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NDC 58914017110

58914-0171-10 - sucralfate 1 g Tab

Reported by 23 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

Based on 9–90 billing samples across every hospital reporting.

Low

$0

Average

$6

Median

$2

High

$38

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.
1The Charlotte Mecklenburg Hospital AuthorityConcord, NC$1$1—2–20$295$2.3k
2Atrium Health Hospitals IncShelby, NC$2$2—2–20$336$2.3k
3Naples HMA LLCNaples, FL$13$11$31–10$2$13
4Northwest Hospital LLCTucson, AZ$0$1$01–10$0$2
5Affinity Hospital LLCBirmingham, AL$38$38$101–10$7$48
6Carolinas Medical CenterCharlotte, NC$16$16—1–10$524$2.2k
7The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$1$1—1–10$240$2.3k
8Bluffton Health System LLCBluffton, IN$3$3——$3$10
9Dukes Health System LLCPeru, IN$3$3$1—$2$10
10St. Joseph Health System, LLCWayne, IN$7$7——$2$7
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