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NDC 0121092816

PROMETHAZINE 6.25 MG-CODEINE 10 MG/5 ML SYRUP

Reported by 20 hospitals in the network.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

National pricing summary

Low

$30

Average

$39

Median

$39

High

$52

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$15$31$33$57$13
2Catholic Health Initiatives ColoradoSalt Lake City, UT$23$35$40$64$12
3Catholic Health Initiatives ColoradoColorado Springs, CO$17$32$37$57$13
4Catholic Health Initiatives ColoradoLehi, UT$23$35$39$64$12
5St Francis HospitalColorado Springs, CO$15$29$31$55$12
6Longmont United HospitalLongmont, CO$15$26$32$58$14
7Catholic Health Initiatives ColoradoFrisco, CO$17$39$42$59$14
8Commonspirit Kansas, Inc.Ulysses, KS$21$54$45$61$17
9Commonspirit Kansas, Inc.Dodge City, KS$23$51$49$58$9
10Catholic Health Initiatives ColoradoPueblo, CO$18$37$38$57$13
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Look up this code directly

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