|
POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN [76913]
|
Facility
|
OP
|
$0.60
|
|
|
Service Code
|
NDC 71656002151
|
| Hospital Charge Code |
71656002151
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.33
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.30
|
| Rate for Payer: Aetna Government |
$0.30
|
| Rate for Payer: Brighton Health Commercial |
$0.45
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.41
|
| Rate for Payer: Group Health Inc Commercial |
$0.30
|
| Rate for Payer: Group Health Inc Medicare |
$0.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.39
|
|
|
POTASSIUM CHLORIDE 20 MEQ/50 ML IVPB PRE
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41641938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.00
|
|
|
POTASSIUM CHLORIDE 20 MEQ/50 ML IVPB PRE
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41641938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$2.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.30
|
| Rate for Payer: Group Health Inc Commercial |
$2.00
|
| Rate for Payer: Group Health Inc Medicare |
$1.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.12
|
| Rate for Payer: SOMOS Essential |
$0.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2.60
|
|
|
POTASSIUM CHLORIDE 20 MEQ/50 ML IVPB PRE
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41651938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.00
|
|
|
POTASSIUM CHLORIDE 20 MEQ/50 ML IVPB PRE
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41651938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$2.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.30
|
| Rate for Payer: Group Health Inc Commercial |
$2.00
|
| Rate for Payer: Group Health Inc Medicare |
$1.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.12
|
| Rate for Payer: SOMOS Essential |
$0.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2.60
|
|
|
POTASSIUM CHLORIDE 20 MEQ TAB ER
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
41654119
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Brighton Health Commercial |
$0.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
POTASSIUM CHLORIDE 20 MEQ TAB ER
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
41644119
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Brighton Health Commercial |
$0.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INJ
|
Facility
|
IP
|
$0.07
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41645132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.04 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INJ
|
Facility
|
IP
|
$0.07
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41655132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.04 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INJ
|
Facility
|
OP
|
$0.07
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41645132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.04
|
| Rate for Payer: Group Health Inc Commercial |
$0.04
|
| Rate for Payer: Group Health Inc Medicare |
$0.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.12
|
| Rate for Payer: SOMOS Essential |
$0.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.05
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INJ
|
Facility
|
OP
|
$0.07
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
41655132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.04
|
| Rate for Payer: Group Health Inc Commercial |
$0.04
|
| Rate for Payer: Group Health Inc Medicare |
$0.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.12
|
| Rate for Payer: SOMOS Essential |
$0.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.05
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
OP
|
$0.30
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
00409665318
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.17
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.17
|
| Rate for Payer: EmblemHealth Commercial |
$0.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$0.32
|
| Rate for Payer: Group Health Inc Commercial |
$0.15
|
| Rate for Payer: Group Health Inc Medicare |
$0.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.20
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.08
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.08
|
| Rate for Payer: EmblemHealth Commercial |
$0.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$0.14
|
| Rate for Payer: Group Health Inc Commercial |
$0.07
|
| Rate for Payer: Group Health Inc Medicare |
$0.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.09
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
OP
|
$0.24
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.14
|
| Rate for Payer: EmblemHealth Commercial |
$0.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$0.25
|
| 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 |
$0.16
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
IP
|
$0.30
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
00409665305
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.15
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.08
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.08
|
| Rate for Payer: EmblemHealth Commercial |
$0.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$0.14
|
| Rate for Payer: Group Health Inc Commercial |
$0.07
|
| Rate for Payer: Group Health Inc Medicare |
$0.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.09
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
OP
|
$0.24
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096503
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.14
|
| Rate for Payer: EmblemHealth Commercial |
$0.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$0.25
|
| 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 |
$0.16
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
IP
|
$0.30
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
00409665318
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.15
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
IP
|
$0.24
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
IP
|
$0.24
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096503
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.12
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
63323096502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN [6429]
|
Facility
|
OP
|
$0.30
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
00409665305
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.17
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.14
|
| Rate for Payer: Aetna Government |
$0.14
|
| Rate for Payer: Brighton Health Commercial |
$0.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.17
|
| Rate for Payer: EmblemHealth Commercial |
$0.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$0.32
|
| Rate for Payer: Group Health Inc Commercial |
$0.15
|
| Rate for Payer: Group Health Inc Medicare |
$0.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.20
|
|
|
POTASSIUM CHLORIDE CRYS ER 10 MEQ PO TBCR [35942]
|
Facility
|
OP
|
$0.62
|
|
|
Service Code
|
NDC 00245531701
|
| Hospital Charge Code |
00245531701
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.49 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.31
|
| Rate for Payer: Aetna Government |
$0.31
|
| Rate for Payer: Brighton Health Commercial |
$0.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.49
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.42
|
| Rate for Payer: Group Health Inc Commercial |
$0.31
|
| Rate for Payer: Group Health Inc Medicare |
$0.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.40
|
|
|
POTASSIUM CHLORIDE CRYS ER 10 MEQ PO TBCR [35942]
|
Facility
|
OP
|
$0.62
|
|
|
Service Code
|
NDC 00245531789
|
| Hospital Charge Code |
00245531789
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.31
|
| Rate for Payer: Aetna Government |
$0.31
|
| Rate for Payer: Brighton Health Commercial |
$0.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.42
|
| Rate for Payer: Group Health Inc Commercial |
$0.31
|
| Rate for Payer: Group Health Inc Medicare |
$0.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.40
|
|
