| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alameda |
Alameda Alliance for Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alameda |
Alameda Alliance for Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alameda |
Alameda Alliance for Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alameda |
Alameda Alliance for Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alameda |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alameda |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alameda |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alameda |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alpine |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alpine |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alpine |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alpine |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alpine |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Alpine |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alpine |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Alpine |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Amador |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Amador |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Amador |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Amador |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Amador |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Amador |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Amador |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Amador |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Amador |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Amador |
Kaiser Foundation HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Amador |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Amador |
Kaiser Foundation HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Butte |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Butte |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Butte |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Butte |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Butte |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Butte |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Butte |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Butte |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Calaveras |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Calaveras |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Calaveras |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Calaveras |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Calaveras |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Calaveras |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Calaveras |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Calaveras |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Colusa |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Colusa |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Colusa |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Colusa |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Colusa |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Colusa |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Colusa |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Colusa |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Contra Costa |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Contra Costa |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Contra Costa |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Contra Costa |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Contra Costa |
Contra Costa HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Contra Costa |
Contra Costa HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Contra Costa |
Contra Costa HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Contra Costa |
Contra Costa HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Del Norte |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Del Norte |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Del Norte |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Del Norte |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
El Dorado |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
El Dorado |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
El Dorado |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
El Dorado |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
El Dorado |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
El Dorado |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
El Dorado |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
El Dorado |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
El Dorado |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
El Dorado |
Kaiser Foundation HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
El Dorado |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
El Dorado |
Kaiser Foundation HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Fresno |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Fresno |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Fresno |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Fresno |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Fresno |
CalViva Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Fresno |
CalViva Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Fresno |
CalViva Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Fresno |
CalViva Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Glenn |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Glenn |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Glenn |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Glenn |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Glenn |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Glenn |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Glenn |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Glenn |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Humboldt |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Humboldt |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Humboldt |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Humboldt |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Imperial |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Imperial |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Imperial |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Imperial |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Imperial |
Molina Healthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Imperial |
Molina Healthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Imperial |
Molina Healthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Imperial |
Molina Healthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Inyo |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Inyo |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Inyo |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Inyo |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Inyo |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Inyo |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Inyo |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Inyo |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kern |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kern |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kern |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kern |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kern |
Kern Health Systems |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kern |
Kern Health Systems |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kern |
Kern Health Systems |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kern |
Kern Health Systems |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kings |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kings |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kings |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kings |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kings |
CalViva Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Kings |
CalViva Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kings |
CalViva Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Kings |
CalViva Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Lake |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Lake |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Lake |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Lake |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Lassen |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Lassen |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Lassen |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Lassen |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Los Angeles |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Los Angeles |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Los Angeles |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Los Angeles |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Los Angeles |
LA Care HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Los Angeles |
LA Care HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Los Angeles |
LA Care HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Los Angeles |
LA Care HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Madera |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Madera |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Madera |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Madera |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Madera |
CalViva Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Madera |
CalViva Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Madera |
CalViva Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Madera |
CalViva Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Marin |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Marin |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Marin |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Marin |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mariposa |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mariposa |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mariposa |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mariposa |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mariposa |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mariposa |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mariposa |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mariposa |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mendocino |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mendocino |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mendocino |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mendocino |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Merced |
Central California Alliance |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Merced |
Central California Alliance |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Merced |
Central California Alliance |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Merced |
Central California Alliance |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Modoc |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Modoc |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Modoc |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Modoc |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mono |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mono |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mono |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mono |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mono |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Mono |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mono |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Mono |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Monterey |
Central California Alliance |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Monterey |
Central California Alliance |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Monterey |
Central California Alliance |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Monterey |
Central California Alliance |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Napa |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Napa |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Napa |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Napa |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Nevada |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Nevada |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Nevada |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Nevada |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Nevada |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Nevada |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Nevada |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Nevada |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Orange |
CalOptima |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Orange |
CalOptima |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Orange |
CalOptima |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Orange |
CalOptima |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Placer |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Placer |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Placer |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Placer |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Placer |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Placer |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Placer |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Placer |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Placer |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Placer |
Kaiser Foundation HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Placer |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Placer |
Kaiser Foundation HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Plumas |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Plumas |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Plumas |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Plumas |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Plumas |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Plumas |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Plumas |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Plumas |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Riverside |
Inland Empire HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Riverside |
Inland Empire HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Riverside |
Inland Empire HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Riverside |
Inland Empire HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Riverside |
Molina Healthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Riverside |
Molina Healthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Riverside |
Molina Healthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Riverside |
Molina Healthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Aetna Better Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Aetna Better Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Aetna Better Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Aetna Better Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Kaiser Foundation HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Kaiser Foundation HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Molina Healthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
Molina Healthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Molina Healthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
Molina Healthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
UnitedHealthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sacramento |
UnitedHealthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
UnitedHealthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sacramento |
UnitedHealthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Benito |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Benito |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Benito |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Benito |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Bernardino |
Inland Empire HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Bernardino |
Inland Empire HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Bernardino |
Inland Empire HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Bernardino |
Inland Empire HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Bernardino |
Molina Healthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Bernardino |
Molina Healthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Bernardino |
Molina Healthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Bernardino |
Molina Healthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Aetna Better Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Aetna Better Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Aetna Better Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Aetna Better Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Care1st HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Care1st HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Care1st HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Care1st HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Community Health Group |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Community Health Group |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Community Health Group |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Community Health Group |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Kaiser Foundation HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Kaiser Foundation HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Kaiser Foundation HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Molina Healthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
Molina Healthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Molina Healthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
Molina Healthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
UnitedHealthcare |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Diego |
UnitedHealthcare |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
UnitedHealthcare |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Diego |
UnitedHealthcare |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Francisco |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Francisco |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Francisco |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Francisco |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Francisco |
San Francisco Health Plan |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Francisco |
San Francisco Health Plan |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Francisco |
San Francisco Health Plan |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Francisco |
San Francisco Health Plan |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Joaquin |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Joaquin |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Joaquin |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Joaquin |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Joaquin |
HP of San Joaquin |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Joaquin |
HP of San Joaquin |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Joaquin |
HP of San Joaquin |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Joaquin |
HP of San Joaquin |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Luis Obispo |
CenCal Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Luis Obispo |
CenCal Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Luis Obispo |
CenCal Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Luis Obispo |
CenCal Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Mateo |
HP of San Mateo |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
San Mateo |
HP of San Mateo |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Mateo |
HP of San Mateo |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
San Mateo |
HP of San Mateo |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Barbara |
CenCal Health |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Barbara |
CenCal Health |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Barbara |
CenCal Health |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Barbara |
CenCal Health |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Clara |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Clara |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Clara |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Clara |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Clara |
Santa Clara Family HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Clara |
Santa Clara Family HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Clara |
Santa Clara Family HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Clara |
Santa Clara Family HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Cruz |
Central California Alliance |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Santa Cruz |
Central California Alliance |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Cruz |
Central California Alliance |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Santa Cruz |
Central California Alliance |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Shasta |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Shasta |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Shasta |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Shasta |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sierra |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sierra |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sierra |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sierra |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sierra |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sierra |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sierra |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sierra |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Siskiyou |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Siskiyou |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Siskiyou |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Siskiyou |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Solano |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Solano |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Solano |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Solano |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sonoma |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sonoma |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sonoma |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sonoma |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Stanislaus |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Stanislaus |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Stanislaus |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Stanislaus |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Stanislaus |
HP of San Joaquin |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Stanislaus |
HP of San Joaquin |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Stanislaus |
HP of San Joaquin |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Stanislaus |
HP of San Joaquin |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sutter |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sutter |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sutter |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sutter |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sutter |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Sutter |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sutter |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Sutter |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tehama |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tehama |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tehama |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tehama |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tehama |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tehama |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tehama |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tehama |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Trinity |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Trinity |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Trinity |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Trinity |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tulare |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tulare |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tulare |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tulare |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tulare |
Health Net of California |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tulare |
Health Net of California |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tulare |
Health Net of California |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tulare |
Health Net of California |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tuolumne |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tuolumne |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tuolumne |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tuolumne |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tuolumne |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Tuolumne |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tuolumne |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Tuolumne |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Ventura |
Gold Coast HP |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Ventura |
Gold Coast HP |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Ventura |
Gold Coast HP |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Ventura |
Gold Coast HP |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Yolo |
Partnership HP of CA |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Yolo |
Partnership HP of CA |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Yolo |
Partnership HP of CA |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Yolo |
Partnership HP of CA |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Yuba |
Anthem Blue Cross |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Yuba |
Anthem Blue Cross |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Yuba |
Anthem Blue Cross |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Yuba |
Anthem Blue Cross |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Yuba |
CA Health & Wellness |
Hepatitis C Non-340B |
$4,406.73 |
$4,406.73 |
$4,561.08 |
| 07/2017-12/2017 |
2017-18 |
Hepatitis C |
Yuba |
CA Health & Wellness |
Hepatitis C 340B |
$5,615.24 |
$5,615.24 |
$6,010.88 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Yuba |
CA Health & Wellness |
Hepatitis C Non-340B |
$3,036.66 |
$3,036.66 |
$3,241.91 |
| 01/2018-06/2018 |
2017-18 |
Hepatitis C |
Yuba |
CA Health & Wellness |
Hepatitis C 340B |
$3,938.43 |
$3,938.43 |
$4,222.96 |