|
ATOMOXETINE 25 MG CAPSULE
|
Facility
|
IP
|
$1,360.53
|
|
|
Service Code
|
NDC 00002322830
|
| Hospital Charge Code |
34446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$598.63 |
| Max. Negotiated Rate |
$1,224.48 |
| Rate for Payer: Aetna American Axle |
$884.34
|
| Rate for Payer: Aetna Commercial |
$1,156.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.34
|
| Rate for Payer: Cash Price |
$1,088.42
|
| Rate for Payer: Cofinity Advantage |
$952.37
|
| Rate for Payer: Cofinity Commercial |
$1,170.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.42
|
| Rate for Payer: Healthscope Commercial |
$1,224.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$952.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,020.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,020.40
|
| Rate for Payer: PHP Commercial |
$1,156.45
|
| Rate for Payer: Priority Health SBD |
$857.13
|
| Rate for Payer: UMR Bronson Commercial |
$598.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,020.40
|
|
|
ATOMOXETINE 25 MG CAPSULE
|
Facility
|
IP
|
$314.58
|
|
|
Service Code
|
NDC 60687056721
|
| Hospital Charge Code |
34446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$138.42 |
| Max. Negotiated Rate |
$283.12 |
| Rate for Payer: Aetna American Axle |
$204.48
|
| Rate for Payer: Aetna Commercial |
$267.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.48
|
| Rate for Payer: Cash Price |
$251.66
|
| Rate for Payer: Cofinity Advantage |
$220.21
|
| Rate for Payer: Cofinity Commercial |
$270.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.66
|
| Rate for Payer: Healthscope Commercial |
$283.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.94
|
| Rate for Payer: PHP Commercial |
$267.39
|
| Rate for Payer: Priority Health SBD |
$198.19
|
| Rate for Payer: UMR Bronson Commercial |
$138.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.94
|
|
|
ATOMOXETINE 25 MG CAPSULE
|
Facility
|
OP
|
$1,360.53
|
|
|
Service Code
|
NDC 00002322830
|
| Hospital Charge Code |
34446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$503.40 |
| Max. Negotiated Rate |
$1,224.48 |
| Rate for Payer: Aetna American Axle |
$884.34
|
| Rate for Payer: Aetna Commercial |
$1,156.45
|
| Rate for Payer: Aetna Medicare |
$680.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.34
|
| Rate for Payer: BCBS Complete |
$544.21
|
| Rate for Payer: Cash Price |
$1,088.42
|
| Rate for Payer: Cofinity Advantage |
$952.37
|
| Rate for Payer: Cofinity Commercial |
$1,170.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.42
|
| Rate for Payer: Healthscope Commercial |
$1,224.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$952.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,020.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,088.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,020.40
|
| Rate for Payer: PHP Commercial |
$1,156.45
|
| Rate for Payer: Priority Health SBD |
$857.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.34
|
| Rate for Payer: UHC Core |
$708.84
|
| Rate for Payer: UHC Exchange |
$534.69
|
| Rate for Payer: UMR Bronson Commercial |
$503.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,020.40
|
|
|
ATOMOXETINE 25 MG CAPSULE
|
Facility
|
OP
|
$10.49
|
|
|
Service Code
|
NDC 60687056711
|
| Hospital Charge Code |
34446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$9.44 |
| Rate for Payer: Aetna American Axle |
$6.82
|
| Rate for Payer: Aetna Commercial |
$8.92
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.82
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: Cash Price |
$8.39
|
| Rate for Payer: Cofinity Advantage |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$9.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.39
|
| Rate for Payer: Healthscope Commercial |
$9.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.87
|
| Rate for Payer: PHP Commercial |
$8.92
|
| Rate for Payer: Priority Health SBD |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.82
|
| Rate for Payer: UHC Core |
$5.47
|
| Rate for Payer: UHC Exchange |
$4.12
|
| Rate for Payer: UMR Bronson Commercial |
$3.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.87
|
|
|
ATOMOXETINE 25 MG CAPSULE
|
Facility
|
OP
|
$314.58
|
|
|
Service Code
|
NDC 60687056721
|
| Hospital Charge Code |
34446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$116.39 |
| Max. Negotiated Rate |
$283.12 |
| Rate for Payer: Aetna American Axle |
$204.48
|
| Rate for Payer: Aetna Commercial |
$267.39
|
| Rate for Payer: Aetna Medicare |
$157.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.48
|
| Rate for Payer: BCBS Complete |
$125.83
|
| Rate for Payer: Cash Price |
$251.66
|
| Rate for Payer: Cofinity Advantage |
$220.21
|
| Rate for Payer: Cofinity Commercial |
$270.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.66
|
| Rate for Payer: Healthscope Commercial |
$283.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.94
|
| Rate for Payer: PHP Commercial |
$267.39
|
| Rate for Payer: Priority Health SBD |
$198.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.48
|
| Rate for Payer: UHC Core |
$163.90
|
| Rate for Payer: UHC Exchange |
$123.63
|
| Rate for Payer: UMR Bronson Commercial |
$116.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.94
|
|
|
ATOMOXETINE 25 MG CAPSULE
|
Facility
|
IP
|
$10.49
|
|
|
Service Code
|
NDC 60687056711
|
| Hospital Charge Code |
34446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$9.44 |
| Rate for Payer: Aetna American Axle |
$6.82
|
| Rate for Payer: Aetna Commercial |
$8.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.82
|
| Rate for Payer: Cash Price |
$8.39
|
| Rate for Payer: Cofinity Advantage |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$9.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.39
|
| Rate for Payer: Healthscope Commercial |
$9.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.87
|
| Rate for Payer: PHP Commercial |
$8.92
|
| Rate for Payer: Priority Health SBD |
$6.61
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.87
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$376.29
|
|
|
Service Code
|
NDC 00904690804
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.57 |
| Max. Negotiated Rate |
$338.66 |
| Rate for Payer: Aetna American Axle |
$244.59
|
| Rate for Payer: Aetna Commercial |
$319.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.59
|
| Rate for Payer: Cash Price |
$301.03
|
| Rate for Payer: Cofinity Advantage |
$263.40
|
| Rate for Payer: Cofinity Commercial |
$323.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$338.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$263.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.22
|
| Rate for Payer: PHP Commercial |
$319.85
|
| Rate for Payer: Priority Health SBD |
$237.06
|
| Rate for Payer: UMR Bronson Commercial |
$165.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.22
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$405.93
|
|
|
Service Code
|
NDC 50268005813
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.61 |
| Max. Negotiated Rate |
$365.34 |
| Rate for Payer: Aetna American Axle |
$263.85
|
| Rate for Payer: Aetna Commercial |
$345.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.85
|
| Rate for Payer: Cash Price |
$324.74
|
| Rate for Payer: Cofinity Advantage |
$284.15
|
| Rate for Payer: Cofinity Commercial |
$349.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.74
|
| Rate for Payer: Healthscope Commercial |
$365.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.45
|
| Rate for Payer: PHP Commercial |
$345.04
|
| Rate for Payer: Priority Health SBD |
$255.74
|
| Rate for Payer: UMR Bronson Commercial |
$178.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.45
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$237.03
|
|
|
Service Code
|
NDC 31722071730
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.70 |
| Max. Negotiated Rate |
$213.33 |
| Rate for Payer: Aetna American Axle |
$154.07
|
| Rate for Payer: Aetna Commercial |
$201.48
|
| Rate for Payer: Aetna Medicare |
$118.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.07
|
| Rate for Payer: BCBS Complete |
$94.81
|
| Rate for Payer: Cash Price |
$189.62
|
| Rate for Payer: Cofinity Advantage |
$165.92
|
| Rate for Payer: Cofinity Commercial |
$203.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.62
|
| Rate for Payer: Healthscope Commercial |
$213.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.77
|
| Rate for Payer: PHP Commercial |
$201.48
|
| Rate for Payer: Priority Health SBD |
$149.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.07
|
| Rate for Payer: UHC Core |
$123.49
|
| Rate for Payer: UHC Exchange |
$93.15
|
| Rate for Payer: UMR Bronson Commercial |
$87.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.77
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$232.42
|
|
|
Service Code
|
NDC 68462026830
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$102.26 |
| Max. Negotiated Rate |
$209.18 |
| Rate for Payer: Aetna American Axle |
$151.07
|
| Rate for Payer: Aetna Commercial |
$197.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.07
|
| Rate for Payer: Cash Price |
$185.94
|
| Rate for Payer: Cofinity Advantage |
$162.69
|
| Rate for Payer: Cofinity Commercial |
$199.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.94
|
| Rate for Payer: Healthscope Commercial |
$209.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$162.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.31
|
| Rate for Payer: PHP Commercial |
$197.56
|
| Rate for Payer: Priority Health SBD |
$146.42
|
| Rate for Payer: UMR Bronson Commercial |
$102.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.31
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$237.03
|
|
|
Service Code
|
NDC 31722071730
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.29 |
| Max. Negotiated Rate |
$213.33 |
| Rate for Payer: Aetna American Axle |
$154.07
|
| Rate for Payer: Aetna Commercial |
$201.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.07
|
| Rate for Payer: Cash Price |
$189.62
|
| Rate for Payer: Cofinity Advantage |
$165.92
|
| Rate for Payer: Cofinity Commercial |
$203.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.62
|
| Rate for Payer: Healthscope Commercial |
$213.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.77
|
| Rate for Payer: PHP Commercial |
$201.48
|
| Rate for Payer: Priority Health SBD |
$149.33
|
| Rate for Payer: UMR Bronson Commercial |
$104.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.77
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$415.14
|
|
|
Service Code
|
NDC 00093354556
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.66 |
| Max. Negotiated Rate |
$373.63 |
| Rate for Payer: Aetna American Axle |
$269.84
|
| Rate for Payer: Aetna Commercial |
$352.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.84
|
| Rate for Payer: Cash Price |
$332.11
|
| Rate for Payer: Cofinity Advantage |
$290.60
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.11
|
| Rate for Payer: Healthscope Commercial |
$373.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$311.36
|
| Rate for Payer: PHP Commercial |
$352.87
|
| Rate for Payer: Priority Health SBD |
$261.54
|
| Rate for Payer: UMR Bronson Commercial |
$182.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.36
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$415.14
|
|
|
Service Code
|
NDC 60505283303
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.60 |
| Max. Negotiated Rate |
$373.63 |
| Rate for Payer: Aetna American Axle |
$269.84
|
| Rate for Payer: Aetna Commercial |
$352.87
|
| Rate for Payer: Aetna Medicare |
$207.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.84
|
| Rate for Payer: BCBS Complete |
$166.06
|
| Rate for Payer: Cash Price |
$332.11
|
| Rate for Payer: Cofinity Advantage |
$290.60
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.11
|
| Rate for Payer: Healthscope Commercial |
$373.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$311.36
|
| Rate for Payer: PHP Commercial |
$352.87
|
| Rate for Payer: Priority Health SBD |
$261.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.84
|
| Rate for Payer: UHC Core |
$216.29
|
| Rate for Payer: UHC Exchange |
$163.15
|
| Rate for Payer: UMR Bronson Commercial |
$153.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.36
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$13.54
|
|
|
Service Code
|
NDC 50268005811
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.01 |
| Max. Negotiated Rate |
$12.19 |
| Rate for Payer: Aetna American Axle |
$8.80
|
| Rate for Payer: Aetna Commercial |
$11.51
|
| Rate for Payer: Aetna Medicare |
$6.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.80
|
| Rate for Payer: BCBS Complete |
$5.42
|
| Rate for Payer: Cash Price |
$10.83
|
| Rate for Payer: Cofinity Advantage |
$9.48
|
| Rate for Payer: Cofinity Commercial |
$11.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.83
|
| Rate for Payer: Healthscope Commercial |
$12.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.15
|
| Rate for Payer: PHP Commercial |
$11.51
|
| Rate for Payer: Priority Health SBD |
$8.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.80
|
| Rate for Payer: UHC Core |
$7.05
|
| Rate for Payer: UHC Exchange |
$5.32
|
| Rate for Payer: UMR Bronson Commercial |
$5.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.15
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$1,478.30
|
|
|
Service Code
|
NDC 00002322930
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$546.97 |
| Max. Negotiated Rate |
$1,330.47 |
| Rate for Payer: Aetna American Axle |
$960.89
|
| Rate for Payer: Aetna Commercial |
$1,256.56
|
| Rate for Payer: Aetna Medicare |
$739.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.89
|
| Rate for Payer: BCBS Complete |
$591.32
|
| Rate for Payer: Cash Price |
$1,182.64
|
| Rate for Payer: Cofinity Advantage |
$1,034.81
|
| Rate for Payer: Cofinity Commercial |
$1,271.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.64
|
| Rate for Payer: Healthscope Commercial |
$1,330.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,034.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,182.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.72
|
| Rate for Payer: PHP Commercial |
$1,256.56
|
| Rate for Payer: Priority Health SBD |
$931.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.89
|
| Rate for Payer: UHC Core |
$770.19
|
| Rate for Payer: UHC Exchange |
$580.97
|
| Rate for Payer: UMR Bronson Commercial |
$546.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.72
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$415.14
|
|
|
Service Code
|
NDC 60505283303
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.66 |
| Max. Negotiated Rate |
$373.63 |
| Rate for Payer: Aetna American Axle |
$269.84
|
| Rate for Payer: Aetna Commercial |
$352.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.84
|
| Rate for Payer: Cash Price |
$332.11
|
| Rate for Payer: Cofinity Advantage |
$290.60
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.11
|
| Rate for Payer: Healthscope Commercial |
$373.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$311.36
|
| Rate for Payer: PHP Commercial |
$352.87
|
| Rate for Payer: Priority Health SBD |
$261.54
|
| Rate for Payer: UMR Bronson Commercial |
$182.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.36
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$145.59
|
|
|
Service Code
|
NDC 64980037603
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.87 |
| Max. Negotiated Rate |
$131.03 |
| Rate for Payer: Aetna American Axle |
$94.63
|
| Rate for Payer: Aetna Commercial |
$123.75
|
| Rate for Payer: Aetna Medicare |
$72.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.63
|
| Rate for Payer: BCBS Complete |
$58.24
|
| Rate for Payer: Cash Price |
$116.47
|
| Rate for Payer: Cofinity Advantage |
$101.91
|
| Rate for Payer: Cofinity Commercial |
$125.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.47
|
| Rate for Payer: Healthscope Commercial |
$131.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.19
|
| Rate for Payer: PHP Commercial |
$123.75
|
| Rate for Payer: Priority Health SBD |
$91.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.63
|
| Rate for Payer: UHC Core |
$75.85
|
| Rate for Payer: UHC Exchange |
$57.22
|
| Rate for Payer: UMR Bronson Commercial |
$53.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.19
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$13.54
|
|
|
Service Code
|
NDC 50268005811
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$12.19 |
| Rate for Payer: Aetna American Axle |
$8.80
|
| Rate for Payer: Aetna Commercial |
$11.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.80
|
| Rate for Payer: Cash Price |
$10.83
|
| Rate for Payer: Cofinity Advantage |
$9.48
|
| Rate for Payer: Cofinity Commercial |
$11.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.83
|
| Rate for Payer: Healthscope Commercial |
$12.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.15
|
| Rate for Payer: PHP Commercial |
$11.51
|
| Rate for Payer: Priority Health SBD |
$8.53
|
| Rate for Payer: UMR Bronson Commercial |
$5.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.15
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$232.42
|
|
|
Service Code
|
NDC 68462026830
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$209.18 |
| Rate for Payer: Aetna American Axle |
$151.07
|
| Rate for Payer: Aetna Commercial |
$197.56
|
| Rate for Payer: Aetna Medicare |
$116.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.07
|
| Rate for Payer: BCBS Complete |
$92.97
|
| Rate for Payer: Cash Price |
$185.94
|
| Rate for Payer: Cofinity Advantage |
$162.69
|
| Rate for Payer: Cofinity Commercial |
$199.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.94
|
| Rate for Payer: Healthscope Commercial |
$209.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$162.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.31
|
| Rate for Payer: PHP Commercial |
$197.56
|
| Rate for Payer: Priority Health SBD |
$146.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.07
|
| Rate for Payer: UHC Core |
$121.09
|
| Rate for Payer: UHC Exchange |
$91.34
|
| Rate for Payer: UMR Bronson Commercial |
$86.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.31
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$415.14
|
|
|
Service Code
|
NDC 00093354556
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.60 |
| Max. Negotiated Rate |
$373.63 |
| Rate for Payer: Aetna American Axle |
$269.84
|
| Rate for Payer: Aetna Commercial |
$352.87
|
| Rate for Payer: Aetna Medicare |
$207.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.84
|
| Rate for Payer: BCBS Complete |
$166.06
|
| Rate for Payer: Cash Price |
$332.11
|
| Rate for Payer: Cofinity Advantage |
$290.60
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.11
|
| Rate for Payer: Healthscope Commercial |
$373.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$311.36
|
| Rate for Payer: PHP Commercial |
$352.87
|
| Rate for Payer: Priority Health SBD |
$261.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.84
|
| Rate for Payer: UHC Core |
$216.29
|
| Rate for Payer: UHC Exchange |
$163.15
|
| Rate for Payer: UMR Bronson Commercial |
$153.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.36
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$1,478.30
|
|
|
Service Code
|
NDC 00002322930
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$650.45 |
| Max. Negotiated Rate |
$1,330.47 |
| Rate for Payer: Aetna American Axle |
$960.89
|
| Rate for Payer: Aetna Commercial |
$1,256.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.89
|
| Rate for Payer: Cash Price |
$1,182.64
|
| Rate for Payer: Cofinity Advantage |
$1,034.81
|
| Rate for Payer: Cofinity Commercial |
$1,271.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.64
|
| Rate for Payer: Healthscope Commercial |
$1,330.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,034.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.72
|
| Rate for Payer: PHP Commercial |
$1,256.56
|
| Rate for Payer: Priority Health SBD |
$931.33
|
| Rate for Payer: UMR Bronson Commercial |
$650.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.72
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$376.29
|
|
|
Service Code
|
NDC 00904690804
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.23 |
| Max. Negotiated Rate |
$338.66 |
| Rate for Payer: Aetna American Axle |
$244.59
|
| Rate for Payer: Aetna Commercial |
$319.85
|
| Rate for Payer: Aetna Medicare |
$188.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.59
|
| Rate for Payer: BCBS Complete |
$150.52
|
| Rate for Payer: Cash Price |
$301.03
|
| Rate for Payer: Cofinity Advantage |
$263.40
|
| Rate for Payer: Cofinity Commercial |
$323.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$338.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$263.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$301.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.22
|
| Rate for Payer: PHP Commercial |
$319.85
|
| Rate for Payer: Priority Health SBD |
$237.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.59
|
| Rate for Payer: UHC Core |
$196.05
|
| Rate for Payer: UHC Exchange |
$147.88
|
| Rate for Payer: UMR Bronson Commercial |
$139.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.22
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
OP
|
$405.93
|
|
|
Service Code
|
NDC 50268005813
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.19 |
| Max. Negotiated Rate |
$365.34 |
| Rate for Payer: Aetna American Axle |
$263.85
|
| Rate for Payer: Aetna Commercial |
$345.04
|
| Rate for Payer: Aetna Medicare |
$202.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.85
|
| Rate for Payer: BCBS Complete |
$162.37
|
| Rate for Payer: Cash Price |
$324.74
|
| Rate for Payer: Cofinity Advantage |
$284.15
|
| Rate for Payer: Cofinity Commercial |
$349.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.74
|
| Rate for Payer: Healthscope Commercial |
$365.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$324.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.45
|
| Rate for Payer: PHP Commercial |
$345.04
|
| Rate for Payer: Priority Health SBD |
$255.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.85
|
| Rate for Payer: UHC Core |
$211.49
|
| Rate for Payer: UHC Exchange |
$159.53
|
| Rate for Payer: UMR Bronson Commercial |
$150.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.45
|
|
|
ATOMOXETINE 40 MG CAPSULE
|
Facility
|
IP
|
$145.59
|
|
|
Service Code
|
NDC 64980037603
|
| Hospital Charge Code |
34447
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.06 |
| Max. Negotiated Rate |
$131.03 |
| Rate for Payer: Aetna American Axle |
$94.63
|
| Rate for Payer: Aetna Commercial |
$123.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.63
|
| Rate for Payer: Cash Price |
$116.47
|
| Rate for Payer: Cofinity Advantage |
$101.91
|
| Rate for Payer: Cofinity Commercial |
$125.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.47
|
| Rate for Payer: Healthscope Commercial |
$131.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.19
|
| Rate for Payer: PHP Commercial |
$123.75
|
| Rate for Payer: Priority Health SBD |
$91.72
|
| Rate for Payer: UMR Bronson Commercial |
$64.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.19
|
|
|
ATOMOXETINE 60 MG CAPSULE
|
Facility
|
IP
|
$1,318.49
|
|
|
Service Code
|
NDC 00002323930
|
| Hospital Charge Code |
34448
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$580.14 |
| Max. Negotiated Rate |
$1,186.64 |
| Rate for Payer: Aetna American Axle |
$857.02
|
| Rate for Payer: Aetna Commercial |
$1,120.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.02
|
| Rate for Payer: Cash Price |
$1,054.79
|
| Rate for Payer: Cofinity Advantage |
$922.94
|
| Rate for Payer: Cofinity Commercial |
$1,133.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,054.79
|
| Rate for Payer: Healthscope Commercial |
$1,186.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$922.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$988.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,120.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$988.87
|
| Rate for Payer: PHP Commercial |
$1,120.72
|
| Rate for Payer: Priority Health SBD |
$830.65
|
| Rate for Payer: UMR Bronson Commercial |
$580.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$988.87
|
|
