CMS Mandate - Chargemaster - Advanced Specialty Hospitals
... ALLOPURINOL 100 MG TABLET. 250. 4.89. 2500402. AZAS2.50S. 250. 101.30. 2500403. TIAGABINE HCL 4 MG TABLET. 250. 10.04. 2500405. ESTRADIOL 0.05 MG. 250. 28.74.
itemnum description revcode serviceid mod1 mod2 amount unitsLS CLAVE MALE ADAPT PLUG100/CS. ICU MEDICAL SALES. 04091-2568-01. 10248700. LS CLAVE PORT LUER LOCK 100/CS. ICU MEDICAL SALES. 04091-1956-01. 10248188. LS EXT ... Product catalog - World CourierTD TOXOIDS ADSORBED PRSRV FR 7 YR + IM. 217.70. $. G8895 636. ANTROM PRESCRIBE. 7.30. $. J0282. 636. AMIODARONE HCL 30MG. 20.73. $. 00143-9875- ... TX CHARGE MASTER_04.26.2022.xlsx... (TD) SYR 10X.5ML. 1 $. 1,760.13 $ 528.04 Out-of-Network. Out-of-Network. Out-of ... SAT/RESP ANAL. 1 $. 1,025.20 $ 307.56 Out-of-Network. Out-of-Network. Out-of ...
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