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NDC 67457038600

Mycophenolate Mofetil HCl For IV Soln 500 MG (Base Equiv)

Reported by 54 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

$35

Average

$140

Median

$179

High

$401

Hospitals reporting this code

#HospitalLocation
1Sanford Medical Center BismarckBismarck, ND$24$56$54$68$15
2UPMC LititzLititz, PA$0$34$35$61$14
3UPMC MemorialYork, PA$0$35$38$61$15
4UPMC HanoverHanover, PA$0$49$45$63$15
5UPMC CarlisleCarlisle, PA$0$34$35$61$14
6UPMC Pinnacle HospitalsHarrisburg, PA$0$47$40$61$17
7UPMC SomersetSomerset, PA$0$36$39$54$11
8Good Samaritan Medical Center, Llc DbaLAFAYETTE, CO$130$402$401$701$166
9North Carolina Baptist HospitalWinston Salem, NC$1$53$70$143$36
10Carolinas Medical CenterCharlotte, NC$27$63$67$113$27
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