|
DESIPRAMINE 25 MG TABLET [2286]
|
Facility
|
OP
|
$0.18
|
|
|
Service Code
|
NDC 5074211301
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.16 |
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California EPN |
$0.07
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Central Health Plan Commercial |
$0.14
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.07
|
| Rate for Payer: EPIC Health Plan Senior |
$0.07
|
| Rate for Payer: Galaxy Health WC |
$0.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.13
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$0.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.09
|
| Rate for Payer: United Healthcare All Other HMO |
$0.09
|
| Rate for Payer: United Healthcare HMO Rider |
$0.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Vantage Medical Group Senior |
$0.15
|
|
|
DESIPRAMINE 25 MG TABLET [2286]
|
Facility
|
IP
|
$1.34
|
|
|
Service Code
|
NDC 4596334202
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1.07
|
| Rate for Payer: Blue Shield of California EPN |
$0.68
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Central Health Plan Commercial |
$1.07
|
| Rate for Payer: Cigna of CA HMO |
$0.94
|
| Rate for Payer: Cigna of CA PPO |
$0.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.54
|
| Rate for Payer: EPIC Health Plan Senior |
$0.54
|
| Rate for Payer: Galaxy Health WC |
$1.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$1.00
|
| Rate for Payer: Networks By Design Commercial |
$0.87
|
| Rate for Payer: Prime Health Services Commercial |
$1.14
|
|
|
DESIPRAMINE 25 MG TABLET [2286]
|
Facility
|
OP
|
$1.34
|
|
|
Service Code
|
NDC 4596334202
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.78
|
| Rate for Payer: Blue Shield of California Commercial |
$0.85
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Central Health Plan Commercial |
$1.07
|
| Rate for Payer: Cigna of CA HMO |
$0.94
|
| Rate for Payer: Cigna of CA PPO |
$0.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.54
|
| Rate for Payer: EPIC Health Plan Senior |
$0.54
|
| Rate for Payer: Galaxy Health WC |
$1.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.94
|
| Rate for Payer: Multiplan Commercial |
$1.00
|
| Rate for Payer: Networks By Design Commercial |
$0.87
|
| Rate for Payer: Prime Health Services Commercial |
$1.14
|
| Rate for Payer: Riverside University Health System MISP |
$0.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.67
|
| Rate for Payer: United Healthcare All Other HMO |
$0.67
|
| Rate for Payer: United Healthcare HMO Rider |
$0.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.14
|
| Rate for Payer: Vantage Medical Group Senior |
$1.14
|
|
|
DESIPRAMINE 25 MG TABLET [2286]
|
Facility
|
IP
|
$0.18
|
|
|
Service Code
|
NDC 5074211301
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.16 |
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California Commercial |
$0.14
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Central Health Plan Commercial |
$0.14
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.07
|
| Rate for Payer: EPIC Health Plan Senior |
$0.07
|
| Rate for Payer: Galaxy Health WC |
$0.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.11
|
| 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
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
IP
|
$0.88
|
|
|
Service Code
|
NDC 6050502571
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.79 |
| Rate for Payer: Adventist Health Commercial |
$0.18
|
| Rate for Payer: Blue Shield of California Commercial |
$0.71
|
| Rate for Payer: Blue Shield of California EPN |
$0.44
|
| Rate for Payer: Cash Price |
$0.40
|
| Rate for Payer: Central Health Plan Commercial |
$0.70
|
| Rate for Payer: Cigna of CA HMO |
$0.62
|
| Rate for Payer: Cigna of CA PPO |
$0.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.35
|
| Rate for Payer: EPIC Health Plan Senior |
$0.35
|
| Rate for Payer: Galaxy Health WC |
$0.75
|
| Rate for Payer: Global Benefits Group Commercial |
$0.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.66
|
| Rate for Payer: Networks By Design Commercial |
$0.57
|
| Rate for Payer: Prime Health Services Commercial |
$0.75
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
IP
|
$0.88
|
|
|
Service Code
|
NDC 6800157400
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.79 |
| Rate for Payer: Adventist Health Commercial |
$0.18
|
| Rate for Payer: Blue Shield of California Commercial |
$0.71
|
| Rate for Payer: Blue Shield of California EPN |
$0.44
|
| Rate for Payer: Cash Price |
$0.40
|
| Rate for Payer: Central Health Plan Commercial |
$0.70
|
| Rate for Payer: Cigna of CA HMO |
$0.62
|
| Rate for Payer: Cigna of CA PPO |
$0.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.35
|
| Rate for Payer: EPIC Health Plan Senior |
$0.35
|
| Rate for Payer: Galaxy Health WC |
$0.75
|
| Rate for Payer: Global Benefits Group Commercial |
$0.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.66
|
| Rate for Payer: Networks By Design Commercial |
$0.57
|
| Rate for Payer: Prime Health Services Commercial |
$0.75
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
IP
|
$2.63
|
|
|
Service Code
|
NDC 6068772111
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Adventist Health Commercial |
$0.53
|
| Rate for Payer: Blue Shield of California Commercial |
$2.11
|
| Rate for Payer: Blue Shield of California EPN |
$1.33
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Central Health Plan Commercial |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$1.84
|
| Rate for Payer: Cigna of CA PPO |
$1.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.05
|
| Rate for Payer: Galaxy Health WC |
$2.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.53
|
| Rate for Payer: Multiplan Commercial |
$1.97
|
| Rate for Payer: Networks By Design Commercial |
$1.71
|
| Rate for Payer: Prime Health Services Commercial |
$2.24
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
OP
|
$2.63
|
|
|
Service Code
|
NDC 6068772121
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Adventist Health Commercial |
$0.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.53
|
| Rate for Payer: Blue Shield of California Commercial |
$1.67
|
| Rate for Payer: Blue Shield of California EPN |
$1.05
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Central Health Plan Commercial |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$1.84
|
| Rate for Payer: Cigna of CA PPO |
$1.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.05
|
| Rate for Payer: Galaxy Health WC |
$2.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.84
|
| Rate for Payer: Multiplan Commercial |
$1.97
|
| Rate for Payer: Networks By Design Commercial |
$1.71
|
| Rate for Payer: Prime Health Services Commercial |
$2.24
|
| Rate for Payer: Riverside University Health System MISP |
$1.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.31
|
| Rate for Payer: United Healthcare All Other HMO |
$1.31
|
| Rate for Payer: United Healthcare HMO Rider |
$1.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.24
|
| Rate for Payer: Vantage Medical Group Senior |
$2.24
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
OP
|
$2.63
|
|
|
Service Code
|
NDC 6068772111
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Adventist Health Commercial |
$0.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.53
|
| Rate for Payer: Blue Shield of California Commercial |
$1.67
|
| Rate for Payer: Blue Shield of California EPN |
$1.05
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Central Health Plan Commercial |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$1.84
|
| Rate for Payer: Cigna of CA PPO |
$1.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.05
|
| Rate for Payer: Galaxy Health WC |
$2.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.84
|
| Rate for Payer: Multiplan Commercial |
$1.97
|
| Rate for Payer: Networks By Design Commercial |
$1.71
|
| Rate for Payer: Prime Health Services Commercial |
$2.24
|
| Rate for Payer: Riverside University Health System MISP |
$1.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.31
|
| Rate for Payer: United Healthcare All Other HMO |
$1.31
|
| Rate for Payer: United Healthcare HMO Rider |
$1.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.24
|
| Rate for Payer: Vantage Medical Group Senior |
$2.24
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 6800157400
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.79 |
| Rate for Payer: Adventist Health Commercial |
$0.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.51
|
| Rate for Payer: Blue Shield of California Commercial |
$0.56
|
| Rate for Payer: Blue Shield of California EPN |
$0.35
|
| Rate for Payer: Cash Price |
$0.40
|
| Rate for Payer: Central Health Plan Commercial |
$0.70
|
| Rate for Payer: Cigna of CA HMO |
$0.62
|
| Rate for Payer: Cigna of CA PPO |
$0.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.35
|
| Rate for Payer: EPIC Health Plan Senior |
$0.35
|
| Rate for Payer: Galaxy Health WC |
$0.75
|
| Rate for Payer: Global Benefits Group Commercial |
$0.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.62
|
| Rate for Payer: Multiplan Commercial |
$0.66
|
| Rate for Payer: Networks By Design Commercial |
$0.57
|
| Rate for Payer: Prime Health Services Commercial |
$0.75
|
| Rate for Payer: Riverside University Health System MISP |
$0.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.44
|
| Rate for Payer: United Healthcare All Other HMO |
$0.44
|
| Rate for Payer: United Healthcare HMO Rider |
$0.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.75
|
| Rate for Payer: Vantage Medical Group Senior |
$0.75
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
IP
|
$2.63
|
|
|
Service Code
|
NDC 6068772121
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Adventist Health Commercial |
$0.53
|
| Rate for Payer: Blue Shield of California Commercial |
$2.11
|
| Rate for Payer: Blue Shield of California EPN |
$1.33
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Central Health Plan Commercial |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$1.84
|
| Rate for Payer: Cigna of CA PPO |
$1.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.05
|
| Rate for Payer: Galaxy Health WC |
$2.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.53
|
| Rate for Payer: Multiplan Commercial |
$1.97
|
| Rate for Payer: Networks By Design Commercial |
$1.71
|
| Rate for Payer: Prime Health Services Commercial |
$2.24
|
|
|
DESMOPRESSIN 0.1 MG TABLET [16052]
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 6050502571
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.79 |
| Rate for Payer: Adventist Health Commercial |
$0.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.51
|
| Rate for Payer: Blue Shield of California Commercial |
$0.56
|
| Rate for Payer: Blue Shield of California EPN |
$0.35
|
| Rate for Payer: Cash Price |
$0.40
|
| Rate for Payer: Central Health Plan Commercial |
$0.70
|
| Rate for Payer: Cigna of CA HMO |
$0.62
|
| Rate for Payer: Cigna of CA PPO |
$0.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.35
|
| Rate for Payer: EPIC Health Plan Senior |
$0.35
|
| Rate for Payer: Galaxy Health WC |
$0.75
|
| Rate for Payer: Global Benefits Group Commercial |
$0.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.62
|
| Rate for Payer: Multiplan Commercial |
$0.66
|
| Rate for Payer: Networks By Design Commercial |
$0.57
|
| Rate for Payer: Prime Health Services Commercial |
$0.75
|
| Rate for Payer: Riverside University Health System MISP |
$0.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.44
|
| Rate for Payer: United Healthcare All Other HMO |
$0.44
|
| Rate for Payer: United Healthcare HMO Rider |
$0.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.75
|
| Rate for Payer: Vantage Medical Group Senior |
$0.75
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
IP
|
$3.76
|
|
|
Service Code
|
NDC 6068773211
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Adventist Health Commercial |
$0.75
|
| Rate for Payer: Blue Shield of California Commercial |
$3.02
|
| Rate for Payer: Blue Shield of California EPN |
$1.90
|
| Rate for Payer: Cash Price |
$1.69
|
| Rate for Payer: Central Health Plan Commercial |
$3.01
|
| Rate for Payer: Cigna of CA HMO |
$2.63
|
| Rate for Payer: Cigna of CA PPO |
$2.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.50
|
| Rate for Payer: EPIC Health Plan Senior |
$1.50
|
| Rate for Payer: Galaxy Health WC |
$3.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Multiplan Commercial |
$2.82
|
| Rate for Payer: Networks By Design Commercial |
$2.44
|
| Rate for Payer: Prime Health Services Commercial |
$3.20
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
OP
|
$0.99
|
|
|
Service Code
|
NDC 6800157500
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.89 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.58
|
| Rate for Payer: Blue Shield of California Commercial |
$0.63
|
| Rate for Payer: Blue Shield of California EPN |
$0.40
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Central Health Plan Commercial |
$0.79
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.40
|
| Rate for Payer: EPIC Health Plan Senior |
$0.40
|
| Rate for Payer: Galaxy Health WC |
$0.84
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.84
|
| Rate for Payer: Riverside University Health System MISP |
$0.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.50
|
| Rate for Payer: United Healthcare All Other HMO |
$0.50
|
| Rate for Payer: United Healthcare HMO Rider |
$0.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.84
|
| Rate for Payer: Vantage Medical Group Senior |
$0.84
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
OP
|
$3.76
|
|
|
Service Code
|
NDC 6068773221
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Adventist Health Commercial |
$0.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.19
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$1.50
|
| Rate for Payer: Cash Price |
$1.69
|
| Rate for Payer: Central Health Plan Commercial |
$3.01
|
| Rate for Payer: Cigna of CA HMO |
$2.63
|
| Rate for Payer: Cigna of CA PPO |
$2.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.50
|
| Rate for Payer: EPIC Health Plan Senior |
$1.50
|
| Rate for Payer: Galaxy Health WC |
$3.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.63
|
| Rate for Payer: Multiplan Commercial |
$2.82
|
| Rate for Payer: Networks By Design Commercial |
$2.44
|
| Rate for Payer: Prime Health Services Commercial |
$3.20
|
| Rate for Payer: Riverside University Health System MISP |
$1.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.88
|
| Rate for Payer: United Healthcare All Other HMO |
$1.88
|
| Rate for Payer: United Healthcare HMO Rider |
$1.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.20
|
| Rate for Payer: Vantage Medical Group Senior |
$3.20
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
IP
|
$0.99
|
|
|
Service Code
|
NDC 6800157500
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.89 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.79
|
| Rate for Payer: Blue Shield of California EPN |
$0.50
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Central Health Plan Commercial |
$0.79
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.40
|
| Rate for Payer: EPIC Health Plan Senior |
$0.40
|
| Rate for Payer: Galaxy Health WC |
$0.84
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.84
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
IP
|
$3.76
|
|
|
Service Code
|
NDC 6068773221
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Adventist Health Commercial |
$0.75
|
| Rate for Payer: Blue Shield of California Commercial |
$3.02
|
| Rate for Payer: Blue Shield of California EPN |
$1.90
|
| Rate for Payer: Cash Price |
$1.69
|
| Rate for Payer: Central Health Plan Commercial |
$3.01
|
| Rate for Payer: Cigna of CA HMO |
$2.63
|
| Rate for Payer: Cigna of CA PPO |
$2.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.50
|
| Rate for Payer: EPIC Health Plan Senior |
$1.50
|
| Rate for Payer: Galaxy Health WC |
$3.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Multiplan Commercial |
$2.82
|
| Rate for Payer: Networks By Design Commercial |
$2.44
|
| Rate for Payer: Prime Health Services Commercial |
$3.20
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
OP
|
$0.99
|
|
|
Service Code
|
NDC 6050502581
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.89 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.58
|
| Rate for Payer: Blue Shield of California Commercial |
$0.63
|
| Rate for Payer: Blue Shield of California EPN |
$0.40
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Central Health Plan Commercial |
$0.79
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.40
|
| Rate for Payer: EPIC Health Plan Senior |
$0.40
|
| Rate for Payer: Galaxy Health WC |
$0.84
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.84
|
| Rate for Payer: Riverside University Health System MISP |
$0.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.50
|
| Rate for Payer: United Healthcare All Other HMO |
$0.50
|
| Rate for Payer: United Healthcare HMO Rider |
$0.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.84
|
| Rate for Payer: Vantage Medical Group Senior |
$0.84
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
OP
|
$3.76
|
|
|
Service Code
|
NDC 6068773211
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Adventist Health Commercial |
$0.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.19
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$1.50
|
| Rate for Payer: Cash Price |
$1.69
|
| Rate for Payer: Central Health Plan Commercial |
$3.01
|
| Rate for Payer: Cigna of CA HMO |
$2.63
|
| Rate for Payer: Cigna of CA PPO |
$2.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.50
|
| Rate for Payer: EPIC Health Plan Senior |
$1.50
|
| Rate for Payer: Galaxy Health WC |
$3.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.63
|
| Rate for Payer: Multiplan Commercial |
$2.82
|
| Rate for Payer: Networks By Design Commercial |
$2.44
|
| Rate for Payer: Prime Health Services Commercial |
$3.20
|
| Rate for Payer: Riverside University Health System MISP |
$1.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.88
|
| Rate for Payer: United Healthcare All Other HMO |
$1.88
|
| Rate for Payer: United Healthcare HMO Rider |
$1.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.20
|
| Rate for Payer: Vantage Medical Group Senior |
$3.20
|
|
|
DESMOPRESSIN 0.2 MG TABLET [16053]
|
Facility
|
IP
|
$0.99
|
|
|
Service Code
|
NDC 6050502581
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.89 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.79
|
| Rate for Payer: Blue Shield of California EPN |
$0.50
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Central Health Plan Commercial |
$0.79
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.40
|
| Rate for Payer: EPIC Health Plan Senior |
$0.40
|
| Rate for Payer: Galaxy Health WC |
$0.84
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.84
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY [27770]
|
Facility
|
IP
|
$47.28
|
|
|
Service Code
|
NDC 2420834205
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Adventist Health Commercial |
$9.46
|
| Rate for Payer: Blue Shield of California Commercial |
$37.92
|
| Rate for Payer: Blue Shield of California EPN |
$23.83
|
| Rate for Payer: Cash Price |
$21.28
|
| Rate for Payer: Central Health Plan Commercial |
$37.82
|
| Rate for Payer: Cigna of CA HMO |
$33.10
|
| Rate for Payer: Cigna of CA PPO |
$33.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.91
|
| Rate for Payer: EPIC Health Plan Senior |
$18.91
|
| Rate for Payer: Galaxy Health WC |
$40.19
|
| Rate for Payer: Global Benefits Group Commercial |
$28.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.46
|
| Rate for Payer: Multiplan Commercial |
$35.46
|
| Rate for Payer: Networks By Design Commercial |
$30.73
|
| Rate for Payer: Prime Health Services Commercial |
$40.19
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY [27770]
|
Facility
|
OP
|
$47.28
|
|
|
Service Code
|
NDC 2420834205
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Adventist Health Commercial |
$9.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.50
|
| Rate for Payer: Blue Shield of California Commercial |
$29.98
|
| Rate for Payer: Blue Shield of California EPN |
$18.86
|
| Rate for Payer: Cash Price |
$21.28
|
| Rate for Payer: Central Health Plan Commercial |
$37.82
|
| Rate for Payer: Cigna of CA HMO |
$33.10
|
| Rate for Payer: Cigna of CA PPO |
$33.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.91
|
| Rate for Payer: EPIC Health Plan Senior |
$18.91
|
| Rate for Payer: Galaxy Health WC |
$40.19
|
| Rate for Payer: Global Benefits Group Commercial |
$28.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33.10
|
| Rate for Payer: Multiplan Commercial |
$35.46
|
| Rate for Payer: Networks By Design Commercial |
$30.73
|
| Rate for Payer: Prime Health Services Commercial |
$40.19
|
| Rate for Payer: Riverside University Health System MISP |
$18.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.64
|
| Rate for Payer: United Healthcare All Other HMO |
$23.64
|
| Rate for Payer: United Healthcare HMO Rider |
$23.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.19
|
| Rate for Payer: Vantage Medical Group Senior |
$40.19
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED) [21135]
|
Facility
|
IP
|
$29.55
|
|
|
Service Code
|
NDC 4733578891
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$26.59 |
| Rate for Payer: Adventist Health Commercial |
$5.91
|
| Rate for Payer: Blue Shield of California Commercial |
$23.70
|
| Rate for Payer: Blue Shield of California EPN |
$14.89
|
| Rate for Payer: Cash Price |
$13.30
|
| Rate for Payer: Central Health Plan Commercial |
$23.64
|
| Rate for Payer: Cigna of CA HMO |
$20.68
|
| Rate for Payer: Cigna of CA PPO |
$20.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11.82
|
| Rate for Payer: Galaxy Health WC |
$25.12
|
| Rate for Payer: Global Benefits Group Commercial |
$17.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.91
|
| Rate for Payer: Multiplan Commercial |
$22.16
|
| Rate for Payer: Networks By Design Commercial |
$19.21
|
| Rate for Payer: Prime Health Services Commercial |
$25.12
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED) [21135]
|
Facility
|
OP
|
$29.55
|
|
|
Service Code
|
NDC 4733578891
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$26.59 |
| Rate for Payer: Adventist Health Commercial |
$5.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.19
|
| Rate for Payer: Blue Shield of California Commercial |
$18.73
|
| Rate for Payer: Blue Shield of California EPN |
$11.79
|
| Rate for Payer: Cash Price |
$13.30
|
| Rate for Payer: Central Health Plan Commercial |
$23.64
|
| Rate for Payer: Cigna of CA HMO |
$20.68
|
| Rate for Payer: Cigna of CA PPO |
$20.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11.82
|
| Rate for Payer: Galaxy Health WC |
$25.12
|
| Rate for Payer: Global Benefits Group Commercial |
$17.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.68
|
| Rate for Payer: Multiplan Commercial |
$22.16
|
| Rate for Payer: Networks By Design Commercial |
$19.21
|
| Rate for Payer: Prime Health Services Commercial |
$25.12
|
| Rate for Payer: Riverside University Health System MISP |
$11.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.78
|
| Rate for Payer: United Healthcare All Other HMO |
$14.78
|
| Rate for Payer: United Healthcare HMO Rider |
$14.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.12
|
| Rate for Payer: Vantage Medical Group Senior |
$25.12
|
|
|
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION [9748]
|
Facility
|
OP
|
$63.00
|
|
|
Service Code
|
HCPCS J2597
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Adventist Health Commercial |
$12.60
|
| Rate for Payer: Adventist Health Commercial |
$7.71
|
| Rate for Payer: Adventist Health Commercial |
$3.84
|
| Rate for Payer: Adventist Health Commercial |
$9.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.10
|
| Rate for Payer: Blue Shield of California Commercial |
$12.87
|
| Rate for Payer: Blue Shield of California Commercial |
$12.87
|
| Rate for Payer: Blue Shield of California Commercial |
$12.87
|
| Rate for Payer: Blue Shield of California Commercial |
$12.87
|
| Rate for Payer: Blue Shield of California EPN |
$11.70
|
| Rate for Payer: Blue Shield of California EPN |
$11.70
|
| Rate for Payer: Blue Shield of California EPN |
$11.70
|
| Rate for Payer: Blue Shield of California EPN |
$11.70
|
| Rate for Payer: Cash Price |
$17.36
|
| Rate for Payer: Cash Price |
$28.35
|
| Rate for Payer: Cash Price |
$21.33
|
| Rate for Payer: Cash Price |
$17.36
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$28.35
|
| Rate for Payer: Cash Price |
$21.33
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.36
|
| Rate for Payer: Central Health Plan Commercial |
$30.86
|
| Rate for Payer: Central Health Plan Commercial |
$37.92
|
| Rate for Payer: Central Health Plan Commercial |
$50.40
|
| Rate for Payer: Cigna of CA HMO |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$44.10
|
| Rate for Payer: Cigna of CA HMO |
$13.44
|
| Rate for Payer: Cigna of CA HMO |
$33.18
|
| Rate for Payer: Cigna of CA PPO |
$44.10
|
| Rate for Payer: Cigna of CA PPO |
$27.00
|
| Rate for Payer: Cigna of CA PPO |
$13.44
|
| Rate for Payer: Cigna of CA PPO |
$33.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.68
|
| Rate for Payer: EPIC Health Plan Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.68
|
| Rate for Payer: EPIC Health Plan Senior |
$15.43
|
| Rate for Payer: Galaxy Health WC |
$40.29
|
| Rate for Payer: Galaxy Health WC |
$16.32
|
| Rate for Payer: Galaxy Health WC |
$32.78
|
| Rate for Payer: Galaxy Health WC |
$53.55
|
| Rate for Payer: Global Benefits Group Commercial |
$37.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.14
|
| Rate for Payer: Global Benefits Group Commercial |
$28.44
|
| Rate for Payer: Global Benefits Group Commercial |
$11.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$44.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13.44
|
| Rate for Payer: Multiplan Commercial |
$28.93
|
| Rate for Payer: Multiplan Commercial |
$35.55
|
| Rate for Payer: Multiplan Commercial |
$47.25
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$19.29
|
| Rate for Payer: Networks By Design Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$23.70
|
| Rate for Payer: Networks By Design Commercial |
$9.60
|
| Rate for Payer: Prime Health Services Commercial |
$40.29
|
| Rate for Payer: Prime Health Services Commercial |
$16.32
|
| Rate for Payer: Prime Health Services Commercial |
$32.78
|
| Rate for Payer: Prime Health Services Commercial |
$53.55
|
| Rate for Payer: Riverside University Health System MISP |
$15.43
|
| Rate for Payer: Riverside University Health System MISP |
$18.96
|
| Rate for Payer: Riverside University Health System MISP |
$7.68
|
| Rate for Payer: Riverside University Health System MISP |
$25.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.64
|
| Rate for Payer: United Healthcare All Other HMO |
$14.09
|
| Rate for Payer: United Healthcare All Other HMO |
$23.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$17.32
|
| Rate for Payer: United Healthcare HMO Rider |
$16.94
|
| Rate for Payer: United Healthcare HMO Rider |
$6.86
|
| Rate for Payer: United Healthcare HMO Rider |
$13.78
|
| Rate for Payer: United Healthcare HMO Rider |
$22.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.55
|
| Rate for Payer: Vantage Medical Group Senior |
$40.29
|
| Rate for Payer: Vantage Medical Group Senior |
$16.32
|
| Rate for Payer: Vantage Medical Group Senior |
$32.78
|
| Rate for Payer: Vantage Medical Group Senior |
$53.55
|
|
