|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
|
OP
|
$2.84
|
|
|
Service Code
|
NDC 0409-4090-11
|
| Hospital Charge Code |
1721199
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.13 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$1.70
|
| Rate for Payer: Aetna of CA Government/Medicare |
$1.70
|
| Rate for Payer: Cash Price |
$1.28
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$1.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$2.13
|
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
|
OP
|
$2.84
|
|
|
Service Code
|
NDC 51754-0102-1
|
| Hospital Charge Code |
1721199
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.13 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$1.70
|
| Rate for Payer: Aetna of CA Government/Medicare |
$1.70
|
| Rate for Payer: Cash Price |
$1.28
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$1.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$2.13
|
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
|
IP
|
$2.84
|
|
|
Service Code
|
NDC 0409-4090-01
|
| Hospital Charge Code |
1721199
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.27 |
| Rate for Payer: Cash Price |
$1.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.27
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$2.13
|
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
|
IP
|
$2.84
|
|
|
Service Code
|
NDC 0409-4090-11
|
| Hospital Charge Code |
1721199
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.27 |
| Rate for Payer: Cash Price |
$1.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.27
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$2.13
|
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
|
OP
|
$2.84
|
|
|
Service Code
|
NDC 0409-4090-01
|
| Hospital Charge Code |
1721199
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.13 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$1.70
|
| Rate for Payer: Aetna of CA Government/Medicare |
$1.70
|
| Rate for Payer: Cash Price |
$1.28
|
| Rate for Payer: Health Smart Auto/Commercial |
$1.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$1.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.56
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$2.13
|
|
|
ZINC OXIDE 13 % TOPICAL CREAM [92811]
|
Facility
|
IP
|
$0.07
|
|
|
Service Code
|
NDC 7430000300
|
| Hospital Charge Code |
NDG92811B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.05
|
|
|
ZINC OXIDE 13 % TOPICAL CREAM [92811]
|
Facility
|
OP
|
$0.07
|
|
|
Service Code
|
NDC 7430000300
|
| Hospital Charge Code |
NDG92811B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.04
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.04
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.05
|
|
|
ZINC OXIDE 20 % TOPICAL OINTMENT [8874]
|
Facility
|
IP
|
$0.08
|
|
|
Service Code
|
NDC 0536-5700-28
|
| Hospital Charge Code |
NDG8847
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.06
|
|
|
ZINC OXIDE 20 % TOPICAL OINTMENT [8874]
|
Facility
|
IP
|
$0.22
|
|
|
Service Code
|
NDC 75834-170-01
|
| Hospital Charge Code |
NDG8847
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.18 |
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.18
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.17
|
|
|
ZINC OXIDE 20 % TOPICAL OINTMENT [8874]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
NDC 0536-5700-28
|
| Hospital Charge Code |
NDG8847
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.05
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.06
|
|
|
ZINC OXIDE 20 % TOPICAL OINTMENT [8874]
|
Facility
|
OP
|
$0.22
|
|
|
Service Code
|
NDC 75834-170-01
|
| Hospital Charge Code |
NDG8847
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.13
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.13
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.17
|
|
|
ZINC OXIDE 20 % TOPICAL OINTMENT [8874]
|
Facility
|
IP
|
$0.08
|
|
|
Service Code
|
NDC 0536-1316-28
|
| Hospital Charge Code |
NDG8847
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.06
|
|
|
ZINC OXIDE 20 % TOPICAL OINTMENT [8874]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
NDC 0536-1316-28
|
| Hospital Charge Code |
NDG8847
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.05
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.06
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 58232-072-13
|
| Hospital Charge Code |
NDG121015
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.04
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.04
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.05
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
IP
|
$0.06
|
|
|
Service Code
|
NDC 58232-072-13
|
| Hospital Charge Code |
NDG121015
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.05
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.05
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
NDC 7430000070
|
| Hospital Charge Code |
NDG121015B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.05
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.05
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.06
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
IP
|
$0.06
|
|
|
Service Code
|
NDC 7430000071
|
| Hospital Charge Code |
NDG121015
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.05
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.05
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
IP
|
$0.08
|
|
|
Service Code
|
NDC 7430000070
|
| Hospital Charge Code |
NDG121015B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.06
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
IP
|
$0.10
|
|
|
Service Code
|
NDC 69968-0061-1
|
| Hospital Charge Code |
1743356
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.08 |
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.08
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.08
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 7430000071
|
| Hospital Charge Code |
NDG121015
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.04
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.04
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.05
|
|
|
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE [121015]
|
Facility
|
OP
|
$0.10
|
|
|
Service Code
|
NDC 69968-0061-1
|
| Hospital Charge Code |
1743356
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.08 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.06
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.06
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.08
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE [8880]
|
Facility
|
OP
|
$0.23
|
|
|
Service Code
|
NDC 7733398310
|
| Hospital Charge Code |
1711267
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.14
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.14
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.17
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE [8880]
|
Facility
|
OP
|
$0.03
|
|
|
Service Code
|
NDC 8068113500
|
| Hospital Charge Code |
1711267
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.02
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.02
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.02
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE [8880]
|
Facility
|
IP
|
$0.03
|
|
|
Service Code
|
NDC 8068113500
|
| Hospital Charge Code |
1711267
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.02
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.02
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE [8880]
|
Facility
|
OP
|
$0.23
|
|
|
Service Code
|
NDC 7733398325
|
| Hospital Charge Code |
1711267
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Aetna of CA EPO/HMO/POS/PPO |
$0.14
|
| Rate for Payer: Aetna of CA Government/Medicare |
$0.14
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Health Smart Auto/Commercial |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: Multiplan Beech St/Commercial/PHCS |
$0.17
|
|
