|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
OP
|
$4.72
|
|
|
Service Code
|
NDC 1366860630
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$4.01 |
| Rate for Payer: Adventist Health Commercial |
$0.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.36
|
| Rate for Payer: Blue Shield of California Commercial |
$2.88
|
| Rate for Payer: Blue Shield of California EPN |
$2.30
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.92
|
| Rate for Payer: Heritage Provider Network Senior |
$2.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.30
|
| Rate for Payer: Multiplan Commercial |
$3.54
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.89
|
| Rate for Payer: TriValley Medical Group Senior |
$1.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.36
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.01
|
| Rate for Payer: Vantage Medical Group Senior |
$4.01
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
OP
|
$5.74
|
|
|
Service Code
|
NDC 7071010473
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$4.88 |
| Rate for Payer: Adventist Health Commercial |
$1.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.87
|
| Rate for Payer: Blue Shield of California Commercial |
$3.50
|
| Rate for Payer: Blue Shield of California EPN |
$2.80
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.55
|
| Rate for Payer: Heritage Provider Network Senior |
$3.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.02
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.30
|
| Rate for Payer: TriValley Medical Group Senior |
$2.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4.88
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINT 3.5G BULK [4082888]
|
Facility
|
IP
|
$5.21
|
|
|
Service Code
|
NDC 2420891055
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.94 |
| Max. Negotiated Rate |
$3.91 |
| Rate for Payer: Adventist Health Commercial |
$1.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.36
|
| Rate for Payer: Cash Price |
$2.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.81
|
| 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 |
$0.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: Multiplan Commercial |
$3.91
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINT 3.5G BULK [4082888]
|
Facility
|
OP
|
$5.21
|
|
|
Service Code
|
NDC 2420891055
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.94 |
| Max. Negotiated Rate |
$4.43 |
| Rate for Payer: Adventist Health Commercial |
$1.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.61
|
| Rate for Payer: Blue Shield of California Commercial |
$3.18
|
| Rate for Payer: Blue Shield of California EPN |
$2.54
|
| Rate for Payer: Cash Price |
$2.34
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.22
|
| Rate for Payer: Heritage Provider Network Senior |
$3.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.65
|
| Rate for Payer: Multiplan Commercial |
$3.91
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.08
|
| Rate for Payer: TriValley Medical Group Senior |
$2.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.43
|
| Rate for Payer: Vantage Medical Group Senior |
$4.43
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
IP
|
$9.51
|
|
|
Service Code
|
NDC 7248567031
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$7.13 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.12
|
| Rate for Payer: Cash Price |
$4.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.44
|
| Rate for Payer: Heritage Provider Network Senior |
$6.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Multiplan Commercial |
$7.13
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
IP
|
$11.92
|
|
|
Service Code
|
NDC 2420891019
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$8.94 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.68
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.07
|
| Rate for Payer: Heritage Provider Network Senior |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$8.94
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
OP
|
$11.92
|
|
|
Service Code
|
NDC 2420891019
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$10.13 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.96
|
| Rate for Payer: Blue Shield of California Commercial |
$7.27
|
| Rate for Payer: Blue Shield of California EPN |
$5.82
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.38
|
| Rate for Payer: Heritage Provider Network Senior |
$7.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.34
|
| Rate for Payer: Multiplan Commercial |
$8.94
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.77
|
| Rate for Payer: TriValley Medical Group Senior |
$4.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.96
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.13
|
| Rate for Payer: Vantage Medical Group Senior |
$10.13
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
OP
|
$9.51
|
|
|
Service Code
|
NDC 7248567031
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.88
|
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.76
|
| Rate for Payer: Blue Shield of California Commercial |
$5.80
|
| Rate for Payer: Blue Shield of California EPN |
$4.64
|
| Rate for Payer: Cash Price |
$4.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.89
|
| Rate for Payer: Heritage Provider Network Senior |
$5.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$7.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.80
|
| Rate for Payer: TriValley Medical Group Senior |
$3.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION [2899]
|
Facility
|
IP
|
$2.49
|
|
|
Service Code
|
NDC 5253613413
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$1.87 |
| Rate for Payer: Adventist Health Commercial |
$0.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.60
|
| Rate for Payer: Cash Price |
$1.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.69
|
| Rate for Payer: Heritage Provider Network Senior |
$1.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.62
|
| Rate for Payer: Multiplan Commercial |
$1.87
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION [2899]
|
Facility
|
OP
|
$2.49
|
|
|
Service Code
|
NDC 5253613413
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$2.12 |
| Rate for Payer: Adventist Health Commercial |
$0.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1.52
|
| Rate for Payer: Blue Shield of California EPN |
$1.22
|
| Rate for Payer: Cash Price |
$1.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.54
|
| Rate for Payer: Heritage Provider Network Senior |
$1.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.74
|
| Rate for Payer: Multiplan Commercial |
$1.87
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2.12
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION [2900]
|
Facility
|
IP
|
$7.94
|
|
|
Service Code
|
NDC 2433813013
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$5.96 |
| Rate for Payer: Adventist Health Commercial |
$1.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.11
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.29
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.38
|
| Rate for Payer: Heritage Provider Network Senior |
$5.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.99
|
| Rate for Payer: Multiplan Commercial |
$5.96
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION [2900]
|
Facility
|
OP
|
$7.94
|
|
|
Service Code
|
NDC 2433813013
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Adventist Health Commercial |
$1.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.97
|
| Rate for Payer: Blue Shield of California Commercial |
$4.84
|
| Rate for Payer: Blue Shield of California EPN |
$3.87
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.91
|
| Rate for Payer: Heritage Provider Network Senior |
$4.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.56
|
| Rate for Payer: Multiplan Commercial |
$5.96
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.18
|
| Rate for Payer: TriValley Medical Group Senior |
$3.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.97
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.75
|
| Rate for Payer: Vantage Medical Group Senior |
$6.75
|
|
|
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION [2903]
|
Facility
|
OP
|
$237.04
|
|
|
Service Code
|
HCPCS J1364
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$201.48 |
| Rate for Payer: Adventist Health Commercial |
$47.41
|
| Rate for Payer: Adventist Health Commercial |
$48.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$148.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$146.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.86
|
| Rate for Payer: Blue Shield of California Commercial |
$86.22
|
| Rate for Payer: Blue Shield of California Commercial |
$86.22
|
| Rate for Payer: Blue Shield of California EPN |
$86.22
|
| Rate for Payer: Blue Shield of California EPN |
$86.22
|
| Rate for Payer: Cash Price |
$106.67
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$106.67
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$109.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$110.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$201.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$201.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$109.75
|
| Rate for Payer: Heritage Provider Network Senior |
$111.12
|
| Rate for Payer: Heritage Provider Network Senior |
$109.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$113.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$114.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.93
|
| Rate for Payer: Multiplan Commercial |
$180.00
|
| Rate for Payer: Multiplan Commercial |
$177.78
|
| Rate for Payer: TriValley Medical Group Commercial |
$94.82
|
| Rate for Payer: TriValley Medical Group Commercial |
$96.00
|
| Rate for Payer: TriValley Medical Group Senior |
$94.82
|
| Rate for Payer: TriValley Medical Group Senior |
$96.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$85.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$86.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$79.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$78.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$201.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.00
|
| Rate for Payer: Vantage Medical Group Senior |
$204.00
|
| Rate for Payer: Vantage Medical Group Senior |
$201.48
|
|
|
ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION [2903]
|
Facility
|
IP
|
$237.04
|
|
|
Service Code
|
HCPCS J1364
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.90 |
| Max. Negotiated Rate |
$177.78 |
| Rate for Payer: Adventist Health Commercial |
$47.41
|
| Rate for Payer: Adventist Health Commercial |
$48.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$152.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$154.56
|
| Rate for Payer: Cash Price |
$106.67
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$109.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$110.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$128.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$109.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.12
|
| Rate for Payer: Heritage Provider Network Senior |
$111.12
|
| Rate for Payer: Heritage Provider Network Senior |
$109.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.00
|
| Rate for Payer: Multiplan Commercial |
$177.78
|
| Rate for Payer: Multiplan Commercial |
$180.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$86.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$85.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$79.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$78.48
|
|
|
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL [2885]
|
Facility
|
OP
|
$2.02
|
|
|
Service Code
|
NDC 4580296694
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$1.72 |
| Rate for Payer: Adventist Health Commercial |
$0.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1.23
|
| Rate for Payer: Blue Shield of California EPN |
$0.99
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.29
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.25
|
| Rate for Payer: Heritage Provider Network Senior |
$1.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.41
|
| Rate for Payer: Multiplan Commercial |
$1.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Senior |
$0.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.72
|
| Rate for Payer: Vantage Medical Group Senior |
$1.72
|
|
|
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL [2885]
|
Facility
|
IP
|
$2.02
|
|
|
Service Code
|
NDC 4580296694
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Adventist Health Commercial |
$0.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.30
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.37
|
| Rate for Payer: Heritage Provider Network Senior |
$1.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.51
|
| Rate for Payer: Multiplan Commercial |
$1.51
|
|
|
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION [2887]
|
Facility
|
IP
|
$0.80
|
|
|
Service Code
|
NDC 4580203846
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Adventist Health Commercial |
$0.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.52
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.54
|
| Rate for Payer: Heritage Provider Network Senior |
$0.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.60
|
|
|
ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION [2887]
|
Facility
|
OP
|
$0.80
|
|
|
Service Code
|
NDC 4580203846
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Adventist Health Commercial |
$0.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.40
|
| Rate for Payer: Blue Shield of California Commercial |
$0.49
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.50
|
| Rate for Payer: Heritage Provider Network Senior |
$0.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.56
|
| Rate for Payer: Multiplan Commercial |
$0.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.32
|
| Rate for Payer: TriValley Medical Group Senior |
$0.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.68
|
| Rate for Payer: Vantage Medical Group Senior |
$0.68
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
NDC 1672916901
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.09
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
NDC 6800159200
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.09
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
OP
|
$0.29
|
|
|
Service Code
|
NDC 6808461711
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.25 |
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
| Rate for Payer: Blue Shield of California Commercial |
$0.18
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.18
|
| Rate for Payer: Heritage Provider Network Senior |
$0.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.22
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.12
|
| Rate for Payer: TriValley Medical Group Senior |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.25
|
| Rate for Payer: Vantage Medical Group Senior |
$0.25
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
NDC 6800159200
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.07
|
| Rate for Payer: Blue Shield of California Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.07
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.06
|
| Rate for Payer: TriValley Medical Group Senior |
$0.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Vantage Medical Group Senior |
$0.12
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
NDC 4354728110
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.09
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
IP
|
$0.18
|
|
|
Service Code
|
NDC 0904642661
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.12
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.12
|
| Rate for Payer: Heritage Provider Network Senior |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.14
|
|
|
ESCITALOPRAM 10 MG TABLET [33512]
|
Facility
|
OP
|
$0.18
|
|
|
Service Code
|
NDC 0904642661
|
| 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
|
|
