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NDC 64980040709

SUSTIVA 200MG CAPSULE

Reported by 50 hospitals in the network.

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.

National pricing summary

Low

$9

Average

$476

Median

$12

High

$2.8k

Hospitals reporting this code

#HospitalLocation
1Northside Hospital, Inc.Lawrenceville, GA$9$40$41$62$15
2Northside Hospital, Inc.Canton, GA$7$40$40$62$15
3Northside Hospital, Inc.Atlanta, GA$10$40$40$62$14
4Northside Hospital, Inc.Duluth, GA$8$40$41$62$15
5Northside Hospital, Inc.Cumming, GA$7$40$40$62$14
6Intermountain Front Range Inc. Dba Intermountain Health Lutheran HospitalWHEAT RIDGE, CO$26$80$78$139$33
7Tri-City Medical CenterOceanside, CA$11$26$33$58$15
8Carolinas Medical CenterCharlotte, NC$684$1.6k$1.7k$2.8k$685
9North Carolina Baptist HospitalBermuda Run, NC$1.2k$2.1k$2.8k$5.8k$1.5k
10Carolinas Medical CenterCharlotte, NC$684$1.6k$1.7k$2.8k$709
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