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
BLUE CROSS OF RI PAYMENT -88 -88 OUT OF STATE BC -382 PAYMENT -382 PSY BC ANTHEM BHV -38HLT PMT-38 PSYCH BC MAGELLAN 0PMT 0 PSYCH BC UNITED BEHAV 0 PMT 0 PSYCH BC VAL BEHAV 0PMT 0 PSYCH BC VAL OPT PMT 0 0 PSY BC MGD HLTH NTWK 0 PYMT 0 PYMT PRO FEE BLUE -21 CROSS -21 PSY CIGNA BEHAV HLTH -17 PMT -17 AIM CIGNA PAYMENT0 0 AMALGAMATED LIFE 0PYMNT 0 CIGNA PAYMENT -557 -557 CIGNA/CIGNA PMT 0 0 CONN GENERAL PYMNT 0 0 GOLDEN RULE PAYMENT -3 -3 GREAT WEST LIFE INS -62PYMNT -62 HEALTH ADVANTAGE 0PYMNT 0 HEALTH CHOICE PAYMENT 0 0 HEALTHNET FOXWOODS -153 PMT-153 INTERACTIVE BENEFIT -9PMT -9 JOHN ALDEN INS PAYMENT 0 0 N E DIRECT HEALTH PMT 0 0 NEW ENGLAND INS PMT 0 0 OXFORD HEALTH PMT 40 40 OXFORD/OXFORD PAYMENT 0 0 ORTHONET PMT -14 -14 US HLTCARE INC PYMT0 0 FOXWOODS BOLLORE -17PAYMENT PSYCH VALUE OPTIONS -2 PMT -2 PSYCH UNITED BEHAV 19 PMT 19 AARP PAYMENT 0 0 AETNA PMT -248 -248 AETNA/AETNA PAYMENT 1 1 ALLIED BENEFIT PAYMENT 0 0 AMERIHEALTH PAYMENT 0 0 APWU AMER POSTAL -1WKR PYMT -1 ASSOC & SOCIETY PYMT 0 0 ASSURANT HEALTH PMT 3 3 BCI BENEFIT CONCPT 0PMT 0 BENEFIT PLANNERS PMT 0 0 BENESIGHT PAYMENT0 0 CBA PYMT 0 0 CHRISTIAN BROTHERS 0 PMT 0 CNA INSURANCE CO PMT 0 0 COMMONWEALTH SER 0 CTR PMT0 CONSOLIDATED HLTH -2PMT -2
CT CARPENTERS HLTH 0PMT 0 DEFINITY HEALTH PMT0 0 EMPLOYER SERV CTR 0PMT 0 FORTIS HEALTHCARE 0PMT 0 GROUP BENEFIT SERV -1PMT -1 HEALTHCARE VAL MGMT 0 PMT 0 HMC PPO PAYMENT 0 0 HUMANA INS PMT 0 0 IRONWORKERS PAYMENT 0 0 LOCAL 371 AMAL WELF 0 PMT 0 MUTUAL OF OMAHA 0INS PMT 0 NE HEALTH CARE EMP 0 PMT 0 STIRLING & STIRLING 0PMT 0 TRAVELERS PAYMENT0 0 UNITED HEALTHCARE -534PMT -534 UNTDHLTH/UNTDHLTH -1 PMT -1 WALMART PAYMENT0 0 HEALTH PARTNERS PMT -3 -3 MVP OF NY PMT -2 -2 UMR PAYMENT -1 -1 ULTRABENEFITS PMT -29 -29 STOP SHOP HEALTHCARE 0 PYMT 0 MEDICAL MUTUAL PAYMENT 0 0 NIPPON LIFE PAYMENT 0 0 RURAL CARR BENE PLAN -4 PYMT -4 HEALTH PLANS INC PYMT 0 0 PSYCH MHN/PSH CARVE 0 PMT 0 PSYCH VALUE BEHAVIOR 0 PMT 0 DIVERSIFIED ADMIN -2 PMT -2 DIVERSIFIED GRP BRKG 1 PMT 1 GUARDIAN LIFE PAYMENT 0 0 HEALTHNET (PHS) PAYMENT 0 0 HEALTHNET/HEALTHNET 0 PMT 0 KANAWHA HLTCR SOLUT 0 PMT 0 MAIL HANDLERS BEN -2PMT -2 MEGA LIFE STUDENT -9PMT -9 MEGA LIFE & HLTH PMT 0 0 MOHEGAN TRIBAL PAYMENT 5 5 SRC AETNA CO PAYMENT 4 4 TIME INSURANCE CO 0PMT 0 TR PAUL PAYMENT 0 0 UNICARE/CIGNA PAYMENT -16 -16 UTICA NATIONAL PAYMENT 0 0 WAUSAU INSURANCE 0PAYMENT0 PRIMARILY CARE PAYMENT 0 0 BENEMAX PAYMENT0 0 LONDON HEALTH ADMIN -4 PYMT-4
- 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 678 and 679: PERSONAL PYMT (P/R -37DED) -37 TCOR
- 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
<strong>CT</strong> CARPENTERS HLTH 0PMT<br />
0<br />
DEFINITY HEALTH PMT0 0<br />
EMPLOYER SERV <strong>CT</strong>R 0PMT<br />
0<br />
FORTIS HEALTHCARE 0PMT<br />
0<br />
GROUP BENEFIT SERV -1PMT<br />
-1<br />
HEALTHCARE VAL MGMT 0 PMT 0<br />
HMC PPO PAYMENT 0 0<br />
HUMANA INS PMT 0 0<br />
IRONWORKERS PAYMENT 0 0<br />
LOCAL 371 AMAL WELF 0 PMT 0<br />
MUTUAL OF OMAHA 0INS PMT 0<br />
NE HEALTH CARE EMP 0 PMT 0<br />
STIRLING & STIRLING 0PMT<br />
0<br />
TRAVELERS PAYMENT0 0<br />
UNITED HEALTHCARE -534PMT<br />
-534<br />
UNTDHLTH/UNTDHLTH -1 PMT -1<br />
WALMART PAYMENT0 0<br />
HEALTH PARTNERS PMT -3 -3<br />
MVP OF NY PMT -2 -2<br />
UMR PAYMENT -1 -1<br />
ULTRABENEFITS PMT -29 -29<br />
STOP SHOP HEALTHCARE 0 PYMT 0<br />
MEDICAL MUTUAL PAYMENT 0 0<br />
NIPPON LIFE PAYMENT 0 0<br />
RURAL CARR BENE PLAN -4 PYMT -4<br />
HEALTH PLANS INC PYMT 0 0<br />
PSYCH MHN/PSH CARVE 0 PMT 0<br />
PSYCH VALUE BEHAVIOR 0 PMT 0<br />
DIVERSIFIED ADMIN -2 PMT -2<br />
DIVERSIFIED GRP BRKG 1 PMT 1<br />
GUARDIAN LIFE PAYMENT 0 0<br />
HEALTHNET (PHS) PAYMENT 0 0<br />
HEALTHNET/HEALTHNET 0 PMT 0<br />
KANAWHA HLTCR SOLUT 0 PMT 0<br />
MAIL HANDLERS BEN -2PMT<br />
-2<br />
MEGA LIFE STUDENT -9PMT<br />
-9<br />
MEGA LIFE & HLTH PMT 0 0<br />
MOHEGAN TRIBAL PAYMENT 5 5<br />
SRC AETNA CO PAYMENT 4 4<br />
TIME INSURANCE CO 0PMT<br />
0<br />
TR PAUL PAYMENT 0 0<br />
UNICARE/CIGNA PAYMENT -16 -16<br />
UTICA NATIONAL PAYMENT 0 0<br />
WAUSAU INSURANCE 0PAYMENT0<br />
PRIMARILY CARE PAYMENT 0 0<br />
BENEMAX PAYMENT0 0<br />
LONDON HEALTH ADMIN -4 PYMT-4
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