|
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION [15706]
|
Facility
|
OP
|
$0.20
|
|
|
Service Code
|
NDC 0121119000
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.12
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.12
|
| Rate for Payer: Heritage Provider Network Senior |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.15
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.08
|
| Rate for Payer: TriValley Medical Group Senior |
$0.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.17
|
| Rate for Payer: Vantage Medical Group Senior |
$0.17
|
|
|
SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION [15706]
|
Facility
|
OP
|
$0.18
|
|
|
Service Code
|
NDC 5723731931
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$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 HMO/PPO |
$0.09
|
| Rate for Payer: Blue Shield of California Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.12
|
| 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: EPIC Health Plan Commercial |
$0.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.11
|
| Rate for Payer: Heritage Provider Network Senior |
$0.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.13
|
| Rate for Payer: Multiplan Commercial |
$0.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.07
|
| Rate for Payer: TriValley Medical Group Senior |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
IP
|
$0.49
|
|
|
Service Code
|
NDC 3932810710
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Adventist Health Commercial |
$0.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.32
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.33
|
| Rate for Payer: Heritage Provider Network Senior |
$0.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.37
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
OP
|
$0.97
|
|
|
Service Code
|
NDC 0486112501
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.82 |
| Rate for Payer: Adventist Health Commercial |
$0.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.49
|
| Rate for Payer: Blue Shield of California Commercial |
$0.59
|
| Rate for Payer: Blue Shield of California EPN |
$0.47
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.60
|
| Rate for Payer: Heritage Provider Network Senior |
$0.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.68
|
| Rate for Payer: Multiplan Commercial |
$0.73
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.39
|
| Rate for Payer: TriValley Medical Group Senior |
$0.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.82
|
| Rate for Payer: Vantage Medical Group Senior |
$0.82
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
OP
|
$0.92
|
|
|
Service Code
|
NDC 0486112505
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.78 |
| Rate for Payer: Adventist Health Commercial |
$0.18
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.46
|
| Rate for Payer: Blue Shield of California Commercial |
$0.56
|
| Rate for Payer: Blue Shield of California EPN |
$0.45
|
| Rate for Payer: Cash Price |
$0.41
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.57
|
| Rate for Payer: Heritage Provider Network Senior |
$0.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.64
|
| Rate for Payer: Multiplan Commercial |
$0.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.37
|
| Rate for Payer: TriValley Medical Group Senior |
$0.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.78
|
| Rate for Payer: Vantage Medical Group Senior |
$0.78
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
OP
|
$0.41
|
|
|
Service Code
|
NDC 6498010401
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.35 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.35
|
| Rate for Payer: Adventist Health Commercial |
$0.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.21
|
| 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 |
$0.18
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.25
|
| Rate for Payer: Heritage Provider Network Senior |
$0.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.29
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.21
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.35
|
| Rate for Payer: Vantage Medical Group Senior |
$0.35
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
IP
|
$0.41
|
|
|
Service Code
|
NDC 6498010401
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.31 |
| Rate for Payer: Adventist Health Commercial |
$0.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.26
|
| Rate for Payer: Cash Price |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.28
|
| Rate for Payer: Heritage Provider Network Senior |
$0.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
IP
|
$1.60
|
|
|
Service Code
|
NDC 6808476495
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$1.20 |
| Rate for Payer: Adventist Health Commercial |
$0.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.03
|
| Rate for Payer: Cash Price |
$0.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Multiplan Commercial |
$1.20
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
IP
|
$0.92
|
|
|
Service Code
|
NDC 0486112505
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.69 |
| Rate for Payer: Adventist Health Commercial |
$0.18
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.59
|
| Rate for Payer: Cash Price |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.62
|
| Rate for Payer: Heritage Provider Network Senior |
$0.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$0.69
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
IP
|
$0.97
|
|
|
Service Code
|
NDC 0486112501
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: Adventist Health Commercial |
$0.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.62
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.66
|
| Rate for Payer: Heritage Provider Network Senior |
$0.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.73
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
OP
|
$1.60
|
|
|
Service Code
|
NDC 6808476495
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$1.36 |
| Rate for Payer: Adventist Health Commercial |
$0.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Blue Shield of California Commercial |
$0.98
|
| Rate for Payer: Blue Shield of California EPN |
$0.78
|
| Rate for Payer: Cash Price |
$0.72
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.99
|
| Rate for Payer: Heritage Provider Network Senior |
$0.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$1.20
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.64
|
| Rate for Payer: TriValley Medical Group Senior |
$0.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.80
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.36
|
| Rate for Payer: Vantage Medical Group Senior |
$1.36
|
|
|
SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET [11067]
|
Facility
|
OP
|
$0.49
|
|
|
Service Code
|
NDC 3932810710
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.42 |
| Rate for Payer: Adventist Health Commercial |
$0.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.25
|
| Rate for Payer: Blue Shield of California Commercial |
$0.30
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.30
|
| Rate for Payer: Heritage Provider Network Senior |
$0.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$0.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.20
|
| Rate for Payer: TriValley Medical Group Senior |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.42
|
| Rate for Payer: Vantage Medical Group Senior |
$0.42
|
|
|
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS [24932]
|
Facility
|
IP
|
$7.63
|
|
|
Service Code
|
HCPCS J2916
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$5.72 |
| Rate for Payer: Adventist Health Commercial |
$1.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.91
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.53
|
| Rate for Payer: Heritage Provider Network Senior |
$3.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.91
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.76
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.53
|
|
|
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS [24932]
|
Facility
|
OP
|
$7.63
|
|
|
Service Code
|
HCPCS J2916
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Adventist Health Commercial |
$1.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.44
|
| Rate for Payer: Blue Shield of California Commercial |
$4.15
|
| Rate for Payer: Blue Shield of California EPN |
$4.15
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.53
|
| Rate for Payer: Heritage Provider Network Senior |
$3.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.34
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.05
|
| Rate for Payer: TriValley Medical Group Senior |
$3.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.76
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.49
|
| Rate for Payer: Vantage Medical Group Senior |
$6.49
|
|
|
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE [28913]
|
Facility
|
OP
|
$424.12
|
|
|
Service Code
|
NDC 8065183055
|
| Hospital Charge Code |
901700017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.77 |
| Max. Negotiated Rate |
$360.50 |
| Rate for Payer: Adventist Health Commercial |
$84.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$262.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$360.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$233.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$318.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$212.14
|
| Rate for Payer: Blue Shield of California Commercial |
$258.71
|
| Rate for Payer: Blue Shield of California EPN |
$206.97
|
| Rate for Payer: Cash Price |
$190.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$275.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$360.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$360.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$360.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$262.53
|
| Rate for Payer: Heritage Provider Network Senior |
$262.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$202.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$296.88
|
| Rate for Payer: Multiplan Commercial |
$318.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$212.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$212.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$360.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$360.50
|
| Rate for Payer: Vantage Medical Group Senior |
$360.50
|
|
|
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE [28913]
|
Facility
|
IP
|
$84.59
|
|
|
Service Code
|
NDC 8544508581
|
| Hospital Charge Code |
901700017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$63.44 |
| Rate for Payer: Adventist Health Commercial |
$16.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.48
|
| Rate for Payer: Cash Price |
$38.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.27
|
| Rate for Payer: Heritage Provider Network Senior |
$57.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.15
|
| Rate for Payer: Multiplan Commercial |
$63.44
|
|
|
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE [28913]
|
Facility
|
OP
|
$84.59
|
|
|
Service Code
|
NDC 8544508581
|
| Hospital Charge Code |
901700017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$71.90 |
| Rate for Payer: Adventist Health Commercial |
$16.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$52.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.31
|
| Rate for Payer: Blue Shield of California Commercial |
$51.60
|
| Rate for Payer: Blue Shield of California EPN |
$41.28
|
| Rate for Payer: Cash Price |
$38.07
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.36
|
| Rate for Payer: Heritage Provider Network Senior |
$52.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$59.21
|
| Rate for Payer: Multiplan Commercial |
$63.44
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$42.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$42.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.90
|
| Rate for Payer: Vantage Medical Group Senior |
$71.90
|
|
|
SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE [28913]
|
Facility
|
IP
|
$424.12
|
|
|
Service Code
|
NDC 8065183055
|
| Hospital Charge Code |
901700017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.77 |
| Max. Negotiated Rate |
$318.09 |
| Rate for Payer: Adventist Health Commercial |
$84.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$273.13
|
| Rate for Payer: Cash Price |
$190.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$287.13
|
| Rate for Payer: Heritage Provider Network Senior |
$287.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.03
|
| Rate for Payer: Multiplan Commercial |
$318.09
|
|
|
SODIUM HYALURONATE 14 MG/ML INTRAOCULAR SYRINGE [4080907]
|
Facility
|
IP
|
$261.36
|
|
|
Service Code
|
HCPCS J3590
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.31 |
| Max. Negotiated Rate |
$196.02 |
| Rate for Payer: Adventist Health Commercial |
$52.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$168.32
|
| Rate for Payer: Cash Price |
$117.61
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$121.01
|
| Rate for Payer: Heritage Provider Network Senior |
$121.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.34
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$94.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$86.54
|
|
|
SODIUM HYALURONATE 14 MG/ML INTRAOCULAR SYRINGE [4080907]
|
Facility
|
OP
|
$261.36
|
|
|
Service Code
|
HCPCS J3590
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.31 |
| Max. Negotiated Rate |
$222.16 |
| Rate for Payer: Adventist Health Commercial |
$52.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$222.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$196.02
|
| Rate for Payer: Blue Shield of California Commercial |
$159.43
|
| Rate for Payer: Blue Shield of California EPN |
$127.54
|
| Rate for Payer: Cash Price |
$117.61
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$222.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$222.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$222.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$121.01
|
| Rate for Payer: Heritage Provider Network Senior |
$121.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$124.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$182.95
|
| Rate for Payer: Multiplan Commercial |
$196.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$104.54
|
| Rate for Payer: TriValley Medical Group Senior |
$104.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$94.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$86.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$222.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$222.16
|
| Rate for Payer: Vantage Medical Group Senior |
$222.16
|
|
|
SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE [33109]
|
Facility
|
OP
|
$232.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$197.20 |
| Rate for Payer: Adventist Health Commercial |
$46.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$143.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$197.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$174.00
|
| Rate for Payer: Blue Shield of California Commercial |
$141.52
|
| Rate for Payer: Blue Shield of California EPN |
$113.22
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$106.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$197.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$197.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$197.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.42
|
| Rate for Payer: Heritage Provider Network Senior |
$107.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$110.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$162.40
|
| Rate for Payer: Multiplan Commercial |
$174.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$92.80
|
| Rate for Payer: TriValley Medical Group Senior |
$92.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$83.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$76.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$197.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$197.20
|
| Rate for Payer: Vantage Medical Group Senior |
$197.20
|
|
|
SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE [33109]
|
Facility
|
IP
|
$232.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$174.00 |
| Rate for Payer: Adventist Health Commercial |
$46.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.41
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$106.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.42
|
| Rate for Payer: Heritage Provider Network Senior |
$107.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Multiplan Commercial |
$174.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$83.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$76.82
|
|
|
SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE [4080908]
|
Facility
|
OP
|
$232.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$197.20 |
| Rate for Payer: Adventist Health Commercial |
$46.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$143.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$197.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$174.00
|
| Rate for Payer: Blue Shield of California Commercial |
$141.52
|
| Rate for Payer: Blue Shield of California EPN |
$113.22
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$106.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$197.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$197.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$197.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.42
|
| Rate for Payer: Heritage Provider Network Senior |
$107.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$110.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$162.40
|
| Rate for Payer: Multiplan Commercial |
$174.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$92.80
|
| Rate for Payer: TriValley Medical Group Senior |
$92.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$83.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$76.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$197.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$197.20
|
| Rate for Payer: Vantage Medical Group Senior |
$197.20
|
|
|
SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE [4080908]
|
Facility
|
IP
|
$232.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$174.00 |
| Rate for Payer: Adventist Health Commercial |
$46.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.41
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$106.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.42
|
| Rate for Payer: Heritage Provider Network Senior |
$107.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Multiplan Commercial |
$174.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$83.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$76.82
|
|
|
SODIUM HYPOCHLORITE 0.125 % SOLUTION [76720]
|
Facility
|
OP
|
$0.04
|
|
|
Service Code
|
NDC 3932806412
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$0.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.02
|
| Rate for Payer: Heritage Provider Network Senior |
$0.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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
|
|
