METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
IP
|
$0.46
|
|
Service Code
|
NDC 68001-501-00
|
Hospital Charge Code |
1711589
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.39 |
Rate for Payer: Blue Shield of California Commercial |
$0.33
|
Rate for Payer: Blue Shield of California EPN |
$0.24
|
Rate for Payer: Cash Price |
$0.21
|
Rate for Payer: Cigna of CA HMO |
$0.32
|
Rate for Payer: Cigna of CA PPO |
$0.32
|
Rate for Payer: EPIC Health Plan Commercial |
$0.18
|
Rate for Payer: Galaxy Health WC |
$0.39
|
Rate for Payer: Global Benefits Group Commercial |
$0.28
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.31
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
Rate for Payer: Multiplan Commercial |
$0.37
|
Rate for Payer: Networks By Design Commercial |
$0.30
|
Rate for Payer: Prime Health Services Commercial |
$0.39
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
IP
|
$0.54
|
|
Service Code
|
NDC 50268-541-11
|
Hospital Charge Code |
1711589
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.13 |
Max. Negotiated Rate |
$0.46 |
Rate for Payer: Blue Shield of California Commercial |
$0.38
|
Rate for Payer: Blue Shield of California EPN |
$0.28
|
Rate for Payer: Cash Price |
$0.24
|
Rate for Payer: Cigna of CA HMO |
$0.38
|
Rate for Payer: Cigna of CA PPO |
$0.38
|
Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
Rate for Payer: Galaxy Health WC |
$0.46
|
Rate for Payer: Global Benefits Group Commercial |
$0.32
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.36
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.21
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
Rate for Payer: Multiplan Commercial |
$0.43
|
Rate for Payer: Networks By Design Commercial |
$0.35
|
Rate for Payer: Prime Health Services Commercial |
$0.46
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
OP
|
$1.05
|
|
Service Code
|
NDC 51079-170-01
|
Hospital Charge Code |
1711589
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.25 |
Max. Negotiated Rate |
$0.89 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.69
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.89
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.58
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.58
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
Rate for Payer: BCBS Transplant Transplant |
$0.63
|
Rate for Payer: Blue Shield of California Commercial |
$0.77
|
Rate for Payer: Blue Shield of California EPN |
$0.61
|
Rate for Payer: Cash Price |
$0.47
|
Rate for Payer: Cigna of CA HMO |
$0.74
|
Rate for Payer: Cigna of CA PPO |
$0.74
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.89
|
Rate for Payer: Dignity Health Media |
$0.89
|
Rate for Payer: Dignity Health Medi-Cal |
$0.89
|
Rate for Payer: EPIC Health Plan Commercial |
$0.42
|
Rate for Payer: EPIC Health Plan Transplant |
$0.42
|
Rate for Payer: Galaxy Health WC |
$0.89
|
Rate for Payer: Global Benefits Group Commercial |
$0.63
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.79
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.70
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.40
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.25
|
Rate for Payer: Multiplan Commercial |
$0.84
|
Rate for Payer: Networks By Design Commercial |
$0.68
|
Rate for Payer: Prime Health Services Commercial |
$0.89
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.63
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.63
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.63
|
Rate for Payer: United Healthcare All Other Commercial |
$0.53
|
Rate for Payer: United Healthcare All Other HMO |
$0.53
|
Rate for Payer: United Healthcare HMO Rider |
$0.53
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.53
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.89
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.89
|
Rate for Payer: Vantage Medical Group Senior |
$0.89
|
|
METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR [30070]
|
Facility
OP
|
$0.08
|
|
Service Code
|
NDC 72516-031-01
|
Hospital Charge Code |
1711589
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 57664-167-52
|
Hospital Charge Code |
1710592
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 57237-102-01
|
Hospital Charge Code |
1710592
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 57237-102-01
|
Hospital Charge Code |
1710592
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
IP
|
$0.05
|
|
Service Code
|
NDC 65862-064-01
|
Hospital Charge Code |
1710592
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
OP
|
$0.05
|
|
Service Code
|
NDC 65862-064-01
|
Hospital Charge Code |
1710592
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
OP
|
$0.34
|
|
Service Code
|
NDC 62584-267-01
|
Hospital Charge Code |
1710592
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.08 |
Max. Negotiated Rate |
$0.29 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.22
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.29
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.19
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.20
|
Rate for Payer: BCBS Transplant Transplant |
$0.20
|
Rate for Payer: Blue Shield of California Commercial |
$0.25
|
Rate for Payer: Blue Shield of California EPN |
$0.20
|
Rate for Payer: Cash Price |
$0.15
|
Rate for Payer: Cigna of CA HMO |
$0.24
|
Rate for Payer: Cigna of CA PPO |
$0.24
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.29
|
Rate for Payer: Dignity Health Media |
$0.29
|
Rate for Payer: Dignity Health Medi-Cal |
$0.29
|
Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
Rate for Payer: EPIC Health Plan Transplant |
$0.14
|
Rate for Payer: Galaxy Health WC |
$0.29
|
Rate for Payer: Global Benefits Group Commercial |
$0.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.26
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.23
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.13
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
Rate for Payer: Multiplan Commercial |
$0.27
|
Rate for Payer: Networks By Design Commercial |
$0.22
|
Rate for Payer: Prime Health Services Commercial |
$0.29
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.20
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.20
|
Rate for Payer: United Healthcare All Other Commercial |
$0.17
|
Rate for Payer: United Healthcare All Other HMO |
$0.17
|
Rate for Payer: United Healthcare HMO Rider |
$0.17
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.17
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.29
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.29
|
Rate for Payer: Vantage Medical Group Senior |
$0.29
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
IP
|
$0.34
|
|
Service Code
|
NDC 62584-267-01
|
Hospital Charge Code |
1710592
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.08 |
Max. Negotiated Rate |
$0.29 |
Rate for Payer: Blue Shield of California Commercial |
$0.24
|
Rate for Payer: Blue Shield of California EPN |
$0.17
|
Rate for Payer: Cash Price |
$0.15
|
Rate for Payer: Cigna of CA HMO |
$0.24
|
Rate for Payer: Cigna of CA PPO |
$0.24
|
Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
Rate for Payer: Galaxy Health WC |
$0.29
|
Rate for Payer: Global Benefits Group Commercial |
$0.20
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.23
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.13
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
Rate for Payer: Multiplan Commercial |
$0.27
|
Rate for Payer: Networks By Design Commercial |
$0.22
|
Rate for Payer: Prime Health Services Commercial |
$0.29
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
OP
|
$0.34
|
|
Service Code
|
NDC 62584-267-11
|
Hospital Charge Code |
1710592
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.08 |
Max. Negotiated Rate |
$0.29 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.22
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.29
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.19
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.20
|
Rate for Payer: BCBS Transplant Transplant |
$0.20
|
Rate for Payer: Blue Shield of California Commercial |
$0.25
|
Rate for Payer: Blue Shield of California EPN |
$0.20
|
Rate for Payer: Cash Price |
$0.15
|
Rate for Payer: Cigna of CA HMO |
$0.24
|
Rate for Payer: Cigna of CA PPO |
$0.24
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.29
|
Rate for Payer: Dignity Health Media |
$0.29
|
Rate for Payer: Dignity Health Medi-Cal |
$0.29
|
Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
Rate for Payer: EPIC Health Plan Transplant |
$0.14
|
Rate for Payer: Galaxy Health WC |
$0.29
|
Rate for Payer: Global Benefits Group Commercial |
$0.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.26
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.23
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.13
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
Rate for Payer: Multiplan Commercial |
$0.27
|
Rate for Payer: Networks By Design Commercial |
$0.22
|
Rate for Payer: Prime Health Services Commercial |
$0.29
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.20
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.20
|
Rate for Payer: United Healthcare All Other Commercial |
$0.17
|
Rate for Payer: United Healthcare All Other HMO |
$0.17
|
Rate for Payer: United Healthcare HMO Rider |
$0.17
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.17
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.29
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.29
|
Rate for Payer: Vantage Medical Group Senior |
$0.29
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 57664-167-52
|
Hospital Charge Code |
1710592
|
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
|
|
METOPROLOL TARTRATE 100 MG TABLET [5008]
|
Facility
IP
|
$0.34
|
|
Service Code
|
NDC 62584-267-11
|
Hospital Charge Code |
1710592
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.08 |
Max. Negotiated Rate |
$0.29 |
Rate for Payer: Blue Shield of California Commercial |
$0.24
|
Rate for Payer: Blue Shield of California EPN |
$0.17
|
Rate for Payer: Cash Price |
$0.15
|
Rate for Payer: Cigna of CA HMO |
$0.24
|
Rate for Payer: Cigna of CA PPO |
$0.24
|
Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
Rate for Payer: Galaxy Health WC |
$0.29
|
Rate for Payer: Global Benefits Group Commercial |
$0.20
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.23
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.13
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
Rate for Payer: Multiplan Commercial |
$0.27
|
Rate for Payer: Networks By Design Commercial |
$0.22
|
Rate for Payer: Prime Health Services Commercial |
$0.29
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.03
|
|
Service Code
|
NDC 57664-506-58
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.02
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
Rate for Payer: BCBS Transplant Transplant |
$0.02
|
Rate for Payer: Blue Shield of California Commercial |
$0.02
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.02
|
Rate for Payer: Cigna of CA PPO |
$0.02
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
Rate for Payer: Dignity Health Media |
$0.03
|
Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
Rate for Payer: United Healthcare All Other HMO |
$0.02
|
Rate for Payer: United Healthcare HMO Rider |
$0.02
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
IP
|
$0.03
|
|
Service Code
|
NDC 65862-062-01
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Blue Shield of California Commercial |
$0.02
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.02
|
Rate for Payer: Cigna of CA PPO |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.10
|
|
Service Code
|
NDC 62584-265-01
|
Hospital Charge Code |
1712281
|
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
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
IP
|
$0.04
|
|
Service Code
|
NDC 57664-506-52
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Blue Shield of California Commercial |
$0.03
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.02
|
Rate for Payer: Cigna of CA HMO |
$0.03
|
Rate for Payer: Cigna of CA PPO |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
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 |
$0.03
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.03
|
|
Service Code
|
NDC 65862-062-01
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.02
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
Rate for Payer: BCBS Transplant Transplant |
$0.02
|
Rate for Payer: Blue Shield of California Commercial |
$0.02
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.02
|
Rate for Payer: Cigna of CA PPO |
$0.02
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
Rate for Payer: Dignity Health Media |
$0.03
|
Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
Rate for Payer: United Healthcare All Other HMO |
$0.02
|
Rate for Payer: United Healthcare HMO Rider |
$0.02
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.03
|
|
Service Code
|
NDC 52817-360-10
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.02
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
Rate for Payer: BCBS Transplant Transplant |
$0.02
|
Rate for Payer: Blue Shield of California Commercial |
$0.02
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.02
|
Rate for Payer: Cigna of CA PPO |
$0.02
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
Rate for Payer: Dignity Health Media |
$0.03
|
Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
Rate for Payer: United Healthcare All Other HMO |
$0.02
|
Rate for Payer: United Healthcare HMO Rider |
$0.02
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
IP
|
$0.04
|
|
Service Code
|
NDC 57237-100-01
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Blue Shield of California Commercial |
$0.03
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.02
|
Rate for Payer: Cigna of CA HMO |
$0.03
|
Rate for Payer: Cigna of CA PPO |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
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 |
$0.03
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
IP
|
$0.11
|
|
Service Code
|
NDC 51079-255-20
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Blue Shield of California Commercial |
$0.08
|
Rate for Payer: Blue Shield of California EPN |
$0.06
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.08
|
Rate for Payer: Cigna of CA PPO |
$0.08
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.07
|
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 |
$0.03
|
Rate for Payer: Multiplan Commercial |
$0.09
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.11
|
|
Service Code
|
NDC 51079-255-01
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.03 |
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 |
$0.07
|
Rate for Payer: BCBS Transplant Transplant |
$0.07
|
Rate for Payer: Blue Shield of California Commercial |
$0.08
|
Rate for Payer: Blue Shield of California EPN |
$0.06
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.08
|
Rate for Payer: Cigna of CA PPO |
$0.08
|
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 |
$0.07
|
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 |
$0.03
|
Rate for Payer: Multiplan Commercial |
$0.09
|
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 |
$0.07
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.07
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.07
|
Rate for Payer: United Healthcare All Other Commercial |
$0.06
|
Rate for Payer: United Healthcare All Other HMO |
$0.06
|
Rate for Payer: United Healthcare HMO Rider |
$0.06
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.06
|
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
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.04
|
|
Service Code
|
NDC 57664-506-52
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: BCBS Transplant Transplant |
$0.02
|
Rate for Payer: Aetna of CA HMO/PPO |
$0.03
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
Rate for Payer: Blue Shield of California Commercial |
$0.03
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.02
|
Rate for Payer: Cigna of CA HMO |
$0.03
|
Rate for Payer: Cigna of CA PPO |
$0.03
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
Rate for Payer: Dignity Health Media |
$0.03
|
Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$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 |
$0.03
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
Rate for Payer: United Healthcare All Other HMO |
$0.02
|
Rate for Payer: United Healthcare HMO Rider |
$0.02
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
METOPROLOL TARTRATE 25 MG TABLET [37637]
|
Facility
OP
|
$0.10
|
|
Service Code
|
NDC 62584-265-11
|
Hospital Charge Code |
1712281
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Galaxy Health WC |
$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: 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
|
|