ZIDOVUDINE 10 MG/ML ORAL SYRUP [11693]
|
Facility
IP
|
$0.18
|
|
Service Code
|
CPT S0104
|
Hospital Charge Code |
1715069
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.04 |
Max. Negotiated Rate |
$0.15 |
Rate for Payer: Blue Shield of California Commercial |
$0.13
|
Rate for Payer: Blue Shield of California EPN |
$0.09
|
Rate for Payer: Cash Price |
$0.08
|
Rate for Payer: Cigna of CA HMO |
$0.13
|
Rate for Payer: Cigna of CA PPO |
$0.13
|
Rate for Payer: EPIC Health Plan Commercial |
$0.07
|
Rate for Payer: Galaxy Health WC |
$0.15
|
Rate for Payer: Global Benefits Group Commercial |
$0.11
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.12
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
Rate for Payer: Multiplan Commercial |
$0.14
|
Rate for Payer: Networks By Design Commercial |
$0.12
|
Rate for Payer: Prime Health Services Commercial |
$0.15
|
|
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 |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Blue Shield of California Commercial |
$2.02
|
Rate for Payer: Blue Shield of California EPN |
$1.45
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
IP
|
$2.84
|
|
Service Code
|
NDC 51754-0102-4
|
Hospital Charge Code |
1721199
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Blue Shield of California Commercial |
$2.02
|
Rate for Payer: Blue Shield of California EPN |
$1.45
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
|
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 |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Aetna of CA HMO/PPO |
$1.86
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.56
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.56
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.69
|
Rate for Payer: BCBS Transplant Transplant |
$1.70
|
Rate for Payer: Blue Shield of California Commercial |
$2.09
|
Rate for Payer: Blue Shield of California EPN |
$1.66
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cigna of CA HMO |
$1.82
|
Rate for Payer: Cigna of CA PPO |
$2.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$2.41
|
Rate for Payer: Dignity Health Media |
$2.41
|
Rate for Payer: Dignity Health Medi-Cal |
$2.41
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: EPIC Health Plan Transplant |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.13
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.70
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.70
|
Rate for Payer: United Healthcare All Other Commercial |
$1.42
|
Rate for Payer: United Healthcare All Other HMO |
$1.42
|
Rate for Payer: United Healthcare HMO Rider |
$1.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$1.42
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2.41
|
Rate for Payer: Vantage Medical Group Senior |
$2.41
|
|
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 |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Blue Shield of California Commercial |
$2.02
|
Rate for Payer: Blue Shield of California EPN |
$1.45
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
OP
|
$2.84
|
|
Service Code
|
NDC 51754-0102-4
|
Hospital Charge Code |
1721199
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Aetna of CA HMO/PPO |
$1.86
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.56
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.56
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.69
|
Rate for Payer: BCBS Transplant Transplant |
$1.70
|
Rate for Payer: Blue Shield of California Commercial |
$2.09
|
Rate for Payer: Blue Shield of California EPN |
$1.66
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cigna of CA HMO |
$1.82
|
Rate for Payer: Cigna of CA PPO |
$2.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$2.41
|
Rate for Payer: Dignity Health Media |
$2.41
|
Rate for Payer: Dignity Health Medi-Cal |
$2.41
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: EPIC Health Plan Transplant |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.13
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.70
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.70
|
Rate for Payer: United Healthcare All Other Commercial |
$1.42
|
Rate for Payer: United Healthcare All Other HMO |
$1.42
|
Rate for Payer: United Healthcare HMO Rider |
$1.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$1.42
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2.41
|
Rate for Payer: Vantage Medical Group Senior |
$2.41
|
|
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 |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Aetna of CA HMO/PPO |
$1.86
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.56
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.56
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.69
|
Rate for Payer: BCBS Transplant Transplant |
$1.70
|
Rate for Payer: Blue Shield of California Commercial |
$2.09
|
Rate for Payer: Blue Shield of California EPN |
$1.66
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cigna of CA HMO |
$1.82
|
Rate for Payer: Cigna of CA PPO |
$2.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$2.41
|
Rate for Payer: Dignity Health Media |
$2.41
|
Rate for Payer: Dignity Health Medi-Cal |
$2.41
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: EPIC Health Plan Transplant |
$1.14
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.13
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.70
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.70
|
Rate for Payer: United Healthcare All Other Commercial |
$1.42
|
Rate for Payer: United Healthcare All Other HMO |
$1.42
|
Rate for Payer: United Healthcare HMO Rider |
$1.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$1.42
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2.41
|
Rate for Payer: Vantage Medical Group Senior |
$2.41
|
|
ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION [8865]
|
Facility
IP
|
$2.84
|
|
Service Code
|
NDC 51754-0102-1
|
Hospital Charge Code |
1721199
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Blue Shield of California Commercial |
$2.02
|
Rate for Payer: Blue Shield of California EPN |
$1.45
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
|
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 |
$0.68 |
Max. Negotiated Rate |
$2.41 |
Rate for Payer: Aetna of CA HMO/PPO |
$1.86
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.56
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.56
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.69
|
Rate for Payer: BCBS Transplant Transplant |
$1.70
|
Rate for Payer: Blue Shield of California Commercial |
$2.09
|
Rate for Payer: Blue Shield of California EPN |
$1.66
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cash Price |
$1.28
|
Rate for Payer: Cigna of CA HMO |
$1.82
|
Rate for Payer: Cigna of CA PPO |
$2.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$2.41
|
Rate for Payer: Dignity Health Media |
$2.41
|
Rate for Payer: Dignity Health Medi-Cal |
$2.41
|
Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
Rate for Payer: EPIC Health Plan Transplant |
$1.14
|
Rate for Payer: Galaxy Health WC |
$2.41
|
Rate for Payer: Global Benefits Group Commercial |
$1.70
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.13
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.68
|
Rate for Payer: Multiplan Commercial |
$2.27
|
Rate for Payer: Networks By Design Commercial |
$1.85
|
Rate for Payer: Prime Health Services Commercial |
$2.41
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.70
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.70
|
Rate for Payer: United Healthcare All Other Commercial |
$1.42
|
Rate for Payer: United Healthcare All Other HMO |
$1.42
|
Rate for Payer: United Healthcare HMO Rider |
$1.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$1.42
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.41
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2.41
|
Rate for Payer: Vantage Medical Group Senior |
$2.41
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.06 |
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.05
|
Rate for Payer: Cigna of CA PPO |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.06
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.06
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.06 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.06
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.05
|
Rate for Payer: Cigna of CA PPO |
$0.05
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.06
|
Rate for Payer: Dignity Health Media |
$0.06
|
Rate for Payer: Dignity Health Medi-Cal |
$0.06
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.06
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.06
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.06
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.06
|
Rate for Payer: Vantage Medical Group Senior |
$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 |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.05
|
Rate for Payer: BCBS Transplant Transplant |
$0.05
|
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
Rate for Payer: Dignity Health Media |
$0.07
|
Rate for Payer: Dignity Health Medi-Cal |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.06
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
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 |
$0.05 |
Max. Negotiated Rate |
$0.19 |
Rate for Payer: Blue Shield of California Commercial |
$0.16
|
Rate for Payer: Blue Shield of California EPN |
$0.11
|
Rate for Payer: Cash Price |
$0.10
|
Rate for Payer: Cigna of CA HMO |
$0.15
|
Rate for Payer: Cigna of CA PPO |
$0.15
|
Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
Rate for Payer: Galaxy Health WC |
$0.19
|
Rate for Payer: Global Benefits Group Commercial |
$0.13
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
Rate for Payer: Multiplan Commercial |
$0.18
|
Rate for Payer: Networks By Design Commercial |
$0.14
|
Rate for Payer: Prime Health Services Commercial |
$0.19
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
|
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 |
$0.05 |
Max. Negotiated Rate |
$0.19 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.14
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.19
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.12
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.12
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.13
|
Rate for Payer: BCBS Transplant Transplant |
$0.13
|
Rate for Payer: Blue Shield of California Commercial |
$0.16
|
Rate for Payer: Blue Shield of California EPN |
$0.13
|
Rate for Payer: Cash Price |
$0.10
|
Rate for Payer: Cigna of CA HMO |
$0.15
|
Rate for Payer: Cigna of CA PPO |
$0.15
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.19
|
Rate for Payer: Dignity Health Media |
$0.19
|
Rate for Payer: Dignity Health Medi-Cal |
$0.19
|
Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
Rate for Payer: Galaxy Health WC |
$0.19
|
Rate for Payer: Global Benefits Group Commercial |
$0.13
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
Rate for Payer: Multiplan Commercial |
$0.18
|
Rate for Payer: Networks By Design Commercial |
$0.14
|
Rate for Payer: Prime Health Services Commercial |
$0.19
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.13
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.13
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.13
|
Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
Rate for Payer: United Healthcare All Other HMO |
$0.11
|
Rate for Payer: United Healthcare HMO Rider |
$0.11
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.19
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.19
|
Rate for Payer: Vantage Medical Group Senior |
$0.19
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.05
|
Rate for Payer: BCBS Transplant Transplant |
$0.05
|
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
Rate for Payer: Dignity Health Media |
$0.07
|
Rate for Payer: Dignity Health Medi-Cal |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.06
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
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 |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$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 |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.05
|
Rate for Payer: BCBS Transplant Transplant |
$0.05
|
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
Rate for Payer: Dignity Health Media |
$0.07
|
Rate for Payer: Dignity Health Medi-Cal |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.06
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.07
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.09
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.06
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.06
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.06
|
Rate for Payer: BCBS Transplant Transplant |
$0.06
|
Rate for Payer: Blue Shield of California Commercial |
$0.07
|
Rate for Payer: Blue Shield of California EPN |
$0.06
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.09
|
Rate for Payer: Dignity Health Media |
$0.09
|
Rate for Payer: Dignity Health Medi-Cal |
$0.09
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: EPIC Health Plan Transplant |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.08
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.06
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.06
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.06
|
Rate for Payer: United Healthcare All Other Commercial |
$0.05
|
Rate for Payer: United Healthcare All Other HMO |
$0.05
|
Rate for Payer: United Healthcare HMO Rider |
$0.05
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.05
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.09
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.09
|
Rate for Payer: Vantage Medical Group Senior |
$0.09
|
|
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 |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: Dignity Health Media |
$0.05
|
Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
Rate for Payer: United Healthcare All Other HMO |
$0.03
|
Rate for Payer: United Healthcare HMO Rider |
$0.03
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
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 |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Blue Shield of California Commercial |
$0.07
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
|
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 |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: Dignity Health Media |
$0.05
|
Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
Rate for Payer: United Healthcare All Other HMO |
$0.03
|
Rate for Payer: United Healthcare HMO Rider |
$0.03
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$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 |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
|
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 |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|