|
CLINDAMYCIN HCL 150 MG PO CAPS
|
Facility
|
IP
|
$1.19
|
|
|
Service Code
|
NDC 6330469201
|
| Hospital Charge Code |
6330469201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.60
|
|
|
CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR
|
Facility
|
IP
|
$0.62
|
|
|
Service Code
|
NDC 6586259602
|
| Hospital Charge Code |
6586259602
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.31 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.31
|
|
|
CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR
|
Facility
|
OP
|
$0.62
|
|
|
Service Code
|
NDC 6586259602
|
| Hospital Charge Code |
6586259602
|
|
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: EmblemHealth Commercial |
$0.31
|
| 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
|
|
|
CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR
|
Facility
|
IP
|
$0.62
|
|
|
Service Code
|
NDC 5976200161
|
| Hospital Charge Code |
5976200161
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.31 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.31
|
|
|
CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR
|
Facility
|
OP
|
$0.62
|
|
|
Service Code
|
NDC 5976200161
|
| Hospital Charge Code |
5976200161
|
|
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: EmblemHealth Commercial |
$0.31
|
| 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
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
OP
|
$0.97
|
|
|
Service Code
|
NDC 4580256202
|
| Hospital Charge Code |
4580256202
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$0.77 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.53
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.48
|
| Rate for Payer: Aetna Government |
$0.48
|
| Rate for Payer: Brighton Health Commercial |
$0.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.77
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.66
|
| Rate for Payer: EmblemHealth Commercial |
$0.48
|
| Rate for Payer: Group Health Inc Commercial |
$0.48
|
| Rate for Payer: Group Health Inc Medicare |
$0.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.63
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
OP
|
$1.36
|
|
|
Service Code
|
NDC 2192200221
|
| Hospital Charge Code |
2192200221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$1.09 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.68
|
| Rate for Payer: Aetna Government |
$0.68
|
| Rate for Payer: Brighton Health Commercial |
$1.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.09
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.92
|
| Rate for Payer: EmblemHealth Commercial |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.68
|
| Rate for Payer: Group Health Inc Medicare |
$0.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.88
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
IP
|
$1.36
|
|
|
Service Code
|
NDC 2192200201
|
| Hospital Charge Code |
2192200201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.68
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
IP
|
$0.97
|
|
|
Service Code
|
NDC 4580256202
|
| Hospital Charge Code |
4580256202
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.48
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
OP
|
$0.74
|
|
|
Service Code
|
NDC 0168020130
|
| Hospital Charge Code |
0168020130
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.59 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.37
|
| Rate for Payer: Aetna Government |
$0.37
|
| Rate for Payer: Brighton Health Commercial |
$0.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.59
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.50
|
| Rate for Payer: EmblemHealth Commercial |
$0.37
|
| Rate for Payer: Group Health Inc Commercial |
$0.37
|
| Rate for Payer: Group Health Inc Medicare |
$0.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.48
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
IP
|
$0.74
|
|
|
Service Code
|
NDC 0168020130
|
| Hospital Charge Code |
0168020130
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.37
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
IP
|
$1.36
|
|
|
Service Code
|
NDC 2192200221
|
| Hospital Charge Code |
2192200221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.68
|
|
|
CLINDAMYCIN PHOSPHATE 1 % EX SOLN
|
Facility
|
OP
|
$1.36
|
|
|
Service Code
|
NDC 2192200201
|
| Hospital Charge Code |
2192200201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$1.09 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.68
|
| Rate for Payer: Aetna Government |
$0.68
|
| Rate for Payer: Brighton Health Commercial |
$1.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.09
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.92
|
| Rate for Payer: EmblemHealth Commercial |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.68
|
| Rate for Payer: Group Health Inc Medicare |
$0.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.88
|
|
|
CLINDAMYCIN PHOSPHATE 300 MG/2ML IJ SOLN
|
Facility
|
OP
|
$1.49
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
0009087026
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.75
|
| Rate for Payer: Aetna Government |
$0.75
|
| Rate for Payer: Brighton Health Commercial |
$1.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.19
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.01
|
| Rate for Payer: EmblemHealth Commercial |
$0.75
|
| Rate for Payer: Group Health Inc Commercial |
$0.75
|
| Rate for Payer: Group Health Inc Medicare |
$0.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.97
|
|
|
CLINDAMYCIN PHOSPHATE 300 MG/2ML IJ SOLN
|
Facility
|
IP
|
$1.49
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
0009087026
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.75
|
|
|
CLINDAMYCIN PHOSPHATE 600 MG/4ML IJ SOLN
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 0009077526
|
| Hospital Charge Code |
0009077526
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
| Rate for Payer: Aetna Government |
$0.44
|
| Rate for Payer: Brighton Health Commercial |
$0.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
| Rate for Payer: EmblemHealth Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Medicare |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
|
CLINDAMYCIN PHOSPHATE 600 MG/4ML IJ SOLN
|
Facility
|
IP
|
$0.88
|
|
|
Service Code
|
NDC 0009077526
|
| Hospital Charge Code |
0009077526
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.44 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
|
|
CLINDAMYCIN PHOSPHATE 900 MG/6ML IJ SOLN
|
Facility
|
IP
|
$0.95
|
|
|
Service Code
|
NDC 2502111506
|
| Hospital Charge Code |
2502111506
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.48
|
|
|
CLINDAMYCIN PHOSPHATE 900 MG/6ML IJ SOLN
|
Facility
|
OP
|
$0.85
|
|
|
Service Code
|
NDC 0009090218
|
| Hospital Charge Code |
0009090218
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.47
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.43
|
| Rate for Payer: Aetna Government |
$0.43
|
| Rate for Payer: Brighton Health Commercial |
$0.64
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.68
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.58
|
| Rate for Payer: EmblemHealth Commercial |
$0.43
|
| Rate for Payer: Group Health Inc Commercial |
$0.43
|
| Rate for Payer: Group Health Inc Medicare |
$0.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.55
|
|
|
CLINDAMYCIN PHOSPHATE 900 MG/6ML IJ SOLN
|
Facility
|
OP
|
$0.95
|
|
|
Service Code
|
NDC 2502111506
|
| Hospital Charge Code |
2502111506
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$0.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.52
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.48
|
| Rate for Payer: Aetna Government |
$0.48
|
| Rate for Payer: Brighton Health Commercial |
$0.71
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.65
|
| Rate for Payer: EmblemHealth Commercial |
$0.48
|
| Rate for Payer: Group Health Inc Commercial |
$0.48
|
| Rate for Payer: Group Health Inc Medicare |
$0.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.62
|
|
|
CLINDAMYCIN PHOSPHATE 900 MG/6ML IJ SOLN
|
Facility
|
IP
|
$0.85
|
|
|
Service Code
|
NDC 0009090218
|
| Hospital Charge Code |
0009090218
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$0.43 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.43
|
|
|
CLINDAMYCIN PHOSPHATE 9 GM/60ML IJ SOLN
|
Facility
|
OP
|
$0.47
|
|
|
Service Code
|
NDC 0009072805
|
| Hospital Charge Code |
0009072805
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.26
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.23
|
| Rate for Payer: Aetna Government |
$0.23
|
| Rate for Payer: Brighton Health Commercial |
$0.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.37
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.32
|
| Rate for Payer: EmblemHealth Commercial |
$0.23
|
| Rate for Payer: Group Health Inc Commercial |
$0.23
|
| Rate for Payer: Group Health Inc Medicare |
$0.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.30
|
|
|
CLINDAMYCIN PHOSPHATE 9 GM/60ML IJ SOLN
|
Facility
|
IP
|
$0.47
|
|
|
Service Code
|
NDC 0009072805
|
| Hospital Charge Code |
0009072805
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.23
|
|
|
CLINDAMYCIN PHOSPHATE IN D5W 300 MG/50ML IV SOLN
|
Facility
|
OP
|
$0.17
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
0338341050
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.09
|
| Rate for Payer: Aetna Government |
$0.09
|
| Rate for Payer: Brighton Health Commercial |
$0.13
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.12
|
| Rate for Payer: EmblemHealth Commercial |
$0.09
|
| Rate for Payer: Group Health Inc Commercial |
$0.09
|
| Rate for Payer: Group Health Inc Medicare |
$0.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.11
|
|
|
CLINDAMYCIN PHOSPHATE IN D5W 300 MG/50ML IV SOLN
|
Facility
|
OP
|
$0.17
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
0338341024
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$1.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.09
|
| Rate for Payer: Aetna Government |
$0.09
|
| Rate for Payer: Brighton Health Commercial |
$0.13
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.12
|
| Rate for Payer: EmblemHealth Commercial |
$0.09
|
| Rate for Payer: Group Health Inc Commercial |
$0.09
|
| Rate for Payer: Group Health Inc Medicare |
$0.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.11
|
|