MED-SUR-GY/PVT - 1,560.00
ICU - 4,010.00
PHARMACY - 7,157.40
IV SOLUTIONS - 2,056.00
PHARMACY OTHER - 1,454.25
IV THERAPY - 55.00
MED/SURG SUPPLIES - 1,697.00
NON STERILE SUPPLY - 13.00
STERILE SUPPLIES - 431.00
IMPLANTS - 2,948.00
LABORATORY - 120.00
CHEMISTRY - 3,624.00
IMMUNOLOGY - 503.00
HEMATOLOGY - 851.00
BACTERIOLOGY/MICRO - 1,563.00
HISTOLOGY - 1,119.00
RADIOLOGY - 293.00
DX X-RAY/CHEST - 1,800.00
CT SCAN/HEAD - 1,862.00
CT SCAN/BODY - 2,907.00
OR SERVICES - 11,035.00
ANESTHESIA - 2,243.00
BLOOD STORAGE AND PROCESS - 1,272.00
RESPIRATORY SERVICES - 2,945.00
CARDIOLOGY - 1,444.00
DRUGS/DETAIL CODE - 1,296.50
RECOVERY ROOM - 3,239.00
EKG/ECG - 456.00
EEG - 569
TOTAL CHARGES - $60,523.15
TOTAL PAYMENTS/ADJUSTMENTS - 0.00
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