|
BANDAGE ADHESIVE 1X3
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100868
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
BANDAGE ADHESIVE 2X4
|
None
|
Both
|
$24.00
|
|
| Hospital Charge Code |
100846
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$19.00 |
|
|
BANDAGE ELASTIC 6
|
None
|
Both
|
$5.00
|
|
| Hospital Charge Code |
100185
|
|
Hospital Revenue Code
|
270
|
|
|
BANDAGE ELASTIC 6 X10YD
|
None
|
Both
|
$10.00
|
|
| Hospital Charge Code |
100625
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5.00 |
|
|
BANDAGE ESMARK 4
|
None
|
Both
|
$12.00
|
|
| Hospital Charge Code |
100191
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$7.00 |
|
|
BANDAGE ESMARK 6
|
None
|
Both
|
$15.00
|
|
| Hospital Charge Code |
100190
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$10.00 |
|
|
BANDAGE GAUZE ROLL 4.5
|
None
|
Both
|
$3.00
|
|
| Hospital Charge Code |
100279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|
|
BANDAGE GAUZE STRETCH 2
|
None
|
Both
|
$1.00
|
|
| Hospital Charge Code |
100622
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$3.00 |
| Max. Negotiated Rate |
-$4.00 |
|
|
BANDAGE GAUZE STRETCH 3
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100623
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
BANDAGE GAUZE STRETCH 4
|
None
|
Both
|
$2.00
|
|
| Hospital Charge Code |
100624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$2.00 |
| Max. Negotiated Rate |
-$3.00 |
|
|
BANDAGE PLASTER FAST 2
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100899
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
BANDAGE PLASTER FAST 2
|
None
|
Both
|
$4.00
|
|
| Hospital Charge Code |
100192
|
|
Hospital Revenue Code
|
270
|
| Max. Negotiated Rate |
-$1.00 |
|
|
BANDAGE PLASTER FAST 3
|
None
|
Both
|
$5.00
|
|
| Hospital Charge Code |
100900
|
|
Hospital Revenue Code
|
270
|
|
|
BANDAGE PLASTER FAST 4
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100193
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
BANDAGE PLASTER FAST 4
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100901
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
BANDAGE PLASTER FAST 5
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100905
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
BANDAGE PLASTER FAST 6
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100194
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
BANDAGE PLASTER FAST 6
|
None
|
Both
|
$9.00
|
|
| Hospital Charge Code |
100902
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$4.00 |
|
|
BANDAGE PLASTER XF 2
|
None
|
Both
|
$14.00
|
|
| Hospital Charge Code |
100898
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$9.00 |
|
|
BANDAGE PLASTER XF 3
|
None
|
Both
|
$5.00
|
|
| Hospital Charge Code |
100903
|
|
Hospital Revenue Code
|
270
|
|
|
BANDAGE PLASTER XF 4
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100896
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
BANDAGE PLASTER XF 5
|
None
|
Both
|
$8.00
|
|
| Hospital Charge Code |
100904
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.00 |
|
|
BANDAGE PLASTER XF 6
|
None
|
Both
|
$11.00
|
|
| Hospital Charge Code |
100897
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$6.00 |
|
|
BANDAGE SYSTEM PROFORE FOUR LAYER
|
None
|
Both
|
$68.00
|
|
| Hospital Charge Code |
100714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$63.00 |
|
|
BASIN WASH 8QT
|
None
|
Both
|
$3.00
|
|
| Hospital Charge Code |
100882
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
-$1.00 |
| Max. Negotiated Rate |
-$2.00 |
|