|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna American Axle |
$25.46
|
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna Medicare |
$19.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.46
|
| Rate for Payer: BCBS Complete |
$15.67
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health SBD |
$24.68
|
| Rate for Payer: UMR Bronson Commercial |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
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 Commercial |
$335.64
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$335.64
|
| 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: PHP Commercial |
$407.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.67
|
| 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 30 MG CAPSULE
|
Facility
|
IP
|
$322.05
|
|
|
Service Code
|
NDC 47781046813
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.70 |
| Max. Negotiated Rate |
$289.84 |
| Rate for Payer: Aetna American Axle |
$209.33
|
| Rate for Payer: Aetna Commercial |
$273.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.33
|
| Rate for Payer: Cash Price |
$257.64
|
| Rate for Payer: Cofinity Commercial |
$225.44
|
| Rate for Payer: Cofinity Commercial |
$276.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.64
|
| Rate for Payer: Healthscope Commercial |
$289.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: PHP Commercial |
$273.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.33
|
| Rate for Payer: Priority Health SBD |
$202.89
|
| Rate for Payer: UMR Bronson Commercial |
$141.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$273.73
|
|
|
Service Code
|
NDC 69238126401
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.44 |
| Max. Negotiated Rate |
$246.36 |
| Rate for Payer: Aetna American Axle |
$177.92
|
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.92
|
| Rate for Payer: Cash Price |
$218.98
|
| Rate for Payer: Cofinity Commercial |
$191.61
|
| Rate for Payer: Cofinity Commercial |
$235.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.98
|
| Rate for Payer: Healthscope Commercial |
$246.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.67
|
| Rate for Payer: PHP Commercial |
$232.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.92
|
| Rate for Payer: Priority Health SBD |
$172.45
|
| Rate for Payer: UMR Bronson Commercial |
$120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.30
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$479.49
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.41 |
| Max. Negotiated Rate |
$431.54 |
| Rate for Payer: Aetna American Axle |
$311.67
|
| Rate for Payer: Aetna Commercial |
$407.57
|
| Rate for Payer: Aetna Medicare |
$239.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.67
|
| Rate for Payer: BCBS Complete |
$191.80
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$335.64
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$335.64
|
| 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: PHP Commercial |
$407.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.67
|
| Rate for Payer: Priority Health SBD |
$302.08
|
| Rate for Payer: UMR Bronson Commercial |
$177.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.62
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$322.05
|
|
|
Service Code
|
NDC 47781046813
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.16 |
| Max. Negotiated Rate |
$289.84 |
| Rate for Payer: Aetna American Axle |
$209.33
|
| Rate for Payer: Aetna Commercial |
$273.74
|
| Rate for Payer: Aetna Medicare |
$161.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.33
|
| Rate for Payer: BCBS Complete |
$128.82
|
| Rate for Payer: Cash Price |
$257.64
|
| Rate for Payer: Cofinity Commercial |
$225.44
|
| Rate for Payer: Cofinity Commercial |
$276.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.64
|
| Rate for Payer: Healthscope Commercial |
$289.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: PHP Commercial |
$273.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.33
|
| Rate for Payer: Priority Health SBD |
$202.89
|
| Rate for Payer: UMR Bronson Commercial |
$119.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$207.39
|
|
|
Service Code
|
NDC 70710100802
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.73 |
| Max. Negotiated Rate |
$186.65 |
| Rate for Payer: Aetna American Axle |
$134.80
|
| Rate for Payer: Aetna Commercial |
$176.28
|
| Rate for Payer: Aetna Medicare |
$103.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.80
|
| Rate for Payer: BCBS Complete |
$82.96
|
| Rate for Payer: Cash Price |
$165.91
|
| Rate for Payer: Cofinity Commercial |
$145.17
|
| Rate for Payer: Cofinity Commercial |
$178.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.91
|
| Rate for Payer: Healthscope Commercial |
$186.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.28
|
| Rate for Payer: PHP Commercial |
$176.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.80
|
| Rate for Payer: Priority Health SBD |
$130.66
|
| Rate for Payer: UMR Bronson Commercial |
$76.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.23 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna American Axle |
$25.46
|
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.46
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health SBD |
$24.68
|
| Rate for Payer: UMR Bronson Commercial |
$17.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$273.73
|
|
|
Service Code
|
NDC 69238126401
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.28 |
| Max. Negotiated Rate |
$246.36 |
| Rate for Payer: Aetna American Axle |
$177.92
|
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare |
$136.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.92
|
| Rate for Payer: BCBS Complete |
$109.49
|
| Rate for Payer: Cash Price |
$218.98
|
| Rate for Payer: Cofinity Commercial |
$191.61
|
| Rate for Payer: Cofinity Commercial |
$235.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.98
|
| Rate for Payer: Healthscope Commercial |
$246.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.67
|
| Rate for Payer: PHP Commercial |
$232.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.92
|
| Rate for Payer: Priority Health SBD |
$172.45
|
| Rate for Payer: UMR Bronson Commercial |
$101.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.30
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$207.39
|
|
|
Service Code
|
NDC 70710100802
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.25 |
| Max. Negotiated Rate |
$186.65 |
| Rate for Payer: Aetna American Axle |
$134.80
|
| Rate for Payer: Aetna Commercial |
$176.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.80
|
| Rate for Payer: Cash Price |
$165.91
|
| Rate for Payer: Cofinity Commercial |
$145.17
|
| Rate for Payer: Cofinity Commercial |
$178.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.91
|
| Rate for Payer: Healthscope Commercial |
$186.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.28
|
| Rate for Payer: PHP Commercial |
$176.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.80
|
| Rate for Payer: Priority Health SBD |
$130.66
|
| Rate for Payer: UMR Bronson Commercial |
$91.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.54
|
|
|
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 Commercial |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$313.29
|
| 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: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.91
|
| Rate for Payer: Priority Health SBD |
$281.96
|
| 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
|
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 Commercial |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$365.81
|
| 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: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| Rate for Payer: Priority Health SBD |
$329.23
|
| 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
|
OP
|
$230.85
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna American Axle |
$150.05
|
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna Medicare |
$115.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.05
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$161.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.05
|
| Rate for Payer: Priority Health SBD |
$145.44
|
| Rate for Payer: UMR Bronson Commercial |
$85.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.14
|
|
|
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 Commercial |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$365.81
|
| 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: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| 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
|
IP
|
$230.85
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.57 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna American Axle |
$150.05
|
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.05
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$161.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.05
|
| Rate for Payer: Priority Health SBD |
$145.44
|
| Rate for Payer: UMR Bronson Commercial |
$101.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.14
|
|
|
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 Commercial |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$313.29
|
| 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: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.91
|
| 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 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: PHP Commercial |
$8.19
|
| 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 Commercial |
$6.75
|
| Rate for Payer: Cofinity Commercial |
$8.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.75
|
| 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: Priority Health Cigna Priority Health |
$6.27
|
| 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
|
IP
|
$276.21
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.53 |
| Max. Negotiated Rate |
$248.59 |
| Rate for Payer: Aetna American Axle |
$179.54
|
| Rate for Payer: Aetna Commercial |
$234.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.54
|
| Rate for Payer: Cash Price |
$220.97
|
| Rate for Payer: Cofinity Commercial |
$193.35
|
| Rate for Payer: Cofinity Commercial |
$237.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.97
|
| Rate for Payer: Healthscope Commercial |
$248.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.78
|
| Rate for Payer: PHP Commercial |
$234.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.54
|
| Rate for Payer: Priority Health SBD |
$174.01
|
| Rate for Payer: UMR Bronson Commercial |
$121.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.16
|
|
|
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 Commercial |
$192.68
|
| Rate for Payer: Cofinity Commercial |
$236.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.68
|
| 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: PHP Commercial |
$233.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.91
|
| Rate for Payer: Priority Health SBD |
$173.41
|
| 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
|
$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 Commercial |
$253.61
|
| Rate for Payer: Aetna American Axle |
$193.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: Cash Price |
$238.70
|
| Rate for Payer: Cofinity Commercial |
$208.86
|
| Rate for Payer: Cofinity Commercial |
$256.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.86
|
| 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: PHP Commercial |
$253.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.94
|
| 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
|
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 Commercial |
$365.84
|
| Rate for Payer: Cofinity Commercial |
$449.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$365.84
|
| 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: PHP Commercial |
$444.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.71
|
| 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
|
|
|
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 Commercial |
$674.44
|
| Rate for Payer: Cofinity Commercial |
$828.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$674.44
|
| 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: PHP Commercial |
$818.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$626.26
|
| 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
|
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 Commercial |
$674.44
|
| Rate for Payer: Cofinity Commercial |
$828.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$674.44
|
| 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: PHP Commercial |
$818.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$626.26
|
| Rate for Payer: Priority Health SBD |
$606.99
|
| Rate for Payer: UMR Bronson Commercial |
$356.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.61
|
|
|
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 Commercial |
$6.75
|
| Rate for Payer: Cofinity Commercial |
$8.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.75
|
| 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: PHP Commercial |
$8.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.27
|
| Rate for Payer: Priority Health SBD |
$6.07
|
| 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
|
$53.96
|
|
|
Service Code
|
NDC 68180067711
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$48.56 |
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.77
|
| Rate for Payer: Aetna American Axle |
$35.07
|
| Rate for Payer: Aetna Commercial |
$45.87
|
| Rate for Payer: Aetna Medicare |
$26.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.07
|
| Rate for Payer: BCBS Complete |
$21.58
|
| Rate for Payer: Cash Price |
$43.17
|
| Rate for Payer: Cofinity Commercial |
$37.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.17
|
| Rate for Payer: Healthscope Commercial |
$48.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.87
|
| Rate for Payer: PHP Commercial |
$45.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.07
|
| Rate for Payer: Priority Health SBD |
$33.99
|
| Rate for Payer: UMR Bronson Commercial |
$19.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.47
|
|
