|
ZINC OXIDE/30GM
|
Facility
|
IP
|
$21.98
|
|
|
Service Code
|
NDC 168006231
|
| Hospital Charge Code |
60634202
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$3.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.30
|
|
|
ZINC OXIDE/30GM
|
Facility
|
OP
|
$6.00
|
|
| Hospital Charge Code |
60634201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$1.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.53
|
| Rate for Payer: Cigna Commercial |
$3.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.78
|
| Rate for Payer: Oxford Commercial |
$3.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.00
|
|
|
ZINC OXIDE/30GM
|
Facility
|
IP
|
$6.00
|
|
| Hospital Charge Code |
60634201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
ZINC OXIDE 40% OINTMENT
|
Facility
|
IP
|
$8.04
|
|
|
Service Code
|
NDC 74300000065
|
| Hospital Charge Code |
60628465
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.21
|
|
|
ZINC OXIDE 40% OINTMENT
|
Facility
|
OP
|
$8.04
|
|
|
Service Code
|
NDC 74300000065
|
| Hospital Charge Code |
60628465
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.02 |
| Rate for Payer: Aetna Commercial |
$2.41
|
| Rate for Payer: Aetna Medicare Advantage |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.05
|
| Rate for Payer: Cigna Commercial |
$4.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.05
|
| Rate for Payer: Oxford Commercial |
$4.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.02
|
|
|
ZINC OXIDE/ALUM HYDR LOTN 1:1
|
Facility
|
OP
|
$52.85
|
|
| Hospital Charge Code |
60629206
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$26.43 |
| Rate for Payer: Aetna Commercial |
$15.86
|
| Rate for Payer: Aetna Medicare Advantage |
$15.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.48
|
| Rate for Payer: Cigna Commercial |
$26.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.87
|
| Rate for Payer: Oxford Commercial |
$26.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.43
|
|
|
ZINC OXIDE/ALUM HYDR LOTN 1:1
|
Facility
|
IP
|
$52.85
|
|
| Hospital Charge Code |
60629206
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$7.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.93
|
|
|
ZINC,PLASMA
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 84630
|
| Hospital Charge Code |
39900153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$36.90
|
| Rate for Payer: Aetna Medicare Advantage |
$11.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.73
|
| Rate for Payer: Cigna Commercial |
$11.39
|
| Rate for Payer: Cigna Medicare Advantage |
$5.70
|
| Rate for Payer: Clover Medicare Advantage |
$10.82
|
| Rate for Payer: EmblemHealth Commercial |
$34.17
|
| Rate for Payer: Humana Medicare Advantage |
$11.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.79
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.39
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.39
|
|
|
ZINC,PLASMA
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 84630
|
| Hospital Charge Code |
39900153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
ZINC POWDER
|
Facility
|
OP
|
$11.25
|
|
| Hospital Charge Code |
60629110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Aetna Commercial |
$3.38
|
| Rate for Payer: Aetna Medicare Advantage |
$3.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.87
|
| Rate for Payer: Cigna Commercial |
$5.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.46
|
| Rate for Payer: Oxford Commercial |
$5.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.62
|
|
|
ZINC POWDER
|
Facility
|
IP
|
$11.25
|
|
| Hospital Charge Code |
60629110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$1.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.69
|
|
|
ZINC PROTOPORPHYRIN
|
Facility
|
IP
|
$247.00
|
|
|
Service Code
|
HCPCS 84202
|
| Hospital Charge Code |
38472037
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.05 |
| Max. Negotiated Rate |
$37.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.05
|
|
|
ZINC PROTOPORPHYRIN
|
Facility
|
OP
|
$247.00
|
|
|
Service Code
|
HCPCS 84202
|
| Hospital Charge Code |
38472037
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$46.49
|
| Rate for Payer: Aetna Medicare Advantage |
$14.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.58
|
| Rate for Payer: Cigna Commercial |
$14.35
|
| Rate for Payer: Cigna Medicare Advantage |
$7.17
|
| Rate for Payer: Clover Medicare Advantage |
$13.63
|
| Rate for Payer: EmblemHealth Commercial |
$43.05
|
| Rate for Payer: Humana Medicare Advantage |
$14.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.11
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.35
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$15.21
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.35
|
|
|
ZINC PROTOPORPHYRIN, BLOOD
|
Facility
|
IP
|
$153.65
|
|
|
Service Code
|
HCPCS 84202
|
| Hospital Charge Code |
3007796
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.05 |
| Max. Negotiated Rate |
$23.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.05
|
|
|
ZINC PROTOPORPHYRIN, BLOOD
|
Facility
|
OP
|
$153.65
|
|
|
Service Code
|
HCPCS 84202
|
| Hospital Charge Code |
3007796
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$46.49
|
| Rate for Payer: Aetna Medicare Advantage |
$14.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.58
|
| Rate for Payer: Cigna Commercial |
$14.35
|
| Rate for Payer: Cigna Medicare Advantage |
$7.17
|
| Rate for Payer: Clover Medicare Advantage |
$13.63
|
| Rate for Payer: EmblemHealth Commercial |
$43.05
|
| Rate for Payer: Humana Medicare Advantage |
$14.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.97
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.35
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$15.21
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.35
|
|
|
ZINC SERUM
|
Facility
|
OP
|
$121.65
|
|
|
Service Code
|
HCPCS 84630
|
| Hospital Charge Code |
3007804
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$36.90
|
| Rate for Payer: Aetna Medicare Advantage |
$11.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.73
|
| Rate for Payer: Cigna Commercial |
$11.39
|
| Rate for Payer: Cigna Medicare Advantage |
$5.70
|
| Rate for Payer: Clover Medicare Advantage |
$10.82
|
| Rate for Payer: EmblemHealth Commercial |
$34.17
|
| Rate for Payer: Humana Medicare Advantage |
$11.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.81
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.39
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.39
|
|
|
ZINC SERUM
|
Facility
|
IP
|
$121.65
|
|
|
Service Code
|
HCPCS 84630
|
| Hospital Charge Code |
3007804
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$18.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.25
|
|
|
ZINC SULFATE 110MG
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 394012402
|
| Hospital Charge Code |
606390322
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
ZINC SULFATE 110MG
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 394012402
|
| Hospital Charge Code |
606390322
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
ZINC SULFATE 220 MG CAP
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 41163026649
|
| Hospital Charge Code |
60627939
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
ZINC SULFATE 220 MG CAP
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 41163026649
|
| Hospital Charge Code |
60627939
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
ZINC UNDECYL/ACID 25.5GM
|
Facility
|
IP
|
$52.50
|
|
| Hospital Charge Code |
6005706
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$7.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.88
|
|
|
ZINC UNDECYL/ACID 25.5GM
|
Facility
|
OP
|
$52.50
|
|
| Hospital Charge Code |
6005706
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Medicare Advantage |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.39
|
| Rate for Payer: Cigna Commercial |
$26.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.83
|
| Rate for Payer: Oxford Commercial |
$26.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.25
|
|
|
ZINC, URINE I
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3030483A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.78
|
| Rate for Payer: Aetna Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.98
|
| Rate for Payer: Cigna Commercial |
$5.18
|
| Rate for Payer: Cigna Medicare Advantage |
$2.59
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.91
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
|
|
ZINC, URINE I
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3030483A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.05 |
| Max. Negotiated Rate |
$16.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
|