|
WARFARIN 1 MG TABLET
|
Facility
|
OP
|
$272.60
|
|
|
Service Code
|
NDC 00832121101
|
| Hospital Charge Code |
11664
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.86 |
| Max. Negotiated Rate |
$245.34 |
| Rate for Payer: Aetna American Axle |
$177.19
|
| Rate for Payer: Aetna Commercial |
$231.71
|
| Rate for Payer: Aetna Medicare |
$136.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.19
|
| Rate for Payer: BCBS Complete |
$109.04
|
| Rate for Payer: Cash Price |
$218.08
|
| Rate for Payer: Cofinity Advantage |
$190.82
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$190.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.45
|
| Rate for Payer: PHP Commercial |
$231.71
|
| Rate for Payer: Priority Health SBD |
$171.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.19
|
| Rate for Payer: UHC Core |
$142.02
|
| Rate for Payer: UHC Exchange |
$107.13
|
| Rate for Payer: UMR Bronson Commercial |
$100.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.45
|
|
|
WARFARIN 1 MG TABLET
|
Facility
|
IP
|
$272.60
|
|
|
Service Code
|
NDC 00832121101
|
| Hospital Charge Code |
11664
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.94 |
| Max. Negotiated Rate |
$245.34 |
| Rate for Payer: Aetna American Axle |
$177.19
|
| Rate for Payer: Aetna Commercial |
$231.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.19
|
| Rate for Payer: Cash Price |
$218.08
|
| Rate for Payer: Cofinity Advantage |
$190.82
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$190.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.45
|
| Rate for Payer: PHP Commercial |
$231.71
|
| Rate for Payer: Priority Health SBD |
$171.74
|
| Rate for Payer: UMR Bronson Commercial |
$119.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.45
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
OP
|
$267.90
|
|
|
Service Code
|
NDC 00093171401
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.12 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna American Axle |
$174.13
|
| Rate for Payer: Aetna Commercial |
$227.72
|
| Rate for Payer: Aetna Medicare |
$133.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.13
|
| Rate for Payer: BCBS Complete |
$107.16
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cofinity Advantage |
$187.53
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Healthscope Commercial |
$241.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.93
|
| Rate for Payer: PHP Commercial |
$227.72
|
| Rate for Payer: Priority Health SBD |
$168.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.13
|
| Rate for Payer: UHC Core |
$139.58
|
| Rate for Payer: UHC Exchange |
$105.28
|
| Rate for Payer: UMR Bronson Commercial |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.93
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
IP
|
$267.90
|
|
|
Service Code
|
NDC 00093171401
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.88 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna American Axle |
$174.13
|
| Rate for Payer: Aetna Commercial |
$227.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.13
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cofinity Advantage |
$187.53
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Healthscope Commercial |
$241.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.93
|
| Rate for Payer: PHP Commercial |
$227.72
|
| Rate for Payer: Priority Health SBD |
$168.78
|
| Rate for Payer: UMR Bronson Commercial |
$117.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.93
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
OP
|
$278.35
|
|
|
Service Code
|
NDC 68084002701
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$102.99 |
| Max. Negotiated Rate |
$250.51 |
| Rate for Payer: Aetna American Axle |
$180.93
|
| Rate for Payer: Aetna Commercial |
$236.60
|
| Rate for Payer: Aetna Medicare |
$139.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.93
|
| Rate for Payer: BCBS Complete |
$111.34
|
| Rate for Payer: Cash Price |
$222.68
|
| Rate for Payer: Cofinity Advantage |
$194.84
|
| Rate for Payer: Cofinity Commercial |
$239.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.68
|
| Rate for Payer: Healthscope Commercial |
$250.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.76
|
| Rate for Payer: PHP Commercial |
$236.60
|
| Rate for Payer: Priority Health SBD |
$175.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.93
|
| Rate for Payer: UHC Core |
$145.02
|
| Rate for Payer: UHC Exchange |
$109.39
|
| Rate for Payer: UMR Bronson Commercial |
$102.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.76
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
OP
|
$278.35
|
|
|
Service Code
|
NDC 68084002711
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$102.99 |
| Max. Negotiated Rate |
$250.51 |
| Rate for Payer: Aetna American Axle |
$180.93
|
| Rate for Payer: Aetna Commercial |
$236.60
|
| Rate for Payer: Aetna Medicare |
$139.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.93
|
| Rate for Payer: BCBS Complete |
$111.34
|
| Rate for Payer: Cash Price |
$222.68
|
| Rate for Payer: Cofinity Advantage |
$194.84
|
| Rate for Payer: Cofinity Commercial |
$239.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.68
|
| Rate for Payer: Healthscope Commercial |
$250.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.76
|
| Rate for Payer: PHP Commercial |
$236.60
|
| Rate for Payer: Priority Health SBD |
$175.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.93
|
| Rate for Payer: UHC Core |
$145.02
|
| Rate for Payer: UHC Exchange |
$109.39
|
| Rate for Payer: UMR Bronson Commercial |
$102.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.76
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
OP
|
$272.60
|
|
|
Service Code
|
NDC 00832121301
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.86 |
| Max. Negotiated Rate |
$245.34 |
| Rate for Payer: Aetna American Axle |
$177.19
|
| Rate for Payer: Aetna Commercial |
$231.71
|
| Rate for Payer: Aetna Medicare |
$136.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.19
|
| Rate for Payer: BCBS Complete |
$109.04
|
| Rate for Payer: Cash Price |
$218.08
|
| Rate for Payer: Cofinity Advantage |
$190.82
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$190.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.45
|
| Rate for Payer: PHP Commercial |
$231.71
|
| Rate for Payer: Priority Health SBD |
$171.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.19
|
| Rate for Payer: UHC Core |
$142.02
|
| Rate for Payer: UHC Exchange |
$107.13
|
| Rate for Payer: UMR Bronson Commercial |
$100.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.45
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
IP
|
$2.73
|
|
|
Service Code
|
NDC 00832121389
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.46 |
| Rate for Payer: Aetna American Axle |
$1.77
|
| Rate for Payer: Aetna Commercial |
$2.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.77
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Advantage |
$1.91
|
| Rate for Payer: Cofinity Commercial |
$2.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.05
|
| Rate for Payer: PHP Commercial |
$2.32
|
| Rate for Payer: Priority Health SBD |
$1.72
|
| Rate for Payer: UMR Bronson Commercial |
$1.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.05
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
IP
|
$278.35
|
|
|
Service Code
|
NDC 68084002701
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$122.47 |
| Max. Negotiated Rate |
$250.51 |
| Rate for Payer: Aetna American Axle |
$180.93
|
| Rate for Payer: Aetna Commercial |
$236.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.93
|
| Rate for Payer: Cash Price |
$222.68
|
| Rate for Payer: Cofinity Advantage |
$194.84
|
| Rate for Payer: Cofinity Commercial |
$239.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.68
|
| Rate for Payer: Healthscope Commercial |
$250.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.76
|
| Rate for Payer: PHP Commercial |
$236.60
|
| Rate for Payer: Priority Health SBD |
$175.36
|
| Rate for Payer: UMR Bronson Commercial |
$122.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.76
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
IP
|
$272.60
|
|
|
Service Code
|
NDC 00832121301
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.94 |
| Max. Negotiated Rate |
$245.34 |
| Rate for Payer: Aetna American Axle |
$177.19
|
| Rate for Payer: Aetna Commercial |
$231.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.19
|
| Rate for Payer: Cash Price |
$218.08
|
| Rate for Payer: Cofinity Advantage |
$190.82
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$190.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.45
|
| Rate for Payer: PHP Commercial |
$231.71
|
| Rate for Payer: Priority Health SBD |
$171.74
|
| Rate for Payer: UMR Bronson Commercial |
$119.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.45
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
IP
|
$278.35
|
|
|
Service Code
|
NDC 68084002711
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$122.47 |
| Max. Negotiated Rate |
$250.51 |
| Rate for Payer: Aetna American Axle |
$180.93
|
| Rate for Payer: Aetna Commercial |
$236.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.93
|
| Rate for Payer: Cash Price |
$222.68
|
| Rate for Payer: Cofinity Advantage |
$194.84
|
| Rate for Payer: Cofinity Commercial |
$239.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.68
|
| Rate for Payer: Healthscope Commercial |
$250.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.76
|
| Rate for Payer: PHP Commercial |
$236.60
|
| Rate for Payer: Priority Health SBD |
$175.36
|
| Rate for Payer: UMR Bronson Commercial |
$122.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.76
|
|
|
WARFARIN 2.5 MG TABLET
|
Facility
|
OP
|
$2.73
|
|
|
Service Code
|
NDC 00832121389
|
| Hospital Charge Code |
8750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$2.46 |
| Rate for Payer: Aetna American Axle |
$1.77
|
| Rate for Payer: Aetna Commercial |
$2.32
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.77
|
| Rate for Payer: BCBS Complete |
$1.09
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Advantage |
$1.91
|
| Rate for Payer: Cofinity Commercial |
$2.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.05
|
| Rate for Payer: PHP Commercial |
$2.32
|
| Rate for Payer: Priority Health SBD |
$1.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.77
|
| Rate for Payer: UHC Core |
$1.42
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$1.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.05
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
OP
|
$267.90
|
|
|
Service Code
|
NDC 00093171301
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.12 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna American Axle |
$174.13
|
| Rate for Payer: Aetna Commercial |
$227.72
|
| Rate for Payer: Aetna Medicare |
$133.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.13
|
| Rate for Payer: BCBS Complete |
$107.16
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cofinity Advantage |
$187.53
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Healthscope Commercial |
$241.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.93
|
| Rate for Payer: PHP Commercial |
$227.72
|
| Rate for Payer: Priority Health SBD |
$168.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.13
|
| Rate for Payer: UHC Core |
$139.58
|
| Rate for Payer: UHC Exchange |
$105.28
|
| Rate for Payer: UMR Bronson Commercial |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.93
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
IP
|
$272.65
|
|
|
Service Code
|
NDC 62584098401
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.97 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna American Axle |
$177.22
|
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.22
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Advantage |
$190.85
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.49
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: Priority Health SBD |
$171.77
|
| Rate for Payer: UMR Bronson Commercial |
$119.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
IP
|
$361.90
|
|
|
Service Code
|
NDC 65162076210
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$159.24 |
| Max. Negotiated Rate |
$325.71 |
| Rate for Payer: Aetna American Axle |
$235.24
|
| Rate for Payer: Aetna Commercial |
$307.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.24
|
| Rate for Payer: Cash Price |
$289.52
|
| Rate for Payer: Cofinity Advantage |
$253.33
|
| Rate for Payer: Cofinity Commercial |
$311.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.52
|
| Rate for Payer: Healthscope Commercial |
$325.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.43
|
| Rate for Payer: PHP Commercial |
$307.62
|
| Rate for Payer: Priority Health SBD |
$228.00
|
| Rate for Payer: UMR Bronson Commercial |
$159.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.43
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
IP
|
$267.90
|
|
|
Service Code
|
NDC 00093171301
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.88 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna American Axle |
$174.13
|
| Rate for Payer: Aetna Commercial |
$227.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.13
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cofinity Advantage |
$187.53
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Healthscope Commercial |
$241.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.93
|
| Rate for Payer: PHP Commercial |
$227.72
|
| Rate for Payer: Priority Health SBD |
$168.78
|
| Rate for Payer: UMR Bronson Commercial |
$117.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.93
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
OP
|
$361.90
|
|
|
Service Code
|
NDC 65162076210
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$325.71 |
| Rate for Payer: Aetna American Axle |
$235.24
|
| Rate for Payer: Aetna Commercial |
$307.62
|
| Rate for Payer: Aetna Medicare |
$180.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.24
|
| Rate for Payer: BCBS Complete |
$144.76
|
| Rate for Payer: Cash Price |
$289.52
|
| Rate for Payer: Cofinity Advantage |
$253.33
|
| Rate for Payer: Cofinity Commercial |
$311.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.52
|
| Rate for Payer: Healthscope Commercial |
$325.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$289.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.43
|
| Rate for Payer: PHP Commercial |
$307.62
|
| Rate for Payer: Priority Health SBD |
$228.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.24
|
| Rate for Payer: UHC Core |
$188.55
|
| Rate for Payer: UHC Exchange |
$142.23
|
| Rate for Payer: UMR Bronson Commercial |
$133.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.43
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
OP
|
$2.73
|
|
|
Service Code
|
NDC 62584098411
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$2.46 |
| Rate for Payer: Aetna American Axle |
$1.77
|
| Rate for Payer: Aetna Commercial |
$2.32
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.77
|
| Rate for Payer: BCBS Complete |
$1.09
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Advantage |
$1.91
|
| Rate for Payer: Cofinity Commercial |
$2.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.05
|
| Rate for Payer: PHP Commercial |
$2.32
|
| Rate for Payer: Priority Health SBD |
$1.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.77
|
| Rate for Payer: UHC Core |
$1.42
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$1.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.05
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
IP
|
$2.73
|
|
|
Service Code
|
NDC 62584098411
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.46 |
| Rate for Payer: Aetna American Axle |
$1.77
|
| Rate for Payer: Aetna Commercial |
$2.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.77
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Advantage |
$1.91
|
| Rate for Payer: Cofinity Commercial |
$2.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.05
|
| Rate for Payer: PHP Commercial |
$2.32
|
| Rate for Payer: Priority Health SBD |
$1.72
|
| Rate for Payer: UMR Bronson Commercial |
$1.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.05
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
IP
|
$201.40
|
|
|
Service Code
|
NDC 51672402801
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$181.26 |
| Rate for Payer: Aetna American Axle |
$130.91
|
| Rate for Payer: Aetna Commercial |
$171.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.91
|
| Rate for Payer: Cash Price |
$161.12
|
| Rate for Payer: Cofinity Advantage |
$140.98
|
| Rate for Payer: Cofinity Commercial |
$173.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.12
|
| Rate for Payer: Healthscope Commercial |
$181.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.05
|
| Rate for Payer: PHP Commercial |
$171.19
|
| Rate for Payer: Priority Health SBD |
$126.88
|
| Rate for Payer: UMR Bronson Commercial |
$88.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.05
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
OP
|
$201.40
|
|
|
Service Code
|
NDC 51672402801
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.52 |
| Max. Negotiated Rate |
$181.26 |
| Rate for Payer: Aetna American Axle |
$130.91
|
| Rate for Payer: Aetna Commercial |
$171.19
|
| Rate for Payer: Aetna Medicare |
$100.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.91
|
| Rate for Payer: BCBS Complete |
$80.56
|
| Rate for Payer: Cash Price |
$161.12
|
| Rate for Payer: Cofinity Advantage |
$140.98
|
| Rate for Payer: Cofinity Commercial |
$173.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.12
|
| Rate for Payer: Healthscope Commercial |
$181.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.05
|
| Rate for Payer: PHP Commercial |
$171.19
|
| Rate for Payer: Priority Health SBD |
$126.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.91
|
| Rate for Payer: UHC Core |
$104.93
|
| Rate for Payer: UHC Exchange |
$79.15
|
| Rate for Payer: UMR Bronson Commercial |
$74.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.05
|
|
|
WARFARIN 2 MG TABLET
|
Facility
|
OP
|
$272.65
|
|
|
Service Code
|
NDC 62584098401
|
| Hospital Charge Code |
8749
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.88 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna American Axle |
$177.22
|
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna Medicare |
$136.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.22
|
| Rate for Payer: BCBS Complete |
$109.06
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Advantage |
$190.85
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.49
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: Priority Health SBD |
$171.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.22
|
| Rate for Payer: UHC Core |
$142.05
|
| Rate for Payer: UHC Exchange |
$107.15
|
| Rate for Payer: UMR Bronson Commercial |
$100.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
WARFARIN 5 MG TABLET
|
Facility
|
IP
|
$3.09
|
|
|
Service Code
|
NDC 62584099411
|
| Hospital Charge Code |
8751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$2.78 |
| Rate for Payer: Aetna American Axle |
$2.01
|
| Rate for Payer: Aetna Commercial |
$2.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.01
|
| Rate for Payer: Cash Price |
$2.47
|
| Rate for Payer: Cofinity Advantage |
$2.16
|
| Rate for Payer: Cofinity Commercial |
$2.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.47
|
| Rate for Payer: Healthscope Commercial |
$2.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.32
|
| Rate for Payer: PHP Commercial |
$2.63
|
| Rate for Payer: Priority Health SBD |
$1.95
|
| Rate for Payer: UMR Bronson Commercial |
$1.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.32
|
|
|
WARFARIN 5 MG TABLET
|
Facility
|
OP
|
$308.75
|
|
|
Service Code
|
NDC 62584099401
|
| Hospital Charge Code |
8751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.24 |
| Max. Negotiated Rate |
$277.88 |
| Rate for Payer: Aetna American Axle |
$200.69
|
| Rate for Payer: Aetna Commercial |
$262.44
|
| Rate for Payer: Aetna Medicare |
$154.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.69
|
| Rate for Payer: BCBS Complete |
$123.50
|
| Rate for Payer: Cash Price |
$247.00
|
| Rate for Payer: Cofinity Advantage |
$216.12
|
| Rate for Payer: Cofinity Commercial |
$265.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.00
|
| Rate for Payer: Healthscope Commercial |
$277.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.56
|
| Rate for Payer: PHP Commercial |
$262.44
|
| Rate for Payer: Priority Health SBD |
$194.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.69
|
| Rate for Payer: UHC Core |
$160.86
|
| Rate for Payer: UHC Exchange |
$121.34
|
| Rate for Payer: UMR Bronson Commercial |
$114.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.56
|
|
|
WARFARIN 5 MG TABLET
|
Facility
|
OP
|
$3.09
|
|
|
Service Code
|
NDC 62584099411
|
| Hospital Charge Code |
8751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$2.78 |
| Rate for Payer: Aetna American Axle |
$2.01
|
| Rate for Payer: Aetna Commercial |
$2.63
|
| Rate for Payer: Aetna Medicare |
$1.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.01
|
| Rate for Payer: BCBS Complete |
$1.24
|
| Rate for Payer: Cash Price |
$2.47
|
| Rate for Payer: Cofinity Advantage |
$2.16
|
| Rate for Payer: Cofinity Commercial |
$2.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.47
|
| Rate for Payer: Healthscope Commercial |
$2.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.32
|
| Rate for Payer: PHP Commercial |
$2.63
|
| Rate for Payer: Priority Health SBD |
$1.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.01
|
| Rate for Payer: UHC Core |
$1.61
|
| Rate for Payer: UHC Exchange |
$1.21
|
| Rate for Payer: UMR Bronson Commercial |
$1.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.32
|
|
