|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$14.99
|
|
|
Service Code
|
NDC 71656002150
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$13.49 |
| Rate for Payer: Aetna American Axle |
$9.74
|
| Rate for Payer: Aetna Commercial |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.74
|
| Rate for Payer: Cash Price |
$11.99
|
| Rate for Payer: Cofinity Advantage |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$12.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.99
|
| Rate for Payer: Healthscope Commercial |
$13.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.24
|
| Rate for Payer: PHP Commercial |
$12.74
|
| Rate for Payer: Priority Health SBD |
$9.44
|
| Rate for Payer: UMR Bronson Commercial |
$6.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.24
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$20.54
|
|
|
Service Code
|
NDC 66689004730
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$18.49 |
| Rate for Payer: Aetna American Axle |
$13.35
|
| Rate for Payer: Aetna Commercial |
$17.46
|
| Rate for Payer: Aetna Medicare |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.35
|
| Rate for Payer: BCBS Complete |
$8.22
|
| Rate for Payer: Cash Price |
$16.43
|
| Rate for Payer: Cofinity Advantage |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$17.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.43
|
| Rate for Payer: Healthscope Commercial |
$18.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.40
|
| Rate for Payer: PHP Commercial |
$17.46
|
| Rate for Payer: Priority Health SBD |
$12.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.35
|
| Rate for Payer: UHC Core |
$10.70
|
| Rate for Payer: UHC Exchange |
$8.07
|
| Rate for Payer: UMR Bronson Commercial |
$7.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.40
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$17.54
|
|
|
Service Code
|
NDC 66689004750
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$15.79 |
| Rate for Payer: Aetna American Axle |
$11.40
|
| Rate for Payer: Aetna Commercial |
$14.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.40
|
| Rate for Payer: Cash Price |
$14.03
|
| Rate for Payer: Cofinity Advantage |
$12.28
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.03
|
| Rate for Payer: Healthscope Commercial |
$15.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: PHP Commercial |
$14.91
|
| Rate for Payer: Priority Health SBD |
$11.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.15
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$21.87
|
|
|
Service Code
|
NDC 00904746260
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$19.68 |
| Rate for Payer: Aetna American Axle |
$14.22
|
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.22
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Advantage |
$15.31
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$19.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.40
|
| Rate for Payer: PHP Commercial |
$18.59
|
| Rate for Payer: Priority Health SBD |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.40
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$73.26
|
|
|
Service Code
|
NDC 66689004850
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.23 |
| Max. Negotiated Rate |
$65.93 |
| Rate for Payer: Aetna American Axle |
$47.62
|
| Rate for Payer: Aetna Commercial |
$62.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.62
|
| Rate for Payer: Cash Price |
$58.61
|
| Rate for Payer: Cofinity Advantage |
$51.28
|
| Rate for Payer: Cofinity Commercial |
$63.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.61
|
| Rate for Payer: Healthscope Commercial |
$65.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.95
|
| Rate for Payer: PHP Commercial |
$62.27
|
| Rate for Payer: Priority Health SBD |
$46.15
|
| Rate for Payer: UMR Bronson Commercial |
$32.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.95
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$14.99
|
|
|
Service Code
|
NDC 71656002150
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$13.49 |
| Rate for Payer: Aetna American Axle |
$9.74
|
| Rate for Payer: Aetna Commercial |
$12.74
|
| Rate for Payer: Aetna Medicare |
$7.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.74
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: Cash Price |
$11.99
|
| Rate for Payer: Cofinity Advantage |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$12.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.99
|
| Rate for Payer: Healthscope Commercial |
$13.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.24
|
| Rate for Payer: PHP Commercial |
$12.74
|
| Rate for Payer: Priority Health SBD |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.74
|
| Rate for Payer: UHC Core |
$7.81
|
| Rate for Payer: UHC Exchange |
$5.89
|
| Rate for Payer: UMR Bronson Commercial |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.24
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$28.20
|
|
|
Service Code
|
NDC 00121494815
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: Aetna American Axle |
$18.33
|
| Rate for Payer: Aetna Commercial |
$23.97
|
| Rate for Payer: Aetna Medicare |
$14.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.33
|
| Rate for Payer: BCBS Complete |
$11.28
|
| Rate for Payer: Cash Price |
$22.56
|
| Rate for Payer: Cofinity Advantage |
$19.74
|
| Rate for Payer: Cofinity Commercial |
$24.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.56
|
| Rate for Payer: Healthscope Commercial |
$25.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.15
|
| Rate for Payer: PHP Commercial |
$23.97
|
| Rate for Payer: Priority Health SBD |
$17.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.33
|
| Rate for Payer: UHC Core |
$14.69
|
| Rate for Payer: UHC Exchange |
$11.08
|
| Rate for Payer: UMR Bronson Commercial |
$10.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.15
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$48.18
|
|
|
Service Code
|
NDC 60687034144
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$43.36 |
| Rate for Payer: Aetna American Axle |
$31.32
|
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.32
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Advantage |
$33.73
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: Priority Health SBD |
$30.35
|
| Rate for Payer: UMR Bronson Commercial |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.13
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$89.03
|
|
|
Service Code
|
NDC 66689004801
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.17 |
| Max. Negotiated Rate |
$80.13 |
| Rate for Payer: Aetna American Axle |
$57.87
|
| Rate for Payer: Aetna Commercial |
$75.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.87
|
| Rate for Payer: Cash Price |
$71.22
|
| Rate for Payer: Cofinity Advantage |
$62.32
|
| Rate for Payer: Cofinity Commercial |
$76.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.22
|
| Rate for Payer: Healthscope Commercial |
$80.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.77
|
| Rate for Payer: PHP Commercial |
$75.68
|
| Rate for Payer: Priority Health SBD |
$56.09
|
| Rate for Payer: UMR Bronson Commercial |
$39.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.77
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$12.10
|
|
|
Service Code
|
NDC 00904706180
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna American Axle |
$7.87
|
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: Aetna Medicare |
$6.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.87
|
| Rate for Payer: BCBS Complete |
$4.84
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Advantage |
$8.47
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.07
|
| Rate for Payer: PHP Commercial |
$10.29
|
| Rate for Payer: Priority Health SBD |
$7.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.87
|
| Rate for Payer: UHC Core |
$6.30
|
| Rate for Payer: UHC Exchange |
$4.76
|
| Rate for Payer: UMR Bronson Commercial |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.07
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$89.03
|
|
|
Service Code
|
NDC 66689004801
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.94 |
| Max. Negotiated Rate |
$80.13 |
| Rate for Payer: Aetna American Axle |
$57.87
|
| Rate for Payer: Aetna Commercial |
$75.68
|
| Rate for Payer: Aetna Medicare |
$44.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.87
|
| Rate for Payer: BCBS Complete |
$35.61
|
| Rate for Payer: Cash Price |
$71.22
|
| Rate for Payer: Cofinity Advantage |
$62.32
|
| Rate for Payer: Cofinity Commercial |
$76.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.22
|
| Rate for Payer: Healthscope Commercial |
$80.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.77
|
| Rate for Payer: PHP Commercial |
$75.68
|
| Rate for Payer: Priority Health SBD |
$56.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.87
|
| Rate for Payer: UHC Core |
$46.38
|
| Rate for Payer: UHC Exchange |
$34.99
|
| Rate for Payer: UMR Bronson Commercial |
$32.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.77
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$38.19
|
|
|
Service Code
|
NDC 60687034145
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$34.37 |
| Rate for Payer: Aetna American Axle |
$24.82
|
| Rate for Payer: Aetna Commercial |
$32.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.82
|
| Rate for Payer: Cash Price |
$30.55
|
| Rate for Payer: Cofinity Advantage |
$26.73
|
| Rate for Payer: Cofinity Commercial |
$32.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.55
|
| Rate for Payer: Healthscope Commercial |
$34.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.64
|
| Rate for Payer: PHP Commercial |
$32.46
|
| Rate for Payer: Priority Health SBD |
$24.06
|
| Rate for Payer: UMR Bronson Commercial |
$16.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.64
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$7.94
|
|
|
Service Code
|
NDC 81033022051
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna American Axle |
$5.16
|
| Rate for Payer: Aetna Commercial |
$6.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.16
|
| Rate for Payer: Cash Price |
$6.35
|
| Rate for Payer: Cofinity Advantage |
$5.56
|
| Rate for Payer: Cofinity Commercial |
$6.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$7.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.96
|
| Rate for Payer: PHP Commercial |
$6.75
|
| Rate for Payer: Priority Health SBD |
$5.00
|
| Rate for Payer: UMR Bronson Commercial |
$3.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.96
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$21.87
|
|
|
Service Code
|
NDC 00904746243
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$19.68 |
| Rate for Payer: Aetna American Axle |
$14.22
|
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.22
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Advantage |
$15.31
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$19.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.40
|
| Rate for Payer: PHP Commercial |
$18.59
|
| Rate for Payer: Priority Health SBD |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.40
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$11.77
|
|
|
Service Code
|
NDC 71656002115
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$10.59 |
| Rate for Payer: Aetna American Axle |
$7.65
|
| Rate for Payer: Aetna Commercial |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.65
|
| Rate for Payer: Cash Price |
$9.42
|
| Rate for Payer: Cofinity Advantage |
$8.24
|
| Rate for Payer: Cofinity Commercial |
$10.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.42
|
| Rate for Payer: Healthscope Commercial |
$10.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.83
|
| Rate for Payer: PHP Commercial |
$10.00
|
| Rate for Payer: Priority Health SBD |
$7.42
|
| Rate for Payer: UMR Bronson Commercial |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.83
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$12.10
|
|
|
Service Code
|
NDC 00904706180
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna American Axle |
$7.87
|
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.87
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Advantage |
$8.47
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.07
|
| Rate for Payer: PHP Commercial |
$10.29
|
| Rate for Payer: Priority Health SBD |
$7.62
|
| Rate for Payer: UMR Bronson Commercial |
$5.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.07
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$9.77
|
|
|
Service Code
|
NDC 00904746180
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$8.79 |
| Rate for Payer: Aetna American Axle |
$6.35
|
| Rate for Payer: Aetna Commercial |
$8.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.35
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Cofinity Advantage |
$6.84
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$8.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.33
|
| Rate for Payer: PHP Commercial |
$8.30
|
| Rate for Payer: Priority Health SBD |
$6.16
|
| Rate for Payer: UMR Bronson Commercial |
$4.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.33
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$9.77
|
|
|
Service Code
|
NDC 63739072450
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$8.79 |
| Rate for Payer: Aetna American Axle |
$6.35
|
| Rate for Payer: Aetna Commercial |
$8.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.35
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Cofinity Advantage |
$6.84
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$8.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.33
|
| Rate for Payer: PHP Commercial |
$8.30
|
| Rate for Payer: Priority Health SBD |
$6.16
|
| Rate for Payer: UMR Bronson Commercial |
$4.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.33
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$32.86
|
|
|
Service Code
|
NDC 71656002130
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$29.57 |
| Rate for Payer: Aetna American Axle |
$21.36
|
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Medicare |
$16.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.36
|
| Rate for Payer: BCBS Complete |
$13.14
|
| Rate for Payer: Cash Price |
$26.29
|
| Rate for Payer: Cofinity Advantage |
$23.00
|
| Rate for Payer: Cofinity Commercial |
$28.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.29
|
| Rate for Payer: Healthscope Commercial |
$29.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.64
|
| Rate for Payer: PHP Commercial |
$27.93
|
| Rate for Payer: Priority Health SBD |
$20.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.36
|
| Rate for Payer: UHC Core |
$17.12
|
| Rate for Payer: UHC Exchange |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$12.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.64
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
NDC 66689004799
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna American Axle |
$12.41
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: UMR Bronson Commercial |
$8.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$12.10
|
|
|
Service Code
|
NDC 00904706188
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna American Axle |
$7.87
|
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: Aetna Medicare |
$6.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.87
|
| Rate for Payer: BCBS Complete |
$4.84
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Advantage |
$8.47
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.07
|
| Rate for Payer: PHP Commercial |
$10.29
|
| Rate for Payer: Priority Health SBD |
$7.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.87
|
| Rate for Payer: UHC Core |
$6.30
|
| Rate for Payer: UHC Exchange |
$4.76
|
| Rate for Payer: UMR Bronson Commercial |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.07
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$16.04
|
|
|
Service Code
|
NDC 00121494800
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$14.44 |
| Rate for Payer: Aetna American Axle |
$10.43
|
| Rate for Payer: Aetna Commercial |
$13.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.43
|
| Rate for Payer: Cash Price |
$12.83
|
| Rate for Payer: Cofinity Advantage |
$11.23
|
| Rate for Payer: Cofinity Commercial |
$13.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.83
|
| Rate for Payer: Healthscope Commercial |
$14.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.03
|
| Rate for Payer: PHP Commercial |
$13.63
|
| Rate for Payer: Priority Health SBD |
$10.11
|
| Rate for Payer: UMR Bronson Commercial |
$7.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.03
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$11.77
|
|
|
Service Code
|
NDC 71656002115
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$10.59 |
| Rate for Payer: Aetna American Axle |
$7.65
|
| Rate for Payer: Aetna Commercial |
$10.00
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.65
|
| Rate for Payer: BCBS Complete |
$4.71
|
| Rate for Payer: Cash Price |
$9.42
|
| Rate for Payer: Cofinity Advantage |
$8.24
|
| Rate for Payer: Cofinity Commercial |
$10.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.42
|
| Rate for Payer: Healthscope Commercial |
$10.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.83
|
| Rate for Payer: PHP Commercial |
$10.00
|
| Rate for Payer: Priority Health SBD |
$7.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.65
|
| Rate for Payer: UHC Core |
$6.13
|
| Rate for Payer: UHC Exchange |
$4.63
|
| Rate for Payer: UMR Bronson Commercial |
$4.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.83
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
IP
|
$32.86
|
|
|
Service Code
|
NDC 71656002151
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.46 |
| Max. Negotiated Rate |
$29.57 |
| Rate for Payer: Aetna American Axle |
$21.36
|
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.36
|
| Rate for Payer: Cash Price |
$26.29
|
| Rate for Payer: Cofinity Advantage |
$23.00
|
| Rate for Payer: Cofinity Commercial |
$28.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.29
|
| Rate for Payer: Healthscope Commercial |
$29.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.64
|
| Rate for Payer: PHP Commercial |
$27.93
|
| Rate for Payer: Priority Health SBD |
$20.70
|
| Rate for Payer: UMR Bronson Commercial |
$14.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.64
|
|
|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$9.33
|
|
|
Service Code
|
NDC 43598089152
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.45 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna American Axle |
$6.06
|
| Rate for Payer: Aetna Commercial |
$7.93
|
| Rate for Payer: Aetna Medicare |
$4.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.06
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: Cash Price |
$7.46
|
| Rate for Payer: Cofinity Advantage |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$8.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.46
|
| Rate for Payer: Healthscope Commercial |
$8.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.00
|
| Rate for Payer: PHP Commercial |
$7.93
|
| Rate for Payer: Priority Health SBD |
$5.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.06
|
| Rate for Payer: UHC Core |
$4.86
|
| Rate for Payer: UHC Exchange |
$3.67
|
| Rate for Payer: UMR Bronson Commercial |
$3.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.00
|
|
