|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$132.30
|
|
|
Service Code
|
NDC 09629513811
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.21 |
| Max. Negotiated Rate |
$119.07 |
| Rate for Payer: Aetna American Axle |
$86.00
|
| Rate for Payer: Aetna Commercial |
$112.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.00
|
| Rate for Payer: Cash Price |
$105.84
|
| Rate for Payer: Cofinity Advantage |
$92.61
|
| Rate for Payer: Cofinity Commercial |
$113.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.84
|
| Rate for Payer: Healthscope Commercial |
$119.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.22
|
| Rate for Payer: PHP Commercial |
$112.45
|
| Rate for Payer: Priority Health SBD |
$83.35
|
| Rate for Payer: UMR Bronson Commercial |
$58.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.22
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$38.31
|
|
|
Service Code
|
NDC 68084098832
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.17 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna American Axle |
$24.90
|
| Rate for Payer: Aetna Commercial |
$32.56
|
| Rate for Payer: Aetna Medicare |
$19.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.90
|
| Rate for Payer: BCBS Complete |
$15.32
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Advantage |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$32.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: Priority Health SBD |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.90
|
| Rate for Payer: UHC Core |
$19.96
|
| Rate for Payer: UHC Exchange |
$15.06
|
| Rate for Payer: UMR Bronson Commercial |
$14.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.73
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$141.75
|
|
|
Service Code
|
NDC 70000003401
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.45 |
| Max. Negotiated Rate |
$127.58 |
| Rate for Payer: Aetna American Axle |
$92.14
|
| Rate for Payer: Aetna Commercial |
$120.49
|
| Rate for Payer: Aetna Medicare |
$70.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.14
|
| Rate for Payer: BCBS Complete |
$56.70
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cofinity Advantage |
$99.22
|
| Rate for Payer: Cofinity Commercial |
$121.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.40
|
| Rate for Payer: Healthscope Commercial |
$127.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.31
|
| Rate for Payer: PHP Commercial |
$120.49
|
| Rate for Payer: Priority Health SBD |
$89.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.14
|
| Rate for Payer: UHC Core |
$73.85
|
| Rate for Payer: UHC Exchange |
$55.71
|
| Rate for Payer: UMR Bronson Commercial |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.31
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$1.92
|
|
|
Service Code
|
NDC 68084098833
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$1.73 |
| Rate for Payer: Aetna American Axle |
$1.25
|
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.25
|
| Rate for Payer: BCBS Complete |
$0.77
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Advantage |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Healthscope Commercial |
$1.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: PHP Commercial |
$1.63
|
| Rate for Payer: Priority Health SBD |
$1.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.25
|
| Rate for Payer: UHC Core |
$1.00
|
| Rate for Payer: UHC Exchange |
$0.75
|
| Rate for Payer: UMR Bronson Commercial |
$0.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.44
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$38.31
|
|
|
Service Code
|
NDC 68084098832
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna American Axle |
$24.90
|
| Rate for Payer: Aetna Commercial |
$32.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.90
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Advantage |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$32.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: Priority Health SBD |
$24.14
|
| Rate for Payer: UMR Bronson Commercial |
$16.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.73
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
NDC 66553000401
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$304.92 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Aetna American Axle |
$450.45
|
| Rate for Payer: Aetna Commercial |
$589.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.45
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Advantage |
$485.10
|
| Rate for Payer: Cofinity Commercial |
$595.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.40
|
| Rate for Payer: Healthscope Commercial |
$623.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$485.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$519.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$519.75
|
| Rate for Payer: PHP Commercial |
$589.05
|
| Rate for Payer: Priority Health SBD |
$436.59
|
| Rate for Payer: UMR Bronson Commercial |
$304.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$519.75
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$179.55
|
|
|
Service Code
|
NDC 00536100715
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.00 |
| Max. Negotiated Rate |
$161.59 |
| Rate for Payer: Aetna American Axle |
$116.71
|
| Rate for Payer: Aetna Commercial |
$152.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.71
|
| Rate for Payer: Cash Price |
$143.64
|
| Rate for Payer: Cofinity Advantage |
$125.69
|
| Rate for Payer: Cofinity Commercial |
$154.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.64
|
| Rate for Payer: Healthscope Commercial |
$161.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.66
|
| Rate for Payer: PHP Commercial |
$152.62
|
| Rate for Payer: Priority Health SBD |
$113.12
|
| Rate for Payer: UMR Bronson Commercial |
$79.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.66
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$179.55
|
|
|
Service Code
|
NDC 00536100715
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.43 |
| Max. Negotiated Rate |
$161.59 |
| Rate for Payer: Aetna American Axle |
$116.71
|
| Rate for Payer: Aetna Commercial |
$152.62
|
| Rate for Payer: Aetna Medicare |
$89.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.71
|
| Rate for Payer: BCBS Complete |
$71.82
|
| Rate for Payer: Cash Price |
$143.64
|
| Rate for Payer: Cofinity Advantage |
$125.69
|
| Rate for Payer: Cofinity Commercial |
$154.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.64
|
| Rate for Payer: Healthscope Commercial |
$161.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.66
|
| Rate for Payer: PHP Commercial |
$152.62
|
| Rate for Payer: Priority Health SBD |
$113.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.71
|
| Rate for Payer: UHC Core |
$93.55
|
| Rate for Payer: UHC Exchange |
$70.56
|
| Rate for Payer: UMR Bronson Commercial |
$66.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.66
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$132.30
|
|
|
Service Code
|
NDC 09629513811
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.95 |
| Max. Negotiated Rate |
$119.07 |
| Rate for Payer: Aetna American Axle |
$86.00
|
| Rate for Payer: Aetna Commercial |
$112.45
|
| Rate for Payer: Aetna Medicare |
$66.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.00
|
| Rate for Payer: BCBS Complete |
$52.92
|
| Rate for Payer: Cash Price |
$105.84
|
| Rate for Payer: Cofinity Advantage |
$92.61
|
| Rate for Payer: Cofinity Commercial |
$113.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.84
|
| Rate for Payer: Healthscope Commercial |
$119.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.22
|
| Rate for Payer: PHP Commercial |
$112.45
|
| Rate for Payer: Priority Health SBD |
$83.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.00
|
| Rate for Payer: UHC Core |
$68.93
|
| Rate for Payer: UHC Exchange |
$51.99
|
| Rate for Payer: UMR Bronson Commercial |
$48.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.22
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$1.92
|
|
|
Service Code
|
NDC 68084098833
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$1.73 |
| Rate for Payer: Aetna American Axle |
$1.25
|
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.25
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Advantage |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Healthscope Commercial |
$1.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: PHP Commercial |
$1.63
|
| Rate for Payer: Priority Health SBD |
$1.21
|
| Rate for Payer: UMR Bronson Commercial |
$0.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.44
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$141.75
|
|
|
Service Code
|
NDC 70000003401
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$127.58 |
| Rate for Payer: Aetna American Axle |
$92.14
|
| Rate for Payer: Aetna Commercial |
$120.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.14
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cofinity Advantage |
$99.22
|
| Rate for Payer: Cofinity Commercial |
$121.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.40
|
| Rate for Payer: Healthscope Commercial |
$127.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.31
|
| Rate for Payer: PHP Commercial |
$120.49
|
| Rate for Payer: Priority Health SBD |
$89.30
|
| Rate for Payer: UMR Bronson Commercial |
$62.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.31
|
|
|
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
NDC 80681014000
|
| Hospital Charge Code |
1308
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.84 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna American Axle |
$88.40
|
| Rate for Payer: Aetna Commercial |
$115.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.40
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Advantage |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$116.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.80
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PHP Commercial |
$115.60
|
| Rate for Payer: Priority Health SBD |
$85.68
|
| Rate for Payer: UMR Bronson Commercial |
$59.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.00
|
|
|
CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
NDC 80681014000
|
| Hospital Charge Code |
1308
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna American Axle |
$88.40
|
| Rate for Payer: Aetna Commercial |
$115.60
|
| Rate for Payer: Aetna Medicare |
$68.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.40
|
| Rate for Payer: BCBS Complete |
$54.40
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Advantage |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$116.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.80
|
| Rate for Payer: Healthscope Commercial |
$122.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PHP Commercial |
$115.60
|
| Rate for Payer: Priority Health SBD |
$85.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.40
|
| Rate for Payer: UHC Core |
$70.86
|
| Rate for Payer: UHC Exchange |
$53.45
|
| Rate for Payer: UMR Bronson Commercial |
$50.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.00
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 09900001946
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Aetna American Axle |
$1.30
|
| Rate for Payer: Aetna Commercial |
$1.70
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.30
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Advantage |
$1.40
|
| Rate for Payer: Cofinity Commercial |
$1.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.60
|
| Rate for Payer: Healthscope Commercial |
$1.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: PHP Commercial |
$1.70
|
| Rate for Payer: Priority Health SBD |
$1.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.30
|
| Rate for Payer: UHC Core |
$1.04
|
| Rate for Payer: UHC Exchange |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.50
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
IP
|
$211.20
|
|
|
Service Code
|
NDC 00121076616
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.93 |
| Max. Negotiated Rate |
$190.08 |
| Rate for Payer: Aetna American Axle |
$137.28
|
| Rate for Payer: Aetna Commercial |
$179.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.28
|
| Rate for Payer: Cash Price |
$168.96
|
| Rate for Payer: Cofinity Advantage |
$147.84
|
| Rate for Payer: Cofinity Commercial |
$181.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.96
|
| Rate for Payer: Healthscope Commercial |
$190.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.40
|
| Rate for Payer: PHP Commercial |
$179.52
|
| Rate for Payer: Priority Health SBD |
$133.06
|
| Rate for Payer: UMR Bronson Commercial |
$92.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.40
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
IP
|
$23.28
|
|
|
Service Code
|
NDC 00121476605
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$20.95 |
| Rate for Payer: Aetna American Axle |
$15.13
|
| Rate for Payer: Aetna Commercial |
$19.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.13
|
| Rate for Payer: Cash Price |
$18.62
|
| Rate for Payer: Cofinity Advantage |
$16.30
|
| Rate for Payer: Cofinity Commercial |
$20.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.62
|
| Rate for Payer: Healthscope Commercial |
$20.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.46
|
| Rate for Payer: PHP Commercial |
$19.79
|
| Rate for Payer: Priority Health SBD |
$14.67
|
| Rate for Payer: UMR Bronson Commercial |
$10.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.46
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
IP
|
$305.50
|
|
|
Service Code
|
NDC 00054311763
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.42 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna American Axle |
$198.57
|
| Rate for Payer: Aetna Commercial |
$259.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.57
|
| Rate for Payer: Cash Price |
$244.40
|
| Rate for Payer: Cofinity Advantage |
$213.85
|
| Rate for Payer: Cofinity Commercial |
$262.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.40
|
| Rate for Payer: Healthscope Commercial |
$274.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.12
|
| Rate for Payer: PHP Commercial |
$259.68
|
| Rate for Payer: Priority Health SBD |
$192.47
|
| Rate for Payer: UMR Bronson Commercial |
$134.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.12
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
OP
|
$305.50
|
|
|
Service Code
|
NDC 00054311763
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.03 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna American Axle |
$198.57
|
| Rate for Payer: Aetna Commercial |
$259.68
|
| Rate for Payer: Aetna Medicare |
$152.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.57
|
| Rate for Payer: BCBS Complete |
$122.20
|
| Rate for Payer: Cash Price |
$244.40
|
| Rate for Payer: Cofinity Advantage |
$213.85
|
| Rate for Payer: Cofinity Commercial |
$262.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.40
|
| Rate for Payer: Healthscope Commercial |
$274.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.12
|
| Rate for Payer: PHP Commercial |
$259.68
|
| Rate for Payer: Priority Health SBD |
$192.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.57
|
| Rate for Payer: UHC Core |
$159.17
|
| Rate for Payer: UHC Exchange |
$120.06
|
| Rate for Payer: UMR Bronson Commercial |
$113.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.12
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
OP
|
$23.28
|
|
|
Service Code
|
NDC 00121476605
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$20.95 |
| Rate for Payer: Aetna American Axle |
$15.13
|
| Rate for Payer: Aetna Commercial |
$19.79
|
| Rate for Payer: Aetna Medicare |
$11.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.13
|
| Rate for Payer: BCBS Complete |
$9.31
|
| Rate for Payer: Cash Price |
$18.62
|
| Rate for Payer: Cofinity Advantage |
$16.30
|
| Rate for Payer: Cofinity Commercial |
$20.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.62
|
| Rate for Payer: Healthscope Commercial |
$20.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.46
|
| Rate for Payer: PHP Commercial |
$19.79
|
| Rate for Payer: Priority Health SBD |
$14.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.13
|
| Rate for Payer: UHC Core |
$12.13
|
| Rate for Payer: UHC Exchange |
$9.15
|
| Rate for Payer: UMR Bronson Commercial |
$8.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.46
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
IP
|
$2.00
|
|
|
Service Code
|
NDC 09900001946
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Aetna American Axle |
$1.30
|
| Rate for Payer: Aetna Commercial |
$1.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.30
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Advantage |
$1.40
|
| Rate for Payer: Cofinity Commercial |
$1.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.60
|
| Rate for Payer: Healthscope Commercial |
$1.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: PHP Commercial |
$1.70
|
| Rate for Payer: Priority Health SBD |
$1.26
|
| Rate for Payer: UMR Bronson Commercial |
$0.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.50
|
|
|
CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION
|
Facility
|
OP
|
$211.20
|
|
|
Service Code
|
NDC 00121076616
|
| Hospital Charge Code |
1299
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.14 |
| Max. Negotiated Rate |
$190.08 |
| Rate for Payer: Aetna American Axle |
$137.28
|
| Rate for Payer: Aetna Commercial |
$179.52
|
| Rate for Payer: Aetna Medicare |
$105.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.28
|
| Rate for Payer: BCBS Complete |
$84.48
|
| Rate for Payer: Cash Price |
$168.96
|
| Rate for Payer: Cofinity Advantage |
$147.84
|
| Rate for Payer: Cofinity Commercial |
$181.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.96
|
| Rate for Payer: Healthscope Commercial |
$190.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.40
|
| Rate for Payer: PHP Commercial |
$179.52
|
| Rate for Payer: Priority Health SBD |
$133.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$110.04
|
| Rate for Payer: UHC Exchange |
$83.00
|
| Rate for Payer: UMR Bronson Commercial |
$78.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.40
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
NDC 00904188361
|
| Hospital Charge Code |
1300
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.32 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Advantage |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: UMR Bronson Commercial |
$56.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
NDC 00904188361
|
| Hospital Charge Code |
1300
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.36 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Advantage |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.20
|
| Rate for Payer: UHC Core |
$66.69
|
| Rate for Payer: UHC Exchange |
$50.30
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
NDC 904188361
|
| Hospital Charge Code |
1300
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.36 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Advantage |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.20
|
| Rate for Payer: UHC Core |
$66.69
|
| Rate for Payer: UHC Exchange |
$50.30
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET
|
Facility
|
OP
|
$340.20
|
|
|
Service Code
|
NDC 00904546072
|
| Hospital Charge Code |
19483
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.87 |
| Max. Negotiated Rate |
$306.18 |
| Rate for Payer: Aetna American Axle |
$221.13
|
| Rate for Payer: Aetna Commercial |
$289.17
|
| Rate for Payer: Aetna Medicare |
$170.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.13
|
| Rate for Payer: BCBS Complete |
$136.08
|
| Rate for Payer: Cash Price |
$272.16
|
| Rate for Payer: Cofinity Advantage |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$292.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.16
|
| Rate for Payer: Healthscope Commercial |
$306.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.15
|
| Rate for Payer: PHP Commercial |
$289.17
|
| Rate for Payer: Priority Health SBD |
$214.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.13
|
| Rate for Payer: UHC Core |
$177.24
|
| Rate for Payer: UHC Exchange |
$133.70
|
| Rate for Payer: UMR Bronson Commercial |
$125.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.15
|
|
