|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$107.64
|
|
|
Service Code
|
NDC 00409114401
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$47.36 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna American Axle |
$69.97
|
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.97
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$75.35
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$75.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health SBD |
$67.81
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$37.25
|
|
|
Service Code
|
NDC 51754020304
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$33.52 |
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Commercial |
$26.07
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: UMR Bronson Commercial |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$36.70
|
|
|
Service Code
|
NDC 00409401101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$33.03 |
| Rate for Payer: Aetna American Axle |
$23.86
|
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare |
$18.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.86
|
| Rate for Payer: BCBS Complete |
$14.68
|
| Rate for Payer: Cash Price |
$29.36
|
| Rate for Payer: Cofinity Commercial |
$25.69
|
| Rate for Payer: Cofinity Commercial |
$31.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.36
|
| Rate for Payer: Healthscope Commercial |
$33.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: PHP Commercial |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.86
|
| Rate for Payer: Priority Health SBD |
$23.12
|
| Rate for Payer: UMR Bronson Commercial |
$13.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.52
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$37.25
|
|
|
Service Code
|
NDC 51754020304
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.78 |
| Max. Negotiated Rate |
$33.52 |
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Commercial |
$26.07
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: UMR Bronson Commercial |
$13.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.68
|
|
|
Service Code
|
NDC 70121158601
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.39 |
| Max. Negotiated Rate |
$20.41 |
| Rate for Payer: Aetna American Axle |
$14.74
|
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna Medicare |
$11.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.74
|
| Rate for Payer: BCBS Complete |
$9.07
|
| Rate for Payer: Cash Price |
$18.14
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.28
|
| Rate for Payer: PHP Commercial |
$19.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.74
|
| Rate for Payer: Priority Health SBD |
$14.29
|
| Rate for Payer: UMR Bronson Commercial |
$8.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.01
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$381.74
|
|
|
Service Code
|
NDC 00409963305
|
| Hospital Charge Code |
112139
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$141.24 |
| Max. Negotiated Rate |
$343.57 |
| Rate for Payer: Aetna American Axle |
$248.13
|
| Rate for Payer: Aetna Commercial |
$324.48
|
| Rate for Payer: Aetna Medicare |
$190.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.13
|
| Rate for Payer: BCBS Complete |
$152.70
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Cofinity Commercial |
$267.22
|
| Rate for Payer: Cofinity Commercial |
$328.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.39
|
| Rate for Payer: Healthscope Commercial |
$343.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.48
|
| Rate for Payer: PHP Commercial |
$324.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.13
|
| Rate for Payer: Priority Health SBD |
$240.50
|
| Rate for Payer: UMR Bronson Commercial |
$141.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.31
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$381.74
|
|
|
Service Code
|
NDC 00409963305
|
| Hospital Charge Code |
112139
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$167.97 |
| Max. Negotiated Rate |
$343.57 |
| Rate for Payer: Aetna American Axle |
$248.13
|
| Rate for Payer: Aetna Commercial |
$324.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.13
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Cofinity Commercial |
$267.22
|
| Rate for Payer: Cofinity Commercial |
$328.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.39
|
| Rate for Payer: Healthscope Commercial |
$343.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.48
|
| Rate for Payer: PHP Commercial |
$324.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.13
|
| Rate for Payer: Priority Health SBD |
$240.50
|
| Rate for Payer: UMR Bronson Commercial |
$167.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.31
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$310.20
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.49 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$136.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$345.45
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.82 |
| Max. Negotiated Rate |
$310.90 |
| Rate for Payer: Aetna American Axle |
$224.54
|
| Rate for Payer: Aetna Commercial |
$293.63
|
| Rate for Payer: Aetna Medicare |
$172.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.54
|
| Rate for Payer: BCBS Complete |
$138.18
|
| Rate for Payer: Cash Price |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$241.81
|
| Rate for Payer: Cofinity Commercial |
$297.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.36
|
| Rate for Payer: Healthscope Commercial |
$310.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.63
|
| Rate for Payer: PHP Commercial |
$293.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.54
|
| Rate for Payer: Priority Health SBD |
$217.63
|
| Rate for Payer: UMR Bronson Commercial |
$127.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.09
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$310.20
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.77 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna Medicare |
$155.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: BCBS Complete |
$124.08
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$114.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$345.45
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.00 |
| Max. Negotiated Rate |
$310.90 |
| Rate for Payer: Aetna American Axle |
$224.54
|
| Rate for Payer: Aetna Commercial |
$293.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.54
|
| Rate for Payer: Cash Price |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$241.81
|
| Rate for Payer: Cofinity Commercial |
$297.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.36
|
| Rate for Payer: Healthscope Commercial |
$310.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.63
|
| Rate for Payer: PHP Commercial |
$293.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.54
|
| Rate for Payer: Priority Health SBD |
$217.63
|
| Rate for Payer: UMR Bronson Commercial |
$152.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.09
|
|
|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
OP
|
$1,324.60
|
|
|
Service Code
|
NDC 62175048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$490.10 |
| Max. Negotiated Rate |
$1,192.14 |
| Rate for Payer: Aetna American Axle |
$860.99
|
| Rate for Payer: Aetna Commercial |
$1,125.91
|
| Rate for Payer: Aetna Medicare |
$662.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.99
|
| Rate for Payer: BCBS Complete |
$529.84
|
| Rate for Payer: Cash Price |
$1,059.68
|
| Rate for Payer: Cofinity Commercial |
$1,139.16
|
| Rate for Payer: Cofinity Commercial |
$927.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$927.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,059.68
|
| Rate for Payer: Healthscope Commercial |
$1,192.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,125.91
|
| Rate for Payer: PHP Commercial |
$1,125.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$860.99
|
| Rate for Payer: Priority Health SBD |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$490.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.45
|
|
|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
IP
|
$1,324.60
|
|
|
Service Code
|
NDC 62175048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$582.82 |
| Max. Negotiated Rate |
$1,192.14 |
| Rate for Payer: Aetna American Axle |
$860.99
|
| Rate for Payer: Aetna Commercial |
$1,125.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.99
|
| Rate for Payer: Cash Price |
$1,059.68
|
| Rate for Payer: Cofinity Commercial |
$1,139.16
|
| Rate for Payer: Cofinity Commercial |
$927.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$927.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,059.68
|
| Rate for Payer: Healthscope Commercial |
$1,192.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,125.91
|
| Rate for Payer: PHP Commercial |
$1,125.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$860.99
|
| Rate for Payer: Priority Health SBD |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$582.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.45
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$4.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.41
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$200.45
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.17 |
| Max. Negotiated Rate |
$180.41 |
| Rate for Payer: Aetna American Axle |
$130.29
|
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna Medicare |
$100.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.29
|
| Rate for Payer: BCBS Complete |
$80.18
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Commercial |
$140.31
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.29
|
| Rate for Payer: Priority Health SBD |
$126.28
|
| Rate for Payer: UMR Bronson Commercial |
$74.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.34
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$325.92
|
|
|
Service Code
|
NDC 57664011688
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.59 |
| Max. Negotiated Rate |
$293.33 |
| Rate for Payer: Aetna American Axle |
$211.85
|
| Rate for Payer: Aetna Commercial |
$277.03
|
| Rate for Payer: Aetna Medicare |
$162.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: BCBS Complete |
$130.37
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cofinity Commercial |
$228.14
|
| Rate for Payer: Cofinity Commercial |
$280.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$228.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.74
|
| Rate for Payer: Healthscope Commercial |
$293.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.03
|
| Rate for Payer: PHP Commercial |
$277.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.85
|
| Rate for Payer: Priority Health SBD |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$120.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.44
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$194.12 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna American Axle |
$341.02
|
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna Medicare |
$262.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.02
|
| Rate for Payer: BCBS Complete |
$209.86
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Commercial |
$367.25
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$367.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.02
|
| Rate for Payer: Priority Health SBD |
$330.52
|
| Rate for Payer: UMR Bronson Commercial |
$194.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$200.45
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.20 |
| Max. Negotiated Rate |
$180.41 |
| Rate for Payer: Aetna American Axle |
$130.29
|
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.29
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Commercial |
$140.31
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.29
|
| Rate for Payer: Priority Health SBD |
$126.28
|
| Rate for Payer: UMR Bronson Commercial |
$88.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.34
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$325.92
|
|
|
Service Code
|
NDC 57664011688
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.40 |
| Max. Negotiated Rate |
$293.33 |
| Rate for Payer: Aetna American Axle |
$211.85
|
| Rate for Payer: Aetna Commercial |
$277.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cofinity Commercial |
$228.14
|
| Rate for Payer: Cofinity Commercial |
$280.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$228.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.74
|
| Rate for Payer: Healthscope Commercial |
$293.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.03
|
| Rate for Payer: PHP Commercial |
$277.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.85
|
| Rate for Payer: Priority Health SBD |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$143.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.44
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$230.84 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna American Axle |
$341.02
|
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.02
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Commercial |
$367.25
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$367.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.02
|
| Rate for Payer: Priority Health SBD |
$330.52
|
| Rate for Payer: UMR Bronson Commercial |
$230.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$2.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$4.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.41
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$432.40
|
|
|
Service Code
|
NDC 68462029301
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$190.26 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna American Axle |
$281.06
|
| Rate for Payer: Aetna Commercial |
$367.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.06
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$302.68
|
| Rate for Payer: Cofinity Commercial |
$371.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$302.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Healthscope Commercial |
$389.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.54
|
| Rate for Payer: PHP Commercial |
$367.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.06
|
| Rate for Payer: Priority Health SBD |
$272.41
|
| Rate for Payer: UMR Bronson Commercial |
$190.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.30
|
|
|
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$432.40
|
|
|
Service Code
|
NDC 68462029301
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$159.99 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna American Axle |
$281.06
|
| Rate for Payer: Aetna Commercial |
$367.54
|
| Rate for Payer: Aetna Medicare |
$216.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.06
|
| Rate for Payer: BCBS Complete |
$172.96
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$302.68
|
| Rate for Payer: Cofinity Commercial |
$371.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$302.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Healthscope Commercial |
$389.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.54
|
| Rate for Payer: PHP Commercial |
$367.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.06
|
| Rate for Payer: Priority Health SBD |
$272.41
|
| Rate for Payer: UMR Bronson Commercial |
$159.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.30
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$209.00
|
|
|
Service Code
|
NDC 75834015901
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.33 |
| Max. Negotiated Rate |
$188.10 |
| Rate for Payer: Aetna American Axle |
$135.85
|
| Rate for Payer: Aetna Commercial |
$177.65
|
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.85
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$146.30
|
| Rate for Payer: Cofinity Commercial |
$179.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$146.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.20
|
| Rate for Payer: Healthscope Commercial |
$188.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.65
|
| Rate for Payer: PHP Commercial |
$177.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health SBD |
$131.67
|
| Rate for Payer: UMR Bronson Commercial |
$77.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.75
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$7.87
|
|
|
Service Code
|
NDC 60687051511
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Aetna American Axle |
$5.12
|
| Rate for Payer: Aetna Commercial |
$6.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.12
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cofinity Commercial |
$5.51
|
| Rate for Payer: Cofinity Commercial |
$6.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.30
|
| Rate for Payer: Healthscope Commercial |
$7.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.69
|
| Rate for Payer: PHP Commercial |
$6.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.12
|
| Rate for Payer: Priority Health SBD |
$4.96
|
| Rate for Payer: UMR Bronson Commercial |
$3.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.90
|
|
