HYDRALAZINE 50 MG TABLET [3701]
|
Facility
IP
|
$0.09
|
|
Service Code
|
NDC 23155-003-01
|
Hospital Charge Code |
1710584
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.08 |
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: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.08
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.06
|
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 |
$0.07
|
Rate for Payer: Networks By Design Commercial |
$0.06
|
Rate for Payer: Prime Health Services Commercial |
$0.08
|
|
HYDRALAZINE ORAL SUSPENSION COMPOUND 2 MG/ML [4080279]
|
Facility
IP
|
$1.49
|
|
Service Code
|
NDC 9994-0802-79
|
Hospital Charge Code |
1715634
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.36 |
Max. Negotiated Rate |
$1.27 |
Rate for Payer: Blue Shield of California Commercial |
$1.06
|
Rate for Payer: Blue Shield of California EPN |
$0.76
|
Rate for Payer: Cash Price |
$0.67
|
Rate for Payer: Cigna of CA HMO |
$1.04
|
Rate for Payer: Cigna of CA PPO |
$1.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.60
|
Rate for Payer: Galaxy Health WC |
$1.27
|
Rate for Payer: Global Benefits Group Commercial |
$0.89
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.99
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.57
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.36
|
Rate for Payer: Multiplan Commercial |
$1.19
|
Rate for Payer: Networks By Design Commercial |
$0.97
|
Rate for Payer: Prime Health Services Commercial |
$1.27
|
|
HYDRALAZINE ORAL SUSPENSION COMPOUND 2 MG/ML [4080279]
|
Facility
OP
|
$1.49
|
|
Service Code
|
NDC 9994-0802-79
|
Hospital Charge Code |
1715634
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.36 |
Max. Negotiated Rate |
$1.27 |
Rate for Payer: Networks By Design Commercial |
$0.97
|
Rate for Payer: Aetna of CA HMO/PPO |
$0.98
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.27
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.82
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.82
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.89
|
Rate for Payer: BCBS Transplant Transplant |
$0.89
|
Rate for Payer: Blue Shield of California Commercial |
$1.10
|
Rate for Payer: Blue Shield of California EPN |
$0.87
|
Rate for Payer: Cash Price |
$0.67
|
Rate for Payer: Cigna of CA HMO |
$1.04
|
Rate for Payer: Cigna of CA PPO |
$1.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$1.27
|
Rate for Payer: Dignity Health Media |
$1.27
|
Rate for Payer: Dignity Health Medi-Cal |
$1.27
|
Rate for Payer: EPIC Health Plan Commercial |
$0.60
|
Rate for Payer: EPIC Health Plan Transplant |
$0.60
|
Rate for Payer: Galaxy Health WC |
$1.27
|
Rate for Payer: Global Benefits Group Commercial |
$0.89
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.12
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.99
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.57
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.36
|
Rate for Payer: Multiplan Commercial |
$1.19
|
Rate for Payer: Prime Health Services Commercial |
$1.27
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.89
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.89
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.89
|
Rate for Payer: United Healthcare All Other Commercial |
$0.75
|
Rate for Payer: United Healthcare All Other HMO |
$0.75
|
Rate for Payer: United Healthcare HMO Rider |
$0.75
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.75
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.27
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$1.27
|
Rate for Payer: Vantage Medical Group Senior |
$1.27
|
|
HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE [19146]
|
Facility
OP
|
$0.10
|
|
Service Code
|
NDC 50228-146-01
|
Hospital Charge Code |
ERX19146
|
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
|
|
HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE [19146]
|
Facility
IP
|
$0.10
|
|
Service Code
|
NDC 50228-146-01
|
Hospital Charge Code |
ERX19146
|
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
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
IP
|
$0.25
|
|
Service Code
|
NDC 60687-593-01
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.21 |
Rate for Payer: Blue Shield of California Commercial |
$0.18
|
Rate for Payer: Blue Shield of California EPN |
$0.13
|
Rate for Payer: Cash Price |
$0.11
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.21
|
Rate for Payer: Global Benefits Group Commercial |
$0.15
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.20
|
Rate for Payer: Networks By Design Commercial |
$0.16
|
Rate for Payer: Prime Health Services Commercial |
$0.21
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
OP
|
$0.05
|
|
Service Code
|
NDC 0172-2083-60
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.04 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.03
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.04
|
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 |
$0.03
|
Rate for Payer: BCBS Transplant Transplant |
$0.03
|
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 |
$0.02
|
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 |
$0.04
|
Rate for Payer: Dignity Health Media |
$0.04
|
Rate for Payer: Dignity Health Medi-Cal |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.04
|
Rate for Payer: Global Benefits Group Commercial |
$0.03
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.03
|
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 |
$0.04
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Prime Health Services Commercial |
$0.04
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.03
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.03
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.03
|
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 |
$0.04
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.04
|
Rate for Payer: Vantage Medical Group Senior |
$0.04
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
IP
|
$0.05
|
|
Service Code
|
NDC 0172-2083-60
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.04 |
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 |
$0.02
|
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 |
$0.04
|
Rate for Payer: Global Benefits Group Commercial |
$0.03
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.03
|
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 |
$0.04
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Prime Health Services Commercial |
$0.04
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
IP
|
$0.25
|
|
Service Code
|
NDC 60687-593-11
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.21 |
Rate for Payer: Blue Shield of California Commercial |
$0.18
|
Rate for Payer: Blue Shield of California EPN |
$0.13
|
Rate for Payer: Cash Price |
$0.11
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.21
|
Rate for Payer: Global Benefits Group Commercial |
$0.15
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.20
|
Rate for Payer: Networks By Design Commercial |
$0.16
|
Rate for Payer: Prime Health Services Commercial |
$0.21
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
IP
|
$0.02
|
|
Service Code
|
NDC 16729-183-01
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
OP
|
$0.02
|
|
Service Code
|
NDC 16729-183-01
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
Rate for Payer: Dignity Health Media |
$0.02
|
Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
OP
|
$0.25
|
|
Service Code
|
NDC 60687-593-11
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.16
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.14
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
Rate for Payer: BCBS Transplant Transplant |
$0.15
|
Rate for Payer: Blue Shield of California Commercial |
$0.18
|
Rate for Payer: Blue Shield of California EPN |
$0.15
|
Rate for Payer: Cash Price |
$0.11
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.21
|
Rate for Payer: Dignity Health Media |
$0.21
|
Rate for Payer: Dignity Health Medi-Cal |
$0.21
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.21
|
Rate for Payer: Global Benefits Group Commercial |
$0.15
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.20
|
Rate for Payer: Networks By Design Commercial |
$0.16
|
Rate for Payer: Prime Health Services Commercial |
$0.21
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.15
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.15
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.15
|
Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
Rate for Payer: United Healthcare All Other HMO |
$0.13
|
Rate for Payer: United Healthcare HMO Rider |
$0.13
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.21
|
Rate for Payer: Vantage Medical Group Senior |
$0.21
|
|
HYDROCHLOROTHIAZIDE 25 MG TABLET [3720]
|
Facility
OP
|
$0.25
|
|
Service Code
|
NDC 60687-593-01
|
Hospital Charge Code |
1710460
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.21 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.16
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.21
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.14
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
Rate for Payer: BCBS Transplant Transplant |
$0.15
|
Rate for Payer: Blue Shield of California Commercial |
$0.18
|
Rate for Payer: Blue Shield of California EPN |
$0.15
|
Rate for Payer: Cash Price |
$0.11
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.21
|
Rate for Payer: Dignity Health Media |
$0.21
|
Rate for Payer: Dignity Health Medi-Cal |
$0.21
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.21
|
Rate for Payer: Global Benefits Group Commercial |
$0.15
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.20
|
Rate for Payer: Networks By Design Commercial |
$0.16
|
Rate for Payer: Prime Health Services Commercial |
$0.21
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.15
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.15
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.15
|
Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
Rate for Payer: United Healthcare All Other HMO |
$0.13
|
Rate for Payer: United Healthcare HMO Rider |
$0.13
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.21
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.21
|
Rate for Payer: Vantage Medical Group Senior |
$0.21
|
|
HYDROCHLOROTHIAZIDE 50 MG TABLET [3721]
|
Facility
IP
|
$0.08
|
|
Service Code
|
NDC 29300-129-01
|
Hospital Charge Code |
1710475
|
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
|
|
HYDROCHLOROTHIAZIDE 50 MG TABLET [3721]
|
Facility
OP
|
$0.08
|
|
Service Code
|
NDC 29300-129-01
|
Hospital Charge Code |
1710475
|
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
|
|
HYDROCHLOROTHIAZIDE ORAL SUSPENSION COMPOUND 5 MG/ML [4080280]
|
Facility
OP
|
$0.02
|
|
Service Code
|
NDC 9994-0802-80
|
Hospital Charge Code |
1715214
|
Hospital Revenue Code
|
259
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
Rate for Payer: Dignity Health Media |
$0.02
|
Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
HYDROCHLOROTHIAZIDE ORAL SUSPENSION COMPOUND 5 MG/ML [4080280]
|
Facility
IP
|
$0.02
|
|
Service Code
|
NDC 9994-0802-80
|
Hospital Charge Code |
1715214
|
Hospital Revenue Code
|
259
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
OP
|
$0.59
|
|
Service Code
|
NDC 0406-0125-62
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.14 |
Max. Negotiated Rate |
$0.50 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.39
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.50
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.32
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.32
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.35
|
Rate for Payer: BCBS Transplant Transplant |
$0.35
|
Rate for Payer: Blue Shield of California Commercial |
$0.43
|
Rate for Payer: Blue Shield of California EPN |
$0.34
|
Rate for Payer: Cash Price |
$0.27
|
Rate for Payer: Cigna of CA HMO |
$0.41
|
Rate for Payer: Cigna of CA PPO |
$0.41
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.50
|
Rate for Payer: Dignity Health Media |
$0.50
|
Rate for Payer: Dignity Health Medi-Cal |
$0.50
|
Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
Rate for Payer: EPIC Health Plan Transplant |
$0.24
|
Rate for Payer: Galaxy Health WC |
$0.50
|
Rate for Payer: Global Benefits Group Commercial |
$0.35
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.44
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
Rate for Payer: Multiplan Commercial |
$0.47
|
Rate for Payer: Networks By Design Commercial |
$0.38
|
Rate for Payer: Prime Health Services Commercial |
$0.50
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.35
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.35
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.35
|
Rate for Payer: United Healthcare All Other Commercial |
$0.30
|
Rate for Payer: United Healthcare All Other HMO |
$0.30
|
Rate for Payer: United Healthcare HMO Rider |
$0.30
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.30
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.50
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.50
|
Rate for Payer: Vantage Medical Group Senior |
$0.50
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
IP
|
$0.59
|
|
Service Code
|
NDC 0406-0125-23
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.14 |
Max. Negotiated Rate |
$0.50 |
Rate for Payer: Blue Shield of California Commercial |
$0.42
|
Rate for Payer: Blue Shield of California EPN |
$0.30
|
Rate for Payer: Cash Price |
$0.27
|
Rate for Payer: Cigna of CA HMO |
$0.41
|
Rate for Payer: Cigna of CA PPO |
$0.41
|
Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
Rate for Payer: Galaxy Health WC |
$0.50
|
Rate for Payer: Global Benefits Group Commercial |
$0.35
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
Rate for Payer: Multiplan Commercial |
$0.47
|
Rate for Payer: Networks By Design Commercial |
$0.38
|
Rate for Payer: Prime Health Services Commercial |
$0.50
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
IP
|
$0.59
|
|
Service Code
|
NDC 0406-0125-62
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.14 |
Max. Negotiated Rate |
$0.50 |
Rate for Payer: Blue Shield of California Commercial |
$0.42
|
Rate for Payer: Blue Shield of California EPN |
$0.30
|
Rate for Payer: Cash Price |
$0.27
|
Rate for Payer: Cigna of CA HMO |
$0.41
|
Rate for Payer: Cigna of CA PPO |
$0.41
|
Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
Rate for Payer: Galaxy Health WC |
$0.50
|
Rate for Payer: Global Benefits Group Commercial |
$0.35
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
Rate for Payer: Multiplan Commercial |
$0.47
|
Rate for Payer: Networks By Design Commercial |
$0.38
|
Rate for Payer: Prime Health Services Commercial |
$0.50
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
IP
|
$0.51
|
|
Service Code
|
NDC 0904-6825-61
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.12 |
Max. Negotiated Rate |
$0.43 |
Rate for Payer: Blue Shield of California Commercial |
$0.36
|
Rate for Payer: Blue Shield of California EPN |
$0.26
|
Rate for Payer: Cash Price |
$0.23
|
Rate for Payer: Cigna of CA HMO |
$0.36
|
Rate for Payer: Cigna of CA PPO |
$0.36
|
Rate for Payer: EPIC Health Plan Commercial |
$0.20
|
Rate for Payer: Galaxy Health WC |
$0.43
|
Rate for Payer: Global Benefits Group Commercial |
$0.31
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.34
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.19
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
Rate for Payer: Multiplan Commercial |
$0.41
|
Rate for Payer: Networks By Design Commercial |
$0.33
|
Rate for Payer: Prime Health Services Commercial |
$0.43
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
IP
|
$0.26
|
|
Service Code
|
NDC 0406-0125-05
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.22 |
Rate for Payer: Blue Shield of California Commercial |
$0.19
|
Rate for Payer: Blue Shield of California EPN |
$0.13
|
Rate for Payer: Cash Price |
$0.12
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.22
|
Rate for Payer: Global Benefits Group Commercial |
$0.16
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.21
|
Rate for Payer: Networks By Design Commercial |
$0.17
|
Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
IP
|
$0.26
|
|
Service Code
|
NDC 0406-0125-01
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.22 |
Rate for Payer: Blue Shield of California Commercial |
$0.19
|
Rate for Payer: Blue Shield of California EPN |
$0.13
|
Rate for Payer: Cash Price |
$0.12
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.22
|
Rate for Payer: Global Benefits Group Commercial |
$0.16
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.21
|
Rate for Payer: Networks By Design Commercial |
$0.17
|
Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
OP
|
$0.26
|
|
Service Code
|
NDC 0406-0125-05
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.17
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.22
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.14
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
Rate for Payer: BCBS Transplant Transplant |
$0.16
|
Rate for Payer: Blue Shield of California Commercial |
$0.19
|
Rate for Payer: Blue Shield of California EPN |
$0.15
|
Rate for Payer: Cash Price |
$0.12
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
Rate for Payer: Dignity Health Media |
$0.22
|
Rate for Payer: Dignity Health Medi-Cal |
$0.22
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.22
|
Rate for Payer: Global Benefits Group Commercial |
$0.16
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.20
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.21
|
Rate for Payer: Networks By Design Commercial |
$0.17
|
Rate for Payer: Prime Health Services Commercial |
$0.22
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.16
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
Rate for Payer: United Healthcare All Other HMO |
$0.13
|
Rate for Payer: United Healthcare HMO Rider |
$0.13
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.22
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
Rate for Payer: Vantage Medical Group Senior |
$0.22
|
|
HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET [28384]
|
Facility
OP
|
$0.26
|
|
Service Code
|
NDC 0406-0125-01
|
Hospital Charge Code |
1730146
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.06 |
Max. Negotiated Rate |
$0.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.17
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.22
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.14
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
Rate for Payer: BCBS Transplant Transplant |
$0.16
|
Rate for Payer: Blue Shield of California Commercial |
$0.19
|
Rate for Payer: Blue Shield of California EPN |
$0.15
|
Rate for Payer: Cash Price |
$0.12
|
Rate for Payer: Cigna of CA HMO |
$0.18
|
Rate for Payer: Cigna of CA PPO |
$0.18
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
Rate for Payer: Dignity Health Media |
$0.22
|
Rate for Payer: Dignity Health Medi-Cal |
$0.22
|
Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
Rate for Payer: Galaxy Health WC |
$0.22
|
Rate for Payer: Global Benefits Group Commercial |
$0.16
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.20
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
Rate for Payer: Multiplan Commercial |
$0.21
|
Rate for Payer: Networks By Design Commercial |
$0.17
|
Rate for Payer: Prime Health Services Commercial |
$0.22
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.16
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
Rate for Payer: United Healthcare All Other HMO |
$0.13
|
Rate for Payer: United Healthcare HMO Rider |
$0.13
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.22
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
Rate for Payer: Vantage Medical Group Senior |
$0.22
|
|