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NDC 42292-0038-01

LEVOTHYROXINE 88 MCG ORAL TAB

Reported by 38 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

$0

Average

$3

Median

$2

High

$12

Hospitals reporting this code

#HospitalLocation
1Northwestern Memorial HospitalChicago, IL$0$3$6$18$6
2Northwestern Medicine Kishwaukee HospitalDeKalb, IL$3$12$12$18$4
3Northwestern Medicine Valley West HospitalSandwich, IL$3$11$10$17$4
4Northern Illinois Medical Center DBA Northwestern Medicine McHenry HospitalMcHenry, IL$0$1$1$3$1
5Northwestern Medicine Delnor HospitalGeneva, IL$1$5$5$8$2
6Northwestern Lake Forest HospitalLake Forest, IL$1$1$2$3$1
7Saint Alphonsus Regional Medical Center - BoiseBoise, ID$0$1$1$1$0
8Saint Alphonsus Medical Center - NampaNampa, ID$0$1$1$1$0
9Saint Alphonsus Medical Center - Baker CityBaker City, OR$0$0$1$1$0
10Mercy Health Services-Iowa Corp.Mason City, IA$0$1$1$1$0
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