|
CLINDAMYCIN 900 MG (IV PREMIX)
|
Facility
|
OP
|
$94.91
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
500560
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$85.42 |
| Rate for Payer: Aetna American Axle |
$61.69
|
| Rate for Payer: Aetna Commercial |
$80.67
|
| Rate for Payer: Aetna Medicare |
$47.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.69
|
| Rate for Payer: BCBS Complete |
$37.96
|
| Rate for Payer: Cash Price |
$75.93
|
| Rate for Payer: Cofinity Commercial |
$66.44
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.93
|
| Rate for Payer: Healthscope Commercial |
$85.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.67
|
| Rate for Payer: PHP Commercial |
$80.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.69
|
| Rate for Payer: Priority Health SBD |
$59.79
|
| Rate for Payer: UMR Bronson Commercial |
$35.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.18
|
|
|
CLINDAMYCIN 900 MG (IV PREMIX)
|
Facility
|
IP
|
$94.91
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
500560
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.76 |
| Max. Negotiated Rate |
$85.42 |
| Rate for Payer: Aetna American Axle |
$61.69
|
| Rate for Payer: Aetna Commercial |
$80.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.69
|
| Rate for Payer: Cash Price |
$75.93
|
| Rate for Payer: Cofinity Commercial |
$66.44
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.93
|
| Rate for Payer: Healthscope Commercial |
$85.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.67
|
| Rate for Payer: PHP Commercial |
$80.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.69
|
| Rate for Payer: Priority Health SBD |
$59.79
|
| Rate for Payer: UMR Bronson Commercial |
$41.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.18
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$2.08
|
|
|
Service Code
|
NDC 68084024311
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$1.87 |
| Rate for Payer: Aetna American Axle |
$1.35
|
| Rate for Payer: Aetna Commercial |
$1.77
|
| Rate for Payer: Aetna Medicare |
$1.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.35
|
| Rate for Payer: BCBS Complete |
$0.83
|
| Rate for Payer: Cash Price |
$1.66
|
| Rate for Payer: Cofinity Commercial |
$1.46
|
| Rate for Payer: Cofinity Commercial |
$1.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.66
|
| Rate for Payer: Healthscope Commercial |
$1.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.77
|
| Rate for Payer: PHP Commercial |
$1.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.35
|
| Rate for Payer: Priority Health SBD |
$1.31
|
| Rate for Payer: UMR Bronson Commercial |
$0.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.56
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$420.65
|
|
|
Service Code
|
NDC 65862018501
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$185.09 |
| Max. Negotiated Rate |
$378.58 |
| Rate for Payer: Aetna American Axle |
$273.42
|
| Rate for Payer: Aetna Commercial |
$357.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.42
|
| Rate for Payer: Cash Price |
$336.52
|
| Rate for Payer: Cofinity Commercial |
$294.45
|
| Rate for Payer: Cofinity Commercial |
$361.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$294.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.52
|
| Rate for Payer: Healthscope Commercial |
$378.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.55
|
| Rate for Payer: PHP Commercial |
$357.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.42
|
| Rate for Payer: Priority Health SBD |
$265.01
|
| Rate for Payer: UMR Bronson Commercial |
$185.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.49
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$453.55
|
|
|
Service Code
|
NDC 42292001820
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$167.81 |
| Max. Negotiated Rate |
$408.19 |
| Rate for Payer: Aetna American Axle |
$294.81
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna Medicare |
$226.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: BCBS Complete |
$181.42
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$317.49
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$408.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: UMR Bronson Commercial |
$167.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.16
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$446.50
|
|
|
Service Code
|
NDC 59762332801
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.46 |
| Max. Negotiated Rate |
$401.85 |
| Rate for Payer: Aetna American Axle |
$290.23
|
| Rate for Payer: Aetna Commercial |
$379.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.23
|
| Rate for Payer: Cash Price |
$357.20
|
| Rate for Payer: Cofinity Commercial |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$383.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$312.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.20
|
| Rate for Payer: Healthscope Commercial |
$401.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.52
|
| Rate for Payer: PHP Commercial |
$379.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.23
|
| Rate for Payer: Priority Health SBD |
$281.30
|
| Rate for Payer: UMR Bronson Commercial |
$196.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.88
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$420.65
|
|
|
Service Code
|
NDC 65862018501
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.64 |
| Max. Negotiated Rate |
$378.58 |
| Rate for Payer: Aetna American Axle |
$273.42
|
| Rate for Payer: Aetna Commercial |
$357.55
|
| Rate for Payer: Aetna Medicare |
$210.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.42
|
| Rate for Payer: BCBS Complete |
$168.26
|
| Rate for Payer: Cash Price |
$336.52
|
| Rate for Payer: Cofinity Commercial |
$294.45
|
| Rate for Payer: Cofinity Commercial |
$361.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$294.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.52
|
| Rate for Payer: Healthscope Commercial |
$378.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.55
|
| Rate for Payer: PHP Commercial |
$357.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.42
|
| Rate for Payer: Priority Health SBD |
$265.01
|
| Rate for Payer: UMR Bronson Commercial |
$155.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.49
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$270.25
|
|
|
Service Code
|
NDC 63304069201
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.99 |
| Max. Negotiated Rate |
$243.22 |
| Rate for Payer: Aetna American Axle |
$175.66
|
| Rate for Payer: Aetna Commercial |
$229.71
|
| Rate for Payer: Aetna Medicare |
$135.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.66
|
| Rate for Payer: BCBS Complete |
$108.10
|
| Rate for Payer: Cash Price |
$216.20
|
| Rate for Payer: Cofinity Commercial |
$189.18
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.20
|
| Rate for Payer: Healthscope Commercial |
$243.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.71
|
| Rate for Payer: PHP Commercial |
$229.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.66
|
| Rate for Payer: Priority Health SBD |
$170.26
|
| Rate for Payer: UMR Bronson Commercial |
$99.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.69
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$2.08
|
|
|
Service Code
|
NDC 68084024311
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$1.87 |
| Rate for Payer: Aetna American Axle |
$1.35
|
| Rate for Payer: Aetna Commercial |
$1.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.35
|
| Rate for Payer: Cash Price |
$1.66
|
| Rate for Payer: Cofinity Commercial |
$1.46
|
| Rate for Payer: Cofinity Commercial |
$1.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.66
|
| Rate for Payer: Healthscope Commercial |
$1.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.77
|
| Rate for Payer: PHP Commercial |
$1.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.35
|
| Rate for Payer: Priority Health SBD |
$1.31
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.56
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$270.25
|
|
|
Service Code
|
NDC 63304069201
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.91 |
| Max. Negotiated Rate |
$243.22 |
| Rate for Payer: Aetna American Axle |
$175.66
|
| Rate for Payer: Aetna Commercial |
$229.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.66
|
| Rate for Payer: Cash Price |
$216.20
|
| Rate for Payer: Cofinity Commercial |
$189.18
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.20
|
| Rate for Payer: Healthscope Commercial |
$243.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.71
|
| Rate for Payer: PHP Commercial |
$229.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.66
|
| Rate for Payer: Priority Health SBD |
$170.26
|
| Rate for Payer: UMR Bronson Commercial |
$118.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.69
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$319.60
|
|
|
Service Code
|
NDC 42571025101
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.62 |
| Max. Negotiated Rate |
$287.64 |
| Rate for Payer: Aetna American Axle |
$207.74
|
| Rate for Payer: Aetna Commercial |
$271.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.74
|
| Rate for Payer: Cash Price |
$255.68
|
| Rate for Payer: Cofinity Commercial |
$223.72
|
| Rate for Payer: Cofinity Commercial |
$274.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$223.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.68
|
| Rate for Payer: Healthscope Commercial |
$287.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.66
|
| Rate for Payer: PHP Commercial |
$271.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.74
|
| Rate for Payer: Priority Health SBD |
$201.35
|
| Rate for Payer: UMR Bronson Commercial |
$140.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.70
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$207.10
|
|
|
Service Code
|
NDC 68084024301
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.12 |
| Max. Negotiated Rate |
$186.39 |
| Rate for Payer: Aetna American Axle |
$134.62
|
| Rate for Payer: Aetna Commercial |
$176.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.62
|
| Rate for Payer: Cash Price |
$165.68
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Cofinity Commercial |
$178.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.68
|
| Rate for Payer: Healthscope Commercial |
$186.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.03
|
| Rate for Payer: PHP Commercial |
$176.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.62
|
| Rate for Payer: Priority Health SBD |
$130.47
|
| Rate for Payer: UMR Bronson Commercial |
$91.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.32
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$4.54
|
|
|
Service Code
|
NDC 42292001801
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna American Axle |
$2.95
|
| Rate for Payer: Aetna Commercial |
$3.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.95
|
| Rate for Payer: Cash Price |
$3.63
|
| Rate for Payer: Cofinity Commercial |
$3.18
|
| Rate for Payer: Cofinity Commercial |
$3.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.63
|
| Rate for Payer: Healthscope Commercial |
$4.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.86
|
| Rate for Payer: PHP Commercial |
$3.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.95
|
| Rate for Payer: Priority Health SBD |
$2.86
|
| Rate for Payer: UMR Bronson Commercial |
$2.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.40
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$319.60
|
|
|
Service Code
|
NDC 42571025101
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.25 |
| Max. Negotiated Rate |
$287.64 |
| Rate for Payer: Aetna American Axle |
$207.74
|
| Rate for Payer: Aetna Commercial |
$271.66
|
| Rate for Payer: Aetna Medicare |
$159.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.74
|
| Rate for Payer: BCBS Complete |
$127.84
|
| Rate for Payer: Cash Price |
$255.68
|
| Rate for Payer: Cofinity Commercial |
$223.72
|
| Rate for Payer: Cofinity Commercial |
$274.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$223.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.68
|
| Rate for Payer: Healthscope Commercial |
$287.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.66
|
| Rate for Payer: PHP Commercial |
$271.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.74
|
| Rate for Payer: Priority Health SBD |
$201.35
|
| Rate for Payer: UMR Bronson Commercial |
$118.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.70
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$446.50
|
|
|
Service Code
|
NDC 59762332801
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.21 |
| Max. Negotiated Rate |
$401.85 |
| Rate for Payer: Aetna American Axle |
$290.23
|
| Rate for Payer: Aetna Commercial |
$379.52
|
| Rate for Payer: Aetna Medicare |
$223.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.23
|
| Rate for Payer: BCBS Complete |
$178.60
|
| Rate for Payer: Cash Price |
$357.20
|
| Rate for Payer: Cofinity Commercial |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$383.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$312.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.20
|
| Rate for Payer: Healthscope Commercial |
$401.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.52
|
| Rate for Payer: PHP Commercial |
$379.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.23
|
| Rate for Payer: Priority Health SBD |
$281.30
|
| Rate for Payer: UMR Bronson Commercial |
$165.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.88
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$207.10
|
|
|
Service Code
|
NDC 68084024301
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.63 |
| Max. Negotiated Rate |
$186.39 |
| Rate for Payer: Aetna American Axle |
$134.62
|
| Rate for Payer: Aetna Commercial |
$176.03
|
| Rate for Payer: Aetna Medicare |
$103.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.62
|
| Rate for Payer: BCBS Complete |
$82.84
|
| Rate for Payer: Cash Price |
$165.68
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Cofinity Commercial |
$178.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.68
|
| Rate for Payer: Healthscope Commercial |
$186.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.03
|
| Rate for Payer: PHP Commercial |
$176.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.62
|
| Rate for Payer: Priority Health SBD |
$130.47
|
| Rate for Payer: UMR Bronson Commercial |
$76.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.32
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$4.54
|
|
|
Service Code
|
NDC 42292001801
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna American Axle |
$2.95
|
| Rate for Payer: Aetna Commercial |
$3.86
|
| Rate for Payer: Aetna Medicare |
$2.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.95
|
| Rate for Payer: BCBS Complete |
$1.82
|
| Rate for Payer: Cash Price |
$3.63
|
| Rate for Payer: Cofinity Commercial |
$3.18
|
| Rate for Payer: Cofinity Commercial |
$3.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.63
|
| Rate for Payer: Healthscope Commercial |
$4.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.86
|
| Rate for Payer: PHP Commercial |
$3.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.95
|
| Rate for Payer: Priority Health SBD |
$2.86
|
| Rate for Payer: UMR Bronson Commercial |
$1.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.40
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$453.55
|
|
|
Service Code
|
NDC 42292001820
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$199.56 |
| Max. Negotiated Rate |
$408.19 |
| Rate for Payer: Aetna American Axle |
$294.81
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$317.49
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$408.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: UMR Bronson Commercial |
$199.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.16
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
OP
|
$400.32
|
|
|
Service Code
|
NDC 00904719461
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$148.12 |
| Max. Negotiated Rate |
$360.29 |
| Rate for Payer: Aetna American Axle |
$260.21
|
| Rate for Payer: Aetna Commercial |
$340.27
|
| Rate for Payer: Aetna Medicare |
$200.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.21
|
| Rate for Payer: BCBS Complete |
$160.13
|
| Rate for Payer: Cash Price |
$320.26
|
| Rate for Payer: Cofinity Commercial |
$280.22
|
| Rate for Payer: Cofinity Commercial |
$344.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$280.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.26
|
| Rate for Payer: Healthscope Commercial |
$360.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.27
|
| Rate for Payer: PHP Commercial |
$340.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.21
|
| Rate for Payer: Priority Health SBD |
$252.20
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.24
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
IP
|
$223.25
|
|
|
Service Code
|
NDC 42571025201
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.23 |
| Max. Negotiated Rate |
$200.93 |
| Rate for Payer: Aetna American Axle |
$145.11
|
| Rate for Payer: Aetna Commercial |
$189.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.11
|
| Rate for Payer: Cash Price |
$178.60
|
| Rate for Payer: Cofinity Commercial |
$156.28
|
| Rate for Payer: Cofinity Commercial |
$192.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.60
|
| Rate for Payer: Healthscope Commercial |
$200.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.76
|
| Rate for Payer: PHP Commercial |
$189.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.11
|
| Rate for Payer: Priority Health SBD |
$140.65
|
| Rate for Payer: UMR Bronson Commercial |
$98.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.44
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
NDC 68084024401
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.88 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$193.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
NDC 68084024411
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.04 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$220.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: BCBS Complete |
$176.26
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$163.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
NDC 68084024401
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.04 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$220.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: BCBS Complete |
$176.26
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$163.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
OP
|
$223.25
|
|
|
Service Code
|
NDC 42571025201
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$200.93 |
| Rate for Payer: Aetna American Axle |
$145.11
|
| Rate for Payer: Aetna Commercial |
$189.76
|
| Rate for Payer: Aetna Medicare |
$111.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.11
|
| Rate for Payer: BCBS Complete |
$89.30
|
| Rate for Payer: Cash Price |
$178.60
|
| Rate for Payer: Cofinity Commercial |
$156.28
|
| Rate for Payer: Cofinity Commercial |
$192.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.60
|
| Rate for Payer: Healthscope Commercial |
$200.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.76
|
| Rate for Payer: PHP Commercial |
$189.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.11
|
| Rate for Payer: Priority Health SBD |
$140.65
|
| Rate for Payer: UMR Bronson Commercial |
$82.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.44
|
|
|
CLINDAMYCIN HCL 300 MG CAPSULE
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
NDC 68084024411
|
| Hospital Charge Code |
9621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.88 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$193.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
