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NDC 11523723402

polyethylene glycol 3350 Granule-Recon 119 gm

Reported by 5 hospitals in the network under the other methodology.

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.

Reflects a payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$2

Average

$13

Median

$2

High

$55

Hospitals reporting this code

#HospitalLocation
1Northwest Sahurita Hospital LLCAZ 85748, AZ$1$2$2$6$0
2Northwest Sahurita Hospital LLCAZ 85629, AZ$1$2$2$6$0
3Oro Valley Hospital LLCTucson, AZ$1$2$2$6$1
4Northwest Hospital LLCAZ 85741, AZ$1$2$2$6$1
5Laredo Texas Hospital Company LPLaredo, TX$29$55$55$539$1

Look up this code directly

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