|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.64
|
|
|
Service Code
|
NDC 70069027205
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.69
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.77
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$7.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.97
|
|
|
Service Code
|
NDC 70069027101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Aetna American Axle |
$12.98
|
| Rate for Payer: Aetna Commercial |
$16.97
|
| Rate for Payer: Aetna Medicare |
$9.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.98
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Cofinity Commercial |
$17.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$17.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: PHP Commercial |
$16.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.98
|
| Rate for Payer: Priority Health SBD |
$12.58
|
| Rate for Payer: UMR Bronson Commercial |
$7.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
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 SOLUTION
|
Facility
|
IP
|
$22.68
|
|
|
Service Code
|
NDC 70121158603
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$20.41 |
| Rate for Payer: Aetna American Axle |
$14.74
|
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.74
|
| 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 |
$9.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.01
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.66
|
|
|
Service Code
|
NDC 70756060525
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.77 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Aetna American Axle |
$11.48
|
| Rate for Payer: Aetna Commercial |
$15.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.48
|
| Rate for Payer: Cash Price |
$14.13
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Cofinity Commercial |
$15.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.13
|
| Rate for Payer: Healthscope Commercial |
$15.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.01
|
| Rate for Payer: PHP Commercial |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.48
|
| Rate for Payer: Priority Health SBD |
$11.13
|
| Rate for Payer: UMR Bronson Commercial |
$7.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.24
|
|
|
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
|
$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 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 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 (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 (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
|
$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) 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
|
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
|
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
|
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) 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
|
$303.15
|
|
|
Service Code
|
NDC 68462026001
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.17 |
| Max. Negotiated Rate |
$272.83 |
| Rate for Payer: Aetna American Axle |
$197.05
|
| Rate for Payer: Aetna Commercial |
$257.68
|
| Rate for Payer: Aetna Medicare |
$151.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.05
|
| Rate for Payer: BCBS Complete |
$121.26
|
| Rate for Payer: Cash Price |
$242.52
|
| Rate for Payer: Cofinity Commercial |
$212.21
|
| Rate for Payer: Cofinity Commercial |
$260.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.52
|
| Rate for Payer: Healthscope Commercial |
$272.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.68
|
| Rate for Payer: PHP Commercial |
$257.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.05
|
| Rate for Payer: Priority Health SBD |
$190.98
|
| Rate for Payer: UMR Bronson Commercial |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.36
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$786.72
|
|
|
Service Code
|
NDC 60687051501
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$346.16 |
| Max. Negotiated Rate |
$708.05 |
| Rate for Payer: Aetna American Axle |
$511.37
|
| Rate for Payer: Aetna Commercial |
$668.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.37
|
| Rate for Payer: Cash Price |
$629.38
|
| Rate for Payer: Cofinity Commercial |
$550.70
|
| Rate for Payer: Cofinity Commercial |
$676.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$550.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.38
|
| Rate for Payer: Healthscope Commercial |
$708.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.71
|
| Rate for Payer: PHP Commercial |
$668.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.37
|
| Rate for Payer: Priority Health SBD |
$495.63
|
| Rate for Payer: UMR Bronson Commercial |
$346.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.04
|
|
