NDC 70004-0920-59
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED
Reported by 18 hospitals in the network under the fee schedule methodology.
Low
$0
Average
$158
Median
$5
High
$1.8k
Filter by billing methodology
Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 18 hospitals; the 90th percentile is 6498.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | San Joaquin Community Hospital Bakersfield, CA | $144 | $176 | $78 | 45% | — | $40 – $329 |
| 2 | Lodi Memorial Hospital Association Inc Lodi, CA | $518 | $537 | $76 | 14% | — | $120 – $661 |
| 3 | Henry Ford Health System Detroit, MI | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 4 | Henry Ford Health System West Bloomfield, MI | $0 | $0 | $0 | 40% | — | $0 – $0 |
| 5 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI | $0 | $0 | $0 | 40% | — | $0 – $0 |
| 6 | Henry Ford Wyandotte Hospital Wyandotte, MI | $0 | $0 | $0 | 40% | — | $0 – $0 |
| 7 | WA Foote Memorial Hospital Jackson, MI | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 8 | Texas Health Presbyterian Hospital Dallas Dallas, TX | $3 | $5 | $5 | 87% | — | $2 – $55 |
| 9 | Texas Health Arlington Memorial Hospital Arlington, TX | $3 | $5 | $5 | 87% | — | $2 – $55 |
| 10 | Texas Health Harris Methodist Hospital HurstEulessBedford Bedford, TX | $3 | $5 | $5 | 87% | — | $2 – $55 |
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