NDC 143929801
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PHARMACY - EXTENSION OF 025X - DRUGS REQUIRING DETAILED CODING (A)
Based on 121–130 billing samples across every hospital reporting.
Low
$3
Average
$45
Median
$20
High
$224
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Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 13 hospitals; the 90th percentile is 11.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Peter's Health Helena, MT | $6 | $6 | — | — | 120 | $6 – $6 |
| 2 | Sanford USD Medical Center Sioux Falls, SD | $267 | $224 | $123 | 55% | 1–10 | $1 – $357 |
| 3 | Sanford Fargo Medical Center Fargo, ND | $22 | $20 | $9 | 43% | — | $1 – $28 |
| 4 | Sanford Medical Center Bismarck Bismarck, ND | $27 | $27 | $7 | 27% | — | $12 – $34 |
| 5 | Sanford Worthington Medical Center Worthington, MN | $65 | $54 | $22 | 40% | — | $1 – $79 |
| 6 | Kaiser Permanente Central Hospital Seattle, WA | $3 | $3 | $1 | 25% | — | $2 – $4 |
| 7 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $19 | $19 | $11 | 60% | — | $2 – $32 |
| 8 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA | $18 | $18 | $10 | 59% | — | $2 – $30 |
| 9 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA | $18 | $18 | $10 | 58% | — | $2 – $30 |
| 10 | The Chester County Hospital West Chester, PA | $20 | $19 | $10 | 53% | — | $2 – $30 |
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