|
OSTOMY FLANGE FORMAFLEX 2-3/4 14104
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100265
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
OSTOMY FLAT CUT TO FIT 8531
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
OSTOMY IRRIGATION KIT 7721
|
None
|
Both
|
$67.00
|
|
| Hospital Charge Code |
100271
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$62.00 |
|
|
OSTOMY IRRIGATION SLEEVE 2-3/4 18154
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100272
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
OSTOMY IRRIGATOR
|
None
|
Both
|
$43.00
|
|
| Hospital Charge Code |
100561
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$38.00 |
|
|
OSTOMY KIT COLOSTOMY/ILLEO
|
None
|
Both
|
$74.00
|
|
| Hospital Charge Code |
100525
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$69.00 |
|
|
OSTOMY M9 ODOR SPRAY 7734
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100269
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
OSTOMY POUCH CUT TO FIT
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100833
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
OSTOMY UROSTOMY POUCH 18424
|
None
|
Both
|
$7.00
|
|
| Hospital Charge Code |
100267
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.00 |
|
|
PACEMAKER DUAL CHAMBER
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1785 None
|
| Hospital Charge Code |
100122
|
|
Hospital Revenue Code
|
275
|
|
|
PACEMAKER DUAL CHAMBER
|
None
|
Both
|
$0.00
|
|
|
Service Code
|
None C1785 None
|
| Hospital Charge Code |
100123
|
|
Hospital Revenue Code
|
275
|
|
|
PACKING NASAL DOYLE
|
None
|
Both
|
$72.00
|
|
| Hospital Charge Code |
100548
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$67.00 |
|
|
PACKING RAPID RHINO 7.5CM
|
None
|
Both
|
$169.00
|
|
| Hospital Charge Code |
100934
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$164.00 |
|
|
PADDING CAST 6 STERILE
|
None
|
Both
|
$25.00
|
|
| Hospital Charge Code |
100772
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$20.00 |
|
|
PADDING CAST 6 STERILE
|
None
|
Both
|
$25.00
|
|
| Hospital Charge Code |
100894
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$20.00 |
|
|
PADDING UNDERCAST 2 STERILE
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100770
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
PADDING UNDERCAST 3 STERILE
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100747
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
PADDING UNDERCAST 4 STERILE
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100746
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
PAD DUO-THERM 13X18
|
None
|
Both
|
$24.00
|
|
| Hospital Charge Code |
100644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$19.00 |
|
|
PAD DUO-THERM 15X22
|
None
|
Both
|
$24.00
|
|
| Hospital Charge Code |
100468
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$19.00 |
|
|
PAD DUO-THERM 25X64
|
None
|
Both
|
$66.00
|
|
| Hospital Charge Code |
100667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$61.00 |
|
|
PHONE MESSAGE BOOK
|
None
|
Both
|
$18.00
|
|
| Hospital Charge Code |
100864
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$13.00 |
|
|
PILLOW ABDUCTION MEDIUM
|
None
|
Both
|
$82.00
|
|
| Hospital Charge Code |
100479
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$77.00 |
|
|
PILLOW ABDUCTION MEDIUM
|
None
|
Both
|
$150.00
|
|
| Hospital Charge Code |
100827
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$145.00 |
|
|
PILLOW ABDUCTION SMALL
|
None
|
Both
|
$84.00
|
|
| Hospital Charge Code |
100801
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.00 |
| Max. Negotiated Rate |
$79.00 |
|