|
BARRON CORNEA PUNCH 8.0MM DIA
|
Facility
|
IP
|
$330.00
|
|
| Hospital Charge Code |
270660738
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.50
|
|
|
BARRON CORNEA PUNCH 9.5MM DIA
|
Facility
|
OP
|
$330.00
|
|
| Hospital Charge Code |
270673281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Aetna Commercial |
$125.40
|
| Rate for Payer: Aetna Medicare Advantage |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.15
|
| Rate for Payer: Cigna Commercial |
$165.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.00
|
| Rate for Payer: Oxford Commercial |
$66.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.74
|
|
|
BARRON CORNEA PUNCH 9.5MM DIA
|
Facility
|
IP
|
$330.00
|
|
| Hospital Charge Code |
270673281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.50
|
|
|
BAR SYN CONN EX FX 80MM 39561
|
Facility
|
OP
|
$139.25
|
|
| Hospital Charge Code |
270601812
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$69.62 |
| Rate for Payer: Aetna Commercial |
$52.91
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.77
|
| Rate for Payer: Oxford Commercial |
$27.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.69
|
|
|
BAR SYN CONN EX FX 80MM 39561
|
Facility
|
IP
|
$139.25
|
|
| Hospital Charge Code |
270601812
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
BARTHOLIN CYSTECTOMY
|
Facility
|
IP
|
$29,961.70
|
|
|
Service Code
|
HCPCS 56740
|
| Hospital Charge Code |
1600000383
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,494.26 |
| Max. Negotiated Rate |
$4,494.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,494.26
|
|
|
BARTHOLIN CYSTECTOMY
|
Facility
|
OP
|
$29,961.70
|
|
|
Service Code
|
HCPCS 56740
|
| Hospital Charge Code |
1600000383
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$722.08 |
| Max. Negotiated Rate |
$13,882.15 |
| Rate for Payer: Aetna Commercial |
$10,460.55
|
| Rate for Payer: Aetna Medicare Advantage |
$12,460.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,882.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,882.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,845.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,882.15
|
| Rate for Payer: Cigna Commercial |
$7,708.87
|
| Rate for Payer: Cigna Medicare Advantage |
$3,845.79
|
| Rate for Payer: Clover Medicare Advantage |
$3,653.50
|
| Rate for Payer: EmblemHealth Commercial |
$11,537.37
|
| Rate for Payer: Humana Medicare Advantage |
$3,961.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,845.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,988.51
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,494.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$722.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$793.99
|
|
|
BAR TIBIAL LOCKING
|
Facility
|
OP
|
$1,160.00
|
|
| Hospital Charge Code |
270619033
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.96 |
| Max. Negotiated Rate |
$580.00 |
| Rate for Payer: Aetna Commercial |
$440.80
|
| Rate for Payer: Aetna Medicare Advantage |
$348.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$295.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$295.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$295.80
|
| Rate for Payer: Cigna Commercial |
$580.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$348.00
|
| Rate for Payer: Oxford Commercial |
$232.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$174.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.74
|
|
|
BAR TIBIAL LOCKING
|
Facility
|
IP
|
$1,160.00
|
|
| Hospital Charge Code |
270619033
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$174.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$174.00
|
|
|
BAR TO BAR CLAMP
|
Facility
|
IP
|
$540.00
|
|
| Hospital Charge Code |
270339499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.00
|
|
|
BAR TO BAR CLAMP
|
Facility
|
OP
|
$540.00
|
|
| Hospital Charge Code |
270339499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$205.20
|
| Rate for Payer: Aetna Medicare Advantage |
$162.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$137.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$137.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$137.70
|
| Rate for Payer: Cigna Commercial |
$270.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.00
|
| Rate for Payer: Oxford Commercial |
$108.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$108.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.31
|
|
|
BARTONELLA AB(IGG,M)W/RFL I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
BARTONELLA AB(IGG,M)W/RFL I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$148.20
|
| Rate for Payer: Aetna Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$99.45
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
BARTONELLA AB(IGG,M)W/RFL II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$148.20
|
| Rate for Payer: Aetna Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$99.45
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
BARTONELLA AB(IGG,M)W/RFL II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
BARTONELLA AB(IGG,M)W/RFL III
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
BARTONELLA AB(IGG,M)W/RFL III
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$148.20
|
| Rate for Payer: Aetna Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$99.45
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
BARTONELLA AB(IGG,M)W/RFL IV
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$148.20
|
| Rate for Payer: Aetna Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$99.45
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
BARTONELLA AB(IGG,M)W/RFL IV
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 8661191
|
| Hospital Charge Code |
39990083D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
BARTONELLA ANTIBODY PROFILE I
|
Facility
|
IP
|
$70.65
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3038535D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$10.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.60
|
|
|
BARTONELLA ANTIBODY PROFILE I
|
Facility
|
IP
|
$70.65
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3038535A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$10.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.60
|
|
|
BARTONELLA ANTIBODY PROFILE I
|
Facility
|
OP
|
$70.65
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3038535D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare Advantage |
$32.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.75
|
| Rate for Payer: Cigna Commercial |
$35.33
|
| Rate for Payer: Cigna Medicare Advantage |
$10.18
|
| Rate for Payer: Clover Medicare Advantage |
$9.67
|
| Rate for Payer: EmblemHealth Commercial |
$30.54
|
| Rate for Payer: Humana Medicare Advantage |
$10.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.87
|
|
|
BARTONELLA ANTIBODY PROFILE I
|
Facility
|
OP
|
$70.65
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3038535A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare Advantage |
$32.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.75
|
| Rate for Payer: Cigna Commercial |
$35.33
|
| Rate for Payer: Cigna Medicare Advantage |
$10.18
|
| Rate for Payer: Clover Medicare Advantage |
$9.67
|
| Rate for Payer: EmblemHealth Commercial |
$30.54
|
| Rate for Payer: Humana Medicare Advantage |
$10.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.87
|
|
|
BARTONELLA ANTIBODY PROFILE II
|
Facility
|
IP
|
$70.65
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3038535C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$10.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.60
|
|
|
BARTONELLA ANTIBODY PROFILE II
|
Facility
|
OP
|
$70.65
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
3038535B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare Advantage |
$32.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.75
|
| Rate for Payer: Cigna Commercial |
$35.33
|
| Rate for Payer: Cigna Medicare Advantage |
$10.18
|
| Rate for Payer: Clover Medicare Advantage |
$9.67
|
| Rate for Payer: EmblemHealth Commercial |
$30.54
|
| Rate for Payer: Humana Medicare Advantage |
$10.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.87
|
|