|
NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) INTRAVENOUS SYRINGE [120692]
|
Facility
IP
|
$3.02
|
|
|
Service Code
|
CPT J2710
|
| Hospital Charge Code |
NDG120692
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Blue Shield of California Commercial |
$2.15
|
| Rate for Payer: Blue Shield of California EPN |
$1.55
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$2.11
|
| Rate for Payer: Cigna of CA PPO |
$2.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.51
|
| Rate for Payer: Prime Health Services Commercial |
$2.57
|
|
|
NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) INTRAVENOUS SYRINGE [120692]
|
Facility
OP
|
$3.02
|
|
|
Service Code
|
CPT J2710
|
| Hospital Charge Code |
NDG120692
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$22.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.66
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.24
|
| Rate for Payer: BCBS Transplant Transplant |
$1.81
|
| Rate for Payer: Blue Shield of California Commercial |
$2.23
|
| Rate for Payer: Blue Shield of California EPN |
$2.08
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$2.11
|
| Rate for Payer: Cigna of CA PPO |
$2.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.57
|
| Rate for Payer: Dignity Health Media |
$2.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1.81
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.51
|
| Rate for Payer: Prime Health Services Commercial |
$2.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.51
|
| Rate for Payer: United Healthcare All Other HMO |
$1.51
|
| Rate for Payer: United Healthcare HMO Rider |
$1.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Vantage Medical Group Senior |
$2.57
|
|
|
NEPAFENAC 0.1 % EYE DROPS,SUSPENSION [42486]
|
Facility
OP
|
$125.38
|
|
|
Service Code
|
NDC 0065-0002-03
|
| Hospital Charge Code |
1740380
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$106.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$106.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$68.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$68.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.70
|
| Rate for Payer: BCBS Transplant Transplant |
$75.23
|
| Rate for Payer: Blue Shield of California Commercial |
$92.41
|
| Rate for Payer: Blue Shield of California EPN |
$73.22
|
| Rate for Payer: Cash Price |
$56.42
|
| Rate for Payer: Cigna of CA HMO |
$87.77
|
| Rate for Payer: Cigna of CA PPO |
$87.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.57
|
| Rate for Payer: Dignity Health Media |
$106.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.15
|
| Rate for Payer: Galaxy Health WC |
$106.57
|
| Rate for Payer: Global Benefits Group Commercial |
$75.23
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$94.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.09
|
| Rate for Payer: Multiplan Commercial |
$100.30
|
| Rate for Payer: Networks By Design Commercial |
$81.50
|
| Rate for Payer: Prime Health Services Commercial |
$106.57
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$75.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.69
|
| Rate for Payer: United Healthcare All Other HMO |
$62.69
|
| Rate for Payer: United Healthcare HMO Rider |
$62.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.57
|
| Rate for Payer: Vantage Medical Group Senior |
$106.57
|
|
|
NEPAFENAC 0.1 % EYE DROPS,SUSPENSION [42486]
|
Facility
IP
|
$125.38
|
|
|
Service Code
|
NDC 0065-0002-03
|
| Hospital Charge Code |
1740380
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$106.57 |
| Rate for Payer: Blue Shield of California Commercial |
$89.27
|
| Rate for Payer: Blue Shield of California EPN |
$64.19
|
| Rate for Payer: Cash Price |
$56.42
|
| Rate for Payer: Cigna of CA HMO |
$87.77
|
| Rate for Payer: Cigna of CA PPO |
$87.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.15
|
| Rate for Payer: Galaxy Health WC |
$106.57
|
| Rate for Payer: Global Benefits Group Commercial |
$75.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.09
|
| Rate for Payer: Multiplan Commercial |
$100.30
|
| Rate for Payer: Networks By Design Commercial |
$81.50
|
| Rate for Payer: Prime Health Services Commercial |
$106.57
|
|
|
NEPAFENAC 0.3 % EYE DROPS,SUSPENSION [199693]
|
Facility
OP
|
$144.84
|
|
|
Service Code
|
NDC 0078-0743-03
|
| Hospital Charge Code |
NDG199693B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$123.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$123.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$79.66
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$79.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.30
|
| Rate for Payer: BCBS Transplant Transplant |
$86.90
|
| Rate for Payer: Blue Shield of California Commercial |
$106.75
|
| Rate for Payer: Blue Shield of California EPN |
$84.59
|
| Rate for Payer: Cash Price |
$65.18
|
| Rate for Payer: Cigna of CA HMO |
$101.39
|
| Rate for Payer: Cigna of CA PPO |
$101.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.11
|
| Rate for Payer: Dignity Health Media |
$123.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$57.94
|
| Rate for Payer: Galaxy Health WC |
$123.11
|
| Rate for Payer: Global Benefits Group Commercial |
$86.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$108.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.76
|
| Rate for Payer: Multiplan Commercial |
$115.87
|
| Rate for Payer: Networks By Design Commercial |
$94.15
|
| Rate for Payer: Prime Health Services Commercial |
$123.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$86.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.42
|
| Rate for Payer: United Healthcare All Other HMO |
$72.42
|
| Rate for Payer: United Healthcare HMO Rider |
$72.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.11
|
| Rate for Payer: Vantage Medical Group Senior |
$123.11
|
|
|
NEPAFENAC 0.3 % EYE DROPS,SUSPENSION [199693]
|
Facility
IP
|
$144.84
|
|
|
Service Code
|
NDC 0078-0743-03
|
| Hospital Charge Code |
NDG199693B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$123.11 |
| Rate for Payer: Blue Shield of California Commercial |
$103.13
|
| Rate for Payer: Blue Shield of California EPN |
$74.16
|
| Rate for Payer: Cash Price |
$65.18
|
| Rate for Payer: Cigna of CA HMO |
$101.39
|
| Rate for Payer: Cigna of CA PPO |
$101.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.94
|
| Rate for Payer: Galaxy Health WC |
$123.11
|
| Rate for Payer: Global Benefits Group Commercial |
$86.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.76
|
| Rate for Payer: Multiplan Commercial |
$115.87
|
| Rate for Payer: Networks By Design Commercial |
$94.15
|
| Rate for Payer: Prime Health Services Commercial |
$123.11
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
IP
|
$40,324.94
|
|
|
Service Code
|
APR-DRG 4624
|
| Min. Negotiated Rate |
$30,933.47 |
| Max. Negotiated Rate |
$40,324.94 |
| Rate for Payer: IEHP Medi-Cal |
$30,933.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40,324.94
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
IP
|
$17,965.15
|
|
|
Service Code
|
APR-DRG 4623
|
| Min. Negotiated Rate |
$13,781.16 |
| Max. Negotiated Rate |
$17,965.15 |
| Rate for Payer: IEHP Medi-Cal |
$13,781.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,965.15
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
IP
|
$6,629.20
|
|
|
Service Code
|
APR-DRG 4621
|
| Min. Negotiated Rate |
$5,085.29 |
| Max. Negotiated Rate |
$6,629.20 |
| Rate for Payer: IEHP Medi-Cal |
$5,085.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,629.20
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
IP
|
$9,679.55
|
|
|
Service Code
|
APR-DRG 4622
|
| Min. Negotiated Rate |
$7,425.23 |
| Max. Negotiated Rate |
$9,679.55 |
| Rate for Payer: IEHP Medi-Cal |
$7,425.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,679.55
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
IP
|
$11,123.13
|
|
|
Service Code
|
APR-DRG 0411
|
| Min. Negotiated Rate |
$8,532.61 |
| Max. Negotiated Rate |
$11,123.13 |
| Rate for Payer: IEHP Medi-Cal |
$8,532.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,123.13
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
IP
|
$12,398.26
|
|
|
Service Code
|
APR-DRG 0412
|
| Min. Negotiated Rate |
$9,510.77 |
| Max. Negotiated Rate |
$12,398.26 |
| Rate for Payer: IEHP Medi-Cal |
$9,510.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,398.26
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
IP
|
$16,376.14
|
|
|
Service Code
|
APR-DRG 0413
|
| Min. Negotiated Rate |
$12,562.22 |
| Max. Negotiated Rate |
$16,376.14 |
| Rate for Payer: IEHP Medi-Cal |
$12,562.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,376.14
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
IP
|
$24,227.24
|
|
|
Service Code
|
APR-DRG 0414
|
| Min. Negotiated Rate |
$18,584.84 |
| Max. Negotiated Rate |
$24,227.24 |
| Rate for Payer: IEHP Medi-Cal |
$18,584.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,227.24
|
|
|
Neuroplasty and/or transposition; median nerve at carpal tunnel
|
Facility
OP
|
$7,385.00
|
|
|
Service Code
|
CPT 64721
|
| Min. Negotiated Rate |
$120.25 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,412.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Dignity Health Media |
$2,412.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,653.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,256.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,412.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,412.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,956.30
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,956.30
|
| Rate for Payer: IEHP Medi-Cal |
$3,908.06
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,908.06
|
| Rate for Payer: IEHP Medicare Advantage |
$2,412.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,412.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,039.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,232.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: Vantage Medical Group Senior |
$2,412.38
|
|
|
Neuroplasty and/or transposition; ulnar nerve at elbow
|
Facility
OP
|
$7,385.00
|
|
|
Service Code
|
CPT 64718
|
| Min. Negotiated Rate |
$169.76 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,412.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Dignity Health Media |
$2,412.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,653.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,256.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,412.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,412.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,956.30
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,956.30
|
| Rate for Payer: IEHP Medi-Cal |
$3,908.06
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3,908.06
|
| Rate for Payer: IEHP Medicare Advantage |
$2,412.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,412.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,039.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,232.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: Vantage Medical Group Senior |
$2,412.38
|
|
|
NEVIRAPINE 200 MG TABLET [17403]
|
Facility
IP
|
$0.20
|
|
|
Service Code
|
NDC 0378-4050-91
|
| Hospital Charge Code |
1711732
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Blue Shield of California Commercial |
$0.14
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO |
$0.14
|
| Rate for Payer: Cigna of CA PPO |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.17
|
| Rate for Payer: Global Benefits Group Commercial |
$0.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.17
|
|
|
NEVIRAPINE 200 MG TABLET [17403]
|
Facility
OP
|
$0.20
|
|
|
Service Code
|
NDC 0378-4050-91
|
| Hospital Charge Code |
1711732
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.12
|
| Rate for Payer: BCBS Transplant Transplant |
$0.12
|
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO |
$0.14
|
| Rate for Payer: Cigna of CA PPO |
$0.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.17
|
| Rate for Payer: Dignity Health Media |
$0.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.17
|
| Rate for Payer: Global Benefits Group Commercial |
$0.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.17
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO |
$0.10
|
| Rate for Payer: United Healthcare HMO Rider |
$0.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.17
|
| Rate for Payer: Vantage Medical Group Senior |
$0.17
|
|
|
NIACIN 100 MG TABLET [5539]
|
Facility
IP
|
$0.02
|
|
|
Service Code
|
NDC 8068105700
|
| Hospital Charge Code |
1710130
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.02
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
|
NIACIN 100 MG TABLET [5539]
|
Facility
OP
|
$0.02
|
|
|
Service Code
|
NDC 8068105700
|
| Hospital Charge Code |
1710130
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: BCBS Transplant Transplant |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
| Rate for Payer: Dignity Health Media |
$0.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.02
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.02
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
| Rate for Payer: United Healthcare All Other HMO |
$0.01
|
| Rate for Payer: United Healthcare HMO Rider |
$0.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
|
NIACIN 500 MG TABLET [5542]
|
Facility
OP
|
$0.06
|
|
|
Service Code
|
NDC 7985420983
|
| Hospital Charge Code |
1710108
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
| Rate for Payer: BCBS Transplant Transplant |
$0.04
|
| Rate for Payer: Blue Shield of California Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO |
$0.04
|
| Rate for Payer: Cigna of CA PPO |
$0.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
| Rate for Payer: Dignity Health Media |
$0.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
| Rate for Payer: Galaxy Health WC |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Prime Health Services Commercial |
$0.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
| Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
|
NIACIN 500 MG TABLET [5542]
|
Facility
IP
|
$0.06
|
|
|
Service Code
|
NDC 7985420983
|
| Hospital Charge Code |
1710108
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Blue Shield of California Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO |
$0.04
|
| Rate for Payer: Cigna of CA PPO |
$0.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
| Rate for Payer: Galaxy Health WC |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
|
NIACIN 500 MG TABLET [5542]
|
Facility
OP
|
$0.03
|
|
|
Service Code
|
NDC 904227260
|
| Hospital Charge Code |
1710108
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
| Rate for Payer: BCBS Transplant Transplant |
$0.02
|
| Rate for Payer: Blue Shield of California Commercial |
$0.02
|
| Rate for Payer: Blue Shield of California EPN |
$0.02
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.02
|
| Rate for Payer: Cigna of CA PPO |
$0.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
| Rate for Payer: Dignity Health Media |
$0.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.02
|
| Rate for Payer: Prime Health Services Commercial |
$0.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO |
$0.02
|
| Rate for Payer: United Healthcare HMO Rider |
$0.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
|
NIACIN 500 MG TABLET [5542]
|
Facility
IP
|
$0.03
|
|
|
Service Code
|
NDC 904227260
|
| Hospital Charge Code |
1710108
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Blue Shield of California Commercial |
$0.02
|
| Rate for Payer: Blue Shield of California EPN |
$0.02
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.02
|
| Rate for Payer: Cigna of CA PPO |
$0.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.02
|
| Rate for Payer: Prime Health Services Commercial |
$0.03
|
|
|
NIACINAMIDE 500 MG TABLET [5548]
|
Facility
OP
|
$0.03
|
|
|
Service Code
|
NDC 8068101900
|
| Hospital Charge Code |
1710144
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
| Rate for Payer: BCBS Transplant Transplant |
$0.02
|
| Rate for Payer: Blue Shield of California Commercial |
$0.02
|
| Rate for Payer: Blue Shield of California EPN |
$0.02
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.02
|
| Rate for Payer: Cigna of CA PPO |
$0.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
| Rate for Payer: Dignity Health Media |
$0.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
| Rate for Payer: Galaxy Health WC |
$0.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: Networks By Design Commercial |
$0.02
|
| Rate for Payer: Prime Health Services Commercial |
$0.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO |
$0.02
|
| Rate for Payer: United Healthcare HMO Rider |
$0.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
