|
DRESSING OASIS WOUND MATRIX 3X3.5
|
None
|
Both
|
$273.00
|
|
| Hospital Charge Code |
100684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$241.00 |
| Max. Negotiated Rate |
$268.00 |
|
|
DRESSING OASIS WOUND MATRIX 3X7
|
None
|
Both
|
$446.00
|
|
| Hospital Charge Code |
100683
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$441.00 |
|
|
DRESSING OIL EMULSION 3X3
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
DRESSING OIL EMULSION 3X8
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100627
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
DRESSING OWENS 8X12
|
None
|
Both
|
$25.00
|
|
| Hospital Charge Code |
100560
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$20.00 |
|
|
DRESSING PETROLATUM 1/2X72
|
None
|
Both
|
$6.00
|
|
| Hospital Charge Code |
100467
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
$1.00 |
|
|
DRESSING PETROLATUM 1X8
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100281
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
DRESSING PETROLATUM 3X9
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
DRESSING RTD WOUND 4X4
|
None
|
Both
|
$46.00
|
|
| Hospital Charge Code |
100752
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$41.00 |
|
|
DRESSING RTD WOUND 4X5
|
None
|
Both
|
$74.00
|
|
| Hospital Charge Code |
100745
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$69.00 |
|
|
DRESSING TEGADERM 2 1/4 X 2 3/4
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
DRESSING TEGADERM 4 X 4 3/4
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100668
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
DRESSING TEGADERM 8X10
|
None
|
Both
|
$12.00
|
|
| Hospital Charge Code |
100663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$7.00 |
|
|
DRESSING TEGADERM MATRIX 4X5
|
None
|
Both
|
$28.00
|
|
| Hospital Charge Code |
100719
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$23.00 |
|
|
DRESSING WHITEFOAM SMALL
|
None
|
Both
|
$104.00
|
|
| Hospital Charge Code |
100751
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.00 |
| Max. Negotiated Rate |
$99.00 |
|
|
DRESSING XEROFORM 1 X 8
|
None
|
Both
|
$3.00
|
|
| Hospital Charge Code |
100466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
DRESSING XEROFORM 5X9
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100282
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
DURAPREP 26ML
|
None
|
Both
|
$24.00
|
|
| Hospital Charge Code |
100366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$19.00 |
|
|
ELECTRODE DEFIB ADULT ZOLL
|
None
|
Both
|
$270.00
|
|
| Hospital Charge Code |
100742
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$238.00 |
| Max. Negotiated Rate |
$265.00 |
|
|
ELECTRODE DEFIB PED ZOLL
|
None
|
Both
|
$267.00
|
|
| Hospital Charge Code |
100743
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$235.00 |
| Max. Negotiated Rate |
$262.00 |
|
|
ELECTRODE ELECTROSURGICAL BLAD
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100594
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
ELECTRODE ELECTROSURGICAL MEGADYNE
|
None
|
Both
|
$35.00
|
|
| Hospital Charge Code |
100734
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$30.00 |
|
|
ELECTRODE ELECTROSURGICAL MEGADYNE
|
None
|
Both
|
$49.00
|
|
| Hospital Charge Code |
100583
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$44.00 |
|
|
ELECTRODE ELETROSURGICAL BALL
|
None
|
Both
|
$17.00
|
|
| Hospital Charge Code |
100595
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.00 |
|
|
ELECTRODE FETAL SPIRAL
|
None
|
Both
|
$19.00
|
|
| Hospital Charge Code |
100317
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$14.00 |
|