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NDC 1093995394

ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP

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

$5

Average

$9

Median

$7

High

$27

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$2$5$5$9$2
2Catholic Health Initiatives ColoradoSalt Lake City, UT$4$6$7$11$2
3Catholic Health Initiatives ColoradoColorado Springs, CO$3$5$6$9$2
4Catholic Health Initiatives ColoradoLehi, UT$4$6$7$11$2
5St Francis HospitalColorado Springs, CO$2$5$5$9$2
6Longmont United HospitalLongmont, CO$2$4$5$10$2
7Catholic Health Initiatives ColoradoFrisco, CO$3$6$7$10$2
8Commonspirit Kansas, Inc.Ulysses, KS$3$9$21$283$60
9Commonspirit Kansas, Inc.Dodge City, KS$4$8$26$283$69
10Catholic Health Initiatives ColoradoPueblo, CO$3$6$6$9$2
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