|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$31.29
|
|
|
Service Code
|
NDC 70756060730
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.78 |
| Max. Negotiated Rate |
$28.16 |
| Rate for Payer: Aetna Commercial |
$26.60
|
| Rate for Payer: BCBS Trust/PPO |
$25.84
|
| Rate for Payer: BCN Commercial |
$25.84
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$26.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Healthscope Commercial |
$28.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Nomi Health Commercial |
$25.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.47
|
| Rate for Payer: PHP Commercial |
$26.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.54
|
| Rate for Payer: UHC Core |
$26.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.47
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$31.75
|
|
|
Service Code
|
NDC 17478071310
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Aetna Commercial |
$26.99
|
| Rate for Payer: BCBS Trust/PPO |
$26.22
|
| Rate for Payer: BCN Commercial |
$26.22
|
| Rate for Payer: Cash Price |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$27.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.40
|
| Rate for Payer: Healthscope Commercial |
$28.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.99
|
| Rate for Payer: Nomi Health Commercial |
$26.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.81
|
| Rate for Payer: PHP Commercial |
$26.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.94
|
| Rate for Payer: UHC Core |
$26.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.81
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$126.42
|
|
|
Service Code
|
NDC 24208043410
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.99 |
| Max. Negotiated Rate |
$113.78 |
| Rate for Payer: Aetna Commercial |
$107.46
|
| Rate for Payer: BCBS Trust/PPO |
$104.41
|
| Rate for Payer: BCN Commercial |
$104.41
|
| Rate for Payer: Cash Price |
$101.14
|
| Rate for Payer: Cofinity Commercial |
$108.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.14
|
| Rate for Payer: Healthscope Commercial |
$113.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.46
|
| Rate for Payer: Nomi Health Commercial |
$103.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.81
|
| Rate for Payer: PHP Commercial |
$107.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.25
|
| Rate for Payer: UHC Core |
$105.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.81
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$119.13
|
|
|
Service Code
|
NDC 33342008407
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$107.22 |
| Rate for Payer: Aetna Commercial |
$101.26
|
| Rate for Payer: Aetna Medicare |
$30.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.23
|
| Rate for Payer: BCBS Complete |
$22.05
|
| Rate for Payer: BCBS MAPPO |
$29.78
|
| Rate for Payer: BCBS Trust/PPO |
$97.94
|
| Rate for Payer: BCN Commercial |
$97.94
|
| Rate for Payer: BCN Medicare Advantage |
$29.78
|
| Rate for Payer: Cash Price |
$95.30
|
| Rate for Payer: Cofinity Commercial |
$102.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.78
|
| Rate for Payer: Healthscope Commercial |
$107.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.35
|
| Rate for Payer: Mclaren Medicaid |
$21.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.27
|
| Rate for Payer: Meridian Medicaid |
$22.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.26
|
| Rate for Payer: Nomi Health Commercial |
$97.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.35
|
| Rate for Payer: PACE Senior Care Partners |
$28.29
|
| Rate for Payer: PACE SWMI |
$29.78
|
| Rate for Payer: PHP Commercial |
$101.26
|
| Rate for Payer: PHP Medicare Advantage |
$29.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.64
|
| Rate for Payer: Priority Health Medicare |
$30.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.91
|
| Rate for Payer: Railroad Medicare Medicare |
$29.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.83
|
| Rate for Payer: UHC Core |
$99.47
|
| Rate for Payer: UHC Exchange |
$29.78
|
| Rate for Payer: UHC Medicaid |
$21.00
|
| Rate for Payer: UHC Medicare Advantage |
$29.78
|
| Rate for Payer: UHCCP Medicaid |
$21.00
|
| Rate for Payer: VA VA |
$29.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.35
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$119.13
|
|
|
Service Code
|
NDC 33342008407
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.91 |
| Max. Negotiated Rate |
$107.22 |
| Rate for Payer: Aetna Commercial |
$101.26
|
| Rate for Payer: BCBS Trust/PPO |
$98.39
|
| Rate for Payer: BCN Commercial |
$98.39
|
| Rate for Payer: Cash Price |
$95.30
|
| Rate for Payer: Cofinity Commercial |
$102.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.30
|
| Rate for Payer: Healthscope Commercial |
$107.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.26
|
| Rate for Payer: Nomi Health Commercial |
$97.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.35
|
| Rate for Payer: PHP Commercial |
$101.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.83
|
| Rate for Payer: UHC Core |
$99.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.35
|
|
|
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$64.80
|
|
|
Service Code
|
HCPCS J2359
|
| Hospital Charge Code |
38263
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.10 |
| Max. Negotiated Rate |
$58.32 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Commercial |
$45.81
|
| Rate for Payer: Aetna Commercial |
$138.86
|
| Rate for Payer: BCBS Trust/PPO |
$44.51
|
| Rate for Payer: BCBS Trust/PPO |
$53.52
|
| Rate for Payer: BCBS Trust/PPO |
$38.96
|
| Rate for Payer: BCBS Trust/PPO |
$37.60
|
| Rate for Payer: BCBS Trust/PPO |
$134.92
|
| Rate for Payer: BCN Commercial |
$44.51
|
| Rate for Payer: BCN Commercial |
$38.96
|
| Rate for Payer: BCN Commercial |
$134.92
|
| Rate for Payer: BCN Commercial |
$37.60
|
| Rate for Payer: BCN Commercial |
$53.52
|
| Rate for Payer: Cash Price |
$130.69
|
| Rate for Payer: Cash Price |
$51.84
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$43.11
|
| Rate for Payer: Cofinity Commercial |
$55.73
|
| Rate for Payer: Cofinity Commercial |
$140.49
|
| Rate for Payer: Cofinity Commercial |
$46.35
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Cofinity Commercial |
$39.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.84
|
| Rate for Payer: Healthscope Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$147.02
|
| Rate for Payer: Healthscope Commercial |
$48.50
|
| Rate for Payer: Healthscope Commercial |
$58.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.81
|
| Rate for Payer: Nomi Health Commercial |
$133.96
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Nomi Health Commercial |
$38.68
|
| Rate for Payer: Nomi Health Commercial |
$44.19
|
| Rate for Payer: Nomi Health Commercial |
$53.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.60
|
| Rate for Payer: PHP Commercial |
$38.70
|
| Rate for Payer: PHP Commercial |
$40.09
|
| Rate for Payer: PHP Commercial |
$55.08
|
| Rate for Payer: PHP Commercial |
$45.81
|
| Rate for Payer: PHP Commercial |
$138.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.42
|
| Rate for Payer: UHC Core |
$136.41
|
| Rate for Payer: UHC Core |
$38.02
|
| Rate for Payer: UHC Core |
$45.00
|
| Rate for Payer: UHC Core |
$54.11
|
| Rate for Payer: UHC Core |
$39.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.42
|
|
|
OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$64.80
|
|
|
Service Code
|
HCPCS J2359
|
| Hospital Charge Code |
38263
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$58.32 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Commercial |
$45.81
|
| Rate for Payer: Aetna Commercial |
$138.86
|
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare |
$11.84
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Aetna Medicare |
$12.26
|
| Rate for Payer: Aetna Medicare |
$42.47
|
| Rate for Payer: Aetna Medicare |
$14.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.84
|
| Rate for Payer: BCBS Complete |
$8.43
|
| Rate for Payer: BCBS Complete |
$30.24
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Complete |
$11.99
|
| Rate for Payer: BCBS Complete |
$9.98
|
| Rate for Payer: BCBS MAPPO |
$16.20
|
| Rate for Payer: BCBS MAPPO |
$11.38
|
| Rate for Payer: BCBS MAPPO |
$40.84
|
| Rate for Payer: BCBS MAPPO |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$13.47
|
| Rate for Payer: BCBS Trust/PPO |
$38.78
|
| Rate for Payer: BCBS Trust/PPO |
$134.30
|
| Rate for Payer: BCBS Trust/PPO |
$37.43
|
| Rate for Payer: BCBS Trust/PPO |
$53.27
|
| Rate for Payer: BCBS Trust/PPO |
$44.30
|
| Rate for Payer: BCN Commercial |
$38.78
|
| Rate for Payer: BCN Commercial |
$37.43
|
| Rate for Payer: BCN Commercial |
$134.30
|
| Rate for Payer: BCN Commercial |
$53.27
|
| Rate for Payer: BCN Commercial |
$44.30
|
| Rate for Payer: BCN Medicare Advantage |
$16.20
|
| Rate for Payer: BCN Medicare Advantage |
$13.47
|
| Rate for Payer: BCN Medicare Advantage |
$11.79
|
| Rate for Payer: BCN Medicare Advantage |
$11.38
|
| Rate for Payer: BCN Medicare Advantage |
$40.84
|
| Rate for Payer: Cash Price |
$130.69
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$51.84
|
| Rate for Payer: Cash Price |
$43.11
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Commercial |
$46.35
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Cofinity Commercial |
$55.73
|
| Rate for Payer: Cofinity Commercial |
$140.49
|
| Rate for Payer: Cofinity Commercial |
$39.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.79
|
| Rate for Payer: Healthscope Commercial |
$147.02
|
| Rate for Payer: Healthscope Commercial |
$58.32
|
| Rate for Payer: Healthscope Commercial |
$48.50
|
| Rate for Payer: Healthscope Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$42.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Mclaren Medicaid |
$8.32
|
| Rate for Payer: Mclaren Medicaid |
$11.42
|
| Rate for Payer: Mclaren Medicaid |
$28.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.38
|
| Rate for Payer: Meridian Medicaid |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$30.24
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Meridian Medicaid |
$9.98
|
| Rate for Payer: Meridian Medicaid |
$11.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.08
|
| Rate for Payer: Nomi Health Commercial |
$53.14
|
| Rate for Payer: Nomi Health Commercial |
$38.68
|
| Rate for Payer: Nomi Health Commercial |
$44.19
|
| Rate for Payer: Nomi Health Commercial |
$133.96
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.60
|
| Rate for Payer: PACE Senior Care Partners |
$38.80
|
| Rate for Payer: PACE Senior Care Partners |
$10.81
|
| Rate for Payer: PACE Senior Care Partners |
$15.39
|
| Rate for Payer: PACE Senior Care Partners |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$11.20
|
| Rate for Payer: PACE SWMI |
$40.84
|
| Rate for Payer: PACE SWMI |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.79
|
| Rate for Payer: PACE SWMI |
$13.47
|
| Rate for Payer: PACE SWMI |
$16.20
|
| Rate for Payer: PHP Commercial |
$45.81
|
| Rate for Payer: PHP Commercial |
$138.86
|
| Rate for Payer: PHP Commercial |
$40.09
|
| Rate for Payer: PHP Commercial |
$38.70
|
| Rate for Payer: PHP Commercial |
$55.08
|
| Rate for Payer: PHP Medicare Advantage |
$11.38
|
| Rate for Payer: PHP Medicare Advantage |
$16.20
|
| Rate for Payer: PHP Medicare Advantage |
$40.84
|
| Rate for Payer: PHP Medicare Advantage |
$13.47
|
| Rate for Payer: PHP Medicare Advantage |
$11.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.61
|
| Rate for Payer: Priority Health Medicare |
$11.50
|
| Rate for Payer: Priority Health Medicare |
$16.36
|
| Rate for Payer: Priority Health Medicare |
$41.25
|
| Rate for Payer: Priority Health Medicare |
$13.61
|
| Rate for Payer: Priority Health Medicare |
$11.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.47
|
| Rate for Payer: Railroad Medicare Medicare |
$11.79
|
| Rate for Payer: Railroad Medicare Medicare |
$40.84
|
| Rate for Payer: Railroad Medicare Medicare |
$11.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.02
|
| Rate for Payer: UHC Core |
$45.00
|
| Rate for Payer: UHC Core |
$136.41
|
| Rate for Payer: UHC Core |
$54.11
|
| Rate for Payer: UHC Core |
$39.39
|
| Rate for Payer: UHC Core |
$38.02
|
| Rate for Payer: UHC Exchange |
$40.84
|
| Rate for Payer: UHC Exchange |
$13.47
|
| Rate for Payer: UHC Exchange |
$11.38
|
| Rate for Payer: UHC Exchange |
$16.20
|
| Rate for Payer: UHC Exchange |
$11.79
|
| Rate for Payer: UHC Medicaid |
$11.42
|
| Rate for Payer: UHC Medicaid |
$9.50
|
| Rate for Payer: UHC Medicaid |
$8.03
|
| Rate for Payer: UHC Medicaid |
$8.32
|
| Rate for Payer: UHC Medicaid |
$28.80
|
| Rate for Payer: UHC Medicare Advantage |
$11.79
|
| Rate for Payer: UHC Medicare Advantage |
$40.84
|
| Rate for Payer: UHC Medicare Advantage |
$16.20
|
| Rate for Payer: UHC Medicare Advantage |
$11.38
|
| Rate for Payer: UHC Medicare Advantage |
$13.47
|
| Rate for Payer: UHCCP Medicaid |
$9.50
|
| Rate for Payer: UHCCP Medicaid |
$11.42
|
| Rate for Payer: UHCCP Medicaid |
$8.32
|
| Rate for Payer: UHCCP Medicaid |
$28.80
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: VA VA |
$16.20
|
| Rate for Payer: VA VA |
$40.84
|
| Rate for Payer: VA VA |
$13.47
|
| Rate for Payer: VA VA |
$11.38
|
| Rate for Payer: VA VA |
$11.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.52
|
|
|
OLANZAPINE 10 MG TABLET
|
Facility
|
OP
|
$100.11
|
|
|
Service Code
|
NDC 43598016630
|
| Hospital Charge Code |
17937
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$90.10 |
| Rate for Payer: Aetna Commercial |
$85.09
|
| Rate for Payer: Aetna Medicare |
$26.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.28
|
| Rate for Payer: BCBS Complete |
$18.53
|
| Rate for Payer: BCBS MAPPO |
$25.03
|
| Rate for Payer: BCBS Trust/PPO |
$82.30
|
| Rate for Payer: BCN Commercial |
$82.30
|
| Rate for Payer: BCN Medicare Advantage |
$25.03
|
| Rate for Payer: Cash Price |
$80.09
|
| Rate for Payer: Cofinity Commercial |
$86.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.03
|
| Rate for Payer: Healthscope Commercial |
$90.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.08
|
| Rate for Payer: Mclaren Medicaid |
$17.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.28
|
| Rate for Payer: Meridian Medicaid |
$18.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.09
|
| Rate for Payer: Nomi Health Commercial |
$82.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.08
|
| Rate for Payer: PACE Senior Care Partners |
$23.78
|
| Rate for Payer: PACE SWMI |
$25.03
|
| Rate for Payer: PHP Commercial |
$85.09
|
| Rate for Payer: PHP Medicare Advantage |
$25.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.10
|
| Rate for Payer: Priority Health Medicare |
$25.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.68
|
| Rate for Payer: Railroad Medicare Medicare |
$25.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.10
|
| Rate for Payer: UHC Core |
$83.59
|
| Rate for Payer: UHC Exchange |
$25.03
|
| Rate for Payer: UHC Medicaid |
$17.65
|
| Rate for Payer: UHC Medicare Advantage |
$25.03
|
| Rate for Payer: UHCCP Medicaid |
$17.65
|
| Rate for Payer: VA VA |
$25.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.08
|
|
|
OLANZAPINE 10 MG TABLET
|
Facility
|
IP
|
$100.11
|
|
|
Service Code
|
NDC 43598016630
|
| Hospital Charge Code |
17937
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.68 |
| Max. Negotiated Rate |
$90.10 |
| Rate for Payer: Aetna Commercial |
$85.09
|
| Rate for Payer: BCBS Trust/PPO |
$82.68
|
| Rate for Payer: BCN Commercial |
$82.68
|
| Rate for Payer: Cash Price |
$80.09
|
| Rate for Payer: Cofinity Commercial |
$86.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.09
|
| Rate for Payer: Healthscope Commercial |
$90.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.09
|
| Rate for Payer: Nomi Health Commercial |
$82.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.08
|
| Rate for Payer: PHP Commercial |
$85.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.10
|
| Rate for Payer: UHC Core |
$83.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.08
|
|
|
OLANZAPINE 2.5 MG TABLET
|
Facility
|
IP
|
$366.60
|
|
|
Service Code
|
NDC 60505311000
|
| Hospital Charge Code |
21057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$255.15 |
| Max. Negotiated Rate |
$329.94 |
| Rate for Payer: Aetna Commercial |
$311.61
|
| Rate for Payer: BCBS Trust/PPO |
$302.77
|
| Rate for Payer: BCN Commercial |
$302.77
|
| Rate for Payer: Cash Price |
$293.28
|
| Rate for Payer: Cofinity Commercial |
$315.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.28
|
| Rate for Payer: Healthscope Commercial |
$329.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.61
|
| Rate for Payer: Nomi Health Commercial |
$300.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.95
|
| Rate for Payer: PHP Commercial |
$311.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.61
|
| Rate for Payer: UHC Core |
$306.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.95
|
|
|
OLANZAPINE 2.5 MG TABLET
|
Facility
|
OP
|
$272.60
|
|
|
Service Code
|
NDC 00904628361
|
| Hospital Charge Code |
21057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.06 |
| Max. Negotiated Rate |
$245.34 |
| Rate for Payer: Aetna Commercial |
$231.71
|
| Rate for Payer: Aetna Medicare |
$70.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.19
|
| Rate for Payer: BCBS Complete |
$50.46
|
| Rate for Payer: BCBS MAPPO |
$68.15
|
| Rate for Payer: BCBS Trust/PPO |
$224.10
|
| Rate for Payer: BCN Commercial |
$224.10
|
| Rate for Payer: BCN Medicare Advantage |
$68.15
|
| Rate for Payer: Cash Price |
$218.08
|
| Rate for Payer: Cofinity Commercial |
$234.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.15
|
| Rate for Payer: Healthscope Commercial |
$245.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.45
|
| Rate for Payer: Mclaren Medicaid |
$48.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.56
|
| Rate for Payer: Meridian Medicaid |
$50.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.71
|
| Rate for Payer: Nomi Health Commercial |
$223.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.45
|
| Rate for Payer: PACE Senior Care Partners |
$64.74
|
| Rate for Payer: PACE SWMI |
$68.15
|
| Rate for Payer: PHP Commercial |
$231.71
|
| Rate for Payer: PHP Medicare Advantage |
$68.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.16
|
| Rate for Payer: Priority Health Medicare |
$68.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.73
|
| Rate for Payer: Railroad Medicare Medicare |
$68.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.89
|
| Rate for Payer: UHC Core |
$227.62
|
| Rate for Payer: UHC Exchange |
$68.15
|
| Rate for Payer: UHC Medicaid |
$48.06
|
| Rate for Payer: UHC Medicare Advantage |
$68.15
|
| Rate for Payer: UHCCP Medicaid |
$48.06
|
| Rate for Payer: VA VA |
$68.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.45
|
|
|
OLANZAPINE 2.5 MG TABLET
|
Facility
|
OP
|
$366.60
|
|
|
Service Code
|
NDC 60505311000
|
| Hospital Charge Code |
21057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.63 |
| Max. Negotiated Rate |
$329.94 |
| Rate for Payer: Aetna Commercial |
$311.61
|
| Rate for Payer: Aetna Medicare |
$95.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.56
|
| Rate for Payer: BCBS Complete |
$67.86
|
| Rate for Payer: BCBS MAPPO |
$91.65
|
| Rate for Payer: BCBS Trust/PPO |
$301.38
|
| Rate for Payer: BCN Commercial |
$301.38
|
| Rate for Payer: BCN Medicare Advantage |
$91.65
|
| Rate for Payer: Cash Price |
$293.28
|
| Rate for Payer: Cofinity Commercial |
$315.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.65
|
| Rate for Payer: Healthscope Commercial |
$329.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.95
|
| Rate for Payer: Mclaren Medicaid |
$64.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.23
|
| Rate for Payer: Meridian Medicaid |
$67.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.61
|
| Rate for Payer: Nomi Health Commercial |
$300.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.95
|
| Rate for Payer: PACE Senior Care Partners |
$87.07
|
| Rate for Payer: PACE SWMI |
$91.65
|
| Rate for Payer: PHP Commercial |
$311.61
|
| Rate for Payer: PHP Medicare Advantage |
$91.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.94
|
| Rate for Payer: Priority Health Medicare |
$92.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.15
|
| Rate for Payer: Railroad Medicare Medicare |
$91.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.61
|
| Rate for Payer: UHC Core |
$306.11
|
| Rate for Payer: UHC Exchange |
$91.65
|
| Rate for Payer: UHC Medicaid |
$64.63
|
| Rate for Payer: UHC Medicare Advantage |
$91.65
|
| Rate for Payer: UHCCP Medicaid |
$64.63
|
| Rate for Payer: VA VA |
$91.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.95
|
|
|
OLANZAPINE 2.5 MG TABLET
|
Facility
|
IP
|
$272.60
|
|
|
Service Code
|
NDC 00904628361
|
| Hospital Charge Code |
21057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$189.73 |
| Max. Negotiated Rate |
$245.34 |
| Rate for Payer: Aetna Commercial |
$231.71
|
| Rate for Payer: BCBS Trust/PPO |
$225.14
|
| Rate for Payer: BCN Commercial |
$225.14
|
| Rate for Payer: Cash Price |
$218.08
|
| Rate for Payer: Cofinity Commercial |
$234.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.08
|
| Rate for Payer: Healthscope Commercial |
$245.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.71
|
| Rate for Payer: Nomi Health Commercial |
$223.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.45
|
| Rate for Payer: PHP Commercial |
$231.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.89
|
| Rate for Payer: UHC Core |
$227.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.45
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$3.83
|
|
|
Service Code
|
NDC 49884032052
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$3.45 |
| Rate for Payer: Aetna Commercial |
$3.26
|
| Rate for Payer: BCBS Trust/PPO |
$3.16
|
| Rate for Payer: BCN Commercial |
$3.16
|
| Rate for Payer: Cash Price |
$3.06
|
| Rate for Payer: Cofinity Commercial |
$3.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.06
|
| Rate for Payer: Healthscope Commercial |
$3.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.26
|
| Rate for Payer: Nomi Health Commercial |
$3.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.87
|
| Rate for Payer: PHP Commercial |
$3.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.37
|
| Rate for Payer: UHC Core |
$3.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.87
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$114.63
|
|
|
Service Code
|
NDC 49884032055
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$103.17 |
| Rate for Payer: Aetna Commercial |
$97.44
|
| Rate for Payer: Aetna Medicare |
$29.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.82
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS MAPPO |
$28.66
|
| Rate for Payer: BCBS Trust/PPO |
$94.24
|
| Rate for Payer: BCN Commercial |
$94.24
|
| Rate for Payer: BCN Medicare Advantage |
$28.66
|
| Rate for Payer: Cash Price |
$91.70
|
| Rate for Payer: Cofinity Commercial |
$98.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.66
|
| Rate for Payer: Healthscope Commercial |
$103.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.97
|
| Rate for Payer: Mclaren Medicaid |
$20.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.09
|
| Rate for Payer: Meridian Medicaid |
$21.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.44
|
| Rate for Payer: Nomi Health Commercial |
$94.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.97
|
| Rate for Payer: PACE Senior Care Partners |
$27.22
|
| Rate for Payer: PACE SWMI |
$28.66
|
| Rate for Payer: PHP Commercial |
$97.44
|
| Rate for Payer: PHP Medicare Advantage |
$28.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.73
|
| Rate for Payer: Priority Health Medicare |
$28.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.78
|
| Rate for Payer: Railroad Medicare Medicare |
$28.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.87
|
| Rate for Payer: UHC Core |
$95.72
|
| Rate for Payer: UHC Exchange |
$28.66
|
| Rate for Payer: UHC Medicaid |
$20.21
|
| Rate for Payer: UHC Medicare Advantage |
$28.66
|
| Rate for Payer: UHCCP Medicaid |
$20.21
|
| Rate for Payer: VA VA |
$28.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.97
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$65.27
|
|
|
Service Code
|
NDC 33342008307
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.43 |
| Max. Negotiated Rate |
$58.74 |
| Rate for Payer: Aetna Commercial |
$55.48
|
| Rate for Payer: BCBS Trust/PPO |
$53.91
|
| Rate for Payer: BCN Commercial |
$53.91
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$58.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.48
|
| Rate for Payer: Nomi Health Commercial |
$53.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.95
|
| Rate for Payer: PHP Commercial |
$55.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.44
|
| Rate for Payer: UHC Core |
$54.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.95
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$7.72
|
|
|
Service Code
|
NDC 55111026279
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Aetna Commercial |
$6.56
|
| Rate for Payer: BCBS Trust/PPO |
$6.38
|
| Rate for Payer: BCN Commercial |
$6.38
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$6.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.18
|
| Rate for Payer: Healthscope Commercial |
$6.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.56
|
| Rate for Payer: Nomi Health Commercial |
$6.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.79
|
| Rate for Payer: PHP Commercial |
$6.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.79
|
| Rate for Payer: UHC Core |
$6.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.79
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$117.08
|
|
|
Service Code
|
NDC 00378551093
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.49 |
| Max. Negotiated Rate |
$105.37 |
| Rate for Payer: Aetna Commercial |
$99.52
|
| Rate for Payer: BCBS Trust/PPO |
$96.70
|
| Rate for Payer: BCN Commercial |
$96.70
|
| Rate for Payer: Cash Price |
$93.66
|
| Rate for Payer: Cofinity Commercial |
$100.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.66
|
| Rate for Payer: Healthscope Commercial |
$105.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.52
|
| Rate for Payer: Nomi Health Commercial |
$96.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.81
|
| Rate for Payer: PHP Commercial |
$99.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.03
|
| Rate for Payer: UHC Core |
$97.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.81
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$231.56
|
|
|
Service Code
|
NDC 55111026281
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.82 |
| Max. Negotiated Rate |
$208.40 |
| Rate for Payer: Aetna Commercial |
$196.83
|
| Rate for Payer: Aetna Medicare |
$60.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.36
|
| Rate for Payer: BCBS Complete |
$42.86
|
| Rate for Payer: BCBS MAPPO |
$57.89
|
| Rate for Payer: BCBS Trust/PPO |
$190.37
|
| Rate for Payer: BCN Commercial |
$190.37
|
| Rate for Payer: BCN Medicare Advantage |
$57.89
|
| Rate for Payer: Cash Price |
$185.25
|
| Rate for Payer: Cofinity Commercial |
$199.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.89
|
| Rate for Payer: Healthscope Commercial |
$208.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.67
|
| Rate for Payer: Mclaren Medicaid |
$40.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.78
|
| Rate for Payer: Meridian Medicaid |
$42.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.83
|
| Rate for Payer: Nomi Health Commercial |
$189.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.67
|
| Rate for Payer: PACE Senior Care Partners |
$55.00
|
| Rate for Payer: PACE SWMI |
$57.89
|
| Rate for Payer: PHP Commercial |
$196.83
|
| Rate for Payer: PHP Medicare Advantage |
$57.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$201.46
|
| Rate for Payer: Priority Health Medicare |
$58.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.17
|
| Rate for Payer: Railroad Medicare Medicare |
$57.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.77
|
| Rate for Payer: UHC Core |
$193.35
|
| Rate for Payer: UHC Exchange |
$57.89
|
| Rate for Payer: UHC Medicaid |
$40.82
|
| Rate for Payer: UHC Medicare Advantage |
$57.89
|
| Rate for Payer: UHCCP Medicaid |
$40.82
|
| Rate for Payer: VA VA |
$57.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.67
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$117.08
|
|
|
Service Code
|
NDC 00378551093
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$105.37 |
| Rate for Payer: Aetna Commercial |
$99.52
|
| Rate for Payer: Aetna Medicare |
$30.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.59
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$29.27
|
| Rate for Payer: BCBS Trust/PPO |
$96.25
|
| Rate for Payer: BCN Commercial |
$96.25
|
| Rate for Payer: BCN Medicare Advantage |
$29.27
|
| Rate for Payer: Cash Price |
$93.66
|
| Rate for Payer: Cofinity Commercial |
$100.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.27
|
| Rate for Payer: Healthscope Commercial |
$105.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.81
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.52
|
| Rate for Payer: Nomi Health Commercial |
$96.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.81
|
| Rate for Payer: PACE Senior Care Partners |
$27.81
|
| Rate for Payer: PACE SWMI |
$29.27
|
| Rate for Payer: PHP Commercial |
$99.52
|
| Rate for Payer: PHP Medicare Advantage |
$29.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.86
|
| Rate for Payer: Priority Health Medicare |
$29.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.49
|
| Rate for Payer: Railroad Medicare Medicare |
$29.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.03
|
| Rate for Payer: UHC Core |
$97.76
|
| Rate for Payer: UHC Exchange |
$29.27
|
| Rate for Payer: UHC Medicaid |
$20.64
|
| Rate for Payer: UHC Medicare Advantage |
$29.27
|
| Rate for Payer: UHCCP Medicaid |
$20.64
|
| Rate for Payer: VA VA |
$29.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.81
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$114.63
|
|
|
Service Code
|
NDC 49884032055
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.78 |
| Max. Negotiated Rate |
$103.17 |
| Rate for Payer: Aetna Commercial |
$97.44
|
| Rate for Payer: BCBS Trust/PPO |
$94.67
|
| Rate for Payer: BCN Commercial |
$94.67
|
| Rate for Payer: Cash Price |
$91.70
|
| Rate for Payer: Cofinity Commercial |
$98.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.70
|
| Rate for Payer: Healthscope Commercial |
$103.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.44
|
| Rate for Payer: Nomi Health Commercial |
$94.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.97
|
| Rate for Payer: PHP Commercial |
$97.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.87
|
| Rate for Payer: UHC Core |
$95.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.97
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$65.27
|
|
|
Service Code
|
NDC 33342008307
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$58.74 |
| Rate for Payer: Aetna Commercial |
$55.48
|
| Rate for Payer: Aetna Medicare |
$16.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.40
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$16.32
|
| Rate for Payer: BCBS Trust/PPO |
$53.66
|
| Rate for Payer: BCN Commercial |
$53.66
|
| Rate for Payer: BCN Medicare Advantage |
$16.32
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$58.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.95
|
| Rate for Payer: Mclaren Medicaid |
$11.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.13
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.48
|
| Rate for Payer: Nomi Health Commercial |
$53.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.95
|
| Rate for Payer: PACE Senior Care Partners |
$15.50
|
| Rate for Payer: PACE SWMI |
$16.32
|
| Rate for Payer: PHP Commercial |
$55.48
|
| Rate for Payer: PHP Medicare Advantage |
$16.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.78
|
| Rate for Payer: Priority Health Medicare |
$16.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.43
|
| Rate for Payer: Railroad Medicare Medicare |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.44
|
| Rate for Payer: UHC Core |
$54.50
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Medicaid |
$11.51
|
| Rate for Payer: UHC Medicare Advantage |
$16.32
|
| Rate for Payer: UHCCP Medicaid |
$11.51
|
| Rate for Payer: VA VA |
$16.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.95
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$7.72
|
|
|
Service Code
|
NDC 55111026279
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Aetna Commercial |
$6.56
|
| Rate for Payer: Aetna Medicare |
$2.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.41
|
| Rate for Payer: BCBS Complete |
$1.43
|
| Rate for Payer: BCBS MAPPO |
$1.93
|
| Rate for Payer: BCBS Trust/PPO |
$6.35
|
| Rate for Payer: BCN Commercial |
$6.35
|
| Rate for Payer: BCN Medicare Advantage |
$1.93
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$6.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.93
|
| Rate for Payer: Healthscope Commercial |
$6.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.79
|
| Rate for Payer: Mclaren Medicaid |
$1.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.03
|
| Rate for Payer: Meridian Medicaid |
$1.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.56
|
| Rate for Payer: Nomi Health Commercial |
$6.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.79
|
| Rate for Payer: PACE Senior Care Partners |
$1.83
|
| Rate for Payer: PACE SWMI |
$1.93
|
| Rate for Payer: PHP Commercial |
$6.56
|
| Rate for Payer: PHP Medicare Advantage |
$1.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.72
|
| Rate for Payer: Priority Health Medicare |
$1.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.79
|
| Rate for Payer: UHC Core |
$6.45
|
| Rate for Payer: UHC Exchange |
$1.93
|
| Rate for Payer: UHC Medicaid |
$1.36
|
| Rate for Payer: UHC Medicare Advantage |
$1.93
|
| Rate for Payer: UHCCP Medicaid |
$1.36
|
| Rate for Payer: VA VA |
$1.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.79
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$231.56
|
|
|
Service Code
|
NDC 55111026281
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.17 |
| Max. Negotiated Rate |
$208.40 |
| Rate for Payer: Aetna Commercial |
$196.83
|
| Rate for Payer: BCBS Trust/PPO |
$191.25
|
| Rate for Payer: BCN Commercial |
$191.25
|
| Rate for Payer: Cash Price |
$185.25
|
| Rate for Payer: Cofinity Commercial |
$199.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.25
|
| Rate for Payer: Healthscope Commercial |
$208.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.83
|
| Rate for Payer: Nomi Health Commercial |
$189.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.67
|
| Rate for Payer: PHP Commercial |
$196.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$201.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.77
|
| Rate for Payer: UHC Core |
$193.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.67
|
|
|
OLANZAPINE 5 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$3.83
|
|
|
Service Code
|
NDC 49884032052
|
| Hospital Charge Code |
28159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$3.45 |
| Rate for Payer: Aetna Commercial |
$3.26
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.20
|
| Rate for Payer: BCBS Complete |
$0.71
|
| Rate for Payer: BCBS MAPPO |
$0.96
|
| Rate for Payer: BCBS Trust/PPO |
$3.15
|
| Rate for Payer: BCN Commercial |
$3.15
|
| Rate for Payer: BCN Medicare Advantage |
$0.96
|
| Rate for Payer: Cash Price |
$3.06
|
| Rate for Payer: Cofinity Commercial |
$3.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.96
|
| Rate for Payer: Healthscope Commercial |
$3.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.87
|
| Rate for Payer: Mclaren Medicaid |
$0.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.01
|
| Rate for Payer: Meridian Medicaid |
$0.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.26
|
| Rate for Payer: Nomi Health Commercial |
$3.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.87
|
| Rate for Payer: PACE Senior Care Partners |
$0.91
|
| Rate for Payer: PACE SWMI |
$0.96
|
| Rate for Payer: PHP Commercial |
$3.26
|
| Rate for Payer: PHP Medicare Advantage |
$0.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$0.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.67
|
| Rate for Payer: Railroad Medicare Medicare |
$0.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.37
|
| Rate for Payer: UHC Core |
$3.20
|
| Rate for Payer: UHC Exchange |
$0.96
|
| Rate for Payer: UHC Medicaid |
$0.68
|
| Rate for Payer: UHC Medicare Advantage |
$0.96
|
| Rate for Payer: UHCCP Medicaid |
$0.68
|
| Rate for Payer: VA VA |
$0.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.87
|
|
