|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$479.49
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$210.98 |
| Max. Negotiated Rate |
$431.54 |
| Rate for Payer: Aetna American Axle |
$311.67
|
| Rate for Payer: Aetna Commercial |
$407.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.67
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Advantage |
$335.64
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.59
|
| Rate for Payer: Healthscope Commercial |
$431.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.62
|
| Rate for Payer: PHP Commercial |
$407.57
|
| Rate for Payer: Priority Health SBD |
$302.08
|
| Rate for Payer: UMR Bronson Commercial |
$210.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.62
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.36 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna American Axle |
$339.68
|
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna Medicare |
$261.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.68
|
| Rate for Payer: BCBS Complete |
$209.04
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Advantage |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$365.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$418.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.94
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health SBD |
$329.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.68
|
| Rate for Payer: UHC Core |
$272.27
|
| Rate for Payer: UHC Exchange |
$205.38
|
| Rate for Payer: UMR Bronson Commercial |
$193.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.94
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$447.56
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.93 |
| Max. Negotiated Rate |
$402.80 |
| Rate for Payer: Aetna American Axle |
$290.91
|
| Rate for Payer: Aetna Commercial |
$380.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: Cash Price |
$358.05
|
| Rate for Payer: Cofinity Advantage |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.05
|
| Rate for Payer: Healthscope Commercial |
$402.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.67
|
| Rate for Payer: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health SBD |
$281.96
|
| Rate for Payer: UMR Bronson Commercial |
$196.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.67
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$218.55
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.86 |
| Max. Negotiated Rate |
$196.69 |
| Rate for Payer: Aetna American Axle |
$142.06
|
| Rate for Payer: Aetna Commercial |
$185.77
|
| Rate for Payer: Aetna Medicare |
$109.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.06
|
| Rate for Payer: BCBS Complete |
$87.42
|
| Rate for Payer: Cash Price |
$174.84
|
| Rate for Payer: Cofinity Advantage |
$152.99
|
| Rate for Payer: Cofinity Commercial |
$187.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.84
|
| Rate for Payer: Healthscope Commercial |
$196.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.91
|
| Rate for Payer: PHP Commercial |
$185.77
|
| Rate for Payer: Priority Health SBD |
$137.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.06
|
| Rate for Payer: UHC Core |
$113.86
|
| Rate for Payer: UHC Exchange |
$85.89
|
| Rate for Payer: UMR Bronson Commercial |
$80.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.91
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$229.94 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna American Axle |
$339.68
|
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.68
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Advantage |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$365.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.94
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health SBD |
$329.23
|
| Rate for Payer: UMR Bronson Commercial |
$229.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.94
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$447.56
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.60 |
| Max. Negotiated Rate |
$402.80 |
| Rate for Payer: Aetna American Axle |
$290.91
|
| Rate for Payer: Aetna Commercial |
$380.43
|
| Rate for Payer: Aetna Medicare |
$223.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: BCBS Complete |
$179.02
|
| Rate for Payer: Cash Price |
$358.05
|
| Rate for Payer: Cofinity Advantage |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.05
|
| Rate for Payer: Healthscope Commercial |
$402.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$358.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.67
|
| Rate for Payer: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health SBD |
$281.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.91
|
| Rate for Payer: UHC Core |
$233.18
|
| Rate for Payer: UHC Exchange |
$175.89
|
| Rate for Payer: UMR Bronson Commercial |
$165.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.67
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$218.55
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.16 |
| Max. Negotiated Rate |
$196.69 |
| Rate for Payer: Aetna American Axle |
$142.06
|
| Rate for Payer: Aetna Commercial |
$185.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.06
|
| Rate for Payer: Cash Price |
$174.84
|
| Rate for Payer: Cofinity Advantage |
$152.99
|
| Rate for Payer: Cofinity Commercial |
$187.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.84
|
| Rate for Payer: Healthscope Commercial |
$196.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.91
|
| Rate for Payer: PHP Commercial |
$185.77
|
| Rate for Payer: Priority Health SBD |
$137.69
|
| Rate for Payer: UMR Bronson Commercial |
$96.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.91
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$63.60
|
|
|
Service Code
|
NDC 68180067711
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.53 |
| Max. Negotiated Rate |
$57.24 |
| Rate for Payer: Aetna American Axle |
$41.34
|
| Rate for Payer: Aetna Commercial |
$54.06
|
| Rate for Payer: Aetna Medicare |
$31.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.34
|
| Rate for Payer: BCBS Complete |
$25.44
|
| Rate for Payer: Cash Price |
$50.88
|
| Rate for Payer: Cofinity Advantage |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$57.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.70
|
| Rate for Payer: PHP Commercial |
$54.06
|
| Rate for Payer: Priority Health SBD |
$40.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.34
|
| Rate for Payer: UHC Core |
$33.14
|
| Rate for Payer: UHC Exchange |
$24.99
|
| Rate for Payer: UMR Bronson Commercial |
$23.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.70
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$275.25
|
|
|
Service Code
|
NDC 62332041510
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.11 |
| Max. Negotiated Rate |
$247.72 |
| Rate for Payer: Aetna American Axle |
$178.91
|
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.91
|
| Rate for Payer: Cash Price |
$220.20
|
| Rate for Payer: Cofinity Advantage |
$192.68
|
| Rate for Payer: Cofinity Commercial |
$236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.20
|
| Rate for Payer: Healthscope Commercial |
$247.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.44
|
| Rate for Payer: PHP Commercial |
$233.96
|
| Rate for Payer: Priority Health SBD |
$173.41
|
| Rate for Payer: UMR Bronson Commercial |
$121.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.44
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$86.03
|
|
|
Service Code
|
NDC 33342025866
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.85 |
| Max. Negotiated Rate |
$77.43 |
| Rate for Payer: Aetna American Axle |
$55.92
|
| Rate for Payer: Aetna Commercial |
$73.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.92
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cofinity Advantage |
$60.22
|
| Rate for Payer: Cofinity Commercial |
$73.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$77.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.52
|
| Rate for Payer: PHP Commercial |
$73.13
|
| Rate for Payer: Priority Health SBD |
$54.20
|
| Rate for Payer: UMR Bronson Commercial |
$37.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.52
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$963.48
|
|
|
Service Code
|
NDC 68094005061
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$356.49 |
| Max. Negotiated Rate |
$867.13 |
| Rate for Payer: Aetna American Axle |
$626.26
|
| Rate for Payer: Aetna Commercial |
$818.96
|
| Rate for Payer: Aetna Medicare |
$481.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.26
|
| Rate for Payer: BCBS Complete |
$385.39
|
| Rate for Payer: Cash Price |
$770.78
|
| Rate for Payer: Cofinity Advantage |
$674.44
|
| Rate for Payer: Cofinity Commercial |
$828.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$770.78
|
| Rate for Payer: Healthscope Commercial |
$867.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$674.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$722.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$770.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$818.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.61
|
| Rate for Payer: PHP Commercial |
$818.96
|
| Rate for Payer: Priority Health SBD |
$606.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.26
|
| Rate for Payer: UHC Core |
$501.97
|
| Rate for Payer: UHC Exchange |
$378.65
|
| Rate for Payer: UMR Bronson Commercial |
$356.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.61
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
NDC 31722063231
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.37 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna American Axle |
$58.16
|
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Advantage |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.10
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: UMR Bronson Commercial |
$39.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$9.64
|
|
|
Service Code
|
NDC 68094005059
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.24 |
| Max. Negotiated Rate |
$8.68 |
| Rate for Payer: Aetna American Axle |
$6.27
|
| Rate for Payer: Aetna Commercial |
$8.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.27
|
| Rate for Payer: Cash Price |
$7.71
|
| Rate for Payer: Cofinity Advantage |
$6.75
|
| Rate for Payer: Cofinity Commercial |
$8.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$8.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.23
|
| Rate for Payer: PHP Commercial |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.07
|
| Rate for Payer: UMR Bronson Commercial |
$4.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.23
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$522.63
|
|
|
Service Code
|
NDC 00004080085
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.37 |
| Max. Negotiated Rate |
$470.37 |
| Rate for Payer: Aetna American Axle |
$339.71
|
| Rate for Payer: Aetna Commercial |
$444.24
|
| Rate for Payer: Aetna Medicare |
$261.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.71
|
| Rate for Payer: BCBS Complete |
$209.05
|
| Rate for Payer: Cash Price |
$418.10
|
| Rate for Payer: Cofinity Advantage |
$365.84
|
| Rate for Payer: Cofinity Commercial |
$449.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.10
|
| Rate for Payer: Healthscope Commercial |
$470.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$365.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$418.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.97
|
| Rate for Payer: PHP Commercial |
$444.24
|
| Rate for Payer: Priority Health SBD |
$329.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.71
|
| Rate for Payer: UHC Core |
$272.29
|
| Rate for Payer: UHC Exchange |
$205.39
|
| Rate for Payer: UMR Bronson Commercial |
$193.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.97
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$298.37
|
|
|
Service Code
|
NDC 60219126601
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.28 |
| Max. Negotiated Rate |
$268.53 |
| Rate for Payer: Aetna American Axle |
$193.94
|
| Rate for Payer: Aetna Commercial |
$253.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: Cash Price |
$238.70
|
| Rate for Payer: Cofinity Advantage |
$208.86
|
| Rate for Payer: Cofinity Commercial |
$256.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.70
|
| Rate for Payer: Healthscope Commercial |
$268.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.78
|
| Rate for Payer: PHP Commercial |
$253.61
|
| Rate for Payer: Priority Health SBD |
$187.97
|
| Rate for Payer: UMR Bronson Commercial |
$131.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.78
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$298.37
|
|
|
Service Code
|
NDC 60219126601
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.40 |
| Max. Negotiated Rate |
$268.53 |
| Rate for Payer: Aetna American Axle |
$193.94
|
| Rate for Payer: Aetna Commercial |
$253.61
|
| Rate for Payer: Aetna Medicare |
$149.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: BCBS Complete |
$119.35
|
| Rate for Payer: Cash Price |
$238.70
|
| Rate for Payer: Cofinity Advantage |
$208.86
|
| Rate for Payer: Cofinity Commercial |
$256.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.70
|
| Rate for Payer: Healthscope Commercial |
$268.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.78
|
| Rate for Payer: PHP Commercial |
$253.61
|
| Rate for Payer: Priority Health SBD |
$187.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.94
|
| Rate for Payer: UHC Core |
$155.45
|
| Rate for Payer: UHC Exchange |
$117.26
|
| Rate for Payer: UMR Bronson Commercial |
$110.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.78
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$275.25
|
|
|
Service Code
|
NDC 62332041510
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.84 |
| Max. Negotiated Rate |
$247.72 |
| Rate for Payer: Aetna American Axle |
$178.91
|
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: Aetna Medicare |
$137.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.91
|
| Rate for Payer: BCBS Complete |
$110.10
|
| Rate for Payer: Cash Price |
$220.20
|
| Rate for Payer: Cofinity Advantage |
$192.68
|
| Rate for Payer: Cofinity Commercial |
$236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.20
|
| Rate for Payer: Healthscope Commercial |
$247.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.44
|
| Rate for Payer: PHP Commercial |
$233.96
|
| Rate for Payer: Priority Health SBD |
$173.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.91
|
| Rate for Payer: UHC Core |
$143.41
|
| Rate for Payer: UHC Exchange |
$108.17
|
| Rate for Payer: UMR Bronson Commercial |
$101.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.44
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$963.48
|
|
|
Service Code
|
NDC 68094005061
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$423.93 |
| Max. Negotiated Rate |
$867.13 |
| Rate for Payer: Aetna American Axle |
$626.26
|
| Rate for Payer: Aetna Commercial |
$818.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.26
|
| Rate for Payer: Cash Price |
$770.78
|
| Rate for Payer: Cofinity Advantage |
$674.44
|
| Rate for Payer: Cofinity Commercial |
$828.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$770.78
|
| Rate for Payer: Healthscope Commercial |
$867.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$674.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$722.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$818.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.61
|
| Rate for Payer: PHP Commercial |
$818.96
|
| Rate for Payer: Priority Health SBD |
$606.99
|
| Rate for Payer: UMR Bronson Commercial |
$423.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.61
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$85.73
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.72 |
| Max. Negotiated Rate |
$77.16 |
| Rate for Payer: Aetna American Axle |
$55.72
|
| Rate for Payer: Aetna Commercial |
$72.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.72
|
| Rate for Payer: Cash Price |
$68.58
|
| Rate for Payer: Cofinity Advantage |
$60.01
|
| Rate for Payer: Cofinity Commercial |
$73.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$77.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.30
|
| Rate for Payer: PHP Commercial |
$72.87
|
| Rate for Payer: Priority Health SBD |
$54.01
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.30
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$63.60
|
|
|
Service Code
|
NDC 68180067711
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.98 |
| Max. Negotiated Rate |
$57.24 |
| Rate for Payer: Aetna American Axle |
$41.34
|
| Rate for Payer: Aetna Commercial |
$54.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.34
|
| Rate for Payer: Cash Price |
$50.88
|
| Rate for Payer: Cofinity Advantage |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$57.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.70
|
| Rate for Payer: PHP Commercial |
$54.06
|
| Rate for Payer: Priority Health SBD |
$40.07
|
| Rate for Payer: UMR Bronson Commercial |
$27.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.70
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$85.73
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$77.16 |
| Rate for Payer: Aetna American Axle |
$55.72
|
| Rate for Payer: Aetna Commercial |
$72.87
|
| Rate for Payer: Aetna Medicare |
$42.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.72
|
| Rate for Payer: BCBS Complete |
$34.29
|
| Rate for Payer: Cash Price |
$68.58
|
| Rate for Payer: Cofinity Advantage |
$60.01
|
| Rate for Payer: Cofinity Commercial |
$73.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$77.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.30
|
| Rate for Payer: PHP Commercial |
$72.87
|
| Rate for Payer: Priority Health SBD |
$54.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.72
|
| Rate for Payer: UHC Core |
$44.67
|
| Rate for Payer: UHC Exchange |
$33.69
|
| Rate for Payer: UMR Bronson Commercial |
$31.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.30
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$86.03
|
|
|
Service Code
|
NDC 33342025866
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.83 |
| Max. Negotiated Rate |
$77.43 |
| Rate for Payer: Aetna American Axle |
$55.92
|
| Rate for Payer: Aetna Commercial |
$73.13
|
| Rate for Payer: Aetna Medicare |
$43.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.92
|
| Rate for Payer: BCBS Complete |
$34.41
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cofinity Advantage |
$60.22
|
| Rate for Payer: Cofinity Commercial |
$73.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$77.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.52
|
| Rate for Payer: PHP Commercial |
$73.13
|
| Rate for Payer: Priority Health SBD |
$54.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.92
|
| Rate for Payer: UHC Core |
$44.82
|
| Rate for Payer: UHC Exchange |
$33.81
|
| Rate for Payer: UMR Bronson Commercial |
$31.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.52
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$9.64
|
|
|
Service Code
|
NDC 68094005059
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$8.68 |
| Rate for Payer: Aetna American Axle |
$6.27
|
| Rate for Payer: Aetna Commercial |
$8.19
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.27
|
| Rate for Payer: BCBS Complete |
$3.86
|
| Rate for Payer: Cash Price |
$7.71
|
| Rate for Payer: Cofinity Advantage |
$6.75
|
| Rate for Payer: Cofinity Commercial |
$8.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$8.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.23
|
| Rate for Payer: PHP Commercial |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.27
|
| Rate for Payer: UHC Core |
$5.02
|
| Rate for Payer: UHC Exchange |
$3.79
|
| Rate for Payer: UMR Bronson Commercial |
$3.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.23
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
NDC 31722063231
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.10 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna American Axle |
$58.16
|
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$44.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: BCBS Complete |
$35.79
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Advantage |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.10
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.16
|
| Rate for Payer: UHC Core |
$46.61
|
| Rate for Payer: UHC Exchange |
$35.16
|
| Rate for Payer: UMR Bronson Commercial |
$33.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$522.63
|
|
|
Service Code
|
NDC 00004080085
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$229.96 |
| Max. Negotiated Rate |
$470.37 |
| Rate for Payer: Aetna American Axle |
$339.71
|
| Rate for Payer: Aetna Commercial |
$444.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.71
|
| Rate for Payer: Cash Price |
$418.10
|
| Rate for Payer: Cofinity Advantage |
$365.84
|
| Rate for Payer: Cofinity Commercial |
$449.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.10
|
| Rate for Payer: Healthscope Commercial |
$470.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$365.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.97
|
| Rate for Payer: PHP Commercial |
$444.24
|
| Rate for Payer: Priority Health SBD |
$329.26
|
| Rate for Payer: UMR Bronson Commercial |
$229.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.97
|
|
