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NDC 68094010120

PHENTOLAMINE MESYLATE 5 MG IJ SOLR

Reported by 17 hospitals in the network under the case rate 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 flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$85

Average

$251

Median

$159

High

$452

Hospitals reporting this code

#HospitalLocation
1St Luke's Methodist HospitalCedar Rapids, IA$291$452$452$831$7
2Central Iowa Hospital CorporationDes Moines, IA$189$452$452$764$7
3Central Iowa Hospital CorporationDes Moines, IA$189$452$452$899$7
4Wesley Health System LLCHattiesburg, MS$146$395$396$1.3k$3
5Vicksburg Healthcare LLCVicksburg, MS$395$395$395$3.2k—
6Northwest Sahurita Hospital LLCAZ 85748, AZ$73$77$85$667$14
7Northwest Sahurita Hospital LLCAZ 85629, AZ$73$77$85$667$14
8Cocke County HMA, LLCNewport, TN$39$159$159$1.7k—
9Oro Valley Hospital LLCTucson, AZ$73$77$85$1.0k$14
10Campbell County HMA, LLCLaFollette, TN$39$159$159$1.7k—
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