEALTH OF NE -1 PYMT -1<br />
NEIGHBORHOOD RI PAYMENT 1 1<br />
OUT OF ST MEDICAID -1PMT<br />
-1<br />
BMC PAYMENT -1 -1<br />
FALLON MASSHEALTH -1 PAYMENT-1<br />
NEIGHBOR MASSHEALTH -1 PYMT-1<br />
NETWORK MASSHEALTH 0 PMT 0<br />
MASS MEDICAID PMT -24 -24<br />
NEW YORK MEDICAID 0PMT<br />
0<br />
MAINE MEDICAID PAYMENT -1 -1<br />
RI MEDICAID PAYMENT -1 -1<br />
CHARTER OAK CHN PAYMENT 0 0<br />
CH OAK AMERICHOICE 0 PMT 0<br />
CH OAK AETNA B/HLTH 0 PMT 0<br />
CHARTER OAK HUSKY -24PAYMENT<br />
-24<br />
MIC MEDICAID INTGRTY 0 PMT 0<br />
BLUE CROSS ANTHEM -1835PMT<br />
-1835<br />
BLUE CROSS/BC PAYMENT -14 -14<br />
BLUE CROSS OF MA -252 PAYMENT-252
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