|
STOCKINETTE IMPERVIOUS MED 8
|
None
|
Both
|
$18.00
|
|
| Hospital Charge Code |
100579
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$13.00 |
|
|
STOCKINETTE IMPERVIOUS SM
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100867
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
STOCKINETTE IMPERVIOUS SM 6
|
None
|
Both
|
$12.00
|
|
| Hospital Charge Code |
100578
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$7.00 |
|
|
STOCKINETTE IMPERVIOUS XLGE 12
|
None
|
Both
|
$18.00
|
|
| Hospital Charge Code |
100338
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$13.00 |
|
|
STOCKING ANIT-EMB LARGE SHORT
|
None
|
Both
|
$39.00
|
|
| Hospital Charge Code |
100342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$34.00 |
|
|
STOCKING ANIT-EMB SMALL LONG
|
None
|
Both
|
$28.00
|
|
| Hospital Charge Code |
100339
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$23.00 |
|
|
STOCKING ANIT-EMB SMALLREG
|
None
|
Both
|
$31.00
|
|
| Hospital Charge Code |
100340
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$26.00 |
|
|
STOCKING ANIT-EMB THIGH LGE SHORT
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100925
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB LARGE LONG
|
None
|
Both
|
$51.00
|
|
| Hospital Charge Code |
100343
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$46.00 |
|
|
STOCKING ANTI-EMB LARGE REG
|
None
|
Both
|
$51.00
|
|
| Hospital Charge Code |
100344
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$46.00 |
|
|
STOCKING ANTI-EMB MED SHORT
|
None
|
Both
|
$51.00
|
|
| Hospital Charge Code |
100345
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$46.00 |
|
|
STOCKING ANTI-EMB THIGH LGE LONG
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100927
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH LGE REG
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100926
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH MED LONG
|
None
|
Both
|
$29.00
|
|
| Hospital Charge Code |
100924
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$24.00 |
|
|
STOCKING ANTI-EMB THIGH MED REG
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100923
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH MED SHORT
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100922
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH SM LONG
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100921
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH SM REG
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100920
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH SM SHORT
|
None
|
Both
|
$30.00
|
|
| Hospital Charge Code |
100919
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$25.00 |
|
|
STOCKING ANTI-EMB THIGH X-LGE LONG
|
None
|
Both
|
$47.00
|
|
| Hospital Charge Code |
100929
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$42.00 |
|
|
STOCKING ANTI-EMB THIGH X-LGE REG
|
None
|
Both
|
$47.00
|
|
| Hospital Charge Code |
100928
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$42.00 |
|
|
STOCKING ANTI-EMB X-LGE LONG
|
None
|
Both
|
$39.00
|
|
| Hospital Charge Code |
100341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$34.00 |
|
|
STOCKING ANTI-EMB X-LGE REG
|
None
|
Both
|
$33.00
|
|
| Hospital Charge Code |
100346
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$28.00 |
|
|
STRAP CLAVICLE LRG
|
None
|
Both
|
$37.00
|
|
| Hospital Charge Code |
100526
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$32.00 |
|
|
STRAP CLAVICLE MED
|
None
|
Both
|
$37.00
|
|
| Hospital Charge Code |
100532
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$32.00 |
|