|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
IP
|
$30.66
|
|
|
Service Code
|
NDC 1672944010
|
| Hospital Charge Code |
1672944010
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.33 |
| Max. Negotiated Rate |
$15.33 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.33
|
|
|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
OP
|
$30.66
|
|
|
Service Code
|
NDC 4733537983
|
| Hospital Charge Code |
4733537983
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$24.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.33
|
| Rate for Payer: Aetna Government |
$15.33
|
| Rate for Payer: Brighton Health Commercial |
$22.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.85
|
| Rate for Payer: EmblemHealth Commercial |
$15.33
|
| Rate for Payer: Group Health Inc Commercial |
$15.33
|
| Rate for Payer: Group Health Inc Medicare |
$10.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.93
|
|
|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
OP
|
$32.27
|
|
|
Service Code
|
NDC 5551307330
|
| Hospital Charge Code |
5551307330
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.13
|
| Rate for Payer: Aetna Government |
$16.13
|
| Rate for Payer: Brighton Health Commercial |
$24.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.94
|
| Rate for Payer: EmblemHealth Commercial |
$16.13
|
| Rate for Payer: Group Health Inc Commercial |
$16.13
|
| Rate for Payer: Group Health Inc Medicare |
$11.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.13
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20.97
|
|
|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
IP
|
$30.66
|
|
|
Service Code
|
NDC 4733537983
|
| Hospital Charge Code |
4733537983
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.33 |
| Max. Negotiated Rate |
$15.33 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.33
|
|
|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
OP
|
$30.66
|
|
|
Service Code
|
NDC 4359836730
|
| Hospital Charge Code |
4359836730
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$24.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.33
|
| Rate for Payer: Aetna Government |
$15.33
|
| Rate for Payer: Brighton Health Commercial |
$22.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.85
|
| Rate for Payer: EmblemHealth Commercial |
$15.33
|
| Rate for Payer: Group Health Inc Commercial |
$15.33
|
| Rate for Payer: Group Health Inc Medicare |
$10.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.93
|
|
|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
OP
|
$30.66
|
|
|
Service Code
|
NDC 1672944010
|
| Hospital Charge Code |
1672944010
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$24.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.33
|
| Rate for Payer: Aetna Government |
$15.33
|
| Rate for Payer: Brighton Health Commercial |
$22.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.85
|
| Rate for Payer: EmblemHealth Commercial |
$15.33
|
| Rate for Payer: Group Health Inc Commercial |
$15.33
|
| Rate for Payer: Group Health Inc Medicare |
$10.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.93
|
|
|
CINACALCET HCL 30 MG PO TABS
|
Facility
|
IP
|
$32.27
|
|
|
Service Code
|
NDC 5551307330
|
| Hospital Charge Code |
5551307330
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.13 |
| Max. Negotiated Rate |
$16.13 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.13
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
OP
|
$61.31
|
|
|
Service Code
|
NDC 6438088404
|
| Hospital Charge Code |
6438088404
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.46 |
| Max. Negotiated Rate |
$49.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.65
|
| Rate for Payer: Aetna Government |
$30.65
|
| Rate for Payer: Brighton Health Commercial |
$45.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$49.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.69
|
| Rate for Payer: EmblemHealth Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Medicare |
$21.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.85
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
IP
|
$61.31
|
|
|
Service Code
|
NDC 6438088404
|
| Hospital Charge Code |
6438088404
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.65 |
| Max. Negotiated Rate |
$30.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
IP
|
$61.31
|
|
|
Service Code
|
NDC 4733538083
|
| Hospital Charge Code |
4733538083
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.65 |
| Max. Negotiated Rate |
$30.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
OP
|
$61.31
|
|
|
Service Code
|
NDC 1672944110
|
| Hospital Charge Code |
1672944110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.46 |
| Max. Negotiated Rate |
$49.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.65
|
| Rate for Payer: Aetna Government |
$30.65
|
| Rate for Payer: Brighton Health Commercial |
$45.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$49.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.69
|
| Rate for Payer: EmblemHealth Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Medicare |
$21.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.85
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
IP
|
$61.31
|
|
|
Service Code
|
NDC 1672944110
|
| Hospital Charge Code |
1672944110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.65 |
| Max. Negotiated Rate |
$30.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
OP
|
$61.31
|
|
|
Service Code
|
NDC 4733538083
|
| Hospital Charge Code |
4733538083
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.46 |
| Max. Negotiated Rate |
$49.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.65
|
| Rate for Payer: Aetna Government |
$30.65
|
| Rate for Payer: Brighton Health Commercial |
$45.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$49.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.69
|
| Rate for Payer: EmblemHealth Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Medicare |
$21.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.85
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
OP
|
$61.31
|
|
|
Service Code
|
NDC 6909741102
|
| Hospital Charge Code |
6909741102
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.46 |
| Max. Negotiated Rate |
$49.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.65
|
| Rate for Payer: Aetna Government |
$30.65
|
| Rate for Payer: Brighton Health Commercial |
$45.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$49.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.69
|
| Rate for Payer: EmblemHealth Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Commercial |
$30.65
|
| Rate for Payer: Group Health Inc Medicare |
$21.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.85
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
IP
|
$61.31
|
|
|
Service Code
|
NDC 6909741102
|
| Hospital Charge Code |
6909741102
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.65 |
| Max. Negotiated Rate |
$30.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.65
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
IP
|
$64.54
|
|
|
Service Code
|
NDC 5551307430
|
| Hospital Charge Code |
5551307430
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.27 |
| Max. Negotiated Rate |
$32.27 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.27
|
|
|
CINACALCET HCL 60 MG PO TABS
|
Facility
|
OP
|
$64.54
|
|
|
Service Code
|
NDC 5551307430
|
| Hospital Charge Code |
5551307430
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$51.63 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32.27
|
| Rate for Payer: Aetna Government |
$32.27
|
| Rate for Payer: Brighton Health Commercial |
$48.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$43.88
|
| Rate for Payer: EmblemHealth Commercial |
$32.27
|
| Rate for Payer: Group Health Inc Commercial |
$32.27
|
| Rate for Payer: Group Health Inc Medicare |
$22.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41.95
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
OP
|
$91.96
|
|
|
Service Code
|
NDC 1672944210
|
| Hospital Charge Code |
1672944210
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.19 |
| Max. Negotiated Rate |
$73.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.98
|
| Rate for Payer: Aetna Government |
$45.98
|
| Rate for Payer: Brighton Health Commercial |
$68.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$73.57
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$62.54
|
| Rate for Payer: EmblemHealth Commercial |
$45.98
|
| Rate for Payer: Group Health Inc Commercial |
$45.98
|
| Rate for Payer: Group Health Inc Medicare |
$32.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$59.78
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
IP
|
$91.96
|
|
|
Service Code
|
NDC 1672944210
|
| Hospital Charge Code |
1672944210
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.98 |
| Max. Negotiated Rate |
$45.98 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.98
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
OP
|
$91.96
|
|
|
Service Code
|
NDC 6438088504
|
| Hospital Charge Code |
6438088504
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.19 |
| Max. Negotiated Rate |
$73.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.98
|
| Rate for Payer: Aetna Government |
$45.98
|
| Rate for Payer: Brighton Health Commercial |
$68.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$73.57
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$62.54
|
| Rate for Payer: EmblemHealth Commercial |
$45.98
|
| Rate for Payer: Group Health Inc Commercial |
$45.98
|
| Rate for Payer: Group Health Inc Medicare |
$32.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$59.78
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
OP
|
$91.96
|
|
|
Service Code
|
NDC 4733560083
|
| Hospital Charge Code |
4733560083
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.19 |
| Max. Negotiated Rate |
$73.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.98
|
| Rate for Payer: Aetna Government |
$45.98
|
| Rate for Payer: Brighton Health Commercial |
$68.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$73.57
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$62.54
|
| Rate for Payer: EmblemHealth Commercial |
$45.98
|
| Rate for Payer: Group Health Inc Commercial |
$45.98
|
| Rate for Payer: Group Health Inc Medicare |
$32.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$59.78
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
IP
|
$96.80
|
|
|
Service Code
|
NDC 5551307530
|
| Hospital Charge Code |
5551307530
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48.40
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
OP
|
$96.80
|
|
|
Service Code
|
NDC 5551307530
|
| Hospital Charge Code |
5551307530
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$77.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$53.24
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48.40
|
| Rate for Payer: Aetna Government |
$48.40
|
| Rate for Payer: Brighton Health Commercial |
$72.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$77.44
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$65.83
|
| Rate for Payer: EmblemHealth Commercial |
$48.40
|
| Rate for Payer: Group Health Inc Commercial |
$48.40
|
| Rate for Payer: Group Health Inc Medicare |
$33.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.92
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
IP
|
$91.96
|
|
|
Service Code
|
NDC 4733560083
|
| Hospital Charge Code |
4733560083
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.98 |
| Max. Negotiated Rate |
$45.98 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.98
|
|
|
CINACALCET HCL 90 MG PO TABS
|
Facility
|
IP
|
$91.96
|
|
|
Service Code
|
NDC 6438088504
|
| Hospital Charge Code |
6438088504
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.98 |
| Max. Negotiated Rate |
$45.98 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.98
|
|