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NDC 121048900

diphenhydrAMINE 12.5 mg/5 mL Liquid UD

Reported by 13 hospitals in the network under the percent of billed charges 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 negotiated percentage of total billed charges.

National pricing summary

Low

$2

Average

$14

Median

$9

High

$35

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1Oro Valley Hospital LLCTucson, AZ$2$2$2—$1$6
2Northwest Hospital LLCTucson, AZ$2$2$1—$1$6
3Metro Knoxville HMA LLCKnoxville, TN$4$3$1—$1$5
4Metro Knoxville HMA LLCPowell, TN$4$4$2—$1$7
5Laredo Texas Hospital Company LPLaredo, TX$3$3$1—$0$4
6Poplar Bluff Regional Medical Center LLCPoplar Bluff, MO$7$7$2—$2$10
7Navarro Hospital LPCorsicana, TX$8$9$3—$1$13
8Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph HospitalDENVER, CO$35$35$15—$11$62
9Intermountain Front Range Inc. Dba Intermountain Health Lutheran HospitalWHEAT RIDGE, CO$35$35$14—$11$62
10IHC Health Services, Inc,. DBA Intermountain Health Alta View HospitalSandy, UT$18$16$5—$1$22
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