METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.67
|
|
Service Code
|
NDC 50268054215
|
Hospital Charge Code |
50268054215
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.59 |
Max. Negotiated Rate |
$1.34 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.92
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.84
|
Rate for Payer: Aetna Government |
$0.84
|
Rate for Payer: Brighton Health Commercial |
$1.25
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.34
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.14
|
Rate for Payer: Group Health Inc Commercial |
$0.84
|
Rate for Payer: Group Health Inc Medicare |
$0.59
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.84
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.84
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.09
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.58
|
|
Service Code
|
NDC 55111046801
|
Hospital Charge Code |
55111046801
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.55 |
Max. Negotiated Rate |
$1.27 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.87
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.79
|
Rate for Payer: Aetna Government |
$0.79
|
Rate for Payer: Brighton Health Commercial |
$1.19
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.27
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.08
|
Rate for Payer: Group Health Inc Commercial |
$0.79
|
Rate for Payer: Group Health Inc Medicare |
$0.55
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.79
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.79
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.03
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.86
|
|
Service Code
|
NDC 00904632461
|
Hospital Charge Code |
00904632461
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.65 |
Max. Negotiated Rate |
$1.49 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.03
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.93
|
Rate for Payer: Aetna Government |
$0.93
|
Rate for Payer: Brighton Health Commercial |
$1.40
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.49
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.27
|
Rate for Payer: Group Health Inc Commercial |
$0.93
|
Rate for Payer: Group Health Inc Medicare |
$0.65
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.93
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.93
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.21
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.67
|
|
Service Code
|
NDC 50268054211
|
Hospital Charge Code |
50268054211
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.59 |
Max. Negotiated Rate |
$1.34 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.92
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.84
|
Rate for Payer: Aetna Government |
$0.84
|
Rate for Payer: Brighton Health Commercial |
$1.25
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.34
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.14
|
Rate for Payer: Group Health Inc Commercial |
$0.84
|
Rate for Payer: Group Health Inc Medicare |
$0.59
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.84
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.84
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.09
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.55
|
|
Service Code
|
NDC 70436016601
|
Hospital Charge Code |
70436016601
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.54 |
Max. Negotiated Rate |
$1.24 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.85
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.78
|
Rate for Payer: Aetna Government |
$0.78
|
Rate for Payer: Brighton Health Commercial |
$1.16
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.06
|
Rate for Payer: Group Health Inc Commercial |
$0.78
|
Rate for Payer: Group Health Inc Medicare |
$0.54
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.78
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.78
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.01
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.69
|
|
Service Code
|
NDC 69097040807
|
Hospital Charge Code |
69097040807
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.59 |
Max. Negotiated Rate |
$1.35 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.93
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.84
|
Rate for Payer: Aetna Government |
$0.84
|
Rate for Payer: Brighton Health Commercial |
$1.27
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.35
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.15
|
Rate for Payer: Group Health Inc Commercial |
$0.84
|
Rate for Payer: Group Health Inc Medicare |
$0.59
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.84
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.84
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.10
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.58
|
|
Service Code
|
NDC 69097040815
|
Hospital Charge Code |
69097040815
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.55 |
Max. Negotiated Rate |
$1.27 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.87
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.79
|
Rate for Payer: Aetna Government |
$0.79
|
Rate for Payer: Brighton Health Commercial |
$1.19
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.27
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.08
|
Rate for Payer: Group Health Inc Commercial |
$0.79
|
Rate for Payer: Group Health Inc Medicare |
$0.55
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.79
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.79
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.03
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.76
|
|
Service Code
|
NDC 51079017103
|
Hospital Charge Code |
51079017103
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.62 |
Max. Negotiated Rate |
$1.41 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.97
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.88
|
Rate for Payer: Aetna Government |
$0.88
|
Rate for Payer: Brighton Health Commercial |
$1.32
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.41
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.20
|
Rate for Payer: Group Health Inc Commercial |
$0.88
|
Rate for Payer: Group Health Inc Medicare |
$0.62
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.88
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.14
|
|
METOPROLOL SUCCINATE ER 100 MG PO TB24 [30071]
|
Facility
|
OP
|
$1.68
|
|
Service Code
|
NDC 60687041301
|
Hospital Charge Code |
60687041301
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.59 |
Max. Negotiated Rate |
$1.34 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.92
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.84
|
Rate for Payer: Aetna Government |
$0.84
|
Rate for Payer: Brighton Health Commercial |
$1.26
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.34
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.14
|
Rate for Payer: Group Health Inc Commercial |
$0.84
|
Rate for Payer: Group Health Inc Medicare |
$0.59
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.84
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.84
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.09
|
|
METOPROLOL SUCCINATE ER 25 MG PO TB24 [29858]
|
Facility
|
OP
|
$0.29
|
|
Service Code
|
NDC 24979003701
|
Hospital Charge Code |
24979003701
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.10 |
Max. Negotiated Rate |
$0.23 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.16
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
Rate for Payer: Aetna Government |
$0.14
|
Rate for Payer: Brighton Health Commercial |
$0.22
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.23
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.20
|
Rate for Payer: Group Health Inc Commercial |
$0.14
|
Rate for Payer: Group Health Inc Medicare |
$0.10
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.14
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.14
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.19
|
|
METOPROLOL SUCCINATE ER 25 MG PO TB24 [29858]
|
Facility
|
OP
|
$1.05
|
|
Service Code
|
NDC 45963070911
|
Hospital Charge Code |
45963070911
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.37 |
Max. Negotiated Rate |
$0.84 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.58
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.53
|
Rate for Payer: Aetna Government |
$0.53
|
Rate for Payer: Brighton Health Commercial |
$0.79
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.84
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.72
|
Rate for Payer: Group Health Inc Commercial |
$0.53
|
Rate for Payer: Group Health Inc Medicare |
$0.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.53
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.53
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.69
|
|
METOPROLOL SUCCINATE ER 25 MG PO TB24 [29858]
|
Facility
|
OP
|
$0.66
|
|
Service Code
|
NDC 00904632206
|
Hospital Charge Code |
00904632206
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.23 |
Max. Negotiated Rate |
$0.52 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.33
|
Rate for Payer: Aetna Government |
$0.33
|
Rate for Payer: Brighton Health Commercial |
$0.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.52
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.45
|
Rate for Payer: Group Health Inc Commercial |
$0.33
|
Rate for Payer: Group Health Inc Medicare |
$0.23
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.33
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.33
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.43
|
|
METOPROLOL SUCCINATE ER 25 MG PO TB24 [29858]
|
Facility
|
OP
|
$1.05
|
|
Service Code
|
NDC 45963070996
|
Hospital Charge Code |
45963070996
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.37 |
Max. Negotiated Rate |
$0.84 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.58
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.53
|
Rate for Payer: Aetna Government |
$0.53
|
Rate for Payer: Brighton Health Commercial |
$0.79
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.84
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.72
|
Rate for Payer: Group Health Inc Commercial |
$0.53
|
Rate for Payer: Group Health Inc Medicare |
$0.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.53
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.53
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.69
|
|
METOPROLOL SUCCINATE ER 25 MG PO TB24 [29858]
|
Facility
|
OP
|
$1.24
|
|
Service Code
|
NDC 00904632261
|
Hospital Charge Code |
00904632261
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.43 |
Max. Negotiated Rate |
$0.99 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.68
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.62
|
Rate for Payer: Aetna Government |
$0.62
|
Rate for Payer: Brighton Health Commercial |
$0.93
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.99
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.84
|
Rate for Payer: Group Health Inc Commercial |
$0.62
|
Rate for Payer: Group Health Inc Medicare |
$0.43
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.62
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.62
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.81
|
|
METOPROLOL SUCCINATE ER 50 MG PO TB24 [30070]
|
Facility
|
OP
|
$1.17
|
|
Service Code
|
NDC 51079017001
|
Hospital Charge Code |
51079017001
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.41 |
Max. Negotiated Rate |
$0.94 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.64
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.59
|
Rate for Payer: Aetna Government |
$0.59
|
Rate for Payer: Brighton Health Commercial |
$0.88
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.94
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.80
|
Rate for Payer: Group Health Inc Commercial |
$0.59
|
Rate for Payer: Group Health Inc Medicare |
$0.41
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.59
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.59
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.76
|
|
METOPROLOL SUCCINATE ER 50 MG PO TB24 [30070]
|
Facility
|
OP
|
$1.24
|
|
Service Code
|
NDC 00904632361
|
Hospital Charge Code |
00904632361
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.43 |
Max. Negotiated Rate |
$0.99 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.68
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.62
|
Rate for Payer: Aetna Government |
$0.62
|
Rate for Payer: Brighton Health Commercial |
$0.93
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.99
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.84
|
Rate for Payer: Group Health Inc Commercial |
$0.62
|
Rate for Payer: Group Health Inc Medicare |
$0.43
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.62
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.62
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.81
|
|
METOPROLOL SUCCINATE ER 50 MG PO TB24 [30070]
|
Facility
|
OP
|
$1.05
|
|
Service Code
|
NDC 45963067696
|
Hospital Charge Code |
45963067696
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.37 |
Max. Negotiated Rate |
$0.84 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.58
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.53
|
Rate for Payer: Aetna Government |
$0.53
|
Rate for Payer: Brighton Health Commercial |
$0.79
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.84
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.72
|
Rate for Payer: Group Health Inc Commercial |
$0.53
|
Rate for Payer: Group Health Inc Medicare |
$0.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.53
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.53
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.69
|
|
METOPROLOL SUCCINATE ER 50 MG PO TB24 [30070]
|
Facility
|
OP
|
$1.17
|
|
Service Code
|
NDC 00378459677
|
Hospital Charge Code |
00378459677
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.41 |
Max. Negotiated Rate |
$0.94 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.64
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.59
|
Rate for Payer: Aetna Government |
$0.59
|
Rate for Payer: Brighton Health Commercial |
$0.88
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.94
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.80
|
Rate for Payer: Group Health Inc Commercial |
$0.59
|
Rate for Payer: Group Health Inc Medicare |
$0.41
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.59
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.59
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.76
|
|
METOPROLOL SUCCINATE ER 50 MG PO TB24 [30070]
|
Facility
|
OP
|
$1.11
|
|
Service Code
|
NDC 69097040707
|
Hospital Charge Code |
69097040707
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.39 |
Max. Negotiated Rate |
$0.89 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.61
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.55
|
Rate for Payer: Aetna Government |
$0.55
|
Rate for Payer: Brighton Health Commercial |
$0.83
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.89
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.75
|
Rate for Payer: Group Health Inc Commercial |
$0.55
|
Rate for Payer: Group Health Inc Medicare |
$0.39
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.55
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.55
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.72
|
|
METOPROLOL SUCCINATE ER 50 MG PO TB24 [30070]
|
Facility
|
OP
|
$1.05
|
|
Service Code
|
NDC 45963067611
|
Hospital Charge Code |
45963067611
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.37 |
Max. Negotiated Rate |
$0.84 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.58
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.53
|
Rate for Payer: Aetna Government |
$0.53
|
Rate for Payer: Brighton Health Commercial |
$0.79
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.84
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.72
|
Rate for Payer: Group Health Inc Commercial |
$0.53
|
Rate for Payer: Group Health Inc Medicare |
$0.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.53
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.53
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.69
|
|
METOPROLOL TARTRATE 25 MG PO TABS [37637]
|
Facility
|
OP
|
$0.24
|
|
Service Code
|
NDC 00378001801
|
Hospital Charge Code |
00378001801
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.09 |
Max. Negotiated Rate |
$0.19 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.13
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.12
|
Rate for Payer: Aetna Government |
$0.12
|
Rate for Payer: Brighton Health Commercial |
$0.18
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.19
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.17
|
Rate for Payer: Group Health Inc Commercial |
$0.12
|
Rate for Payer: Group Health Inc Medicare |
$0.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.16
|
|
METOPROLOL TARTRATE 25 MG PO TABS [37637]
|
Facility
|
OP
|
$0.24
|
|
Service Code
|
NDC 65862006201
|
Hospital Charge Code |
65862006201
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.09 |
Max. Negotiated Rate |
$0.19 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.13
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.12
|
Rate for Payer: Aetna Government |
$0.12
|
Rate for Payer: Brighton Health Commercial |
$0.18
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.19
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.17
|
Rate for Payer: Group Health Inc Commercial |
$0.12
|
Rate for Payer: Group Health Inc Medicare |
$0.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.16
|
|
METOPROLOL TARTRATE 25 MG PO TABS [37637]
|
Facility
|
OP
|
$0.24
|
|
Service Code
|
NDC 52817036000
|
Hospital Charge Code |
52817036000
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.08 |
Max. Negotiated Rate |
$0.19 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.13
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.12
|
Rate for Payer: Aetna Government |
$0.12
|
Rate for Payer: Brighton Health Commercial |
$0.18
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.19
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.16
|
Rate for Payer: Group Health Inc Commercial |
$0.12
|
Rate for Payer: Group Health Inc Medicare |
$0.08
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.15
|
|
METOPROLOL TARTRATE 25 MG PO TABS [37637]
|
Facility
|
OP
|
$0.24
|
|
Service Code
|
NDC 57237010001
|
Hospital Charge Code |
57237010001
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.09 |
Max. Negotiated Rate |
$0.19 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.13
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.12
|
Rate for Payer: Aetna Government |
$0.12
|
Rate for Payer: Brighton Health Commercial |
$0.18
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.19
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.17
|
Rate for Payer: Group Health Inc Commercial |
$0.12
|
Rate for Payer: Group Health Inc Medicare |
$0.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.16
|
|
METOPROLOL TARTRATE 25 MG PO TABS [37637]
|
Facility
|
OP
|
$0.27
|
|
Service Code
|
NDC 57664050658
|
Hospital Charge Code |
57664050658
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.09 |
Max. Negotiated Rate |
$0.22 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.15
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
Rate for Payer: Aetna Government |
$0.14
|
Rate for Payer: Brighton Health Commercial |
$0.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.22
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.18
|
Rate for Payer: Group Health Inc Commercial |
$0.14
|
Rate for Payer: Group Health Inc Medicare |
$0.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.14
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.14
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.18
|
|