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1605.02 |
1605.02 |
6750030877 |
272 |
CATH |
EMBOLECTOMY |
A |
1 |
382.72 |
382.72 |
6750030877 |
272 |
CATH |
EMBOLECTOMY |
A |
2 |
382.72 |
765.44 |
7110000780 |
300 |
BLOOD |
TYPE-ABO |
1 |
155.00 |
155.00 |
7110000782 |
300 |
BLOOD |
TYPE-RH |
1 |
54.00 |
54.00 |
7110000925 |
300 |
CROSSMATCH-ELECTRONIC |
1 |
168.00 |
168.00 |
7110000925 |
300 |
CROSSMATCH-ELECTRONIC |
1 |
168.00 |
168.00 |
7020000762 |
301 |
HCG |
QUAL-SERUM |
1 |
297.00 |
297.00 |
7020001187 |
301 |
HEPATIC |
FUNCTION |
PNL |
1 |
261.00 |
261.00 |
7020001188 |
301 |
BASIC |
METABOLIC |
PNL |
1 |
218.00 |
218.00 |
7020001188 |
301 |
BASIC |
METABOLIC |
PNL |
1 |
218.00 |
218.00 |
Date |
Code |
Description |
Quantity |
Amount |
4/4/2013 |
STATS |
BIPAP/CPAP |
CHECK |
Q15M |
3 |
$0.00 |
4/2/2013 |
94660 |
BIPAP |
MNGMNT |
DAILY |
ADULT |
1 |
$2,630.25 |
4/2/2013 |
STATS |
BIPAP/CPAP |
CHECK |
Q15M |